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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.14 -1 -17 BOX 34 Nil Is J 1 y' r le f ` • '• 17' 1 T • 1" . yIL 1r SRpE�gVSiLE02 @^lpA�yB� ®R^�►Tp ®DIES DRCYrJ�R, WATER ANALYSIS REPORT SAMPLE PTO. 3561 SOURCE: He f nz Geyer well Putnam Valley, New York coL xcTED: Dec, 3, 1975 . B�•_ LoutisytaZanchuk- & Son,, Inc BACTERIOLOGICAL EXABMATION Coliform Count, MF Method This result indicates the source 'of the sample was of satisfactory sanitary quality when the sample was collected. Dec. 6, 1975 0 per 100 ml. ownFF or PurcEas-e—r-57-Bullaing Municipality BuIldIng Construct6d by Sec tion Location = Street Block Bunding Type Tot GUARANTY OF. SEPARATE SEWAGE SYSTE14 I represent that I am wholly and completely responsible for the location, workmanship, mater'ial, construction and dr ainage of the sewage disposal system.serving the above des'6ribed 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- ..th.e.Putnam County Departrn9nt*,.6f, Heaitti'p.*`iiiid...h'b"reby Varant y to the owner,:: ni s. succea- sors, heirs or assigns to place in -good operating . condition-any part of b Tvihl c h operate arate for a.p.eriod.Qf two said system constructed by me rails to years immediately following the date qf jnitial- 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.wil:lful or negligent.act of the occu- pant.of the building utilizing:. the: system. The u.ndersigned. furthor agrees to accept as conclusive the de- termination of the Dirbctor.of. the 'Division of Environmental Health Ser- vices-of the Putnam County D9p'Jar.tm9'nt.--,*o-f ---Health as to whether or not th6 failure of the system to operA.t,e..!wak: qausad' by the willful or negligent' act of the occupant of the buila.fi g ' tiji ing they _ system Dated this day of J.9_;�, 7 Signature Title (�'CG`� (If corporation, g1ve name and address) --- - - - - - - - - - - --- - - - - - - - --- - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) -COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL.0 ISSUED. GUARANTOR IS REQUIRIEP TO FILL ROTIC4 QF.RM OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- Division of Environmental Health Services, , Putnam County Department of Health ., �:"- cs.;. v <"^'^1wi�• ®- ..�."...�..T'•.�,.. c Heinz Geyer Inc. Owner or Purchaser or Building Municipality Heinz. Gayer Inc. Bui ding. onstrructe- by Cindy's Lana Geyersberrgy Futnamn Va11eYpN*Y. Location - Street 2-story contemporary ui ing ' ype section Block 9 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 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- as: -Pl m....failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the syst cX e Dated this 7 day of " l9� -Signature ,✓ Title 4�� 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 7.�- O e ��. ��y. �• - Uq �'... .. ! 4! 4 07 0 ADDED /� 7 j t LEVEtr FLOD 7707.5 aR EA,f>•r -lC1' ..� -,•CIa�BRr; t,S i+RE �..w.,,,,..r y. .., �� t•�' f- __. CT'YP�GL, ��'F�455�6 _ •�`,x iy• UP' S ' 8E, R R C. 1 O'�2 560. 01OfeSS1'0 10 /'E17 9ine(?fi179' .Lond 15uryeyi179 Rtnr�ntt�wrn3 N t /2d G /enei do Ave/) ue Carmel, /V. .R ' 1 to t .1•h,/µ 1°r„'«�q } -' -_ l +' .: SS .' t `..• AV '};' rFt ':... -. '. ,,. .� ° "* ^. ,. .. 1....1. ..,.... ,.. __.. .... ... ... is .'