575 Septic Application Permit & Plans 2000 CHECK OR FILL IN%%HERE APPLICABLE
7141 COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
C IT? OF blo CTR fl lP7an r
Appliratinll fur flthipazui Marks Qlunazwftu i Permit
Application is hereby_made for a Permit to Construct ( X) or Repuir ( ) ao Individual Sewage Disposal
System at S7°j
l.JT' T CcfeS• hz 1 d„, ti or 2
hone ScZCJpa r r %'=2C..,n,E 3wZi)ui v.,
/ A "4 tear HAOLSy MF�GKT.7��
Type of Building Cr”. ? oJJ eq lea
Dwelling— No. of I3edraoms-5 Expansion Attic ( ) Garbage Grinder (N )
Other—Type of Building No. of persons. Showers ( ) — Cafeteria ( )
DM,�r fixtures
Design Flow -5 gallons per person per day Total daily flow ggs C?%�O°'
Septic Tame—Liquid capacityl.Sthh�.galluns Length ) '5 W'dtl•/S " Diameter — Deptls_7'O '
Disposal T.si— No._._.L-- Width. . _Total Length 50 - Total leaching arm U •q ft
Seepage Pit No_. Diameter_____....... Depth below iule• Total leaching area.......—sq. ft.
Other Distribution box e( ) Dosing tank ( )
Percolation Test Results Periormed by �e4 a4.t /11c�..R1'+ Due ��G,/n.�
Teat 1'ii No. I.._G Zminutes per inch Depth of Test Pit/Zo' Depth to ground water..71?u ''
Test Pit Nu. 1..__4 minutes per inch Depth of Test Pit. /20 ` Depth to ground water7/70
Description of Soil n'1-`,e 7ic/i)-r S. O
Nature of Repairs or Alterations—Answer when applicable_
Agreement:
The undersigned agrees to install the afaredescribed Individual Sewage Disposal System in accordance with
the provisions of?ITIF. 5 of the State Sanitary Cade—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance. has been issued by the board of health.
Signed ��- ,✓ ccl-�-�
Application Approved By
Application Disapproved for the following
Permit No laurel
Dam
tsw.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OOF�� t"�N
v X OF
Qlrrtifirutr IIf CCIIIntglt'unrp
i ideal Sewage Disposal System constructed ( or Repaired ( )
THIS l,.ij'O S, TIF That the 1
by
at__...Lo-£[ _L PLC /4X
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No._ qZ- - _.. dated Z.yll d//p___. .__
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE--- / Inspector ✓J _, ly
THE COMMONWEALTH OF MASSACHUSETTS /-�� 7// /a-cJ
Fa.
No as Jam'
BOARD OF HE
OF /Mg'
64I
I3lnpnaai nriw IInntnwXinn lUPrmit
Permission is hereby granted- � �
to Cons
at N
or ( ) >n 1.dividua{!$elyage Disposal System
firm
as shorm on the application for Disposal Works Construction Fermi -UU ••j•%
4 /e
YW r MINIM
r 750DRoTORIEB of ntW ENOLAMD, jN0 750 North Pleasant Btreet
it 12 2030 Amherst, MA 01002
(413)549-6280
Pam: (413)540-18SO
i.EPTOF Bill:LNG ENSPE TIO I MA Lab Lief M-00851
WATER A1DILYBIB REPORT
Analyzed For:
Address:
Telephone:
Bercume Builders
25 Sylvia Heights
Hadley, MA
sample 87352
575 CD As goeek/
Sample Location: Lot. fl Coles Meadow Rd
Northampton, MA
Sampled By: HWD
Date Sampled: 7/6/00
Date Received: 7/7/00
Total coliform
Bacteria
Absent
Presence/Absence
OK
pH
7,93 pN Unns
6.5-5.5 pa unit.
OK
Manganese
0.031 ma
0.05 NA
OK
Hardness
39 NA
No Standard
TS0 soft, >100 hard
Conductivity
0.21 .a/an
No Standard
No Standard
Chloride
9.2r0
dNPp/l
OK
Iron
0.05 own
0.3NN/t
ox
Sodium
9 ap/l
lam/I
OK
Nitrate
0.4 .w/I
10w0/I
OK
Nitrite
0.005 awn
1 NA
OK
Color
*
30 PtCo Color Units
15 It Co Color Unita
*
Turbidity
•
7.8 NTU
$ NW
*
Recommendations: See enclosed MA DEP interpretations sheet for color &
turbidity.
This sample meets acceptable standards of potability for tjhe parameters tested,
except for those parameters marked with an asterisk (*) .
Analyst: D.C.
Checked By:Jonathan S. Begq
Laboratory Supervi
Date: 7/11/00
Deep Hole Number
On-Site Review
Date 4 ' V' w�Time Ct �B Ran
Weather c LooD7
Location (identify on site plan)
Land Use LI)oobl•r r'b/Atc1lnn Slope(%) .i Surface stones a %
Vegetation O.a7u2E
Landfonn art Nn 0'11 Olt et.st e.E
Distances from-
Open Water Body 4ix.:1- feet Drainageway juearic feet
Possible Wet Area 4 et 7' feet Property Line b`6 feet
Drinking Water Well zcunT feet Other
DEEP OBSERVATION HOLE LOG
Depth from Surface
()nches)
Soil Horizon
Soil Texture
(USDA)
Soil Color
(Munselll
Soil Mottling
Other
(Structure.Stones,Boulders,
Consistency,%Gravel)
/
Fi2rr Reny 5.
' 3
It)onoc
Tb y
t
R.i Ce34/Es
013ii4U 27 jZgp&j S a/t,
B
y
/5
7.yy241/,
Tt, 4.-4,r0EL7Fci43le
n
I l
9is UFizy LOD St`r
It
,NrylV n7 5ofrtl?
)1p
C
l
4
LL
/7 ez/LJ
/
UcrLt=gYED
L.AyMY of ? If
1 -ermy 7A " 1-0
I io "
1444 SytOt
Parent Material (geologic): DuT u i s5 Depth to Bedrock 12-eb
Depth to Groundwater: Standing Water in the Hole: NaN= Weeping from Pit Face: No
Estimated Seasonal High Ground Water.«*
No.: Date: April 1,1996
Commonwealth of Massachusetts
1\ 6re *)4e.,, a Massachusetts
Site Suitability Assessment for On-Site Sewage Disposal
Performed By:. .0•.• ? _ 1—g Co02 SE Certification Number. /5/9S
Witnessed By: { 7t2 re>, EL�i.0
Location Address or Lot No.: Fae
Cores in-zERDose Rflb
Owner's Name.Address and Tel.#:
Ron 0,orne
a5
51l4e.
Ebd.\ey, MA 01015
New Construction Fit, Repair ❑
arcfp
Office Review -7 `� 11
PO ,')n&?/-
Published Soil Survey Available: No ❑ Yes 0
Year Published 81 - Publication Scale /•'1 5 g , Soil Map Unit IC9 /C4 t
Drainage Class LUEI- Soil Limitation 5L.ep
Surticial Geologic Report Available: No ¢1 Yes ❑
Year Published Publication Scale —
Geologic Material (Map Unit)
Landform Crcevu v rz rq,A e
Flood Insurance Rate Map:
Above 500 year flood boundary No ❑ Yes S
Within 500 year flood boundary No fig Yes ❑
Within 100 year flood boundary No j6. Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) _--_
Wetlands Conservancy Program Map (map unit)
Current Water Resource Conditions (USGS): Month . Brcch m
Range: Above Normal ❑ Normal g Below Normal ❑
Other References Reviewed:
t is moQE h4 s ?) v
Hf
•
3 it.
g.
cv
P p
)
4 1*
V
r., 5i36-,-,7•4
£/ 6
os 54-11' dad t 9vad
0
dJC/ t CD rot s o b �h
b WI
-v7 re Cr. `i 3'f .rL1 1>Q.p,/ t ll
-LAS�a;1 1d 1143.1 rAm Tsai , 54_,
Ai/ l1"�aJrc�( <1'616i -7 c.vo Fri
O Q
b -c-,iad
wgr ? �•ce' -f-
n0+ r 0(_f_..4
1 -_-_-%_.--/
On-Site Review
Deep Hale Number d- Date 9- lc • 2-bet Time / Weather caent y
Location (identify on site plan)
Land Useprmubl•r•+D e �nsltr2i- Slope (%) .W Surface stones Z is
Vegetation 794.'tyizE
Landform .z4s&.t '/e rl.
Distances from:
Open Water Body Li 00 feet
Possible Wet Area yber feet
Drinking Water Well >X" feet
Drainageway
Property Line
Other
NBLC feet
7a feet
DEER OBSERVATION HOLE LOG
:eon from Surace
(inches)
Sol rcrz:n
Soil Texture
IlJSOA)
Sod Color Soli Mom:ra
iMunseill
Other
(Structure, Stones.Boulders.
Consistency,%Gravel)
p -Tb Y
( Tb ��
9
1 l T6 r�-0
A S/_
L
13 /c)
A
U E¢ uA Ycrr, L_9
Y
ST9/LT<�r/, RT
lb ye%
7Sye �
-
ee', %"
p (
Y7 L d"r
Sy- %
No
vomit)F..5
b&smut
"rut ev
z tNrc
Fe.n ,
� � R�
goo?
CBSail
1,.)
400Ts•
t,�
Fat 44)E,He-q
3. &24WJ
t� MhLY)ii'
eat./ LObSC
u€2)4 lit- D
c.. yet% ben?
