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631- 589 -8100
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01434
Rev.
3/86
YU1 141AM UUUN7'T VErAlt1'1Y ENT 11F HEALTH
Division of Environmental Health Services, Carmel, N.Y. 10512
Engineer Must Provide,
t P.C.H.D. Permit #
CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM
Malling Address ZD6 .8a6- VSO 0i2&P .s! W Zip_ /7,</ -7
own r Vhlage
Tax Map � ock _ _2 Lot
Subdivision Name d /e •�dY Subdv. Lot #_1Q)
S
Date Permit Issued
Separate Sewerage System built by P Address
Consisting of %012 Gallon Septic Tank and _7100
Water Supply: // Public Supply From Address
or. Privates Supply Drilled by ez 4 F . r— M < Address S
Building Type t? s�����>� / Has Erosion Control Been Completed?
Number of Bedrooms _ Has Garbage Grinder Been Installed?
Other Requirements
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 accordance with the filed plan, and the permit issued by the
Putnam County Department Of Health.
d
Date �y� �� Certified by e ! v P.E. R.A.
Address 974, r 6 2 License No.
Any person occupying premises served by the above systems) 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 publi: unitary sewer becomes
available d the approval of the private water supply shall become null and void w
bfK'w+td{_ M+PDIY becomes available. Such approvals are
subject t.ano modification or Change when, In the judgment of the Commissions Mealt a Ora , modification or r change Is neeeswry.
Date �_ /� �/ �� By— Title ��
A 01_ _ G�
a' WL'LL GVr1rLL11VLV mr,rVA1
DEPARTMENT OF HEALTH
nevi - L-rv-i, u—'-'n nil TleaIth
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
--
WELL LOCATION
STREET AOURESS: TOWNIVIELACILICIfy TAX GRIO NUMBER:
Lot #10, Hi hview Drive Windsor Oaks, Carmel, NY _Z
WELL OWNER
NAME: ADDRESS: BOX 451
Pyramid Custom Home Corp. Crompond, NY 10517
❑ PBIVATE
O PUBLIC
USE -OF WELL
1 - primary
2 - secondary
Q RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED
❑ BUSINESS ❑ FARM O TEST/ OBSERVATION ❑ OTHER (specify)
O INDUSTRIAL O INSTITUTIONAL O STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT 5 gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal.
REASON FOR
DRILLING
[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY
@NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 205 ft.
STATIC WATER LEVEL eft.
I DATE MEASURED 4/10/95
DRILLING
EQUIPMENT
CR ROTARY Q COMPRESSED AIR PERCUSSION ❑ DUG
O WELL POINT ❑ CABLE PERCUSSION O OTHER (specify):
WELL TYPE
O SCREENED O OPEN END CASING Q OPEN HOLE IN BEDROCK ❑ OTHER
CASING
TOTAL LENGTH 52 _ fL
MATERIALS: Q STEEL O PLASTIC O OTHER
LENGTH BELOW GRADE 51 f(,
JOINTS. O WELDED Q THREADED ❑ OTHER
DETAILS
DIAMETER h in.
SEAL: W CEMENT GROUT ❑ BENTONITE ❑OTHER
WEIGHT
PER FOOT 19 lb./ft.
DRIVE SHOE Q YES 0 NO
I LINER: ❑ YES Q NO
SCREEN
DETAILS
GRAVEL PACK
DIAMETER (in)
SLOT SIZE
LENGTH (ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
O YES ONO
HOURS
SECOND
O YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH ft.
BOTTOM
DEPTH ft.
WELL YIELD TEST t If detailed pumping
METHOD: O PUMPED ; tests were done is in-
COMPRESSED AIR ,formation attached?
O BAILED ❑ OTHER ; O YES O NO
1r�l�LL LOG If more detailed formation descriptions or sieve analyses
are available. please attach.
DEPTH FROM
SURFACE
water
pear-
Ing
Well
Dia-
octet
FORMATION DESCRIPTION
CDGE
tt
n
WELL DEPTH
ft,
DURATION
hr. min.
