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HomeMy WebLinkAbout2421DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 50.16 -1 -19 BOX 21 !7-- Iry .. J T ,or { 1 l 1 6 114 111 I 4 I 02421 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512!' _".. CERT•IFICATE :- GF=,CONSTRUC.T4UN;,: COMP LIANCE >FORa= SEWAGE:�DISPOSAL- SYSTEM..= =._ 'Town or village L ' °t " V Located at Section Block r-- Z—, ` Lot �' Owner 1• �"1l) " li � Separate Sewerage System built by K P Address � �� man t. rT T Consisting of v Gal. Septic Tank lineal Feet X width trench Other requirements Water Supply: Public Supply From Private Supply Drilled rQy 4 � �/1� tai ji1G'�+� �A 'ti r�� A li /Address Builtling Type '�'` I n'" No. of Bedrooms Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans -the comp) led work (copies of which are attached), an in accor• ance with the standards, rules and regulations, plans f• ed and the permit I ed y he Putnam unty Department o ea It h. b P.E7 R,A. Date Certified ' License Nor Address -11 1 /son Any pe occupying premises served by the above system(s) shall promptly take such action as may be necessary 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 water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Commissioner of Health, such evocat rrm�bUtsication or change Is necessary. "�`� Date BY Title - r PEEKSKILL' 1v1EDICAL LABORATORY 9 pro lvia 1 ` 18Z Crom nd. Rd p e Terrace Bldg A l Peekskill, New York PE 7 8777 "' ` ` �� "" �z� `� � �D,�;TE CQLLECTE•D RESULTS.YOF EXAIVI`I NAT ION OF WATER' 3.17.73_ i OWNER DATE RECEIVED Iy HENRY.FINCER = 47 473 r 1 CITY VILLAGE TOWN D.' . f, RFD #2 FAR REACH TRAIL PiTTPf VALLEY r 3- 4 73 SA PLI MNG - POINT BACTERIA PER ML. (Agar late count at 35° ) COLIFORM'GROUP (Most robable No /100m1) ' RESIDUAL CHLORINE .AS RECORDED AT P ;. LESSt THAN 20 2 SAMPLING POINT POINT OF TREATMENT CHLORIDES; (CI) mg /1 A , ,, NITRATES fFLOURIDE (F) mg /l ^ C These results mdicaie that the ,water was Yes ofa sahsfdctory sanitary quality when the - sample was collected' l A. H PADOVANI M T .(ASCP):, Q1 1: arse' of •l, oun ty �.�o. f . ��,�?'j.� "�";yx� lv�,•.:.. ..�.,., .�_. .' ace City,,,.Vil` age or ToWffi � Y Cz;ni P.O. Addre s s F p_ �0 ' [, �7`AiP (w V/� �.� w�. ���e _ rl�eptii �_�f w� y�.� Diameter Y163;d- • �– 'Was wel l disinfec.te _/vD ft. in. y- — or no - 1,�' :t a, of casing above -- .ground /2- Below -- round oll seal C C'M tiv'f t t in......- . -ft , ce�:en;__ P t Draw a .:11 diagram in the splice provided below and show `Jhe depth of the w::l.l s'.:a'1, kind and 'thicki�ess of formQ,,i'ons ,i.erietrated,- water 'oearin. - f orna,cions, diameter-of drill holes with- dotted lines and :ce.si.^x s) with: solid lined. h11E',IIL .DI1.' ?,•.,:15A, 11 ..... l , yi... n T. i - ._ �' v�Z 1. ��: 1IvNS•'�l'L+��_:,Tl�'i'1'_�D_�. REP'z.K D ,�LLete,r, :i. Depth ,.',Ind s thic�Mess; and Type of well A A � A in. ft.: ` if wat:::r bearing drilling mit'l.v �r, i. -•--a -- �. �. �. Grade ., Wes . _well dynamited, 25 PUPTING ` _`_1Q S =i7 Details. ftati, aater Iev�el in ft'50 6lo��► rade : unpin r C . g. at.c.