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35-227 (5) spy THE COMMONWEALTH OF MASSACHUSETTS GARY R. BOARD OF HEALTH SWANSON CITY ' No. 7 93 ................ ... ....................OF.......NORTHAMPT ...................................._... p irMtiou for Dhipoind Workii Tomartirtiou P.rrutit plication is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal J Sy em at: V5 LADYSLIPPER LANE LOT N0. 12 1 .............. ...................................................... •.............. LAWRENCE Aft&Ttdress 65 WHITELOAF Rb" r'tOUTHAMPTON MA ......................_•--................... .....••••--•-••-••----•------._.._......_.._... ...................•--.......•-----•-...... t.1................................... _......._. W Owner Address ......................................................... e� Installer Address 32 432 UType of Building 4 Size Lot._ .!...................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (XX) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------- -----.....................-----•••...-••-••-------•••••••-••-------•................•---..........------•--.......----•-... cz� Design Flow.11 O,,,GAL.BDRM., gya tit uxo per day. Total daily flow.......4.4.0............... ............ga�llons. W. Septic Tank—Liquid capacity1•5GO.galIons Length.•- 6'�..... Width.6.8......... Diameter................ DepthA.5 '....... x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.....I—.......... Diameter_?5X.12,bepth below inlet-_-5.,33... Total leaching area....524......sq. ft. z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed bPXRY...R-.-- SWANSON,-_•P-,_E-,•�JHW_.. Date6mi=.$4_.._ 5-29-84 0-1 rest Pit No. 14.2.........minutes per inch Depth of Test Pit ................. Depth to ground water.NONE......_... w Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil......__.61" TOPSOIL' _SANDY SUBSOIL. .1 .'...COARSE SAND TO...FINE, „ GUV-EL.�...b-•• . - -••- ' MEDIUN....l'O..COA(tSE..SAND N x .........--• .. ...........................•----........---•-•--.......---•----.....-----•-•-•-•...--•••---•-----•----•-•-•-----••--•--•-• ............................................................. V Nature of Repairs or Alterations—Answer when applicable.............................•---_-•._----.---------------------------------------------------- •-•----•-------------••--.............................................................................................._.............._........................----•.................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ' 'tlie provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... .....------...•-•---......--••-- Date ApplicationApproved By........................................................ .........._............................. Date Application Disapproved for the following reasons:................................................................................................................ ..........-•-•--•--....._•---•-•-••.....................•-•....................................-----.................•-----.......••••-•-••-•----••-•---------•-•-----•----•...-•----•--••--••--......... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY OF. NORTHAMPTON ................................................................................... Trdif irttfr of Tomptittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( X) or Repaired ( ) by............................•------•-----•-----......-•--•-•-----..-....-•---..............------------.......-._.-...........------.........------.......-...--•--......................._....-•-- LA DYSL I P P ER LANE LOT NO. 12nstallei at .......................... ..• •• •.•. -•--...._..............------............................--•-•---•--•--•--••---...-•----............-----•----•-•-•-----...... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector................ •--........._.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............CITY...............OF.........NORTHAMPTON ........................•-•..._....................... No......................... FEE........................ Blopoott1 lVar1w C onotrurtiuit Prrutit Permission is hereby granted...........LAWRENCE AUDETTE to Construct (( X) or Re air ( ) an Individual Sewa e Disposal System at No........ ADYSLIPP R ,LANEI...�-.OT...NOA.....i ._..... --------------------------- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... .................................................................................................. Board of Health DATE................................................................................ FORM 1258 HOBBS & WARREN. INC., PUBLISHERS FRONT Vill. ZONING PLAN EXAMINERS NOTES SIDE YARD SIDE YARD REAR YARD IX. 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A,udette Address 65 Whiteloaf Rd., Southampton Applicant Same Address Same Use: 1st Residential Occupancy 2nd Same Occupancy 3rd Occupancy 4th Occupancy Zone District SR Required Inspections: New Building k Existing Building Elevator ? / Electrical Plumbing ' r� Fire l Building 'jI Other Inspector of Buildings IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, strut, city, and State ZIP code Tel. No. Owner or �t� � "i.l"�: j��As°. S�»�r ei,�o � ��- S o a 73 a 766 Lessee 0J67" S Builder's 0-?7 2. License No. (/.7 Contractor 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. Signat of applicant Address / Application date DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes 9 Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date D Permit or Approval Check Obtained Number By Permit or Approval Check Obtta t 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 VII. VALIDATION Building ' l� FOR DEPARTMENT USE ONLY Permit number yl Building Q�� Use Group Permit issued Building ,0� Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load A d by: Drain Tile $ Plan Review Fee $ TITLE �•.. CITY OF NORTHAMPTON $+ MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS Page 3S' Plot 247 APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete ppallyll items in sections: 1, 11, 111, IV, and IX. O I• AT (LOCATION) V 14z)y, f1/-t ZONING /t` DISTRICT- LOCATION IN 0.) (STREET) OF BETWEEN �J�/` K Tr 6,,, AND BUILDING yy rr31.,, (CROSS STREET) (CROSS STREET) LOT SUBDIVISION /t�Gr�l7S LOT A? BLOCK SIZE 3 �J N 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 [K New building Residential Nonresidential 2 ❑ Addition(If residential, enter number 12 ❑ One family 18 Amusement, recreational of new housing units added, if any, in Part D, 13) 13 ❑ Two or more family - Enter 19 ❑ Church, other religious number of units- - - - � 20❑ Industrial 3 ❑ Alteration (See 2 above) 14 l t l t h i Transent hotel, motel,❑ 21 ❑ Parking garage 4 [:::] Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (If multifamily residential, of units ------- - -i 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) 7 [__1 Foundation only 17❑ Other - Specify 25❑ Public utility 26 ❑ School, library, other educational B. OWNERSHIP 27❑ Stores, mercantile 8 5jq Private (individual, corporation, 28❑ Tonks, 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 (j (, processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement•,•••••,••.•..,. 1 Q UU 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..................... '! b. Plumbing ..................... (f oo c. Heating, air conditioning.......... 6 o d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ A GUD 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............... 31 ® Wood frame 41 [VJ Private (septic tank, etc.) 49. Total square feet of floor area, all floors, hosed on exterior f U 32 ❑ Structural steel dimensions ..................... 33 Reinforced concrete H. TYPE OF WATER SUPPLY ) 34 ❑ Other - Specify 42 ® Public or private company 50. Total land area, sq. ft. ........... � 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 Gas Will there be central air 52. Outdoors........................ 36 ® Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 ❑ Yes 45 'Y No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other - Specify Will there be an elevator?D Full.......... D 54. Number of 46 ❑ Yes 47 No bathrooms � Partial........ u ° ? u p C by ON o Z � m v � 0 3 z > mo 0 rTj D U z -r+ Vx �� m i Lh o � Lh \, / M &A ) q ® / \ � . � � � � / � \ � �� }n % tA � % : n = � ITIM �\ n �_ ®• o . 00 / )� ) ƒ ED ® > ± \ ! : « 0 0 » ;a § & , Q m . > / \ 2} �� § q I < / 2 � 9 § � 9 ` o , T VI > § r ■ / / }� � n , % m . I � ( ® a On } ` / ) ) � ' \ ( ) » ; > ,xy m , : t � � §• ( �� . Z ; - ! a L r Z s m ce- ? z M " F CV J N n + O a N v t.0 O CJ c Z v oc^t u ¢ m rl O s H o H o r % C� N t rv1/�R J C j O W t) rw V t!1 i v > �2 ps., J Vf O i7= W.J „ H ro jW a Q 1 0 +j zo a a 10 w f N s a Ix V) 0 O— T J N Olvd a`Q •H _ ZO • 1Nnoo4v ' M- o 1- J >' � W ^) 7} O ,^ F 3 LL ? mm U ... O tD —1 W W 1^ Z 00 (1) 0 z Q Q tj J J ig J CL ono � 6 = m `Q' a tQ 43)- < = W cc W 1- 0 M W ft3 IC Y OC O = E < O J V Z N N > > F 1� • O O o ^' a W �- V CD 'FJ N 'n w 4. 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