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HomeMy WebLinkAboutSoil Testing Results - 1030 JOHNSON STREET 9/18/2002 BOARD OF HEALTH F f0RT 3 AN A"ERA ' NORTH ANDOVER, MA 01845 978-688-9540 r Y APPLICATION FOR 50IL TESTS DATE: g ,� z MAP &PARCEL: LOCATION OF SOIL TESTS: OWNER: �� i� {Z S �� TEL. NO.: ADDRESS: j 3© )�►�NS�� / ENGINEER: TEL. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. 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$200.00 per lot for repairs or upgrades. (If time is not critical, fee for repairs is $75.00) GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarian and Professional Engineers can design septic 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. Please Do Not Write Below This Line m - N.A. Conservation Commission Approval: Date Received: Check Amount: r Check Date: s_J :�/ �' OR MAGE INSP r/ON PAN AT 1030 JOHNSON S TREE T NORTH ANDOVER' MA. NO ESSEX REGIS TRY OF DEEDS,' SK 3/88 PG. 180 II PLAIN',* N0. 5080 CERTIFIED TO"NORTHMARK BANK SCAL£.' "= 60' DATE. NOVEMBL R 06, 1997 �Ve 30'—REQUIRED O'/ -EXI:ctING oo 3yDO0 � -SHED" WWD SHED ON 90 � CONC. PAD POOL. � 2ST. �w/F. LOT f Q G. 4 4,190 '>-'f x OF cv s i r NOTE'S.' 7 :. l) TH IS IS NOT A PROPER 7Y SURVE Y, DO NO T USE THIS PL A N TO ESTABLISH PROPERTY LINES OR TO ERECT ANY STRUCTURE. 2)PROPERTY LINES ARE DETERMINED FROM COMPILED INFORMATION TO BE USED FOR MORTGAGE PURPOSrS ONf_Y 3) DWELLING CONFORMS, WOOD SHED DOESNT. CERT IF ICATIONS.' BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF, I HEREBY CERTIFY THAT THE PERMANENT STRUCTURES INDICATED ARE LOCATED ON THE GROUND APPROXIMATELY AS SHOWN AND ARE. (SEE NOTE3) CONFORMING TO THE ZONING SETBACK REOUIRE-MENTS OF THE APPLICABLE MUNICIPAL I T Y WHEN CONS TRUC TED OR MAY BE EXEMP 7- PER MASSACHUSf_T S GENERAL LAW CHAPTER 4OA, SECTION 7 AND THAT THE STRUCTURE SHOWN IS:NOT LOCATED IN A FL DOD HAZARD ZONE PER FEDERAL L-41ERGENCY MANAGEMENTAGEM;YMAP' COMMUN/T Y NO. 250098 EFFEC77VE DATE,' 6 6-02-93 ZONE.' X JOHN ABAGI,S 8 ASSOCIArES, PROFESSIONAL LAND SURVEYORS 137 CHANDLER ROAD, ANDOVER, MA. 0508) 688-489-9 APPLICANT,'PEARSON NO. 32 7.3 r �} �� 1 ,� r m-6 y. tsc l ' j I 9 y I r - � L L V C/ 17 0110 _. C,0 7-10 N i=S:i .= =G.1—i Ofvl Jc:i I; C,F 0vCE=NYIc- i mil.',-.^. IiVi:; E i -Adr-I5 AUj I i�I= ,,, , 15 I VV i, J.G�J�IG J•J�f i-1 I- .J FROM : R.C, THNLAFD FHOIdE N0, 781 334 01115 FORM 11 - SUII. EVALUATOR FORM Page 2 of 3 A' *� Location Address or Lot tvo. � ��'�/•�� ����t �✓ 1�. On—site Review 1 f / Deep Hole Number 1. Date:-0"!.J(0 Z- Time: Weather Location (identify on site plan) ' , . 014 r _ Land Use .. Slope (a/o) f Surface Stones ^° Vegetation Landform .... Position on landscape (sketch on the hack) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other _ DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture $ail Cotot Soil Other Surface(Inches! (USDA) (Munsall) Mottling (Structstre,Stones,Poulders, Consistency, q, / Gravel) f` _-- �- t L/ r . Parent rvtateriat(geoiogio} DeptntoBedrock;� --�_�_ Q, tp h to Groundwater,: Standing Water in the HQ* Weepinj from pit Face: Estimated Seasonal High Ground t5t:! APPROWD FORM-1./07195 i I. J.G.JCAG ­ 3346i15 JJI I I Y FROM R.C. TRAGARU PHONE f�l0. 7B1 1 FORM 11 - S011.. f A A1.UATOR FORM :.OQ(ttion Address or Lot ire, . � �� �r /�, ��(PC)Gr�-/L Qn:site Review L"- /46(p Z- Time; _ a Deep Hoye Plumber Date: � � Weather /�`" Q' Location (identiiffty on site plan) x I . /7�= ( l 1 tom/ Land Use %?P 4t" Slope ;%)/e�9 Swfece Stones Vegetation Londfcrm Position on landscape (sketch on the hack) Distances from: Open Water Body feet Dreinage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOO* bean f(om Soil Horizon Scii Text',,ra Sod Color Soil _ Other Surface(Inghes) (LJSQAI (Munseil) Mottling (Stndome,Stones, Boulders, Cur siswncy, Gravel) 1, Z; �� Parent Material(geologic! bepthto6adroak: '� QN,,l'to,Greundwater. 7tanding Water in the Hole: i Weeping from Pit Face, Estimated Seasonal High Ground UEI'APPRGWEA Y01tM1I. 121 7!95 Form No. 1 Town of North Andover, Massachusetts BOARD OF HEALTH F NORTF ,'Y.A O��S4ED I64O �S= 0 A 1 m A0� APPLICATION FOR SITE TESTING/INSPECTION 7 QORATED �SSACHU`'� Applicant ADDRESS TELEPHONE AME Site Location TELEPHONE Engineer NAME ADDRESS Test/Inspection Date and Time CHAT AN,BOARD OF HEALTH %y Test No. Fee S.S. Permit No. / D.W.C. No. C.C. Date__Plbg. Permit No.._—