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Lot 3 Septic Application Permit Perc Tests & Plans 2012 Commonwealth of Massachusetts ga City/Town of Northampton Application for Disposal System Construction Permit Form 1A Important: When filling out forms on the computer,use only the tab key to move your cursor-do not use the return key. WWI S0/2 -/D Number $ /✓r ' 00 Fee DEP has provided this form for use by local Boards of Health if they choose to do so. Before using the form, check with your local Board of Health to make sure that they will accept it. A. Facility Information Application is hereby made for a permit to:Z Construct a new on-site sewage disposal system ❑ Repair or replace an existing on-site sewage disposal system ❑ Repair or replace an existing system component 1. Location of Facility: Lot#3 -Dunphy Drive Address or Lot# Northampton City/Town Owner Information Jeffrey Borer Name 61 Elm Street MA State 01062 Zip Code Address(if different from above) Hatfield City/Town 3. Installer Information TBD Name MA State Cell: (208) 705-0859 01038 Zip Code Telephone Number Address Name of Company City/Town State Zip Code 4. Designer Information Timoth E. Ma.innis R.S Name 70 Monta.ue Road Address Westhampton, City/Town MA State (413)527 5291 01027 Zip Code Telephone Number t5for1a.doc•06/03 Application for Disposal System Construction Permit•Page 1 of 3 Commonwealth of Massachusetts City/Town of Northampton Application for Disposal System Construction Permit Form 1A Number $ /60 Fee A. Facility Information (continued) 5. Type of Building: ® Dwelling Other: Type of Building ❑ Showers Number of showers Specify other fixtures: ❑ Garbage Grinder(check if present) 8 Number of Persons Served ❑ Cafeteria ❑ Other fixtures 6. Design Flow: 440 qpd Gallons per Day Calculated Daily Flow: 330 qpd Gallons 7. Plan: June 21, 2012 Date of Onginal 2 Number of Sheets Revision Date Subsurface sewage disposal system desr gn Title of Plan 8. Description of Soil: Sandy Loam 9. Nature of Repairs or Alterations Of applicable): N/A 10. Date last inspected: Date t5forml a.doc•06/03 Application for Disposal System Construction Permit•Page 2 of 3 ,ommonwealth of Massachusetts City/Town of Northampton Application for Disposal System Construction Permit Form 1A o?O/a-/O Number Fee B. Agreement The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in oseration until a Certificate of Compliance as been issued by this Board /gf Healt�� / 2-5//t- Signature / Date /� Application Approved By: Nam Application Disapproved for the following reasons: 7/S/02 Date. t,Vik i;liiwl t •d NORTHAMPTON BOARD OF HEALTH 212 MAIN STREET NORTHAMPTON, MA 01060 Cnndilions: 1).SI=t<ni Ues'Ene muss inspect and verify in writing nslalled 1 II Olt aonrot-in plans nd Title 5. 2) It d tn S -Lentil-tided in al conduct a bottom jp:Ior to the placement rn P�. lion by the hn tat slain t5formta.doc•06/03 Application for Disposal System Construction Permit•Page 3 of 3 BOARD OF HEALTH DONNA C.SALLOOM,CHAIR SUZANNE SMITH,M.D. JOANNE LEVIN,M.D. Benjamin Wood,MPH,Director Javeria Mir,MPH,Health Inspector Patricia Abbott,RN,Public Health Nurse Heather McBride,Clerk CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH (413)587—1214 FAX(413)587-1221 212 MAIN STREET NORTHAMPTON,MA 01060 Onsite Septic System Construction Permit: Conservation Commission Review NOTE: As of 1/1/11, Septic System Permits will not be issued by the Northampton Board of Health until we receive this form signed by the Northampton Conservation Commission Staff Member. The Conservation Commission can be reached by contacting: 0 Sarah LaValley,Conservation, Preservation and Land Use Planner SLaValley@northamptonma.gov Office of Planning& Development 210 Main Street, Rm. 11,City Hall Northampton, MA 01060 Property Owner: Re—_-C-C-,e y ore !" Engineer: rim Address: Lof 3 nA,pliy l-we fd ko d+ ne�lpP �efidvtda- rpt yet ) Ca,,u.rt.4 servation C fission Conservation, Preservation and Land Use Planner Date: Dfi/,- a Re- Ces t 2- / o y paoposeO No.- uitabili FORM 11 - SOIL EVALUATOR I.OIt11 Page 1 of 3 COPY Commonwealth of Massachusetts N O1ZTHAMW1-Ot.I, Massachusetts nt or Date: 0-'2'-0J •wr • e Di al Performed By: a,.atby fi , MAG.IN MIS RS . Date: (o-2y—O I Wimessed By: .. PETER PA`ERLFtiki - 1-iaecn,4 A&Ltsr..__. _._. �..... E SiH A✓✓tPTUtJ ROAD a• La 1 - j 4 (3EH,wO 71124 mnplE (110<E OOwE 'Jew Construction Q Repair ❑ O...,Na. (3RUC-C GRAFT 1 " ..' l (DC WESfhiThATcP RD• x•4(3) 584' $996 Office Review Published Soil Survey Available: No ❑ Yes © I1 / Year Published 1561 Publication Scale t ' 584° Soil Map Unit WXC-- SkECTT 17 Drainage Class o ti� t%`tt Soil Limitations SEVERj_,.- PE{u.S...CLp .'Ly Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) Landform .l.. .Pl_E.. VPLe ND.__.(o-cikL.IAL M■LL). Flood Insurance Rase Map: Above 500 year flood boundary No ❑D,Y/es E' Within 500 year flood boundary No Yes ❑ Within 100 year flood boundary No 2/Yes ❑ Wetland Area: National Wetland Inventory Map(map unit) - Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions(USGS): Month Range :Above Normal ZNormal ❑Below Normal ❑ Other References Reviewed: 0O APPROVED FORM•11107195 P-2 FORM 11 - SOO. EVALUATOR FOR% thr-it Location Address or Lot No. VJES IHA✓vt01 bhl ROAD - 17 R3EHipto 124 rlwpLE RroGE OTvt On-site Review Oeep Nola Number I ? 2 Data; (0'28- 0I Time: 10:00 AM weather C-Lei"R. Location lidenuty on site plan) 6n1..,..a U vz- Marl_ RLdyt Land Use VAGdj NT Slops (%) Z`/r $uNece Stones Vegetation Up LA^^D TREES — E1 Lswtorm 'L,LL .R•o G6 Position on landscape (Watch on the back) Distances from: Open Water Body 'loo / leer Drainage way > too legit Possible Wet Ara >IGO I leer Propury Linea — Isar Na Or.F'rJED Drinking Water Well n)/k sat other led.J DEEP OBSERVATION HOLE LOG' Depth from Selman ammo 5-Manion Sod Tomes (USDA) sea Color IlAtasoM) Sod Mowing Owes (So-wars. Stones.Swiss.Con.uuncl. +) Gown o - 9 ,. Ia -92/ 72- IZo" o - Q P I E- 12 92 - L2d A 6 C- I c-2 A 6 C- l C - 2 Io YR. 3/2 °YR y/w IoYR S/2 IGyRY3 N/A N/A '5% a) 40" 9.�yR 3/Y typ_ OPLC H(to vJ- Ci.,E (toots- No STOUt-S ft RGL.C- Mdo. Re T- - FM,a,SLE- F¢.” STo.:ey F.NF SA..p/ lu9 ■ Day_ Fe..,, Sk—) F R1Pae I ( I-Ng- - C..e, SA&-t'1 Lu.w� a..-4.1 ) (0,9e- ...,tt... d.>Tv.be.,1 ORAL Raw 3- Gr toe- Road Cftt ARLe- f"R Pr t— An to too+ Stu CR'POLE - G.r. $da.t [c P».- CipM ILO>a_ wLpN dt31s-bp ' momatAM oe 2 MpuAs Amato Al Win moeoa&ua Q i.wRA Ina SSW laselegki L oaeat-psa Gta®.aisome . aa.rnfwr Ire Hos: 120 gamswe a._. s Sttb Gael wear: 40 " ¢O > 12d W._L_SMafFa (.O" j( Sou• -r' 6d= Re.AcnSD Te (C -z) t-;ca12cry : Ie. W'Tt -r.TI.