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48-006 Certificate of Compliance 246-535Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 8A — Request for Certificate of Compliance 246 -535 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP Upon completion of the work authorized in an Order of Conditions, the property owner must request a Certificate of Compliance from the issuing authority stating that the work or portion of the work has been satisfactorily completed. 3. The project site is located at: 140 LOUDVILLE ROAD Street Address MAP 48- Assessors Map /Plat Number 4. The final Order of Conditions was recorded at the Registry of Deeds for: JANE CAREY Property Owner (if different) HAMPSHIR 7633 66 County Book Page Certificate (if registered land) (PLEASE NOTE: 5. This request is for certification that (check one): WORK WAS DONE FOR APPLICANT IN 2003 BUT REQUEST FOR CERT. OF COMPLIANCE WAS the work regulated by the above - referenced Order OT C�Ei) s has been satisfactorily completed. ❑ the following portions of the work regulated by the above - referenced Order of Conditions have been satisfactorily completed (use additional paper if necessary).. NORTHAMPTON City/Town 006 -001 Parcel /Lot Number ❑ the above - referenced Order of Conditions has lapsed and is therefore no longer valid, and the work regulated by it was never started. Page 1 of 2 wpaform8a.doc -- rev. 7 /13/04 A. Project Information Important: 1. This request is being made by: When filling out forms on the DEBORAH S KOCH (SUBSEQUENT OWNER — BY'DEED IN BOOK 7669, P 1 9) computer, use Name only the tab 140 LOUDVILLE ROAD key to move your cursor - Mailing Address do not use the NORTHAMPTON., MA 01062 return key. City/Town State Zip Code (413) 586 -2092 (H) (413) 755 -4479 (W) rag Phone Number 2. This request is in reference to work regulated by a final Order of Conditions issued to: <nm JANE CAREY Applicant 246 - 535 DECEMBER 17, 2003 (DATE ISSUED) - — - Dated DEP File Number Upon completion of the work authorized in an Order of Conditions, the property owner must request a Certificate of Compliance from the issuing authority stating that the work or portion of the work has been satisfactorily completed. 3. The project site is located at: 140 LOUDVILLE ROAD Street Address MAP 48- Assessors Map /Plat Number 4. The final Order of Conditions was recorded at the Registry of Deeds for: JANE CAREY Property Owner (if different) HAMPSHIR 7633 66 County Book Page Certificate (if registered land) (PLEASE NOTE: 5. This request is for certification that (check one): WORK WAS DONE FOR APPLICANT IN 2003 BUT REQUEST FOR CERT. OF COMPLIANCE WAS the work regulated by the above - referenced Order OT C�Ei) s has been satisfactorily completed. ❑ the following portions of the work regulated by the above - referenced Order of Conditions have been satisfactorily completed (use additional paper if necessary).. NORTHAMPTON City/Town 006 -001 Parcel /Lot Number ❑ the above - referenced Order of Conditions has lapsed and is therefore no longer valid, and the work regulated by it was never started. Page 1 of 2 wpaform8a.doc -- rev. 7 /13/04 Massachusetts Department of Environmental Protection DEP File Number: ,. ;.. Bureau of Resource Protection - Wetlands WPA Form 8A — Request for Certificate of Compliance 246 -535 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP L! A. Project Information (cont.) 6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain an approval of any plans stamped by a registered professional engineer, architect, landscape architect, or land surveyor? Yes If yes, attach a written statement by such a professional certifying substantial compliance with the plans and describing what deviation, if any, exists from the plans approved in the Order. SEE ATTACHED LETTER DATED DECEMBER 22, 2003 No FROM REGISTERED SANITARIAN /HYDROGEOLOGIST ALAN E. WEISS SUBMITTED TO NORTHAMPTON BOARD OF HEALTH B. Submittal Requirements Requests for Certificates of Compliance should be directed to the issuing authority that issued the final Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit this request to that Commission. If the project was issued a Superseding Order of Conditions or was the subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional Office (see htfip: / /www. mass.- gov/ dep /about/region /findyour.htm wpaform8a.doc -- rev. 7/13/04 Page 2 of 2 COLD SPRING ENVIRONMENTAL CONSULTANTS I NC. •Percolation Tests • 21E Site Investigations . Septic Designs • Subsurface InvgJt a • Regulatory Compliance • Pollutfon.Rem i _ _ tuber 22 , 2 0 0 3 • Recycling and S( • LSP on Staff • Second Opinion • Forensic SeptiMOdSt(i8h &Milton Board of Health RE:Septic System Installation Inspection 14,0 Loudville Road (Carey) On this date, the writer inspected the installation of a soil Absorption System (septic system). The writer found the installation to be complete (except for completion of cover material and final fill) and in compliance with our plans and 310 CMR 15.000.: The installer representative (Jim Dimas) My inspection noted that the system was built properly, in accordance with the state regulations. and our plans. The contractor was requested to have sufficient breakout soil on site and properly cover the system according to our plans and may backfill the system after review by local Health Department representatives. sincerely, Cold Spring Environmental Consultants, Inc. Alan E. Weiss, M.S., L.S.P.. President Principal Hydrogeologist Licensed Site Professional #6442 Registered Sanitarian #933 Cold Spring Environmental, 350 old` Enfield Road Belchertown,;Ma. 01007 413- 323 -5957, phone 413- 323 -4916, fax ALAN F \ r REG 1 n rn cis uED Sti� 350 old Enfield Road - Belehertown, MA. 01007 ° Phone: 413.323.5957 Fax 413.323.4916 email: aeweissftharter.net www.coldspringenvironmental.eom V Q) ti CV ) C, b4 rx LU lu 2, 0 U- 0 LL. 2i, Owe z U- 0 0 Zap 2. uj 2 x 0 u u, 0 0 ,� > z II LU a. 0 J_ u <L w ul 0 , I . 0 .T- C) z ;z C 0 m -j z ti CV ) wl; LL. F- cr c Ll C/. rx LU lu 2, 0 U- 0 w 2i, Owe z U- 0 0 Zap 2. O 2 x 0 u u, 0 0 ,� > z Z 1- M LU a. 0 J_ u <L w ul 0 , I . 0 z o z ;z C 0 x W aw U, L l- lul 0 z z u - , m 1 0 W �z 0-"m z Oa-<> wl; LL. F- cr c Ll C/. Bk: 07633 Pg: 66 (^t� I � Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 -- Order of Conditions 24 Pro vided ILI by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. rat ream A. General Information III>IIIIII�II ElI VIII II +) I IIIIIIIIIIIII From: Sk: 7633Pg: 88 Page: 1 of 9 Northampton Recorded 12123/2003 12-49 PM Conservation Commission This issuance if for (check one): ® Order of Conditions ❑ Amended Order of Conditions To: Applicant: Jane Carey Name 1922 River Road Property Owner (if different from applicant): Name Mailing Address Mailing Address Guilford VT 05301 City/Town State Zip Code City/Town State Zip Code 1. Project Location: 140 Loudville Road Northampton Street Address City/Town 48 6 Assessors Map /Plat Number 2. Property recorded at the Registry of Deeds for: Hampshire County (if registered land) 3. Dates: Parcel /Lot Number 5960 32 Book Page October 24, 2003 December 16, 2003 December 17, 2003 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4, Final Approved Plans and Other Documents (attach additional plan references as needed): "Septic System Repair Plan For Jane Carey, 140 Loudville Rd, Northampton, MA" 10/22/03 Title Date Title Date Title Date 5. Final Plans and Documents Signed and Stamped by: Alan E. Weiss Name 6. Total Fee: $55 (from Appendix B: Wetland Fee Transmittal Form) WpaformUoc • rev. 12/15/00 Page 1 of 7 Bk: 07633 Pg: 70 I - Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 —Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 24t,- 535 Provided by DEP B. Findings (cunt.) Additional conditions relating to municipal ordinance or bylaw: This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of issuance. 