Loading...
HomeMy WebLinkAbout0411DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.3 -65 BOX 5 00220 r 3 3 c�� PUMAK C0DM7f DE A 222E i OF EMUS J i DMIAMORKdresineWdRi6iftcli ri, Cass" 'N Y 11512 PMvMa M ram_ 0 0i C8 OF ran* 2a 8U i"o>t SRWAG&DLMMU SYST®1! /3 -3 . s' T. Patterson <k Btp 311 o" w v0nge er„r4. VonEssen & VonEssen saw,w . 2 T �� 10 2 11.22 � � Elfsa & Vincent Guerriero R =� ❑ Daft of PreviseaApprove] 6/22/88-& 7/17/90. 29 W6eell Avenue Toro Poughkeepsie, NY �— at Subdivision Annr6ved 8/29/86 #2164 Fee Enclosed 1 Arnn),nt No Frame � 44625 sq. ft.' sah� Tl P@ Lot Area Fm Seedoa.o* Deptb30 - valooe 434 cu yds. Naitaib.e sit Below ' . rdg DeO p Flow G P D 6 n PC® Nod§cMlon Is Required Wism Fm d ee.pleted Sep.ael. S.aetase SY"= t. e,=W sit 1000, „sq* Tack ..,d 5001. X24" wide X 18" deep To be owlib.eW by Atbbm: Waaar Sappb: Fiibtic Sq,* Fsosis Addteao gwRoo,ranat, Curtain nrdin: 1321 X-41 deep w %601 solid pipe to-grade (in place). 1 represent that 1 am wholly 'and- completely'►esponsible for the design and'klcation of the proposed system(s); 1) that the separate Ywa • di YI s stem above described will be constructed as shown on the approved amendment there to and' in accordance with the standards. rules an rpu a qns o ham County Department of NaeKh, vnd that on completion' thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Meelthwill be submitted to the Department, and a jiirittsn guarantees will be furnished the owner. his succissors, heirs or assigns by the builder. that said bulkier will piece in good operating eorld"n. any pert of said sewage disposal system during the period of two (2) years immediately following thedati of the IM. and of the app►aial of the .Certificate of Construction Compliens:r.of the original system or any repairs thereto; 2) that the drilled wall described above mill brbcated as shown on this approved plan and that said wed will be Installed i etoordance with the standards, rules and rpu T o.of the Putnam County Oepartmesst of Meiith. We Apri 1 22, 1993 Signed , ' P.E. X R.A. Addre License No 29206 APPROVED FOR CONSTRUCTION: This apprpval expires;two years frorn1he 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 repui►sa a new permit.. Approved for disposal of domestic sanitarysewage d /or private water supply only. Rev. Title 10/88 D!t• DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster,.New.York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL /,P^��y PCHD PERMIT # WELL LOCATION Street Address Town/Village/City Tax Grid Number Rte. 311 T. Patterson 10 -2 -11.22 WELL OWNER Name mailing ddress ou eps e. gRk8'' Private Elisa & Vincent Guerriero NY 12603 0Public USE OF WELL 1 - primary 2 - secondary D3 RESIDENTIAL ❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS 0 FARM 0 TEST /OBSERVATION p OTHER (specify, 0 INDUSTRIAL b INSTITUTIONAL ❑ STAND -BY O AMOUNT OF USE YIELD SOUGHT five gpm /# PEOPLE SERVED6 /EST. OF DAILY USAGE 400 _gal 0 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION EI ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING D DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING DemPStir Supply WELL TYPE ®DRILLED DRIVEN DDUG ® GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES __j_NO I WELL IS LpCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: VonEssen & VonEssen Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES_NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: Over one mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ee #9 Re "A"-4L22 by John H. 00N SEPARATE SHEET �1"en�1S�h Pp �. i A- >5.0., � 'I ) 4/22/93 (date) PERMIT TO CONSTRUCT A WATER WELL .ire)John H. Prentiss, P.E. lc