1235 Septic Application CHECK OR FILL IN WHERE APPLICABLE
NO Sir/
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFI HEALTH
Appliratt n fur f3ahponal�u u ks TimalrnTrtinn irrmit
FEE Or'
Application is hereby made for a Permit to Construct ( ) or Repair (than Individual Sewage Disposal
System at: � c�
1.�: 5' iir�i �tI r
or Lot No.
O ...L)OQ:es.r Address
filer ((ii�a Address
Type of Building
Dwelling—No. of Bedrooms
Other—Type of Building
Other fixtures
Design Flow
Septic "Lank--Liquid capacity
Disposal Trench—No.
Seepage Pit No Diam
Other Distribution box
Size Lot Sq. feet
Expansion Attic ( ) Garbage Grinder ( )
No. of persons Showers ( ) — Cafeteria ( )
gallons per person per day. Total daily flow gallons.
gallons Length Width Diameter Depth
Width Total Length Total leaching area sq. ft.
eter Depth below inlet Total leaching area sq. ft.
Dosing tank ( )
Percolation Test Results Performed by Date
Test Pit No. 1 minutes per inch Depth of Test Pit Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil
Nature of Repairs or Alterations—Answer when applicable aste-._.eQ.}tij....k}.cee
Agreement:
The undersigned agrees to install the aforedeseribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued bq the board of health.
Application Approved By
Nate
Application Disapproved for the following reasons'
by
Permit No -`Vj
�
_ // /� Nate
Issued r '• �4.' 7 �3—
Dale
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Terttfirate of fdumptiaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
at
has been installed in accordance with the provisions of Article XI 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
Samuel B. Brindis,P.E.
Director, City Engineer
Peter J. McNulty,Sr.
Assistant Director of Public Works
March 11, 1998
Laurie Sarafin
1255 Burts Pit Road
Florence, MA 01062
CITY OF NORTHAMPTON, MASSACHUSETTS
DEPARTMENT OF PUBLIC WORKS
125 Locust Street
Northampton, MA 01060
413-587-1570
Re: Sewer Connection - 1255 Burts Pit Road
Dear Ms. Sarafin:
This letter is to confirm that the above referenced location was connected to the municipal sanitary
sewer system on September 10, 1991
Please call me or George Andrikidis if there are any questions.
Very
y,
ours,
Samuel B. Brindis,P.E.
Director of Public Works
SBB/GA
GA
co. Guilford Mooring
Peter McErlain
a:\Pers\LSO3 Weis 1 198
BOARD OF HEALTH
MEMBERS
JOHN T.JOYCE,Chairman
ANNE BURES,M.D.
CYNTHIA DOURMASHKIN,R.N.
PETER J.McERLAIN,Health Agent
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
210 MAIN STREET
01060
(413)587-1214
August 8, 1997
Linda Rowley
3 Hatfield St
Haydenville, MA 01039
Dear Ms. Rowley
RE: Sewage Disposal System Inspection
1255 Burts Pit Rd.,Northampton
The Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System Inspection
conducted by Tom Leue at 1255 Burts Pit Rd.,Northampton on July 31, 1997. That inspection report indicates that your
subsurface sewage disposal system fails to protect the public health and the environment as defined in Section 15.303 of
CMR 15.000, State Environmental Code,Title 5.
Therefore,in accordance with the provisions of 310 CMR 15.000 of the State Environmental Code,Title 5,and under
authority of Massachusetts General Laws, Chapter 21 A, Section 13,you(or the subsequent owners of the property)are
hereby ordered to repair the subsurface sewage disposal system at 1255 Burts Pit Rd.,within Two (2)Years of the
receipt of this notice. PLEASE NOTE: IF THERE IS A CITY SEWER MAIN ACCESSIBLE TO YOUR
DWELLING, WITHIN 300 FEET, YOU MUST CONNECT TO THE SEWER RATHER THAN REPAIRING YOUR
SEWAGE DISPOSAL SYSTEM
All work to repair/upgrade the subsurface sewage disposal system must be performed by a licensed sewage disposal
system installer, in accordance with the requirements of 310 CMR 15.000,and with plans approved by the Northampton
Board of Health. Permits to connect to city sewer must be obtained from the Dept.of Public Works Office on Locust
Street. If you do connect to city sewer,you must abandon your septic tank by having it pumped,and the empty tank
filled with sand to prevent it from collapsing.
Please be advised that you are entitled to a hearing on this order to upgrade your subsurface sewage disposal system or
connect to city sewer,provided that you file a written petition requesting such a hearing in the Board of health office
within seven(7) days of the receipt of this notice.
Please feel free to contact the Board of Health office, at 587-1214, if you have any questions concerning this matter.
Thank you for your anticipated cooperation in this matter.
Very truly yours,
Peter J. McErlain
Health Agent
Certified Mail#P 082 853 176