Loading...
HomeMy WebLinkAbout0245DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 5. -1 -5 BOX 3 ♦' . n N 1' F L . � INN L �. 00054 k 'V PUTNAM COUNTY DEPARTMENT OF HEALTH Engineer to Provide Permit M Dlvlelylo nmentel Health Services. Carmel, N.Y. 10512 1 u 1 �r on CERTQ [LATE OF COMPLIANCE NSTfitUCTION PERMIT FOR SEWAGE DISP /� . SYSTEM Permit / CaRGtf- �oRD 12a TT y'N Town w— � Subdivision N e Sabd. Lot N Tax Map Block Lot Owner /Applicant Name a /G - -y- - Renewal_❑ Revision ❑ Q Date of Previous Approval Mailing Address /X/ •r � Town Zip p Building Type L Lot Area 2 �a FW Section Only Depth volume Number of Bedrooms 1 Design Flow G P D �t PCHD Notl&atlon Is Requlred When Fill Is Completed Separate Sewerage System to Consist of Gallon Septic Tank end 2_�.� l0� T�� To be constructed by 'TO g0 7)6i-M I /j0;b Address Water SapPlpc Pliblic Supply From Address or: Private Supply Drilled by Q 15 fU �� Address Other Reodrements 1 represent that 1 am wholly and completely .responsible for the design and location of the proposed system($); 1) that the separate mwaga disposaa system above described will be Constructed as shown on the approved amendment there to and In accordance with the standards, rules an regu wns o 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 mid sewage disposal system during the period of two (2) years Immediately following the date of the issue once of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 211 that the drilled well described above will be located as shown on the approved plan and that said well veil 7ja d in ccordance with the via rd rules and regu a ens of the Putnam County Department of Health. P.E. R.A. - Date Sign I Address '3 r T/ FI Licen se NoT APPROVED FOR CONSTRUCTION; This approval expires two years from the date Issued unless construction of the building has been undertaken and Is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a now �permit. .�Alpproveed�for disposal of domestic sanitary $ewagagl; a private we pply only ley. Date ��i! ! L / �� gyiA Title J87 Q <`e /cam rw C S jG� 74 4 tJ ,jam ell 17e FROM � BI -STATE INC. a_ PHONE NO. : 2037460175 Sep. 17 2002 05:49AM P2 SlmSTATE e�axta -mss AS BUILT PRAWNS 2"w.746-9�175 6-00 r c t c� pD � tin !ad` x "k Te-�� 5 S Instomed IW 3/// ra QFP- 17 -PMMP TIIF 14:619 TFL:945- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 pppill ra QFP- 17 -PMMP TIIF 14:619 TFL:945- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 r %n N c Ng9• A' & F1 i I rl wx�L � •0 PIeOPOSED�`� 2 t3EDf2GbM \� �� ADDITION . c lOb2.0 EKISTIN6, 1 beDKooM RC-5IDENGe 4 "o G. I. I? z GAL. - - - - - -- O SEPT IC TANK p `ft"330 50LID RV.G. 6APPLE PSI( _-L OM2 ION 15OX CW' PT -I Mfl..) 2 - -- - -- - - - - - - - - - - ---9 ~- - ------ --- (1p 100Y. f;X PA NSION AMeA - --- - - - - -- U's -------- - - - - -- - -- -- —@2 - -- °> 550KO 106 @ ZOO G.PD = (oG}7 &.P. D. $OIL RATE USED-. 6-10 MIN. I ,' DROP APPLICATION KATE : 0.410 A550RrTION TRENCH 95auIREO: 333 L.F. PIeOvIDEO : 33�o L.F. TF-ST PIT D55GR PTION5 HOLE `a` I : O "O�'O(o TOP501L Ofo "'7 " &" SANDY SILT F- 10LE'p 2'- 00 --0'&" TOP°>O►L O "fo ° -7 "O' SANDY 4✓1LT ND'fE: 60UNDAKY DATA TAKEN I-XOM MAP F'KE- PAKC -P POK 6,IK7I006 E. KOe7eNOOKF' 4 E�KIC KIKMI-DC OAT60 MAY , IQ 38, PREPA fJ'( HANK A. 15NYOCK • TOP06KAPH IC DATA SUPPLIED 5Y K006KT H . DC —K6CM PoRF , L.':�'• Putnam county Division of n -_nt 1 health Service. � d as n ot orl for co7-c�anrs With Ipplicable R`ul�s e Of the �'- � TM . PROJECT' Pi�DP05�1� SSDS 5T, ^.sl COACH 1<10A 12 rA-TYOr IZG�, CLIENT . K�NNE57N 5GOF0�-L.D t✓TAGEGOACH ROAD PATT K'-')0N ; NEW YOKK RANDOLPH W. LAURENT ASSOCIATES, P.C. j \ 73 FAIRFIELD DRIVE PATTERSON. NEW YORK 12563 914.278.6108 \ CONSULTING SITE ENGINEERS