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HomeMy WebLinkAbout319 Griffin Road (4) Town of South Windsor - Health Department /o 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address `\ 1530 Sullivan Ave., South Windsor, Cr 06074—Office Address Phone Number: (860) 337-6173, Fax Number: (860) 644-1930 APPLICATION FOR APPROVAL TO CONSTRUCT A SUBSURFACE SEWA(;E DISPOSAL SYSTEM Application/Permit#: To the Director of Health,Town o f:: )O L7P 6&J 1 U_Z>SC.4_Date: _ :3 Application is hereby made for an approval to construct a subsurface sewage disposal system for a: 3, Y-In* (Residential Building, Restaurant, Retail Building,etc.) located at: 3 I "I (Street Ad . Lot Number, Subdivision,Nam/e, Map, Block, Lot,etc.) New System Addition Repair Other Owner 64).V�L Address Tel.No. Instal lerjj ,!5 Address Tel.No. Installer License No. In accordance with detailed information stated below: _ Application fee paid A Siuned (Owner or duly adhorized representative) GENERAL INFORMATION Soil Tests Conducted(Date): �� (, / /� Lot size _tQst, 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): AJ If yes,Name of Engineer: Address of Engineer: Design Plan Approved(Y/N):4 _ Date of Approved Plan: 3/�f// Revision Date: Type of Water Supplj����(� If well, has location been approved(Y/N): Well Driller's Name: Address: OFFICE USE ONLY Approval to Construct issued by: �irector t ��L L �S _Date: 3 / th or Registered Sanitarian) Si=nature: / 't—�— Title: g - — lviw —�� w� \� 5&--CA-5 on Sy54•ern � LL T- Sly wit1 / Tf -- qo tl/ !S� I 3S RECE VED MAR 0 6 2017 O-�O� SOUTH WtNDSOR / HEALTH DEPT. S3G = S� - 3rr1PK 17 a-Ti wit OTr 1 ' `�� Town of South Windsor — Health Department = ` 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address ' ;.. 1530 Sullivan Ave., South Windsor, CT 06074— Office Address Phone Number: (8601 337-6173. Fax Number: (8601 644-1930 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): Jonathan Bonds STREET ADDRESS: 319 Griffin Road TOWN: South Windsor INSTALLER: James Throwe CT. LIC#33.03856 EXPIRES: 5131/17 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 PROPERTY LINES, 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*****: 1. Install per approved plan, (James Throwe, Dated: 03/06/2017). 2. Cleanout with cap to grade to be installed on building sewer at me. 3. Licensed Installer to field stake house, well (if applicable), permanent benchmark, and septic system. Offset stakes to include bottom of trench or flow line elevations. Health Dept. staff to conduct stake inspection prior to construction of system. 4. Permanent benchmark to be set within 50 feet horizontally and 12 feet vertically of septic system. 5. Install a 1,000 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. 6. Install 495 square feet of effective leaching area, consisting of one row 45 feet long of Mantis 536-8 units, bedded on the bottom and sides with sand fill meeting both the manufacturer's and select fill specifications. System to be installed per manufacturer's specifications. Systems with total cover that exceeds eighteen (18) inches as measured from the top of the units to finished grade shall be vented at the distal (far) end of the system. 7. Current Sieve analysis (within 30 days) for sand fill must be submitted to the South Windsor Health Department. 8. Max depth into original grade is not to exceed fifty two (52) inches. 9. 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. 10. Installer to complete and submit septic system as built plan and drawing with ties to the house. 