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HomeMy WebLinkAbout3559DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -34 BOX 28 6 IN L 9 7 -it -1 IV m 03559 C CERTIFICATE OF `CO Located at _ D PUTNAM COUNTY DEPARTMENT OF HEALTH S Q . 1936' Division of Environmental Health Ser foes, Carmel, N. Y. 10512 ' permit a 'ION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM RUtnarim'�lal l e� Town o►. Village .. ...'Dax Map Foxmeily.. , r Ham^•,.. . - .........- ...,,,.•.r+ax Map Lot'n 1�3 .s.ubawY -a`4% Separate Sewerage System built b/y� owner Address �� Consisting of 1666 Gal. Septic Tank and AM LE- X 24" , Wi d th_Teench Other requirements 1001 x 24" W x 6' .Deep curtain drain Water Supply: Public Supply From _ X Private Supply Drilled By Boyd Artesian Wells Address Rte. 52, Kent, N.Y. Building Type Modul ar Eramc No. of Bedrooms three* Date Permit Issued 10`23 -81 Has Erosion Control Been Completed? Yes * Actually 2 B.R. Erected 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. Date 28 July 1982 Certified b v P.E.�_R.A. Addreu RD 9 - Fair Std, �armel: N.Y. 1 , 512 le was 1110. 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 become null and void when a pub ter supply becomes available. Suih approvals are subject to modification or change when, in the judgment of the Co ner of Health, ch rev cation, modification or change ii necessary. Date BY L, Title Rev. 9 -81 30-91 PUTNAM COUNTY DEPARTMENT OF HEALTH Allsf O Division of Environmental Health Services, Carmel, N. Y. 10512 S01936 ... CONSTRUCTION ..PERMIT -FOR SEWAGE. DISPOSAL -- SYSTEM :. :_ - Putnam' Val lee -Y `Town or Tillage M Located at McG1 arson Bui 1 dens, TInc. Tax neap 62 Block 9 subdivision Boswell Estates - Lot #47, Sec. 'B" Lot 13 ,obS01936 Owner r1l.ulaaavn Liu 11uc1a4 ant.. Building Type Modul ar Lot Area 14.089 A. Number of Bedrooms Three Design Flow 600 Gal. Separate Sewerage System to consist of Two 1000 To be constructed by ? Water Supply: V Public Supply From n Private Supply to be drilled by Address Other Requirements None Gal. Septic Tank Address 93 Gleneida Ave. Carmel, NY 10512 Total Habitable Space 1160 Square Feet and 600 L. F. x 24" Width Trench* Address *(360 - Toilet Wastes; 240 - Kitchen & Laundry Wastes) 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 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. 4 Date 11 Sept. 81 Signed P.E.X R.A. Address R.D. 9, Fatr St. armel, #Y�OiU 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 cause or may be amended or modified when considered necessary by the Commis si ner-e Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic y swage, d /or private ate " Date �V d—� By �a11""� Title' 1 ,1A I M UV I L.C.1 M N.4, UNITY STREET AT' ROUTE 376,,P�6' 86x -to.L - -77 0 Ift - i0PEWELL:JUNCfl_ '0N NEW ,Yb, 2533 v. 4 OK—k - (914)221 -2485 NAME 13 ­30 - - 1 4 2 hop ADDRESS., cl 4#,T fr [Irwh i Vick 4A SA MPLIN G POINT 'y 7 TREATMENT CHLORINATED G( ­-'PPM); -SOFTEN EO'D OTH ER 7 SOURCE: DRINKING-W�ATE WASTEWATER EFFLUENT OTHER - --, COLLECTED, BYv' Client, 71 ME. pm P. DATE. 0 APARTMENT -COMPLEX., b INSTITUTION zd PRIVATE, RESIDENCE ❑ Swim, POOL ❑ BEACH ❑ C d. -RESTAU RANT,.