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