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Home My WebLink About3235DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -21 BOX 26 03235 I ! PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.: ENVIRONMENTAL - HEALTH SERVICES IDate LG / jh73 .... Re: Property of Located at- L ee— .FCc -Ur- Z_.4,rle Section Block Lot y . Gentlemen: This letter is to authorizeirf a duly licensed professional engineer 41-1--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 with this matter and 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. Countersigne P .E ., R.A ., # Address Telephone Very truly yours, k Signed ! , .gzaaa4) C- r of Pro ^� '. Address Telephone Building Constructed by Location - Street Municipality Section 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` "uiiders gnod furtYier agrbe's "to" "acc`epL as conclusive `t ie" 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 neg igent act of the occupant of the building utilizing the system. Dated this , b day of 19 �q Signa 1 Tit If o poration, gyve me an add - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS. BEFORE CERTIFICATE OF COMPTETION 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 1 d Building Constructed by Location - Street Municipality Section 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` "uiiders gnod furtYier agrbe's "to" "acc`epL as conclusive `t ie" 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 neg igent act of the occupant of the building utilizing the system. Dated this , b day of 19 �q Signa 1 Tit If o poration, gyve me an add - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS. BEFORE CERTIFICATE OF COMPTETION 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 1 � b TEST PIT DATA REQUIRED TO BE'SUBMITTED WITH APPLICATION _..DESCRIPTION,•,OF SOILS. E OUNTERED IN TEST-HOLES DEPTH HOLEM NO. � HOLE NO. HOLE NO. G.L. 6" 3 �` 12" C 18 c4 24 11 �� 30" 36" 42" 48" 54" 6o" 66" 72'1 78« 84" MICATE.. LEVEL .AT WHICH GROUND WATER IS ENCOUNTERED �Ni7I0A�'`E'••L�T'�` �fHICH° WATER -L�E�,- I��ES- �FTEP= BE -il�r :: �NGOUNTER�Dr�.,..- �:.._.�.,�.,�:.,:;�.�.`�;��:�,; . TESTS MADE BY Date DESIGN .Soil Rate Used _L_Min /l "Drop:. S.D. Usable 'Area, Provided . No. of Bedrooms- 4- Septic Tank Ca edS Capacity ?�"7 �s .� ��. Absorption Area Provided By aA! L.F. x24" 1 36 % tti w dth t -rent . ivame W \(_cj Nm iL " ,blgnature� Address�lnl THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by_ Date PUTNAM COUNTY DEPARTMENT OF HEALTH Fri ION_aOF.._EIV Fi01QNlEN'I`;L` REALT�I "SEt�VICEB -' COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512^ DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE N' &.� Owner .�T,Va)oc)b A «�c Address Q- ?J. /fox Located at (Street ejfQV'cc-_/7" Lillva Sec. Block •_`� Lot- Indicate nearest cross street) ° Municipality 1001NAA1 ✓�4cC e �! y� Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole i Number CLOCK TIME PERCOLATION PERCOLATION RILM apse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in an. /in drop Inches Inches Inches 1 a� of 4Y(6 9 y6 14 (0 1-L 4ek'6 8 zldr- 2-0. � 4, 5 Z, , "Q 3 yy ZAj _Z e Z 4 q', 37 -5 z14:� Z'ZI Z �'•.. 5 kc� 7_1 5 3 Z, -4 Z' 4rZ l2. to Z?-- 1-L 4 7z� Z� 5 Z, , "Q Z G 21 -L ZZ 2 kc� 7_1 5 3 4 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. rr" PEEI{SKILL MEDICAL LABORATORY 1879 Crompond Rd. Barclay Plaza .Bldg. A; Apt. 1 Peekskill, New York 10566 PE '777. " DATE COLLECTED RESULTS OF EXAMINATION OF WATER 6/3/74 "- OWNER DATE RECEIVED - Stanwood Builders 6/3/74 CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED Lot # 18, Church'Rd., Putnam Valley 6/5/74 SAMPLING POINT BACTERIA PER ML. (Agar plate count at 350C). 