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661 Local Upgrade Application for Local Upg—ade Aonrnval Title 5, 310 CMR 15 . 000 DEP Approved form required by 310 CMR 15 .403 (1) To be submitted to Local Approvinc Authority/board of Health: For the upgrade of a failed or nonconforming system with a design flow of <10, 000 gpd, where full compliance, as defined in 310 CMR 15 .404 (1) , is not feasible. To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design flow of 10, 000 to up to 15, 000 gpd and/or for upgrade of a state or federal facility, where full compliance, as defined in 310 CMR 15 .404 (1) , is not feasible. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of new design flow to a cesspool or privy or the addition of new design flow above the existing approved capacity of a system constructed in accordance with either the 1978 Code or 310 CMR 15 . 000 . 1) Facility/system owner Name Michael 0 Brien Address 661 Westhampton Road, Northampton Phone # (413) 586-5413 Address of facility Same 2) Applicant (if Name Address Phone # different from above) Miter }kmtley Jr., & Associates 30 Industrial Drive East, North ton (413) 584-7/64 3) Type of facility x residential commercial _ school —institutional (Specify) 4) Type of existing system _privy cesspool (s) conventional system x Other(describe) septic tank learhine ch.n+mber Type of soil absorption system (trenches, chambers, pits,etc . ) Leaching chamber 5) Design flow based a) Design flow of Approved? b) Design flow o c) Design flow of on 310 CMR 15 .203 design flows existing system N/A gpd no x yes approval date unimown proposed upgraded system 396 gpd facility N/A gpd 3 BDR w/garage grinder -11-i7 sa:dd 1414/tl411Vu 2 6) Proposed upgrade of existing system is a) x Voluntary Required by order, letter, etc. (attach copy) Required following inspection required by 310 CMR 15 .301 (provide date inspection form(date) submitted to the approving authority) b) Describe the proposed upgrade to the system Installation of a leaching area to be connected to existing septic tank, with abandorrrent of existing leaching chamber. c) Which of the upgrade? Reduction of reduced with following are applicable to the proposed setback (s) (list setbacks to be proposed setback distances) Percolation rate of 30-60 minutes per inch (state actual pert rate) reduction Up to 25%requirements (staterequired & proposed disposal design size) Relocation of water supply well (identify well, describe relocation) x Reduction of required separation between bottom of SAS & high groundwater (specify proposed reduction & pert rate) erc rate < 2nnn/in separation from 5' to 4' Other requirements of 310 CMR 15 . 000 that cannot be met (specify sections of the Code) System upgrades that cannot be 310 CMR 15 .404 & 15 .405 , or requirements of 310 CMR 15 . 000, 310 CMR 15 .410-15.417 . performed in accordance with in full compliance with the require a variance pursuant ,-11-1777 SC;CO 1a1J a» 1vv 3 7) If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high ground water elevation pursuant to 310 CMR 15 .405 (1) (i) (1) . Thuevaluator must be a member or agent 1 of the local approving authority: Distance from soil absorption system to high groundwater 4 feet As determined by Peter Mcerlaia Evaluator' s name Evaluator' s signature? ig5a Date of evaluation 8) Notice to Abutters No application for upgrade approval shall be complete until the applicant has notified all abutters by certified mail at least ten days befo Board be on Health meeting at which the upgrade approval will the agenda pursuant to 310 CMR 15 .403 (1) and 15 . 405 (2) . Such notice shall include the date, time and place where the application will be discussed. If the Department is the approving authority, then such notice to abutters must be completed prior to the date of submission of the application to the Department . All notices to abutters shall include a copy of the completed application form and for applications involving the reduction of a setback from a property line or a private 310 CMR 15 .402hthrough e the standards 15 .405 List of Abutters to facility with proposed upgrade : Date notified Abutter Name Address_ Abutter Name Address. Abutter Name_ Address Abutter Name Address Date notified, Date notified, Date n! otifed 9) ispnotnfeasiblel leachl as CMR 15 .404 (1) , completed) : a) an upgraded system in full compliance with 310 CMR 15 . 000 is not feasible: The 5' senaration between the seasonal high gravid water and the bottom of the proposed leaching area would require the installation of a pump chavler, and additional grading that may require the removal of several large trees due to site constraints. 4 b) an alternative system approved pursuant to 310 CMR 15 , 283-15 . 