HomeMy WebLinkAboutMiscellaneous - Rocky Brook Road (2)' TOWN OF NORTH ANDOVE
BOARD OF HEALTH `J /,��
Location
Permit
Food Service
Retail Food $
Limited Retail $
Seasonal $
i
Disposal Works In: $
-....Di,sposal Works Construction $
Testing- g $ �v -
Design Approval Permit $
Dumpster Permit $
Burial Permit $
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Swimming Pool Permit $ J
Animal Permit $
Recreational Camp Permit $
Well Construction Permit $
Funeral Directors Permit $
/Massage Establishment License $
Massage Practice License $
Suntanning Establishment $
Offal/Trash Hauler $
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Other $
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7501
Health Agent
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White - Applicant Yellow - Dept. Pink-,- Treasurer
I
ttORTH
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT p
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01845�qS CH
SACUS
Susan Y. Sawyer, REHS/RS 978.688.9540 - Phone
Public Health Director 978.688.9542 - Fax
Daniel Ottenheimer
To:
Mill River Consulting
978.282.0012
Fax:
1.800.377.3044 or
Phone:
978.282.0014
Request for Soil Testing or
Re:
Septic Plan Review
❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
• Comments:
Septic Plan Review Soil Test OTHER
Note: For plan reviews, this is notification only. Plans will be mailed or arrangements made to pick
them up as requested.
Please call 978-688-9540 for assistance with any questions. Thank you.
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Cc: File - Address" �� C!
t30RTH
TOWN OF NORTH ANDOVERo�
HEALTH DEPARTMENT
27 CHARLES STREET
NORTH ANDOVER, MASSACHUSETTS 01845 �q'°A•�E° ��'t<y
$sACHuSE
Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone
Public Health Director 978.688.9542 - Fax
Daniel Ottenheimer
To:
Mill River Consulting
978.282.0012
Fax:
1.800.377.3044 or
Phone:
978.282.0014
Request for Soil Testing or
Re:
Septic Plan Review
From:
Pamela
Pages:
Date:
CC:
❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
• Comments:
Septic Plan Review Soil Test !/ OTHER
Note: For plan reviews, this is notification only. Plans will be mailed or arrangements made to pick
them up as requested.
Please call 978-688-9540 for assistance with any questions. Thank you.
Cc: File - Address"
:--�/ �7//
Y
TOWN OF NORTH ANDOVER e NORTH
Office of COMMUNITY DEVELOPMENT AND SERVICES or���'�
HEALTH DEPARTMENT
27 CHARLES STREET * r r
NORTH ANDOVER, MASSACHUSETTS 01845 CHuse`
Susan Y. Sawyer, REHS, RS
Public Health Director
APPLICATION FOR SOIL TESTS
978.688.9540 — Phone
978.688.9542 — FAX
healthdeptna,townofnorthandover. com
www.townofnorthandover.com
DATE: March 16, 2004 MAP & PARCEL: Map 90A Lot 28
LOCATION OF SOIL TESTS: _Rocky Brook Rd. /lot 11 Wintergreen Estates
OWNER: Frank Denuccio Contact #: 978-688-0079
APPLICANT: John Grasso Contact #:978-688-8895,
ADDRESS: _865 Turnpike Rd. North Andover
ENGINEER: _Christiansen & Sergi Contact #: _978-373-0310
CERTIFIED SOIL EVALUATOR: Gene Willis
I
Intended Use of Land: Residential Subdivision X Single Family Home Commercial
Is This: Repair Testing: Undeveloped Lot Testing:_X Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
J
No X
Proof of land ownership (Tax bill, or letter from owner permitting test)
o en - 7 I" "1— _Y..- D_ 1 Z-1 ---- 1-11_._s.. --1, -1._
BOARD OF HEALTH
k MAR 1 9 70"4
Fee of $425.00 per lot for new construction. This covers the minimum two deep hIles and
two percolation tests required for each disposal area. Fee of $225.00 per lot for repairsor up9"radfs: -'
GENERAL INFORMATION„__
Only Certified Soil Evaluators may perform deep hole inspections.
Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
At least two deep holes and two percolation tests are required for each septic system disposal area.
Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH
representative.
Full payment will be required for all additional tests within two weeks of testing.
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).
Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date.
Signature of Conservation Agent.
LOCUS ModP
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HP Fax K 1220xi
Last Transaction
Date Time Tyke
Identification
Log for
NORTH ANDOVER
9786889542
Mar 30 2004 11:16am
Duration PResult
Mar 30 11:11am Fax Sent 819782820012 5:17 5 OK