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HomeMy WebLinkAbout3551DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -26 BOX 28 Icy,- � �•!• r� ,. uLh 03551 A PUTNAM COUNTY DEPARTMENT OF HEALTH ��� Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Located .,et. Boswell Road `Subtl io�'Boswe'11 `Est -. Sec`t "B- Fi�ed�INan 1238 Mg Owner McGlasson Builders, Inc. Building Type Frame Lot Area 2.154 A. Number of Bedrooms Three Design Flow 600 GPD Separate Sewerage System to consist of 1000 Gal. Septic Tank To be constructed by Owner Water Supply: _ X Other Requirements Public Supply From own o� r TYllage 39 Lot _ -- 14 Job S. 0. 1929 Address 93 Gleneida Avenue Carmel .Y. 12 Total Habitable Space 1160* Square Feet and 429 I _F_ x 4" wide trench Address Private Supply to be drilled by Boyd Well Drillers. Tnc Address Rte 52; Kent, N.Y. 10512 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 of e Putnam County Department of Health, and that on corn pletion, 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 dards, rules and regu a�iTons of the Putnam County Department of Health. Date 18 November 198n Signed P.EX- R.A. Address R. D. 9 Fair Ste Cam .11 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable.for ca a or may be amended or modified when considered nece nary by the Commis ner of Health. Any change or alteration of construction requires a new ermit. Approved for disposal of domestic tar s wage, rivate ater supply onl . Date By , (' Title PERMIT #PV 28 -80 _ -PIi.TN4M i�tUN'l; �3E��9It'�� �F_ �`�[1LT1 �..... _.... • _.: -...._ _�. _._ Division of Environmental Health Services, Carmel; N. Y. 10512G19G9 ~ `' CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley Town or Village Located at Boswell Road Tax Map 62 Block 10 Owner McGlasson Builders. Inc. Tax Map Lot # 14 Subd. # 39 Separate Sewerage System built by Owner Address 93 G1 enei da Ave, , Camel. NY 10512 Consisting of 1000 Gal. Septic Tank and 430 L.F. x 24" Width Trench Other requirements None Water Supply: Public Supply From X Private Supply Drilled By Boyd Artesian Well Drillers Address Route 52, Camel. NY 10512 Building Type Modular No. of Bedrooms Three Date Permit Issued 11/26/80 Has Erosion Control Been Completed? Yes b 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. l7 Date 14 Aug. '81 Certified Address R. D, 9, Fair S ' P.E. X R.A. Carmel NY 1d;12 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 ps soon as a public sanitary sewer becomes available and the approval of the private water supply shall bec5!�� vol when a public water u becomes available. Such approvals are subject to modification or change when, in the judgment of of Health, such revo,at , modification or is necessary. / - NANCC' ENU. - VIRQ-N,MENTAL SERVICES;} INC UNSTY STREET AT ROUTE 376 P O BOXr10 4 HOPEWELL JUNCTION NEW YORK 12533 ''�* RVED NAME. +4s>S;H7 ADDRESS. { ME r a SAMPLING POPIVT= �3�3�� TREAT_.MENT:. CHLORINATED❑( _ - .---:,--,PPM); SOFTENED D;ATHER ❑ SOURCE DRINKING WATER,:❑ WASTEWATER EFFLUENT ❑OTHER } _ z AM _ ' COLLECTED BY ". _ - # C a ai3Y3 , .:. _- P M .x : DATE 3= - - TPwtE_. ­22-4 . ❑ *APARTMENT COMPLEX ❑INSTITUTION - ❑ PRNATE>RESIDENCE ❑SWIM POOL BEACH.' _ D MUNLCIPAL 0:;TIESTALIRAW,7, TEMPORARY RESIDENCE; - `- D CAMP ;" q NURSING HOME" p SCHOOL.. ❑TRAILER PARK'. j - ) FARM i` -ABOR CAPMP ❑.: PRIVATE COMPANY 0 SEWAGE TREATMENT PLANT ❑OTHER ❑ TOTAL GOLIFORM COUNT M.F T:. PER 100 M.L - -. ❑TOTAL COLIFORM COUNT MP N.' PER' 100 -M.L .FECAL COLIFORM COUNT F T PER 100 M.L. ❑FECAL COLIFORM COUNT M P N PER 100 M.L. ' -M o FROZEN'DESSERT PLATE -,'COUNT ❑AGAR PLATE COUNT 4 ;' _ -PER 1 M.L: ,. ' LABORATORYTECHNICIAN r DATE REPORT L ORATORY DIRECT R 777 t t ;: _k ;'ti§ ✓ e'`'rr ' _. - - t, r x "3;. DEFT. .. r WELL COMPLETION ftEVORT PUTNAM C06NTY DEPARTMENT OF HEALTH W f . . Division of Environmontal Nualttl Corvicos ' ,r . COUNTY OFFICE BUILDING • CA.RMEL,'NGW YORK ., Thfs report is to .be completed bV well driller and submitted.to County Health Departnic6t together with laboratory report of analyses of water sample indicating water -is of satisfactory bacterial quility aefore'certificate of construction compliance is'issued. ih&RT �must4-,Dr': `�u4mrrTEI?