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13.-3-62
BOX 5
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rum I,yti ` ,r .ir •�
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' ` �', ' � 111_ ' V■ �
00218
1 My. t
Located at ,
Subdivision
Owner • .. � �` +
Building; Type
Number,: of Bedrooms
'Separate Sewerage Svst
r
PUTNAM COUNTY DEPARTMEOF HEALTH
„ r,
Division ".of Environmental Health Services . Carmel N: K40 5
^ ` •`- Lot :A
r
' Design FloW
ern to consist of
To be constructed by L-'' / 7 F✓� • �E'
SYSTEM ='
Town or.Village''
Tax .Map l� Block
Lot Job
Address
Total Habitable Spa�rc+e,; Square Feet
G /al optic Tank en'd �1 < /•.X,g!•��� LE'Cit -ZDJ'
Address
Water Supply Public 15uPPly From
_PrnrateS;Supply to be drilled by. M
Other ,Requirements',`' - i .1 ':, • .
I represent that I arr wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system
above deschbed will be constructed as shown on fhe`approved amendment there to and in accordance with the - standards, rules an ,regu a wns o e, Putnam
.County ; Department ,of: Health,• and ..that.on'compleiion= thereof'a "Certificate of Construction _Compliance ".satisfactory to_the Comm ssioner,of Healthwill
be submitted to the Department -'and a.wrdten; guarantee will be furnished the owner, his successors heirsor.assigns by tFie builder, that said builder will
place in good operating ;"' ondition any pert of said sewage disposal system during the period of two (2) years Immediately •following the date of the issu-
ante of the a
W pproval•of' the Certificate ;of, Construction .Compliance of ;.the original stem .or any,repairs'thereto;2j that the'ddilled, well described above
will be located'as'shown o'n the approved plan and that said well will tie installed in" rdance 'with.,
with the standards; rules and regulations of „yt66 Putnam
County Department of H alth i
Date /% wry Signed,' P E,R A
VIZ
i
y., , Adtlress ,'y, • icense
%APPROVED, FOR.CONSTRUCTION Th�sapproval,expires one year.'from the date.'issued unless hstruction of the budding has been undertaken and is-
::-
revocatile for cause or may, be amended or modified when considered necessary, _by ,the Commis r �of. Health: Any change or alteration of construction'
requires': a new permit. Approved for di4posaP•of'doniestic sanit e, a vate ater' supply only.
D. 'By. Title
w
Located at ,
Subdivision
Owner • .. � �` +
Building; Type
Number,: of Bedrooms
'Separate Sewerage Svst
r
PUTNAM COUNTY DEPARTMEOF HEALTH
„ r,
Division ".of Environmental Health Services . Carmel N: K40 5
^ ` •`- Lot :A
r
' Design FloW
ern to consist of
To be constructed by L-'' / 7 F✓� • �E'
SYSTEM ='
Town or.Village''
Tax .Map l� Block
Lot Job
Address
Total Habitable Spa�rc+e,; Square Feet
G /al optic Tank en'd �1 < /•.X,g!•��� LE'Cit -ZDJ'
Address
Water Supply Public 15uPPly From
_PrnrateS;Supply to be drilled by. M
Other ,Requirements',`' - i .1 ':, • .
I represent that I arr wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system
above deschbed will be constructed as shown on fhe`approved amendment there to and in accordance with the - standards, rules an ,regu a wns o e, Putnam
.County ; Department ,of: Health,• and ..that.on'compleiion= thereof'a "Certificate of Construction _Compliance ".satisfactory to_the Comm ssioner,of Healthwill
be submitted to the Department -'and a.wrdten; guarantee will be furnished the owner, his successors heirsor.assigns by tFie builder, that said builder will
place in good operating ;"' ondition any pert of said sewage disposal system during the period of two (2) years Immediately •following the date of the issu-
ante of the a
W pproval•of' the Certificate ;of, Construction .Compliance of ;.the original stem .or any,repairs'thereto;2j that the'ddilled, well described above
will be located'as'shown o'n the approved plan and that said well will tie installed in" rdance 'with.,
with the standards; rules and regulations of „yt66 Putnam
County Department of H alth i
Date /% wry Signed,' P E,R A
VIZ
i
y., , Adtlress ,'y, • icense
%APPROVED, FOR.CONSTRUCTION Th�sapproval,expires one year.'from the date.'issued unless hstruction of the budding has been undertaken and is-
::-
revocatile for cause or may, be amended or modified when considered necessary, _by ,the Commis r �of. Health: Any change or alteration of construction'
requires': a new permit. Approved for di4posaP•of'doniestic sanit e, a vate ater' supply only.
D. 'By. Title
w
"- PUTNAM COUNTY DEPARTMENT OF HEALTH
Gentlemen:
0
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date Id,
Re: Property of Mr. & Mrs. Patrick McEneaney
Located at RT I
T4x Md .
Block c Lot /er.
This letter is to authorize Gebage A. Haughne.y
a duly licensed professional engineer X 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
WLI1Cl L1V11 W 1111 l Ilis ma L L' ev and to. supervise the construc ciun of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned:
0 3880 �
P .E .; R.A. , ' #
Very t u yours,
Signed_
Owner of Property
Address
t� - g30 -0-7S �
Route 52 Telephone
Address
Carmel, New York 10512
(914) 225 -9353
Telephone
/j y
f PUTNAM.,COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET`S SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner ' Address lfrC'
Located t (Street . Block" V Lot
Indicate nearest cross s ree
Municipality. Watershed —6z k 4,
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole"
Number CLOCK TIME
:.
PERCOLATION
PERCOLATION'
Run Elapse
No. ; Time
Start -Stop Min.
p o a er Water ve
From Ground Surface.in Inches
Start -Stop Drop in
Inches Inches Inches
Soil Rate
Min. /in drop
19,417 -
2
OP3
3 O94
5
3G`•oS`° ,'.fit%
�a
.��'"
�6
.,` ,,
o��"
N
V
Notes: 1) Tuts to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. All 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.. % HOLE : N0:::: . , . -- HOLE' NO .
G.L.
6"
12"
24"
30"
J
42" z d
54!1
6o"
66"
72"
78"
84"
INDICATE LEVEL AT WHICH GROUND.WATER IS ENCOUNTERED -9'
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY Dated ,FD
.. DESIGN :.. ..
Soil Rate Used�l-C� Min/1 "Drop: S. D. Usable Area Provided .5'®v
No. of Bedrooms .7 Septic Tank Capacity OO Gals. Type 1v14J6 l�C'
Absorption Area.Pr�ded Soo L.F.x24" width -french.
p � �— Other
{
Addres
s �7 S .
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal. Checked by A
043aap
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TOWN OF PATTE�P.SOw - PUTN�' ; � COUNTY - N, y
5UZI:1n =.50" M Ife'll21972
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