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HomeMy WebLinkAbout3607DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.10 -1 -27 BOX 28 ir J, I Ir �L rJ r I 1-- ■ r I 03607 Divi_s�on of En onmenia s , CERTIF_,ICATE O.F 1CONSTR,UCTJON COMPLIANCE FOR l A5J,1 17^41 i v i '' rCifL i7' iepsrate Sewerage System builtFby ��� Consisting ofs �' ®� OaI `Septic. Tank„andt Other ` 0uliements + ,;', a 7 �5 '�+ ;Private,9upP,ly [)ri118d r8 "y4 - ;Atldiess { a :9uilding ,Type'.B,�j Has Erosion Control Baen�Completedt c`ertify that' tine system (s) as listed serving ,thd abov'ek,i of which are; atteched),,, and in accordance with the atanda� 'PUtnam'County Department Of [lea3th,' }� 3 S Address I i ♦ 5 l `J h J � 1 DEPARTMENT "bF' HEAD /elq /t/i Services, < Carm% N Y 0512 permit e ' f �_ ¢� . EWAO DISPOSAL_ SYSTEM N C. " Town or V {Il�agye' 'Tax Ma P /_l'R"iJ -� Block ,L.Pr Tax Map Lot:. N' Subd ;Lot' tl . _i`�!✓4-W { z l uuh''M'511 No of Bedrooms Data Permit Issued; F y ' - O ti Pte: s ire constructed essentially aa-ahown on the „plena of`the completed work ( copies and regulations yin accordance with the ffied� plan .and the permit issued by the t A P.E •R A. It ,�� License No .n U M � , ' nptly�taks aiq may?be necessary to iecure the correctlon :of any ,untanlYary ragesystem` shall beco ` Il:antl voldtis soon as a' pu6lict uriitery sewer: becomes I'andvoldyvvhepwa p Iic at supply becomes avillable. Such approves aret Is oner of�Heslth,, ch ocat{ modifiatfon or ehinge Is 'necessary d S Title CC Y � 1 as ,•7 Y '�w Date 3 z 1 Y '? Rev, 9 =81"_ I i ♦ 5 l `J h J � 1 DEPARTMENT "bF' HEAD /elq /t/i Services, < Carm% N Y 0512 permit e ' f �_ ¢� . EWAO DISPOSAL_ SYSTEM N C. " Town or V {Il�agye' 'Tax Ma P /_l'R"iJ -� Block ,L.Pr Tax Map Lot:. N' Subd ;Lot' tl . _i`�!✓4-W { z l uuh''M'511 No of Bedrooms Data Permit Issued; F y ' - O ti Pte: s ire constructed essentially aa-ahown on the „plena of`the completed work ( copies and regulations yin accordance with the ffied� plan .and the permit issued by the t A P.E •R A. It ,�� License No .n U M � , ' nptly�taks aiq may?be necessary to iecure the correctlon :of any ,untanlYary ragesystem` shall beco ` Il:antl voldtis soon as a' pu6lict uriitery sewer: becomes I'andvoldyvvhepwa p Iic at supply becomes avillable. Such approves aret Is oner of�Heslth,, ch ocat{ modifiatfon or ehinge Is 'necessary d S Title CC Y � 1 as ,•7 Y '�w r� C ri f .C.n� *. -r ' •��r.Y4ry. �. .j �. ��� 4 �i ! 1 ., Z.y r . .... -�.v ..Y �.'�'.. .a „T n • _ .. Ai'r• -J � V�1 i VKr<- r Owner or urc aser o Bui ding Municipality Building Constructed by ? -0�_� 6'�VQL Location - Street Building Type F, Section Block VDL 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 succes- sors, heirs or as.signs, 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 occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of. Environmental Health Ser- _._.:,__iees -of.� sh���Put��am• County:- Dcprtme <<�t- Heltrr�as-= to_:w�Yiebhr• or not�tr�c _- failure of the system to operate was caused by the will 1 nt act of the occupant of the building utilizing the s stem. i. Dated this day of 19a Signatur Title ., (rIf- corporation, give . narie t� and address) - - - - - - - - - - - - - - - - ... - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Depa q OV 3) 0 1983 PUTNAM COUNTY DEPT, OF HEALTH IVAR1 Unn.mr-UIUAL LADURh1Uf11 Orlr. P.O. Box 99 321 Kear Street" LOCATIONS: 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 2453203 Yorktown Heights, N.Y. 10598 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10560 737.8777 24.5.3203 4 666-3335 :_ ....,. ,;•; KN,.r� y17SQO+h1i 1:, )0.5 Z.