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BOX 9
1, -2 :4 �i
'` i
IN IN I
f Or -
11: •
PUTNAM COUNTY DEPARTMENT OF HEA TH
-'
Sp1812.
t i Drwsron of Envrronmental Heal[h- Services, Cariii% N'•.Y 10512 �
CERTIFICATE•OF CONSTRUCTION`:CoMPL''IAN P..atterSO:n
CE. F_OR.,SEWAGE DISPOSAL "SYSTEM
F1 ed Mdp #,1s2Q3 Town or "Village
` Doansburg Road 18 1
L.ocatetl at `. > - Tax Map Block i
=,
M /M. John - And'reykovic T" Map �t # 15 3'. Subd #
C.1 n
Owner
ni
' Cro ser Const; Corp Rte: 82, Box 26, Hopeweil Jc`t NY
Separate Sewerage System, built by' Address
Consisting ofC3al Septic Tank ana 516 fL F X 24'' Width Trench
otne� reauireinents Curtain Drain ° '`4' Deep x '24'
4.
Water Supply, Public :Supply From
�E
X Private Supply Drilled By
J T ckerson, Inc
Address Rtei {j9W`.R Mi l.ton , "0,
ti
Frame Three 62 80
Building Type No, of Bedrooms _ Date Permit I wed
Has Eiosion Control Been Completed?
Yes Renewal:
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. standards, rules and regulations in accozdance with the filed -plan'f; and the,permit issued by the
�} Putnam Coudty. Department 6f Health:
1:7 November. 1980 P.E X ti A'.
Date Certified by
R.:D ..,9; :Fair:.S ; ' .armed ..NY,' .10 2 29206
Address License No.
7 7777
Any person occupying,,premises served by ,the 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 ti'ecome null and 'void whin 'a public wale► becomes available. Such ,-Approvals are
subject to modification. or 'change .when, in the judgment, of the C, loner of `Health, such iev tlon odificatio ',"or. change .Is, necestaiY. 11
Date 00 , . O BY Title
IM
I Oki
W�Lk VQW,49TICIM RgPART V4TNAM COUNTY DEPARTI41E$!IT AV
Division of Envlrpnmental Health Serviooa
COUNTY QFFICE DUIhOINiQ • CARMEL., NEW YQRK .
This roppq 19 to pa Fompliitetl by wool Orillar and submitted to County Health Department together with laboratory r® on of
6n @1V¢Iq qj Wqr ar gainple Indicating water Is of satisfactory bacterial quality before certificate of construction compliRncQ,jp Ig�NRt11
REPORT MUSS' :BE SUBMITTED WITHIN 30 DAYS OF WELL CQMPLETION . :.
pWNR@
...
ADDRESS
Route 82, Bcsx 26 — Hopewell 'Junction', N`. Y.
OCATION
@� a . )►alit
atvn (Af NNmAeI
"OPOSirp '
YP44
I ..19a �STlt� D �;iTA6tISHM�NT..
DPUDLIC .
4UPPag IMRUSTRIAL
D FARM Wf L• `
AIR
EI CQNDITIONINO D OTHER r)
9A)LLlFdQ
EWUtPFAE�lL
COMPRESSED
RQTAQY, D AIR �ERCUSSIOly '
CABLE OTHER
D PERCUSSION D (Spe�ifr)
CA£Ifd4
QdTAIL$
L$tdf IN (19QI)
D14*1 "(Inohse)
wE1901 r"t
#
WELDED
-
0
YES . NO
Em
I JNo
7tELS1
TRO
HOURS O.P. , ....
E I BAIP.P D PUMP96 9 COMPRESSED AIR Y hr. 6 ggit:
TI f LD (Q,P,4f,)
g gpn
WATER
E7<
h1E ,S.Qit,R FRppi L414P SURTACP-- STgiIC(SA @GltytooU
DURlN4 i1�LD TLOT left)
j
Depth of Complated Well
In feet kiglaw Land surface)
SCREEN
GETQI4°a
'
!t® .