DRAWIN'Q TITLE i• 0 S \I-O 1 V• V ' O, O �Q N __ ____ - Q 0 i i' 2 6CPMOOM ADDITION �,-�-ra, 1002.0 JUNCTION 15OX (TYP. P-XlsrI ` et-L. �X15TINC� 102DROOM Kf;51DENGE -ICOO GAL. SEPT IC TANK `1-11 50LID P.V.G. OAWIX 2bl( 2 - -Llalw ------ -------- 1_— ------ - - - - -- - --1 LlPb9� �` -'�_ - - _ _ `- ------- - - - - -- 100/ EXPgNSION ~ - - -- - --- - - - - °L ---------------------- AREAS PROJECT Pl rATTO Ks. CLIENT . KEN PAT TE1Z , Fvmi�i": � � t' t PUTNAM COUNTY::DEPARTI�wN OFHEALTS tel Hedt6'Ser doer Carmel N.Y 10512 . � P CERTD? NSTRUC110N P FOR SEWAGE D_ _ STSTEM. _ near to ProvMe Permh M� "4 ► f�JAG>ti . DRS own a*- Sabdlvidon N e Saw. Lot # 00. _Saw. Tax Map Block Lo6� i - Owner/AppWant Nwe 1`L�/1/l�lE�%!� J��ELD Reaewal_a Revleloa ❑ Date of Previous Approval Mailing Address n s 1� Iq 4 l7o x.-3-7. ' Town ZIP Ba11d1nQ Type /�, Lot Are. FID Section Only' Depth Volume Number of Bedrooms` e /��/� Design Flow G P D G . PC�HpD NoUBCatlon is BegalroTdpWh�eynFib Is completed separate Sewerage System m. oondst eat C.B. Septic Tank as i/ r n L� v0/j To be comtraeted by ?D Y7EZAAIIJ &�b Address Water Supply. Paibac supply From Address or Private supply Drilled bx �iX 1571 �1i C A Other Requirements A represent that 1 am wholly. and completely responsible for the design and.iocation 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 stvndards; rules ago regutat ions. of a PutnWrFn County Department of Health, and that on completion thereof a "Certificate of Conrtruction Compiiance" satisfactory :to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his suceesso►s heirs or afsiyn3'by the builder, thst tisid builder. will :,plan in good operating condition any part of said sewage disposal system during the period of two (2) yearf ifnmediately following the date of tbe'ifsu- ance of the approval of the Certificate of Construction Compliance of. the original system or any rspeirsthsreto; 2) that the drilled well described above will be loused as shown on the approved plan and that so id well earl a led in ccordance with the `Its rd rubs and rpu aZiTons : of . the Putnam County Department of Health.. . 'Date Il I 0 U J �{// Signed P.E. R.A. _ Address ✓lj BFI YA License No "APPROVED FOR CONSTRUCTION TMs approwl expues two Mrs.. from the date issued unless construction. of thg building has been undertaken and is revocable for cause. or may be amended or rrmodrfied when considered necessary by the Commissioner 'of Health. Any change or alteration of construction . requires aaa new permit. A Drov /ed.for disposal of',domestic sanitary sewaq$, a'. rivals wa Ply' oMy. 1/87 Date v mac/ / [ / �v BY�T Title ���� 3 F 5f PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of f:ENA1eTfi Located at ,S7- (T) P�}7rN �6� Section 7 Block �3 Lot Q Subdivision of Subdv. Lot # Filed 'Map # :Date Gentlemen: This letter is to authorize P/3/V W� _ 146IfZ-�UT a duly licensed professional engineer k 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. � �, bF N IA � Very truly yours, Uj C7 Countersigne �i � -e- R.A. , # 9l4 2 -fV J-A-6te �3 �i���'�i�� 172 ✓� ,Address _ / - l)me-7�o.y Al' 5 -- & /el Telephone Town, Telephone. tea. P V .b . 1 LAURENT ENGINEERING ASSOCIATES, P.C. 73 FAIRFIELD DRIVE PATTERSON, NEW YORK 12563 RANDOLPH W. LAURENT. P.E. \ 914.278.6108 HARRY W. NICHOLS JR., PE. CONSULTING SITE ENGINEERS November 1, 1988 Putnam County Department of Health 110 Old Route 6 Center Carmel, NY 10512 Att: John Kareil, Jr., P.E. RE: Kenneth Scofield Stage Coach Road Patterson, NY Dear John: Enclosed are the following: i. Four (4) prints of Drawing SS -1 "Proposed SSDS ", dated 11 -1 -88; 2. "Construction. Permit for Sewage Disposal System ", dated 11 -1 -88; 3. "Design Data Sheet "; 4. "Letter of Authorization ", dated 10 -1 -88; 5. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Orly "; 6. A money order in the amount of $100.00 for filing fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Randolph W. Laurent, P.E. /map cc: Mr. K. Scofield w/ l copy each enclosures: r . p APPENDIX B PL'Ii�M COUNTY DMRMENr OF HEALTH - DIVISIal OF MTJ__RCM4aML HEALTH SERVICES INDI47DUAL MTER SUPPLY & SUBSURFACE: Sr qA( DISPCSAL SISTIIMS REVIEW SHEET - CONSTRUCTION Pr2MIT DATE RiJT_= vr'D : 66 N &i&_T14 Ica r-t 6L-0 - CO PI BY: (Name of Come_*-) (Street Location) C:2RM YES I NO ► DCCL4�s Permit Application Corporate Resolution Plans - Three sats s/s Engineers Authorization Design Data Sheet MCS) SUBDIVIS— I Deep Hole Lcg Parc Consisten t Per- Res i t (3) Fill Pert Hole Depth House Plans - Two sets �%. - .:1. Well Fermi t; P ;v3 Variance Request , L' t`en't provide-a 60 ft. max. Parelle to 100, exm. 10 i . fill otes new s ec. denth uses 100 yr. flood elegy 200 ft. reservoir, It 150 ft. tricrallYga Vq lecal Subdivisicn -,Sund.i vision Accroval CE= tc E­x- acaroval SSDS Pd- Lots Chec:c_ ?W & D ) -Data Cn DDS Plans & P_r:iiit M = REQUIRED DEIA TLS ON PL?-INS S=.aage Syst_n Plan - (ncrtn arrow) Sewage System Hv1=_ aul is Prot _1= -Gray �y Flow ....r & Dimensions - Voi�� -re D o g ,Tranch /Ga11e?y; Puira pit de:..sils SEptic '1`�Ic lk - Size, Detail W1211'Detail, Service Line if cver Ccnstrructicn Notes (grinder rte) - ,Design Data: perc and deep resa is —%�o -Foot Contours Existing & Proposed Driveway & Slopes C=at Footing/Gatter,Curtain Drains (discharge OK) -'P-erc & Deep Holes Located Representative or primary and Expansion Expansion Area; shown; gravity fiaw,suff. size - °°°T,ff �ed Pit & D Box Shcwn & Detailed House -'No. of Bedroans Wells & SSDS's w /in 200 ft. of Proposed System. Derty Metes & Bounds -Eou4e Setback Necessary (Tight lot) - H e Seger - 1 /4 " /fL. 4 "0; Tyre pine No Bends; Max. Bends 45° w /clernout SEPARATION DISTALNCES SPECIFIED CN PLAN Fields 10' to P.L., DriveHay, Large Trees,Top of fi. 20' to Foundation Walls 100'.to Well; 200' in D.L.O.D, 150' pits ['­-160, to Stream, Wate rcourse, Lake ( inc. erpa: 'i5"' to Drains Curtain, Leader, Fcoting 351to catch basin,storndrain,aicei -ovate- rcou_r_ 10„ to Seater Line (pits-20-'Y' 0 iinte ittent drainage course `{ 10' -fran-Foundat'ion; 50' to well 15' WP11 fin Pr. 9 4-,�1 ,• •:�` . . • 110 12 - In IVA *3 •• C 101 Y• •1 III• •1'.F•. DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE M. Owner Kcmye T Address ���'� ,igD� ,y 57, S77k>,,5(O19GtI 1Z44. Located at ( StreetGR I U- 4). Sec. -7 Block 3 Lot (indicate nearest cross street) Municipaiity ��7TEjZ ti' Watershed C 6 %Ql,� SOIL PERCOLATION TEST DAT A RBQUlRED TO BE SUBMII= WITH APPLICATIONS aa� ( // Date of Pre- Soaking le g,F Date of Percolation Test /a o'L l pr HOLE NUMBER CL am TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 IA; if- /S a j 0-7 �5 8 G 2 �� �l l GL� �� �� �7 I 3/ -' 0- J-,3 8 2-9 9-7 S 4 5 r 1 /aA. /q -- 9 : a-("1 -7 2 1�11;a7- l�?-:/,-7 /e ;�--7 3 la: 153 P-7 q' 4 5 1 2 3 4 5 N=S: 1. Tests 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. rev. 9/85 DEPTH 1' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' 13' 14' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. I HOLE NO, 11), HOLE NO. INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: D DATE: DESIGN Soil Rate Used Min /1" Drop: Q. -),,9 S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity %liOC► gals. Type LONG• Absorption Area Provided By :Z,,? L.F. x 24" width trench Other Name LEFT �/V G //11�7ZiN G rSGC, Signature P/ Address % F/i 12Pi LLL> Dl-1 vet ,SEAL 'FeTT aF- ,U THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date c� r 4 ' 6 <q C- '60 5 , 0