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HomeMy WebLinkAboutSeptic Installation Certification - As-Built Plan / Installation Certificate Form - 597 FOSTER STREET 1/13/2021 PUBLIC HEALTH DEPARTMENT Community 3 Economic Development TOWN OF NORTLI ANDOVER SEPTIC DISPOSAL, SYSTEM —INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(x)constructed;( )repaired; By. Daniel and Andrew Fonzi _ (Print Name)____ Located at: 597 Foster Street (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated 08.10.2020 and last revised on 11.05.2020 with a design flow of 330 - 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. Q 24.20 Bottom of Bed Inspection Date: 11. ___�_ Thad Berry Engineer Representative(Signature) And-Print Name 12.3.20 L741, ,j �7 19 Final Construction Inspection Date: Thad Berry Engineer Representative(Signature) And-Print Name Installer: D (Signature) �- Date:— 12.6.20 And-Print Name Engineer: _ _(Signature) Date: 12.6.2020 Thad Berry And -Print Name 120 Main Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov