HomeMy WebLinkAboutInstallation Certification - As-Built Plan / Installation Certificate Form - 249 REA STREET 10/19/2021 PUBLIC HEALTH DEPARTMENT
tommunily&Economic Development
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System( )constructed;04 repaired;
By:Jim Heider, Heider Buiding Associates
(Print Name)
Located at:249 Rea Street
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
March 26,2021 and last revised on May 24, 2021 ,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:9/10/2021 iEYllsi
Engineer Representative(Signature)
Will Schkuta, PE
And—Print Name
Final Construction Inspection Date:9/17/2021
Engineer Representati re(Signature)
Will Schkuta, PE
And—Print Name
InstalleriL (Signature) Date: 9-29-2021
Jim Heider, Heider Building Associates
And—Print Name
Engineer: Crt,trv. (Signature) Date: 9�Z9/ZEiZI
John M. Morin, PE
And—Print Name
120 Main Street, North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov