HomeMy WebLinkAbout0488DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
14.-l-6
BOX 6
iyL
�
G;, ,d. ;, 1 9 1�.
_ . ,�
jyj I
Ilo" 1- ,
r.
IN
9r 6
NEImm .� - ,
ma
00297
%
F
-Mioiff Got
CONSMUMON: COPMLMCE MIR SEWAGE DISPOSAL tYih!M '
77
d
Et%
LOMW at
' T vmaQe Lot._s� —_
MaUbg Addr" - Su b( -L'A I X
K
Fee .Enclosed Amount:. Date , ermit..,._Issued
Separate sewenyle System Cjl��
bWft by
Cosuds of Gallon -e
on' Privatti 7-7
77P 7-
DWIdb TP�' Lot Site_ H
a8,Et6si '0
n n. r
M P
—
Number of Gdo&r Been -witaned
Other Rjqgjrjjp�enta -4
I certify that the skstqn(s),&s listed 'qsrviiiq the "ve'pr;3iiise,8`1-1 of the Co�pletsd,
06. work copies
of which iis r�, accordance vith,the standards ,'rules , latio in rd anE
e NT ith the 11 dd plan, `and tfiep"imit'issued by the
e
ihat*r m County"
Cute _ Ctrtifiad P.E. PA.
Adanst Limnos N a
P
Any person OCCuoyji6v premisos Laved by,tht 06niptij take such action as novvssary to, socure the correction , of, any unsanitary
C66ditions resulting frorn Mtn- 62119G.' Approval* separate soon as a piobuz' unitary 'moos becornes
ovalle6le and Ahi. approval of 44, privets *st4k!- �Opply "shall, O'corne:4.0 -Od' lklooyl.boix" 4WMISIOW :Such 4000vals We
14A when. in 'the Judgment 6f,169'V6rnMIs*o.Z -oc r ion, wod Ication. or change Is nocasso y.
subject -to or change
._F1go:w P
T It'
5
10
QM
Pumm coupe i DBPABYMm OF HEALTH
Dhlalw a[ BiavbomaeW HeaNb Seevloes. Caamd. N.H. lildl? a• CM T8 OF COMPUANCB 175—
f R
P�k i
COMMMON PEUM FOR SEWAGE DWOSAL SMUI
n / ,GiYtrY9",S"O
Stdldlwldw Ntune Sid. Lot i Tat Map Block at
Owe /A�Yaot Name %�iol's�G c t ,�di /A �(��aS�'P V s� —� � .
/ ` /� r, Dote of Prevlo�as Approval
� Address �tiuc d W 9&39,50 /Y 1�4i d3 Town 7I
Date Subdivision Annrojved Fee Enclosed 0 Amr„i„t
Bt GIft Type c / Lot Area ` �i A r , F)p SeeUon Oob fta vatame
Nara bw of Bedeoow -3 DWW Flow G P D y . PCHD NeflBmdass 4 Bequked When FM le completed
Sepuub Sewemp Syoien to cendet oit /Udc- rWJ= Septic Took -ad "47 • L. �tb.t . 1/Yhal P. r
To be. by � /� Addmiss
Water Sofftr:ee!%4�o pAUc Soppt9 Fsem .
Ad&m
an fdwaft SOP* Dented by Ad&m
Otber I:egdeemaafe .
1 r•pr•sent'.that 1 am wholly and completely rosponsible for the design and location of the proposed system(s); 1) that the separate sewage di s•1 a stem
.bow described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a repo ns o Harm
County Department of Health, and that on completion thereof a "Certificilt• of Construction Compliance" satisfactory to the Commissioner of H•althwfll
be submitted to the Department, and a written guarantee will b•. furnished the owner, his successors, heirs or assigns by the builder, that aid builder will
piece in good operating 'conditfon any part of said sewage dispofel system during the period of two (2) yeas immediately following the date of the Issue
er4s of the approval of the Certificate of Construction Compliance f the original system or any repairs thereto; 2) that the drilled well described above
will W located at shown on the approved Wan and that aid well w Instal fn ac anp ith the nda s, uks •g a�%ni oho Putnam
County p•peg pf "Ith.
