HomeMy WebLinkAboutMiscellaneous - 104 BROOKVIEW DRIVE 4/30/2018r
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' MAP #
PARCEL #
LOT # 1 Z
STREET�YUOICV 1 Qua��.p
CONSTRUCTION APPROVAL
HAS PLAN REVIEW FEE BEEN PAID? YES NO
PLAN APPROVAL: DATE lll� P. BY 1J_�e�t-1k-
DESIGNER: 1�-� s /4 PLAN DATE 7 q
CONDITIONS
WATER SUPPLY:TOW WELL
WELL PERMIT DRILLER
WELL TESTS:
PLUMBING SIGNOFF
COMMENTS:
CAL DATE APPROVED
I DATE APPROVED
BACTERIA II\ DATE APPROVED
WIRING "aIGNOFF
FORM U APPROVAL: APPROVAL TO ISSUE ES NO
DATE ISSUED jy' BY r "%
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID YES NO
WELL CONSTRUCTION APPROVAL YES NO
SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO
OTHER YES NO
ANY VARIANCE NEEDED
YES NO
FINAL BOARD OF HEALTH APPROVAL: DATE: BY:
A
SEPTIC -_SYSTEM INSTALLATION
IS THE INSTALLER LICENSED? YES./ NO
TYPE OF CONSTRUCTION: /ANEW REPAIR
NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEWN.0-
CONDITIONS OF APPROVAL YES NO
(FROM FORM U)
ISSUANCE OF DWC PERMIT L- -Yp�S' NO
DWC PERMIT PAID? NO
DWC PERMIT NO. �� INSTALLER• c,
BEGIN INSPECTION �f NO:
EXCAVATION INSPECTION: NEEDED:
PASSED �/ %5'r�' BY
CONSTRUCTION INSPECTION: NEEDED:
n
AS BUILT PLAN SATISFACTORY: YES: 1-
r,
kr�
APPROVAL TO BACKFILL: DATE:/BY_
FINAL GRADING APPROVAL: DATE /BY
FINAL CONSTRUCTION APPROVAL: DATE: BY
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FRU- "L i NTl OC C r IN"
The undc;
by
TOWS OF NORTH ANDOVER
SEWAGE DISPOSAL SYSTY.M
LNI STAT,.LATXON CERTIFICATION
3. n. 17 1956 0_ 39PM P2
hereby ccrti--�• that the Sewage Mpes.<l Sysma (J`} constrach.,d; ( )repaired;
P 8 rec tJ
,001 ;ei.j eve.
/2„
was in,, -,tilled in :onformauce with Oho North Andovsr Do u -d of i-Teal°:h xpprovcc ptrr,, Systcn:
Design Permit # z/3 dared 7� v 4th as approved design flow of '/—/z)
gallozlS p� day. The rn¢torithls used x'ex� itt c�nforr±tance .�-ith those 3p�•cified on the app.aveC
plaxh; the systcm. was installed x aoeordance with the prnvisicr;s of 110 C&R, 15.000, Tide and
local regulations, ax•d the ><`vwl Sidra& agree$ subsumially rv:tlh the auproved plan. All w•irl~ is
Accurately represented on the As -built which, has been sub-nitteJ to the Bove, of �ma;th
{.
Bed imeoaon date; "/` .i?
Final i:tsper lGn date'
Tnspe�tcr
Installer::..-- ..o• #: Date: ,
Design Engznca/�y�
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27.00'
a
11 100'
50,480 S. F.
1.16 Ac.
BROOKVIEW
DRIVE
0
�= D
36.50' v'
rr
J
A30..4'
SL
119.7' PSG 26.0'
48.6'
4� 0
EXIST. FN D.
T.F. EL.=127.31'
/ p0 EX. CAL.
