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PUTN -AM" dUNT-.'�,-�-..1),EPARTM,ENT'-.OF.-�HE-AL--TH-�,,-�"-",
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I Health Services ; Division �` E
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CONSTRUCT, I b N- R IT:
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Town. at?%mwk, 7
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ax map, Block
Subdivision
Shop
owner Ah Address r
Efh b' ew.- 61-
IpAt: 6 a iy-
Buildino Type 8. -at. - - . .
A rea',": 0-01 .2-�` re's
I f �ri4.,,J.,
h s Design Flow Square
Total 'Habita.t�le _.Space .Feet
0.
a 'AA
ierwIll-
eia _ 46 ..SAterh._,,j 4 0, 1 F
Separate . W2, "t d trenches ot' selected
_x
To Abe . constructed by n
a -A
vater-.Sdoply: .: Public. ,Supply, . From
* Private Supply cis- e lecte
-be, drilled
oa
Address, 4* .
0 t 14 ner equ remen ts
dornplet6lyf f
asig n-,p ion osid t6 t6�L: Sew al",
I represent that I am-,wholly and responsible i-f�r-fhe diii sew sp..
to and �:Wiccoeda standards rules_
above dqscrij1bpd,,,wiI! be constructed ions. of
-�D' ' 't-ment of Health, an -thatz�,on-,�cpmpi��i,on:,�p,�r.gqf. 4 "'Per e,'L,$ r
County epjr! .1 s act
Certificate'
d- 11iiiiiihed :the heirs or,as 6� u
A61-the L Dep�� signs
ten egu,ar4nteg:,wiII,:64 e
_men,
place 'in �good,oper-aiini-,'��dnditioln any_ part -'of said iWi4e 'disposaf'.system. during ,th ri imm cliately.fol e, issu
of the - -6�itificAt6,df--Constru�:ti6ri-,',to' drill
::anc4 ipproval of .the Certificate Tpliprice o - .�that the scribed above
_ijne . _ .- , I
'sta nda <ru!eI - ' �L�Putna
Will be located as shdiiin on the appr',6'veid-p6 will be InstalledAn. acc da ;ce", ith s _and rec ulatioRs.-- V"lhe" j M
nty yep
September 2 &t, 1976 F d , R • 'A"
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Box 41 °7
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t (5 6�a ft
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Apo RPYEPFCRL -CONSTRUCTION: T a e xpqes _qne y- e ' r
0__ ` iSi-- ziid -m Ugj�S$.C% 0
construction
the
u ildin
nde'rt'ak 6n ,and
is
revocable for,cause or may be modified W he n considered re i�n c eijarV - by, Ah the -Co";' 'H I h Py" h er n of co rist ruct i6 n -
it
disposal :of, dome ic!
r ires a new; perms' '!,Approved, 0!, or- nrivatp'
Date 8 .? �.q
A Me
-1
y
4
p". PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
4 . - 'CWNrfY OFFICE '13UIQhT6, -CA L-9 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner Mr. & Mrs. Hans StaegerAddress 2 Sunrise Drive, RD #4, Mahopac, N.Y
Located at (Street Shopis Drive Sec. Block Lot
6dicate nearest cross street)
Municipality. Town of Putnam Val 1 ey Watershed Croton
TM65 -1 -22
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run Elapse DepEh.to Water Wate—FIEWel
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
1. 1 8:30 -9:06 23 26 3 36/3 =12
2 9:07 -9:42 23 26 3 36/3 =12
3 9:43 -10:19 23 26 3 36/3 =12
4
5
2. i
8:35 -9:11
24
27
3
36/3 =12
.24 .
_._ ..27 __
3... _..._
.. -36% 3 =1.2 _ :...:..._ . ,.
4
5
Notes: 1) Te'�ts to be repeated at same depth until approximatelyy equal soil
rates are obtained 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 SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
b
DEPTH HOLE NO. 1 HOLE NO. 2
HOLE NO. 3
G.L. p To Soil Top $oil_
Top
- Soi r
6" Sand & Clay Sand & Clay
Sand & Clay
12"
If
3611 It 11
"
42"
48"
5 4 It
6o
6611
If
7211
781
8411
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
none encountered
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED not applicable
TESTS MADE BY Joel Greenberg
Date September 23, 1976
DESIGN
- Soil Rate Used i 1- 151,1in/1 "Drop: S'. D. Usable
Area Provided . 500 S. F.
No. of Bedrooms 3 Septic Tank Capacity. 1000
Gals. Type Pre -Cast Concrete
Absorption Area Provided By 400 L.F.x2V X '-.
.
width tre ch.
Other
Name Joel Lawrence Greenberg Signature.,
Address Box 417 S
\ �?�.ENCE
ti
Deer Park-Plaza
ov
Katonah, New York
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. It/Cal. Checked b
�0. 0110,60
of NS44
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