�-S CLEY,L) FLt OO ASNOI'W IOW•LIMAS 721)- Replace Go%3 0 -t1 Location Address or Lot No. � �' I-11.0 O 12 a MAIL6 Q■DGE OPAVE. FORM 11 - SOIL EVALUATOR FORM Page 3of3 Determination for Seasonal High Water Ta31e Method Used: 13 Depth observed standing in observation hole 12o' inches r0 Depth weeping from side of observation hole (q o " inches U Depth to soil mottles 4-c 'I inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurrina 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? ypis If not, what is the depth of naturally occurring pervious material? Certification I certify that on tlAc (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 requiredtraining, expertise and experience described in 310 CMR 15.017. Signature ice^ • w.-tee Date Q-a9-O/ m afnorsD row-umm FORM 12 - PERCOLATION TEST COMMONWEALTH OF MASSACHUSETTS 02:11-tPc pTO KI BUT it- , Massachusetts /dCHlnA 4 L24 vkf\pt_E (2.' DfrE Percolation Test Date: c z - ol Time: 16 : 3 0 Ant — • Observation Hole # Depth of Pero '72 " Start Ere-soak lo'• ZS AM End Pre-soak 4o Am li '• oS AM Time at 12" 10 . 'k-o II : oS A, Time at 9" 10 4F) Am it ; to Aivl Time at 6" Io ; SS A4" It 1S AM Time (9"-61 Rate Min./Inch 8 W.ir.)S • 5 An ir,IS 2. CS) ,v P : 4 2 rn ,pT- Site Passed LI Site Failed ❑ Performed By: I .w+Ly L , MAGNkits RS Witnessed By: PE-vat. McCK(f J - tiE-Acm Comments: 1000 GALLON PUMP CHAMBER CALCULATIONS Use 1000 gallon septic tank: Outside dimensions = ( 8.5'L x 5.33'H X 4.833'W) Walls = 3" (.25') Bottom = 3'(.25') Top = 4°(.33') Dosing frequency: Loamy sand = 4 Doses per day 825 gpd Dosing frequency: 206.25 gallons / dose Float # 1: Above tank bottom — Set © 4" Float # 2: Volume pumping — 8.0'L x 4.33'W x .79 (9.5") _ . 27.37 cu. ft. 27.37 cu. ft. x 7.48052 202.70 gallons / dose — Set © 13.5" Float # 3: High woter alarm switch: — Set © 25.50" 8.0'L x 4.33'W x .5' = 17.32 cu. ft. x 7.48052 = 129.56 gallons Reserve after alarm 8.01 x 4.33'W x 2.45' = 84.87 cu. ft. x 7.48052 = 635 gallons 635 gallons x 550 gpd = 1.15 days reserve after alarm Float # 1 : Set ® 4" Float # 2: Set © 13.5" Float # 3: Set © 25.50" 1000 GALLON PUMP CHAMBER - BOUYANCY CALCULATIONS SITE: LOT # 3 - WHITE OAK WOODS - NORTHAMPTON, MA. FOR: DIONNE MGT. TEAM - SUNDERLAND, MA. DATE: JULY 16, 2004 WEIGHT OF 1000 GALLON TANK = WT(tank) Sides: ( 8.5'L x 5.33'H )2 = sq. ft. x 0.25' = 22.65 cu. ft. Top/Bottom: (8.5'L x 4.83'W )2 = 82.11 sq. ft. x .333' = 27.34 cu.ft. Ends: ( 4.83'H x 5.33'W )2 = 51 .49 sq. ft. x 0.25 = 12.87 cu. ft. So: 22.65 Cu. ft. + 27.34 cu.ft. + 12.87 cu. ft. = 62.86 cu. ft. Then: 62.86 ft. x 150 lbs/cu. ft. (cement) = 9,4291bs. WT(tank) VOLUME OF 1000 GALLON TANK OUTSIDE DIMENSIONS: ( 8.51 x 5.33'H x 4.83'W ) = 167.31cu.ft 167.31 cu. ft. x 62.43 lbs./cu. ft. (WT(water) = 10,445 lbs. Now: 9,429 lbs. WT(tank) < 10,445 lbs WT(water) THEREFORE: COUNTER WEIGHTS ARE NEEDED TO SECURE THE PROPOSED 1000 GALLON TIGHT TANK(septic tank) (3' x 3' x 3') concrete btockls each corne II • \ ° UMP MANHOLE # 5 REBAR TIMOTHY E. MAGINNIS "BECKS 8RE0 IN R1 MUNICIPAL WATER AVAILABILITY APPLICATION Northampton Water Department 237 Prospect St. Northampton, MA 01060 587-1097 A Department of Public Works Trench Permit shall be required prior to any construction or connection activity associated