The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 598 SALEM STREET 4/30/2018 (2) 598 SALEM STREET J _ 210/038.0-0099-0000.0_ C.;,c;:> 4 SEPTIC SYSTEM INSTALLATION IS THE INSTALLER LICENSED? NO TYPE OF CONSTRUCTION: NEW EPAI NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO CONDITIONS OF APPROVAL YES NO (FROM FORM U) ISSUANCE OF DWC PERMIT LEES NO DWC PERMIT PAID? YES NO DWC PERMIT NO. ,I I INSTALLER: 7' SDt>c)/ BEGIN INSPECTION (IES NO: EXCAVATION INSPECTION: NEEDED: PASSED ql3lq 7BY CONSTRUCTION INSPECTION: NEE ED: AS BUILT PLAN SATISFACTORY: YES: APPROVAL TO BACKFILL: DATE: BY Q FINAL GRADING APPROVAL: DATE Z D BY FINAL CONSTRUCTION APPROVAL: DATE: BY r .. r f TOWN OF NORTH ANDOVEP, UA i'k SYSTEM PUMP]Np RECOIZL SYSTEM OWNER & ApDRESg SYSTEM LOCATION s� �c (37 J 7eI//� a DATE OF PUMPINQ; 1Z.T. l__ _._QUANllTyPUNfPED: �'t;SSPOOL; NO_.. YBS . Sop(ic Tank: NU y NA rUKU ON SERVICE: KOU'rINE,., ' MAS � 6 2005 .. OUSERV^'(' M: vER v r1 r1T OOOD CONDITION PULI. 'T'U COVER ,�t�-�-� ME - RZAVY 0U k3B BAppL,BS IN PLACL. ROOTS LBA,CHM-LD RUNBACK . OXC636IVE SOLIDS „__, FLOODED .SOLIDCARRYOVER OTHER EXPLAIN """ �y.tim Pump d by . Q..S,�ar'vice� CSt: . terra. VUMMENTS. t.:UN MNTr rKANsPERRf L) I'tj FROM HR PERKINS & RJ BYERS FAX NO. : 9784703803 Sep. 21 1999 01:29AM P1 BOWARD R PERKINS, ,IX ATTORNEY AT LAW One Elm Square Andover, Massachusetts 018I0 Telephone(978) 470-3801 Telecopier(978) 470-3803 E-Mail hrperkins@earthlink.net TELE DATE: SEPTEMBER 20, 1.999 TO: SANDRA STARR,R.S.,HEALTH ADMINISTRATOR FIRK OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES TLLECOPIER NUMBER: (978) 688-9542 FROM: HOWARD R. PERKINS,JR., ESQUIRE TOTAL NUMBER OF PAGES(including cover sheet): 3 IF YOUDID(978)4)470-30-3801 RECETVE AI,1 (97 AT OF THIS TRANSMISSION,PLEASE CALL: HOWARD : OWARD i '�'PECIA-t IDL5WJ -=M, : Hello Sandy, I have enclosed a signed copy of the Deed for 598 Salem Street pursuant to my conversation with your assistant today. The closing is scheduled for Tuesday, September 21, 1999 at 3: PM at the Registry of Deeds. The Deed will be recorded prig to 4 PM. If you require any additional information please contact me. ------------------------ ------------------------------------------------- --- The information contained in this facsimile message is privileged or confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient,you are hereby notified that any dissemination, distribution or cop yin intended. g of this communication is neither allowed or If you have received this communication in error, please immediately notify us by telephone at the above number and return the original message is el at the above address via the U.S. Postal Service. Thank You. FROM HR PERS;I NS & RJ BYERS FAX NO. : 9784703803 Sep. 21 1999 01:29AM P2 D.GIJ I, ROBERT MAIORANA, of North Andover, Massachusetts in consideration of One Hundred Ninety-Five Thousand and 001100 (S 105.000.00) Dollars grant to STEVEN M. DESANDIS and TRACIE A. DESANDIS, as Husband and Wife, 'Tenants By The Entirety, of 598 Salem Street, North Andover, Massachusetts with QUITCLAIM COVENANTS s� a 0 The land in North Andover, Essex County. Massachusetts. with the buildings thereon, bounded and described as follows: L SJ 0 1; Being shown as Lot 1. on a plari of land entitled: "Plan of band in North Andover, Mass., Scale I inch_40 feet, Dated: October 1. 