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HomeMy WebLinkAbout2681DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -36 BOX 23 Iva tip, � �'� J � T I ,` ' 1 ,; � ■,` r . UL 02681 NYp, 7 T�'"''a`^�J _."i!am r R^n ie..h � M''j•'C iVi y�l•4Wff4R!r "i T PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 1051 '' CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM WtJ or U'$h'A1 �''V d�'� -L f _.. _._..__ - Town or Village Located at ..r �Lt ' yW'+ Section Lot o 'ha �"� Job Subdivision Lot Win. + /'� �'' Owner !r ` P_1�1i^� 1� O •%- w L% ,{ ` j AdQdrress Z 7 ✓ �! mI�i�i 1.� �% `,1i1 F�� Building' Type 1 rNM.� �V ELL ty1• Lot Area `71. •, "o it 117 um y u..y to 0 tiw • © (LK Number of Bedrooms :3 Total Habitable Space Square Feet Separate Sewerage System to consist' of Cl 0 0 C Gal. Septic Tank n lineal feet X DD��,,� (����,,��' +. %width trenchY To be constructed by ��' �/ "" ©J S�"�) Address S904VT P""A ` odima- "(�J.A�aE'1✓' Water Supply: Public Supply From Private Supply to be drilled by �`)GK� "'Oe'LL. 'Oinikkifabi, 1)i�J/�I Address �+� C1UT �� YLOO►�C 12"n . .1 g—y<S"1l4 0 . , Other Requirements I represent 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 described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o F-TiOnarn County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be, submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following thedate of the issu- ance of the approval of the Certificate of Construction Compliance of the original system o any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be Installed n o wi the standards, rules nd regu a7ons of the Putnam County De artment of Health. x Date C_-rr. I Signed t P.E. /LA R. A. Address IrQ l� LJ ` r License No. �ov -1 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and Is revocable for cause or may be amended or modified when considered nec scary by the Commissi f Health. Any change or alteration of construction -requires a new permit, A proved for disposal of domestic y wage an r private u ply only. Date By'�'� Title -I r(- . PUTNAM COUNTY DEPARTMENT 'OF-HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date t =J C T' . Re; Property of KE y K of e-:r 0 t.� . Located at ��- t �.� 0 A� Section 5 % Block Lot . MAP Gentlemen: ,This letter is to authorize C. A 6LA S sr. i ut G A h-t k 4E %-- � a duly licensed professional engineer or registered architect (indica e to apply for a Construction Permit fora separate sewerage system; to j i T serve the above noted property in accordance with the standards, rules or regulations as promulgate. by the Commissioner of the Putnam County a UDcp.i Uiiciit Of nca-LU, and to sign all riecessary 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 - -,-.---14 -- Edu.cation .Law.; - ...the . Public. Health law, ands-the--Putnam County Sani= tary Code. Very truly yours, Signed R.��- �v`"^� -' -49 Owner of Property Countersigned:' %0 ��'✓' : °�!�Gy'� /V/ ress P:E., R.A., #40a4 ":7i2 - 1;2 9LCJ CttDM oL) © Telephone A ress �E NEW yo , N/r {� g ione 2�Fp �O 4682 ` ARo ESSIWAN" 1 a - PUTNAM COUNTY DEPARTMENT ..OF..NE61 -TH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL,' N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner s �. 10 t4 o LTD 0 Address HILL 2.13-A p Located at ( Street 1. W Ai op b 5 1�6�t1w� . Sect: 0 5'7 Block Lot IndIcate nearest cross s ree Municipality LQwA._� ,r_ &r4 m VA L( Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH'APPLICATIONS Role _ �4 .Number CLOCK TIME PERCOLATION PERCOLATION film apse Deptti to Water Water Level No. Time From Ground Surface in Inches Soil Rate' Start -Stop 'Min. Start Stop Drop in Min. /in drop Inches Inches Inches 31 z 1 (° 2 10`.40 -10'st 1 33 �zl, 7 60 1,3 1 ,02- 11 -.10 11 .10 3 �-- 4 i,a 33 3. 2�.2 IV, 4 -S- 1',03 �4 2 _ 3 1 1 2 3 . 5 Notes: 1) Tegts to be repeated at same deptn until approximately equal soil. rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. c? C TEST PIT DATA REQUIRED TO BE SUBMITTED WITH_APPLICATION DESCRIPTION1, -OF SOILS ENCO-UNTERED -IN; TEST DEPTH HOLE NO. I HOLE - -NO. HOLE NO. G.L. M 6016M V f=11Je SAiVd 14.6VIPS4 to LInN S,d" 6ii SdtiwE ' S)Lr 6"il-a, 6drigE 5u_r�6YWdw'Z. i i 12" _ 18" 24'i - - 30" i 36" 42'! 48" . 5411 60 66" 72 7811 84" :: -_ -- - - -: SNDICATE :LEVEL AT: WHICH .GROUND WATER . IS _.ENCD?1NTERED.:: zNDICATE LEVEL. 0 WHICH WATER LEVEL RISES AFTER BEING- ENCOUNTERED TESTS MADE BY k) I (A-4 A 5 Sc:.1 w i C-A V• i �La Date e S ?�'� . Z ¢� / 4 % Z- .t":, DESIGN• - Soi1 Rate Used__�? Min/1 "Drop:. S.D. Usable Area Provided No. of Bedrooms 3 Septic Tank Capacity (V Gals. Type Absorption Area Pry By L.F.x24" b- Ot �renc . X54 ��""�•, ".� _ Name 0_ i c_ iacn.e4 S Sc. ) PJ ► ufi W 1 t'--0 bignature // .>/4. .1 Addr6ss 00 0- 0-d- V40-0 SEAL U � u, .s:r,,.• THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Checked by q � � 46"""' wr y ��FESS40NP� _ to .1 .p 4xs .r-. .,T- .a.�. -. .{'c'd"1"_'Vr - rr- rt£"..•+t' `r° -i.-. ski 7 - -:t"' r 5. \ s - L�[y(1(' •.4 �. {; :f3 -: l„ `' ��Ac• 7.I'Fa;.'y:1. =' qI': 1: � -S �-1 -. -S i \ 4 kPPqOVED yl ( .. � -_C� \ ` `r f j � � .. lam• � .', � .�2 .. b - - � . ` �� � � � : h t D�t�.tEia •�1/I�i+�C+1�.1 �' ,iF _. � .. '. 6 �. i` `r. r� .�', a -7f• :4 _ {• ,� J _ \ Y z. \ �40t:0'i ltd � "' � , ,�51�5 � L' QT -�t2H g i `4;3, S�-lO: �+ , - . - a - .7 'y . -• � O r - 'NOV 14 ign ' 3� fa Ut DEPi. 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