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Home My WebLink About1899DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.09 -1 -22 BOX 17 ML f '-i #' �� m ul Nr 1A* s t ti 1 PUTNAM COUNTY DEPARTMENT OF HEALTH Division . of .Environmental Health Services, Carmel, M Y 10512 CERTIFICATE OF CONSTRUCTION. COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM 6tt6fton Town or Village East Branch Road Located at Section Block Owner Barbara & . Edward Krauss . Lot 7, 8, 9, & 1 Of x � SO484 s Separate Sewerage System built by Andrew' T. Mill Brewster, N Y 3 1050,9'��{r Address ac s aS* Consisting of 1000. Gal. Septic Tank 240 lineal Feet X ' 36 nC� 3 width trench Other requirements Trenches In Fill Sect -.'661 x 33' x 24" ' Water Supply: Public Supply From X Frank Carroll Well. bri 11 i ng , Inc.`" Private .Supply Drilled 'By Address Rte 22, Brewster, N Y.''10509-' Building Type Frame No, of Bedrooms Three Date Permit le :uad 5/26%7x1 Has Erosion Control Been Completed? None Req' d. ' 1 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 filed, and the permit issu y the Putnam County Department of Health. n •,fit,.• y Date 6/17/72 Certified b t P.E. X R.A. Address R. 0. 6 5..353 rmel New 4k 10512 License No. 29206 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 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 Commissioner of Health, such revocation, modification or change is necessary. Date' —c �� ! 7y By �� i-��± Title �� 517ni. e r c ing Bia_Elding _e I C, p al _t _y Lot; GUARANTY OF SEPARATE _Q=L'V1Ar1E- SYSTEM I represent that I aril wholly an-L - Lcor,,,p_Tetely responsible for the location, worimmanship, material, cons, true t-tion and drainage of the sewage disposal system, serving the above descri.b.'ed property, and that it has beet- V constructed as shown on the approved pla?z , -.or approved amend-rrent- thereto, and. in accordance with the standards, rules and regulations of the Putria-m. County Department of Health, and hereby r--Ua,ranty to the owner, his succes- sors, heirs or assigns, to place i . n good -.6f),erating condition any part of said system constructed by rre vihich fail- to operate for a pi;riod of tvio years imr-riediatel,1- following the date of il-idt-lal use Of the Sewage disposal systeor any repairs made by nlie, to sucli system, except where he fallur'e m, t to operate properly is caused by the willful or negligent -act of t 1-i _e o cc a - .''Pant of the bLiildinu utilizing the systen. The undersi.cnied further a�ees to accept as concll-is fewe the de- tern ilriation of the D.1.1,ector of ti-le Division of Environmental HRs,alth Se_W4�_ vices of the Putnam County Dep.art--ment of Health as to whether-**&r.not t lie failure of -the system to operate was caused by the willful o.,..r nieg'lig-ent act of the occupant of the building utilizing the system. Dated this 2 day' of e 17 72- Signature Title If corpora t4 011, give name arid address) THREE (3) COPIES ARE REQUIRED WITH TT REL- i - (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLET'I'ON' 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 llealtii F. 517ni. e r c ing Bia_Elding _e I C, p al _t _y Lot; GUARANTY OF SEPARATE _Q=L'V1Ar1E- SYSTEM I represent that I aril wholly an-L - Lcor,,,p_Tetely responsible for the location, worimmanship, material, cons, true t-tion and drainage of the sewage disposal system, serving the above descri.b.'ed property, and that it has beet- V constructed as shown on the approved pla?z , -.or approved amend-rrent- thereto, and. in accordance with the standards, rules and regulations of the Putria-m. County Department of Health, and hereby r--Ua,ranty to the owner, his succes- sors, heirs or assigns, to place i . n good -.6f),erating condition any part of said system constructed by rre vihich fail- to operate for a pi;riod of tvio years imr-riediatel,1- following the date of il-idt-lal use Of the Sewage disposal systeor any repairs made by nlie, to sucli system, except where he fallur'e m, t to operate properly is caused by the willful or negligent -act of t 1-i _e o cc a - .''Pant of the bLiildinu utilizing the systen. The undersi.cnied further a�ees to accept as concll-is fewe the de- tern ilriation of the D.1.1,ector of ti-le Division of Environmental HRs,alth Se_W4�_ vices of the Putnam County Dep.art--ment of Health as to whether-**&r.not t lie failure of -the system to operate was caused by the willful o.,..r nieg'lig-ent act of the occupant of the building utilizing the system. Dated this 2 day' of e 17 72- Signature Title If corpora t4 011, give name arid address) THREE (3) COPIES ARE REQUIRED WITH TT REL- i - (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLET'I'ON' 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 llealtii BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 2678 SOURCE: Edward Krauss East Branch Road Patterson, N.Y. COLLECTED: BY: Frank. Carroll %Yell Drilling, Inc. BACTERIOLOGICAL EXAMMATION Coliform Count, MF Method per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. June 