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Home My WebLink About1102DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.54 -2-44 BOX 11 in , . . ` N Is � I rL I r I { ,r '1 Ii r :., Is I 1 L. 01102 Y a -PUTNAM= :COUNTY DEPARTMENT OF HEALTH ': Diwsron`;of Environmenia/ Health Services ;'Caime %' N Y. 10512•, ,_ CERThFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAISY.STEM Town' or Village' fr °Located at *!% Section Block .,. , Owner' Lot Job ZI Separate Sewerage System built ,,by11 `� Address'"' �,n_�•� I�h,,`M� . f MA r : • . consisting of Gal Septic, lineal Feet ,X width trench r y / liJD 7�X �� .z Other requirements'• .p „ >'�, V"'O' � / /�® �'a%� IRaT f� -t'� �� o ��S =rJ� • Supply Public15upply From Prwate' Supply Drilled BY, Address `- .i, C t Bwlding TypetQ1 2 No of Bedrooms �� a Date Permit Issued 70 Has Erosion Control 'Been Completed? �l� "/Ce�ji9• ;} d certify that the systems) as listed serving the above premises were constructed esseritially as ,shown..on the plans of -the completed work (copies of which are ,attached) and in accordance with the sfandards 'rules and regulations, plans,filed,.and the permit i ;sued the .'P.utnam •County?DeparEment of, Health. ? t r 9 "r Oats Cerfifie P E R A' s Address Q l Z License No Any person occupying',oemisbs served liy the above systems) shall promptly take "such action as may be necessary to secure the correction of any unsanitary } conditions�Cesulting ,from such usage.; :Approval of the separafe sewerage sy ;tem,stiall become{null and void assoon'as. a; public`sanitary` sewer becomes. available and' "the app roval of the prnrate water Supply shall become null and voitl; when a; public;rwater supply becomes•;available Sucfi:, approvals, 'are a' Sub4ect4 0 modfication ,or change when, in the' judgment of the Commi' ner of Health such revocatwn modification -or chan'g'e is necessary t �r S. ! rrr Y f! .. ;,: ;;; ,•. In ;•`. ° r x �, S^ .,? + b - Y k' ��' `Title'. f � BY � -. o -.• - -., .Si : 4 .,.�.....�i..._.+.- :.._.+. �.__.;:,,w..>. A:.__. - .....,e- .....w� r....,.:-- .�..s._P .-.. .. ismi. r._ _v._...u..�"......�_•_,:1_... -a ... �i3- .1��1 _'-._...,.. i.+... �_.. v.. t._ r._.. ......._ u.. a. _...a..:.r�_�1_.-- ..........x.. 7 James Caracappa Patterson Owner or Purchaser of Building Municipality Exj.pg .. gth. Map of Putnam Lake . Building Constructed by Section.. Randall Rd:,' B .Gar'fieId D. rive Location - Street . Block Frame .6952 4n4-5,4 Building Type Lot GUARANTY.OF SEPARATE, SEWAGE SYSTEM I represent that I am wholly and completely responsible..for,the location; workmanship, material,, cons true tion:and drainage 'of the I sewage disposal system serving the above :.described property,. and. that .it has been constructed as..shown. on: the ` approved ..plan or approved amendment thereto, and in accordance with the'standards, rules and regulations of-the'Putnam County Department 'of Health, and 'hereby guaranty to the owner, his 'succes- sors, heirs or. assigns, .t.o place in good. operating condition. any part of said system .constructed. by me which fails to . operate for . a..period. of ..two, years immediately following the date of: initial, use.of :the sewage disposal-: system, or any repairs made by me to such system, except where:the. failure to operate properly is caused.by the' willful :or negligent .act of the occur . pant of'the.building utilizing the.sy:stem.. The under.si gned further agrees.. to accept as conclusive the de.- . termination, of the'Director of.the.Division of Environmental' Health Ser vices of the Putnam County Department of Health as to,whether'or not the failure of the system to operate.