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HomeMy WebLinkAbout0818DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -53 BOX 9 I m Mid '�" IFellT4 MYRTIN I Q ,t m I fi r" �,k y '* 7 + .t`:_ it - - �'� 1 C. •' a PUTNAM COUNTY< D PARTMENT O HEALTH x` r ' j 1 Division "'bf Endironmenfal Health Services Carme/ N Y 1.0512 CONSTRUCTION PERMIT.,FOR•'SEWAGE :DISPOSAL SYSTEM;' (Z Qf. , 3 �i,,, .' >• r c� , .,.0 a t }"` • t F' ai n or:-, illage' �L "ocated.;at t-AS^r 2A ►1Ck -1 P+� A�. Block .e' Subdivision G '•— , ;: Lot'. S r? Job i) t� .. Owner 1�4Ai2=' G.\ Address i✓ Bwldmg ;TYPe � ... �hrtiC.'l'� L'ot Area �e3 : 04. 3 S r Number :of Bedrooms Total Habitable Space , S ©� Square Feet I Separate Sewerage System to consist of,' 0 Gal Septic Tank Z�lo lineal feet X' 3 width trench` "+ To be on by`3• - A2.C.0 Address �. a Water SU - I Public_Supply From 1 PPY rrvafe Supply to be drilled by Address CO0c o^ At_ 1�0 Other Requirements s C c1 ` tiS i Fvepresent that I am wholly and completely responsible for the design and location of the proposed• �system(s)';• 1) that the; separate. sewage disposal system above described7,wifi be constructed as shown on the, approved amentlment there to and in accordance with the standards,�rules an `regu a ions,o e u nam County Deparfrnent of :Health, ;antl that on completion thereof a 'Certificate of. Construction Compliance" satisfacfory-tb the Commissioner.of Healthwill %be submitted .to the' bepartmeht,;and a: written :guarantee will be' furnished the owner his 'successor; heirs or assigns by.6e builder; that said builder will plat's in good operating- condition any, part of said sewage disposal system during the period of two (2) years immediately,, following the date of the issu -; ante of the approval of_•the ,Certificate.of Constructrom ,Co- mpliance of the original system,or any repairs tFiereto; 2) :that the;drilled,well described above -, ` will bellocated as shown:on the approved plan and :that said well will be installed m ;accordance;•with: fhe standard , rules en ,r u a ons of ,r the., Putnam.,.. ; County Department of Health 3';s Y 'f4� 7�;\ •,.0 iL� s::r ` ° Cam, :t7"�` ',, � ` Date x ,._ i% j / �,e� /� Sinner! ai a P:E pit R A • Address License .,• ... .� �' •" N • APPROVED FOR'CONSTRUCTfON This'approJaltexpires. one year' from the date issued 'unless construct: n of the building has;been undertaken and is s r a; use or may be amended en co necessary by; the Commission Health Arty, change. or alteration o on revocable;for'ca per t prove for disposa domestic sanitar" d v ats• y oly requires a new OateTitle ` { i 0 ti. INI` TAL. SITE INSPECTION Prop;rty lines or corner. 3 found . Can estimate. house location . . . . . . . . Will driveway need cut . Must trees be removed -note these Is deep hole representative of entire SDS area .Additional deep holes needed. . . Sufficient SDS area available considering; driveway cut, house location. separation distances, etc. DEEP HOLE.D�TA Depth: Water elevation: Rock elevation: Soils description: _ Date: FIi-L SITE III ?SPECTION Insp, by House located where . shoi•1n on approved plan" SDS located where approved - Slope of vile line and" tr-HFI able'". jjj • Room allowed for. expansion trenches _ Over 50 ft . , from swat;w, watercourse . . . . . .Natural soil not stripped or SDS.area unnecessarily- graded - _ - 10 Ft.•maintained from prop -line and 2O -ft. from house . V/ Separation of trench from. house, -well etc. follows plan _ Number of bedrooms checks a Stones; brush, stumps, rubble, etc. greater than 15 ft. from nearest trench / 15 Ft. of peripheral soil horizontally from trench ..... Junction boxes properly set Could surface run off from driveway, roads, ground surface, etc. channel near SDS r area .... lYies lot dralnaa- anvewr 0.K: in area of SDS FII U .. GRADING OF SITE .ACCEPTABLE PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date '3� p -1 Re: Property of Located at T) Q AV� c �� . �o A b Section Block 1 Lot 1S, Z Gentlemen: 1I11 This letter is to authorize C-►Q�a�� A a duly licensed professional engineer or registered architect ( Indical-e-F- to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the Putnam County T1.•...... y d- 1 TT- a" 1 7. 1 - '• '� ^t LC7�/a,l U1C:lll, Vl nt'. t7,.L fill, and, o s.L l £ill neueasary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147;-Education Law, the Public Health Law, and the Putnam County Sani- tary Code. E s S I p Countersigned:oQ ©A Kc�� P. E. 5e,9- Z-4 q fmA Ad re s s as Carme a =t - nom`' (���'�+� >;.F- Very truly yours, Signed" Owner -o Proper y Address —Ted rye -c—. P a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0. �� Owner let cNA2Q IJUSc -L Address 59 jcy'Lo-­%z7 `�bvcv-e., Located at (Street FAs t�R.ati.c� ark. Sec. l Block 1 Lot OndiCate neares cross street) Municipality r�)(A Tz c' 5or-, Watershed po%j SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 g' SS 4 6 YL t��1 2 C av 1 o< l 3 t 3 ''z yz 3 4; 44' . 14 z 5 Notes: 1) Teets to be repeated at same deptn until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. DEPT G. L. 6" TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS -ENCOUNTERED IN. TEST. HOLES H HOLE NO. HOLE. NO. HOLE NO. 12" 18" 24" 301 36" 42" O� 48" 54 6o" 66" 7211 7811 84" . INDICATE LEVEL AT WHICH GROUND WATER _ .IS .ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED :'TESTS MADE BY 'j `� S C to , Date �b G c- ') 'L DESIGN ... Soil Rate Used .l �- (ate Min/1 "Drop: S. D. Usable Area Provided S6_ "- No. of Bedrooms Septic Tank Capacity %pe Absorption Area Prov del By 'Z L. F. x24" ' ?= A rent . C. f f�� So C ame <-, igna u ai �: Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date ol VAT r� A • � � 7M+`OppC�n2Y C+.�n �i �.' &FFf_p'. If (L�'C��p.•� t � y. HIGHWAY DENAtlmENT + 7.5 M!w 6267 rr SE - ( 0 tilt. TO L = ,g r' 7 ++ ^' lPAWLING) 21 32'30!' 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