HomeMy WebLinkAboutSFR 1971 _ ...,
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TOWN OF MONTVILLE
Department of Public Works
Application for Building Permit
Application & Permit No. . . . . .7/!...../.,7. . . Date "line.e,,a+. . pl../;. . ./77/
Estimated Cost 40/47,..fee'-' Fee
Owner . . . . . ........... . .Cloff/Or u00. • Address .7. ./417 •00,11° -
Contractor or u'•-, r Address
.....--
Architect Address —
Location of Building 14•1/'lie / /44 04,7 e Zone No.
Additions & Alterations (including moving or demolition and sign erection)
New Building — Type of Construction
Size 4,6 X i# Type of Heat . . . . . /
No. of Stories "it 44f-4,-taigre.A Fireplace i
No. of Rooms s..r Breezeway .
No. of Baths /
Garage . . . . . .4- #l/CV!". . . .
Proposed Use .e..1`./
I hereby certify that the proposed construction will conform to the applicable zoning regulations of the
Town of Montville and the Basic Building Code f the State of Connecticut.
Signed . (::-,..-.,Z,la: ;e5. ...e4. -•.`,?(.4-:"k . Approved ...f ".*:f 4.1.7.7./. .. .. .. .. -
Date 5 glY-7/
Building Inspec t . .
Form No. BIMO 70-100-1
APPLICATION FOR PERMIT FOR CONSTRUCTION OF SEWAGE DISPOSAL SYSTEM
TO THE HEALTH OFFICER Application No.
TOWN OF MONTVILLE Date 4'e/L '! /
I hereby apply for permit to build a sewage disposal system for a
S,®1 Nc_ .
(Residence, boarding house, hotel, etc.)
Owned by err T" L CL r-t-IErr r- of_1_IHN rt1t-T( )NI AVE
_AL/!Z
And located at 1T LA E-
To be built by "Al N of SI mE
in accordance with detailed information stated below.
v � '
Signed �. . _. «t.t1
(Applicant)
GENERAL INFORMATION
1. Estimated population of premises (present) (future) 4'
2. Description of premises I o,X 'Zoo''a1 S RSM .s +16E.:\) p M
No. Fixtures
(above basement): Water closets I Urinals _" Lavatories ' Bath Tubs
Showers Kitchen Sinks / Laundry Tubs
List fixtures in basement V1IHER
3. Water supply A 1E 1 AN .E`-L Kind of well 51 Af\-)&;,'R 1 1--1._t.D�
(public, well or cistern, spring)
Location of well F 20 n LE r- r NT> i\ E 1
Method of obtaining or storing supply ` L4114P S fl TANK
(pumps, tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of various strata
LoA \ a 1)1 1 -
(sand, loam, clay, hardpan, etc.—use test pits)
5. Elevation of ground water 4 FE. 7
(with reference to both present and future grades)
S U 7L O
/'
•
( 2)
6. Description of proposed system (Furnish drawings of same, with plot plan showing system).
`Septic Tank 11
Dimensions_61 1.1 10-4, L.15)- ‘1,4 Capacity below flow line 12.5(D KA--
Facilities for cleaning 3 N4. C-crAiF - -Distance from water supply on same prop-
erty 101 FES , on adjoining property !'60 T EE'T
Distance from property lines 5o
--- _-- —__ Distance from dwellings on same
property FEET , on adjoining property 75- FiEk j
Automatic Dosing Apparatus, if any (describe)
•
** Soil Absorption System C-
If cesspool, size is _�._ _ ft. diameter and__,_L_-_ ft. depth below inlet.
If tile field or leaching trenches, total length is____ ft.
Width of trenches ft., depth of broken stone or screened gravel_- ft.
Stone or gravel will be covered by
-- -- ---- -------------------
(salt hay, tar paper, etc.)
Distance between trenches ft. Distance from water supply on same prop-
erty , on adjoining property
Distance from property lines _._ Distance from dwelling on same prop-
erty , on adjoining property_
Secondary Treatment, if other than soil absorption.
Describe in detail, and locate on map.
System was designed by -_
40.
Above information furnished by ' - - ,
* If privy or chemical toilet is proposed, submit information as to pit, fly proofing, chemical tanks, etc.
on separate sheet.
** No discharge of sewage or sewage effluent into any watercourse should be permitted without approval
of the state department of health and state water commission.
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