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02284
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT #
Located at DO, Town or Village Ri t1, 1 \4
Owner /Applicant Name gar—
Tax. Map Block �_ Lot
Formerly
Subdivision Name /-6wJ 15 LE=T
Subd. Lot # Z
Mailing Address 12D ,412i i f ( i$ZW k 1)'e- Zip
Date Construction Permit Issued by PCHD 6 2 9 4
Separate Sewerage System built by tai Address
Consisting of % 00 0 Gallon Septic Tank and 50 of 2
Other Requirements: 2 l2b f5 r Z C 1,0 C.
Water Sup/ly: Public Supply From Address
r: ✓ Private Supply Drilled by Address.
Building Type 6 c - L Has erosion control been completed?
Number of Bedrooms Has garbage grinder been installed? _
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the PutnamAounty DApartment of Health.
Date:. Certified by
Address
P.E. L / R.A.
License # ��(a��'-
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 sewage
treatment 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 Public Health Director, such
revocation, modification or gbange is necessary.
B'/ '"` -' ~ _ — `'� Title: Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange bopy - Design Professional
Form CC -97
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
(914) 245-2800
Albert H. Padovani, Director-
LAB 4: 32.0 08131 CLIENT #: 12958 NON STAT PROC PAGE 1
D I NOTA , ANTHONY DATE /TIME TAKEN: 12/14/00 i }9: ooA,
8 ROARING NG BROOK DR. DATE /TIME REC ' D : 12/14/00 03:35P
PUTNAM VALLEY, NY 1 0579 REPORT DATE: 12/19/00
"PHONE: (845)- 528 - 2803
SAMP I NG SITE: 8 ROARING BROOK DR. SAMPLE TYPE..: POTABLE
: PUTNAM VALLEY, NY, 10579 PRESERVATIVES: NONE=
COLD BY: ANTHONY DINOTA TEMPERATURE..: < 4C
NOTES... COL I FF ORM METH: MF
?.ATE FLAG. PROCEDURE RESULT NORMAL - RANGE METHOD
12/14/00 MF T. COL I FORM ABSENT /100 ML- ABSENT 1 002.
COMMENTS:
1ENTS :
,ACT THESE RESULTS INDICATE THAT THE WATE NOT) GF A
SATISFACTORY SANITARY QUALITY ACCORD ( NEW YORK STATE
AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS
TESTED, AT THE TIME OF . COLLECTION .
SUBMITTED ELY: L/
Albert /k. Padovani, M.T.( SCP)
Dire Vor
ELAP# 10323
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
4j7 / /o
r
Owner Purc aser of Buil ing Tax Map Block . Lot
Building Constructed by TownN lage
6 6
I
Location - Street Subdivision Name
Building Type Subdivision Lot #
I represent that I am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is 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 successors, 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 approval of the "Certificate of Construction Compliance" for the
sewage treatment 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 occupant of the building utilizing the
system.
The undersigned further agrees to accept as conclusive the determination of the Public Health
Director 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: Month Day Year gn
cu Si ature:
Title:
General Contractor (Owner) - Signature
Corporation Name (if corporation)
Address:
State Zip
Corporation Name (if corporation)
Address:
State Zip
Form GS -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
LETTER OF AUTHORIZATION
5
RE: Property of
Located at P 2 , �j , -b t-,.
T/V \1,41]eq Tax Map # Al.] Block _ Lot
Subdivision of \19Ae-i>A A We,,.l Vie4tSL —,l
Subdivision Lot # 2
Gentlemen:
This letter is to authorize P10
Filed Map # 2 Date Filed
L�
a duly licensed Professional Engineer r Registered Architect to apply for the required
wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and to supervise the construction of said wastewater tretment and/or water supply systems in
conformity with the provisions of Article 145 and /or 147 of the Education Law, the Public Health
Law, and the Putnam County Sanitary Code.
