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BOX 19
02213
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PUTNAM )COUNTY A
v V Division of Environmental E
1
CERTtom,-- „OC OCOMLINE °ICATE FOR SEA
Locatetl'.et Oakrl;dge Drlve, Roaring�;Brook
au
P'1 Can'I ck�i
Owner '
' A Kastuk Sons ��e
Separate, Sewerage System bwit ,bye+
100
0'�4;68�.
Consisting'`'of s ` Gal Septic Tank L t
Other requrtements.
-Water Supply N Pubhc Supply From }
X
Norman An
` ° Private, Supply-- =Dnlled.By
p Address ` Ba.rger Street, `Pint
4-t1
1 Fam i 1 y, Res l'd'enee
Buildln9: TYPe a:
Has Erosion Control Been Completed
i`I certify;that, the systems) as I�sted serving the��above�premiseswereconstr�
°'- attached), and in accordance with the. standards rules and regulations p
'Date F:eb rua ry ;1977} Certified E
Ad`dressBox 417 Kator
Any person occupying;prem�ses served.by_ the atioye systein(s) shall prom
conditions resulting from such? usage Appro4al of the separatep sewer
* ct i'M n
a5ailable arid the approval of the private -water supply Shall become null
!
_. ;subject -'tor modification;'or charige wher, In the.. Judgment of rthe Com
G $ a
Date' s h ! B
a t Y -
` L7
ry S
PARTMENT' OF HEALTH y
e
th Services Carmel N Y 1,0512 '
r �
AGE DISPOSAL SYSTEM Put`n "am Valley
Tai#
4 � 308
y
, r
7 Doty Job i
Peekskl,ll Hollow Rd P Va
.ut l
Address `
r 2 I `011
lineal Feet:X width tr.,ench r
i x i
} S k
i§
amVallAey, New York
9 7 6 ;
of Bedrooms � ,Date rPermit Issued` u '! 16 , 1
4 t
ed essent�allq,asishown on the plans�of, the completed work (copies of which are,,
s Bled;�and the;'perm�t ued .tiy the ;Putnam'' +Courtly "iDepartment of, Health. 11
t° Y PE RA•
:j 1.1056
New Y'o r�kf 0 3'6 ,:a icense' No
ake °such acUon as may be necessary to secure the c&recti6h of,any unsanitary ,
systemsh '11 become null and void asrsoon as ,a ;public sanitary sewer becomes
d void`',when a :public water .supply becomes `a4allable. " Such.,, approvals are
ssio Health such_rev Yon modification'or change is` riecessar,y.
d a• tr .. n Title' '�
7�.= ':
Paul Can i ck' ._. Town of Putn'aW Va o e
Owner or Purchaser or Building unicipality
Paul Canick
Building Co nstructe y
Oakrid e Drive
ocation - Street
1 Family Residence
Building . Type
Map 308 -1
Section
Block
508
of
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-
sorsp heirs or assigns, to place in good operating condition any part.of
sa°id.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 de-
.termination of the Director of the Division of Environmental Health Ser-
vines.. orf.._the:_.P.utnam. Gounty _Department of- -Health a'•s 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. s
Dated this 9 day of February 19 77 Signature•
I
Title - C.
Si nature
9 "� � � f corporation,- give _.name
(owner) and 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
WELL COMPLETION REPORT
i
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 :ar)d s ubmitta :_tG C ount _ Health D.epartmen t.t gether_with. laboratory re port of
_
anayis
of water simple indicating water Is of satisfactory bacteaquality before certificate of construt ction compliance is i'ss,ur ed. ,.,„:.�.,�_
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
AME ry
ADDRESS
OWNER
✓ �'
LOCATION
OF WELL
Ir
� (No. & S�t)
c.
(T n � (Lot Number)
BSINESS
❑
❑
PROPOSED
DOMESTIC ESTABLISHMENT
FARM TEST WELL
USE OF
WELL
❑ SUPPLY ❑ INDUSTRIAL
❑ CONDITIONING ❑ (S(Specify)
DRILLING
❑
CABLE
❑ ❑
EQUIPMENT
ROTARY ACOMPRESSED
IR PERCUSSION
PERCUSSION ((Specify )
CASINO
LENGTp�H�(ree�)
DIAMETER(rnches)
��
1NE wHT PER FOOT
❑
O
❑
CASING
DETAILS
if 0
THREADED WELDED
YES NO
YES
NO
YIELD
HOURS G.P.M.