'jAw�D LB e
r �
Floe
Parent Material (geologic): OLf t vR
fpnth to Groundwater Standing Water in the Ho
Estimated Seasonal Hi
v
Depth to Bedrock I7 D
le: )• bPc Weeping from Pit Face: No
gh Ground Water.sari l
FORM 11 - SOIL EVALUATOR FORM
Page 2 or 3
Location Address or Lot plo. 1 Co (• t"tcrgata Re9
On-site Review
Deep Hole Number -; ._ Date:i'k Deo
Location (identify on site plan)
Land Use PR>7uxE
Vegetation ,P2iTtr; .. . ..
Landform G.CP1)0"D /s1p,ca.,tatE
Slope (%)
Time:.Its:,3e7.v
Surface Stones
Weather Cla-suD\/ „
2- Jp
Position on landscape (sketch on the back)
Distances from:
Open Water Body• �� feet
Possible Wet Area, YET feet
Drinking Water Well ?C321- feet
•
Drainage way Wov6 feet
Property Line Y2r feet
Other
DEEP OBSERVATION HOLE LOG'
Depth from
Surface(Inches)
Soil Horizon
Soil Texture
(USDA)
Soil Calor
(Munn'))
Soil
Mottling
Other
(Structure.Stones,Boulders,Consistency, %
Gravel)
p Tb
-i0
TD
A
aa
FJW
C
0 E;121 ,4-1-
tr
yY ArvP
S/L
tL-!/�
l5
/+//
r�
Et,- 1-6e
iL.rA�F
•
Zpy�a3( .
�'il`
7.$ tJs.
y^//
SY` !4
th—ar
j�ay.,P
,5y 37.
Nc
Y+to'�f1t>
03u
ro
F1ern Rccir ,, essz-RNVIa2
Fale93t'1 tfr+4/c% ?attS
� GL .r .B„I„z.
lrEre-y Lon E ✓'Z&Dun'-
&Rr•r»/ ( e a tv.rTED L9ytos
of Ft..tE Srt..,>y t-e+s�t
X:7:
ri
57-4-.E1
A Ter 1
MUM OF 2-tOlca htttulHCJ Ar EVEr{PROPO>cD DISPOSAL ABcA •
Parent Material(ge logic) _ f2tJ.1 W?S1 Depthtaaedrock:
Depth to Groundwater: Standing Water in the Hole: ili'J1J t
Estimated Seasonal High Ground Water:' 12p rr
Weeping from Pit Face: AJ 0
DEP APPROVED FORK•12:01195
Location Address or Lot No.
1
FORM 11 - SOIL EVALUATOR FORM
Page 3 of'3
COtc`� n,-tDo&, ' s9
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 mottles Dr inches
❑ Ground water adjustment feet
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? 4�
If not, what is the depth of naturally occurring pervious material? /-_
Certification
I certify that on (date) I have passed the soil evaluator examination
approved by the Dep tment of Environmental P •tection and that the above analysis
was performed by me consis -nt with a • training, expertise and experience
described in 310 CMR 15 •L%
•47 Wi:�
Signature ///, /illina'. 'i . Date `7- G ' a"s'a wir
DEP APPROVED FORM- 12/07/95
FORM 12 - PERCOLATION TEST
Location Address or Lot No. --/— Ca Le- 7 ntfae>a)
COMMONWEALTH OF MASSACHUSETTS
Ns-T+ ^Pea , Massachusetts
Percolation Test'
Date.`-( . G 2eey7 Time.. 'ggetr7.
Observation Hole #
T
Depth of Perc
,•
yit
.
so "
Start Pre-soak
Q: LD
e;5s
End Pre-soak
Penpatt, �-6/ • l•
!W TEN Prig,
revann 34 an Revs
iN I`l n9,N•
Time at 12"
Time at 9"
Time at 6"
Time (9"-6")
Rate Min./Inch
S a
K Z
Minimum of 1 percolation test must be performed in both the primary area AND
reserve area.
Site Passed 91 Site Failed ❑
Performed By: T 3 /v.v /-s . A ce Utr y�
Witnessed By: }7E2 PL. to tt,a
Comments:
DEP APPROVED FORM-52/07/95
Thomas J. FibGerald, R.S. M.S.
Percolation Testing• Septic System Design
Registered Sanitarian* License#1026
November 29, 2000
Mr. Peter McCertain
Northampton Board of Health
Main Street
Northampton, MA. 01060
Dear Mr. Marlain:
This Is to certify that a septic system constructed at Lot 1 Coles Meadow Road in
Northampton was Installed according to plans as approved by your office using a
non-intrusive inspection methodology.
Sincerely,
Thomas J. FitzGerald
72 Dayls Road, Southwick, MA 01017. 41316694626