HomeMy WebLinkAboutMiscellaneous - 217 WINTER STREET 4/30/2018 (2)P
7-4
02-05-00 01:14AM
Town of North Andover
OFFICE Of
COMMUNITY DEVELOPMENT AND SERVICES
146 Main Street
North Andover, Massachusetts 01845
On May 24, 1996, the Board of Health Office received the passbook 920-246901-2 for
$3,100 for sewer hook-up for 217 Winter Street.
Sandra Starr, R.S., Health Administrator
Roger Vlaauci, Owner of 217 Winter Street
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BOARD OF APPEALS 688x9341 BUILDING 6M9545 CONSERVATION 688-9130 HEALTH 688-9540
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PL AMNO 688-4533
BOARD OF HEALTH
146 MAIN STREET
TELEPHONE# (508) 688-9540
APPLICA TION FOR ABANDOAVEVT
OF SUBSURFACE DISPOSAL SYSTLVI
(SEPTIC SYSTEM)
Pursuant to Section 310 CMR 15.354
of the State Environmental Code, Title V
Name_
Address
Contractor hired for work:
Name A1^6 -d L V4 114 r -r-'2 Phone
Address1�v;,,�
U `
Date for scheduled abandonment
The septic system at the above address has -bee ab5andg-ned according to
Title V specifications.
Sign a - re of Contractor
Method of septic tank abandonment (check one). () removal () sandfill
�V) crush () other
Name of Offal Hauler C�t- r G r
This form must be returned to the North Andover Board of Health.
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
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Inspecting Agent Date
rows
BARD of y dEfi�LT;� 33
1
.JAN 2 1 1999
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