❑ BAILED El
YIELD (G.P.M.)
Jv
TEST
PUMPED COMPRESSED
AIR
d
/
WATER
MEASURE FROM LAND SURFACE— STATIC (Specify teat)
DURING YIELD TEST (feet)
Depth of Completed Well i
LEVEL
in feet below land surface:
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
FEET to
FEET
.
two permanent landmarks.
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE W LL CO
I
LETED
��._�
DATE OF REPORT
WELL DRILLER (
nature).
f t
- ^ '+af � c � HE ALT II S U�NA T C f / � fA � -
r .
�' �%', : + - � �D_rvision aof Environmenfal Healh Services, � Caimel :N . Y. 10512: .
x
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL,SYSTEM Putnam Val.
1_ey
Town or: Village
W�c aYzd at A;`
r i e clock
Roa r:iamacB rook Lake: got' 508 Job
owner Paul M Can I ck. 4 Address 1 19 west 71 st St reot
1; fam;i.ly res,`. y 35148,ksf i New York ew .
, N York 1'0023
Building. Type Lot Area
Number Hof Bedrooms " 3 Total Habitable 1 s 656- Square Feet
1.000 ; 460, I LI.
SepaCate Sewerage Sy'sYem to consist of - Gal Septic,.Tank lineal feet X — width trench
2 0
;.
To'•be constructed by not rS' -e'1 eC't`'ed i`Tx " Afddress
Water Supply: Public Supply From
•� =not se7lected
Private Supply to be drilled by
• -. `-Address. -°•� �. _ {�n,f}� ; t
-
Other Requirements - EKED AR
446r iesent that I arp wholly and completely I I,,
f.e,s_p-ons-ible for the design and locatwn of the �proposedg system(s); 1) that the, airA� osaW AM .
above described -.will be constructed as shown on the ,approved amendment there to grid in accordance with the standards;: rules: r I n t
County Department of _Health; and that on completion thereof a''Certrficate of,.Construction Compliance',` satisfactory to e m I a wil
tie submitted to ".the Department, -and a wntten'.,guarantee will tie.,furmslied-the owner his successors; 'heirs or °assigns by Ide cJar wil
=place -in good operating 'condition any part of. said sewage disposal system durng`the period f !)'years immediate Ilowi the'
ante "of the a ificate of 'Construction. Compliance of the orig al em o ny repairs<tFiereto;:2) th' rille d,.
will be' located as.shoavn on the approved plan and that said well will be installed�m _ c ice ith the; Bards 'rule ��a�c s ;. h ®Pig
pproval of :the Cert'
County Department of Health a `
Date J U y 9 ! 197 - Signed
avh -. ,a
,. -. ..� -,` rk
x, h .Address 5 �4 �,, Kat�On New3�
BOX _- 7 ':' L "icense No. ,.
'APPROVED FOR CONSTRUCTION ,This- approgal expires one- .t'ea'r from the date .issued : ristiuction of -fhe building ,has been undertaken and is
revocable for cause or _!nay be:amended'o`r _modified wh -side'- necessary by the C missioner f Heal_t'h. "_.Any' change or, alteration of construction
',squires a new permit Ap ro ed for disposal of dom stic it r sev o ' p ate`
}
Date
p
By Title
CO[JI,JIITY
PUTNAM OF J!F:PJ,TJ1
717TAL IMU,T11 ST-TIVICI
D TV.T,:, I ON, OP RNYTROINI-117
CART
.0
-,GOUNTY 014101M, RUILD711
2u
DESIGN'D.ATA SMELT-S'EFARATE SEne,AGE DISPOSAL SYSTEM ME 1110.
Owner Paul M Canick Addre3s 119,West 71st St. New York, NY, 10023
gap
Located at (Stroet) ;Oaks i d -D r Vve kox • 308- 1 B.1 oc-1, Lot 508
(Til:�n cate n0llrcst cross stHTe
ni,-- j. pa I i ty- Town
SOIL PE""'C"OL.-ITION'
of Putnam
'il:,:,ST DATA
Valley -latershed- Hudson
REQUIRED TO BE SUBMIT'.P2"D L'ITH APPLICATTLC75
Hole
F u-nh, D- r CLOCK TII,7,',
pFP, C 0 T AT! ONT
PERCOL;��TIM'
Lapse
ITO. Time
Start-Stop Min.
