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HomeMy WebLinkAbout4496DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.19 -1 -30 BOX 34 kL 1, 1 '1 ::Ij L r Low ILI I i ` IN, :rL '. Oro : kp 1 1 = 0 • I CERTIFICATE OF CONSTR Located at � ,­Ov►ner ,' PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER ST PERM /J< Division of Environmental Health Services, Carmel, N. N. Y. 10512 �TION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM /�eA;1 0,v /i✓js �,/ /! �o _ Town o► Village / G� s•r 4. Tax Map Block FOrmerFY - % , ...i..... Tax Map ..Lot ' _ J �J" •.�_6� �Subd. Lot ,/ -y Separate Sewerage System built by v �' �'4LJ7 , ��'�� )Address y' Consisting of �« f byl Gal. Septic Tank and O 6 �� /�17d O 1 •�. Other requirements Water Supply: Public Supply From L�N� N J f -S �r V Private Supply Drilled By Add 7 Building Type /4 /fj���a+' � �C No, of Bedrooms Date Permit Issued r'•�� �O �' Has Erosion Control Been Completed? G°'a -- Has garbage grinder been installed? Ala I certify that the system(s) as listed serving the above premises were constructed:essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in a 6°f4th, the filed plan, and the permit issued by the Putnam County Department Of Health. ��@@.• °4 Ci • Date z Certified by P.E. -R.A. Address T $fi. N , License No.`y a''f-- Any person occupying premises served by the above system(s) shall promptly take we s n'as ssaryt Ocure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system sh ms nul and void as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void whe IfMrSgfOpgdgrt�gomes available. Such approvals are subject to modification or change when, in the judgment of the C missio r of H �o utipn, Hication or chants Is necessary. ./,23/91 3/ 9 1 BY h � s:sac cl G N Data Title Rev. 6/85 PUTNAM COUNTY DEPARTMENT OF HEALTH Engineer to Provide Permit # R 3 86 Division of Environmental Health Services. Carmel, N.Y. 10512 y�3 • /�L /r-�� r 17 lf��I� 40 e,*- on CERTIFICATE OF COMPIdANCE CONSTRU ERMiT FOR SEWAGE DISPOSAL SYSTEM Permit # — Located at -� / Town or Village •� Subdivision Name /�-j /-Ze Sabel. Lot # Tax Map— • =Block Lot -� � Renewal_❑ Revision ❑ Owner /Applicant Name / /� yip Date of P,rreevion Approval Mailing Address 1/ �� /1' / Town /' 6/ R Zip /0177 a 'r / e/ Building Type � &/ 41— , A�W Lot Area 'a' 46" Fill Section 0 Depth Volume Number of Bedrooms Design Flow G /P /D ;PCHD Notification is Required When Fill is completed Separate Sewerage System to consist of Gallon Septic Tank and / ZWIV � r To be constructed by Address G ® ®zV Water Supply; Public Supply From Awe or: —Private Supply Drilled by Address Other Requirements r—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 an 'regulations o 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 accordance w th stand ds, rules and regu i ;T omens of the Putnam County Department ol Health. Date , ,,,///r!!!Signed P.E._ R.A. — Address �' "' ' } License No ay " -c APPROVED FOR CONSTRUCTION: This approval expires year from the date ' s e unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when co i red ne scary y C m issignerHealth. Any change or alteration of construction requires a new rmit. App oved for disposal of domesti I.tary wag n r rival w pp only Oat sT - �— ey Title //y 3 PUTNAM COUNTY DEPARTMENT OF HEALTH Permit r J Division of Environmental Health Services, Carmel, N. Y.} 10512 CONSTRUCTION,- PERMIT FOR SEWAGE DISPOSAL SYSTEMS LG�" own or village —� L'Acaia£roi ? ) `iCf. i�7 J isx' -Map ''J aiock -lot Subd)vlfiOn i � v �`J.�/ ,litj Subd. Lot 1 % Renewal Revision _ Owner /Address �r�f'` I t�C�+'� "�' / j�� `� Date Of Previous Approval - - Building Type _ -.._'. .--� Lot Area .4, ! _ Fill section only ❑ Number of Bedrooms Design Flow G /P /D �4 J P.C. H. D. Notification Required y66 Separate Sewerage System to consist of - 1e7 *e:7 Gal. Septic Tank and ' 4� 10c, 5 �✓l �' I�GY►�Sr; To be constructed by i Address Water Supply: s�Public Supply From Private Supply to be drilled by 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 disposals stem above described will be constructed as shown on the approved amendment there to and in accordance with the : VPAaedf ®rules an regu a Ons OT e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compli$ 4 sosf Lt $-jP the Commissioner of Hsalthwill be submitted to the Department, and a written guarantee will be furnished the owner, his succes spS."Qgns t�e builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of 2dP$psnetya s�ollowing thsdate of the issu- ance of the approval of the Certificate of. Construction Compliance of the original system or a rei>� thereto; 2�'iat th drilled well desaibe0 above will be located as shown on the approved plan and that said well will be installed in accordance wit ea r "rules <prid r a ons of the Putnam County Depart ant of Huh. Q Q o n <� � / - a P.E. �RA. Date Signed S, � a �v a 9 Address v� � a L ne No- APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unle e® tiejt 8f3��e,bQ!�''g(�ohas been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Commissio f h.% *Ah CITa or alteration'of construction requires a new a mi/t. Approved for disposal of domestic itary age, -and/or rivate su 6 101k s96s01 Date / Title Rev. 9 -81 PUTNAM COUNTY DEPARTMENT F ®HEALTH Division of Environmental Health;' Services. Caf=md, Nj''Y. ,1.0512 - CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM zv��� Town or Village r �n� Located et y�} � _� Tax Map / 20 Block Owner E` % i` Tax Map Lot N � Subd.q# Separate Sewerage System built by � � Address 11' �`� • Consisting of 5 (;al. Septii Tank and s C ,V -of W� ,r Other requirements �7 Water Supply: j Public Supply From Private Supply Drilled By jAddress _ Building Type Has Erosion Control Been Completed? No. of Bedrooms Date Permit Issued I certify that the system(s) as listed.serving the above premises were constructed ease, of which are attached), and in accordance with the standards, rules and regulations, in Putnam County Department Of Health. Date CertifJod by""�`� Address Any person occupying premises served by th0'above system(s) shall promptly take such action conditions resulting from such usage. Approval of the separate sewerage system shall beco available and the approval of the private water supply shall become null and void when a pi subject to modification or change when, in the Judgment of the Com ner of Heal , 9 }A n. Sf ten, ZVIM9 t 1ial7 t ehiown on ,the' fans of the completed work ( copies sccordaancei"wi't '� he fiied. 'plan, and the permit issued by the ' P.E. R.A. 6 License No. � IV a ` ay beEnecess iry to 'secure the correction of any unsanitary me nulNand.Volit as soap as a public sanitary sower becomes ter supply, becomes available. Such approvals are such revOotion, modification or change is necessary. PUTT )W C OURN DL;FN 1140NT OLD HF -ALT11 U1:di.`•i.I:UN .Ul'.:.r:�tiVIRCR9: iUT'llAf. ;El��`�'I�.oSEL��%IC.�:5 -- _.. Owner or Purchaser of Building Section Block Lot A-0 r7 Building Constructed by l Location - Street Municipality g Building Type Subdivision Name Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSMM 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 tha standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, 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 imnediat.ely. following the date of approval of .the "Certificate o ConstructionY :oinp7'iarice "'"f'o "r °tfie' swage" dipttl syst�z,��r-„lY_._ = 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 (it the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the systeii to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. - Corporation Name (if Corp.) /�. n Address rev. 9/85 mk Signature��z� Q %� =r Title F /Yio�i %C Loius��k,f f /o�J �•�NC,� Corporation Name (if Corp.) Address PUTNAM COUNTY DEPARTMENT OF HEALTH Re: Property of Located at— Date 7 Z/&Z7 I or Block Lot S -00' Subdivision of Subdv. Lot Filed Map # Date Gentlemen: This letter is to authorize— r -4 a a duly licensed professional engineer - r1o"-or registered architect (Indicate to apply for a Construction.Permit fora 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 ari'd t 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, Signed Owner of-Property Address Town k' Telephone JOSEPH F. SULLIVAN, P.E. YORKTOWN HEIGHTS, N. Y. 1CIS98 (914) 962-4248 /emu -71 10, L7 r Own, or.Purc aser of Building Section Building Constructed by • i ~� Block e- 344 Location - Street ` Lot Municipality Subdivision Name 2, Building Type Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 determin- w