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7 BONNY LANE
210/062.0-0034-0000.0
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PHONE 11710 J�/�� YOUR CALL'
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SIGNED "' (Ulniv@/Sal*48003
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iAt FORM A
`,PLICATION FOR ENDORSEMENT OF PLAN -
43A BELIEVED NOT TO REQUIRE APPROVAL D
19
To the Planning Board of the Town of North Andover :
The undersigned wishes to record the accompanying plan and requests a
determination by said Board that approval by it under the Subdivision
Control Law is not required . . The underssgned. believes that such approval
is not required for the following
1 . The division of land shown on the accompanying plan is not a sub-
division because every lot shown thereon Lhas
.andthe
,ismouna pf f ontage
required by the North Andover Zoning or a private way , namely ,
namely , r
being land bounded as follows :
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2 : , The divisign b.f .land shown on the accompanying plan i-s not a sub-
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d i 0 s`'14()n%I or. the following reasons
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a ; Book 1 7J `� Page
3 . Title reference North Essex Deedsi,
Certificate of Title No . Registration Book
Page
Applicant s Signature , Owner ' s signature and address if not
the applicant :
Appl i c�an,t''s Address
�s
GST
�N N
A
1
Notice to APPLICANT/TOWN CLERK of action of Planning Board on
accompanying plan :
1 . The North Andover Planning Board has determined that said plan
does not require approval under the Subdivision Control Law ,
and the appropriate endorsement has been made upon the same .
2 . The North Andover Planning B d has determined that said plan
shows a ubdivision , as efined G . L . - and
must ther fore be r -submitted to for approval under the
Subdivision rol Law .
Very truly yours ,
NORTH ANDOVER PLAN NG BOARD
By ,
Date Z n
x
Town of North Andover, Massachusetts Form No. 1
RTH BOARD OF HEALTH
Ole NOt4Oo i b-1 y .
3a y� 46 0 19
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APPLICATION FOR SITE TESTING/INSPECTION
SSACHUs���h
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Applicant
NAME fp J TELEPHONE
Site Location -- `
Engineer
NAME ADDRESS TELEPHONE
Test/I n,--
CHAIRMAN,BOARD OF HEALTH
Fee_ Test No.
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S.S. Pel ' / D.W.C. No. C.C. Date / �`/Plbg. Permit No. /
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Town of North Andover, Massachusetts Form No. 1
NORTH BQAKO OF HEALTH
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32���t`E° OL y
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� APPLICATION FOR SITE TESTING/INSPECTION
X1,9 AORnreo PPP��y
SSACHUSE
Applicant '
NAME p TELEPHONE
Site Location
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
i
CHAIRMAN,BOARD OF HEALTH
Fee Test No.
S.S. Permit No. J' ? D.W.C. No. C.C. Date6-/Plbg. Permit No.
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" NOR",-_t; ANDOVER, IRAS5- —Dec_ 3 , 1982
BOARD OF HEALTM
Alfred A . Shaboo , P . E . OE51GU E,;GI ,'.EEi Re: So-(I Absorption
Flynn Assoc . P . C . Same ge Disposal
Systef:
certify that I have inspected thu construction materials of said
ist3ma at Lot #19 Great Pond Road
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t Afl over, licss.
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r -. 4e, Lnd construction materials are as specified in Allf plans and
T •. L• at-ions dated April 15 , 1980 and As-Buil ': Nov . 1 , 182
Reg. prof. Engineer,
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T0 ?'A 'NORTH ANDOVER , MASS .
BOARD OF HEALTH
FROM: A. a"i'Do DESIGN ENGINEER Re: Soil Absorption
�' �SS� �C• Sewage Disposal
�x so �'a�s� N�{ 038(5 systems
This is to certify that I have inspected
the construction materials of slid
disposal system at
Site Location
North Andover, mass.
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The grades and construction materials are as specified in my p4ra-m. and
sp- fteaf iwaQd-��:f 198Z and As-Built �, 2 � , 'i9
Reg. Prof. Engineer/ReqW--��
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PPEPAREU F Y-�-- REV, 12-28-82
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