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02931
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02931
PUTNAM COUNTY DEPARTMENT OF . HEALTH
Division of Environmental Health Services, Carmel, N. Y. 10512. /
CONSTRUCTION PERMIT FOR SEWAGE .DISPOSAL SYSTEM , � V LL L
A, _ Town or Village
Loot_ -J a:
Subdivision
Owner_
Building Type (fie -VWQ �•T 10 ?J Lot Arta
Number of Bedrooms
Separate Sewerage System to consist of G X X5+1 1 Q-AT. Septic Tank
To be constructed by
Water Supply: / Public. Supply From n.
Private 'Supply to be drilled by
Address
Other Requirements
Lot rr�� Job 1;
Address 0 S CA W AN IQ L
?%j x 0 A ON IAL L
Total Habitable Space It -Lou, Square Feet
Address
dr
lineal feet X
width trench
I represent that 1 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 and regulations o e u nam
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 or 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 in accordance with the standards, rule and regulations of the Putnam
County Department of Health,,/ d
Date 1p' Si ned'yw i P.E. R.A.
!Address � Co. Cc, Ir ou License No.
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of t e building has been undertaken and is
revocable for cause or may be amended -or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction
requires new permit. Approved for disposal of domesti age, n or priva w ter supply only.
Date By Title��
i
i
A
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmenta/ Health. Services, Carm% N. Y 10512
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM
Town or Village
Locate
Owner
Separate Sewerage System built by !NA e- 4 t-- Z_ b, fl I D SZi -1 u
Consisting of Gal. Septic Tank
Section Block c
Lot Job % a _:1 - 3
Address 55St 4,W LVA A �ltkk 1 712-
lineal Feet X
e
width trench
Other requirements Jv %5�1 a �•i - �1 i ti % A, IA. Y� D I~ D - 406 $-t
Water Supply: i'� Public Supply From (S- L P_
Private Supply Drilled By
Address
Building Type i` V 1 No, of Bedrooms Date Permit Issued
Has Erosion Control Been Completed?
I certify that the system(s), as listed serving the above premises were constructed essentially as shown on the plans of the completed work (copies of which are
attached), and in accordance with the standards, rules and regulations, plans filed, and the permit issued by the Putnam- Doynty Department of Health.
Date U C) +� Certified by— � P.E. 2R.A.-
i2_
Address > �� + f 5��� ) C�i�� - License No. t`
Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary
conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer 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 change when, in the judgment of the Commissioner of Health, such revocation, modification or change is necessary.
Date �� By Title
PtY..I11AM C01JP., Y OF 11T;.ALT11
DTVI:SION 01 1,1;SJTFi71`;f °rr1'rnl," 1!I?(1'(1`I'11 S'::'I�VTC1?`1 .
po'-3T1ri" nri::' ^1�=.r`.TLTi::'�-; nl�. (7,11;'1/ .'� %, •j l lr � ��
kl-
DESIGN DATA SHEET-SEMRATE S'1, 1AGE DISPOSAL SYSTEM FILI, No. —_
BRM Develo,ppers. Inc.
Crimer &JWX= Address �f1tLtu�6 ►mact�s �Zort
.SI��Zte -�G. O�..t_S (= .STt4T�"� SU3Dtv'r5 foN
Located at ( Street Sc 131 l: :c . oc
�Indica t n0arosEcro:ss 5 -reef —
A;unicj.pa1ity 7-14 T- Watershed C(Z-0 T-0 L _
nln },ran 1;� f�l T�t� �'T f�l lj j T I ^li
SOIL PI;RCOLWT0N 'i "EST D_.TA v.: UIR_D O BE, S Il?1'1T..' 11,D •r1.i
1 (143?-- IY3y
Z
Z'-►
Z-
1o1_e
Number CLOCK TI; -- T
PERCOh.ATTO"d
PERCOU:TI011
Run
No.
Start -Stop
Elapse
Time
Min.
Dapth to vat rvater cave
From Ground Surface in Inches
Start Stop Drop in
Inches Inches Inches
Soil Rate
14in. /in drop
1 4;33 -ly3Sr
5 (q-37- 14 3.9
4 N 39 — / g9 !
1 (143?-- IY3y
Z
Z'-►
Z-
_...a 2 j4 3j - iI.j6
Notes: 1) Tests to be repeatod at some depth until flp �roxl.tnately cclurs.J_ noll
rates ,.Lie obtained cif: each p0rcolation test hole:. . A y data to be stibmij ted
for I- Oview.
2) Depth mcasairements to be made from top of hole.
5
_ .:...... .
Notes: 1) Tests to be repeatod at some depth until flp �roxl.tnately cclurs.J_ noll
rates ,.Lie obtained cif: each p0rcolation test hole:. . A y data to be stibmij ted
for I- Oview.
2) Depth mcasairements to be made from top of hole.