247 Septic Application Permit & Compiance 2000 Atir • No J
FORM 1-APPLICATION FOR DSCP
Fee %s—`'c)
Commonwealth of Massachusetts
NORTHAMPTON, Massachusetts
Application for Disposal System Construction Permit
Application is hereby made for a Permit to Construct(X)
system at:
or Repair() an On-site Sewage Disposal
Location Address or Lot No.1
COLES MEADOW ROAD
Owner's Name,Address and Tel.it
ROY GIANGREGORIO
31 RUSTLEWOOD RIDGE
NORTHAMPTON,MA 01062
413/586/7623
Installer's Name,Address,and Tel. #
Designer's Name,Address and Tel. #
MacLeay Associates, Inc.
102 Bridge Street
Shelburne Falls,MA 01370
(413) 625-9774
Type of Building:
Dwelling
Other
No. of Bedrooms Garbage Grinder
Type of Building_No. of Persons Showers_Cafeteria
Other Fixtures
Design Flow 660 gallons per day. Calculated daily flow 1018 gallons
Plan Date 6/22/99 Number of Sheets Revision Date NONE
Title SUBSURFACE SEWAGE DISPOSAL PLAN IN NORTHAMPTON,MASS FOR ROY
GIANGREGORIO,LOT 1 COLES MEADOW ROAD.
Description of Soil COARSE SAND SEE PLAN FOR DETAILED TEST PIT DESCRIPTIONS,
SEASONAL HIGH GROUNDWATER AT 84"PERC RATE 4 MIN./INCH, . WITNESSED BY PETER
McERLA1N
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the co
sewage disposal system in accordance with th
place the system in operation until a Certif
Signed
Application Approved by
etion and aintenance of the aforedescribed on-site
5 of the Environmental Code and not to
ce has been issued by this Board of Health.
Date VZS/072
Date
Application Disapproved for the following reasons
Permit No.
Date Issued
FORM 2-DISPOSAL SYSTEM CONSTRUCTION PERMIT
Commonwealth of Massachusetts
NORTHAMPTON, Massachusetts
Disposal System Construction Permit
No 3D—CD
Permission is hereby granted to ROY GIANGREGORIO to construct (X) or repa
an On-site Sewage System located at
LOT 1 COLES MEADOW ROAD
O
and as described in the above Application for Disposal System Construction Permit. The
applicant recognizes his/her duty to comply with Title 5 and the following local provisions
or special conditions.
All construction must be completed within two years of the date below.
Date
Approved by
FORM 3-CERTIFICATE OF COMPLIANCE
Commonwealth of Massachusetts
NORTHAMPTON, Massachusetts
Certificate of Compliance
This is to Certify, that the Off--site ewage Disposal System installed (X)
()
aired/replaced on .SOU by
for ROY GIANGREGORIO at
LOT 1 COLES MEADOW ROAD
has been constructed in accordance with the provisions of Title 5 and the for
Disposal System Construction Permit No. 30—60 dated
5700 Use of this system is conditioned on compliance
with the provisions set forth below:
The issuance of this certificate shall not be construed as a guarantee that
the system will function as designed. The Certificate expires on
Date VD-5/0 Inspector 6t-,--r`^—'6(94-6 fig
co ,o ILI_ •v1U JON/ NR-01 I
Analyzed For
Address :
Telephone:
NCO LO .VV 14 L vU .VUL r .w
HOWARD LABORATORIES of NEW ENGLAND, INC
750 North Pleasant Street
Amherst, MA 01002
Phone: (413)549-8260 Fax: (413) 549-1850
MA Lab Lic# M-00851
WATER ANALYSIS REPORT
Sample#7504
1,0 (
Contemporary Country Sample Location: 74 Coles Meadow Rd
Builders
31 Russelwood Ridge
Northampton, MA 01060 Sampled By: HWD
Date Sampled: 8/22/00
Date Received: 8/22/00
Parameter ( Results I Limits
Conic;me
Total. Coliform
Bacteria
0 em onf eon DIM:
0 cm onieeh 00r
OK
pH
7. 07 pH ea:;,
OK
Manganese
*
1 .205 ,,.qr
o 01 f'
Hardness
154 ,g:
No .00mra
•., ..m.,
v.o „,n
Conductivity
0 . 12 ms4..
"° 't""""d
"o
"`
Chloride
18 osn
2N1"9c`
OK
iron
*
2 . 15 -9 c:
a.,.gil
*
Sodium
7 ,an
floor
OK
Nitrate
0 . 6 ogn
o n
OK
Nitrite
0. 000 mu
OK
Color
*
1880 Piro color
14:0,
t, u Co Cm Of
Turbidity
*
99. 9 w„
ONa
9
Recommendations: See enclosed MA Dap Chemical Interpretations sheet for
manganese iron, color and turbidity .
This sample meets acceptable standards of potability for the parameters tested,
except for those parameters marked with an asterisk (*) .
Analyst: JK Date: 8/23/00
Checked By:Jonathan S. Berta
Laboratory Supervisor
Ma c L e a y 102 Bridge Street, Shelburne Falls, MA 01370
'Associates, Inc. civil engineers phone (413) 625-9774
fax(413) 625-9704
email: macleay @crocker.com
SYSTEM INSTALLATION OBSERVATION REPORT
SITE INFORMATION
LOT# 1 DATE: 1/18/2000
STREET COLES MEADOW ROAD
TOWN NORTHAMPTON
JOB# 99-015-I
OWNER INFORMATION
PROPERTY OWNER ROY GIANGREGORIO
STREET ADDRESS 31 RUSSELL WOOD RIDGE
TOWN NORTHAMPTON,MA 01062
INSTALLER INFORMATION
NAME OF INSTALLER ROY GIANGREGORIO
STREET ADDRESS 31 RUSSELL WOOD RIDGE
TOWN NORTHAMPTON,MA 01062
OBSERVATION RESULTS
DATE OF OBSERVATION: 10/3/2000, 8/23/02
O
O
THE SYSTEM APPEARED TO BE INSTALLED SUBSTANTIALLY IN
ACCORDANCE WITH THE APPROVED PLAN,AND IS IN COMPLIANCE WITH
TITLE 5.
THE SYSTEM DOES NOT APPEAR TO HAVE BEEN INSTALLED ACCORDING TO
THE APPROVED PLAN,AND IS NOT IN COMPLIANCE WITH TITLE 5.
DEFICIENCIES:
THE SYSTEM DOES NOT APPEAR TO HAVE BEEN INSTALLED ACCORDING TO
THE APPROVED PLAN,BUT IS IN COMPLIANCE WITH TITLE 5. ENCLOSED IS A
COPY OF THE PLAN SHOWING"AS BU/L 'LOCATIO S AND EL ATIONS.
COMMENTS:
-ar's�
�UGLAS J. acL AY,P.E.
PRESIDENT
SEND COPIES TO: BOARD OF/HEALTH
GIANGREGORIO