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NO......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
rl-V.... ...........OF................. ...................
for Dingusal Marko (gonotnutivit rprutit
Application is hereby made for a Permit to Construct (✓f or Repair an Individual Sewage Disposal
System at:
Ze.C............................ ..............................................................................««........»...«.
),,,Locatiun-Address or Lot No.
.............. A1?........... . 4 t 6. .....................«...........«
ef.w..'sAj...........................
Owner Addre"
......... .........
.............................................Install er......................................... .............................................Address...............................----------
T,W of Building I Size Lot............................Sq. feet
Dwelling—No. of Bedrooms..........4..............................Expansion Attic ( ) Garbage Grinder (
04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteri—a (
Otherfixtures .......................................................................................................................................................
Design Flow..............Xta.......................gallons per person per day. Total daily flow...........jina........................gallons.
Septic Tank—Liquid capacity/V�aja..gallons Length..Jt.:-&".. Width.P.-' Diameter................ Depth..Y.......V...'
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.........Z......... Depth below inlet..( Total leaching area.IC Ki........sq. ft.
her Distribution box Dosing tank
Di
t�k Of ti, ;-./.--X.. Date....... /...............
ation Test Results Performed by.a/./`/`,.)4.')-..-.,:,/�re�.V-
't
AL t Pit No. I......:3.......minutes per inch Depth of Test Pit...1�1 �(....... Depth to ground water.....y
ME
"Z�' ALMER
Pit-No. 2...... .......minutes per inch Depth of Test Pit... Depth to ground water.. ........
TL
.............................................................................................................................................................
bN TL E IR 1:�'
Iesc*Von ..... .............
P 941,ib- of
? . . .... ..........................................................................................................................................................................
.........................................................................................................................
')Nj'0 L ........ . . . ............................................
r i or Alterations—Answer when applicable...............................................................................................
..........
Agreement:
1�� The undersigned agrees to install the aforcdescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
opexatiou until a Certiricate of Compliance has been issued by the board of 4ealth.
Signed..;,.................................................................................. .................................
A pplication Approved By..........................
I Dat✓
Application Disapproved for the follouring reasons:........................................................................................................
.....................................................................................................................................................................................................
Date .
PermitNo....................................................... Issued...........------.........._............................
Date
. . ........................I.........I..............I.........................................•.......................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........................I................OF.... ..............................................................................
(Irdifiratr of Toutphattrik
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
by..................................................................................................................................................................................................
Iiistaller
at....................................................... ............. ...................................................................................................................I...........
has been installed in accordance with the provisions of Article X1 of The State Sanitary Code as described in the
application for Disposal Works Constriction Permit No.......................................... da ted............................._..................
THE ISSUANCE OP'THIS CERTIFICOATE SHALL NOT BE CONISTRUED AS A. GUARANT04 THAT 714#0.
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................ Inspector....................................................................................
. .......................................................................... 0........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
No......................... .............I................... .....1 OF.................................................................................... Fzz........................
Uttipaoul Works Tonotrurtivit Pruitt
V
Permissionis hereby granted.........................................................................................................................................--
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
atNo...............................................................................................................................................................................................
t
i ,vot I
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
............................................ ...........................I........ ...................
DATE............. . ..................... ...........................................
roltm 1205 Mona$ & W.&MRIN. INC. PUBLISH9110
7, "k �41"W"
. �
THE COMMONWEALTH mpMASSACHUSETTS
� B =ARD OF HEALTH
^
�� K�F----.4��^�.7-Yel .......................
Apphration for UK sposal W Tomitrudion lie=mit
Application is hereby made for s Permit to Construct (44mr Repair an Individual 3mm,uge Disposal
oNnmwmmat:
�$ ................ ..............-........-.............................................-...-....
-'--~---
Location-Address L., N..
. ------'---~---------- _`____ ........................ ...~....
owner A���
'~^-----'---------~^~---------------------------''-' ----------------------------------------------'-'
Address
TjW of ]0oi1d6mg Size Lot............................Sq. feet
Dwelling--No. of Bodromoua---'- ...............................Expansion Attic Garbage Grinder
Other—Type of Building ............................ No. of persons............................ Showers ( ) -- C-.fet!!-;_-
Otherfixtures ................................................................................ ......................................................................
Septic Tank—Liquid capacity,6vaa.gallons Length.X.''d,." Width.A..... Diameter................ Depth..�'.'"-'*V
�kher Distribution box Dosing tank 4
a ion Test Results Performed by.-2.16.M.
ALMER 4 Pit*No. 2..............minutesper inch Depth of Test Pit... Depth to ground water.. ......
_t_11_NT
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operatior. uw.il a Certilicate of Compliance has b"n issued by the board of health.
pplication Approved'
By................................
.-_-
Application Disapproved for the folImping reasons:................................................. ......................................................
----
-------`----------`---`--------'—`--------'-----------`-'---------`-----------`-----`---
� Date
PermitNu......................................................... Issued.................. .....................................
Date
. . ...........'...............................................................................".........^...........
^.."..
THE cowmowWEALT* OF "xAssuc*uSsrrs
BOARD OF HEALTH
�
.........................................OF........................................ ............................................
