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BOX 22
02525
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A
02525
- PUTNAM COUNTY DEPARTMENT OF HEALTH
u. �� � - -- �€ � �Dwis�on of kEnwronmental Heal #h Services Carmel, N Ys 10512
CONSTRUCTION PERMIT: FOR SEWAGE :DISPOSAL SYSTEM.' ".��"iC/F�Y! Ys�GG, €Y
Town or village `
1 Laca* d a• ,SIIA/!� /Y%!/✓E019D �3 Block Od
.- . a �b Job
w
5'ubdision
,. "Owner s CAF T/yE' L.9.il� L.clG Address 37� N� STG /f s? Y� ��ic k5
Bwm
ldg Type ot Area
Number• of Bedrooms Total Habitable Space x500 Square Feet
900
Separate.' "Sewerage System to consist of y. -Gal Septic Tank ✓� % lineal feet X 3� width trench
-;To be constructed by U�✓ "� /V y ��
Address
Water Supp1Y Public SuP019 From z
E3 4V •. Jlr:`
I Private. SuPPIy to be tlrilled by /A C'W
Address
Other Repuirements L`I
I °re resent ttiat,l am wfiolly;,and_complet @I 'responsible for' the des gnand'locatof: the. proposed systems) 1) thaYthe separate - sewage disp
sa system
P y
i above described' will be cons#ructed as shown on the approyed amendment there 4o'.and in accordance with theatandard-s; rule's an regula ions,o oe, Putnam
Hance- .satisfaetor to the ehiuu� siltWpof, Health will
,
= County Department of ,Health', and that.on cbmPletion,thereof a "Certificate of_ Construction Comp- '. y 4 ! x,,
",be ,submitted to. the Department, and a written guarariiee will 6e, furnidhgd the owner hissuccessors heirs or assigns: by ttL4�- (tle , th F itt ilder will
I
q' place'= in~,good ;t�peratmgcondition any part of said sewage disposal system during the period of`two (2) years immediat�l'y �11gw ' at�� 3he.)ssu
6 „-ance"of•.:the;;approval of`o;t,he Certificate of Construction Compliance of the original system or any repairsafiereto 2) ;th tFie�d iIQWL4D'd�4�`r., cf,'above
will' be located'ai: shownbn the approved plan and.flat said well will be installed m accordan a -with the standards rules d "� ations of. lure Pvtnain
County' Depart lento Health:. -� y
c : Date Signed • ~t•A
. r s Imir
x �� Addressbx 3'O;M4�►N�PA� %3 i (054 �tt�.nse No. .
APPRO,vfD.FOR COl` TRhUCT10N This approval expires one year from the date ;issued unless construction of the bu �'fia3ape Le'it 1 n: and �s
`
revocable fdr. cause or',ma.y be amended.` orinotlrfied :whencons�dered,nece_ssary by-,the Corrimissioner`'of Health Anycha� 'gtr,:�,lliPfp��ptaei'fruction
requires a; ew'perm�t Approved for disposal of domestic Sang r s age pnva water supply only �o� ��� �� a *c`
r % �� rSIg9 ®CS�� �e
lDate - I Tale
Sa `F -._.. ��.._.......__ u.._..-__. .__.........�__•_••______.__�.� _._..._._- Lam_...,__ .. ._....�...�__� -.1 _. .,�.�¢.v..v -.l
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r
DI`IISIO'I 0� - •- �� _=- L•'�'= S � "IIC 'TS
Dat°
Re : Proper., of ' aEtid. o� SHE L� A L eo
Located . at ,2av-9[q
\./fix
BI acic ®4 / Lot O1
Gen' C::::--
'I'h1 1 '- } `J ' : _O _ .SGL C i�V131✓
i
;J S _ J" , ;� - ~ -J"1 or Z*- S 'Je-e
a au-7
to aj-
10 a V
sv�ve ,li .: �i ^__b'o �l -a not-A.'•. -'r17Je -L .�_v J_.?'�'�_"' -�j' +'+.•.�'�.J
Ora 7)ov '1_a iyC1 ^, aJ �., y.v Mu1 tv. v� ..._'. C'o ----J J_v'. �'_' V_ v �-B PU.v Vou_ vii
+ v J
i L ;�al'-'n �.,K l0 S:_ -1 ���� ASS"— •' .� »S o'" ^its bed
Depar e� o:. - - - _ -- - - - - .
S
CO?L'1ect _ �Cl �1:' J _._- v8= °___ C �._ _ __J._ O_
'' O_
. .. J Vel,l �=' SJ J V J -n conform-
S7 �J �+
17 Li�ilCa'';O'1 LS:'� . �i e Public He 3 Pu�?�?^? CO ^ � j San---
�'
tart' .Code
ours
AC's =' 5
�`sOLunterSigae'
�
c.,� m (Seal-)
Addre s s~.
aaa. ' +�ipX. tie`s
lelep�o s . -
PUTNAM COUNTY D: ?
