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PUTNAM COUNTY, HEALTH DEPARTMENT
DIVISION. OF_ ENVIRONMENTAL HEALTH..SERUICFS<
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR �Olt
R
OWNER'S NAME Ai.Lton Roaen6ea2 PHONE 528 -6386
SITE IACATION 105 Rochda.Le Road Camp 3 4anowA 20
MAILING ADDRESS /05 Rochdale Road , Camn 3 44aowa Putnam Vall ec , N.Y. 10579
PERSON INTERVIEWED /fl. & t o n R o4 en 6 e n g( own e n% PCIID Canplaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE /0/18/90 TYPE FACILITY %aLVate 12weMna,_,_
PROPOSED INSTILLER _ Aahog c .Sari tati nn Sea—fir, fn r. PHONE 628 -4526
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system. .
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
Old 300 Qal. on Aeptic tank caved in. Reelace tank
with . angea tank that wi.L.L lit. 4iiea .Ledge hock.
Proposal Disapproved
's Sig 'ure &Title
Ad /I �_ /16
C Da
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable..
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name.
b. Site Street Name, Town and Tax Map number..
c. Location of installed canponents tied to two fixed points (e.g.,house corners).
.d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep
drywells surrounded by one foot + gravel)'.
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as own
or reported a ent of owner agree to
the above conditions.
SIG
—'
TITLE C�
DATE V �IAO / p 0
PIES: *1te (POD); Yellow (Tam ED; Pink (Appli®nt)
MAHOSEPAC
e A pig I P
cr.
Ne
Septic Tank Service
Kennicut Hill Road
MAHOPAC, NEW YORK 10541
628-4526 Joseph A. Mantovi
PIr
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BRUCE R. FOLEY, R.S.
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
G PROPOSED ADDITION APPLICATIOyN) - (RESIDENTIAL ONLY )
STREET: ,J 6 �'`R;�, , - TOWN V TX MAP #
NAME:_ TfiCO3Sc71% PHONE X101 �I l 9I PCHD PERMIT #' ?7 ,
MAILING ADDRESS 1 Et OC. S% L414rvg- %fit; °,t)g7e1 -
t c
Description of Addition X IV 40 77ov �VQ A!Vj7- 1oxj/R_ ilr¢;4_*V6'XSi57-1AI-
Pt�72oc+�"�,
Number of existing bedrooms Proposed number. of bedrooms. 5�
from Certificate of Occupancy or
Certification from Building Inspector
Any addition which is considered a bedroom requires formal approval of plans
(Construction Permit) prepared by_a_Professional.Engineer or Registered Architect
in accordance with applicable sections of the Putnam County Sanitary Code.
Please submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT,
4 GENEVA ROAD, BREWSTER, NY 10509, Phone 278 -6130 with the following information.
,:.,�.--- �......:... _ i_.. Ce!'t.i.fiPd.Chark. for- ��10n..:00:... ,_---•._•.: :��..::::r- :�,;.��.;�'.;`��_:. _ ":_`.�::�:.._ �:._:.�:...-. _._:..:_�....
'2 ." SKetcn'or" ex i `stli ng* fl oor plan (01' living area including basement , if any)
Non - professional drawing is acceptable.
3. Sketch of proposed floor plan.
_.Non professional drawing is acceptable.
4.: Copy of survey showing well and septic location, to the best of your
- knowledge. Include date of installation if known.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. .Copy of Certificate of Occupancy from Town or Certification from Building
Department of legal bedroom count of dwelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
November 26,1997
DEPARTMENT OF HEALTH
Division Of .Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Jacobson
16 Roachdale Rd
Putnam Valley, N.Y.
Dear Mr. Jacobson:
Acting Public Health Director
Re: Addition -. Jacobson
16 Roachdale RD.
No increase in number of bedrooms
(T) Putnam Valley Tax # 74.1 -5 -9
I have received and reviewed the plans for the proposed addition to the
above mentioned residence.
The proposal for the addition has been approved as per plans bearing the
latest revision date of November 26,1997 and this Department's approval
stamp.
Based on the.information submitted, the above mentioned addition is.approved
�i! to the. £o -11oT aing cond.ittc;._^.s.
1. The total number of bedrooms must remain at Two without prior approval
by this Department.
2. The area of the existing sewage disposal system, and its expansion area,
must be maintained.
3. All plumbing fixtures must be updated with water saving devices, i.e.,
new low flush toilets, restrictors for shower heads and faucets, etc.
Approval is granted for sewage disposal only. Any other permits or variances
required are the responsibility of the applicant and the jurisdiction of the -
Town of Putnam Valley.
If you have any questions, please contact me at your convenience.
Very fly_ o� urs,
William Hedges
Sr. Public Health Sanitarian
WH /kg
cc:BI (Putnam Valley)
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D ' EPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, ..New York 10509
(914) 278-6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, MY 10509
BRUCE R. FOLEY, R.S.
Acting Public Health .Director
Re: 77� W (3 5
Residenc
Tax Ma 7 L/-. -S-
TovmF07-70/1-m
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS-
IS NOT
in compliance with Town code and the total number of bedrooms on record
is
This information has been obtained from:
'CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER S-1 -T—t Y% 5 -77
Building Insp or
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
• _ _.- r:.x.�:v_.rn:.'•�r -.n e.,•.;T:: _�_.n -:r.+. .s _,..c.... ._- ^i-.- �:?,�ya?s'�,. @'>�:bS;'...e'.. �iO;rx�d�_•' <'at,��rn��. -5'.. r 7�ai=ewR.�c•=�
„
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPME
OFFICIAL USE ONLY
3 0� =-2�
SITE LOCATION A& K o C t� TM# M —
/.
OWNER'S NAME iN� AlZi e G 0 Gi 1`A PHONE
MAILING ADDRESS N.:-1 , ID 5-
QV -- -3&a-0
vo ` i vy- e he,4,
PERSON INTERVIEWED PCHD Complaint #
--Name & Relationship i.e., owner, tenant, etc.)
DATE 2 S— ' TYPE FACILITY
PROPOSED INSTALLE R C,411---
, . PHONE
,Pq (n V S"Ca9 K /j- L-A-KC f2 L
ADDRESS_ ,,n- i4-m j% A- L Lk—v , M -,j _ l o.a:—ZREGISTRATION#
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system .Different location
may require submittal of pro osal from licensed professional engineer or registered architect.
�— 1�'
SIGNA �✓ �dl�i -�� TITLE ��`�� DATE S Z
Proposal annroved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6 diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99ML
DATE
CpG�
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL S'1JFGl'YAlii "'
OFFICIAL USE ONLY
07 Z
SITE LOCATION `t0
.: `Ro Ll�..�,�.(,_f ,...
TM# 7
OWNER'S NAME
N 1Vl.G
rhor +x410
PHONE
MAILING ADDRESS tt�-IY�4-!y_ (/'A I- (-Cy N-,' r no E22
PERSON INTERVIEWED PCHD Complaint # \
ame & Relationship (i.e., owner, tenant, etc.
DATE '712 A, z TYPE FACILITY
PROPOSED STALLER Asc P 6m6cer PHONE 57?
6X#W—A-1y4 Rd
ADDRESS IV- )(, �®S-?f REGISTRATION# PC I
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system .Different location
may require submittal of proposal from licensed professional engineer or registered architect.
o -uzu,
ov���er; o: reported
SIGNATURE l-t�/� -�t'� TITLE �GF-- '•� DA.-7/ n 2� -;L
Proposal approved with the following, conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam..X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposalapproved
Inspector's Signature & Title ATE
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99ML
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRMWIRL HEALTH SEWICES V `
PROPOSAL FOR SEWAGE DISPOSAI, SYSTEM PJRAIR
O5QWS NAME
SITE I=TIOV
PHaUE
TKO '7V•
NAILING ADDRESS ` rJ' - JVAVyl
PERSON INTERVIEWED PCHD Complaint 0
Name & Relationship (ice, owner,tenant, etc.)
DATE fl I )k2 TYPE FACILITY Sy
PROPOSED INSTALLER *LVAP-o 6P- A 6 eaf PHONE 57 2,
REGISTRATION # PC_ t3 T
?o (include sketch locating all adjacent wells).
MWE: Repair must be in same location and of same type as original sewage disposal syst M.
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
�o � � cc. � itc to �v ���- v c.�r� --rya. �li'�� �� p�- R,►zo -z�.s i
Q SpLncz S Hirt N a LU , 7 -Y AV r,;v `) 50 64-c-
L_ _4
J�
.ie.�. - r•-.a v.w..- ..,,,.ss.�...e. �-- '..r..-- .v.�...v.•.+.•ar �...�...•w._...._. :�.... �.. .�.y.... �. .. ®... .... �,. ......_.......�r.ns- v...`�..�.. s.�.._.tv+.�.....- ..+e.. ... _ .pw
Proposal approved �4 Proposal Disapproved
r000sal amroved with the following conditions°
to Procurement -of any Town permit, if applicable.
