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Home My WebLink About1422DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -2 -8 BOX 13 01422 IL a oil me 01422 Owner or Purchaser o Building Constructe East side �,,-est Gate Location - Street Building Type Krsje ski• Y- - . Building Municipality 76 by Section Terrace I - Parcel. 23.6 Block Lot 6 Clara A. fT ^er Lot GUARANTY OF SEPARATE SEWAGE-.SYSTEM I represent that I am wholly and completely responsible for the location., workmanship, material, construction and diair_age 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 occur 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- Rutnam- _Cour_ty ..Department of Health-as-to to. t• hether. 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. v� Dated this a6 -day of O��. 19 -/'7 Signature .2- 2 7 Title If corporation, .name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) 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 W / <n c f A1:'. S i N.Y 10598 245 -Q3 L N:Y 10566 737$777 f :666-3335 AVEk P19Mator of well 1nc 90AY f-OI m I .. F g . — —0—Ri PACKEM 4mvel PC* (inches). CU= . I n wQ11 wilb d1st4P99?0, to of jQqq( F981 OAT19H P94 111PTIQN {Stretch exact location at permonc? I at 14.79m4g4a. If PER MINUTE 6, 94% !1: 1,111,�! K7 TFP Q1 I-L, PRI"r 14nallw IRIEWPOT (0 51F WIM . ..... ... . PUTNAWJ (,P9,UNTV. P9PA OlvJ4 on of Roorgnmenwo Havith r*;v* COUlyry OFFICE PUIOINO • CA mgL, pjgW V.Qpr f9par4 19 99 49 PQMP19t@d by w9ll driller prid ombMittaq to Cognty I .1pAlth Pep4rtrnent tqrG#the.r With I@ ctrl Vlar gai.nplQ indic qtinq water ip of sqtiob ctqry bacterial quality 009re certificate. of con REPORT MUST BE SUBMITTED WITHIN 30 04YO OF WELL CO 2APLETBODA Mrs ra C, -6 10 mom. fa !ATA%Is "M"y FA Ulm WO; Ka CU PIlRSIC AIR Roulpm4w COMPRESSED C-ASLE OTHER 1-449149 YuLAIN ?9RCUPI M . - .. 11 (spocif Q-1 VIRCUS01ON V) CABIN() 4J W419"T Pon f THREA =,H- 10 No Y Yes now TOO? "Quo$ 4_411$1.? qwpgueo, All 004104 POP* 1,401P §Uq?A;P-UjTI 01?pth of Complgftd Well In f09t kqlaw Land . pvrfq;qt Tw_ lefflono Opp .4 To j7 oyjVp (19q# MAIN R.1 IN 9 AVEk P19Mator of well 1nc 90AY f-OI m I .. F g . — —0—Ri PACKEM 4mvel PC* (inches). CU= . I n wQ11 wilb d1st4P99?0, to of jQqq( F981 OAT19H P94 111PTIQN {Stretch exact location at permonc? I at 14.79m4g4a. If PER MINUTE 6, 94% !1: 1,111,�! K7 TFP Q1 I-L, PRI"r 14nallw IRIEWPOT (0 51F WIM . ..... ... . RE'-SUBMISSION f UICAT l ON �LTH Y '10512 _ To?frn o`f patters on wtvb i mulr tavry _rcmmi i rum acvv.Hur , uwrubm �T� � �m -- - - - East side hest Gate Terrace 76 Town o. vinage Parcel 23.F Located ,at` 4 ` 'i - Tax =Map - Block - Subd ry isioh Clara A,, Pfeiffer o L nna Edward_ PhZlori�exia Kr.a�es z ot caner Address 2. sty dve`Tlzn acres Building Type ° Lot Area Y h Number. of Bedrooms Design Flow 11 1 " Tt tal'H bbiittibW_Sp ce r. 9,quare.'Feet . 