Date ( /y" {{jj,, Sign j Me 5 P.E.- R.A.
Atldro I/% / C1� S Uleenso No
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issuetl unless construction f he building .Ms been und•rtak•n and is
revocable for cause or may be amended or when considered necessary by the Commissioner of Healt ny change or alteration of construction
r•ouires a I . • w permit. Approved for di of domestic sanitar n ivate water supply only.
10/88 .
PUENIPM COi = DEPP.FM/iiENT OF HEALTH
DIVISIO^l OF EQVIMN'Z 7rxr• REALM SERVICES
i
Building Constructed by
Location - Street
Muiicipxl.ity
Building Ty'_Ce
Section Bock Lot
Subdivision Names
Subdivision Lot 7
GaAPA=L OF SUBSL?RFA(a; S0,LA —GE DISPOSAL SYSTEM
I represent that I an wholly and completely responsible for the location,
workrronship, mate_r.ial, construction and drainage of the sewage disposal system
serving the above described: property, and. that it has -been constructed as shoran on
the approved -plan or approved amendment. theretoi..and'. in accordance with the
stanLrds, rules and regulations 'of the :Putnam County Depa l rent of Health, and
Jzereby 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
operat w.
e for a period of two years inediately following the :date of approval of the
"Certificate of Construction. Compliance" for the sewage disposal system; or any
repaixs 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 detersuination of
the Director of the Division of Environ rental Health Services of the Putnam County
Department of Health as to whether or not. the failure of the system to operate was
caused by the
the system.
willful or negligent act of the occupant of the building utilizing
Dated this / day of 190 , Signature
4c_ontractor (O"'-ner - Sig ture
Title
M.sx-
I
Corporatiai tarn✓ (if Corp.)
Corporation us (if Corp.) S �,� cG
ta 4a-
Pd&ess /ZS63
.F.ddreSS
rev. 9/85
n1k
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Re: Property of_
Date �• 5 �%�
4,;rl
P
Located at
(T)'j:?j b0 n Section Block Lot
Subdivision of
Subdv. Lo k. ;1 '
Filed slap 1
--- Date
Gentlemen:
This letter is to authorize Z.
..a duly licensed professional engineer X or registered architect
(Ind4cate)
to-apply for a Construction Permit for a separate -sewage system, to
serve the above noted property in accordance with the standards., ruleq
or regulations -.as promulagated by the Commissioner of the Putnam County
Department of aealzh, and to sign., alll ,necessa.ry 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 •Publ:ic Health Law, and the Putnam County Sani-
tary Code.
X
Counters n jy z
w
Millbroo4 Office L
Address
$rewster,,NY 10509
914 - 278 -6108
Telephone: ;
Very truly y rs,
Si ned
Oi.-ner of Prope ty
ouC'
Address.
pot Soh, FU•�.
To ism
Telephone
PUTNAM COUN'T'Y DEPAR'B'ZEIVT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES •-
DESIGN DATA-SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner I k'ecs�Uy Address _ ,y� %Ic( Ni
Located at (Street) 60uo� Sec. / Block_ Lot &
(indicate nearest cross street)
Municipality /tea #er.5o,, Watershed
SOIL PERCOLATION TEST DATA -REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre - Soaking 5� `� -�%� Date of Percolation Test
HOLE
NUM]3ER CLOCK 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
S67
2
// -•12 - //-32
; Zy. _
22 ...
?5 "
3
6.67
1/ "37- 7
9 3 - /2.24
= 20
2
•-/2.28
Z
3
12:3e - / =yo
_o
„
ZI
Zy '
3'
/O,o
1
2 - .- -
3
4
5
NOTES: 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 fran top of hole.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS EDiCOUNTERED IN TEST -HOLES
DEPTH HOLE NO. / HOLE NO. Z HOLE NO.'
0-
G.L.
