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04497
Rev. 3/86
C
CERTIFICATE OF CONS
Located at
Ownor /appllcant Name yCr
Mailing Address —jL
Senaarate Seweraoe Svatem hullit
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services, Carmel, N.Y. 10512
Engineer Must Provide �r
P.C.H.D. Permit N
ey,I ? -t -s!
FOR SEWAGE DISPOSAL SYSTEM
.. ;p: . ;�, 'ri. c; r. . _. ,� ..;;.,i . . ;.: _ (a, ::., ... _ ._ °T'awni�r.'yUll�er b' • - :_; ,,m.; •, :"' •�, :,;f
i Tax Map J / --'V j Block ?" - Lot
— Formerly Subdivision Name ;J RSt�SubdV. Lot N 3-3
4 ZIP 1U 37 i Date Permit Issued f f g13
Consisting of % Z -4-V Gallon Septic Tank and
Water Supply: 1/ ' Supply From I °� ' �! r_ L-11'r'r7Address
ors Private Supply Drilled by Address
Building Type ✓ r� Ly Hue Erosion Control Been Completed? -�
Number of Bedrooms Has Garbage Grinder Been Installed?
Other Requirements
I certify that the system(s) as listed serving the above premises were constructed esseri i ��tidiph fthe plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules and regutio la s, ipIac an th filed plan, and the permit issued by the
Putnam. County Department Of Health. r 415 j
Date C� !� ified by `A w P.E. R.A.
Address License No.
Any person occupying premises served by the bove systems) shall promptly take such action esF�Ve sq�e��a y to secure the correction of any unsanitary
conditions resulting from such usage. Ap roval of the separate sewerage system slNll become nulf�6eat5Ylffd'as soon as a pubi :: sanitary rower becomes
available and the approval of the private water supply shall become null and void when a public watW' supply becomes available. Such approvals are
subject to modlfi tan or cXchange when, in the judgment of the Commi loner of Health. such r cation, modification or change Is necessary.
Date
?q,Iq _ P -� t
P
f Iv-
UTNAM COUNTY DEPARTMENT OF HEALTH Permit a
:.:. -.... .. Division of Environmental -Health Services, Carmel, N., Y.. 10512 ....
CONS CTION PERMIT FOfi SEWAGE DISPOSAL SYSTEM
Jam. i I If n Town or-village
Subdivision
Tax Map '4' elocx
Lot a 3 _ Renewal Revision
owner /Address / ✓ fly r l-// ' wl J iJGE / A7 -7 G Z
Building Type/ /. Lot Area
Number of Bedrooms _L— Design Flow G /P /-n
Separate Sewerage System to consist of Gal. Septic Tank
Tn hw rn 0,—taA by /7^t1. J_, / Lr- /� V ✓9�� �
Water Supply: Public Supply From
Private Supply to be drilled by
Address
1•
Other Requirements
Date Of Previous Approval
Fill section only V
P.C. H. D. Notification Required
and .3
Address
I represent that 1 am wholly and completely responsible for the design and location of the
above described will be constructed as shown on the approved amendment there to and in ac*'i
County Department of Health, and that on completion thereof a "Certificate of Construalo
be submitted to the Department, and a written guarantee will be furnished the owner, his i
place in good operating condition any part of said sewage disposal system during the per
ance.of the approval of the Certificate of, Construction Compliance of the original syste
will be located as shown on the approved plan and that said well will be installed in t
County Department of Health.
Date Z -3 Signed
Address
APPROVED FOR CONSTRUCTION: Thi pproval expires one year from a date issued un
revocable for cause or may be amended o modified when considered necessary by the Commi
requires a new perm p�� for disposal of domestiCar :swag lvate
Date By
&
1) that the separate sewage disposal system
s, rules and regulations of e Putnam
to y to the Commissioner of Healthwill
�9srata y the builder, that said builder will
y tl tely following thedate of the issu-
ther °�) thi'the drilled well described above
rtls, i�►es regu a of the Putnam
a
ey.
P.E. R.A.
sg " eLicense No.
