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03392
IN
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03392
Xl Permi`t #PV =30 80`'
rte.
r Ct, PUTNAM COUNTY DEPARTMENT OF HEALTH S01 9738
Division of i5nvironmental Health Services, Carmel, .N. Y. 10512
CERTIFICATE OF' CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Val ley
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Located at Boswell Road Tax Map 62 Plat I I Block 9
owner Mdola`sson Builders', Inc. Tax'Map Lot #10 subd. # 50
Separate Sewerage System built by Owner Address 93 Gleneida Ave.'
Consisting of 1000 Gal. Septic Tank and .385 L. F x 24" Width Trench --
other requirements None
Water Supply: Public Supply From '
X Private Supply Drilled By Boyd Artesian Well Co.
Address. Rte. 52, Lake Carmel., NY 10512
Building Type Modular No, of Bedrooms Three Date Permit Issued 26 Nov. 80
Has Erosion Control Been Completed?
Yes
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, in accordance with the filed plan, and the permit issued by the
Putnam County Department Of Health.
8 May 1981
Date Certified by
Address R.D. 9, Fair .1
RE. X R.A.
t, Cannel , NY M 2 License No. 29206
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 beco and void when a public w becomes available. Such approvals are
subject to modification or change when, in the judgment of t e Com ssioner of Health, such evocation, m Ification or change is necessary.
Date _4, By Title
� . ENVIRON MEN TA -L SERVICES; INC
STREET AT ROI=TE 376 F O BOX 10 .
n, f x riOREWELL JUNCTLON NEW YORK':12533 'u --
{914)221`-2485
-, Z, DA'T`E R G lveb
R F � .lam • � .
SAMPLI'NGROINT -
T;,REATMENT CHLORINATED ❑( =PPM) .SOFTENED R OTHER ❑��
T .-
SOURCE DRINKING WATER ®'�NASTEWATER EFFLUENT ❑OTHER` cf
COLLECTED BY. , , 3 TIME . `. J A.M. DATE _
,-
.AP.ARTMENT. COMPLEX � -� ` D INSTITUTION - VATE RESIDENCE ' : ❑ SWIM POOL
�=
E BEACH ' ❑MUNICIPAL _ , ❑RESTAURANT 3, '. ❑TEMPORARY RESIDENCE
a
CAMP O NURSING HOMES � ❑SCHOOL° ❑TRAILER PARK ,
- p
O :FARM LABOR:CAMP "_ O_ PRIVATE COMPANY ❑;<SEWAGETREATMENT PLANT ❑ OTHER
❑ TOTAL COUFORM COUNT M F T ':PER 100 M L. ❑ TOTAL COLIFORM COUNT M P N PER 100 M.L.
O, °.FECAL COLIFORM COUNT_M FT. v PER 100 M L: ❑FECAL COL'IFORM COUNT M.P N PER 1OO M L.
O, FROZEN DESSERT PLATE COUNT. ❑AGAR PLATE COUNT - PER T'M.L. '
r
l/ f
7, LAB RATORY CHNICIAN D PORTED LAB RATOR DI E T
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McGlasson Builders, Inc.' Putnam- Valley
Owner or Purchaser of Building Municipality
19MJQNUXUXXX Owner
Building Constructed by
,Boswell Road
Location - Street
Modular
Building Type
Tax Map 62, Plat II
Section
9
Block
10, Subd. Lot #50
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 jhereby 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 :Wade 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-
- - - es=- •of�the'•'-patnarn' County Department -of- Health sus to whetheri -or not- t:ie:L
failure of the system to operate was caused by the willful or negligent
act of the occupant of the building utilizing the system._
J
Dated this 8th day of May 19 81 Signatur
Title McG7ass6n Builders, Inc.
If corporation, give name
and address)
93 Gleneida Ave., Carmel, NY 10512
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMP,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
A
`rt
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McGlasson Builders, Inc.' Putnam- Valley
Owner or Purchaser of Building Municipality
19MJQNUXUXXX Owner
Building Constructed by
,Boswell Road
Location - Street
Modular
Building Type
Tax Map 62, Plat II
Section
9
Block
10, Subd. Lot #50
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 jhereby 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 :Wade 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-
- - - es=- •of�the'•'-patnarn' County Department -of- Health sus to whetheri -or not- t:ie:L
failure of the system to operate was caused by the willful or negligent
act of the occupant of the building utilizing the system._
J
Dated this 8th day of May 19 81 Signatur
Title McG7ass6n Builders, Inc.
If corporation, give name
and address)
93 Gleneida Ave., Carmel, NY 10512
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMP,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
1PU'gNAM COUNTY DEPARTMENT OF HEALTH ���- � 0 6�
Division of Environmental Health Services, Carmel, N. Y. 10512
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
Putnam
Ualley
Town or ... i,,age
� •- -•.-• :..�.:� k ..:. ... ,.
-_ �. r .AL'�....il++s•L-- r +l..�rrl:'• _ �s= y',.nr..x. •• .._ ..... .... .�:... ..... _. .,. .,.
Bloc'
Subdivision Boswell Est.. Sect. "B"
Filed Map 1238 B Lot
1;0 Lot 10
Job 5.0.1938
Owner McCgl asson Builders,
Building Type Frame
Number of Bedrooms Three Design Flow
Inc.
Address 93 G1 enei da
Carmel, N.Y.