DRAWOOWN
It.
YIELD
gt:m.
surface
30
Dr..11dncf
in overburden clay & boulders
30
Hil
r
ck at 30'
205
6
120
30
30
52
Dr:lllng
in rock, set casing, grouted
52
205.Dr::114nq
in rock granite
WATER O CLEAR TEMP.
QUALITY O CLOUDY HARDNESS
❑ COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES ONO
STORAGE TANK: TYPE Well Xtrol WX #250
CAPACITY l•
PUMP WFORMATIOH
TYPE submersible CAPACITY 7gpm
MAKER Goulds DEPT}( 140'
MODEL 7EH05412 VOLTAGE 230HP_s
wELL DRILLER NAME P.F. Bea 1 & Sons, Inc. DATE 22 9 5
AODRESs 4 Putnam Avenue SIGNATURE
Brewster, NY 10509
siuy
I'vfcofm T. Beal, Jr
TYPE:
LAB ID NUMBER:
LABORATORY REPORT
PW
95 -2933
CLIENT: P F Beal & Sons
4 Putnam Ave
Brewster NY 10509
SAMPLING LOCATION: Pyramid Const., Lot 10, Highview Dr, Carmel NY
COLLECTED BY: P. Beal
DATE COLLECTED: 06/13/95 TIME COLLECTED: 9:15 AM
DATE RECEIVED: 06/13/95 -
DATE OF REPORT: 06/16/95.
ANALYTE RESULT UNITS METHOD ANALYZED
Total Coliform Absent - Colilert 06/13/95
E. Coli. Absent Colilert 06 /13/95
This sample, as submitted to the laboratory, and as compared to the New York State limits
for drinking water quality for the tests performed, was:
ACCEPTABLE. NOT ACCEPTABLE.
Laboratory Director
NYSDOH ELAP #11218
CT Lab Approval #PH -0171
618 Clock Tower Commons, Rte 22, Brewster, NY 10509 / 914- 278 -7600 / Fax 914- 297 -0536
PUTIQPI4 COJN'L'X DEPAX<M� T OF HEALTH
DMSIOIN OF E1YViR0LQ -ID4 A.L RFALTH SERVICES
Oar Znstruc vex of Building
3
Building by
r
!? nor
L�tYon -'- Street
2 3y
Section Block Lot
j / /*��C C
�2 /ec'
Subdivision true
Subdivision Lot
Building ice .
C- UPR`lTi- e.E OF SUBSURFACE SO,e_ CE DISPOSAL SYSTEM
I represent that I an wholly and completely responsible for the location,
wor}rnrrnship, material, construction and drainage o€ the sewage disposal system,
serving the above described property, and. that it has -been constructed as sham on
tiie approved -plaft or approved amend Tent. thereto ..and :.in accordance with the
staneards, rules and regulations of the .Putnam, County Department of Health, and
hereby guarantee to the cremer, his successors, hears or assigns, to place in good
operating condition any part of said systen constructed by me which fails to
operate for a period of two years i.umediately following the date of approval of the
"Certificate of Construction. Compliance" for the sewwage disposal system or any
caused by the willful or negligent act of the occulpant.of_ the building utilizing
the system. N
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Envixor_ -,ental. Health Services of r the Putnal-n County
Department of Health as to whether or not- the failure of the system to operates
caused by the willful or negligent act of the occupant of the building utilizing
n
the system.
Dated this 3U day of 19 qk Signa
Title
Co. .tractor (D6,er> - Si Inat�
Corporation blame (if Corp.) 0 111)&J27
Address I
rev. 9/&5
mk
Corporation Name (if Corp.)
