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Home My WebLink About0018 THYME LANE - Health °�� me. -�.. ,_. f ,ASSESSOR'S MAP NO. PARCEL L O CAT ION Thyrne LA S E�7 A C E PE R M I T NO. e VILLAGE r I N S T A LLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED ---� DATE COMPLIANCE ISSUED 2 • ,r� 0 0 ASSESSORS MAP NO: PARCEL NO.: r 9 I. THE COMMONWEALTH OF MASSACHUSETTS BOAR® QF HEALTH e. ...........OF..... � Applira#inn for Disposal Works Tonstrnrtion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( A-)Ioa'n Individual Sewage Disposal System at: Tt y. ... ..............Z.,O!fA;..e...........OZ71 ee-4 ...........) o Location-Address or Lot No. 11 ............................................................. .......-••---•-•-------....---•--•---......---- .......-•-----•-•----..__...............-•-••- .�� Owner Address aik... ..........................a .,�1 .......................... Installer Address Type of Building , Size Lot............................Sq. feet U Dwelling o. of Bedrooms................. ...Ex Expansion Attic a g— p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons................_._.._______ Showers ( ) — Cafeteria ( ) dOther fixtures -----------------------------------------•--•---------•------•-----••--------•--•-...... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_-_--_-_.____-------sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit,No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-._-__--_____-__--___--. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of S - r x U •••---•----------------•--•-----••-•----------------•------------•••-•-•-•-----------•---•-••-•----•-••----------------......--•--------•--•---------•----•--•--••-••- --------------------------- UW ----------------------------------------------------------------------------------------------------------------------------- ---- Nature of Repairs or Alterations—Answer when applicable------- _ �� - - ------------------------------------------------------------------------•-------------•-•--.....------------...----------------------------------------•-------........................................ Agreement: The undersigned agrees to install the aforedescribed Individual. Sewage Disposal System in accordance with the provisions of i TT�,, p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee sueWbyt..,bo d o lth.Signed ---- ..l'��'�' D to Application Approved By... � ,} ---•---------•----•------------------------ ............... -`�� U Date Application Disapproved for the following reasons----------------------••-----•--•------....._......--•---------•-----------------......-••--••----•-----..---••- Date PermitNo. � 65.................................... Issued_....................................................... Date No_-- -v� 1-- FE$....c THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r ✓°.�re1 ' ...OF.....Y ��! � / r�!` �F''iC '...................... Appliration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( " � 'an Individual Sewage Disposal System at: _��y r J r F 1 l c� *�s. ......._f ' r "M ✓-�c.': � ._..... r.. t .11�'� L �'c4�� ......^................... ....... » ___ _____. »_... _ .-._ .. ... . .......... d Location-Address or Lot No. t Owner Address ....................-..... •-••------....-........_...--- - Installer Address UType of Buildin��g/- Size Lot............................Sq. feet Dwelling—'No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building No. of persons............................ Showers — Cafeteria P4 Other fixtures ----------------------------•••. . W Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. P4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth.......... Disposal Trench—NTo-------------------•_ Width.................... Total Length...._............... Total leaching area....................sq. ft. 3 Seepage Pit No-_----------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water................... (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ell a .............. -----------•-•--- •--. ............................................................. O Description of Soil...........k --� W •--•-•----------------------•------------•-•--------------•-----•------- . `}' ------ U Nature of Repairs or Alterations—Answer when applicable_________________ +__... ,�'< � ._. _•-.___..__-_-____•--•_._-__..... ------------------------------------•-----------------------------•---------------------•------•--•-----......------------------------------------------...-----------------------------....._......---- Agreement: The undersigned agrees to install the aforedescribed ,Individual Sewage Disposal System in accordance with the provisions of i i ItL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board or health ,✓` Signed "# ,` ,' � ! v . ---•. ------ -----� •. .... . _ Date Application Approved B �� s__.__:}._..___.'_'°.. �!`��_ 71_�_�_ g Date Application Disapproved for the following reasons:---•---•---•------•---•---•---•------------•-•--------•------••------------------------------------------•--» ...--•--•-•----------•-----...-•-------•---------•-------------------------------------------------------•--•-----•--.......-•--------•--------•---------•--••---•---•----••-••---••-••••-•--------•--•- Date PermitNo.... ....................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �.1'�Y� �'t�'.+. .......OF.... !F d �':�...f.M1.:",jf" >c.+ ,•�.. ............................. %TLYrrtifirtttp of Toutpliatt TH S 1S TOgRTIFYj That the Individual Sewage Disposal System constructed ( ) or Repaired , s-:;- ----- -- ----------------------------------------•---•----------------------•----•-•--------------- _ Zns alb;r, ` has been installed in accordance with the provisions of ii i,t; j of The State Sanitary Cod . as escribed in the application for Disposal Works Construction Permit NTo.._�_..��..._..... - dated_..` ._ _ 1� _ . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A G ARANTEE THAT YHE SYSTEM WILL 64tVlONS TISFACTORY. ____1 � DATE...................... '. ...FC......................... Inspector........1 a 14 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH G i No 72..................... FEE..............n........ Disposal Works Tonstrudion Vrrmit Permission is hereby granted......... �.. ..................................................................................... to Construct (� ) or.Repair (-') an Individual Sewage Disposal System atNo..........:....................................•--.._.:. = == = .... Street as shown on the application for Disposal Works Construction Pe mit Dated.___7___j_1._._f-6............... DATE_ .. 6......................................• Board of Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS