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HomeMy WebLinkAbout0220DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.18 -1 -28 BOX 3 1 all al r I T T `fl ` 111 •, PUTNAM . COUNT P RTMENT OF °:HEALTH r . r Division of Environmental.He Services, .'Carmel, N. Y. = 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM' ^�-- Town,. or Village Located at 5�,� �[. �9 Section Ilfl ' �r Block •' ° OwnerLL9�i iXa9C Lot 7 Job Separate .Sewerage System /built by p �,, �9 Address Consisting of f . ;bai. sceptic Tank -fire linea_ l Feet X width' itrench Other requirements Water Supply: — %-Public Supply From L/sLCSLr ��f —qtr Private, Supply Doled By Address Building Type -�� No. of Bedrooms Date Permit' Issued Has Erosion Control Been Completed? Mica& 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'sfandards, rule ;,and regulations; plans filed', and the permit issued by the County .Department-of Health.. Date Certified b P.L. R.A. • Address License NO. 6 a. �� Any, person occupying. premises' served. by ttie above system(s) shall, promptly, take such action as may be necessary`to secure the correction ,of,any unsanitary= conditions 'resulting from such usage. 'Approval of the separate sewerage system shall become null and void as.soon as. a public sanitary sewer ;becomes' available and the approval of the private water•supply shall become null And void when a public waterr supply" becomes available. Such "approvals are subject to modification or change when, in the judgment of the Commissioner of Health,:such r vocation, modification or.change.is necessary. 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