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s• {_ ?. � :, x A � r. a � ;
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��� : ` `..p. - PUTNAM COUNTY DEPARTMENT '.OF HEALTH - y
�
. ✓�� ✓..
Division "of environn►entij Heh /th Seryfoes, Cerro% N Y 10512 _ee�le e.
CERTIFICATE .OF °,'CONST.R.UCTION COMPLIANCE FOR' SEWAGE ;DISPOSAL• SYSTEM' `"
Village(
Located
l a�lr•f Y- P
•OWnef �� S.,,r. �Y�^ /. Formerl Tax .Ma Lot(i ` - Subd .LOt p _
Separate- Sewe!ag'e System{ built - Address
y 1
Consisting ofO —QaL Septic Tank and � Qi2G
Other requirementsc
, Lti 1
Water Supply Public Supply From _
. P►Wate 'Supply Drilled BY�
Address
jo
8uilding'Type No„ of Bediooms— Date Permit Issued
Nas Erosion "Control Been ComDletedP' �r� T 7 DYN if A�C6�
I ce ;tify that':the syetem(s) as:liated; serving the above;premisea were constructed easenEially as shown bn the,•plane of, .the "completed woik (copies,
,,'of which are ittachedj,' and in`-accoidance wit}i' the standards •rules and' egulationa 'in accordance with" the filed plan Wand the permit iseued',by ,tlie
j yPUtnam ,County . bepartmenf :Of Health
17XDate / Certified •by P:E. R.A.
_. J
Address���JJ �dJ[ �i%� L./ %f¢f.C�a/,`• LieerigNo.
`Any person occupying premiss ssrvetl by the above systems) shall promptly take4such actb� as;,ma��neced y ifcure the eorrection of any unsanitdry
'condltions :resulting from such :',usage Approval .of the`separate`rseweraye system s<hatl become. null °intl void as`aoon as a',publle'gnitary;wve becomes
,.:,,
available and t, of .the. private "water suppiy� shall become'- nult-ano :void ;..lien a +public`:wdte► supply beeoma wailible: such ,ipprovaI are
subject to modification or cnanye when,' In" fhe, judgment of lire m stoner of.:Nealth,_'suc v tion;'mOtlNlcation or cfungf .is neceiiiiii
_
Date 8Y Title
Rev. 9.-81
SAMPLE NO. y V U
SOURCE: Classic Homes, Inc. Well
Pudding St:o
Putnam. ;Valley, NY
COLLECTED: August 15 0 '1985
BY: Mill Drilling, Inca
BACTERIOLOGICAL, EXAMINATION.
Coliforrh Count, RRF Method. _
T bit '.' rttult
: 4xdiia"iPi the
source of
the sample wai
of ,ratirfactary ,fapritary
,gaclity. when
the iample
wai collected.
August 19,q „;1.985
n
0 per 100 ml.
l
C
Rickwit P. E.
Director
: yr.ntll tll trntmmenlel IIe111h :.LpY1111
• . �" COUNTI' OrFICC DUILDING • CARMI:L. NEW YI
`This,reiAort.a?s to be-'completed by well driller and submittee to County+1ealth Deportment together with laboratory report of
xnaly :i ;of water ;ample indicating water 1: of sati;faetory bacterial nuSllty before eert•ficrtc of construction eompllanee is issues.
REPORT. frUST 11E SUWAITTED WITHIN- 30 DAYS OF WUL CO- MPLETION
•1K IR;1a 1�! :� SJt►� :ll Ssalen erect location of well with 01Slances• to at least
PEET eo Fill ; FORMATION mrsainioN two pertranenf Ianomsrrs.
0 5 Silt & clay.
5 285 Hard granite.
�Qd�Tf'
If yield was beard of oinr..nl deriM dvrlr.a dill :nq• I.rl below
FEET GAIIONS MR MINUTE
285 10
' o)8r .1l3•f�nT `�YLLt.0141L.LL11 0;1911slu1.1 / • °� (YI�L.L (JtV.LL.Lt�fq.+•rv`•
ate
OWNER.
