The URL can be used to link to this page

Home My WebLink About2412DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 50.-1-1,0 BOX 21 02412 is 61 ..L LM �_it m sin Lo m 02412 ..L LM �_it 02412 1 � 4 4 j k4' � CERTIF,ICAT +E: OF -CONSTF I Z ' 2 PUTN,AM COUNTY DEPARTII 1 { t a wn/ jQoi4 a C ,OF HEALTH arme! N' Y 10512 y.• .,I1r •r/1�l f'i -A.Anr Tlft }SA AA�� I�1 RTTP n...• 'i-I lk,�',�w / ✓.� __� %� Town or Village,- 8ed�ios Z Block owner /L (.1�OM /i/DRG QI✓ Lot [� Z' Job mg 7. K z K 3 Separate 'Sewerage•.,System °,fiuilt by;' _ ` Atldress %g MA/ v. 3� Consisting of Gal Septic Tank ,L�a lineal Feet X - + .width trench Other`regwrements' } Water Supply Public Supply1 From +� Private Su I Drille PbeL pp y d By . C • ddress `y OF 8ui'Idmg Type ��J/ No of Bedr`,00ms pate Permit `Issued` Has Erosion Contrdl Been .Complete6i I certify that the systems) as fisted serv,g the aboveprem3eswere constructed essential s shown on t_he plans °of the corriplete"d work (copies of�which 'ale attachetl) antl ,n accordance with the standards rules and r u(atjons, plans filed a ' he permit iss d . b `th .utnam County 1]epartment,of Health. i � � .. -;[' � ,• f /2 its' Date + i ` - Certified by P E R b d s q 6 , .b Z2 0 , Adtlre55 L�Cense NO; S tt Any person. occupying premises served by the above systems) shall promptly take such acilon a's maybe necessa {y to secure the correction 'of any unsanitary 1 conditions' resulting from such usage Approval,-of the "separate sewerage system stall become null and void is soon`as ,a.`pu6lic'•sa'm airy" sewer becorhes' available .and ,the approval ",of the prvate+water supply "shall ;become:null and'void,.when a pub ater supply. becomes availab'le;:': Such approvals' are subject to :modification or, change when, . in the yudgment of the:`Comm�ssioner of';Health '`s ch r vocation, modrfication or change ts. necessar.y Title N"r r r _. :.. e_ ..5_.�.., ....,. .. . -,_., .. .,o .. v_�7t. :- .. .'_. ....,�-.n .. :..i•: d� „;s n„ .�:. ., ,._....,.a,,.,.. .. ..., _.. v,, '. r.• .. �..._. %4.�s.,r ..,...,1 ..fA ._,,, _ ,. WELL LOCATION 1FEIIJL OWNER dELL DRILLER ree name ction ill jV ess e address city.Or town, CASING DETAILS YIELD TEOT I WATER T SCP7-jEN DETAIMT _'� Bailed (Measure a.'rom. 1,,Fd surface feet or Pump ed,!5'U" o Static ft Make' When Bailed Inches Yield: ,�rGPM o r PM R ed ft terigt'ii Ft Ck-5 J_ Diameter '.1110 AL i12TH OF WELL 3(rp Feet Depth From 'Give description .of forma-,-ion penetrated such 6s';'''1je6ti` Ground 'Outface silt, sand, gravel, clay, hardpan, shale, sandstone'.9f:.- granite, etc. Include size of gravel(diamdt'erand.ba�d (fine, medium, course), color of material, strufttird .(Loose, packed, cemented, soft, hard) .(Ex'.-Oft.* "t� fine ,_packed, ye . llow sw..d, _27, ft to 134 ft gray granite) ie) to Feet .11 --re—C 7� Formation Debcri-pbioh� Sk(! tch: exact location, of:* -611.'to at least two Eerme ant 1a.Adm*&rks'�,. DIRT k J&,,w 4/,j" 1�60 LZ &�rj cri ev/ .� o S � "�T�G �, ! A; ------------------- V -Da-be t Deli Completed Date of Report a4f- ..Well Driller signafdi�e d, d. A P.O. Box 99 321 Kear Street 2453203. Yorktown Heights, N.Y.'16598 LAB # go81 DATE COLLECTED RESULTS OF EXAMINATION OF WATER OWNER ATE RECEIVED GRACE MORGAN 1 2-/4 /7 5 CITY, VILLAGE" TOWN &/OR NAME OF SUPPLY DATE REPORTED BOX 518 A DENNY PITTNAM VAIJEV, N-V- $AMPLING POINT TCHEN TAP BACTERIA PER ML. (Agar plate count at 35* Q. POLIFORM. GROUP (Most- pro mli. HAHUNEff�TAL -PPM LESS THAN 2.2 DETERGENTS - ppm N) - ppm., IRON, TOTAL. ppm' -7 FLOURIDE (F) - mg• /l• These resultwas YW. when the sample was collected s'indicat"e that th..wtel, of a satisfactory sanitary qudlity t -p APOYANf, M. T. PUTNA:M COUNTY DEPARTMENT _OF HEALTH Division of Enw wmeni� Health Services i,wme% -N Y: 10512 CONSTRUCTIONU PERMIT�FOR SEWAGE ,DISPOSAL n - Town or Village �o��rto ar lJ.ea��%9 T�ldf� /,�� _� R'orE G3' Subdrvlsion Lott da. Z Job owner' wner GifGa: /�DiC °.5EA0 7Y Address Building Type �C✓f aka a/T ;00 Lot Area; � Total Habitable S acq_ f'O�' Square Feet Number':of Bedrooms - p :Separate %Sewerage System to cofl5ist �w %�� Heal feet X width trench ? 