�I;. LAB 4� _ nr DATE TAKEN. ' DATE RECEIVED: DATE REPORTED:-41'��� SAMPLE SOURCE: Ale REFERRED By, 2y COLLECTED BY: S•< /L/ / /, ISOAJ LABORATORY REPORT mg /L 0 ACIDITY ........:.......... ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ❑ ANTIMONY. ................................ ............................... BACTERIA, TOTAL /mL ........ ..................... ❑ ARSENIC ................................... ............................... 0 BOA, 5 DAY ................... ............................... ❑ BARIUM ....................................... ............................... ❑ BROMIDE .................. ............................... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE .............................. ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ............................................... ❑ BORON ........................................ ...............:............... ❑ CHLORINE .................. ............................... ❑CADMIUM .................................... ............................... C-`: COD ........................... ............................... 13 CALCIUM .................................... ............................... L" COLOR ...................................................... ❑ CHROMIUM (tot.) ............................ ............................... ❑ CYANIDE ................... ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ c4f ERGENT, ANIONIC .............................. O COBALT .................................... ............................... ❑ FLUORIDE ................................................... ❑ COPPER .................................... ............................... , ❑ HARDNESS .......... ...... ❑ COLD ............. .... .............. .... ............................... ❑ MPN COLIFORM COUNT/ 100 ml ❑ IRON .................... ....... . . .....,.r.�............... ... .... ....... �I MFT COLIFORM COUNT/ 100 ml 0 .............. I.O LEAD ........................................ ............................... ❑ CONFIRMATORY TEST. ... ......... ❑ LITHIUM ............. ................. ............ .: 0 NITROvEN.A7JMONIA ::......:...:...... :.: — 0 MAGNESIUM - .......... ..... .......................................... . ...: ❑ NITROGEN, KJELOAHL ........................ .I....... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ... ............................... ' ❑ MERCURY ..............:.................. ............................... ONITROGEN, ORGANIC ... ........... ..................... ❑ NICKEL ........................................ ............................... .00008 ....................... ............................... ❑ PALLADIUM ................................ ............................... OOIL & GREASE ............... ............................... ❑ POTASSIUM ................................................................. ❑ PH . ..........................'. ............:.................. ❑ RHODIUM ..................................... ............................... ❑PHENOL ....................... ............................... 0 SELENIUM . ...:................................ ............................... ❑ PHOSPHATE (ortho) ....... ............................... ❑ SILICON .................................:.. ........................:...... . ❑ PHOSPHATE (condensed) ... ............................... ❑ SILVER ❑ PHOSPHATE (total) ....... ............................... 0 SODIUM ........................................ ....... ........:................ • ❑ SOLIDS, SETTLEABLE, mt /L .............. ....... ❑ TIN ................................................. .