with this application. Location: 143 Dunphy Drive (Lot#1) Inquiry Made By: Date of Inquiry: Justin Dionne 413-219-2799 5/10/05 Number of Units: Type of Unit(s): X_Single Family Accessory Apart Multi-family Type of Ownership X Private Condo Rental (Applicant to fill out the above) Municipal Water Main in Yes: ❑ No: ❑ Front of Location? Size of Water Main: Material: DI Existing service to site? Approximate Static Street Pressure: Size of Service Connection: 1" Yes: ❑ No: Age: 2003 70 Flow Test Conducted:Yes: ❑ No: LJ If done attach results Suggested Meter Size: 1" Comments: The Water Department cannot guarantee adequate water pressure during peak demand times at elevations above 320 feet. Northampton Planning Board approved this subdivision on Dec 12, 2002. It is the responsibility of the developer to provide necessary infrastructure as shown on approved plans. A corresponding water entrance fee shall be paid prior to making any connection to the municipal water system. Arrangements of such installation shall be made with the Northampton Water Department with a minimum of 5 working days notification. All work shall conform to Northampton Water Department specifications. David W. Sparks, Superintendent of Water cc: Ned Huntley, City Engineer ) - 512 - ..4 Date: Type of Service: New x Pipe: Size 8" Water Entry Fee Paid? Yes Meter Size 1" Fee P Permit No. W72-05 Permit No. WATER CONNECTION INSPECTION REPORT Northampton Water Department 237 Prospect St. Northampton, MA 01060 587-1098 Renewal Material DI Repair x No N/A id? Yes x No Location of Installation: 143 Dunphy Drive N/A (Street and Number) Permit Issued To: Dionne Management Team, LLC Contractor/Developer Obear Construction Installing Service Connection: The service connection at this location was inspected by the undersigned on at (Time) I have instructed and approved. installation can be backfilled. (Date) of that the Measurements for all installation shall be documented by the Water Department. The information shall be on file at the Public Works Department office. Page 3 of 3 Commonwealth of Massachusetts City/Town of NoRT4-tANnaror.s ° Certificate of Compliance Form 3 Important: When filling out forms on the computer,use only the tab key to move your cursor-do not use the return key. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here Before using this form, check with the local Board of Health to determine the form they use This is to Certify that the following work on an On-Site Sewage Disposal System ® Construction of a new system ❑ Repair or replacement of an existing system ❑ Repair or replacement of an existing system component Has been done in accordance with Title 5 and the Disposal System Construction Permit(DSCP): DSCP Number DSCP Date Jeffrey Borer-Tel: (208)705-0859 Facility Owner Lot#3-Dunphy Drive Street Address or Lot# Northampton City/Town Designer Information: Timothy E. Maginnis R.S. Name Ma. State 01062 Name of Company Signature Date Installer Information. Zip Code Name Signature Name of Company Date Use of this system is conditioned on compliance with the provisions set forth below: No garbage disposal is allowed The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. Approving Authority Signature Date t5form3.doc•06/03 Certificate of Compliance•Page 1 of 1