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HomeMy WebLinkAbout2749DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62. -1 -13 BOX 23 .. t1lim . I 02749 PUTNAM COUNTY DEPARTMENT :.OF HEALTH R�5' Division. of Environmental .Health Services, ,Carmel N Y .:10512 151ub1 . ; 'CONSTRUCTION -PERMIT FOR -SEWAGE DISPOSAL:SYSTEM Town or.- - (z �4 . ? -1 eat� � Subdivision 'Lot Job owner 'Q6 AT s •` M U2[�L C (( ii it EA3,ELI _ Address 888 �rIRK' y Building Type F Lot Area. .{ 5. 44& A4_1 T . a /�+`.Z ■ ; Number of Bedrooms \ Total Habitable Space ! d,3..Ss'c Squere.Feet Separate Sewerage;.System to 'consist of 1570 Gal. Septic Tank �� lineal feet 'X y 'width trench To be constructed by 9 aAa P 61.14 r�wS . Address Q 2 ['Sam ► �. �� . Water Supply: Public - Supply From ' • � Private SuPPIY to be drilled by Address _ Other Requirements TK [ S d1 • MCOA4 aQ(. -Z< ' o.tTA G 1 represent that I am wholly and completely responsible for, the design and ocation. of the proposed system(s); 1) that the separafe sewage disposal system n above described will be constructed as'show on the approved amendment there to and in accordance with the 'standards, rules and regulations of, e,: Putnam, County. Department of Health, and that,on completion thereof a "Certificate'of Construction: Compliance^ satisfacfory to 'the Comm isslonerof Health will be- submitted to 'the Department and a written' guarantee will.`be•.furnished the owner, his successors, heirs or assigns by the bullder;'that, said, builder will place -in good operating condition-'any part of said. sewage disposal system.during, the period of two (2) years immediately following'.thedate of the'issu ance of the approval of the Certificate of Construction Compliance of the originafsystem or any repair' reto;'2)`that the drilled well described 'above': will be located as.sh iyn on the approved plan and that said well will be installe in accordance with stan rds, rules and :regulations of 'the . ,Putnam' County Department..of' Health, dt i„ Date' / /% Signed P.E �. R A Address a T . G04ac— A& t so 100 . A) IV License No. APPROVED FOR CONSTRUCTION. This, approval expires one year fr m the date issued unless construction of the building has been undertaken and is revocable for .cause or'may' be amended or modified when,considered; necessary by the Commissioner of Health. Any change or alteration of construction requires a, new permit. Approved for disposal of domes/ticsanitary,bewage and /or private wate . sup only. C.,C.Oi Si c, _ 1 g r ✓ i Date Y le ��„ ! •` Y Q] E DAVID D. BRUEN County Executive JOHN SIMMONS. MD. Deputy Commissioner . DEPARTMENT..�,-.0F,. HEALTH Division" Of Environmental Health Services August 22., 1986 Carolyn Eisner_ 161 W. 86th.Street New York, NY 10024 Kabcenell SDS Construction Compliance RE: Bell Hollow Road, (T) Putnam Valley TM 57-3-1.1 Dear Ms. Eisner: Recently an inspection of the sewage disposal systen and well serving the' above captioned residence was conducted by a representative of this Department. Subsequent review of Departmental files indicates that a Certificate of Construction Compliance has not been issued for the completed sewage system, therefore, final approval of the construction of these facilities was not granted. While,we realize the difficulty involved in locating older records, at this time it is requested that you attempt to locate the following materials and forward copies to this Department to complete our files: 1. Well log fran well driller. 2. Bacteriological analysis of water supply. 3. As -built plan prepared by the designing engineer or architect. Procurement of these necessary documents may be facilitated by contacting the well driller, engineer, former owner and /or Town- You should be aware that proof of approval of the sewage and water .supply facilities serving this property may be required relative to future sale or refinancing of the property. Therefore, it is in your best interests to obtain the above - captioned documents. If there are any questions or this Department can be of any assistance in this matter, you can call the writer or K-L. Hodgens at 225- 3838/3833. JK:mk cc: V O'Dell., BI, PV File fiery trul 'your hn Karell, Jr., P.E. Director Environmental Health Services F/1 /jk/jay -4 TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 3641 REV?E- ' CHECK. SHLET �� 2 IMeets, Std... ( Remarks I =e on -- - � I DOCUMENTS Clouse plans 'O. K. y Design data 'sheet _ Perc , presdaked.9 Min, 30 "" pe ," test' depth .. Const. results for 3 runs Y l { _ D. Hole log O.K. I i Corporate Affidavit for other than individual Authorization for efigineer _ Letter from Water Supply if applicable !' Tf variance requested -such noted. on plans & apps.: DETAILS Rhow f charge is P'oposedExisting contours. shown new contours) '.z, i• e_"1- = Slopes for driveway cuts, etc. shown "a I Water service lire location _ i I Footing drain, etc. location Top slope, bottom'slope of fill Percolation tests and deep test pit location Septic tank size and conformance to std. S7 C3 3 B.R. house minimum I ,- ! House setback shown i o, _p ALL Lei° w.