HomeMy WebLinkAboutSeptic - Installation Certification - As-Built Plan / Installation Certificate Form - 300 FOSTER STREET 6/21/2020 RECENED
JUN 212020
OF NORTH ANDUVER
T NTH DEpomENT
PUBLIC HEALTH DEPARTMENT
Community&Economic Development
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL.SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( )constructed;(x)repaired;
By:Bateson Enterprises _
(Print Name)
Located at: 300 Foster Street
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
11��1 g j j,� and last revised on 1/8/20 with a design flow of
1 I o 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.Af�vorl'accurately represented on
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the As-built which has been submitted to the Board of Health. �
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7 r
Bottom of Bed Inspection Date: 5/29/20 ! 1
EngineeVRepitese t a Signature)
John D.Sullivan ill,PE f -'
And—Print Name
Final Construction Inspection Date: 6=0 �
Engineer�pi-24d-&e(Signature)
John D.Sullivan Ili,PE
And—Print Name
Installer• gnature) Date: 30
And—Print Name
Engineer: (Signature) Date: 70
r :1 J nt.'�� ►7�Y
And—Print Name
120 Main Street,North Andover,Massachusetts 0184S
Phone 978.688.9540 fax 978.688.9542 Web http://www.northandoverma.gov
PUR11C HEALTH DEPARTMENT
community&Economic Development
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( }constructed;(39 repaired;
By:Bateson Enterprises
(Print Name)
Located at: 300 Foster Street
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
1115/19 i j L,� and last revised on,1/8/20 ,with a design flow of
/ / gallons per day. '£he materials used were in conformance with those specified on the
approved plain;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.Aor 's accurately represented on
the As-built which has been submitted to the Board of Health.
1 f
Bottom of Bed Inspection Date: 5/29/20
EngineetRepilse a Signature)
John D. Sullivan III, PE 1
And—Print Name
Final Construction Inspection Date: 6/2120
Engineer RApre ive{Signature)
John D. Sullivan III, PE ((��
And—Print Name
Installer: (Signature) Date:
And—Print Name
Engineer: (Signature) el- Date: {�ivy _ail
And—Print Name
120 Main Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov