35-205 (6) FE z..............................
................_.......
�I THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
;n a ...... City __OF_.........Northampton ...... ...... ....................
Appliratiott for Diipo�:tl orka Cnojt� r rt"toff rani
for a Permit to Construct ( ) or repair ( ) an Individual Sewage Disposal
o�Application is hereby made o X
�ystrm
at:
Burts Pit Road .......................Lot 5
..................• •- --- ._........-•-••-••••-
�,oy� Wdivss
James
.._.-•-•.........................................• A dar"w
...................... Owner
......._..............................
.... ....................................................................
......................................................... Adess
InInstaller - dr1. 434 Acrd _
Sire Lot................••--•--.....
Type of Building Garbage Grinder (X)
Dwelling o. of I3edrooms---------3_._-__--•-.--••••----• ._.._.l.�;p;uiston Attic ( ) g
R"--- , Show•crs ( ') -- Cafeteria ( )
Other--Type of Building --------- ---------- No. of )ersons..._.._-..--------...._.
Other futures ...... - -•. ........................ _.._.._---. ._.__.........
gallons.
Design Flow- 55- ..._...gallon per pencni per day. Total daily flow...... _..�3_Q... ...............-----g�
---------------- - 1
Sel;tic Tan — ,iyuid capacity----150_ allons Length _-•--.. .. - ��'idth._...--i.- - . Diameter. .. --ca 1ae�ly_e,�7 Ga
l , `- �'o. 1
`�'idth_JP..-5 ... Total Length . 1.4 5 .._ Total hmch,ing•tet}��-------- -•--•-sf�p°FF.—
Disposal "� . Total lcaching area...... ... .......sq. ft.
�cepage Pit No.....-.- -- Dian;etcr.-_- Dcl)tl, below tniet-- ----------------
Other Distril ution box ( ) Dosing tank ( )
f)ercolation Test Results Performed by__.RPB...Huntley...A-3S.0 .C._-_.-._..--• ------ Date......5-13-.76. _.------..
Test Pit No. 1..... e.8..-minutes per inch Depth of Test i'it------V-0�...__ Depth to ground water_ _.N.Q_ne- .
Test Pit 'No. 2.-----------•--.minutes per inch Depth of "Ce t Pit.. ...9-�_ Depth to ground water----. None...._.
Description of Sol 9o.._OTS_..��2.�.0"...silty-...s,and..2 ' 9" ... .fine....and........
4 0 coarse...sand._-- ---
......... ............................
Nature of Repairs or Alter; tions --Answer when applica ,e
Agreement: tiew�a.,e 1)i 1 �1,stcm in accordance with
The under,,igncd at;rces to install the aforeilesi riled lu�lividu .l 1
_ I ot,,(. State Smiltary Gnh Tli furthf i agicu.s m)t b, plaice the system in
the proyi;irai> +f
operatioi-i until a Certilicate of Compliance has been issued ly the lx,,1"1 of health.
-•----------- ------ --•- ------
Sigurc -- - .._ ----- nape
Applicatu;n Approved BY--------- ----------- _. - -
- ---...--•-- --- -----_ -------------- - -------- e
A1;phcatVni Disapproved for tlrr folio-wing reasons:_.---- --
--- - - --------- --- -------- ---
• Issued-•--- ...-• - - - - .
-- ------------
1'eriztit No.._......... •-----------•--- t><<�
THE COMMONWEAI_7H OF MASSACHUSETTS
BOARD OF.. HEALTH
OF_
Crrtiliratr of (fotttplitturr
the Lui.�idu;l `�w^i c I)i�`I�,i,:�l .`iy.�teni r�mstnuir,l ( ) or Repain ( )
.-
_...... ...............
---..
at � -
-..--
;.�; lrcn in,i:�llcd in - _
:v, c in the I ( l do .(t il.
acoordlllce witn the pi-misi-Ili, 1�1
;il�phrati�,n i,�r I�i;l,���;al \V•�,ri::, l��m�.ir;u-tinn I'�•rniit `�,��. _ _ -
THE ISSUANCE OF THIS CERTIFICATE S14ALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
i , yr l