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HomeMy WebLinkAbout4478DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.19 -1 -7 BOX 34 1, L ' 61 } �.i' 1 { 1 T!�!� • ...3 /86 '' PUTNAM COUNTY DEPARTMENT OF HEALTH Rev Dtvi i f E vivo ental Health Services Carmel N Y 10512 V 01�, CERTItr ICATE Located at i A 9- Owner /applicant Name Mailing Address e ono n am Provide M Engineast .. P ,w�t I( - L --""7 FOR SEWAGE DISPOSAL SYSTEM 4 *0, zip /a �"7 i — A rYl Y el,z Town or Village Tax Map_% 2_c/ Block —Lot ��G{' Subdivision Name Jii, %% Subdv. Lot N J O Date Permit Issued 7 % f�G `Separate Sewerage System built by ©� mfr / /Address /± Consisting of f� S� Gallon Septic Tank and Water Supply: Public Supply From 5GC �3 ' �' %�y Address or: �f Private Supply Drilled by Address Building Type v / S i dd �9 Gtr Has Erosion Control Been Completed? ' Al Number of Bedrooms � Has Garbage Grinder Been Installed? ---+ter - /V Q - - - - � Other Requirements I certify that the system(s) as listed serving the above premises were of which are attached), and in accordance with the standards, rules and Putnam County Department Of Health. Date / Z J A 0/ Certified by_ Address y ��W7 Any person occupying premises served by th above systems) shall promptly take I conditions resulting from such usage. A roval of the separate age system available and the approval of the private water supply shall becom ulI and void subject to mMAI tion ;Z1 nge when, in the judgment of th mmf ner Date BY the plans of the completed work ( copies t filed plan, and the permit issued by the P.E. eR..A. License No. Z Ll 0 9� ft to secure the correction of any unsanitary as soon as a pubs% sanitary sower becomes y becomes available. Such approvals are modification or change Is necegary. L Title +_ PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 3/86• �j19 Division of Environmental Health Serviees. Carmel, N.Y. 10512 Engineer to Provide Permit # _ .. a - -` - CERTIFICATE LIAN CATS OF COMP CE _.. _ • � _ _ - _ .Permit CONSTRUCTION EERMII' F0. N AGE uTBPOSAL` SYST-it,111 - _ Located at l� I— te-- � �i� Town or Village Subdivision Name � �� ° �'•'y Sabd. Lot 0 Tax Msp � Block Lot h Owner /Applicant Name Melling Address / / �/ !3`/��°' ✓ C'%� Renewal ❑ Revision ❑ Date of Previous Approval Town f c� G": s o'7 � Ile.. Building Type ✓ / f''� Lot Area Number of Bedrooms Design Flow G /P /D /� syc, Separate Sewerage System to consist of Z �`Gailon Septic Tank an To be constructed by Q �,'7 e -� Address_ Water Supply: ! Public Supply From or. Private Supply Drilled by Fill Section Only " Depth Volume PCHD Notification is Required When FIB is completed Other Requirements represent ha I am wholly and completely responsible for the design and location of the proposed above described will be constructed as shown on the approved amendment there to and in accorrA County Department of Health, and that on completion thereof a "Certificate of Constru be submitted to the Department, and a written guarantee will be furnished the owns �tucyeI place in good operating condition any part of said sewage disposal system during a VIA i ance of the approval of the Certificate of Construction Compliance of the o►igina ystent�r an will be located as shown on the approved plan and that said well will be installed in Ipa with County Department of Health, Date tj�s Signed s� 64 APPROVED FOR CONSTRUCTION: T.Ks approval expires one year from the'�date is i revocable for cause or may be amended or modified when considered necessary b the el •- nn,u nerm;t- ADDroved for disposal of domesticisanitary'sampaq d /9r pr 1) that the separate sewage disposal system } ondards, rules and regulations of e Putnam jJ k-sfactory to the Commissioner of Healthwill ¢T igns by the builder, that said builder will Pr I ediately following thedate of the issu- ( *eto; ) that the drilled well described above ru s and regu a ons of the Putnam alp 4 Y P.E._ R.A, b License No i building has been undertaken and is y change or alteration of construction, ,/1 n, /-rr- 1 m. ( a PUTNAM COUNTY DEPARTMENT OFHEALTH Rev . 3/86 ? -t f)ivlslon of Enviionmenfal Health Servteee Camel r N.Y. 10$12,,, Engineerto Prov(de Permit # °jj .? on CERTMCATE OF COMPLiA13CE •k =N ':s Permit , `CONSTRQCTION PERMIT • FO �SEWAGE'DYSPOSALYSTEM' p Town or Vlllage o 2`Sabdivlelon Name 3*€ �" iL cubd. Lot Bledl >.�. j �a f ""t ,�"�` ' ltenewal� ❑ = Revleion p b Owner /AppHcantName"�' "'�f�_ s Date of Pro vtoae PProval Mtdling Address �Y BWlding 1j pe ""¢` "� , Lot' Mea'p '� FYII Soctlon Only Depth Volume ,. Namtier, of $ediooms ` I)esiga:Flow- G/P /I)f PCHD Motiflcatlon is R" equired When:Flii is completed 7t eonatst of Gain Separate Sewerage System: o To 6e consteactEKl by Address ,��' Water Supplj i �� ]'dbllc Supply Feom i Address > ors j! ,.w Supply D_rg6d by Addeeea '_- 4 Other Regtdrements :F r ropr8sen a f °am wholly and completely.reapons�ble }or the design and, location oft oaY3t m °b�'that the separate sewage dispOSa)- system , "-$ .above tlesCritiad wilt be cor5tructed,asshown on the approved amentlment thereto and f`tf ds, rutesan regu a ons o > _e. C +� I 'County OepartFnent of lieatth, and.that on completion thereof a "CerUf�eate',of'C stru mp�o�ati tory to the Commisslonar -of NealMwill be. submrtted`to the'Depa�tment; an0 "a written gua`iantee will be furnished'i o ner ccessors, hei� or ass ni by the buudar that said;DUilBer Will s :place in good- operating, cnndition any part of ,soli); sewage disposal system -'duri h io o (2)° yAbu tfnlhediately- following, thednta -f the jug g once of, the approval of, the, Ce►tif�cate of - Construction 'Compliance of the odgi 1 f ir�•t 0jto: j) that_the drilletl;well'descii d,.above wl11 De,loeated:as shown on 1 he approved plan•and thatsaid well:'wJl be,lnstalled r_ i Rye' sad vy4es and' regu a ons of The Putnam County•::DOpsrtment o�f Health - - - �'' e.�: �,. �' TGate y, S �1a' r 2i p E R A Alf? License roo Y APPROVED FOR CON5FRUCT -IQ, T+h s approval; expire ;.one year from the `date Issu r` of, ttie�bu,lcgmg has been untlertaken and is revocable fore cause or may be amentled3ormotlAied when considered neeessary by the Cord th Arty change: or alteiatwn of,EOnitructlon a 'required ,a new. parm�t "A sproved. for 'disposal of domestic s5mta%y sewage, tl/ r privbte -wa- a ippiy,:only. I � � � ��• � ��� Date gy r_ s h t Ptfl \YAM COURN DEPI'\RIMEWr OF fITEALTH DIVISION OF ENVIRONrif: NIA.L. H.EAIdi: S%RVICES Owner or Purchaser of Building Building Constructed by G� e5,4---7 /lG re-'d -! Location - Street Section Block Lot Subdivision Name Municipality Subdivision Lot # Building Type GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I an, 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 hexeby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition dhy part of. said system constructed by me which fails to operate for a. period of two years irrmedia'tely following the date of approval of the Y_ ioat of , Celistruction.: Gpirbl� nrP°,y fob- - the,s6wage .:d -ispo alp` systc or -and: repairs made, by me to such system, except where the. failure to operate properly is caused by the willful or negligent .act of. the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of, Environinental Health Services of the Putnam County Department of Health 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 \ � day of al Contractor (Owner) - Signature -' �on�Name (if Co .) Signature Title O W" er" Corporation Name (if Corp.) Address 9 BLUEBERRY LANE ^ PUTNAM VALLEY. NEW YORK 10579 (914) 526 -3899 Mr. Larry Werten Putnam County Dept. of Health,,,---`,' 110 Old Route 6 Carmel, NY 10512 Dear Mr. Werten: Enclosed herewith you will find a copy of "Construction Permit for Sewage Disposal System ". The Construction Plan has been misplaced. We shall keep on search- ing and as soon as we have located the construction plan, we shall forward same "to you. Thank you. Yours truly, APHRODITE CONSTRUCTION CO., INC. l/ Josep Marinelli im Encl. (1) S PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date' Re: Property of ;%t J _ cG ✓ -lle*_, , Located at � � �,� 7a � (T)/ ' 10 IleV Section jhr Block. 5 Lot G� Subdivision of //� f C'r Subdv. Lot #: - Filed Map # Date Gentlemen: _ This letter is to authorize .!,/ 61 a duly licensed professional engineer, or registered architect (Indicate to apply for a Construction Permit for a separate sewage sy.st'em., to serve the above noted property in accordance with the-stand ards, 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 sy_stem_or_;Sj�.tCG 3._lll.- COXifO rip l.y,�th_:, the. grow %s.ions,o �Ard- •4•. -� =r .ate 147, Education Law., the Public Health Law, and the Putnam Courity.Sani tary Code. Very truly yours, Signed Owner of Property P.E. Address Address Town Telephone Telephone PUTNAM MUM DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL TARTER SUPPLY & SUBSURFACE SERE DISPOSAL SYSTEMS a� REVIEW SHEET � -- C-{ O�N`S�TRUCTION PERMIT }� �}�e 7 .- _ . ��l���" ti�'3,�.�_r..� . t. - :•ri -, — A' I C�iZ%JV VIU 7L�/��. '.. 1 _ . q . s_.