1 e ept nk h ,. '� e ii Gal S is Ta u , To -:be constructed by J,4 1�lES 6eCl.LGM z Address /I�OSU T�sE ' �•.�, Water',Supply Public ;SupplY'From { Pnvate 'Supply ao be drilled . by Address, .. _00f, Other. Regwrements 64A i I represent .that I am wholly and completely responsible for ify. 1 0 oft "posed system( ;); 1) that the separate sewage disposal system above described will be constructed as shown on the`approv, n8 _ din dance; with thb.standa ds, rules an regu a ions, o e.. u Hem ! County_ Department of. Health, .and that on completion "t red a "i c on u "c n'Compliance '° satisfactory -to the Comrnisstoner of. Health will t be submitted to the .Departmerit,.and a '.written guarant be wn h successors; heirs-or assigns'by the builder, that said builder will ( , ., place in, good, operating'.conditio.n` any part of_,said- sew. di :o g e iod of ;two.,(2). yea rs immediately following ahe date of the issu- I once of ;the approval of. ahe' Certificate of Construction, pl o �a sys ny repairs.t_hereto;' that the .drilled Well tlescribed above ' } will be located as shown on the approved plan and that said w -alle h ce w h the sta Ards r sand regula i� on "s of the Putnam County Department of Health rt �f0 t�o t 4 <' P.E v Address •� 2�7 � ' /ys License No .7 _ c APPROVED FOR, CONSTRUCTION This approval expires one year from the date :issued unless.,construction 'of 'the building has "been undertaker '+ revocable for cause or may be amended or modified when = considered necessa ►y -by the Commissioner of Health Any,changeTor alteration -of c� regwres a newrmit Approve /d for disposal of domestic sanitac �rrvate water supply only. t� Title �......�y ae 7 GUARANTY OF SEPARATE SEWAGE SYSTEM l i I I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system servr_g 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- sors,, 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 unders,gned further agrees to' accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- f Gol my department of - Health -as .•-to whether- or no-t_the- viees of -.the• Putnam failure of the system to operate was caused.by the willful or negligent act of the occupant of the building utilizing the system. Dated this /T-' day, of &_c 19- r Signature Title If corporation, give name and address) THREE (3) COPIES ARE�REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,E.TION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Division of Environmental Health Services, Putnam County Departme, i Owner or ; urc aser of Bul ding Municipality Nli.L D C /ant Z Buil�dii�ng Constructed by Location - St eet Block Building Type Lot GUARANTY OF SEPARATE SEWAGE SYSTEM l i I I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system servr_g 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- sors,, 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 unders,gned further agrees to' accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- f Gol my department of - Health -as .•-to whether- or no-t_the- viees of -.the• Putnam failure of the system to operate was caused.by the willful or negligent act of the occupant of the building utilizing the system. Dated this /T-' day, of &_c 19- r Signature Title If corporation, give name and address) THREE (3) COPIES ARE�REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,E.TION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Division of Environmental Health Services, Putnam County Departme, i -..:.. -.. _ PU.TI�1ki C.Oi7YiTY D:-]'P 1-- ...Q"'_.; HEALTH - - - V...�., acv+-. �. �-.. �..... .- �-- ,.�- •- .:_..y•:....:r,. -. a.