O ilding has _b n undertaken and is
nu4;ap chang al n of construction
Title
PUTNAM COUNTY DEPARTMENT OF HEALTH Permit # v
of ° . � ,,� o : o:: �"�_ • , ` ivi ioi, -'uF•E��vifonrhrcl'iai Health Servicos;- Gyrme% Pd. -Y.- !f!5l�.. -, - - • -.�-:- �.� � ��. .. ' 4
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
Town or VIR age d,
Located at°°' "' �� . Tax Map /� clock Loi Jj
Subdivision
sus
Renewal _ (j Revision _
owner /Address 400�P�77111't '�j'� .Date Of Previous Approval
Building Type ��r " Lot Area ly/ ZF �° a Fill Section only ❑
Number of Bedrooms Design Flow G /P /D P.C. H. D. Notification Required /
Separate Sewerage System to consist of Gal. Septic Tank and / ✓✓
To be constructed by Address
s r r7.
Water Supply: Public Supply From
Private Supply to be drilled by
Address _
..r
Other Requirements
I represent that 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 accordance
County Department of Health, and that on completion thereof a "Certificate of Construction Co
be submitted to the Department, and a written guarantee will be furnished the owner, his w s
Place in good operating 'condition any part of said sewage disposal system during the perk) of
ante of the approval of the Certificate of Construction Compliance of the original system an
will be located as shown on the approved plan and that said well will be installed in accordance a�
County Depa ent f Health.
o
Date � Signed
-•f a
Address
•
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issue unlek
'revocable for cause or may be amended or modified when considered necessary by the Commis rd
requires a now permit. Appro(Xv��d or disposal of domestic sa so age, nd/ rivate
Date �, ~`� By
Rev. 9 -81
'n s • 1) that the separate sewage disposal system
A spe�ie.pj rules an regu a ons o o
satiftct to the. Commissioner of Health will
M aisig: the builder, that said builder will
>i arpA0.ett%ly following thetlate of the isw-
irs therel:807.thatAhe drilled well described above
aftaads. r anda_reou aeons of the. Putnam
d • � 4
bo �
P.E. R.A.
s+
- '!4 tense No, y y ;
�►7lding has been undertaken and is
nvs!hange or alteration of construction
Title
/.
PETER C. ALEXANDERSON
County Executive
L, ✓Mj
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
DEPARTMENT OF HEALTH Director
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
May 11, 1989
Mr. Marvin O'Dell
Building Inspector
Town of Putnam Valley
New York 10579 Re: Addition - Davola
Pleasant Ridge
(T) PV - TM #120 -5 -35
Dear Mr. O'Dell
Please disregard Condition Number Three of my April 25, 1989 letter. Since this
is a relatively new structure there is no need to update or convert existing
plumbing facilities.
.If you have any questions, please contact me at your convenience.
..Very truly goursr....:_._
Lawrence C..Werper
LCW:jr Assistant Public Health Engineer
�1
0
PETER C. ALEXANDERSON
County Executive
'd .. :.�< � ' ., w:.c:n";h, �-oa::��:°'Y'J�" va n `tirr:r - .'� ;etii --..[• ; : _
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Mr. Frank Davoli
RD 463 Box 260
Mill Street
Putnam Valley, NY 10579
Dear Mr. Davoli:
April 25, 1989
Re: Addition = Davoli
Pleasant Ridge
(T) PV
TM 46120 -5 -35
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
I have received and reviewed the plans for the proposed addition on the above -
mentioned residence.
The plans indicate that the addition will be a family room on the first floor and
a exercise room on the second floor. The proposed addition is not considered by
this Department to be an additional. bedroom, or will it result in a potential increase
in occupancy.
A. review•�of.- the_ "As Ku la" plans indicates that - suffic- ie.n.t- f area-exists
repair'the sewage disposal system, should it become necess`a'ry•in the fufure. Therefore,`
the plans for the'above mentioned addition are approved with the following conditions:
1) The number of bedrooms remain at its present number.
2) The proposed family and exercise rooms not be converted to bedrooms
without prior Health Department approval.
3) Plumbing facilities be updated or converted with water saving devices
(i.e. low flush toilets of 3 gallons or flow restrictors for faucets,
shower head etc.)
