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Home My WebLink About4493DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.19 -1 -26 BOX 34 III IN III I.tiL . ; . i IN �` 1 : I r 6 ,,s 1, ,. ` 1 71 + 1 L c4le_ r wne or Purchaser o Building Municipa ity 'Nu-ilding Construct6-d by g-ec on L-o—cati6n, - Street Block BuIlding Type Lot GUARANTY OF SEPARATE SE14AGE 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 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 occu- pant of the building utilizing the system. The._undersigned further agrees to accept as conclusive the do- termination of 'the Director of the Division of Environmental Health.Ser- vices 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 negligent act of the occupant of the bi4il4ing utilloing the system ii t_ed- this �dgy -off; y T . 19 .. Signature Titles ' corporation, give name and address) ,f - - - - - - - - - - - - - - - - - - - - - -. .. - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH ThnE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REaUIREP TO EILF NOW CF, QF RM OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - -• - - - - - - - - - - - - - - •- Division of Environmental Health Servioes, Putnam County Department of Health MTNAN M".-IT M-T-ART�M�:T OF M-ArMV 'T. DTVTSTnN nr 7� Re: Property c Located at Date Section Block Lot Gentlemen: This letter is to authorize i"duly. licensed professional engineer or registered architec� (Indicate) to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance= vith-th6 standards, rules or regulations as prori-,ulacated by the Commissioner of th Putnam County C.13 e '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,_tbe- -Pub Heq3-ht, d- - h e- Putrdff7County S an tary Code. Count rrol'A P.E.9 !&Zrls Aaaress QUO A, 'lot Yg Telephorie 9 Very truly yours,, Signed X01 afiner of Property 01 41- z Address k-e Telephone 1� 04Aer or Purchaser of Building Municipality Building Constructed by Location - S/treet / Building Type '/'7V Section Block 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 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 :Wade 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- vi�ces:.•of: the. - Putnain -Cq. y. Department - HE a"1 -fin.. as. to;,;wh�t.het =o "r nof: fYie -: " failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the sys ,m. Dated this / day of G2 199d Signature 1 Title 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 Department of Health PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUTIDING,• CARMEZ N- Y"` DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �/jir� a!�'��; 15iddre s s Located at ( Street / /�� /� Sec. AXV Block Lot 12- �indlcate nearer cross street) Municipality e Watershed SOIL PERCOLATION TEST DATA REQ'fJIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water- a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches. Inches Inches C � l 1 12,/a ��• 2 � � � �% f _'i 2_ /i-1 - 2. 3 ;� 112 4/ /?-/ �; Z 2-V ?-,/ I / Z_ 3 4 5 1 2 5 Notes: 1) Tots 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 o.- -DEPTH" HOLE -NO *.�" - "---" v G.L. 42 6'f 1211 1811 2411 3011 3611 4211 4811 5411 6011 6611 72111 7811 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WBI.CH11,WATE&LEVEL RISES AFTER BEING ENCOUNTERED -TES TS -AAb.9,, SYV� DESIGN Soil Rate Used Min/l"Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity )OoC2 Gals. TYPO Absorption Area Provided BY-131 L.F.x24" �" wid th Trench. Other ure Address -,--�ZtAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Cal. Checked by or- N +0 20') ..... o. Edite Il m on v A� 3. ,312 zj-- Al Z--O GALLON SEPTIC TANK 3 40 LF X 2-VA13S. TRENCH IN of 6 d — 0 r 30 zro A PIPROVEC T: - C��> M 2- o' -0 SAC /2v 3/o S_ /c, 4' 2 AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEM '4'l 1 12 YORK DATE I SCALWs -Y)y,7 I JOB NO.Ze> P H� F -SULLIVAN - TM*M P,r--• CONSULTING ENGINEERS v c7 -V-j< TO WN 14 a . •t . __ 1 I 1 A' n� t. a AGE, ESTABLISH ELEVATION HOUSE TO PROVIDE DRAIN 40f LOWEST FIKIUNt, TO SEPTICOTANK AND FIELDS ...... AREA RESERVED FOR SEWAGE DISPOSAL', t SYSTEM TO REMAIN UN DISTURBED .ALL CONSTRUCTION TCjCONFORM TO STATE y.a • r � AND LOCAL STANDARDS AND REGULATIONS .........�� r. . l,�:�. -- - - -- °'� `r •� � moo! --- ._3s I y -s _ \ \, V - r �/ Lot i r 't � Q . r, ' VS I � � > F• a y� v 1 s. �� ' -1„-•_ „,.,._. ,_ _. — / / / 1..' 1y \� a �� •� 11 v / Ike I Nl, q ---- -- /'L.9 /✓ PIChNAM COUNTY pEi r... OF. HEALTH s ,Sc c PROPOSED .t) 1 f SEPARATE. SEWAGE DISPOSAL I: SYSTEM PL A /✓ CG. e 'All n. 4 "s fir. � ScG1`•orr / N�,� o� d v /2 TOW�OF_'w rinfv °°-'1 �)COUNTY. NEW. YORK DATE SCALE rjx JOB so. mar 6 ti'N G SULLIVAN - TVFPiPk 2 . IN/IN /�i`4 GALLON SEPTIC:TANK CONSULTING / ENGI{�JEERS • SOIL PERCOLATION RATE .... . , / J, �,s �,�%�' ,,/I/. DEEP TEST .. /y'a ��, c% •.3'¢O LF 1�ABS. TRENCH � 1 , �d Carr "•.. -'lyr �✓ er ..... : Vii.. .. .�.. ._ `sx., ,l TC y G Jrpa r/ -r a , —e C4 rr� •, W� r q y!�cc%rcrsfr, F /IlU U Q QL 13 ,p Al 't GALLON SEPTIC TANK ,g �40 LF X�A BS. TRENCH IN V s ' k' 9� a i! A(JP OVE ' MAY 8 190 atn ntntt% i'" � DIVISION N '(t'4vpe Pr .� 21 ti I i K0 30— -? / ! U, 5e c / z CJ 3/0 CA, 'S- dc, Z / 2 AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEM d, - ✓ -G. 5cc�ioy, / /� P anff Lod /2 TOWN OF 1/ l/ COUNTY. NEW YORK DATE," ) ,i7 SCAL 5 w JOB NO. 74> � ,3-6.5 >° PH F. SULMAN - TWIME P,P rnN4111 TING FNGINFFRS 4' i Ia i� I m: Q � R e - 2 s ' k' 9� a i! A(JP OVE ' MAY 8 190 atn ntntt% i'" � DIVISION N '(t'4vpe Pr .� 21 ti I i K0 30— -? / ! U, 5e c / z CJ 3/0 CA, 'S- dc, Z / 2 AS CONSTRUCTED SEPARATE SEWAGE DISPOSAL SYSTEM d, - ✓ -G. 5cc�ioy, / /� P anff Lod /2 TOWN OF 1/ l/ COUNTY. NEW YORK DATE," ) ,i7 SCAL 5 w JOB NO. 74> � ,3-6.5 >° PH F. SULMAN - TWIME P,P rnN4111 TING FNGINFFRS