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BOX 29
03633
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03633
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Separate Sewerage System -�t{0 6ontist .qf Ga! Septic Tank lineal feet- X width• trench . ,
1 O y P /'/ / X� Address .�/�y /y,
To• be constructed by �,— R �F�' +---� H en -r--�" t"
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Water Supply ; ply From
Private Supply:. toy be drilled by -Al
Address Y f
Other Requirements
1 represent that l am wholly and eomple "e i ntlantl location of the proposed. systems) 1) that the. separate sewage disposal system
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above descritied,wiii be; constructed as;s appro,• ent there to and in'8ccordancgvyItn the standards rules:an regulations o " t
e u nam"
County Department of.:? Health; and itificate- of Construction Compliance.. satisfactory to,the CommissI ner,of Heatfhwit.,
be'su6mitted to the.,D,epartment ;a° �' it g „, eglw I� t rni3hed tha. owner `hi succes "sots hei[s or assigns by the builder,'that said builder `will.
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place good opera ;ing condition ' ya rt a „ gE disp system during the period of "two (2) years immediately. following the date of tfie issu=
to
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ante, of • the,.approvai:,:of the Certif' te, f C (t;lGS npl� nc of .the g�nal system or any,repairs;t ereto 2) that'the,dr:illed: well.d'escribed ; abote'
will be located -as shown.ori the appro dt n a. E 'i)i�ll wUpe �hstalled ,in accordance h'the sta` aids rules and `regulations of the :`FUtnamr
t County Department of 'Health
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Date C,C' �Vp 2' 2 �' . P E - `y
k 'Address. r' ✓�ii.: /t".." ;.�a- /l_iCenseNO.o�- / ,0�"•
APPRAPPROVED FOR CONSTRUCTION: This appr o ar froPn the date issued. unless ,construction 'of". Ihe'building has been undertaken 'a --..is
revoc' ' _,
able for-.cause or 'may be amenQed or modifie considered n ry `by:' lth, Any' change or- alterati �of�constructi un
C -requires a new.t+ermit Approved for disposal,o oaaeStiC sanitary sew g and p nr to vizier supply
Date ``_ ! BY• '. Titl
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2452645 �\ Jr
Telephone
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Notes:
1) Tests to be repeated at same depth until approximately equal soil rates are ob-
tained-at each percolation test hole. All data to be submitted for review.
2) Depth measurements to be made from top of hole
DEPTH
HOLE NO
.HOLE .NO.
- HOLE:;NO . Q�
G: L
o P o tL
ops� rL�:r°
6'T
4
12
. 2 4T'
A.
3 0'T
(n
" 361?
A .
42t?
A.
481'
JA
5 4"
6 0T'
a
66 TT ..
�
78rT
8 4rT / ti
INDICATE LEVEL AT WHICH GROUND WATER IS "ENCOUNTEREDa l-
INDICATE LEVEL TO WHICH ATER LEVEL.RISES AFTER.BEING ENCOUNTERED
TESTS MADE BY ��„�o� Date
DESIGN
Soil Rate Used Min/1" Drop: S:D..Usable Area Provided
No. of Bedrooms Septic Tank. Capacity ` °O Gals. Type//e,C3
Absorption Area .Provided. By .A.36 L. F.x24" 36TT I,' ridth tren ch.; Other
Name STANLEY I LANDER @�
Address BOX 267
PUTNAM COUNTY DEPARTMENT OF HEALT
\�,� �,—Iofc No... 32? .�_
�o So il Rate Aeoroved Su. Ft. /Gal': - ked'
Date
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y
54
Q 0I
SURVEYED & PREPARED BY
BUNNEY ASSOCIATES
ENGINEERS & SURVEYORS
20 WOODSBRIDGE ROAD..
KATONAH. NEW YORK-10536
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"All ccri,ifi,-A-tioas het con are vatic, for the map and mpivs
-11*f if Said m-p If copies hear the iznpr�,,e,l
weal of the smveyor svituse signature appea,'i hvrw>;."
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c5VR�12�1 0117 PWIDZI97111 /rUArE /,4/
roOWAI 49,= AVrA1,44#1 041.4eY
4'
. A,sting C.Qja Of Pr.ctice far Land
burveys .,uupled by the Newyork slate
Afiloddf?9n pf P.,afe.,slonal Land Surveyom-
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+ f G E N B.R A.L N -,0 T `S
1. All r�egUifement -s and constru.ciis
y f details shall meet the requi.remarcts
f of the Division, of Environmental
Sanitation :Dept. of hea' tb of" the
F., County of Putnam.
. yam..... ,
2. House.:'sewer 'shall be, "cast ir<
set on: a grace of 1/4 inch per. foof
t 'rye J i watertight and root proof
W. 3 Provide 4" approved rion aetlli<
i pipe °:or equal to <.'jubd.ti6' bo es 'wit
I ( slows es reQuireil to meet, field
{ % �J /.'onAbsorpfon fields shall consist
i }. . r���x F.{j� r' zdt ' r�' of. 4" open Jo'ih 4r peTferafed
i umin us 'im reg ated fiber pipe
laid on a. de of 1y26"
P
` if per foot i
i { , t'dshed gravel or-crushed stone. of
i r: Sao urri form size Q'/1+11 to 21/2 ") , . T^
a -11. be laid in, 13" ,o.f stone so
a 5 ; that its invert 'shall 'be 6" from ti
` r. bottom, of the trench. !>over river
gravel -shall be ,rn minimum to '1511. .
3 maximum: a minimum gdvc 'shall d
,_. used. wherever 'posse ble'.-
t 5..3,s�osa1 fields shall bF 36 ". wit
and of ihe; lergtF stawn on .th'e F7ai
6. For details of septic tarn,,
distribut.16n•'tox and' ji:nction box,
see County Standards.
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All trees in field area and
{ 8 tnurin� herons sral "1 h, remover'
a `
i g;�,ny construction, 'keep
i heavy oads off field area,
. -- Leader and footing drains '/Host
discharge, away f_*om septic fields..
10: -Well :log ana i , ter analysis
f j - must be submitted tp Healtt; Dept.
�� ; •ref <r.,.,.� i before Gertificat'e of Construction
will be issued.
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