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HomeMy WebLinkAbout0211DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.15 -1 -13 BOX 3 00020 ti J L {' 11 ' �'� T IkQ I No I f Td' rl .L . .. m I ;I 00020 PUTNAM COUNTY s * 'D/V/S1 if, 6f Environments/ CONSTRUCTION PERMIT -FOR SEWAGE - .:DISPOSAL SYST Located at B`� rCh ;H I I .I -Rd ' Subdivision - - Owner At711[ R.- -t,FOSter Building Type Frame Lot Area' I 38': Number of Bedrooms Three -;: I, Separate Sewerage System` '-to consist of 1000 Gal r ` To be °constructed by z h' Water Supply Public Supply From ' EPrwate Supply to be drilled by t Address- ' Other Requirements None I represent that f am wholly. and completely responsible for the design an above described will be constructed,a's shown on the approved amendmen t County' Department of - Health,'ind- -that on cornpletion thereof a �'Cert be submitted to the Department; and. a', written guarantee :will be,fur place in good operating. - condition any -part of sal sewage disposal a.nce of the approval of the Certificate of ' Constructwn. Compliance will be located as shown onrtheap roved' -Ian and'thafiiid well-Will 'be.in i C_ ounty - Department of Health 9 Q t D I X74`' DEPARTMENT ,OF HEALT Healtih Services,, ;Carme% N Y ;1Q51 r Tax Mai 0 Lot` •08. 'Atldress A Patterson Total Habitable Space Septic Tank 230 lineal f a � R A'dd"ress tl location of 'the proposed system(s); 1) t there. to .and in accordance with•the "stanch ificate of= Construction Compiiance -satisf Wished the owner, his successors hens or a S dunng` the period of two (2)'years l of the or�g�nal system. or any repans theret stalled accordance' with the.�stand64V i s Date C O elf Signed ` :� f f + Add'r "ess 6 O 353 x " APPROVED FOR' CONSTRUCTION This approval expires one year from the date issued unless constructio revocable for cause or may - be a'rriended of modified-,when considered. necessary by -the Commissioner. of Heal requires a" new,!permit Approved for disposal of, domestic nrtary sewage; and /or' private water "supply A% ` BY Z_ i 0 Patterson Town= oK Village 5 - .Block -02 Job ' S0151 Rcl N1^ 12563 1- -1.96 Square Feet eet x' 36 finch width trench '. that the' separate sewage disposal, systerri rtls, rules.an regu a ions.o e u nam actory,to - the Commissioner of. Health will ssrgrisrby. the .- b'uilder, that saidrbuilderwill ' mmetliateiy following :the date of the issu 0 2) =that the' drilled well 'described. above rules and regulations of ,the Putnam a•� P E V License No0S ' the burldig has been undertaken grid rs ' Any change =or alteration; of constructidn c Tit le - '2� ,a 11 "g e !6/ /1 3a'.f . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL, SYSTEM FILE NO. Owner Axe,,., Address Located at (Street) 7n/ �p Block p� Lot 48 dica e neares cross s re Municipality IS 79evy-009 Watershed CAC -6®,., SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole 5 Number CLOCK TIME PERCOLATION 1 PERCOLATION Run Elapse p o a er Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Mini. /in drop Inches Inches Inches ® 1 D470/ '2 2 /1- � �•/ rn rN 5 Notes: 1) Tuts to be repeated at same depttl until approximately equal soil . rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. 5 1 �.: rn rN 5 Notes: 1) Tuts to be repeated at same depttl until approximately equal soil . rates are obtained at each percolation test hole. A11 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 DEPTH HOLE NO. G.L. 6" 12" 18" 24" 30" 36" 42" 48" 5411 6o" 66" 72' 78" 84" INDICATE LEVEE KT-V=H GRO77ND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTE TESTS MADE BY /� dj�,o Date �jo - //% LLJ1lr1V Soil Rate Used_j/-/Miri/1 1tDrop: S.D. Usable Area Provided No. of Bedrooms /e Septic Tank Capacity ZM Gals. Type' ®®yy�0 Absorption Area Provided By j&0 L.F.x24" 5b d/ width trench. Other lva,mtj �' Y-xnEn-r - =T� bigna Address RfV-i, s THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: c 4 0 Soil Rate Approved Sq. Ft /Cal. Chec y +! Date ��op EHE SSN, 1' ' � .�S y 4Gp. �tj'jG/, �V �.? G't+.ON �i�7X � �Lbi`•'7+�rt'�(L':'i�2.. i�'."LAk4%S 5