SEPTICICTANK
Q 13'
20' 112.6'`
CONC. 12 n
G
D -BO
O
43,763 S.F. o
12 1.00 Ac. ('V
A
B
100 FT. WETLAND
C BUFFER LINE
EX. 3' X 50' TRENCHES.�,A
V
N
OPEN SPACE
00
12.06'
EDGE OF WETLAND
ELEVATIONS TAKEN AT TOP OF PIPE
TOP OF FOUNDATION: SEE PLAN
PIPE @ DWELLING:
125.21
TANK IN:
124.84
TANK OUT:
124.45
D -BOX IN:
123.58
D -BOX OUT:
123.39 (ALL)
END PIPE - A:
122.85
END PIPE - B:
122.85
END PIPE - C:
122.85
AS—BUILT SEWAGE DISPOSAL
S i STEM PLAN
LOT 12 BROOKVIEW DRIVE
NORTH ANDOVER, MASS.
PREPARED FOR
BRnnK\iIE\ni rr)U\ITRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
N
Ln
N
O
_T
_
JUN 2 4.:� .
s
Q0
17.5'
C
Ln
N
MARCHIONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE., SUITE I
STONEHAM. MA. 02180
(617) 438-6121
SCALE: 1=30' DATE: 6/12/98
M & A FILE No.: 351 — 22
e
NORTh
o �
F w
P
40 ,, � ►
,SSACHUSEt�
Town of North Andover, Massachusetts
BOARD OF HEALTH
DESIGN APPROVAL FOR
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.
Site Location
Reference Plans and Specs.
19
Form No. 2
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
6 11
Fee &C
CHAIRMAN, BOARD OF HEALTH
Site System Permit No
C/4 3
NORT1y
Oe t�`aO 4,
3? a r a OL
h A
SSA�MUSE
Applicant
Town of North Andover, Massachusetts
BOARD OF HEALTH
1319
DISPOSAL WORKS CONSTRUCTION PERMIT
Form No. 3
NAME ADDRESS TELEPHONE
Site Location
0 C k
Permission is hereby granted to Construct (✓f or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. q43
Fee 74i-' C
,422t7z==-2
CHAT MAN, BOARD Of HEALTH
D.W.C. No.
_'/ r't'
v
t�
gp 1 1 � [Juzi
27.00'
100'
50,480 S.F.
1.16 Ac.
o�\
BROOKVIEW
DRIVE
° =
4�,
O
36.50'
N
I/
/ 11.3'
L 30.4'
/4fc)l))
48.6'
'
EXIST. FND.
T.F. EL.=127.31'
00
/ P 16' o h
119.7' G _., . „ 26.0
12.06'
EDGE OF WETLAND
ELEVATIONS TAKEN AT TOP OF PIPE
TOP OF FOUNDATION: SEE PLAN
PIPE ® DWELLING: 125.21
TANK IN:
124.84
TANK OUT:
124.45
D—BOX IN:
123.58
D—BOX OUT:
123.39 (ALL)
END PIPE — A:
122.85
END PIPE — B:
122.85
END PIPE — C:
122.85
AS—BUILT SEWAGE DISPOSAL
SYSTEM PLAN
LOT 12 BROOKVIEW DRIVE
NORTH ANDOVER, MASS.
PREPARED FOR
BROOKVIEW COUNTRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
N
rn
L
O N
L0
N
17.5'
MARCHIONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE., SUITE I
STONEHAM, MA. 02180
(617) 438-6121
SCALE: 1=30' DATE: 6/12/98
M & A FILE No.: 351 — 22
L� V 2.00'
50,480 S.F.
1.16 Ac.
100'
BROOKVIEW
DRIVE
36.50'
/ ��11.3'
S��
�P
L 30.4'
119.7'-18 r, .c^^ ^26.0'
7's
48.6'
4
2' 26 \'
AA d
EXIST. FND. c'
T.F. EL.=127.31'
�n n
12.06'
EDGE OF WETLAND
ELEVATIONS TAKEN AT TOP OF PIPE
TOP OF FOUNDATION: SEE PLAN
PIPE ® DWELLING: 125.21
TANK IN:
124.84
TANK OUT:
124.45
D—BOX IN:
123.58
D—BOX OUT:
123.39 (ALL)
END PIPE — A:
122.85
END PIPE — B:
122.85
END PIPE — C:
122.85
AS -BUILT SEWAGE DISPOSAL
SYSTEM PLAN
LOT 12 BROOKVIEW DRIVE,
NORTH ANDOVER, MASS.