`VVIIIAIN -36 I AY9 ELF -�Ett C411IIpL-ETtON. NAME „ ADDRESS ow,vEe McGIvilason B ildey�..�I' Inc 93 Gleneida Avenue" Carmel N.; Y. "10152 LOCATION ` (No., 6 Sb ol) : °• (Town) (Lot Number) OF1YELl' '. B Ili Valley -4 BUSINESS �'DOMESTIC.' ❑ ❑ ESTABLISHMENT ❑ �' PROPOSED FARM TEST WELL USE OF \YELL { f t' t i ��7 yx�tf�t; a I PuBLI+C�r �i _ 1-- 'I'"' AIR OTHER — D ❑CONDITIONING ❑ 1•_— IN'DU5TRIAL`' - (Specify) IDIIIttINO COMPRESSED ROTARY F PERCUSSION ❑ Q OTHER EQUIPMENT LJ AIR PERCLUSSION ) CASING,• ' LENGTH (reel) DIAMETER (inches) ,' WEIGHT PER FOOT ®THREADED ' C�'WELDED 1 ®YES CASING R U7ED? DETAILS' 178 s ° NO YES NO YIElO _.. HOURS .:.,•. G.P.M. D ❑ YIELD (O.P.M ) 1. •.TEST. ,, ' _ . BAILED { PUMPED . COMPRESSED AIR 8 Hrsj. WATER MEASURE FROM LAND SURFACE — STATIC (Specify feet) DURING YIELD TEST tleof) '.. ; Depth of Completed Well '. LEVEL} r in feet below land surface: '525 t MAKE'' .. .. LENGTH O tQ.AQUIFEk (l9ef) SCREEN . DETAILS SLOT SIZE DIAMETER (Inches), _ IF GRAVEL Diameter of well including . GRAVEL SIZE (inches) FROW(leof) TO (loot) PACKED: gravel peck (inches):' DEPTM FROM LAND SURFAC[ "o. FORMATION DESCRIPTION Skotch exact location of wall with distances, to al least caFT. • rr -� two permanent landmarks. .. .. .O , h , 4 )' Sly r� _.. .:._ ,..._. ,o.. ...... s. ?-'...: [ t• '1: 1 } M t h ylk If plaid wot totted at different depths during drilling, list below FEET GALLONS PER MINUTE " 7 DATE WELL.COMPIETED ATE OF REPORT_ WELL ORILL£R (Signature) G 7 -3 -81 7 -7 -81 W 9 ro _0T` uilding'.­ Minfc#stlity' ..Owner yen map 62 GOA Nctldn mudins Or swell Road V0 Modular tot Boswell Estates Subd.9 Lot. 4o. 39 GUARANTY OF SEPARATE SEWAGE- SYSTEM rippresent that I am wholly," And completely repponp-ible fq workmanship, material, construction and drainage of the saw Ag@ diepp4gl pyptem serving the abov'e deaq . ribed property, and that it has boan . constructed as shown on the approved plan or approved amendment t h. are o, and In aqpordanpe with the standards9 rules and regulations of the Putnam County Department of Health, and hereby.guaranty to the owner., his u hp,irs or apsig4s, to ­ place in,good operating condition any part or said syatom constructed by -me w4ich fails to operate for a period of two ypgrp bimp4l4tely following the date of initial use of the sewage dispQpa� system, or any repairs made by me to. such system# except where the faildr* 0 t, ppoi4tq p negligent act of the occua . properly is caused by' the willful or n pant or the building utilising the s yster.. The undersigned -further agrees to accept as conclusive the do- tqrM1n0iQA of the Dir ector t r of the Dixision of Environriental Health 4ep- Putnggq County . Department, : -as . to whe ther_o'r 11 .0 'ot" the" -14M,141fa ..qi"-vh0_4yatefa an act of. the 000up4rit or than 'building ,p .illzing the system, I t 'd 140 day of August 1981 Signature th -.Is Title (If cor5pFatlon,, giVe ''5ame And address) Wl assoh - BI drs. �9 P. 93 910selda Ave. Camel My, - - - - - - - - - - - - Imo. - -- "lost THR94 (3) COPIES ARE REQUIRED WITH TIML-2 (3) COPIES OF FINAL PLAN COW.749TION WILL R1 ISSUED, GUARANTOR IS REQUIRED TO FILE NQT1CF- OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - -- - - Nvi.alqn or E�iviroamental Health Services, Putnam County Department 4. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES- Date— 29 October 1980 Re: Property of McGlasson Builders, Inc. Located at Boswell Road, T. Putnam Valley Section 62 Plat II- Bloc k10 Lot 14 Gentlemen: Boswell Estates Subd., Sec. "B ", Lot #39. This letter is to authorize John H. Prentiss, P.E. a duly licensed professional engineer x 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 1,:U1111CLL1V11 w.LLfl L1116 1j1aLLCt• a11Li to. supervise the cUnstiuct1un of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, . the Public Health Law,. and the .Putnam Counfy..Sani, _. . _ .�.._� •-- tary Code, ..,dn.._ .- .P,,.. _.- �...•.. _.._ .. 9 FESSI(Nq� r P.E., R.A., # 29206 R.D. 9,.Fa1r St. Address Carmel, NY 10512" 914 - 878 -6170 Telephone Very truly your, sighed—,",. ner of ftdodrity 93 Gleneida Avenue anal. NY 10512 Address 914 - 225-7964 Telephone THE OFFICERS SHOWN Ohl,THE CORPORATE AFFIDAVIT ON-FILE.-WITH THE PUTNAM: .,COUNTY HEALT DEPARTMENT HAVE NOT BEEN CHA SI E SUCH FILING. 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 110. Owner McG1 asson Builders, Inc. Address '$pstAlea I Road . Located at-. (Street Sec. 62 Block 10 Lot 14 a nearesU cross street) ... .... . Putnam Valle Sub�l.: Lot ..39, Municipality Y Watershed .:te ..:.SOIL PERCOLATION 'PEST DATA REQUIRED TO BE'SUBMITTED WITH,APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water Water ve No.. Time From Ground Surface in Inches ..Soil Rate Start -Stop Min. Start Stop Drop in Min. in drop Inches Inches Inches, � ,p 1 i Notes: '.l) Tuts to.be repeated at same depth until approximately equal soil :I rates are obtained at each percolation test hole. A11 data to be submitted for review. '2) Depth measurements to be made from top of hole. �: TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES.. DEPTH HOLE. NO HOLE NO. ..HOLE NC �.YV c .. t < - rs i v _.t?,.,. s.. r .�i. .. a` %i ,..�,. •:. ti A r fu A =.'z" K ...r =✓ Vin, ii-�u "': .r,:.�. 6" 12 THIS S SPACE:' FOR. USE ' 'BY "HEALTH DEPARTMENT O ONLY. Soil- R Rate, Approved S Sq: Ft /G�1. C Che � i t "a I A f, T - PA BnrPs i. tZ. 37 57-00 L -- 1P p N .605WELL wet! tocare-o o-y; purveyors surve y..-, Well drtllors report 7 So - ; esuremerto Tc;n k, Boxes; pits, galleries B lateraI5 In-cated by: GDnt!uctor; Enotneat: He a Itt, qapt: Field 'inspection- b.y: Health dept do I e:. L+ Engineer ED date'. NOTES: -0 L q+—*1 Len,j�.s As .` -how 5 ,C -vutfiamireag"' .0 71i tFTb`CP!PfnZ;�t of Heai4t Division Of Environmental Health Servioes. Approved as noted for conformance with applicable Hui and Regulations of the Co ty e Ith Department. B lal,, A E B E A - F 8 F _ft: - �- A. 1�719 A. K -B -K A SANITARY SYSTEM QES1G.U.,"a,SQtaL OWAER': LOCATION Street'. Town 1-4 C 0 u n! Y: �?o t-^ State: SUBDIVISION': Me 0: Block. L o-r N Builderc Surveyor: D r o; 7 P Date: JOHN H, PR E N T1 S S EE.'.1- CONSULTING ENGINECR RD A R M E L NY 10!512 (914 1 878 -6170. P /fb 60 P-t It tZ. 37 57-00 L -- 1P p N .605WELL wet! tocare-o o-y; purveyors surve y..-, Well drtllors report 7 So - ; esuremerto Tc;n k, Boxes; pits, galleries B lateraI5 In-cated by: GDnt!uctor; Enotneat: He a Itt, qapt: Field 'inspection- b.y: Health dept do I e:. L+ Engineer ED date'. NOTES: -0 L q+—*1 Len,j�.s As .` -how 5 ,C -vutfiamireag"' .0 71i tFTb`CP!PfnZ;�t of Heai4t Division Of Environmental Health Servioes. Approved as noted for conformance with applicable Hui and Regulations of the Co ty e Ith Department. B lal,, A E B E A - F 8 F _ft: - �- A. 1�719 A. K -B -K A SANITARY SYSTEM QES1G.U.,"a,SQtaL OWAER': LOCATION Street'. Town 1-4 C 0 u n! Y: �?o t-^ State: SUBDIVISION': Me 0: Block. L o-r N Builderc Surveyor: D r o; 7 P Date: JOHN H, PR E N T1 S S EE.'.1- CONSULTING ENGINECR RD A R M E L NY 10!512 (914 1 878 -6170.