34 Septic System Permit 2012 BOARD OF HEALTH
DONNA C.SALLOOM,CHAIR
SUZANNE SMRH,M.D.
JOANNE LEVIN,M.D.
Benjamin Wood,MPH,Director
Jostens Mir,MPH,Health Inspector
Patricia Abbot RN,Pubs Health Nurse
Heather McBride,Clerk
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
(413)567-1214
FAX(413)587-1221
212 MAIN STREET
NORTHAMPTON,MA 01060
Onsite Septic System Construction Permit: Conservation Commission Review
NOTE: As of 1/1/11, Septic System Permits will not be issued by the Northampton Board of Health
until we receive this form signed by the Northampton Conservation Commission Staff Member.
The Conservation Commission can be reached by contacting:
0 Sarah LaValley,Conservation,Preservation and Land Use Planner
SLaValley @no rthamotonma.Rov
Office of Planning&Development
210 Main Street, Rm.11,City Hall
Northampton, MA 01060
Property Owner: /on? Mme/5cw" Address:
Engineer:
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on Conservation, Preservation and Land Use Pla er
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