340 Applications & Permits ALMA
M.
HUNTLEY
NO
Pas �:.•
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY OF NORTHAMPTON
pp kaftan fur Qispnsnl Works Qluuntrurtiun Vrrmit
pplication is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal
System at:
Westhampton Road
Lotaeon.Address
John Fischer
Owner
[nstaaer
Type of Building
Dwelling—No. of Bedrooms 1
Other—Type of Building
Other fixtures
Same
or Lot No.
Address
Address
Size Lot.._IQ...AC, 9grfeet-
Expansion Attic ( ) Garbage Grinder ( )
No. of persons Showers ( ) — Cafeteria ( )
Design Flow 55 gallons per person per day. Total daily flow__11.Q gallons.
Septic Tank—Liquid capacityL5.0.0gallons Length Width Diameter Depth
Disposal Trench-- No. 2._._.. Width. 1' Total Length 50' Total leaching area_.SOO sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by...HAIItLey....Asaoe.._0..Jac _ Date..Sm2.6-.fll
Test Pit No. 1 minutes per inch Depth of Test Pit 9 Depth to ground water .none
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil See attaCh.P.i__,jagg$.a
Nature of Repairs or Alterations—Answer when applicable
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed
Application Approved By
Application Disapproved for the following reasons'
Permit No
Date
Data
Date
Issued
Date
by
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Qirrtifiratr of Qiomplittnrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
Installer
at
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No dated_
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector
No Y./- 2.1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
tt7 or 0-A.,f/Ia y.2,1: ein
Qispn 1 ranrks jnnntrurttuu Vrrmit
Permission is hereby granted..... .. ./I^ . fr ` 17 '. F,t4.�.L-
to Construct ( ) or Repair (x) a Individual S,x'age Disposal System
at No ?-4Lot f,ujr.L,Yb�C .__._.._.._ .._.... . _.........._...
as shown on the application for Disposal \\'oaks Construction Permit Noerf",2../- Dated_LICl.-y: I!
DATE..LL.i1.f-.L94/.lf/ /
FORM ■255 HOBBS 8 WARREN. INC.. PUBLISHERS
No..t) 1' ut.l
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
te," OF {/fit-!. E-0n't G-?.
Uispnsxl WCinrk$ Tfinstrurtisn j rrmit
Permission is hereby granted__) ✓Y�._ I-x4.
to Construct ( ) or Repair O a' Individual S age Dii posal System
at No 3/70 sib' mw•.:.4.4 k,a2-.GEr
4,
FEE.2. l-0
Street (
as shown on the application for Disposal Works Construction Permit NoOf2.,2.L Dated
DATE... _L9,/'9t
FORM 1255 NOSES & WARREN. INC.. PUBLISHERS
THE COMMONWEALTH OF MASSACHUSETTS
^ , , BOARD OF HE - LTH
OF
No / Fec2'crO
�iLipnLial r:f • •u tlln,Litt ertttit
Permission is hereby granted / ./ZA/C-i"'w /c.e.A.rui
to Construct ( t Re r ( ) a� ndivir ewage Di- osal System
1 /
at No
Street
as shown on the application for Disposal Works Construction Permit N
DATE �f 3/P
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
of Health
CONES
11.30452
PE ISTERE' 0
ON
4-6 CIVIL #1}t
liratiun fur Disposal Works Ointintractim lrrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal
System at:
340 WESTHAMPTON ROAD
9-%4
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY OF NORTHAMPTON
Fas..._.1....D../v
VERA FISHER Location'Address
Owner
JOSEPH..MISTEFKA.
Installer
Type of Building
Dwelling—No. of Bedrooms 4 Expansion Attic (
Other—Type of Building No. of persons
Other fixtures
Design Flow 55 gallons per person per day. Total daily flow 166 gallons.
tSeptic Taplf isiquid capacity.1.301/gallons Length Width Diameter Depth
Disposal "Petaaah— No. I_....... Width 2.0 Total Length 64 Total leaching area...12On sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by}UNILEYSASSBC_...RRE Date 4-14-434
Test Pit No. 1 10 minutes per inch Depth of Test Pit_511" Depth to ground water
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
or Lot No.
SAME
Address
Address
Size Lot Sq. feet
Garbage Grinder ( )
Showers ( ) — Cafeteria ( )
Description of Soil 10" OTS 29" SILTY FINE SAM.. 24" SILTY._SAND...TRACE..OE..CLAYr.-1-'-9" VA&YED
CLAY AND SILT, NO GROUNDWATER
Nature of Repairs or Alterations—Answer when applicable*.PU.Mf._SEPTIC...TANK>_.CBECK-.SAEFLES..ANA.-RPsPLACE
IF BROKEN, IF TANK IS UNDER 1000 GALI,ONS...OR..IF..ILLS..HAMAGED_REELACE..WSTH..A-.NEW
Agreerl,eQ0 GALLON TANK, INSTALL PUMP CHAMBER AND 1200 SF LEACHING FIELD.
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitar�Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance)aCbeep issued bye board of health.
