HomeMy WebLinkAbout1342DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
25.78 -1 -41
BOX 13
ONE
I
IN No
'I
Ll -.
*a,,-
ire,
,
T�
� . I
r,
..
.
�
fth
-
-
rd
01342
=
x Put NAM I` 1 CY DEPARTMENT OF_ HEALTH
t Division of Environmental Health Services, _Carmel,.,IV Y., 10512
� C li'll��ICAT€ OF C."% ST',�-U^T1011! CQPy?IP:.4AP.lC FOR_SEVVACE _L�ISPOS.�.� �1!,4i'J�M.: '" ,
;Patterson
,G _
s
Town or _V.illige "
Sulftit Pond ap
Located at' + _K M
4 9
File M
- d #149
Barton Dr,00dfatri Tncl S0769
pwner. - Lot' B Job
' 2055 9 � y�
f,- - Separate Sewerage System built by Swart W Bate$, °�nc Address Brewster, `NY 1 V509
X000 p , nc u
Consistmg'of _ Gal. Septic; -Tank 3`�9• lineal Pe et _ 2`t s width trench,
Other requirements F��1 7` Seetto 75` 1 /2 �_' L x. 74 ` W. x; 6' Deep
Y
Water Supply Public Supply 'From ,
X Boyd,.Artesan Wel1.Dr�11e'rs
j .ovate Supply'Dr�lled By
` Address Carmel , ,N�Y� 10512�k
frame Three :10 4. , 6 ;
r "Bwlding Type � - No of Bedrooms Date Permit Issued --
N
Has Erosion Control Been Completed IGS ,, ; 17C� P01fP
J yy app . .
�1 certify. that,thesysten`i(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work copies 'of which are
.n
r attached) and in:'accordance with fhe iii 'r dards; iules and regulations plans f ed ,arid the permit issued .'by the ;Putnam'.County'_Department of Health.
c
3] October 1977. b
Certified b• P E R A.
X
R.D `:9,Falr, eet': Carmel Y 10512 29.2.06
' •: Address L�cense.No _
Any person occupying premises served by. the above systems) shall`promptl ake such action as.rnay be necessary to secure the correction of any unsanitary
} conditions resulting :from such. usage .'Approval _of ,the separate'sewe a sy em- shall' lbecome null and Joitl as soon as a ,public sanRarysewer ibecomes
available and- :the approval of the private water supply shall-666 e _ II and oiii`.w a pubiic water supply becomes 'available ,'; Such. - approvals are
i subject to modification :or change when, in the judgment of th`' " goner a n; modrficatkon;or change.is•necessary
P .
n �
00
V f
e ./- �. : ` Tdle
Dat
—.n
'Betut Orooduin-
Owner or Purchaser of Bui d ng
Owner
Building Constructed by
Summit Road
Location - Street'
Frame
Building Type
q
N
Patterson
Municipality.
Putnam Lake Subd. (Map 8)
Section
Filed Map No. 149 -K
Block
B2055 -9 Incl.
Lot
GUARANTY OF SEPARATE SEWAGE SYSTEM
I represent that I am wholly and completely responsible for the
location, workmanship, material, construction and drainage of the 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, to 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 occu-
pant of the building - utilizing the system.
The undersigned 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 day of October 19 7.7 Signature
Title
If corporation, give name
and address)
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMPjETION 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
I
BMrt- Dr6dQ,-
-Mr -*-'. I Ra t t i -r-s- 6 n
OW r'0r"j.?q*_,qh_A
r B7U�j n WE
'Bu:E.Tdi 'Con4tr4ot6-d jq '_Septic. -
Stuart W'. Bates . Inc
Minor Road, Brewster2New York 10509
House Septic system
ul'14i4g` Ty
...
Putnam Lake Subd.
B2055-9 Incl.
Qt
GUARANTY OF SEPARATE SEWAGE SYSTEM
1. reprqaant that I Am wholly And completely resppnalblo for the
joqqtjqq, wqrlkmanship, material, construction constr tipn and drainage of the sewage
dlsPQ441 . system serving the above described 'property,: and that 1. j I it has I been
constructed as shown on the approved plan. or approved amendment thereto,
and 14 accordance with the standards, rules and regulations of the Putnam
County Department of:Hqalt4, and hereby guaranty to the owner, his succoo.
so.r4,. heirs or assigns, to place in good operating condition any part of
said system constructed by me which fails to
oparqto for a Period of tiro years immediately following the date of initial use of the sewage dialppoAl
system; or Any repairs made by me to such system, except where the failure
to-oporgte properly is caused by the willful or negligent.act of the ocell-
pqnt of the building utilizing the system.
The undersigned further agraeo to accept as conclusive. the
ermiratl,on . of the Di rector of the Division of jEnvIronmental Health Sep,.:.
VIC.,44,9r. the Putnean_ Co=ty..-])Op'artmer,t-.-o-r--H.a,%It h pL -s-to, Whether -or- riot the
fAllure of the- system to operate was caused by the willful or neglisont
act of the oqqu Pint of the building utIll s
.zing the cyst M.
P010 thia 24th day of October 1977 Signatur A-
Title
6�_11
(if corporA ioO giv
.0 Fire
and address)
THREE (3) QQP193 ARE RE4UIRED WITH THREE (3) COV195 OF TINA PJLANP IBMRZ
CERTIFICATE OF QO PLETION WILL BE ISOW
GUARANTOR IS REJUJUP TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM,
Division a,f Fr ,vironmental Health services, Putnam u Co
....nty Department 0jr
El
W V10.4 "gPORT PPTNAM COUNTY 419PAOTIV944T Of "VA&,T-j"
61vis on of E ovi nroantal Heolth PW
V9 yk"
COUNTY OFFICE PL,1110ING IPARM94, N4W YORK
,nt Health � 'e — -rt--
Thas qmp*94 by YWI'driller and submitted 0 6ju V M h j), Pa Meni together v
vith laboril"rV F@
pqrt qf
analysis of w,
g;or pMple indicating water Is of satisfactory bacterial quality 0qfqre ;o ific U P 9 f construction pq
p!Ie
REPORT Muii BE SUBMITTED WITHIN 30 DAYS OF WELL CO" M
*PLETION
SCRUM
DITA14
FEET
0
8
IF GRAVEL I Dig ?"- I M! 4-fl—IfT19V 11TV1.4
motor of well ln�lqdinp J J
srPVQI pack k(Inches):
I . .
3600ACEJ Aketch exact location of well With c(latan
EET FORMATION DESCRIPTION two Pofmanqnt landmarks.
000, to M0,21t
8 overburden
50 led&e.
If ed c� en , depths during drilling
yl.. I W; tasted at 411ot . t d- , ljoi belpw.
E99T —F GALLONS PER MINUTE
WlELL PRI "ER (Signaturo)
Bartos'Drooduin.
935 E.
LOCATION.
Pt Nymoef)
Summit Dre
Patterson
B2055-9 Ind.
poop*
BUSINESS
EAT444H M4NT
❑
❑T
FARINA
ST WEI
W114*
PUBLIC
APPLY
❑ INPURRIAL
AIR
❑
OTHER
El
fPNPITIP Q
"ON
❑
RPTAII.y
COMPRgSSED
FAIR
CABLE
OTHER
sQ41PMg T
9 , $S.ION
PERCUSSION
P CUSMON
IRC
(4pocify)
CASING
1.9"PTI:1 00P.0
jDIA)0ET;R(1nchga)
6
10"T PER fyVT
WEI_
ry
S
WAS A 111119 QED
PITAIIA
THKAPED
�Xo
YIELD
Tl#
❑
❑
HqUR'
2
yl" (P-P'166
0049
FUIMPEP I!Lj
COMPRESSED
AJR.
WATIP
I
FROM
k#N 0 SUR
oval Traw
Depth of Completed Well 2.561
LE"
In feet holow Land skirfqcec
SCRUM
DITA14
FEET
0
8
IF GRAVEL I Dig ?"- I M! 4-fl—IfT19V 11TV1.4
motor of well ln�lqdinp J J
srPVQI pack k(Inches):
I . .
3600ACEJ Aketch exact location of well With c(latan
EET FORMATION DESCRIPTION two Pofmanqnt landmarks.
000, to M0,21t
8 overburden
50 led&e.
If ed c� en , depths during drilling
yl.. I W; tasted at 411ot . t d- , ljoi belpw.
E99T —F GALLONS PER MINUTE
WlELL PRI "ER (Signaturo)
BREWSTER LABORATORIES
Box 224 - BREWSTER, N. Y.
WATER ANALYSIS REPORT
SAMPLE No. 3970
SOURCE: Fartus DmMutn-.
28 Smmit Road
Putham Lake..,
COLLECTED: Octivber- 24 11977
BY: Jahn. Prentiss
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
faucet' — well. supply,
0' per 100 ml.
This result ixdicattj the source of the rampit war
of m6ifactary ranitary quality when the sample war collected.
t.
OCT (2 8 1977
JOM H. PRLL-'N I-Issi P.-E11
October 26-,, 1.977
h4 Bickwit P. E.
Director
i
0
:v
• I �
I
I I �?
I
it
o=
40
CL
�
O
W �
L
i
�_
-
o -:
I
N
Z <
p1
_�I
XU
I I I
Q•
1
I
J
a
(� .I 1` I ,
D i '_
�
Stn
_!I 1 �
I t
r,� • « e
<
' "tom I of 7,I
.. Q-
1 !
? Z
o
`�»
t
Li
O
I
� � r �
7
V L
� \ \ t
N•
u u �•
zu 3aT�
r�G O
o
2.m
> > c
m N f °
�;:
•,
m
of C:
°
�;
'
M m m ..
m m :o s
w
E c
o
T
o �p
1 1
\ - l 1
_ I�t t- a I
'iI �1 V� {I
H
rt
O
a
z
i
0
:v
Qj
• I �
I
I I �?
I
it
o=
40
CL
�
O
W �
i
�_
-
o -:
I
N
Z <
Lop
�fi.ol�!al
_�I
XU
I I Z
W
�
Stn
_!I 1 �
I t
r,� • « e
<
' "tom I of 7,I
.. Q-
1 !
? Z
o
`�»
I
zu 3aT�
r�G O
o
2.m
> > c
m N f °
Qj
O `
07
I
it
o=
40
CL
�
O
W �
�_
3 W
IL
1-4 (:r.
rZ
C� � .� � � �yt„i �nd -cry W.,-..� - �� � - � �-�t l ••::__ . � � � - �. �: -.
\ M
}
0 1 S
RV.
ol
s
• � � / C, � t 3ST fTl +4�
/iy ,/ � 19 •pf �j'•,
f
nAl
51 i
MA
V
Q Nt y
1 O..
mill-
it
SM
a
S
I � „
', � _ � ryt k�nr•
i
l ! '
t n
b/ s_
t� >y �PU�TNAM COUNTY D'
t " Division of `Enwronmenial HE
CON . , ..UCTION PERIIAITr FOR SEWAGE +D=ISPOSAL
Located at S'lfRlm3 t' I�Dad , y
' Subdivision; P.utnaim� Lake: (Map 6,)>
•Ovine► Bahtos"
.Drooduin
8uiltling Type Frame Lot rea198
` `Three 60.0 a r
Number of Bedrooms D f w
Separate Sewerage System ao consist
To be constructed "by
Water- Supply ,Public Supply From'
h F
e Y Private Supply ;to'be dulled y
x Adtlress
Other Requirements r 1"l SeC.ff. n'.
I represent:fhat I am wholly and completely respons ble for the des
county oepartmen(; of Health
g�22�.76w �t
Date - ,Sign,
Address RD 6, ,Box 353
i APPROVED FOR CONSTRUCTION This approval expires ,one yc
revocable for cause,or may be amended or modrfied when cohsider "
requires a new permit approved for disposal ofrdomestic� wt
Date u By
e
G I Sej
7
... l
RTMENT OF HEALTHx i
SWV'Wes Carmel N Y 10512
4
i
��Patterson p
Fi1 ed VV Town or illage
t d fvlap�A�
LotLB2055 9 Incl` t : ,oti,S0769 f
..
Address 935- E..216 h St
• _ -� �gronx , NY 10469
n, r
Tota1� Habitable Space � � � •Square .Feet` ,
X333 l: meal- :feet:'x..,24 "...w,.d =th trench
3 Address m
r' -
r x ,
if
m of fhe proposed sytfem(sj 1) that t hq' separa 91 sewage disposal system
o and >in accordance witWthe, standards rule ;'.an regu I at ions o : e > u nam
of Construction 'Compliance safisfactory.to the Commissioner of�Nealth "will
he owner his successors, =heirs or:essigns' by the builder `that said4iu�lder will
luring alie periotl ofstwo,(2) years immeiiia'tely followmg'•thedate of,theissu
�rigmat °system or any repairs thereto 2),tihat the drilled well described 5bove � '
n accordancewith� standards rules and regula ice" of, ahe Putnam ,
NY 10512 `_ 4 License A o 29206
late assued unless construction- ":ofdhe building tas been undertaken and is
ry the Commissi r of. Health;, Any change Or alteration of "construction
n¢Jer rrvate r Y
7r ��
-4.
