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487 Application & Permit THE COMMONWEALTH OF MASSACHUSETTS Ur 4/I/ BOARD OFtr HEALTH OF A 'Qirriifirair of Tom liana THIS IS I QQ CE TWA, That thee Individual Sewage Disposal Sys t constructed (j/j or Repaired ( ) by JET. ..acti111.1 -y7-......._[�� .... I at .7 YI? JGZL:Rso f.-..r7.k5d IVfr U1 $/O' i AutipM...:! .� .. .raizT'h has been installed in accordance with the provisions of TITLE /5/ofa a State Sanitary Code; esert application for Disposal Works Construction Permit No fi µ4n dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT RE CONSTRMED AS A GUA RA YNAT THE SYSTEM WILL FUNCTI N SALT ORY. DATE Inspector No ii—ZO THE COMMONWEALTH OF MASSACHUSETTS BOARD OFaAITlryl OF ThopoS / Qioie f rnntit Permission is hereby granted I to Construct ({/forte 1 j ) an tdivi. al Se age Dispo7 at No ..9... .... .. .. ._ sv as shown on the application for Disposal Works Construction Perm DATE ) FORM 1255 HO BS S WARREN. INC.. PUBLISHERS 0V70/5- 1/s Fmt&.6 Board of Health THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH City OF Northampton ppliratiun far ffispnaal Marks Cltanstrurtian Patna Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Jackson Subdivision Northampton Lot #2 Location-Address ai.ana..Kraaath W7 Yu Q Audubon Road Owner . Installer G Type of Building O Dwelling—No. of Bedrooms 3 Expansion Attic '"l pe Other—Type of Building No. of persons im Other fixtures or Lot No. 186 Cresent Street Northampton Address Address Size Lo Showers 5.112 Ac. sgoKua Garbage Grinder (X) ( ) — Cafeteria ( ) Design Flow 55 gallons per person per day. Total daily Septic Tank—Liquid capacity15f10gallons Length Width Disposal Trench—No. 1.0 Width._....3..._..... Total Length 544' Seepage Pit No Diameter Depth below inlet Dosing tank ( ) Performed by MI Huntley. ....minutes per inch Depth of Test Pit minutes per inch Depth of Test Pit flow.........33.0 gallons. Diameter Depth Total leaching area sq. ft. Total leaching area sq. ft. Other Distribution box Percolation Test Results Test Pit No. l..ZC Test Pit No. 2 Date 3-10-81 71 6" Depth to ground water ' ° Depth to ground water Description of Soil....3._...0T.S.* 18" SLIt_4 5'9" say till at 7 0" th boulders. Groundwater 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 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 Application Approved By Application Disapproved for the following reasons by Date Date Date Permit No Issued Data THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF Qlrrtifiratr of Qlontpliattrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) Instant, 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 CHECK OR FILL IN WHERE APPLICABLE THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH City or= Northampton ppiiratinn for f inposttl i G=kg Cnonwtrurtion hermit Application is.hereb mad fora ermtt to Construct (X ) or Repair System at: 9f7 , to Jackson Subdivision Northampton D.ana_Krauth Audubon Road Location.Address an Individual Sewage Disposal Lot 1(2 or Lot No. 186 Cresent Street Northampton Address ize Addresa 5.112 Ac Type of Building rV` " ` Size Lot 9grtfmt Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( X) Other—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures Design Flow 55 gallons per person per day. Total daily flow 35.9 gallons. Septic Tank—Liquid capacity.L5_QO_gallons Length Width Diameter Depth Disposal Trench—No. 1.0..._.... Width 3 Total Length___5.0Q' Total leaching area sq. ft. Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test R Performed by Dill' klun.tley....6.6ESOC. Date 3-1water 0-81 ° Test Pit No. 1...2.5. .minutes per inch Depth of Test Pit 7' 6" Depth to ground ' ° Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water Description of Soil....3.��...Q.I.S...+ j,8" silt 4 5'9" sandy till with boulders. Groundwater at 7' 0" 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 Sa itary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliant as been issued by the board of health. Application Approved By ype Application Disapproved for the following reasons' Permit No 1.,- 010 Issued- gil.e{..7L 2 Date