HomeMy WebLinkAboutMiscellaneous - 525 TURNPIKE STREET 4/30/2018 (5)z
Of MORTOI l'
O
Town of North Andover
HEALTH DEPARTMENT
cM 5
CHECK #:
Type
of Permit or License: (Check box)
❑
Animal
$
❑
Body Art Establishment
$
❑
Body Art Practitioner
$
❑
Dumpster
$
❑
Food Service - Type:
$
❑
Funeral Directors
$
❑
Massage Establishment
$
❑
Massage Practice
$
❑
Offal (Septic) Hauler
$
❑
Recreational Camp
$
❑
Sun tanning
$
❑
Swimming Pool
$
❑
Tobacco
$
❑
Trash/Solid Waste Hauler
$
❑
Well Construction
$
SEPTIC Systems:
❑
Septic - Soil Testing
$
❑
Septic - Design Approval
$
❑
Septic Disposal Works Construction (DWC)
$
❑
Septic Disposal Works Installers (DWI)
$
❑
Title 5 Inspector
$
❑
Title 5 Report
$
Other. (Indicate) G'���
�t� $
1772 4,r
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
f NOPTh ,
F: •r• Op
• Town of North Andover
HEALTH DEPARTMENT
SACHUSt
CHECK #:
PRO kt,"d
Type
of Permit or License: (Check box)
❑
Animal
$
❑
Body Art Establishment
$
❑
Body Art Practitioner
$
❑
Dumpster
$
❑
Food Service - Type:
$
❑
Funeral Directors
$
❑
Massage Establishment
$
❑
Massage Practice
$
❑
Offal (Septic) Hauler
$
❑
Recreational Camp
$
❑
Sun tanning
$
❑
Swimming Pool
$
❑
Tobacco
$
❑
Trash/Solid Waste Hauler
$
❑
Well Construction
$
SEPTIC Sustems:
❑ Septic - Soil Testing $
❑ Septic - Design Approval $
❑ Septic Disposal Works Construction (DWC) $
❑ Septic Disposal Works Installers (DWI) $
❑ Title 5 Inspector $
❑ Title 5 Report $
Other. (Indicate) �T. $ �a
1772 v
Health Agent Initials
White - Applicant Yellow - Health Pink - Treasurer
�E
1
r Town Of North Andover
Department of Weights and Measures
1600 Osgood St. Blg 20 Suite 2-64
North Andover 01845
Phone (978)688-9540
(Cell) (508)783-6403
TO:
Brooks Pharmacy
525 Turnpike St.
North Andover 01845
'RIMWORCE
/ \ INVOICE
FOR: — V
Testing and Sealing of Weights and Measures Devices
Fees and adiustinq charqes authorized by Section 56, M.G.L. Chapter 98 as amended.
Device
Legal Sealing
Fees
Adjusted
Sealed
AMOUNT
Scale less than 10lbs Apothecary
$12.00
$12.00
RECEIVED
i AUG 2
r
4 2006
TOWN OF NORTH
ANDOU'F-
HEALTH DE
'ARTMEN7
_1
TOTAL I $12.00
This is to certify that I have this day tested, adjusted, sealed or condemned the above described device in compliance with the
M.G.L., Chapter 98 as most recently amended. (F
111�pector — Sealer of Weights and Measures
*t 0
Date