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HomeMy WebLinkAbout2937DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -77 BOX 24 02937 Bob - . r�.�. 02937 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM ar,% own or Village Located at Subdivision f tv�_" Lot ` A . p Job iV` l a Owner Address ®S c,4W ANA $ Building Type C. O i� Lot Area IV LS= Number of Bedrooms Total Habitable Space `2 ©C? } Square Feet Separate Sewerage System to consist of erV- Septic Tank lineal feet X width trench To be constructed by Address Water Supply: Public - Supply From IPAI Private Supply to be drilled by C _ pp r ` Address go 0 Y { 5 ro u ) t� t � �b S5 ) o 1'_Rld Other Requirements 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage dis posal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an 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 the date 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 sta d rds, rules and iulaTionsof the nam County Department of Health. Date S' n �T7 R.A. Address lam" t J_k_ ~""�` License No APPROVED FOR CONSTRUCTION: This .appro I expires one year from the date issued unless construction 04 the building has been undertakWh and is revocable for cause or may be amended or modified when considered necessary by the Commissioner-of- klealth. Any change or alteration of construction requires a new permit. Approved for disposal of domestic tary se ge, an 'v or p a water su pI only. Date" it ��� BY Title QJ� "'� 6a1 Is- I - -` -1 PUTNAM COUNTY DEPARTMENT 9F' HEALTH .Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM T Town or Village Locate Owner Separate Sewerage System built by OE_ T � ��I Consisting of Gal. Septic Tank Other requirements Section Block Lot 1 `• Job Address 'pSt/�i,�jAjUt� LA-K.e RPM). 1'Pd1 oad4l lineal Feet X ii width trench o rl eez �, U IC. I< . r Q� = 6-1(n *,; = Water Supply: Public Supply From Private Supply Drilled By oAddress Building Type Ki 4:1 to No. of Bedrooms Date Permit Issued Has Erosion Control Been Completed? 1 certify that the systems) 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 Pu County Department of Health. �j l✓ '� `` J Date 6/�Lr / `/j ✓ Certified byz� p P R.A. Address 4- 1 COL "^ License No 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. 1./ 1014 , -? /Y f� a QLv"_'18i or . LtrC aj O.= ]:�i l .�i • i�llZ'_`: =ci. a ! vJ Buller, z, Qy Sec to Location J -reef . . ovci-'� l 5 Builalr_c- Type Lo.t I r.enrv��r: : ^a� I _._� cCvo, = ��i - - =,_ on_ ^? _ J v _ VO,.ti_L -` :_ J__�� -J .J _.nom_. - ^.__w .,'w'1_ - _.�__..__ -__ _v -: ✓ v .��i�) __ -_• _- .._..�� -- t/ O 0,0 Z, r _= J z v J r- V _, i t A_ `'J r' n- 7 z, t a i J _ .J "_r v . T'he T..L•..�'..l�vJ__•,.�:. ,- _... +�_�•, .n - �..'��_ JJ .. w. �.vJ a v'�in _., AJ_ v .. .' 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