AZZ.ress
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De artment o H ®al3�t� 11 rutinam County. p R
tal Health S-A, ,71
NZ ,
r vi j T , �' X30 �', �h
:v
a it ,, . I ,
.!,
sion o nv ro,
• pprOVBL� as :noted for con, . _,.,e?,_ the n
; Plicable; °I ules and Regulation I � ,?" �, � - `,
. _ .. .: . .;_ ' V^Iirn$'y HAalth . _ Ani 'tmeat • L,�`,:. � h� � 'a ,
S r r
s y r r
� � "'Sr x. s:.'
3 ; �, �Y 4 Ytr
�., r..... K'- .,. .. - i. � .. .. � � � .. .. -. �' .. ..� ... i ,.,
__ .. ..- -
Sabitrltki� liira �,✓ h�%sdr l "%� �s Subd- Lest ll) Tu map ` :3 BMek _LN
o..IKi�pprca Na■P
yrAlr�;�d �r.� ?fin �Qre,P_ /o— Ra°°"v_° R°.W°° °
Date of Ptevbo App mvd
MraS Adiraa %�, 0, B S!Sr�ir�e l: ���> Towa (.X. ZIP
Date Subdivision ADDr-yed Fee Enclosed u Ammin Aj
D.r+rs Tn. 5,��- � hot Arms I Fm settle. o* u Depth off '- volaoe 416!�z
Nobadaf Beienmr `S DWV Flow G P D %D PC® NoMmi lag 4IIeQdm4 W6es Pm 4 oa tpMOrd
saparNa sacra imp syalam a aaaalat at
To w:' by
Sept)c Tank
Wa4a SIlp*. pile Stiff Ftim Addran
an Vol" a.t..f. Seip* Dowd by se
Otrar �ataa�b
1 repe»nt1hat 1 am wholly and completely iesponsibl� forths.desgn and location of the proposed system(s); 4) .that the apa►ata saw di sal stem
above described will be constructed as shown on the appro've'd amendment there to and in accordance with the standards, rules a ►pu ns o na
County Departnlant of Health, and that on completion.themof a: "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill
be svemitted to the Departpent, and a written guarantee will be 'futnished.tha owner, his successors, heirs or assigns by the bulkier, that said bulkier will
one in pod oparatkg f:Ondition; any part Of, uq sawaga disposal system during the period of two ( yews bnnadletely following the dab Of the IM-
once of the apparel of tlw Cortifkate � of;.Const►uction Compliance tin riginal system or any r, s thereto; 2) that the drilled well dassyibad above
will be located as Mlown on the aPprosesl plan anA.thifulowall will be In act n n w h the nda rules and regUUMons of the Putnam
County .04pertnnnt Of t "itit.
Date r . _ r/� _9� Si/ne0 P.E. It^.
tllhrorfQ:'' s6r71/
F� AAdreM erae No
APPROVED FOR CONSTRUCTION: This app►aral e"irimtwo years fro n" dt :issued unless construction of the building ilas been undertaken and is
rerOCable for cause or may be amended or modified whim considered necessary_ by' the COmMISSiOMr of Health. Any charge or alteration of Construction
requires new permit. ow_ d ter. disposal of domestic sanitary aver nd or ivab warp supp
Title
10/88 .
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New.York 10509
(914) 278 -6130
APPLICATION 'TO CCiNSTRUCT A wA'�ER WELL
PCHD PERMIT 0i��
WELL LOCATION
Street Address
>
T Village City Tax Grid Number
A, « _.'20
WELL OWNER
Nam
t-a 71 Cri
e
ail* 9 Addrss ,Private
as u+ On lY O Public
USE OF WELL
primary
secondary
RESIDENTIAL
0 BUSINESS
0 INDUSTRIAL
❑ PUBLIC SUP AY Q AIR /COND /HEAT PUMP O ABANDONED
O FARM [)TEST/OBSERVATION O OTHER (specify,
b INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT gpm /# PEOPLE SERVED& —S /EST. OF DAILY USAGE 4 b_,gal
O REPLACE EXISTING SUPPLY O TEST /OBSERVATION GL ADDITIONAL SUPPLY
aNEW SUPPLY NEW DWELLING D DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
DRILLED
DRIVEN ODUG O GRAVED O OTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
h 66k s Lot No. /n
WATER WELL CONTRACTOR: Name %a!� Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ,X NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
PON SEPARATE SHEET
9S - I 't, I JIV
(date) (si g nature)
(date)
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirty (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a manner as not to degrade or otherwise contaminate surface or groundwater.
