255 Certificates of Compliance 69 T Milan, mime chcedett t
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Title V Certification of Compliance
TO BE FII i En OUT BY THE SYSTEM INSTALLER
INSTALLER SIGN-OFF
Pursuant to 310.CMR 15.00 of the State Environmental Code:Title V,Minimum Requirements for the
Subsurface Disposal of Sanitary Sewage,Section 15.021 (3),the Installer of a system is required to sign
this form as a condition for issuance of a Board of Health Certificate of Compliance for the onsite septic
system.
This is to certify that the onsite sewage disposal system that I installed as: x new construction
repair(existing system)
DWCP number
at 255 Sylvester Road
(Address)
on 10-10-05
(Date)
has been constructed in compliance with 310 CMR 15.00, and all local requirements.Any changes to the
original approved plans have been reflected on an as-built plan that has been submitted to the Board of Health.
Mark LaValley & Sons
Trucki(Agt rummer's name)
207 Sylvester Road, Florence
ass. U t$}M City,mtZip Code)
10-27-05
(Date)
NOTE:This certification r..pn ents no warranty,expressed or implied as to the functioning or longevity of the on-site
subsurface disposal system.Rather,the plan and installation are in compliance with all applicable rules and regulations as are
in effect at the time of plan submittal.
NEWMAN ENVIRONMENTAL ENGINEERING
November 3,2005
David Premo
40 Trumbull Road
Northampton,MA 01060
Engineer's Certificate of Compliance
THIS IS TO CERTIFY, That the On-Site Sewage disposal System installed® or repaired/
replaced❑ on October 11,2005 by Mark Lavallee,Northampton,MA
for David Premo at 255 Sylvester Road,Northampton, MA
has been constructed in accordance with the provisions of TITLE 5 of the State Environmental Code
as described in the plan entitled:
SEWAGE DISPOSAL SYSTEM
at
255 SYLVESTER ROAD,NORTHAMPTON,MA
Dated 3/18/05
Prepared by:Newman Environmental Engineering
Drawing No. Z0503-2
With the following exceptions noted:
1. Minor changes to the location of the new septic system facilities as noted on the attached
"AS-BUILT" site plan.
2. Leaching facility cover,final grading,and loam &seeding had not been completed at the
time of inspection.
Use of this system is conditioned on compliance with the following provisions:
1. The area over the leaching facilities shall be foamed&seeded(with grasses)and
maintained (by mowing)to prevent cover erosion and/or root intrusions from trees and
shrubs.
2. Final grades shall be constructed and maintained as shown on as-built plan,attached.
3. Avoid driving vehicles over leaching facilities.
DATE: 1 (5/01 ENGINEER:
CC: Board of Health
Contractor
Gr.7, J.Newman,
P.E. No.34017, Sanitary
r¢r v-s ,eLV I
\ I - ' . I OVER OUTLET PORT
r al AO p CONNECTION TO
NEW BUILDING SEWER
Pl s D-BOX TTEE d% At*
N �� INTA1 00 m GRADIENT
—1 r 1 1 ' OPESW/A "DECF
TAI I I I I Ir 1 '�� , NORM 1 A LWELI.FLATTER
A
WELL
2> 1 \ I , �/
9 i � i r LEA C TRENCHES(TIP) _-
1 60'L. G BY 41170E -' pi�I
J ' v H°
1 RESER :AREA I /
1 4-DIA VENT l�\ /
BELL-AM l/55 / M wv
•
0 ! WOODS- -\ 4, %
i nuo - — • SITE HA•1WA
f NAIL V/ METAL PLATE
— 9 voopS IN 20' MALE
i _ NOTES:
I 1.A5-BUILT BASED ON INSPECTION-10lIPoS&10/11/0
f n 2.FINAL GRADING, LOAMING&SEEDING NOT
a: SITE PLAN COMPLETE AT TIME OF INSPECTION \ I
APPROX,SCALE: 1'=40'
AS-BUILT INVERT ELEVATIONS: =TP-I TEST PIT No.I AS-BUILT SITE PLAN (Z0503-2) — 10/7/05 & 10/11/05
(RELATIVE TO SITE B.M.) OPIX-I PERC TEST No.1
SEWER AT WALL: 96.52
PROPERTY LINE(APPROX.LOCATION)
■ WELL 255 SYLVESTER ROAD, NORTHAMPTON, MA
SEPTIC TANK INLET: 96.23 —. R
EXISTING CONTOUR TO SITE M.)
—-— PROPOSED CONTOUR FOR DAVID PREMO
SEPTIC TANK OUTLET: 95.95 _ • - STREAM/WETLANDS BOUNDARY _
D-BOX 94.39 - - — BURIED WATERLINE OUND%.LOCATION) -_
D-BOX OUTLETS: 94.22 - - - BURIED ELECTRIC LINE)APPROX.LOCATION)
DISTRIB.(NORTH): 9t20 - -•-
4.20 — BURIED GAS LINE(APPROX.LOCATION) NEWMAN ENVIRONMENTAL ENGINEERING
—.—.- FENCE P.O. BOX 395, 21 GUARD ROAD, WORTHINGTON, MA 01098
DISTRIB. (SOUTH): 93.95 ROCK WALL TEL'. 413-238-5383 FAX: 413-238-4276