1972, Drawn by Charles Peterson. Robert f'. Morris, R.L.S_, 21 Carter Street, Tewksbury', recorded with the Irsscx North District E Registry_ of Deeds, Plan No. 6738, bounded and described as follows: ca SOUTRERLY by Salem Street, on two courses, as shown on said Plan, seventy (70) feet a and fifty-five(55) feet; W WESTERLY by Lot 2, as shown on said Plan, two hundred eighty-four and 82/100 (264.82) feet; NORTHEASTERLY by land now or formerly of Peterson, as shown on said Plan, one hundred fifty-six and 29/100 (156.29) feet; and a a EASTERLY by land now or formerly of Smith two courses, as shown on said Plan, one hundred fourteen and 50/100 (114.50) feet and eighty t and 50/I00 80.50 feet. Subject to a restriction by the North Andover Board of Health, dated August 26, 1999, resulting from the request of the grantor for a variance to repair the existing septic system on the premises, that the dwelling located on the premises is restricted to a maximum of three(3) bedrooms until such time as the dwelling is properly J p perly connected to a mwaicipal sewer system. Said premises are conveyed toggetlter with and subject u., any casements, restrictions or FROM HR PERKINS & RJ BYERS FAX NO. : 9784703803 Sep. 21 1999 01:30AM P3 conditions ol'record so far as same are now in tierce and <rpplicahfc. For my title sec Deed of Christine M. Maiorana. dated September 12, 1997, and recorded with said Registry of Deeds at Book 4844, Page 262, sec also, Death Certificates for Christine M. Maiorana and Charles 1. Maiorana and Affidavit pursuant to MGL c. 65, Section 14(a)to be recorded herewith. Witness my !-land and Seal this 21 sr day oi"Septcrttbcr, 1999 ROBERT MA[ORANA COMMONWEAL'T11 OF MASSACHUSETTS Essex. ss September 21, 1999 Then personally appcaied the above named ROBERT MAIURANA and acknowledged the foregoing instrument to be hi fire act and deed, be of-,e 7 ee, i i H ARD R. PERKINS, JR., Notary Public My Commission Expires: April 7, 2006 2 TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 09/20/99 This is to certify that the individual subsurface disposal system constructed ( ) or repaired (X) by John Soucy at 598 Salem Street has been installedin accordance with the provisions of Title V of the State Sanitary Code a P �'Y and with the North Andover Board of Health regulations as described in the Design Approval Site System Permit# 1086 dated 8/27/99. The,Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector Sep-20-99 10:31A North Andover Com, [�v. 608 888 9642, P-01 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYS"CCyI INSTALLA TLQ�Y CERTIFICATION The dersis-es re-e�y cec-:1<,. ;.iat tate�ewase:Dis�csal �;a�cr-..( } cons;r�cted; ( reraired, by_ 'ocated at was installed in .crl:bcYi..rtce with tEe Hort rpt over Board of Health av oved -Jar, System Des-.en Per: t # ldf�, dated '7199 �,Nith ar approved des. 9.11 d J, O g3Z!ors per day. The matt^als used we.e in coeiort:tnnce %vith chose sceci$ed or the acv'roved pian; &.e.systern was installed in accordance with the proV-3ions Cf 3 1 C CiVIR 15.600,Title 5 and lUCUI -e_Ulations, and the finial strking agrees subs.antially with the approved plan. All work is accurateiv representee: cr. t:e as-built MLch has been stbmitte: :o the Board E er is soec::C r date:: E;t�_'nerr Rzoresertaave Final inspecaCr, ;fie Engltear Representacve Installer. Lica: �-- Date: I Design Engin �'�` Date: W, 1r"�(,` 5� � f,y SeYii.fiy'^kfxe �ij r't¢ �' �AC K �fYY 07 �1 hey t f Y1 x � `4 FILE# o�+2QJ'l° e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ; PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmairks or benchmarks locate all wells within'100' B"k dF 11o,4 $to A to 7,1=.