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HomeMy WebLinkAbout0030DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 1 -1 -40 BOX 1 ' IN Nir IN IN 1.1 IN 301111 1 T 00030 a x ?' PUT1 N COUNTY DEPARTMENT 01 HEALTH 1 ` Division ,of . Environmental Health Se�wces Car`me! N ` Y 1Q512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Pd',tteY'S.On f(. # Town or village, Route --292 }ti ocated' at Section c { k � Blo (� s Subdrv�s�on �t % _ s Lotf n 1Job Od1 332 Owner k� °Mr &fMY` Joseph °�Wdnflel'��fingh \.f %Ye�t0�.• AtlCr'essRoute Ex i stfi5n9 tiF �n Building Type Lot Area z = r Q } t A. .1 Number of BedroomsA� +tl�n ltdel l'ng '3 <BR ?Ex4stn Total Habitable Space 6�'2' Adu�4t��n Square Feet t _ _ 1'000* 20`8 6_ inch _r Separate Sewerdge.,5ystein' to consist of Gal Septic Tank lineal feet. X width trench,:. .To be constructed by Address s s Water Supply Public Supply From c � 7 �x�fiSt�ng `r �i F'� fx-. -� ,. a �'•''� r Prwate Supply to be drtilled by -�' 3 ' �• 'r, T _ f Cry - - i `'� ; •{ x s �" q rc x'' m .: 4a3 s�; ".yu ,#i.,x cu'rta fi n5 pray n'S 1 °50 (x 5 s;Dee b- e:v ,ous Cont�^acto:r* Y' 4= ��.:_ Other. Requirements p d Fi11 Section: 7360 °S .fit. 30" Aep (`►ry''taut Tj�enches -'`)m pum" Pity &Pum��ExSt$in(�`Fie1<d for: over` o 11 represent thata ;am ;;wholly aridcoPnpletely responsiblb'for,th� design ;and focatron; of,.the,_pro�osed,system(s),2) that •the_sep3rate, sewage disposalsystem 'above described Will.be constructed; • PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Re: Property of Located at Section Gentlemen: Date 'Z2 Block Lot This letter is to authorize �oCih i7 • ���`,�is5 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 witn tnis matter and to.supervise the construction of said system or systems in conformity with the provisions of Article 145 or 1.47, Education Law, the Public Health Law, and the Putnam County Sani- Lary Code. Very truly you , Signed ounter ign 00 Address R.A. # 2T,106 -R. D. 6, Dox 353 T lephone Address Carmel, SAY 10512 914-878-6170 Telephone F G 2920' ry�FTkE STOO,