�ywh the �ro.✓N �i'N�
1 . 2 H y L tM /aa "i
'
3 5
j�n� �
4� 3 s
61 flAe_
7.' l✓ Ofc-�p 0(iVe�O�dw� ?C� .�xtt -td
8�6v �rh0 �Sa�e iHOr� /iGia IVY
9'
10'
12'
13'
14'
INDICA'T'E LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: y,'�ti„t,�, (�`,�) 1 4gy ") DATE: ...,61 ,2411915
DESIGN
Soil Rate Used 0-lo Min /1" Drop: S.D. Usable Area Provided
No. of Bedrooms �3 Septic 'Tank Capacity /000 gals., Type foWC.
Absorption Area Provided By _ _ L.F. x 24" Width trench
Other
Name �nurf%res ,�G. Signatur
Address f�l. / /bz�i`�v_ o�'�i�� lr,�� SFAL *�
-22 le-
• ...... sFG R'o.1;;;5781 w
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Sail Rate Approved sq.ft %gal. Checked by Date
LAURENT ENGINEERING
ASSOCIATES, P.C.
MILLBROOKE OFFICE CENTRE
Route 22 & Milltown Road
Brewster, New York 10509
RANDOLPH W. LAURENT, P.E. (914)278-6108 - (FAX) 278 -2858
HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS
June 5, 1995
Mr. William Hedges
Putnam County Health Department
4 Geneva Road
Brewster, NY 10509
RE: Individual SSDS Repair
Couch Road
Patterson, N.Y.
Dear Bill:
Enclosed are the following:
1. Four (4) prints of Drawing SR -1 "SSDS Repair ", dated 6 -5 -95.
2. "Construction Permit for Sewage Disposal System Repair ", dated 6 -5 -95.
3. "Design Data Sheet ".
4. "Letter of Authorization ", dated 6 -5 -95.
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.
RWL:TR:bd
95053
cc: Mr. & Mrs. Keasby w /enc.
D MEN P
Mr. Randolph Laurent, P.E. .
Laurent Engineering Associates, P.C.
Bureau of Water
Supply & Wastewater
Collection
Sources Division
(914) 742 -2002
Dear Mr. Laurent:
June 27, 1995
RE: Edith and Thomas Keasbey SSDS Repair,
Town of Patterson, County of Putnam
East Branch Reservoir; Project Log 3039
Enclosed please find the New York City Department of Environmental Protection's
(DEP) SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINA TION for the above
referenced property located on, Couch Road in Patterson, New York.
465 Columbus Ave. Please contact Margaret Lloyd at 742 -2033 at least 2 days prior to the start of
Valhalla, New York 10595=
1336 construction of the subsurface sewage treatment system so that we may inspect and monitor the
installation. A copy of this determination must be available at the project site during
construction.
MARILYN GELBER
Commissioner
ROBERT P. LEMIEUX
First Deputy Commissioner
Acting Director
Printed on recycled paper
One set of plans bearing our conditioned stamp of approval is enclosed.
Very truly yours,
J s W. Roberts, P.E.
Program Engineer
Encl:plans
XC: Director of Environmental Health w /encl.
Putnam County Department of Health
4 Geneva Road
Brewster, New York 10509
Millbrooke Office Centre
New York city
Route 22 and Milltown Road
Department of
Environmental
Brewster, New York 10509
Protection
Bureau of Water
Supply & Wastewater
Collection
Sources Division
(914) 742 -2002
Dear Mr. Laurent:
June 27, 1995
RE: Edith and Thomas Keasbey SSDS Repair,
Town of Patterson, County of Putnam
East Branch Reservoir; Project Log 3039
Enclosed please find the New York City Department of Environmental Protection's
(DEP) SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINA TION for the above
referenced property located on, Couch Road in Patterson, New York.
465 Columbus Ave. Please contact Margaret Lloyd at 742 -2033 at least 2 days prior to the start of
Valhalla, New York 10595=
1336 construction of the subsurface sewage treatment system so that we may inspect and monitor the
installation. A copy of this determination must be available at the project site during
construction.
MARILYN GELBER
Commissioner
ROBERT P. LEMIEUX
First Deputy Commissioner
Acting Director
Printed on recycled paper
One set of plans bearing our conditioned stamp of approval is enclosed.
Very truly yours,
J s W. Roberts, P.E.
Program Engineer
Encl:plans
XC: Director of Environmental Health w /encl.