Ditthnri7Atinn) This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt3• (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or-otherwise contaminate surface or groundwater. Date of Issue: '& r- � C 19 Date of Expiration 19-�5; 5 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller A- 7- z V ' � n Lv 0 ' ell O 00 - od � — tn l00 -o. �a�Ex PUTFAM COi7'f;3Y D PAFTMENT OF HEALTET FIR z � ' Signature & Tit_ ate y4' -c" �V�W-P,0�RESI�E�IL.E SCALE: Ile.ILV APPROVED BY DRAWN BY DATE: 2--#&-1!, EL =HOME F F� bry Llv d -r�� � �c6 -11 -Z :31Varlo-����l AS a3AOHddV .�% c�h r31vOS - 3 -3[173 61-9 3�, o l 'A'd 3fIL9 • Fo-� SCALE: • •'= Ld' I DRAWN BY IrW I SINcjw f:kmt,4 M rL rh�E�sDa , r4� z.--zcg Fes- _ J f' -d' Jiwd v -U, .I .I Q -1; J / J (J1V L1'�C1�Cr1V TILJ IVL N�-L. SCALE: • •'= Ld' I DRAWN BY IrW I SINcjw f:kmt,4 M rL rh�E�sDa , r4� ' .DRAWING NUMBER F F - ?_ KD-1 (J1V L1'�C1�Cr1V TILJ IVL N�-L. SCALE: • •'= Ld' APPROVED BY _ DRAWN BY IrW DATE: 2-ifo-CIS SINcjw f:kmt,4 M rL rh�E�sDa , r4� ' .DRAWING NUMBER F F - ?_ CoaMy oaoartr ient,. of a' wlglnittae to th ' :p• 11,01441 in toiid ow► tMM Mq Of ten aggraral of .welt ee`locatee as Shawn e cowry oeoartntaltt -01 1leeltn,; • 6.J111y. 1990° A Del M40nC011101at loll tMfe01 a "Geri it Kate ,Of,000A a written guarantee WMAit furnished the, fort of ,said fewage -flits oql -.iyftam durinjr th a of •Constructiai comp Ilene a o� .the o►pinai;r 1 gdan a4.that saki well will IN instel in acam APONGVEO FOA CONSTkkC ndW: This appoval e><oMes two y M revocable for Caule p may M a1helWed;Or nlOdpied• When cons" redU"If s a n gar try Appovs0 for "dismal of dornestk n i 0/88 • c� at l �Oy •ten kCdrdanCe with tha'standards,-rules a ►egu ns o n m' ruction C0lnpllenwl* "Ntiefactory, to the COmlhisslonor of Healthwill his pAcceUprs. heirs or anigns by the builder. that acid builder will e lloki6d of two;(t) yeas ltnfn diatey following thedaN of the ltau- /Rein o►'any rglNrs'tha►etoi 2) that the d►i11id'wNt detpibell Aa4e IMOa with ten standards, rules and ►egu ns of the Putnam /� �Y ?i1LGt.GL,� RE._}�_ RJ►.__. Y -10512 Lieonse No 29206 ed .unless construction of the building has been undertaken rind if C6MYnissiOne►" of H"ith. Any Change or alteration. of conftruCtion wat r.. supply only. Title' i f PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date April 22, 1993 Re: Propertyl�of Flisa & Vincent Guerriero Located at Rte. 311 (T) Patterson Section 10 Block 2 11..22 Lot Subdivision of Subdv. Lot # 2 Gentlemen: VonEssen & Von Essen Filed Map # 2164 Date 8/29/86 This letter is to authorize John H. Prentiss i a duly licensed professional engineer X or registered architect 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 promulgated 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 Education Law, the Public Health Law, and the Putnam County 4 ,Sanitar PRA, �Ci Very truly yours, Signed L Property Owner z �0.429206i RD9YFair ; i� Ao 1, N.Y. 10512 29 Worell Street Address Poughkeepsie, NY 12603 Town 914 - 877 -6093 Telephone �i • I s PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 6 July 1990 Re: Property'. of Gabrielli Mason. Inc. Located at Route .311 (T) Patterson Section 10 Block 2 Lot 11.22 Subdivision of VonEssen & VonEssen Subdv. Lot # 2 Filed Map # Date Gentlemen: This letter is to authorize- John H. Prentiss a duly licensed professional engineer 'x 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. Countersig d: .L °F \ry c1 . r t HE Pj� S R.A. , # Ad dr a s.s.......... .. _ �HN N. PRENTISS. P.E. R09•FAIR ST 914 -978 -6170 CARNET, NEW YORK 10512 Telephone Very truly yours, �. S i g n e d . Owner of Property Route 312 Address _......... Brewster. N.Y. 10509 Town 914 -279- Telephone. 