Q
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.
OwnerXs a7f* ,.we Jos, -7 A j V,,g Address S w..w; t IeW. t T. A tV ers v.,
Located at Street F. /e� //o
( $s. Ma � Block =Lot �-�o�9SMc%
indicate neares cross s ree so
Municipality fdr _ e/S-a m Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME
PERCOLATION
PERCOLATION
apse
No. Time
Start -Stop Min.
Depttl to water
From Ground Surface
Start Stop
Inches Inches
Water ve
in Inches
Drop in
Inches
Soil Rate
Min. /in drop
2
4
5
2 /j�#%
L/
yl•
1
3 IaJ
- /o
4
5
1 -,
2
4
5
Notes: 1) Te'gts to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. A11 data to be submitted
for review.
2) Depth measurements to be made from top of hole.
s
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
M.------ DESCk- FTTON -OF -SOILS ENGOUNTER:ED T1V EST'HOL�'S�---- _..�
DEPTH HOLE NO. ® HOLE NO.'
G.L:
6." •c�
12"
18" '
24"
301,E
3611
42"
48"
5411
6o"
66"
.7211
78�� .
8411
:.:.:...._
..'INDICATE...-W-171-AT WHICH GROUND. WATER IS .ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES-AFTER BEING ENCOUN
TESTS MADE BY /)e4 . ( f2. g)
Soil Rate Used m/® Mn/1 "Drops S. D. Usable Area Provided °
No. of Bedrooms 7&ge Septic Tank Capacity Gals. Type
Absorpti =on Area Provided . By ,s® L. F. x24" p width trench.
Other
THIS
SPACE FOR USE
BY HEALTH DEPARTP/MT
ONLY:
Soil
Rate Approved
Sq. Ft /Cal.
Checked by
Date
r
PUTNAM COUNTY DEPARTMENT -0F HEALTH
Division of- Environmental Health Services, Carmel N. Y 10512
`CONSTRUCTION PERMiT; FOR SEWAGE DISPOSAL SYSTEM f _ .Patter. son
Town or •Village
y Located at SUFI 3 t Road )6J(dE bx F I 1 ed. Piap #149K Blocs'
Sutidivlsion` Ru.tnaln "Lake: (Map B) Lot B2048 =54 Intl ,db S0735
OWner E- state of 'Jos S Kraus Margaret Carter Ex>=i x 6 Smadbeck= `Avenue
h
Buirding Type Frame got Area 19,200+ Carmel , N Y 10512
Three x
. Number of eetlrooms ` � r � _ nTotal Habitable{ Space r F, Square YFeet
36 inch
";Separate .Sewerage System to consist of Gal Septic Tank lineal feet Width trench ?
jl
7100.0
To be constructed by Address
Water. ,Supply Public Supply From
Private Supply to be drilled by
:Address
i Other Requirements
Six Ft Deep Section= 1932' f
f represent thatl;.am Wholly and completely responsible forahe design and tocation of the "proposetl system(s); 1) thatt,•the- aeparate,sewage disposal; system
above, described will be constructed as shown on the - approved amendment there to antl_ m accordance with the standards, rules an _ r ,gu,.a. ions o the. , u. nam
:.County Department of Health, 'and that on completion tne'reof a -Gert�f�cate of Construction Compliance saUSfactory to th'e Commissioner of Healtfiwill
tie submitted to the Department•''and a. written_,guarantee will be,furnished the -owner his; successors heirs or•assigns by:the'builder,`that-taid 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 ' issu =
ante of aheTa ` " _ P v_ ,Y ) he drilled well described above
a ordanee with'> a standards` rules and
pproval of the Certificate'.of Construction _Coin Dance of .the orig{nal system •or an repairs thereto 2 that t 11
will be Igcated a s s hown o 4he approved plan and that said well will be installed in cc regula , f the Putnam, ,III
County, Department of Health °'
;Date JUne 28,`: 197.2: Sign P.Fr "AA
35 ' rmel , New Yo k 10512 29206 .:
Address , -
License No
APPROFVEO FOR CONSTRUCTION Th�_s='approval expires one year from _jr he date .issued unless construct�ori not the bu,lding has been undertakers and is .
jrevocaD'le for cause or may be amended or:modified.whenconsidered necessary by the Comm�ssionerof Health Any. change.;or alteration of 'construction
requires new permit:' "Approved fOr", disposal of" domestic sanitary sewage` and %or private_ water: 'supply .only
Cop
Date 71
Gentlemen:
PUTNAM_ COUNTY DEPARTMENT OF 'HEALTH' -
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date �].6 /172.
