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Misc. Lots Applications & Permits FEE COMMONWEALTH OF MASSACHUSETTS Board of He bh, /__Ha4441A. CATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT inn p/Parcel # tore roller's Name ce/( ( -- dress lephone# of Building [ling-No.of Bedroom _r-Type of Building i • .ac/tes t re-e .-r✓ AO 11GVm 7 JLr - i'd ) 7 �/tJ Onnrer's Name/77, .eotO re/20 Gite997Ynr[`/ �ipii . Address Telephone Designer's Name Address Ezmissi No.of /09 er Rxtures 060 d) 5L,('//d ,Y/'�pd Calculated design flow gn Flow (min.required) 2 H4%i t: Date S6 8 /99% Number of sheets to e / / N pot , - o1O77 cripdon of Soil(s) �QP �J",�/lG/Y.// Dare of Evaluation Evaluator Form No. � Name of Soil Evaluator dose G /(o //Ql4 d Lot Si • L d tS /Q /7/'J pp Garbage grinder(yCg persons CJ Showers&,Cafeteria (yt)6 re A ' y0 A/5 OS.dL- _ Design flow provided gpd Rlsisiou Dar . .' avr O e esiedat1/n J SCALP PION OF REPAIRS OR ALTERATIONS Veld 5-0 Ire to undersigned age rther agrees to no gncd described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and o err anon until a Certificate of Co Lance been issued by the Board of Health. �•✓ Date Z"S uspeCtiOns f c77 COMMONWEALTH OF 1ASSAIIIIUSETTS Board of Health, /n(46 CERTIFICATE OE COIN, PLli\NCE ription of Work: ❑Individual Component(s) Rennplete System O,Upgraded O•Abandoned ( ) undersigned hereby certify that the Sewage Disposal System; Constructed (L Kepat'red FEE Cat 17 Se,r',}y ee e d with the provisions of 31 O CMR 15.00 (Title 5) and the approved design plans/as-built plans rel been installed}t acuu anca. wr k Approved Design Flow y�>—(gpd) ll erion No. ✓ dated igner: �* • SIP YOTef Inspector: J . /c r 1 Date: • issuance of this permit shall not be conseued as a guarantee that the system will function as designed. 34,-12 tn p' d Board of Health, �CY'f(I(i,W,l] MA. ea 8 } 'DISPOSAL SYSTEM CONSTRUCTION PERMIT En O a �i ' isherebv gra e o' Cu struct( epair( ) U radel ) Abandon( ) an individual ewdgedisposa(system - eft? /�/{ I ,r-.}N C /I). PA)l e 11/j/p as described in the application for 'Sn77 G j("- / -7 dated s/a7 ..7 ,. COMMONWEALTII OF MASSACHUSETTS ing to FEE sir ra w sits$1f'stem Construction Permit No. pli Construction shall be completed within three years of the date of-this perq)it. Ail oc�.11cconr, must be met. ..a qq / I//� a He 3 5.421 7Board of Health 1255 Hey 5/96 AM1LSuIkIn Co Boston MA Date y- ,a-TY THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH City OF Northampton 14ppliratinu for Uispnnat iflnrks Cnnnntrurtinn j rrutit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal ystem at: Lot 11 L Audubon Road wt Bug Hill Road, Ashf reld Location-Address Robert-.itilson �.addre. 1.09 AC rozmn� Size t -Sq,=feet Cype of Buil g Expansion Attic ( ) Garbage Grinder (x ) Dwelling—No. of Bedrooms a Showers ( ) — Cafeteria ( ) Other—'Type of Building No. of persons Other fixtures 330 gallons Design Flow 55 gallons per person per day. Total daily flow Depth Width Diameter Disposal Tank—Liyvid capacity_150D_gallons Length Total leaching area s . ft. Width Tons Length..3.B., Disposal Trench-No. Total leaching swamity=69s RED Diameter_ Depth below inlet Other Distribution No 1 Dosing tank ( ) Other Distribution box ( ) g Date Percolation Test Results Performed by_—G_epth of Pit .ASSOn Depth to ground water Test Pit No. l..__1..6Zminutes per inch Depth of Test Pit Depth to ground water Test Pit No. 2._.._1..QQminutes per inch Depth of Test Pit Depth g Description of Soil 10" OIL.