-> rr_.a- a.;...v .,..�.�.......�.... - -.. --- w�.•• �... �.--.-, r-. o�rr,-. �....:.... ..•..�..rm.-- rasv�w +.....c••. „•._.. a:�..s.:.a'..._. ..� -DIVISIOi`! OF " `,iIIRON!,,L;TAL. HEALTH SERVICES Date Re: Property of WILL i4 k6 /A Located at 7 m �, �- �,��+ A.L. Sn zo Block Oz Lot' 09. a Gentlemen : ®�� ST,L Jo . This letter is to authorize a duly licensed profess _ o -al en. i ne8r ,' or reoi ste.^z architect (Inuica4- to apply for a Construction PerWit for a secarate s_.- Terage system; to Serve t�1a above noted �nqp�= ��; _r accordance L�itC1 t'P_e standards, rules or r u1ati ons a S �i'O t ! "_tad v I ti'�n Cv? "_1SSi0ner Of tr1C Ptivnam, Cour D_-Dartment of Health, and to si =n all necessary papers On MIT behalf in CO l`i0 "Ct "'O':" :::'i th -th-1 7aat'�er and to superfise tie cons truCtion Of said Syster? Or syste_'11S in Confor -m-I ty with tree provisions Of :ArtlCle 11 5 O_' .147, Education Law, the Public Health Law, and the Putnar. County Sani- tary Code. Very truly yours, , 'rOJ° y r'? � P.E., ., , "" V 8 267 CAI V ha V 11 n5Q sm v c PUTNA'1 COUNTY .D 'T OF E =.LTH DIVISION OF ENVIRON:KE. AL HEALTH SE?t ACES ,.,b; ;.,ya.+�$• +e.�o._ -.»•.. . ..:._ ... .. ... . ::�-..{ J;=:, '`•..< -'._- .•... ..- a, r. r...-.. ...,_.....:.- ..- ._,— ...:,... �w..w.0 :a ,...:w... _.:. s.— _..: ;, : °...:.':v:=i.= sec>�. ,e r.-. ,..ar,;aw�r.• ...d -a+ e..•. DESIGN DATA SHEET,- SEPARATE SE::AGE DISPOSAL SYSTE:: FILE NO. Weer. bola � uL� �IAotCG.ArtJ Address 1.4 5 1�t4��L�rv�o r�lJu. iUl? � i11 �y .Located at (Str.et).l�= .,N i�u�j� Yia �� Block ..yL Lot �� (Indicate nearest cross. street) l �u., Munici alit _ v ell: V&IMAM_VAL `!4 Watershed . P SOIL PERCOLATION TEST DATA PFOUIPED TO BE SL'L::.,I? TSD t,'ITH APPLICATION Hole N�:mher CLOCK MIE PERCOLATIOY PERCOLATIO` Run Elaose No Time start Stop Iin'. Dept'- Lo t' aver t, ater Leve From. Ground Sur:'_ce i- Inches Star_ Stop Drop in Inches Inc::es Inches Soil Rate ' Min/in.drop Notes: 1) Tests to be repzated at same depth until :approx- ._Le1Lr equal soil Pates are ob- tained at eech pe'rcola'tion test hole.. all data be s't:bmitted for. review. 2) . Depth meas��.re�:e�t,s to be m::de from top of .hole %73% 27-314 -3 1 2 �_' �� 9' /� . 17 Notes: 1) Tests to be repzated at same depth until :approx- ._Le1Lr equal soil Pates are ob- tained at eech pe'rcola'tion test hole.. all data be s't:bmitted for. review. 2) . Depth meas��.re�:e�t,s to be m::de from top of .hole TEST-PIT DATA REQUIRED 70 2E S'UTBLfITTED T-:ITH APPLICATION DESCRIPTI0\1 0; SOILS \,-.2T yTERED I': BEST. HOLES .DEPTH. HOLE `NO. O. HOLE NO. 40Ze G.L. So /u so /4L 121T 1 Q.tT 2.(J4`T 3 0'T 3 6if1 42` 48 t: 5 4'1 ALIM l�YD T�.9cr 4c.4 ZV. q . 66" 7 21' _ 78'' . A a l {{, . &i Ar A, 8 411 INDICATE LE.kE "L.AT. 4,,N{ICH GROUND WATER IS =;.\ NTERED Gvi�TC� ItiTDICATE LEVEL TO WHICH G�TER LEVEL RISES AFTER BEI ?�G ENCOUNTERED TE.S'IS .%fADE BY Date 7= 24-71 Soil Rate Used S.D. U e Urea. _°ro'ided No . of. Bedrooms. 9 Septic Tank Cap _city boo S. Type W245 49 Absorption Area. Provided By 177 L. F.x24'1 361' reach. Other 09--s'2 �. LLT ® ` -Name q Sic �' ature � ;W-4 / . Address .. - _ EA f Pg PUTNAM COUNTY DLPARTL%TNT OF HEALTH Soil Rate approved Sq. Ft. /Gal Checked by, Date 1. §nd �'�'''• o a 41�,. G� 4."^'�wrd " d` '� a, ,°y + �,• t J h T'Pt+ e 'F '.n➢ nl In P '1r 'i y .§IF F 00, y k 4 IQQ °iw µ`'. e .emu OPEC I ati. Y r t ' � i�lr 4 �^ ° • �•� � � } £�".,"h 1 �w'Y t 1 �, th '�'•:. '�"l A•n t 1 r, ro ,, 1 t n L AT # * ,"• 2, a; x1� �°'. ti er kc a ,� 1 t J 1 4�%b�' �o-�i}�y � #'! {.y��w j{py�ky�•�y�. S �E {.1 d' .+M1 •n*r- i �f"+M� � 1l1� BAr+�V#M�i 4 4r � ` W " 1ARu�," \�FM W""1�^i�h'+r•��IR 'tif �' � ' . � � r + + 1` F 4 PA ' �:� . � *'• l s+ a kA,w� v t n u t �". ice` .t�. � n T �'dy, 'w . 4 a n ••�Q 'w a Q., . kn u e ¢ t� Y ae e X ?. NOA\ y f. I 'P424 NY -Ak I a Uwa if-a La