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HomeMy WebLinkAbout3897DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.16 -133 BOX 30 03897 ti r 16' ' T : _u 03897 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH ® . I Geneva Road, Brewster, New York 10509 6 ADDITION APPLICATION RESIDENTIAL ONLY STREET 2-3 W 00 0 L, A-N aV P a O TOWN BA MAIM \/ _TAX MAP# i NAME ' c�i+ -i-S Mh2t✓'a - TPHONE $�6� °Z`F�1 y' PCHD# MAILING ADDRESS 2-3 Wz) ob GAt.atj Kzl A4), Vit-cx P (0S7°l 0J) W) 14, T2-.k r7Q DESCRIPTION OF Nfis7&/L t34ay>a_o-­x d31'ffr-�­&.-x A4 Er�PAHQ S) atv , Prt�T�2: A- Y3 -,tv (l r A- V-) ADDITION;,�_��.� NUMBER OF EXISTING BEDROOMS cf PROPOSED # OF BEDROOMS 3 (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 Genevand, �.:I3i=ewster; i11Y 105:;9; i'lii3i�e: (845)278 6130. _ - -- _..., _.. .... . 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 3. Two sets of proposed floor plan (drawn to scale — with name, street and tax map #) *Non- professional sketches are acceptable 4. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845) 278 -7921. Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Interventiow?reschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN r Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, NY 10509 To Whom It May Concern: ROBERT J. BONDI County Executive Re: -.r (26X Residence TAX MAP# ' 3,41' 1 — 33 TOWN l According to records maintained by the Town, the above noted dwelling, N- M.-. LI_AN � CODE: IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS This information has been obtained from: CERTIFICATE OF OCCUPANCY: OTHER:u uil ing Inspector -Y/6d� Date CERTIFICATE OF OCCUPANCY Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 lm Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Interventiori/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health W LORETTA MOLINARI; RN, M$N Associate Commissioner of Health Me mo ROBERT I BONDI County .Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 To: ALL ENGINEERS AND ARCHITECTS From: Sherlita Amler, MD, Commissioner of Health Cc: Loretta Molinari, Associate Commissioner of Health. Date: March 9, 2005 Re: Bedroom Count Policy Please be ,advised that the Putnam County Health Department policy for bedroom count related to new septic system installations is as follows: 1. The Department will allow on the first floor of a single family, stand alone dwelling, the following rooms: a. Living room b. Dining room c. Kitchen ...... ..w . d. Family room e. Home office /den /study Any other rooms beyond the 5 above mentioned rooms, regardless of openings, will be considered potential bedrooms,. except for rooms which meet the following criteria: • If the room has a floor area less than 80 square feet. • If the room has a horizontal dimension less than 7 feet. • If the room in question can only be accessed through another room with no other means of potential egress, one of the rooms will be considered a potential bedroom, if the dimension criteria for a potential bedroom is met or exceeded by one or both rooms. 