HomeMy WebLinkAboutMiscellaneous - 1423 SALEM STREET 4/30/2018 (42) Commonwealth of MassachuseG-1
W Title 5 Official np ion Form
Subsurface Sewage Disposal S tem rm -Not for Voluntary Assessments
1423 Salem Street
Property Address
Courtney Scruggs
Owner Owner's Name
information is North Andov MA 01845 May 1, 2017
required for —
every page. Cityrro State Zip Code Date of Inspection
ystem Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
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