HomeMy WebLinkAbout2013-9-17 - 17 Greenwood Drive - B100a ApplicationTown of South Windsor —Health Department £2?CQV1540SullivanAvenue,South Windsor,CT 06074
Phone:860-644-2511 ext.248 Fax:860-644-7280 «Yfp $0
May 2011
B100a APPLICATION So 20/3
(for building conversion,change of use,building addition,accessory structure and lot line cha H W/
lication review time is 5-10 da s,if soil testin is needed,additional time will be re uired to com lete the pT.
Street Address of Proposed Activity/Structure
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Owner Name «J Mailing Address Telephone
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Applicant Name (if different than owner)Mailing Address Telephone
Describe the proposed structure or activity with dimensions:
C?0 W a?pi»i2”e A I
Residential Number of existing bedrooms A/
Non-residential Please describe
Property served by on-site well?Y ®If No,List name of water company
Property served by septic system?®N Age of system 4/3/Date last pumped Kwv p Q 0 )9,
Plot plan —attach a scaled drawing showing property lines and dimensions,location and size of exiSting and proposed
structures,and site features such as driveways,wells and septic systems,drains and water courses.
Building plan —attach a sketch/floor plan of the proposed structure,addition or renovation showing existing and
proposed rooms with door and window locations.
Soil test data (deep test pits and percolation test)are required for the review ofthis application.
If the data is NOT available,you will need to schedule an appointment with the health department for soil testing.
As property owner or duly authorized representative of the property owner of the above referenced property,I agree to allow the
health department staff to enter the above referenced property as part of this B100a application review process.I further agree that
this authorization to enter the subj ect property may extend through a period of time ending with the final B100a application
approval and affirm such with my signature below.
Applicant Signature:
NEW/av
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FOR OFFICE USE ONLY:
Approved:®N By:wkgw
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Date:Cl [I 7 [I ‘3
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Comments/Conditions:pvxlDV Ln Se wt f [At/(k a \aaloLk "''34“;Lvl‘lveeb‘dt “W
Notes:
1FOR OFFICE USE ONLY;
Application complete:
Fom1:
Plot Plan:
Building Plan:
Information Needed Y N Notined Applicant
Soil Data Available
Test Pits
Perc Test
Need Soil Data Y N Notified Applicant Scheduled
Activity
Building Conversion
Change in use _Addition wAncrease
of tlow
Addition w/no increase
of flow
Code complying area found Y NWillproposedchangeresultinexpandingsystem?Y N
Addition w/no increase
of tiow OR potential repair area found that meets the following conditions:1.Replacement area provides 50%of effective leaching area Y N2.Replacement area provides 50%of MLSS requirement Y N3.No exception(s)to well separation distance is required Y N4.The addition does not reduce the potential repair area Y N5.The addition does not increase the design flow of the building Y NAccessorystructureCodecomplyingarea?Y NPotentialrepairareaidentified?Y NLotsizereduction\
Lot line change Code complying area?Y N
General Information Will this activity negatively impact existing sewage disposal system?Y NWillthisactivitynegativelyimpactexistingwell(s)and/or drains?Y NAreseparatingdistancesokay?Y N
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1540 SULLIVAN AVENUE o SOUTH WINDSOR,CT 06074
TELEPHONE (860)644-2511
September 1 7,201 3
Mr.Edward Kiessling
17 Greenwood Drive
South Windsor,CT 06074
Dear Mr.Kiessling:
On September 17,2013,this department received a 3100a application for the proposed additionofa2Ox16footporchtoyourexistinghome.
Upon review of the information provided on your application,the proposal has been approved withthefollowingconditions:
v A minimum of 5 feet is to be maintained between the porch and the septic system.
o ln the future,if your existing septic system fails,you will be required to connect to thePublicSewerSystem.
Be advised,that you must obtain all appropriate approvals from other town departments prior tocommencingworkonthisproject.
Should you have any questions,please do not hesitate to contact me at 860-644-251 1,extension248.
Sincerely,
J
Sherry Gann,BS,REHS,HHS
Environmental Health Officer