HomeMy WebLinkAboutSeptic - Installation Certification - 01.11.2007 - As-Built Plan / Installation Certificate Form - 345 BOSTON STREET 8/13/2019 TOWN OF NORTH ANDOVER NORTH
Office of COMMUNITY DEVELOPMENT AND SERVICES 3:O.s+�.� •'�O�i
HEALTH DEPARTMENT I.- ' ^ p
400 OSGOOD STREET
NORTH ANDOVER, MASSACHUSETTS 01845 's3ACHU6�S
978.688.9540-Phone
Susan Y. Sawyer, REHS/RS 978.688.8476-FAX
Public Health Director E-MAIL: healthdept(&-townofnorthandover.com
WEBSITE• http•i,www.towiiofnorthandover.com
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFIC ION
The undersigned hereby certify that the Sewage Disposal System (x) const ted, (*)'rrepffi
by
(Print Name) y��q o /v" 200?
located at S-t 2FE'-1 1—Q-c
(Installation Address)
was installed in conformance with the North Andover Board of Health approved plan, originally
dated 9/28/04 and last Revised on 11/08/04 , with a design flow of
550 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
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 of Health.
Bed inspection date: September 5, 2006
*inesesentative ature)
MacDowell
ame
Final inspection date: December 28, 2006
resentative(Sign re)
And-Print Name
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Installer: (Signature)
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