Lot 2 Title 5 Application/Permits 1984 No.32- Ic
ECK OR FILL IN WHERE APPLICABLE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City OF Northampton
Fli w
irntirm fur Otspnsai 3Inrtts Cinnstruftinn Permit
lifation is hereby made for a Permit to Construct
at:
Marion Drive
Al Hankowsg.i -Addre"
oy
minus
Type of Building
Dwelling—No. of Bedrooms 3 Expansion Attic
Other—Type of Building No. of persons
Other fixtures
Design Flow 55 gallons per person per day. Total daily flow.. 330 gallons.
Septic Tank—Liquid capacity..151)0gallons Length Width Diameter Depth
Disposal Trench— No. Width Total Length Total leaching area
capacr 2 .s (t46GPD
Seepage Pit No 2 Diameter Depth below inlet 5 Total leaehingatca -3 .-tt.
Other Distribution box ) Dosing tank
( RPB Huntley,
Percolation Test Results Performed by Y. Date 6-7-$4
Test Pit No. I 6.0..minute=per inch Depth of Test Pit 4 '6" Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil 3" OTS 3 '0" sandy silt, 5 3" compact sandy till with cobbles
and..bauldees No-.ground-wat-er
g) or Repair ( ) an Individual Sewage Disposal
y
or
Address
Address
Size Lot Sq. feet
Garbage Grinder ( X)
Showers ( ) — Cafeteria ( )
Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedescrihed Individual Sewage Disposal System in accordance with
the provisions of 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation untilaa Certificate of Compliances been i�ssued by the board
ee/
Application Approved By /AC' - ..- ff Dot
Application Disapproved for the following reasons
Permit No 3_.2-1Y
Issued
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Cnrrtifiratr`
THIS IS TO CERTIFY/let-IA the It}u�(y11ua1 Sriv ethispAaTj ,, .: m constructed ( ) or Repaired ( )
by
._
at ..�
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code ',lex Mile
application for Disposal Works Construction Permit No dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS UARAAN E
SYSTEM WILL filiMaTION b4T CTORY.
DATE Inspector ! (
Installer
2---
THE COMMONWEALTH OF MASSACHUSETTS
y BOARD�i, � H
Sit No
37— it [�/ OF
Ilispasttl k nn „n irrmit
Permission s hereby granted
to Construct ( 1) or ituair ( 1 an Individu Sewage les
at No ,/t J
career
as shown on the application for Disposal Works Construction Permit NoSIA 81/ Dy ted //
ant' -% ILL-4- B 6)
DATE 1 e( rr
FORM 1255 HOBBS 8 WARREN. INC., PUBLISHERS
Health