Date of Issue: r �[G%`���G 19
Date of Expiration 19,07 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
2' O S 3✓ A, �. ' C
APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
i . Name and Address o- Appl tcant:
2. Name o-" Project: / 1l do Locatioro/Y /C;
4. Project_ Engineer: r S.,Address:
License Number: 5 124 Phone: ;;-7� —G d�
5. TyEa of Project: --
r.� Privaie /Resice�ntial Food.Ser.vice .•COwc�ierciAl ,
Apartments - jnstitutional - ;iobi le, Home Park
0.Irrice Builaing __;.Realty Subdivision Other (specify)
7. Is this. project subject to State Env ironmental•C•uaIity Review.(SEQR)?
Tvee Status (Check One) Type -I... Exempt
s. Is a Dram Environ:;:ental imipact Stater�ent (DEIS) required? .. ...... d
s. Mas DEIS•been completed and found' acceptable by Lead Agency ?.. .........
t0. Name of Lead Agency` l
�i. Ts this project in an area under she control of-local planning, - zoning,. ,�/�
or other oificials,-crdinances? ........... /vo
�2. 1-1 so, have plans been to such :authodties ? .................. .• _ 1/
11- �.1 .. 1 • • • L -
'as preliminary approval been 'gran�ed by such -authorities ? / Date Granted: 11V
Type of Sewage Disposal. Sysle -m Discharge...... Surface Water t,�Grdund Watei
15• 'f surface water discha -roe, chat is the stream class designation ?........ "U
:6. 'haters index number (surracb) ............. _..........................
�. Is project located near a'public Mater supply system? .................
3 'f Yes, narle o; water supply Distance to water supply
project site near a public sewage collection or disposal system ?.....
g. Name of sewage system /// Distance" to sewage system
S • Date observed: 23. Name of Health Inspector:
•
Pro'
ect design "low (gallons per day) ..................... ... i .......... .
60 0
25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.._ /v o
26. Has SPDES: Appl ication been sut itted to •Local DEC - Office?
27. Is any portion of this project located within a designated Town or State
wetland ? ........ ......................... ............................... a
28. Wetland ID , lumber .......................... ...............................
29. -Is Wetland Pe „it.• required?' .............. ..:............................ —A
has application been made to Tewn or Local DEC Office?
30. Does project require a DEC Stream•Disturbance Panit? ...............
33. ?s or was project site used Tor agricultural activity involving application.
O pesticides to orchards or other crops, solid or hazardous waste' disposal;
fi 11 ing, sludge application or •industrial acti`rity? .. - .. YES or No /Vc
32: is project located--within 1.-,000--Feet of existence of abandoned` landfill,
hazardous waste site, salt stockpile, landfill,.sludge disposal site or 1J
any ether potential kno n•s'curce of ccntaninaticn? ....YES or No' -
_ - _...... _,
_ J
33'. 1s •tbere a local n2ster plan or file - with: the Town or Village? .
34.- Are cor,:;:0nity: water, sewer facilities planne -d i o be developed within i5 years?
35_ Are a6y sewage disposal areas-in excess of 15-- slope? .........................
35. Tax Nip ID t;u,_,ber ............ ..... ......:. ' 3 � : —��J
37 -Approved Plans are' to'•be returned to: ..... . .......... ApP� icant y' Engin
the application is signed by a person Other than ttie. applicant shown in Ite:�.1, the:
'cplicat"on rust be•acca�,paniad by •a'Letter of Autherizayicn: Failure to cc:mply with th•
provision ray be -grounds for the rejection of any sub{nisslon.
