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Lot 6 (167, 172) Title 5 Applications/Permits Soil Survey 1996 Performed Commonwealth of Massachusetts Alor , Massachusetts Date . Z] 9(p Site Suitability Assessment for On-Site Sewage Disposal By Ailmilliew S0k eo v Witnessed By. Pe+rr M f E-rinirl Certification Number. I Loath Address or Lot No. LOT # 6, FtorovEnLy /GCo/toat As e-or >s 2v NaRTM PAU1S f Owners Name.Address and Tats (9 17) -534 - I g 71 KEVIN I)EA,PY R /97 NOTH mddPR,e ST NorzrNAmpmp) MA 010(00 New Constnution t( Office Review Repair ❑ Published Sail Survey Available: Year Published /971 Drainage Class C. Surficial Geologic Report Available: Year Published Geologic Material (Map Unit) Landform Flood Insurance Rate Map. No ❑ Yes Publication Scale I /5840 Soil Map Unit Pc S Soil Limitations SEvSR E : ?ERC$ sww t-Y No Yes ❑ Publication Scale Above 500 year flood boundary No ❑ Yes P( Within 500 year flood boundary No * Yes ❑ Within 100 year flood boundary No)s( Yes ❑ Wetland Area. National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): /99(0 Month Suly Range' Above Normal It( Normal ❑ 0elow Normal ❑ Other References Reviewed: O. S. G. s, Tornc4RArNcAL- MAP z On-Site Review Deep Hole Number 2 -I Daze G(21 /9% Time /1 90 Weather Snr/ 750 Location (identify on site plan) SEC Sitattf Land Use woo OS Slope (%) 3% Surface stones /4-104.1a- Vegetation l Z5oLM 5 Landtorni DP°nl Li A) Position on landscape (sketch on the bads) Distances from: Open Water Body 7/00 feet Drainageway 7/00 feet Passible Wet Area 7/00 feet Property Line 7Z 0 feet Drinking Water Well >/00 feet Other DFFP OBSERVATION HOLE LOG Sad Horizon Sail Tenure (USDA) Sod Color (MUnsell) Sad Mottling Other (Smrmn,Stones, Boulders. Cansistenc .%Gravel) Depth from Sadao. (Indies) — / low- ZgW I 28 - 34 3 '� - San <I 4o" — qg„ 9?' — Iza` r S C C 1 Cz Ca sl- S L rsM o 34Ioel, Na � 4 5H loati-. TS YR 2. z. /0'/R 9/Q !!�� 77Yi13 10VKs/3 Z.S)/ 5/3 25Y 313 -- LWsz=, FRIABLE- mAss uE �4SSW€ FRIABLE Sn5ie Gra(, too �lKmr ,nASru-€1 C, u+, r3. G s 2 2o'3°% mNSLt , zo°/G-.-el nRA\ 3 " SY2 lovlt(n(G w 5% 3/3 Parent Material (geologic) "ftenlac;ct O” CIS Death to Groundwater Standing Water in the Hole: 85 Weeping from Pit Face: �5 Estimated Seasonal High Ground Water. 35° 3 On-Site Review Deep Hole Number 2 -2. Date 2/<7/W0 lime IV ;0 Weather5°e./ 75° Location (identify on site plan) I Land Use Coon-Ilan al s Slope (%) 37n Surface stones ti oA/F Vegetation /14 rro/Solo- wood r Landform D2um L/.V @ Ef)cic Position on landscape (sketch on the bads) Distances from: Open Water Body ?/0-0 feet Drainageway %/G'J feet Possible Wet Area 7/OD feet Property Line >20 feet Drinking Water Well _ ?/Co feet Other DPP? OBSERVATION HOLE LOG Depth from Surface (inches■ Sad Horizon Sod Inoue (USDA) Sod Color (MUnaed) Sod Morning Otter (Strucun.Stones. Souoan . Comic moy.%Gravel) 0 - 2 ' „ 2 - 2 0 20 3 ' 4 ?q - d 56 rr— / 0 4 u A f3w C �' Z �3 S L s /— ScnQ SlE} L S2n1 Loam /OM 5(3 /o Y i 9 9 25 Ys/ 25 r4 2.5Y1/3 _ /4 AS67 fR/A B/ MA.3511T FZar & ,1605 niEb 'rams LGOS(._) !os ernxct �Ye--ciLa,fl,es,�mri • ra�I ,fin,,V015/ 20 to coli-I (r tr.:1- /L4Y2SS oT Sri Qrcatc 39y 75y I5YRs]co Sb/0 4/2 I Parent Material (geologic) -C'r,.y 1,/I Depth to Groundwater. Standing Water in the Hole: 9i Weeping from Pit Face: 9� t1 Estimated Seasonal High Ground Water. 3 9 '/ i Determination for Seasonal High Water Table Method Used: o Depth observed standing in observation hale inches ❑ Depth weeping from side of observation hole inches )5t Depth to sail mottles 35- inches o Ground water adjustment feet Index Well Number Reading Date Adjustment Factor Adjusted Ground Water Level Index Well Level 4 Percolation Test Date: 6/2 7/7, Time: //9(P Observation Hole 4 2 -/ I 2- 2 Depth of Perc 95' Start Pre-Saak //:96, / 2:5/ End Pre-Soak /2 6/ 1 ;66. Time at 12° IZ ; 02. L0 % Time at 9• 12: 05 1 . 15 Time at S' 12: 0q 1: 24 Time (9-- r) 4 % Rate MinJlnch 1/3 min/�n 3 ro1in Site Suitability Assessment Additional Testing Needed: Performed By: YY! eij Witnessed By: Site Passed Site Failed ❑ Comments: Certification Number. tea« Location Address or Lot No. FORM 11 - SOIL EVALUATOR FORA Page 3 of 3 (o FORmERLy REcoRbEU ac Lot' itZ AJORTh RARmS RD fOR reianrro.v 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 35.__, 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? YSs If not, what is the depth of naturally occurring pervious material? Certification I certify that on 6/ze6 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature i1�i7tiol.c.> �t oyY Date 61277U0 DEP APPROVE)FORM-11107195 Almer Huntley Jr, & Assocs. Inc. Surveyors - Engineers - Landscape Architects 30 Industrial Drive NORTHAMPTON, MA 01061 (413) 584-7444 J `? — l3/ 1 r !Sevin yeofey SHEET NO CALCULATED BY MSS CHECKED BY N T S. SCALE OF / DATE V*U.. DATE 1=U-F4' TEST PIT2 e PE IC Z_ LDT4 F 1=57-PIT [FAIL] N ❑ \ N NO STN FARM 13D 1 GRAVEL ACCESS UP 39 /90 LIP 35 / 91 NO IL LOT NUMBERS CHOI,VNAI< rI/FFFkrr Almer Huntley Jr. & Assocs. Inc. Surveyors - Engineers - Landscape Architects 30 Industrial Drive NORTHAMPTON, MA 01061 (413) 584-7444 ,oe 9 C' - 131 fo Ilevin i{c. y SHEET NO 1 OF DATE Ii//3/q(o CALCULATED BY MSS CHECKED BY WT.5 . SC LE DATE NOT-E : LoTNVM ?EF5 SHOWN A1E GWENT Almer Huntley Jr. & Assocs. Inc. Surveyors - Engineers - Landscape Architects 30 Industrial Drive NORTHAMPTON, MA 01061 (413) 584-7444 JOB Cka - /3/ Tai lettin Aka-Fe/ SHEET NO IT OF I // CALCULATED BY MSS CATE /1//3/9(0 CHECKED BY SCALE /✓.T S. DATE 1 NORTH FARM ND, PEKC LOTS N m PEI3C Z OT (o HERE LOTS- COUNTRY 1411=N -t A11ROX. SOUTH PER I_ LOT LO / 7 3 / AFTIVOX• WEST Ft- 99' -J -TEIPLE PAINT MAR-KS ON 71TEE ON SOUTHWEST PROT? Y LIN£ Y (JOTr• LO' UUTBERS SNDUJN ARF Cr/PRFAJT Name: EASTHAMPTON Date:9/28/104 Scale: 1 inch equals 2000 feet Location: 042°20'37.3" N 072°40'28.5" W Caption: Proposed septic system Lot#6-N. Farms Rd. Florenc, MA Copyright(C)1997.Maptech,Inc. 'HERE APPLICABLE CIIECK OR PIL No . ...w FEN -570 0 0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF ) pptiratian -far fliapasttl Marks Application is hereby made for a Permit to Construct System at: 1)6.77- /rq.{ry -21 4L2.--Yt4- .J- n or Inv No. uui trurtinu Permit or Repair (✓) an hidh'dual Sewage Disposal Installer Address Type of Building Size Lot Sq. feet Dwelling—No of Bedrooms __________ _ _ __ Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of person- Showers ( ) -- Cafeteria ( ) Other fixtures Design Flow gallons per person per day. Total dady flow gallon._ Septic lank—Liquid capacity_ gallons Length VCidth Ibamete- Depil._. Disposal Trench—Mo. Width Total Length Total leaching area ,T ft_ Seepage Pit No Diameter Depth below inlet Total leaching are sq. tt Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by Date Test Pit No. I minutes per inch Depth of Teq Pit Depth to ground water .._ Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground watc Description of Soil Nature of Repairs or Alterations—Answer whe a applicable �y�jR/j`-* `�i - Qx �441 e ate / -/ - . .. Agreement: The undersigned agrees to install the aforedescrihed 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 bee9 s dQd,lby the boankof health Application Approved By vened 1, _f"'i___.ft�.%i-�••-^- 4e1411121- ac- 41-3 Application Disapproved for the following reasons' Permit No {...p Date Issued C0Ff.-S.l99L3 THE COMMONWEALTH OF MASSACFI- BOARD OF HEALTH CL17-LA OF 1,1-‘-'751'""c-((" exrtifirate of Tampion-ire THISKI,S jO�C/ER J 1 Tha`the,,Individual Sewage Disposal System constructed ( ) or Repaired ( ) by L �.'=e«-. —1... .tkr :Cr.:-. at Q' � Installer q i has been installed in accordance with the provisions of Article Xl of The State Sanitary Code as described in the application for Disposal Works Construction Permit No dated_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. CD : v xu DATP Inspector__ '- /• `N-L✓. t tC+(, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ OF J 7" No �i,nn ttl If urko clnnstrurtiva Permit Permission is hereby granted ��yye�-� -L- to Construct ( ) ,or Repair (s.� an Indtidual Sewage Disposal System at No �JJ street as shown on the application for Disposal Works Construction Permit No Dated card or 115911 DATE FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS kt1 N.25'03-50 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C ' 1 OF A-16, -rc APPLICATION FOR DISPOSAL SYSTEM CONS "Fn S e UAA: Application for a Permit to Construct RA Repair I 1 upgrade t 1 Abandon I ] - ❑Complet FEE System —I nd ividual Component • Nor TAhr.I Q.�r�o. S i EueN Piz oksrr�a�ae 172h- Frh.ne /2B uc,TArrT. Adeass L/I3 — S17-:3a57 LOGO . Telepnones Ti.- MA51rN,) 70 /t^ONIA}LEs .(L) WEJIN•-fic.S Address y{1) 51-7 1391 1 wnpnn a� l�i � 6 iDi. Sara I>A.,-1.iA) TR_ p,r;b )NC, On AA- c Vb f✓c.•TNfiAC6 .--46C Amass et) -In -iti7) CELL_ Cvl7- Oy -117i') Telephone} \ Telephoner Type of Building: S ;•v9LF h/{r-IL� Dwelling—No.of Bedrooms 3 ' �,-PA BA - Asia.nL) Other—Type of Building Lot Size a pcnejlSq.feet Garbage Grinder (a) No.of persons Showers ( ). Cafeteria ( ) Other fixtures Design Flow(min. required) -310 gpd Calculated design flow `f 9) gpd Design flow provided H'/ gpd Plan: Date 5E0, a Y 2° j Number of sheets % Revision Date Title REL.Sf-s) S. S 1..F-. D;-;5 e v J Description of Soil(s) S'f-E ?LAN et So. (, (VA I . fpAe-. oPi FIL, BO )1 - Soil Evaluator Form No. Name of Soil Evaluator f`'yAY7Ne-z 5nKcfDate of Evaluation /- it -91- DESCRIPTION OF REPAIRS OR ALTERATIONS N/A NFI^' Lo^'=in,JT. -. The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the aprovisions of TITLE 5 and further agrees not ro� place the system in operation until a Certificate of Compliance has been lesued by the � Signed - I Yzsti Ov ) Date / tiE(L Gf- LY- " Inspections FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. THE COMMONWEALTH OF MASSACHUSETTS Fe -lc)) !. -Kra'i/1/.YBOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System et The undersigned hereby certify that the Sewage Disposal System,Constricted(v),Repaired( ),Upgraded( ).Abandoned( ) LtJ i3'1N. by: !� p fit 1_' �) -1.i1 .1�. JY% ZD �Frt-,�L Cy/ r I-ll at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built rS plans relating to application No. 2 f) dated >cr. : -ON Zbt U Approved Design Flow y i r-(gpd) Installer Designer </1.• , )..;" 1 r U r ..i ; �'I I tom')^— } 1 r/) // i e �k !t /J(.j ly Inspector //1/ % t / D // �"A'/-,y yl ! t., , Date ' The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 Na. 9b -4003 THE COMMONWEALTH OF MASSACHUSETTS FEE Nr t L-/E(Erritl%) BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted tb Construct repair (' ) Upgrade disposal system at jO/(2%,t-t- U4C ttY in the application for Disposal System Construction Permit No. Abandon ( ) an individual sewage as described dated :)71-7/2-71. '2- <-(`7/c.A, iii r Provided: Construction shall he completed within three years of the date of this permit.All local conditions must be met. Date /, /2c/o ? fC'ffE Arnicocl> Board of Health` / / -I -,)01Cr . FORM 2 - DqSC DEP PPROVED FORM 5/96 �/,^ --- t , / 0 /� L/ _%L fSE.2 f PA) /JGh/Zo oL7) 7/1 FORM 1255 1 R V596/ � / �H&W) HOBBS&WARREN P U ON 5C -2.663 No. —�� THE COMMONWEALTH OF MASSACHUSETTS n BOARD OF HEALTH C t-ry OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUC nphr�ran<„nor a Permit to Omistrust I✓ Repair t I Upgrade I Abandon t ) - Vil'Uomplete System /1),UO2Z14- !` s lick-0 11--/r4nesk Hne_-c4so&- I.,.a;..1 V enPaa.Ia AJJnTa I.n a -T lde��p M1p..�nYr'd Lc rp_LO_YLNi rpa a w0 muJlcr Yrnv J... 4 3 AJJr es O%3 c T.�.e„.,,.. r.aeaagn., Type of Building: Pt Iw3de-fit Dwelling No.of Bedrooms atlf t f Other—Type of Building No. of persons Other fixtures Design Flow (min reg uued)At op(' Calculated design flow 860 gpd Design flow provided Plan: Date ri Q Number of sheets 4 Revision Date Title sv€-r '-1 1-4-i our Lot Size 22: genfent- Ac. Garbage Grinder (...< Showers ( ), Cafeteria ( gPd Description of Soil(s) SPt4P Soil Evaluator Form No. Name of Soil Evaluator M.Eiiltao eCe Date of Evaluation 3k-& 2b, 1 999 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of 1111E 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. Description of Work: THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CERTIFICATE OF COMPLIANCE ❑ Individual Component(s) ❑Complete System FEE The undersigned herehy certify that the Sewage Disposal System:Constructed( ),Repaired( ).Upgraded( ).Abandoned( ) at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated . Approved Design Flow (gpd) Installer Designer: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 Inspector Date No. cD--673 / > L/ 13 THE COMMONWEALTH OF MASSACHUSETTS /!02 !4fi4 %K BOARD OF H EA LT H DISPOSAL SYSTE CONSTRUCTION PERMIT Permission is hereby granted to Construe ( Repair ( ) Upgrade ( ) andon ( ) an individual sewage as described �` 9 - i � In ✓ disposal system at / �_ r. - �•- ' Gr ;-C.7 rl7 r'/ . in the application for Disposal System Construction Permit No. j C� L ,dated Provided: Construction sgall he completed within three years of the date of this permit. ll loc. condd p must be met. 11-%% 9 , ll Date ���-� v / � ����y Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 IREV 5/961 t HEW J HOBS fl WARREN PUBLISHERS-BOSTON No....._.....'..—__. Fes THE COMMONWEALTH OF MASSACHUSETTS BOARD QF HEALTH 0r7Y OF e,f4te/si7/rt1Y%oat Application for Binomial 1:r arks (ffunntrnrtion Prrmit Application is hereby made for a Permit to Construct (.4 or Repair ( ) an Individual Sewage Disposal Systea,at: Location.Address No. Owner Address Ins Type Type of Building Size Lot •-21,4 Sq. feet 1 Dwelling-No. of Bedrooms � Expansion Attic ( ) Garbage Grinder (a ) WOther—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures {{yy Design Flow _.5,—,:i gallons per person per day. Total daily flow 1%0 41 gallons. 1C Septic Tank—Liquid capacity/fIC.e..gallons Length?'6" Widths-¢` Diameter Depth.� !4 ` ssZlt Disposal Trench—No. ¢ Width..:''A ' Total Length - .fr Total leaching area z•C'.- sq. ft. • Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft. z Other Distribution box ( ) Dosing tank ( ) �7 Percolation Test Results Performed by....('d/..._Ascrtc....I 4es/de - Date /2 7/7<-. .] F' -'rTest Pit No. 1z. 7 minutes per inch Depth of Test Pit/S&Ls' " Depth to ground waaterr.dl&S • ,e s c.T e s t Pit No. 2 / minutes per inch Depth of Test Pith '-r" Depth to ground water *thee." P4 O Description of Soil./` re P-lc'"r:,,/.'"/` J/t 7 ;-../7 0 ` f/w/C lArtr7) NNE W 6 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. Signed Application Approved By Application Disapproved for the following reasons• Date Date Date Permit No Issued Date CHECK OR FILL IN WHERE APPLICABLE No 31 THE COMMONWEALTH OF MASSACHUSETTS el./OA R DOF�{{H EAR H [d' OF...././LJ.1r[.KQiYy )i.pplirtttinu far Jizposttl Ifllurk J nnstrurtinn hermit Application is hereby made for a Permit to Construct System at: or Repair ( ) an Individual Sewage Disposal Ow e" f -& Address Address Type of Building Size Lot Sq. feet Dwelling—No. of Bedrooms Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons Showers ( ) — Cafeteria ( ) Other fixtures Design Flow gallons per person per day. Total daily flow gallons. Septic Tank-Liquid capacit/Q3igallons Length Width Diameter Depth Disposal Trendy—No. Width Total Length Total leaching area /_Q.d°sq. ft. Seepage Pit No Diameter Depth below inlet Total leaching area sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by Date Test Pit No. 1 minutes per inch Depth of Test Pit Depth to ground water Test Pit No. 2 minutes per inch Depth of Test Pit Depth to ground water Description of Soil 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. Si �e d� (7 � °'' Jam./ r Date if Application Disapproved for the following reasons' Application Approved By Permit No -53—i Issued. Date n.-1 J.I7� Date by THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF Trrtifirntr of Tymplinnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired Installer at has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE Inspector No. 1._I Permission THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH [21..€3 OF %.y6.jrA.AdTI7.(.tay flisposnl; i,orkn Cnnns Vtrnrtinn tirrmit iereby granted_.....v:cral�.4 --: -T`t�'t'e+ to Constru t ( ) or Repair ( ) an individual a¢f- e Disposal System at No .-J.s - terE'*-Lh..- ...Q.KJwn Street as shown on the application for Disposal Works Construction Permit Not-.'„y...:j DATE FORM 125E HOBBS & WARREN. INC.. PUBLISHERS Dated .14,