HomeMy WebLinkAboutSoil Testing Results - 38 WELLINGTON WAY 3/31/2016 'TOWN OF NO RIM ANDOVER
Office of COMMUNITY 11 EVELOP EN'F AND SERVICES '
HEALTH DEPARTMENT
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1600 OSGOOD STREET; SUITE 2035
iJ()R 11 ASSA('11IJS1sT S 01 845
978.688.9540 Phone
11A °"� „" I 0 16 978.611ti,8476 FAX
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APPLICATION FOR SOIL TESTS
DATE: MAP&PARCEL: ! �� +�+�
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LOCATION of sa►rL TESTS:
OWNER: c ..• Contact#:
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APPLICANT: . Z" `S" Contact# ', 3 (" �
ADDRESS: ' t� l k' ..6.
F 1 .. % _Contact#: m� " .,
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CERTIFIED SOIL,EVALUATOR:ivia,
Intended Use of Land: Resider ial Subdivision `Smgl Farnily Hama Commercial
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Is This: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition;
In the Lake Cochichewick Watershed? Yes No I
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
Y Proof of land ownership(Tax bill, or letter from owner permitting test)
Y 8.5"x.11"Plot plait&Location of Testing(please indicate test pit sites oil the plan)
Fee of$585.00 per lot for new construction. This covers the ininimum two deep hales and
two percolation tests required for each disposal area. Fee of$440.00 per lot for repairs or upgrades.
GENERAL INFORMATION
Y Only Certified Soil Evaluators may perform deep hole inspections.
Y 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.
Y Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
11 payment will be required for all additional tests within two weeks of testing.
y WithI days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health
showing the tion of all tests(including aborted tests).
Y Within 60 days o ting soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Coinmission Appiroval Date.
.Signature of'Conservation Arent.
Date back to Health Department: (stamp in):
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TOWN OF NORTH ANDOVER ,%
Office of COMMUNITY DEVELOPMENT AND SERVICES '
HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH ANDOVER, MASSACHUSETTS 01345
Susan Y. Sawyer,REHS,RS 978.68 8.9540—Phone
Public Health Director 978.688.$476—FAX
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APPLICATION FOR SOIL TENS
DATE: 11/24/2014 MAP&PARCEL: 105C.22
602 Boxford St, NA Lot Z 01
LOCATION OF SOIL TESTS,
Gorton Family rust
OWNER: Gorton Contact#:
APPLICANT:Messina Development Contact#:978-837-95
ADDRESS: 277 Washington St, Groveland, MA 01834
ENGINEER: Christiansen & Sergi, Inc Contact#l: 978-373-0310
CERTIFIED SOIL EVALUATOR: Philip Christiansen
Intended Use of Land: Residential Subd ion Single Family Horne 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)
Y 8.5"x 11"Plot plait&Location of Testing(please indicate test pit sites on the Plan)
Y 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, 3'� 60.00 per lot for repairs or upgrades,
GENERAL INFORMATION
Only Certified Soil Evaluators may perform deep hole inspections,
w Only Mass.Registered Sanitarians and Professional Engineers can design septic plans.
A At least two deep holes and two percolation tests are required for each septic system disposal area.
Y Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
> 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.
i
Please Do Not Write Below This Line
N.A. Conservation Commission Approva Date.
Signature of Conservation Agent:
Date back to Health Department: (stamp in): O
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