HomeMy WebLinkAbout- As-Built Plan / Installation Certificate Form - 542 SALEM STREET 9/28/2018 (3) ccro�6 RECEIVED
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HENLM DEPMOMEN1.
PUBLIC HEALTH DEPARTMENT
Community s Economic Development
TOWN OF NORTH ANDOVER �� w
SEPTIC DISPOSAL,SYSTEM[—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( )constructed; repaired;
By: Bateson Enterprises
(Print Name)
Located at: 542 SALEM STREET
(hnstallation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
AUG. 223,2018 —,__ and last revised on_N/A __.._ _._.._.x 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 of310.CIVIR 15.000,Title 5 and local
regulations,and the final grading agrees substantially with the approved plan. 11 work is accurately represented on
the As-built which has been submitted to the Board of Health.
N
Bottom of Bed Inspection Date:9/5/18
Engine Represent a(Signature)
John D.Sullivan III, PE
And—Print Name
Final Construction Inspection Date:917/18 '
Engine Re es` a i Signature)
John D. Sullivan 111, PE
And—Print Na�.m,
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Installer: nature) Date:
And—Print Name
Engineer: (Signature) Date: 9/11/18
r " John D. Sullivan ill, PE
And—Print Name
120 Main Street, North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov