650 (Lot 1) Title 5 Application/Permits 2003, Well Completeion Report FROM : WELCH LFIW OFFICES
DATE:
FAX NO:
FROM:
PHONE NO. : 413 586 3847 Oct. 06 2004 02:09Pt1 P1
FAX SHEET
rni M - of
ice 041
Margo E. Welch, Esq.
Telephone: (413)586-355S
FAX: (413) 536-3847
PAGES FOLLOWING(not including Cover Sheetp
MESS�A .E_
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CONFIDENTIALITY NOTICE
The documents accompanying this FAX transmission contain information which is
confidential or privileged. The information is intended to be for the use of the individual
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FROM : WELCH LAW OFFICES
BOARD OF HEALTH
MEMBERS
CYNTHIADOURMASH/ N,R.N.,Chair
ROSErMARIE RARPARIS,R.N.,MPH
RICHARD P.BRUNSWICK.M D.,MPH
PETER J.MCERLAIN,Health Agent
(413)587-1214
FM(413)587.1221
FlU E NO. : 413 586 3847
CITY OF NORTHAMPTON
MASSACHUSETTS 01060 --
OFFICE OF THE
BOARD OF HEALTH
To: Mark Ledwell, Vice President of Operations
Wright Builders, Inc.,48 Bates Street, Northampton
From: Peter McErlain Health Agent
Date: December 18, 2001
Re: Waiver of Well Test Requirement for Sweet Meadow Properties off of North
Farms Rd.
Oct. 06 234 02:09FM P2
pMA1N VIREO',Room
2iT BU ntnAmPTON,MA 010603167
On December 17, 2001 the Northampton Board of Health approved your request for a
waiver of the requirement that wells be installed and tested prior to the issuance of sewage
disposal system construction permits. This will allow the installation of three (3)leaching
systems on land owned by Sweet Meadow Properties, LLC., off of North Farms Rd.
Sewage Disposal System Construction permits are enclosed and copies of the approved
plans submitted to the Building Inspectors office
The waiver is subject to the following conditions:
• The weirs must be installed and test results submitted to the Board of Health prior to
the completion of septic system construction project..
• The septic system construction easements for lots 2&3 must be documented per
Title 5 requirements and submitted to the Board of Health prior to the completion of
the septic system construction project
• The leaching systems must be inspected by the design engineer and the Board of
Health prior to burial
• The Certificate of Compliance will be issued after installation of the remaining
portions of the complete septic systems.
Please do not hesitate to contact me if you require additional information.
Thank you.
cc: Building Inspector Anthony Patillo
FROM : WELCH LAW OFFICES
TYPE OR PRINT ONLY
PHONE NO. : 413 586 3847 Oct. 06 2004 02:10PM P3
Mass. sets Department of Environmental Man -nent
Office of Water Resources
Well Completion Report
109356
1.WELL LOCATION
I GPS (OPTIONAL) LATITUDE i - ihi LONGITUDE
Address at Well Location, `' i ' -" - "-"`
Subdivision Name- Mailing Addess' ) ' '-°'--' S -et
Otyrown- . -__._.. ._ ^'ty'Town- _ . - 1105 ,
Assessors Mao Assessors Lot : NOTE: Assessors Map and LOt A mandatov if no street address availaole
Board of Health permit obtained Yes = Not Required Permit Number Date Issued
2.WORK PERFORMED
3. PROPOSED USE -
4. DRILLING METHOD
�• New Well 0 Abandon
C Deepen C Recondition
C Retbace 0 Other
b- 'Domestic _ Irrigation
7 Monitoring _I, Municipal
77 Industrial Other
E Dante Alger
Ln Mr Hammer 7.L1 Direct Push
1 Mod Roan = Other
5.WELL LOG
¢
$
Permemity
Unconsol dated ; Conscbdered
6. SITE SKETCH (us.penman(wam •a Mel al.mncn)
.
0
r
m
a
E
$
E
a Osier Pock Type
fD ', O 'Ctic--•- ?a,—.-. ---
t pz c:
/
3----�
I ,a o�
From (ft) To (ft)
.rgm
to..
1. r4
�'.a_ -psis
i -
?)1
i 11.10c._
I k , ,.
" Cr-. _ T. ... - Ra
1.WELL CONSTRUCTION .
8.CASING - --
Total Depth
Data Drilling
1 -11 -12
Dolled -4°
F orn tt) To Et) Casing Type and Material Size O.D. (m) Well Seal Type
Complete
3 19? H sound Steel are ID c' esdoe
I I
9.SCREEN . . -
From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter
I I I I
it FILTER PACK(GROUT/ABANDONMENT MATERIAL -
it ADOMONAL WELL INFORMATION
Prom (ft) To (ft) Material Description Purpose
Fevebeetl? I. Yes O No
Fracture
EnmanCement? - Yes ki No •
Method
Disinfected? L Yes ❑ Na
12.WELL TEST DATA 4PFIODUCTION WELLS) --: _... . -..__
13. STATIC WATER LEVEL(ALL WELLS)
Yield Tune Pumped Orawdown t Time Recovery to
Oate Method (GPM) (Ws& min) (Ft. SGS) (Ws& min) (Ft RGS)
Depth Below
Date Measured I Ground Surface(FT)
/n/C;
P.i•Ci.%-r
S
C//✓ ]..?hnrsl 1/
/'r/cci cisD I cr/o
itkc. , I-
I
I
14.PEFIMANENTPUMP.(F.AYALABLE) t'±�!:r; :-:n.rr. ..