87 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y 1051?- Englneer'to Provide Petmlt:IY on CERTIFICATE OF COMPLIANCE . CONSTRU ON PERMIT FOR SEWAGE DISPOSAL SYSTEM Permli' . N . P = 5.2 8 7 T`.. Tatter , On Located u Rte. .311 Town or ` alege. Sabdtvlslon Name V OriE S s e n & V OnE S S en cabs. Lot # 2 Tai P 10 ` Block 2 Lot 11 -2 Gabriella Mason te ; R ®rtato° Owner/Applicant Name ' Inc. . . Date of, Previous Approval.. pproval `" 6/81$7. Rte. 312 Brewster, NY 10509. Mailing Address Town ZIP Building Type Frame Lot Area 44625 sq. ft. Fm section only Lxj Depth 30 Yelame 434 cu yds. Number of Bedrooms Three Design Flow G P D 000 PCHD Notiff6dun Is Required When Fill Is completed 1000 500' x.24" wide x 18" deep Separate. Sewerage System to consist of Gallon Septic Tank and To `be constrncted by 7 Address Water Supply: PuMe.Supply From Address or: X Private _Addrees rl Other Reoulrements Curtain Drain: 132' x 4' . Deep V160', Solid Pipe to grade -IN PLACE 1 represent that I am 'wholly and compietely responsible for the design'and.location of the.proposed system(s); l) that the separate sewage, disposal:-system above described wM-be constructed as3hdwn on the approved amendment there to and inaccordance with the standards, rules and regulations of - the u cam County ..Department of Health, and that on completion thereof a'- 'Certdicate of Construction Compliance- satisfactory to the Commissioner.of Health will be ,sub4niiied to the Department.-'and a;-written guarantee will, be furnished the owner, his wccessois, 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 the date of It he issu- ance of the 'approval of fha Certificata 'of .Construction 'Compliance. of .the original system or any repairs hereto; 2) that ,the drilled well described .above will be located as shown on theapp►oved plan and that said,wall will be installed i ,accordance with the 'standards, rules and regu a runs of the Putnam County Department of :Health. Date 21 `July 1988 Signed" ." P.E. X R.A. Address RD9- Fair 'St . , Carme-, Y 10512 license No 29206 APPROVED FOR CONSTRUCTION This approval expiies 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 per' Approved for disposal_ of domestic sanitary sewage, and / piiv water wpply only. ® 1pp Date)�FF' c `J. 2 2, z By Is PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 21 July 1988 lie: Property of Gabriella Mason, Inc. Located at Rte. -311 (T) Patterson Section 10 Block 2 Lot 11.22 Subdivision of VonEssen & VonEssen Subdv.I,Lot # .2 - Filed Map # Date Gentlemen: This letter is to authorize John H. Prentiss a duly licensed professional engineer X 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 with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Al/ 6 C untersigned Very truly yours, Signed c� Ow6Sr of" P operty Address JOHN H. PRENTISS, P.E. ROS FAIR ST 914 -878 -6170 Telephone Rte. 312 Address Brewster, NY 10509 Town Telephone PUTNAM COUNTY,DEPARTMENT OF HEALTH Division of Envli onmental Health Services. Carmel, N.Y. 10511 t'EngClnpeer to dh P . rovide PenailfX Permit' . N F COMPLIANCE GONSTRUCTI N ERM1T FOR SEWAGE DISPOSAL SYSTEM S T_ Paftersnn Located at 311 Town or . Village SubdivialonName .Van F.caPn VATF.CCPrRubd. Lot # 2 TazMap 10 Block_' 2• Let'' 11:22 Renewal _0 Revision `- 0 Owner /AppllcaptName Gabriella .Mason, Inc. Date of Previous Approval gAddress Rte 312 Town— N Yztp '10509 Boudiog Type ..Frame Let Area 44625 sq. ft. FWSecNonOnly $ Deptb 30" vdioolte 434cit. ds. Number of Bedrooms Th re's Design Flow G P D 6 00 � PCHD Notification is Required When FIR is completed Sopaate Sewerage,5ystem to consist of Gallon Septic"Tank and p ` 100.0 500'x 24 "wide"x 18 "d'ee To be constructed by Address Water Supply; Public Supply From Address on .X Private Sapply:Dillled by—, Address Other. 