288 is not feasible: c) a shared system is not feasible: d) connection to a sewer is not feasible : No sewer present. 10) An application for a disposal system construction permit, including all required attachments (e .g. plans & specifications, site evaluation forms) , must accompany this application. Is the DSCP application attached? yes no il) Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the endest of my knowledge and belief, are true, accurate, complete. am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for knowing violations. " ittujia Faci-iT ty owner' s signature Print Name Almer Huntley, Jr. & Associates, Inc. Date 6-22-98 Date Name of preparer (413) 5£Y+-7/di■ 30 Industrial Drive East, Northampton, MA 01061 Telephone # & address of preparer NOTE: Title 5, 310 CMR 15 .403 (4) , requires the system owner or operator to submit to the Department a copy of the local upgrade approval upon issuance by the Hoard of Health and prior to commencement of construction. Soil name and Hydro Duration Months Depth Him action -r _ map symbol I logic Frequency - -----------1 °°16--12 ._,____ T �— o- n --- High ;High High. rD None --- --- 0-1.0 Apparent Jan-Dec >60 -- H Fm v Freetown j GIC, GM1B, Lov :Low High. of G GB, GxC, — >60 ___ WIC, GxB, ___ ___ >fi.o ___ m D A None Gloucester _ Xlgh Mow Moderate. m Ha B Occasional Brief Feb-Apr 4.0-6.0 Apparent Nov-Apr >60 ,b Hadley m High Mow Moderate. .O HO: Feb-Apr 4.0-6.0 Apparent Nov-Apr )60 -- 1 Winooski B Occasional Brief >60 High :Moderate Moderate. M. Broom ki R Occasional Brief Feb-Apr 1.5-3.0 Apparent Nov-Apr i Urban land. Moderate Mow High. >6.0 --- ___ )60 ___ B None -'- 1laven 1 --- >60 ___ Low______ILow High. NBA, HgB, HgC, ___ ___ )6.0 ___ HgD, HgE A None________ Hinckley Low �LOw High. >60 --- ___ >6.0 ___ Hue: A None ___ Low :Low------ High. Hinckley ___ >60 --- Merrimac A None '-- Urban land. N ___ 10-20 Hard Moderate Mow High. >6.0 -- vC C/D None --- Holyoke 0.5-1.5 Apparent --- High :High Low. Brief t Nov-Jun >60 Lk C Frequent---- Limerick ,1_0.5 Apparent Oct-Aug >60 --- High IHigh Moderate. Mace D None --- Maybid Low Low High. NPR, MeG, ___ >6.0 ___ >60 ---Me A, A None --- MeD Merrimac >60 Moderate ;Low---- High. MoB, MoC, MsC, ___ 2.0-2.5 Perched Feb-Nay MSB, MxC, MADNone-------- Montauk Moderate .Low Moderate. >60 --- >6.0 ___ ___ NaCe, Nape: --- High. Holyoke C/D ;None Moderate Low B __ >6.0 --- --- 10-20 Hard c/D .None - olyoke b See footnotes at end of table. S g 33 » — .. o a E1 ,14 I C 1 Ra ¢ o, W") 3333 - : ,. i & & m '+ 22 a _ _ idi1D *eFEbeii"assiihCE`S* AR est Farms FL# PI' ISORANCE RATE MAP t ; OF---- NOI.THAMPTON, MASSACHUSETTS HAMPSHIRE COUNTY F COMMUNITY-PANEL NUMBER 0001 A PARE 1.0F 2 ISEE MAP INDEX FOR PAGES NOT PRINTCDI EFFECTIVE APR L3:1978 DEERFIELD PARSONS BROOK 9T 1 i us. PAHr t oP HOUStNti ANUU#I AN OEVWLopMENT:;: :. FED PAL MSURRMCE ADMINISTRATION APPROXIMATE SCALE 1000 FEET Y_.\9f )1 ,I ,// ) u' �� i �11 mss_ �l1( e' lf Cl�I ` � ' c i °'7 r '\\ \°•. . � ;walk 3i '0. `v \\\ (,, ,,I.‘ 4E21,3; w lll�l� Illy �, '� (-\`' \ - 4j)1 o, i( %j o' 4 Q �� • 0 A+ f ) ' 4 1 . '_ \: , > i it , \ r — �\ �)_r ! ' ,. _i! k1tZ U� � / 1��/ ' 1 p_ �) \. -- 5. .f IF�r/ ti 1 1 )if 1 }J . ' s `s'J f : k Lsr S )1111\�i ` O .tl fS�i, :4110 �II ei2?-5.c: s . '- ()C ti 2 ) ,� z I I « ' laiLIC5�11 �� S /J r I f��(n r� �f'i � (` (.. a -1 9IJ '1'21 '1.�:'� ° /iso it. s� 1%0 0 b r p f-'4 f i 1 i : 7 /(\� —I` ` Imo" --���;-1- / tO �1 I A AI, ,,$ f,) — , ( _ r 1.i i (`. ,A /. j it sI J \ , 4 ,> (�\ &[4:9' �i �1,�� `� �) f 11.0 1 � l � '"� ,} `/ } / _'p A. , „ ,/� abl y. ,,w 'f i ? ( s , 1i '' i 11 tV 1'r. i. �� 8 y P�il].%4,141. 1 f 'P) 4/ j .I\�I of I ) / )�` "O c p° ��� �. °? f •rl ‘S CIIIS WESTHAMPTON ROAD (RTE 66) HUNTLE`. ALMER HUNTLEY,JR. &ASSOCIATES,I: SURVEYORS •ENGINEERS -LANDSCAPE ARCHITI July 30, 1998 Mr.Peter McErlain City of Northampton City Hall 210 Main Street Northampton,MA 01060 RE: Septic System Record Plans, 661 Westhampton Road,Northampton,MA Huntley No. 98-094 Dear Mr. McErlain: Based on the inspections performed by our office during the installation of the repair system for the house at 661 Westhampton Road,Northampton,MA. The system appears to have been constructed conforming to the Title V,Sanitary Code requirements. We are therefore requesting a Certificate of Compliance from the Board. Thank you for your attention to this matter. Please find enclosed two(2) copies of the record plans. Should you have any questions please do not hesitate to contact our office. Very truly yours, ALMER HUNTLEY,JR. & ASSOCIATES,INC. Re a L. Sherer,P.E. Project Manager RLS: cjh cc: Mr.Michael O'Brien Enclosures himtleyl\projinfo\projects\98-094'SIs01 (800)227-7723 •(413)584-7444 •FAX(413)586-9159 0 30 INDUSTRIAL DRIVE EAST •P.O.Box 568 •NORTHAMPTON,MA 01061