- TEMPORARY,RESIDENCE, - ol CAMP ❑,NURSING HOME SCHOOL - -' TRAILER , PARK, :0 TARilABOT-CAM P- Q PRIVATE-COMPANY. E WkG� TREATMENT PLANT E-OTHER"' OTAL COLI .PER 100 M.,L.': ❑T AL- U M P� Pfft, FORM',00LINT M.F.* 0 OT LfF6kM'.(jO NT 100,M .L b, FECAL 'bOLl FORM COUNT-M. 71 __,PER `100M:L.._-ff0ECAL O LIFORMCOUNT M.P N PER' 00 WIL. � bAGAR PLATE COUNT. FROZEN,DESSERT PLATE COUNT. PER fVL. ---- tE 13 'REPORTED:-'.,, LABORATORY TECHNICIAN �OA THESE FlIESULTSWIDICATE THAT TM WAITW $AMP414. WVW, "qwju MUT" _4tATMVAf'.TnRV;AAWlTAltV SUALItY W�Wft rAWILECtMAND t4Llvlifitll!td TO UAIIIWO, WU ,OA M.M49TION 0;,PQ Ri P4TNAM C0.UNTY DEMATMEN T' Of ��PA4 �t a 3171 Divialon of EEnvirpnmantal. Health 6ervlov0 COUNTY OFFICE 13UII -.WNO - CARMEL, N W :YQR1C This. repprt N N 4-9 pomplated by wall driller and submittsd'to County Health Department together with labocatorw repdri.of _ r .:. ; ;� � �I _�fi• att3i;�am la g �:k';, t® �3Z24::t ttE�> f s iy'. ActetW cµ;; or i REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION , W liAh1§ ADDRRSS EOCATIO T� lla, . t� A TQafn " (RA1 ymDol 'I + Xlltpaw Val 10 0Usimcss t 9PASE� L^t 90kil Tlc; I-..J wA4IiSHMm FARE Wf §T Ktl,'. pS6 O� �� PUDLI� . ((^^� AIR OTHER Q (:ONDITIONINL3 lfyl ;UPFlY l,:,I 11�PUSTRIAL tf fL+RiLLIFIQ (�'j COMPRESSED CABLE j'"� OTHER -AR.Y ❑ 4 EQUIPMENT �- � -a ROT AIR PERCUSS1014 PERCUSSION t_J (SPPrify) -� CASINO . -�-- LCIN014 (100 DI,4m R(Inchee) W9ipttT FER FOQT j'�yj (''j 0 W9U?ED r, q YES NO P ;TA,IL$ 3 0 T It EA THRFADED YES �iC? YIELD HOURS P.m, (j��7'� � Q El c6MPRESSED AIR YI(LLT fu -mof,1 . . rasT PA10P L.,-_I PUMPED 40 ti ftTER hFAS,gR.R FGpi 6A14i IaaU 7 DURIN4 YIELD TEST [feet) Popth of Compiated Wall EGk total CirawdOWn in feet klvlow Land surfacof '3601 OPEN TO QgtilPEtt (IggtI SCIt@t4 . pETAIES 491 414 7 ¢IAMETER (layh#sQ IF GRAYEI, Pipmatar of well inclvdinp WWI, &1aF PACi:EPt gravel pack (lnchaal: pERr^ H 11!0x4 LAND SURFACE FQRMATION DESCRIPTION Sketch exact location of well wlUt dletanoos, jo at /goT( two permgngnt landmarks, FEET to FEET 0 00. " _ .. 3a(i COUNTY .,- OO 0 •o o •320:: G`r. rc yyn.•e.�ww 325 ° - �M4�RrnT. wh +e �? 'st0 .. - �•. .. 325 360 brown :1 L F "N �,� ALTH If yiold was heated of diffarcnt daplhs during drilling, list below FEET GALLONS PER MINUTE p ;( i1s6L G4h1P196F,( ' "' At3Td� Off EtExFAfiT YygLI. PAILLER (Slgnaturo) a Rr v , W " (Tax Map.) :6241 at ft; Owner or urc a e ' Buildi.ng Section f)wnpr 9 •.a�w ..- ...w.jrcJ`. w• .. -.. �•.� ;.+ w ^:• -.�+.i •:�•a.:....o� �.f::'..:...,....a ..n.•w��a�.u.�o�. Boswell'Road Location - Street Putnam Valley Municipality Modular Frame Building Type 13 Lot Bnswell•Est�tPS; Subdivision Name 47 Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 undersigned further agrees to accept as conclusive the determin- ation of the Director of the Division of Environmental Health Services _. -..� :£.:ttiA.P:ut►i.C:c;.u'"1 ure of the system to operate was caused by the willful o ti~ ntt of the occupant of the building utilizing the system.. /Z // /'' Dated this 28 day of ,lull 1%22_ Signat a Title , /Vice President McGlasson Builders Inc. y Corporation Name if corp. AU � ioo7 J`J`. 