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HomeMy WebLinkAbout2955DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.17 -1 -51 BOX 25 02955 ro 0 IN i No kIN IN �, I . � , 1� r LIIr - i -T II. ��. - . IN 02955 . Q►jimoll_ I— . _^xff"T "TTl1TT nT. nnnm WGLL t Vvr" LG..L LVL\ L\LfL VIT1 J � DEPARTMENT OF HEALTH " IIiv'is6n Ofnvi6nfaE>ital Heaitn • Services VFW NO PUTNAM, COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET AOURESS: WNlVIL / I Y rr TAX GRID NUMBER: ,:t .w, �i �p� A/ 6*2 — I -51 WELL OWNER NAME: ADDRESS: / %f G / � � l° 1U�1 1 � ! b�. � 2 s' :'i /�, / PRIVATE PUBLIC USE OF WELL 1 - primary 2 - secondary [J RESIOENTIAL Of /PI SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDON 0 ❑ BUSINESS ❑ FARM 0 TEST /OBSERVATION O OTHER (specify) O INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY ❑ MOUNT OF. USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY By ffJ W SUPPLY (NEW DWELLING) ❑DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ° ft. I STATIC WATER LEVEL a ° jftDATE MEASURED Z DRILLING EQUIPMENT O ROTARY O COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify]: WELL TYPE O SCREENED O OPEN END CASING ❑ OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH LA _ 57 ft. MATERIALS: 0-STEEL O PLASTIC O OTHER LENGTH BELOW GRADE -eft. JOINTS: ❑ WELDED Q4HREADED ❑ OTHER DIAMETER in. SEAL: an-MENT GROUT ❑SENTONITE ❑OTHER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE O YES Via.- LINER: G YES p.NO• SCREEN DETAILS _. _• _..,..�.....� ... DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (f t) DEVELOPED? FIRST OYES .ONO HOURS SEGONO. - GRAVEL PACK O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH ft. WELL YIELD TEST !f detailed pumping METHOD: ❑ PUMPED tests were done is in- � COMPRESSED AIR , formation attached? BAILED ❑ OTHER :OYES ONO 1PIEL1. LOG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- i„ g well Ora- meter FORMATION DESCRIPTION poE R It WELL DEPTH It. DURATION hr. min. DRAY /00'NN . YIELD gpm. su 'j"e DV o WATER O CLEAR TEMP. QUAUTY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO ] STORAGE TANK: TYPE CAPACITY GA> . / r PUMP INFORMATION �1 , TYPE - Sr1� k.M'6' & CAPACITY ) c \ MAKER _`� (U H f � DEPITH MODEL VOLTAGE 23� HP', 2, WELL DRILLER AME pp DATE ADDRESS �h` q F �,x CFA SIGt,3tTURE / t'_ ld �� � 1� L n n' f r V 4. fie , A6 1 i) 5 3 l•`�In )r. J/ V7 PUTNAM COUN`T'Y DEPAR'IMEgr OF HEALTH DIWS10, OF FNVIRMiZEWAL HFALTH_SFRVICES Owner or Purchaser of Building Scr_ti.on 0 tv VtX Building Constructed by O ('a-W "1 ?/ I Location - Street '?W,-rN6(M ii/d u r P , Municipality Building 4�,7, /7 — / -s/ Block Lot L'�, 1 544- Subdivision Name c Mock 6 Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL 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 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 Consttuctioii'Compliance" for '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 the system. 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 willful or negligent act of the occupant of the building utilizing the system. f a r' o n%man L p Dated this To day of / r__ 19� Signature Title / n ea/i. neral Contrau for r- rporation ) - Signature 6,CL (1 -11. A Name (if Corp.) Dow Ro . w_ cosLz rev. 9/85 mk Coata & Fe.n2eLna, Inc. Corporation Name (if Corp.) 66 AAgyll ive. New ?ocheUe, NY Address (bate o� LnatallaiLon 6112190 DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Fred Zenz 292 Main Street Nelsonville, NY 10516 Dear Mr. Zenz: r- JOHN KARELL Jr., P.E., M.S. Public Health Director September 19, 1994 Re: Certificate,,of Construction Compliance PV -66 -83 Gargiulo Lake View Drive (T) Putnam Valley A field inspection was conducted by the writer on September 14, 1994. At the time of inspection friends of the Gargiulo's were living in the house and a thorough inspection could not be conducted, but it appeared that a three bedroom house was constructed. The above referenced permit was issued for a proposed two bedroom house that required 286 linear feet of absorption trench. A review of this Departments files indicates that a final as -build inspection of the septic system and well was not requested. Therefore, based on the above the following is requested. 1..... The septic tank, :junction.- boxes- and .ends -,.of the. trenches are: to be exposed for ' i nspect i on ... .. _. .. 2. A mutually suitable time is arranged for a thorough inspection of the house. 3. The results of a bacteriological water test is to be submitted. 4. Three copies of a SSDS guarantee is to be submitted. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, iR b&4 gmxo Robert Morris, P. E. Public Health Engineer RM/i P . PWNAM O�UEV?'Y:_HF�ATaTFl..r? AR - I' _ ; -., ,:: - — ..- -, . _.. DIVISION OF ENVIROWMAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAIL %- k G r v i. fd _ Orig. Routine Orig. Complain ll , ADDRESS !L a �U i L-w %JAL c Go m l*' `'a ,i ��- Orig. o Request r"' Z MAILING ADDRESS P.O. Baas Post Office Zip Code PERSON IN CHARGE OR INTERVIEWED Name and Title DATE � `Z G' TYPE FACILITY Compliance Complaint Comp Final Group Illness Construction. Reinspection Field, Sampling Only Field Conference Other TIME ARRIVED o 0 TIME LEFT Ar Explain FINDINGS: troy G r-� u� crQ F. -: yJi JJ i 0 aC.1 1 -01 r - ra INSPECTOR: PERSON IN CHARGE OR IN'IERVIEidED s I acknowledge this Field Activity Reports SIGNATURE: 6/86 TITLED TELEPHONE: PP =mLC 3 CC:."V'_"_ OF - Drj? -c::o CF M-=.= SUPaLY DISp, --E -L SiS= —S Adz'Co,v �.� LA,�W, DA �,.►Mv/✓, r�v F- Ltd NO DMY-HRM Ccr -crag F-So11t_ca Ea--v` i -, etc. W, E.�c; , rA»tzcr_z -t_cr. r Sit == (ZCS? S'urDiv_�_r�: Deep acin L.^c P=te Ecle Ce_ t_z c- wiail =-A L - L � Sa ci c:: EC—Zrcval SEES : TC C eakaa P_ tic -LK we in Twc -Fcct & P_cx== Dr_v--Yav & Slcces Cat FCC =- /C-= Dra *�� (-__= arse CK, F_rc & Dec Pot== Lcc== RecrEser -i . tiyr Cf and ct"..cIISiC Frs_nsica a_e.;_ c��_;..: ri _r f_ -H, -cuff. S_=S If Fes= Pit & D Ecx slcwn & FCL2O . CL We1!s E"OSts W /_: 200 L--- cf - -occse S = =_ P -ccE_r `r �T�s & EcuL= ScT =cC:t Ne_2ssa --; (T_c_ht 1ct) Ii10 E�.s; Max. Ear.:- 455' W %C_�..c Lit c 7r 7T 10' to P.L., Dr_ emav, Imo_- Tr es,Tc= c=: 20' to Fc`nc .tic:, Walls 100' to Well; 200' in D.L.O.D, 150' Pi== 100' to StraE ", <<C == MLTTL..�� L.kcB ( =nC. Ems. 13+ to �rG i P1C (1, L� L�r, FccL -ZC 351tr- CtC_ -1 501 .��C ` C 1Gr::, c 10, fz--n t-.D iz, pr .I I PV I I I I I i I � I ' I .......... -- I i I —_ re zu __ =—,` 2'ti'L '14-3 60 - -_ rte:. I I I 0 v -- I IN, I I I I I t I — \I0 ' I I Ea--v` i -, etc. W, E.�c; , rA»tzcr_z -t_cr. r Sit == (ZCS? S'urDiv_�_r�: Deep acin L.^c P=te Ecle Ce_ t_z c- wiail =-A L - L � Sa ci c:: EC—Zrcval SEES : TC C eakaa P_ tic -LK we in Twc -Fcct & P_cx== Dr_v--Yav & Slcces Cat FCC =- /C-= Dra *�� (-__= arse CK, F_rc & Dec Pot== Lcc== RecrEser -i . tiyr Cf and ct"..cIISiC Frs_nsica a_e.;_ c��_;..: ri _r f_ -H, -cuff. S_=S If Fes= Pit & D Ecx slcwn & FCL2O . CL We1!s E"OSts W /_: 200 L--- cf - -occse S = =_ P -ccE_r `r �T�s & EcuL= ScT =cC:t Ne_2ssa --; (T_c_ht 1ct) Ii10 E�.s; Max. Ear.:- 455' W %C_�..c Lit c 7r 7T 10' to P.L., Dr_ emav, Imo_- Tr es,Tc= c=: 20' to Fc`nc .tic:, Walls 100' to Well; 200' in D.L.O.D, 150' Pi== 100' to StraE ", <<C == MLTTL..�� L.kcB ( =nC. Ems. 13+ to �rG i P1C (1, L� L�r, FccL -ZC 351tr- CtC_ -1 501 .��C ` C 1Gr::, c 10, fz--n t-.D iz, pr V"!.iT'.._�. . +.a i •...... cwt Dear 1 DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Re: Proposed SSDS: (T) Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." "You are referred to Article 128.' o4 the official compilation of Coces, Rules and Regulations of the State of New YO�-k, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You =shoo' d contact-City Of f_i ci alts -i n_ th s regard." Upon Receipt of a submission, revised to reflect the above comments, this application w-i'; be considered further. Very truly yours, Robert Morris Assistant Public Health Engineer RM/j P Watershed SSDSProposed (A PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Mr. Stanley Lander PE PO Box "L" Amawalk, NY 10501 Dear Mr. Lander: July 31, 1989 Re: Renewal - Gargiulo Lakeview Drive & Community.Place (T) PV - TM #48 -5 -1.1 Permit #PV -6683 :114 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1) Due to age of permit, it will be required that deep test holes and perculation tests be witnessed by this Department. 2) A variance for a two bedroom design will be required. 3) Design data sheet must be updated to reflect new design, .:ie .1000 g,allon septic :.tank -.tank- 72..-..foot . wire trenches., two bedrooms. .. ... _........,, ._...._ .:.,..._ __._._._ .. .. .. _. ,. � . ,.... . 4) An effective length to width ratio of at least 2:1 and not more than 4:1 is required for septic tank. 5) Deep test hole and percolation data must be shown on plans. 6) Deep test holes not representative of SSDS expansion area. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Lawrence C. Werper LCW:jr Assistant Public Health Engineer Design & Construction Consultation 914- 245 -2645 STANLEY J. LANDER, P.E. Civil Engineer Putnam County Health.Department Division of Environmental Health Services Carmel, New York 10 ,512 Gentlemen: Mailing Address: Box L, AmawalK New York 10501 July 179 1989 Res Septic Permit for .Arnold Gargiulo Lake View Drive and Community Place Town of Putnam Valley Lot 1.1, Block 5 Tax Map 48 Please find attached 3 copies ofrevised septic layout for a permit originally issued in 1972 and re- issued in 1983 as Permit PV- 66 -83. Two sets of house plans are also enclosed. It Is my* understanding that the'permit fee 'is waived There has been no change in the soil conditions in the proposed septic area. Very truly youA)s9 SJLs bl Stanley J,�J�/ der En C. ( PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Mr. Stanley Lander PE e PO Box "L'! Amawalk, NY 10501 Dear Mr. Lander: October 5, 1989 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Re: Renewal - Gargiulo Lakeview Drive & Community Place - (T) PV - TM #48 -5 -1.1 Permit #PV =66 -83 Review of revised plans and other supporting documents submitted at this time relative to the above captioned project has been completed. Comments are offered as follows: Construction permit must be revised to reflect change in the linear feet of two foot wide trench required. (A construction permit form is enclosed.) Upon- receipt:-of.-a submission, revised to reflect the above.comments; this application will be considered further. LCW: jr Enclosure: Const. Permit l06,e'p F/d . Very truly yours, Lawrence C. Werper Assistant Public Health Engineer • DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER — CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION Street Address ,�9�CE !/feyV _ �MMr1i�l P�. Town Village /City Tax Grid Number acv �✓ 11 ALE T 48 6 5 Z A/ WELL OWNER Name Address ,44g,oi.o wzo 68akoy1,q. ,4✓e_ z7howAiwe /Y- ° Private 0Public USE OF WELL - pr mar 2 - secondary ZTRESIDENTIAL ❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP ❑ BUSINESS O FARM ❑ TEST /OBSERVATION ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY 13 ABANDONED ❑ OTHER (specify] ❑ AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED -4- /EST. OF DAILY USAGE.360 gal REASON FOR DRILLING KNEW SUPPLY ❑ REPLACE EXISTING SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL ❑TEST /OBSERVATION DETAILED REASON FOR DRILLING Foe 0 WELL TYPE ®DRILLED DRIVEN ®DUG OGRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES d/ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name //• j91y®EAS�W_ Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION ON SEPA. E T 7-17-69 "(date)' 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. Date of Issue:�Ir. P- 19 Date of Expiration: 19 Permit Issuing Offi-etgl Permit is Non - Transferrable j a PUTNAM -COUN'T'Y DEPARTMENT Off' DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 4647-4,rsr- ly7f Re: Property of (-/z 0 Located ate'eMInelV17Y Zqlr;� 7757r-' rn -f-ge TA /- HAP 7CIWAI ?9r--A1111)Vn A=t= 46 -Block 2 Lot Gentlemen: This letter is to authorize— LEY 1. LANDER a duly licensed professional en SUB ,ginee 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 rN - of Health, and to sign all n -t-e-4 L U L (Vu::i8ary papers on my behalf in connection with this matter and to, supervise the,construction of said system or systems in conformity with the provisi 4QA s of Article 145 or -147j.- Education. Law,'' th6- Public Aeal:Eh*-Ijaw,, -- and th6­-'-Putiiam'Co*unty Sani'-. tary Code. Co ersigned: P.E., Zgr., # -37,77,0 STANLET I UNDER (Seal) AdAdres D U A z o / 1 AMM W '. M Y 1050 — 245 -22645 e-L.epnone Very truly yours, Signed Owner of Proper t. Address ad 3 --���` Teiephone Design & Construction Consultation r.. �F•..a+- ._.v: _.max. � .: .. . -. .� CONNECTICUT OFFICE: 22 East Avenue New Canaan, Conn. 06840 203- 972 -1192 Mailing Address: Box L, Amawalk, New York 10501 STANLEY J. LAND EJI: Civil Engineer WESTCHESTER OFFICE: Corner of Mahopac Avenue &. Watergate Drive Somers, New York 914 - 245 -2645 December 199 1983 Putnam.County Dept. of Health Division of Environmental Health Services Carmel 9 New York 10512 Res ..Re.-Issuance. o . Septic Permit_ for Arnold ,Garg.iulo 9 Lakeview Drive ':And Community Piie_e Tovh 'of Putnam galley 9 New York Trot 1014 ° H7.ock 5, Tax IKa 48 Ca ®ntleft� ®�s _ . _ I visited the above refere. Wod. lot on December 16th 9 1983.. earl. Found Re h>�n a in thy, existing .eonc�itions pith4 rospect' to existiag wells and septic systems and the lot in questioner - Accordingly 9 I recommend that this permit be re =issued. ;Very truly you 9 JL o bl Stanley J a er cc To Mr. Arnold- Garg iul,o 68 Colonial Avenue Dobbs Ferry New York 10522 D E C 2 21983 PUTNAM COUNTY DEPT a OF HEALTH PETER C. ALEXANDERSON County Executive .. _ .... .. . .. ..... .. ... . •_+ a L..: •vim• •. _..... � .. .. , DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Stanley Lander, PE PO Box "L" Amawalk, N.Y 10501 Dear Mr. Lander: September 22, 1989 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Re: Renewal - Gargiulo Lakeview Drive & Community Place (T) PV TM#48 -5 -1.1 Permit #PV -66 -83 A field inspection of the above captioned property was conducted by this writer on September 20, 1989. The following observations were made: 1) Perculation rate was witnessed to be 20 Min /In. 2) Deep test holes were seven feet deep with no _.._- evide.n:ce :of. g.r.ound..water :cri'..edg'e,__..._ This Department therefore, will require that the proposed sewage disposal system for the above captioned property be designed on a 20 Min /In perculation rate. Since this permit was approved prior to the requirement of 100 percent SSDS expansion, only 50 percent SSDS expansion will be required. If you have any questions, please contact this writer at Ext. 317. LCW:jr Very truly yours, Lawrence C. Werper Assistant Public Health Engineer PUTNAM..COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N.Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner', &11040 15;,4467161 0 Address 68 (�G'Jiyyd/s . A./,r Z- 4,65 A;-xJ y /"m Mil r✓�✓1 r,y %,iGfi c'e' � fi49% IY1 !41� Located at ( Street) 4q,<'� v1,—,v �1�r�1� S� S. 4 t3 Block Lot (• i ( Indicate nearest cross street) - Municipality�4g,. p` la7d -1441 t6jcN y Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS ole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water Levei No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop'in Min. /in drop Inches Inches Inches 3 4 3 -33 /a¢ /9 s- S- 5 2 3 m KI 5 Notes:. 