� der ❑ SOLIDS, SUSPENDED .. .r .....:....................... ❑ SOLIDS. DISSOLVED ... ............................... ❑ .................. ............................... ............................... ' O SOLIDS. TOTAL .........................:..... ❑ .......:...... ............................... ....... jj ��jjp••�� ❑ SOLIDS. VOLATILE ....... ............................... ❑ REMARKS:............ ............................... .�JOV..3. ..1,18J 0 °PECIFIC CONDUCTANCE .............................. i.. ........................................................ 'ULFATE ................... ............................... ❑ ....................... ...... ©�i p AinTY ❑ SULFIDE. .................... ............................... ❑ ........................... ............................ ....... 1.REALTH 0 SULFITE .................... ............................... ❑ ..................................................... ............................... ❑SURFACTANTS ............ ....•.......................... 0.................................................... ............................... ❑ TURBIDIT .. . ....... ............................... ❑ .............. .............. ............................ ... - .. ........ THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY MIEN THE SAMPLE 14AS COLLECTED, THESE RESULTS INDICATE THAT,T11E WATER DI MEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & RECULATIONS,.DRINKINC 1J TER STANDARDS (PART 72) FOR THE PARAMETERS TESTED. /� ®✓ / � . ���� AT RFRT 11 PATV11 /ANIT 1.1 T (Arrl)N nTPrrTOR ,/ ��irvL�/!.I/ T PU �M OWrT OF TN. .VALLEY W;,'-LL DRILLERS LOG ArTD REPORT • k WELL DOCATION _ street section block lot WELL OWNER WELL DRILL name I Kzndo address Oaddress c city or town . WATER BEVEL SCE610 DETAILS _ Measure from land surface Statiq: �ft, :Make When Bailed. Slot. or Pumped ft Len th -Ft . ,ize Diameter` 'Ino —_ -- )TAL DEPTH OF WELL o�li�% Feet. ; Depth From ' Give description of formation penetrated, such as: peat, Ground Surface °Silt, sand'. gravel, clay, hardpan., shale, sandstone, granite, etc® Include size of gravel(diameter and sand fine,` medium, course), color of. material,, structure: (Loose, packed, cemented4._• oft,.. hard)- o_(Ex. _Oft. to 27 ft- -:fine ackeu• cli-6wa7 -d- L; �r J � .��:�: �, i -t 3 'ee t -to eet-�- - Forma-tion-- -Descri tion - Sketch-- exactlocation -of --- well _i -� , , ^.Q If , / I , I at _least two permenant Landmarks Date Weil Completed �� s %�� Date of Report Well Driller .�•-�� signature EC HV Pd 0 V 3 01993 PUTNAM COUNTY Fes; DEPT. OF HEALTH feet or Pumped Di.ameter.° G �r IncYies- Yield : /0- GPM I Kzndo address Oaddress c city or town . WATER BEVEL SCE610 DETAILS _ Measure from land surface Statiq: �ft, :Make When Bailed. Slot. or Pumped ft Len th -Ft . ,ize Diameter` 'Ino —_ -- )TAL DEPTH OF WELL o�li�% Feet. ; Depth From ' Give description of formation penetrated, such as: peat, Ground Surface °Silt, sand'. gravel, clay, hardpan., shale, sandstone, granite, etc® Include size of gravel(diameter and sand fine,` medium, course), color of. material,, structure: (Loose, packed, cemented4._• oft,.. hard)- o_(Ex. _Oft. to 27 ft- -:fine ackeu• cli-6wa7 -d- L; �r J � .��:�: �, i -t 3 'ee t -to eet-�- - Forma-tion-- -Descri tion - Sketch-- exactlocation -of --- well _i -� , , ^.Q If , / I , I at _least two permenant Landmarks Date Weil Completed �� s %�� Date of Report Well Driller .�•-�� signature EC HV Pd 0 V 3 01993 PUTNAM COUNTY Fes; DEPT. OF HEALTH 1 ,4 _3 i W n, < N _y 19A -2-1 co SCALE; 491*-rg : 01 0-of - NEvv 't 0 0- \NT4 F. Z Nece_",� 04251 X ri 7r- ly. 040,j $4r 0 0 Putnam County Department 61 Health Division of'Environmbntal Health Servio4b Uproved as not:.. manc e with -the nplicable. is of 'h 'I Putnam Co-rity Heal U Del)a SignatureVT.Itle ate THIS 1S TO CFiPTIFY'TT.0 THE -SEWAGE DISPOSAL SYSTEM it WAS AND THAT only !Cf-TED THIIS PLAN A S -PE,-70 IT TRIAS COVER - 7 ED ED ovj�R CORDANCE �2- z t ' - Z - r 4_1 C:) C> co W 9: lvs� y 113.01 11q.