Lot 7 & 9 Applications & Permits 7- YS40
THE COMMONWEALTH OF MASSACHUSETTS
FEE
BOARD OF HEALTH
OF . LI 0CS T f-I Fi ' 1
,gppliratiun fur fliapuuai Works (nunutrurtiun Permit
Application is hereby made for a Permit to C pst;uct ("pG) r9 , Repair ( ) an Individual Sewage Disposal
System at:
-
. Location-nddres
t�G Fr 4vi t'A.;:T.,Owner /
Type of Building 4
Dwelling—No. of Bedrooms
Other—Type of Building No. of persons
Other fixtures
Address
cr
dd
Size Lot -Zs '> q feet
Expansion Attic ( ) Garbage Grinder ( )
Showers ( ) — Cafeteria ( )
Design Flow gallons per person per day. Total daily flow
Septic Tank— I:quid capacity.
Disposal Trench—No
Seepage Pit No Di
Other Distribution box ((z5)
Percolation Test Results P
Test Pit No. I i t in
Test Pit No. 2 mi
gallons.
ri
h4d`-' !"� Diameter Depth -f-[
sq. ft.
q. ft.
fo<.r•galions Lcngth.S _
_.... Width .0-• .�- Totsl Lengtla �-- Total leaching area. _,-
.-
ameter Depth below inlet Total leaching area
Dosing tank ( ) .T _
erformed by A, t") H:..in}._Fy .v._
mutes per inch Depth of Test Pit/ t!t�(-- Depth to ground water.l3.',-d1.1�
Depth to ground water 4''-t°'^
notes per inch Depth of Test Pit.a�-°= V g
Description of Soil ' C-
_
�. _ n•' .
.
T,fs:._.
J t
Nature of Repairs or Alterationd--Answer when applicable..
Agreement: -
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to pl:
operation until a Certificate of Compliances . r - ed b board a health.
Application Approved By
Application Disapproved for the following reasons-
Permit No
/ matt
Issued .3fl.k �s
by
THE COMMONWEALTH OF MASSACHUSETTS
THIS IS TO IF , TI
BOARD OF HEAD TH
f QInmptt
posal System constructed ( or Repaired
has been t- e with the provi t LE State Sanitary Cod as /of ' the application for Disposal W orks Construction Permit N o dated. `L s
��
Li� Lir^-fJ�-•--�'
Inspector
at
THE ISSUANCE OF THIS CERTIFICATE SH
SYSTEM WILL('?-t/-FUN 2T� TISFACTORY.
DATE d'- (JJ
ALL NOT BE CONSTRUED AS A GUAR NTEE THAT THE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF_ # 4.-e+r.-.-tr -�--.
Uinpnntti ttiork «ttnnsstrttrttntt Permit
7
Permission is hereby granted-___.._
to Construct ( L or Repair ( ) an Inds ideal Sewa e Disposal System
at No ✓-F" An . 11 f.. i, x-�v G - sire/ /'
-'' / r_4 Dated
as shown on the application for Disposal Works Construction Permit No
DATE
FORM 1255 HOBBS
C.. PUBLISHERS
,Roam elf tarUrs
;O....�.3
FE=-.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Aainliratiun far Uispa5a1 3&iurks (nunntrurtiun Permit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individu/ Sewage i posal
Installer
Type of Building
Dwelling— No. of Bedrooms
Other—Type of Building
No. o
Other fixtures
Design Flow gallons p
Septic Tank—Liquid ea y a s
Disposal Trench-- No. . 'idth
Seepage Pit No iameter
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by
Test Pit No. 1 minutes per inch
Test Pit No. 2 minutes per inch
Address
Address
Size Lot Sq. feet
Expansion Attic ( ) Garbage Grinder ( )
persons Showers ( ) — Cafeteria ( )
ily flow gallons.
Width Diameter Depth
Total Length Total leaching area sq. ft.
Depth below inlet Total leaching area sq. ft.
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
the provisions of TITLE 5 of the State S
operation until a Certificate of Comvlia
Application Approved By
Application Disapproved for the following reasons
aforedescribed Individual Sewage Disposal System in accordance with
y Code—The undersigned further agrees not to place the system in
issue+ by the boa ealth.
Permit No
Issued
Date
Date
iy
tt n--
tas been installed in aecerdance with he provts ons of TITI
application for Disposal Works Construction Permit No
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT
SYSTEM WILL FU t� ,3SA T S ORY.
DATE (i'Jl ✓ 7 `�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Tertifirate (Qnmplianre re
THIS I' 0 ERTIpY .; `:t he Individual Sewage Disposal System constructed ( or R epai d (
n
No
of State Sanitary Code a d J��d in the
dated ?J
BE CONSTRUED AS A GUARANTEE THAT THE
Inspector
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Biopooatipilnryo
Permission is h y grained "
to Construct ( R ( ividual S
at No _.sQIT'c`'4!n Street
as shown on the application for Disposal Works Construction Permit
inn Ile ft
sal,cJl�t rnJ
ag
DATE
FORM 1255
SULKIN. INC.. BOSTON
rz
c
_.
Dated C -ih
/Hoard of Health
No FEZ
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
City- OF Northampton.
Application for Dinpnsal 3Wlnrkn «nnstruriinn Vaunt
Application is hereby made for a Permit to Construct (x ) or Repair ( ) an individual Sewage Disposal
System at:
._.Sheper.d..AO].law 9
Ed & Barbara ItrATe rss Leeds, MA,= is^ ^_
Owner
h"me.r
Type of Building Size Ott 4 IS1 37Sq. feet
Dwelling—No. of Bedrooms 4 Fxpansion Attic ( I oage Grinder (X
Other—Type of Building _ No. of persons ( — Cafeteria ( )
Other fixtures
Design Flow 5.5 gallons per person ,(fcr day. Total dail i, VD 660 �gallpns.
Septic Tank—Liquid capacity 150 gallons Length 111 6 Width 5 " r i .- Dom 4
Disposabgpr�eS No 1 Width 7 ' Total t engthq 2 - ' T.• -sing are a47 (O-_sq. ft.
Seepage it No Diameter__ ._ - Depth below inlet rot,' it L king area _.sq. ft.
Other Distribution box ( X) Dosing tank ( )
Percolation Test Results Performed by Almer Huntley & Assoc . Date 06/06/84
2 minutes per inch Depth of Test Pit 8 ' Depth I gro
minutes per inch Depth of Test Pit Depth t
Test Pit No. I
Test Pit No. 2
Description of Soil
OTS
3" - 2 ' 6" Silty Gravel
2 ' 6" - 8 ' 0" Layers M-c Sand, F-M Gray
.Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to 'nstall the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— 'fhe undersigned furrier agree: tot to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed
Application Approved By
Application Disapproved for the Pilo wing reasons: ._. -.
Permit No Issued
e
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Tertifirtttr of fLnnt}Tlittnre
THIS IS TO CERTIFY, That the Inchvidunl Sewage Disposal System construrrc;l
or Repaired ( )
by
at
pans Lrrn installed in accordance with the provisions of Article XI of The State Saoii.:•. Code .is descrilcd in the
a;,gilic. 1 .n for Disposal Works Construrtinn Perna No ■]:r _
THE ISSUANCE OF THIS 1ERTIFICATE SHALL NOT BE CONSTRUED AS 3UARANTEE Tf!AT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector
No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
1liapnstt1 ilnrlts @Innstrurtinn Vain
FEE
Perms=ion is hereby granted _
to Construct ( ) or Repair ( ) an Individual Sewage Disposal System
at No
Si a
as shown on the application for Disposal Works Construction Permit No D:.tcd
DATE