20 Submission -of as built repair sketch in duplicate showing:
ao Owner's name.
bo Site Street Name, Town and Tax leap number.
c. Location of installed components tied to two fixed points
do System description (e.g., 1250 gal. concrete septic tank,
drywells surrounded by one foot ¢ gravel).
eo Installer °s name and number.
Ate
(eogo,house corners)
three precast 61 diem. x 61 deep
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or reported agent of owner agree to the above conditions.
SIGNATURE �` TITIaE DATE 1 13
Ss 6bite MD),- g(eUm (Toil ED; Ptak (k#ioant)
'n R r hf30 -Irnsid
Located
'77 -
777—
3.,Axt6m�-.J6 0 pe
ra A
�Sheildoh,-Gara
separate'Sewerage System
buiilt" by
00-0 'septic Tank
ung of G
—fits';
Water :supply.' Public Supply-,From:.
"x I rive t
e, u ppjI y ;Dulled
A d
S e
ddres
-�
- n- i .
. T j-"- -
pe ^' ' Punch
Yes
Has 'Erosion Control Been -Completed
I certify - t hat the Jiyst bm(sj.as.listed ser`v?in,-,g
the
above :premises ,were consti
attached), an Ifna c irda nee with ihd stindbrds, rule s an d regula.
i o r
S
Ma 28 1974
'Date' Certified:
,
Address Northridge:
14 isis served by the ab'bve.'syst6 M,( s),sfiaII`,pr6r
qpn.ptions,resulting from. such. usage �j-,..,Appr.oj A
he -separaxe,sewe
iva6ble: and -,the':Ppprioval o . f'-.ihe privat&,watei supply ihali'
.'—.subject Ao-.'modification or change when n the judgment; of the `� C
;67>Date '
0
DEPARTMENTOF'HEALTH
foalth Carmql, �Y. :105.12
-,n7.
Town or Village
Section 5 Block 2
Job
Address Stevenson'
-Peekskill,, NY
lineal width trench
T : other l l s
0'- ft fro own n r her ye
t"W0,11- d r i 114r e;
It%
Bedrooms
z,
f th
acted essentially as shown ton M t e 9
aN�.'fklecl and'Ahe'p
si er: of - I ea It th s
is. R
W rS*p ies of which are
ty q,!Wment of Health.
42 •
POE, X R.A.
27846
W
40 7
e1nqceAary' #-Vrrbcfi`dn of any unsanitary
may tie to� 0
ndlijfid• V6id -as,soon as a public' sanitary sewer becomes
supply becomes available. Such approvals are
.g:
K.reV64-ion; modification, or change is necessary.
Title
'o, Y
_ 0
SAMPLI,NG' OINT-
BACTERI XPER ML-..(A4c[t bldte'ddunt COLIFORM. ARDNES
.p6bdble'No-.-/1-00rfil
DETERGENTS -"'0* NITRATES (as�N) ppm i '-IRON, TOTAL
FLO,
AH-�,P.ADOvANI
T.
in
394
'ICAU'LABORA
WAS-
0
P O -'Bok�
. 2
, , 6
TE.�ECTED�-,
EXAMINATION ,
OWNER D
DATE R E CEIVED,
J.
V-4 174
OFD
su- 5M D
DATE-REPORTED"'
_ 0
SAMPLI,NG' OINT-
BACTERI XPER ML-..(A4c[t bldte'ddunt COLIFORM. ARDNES
.p6bdble'No-.-/1-00rfil
DETERGENTS -"'0* NITRATES (as�N) ppm i '-IRON, TOTAL
FLO,
AH-�,P.ADOvANI
T.
in
FLO,
AH-�,P.ADOvANI
T.
in
3 Arrows Ce stive S e e tT me. 1°"ezkt ya7leyo . (T)
Owner or Purchaser of building Municipality.
.,.; :s::ia,. P,y i - .; ..c.e�.+c`"'.,•.'. a.,. a: 'i"..i. ..- r ..�.�%�. _ .a. ..y`�' • _ lr:,w .- .%..i.;.- .:.,,;,;w,.e^r.:- eJ:v w• � ,v .. �yt�Lq�'o. . s-� a. wr%•c ~ rz• : •.� c•.: � er ,. w o '"Y.�..:+.:a':.::
Mame Andooistes c�7
Building Constructed by Section r
ftt of Rodwe3.g Road �
Location - Street Block
• .. P.s�nsh .
