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Home My WebLink About3223DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 71 -1 -8 BOX 26 03223 I,yti . all, J '+T �' A IN kQ w, ' ' �.. ' , �'`,T - T, '� - 1 1 1 ` ' �' 03223 1 �• PUTNAM COUNTY DEPART OF HEALTH Division of Environmental.Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM '!Ryxxo%kw\ (� /^ Town or .Village Subdiv Owner q` s�'- �"�`^�� _ Building Type We' Lot Area Number of Bedrooms Separate Sewerage System to consist of t�'� Gal. Septic Tank To be constructed by Lot 9 Jo�.b�� Address Sum NNNA Total Habitable Space 2`� Square Feet lineal feet X a� width trench Address Water Supply: Public.Supply From Private Supply to be drilled by Address Other Requirements�� I represent that I am wholly and completely responsible for the design and location above described will be constructed as shown on the approved amenAill County Department of Health, and that on completion thereof a be submitted to the Department, and a written .guarantee will b place in good operating condition any part of said sewage disp ance of the approval of the Certificate of Construction Complia will be located as shown on the approved plan and that said well will Count Department of Health. Date - k -t " Sign APPROVED FOR CONSTRUCTION: This approval expires one year revocable for .cause or may be amended or modified when considered r requires a new permit. Approved for disposal of domestic sa itary Date � BY ed system(s); 1) that the separate sewage disposal system ce with the standards, rules an regulations o e u nam mpliance" satisfactory to the Commissioner of Healthwill c ors, heirs or assigns by the builder, that said builder will of o (2) years immediately following thedate of the issu- ny pairs thereto; 2) that the drilled well described above standards, rules and regulations of the Putnam P E�-- �1R.A. License No. struction of the building has been undertaken and is of Health. Any change or alteration of const ction supply only. Title MXT OF HEALTH PUTNAM COUNTY DEPAR T Division of Environmental Health Services, Carmel, N. Y. 10512 Amw iz-&"10 F; dwo CONSfk_Lj I`i'UN tNnt` rUk atrlvH�t` fii3F ,S ►Z'SYJTc1Yi ' 1 ; Town or Village Located at ice► �� ` ��'�- ®d�U Section Block Subdivision + +� �« S" Lot Job w I Owner S=Ei�VZw..S 1��• Address Building Type Qt-AG •�GS10 Lot Area 431 73-S SS :S: Number of Bedrooms ': Total Habitable Space s�zQ� Square Feet 2 ti Separate Sewerage System to consist of i*Z. Gal. Septic Tank Z4`0 lineal feet X ab. width trench To be constructed by Sz- �P�r ` C, w Address Water Supply: Public Supply From V" Private Supply to be drilled by Address Other Requirements No M, I represent that I am wholly and completely responsible for the design and location of above described will be constructed as shown on the approved amendment there to apd County Department of Health, and that on completion thereof a "Certificate (/(14 be submitted to the Department, and a written guarantee will be furnished k'07 place in good operating condition any part of said sewage disposal syste �9 ance of the approval of the Certificate of Construction Compliance of t on i will be located as shown on the approved plan and that said well will be instal i c County Department of Health. {,X Date VA`e�' 7— '0' t9 ry I- Signeda Address' `-'�° �`��v4`t� APPROVED FOR CONSTRUCTION: This approval expires one year from the revocable for cause or may be amended or modified when consider necessary by requires a new permit. Approved for isposal of domestic sa itaiy se page, and /o; Date BY pflfp�, system(s); 1) that the separate sewage disposal system acbb�4$n C�� the standards, rules and regulations o t e u nam If ce" e Commissioner of Healthwill s�i�2 rs builder, that said builder will d� (2 ears immediately following the date of the issu- ystem, or n� r hereto; 2) that the drilled well described above th °the n Ards, rules and regula i�of the Putnam P.E. --'- R.A. License No, 04-7-1 Q 3 tlon of the building has been undertaken and is Health. Any change or alteration of construction dy odly. Title PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health SerVices Carmel, N. Y 10512 ` rFRT!PlCFtF� OF ('Oi�SFR�Ir;�_lrP� Onrrpi !p,yC.F FOR SEWAGE �!SPC�cAIr�SvcTEnn .. IF :,.,._......