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HomeMy WebLinkAbout0726DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.13 -1 -13 093w; IL A'6. Ur {' 00726 Oivision of. Environmental', He4 CERTIFICATE:OF CONSTRUCTION. COMPLIANCE FOR 'SEV `%ocated at / ✓Gd+. - U" : %7� /,L..c `/AIJIIIY /C rJq /J. T"%Map . oI arocx, ifs Owner. Taxk '*p rot # 0� sutia. # �icfx Ie, � 9 m lit by RIIL• "•. Address Separate Sewers a Syste Con Isting . of D G Septic Tank and' ` ^ 1lZ� p Other. repuiraments Water Supply:. Public:Supply Frorn. - Private Su.pply'Drilled By Address' Building Type /. ` No. of Bedrooms Date Permit Issued Has Erosion Control, Been C_ ompletad? G ' �i citify that the syetgq,(s) as- listed serving the above premises were constructed essentially as shown on the plans of the completed work (,copies ' of which, are atta ed), and in aFcordanba with.the:standarda, rules and regulations, in accordance with'the filed plan, and the permit issued by the Putnam.Guntp Department Of Health. -0. �p _P.E Date Certified by R.A. Address �I e 5 GL.. N Y. License No.�S� Od 70 Any person occupy4ng promises ierved by the above system(s) •shall, promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting'•/rgm such usage. Approval of the separate:sewerage'systam shall become null and void as soon as. ,a public sanitary sewer becomes available and the approval of the,.:privafe water suppiy �shall'become null and• void'wheh 'a •public wa poly becomes available. Such. approvals are subject to modif)yatlon or change when, In the Judgment'of' the, ,Commifsioner of 'Health, such r ocatio modification or change is neees Date _S By . Title 1 CITY, VILLAGE, TOWN & /OR N•AME_OF SUPPLY DATE REPORTED SAMPLING POINT i_1 1t? BACTERIA P.ER ML::(ZT. plate "count at 350 Q. ." COLIFORM GROUP (Most probable No. /loom1.) MEE HARDNESS, TOTAL - ppm DETERGENTS - Mg NITRATES (as N) - Mg /L IRON, TOTAL - IIRg L AMMONIA, FREE (as. N W mg /L These results indicate that the water was t-:rz� of a satisfactory sanitary quality. when the. 4ffiple was collected. 11A9 Srfo,.A-bECk, Plot, 1 mac': 1.�5cTc, Cc:�rm�� �1'x:•rv`nt..Li4 IUS1Z. A. H. PADOVANI, M. T. (A CP) F4T AM M _IT CAP "OfAkT" 9. olviaipn of Ggvitlgnmentol Health 69rv0a COUNTY QFPICF PU1WINQ • 4AIIMII., New 'M'gIRK ghat! ma Ili tq 49 (x�mpletL l � tivgli �Irillar anc) e;udmittaq ita Coynty H @pith Department tggether With la bargarV fQR pf 610gjV0# 9 t1 s trlplwl indicgtinq water le of sptisfactory bacterial gLtality before kgftificate Df construetipn� i llitpii�ta I� I���A� REPOIRT MUST EF SUBMITTED WITHIN 30 DAYS OF WELL CORAPLETBON Mop MA Hal.Barrett APAPkSS Deacon Smith Hill Rd$ Holmes, NY' TLt2q . 041 11 ttetrtl grXn (At umoar 2 P l$!",Q E9�0 01,12 pIJSINE9Y .. � i EST�►iI�ISIfM�s�T PIIa1; L� J 1-�1 �u�@�y Il�pv�TRIAt I Aar OF W94 4� AIR OTHER CIOPIRITI�NIM(� � . t�v�lfr) �Qalll'I: $ COMPRESSED TA9T LXJ AIR PERCUSSIQN ((''''''''� CASLE OTHER i., i p9RCU. "ION © ropvcilT? c law EaT� EP�y�Ytf reG@U 20 pl( ER(lnch�tal 6 WR190F PEd Ft?4T 19 . ss 11 � T"AlIApkp) LJ tNupop TkS tj NO mkt} " tv Too IlQyp . 0.? 4041 DA►Igg 1...! PUMM 1.,.1 4QM.p#4qP FAIR TRIP (Q-P,047 W/! F4 P @QM Ito► t+4 'A E - S��tliG( !Ixtpat) Overflow: OU41NGI'(l��p TF,Sf �fe0U total. drawdown Wo pppth of Compigted Well In fast bglgw Lard evrfpfoe 200 MAIR! 4 , pIA(A! Toll aoanPs! .. le 6Rnvs� PACKEDi MV ROM &AMP 4FIQB�4 NOT to hal P>pei�lATIS?M DgSCRIPfIQPI .... p14mater of wall l�sittdina gravel pgck pncim): etch exact location of wgll wlth d /@tapes, to al 1"q( Pa permenQnt 14440044. 0 6 overburden $oyd Artesl -an ii PA CO., Qnc. . . 5 • Route 52 Carrriei, 'N. Y, 1-0512 6 200 lades 19 rl l Mxq� issAlod at 144 thA during 00111n R, liar hgipw Fool GALLONS PER MINUTE 6/13178 ftiill i T/�2 8 PQhF PRIL,L�� A/C WIZAV14V -5110-11014- 7 /-r//S A143 --B—AlckAl AS pe)e- "06 0 2 32 mc WeZ, 4. 77 67 4 r V" hL) <: 79 W,Ti" "NEY P. U , 6 PL I ING ENGINEER P .,i. f!e P., Am L La 'i IRA 44 ... . ...... . L CALE� .... 6 DR. CiA K,"b BY v1r ip- PiJTNAM COUNTY: rDEPARTMENT OF HEALTH , ' Division of• Enwronmenta/ H&Ith Services Carmel N Y' 10512 `. ! CONSTRUCTION. PERMIT F,OR .SEWAGE, DISPOSAL, SYSTEM ^`' f,.... :r "TOwn,orWillage Located at Tax Nlap Block Subdivision Lot Job - . "`oWn e Address x ildin9' Type Lot Area j Number of Bedrooms `Design Flo �� /�� Total Habitable space O0 5 uare Feet T7 N Separate ,Sewerage•'System o co sist of �o. Gal Septic Tank, and ��' 1 ...w . , To <be constructed` Dy,'' Address `.Water Supply Public Supply From . _ • • Private Supply.