PREPARED FOR
BROOKVIEW COUNTRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
N
0)
L
00011 C� N
LO
(N
17.5'
MARCHIONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE., SUITE I
STONEHAM, MA. 02180
.(617) 438-6121
SCALE: 1=30' DATE: 6/12/98
M & A FILE No.: 351 — 22
27.00'
o`\
BROOKVIEW
DRIVE
11 100' 36.50' C\t o
50,480 S. F. J
1.16 A C . 11.3'
off, PS��
30.4' w
o.
16
�� • � 119.7' 26.0' .
00
i
-:.
4A'.
Ao
EXIST. FND.
T.F. EL.=127.31'
12.06'
EDGE OF WETLAND
ELEVATIONS TAKEN AT TOP OF PIPE
TOP OF FOUNDATION: SEE PLAN
PIPE ® DWELLING: 125.21
TANK IN:
124.84
TANK OUT:
124.45
D—BOX IN:
123.58
D—BOX OUT:
123.39 (ALL)
END PIPE — A:
122.85
END PIPE — B:
122.85
END PIPE — C:
122.85
AS -BUILT SEWAGE DISPOSAL
SYSTEM PLAN
LOT 12 BROOKVIEW DRIVE
NORTH ANDOVER, MASS.
PREPARED FOR
BROOKVIEW COUNTRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
17.5'
Q0
L0
N
MARCHIONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE., SUITE I
STONEHAM, MA. 02180
(617) 438-6121
SCALE: 1=30' DATE: 6/12/98
M & A FILE No.: 351 — 22
El
1111101111111111111
Town of North Andover, Massachusetts Form No. 3
f NORTH BOARD OF HEALTH
o t,'.°
3? e B .. a OL c/ 19 ! 0
O �
I 9
DISPOSAL WORKS CONSTRUCTION PERMIT
,SSACHUSEt
Applicant—67C�z�
NAME ADDRESS TELEPHONE
Site Location
Permission is hereby granted to Construct (/ Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMAN, BOARD Of HEALTH
Fee ��� D.W.C. No. /- Y
FORM U'- LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/perrr its from
Boards and ^--partments having jurisdiction have been obtained. This does not relieve
the applicant andlor landowner from compliance with any applicable or requirements.
"'APPLICANT FILLS OUT THIS SECTION
APPLICANT//e
Z—
Z
.U, 6 �&1--44C/PHONE
LOCATION: Assessors Map Number 7�' PARCEL_
SUBDIVISION J�
LOT (S) =_
STREET ST. NUMBER
"""'OFFICIAL USE ONLY
DATIONS OF TOWN AGENTS:
TION ADMINISTRATOR DATE APPROVED
DATE REJECTED
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATE APPROVED
O� -D DATE REJECTED
TH DATE APPROVED y/r_T — p
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Town of North Andover, Massachusetts Form No. 3
f,40RTN BOARD OF HEALTH
1
19 �0
�..
''qS^,�•� 'tom
HuS� DISPOSAL WORKS CONSTRUCTION PERMIT
S�c
Applicant
NAME
Site Location
ADDR
0 1 J, v -)7 -
LE
Permission is hereby granted to Construct (V� or Repair ( ) an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
CHAIRMAN, BOARD OF HEALTH
Fee—•�� � �
D.W.C. No. LY
27.00'
0,
11 100' 36.50' ,_ c
50,480 S.F. -�
BROOKVIEW
®RIVE iii_
'o 1.,.7
fi'?
4
-:.
1 Qo
1.16 Ac. �� ��.o'
EXIST. FN D.
