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HomeMy WebLinkAbout1538DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -4 -34 BOX 14 ,. or Sol as i u . F r I ,Iii -�� 01538 TNAM ` COUPI'TY H �V( 6� Permit r Divrsron of Environmenfa/ Health Services, Cairn %N. Y 105 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL -SYSTEM Town orr Village .. I,, �{ Located at O .E Tax Map 3 alock �O. 7 .. r l Y Owner E JSO/V/ Formerly - _ >- - - Tax Map Lot r Subd. Lot r' !' - Separate Sewerage System built by v - �0� /� �%M Address ���dWAJ Q� /70ZA�i Consisting of. �Gal.Se ptic Tank. and �S`� L T,NE/VCH -L��r Wr DE % !� U - s✓ Other requirements Y Water. Supply: - Public Supply From n �P►ivate Supply Drilled By 13F ,e / r A Address Building Type 1Qg5 a!51,JC�5. No. of Bedrooms' Date Permit Issued Has Erosion Control Been Completed? 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 tbF6tgd.plan, and t1i sued by the Putnam County Department Of Health. KEANE �QPPE 113 SMITH AVENUE; ENGINEERS Y Date Z- / %% / l'� MOVINT' YC- 090,,d P.E. R.A. RATION Address (914) 241'2235 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 public sanitary, sower becomes available and the approval of the private water supply shall become null nd void when a publ water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Co m o r of Health, C. revocation.' modification or change Is necessory. Date !� ` By Title Rev. 9 -81 PUTNANY`COIJPiTY ®EPAflt�'I�IETdT OF HEALT�I Divisioit. of Environmental lea /th Services, Carmel, y2 ��� ' ¢e=mit r ~ CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTE Towri .or'. Village. Located at 0 Tax map Block' LO ' ...._ .y..,...,..._...� .... _ ....... _ -4 _ ._ ... _ ..... ... Formerl �~ Owner Soul/ y .. Tax Map ,Lotyry .�'o Sub/d.Wt~r Al Separate. Sewerage System built . by � •!LA� Co c%ai/E�U � >w� / Address ,' /�� /��� w�l / F'D HOG/W65 A /60;/ Consisting of �V Get. Septic Tank and 4-S f L /� T,QEI�ICf -7 L�`t 7�E' `7 " �7•L Other, requirements /�LC)/liC► Water Supply: Public SuPPIy'From T �JL Private SuPPIy. Drilled 8y. 4 1- 3`"G R NYA rr , Address t' Building Type „ r/� /�' G�J No'..of Bedrooms' Date Permit Issued Has Erosion Control Been Completed? �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, miles and regulations, in accordance with ft filed plan, and the t issued by the Putnam County Department Of Health.. i' V - '- 113 .Si�gTI ` AVENUE, KEANE COPPEL y .,S ENGINEERS, Date — F— MOUNT F�. ; .. v: P.E. R.A. SSIONAL . ORATION ..Address'- 914 2,11 -2235 License No. ' Any person occupying premises served by the above system(s) shall promptly take such action as necessary to secure the correction of any unsanitary conditions resulting from such usage. ' Approval of the separate sewerage system shall beco Il and void as soon as a public sanitary sewer becomes available and the approval of t e.: rivate water supply shall become null and void when a public wai pply becomes available. Such approvals are subJect o odificetion or. c ng when, in the Jud m' f -the.0 mission f H It such r lion, modification or. change is necessary. Date By Title Rev. 9 -81 _.. �e w �erf /V/ ` Ply Jo �tso`t. Owner or Purchaser 'of Building Section Building Constructed b ''BYock _ Location - Street Lot 1pa Ile rso" 4r �er -y 2y, Municipality Subdivision Name Building Type Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success - ors, 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 determin- ation of the.j).irec_to-r of- the Division of Environmental Health -- Services the Putnam County Department of Health as to whether or not _ the -fail- ure 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 C 19��5 Signature g� Title Ties Jo�IN-Sn K'tOC/ /it0 y Corporation Name if-\,/corp. &'e- oc'b g _n r 1__A4y 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 'r..