-1.14°...silty..saint,..31" sand..andgnavel...with...cabbie No ground water 5-27-76 Nature of Repairs or Alterations—Answer when applicable Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to operation until a Certificate of Compliance has bee issued the%board health. Application Approved By Application Disapproved for the following reasons' S in accordance with place the system in Permit No a Issued. Date by Lot o t At# ¢vN R4AO at d A�t7�� has been installed in accordance with the provisions of TIT UT State Sanitary Code as de� ribed in the application for Disposal Works Construction Permit No THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRU 5 A GUARANTE THAT THE SYSTEM WILL FUNCTION. SATISFACTORY. �i° ,/y DATE jr�Z/ t9 Inspecto .. / THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH crri or__NOtryninproi✓ h ntifiratr of Tontolianrr h Individual Sewage Disposal System constructed (`{or Repaired THIS IS 1Q CERT AytnaNDYGRR�' e /1SyH>=a0 THE COMMONWEALTH OF MASSACHUSETTS BOARD��//OF EALTH/ OF 1t4i. .fF^�r. D'�t._ . ... ._.. . ��ton rrmit Bis}�nsttl 3rk:i o�os--�,a--I � Permission is hereby granted to Construct ( " raepy i) an ivi age Dis ystem at at No slay as shown on the application for Disposal Works Construction Permit No DATE FORM 1255 HOBS g WARREN. INC.. PUBLISHERS Bo LCoi Health HJNIL THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH City Y .., anon fur flispailat i' arkn Tnnntrnrtinn j rrmit Application is hereby made for a Permit to Construct ( X) or Repair '(( (,/)) an Individual Sewageef Disposal system at: Lot #1 " 1,( k dl / Jackson Subdivision or Wt No. Location-Address 41 Park Roadt Sunderland Jim Williams , y ) OF Northampton Type of Build ng Dwelling—No. of Bedrooms Other—Type of Building Others fixtures Design Flow gallons per person per day. Total daily 1500 gallons Length Width 60 Septic Tank—Liquid capicity Width 3 Length Length Disposal age Pit No No. Diameter Depth below inlet Other Distribution No Dosing tank ( ) Other ation Test box ( ) DT Huntley Assoc. Percolation Test Result�y 6 mnutesmedr inch Depth of Test Pit Test Pit No. 1 p Test Pit No. 2 minutes per inch Depth of Test Pit A r - DSize Ls 8.354 Ac gnat Size Lot g 3 Expansion Attic ( ) Garbage Grinder (X ) p No. of persons Showers ( ) — Cafeteria ( ) Description of Soil _.._at._4.:.Q" flow Diameter - Depth eht Total leaching 2i p----Y Total leaching area 330 gallons Date Depth to ground wate Depth to ground wate 3-10-81 Qt GPI) 6"YiTS 1'D" silt, 8r6° sandy till with boulders, groundwater Nature of Repairs or Alterations—Answer when applicable Agreement: The undersigned agrees to install the provisions of TITLE 5 of the State operation until a Certificate of Complia Application Approved By the aforedescribed Individual Sewage Disposal System in accordance with Sanitary Code—The undersigned further agrees not to place the system in has been issued by the board of Ith C // '^"� Li- 4Pthfic Application Disapproved for the following reasons' Permit No / — S Issued_ J . rr Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITYor..N.ORTHAM.PTON . hTertiftrate of Otumptntnte or Re aired ( ) THIS IS T9 CER I T he Individual Sewage Disposal System constructed / ,r P by Se' at 4"r ' il""" ' i y� / f e to Sa ry Code as described the has been installed Disposal in accords ce Construction the provisions Permit No TITLE f `yp - dated y. '-�-t:-.3.of appli THonSSDiNCE Works sCoCERTIFI ATE S SHALL L� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS��J�TEE-THAT HE SYSTEM WILL FUNCTI N SATISFA?CTTYy DATE e..1j.! { Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY NORTHAMPTON FEE a s � No.._14F�I� °ispnnnt ranks Qlnnsfrnttinn Permit Permission is hereby granted....TOAN4.l---.04.“4"0=' c.c ' to Constructs r RRepair ( ) an Indivi ual Sewage Disposal System - /��,,.., /.�. �L at No / / 4!.:3-4.4-/e..-4 .„%-"'--'v it, rest :'`..°'� _..F. ..(r..y.J..t.�.^f. p ._. Incr. Dated.._..e� .-dr. _.QS as shown on the application for Disposal Works Construction Permit - ' � of Health /� DATE._' 0.�,�.� C. ` �� cy< FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �'" O FORM 1 - APPLICATION FOR USCP_- Fce 75 COMMONWEALTH OF MASSACHUSETTS Board of Health, Northampton , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Applkation for a Pemtit to Construct C Repai!