�f�'d,,. A to *D x SOW $to D =30' A � . B T� 1000d6r S �r�✓e � ;GTank N Tz t 4 D PTH OF GROUN WATER D pth to groundwat r: 101 lTkfeet / ;� Al- m thod of determin ion or approximation: llaut� h _ sd/i ! rie/ Z n iS�n�•T „ a s . rite' T.k ac Ya-,.l s 1pl-orw =En Llw 5;b ' k n l CI 'k { p' S�to I i. n i �.. (revised 8/15/95) 9 � �;� r' FORM 11 - SOIL EVALUATOR FORNZ Page 1 zo.— commonwealth of Massachusetts Ito ,moi"veP-, Massachusetts soil Suitability A csaccment fr r Ott-site Sewaee_ Disposal Performed By: -.......: .�t� fi�� .........................................................._....._......._.... witnessed By: ...w.w.... :. . . ? ? ' .... . .............. ........ .................... :.:::::::::::.:::...:. ::..::::::........................................... .�. Learla Ad&M« �� l S/S^-K-7� o.mr%wm. /'2,17-er4' /Lle�im/a a- I Tdom T �J , . TL �7 �t�o - 386 pyo � �'.��•� New Construction ❑ Repair Office Review Published Soil Survey Available: No ❑ Yes LJ' Year Published ...11ft. Publication Scale �'. Soil Map Unit Drainage Class .....0...... Soil Limitations ..../.............................................................:......................4'�'�,Y�iic�.. Surficial Geologic Report Available: No L Yes ❑ Year Published ................... Publication Scale .................. GeologicMaterial (Map Unitl .................................... ................................................._......._..._........:..................................... Landform ................................................................................................................ Flood Insurance Rate Map: Above 500 year flood boundary No ❑ Yes l� Within 500 year flood boundary No L7 Yes ❑ Within 100 year flood boundary No Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ............................................................................................................. Wetlands Conservancy Program Map (map unit)...................................................................................._......... Current Water Resource Conditions (USGS): Month ..-.� Range : Above Normal ❑ Normal ❑ Below Normal l� Other References Reviewed: �S S� �&,'2 . OR114 11 - SOIL EVALUATOR FORM Pago 2 On-site Redew • m LHole Number . ._ Date•_6". � Time.. Weather �h - -------- ocation (identify on site pian! ------- ._._........._..__.___................ _..._.. �`• Land Use - 5•.----____. Slope 146) surface Stones .... Landform _..__.�(a� eC._ �?�!" �....__...._ ._....._..__.___..................._................................. .___...._...__ Position on landscape(sketch on the back! -____ Distances from: ' Open Water Body feet Drainage way ?l _f feet, Possible Wet Area _ feet Property Una feet Drinking Water Wall "_'_�.• feet Other .,................................. Impth(f iufaa 6oU Nctlton Sao 1U8�0 1MW�aIU 6011 t�AAttIM�p (guar!' .6owpan. �r�ve � �. 2,•i y(,-Iq Parent Material(geoiogici �-- ........ Depth to Bedrock: _ eeo� t_ h to oroundwgiou Standing Water In the Hole: .& -Weeping from Pit Face: .... ° Estimated Seasonal High Ground Water: .. •/1 1�0R114 11 - SOIL EVALUATOR PURI Page Z 0-n-situ • Weather Deep Hole Number De:_ _n�7 Tlme:-/.O.::"•'. tl Dation (idendfy on site plan) /?laic.` ..........