aian..of.th�_ -IIrt #- r- 3f- �t�ie- �3i3en oof- Etiva onrcient.al.:.Haa.7 tYi. _a ®rvs.ces;::`. of the Putnam County Department.of Health as to whether or not the fail- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 2V day of 19J� Signature Title Corporati n Name if core..) Address THPEE (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 t4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ...... ..... Date Re: Property of Located at I r-� (T) 7""�/�Aze'07 ;ection-, --49 Block Lot 0 Subdivision of Z> Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize- a duly licensed professional engineer or registered architect (Indicate 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 connection with this matter and to supervise the construction of said ' 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, V NE 4; Signed__' 4 / ' �-�• Countersigned: 61 Owner of Property ,iceP E Address Addre s '•. •o ESSIG Town #make 14 r nAiYone r. Telephone MAR 111983 PUTNAM COUNTY DEPT. OF HEALTH PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE - BUILDING;', CAR1V1EL . -;.N -Y.. -,- G.10- 5 12,-i DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.' Owner,/.l�►�y J, C�'�� . Address / ,0- % � j'a % c"� Located at (Street ��- %� �% %r� C Sec. 1.2CI Block-5 Lot indicate nea,,vest cross, s ree Municipality Watershed PERCOLATION TEST DATA RE( TO BE SUBMITTED WITH APPLICATIONS 5 1 . 2 CRA /m U s N&J"A CQt1:s fq r $, 5 DEPT. OF HF_Ay -j'�e Notes: 1) Te'�ts to be repeated at same depth until apppproximatelyy equal soil rates are obtained 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 PERCOLATION PERCOLATION Run apse Depth to Water Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches �; 02 1 i90 212i Z- % 7- 5 1 . 2 CRA /m U s N&J"A CQt1:s fq r $, 5 DEPT. OF HF_Ay -j'�e Notes: 1) Te'�ts to be repeated at same depth until apppproximatelyy equal soil rates are obtained at each percolation test hole. All data to be 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- ; . z::HO!2 , NO ;; _ HOLE NO : G.L. t? t '1C� C ©� >�' e- 611 12" 18" 2411 3011 361f 42" 48" 5 tl .66off 66" 7211 78•• 84° INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED, INDICATE LEVEL T_O WHICH TER_ RISES AFTER BEING _. TESTS - MADE' BY- ' ;,�..' %! t�L `) ,i v!i� ;: ENCOUNTERE i ll��lUlV Soil Rate Used 2— Min/1 "Drop: S.D. Usable Area Provided _:4,e cv, No. of Bedrooms Septic Tank Capacity 5me Gals. Type Absorption Area Pr� o de By Z F L. F. x24" _ a.anlr -,dth trench. OFD NE , °�%,her Address .rC r 2 - 0-+ Ur: THIS SPgE FOR USE BY HEAILTH DEPAVTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by_ de'b� 'o. 248y"po° Date t f � ° l'' Ser✓ at lfc.,t. � a a 8 44 4 p8 ,> s - f i 1 i E Scale 4 ...5 {rq f`-r e ,�.�.� � • �.5�© //'acv/ �G � o `� .2� /K .ZrJ ai "--- 74 Co,rl r,/ Rho h c4 r, e' t ;-I fi" n_rj. . oxe-5 re /cex, A! i m� tr. Ic a 14 7 At Sion COuntY Department of Health If 2nvir ent 1 Health Services on ed or a ormance with Eules and Regulations of the .2 /* 2 21 3 G2 Trop t.�rS At Sion COuntY Department of Health If 2nvir ent 1 Health Services on ed or a ormance with Eules and Regulations of the .2 /* P41 A1& 3 11-5 4�07-,4 ` 4e I 2 21 3 G2 P41 A1& 3 11-5 4�07-,4 ` 4e I 5c. �Q 11D f/ ly 38A p 1lCWo,lc,1.,l .5__ MR ioo0,y® -44nR c 77 i de r7 C- C Ir" 9 9 4- /Yo Wale., Putnam County Department of Health Division of En-,,-',rc.-z,.sntal Health Services A Oc'f.o r* m ance With .p n2a,,OnB of the .store T le rite R F Ila, 5z�� 0 e- a h- 5c---Og47 -Od" 2�"-Slrac /4/1' /45' 10 ,cy3 2 A(- 4414 s LOT M0: 32 s AREA= l8,884 W bh ' N O r s `L om ..'. 1 4 tip Aw •rt i r F R.I h t i r •'p^''�'£+ .`737,..c- .'w�'� -7 �.7e�•�D -:t,.� a �' � �v�I ^;. t.. '' � `' �- £_ .s, s's �. s_ na :. yCyi" c 4. A 17 MAf -, I V �, -.A PfI1 :Ff1,P :t L9 Tl1!d1 iYl /LL G9NPS JHE,`lfPy „}, , • Mq"RCli J3 I984 REY!$E!T CERTIFY TO 1 WON' STATE BAAW NANLFTTF MY { 2' MARATHONABSTRACT LTp =, ,3 THE TITLE 6(/ARRNFEE CQ ( Eii�tF £'I.A�"C}iN5't'�N�itt�h9'Ekt HbR,b.iW S(tNiFY' F`t11�+ / � s SLBdE1: S" PREPARE,yU,, [N Ah(( ,"CEI ITN' THE EXIS•T>Nr CpI)E;pF KL�ACTICE FOR':sLANts S13RbF�Yk a AROP11iD BY T1i 13 Y S 'pSSOC QF,POF6S61 ONA LANIX SJ4RY8YORS ? [�NAUIHKRUED %TER\TIUN OR AllD[j`lON 1FT "PHIS SURVEY 1, A. 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