43 Septic System Construction Permit 2011 BOARD OF HEALTH
DONNA C.SALLOOM,CHAIR
SUZANNE SMITH.M.D.
JOANNE LEVIN.M.D.
Benjamin Wood,MPH,Director
Javeda Mir,MPH,Health Inspector
Patricia Abbott RN,Public Health Nurse
Heather McBride,Clerk
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
(413)587-1214
FAX(413)567-1221
212 MAIN STREET
NORTHAMPTON,MA 01060
Onsite Septic System Construction Permit: Conservation Commission Review
VOTE: As of 1/1/11, Septic System Permits will not be issued by the Northampton Board of Health
_Intl we receive this form signed by the Northampton Conservation Commission Staff Member.
the Conservation Commission can be reached by contacting:
0 Sarah LaValley,Conservation,Preservation and Land Use Planner
SLaValley@northamptonma.gov
Office of Planning&Development
210 Main Street, Rm.11,City Hall
Northampton, MA 01060
Property Owner:/Man/7 C.ohar✓o GurcZ
Engineer 4iun) 0e i55
,.nserve
)ate: e4/121il
Address: 173 11/1711/ /son/
ssion Conservation, Preservation and Land Use Planner