Lot 5 Septic Application & Plans No P'as
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALTH /
I. .Y OF ()✓%`a tiir7rt/ti
Appxiratinil fur thipnEat Thuds Qimuitnilltilln Prmit
Application is hereby made fur a Permit to Construct (}r) or Repair ( ) an Individual Selvage Disposal
System at: \\
Ca -c A(-.J-6104J
Location r AA ress
Owner
Installer
tc
!/
No.
S..
Address
D
Address 27_[�0
Type of Building 3 �/� Size Lot CSC-' Sq. feet
Dwelling--No. of Bedrooms Expansion Attic (wy Garbage Grinder ( -;',
Other—Type of Building No. of parsons Showers ( ) — Cafeteria ( 5
Other fixtures
Design Flow D gallons per person per ay. Total daily flow 0 0 gallons.
Septic T:ith J�ieuid capacity-JO atlons Length Width Diameter Depth qt :(2---
Disposal Tret+erh --No. 1 . Width JO Total Length 3
Seepage Pit No Diameter Depth below inlet
Other Distribution box 06 Dosing tank ( ��/`
Percolation Test Results j•(�
ps Performed by
Test Pit No. 1 - minutes pc inch Depth of Test Pit 30
Test Pit No. 2 minutes per inch
Total leaching area....xr iP sq. ft.
Total leaching area sq. ft.
Depth of Test Pit
Description of Soil Ce.Ore..1 -Co -th2-C .%..�
Its S_-___ Date /0 _/tf_ 7 L
Depth to ground water ?' f N{'r
Depth no ground water
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.
Application Approved By
vgnea -
_Application Disapproved fur tike foloroirp reaso
Permit No
Dace
Date
Date
Issued
Date
On-Site Review
Deep Hale Number t Date U/i3/6O Time 9105 Weather Gear
Location (identify on site plan)
Land Use feSiokenMka\ t� Slope (%) e2- Surface stones (C To
Vegetation W OOFI(O V t-r!
Landform drt..mtti,
Distances from:
Open Water Body "a0,01:- feet Drainageway none feet
Passible Wet Area ea-00 f feet Property Line 50 feet
Drinking Water Well In /ol feet Other
DEEP OBSERVATION HOLE LOG
Death from Surface
(inches)
Sail Honzon
Sail Texture
(USDA)
Soil Color
(Munsell)
Soil Mottling
Other
(Strucure. Stones,Boulders,
Consistency,%Gravel)
O ro ei
Lj r6 aG,
2G TO 7C.
A
G.
G
SA[
5/L
m/s
IDVl2 3/1
LbYR le
7.5-02 4/4
0- t
cernen\--ed,
10oi5, 5bne,col kles,
loose
CI'rm,Shall CS)edCbea,
c-table,rEo45
F;rm, rtb_sani1,
Ccilr ktsate
Parent Material (geologic): Cio.ku)&SS" Depth to Bedrock iC:V
Standing Water in the Hole na n ¢. Weeping from Pit Face: nine
f)enth to Groundwater:
Estimated Seasonal High Ground Water: 63'
No.:
Date: Apri11,1996
Commonwealth of Massachusetts
/UOr-L an-lp Massachusetts
Site Suitability Assessment for On-Site Sewage Disposal
Performed By:. Oenri5 R. Lacokrse Certification Number. II/95-
Witnessed By: Peer AIC Er!iv,
Location Address or Lot No.: eJ
Cote i`deortcw rd.
Owners Name,Address and Tel.#:
Rom Serwme
"a5 Sy Iu;a \A:9r"s
Fiay.\.\¢ iMA O1035
New Construction ® Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published X61 Publication Scale t:ISByo Soil Map Unit tO/CRE
Drainage Class t_,_72» Gnd Sail Limitation 51o1'e
Surncial Geologic Report Available: No Yes ❑
Year Published -- Publication Scale —
Geologic Material (Map Unit) —
Landform d'n 4 rnlh
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑ Yes El
Within 500 year flood boundary No ® Yes ❑
Within 100 year flood boundary No ® Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit) —
Current Water Resource Conditions (USGS): Month Mara—. re-000
Range: Above Normal ❑ Normal c. Below Normal ❑
Other References Reviewed:
a1
,h:
7 74-7
141
'c ,o7
uh —33
L°
v', a5
05
T1d
On-Site Review
Deep Hole Number -a Date 4//3/60 Time 1:46- Weather Ciea
Location (identify on site plan)
Land Use CPGir*en Ha, Slope (°6) a Surface stones (CD 1-o
Vegetation womd VA
Landfann r%xc&,rvll;"
Distance's from. �s
Open Water Body .4JC 4- feet Drainageway n-one feet
Passible Wet Area XOO r feet Property Line Spl feet
Drinking Water Well hld feet Other
DEEP OBSERVATION HOLE LOG
Caom from Surface
(incnesi
Sc'l etrzon
Sail Texture
t USOA)
Scil Calor Sail,Martl:ac
lMunseill
Other
(Strucure.Stones.Boulders.