Avenue
Lot Area
600 GPD
10512
Total Habitable Space 1160±
Square Feet
Separate Sewerage System to consist of 1000 Gal. Septic Tank
To be constructed by
Owner
Water Supply: Public Supply From
and 375 L.F. x 24" wide trench
Address 93 Glenefda AyenuA
Carmel, N.Y. 10512
X Private Supply to be drilled by Ro d Well Dri 1 l ers , inc.
Address Rte 52, Kent, N.Y.. 10512
Other Requirements None
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 t 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 original system or any 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 in accordance with the standards, rules and regulations of the Putnam
County Department of Health. A
Date 18 November 1980 Signed 1 ( 1 P.E. X _ R.A.
Address
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless
revocable for cause or may be amended or modified when considered necessary by the Commissio
requires a new permit. A proved for disposal of domestic rani w ge, nd /or ivate wat
Date 6 krj By
29206
can and is
nstruction
PUTNAM COUNTY DEPART MIlV T OP HEALTH
DI's IS [ON ° OF' i TRONMEI TAL-- HEALTH ° SERVICES
Date 29 October 1980
Res Property of McGlasson Builders, Inc.
Located at Boswell Rd., T: Putnam Val ley
Section 62 Plat II Block 9 Lot 10
Boswell Estates Subd.; Sec. "B ",.Lot #50
Gentlemen: '
This letter is to authorize John N. Prentiss, P.E.
a duly licensed professional engineer X or registered architect
(Indicate) -
to apply for a Construction Permit fora separate sewerage system; to
�I
serve the above noted property in accordance with the standards, rules
or regulations as promulgated 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 . ofT.a,d,,,....o�.:..:,:....�
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the. Putnam County Sani-
tary Code.
29206 " QRCFE,
R.D. 9, Fair St.
Address
Carmel., . NY 10512
914 - 878 -6170
elephone
Very truly f--- PFr�s,
Signed
Owner of Property
93 Gleneida Ave.
Carmel NY 10512
Address
4
H r R C VTisl1�'
No. 29 2�6
THE STNIt
914- 225 -7964
Telephone
TK OFFICERS SHOW ON THE CORPORATE
AFFIDAVIT ON EIl E WITH WE PUTNAM
MUNITY ;4EAI.TH PEPAMMUT .?1AVE MOT
95EN MANGER SIM
PUTNAM COUNTY DEPARTMENT OF IJEALTIi
DIVISION. OF ENVIRONMENTAL PEALTH SERVICES
C7Ty =`00�10 °1U)I` .rte cc { c L." 0 Z2 .,- _�....,r .tea �....:v _ .T w:a - •r. —, :::...ii
DESIGN.DATA SIIEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner McGlasson Builders, Inc. Address' Boswell Rd.
Located at (Street Sec.62 Block 9 Lot 10
Indicate nearest cross street)
$ubd. Lot 50
Municipality Putnam Valley Watershed Pee �s�rl�
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run Elapse Depth o a er Water Level
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start . Stop Drop in Min. /in drop
Inches Inches Inches
1
2 n ..
4
Notes: 1) Tests to be repeated at same, depth'until a roximately equal soil
rates are obtained at each percolation test hole-. A�l data. to be submitted
for review.
2) Depth mcasurc;ments to be. made from top of hole.
TEST PIT DATA REQj)11TJT) TO PE ST-113i,1Vf-TED 1-1;1_T11 APPLICATION
D1ESC13TP'_M'OT4 OP SOTT.�') TIVP 1111,FV1, ITM.1�,.
DEPTH HOLE, NO. HOLE NO. HOLE NO.
C,
6"
1211
2411
3011 V
3 6 11 0
4211-
48
54 it
60"
6611
7211
78
INDICATE LINEL AT 1, CH GROUND WATER IS ENCOUNTERED
INDICATE LEVEL TO WBICH WATER LEVEL RISES AFTER BEING ENCOUNITE
TESTS MADE, BY e
Soil Rate- Used /Min/l"Dro.P: S.D. Usable Area Provided
No. of Bedrooms /000
—Ap-ee Septic Tank Capacity Gals, Type Alq5o
Absorption Area Provided By 57 L. F. x24 It t__
—width trenc h
Other
Al je
A, W
Name
Oomt PrentIss,
Address
17. .,
- - �
T S C
HIS PJk E FOR USE BY BEA112H DEPARTME111T 0) k
V, 29'1
Soil Rate Approved —Sq. Ft/Gal. CIftecl-fa Date
i
r- B: -_, k
'Sifuctufs- {er.olea;;tt•ain sufvey. by surveyor rote) Si "afaty _
alt 12oO4 "ud by:
5u
_ . _ - - Well •cirl'.piers Ebporf ' -
`� : •- Tanis;'tsoR�s,;pt$s, gct7crtes g 1p3sfols la;cgied oy 'Cnn'�rotrr�r:
x,570 °�2'. j•tt�'E_"'�'2�7l2 -' L��_ A_ o � r, ��
of a'm Field Inspection by: iieaifh; depi ! dete
°� ♦t r ' =S O q;..S G.. T4f1!i_`_}D4?0., — �.an4rC ;
S st
NOTES:
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/Y Division of E" _ atal Health Servio0e
o.dc .. f r r ^}anoe with
ions of the
AP
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Putna k.
_ -'x.< - Date
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