LE1jAT)1 OPFtd A(�t+I
TO PtR
s(,?X 17
QIAMWR (f mho)
IF GRAVEL
FACKEDs
Wolmoter of well including
grovel pack (inches):
WAy 4 � ZE (InchP9 FRAM (pot)
TO ffaPQ'�'�
pfrrk FROM LANG SURFACE
T9RMATIOI9 RESCRIP►10ly
Sketch exact location of nq/l with d(stsnCgs, to of lga8t
trvn permenont lename M,
FEET to FEET
0
20'
, Overbuy
1
20'
183 !
Granite.. ;
If ylofd waa scaled at di$srant depths during drilling, list below
FEET -
GALLONS PER MINUTE
G 1
U
� ✓�F �
�Gf
Zw /FEEL
/ReN Pi•/ s �Il
JET /
33.
s �
S7 NC wArLLNa
0
0
bFit 60 �n SOP /O e,3
q OA
i
0 F' oc 7
A
/ReN a.N � a z
z(,,j /6EEL
�O
�✓ 6S�-Si -3� � �b
70. o o 0�
i
6 /oi f.�8o
i i
FooTiNG Loc�Y eN
/RaN O.N _ �
IU
b �
a
o I
I �
/ReN Pi,y JI FCN �C
JCT �
�V S- 08- oo
3V.77
iv8 - 13 " ?e u/ 75.23�
' 6
6� 2
Ar
SVRVEy PRG- P/9RE0 Fo .e p
® S
p�
L O C q / N
OF' 00177- TER S 0A/
C0uv r OF �ot/T/vIV S 7 of Ne w y
yo e,<
gCg4E /S, /979
G"ERT /.�/ED To
EL /zg/,jdTh'iVERo �
d
Ts7/•>ydS K. OEv //rE
L 9.v0 SuR vByoR
�/ m vote
ias� y
790x6
p!' . .LJ
SEP 2.519
"AUTHORIZED ALTERATION OR ADDITION
TO TNg S1IRW YAP 17 A VIOIAT1ON
OF SECTION 72119 0 01 THE NEW TORX
STATE EMrATM LAW.
WON at oq mm ma wT belft V.
lum 8-rMP..om UM.W ow oot a.
.00.la.r.l to b. valid true w".
^ nwall ..r awes.. Y16mell Mt.ln do t'
an ab swm was Tm.nw+ In —ft— mee ew
muse ae..t w.am.. •r, tat Ttt glow m wlr+ b
a• rtmr Vaa. "ft Aw mb— M Pw1Mfm1 SM
Sumo a am pow.. or mteeNRer dM M
only to a. PWW for .low M @WNW Y /trtryetl
.M on IN...b.M b tM 0e11 GNMG . e.wTmmN�
.gene! .n. MndtrNt IasUO . 4l./ Mw.R M to
th. mECm.e of the Tmt w bdfto- mwmr.. ar
c.ronc.uone ew naE bamhr.tl. 0 *"Umd bs*
tu0on. or .uW..uent omn.te.'
�oi:at 6 d, at
Ubdivision'.
owner
a._
P WN COUNT'
41
T.,Ype� Friame Lot:
Three 7.of,Bdo�?o Design Flow 660''061,
lumber k -
11000
eparate Sewerage: [System; to co
7,
b
6 be constructed' O
blic-1
later Supply.-, - � -: � w.. *,,-P.- u-
V
7
Mvati-,Supply to. 4be_, drilled
Addreis .
ithei Requirements i L None'
J
� pirei4rit',that,l !-M. *�'hbiiy and Completely -iisIidnsitfle for 4ilieAdsig"Waindild
tio4iiAbschbea will"be.construct6d isi-sh6wri<'on the app.rqygd,amendment t
Rynty'-Departmerif ., of rWealth, and that on completion thereof a.;11,d4Vtiffcz
1, j b* 6:,
6-Ls-tibmi�ted�-io',thb�--bepartriiihi','.":and a' Written.g6arariiii,,wili _j,6-rrfis6
laC61- "Opera , ting dondiildns'any.apart,�o sald', sewage' dlsposal, - e
qsy$
n;e of -,the a-pprovai_,oi .Compliance Q[A
pli�n
,ill b-6'lcidiited.-ai-shoa",�on' the --approved Olifri-and that- said well w6tw�;*I'nsiail
ourity�.P.Op6itm6rit oi Health.'