Consistency, %Gravel)
O TO 9
[.I TO '3L1
'dLI TO 4a
A
S2Dw
C
54
eic
`"'/s
10 YR 3/4
IoVP. 4k6
7. 5Y4/4
af7-o"
ceme.vlt-e0\
reols) sbner rObb'es,
!Cotoe.
Irw,,sbeeS,(obb's,
Fraxiben ieol5
Firvr,, reoi4&nd,
Cobble; ainable
Parent Material (geologic):
peoth to Groundwater
OLA.1- ooesH Depth to Bedrock q2"
Standing Water in the Hole: v r,e Weeping from Pit Face: non
Estimated Seasonal High Ground Water:jO"
On-Site Review
Deep Hcie Number 'a. Date Li//3/00 rime IC00 lNeather CdllA.r
Location (identify an site plan)
Land Use `fecZaeCU-ta1n Slope (%) Surface sLcnes ■0 TO
Vegetation CCNCiI&Nd
Landforrn rumv11l11
Distances from.
Open Water Body 'C0 4- feet Drainageway Mane feet
Possible Wet Area 'rOO + feet Property Line N O feet
Drinking Water Well in /cL feet Other
DEEP OBSERVATION HOLE LOG
Cenci from Surface
(incnesl
Soil Hcraon i
Soil Texture
1 USDA)
Sal Cclor Soil Motti:nc
;Munseill
Other
(Structure. Stones.Boulders.
Consistency,' Gravel)
0 t0 Cu
Co' Tt 14
tc6 TO ky
IN TO gib
fS
CI
G a
S
�G
5/c
L/5
m
/S
IOYKI 3/3
lb\02\ k4e
a.s vR y/y
S
'ism Y! �4
-ii;
horc ko
No"
loose, (.01-5, rnbli3
r»w sfw+es
ltao�, reoLS cobbl[S,
&lane, CHAN%
Cease yi.ruS,oywrel,
1ocSe, Friable
Uely late) m�ss,LO,
Crrluole
Parent Material (geologic): Oicek-u_)015S1n Depth to Bedrock t40'
Drenth to Groundwater Standing Water in the Hole: mm he. Weeping from Pit Face: none
Estimated Seasonal High Ground Water.lo 4-
( c1
107
z'u3d
z'1 i3 1<31
oh sn
J
r rd isn
5
1a�
No.: Date: April 1,1996
Commonwealth of Massachusetts
kOr'rh.0.wciOn r
Site Suitability Assessment for On-Site Sewage Disposal
Massachusetts
Performed By:. Oe.'nvus R. Lato“-rSC' Certification Number. Vir
Witnessed By: 96-et Mcerlin
Location Address or Lot No.: q
Cole. J4eo.akte
Ownees Name,Address and Tel.#:
ROr\ Serckme
'DS Syluia \a"C 3
NoJ.\ey ,AA OY o
New Construction ® Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes isc
Year Published $1 Publication Scale 11$`4.40 Soil Map Unit lb/CAE
Drainage Cass we» 6 -&itcel Sail Limitation stye
Surficial Geologic Report Available: No 2 Yes ❑
Year Published — Publication Scale —
Geologic Material (Map Unit)
Landfonn kftiorvItLn
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑ Yes
Within 500 year flood boundary No ® Yes ❑
Within 100 year flood boundary No 2I Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month /t(a6'ch aDoO
Range: Above Normal ❑ Normal W Below Normal ❑
Other References Reviewed:
On-Site Review
Deep Hole Number I Date 4'43/00 Time /0:45- Weather Cl2ar
Location (identify on site plan)
Land Use re-Sic/en MO Slope (%) re. Surface stones /0 to
Vegetation Cy)eta lo-Vit a
Landform Glrt-kiwtili
Distances from:
Open Water Body -abo h feet Drainageway •Zane feet
Possible Wet Area x.00 h feet Property Line 'c1C feet
Drinking Water Well lZ /O( feet Other
DEEP OBSERVATION HOLE LOG
Depth from Surface
(inches)
Soil Horizon
Sail Texture
(USDA)
Sail Calor
(Munsell)
Soil Mottling
-
Other
(SWCure,Stones,Boulders.
