HomeMy WebLinkAboutCertificate of Compliance - 206 FOREST STREET 12/4/2003 Town of North Andover a� "O TH
Office of the Health. Department
Community Development and Services Division
27 Charles Street 41
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North Andover, Massachusetts 01845 �SSACHU§��
Heidi Griffin Telephone (978) 688-9540
Acting Public Health Director Fax(978)688-9542
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
December 4, 2003
This is to certify that
the individual subsurface disposal system
constructed ( ) repaired (X)
by
Mike Reilly
at
206 Forest Street
North Andover, MA 01845
as been installed in accordance with the provisions of Title V of the State Sanitary Code and with the
North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will function
satisfactorily.
JonaffiaAarikey
Chairman,North Andover Board of Health
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL, SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System C "constructed;
( ) repaired; �y jlu by � r` _ � t
located at
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit # , plan dated , with a design flow
of gallons per day. The materials used were in conformance with those specified
on the approved plan; the system was installed in accordance with the provisions of 310
CIVIR 15.000, Title 5 and local regulations, and the final grading agrees substantially with
the approved plan. All work is accurately represented on the As-built which has been
submitted to the Board of Health.
Bed inspection date: j "" , ' °
Engineer Representative
Final inspection date:
Engineer Representative
Installer: .
Lic #:
° Date: .
Engineer: Date: '7°