Very truly your
Countersigned: Signed:
P.E., R.A., (Owner of Property)
Mailing Address F—C—) &x
State Zip US-4
Telephone: 8 — 6026-0 37[o
Mailing Address: 4B & &>t - '0;Z,
State Zip
Telephone:
Form LA -97
FI
...... .....
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
APPLICATION TO CONSTRUCT A WATER WELL 2
= PCHD PERMIT #_�
WELL LOCATION
Street Address
?" C> wt RMR1.0 8N k
Town Village City Tax
ai;v� Po'vmm Ou&y
Grid Number
W-0 —) —ry
WELL OWNER
Name Mailing Address
Al') -mwl Di po'm 50 ELM' 51-, Poe RattF
OT-rivate
O Public
USE OF WELL
1 - primary
2 - secondary
B- RESIDENTIAL 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP
0 BUSINESS O FARM O TEST /OBSERVATION
0 INDUSTRIAL b INSTITUTIONAL O STAND -BY
O ABANDONED
O OTHER (specify
AMOUNT OF USE
YIELD SOUGHT 9v0, 5- gpm /#
PEOPLE SERVED /EST. OF DAILY USAGE al
REASON FOR
DRILLING
E3 REPLACE EXISTING SUPPLY
U NEW SUPPLY NEW DWELLING
O TEST /OBSERVATION 12-ADDITIONAL SUPPLY
® DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
WELL TYPE
EJDRILLED
13DRIVEN
®DUG
OGRAVEL
OOTHER
IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: {M Z361
EvJ v V L (z DA- k P 15Z.&I Lot No. 'Z__
WATER WELL CONTRACTOR: Name bF EtZ JA WE;D Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: 2 H TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
SEPARATE SHEET AV
(date) (signature)
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirty (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or aste products from such well drilling operations be contained on this
property and $n su ti manne as not to degrade or oth rw se contam'nate surface or groundwater.
Date of Issue: 199
Date of Expiration 19 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
- wDate
Re: Property of A�
Located at cT -k- pnmz�p(' V>ROOK NR'l V --E
(T) 'N�Oh"\ VALt4y Section Block Lot X17.
Subdivision of C-f
Subdv. Lot # Z Filed Map # Z Date 11 )b ag
Gentlemen:
This letter is to authorize i�_ZYJz-
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 .14.5 or*-
147, Education Law, the.Publie.Health Law, and'the Putnam County Sani-
tary Code.
Countersigned:
P.E. , .R,-&. , # tj373C
Address
Z6 S - 1632
Telephone
Very truly yours,
Signed L-L'
l
GOwn of Property
• Address
&d F
Town
6 --56 7c:9 Y3
Telephone
UI BATH
CLO
00 _- T D BEDROOM 3 BEDROOM 2 BATH.. O O
10'0" x 10'6" 10'0" x 11'6•'
.,BEDROOM,],,
2'8•' x 12'1
BEDROOM 1 OINING ROOM . KITCHEN O • WALK-IN,
13'0" x 11'3" tt0 0.O 0.O
Llx 1 t'6" x 11'3'• 12.0•• x 11'3" O ,
HALL I PAN HALO I
I ttO i
t
. I DX LIN tt0,
i
BEDROOM 2..; p,p BEDROOM 3 LIVING ROOM4
1 -
10'6" x- 11'3" - 10'6" z 11'3" 20'6" z 11'3" �- KITCHEN FOYER LIVING ROOM
t0'1" : 12'11" 18'3•• x 12'.11"
DINING ROOM
0 12' 10" x 9'6"
CLO CLO 1 -
LAKEWOOD I P'T'i'iIAM C'U'UNTY ! EE IFAR lMEN OF HE
2448 LAKEWOOD it
p7e i� ! ' c? NS r.p(r``�ROV D; t' Os 2748
Y. BEDRO",,;'l Lt iliii l 1Vl.v�
A,4_gA.
pr .D' 1PJ �_q O O DO
S1'„ .a tur'e u 1 i �l
O I° ;w 1 710
CLO - -` i:iTCHEN DINING ROOM i�n� " BEDROOM 3
BEDROOM 1 DINING ROOM 1*6 9'6 U 12'4" x 12'11" 12'0•• x 12'11" r�- 10'6'• x 10.0'•
" 13'0'• x 12'11 11'8° x 12'11" 11'6 "x 9'6" I' -
0 BATH 10
BATH O I r\ Cr-O VAN. _ I 7AXT11Y I I DN ! 'tt0
AC 0; I CL Ao
a0 I ao
L1N HALL
tto ttO
FOYER.
LIVING ROOM
17'2" x 12'11" BEDROOM 1 LIVING ROOM 1 BEDROOM 2
BEDROOM 2 BEDROOM 3 13'6" x 12'11•' 20'T" x 12'11" 10'6^ x 10'6"
90'2" x 9'6•' 10'9'• x 9'6"
tto. :? . ( _o
1
LAKEWOOD 111
2748 i LAKEWOOD IV
27' x 48'
i
f
APPENDIX 3
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
REVIEW SHEET for CONSTRUCTION PERMIT _
NAME OF OWNER STREET LOCATION
BY
DOCUMENTS.
DATE
Y ril
PERMIT APPLICATION
= PC -I
I= WELL PERMIT; PWS LETTER
M ENGINEERS AUTHORIZATION
LZl DESIGN DATA SHEET(DDS)
m DEEP HOLE LOG
= CONSISTENT PERC RESULTS (3)
= PERC HOLE DEPTH
= CORPORATE RESOLUTION
= PLANS THREE SETS
= HOUSE PLANS - TWO SETS
= VARIANCE REQUEST
GENERAL
C= LEGAL SUBDIVISION
C= SUBDIVISION APPROVAL CHECKED
= PERC RATE
= FILL REQUIRED
= CURTAIN DRAIN REQUIRED =STANDPIPES
EX- APPROVAL SSDS ADJ. LOTS
m WETLAND (TOWN/DEC PERMIT R & D)
m DATA ON DDS PLANS & PERMIT SAME
= PRE -1969 - NEIGHBOR NOTIFIFICATION
C= LETTER Bl/ZBA
= 100 YR. FLOOD ELEVATION
REQUIRED DETAILS ON. PLANS
= SEWAGE SYSTEM PLAN - (NORTH ARROW)
= SSDS HYDRAULIC PROFILE = GRAVITY FLOW
= D/ J BOX = TRENCH/GALLEY = P- PIT DETAILS
I= SEPTIC TANK - SIZE, DETAIL
= WELL DETAIL, SERVICE LINE IF OVER
m CONSTRUCTION NOTES (GRINDER RATE)
= DESIGN DATA: PERC AND DEEP RESULTS
TWO -FOOT CONTOURS EXISTING & PROPOSED
DRIVEWAY & SLOPES CUT
TJ FOOTING /GUTTER/CURTAIN DRAINS
]OMMENTS:
o 0k i3y%\
= DISCHARGE (OK)
PERC & DEEP HOLES LOCATED
= REPRESENTATIVE OF PRIMARY AND EXPANSION
= EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
= IF PUMPED PIT & D BOX SHOWN & DETAILED
m HOUSE- NO. OF BEDROOMS
= WELLS & SSDS -S WAN 200 FT. OF PROPOSED SYSTEM
= PROPERTY METES & BOUNDS
= HOUSE SETBACK NECESSARY (TIGHT LOT)
= HOUSE SEWER - 1 /4 "/FT. 4"0; TYPE PIPE
= NO BENDS; MAX. BENDS 45 W /CLEANOUT
FILL SYSTEMS
=CLAYBARRIER
I=10 FT HORIZONTAL: SLOPE 3:1 TO GRADE
= FILL SPECS
=DEPTH GAUGES
= FILL PROFILE & DIMENSIONS
= VOLUME
TRENCH
=LF TRENCH PROVIDED
=60 FT MAX
= PARALLEL TO CONTOURS
=100% EXPANSION PROVIDED
SEPARATION DISTANCES SPECIFIED ON PLAN
FIELDS ..:
10' TO P.L.,'DRIVEWAl , LARGE TREES, TOP OF FILL
=
20'170 FOUNDATION WALLS
= 100 TO WELL, 200' IN D.L.O.D., 150' PITS
C=7 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN)
= 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
= I O' TO WATER LINE (PITS -20')
C= 50' INTERMITTENT DRAINAGE COURSE
CD 200 FT. RESERVOIR, ETC .M 150 FT: GALLEY SYSTEMS
SEPTIC TANKS
=10' FROM FOUNDATION; 50' TO WELL
WELLS
=15' WELL TO P.L.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
:: QQUNTY_ OFFICE. BUILDING,,- :rARMEL,.: N.. Y. 10512 .,_._:.,n:- _
DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner A v- F;A0a'4 �',YA A Address �G �cr� 5 c-_ • N 2,� uc� N_(_
Located at (Street Sec. 'fl-ill Block Lot .)D
�Indicate nearest cross street)
Municipality. ?wvwkv\ v(\L(,CY Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
him 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
2
3
5
2
4
'Z. i
j; 3
7-o
5
2.
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.
1
TEST PIT DATA REQUIRED TO BE.SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED. IN TEST HOLES
DEPTH HOLE.... NO: HOLE. NO.. .. .. HOLE..NO..
G.L.
.611
121 _
18"
24"
30" S c G Fr' 23 6 Z
.36��
42"
48"
60"
66"
7211
78
84
INDICATE LEVEL AT WIiICH GROUND WATER IS ENCOUNTERED <-
_: INDICATE LEVEL TO WHICH WATER LEVEL _RISES _AFTER .BEING ENCOUNTERED
._
__-TESTS MADE. BY.a .___ .,. _ - �� 236 _ _ __._.._ - - Dat-e.:t._
DESIGN
Soil Rate Used 7 Min/1 "Drop: S.D. Usable Area Provided 5��'
No. of Bedrooms 3 Septic Tank Capacity rood Gals. Type c�
Absorption Area Provided By 3L0, L.�F.x24" �-36j "- w rent .
ame _ e� - 2 -6az --Signature p
Address '2 z e Y', sT- SEAL
Le.
Ilk
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Cal. Checked by to
ru —t
PUTNAM COUNTY DEPARTMENT OF HEA]�.,TH
APPLICATION, ,FOR .APPROVAL.:O.F: PLANS:, Fats = A= WASTEVAfiER 'DISPOSAL' SYSTEM
1. Name and Address of Applicant:
2. Name of Project: �E5 bf�_KE_ . 3. Location T /V /C:
4. Project Engineer: 5. Address:
License Number: g3l3G
S lOSIe
Phone: Z�s -ro32
6. Type of Project:
/Private /Residential Food Service Commercial
Apartments Institutional Mobile Home'Park
Office Building Realty Subdivision Other (specify)
7. Is this project subject to State Environmental Quality Review (SEAR)?
Type Status (Check One) Type I.. Exempt
Type II. Unlisted r
8. Is a Draft Environmental Impact Statement (DEIS) required? o
9. Has DEIS been completed and found acceptable by Lead Agency? ...........
10. Name of Lead Agency
1. Is this project in an area under the control of local planning, zoning,..---,
or other officials, ..ordi.nances. ?. . .. .::: : :.............................. �5
2. If so, have plans been submitted to such authorities? .................. �� 5
3. Has preliminary approval been granted by such authorities? Yes Date Granted:�:_`�OH
1. Type of Sewage Disposal System Discharge...... Surface Water' Ground Waters
If surface water discharge, what is the stream class designation ?.......
Waters index number (surface) ...........................................
Is project located near a public water supply system?
. If yes, name of water supply V))p"
tJ a
Distance to water supply
Is project site near a public sewage collection or disposal system ?..... pv
Name of sewage system Distance to sewage system P�A
sc� V rm 236 Z
Date observed:
23. Name of Health Inspector: t",, r, ""'W'
Project design flow (gallons per day) ...... ............................... &&0
2.
5.- .- ..Is_Sta.te Pollutant D.scharge_Elimination S stem ( SPDES) Permit required ?.. P°
Y
6. Has SPDES Application been submitted to local DEC Office? ...............
7. Is any portion of this project located within a designated Town or State
wetland? .................................. ...............................
8. Wetland ID Number ........................ ............................... 0 1 n
9. Is Wetland Permit required? .......... ............................... .. J�o
Has application been.made to Town or Local DEC.Office? ..................
0. Does project require a DEC Stream Disturbance Permit? ...................
�o
�o
1. Is or was project site used for agricultural activity involving application
of pesticides to orchards or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ........ YES or NO
;2. Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or
any other potential known source of contamination? ..............YES or NO
DESCRIBE:
13. Is there a local master plan or file with the Town or Village? ........... ACS
14. Are community water, sewer facilities planned to be developed within 15 years? ra
i5. Are ° any, sew age -disposa-1 �areas �in..excess of 1'.5%.5tope? ; ......... ..
36. Tax Map ID Number ............. .3: °.�. -.` �� ............................... L0.01- 1 -io
37. Approved Plans are to be returned to: ................ Applicant ✓ Engineer
:f the application is signed by a person other than the applicant shown in Item 1, the
application must be accompanied by a Letter of Authorization. Failure to comply with this
)rovision may be grounds for the rejection of any submission.
I hereby affirm, under penalty of perjury, that information provided on this
form is true to the best of my knowledge and belief. False statements made
herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of
the Penal Law.
N TITLES:.
SIG ATURES & OFFICIAL
BAILING ADDRESS: `' i2�cvAr- Lt £1 -�-
..Y. ; t —. __.. ' ,...y . ,-T° v. -•� "F :. ri.'c .�iLiSF- iT— f.--`^ q ,r e,." "fEi= __^v 777r
P110171IAK.C9DM , DBIA' W- M Tl'.OF RMTH .
,( ( Dh!Yw �f $tnAowhl HeiJ� Seeoioe�. Cnan1.I7.Y. IPSU : , , : 6o Peiv18� I�w�it./ . ,.
w C8l1D?IG►TB OF._
CO R SEWAGE D{S<OM ST32M
LA 0 AAA
H,.e K �j is ?-F-4 FM z34Z. law- lost 0 �- TM t ;(.: .a. t 1
o.ae /App --st Ne.a /HIV �i. orvj ; N AA Qettewd_ ❑ Oe.Mea p
Dade or Ptevlooa
1 crabs Aaivee � ►�. Town av �
�'3�
date bdivision Ark _Fee Enclosed 3e0
�b Depth vaime
Ntil ar at it Deals Ile. G PLO '00 PCHD Nottec d.%lil Wbpe d '
8OPOM1s Sawwasi s>.h.ee e...w .t Gallo. Sapde
Took , Zy
To be.eeegd b� u AflrLen
Waterss>p*. Pliaaic,Seipp�y.Ft� Addeoaa
an DttBdd
Ofbe[ - C _y 1t-'D ; �i_ SU. i �»bPA V. ' Iry L "FI I/1
1 represent that 1_am wholly and completely responsiblo for.the,dasign and.locaiiori of tM proposal syst am( t). 1) that the'separate,serw di sal stem
above dewibed will be eonftructod as shown on Me approved aimandment'thera to Intl imaecordance with`the standa►tls, rules,a rpu ns o : nanl
.