T.F. EL.=127.31'
0 — f
pis20,
12
43,763 S. F.
1.00 Ac. o
O
o
100 FT. WETLAND ('V
BUFFER LINE
230'g1 N
OPEN SPACE
00
Lo
N
EDGE OF WETLAND N
O
N
CoQ
►►\N S U R��44
THIS PLAN IS INTENDED FOR ZONING
PURPOSES ONLY. IT WAS PREPARED
FROM EXISTING PLANS AND RECORDS
WITH THE STRUCTURES SHOWN LOCATED
BY AN INSTRUMENT SURVEY. THIS PLAN
SHOULD NOT BE USED FOR PROPERTY
LINE DETERMINATION.
17.5'
WE HEREBY CERTIFY THAT WE HAVE EXAMINED
THE PREMISES AND THAT ALL APPARENT
EASEMENTS AND ENCROACHMENTS ARE LOCATED
AS SHOWN. THE STRUCTURE SHOWN CONFORMS
TO THE ZONING LAWS OF THE MUNICIPALITY
WHEN CONSTRUCTED. ALSO, ACCORDING TO THE
F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP,
COMMUNITY PANNEL NO. 250098 0009 C
DATED 6/2/93 , THE STRUCTURE IS NOT LOCATED
IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE.
CERTIFIED PLOT PLAN
LOT 12 BROOKVIEW DRIVE
NORTH ANDOVER, MASS.
PREPARED FOR
BROOKVIEW COUNTRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
MARCH ONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE. SUITE I
STONEHAM, MA. 02180
(617) 438-6121
SCALE: 1 "=30' . DATE: 4/8/98
FA
O
BROOKVIEW
27.00
DRIVE \V oc�
-Qo
17
r-
Qo
Z� 600 41�_ 1\ _ 8 0
48.6'
11 100' 36.50' _c N
50,480 S. F. 'f
1.16 Ac. �11.3 44 0,
0�
'v EXIST. FND.
T.F. EL.=127.31'
o
P
2 0'
12
43,763 S. F.
1.00 Ac.
0
0
100 FT. WETLAND
o
BUFFER LINE
Ln
230.91 N
®PEN SPACE
N
i
F
9
tv og�o� STEPH G EDGE OF WETLAND N
4 3I
�Q
\N SUR0
THIS PLAN IS INTENDED FOR ZONING
PURPOSES ONLY. IT WAS PREPARED
FROM EXISTING PLANS AND RECORDS
WITH THE STRUCTURES SHOWN LOCATED
BY AN INSTRUMENT SURVEY. THIS PLAN
SHOULD NOT BE USED FOR PROPERTY
LINE DETERMINATION.
WE HEREBY CERTIFY THAT WE HAVE EXAMINED
THE PREMISES AND THAT ALL APPARENT
EASEMENTS AND ENCROACHMENTS ARE LOCATED
AS SHOWN. THE STRUCTURE SHOWN CONFORMS
TO THE ZONING LAWS OF THE MUNICIPALITY
WHEN CONSTRUCTED. ALSO, ACCORDING TO THE
F.E.M.A./H.U.D. FLOOD INSURANCE RATE MAP,
COMMUNITY PANNEL NO. 250098 0009 C
DATED 6/2/93 , THE STRUCTURE IS NOT LOCATED
IN AN ESTABLISHED 100 YR.FLOOD HAZARD ZONE.
CERTIFIED PLOT PLAN
LOT 12 BROOKVIEW DRIVE
NORTH ANDOVER, MASS.
PREPARED FOR
BROOKVIEW COUNTRY HOMES
P.O. BOX 531
NORTH ANDOVER, MASSACHUSETTS
17.5'
MARCHIONDA & ASSOC., L.P.
ENGINEERING AND PLANNING CONSULTANTS
62 MONTVALE AVE. SUITE I
STONEHAM, MA. 02180
(617) 438-6121
SCALE: 1"=30' DATE: 4/8/98
9
FORM U - LOT
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
p 7
APPLICAiTT • �C �' pU; c'rcJ �dv.� l �'y c5 Phone �u ' Q J~J
LOCATION: Assessor's Mat) Number Parce?