2. Any room proposed on the second floor will be considered a potential bedroom, regardless of openings, whether the room is finished, bonus room, or loft areas. Noted below are the exceptions: • if the room has a floor area less than 80 square feet. • If the room has a horizontal dimensionless than 7 feet. Environmental health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 } T • If the room in question can only be accessed through another room with no other.means of potential egress, one of the rooms will be considered a potenti i bedrnarrt, if the dirriensioh criiei'ia car e °pz�te nar' edrtiuni "is rnet or• exceeded by one or both rooms. The bonus room will not be considered a potential bedroom if it can only be accessed through the garage and if it has no potential access through the living area of the house. 3. The basement area can be converted into one large room. Any other rooms proposed in the basement, laundry rooms, storage rooms, etc... will be considered potential bedrooms regardless of opening, whether it is finished or unfinished or whether or not it has windows. Noted below are the exceptions: • If the room has a floor area less than 80 square feet. 0 If the room has.a horizontal dimension less than 7 feet. 4. The following is concerning special circumstances: a. Utility /mechanical rooms will be allowed in the basement where the purpose is to enclose the furnace, water heater, etc... b. Architectural house plans will be required for a two bedroom house. The two bedroom house plans if approved by the waiver committee must be the house constructed on the lot. c. Raised ranches will be considered to have a basement and 1St floor, i.e. the lower area will be considered the basement. 5. All submitted house plans must have a .title block noting the .owner's name, street address of the property and tax map number. All house plans approved by this Department must be original prints, i.e. hand revisions will not be acceptable. The - above- dolicy _wi l go into effect on April.l , 2005. Please :advise -all new septic system . ;_. _ installers of this change in policy. 0 Page 2 Aq '-S*iby, RA ... .. Edw ard ia. 25 Chadwick Road White Plains, NY 10604-1802 August 15, 2005 Joseph Pavarotti Dept. of Health I Geneva Road Brewster, NY 10509 Dear Mr. Pavarotti: Re: Thomas & Marlene Tarpey 23 Woodlawn Road Putnam Valley, NY Addition & Alteration Enclosed are 2 sets of the latest drawings for the addition. Use these 2 stamped plans to file with the building department. Yours truly Edward G. aby, RA Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health August 17, 2005 Edward G Swaby R.A. 25 Chadwick Road White Plains, NY 10604 Dear Mr. Swaby: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERTX NO County Executive Re: Addition — Approval - Tarpey No Increase in Number of Bedrooms 23 Woodlawn Road (T) Putnam Valley, T.M. 83.16 -1 -33 I have 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 the Department dated August 17, 2005. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at four without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be 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 proposed changes only. This approval does not validate .any construction shown as existing that has not obtained proper approvals. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. V truly yours, �.�e`7 Joseph S. Paravati Jr. Assistant Public Health Engineer JSP:cw cc: Building Inspector, (T) Putnam Valley Thomas & Marlene Tarpey Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 t i - 1j ,� � ��S•lT�•hyt, pal IL O uh F ti. °I U W �1 J x UP _ " e � �,.Q� ,h 1 gyp' • - � � p� f� �� ; �� � p � � z .. �. d • r. �.� ��� �� /��� /� / � /' j� hry ry °, `� �0.. -i �i b� 1� �j ;yo.J`E�"an•• .a• j / ��� l fir/ i i- ::/�.!•,J /: /P�i. / p' i• a o � o Ion o 110o 1 `�• Y Q� p� F� � �� J t o �o ove b k� 4, 14 rL ul O J ;q H i u , PUTNAM, COiJNTY DEPARTMENT OE' HEALTH `- ;t Division of Environmental Health Services Carme% 'Al. Y 10512 s CERTIFICATE AF,CONSTRUCTION COMPLIANCE FOR SEWAdE: ZISPOSAI SYSTEM,- �'o�ak cr~ �Pu-r�A�N4_v'_AtLeel - Town` or .Village•:: 7' j Tit T +Ai001i^i lltfl�l�3 I2.b7Ab B�C9ts�eQ�)- +� "�^4'QM�$ 7 Located`at•. _ - Block T%{ i'7,. Owner Lof.B %rw� Job' ' 1 NJ A E►alA�•N^ERb[�' SRf�.ru_1C �4�.� Cro°3 y`�4L�Yr�� Separate.Sewerage System•built by Address _ Consisting of V2'SC:D Gal: Septic ,Tank lin eal Feet X �It. width .trench I;x, Other r'equirements;'��`� ` x � - . 4. Water Supply; ' ... Public Supply from i J .Private Supply :Dnlled.!By Address �aA.� C� c R S T'Q- 115-19! PST 1J/1 M ✓ ALi_�i J_ `� c Building Type "�jYJ� �Aftit IL�` �$�1 �! �➢�� No of #Bedrooms L�»i °. Date Permit Issued C% Has Erosion - Control`,Been Completed ?, -�� �' 7 •1 I certify that the'sysfe'ri(s) as listed serving the atiove premises were constructetl e�l�N" y,as+elWVyn iirpp�fje ns of the mpleted work (copies`of which are attached), and in accordance with the standards rules and regulations plans f�iihd ?a P�QiSni s5 the,, P am Co ty Department of Health. i a °• .J !? P t-1 i� L. 4-'A ✓ A AJ Date i�L�f -1Z , Van i >� Certifie by_' Q� ' °3u1_�1i/'AIJ • 'iYi►EO 2e Lt Pt.G, Address 1 0a 88 iC CJ oA 9 ►G� 4 License No - l Any: person occupying premises served by the above system(s) shall promptly sucI��ction as a �b@�Secessary to secure the correction of any unsanitary conditions resulting from such•-usage.:- :Approval of the separate sewerag ai)?pepa(8% no4o4 VC'void as soon ass ' a ,public sanitary sewer becomes . '61 ':. _ available and: the. approval of !he , private; watersupply, shall become null and dote; Reaaplyblt .vbWtii? supply becomes available Such 'approvals- are subrect`tb modification "or change when;' in the =judgment of the 'Commissioner�mj! i ovation, modi#,icaLon or change: is necessary. .T_ �� .. ,� .. -... ,.. ... -` _.• �'. .�.,: �. -. I ,171,1. � , Date" Title• � ACTI;RIA PER ML (Agar; ^plate count of 35° C) COLIFQRM GROUP (Most probable No /100m1 )' T HARDNESS„ OTAL ppm DETERGENTS ppm NITRATES (as N) ppm `✓ IRON, TOTAL ppm u Y ' i yaihtC 3 l y, Y s, { ... �" 1 K N 3 c t P ,.a ,¢1cGyr Y +� , S.r ,}• `C� ! i n �-•-., �:.,.;.s+- c,r+.: .'