Consistency.o Gravel)
Q rc7 6
Go To asy
ac6 TO Coo
60 ro
7.0 TO lad
A
CS
c
GI
Cg
`%
54.
o/s
C7S
ills
/OYR 3/3
loY R,61/4,
a.s (R 4/y
5Y1\ `Vs
a.sYIS 5/q
YtChe
iat
Ithosei rcols,col ,
&AD-sioiten
too , mats, cabbies.,
Skne, Prktble
c« rse sad 9 mow,
t, (e
Ft,-pM, f-riobie, mQSS�x
C /O ,ei)
Very kos; wutsstuer,
Ccaiste
Parent Material (geologic): C1&w 15,t, Depth to Bedrock @itt
Depth to Groundwater. Standing Water in the Hole: rum"- Weeping from Pit Face: 4on2
Estimated Seasonal High Ground Water:la3"+
Location Address or Lot No. 5.
Case,
FORM 12 - PERCOLATION TEST
('7Eir'p& l
COMMONWEALTH OF MASSACHUSETTS
/00,(14, QPnp/0,„ Massachusetts
Percolation Test'
Date: 61/3/ Time:. 9:Os-___.
Observation Hole #
/
,a
Depth of Perc
115 "
So"
Start Pre-soak
9: as
10; 0i
End Pre-soak
9: 37
io : /6
Time at 12"
el: gt
ro : 17
Time at 9"
usi
10: 2-96
Time at 6"
10:07
l0 : SI
Time (9"-6")
(e miv.
"13 ,„t„.
Rate Min./Inch
G min. /i44
Ci
a won. fin.
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed ® Site Failed ❑
Performed By
Witnessed By
Comments:
Oenr■iS K. L&co rsQ
'Peen- At r\ v
DEP APPROVED FORM-12/07/95
FORM II - SOIL LVALUATOR FORM
Page 3 of 3
Location Address or Lot No. 6 Ca`ei l €aM,Z « .
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole...... . . inches
❑ Depth weeping from side of observation hole _.. inches
Depth to soil mottles9d F 70 inches
❑ Ground water adjustment feet
n'
Index Well Number
Reading Date Index well level
Adjustment factor Adjusted ground water level
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system? yes
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on !//ls- (date) I have passed the soil evaluator examination
approved by the Department of Environmental Protection and that the above analysis
was performed by me consi ent with tare •red training, expertise and experience
described in 310 CMR 1 .017. c`
Signatur
DEP APPROVED FORM-13/07193
Date LO 3/00
On-Site Review
Dees title Number cY. Date L ` I' C , "rime !• b0 P's Weather LCe9`l
Location (identify on site plan)
Land Use L Slope (%) Surface stones 10 °Ce,
Vegetation LCSCt'I /1"al f7
Landfcrrn -CZU n-it Li
Distances from:
Open Water Body '3tc i- feet Drainageway none feet
Possible Wet Area Qco r feet Property Line aro feet
Drinking Water Well n /eA feet Other
DEEP OBSERVATION HOLE LOG
Cecrn ion Scrtace
(incnesl
Scil r.....,.
Soil Texture
(USDA)
Sod Color
iMunsedl
Soil Mortl:nc
Other
(Strucure. Stones.Boulders,
Consistency,%Gravell
O TB
Lo- lb 10
7P TG 5t
1 4
`�tU
C(
��
5
4.
C/9
IDYL
•
I8V /
7`5Y2 '%
[ AI
leebe)rooAS,stones,
Loose, r00% skneg,
('rtalo , 9re...,.4 .
t-lrwn, forte Crl�c.ble)
n'v askr-
fa ``
Parent Material (geologic): 'i7R 1
->a1-- T�t ( Depth to Bedrock i.2b
Depth to Groundwater. Standing Water in the Hole: ddovE Weeping from Pit Face: /Vodee
Estimated Seasonal High Ground Water. I)[3'r
Z ioy E. goy
n h fl
i
.411,05‘
fi E t 4161 N(d
S 1°'7
No.:
Date: Apri11,1996
Commonwealth of Massachusetts
p!ha FrAMpTca , Massachusetts
Site Suitability Assessment for On-Site Sewage Disposal
Performed By:. `PEA.,
R . L9coveabe.