Sete 'Moy,-
00
S
-A -qf-j,-f
rf inj,,$ -Pdm'-f`t`I 78 6�.
dress
,F!F��tqVI�D FQF�,,q"STRUCT-101`4- this"A ippr ip I
9 lies 6
PARTMENT QFHEALTwH
k., :- Patterson
r-, y, 1.1age
—Block-
50.1,812
J, -"b
Broadway-
07,01
EX
11 0,0
T7&A --Ha table,* Space,
Square, Feet
F. 1� I . I
$ kh',
-Tr e n
4�i, N'; nt
It
tie 'T
IT
-
cation of, the proposed ,.iystiii-n(s),;,I').-.thait Ahe separate sewage � disposal system
j��he,:Sta Oida�. 16s,arfd,regu lat ions 7 am
or-TFe—Vu =n
ii Compliance, i" 'satisfactory, t6the,Comm - issiondr of',Health will
ed`the owner his W the��iiullder, that ld
_.!iajd buji, er will
te
i-lwd�(Z) , years ,'� i' 'fo i low I ng', heidi i 'qf the Issu-,
e_cWig1`nii.sy thai"thedrililed �well described•above
stqndar'g'sruli3sgand,--regua�,ons�of 'the Putnam
!R.A.,
5 1
A, •29,206
'MY
N
Li'cense o.
:he date issued ,uP
unless uc' t- ior of the building! his beeh undertaken ake,n,,and
Is
,
1y �vjh�"66M ; s, , f A it Any alteration construction
ter.
-S
-7
11
F
rPUTNAM CO UN
=� � � D��ision Tof Envirofime
`- CONSTRUCTION PERMIT +FOR SEWAGE DISPOSAL:
4 DoansbUrg; Road;
4 .L-bcated at F '* _ �--
Subdivision P�� ��0 4 Y �
`$I�... t& Mks �t7ohn And;reykovac
Owner -
T xFr�me = r
Building Type � r Lot Area,Y
aNumber pf Bedrooms 7h�e+e� Design Ar, OW 6�0'
r Separate Sewerage. System 'to consist of
P,, To be constructed, W } �Y
s a Water S�upp� ��r } ��blic SuPPIY �F Om� 'a• o � a, <,
_ v _t 4r
s X ,Private Supply •to b`e drilled by-
_ f -
Other Requirements
°,Nbne��
a +v., .'�'�. : &Jt: .l. �.�,a+'. ....r.!, a+�,, u.?'� r. jx'"n
, .µhaw ui yyva vgnrauny cynaiugn�, any park yr saia;x
ance�of the approval of the Certificate of "Constructia
will be located as'sliown on "Lthe a
K' �, pproved�plari and that sa;
� t County Department 4of Hecalth �" o�°�
i Date 2� Pt MOD J,
" APPROVED, FOR CONSTRUCTION Thisapproval -ezp
revoeableefor cause,or maybe amended ortmodifiedew,he
si requires a' new permit Approved for disposal of don
:K:
DEPARTMENT'.?OF HEALTH
Health Services, -anm-eUYV. Y 10512 z
i
rEnn - Patterson
,Town or .V,iIlage
#7:203"
,Block
S01:812
f nCn
Lot -• Joti
Y
y a .r X3'00 N . Broadway ' t
Address
;�Yonk rQ, NY` j0701
Totah Habitable Space �DO ` Square Feet
it S ptic Tank and X500 L. F: x24" iW>>dth Trench_
Address �
s
*7.+•ti
id location of the proposed. systems) , 1) that the separate sewage disposal system.
t thee, to and in accordance with cthe standards `rules an regulations; , , m-
trfi�cafe of Construction Compliance satisfactory to the - Commission !H' Ithwill
nis Z&the owner, his.! isuccessors heirsor assigns byathe.`buitder thav id'IbUildercwiil ;..�
system' during, the period of two (2) years immediately followuig. the date oitheYi ;su
of tFie' original ystem `or anyiepairs thereto 2j;that?the;`dr,illed well:descrabed above 'r
Isla letl tin accordance h t no. ards, rotes sand regula ions; f the ; Putnam
4
y
{ Y a jcense N- r29206 `
omthe date��ssued unless construction:'of tNCbwlding, has been' undertaken and is ,
cessaryiby the�Commissi er o eatth. Any change or alte►ation of construction
Z.