•••............" "_-- __ ... Slope 196) tff0/`" Surface Stones .......l.,l d Use _.. _ Land .......... _....__�...� vegetation ...... Landform � _..ti! L __ ._W__ _ .._._ __._..__....._....._..__.........._.._....................__.___...._...___-_ _....._.__ Position on landscape (sketch on the beck) ----- zA&J)-L�---w_-- Olstan0e4 from: ' Open Water Body •fid`"{• feet Drainage feet, t Poaaible Wat Area feet Property Una feet Drinking Water Well feet Other .......-.................--..-- DEEP ISERVATIONHOLK 1A Cir DePtiitfr iuteos Boa Horizon Salow SDAI a jj SON I�AatWnO (g ft- Mus, Grave Sly nueft--4 SLI" co loy��8 77 rock: Parent Material lgeologicl .._............................. Depth to Bed _ neeth to roundwater: Standing Water in the Hole: �A�Weeping from Pit Face: ..N" Estimated Seasonal High Ground Water: .... 7. �t FORM It - SOM EVALUATOR FOR Page 3 petermina d on ansonal High Yater Table Method Used ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of-observation hole inches D Depth to soil motiles . tom Inches ❑ Ground water adjustment _ -__- feet Index Well Number Reading.Date..- Index well level Adjustment factor Adjusted ground water level nAnth of Nah!raily 0�'Mrrina Pervious Materiel Does at least four feet of naturally occurring pervious material exist In.all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? I certify that on ldatel 1 have passed the examination approved by the Department of Environmental Protection and that the above analysis was Performed by me consistent with the required training, expertise and experienoa described in 310 CMR 15.017. Signature 1 FORht 12 - PERCOLATION TEST COMMONWEALTH *OF MASSACHUSETTS . Massachusetts Percolation Test . E: _.lam -` ' Time: ...1 oats: ..L............ Observation Hole # Depth of Perc Start Pre-soak J /,z End Pre-soak J Time at 12. « Time at g". / Time a� 6" 570 . Time Rate Min./Inch Site Passed Site Failed ❑ Performed By: Witnessed By: -d - Comments: ............................................................................................. ........ _..............................................._..... DAT EF LOCA ION: — ENGINE -- - — - - - OIH \N 1 T c`I--,v0L^,T10N T- T 30 1 1 0Ni UC"TH, 0r -7E:RC T E 1ME OF SvA.K.: _ .� __ - / TIME , T 12 ` TIME IME AT E E-Nic ivi T i Ii= , .T WE r", f E i IT h �Z s. --- ---- — — -- — —�--i--' --— — ^J � dt" t 1&�".` � _F!(�• Y 1Y z-r 1 �il M�F � i �. _ - e — -- — x • t a td 4 q, X q �t,5� ..r,;!��n.�d '4 C ;da� k«M�#. �r!". yy •_, r n !�' 'M, � ..,.; h., s 4.�n :t:� � �; c.. .i� ,:..fi '[. � � a s r. t, f .�F,.P'w'1,.. »«.-.��". •,...I-y I..-,. �,r -S. ..�� ,� .., dr. n� ,.,.,. � ...... ob..:r�i r. ..: b'Y •'�'L"4 e'.�''"' n1� ..u,��'�FF"Y'rw ... ,:r.,.:,�'� ds r.,,..^ d Y- .. � ,.., t 'r.: ,� h ,d ,I� •.�..n.. .,.Il. 1fi'�.:x ,. � n.,. .. ...: } t.. . , 'r �,:•v ,4 ,`* Wr:�. x..V,: r,�.,_.r:, ,: .�,....t >^.;b -. . a. � .. � r ,J4r , dR'�r. 1, .w ,r 7., i. s.. ,�. .. B.L. :,:,,, �� {., R4' .. �•«� � ,.�:;y. ,: ., .. j. 1�'4�. 7, .. .-. v t ,,...•v: .,�A r, ';' r .,' 1, ,+fl N p w., �.J+i. �} �`, ,, ,.F kkSr•i"., �„,�r v..ii.Pk k" �:. �� :' :.. f � YS ... : y. ., ,....�.� "a.' •. ,,. � ;q, �� .:. �:I' .I.. f .. . i4. , , ..,J i .. M �`:: ,.w '� ;,... :..:�+":' .; $ r_r s ';fi'p�'•. �''��+:�. a. r+ �.,t n .. . .;�y 3 .-. Iw ''�' 4rl :�t1 , ' .�,y .S,d..: "h t; *. �;. r• ,:� ., ff r � a S }a 4� ,, E gg a�a a s ,' �, .