CLASSIC HOMES, INC. (
Ro> 22, Brewster, New York 10509.
IWCATION
Pudding
(ho. A 4#000 1)
Street -
(7 own)
Putnam ::Valley, NY .
f101 I•wnoe.V
'
OF WILL
.
0
D BUSINESS
❑
,ttorosco
DOMESTIC
w*i�ut : :.
TEST WELL
:: us[ Of
a Wul
�j
SUPPLY
IHDUSTPIAL
CONDITIONING
OTHER
U
Ot1U1NG
D
COMPRESSED
CABLE
OTHER
Q
iQUt ►w[Iti
ROTARY
AIR P!RCL'SSION
PERCUSSION
(S..allrl•
WII O
I
LLNGIM peel;
i4;1^*ALIL4l1nCft031
WClyf11 PEI 1001
Ut��:IVL 3,"O!('�''^' ^AS LAriN �.tiiY�C.�
F=
`.DETAILS
30
6
19 (�
THREADED WELDED
YES L._JPtO� OYES UNO
11E1D
11
!{quits
•
D 2
".0.
10
TILLD (G. -.A(./
•10
TEST
EAILFD
PUMPED COMPRESSED
AIR 4
MEAbURS /ROM LAND SURFACE_SIAIIC($OeCN/ feet/
DURItiG TIELG TLST prev
Deplh of Cornpirl.d well
tE1iEl
20
285. a
In feel below Land aurioce: 285
MALE
L.NGIH O ►EM IQ AGJIFE: ;:
ftREtH
-
ImAi S
SLGT 44
i
DIAMETER pncnes/
!F GRAVEL
Oi on,ele{ of well inc {Yding
I
GUVEI SIZE (IncneS) +QO Meetl TO 11.etj
M
i
PACKED:
prortl pock (in::+elf:
•1K IR;1a 1�! :� SJt►� :ll Ssalen erect location of well with 01Slances• to at least
PEET eo Fill ; FORMATION mrsainioN two pertranenf Ianomsrrs.
0 5 Silt & clay.
5 285 Hard granite.
�Qd�Tf'
If yield was beard of oinr..nl deriM dvrlr.a dill :nq• I.rl below
FEET GAIIONS MR MINUTE
285 10
' o)8r .1l3•f�nT `�YLLt.0141L.LL11 0;1911slu1.1 / • °� (YI�L.L (JtV.LL.Lt�fq.+•rv`•
Dennis* Barter
Owner or Purchaser of Building
Classicv Homess
Building Constructed by
Pudding Street
Location - Street
Putnam Valley
Municipality
Raised Ranch
Building Type
5
Section
1
Block
8
Lot °
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-
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 Director of the Division of Environmental Health Services
of 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 Z-4 day of !U 19A1__ Signatur
Title�A19__1f0A'
=Well 611*11 W.�'
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
MENOFLOW1rz
N.lE I o oo
o°
ci ern
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P�o�o�i -l� of Den�i:
- Tax HAP Mc. S - - /-B
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COUNTY, DEPi��RTjMENTF OFHEA�LTH�r r Y�� "� eit#
,;, t • .� Di�fsfon of E�trironmental Health SeiYioes .Carmel N�a, Y d105,12��_�: � �,Y,�,, � ,ty ., ;�♦a �., ,t
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it
CONSTR CT�ION PERMIT FoOR SWAGE .DISPOSAL
Y ? �s +.l'd �i y : ^, ,' .. ,s `• _ �, �" T}'�„ ,� "71�,� "� Tt di �, 3„w< .:+. >. `4°`.s�MTOWn O ►�8ge t ^u c�-, a
