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149 SWAMPSCOTT ROAD (2) X149 SWAmPSCOTT rRD . Gt>esLL 5 LL 'i , s Kimberley Driscoll Mayor WELL CONSTRUCTION PERMIT Location: 149 Swampscott Road Owner: Leahy Landscaping Address: Sanderson Street, Lynn, MA This permit is granted in conformity with the statutes and ordinances relating to well permits. Well Construction permits are non-transferable. This permit shall be on site at all times that work is taking place. Permit shall expire one (1)year from the date.of issuance unless revoked from cause. This permit does not constitute a Water Supply Certificate. Permit#: 004-08 Date Issued: 149 Swampscott Road (Monitoring Wells) (TED Inc. — Reg. #560) HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 5! 120 WASHINGTON STREET, 4TH FLOOR o SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Well Construction Permit Application Date:��`� ©o Fee: $100. Check payable to the City of Salem (no cash) Location: Iu '( JOW41v�PS«T (z-d- Salem, MA. 01970 0wner:L-e6w-e L6r-o5dPW 6- Address S 2Sar1 ST-- Tel. j!g� ro1-7 y3g6 Type of well: 806-2�V- Well use: �✓L 1��6 +4 rl o rJ Well Contractor: Chftig t.2S M- Lt r�lt6c • Pump Contractor: 1^� Address:i 19 oePor lad !.'oxFo2o ,�q . Address: Phone: 97g_ 2j"�- Z 3 2 o Phone: Reg. #: 30 5- Have Have abutters been notified? (y) ✓ How? In the space provided below(or on back) show the location of the proposed well in relation to existing or proposed above or below ground structures. A description of visible prior and current land use within (200) feet of the proposed well location, which represent a potential source of contamination. A—TTA-TGN-e0 Pe— There LThere is no fee for monitoring wells but a permit is required for installation. ------------------------------------------------------------------------------------------------- B.O.H. useonly. Check#: y5'a35 Check date: $-28-o8 Permit#: &0 Well const permit appl revised 11125/02 1 i