�to be drilled by Address .. l t.) i • -tOther .Requirements ('represent that 1 an wholly and completely `responsible for the design and location of the' _, proposed system(e); 1) " that, ' the ;separate sewage disposal•. system atiove.de ;cubed will be constructed as shown on the;a'pprovedamendment there to arid' in accordance with thestandarde,yrules an regu a ions o e u nam I County_ :.Department' •of' "Health; 'and that on completiomtliereof a 'Certific5te of•;Construction Compliance" satisfactory to the'Commissiorier of Healthwill be submitted: to'the -, Department; aril a, ritteq guarantee will be •furriished'the own& his successors, heirs or assigns by the builder, that said builderiwlll place in ,good •operating, condition any. part of 'said sewage disposal syitemAduring the period oitwo (2) :years immediately following -the date, of the issu- ance of ,the approval of the Certificate of Construction Compliance of the original system or any;repairs; thereto 2)`that the tlrilled well described above i :.: will be`located'as shown on.ihe approved;plan and that said well wilt be' installed` in accordance with the'stand'a s .[ules a n d ,regulationsT ' of. 'the ' Putnam County Department of Health Date Signed - P•E � R A Address tense No. b -.• . : ,APPROVED FOR ,CONS,TRUCTION This approval expires one year 'from the date issued unless const �'n, of th .b ding has been undertaken and `is ,•revocable -for, ca'use.o may De amended ormodified when corisider s byith Commidsioner 'f_ 8alth: Any change -or alteration of onstruction ' ".: requires a' new per it pr ved'for dis o of` domestic san ar ri t ',',ovate .Date "P El r r Y d/ v ge a o � Tale } y clrrY;t; 7) r INITTA..L SI`1'r Iri 3PPECTION ,Property .lines. or corn-r3 found. . Can estimate, hou Se loca.tion.. , Will driveway need cut . Must tre;eU be removed-note these .. . Is deep hole representative of entire SD 3 area Additional deep holes needed. . . Sufficient SDS area available considerinc driveway cut, house location, separation , distances,, etc. . . . . . . . DEEP HOLE DATA.- Dop1;h : Water elevation: Rock elevation: Soils descri.z)tion : I °4,.uate : FINAL SITU INTS] EEC T T 1 0 DI Insp. by: House located where shot.,n on approved plan SDS located where approved . •ZengLh of trench measured Width of trench average Slope of the line-and trench acceptable . Room allowed for expansion trenches . .., , Over 50 :ft. from swamp, watercour. se . . Natural soil not stripped or SDS area tuujecessarily graded . . . . . 10 FU-. maintained from prop.line and 20 ft from house ; Separation of trench froi;i house, well etc. follows plan . . . . . . . . . . . . . . - Nwnber of bedrooms checks . . . . . . . . . . Stone-., brush, . stw,lps, rubble, etc greater than 15 ft. from nearest trench 15 I't. of peripheral soil horizontally from trench . . . . . . . . . . . . . . . Junction boxes properly set CoW.d surface run off from drivowa.y, roads, ground surface, etc. channel near SDS , area . . . . . . . . . . . . . Doe," lot drainar*_e ann�n.,r O.K. -in a.rpa. of Sp4 FINAL ' GPADING OI'' SITE ACCEPTABIX Date :_ ---� . Insp.by: r I No � C`t�►mm�ni-.� 1 PU`I'NAM COUNTY DEPART sI 'r OF IUALTH DIVISION. OF FNVIRON AT;i`ITAT, IIL,ALTH SERVICE'S COUNTY OFFICE PUTLDING, CARMU.,, N. Y: 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM. FILE NO. Owner Address Located at (Street . r Sec. Block Lot o`�c (Indicate nearer- cross street) Municipality. Watershed SOIL 'PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse DeptF . o •;a e-r water Level No.'. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches icy-, c /v 2� /0 -�, /a 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole.. All data to be submitted for review. 2) D,;pth moasurements to be made from top of hole. TEST PIT DATA REQUIEM, TO DE SMINITTIM W1011 APPLICATION } DESCRIPTION OF SOILS .i ;i'1COUVJ'.N -,ED ' IN' Tl?`��i' 1i0>�;S DEPTH HOLE . NO. � HOLE NO. HOLE NO. G.L. 30 it ;., 36�� 42" 5'* off 72�� 84" INDICATE LEVEL AT WHICH GRQUND WATER ZS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED' TESTS MADE BY A 1C. Date Soil Pate'' �. D Used�Min/l "Drop; S.D. Usable Area Provide60`0O0 No.. 'of Bedrooms Septic Tank Caps,city L06 Gal s. Type i�%iQiOrlr?' Absorption Area Prov ded ByQ�L.F.x24" X width,trenc Other At ame gna ure Qq'� Ct54'q %I Address SEAIa Alezov THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate k i� A do Pg 043�g�'. `.Approved Sq. R /Cal . 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