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�'+c'_3UbdivislOn a: Suk)d iot # ?tiv..s. �.<,• Renewalssati iRevision
IS,. • 3 - - _ x.i. -; • P 3� 4 v?' rc4"'i -a r w�a+"f.% ., 7. �y -r` I w 1 : �:_.,.; d?r
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+,.�ti,�Owner /Address n- :.-r (,�,ilGr (JI<fidtCCi'g,�`� Dete^Of„Previous ApprovalI> �' x�^•t .- '.r+z. 3 t�,r,, pct ,: ., •,ry
i, �!. .+a •z;. _ �_ S ,,:;�i tg ,r.,'J° ,,i „:, w)rr t "".i.... .w-' .7;r,... °.?.- ea,'w.trnJ'” Al
+..3 y � f �: m•z t' r �,a?!s {',ter , ». E ^h r' y ,;r �.„ ( �'C� K1¢ •t
- l �, TJ' s i"t ?''� h -,, d -3tUr tty
�� �fBull Vl gt.TYPe1 r =LOt Area i at ti ti (Fill�S�ea�t onion f s t -
?F ,'fl µ,, ?�c ti �: r� �;✓� 'k n. �.;t�y L i*�.. ?a 5, Sf• rr;;,.':'S`;i`'.i. t' °w:'J ..'il•.)` v�'„i i aC,�.x t `
r Number of Bedrooms Design Flow ' ire'
s.. r..c P C'. H D Notification uire
r
;1 t` :: r .r ,g .. s � cy'4, < o a �i• u -x. y. ._^' a-. ' y /u l ±.) t� �(��
Separate Sewerage Syste h to consist of f dT� � Gal Septic Tankt antl ; � r /�'tt't��� ''' �4 '1. 4a'Ct�►' /,s i//v'1tG%J
tl ,Y•ri ,$ - - t : ' Y - *X'�_ °y.•'yG ,.£ ?7 .C�y��?•• �. ...t Lx, .d'G�Y 'mr. [ , 'h k: " .R., r4 •,,� /'
�tTO be 'c
J 'R MI
by, �( �Fk f Ul1.�' -L f�q ;l %�GlI �jltt r ?r ,G°"rI-6`q:�eD li �:i'Lt/M G �.../� i `• .
"� ,•w >• #r"•F w ¢ `c- '%. •tn. _ tj: "z Address�•�' e \ y
u IekW` ater Su- DPIY ! Publw a jS;.• upt ply Fo,•• m z '���„C ��f ��� � � H � � y I, 44 —2,54"R',
Fi i�
ry,v';4 >� ."t F"+�'S'nx � ��"a).4w C 7�"�Z ;�. iN x # `�5 h'At �`' •r' d4 J
}. ?". °t r F ?i i`v `•�cat(��4 y }"i� #. a a.�.+•tJ` y`}'�'' 1t e ;`�* S < r_* \ `>,C .'� t , ��
Prrvate'SUPPI :t0 be d►}illetl1 by.'
} � •Atld►ess ,L y t bS-, tr1d S � S t �-": � "' os _ .,� .,4, ry ox $. "G,. 'y§w" . '° � evx w, x, t •�' hg; r. f t r
i ..
-� �++s... c a�� -t, Yyf, .,. �xu �o- Via. ?^, t, •any. Ti y. a cxu S �1
t1 : 6-wy i: r
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T', tom` �.: ,"e +_.5,'� -Y nz ",tx «[, 'k: :) W 4 ^ t , i ft ,. •t'.I Z.� e,
4.,i s• c-y,, x ,.,J' `4: t'�.' o -53+'" ' ' t
..,�icsF •CJ �.•,'��. fS�. -.. 'R v .. w?� r. a� ,.sr s }.. o� r; -•oc f' . -y, �?� �uJ °� C�Y Q`4 � t Yti -.^!�, h�~C t:.�� •h;.y _ " t
repcesehVthat IFtam w,holl and com letel Tres ohsible fo $hexdest nand location of',the p ►oposed isy. stems , Tit - Zthat! the�lseparatecsewage: ",di3poial system
`Y P : Y p 9 T }. mss. z m >•._ .0 �) Ft ?-:..
