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Lot 24 Septic Appication CHECK OR FILL IN WHERE APPLICABLE No Jr f THE COMMONWEALTH OF MASSACHUSETTS PEE BOARD {OF HEALTH rt) OF ,f M(atA'r lf Appliratiun fur i liapuunl Marko Eiunstrurtiun lrrmit Application is hereby made for a Permit to Construct (V or Repair ( ) an Individual Sewage Disposal System at: cirri ii/44„ dress a1 W rxG ✓ ++ owners" ,6GLe+t� /4.".� ,}._K-. Type of Building Dwelling— No. of Bedrooms Other—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures or Lot No. Address Address Size Lot Sq. feet Fxpansion Attic ( ) Garbage Grinder ( ) Design Flow gallons Septic Tank—Liquid capacity.24 gallons Disposal Trench— N4. Width Seepage Pit No i Diameter Other Distribution box Percolation Test Results Test Pit No. 1 Test Pit No. 2 per person per day. Total daily flow gallons. Length Width Diameter Depth Total Length Total leaching area s ft. Depth below inlet Total leaching area.I-l.. ft. Dosing tank ( ) Performed by Date minutes per inch Depth of Test Pit Depth to ground water minutes per inch Depth of Test Pit Depth to ground water Description of Soil 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ttee t�iiissued by he board of health. ////((''--gy�pp Si ed✓ f'O"^ /.(�Nc. 1'r X11 aMi • Dam Application Approved By pot t !� ; _ td F:_3t.., ,aY/QE_}!. Date Application Disapproved for the following reasons Permit No I Issued. fa . - '7 /It Date 0 by at has been installed in accordance with the provisions of Artic,G application for Disposal Works Construction Permit No THE yIy/SSS�UANCE OF THIS CERTIFICATE SHALL NOT DATE " 421 FUNCTION( I yloY SATISFACTORY. �1. 1 J1rl. 'Y Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF ))C4-ttet+tan rrtifiratr of Qlnutplianrr THIS IS TO CiIrTI-F� cc cc, ThaYrthe Indipidnal Sewage Disposal System constructed t ) or Repaired ( ) A NP Yom' ofd qty %1 +t fJ Olt` of The State Sanitary Code described the . dated `W L y y BE CONSTRUED AS A GUXRANTEE THAT THE No Rt THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF " ly-'v �'1hl ri Via=°'A Motional Witrka Oinitaintren Irrntit Permission}" hereby granted to Construct{' or Repgir ( ) an Indjcidtp Sewage Disposal System at No 'jilt- r' °1 7 Px) an n iect tniL street 9 as shown on the application for Disposal Works Construction Permit No Lf DATE - " a. .._�. ._c.7r..p FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Bo FEE Dated ALMER HUNTLEY, JR. & ASSOCIATES, INC. Successsors to Davis Engineering Co. Established 1870 Registered Land Surveyors & Civil Engineers Board of Health City Hall Northampton, Mass . 30 CRAFTS AVE., NORTHAMPTON, MASS. TEL. (413) 584-7444 July 7 , 1964 Gentlemen : i have made a percolation test at Lot 24, Mayorsville, located on °arts Pit 30=:_l, or '_.and belonging to Wm. Ormond , Jr. Soil : Coarse sand, stones. A good clean gravel. Percolation Rate : One inch in three minutes. No ground water. 0 if Almer Huntley, J Registered San', o;