HomeMy WebLinkAboutCertificate of Inspection - 127 TUCKER FARM ROAD 9/28/2017 � • RECEIVED
SEP 2 a ni/
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
PUBLIC HEALTH DEPARTMENT
Camn)unily&Econonoic Developrnent
TOWN OF 1NC1W111 ANDOVER
SEPTIC DISPOSAL SYSTEM--INSTALLATION CER TIF°ICSA.°TION
'File undersigned hereby certify that the Sewage Disposal System( j constructed;( )repaired;
By:------------------_.—_.
(print Name)
Located at: i . :• A
(Installation Address)
Was installed in conformance with the North Andover Board of flealth approved plan,originally data!
and last revised on with a design flow of
. __--------._gallons per clay. 'I"he materials used were in conformance with those specified cna the
approved plan; the system was installed in accordance with the provisions of 310.CMR 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 ofl-lcalth.
13ottonr of fled Inspection hate:____. -r" --. .. ^fie_ '2 v t`3 ___ .. _ _ " _. _. —Vj
E gille I c Dar°cscrttativettire)
And—Print Name
N, . 2_0: ck( "I'liaLtur,41
I iiaalC'otastructionfns cctiora Date: tingineer I �presenfativ )
And Print Name
Installer: _ , (Signature) Date: � (_)j2
And—Print Name
Engineer: � i� (signature) Date:
And—Print Name
120 Main Street, North Andover, Massachusetts 01045
Pitons 978.688.9540 Fox 978.688.9542 Web litti)://www.northandovertua.gov