_.._..` a Town or*Villa9e � Located a��t,� -� ��-` �� Section Block . Owner r� �� t7 �1.� Yv� Lot. / Job Separate Sewerage System buuiltt by ~ :° Address Consisting of Rnr"19 Gal. Septic Tank 2- lineal Feet X width trench Other requirements Water Supply: Public Supply From Private Suppl rilled By Address (��t� Building Type Q&-)Z i�A `"�Vr° 0 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 of the completed work (copies of which are attached), and in accordance with the standards, rules and regulations, plans fil , ancLtpe permi is d by the Putnam County Department of Health. Date * Certified by ,o ,�..��op�� c� P.E. s�1� tR:i4. Address Q N� � N CA K"~'" License No. X34 -�ZI 19's Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to 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. SuchV-appro als are subject to modification or change when, in the judgment of the Commissioner of Health, such revocation, modification or change is necessar < <y `k l Date By Title -L1E"N SalIilr V ME i1IGAT"J --'-A —'R iA ;no-%, 1 Y .. _ .. .. � ,.... _ . .. .. .. .... 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 Peekskill, New York 10566 41828 PE 7.8777 UATE UULLLU1'EV RESULTS OF EXAMINATION OF WATER 3 /5/74 OWNER DATE RECEIVED STAN140M BUILDERS 3/5/74 CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED P;O, 335 CHURCH RD,, PUTNAM VALLEY, N.Y. 10579 3/7/74 w a...aary s-vaar a ( UELL) LOT ## 9 BIRCHHILL ROAD BACTERIA PER ML. (Agar plate count at 350C). 6 COLIFORM GROUP (Most probable N6. /100ml.) less than 2.2 EST, TOTAL - ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm.. LUuruuL (r) - mg. /i. These results indicate that the water was Yes of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) PUTNAM COUNTY DEPARTMENT OF HEALTH i7X1 ° v 101 COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO." Owner ++ �1��- �1s�'YZ� Address 0,11 Located at ( Street Sec. Block Lot-, �L�c �es�ross cj street) Municipality s��1.�<?� 1 Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH A. PPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Rum 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 X01-" kal. ,K`i ti ice. 7-7 �Z i 2n if 2 ko%S:q is -A- ks: 40 z,� -71 3 2 r,, Z4 37 =- - 3 k\,-6-7 ' 4V 'k i 7�9 Zq g 1 1 LIZ 2 kg •�,\ ry i� ✓cif'^ t>r..... 5 Notes: .1) Te':}ts 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. f PUTNAM COUNTY DEPARTMENT OF HEALTH i7X1 ° v 101 COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO." Owner ++ �1��- �1s�'YZ� Address 0,11 Located at ( Street Sec. Block Lot-, �L�c �es�ross cj street) Municipality s��1.�<?� 1 Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH A. PPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Rum 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 X01-" kal. ,K`i ti ice. 7-7 �Z i 2n if 2 ko%S:q is -A- ks: 40 z,� -71 3 2 r,, Z4 37 =- - 3 k\,-6-7 ' 4V 'k i 7�9 Zq g 1 1 LIZ 2 kg •�,\ ry i� ✓cif'^ t>r..... 5 Notes: .1) Te':}ts 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. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION _ _ - ..:.. :PEcCR CIO_ '��,r _ - - _ _ ITS .TIC L�i�I' i T1V DEPTH HOLE NO. ► HOLE NO.. HOLE NO. G.L. \01? 611. 12 - 18" - 24" 3011 G oZNA 136 11 `h 2" 48" 4n 60" 66" 72 If 78" 84" JNDICAT '-. -I - 7E AT- l• - -CH GR01 [CATER IS ENCOUNTERED �._- ..._____ 11Vll.LUA'1'� LEVEL l'(1 WHl(:H WA'I'L''Ft� L�liVEL �R17EJ"Ar lEli ti�1 .1V1i°1�;1Vl:UUiV'1'L'tC�'' TESTS MADE BY SAU?. . Date. ;SsLN VR i Z j DESIGN Z. Soil Rate Used Min/1 "Drop: = S.D. Usable Area-Provided No. of Bedrooms Septic Tank Capacity NEW yo e Absorption Area Provided By Z, L. F. x24 c A, & trench. 