<... ....., in gpm P M ping level - in 75 -Pura Duration of t; sip rocs' %-� - EF /-Lear _ r oud ' urb id y_� �'.� 50 Lecom i,end�d c+: eptn of puz:p iri.� .... _. . ..w'11, feet .b•.•lc>zrr,:''.;ade V, 11Y _� 1'•�1:... .. r.. r t " 1.".•"TY l::l ur.... —.sr rw.v_�.rr�11 u i �► 200 - - - ��and mm, a . �3z� ��i d� eefsi:�e�------ ._.._. � Length of screen a"" Diata y of..• s6 rEeri.. ---- i .... 250 Type of screen Screen- � W n in4 s C .JJ1 I S .:.w a sRetch of the .p.rolierty ._._. t -Le back of tl••i met loca g start::d .`` , s -5b� do Dril:l.ing p1etd �%,3 ....,.'..' i ^i.�:.S..L1 i.7. _A (i(?. L'�;:�i�Vt�tiL CCi �`` .�•.F,. Well Dr_ller. Si ,nature _ ~W. V\ rA 7) VVI n, -0 A4 Vi) I k)(2 Px,' ,nwner or Pu ciias r ofing Municipality *o^.'�. ta: ...vi., .: ��..v'v Y.I". F.'•q .C. _.. i.. .. ....i...��v�ri 's •..�..a +..Mw.+O ...�i:a _vna...-S....x f.:.:b .. v .. _. ..._., .. i �+.rs�rf •.xi'a e. M. W �..t n..m.Y -e ..�.. .rr .�� • �. ai.ry Building Constructed by Section Location - Street Building Type 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 o•f the Putnam County Department of Health, and hereby guaranty 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 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 occupant of the building utilizing 't'ha cvctam _ The undersigned further .agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the_ system to:,operate was _...._caused- by:^the-..,w lhful.- or-- negl3gen•t, act of the occupant of the building utilizing the system.. Dated this �� day of ,( .- 19U Signature Title (if corporation, give name 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 ,Pp - - . �,`- , r , , : — �`."�, , �:'.:. '.. jf�� !" : :.,.-.. i-LA"iV5 E�;�t�% e.* e . v,�. �: i'... � '_�;- ,. - : .,:',,*, 31 1� * .. . � . :-,�.-�-,�.,-,: �.,'�;" -'k�, -i- f � , .1.1 '.. �11, : � t....­'-, . ,.:,;!.�...'..,. , � . .. ..% 711;1"1 I. -1 - ­ � I I � .. � 1. : -j�'J---,1 '' I.,. -1 .. e ��.,. 01 I �-- "I —.:,",�"I'l, �, , ... :-t;_ ",%:'....." -q- . ,..�,q,:,:",�.;:not�vto:nttDlvh,tl.�v� -:1 - -,;* I . .., At. .,. .%,-.I,�-, .:� :, ''. ,,- I . .k."I''..'... . - . 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"'I !.:`. �,�., . , . 7 , , � '-:. :�', . . - . . , 1, I - ',,- ,:, , .�: ��. , % . " , . . 1. .1 � , , .'� - ; '! :�. t . �.:.., i,� -�,�-'. . Willill ! , ��,"/"-?r - - - It i,� -�,�-'. . Willill ! , ��,"/"-?r - - - A. PUT,. NAM COt wsron of. Envrroiii - e i Subdivision Y - :Owner Building,,Type Lot'' Area' ,0 4gmbbr'6f Bedrooms r ' Separate Sewerage System to consist 1 To be constructed Water Supply Public,rSupply :f rom eL- F •_,`Prrvate'`Supply to be dulled by' �? £ � Address' ' - Other' Requirements p" I represent that F.am wholly and completely