4 COLIFORM GROUP (Most probable N6, /100ml.) less than 2.2 HARDNESS, . TAL - ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, _TOTAL - ppra FLOURIDE (F) - mg. /1. These results indicate that the water was yes of a satisfactory sanitary quali �wh m,tthe�sam'pllee w coll A. H. PADOVANI, M. T. (ASCP) jx .y r- CERTIFICATE OF Located at PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 3_ U C_ TION -sCue O M�P:.L: IA : N- C�E . . FOR S_ EWAGE.,DISPOSA- L .SYSTEPI.' Town or Village Section � 3 �Q Block c Owner pr wQlao � (—D 's Lot Job Separate Sewerage System built by isk Address � Consisting of i � Gal. Septic Tank lineal Feet X bn width trench / Other requirements f ' OP4 Water Supply: Public Supply From Private Supply Drilled By AdddrA C Y S. --� Building Type IJ \#A%U �{l v �� No, of Bedrooms Date Permit Issued Has Erosion Control Been Completed? v v I certify that the system(s). as listed serving the above premises were constructeni own on the ns of the completed work (copies of which are attached), and in accordance with the standards, rules and regulations, plans mit is d e Putnam County Department of Health. Date � 7 Y �!t nTI[d Certified by /►� tp�, C (t//1 �e P,E. R, 4. Address ` " °" , Z2� �CT�F Ny �^+3`>,y� License No. o ?" 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 ig as a public sanitary sewer becomes available and the approval of the private water supply shall become null and when a public water su y be mes available: Such approvals are subject to modification or change when, the judgment of the Co sioner Health, suc evocat" n, rfiecaa ion or change is necessary, i Date By ® v Title PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 ter•. �_ E— - o�.,.. CONSgRUC` ION--PERrV1iT °FrDR`a� viit►aac ut�lziiS� is S'�STEIiOi _..... _ � f i�o �`�.cla - I' Town or Village Located at 4�.P 41C �/z( 7- Section Block Subdivision �8 /zeLN 'Y1441 Lot y v Job Owner ./g�[.��'p�j �y.Lt)�!?� i/✓�. Address �/e�- rGC >✓l/Sr /�N� Building Type �� Lot Area Number of Bedrooms Total Habitable Space � Square Feet r Separate Sewerage System to consist of Gal. Septic Tank lineal feet X width trench To be constructed by GJ 1' �2 Address Water Supply: Public Supply From Private Supply to be drilled by pN, 4r1PeAo A) 19 Address ! yTi�/ -VAL�Jr — Other Requirements 1 represent that 1 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 an regu a ions o 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 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 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 install dance i , the standards, rules and regulations f the Putnam County Department of Health. Date Signed P. E. R.A. Address License No. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued Vs.-ner construction of the building has been undertaken and is revocable for cause or may be amended or modified when consitler a he C of Health. Any change or alteration Of construction requires a new permit. Appro ed for disposal of domesti r sewa / r pply only. . natty / � G'` 7� By Title m v b` �t i 5 k°iVE J +; r'' IV, . r_ ��^ -_ALA► j__ _ � - � __ __ - -- � _ SEPARATE SEW RAGE SYSTEM OWNER: 4 NO TRUCKS,MACHINERY,BUILDING MATERIALS NOR EXCAVATED EARTH SHALL BE ALLOWED IN THE SEWAGE DISPOSAL AREA. CONSTRUCTION OF THE SYSTEM IS TO BE IN ACCORDANCE WITH THESE PLANS ANY REVISIONS THERETO AND THE RULES AND REGULATIONS OF THE PERMIT ISSUING GOVERNMENTAL AGENCY. APIiROP BUILT PLALE�N:_._� LOCATION:ti- �'wf•'T 1-wr' )SEC.— .BLK._LOA CONTRACTOR: DOLPH ROTFELD. ASSbCIATES -- 512 MAMARONECK AVENUE,WHITE, PLAINS,NY v'