1526 Certification of Compliance 2009 01 l of (an facum, 9t1 aeli 4e
2/2 7160e Street
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lee, 413-517-1214
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Title V Certification of Compliance
TO BE FILLED OUT BY THE SYSTEM DESIGNER
DESIGNER 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 Designer 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 designed as: XX new construction
repair(existing system)
at 1526 Westhampton Road(Rt.66) December 18,2006 DWCP number
(Address)
(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.
Timothy E.MaainnisR.S.
(Print Designer's name)
70 Montague Road—Westhampton,MA.
(Address)
NOTE: This certification represents 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.
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Oct.• Distribution box ('C') + _ —,�
1.500 gallon septic tank i
Reserve area •' pvc solid pipe
C..
'Reserve area
• O
..E.. ee .,A.
'•B•• Existing
"Reserve area \
Existing garage
--' 4 bedroom \
house
4' pvc solid pipe
1
Pump-out manhole ('C' Orr Deck
•Olf of 4' pvc pert pipe
Inspection port C'E')
AS-BUILT DIMENSIONS
As—built plan
Subsurface sewage disposal system
H
4 Trenches @ ( 40'L x 31 x 2' )
1526 Westhampton Road
Northampton, Massachusetts
Owner: Paul & Marchelle McCutcheon