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HomeMy WebLinkAbout3670DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.15 -2 -10 BOX 29 ir No .. r ,. :a lima J ' L �� T '` - ,,,r -1 - I r- ;. IL ,- .�., �; III 03670 7. PUTNAM COUNTY DEPARTMENT OF HEALTH. v °-1�� Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEMyi,.3t' Town or village Located At '�j� % �. Tax Map Block Subdivision 7l-aC� k� Lot ,{ -1/ " Jot, tr L �� r� aiy Add l �/\ Owner --rase Building Type - ;yam- �'�G7�A.)il/4ir Lot Area Number of Bedrooms Design Flow Total Habitable Space V:2_�P Square Feet Separate Sewerage System to consist of I Qn Q Gal. Septic Tank and 4 ,9 To be constructed by Address . n (dl �, n^ Water Supply: Public Supply From �' N (/ Private Supply to be drilled by��i" Address Other Requirements 1 1 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 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; hat the drilletl well described above will be located as shown o the approved plan and that said well will be installed Wccornith th , standar r les and r u a ions of the Putnam County Depart ent of H alth. P.E. R.A. Date Signed .!7 Address �. License No. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of a building has been undertaken ,and is revocable for cause or may be amended or modified when considered necessary by the Commissi ner of Health. Any change or alteration of construction requires" a new permit. Approved for disposal of domestic ag private a Date � � ��� By Title P U T N A M 4UPN)T C �PA TMEN O HEALTH of Permit , - Ir`�� G Division of Environmental Health Services, Carmel N. Y. 10512 v CONSTRUCTION -PERMIT-FOR, SEWAGE DISPOSAL SYSTEM - � ` ! y-ryAAA_ Town or illage Located at,lDl�i�� VG1%r Tax Map Block tot Subdivision subd. Lot # Renewal _ [] Revisions _0 Owner /Address Date Of Previous Approval '_`+MICA i 196 L I7 Building Type �C L ei � ��iA+. Lot Area Fill section only ❑ Number of Bedrooms — Design Flow G /P /D 4, P.C. H. D. Notification Required Separate Sewerage System to consist Of �n� E3 Gal. Septic Tank and Liu m-r fto To be constructed by [3{ ttl { 1 Address Water Supply: Public Supply From Private Supply to be drilled by Address ��M-X j Other Requirements —_ ~% fib in 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 an regu a ions 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, ru and regu a iT{ on' s pf the Putnam County Depart ent of Health. Date � J Signed r O .9A Y P.E. l-� R.A. Address /Q' X License No. 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 C sioner of Health. Any change or alteration of construction requires a new permit. Ap oved c isposal of domestf sewage, and /or pr vate ater { °� J Date By Title Rev. 9 -91 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, M. V. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM T—ru-k"L& Law Town or Village Located at �' ` d S Block l Owner .Tax Map Lot H I �� Subd. # . Separate Sewerage System built by Address �•�0 Consisting of _0 Gal. Septic Tank and (� � 'Z44 -Mick Other requirements 0zt .Z . fl a la> rl L L' water Supply: Public Supply From _Private Supply Drilled. By ass Building Type j No, of Bedrooms Date Permit Issued Has Erosion Control Been Completed? 