36"
42
48'r
5`411
60"
66"
2:..
78:�
84
INDICATE LEVEL I WTHICH GROUND j,LATER IS, E\COU1'TERLD ��b�E (�v•c�
INDICATE LEVEL TO WHICH WATER LEVEL RIS_� :AFTER BE I'-G ENCOUNTERED A T S ^�.
m� ,L�.DE :B �'
.'Date. %0 -26 -7/
TEE 1 S ,SUG G >vfai✓- TE Ea6 C c»� Uti_-T'.c � c
` E fJ G � NE'i✓ Cc
LL���
Soil Rage Used // ,`Iin /1`' Dr S. D?, '•s.a-le Area '.'ro: i ^ed ,ADO o _
No.. of Bedr.00-:s 3 Septic Tan::. Cap _c i ty 9do Gals . Z�p.e 1Yr19519Av2�
:Ab$Qrptzon area Provided By Z3/ L.F.x2' 36"
A1J l t= t i_ i :., �� ,•�qt ' OF .Nf so,��
J �s -Ste�� +�r,., Si- a ure�
Name . A •
Actress - SEAL o y;
M
CIARII DACE o
PUTNAM COUNi'_HIJr' ;A# UY WkEaLTH
Soil Rate Approved Sq. Pt. /Gal
Checked bv_
to • '" C, .
. s�/ri�ltl�ltit4i1r1 ^S
Date
.5
is
ii
r
j
I
Q t
n y
I �Ib
-1 -�
i
t.-cc9 �ra�•-EM . -'�' '�
SOIL PERCOLATION RATE ..� ....... MIN/IN
DEEP TEST
S ;t
`� /G 7Fin�iG
ESTABLISH ELEVATION OF HOUSE TO PROVIDE DRAINAGE OF LOWEST FIXTUI
TO SEPTIC TANK AND FIELDS ...... AREA RESERVED FOR SEWAGE DISPOS,
SYSTEM TO REMAIN UNDISTURBED.ALL CONSTRUCTION TO CONFORM TO STA'
AND LOCAL STANDARDS AND REGULATIONS ........ .
CEO,(- 'oOM.S
f;Vdp 7L .
V
Ti HT --
I
G' 2l ✓�"
1
__ O
APPROVED
NOV 111971
PUTNIWJF:- 7il`TG.TwOT 01 a HEALTH.
.s�E HT
8Y�•:?.SG..: a.. ...:..: • - :. �,,° a a: APnolg..J r
BfREEY9R DIVIS�OF { � a �,�, E G� `
@1YIRONNIENTAL HEALTH SERVIC" j h
qQC) GALLON SEPTIC TANK j '�:•7; "'; , ,,,_
LF X 3L ABS. TRENCH ;
- 7- �a•- ��.o�.✓o .Z3 B.LOC.t''NO.GQ sue,. tor.✓a.
SEPARATE SEWAGE DISPOSAL
, �L,V 1-1 OF 7Tf1E l✓ -J.�_-e INC.
TOWN OF f'r/YVy/✓I (/.gGLEY
F�UTi(✓igM COUNTY. NEW. YORK
DATE SCALE ?.6 sNOw!✓ JOB NO. 7/- /¢/
SULLIVAN - THIEDE
CONSULTING ENGINEERS
CLARK PLACE _ IAAHOPAC, r4EW YORK
sys rte-.. -a �c c-c...✓f= a.�".' -y �-c
9
^.G'
_
�-is•c s�a'r�I�3�..;: c'c .^,!.✓�-v
35"
` -JU.VC
iiO �'CJ.✓
77
p ✓iV•ri C_ni' OF �i✓Y �r?N� >E'..✓7yJ,C
/./
•�7�0��/2Q13_
�;�Fit/EG
� /GL w�7ZJ�.5o /G`�,
X10
f
o s
— • a. �. q. r
__ O
APPROVED
NOV 111971
PUTNIWJF:- 7il`TG.TwOT 01 a HEALTH.
.s�E HT
8Y�•:?.SG..: a.. ...:..: • - :. �,,° a a: APnolg..J r
BfREEY9R DIVIS�OF { � a �,�, E G� `
@1YIRONNIENTAL HEALTH SERVIC" j h
qQC) GALLON SEPTIC TANK j '�:•7; "'; , ,,,_
LF X 3L ABS. TRENCH ;
- 7- �a•- ��.o�.✓o .Z3 B.LOC.t''NO.GQ sue,. tor.✓a.
SEPARATE SEWAGE DISPOSAL
, �L,V 1-1 OF 7Tf1E l✓ -J.�_-e INC.
TOWN OF f'r/YVy/✓I (/.gGLEY
F�UTi(✓igM COUNTY. NEW. YORK
DATE SCALE ?.6 sNOw!✓ JOB NO. 7/- /¢/
SULLIVAN - THIEDE
CONSULTING ENGINEERS
CLARK PLACE _ IAAHOPAC, r4EW YORK