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2 Septic Applications & Permits CHECK OR FILL IN WHERE APPLICABLE No -- Fax THE COMMONWEALTH OF MASSACHUSETTS .,(BOARD OF HEALTH OF . ttz,a4 / - - - - — - 1pplirtttinn fur 3lispnnttl 3 arks ftunutrurtiun 1rrmit Application is hereby made for a Permit to Construct (4 or Repair ( ) an Individual Sewage Disposal System at: keree or IS No. Address Installer Type of Building Size Lot Sq. feet Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures Design Flow gallons per person per day. Total daily flow —''" ' gallons. Septic Tank—Liquid capacity/.dQ.egallons Length Width Diameter Depth Disposal Trench—No. Width Total Length Total leaching area £.F..Dsq. ft. Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft. Other Distribution box ( ) 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 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 nom Application Approved By 7:1"� ' t ;f -e .C./2 S`7"" .ate r Application Disapproved for the following reasons' Date Permit No._w'..L-J Issued su`-f.--.n.1r..,L.LE_.Y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF ,1r 72..4 elertifiratt of Tomptitotrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed V) or Repaired ( ) by •?' (• ., /-)k- • at has been installed in accordarwe with the provisions of Article XI of The State Sanitary Code as described iu. the applies tiiin for Disposal Works Construction Permit No —tat LI dated Ari THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A ISUAIIANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE " IV Installer THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No ->1 FEE ialoposal oe ark!' Tonotrurtion frrtnit Permission Is hereby granted to Construct (t' ) or Repair, ( ) an Individual Sewage Disposal System at No •rtar.C1. street as shown on the application for Disposal Works Construction Permit No. Dated t DATE FORM 1255 HOBBS & WARREN. INC., PUBLISHERS Board of Haab ERE APPLICABLE CHECK OR FILL IN No THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH OF O-1. _4 Application or flispnsttl Pcnrks u1tntrurtinn ermit Von is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Application age Disposal Sys t• f ien..lddmss Lot No. G rQ4 _ . .Ownof La c c ....._... � .....Pe.. Owner Address tnaa��er Address Type of Building Size Lot Sq. feet Dwelling—No. of Bedrooms 3 Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures Design Flow gallons per person per day. Total daily flow gallons. Septic Tank—Liquid capacityttit %gallons Length Width Diameter_. Depth Disposal Trench—No. Width Total Length Total leaching area 7t/ fl. sq. ft. Seepage Pit No Diameter e th below i. et Total leaching area sq. ft. Other Distribution box ( ) Dosin ) i . p 69 Percolation Test Results Performed by.... .. ... .. . .: ��'yq 1. i Date 3 `1J f Test Pit No. I LTi minutes per inch epth of Test Pit 7/� th to ground water IS r Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water Description of Soil s j 1 _,-. .� _ctLA 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 Date Date Date Application Approved By Application Disapproved for the following reasons Permit No Issued Date ALMER HUNTLEY Jr. & Associates, Inc. REGISTERED LAND SURVEYORS AND CIVIL ENGINEERS 238 BRIDGE STREET, NORTHAMPTON, MASSACHUSETTS 01060 PHONE 584-7444 June 27, 1968 Board of Health City Hall Northampton, mass. Attention: Mr. Robert Langdon, Health Inspector Dear Mr. Langdon: BRANCH OFFICE: WEST STREET - ROUTE 32 WARE, MASSACHUSETTS 01082 PHONE 413-967-6961 I have made a percolation test and deep hole exploration at land belonging to the Bible Baptist Church located on the easterly side of Florence Road. This tract contains approximately 5 acres. The results of the percolation test and deep hole exploration are as follows: 0" to 8" B" to 24" 24" to 71 loam and organic material silt and stones coarse gravel, sand, stones - hard packed Water Table 5}1 below ground surface Percolation Rate 1" in 15 minutes The sewage disposal system to be constructed for this church should be constructed on the high ground and should definitely not go into the low area in the rear of the building. In the construction of this system, I would suggest that the approximately 24" of organic material, silt and stones be removed from the gravel area and that coarse sand or gravel be used to build up the area so that the minimum distance between the bottom of the leaching field and the water table is 4' . If you have any further questions regarding this please do not hes- itate to contact me. Very truly yours, tilWA Aimer Huntley, Jr. Registered Sanitarian AH:ss