486 Applications & Permits TIMOTHY E. MAGINNIS, RS
Environmental Consultant • Registered Sanitarian
70 Montague Road
Westhampton, MA 01027
(413) 527-5291
Northampton Board of Health
City Hall
Northampton, Ma 01060
Attn: Mr. Peter McErlain
Health Agent
Re: Northampton - Sewage Disposal
System - Final Inspection
486 Haydenville Road (Rt. 9 )
June 18, 1996
Dear Mr. McErlain:
This letter is to inform you that I conducted the final
inspection of the individual subsurface sewage disposal system
at Mr. J.A. Andrulis ' residence at 486 Haydenville Rd. in
Northampton, Ma.
Based on this inspection it appears as though the sewage
disposal system at this site has been installed satisfactorily
and in compliance with the State Sanitary Code Title -V. With
diligent maintenance and operation it should provide trouble
free service in the years to come.
If you have any questions please do not hesitate to contact
me.
Fn
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
or
Appliratiott foe Disposal i'ork a:Construction 1rrmit
Application is hereby made for a Permit to Construct ( ) or Repair (1/1an Individual Sewage Disposal
System at:
Lif-rf s'S I . / jib 41et
Address - or Lot No.
—......—.----t'i ,. ..;.)- 1-1-)••■-4-4,...—
fri 3. ,/ . owner r Address
Ce 711-jalf4 Clrit
Type of Building t.,, „,, „„. Address
Size Lot Sq. feet
Dwelling-No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
:3
ni Other-Type of Building No. of persons Showers ( ) — Cafeteria ( )
n■ Other fixtures
<C
Design Flow gallons per person per day. Total daily flow gallons.
Ill
C4 Septic Tank—Liquid capacity gallons Length Width Diameter Depth
Isl
• Disposal Trench—No Width Total Length Total leaching area sq. ft.
i Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
.>
X Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by Date
41
wl Test Pit No. I minutes per inch Depth of Test Pit Depth to ground water
Iz Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
g
O Description of Soil
g
(...)
ttl
X
O Nature of Repairs or Alterations—Answer when applicable. 4ea-4. , ....44 4-#3..4..1:raii.......„4".41.,,,d
.,,
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.
c > i .-4/ fl
Signed 4 • • . _
- J
//
f t .,,
Application Approved By - A.
.„j .4(.42:24.t A ---4H4.44.444.- 4
Application Disapproved for the following reasons• v
Date
/
Permit No.......L2i 2r. Issued 1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
L
t it1 OF -14.€4-i CS .0c., 6-..
flertifiratr of Qtnnlplianrr
THIS IS TO-CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (v)
by J.'am- j,. fr.. :......4-1 ‘._
p Installer
at ',L J. ,: 6<.,.,r��k._. T:o J
has been installed in accordanke with the provisions of Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No 3 F"Y dated Z41.1%. Li, /-y/f:._....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE 1,44-!.' L� 1. .ZC �ti.x . R
lad,
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
: -if J OF , r
;{r: d:MYa <a�
No. 34+ FEE
Disposal Forks l/tnnslruErfinn lrrmit
Permission is hereby granted ,..r;y.....,.} .ell-4;•••:
to Construct ( ) or Repair (gn an Ind.widnal Sewage Dis'pd4al System
at No Li r.i .1.14 t.-..prim ','iOJJO
Street
as shown on the application for Disposal Works Construction Permit No : f Dated t i / '
a;
swra er x 1
DATE
PORN 1255 HOBBB I, WARREN. INC.. PUBLISHERS
ri
tr.We . vt \ THE COMMONWEALTH OF MASSACHUSETTS
: a E. /A • 0:1 i.a ' • , MASSACHUSETTS
'lh �f
II„NO I F rm
\ s 0 ,�, 41 j-a lion for pisfrasal $getem' /Cans#rue#ion permit
A -?tom _.y made for a Permit to Construct( ) o (Repair ie an On-site Sewage Disposal System at:
Location Add'rqss or Lot No. owners Name.Address and Tel No. ss� —01436
486 I-igyOeravii LE ROA S, A. An117 RJ CIS
4% Naldaul ■ik Rd.
Installers Name. Address,and Tel.No. Designer's Name,'Address and Tel.No.
DONI W POE I .w THy 8 , NnP+6ora� �mS RS S .
go motJ(P(rfla. Rd. (A) 41,4114)
Type of Building: 62"1— S ly��
Dwelling No. of Bedrooms 3 Garbage Grinds -4-r
Other Type of Building Sit No. per Persons to Showers( ) Cafeteria( )
Other Fixtures .
Design Flow 495- / gallons per day. Calculated daily flow Sa3.2 0 gallons. (7
:, Plan Date //"27'q Nu ber of sheets / Revisiop Date _____ 1 Re�A'�
Title La N./ pF (io(doSSO buBSURF•Ce SHWA a U
Description of Soil ON — 6 OIL i I — ,,,h, •a C A LA. / f
lA/c T 'NO
Nature of Repairs or Alterat ions(Answer when applicable) A421,441 CC— S/ASTANOA2D '561..”9-6E
Del&SAL 4y • 7rM
Date last inspected:
r
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal
system in accordance with the provisi.-s of Title 5 of the Environmental l Code and not to place the system in operation until a
Certificate of Compliance ha :‘,s yed by this B$rd o ealth.
Signed �p r-s. - Date // 9� �-
Application Approytd by i� /�iil/ `4-z9---, Date 713 f/9 t'
lir
Application Qiiapproved for the following reasons
Permit No. Date Issued
THE OMMONW
Wda
ALTH OF MASSACHUSETTS
,MASSACHUSETTS
Certificate of Compliance or repaired/replacedx ) on —
THIS 1S TO CERTIF hat the On-site Sewage Disposal System fortallee( ) y
has been constructed in
f .0 i •b➢ ' ei7- 9� dated
at
accordance with the provisions of Title 5 and t this for system col dystem Concompli n compliance ewith No.
� � � i•�G L . Use of this system is conditioned on wmpliance with the provisions set forth below:
The issuance of this certificate shall not be construed as a guarantee that the system will function asdesigned. This
Certificate expires on ��i � �� t
„�■ / i /Jv Inspector
DATE p
THE COMMON EALTH e F MASSACHUSETTS 76 i
No 41_ 95- MASSACHUSETTS
!isposnl Sigstem Construction Permit
permission is hereby granted to
S. A . _ La .,2 ti L,-
to construct ) or repair
an an On-site Sewage System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his;her
duty to comply with Title 5 and the following local provisions or special conditions.
/i
All construction must be completed with��re`y of the date below.
• C_%/ �5 Approved by �l
DATE
FOCA,1255 Re
UDC Co-BOSCO