468 Certificate of Compliance 11-12-19 FORM 3A -CERTIFICATE OF COMPLIANCE
i
No. Fee
f(yx,-qA%SS U5!FTt�S
ward of Health, Northampton, MA :.
,ERTIFICATE OF COMPLIANCE =
Description of Work: ('n ) Complete System ( ) Individual Components
The undersigned hereby certify that the Sewage Disposal System: Uggrade
ade
bv: Har is and Gray
at: 468 Coles Meadow Road Northampton
Homestead Inc. Project# 809
has been installed in acc rdance with the provisions of 310 CMR 15.00 (Title .9) anri tha
approved design plans/a built plans relating to application No. dated_
10/3/19 and Ap roved Design Flow 660 (gpd). Date of sub-grade
inspection:
Installer /.
Date.
H4 is and a
Designer: Date: 11/7119
19
Tho ,as Leue Homestead..Inc. m
166 CaDe St. Williamsburg, MA 01096
it OF ik,��cy
0� .G
Inspector: Date: TNONAS.So `
I _ � I,EUE
Local Approving AuthorityIXUE
�i Nor ham ton Board of Health 9F Q!
I Qhs ICED SN'
N This certification represents no warranty, expressed or implied as to the fun ning
or longevity of the onsite subsurface disposal system. Rather, the plan and
installation are incompliance with all applicable rules and regulations in effect at the
time of playa submittal.
I cc: Coles Meadow Propeities LLC, 52 Ward Ave., Northampton MA 01060
I -
DEP APPROVED MRM 5/96
Closeout Notes
1. Septic tank i'/ equipped with an-outlet filter.This is maintenance item. Filter must becleaned whnever septic tank iopumped, mr every 3years, whichever issooner. Failure tomaintain
filter may lead tosaptidmyi6amback6pand failure. ~'
2. Recommend pumping septic tank mmaSurSyear schedule, depending onhouse occupancy.
3.The leaching technology used ivEljwn (www.aUen.uom). `
4.Acopy nfthis dnoummnt attached inthe basement/utility area will keep this informationavailable|nfuture years for maintenance.
_�
House 2
House 1
House 3
— Existing Septic Tank:
h pump and reuse.
1:70-
New 1500-gallon Title 5 septid tank with outlet filter.
Inspection Port Distribution Box
System Vent
Date: bwner:
As-Built Drawinz HOMESTEAD INC.
Existing Septic Sys tem 10/3/2019 Coles Meadow Prope THOIA. L Thomds S. Leue R.S.
— 468 Coles Meadow Road #l172
Scale: 1 :30' Revision Date: 1664 Cape St.
Except as Noted 11/7/2019 Nodhampton MA 01060 Williamsburg,MA 01096
ED S [413]628-4533
Project 809
Particle Size Distribution Report
C 4 O O
Cd C C C C 4 O O O O cOcpp 4 O
04
p 100 -- ASTM C 33-Sand
90
80
�I
70
Z 60
LL
2 50--
LU
W- 40
w
CL I I I l l l l I I ( > 1 I I I
020 30-
20-
10
0
100 10 1 0.1 0.01 0.001
GRAIN SIZE-mm.
%+3„ %Gravel %Sand - %Fines ry
Coarse Fine CoarseMedium Fine Slit Clay
0.0 0.0 i 0.1 11:5 j 44.6 42.2 1.6
TEST RESULTS(ASTM C 136) Material Description
Opening Percent Spec. Pass? Presby Sand-Sample Sample#1
Size Finer (Percent) (X--Fall)
3/8° 100.0 100.0
#4 99.9 95.0-100.0 Atterberg Limits(ASTM D 4318)
#8 91.4 80.0- 100.0 PL= LL= PI=
#16 76.0 50.0-85.0
#30 54.4 25.0-60.0 Classification
#40 43.8 USCS(D 2487)= AASHTO(M 145)=
#50 28.6 5.0-30.0 Coefficients
#100 7.6 0.0- 10.0 ' 1390= 2.1795 D85= 1.6913 D60= 0.7177
#200 1.6 0.0-3.0 D50= 0.5136 D30= 0.3100 1315= 0.2067
1310= 0.1699 Cu= 4.22 Cc= 0.79
Remarks
Date Received: 7/22/2019 Date Tested: 7/24/2019
Tested By:
Checked By: Jahn McGreevy
Title: Dir.of Testing Services
F ASTM C 33-Sand ;
Sample Number: 7336b Date Sampled:
ALLIED TE TING
LAB{3RATOR S, INC. Client: Meehan Construction
Project: Meehan Construction QC
r
Springfield, MasEachusetts Project No: Fi lire
:Common ealtf of Massadhu_ setts
v F .