« law Dt'�lra iTL�"Ti+— ',•,�i�Y+:7: � -f� —� BY: Make of Owner) (Street Location) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed r v y7v Slopes Cut q/-Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff. size ry " If Pirped.'pi t. & ' -Eox- Shxoxkn- &- D6ta -led- -v-- House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 '0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to'P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -20') Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same CE'UTIFICATN' OV RE'SOLUTION The undersignod,__ eevA- fir Co J- hC. cqjrlx)lrllLlf)ll (linnio or Corpol'11 t loll) duly organized and validly existing undor the laws of (Statel hereby certifies that the following resolution was duly adopted by the Board of Directors of said, Corporation, at a meeting duly called and hold on the day of (f. 1974-- -Be it resolved that the Board of Directors, o resident if there is no 11onr(l of Directors, of of corporation) with offices at C+ hereby authorizes 0 (n@ao of person authorized) to execute and deliver to the Westchester County Department of 11calth,. for and on bel►al'i of said Corporation, an Application for a Permit to Operate a and to execute and deliver any and all additional documents which may be apprf1printo qi� oepirnblQ-in,conne.cti6n-.tlio,re-w The undorsignod further certifies that said resolution han not been rr')Vol,q)(j, rescinded or modified and remains in full force and effect on the date heroof. IN WITNESS WIMMOV, the undersigned has duly executed this Co-rLificate this day of Hoy" lgf,- Ofticer's, Signature; Title: ACKNOWLEDGEMENT STAI IL OF COUNTY Or (LQLAcA--e--) ; On thin dny of 07 i)ornro.mo C-,L ZN e C(-e rte no knowis,. 111111 lillowil to 1111t to Im I lilt & Of tile corporation roforred I:f) in the within Certificate of Resolution, who being by me duly sworn did d1upone njid that (8)110 is ".4 A.-I of said corporation and that (s)he signed 11 name flier Ntft GASPARINJ NOtari. Public in tiic s,.,at, of New York NO: 461068) Ajppo!n ed for VVe 'Chc Sier Cc in` CQI-41111;ssion EX! Was IVlarcil 30, 19 F Notary Putt kf County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services July 1, 1986 Frank Sullivan, P.E. 2972 Ferncrest Drive Yorktown Heights, New York 10598 Dear Mr. Sullivan: < -' - 'JOHN SIMMONS, VD. Deputy Commissioner Re: Aphrodite SDS Construction Permit Application Greenhaven .Putnam Valley, TM 120 -5 -40 Mill Ponds Lot 38 Review of plans and other supporting documents submitted at this time relative to the above- captioned project has been completed. Comments. are offered as follows: ✓1. Deep Test pit data on plan does not include description of soils encountered. 2. Subdivision approval is based on standard absorption € C .,e 1 _s_ .QLS.e;_:an ..sfaipa;: �.... ....__ rapid percolation.rate. Revised permit will be necessary. ✓ 3. Septic tank detail lacks pipe slopes, cover depth and bedding. 4. Water main size is not shown on plan. .% 5. Driveway is not shown. ,/ 6. House setback from property.line is required. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. ours v r truly, mes S. Bens JSH:pt Asst. Public Health Engineer cc: file` JK TWO COUNTY CENTER - CARMEL; N.Y. 10512 (914) 225 -3641 • •' OF •' •' ' 1% Y• EEALTH �• �i� DESIGN DATA SHEET- SUB,S�UFACE S39AGE DISPOSAL SYSTEM FILE NO. Ownerr /c: C - �5 Address Located at (Street) � Sec. / Block .-- Lot (indicate nearest cross street) Municipality i�ls`j/',// Watershed, SOIL PEROOIATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking "' >' i Date of Percolation Test~ 1 SOLE NUCER Q,OCR TIME PERCOLATION- PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches .4 5 gay 4/T C: 3 3 /` e .. a . .4 5 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil. Yates are obtained at each percolation test hole.. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 3 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil. Yates are obtained at each percolation test hole.. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 r { TEST PIT DATA REQUIRED. TO BE SUBAMED WITH APPLICATION -- - - - - -+ DESCRIPTION OF SOILS ENCOUNT M IN TEST HOLES DEPTH HOLE NO. HOLE NO. � HOLE NO. G.L. /G2�� w . -: j:•,- a 2' 3' �a 4' 51 6' 7' 80. 9' 10' 11' 12' 13' 14' INDICATE LEVEL AT 'WHICH GROUNUIali ER INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: ¢ / 1 �'` u% DATE: l� . DESIGN Soil Rate Used 7 Min /1" Drop: S.D. Usable Area Provided No. of Bedrocros Septic Tank Capacity gals. Type Absorption Area Provided By A! PCc L.F. xf24" width trench Other Name d Address FOR USE BY HEALTH Soil Rate Approved Signature 1 � ® ! s /^ -S 7 e e c sq.ft /gal. Checked by' - Date i i } 4 i i ri " r i ��'� � ��f ..J�� i ���' i'!'"7 r _�:. 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