HomeMy WebLinkAboutSeptic New 383 Deming Street dlee
Town of South Windsor — Health Department
1540 Sullivan Avenue South Windsor CT 06074
Phone: 860-644-2511 ext. 248 Fax: 860-644-7280
o -
PERMIT TO DISCHARGE
Approval is hereby given to VGA C. 1A.14 Co 4A on, LL(- ,in accordance with Public
(Property Owner).
Health Code Section 19-13-B103e(h)to discharge to a subsurface sewage disposal system located at
(S ree�ress)
in the town of S uj;►'\Ido e ,CT that will receive domestic sewage from a:
Residential building containing L� bedrooms. Single family(Y/N):__L.
Restaurant containing seats.
Commercial/Office building providing square feet.
Other structure as described:
Design Flow= (e 8() .-_gallons per day. Permitted Flow= U U gallons per day.
The design flow shall equal the permitted flow,except for non-compliant repairs(See Section IV D).
In order to provide a sufficient factor of safety it is recommended that the average daily discharge not
exceed 2/3 of the permitted flow or N 0 V 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) 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) If yes,
stipulate pump-out requirements:
Special Requirements and Restrictions: 1.In the future if there is a septic s stem malfunction or
failure,it must be addressed.
Exceptions(Repairs Only):
File Information: Construction Permit No. Approved as-built on file(Y/N)
Date of Final Inspection: Inspected By: � "S
Permit Issuance: Issued by: V1/ V S S Title: V. Q ln UV1
(Director of Health or Registered Sanitarian) fVU
Signature. Date: >t u l( (,
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Town of South Windsor — Health Department
1540 Sullivan Avenue, South Windsor, CT 06074-2786
�`•NasOlt.���� 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): Jacques Construction
STREET ADDRESS: 383 Deming St. TOWN: South Windsor
INSTALLER: John Jacques CT.LIC# 005562 EXPIRES: 04130/16
RESIDENTIAL: #of Bedrooms-4
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:
1. Install per approved plan, (Isherwood Civil Engineering, Dated: 5/15/15).
2, 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.
3. Permanent benchmark to be set within 50 feet horizontally and 12 feet vertically of septic system,
4. Install a 1,250 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.
5. Install 1050.4 square feet of effective leaching area, consisting of two rows 40 foot and 48 foot sections of concrete
galleries,with 1 foot of stone on each end. System to be installed per manufacturer's specifications.
6. Current Sieve analysis (within 30 days) for sand fill must be submitted to the South Windsor Health Department, if
applicable,
7. Max depth into original grade is not to exceed twelve (12) inches.
8. 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'slsurveyor's as built will be required.
9. Installer to complete and submit septic system as built plan and drawing with ties to the house.
10. Field confirmation of test pits to be conducted.
SIGNATURE: ���c ; DATE ISSUED: 717115 RENEWAL:! 1
ennnnn n� QCfZ[iG J. Wart� EI�iRErt7: 7++i16 EXPIRES _�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 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:20.00 DATE PAID:711115
SITE COMPLIANCE CHECKLIST
TOWN OF SOUTH WINDSOR,CONNECTICUT
***** BUILDING PERMIT ****
ADDRESS 3193 De-►n►2f _- LOT/UNIT# Reviewed by -5.�k (Engineering)
CONTACT/DEVJe,[ �u�QS C n S�-Iru CAI�s r�
-- Date Reviewed a �,� Approved/Denied
Reviewed by �(Planning)
Date Submitted LP 1211 '�7 Date Reviewed —� Denied.
Reviewed by_-0—(Health Dept)
Date Reviewed WZli Approved/Denied
In accordance with the Zoning and/or Subdivision Regulations, prior to the building of any structure on a lot,a Topographic
Plot Plan shall be submitted for approval. The minimum requirements shall include:
Approved Denied N/A
1. name,address&phone number of
owner/applicant
`✓ 2. Name,address&phone number of plan
preparer
3. Zoning information—I.e,zone,open space,
floodway,street address
20
4. Plot Plan at 1"= scale
a. Subdivision reference,abutting properties,,etc.
b. Easements of record
C. Lot description,bearings,building lines,
distances,area,etc.
d. Contours,existing&proposed, 1 Cr 2ft.interval
where appropriate
e. Building location with dimensions. Elevations of
proposed finish floor,garage floor¢eriine
of road at driveway
Elevations of gravity drainage systems,sanitary
&foundation drain at the house and the street
g. Tentative utility location(gas,water,electric,
se tic stem,etc.
h. Title block with name&address of preparer,
date,appropriate certification,live seal&live
signature consistent with the Board of.