-_i,� , -17 7 - --k 77/ 71, OF`��Hf' IH - # _ PUTN*M,:iCOUNTY':IDEP) 'x Division .0 V' tnWrbnfiibh6VH�a1th, S* r W&4, t -armel N aY 10512 7 11 CONSTRUCTION i fbk SEWYAGf Y, '"PE 'T R own 7Ut, la Loeatetl oc 'T a x 4 M a 7� Lot # Ts Subd SubdIVIS166" Of T- Owner /Address Previous P` Building Area ! Of. *z . "A, ; Y., D Notification -Re wired De's n Number; f P. C. E piiaie era e"- _2 .Aq:�O consist System c_Tih*k'­ "il To be ii -A constructed 1 1 , - S" 4i Pu -Sapp water ypp!y, biic, •vaie ,s-UPPIY 16'6tw re a Address '� �4 W V 6. ripreieiivthat f'am,,* p6i�-OthOlelil�. big fq'rAhe.,deikigp, anq,iocatiow of. i he propqsed -sysie`r'p`(s');` ais im poilil st uct6a'as on i he'appro%i6dimen�imentthere iq'a'na in iccordarice withth'iR.stanoards, rules ano rpoulations; of. -- e• Putnam abov4 de-'sicro ed will be con r S a .County bepa.rtment,,6f Health, and'.1hat or�compiefion t . ereof a --qertmcaie-,6f.. Construction Compliance-' satisfactory t6'Ahe c6nnMissionbr qf:Healthwill be "iutifilitted to the Deportmopht, anq'a. written �96ararifed,wIll builder Will'A. s, W;4;e"rs,. eirs or :':in goo -"op-erating 'co I ndit'lOn--,a,ry,,iJar -o said sews e. spo!@I. sy eiT;�clitring Ahe p-4-rii- ' 4 Place d , t, f di st , - dd'o two (2),. birtlie, Asw the original; m.ovany'repays ante 6i-'the;aOp(6qq1 'tj ej will located 'as onAh approved plan AM 43 ai,saiii 4ell will be l6ita;1id"jin,� acco.rdahce!..-�Whh '66_Iiano County 'De meet of Ith—," .7 7: Signed Date 4 Address -5 1114i ACW .-License hiol- M 'APPROVE 6 Opi-' 6,pNs"T .uc-'ri` ipDr-64al-exp one year ! ronthi date .Is�ued, -unless -construction -of ' the"building hi i , undertaken and -is revocable for cause.or -maybeamenced,be mod i ied'when considered; 9 6 y Y106,(Commis of, keilth.? An� cha nge -or -alteration of -Cowk riaion requires,s new permit Approved fo­r', disposal of,;domesti` sane , t- .water ply only te 9-81 77 777 77- 77 ,77 X11 P -TNAM COUNTY- DEPARTMENT OF HEALTH 1pe rmit ` Ofvisfon ' of. Environmen61 Health Services Carmel, , N. Y : f0512 CONSTRUCTION,_'PERMIT ;FOR SEWAGE DISPOSAL SYSTEM ': �firTTt�Z;SO!J ,` ; Town or �I age Bt,1.L�T CIE. - 4 - -r�AQ_ _ C]t.� �, �)[��:. • r 5.�_ N E Q06l�12�T S[] si ,Owner /Address i i. ?, C,o g d : , Numb @f' Of B@d rOOTS '_:,L— ,pesign Flow G /P /D P C. N. D .NOtlfication .Required ' Separate Sewerage System, to - consist of 1060 .:z Gal. - Septic Tank and To be. 'constructed by Address .;. 1/ N VY ater S upply: Public Supply From private. 'Supply to. be drilled by Addres's L1-1 •� W v ` `�' �FwLr °� ` `Is2 0 2�[pew s 4I2 �4 1'ti �►tif gE A, IE�` ffln represent that) wholly and completely responsible for th'e design 5nd location of} the proposed sysieni(s),L 1) that the s above described will be constructed as shown on:theapproved' amendment there to and in_accordance withihe- standards, rulesa County Department pf MeaKh antl that on complet�on'thereof a- '!Certificate .ot Construction, Compliance ".satisfactory to .1 be submitted to the .Department,'• and ,a ,,written`,guarantee-,will be.`furnislfed -.the owner his successors; heirs,or assign s "Dy,ti place, in good operating conbition any part of ,said sewage, disposal' systeniduring the period of two'(2) years immediatel" darate sewage disposal system bu once of the approvst of the Certificate of, Construction''Compliance °of the oryginaf system or.any repairs-thereto 2) that the di wilipe located_as.shown on the approved plan and that said well II•be installed m accordance with the standards, rules,antl regu County Department of 'Health NEAIVE ASSOCIATES Data KEANE" O@PPELMA14 T ENGI'Nf TERS, T KISCO, NEW i e� AddreSSK— Z'YCIIP /► w w j3 APPROVED FOR CONSTRUCTION This:approval. expires one year from theY':date issued uAIUCii6n 'of the budding revocable for cause or may be amended oi,motlified when eonsidere8 n essary .by the CbmHealth. Any change require'Va ne permitt "A prow ` ' for disposal of domestic' nit y aga sand /or ivatly only. Date BY Title — Rev. 9 -81 - - - m of Healthwill id,builder �vvlll is of the isi6- seribed above . o*6 Putnam. A r'-' �— • ' �'y '_ has been undertaken and. is i► alteration of construction •� ' � � � ra:r�l.,n crrr.rl: 1.