235 Trench Permit 2018 •
r^„p„A�.y_ CITY OF NORTHAMPTON,MASSACHUSETTS 235 COLES MEADOW RD
1 ', /1 ` DEPARTMENT OF PUBLIC WORKS
125 Locust Street Trench Permit Number: 2018-349
I= :S Northampton,MA 01060 ,,��//
413-587-1570 Date Approved:.34?-, ”( iy'/t ' 7,
Fax 413-587-1576 1y1//
Expiration Date: 27j /�
(for City Use Only)
EXCAVATION/TRENCH PERMIT
Pursuant to G.L.c. 82A and 520 CMR 14.00 et seq. (as amended)
This permit must be fully completed prior to consideration. Submit completed form with permit fee to
Northampton Department of Public Works, 125 Locust Street,Northampton,MA 01060.
This permit is issued under the provisions of M.G.L.c. 82A, 520 CMR 14.00 and applicable sections of the
Revised-Ordinancee3aftfie-City of Northampton,including,but not limited to, Section 285-21.
ee: $250 Check#: 9823) Date Issued: 03/20/18
a nt--- Primary Phone#
J.W. COTTON LLC 413-247-9608
Street Address Emergency Phone#
PO BOX 713 413-563-5639
City/Town State Zip Email
HATFIELD MA 01038 john@jwcotton.com
Name of Excavator Primary Phone#
SAME
Street Address Emergency Phone#
City/Town State Zip Email
Name of Property Owner(s) Primary Phone#
JOSEPH BARKER
Street Address Emergency Phone#
235 COLES MEADOW RD
City/Town State Zip Email
NORTHAMPTON MA 01060
Insurance Certificate# Policy Expiration Date
ON FILE
Name&Contact Information of Insurer
ON FILE
Dig Safe#
20181201144
Pg.1/4,Excavation/Trench Pencil