HomeMy WebLinkAboutP to D 578 Ellington Road 7_0u� 011le S_0� ?d&U&ot
1540 SULLIVAN AVENUE a SOUTH WINDSOR, CT 06074
TELEPHONE (860) 644-2511
October 3, 2016
Marcelo Campos
578 Ellington Road
South Windsor, CT 06074
Re: Future In-Law Apartment at 578 Ellington Road, South Windsor, CT
Dear Mr. Campos,
On September 27, 2016, 1 performed a final inspection for a septic tank replacement at
your property listed above. During that inspection, it came to my attention that a sewer
line had been brought up from the new septic tank to the existing garage to allow for a
future in-law apartment to be built. This was not on the plan that had been approved
prior to issuing a permit to construct. Approved pipe was used and it was installed at a
pitch greater than 0.25 inch per foot.
In order for building permits to be signed off on by this department for the construction
of the in-law apartment,you must complete a B 100a application for the change in use on
your property and submit the information required to apply for a Central Sewage System
Exemption. At that time,you must attest in writing that you will connect to the public
sewer in the event of a septic system failure, as it will be required by the South Windsor
Water Pollution Control Authority.
Thank you in advance for your attention to this matter. Please call at any time with
questions as they may arise, (860) 644-2511 x250.
Sincerely,
D 0-0
Heather Oatis, REHS
Environmental Health Officer SCANNED
Enclosed: Central Sewage System Exemption Application
Permit to Discharge for Tank Replacement
CC: Christopher Dougan, South Windsor Chief Building Official
C. Fred Shaw, South Windsor Superintendent of Pollution Control
Michele Lipe, South Windsor Director of Planning
6"'
Town of South Windsor - Health Department
1540 Sullivan Avenue, South Windsor, CT 06074
Phone: 860-644-2511 ext. 250 Fax: 860-644-7280
°sot C0
PERMIT TO DISCHARGE
Approval is hereby given to MaACAj �,�WI Vo S _. in accordance with Public
(Property Owner)
Health Code Section 19-13-B 103e(h)to discharge to a subsurface sewage disposal system located at
Y ' E1\infi4-oy' d
(Street Address)
in the town of S. k/J k �SU f . CT that will receive domestic sewage from a:
Residential building containing bedrooms. Single family(Y/N):—Y—.
Restaurant containing seats.
Commercial/Office building providing square feet.
Other structure as described:
Design Flow=_ llons per day. Permitted Flow=_ gallons per day.
The design flow shall equal the p itted flow,except for non-compliant repairs(See Section IV D).
In order to provide a sufficient factor of sa it is recommended that the average daily discharge not
exceed 2/3 of the permitted flow or gallons per day.
Operation and Maintenance: Septic tank shall be inspected regularly and pumped as needed but not
less frequently than every five years. The septic tank has an effluent filter(Y/N) 7�f . Effluent filters
require periodic cleaning. Failure to clean filters can result in sewage backup into the building or effluent
breakout. Restaurants serviced by external grease interceptor tank(s)require quarterly inspections and
cleaning as necessary. Tank pump-outs tracked by local health department (Y/N) A/ If yes,
stipulate pump-out requirements:
Special Requirements and Restrictions: 1. In the future, if there is a septic system malfunction or
failure. it must be addressed.
Exceptions (Repairs Only):
File Information: Construction Permit No. Approved as-built on file(Y/N)
ti �.
Date of Final Inspection: l 12--1 \�� Inspected By: �- O'' r o"-E 1' , a(ky
Permit Issuance: Issued by: a A r Q A lr�;. �.E!~�f Title: 0Q cB✓
(Director of Health or Registered Sanitarian)
Signature: . Date: 1 U� -� h b
0
Town of South Windsor — Health Department
1540 Sullivan Avenue, South Windsor, CT 06074
Phone: 860-644-2511 ext. 250 Fax: 860-644-7280
SEPTIC SYSTEM AS-BUILT PLAN
I)ate 9 02 9 /6 Permit Number
Street Address
New Septic System Repair of Septic System Alteration of System
Number of Bedrooms_ y OR Design Flow of Building
Type of System / /
Installed A151fe?4 ,p, c
(e.g.. one freliches. infiltrators,galleries etc.)