Cityffown .of Northampton
:.- Certificate of.C:ompliance::
Form:-3 :
.. a q ..
DEP has pr vided this form#or:use by'local Boards:of Health::O.ther:forms may be:used,:but the
::informatiio:n ;u.
st be:substantially the same as that provided here. Before using: form,check with
the local B.oof Health.to determine the:form they:use. ..
This is to C :rtify that the following.work on an On-Site:Sewage-Disposal-System
Important:When
:
❑fining out.foms � " .. : Constru tion of•a newaystem • • .. ..
on the computer,
..® Repair o replacement of an existing:system::. .. ". ..
use only the tab :.
key to move your .: '❑ Repair o rep lacement-of:an existing.system component:.:
.. :
cursor-d6 not .....
use the return Has been do a in accordance With Title 5 and:the Disposal System:Construction Permit:(DSCP)
key:.
1-0/29/19 `-
::
Coles.Mead w Pro erties LLC
DSCp Number � � �� :DS:CP Date::
.:'.'Facility Owner
: :468 Coles M adoW'Rd.
Street Address r Lot k.:
Northampton..-
MA- 01060
City/Town :State Zip Code "
Designer Inf rmation::
:Tom Leue
Name: .. .. ..Name: �: � ofCompany
:. .
:.
i... : Signature: :
Date: .:
Installer Info. nation: : : .
: Name
:,Name of Company
ignatur Date-.
---
...Use of this sy tem']s conditioned on:compHance with the provisionssetforth below;
V The:issuance- f this certificate 'shall:not be construed as a guarantee that the'system will function as :
:. designed..
:.Bri Eichstaedt REHS/RS _
:.:Ap roving: thor ty
. . ..
: "..:
. .. . : : .:..: 11/12/.19 :..: .: ..:
: Signature Date.
0f6rm3.do6•06/03 Certificat6of Compliance•Page-1 of 1
FORM 3A -CERTIFICATE OF COMPLIANCE
No. Fee
Board of Health, Northampton, MA
ERTIFICATE OF COMPLIANCE
Description of Work: ( X ) Complete System ( ) Individual Components
The undersigned hereby certify that the Sewage Disposal System: upgrade
by: liar is and Gray
at: 468 Coles Meadow Road Northampton
Homestead Inc. Project# 809
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5,) and thin
approved design plans/as built plans relating to application No. dated_
10/3/19 and Apriroved Design Flow 660 (gpd). Date of sub-grade
inspection:
i
F Installer Date:
Harts and Gra
Designer: te+ 11/7/19
.Thomas Leue, Homestead Inc.
�
1664 Cane St. Williamsburg, MA 01096 :OF ygsa�
Inspector: Date: TMO[ItASS. '.
LEUE
�I
Local ADDroving Authority t ##1172
Nor ham ton Board of Health r
DS
This certification represents no warranty, expressed or implied as to the functioning
or longevity of the onsits subsurface disposal system. Rather, the plan and
installation are in compl lance withall applicable rules and regulations in effect at the
fine of playa submiftal.
cc: Coles Meadow Propeities LLC, 52 Ward Ave., Northampton MA 01060
f
! DEP APPROVED FORM 5/96
Closeout Notes
1. Septic tank is equipped with an outlet filter.This is a maintenance item. Filter must be cleaned whenever septic tank is pumped, or every 3 years, whichever is sooner. Failure to.-maintain
filter may lead to septic system backup and failure.
2. Recommend pumping septic tank ona 3 to 5 year schedule, depending on house occupancy.
3.The leaching technology used is Eljen (www.e1jen.com).
4.A copy of this document attached in the basement/utility*area will keep this information available in future years for maintenance.
House 2
House 1
deck�
House 3 LOP,
Existing Septic Tank:
porch pump and reuse.
0
New 1500-gallon 5 septic tank with outlet filter.
Inspection Port Distribution Box
4V
2z f
PL Iq 0 kTH
System Vent
_uX"AA4
Date: Owner: HOMESTEAD INC.
As-Built Drawing
Ow INC:]
Existing Septic System 10/3/2019 Coles Meadow Prope THOU Thomas S. Leue R.S.
�o
Date: 468
Scale: 1 : 30' Revision DI Coles Meadow Road #117 1664 Cape St.
LExcept as Not d 9 d Williamsburg,MA 011396
'e 1,1/7/2019 Nodbampton MA 01060 [413]628-4533
Project 809 ED
- , J
1664 Cape Street
H0MEc,"_,,',TEAD INC . Williamsburg, MA 01096
413 628-4533
Ve heatC gmail.com '
November 7, 2019
Contractor: Harris and Gray
Project ID.: 809
Dear Sirs,
- Enclosed are the certific tion of completion papers required for the septic system you have
installed on 468 Coles Meac ow Road in Northampton for Coles Meadow Properties LLC. Based on
my inspection of 11/7/19, a ertificate of Compliance form is enclosed that states the construction
complies with my specificat ons.1 have prepared an As-Built Drawing, also attached. There are two
copies of the Drawing/Certif icate form. I have signed and dated the form as of the day of my final
inspection and approval.
Your sign-off on thero ect is requested on the attached Certificate of Com liance form. Please
P q
sign the completion of your, ork. Please return one copy..of the Drawing/Certificate to me. Please
also sendme a copy of any 1 ib tests that certifies the sand used on this project meets the
requirements of Title 5. Any other certifications on this project should be added to the file at this
time.
I will notify the Board o Health and the Owner of this information when you return the signed
form to me. If there are addi onal questions on this matter, please contact me.
�I
Yours truly,
S
Thomas S. Leue,R.S.
� r
Particle Size Distribution Report
100 ——— Mass title V
90
eo
70 --
w
0 t
z 60 f I I I ! I
C;
Z 50
W,
U 40
30
20
,1 f`-i l
10
I•. I I I I I I\
o I
ti.
100 10 i 0.1 0.01 0.001
GRAIN SIZE-mm.
%+301 %.Gravel %S'and %Fines
oarse Fine Coarse! Medium Fine Slit Clay
0.0 OA OA C11.4 44:7 42.3 1.6
TEST RESULTS STM C 136) Material Description
Opening Percent _ Spec.* Pass? Title V Sand(MA)-Sample#1
Size Finer (Percent) I (X=Fall)
#4 100.0 100.0
98 91.5 Atterberg Limits{,ASTM D 4318)
#1'6 76.0 PL= ILL= PI=
#30 54.5
940 43.9 Classification
#50 28.6 0.0- 100.0 USCS(D 2487)= AASHTO(M 145)=
4100 7.6 0.0-20.0 Coefficients
#200 1.6 0.0-5.0 1390= 2.1583 D85= 1.6741 D60= 0.7167
D50= 0.5127 D30= 0.3098 D15= 0.2066
D10= 0.1698 Cu= 4.22 . Ce= 0.79
Remarks
Test results based on the fraction passing the#4 sieve.
Date Received: 7/22/2019 Date Tested: 7/24/2019
Tested By:
Checked By: John McGreevy
Title: Dir of Testing Services
mass Title V
Sample Number: 7336a Date Sampled: 7/22/2019
ALLIED TESTING Client: Meehan Construction
LABORATORIES, INC.
Project: Meehan Construction QC
Springfield, Mass ichusetts Pro'ect No: Figure
I 3. . • + \
Particle Size Distribution Report
0 0 0 0 0 v 0
V R 4 W :g :2 V
100
— Mass T9tie V
f f l ,il Ii I ' ;:I •. .:� : � I IiI
g0
80 \,
: I
70t
w
Z 60--
FL
2 50 ! I 1 1 1 1 1 I
w 40--
w
30-
20--
100
a20100 10 1 0.1 0.01 0.001
GRAIN SIZE-mm.
+3" %Gravel %Sand %Fines
_ _ _ ..__.._. —T--
oarse Fine Coarse 1 Medium Fine— — Silt j Clay
0.0 10.0 ; 0.0 11.444.7 42.3 1.6
TEST RESULTS ASTM C 136) Material Description
Opening Percent Spec." Pass? Title V Sand(MA)-Sample#1
Size Finer (Percent) (X=Fail)
94 100.0 100.0
#8 91.5 Atterberg Limits{ASTM D 4318)
916 76.0 PL= LL= PI=
#30 54,5
#40 43.9 Classification
950 28.6 0.0- 100.0 USCS(D 2487)= AASHTO(M 145)=
#100, 7.6 0.0-20.0 Coefficients
r #200 1.6 0.0-5.0 D90= 2.1583 D85= 1.6741 D60= 0.7167
D54= 0.5127 D30= 0.3098 D15= 0.2066
D10= 0.1698 Cu= 4.22 . Cc= 0.79
Remarks
Test results based on the fraction passing the#4 sieve.
Date Received: 7/22/2019 Date Tested: 7/24/2019
Tested By:
l Checked By: John McGreevy
Title: Dir of Testing Services
Mass Title V
1
I�
Sample Number: 7336a Date Sampled: "7/22/2019
ALLIED TES ING Client: Meehan Construction
LABORATORI S, INC. Project: Meehan Construction QC
Springfield, Mass chusettS Pro'ect No: Figur