_� `
����tifir��te �W� �&��«o4»�u�ua»ir«/ i
THIS IS TO CERTIFY, That the Individual Sewage Disposal B;amm constructed ( ) or Repaired ( �
ny.................. ................................................................................................................................................................................
Installer
at........................................... -......................................................................................................................................................
has been inauUoJ in accordance with the provisions of Article Xl of The State Sanitary Code as described in the
application for Disposal Works Construction Permit 0o............................... ......... d:t,6-..... .... -....... ......................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTV THAT ���
SYSTEM WILL FUNCTION SATISFACTORY.
DA3I .-.--------------_--..------..-----.. Inspector....................................................................................
� .................................,... ..................................."...........
^...^."^°..^.^.....^^..,,,,..°^^.^,.^,.
THE COMMONWEALTH orMASSACHUSETTS
BOARD OF HEALTH
--------------��F.------------------.----.---'
No......................... Fnz........................
�� °� ��
/�K������� ��D���� ���D����������� 1��rutit
Permission is bccrby granted.........................................................................................................................................
~~
to Construct ( ) or Repair ( ) ao Individual Sewuge Disposal System
atNu..............................................................................................................................................................................................
^*,oa' ,
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
~'~'^~--'~~''~-'-'~~----------------~'-^'~~~----~
DATE............. . .........--..... .......... ................................
r»nm 12155 wvmwwe, w^mRuw. INC. runuw°MIS
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NOTES
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NOTES and Data — (For department use)
i
r
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anti State ZIP code Tel. No.
lc k l C'u Ca S< g� jl
Owner or Ln
Lessee
Builder's
2 r\sZ_l.>J u,t���` �(� License No.
Contractor
wt 1ti��
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Sign re A t Address �L pplication date
S
�Z� D��
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate ote
Permit or Approval Check Obtained Number By Permit or Approval Check 0btai ed Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued �T 19Z_
Building Fire Grading
Permit Fee $ _ r7. /. Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TI L
0 CITY OF NORTHAMPTON
�� *! MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page '* Plot { _ APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICTS
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE ��� / 2< C"
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -�
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 �❑ Amusement, recreational
J new bousing units added, i/ any,
in Part D, 13) 13❑ Two or more family — Enter 19 �❑ Church, other religious
number of units— — — — --)P. 20 �❑ Industrial
3 Alteration (See 2 above) 14 ❑ Transient hotel, motel,
21 �❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — -- 22 �❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 �❑ Hospital, institutional
Part D, 13)
16 Carport 24 �❑ Office, bank, professional
6 ❑ Moving (relocation) jJ
1 Other — Speci/y 25 Public utility
7 ❑ Foundation only 26 �❑ School, library, other educational
B. OWNERSHIP 27 �❑ Stores, mercantile
8 Private (individual, corporation,
28 �❑ Tanks, towers
nonprofit institution, etc.) 29 �❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,,•,••,•••••••• � C,i°l school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical....................... 454
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $` Z),G�CU
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories................ h
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on r. r
32 ❑ Structural steel dimensions ....... 57
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specifv 42 Public or private company 50. Total land area, sq. ft. ........... Z Q/ C C7 C5
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
37�j Electricity 441❑ Yes 45 � No L. RESIDENTIAL BUILDINGS ONLY
53. Number of bedrooms.............
38 ❑ Coal
39 Other — Specify Will there be an elevators Full...
X
�1�v�J 54. Number of
46 ❑ Yes 47 No bathrooms Partial........
hereby certify that the proposed' work is authorized by' the owner of, recd
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT ��'
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 1q '.
?1/71
3�� -- t
r DEPT. FILE CORY
DEPATMENT OF BUILDING INSPECTIONS fA,�+
212 MAIN STREET BUILDING a.a
NORTHftWTON' MA. 01060 PERMIT
�VALIDATION
35 • 168
DATE San amhar 26_ 1980 PERMIT NO. 510_
APPLICANT John Carver ADDRESS
(N0.) (ST EET) (C ONTR'S LICENSE)
' NUMBER OF
PERMIT TO NQti' A�Tallin --(-2--) STORY flf+a..famity rasidenc_e DWELLING UNITS
(TYPE OF IMPROVE NT) N0. (PR OSED USE)
ZONING SR
AT (LOCATION) Burts Pit Rd !x
-, t. DISTRICT
(NO.) (STREET)
a BETWEEN AND
�o (CROSS STREET) (GROSS STREET)
a
LOT
IL SUBDIVISION BLOCK SIZE
a
U BUILDING IS TO BE 24 FT. WIDE BY L KG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
B
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
C �-_,,�1
IL REMARKS: f nA = ^r new enemf anvil y dwell I & i nc tg� *�_,., •.*•+^�--burns ng stoves.
Wood frame, electric heat, private sewage disposal, public water supply,
2 bedrooms, 1 full baths ' 0--.q
PERMIT $ �O
VOLUME ESTIMATED COST FEE P r
(CUBIC/ QUARE FEET)
OWNER oh-0 & Churl(Jtta corye7. BU LDI EPT
,
-Ma. 0 BY
ADDRESS 175 Drno r not Ctrnnt ln r��smpf n� r
(Affidavit on reverse side of application to be completed by authorized agent of owner)