�. -': - _- c.-.�, ci x.. v�� _ , . .�.. .._. o..a. -_.: xt �.A: n .. .;oa...- wa... -�,. �.:..� .. .c ws- �cac�tt7ALt c-=,A k:VEK_Y�S 10-DC., awe C> V_ •P LC —r>AAA VALLEY Owner or Purchaser ot' Building. Municipality �ecac��c�L ALe GAyr_ � .. c �� , %A Building Constructed by C�0 %-Awl �aA� Location - Street Block �o�;:.t. —s7 Building Type A- Lot s GUARAtiTY OF SEPARATE SE" E SYSTEIi I represent that I am wholly and completely responsible for the location', work- manship, material, construction a ~3 drainage: of the sewage disposal system serving the above .described _ property, and that it has been constructed as shown on the approved plan or ap_roved amendment thereto, and in accordance with the standards', rules ana r °gulations of the Putnam Ccurity Depart.,,ent of Health; and hereby bra t; to the owner, his succes- sors, heirs or assigns, to place in goodV condition any part of said system constructed by me which fails to o, erate for a period of 'Wo years immediately following the.. date of initi -1 use of the seti-,age . disposal System, or any repairs made by rrle . to such system, except where t",e failulre to operate properly is caused by the willful or negi` gent act` of the occu- pant of.the building utilizing the system. The undersigned further agrees to accent as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vices of the Putnam County Department of 1EealtIn as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 41 %A day of J :_-t 19 7 i Signa.ture Title seuo NoY if corporation, give name and address) ..THREE (3) COPIES..ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE 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 M A t? NQ , \ i 7 `�1�a C 1r 1Jf3. WELL DRfi Rx;S ,LOG AND REPORT v Tex ��:s ►��. �z� Well .,a�.. � = _ °r County of S �� Name of age ; P 'ace i ill o own t rYUk'r�p�'�1'fJ� y-��.��' �+- �•t"'ir/- �-'tir'�g �5 -:.. Toll' ®' :1'illlAtes.�1.'� I/1 �.Y /%� .,..�•_"" � -�?. �.._,.F_ . `. , " ;epth of tvel3ayo `Diameter��'" > Yzeld ( Was well disinfected ? — - A� -fit :,. gpme yes or no z{ i -Amt. of casing above ground %� Be�kop,'i rgr©und Well seal ,� � ft. packer, cement' grout P k 7 1 Draw a well'diagram in the space provided below`aad sh the depth of IM {'casing, the well seal, kind and thickness o•f, forznatMIDIR � enetrated, water bearing -formations, diameter of drill holes with dotted lines and �� casing(s) with 'solid• •lines. YWELL DIAGRAM - FORMATIONS PENETRATED,, � 7tARKS i Diameter in., Depth Kind, thickness and Type of we q �i in ft.' i water. bearing Drilling mehod ��. ` GRACE _ _ . `Uri las ti� e d am,ted. s y � 25 - PUMP�ING� TESTS Details Wl #2..._.... #3 Static dater i s�; level, in ft .s i .. z 50 below grade }$ -- Ty3._ ,.. Pumping rate ; °z r Rf } r } in g. p m. Pumping levelzn } ft. below F3 F �.._•� - Duration of u PS r� 100 } test, in hrs.a jI1,TLR AT ETvI1 CF TEST . j' --- 00 1 E Clear M4` Turbid 150 Recommended r of :pump in ! well, feet t; ehrade 1 WELLS IN SAND i 200 o Sand Eff, size, ,......_.�_._ti Unif. ,Coef. y Length of screen f Diam. of screen 250. Type of screen Screen openings x NI A COBM4NTS : . t f F � . .. ;• � J yN,���y� SAG i Draw a sketch of the property Ion the back of this sheet Drillin g st�rt `� Completed �w i locating the well and sewage f disposal systems. Well Driller pw Signature' }mot y�1{ y,ty i ,YOk - r o :1 .......... Nk A I—Ile le 11;e 1 �4r�" aj C=f- dv 17 u'.. ' ut ja a 0 Z w 0 1r) 11A = I K K% k v v \ w - w (n ...... ..... ON t� mho jV f, 07 qxX CIP ir 10P -Lo 12 ol t t Z U Z W cc z \L1 40, -- ...... ..... ON t� mho jV f, 07 qxX CIP ir 10P -Lo 12 ol t t Z U Z W cc PUTNAM COUNTY Division of Enwronmenfal ­W6a ',SYSTEM' ,',._�-.-CONST13UCTION::.PERMiT-'FOR SEWAGE ,DISPOSAL- . -A '�%Town or village vz; ea. ca A:�i j ocaterj�,-a_ lock, 77- -7- VA,c>. -r. F, Le Y Lot; Are. 7 square Feet Number -of Bedrooms li eal -feet,, -X width trench - System `Separatel±sbwerag&,, to Tank J To beG constructed by' Address 'Water,Supply:, �2 - 7 PeiVatd. SUOOy ,to by Address 7, Other Requirements �y NZ-) t �wmole� the proi� idi�ijs); I al: r�n..W h o I I y'a rid e!,y r!sp?psii and,A6:cati66.. of qse sv,, f d' I represent that b!e" o��ttte., e�iOfi i 1) that the.,separa - e sewage disposal system I t to and i cordance with the sta ndard Liles %of the Tutnam above.diicribed will lie constructed as shown bri,thd,i0proved amendment, here t n ac ano,regulations completion hereof, a "Certi ica on County 'Department:_ of :Health and tKat on c' 6' 't if t e 'Otif4vj omp lance satisfactory to the'C6ryimissidner of Heal hwill ,fie submitted o1l�'e.,.Depa.r_rpont, and �,wriftbri;guWrdrhee will. be.,., t1h -buildeV,ihat-,`said builder will 4 of 6i� ollow lace Jn,goo . operating 6n­6'Mb`n_':ar�y-, par, -,o -saf sewa6et ipi;� %d date bf "the; ^issu - d teIN -Val ►*j?Y*AV7!tan; repairs- therel:6'f:2):tha 6e�jclrilled-V"'Il descrlbed above anci'of. the approval- - bf,thei��rtifii:aiti-�-�of,..C:6rfitrudtioh Cdffipliani s n stai �wl th standards 7rul will beldcated As shown on- the -ap'p,robved, plan-aiid-that -'siid we -wi 0 d e OLitnam County Departrnent*.�oi Health-" 'V Date 7 EPA H 05 Sck C�S 7 Address i License N ;V-'APPROVED FOR CONSTRUCTION This .;apOr6-vi_1; 6 xpire 74 h I d I tj construction n i' ildi h ndertaVeln.. and is -:,revocaI?je or�ca' ie_q,r',ffiay48 o n �r,'p IM Any -change�. altdraiior -�t u a� e n d od.itieq...wDewconsidered n% I - . i 0 tructiori. or On! it. disposal UO wsar ry,.-.s a L U Wes r�e p 46�jtbVid 'Jordi, domestic y Y. er. _yta tzll Date a Tale ? o' i:fi 77-E% ®EPARTMENT OF HEALTH xy -W PERMIT -.,SEWAGE - tM, ,,,FOR -7' -Town, 7or vil iagii� 7 Located at A- O Sectid /�Rlock Sri A- ivision Job -Subd :Owner d "z `Spic Number of Bedrooms :.TotaF �Habitable, --F quare—eet" Separate: Sewerage_System.to� '' �� Gat -Sc�iitic- Tank V s irench consist of -' W1 The Supply PijbA6 yppI' "FY qM T ,y-,,r,_ f 4"M Private UPPI %97Jr riva e "0 Other eq .......... ......... z J, I: represent w ' esent that 1�,awhollyand . co - mpleti. ,above described �'onst�,­ "t" -a's's oun y ,Dep 'j'!.gand, ha bet submitted Au-the Depart an pate 4A- 77� 4 _ Address g APPROVED FOR CONSTRUCTION This approval exprres e,, ,,r revocable for cause or may -�be amended or rriodiflad. when consitlE Go rid dt!bh-7bf'.tKb'-proposed , I '-sy'sterri( INt"66..., sip�irate.:sewig6�diti5o�sal-'sy . s,t there -1, -11 -1-1111 .0 - - I ". - , in , t - t 6 ... 