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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. ... �_..�___ �.