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1162 Request for Determination of Applicability 2016 nportant: Then filling out Imes on the omputer,use my the tab key move your ursor-do not se the return ey .pronn1 moo Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Northampton C4yROwn WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information 1. Applicant: Darlene Kellogg dadene J kelogg@yahoo.com Name E-mas Address 1162 Westhampton Road Mailing Address Northampton City/Town 413-586-4573 Phone Number 2. Representative(if any): Cold Spring Environmental Finn Alan Weiss Contact Name 350 Old Enfield Road Mailing Address Belchertown City/Town 413-323-5957 MA State 01062 Zip Code Fax Number(ii applicable) aeweiss @charter.net E-Mail Address Phone Number MA State 413-323-4916 01007 Zip Code Fax Number(d applkebie) B. Determinations 1. I request the Northampton make the following determination(s). Check any that apply: Conservation Commission ❑ a.whether the area depicted on plan(s)and/or map(s)referenced below is an area subject to jurisdiction of the Wetlands Protection Act. ❑ b.whether the boundaries of resource area(s)depicted on plan(s)and/or map(s)referenced below are accurately delineated. • c.whether the work depicted on plan(s)referenced below is subject to the Wetlands Protection Act. (21 d.whether the area and/or work depicted on plan(s)referenced below is subject to the jurisdiction of any municipal wetlands ordinance or bylaw of: Northampton Name of Municipality ❑ a whether the following scope of alternatives is adequate for work in the Riverfront Area as depicted on referenced plan(s). P .1 a. G3 w+orr•1 doe Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Northampton grown WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description I. a. Project Location(use maps and plans to identify the location of the area subject to this request): 1162 Westhampton Northampton Street Address CilyRmm 41 -033 01 Assessors Map/Plat Number ParceVtot Number b. Area Description(use additional paper, if necessary): See Septic System Repair Plan Board of Health and Conservation concurrent.(New septic system exceeds 50'from BV W and intermittent stream,bout work is within Buffer Zone). c. Plan and/or Map Reference(s): Site Plan 05.102018 Title Date Title Date Title Date 2. a. Work Description (use additional paper and/or provide plan(s)of work, N necessary): Septic system repair on site as shown on plans. Siltation control noted, Limit of xoddgrading within 45-50 ft BV VV (rid system decommission at closest,45'). RDA filed as for area of work to Conservation. Comm as required. P.se x a/ .Morrn+.eoc Massachusetts Department of Environmental Protection Northampton of Resource Protection-Wetlands City/Tom WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description (cont.) b. Identify provisions of the Wetlands Protection Act or regulations which may exempt the applicant from having to file a Notice of Intent for all or part of the described work(use additional paper,if necessary). See above 3. a. If this application is a Request for Determination of Scope of Alternatives for work in the Riverfront Area,indicate the one classification below that best describes the project. ❑ Single family house on a lot recorded on or before 8/1/96 ❑ Single family house on a lot recorded after 8/1/96 ❑ Expansion of an existing structure on a lot recorded after 8/1/96 ❑ Project,other than a single family house or public project,where the applicant owned the lot before 817/96 ❑ New agriculture or aquaculture project ❑ Public project where funds were appropriated prior to 8/7/96 ❑ Project on a lot shown on an approved,definitive subdivision plan where there is a recorded deed restriction limiting total alteration of the Riverfront Area for the entire subdivision ❑ Residential subdivision;institutional,industrial,or commercial project ❑ Municipal project ❑ District,county, state,or federal government project ❑ Project required to evaluate off-site alternatives in more than one municipality in an Environmental Impact Report under MEPA or in an alternatives analysis pursuant to an application for a 404 permit from the U.S.Army Corps of Engineers or 401 Water Quality Certification from the Department of Environmental Protection. b. Provide evidence(e.g.,record of date subdivision lot was recorded)supporting the classification above(use additional paper and/or attach appropriate documents,if necessary.) N/A •eeuue^1 a: Massachusetts Department of Environmental Protection Northampton Bureau of Resource Protection -Wetlands N N ofroem WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability and accompanying plans,documents,and supporting data are true and complete to the best of my knowledge. I further certify that the property owner,if different from the applicant,and the appropriate DEP Regional Office were sent a complete copy of this Request(including all appropriate documentation} simultaneously with the submittal of this Request to the Conservation Commission. Failure by the applicant to send copies in a timely manner may result in dismissal of the Request for Determination of Applicability. Name and address of the property owner Darlene Kellogg Name 1162 Westhampton Road Melling Address Northampton City/Town MA 01062 State Zip Code Signatures: I also understand that notification of this Request will be placed in a local newspaper at my expense in accordance with Section 10.05(3)(b)(1)of the Wetlands Protection Act regulations. Signature of Applicant Alan Weiss Signature of Representative(if any) Date 6- id-96 Date 05.10.2016 Nee♦S4 LEACH FIELD DETAIL(ITS) 9 . ,4� {p "I tlw SUBJECT -- _y,i��!� yy(I1<..�, SITE • / i SUBJECT N. . re, �� ' ,, .a'y`.a'''y'-. '� LOCATIO ��� . .: . SITE CI l POWCAATO Wt.. \ yewY¢.. e,...."I"-41.y* ''' s.. LOCATION- IY y. nw w.•n., r. pesnn NOTES AND CAtCULAIIPYS: u�h fie..- 1.. . . . u sawm.weao.w.wn EFFLUENT OISPOSALALE r m• sh..-Saaiii � — usseevrov-wrrosrxe -}^¢m neu ms an .sn NI s .. /1 -,. 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