Lot 15 Title 5 Application/Permits 1992 CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH OSCV
City OF Northampton
,Application for 33iopooal nrkn (nonstrnriinn perm
Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage
System at:
maple R idge Road
Location•Address
T-Qactoovar ts._..DS.a.slcy -2.96._as.'dge..-14Oad-TA
Lot 15 1 O5V)
or Lot No. 0
Type of Buildi
Dwelling—No. of Bedrooms 4
Installer\
orthamptcut.,...MS
BB
Address
Size Lot....5L .531 Sq. feet
Expansion Attic ( ) Garbage Grinder (x)
Showers ( ) — Cafeteria ( )
Other—Type of Building No. of persons
Other fixtures
Design Flow 110 gallons
Septic Tank—Liquid capacity.150.Qallons
Disposal Trench—No. 4......._.. Width...2
Seepage Pit No Diameter
Dosing tank ( )
Performed by_.Ehartter._Eng...._Corp.. Date_A1.22/86
minutes per inch Depth of Test Pit Depth to ground water 50"
minutes per inch Depth of Test Pit Depth to ground water
per person per day. Total daily flow
Length__1D ' Width..5.a.1.22. Diameter
Total Length 120 '
Depth below inlet
449
gallons.
Depth 4'
Total leaching area. 549 sq. ft.
Total leaching area-- sq. ft.
Other Distribution box
Percolation Test Results
Test Pit No. 1....3
Test Pit No. 2
Description of Soil 0=12"
12.-24"
24.-.8.4"
Nature of Repairs or Alterations—Answer when applicable
Tpp.s.a.ii.
&i1.ty._svhs.a.i1
Compact silty. ll
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Enviro mental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compli ce has been issued by t e board of health.
Application Disapproved for the following reasons:
Application Approved By
Permit Na
Issued
tint
CHECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City OF Nor tham;>ton..
Application for lainpnuttl Harks Cnonstrurtion
Application is hereby made for a Permit to Construct (x ) or Repair
System at:
....Maple..Eid4a...Road
Lcoation.Address
----Sames.-AS.o£sK .
owner
an Individual Sewage Disposal
Lnt_13
or Lot No.
{514- 2eai)
296-.&r-zd e--Road Jett-h-aintatetir44k----
Installer ' Address
Type of Building Size Lot §4.r.5.34.---..Sq. feet
Dwelling—No. of Bedrooms 4 Expansion Attic ( ) Garbage Grinder (x )
Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
Other fixtures
Design Flow 1.1.0 gallons per person per day. Total daily flow 4.4.0 gallons.
Septic Tank—Liquid capacity_L5Qljallons Length._1.0 ' Width_5._17..:. Diameter Depth..4'
Disposal Trench—No 4........... Width_2 ' Total Length..12f1' Total leaching area..54Q sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
) Dosing tank ( )
Performed by_Pharmet._Eng_._Cotr Date_4122.411 i
minutes per inch Depth of Test Pit Depth to ground water....5.0"
minutes per inch Depth of Test Pit Depth to ground water
Other Distribution box
Percolation Test Results
Test Pit No. 1....2
Test Pit No. 2
Description of Soil 0.-12" Spps.011
12..=24't S.i 1.ty:...suhso.il
24.-8.4" Camp.ac-t._silty
..til
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 Environmental Cod—The undersigned further agrees not to place the
system in operation until a Certificate of Complignce has been issued by the board of health.
Application Approved By
ign
Application Disapproved fqr the folio reAr?nr:
Permit No.
Issued
as
Dme
e
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH,
OF Certifi MIP P
T IS IS TO CE TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by
has b e nit d in a rddaaoce with tne prfocprons ir E 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. J ,�''�1y_' dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT It C:vs+RUED AS A GUAiTT THE
SYSTEM WILL UNCTION SATISFACTORY. /
DATE /71 Inspector ._...a S Jt�.v. �`_
Rat,jG
N o..6—4r
THE COMMONWEALTH OF MASSACHUSETTS
Bis}Tnsa.
Permission is hereby granted
to Construct ) qr,�t it ) a
at No ' .N
BOARD OF HEALTH
OF/1/0-1.S.
.. ....P�
arks Finns n lrrmit
iv,duai Sew..S !tisposal "stem
Street / G
as shown on the application for Disposal Works Construction Permit 1e�../� Dated -J7/-(
f
Berk of Health
DATE 111
/ )- /11 )—
FORM 1255 HOBBS B1/WARR EN. INC.. PUBLISHERS