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02428
T PUTNAM "COUNTY - DEPARTMENT .OF HEALTH
Division of Environments/ Hea /ih Services, Carmel; N Y.' 105-12 ,
CERTIFICATE OF, CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley (T) _
Town or Village
to
Denny n' Road ` 23 1
Located at y - Section Block
owner Thomas by Lot 3.3 Job
4 Otto Righi Or on Road RFD Peekskill, NY•.
Separate Sewerage System built <by, — Address g . -
.x 1200 5 leach :pits g+ `
x 6.5 ft•
Consisting of: Gal Septic Tank lineal Feet X width'" trench
Other requirements NOne
f } V
Water Supply: Public Supply, From
x Aierson ell Drillers ,�
Private Supply Drilled :By
Address Barger •S'ti'ec:ti Putnam 9elley♦ N Y ._ ti � �-
Budding Type 2 3tOTy. F�'sme - No of Bedrooms' Date 'Permit I ®� T
Has Erosion' Control Been Completed ?' 8�6 w 0e
101 Yes
I certif that
- , the system (s) as listed serving the above premises were constructed essentially as shown >on the plans of', (F� AVof,whlch are
Y
attached) and .in accordance with the - standards, :rules and regulat_ions plans filed and the „permit .issued by the art �f Health.
Feb "rusty. 3 1973•:
:Date V Certified by,.
�� • i
Address 1 Narthrid a Ro 'Peekskill N.Y. iced Ii
H- -Any person occupying premises served by the above systems) shall promptly take such action as may be necessary to se ++ �1�ny unsanitary
conditions `resulting, from" such usage., Approval of the separate: sewerage system shalt become null and void as. soon as f sewer becomes
available and the approval of the private w_ ater supply shall become null and void when. a public water supply •becomes avai Such approvals are +
Subject to 'modification 'or change' "when, in the judgment of� the Commissioner 'of Health,, revocation, modification or change is necessary.
e
i� � Date ���� � � ` ��� BY/'"_ � �� , �:- -7 ��- -Title, '� /
6 8161 MUM V6116Y (T)
Owner or Purchaser o Build Mun c pa ty
e 23
Bu ng. ons rue e y ec on
Deli Road - -
1.66':at on m rest B oc
2: AM. 3.3
-Euilding Typ.e
Lot
GUARANTY OF SEPARATE SEWAGE SYSTEM
I' represent that. I am wholly and completely responsible for the
location, worlmanship, material, construction and drainage of the sewage
disposal system serving the above described property, and that it has be.emTL
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 'T
�c 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 .:failur ®,:•
to operate properly is.. caused by the willful or negligent act of the occur.,
pant.-of the building'uti.liting. the systemo s
The, undersigned furt -hi agrees �to' accept 'as conclusive `the' de-
termination of: the 'Director of the Division of Environmental Health Sero't:;::
u> vices of the Putnam County, Department .of Health as to whether or not the '
- fa i lure of the system,. to operate was caused by the willful or negligent f,
act of the ;occupant of -the buildin''' tilizing the system.
Dated- 'this day' of b®P .1 Signature s¢:
iy
-Title
L corpootion,, give name L
and addr ss) �
THREE ('3) COPIES :ARE REQUIRED WITH THREE (3) COPIES OF .FINAL PLANS BEFORE )
CERTWICATE OF COMPLETfON WILL BE ISSUED •
GUARANTOR- IS .REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM,
•J
Division of Environmental Health Services, Putnain 'C'ounty.:.Department of Health
„
'o
�4v PUTNAM GOUNI -Y DEPARTMtI4T'OF HEALTH ,
Division of Environmental HeaL[h Services Carmel, N Y ,10512
R. ED,
CONSTRU TION% PERMIT° FOR SEWAGE DISPOSAL, SYSTEM, 1 ?ri Va1lCy;. '
Loeated at
;}� Denr>wtown Road.. ', sectign 23 Block. l
ob
*T , a t.•
SubO vision Lot 1
µ
mas: 'Mur
PAY ' $ Nadel Plane
fOwner- � Address •• '
Colonial` 3 Acres, Staten Island, .New York
Building Type„ Lot Area
4 Number of Bedroom's Total Habitable Space 2200 f Square Feet
Separate Sewerage. System to consist of 120 ? X. Gw5, Defer
Gal Septic Tank Le$Cht8li�ea/ (4`t: -x$�0 Tns Di
._Otto Righi w ]]1,6 Oregon: Road
To .-be constructed by Address
Water.- SupPIY: Putilic.Supply From s- : PeekCkll,' N. Y
^ X ' private Supply 'to be drilled by.` �''tiCkey Well dz`i 11 ers
j Address . S t. hook Road peev"il].BT.Y.
! Other Requirements None
.1 represent that f am wholly and completely responsible for the design and' location of the proposed system(s); 1) '.that Z p,�rAQ s� : a disposal system
above described will be constructed as shown on the,approved amendment there to and in accordance with ,the standardi* Roo e Putnam
County - Department of Health, 'and that on completion thereof a' "Certificate of Construction Compliance" satisf !t i�l n°er of Healthwill
'be submitted =to -the Department :and-:a written '.guarantee- will be furnished Md'owner, his; successors heirs:or'a i h 'b R'T d builder will
i place in good_ operating condition -any part of said :sewage- disposal,::systeii during the period.of :two (2) yearAm I i �a of the issu-
ance of the approval of the Certificate of Construction Compliance of-'the original system or any repairs theot ttia h i w !bed above
i will be, located as shown :on the approved plan and.that said well will, be installed in accordance with; the I s a s Se Putnam
} -County Department of Health. s
®
= ` o
June 14 1971 x'
Date Signed P ._ R.A.
