Stormwater Permit App Form - 42 Rustlewood
1. Project / Site Information
Project / Site Name:
Project Street / Location:
Assessor’s Map: Parcel(s):
Estimated Area to be Disturbed (ft2):
Total Area of Impervious Surfaces: Existing Proposed
(paved, parking, decks, roofs, etc.) (ft2)
Project Type (check one) Permit Review and Inspection Fee
Residential Site (1 unit and 1-5 Acres Disturbed) $700
Residential Site (1 unit and greater than 5 Acres Disturbed) $1,100
Minor Residential Subdivision (1 lot and disturbing 1 to 5
acres of land)
$700 or $1 per linear foot of roadway or
common driveway (whichever is greater)
Residential Subdivision (2 or more units in a common plan of
development)
$2000 or $2 per linear foot of roadway or
common driveway (whichever is greater)
Other Residential such as Townhouse or Retirement
Development (2 or more units in a common plan of
development)
$700 per acre disturbed (maximum of $5,000)
Commercial Subdivision $2000 or $2 per linear foot of roadway or
common driveway (whichever is greater)
Commercial or Industrial Site $700 per acre disturbed (maximum of $5,000)
Land Disturbance Only (No change in site use or buildings.
May include reconstruction of parking lots, roads, and
driveways; utility work; and lawn and landscaping work.)
$100 per acre disturbed
2. Applicant Information 3. Owner Information
(if different from Applicant)
Name:
Address:
Telephone:
E-Mail:
4. Certification
I herby certify that the information contained herein including all attachments is true, accurate and complete
to the best of my knowledge. Further, I grant the Northampton Department of Public Works and its agents
permission to enter the property to review this application and make inspections during and after
construction.
Applicant’s Signature Date Owner’s Signature Date
STORMWATER MANAGEMENT
PERMIT
APPLICATION
Fee Paid:
Date Paid:
Permit #:
( For DPW use only) City of Northampton
Department of Public Works
42 RUSTLEWOOD RIDGE
42 RUSTLEWOOD RIDGE
11 022-001
6,493 SF
63,217 SF (clearing limit) 29,796 SF (earth work)
x
Garrett Washington & Camille Washington-Ottombre
cwashingtonottombre@gmail.com
26 Ford Crossing Northampton, MA 01060
1,900 SF
10/21/202210/21/2022
Northampton Department of Public Works Page 2
Stormwater Management Permit
5. Application Requirements
The application to the Northampton Department of Public Works (DPW) for a Stormwater
Management Permit must include submission of the following:
Completed and Signed Stormwater Management Permit Application
Non-Refundable Permit Review and Inspection Fee (made out to City of Northampton)
Completed MA DEP Stormwater Report Checklist
Stormwater Report as defined by the MA DEP Stormwater Report Checklist and by the
Northampton Stormwater Management Ordinance (Chapter 281) prepared by a
professional engineer licensed by the Commonwealth of Massachusetts
Construction Period Erosion and Sedimentation Control Plan or Stormwater Pollution
Prevention Plan (SWPPP) prepared by a professional engineer licensed by the
Commonwealth of Massachusetts or a Certified Professional in Erosion and Sediment
Control (CPESC)
Submission must include one paper and one electronic copy of the documents listed
above and include the minimum documentation listed below (see the Northampton
Stormwater Management Ordinance (Chapter 281) for more information):
Project Documentation:
(Check circles below indicating that you have provided the following minimum information)
Identify all operators for the project site and the potions over which each operator has control.
All plans submitted have been prepared and stamped by a professional engineer licensed by
the Commonwealth of Massachusetts
The applicant has certified on the drawings that all clearing, grading, drainage, construction,
and development shall be conducted in strict accordance with the plan
Locus map
The existing zoning, and land use at the site
The proposed land use
The location of existing and proposed easements
The location of existing and proposed utilities
The site’s existing & proposed topography with contours at 2 foot intervals
Soils investigation (by a Certified Soil Evaluator or Certified Professional Soil Scientist)
including borings or test pits, to a depth greater than 4 ft. below estimated seasonal ground
water for areas where construction of infiltration practices will occur.
Estimated seasonal high groundwater elevation (November to April) in areas to be used for
storm water retention, detention, or infiltration (by a Certified Soil Evaluator or Certified
Professional Soil Scientist).
A description & delineation of existing stormwater conveyances, impoundments, and
wetlands on or adjacent to the site or into which storm water flows.
A delineation of 100-year flood plains, if applicable.
The existing and proposed vegetation and ground surfaces with runoff coefficient for each.
A drainage area map showing pre and post construction watershed boundaries, drainage area,
storm water flow paths, and receiving water.
A list of all hazardous chemicals and petroleum products that are planned to be used or stored
on the site.
A description and drawings of all components of the proposed drainage system including:
Northampton Department of Public Works Page 3
Stormwater Management Permit
1) the structural details for all components of the proposed drainage systems and storm
water management facilities (including size, inverts, and grade);
2) all measures for the detention, retention or infiltration of water;
3) all measures for the protection of water quality;
4) notes on drawings specifying materials to be used, construction specifications, and
typicals;
5) the existing and proposed site hydrology with supporting drainage calculations (including
the 1,2,10, and 100 year NRCS design storms);
6) proposed improvements including location of buildings or other structures, impervious
surfaces, and drainage facilities, if applicable;
7) location, cross sections, and profiles of all potentially impacted brooks, streams, drainage
swales and their method of stabilization; and
8) proposed ownership of drainage system structures.
Estimate of the total area expected to be disturbed by excavation, grading or other
construction activities.
A description and location of all measures (i.e., Best Management Practices) that will be
implemented as part of the construction activity to control pollutants in storm water
discharges. A description of when each control measure will be implemented in the
construction schedule, which operator is responsible for the implementation of each control
measure and a maintenance and inspection schedule for each control measure during
construction.
A description of construction and waste materials expected to be stored on-site, and a
description of controls to reduce pollutants from these materials including storage practices to
minimize exposure of the materials to storm water, and spill prevention and response.
Timing, schedules, and sequence of development including clearing, stripping, rough grading,
construction, final grading, and vegetative stabilization.
6. Application Submission, Review, and Approval Procedures
1. Application Submittal: The application to the Northampton DPW for a Stormwater
Management Permit must be submitted prior to or concurrently with any land use
permit application. Submission of an application should be made to the Northampton
Department of Public Works, 125 Locust St., Northampton, MA 01060. For more
information and copies of the Northampton Stormwater Ordinance visit the DPW
web site at https://northamptonma.gov/1813 or contact Doug McDonald at 413-587-
1582 or dmcdonald@northamptonma.gov
2. Administrative Review: The Northampton DPW will have 7 days from the receipt of
the application to review the application for administrative completeness. Incomplete
applications will be disapproved and returned to the applicant based on the
determination that they are administratively incomplete.
3. Review: If the application is found to be complete, the Northampton DPW will
review the application and supporting documents based on the criteria set forth in the
Northampton Stormwater Management Ordinance (Chapter 281) and will take final
action within 21 days (including the 7 day administrative review period) of the receipt
of a complete application unless such time is extended by agreement between the
applicant and the DPW.
4. Final Action: The Northampton DPW’s final action will be in writing and will be
sent to the applicant and the appropriate City Department(s) and Board(s).