47/6'
Application Approved By
Application Disapproved for the folio seasons'
gn
Permit No
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
OF
(fin- firtttr of Tonto Ha
THIS TO CE FY` t t Ind 'dual Sewage Disposal System constructed ( ) or Repaired ( )
by 1st
has been installed in accordance with the provisions of TITLE. 5 of�Ttte State Sanitary Code as des rib to the
application for Disposal Works Construction Permit No 7 J fit/ dated 7/3.1
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATIS ACTORY.
/
DATE �L' —/ 7 Inspector
No
1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF.::,
Otnpnottt
I:IE
nrks_elonntrnrtinn hermit
Permission is hereby granted....„,
to Construct ( ) or Repair (t-') an Individual Sewage Aispo;al System
at No •.i-_Y.a.
Street
as shown on the application for Disposal Works Construction Permit No Dated
s _.
co
FEE
DATE
FORM 1255 HOBBS h WARREN. INC.. PUBLISHERS
Board of Health
mow......,-_
•
�[N O; /
P R
M.
UNTL
> M
•
FE
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY OF NORTHAMPTON
Appliratinn for finpnsal 3lnrks @lnnstrurlinn Frrmit
Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
Westhamaton...Rpad
Location.Address
Jahn..F.laches
Owner
Installer
Type of Building
\] Dwelling—No. of Bedrooms
Other—Type of Building
Other fixtures
1
or Lot No.
Same
Address
Address
Size Lot...l0....AL'.. Strteer
Expansion Attic ( ) Garbage Grinder ( )
No. of persons Showers ( ) — Cafeteria ( )
Design Flow 5.5 gallons per person per day. Total daily flow__}10 gallons.
Septic Tank—Liquid capacity1500.galtons Length Width Diameter Depth
Disposal Trench—No. j...._..._ Width..j 1 Total Length 5.0 s Total leaching area.5 OD sq. ft.
Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft.
Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by._HuIitley..Aasocer--.Ine.. Date..5."_Zfi,B.i,
Test Pit No. 1.j minutes per inch Depth of Test Pit__9 Depth to ground water E0/16_._.._
Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water
Description of Soil $ea..attache -.Loga.
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:L::.0 5 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
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
Trrtifiratr of alumptiattre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by
insiacei
at
has been installed in accordance with the provisions of TITLE, 5 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
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
rLz
No ' /- .t / _„t t ei
FEE : .
nifipmutt Horkn atuntstrurtinn Permit
Permission is hereby granted , 11/ 1.- --cia-----....4 Tra.../....ii i 1....•
to Construct ( ) or Repair I.S() an Individual Sewage Disposal System
at No L /./{
SLreeL
as shown an the application for Disposal Works Construction Permit -1
/(
a
Board
1 Board of Health
DATE - -
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
No. aL
COMMONWEALTH OF MASSACHUSETTS
Board of Health, /VG/'
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION
Application for a Permit to Construct( ) Repaid( Upgrade( ) Abandon( ) - ❑Complete System
E
Pape of Building
)welling-No.of Bedrooms
)ther-Type of Building_
Sher Fixtures
resign Flow (nun. equired)
Ian: Date 12 31 %Z
Isle
escription of Soil(s)
ail Evaluator Form No.
No.of persons
Lot Size 075-41
Garbage grinder (M
e
Showers( ),Cafeteria ( )
gpd Calculated design flow
Number of sheets /
Pro/ •
GC:)
Design flow provided
Revision Date
gpd
t lst°
:SCRIPTION OF REPAIRS OR ALTERATIONS
Name of Soil Evaluator
Date of Evaluation
opmct/ els% S(S.J On �.� 7orf, (rzio 5Ft-rt kupe a
e undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
ther agrees to not to place the system in operation until a Certificate of Com
ned fica pliance has been issued by the Board of Health.
Dare
rections
COMMONWEALTH OF MASSACHUSETTS
Board of Health, 1J.rftiArk, AfA
// CERTIFICATE OE COMPLIANCE
escription of Work: 1-Individual Component(s) ❑Complete System
re undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired O&Upgraded ( ),Abandoned ( )
laf <.k (1-k !r<1-
i
-1 C I 0 W'At-< .., P
s been installed in accordance with the proyisio s of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
plication No. 27E -/ dated 7 / . Approved Design Flow (gpd)
taller /
signer: Inspector s _— - Date: r 7
e issuance of this permit shall not be construed as a guarantee that the system will function as designed
FEES/✓()
COMMONWEALTH OF MASSACHUSETTS
FEE'S///(/
DISPOSAL SYSTEM CONSTRUCTION PERMIT
rmission is hereby grant d to; Con¢truct( Repair,\' Upgrade( ) Abandon( ) an individual sewage disposal system
?1/0 �//'5/f6 /n i/fiti/ Oa e as described in the application for
,posal System Construction Permit No..76/3- / dated //7//3 .
rvided: Construction shall be completed wi n th eee years of the date of this permit. All local conditions must be met.
1255 see 5/96 A.M.Sulltin Co.RSWVwm,MA Date //7//3 Board of Health