responsible for ahe design an above descrlbed`wlll be constructer! as shown on`the4pproved a men dmen t >. County., Department of ;Health, .and thafion completion thereof a `Certii be submitted to` the Department;, and a -written °guarantee will be; furn place in' good operating _condition =any part 0 ; said sewage disposal sy ance.of•.the approval of .the Cerfificate'of Constructwn •Compliance o < ; wilP:be leeated.. as`shownion- the.an6rnvad' elan` anYf Ghat w;d,well..wi ll.'ha. "`in�i e w; Date - r ; 'APPROVED FOR COIVS'1 revocable -for--,dau`se or, ma requires';a "new' ermlt Date r 4 .4dtliessy ��Eti+Ert iroved for d�`sposal of domestic sink / BY )EPARTMENT OF ,HEALTH ►ealih .Services,. Carme% III Y,: 10512 v Town,or Village ' Lot. - Job q•_2 /• /d Address % ✓.fJ L r Total Habitable Space ✓ 0+� Square .Feet Septic Tank /Qio:�. lineal feet X �� width- trench r i d location.,.of the proposed . "system(s)!; -1) :that the, separate sewage disposal -system • +L ate 'issued .unless construction of',tp .Y- the'Commissloner; of Aii lth A "n y to the Commissioner of Healthwili by tlie-builder; that said builder will - dlately'•following the date of the Issu- that the'drilled' well described above raand',regu:a,I of the Putnam- P E.. f4:� R.A.' ,License building,has been undertaken and is Chine ,or alteration of construction_ le /or pnvate water ..supply only .r D.I.V, SlON-i OF— Sl��,*Vi 0\*?�,*�-:r\,,-r*-'-i�L:F",L�C.�VL"!-:1�i�-i--.*-��:-:-�-�l,,�`l;(-'--,-.�-��-,-:,--.�, I DESIGN DAT.-*k SHEET SL?. -APATE SE`' GE DTS �,`, S Ti.-' FILE "0'. �.j-,AL S%" 0 Addre3s VALZ F- El 0 c F. t-e d at (S-r.en _Z �- - - �- sec.�e B 10 c to (Indicate SZre=. K n i c i p alit 'aLe r S hed Soil v-PC`l,ATlCY TEST DATA REOUIP D O BE S U.... -T ED �-7ITH AP,PLICATT��* Z -- l 11L 0 -1 e Nu L r.---) e r CLC'-'. PC?"OT PEDLTOLATTC� Jt Ei-=0sa -Deot` to L 2- r ��-,--el To., T i.r:e Fro- Ground Sun�=-e i.. Irc'-ms' S o 4. 1 1R. a -2' Soar r S t 0 o Ni-. S tar t S-Lo:) Dr o c.2roo Z.2- /Z- 2 A 4 S eLe Zo z e, 2 ze. 3 —2 4 .4, Notes: 1) Tests to be repa-=ted t sa d8--pfq ilntil aDD--0,-K-47.=-tel-.., eq�---! sol"l rates are ob- L L i i -L - d a. e, c " a C) E? .1, c 0 1 - a 0 -. I e s t o 1 `11 d t a t b e s 1. lb L Le' o r r e 2 ) D e o t-b r-- e a s -,,. r -2 im-:27. :s t o be .,.ode. f r o:7, t r).-) of i c .. cr -. - -.r , o - � > F. _ .- ,..,s,.. ,..,.,r..e .- :. +, -.. _ r. ;,�.,..Ft •. •.. _ .- i...rac -t-:� .< «... r. ,:..,.r ro. s.- .= �,.� - _ >,...,.:. ^a�' -;i.: ...;N:. _.... ,.v w..w.. - . r ..�. TEST P "! J'.T 1 � _i'= ;,� ;J -_ w3`i� T'TED , _: AL LICATIO\ DESCt! PT �- -� ` :. -,, \IE�ED ?' OJT :{OLES DEPTH HJLE \0. l , _ ,HOLE \0 . HOLE \0-, G.L. iO� Sdi� Err ,ls iT 30` 36" - 42` 4S'• 7 -0 . 84' I`DICATE L, =1'L'L AT ',,jTC _ GRC' ND WAT INDICATE L i�L TD 'i iC ;'-AT= �,EVEI ?I_ =S AFTE.� 5E_'�C .E \CGli \TER D I `` 1t,;,iS DE �. �V/ Dare Soil. R-= -2 C �_1 / -L� -- -ail- �l'' D "CD, S.D. L's =c!c ;�:' °^ r^�^ + ' LNO. OL U�C�...