The URL can be used to link to this page

Home My WebLink About4498DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.19 -1 -32 BOX 34 tiL , ills ■ * L ra o� IN ti.,.:k�. 1.6 t 0 1 2 j A`' , r'UTNI AM Division of E, CONSTRUCTION PERMIT FOR, SEWAGE C; r7 7 Subdivision ✓ -' / /, Building Type Number of Bedrooms Design Flow Separate Sewerage System to consist of _ To be constructed by Water Supply: Public Supply Fro - ��..... ��. •. ..,,,4fc 9 :: '.' ......�r i a ..uya.. ,.r. � -. .. '. ?;rN^, f K1��.. :;'P .. LW DEPARTMENT OF HEALTH Permit a ta/ Health Services, Carmel, N. Y. 10512. L SYSTEM /�07 711�pCf , 4:7 / a, /� Town or village r - .. _._.. �.. 1 ._r.�.1T 3..•Rn�h,, s. ��"t� :; - -Block � .-� �;7 "' . 7vt .,�G. .._ . ii 'i'•° ._.. / I SUM. Lot # 7 fir. �� r'�• if Area Renewal _ ❑ - Revision _ ❑ a� Date Of Previous Approval Fill Section Only ❑ P.C. H. D. Notification Required 1 y Gal. Septic Tank and -3 �P /j , r-,r4 / �! 2-�4,ox, j A-r .5.'a v'i.si C? Address Private Supply tc a drilled by Address / Other Requirements v�9/ I represent that 1 am wholly and complet � responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal. system above described will be constructed as shcZn on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam County Department of Health, and thf on completion thereof a "Certificate of,Construc ' ce" satisfactory to the Commissioner of Healthwill be submitted to the ,Department, ands written guarantee will be furnished the owner. s *elUdjll or assigns by the builder, that said builder will Place in good operating condition an/ part of said sewage disposal system during (o esdwp ( s immediately following the date of the issu- ance of the approval of the Certificae of Construction Compliance of the originejn� Eeeo3jts� to; 2) that the drilled well described above will t located as shown on the approvvG plan and that said well will be installed in a rd iii th theJ�iidard rules and regu a suns of the Putnam County Departure t of He Ith. j J �; Date 3l/ signed P. E. ZR.A. Address i 'off � � License No. APPROVED FOR CONSTRUCTION: his approval expires one year row the date s urn s `o Puc>abQ� the building has been undertaken and Is revocable for cause or may be ame ed or modified suns dared necessary by the � s neYnofpbfb�f�y° Any change anon of construction requires a new permit. A roved for disposal of dome c sa sew e, and /or p atg . HpR► . Date t 1— t�-- ,, a� s By Title Rev. 9 -81 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, I`Iarmel, N. Y. 10512 Permit # I CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or Village Tax Map Block ✓ Tax Map Lot #� Subd. Lot #� Separate Sewerage System built by %Y� Address Consisting of Aw U Gal. Septic Tank and Other requirements r Water Supply: Public Supply From 5 d' ' /✓ f 4'.i i i .a rJ s/�� `gy Private Supply Drilled By _ Address % G Building Type '�" No.-of Bedrooms Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. r � Date Gs' /', C tifletl P.E. R.A. Address f / License No. X N $iii Any person occupying premises served by the bove systems) shall promptly take such action as be necessary to secure the correction of any unsanitary conditions resulting from such usage. Ap roval of the separate sewerage system shall become null and void a n as a public unitary sewer becomes available and the approval of the private water supply shall become null and vo when a public water supp ecomas available. Such approvals are subject to modification or change when, in the judgment of the Commis ner f Health, wch_�oeatlo Iflution or change is- �ry. Date °�,��-� -5 BY -�� /l► Y' r /%��[I - Tit - PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Re: Property of Located at (T) .1e, Date 0P iWA - e' Section / Block Lot Subdivision of je�L �p/j u° /�d�? 2� Subdv. Lot # � Filed Map # /X� 70 Date Ale -/YOW Gentlemen: This letter is to authorize 75 'o,� 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 connection with this matter and to supervise the construction of said system° or systems in 'co1Iform:ity w3_t�x ='the. provi sioiaa` of A�tici�; 1 .S..or:_ .,,, 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersien P. E. , ..F� -rr: , # Eo � go � o 7 Address Oslo menu %'a Telephone Very truly yours, Signed Owner of Property Address Town Telephone i Owner or Purchaser o Tu_il ding Section Bull.ding4 Constructed by. Location - Street Lot 41757 Municipality Subdivision Name Building Type Subdv. Lot # GD'ARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and complete& 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 guarantee to the owner, his success- ors, 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 determin- ation of the Director of.the Division of Environmental Health Services ^.; .., -of,. the Putnam .County. D.epa-r- -tment of Health ae- to whether, or, not -the, fail- _ ure of the system to operate was caused by the willful or negligent 'act of the occupant of the building utilizing the system. Dated this day of 5le'y1C 19,;F� Signature_: :vY\ ",, Titlee�. Corp ration Name if Corp. 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 �IW 0-A". /Yt 07 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISI61 QF ENVIRONMENTAL HEALTH SERVICES' COUNTY OFFICE BUILDING. CARMEL V. Y. 410512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. j/ Owner,p/`, JJ Addressi Located at ( Street ��f � e- Sec. 42 Block '' Lot indicate nearen cross street) Municipality. ��ct Watershed SOIL PERCOLATION TEST DATA "REC D TO BE SUBMITTED WITH APPLICATIONS Hole _ Number CLOCK TIME PERCOLATION PERCOLATION.. Elapse p- h 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 J 4 5 Notes: 1) Tests to be repeated at same depth until approximately 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 APPLIGATION DESCRIPTION OF .SOILS ENCOUNTERED IN TEST HOLES_ DEPTH HOLE NO. % ~ HOLE` NO. HOLE NO.— G.L.ix�2 /��''� /. . 6" 12" 18" 2411 - 66" 72" 78" 8411 INDICATE LEVEL AT WHICH GROUND WATER -IS ENCOUNTERED AA7* e_- -- - -- ` 'VEi -' 0 WELfCI .WATER- F'v- RISES..AFTETi;£sFZN r ENC.Qt?N`i'ER :: TESTS MADE BY yv,� Date DESIGN.. Soil Rate Used .2— Min/1 "Drop: S.D. Usable Area Provided '-5—dy No. of Bedrooms �Septic Tank Capacity% -� Gals. Type Absorption Area Provided Bygd of L.F. x24" width trench. tether Name _ e FQ v ow Address ., THIS SPACE'FOR USE BY .HEALTH DEF'ARTMENZ Soil Rate Approved Sq. Ft /Gal. 9 E� s aeemeo. ,Q%. .. ONLY: Checked b Date �l 42' 13 A2 9' 4 ftftm GOOD* Dwaftwt ar amits olvisica at Health 8"', -iP*Md as'6oted for conformanoe with Rules Regulations of the CZ, zlll� I ycl 7z ZZ J.- 4 ftftm GOOD* Dwaftwt ar amits olvisica at Health 8"', -iP*Md as'6oted for conformanoe with Rules Regulations of the CZ, zlll� I ycl 7z ZZ ov C4 4 4