�rST. Date: ' Insp_ l IA ?ITTAL SITE IT- 13PECTION Yes No Comments ,Property lines or corners found . . . . • • • . Can cstimate house location . . . • . • o Jill. driveway need cut . . . . . . . . . . • Must trees be removed -hote these . . . . Is deep hole representative of entire SDS area Additional deep holes needed. . . . . . • . . . Sufficient SD3 area available considering driveway cut, house location, separation etc. . . . . . . . . . . . {dist.ances, is L- LL`a / S E P 7 I C DEEP HOLL' DATA D -apth: Water elevation:. -- Rock elevation: Soils description, Date -- FINAL SITE, INS 3P JECTIO Jnsp , by : House located where - shoi-rn on approved plan SDS located vihere approved .. . . . . . . . -ongth of trench measured Width of trench ave case y "' Slope of the line and trench. acceptable -' Room allowed for expansion trenches Over "5 °'f t•: - from sm-rarip, l•Tatercourse Vatural soil not. stripped or SDS area — iuuiecessarily graded 10 11t. maintained ' from prop . line and 20 ft. frorn house . . . . . . • Separation of trench from house, well _ - - - - -et c.- follows -plan _ . ....- - -- _ - - -- - .: - -- - Vhut)ber of bedrooirs checks . . . . Stoner, brush, Stu- ps, rubble, etc-. greater than 15 ft. from nearest trench ... . •,. 15 Ft. of peripheral soil horizontally from trench• . . . . • . . . . • • a . a • . • • • f� Jwiction boxes properly set _ Could surface run. off frorn drivoway, roads, ground surface, etc. chaiulel near SDS .. � area. . . . . . . . Does lot dra ins f,e a.nr-ar 0.i. in area of SDS � -- FIl\rAL GRADING OF SITE ACCEPTABLE, c 1" . u•+. n. f--... v .ru..x.urnu.w.+a.... +«..a,.m_.. l r �_y . �._�.., .. _ _ _ •y l.�l / y! 5i a PUTNAM COUNTY DEPARTMEIV'I' OF HEALTH DIVISION OF ENVIRONMENTAL =�`iLTH SERVICES COUNTY OFFLCB- BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO- Owner Owner Fop mr _ I dwSDo_ Address B JL� 1 _-T Y)-Lf, LVAD aeM91, I� Located at (Street) . &)LLI .1 &-D Sec. -7 3 Block_ Lot FA nd1ca e nearest cross s ree o Municipality 1 PA -r Tou2oo Watershed .G- SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to a er Water Level •No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Tnches Tnches Inches. 1 od 9�a �`6 I �� 3 l0`�°• 131 I '; zL 3 17 ;` 4 5 311�� I(I S 4 . a 5 1 10 0 u M V 2 , %� `6 F .. a: 3 4 ;.y y: 5 -� Notes: 1) Te.sts.to be repeated'at same depth until appr-oximbt.ely equal soil' rates are obtained at each: percolation. test hole.' data to be- submitted -- for review: 2) Depth measurements to be made from top of hole. ' TEST PIT DATA REQUIRED TO P� � _ _ . D ,:1'T � AFrL'C?� ION DESCRIPTION OF' SOTLa T.fC,"L; =D - 'NEST HOLE'S 04 #DEPTH HOLE NO., I HOLE N0. Z HOLE NO. _- - 12'` - I 1811 kY" LOrx6 Loo corn _ 2411,. , (20A129.,�_(�y �. 30'j S 1 t, ru tr t u 3611 _ IM LVkM COQ 421f �l�rn1 DS 4X. 4 8 &mu tv tJ� c2 5411 60" 66" 72.. 7811 84'' INDICATE LEVEL. AT VTHTCH CTRQUIVD.UTA'1'ER IS ENCOUNTERED ' INDICATE LEVEL TO WHICH WATER -LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Sig Date DESIGN Soil Rate Used �6 ?-�% Min/1 "Drop : S.D. Usable Area Provided.—O No. of Bedrooms ) Septic Tank Capacity 10049 Gals. Type 1)9 *5 Absorption Area Provided By¢+�Lj L. F. x24 _ width trench. Other t - me 4j I L-2, Signature Address ,t(✓ KEANE COPPELMAN F ENGINEERS, P.C. A PROFESSIONAL - CORPORATION ' THIS SPACE FOR USE BY HEAUPH DEPARTPT,,NT ONLY: ry Soil Rate Approved Sq. Ft /Gal – Checked by Date .2w .."I .... .. ..... . 5A A,c 'I It 71. 92' iA . . . . . . . . . . . . . . . a. :F Z;�� AAVq� -2 -011' Z, WK. t:%'! It, 47 Y vA .... .. ..... . 5A A,c 'I It 71. 92' iA . . . . . . . . . . . . . . . a.