4) A written approval from Marvin O'Dell, Putnam Valley's Building
Inspector, be received by this Department for the above mentioned addition.
If you have any ques concerning this matter, please contact me at your convenience.
Very truly yours,
t
Lawrence C. Werper
LCW:jr Assistant Public Health Engineer
CC: Putnam Valley B.I.
a
0
PETER C. ALEXANDERSON
County Executive
. DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225-0310
Frank & Sarah Davoli
RD 3 Box 260
Mill Street
Putnam Valley, NY 10579
Dear Mr & Mrs Davoli:
April 17, 1989
a
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Re: Addition - Davoli
Pleasant Ridge
(T) PV -TM #120 -5 -35
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:
There is no record of a construction compliance being received
by this Department. An approval for a construction compliance
must be completed before an approval for an addition can be
started. The services of a Professional Engineer will be re-
quired to accomplish the above.
Upon receipt of�a submission, revised to reflect the above comments,
this application will be considered further.
LCW: jr
Very truly yours,
Lawrence C. Wer r
Assistant Public-Health Engineer
PUTNAM COUNN DEPAR7KW OF.HEALTH
DIVISION OF ENVIMNKD? L'.HEALTH SERVICES
Owner or Purchaser of Building
Building Constructed by
Location - Street
Municipality
��s %dam �• �
Building Type
Section Block Lot
Subdivision Name
33 •
Subdivision Lot #
GUARAN= OF SUBSURFACE SEKAJC=E DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the
workmanship, material, construction and drainage of the sewage disposal systel:
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 i'
standards, rules and regulations' of the Putnam County Department of Health, L.n
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 fa-4-'- to
operate for a period of two years immediately following the date of approval of the.
"Certificate of Construction Compliance" for the sewage disposal system, or am:
=..rep�iks� m 6 -6,'by _ ' tcL.Gu&- _-system-. except - where' the "fa ltWe"to, operate.�pr9per
caused by the willful or negligent act of the occupant of the building. utili:� :.
the system.
The undersigned further agrees to accept as conclusive the determination c.`_
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 system to operate w--
caused by the willful or negligent act of the occupant of the build' utiliz_.._;
the system.
Dated this 1,5 day of 19 " Signat e
General Contractor (Owner) - Signature
Corporation Name (if Corp.)
Address
rev. 9/85
mk
Title
Corporation Name (if Corp.)
Address
PUTNAM COUNTY DEPARTMENT OF HEALTH Permit +, . V:1
Division of Environmental Health Services, Carmel, A Y. 10512 .
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
_ Town or Village
.. ate: wX- • -- - y"r �_ . j. < <-' ,% +... _ ,l '•Block,. Lo t.. ..�a,a_i.+ :a + -x-.. .••r "+•-i: ,
Located at F f + Tax Map
Subdivision `r Subd. Lot 0 '.� � _ Renewal __❑ Revision
owner /Address— �� ✓?• ,f'�9t ! t,.'..r_•,I �-+ + -1, ✓`. t Date Of Previous Approval! "'�' �^ ''_�j
Building Type. `�" "Y.� Lot Area tic f Fill Section Only ❑
r7 ;?
Number of Bedrooms Design Flow G /P /D P.C. N. D. Notification Required
Separate Sewerage System to consist of " 2-- C, Gal. Septic Tank -7
and � � -V
/.
To be constructed by 4 92 it s -� � � fir• �` Address
Water Supply: Public Supply From
Private Supply to be drilled by
Address
Other Requirements
1 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 witjkst .1Md#;Vs, rules an regulations o e u nam
County Department of Health, and that on completion thereof a "Certificate of Construction C -�jjnc0 s petQr� to the Commissioner of Health will
be submitted to the Department, and a written guarantee will be furnished the owner, his su j�rsroro�s04biV the builder, that said builder will
place in good operating condition any part of said sewage disposal system during the peri of ;WJ0. 4 i S%inely following thedate of the issu-
ance of the approval of the Certificate of Construction Compliance of the original system r ap�� pairs thereof thalkthe drilled well described above
will be located as shown on the approved plan and that said well will be installed in 'pccordance•'oW * t, ° jie st ds, ^an regulations of the Putnam
County Department of Health. �° . ", 4 fY! * s
Date _�7 Signed 3423 /
P.E. R.A.
