HomeMy WebLinkAboutSoil Testing Results - 51 WELLINGTON WAY 11/24/2014 AID
TOWN OF NORTH ANDOVER
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
1.600 OSGOOD S'TREE'T", SUITE 2035
NORI-11 ANDOVER, MASSACHUSETTS 01845
Susan Y.Sawyer,REIIS,RS 978.688.9540—Phone
Public Health Director 978.688.8476—FAX
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APPLICATION FOR SOIL TESTS
DATE.
. 11/24/2014 MAP&PARCEL.. 1050..22
+,
NOV ,�a 214
LOCATION OF SOIL TESTS: ��� Boxford St, NA Lot
OWNER: Gorton Family Trust Contact
APPLICANT.Messina Development Contact :978-837-95
ADDRESS: 277 Washington St, 0roveland, MA 01834
FNCr1NFER: Christiansen & Sergi, Inc Contact#: 978-373-0310
CERTIFIED SOIL EVALUATOR: Philip Christiansen
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No X
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
> Proof of land ownership(Tax bill,or letter from owner permitting test)
> 8.5"x 11"Plat plait&Location of Testing(please indicate test pit sites on the plan)
Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of 36_0.00 per lot for repairs or upgrades.
GENERAL INFORMATION
A Only Certified Soil Evaluators may perform deep hole inspections.
5� 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 disposal area.
> Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
Y Full payment will be required for all additional tests within two weeks of testing.
Within 45 days of testing,a scaled plan(no smaller than 1"-100')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 submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval ate:
Signature of Conservation Agent:
r"' 1A
Date back to Health Department: (stamp in):
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