� s.. kk J ,: C i ,.Fyq rr, � .. ars' a 't�',:, ,.:..,� .,. .y,•7, y,}f¢; p" ,,. y,. �. i r r,.r 'S a. .. ..:.", #'��. ilr�.p. ... W,. U '., ..;11 . .'Yt ., -w.cF u,;¢d � y. Syyfi�s ..y. ,1„ -ifl S a Y}..I L,^f:., P 7 4 g `,El .P .tI' Y 44 M: R. �"� ra•,�, °II ,W i.' �,,., �,�:��' 1 :i,,•"d:;n , ,s ,,� r' '� r » t 04 s• b�', r n a�:r,a, A.. +,, .,r:�„� ?'rod�..r. •,`a,,.�': Y,.,P.. M F, . .: � :7�x t.dP �,: .» , 'G. ,. +� .. ;. +r�, ,yy�di� a 1 a .��r.,,�.a.f,t,...7. .t •rw`s ..w •' ..:• ,� . �. ,.� ,k� .t 'E .,•....r. -„ �E, 1��?�.. _ t. y�::-.i,, � ,° :�;S �. �r: Rifr,v> Rf•.y. tiv ,.'.M+- r�... "(::, ,1 '�. ,. ':> i .':, + �;lr:.' �el�, �,'. :.: ,tri,,:... ;.,• ..! .::r�.-, g x t..yl�. St..t .,�. . r.; ,v ,,'� ,.: „. ..r� ..'hr::'.. �, i�: _ °r• ' .i� j ,:Si.,knr.a. [q .: «t a ;_: � "'• g., ; . �:. p., : Y a ;f'' n 1.•' GA. ;; + _,-.�i:ti "i� .�e,e- �C""1 ..• K. • .: .r ,�4r. .... � S ><. ►S� .,.. ri;y .,,d��.;, '.; .x : � ,+ .4..a ...; a&`- :a:r� ,,.•. rt. "x ...• ... ,s »in iv �:iidC„„ees; k.. ss,• a �ti ".:a7".• a•Cn�:.;�-r;� �::a�� .. •.:p .�#t a !^ y' �S�t' R «:S. ;G��•k hf`sig � i�, � tt,.,,.,. t ,w� LYS: A a i + pkS �',""3t d� �� '� �✓ !' �� .a °^. �� + r s'i`�3`,�}.'tk �i��, 'ra � iL, '• 4r. , .� �b�'`k ��4 �!aa.A w�T• �ea Cy` k;fF`:71:•: f Yf. ?. ;�f�}3y��^-L d "ice . ;�'+4 i l'' •h' aS..a-0 2F t.. ,�f},d .” a *i2�li rx..G.P F ¢ a. . ;Po f r { J 5't's�F Y i t P 1 ;:t «i,i 3_u. �� }•. sjfi � i �: �.. P �;tr ,.t. Y ut 54 .y~ c rgY ''y ; . rt„¢ ?�E.`.1�. •s; .^ yr,'6~ ”,>r a:'r de .aa#., a. '& v1+� .Y... r {�'�;y�f I'�'t}`��•�,�k v t?., 1 .� �' . �y�� _ � ` J 'E� y �. . �t ,s�y',...' ��+¢, .s:. �4.. .., p1•��'za' 1 ' �k� ,Y�+ � ,r, �, k&�1��•�3r�'F�i ST� � II��rP �.. r € Nr ..gL' 1 I H?-� gry'.,a r E *d $ 7 ] y Fi, r ti• fy #N �#It i +i�,t.:E � f�1,t j;adl�dt,x wSsT� 2M��a tM'S�rG {-r y '+5 �',k� �1._. �='jt.'..r,.'i'd�, ` •A� °*�s`S'f f h'P�,"y, y,�. >'�'�� '. •d:�M ` c �_ 9 �tZirt t er rx', ��a ,y f � F y. ..��d� �3q"t, .,•a� � w �t °� 3 Y K 'Y: .Z u r t�3't;. .Ft 5:�'r s{ �. fs i�x'i` �.. t .w .r✓.R �,"� .;•"p'. ��r \'t r,4��, ;., ;3�a a-. "xq�3 ^,gTMx,;,«r .. �v ap� •,i� -: �� , "�'R m` s#;, � ,� �;rf .:. .17Y+i�,...` �.,.3, .}.a T,v,n,. `r`,f' n;#:h +�; ? ,. •. � ' �, � � :�.:3, .. '? z,.;- .�h `h-�. .,�iS ,F�,, .� �J, a:.... �.��;', ' � £i.t2 a�{ad�a � - 5;•.,:,.�yS`. �ad�, A• .5.. - .f , ,r,-iT '..� �'M,,,Te�;. ysa'y-�- is _.d'Fw ��, w.� h. � ,g'j' �. -. k` g� .,>. sex r«•',•Ctr; Commonwealth of Massachusetts City/Town of NORTH ANDOVER MASSACH USEMI' D I e1 System Pumping Record M- Form 4 JUN _ 5 200 DEP has provided this form for use by local Boards of Health. The S SOWNT F No�TH 9N01� a VER u, be submitted to the local Board of Health or other approving authority. �4 A. Facility Information Important: When filling out 1. System Location: forms on the computer, use only the tab key Address ------ _ to move your cursor-do not use the return City/Town Sate �_- key. Zip Code 2. System Owner:— Name Address(if different from location)— - — - --- -- — City/Town State ---- Zip Code Telephone Number '— Pumping Record 2.4. Date of Pumping p g Date 2. Quantity Pumped: -- Gallons Type of system: ❑ Cesspool(s) ❑ Septic Tank ❑ Tight Tank F-1Other(describe): Effluent Tee Filter present? El ❑Yes ❑ No If yes, was it cleaned? Yes ❑ No Condition of System: 6, Sy em Pumped By: r ` �. Name Vehicle License Number Company 7. Location where contents were disposed: Si ature of Haul Date i http://www.mass.gov/dep/water/ provals/t5forms.htm#inspect 4 t5form4.doc•06/03 System Pumping Record•Page 1 of 1 BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER9 MASS. 01845 APPLICATION FOR SOIL TESTS RECEIVED DATE: gCATION OF SOIL TESTS: t a tTr16Ef MAY 2 81999 sessor's map & parcel number: H'7iSNORTH AINDOVP-R ' = C4(��EFi��ATi )ii COMMISSIONOWNER: ��EYLT t-'I C�tf�.4t.