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 accord ce with the fi plan, and the permit issued by the Putnam County Department Of earth. Date Certified by P.E. R.A. Address License No. r Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary 4 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 sower becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the Judgment of the missioner of Health, such re tion, modification or change Is necessary. Date ` ` `o �� BY_ Title_ .,- ALLEN BEALS, M.D., J.D. Commissioner of Health __ :.:. ��B�SPaS ��® dt4l�it3,•F.L':�1lo's;�H�. - - -;: .:,�:- ���, -;. Director of Environmental Health April 15, 2014 DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Raschid & Jasmina Bezama 4 Shopis Drive Mahopac, NY 10541 Re: Addition — A- 045 -14 No Increase in Number of Bedrooms 4 Shopis Drive (T) Putnam Valley, T.M. 74.15 -2 -10 Dear Mr. & Mrs. Bezama: MARYELLEN ODELL County Executive This Department has received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated April 15, 2014. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices; i.e., new low flush toilets, restrictors for shower heads and faucets, etc ... 4. The approval is for the modifications only and does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 5. This approval is valid for two (2) years and expires on April 15, 2016. Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43261. GDR:cw cc: BI (T) Putnam Valley Respectfully, M FA Gene D. Reed Principal Engineering Aide Z ALIEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E. Director.gj.Environmental Health.: DEPARTMENT m 3) -IV tA) $�� MARYELLEN ODELL County Executive V a HEALTH Geneva Road, Brewster, New York 10509 Phone # (8457 808 -1390 Fax # (845) 278 -7921 1W ,r ADDITION APPLICATION RESIDENTIAL ONLY /, / jP�a.wL V6, I (.e y STREET �1 S�kOp1S .7)rt TOWN TAX MAP # NAME 'Be Qza 1a PHONE e 8 '7a:3S� PCHD# MAILING ADDRESS IS A® t'-... , /\I,\/, /as-q/ DESCRIPTION OF ADDITION r- /J I S4 a *NUMBER OF EXISTING BEDROOMS 3 NUMBER OF PROPOSED NEW BEDROOMS * (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *"Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 808 - 1390. 1.�Certifed check- or.�money =o pderzfor:.$10040_.,` 2. Sketches of existing floor plan (drawn to scale, all living area including basement, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE COMMENTS 4. ALLEN - BEALS, M.D., J.D. Commissioner ojHealth MARYELLEN ODELL County Executive ROBERT MORRIS, P.E. - . -.��. <.. .... ___. -.� aY •- .tee, -. ... � �... � - ,. .. ... ..;� _ DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Town Legal Bedroom Count & Proposed Addition Status Re: LQ_S Gk\ % G( E)�Z" 12 (Owner's Name) Tax Map it 74, 15 - 2-- 10 Address: Town: Year Built: WA 83 According to records maintained by the Town, the above noted dwelling, is in compliance with Town Code. Is not in compliance with Town Code. `1`he -�.egal Bedroom- Cowit -is: T This information has been obtained fro Certificate of Occupancy: Other: The plans fo the proposed addition are considered: Addition to existing house only Teardown and/or re -build allowed under Town Regulations enlpco,,& 6t� 3�2ko 11 Building Inspector Date 5. sa3uulpl000 3pulpnno :Q LT CE tii a. 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AT O�.HLALT HEALTH pe A COUATV D P Permit s ))V Division. of Environmental Health Services, Carmel N. Y. 10312 !' vi1149U CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL.SYSTEM c.i � Tov, or . village Located at :.:Jafi'.'a'i �d�:fQ 3 ..; _ .Tax" Map Hlocki :rot Subdivision - Subd.. Lot # Renewal Revisio }Z — 0 - ° <a Owner /Address? %.. �1f F:Y� ae¢.rK �+. Date .Of Previous Approval1 .r ,ly'7 �'��7l Building Type _Jt %i + ' - Lot Area Fill Section Only Number of Bedrooms Design Flow G /P /D �G'° � - P.C. H. D. Notification Required,] a5 $i xl 3f' ;t 3 �4� +�'�, `�`�"'�'` " +��,��' -, ��d a a � � at* Sepa►ate. Sewerage 'System - -to consist of `i . Gal. Septic. Tank and �— i `'� # i1�_i °'I +a a �+ r +� 4ti • z r 'as To be .constructed by, C[e,y sfl s ` S Address T �" Water Supply. Public Supply From i n Private :SuPR1Y to be drilled by: ts� Address«c TYy7i5 5�r si/a 5�V ther ReouiremeJ:ts t a. C�' i.� �p 1 i-.1 .•..- � y 1 I represent that loam wholly and completely responsible for the design and location of the - proposed system(s); 1) that the', separate sewage dis posal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, ruiett and regulations 01 ins, rwinam � r , � : j�s• >'�i � , � "� County Departrtitnt 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,; he builder, that. said builder will RVI place in good operating condition any part of said sewage disposal system during 'the period.of two (2) years immediately following thedate o4 the issu -'1 �;; ;yt. ante 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, ru)s art'I regu aTf;ons of the Putnam y� County Depart en of Health: r ; ii"i; t 6 xi,, ha,Sr a w,r zts. `' { Date / J i Signed P.E. ,tR f7 A License No.Address 43 4 o £ APPROVED FOR. CONSTRUCTION: This approval expires one year from the date issued unless construction of the building ties been undertaken and';is ,5 , y a. C d Lair Pq revocable for cause 'or may be amended or modified when considered necessary by the CorIlMissioner of Health. Any change. or alteration of construction 1 a cd requires- a new per�nit. ApIroved _fgradisposal of domestic eaifit3r sewage, and /or pevate 3viter�sawy, only.' ) Date4 tx 1 w ) _... BY Title / r Rev. 9 -81 e)pi)a0r upon camp 10110'1) of we /% Putnam Connty Department of flealtp Division of 4wSropp�entaT•Hea1tL 9ervioe4:. `» i Approved u eo ed f" contoimanoo ♦itL applica6u ..u..c an '$_sgly7,atlons + oi. . , . �.. patnam.,Count -e t:Le oD9rtment. Signature'. 1 le ,-+, • ;Datay- SEPTIC SYSTAI AYOUT F�FI j PREP AAED, )FO , a \ I� WOn'0 �'� c•' 1 1 Y _ .. - 3 t � � e I r 4 " f 8 7 i YJ� - " f ' t % I j i� Nj 1P N i t R I r � t _ r}t v I t < • � 1ST Fi.vc�tir \Y�%1:Y . ,r cone Ulsirict ®- - ■ — - -. ' - - ®�' �� - - ®' Application is hereby made for Bldg. Permit Work to start 1 Family 2 Family Extend Deck. — 10' x 12' Wood Shingle Asb. Shingle Description Paved Dirt Log Cebin Brick Shopis Drive - TM #74.15 -2 -10 Location of Premises — Street or. Road Oiled SEC: BLOCK LOT FRONTAGE Concrete Depth Rear ACRES (other description) or number of square feet Swamp Apartment K. Shopis TEL. 528 -7285 SUBDIVISION NAME Raschid & Jasmina Bezama ADDRESS4 Shopis Dr. - Mahopac, N.Y. OWNER INTERIOR `[Lake F. Store & Apt. Stone Rooms Dams_' Dimension of Building Width Depth Stories Type Foundation Size & Use Each SaniLarY Permit pluub ing Peind L $� _ Well 1)ernu. L- $ d C�' TOTAL $ 1tev. 1 /05 Bzs Z13A Approval P. C. B.O.I-I. Planning 'Boara USE CONST. ROOFING LAND 1 Family 2 Family Wood Steel Wood Shingle Asb. Shingle Paved Dirt Log Cebin Brick Tile Oiled Bungalow Concrete Metal Swamp Apartment Stone. Brook Store .'-FNDTNS. INTERIOR `[Lake F. Store & Apt. Stone Rooms Dams_' Type Foundation Size & Use Each SaniLarY Permit pluub ing Peind L $� _ Well 1)ernu. L- $ d C�' TOTAL $ 1tev. 1 /05 Bzs Z13A Approval P. C. B.O.I-I. Planning 'Boara 3/11/83 ate , 19 TOWN OF p 83- - - - -- - - -- - N_ 6790 Zone District PERMIT RECORD Building at once Application is hereby, made -for._ ��_ v Permit Work to start Description one fermi 1w(ndeck) Location of Premises— Street or Road Shopis & Wood Sts TM 6r;-1-16 SEC. BLOCK LOT FRONTAGE Depth Rear ACRES (other description) or number of square feet SUBDIVISION NAME TEL. OWNER Ruth Keisner ADDRESS Same USE CONST. ROOFING LAND Dimension of Building t Family Wood Wood Shingle Paved 2 Family Steel Asb. Shingle Dirt Width Depth Stories Log Cabin Brick Tile, Oiled Bungalow Concrete Metal Swamp Q—,, Type Foundation 10.00 - - -- - - -- � - -- - ..- - - $ Plumbing $ 15.00 Well . �) Plumbing Per �:t7vc %'bc -A Approval Well Permit.� -4 SO,), �A &ACA Approval TR 2, 3SW LLS - 1 -77 Owner or PiArchaser of Building Municipality Building Constructed by Section Location - Str et Block .,0 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 followir_g 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- vices. of t_h.e_. P_atnam .Coun -ty -Department.-of tc7?�rh.ether cr no't 'operate' was caused by the wi f or negligent act of the occupant of the building utilizing the sys e Dated this day of 19 Signatur IV% IV Title, If corporation, `give name and ✓�' THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS ORE 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 WELL `COMPLEt TION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3171 -- — — T COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction .compliance..is , jssued.. ..- ......;a... .. , . REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME M.D. Campoli', Inc. ADDRESS Lakeshore Drive, Mahopac., NY LOCATION OF WELL (No. 6 Street) (Town) (Lot Number) Shopis Rd., & Wood Street Putnam Valley, NY PROPOSED USE OF WELL BUSINESS ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ OTHER (specify) DRILLING EQUIPMENT COMPRESSED CABLE O ® ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ OTHER ) CASING DETAILS LENGTH (feet) 42 t DIAMETER( Inches) 611 WEIGHT PER FOOT 1 lbs . ® THREADED ❑ WELDED DYES. OE j DYES. ❑J NO W- CASING U L.1S l � NO YIELD TEST HOURS G.P.M. ❑ BAILED ® PUMPED ❑ COMPRESSED AIR 6 1 YIELD (Q.P.M.) 1 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 471 DURING YIELD TEST (feet) Depth of Completed Well in feet below land surface: 305 t SCREEN MAKE. LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED., Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET O 12 Drilling in overburden c a and boulders Hit rock at 2 feet 12 42 Drilling in rock,set, casi-ng. grouted, illing in granite. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT 10/25/83 WELL DRILLER (Signature) y - ®REr ... 9R ' WORATORIE'S Box 214 - BR6ViMSTER, N. Y. WATER ANALYSIS REPORT SAMPLE No. 5225 SOURCE: Campoli Homes Hose Bibb - Well Shopis Drive Mahopac, NY CoLLECTED: October 10, 1983 BY: P. F. Beal & Sons, Inc. BACTERIOLOGICAL EXABUNATION Colifortn Count, MF Method This result ixdicatts the source of the sample was of satisfactory taxitary quality whtx tha sample was collected. O per 100 ml. l October 17, 1983 zt C Bickwit P. E. Director PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of KER 6d tM Located at '59tPAS n2jP.%qjj td a'> Sr- (T)-T,OT. 4AWdsl Section Block Lot Subdivision of Subdv. Lot # Filed Map # Date Gbhtlemen: This letter is to authorize M %[ 14 &ax' 7—A- a duly licensed professional engineer L-1 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 connection with this matter and to supervise the construction of said stem or -systems, in -,confoxm-ity- with th-e-- '-f. 'A.r-.-.- P -0 —11 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, S' ned : of Property Countersigned: -.- "4 A P.E., R.A., # H—�—'(421 Address Telephone Address Town /a - 771 - --"( Telephone R. E ('-M' V -t: U FEB PUT!--1AM COUNTY DEPT. OF HEALTH Gentlemen: 1 T1`IAM COUNTY DEPARTMIN T OF HEALTH t DIVISION OF ENVIRON MEN TAL ::_ HEALTH— - SE;UVICES- . Date.. �1��•1i�..C1 i � ��' � ��n Re; Property of �r�► �, � LLW3'�,I tiStN Located at LCURt� iE R Worms 's N ,1oP\ °Section Block, Lot This letter is to authorize T.44'ichael Dply„, n.E. a duly licensed professional engineer or registered architect (Indicate) to apply fo.r a Construction Permit fora separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Co =ssiorer 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:__cons.true�tion of 41d_: = -- 4, •or ••syst-aius in, con ormity with the provisions- of Article 145 or 147,: Education. Law,: the Public Health. Law., and. the Putnam County Sani- tary Code Countersi ned:C/ P .E., R.A.$ r 4946.8 Box 243 2hepprock (Seal) Ad ress 'T.-Y., 10587 248 -7022 Tale-phone Very truly yours,, Signed t&6"" Owner of Pro erty- WiL Address Telephone RECEYEU MAR 2 9.1962 PUTNAM COON e Y . DEPT. OF HEA11 PUTNAM - COUNTY- -- DEPARTMENT -- OF- HEALTH _.. DIVISION OF ENVIRONMENTAL HEALTH - SERVICES Al.i!Lt�d.JS :Nd _:[ — JQ DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.. Owner Address G4 q Vitt SU C- 'bR, -I-Zr PA. Ft-CM%oA Located at ( Street S aov k S WOOD sec. 4"_-) Block ( Lot Ito �'Inaicate n ares cross s ree Municipality __Tv_ k V y�,E�� Watershed 1 Ajekv 2 0. o SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME `moo PERCOLATION PERCOLATION Elapse Water ate__r_Teve No. Time From' Ground Surface in Inches Soil Rate Start -Stop Min. Inches DInPhes Min.. /in drop Inches 10 2 Notes; l) Tdsts'to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted f or ' : 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 NO. SM j - - - 12" �, � W LT1kg; .V . W tTVk 2411 T - 3611 42" r 5411 6oll 66" 7211 If M , 78.. 84" rr INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ��c �6 wt�j eoL INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS ^ MADE BY P%� Date .t � DE IGN Soil bate �Used-ll -- tc Nair l Drop. S.D. Usable Area - Provided (0J0Z_ Sbo®t No. of ` Bedrooms Septic Tank Capacity 1000 "Gals. Type. 4Afwo f Absorption Area Provided ByL.F.x24 �fi' w idth tre —ncl -Iz O �- �= �, k? Other tiu.t. �.. l Lo �' . s Yl Name - a��cal A7 ®L_.c (P- ip-nature r Address O y, Z A, 3 SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by_ Date MAR 2 91982 PUTNAM `COUN 7 Y D�PTO 9F WALT �`r•iee n ; S 247.07' gaBA 8L1• BL AF °I• Q� i.00` pert s PQEMtSL3 3NOWN wE�EO�✓ `AN cC, i Lo T Np ! ON I� A?AP ENT /TG6.� , K. 'SI4/0 MAP fG1"6D TF/6 OPF /CE" Of TNG Lov^erk' o �GEL'K Of P6�7NAM CoUVr1 'CO& 17 S A9,OP N S 843. 016 V -JV -0{ f 8.4D l aa wc .-T Sroa f y Ra/4E . p I ,a.AISLC R.q,r u! ° Q 7H.S1• Z•ovasNa � d' N' ®" r pi h 14 M IQ� W ds.a 0 V IM2 Q � t i sOt �A�a I • .• IRON P"i ' 1 7 ' FOY ND - _ DA"1 VE SURVEY OF PROPERTY Certifications hereon are valid For Bank, FOR . " Tifle�• -Ca.. & Owners for this transaction ' F only. Certifications are not transferable to i - "•' MID HUDSON SAVINGS subsequent Bank, Ti +le Co. or Owners. M: ' :` C' AM6?0L,/ HOMES e " ; ' CERTIFIED TO:—,_ BANK, SEGURIT,,p TITLE E• All certifications hereon are valid for this :JOHN gSALVATORE ROMEO y,... SITUATE "IN THE GUARANTY NV A6P 704)098, map and copies thereof only if said map or Consul ing Engineer 6 Land Sursryor TOWN OF " PUTNAM VALLEY copies bear the impressed seal of the wr- t A(p. CAA100L1 HOME$ veyor whose signature appears hereon. 1 . NQRTHRIDGE ROAD PUMAN COUNTY F.. "14 Ei'E'EKSKILL. N. Y. NEW YORK • � is hereby certified that this survey was 1 SURVEYED: JIo—y4,�*B04 20, /982 prepared in accordance with the existing J� �o BROUGHT TO DATA pya 4 • 198i iNowa ..Mesa taac)' Code of Practice for Land Surveys adopted by the New York State Association of Pro - E. & L °.. S. NYS.LIC. NO. 027846 SCALE: t "_ BROUGHT TO DATE AUG. ,9 /98Se�COrsNrAr/earf) fessionel Land Surveyors." ENGROACIIMENTS /!BLOW GRADS IF ANY NOT SHOWN ", SURVEYSO AS IN POSSESSION. ,5"06Nr ro' oAr1 O[f. EO, 1983(Nowa6 eew0[br6o) I � Cez r 4 :j j F7 - U(y � 6 � / N K � Vk i tiry or D ..ta HealtjHServioee: DivisionaofC�uri roved �� ._ r..co..formanoe with . rations pf the •. ;;! .: app Putn unty r5 �ir-ti i \.: t t - d Date. tore & T ]e Q _ E R5 .?iEr - C-�,irJ. .xrr1►.M �fays.G"� r. �cc2'v l ooc7 �.t�y..M A�JO►.1RK �Pn - �c..�yK , N �' pOFesstoKP� _- 4 - .