1 T Otte` �s
Gentlemen:
PUTNAM COUNTY DEPARTMIN T OF HEALTH
DIVISION OF ENVIRONMENTAL-HEALTH-SERVICES
Date 21 September 1978
Re: Property of John.Andreykovtc
Located at . Doansburg Rd., Peloso Subd. , T. Patterson
U=ft Fi 1 ed Map ` Block Lot "C"
01203
This letter is to authorize John H. Prentiss, P.E.
a duly licensed professional engineer XX or registered architect
(Indicate)
to apply fo.r a Construction Permit for a separate sewerage system; to
serve the above noted property in accordance with the standards, rules
or. regulations as promulgated by the Commissioner of the Putnam County
Department of Health, and to sign all.necessary papers on my behalf in
,connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
i47, Education Law, the Public Health Law, and the Putnam County Sani-
'tary Code.
V•
A-E ersigned: Q�P.
R . A : , # 29206 0 '!
R. D. 9, Fair Street
Address c
v
Carmel NY 10512
�4F1E ST��c
914- 878 -6170
Telephone
Very truly yours,
Signed
Owne . Pro rty
300 N.- BroadWay .
:.; Yonkers,AY 10701
Address
914 -423 -6458
♦
::Telephone
Testa to be
repeated at 'eame depth'until
an � oft tel va�:'t
ralw a are
obtained At.
e4oh POCQIAtipn� too
Ai da to �
X08° $���OW.. �' • ..'� .. ,.
.hpli.
.. ,'.
a . ;.," "•�:;:'; �
,.
: .. .
mpth. iQa ements to be mado
n fur top �pf, hole►.
.
DEPTH
y G.L. -
u.
'6 II
1211
TEST PIT DATA 1•':1.7'11 APPL;LCA'.!'ION
DL'SC13II11.I1TOTd OF' SO,T1,:', i;;l(;OiJT'.'i'!;I ! ?7 T1lI
HOLE NO. � - HOLIs P,O,
M
1$11
. 32
.421t �1gYe v Co �•,, .. .
,7211
.781
84411 ' ' J 1
To
A L���►f .tea -��/�► ��'; �: � i` � �, a
r,
I1\11JIMCATE L CH ROUND FIAT 1�R IS EPICt!t1.11'.,R _D
INDICATE LEVEL TO WlaCH WATER LEVEL RISES AFTER B�'' P�TG EPJOUIWERED %i'!B!/�M' ��1Dfe
TESTS MADE- BY�•��J.�•�� ��i���8 y -� ='Date
DESIGN - - - - t- . -�- --
Soil Rate Used D - Mih/l "Drop: `., S.D. Usable Area Provided '
No. of Bedrooms Aree %. Septic Tank Capacity /DOD Gals. Type mare
Absorption. Area Provided By�'D �L..F.x2�E" :�; „. width`,.trenct :
-9ame John 11, Prentiss, P.E, 1 ,
Address r.D, 09, rair Street
Car.MOT,, NY 1051Z
THIS SPACE POP USE BY I- ALf.1'H DEPAI,
Soil Rate Approved
PA
6
N 20 Date
ENE STP�
I
y.
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:SCa1�ia rr, Address
Located at (Street Sec. Block Lot
kIn ica e nearest cross s re
Municipality Watershed ofo n
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK
TIME
PERCOLATION
PERCOLATION
Run
No.
Start -Stop
Elapse
Time
Min.
Depth to Water
From Ground
Start - '
Inches
Surface
Stop
Inches
Va-ter'Level
in Inches
Drop in
Inches
Soil Rate
Mih. /in drop
201// 0 9f1
04
3 0967 10 4tz_
SO
..
5
-
2, 108
33
2 OfZif 091Z
3-9
3 0967 /oko`
e L
i
4t s-
5 y
2
Notes: 1) Teets to be.repeated at same depth until approximate3r.�:equal soil
rates are obtained at eaa'.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 -ENC.OUNTERED''IN'TEST:HOLES
DEPTH HOLE NO. HOLE Ntr
G.L.
6" A
I
12" "
"
3611 w
w�Sa•. q/
�vN�i'•. 42"
rr48 ►,.,
-
5411
6o'l
72
-
78. 11 p
p Lo �• -
asww.! �w i✓M�'Ir
84'1 a
ape- "am, ew,
:... :..:.: _.._.1M.ICATE L
LEVEL-.AT WHI.CH.._GROUND. WATER. IS. ENCOUNTERED- ._..__._..
