Lot 27 Title 5 Application/Permits 1995 FOR 1-APPLICATION FOR DSCP
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Commonwealth oT\f;csxchtuetts
a/a/n/
NORTHAMPTON, Massachusetts
Application for Disposal System Construction Permit
Application is hereby made fir a Permit to C onstmct IS or Repair 1 ! an Utt site Sewage Disposal
system at
Location address or Lot'io
MAPLE RIDGE 1COAL)[L0T ? )
Installer';Name.AddresY,ur
i'pe of Bw Rine
Du Ana
one
tthx'
No of hi
O;rner's Name,Address and Tel. _
NIIC HALL AND R0BIATA i,AGA
31 tIOLDE\DRIVE
11.0RCSCE,AIA O1002
s.13i $8o-432o
Designer's Name. Address and l el.
\lacLea3 A coctate... Lnc.
102 Fudge Street
Shelburne Fels- ■LV 013"0
.1131 n25-n--4
. of Person __ Sher ets ('afetena -
- p Au ''0
of
alter PL.ane>
Design Flow TIO gallons per lac Calculated dcl I w
--3 gallon3
Plan Date I I 10 . Number of Sheets ONE Revision Dace I u
10_ Si IBSTREAS L SEWAGE DISPOSAL
PLAN IN N0R7 H VAIPTUA MASS FOR
MICHAEL. U R0111:11TA L,AG,A.MAPLE RIDGY ROAD t LOT 2D
Description o f Soil _ ELI \IEDIC31 SAND AND S ANDY TIt L SEE PI AN FOR DETAILED
IF PR DESCRIPTIONS. SEASONAL HIGH GROUNDWATER R AT 1 PERC RATE 10 AIIN. INCH.
..
WITNESSED BY PETER McERLAIN.TESTED BY TIMOTHY MAGINNIS 12 3—_— —. ---
Nature of Rgpair_or Alterations f Answer when applicable -- — — — —
Date last utipected.— _ S.A— -
T
undersigned agrees to ensure the constnichon and m trvnm on he ter nledkm .tte\£IeCrpe t
"(C(U(12:Tsposal sy stern ut accordance kph the pt ovIsions of Tide 5 of the Fin n nmt' l Code and not
place the,stem in operation until a s e,rUticate of Compliance lms been issued by this Hoard of Ilealth.
, a/r'rl..t. Iry __
Application Appianed b3 _
rptuCIII n Dnapproyeit the to]lowrn r a.in,—
Penult\'.--_ i L
Date is,uecI _8�r /Ai /
FORM 3-CERTIFICAI F OF COAPIIA CE
Commonwealth of Massachusetts
NORTHAMPTON, Massachusetts
Certificate of Compliance
This is to Certify, that the On-site Sewage Disposal System installed (N)
or repaired replaced( ) on
by for <IICIIAEL AND ROBERTA LAG.%
at MAPLE RIDGE ROAD (LOT 27)
has been constructed in accordance with the provisions of Title S and the for
Disposal System Construction Permit No. ir -±1( dated -/a/9,5%
_
Use of this system is conditioned on compliance
with the provisions set forth below
The issuance of this certificate shall not he construed as a guarantee that
the system will function as designed. The Certificate aspires on
Date Inspector
FOR11 2-DISPOSAI.Sl S f EM ('O\STRI C I70\ 1311141111
Commonwealth of\lassachusetts
NORTHAMPTON, Massachusetts
Disposal System Construction Permit
\o. 4-7
Permission is hereby granted to ABC1iAE1. .AND ROBERT.-11.AGi io
construct(N) or repair C an Un-site Sewage S}•stem located at
a .^-1 �� u MAPLE RIDGE ROAD (LOT 27)
a.c
4-3 cl
Y 'rwwo c,_,_'4
3 M
E ' rind as described in the above Application for Disposal System Construction Pennit. the
napplicant recognizes his her duty to comply with Title 5 and the following local provisions
Ti cnr special conditions,
7.51 c.
$ y SI
40 Na ,
r A1 construction must be completed within two scars of-the date L+clove.
to -co ci (0 �
' Date
Approved by
3-4. // /`/ %c�
FOR]1 1-APPI IC.ATION FOR DSCP
Fee
('oun u)i ealth of N lassachusclls
NOR'fll_AAtP'1'ON, lassachu.setts
Application for Disposal Sstem Construction Permit
Application is hereby made fore Permit to t'onslntcl tit or Repair an On-site Sewage Disposal system
at:
Location Address or Lot Nu. Owners Name Address and Tel. Il
LOT 27 MAPLE RIDGE
MICHELLE !CASKET
331 NORTfI FARMS ROAD
FLORENCE,MA
586-6128
Installers Name,Address,and Tel # Designers Name,Address and Tel#
Macleay Associates, Inc.
102 Bridge Street
Shelburne Falls,MA 01370
(413) 625-9774
Type of Building:
Dwelling No. of Bedrooms FOUR Garbage Grinder NO
Other Type of Building No-of Persons Showers_Cafeteria_
Other Fixtures
Design Flow 440 gallons per day. Calculated daily flow 672 gallons
Plan Date 11/10/95 Number of Sheets ONE Revision Date NONE
Title SUBSURFACE SEWAGE DISPOSAL PLAN IN NORTHAMPTON,MASS FOR
MICHELLE KASKEY MAPLE RIDGE
Description of Soil EINE/MED SAND AND SANDY TILL SEE PLAN FOR DETAILED TEST PIT
DESCRIPTIONS SEASONAL HIGH GROUNDWATER AT 120" PERU RATE 10 MIN./INCH
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected'.
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site
sewage disposal system in accordance with the provisions ofTitle 5 of the Environmental Code and not to
place the system in operation until a Certificate of Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issue
FOR11 1-,1PPL.I(' 1 FION FOR DSC'P
Fed
i tommum'eallh of:\lassac Mist:Its
NOILTII-1AIP'ION, Alassachusetts
Application for Disposal Slstenr Construction Permit
Application is he eby made Ri a :rand H ■ nshtLCI t Nl r P dpah di On-site Se'..:ge Disposal system
at:
Location Address or Lot No owners Niene. Address:nd Tel 4
LOT 27 MAPLE RIDGE
MICHELLE KASKEY
331 SORIII FARMS ROAD
FLORENCE,MA
58o-6128
Installers Name,Address,and'Fel. # Designer's Name,Address and Tel.
?,lacLeay Associates. Inc.
102 Bridge Street
Shelburne Falls,MA 01370
(413) 625-9774
Type of Building:
Dwelling No. of Bedrooms FOUR Garbage Grinder NO
Other Type of Building No. of Persons_Shower_Cafeteria_
Other Fixtures
Design Flow Si gallons per day. Calculated daily flow 672 gallons
Pan Date 1010/95 Number of Sheets ONE Revision Date NONE
Title SUBSURFACE SEWAGE DISPOSAL. PLAN IN NORTHAMPTON,MASS FOR
MICHELLE KASKEY MAPLE RIDGE
Description of Soil FIN&WED SAND AND SANDY TILL SEE PLAN FOR DETAILED TEST PIT
DESCRIPTIONS SEASONAL HIGH GROUNDWATER AT 120" PERT- RATE 10 MIN/INCH
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site
sewage disposal system in accordance with the provisions of Title 5 of the E:mironmental Code and not to
place the system in operation until a Certificate of Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit So
Date Issued