Mb X_x
Address _ 1 Northr' d e. oad .Pfaeke�cill N.y: --T �• /,IF�,nn��?�a�6 2
1 APPROVED. FOR CONSTRUCTION; This approval.,expires one,year from the date issued 'unless construction'.of• thelptiufld�g: *undertaken and is
revocable for cause or may be amended or modified when considered-necessary by the Commissioner. of Health. Any chIrMS Qy,Jjft%tiorl of Wnstruction
requires new permit. Approved •for disposal ofidomesf c anitary se g and /, r riv e- water, supply only.
Date / .. - . ey. Title 1
I
PUTNAM COUNTY DEPARTMENT OF . HEALTH
DIVISION CAF ENVIROtin -NTAL HEALTH SERVICES
DESIGN DATA
SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner
T'ns��n s i Address 8 Pldgl naee Staten lsland�
10 "Y
Located at
(Street) -Deny cr, #n R° *d Sec . Q3 Block,
Lot
(Indicate nearest cross strA-t)
Municipality
4 Watershed-
SOIL
PERC:OLATION.TEST.DATA REOUIRED TO BE SUBMITTED WITH APPLICATION.
- --
Hole
Number .,.
CLOCK TIME PERCOLATION
PERCOLATION
Run
Elapse Depth to Water Water Level
No.
Time From Ground Surface in Inches
Soil Rate
Star_ t Stop. Min. Start Stop Drop in
�Iin/in .,drop
Inches Inches Inches
)' 1
7x32 Ss02 30 3,800 20,0 .2000
15.00
8802- 8s 2 30 20,0 21,75 1.075
V-14
n
G
3
-
4
-
5
(2) 1
714l 9.011 30 1925 1.75
5:11 80"1 30 19x25 2.0075 1.50
20,00.
2
3
.
S
1
2
4
I
5
Notes:
1). Tests
to be repeated at same depth until approximately equal soil rates are ob ='
twined
at each percolation test hole. All data to be submitted for
review.
2) Depth
measurements to be made from top of hole.
.
SOILS 'X-\;r`R-D -I'* '_EST HOLES'
DESCRIPTION OF -.S.E�,:'
DEPTH HOLE* NIO. :HOLE NO. 2 HE OLE NO. 3
G.L. 4" : ToQsoil
611 fine grained soil
12t" with boulders
18
2 4-
301,
36'
48
Dr 411
6 07
66"
;2
:3" Tbposil.
#ne.,grained soil
with bilulders
_vv
411 ..Topsoil
fine grained soil
with boulders
fine sand
78!1
84
INDICATE LEVEL AT MHICH GROUND E R IS E\COUNTEREn
None
; E 'TA ET
INDICATE LEVEL TO WHICH t,T TER ILVEL RISES AFTER
BEING
ENCOUNTERED
TESTS D E B:' John So Romeo
Date Mzy 13, 1971.
Soil Rate I'e u 16- -20 `tin /1. Drop
S.D. is =
-le 'Nrnn Provs--s-I 50006F +
No. of Bed-rooMs 4 Septic Tank Cape; t
1200
Gals. Type Masonry
Absorption Area . F'rovided . By L. F. x 2-.
6
i d 0.•.°° a Other x
4 Leaching pits 8.0 Dia x 5.5 I Deep
Nanie John Sg-.Romeo Si&--atLire
-g
Address 1 Northridge Road
SE:,
* R -
M •
)
Peekskill,. N.Y.
a I
V
go
2790
�
iF Ma�
P U TNTI A I COUNTY DEPARTLKENT OFL.HFALTH
Soil Rate Approved Sq. Ft. /Gal'.
Checked 1--v
Date
PUTNAM,COUNTY DEPARTMT OF HEALTH
Date June 39 1971
Rev Property of Thomas Mwphy
Located at Debbytown Road
Section Block '—Lot
Gentlemen:
This letter is to aijIthorize John S. Romeo
a duly licensed professional engineer or.registered architect
(Indicate)
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 promulgated 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
conf6imity*with
the provisions of Article
1,45 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned:
Very truly yours.,
Signed-/
Owner bf P operty
5*7h Pi 17),o-4
Address
P*E.q RoA., # 24711814416',X-X
hone
I N Telep
-rtbridge Road (Seal) 1.
Xd-dres-s a&,
0. �L INS
0 � ..
Peekskill,., N.YD c s . Ro 0 0.
PE 7 1056 -0 0 0 0 0
TelepTone
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rn
0
27BA16
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a
. /E5/IA/ 9TA .�ptcs /til fc 30' 'i6 2Arnr./
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APPROVED
/
qt .vamp 1200 ga/x l 9z .o8.'sp /Fr EEC
�.
Nr 43 -M.c jt
<5/)_
B� nsi�cJ.X 982•ZS�C7FT $J. s:
FEB 2 2 1973
PUTNAM cuunrr Orx n to
(.11j"�
SION
ENVIRONMENTAL HEALTH SERVI-
yE
"
SEPTIC SYSTEM {
'
DESIGNED &, 'SUPERVISED BY
•eo °••
BEDROOM HOUSE
FOR
ROMEO- ROMANELLI.AM.IEO
c '�° ��, :
96fL3 RATE:. // -• S
-7-�%o A4
CONSULTING .ENGINEERS
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_ �. -�° —GAL} TANK .�. _ _-- _,_.._ _
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TOWN OF DuTNAw?D
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