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Home My WebLink About2129DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 30. -2 -8 BOX 19 02129 M� CIS -k �6 L ;, L .A{ I ,, 02129 31 PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER MUST 1 0 Division of Environmental Herelth Services, Carmel, N. Y. 10512 PROVIDE ' PERMIT # CERTIFICA OF CONSTRUCTION, COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM fAh4_/A4 ,LL �_. _.. Located at 1>]f °Lk /V Tax- Map 7 Block Owner V / / Formerly ^ Tax Map Lot N' Subdd.. Lot & Separate Sewerage System built by �� l �`�--' Address s 0 C aQ'JV �`��,1,6 Q Consisting of Mao Gal. Septic Tank and v – f3! D ss z�A N6 10/, -XS Other requirements Water Supply: Public Supply From Private Supply Drilled By Address Building Type —No. of Bedrooms ,3 Date Permit Issued �Y Has Erosion Control Been Completed? Has garbage grinder been installed? 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 d the permit issued by the Putnam County Department Of Health. Date Certified by r P. E. R.A. Address • v � 16 URtrtt 0' 7 License No. Any person occupying premises served by the,above system(s) shall promptly take such action as may be neussary 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 wat supply becomes available. Such approvals are subject to modification or change when, in the Judgment of the om Toner of Health, such r out n, motlifiution or change t eeestary. 1 Date " `< a �T� wv Rev. 6/85 �i `O�vo 1eo� Location - Street "am ()J /l t� Municipality Buildi g Type Lot rere-yr Ark Subdivision Name 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- or's, 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 Director of- -the Division -of Environmental Health Services of the Putnam County Department- of Health-as to whether 'or' not the fa .l- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. 0% . - CL" Dated thisday of 19 Signature C. Title Corporation Name if corps 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. ®I Division of Environmental Health Services, Putnam-County Department of Health r Owner or Purchaser of Building Section . C. : feven tq / A4 c `.$ui aing Constructed by � . I-— ° �B1aCk - _... ... _. _.., _ �i `O�vo 1eo� Location - Street "am ()J /l t� Municipality Buildi g Type Lot rere-yr Ark Subdivision Name 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- or's, 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 Director of- -the Division -of Environmental Health Services of the Putnam County Department- of Health-as to whether 'or' not the fa .l- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. 0% . - CL" Dated thisday of 19 Signature C. Title Corporation Name if corps 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. ®I Division of Environmental Health Services, Putnam-County Department of Health P.O. Box 99" 321 hear Street LOCATIONS: �-� 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 Yorktown Heights, N.Y. 10598 g ❑ 201.BUTTONWOOD AVE., PEEKSKILL, N.Y. 105GG 7378777 245.3203 ❑ 495 MAIN ST„ MT. KISCO, N.Y. 10549 666.3335 ❑ STONELEIGH AVE. (NEAR HOSPITAL). CARMEL, N, Y. 10512 27E ..., LAD # = a2 DATE TAKEN: DATE RECEIVED. DATE REPORTED: SAMPLE SOURCE: F� REFERRED By! -- J COLLECTED BY; AR S qtr 9 3 f --.496 5-.3 LABORATORY REPORT mg /L ❑ ACIDITY. .................. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ............... ........ ❑ ANTIMONY ................................ ............................... .4`! ................... BACTERIA, TOTAL /.. L .......... ................... ❑ ARSENIC .................................... ............................... ❑ 800, 5 DAY ................... ............................... ❑ BARIUM ....................................... ............................... ❑ BROMIDE ........:.......... ............................... ❑ BERYtLIUM ................................ ............................... O CARBON DIOXIDE, FREE .............................. ❑ BISMUTH .......................... ............................... ❑ CHLORIDE ................... ............................... O BORON ............. ............................... ",, *..................... ❑ CHLORINE ................... ............................... ❑ CADMIUM .................................... ............................... ❑ COD ............................ ............................... ❑ CALCIUM ....................... :........................................... 0 COLOR ....................... ............................... "3 CHROMIUM ( tot.) ............................ ............................... - YANIOE ................... ............................... L7 CHROMIUM (hexavalent) .................... ............................... CJDETERGENT. ANIONIC ... ............................... ❑ COBALT . ................................. ............................... ❑ FLUORIDE .................................................... ❑ COPPER ............................... ............................... OHARDNESS ............. ... .....................6......... . ❑ COLD ........................................ ............................... O MPN COLIFORM COUNT/ 100 ml ....... .......... ❑ IRON ........ . . ,W HFT COLIFORM COUNT/ 100 ml ........... ❑ LEAD ....................................... ............................... ................. ❑ CONFIRMATORY TEST ................................... .. ............................... ... . O LITHIUM ................,.................... ............................... ❑ NITROGEN, AMMONIA ....... ............. '' ❑MAGNESIUM ' ❑ NITROGEN, KJELDAHL ........................ .I....... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ... ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN. ORGANIC ... ............................... ❑ NICKEL ....................................... ............................... ❑ ODOR ..................................................... ❑ PALLADIUM ................................ ............................... ❑ OIL & GREASE ............... ............................... ❑ POTASSIUM ................................ ............................... OPH ........................... ............................... ❑ RHODIUM .................................... ............................... ❑PHENOL ....................... ............................... ❑ SELENIUM ....:............................... ............................... • PHOSPHATE lortho) ....... ............................... ❑ SILICON ........:........................... ............................... • PHOSPHATE (condensed) ... ............................... ❑ SILVER ........................................ ............................... OPHOSPHATE (total) ....... ............................... ❑ SODIUM ........................................ ............................... OSOLIDS, SETTLEABLE, mt /L .......................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ...r ..................... ...... ❑ ZINC ............................................ ............................... ❑ SOLIDS. DISSOLVED. .... ............................... ❑ .................. ............................... OSOLIDS. TOTAL .......................................... ❑ .................................................... ............................... ❑ SOLIDS. VOLATILE ....... ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE .............................. ❑ .................. ............................... .............................. ❑ SULFATE ................................................... . .................................................... ............................... CJLFIDE .................... ............................... Li .................................................... ............................... ' ❑ SULFITE .................... ............................... ❑ ...... ........... :..... ❑ SURFACTANTS ............ ............................... ❑ ................................................:... ............................... ❑ TURBIDIT ." . ............................................... ❑ .............. ........... ............................... _.. _._ _....... THESE RESULTS INDICATE THAT THE WATER 'WAS 1&-9 OF A SATISFACTORY SANITARY QUALITY mIEN THE SAMPLE )JAS COLLECTED. THESE RESULTS INDICATE THAT, TIIE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY OF NE14 YORK STATE ADMINISTRATIVE RULES & FOR THE PARAMETERS TESTED. REGULATIONS, DRINKING 14ATER STAP ARDS (PART, 72) ALBERT H. PADOVANI M. T (ASCP) , DIRECTOR v C WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH 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 OWNER NAME Steve Alford iRichardsville ADDRESS Road Carm&'l NY LOCATION OR WELL (No. 8 Street) (Town) (Lot Number) SAME PROPOSED USE OF WELL INESS ® DOMESTIC ❑ ESTAB ISHMENT ❑ FARM ❑ TEST WELL ❑ SUPPLY El INDUSTRIAL ❑ AIR ❑ OTHER CONDITIONING (Specify) DRILLING EQUIPMENT fX1 COMPRESSED CABLE LJ ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION El ((SSpecifRy) CASING DETAILS LENGTH (feet) 201 DIAMETER (inches) 611 WEIGHT PER FOOT 19 lbs a ❑X THREADED ❑ WELDED SHOE YES El NO C YES � 7 NO YIELD TEST HOURS G.P.M. ❑ BAILED El PUMPED ❑ COMPRESSED AIR 6 O YIELD (G.P.M.) O WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 20# DURING YIELD TEST (feet) Depth of Comploted Well in feet below Land surface: 1851 SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET O 4 Drilling in overburden Hit rock at 4 feet 4:? 20 Drilling in rock,set lca'sing,. grouted Drilling- i lin in rock rani.te If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 10/10/83 DATE OF PORT 10/11/83,, WELL DRILLER (Signature) of Environmental'' 19 I'iEALTH. N Y '10512 Block Pj/ f Permit., r �.. . Nr r Village Subdivision Renewal _❑ Revision ❑ ..-� Owner /Address- �� -, 5�� Date Of PreviousApproval L Lot 'Area only Building Type o F ill Section, Number of Bedroomi Design Flow G /P /D P.0 N D Notification Required Separate Sewerage System to, consist of Gal Septic Tank and 'S IOU �• To be. constr.uctetl.by li ' - Address r.- Water Supply: Public 56pply- From • f r i �G PnVate Supply to'be tlrllled; by ... `Address C Other Requirements ' a r. • t represent That 1 em wholly and completely responsible for the design a' nd;locatwn of th6:�proposed; system(i) 1) that the :separate, sewage ,;disposal sy, 1 above described will be constructed as shown on'.the approved amendment there to and in accordance -With the standards, rules and regu a ons o e u ' County ,Department ' of Health, and that .ch completion thereof, 6 k. Certificate 'of Construction Co`niDliance ^'satisfactory to the Con►missioner.of Healti t' be„ siitimitted to the, Department, and a wrltten,'guerantee wili,be� fur fished' the owner ,his - successors ;h'eirs or assigns.by this builder, that said builder place in good operating condition ,any part of said sewage disposal system -during the: period, of two_(2j years immediately fol wiry the dste of the' k ' •' ance of .the'approvah of the` Ce►titicate of Construction Compliance ;of the driglnal,;system or:any repairs thereto; 2) that'•t dr Iled °well 'described a` Gwill be locatetl as shown on the approved plan and that saitl well well be installed in, accord a wit the standards, ules an egu ons of, the Put County Departure ^.� 1� c P.E: `h Date / _ - ,.,5 i•netl _ Address c LI en No:. i s APPROVED "F.OR CONSTRUCTION. =.,�Thii' approval expires one' yearfromthe date issued unlesi: construction of „the building has.been undertaken ar, revocabie for, cause or maybe `amended or modified when considered necessary by the Commis n r of Health. Any Change .or alteration of cdnstrucl requires a new permit roved for disposal of domestic sari a age and /or private at y ��° } Date . By, e Ti t �.. PUTNAM COWTY DEPARTUMT OF HEALTH D�YU�.��0�..GE.�d�V.- IRD•N�I� �;T�:°'S ..5� Date- Re Property of�� Located at 'r- . o . Section Block 8 Lot t&P D Gentlemen .o 6- v54 This letter is to authorize T,- Michael Daly, P.E. a duly licensed professional engineer or registered architect (Indicate). to apply for a Construction Permit fora separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations. as promulgated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in: connection with this matter. and -to. supervise -the cons.truction:= bf.