- TEL. NO.: XDDRESS: r9q°J ' ri1GINEER: �jO1" TEL. NO.: qZS' �� CERTIFIED SOIL EVALUATOR: 6��i.1(---' rNse o lain residential subdivision, single family home, commercial stin/ervation Undeveloped lot testing Commission Approval: THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of 1275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of 75-.00 per lot for repairs or uoorades. GENERAL INFORMATION u 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two dee holes and two percolation tests are required for each septic system ' P p q disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at i14 r discretion of the BOH representative. z f `for all additional tests within two 5 Full payment will be requiredweeks. , . 4. , thin 45 tla s of testing a scaled Ian (no smaller thanAl '1 �} 8 I-P—i10yHealth.showing the location of all testsgincluclhtr ting sail,evaluation for U N e I Town of North Andover, Massachusetts Form No.2 OT MORTN BOARD OF HEALTH r719-o � k 19� DESIGN APPROVAL FOR ;�SSACMUSEt� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location J , Reference Plans and Specs. ENGINEER SIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH D 8-6 Fee I�,J '�� Site System Permit No. Town of North Andover, Massachusetts Form No.2 f NORTH BOARD OF HEALTH o � F w • WNW DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant .l 4 h n Q Test No. : Site Location 5q 'IV-\, _ • I Al- Reference Plans and Specs. • ENGINEER DESIGN 6 D E Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CI IRMAN,BOA D OF HEAL • FeeSite System No. Town of North Andover, Massachusetts Form No. 1 r1ORTH BOARD OF HEALTH ,11E' 16 6 - (/ rh .w,° ''0 '` APPLICATION FOR SITE TESTING/INSPECTION TED SSACHUs��y Applicant` NAME ADDRESS TELEPHONE Site Location �� tU✓ .� ,ll-Engineer-' AME ADDRESS TELEPHONE Test/Inspection Date and Time /6711 /o Z,3,:�) CHAIRMAN,BOAR OF HEALTH FeeTest No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH X05 ", - 'b-1 -;f�' `jf 192 �. FO ? 14- At T .m APPLICATION FOR SITE TESTING/INSPECTION aDRATED PPP`.�5 �SSACHUS�S Applicant NAME - ADDRESS TELEPHONE r Site Location 1 u' Engineer f �,� E.� r 1�_.- ( � �� 'f k 'i.4 .t 0 NAME J ADDRESS � ) TELEPHONE Test/Inspection Date and Time /'tea CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. BOARD OF HEALTH TEL. 688-9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: OCATION OF SOIL TESTS: assessor's map & parcel number. W2 k&GIGI WNER: F-14ILVAqk TEL. NO.: e'DDRESS: c5'1°J 5,A�M _ 'aec— GINEER: TEL. NO. `Z7s-j5x5�c5' � CERTIFIED SOIL EVALUATOR: 13t I 2die�s�e lanc residential subdivision, single family home, commercial e testing ��// Undeveloped lot testing N. A. Co ervation Commission Approval: THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of 1276.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or uogrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians an Professional Engineers can design septic c plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. 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). 7. Within 60 days of testing-soil-evaluation forms shall be submitted. TO c F N Oi t i4 3JG�r�� C7 -7 17H 8 1999