Lot 24 Septic Applications lz
THE COMMONWEALTH OF MASSACHUSETTS
pia_
BOARD OF HEALTH
eny OF Acee$14/0041
App tirafirnt fur Disposal Works etanstntrtion Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Systan at:
eV-2 Aideraer .2f
dd ./Z1 itlaideter•
Installer Atlas
Type of Building Size Lot .Sq. feet
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
ckt Other—Type of Building No. of persons Showers ( ) — Cafeteria ( )
n
P. Other fixtures
.11 Design Flow gallons per person per day. Total daily flow gallons.
6
c4 Septic Tank—Liquid capacity.2.47.4tga Ions Length Width Diameter
rt Disposal Trench--No Width Total Length Total leaching area...f....-...-..sq. ft.
;-.-.. Seepage Pit No Diameter Depth below inlet. Total leaching scat N. ft.
z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.effeeeft/ialISOK...49/ .eaet-A-47 Date -24eitlif
.-I Test Pit No. I / minutes pi inch Depth of Test Pit...3..:..12 " Depth to ground water.. trtfe.e.
.-4
It Test Pit No 2 minutes pm inch Depth of Test Pit Depth to ground water
0 Description of Soil Lot. .2€44C..(0.,c4z,...ritregdf."..52a.c.....exterfacdr
re
ad
u Nature of Repairs or Alterations—Anwer when applicable.
X
Agreement:
The undersigned agrees 16 'lista I the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the Stare Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the beard of health.
Application Approved By
Signed.
Application Disapproved for the follototsg reektems•
RE APPLICABLE
CHECK OR FILL IN W
No
THE COMMONWEALTH Or MASSACHUSETTS
Fmk
BOARDt,OF HEALTH
CtTyoF !v oRr," ig" 'PTcn/
Appliratiott far tlispnsal 3finrku (lnuutrurtinn Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: 2_4
f....43. r-/Fr9v0Lot No.
7T Loation-Addre=-.
,�,R u v£CT
Owner
Type of Building
Address
T< N2iaam.
Installer Address
Size Lot it °13 O Cr,, feet
Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( )
No. of persons Showers ( ) — Cafeteria ( )
Other--Type of Building
Other fixtures
Design Flow .
Septic Tank—Liquid capacity
Disposal Trench—No.
Seepage Pit No Diameter Depth below inlet
Other Distribution box ( ) Dosin tank ( ) /Qis t,
Percolation Test Result Performed by.,.l_.�iA. .� — ��furL With 4//9/ J.7 •
,i -T minutes Depth -7 L Q. Depth to ground water. Z,
Test Pit No. 1.... :_{.... per inch D th of Test Pit
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil 5 t• L o 9#% 22-<` S/C[:_.�_..I 3 n VFW/Cie F,?via
gallons per person per day. Total daily flow gallons.
gallons Length Width Diameter Depth
Width Total Length Total leaching area sq. ft.
Total leaching area sq. L•.
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 NI 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'
Permit No
Dae
Date
Date
Issued
Date
L
CHECK OR FILL IN WHERE APPLICABLE
No Fax.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
city Nort hampton
Appliration for Binomial thorito Untotrurtion Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Florence Road
Brad Collins
Location-Address
#24
or Lot No.
Owner Address
Installer
Type of Building
Dwelling—No. of Bedrooms Expansion Attic ( ) laarla Grinder ( )
Other—Type of Building 3 No. of persons Showers ( ) — Cafeteria g )
Other fixtures
Design Flow gallons per person per day. Total daily flow gallons.
Septic Tank—1541iid capacity gallons Length.. Width Die.meftett Depth
Disposalkt—No 12.0 Width TlzOnaekth 5.10" Total leaching area 5'441.ft.
Seepage 1... Diameter 201 Depth below inle8.0 ' Total leaching arez603 sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by Date.
Test Pit No. 1 minutes per itaBnisleami-Bmnabley...R...Atamtato groun4
Test Pit No. 2...9.*.0 minutes per inch Depth of Test Pit 4.13" Depth to groun
5.!.0."
Address
Size Lot Sq. feet
Description of Soil
9" ina,_217tailty_sand....5.111" mery_fine_sami_ i7-
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 been issued by the board of health.
Signed.
Application Approved By
Application Disapproved for the following reasons
Permit No
Date
Date
Date
Issued
Date