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HomeMy WebLinkAbout3691DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.17 -1 -23 BOX 29 17-2 f `�. I6 .4 Ipig;. +� T, tiro I 1� 1� _. L1 _1 • ' 03691 ` .• ^� £ PUTNAM COUNTY 1 Division of Environmental H r GERTIF..:ICATE OF CnNSTR,ICTIOIV' COMPI.IAI�CE FOR, SE (j Located at A gWkI j Owner�(�11✓ p Separate Sewerage System built by_� �?!CedeirlD� Consisting of ©�® Gal. Septic -Tank } Other requirements �QiuE i Water Supply: Public Supply ,From l , Prwafe. Supply !Du�llledd- BY Address Bwldmg Type Has Erosion Control`Been Completed? �h l certify that the system(s), as listed servings the abovespremises were constr attached){ and in,•,accordance with the s'tandartls °:rules and. regulations G 1 a V ,� Date Certrf�ed -t Address : Any person occupying premises served by t_he above system'(s) shall pr�orr conditions resulting frorr such usage.yApproval ' of the separate sewer available. and the'approValof •the.prrvate: water supply shall become nu(I,' subject.to modif ication or change. when in the. judgment I I the Co Oate � � t PARTIVIENT .OF HEALTH th 7 Ser vi, ces Caimel N. Y 105.— AGE DI$POSAt SYSTEIVI Town .,or V illa /ge tecti6n f2 Block Job Address lineal . Febt, x width. trench of Bedrooms Date Permit Issued ed essentially as shown oh the plan m s of the copleted work (copiiii of which are sfiled and the,permit issued. ` •the °`Putnam County. Department of Heallth "; =-T;� �Mldf Then a ,public water s " ly becomes available `, ;Such approvals, are,; (•-;Health ouch revo tfon`modrficeUon or'xhange�is necessary 1Cg Title Owner or Purchaser of Building Municipality . « g-7'% / )JG. Building Constructed by -510 M%M 6z Location - Street Z ___ Section Block 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- sor,s, 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 -_ . . ,��-. �-•vi�ce s- o'f ttlp:.- �'u�tnam Caurrty -Dep artmeri't ��of--He�a�t�i = =a s � tcrw�-rz she r.-o r -rev t the .: _ _ -..- .:.. failure of the system to operate was caused by the willful op negligent act.of the occupant of the building utilizing the sys Dated this day of / 19�! Signature Title i. If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP± _jETION 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 0 A PUTNAM COUNTY DEPARTMENT OF HEALTH `^ DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. t Owner Dr. David Freudlich Address (Street Partrid. a Lane Sec. 69 Block Lot 6dicate neares cross street) 304 W 105th Street New York N.Y. 10025 Located at Municipality, Putnam Valley (T) Watershed Peekskill 13 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION l I Run No. Start -Stop apse Time Min. Depth o Water From Ground Surface Start Stop Inches Inches Water Level in Inches Drop in Inches Soil Rate Min. /in drop (1) 1 5:02 5:O8 6 18.5 19.5 110 6.o 2 5:08 5:15 7 19.5 20.5 1.0 7.0 f 3 . 5.15 5.26 11 20. 5 22.0 1.5 7.33 I 4 '. 5, (2) 1 5:04 5:11 7 18.0 19.0 1.0 7.0 5 :1 -1 5 x 23 .__ 12 19.0 . 20.5 1.5.:;. 8'' 3 -5:25 5:33 8 19.5 20,.5 1.01 8.0 4 5 2 3 0 4 5 Notes: 1) Tests to be repeated at same depth until aroximatelyy equal soil rates are obtained at each percolation test hole. A11 pppp 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. 1 HOLE NO. 2 HOLE NO. 3 G. L, Tons o l.; .. _'_... mops oil Topsdil. 6" sandy gravelly loam sandy gruvel.lyloam sandy gravelly loam 1211 i 24" - i i 30" -C 361f i • 42,t 48� 54 6011 i 66" , 721 - 78'' 84 If INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 6 °0 INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 5 °0 TESTS.MADE BY John S. Romeo _ Date July 179 1974 Soil Rate Used $ °10 "Min/l "Drop: 'S.D. Usable Area - Provided "f° Bedrooms 3 ° Se tid Tank Capacity Masonry No. o p paoity Gals. Type ° °oo ° °o Absorption Area Provided By 180 L.F.x24" 3b" x wigs 14)FFo lvame Jogn J. ,`tumpo bignature tAt g o 1 N rthri dge Road m m Address SEAL Peekskll, N.Y. 10566 J 4� 6 : T 0 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ® ® °epf NEW y�_ ~ Soil Rate Approved Sq. Ft /Gal. Checked by Date /Y _ --t YORKTOWN MEDICAL LABORATORY P.O. Box 99, Crompond Road .Yorktown Heights, N.Y.._ 1.0598 RESULTS OF EXAMINATION OF WATER DATE COLLECTED -- S o?Y OWNER A DATE RECEIVED ' CITY, VILLAGE, TOWN & /OR NAME OF SUPPLY DATE REPORTED SAMPLING POINT BACTERIA PER ML. (Agar plate count at 3S 6C.) COLIFORM GROUP (Mcst probable No. /l00m1J RESIDUAL CHLORINE AS RECORDED AT .4-eSS i'ha i� d� . SAMPLING POINT POINT OF TREATMENT CHLORIDES (CI) mg. /l. NITRATES (as N) - mg. /1. I FLOURIDE (F) -.Mg./1'. These results indicate that the water was,y f S of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) ;4 YORKTOWN MEDICAL LABORATORY P.O. Box 99, Crompond Road Yorktown Heights, N.Y. 10598 245-3203 DATE COLLECTED RESULTS OF EXAMINATION OF WATER y 0%11NER DATE RECEIVED CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY —DATE REPORTED d4n. _5 _4 C'7w SAIMPLING POINT BACItRIA PER ML. (Agar plate count at 35 nc.) CoLIFORM GROUP (Most probable No./100ml.) RESIDUAL CHLORINE AS RECORDED AT SAMPLING POINT I POINT OF TREATMENT CHLORIDES (CI) • mg./ l. NITRATES (as N) mg./I. (F) - -g./l. These rESUItS indicate that the water was. Yes. of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) M •PU`1'NA.M COUNTY DEPARTMENT NT OF HEALTH DIVISION .:0 ENVI: RONMI ENTAL.- FEEAL.T1,I•_SERVI.CES _ Date. ... October 19 1974 .:F..• ... . Re • Property of, Dr, David' Freundlich ' Located at Partridge Lane, Putnam Valley' Section 69 Block l Lot 13 (Fled N'�aP 015A) Gentlemen: This letter is to authoriz -a duly licensed professional engineer x or registered.arehitect (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 l: V14ltC l: 4.A.1J1i YvZ t_ll ViIJ.J If.I CQ V 1. C'. 1.' Ai)�l 1 -(./. 51U11e,( V Se l,_.(lH UUr1S L.('U(_! V10r1 01: .Salo. system or systems in conformity with the provisions. of Article 145 :or 14.7, Education. Law, the' Public Health Law, . -and the Putnam .County Sani - tary Code. Countersigned: l ✓� Vim-- -✓ 6 Very truly yours, yours, Signed`.' . Owner of Property ` Lj . lot r. Address P.E R.A 4 02704 ., ., see °0 MIG_ ° a , ; ID 1 Northridge Road ® S. ROA Telephone 7. Address Peekskill, 'N.Y. 10,566 o p�J�.+ ,ay iy fly 0C_� a a 737 - 105b o, e o s� 2784 Q °a'��f ll� bcw Y�` a• Telephone