1) Teets 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. 18" 24 n 4Y 14 30 n y f� tt 36" 42" P ei 48" 54 fl fy 60" �t 66" 72 ►' _� 78„ o� 84 if TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION - NDICATE LEVEL AT WHICH -GROUND_WATER,..IS ENCOUNTERED:. _DESCR- IPTION..OF, SOILS TT+1C01WMRE_I_N TEST ..HOLES.. DEPTH HOLE NO. Iii HOLE NO. �Z.- HOLE NO. Pe6f / ce g' G.L. /af���rar� Date" �v c: 6" dl 18" 24 n 4Y 14 30 n y f� tt 36" 42" P ei 48" 54 fl fy 60" �t 66" 72 ►' _� 78„ o� 84 if Address BOX 267 THIS SPACE FOR USE BY HEALTH DEPA, P 0 Soil Rate Approved ' Sq. Ft � '�O by Of. H13H3H j0 '1d3Q 171j�IfTQ� Ir,lifil!.�ftd ?Zbl '_� % Sill`. � C J �, I Date t , fp 1414 re,--0- _ - NDICATE LEVEL AT WHICH -GROUND_WATER,..IS ENCOUNTERED:. 1NDICATE 1EVEL-TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 'PESTS MADE BY Date" �-- �- DESIGN Soil Rate Used le) Min/l "Drop: S.D. Usable Area Provided i'7r No. of Bedrooms •_ Septic Tank Capacity Gals. Type IOA50,ley Absorption Area Provided By L.F.x24 —jb"— a/ width trenc . Address BOX 267 THIS SPACE FOR USE BY HEALTH DEPA, P 0 Soil Rate Approved ' Sq. Ft � '�O by Of. H13H3H j0 '1d3Q 171j�IfTQ� Ir,lifil!.�ftd ?Zbl '_� % Sill`. � C J �, I Date P - PUTNAM COUNTY DEPARTMENT OF HEALTH DMalon of Envteonmentrl Health Services, Carmel, N.Y. 10512 Fagg Must Provide Q\Y — 6 6 —63 n P.C.H.D. Permit N I� Fee CERTIR+ICATE OF_ CONSTRUCTION COMPLIANCE FOR_SWAGEDISPOSAL.SYSTEM :.: .._Pu Clfrk;r�n ��� ,Vi(} s kf�y _._ ;::.: r:�,•_ KEVI'F•.) DR d- CC��Ip�v��yl?y PLACE Town or Village Id at Taal Map 6 2` �� Block Lot ;10 Name - j`ARl l u L O Formerly &- Smbdivlelom Name- ©S cq k�a �. w a . be f M Trip /0522 Subdv. Lot # ed[ Amount 1v0,00 Date Permit Issued T-z7r, 7;-4 Separate Sewerage System built by CO 4k d- Fr r-f-e t'raL Address tiu„ (1, <_ c .. Consisting of 1 t7Ctn Gallon Septic Tank and Z� G 0 2W, won Water Supply: bllc Supply From Address on Private Supply Drilled by + An Address Building Type- RVkote Lot Size Has Erosion Cnntrnl Rapn fmm�lataA9 Yf5 Number of Bedrooms _ Has Garbage Gunder Been btatalledY — /Jn Other Requirements I certify that the system(s) as listed serving the above premises were Of which are attached), and in accordance with the standards, rules and Putnam County Dep�rtm¢nt Of Health.. as on the plane of the completed work ( copies n L9f the filed plan, and the permit issued by the I / Z Oats t Certified by /Y- P.E. 1 /R.A. Address 29 Z )ti1�„w _ Af G�tB„ ✓al' , N �� `/% Llcenfe No. 3'� tl _ Any person occupying premises saved by the above systam(s) shall promptly take such action as may be necessary to Secure the correction of any unq conditions resulting from Such usages Approval of the separate ssweregs system Shall become null and wolf as soon as a pubs% unitary fewer fnfe available and the approval of the private water supply shall become null and woad when a public water Supply beconNs available. Such appr Is are subject to modification or change when, in the judgment of the Commissioner of Health, such revocation. modification or change is necessary. 1189 Date By Title PUTNAM COUNTY DEPARTMENT OF HEALTH R r,V . 3 / 8b:. - : ...:.; _..; Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Must Pravlde ::, _...... _.. .. , . w ATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or V e o W 1 C0 1A L Atr, Tax Map_ _11 —Lot S Formerly Subdivision Name Subdv. Lot q Owner /applicant Name 10 S LZ Date Permit Isaueil I Z 271 g3 Mailing Address �Q' C � � • DO �� Zip _ - er Separate Sewerage System built by_ C e' [ n - Gallon Septic Teak and Consisting of Address Water supply:. or: Supply From rq Qi� tin ors Private Supply Delved by ei Address �f. Has Erosion Control Been Completed? � Building Type �- Has Garbage Grinder Been Installed? Number of Bedrooms Other Requirements as sir on the plans of the completed work ( copies I certify that the system(e) ae listed serving the above premises were regulatio ssentially of which are attached), and in accordance with the standards, rules an regulatio in ccorda e ` the filed plan, and the permit issued by the Putnam County Departme t Of Health. P•E•_L R.A. Certified by Date --� t`3 i1 ,LIZ �iASC"�'V - �CSrli License No• y�13d Address Any person occupying premises served by the above system( :) shall promptly take such action as may be necessary to Secure the correction of any rovelf are unsanitary conditions resulting from Such usage. Approval of the separate sewers system shall become hull and void as soon as a Pub(= sanitary sower becomes a the judgment shall of the Coin �ner of Mea Ii�Ji/I"ch revocation, modification or change Is necessary available and the aDProvel of the private water supply shall become null a d void when // /1� n ester Supply becomes available. aPP ....__.._. ... w•we• when. ...,........_,_.. ._- ._._......._._�--_.... - -.... _ �....., ..._ . .. _ t-. W I v t I' N U V I I' k. I P. v I r r I n t UANAht LUIJiV'f N f.)f?: IAIt'r111i.t'J!" Uf? f11.A1:D li I to <, Iu qH f. l'H I�f Ir' fI'+fl' utli•Ir,iznetr I' `ra ^ rtk , '.? Alvlalon of EnV11"Onalental livelth Services, Carmel, N. Y. IU51.? PLRMI I' _ �U 0C ION ERMI- j FOR SEWAGE DISPOSAL SYSTEM ._._ ��!�. d�I/ -r _/_�'/J� I's MI •'r1!�., .•�.mw re+ Inwel �Or �%iIlay9. ..._ �.oeate9 - -ai• �°°� P1Ltt/E CF.CoM:rAt.'r�Q1' PLr4C_ Tax NASD_= �Oloak a - - -•- 0ubdltllflOn aubd. Lot D Ovnor /Addeoea d d L ��Dato Ot Proviouo Approval c / Dullding TYPm €S /��Ni //��- Lot Area 1 1 0. 6d L ?111 Sootion only ❑ -- - Number of Bedrooms Design Plow G /P /D .4oO P.C. ". D. Notification Required Separate 4ewarage System to consist of o © Gal. Septic Tank and �• 2� 1 �� �T �� `f� / ' ' ' NL fd i.i.0 bo constructed by Address - - -- Supply: Public Supply From ! %Pr)vate to be drilled by �— Supply 6 - w� t; Address /! 6��L4E1 Othee Roquiromonts vop►osent that t am wholly and completely respor t r rie ove deatribad will be Constructed as shown on aunt C Y D apartment of Health, and that on c eo ba submitted to the Department, and a we to ." ',!• ®taco In good operating condition any part o of tho approval of the Certificate of n uett 4 { +. will be located as shown on the approved plan It Department of Health. of the proposed system(s): 1) that the separate sewage disposal system to and in accordance with the standards, rules an regulations a the u Warn of Construction Compliance" satisfactory to the Commissioner of Healthwill Ication a owner, his successors, heirs or assigns by the builder, that said builder will ring the period of two (2) years Immediately following the date of the issu- tgi I system or any repairs lher.eto :2) that the drilled wall described above ordance with he sthndai , rules and regula ri'ona or the Putnam Pilo IZWK- Address �O v ®/ License No. ��. APPROVED FOR CONSTRUCTIONi This approval the date Issued unless construction of the building has been undertaken and Is .:t �v:i :•! favocabie for cause or may be amended or modified when c necessary by the Commissioner of ealth. Any change or alteration of construction vaqulfea a now permit. Approved for disposal of domestic sanitary sewage, and /or private water sup ly only. bat© ® Title Y ' PU`lNAM COUNTY DEPARTMENT OF HEALTH ttvtsilvtcr< lu triuvlut rtr<rlll r ON CERTj.FIC,j,T'OF COM�A14CE Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT JJ�t I C0NSYRU ION PERMI FOR SEWAGE DISPOSAL SYSTEM _ ® own or age - iroeated at- LA :k iii .... CdOM(� 4'Nf i_iil( ��.r�C� Tax map �G7 Block � toc ion/ Subdivision Subd. Lot / Aoneral r. Rovialon Owner /Addeeea /7/�/�Pi�l% gkm&Ula 6jW_Vi -0A0A! 40' &NIS' F9j s°,'Dat. o Provioua Approval Suilding Yypo -RES! DOE /.QC. Lot Area.1 ! 