County Deportment .of t WKIy anO tMt.on completion thNaoi a Catificato of, Construction Compliance•' satisfactory to tlle.Commiisiono► of. Nwlthwill
be tubmltted to the Ip"NAment,, -atnd ay writtM quanntN will' be furni" ,his successors. hairs or as�igns'by the bull er that tNtl,builder will
.:
owe in good ope►atiilg cbnditbn, any part- of pad 'fewage disposal sythe psrioA of two Ii1Yaars immWiateiy following'tMdate of CM ifau• or" of the approval of the CartiOcate of Construction ComplNnw o sy . _ or any repairs tMnto.2).that the drilled wall described aboe
wNl M loc as and tMt fekl wNl will ba Insrda Ce wit { standards, ruMS antl 'rpu aii%�s', of the Putnam
County D of FlMlth
Date Sig Hr ire r;�r;
IV0 P.E. 7 , J . R.A. 2 JJ %3(Address License
APPROVED FOR CONSTROCTION: This approval expires two f►mo the data issued unless construction of the building has been undertaken and is
revocable for caw or may be amended or modified when consider necessary 11 t ommissioner of MeaRh. Any change or alteration of construction
;nauNas a n w ermt Ap owed for disposel of domestic ►y sewage, a r t star supply only.
(88 Date 9y Title
NO.
:IED TO:
nice with the existing code of practice for land
iopted by the New York State Association of
ial Land Surveyors.
ons shall run only to those individuals and
s shown hereon under the title policy number
ove. Said certifications are not transferable.
COPYRI07HT CO 2000 - 000 /
VEr ASSOCIATES, ALL RIGHT'S RESERVED
1QUH7or /zed dup/:cotion is o viola lion
of oppl ,,cab /e laws
cations hereon are valid for the map and copes
my it said map or copies hear the impressed seal
"ever whose signature appears hereon
SURVEYED & PREPARED BY
BUNNEY ASSOCIATES
LAND SURVEYORS
FIELDS LANE, BREWSTER
W
ti
T
J�
V
�T
0 /D
�Z of 0
0
Z
0� W
O 4
82'
520' N54�40'/7 "W cATV.
c,- es�__==
ASPHALT
LURE
ASPHALT
PAVEMENT
ROARING ® ®K ®lam �®
IN
Y
�a _n
,tn\ m
wml z�
iA n\ i,
O• II
boo I
PREMISES SHOWN HEREON BEING 4.07-4=
AS SHOWN ON "SUBDIV /S/OiV MAP PREPARED
FOR V.-RDA gGW&V ArA11S4EY, FILED AV THE
PUTNANI COUNTY CLERK'S OFFICE ON;vov /6, 1968
AS MAP/Vo- 2362.
AREA = 2.24 i ACRES
Unauthorized alteration or addition to a survey map
bearing a lic ensed land surveyor's seat is a violation of SCALE: I"=50' DATE: NOV•5,0000
Section 7209. sub- division 2, of the New York Stale NOTE SSDA ADDED F£8.8, 2001 (SEENOT£)
U41
IED TO
ice with the existing code of practice for land
opted by the New York State Association of
d Land Surveyors.
ns shall run only to those individuals and
shown hereon under the title policy number
ve. Said certifications are not transferable.
COPYRIGHT CO 2000 - p00 /
iEY ASSOCIATES, ALL RIGHTS RESERVED
authorized dup/icaf /on is a Vio %/ion
ofopp/icob/e laws
a ton s hereon are valid for the map and copies
dy if said map or copies hear the impressed seal
veyor whose signature appears hereon.
;URVEYED & PREPARED BY
BUNNEY ASSOCIATES
LAND SURVEYORS
FIELDS LANE, BREWSTER
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PREMISES SHOWN HEREON BEING LOT e
AS SHOiVN ON "SUBD IVISION MAP PRCPARC0
rOR VERDA ig GWEN KN/SLE'Y'; F /GEO IN THE
PUTNAM COUNTY CLERK'S OFFICE On/ NOV. I6, 1968
AS MAPNo. 2362.
AREA =2.24/ ROPES
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Unauthorized alteration or addition to a survey map
bearing a licensed land surveyor'sseal is a violation of SCALE: / 'II SQ' GATE: NOV. 5,2000
Section 7209. subdivision 2, of the New York State It/OT--: SSDA ADDED FEB.B, 200/ (SEENOTE)
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Putnam County Departm
Division of Environmental I
Approved " noted for contort
applicable Rules and Reaula:ti
Putnam CquntSryeaith_Deoart
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