35-228 (4) i
0= yG THE COMMONWEALTH OF MASSACHUSETTS
GARY R. BOARD OF HEALTH
SWANSON
°v No. 7 93 ` .............CITY..............OF.......NORTHAMPTON................_.-_..._................._.....
t�flirtttiou for Diupouttl Worko Touutrurtiou Frrutit
plication is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
Sy em at
q�z/ LADYSLIPPER LANE LOT N0. 11
- _ ............. dress........... ........_..... ................ --........... ...............
LAWRENCE At�J•eWT"T�aar"' 65 WHIT ELOA F RTC*.t N�OUTHAMPTON MA
...•......................... ....•----•-•----.........-----•------------_.._ .._..........................-----......--- ,......................---•--....._..i_.._......
Owner Address
W
Installer Address 32 466
Type of Building 4 Size Lot.......t....................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (XX)
pa Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P4 Other fixtures ......................
Design
W Flow.�.�O...GAL t f BDW,...6dXUAWX per day. Total daily flow.......44.0.............................�.lons.
Se tic Tank—Li uid ca acit Y1-500-g�Mons Len th.12.6 .... Width.65......... Diameter................ DepthA.5 ......_..
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.....I............................ Diameterl.b.-5X 12,$jepth below inlet---5135. ... Total leaching.area....5. 4......sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed b3 p!°.!RY__.K,.,•SWANSON�...P_,.E.,./JHW... Date.....................I5-29-84
Test Pit No. I....2.........minutes per Inch Depth of Test Pit..3............... Depth to ground water.... .... ----....
�14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O ` .....................................................
Description of Soil........... ' TOPSOIL 1 ' SUBSOIL;_. 1..'.__ COARSE SAND•._...7'__ FINE GREY SAND
U ...............•----..........--•-•.._.. .•-•-••......•...... •••.............._........ -• ....... ..••...... .....•... .............- ••. -•............---••-••••........---
W --------------- -------------------•--._._...------------------...---------------------•-•-------•-•----•-•-------...._..-----------•-•-----•-•----...................................................
UNature 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 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.
Signed...................................•--••---..........------•••••.....-•-.............. •.................
Date
Application Approved By............................................. •--••.........--•-••Da--••....._--•---
..................................................... Date
Application Disapproved for the following reasons:..............................................................................................................-
---•-••...............................•-••••••••••-•••••....................................................................-•••-•---••••-•-----••-----•------..................... . •--•--......_
Date
PermitNo......................................................... Issued--------------------------------------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................CITY............OF......NORTHAMPTON............................................
Tertif irtttr of Toutplitturr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( X) or Repaired ( )
bY.................................................••---••--•........_..........•----•---.....--•--•.....................................................................................------••--•--
LADYSLIPPER LANE, LOT N0. 11 Installer
at.......... ............................• .............. ---•--- ......-... . ............._...
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated------------------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.....................:..............................................-•-----•---•. Inspector------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............C ITY...............OF.........NORTHAMPTON
No......................... FEE........................
Diopouttl Worko Touotrurtiott rprutit
Permission is hereby granted...........LAWRENCE AUDETTE .......................••-.-.--.-,........,..-•...-........................
-
to Construct (( X)) or Re air ( ) an Individual Sc a Disposal System
at No......LADYSLIPP R...LANE,�...LOT NO.. ......... ..............................•----------------...---...........-••-•-......---........
Street
as shown on the application for Disposal Works Construction Permit No..................... Dated..........................................
• ---••--••--••-•--•-•..................••. --•-•-----•------------...•---•-.............................
Board of health
DATE................................................................................
FORM 1235 HOBBS & WARREN. INC., PUBLISHERS
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NOTES and Data — (For department use)
C I T Y n r O R T H r "? P T
June 19, 1 q85
T-HE BOARD OF PUBLIC ',•IORKS
The undersigned respectfully petition vour honorable holy for
permission to install a driveway at lot Yt11 , "Tinkham Woods" off of
Westhampton Road. Twency-four (24) maximum width at the street line.
Gutter drainage not to be disturbed. Driveway surface to be paved
if the grade of the proposed driveway exceeds 3% or more.
By' ' /
err�uae't'�-
65 White Loaf Road
SouthaMPI-n 527-7766
Inspected by:`ti
THE BOARD OF PUBLIC TIORKS
Voted that petition be granted.
i
Acting Di ector of ubl' Works
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee f�!
/ Builder's
2. License No. 7
Contractor
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signs re of applicant Address Application date
t
00 NOT WRITE BE 0W THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Permit or Approval Check ObDta ned Number By Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Bui Iding �-+ Use Group
Permit issued _ � 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�+ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN (/✓ r � lnl0 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION J- l�•�t��o] LOT� BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
m
—f
1 X New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 n Church, other religious
number of units— — — — --o- 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 parking garage
4 a Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (if multifamily residential, of units ——————— — -- 22 ❑ Service station, repair garage
enter number of units in building in 15 FV Garage 23 Hospital, institutional
Part D, 13)
6 Moving (relocation) 16 Carport 24 Office, bank, professional❑
�
17 Other — Specify 25❑ Public utility
7 Foundation only
26 F__1 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 [K Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9E:] Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,•••••••.•,.,• 00 school, secondary school, college, parochial school, parking garage for,
deportment store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical..................... /�jd�) •
b. Plumbing ..................... '7TJovi
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ 800
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS `}
30❑ Masonry (wall bearing) 40 ® Public or private company 48• Number of stories................
31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior ! f,
32 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY "
34M Other — Specify 42 ® Public or private company 50. Total land area, sq. ft. ........... .3�t) j (G�
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
35 F_� Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 D Yes 45
�X Nc 53. Number of bedrooms..............
38 Cool
39 Other — Specify Will there be an elevator?j Full..........
� 54. Number of
46 Yes 47 E No bathrooms
Partial........
DEPT. OF ENILDING INSPECTIONS Z o ao
BUILDING °
a 212 Main Street o
Northampton, MA 01060 PERMIT <a
35 - 228 VALIDATION
DATE September- 19 PERMIT NO. 513
APPLICANT L.P. Audette ADDRESS oaf Rd. , Southampton 021237
(NO.) (STREET) (CONTR'S LICENSE)
New Building g Sin le Family/Garage NUMBER OF +1
PERMIT TO I—) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Lot #11 Ladyslipper Lane/House #11 ZONING CT SR
AT (LOCATION)
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS. permit for the construction of a new single family dwelling with attached garage
AREA VOLUME 2620 sq. ft. ESTIMATED COST $ 113.800.00 FEEMIT $ 8�3-0o
ICUSIC/SQUARE FEET)
OWNER
Same a s A �`
Applicant
�(�
ADDRESS ame as Applicant's BYILD
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