1.��f ":;�' cif ,. -.v , fi'''��'t';
Address •� "• �ea t) • �.+cense No.
APPROVED FOR CONSTRUCTION: This-ipproval expires one year from the date issued unlaki4ollst uctiah 00(,4 •fib siding has been undertaken and is
revocable for cause or may be amended or'modified when considered necessary by the Commissi,94. A ftfi °•�ln �t°hange or alteration of construction
requires a new permit. Approved for disposal of domestic ..•saiiitary'sewagei-tn8 %6r- private water* Sd�i t�•'
Date r ,J a �' BY !� .'.9 =.` j d.9 Title
Rev. 9 -81 tom'
6 PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date -
Re: Property of
Located at
1"57%Y07 Section Block Lot 3
Subdivision of ��j ��4 ��� :21
Subdv. Lot # ;a Filed Map # %`-% Date
Gentlemen:
This letter is to authorize Ci - �'i F "-S
z
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 er systems-- -of Article 1457 or .
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
S i d.
gn e
Countersigned:
o +s'' °pf ° °'•�..,
caner o Property
Address
`•
Address
a
. k.
Town
j S ®
e,, Ssl9�
�goaaaa►c
R ECEIVM hone
Telephone
MAY 3 1983
PUTNAM COUNTY
APT, ®E HEALTH
DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM ' FILE -N0.
Owner &a -11 X 104 6e0.1;1 / r Add-
ddre s s -.E� � ���, �= �C " ,��� xF
Z
Located at (street Sec . I°6' Block Lot
6dicate nearest cross street)
Municipality / c 47 ��Ile Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME
PERCOLATION
PERCOLATION
Run
No.
Start -Stop
apse
Time
Min.
p o a 7-ter
From Ground
Start
Inches
Surface
Stop
Inches
a er ve
in Inches
Drop in
Inches
Soil Rate
Min. /in drop
27 3,Z 7,Y-
Is
37Y2- 7i/9
��' .
✓
.
Notes: 1) Te'pts to be repeated at same depth until approximately 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.
t
TEST PIT DATA REQUIRED TO.BE SUBMITTED WITH APPLICATION
DESCRIPTION OF .'SOILS ENCOUNTERED _.-IN TEST HOLES
DEPTH HOLE . N0. !_, HOLE NO. HOLE: NO.
• - �. U - s . — . _ _..._ -..
G.L.
6"
12'� ... ..
n
30 .. ..
2"
781
84" .. '
INDICATE.LEVEL AT.WHICH.GROUND..WATER IS ENCOUNTERED —77°
INDICATE LEVEL TO WHICH WATER LEVEL ISES AFTER BEING ENCOUNTERED
TESTS ,BY µ 1 +.�/�
.. MADE _ Date ..�... � -
- - _ .... DE IGN
Soil Rate Used t7-- Min/1 "Drop: S.D. Usable .Area Provided
No. of Bedrooms �° Septic Tank Capacity A160 Gals. Type
. . . y L. F.x+ . Absorption.Area width trenc
Other
Name Signature p �.
Address SEAL/j � .• e ;
e •
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
� Eo •. �. 2d�8g .° �e6� a
Soil Rate Approved Sq. Ft /Gal. Checked by N;..
�►°aete1e
X.ECEIVED
MAY 3 14na
{
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF'ENVIRONMENTAL HEALTH SERVICES
- COTEY- GFFICE-BTJILDING,- CARTEL; :N. Y.. ; - 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM r FILE NO./
Owners.:7� Address
A.
Located at' (Street) /mss. JS ; sec. ,1 ' Block .9 Lot _Y_S'
(7ndica e nearest cross street)
Muni cipality_ee , f � Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK
TIME
PERCOLATION
PERCOLATION
Run
Elapse
Depth to
Water
a er ve
No.
Time
From Ground Surface
in Inches
Soil Rate
Start -Stop
Min.
