HomeMy WebLinkAboutSoil Testing Application & Sketch Results - Soil Testing Results - 500 BOXFORD STREET 1/28/2020 TOWN OF NORTH ANDOVER iV
Office of COMMUNITY DEVELOPMENT AND SERVICES 'HEALTH DEPARTMENT
1600 OSGOOD STREET; SUITE 2035
NORTH ANDOVER, MASSACHUSETTS 01845 R -c)
Susan Y.Sawyer,REHS,RS 978.688.9540—Phone AUG 13 2015
Public Health Director 978.688.8476—FAX
healthdept(&townofnorthag $ RTH ANDOv;_'R
www ownofnorthandover.coKALTH%IARTMENT
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APPLICATION FOR SOIL TESTS
DATE: August 3, 2015 MAP&PARCEL: 105C 42 l
LOCATION OF SOIL TESTS: 135' northwest of existing dwelling (see sketch) ��OQ
OWNER: Thomas Donovan Contact#:
APPLICANT: Andover Consultants, Inc Contact#: 978-687-3828
ADDRESS: 1 East River Place,Methuen,MA 01844
ENGINEER: Andover Consultants,Inc Contact#: 978-687-3828
CERTIFIED SOIL EVALUATOR: James Fairweather �`Q,�, r YC v�rtN1 '
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is This: Repair Testing: Undeveloped Lot Testing: ✓ Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No ✓
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
➢ Proof of land ownership(Tax bill,or letter from owner permitting test)
➢ 8.5"x 11"Plot plan&Location of Testine(please indicate test nit sites on the plan)
➢ Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades.
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: C)K— IN v
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Date back to Health Department: (stamp in): 1"L.
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