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Home My WebLink About1483DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -3 -21 BOX 14 01483 .41 rJ6 116..1 �. Effr 41 r ro . rso ; L I UL 01483 LL r PUTNAM COUNTY- DEPARTMENT OF HEALTH 1,7 Dwision of vi onmentat. Health Services Carme% N Y 10512r r, •CONSTRUCTION PERMIT FOR `SEWAGE DISPOSAL SYSTEMy��% Town Villa ax kId?j Subdivision L ,�J y� J�� of J. , 3 T �J nor; � 76Q/.2`� �3 5 1... �o— W4je,P `:.BUMP_AOJ C ��_ Address 4604- / L�OL�• /�U ` Owner F ` /►� / PSI TT�'�eS 8 :o 00, /U Y wltling T ype Lot Area �f _ Number of ,Bedrooms Design Flow �1Q . G PD / Sep, ;FT. Total Habitable Space Square Feet Separate Sewerage'S9stem -`.to consist of 70O Gal Septic Tank and ��7 �� QF / I«!i�[7•�S To be constructed by W 14 41 D AD le-;e Address Water SuPPIy: Public :Supply From p a.� . —.. Private SuPPIy to, be drilled by ,E T_R,At1�� r Address Other Requirements 1. represent "that I am wholly, and completely. responsible for the design and location' of" the proposed system(s), 1) that, the separate• sewage disposal ystem above describ ed. will.be_ constructed as shown on, {he. approved amendment there to and in accordance with the standards, rules an regu a ions_o e u nam County- Department ' of Health; :and that on completion thereof'a "Certificate of Construction Compliance" •satisfactory to the Commissioner of Health will tie submitted to the•.De artment ;' and a written guarantee, - will "be furnished, the owner, his successors; .heirs or assigns, by the - builder, :that said. builder will p' - lace in good, operating condition. any part. of said sewage disposal system. during the period -of two (2)'years immediately,follow)n9 thedafe,of. the -)ssu nce of the approval -of the Certificate of - Construction Compliance, of the or system or any repairs: thereto; g) "that the drilled well-descrlbed above will be located as shown on the approved plan,and that said well will be Insta'!I96, in accordance h the 'standar/rule and regula,i— o�f- the- Putnam County Department. of Health. Date 9.20.7 Si9netl P E: R A Y. Address ` License No. 3B i Q o APPROVED FOR ,CONSTRUCTION. This approval.- expires:_one year`from. the date issued constr ction of'the building has been undertaken and is revocable :for cause or may.:be amended or modified when'consld nee . scary by the`Co missio er of Health. Any ,change or alteration of construction requires 'a new per t. Appro ed "for disposal' of domestic''sa star s age, antl or pr` to . (' up�Wy only. Date �® BY Title w " ic eo v.(s g J 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 NO. Owner1low4k,p BuR,Dicx JR,, Address 13U LL. ET l4,=,�� Located at (Street Buy -LET Not � E o. e 77 Block / Lot 3, ,3 4 n lca e nearest cross street) Municipality, f AT % ,,FR-S 01V Watershed C ko T B u SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS '"Hole Number CLOCK TIME PERCOLATION PERCOLATION apse DeptFi Eo a er Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Mina Start Stop Drop in Min. /in drop Inches Inches Inches 1 -AT j P- :t4iT_-i - 2 0.7 6 ?,,z c3 4- Z 0 3 2'30 (o Z' 3 a Z ;C�. G % Z 3 z s Z- 2 3 5 Notes: 1) Tots to be repeated at same depth 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. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 3 ryPicigi-HOLE 'NO. HOLE NO. or 611 1211 1811 A.) Y 2411 30" M r K 3611 TRAC JE S a F- c Lq %e 4211 48" _S ro ej z _S 54". 