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04303
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i4' "6UNT-Y-�--�DEP�A�,RTMENT.�,,'OF-,.,zIlEAfL-TH
"VE- bhmentitlfeqlt��,s�,
DIW"SI-04Z. 0 :' .
0512 II
CERTIFICATE' OF CONSTRUCTION
COMP LIA NCE FOR' "SEWAGE ' f$006kL o SYSTEM
Towri or, Village
-4/
j
koc
Located
I S00-y'"
Tax k'
Owner Tax Map Lot # Subd
7
7 77
71
Separate - 0 a
- �Systern' h,-Ilt by -Y r
I-, of which. are 'attached),," and
nA
—f-
.6cordamcd with the filed and the permit t issued by'the
-P.
of
V
License Wo J27
07
In, aSnlaYDa necessary tosecuiri the corieciidn, of any, unsanitary
Mimi
, 'r"ull-i.rd vold
,as400n as a
public sanitary'sekeri. , becomes
,
puillC at 4! ply bicomOs available iuCh":ipprovals are
such revo o, 'modification or' -change Isnpceslary
.
Y'. i
it
` x JC ��l V tb1�A
I�l _., Y •r Y
Orvfsion of ::Ent
PE6iMI FQ�63 .SE�lIAGE,DBSF
bdivision '' is
iilding Lot
Type Area
y.,
imber of`Bedrooms � Design .Flow �0�
parate - 'Seweraye'System` ?to consist of
R T
i be constructed by �• a �'�� `
iter Supply Public Supply , F,rom
Address
Other Requirements 7
I •represent that I am wholly and�completeI responsible
above descrnbed will be constructed as shown'on the app
uaie _ t
a Address p�u
APPROVED FOR rGONSTRUCTION_ This approval expire
revocable for cause or may _be amended or modified when c
requires a `new permd P1 proved %for disposal of. domed
Date �� By
Services, Caeme% A% 4 Y .10512 -
f
a. ®:�. cv.
4To or Ulage
,� ... k � t rT . r *• � j ca.,
Tax Map - Block
Lot a .Job $ x
OO '�� _ r9
Address
Total Habitable Space Square Feet 4
Q
e - i1
trc Tank'- and � �` •2 -
Address�t
r
�o the proposed systems) 1) that ahe sepa ►ate :sewage disposal. system
in accorCance wifh the standards, rules an regu a -ions
ruction Compliance satisfactory to the Commissioner of Health will
r his successors'hevsor,Assigns'by the.tiu�lder that said.`bwlder'will
�du a period of two (2) years immediately following the date •of the lssu
orig na stem or any repairs there 2) that the,_dr�lled well described above '
in ante withz t standar ,rules ,and regula i�OnS of the 'Putnam s
r
License
date issued unless construction :of the; bwlding_ has been„ undertaken and;:is
by the;Comm'is r of Health: Any change; o.r alteration of , construction
and /or rvate:' at . °supply
Title C i
RITNAM Cr 1117ArMf
r' DTVTSTnN Cr. P \A71P\O..-iF TAT, IfFALT11 S1-.1?VTCr.S
��. :.ix- °V V.''•a - .M...- :.•i- .--v,� ya.n�w- .w'4.4.,.�.y liar �._y°pi�r. •e si. :..w to . •Y w". 1 -. •e.
Date • 7-21-7G
.
Re: Property of
Located at i�Sl�G� f7;JL t o y'ij;r1® / ;►ry°a+/ F�� / tr�1�M1..1
T A-;x T?4p .
xtan Block ! Lot
Gentlemen:
This letter is to authorize STAN
a duly licensed professional engineer L-° 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
connection with this matter and to supervise the construction of said
system or'systems in conformity with the provisions of Article 14S.or
147, Education Law, the Public Health Law, and the Putnam County Sani-
v
Countersigned:
Very truly yours,
Signed
vner of Property/.
i 0
Address
P.E. .., TM
Address ' n' ' - W', I U
BOX 267
v j AW I_
10501
Telcp}ione
,I ( /�- q.
THE NEW YORK BOgRD
OF FIRE !JN �FpWRiTE:,js
BUREAU OF ELECTRICITY
85 JOHN STREET
NEW YORK, N. Y. 10038
t, T1 �.
I
6 1 12
�Ay % a 19 l9
pUTNR� VC
OOUN
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEY�Vve_zha EPARATE SEWAGE DISPOSAL SYSTEM FILE NO...
Owner >1c �?M Address RD'&i 64, _ZD
Located at (Street� aetvN/��/�- l (9 Block Lot
hM-e nearest cross s ree )'
Muni cipalitYTOW 0' ! V'WAH )Aj_,L6!( Watershed Sic �.�- / L���a.° [520�►cm
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole,
Number CLOCK TIME PERCOLATION PERCOLATION
Elapse Depth to a er Wate__r_1Fv7e7
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop. Drop in Min. /in drop
Inches Inches Inches
1
10-o51 is 2(0 21 d� 11211
4
5
• o°
4
2
3
4
Notes: 'l) Tuts to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. A11 data tope 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
DEPTH HOLE NO.
G.L. �pPi
Of 54.00 Y � 90 A 1:1
12"
18"
24"
30„ a
36„
42"
4811
5411
60"
..
HOLE NO. 4
fa- I> j L oAM
HOLE NO Pr_- 6P
Ax t!
41
4
w
6 C-L
A
72" G1
8411
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ®`4�
INDICATE LEVEL TO WHICH WAT R LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY Date 7 �
DESIGN
Soil Rate Used-1:5 Min/1 "Drop: S.D. Usable Area Provided,dam``
No. of Bedrooms - Septic Tank Capacity logo Gals. Type tee' 1 raj<•
Absorption Area Pro ded By 334 L.F.x24" �-,, width trench.
Address
novi69uvu -m-0 j u v0 00
THIS SPACE FOR USE BY HEALTH DEF
Soil Rate Approved Sq.
2°,
by Date
o_
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