Square Footage of System: Total Length !� Width
Effective Leaching y
Capacity of Tank I5-6O Tank: New /C Existing_
Length of House Sewer Pipe_ 3 i I
i
Minimum Distance Between Septic Tank &Foundation
Minimum Distance Between Leaching Field & Foundation r
Minimum Distance Between Sewage System & Nearest Well `J
Public Water Supply
Minimum Distance Between Leaching System and Property Boundary I
Curtain Drain Required? Aa
Minimum Distance From Leaching System to drains a,5
(curtain,foundation,storm water,etc.)
RECEIVED
SEP 2 8 2016
SOUTH WINDSOR
HEALTH DEPT.
***DRAFT DRAWING ON REVERSE SIDE OF FORM
SEPTIC SYSTEM AS-BUILT PLAN (continued)
Address ��� //•�ti , fs 5�,�� �/i��s� Date
Location of System side of house
(N.S.L W.,Front,Back)
Draft a substantially correct drawing showing separation distances of septic system insallation.
Include all of the following information to provide an accurate record of the entire system
location:
At least two sides of the building nearest the system,septic tank, house sewer,
distribution boxes,trench ends, dry wells, curtain drain,potable water supply wells,and any
other features affecting the system and its location.
Installer's Name__5��r s L✓�.5 � S rt,,LgS License# C�
Installer's Address � � �C,u //,17 q fen
t t,6ty,state,zip code O
Installer's Email M7 } .,,;<.,�� La
�m 1530 5—
y
Tcan� �S
ae.e q
3 e
R�Se�S 3 1576( U
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LL �
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J 3-box
Point #1 #2 #3 #4 #5 #G #7 #8
Distance from corner"A"
3S' 3 7' V' 3 '
Distance from corner•B"
Dbtance rrmn corner"0'
Distance from corner"D"
�6'
�► �� - Town of South Windsor — Health Department
1540 Sullivan Avenue, South Windsor, CT 06074
Phone: 860-644-2511 ext. 248 Fax: 860-644-7280
Subsurface Sewage Disposal System Final Inspection Report
Property Owner: AA ( d6 (em W 0t) s Appl/Permit#
I
Property Address: ( 11 I r)' Town: 51 L6214O t/
Licensed Installer: ( � Q� n�,Pt/ License Z
Approved Plan Information
Check one: New System Repair/Replacement System ❑✓ "4�'�L
Residential Building: bedrooms Large Tub: YES nNO Garbage Disposal: YES O
Non residential Buildin sidential Institution: GP
Plan Prepared by: Title:
Plan Approved by: Date:
Approval to Construct
Date Permit Issued: 1 I `� Permit Issued hv: G
Registered Sanitarian or Director of Health
InspectioU Information
Licensed Installer
Type Date Present? Yes/No Comments
Field Stake Inspection(house,
well,property lines,system etc)
Strip/Scarification
Sieve required(Yes/No)
Select Fill Placement
Other: ie
(� QALtQ Udd-94 {-o^ ;
Final Inspection I I2 zo
Was 24 Hour(min)Installer Notice Given(Y/N) : V Date Final Inspection Requested: Z Z
r Date of As-Built
Final Inspection Completed by: Approval:
Permit to Discharge Issued by: Date:
(Registered Sanitarian or Director of Health)
Subsurface Sewage Disposal System Final Inspection Report
House Sewer Information
Pipe Type and ASTM Specification: Q�, . V Pipe Size: in.
Pipe Invert Elevations at: Pipe Length: �)3 ft.