Start
Stop
Drop in
Min. /in drop
Inches
Inches
Inches
1 l ape /Op
-Z
: -/
21C orl AP i
-
311P/
4
5.
3W/>
4
Notes: 1) Tests to be repeated at same depth until approximatelyy 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 HOLE NO. HOLE NO. 7- ` HOLE NO.
G.L.
6"
12"
18"
24"
30"
36"
4211
48"
54
6o"
66"
7211
d
78'•
84"
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
- INDICATE LEVEL, TO WHICH�I' - JEVEL, - R-TSES . AFTER BEING ENCOUNTERED
TESTS -MPME BY - 64 '� y' clil - -Date
DESIGN
Soil Rate Used Min/l "Drop: S.D. Usable Area Provided
No. of Bedrooms Septic Tank Capacity/ Gals. Typedi'�li i
Absorption Area Prodded By L.F.x241! width trenc .
Illy Ile" ` 41a;- Other . .
Name
Signature ,p " °•o-,_
Address
SEAL
a�
s o
THIS SPACE F R USE BY
HEALTH DEPART14ENT ONLY:
Soil Rate Approved
Sq. Ft /Cal. Checked by
F.
A'�
°.°
anaceesead
r1 Fl9
tr�� l7'Grt�r'
R',
30, 3 o i
e h �
r. J0 '
A) A/
S s l�c0'" 710
r.'
t,
1
Putnam County Department of Health
RECEIVED
Division of Environmental Health Services
A as noted for conformance with
applica *].o -"I- u
MAY 31983
e. gulations of the
Putnam anty ealth D partment.
PUTNAM COUNTY
DEPT, OF. HEALTH
aZ
gnature & e Date
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/ F ri.
_ I•
rx�,.e,w.t.
iE
a_dl-Zl 0.--17
J ) cle rl C e-
.9 !C -.
_ - 1 45 V POO 6 y �l elf
(35'J
3 61 t Lt YcA, -!I, P; 6
P/- / vA
Z? 3
u i5
2W
C
�.ROFFSSIONw•
certify that the sewage disposal system was
1 as indicated on this plan and that the system
ted by me before it was covered over. The.
constructed in accordance with all standard
gulatione, of the -Putnam-- �oa.Pty Depart merit 0f -;'
Eheevr York State Department of Health.
'fa
Putnam County Department of,Heal'-
division of Environmental Health Sera:;:.:,
QL;,r_7 ?V-// -f3
ipproved as noted for conformance w'-
applicable P:aZss and Regulations of tae
7utnaw.Co:nty a.ealth Department.
SignaturA i xi e
AS- BUILT SEWAGE. DISPOSAL
SYSTEM
��d r?/� �✓ m ro�r
/..-s
SUB— B— DIV.'
1v 3 3
NO. �^ $� DATE.
} - JOSEPH r SULLI.V P.
= . ..
YORKTOWN HEIGHTS, .NEW
YORK
s
3/
.9 !C -.
_ - 1 45 V POO 6 y �l elf
(35'J
3 61 t Lt YcA, -!I, P; 6
P/- / vA
Z? 3
u i5
2W
C
�.ROFFSSIONw•
certify that the sewage disposal system was
1 as indicated on this plan and that the system
ted by me before it was covered over. The.
constructed in accordance with all standard
gulatione, of the -Putnam-- �oa.Pty Depart merit 0f -;'
Eheevr York State Department of Health.
'fa
Putnam County Department of,Heal'-
division of Environmental Health Sera:;:.:,
QL;,r_7 ?V-// -f3
ipproved as noted for conformance w'-
applicable P:aZss and Regulations of tae
7utnaw.Co:nty a.ealth Department.
SignaturA i xi e
AS- BUILT SEWAGE. DISPOSAL
SYSTEM
��d r?/� �✓ m ro�r
/..-s
SUB— B— DIV.'
1v 3 3
NO. �^ $� DATE.
} - JOSEPH r SULLI.V P.
= . ..
YORKTOWN HEIGHTS, .NEW
YORK
,_-
SCALE.. As_sHw� JAB N`0 -