0 -, r
DJp Tt T T 7� t
From Ground Surface
Start stop
Inches Inches
17ater Ue-i-re-l-
in inches
Drop in
Inches
Soil. Rate
1-,1in.'/i'n drop,
I 8:00-8:48
.48
14 17
3
48/3=16
2 8 :49 -9 :3Z
48
14 17
3
48/3=16
3 -9:38-10:26
48
14 17
3
48/3=16
4
.5
'I '8e05—,8:'53-" 48 15 t8 3 48/3=16
2 8,54-9:42 48 -.15 ..,18 3,
3 9:43-10:31 48 15 18 3 48/3=16
A.
5
2
JI
Noton: d(-',-Pi"h i1111-,Ij apivoximately equal. --ol.]
I lites ".11 c., obta-incd r,t each po.rco.].ation te-,�t holb. AID. date .to Le
for roview.
2) )): pth mbas,va,cmcnts to be n;iLde from top of.hole.
T.LS1' PIT DATA RMIIMJ) 1110 PT, 21., 9 111111 Al"11TCATT0111
D1,I)CRTY1JOINT 01, TH IVI
DE PTII HOIX, NO. 1
1 IOM 110. 2 TPLE N.O 3
w. aop.:'.-Sol
To so 1
R TQP. spi
611 Top soil
Top soil Top soil
.1211 clay and sand
clay and sand clay and sand
IJ
361f
4211
54
6011
66
7211
78
84
RMICATE LEVEL AT 1,4THICII GROUI,7D,
1-,IATER IS EINCOUTNTERED 51-011
_04 I
INDICATE LEVEL TO 1,111--ECH WATER rE'%rj',,L RISES AFTER BEDNGS ENCOUNTERED P:- '. ;
TESTS 1-.,AU2 BY Joel Greenberg Date June §, 1'976
DESIGN
Soil to Used 16= 201'ti -n /1 "Drop:
S.D. Usable -Area, Provided .5600 s
Ho. of Bedrooms 3 Septic
Absorption Area Provided }3y 460
Tank Capacity 100 ,jtED A . e pre-ca onc.•
L.F.x24" u A reric'I
Name- Theodore Laurence Strauss bignatu
Address Box 41 Deer Park �Plaza
--Ka—f—or
THIS SPACE FOR USII� '131' PliALTH DZPARTIG",I%'T 0-1iL*Y: Nzgk
Soil Rate, Approved _Sq. Ft/Cal. Checked by
r /.0
.�j
Date
11
Gentlemen:
o
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date July 9, 1976
Re: Property of Paul M. Canick
Located at Oakri dge Drive
?A-KXk c Map308 -1 Block - Lot 508
This letter is to authorize Theodore LaurenceStrauss
a duly licensed professional engineer or registered architect
(IndicaTe-T-
to apply for a Construction Permit for a separate sewerage system; to
serve the above noted property in accordance with the standards, rules
or regulations as promulgate. by the Commissioner of the Putnam County
Ti..n...n .4. L0 TT._ _ 9 .�
Depai tmiien� ul . nGd1 Uu, and uu 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
4 . ..
147,' Education Iaw, -the Public-'Health 'Iaw," and "the - Putnam County "Sani'- .
tary Code.
Very triAy,:purs,
� /W
Countersign West 71st St New YQrk
Address
R,-4R-.j R.A., 81 4Teilephone York,
Box 417, Dee r Park a (Seal)
ress
Katonah, New York 10536
914- 232 -5033
e ep one
��RBO ARC
�� yAURgN 'S'iT
owe
2 00
C H
m o
��THH STA�EOle
1. CONTRACT DOCUMENTS
The Contract ocuments
"Standard Form of Agre
latest idition and "Th
Buildings'',
2. SUPPLEMENTARY "GENERAL
T e Contractors s hall
Permits, Certificates
and all manufacturers,
to provide labor, mate
drawings and /or specif
All work shall be guar
terials, equipment and
appear within one year
La ?, ji2 3. INTENT OF THE DOCUMENT
N/p 9-0421NG 1320,z2K L,AKe a Contract Documents
shall be binding as if
Pna..'V,� 1,7."1-5 7ra.1cT 6 dfawings and specifica
_�— rvo ueu5cr _ Documents .shall be bin
N, 4c•.a1'_50"E. io8.91' let by the Owner, as w
shall, regardless'of a
N contractors perform a
Z '
A 'AI1 Work that l be, subj
v A'll labor, material an
T r- 9 drawings or' specified
L sfb �riq but is not lim.ited to
cornpletethe work indica
4l Sz't p p
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� $ti~ �•, e � 52G o
524
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