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Home My WebLink About1860DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -48 BOX 17 !,� - . m l ��, T , .y r �!I'r1 is Is I f 1. it I_ - C. j ' � � � i�riivi � vu1v 1 I iv�r.�tc l mtu ii i Vr' HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Patterson Town or Village g Lakesp rinrt Drive Ff^ d Map #872 Block Located at owner, MGGlasson Builders, _Inc :`r1Q' . -. _.:.,. - a- Jobe 501572 TSeparate Sewerage System built by Owner Y Address 93 01 enefda Ave., Carmel , N•[ Consisting of 1000 Gal, Septic Tank "" lineal Feet X width trench Other requirements Two ^ 6 1121 D1a. x 61 deep seepage pits Water Supply: Public Supply From X ' Private Supply Drilled By Henry Boyd Address _ Rte. 52, Lace Carmel, NY Building Type Frame w to No, of Bedrooms T Date Permit Issued Has Erosion Control Been Completed? i es 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, plans fileq, and the permit issued_.,W the Putnam County Department of Health. Date 5 Noy. 1975 Certified by - P.E. R.A. Address f>•D' 6 Sox :35 C �inel N 10 .1 2 License No. 29206 Any person .occupying premises served by the above system(s) 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 sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Co ' sioner of Health, suc�diflcafl�onor ch ange is necessary, Date V 13 Title 5 Y�.. PUTNAM . COUNTY DEPARTMENT OF HEALTH Division of Environrfien'61 Health Services, Carmel, N. K. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson '~ f' Town or Village Located at Lakesprtn.q Dr1,Ye IK Block -'- Subdivision LakesprQ„ 1�eadopts' _ Lot IO Job McGI asson Builders, Inc. 93 Gl enetda Avenue Owner— Address Frame 32862± Carmel 10512 Building Type Lot Area ,_NY 1976 (2 fl oors) Number of Bedrooms Total Habitable Space Square Feet Separate Sewerage System to consist of 1000 Gal. Septic Tank 230 lineal feet X 36 �h width trench To be constructed by Owner Address Water Supply: Public Supply From _n_ Private Supply to be drilled by Address Other Requirements None I represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years Immediately following thedate of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be Install in accordance with ndards, rules and regulai oT—ns of the Putnam County Department of Health. �/ Date 26 February 1975 Sig ` "z y P.E. ^ R.A. Address R.D. 6 Box 3 3 dirrael , NY) 051 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when consi ecessa y by the Commissio f Health. Any change or alteration of construction requires a neew ermi�AppMove ti sposal of domestic nitar se and to supply only. Date By Title Owner Building Constructed by Lakesering Drive Location - Street Frame Building Type Lakesprtngq Meadows Subd. Section Filed Map #872 Block 10 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 :Wade 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 _Ddrector: 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 5th day of November 1975 Signature Title ( f corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP�.,ETION 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 _ - ,......_.., _ z___. .PTJTNAL�COUN'I�'•-DEPARTMflV -T- OF "•HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Af� �o►h ,d;/ ��Address Located at ( Street �/ Sec .Later �e k Lotp 9 Indicate eared cross street) AFAV Ae a*7Z Municipality —_A s Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME 5 PERCOLATION 1 PERCOLATION RM No. Start -Stop Elapse Time Min. Depth to Water From Ground Surface Start Stop Inches Inches a er ve in Inches Drop in Inches Soil Rate Min. /in drop 5 3 /3,�13�ir L yet ys- / zur 13f/ 2 /34l 1,14. f / 3179'f /d IF 4 5 1 2 5 Notes: 1). Te'gts to be repeated at same depth until ap atelyy equal soil rates are obtained at each percolation test hole. Al. data to be submitted for review. 2) Depth measurements to be made from top of hole. DEPTH G.L. 6" 12" .1811 2411 30" 36" 4211 48" 5411 60" 66" 72" 7811 _ TEST. PIT. DATA ..REQUIRED T.0 .BE SUBMITTED WITH IN '1'ESiA' PIPLOII,DE A TI"n ON".A . ._..._. _ , -.: F' "SOSENCOUV�!'EE15 ..._... ..v . ,� >.. NO._�� 84" fo 11 .INDICAT � �, L -A WATER IS ENCOUNTERED - INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY t �R, , )®4/2 � �.i� �ate 7: DESIGN Soil Rate Used /n/1 "Drop : S.D. Usable Area Provided Rn W No. of Bedrooms - Septic Tank Capacity Gals. Type Absorption Area Provided By�L.F.xN width trench: Other 4A Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Chec t,� �s , u 1 I All t : 1 y` SITE IACATION BID • Dq I I • a " PUTNAM COUNTY HEALTH DEPA[IJ.L•ER DIVISION OF ENVIRONMM� HEALTH SERVICES 4 PROPOSAL FOR S394E DISPOSAL SYSTEM REPAIR a�1— S &93 PW CW plaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED IISSTALLER PHONE -�L 7r REGISTRATION # Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. i(,t/-f's O� 6N3 Proposal approved Proposal Disapproved roposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed carponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep. drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. SIGNATURE TITLE DATE A as owner, or reported agent of owner agree to the above conditions. M WAte (MD); YeUcw Mmn HO; Pink (kVliamt) e I LI i tr ( r y V. � 111 I q W t _ rr API i I 1 c p ./ 3 c� '!1 LJ vl J �JJ �l nEAiTG trugture' located from, survey by surveyor note d:; beldw�T Well located' by: Surveyors survey._ ❑ y Weil drillers report•_ -. M- _ xs mesuremenfs..®.�_ _, Tor k, bokeg, pills, 4jallerid's' 8 laterals lo- caled. by Gontroia4r �- Enpineer'. • Nedlihda� =/f�` Pt th al .inspIaction-byi Heal-dept C3 - do a ,_ finginaer 0 dnte,_ Ja NOTES:. E LOGATION,Sireet^ 4E tau s4 SUBDiV ISION,I s Y Map: —'� Block., _ — - _ — - LOT NQ 1..0 pf Builder:_ l Drawn k o e �1-4 7S Sca1e:� S,) .C) i _ JOHN H PR E N T I S S PE. r ' rnwaui -TING ENGINEER e I LI i tr ( r y V. � 111 I q W t _ rr API i I 1 c p ./ 3 c� '!1 LJ vl J �JJ �l nEAiTG trugture' located from, survey by surveyor note d:; beldw�T Well located' by: Surveyors survey._ ❑ y Weil drillers report•_ -. M- _ xs mesuremenfs..®.�_ _, Tor k, bokeg, pills, 4jallerid's' 8 laterals lo- caled. by Gontroia4r �- Enpineer'. • Nedlihda� =/f�` Pt th al .inspIaction-byi Heal-dept C3 - do a ,_ finginaer 0 dnte,_ Ja NOTES:. E LOGATION,Sireet^ 4E tau s4 SUBDiV ISION,I s Y Map: —'� Block., _ — - _ — - LOT NQ 1..0 pf Builder:_ Surveyor. Drawn k o e �1-4 7S Sca1e:� S,) .C) i _ JOHN H PR E N T I S S PE. r ' rnwaui -TING ENGINEER D I N SIGN S; t A - F — _B - - V v - - - -- - A G --- -8 -' = G -- -- -- A H -- - --0 _ H. _.---- - -- -- _ A. -'K - - - - -B -.K -- - - ^- - OWNER:_ E LOGATION,Sireet^ Town:�rrr,= r�_�,Y _County: jr,_ State; tau s4 SUBDiV ISION,I Map: —'� Block., _ — - _ — - LOT NQ 1..0 Builder:_ Surveyor. Drawn k o e �1-4 7S Sca1e:� S,) .C) _ JOHN H PR E N T I S S PE. r ' rnwaui -TING ENGINEER •I: �t