19 applications and permits by
THE COMMONWEALTH OF mADSAt.ntae.t is
BOARD OF HEALTH
OF
QItrtifiratt of fllampliatut
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
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
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector
No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Elispasttl
arks Olanntruttian termit
FEE
Permission is hereby granted
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
at No Street
as shown on the application for Disposal Works Construction Permit No Dated
Board of Health
DATE
FORM 1255 A. M. SULKIN. BOSTON
CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City Northampton OF
piiratinu for 1Binpnzal Works (nnnstrurtinn lrrmit
is hereby made for a Permit to Construct ( ) or Repair ea) an Individual Sewage Disposal
19 QQl mtx$t_Way _.... _............_.._..__......_...._ or Lot Nn.
Location-Address
Frank Heston 19 Country Ways h1o,Et1I 1Q tGS1s. Ma • -...
Owner
Installer
Type of Building
Dwelling—No. of Bedrooms 3 Expansion Attic ( ) Garbage Grinder ( )
Other—Type of.Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Address
w?t'ot 0.52 Ac_
Size Lot
Ions per person per day. Total daily flow 330 gallons'
Septic Tank 55 g� Pe P p y' y
Septic Tank—Liquid capacity1.5.0-0gallons Length...1.0 ' Width...5 I Diameter Depth.....4•
Disposal Trench—No. 8 Width A' Total Length.4.00.4J.-- Total leaching area..2.r4.00—..sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
Other Distribution box ( x) Dosing tank ( ) Date
Percolation Test Results Performed by
Test Pit No. 1 minutes per inch Depth of Test Pit Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil
Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersi ed further agrees not to place the system in
operation until a Certificate of Compliance has issued by b f health.
Date
Application Approved By
Application Disapproved for the following reasons
Permit No
Date
Date
Issued.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
or eli
,r1
tifirafe of Otnittpliattre
nragidualsSewag Disposal System constructed e ) or Repaired ( )
er
THIS IS TO CERTIFY, That the
• , ‘,
by
at
has been installed in accordance with the provisions of Artie e IC? of The State Sanitary CtOe as described in the
application for Disposal Works Construction Permit No dated - '149 'el
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUA r I ANTEE THAT THE
SYSTEM WILL°FUNCTION SATISFACTORY. .,
DATE - i - Inspector
No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
A .1-
f c:/) e/-:CI
OF
FEE
Bisposallitiork Tottstitutint tivrmit
Permission is hereby granted 1 ^ .i., -.? .1--..9“( 444 (.4
to Constra4(4 or Repair ( ) an Indthdual Sewage Disposal System
at No ie.. ."24-..-t-Lit- /Te et"....
Street
as shown on the application for Disposal Works Construction Permit No ate
it d fr /y/
is.-4-7„,.. r,,_,,ii•- „; 1^,tkrt-ircl
Board of Heal*
DATE acct..). 324 if . .—
FORM 1255 itiOSSI3 & WARREN. INC.. PU•LISKERS
C
4
k
J
4
No '
FEE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.Appliratinn fur Motional iiii urkko' Qlnnstruftinn Permit
Application is hpreby made for a Permit to Construct (f )or Repair ( ) an Individual Sewage Disposal
System at: j ;�pw((_�-•''��//�
LeeutW/ddrea
Gr alai / nr. /`2+ Par.
Owner Addrda
(:
v Lot
� !.:�
Installer
Type of Building
Dwelling—No. of Bedrooms Expansion At
Other—Type of Building No. of persons
Other fixtures
Address
Size Lot Sq. feet
c ( ) Garbage Grinder ( )
Showers ( ) — Cafeteria ( )
Design Flow (,. gallons
Septic Tank—Liquid capacityLQ ..gallons
Disposal Trench—No Width
Seepage Pit No
Other Distribution box
Percolation Test Results
Test Pit No. 1
Test Pit No. 2
per person per day. Total daily flow gallons.
Length Width Diameter Depth
Total Length Total leaching area..... 71 sq.ft.
Total leaching area sq. ft.
Diameter Depth below inlet
Dosing tank ( )
Performed by
minutes per inch
minutes per inch
Description of Soil
Date.
Depth of Test Pit Depth to ground water
Depth of Test Pit Depth to ground water
Nature of Repairs or Alterations—Answer when applicable
Agreement:
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
operation until a Certificate of Compliance has been issued by the board of health.
Signed - 2:?• . .L •.•i `.,; d< tL
f L..iig.-y.vf -1 f. 4_ ,.° .•,C L/.. Ate
Application Approved 1 y ., :,a.,,.T.t.tc.t, yOri r
Date
Application Disapproved for the(oilman° reasons'
Permit No /
Issued "`le
1) rate
Date
CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City OF Northampton
Oration fur 3llinpuzal
rr;
n is hereby made for a Permit to Construct
System at:
19 CQUAL.CY....Jiay
Frank Heston
Location.Address
Owner
FEE
arks Tunatrurtinn tiennit
or Repair Q(X) an Individual Sewage Disposal
or Lot No.
19 Country Way, Northampton, Ma.
Address
Installer Address
Type of Building Size Lot 0. 52 Ac . MX
Dwelling—No. of Bedrooms 3 Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow 55 gallons per person per day. Total daily flow 33D gallons.
Septic Tank—Liquid capacity1.5.0C-gallons Length_-1.0 ' Width is. Diameter Depth ¢'
Disposal Trench--No 8 Width A' Total Length.4.OD...1.£-.. Total leaching area-2-,-4-0-0 sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
Other Distribution box ( x) Dosing tank ( )
Percolation Test Results Performed by Date
Test Pit No. I minutes per inch Depth of Test Pit Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil
Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System
the provisions of TITLE 5 of the State Sanitary Code— The undersig ed further agrees not to
operation until a Certificate of Compliance has n issued by bo f health. •
Signed.
Application Approved By
Application Disapproved for the following reasons'
in accordance with
place the system in
10-/1 -i"f
Date
Permit No
Date
Date
Issued_
by
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Qtrrtifiratr of C omplianrr
THIS IS 7' ERTTIFY at th Individual Sewage Disposal System constructed ( ) or Repaired (X)
at. 17
has been installed in accordance with the provtst. .f TITL, T}he State Sanitary Cod�% descr ed in the
application for Disposal Works Construction Pe 'o 7)/5.. i/ dated / )/ ,I..0
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUES AS GUA
SYSTEM WILL F NCTION SATISFACTORY.
DATE .. 7 Ago Inspector
No
NTEE TH/1 THE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Binomial Works Qtonotrtution hermit
FEE
Permission is hereby granted
to Construct (2') or Repair ( ) an Individual Sewage Disposal System
at No 4_.r Street
as shown on the application for Disposal Works Construction Permit No Dated
B9e d f Health
DATE
FORM 1255 A. M. SILL KIN. INC. BOSTON
CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Application for Disposal
II
FEE
inks Cionstruttion permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
. - Lotation‘Address I • /
or Lot No.
Installer
w'Aress
ree, r dd(I L1
Address
Type of Building
Size Lot Sq. feet
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow gallons per person per day. Total daily flow gallons.
Septic Tank—Liquid capacity gallons Length Width Diameter Depth
Disposal Trench—No, Width Total Length Total leaching area sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area. sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by Data
Test Pit No. 1 minutes per inch Depth of Test Pit Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil
Nature of Repairs or Alterations Answer when applicable :\
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the 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.
ltigned
Application Approved By 1-•r1114`
Application Disapproved for the following reasons
Date
Data