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HomeMy WebLinkAbout4426DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.11 -1 -37 BOX 33 i7 W L A IL ' L . , ii. ii W; f E., ' , 16 - 1 X, PUTNAM COUNTY, 1 Division' of Environmental Hi �' Fri(3�i 'r'9FfCsA E �,- CONb`i R ICTIOIV -�`�NbTFCiANt?& FORFSE Located' at .. a.ti 'Separate Sewerage System built. by lads C� Consisting -of Gal. Septic. Tank Other requirements.' fi .Water Supply `>. Public'.Supply ;From tl Private 'SuPPIy Drilled : BY Builtlfng'Type -Has Erosion Control Been Completed? �mvuslO I certify that the:system(s) as hstetl serving the abov' �{rek, attached) and in• accordance with the standards,` Date F Address' Any person occupying premises Served by the eb 'Conditions resulting from such .u'sage Flpproyalf available and the approval of the private water su,l subject'to otlification...or change when;iin the ; Date •e K• Qf A NT OF MEALT'H Came% N Y 10512 ; �S 1, of Bedroon c own - or' V illage., Block •..J eal Feev X width trench'; h � . Y E Date Permit Issued 1 Ye � Y t � shown on the plans of the completed work, (cop iesof nt which are permit: su th Put".... Couy Department of Health �'+" ^— �` �� �'` '` + •License No. �2 / G ©' �n as maybe necessary to sgcure the correction of °any unsanitary come null, and void as soon as "a public sanitary sewer. becomes ` :public water supply becomes available Such ,approvals. are i such revocation; modification 'or change'. is necessary. rte_.._. � $ ""'�^r• --i —'°- �-- wl - L ME ICAL. 1- 09A.TORY -D - 8 I�f�pi6 terta,6b Bldg -dYb 5ftd' R mPQ-, Peekskill New York PE 7 8777 ' ATE COLLECTED RESULTS -OF:�--1 EXAMINATION -bt. - WATERS -1172 L _I OWNER DATE: REQ 'Paul JGame 7 CITY TILLAGE ME OF SUPPLY -,, DATE REPORTED,, -PUTXAMJfiTA,= ;,b -11 S�,kMPLING,',POINT BACTERIA PER MI : (Agar,plate count at 35 °:) z ° C MIFb RM: 9YP ;RESIDUAL CHLORINE AS RECORDED AT PC TREATMENT SAMPLING POINT POINT. OF --n, aj S Tm. s �2, [cqL-b (CI) /I, RIDES jng,. A TUI :12 NITRATES FLOURIDE (F) mg vl- These results n - dic6te that -the .�water" wds-ysatisfactory e's 6 a quality , wOt,vqu 'VAP -H .:'- PYANI M .'T.,(ASCP) pumpin in gpm raze 75 -",.. ui`ummpinng .revel in Well at _ � � -,_ ;_,1 �`� ,r,,. oun y o �� � _.._....._.....(. -ame -of Place, y, i age oy/,e own. z - � a c': c�.....2' • e :; t`.: � - -�•, _ ..•cam . -�r.. �',. :d.:: "�,:7.':s:a•� e.w' �:m : :Y ••_o __..^'iG r� -. . --e:ta w•'• ::... �tivnez �._s �., - d P*.O* Address :y'.,m, q.,. t.. M. Depth o wci:�_ ?._= �� �,ameter %_�,,,,� ' e3d Gs we � iREn cteds r _ ft. in.m yes or no iAmt. of casing above ! gr'ound / _Below . ,,round ;_W.oll seal af. •rN >��, in ft packer, cement, grout Draw a ,: -11 diagram in the space provided below and show -',he depth of r' :c. sing, the w-11 s'..al, kind and thickness of: formations :.enetrated, water 'bearing fort ia Lions, diameter of drill holes..with doted lines and -- --- --- 13�-- -- casing( s) witli solid 'lined....... :. .... . WG, LL li I.': ': it.ii I FU�2ra, T I UNS i'E?�': Tl '�rl'��D:: REP Diameter, in, Depth in ft, Find, thic' mess and ' if bearing Type of well 7-777// drilling (_ —� water ►nit'�.ud ::.:':y=— ' 200 Grade _! Was well dynamited. ' .. ' 13n1d. e0defsize �. ' 250.-__ , `. 25 _ _ PUKPING -T ]:3`TS r > ` f Details ;1 r2--3 -. , Static aater . .... ... . .............. ..__........... ........ _ . .... level, in ft.. 50 1a6low ,_rade pumpin in gpm raze 75 ui`ummpinng .revel in ft. below -.rade k - Duration of `- + 100 r tc:"at in hrso _ af. •rN >��, .Will.l'Ii� 1:1T .•. _ _ _ .. ear-, Cloudy._- ~: . �..urbir;. -- --- --- 13�-- -- �2ecom; end ed depth ' of p i;u; yn—__ :.... .... well, feet b:,low .•. :rack W� ,'LLS.. IN bY.. D L 'GIL V. t, , 200 Sand Eff, , siz:: .. ' 13n1d. e0defsize �. ' 250.-__ , u� I Length of screen Diam. of screen��� - �- - -- Type of screen Screen a,ieninks x _ •. .:.w a sket%;h of the property r. the hac- : of: t-bis .sheet loeatiog Drilling 'start : --d le- d `_.' S.�WA GE D1.3POS�iL. SYS _. _11Z .: % Well I?:ri ller Si, :.nature d vfit, I I er; (.4 p I cLA-?,� o C PQ -t"WI A M VIA L L& Y. a._. Owner br Purchaser _of' Building-.. ,.. .rt..8si.-w�n:.m:....s.... a. a-+ � $::..ouR�•"".'..'i.�:;yl1i't-�. = •ti.:4'::•.�':= h.a�<< �. Buildin8j Constructed b Location - Street Bloch KivSti� affil l_ 4- Building Type Lot GUARANTY OF SEPARATE S 2j PAGE 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 r?e ti•�hich fails to operate for a period of two years irLmediately following the date of initial use of the sewage disposal system, or any repairs trade 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 aivironmenrual Health Ser- vices of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful, o_r. negligent.,.. : . :act of the�.occupant of; °the building= util.1zng =the =sy=stem. - Dated this day of a✓ 191'f Signature f ad *Title If corporation, give name and address) �ILLS addre s s ) G��c r��; Cv� �MCA ur0A,,m %%ALL � THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP-TTETION 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 I 0 N 1300 CnAL SE -T A r-4, o v 0 rZ L D W F L k % di! di; wt o 0 Z o 20" w tz E-7 E -T L A N. rAl .1 L L Au OJIJ —5 1./ L -r , A4G A 1,4 A 5 6: Z e; 4 47.4. 4c) I 0 N 1300 CnAL SE -T A r-4, o v 0 rZ L D W F L k % di! di; wt o 0 Z o 20" w tz E-7 E -T L A N. rAl .1 L L Au OJIJ —5 1./ L -r , A4G A 1,4 A •Separate Sewerage System to consist of - To be -constructed by��� o- ; Water Supply c,'- PublicSuPPIy From ,Private {Supply to be drilled by Address 1jF r Other °Requirements 4 Isrepresent that.f am wholly and completely responsible for' above described wUl be constructers as shown on the approve„ °County m Department of 'Health, `and that -on compleUon'tH i tie submitted. to the Department, and 'a written'guarante ;place in' good �operati'ng'. condition , any part of''said sewag, Fi ance of, the approval' of the Certificate of Construction ',C :will be , located i1h6wn�06 the approved plan and that said wel_ 'County Departmment of Health dd Date �Git' z I -i7j r ;5 IL t T " ' � • °Address ";0" PPRO:VED FOR CONSTRUCTION Thi; approval expires on 13�/ Y DEP ARTMENT ,OF HEALTH al tHeal ,h Seri) /ces, Cacme% N. Y 10512 (STEM Town or. jI'age ... . �. rrnr A q Block—— r _ x j T 't a'1 Habitable Space 1 ( ©� Square Feet �,/ ,' ' Gal Septic Tanks `77 lineal—,feet 1°_ width bench M1 F $p . n tha. the d separate sewage disposal system , nt _ in ance with the ,standards, rulevan regu a ,ions o e u nam 'Ca f.: _ sic ct Compliance" °satisfactory to'the Commissioner of HealtFiwill T!' ors heirs or a'ssi ns b ''the. builder ' that said ,builder, •will j f etf+ : _ner , ccess ,. 9 . Y 1 _ ;sal (s d of two (2) ' years' immediafely,foilowing 'the date of the issu s st ory y repairs ".thereto; 2)'that the drilled :well described -above q�t Iled I ' w h- he st5ndards rules d regula— Elonsof the ,IP.utriam ' I►o. Of: WE`1 :. >w. .n.� K License No. iar from the date' ,issued uniess construction of -the building has been undertaken ,and 'is, ' 'necess8iy Iby "the Commi loner of Health Any change or aiteiation pf construction y wage a privet ate+ supply only PUTNAM COU11 '' � , Orvision of EnwronmE z ON8TRUCTION O,ERMIT 'FOR: SEWAGE: bISPOSAL' .. j tl' ` Subdivision _,•,.0 Owner" QQ � ✓P�` � * 1 �_ ' �. fit!' CV` 1�0�✓ ;'� F � " - 1 r Building, TypeSBOs�J� ..Nt.C� +,Number ��L° Hof Bedrooms •Separate Sewerage System to consist of - To be -constructed by��� o- ; Water Supply c,'- PublicSuPPIy From ,Private {Supply to be drilled by Address 1jF r Other °Requirements 4 Isrepresent that.f am wholly and completely responsible for' above described wUl be constructers as shown on the approve„ °County m Department of 'Health, `and that -on compleUon'tH i tie submitted. to the Department, and 'a written'guarante ;place in' good �operati'ng'. condition , any part of''said sewag, Fi ance of, the approval' of the Certificate of Construction ',C :will be , located i1h6wn�06 the approved plan and that said wel_ 'County Departmment of Health dd Date �Git' z I -i7j r ;5 IL t T " ' � • °Address ";0" PPRO:VED FOR CONSTRUCTION Thi; approval expires on 13�/ Y DEP ARTMENT ,OF HEALTH al tHeal ,h Seri) /ces, Cacme% N. Y 10512 (STEM Town or. jI'age ... . �. rrnr A q Block—— r _ x j T 't a'1 Habitable Space 1 ( ©� Square Feet �,/ ,' ' Gal Septic Tanks `77 lineal—,feet 1°_ width bench M1 F $p . n tha. the d separate sewage disposal system , nt _ in ance with the ,standards, rulevan regu a ,ions o e u nam 'Ca f.: _ sic ct Compliance" °satisfactory to'the Commissioner of HealtFiwill T!' ors heirs or a'ssi ns b ''the. builder ' that said ,builder, •will j f etf+ : _ner , ccess ,. 9 . Y 1 _ ;sal (s d of two (2) ' years' immediafely,foilowing 'the date of the issu s st ory y repairs ".thereto; 2)'that the drilled :well described -above q�t Iled I ' w h- he st5ndards rules d regula— Elonsof the ,IP.utriam ' I►o. Of: WE`1 :. >w. .n.� K License No. iar from the date' ,issued uniess construction of -the building has been undertaken ,and 'is, ' 'necess8iy Iby "the Commi loner of Health Any change or aiteiation pf construction y wage a privet ate+ supply only PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION -. OF E I .IRONMENTAL ::H EALTH S RV Date 2- Re: Property of Orvc" 15 C4,CV_1 6-C).V Located at `rA'V V44w Ilel Block Lot O 4 Gentlemen: This letter is to authorize : $TNILEY LANDE a duly licensed professional engineer V or registered architect .(Indicate— to apply for a Construction Permit .for a separate sewerage system; to serve the above noted property in accordance with'the standards, rules or regulations as promulgated by the Commissioner of the Putnam.County T1....... J- .•..,. —4- - TTi... 1- -J- L. ..7. d-•.. • 7 -1 � n n n v��r r,n r�� v�[+ nr•� mtr b ehn 1 fl -1 r LG�JtLrli111C'illlr V1 11GGL1 u11, cL11U QV s1gi1 a,11 11�:;C�.uUa,t y �a,rv- +� vii "AJ ..v.ica,.L.i i.. connection with this matter and to supervise the construction of said system, or systems, in conformity with the .provisions of Article 145 or 14T, Education Law, the Public Health Law,and the Putnam County Sani- tary Code. _d �. Jj�t f AM - Lr/� �/ ' a ".y67 2645 e Very truly yours, Signed Owne of rop rty Address. ;1 .f5 dq 1 �:1 1: (f L. `1 I I •r 3 .a 1 t f BASIC FLOOR PLAN AND SPECIFICATIONS MODEL 1104 with GALLEY KITCHEN -- for BASEMENT FOUNDATION or CRAWL SPACE Room Dimensions Shown are Approximate MASTER BEDROOM 13' x 11'6" BEDROOM No. 2 10'1(Y' x 11'6" It BATH 4'10" x '6" 3�y STOrAGI _— 1 L. ` O BATH 8' x 6'6" LINEN BEDROOM No. 3 11'2" x 8'2" KITCHEN 12.3" x 8'2" STORAGE DINING AREA 9'6" x 11'6" LIVING ROOM 17'1" x 11'6" i .. -_ I. .._' .•4 . . PUTNAM COUNTY DES --%D- TLMENT OF HEALTH DIVISION OF ENVIRONNI✓`TAL_HEALTH SERVICES DESIGN DATA SHEET - SEPARATE SEt�GE.DIS?OSAL SYS Tr, L FILE.NO. Owner 13e' 6ev Co ,,' Address Ada -� C u Located at (Street)._ VIA i CC : STv:f:ci' �.. ! �`� Block '� : Lot (Indicate nearest cross street) Municipality f0ya y Cl .PuTA;A -o4 U,�L. e 'Hatershed ACS /LL ---- SOLL.PERCOLATION TEST DATA REOUIR£J TO BE SUB`iITTED WITH APPLICATION. Hole Number CLOCK TI*LIE PERCOLATIONT PERCOLATION Run Elapse Pepti- to Water Water Level No. Time From Ground Surface in Inches.. Soil Rate. Start Stop... Min. Start Stop, Drop in Min/in.drop - Inches Inches Inches 1 4#©o 4! 1'7 7. �b lei 4 5,7 Z. .3 4- O (b ��i .3 (o, o 1 4: o7 4, is 1.7 0, Zo 2 -4- 3 2,ob :?v S • 1 Notes: 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 submitted for review. '2) Depth measurements to be-made from tog of hole. `REO_UIRED' '�0 u " St1Bi1TTTED-r;;T`TH` A PfIUXTI0 -,` DESCRIPTION OF SOILS E�':`,OUNTERED I`: TEST HOLES DEPTH HOLE NO. Pi .HOL-E \'0. FP2, 'HOLE No. Dte� 1 LC 'row is w ,S� tL .. ow ,6'r , 1'2tt 4SA�� I.YZ�1u; Cl S/aup ^`SF2�Gu :..0 SA 0 - `+' Acz: c�.r��. /' !l. — . r� _ 18 i1 2 4" 3 0'T 367". ' 1 42" 48' S 4t1 6O't. 66" 781t it 8 411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED N° `NAT "Z INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS. MADE BY .S. Date to -27 -7I 51 6 _\ Soil Rate Used iQ Min /1" Drop: - S.D. Usable Area Provided Soho _ No. of Bedroo.;:s .3 Septic Tank Capacity 'oc- Gals. Type AjAs- w q Absorption Area Provided By 177 L.F.x2' ". 36" trench. Other Name STANLEY I LANDER Sio atur Address BOX ..267 AAA Y. 1050 PUTNAM COUNTY DEPARTMENT. OF HEALTH Soil Pate Approved Sq. Ft. /Gal. Checked by _'Date