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Home My WebLink About3224DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -9 BOX 26 pir 09% Ir J 161 . � y� !m • k 9 03224 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 ` v CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM U_11`1 Kiv\ ( Town or lgve Subdivision Owner ✓ % r Building Type Lot Area t K(2, Number of Bedrooms `I-- �—�^4 Separate Sewerage System to consist of ouco Gal. Septic Tank To be constructed by A ; Water Supply: Public Supply From Private Supply to be drilled by Section—___ Block Lot �e� Address i K\ IV NIK l��V Total Habitable Space 7✓too Square Feet .106 lineal feet X 3A0 width trench Address Address ! �' T/U/�.✓1 ydict�i f —r Other Requirements $J&-Ay' alle41t. I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown 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" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will . place in good operating condition any part of said sewage disposal system Uring the period of two (2) years immediately following thedate of the issu- ance of the approval of the Certificate of Construction Compliance of the [in iginal system or an repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed Aaance w h the standards, rules and regula ons of the 'Putnam County Department of Health. Date ! • �, / ! ti, Signed P. E. R.A. Addres `�� \ " , �` `�� License No. CZ� APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued u=.slonerof n of the building has been undertaken and is revocable for cause or may be amended or modified when co scary by th Co h. A ny change or alteration of construction requires a new permit. Appr ved or disposal of do stic sanita ag and ri rgy. Date i By Title v-) 73 -1 ' PUTNAM COUNTY DEPARTMENT OF HEALTH t'liviginn,rif Fnvjra!1mp, -it.7f i %alih Services. Carnet, !.'. y. 1vJl� CERTIFICATE QF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM -Wc.c't'M V et Town or Village Located at v'VW Section Block w0 ®�C�or��r Owner 1t.� Lot Separate Sewerage System built by "' • & Address 1� ( [ �{J�ob[ e ° `+ (+ ^�? 2 �Gl�alr. Consisting of s =� Seppti�c Tank °� lineal Feet X width trench Other requirements r �'��y Water Supply: Public Supply From Private Supply Drilled By I T ' r Address (� � Building Type �' TO l�, � No, of Has Erosion Control Been Completed? "Ite Bedrooms Date Permit Issued I certify that the systems) as listed serving the above premises were constructed es attached), and in accordance with the standards, rules and regulations, p i n ial y show 0 e plans of the completed work (copies of which are an t permi is by the Putnam County Department of Health. Date �N►/iv__2r `` Certified Address P.E. R.A. License No.®f_v6z Any person occupying premises served by the above system(s) shall promptly take such action as may be necessar secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and as soon s a public sanitary sewer becomes available and the approval of the private water supply shall become null and vo' n a public wat supply beco es available. Such approvals are subject to modification or change when, in the judgment of the Comrr)ie loner o ealih �Qch�e cation, mo ication or change is necessary. Date fi By uvS.:ulai, PEEKSKILL MEDICAL LABORATORY l4L 1 TI 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 79.2- RESULTS OF EXAMINATION OF WATER DATE COLLECTED 6/3/,74 OWNER DATE RECEIVED Stanwood Builders 6/3/74 CITY, VILLAGE, TOWN &/OR NAMt OF SUPPLY DATE REPORTED :Lot # 8, Church Road, Putnam Valley 6 /5/74 BACTERIA PER ML. (Agar plate count at 350C). 