270 Application & Permit 2002 NEWMAN ENVIRONMENTAL ENGINEERING
July 20, 2003
David McCutcheon
41 Loudville Road
P.O. Box 43
Easthampton, MA 01027
Engineer's Certificate of Compliance
THIS IS TO CERTIFY, That the On-Site Sewage disposal System installed® or repaired/
replaced ❑on April 30,2003 by Mark Lavallee,Northampton,MA
for David McCutcheon at West Farms Place 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
WEST FARMS PLACE,NORTHAMPTON,MA
Dated 11/12/02
Prepared by:Newman Environmental Engineering
Drawing No. Z0211-2
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 Warned&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: 7l Z 0 103
CC: Board of Health
Contractor
ENGINEER
Gregdnriljllewman,
P.E. No.34017, Sanitary
0-BOX W/INLET TEE
SLOPES SHALL HAVE A GRADE LLEANOUT W/ACCESS R.
OF]NORIZ.:IVERT OR FLATTER P AT GRADE - _.
m In .2^" w - Jr S CD 3AOO GALLON SEPTIC TANK W/
Ili ' .4 / I I / I OURS(FILTER A RISER TO GRADE
i I 11 I I OVER OUTLET PORT
I GRASS
I 1 i 1 II *� vq°ww� •• Y,Ir PROPOSE IRL vE _.- -_ ��C I .��.draa A rm.I �/ i I l00 W/A LESS IY /
i1II a �F9p ° Wa�Iimr'
q
,1 i � — �
/
fill / I
� R
,� I I
I i �/ i l� I
B
I �_ / I
I
I
IIII I /9/ ii/ / //111 T ICI / AREA
II j IN.jR.-123 t
� llllll �/ I �iI II , _ _ 9q. f
/ I l� �RESERVE A'EA ��
II , I T
�1 ® _ -S� .N . I�W
11 • NAIL V/ • 103 O PLATE
,I l ijl / - MIS' MIRE
NOTES.
I
i n
T ELEV.=iN.➢'
oYAINTAIN 9REANOU DON
AS-BUILT SITE PLAN BASE
1 . ill I Iv. /
i. S
1
I _ _
I I - MORE 15 FT FROM LEACH FIELD
_ N 4/30/03.
INSPECTION 8 0
it � O'wA.VENT li
N _ _- _ _ _ o LEACH 50m REPLACE ND FILL SOILS TOE ro EXTENTS 1 i 0
NOT COMPLETE AT TIME OF INSPECTION
AT GRADE E SIT PLAN
30' AREA=60xN'
J 1 E C L
AS-BUILT INVERT ELEVATIONS: SCALE: 1"=30'
(RELAIIVE TO SITEB.M.) =TP-1 TEST PIT NO 1 AS-BUILT SITE PLAN (Z0211-2) - 4/30/03
SEWER AT GARAGE: 103.23 OPFRC-1 PERC TEST No.f - - - - -SEWER AT WALL: 101.34 --- - PROPERTY LINE(APPROX.LOCATION)
SEPTIC TANK INLET: 100.74 ® WELL WEST FARMS PLACE, NORTHAMPTON, MA
SEPTIC TANK OUTLET: 100.43 ,s EXISTING CONTOUR(REL.TO SITE B.M.)--
—oe
PROPOSED D CONTOUR FOR DAVID MLCUTCHEON
D-BOX INLET: 100.38 - • - • - STREAM/WETLANDS BOUNDARY
D-BOX OUTLETS: 100.20 - -.- BURIED IED WATERLINE LOCATION) - - -- -- - - --
DISTRIB.(EAST): 100.2 - -- • - BURIED ELECTRICLINE(APPROX.LOCATION) NEWMAN ENVIRONMENTAL ENGINEERING
DISTRIB.(WEST): 99.9 - --' - BURIED GAS LINE(APPROX.LOCATION) P.O. Box :395, LI GUARD ROAD, WORTHINGTON, MA 010911
-.- FENCE
TF.O. BOX 395, 21 FAX. 413-238-4276 A 01098
*ay
THE COMMONWEALTH OF MASSACHUSETTS
�
BOARD. sOF HEALTH
C 1 1 '' OF of nA-Mpz1�
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
FEE 7_5—
Application for a Permit to Construct Del/Repair ( ) Upgrade ( ) Abandon ( ) - [✓Complem System ❑Individual Components
:470 t )ecf 2 k4 s
NI,;u.f1/4Aeeare1,
wcmion
Oxners Name
O,ik0w 43 -raratAfslzn-1 fak ()toil
[
413• S2� 91'3
6.u&., r, Nai`4P aift64ylur.
