192 Septic Trench Permit 2010 OE NORTHAMPTON
.NTOFPU$LIC WORKS
�12S Loc.=Eteet
InJ ampton,MA 01060`
'Phone 413 387-1570
£AX413 587-1576
PENDING APPROVAL 192 COLES MEADOW ROAD
Permit No. 6037
DISAPPROVED
Date Issues ,, 9/16/2010
By
(Department of Public Works)
No work to start until signed
TRENCH PERMIT
'c„82A§ 1 and 520 CMR 7.00 et seq.(as amended)
MUST BE FULLY COMPLETED PRIOR TO CONSIDERATION
pubhc*65i and pnvafepropeny)is issued under the provisions of M G L a 82A§l and 520 CMR 14.00
e oflhe City of Northampton subject to the"Specifications for Care of Street Cuts"approved and adopted
ea@fnbei21.1991 The apphc9nt hereby agrees to protect all cuts with barricades and lights,and to save the
der dmla$s whatsoever mrsing from the occupation of all properties affected by this permit,until such
"-'the Department of Public Works as provided for below,and in the case of private utility,to pay all
Yxlid tor30 days from date of approval.Expiration Date, /D r 9—/D
Cell
413-563-5639
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QI060
Cell
192 COLES MEADOW ROAD
Pi,please ilescribe the exact location of the proposed trench and its purpose.Include a
bedatd uipmpose4 french(eg;pipes/cable lines etc...)
6.t`rt as
`- NEWSEPTIC TANK INSTALLATION
PENDING APPROVAL
ON-FILE
ONFfLE
ON FILE
2010-380-7912
SHALL BE-POSTED IN PLAIN VIEW ON THE SITE OF THE TRENCH
dos requested outside of regular working hours(7:00 a.m.-3:00 p m.M-F)
rP ress- :. -
r records.
TRENCH CUT IS MADE
NOTE:
TEMPORARY
PATCH REQUIRED
PENDING APPROVAL 192 COLES MEADOW ROAD
FORM{THE APPLICANT,OWNER,AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT
AT'1Q.IAR V ITTE OR,BEFORE COMMENCEMENT OF THE WORK,WILL BECOME FAMILIAR WITH ALL
TUNE APPLICABLE TO WORK PROPOSED,INCLUDING OSHA REGULATIONS,G.L.c.82A,520 CMR
APPLICABLE MUNICIPAL ORDINANCES,BY-LAWS AND REGULATIONS AND THEY COVENANT
*DONE UNDER THE PERMIT ISSUED FOR SUCH WORK WILL COMPLY THEREWITH IN
CONDITIONS SET FORTH BELOW.
WNERAUTHORIZES THE APPLICANT TO APPLY FOR TEE PERMIT AND THE EXCAVATOR TO
ORK ON THE PROPERTY OF THE OWNER,AND ALSO FOR THE DURATION OF CONSTRUCTION,
ISMULYAPPOINTED BY THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR
ORKFOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND
H
SUCH WORK '"
OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO REIMBURSE THE
ALL COSTS AND EXPENSES INCURRED BY THE MUNICIPALITY IN CONNECTION WITH
CONDUCTED THEREUNDER,INCLUDING BUT NOT LIMITED TO ENFORCING THE
cW AND CONDITIONS OF THIS PERMIT,INSPECTIONS MADE TO ASSURE COMPLIANCE
`TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC WHERE THE APPLICANT
ASFAILED TO COMPLY THEREWITH INCLUDING POLICE DETAILS AND OTHER REMEDIAL
;CESSARY:BY THE MUNICIPALITY.
OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO DEFEND,
SS THE MUNICIPALITY AND ALL OF ITS AGENTS AND EMPLOYEES FROM ANY AND
•!'..• . 111 • • •1 I • • I • I• 111• •I • .•' ' • •• •
PERSON OR PROPERTY DURING THE WORK CONDUCTED UNDER THIS PERMIT.
DATE 46\ -15TI'
DATE
DATE