Building Type
't of .2
Lot
GUARANTY OF SEPARATE SEWAGE SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it has been constructed as shown on
the approved plan or approved amendment thereto, and in accordance with the standards',
rules and regulations of the Putnam County Department of Health, and hereby guaranty
to the owner, his successors, heirs or assigns, to'place in good.operating condition.,
any part of said system constructed by me which fails to operate for a period of two
years immediately following the date of initial use of the sewage disposal system; or
any repairs made by me to such system, except where the failure to operate properly
is caused by the willful or negligent act of the occupant.'of the building utilizing
'F}n crc4 -..m
The undersigned further agrees to accept as conclusive the determination
of the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful.. or'
r. r.eQ.l.a.gent ac of the occupant of the. buildi_nG 1_1t— J1.i.7ing the
system'..
Dated this 29 day of 19 Signature . �•-
a
Title
Li: rporation, g' a m� and address)
�1,�Q �, '- �--r�z mot;
---------------------------------------- - - - - -- ------------ - - - - -- - - -- -. -���-
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL .PLANS BEFORE CERTIFICATE.
OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTIft OF DATE OF FIRST USE OF SYSTEM.
'.Division of Environmental Health Services, Putnam County Department of Health,
• II
8
W6LLI COMPLETION REPORT
3/71
PUTNAM COUNTY DEPARTMENT OF HEALTH..
Division of Environmental Health Services
COUNTY OFFICE BUILDING - CARMEL, NEW YORK
w . This report is...t�3�b, pleb s- r --and-sub �r1'�I" $�"_'ft a:%n i oa I].I�Aat!a� � �At ��Sa� �� +far• 1za ��
" `naisis of Water sample Inrcating Water Is o satis'actory bacterial quality before certificate of construction compliance is issued.
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
OWNER
NAME
Mr. Greenfield # 1
ADDRESS
LOCATION
OF WELL
(No. a Street) (Town) (Lot Number)
Camp Three Arrows
PROPOSED
USE OF
WELL
BUSINESS
DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
❑ SUPPLY F] INDUSTRIAL ❑ CONDITIONING ❑ ((SSpe ify)
DRILLING
EQUIPMENT
COMPRESSED CABLE OTHER
❑ ROTARY ® AIR PERCUSSION ❑ PERCUSSION ❑ (Specify)
CASING
DETAILS
LENGTH (feet)
15t
DIAMETER (inches)
6"
WEIGHT PER FOOT
15
® THREADED ❑,WELDED
ULVE SH O E
LIJ YES El NO
WAS CASING
EYES
nUTED?
NO
YIELD
TEST
HOURS G.P.M.
❑ BAILED ❑ PUMPED ® COMPRESSED AIR 7¢ 3
YIELD (Q.P.M.)
3
WATER
LEVEL
MEASURE FROM LAND SURFACE—STATIC (Sp&cityfeet)
DURING YIELD TEST i
[feet)
Depth of Completed Well
in feet below Land surface: 3951
SCREEN
DETAILS
MAKE
LENGTH OPEN TO AQUIFER (feet)'
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
PACKED:
Diameter of well including
gravel pack (inches):
GRAVEL SIZE (Inches) FROM (lest) TO (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION.
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET to FEET
if
5'
hardpan
5'
395'
bedrock- granite
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE WELL COMPLETED
3/11/74
DATE OF REPORT
I WE ILLER,(S�Ignat e)
TRjU(
Tg
'2
New York
z
A,
ision
Job
31 SclUarq Feet
FeetTX T:
width' •tr 6nO,
V.pnson-
i OS Arej
'sp ta
-0
e$se &disposal -syAtem,.,.
the muinlarn
ibr o_ m •-df Healthwill:
i -ns, Pri 'id builder will
i `med in itale, , of it'e issu-,
ille -Ilescribed, above,
lies :a u ati e Putnam
2746
,T' W 'OV
:2784
e,,bujlOipqhas been unddirtaken :and-is
change a eratloh of construction
"91
DIIIUT-T�-."
07
�77
-TC
D a t t e August 279 1973
Re: F r o p e
L o c a Tt e d- a t
C -,; 68 BI o c 1,- 2 T 0 -port of 4
G a n IC; 1 er" :
John S. Romeo
Thl i s lettleir IS to va-at"Ol'i-
e� dul%r I i tee._ E 4EL x
S eC a a:;.e
...Jib~ a- C -3n 5 1- c
n f a
ZL
s 2,
147, iJ d'-acation La7l.-I i c e 1J Lcmrj an'3. th e u t- n sa n C n v a 1
tary Code.