9ti r Address THIS SPACE FOR USE BY . HEALTH DEPARTMENT ONLY. Soil Rate Approved Sq. Ft /Cal. Checked by Date ' Y cy "d CZ ,�r "Owner or Purchaser of Building 5�17,,J 44)d d 1S �y. � d � 2.! /i✓ G , Buil�id ng Constructed by Municipality ,&4C fig Section _ � /•e G fly � � c_ �d�y Location - Street Block! Building Type Lot �( v 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 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 followir_o 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- :; s ..�,a7-it:_.czf. tne.�bai1d: -ing- utili- zing the- system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vices 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. Dated this 1' day of 19 Signatu ` Lam' /� -)Oa i Title corp ration, give and a es�f 7'4 — THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP.T�ETION 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 WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING • CARMEL, NEW YORK .- �:::.�= :.��:�i� °vt°�o�is� — T– ,�ferfi•i3^�so'd`�I'a'�I�titts: ,/= 1Q' `kk�t� "�tddi,�i.�C-��.,. <::;:�: analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME STANWOOD T"TILDERS I ADDRESS r LOCATION OF WELL (No. 6 Street) (Town) (Lot Number) SIRCRI(ILL, CUURCK ROAD, PUT NAM VALLEY N PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL SUPPLY INDUSTRIAL ❑AIR F] OTHER Y CONDITIONING (Specify) DRILLING EQUIPMENT COMPRESSED CABLE OTHER ❑ ROTARY ® AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) _CASING DETAILS LENGTH (feet) 221 DIAMETER (inches) 61, WEIGHT PER FOOT 15 E� THREADED ❑ WELDED IVE SHOE 1 7 YES ❑ NO G YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPEDI COMPRESSED AIR 7+ 10+ YIELD (G.P.M.) 10+ WAVER LEVEL MEASURE FROM LAND SURFACE— STATIC (SP eclfy feet) DURING YIELD TEST (feet) Depth of Completed Well in feet below land surface: 11�Qt SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches ) IF GRAVEL PACKED: Diameter of well including gravel pack (inches):. GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 11 10, hardpan lot 140' bedrock- granite If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED __2Z2� III DATE OF REPORT T W Signature) /� I - S Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH 1.CVI�+.�•_ffF rn�in: Date \ ... . . Re: Property of��,9'�� Located atcm CcZ- •- ��!( �� Section Block Lot 'This letter is to authorize a duly licensed professional engineer or registered architect (Indicate) to apply for a.Construction Permit for a separate sewage system; to serve the above noted property in accordance.with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection wi.tn this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or tary Code. the _Public Health .Law, .and .the- Putnam. County Sani- Very truly Telephone gne d Address 41 -� Telephone 7 /c� Szj- i3od ��J4 ' .�c �y^.Ie4 `��'1Ld�},� � #. "� y \ t ``� � � Cl'�Gi l 1' /' f � W �i✓ I 1 S t "1 Y �eh .. k 776 107— APP OV D UGC 1 �3 \Sj //t�(pCpzH� Q COUNTY HEALTH E. .. " 'DIRECTOR, DIVISICM OF ENVIRONMENTAL HEALTI: SERVICN //C,� 1 } 'Zoo Win•°:.. SfRARATE: -- SEWERAGE SYSTEM ; ��S�oPHERsioyq� DI's` F�2 *� 7H�t61t�G FJJf?v e S _OWNER.- /.,a :S-O• _... - �GX /3i CfV•1lTDiee �. ___ � lei Ni LOCATION: � YNF%/ %P:t 4 , !l7"jSEC.'_,FI_K.____LOT 3705 :No TRUCKS.MACHINERY.BIJILDING MATERIALS NOR EXCAVATED EARTH SHALL BE �r 0 CONTRACTOR: ALLOWED IN THE SEWAGE. DISPOSAL AREA. CONSTRUCTION OF THE SYSTEM IS TO BE [N ACCORDANCE WITH THESE PLANS ANY REVISIONS THERETO AND THE RULES.,ANU REGULATIONS OF THE PERMIT ISSUING GOVERNMENTAL AGENCY, DOLPH ROTfELD ASSOCIATES P :c91/G 7 AS BUILT PLAN: 5.12 MAMARQNECK AVENUE,wHIT�i: PLAINS,NY