Witnessed By: 1"r e &t 1, .3
Certification Number. // `A—
Location Address or Lot No.:72B '}�b4 cc C 1.0r
3 I Cfr r>ziP.breu 17-4),
Owner's Name,Address and Tel.#:
Poh QcYYkm e
'd.6 Syluia 1-If9Ht•s
tiadtey AAA ot03s
New Construction Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes
Year Published g/ Publication Scale /.vsgVn Soil Map Unit /Z/cxt
Drainage Class /io,t// Soil Limitation c- triiii-
Surticial Geologic Report Available: No j Yes ❑
Year Published — Publication Scale
Geologic Material (Map Unit)
Landform.i>ZO rn Li nr
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑ Yes CZ
Within 500 year flood boundary No g Yes ❑
Within 100 year flood boundary No Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit)
Wetlands Conservancy Pragram Map (map unit)
Current Water Resource Conditions (USGS): Month VYlm&O-1, ?�n
Range: Above Normal ❑ Normal Below Normal ❑
Other References Reviewed:
On-Site Review
Deep Hole Number I Date y�/3/G0 Time /DO 'Neather C kar
Location (identify an site plan)
Land Use fPSidedtlael Slope (%) ')- Surface stones (U M
Vegetation wo:et-Mawd
Landform Otrumtliv,
Distances from:
Open Water Body 300 ' feet Drainageway inn ne feet
Possible Wet Area 0-60 i• feet Property Line tSl feet
Drinking Water Well n /01 feet Other
DEEP OBSERVATION HOLE LOG
Death from Surface
(inches)
Soil Horizon
Soil Texture
(USDA)
Sail Cola
(Maisel()
Soil Mottling
Other
(Slruaure.Stones.Boulders.
Consistency,%Gravel)
CI lla Co
La rt 77-•
.72- 11, VD
C 'fp [, 7
L9 m g(Z
A
1310
�.�
C�
54_
'
C` 5
/.>
�
(D yr 363
b)/2 I
l 4
5-yez 9/3
Cr ` .
rCtr
/y
57� SA/
a), 6th.,
C4ace atm
UUn[ 1•t.,..43
s '
9
Pam, ftnc, ktwk,
me.45%)C
tee' S Wig,
S4
Parent Material (geologic): ,q Z- 7-) ( Depth to Bedrock 01)-
Depth to Groundwater: Standing Water in the HoleIVO-ne Weeping from Pit Face: Nom&
r
Estimated Seasonal High Ground Water:L�'
Location Address or Lot CI
Date
PERCOLATION TESTIS)
Time:
1 Time:
Observation Hole
#1
Observation Hole
#2
Depth of Perc
Depth of Perc
Start Pre-soak
Start Pre-soak
End Pre-soak
End Pre-soak
Time at 12"
Time at 12"
Time at 9"
Time at 9'
Time at 6"
Time at 6"
Time (9"—6")
Time(9"—6")
Rate Min /Inch
Rate Min./Inch
'minimum of 1 percolation test must be performed in both the p'many area AND reserve area.
SITE
PASSED
'SITE
FAILED
I SITE
PASSED ._
'._
SITE
FAILED
Performed by
Performed by
Witnessed by
I Witnessed by
Comments:
NORTHAMPTON BOARD of HEALTH- Title 5- Site Review
Location
Address or Lot#
Date
(' 4ti t
[NU �_{�Ly r
Owner-
Engineer
Land use
NegataPcn
Ptctsitigatt
rSketth
A mr, 14 l r$IOPR
y
-
Phone#
Open Water Body
feet
feet
iii,l,i9PPRVIr.
feet
Possible Wet Area
feet
DralnageWay =:
feet
ier
feet
Deep Hole#:
DEEP OBSERVATION HOLE LOG*
1,11NI Mum OF TP1O HOLES REOUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from
Surface(Inches)
Deep Hole#:
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TWO HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA
Soil Color
(Munsell)
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Sail Mottling
Other
(Structure.Stones.Boulders,Consistency,%Gravel)
/1 �
j.
1
�-
1
!