1: XD�r_PXYI Date This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office (see Appendix A) and the property owner (if different from applicant). 612, 4/4��� On Of Serfe--631'- Day Month and Year before me personally appeared " , �ONtN� �d to me known to be the person described in and who executed the foregoing instrumen %� ted �o� * y. • �` 2 acknowledged that he /she executed the same as his /her free act and deed. = COMMISSION �i' CT�'✓� �� • G plR� S ZI Notary Public/ My Commission Expires 8 g 5: This ❑ Or �� is delivery on a pplicant as follows; f&by certified mail, return receipt ' r ' e / gUftldAtitl4����� ,`\\\` � n �_•C G 7 7 Date Date Wpab rm5.doc • rev. 12 I SMO Page 6 07 Bk: 07669 Pg: 19 h' Recorded: 01129/2004 03:16 PM QUITCLAIM DEED '1 Affected Premises: 140 Loudville Road Northampton, MA KNOW ALL PERSONS BY THESE PRESENTS THAT I, JANE CAREY, of Northampton, Hampshire County, Massachusetts, in consideration of ONE HUNDRED TWENTY THOUSAND AND 001100 ($120,000.00) DOLLARS, grant to DEBORAH S. KOCH, of 23 Pomeroy Terrace, 1 Floor, Northampton, MA 01060 with QUITCLAIM COVENANTS The land in Northampton, Hampshire County, Massachusetts, more particularly bounded and described in the Exhibit "A ", attached hereto and incorporated by reference herein. Being the same premises conveyed to the Grantor herein by deed of Anthony W. Warren and Kailee J. Warren, dated December 28, 2000 and recorded in the Hampshire County Registry of Deeds in Book 6097, Page 320. ,� Executed as a sealed instrument this �9 day of January, 2004. JA rICAREY COMMONWEALTH OF MA Hampshire, ss. January /9 , 2004 Then personally appeared the above -named JANE CAREY and acknowledged the foregoing to be her free act and deed, be ore me Leonard a anowski, Notary Public My Commission Expires: 08/22/2008 MASSACHUSETTS EXCISE TAX Hampshire Dletrlot ROD #13 001 Date: 0 1/2912004 03 :18 PM otrl#F 008577 27998 Doc# 00002877 Fee: $547.20 Cons: $120,000.00 Bk: 07669 Pg: 20 r� EXHIBIT "A" The land with the buildings thereon, situated in the Village of Loudville in Northampton, Hampshire County, Massachusetts, on the easterly side of Loudville Road and bounded and described as follows: Beginning at an iron pin on said easterly side of Loudville Road at the Southwesterly corner of land now or formerly.of Harold W. Lacombe, et ux, and running S. 77° 44' 30" E. along said land of Lacombe a distance of 67.49 feet to an iron pin and thence continuing in the same compass direction a distance of 10.5 feet, more or less, to the North Branch of Manhan River; thence turning and running in a general southerly direction along said North Branch of Manhan River a distance of 202 feet, more or less, to land now or formerly of Raymond V. LaPrade, et ux; thence turning and running N. 51° 26' 30" W. along land of said LaPrade a distance of 147.71 feet, more or less, to a point on said easterly side of Loudville Road where Milton Brook crosses said road; thence turning and running N. 6 07 E. along said Loudville Road a distance of 12.5 feet to a set pin; thence continuing in the same compass course along said Loudville• Road a distance of 114.92 feet to the iron pin at the point of beginning, containing 16,350 square feet of land, more or less. Subject to a restriction recorded in Book 7597, Page 279, that due to the design of the septic system that a garbage disposal shall not be installed on the premises. Subject to an Order of Conditions .issued by the City of Northampton Conservation Commission dated December 17, 2003 and recorded in Book 7833, Page 66. ATTEST: , ��tGta�F - � GISTI3R M?aRI&MM L. DONOHUE