HomeMy WebLinkAbout3635DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
74.13 -1 -12
BOX 29
03635
_
(' '1(I tSLOG ac i� r - '�'---
f,. _ gv r ACRD PUTNAM _COUNTY DEPARTMENT OF .HEALTH
�*
DrvrSron 6f, Envrr6nmM -61 Health Services, Carmel N Y ., 10512-
-
CONSTRUCTION :PERMIT' FOR SEWAGE DISPOSAL :SYSTEM
Tow -
L`ocafed at , --
or Village '
�n td' _ BIOCk
` 3
r Lf1% i�— T— l� ��� <'T.�s�Gi Lot Job
Subdivision / n✓J �—
Owner- aIOSF�%. %fs�� Address OIYic �l�G c5�'%r
Building' H� x Total Habitable ,Space Squa ye Feet =
Number of Bedrooms u
Separate Sewerage System to :consist of Gal :Septic Tank 17`S Imeal "feet X ` width trench',
To be, constructed b`Y "�G����"� Address % �OG�E�C�
-- -�
Publii Sup I From- r
Water- Supply:. - p y
Private Supply, to -be drilled. by - .Di2i L
Other, Requirements -
i ,�rrr.y„
q *' system
I re resent.that 1 am wholly, and completely responsible r des o of th roposed systems) 1)'.•fhat the ieparate; sewage disposal
P, : - an cordance with,,the standards rule_s'an, regulations o : 'the Putnam
above described will.'lie constructed as!showp.Owthe appr, a eh t ,; w ,
r_.
County- Department bf Health; and-�that on completion er'e f f n coon Compliance satisfactory fo the Commissioner of HealthwilC
be submitted to the Department, ,ani1 "Fa 'written guaran furnshed wn his successors !fievs or assigns by'the builder that.; said builder':w'il'
lace; ;in,good opeKating coridiLen "any -part of sa,d`sewa(s$4h� a period of two (2) years'immed,ately followmg,thedate of'the issue
z P _
ance of ,the. approval, of the ;Cert,f(cate 'of ';Construction C n� o V system `or any `repairs ereto 2) that the tlr,illed welb.descritied above
i_,, M.
}t will°'be- located as shown on the,approved plan and that said well cordance wif he ,sta Ards .rules and regula4ons of the' - Putnam
iy County Department:.of Health::
a Date: Signed
L.,cense No s2 %2.Q
r '•:Address` !
„ w
APFROV.ED_FOR.CONSTRUCTION., This approval ezpves oneEyear from the date , k' "f less'wconstruction of. thezbuild,ng has.:been. undertaken and 'i
revocable for ,cause or, may, 1-- e amended- or modified when cons,iiered ne` sary by t e Com issidner of •Health s° Any change or'alteration of nstrucfioi
requires a new permit Ap rove for disposal of dome ewage 'an o priv pply only
1 ` � I!
< Dater'_t Tale -
-
ti
.w
4 r t
e»r--_
r.
T_
t
PUTNAM COUNTx DEPAFcTNI:ENT OF HEALTI
Division of:: Eh,
irorimental' Hea %th Services, Came%
CERTIFICATE :OF CONSTRUCTION COMPLIANCE FOR .SEWAGE DISPOSAL _SYSTEM ' >W41. p,� ,�T� i L
Town or Village
Located at` K�
- Siff G^� Block�� J '41
Owner �.i _ Jo ('R
Separate Sewerage, System bwlt by, +'3drp%{ "f.+L �-
s :' Address
��%/ ✓
Consisting of Qs�. Gal Septic Tank N..
Other.-,requlrements a.4� e dall!/d7 d c
i� t width • trench {
Water SupP1Y 'ublic Supply From
Private supply Drilled B
-
Building Type f
No of Bedrooms Date Permit Issueii
Has Erosion Control Been Completed ff
I certify .that the systems) as listed serving the essentially shown on the plans of he completed work (copies of. which are •
attached), and in accortlance with .the stand - s 'r ti `s ", 'led and a permit issued by `t $utnam' "County Department: of• Health.
b
n- -
rd b A.
P E.
