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HomeMy WebLinkAbout4502DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.19 -1 -36 BOX 34 04502 Nr ;e a 6 ir L' m . ' k.1 . Lj imp i 04502 A PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Envird imental Heelth Services, Carmel, N. Y. 10512 Permit # P CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM To `j wn or Vulagja Located a /t,/t ,', `e / ��- Tax Ma / �' ✓ alocx y Owner ��+ �� �.ir 4/P ✓ /Formerly Tax Nap Lot # ��% Subd. Lot # / Separate Sewerage System built by t%jt✓I�C �� Address Consisting of 142,00 Gal. Septic Tank and / �y Other requirements r Water Supply: Public Supply From= Private Supply Drilled By Address Building Type ,' `; e,", -- -y No. of Bedrooms Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentiall'y.I. shown , r�rthe plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordagc �kg d plan, and the permit issued by the Putnam County Department Of Health. ' -� o od Date P.E. R.A. e � Address r E � W 6i Ligonse No.� Any person occupying premises served by th above system(s) shall promptly take such action a msyv necessary to.Saeurt�'t correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall becoma Uwjsnd void as soon as" ra�publte sanitary newer becomes available and the approval of the private water supply shall become null and void when a public,.,w ter "supplyF.beCOmiis ?available. Such approvals are subject to modification or change when, in the Judgment of the C Seto Health, such° ocetlop, rriotllfication „or change sary. Data Rev. 9 -81 :.. a 3 � �:: _ - _ PL�TNAM. 111►iTY DEP.ARTMENIT� - HEALTH... n rmiti # L Division of Environmental Health Services, Carmel, N. Y 0512 CONSTRUCTION PERMIT: FOR SEWAGE DISPOSAL SYSTEM (,� ! �e r : own o illage Located at © / a 4 Tax Map Block Lot L� Subdivision r - %B��i Subd. Lot # ,(/J/a' / Renewal _ � Revision _Q Owner /Address t / C' ®� ' 4!:G, �r✓�' /�j� Date Of Previous Approval / �+ Building Type • Lot Area Fill Section only ❑ Number of Bedrooms Design Flow G /P /D dU P.C. H. D. Notification Required J% Separate Sewerage System to consist of fd 60 Gal. Septic Tank and �§W To be constructed by 9J14`A0'0 Address Water Supply: Public Supply From Private Supply to be drilled by �✓ —�Ir�fss l0l� Address e.. 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.��h`(li 'standards, rules an regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction C6W"41dnce i o the Commissioner of Health will be submitted to the Department, and a written guarantee will be furnished the owner, his wccssois a builder, that said builder will place in good operating condition any part of said sewage disposal system during the period df t'` mss%- ii»b!igg4iat� ollowirg the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any eQ�� t4t of rilled well described above will be located as shown on the approved plan and that said well will be Installed in accordance with e'' ds, rulesr, tie rag a Ons of the Putnam County Depart ent of Health. - ��a ra t DateT� Signed - N p. p. P.E. - R.A. Address �/ / �' �igrr7 �i�G3 �/ rte.. x ,,..a 1° ° a- y t�73 ,v L�cen3efNo. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued less cons r Gt of the buildmg`htas been undertaken and Is revocable for cause or may be amended or modified when considered necessary by the Com stone uWa)L{Y: `Any change of construction requires a new permit. Approved ror disposal of domestjefarrl 7a ftwage,'asd /or privat water uppl • o rF , a % .. .� �j PUTNAM COUNTY �DEPAItTMENT OF HEALTH . Permit o - 1��� Division of Environmental Health Services, Carmel, N. Y 10512 CONSTR TION QEFfJ,1lIIT FOR SEWAGE DISPOSAL SYSTEM _ Town or Village Located at y V %f�•' J%°!`OII., Tax Map block Lot ..__. _ SUbdiM3sioR �f� �. •7 `''ii SuMi': r,ot -N_ �. .Renewal q. c33iop' ' . • _ - ... - - - -1 —. -_� - —= - �j eta Owner /Address �f'iYr .��eL, .. (..tae' ri G� -.�' -� / /'�(✓ / f� �fS r' 7•� Date Of Previous Approval e, Building Type ZSJy Lot Area /{ •� � - S � Number of Bedrooms Design Flow G /P /D Ca.O�a Separate Sewerage System to consist of Gal. Septic Tank To be constructed by Water Supply: Public Supply From " ie6',' Si CJs li Private Supply to be drilled by Address Other Requirements - Fill Section only ❑ P.C. H. D. Notification Required and / .s oC'` 1✓L'�GtC' TYtCs Address 1 represent that 1 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.,C4� "r be submitted to the Department, and a written guarantee will be furnished the owner, his succes place in good operating condition any part of said sewage disposal system during, the period of` ante of the approval of the Certificate of. Construction Compliance of the original systelpAgvan will be located as shown on the approved plan and that said well will be installed in accordance woA_% County Department of Health. Date Address '/Q//f Signed APPROVED FOR CONSTRUCTION: TAs approval expires one year from the date issued ul revocable for cause or may be amended or modified when cppsidered necessary by the Comm requires s new permit.