.. .. ..t .. ,h �f AS BUlLT PLAN i :` _ {4 „_ 20: ,{ NOTE: TN IS IS TO CERTIFY TkJAT 'TNE SEWAGE 0lS SYSTEM WA5 CONS'TRUGTEp AS /ND /GATED ON TNJ -�-� AND THAT THE. SYSTEM WAS INSPECTED .BY ME BF / WAS COVERED OVER_ THE SYSTEM WAS CONSTRt✓ IN ACCORDANCE WITN ALL THE RULES AND j . COUNTY DEPARTMNT OF NEA.LTh OF THE PU T NAM E �' \ i EXCEPTIONS TO ,TJIE ABOVE /FA7VY NOTED 86LOW 9 .. , „ a LATDRA -L ELEvA.T7oiVS A.RE GOOQ. { •'-- DAI rR Ac ro k FiA S 1 /VS'TA G L �E L) ROOF: 09,q 4J S�S`TE7y / E TO CATCf /. F3AS /n/ 6ETG✓EEM 4075 9Q'nU' /0 A P `S } AZSORF,OUDDRT OrJ ORQnJ S 7- M. DK>vGw4 y OA/A<! f soap 1 wo L o ALS © %JEG P Gu, O A j t F Amy s�RFACa w r�rz: o ELBV. F?q... cc�scxSG�°G' cs •, - Bk.D fa- `- I .- D /R[ CJ7bAJ ON_'TNC a� ,S, S bF 7HE ;A wE i4LSC } .oao19 Za THE oR're� /rvac: ouRrR'i� O/?A /n/ /S NoT NLED`C�7 f AS' �U /LT 'PLA'N . t GE D /SP M OF, S.EWA`. 05AL' SYSTE T!E MEN, Ea tIR�M TS s4 r A B: LOCATLON sli 3 4z a4o = 49:0 37'0 SOX iDYV F Pll'TiVAM VALLEY PUTJVAMxr } 4i 40' �o r'' 4a' < $.�.0 so o 0 icx ed /97 k A 7.�- O e ��. ��y. �• - Uq �'... .. ! 4! 4 07 0 ADDED /� 7 j t LEVEtr FLOD 7707.5 aR EA,f>•r -lC1' ..� -,•CIa�BRr; t,S i+RE �..w.,,,,..r y. .., �� t•�' f- __. CT'YP�GL, ��'F�455�6 _ •�`,x iy• UP' S ' 8E, R R C. 1 O'�2 560. 01OfeSS1'0 10 /'E17 9ine(?fi179' .Lond 15uryeyi179 Rtnr�ntt�wrn3 N t /2d G /enei do Ave/) ue Carmel, /V. .R ' 1 to 2� Division :of. �nwronme CONSTRUCTION PERMIT FOR SEWAGE 'DISPOSAL' •LO ted .at a` on in y s° ane Geyersber Subdivision' He�nti ever, - ' J.h c Owner r` 2 stye dtaelling 1 Bu'ildmg Type 3 Loo Area b 1200 Separate Sewerage "system toy consist of" .- � - To be constructed by� �Ph� lsin fit..` Marti_i Water Supply Public supplyf From R Rrrvate 5upply`fo` be �drifled by - _'� Other Requirements Tnatall etxrGalri dra;n'. a 11'. re qui rements, as shown' on In I represent that r'am wholly: and completely: responsible for;the,de above described wjll be constructed'as shown ^on the approved -amel County Qepartment of Hea ►th, ,and that on compleUOn thereof r ' -bes submitted to the Department- ,.-a ; i d a written guarantee :wilt place in- good fb- pedatmg condi ion ''any "part of said s@wage?disl ance ,of- the app'ro`val of the Certrf.icate Of:,C6hstruction Compl vVll be located asistiown on =the appro_ved,pla'n and that said wellw,i County Department of Health rf� x a Date i "� �Octob'er s��� 1�7;i£� * dr ` a «sigJi `� F1P.PROVED FOR- ,CONST =RUCTION �7Th,is 'approvalre)Kpires one. revocable for cause =or maybe amended or modified when consider requires a ;new /r�peymit/ Approved'. -for disposal of domesti 'sa s � r 3EPARTMENT -OF HEAL'T'H lealth Services, Carine% N Y 105+1e EM. : T_ own of ra. jl, — ggS.} -gmw:] �ection Lot 9 = dtlress R "D ` l milli-irli�IM.fti •4 -- SAW of u tnamVa l le y own of ✓ iisga ;`�� -r' _ Block 1072 0 Job - e�,� Y 10579 �� �� Square Feet X width trench and Up. t [rate_sewagal.system rules an regu a ion u nam �r'y to the :Commissionerbf Healthw�ll is =by the builder,, that said ^builder -will ✓ eiliately folldwing, lhwdate Hof the 'W'U_- -; ) ethat the,.;dnlled'.well described above ; es? and =regulat —ons of `the Putnam License�iNO - 'tiwldmg ,has tieen undertaken and-�s Y TChange 9f alteration Of construction w' .'z - , z - ... ,._.. ..._ - -��.. .. ... �- � _.____. ..._.._.. .__. -._ _..._- ,.._�. -_- .:max-,.. ...r -.. _.._.e ..... e.... �. ...� ... -_ ..�..v,l'_ ... .._..... .._. . -.. .c �v- ......�......_.+.rn®ca- W1 -_-.- FLIVTNAM_C.01 TEENT;.QF---J ELEAL—TH, 10 DIVISION OFENVIRONMENTAL HEALTRI.SERVICES DESIGN.,/DATA SHEET SEPARATE.SEWAGE DISPOSAL. SYSTEM FILE' NO 1072-i-560 Heinz Ge ye r Inc' Address es s D 1 Putnam Valley.,' 'N,' Y. 16579 Southerly.side Cindy's Lane,. approx..650 fto. Located at '(Street)east of Peekskill HoIlba • 119 Block - 2 Lot 9 (Indicate nearest, cross street)-*Geyersbbrg MunicipalityTOwn of Putnam Valley Watershed Ne-vi York City' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATION 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 top of hole. Hole Number 'CLOCK TIME .110:25 PERCOLATION 12 PERCOLATION 25 Ran 12 - - Elapse. Depth to Water Water Level 13 No. -.13 Tinie:-. From Ground Surface in Inches Soil Rate `13 Start, Stop Min. Start Stop Drop in Mirx/in. drop Inches;- Inches Inches 5 110: 11 10 :24 13� 24 2 5'� 13. Min�. 210:24 10:37 13 -24 25 13 rf 310..3.7... 10 1-1 0 3 .26 'LL 26 13- .4 3 4 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 top of hole. .110:25 1Q:'37 12 2la 25 -1 12 - - 21, 0:17 10 50 13 25 -.13 3 10:50 Al: 03 `13 24 2 5. '13 4 5 2 3 4 5 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 top of hole. :� �J+' �:� . _ � tip.. `,�-a! ,c -7Y::. v.. -.E� ``.°�r:.av r °.�.� � ,. _-N•_�N :'T' ¢. � ii- r- ..'W >c-- v% -t��•. ,-.. ,.,. -..-.. ... w � ' ' y,.a .fiw. �<`i.:._�nri'.:do ":n'e:a -..-.v �t^by •yxn,,.ma ., -':T. o,'e. TEST PIT DATA REQUIRED > .T0 13E SUBMITTED. WITH APPLICATION DESCRIPTION OF SOILS•ENCOUNTERED IN TEST HOLES' DEPTH HOLE N0. �;...;..., .HOLE , NO. - HOLE N0: G.L. Topsoil Topsoil 6" 12" Sandy Loam Sandy Loam 18" 2411 . 3 011 N 42rt - 4811 Sand Loam with clay small stones(packed) 5411 - - 66" 72,1 8 4" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED none at 8' Orr INDICATE LEVEL TO WHICH. WATER LEVEL RISES AFTER BEING ENCOUNTERED none at 8 t Or' TESTS MADE BY burgess & Behr, P. C. Date July 19. 197LL DESIGN Soil Rate Used 13 Min/1"- Drop: S.D. Usable Area Provided 5300 + -SF No. of Bedrooms 4 Septic Tank Capacity. 1200'' Gals. Type Pre cast. cone. Absorption Area Provided By 32D . L. F.x24" 36" X width trench. Other install curtain drain as per plan and comply w1E`F 611 o -her .requirements. as sh on Name Roy A. Burgess Signature '"fit Burgess s s& Behr P. Address C SEAL it .0 8-Fors9pound RZI e , Q° s+ PUTNAM COUNTY DEPARTMENT OF HEALTH Soil Rate Approved ,,�_Sq.. Ft. /Gal. Checked, h `�s. ^►o. "`' Date v PUTNAM COUNTY DEPARTMENT OF HEALTH •.� ..,�.�- ,,:,�'.•�' 4 . �.' v �,.. - �,_..:� �. � .�I � F ..FTNVT- ROIL- L�Y�fEAiT 4 (�-� (!'��} a _' VL��/�1 V�1J ay.. October .7 9 1975 Date Re Property of Heinz Geyer, Inc eesekilalt Southerly side Cindy's Lane, approx 650 ft from 0 ow Rd, as measured easterly o, g y s Lane Section 119 Block 2 Lot 9.%� ::Subdividion of Geyersb4rg m Town of PutnamValley Gentlemen: This letter is to authorize Roy A. Burgess a duly licensed professional.engineer X 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 conformity with the provisions of Article 145 or 1 .?,.- EduQation a Public Health Late, and:.the:;Putnam iCqunty .,$,a.ni- tary Code.. Very truly yo s, f Signed (%I.- ein_ z W e1,99 A y Countersigned: R D 1 Lovers Lane 9x45 J rutn� fey, No Yo 10 79 P.E., R.A., # 528-2144 Burgess &.Behrs P, Co ldBegs® Horsepound. Roa �.GF NEW; Carmel, Na Yo 10512 225 -3312 ByR '` 1s - • 1:,-t Telephone