661 Applications & Permits f
No.
THE COMMONWEALTH OF MASSACHUSETTS
NORTHAMPTON ,MASSACHUSETTS
Rpplitation for Disposal *pstem Construction permit
tto Construct(X)or Repair()an On-she Sewage Disposal System at:
Type of Budding:
Dwelling No.of Bedrooms 3
Other Type of Building
Other Fixtures
Garbage Grinder(X)NO
No.of Persona
Showers( ) Cafeteria( )
Design Flora 3996 gallons per day. Calculated daily flow 330 gallon.
Plan Date 6-23-98 Number of sheets 2 Revision Date
Title Plan of Proposed Sewage Disposal Systems repair Prepared for Michael O'Brien
Description of Soil See Deep Observation Hole logs-Sheet 2 of Design Plans
Nature of Regain or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedeaeribed on-site sewage disposal system in accordance
with the provisions of Title 5 of the Environmental Code and sotto place the system in operation until a Certificate of Compliance has been issued by
this Board of H Date 643/i'�
Application Approved by
Application Disapproved for the following reasons
Date
Pernik No.
Date Issued
Location Address or Lot No.
661 Westhampton Road
Northampton MA
Owner's Name,Address and Tel.No.
Michael O'Brien
661 Westhampton Rd
NoNunlptmt MA 01060 586
-5431
Designer's Name,Address and Tel.No.413-5847444
Abner Huntley,Sr.&Associates
30 Industrial Drive East
Northampton,MA 01061
Type of Budding:
Dwelling No.of Bedrooms 3
Other Type of Building
Other Fixtures
Garbage Grinder(X)NO
No.of Persona
Showers( ) Cafeteria( )
Design Flora 3996 gallons per day. Calculated daily flow 330 gallon.
Plan Date 6-23-98 Number of sheets 2 Revision Date
Title Plan of Proposed Sewage Disposal Systems repair Prepared for Michael O'Brien
Description of Soil See Deep Observation Hole logs-Sheet 2 of Design Plans
Nature of Regain or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedeaeribed on-site sewage disposal system in accordance
with the provisions of Title 5 of the Environmental Code and sotto place the system in operation until a Certificate of Compliance has been issued by
this Board of H Date 643/i'�
Application Approved by
Application Disapproved for the following reasons
Date
Pernik No.
Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
NORTHAMPTON MASSACHUSETTS
Certificate of Compliance
THIS IS TO C ERT n , -t On-site S-....e�a�' •.. System installed )• repaired/ .aced( )on a
orr I _ a_. _ , 40_,7411._----
at at , y«ri, tr-s_t i :� has been constructed dated
in accordance i , Pro ors of Tide 5 •for the Disposal Use System Construction n Pemdt No.liance with set font below:
- 1" • Use of system is conditioned on caM provisions
sort tE conserved ass guarantee that the system will function as designed. This Certificate
The Issuance of this , 3 _ �: or .^ q� //
expires on fG/i/�r `"-
DATE If •
THE COMMONWEALTH OF MASSACHUSETTS
NORTHAMPTON ,MASSACHUSETTS
rvo. 42-__:_Y__—L25(--'
' FEE .3DK ge,t, 1°/3syl?
Disposal llstteem�Conns/truction permit
Permission is hereby granted to ✓r—" ,a-Q f Oikt ' °u.�e.. /�-1L
to construct( )or repair f On-site Sewage System -Y
and as described in the above Application for Disposal System Construction Pemnit The applicant recognizes that hisMer duty to comply with Title5
and the following local provisions or special conditions.
AS construction mast be completed Mlhiu three y- :of the date below.
% ••
DATE Approv ed by /-J —0 �"
_--"
adnsin\wpadmin\forms\fortnseng\dispcons FORM 1255
96-046-225
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�'1p
Appliratinn for Oihpr i ihnrku unstrnrti n Dermit
for a Permit to Construct or Repair ( �Indiridua]
Sewage ST id)
Application is hereby made fo ( ) age Disposal
stem at:
�oi.�..._ ea d r Lot Ada V
1K"VJ .Address
In
Io-c al .. Address
Ile 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
:sign Flow gallons per person per day. Total daily flow gallons.
:ptic Tank—Liquid capacity gallons Length Width Diameter Depth
sposal Trench--No. Width Total Length Total leaching area sq. ft.
:epage Pit No Diameter Depth below inlet Total leaching area sq. ft.
ther Distribution box ( ) Dosing tank ( )
ercolation 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
escription of Soil
'attire of pars Al rations—Answer when applicabl
_.,� —�ct�__lLx..E
greem ,.,.
The undersigned agrees to install the aforedescrihed Individual Sewage Disposal System in accordance with
le provisions of TITLE 5 oI the State Sanitary Code—The undersigned further agrees not to place the system in
peration until a Certificate of Compliance has bee ls u:d b the bo: d o `
SiSi e
application Approved By
application Disapproved for the following reasons
Permit No e
Issued_
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF
(grrtifiratr of Tnmplianfr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired
by
at Installer
has been installed in accordance with the provisions of TI°Ili; 5 of The State Sanitary Code as described in ti
application for Disposal Works Construction Permit No dated_.
\ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT TI
SYSTeM WILL FUNCTION SATISFACTORY.
DATE —. Inspector
•
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
•
No /1. ,
OF —
., .. ......�..::...
finpnsal corks Qlonntruffinn jrrmif
Permission is hereby granted
to Construct %
( ) or Repair (( ) an Individual Sewage Disposal System
at No
Street
as shown on the application for Disposal Works Construction Permit No Dated
DATE Board of Health 1"t
FORM 1255 HOaRS & WARREN. INC., PUBLISHERS
• ii---9c/ I1ja
irt s NO. J
t9a
THE COMMONWEALTH OF MASSACHUSETTS
e��� NORTHAMPTON ,MASSACHUSETTS
a Spplication for Disposal $jjsttm Construction riermit
Application u hereby made for a Permit to Construct(X)or Repair( )an On-site Sewage Disposal System at
location Adhm or Ld.No. Oumer's Name,Addr®and Tel.No.
N Iosthaesthan'1' Road Michael O'Brien
66W lm Rd.
Northampton,MA
01060 386-3431
Designer's Name,Address and Tel.No.413-584]444
Alma Humley,Jr.&Associates
Ind sfisl Drive East
Type of Buudb.g:
Northampton,MA 0I061
Dwelling No.of Bedrooms 3 Garbage(hinder(X)NO
Other Type of Building No.of Persons Shower( ) Cafeteria( )
Other Fixtures
Design Flow 399.6 gallons per day. Calculated daily flow 330 gallons.
Plan Date 6-23-98 Number of sheets 2 Revision Date
Title Plan of Proposed Sewage Disposal Systems repair Prepared for Michael O'Brien
DearIplhM of Snit Sec Deep Observation Hole Loss-Shat 2 of Design Plans
Nature of Repairs or Alterations(Answer when applicable)
Date lest inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the aforedeseribd on-site sewage disposal system in accordance
with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate ofC 1
this Board of II �� Compliance has been issued b.
g y � 0f/fr
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued