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Home My WebLink About3734DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdoias.com 631 - 589 -8100 74.18 -1 -1!2 BOX 291 03734 1 1 1 1 1 11 ' ' . 61 , 1 oil ' . 1 ■ ,1 �e. 1_, 1 1 1 T ily 1 1 i_6 1 Jr I r AL 1 03734 �.... -.. �� ]PUTNAM COUNTY DEPARTMENT OF HEALTH ` \b Division of Environmental Health Services; Carmel, N. Y 10512 Permit a P. V- 7-812 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPIDSAL SYSTEM Putnam Valley Town-or Village Located at Tauret ^�P�lace _ Tax Map 65 a ~_ Block ^T.2... ,.. owner Frank Hart , Formerly Nugent Tax Map Lot # 1 subs. Lot I separate Sewerage System built by Paden Construction Address Baldwin Place,N_�Y_ Consisting of 1000 Gal. !Septic Tank and 500T,1F Of laAt -hi Mg ronn gS Other requirements — Water Supply: Public Supply From XX Private Supply Drilled By Norman AndP-r,GOn Address Bal ser StreetrPutnam Valley N v Building Type One Family Residence No, of Bedrooms 3 Date Permit Issued 5 -2R -82 Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed assentially of which are attached), and in accordance with the standards, rules and regulations, in accord Putnam County Department Of Health. Date 11/12/84 Certified by Address"uscoot North shown on the plans of the completed work ( copies with the filed plan, and the permit issued by the .r P.E. R.A.-2M 10 41 11056 L no No. Any person occupying premises served by the above system(s) shall promptly 11,0/Ch aet as may be necessary to secure the�r►ectlon of any unsanitary conditions resulting from such usage. Approval of the separate sewerage hall come null and void as soon as a p blic sanitary sewer becomes available and the approval of the private waiter supply shall become null and ho a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Co roo r of Health, such r tion, modification or change Is necessary. Date T ` -' _ By. 1 '~� �� TitN 1 TOWN OF PUTNAM VALLEY WELL DRILLERS LOG AND REPORT' _ . . WE'LL 001,MPLETIO T. REPORT This report is to be completed by well driller and submitted t& Bldg. Department, together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality. Well- Location Tax Map Street Sec. Bl. G, LotV, '7I- Well Owner, %,Z Name Mailing Address Well Drille3z Ll/ Name Mailin ddress City or Tel® # ty or Town 1V1 =1{r L/C.l'1I1 %JV Ytlr.L.L V J • T t:w L WELL LOG Depth from Give description of formati.ots penetrated, such Ground Surface as: Peat, silt,- sand, gravel, clay,,hardpan9 shale, sandstoneo granite, etc. Include size of gravel (diameter) and sand (fine, medium, coarse), _ •,s ; ..,- ..:.;.,...__.... , . cal!�,r Of n:ateri3l, structure, (Locse, pac�:ed e ' cement, soft, hard). For example: O ft. to 27 ft. fine, packed, yellow sand; 27 ft. to 1.14 ft_ nrav nranitc_ Feet to Feet Formation Description CASING DETAILS YIELD TEST WATER LEVEL SCREEN DETAILS Length f /� Ft: x /fo Bailed or Pumped. rs. Measure from '* . a Statics Ft• land surface Make: /a Diameter: G Inches 'Yield:-/d GPM When Bailed or Pumped Ft.' Slot Length Ft. Site Kind: Diameter In. 1V1 =1{r L/C.l'1I1 %JV Ytlr.L.L V J • T t:w L WELL LOG Depth from Give description of formati.ots penetrated, such Ground Surface as: Peat, silt,- sand, gravel, clay,,hardpan9 shale, sandstoneo granite, etc. Include size of gravel (diameter) and sand (fine, medium, coarse), _ •,s ; ..,- ..:.;.,...__.... , . cal!�,r Of n:ateri3l, structure, (Locse, pac�:ed e ' cement, soft, hard). For example: O ft. to 27 ft. fine, packed, yellow sand; 27 ft. to 1.14 ft_ nrav nranitc_ Feet to Feet Formation Description 4 .- goo Date Well Completed q Date of Report Well Driller Signature BZS 1 -77 Frank ,Hart � _. Tow -of . Putnam = Vag c'nase:F7Br .. .. 3u` ding .... -. Manic pa ity Frank Hart Building Construci;e by Tauret Place Location - Street 65 Section 2 Block One Family House l M—ilding. Type Lot GUARANTY OF SEPARATE SEWAGE- SYSTEM I represent that-I am wholly and completely responsible for the location, workmanship,. material, construction and drair_age'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 fail -s 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 systems except where the failure to operate properly is caused by the wi:Llful or negligent act of the occu- .pant of the building utilizing the system. The undersigned further agree: to accept as conclusive the de- termination of the Director of the Division of Environ_mental Health Ser- vices of the Putnam County Department of Health as to whether or not the _failure of the system to operates was caused .bT, -- hr.Pwji .lful act"of "fife "occupa*it oi` the building utilizing the syste 4wntr15 Dated this 9 day of Nov. 1984 Signature C-(- C` Phone, Z z THREE (3) COPIES ARE REQUIRED WITH THREE (3),COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COM',ETION WILL BE. ISSUED. GUARAITTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Envirorunental Health Services, Putnam County Department of Heal ROSELAKE MEDICAL LABORATORY 21 CLARK PLACE PIAHOPAC., NEW YORK 10541 „b 914 629 -3790 NAME: 1 il�l %C TEL# I ADDRESS .k),L,)wO d S 01--72 (f, „ CITY-.- DATE RECEIVED t WATER ANALYSIS COL I FORM COUNT -LESS THAN (a,) CO _ I FORMS PER 100 ML •' .MEETS STANDARDS - i DOES NOT MEET STANDARDS ,1 DATE REPORTED ll TECJ: - ; ! t .r z W. DEPARTMENT OF Pr" I Vvisiop qf', tn'v' ronmenta Health ca� t -,' CONSTRUCTION PERMIT',:FOR SEWAGE,- diltpoiA C-SYSTE 'Located ,41 Tak Map _-L Subdiviii0 , t 68 ckkss, kc Building'.1eypeGYM& 2-4= ,,j -L&L-Area -3 Number besign 10i, G/P/n- -Ta k Sewerage System to -1,cciritiji 6i�� Sepa I ra . t - Slew; al. - -Septic n To be constructed ;'A - - 7 uctc 44 � by Pit 'Water -..Supply Public :,P6 v A f4i supply Ab be '-drilled by ;4. .,. -Other Requirements , JI Af I re presen t.that I am 'who lly an completely i` e spcK,ibii'f6rihe sign location of th,i proposed .sysl above descr,ibed Will biF constructed as shown',,qn, th e appro - amendment theip to ano:ln jccordi666 , 5 with County ved 6epaitmiKi--bi :Health "on LCoiroi"etic- r ther Sf-a iCer1t-if i—c! _ . of Construc tio - n7 ` e ? pi la 'e submitted to e� Deportment and iarantee. willlbb h is i6&i is6i 3 place ingoo d 0 erating.c6ndiiicr any pa rt of said �sewagpdisposal- er io 4 ."ante oVthe a g• f o nan Ce o i iraSyst or any re will be ldcated.as sh own pnthe:*pproved.pISn and well Instilled in accord itI' the County 0 t SD&r ment of Health�' t2� N Date Signed cl MUSCAdareis �, -0 0 T,--"�5 O.Y,4 2 D -APPROVitb*F.O-R..c6i�sT*'R'Y!qT-,,ION:� r., e Assuti-if �unlessconsz : 2 . -1 jr�es,.o. ! i Y,t I �tl� '-Cause or maybe amended 'of.". R(!O,If iedr.%!n!n 'con id 4 �-'req P�fm-1,t Apt) ft d,n sa !Iprer, ;.,a. 0 v su uires a I v I clispcisal of.dome .domestic' i r sew 6, MSiUSfiCtbiyA6 the Commissioner -of Health will' its :Pr- assig!" 114,664der _tlhit�said lbtiilder..will , ,y�Rprs Immediately following thedate of the issu- 2)j the iil�� d;,scrlibed above s thereto,' � that -6r WOW ards, rules _:and requ =a.on.s,. of--.: t - he Putnam . P.E. bon I cen s e N 6 the building has been -uhdekaken_and is . IR!t Q Any ,Piapj .0 f construction o J Tit e�, J 7512 - J. . . . . . . . . . . . . . �A Town Wt, MSiUSfiCtbiyA6 the Commissioner -of Health will' its :Pr- assig!" 114,664der _tlhit�said lbtiilder..will , ,y�Rprs Immediately following thedate of the issu- 2)j the iil�� d;,scrlibed above s thereto,' � that -6r WOW ards, rules _:and requ =a.on.s,. of--.: t - he Putnam . P.E. bon I cen s e N 6 the building has been -uhdekaken_and is . IR!t Q Any ,Piapj .0 f construction o J Tit e�, J . �. _. _. __.._.._._.. ... _, _ _. .. ....... .. .� .. '1 r 7,k-` PUTN AM COUNTY DEPARTMENT OF HEALTH H Permit # Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Located at ' A uQ-r--`"f �� A �✓� Subdivision NIA subd. Lot N owner /Address WM• l�UG.;✓N.T ROV-019 kASE10 10—V. 49 Pi•.5'A C7R..KTOW N HEIGNT'IS . Building Type Q) TEAM` Z3E.S' Lot Area 1,115A 4CaES 1. r !du>IQ 0 P T W A M V cI� �} - - - -- Town or Village. Tax Nlap(.n Lot. Renewal _ ❑ Revision _ Date Of Previous Approval Fill section only ❑ Number of Bedrooms 3 Design Flow G /P /D ('00 0 P.C. H. D. Notification Required Separate Sewerage System to. consist of %Odd Gal. Septic Tank and Son LF OF V U20e L56(. 424 12ENCNES To be constructed by ON PaAD Address C.ANoPUS 06LLbLd RD Pun�jAm111 LLC to Water Supply: Public Supply From + by AnL`{ Aiv,Ar=r2_G Private Supply to be drilled /D1 �!Iii> fY�>�.�uU S�Q_F_E7- tu, l 7 l�.�• Address Other Requirements 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 OT 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 thedate 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 accorda a with the standards, rules and regu aeons Hof- the . Putnam County Deppartnment of Health. Date 5 / / Signed P.E. R.A. toss o 12 >.� o I=T li 46 P l o Address License No. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued less construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Co m sioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic /order vrafar ^ply only. Date ByL�O'Y ti C Title Rev. 9 -81 q I PUTNAM COUNTY DEPARTMENT OF HEALTH _...;.. _.__.. �:.._ :. I ]:SION OF..ENVIRANMENTAL..iE AITH..: SJU VIC-ES.. - .: -,._ ..... Date // 1�4 Re: Property of ERA k. x. d A P.T Located (T) C%� Section -' Block 1 Lot I Subdivision of NIA Subdv. Lot # Filed Mal) # Date Gentlemen: This letter is to authorize -JOEL-, EE E:N L a duly licensed professional engineer or registered architectC ( IndicateT- 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 c:onnect-ion- with- .thi.,s matter. and to .supervi:se- th•e- . cons truction of sai.d system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, f Signed Countersigned: QOwner of Property P.E. , R.A. , # `�0 54 _ C� S CEO SS f4 l LL '2 OAP Address 1AU5C,00T N0Z;T44,Z =D#1 8x-4-86 _M#gNoPAC.,, N.Y. 105-41 Address Town f-A ) 4 ` �� a �� /� Telephone Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,..,Date Re: Property of :3,A1AUE1, 4 I ti- DzeD NucirhaT Located at (T) " Section Block Lot Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize oEt- CMR__k51 13G" a duly licensed professional engineer or registered architect (Indicate) to apply fora 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 system or systems in c.ontormit'y wit'li' tile' provi`aioris of -' Ar-tic e"'i4�) or 147, Education Law, tary Code. C tersi ed: P. ., R.A., # Joel Greenberg - Architect Musc of North RFD �2; Box 488 Mahopac, NY 10541 'r NC t� is Health Law, and the.Putnam County Sani- �t� Very truly-yours, Signed Owner of Proper Chadeayne Road Address Ossining, N.Y. 10562 Town 914- 941 -0363 Telephone Telephone PUTNAM COUNTY DEPARTMENT OF HF�.LTH T)1VISION. OF ENVIRONMENTAL HEALTH SERVICES ' F COUNTY. OFFICE BUILDING, CARMEL, N. T. 10512 . DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL, SYSTEM FILE NO. Owner JAM�L�5 Address C pEAM€:�QSS�t��C�,� Located at (Street' �KA (,P Sbc . Block�Lot _ ..:..,..:. xi ca near st cross s Municipality ,... ;� t� ' .' � 1L9 i Waters:he �aC�nl l SOIL .PERCOLATION 'VEST DATA .REQIRED TO BE 'SUBMITTED WITH,APPLICATIONS 'Hole Number CLOCK ...TIME PERCOLATION PERCOLATION Run Elapse Depth Eo Water Water EUVe Time From-Ground Surface in Inches - Soil Rate Start -Stop Mina Start Stop Drop in Min. /in drop Inches I- riches Inches �-a 4. 2. . 0/t %b Notes: 1) T Ats to 'be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to Yee 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. HOLE, No. G.L . L 6" SAY SA1�tD CLAIV SnND 17 Sr0Nr-_S 1211 24" 3011 36'! 42ft 4811 5� 11 6011 6611 7211 78 84 rr INDICATE I= AT WHICH GROUND WATER IS ENCOUNTERED N (W49 INDICATE -LEVEL -TO- WHICH WATER LEVEL RISES AFTER BEING ENCOUN7M 19 TESTS MADE BY Date_ ........... DESIGN Soil: Rate Used :fib Pan/l "Drop - S.D. Usable Area �rovided5666. No. of Bedrooms Septic Tank Capacity 6 0o Gal -L2 Absorption Area Provided By,�,, L.F.x2411* 36" ch. 3 Name Signature Joel Greenberg- Architect Muscgot North Address.: RFD f% Box 488 S L Mahopac, NY 10541 THIS SPACE FOR USE BT-HEALTH DEPARTPIENT ONLY- - - Soil Rate!Approved '': - Sq. Ft/Cal. Checked by 11 Date. ij 501_!'/2. kN O.as2r Awn 646 (D 0 p pd� j 'CT' 10 � T 'O � ''�, L 50-01 N JLU4C;tlQv-i x elOOO GAL ,-$efpTl 'TA t-4 K. IJ 7 o 40. 00' T E M 0