Subd4 ,vision ,L� cc�G',°�`�J ,ez-5,T4- SS treet "glee 67 (rv-, t'
Lot (s)
St. Nu-lber
****�c�t�i�c�c t�F�t�eicic* Eic�c�k**�t�irQfi1C1a1 Use Only************* Ficic�cic�c�c�cic*x
i
RECOMHENDATIQ11 ', OF OWN AGENTS:
Date Acnrove-
Ccn : at_on fid_.._. iszratcr Date Re; ectad
_ .�
,, v Vt
Date Armrovei
Town Planner kJ Date Re;ec-ad
FCC
:vcr�:s - se-.:er,'water ccnnec-_ons
- dr_vewa:• pe=it
F=re Derar-mert
Date Approved
Date Re;ec-ed
Date Apprc7ed
Date Resect=_
Recei�:ed by Building Ins-pectCr Date
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
July 9, 1997
Mike Rosati
Marchionda & Associates
62 Montvale Ave., Suite 1
Stoneham, MA 02180
RE: Brookview Circle
Dear Mike:
30 School Street
North Andover, Massachusetts 01845
This letter is to inform you that the proposed septic plans for Lots 1, 11,
12 and 13 Brookview Circle have been approved.
If you have any questions, please do not hesitate to call the Board of
-Health office at the number below.
Sincerely,
Sandra Starr, R. S.
Health Administrator
cc: Wm. Scott, Dir. CD&S
File
Dave Kindred
CONSERVATION 69R-9530 HEALTH 688-9540 N.ANNTNr 688-9535
SEPTIC PLAN SUBMITTALS
LOCATION:
NEW PLANS: YES
REVISED PLANS: YES
$60.00/Plan
$25.00/Plan
DATE: G L,-,?
DESIGN ENGINEER:
When the submission is all in place, route to the Health Secretary
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
30 School Street
North Andover, Massachusetts 01845
June 16, 1997
Marchionda & Associates
62 Montvale Ave., Suite 1
Stoneham, MA 02180
RE: Lot 12 Brookview Circle
This is to inform your that the proposed plans for the site referenced above have
been disapproved for the reasons below. If new plans satisfactorily addressing
all these issues are submitted to the Health Department by June 20, 1997, then
approval for the plans should be given by June 27, 1997.
1. Only 2 copies submitted. (NA 6.01)
2. Plans do not show legible signature. (310 CMR 15.220(2))
3. Log missing for TP 30B, and it's in the middle of the system.
4. Perc elevations missing. (NA 6.02j)
5. Manhole on tank within 6" of grade missing. (310 CMR 15.228(2))
6. Reserve not 4' from primary. (NA 2.23)
If you have any questions, please do not hesitate to call the Board of Health
office at the number below.
Sincerely,
Sandra Starr, R.S.
Health Administrator
cc: Wm. Scott, Dir. CD&S
File
Dave Kindred
CONSERVA710N 6R$-9530 HFAI,'M 688-954.0 PLAM1 TNO 689-9535
NORTH ANDOVER BOARD OF HEALTH
DESIGN REVIEW REPORT
DATE Co // Aa
FEE: *o PERMIT # DATE RECEIVED
APPLICANT P4tIE- lelt)6 4'-6b MAP PARCEL
ADDRESS LOT ## STREET #
ENG. 547V STREET-0,leWXl)/6&-) °
ENGINEER'S ADD.
PLAN DATE �6-//,?/97 REV.