Foundation Wall: 3 Pitch Required: F• 2 S
Septic Tank: Pitch Provided:
Tank Information
Septic Tank Size : Gallons Tank Inlet Elevation: Z�
Tank Manufacturer: 1�/ (���CG, l Tank Outlet Elevation: •y
Date Manufactured: Riser Needed(Y/N): k1d i ,,--*`( 6 u&asd
Outlet Filter l')pe/Manufacturer: ��,� t F y
Pump Chamber
Size: Gallons Pump Alarm Checked(Y/N):
Pump Chamber
Manufacturer: Float Control Elevation Verified(Y
Grease Interceptor Grease Interceptor Tank-
Tank Size: Gallons Manufacturer:
Leaching System Information
Approved Aggregate: Free\siltand debris(Y/N): Sieve Required( 'N):
Filter Fabric Present(Y/Nype:_ Aggregate Meets PHC Specificat\Fil
(Y/N):
Select Fill(Y/N): Meets 11HC Specifications(Y/N): Sieve Information on Y/N):
Leaching System Description(product,size,length,number of rows,level or serial etc.):
ri
r T`k
Effective Leaching Area Required: sq. ft. Reserve Area Provided(NVY/N),,:Effective Leaching Area Provided: sq. ft. Center to Center Spacing: ft.
System Installed Per Approved Plan Elevations(Y/N):L Elevations Field Verified(Y/N): vl
Elevation notes:
u Gv\ 9UZ /-L MU
n k n T
Separatiofi Di tances
Separation Distances Conform with Approved Plan(Y/N):
Separation Distances Field Verified(Y/N): V
Town of South Windsor — Health Department
1540 Sullivan Avenue, South Windsor, CT 06074-2786
5.0 Phone: 860-644-2511 ext. 248 Fax: 860-644-7280
APPROVAL TO CONSTRUCT OR REPAIR SEWAGE DISPOSAL SYSTEM
Approval is hereby granted for the construction/repair of a subsurface sewage disposal system
at the property described below:
PROPERTY OWNER(S): Marcelo Campos
STREET ADDRESS: 578 Ellington Road TOWN: South Windsor
INSTALLER: Jonathan Skipper CT. LIC#3425 EXPIRES: 7/31/17
RESIDENTIAL: #of Bedrooms- 3
INSTRUCTIONS FOR INSTALLER
1. Construction plot plan submitted and approved by this office must be adhered to.
2. This office must be contacted for approval if any change is going to be made in the system
location,size or design,or any changes in house,well or property line locations.
3. Any NEW sewage disposal system must conform to ALL requirements of Section 19-13-BI03 of the CT
Public Health Code.
4. ALL new construction to be under DIRECT supervision of a CT licensed installer under Section
20-341 of the CT General Statutes.
5. The installer is RESPONSIBLE for VERIFYING LOCATIONS of PROPERTYLINES, WELLS,
and BURIED UTILITYLINES prior to construction.
6. Installer to notify South Windsor Health Dept.24 hours prior to the start of construction.
7. Installer to have septic tank covers removed at the time of inspection.
SPECIFIC INSTRUCTIONS:
SEPTIC TANK AND SEWER LINE REPLACEMENT ONLY
1. Install per approved plan, (Jonathan Skipper, Dated: 9/16/16).
2. Install a 1,500 gallon two-compartment septic tank, with an approved outlet filter. Risers are to be installed if there
is to be more than 12"cover over septic tank cleanouts.
3. Replace existing sewer line with schedule 40 piping. Sewer line pitch to be at least''Y4 inch per foot,
4. Installer to schedule, and be present for final inspection with Health Dept. staff. Level to be set up for verification of
elevations OR an engineer's/surveyor's as built will be required.