Address ° e �?
y /
License No. °'
Any person Occupying premises served by the ab, p),sb$11- �tT take such action as may be necessary to secure the correction of any unsanitary
conditions. resulting from such usage. Approval . e; a system "shall become nulf,and -void as, boon. as.. a public sanitary sewer; becomes i available and the approval of the private water supp `b arid'vo,d when a. public .water-,: ly'beco s- available Such'a
pprovals' 'are
subject to modification or chang/e�when� in-the Judgme Commissioner Hea7lt/;h�,- s�uc ^h \revo ion,;rnodrf,c on or change is, necessary,
P
*J -
t YORKTOWN MEDICAL LARORATORY:INC. °"' °, 4172
P.O. Box 99 321 Kear Street
Yorktown Heights, N.Y. 10598 245 4203
DATE COLLECTED.
RESULTS OF ;EXAMINATION OF WATER
OWNER DATE RECEIVED
CITY:, VILLAGE; TOWN &/OR NAME OF SUPPLY DATE REPORTED -
12 -1 3=7l
,,SAMPLING POINT
;t
BACTERIA PER ML. (Agar plate count at 35' C). COLIFORM GROUP (Most probable No. /100ml.) HARDNESS', TOTAL -ppm a
f.`
DETERGENTS - ppm -NITRATES (as N) -, ppm IRON, TOTAL - ppm
'LOURIDE (F) - mg. /I•
these results-indicate that the, water was Yes of a satisfactory sanitary qublity when the sample was, collected.
s A: H. PADOVANI, M. T; (ASCP) `+
M
y .. ._ b
0:•ma, '.or uI, se_' .o=- -a "ian_cipa' j
-r.i .
. Bui ? di nj ions �_ �.c .,:::� oy • : .
Locaci.on - 3tree Block
As'
Build1n- Type Lou
_FL J -J --
In
location, 0 On- s
and
.._. .-. ... ..aT U.v'i �- 1 — Y J/1 '.1 � "` •� ��r' •l'___. -- y? �•, �_ 'J__.J ` ^.iv .... Jv�..r •_..r ...r ._a - »..n ..._� V .. ...ry •.... ... ... _.. _. .. _ y _.
vvy=.. min d- C __ ___ — ^— __ •.. +
fa.i I u: - o t e s y 3 �O 0 P _U J_ .. e 1
nG Ci L �f 'J '.'fir' au— ...•.i_.. '�_ �c�C�. 177.x11,.� ..�. .+_, z -- v L..+ rJ J r .�
Dated* - ] S_ = L '',-
1_ S' dart '0= L -- - --¢ --
and
C'O Zvi
n n �, -, - '� JIl ',fir 77 � 0_'i ';: ! L.L BE T.S_S �_^J .
- - - - - - - - r
• z
Dive s �'1`i? =' = = :^ 1 t c '1Ln _ces, �u —am Courn,
e syon O O
_ r
.._ :..�.. �-r r. :: >... _,- -• . • �r:.,;�_.. :.. �..... :- m „.,.n .. ..d .. : -+ .,; .i .- .�xa.... ;_cam �. -ra, -r »:,:. ._a •- :.+•am � . _. a. _.. ... ;t: .. wi -
PUTI•�AM COU:^i ^Y DEF -' ?'i y ^ O N i-Lr1LTH
DI`JISIO i OF yip; IR0N ^Ar T�-�i;T�i SBRV?CLS
Date, �Lfc '�' . �� 14171
Re: Property of eC'
Located a t
n Block L.o t
Gentlemen
This .letter *s to author-- Ze STANLEY Jo LMDER
a duly i.-;. c.en s e d Dro fe l , e—n / r _ i t
.. 1 S S 1 O n 3 _ :?' � _ B/ O _ 3 � �1 �S..� � '•” �''a a 1" C �'1. i � 8 C �
(Indicate)
to apply for a Construction Pv.,,.,:. `col, a S S 3 f "1:1 t `m. tG
serve the above n ' �.� prGO '`` --- - :.C..J~ "a t e s'.ar'dards rules
Or r e --ou -a V.�.O S a � oror-,, - m,4 b' -SS =V" �H G ^ T r+ t_
_ -
De±J$1 tF nv' Cif aI ,71r _9' nrd -t o- _V'� ._ ;'jy_. p_ -
•,
connec -i n :• l t' .l this matte-1- � _5 tv 3upe_r r ?_ t t- '+
G I- - r _ se CO?1S .T'?�C Gn of Sa? d..
syste-r i or Systams in conform-- vy O ^S of Article 1.!5 or .
