HomeMy WebLinkAboutSoil Testing Results - 87 FOSTER STREET 7/16/2018 p
TOWN OF NORT11 ANDOVER
Community & Eeoimmic Develop east
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120 mailm Street
NORI'Cl ANDC Vfl,R, j\4 AC:'1-ii)Sl:;`l"'1'5 01845
978.688.9540 Phone
978.688.9542-- FAX
ltcalthdept@northatrdovcrana.gov
www.northandovernm.gov
APPLICATION OR SOIL TESTS
DATE: MAP PARCEL: 9(,)Y
LOCATION OF � N ,� 4/
OWNER: Jerome W Gabbert Contact#:
RF=O Asset Mana-er. J._. f F� y
L.p1.,iC��Tr1 f: d'� ;rpt ' C:? 17 c�a' d Contact#: ) ..r�..3 l
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ADDRESS: �K/ j�C'�� ��> i�lGa �fl7`�` }1T�. ���� 7 e)"5
lsNGtNE,tsR: Jaynes Kavanaugh Contact{l: 978-375-9781
fv;LM:I"f 1FIED SO]L EVALUATOR: James Kavanaugh No.13 53
Intended Use ofLand« Respden iat Subdivision Singlo lain �ornc Commercial
Repair Testing. Yes__ Undeveloped .Lot Testing. Upgrade for Addition,
In the Lake Cochichcwick Watershed? Ycs No x
f"ftf,t'OLLC WING MUST BF INCLUDED WITH T HIS F(.1).
y> Proof of land Owner•std fa(Tax l>:411, or lrttcr fi-oni omw mor porsrtittiag test)
�- R. '_'.a r 1'P'loi t fiut&Locallou of TesUL)LY Blease hrr1!crt2c 9e rr iter oil Lhg rleaal
> free of$585.00 per lot for v r This covers the rninimurrr two(loop holes and
two percolation tests required for each disposal area. Fee of, 440.01)per pot for repairs or upgrades.
GENERAL INFORMATION
Only C,ertificd Soil Evaluators may perform deep hole inspections.
Only Mass, Registered Sanitarians and professional Engineers can design septic plans.
At toast two deep holes and two percolation tests are rcquired for each septic system disposal arca.
> repair's t:eWuire at least two beep hales and at teast onlawrcolation test,at the discretion of the W31-4
representative,
Full payment.will be required for all additional test.,witfim two weeks of testing.
Within 45 days of testing,a scaled pian(no smaller than P'-100')shall be submitted to the Hoard of Health
showing the location of all tests(including aborted tests).
r' Within 60 days of testing;still ovaluation forms shall be submitted.
Pl&,se D6-Not Write 13elow This Line
.tw°fig. a»ifJbBh'G�a'P11ad°!�d?.S! t'��:7)Ao"ad$�.a�1947➢� �0�8"U£°ft+.l 't
��`lg�raaaz"a�a'a>�a�" 't,�ras•ryrvaata®aa,�1��.�aJ' � ------..�-..---- �._ __ ..._�.__....______
Dole back for Health frog
Town of North Andover, MA February 8, 2018
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MAP FOR REFERENCE ONLY
NOT A LEGAL DOCUMENT
Town of North Andover,MA makes no claims and no
warranties,expressed or implied,concerning the validity or
accuracy of the GIS data presented an this map.
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Page 10 of It
OFFICIAL INSPECTION FORM ' NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: ?
Owner: "e<r9
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provides a sketch ofthe sewage disposal system including ties to at least two permanent reference landmarks or
be3nclunarks.Locate all wells within.1.00 feet,Locate where public water supply enters the building.
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Town of North Andover
HEALTH DEPARTMENT
S
CHECK 4: DATE-
LOCATION:
Alk?,r
cZ, ') ,17
CONTRACTOR NAME
Tyne of Permit or License: (Check box)
0 Animal $
0 Body Art Establishment $--
0 Body Art Practitioner $
0 Dumpster $
0 Food Semice.- Type:
0 Funeral Directors
0 Massage Establishment
0 Massage Practice
0 Offal(Septic)Hauler $
0 Recreational Camp
0 Sun tanning
0 Swimming Pool $
0 Tobacco $
11 Trash/Solid Waste Hauler $--
0 Well Construction $
SEPT1g_5yqems.
Septic-Sail Testing $
Septic-Design Approval
13 Septic Disposal Works Construction(DWC)
0 Septic Disposal Works Installers(DWI)
0 Title 5 Inspector
0 Title 5 Report
0 Other. (Indicate)— $
Heaiih'-Agent Initials
White-Applicant Yellow-Health P,in, ,k,- Treasurer