5. Installer to complete and submit septic system as built plan and drawing with ties to the house.
6. Existing septic tank to be properly abandoned.
SIGNATURE: 00j� DATE ISSUED: 09/22/2016 RENEWAL: _I_I
APPROVED BY: Heather Oatis, REHSIRS EXPIRES: 09/22/2017 EXPIRES: 1 1
THIS PERMIT IS VALID FOR A PERIOD OF ONE YEAR FROM DATE OF ISSUE. IN ACCORDANCE WITH THE CT PUBLIC HEALTH CODE
SECTION 19-13-BI03e(F)(1). ONE RENEWAL IS POSSIBLE PROVIDED SOUTH WINDOR HEALTH DEPARTMENT IS NOTIFIED PRIOR TO
THE EXPIRATION DATE NOTED ABOVE. IF PERMIT EXPIRES, INSTALLERS ARE CHANGED, OR ANY OTHER DEVIATION FROM THE
ORIGINAL PERMIT,A NEW APPLICATION MUST BE COMPLETED AND ALL APPLICABLE FEES MUST BE PAID.
FEE PAID: 10.00 CHECK# Z 9 i-� DATE PAID: 09/1912016
vK
Town of South Windsor — Health Department
QI `y
o= y = n 1540 Sullivan Avenue, South Windsor, CT 06074
Phone: 860-644-2511 ext. 250 Fax: 860-644-7280
APPLICATION FOR APPROVAL TO CONSTRUCT A SUBSURFACE SEWAGE DISPOSAL SYSTEM
Application/Permit#:
To the Director of Health,Town of: "'�' ..',�c� of Date: Q 2-0 - (O
Application is hereby made for an approval to construct a subsurface sewage disposal system for a:
(Residential Building.Restaurant,Retail Building,etc.)
located;it: 7� ,` � � C >, .-1-\-\
(Street Address,Lot Number,Subdivision Name,Map,,Block,Lot,etc.)
New System Addition Repair , ��t �."`�4)ther
Owner !'�Cu r'P 10 Cal- gO.S Address S 7 H ��l•L7 �l� Tel.No. Jc " 9�"�7G�
Installer Si"'�':�, G� 5+0"1'444- Address .7-1 Covr pnelS.L/' Cl I�7tTeI.No.,G"f 57/ -U/6
v—
Installer License No. 3, Z 5-
In accordance with detailed information stated below:
Application fee paid .� to Signed
ner or duty authorized representative)
GENERAL INFORMATION
Soil Tests Conducted(Date): Lot size sq.ft.
Area of Special Concern(Y/N): If yes, Reason(s):
Basis of Design(#of Bedrooms,Restaurant Seats,Building Size,etc.):
Engineered Plan Required(Y/N): If yes,Name of Engineer:
Address of I :,-inc.r:
Design Plan Approved(Y/N): Date of Approved Plan: Revision Date:
Type of Water tiupply �v-(�A well,has location been approved(Y/N): _
Well Driller's Name: Address:
OFFICE USE ONLY
Approval to Construct issued by: t'ri Gt Z U A:b f Date: C1 I Z Z
( irertor of Health or Registered Sanitarian)
Signature: Title: C by • ri"J(� 0 �✓
Septic Repair For: Marcelo Campos 578 Ellington Rd. South Windsor 860-877-6761 9-16-16
Design Criteria: 4 bedroom, no garbage disposal, no high volume tub, no water treatment discharge, well
>75', leaking and undersized concrete tank existing, leaching fields are pipe and stone which are currently dry,
no evidence of prior high levels in the deteriorated distribution box
Proposed: Pump and properly abandon the existing septic tank, install a 1500 gallon IM-1530 with an effluent
filter and risers as required, connect the inlet of the septic tank to the cast iron house sewer with SCH40 PVC
and a clampall as required, connect the outlet of the septic tank to the existing leaching fields with SDR35 and
a Tuff-Tite distribution box, maintain 75'from wells, 5' from known drains, and 10' fTn) property lines
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Designed By: Jonathan Skipper Skips Wastewater Services 21 Courtney Drive Ellington CT License: 3425
Print Lookup Details Page 1 of 1
State of Connecticut
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Name
Name
JONATHAN L SKIPPER
License Information
lookup
Licensure
Actions or
License License Expiration Granted License License Pending
Type Number Date Date Name Status Charges
Sub- 3425 07/31/2017 07/17/1987 JONATHAN ACTIVE None
Surface L. SKIPPER
Sewage
Installer
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