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20-98
CITY OF NORTHAMPTON, MA
PUBLIC WORKS DEPARTMENT
RESIDENTIAL/COMMERCIAL OR INDUSTRIAL SEWER CONNECTION
INSPECTION REPORT
DATE: December 20, 1997
TYPE OF SERVICE•
`t PVC IN4c Crs' PvC
NEW SERVICE PIPE SIZE & MATERIAL
SERVICE RENEWAL
SERVICE REPAIR
108 Marian Street
LOCATION OS INSTALLATION :
( Street and Number)
James Kohrman 586-9762
PERMIT ISSUED TO:
Karl's Excavating 549-5396
327 River Drive, Hadley, MA 01035
INSTALLING SERVICE CONNECTION:
CONTRACTOR/DEVELOPER
The service connection at this location was inspected by the
undersigned on /a - /7- % 7 at -? P/fl and approved.
(DATE) (TIME)
i
I have instructed fh R g YD11 of I K A R I S .6YCAL/4f'/'/&
that the installation can be backfilled.
Imr,Rfm,i4 i I
Signature and Title )
Measurements for all installations shall be listed on the back of
this form. The information shall be attached to the permit at
the Public Works Department Office .
20-98
Page 2
R. C . B . S . A.
A . The City shall not be held liable for any open plumbing fixtures
below street level .
5. The applicant and/or owner hereby agrees to pay to the City any
sewer use assessments or charges as may be established under
city ordinance.
GATE : December 10, 1997
SIGNED
ppl ' c. nt
'108 Mari.n treef 586-9762
Northampton, MA 01060
(Address of Applicant )
$ 500.00 11 111 inspection fee paid .
Application approved and permit issued :
DATE : /2- 11-97 S I G N E D : °,{�j
(Su p eA n t e n d epi)
Attachments
Code of Ordinances , Section 22-41 through 22-46 .
Tie-in to sanitary main $200.00
Tie-in to sanitary service at street line $500.00
Tie-in to storm drain $100.00
X
20-98
FORM 79- 1
RESIDENTIAL OR COMMERCIAL BUILDING SEWER APPLICATION
To the City of NORTHAMPTON, MASSACHUSETTS:
The undersigned , being the Owner of the
(Owner , Owner ' s Agent)
property located at 108 Marian Street ,does
(Number) (Street)
hereby request a permit to install and connect a building sewer
to serve the
Residence
(Residence , Commercial Bldg . , etc . )
at said location.
I . The applicant and/or owner shall furnish upon request of the
Superintendent the estimated quantity and characteristics of
waste to be discharged to the public sewer .
2. "Owner" shall mean the person holding title to the property
served or to be served by the building sewer .
3 . The name and address of person or firm who will perform the
proposed work is Karl's Excavating 549-5396
327 River Drive Hadley MA 0IO1S
4 . Plans and specifications for the proposed building sewer are
attached hereunto as Exhibit "A".
In Consideration of the granting of this permit , the under-
signed agrees :
1 . To accept and abide by all provisions of the Code of Ordinances ,
City of Northampton , Massachusetts , Sections 22-41 through 22-46 ,
and all other pertinant ordinances or regulations that may be
adopted in the future .
2 . To maintain the building sewer at no expense to the city .
3 . To notify the Superintendent when the building sewer is ready
for inspection and connection to the public sewer , but before
any portion of the work is covered .