'Reaiujihnm uis Curtain Drain 132'x4' Deep w /60' Solid Pipe' to grade IN PLACE I represent that !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 thereAq and in accordance with,the"standards, rules an regu a_ ions o , e u nam County,. Department of . Health, and that on completion thereof b'•Certificate" 'of Construction Compliance" s5tistactory to the',Comri issioner of Healthwill be wDmitted 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- anee of the. approval of the Certificate .of Construction Compliance of the origins system .or any repairs thereto; 2)4hat the drilled well described above Will be located as shown on the approved plan and that saitl well will be install a in- ;accordance with the standards, rules and regu Tons of the Putnam County.Depariment ' of Health. - - - Date ..19 Mav .L987" Signed v P; E. R.A. Address ,RD9 Fair Stree Carmel NY 105.12 License No 29206 APPROVED PO CONSTRUCTION: This approve( expires two years „from the. date "is ed unless construction of ttie building has been undertaken and is ►eVOUtile for ca a or amended or mod' wheh'consideied nece ry -by th -C mntissioner of Ith. Any Chang r alteration of construction requires a ew pe it , proved .tor disposal of d mestic Wi0ge, and/ e, a y 'only. ` jjgj Date By Title DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #� WELL LOCATION Street Address ,RTE 311 Town/Village/City Tax Grid Number T. Patterson 10 -2 -11.22 WELL OWNER Name Gabriella Mason Address Inc. RTE 312 Brewster NY 10509 QPrivate O Public USE OF WELL 1 — primary 2 - secondary (I RESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL D PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0 ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT Five gpm /# PEOPLE SERVED Six /EST. OF DAILY USAGE4 D gal REASON FOR DRILLING 13NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING Residential Supply WELL TYPE X®DRILLED DRIVEN ®DUG GRAVEL [:] OTHER IS WELL SITE SUBJECT'TO FLOODING? YES ___X _NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Von Essen & Von Essen Lot No. 2 WATER WELL CONTRACTOR: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __X _NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: Over one mile LOCATION SKETCH & SOURCES OF CONTAMINATION O ON REAR OY THIS APPLICATION 19 May 1987 (date) PROVIDED(See Diag. #l, Job 45.0.2413, by John H. []]ON SEPARATE HEET Prentiss, P. (signature) TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of! ' Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump;the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well pompletion Report on a form pr vide b e Putnam ,o my Health Depar e ... � Date of Issue- Date of Expiration: 19 ermit Issuing Official Permit is Non- ,Transferrable W, O -- N 3 4 8'- 0% Z4!-9'--A FQ7. ZO P7i,v-� ka . - 11r TCHEN O ©❑ 240 S 2430 2430 33 i three Be�irne». elli,� rer 4'q e11414450.1i --ko > e 3fIiTPd 6erse►,(Twto- i- I.I•y2. L , INC. • 2748 ENGLEWOOD '- ------ u�. -'x -z-e- IIe.­ o 5W 7-1V s W i t 10" \\ Y ...y`�,.. \ , •;;.� it ��.( +i�,i ,li�!'.t1 ,i lea� } , FZ Cs PRC tj N /7•(�l"JOE ,,1 �� f�E - � °'lV'�'�.J "�C r PUR M COUMY DEPARTMENT OF HEALTH � DIVISION OF ENVIRCNMERM. HEALTH SERVICES 4 •:1 DESIGN ~DATA SHEET- SUBSUFACE SEWPM DISPOSAL SYSTEM FILE NO. fr' owner �1 i L�%Nt ;°".i ^I%an S!L °y �b M Tess ? . located at (Street), �,,,,� �Q� , sec .7hm Block 9 Lot /L—LL (indicate nearest cross street) Allnlcipality �T x-SbN Watershed Crzr6 r1 SOIL PERCOLATION TEST DATA RDQUIM TO BE SUEMITrED WME APPLICATIONS t / Date of Pre- Soaking 1118/64 Date of Percolation Test HOLE NUMBER CI= 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 1-$ %6 Z 2 tl3o ILGO 3© l f78 3 tYfl4 1140 30 /] /a -- 9 3o 5 2 ((5f I Zoe' 30 I 6 t .30 000 4 I1 S I;o� 30f lYr �-I -a N 3. 