.i hereby a-`firm, uno'er penalty o;` F -_rjury -- that info JJ at ion pr•cyided on this
form., is true to the best of my knculedce and belief. False stat6-7rents made
herein are punishable as a Class A Hisde:7eanor pursuant to Section 210.45 o;"
t� e Pena 1 Law,
IC;;Ai I;RES
OFFICIAL TITLES
J LING ADDRESS:
_.PUT'NAM COUN'T'Y DEPARTMENT OF HEALTH -
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET- )SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner /��� ✓� ;R�� �' vsrer_2n, AV4rC �Mdress Rd• Ar enl Cio.,,d �3:� l►/Y �/,7
, r
Locatea at (Street) 'e „,/ & ye A17"j,.5o i Sec. 3 L/ Block 2- Lot
(idaicate nearest cross street)
Municipality ��p,�,�,,,, Watershed
SOIL.PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre - Soaking
Date of Percolation Test
/ -may - 9 -
L�I /0
2 /�'o - is = ?>
HOLE
y.
;?3-
�S �r
NUMBER CLOCK TIME
PERCOLATION
PERCOLATION ”
Run Elapse
Depth to Water From
Water -Level
No. Time
Ground Surface
In Inches
Soil Rate
Start -Stop Min.
Start Stop
Drop In
Min /In Drop
Inches Inches
Inches
5
2 /�'o - is = ?>
�)^
y.
;?3-
�S �r
.�6.-7
L
5
1
42:d14
:3�
�y..'
�S �r
.? /.S
L
are obtained at each percolation test hole. All data to be submitted
for review. '
2. Depth measurements to be made from top of hole.
rev.. 9/85
mk
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. HOLE NO. HOLE NO.
G. . L.
21
31 Y-e— y ✓eo y
41
51
61
7'
8'
91
10,
121
131
14'
INDICATE LEVEL. AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH VATER LEVEL RISES AFTER BEING ENCOUNTERED V /_4z
DEEP HOLE OBSERVATIONS MADE'BY: DATE:
DESIGN
Soil Rate Used 21-3c) Min/1" Drop: 'S.'D. Usable Area Provided
No. of Bedrooms Septic Tank Capacity /00c, g-61s.' Type
Absorption Area Provided By ��Oc) L.F. x 24" Width trench
Other '21 /,// - - -
Name Signature . . . ....
N I CP
Address -%
SEAL
P1 r ,111ow- Aerlekec)v�Cfr All lr,?.F
'1111-6--bPACE -FOR USE BY HEALTH DEPARTMENT ONLY: sF N9. _51 1?1.
00-
Soil Rate Approved sq.ft/gal. Checked by
Date
0'
I
First Floor
Ul
DINING ROOK t
' "cNEN
1.I1 .G' X IS' -O'
KI+
16' ;
Ems:
�� r1
a _I
fl. _
r _ c.) L14
.a r
r
2T 8 N �}
r
\•- LIVING R O O ld .�
FtaSTEFr BEOROOF! ,_,�,� _ �• � +
1 1,\
STANDARD D
��D �EVV FOUNDLAND FEATURES
Luxurious First Floor Master Suite - Fireplace Options Available
• Compartmentalized First Floor Bath with Consult an authorized V'Jestchester Builder
• . Two Separate Vanities for a Complete List of Options
• Formal Entry Foyer • A.Ilstls ren�er;ncs and FloDr Plan Dirrnsions are
«,;iSCa Jo: rs n+USt'tP_ vvr; en irl hr
ap�rcr�,.ate. i,;l ._
• Formal Dining Room Contrac-L No oral co, K5iz;ons.
• Formal Living Room
• Spacious Eat -in Kitchen
ESTCHESTER ODULAR OME�S[ �C.
Reagan's Mill Road �Yjngdale, NY 12594
i.