�ii�. "5v i t. 01: rL, Z5jJUW1l� Plan and profile. SDS 1 1 11G 1 wells ca 11CA S e l shown. or reference made Property boundaries (-,netes and bounds- clearly shown . --T -SEPARATION DISTANCES SPECIFIED C)N PIA 10' to P.L. 20' to Foundation walls i I 100' to Nearest well 50' to, stream, irarch, lake, etc. incl .expansion 15' to Curtain drain 10' to water line (pits -20'�— 15' to storm drain i 10' to large trees ! 10' from foundation to septic tank 5' to pipe from leader drain & (doffing drain __ __ G*--s - 1 .1 DI ISIONOF ENVIRONMENTAL HEALTH SERVICES John.M. Simmons, M.D. Deputy Commissioner of Health-,--' FIELD ACTIVITY REPORT:- Sheet of INSPECTION 'NAME Orig. Routine Orig. Complain ADDRESS S_ eu- RbLLOW &OAV' PUT"ftm VALt," Orig. Request No. Street Municipality (T)(V)(U) Compliance Complaint Comp MAILING ADDRESS Final #.Q.-.,Box Post t Office Zip.Cod(i Group Illness Construction. TELEPHONE ✓ Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title Other DATE -TYPE FACILITY Oft 2� TIME ARRIVED P.M. TIME LEFT Explain FINDINGS:" A 7 is m Liver -*6 IVOEbby AptAK . -kNe- rAUfC AM) n Ak 0LAjL10a4&N,_ Sf� APr- LOd'AIW INSPECTOR Signature and -Title PERSON IN CHARGE OR INTERVIEWEPI_ I acknowledge receipt of a copy of this Field Activity Report.........:....,.. -... SIGNATURE: TITLE: TELEPHONE: r=:. :Z - --. i. llv; PIELL) U1JEUR JAbIj., 141V � V14 &//'Date: Insp.by: INITIA-1-1- SITE INSPECTION-. Yes ["110 comments Property lines or corners. found Can estimate house location Will driveway need cut . . . . .. . . . . . . . . Must trees be removed-note these . . . . . . . . Is deep hole representative of entire SDS area Additional deep holes needed. Sufficient SDS area available considering driveway cut.,house location.,separation distances., etc . . . ... . .. . . . . . . . . DEEP HOLE, DATA Depth: Water elevation: Rock elevation: Soils description. Date : FINAL SITE INSPECTION Ins p.. by: Hotse located where shown on approved plan SDS- located where approved J_ —1-11 ITA A 4- 1, 4- r V \L'.L CLbc Slope bf'tile line adnd*trench a:cceptable Room allowed for expansion trenches Over 50 ft. from swamp, watercourse Natural soil not stripped or SDS area, 10 Ft. maintained frbm prop.lin6 and 20 ft. from house . . . . . . . . . . . . . . Separation of trench from house well etc. follows plan Number of bedrooms checks Stones, brush., stumps, rubble, etc. greater than 15 ft. from nearest trench . . . . . . 15 Ft. of peripheral soil horizontally from trench. . . . .... . . . . . . . Junction boxes properly set Could surface run off from driveway., road6., ground surface., etc. channel near SDS. area. . . . . . ... . Does lot drainage appear O.I. in area of SDS FINAL GRADING OF SITE ACCEPTABLE* DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date .50 LY 5 Re: Property of Go ieo7 71- 4 -AA uac e KA A r- F- AJ Z LL Located at &-e- —LLI L46 L. 9-43 W COAD Section 57 Block Lot Gentlemen: This letter is to authorize `fit eAcs A ej o r� a- s o Aj a duly licensed professional en gineer or registered architect (. IndicaTe-r- 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 --J- ff TT-a'I L-1- -I to sign all necessary papers on my behalf in lj��.PCLI LIAUIIU I flt5 U11, anu U connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or "al 4—* '.T 1-3 - --Healt- a.— the -Pu nEEti -,- xnt -a.r-1 -1 7,- -Edruc"�-E i. -Law -I-- - L'I 'j tary Code. Countersigned: P.E.51 'CA-T Address 4 'Telephone Very truly yours, Signed L JU T..4 At Ot 41S )A- 2 ' -; N "-�ner 66f Property Address Telephone `.i DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Re6T Z jMyR«e• j(4%cfAeu_Address 8E8-PA2yC Ay c q,) Y? gLO- 440t4,0"0 (gyp, Located at ( Street jAAije enoM CAOMs Sec. 167 Block 3 Lot i nd cagLnWFe#t cross sree Municipality, pufTVAA VA L L r Y Watershed S F2ov T 6c00o<_ SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1� kIo q:24 .2 23 3 8 2 q,:40 .10:0' 2.5 3 10;15 tO'.4 0 15 14 z2 3 $ + 1 to,. 45" 11'. S 2•z 2S 3 8�- 2t:115 11.42 2,7 23 2Q. 9 3 II. so 12: IT 2'1 2.3 2 6 3 q 4 5 1 - - 2 3 4 5 Notes: 1) Tents to be repeated at same deptn 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 " Q --.-TEST. PIT DATA REQUIRED TO BE SUBMITTED, WITH APPLICATION ' DEPTH HOLE N0. Q HOLE`-NO. HOLE,. NO., G. L. iaP SOIL _ 6" 7-1. ib UcE SA oO -LOS 18" s1iAVY L •'z2Ace 6"VEL 2411 3011 Tib 3'0 3611 AO _ 4211 00 4811 00 5411 6011 6611 P0 72" i o o 78" ®0 84 A o SOH. Z WQ&E S AWC$ R 1S— 1Y=! PP A ZNDICATE'LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY A,40 0 £ 01 5-* Aj Date = 3 -13 DESIGN Soil Rate Used Min/1 "Drop • S D Usable Area Provided AvE 2 9066 5-IF- No. of Bedrooms 8 Septic Tank C Absorption Area Provided By 0 L.F. OTC: "ftdi LS Address CokT ROCK- Rc Np city `T Gals. Type P 2E ceps T a width trench. m ?A 4 9F 4 Other THIS SPACE FOR USE ' BY HEALTH DEPARTMENT ONLS Soil Rate Approved Sq. Ft /Cal.