INDICATE L
LEVEL TO WHICH WATER EL RISES AFTER BEING ENCOUNTERED
,.:TESTS MADE BY ./art to. . _. ,11 ./. D
Dat.e� -/�1
Soil R
DESIGN:.,:,..,;
Area Provided' rdoo
No. o
of Bedrooms 21,rp Septic Tank Capacity 4-goo G
Gals. Type
Absorption A
Area Provided, By .R9g,, .. L. F. x24 "..: -`5.b -
- - . woo' width _ rent .
4
�
• Ot er
405,11
.
Address , 6. 30y, 153
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:*
Soil Rate Approved Sq. Ft /Cal. Che
!Y!!' ss a-
b�r Date
t
°r The $1031
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date— December 14, 1972
Re: Property of Scotia Construction,- Inc.
Located at Doansburg Rd., T. Patterson
Section Block Lot Parcel" 1.1cit
Gentlemen:
This letter is to authorize John ".Prentiss, P.E.
a duly—licensed professional engineer or registered architect
UndicaTe
to apply for a Construction Permit for a separate sewerage system; to
serve the above noted property in accordance with the standards., rules
or regulations as promulgated by the Commissioner of the Putnam County
11- o" and to sIgn a'! necut38ary papers on my behalf in
Departme t I nt" -L U11
connection with this matter and to supervise the construction 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.
to
R.A., 29206
3
ROD,, 6* 9.
Address
Cam, Rte! York 10512
914-8*M 10
Very trulv vou S.,
Signed
Owner Property
W.O." Scotia tonst.. , 'Inc.
Gleneida Ridge Road, Carmel, N.Y
Address
ESSION4� 914-225-3470
Telephone
♦K
NO , b
or
e q eor a Westln gh Ouse
US 50 SE
FOR THE UTMOST IN BEAUTY,
CONVENIENCE AND.DESIGN ...
IN
BEDROOM -1 DINING KITCHEN QUALITY
12-Ox 11-11 ❑ 10-5 x 11-11 14-2 x 11-11
CONTROLLED
HALL HOUSING
MEETS OR EXCEEDS
FHA - VA & BOCA STANDARDS
BEDROOM -2 I BEDROOM-3 LIVING-ROOM
For choice of interior - decorating schemes
13-0,x. 11,11 11-6 x 11-11 17-0 x 11-11 refer 'to data sheet entitled I "Professional
Interior-Color Schemes."
For specifications and options ask your
Continental representative for data sheet
24'X 50' entitled "Unit and Material Specifica-
1200 SQ. FT. tions."
Refer to Working Drawings for more exact dimensions.
e e—
ELEVATIONS AVAILABLE: H, J, K, L
ZONTineNTR HOMeS
�0"q*v AAY. NEW ENGLAND
DIVISION OF WEIL —McLAIN
ROUTE 3/DANIEL WEBSTER HIGHWAY
NASHUA, N. H. 03060
CONTIflefflTOL \XYxiiIIIIIIIIIIIIIII1 OtxwLict-Lizue"K TEL. (603) 888-2191 DIVISION
Inorder that product improvements may be introduced at any time specifications iire subjectito change 'withio
ut notice.
PLANTS: BOONES MILL, VIRGINIA
MALDEN, MISSOUR I
A
. y i f� 'tai { t d : d ci
i J a auVM'X W. (I' � $
,.; d1try�[ . i i eye;; 6q firl�f� ! ..� .�lpt.s_� IJ �aaJ,t ( 19 T .t; rw : iLr1TE i ct } i ris K
-rrra�sarr,�:'�ii �1'�r i)tt71 \�i.Qt -a. s+xe aae.a":n Ja•6iT'� i�4>� {.� �:f
�x Af "WE ' Iido -MIL :I VC ® mi 3:'..I wlfl ;,. 6i" )WILA i, [_� �''a2t.�t< '
'•J6$ +�dc �i 9�1r 5i le q AM
1
i'
r
a
,�,� {'X •FFi $ � Y �}� 3 �y .r! 'r ' ' <:EwE�. i.... ^ f.l t.
m
28 LICOFA
IJWWTO
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V 11811 RYi