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HomeMy WebLinkAbout2196DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 30.18 -1 -65 BOX 19 -o'7 w "Nri A. �.. r L 9 ell L ' �I -o'7 w "Nri 02196 A. �.. . L 9 ell L ' �I 02196 l 1 u 4 PUTNAM COUNTY. DEPARTMENT OF .HEALTH ' `s } ' Division of Environmental Healtl% Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT' FOR SEWAGE DISPOSAL SYSTEM o Town or Village Located at - _ L a _ . _.. _ Block _ Subdivision % /MTh/ %��(A t/J4= Lot Job Owner r/Q Al Address J` J �1 .SETl irk /LfFA/l�.�UE `�yiy C, "A%�• Building Type ��SflJz'rA! r`,� L. Lot Area 1 �i C/�C , ��G ° a<F �v (� 74 Number of Bedrooms Total Habitable Space /w O 'Square' Feet Ff i Separate Sewerage System to consist of � O ° Gal. Septic Tank =�/ lineal feet V44-464 X to width ,trench To be constructed by v f` �% Address' 29171V r Water Supply: Public. Supply From /��J � Private Supply to be drilled by 41V,0,&4SoA Address -- uT/✓�ls� P144 e)! Other Requirements , Ol�°c� rYE�D ,✓ 'ion / �/�, I represent that I am wholly nd comp Jr. and location of the Y p ,�p�,, proposed system(s); 1) that the separate sewage disposal system . above described will be constructed as °!" ent there to and in accordance with the standards, rules an regulations o e Putnam County Department of Health, an p t17(,P're rtificate of Construction Compliance" satisfactory to the Commissioner 6f-, Health will be submitted to the Department, wri, Will �:� rnished the owner, his successors, heirs or assigns by the builder, that said`.` iutlder' will ':,.'ty place. in good operating condition y rt +! i lmb 4 & dis osa system during a period of two (2) years immediately following the date, of the issu- ance of the approval of the Certif te, f C �rigti�btjon ;�pmpl an of the origi system or any repairs reto; 2) `that the drilled well described, above ' will be located as shown on the appr p n aja1NS$5ei YV911 w I b nstalled in cordance with the sta rds, rules and regula +moons of the ,,Putnam County Department of Health.: /? : =U Date` a �r C`'�O 'Q`� d 4Gt�Y� t.� _ � P 7R A E Address - �a LfG' N A License No. -� Z a APPROVED FOR CONSTRUCTION: °This approval expires one r om the date issued unless construction of the building has been undertaken and revocable' for cause or maybe amended or; modified when con' der necessary by the Commissioner of Health. Any change or alteration of construction.. requires ew perm; , Approved for d4dsal of domestic Mary se , and upply only. + Date 0i 'y% /•� t / %';1� BY .. ,' Title h�fbY �l r� YUTNAM COUNTY-- DEPARTMENT OF HEALTH Division o( Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR QJEWAGE DISPOSAL SYSTEM r/.✓ 4� , i'�i�F�iLJ !/s1G4 ti1/, Town or Village Located at ����� "'� �' SEC�r- a� Block Owner QEf�iir Lot `� Job Separate Sewerage System built by A47- aL C-4-1 At f Address �� / /14Za <4 /{ L/ Consisting of ©® Gal. Septic Tank lineal Feet X ' -width ,'trench Other requirements .!>S' %AJ.ST�JJt�4f_/) iA✓ �B �/i, r'�- i Water Supply: ublic Supply From Private Supply Drilled By Address No. of Bedrooms Date Permit Issued Building Type � , Has Erosion Control Been Completed?• IC V I certify that the system(s) as listed servin v e ae con essentia ly as shown on the rplans of. the completed work (copies of which are attached), and in accordance with the st jar •s, r as rid- a 'ons pi s filed, a the permit issued by the Putnam County bepartment of Health. Date % �+7 e iii d b P E R A Q Add re �rZ. D License No Any person occupying premises served by the a y� omptly take such action as may be necessary to secure the correction of an unsanitary' Y any 'unsanitary resulting from ' such usage. Approval sewerage system shall become null and void as soon as a public sanitary sewe ";becomes available and the approval of the private water supply shall become null.'and.void when a public water supply becomes available. Such approvals are subject to modification or r change when, in the judgment..of.the Commissioner,of Health, such revocation, modification or change 'Is necessaryy; '.;., ` s r d.� a•,r„r ;5 t tF �` t rhi:..M 6 � .8 0 ar.'C" .: t $ - YORKTO N MEDICAL Y BK' ` 0 Eox 9 21 Kear' ree4 Yor�Ro wn 3 DATE COLLECTED., ; ' e F RES) ULTS OF,EXAM,IIVATIOPI OFsxWATER >' ; ` R OWNER DATE RECEIVED r 4! - A` :SHERRY {f 10 2 :JOHN , .`` CITY; VILQLLAGE, TOWN.,'&��/O�R�+ NAME OF SUPPLY DATE,REPORTED/�� ' rQ['� �� P[JT `30CJ�..? fJll® StY�S:o Y T. BACT`IrRIA PER ML;(Agar plate count at 35 ° >C) GOLIFORM GROUP (Most probtible No %100m1) HARDNESS; TOTAL ppm I AN.: :SJSa1JS r l ti ;�, DETERGENTS ppm NITRATES (as iV) ppm IRON, TOTAL Ppm s . 1po