HomeMy WebLinkAboutCertificate of Compliance - 594 BOXFORD STREET 4/28/1999 TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE:
04/28/99
This is to certify that
the individual subsurface disposal system
constructed ( X ) or repaired ( )
by
Raymond Fraser
at
594 Boxford Street (Lot 2A)
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations as described in the Design
Approval Site System Permit #1042 dated November 20, 1998.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
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9-08-1995 0:55Ar_t FROM P. 2
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TOWN®F NORTH ANDOVXR
SEWAGE DISMAL SYSTEM
The IMMiPed hCTCbY CerbfY the the Sewage Di*vW System( Cons ed; ( )
by
locgurd at
was' ltd is 0009MIMCA with tht NMII Andover 900rd of Health approved SYMM
Desip P t ur d // t}Ow of
dV- 'fie MWJiWA Used*min Confbmace with thow bpWficd on the IpMVW
plA;t6 syst=wa$WWWD&MMAM with the pmvislorls of 310 CIVIA 15.000,Title 5 ud
rc tioos,Md Iht UN 94118 RIP subOARSAY with the ved plop. All wMk is
acciumly iqresantad on dw Asbuilt which has to tk Swd Of jedaL
Bed inspection due
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Ir�tellcs• e, di ioac.�: 8ace: �
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AS-BUILT CHEC LI T
LOT NUMBER, STREET NAME
�,. ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATION & DEMENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
�7. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
a LOCATIONS OF WELLS, DRAINS, WATERCOURSES
W/rN 150' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D-BOX
STAMP & SIGNATURE
FMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
a - FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
LOCUSPLAN
XAORTIq
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APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
ADDRESS/LOCATION OF PROPERTY:
DATE REQUEST FILED/READY FOR INSPECTION:
CLOSING DATE ON PROPERTY: h, 91 q
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED
ALL WORD. AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME.
A RE-INSPECTION FEE OF TWENTY DOLLARS ($20 . 00) WILL BE CHARGED IF
THE STRUC'T'URE DOES NOT MEET ALL APPLICABLE CODES.
SIGNED: