4 Perc Test 2009 BOARD OF HEALTH
MEMBERS
JAY FLEITMAN,M.D.,Chair
SUZANNE SMITH,M.D.
DONNA C.SALLOOM
XANTHI SCRIMGEOUR,MHEd,CHES
DIRECTOR
(413)587-1214
FAX(413)587-1221
To: Marc Durso
Berkshire Design Group
4 Allen Place
Northampton, MA 01060
/CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
PERCOLATION TEST FEES
RECEIPT
212 MAIN STREET
NORTHAMPTON,MA 01060
Date: June 19, 2009
Pere Test requested by
The Northampton Board of Health charges a fee for the witnessing of percolation tests:
$50.00/hr - (minimum fee-$50.00).
No. Date
1. 5-20-09
2.
3.
Location Lot#
Kensington Estates
Ellen Bokina
Witnessed by
Ellen Bokina
Start Time
1. 8:30 am
2.
3.
Stop Time
4:30 am
Hours
7.50
Total Hours: 3.0 @$50.00/Hr.
Re air
Amount PAID: $375 .00 CK#8380 dated 6-12-09
Please make checks payable to: The City of Northampton and mail to the Board of Health Office,212 Main St.,
Northampton,MA 01060
Thank you.
Ellen Bokina, Title 5 Inspector