`said- system or, systems in conformity with the provisions of Article 145 or 14L Education Law, the Publ riealth Law, and the Putnam County Sani- tary Code.. AUG 181982 auq. OF HEALTH Countersii P.E., RoA s, 48468 P_o-c 43 Pnoroc c (Seal) Address N.Y., 10587 248 -7022 Telephone Very truly yours, Signed Owner of Property Address Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ C<QLTY_.,OFEZCF BUILl?I�VG:, _�CARMEI� N. Y .. DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE^ NO. `l Owner � A6•Y R Address �4 ItNC ��V�t� - Ero't�.� o�J I�Vag� Located at ( Street H-Fi—cate D%cK_TmA � jZ0 Sec. 4-- Block�_Lot 1 �• nearest cross street) Municipality. b lij1JAw,_ ��1..i..cU Watershed • l.� . ' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS oe Number. CLOCK.TIME PERCOLAT_ION PERCOLATION Elapse ___DePTh to Water water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches . Inches Inches , 1 0 t3 13 z. 0 .. i 4 14 i 1 14 30 J.i� 3 I(0 9 1/0 5 0 ISO 1( s l3 4 10 -1-0 -2-( 1 1� 1• 2 AUG j 8 C7UNTY DEN t. ,Of HEAL; H 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. r TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH ..... HOLE. _..N9_... HOJ E NO G.L. 6" 12" ... 18" 2411 ,1 30" �► 361f 42" 48" 5411 60" rJ 66" 7211 a l 7811 84" INDICATE. LEVEL AT WHICH GROUND WATER IS ENCOUNTERED �1O yg`P�� INDICATE LEVEL TO WHI H WATER LEVEL RISES AFTER BEING ENCO)TERED TESTS MADE BY., -Date DESIGN .Soil Rate Used l(o'20 Min/l "Drop: S.D. Usable Area` Provided toque t� No. of Bedrooms Septic Tank Capacity \000 Gals. Type- M"O Absorption Area Pro ded By L. F. x24 j '� width-trench.. 6 {, Other THIS SPACE FOR USE BY HEALTH DEPARTPENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date t ,PUTNAM COUNTY DPARTI4IENT :OF HEALTH : .. Dfvfsion` of: Environmeriia/ Hea %th "Services, Carmel 1V Y. '10512. sF: is Town of Putnam Valley NSTRUCTL QN PERMIT FOR.$EWAGE DISPQSAL SYSTEM, Northerly s' ide Dickto rn ap rox ft' Town o► village ` Locaied,at A, t:# P�� r of _1 er�le $terfcila. Lan @axwMap # kock a.�_n r..ir•: ...._. +.r. F.°' "'+Y. 1 - '- ,s•¢.saw,..S •� •tn tw _.rya' v-I 1 1 - tr..i. .. ...w w. Sw1 P . >SUbdiv.isiOn -'F'Orest Park A f. - :s '• Taic- MaprLOt# Sum. 41 s :owner Tohn Prendergast: 100.. P.arkwa ,Road Address +Acres ronxvi e, • Building ^T l t tea" 1 (� 0 minutes Number'of Bedrooms Desi n Flow Total Habitable Space Square Feet 1 3 g s = .900 430. , Separate .Sewerage System to consist of _ Gal SeptieyTank ana, ft 2 ?drench /.( ), •;( X )leaching pits' G D excavations Putnam „Valle. N Y To be constructed py -__ __ _— Address y1 Water Supply Public Supply' °From x rlorman Anderson a, Pnvate .Supply'. to be drilled by „I Putnam ,a eY I ` Address. 4 a' C,om 1 w1t h all notes 'and r:estr' ctlon-s "as: de,l�ho' Tho' on Filed Other Requirements �_ i Su'bdivisi`on Plat .and Inte;ra a 'f : ea an' I represent'that I am wholly and completely'responsible for the` "design and location of the proposed,system(s)t l) that the separate sewage disposal k system above described will be.constructed.as shown on the, approved attachments hereto, and in accordance, wifh -the standards, rules and. regulations } _of thi Putnam County Department Of'xealth, arid: that on'oompletion thereof a "Certificate of.'Construction`Compliance'" satisfactory to the Commiseiori- er of Health'•will-be:submitted to the, Department, and a written,:, guarantee will, be furnished the .owner ;this successors, -heirs .or.asaigne by, the build + .p.•.er that said builder -will piace.in. good operating condition any.part•of:saide sewage disposal system during`ihe, period of two (2) years immediately ' ,following the::date of the issµarice,of.:the "approval of the Certificate ,of.Construction Compliance_'of the original system or any repaire,theretoi 2)' :`that the,dzil]ed well`described,above will be °located as shown;on the approved plan and °',that said well will be'installed'in' accordance with the stan- j clarda _rules and regulations: of the ]?utnam County Department Of Health TT6Vember ..1. � 197. 