-was caused by the .willful or negligent act of the occupant of the building utilizing.'the system. Dated this 10 day of Sepiemoer 19 70 Signature Title . CIf corpor8 on, give name and address) THREE. (3) COPIES ARE REQUIRED WITH THREE ( }) COPIES OF FINAL._ PLANS BEFORE . CERTIFICATE OF COMPLETION WILL :BE. ISSUED. GUARANTOR IS'REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. .Division of Environmental Health Services, Putnam County. Department of Health - PUTNAM.' COUNTY - DEPARTMENT OF' HEALTH Separate' Sewerage System v I, Municipality CONSTRUCTION PERMIT Located ,at4.7,t / ,�/ ��r P %� -hr Section "/E'd Block Subdivision �-{�dn, k-� Lot6Q92 �Job 1.1� C�£ahq Avg. • Owner,/�y W5 r' co Address ,, y, Lot'-Area /0000 s . Building Type_ �r,sZG,v,o No.. of Bedrooms '7z , ,�,�;�,,� .Total Habitable Space 78 0 sq . ft . Separate Sewerage System to consist. of_Z�V Gal. Septic Tank lineal feet width .trench Z�rvd slap ez a 4e� , To be constructed bY�c,iv Address 1G „Sf, -. l�- E,,d,,, 4,ke,ell, y Water Supply — Public. Supply from Private Supply to be drilled by_ Address Other. Requirements i I represent that I am wholly and completely responsible for the design and location of the.proposed system(s): 1) that the separate sewage dis- posal system above described will be-constructed as shown on'the approved plan or approved amendment thereto and in accordance with-the-standards,' rules and - regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satis- factory to the Commissioner of Health will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder,. that said builder will place in good operating .- condition any .part of.said sewage disposal system during the period of two (2) years immediately following the date of the issurance of the approval.' of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the. drilled well described above will be' .located "as shown on the approved plan and. that said well will be installed in accordance with the standards, rules and regulations of the Putnam County Department of Health. Date— �vy %7o Signe APPROVED FOR CONSTRUCTION: This app ova expires'one year.'from the date issued unless construction.of the bui ng has been undertaken and is re-' vocable for cause: or may be amended:.or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposa �domesti c �ynitary sewage. Date_ 71,3i 1 TO By ` ..PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL.HEALTHSERVICES - DESIGN ,DATA SHEET - SEPARATE_SEWAGE DISPOSAL .SYSTEM FILE NO. Owner.:Jcr;WfE.s Address 4ndyl/ e Located at (Street) Sec. Block Lot`69 f=� (Ind' icate nearest cross street) -3_¢ Municipality AVefigg o" Watershed C/b%� SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED.WITH APPLICATION• Hole Number CLOCK, TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water Level No. °' .Time.: From Ground Surface in Inches Soil Rate Start Stop. Min. Start Stop Drop in- Min/in.drop Inches Inches Inches 1 7'34TA 73 9 • / /¢ / 3 / / 2 7'39, , 7.'¢M. 4 5 5 Notes 1) Tests to be repeated at same depth until approximately equal soil rates are ob -. tained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top.of.hole. 12 rr 18_rr _2 Orr 3011 367 42" 48 rr . 5 4rr 6011 66" 72'11 J 78'1, i%b l e�& 8 4rr INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ' INDICATE, LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY on _ % a�cvsz Date 71 -YI7u DESIGN Soil Rate Used Min/1" Drop: .S.D..:Usable Area Provided e No. of Bedroomsr• y; r.•,.Septic. Tank. Capacity _Gals. Type �•,cee -ee Absorption Area Provided By Ira ,, 361' width trench. Other Ta CIG+P �RY� %N. -.'oc C7s:i,I -- IRR sr.-A4. Name fn's M. Address / Q j QN PUTNAM COUNTY DEPARTMENT OF HEAI,`i •. F• ivr �j' fit- j Soil Rate Approvipd S4. Ft. /Gal,. Checked b' a y�.�•� �' —i;_ Date �: C Y', J r� 7- L. 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