Re: Property of ex-&ie ®-jo joir, .S-. k- 0-4-ox
Located at AOMI.0• .e._ . -7— A. .o —CPS
1^
ME
This letter is to authorize John H. Prentiss, P.E.
a duly licensed professional engineer XX or registered architect
(IndicaTeF-
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
%epar tuient of He&iti1, aitu to sign all 118C:e�saT'y 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
-
_147, Education .T, aw-, -- the Public -Health •Law; -and the Putnam- County Sani
tary Code. /� cyfifeet® ger�'aocoq
��'� •
Very truly yours,
a'I,r
..'g •
J� ` 1 •
ress
Carmel. New York 10512
0
- " • �f_ iii.' �:.�/ �r_..1/ 1 _
'o
r
ft FESSIun,4i ress -
PRFy�;;
0
�o. 292 �'�
°�rHE ST;tIt
0
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 *r e4e S�W, I ' Address �,�,�;t W.
Located at ( Street A/atm�a_� aw*Lo ,�Q otB
n pica e neares cross SR ree o0 A-Aw"'A'o Lw ke
Municipality ��sr -��� Watershed�f�
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME
PERCOLATION
PERCOLATION
Run apse
Depth to
Water
a er ve
No. Time
From Ground Surface
in Inches Soil Rate
Start -Stop Min.
Start
Stop
Drop in Min. /in drop
Inches
Inches
Inches
2 [L�1 /0 Z
3 //13 // W L 14 yi /
4
2Ir3�� "14 i
m
5
1
2
3
4
5
Notes: 1) Tests to be repeated at same depth until aroximately equal soil
rates are obtained at each percolation test hole. A11 pp 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 1,�vCuUNTEkr,D IN .�E�1 'rT01;ES
DEPTH HOLE NO._ z HOLE NO.
G. L.
6"
1211
18"
24"
30"
36"
42"
ff:1i
54
60"
..
72"
78 if
84"
g
r
.INDICATE IEVEL AT WRTCTi GROUND WATER TS- .EN00UNTE -FD N®svlg, .
INDICATE LEVEL TO WHICH WATE LEVEL RISES AFTER BEING ENCOUNTERED e2e
TESTS MADE BY &W & , ,,cam, japjDate
DESIGN
Soil Rate Used810/6 Min/1 "Drop: S.D. Usable Area ProvidedP Z-a ® ®®` t
No. of Bedrooms Septic Tank Capacity Gals. Types_
Absorption Area Provided BY-L79-L. F. x24" _Vwidth trench.
Other
Address
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Cal. Checked by Date
EI
Supervisor
Lawrence Lawlor i
PAT'TERSON TOWN HALL
Routes 311 and 164
Patterson, N.Y. 12563
TOWN OF PATTERSON
BOARD OF ASSESSORS
(914) 878 -9300
Department of Health
Div, of Environmental Health Services
110 Old Route Six Center
Carmel, New York 10512
Dear Mr. Karell;
Chairman
Erika Waring, S.C.A.A.
Assessors
Frances Kardauskas
Edmond.P. O'Connor
September 25, 1991
RE: Tax Map #25.78 -1 -40 (65 -3 -37)
Santamaria (owner
would you kindly advise this office, if application for a BOH permit
has been made to erect a dwelling on this site:
l , A-ik w g
f
V
�o
_ AA S
V
-
-- �j
-- -- - - -- -- -- - -._
C\j
1;T
I
C\i
I;zl-
0
JI
; . ........... .. .....
........... ..
- ---------------- ---- --
QO
VA\
Cfl
----------- 0. qp""
J
- — -----------
---- — --- r1r)
>- -Z
ct
<
z
w
CL ►
IN
I
r.
.77
It� h 11ra
PT
I IS
Vw-
tt
r
T
i
• j "�_ � \� tit ' "t ''��`a'x iFm
Fa
t
---. 5
� "i- F ,��� Ve� .r R" �"� t'� "e xr .F,t'. � �.5>C•1
w t
�f
��' _ -. -. ?v a it J' j' 'k t � z, ,•t a✓. dii`'�, � d �r �..J �.
1