0- CO C Pill Section only ❑ Number of Bedrooms 9 Design Flow G /P/D � ®� P.c. ff- D. Notification Required �p Separate Sewerage System to consist of �B p ® 7Tr--"� Gal. Septic Tank and �• Z2 ��' �% 24 ul� /� /�C/yc q To be constructed by siy� J i'�NJ • ile Address Water, Supply: Public Supply From �Prlvate Supply to be drilled by Al, Ay� neX std , c. Address — !tQ/L% ��L��3S /Y" 7• Other Requirements — I represent that 1 am wholly and completely ►espo cation of the proposed system(s): 1) that the separate sewage disposal system above described will be cons t r r tructed as shown on � to and in accordance with the standards, rules an regulations o the u nam County Department of Health, and that on a eof of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a wri to u e owner, his successors, heirs or assigns by the builder, that said builder will Place in good operating condition any part o ring the period of two (2) years immediately following the date of the Issu- ''�;:?ance of the approval of the Certificate of n ucti of 1 i i ^� will be located as shown on the approved Ian p at 9 system or any repairs thereto; 2) 4hat the drilled well dedescribed above tal cordance with he standar rules and regula r'ons of the . Putnam County Oe1pgartment of Health. Data Q ne o- P.E. R.A. Address ��% / f� ' ®� License No. APPROVED FOR CONSTRUCTION: This approval the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when c necessary by the Commissioner of p�ealth. Any change or alteration of construction requires a new permit. Approved for disposal of domestic sanitary sewage, and /or private water supply only. bate 8Y Rev. 6/85 Title "` "' "' I 1'U1 NAM LUU111Y 1..11- AAltiAiIJ41' ()I-' IlEA1-11i t leIIvCkl< 1V YI <l1VIIll 1'ri. irr rr D /vhlorr ILI 11, o/ [nv /ronmwr►fal / /ww/fh Swrvlcws, Car'nlwl, N. Y. JO,1? f'IItPtllrl�lrll i( rrl' r nnl I Inur I CONSTRU ON PER IT, FOR SEWAGE DISPOSAL SYSTEM aA/w1 /- Located at -L A K f-YI E Y1/ �1 ya 1 t/E IIW 11 11 �% a i III�� Tax Map Block Subdivision !;• : bullding type DES /l�ENri1aL Lot Aree.l l p• b LIES Number of Bedroom$ .Z Design nor c/P/o 4 O o Separate Sewerage System to Consist of /000 Gal, Septic Tank .:3 be constructed by UDC .S^ON.( .IZiyC � te �' is x- :.. _ ,.; . r--� „_ . , .- __ �:rJi:� t : • 4. !C: � � c- ::::..,� /,ba-of Previous Approval Fill !action only v P•C. R. D. notification Required __ and .222 Z 24 i�v/oe 7A-E/YL►i/ Address Watt' Supply, Public Supply From n Private SupDIY to be drilled ��b�yy' __All Address f UiA/A.N l4AGLEY /y 7 Other Requirements – — i represent that 1 am wholly and completely res above described will be constructed as shown on County Oapartme,it of Health, and that on ci be submitted to the Department, and a wrl place In good operating condition any part ante of the approval of the Certificate of Will be located as shown on the &PP►oved plan County Department of Health, ,,:: dal.• T- - 89 - - -, _ . P.E. != R.A. �v + License No..��,% ;;$' ' APPROVED FOR CONSTRUCTION, This a / Q -- ,r:r;;,•: PP ►oval revocable for taus, o► may be amended or mo the date Issued unless construction of the building has been undertaken and Is dified when c necessary by the Commissioner of • ealth• Any change or alteration of construction g fequkaf a new permit, ADproved'for disposal of domestic sanitary sewage, and /or private water suD<S'Y only. BY Title Ilion Of the proposed system(s); 1) that the separate sewage disposal system to and In accordance with the standards, rules and regulations o the UG-5 of e Construction Compliance" satisfactory to the Commissioner of Healthwlll owner, his successors, heirs or assigns by the builder, that said builder will ring the period of two (2) years Immediately following thedate of the .Issue I 19 1 system or any repairs thereto; 2) that the drilled well described above ordance with he standards. rules and regula r�'T ni of the Putnam /4•tJ G E O $' 1�' PUTNAM COUNTY DEPARTMENT OF HEALTH 