}'� 15bove..Cescribetl ;will tietconstructed aS,show,n on theapproveC.amendmentheretoand �n accordance +w,ith, the stantlartls, rules'an .►egu,a ons o,as; e u nam;
. Count e
_ yI, D partment of •- Health and that;on completion thereof a Cert�f�cate " +'of Construct ;on Compliance 'satisfactory to theCommissioner o'.Health 'will
t bed SuIiI'itted'ao`thee' rtment =. andu;b written' uarantesbwtll'De fucn'iihedtihe�owner'�his - "ii'�h'eirt o`r assi ns x= fhe�buil' er that said ti'uilder',will
•...•t,s:X. -� _; ._ '_ 9 ,r ..'�`..>;.ss?:* ±- w.Hw'� .z�..:�:��� ,., . ^..;fuCC8550...c ��C _>... {. g bY... d.r.' �-ct
tplacet,lingood, ,o,peratirtg; condition iany,;apart. of said °sewage;,disposaPi {ystem7 °during; the- per(iod'ofRy wo, 2)'syears Immediately' - following 'the date of the „issu
4 3 ',the. i n
'- 'ante approval•,:ofpthedCeatifrcate' oiaCohstrucLOn` Complies ce'ot,the,o►iginalXsystem or any- 'repaustheretos2) that,'the'drilledkwell descr;ibedratiove ,
M� ?wtll'beil0 t e i.., . '. q.r
:5 cat d,asGSho>vn „on the:approvedr plan anp that sa?d.well willhbeinstalletl m eeordaneenwith.'the- estandartls, •,rules';andgregu ate{ ns of the' rPutndm t '
s COUntybeparttmeent Ofr'FFieeaalth a :� s c a a .
�� t � 4,r > .� .� �„ � 1 �. f� � � r j i � 1 ir., ��Sk h �' '' � d v:; *� • ti t r ';, � ^ Y '
i :. J�..Mv. ��u,.a/ /L•>A. /1Lir'-ir.' .� =A. £ :_ n rn.�z� „ /� \>fi V. +.i1JQ i� r ..
t
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date
01 Re :. Property of " DZ-V) -I Is Per ke,o- o
Located at PU Idi.-Lqne e, / .,
%
(T) ask
Subdivision of
_N
Subdv..Lot # Filed Map # Date
Gentlemen:
This letter is to authorize
a duly licensed professional engineer or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated 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.construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
�. Signed
Countersigned: _ Owner o Property
PeE. , R.A. ,
p® *// Rey d-00
Address v
topic At Y, 10J-41
Telephone
7,2oo /�/J/ft� �.9QO�NS
Address
Town
.Sa S- -7S6 7
Telephone
DIVISION OF ENVIRONMENTAL•HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner AC 4.17; X & el- kc� Address 26 6 /f A
Located at (Street r4-a-h, S {L-e.f Sec. Block Lot
�dicclte in nearest cross street)
Municipalit Ile.'(r) Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run Elapse -----'Depth to Water a er: ve
No.. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
1 Inches Inches Inches
13
5
14 1,2L
24 J.3 . .' 3 8, . l s- .2
T
34; yo 4,' 12 Z ? .2:7 02
5
2
4.
Notes: 1) Tests to be repeated at same depth until apppproximatelyy 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.
'1'.x;61' 1 iT BATA REgUIKE.D TO BE bUbMl'1 "1ED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
D8PTH HOLE No. � HOLE NO. OU HOLE NO. -�
G.L.
611 70 PS b PTo IL
12"
18 p
1'
24" D�
3011 o
361
42"
48"
54
60 OL
66"
72,.
78 i�
84 ".
INDICATE LEVEL AT,WHICH GROUND WATER IS ENCOUNTERED
INDICATE LEVM.TO WHICH W TER LEV RISES AFTER BEING ENCOUNTERED /felve-
TESTS MADE Date 3
ll�a 11i1V
Soil Rate Used �.`� Min/1 "Drop: S.D. Usable Area Provided 06
No. of Bedrooms Septic Tank Capacity %0 0 Gals. Type PrIe' °
Absorption.Area Prov ded By�_L.Fex24" 36" � width trenc .
lame n an--; e4 Q 1, ilhA e4 -C Signature
Address OfFO SEAL;
THIS SPACE FOR USE BY. HEALTH, DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal . Checked by
iron pin
found
N a
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1 h
i
i
O I
O I
z I
II
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a
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Q o
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2
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iron pin W
I� N now or formerly - NEGERSM/TH bound
N
L -S 32 °00'00 "E. 286.97'
I ► I 1 � � � I � ► I I I I
I� �rea�= 0.�959,(-t) Acres
\ \ \ 1 I I 1
ool
It / / /// puy coole.
�.I
a
O r�
2
Jo /v iY ,,5 lam the original of Wars survey marked writ, on original of the
!ond surveyors roved seal or his .mbossed sea; shoU h considered to be
vuhd rrue copies
ROBERT E. BAXTER B ASSOC.
Land Surveyors and Planners
P O Box 298 R D I, Box 277 C
Mahopoc, NY Hopewell act, N Y
i; ?_d - 2200 22i - 1192
0
Yo2
a
a
a
a
tog
ON 76-
•1,
ti
TITLE N2
Surveyed in accordance
Libor 629, Page 294
deeds.
� - TOPOGRAPH IC
SURVEY OF PROPERTY
SITUATE IN THE
wit,
of
!rrlrflcobons hereon signify that fArs survey was prepared In accordance wr'h the TOWN . �PUTN ALLY
e-strng 'Code of Practice for Load Surveys cdopled by the Ahw York State Assoc- M
of Professional Land Surveyors Sold certrtico /tans shall run only 10'hepers0n jjj��� /�1 /�
.'or wbon,, the survey is prepared, ond oo his behalf to fhe 1, Ile company, governmental �® /��� /% ®����
agency and lending tns'it ✓!ion listed hereon, 'no to the oss,gnees of the lending in- v ®�I� �J
sI /tuaon Certifications are no. transferable to additional Institutions or tosub-
sequent owners NEW YORK
✓'author —a oiterpf,on ar cdd lion to a su veymap b^otmq a /,tensed !ond surveyors SCALE / "= 30' DATE.-APR. 8, 1985
,eof is u + alal on of Section ?09, Sub- drvrsron 2, of the ;tlw York Sfofe Education Law.
Or
�0 I
N.32 °00'00 "W.
I I �' / ' If
/ / / / /
_77 -7 270. 0/1
pole
drill We
1 ' I
/ ry0
/ / ' / / /
Y -cut with
found at east
O
n ry
N
O
ti
drill hole
found
/
face of Wolf
N
now or formerly -
GA/NEN
l
Jo /v iY ,,5 lam the original of Wars survey marked writ, on original of the
!ond surveyors roved seal or his .mbossed sea; shoU h considered to be
vuhd rrue copies
ROBERT E. BAXTER B ASSOC.
Land Surveyors and Planners
P O Box 298 R D I, Box 277 C
Mahopoc, NY Hopewell act, N Y
i; ?_d - 2200 22i - 1192
0
Yo2
a
a
a
a
tog
ON 76-
•1,
ti
TITLE N2
Surveyed in accordance
Libor 629, Page 294
deeds.
� - TOPOGRAPH IC
SURVEY OF PROPERTY
SITUATE IN THE
wit,
of
!rrlrflcobons hereon signify that fArs survey was prepared In accordance wr'h the TOWN . �PUTN ALLY
e-strng 'Code of Practice for Load Surveys cdopled by the Ahw York State Assoc- M
of Professional Land Surveyors Sold certrtico /tans shall run only 10'hepers0n jjj��� /�1 /�
.'or wbon,, the survey is prepared, ond oo his behalf to fhe 1, Ile company, governmental �® /��� /% ®����
agency and lending tns'it ✓!ion listed hereon, 'no to the oss,gnees of the lending in- v ®�I� �J
sI /tuaon Certifications are no. transferable to additional Institutions or tosub-
sequent owners NEW YORK
✓'author —a oiterpf,on ar cdd lion to a su veymap b^otmq a /,tensed !ond surveyors SCALE / "= 30' DATE.-APR. 8, 1985
,eof is u + alal on of Section ?09, Sub- drvrsron 2, of the ;tlw York Sfofe Education Law.