7 COLIFORM GROUP (Most probable No., /looml.) less than 202 HARDNESS, TOTAL -ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm r L,vuniLir. tr / - my./ a. These results indicate that the water was yeB of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) p c Owner or Purchaser o Building Municipality Building Constructed by Section Location - Street Block Building Type Lot 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 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 occu- pant of the building utilizing 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 e building utilizing t vstem. Dated this day of 19� Sign Tit �- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -/ - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF CO MP-7,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 ""I sir 4 Iv P5 IA's ,�!..\ Jj �_ ; C'D Lk MR -A-/ A-Z -A, 3 PPROVEL 419 7 7A-. ij.t� 70' ZC4-197, ric JAU& AJ C,-I- OJINAM COUNTY DEP1 E�- M Ov - N-OV. CC r4�- __;�y}RQNId I lNTAC.HEJILIH S6iRYt�1F° ..—_.. ,._. ..~_- i-T ro This letter is to authorize Wk .. \t- � (\J-j a duly licensod professional En?inaar �/ or ra�istered a „cb —eet .(Indicate) ^� to apply for a Construction Parmit fo.r 2. separate sa.'rara--o system; to 88rra the abO;,a rioted p rOJa-.`i a COrdaTC8 ,it h s a dards, Mules or re in -ti o�?s as DrO ?:l:l to bT the Co= ssi Oi,er of he Futn =r',1 COLu ".y Dent eart,! --e ? v O_`' THealt ^, and to size `3.11 ri:=�Cessa_' D e. s on m b.-'.i_.,1l in COIITizCt10`1 ?: =. tilts ma tt 3r aid to su: _-v_sa 't!2-.' COnSt�'?i^. v;o"'i of Sa_ d LSvStE ^.'O', Ss ms - ,.n.,. co11 �0"``'� uy .1 Uf? t D:O �:iS� OriS -.O , .� C I v,Tl�-�.. o �._ _. 147, Education Lai:, the L LLvli c 'Health Lam. :'r., and the Putnam Coun -Y San4 tart' Code. '..off NEW Cownt Aaaress Uk Telephone Very truly Yours, Signed i.c1c- r•, r' Address eal) .. Telephone 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. Address U" 00<U_�{ Located at (Street kkC- W LA-r3k2-- Sec. Block Lot kindicate nearest 'cross street) Muni cipality yL ') � jc- Watershed. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole 5 9% �K k 1 Number CLOCK TIME PERCOLATION 7, PERCOLATION Run Elapse Depth to Water WaUer7LFv_eI L4 No. Time From Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop in Min./in drop Inches Inches Inches 7 2 I 4q-,k 0 5 9% �K k 1 711 21•L Z \0 7, 3 -2-". \0 i zz L4 3 ko'-S7!1� _W JS 9 4 <D IA- 5 Z;,� 4c- 2,,� Q_- ZL 2 I 4q-,k 0 5 9% �K k 1 711 21•L Z \0 1 i0,11 4,0 -L9 ?_� 3 k 0 2 JC',W \0 3 ko'-S7!1� _W JS 91K, Notes: 1) Te':.�ts to be repeated at same depth until �yroximately equal soil rates are obtained at each percolation test hole. data to be submitted for review. relixz-.'nts--�o, be, ri-ade top* of. -10' JT TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO.'b k-� -0-1 HOLE NO. HOLE NO. G.L. 6 1211 1811 2411 3011 3611 4211 4811 5411 6EV 6611 72 It 7811 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED Q�Qr INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY'�>,Kkkyu Date It 17-7Z, 10 DESIGN Soil Rate Usedl:t S MirVl "Drop: S.D. Usable Area 'Provided `� No. of Bedrooms 6 Septic Tank Capacity �-ZQQ "Ga of NE Absorption Area Provided *�b L.F.-x24- 5b" nch Address . , f,\Nj\z-? ,JLAI k) THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Cal: Checked by No, 4?,& W Date Vr '. 1l ! } r P ' F i. rx :. a J o (/ r a t l \ j \\ 5 Il t 11 b' a a �•, 1y 1 ,t ! j i f, I �fp i-�i1J�K5 , MARCH I NERY ,BUILDING MATERIALS NOR EXCAVATED EARTH SHALL BE , t AAE, WED A N !HE SEWAGE DISPOSAL AREA, CONSTRUCTION OF THE §Y.STEM I'S ' fi3O $fi':'IN ACCORDANCE WITH.THESE PLANS ANY REVISIONS THERETO AND THE - f �UtE AND REJGULATIONS OF THE - PERMIT ISSUIN7G GOVERNMENTAL AGENCY PRDPOSED PL %P AS BUILT PLAN I i SEPARATE SEWERAGE SYSTEM - OWNER :.,i r�V1G °C1C�J'vrc�? LOCATION: .rr''y✓%"•G'.47>7r� &ice }(T)SEC..BLK.� L.OT .. CONTRACTOR: :_ _ DOLPH ROTFE•L.D AS90GiAT ES' -- S,IZ MAMARONECK AVENUE',WHITE:PLAINS,NY } IiI ITA h � til l q' ti } I i SEPARATE SEWERAGE SYSTEM - OWNER :.,i r�V1G °C1C�J'vrc�? LOCATION: .rr''y✓%"•G'.47>7r� &ice }(T)SEC..BLK.� L.OT .. CONTRACTOR: :_ _ DOLPH ROTFE•L.D AS90GiAT ES' -- S,IZ MAMARONECK AVENUE',WHITE:PLAINS,NY }