147, Education Law, the Public Health La7.1 and the Putnam County Sail -
tart' Code.
Very— t r T yours,
S.Dz 1
`Ltd° "• G! Y
''0: _ ��j
Addi-
P.E.;:R.A., Tr �§'Z72� "' d ��, -� �' �•. i
ry r, 7.
eat �„ 3
BOX 267 . � ,d.,, •Y.
NO
Ai-
- MU
Telephone .
PUTNAEI COUNTY D E\iT OF n_AL 1H
DIVISION OF ENVIRONI-E\TaL HEALTH SERVICES
DESIG \T DATA SHEET. - SEPARATE SE.:AGE.. DISPOS IL SYSTEM: FILE NO'
Owner
Address �.41e4 coz- sr
Located
at (Street
CWT''VG_ RM._ (,$ Block
Lot.
(Indicate nearest cross street)
Municipality
,,%oidry o %. f&,P/V!
!/r4CC��:.'atershed -
SOIL :PERCOLATION TEST DATA
REQUIRED TO BE. SUB'-1- '!! QED WITH -APPLICATION
Tole
'
Nurrber
CLOCK TI`IE
PERCMATION
PERCOL: -1TION
— Run
ElaAse
Deo" to f•,'ater r,,iater Level
No.
Time
Frog:, Ground Surface in Inches.
Soil Rate
Start Stop ..fin.
Start Stop Drop in.
Min/in.drop
Inches Incnes Inches
�� 1
�a -o ` /o -�� � o
�b l i�r•� � `�
ze
2
16 17
S
2
/0 &6 // ' C j 0.0
4
_
S.
1
3
-
S
-
Notes:
1) Pests
to be repeated at-same
depth until approximately equal soil
rates are ob-
tained at each percolation test
hole. All data to be submitted for
revie:•J.
?1 Tlant'n
ma�ct ra-�nt S t'n bin •mzdP
fram t» of holy+ _
TEST PIT DATA P,EOLII?�D ,0 PD SUBK-IITTED i':I TH .APPLICATIO`
DESCRIPTION OF SOILS iJ` :-CUVTE.RED I`: `TEST HOLES
DEPTH HOLE:. N0: �'/ ;HOLE \0. �z HOLE �O.
G.L. ?oy' SoiG
611
121' •9�,� > cr y s ( �i�itio �c chi owe
.18'
2 4f1
30"
3611
42'. Al
48
�.,
..6'0'1 r�
66t1
78f1
8411-
Ii DICaTE LE�LL AT 4,`KCH GROUND S`'ATE_R IS E \COUNTERED
INDICATE LEVEL TO W7HICH A,ATER LE` EL RISES AFTER BEING ENCOUNTERED
TESTS BLADE B.Y... �`i/a!t� --� Cd�itidi��'..:. .Date -3 &o _-7!
lli6 \
Soil. Re.te L'sea Vic% Mir /l" Drop: S.D. Us able Area Provided ��00
No. of Bedroo -:s Septic Tank Cap =city 900 Gals. Type
Absorption Area Provided By 3Z L. F.x2' ` 361i cuidth trench. Other_
Name, STANLEY° . J.- AANDER Sio
Address -_BOX 267
JOF
PUTti'AM °COUNTY DEPARUMN -T OF HEALTH
Soil Rate Approved Sq. Ft. /Gal. Checke __ Date
N . . . . . . . . . . . :,
TOW
- - - - - - - - - - - -
rt
AjUd"? 7�-
r _ pit
I X
00-1
ROW
j., �SA: AM.
-Y moo
010
15
SAW
Vt
M V
he
Qn,
m-Y
QQ
Mw
_41 A QUIN "y MM V
Yam
too
OWE
w N
7-
act 4Q,
-jo
U-
ty
Tom:
710 "A
a A Ann
"'"Wh
A
:Oz
I'M
NN
"N M- !N"j
Mygy"-
RM,
00, VIM
silks w"
I
Z
QI/
0 A QT
—00 TWO
10; "
40W
1 Sao 'anon,
1.0 WE