11 d !.�knd,%jregulatio n tificate of Construction om v at�isfactryy .4 rri fShed ne,owner, ,imilb s9qs I � " r,,: that system; during the period o @two +y, rs i -- Iy `flowing the date o theAssu O thelor iginal sy it b thereto 2)jfbg i I d � 1`11�p`k�i6ed:Wbove "I n i st alled in ,accord n a of Jhe,-::Rutnam R, A IW - W.;!z A use No "x: n ate�, ss ea. oM- f undertaken „an d is cessary., y- th! ” 04 t ruc ion. kewage,-..,an or :pr!v iv 3� n December 17, 1970 Sullivan & Thiede Clark Place Ma.hopac , N.Y. 10541 RE: Proposed sewage dispolsal'system for Mr. Einar Anderson., Woodlaatn Road, Brookdale Gardens' Putnam Valley, New York Dear ter. Sullivan: Your application fora sewage disposal systei for the above -noted property has been received and reviewed by this Departmento .At this tide a.t- inporary approval will be -issued. Construction of the four bedroom dwelling may begin, A final decision as to the•design of the proposed sewage disposal system. will be pending new test data taken in _ .. the . x�zrir�- ...og_. 19- -�2 0 - • - - ... _ _.. _ :. ... _ . _ ... _ _ _. __ - - - - - Very truly yours, p James d, DeVito Enviroaamental.Realth Technician COUNTY BOARD OF HEALTH •-QEf2ALDYN£ "A:'�7AMOYSICi, Aq.lh. _ ,r `"���NA -�Vi- 4�OUPV 1 Y -n �- - = ��A- `J�=H��%'^S ` - . 'President CA 6-3641 DANIEL SELDIN, D.D.S. Vice President JOHN SIMMONS, M.D. HARVEY PRINCE; •M,D. DEPARTMENT 4F Deputy Commissioner MICHAEL ROSENFELD, M.D. GEORGE A. HAUGHNEY, P.E. COUNTY OFFICE BUILDING Director of Environmbrttal LLOYD BROMFIELO CARME'L, NEW YORK 10512 Health services RAYMOND JONES ELAINE K. KRUEGER, R.N., M.A. KENNETH C. CARLSON Director of Nursing December 17, 1970 Sullivan & Thiede Clark Place Ma.hopac , N.Y. 10541 RE: Proposed sewage dispolsal'system for Mr. Einar Anderson., Woodlaatn Road, Brookdale Gardens' Putnam Valley, New York Dear ter. Sullivan: Your application fora sewage disposal systei for the above -noted property has been received and reviewed by this Departmento .At this tide a.t- inporary approval will be -issued. Construction of the four bedroom dwelling may begin, A final decision as to the•design of the proposed sewage disposal system. will be pending new test data taken in _ .. the . x�zrir�- ...og_. 19- -�2 0 - • - - ... _ _.. _ :. ... _ . _ ... _ _ _. __ - - - - - Very truly yours, p James d, DeVito Enviroaamental.Realth Technician 8-� SULLIVAN - TRIED – x CLARK PLACE 3 MAROPAC, NEW YORE( -10541 — NTotes , 1) Tests t0 be rep_eate' at Sa -e deoth U"1--i1 appr0 =-el,.r emu 1 so- rates are OtJ- talned a.t e_ =_ch be-Cola' 0-1 teSt hole . All data -o be submitted for 2) Dept h n::e_.s e -e7 is . to be made -from :op of hole. FUT�a`1 COtJ� ;! y �� RT. =•:T OF - '= .LT,- f DIVISIO�i OF E`;�TiP01 -'r :T_aL Ta',LT� S�?T-C?S 3. DESIG`. DAT� S::FFT. SLP` -1ATF SS`':�GE DIS_ �SaL SYSTE %. FILE \O. Ct�'ner �o�ka�A,L� GAt2.t>E>JS, Add. eSs P.>.: ,a P. Va.\.L-tr -/, E' -�t� J, S •_ t)i- -y tm. i�'t_ Blocs E Lot Located at ( 2�.4. -r` ` _ (Indic.. -_�e r -- �St c_'Oss V ALLF -') Municipali y acute o� P +.��� -. aLershed �.�V: :Ly L- -_ t- ', oL.L0 aV_ooi; 1. e(, SOIL PERCJLAlIO`: TEST DATA REOLTIPf`'D T.0 B St.'s 'I --E D ..IT1 ppLICATIO\ t Zo Hole 3 ,. P� ��ur5e'^ CLCCK TI`IE �?COi��TIO�: - PEP,CCLa'! _��`: 1n Elaose De ?_- .o ..a_'„ ;.aver ie.e'_ NTo 'ime FrO: Gr0!r:` S:r_�Ce L -1 I:,C',S so; ? =_° SI_a_ St0? `.11.. Star _ Sto? Dr0? l- � T J fin/ , c= c Inc ^_s Ir.c' -.�s 8-� SULLIVAN - TRIED – x CLARK PLACE 3 MAROPAC, NEW YORE( -10541 — NTotes , 1) Tests t0 be rep_eate' at Sa -e deoth U"1--i1 appr0 =-el,.r emu 1 so- rates are OtJ- talned a.t e_ =_ch be-Cola' 0-1 teSt hole . All data -o be submitted for 2) Dept h n::e_.s e -e7 is . to be made -from :op of hole. Z-a 3. 5 i 2. E' -�t� t.c15 ►S 1' 3' 1. e(, z' o® t Zo z7�5 3 s 4. 2 t:Z i'.d►7 t ZO 23 3 �. �. 3 114-1 o 3 , 4 - — - 8-� SULLIVAN - TRIED – x CLARK PLACE 3 MAROPAC, NEW YORE( -10541 — NTotes , 1) Tests t0 be rep_eate' at Sa -e deoth U"1--i1 appr0 =-el,.r emu 1 so- rates are OtJ- talned a.t e_ =_ch be-Cola' 0-1 teSt hole . All data -o be submitted for 2) Dept h n::e_.s e -e7 is . to be made -from :op of hole. SU I T T E APPLICATION 'TEST. PIT 'DA _z _T D 7z D 2 0 '0 0'7" S NTERED EST IHO L c S DESC0T'DT D EPTH RoLj E NO. I HOL YO HOLE N 0. G.L. 6fr 12" 2 4" 3 0:, 36'• 49 5 W, 6 0" 66?1 7 2:* Qp-V- L FILL li U21, E.- UvT ABA. c Qv ftAv e- 'Pk N6, L- AT -T L- L Ali 78 0. cz, F- c, u w� A,-r ET- Tj -NC�o U I N D ICA T:`.* VE 7 A �.-t.-IjCr7 G'l )-> C> L- F-V�> L; R B, INDTC-ATE L11"VH, T G -,71 '1 C!-r TER LEVEL RI S 7 :3 AFTE, E IN G t. COUNMI E D '.'A ER E TESTS. KLADEE� Date %k A.y z8. 0, 1 ct -7 k soil - L C -,/l D r S. D. 1: S No of a - o.- 7 2 _c Tan Ca 2 1- Gals e )LA Absorption a Rr- ovide d By 240 --L. F. x 2'-"' 36" t..,idtin trenclh, Othez, (? 00 SiZ7. ature -vv 9.-' Address SULLIVAN - THIEDE • CLARK 'PLACE Z 0 P. 0. JOR 308 LT.' 0 F HL-n H PU T\-A,-f 0 C U.- Vii'_ E Soil R. a t e -1,oproveL2 Sq. FtL./Gal. Checkle d Date PUTNAM COUNTY DEPARTMENT- OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH,SERVICES DESIGN DATA SHEET - SEPARATE..SEWAGE DISPOSAL SYSTEM ..FILE NO. Owner /?oo�yl� -�.g 4.g��t ln/� Address :r� 3vr.r/ Located at (Street), ,g�oo,rc a/�1oee�_ li7___ Block / Lot ,t ...� /��/ ° (Indicate nearest cross, street) Municipahty, Ao, nNA� v,4LLL}y Watershed,D �-/cs _(L.4: 1, o J. �.. ' SOIL PERCOLATION TEST DATA'REQUIRED TO BE SUBMITTED`WITH`APPLICATION S. Hole :. Number: CLOCK TIME PERCOLATION PERCOLATION Run Elapse `` ';`Depth', to'Water ::' Water Level a'. No. Time: From Ground :Surface in- Inches Soil Rate Start Stop Min. Start. Stop .: Drop in Min/in'.drop Inches Inches Inches Z4— 1a 2 4e- 3 zz 'or 3 4 , .n 5 . .w._,...... '• �.,.� �; �:.,� � o s�� -� 4 < as fi �� 5't to Notes': I 1) Tests to'be repeated at same depth until approximately equal soil rates are-ob- tained at each percolation test hole..All data to be su1.n:itted for review. 2) Depth'measurements•to be made from top of hole. 6" G.96r �oN � /P6 L� uSE .3E11�G�� / � / / —dv.✓c �io�✓' Box �O e JUN 971 POT COUNTY DEPL -OF "HEALTH f. DIRECTOR, DIVISION ENVIRONMENTAL HEALTH SERVICES - -.. �� � 0 ��` 4 �PC°.PF. .� /vB' nb.-- ....4: / <�30-..G.RC. ' "SE.G a"!G >Hi✓. ' Y �� ° ti•, . CirT°.ec- r rr i p' � \ Q� r/rNC> oN .�m,�' 'l 11 S- YSTEi ✓i TP CO/. /i�=G+'E' /'�J J'v"i T.ti 9.G .t I - - - - -_- _ -_�� �_ �_ ��•,,/ n'� �F'uc. E• S �.�'` .GREG U.G.97' /rJ'_�1�5' o.� T-rC' �. / ;'" a A? A• 2 " �°C/T.�f�.?�is�J �o//NYY G�CF�9.t•�T /17G"�il/7' ... .mss' Off' Nt°r -i"DiC T.h! Oi ✓ /.S /Oiler O.c' E� / ✓ /�°ON; /�°')�TlG.' !....,,i' __-_-----_- - •!' c%V'.3-v T/JB.GE M/YlE.0 /ip.G ,��-MOt E-o .cco/%� I'1 Mfr- ,E�ff'✓isCd> PROPOSED Sd•'ry'.•�G: E v /ss+°a svt .a.� e'-> � .�E.�.c - .9cc-� o sE,�c.✓ ,c s�.c.c / ✓�9.✓ .s? �`. - . it // 3 =�'- .ee �. �v .-_.� v.,-c� �--„ � r✓; a'. S. .c /c. n o. 2 #B9S K SOIL PERCOLATION RATE ..... ...... ..yMIN /IN I /,2So GALLON SEPTIC TANK.` DEEP TEST �vo ,ce'c+�r �eoc -�C 2'RO LF X-2-6 ABS. TRENCW ' ESTABLISH ELEVATION OF HOUSE TO PROVIDE DRAINAGE OFLpWEST FIXTURE B.E�noCO�'.GE Gfi'/E'G7�r ✓S /N'C TO SEPTIC TANK AND FIELDS ...... AREA RESERVED FOR SEWAGE DISPOSAL SYSTEM TO REMAIN UNDISTURBED.ALL CONSTRUCTION TOE' ONFORM TO STATE ' AND LOCAL STANDARDS AND REGULATIONS ......... .I sG� '^J r.•rr �wvf+ ,. , vcoc.c' c TOWN OF PdriYAM i'iJ.C.Ct'"Y •.' . kT`''d: GvrN.rAM COUNTY. NEW. YORK DATE 6-/ -7i SCALE J08 NO. 7o - /BY II ` - CONSULTING , ENGINEOS CLARK PLACE MAHOPAC, NEW YORK 93 i it � d .� D.c'c6c B �+,� � - �o.4•r ` L / _ O�✓E' F.9/�a /4Y //o uSE A ) �• - -.. �� � 0 ��` 4 �PC°.PF. .� /vB' nb.-- ....4: / <�30-..G.RC. ' "SE.G a"!G >Hi✓. ' Y �� ° ti•, . CirT°.ec- r rr i p' � \ Q� r/rNC> oN .�m,�' 'l 11 S- YSTEi ✓i TP CO/. /i�=G+'E' /'�J J'v"i T.ti 9.G .t I - - - - -_- _ -_�� �_ �_ ��•,,/ n'� �F'uc. E• S �.�'` .GREG U.G.97' /rJ'_�1�5' o.� T-rC' �. / ;'" a A? A• 2 " �°C/T.�f�.?�is�J �o//NYY G�CF�9.t•�T /17G"�il/7' ... .mss' Off' Nt°r -i"DiC T.h! Oi ✓ /.S /Oiler O.c' E� / ✓ /�°ON; /�°')�TlG.' !....,,i' __-_-----_- - •!' c%V'.3-v T/JB.GE M/YlE.0 /ip.G ,��-MOt E-o .cco/%� I'1 Mfr- ,E�ff'✓isCd> PROPOSED Sd•'ry'.•�G: E v /ss+°a svt .a.� e'-> � .�E.�.c - .9cc-� o sE,�c.✓ ,c s�.c.c / ✓�9.✓ .s? �`. - . it // 3 =�'- .ee �. �v .-_.� v.,-c� �--„ � r✓; a'. S. .c /c. n o. 2 #B9S K SOIL PERCOLATION RATE ..... ...... ..yMIN /IN I /,2So GALLON SEPTIC TANK.` DEEP TEST �vo ,ce'c+�r �eoc -�C 2'RO LF X-2-6 ABS. TRENCW ' SEPARATE SEWAGE DISPOSAL ; +t SYSTEM B.E�noCO�'.GE Gfi'/E'G7�r ✓S /N'C sG� '^J r.•rr �wvf+ ,. , vcoc.c' c TOWN OF PdriYAM i'iJ.C.Ct'"Y •.' . kT`''d: GvrN.rAM COUNTY. NEW. YORK DATE 6-/ -7i SCALE J08 NO. 7o - /BY SULLIVAN - THIEDE - CONSULTING , ENGINEOS CLARK PLACE MAHOPAC, NEW YORK 93 i it