Registration requirements.(P.E.&L.S.)
--. edmentation-and-emsioa-control
con
6. Special Planning&Zoning,Inland/Wetlands
considerations(Plans on file w/Town Gerk)
COMMENTS: I P ' Mo. r
6 ,A t L
"'I v+ i
s/engineering/molloy/bullding compliance checklist
d
Town of South Windsor - Health Department
z. 1540 Sullivan Avenue, South Windsor, CT 06074
Phone: 860-644-2511 ext. 248 Fax: 860-644-7280
CHECK LIST
REVIEW OF PLAN OF SEWAGE DISPOSAL SYSTEM
Owner Location 133 — YYt t 13�) a_Date Received 61 Z 1
Plan prepared by ✓wUJ Y'A✓'RYl Title r
Address c.JG66t4 LJ by
Installer License#
Investigated by Date
Benchmark Location \IaAA Elevation
Design Percolation Rate Mins/inch at hole(s) 0 'Z0 V..1w/el
If residential, number of bedrooms If non-residential,estimated daily flow
HOUSE SEWER(INVERT LEVELS) C-4-VV P Ve�
Depth at foundation wall V-\ Depth at septic tank. ` LA O '7• 2 in LI t
SEPTIC TANK
Cleanout located ft.from and ft.from
aIs—Depth-to-Gleaneu
Reviewed/inspected by Yr •U Title U. Jr .
PLAN/INSTALLATION APPROVED ei DATE
LEACHING SYSTEM
Description SOW S �I" CUVAC. GimttPA,i40 "J� 'H C1 LQ ' Ef C-KVV�.o
t ' S a,-uwQ. a e.A tK0 e.r,a
Effective area sq.ft. Required effective area q O sq.ft.
Spacing between units ft. 100%reserve area provided
Bottom of leaching system 18 inches above maximum water table ✓
Bottom of leaching system 4 feet above ledge rock ✓ _
Bottom of leaching system 1 A inches below final grade
Pumping required N�!� Curtain drain required
Serial distribution Level system —^
If served by well,future backwash disposal location for potential water treatment
SEPARATING DISTANCES
Well located N I A ft.from and ft.from
Distance sewage system to well on property !"1 N ft. To water surface ft.
To well on adjacent property ft. To property line
To house served ft. To dwelling adjacent property ft.
To nearest watercourse N A- ft. To nearest ground or surface water drain ft.
NOTES
Reviewed/inspected by Title
PLAN/INSTALLATION APPROVED DATE
TO*O of Sou h Wndsor:, Health Department
40.:Suliwan Avenue,South Win 'or: CT. 06074
Phli e4,: 866 4$1`I ext.?48 Fax: 860.-64�-7�8�
APPLICATI N FOR RO TO CONSTRUCT UBS ACE SEW GE DISPO Af:SYSTEM
App #;
Difecto
:To the of H
r ealf,Town of: 426 J�X�- tz Date:
Application is:hereby mecie fbr.an approv -to,construct a subsurface sewage disposal system for a
(Residential Build ing,Restaurant,Retail Building,etc)'.'
Iocatgd
(Stre6fA4dr67s,Lot Number,gubdivikon ATahte;'Map,Block,Lot,
New System Addition Repair Other
M
7 .
Owner Uss gr (.'Iryf�• aTe1:No:
Installer,�cs � •- � .. -
�t;. S Address �.Jae � Tel.l+No.10��( g �•
)itstaller Incense Igo. .. .
b accordance with detailed information stated below:
Application fee paid Signed.
(O du `rorizedrepresentative)
-
E1VE .L INFO TIO q
Soil Tests Conducted(Date): t .. .. Lot size t'•� 3 �.U l sq1-
Area ofSpeoial Concern(Y/N}: Ifyes,Reaso (s):
Basis of Design(#of Bedrooms;Restaurant Seats,Building Size,etc.):'.
sred Plan aired
$..nee. :. ... . . If yes,Name:of Engineer: 61�1 W(J �!ti`. fig
y�
tt
1
Address:bf Engineer. t CW ��. • ' AM:
-Design PIan.Approved' _Date of Approved Plan: �� i . Revision'Date:
Type o€Water Supply: ,01�1:. If well;has location been approved(Ymr):
Well Driller Name: Address:
OFFICE.USE ONLY
Approval to Construct issued by: Date
(Director of Health or
Signature: