HomeMy WebLinkAboutInstallation Certification - As-Built Plan / Installation Certificate Form - 130 REA STREET 4/27/2020 ' RECEIVES
low"OF NOR3 R MENT R
H�d.TH EPA
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;(Y4 repaired;
By: James Kellett
(Print Name)
Located at: 130 Rea Street
(-Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
September 9,2019 and last revised on_November 18,2019 ,with a design flow of
440 _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.
Bottom of Bed Inspection Date:" 3/2/2020
Engine •Represent ve(Signature)
Benjamin C. Osgood,jr.
And—Print Name
Final Construction lnspcetiun Date: 4/10/2020 G
Engine r t' a(liepresentaSignature)
Benjamin C.Osgood Jr.
And—Print Name
Installer: _ (Signature) /1 `�y �e(y)
6y7/,n
Engineer: _ CAL , 4
yOM Q.�C
120 Main Street, North Andover,Me 9n x, vr� V n a,61e 4/ o
Phone 978.688.9540 Fax 978.688.9542 < / / b ��J�+277
,6Q— O1OTQ..;elam Y
NORTH ANDOVFR
Massachuse#is Toni Wolfenden <twolfenden@northandoverma.gov>
130 Rea Street
Timothy Breen <breenmulch@gmail.com> Wed, May 13, 2020 at 12:07 PM
To: Toni Wolfenden <tolfenden@northandoverma.gov>
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Visit us online at www.northandoverma.gov.
Tim Breen
Peter Breen Excavating
North Andover I MA
978-265-7484