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HomeMy WebLinkAbout3314DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.05 -1 -49 BOX 27 1 Tr I L 4 . . , 03314 �-',� RON 03314 TUT-Er INSTRUCTION �i 1St ructe PIY ARTMENT OF,) R HEALTW--` :' 6 "SaVi6of" xw P' % 512 -A 3. k " .*Town - Or -viliage'.., 77 P�b 't gl�lv �t 0 'A 4 -.;i W� Tl� .A"cld e ­_7­,'` Ii m Z Z IN rkltz ........ j�.,r ,A� 9 �0 itiofi 6f� the`-.,'i proposed — e ' dis _e. yvage' p gsal;l System.,,;! eAw and Ari' accordance s ar I art. eQU Mons e of Construction Co la, Ith-will b o er,: , ij -d V ginalsys�tem orjany p s t " he well described above �.- of he 'Putnam e date issued unless construction of�the' building has 4 been "wicidnaken-4nd is­ is i It :7, A, PUTNAM COUNTY DEPARTMIN T OF HEALTH -... �. s... .. a. .. ... .R... Fd - -r• r.y T� S.'\'T.�.:7^c T, T,. r !n.•± r..� T T,-. r� . ._. - -".S; .. �IJ1�11%J1 V1�•c:Ji 7.' iWl. arJ L .., ..+ .•e .•..4,..ru >n Gentlemen: Date_ 007719 /970 Re: Property of 7' l//✓.DE.�°/NC�p� Located at Section ss Block I Lot T This letter is to authorize a duly licensed professional engineer or registered architect (Indicate) to apply for a'Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said . Z> _. -- system or- sy's items "iii c oi� ui�irii Ly uv i;i1 tl�a P.l cvi s_L - cf :�rtic±c 1!,�` or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: P.E., R.A., # Seal) Address Very truly yours, p (� Signed `; • V�'�` \J Owner of Property Addr ss Seca 30�' q Telephone �f NE1ty } Telephone in 90 124,Q° /THAI EH SAO eE�� A' W PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL. HEALTHiSERVICES DESIGN:DDATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner /71eG,c-N T, f�iVoE,e"p1' Address Ao,Y A/ ' Located at (Street) Sec . S (Indicate nearest cross street) Municipality /yTiYr9/J7 l�ii�GGEJ__/ Watershed Block / Lot..y 2 a -SOIL PERCOLATION TEST DATA.REQUTRED TO BE SUBMITTED WITH APPLICATION Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth 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 © 3- /0.`/2 /2.'Z 7 /D /V1 / 4 . 5 3 /2- 2e: ice' 19 y 06 �`3V d 3� 8, /,,1/%N 4 5 1 . 2" 3 4 5 . Notes ,yy' :..fl- .- .W..r. ..— a -.r... - a:..:> r.o.. .a..:r: '. -�a�. .w •<.,a. +c�i, v i. �. `+CJ.. V W Y+ .'sY,ao..,r `_ .` -... `Casts• � �•� •F-s1 ':.�.,'C.9'.` '•Y..lu/45.'�:. o'' •- :� tv �cW.] T) ''1`ests "to be "-repeate at same dep iii= uritil approximately equal- soi-1' rates are tained at each percolation test hole.'All data to be submitted for review. 2) Depth measurements to be made,`from top of hole. .... . ... .. �:. - ... . TEST PIT DATA REQUIRED- *..;-TO -BE-- SUB , MITTED . -WI . TH'APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO., HOLE NO. G.L. 7-6 ze- 7-61-2 6" 6;e 1211 V-1 I- 5 V 6011 66't 7 2" 78" 04 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH:WATER LEVEL RISES ATTER.BEING ENCOUNTERED TESTS MADE BY ;!F'� Date OC7.- IF 19,70 DESIGN .Soil Rate Used ....min/1" Dropt:5,.. - Usable .Area Provided .6-006 No. of Bedrooms � Septic Tank Capacity 2!j0 Gals., Type Absorption Area Provided By /26 L.F.x24"-36',' P-1.width trench.- Other Name q�• Signature Address ",-07q SEAL PUTNAM COUNTY DEPARTMENT OF HEALTH ........... Soil Rate Approved Z�.�_Sq..Ft./Gal.',­ Checked by C (n A IV UNGA L:ow-': 'INOT /MPRO ✓£DJ ,RA IL m S -6'S /4 00' -,£ :. \ 100.00 j p Z MO UNTA ROAD '4 4 �- s -" � a 4 .c ry„ �„'�c• , s ".`"f L ; .s d ``.f v -r .a•` !1 2 �. �.' ti"` Y s '� ��ra..'"+ '; ?.3'�R' r rl '� T � � a'i! r`'e � � Ge ✓T J{ i •w,a '�� ,. x° x '" �, y�. a..ra- 3mS',A" P ✓t_ ^ms r .x,dG �k 5�-rc .Y. +�^2'''?i.,. �,5 •''',x�tt�'. rqT rfi',k ^;t'� �.?:>v shdF�`:�'w+`Z "M �. �N,•�.iXw;,S�g,tY .�i �a30y {�'�a' .� VeVi 9-?,: .`s.rra..- y:w�..•Ra:rv:,eyS'i�Y l•+# k(t+r✓_,.M.,,y 7�r`' .'°tia"4 r�iy ,4 r: ii. `y"� Y�.><.. hs.•'�4 gs, .,:7.,FY �'tr4 9 Ct,v. Af1NyKOwWNA��tOT$ /2,.�9 _.. __.___..._ T �ii1VlZ' �'n�rneers �. r „�� >Fi��t/��?��"�i � ��.vE��k,� s,`, °76- I'7��r i;3 nr ��Ia,Yuc,%'r �Uo� ✓3��,v a'":;"*.a�`"{�; �'�' F ` TOWN OF PUTNAM YA f £Y XAX M P D£Sl6NAT /ON ,,, a � � .d ,� "'� , �t `t S£liT /i�L� SyS 8¢09'• %iQTSd j Z�i�zo 'A i