2 i.nc tr�nc Separate 'Sewerage.System. -to consist of �- Gal .Septic Tank and Contr.:actor: not en ag6d as. et '"� To be constructed by Address l' Water SuPPIy Public SuPPIY From A. C' _ Prwate Supply to be drilled by.,; Alb,, rt- Hyat Patt'eraon ° ..00T Address Other Requirements r�GLnsti'llf'f '9�T�;m acc6rd1n 'to p1a11 ptiTNAM COUNTY° 'EP_T. QFIEAl I `represent ;that I am wholly and completely.respoh sib 16 for the design and location of. ;the proposed system(s); 1) that the separate sewage.d�sposal system ' above described. will be constructed as shown on_ the_approJid amendment there to and in accordance with -the standards, rules an reguta ions o the u nam, ,County_. Department of Health, and that on completiomthereof a "Certificate of Construction Co'mpliancei1.aa6ifictory to the.Commissioner of Health,will be submitted to the Department, '-and -a wrdten. guarantee, will be furnished the owner ,hi successors, heirs or assigns by 'the builder; that sail! builder will place in`-460 operating condition ' any part of 'said sewage disposal system'dunng "rthe p tiod of two'(2)' years tinmeiJiatelY:following . fheda e. of the issu arice of the approval 'of. the Certificate of Construction ;Compliance of the original sysiA .or any repairs.thereto; 2) that the drilled- ,well.oe crlbetl above..- will be located: as shown,on the approved plan and Ghat said -:well will be,installetl in'accortlan with the standards, rules ' and. re ula ions of `'the. Putnam County Department of Health October 17 1979 . Date Behr P'i nf a P:E X R A F n.8 Tiorsepourid.Ro.a Carmel, _ 1051�iCe 984 Address a Y. rise No` _ .w APPROVED:;FOR CONSTRUCTfON This approval expires one ye t '-from the date: issued unless c' 'truction ".of the building has been undertaken and'is revocable for,wuse oNmay.be amended or modified when consid ed,; ec sar .• -by, t' Commissio r`" onv e�p r. alteration of construction requires'a.'ri w permit,',, Approved :for di'sposal'of domestic' ¢a' wag. .; rive e_'w sup only.. Date ~� BY Title ool PUTNAIVI COUNTY DEPARTMENT OF HEt�LTH Division of Environmenia/ Health Services .Carmel, N: Y.. .10512 C6, NSTRUCTION. PERMIT. FOR-SEWAGE- DISPOSAL :SYSTEM Town of Patt erson East side )Writ Gate Terrace M 7b wn o lags To r V.,I Clara. A. Pfeiffer'' ax map Lot -# 23 °.:� subd q', ion Edward 8c Phil ome 'a Krajeski 20 Anna Street Owner 2 S t dwe, ing Address y Building Type Lot Are 1.6 acres Number of Bedrooms____ Design Flow Total Habitable space Square Feet sepa rate ;sevyerage . systpm to consist of 1200 Gal. Sep ,c Tank and. 500 ft. trench / (. ) ( x )leaching pits Contractor .not ygtengagec� To be constructed by - ._�___._..__ ...__._.__ I Address Water s.d I `, :, Public S'uppiy: "From R Alber t Supply drilled by Hyatt Ad re PatteTSOn9. e• Y. Install r -o -b iii -1 s era e�_ p ac- ' Y. CSI--,' Y. Other Requirements �, topsoil --DO t•''RGGVvp�qaNAAew 's'oiL tests must be made after s;ettlsment Iii l se '�i3.anT,�ho17y.. 8dd?Cb��2et`ery re pons3Sle.'fOt."L. Resign arid.. locationt of .,the proposed system(s); 1) that the separate sewage disposal L"` ""..... _ systein.abpve described will be ,constructed as shown on he approved attachments'kereto•_and in, accordance with the'standards,•rules: and regulations' of the Putnam Ccunty Department':Of Health', and ;that on completion thereof a Certificate of Construction Compliance' satisfactory.. to the Commission- er of'Health will be submitted to the Department and a",' written guarantee will '.le• furnished the owner, liis successors, heirs, or assigns by the build . er, that :said builder will place in,good:$peratinq condition.any;`part of'said sewage disposal system auring the period of two (2J ,years immediately