93 Gleneida Ave, Carmel, N.Y. 16512 "a a� ;'; t�• Address - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 PUTNAM COUNTY DEPARTMENT OF HEALTH ;: UERd'i&E Date 29 October 1980 Rea Property of McGlasson Builders, Inc. Located at Boswell Rd., T: Putnam Valley Section 62 Plat II Block 9 Lot 13 Boswell Estates Subd.; Sec. "B ", Lot #47 Gentlemen: This letter is to authorize .John, H. Prentiss, P. E. a duly licensed professional engineer X or registered architect (Indicate) to apply fo.r,a Construction Permit for .a separate sewerage system; to 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 of said. r-00nfU:rmit3r" with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly y Signed I VE Owner ' of Prbjp(eftjr 93 Gleneida Ave. SEP 3 01981 Carmel, NY 10512 i n cl Address PUTNAM C UNTY 29206 4pTESSifllyq� DEPT. ®� HE,QLTH (?.Ottrs E., R.A., # e Fry 914- 225 -7964 Telephone R. D.. 9, Fair St, 'A dress T.NE OFFICERS SHOWN ON THE CORPORATE: Camel, NY 10512 AFFIDAVIT ON FILE- WITN THE PUTNAM . CQUM HEALTH DEPARTMENT 14AVE NOT 91®48 -6170 /��'J, No. "Z9ao6 ��� OEE C #'rlt0 SINCE SO'� TLIIf. © ephone ryOPNE STNIto 0 114T'OF BRALT11 &UTD!AM COUT-FLY DEPARTME DIVISION OF EffVTPOD!rD- 4TAL HEALTH S" E, I I V I C E,- S DESIGN DATA SBE ET- SEPARATE SD-•IAGE ..DISPOSAL SYSTEM FILE 140. Owner ....McGlasson Builders, Inc. 'Address— Boswell Rd. Located at Street 62 Block' 9 Lot 13 • cross treet) near es i es t c 0. 4 _Q S,ubd • Municipality. Putnam tnam Valley Watershed N SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBP-41ITTED WITIT APPLICATIo?'s Hole -Number. CLOCK TIME PERCOLATION PERCOLATION Run '' 1apse De l pth to ater W Ll ater eve No. Time From Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop in Min./in drop Inches Inches Inches 4 Z�* mckcIVE gm 'PUTNAM COUNTY. DEPT. OF HEALTH Aegi a ef x ✓ Aln //a A. * QI-lv AAW 2 SP klotes: I). T(-,,!,,ts to be C, tlil ay�rqyimately,cqtvil soil. vopeated at same 1.111 .1 .rates a.t,o obtadnod at each p0r!colation test ho.le". A da*;a to 'be suUwitt".Od for rowiew. 2) IX,,pth mcaluremeiit�o to be ii;.We from top of hole. TEST PIT DATA Rt,0UTR� -M TO BE SIMM -'7TED l!1MI APPL'f.CATION ))I 3CJt:I:I']'TGfJ OT`' SOITr; i,F;C(.)i)t;'i'f ;IiI;D IN `.P!,,;T Ii0L:i;S DEPTH HOLE NO. 6" 12" .0 ti A,eezA 30" 36,E 42" 4 it 54`' 60" 6.6" ' ' 4 72.. ., 78„ '84" Il1?DTCI�TE,LEZrEL AT la'IIICH GRUL��'D I,ATLR IS En ?CGUI`JTERT,D ' IND "GATE LE I L TO WEICH WATER. L>J'` EL RISES AFTER BEING ENCOUNTERED TESTS ' FADE BY1�L t /i G c� _. - - - { ?�.`. :.' DESIGN Soate Used 3Miri/1 "Drop: S.11; Usable Area Provided •j! Z;;© — `No of L�dropi�is__j_Septic Tank Capacity 00O Gals. Type A/W 5yd 4V ''Ab'sorpt on Area Provided By 6 ®O L. F. x214 " . `— width tre ch. Z Other A/o4 • RoFESSIONA o,, s - -- -main John He Prant4ss. PoEi e Ij Address R. D. 9, Fair Ste . . THIS SPACE FOR USE BY 11114LTIJ DEPAPTIMEi1T 0i Ho. 2g 2o6 r OF!Hf S'j� / So:i l Tate Approved Sc�. F'l: /G 1.. Ch . 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