263 Septic System Permit 2003 41. 01
57/
THE COMMONWEALTH OF MASSACHUSETTS PEn
BOARD OF HEALTH
M CONSTRUCTION PERMIT
DISPOSAL SYST
Permission is hereby granted to +nstruct ( Re. r ( ) U grade ( ) Aban .n ) an in.ividual sewage
" i Y �/ , as described
lisposat system at
/G�� D�i
.n the application for Disposal Sys em Construction Permit No. .dated
Provided: Construction shall he completed within three years of the date of this per A c o tionr met.
�/�'l21A Cl
Date
Board of Health
FORM 2 - DSC DEP APPROVED FORM 5/96
FORM 1255(REV 5/96■
1-1(aMD Hoses fl WARREN'm
PUBLISHERS- BOSTON
BOARD OF HEALTH
MEMBERS
P.BRUNSWICK,M.D.,MPH,Chair
MARIE KARPARIS,RN.,MPH
JAY FLEITMAN,M.D.
R J.MCERLAIN,Health Agent
(413)587-1214
FAX(413)587-1221
MEMO
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
To: David McCutcheon,
P.O. Box 43, Easthampton, MA 01060
From: Peter McErlain, Health Agent
210 MAIN STREET,Room 8
NORTHAMPTON,MA 01060-3167
Date: May 7 , 2003
Re: Sylvester Rd. Septic System Construction Permit
The Northampton Board of Health is in receipt of your septic system construction
application and plans for a lot (Map 28, Lot 14-1) on Sylvester Rd. The plans have been
reviewed and approved. Your septic system construction permit will be issued upon
submittal of the following:
• The test report on well water following the installation of the well and
• Payment of the septic system construction permit fee of$75.00
Please feel free to contact me with any questions.
Thank you