6o if 66" dun G.Q. C-MCOOMMeED 7211 7811 8411 INDICATE LEVEL AT WHICH GROUND-WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Co.t_ S M U M Aj Date 9-16-77 SO4.1 'o-ts DESIGN - . -L.L It" V d I%., MULVT-trop -- 0 D. Usable Area Provided No. of Bedrooms Septic Tank Capacity '/O 0 Gals. Type Absorption Area Prov ded By :333 L.F.x2411- width trench. er Name 00� /-/a wA e D oL g- Y j le, SignatuFe— /1' 1, ol", Address 37 F4 IP S 10, SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: If V Soil Rate Approved Sq. Ft/Gal. Checked b \ \_ - "� � '� CONSTRUCTION O.whe °Building Type Number of Bedrooms To be constructed by L Water Supply :. Other ts'. represent A h t ;I am n Who 11 to-the- IbEPARTMENT. _OF "HEALTH 'Division '.',bf tal -Health-Serviqes,--C-affne Enwronmen Y. IT", FOR ,SEWAGE, DI DISPOSAL .SYSTEM ,; V. -T ITown or viiiage. 77- X Tax ax -,Block T Jo — Lot 2 Lot Area C- ': P PY -S—Q (-�- r. eotii4a -Space Square Feet consist of �� Gal Septic k :40 :7 blic Supply From ate uj - )p , ly �to' be - drilled b Tc: �Iress 7, end completely'respons�ble for the tles�gn and tocaUon : ` ` ' .and ; 6 f"' t' ' "-, `,pr,�-- 6se'd s " y s te. mI;s). ; , - . + _ wa g!e�,,d'isposal system ucteC as sh n, �_apRrp�q� amendmentAheret o Ai h accordance with the standii i r and � e ula o r .t_ e• utnam fiIUN here6f.aidert! o ponst�qcI op- prpp1. ance _sati a6ioyto t h e 0 n6 i ,, ner ' ealth will mi4it;:and a 4rittiin iahieli:,'will be.. urnished the owner hi heirs 6r. assigns by the'builderi thii-sail- builder i- will is successors, years immediately ssu- i0ition any-part o 'ii4e* the -p6ribb-of two 2) the i ,Cer)iificate p 'of Conqru ion Compliance of th .1 gipa1-syst" a py , repars t"rqti --I)A; 'atthe drilled well . well d' ej&'j6ed above ove fie approves :!.' A and that-said-Well w ill be nstalle accordance stan ards"ruI i-and �eguJaTo�si Putnam , 0 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 NO. Owner 41,0 W.4 oq0 9cl .CI91 C l< 4dre s s �o L t- (,F-: T Located at (Street 614010 r' r r �D.�. % Block Lot 3 �Indicate cross s ree Municipality les 8 Aj Watershed G 9 O %'p N SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION RIM Elapse Depth to Water Wate—FIEV61 No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start, Stop Drop in Min. /in drop Inches Inches Inches 17,/3 ZZ 0 7 /s % / , /,-( 2 z ?_ 13 /t 3Z;3.0 z'4 o /0 17 1 FO 3 4 5 1 2 3 4 5 Notes: 1) Tuts to be repeated at same depth until approximatel equal soil rates are obtained at each percolation test hole. All data to bYe submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES TY� DEPTH HOLE NO.- HOLE NO. 611 12"► 1811 A A) 24 &0 11 3011 /1-1 t x 3611 7eAc F5., C L 4 Y 42t' 4811. 5411 ..6011 66" . 6ko 0 Aj I-) 72. 21. Dj Cvv to T—r-, r? F r� 78 84 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Date /2 - 9 7 6 *. Soil Rate Used - 150 fdrvi - "Drop: -DESIGN' S.D. Usable Area Provided 0 No. of Bedrooms k Capacity 900 Gal AS Absorption Area Prov ded By 3Q L. F.x2411 vrat-W.,trench. ATE Z7 Address 3% �111,P ST ftELr, - AL re THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Checked by.' Date.. i'UTNr1�i Crt' \'I`1' f)f :1',IItT`T \'T 0T' 11rAr,T1( _a ---T1 VT;i-no ��."T:�t, �IF:�r;�n er°r, rCFS _..�.. Date Re: Property of //6 WAR 15 .fc) a D ! e r, Located at ?UL L 4� ;41O 1- 1F- R L Block, Lot 3,3 Gentlemen: This letter is to authorize wQ W,4,C,> A L L a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system; to serve the above noted property in.accordance with the standards, rules or regulations as pro.mulagated by the Commissioner of the Putnam. County Department of Health, and to sign all necessary 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 Laco, •'fhe Public Health Law, and the Putnam County Sani- tary Code. ri %'r ti 1' K y P Countersl P.E., R.A., 7 ?4296C Address on C Ap, /4 /V, Y Z2s �at38 Telephone Very truly yours, .Signed Owner or Property Address Z 19- z Telephone s 7612 u 7-p _ _�.� Qtd19(A ILIA ia° oJ�ti -10 �� ►'4° � t'a tai x ► a n - O LL ir--- CL°' F-jLfl Ito �.td.►�;� kin • � ,��{ ��z yy � x t �6 i ��G 12r.� • �(o. � LL° OPT � I , • v��'�:k ..Rai i ... G.C� avr L, 5. w CL f X 1�6. > 1� a � � 2ECeEaT 10 ss 1 � I S PL'T Lt -v E:- L u