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,