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198 Septic System Construction Permit 2015■ARD OF HEALTH A C.SALLOOM,CHAIR IZANNE SMITH,M.D. DANNE LEVIN,M.D. min Wood,MPH,Director I Wasiuk,Health Inspector M Smih,Hearth Inspector Mott,RN,Public Health Nurse rather McBride,Clerk CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH (413)587—1214 FAX(413)587-1221 212 MAIN STREET NORTHAMPTON,MA 01060 ite Septic System Construction Permit: Conservation Commission Review As of 1/1/11, Septic System Permits will not be issued by the Northampton Health Department receive this form signed by the Northampton Conservation Commission Staff Member. reservation Commission can be reached by contacting: 0 Sarah LaValley,Conservation, Preservation and Land Use Planner SLaValley@northamptonma.gov 587-1263 Office of Planning&Development 210 Main Street, Rm. 11,City Hall Northampton, MA 01060 rtyOwne//r: ' 7/ 51ts wn� L eer: Ili l/c%P/rJi Address:M 57/vesA7 KcJ v; a ,r�i//ir —ND agt Sa444 - [,3 Ce4 4 e I ,rvation o issio ,Irnservation, Preservation and Land Use Planber