(914) 832 -9400 • (800) 832 -3888
ca
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PUTNAM COUNTY DEPARTRENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
J
Re: Property of. YGti id
Located at
D 1i Section ��/ Block 2 Lot �O
(T)
Subdivision of �,✓
1 �Q Filed 114an 1 Date
L,
Subdv. Lo T _
Gentlemen: // I
This letter is to authorize arm T,
a duly licensed professional engineer X or registered architect
(Indicate)
to apply for a Construction Permit for a separate ses. *age system, .to
serve the above no
property in accordance sai.tiz the standards, rules•
or. regulatiori s..as, promulagated by . the Commi.ss.ioner of the Putnam County
Department of Fiealth', aid to sign. a11. necessary gapers on my :behalf. in
connection jYith this matter and to supervise the construction of said
system or systems in conformity -with- -thy =N o ^ z5t. o .I�s,-- _o.f_::arti cle_1- 5�_.Qr.
147, Education Law, the - Public Health Lau,, j and the Putnam County Sani-
tary Code.
Countersign
P.E., R.A.,
Millbrooke Office Centre
Address
Brewster, NY 10509
914 - 278 -6108
Telephone
Very truly yours,
ti
Signed
/ %mer of Property ,
ddress �1
Telephone -
Fiitnam "aunty Department of Health
Divisior; .'.f Environmental. Sanitation
AFFIDAVIT - CORPORATE a4NER APPLICATION
. FOR PERMIT. A.PPL,ICAT. -IOXt SI;E.1 TAD TO'
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health - In the matter of application for
4 . --
represent.
that .x am an officer or employee_ of the corporation and am. authorized'
to act for. P r '
(name of corpo tion'-
having offices at -� �P � ab Pofvo
- - - - - - _ ._. _ Whose officers -are
President - �G'S•E� /f /%%� -. -, /� ^ , - - _
tame ana- TddreSS) _• ` -' -' -
Vice President -
• (Name and _Address) - _
c
Secretary
(Nam and Tddress)-
(Name and dress),
r
and that z= am -and w�.11 be individually responsible fort any' or all a�tp�
of. the- corporation with respect to the approval requested and all •sub-
sequent acts relating -thereto.
S orrk to before me this •�y day r
. // .. y .Signed
o f c`�t''j b�{_ 19�t3 Title '
.Notary Pull ic' J
BONWE
N=ARY PUBLIC, e — —
QUAURD, !:2 [ T;
ffi GGE��i�ISS !Qf <t.7.5'•'ilics�,.:c. ��,�? .
Corporate Seal
I
LAURENT ENGINEERING
Ap§PCIATES, P.C.
MILLBROOKE OFFICE CENTRE
Route 22 & Milltown Road
Brewster, New York 10509
RANDOLPH W. LAURENT. P.E. (914)278-6108 - (FA)) 278 -2658
HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS
January 19, 1995
Mr. William Hedges
Putnam County Health Dept.
4 Geneva Road
Brewster, NY 10509
RE: Individual SSDS
Lot #10 Fair Street Subdivision
Windsor Oaks
Highview Drive
Town of Patterson, N.Y.
Dear Bill:
Enclosed are the following:
1. Four (4) prints of Drawing SS -10 "Proposed SSDS", dated
12 -3 -94.
2. "Application For Approval of Plans For a Wastewater Disposal
System ".
3. "Construction Permit for Sewage Disposal System ", dated
1- 18 -95.
> -- 4., -to- Construct a- Water Wall'- ' y dfl�Ed i•. 1V� �.�.�._.._.. . -.
6. "Design Data Sheet ".
6. "Letter of Authorization ", dated 1- 18 -95.
7. "Corporate Affidavit ", dated 6 -3 -93.
8. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count
Only ".
9. Check in the amount of $300.00 for Review Fee.
Kindly review the enclosed items and contact us with your
comments and /or approval at your earliest convenience.
Very truly yours,
LAURENT ENGINEERING ASSOCIATES, P.C.
1.tr
Ha ry W. N'chols, Jr., P.E.
HWN:bd
94103
cc: Mr. J. M _rra- w /enc.