*=` ;-,.. ,r:.•;c '.
IN NFY&ASIEMS WNW MSTAUA1WICMPAKT,-
on ,•!J''_ Horsepower
Pump Description
X t;v+C
Pump Intake Depth - - (ft) -"A Nominal Pump Capacity (00m)
7re.WEI af'SMA1 TC +1 This well was drilled and/or abandoned under my supervision, according to app6Cable rules
and regulations, and this report i/s complete a to the best Of My knowledge.
Urger Michadl 'LaRoche Supervising Drifter Signatures s"J 'r / + - Registration It 11 9 5 I 1
COMMONWEALTH Of NIASSACIIL'SETTS
Board of Health, Northamp Fon MA.
APPLICATION FOR DISPOS AL SYSTIN CONSTRUCTION PERMIT
asI,-r
Type oBuldnrg House
Dwelling-No-of Bedrooms 4 Bedrooms
Other-'Type of Building
Lo
No. of persons
Size of o,n✓ i sq it.
Garbage grinder,kl
Showers( ),Cafeteria(
Other Fixtures
Design Flow (min. required) (>(40 gpd
Plan: Date QGtr be r 11, 7061
Title
Description of Soil(s)
Soil Evaluator Form No.
See
Calculated design flow i0 b.8
Number of sheets 2
f Pro• _ . ! D 1
Design flow prosided gpd
Na vem ber 28, 2001
• , r P. 'I 2c
Revision Date
o . l ` she
Sh,'ef aof a %r Sail I-a95 5/3110/
Mar P. Date of Evaluation (
Name of Soil Evaluator
/1-16610 ep/zl/O(
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Date k u� 2o,
Signed + r�ti % :s• s ,E✓"�. �/-'. /i/0 11603
oettions �/�JvJi�arvY_w`i���Y & i8Op� ���i(
Nor s Ro•
(Nort 'r W..
OenersName &acel- Meadow Properfles, lie
1,1%, ,r
dap)ParrelN 2 I ' -
Address 49 Bales 5freJ Worthampinn
Lots 1
�r..,..!...24.,,e,f
ul
, e pbnne# . 58(-8287
Installer's Name t i's
•
nnr,tuclion Cora- B.
g er s Name Her; Fast Survey 5, 17ic
Address Love
e.ld S . t-05rharc
to
ddress Collet C (IiiLiwa E C/cu'kuf. e0.601
13
' I -0 )
Telephone#
27-300 6oufhamP1-
Telephone# • ^ 5Z7 -2(d95_
n ,in nca
asI,-r
Type oBuldnrg House
Dwelling-No-of Bedrooms 4 Bedrooms
Other-'Type of Building
Lo
No. of persons
Size of o,n✓ i sq it.
Garbage grinder,kl
Showers( ),Cafeteria(
Other Fixtures
Design Flow (min. required) (>(40 gpd
Plan: Date QGtr be r 11, 7061
Title
Description of Soil(s)
Soil Evaluator Form No.
See
Calculated design flow i0 b.8
Number of sheets 2
f Pro• _ . ! D 1
Design flow prosided gpd
Na vem ber 28, 2001
• , r P. 'I 2c
Revision Date
o . l ` she
Sh,'ef aof a %r Sail I-a95 5/3110/
Mar P. Date of Evaluation (
Name of Soil Evaluator
/1-16610 ep/zl/O(
DESCRIPTION OF REPAIRS OR ALTERATIONS
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Date k u� 2o,
Signed + r�ti % :s• s ,E✓"�. �/-'. /i/0 11603
oettions �/�JvJi�arvY_w`i���Y & i8Op� ���i(
Cf i 1ON\\'F 1LTfl ()f NASSACIIUS£TIS
. aaA.
Board of Health,
CFRTIf l D
1I- OE CI IPLIAN( L
Description of Work: b Individual Component(s) C mpl t System
The r designed/hereby(el t fv that the Sewage Dispo al li t a C onsvoeted ( ).Re I (I. Upgrade 1 () Abandoned ( )
m LU , w/L-L1 A mCOD�� � C 4 Lvl'-C700,: iH Sl'&(
at • li %a Y� l.!" rarr4sfari .tf
has been in t Il d in awndaunt' yteju �ious of 310 C}lR 15 00 ST rl :) and the pp 1 design plans/as-built plans'plating to
ppbcadon Vic rVi l <1 . .0 x.p ofed 12egge'�fit%%G„ (gp )
Installer --t rVis. l 419:1)
Y yt.
aq!:4 i1(L
7J ,
Date
The ssuan of this permit shall not be construed as a guarantee that the system m wJ(functtmt as designed.
Permission is h
at /- r
i
FFE f—,'
CJLlhIONWLAITII Of" MASSACHUSETTS
DISPOSAL SYSTEM CONSIRUCIIf ! Pf MIJ
tied to;Constt t ) Repair( ) . Upgrade( ) Abandon( ) an individual sewage disposal system
/1. / / _ ,�. l r_ ) as described in the application for
Disposal System Construe don Permit N �' :ra . dated i , -
4
Provided: Cons hukti on shall he completed etjitubPhic'c vems of the date of this pet wit gill hoed eo3t Lion s mu 51 he ntet.
4Va y.� -. i/ � r
romn2sr 3e.5 so A ms kin co aorms.MA Date 2•'i. Hoard of health /—� t -
4t