Water Entry PermitPermit No.
W30-23
Date Approved:_
Exp. Date:
CITY OF NORTHAMPTON, MA
RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY PERMIT
A Department of Public Works Trench Permit Shall be required
prior to any construction or connection activity associated with this application.
To the City of NORTHAMPTON, MASSACHUSETTS:
The undersigned, being the
OWNER'S AGENT
(Owner, Owner's Agent)
of the property
located a 95 CHESTERFIELD RD , does hereby request a permit to install and
(Number and Street)
connect i I " Water Service to the RESIDENCE at said location.
(Size)
(Residence, Commercial Bldg., etc.)
1. "Owner" shall mean the person holding title to the property served or to be served by the
water service.
2. The person or firm who will perform the proposed work is:
RCW PLUMBING & HEATING
(Name)
of 3 WEQUAMPS DR, S. DEERFIELD, MA 01373
(Address)
3. Plan/sketch and specifications for the proposed water service shall be attached to permit.
In Consideration of the granting of this permit, the undersigned agrees:
1. The Water Department shall make all taps to the water main of 2" or less, unless approved by the
Water Superintendent.
2. WATER ENTRY PERMIT FEE IS $1250.00
3. Additional work performed by City forces from the water main to street line shall be paid at
the prevailing labor rates and cost of material.
Water Meters 5/8" $450.00
Water Meters 3/4" $450.00
Water Meters 1" $550.00
Radio Read N/A $150.00
**** Water Meters >V will be purchased by the City and charged to the customer. ****
4. A Radio Read Fee is charged with the purchase of a new meter.
5. The Water Superintendent shall be notified for water line inspection prior to backfill of
trench.
SEE ATTACHED UTILITY CONNECTION REQUIREMENTS
Permit No. W30-23
CITY OF NORTHAMPTON, MA
RESIDENTIAL OR COMMERCIAL BUILDING WATER ENTRY APPLICATION
DATE: 6-512023 SIGNED:
1DR BUILDERS
(Name of Applicant)
177 STATE RD, S. DEERFIELD, MA 01373
(Address of Applicant)
413-374-7983
$ 1250
Entry fee paid
Check No.
$ 450
Meter fee paid
Check No.
$ 150
Radio Read fee paid
Check No.
Application approved and permit issued:
(Telephone No. of Applicant)
6319
6319
6319
DATE: SIGNED: // �� I ��
( irector oT—fio6 Department of Public Works)
Fee Schedule: Fire Line Fee included in Water Entry Fee
Water Entry Permit Fee $1,250.00
5/8" Meter Fee: $450.00
3/4" Meter Fee: $450.00
1" Meter Fee: $550.00
Radio Read Fee: $150.00
SEE ATTACHED UTILITY CONNECTION REQUIREMENTS
Date: 6/5/2023
Type of Service: New X
Pip Size 8"
Water Entry Fee Paid:
Meter Fee Paid: Yes X
Permit No.
WATER CONNECTION
INSPECTION REPORT
Northampton Water Department
125 Locust St
Northampton, MA 01060
(413) 587-1570
Domestic: X Fire Line:
Renewal Repair
Material DI
W30-23
Irrigation:
Age 2018
Yes X No
No Meter Size:
Radio Read Fee Paid: Yes X No
Check# 6319 Cash Money Order#
Location of Installation: 95 CHESTERFIELD RD, LEEDS
(Number and Street) (Parcel ID)
Contractor.. -'Developer Installing Service Connection RCW PLUMBING 413-575-9089 CHRIS
(Name)
413-977-6428
(Telephone Number)
This service connection at this location was inspected by the undersigned on
at
(Time)
and approved by:
(Water Superintendent)
I have instructed of
installation can be backfilled.
Measurements for all installation shall be documented by the Water Department. The
information shall be on file at the Public Works Department office.
Copy to Supervisor: Date:
Copy to Utility Billing: Date:
Copy to Water Dept: Date:
(Date)
that the
SEE ATTACHED UTILITY CONNECTION REQUIREMENTS
Requirements for Utility Connection Permits
The following requirements shall apply to and be incorporated into any Utility Connection permit,
as defined below, issued by the City of Northampton Department of Public Works (DPW) for
interconnection to City owned utilities including the Water, Sewer and Storm Water systems.
1. Utility connection Permits and Trench Permits will be good for a period of thirty days, unless
extended. Please contact the DPW at 413-587-1570 seven days prior to permit expiration for an
extension, if needed.
2. The DPW will be strictly enforcing the following inspection requirements for all Utility
Connections:
a. No Utility Connection shall be back -filled before the utility connections have been inspected
on -site by a DPW representative and determined to be in accordance with City standards.
b. Any trench that is backfilled prior to inspection will be required to be re -excavated to expose
the new work in its entirety to satisfactorily close the permit.
c. To request an inspection, please contact the DPW at 413-587-1570. Every effort will made to
accommodate same day requests if made before 1 PM, but the DPW cannot guarantee same
day inspection. There will be a $100 fee for same day requests made after 1 PM on business
days, and all same day requests made on weekends or on legal holidays.
d. PHOTGRAPHS ARE NOT ALLOWED IN LIEU OF ON -SITE INSPECTION.
For purposes of this Policy Order, a "Utility Connection" shall be a connection to the City water
system in accordance with the Code of City Ordinances § 325-3, a connection to the City sanitary
sewer system in accordance with the Code of City Ordinances § 260-5 et seq., or a connection to a
drain within the City stormwater system in accordance with the Code of City Ordinances § 256.10.
A "Utility Connection Permit" shall be any permit issued by the DPW, regardless of its title or form,
necessary to make a Utility Connection.
SEE ATTACHED UTILITY CONNECTION REQUIREMENTS