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HomeMy WebLinkAbout2261DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourclocs.com 631- 589 -8100 41.06 -236 BOX 20 02261 .. r • i . I Air. 02261 to WTNAM COUNT Division' of Environmeni VS'MUCTION P,ERMIT.fOW- SEWAGE 'DISP.OSAL `S Located at Subdivision > MAY S' Owner. Building TYPe RGS lttiE1JGE DEPARTMENT "OF HEALTH Heaith Services Carmel N Y 1051 ' r`ar sio'3 i . _ot Area 2/,300 Number of .Bedrooms, Z Total Habitable Space Square Feet Separate Sewerage System to consist of; _ p> Gal. - Septic Tank A-100 I 7 lineal feet :X � ..width .trench To 'be' constructed by Address Water',Supply 6.14c., uPPIy From I� Private Supply to be drilled by -Address. Z31: her .Requlrements 1119 q blr 2 h f� O� B C- G214'VrCI mil L 1i,S' (tea• 'r^t�PSm►� co�r�P�•; F. I represent that I am wholly and completely responsible for the design and location of the 'proposed system(s);-I) :that the separate sewage disposal system above described will be`.cor structed as shown on.the approved amendment;tliere: to.and in accordance with the standards ,'rules and regulations o the u ham S : - County Department - of Health, and that on completion ",thereof a "Certificate of Construction- Cd " satisfactory to the Commissioner.of `Healthwill. be submitted .to the. Department,. and k'.written guarantee will be furnished the owner, his efffli assigns by •the. builder; that said builder'w.ill place �n .good operating.wcondition any -part of said sewage disposal system during the'n'xldpa6 mmediately following thedete of the.issu .,� y ante of ,'the approval of =the'Certificate of Construction .Compliance of. 'the original sye;te�i6 is, 4; 2),ahat the drilled ,well described above :: will be' located as shown on the approved plan and that saitl well will be installed in 'accoriance.�yt e s a Ides, -and egklations of.' ;4he .Fulham County .Department of Flealth -.- `4- L_% pateG c�iPT i eL ` " Signed R A. y ^ oLV,^— �'- tw£..: �.�l►..i�t G,. Vii: h.. �' aE,6 Ye{R:�' Address. z4B9S : License NO. APPROiiED'FOR CON §T:RUCT.ION This approval expires one year from the date, issue alesV. constr i ioq' �t�ie building has `been unde ►taken and is } revocable for taus or may be,amentled or modified when considflred ecessary by the C t6lisejpRer78l8ea�v',pny change ;or alteration of construction requires a ne erm' : Appr /ov/e�ii for :disposal of_ domestic sa sewage, and or pri �1!s o`�1i(!� l /- BY . - Title fir .. -- PUTNTA.I COTINTY DEPART" 'T Or F-- r,i i DIVISIOi� 0:� ,_TVIRO ii•1"".