2 1972 Roy Bickwit P. E. Director WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating.water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION NAME J DRESS ' 0.0 _} fA✓l�vi9 A // LOCATION (o. 6 Street) (Town) (Lot Number) OF WELL .:-�- � ❑ ❑ '❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ SUPP Y ❑ INDUSTRIAL ❑ ❑ CONDITIONING ((Specify) DRILLING ROTARY COMPRESSED CABLE OTHER AIR PERCUSSION ❑ EQUIPMENT PERCUSSION (Specify) CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ❑WELDED p❑ MXVE S O❑ GROUTED? is j THREADED NO YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ YIELD (G.P.M.) PUMPED L� COMPRESSED AIR 16— / 5 WATER MEASURE FROM LAND SURFACE — STATIC(Specily feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL >', f ! in feet below Land surface: d 10 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (Inches) FROM (feet) . TO (feet) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET f /% C ),,d G a i L' 7 y If yield was tested at difFerent depths during drilling, list below FEET 3. GALLONS PER MINUTE �A DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) 1_7777 E: 7 .7, 77 PUTNAM COUNTY, DEPAR 1 MENT OF HEALTH Division of En'vironmental Health S&viqes, Q?rinql; N. K 10512* 7 .CONSTRUCTION. PERMIT `FOR SMAG I E DISPOSAL, SYSTEM 7 7 Are r village Located at' Section Block' Subdivision 0 Lot J'b Owner Address ev Building Type 7X _Zh� +A2 I Square Feet- Number of •Bedrooms - Total Habitable Space /4 Separate Sewerage System- to 6onsistl'of Gal. Septic Tank lineal feet X. width trench To be constructed t. d 6 y Address _ Water Supply: Public Supply, From Private 'Supply, to be, drilled by, Address - rP*'%�JC1he -XQ Other. Requirement I represent that I am wholly and completely responsible for the design and location 'of the proposed system(s),; 1) 'that the separate sewage disposal systerin above described.will be.constructed as.shown on the approved arriendmefit there to and in accordance With the standards, rules and regulations .7_7e_TG =na- County . Department I of Health and that on.c . oirripletion,thereof a '�CeVtifi . cale' of Construction Compliance" satisfactory to the'Comniiisloner of HealthWill written gua, - X . , , , , " owner, h_1 :succiiiiscrs heirs or isiigrii.by the builder; that said I .buiicier Will' be submitted to the D66artrheht,.and 6 ' t rantee'will be furnished owner, Is clurinig the place in -good operating condition any part* of said "age dispissa system period o . two (2) yeais immediately follow - Ing thedatii of the issu- ance of the approval of the Certificate of Construction Compliance p!!a-n.ce of% the originail,systern or any repairs thereto;'2):that the drilled well described above will be located as',sh6wri on the approved plan and that said well will be installed in accordance with, the stand rds, rules. and regulations of . the ..'Putnam County Ddpartment of Health Date E. R _' P. R.A. Address License No. APPROVED FOR CONSTRUCTION: This approval expires one year rom.the date, issued unless construction of the building has been undertaken and is revocable for.cause or enay, be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit.. Approved for disposal of domesti aniVry sewagel-A nd/®r prJivat6 water supply only. Date-' By UZZ11 Title T '� T OF PUTNA?1 COUNTY D� � n ?"' ' LTH -� ,l_u. DIVISION OF ENV- IRO`��`TaL HEALTH SERIV IC S DESIGN DATA 'SHE ET - SEPARATE SE:' -AGE DIS ?iSAL SYSTL_- FILE NO Owner i � ,��a$ Addre s ,_e� - f�1�N 1x _ a Located at (Street)_ Sec._ hj,. Block Loth - o�� (Indicate neares.t. cross. s Lreei.) Municipality P -ef V;0M NTatershed Cy c. SOIL PERCOLATION TEST DATA REQUIRED TO B£ SUZ.,.- TIED t• ITH APPLICATION Hole NtImber CLOCK TIME P`RCOL•ITIO \t . PERCOL -11I0ti Run Elapse Dent:-: to t%ate-- ;later Level No. Time Frog:: Ground Surface .i'n "Inch:es Soil Rate Start Stop Min. Star= Stop Drop in Min %in.drop Inches Inc .es Inches S — �- -- 3 `NIt, 4 Notes.: 1) Tests to be-..repeated at same depth until approximat-ely equal soil rates are ob- tained at. eac`i percolation test hole . all data to be submitted .for revie;: . 2) Depth meas1.r'::ents to .be 'made from to» . of hole. TEST PIT DATA REQUIRED -0 2E SUBMITTED :IT APPLICATION DESCRIPTION OF SOILS OU`TERED I`, :EST HOLES DEPTH HOLE .M . � HOLE \0... HOLEr Err 'of��i�� - 18 it 24" 30" 36 42' 481. 547? 6 0" _ 6611 le meek Q 2:' i V. .. 8 41. INDICATE LEVEL aT t�,7HICH GROUND t�YaTER IS ;:ENCOUNTERED. MOP, j INDICATE IE LL T.0 tJHICH tvATEF. LEA %LL RISES AFTERBEING ENCOUNTERED41, � . TESTS "LADE B:' Date 1)E L _N Soil Rate Lised 'Min /1" Drop • S. D. Us �!Dlc Area Prop ided� No. of 5edroc: s_S`ptie Tan- Cap_ _ty ®� Gals. Type I2 ak�g --_ Absorption Area Provided By c_ Ln trencn. Other_ John No Prentiss, P.E.- •C.E.:C• Name. Sim ature Address R: D. G.9 E3 35 AL Carmel; N.Y; . 10512 .. PU LNAM COUNTY DEPART�F,�T OF HEALTH Date Soil Pate Approved Sq. Ft. /Gal. Checked, n;; �t _ Es ✓,z . a / r "iR CE .yam _ .. Y y9 0 t . "�3 z � mv � I --= 'An eN � t ��` `�= —� + f ..- ..�.`.. ter,..,'_• --