8 Date Signer) x Burges ehr;,. Address "T APPROVED FOR, CONSTIRUCTION: This approval expires one year from the date. revocaple for,cause�or may be amended -or modified' .When -consi ere_d'necessar,y by`th requires a, new permit Approve for .disposal _of domestic ni r s a and /oi 1 'a Date_ eY P :E R.A. 32 .'9845- NY l- K-i—?_ Lica�se No. 9845 ued unless construction of ;the building has been undertaken:; and is Commissioner )'j ealth. `Any change or alteration of construction t pr ate. w er wpply ;o_ my Title . a _ - ..•w. .. .. .. .. ...t, ...- .- _..._� .�_.._ .__ . - v -T.. ... ...._ p._. _ .. a _.. .. .. _... -..� .. .- '.� ......_mow - -«-. -.._�� . -. .. ti v s... .. ..�.. V ... r ... C_'' i I" D 1EALTH -V"LRONMENTAL HEALTH SERVICES :.Ou1?TY OFFICE BUILDING, CARMEL, N. Y. 10512 1107-616 SHEET.- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. s er John Prendergast Address 100 Parkway Road, Bronxville9 NY 10708 (Street 6dicate Dicktown,Road Sec. 4 Block 1 Lot 15 °1 (TM) nearest cross street) Lot 1 of Subdivision of Forest Park m Filed Map #1546 cipar.ty Town of Putnam Valley Watershed New York City SOIL PERCOLATION TEST DATA.REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION u1 Elapse De p th to Water Wafer ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches . 1009 -1028 19 24 25 1 19 Min 21:28 -1 <48 20 24 25 1 20 " -1:48-2:08 20 24 25 1 2D " L2:08-2:27 19 24 25 1 19 11:13 -1:28 15 24 25 1 15 11 21:2_8 -1:44 16 1 24 25 1 16 1:115 -2:04 19 24 25 1 19 „ -2:05-2:23 18 .24 25 1 18 5___ ;�oU 1) Tests to be repeated at same depth until approximately equal soy.;. .tes are obtained at each percolation test holeo:.::.All data to be submitted 2) Depth measurements to be made from: ,top �of hole. Q x TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPT.InN- •OF�- 'SOILS•ENCOUNTERED•- =Tip= -T-EST HOLES -- 3 DEPTH HOLE NO. 1 HOLE NO.- HOLE N0. G. L. Topsoil Topsoil Topsoil 6" 12" 18" 2411 3011 3611 4211 4811 5411 601' .. 72" 78. rr n Sandy Loam Sandy Loam rr 1t . ti 1T rr . 1t .stones and gravel., Stones and gravel IF � 11 tt It rr it rr tr I, 1r IT It rr • Sandy Loam tl II ,I stones and gravel 11 1r 11 tr 1r "'INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED none ::INDICATE LEVEL TO WHICH WATER, RISES A TER BEING ENCOUNTEg� TESTS MADE BY Burgess! Behr, 7� . Date 517 6. y 16 - 0 DESIGN Soil Rate Used 2 DTW1 "Drop: S.D. Usable Area Provided6,000 SF +- No. of Bedrooms 3 Septic Tank Capacity 900 Gals. Type Precast conc. Absorption Area Provided By430 L. F.x24" rent . All conditions and restrictions of Subdivision Plat A, me P1 n hall _ lvame x oy A Burgess bignature Address Burgess? Behr, P. C. SEAL^ j) Forsepoi�KZI Road Carmel, N.Y. 10512 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: -es�tor�� Soil Rate Approved . Sq. Ft /Gal. Checked by Date �� ..... ` . PUTNAM COUNTY DEPAI • DIVISION OF ENVIRONMEI I ' John Re: Property of Located at Diektown O Section 4 Blo - Gent Lot 1 of Sumdivis This letter is to authorize a duly licensed professional engineer .� IT OF HEALTH HEALTH SERVICES ;July' 109 197'8,• .' ... . e ! sndergast- ad , 1 ... .Lot �'� ° �' • :of Porest Par k9Piled Map #1546 Dy Ao Burgess or registered architect serve the above noted property in accordance with the standards, rules i j ;or regulations as promulagated by the Commissioner of the Putnam County' j I Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the co>r'struction of said " I ' system or systems in conformity with the provision" of Article 145 or j i I - ,...._ - -' . - .147.. Education Law,. the Public, Health -Law; and the - Ntnam County Sani Lary Code o.. - � • .. � - -_ -- _ � ... - - j Very truly yours Sign ; e 1.0 Pa ae o' Countersigned4fe# .9845 xville No Yo 10708 I p # A ess f , Burgd-6s r., P o Telephone Address D 8 Horsepo to Carmel, Z. Yo �.2 225 =3312 e° c Telephone �. . r G i 04ESSI0>VP�' 0 f "/'1��1•, Lo 1 .. •�> :• laidd. .;..� '�.r -ns-a . ,�'. � +-r ...0. � � d' = i Q' o- «� n . .. .. ..... , ..a ..n � .e^� m q G7f?l r 4 Z Y ^Y � •� ci ' a .. nj Q � 1 \ J �� .0 1 " m . O `V _ FF• l' ko U l ec U p J YJ • p.Q � � W f m o 00 j f "/'1��1•, Lo 1 .. •�> :• laidd. .;..� '�.r -ns-a . ,�'. � +-r ...0. � � d' = i Q' o- «� n . .. .. ..... , ..a ..n � .e^� m q G7f?l r 4 Z Y ^Y � •� ci ' a .. nj Q � 1 \ J �� .0 1 " m .