�.'ITA— HEALTH SERVICES DateuGVS Re. Property of N:'A� Located at u,AP -7 Block Lot Gentle;:^en : This letter is to akthorize �j��GpH �cZa�G,�� c��l�yJ"�3 p. , a duly licensed professional engineer or.reoistared arc:_itect (Indicate) to apply for .a Cons tructi on °er :it for a separate- sa:•ierage sy stem?; t0 sere the above noted property accordance with t ^e standards, rules or rah; i? at=ons as p•romul-z- ,ted by the Co= ss_oner of the ?uu -n =— . Counter D D?rtZ_� ?t O" .r. -'c^� tC? � ? ^_: �O s c• ! a!! necessary D� ers on i a i a, °�^ a : .tea e lh COilii -c I n i h �f1�S la _�.d 'v0 SJ: _ "v_S t._e co struct_on O� s _d system, or, sy 3 e':` -s in confo_-Ity :,i -'uh the Drovislons of - c1e l� j Oi' . 1?,7, -T'duc.at-ion ia.:, she P ib-1ic '`'_e. -..lth and e i)utn=. ^_ COun_,y tary Code. eery truly ours' Signed . :•rner of _ rop r' y S4 - Countersigned.: Address - )c�E -C'►�• ��.?.yl`ic�S Sv�L.tVA?J r1�•E,. .� • P.E., -., z� gags „uu,,, z`Z -4-� - �-�`�o ,10 pF IYEW Telephone Sill UVAN-THIMF ° FOCIsp Address . CLARK ;'LACE 'Eso °z, MAHOPAC,. NEW YORK s 6, 2489 •° ��2� Telephone -., °'0 •..... °.•� ��.� PUTNA�1 COUNTY DEPARTMENT OF HEALTH - .' DIVISION OF ENVIRONZIti:TAL HE.ALTH' SERVICES - DESIGN.DATA SHEET. - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. t .Owner .� Ho•, -���� �= Er, M F Address 84-o-7 -zGz .` -&T, F- �_vgNl- 1,-.N RK, L. C,j L,_ -a•� L riKE �H oV,- E- R! C5 LtGG f- a� Located at- (Strzet) . Block Z Lot (Ind:.icate nearest cross street) Municipality -c-o,. V.4\_+_zj Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SMMI-TTED WITH APPLICATION for 0 333 1L� �ow*� 2 p��tct� �O tIkA,P CF QoA.P 1c i3 C, C3Gat_- L,P,tivz Hole Number CLOCK TIME PERCOLATION PERCOLATION _ Run Elapse Depth to Grater Eater Level No. Time From Ground Surface in Inches Soil Rate Start Stop tK7n. Start Stop Drop in rlin/in.drop Inches Inches Inches 3 z4• 3 -z oe�� Z. Zd- Z_ 4- 3 4 3 Z4- 4 2 SULLIVAN- THIEDE AP Pa a . fox 308- 3 MAHQPAC, NEW YORK 4 Notes: , 1) Tests to be repeated at same depth until approximately equal soil rates are'ob- tained at each *percolation test hole. All data to be- submitted for review. 2) Depth measurements-to be made from top of hole. Q. 30" 36rr w RTc �T 42" 48" 5 4" 60° 65" 72:. 78" . S 4i1 INDIC. -`ITr, LrVE.L AT t.THITCH GROUND WATER IS ENCOUNTEfiFD IMM INDIC: \TE LE iIEL T J TF'R LEVEL RISES ?:FTER B'LE1 E \'COUNTERED �L ��G E P, o�•K TESTS �U. DE pY C$U�1 IEDE Date g — 11 =- •7 0 ULAKK FLAUE, $'. a, 2a'G P Cb MAHOPAC, NEW YORK , s ©S I DE 5 L ` Soil Rate. Used' 8 rHn/l" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity ^ Gals. Ty pe V4- sPAXRy Absorption Area Provided By !77 L.F.x241C 3611 V"' width trench. Other _ 14 0:0 � z'- Fes" 2 -� 8, v€• L r= ►�1... .�, E,�:-�c�t'� -g�,L c�v� � o N. L1,�. cG, 1a6, Z$ sqS i ,�i NE , Na, t, r,�EPH F�Ar�C S ���-- �y�N,}�, Signature Address SULLIVAN- TAIEDE 5E[�RANCissG °��: t' CLARK PLACELP.o: gox 1308 - •� + e MANOPar, �EyV YORK a s ► - �z� - $ ° �,, m: , o _ C' ° PUTtiA COUNTY DEPAR 1ENT OF HEALTH o. 2489y.• °c,�: O;ESSwNP Soil Rate Approved Sq. Ft. /Gal. Checked by',�� Date TEST PIT. DATA P.EQUIRED :0 BE. SUBMITTED GIRTH APPLICATION '• DESCRIPTION OF. SOILS ENCOUNTERED IN TEST.HOLES DEPTH HOLE h'0. �::= " . .HOLE N0. Z; HOLE N0. 