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HomeMy WebLinkAbout3392DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.08 -1 -36 BOX 27 03392 IN I. L . 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 ti- aonr .m- : ""- �;:::'�_�_.,'.,::ri-:..: �:•v: ...:-..,,..+ w•-. w.-._;: �T4.. f31S .:.1/ii:1"it- �k':- ra+'uii:34a 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 5A Aa v I _A , _�ll:�? �p NANO► � r v '- r _ X. f ... ..,a..- •..rrt- �?"F+ii:- :s.v`.m% °f.:. C"t .;�_.�.a -... ... -..". � r. }G "kT'•�..�...s�,�..� aic:. .,r ..:. rw+:.:' �:�!�.iiv�M- e- .•= �- •c-�.:��i:.. �=r��ar.�,.::,.:�.',,,.. ... ..,+,.•rn rp...•..�.:�.. •.�r.e�� 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 ... ..,a..- •..rrt- �?"F+ii:- :s.v`.m% °f.:. C"t .;�_.�.a -... ... -..". � r. }G "kT'•�..�...s�,�..� aic:. .,r ..:. rw+:.:' �:�!�.iiv�M- e- .•= �- •c-�.:��i:.. �=r��ar.�,.::,.:�.',,,.. ... ..,+,.•rn rp...•..�.:�.. •.�r.e�� 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: x 'N Seen {7 % -14.• Sql.. _ �r \ i %hg¢'# a {.\ 1 V - _ jj¢ 6rt ✓c a �'0' 1 7e i' �'+�'i '!1 A - C r JyxE a Bo r., y3 3� on� sES� j A - m iy�0 9 _8 - F a fa }' A. ' K s 6213utnap* Cou**y Oepart�9rit:, of $salth h /Y Division of E" _ atal Health Servio0e o.dc .. f r r ^}anoe with ions of the AP i ca' Putna k. _ -'x.< - Date S, 141 - __� -` "� �.�.�u.S OWNER' tie Tgvt.n T't ., @y2ef SVSDIV3sf(iN; -G� WIPU..�3 k .� 'ag.! 1 Lc {f k x'u, l' uPc.4`� 1�" - _ - 4-9 F ot6,S" roM' a 0lottc { QT " { CJ • r^ trop �,. 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