Map'parcd 0
Rae K ill s 17
PO RN 29S:- Ithlil`ig at. -6495
4/3- 239-s 393 Address
remvnnnc
„
td„rhnnc f
Type of Building: 12.&6I fsfl L t(11)MM&n I lift Lot Size,21500 Sq. feet
Dwelling—No.of Bedrooms 3 Garbage Grinder (
Other—Type of Building Coenm`i;+tl.1 A-L. No.of persons Showers ( ). Cafeteria yI J
Other fixtures
Design Flow(min.required) 5>L' gpd Calculated design flow S gpd Design flow provided 5-Wt gpd
Plan: Date I I U Z Number of sheets Ip Rglision Dat
Title SS-r. l- `y 621,02� SYSaEM M I oYfl!MS rLAY.S (JYL init t!N
Description of Soil(s) Y1NA-7 t-oPrnA OY )L LUM`^'/4mc S6e2freirt, iS%E
Soil Evaluator Form No. it Ii- Name of Soil Evaluator [-a A' e,
"7r,W1F=Date of Evaluation - 2100
DESCRIPTION OF REPAIRS OR ALTERATIONS 1'&14 /tiC
) ( 'Qn.ssr uc,tna iIJC-1-t-veiCi'
%g : 1)- Fjf J.h/.\ ilC Il -tj?C O-*Snu 1 r 1 Itt do 660 t-
The under ig ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of
TALE 5 and agrees to la the system in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed agrees�' Date i J,/q'//y
Inspections J
FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96
No 3if T 0
THE COMMONWEALTH OF MASSACHUSETTS
4171/477ij/) J44/ BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: ❑ Individual Component(s) Complete System
The undersigned hereby erlify that the Sewage Disposal System;Constructed( ).Repaired( ),Upgraded( ).Abandoned( )
by: 6�29-,(7/ � a l a//ci
at . -iC /,I 1 G(.. t. ffr i &s 4,7 .
has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built
plans relating to application No. / =� (gpd)
%J '}C/- ia--dated cr.� Approved Design Flow d
Installer /^ / A/`_ � li/if 6-
Designer:l /lIPL1% d�I L,� Inspector .f ✓t 4 aYe- ��2 /�
v
The issuance of this certificate shall not be construed as a guarantee that the system will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96
FEE
s 7S
No 39-c"y" THE COMMONWE// LT
A //H OF MASSACHUSETTS FEE
'T bs/BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to Co�ns¢truct ( epair ( ) r de ( ) Abandon ( ) an individual sewage
disposal system at ci 70 /tlie S� T-�'t'T^i ( -'* . as described
in the application for Disposal System Construction Permit No. 3“'(5' )--- .dated /-) ,. e /1T.
Provided: /nnsstruction shall be completed within three years of the date of this per n Aylbcal/r$n tionssm fbe met”
Date -s—<-G- ,D f G e- Board of Health vs- " E (�Ui��sgrs'-'-/
FORM 2 - DSCP DEP APPROVED FORM 5/96
FORM 1255 IREV 5/961
ER-
HAW) Hoess e WARREr4
PUBLISHERS • BOSTON