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Home My WebLink About3226DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -10 BOX 26 03226 I rL J v ldt T1: 03226 PUTNAM COUNTY DEPARTMENT .OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 ��`E?TIaT H`�+.T :�o�t t`__s . �`•1! Z�u�O_ dC'� r� = t� si�tiiyv. ".�i.�ir �i.Y'iL :iYJI Eel [(\ .►1 , .-� Town or Village Located at Section Block Owner oQ . Lot 7 Job Separate Sewerage System built by Address Ivz e Consisting of -1Zy`''Gal. Septic Tank Z- eQ lineal Feet X go width trench Other requirements Water Supply: Public Supply From Private Sul}pi(, Drilled By ress Building Type Has Erosion Control Been Completed? No. of Bedrooms T Date Permit Issued 1 certify that the system(s), as listed serving the above premises were constructed attached), and in accordance with the standards, rules and regulations, piaur Certified bX{ Address plans of the completed work (copies of which are by the Putnam County Department of Health. P. E. A-- R.A. License No. 10 y 3 '] Any person occupying premises served by the above system(s) shall promptly take such action as may be necessar o se cure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage stem shall become null and voi s so as a public sanitary sewer becomes available and the approval of the privat water supply shall become null tl Vol n a publi ater su iy comes available. Such�approvaIs are subject, to modification or change w n, in the Judgment of the Com ission f Health h revo mod' ication or change is necessary: - 1 Date 6 / By Title e—CG PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 ..a U -C ib , PEriidi1 -1— rt(•`SEV��it;l� G Sri,�NL SYsi tnri.. ....� .�_ -� �j �U��.' i •�(_�1 "�..::`. 1 , �:- _ �_ _ Town or Village Located at Subdivision L41 Owner c Building Type Lot Area Number of bedrooms Separate Sewerage System to consist of Gal. Septic Tank To be constructed by -" Water Supply: Other Requirements Public Supply From . Private Supply to be Address Section Block Lot ` Job Address Total Habitable Space ZQ§�n Square Feet -2-31"10 lineal feet X -?!�Al width trench Address �1► A 00 � 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 o e u nam 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 during the period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the iginal system or a y 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 n c County rdance e standards, rules and regulaions of the Putnam Department of Heajlth, th Date /�-' ° `� '—� ` ` 5 i P.E. R.A. Address '�T • �icense No.� APPROVED FOR CONSTRUCTION: This approval expires one year from 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 Commis 9k 9r of Health. Any change or alteration of construction requires a new `perm-iitt. Q}Apprrojved for disposal of domestic / _Y s "age a rivet ly only. Date .// — r7'—/ _ / � BY /� Lei% t Title Building Constructed by Location Street Section Block Buildin g 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 s- rstem, 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 the stem. Dated this �� day of 19 Signature Title con oration, g've me znd r d _j - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION 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 PEEKSKILL MEDICAL LABORATORY 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt..1 - Peekskill, New York 10566 PE 7-8777 41.988 - 2 DATE COLLECTED RESULTS OF EXAMINATION OF WATER 7/31/74 OWNER Stanwood Builders, Church Rd., Puts= Valley 7/31/74 CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED Lot # 7 8/2/74 WMII BACTERIA PER ML. (Agar plate count at 350C). 6 COLIFORM GROUP (Most probable N6. /100ml.) less than 2.2 HARDNESS, TOTAL -ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm r- LUUM1ut; (i• -) - mg. /1. These results indicate that the water wasyeS of a satisfactory sanitary quality when the sample was collected. I - 9 "1 A. H. PADOVANI, M. T. (ASCP) ►j Q 4 PUTNAM COUNTY DEPARTMENT OF HEALTH J VISTG'N Or 1?NVTRO�?`?E TTAL Nt GA ;.LmuLCZJ�r'F •: Date 7, l 7 .S Re- Property of �y�W�� $�.}��,��"� 71k Located at CfL �A Section Block Lot % Gentlemen: This letter is to authorize. W �W V�ekNc a duly licensed professional engineer cl� 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 witri this matter anct to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 1.47, Education Law, the Public Health Law, and the Putnam County,.. Sani- tary� Code . Very truly yours, Signed Owner of Property Counters* n Address P.E., FgA., #, 1 Vk'k,, � W _ Telephone Address -- Co3i -�6ag Telephone a PUTNAM COUNTY DEPARTMENT OF HEALTH COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner5VA*3WQW%LLLWZ►(S3WC_ Address "�N\k Located at (Street �=1gndW1—nc_a_TE_e_ rlA -j3lg L C� Sec. Block Lot nearest cross street) Municipality�cl�CIS Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 13_1Z_1 31. Ll Cp 12 t 9 - 1 Z 12 CA- 3 zI5 Z- 3 4 'S %7 -dr 4-z- 110 ?10 ( `7 5 �,ALSO l 4 3', Z¢ 3°,3Z f'i Ib zo 6r- Z 3 3 A 9 'S %7 -dr 4-z- 110 1 b (4 l 4 3', Z¢ 3°,3Z f'i Ib zo 6r- Z 5 3: 3Z S. A `zo Z 3 3 3 1 3' 3'• 4� <0 2 '3: 4-Sa •.�Z cv v4- t to 3 4 5 Notes: 1) TE�ts to be repeated at same rates are obtained at each percolation for review. 2) Depth measurements to.be made depth until approximately test hole. A11 data to from top of hole. equal.soil be submitted TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION TFSPTn`1'T!1N !1T+'VOTToti, UnT�e.e_ DEPTH HOLE NO. �� HOLE NO. HOLE NO. G.L.�41�. n 6" 4� 18 1 4VS 2411 30" 361f 42" 48" 5411 60„ 66" 7211 78" 8411 MICAT TEL' VET, AT- h�LICF CM(M �'•I-` WATER I J�`J -QU.N?'E + m. K -INDSCATE'LEVEL TO` WHICH WATER LEVEL�RISES AI'E i1VG "I�CUCIVTERED` ' ` - TESTS MADE BY Date DESIGN Soil Rate Used__LO _Min/1 "Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity k-LG� Gals. Type �t Absorption Area Provided By `Z?,(,o L. F.x24 " 5b" c/ width trench. Address)_ -A SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date « : = � Z .. \A4 \ \IR k k�Akio \A4