Very truly yours,
Address U
I I T in't, 'I �"n
71' v INC
P..E., R.A. L 27846
RO
1 Nortbridge-Road )0 ON,
eal
Address
Peekskill 0.=
.9. NoY. 10566 0
0, 0
0 2786
0
737 = 1056 ° ®9�i Of �E�i �� ° ° ®: .
000 0 0
�. ' �6 (-) -"/-,
ep nc n e
A.
Notes : 1). fists to• be;reat; at same depth until approximately equal .soil,
rates are o taihed- at-- ��:cn,..- :p.Q�colation test .hole. All data to be submitted
-for re, iew.
Depth measurements to t" n•,ade from top of hole.
`y
FUTFU%M C01PITY DEPARTMENT OF 111,:ALTIi
DIVISION OF ENVIRONP47DITAL 1ILALTH SERVICES
>.;���•..... -::: �<:- �..+.::; �- fail lti��' �01<` n' 3�• 3�1�1�- t�l�` r����:' r�i��: z'"' �:": i^ �. �� '.��'�:";:.�:�:�.= „::�::;:a:;� ;�.. � .,:��'.;:.;;'
r
DESIGN
DATA STMT- SEPARATE SEWAGE DISPOSAL SYSTEM FILL 110. ”
Owner 3
Arrows Coop. Society, Inc, Address ' Barger Streets Putnmm Valley, N.Y.
'Located
at ( Street )act of Rochdale Rd. See. 68. • .Block '2 . Lot . • . 4" (Port)
n. lca -e _neares ...cross s tree T.
Municipality. Putnam Valley Watershed Peekskill
SOIL. PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Idle
Number
CLOCK TI ?12- PERCOLATION PERCOLATION—
him
Elapse Depth to va er Wa t e r ,ve
No.
.:Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
(1) 1•
could not get good readings as. hole was d ug to rock. From appearances of soil,
2
a rate of approximately5 to 10 minutes would be aptained in this type of soil
(2) 1
Same as above
(3) 1
n e as above .
r•
3
•HI�e]N �0.1-d3n
f A.i.Ninoo' NVNind
433
Notes : 1). fists to• be;reat; at same depth until approximately equal .soil,
rates are o taihed- at-- ��:cn,..- :p.Q�colation test .hole. All data to be submitted
-for re, iew.
Depth measurements to t" n•,ade from top of hole.
`y
6.11
1211
1-811
2411
361f
421'
4811
5411
60".
'6611
7211
811"
I E ST PIT REQUIRED QUIRED T BE 0 SU13MITT M WITH APPLICATION
T
SOTI -.1TE'REJ) T1\1 TEST HOLES
DE IPTION 01" � _Z ETICCUP
_01- -1-MT-T-1 I r
stones
INDICATE LEVEM AT W]UCH GROUND WATER IS ENCOUNTERED None
L'T A R71`E J, 3 -R -M
TTUMJI r1_-JT, G7�_ENC% 7F
i,*T! R12I.FiS BETN , :2
.TESTS: MADE BY John S. Romeo
Date August 27, 1973
DESIGN
Soil Rate Used.. Min/1"Drop: S. De Usable Area Provided. 5000 SF to be fille
No. of Bedrooms 3 Septic. Tank Capacity 90.0 Gals. Ty pe Mas
Absorption Area Provided By L.F.x2411 width trencl?
er. 0
apptox 51,to be'brought in and settled prior to tests edng,-rm 0
R.O.B. Gravel to Its Fyn
d by MAI# Dept
a=o
Vat.ne Signature All =0
0
Address 1 flortbridge Road SEAL AUOO
46 0
Beekskill, H_Y_ -105,66 0
00 MEN 0000
0000010
THIS SPACE FOR USE BY HEALTH DE PA RTM M,1 T ONLY:
SCALE: 1"=10'
-
f -11AL LOG�T /dNS it waf
At- 3rt' n w i
AZ. 4 ?' 2._ 14
•f.
NC -0 SQ. FT
Aµ* 3.7' S4> 58'
A5 44`
O TrS C i
AS -50 22'
t {lam
Aso -46`
. F,
/Ol0
SeP �� s„�H�;� IUO '—A
�ro srrS sys�r.m�. 10114
' on s-. a{ aq�
pa rt
4 g
�o� IIS x I C�tJi4�.iX11 ?', �yi;
APPROVED
Well,
;f JUN 3974
`
-� �J Su ru
LW
1 DIVISION T X'- 7 �I NEALT* WYMMI.
,
') SEPTIC SYSTEM;
BEDROOM HOUSE FOR
DESIGNED & SUPERVISED BY n q� T
.3 AeeowrJ COOPEPl� I
SoiLS RATE _-
,. 1