-1 /20.7' 0' .13!r z.' 6 3 0. ri 7r- ly. 040,j $4r 0 0 Putnam County Department 61 Health Division of'Environmbntal Health Servio4b Uproved as not:.. manc e with -the nplicable. is of 'h 'I Putnam Co-rity Heal U Del)a SignatureVT.Itle ate THIS 1S TO CFiPTIFY'TT.0 THE -SEWAGE DISPOSAL SYSTEM it WAS AND THAT only !Cf-TED THIIS PLAN A S -PE,-70 IT TRIAS COVER - 7 ED ED ovj�R CORDANCE Vi IT , j --'--.-D 011. THE PUTHAIL esO 7 NIL' S's 0 z t ' - Z - r 4_1 C:) C> co W ri -n QT W/ 4 e-,t OW V &Wt.. C, .6 2-F - V74 I/ y PUTNA.M, C 4 _ � i DI*WSI'on of,Envih COMST,RIJCTtON PERMIT 'F;OR SEWM E. UISPO; x Subdivision A Owner, Building Type Number of Bedrooms_ Design ,Flow j'R Separate:Sewerage,Systeni to consist o Tq 'be .constructed by "'� / �AA)4 Water Supply 'Public Supply From x v Rrrvate Supply to; be drUled by' v 4 Address r ��,j,I s Other Requvemen`_ts s f�"' 4 Y_ DEPARTMENT OF HEALTH talHealth Services, Carme% N .K_10 5_12 YSTEM "Town, or Village P ; As a p r fax ;ivlap "Block` Job - Address IlaC -yy. L° Tota4 LHabltable Space • Squ�arep Feet . Gal Septic Tank and W 'Il G/d 'T � � 5 In and location of the proposed sy;tem(s), ,1) that- the separate sewage disposal system meet thereto and:in accordance with the standards,, rules and' regq a Ions o e Putnam. 'Certificate ;�S*rdonstructit n C6� Dance :sa'ftsfactory to the Commissioner of- Health:will hfurntshed theiow er, his successors; heirs or,asstgns,`by the!builderthat said:bullder, will' sal.asystem�tlurtng, the period of �two��(2) years Immediately '.followtng'tihedate�of the •issu ice of the oilg�nal system or anyYepairs thereto, *2)'that the-,drilled well descrJbed above > Mi rds r les and regu a Ions-' of the j IIP utnam l T - �u�� I►from�thedate�,t55ued unless constructi n of thefbuildln9 Nas been:iundertaken and its ces ry by t iCommts; er of H ' ny. change or alteration of construction se a9e'- ors- rrvate �p ly only �' - � x� 'Title ti #Rf ' PUTN AM COUNTY DEPARTMENT ,OF HEALTH Permit a i D.iv "1st n' of Envion ental• Health Services Cannel N. Y 10512 IL (: .Tip. �GL- sts � , CONSTRUCTION P -._MIT FOR. SEWAGE ?DISPOSAL SYSTEM 3 7"A� ji(�Q� D gown ► xvTllage T lricatad, at PjK= �:� r - Tax Map _ Block Lot 'xe�VNUIr .:. iL Cii'T/�R Subd Lot M� }� fob Renewal 3 z,.:- Revision r5ubdivision� n��4 #Owner /AddYesa �•�� ✓���f�N+� //sl%� I�.� + ' �r S Date Of Previous Approval ti. x S/= tl6 T'e 8uildiing Type R`D�/ :' lot Area':- - C Fill Section Only ❑ R it s s Number'of Bedrooms Design slow G /P /D ®O P C A D Notification Required �I SeParafe.'Sewerage System torconsist Of - 9; ®® Gal Septic Tank antl ��� X woe 4�k70RI"J a �! So. be. constructed by A 2�/�� Water Supply. Public Supply From :. —T _ �`F "2 Y ' � s � Private SuPP1Y Ito be drilled Eby 'A�� MAddress r Other, Requirements C ( represent that 'I 'am wholly andjcompletely respons ble'for:fhe design• and loeation of the proposed systems) `.1) that..the •separate 'sewage disposal system above described will be' constructed as shown, on the•approvetl 'amendment there tc and_ in accordance w16' ;i a standards, rules an •regu s ions o e u nam County Qepartment of'"He alth, 'andthat'on completion thereofya "Certificate` of Construction Compliance "'satisfactory to the Commissioner of. Health will C t -be :submitted to the bep5rtment, . and, a written guarantee, will be'. furnishetl. the owner his `successors; heirs.or *assigns by the-builde'r. that, salt' builder will A—— - An good operating_ ,condition any, part` of said sewage disposal system: during he period of two':(2) years immediately following thedete,of the assu- ante .of'the approval of 'the Certificate of, Construction' Compliance of :th•e original,systerri or any: repairs thereto.; 2)3hatthe d ►111ed -well ,described above -14-W l be located as'jshownlon the approved. plan and thot said well``wil64"Installee intac ordan`ce 'with the.? standards, rules and ►eyu a ons ; of the Putnam County - Department of Health a u r•' i/ Date sit. nad' P., E.' A.A. ., Add • E ress z 3gelt r Lfcan_se No r APPROVED FOR *CONSTRUCTIOfV: Thls.approvii expires one yeas' from the date ,Issued' unless co tion 'of ,the building has been undertaken and is - revocable for cause or may be'amended, o► modified when consideredrneces b tfie Com `missione of ealth: Any' change or alteration of construction requires..a new arm - Approved 'for disposal of tlomestI' Bandar. w d /or••;p►i ter was ly pay iris a r_ w4 i Date 91 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL ONMENTAL L H _ r t*_.iru. ., -... ..�.�...va„ .- ...r�:.: "' _ r' ... _. r. . - TC-a•- .- .-- .v.F+aw �, .. .._ - •:1� -�. -- _ .. .. ..... Date �-, 2,4— S- -)' Re: Property of /V i [. Ss®d Located at IOAlLtc DJ, . PU A)A*j _111ACG �=/ Section Block Lot Gentlemen: S vr3 ,o. L- 4112e`L IYI G (. P O�?lC C-07- j�1 �--- This letter is to authorize i /L (_/49-4 a duly licensed professional engineer +� or registered architect (Indicate) to apply for a Construction Permit for a'separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on-my behalf in L:U1111C1: L1V11 wy Lfl LIDS nod L Let' anLi to. supervise the construc ciuil of said system or systems in conformity with the provisions of Article 145 or 1 47, Education Law, the Public Health Law, and the Putnam County Sani Lary Code. Very truly yours, Signed , Owner of Property Countersigned: kA19 W_ es If /__P / 190A111ma Ad 43e, W Telephone Address Telephone Z 7 N\W 1 IZ 0-b 5 1� I 2 &I - ij WW 2 :z "J -4 co CL u 10 ON QC`'Ze , Z Co LU LU ooh 0 u Q, Lu le 02Q� tj 'S 4, z t 11 zo ui W CL Q rjW > C uj L-) Lu. 141 0-b 5 1� I 2 &I - ij WW 2 0-b 5 1� I 2 &I - . ..... .... N TIN LU le d rjW Lu. W tu Way . ..... .... � v •{rrnn': r, :... f/e•1.•r.•.y... e'_.. . ., p. .,�Ma• -.�i: +.vr++.. ?:-. `.rtl.•. .r! ..ti4..'..s ➢...a •T,aa.w. �.li...;r: •y( .. rasawWiKTr �(•�%1-uFYtia iy Q a� •tf ST. ,A S a p� a•.__..._. -__ ._ � .� ... _.� ......�_._ _ .;- .��_.- ,._.NQ ____- _ __ . r.... OCR °� ..- - .. .__ - \� 2° 0 CO CP- m o 9nti a` o rn� ci ZIs 2. I ccA ray D : 0 mm ` zrn3Oy �cD do a2�ar z.° � ✓. � b °rep " 0 0 m OD Z y y� �� '+S � 9� � b Z `Im � m� r` •o L ' 1� 1 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES... COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner(!�CO G6 SO L 6R Address Located at ( Street Sec . Block Lot )Z-- 6dicate neares cross street) Muhicipolity U7-� .G� Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS '"Hole Number CLOCK TIME PERCOLATION PERCOLATION apse 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 5 9; 2 sy 10; ao 30 a :3 3 a z a- 4 �d; sa 1f ; �� 3� a 3 . , : al.� ��. 13,3 5 . Z a z a- 3 10,' d 36 a 3 c?s a 31 4 lo,, SY • ll' 2 30 /0 9 5 3J0, Eb 30 5 Notes: 1) rates are for review 2 Tuts to be repeated at same depth until approximately equal soil obtained at each percolation test hole. All data to be submitted Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. 6" 12" 18" 24" 30•• 3611 42" 48,. - 54.11 .60" 66" 72" 78" 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY liU l L L� i4 /l'/o Z/L �R Date DESIGN, Soil Rate Used Min/l "Drop: S.D. Usable Area Provided J-000 5F No. of Bedrooms Septic Tank Capacity 1)6 Gals. Type E 7�!: Absorption-Area Prov ded 3 S L.F.x24" width tr. Other /LL✓ C _ U/ s Name F, Signature ff 6f4KAQj .k f� Address ` AJ - .Q SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. lit/Cal. Checked by !'SFr ��• 04'0' I PUTNAI.1 COUNTY DEPARTMENT OF - HEALTH • DIVISION OF ENVIRONMENTAL'FIEALTH SERVICES �„ T.T -_. , . _ . _ . _.: � . _- ,_,... -c, -...., _. .... , • -- Date• --�� Re i Property of Located at ., Section Z,q1/P�'� .c P Block, Lot Z--" ,,Gentlemen: J a duly This letter is to authorize 144 ',licensed professional engineer ✓ or registered architect .