^roo.,.J SeD is lc. i �. C =: - _.�'.—1 G�I.S 1 y 7s :o y p - Ab. s.0r'Pti on ea 'c, C':'ide^ F.Y2`: 36' dt 1 0 L IFIQ V _ _ FN -- ?me � \\� UR .. Address`s �L�.�A�E SEAL V r-i "" -- C? PE P TN I C CU _: l Y D OF , -;EAS T, S�_1 Rate A0'.) Y0 ; : -ef Sq Ft. /Gal. Checked Date . - _ PUTll9?1I GOU�TTX DED !RNa T OF HEALTH DIVISI01? OF F`i\TVlRON'i'j TTAL HEALTH SERVICES Date //_ -7l Re: Property of, Located at Section a Block ,e-, _Lot Gentleman: This letter is to authorize a duly licensed professional engineer 2_ or registered architect (Indicate) to apply for a Construction Permit for a separate sewera2'° system; to serve the. above noted proioertv.ir_ accordance ti;cith the .standards, rules or regulations as pro: ulgalad by the Con_w:issioner of the Putnam County Departm::nt of Health, and to sign all r_ecessary .papars on ray behalf in _ .._.. _._c-onne-c . o - -thie- -matte r a.nd.... to •suD —e -rvi•se -t:.e tion• of sa_d- ........._. . system or systems in confo2'_i ty with the provisions of Article 145 or 147, Education. Law, the Public Health Late, and the Putnam County Sani- tary Code. Very truly y urs, j_ r • Signed .T OF.i�eT' 1 rop U Countersigned: Address P.E., R.A., 7,... 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"... li� §Q . 1. .. .. . ­ -1 P to ill A QYMMAW A- W � 1" , , , QW0 . 4 , � , - ...v , t �. qn� W� - W - , . I , �.., ­f, , , , - ; . - - I '*. �, ` ­ , ` � �` -,-`:)`��,:" W"Youl W q., J'� 1, � � - , SK A IN M won . - , - - - ! -,;. , .. - - ­'y C. - _ft�� Nuf . -, - & ­ M i'* `;, -11 .- `­� .1f., nick , ... . . pg A - OR, - �" �, � , . '. , I ,"', " _'.1'. -t,t .; . .". - ` ", ­ .. , -­ 1� " i'��,,,,�,�.."..,-..*"-."�,-, , x4f 1 001 5, K , I , m'.�-il'-"..'. .....: '.1 .!..-.,.-,"i.l.,,��)'ll..�;!-�"..7*.i"�.�����,,--,i,i, , l . .I . zl Sup A "N" _. , . , A 4 BRUCE - R. -TOLEY, :R.S., a . „,.. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva Road, Brewster, New York 10509`�ctober Tom Pierce (914) 278 -6130 545 South Prospect St. Burlington, VT 05401 Dear Mr. Pierce: #10 17, 1996 Re: Addition No increase in number of bedrooms - Pierce Far Reach Road (T) Putnam Valley I have received and reviewed the plans for Lhe proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the latest revisic)'n date of.October 17, 1996 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the foilowina conditions: -- - 1. -- The -total -number of bedrooms mast remain at t h ree. 'without, Prior approval by tl-:iJ 2. The area .of the etLsting sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e.,new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required.are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at _your convenience. Ver my yolaw, 0 Robert Morris, P. E. Public Health Engineer <....�. RM /jP � !,� A 'V', 94 K, Got! ��,'�'�,.,�4�;, ��,t- � I 1 -A ,, , ;. , � . I,,,- ,I Q, Ism " : ...., 4._` i . 