following the date of :the issuance of ,tlie approval of the Certificate of Construction Compliance of -the original system or any. repairs .thereto; 2) that the dzil7ed <well'desbribed '•above = will "be ;located as'shown 'on,the approved plan and that.,said well will be installed in accordance with the stan- dards, rules and regulations of the Putnam County Department Of. Health. June. 18 1979 Date S red P. E. R.A. 1D UI 716 4v -3 & Behr; P ", o Address i7 B- NOrSep011rid R'oad�.' Carmel, ;Na Ye License Ivo. — APPROVED FOR �CONsTRUCTIOIy Th,s`approval•expves? one year.from the date issued unle onst►uct;on of .the building has been undertaken and is revocab�,le',ior'causs or may be 4, mended or modified ",when cons, red'necessary .by the Commi i er of. Health. Any change or alteration of construction requirgs a new permit. `Apprpvetl` for disposal of domestic ni ar sew an 'r ^pr` Date �W �! By Title i� i' Gi r; ( I• f i� I I 3 5 Notesf 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. , PUTNAM COUNTY DEPARTMENT OF HEALTH "� — S-01' .0E' ...Fv V�r.%I�PIIF NTAL- "HEALTH �• SERVICES' .._.. .. _ -. ... J. DESIGN fiATA SHEET - SEPARATE . SEWAGE DISPOSAL SYSTEM FILE NO. 939,-,63-7 OwnerEdward 8- Philomena Kra jest cjdress 2O .Anna Street, - Carmel,," N. T 10512 Located .at (Street)East side .We'st .Gate �e .7.6 .: Block- . ? Lot 23'6` (Indicate nearest cross street) Lot 6 .Clara A. Pfeiffer Municipality Town of Car mel Watershed New 'York City ' ' SOIL PERCOLATION TEST DATA-REQUIRED TO BE SUBMITTED WITH APPLICATION Hole Number CLOCK TIME PERCOLATION - PERCOLATION Run Elapse. Depth to Water Water Level No. Tine:'. From Ground Surface in Inches "' Soil Rate Start Stop Min. Start Stop ... Drop in Min/in.drop - Inches- Inches Inches 1 :1:59 -' . 2:04 5 .:... 22 23 ... l . 5. Min. ' 22.'04: _.:. 2:10 6 22.. 23 ?... -. 6 2x;12 2:7.:8 6 22 .23 1. _.3 .. .:_.... .., ._ ._. _. _... 4.2 :18. ,. 2.:.25 7 22: 23 _ 7 5 ...... _ 1.7.::59 2 OK 6 2 23 .1 6 . 2 2 : Q5.... 2.:12- 7 22 ........ 23 l .. - 7 2:12 2:1.9 22' 23. 3 2,:20........2. :27 ,,.. 22. 4. 5. 3 5 Notesf 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. , i TEST PIT DATA REQUIRED .TQ. RF_ SUBMTTTFD WITH APPLICATION: _ _ �...... _ DESCRIPTION OF' SOILS- ENCOUNTERED I1V TEST HOLES DEPTH HOLE N0. l HOLE NO -� 2 HOLE NO. G. L. Topsoil Topsoil 11 TI 6'1 .I I 2 if Sandy loam with traces of clay and stones tt f! 1811 2411 If 3611 11 4211 f! ►p 4811 It Ii 6011 ; .. 66" 7211 7811 8411 : INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED none .-INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED — a s j TESTS MADE BY Burgess ec Behr., Pm Co Date 12/3/72 DESIGN Soil Rate Used 11- 15Min/1 "Drop: S.D. Usable Area Provided. 5000 + -SF No. of Bedrooms 4 Septic Tank Capacity 1200 . Gals. a Precast cone. Absorption Area Provided By 0 L. F. x24+ 11 z 6 r -o -b fill(400 cu yds� -3Y deep -) allow to settle _ju-9 -90' ays Othe% nc nstall.e re, -test prior to const. DO NOT STRIP TOPSOIL FROM AREA ee, me Roy A, Burgess 51gnatur e s Address Burgess &. Behr, P. C. SEAL 1 -Horse ound Road — Carmel; N, Ye iu) t' ti �vo ►� �� THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: OARO E33 ONP��O Soil Rate Approved Sq. Ft /Gal. Checked by .Date .. �.. ...s afi.J. r. ... �_..�___ �.