` . Appioved for, disposal of dourest sa ` a y sewa and /or priv Date . `(�fl' ��ii]] tT�IF/ By Rev. 9 -81 -Located &�°cI Located at Subdivision �) (,,.;that the separate sewage disposal system U&tis� rules an regu a ions o e u nam o. sfictory to the Commissioner of Healthwill a41jds`by the builder, that said builder will egnediihely following thedate of the issu- 9Co;,A) thin the drilled well described above i, r6l0s1Lrid regu a ITf'ons of the Putnam o d P.E. R.A. ° }License N0.. It the "building has been undertaken and is An "y change or alteration of construction title PUTNAM COUNTY DEPARTMENT OF HEALTH Permit a Division of Environmental Health Services, Carmel, N. Y. 10512 FOR = SEWAGE . DISPOSAL SYSTEM... o Village. - " _ l• s M Tax Map stock Lot r Building Type Number of Bedrooms Design Flow Separate Sewerage System to consist of To be constructed by aWAI �_ y Water Supply: Public Supply From Other Requirements Sulid. Lot R Q _ Renewal _ 0 Revision _[3 Date Of Previous Approval Lot Area ;?Oz S e f Fill section only ❑ /P /p 'ere P.C. H. D. Notification Required �j � ...�1t �, ©� Gal. Septic Tank and 3 LL- 6e F c�'+r �• � j`" -e �C I 11 Address Private Supply to be drilled by Address 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 with the standards, rules and regulations o e nam County Department of Health, and that on completion thereof a "Certificate of Construction Complia '_" to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his butte I�iE►r MCI )tar the builder, that said. builder will place in good operating condition any part of said sewage disposal system during the period of ,elm��f Imete �dr following thedate of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or y repeJ; ; th'> tie drilled well 'described above will be located as shown on the approved plan and that said well will be Installed in accordance wi the ndards, r 4y s the Putnam u 1ae onof County Depart ent W k4ealth. _ wo Date Signetl P.E. R.A. Address �` . cs ` se No X Y4 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued less° cQit, li on„ e ° has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Co missions M t or alteration of construction requires a new permi . Approved for disposal Of domestic s704age.. and /or private Date By Title Rev. 9 -81 41 0--iii-9F or Purchaser of Bui ding Section �> _., ..:..$ail.'c di-iig� .0 oh -s true t e.d; Eby .. 2-3 Location - Stree // Lot Ile Municipality Subdivision Name ae/ 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- ation of the Director of the Division of Environmental Health Services ._..:.of -tlie Pu.tiiarri Coarity D:epa:�tmer`it 'of HeaTt'h as to "_i�rhet'n "fir .'or: �iot' 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 f day of Wtr% 19 Signature�� Title Corp ration Name if Corp. 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 i Z PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES r Date Re: Property of Located at (T) "I' )��-6ection 1,V Block Lot Azzy IV_ Subdivision of Subdv. Lot # Filed Map 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 y 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.co'nstruction of said , ' system I or systems in conformity with the provisions of 145 or o 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. ddd OF EW, Countersigned: 060400 *00 Nei P.E. 9 �r* 97 2-- Address 24 SS Telephone Very truly yours, Signed /� .`�. j�caner of Property- Address Town ,<2 Telephone IV E MAR 11 1983 PUTNA"A COUNTY � o JOSEPH F. SULLIVAN, P.E. eonsc�itn9 �nylnccs •..2972:FERNCREST DRIVE .. a ':r' u• .n _c- n 'i:: �' . -. ,. -- YORKTOWN HEIGHTS, N. Y. IOS95 (914) 962-4245 September 5, 1984 Putnam County Health Department Rte 52. Carmel N.Y. Re: Sewage Disposal System Aphrodite Const. Co Woodridge street Putnam Valley, N.Y Map 120 Block 5 Lot 23 Gentlemen, From a. field. inspection made of the above lot the site has remained unchanged and there should be no interference with the proposed sewage disposal system, Very truly yours Joseph F. Sullivan P E. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES `cbukk 'OFFICE B DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner A8kCzj;A, zLS,eC14 Address- Located at (street W.0 e sec.,/�� Biodk -5- Lot Indicate nea—restcross stree Municipality r jWl'T a,,tV )p Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Eiapse Depth 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 2,2_4 -z-35-- 2 2 )1 3> , qL 2- 7 1 4 2, 3 2,3 87 2 MAR Ar UNTY C4; �H&AIJH Notes: 1) Tpios to be repeated at same depth until a roximatel� equal soil rates are obtained at each percolation test hole. Affdata to e 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 ;i_ HOLE NO.------' G.L. 611 1211 1811 2411 3011 3611 4211 4811 5411 6011 6611 7211 7811 ROM INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED nPjQATE._ LEVEL- TO WHICH. WATER .LEVEL RTSES AFTER_ABT��G_ENCOUINTERED. °® ,' Tr6TS-MADE­-BY: DESIGN Soil Rate Used J/ bUxVl"Drop: S. D. Usable Area Provided Jac 7 t' No. of Bedrooms ' Septic ,Tank Capacity 0 e, <) Gals. Type ti o., r Absorption Area Provided By_ �L.F.x2411 36" 44,.trench. Address SEAL 'r2 M tf� . 00 0 rt V 0 24 THIS SP E FOR USE BY HEeTH DE/RTMENT ONLY. Soil Rate Approved Sq. 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