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Home My WebLink About0053 EISENHOWER DRIVE - Health 53 Eisenhower Drive _ Cotuit -- -- - - - A= 039 095 - I LOCATION SEWAGE PERMIT NO. I L l=f- t INSTAL EIt NA i ADDR'E-SS BUILDER OR OWNER 4.. DATE PERMIT ISSUEDa +h DATE COMPLIANCE ISSUED 64Q96e ��.gcK-) qg� No. 1. �. '.�- FiziR... ........ _ 'THE COMMONWEALTH.OF MASSACHUSETT.S BOAR® OF HEALTH ............ ......... .................... OF.......................................................................................... ApplirFa#ion for Dispas al Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ............. ............, r ................. - ............... Location-Address or Lot No. ..............�_cS ��----....-C_ , _ �:�N`�'� �---`� ..._...... Owner Addmss .......................= ..Q. ! ....46Z4 :6 ...................... ......----•-------. .. ...---- --. -- -................ Installer Address Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms.................q........................Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building ...... No. of persons............................ Showers — Cafeteria G4 Other fixtures .----••-----------•--------•--- d ------------------------------ -------------•------ ------ -........... .. W Design Flow...... L°2........................gallons per person per day. Total daily flow..... �.0....................gallons. WSeptic Tank—Liquid capacity.14%�O.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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--___-----_-_-__--_-_--. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ �+ ----------------------------------------------•--.....--------------..........:--------.------------------ ------------------------- ------- ---- ---------- ..... 0 Description of Soil........................................••---•-------•----------••-•-----•-•------------------------•--------------------------•------------------------.............--- U •...._..-•----------•------------------------------••------•-------------......----••----•---•-----......•--•-••-------------------------------......•••••------------•••-----•--------------•--•-....-- W VNature 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 TITI- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation up ' a Cer� rtifica Compliance has been i sued b the board h —_ Si ed----- !.._. ..... .......................... ...... op --Date.......__... Application Approved B r-''� y........... � �' ✓PP PP y-- -....... .............. Date Application Disapprov d r e following reasons----------------------------------------------------------------------------------------•----•---•--------------- ---•----•....................................•--•--•-••-----------------•-•---•----------.....-----------...........•-•-......---••------•------••--•----•---•--•---------------------•--•------...-•--- Date PermitNo......................................................... Issued....................................................... Date No. .... FlzsR..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEI ALTH ...............................O F.........................------.......----------- Appliration for Uhipoii al Works Tonstrnrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ..............� ........ t 5 /4_4�.!. ......•. ........................ ................................................. . Location-Ad ess54ft ......... Q k ......................... , ------ .......... a Ow er A d2s' ................... if ..... ......................................... ----- --- Installer Address UType of Building Size Lot...........................S q. feet Dwelling—No. of Bedrooms...............:�-•----------._.___-_-•-Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building _...... No. of persons............................ Showers a YP g --------•------------ P ( ) — Cafeteria ( ) Otherfixtures --------•-•-•-• ---•••-•-•••-•••••--•--••-•-•-•--••••••-------•--•••-•--••••-•--•-••-•--•----------•.----• •-- Design Flow........ ••--- gallons P P P Y Y Z I.W �Q...................... Ilons per person per day. Total daily flow._._.....__.........................__._..._gallons. WSeptic Tank—Liquid-capacityl 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 ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ 1-4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ---•--•--•-•••--•-------•---•---•--------•--••--....---•-•-••--•....._•----•••--........••••._...----•-••...•--•--•••-•-•••.............••................... 0 Description of Soil...................................................-.................................................................................................................... W U ---•-••-•-•-•-•••--•--••-------••---•-••••-•-•-•-•--••-•--•---•---.........•----•---•..........•••-••••-•-••-••-•-•••••-•-•••••---•---•••.....-•-•---•--•--••--••-•••-•-•-••---••--•••----•••-----•-•••. W UNature 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 TITI.P: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation unt' a Certifica Compliance has been ' ued b the bi r h . ;ried......•...•--• ••• •......-•-•••--•-•-••------•-•-•---- . f S /�� / to ApplicationApproved BY•- ....'...... .................... ..................................................•. -• -- . Aff / Date _ Application Disapprov d r e following reasons---------------•--•-------------------------------------•--------------------•----------------------------..._._ ....................................••--......_....•-•-•••........----•-........-•------••••-•----•••••••-•---•-••--••-••••------••--------•----•-••••-•-•----•-•••-••-••-----••-------•--•-•--...--•--- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD , F HE �...........................O F........................ ......................................... (Intifiratr of nntpliFanrr RTIFat th Sewage Dispos �s em constructed ( �r Repaired ( ) bY•--- •--•- .........---•--... .. .G"� ... .. .. •. •` •----•--•---•--- --•-•---- ..�s...... �^ / Installer has been installed in accordance with the provisions of TITLE 5 of T e State Sanitary Co described in the application for Disposal Works Construction Permit No....?t.__.._;?-.f-If............ dated_.-Z.5/_ /------------------•----•- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.-•••--••-••-•••._•.5� -.�,,1.O..1------------------------------------- Inspector---. THE COMMONWEALTH OF MASSACHUSETTS BOARYOF H TH .......................OF .............. ........ ..............................._.... No..1�r/--�.q�. !. .................................. FEE .................... M111rn k �uaan _;Permit �' _ �; Permission is reby granted <.................4-0 ' •- r'-_f 'L='--•--•. to Construct ) or pair ( an Individ "1 Sewage D', sal System at �To..._..- O_.. ... ............ •-------- ..... ......' ......--•--------•-•-------------•-••--•------------.. .. -- ..................... Street as shown on the application for Disposal Works Construction Permit Noll+' Dated_ ..____.:._y ............... � �. I— ell , Board of Health / DATE................................................................................ (/ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS T I v AW KII -4 04 e"ol(PI I:: 'k 114�11<�"� 4m "o V -l4 Q j 1, -v 7AIIOow 7' eA74WZ ovq /17 .................. 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