HomeMy WebLinkAboutHealth Permit # 9/19/1997 Town of North Andover, Massachusetts Form No.z
o e "ORT" BOARD OF HEALTH
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�,b•,,, ..� DESIGN APPROVAL FOR
S34CHUSEt
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant
Test No.
Site Location _36,�!
Reference Plans and Specs /l� �sc7
ENGINEER DESIGN
DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
LTiAIRMAN,BARD OF HEALTH
Fee Site System Permit No.
Form No.4
Town of North Andover, Massachusetts
BOARD OF HEALTH .
Dece�r,, 18 19 7
CERTIFICATE OF COMPLIANCE
This is to certify that
the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired
by Ben Osgood Jr.
INSTALLER
at 369 Salem Street
SITE LOCATION
has been installed in accordance with Board of Health Regulations as described in the Design
993 Nov. 19 97
Approval Site System Permit No. dated 19 .
The issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
r � r
' BOARD OF HEALTH
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Town of North Andover, Massachusetts F°�`""°'a
BOARD OF HEALTH
f NORTH
p t,'.o ,,,tip /V01/• /q 19 97
3? e?-._'•..a pC
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,0 DISPOSAL WORKS CONSTRUCTION PERMIT
.„ ,SSACHUSEt
Applicant d 5
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NAME ADDRESS TELEPHONE
Site Location �� �� 5,
Permission is hereby granted to Construct ( ) or Repair ( n Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. qq�
CHAIRMAN,BOARD OF HEALTH
Fee
7` 7�j D.W.C. No. 9e
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PE
RNIIT
DATE: ► 9���7 CURRENT INSTALLER'S R S LICENSE# �IT
LOCATION:_
LICENSED INSTALLER:
SIGNATURE; - TELEPHONE# --
CHECK ONE: ---
RE-PAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT
Administrative Use Only
$75.00 Fee Attached? Yes No
Foundation As-Built? Yes
Floor Plans? Yes
No
Approval
Date: / /Z/
/U FA0
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