'I,.',� . ,- . ..:. �� I jV . :" , ­­,_, ­;.. li��.,. "y or -. I ;�),,,;,"� .. ,,I­ , I! _ 1:.,f:-�.'�... -.1. ,.'., ..;,:; , , � , , , � 11 .1.4 ,�v Kl�,,; :_: . * I .. . '�. c � . A It. . � � _. ., � it., Al"', ,;.' � I' �. 1_; 1: �'!i.-'j',,:j " :- - . J,tif,� I:�, Tie.;. -,,-�,l,..;. ,lv,,� , -,�-",. TIMPOT ,,, , as i� " ,:� i.: ,:j'­�­ ,,4,,,,, ,,.,,;).-,.,�, ,� ,. .".­:,..�.­ . I '. ., , ,� mL', , ) . . � -.- ". ...:­,,�,�. ,� .,,: .,,a ;-`,'v,!, , ., - :" ". �� , . 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Ica 'j co-. Pup COUNTY DEPARTMENT i 11 OR SE ?LAj,,,S APPROVED 0V BEDROOM CoIjI, -T ONLY; 4 R4 "Its oitle I C s 1 ......... . 114' 4! , qg w�- r .co rev 1-777- Itz. —1 F4 I-NT I 414 c;..,t', .•y.t ea.Wt� +7...k.r• ' :iri� x'7'!''kA`kt81lN,Y�F!'}•:vt.,: p:y ^:'„'•.. , . .. ..... :. .. .., .,. .. .. .. ..,. .. ,. 'T� �' :•f,r;�l ±::rda,. ?5i: �!�: ?the" n:. g .YS,..��•;.Y ^cie�iJ.`.4 "?::39'' C.4::CL 4i' tt` R�1J I i •f t i 1 ,f , PLANAl •�.• _ MANHOLE -COVER 1. f A l to t -� ��. i L EV JUNC I ION. BOX •-GR' ELam MIN 12 -0" MANHOLE " COVER ' MIN. I LI ° a -' I OO.00.r_ .. ._- • - OWD LEVE - _ �._ 3 ' I MIN. 1. I CAST IRON- 1 LI'NL -p LLf7 C j`V i !ON I i SA "II7AH Y'7EE ±: . , • Gays,. A LN:. t�.FZ -la.l N __./' F CI 1 ro� Y i TYPICAL GONG. I �� PRE CONC, i _ .. SEPTIC TANK !. RE -INF. B "O_c. B!w -3 or 13ANK_(:2u.N o.A .. r.. .TO TimL_ ' � FA TZ•LA YOL' U%'S� -'.2TO Y' ' a _ •Q - a / \ p $2uN:{o coVk GRV_ LEVEL`` r_mpFZ� /�RG'A: ) IS �A>(1� {y(. `. _ • i �• s .y/:m , - aEAR7H �"at�rin { I' .'�� i BACKFILL `JOINT. !6" Ic.18TWG i Tj n o! f.OVEfi I- - a r +� BLOG PAFER / I I �•� Q i'� �/ La.cn T ION TANIt m OR HAY' PERFORATED 'C. 2 N O I - _. .-'.VV. RANGESURG I •J��_Fz 1 0° PIP'I .L. EA»N : -G. R AV:E? M' L OFS R ITN IN'- loo R% oeq. rJ - I � r I I < ^IZj ' w _ -� CRUSHED ST ONE , ABSORPTION TRENCH lo" nm1vI- r `� °V- •V4S -L.._ LoCAI%D' -1 NOTES- I SYSTEM TO BE CONSTRUCTED IN ACCORDANCE WITH THE RULES AND REGULATIONS OF THE �LL�1yL�L1 COUNTY.DEPAiiTMENT j ! 1 ' I OF HEALTH. - - -- - - - - - - - - - - -y- • - - - - - - - -\- - - - Nt-.^_w fosco pLca:TY - 1_ING- SYSTEM SHALL NOT BE BACKFILLED UNTIL INSPECTED BY DESIGN Ro /' n Isl_t_ - ENGINEER AND THE LOCAL HEALTH DEPARTMENT IF REUUIREO. w 6- S}'S'(EM ''O CONS,J$ ' CrF -A _.75.0= GALLON SEPTIC TANK oL1� =`( TiO(aLrtTY LINL "k{ ANID- Cfo.2__FT. OF'--3'. . FT, TRENCH Y+17 A MAXIMUM PITCH OF 1/16` PER FOOT. S. (�.. Y_ ...C,_ /1.. , ' r F'O- 2;.NICN12Y n ® n yFD r •� ' ' � L 7j►I,�� .. --- ` REVISIONS � L ': J _ A S .. N. �/ �nl V • :. ;r. _ No. Ooi'e By C°A S N Y I 512 , Y. 1 1 - _ 9,O P:L C. .1 �Qp•._ i 9%2. /? /- 1 /i•/9.7/ - . -.. -: _. _. 'T'Q]M. t9 -:__G [?11'j': VP.LL_E -Y - .,. �0 2 12.n -n ii At _ (?uT a N.Y - -Tf—q rI OF Nal"' J Drown Bf Scale - 1 larlol - _ �DIYISION�OF /ns c oTE v r C11 R - 4NVIRONMENTAI HEALTH $EItY - I / 4 Ch d li l7_1 - - -Au _P j /� . +r �aO 5 Traced P a _571 _l.O_�_70 i M1