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HomeMy WebLinkAbout3653DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.14 -1 -9 BOX 29 I In re 1 02 , � I k-r � ti I f. J �I1� �' ' ■:�I ■� 'T' ' Ion ME I A4,16. 1 03653 �� � � `��r � � �°� ''•; ;PUTNAM COUNTY DEPARTMENT: �OF HEALT•H � � � �A �. %jDivisfon of Environmental Health Services Car N Y 10512_ -,CONSTRUCTION. PERMIT _FOR SEWAGE DISPOSAL SYSTEMQjgi�/�(�{,•(, T vin or V e I Located • at�" �- �% Section �r7 Slock - v�siti:n Jilt? a. L @t— y _j�, �q�1���y=� r. Owner- ".,S,KJ + KA LA Building •Type �� Lot Area. I I f�rC�S /fie - l Number of Bedrooms Total Habitable Space r Square •Feet}- ° �I•, �Z >.SeparaW.Sewerage System, to consist of _= �L+1 u Gal Septic Tank � lineal °feet 'X � � width 'trench'. To be constructed by 'H�`� r Address ; Water Public Supply From- Supply: e -Private "Supoi`y to be drilled by t r v f •Address -� t Other Regwrements m { s \ ^d represent that I am whoily and completely r esponsibiefor ,t6edesignand1ocation 'the "Oro .'fystem(s);'1) ",that the : separate sewagefQisposa6'system._;. I' above °described ,will be 'constructed as shown on,tbe approved amendment there to and in accordance with the'standards rules an 'cegu.a eons o e Putnam, County Department , of -Health, and that on completan thereof a "Certificate of Construction Compliance '' satisfactory to, the Commssionero_f Heatthwilh l be submitted to the Department, and a;;wrdten guarantee will be:furnislied the owner his successors,;heirsor assigns by the,builder.,Ghat said budder `will place in good .operating, "condition any part of 'said sewage disposal'system during the period of two (2) years immediately :followinglthe6ie of. the. issu '.I 4 + ance of =the approval of;the Certificate of Construction Compliance of :,the original system or any repairs. thereto, 2) that he drilled well describe'd':above .! will be. located as•shown on the approved plan and that said well w�li tie Installed m accordance - with; the standards rules antl .regulaons F of ;the PUtriarli County 'Department of Health ..- r O `� Date Signed _ , P.E G� R.A. ' Address - License No;_� + '� PROVED FOR CONSTRUCTION This approval expires one year from the date .issued unless construction of the building has 'been undertaken and is focable for,;cause or may be amended ormodrf�ed when considered' es ry by {he Com sswner,'of Health ':Any change;,or alteratan of construction, . wire's a ne permit' Appr fps- �rsposal of domestic san ry s age or pri w er, supply only - e PUTNAM COUNTY DEPARTMENT OF HEALTH r +WS of �nWrmhmep it l Nealt/r SN�y�ces, �3!�np% n1. a' _ loft 1?_ - �< CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM °- � Town oY VII /,"� ,rte r (� (� Located at: v Y`��•T" g'`' Section n Block v Owner ( rfi7lJ /yf! Gfl r!y/� ►� ^,.T //' !� /f //� .,_ ".. �` Lot `%G4�/' _jo Z N Separate- Sewerage System built by \IVFA^� •`"��^'��1�'/� - ' -°"� v.�6�2'�v,. • •�? �//�� �} Address Consisting of ? =Gal `Septic :Tank o `� lineal Feet X width trench 33 Other requiremehts ` 5�2 �AiL1 �d�rTi�llllG f- 1 Water Supply, 'Public Supply From 4 Prwate SupP1Y, Drilled BY -1:Address f Bwldmg.,Type. /f f'[aw Y7/�+ No' of Bedrooms -'Date Permit Issued LL _4f 7 `Has Erosion Control Been Completed + I certify that the system(s).�as- listed serving "the -above premises were constructed.esseritially as shown -,oh ttie plans of the completed work- (copies of which are attached); and.in accor ance ith the standards, rules and - regulations' plans Bled and t ermit issue Putnam County Department of Health. 9 : ` Date. Certified.b P E R Address License No. Any person occupying premises, served by. the above systems) shalt promptly take sui:Raction as- maybe 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 an : " hen- a, public ,water ; be."co availabie. Such -approvals are 1. j subject ` -to modification or change When;,, in'the `judgment of the missioner Health, such revo vin, modified or change is necessary. t Date • G / BY "• tle` . { 9105 YORKTOWN MEDICAL LABORATORY INC. : V:0: Bbk 9 9 Strut Yorktown Heights, N.Y. 10598 245=8203 ' DATE COLLECTED RESULTS OF EXAMINATION OF WATER NNER DATE RECEIVED PATRI CI A GALBRAI TH ITY, VILLAGE, TOWN & /OR NAME OF SUPPLY DATE REPORTED 2-39 ROCKLEDGE RD. C -1 MAHOPAC, N.Y. AMPLING POINT TAP iACTERIA PER ML- (Agar plate count W'13350 C). COLIFORM. GROUP (Most probable No, 1100m1.) HARDNESS; TOTAL - ppm 8 LESS )ETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm. 'LOURIDE (F) - mg. /1. These results - indicate that the water was YES of a satisfactory sanitary quality when the sa p e w s c eoted. r' j PER: LAKESIDE PHARM. i. /x A. H. P.ADOVAN , M. T. (ASCP) Gentlemen: It 'T 01' HrAuif MITN"M M'NIT 'IMALT11 SFP\k'fCrS Date \, �` 51 -1 q 715 , to Re: Property of r, i?-, YD 64t, vsrz,,+) j' UT Located at Section Block Lot 12,12 .This letter is to' authorize 1 i-duly licensed professional engineer or registered architect engineer to apply C) for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards,, rules ' lations as promiulagated by the Commissioner' of the Putnam County or re.cru C3 -Department- of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction-of said system or systems in conformity with the 'M or Law) the Public Health Law, and the Putnam COUnty Sani- tary Code. .$Bsn C, 0 0 .4 (A 'a 04, 916 TS -74 Pi aAA 1910 6. Very truly yours Signed- . tamer of ProperTy Countersigned: -c7s��� P.E.,I R.A. Address 015:6 Telephoiie Address Telephone a ' DELL COMPLETION REPORT PUTNAM COUNTY DEPP RTMIENT OF HEALTIi 1171 Division of Environmental licalth t- vrvicvs COUNTY OFFICE EJUILDING - CAHMEL• NEW YORK - e.,:: >; ,bltiie :iia;a 1s.,t c>aTpfetr. b;: v;.ILdC411ar:ind.s(F+- W— to; Goi"Viae crR=tiy �tfi�er °wref� Fr5tr5ivrgrte�,it�af.° -,� analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance Is' issued. REPORT MUST RE SUi'MI1TED VATHIN 30 DAYS OF t:�LL COPPLETION 'TH FROM LAND SU±iACEI Skotch exact locai:dn Ol well Ni:h. Oi513nClS, to at toast FORMATION DESCRIPTION two permanent landmarks. If yield was tested at different depths dvrino drilling, list below FEET GALLONS PER MINUTE WLLL COMFLt''.3"0 r I T UATF OF FtLPORT I WFI I r11111 I Fn 151nnaturef 7i1 ;l NA ADDRESS OWNER LOCATION OF WELL Rto. 6 Stieot) (To n) (tot'Hunaer) T -6 -J'7 BUSINESS — - - -- - - 0 PROPOSED DOMESTIC ESTABLISHMENT FAR1A u TEST WELL USE OF VJEII OTHER SUPPLY INDUSTRIAL CONDITIONING ) DRILLING COMPRESSED Q CABLE Q OTHER EQUIPMENT ROTARY ,'�( AIR PERCUSSION PERCUSSION (Specify) CASING - -DETAILS LENGTH (test) I DIAMENR(inches) WEIGHT PER FOOT Fn ' ❑ DRIVE SHOE RYES ❑ V0AS CA5ING GLOU D? � 77 )rJ THREADED WELDED NO YES D NO YIELD HO G.P M; YIELD (G.P.M.) TEST CAILED PUMPED ® COMPRESSED AIR ^U -SRS WATER MEASURE FROM LAND SURFACE- STATIC(Specilytect) DURING YIELD TEST( loot) Depth of Compte!ad Well LEVEL in feet below Land svrface:�) -- - - -_ MAKE_ LENGTH OPEN TO AQUIFER (leetj SCREEN - DETAILS SLOT SIZE DIAMETER (Inches) FIFGRAVEL Diameter of well including GRAVEL SIZE (inches) FROM float) ., TO (loot) D: gravel pack (inches): I 'TH FROM LAND SU±iACEI Skotch exact locai:dn Ol well Ni:h. Oi513nClS, to at toast FORMATION DESCRIPTION two permanent landmarks. If yield was tested at different depths dvrino drilling, list below FEET GALLONS PER MINUTE WLLL COMFLt''.3"0 r I T UATF OF FtLPORT I WFI I r11111 I Fn 151nnaturef 7i1 ;l 5: .. -.ate= e - .�K- e. »•.ye a` >rr 4 - e ct- .,.. _ , .. . -..v" , «» . ._. . •'i�i'i"'. �Yi "�'l�'�Yi�:IC[�'4ai`1 "� ' -1'� �, .°•- •:•:� Owner or Purchaser of Building Municipality owner B Building Constructed by Section 22 Shamrock Drive Glockamora.Acres Location - Street Block 3 BR high ranch 22•;_ Building Type 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 hereby 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 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 de- termination of the Director of the Division, of Environmental. Health Ser_- _ of�- pufneue LieFartm :t° failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system:7.7 Dated this 8 day of Dec. 19 75 Signature T i t 1 e il' corporation, give name and address) - - - - - 7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 4 'SANITAibe SYSTEM -- DESIGN .CRITERIA S'e-Oti6;data transf6ired.- from, :Appr4v6d �4 tliid�liii Z, ­5 divistoft,plaur- a Y', 410 1 revised 'June 7 Percolation minutes low 70 o rock' or ,.water be 12 . of. ii, A 6 , el requared :Effluent be pumped. s. .2. Sy ster I a to'consist of 180 absdOtion -trenc :t 36" wide x 24" deep, spaced 9­0 -o;c. 3. Septic tank to be 900 galons- concrete. 'Siphon tank to bee 500 galons- concrete. 4. Fie Ids to be 4 perforated Orangeburg pipe oreqquai; 4" solid tank to junction box and be-- -:4iahing of tile run; 4'p solid cast iron.'. pipe I i4* hiAite- to septic tank and from'* septic siphon tank. S. 'S e tank shall be equiped with an electric.'' �4 automatic high leVel alarm system ta a bell alarm within the proposed residence.,. 6. All construction. :County be performed. in , accordance. with the bea ' 1 ' th codes of Putnam and7 146w. York Stat&. see N.Y.S. bulliten'1,6 Tart- ia.i, P..I-I 4J_I �'.t r3ui-4 CAL IGI 4./\A i U V M4 CP a*-W, R FC _H A f� C, &'4 L 1� Pi k, I LO-T- u '?/21