(Indicate ) 'to apply fora Construction Permit for a separate sewage system; to serve the 'xabove noted property in accordance with the standards, rules or regulations as 'promulagated 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 systsdn or systems in conformity with the pro - 0 { visions of Article 145 or 147, Education Law, the Public Health Law, and the `Putnam County Sanitary Code. Very truly yours . Signed .. u Owner f •Pr petty ' Address � Countersigned: Telephone ' Address 0 ,S ''•:Telephone 4V ? TI'J!JP by 0 11.117 M L S 11"I"'IM"ICT1.0ri Y(" Wo Coirimon N �3,:--Tound- t cor Ua*n- estj.--r itc .1 '10 111; 0 1 o c a tJL o n 0 0 0 tU). drivev.,ay need cut a a 0 0 0 '0 0 0 "Au s be r-move-d-note those Is deep hole r c T) o e n -'U- a t j. v e of cntirc'-SD3 area liddltio.na,l do--T) !-.,olcl- nu-cdod. 3vf'.fJ.cioiit SDS area available consj.derii)� drj-vew" q Cut- se location Sepaation- .,'hou. r distances etc 0 0 .0 a 0 0 0 a a a 0 : Z- 1)opth: I-later eloval tion: 0 111c)ck elevation: 6 3z. SO:'Lls de-scrir,"Gion TKAL SITE IT-ISPECTION.' Date Insp, by: Ouse located i-.,her-- shown on approved plan T)3 lo-atr-d"vhere ap v.- d Pro Lope of ti I e, 1-J n. 6 ay d' t r'-p- -*n'7Fjj- ZI -CC r- p t a '110 Dom allo,vllod for expansion trenches 0 a vc-r. 50 't - from si.,,aiq), watercourse . 0 0 a 3-tural soil. not ,j' or I SD3L area unnecessarily graded )1 0 - 0 0 !` .LPL... irzintai;:--d-fr line.....and.. r0ill LIC)"Iso, 0 a a 0 0 0 ,-paration of trench from house well .etce .follows plan . ...o. a 0 0 wibe.r of bedroci-Is checks o 0 0 0 �Q 0 0: a ;CnQsJ9 brush., Stumps, rubble, etc. greater .tban ft. from nearest trench 0 0 I PL- of pl-riphecral soil. horizanta-'Lly from trench * 0 0 0 a e° 0 0 0 O 0 notion boxes properly set . luld surface run off: from drivev,ay, roads, ground surfzice etc. channel near SM o o area o o . - a a a 0 1 * . •0 := 0 0'' 0 0 0 --s -16t drainac-- anucar O.-K. in area 'of SD 1141, GRADING OF SITE ACCEPTABLE 0 . 0 0 . 4, REVIEU CI'IC,CK SHEET Meets Std. Rer�arlcs es . No DOCW,NTS "•' House plans 0. K. Design data sheet I Peres presoaked? i + Alin. 30" perc test depth I Const . results for 3 runs I V D. Hole log O.K. i - I ' Corporate Affidavit for. other . than individual Authorization for engineer Letter from Water Supply if applicable i If variance requested -such noted on plans & apps.: DETA:IL,S if charge is proposed,) Existing contours shown (show new contours). J Slopes for driveway cuts, etc..shown Water service line location ' Footing- drain, ain, etc ...location I AI 4 + Top slope, bottom slope; of fill ! 0 16 + Percolation tests and deep test pit location i Septic tank size and conformance to std. 3 n .'R. house' minimum + I House setback shown I �,1' �,)t J s, •'art= 'i '� 11 s+„� i1 _ �I ll.�l. ! All Wa LC v wj_- U171J1 50 1-be U1. i "11 6L1UW11 1 ' J Plana ld, profa_`ie' -SDS �_ • , - �J All other wells and SDS closer 200' shown or. reference ?made Property boundaries (,metes and bounds- clearly show �— r SEPARATION DISDUITCES SPECIFIED ON PIX 10' to P. L. 20' to Foundation walls L00' to Nearest well 50' to 'stream,,, march, lake, etc. incl 15' to Curtain drain 10' to water line (pits -20' 15' to storm drain 101.to large trees 1i0'.from foundation to septic tank 5' to pipe from leader drain & fCo ing I .expansion kckQ 0 �[ %AN