1� - Division: of. Environmental Y . Health Services, Carmel, N. Y. 10512 L CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM aN� aF, ��TM14� �-�y Co ' w�i -or Village - Located /, VO Ili a� IM �a 1� YIP'9 - i r1 P &AGE Tax Map Block Located at Job Subdivision Lot ,q � �� 1,.o(,i �V� Owner ARrgoi.r2 �Ap �'/ 7 Address 0C2.2- Building Type 17Ee i OF n1 R! Lot Area 0- 41 lk-&F f' (moo f3�5 ,+fie COO Gi Total Habitable Space OVE•�' 1 sac Square Feet Number of Bedrooms i Design Flow a � Gal. Septic Tank and J-/ Separate Sewerage. System to consist of _s / To be constructed by KA -r o IL �1IL fJ5" d aJt Address �U'TIJAM �s AZL�i�i N water Supply: Public Supply From Private Supply to be drilled by Address F—OT Other Requirements 1 represent that I am wholly and completely responsible for above described will be constructed as shown on the appr County Department of Health, and that on completi be submitted to the Department, and a written gu place in good operating condition any part of sal ante of the approval of the Certificate of Constr will be located as shown on the approved plan and th County Department of Health. Date ( Lai 7 -V Address APPROVED FOR CONSTRUCTION: This approval exp revocable for cause or may be amended or modified when requires a new permi Approved for disposal of dome: !� 1 Rr of the proposed system(s); 1) that the separate sewage disposal system nd in accordance with the standards, rules an regu a ions o e u nam on ruction Compliance” satisfactory to the Commissioner of Healthwlll ner, his successors, heirs or assigns by the builder, that said builder will �i the period of two (2) years immediately following thedate of the issue system or any repairs thereto; 2) that the drilled well described above dance with the standards, rules and regula ons of the Putnam P.E. !!�R.A. "issued License No. s construction of the building has been undertaken and Is oner of Health. Any change or alteration of construction and /or pply only. `� Title �_� .y - PUTNA COUNTY, DE, Diwsfon of Enwronmenta/ Health Services; lrarme/ N Y 10512 CONSTRUCTION .: PERNIITQQFOR: ,S.EWAGE. DISPO, $!AL SYSTEM �^'orr� A ©�" �` i o�i/a /1 Town or Villages --�+ Located at G�wt3'l�A�li/ >� Section ��-!' Block *l r ir�L d Subdiv ision Lot _ Job Owner Address. 9 YP_ !r. :54i B ildin T e . Lot Area I Number of 'Bedrooms ���� Total, .Habitable Space -w� �' / 7 �; Square Feet x� Separate Sewerage System to, consist. of Gal. Septic'Tank f lineal feetX r ' widtti trench: ,. To be constructed by "'"'� fir% Address�_��°� /` ' } Water' Supply '`Public Supply From ` r" Private Supply to :tie dulled by >v�+Z Addresss Other Req uvement s; - ♦X 1 `5T ' r I. represent that I am'whoily and completely responsible -f ® of the propdsed sysfem(s) 1): it ha he separate sewage disposal system above deser� bed will,be constructed as;shown on, the ap a` ` nd m accordance with'the standards, ules 47M"7 ions'o the, ,.' u nam �', County Department of Health, and +thataon comple er a onstruction Compliance satisfactory to the Cortim�ssione of`Healthw�ll ._ .. _.: z place in gootl operating condition any part, :of � ale p yster the_ period of two (2) years immediaely folowmg the'd anew of 'the. approval, of the - Certificate of 'Const ctT, C system or >any ie rs thereto, 2} `that -fhe drilled:welhd will tie located as shown on the approved plan and t t d we d rda_nce 7th kth andaedsi rules and regu a ions of County�D/epartment of Health, r�� Date. .- ♦ Si gym. P E ti Address �� :`�' h� A. License NO` -32 APPROVEDFOR CONSTRUCTION. This approval expi y o date issueil unless const dmg'ha5 been and revocable'for, cause or may?.;be amended br "'modifiedwhencon r`y- t4y the:'Commissioner'of Health. Any-change or`_alteration':i requires a new permit., ' Approved for disposal of domestic sanitary "sewage a' d rrvate'w p ' ply only. Date's BY r - "rc%i- Title M _. V