CONDITIONS OF APPROVAL
APPROVED
DATE
DISAPPROVED
REASONS FOR DISAPPROVAL:
,G
06 s Y s7-6 M
Mio� T
lql651A)6, (,V4
�( Sco/7-
LOCATION: 1,J—
NEW
,L
NEW PLANS: 6)
REVISED PLANS: YES
DATE: C121 Z/z f /7
DESIGN ENGINEER:
SEPTIC PLAN SUBMITTALS
$60.00/Plan
$25.00/Plan
When the submission is all in place, route to the Health Secretary
PLAN REVIEW CHECKLIST
ADDRESS L- /Z -54natf 016: , ENGINEER
3ENERAL
3 COPIES STAMP
LOCUS I/ NORTH ARROWy SCALE
:ONTOURSf,z PROFILE I/ (Sc) SECTION- / BENCHMARKy SOIL &
'?ERCS ELEVATIONS WETS. DISCLAIMER 4�--' WELLS & WETSy
4ATERSHED?A/o DRIVEWAY (, WATER LINE b-' FDN DRAIN L/ M&P
!i3CH40y TESTS CURRENT? L -----
SEPTIC TANK
SOIL EVAL 7-,
`SIN 1500G—/ .17 INVERT DROP L,GARB. GRINDER_kO(2 comps +200)
10' TO FDNB/ MANHOLE ELEV L---� GW
# COMPS. GB L,�
D -BOX
SIZE
# LINES FIRST 2' LEVEL STATEMENT
INLET Q&�IZ - OUTLET /2,3.00 = ` /% ( 2" OR .17 FT) TEE REQ' D?_zeo
LEACHING v
MIN 440 GPD? RESERVE AREA/ 4' FROM PRIMARY?/�
100' TO WETLANDS 100' TO WELLS 4 TO S.H.GW
2% SLOPE
(5'>2M/IN)
20' TO FND & INTRCPTR DRAINS 400' TO SURFACE H20 SUPP L�
4' PERM. SOIL BELOW FACILITY �� MIN 12" COVER L- FILL? 15')
BREAKOUT MET? !/
TRENCHES /
MIN 440 gpd SLOPE (min .005 or 6"/100') �SIDEWALL DIST. 3X EFF.
'W OR D (MIN RESERVE BETWEEN TRENCHES?y IN FILL?L-----' MUST
BE 10' MIN. L--' 4" PEA STONE?VENT? (>3' COVER; LINES >50')
BOT S� + SIDE- _ /0 0 X LDNG = TOT 4j?� 7 10W
(L x W x #) (DxLx2x#) (G/ft2)
Copyright 9 1996 by S.L. Starr
t
APR 1� ,
APPI
TION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: `f CURRENT INSTALLER'S LICENSE#
LOCATION: 4�6 lao c 1/Ge-q-,
LICENSED INSTALLER:
SIGNATURE: - TELEPHONE# 22,241
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
$75.00 Fee Attached?
Foundation As -Built?
Administrative Use Only
Yes No
Yes v No
Floor Plans? Yes �._ No
Approval l/�/ C/�%�,� Date: /�/
_TUL__ 6_15J8 MON 10 :57
FROM FL,lNTLOCK,tNC.
The
by
RHONE NO, : 19786834430
TOWN OF NORTH ANDOVER
SEWAGE DISPOSAL SYS7CJir'Mf
IINSTALLATION CERTIFICATION
P.0:2
Jun. 27 1996 01:39PM P2
hereby certify that the eSmaga Dispas�l System J) ) constructed; { ) repaired;
located at eropp ioi 19e, ,,d
/Z
was 1;dsWled is conformamce with the. North Andovcr-Board of 14calth approved Plan, System
Design Acrrait # ` rf� slated 7,,Z2 &Z with an approved desist flow off"`/-/zD
olom per day. The materials used wext ixt oonformmme with dosesposcifiedonte approved
plm; the systom was installed in accordance with the provisions of 310 CN RL 15.000, Title 5 and
local regulations, am.d tho fma., w4AS agree$ S0$1U1WlY with the approved plan. All work as
Accurately represented on the As -built which has been submitted to the Sowd of Health,
Bed inspection date; d
s�d r
r �
Final inSp6Gta8A date' __....
Inspector
Design Engimecz,4