3 G.L. 61T 7-c3 121 « - • s�.a� ®y ��,�y is - �k.? t> .Y Cl A- �p.0 y Ci Ay 24 11 L. E) A + �.. t- n A, 30" 36rr w RTc �T 42" 48" 5 4" 60° 65" 72:. 78" . S 4i1 INDIC. -`ITr, LrVE.L AT t.THITCH GROUND WATER IS ENCOUNTEfiFD IMM INDIC: \TE LE iIEL T J TF'R LEVEL RISES ?:FTER B'LE1 E \'COUNTERED �L ��G E P, o�•K TESTS �U. DE pY C$U�1 IEDE Date g — 11 =- •7 0 ULAKK FLAUE, $'. a, 2a'G P Cb MAHOPAC, NEW YORK , s ©S I DE 5 L ` Soil Rate. Used' 8 rHn/l" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity ^ Gals. Ty pe V4- sPAXRy Absorption Area Provided By !77 L.F.x241C 3611 V"' width trench. Other _ 14 0:0 � z'- Fes" 2 -� 8, v€• L r= ►�1... .�, E,�:-�c�t'� -g�,L c�v� � o N. L1,�. cG, 1a6, Z$ sqS i ,�i NE , Na, t, r,�EPH F�Ar�C S ���-- �y�N,}�, Signature Address SULLIVAN- TAIEDE 5E[�RANCissG °��: t' CLARK PLACELP.o: gox 1308 - •� + e MANOPar, �EyV YORK a s ► - �z� - $ ° �,, m: , o _ C' ° PUTtiA COUNTY DEPAR 1ENT OF HEALTH o. 2489y.• °c,�: O;ESSwNP Soil Rate Approved Sq. Ft. /Gal. Checked by',�� Date ESTABLISH ELEVATION OF HOUSE TO PROVIDE DRAINAGE OF LOWEST FIXTURE .t TO SEPTIC TANK AND FIELDS ...... AREA RESERVED FOR SEWAGE DISPOSAL SYSTEM TO REMAIN UNDISTURSED.ALL CONSTRUCTION. TO CONFORM TO STATE AND LOCAL STANDARDS AND REGULATIONS ......... , T n�o, 33S o o `+ Y,5 7---~ LOEi'9.P7".� -/E/✓T O/�' h'EA�TiY ,E'E�LiG9Ti r�n/S /. t ° 34� ,Jc .l ups %2\ I I ' Z9' ','. �//UiYC T /o�✓ igoX �: :,<arr.� ° .'9n/ /i✓E.E'/lG6 0.� ,2/ -6" c�.� .P o,$ /_ 2d I G.e.4 YE',t 6 "- o.nsa /< co✓E.2 j 1 ' i 900 G9L, SE.o T/G T9N.fi Aq \ N a f'..E'caPn6E0 .�E1�VArE O /.S PO S-,q! S.S O, 0 1 I o1 I - S, coo ji 1 t LoTA/o, 334 11 I + /oo o I j EAM /LY _ I Ex/�i9NSi o%✓ floUSE iG07 �,o.133 1 1 o -r .v'o, s.9z I I YEL F /4 4 ` goo 3 46 11 e00M AG'I2 00 \ \\ Q C� bLLII Fep 1 \ & Rn ArcK roc- �/ 2' -6" or- C � 6 of /i � est _ � --\_.l _� - �Ep �FC,. rte. B: �KAYE< F /�� w� 6 ". ,a,e 4'• PB'RF. /°i.�E vg9G--T 5 L�oy,z �PccP, p� � Br� VL D s- 247.092 le S E P 181970 0 LUTNA NT.1F' T. HEALTH N � q.�+P•PoX- EX /sr 't...... -f C7.4 of •E " C7.4 ST /.0 aN i° /f'E 1' 9 0o s 9 c� sEi' �" /c �-�/✓K ¢.MV RONMENTAL HEALTH SERVICES eo o Ex/sr: WBGL TgA- /Yn9P No, B <ocr /✓a, ,g -Aqx tar /✓o, 6 PROPOSED SEPARATE SEWAGE DISPOSAL SYSTEM. T.'/oMAS K' /E.E'Ne9N' . '- '•L -`--c _—.._ M. � _._ __. - � .,�2� '<' <!'.e M9F o.c' .0 o��t?. //VQ B.CO oK .C. �1''E /oSEPN FANG /.S Suc< /v9v PG "b ` TOWN OF f'/JT/✓i9iv? h'.9LLBY �COUNTY. NEW YORK, ADATE 9- /¢ o SCv�—TE JOB NO. SOIL PERCOLATION RATE ............. �.. MIN/IN 5100 GALLON SEPTIC TANK z �„ - '�a4N� �, ``'� - SULLIVAN- THIEDE,. DEEP TEST .. .✓o LEDGE �Poc.r �'�FSS1�9P CONSULTING ENGINEERS. cpou/VP r✓9TE.Q .9T 3'-o- 177 LF X 36 ABS. TRENCH ��_... . - - - CLARK PLACE .. - MAHOPAC. NECY YORK