11. Existing septic system to be properly abandoned. SIGNATURE:'' R �--e-e- (—v�' DATE ISSUED: 03107/17 RENEWAL:_I_I APPROVED 6 : Diane L. Collelo, RSIREHS EXPIRES: 03/07/18 EXPIRES:_I_I THIS PERMIT IS VALID FOR A PERIOD OF ONE YEAR FROM DATE OF ISSUE. IN ACCORDANCE WITH THE CT PUBLIC HEALTH CODE SECTION 19.13.6103e(F)(l). ONE RENEWAL IS POSSIBLE PROVIDED SOUTH WINDSOR 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 CASH CHECK NIA DATE PAID:03/0712017 Town of South Windsor — Health Department 1540 Sullivan Ave., South Windsor, CT 06074— Mailing Address 1530 Sullivan Ave., South Windsor, CT 06074— Office Address �oWp gE� Phone Number: (860) 337-6173, Fax Number: (860) 644-1930 DESIGN RECOMMENDATIONS FOR REPAIR OF SEWAGE DISPOSAL SYSTEM DATE: March 7, 2017 PROPERTY OWNER(S): Jonathan Bonds STREET ADDRESS: 319 Griffin Road, South Windsor RESIDENTIAL(#of Bedrooms): 3 SEPTIC TANK: Install 1,000 gallon two-compartment septic tank with approved outlet filter. LEACHING SYSTEM: 495 square feet of effective leaching area required. Minimum Leaching System Spread(MLSS) need not be addressed due to suitable soil conditions of receiving soils. SPECIFIC INSTRUCTIONS: 1. Permit application to be completed and permit fees to be paid in full at time of application submission. 2. Installer's construction plot plan (drawn to scale)to be submitted and approved by this office prior to issuance of permit to construct. 3. Plot plan must indicate location of proposed structure,water supply, septic system, embankments, watercourses, property lines, and existing and proposed finished grades. Benchmark to be set and indicated on plan. Note on plan that existing septic system is to be properly abandoned. Wells on adjacent properties must be located and verified to meet minimum separating distances with proposed septic system (in accordance with Table 1 of Connecticut Technical Standards for Subsurface Sewage Disposal Systems). If adjacent properties are served by public water it must be noted on plan. SIGNATU � `ti�� � DATE: �- i ---PR07GRESS FILE NAME: FILE-NUMBER, - NOTES ADDRESS: TOWN: DATE TIME ACTION INITIALS DATE TO D/�Tj � TIME AM ♦`"1� M P FROM PHONE! 1 O OF CELL ) 7-16 �DLn FAX( ) N E m �• , E - M s s E A M G O E E-MAILADDRESS SIGNED PHONE CBAACL RETURNED WANT S OUO❑ AGAIN❑ WAS IN ❑ URGENT❑ ©Bluelirw REDIFORM. 02012 TO TIME 3 � P FRO PHONE( ) CELL( ) O Og- FAX FAX( ) N E m E M S - it E A 2 M E O E-MAILADDRESS I SIGNED PHONE SCACK CAE�URNED❑ WANTS TOEJLL SEE YOU ❑ WILL ALL❑ WAS IN ❑ URGENT❑I AGAIN OBluarw REDIFORM. �201 z IJ142 MAR-22-2017 15:48 From:DESIATO SAND 8604295436 To:8602822684 P.1/1 T� MATERIALsTESTING, INC. r. N . 55 LAURA STREET• NEW HAVEN,CONNEC1'1C.U'1'06512 0 (203)468-5216 'qM1` 001i 42 ROSTON POST ROAD • WII1.,LIMAN` IC,CONNECTiCUT 06226• (860)423-1972 UATF 12-12=1 6 REPORT: CLIENT' Desiato Sand & Gravel 999 Stafford Road Storrs, CT 06268 PROJECT: Client's information SUBJECT: WASHED SIEVE ANA�YSI.S..(AS.T.M. Material: Concrete Sand i I Source: Desiato Sand and Gravel, Storrs, CT Sampled:' by client and delivered to MTI on 12/6/16 Sieve Size Percent Passing ASTM C-33 (9.5mm) 100 100 #4 (4.75mm) 99 95-100 #8 (2.36mm) . 81 80-100 #16 (1.18mm) 61 50-85 #30 (600pm) 39 25--60 #50 (300pm) 17 10-30 it 100 (150Nm) •4 2-10 #200:.(7..S.Nr.n)- - — -A.5 - -- _ 0-3.. , Fineness Modulus 2.99 2.3-3.1 This material as sampled and dolivered meets the listed specification. Materials Testing, Inc. Richard C. Kearns RECEIVED l F �oNh William J. Soucy,.1*4�1 Ppvl s CIS y � r tcc: Client SOUTH'WINDSOR - r HEALTH DEPT. o t".2 �to4' eaw �C fs TexnYxirG.mymltr.rrPrgM��!t11N1I1oiAVIBe11MeB90�SriaofMalaialzTrserq.trx:.kmi118olrYrelebbilerhlec�ed � ts/ `��� 111/111111111`,``