well construction permit 2017 •
BOARD OF HEALTH
City of Northampton
APPLICATION FOR A WELL CONSTRUCTION PERMIT
Well Permit Number (TO BE ASSIGNED BY BOARD OF HEALTH) Fee $50.00
This application must be accompanied by a scaled plot plan, produced by a civil engineer or registered
sanitarian showing the minimum distances required in Title 5 of the State Environmental Code. For new
construction, requiring a septic system. the septic system plan submitted for the property in compliance
with Title 5 requirements will be acceptable if the proposed well location is included.
Application is hereby made to construct 0 or repair( ) a private well. -For -Farm irrs jacili D h
FRED BED -DAC—L. JvLy M , 2°l - • '
•
Owner's Name Date ' "
FA l,R S TROESTE
Kt E$Tt®W 413 - 58'4 - 134 I PRec C '' "
Street Address Telephone Number -,
DRTWAMpro N MA 0 [ a 60 )(c1.-`
bPAciV
City, State, Zip Code 3211 CA
032.— C60 —OD
Location of Proposed Well Tax Map # Parcel #
(if different from address)
f 06E.C,T. P. Tu e P eR. A- 6X5=1 �►
Well Driller(submit evidence of valid state registration) Conse '•.'tion Co ,mission Approval
(SLaValle_y northan tonma.gov)
For new construction:
Septic system plan complies with Title 5: yes (4no ( ) n/a( )
Septic system plan shows location of well: yes (V1no ( ) n/a ( )
For new, repair or location to leach field, septic tank or city sewer:
A scaled well construction plan has been submitted:yes no ( ) n/a( )
€.140,,.,,G ( (341c600 JH 1/ ! R ! 20 t "i-
Signature of Applicant Date
Please Mail Application to:
Northampton Board of Health
212 Main Street
Northampton, MA 01060
TO JIBE COMPLETED BY BOARD OF HE L H
v . //070g
/-7 Permit expires on: .F i / (One year from date of issuance)
Permi> ssued (date)
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. DEPARTMENT OF ENVIRONMENTAL PROTECTION c-..e.;11......ta
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' -=fL : = - SETTS WELL D _SSACIIU
El CERTIFICATE '
'K� Pursuant to the provisions of
c °� Massachusetts General Laws Chapter 21G Section 20.._
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o-:I.VRobert Tupper #689 y
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is authorized to di or drill '-"' �
g all types of wells
4 = in the Commonwealth of Massachusetts during the period
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01/01/2017 to 12/31/2017
ha-^:Y?
iti4W-:,_
Commissioner/Designee _ S
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CERTIFICATE OF APPROVAL
FOR AGRICULTURAL IMPROVEMENTS
ON LAND SUBJECT TO AN AGRICULTURAL PRESERVATION RESTRICTION
The Massachusetts Department of Agricultural Resources (the `'Department") received an
application (the -.Application-) for a Certificate of Approval ("COA-) from Fred Beddall. the
current owner of a parcel of land located 141 Fair Street Extension in Northampton.
Hampshire County, MA (the "APR Owner"). An Agricultural Preservation Restriction (the
"Restriction" or the "APR") on this land, approximately 8.1 acres in size, was granted to the
Commonwealth of Massachusetts by Marcia Russell on June 27,2014. The APR was recorded in
the Hampshire County Registry of Deeds in Book 11679, Page 177. The Application sought
approval for construction of an Agricultural Related Improvement as further described below. as
the"Work".
Work
z The land owner seeks approval for the following agricultural improvements: (1)a drilled well
with buried pressure tank and electrical panel or a buried water line to connect to town water for
irrigation purposes, depending on well yield (2) a buried main irrigation line with risers/hydrants
extending northerly for the length of the property (approximately 900 +/- ft)(3) buried electrical
service lines for well pump/tank. The approximate Work area is depicted on Exhibit A attached
hereto.
Approval
The Department finds that the Work is authorized by the APR recorded in Book 11679, Page
° 177. General Laws Chapter 184 §§ 31-33 and Chapter 20 §§ 23-26. and does not defeat nor
derogate from the intent of this APR to provide cate and does nottion certfydthatothetcondition
ion of
agricultural lands. This COA is not an estoppel cert fi
of the APR Land nor the APR Owner is in conformance or compliance with the terms of the
APR. THEREFORE,the Commissioner of the Department approves the agricultural
related improvements as described in the section entitled "Work", subject to the
Conditions of Approval.
After Recording,PLEASE RETURN TO:
Dorothy Du
Mass.Department of Agricultural Resources
251 Causeway Street,Suite 500
Boston, MA 02114
I
City of Northampton
BOARD OF HEALTH
PERMIT NUMBER: 17-EXT-FAIR FEE $ 50.00
CHECK# 174
This is to certify that Robert P. Tupper
NAME
The Wash Well Co.-112 christian Hill Road-Swanzey,NH 03446
ADDRESS
Is Hereby Granted a Permit to Install a
Private Drinking Well:
LOCATION: Fair Street Ex n, Northampton, A ()Ka�
DATE:July 28, 2017
Board of Health Director
This license is granted in conformity with the Statutes and ordinances relating
thereto and expires_January 28, 2018_unless sooner suspended or revoked.