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HomeMy WebLinkAbout0242DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 5A-2 BOX 3 17-2 il?", ., 1 i -, - �F ;1 �1. �a ,. L6 ` , .� r �r �J. : , i ILL I 00051 " ` P TNAM COUNTY DEPARTMENT 'UF` 4HE`ALTH,X d r Division ,of fEnwronmenia/ Health Services Carme/ N iY 1Q512 °`''t .. ' �.� C_O,NSTRUC LION PERMI,,. FOR SEWAGE. 'DISPOSAL, SYSTEM TEdpSo l/ ;j Town ,or VAIlage Located at �� �L L t n0� Section Block 5 Subdivision 0/ r owner �M�S N.�NNlG�Yitl _ r j�j Addre s -- 6'fiRN�1,KD�, 8/4EcS7 Building Type Area 3 Number. .of Bedrooms _ . •.:�� _ ` r " ' x T t a t + e �SOO e g - i o of H b� ab,le Spac Square Feet tY Separate',Sewerage'System ' to consist of �9bo —Gal Septic Tank', , ° lineal feet "�Xf 3 * -' width trench To °be constructed by Address } 2W5ter Supply public ! UPPly V§Fr a '7 r Private ;SuPPIy ,to be drilled by w •F. ' ' Address t: a VV Y Other Regwrements s r 4 t 4 et 4T 4 �,t v I ;kepresent, that l am wholly and completely respon ;able for the design antl location of, =.the proposed systems) T, that, the separate Sewage Aisposel system..' `atiove described •will be'.coiistructed as shown on the approved amendment there to'and;in accordance with,itheystandardsrrules and'xegulatrons�o t _ e ,u.narn_ r County Oepartmeht of Health, andsthat o`n complgtion thereof a ',Gertrfica "te" of C9nstruction,Compliance satisfactory to the .Commis"s_ione:'o"f`'Healthwill - h _ be submitted to the Department, and a •wr�tten,guarantee` will be.,furmshetl. the owner ,his successors heirs'or assigns by the'aiuilder,„ that said'builder,':wll place m- good operating' condition, any part of mitl sewage disposal system, dunng: the period of two (2) years immediately- following, the date of the issu- ance of the approval rof, l 16 battif,icate of- Construction Compliance of the original system ,or any repairs thereto 2)';that the drill "ed!well descf gybed atiove' will be located asshown on ,the approved plan and that sa�tl well w,ll t e'�nstalle 1, in _rdance with the' -- standards, rules- and :,iegula l� of : ,t6e P,utnairi County Department of Health r 7 f r . , Date .^ _. _ _ s Si9ne �n ✓; P:E - 'IR A t � -Address-- HPPROVE'D rovaxrs one FORT s year from the dame issued unless construction of the.build�ng: has been undertaken and:.is; _revocably a -for caU`se_ or may bejarrierid4 ed of %modifiedwwhen considered necpssary�by the Commissioner of Health: Aoy ;etiange or alteration of` construction requires a'mew permit Approved. for disposal of do��} wage; a ter supply only A._��.� F Y <?��..'.. *'�'Fy $..M t`I.Y. „_.�,z.� _ i. .4•' STD. �., `� . •r..i�"�, s; {..t._ . a ,t .. .: ,a, x:..+w. �.:a ...._ .... ws. w,«v,.:.v..- .v.: «......- ,y...... 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P7-COL. „ P : ? n_/� ,._F�. -n P " ; .___yD OJT , 4 a Ppr,ICATTON SOIL uule Nu:�er CLO F ^I_ - PF,.CG? ' i- ` P E R C 0 L. ' ;`;; No . Fire Fro-. ro,rd . _- _ _� : ., _.. Inc:._ Soil ° _ _ 5�2�� ��0� ,�. Star= Sto7 Drop i Inc I- ? c'-.-' Ir.c'.es - -- - - -- 4 - — -- —_ S — I�1Q 3 - -- S - - - -- - - - - -_ ____ _ - -- ------ -_ —__- _ _ — -- - l_ - 2 4 - - 5 - -- - - — - NoiD s : 1) 1•e.s _s to be repealed at sa -e dsp th, u7- ` l a- -0_.c :_ - -ate _ eq•�al soil ra t e s __re oj- ained a� e `h o�rcol__iior. test ho' in `11�dE __ �o �e�su� -._ =d nor rzE ie.. . TEST PIT DATA REQLID u ,0 I� 5�3;iITTED rTH APPLICATIO\ DESCRIPTION OF SOILS, L..,:\1 J_o.E D I _ =S1 T HOLD DEPTH HOLE \0. ,H0Ls \0. HOLE \0. G.L. 6<< 1217 18t1 2 4;. 3.6'. 42 43 54` 6 0' 66" _ 75.. 84.7.- - - - - -- D LEVEL AT t'-�IC r GRO 1 D Tv;�.TER IS EtiCOT'\'"JP„ I`_•IC .iE LEVEL v: INDICATE L•= i'�I, TO Tti'{ICc( Tr:1TE: J��t L RI. =S AFTER SEI \G E \COU`tTC R D TESTS uAnE pv L •_ A4AEL Date Soil F,=! c DTs. °�.— ,1�1,i_:`ilr /1.' D_' �. � S.D. — No. o� Sa:�oc -s ^_Septic Tank Ca, =__ty_ Gals. Type Absorption � . ;rca t'rorided EY_2eo L.F.Y2': 35.'T- _u:idth trench. Other Name -22 •Qs Si - a � ire Address .may �CE,�.c �F: _ SE4L G��n,EL .rte y PUT`ANI COUNTY DE PART-�r:\T OF HE`.LTy Soil Rate Approve` Sq. Ft. /Gal. Checked Date For —4-4 �y RTMENT OF--H. ALTI { V11 YORK EPA _ g ;NEE S TAT. { Division of Laboratories and Research • .. -. O Mechanical Sand Analysis •�o SAMPIE Na SA� 1446 x.36 Tyr Acr,or.rir q,,ouxr vccacun ftETF_.yCO mill. PAS`�iNG So � N0.8 t.3a...... N0, IZ 1.68 n1�. N C9 W 1p- We 0! 1,{0 t0 0.84 No. YI Q 1:0.50 OLM..w• I In �c� i _,� 140.60 QIS.... 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