/,
I
-,
P'iI-1
i
I Weeping from Pit Face I
Estimated Seasonal High Ground Water
Parent Mated&(geologic) I
Depth to Bedrock I >/ '` l
Depth to groundwater. Standing Water in the Hole
I Weeping from Pit Face I /1/o c;
Estimated Seasonal Seasonal High Ground Water
'7 / 1
Deep Hole#:
DEEP OBSERVATION HOLE LOG*
1,11NI Mum OF TP1O HOLES REOUIRED AT EVERY PROPOSED DISPOSAL AREA
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munsell)
Soil Mottling
Other
(Structure,Stones,Boulders,Consistency,%Gravel)
Parent Matedal(geologic) I
Depth to Bedrock. I
Depth to groundwater. Standing Water in.the Hole
I Weeping from Pit Face I
Estimated Seasonal High Ground Water
PERCOLATION TEST(S)
Time: Time:
Observation Hole #1 Observation Hole #2
Depth of Pero (/�i Depth of Perc
So If
Start Pre-soak G , Start Pre-soak
End Pre-soak / r-I End Pre-soak /0 40
Time at 12" l Time at 12' / .11
Time at 9' J C Time at 9'
Time at6' Time at6' -J )
Time (9"—6') I Li /z7 Time(9'—6") z/k.
Rate Min/Inch
0/11"---/ Rate Min/Inch j
'minimum of 1 percolation lest must be performed in both the primary area AND reserve area.
■ . : .... • ■ .J
Performed by Jq-._ I Performed by
Witnessed by � Witnessed by
Comments:
VR
k� \
NORTHAMPTON BOARD of HEALTH- Title 5 - Site Review
. . - L4 5 LPL. kia(UJ'-) Owner K6-v, r3-{/1.Cir-[,w��t_
Date r"t
I 15 a
Time
Sail Hohzon
Owner's
Address
Sort Cdor
(Mansell)
Engineer I
(�
Weather
Phone#
Land Use
4 0�/,w+ '
%Slope j
jl� Surface Stones
�•��
Landform
Estim ted Seasonal HO Ground Water
Ve•etation Start Time it t.�
Position on Landscape( ketch on the back)
Distances
Drinking Water Well
Stop Time
Open Water Body
feet
feet Property Line
feet
Possible Wet Area
feet
Drainage nage Wa
Way
feet Other
feet
Deep Hole p: E -
DEEP OBSERVATION HOLE LOG*
'MINIMUM OF TW
Deep Hole ft: S— d--
DEEP OBSERVATION HOLE LOG'
`MINIMUM OF
Depth from
Surface(I nches)
Soil Horizon
Sail Texture
(USDA)
Depth from
Surface(Inches)
Sail Hohzon
Soil Texture
(USDA)
Sort Cdor
(Mansell)
Sol
Mottll't9
Other
(Swdure.Stones.BoNtlers Consistency,%Grovel)
(7 t(
A
5l
Vid
Parent Mabial(g ologic)
i)
l��{
1
Estim ted Seasonal HO Ground Water
.
n-er-A4 /i ce-"-t Cis 41'
E
Patent Mahal(geologic)
Depth to Bedrock i 7 4 e
Depth to groundwater-. Standing Water in the Hole
7-7 1 We ping from Pit Face j/p-r../-
Estimated Seasonal High Ground Water
.5 1--
Deep Hole ft: S— d--
DEEP OBSERVATION HOLE LOG'
`MINIMUM OF
Depth from
Surface(I nches)
Soil Horizon
Sail Texture
(USDA)
Soil Color
(Munsell)
Soil ✓✓
Mottling
Other
(Structure,Stones.Boulders,Consistency,%Grave l
�/
q J(I
ail
e
El
-2 1—
(0 III*
NCA
Parent Mabial(g ologic)
Depth to Bedrock
> pi),---- Weeping
$-
from Pit Faces /
Depth to groundwater Standing Water in Inc Hole
Estim ted Seasonal HO Ground Water
Gn e --
. . . . . ... . . . .... .... ...
LOT # 5 4' PVC SOLID PIPE
48 Li of 4• PVC PERT PIPE PER TRENC PUMPING MANHOLE C'C')
'1 4'PVC SOLID PIPE
Pr- ( Arr
A I ' EXISTING
HOUSE GARAGE rr�.. r8r,
r,Dr,
pp�tH�OF
1500 GALLON SEPTIC TANK 4+ TIMOTHY yr
OISTRIBUT ION BOX 33 MAGINNIS '�^
SRI EEWg y
—1--- No.9B2
NI e1
AS-BUILT DIMENSIONS
'A' to 'C' = 29.5' AS-BUILT PLAN
'A' to 'D' = 61' EXISTING SUBSURFACE SEWAGE DISPOSAL SYSTEM
'B' to "C" = 23.5' LOT t1 5 - COLES MEADOW ROAD - NORTHAMPTON, MA
'B' to 'D' = 49' 4 LEACHING TRENCHS @( 48'L x 3'W x 1.5'H ) EACH
MARCH 26, 2003