2. .rev. 9/85 Tests to be repeated are obtained at each for review. Depth measurements to at same depth until approximately equal soil rates percolation test hole. All data to'be suhnitttd be made fran top of hole. G.L. 1' 2' 3' 4' 5' 6' 7' 8' g' 10' 11' 12' 13' 14' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE N0. 4Nic5 Loam �atid tr Il�o Ce�� a ro e t INDICATE LEVEL AT WHICH GROUNMTER IS ENCOUNTERED LP&A bit a " 6e b F, INDICATE LEV M lb WHICH WATER LEVEL RISES AFTER BEING IIJ00UNTER D ,n . DEEP HOLE OBSERVATIONS MADE BY:� 14 . DATE: G C - DESIGN Soil Rate Used Z1- d Min /1" Drop: S.D. Usable Area Provided 0 �� No. of Bedrocros L►w2e Septic Tank Capacity ( d 0 0 gals. Type Mq Absorption Area Provided By L.F. x 24" width trench vro✓�1 �FESSIOngI Other " 00 , f '� S. irr u' ' Q� F -.- - Nam i Signature JOHN H. PRENTISS, P.E. RD9 FAIR ST 914- 878 -6170 SEAL f Address CARMEN, NEW YORK 106-32 FOR USE BY HEALTH DEPAR24E TT ONLY: Soil Rate Approved. sq.ft /gal. Checked by V 1 R G `fps ho. 29ZV� /��F KHr ci tF n` Date PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: I, --1 jGx0 'M�iLrGLLi represent that I�-am an officer or employee of the corporation and am authorized to ac, l� t for i3A �`�� A-96 AJ �� C, (Name of Corporation) having offices ate ✓�' "" `y S� %l.!`'� Whose officers are: President: 1-1-11 6.61 Lv C-1 4 /. i e_ L-f- + z ". 3+Z (Name a d Address) Vice - President: �/ 6 fi, / 0 ftA A-� �� �J �j 4 ou (Name and Address) r Secretary: i i w�� z`� j j i/�i �r`uilL 0a4� (Name and Address) Treasurer: All t Z- A.Q�w(1� (Name and Address) and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this day`` of . Y']- 19 0 i p'^ "ARD L No ary ub12 NO" 1! .IC. p11, I ,rn i NOW',, York Qualif;r'.± 11 Signed : A /ja � �� c��- ie7�`�•,� Title: Quai: nam No.l& -y C.)mmisa ,,,, � pires 0 31,1913 Bd t �tE 1a"30 SBltd 40A AN lduno0 wer;yrb Us � n� 0 EL 8/84 IM •i a �� V10N Corporate Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date MgV 0 Re: Property of i� R4 Sort, -THC . Located at (T) Section TM 10 Block 2 Lot 1'I.22 Subdivision of V. 4 Voh F55ev1 Subdv. Lot # 2 Filed Map # Gentlemen: This letter is to authorize .JoAn. ;4 • I'ir n'tt55 Date 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, EducationlLaw, the Public Health Law, and the Putnam County Sani- tary Coc Address JOHN H. PRENTISS, P.E. RD9 FAIR ST 914- 878 -6170 CARMEL. NEW YORK 10512 Telephone Very truly yours, bri e II i M soi, In , Signed owira of 1/¢„ of Property nejt en{ Rte. 312 Address 8rewsfes,- A). Y 10 Town 914- 2' -6Dtf Telephone �1 1 r Bud*po 611 top sol igrade 12 '.deep3 3/4 "stone �{ pry gravel fry grad stone �,—,r 0perforated z o pipe a� TYPICAL CURTAIN DRAIN SECTION 2 �1 fl 1C °42' r MIN. •: 1 �v \ Pv!apAauia:rt,k,forcrccdce • \� \ �— � � Slbpa.a.vr`Y,iyn�ymn P.r -era i- 44& diem l(w __S_ •� fhe msrdo cturrig(iS,m1! ' � i' >, QR9LLffl WfL�I �z }��L.2 - ��'p% 1 5 �' � yitir t Y +{ ' . �.z .x -r { ` y ..• ' �`. ��4, In � , .ri -� Z � �j : q z F � "+ ✓ ,✓•t ai - ,�-`,. �y di + �c. r.,..'�_,..,,�,,,..,:.,a•.,++., !` r „t .� �{ f .� > ' �fQ° it �� rn 4.�"`` YF'iTS 4••_ez,• !�t r�t 4 4�rY S ".+u� ft''CC:. i % S .`a i � �at�x �t �N.YS:t. � , ' �'�J�. r,'�,,'A,i� -� �r e•Y F '� �'¢G�'I;,! n � .' ' 1 3k' ,� �' ((,�J'i '. �: -`+1 �Ak:'i�k' .ev �...., i . , : i %� J.`t .. � �F:+ ,.uA �� >,i.,.ii A __ e., .ei ..�.z'ti �e b�. •...a .V'e:.5 �,J ,4,1! ri: .� a.:.. '+lei w�i„� - I Yi�u kA �?'����i��•M V '•