()Ronde()Abandon()- Complete System DIndlvMNt Component Type of Building: Residence Dwelling-No.of Bedrooms three Other•Type of Building Other Fixtures Dedln Plow(min. required) 330 god Calculated design flow 330gpd none Design flow provided 360gpd Pte:Dare 11!77/06 Number of sheet one Amnion Date To •_ - - • t. s-o�. . e e v: • e.h and Kathlee Maiewski Deleription of SoiAs)_ Fine sand and gravel. Please see plan for detailed descriptions. Soil Evaluator Form No. Name of Soil Evalmtor nouglas MaCLeay Dm of Lot sue 7.487 'es Garbage grinder( Not! ! No. of persons Showers( ), Cafeteria( ) DESCRIPTION OF REPAIRS OR ALTERATIONS 5 and further agrees to puree the �Iyste ON operation until•Certificate of Compliance a in mesoderm Ms been issued tby the provisions of Health.TITLE the above Signed Q Pr bail-4"A. Date 3)I Z bwp.dbae 0 DEP APPROVED FORM 'I Locrion Audubon 1 ad Owner's Name Joseph & Kathleen Ma ski Mep(PsIC{l Addrel 10Z V el-00A S4. 10a:i}vtwveitbq Lou 9 Telephone/ 535-1065 or 584-5555 ' Imulle?I Name ryq��LL lsu f Designer's Now Mac1eay Associates, Inc. Adam' ?p,1\x g06- 4'V k,tns Sti (.14LC Address 102 Bridge St, Shelburne Falls Telephoned 7--{'1-55!04 Telephoned 913-625-9774 Type of Building: Residence Dwelling-No.of Bedrooms three Other•Type of Building Other Fixtures Dedln Plow(min. required) 330 god Calculated design flow 330gpd none Design flow provided 360gpd Pte:Dare 11!77/06 Number of sheet one Amnion Date To •_ - - • t. s-o�. . e e v: • e.h and Kathlee Maiewski Deleription of SoiAs)_ Fine sand and gravel. Please see plan for detailed descriptions. Soil Evaluator Form No. Name of Soil Evalmtor nouglas MaCLeay Dm of Lot sue 7.487 'es Garbage grinder( Not! ! No. of persons Showers( ), Cafeteria( ) DESCRIPTION OF REPAIRS OR ALTERATIONS 5 and further agrees to puree the �Iyste ON operation until•Certificate of Compliance a in mesoderm Ms been issued tby the provisions of Health.TITLE the above Signed Q Pr bail-4"A. Date 3)I Z bwp.dbae 0 DEP APPROVED FORM 'I No FORM I - APPLICATION FOR DSCP • COMMONWEALTH OF MASSACHUSETTS Board of Hcalt, Northampton , MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application fat a Pcmtil m Constmct(N Regal'()Upgrade()Abandon()- Complete System OlndlviduSl Components Addmsa 8 Hemlock Drive Sunderland Addma102 Bride St, Shelburne Falls Type of Building; Residence Dwelling•No.of Bdsuoms_-. — Othct•Type of Building,`_—. Other Fixtures Design Fbwtmin. required) 330 gpd Calculated Plant ote i i InJo6 Number Number of cbeeta_pne_ Title Description of SO(s) . Soil Evaluator Form No !rat sae 7.487 gjes Garbage grinder O NCH I I No. of persons Showers( ). C•feleria( ) design now 330gd Design now provided 360gpd Revision Pete none .• e•h and 1 s• •.m• •e u: w d • avel. Please see plan for detail Kathle@ Maiewski ed descriptions. d De of Evelun 10/02/96 Name of Sell Plaintiff Douglas Maf'T,eay u um DESCRIPTION OF REPAIRS OR ALTERATIONS the liw 5 and fusyhe spin not e0 Install st the above tens N operation •i Certificate oofCu nplle System( in has accordance been issued tby the Board of Health. Date _� 12.1a� p DEP APPROVED FORM S No. I '1 $ B • . n.\• Fee COMMONWEALTH OF MASSACHUSETTS Board of Health, Northampton CERTIFICATE OF COMPLIANCE . • • - • Description of Work: ❑Individual Component(s) ID Complete System The undenigned hereby certify that the Sewage Disposal System,Constmcted W Repaired().Upgraded(1.Abandoned O.•hY: ✓ at Nu been installed in accordance with the g• i c of 310 CMR 15.00(Tide si sod Fl we 2D igpd)kn 9linslanWih pbm relating no approved 'application No. - �. dated 3 e • 'Installer / ' 1 �_. WS./ 'tom DeaiEnea:Ma Ld5nClatES. ndnspecma_ r ' The Sane.of this pennh shall not be construed as a guarantee that the system will function c dni put' `. DEPAPPROVELI FOAM 5/96 '^/ _ 1 • (�V` 5/.54,7,•• d •k Fee • COMMONWEALTH OF MASSACHUSETTS • Board of Health,_. Northampton . MA. • ' DISPOSAL SYSTEM CONSTRUCTION PERMIT Comma()o Repaid 1 Upgrade( ) Abandon( ) an individual sewage disposM system Perminbn is hereby grained or, C Isdescdbed in the spoliation for Disposal at T t 0 AtadnMn System Cannrvction Remit No._/ —,� Dated /24/5 provided:Construction shall be completed within three years of the date of this permit. All local conditions must b t j/ /cykoAulniHealdt B LF')AMAOR'y FORM 3I96 fate a� 1