HomeMy WebLinkAboutSoil Testing Results - 461 SUMMER STREET 6/2/2008 O WN OF NORTH ANDOVER
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HL`fE'L TH I)EPA1�11Ci.Bl'Jl\E.
1600 OSGOOD STREET;BUILDING 20;SUITE 2-36
NORTH ANDOVER,MASSACHUSETTS 01845 '
Susan Y.Sawyer,REHS,RS 978.688.9540—Phone.
Public Health Director 378.688.8476—FAX
healthde ownofnorthandover am
www.townofnorLban(lover.com
APPLICATION POII SOIL TESTS
DATE: , . .. MAP&PARCEL: �� ���•�
IRCATION OF SOIL TESTS.
OWNER: �C� 't.'s� '�1 .. f'�Z _ Contact#: '7 'C
.APPLICANT: 1 _ act#:
L Cont
i
ADDRESS. �C> �t.t i'C
ENGINEER, C k& o
CERTIFIED SOII:.EVALUATOR: (—r / _ exec b
Intended Use of Lands Residential Subdivision Single Family Home Commercial
U TI#is.)Repair Tesfing:-Z Undeveloped Lot Testing,- Upgrade for Addition,
In the hake Cochlchewick Watershed? Yes NO
THE FOLLOWING MUST BE INCLUDED WITH TMS FORM
Proof of land ownership(Taal bill,or letter Rom owner permitting test)
➢ I"Plot Mott a 7' tin ! o ldu
➢ Fee of$425.OtI per lot for go construction. This covers the minimum two deep holes and
two percolation hosts required for each disposal area. Fee of$3,6fl.00 per lot for repairs,or umm rades.
GENERAL INFORMATION
D Only Certi$ed Soil Evaluators may perform deep hole inspections,
D Only Mass,Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system dispossai area.
Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOB
representative.
A Full payment will be required for all additional tests within two weeks of testing.
➢ Within 45 days oftesting,a sealed plan(no smaller than I"4001)shall be submitted to the Board of Health
showing the location of all tests(including aborted tests).
Within 60 days of testing soil evaluation forms shall be submltted.
Please Do Not Write Below This Line
N.A.Conservation Cotnmhslon A val Date
Signature of Conservation Agent:
Dare back to Health Department: to p in):
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Page I of I
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Wednesday, June 04, 2008 2:43 PM
To: Daniel Ottenheimer(info @millriverconsulting.com); Marianne Peters (Marianne Peters);
Randy Burley (rburley @millriverconsulting.com); Rowe Isaac
(irowe @millriverconsu Iting.com)
Subject: F'W: 461 Summer Street-Soil Test Application
Hi Dan,
Comments from Conservation - 100 feet to wetlands from front corners of the house per Jennifer Hughes,
new Conservation Director.
Pam
From: DelleChiaie, Pamela
Sent: Monday, .Tune 02, 2008 4:33 PM
To: Daniel Ottenheimer(info @millriverconsulting.com); Marianne Peters (Marianne Peters); Randy Burley
(rburley @miI[rive rconsulting.com); Rowe Isaac (irowe @millriverconsulting.com)
Cc: Hughes, Jennifer
Subject: 461 Summer Street - Soil Test Application
From: noreply @yourcopier.com [mailto:noreply @yourcopier.com]
Sent: Monday, June 02, 2008 5:14 PM
To: DelleChiaie, Pamela
Subject: Message from KMBT_600
i
6/4/2008
Commonwealth of Massachusetts
City/Town of
Percolation Test
Form 12
Percolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage
Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but
the information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
Important: A. Site Information
When filling out
forms on the IF V�e-X717 115.. C 2s
computer,use
only the tab key Owner Name
to move your L�(Q� '�D k('n YY)C'V< 7ST t5c-��
cursor-do not Street Address or Lot# ----------
use the return
key. y_ _....._----------
City/Town state Zip Code
qml __ .. r- , c' ;?-"r
....................
Contact Persofto different from Owner) Telephone Number
B. Test Results
Date Time Date -Time'
Observation Hole# ........r.
Depth of Perc E, .58
Start Pre-Soak ` 3,jr
0
End Pre-Soak ----------
Time at 12" L�2)
Time at 9" l ........
Time at 6"
Time(9"-6")
Rate(Min./Inch)
Test Passed: Test Passed:
Test Failed: ❑ Test Failed: ❑
Test Perform By:
A(Q 1>
Witnessed By:
Comments:
...................
t5form12.doc•06/03 Perc Test•Page 1 of 1
Page l of 1
DelleChiaie, Pamela
From: DelleChiaie, Pamela
Sent: Monday, June 02, 2008 4:33 PM
To: Daniel Ottenheimer(info @millriverconsulting.com); Marianne Peters (Marianne Peters);
Randy Burley (rburley @millriverconsulting.com); Rowe Isaac
(irowe @millriverconsulting,com)
Cc: Hughes, Jennifer
Subject: 461 Summer Street- Soil Test Application
From: noreply @yourcopier.com [ma!It:o:noreply @yourcopier.com]
Sent: Monday, June 02, 2008 5:14 PM
To: DelleChiaie, Pamela
Subject: Message from KMBT_600
6121200$