Putnam County Department of Health
4 Geneva Road
Brewster, New York 10509
New York City
Department of
sr Environmental Protection
SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATION
Pursuant to the authority granted under:
Section 1100 of the Public Health Law;
Section 18 -03 of 15 RCNY; and
Section 128.1 of 10 NYCRR;
and in accordance with the standards of
10 NYCRR Appendix 75 -A Wastewater Treatment Standards - Individual Household
Systems;
NYSDEC Design Standards for Wastewater Treatment Works; and
NYCDEP Procedures and Practices for the Approval of Septic Systems and Wastewater
Treatment Plants.
the New York City Department of Environmental Protection makes the following determinations
with respect to the sewage disposal system(s) plan described below:
Name of Project: Edith and Thomas Keasbey SSDS Repair
aka:
Location: Couch Road
Owner: Edith and Thomas Keasbey
Address: Couch Road
Patterson, New York
Drainage Basin: East Branch Reservoir
Type of Sewage Treatment System and General Description:
A shallow absorption trench system is being proposed with a 1000 gallon septic tank and
336 lineal feet of trench. This system will replace a two cesspit system for the existing
three bedroom house.
Dates of Site Inspections and Soils Test (Reports Attached):
Deep hole and percolation tests: May 24, 1995
DETERMINATION
(XXX) Approved ( ) Disapproved
( ) Conditionally Disapproved ( ) Accepted design
CADATAWISOUASBEY 2
r Conditions of Approval:
Prior to the commencement of any construction requiring a building permit, the applicant
must provide at least 48 hours actual notice to the NYCDEP engineer or his
representative making this determination.
2. The facility shall be constructed and completed in accordance with the engineering report,
plans submitted, specifications provided, which form the basis of this approval, and in
_accordance with the conditions of this determination.
3. The project construction must be commenced within two (2) years of the date of the
determination.
4. The applicant will provide "as built" plans to NYCDEP, certified by the engineer, where
required or requested.
5. When installed the system must be operated and maintained in accordance with NYCDEP
Regulations and all other applicable regulations and/or standards.
6. In the event that the material submitted is inaccurate or misleading, or the owners of the
project do not have the legal right to develop or use the property where and as shown on
the material submitted to this office, this approval is withdrawn.
7. This determination constitutes approval only of the physical design of the septic system for
proposed installation and operation on a watershed of the New York city Water Supply. .
An approval of the septic system design does not effect any existing property rights, title,
or interest, including without limitation, any public or private restrictions upon the use of
the land. Therefore this determination shall not be considered to be a grant or waiver of
any property right.
8. The sewage disposal system shall be constructed in conformity with the data and plans as
approved or commented upon. Any significant change in the system must be approved in
advance of construction by the Department of Health and this Department.
9. The system shall receive only the domestic sewage from the structures shown on the
plans. The nature and quantity of flow from the structures shall not be changed without
prior approval of this Depart ment and the Department of Health.
10. All parts of this system are to be operated and maintained properly. In no case is sewage
or sludge to be exposed or any other unsanitary or unsafe condition to be created because
of the use of this system. Guidance on standards is found in the Waste Treatment
Handbook issued by the New York State Department of Health under New York State
Code of Rules and Regulations (10 NYCRR 75).
CADATAMMKEASBEY 3
11. Whenever sludge and scum shall so accumulate in any septic tank so as to occupy together
at any point more than one -fourth of the distance. between the bottom and the flow line,
the tank shall be cleaned.
4
12. Whenever sludge and scum are removed from any septic or settling tank or any part of the
system it shall be done in such a manner as to cause no nuisance, and the material shall be
disposed of in accordance with applicable regulations.
13. This approval shall not be construed to invalidate any rule or regulation enforceable by
local authority having jurisdiction.
14. All duly enacted rules and regulations for the protection of the water supply shall be
complied with (Administrative Rules and Regulations for the Protection from
contamination to the Public Water Supply of the City of New York adopted under the
authority of Section 70, 71 and 73 of the New York State Public Health Law).
15. This system shall be abandoned and a connection made to a public sewer if and when a
public sewer is built that is available to this project.
16. _ Whenever it is determined by this agency that additional replacement or improved sewage
treatment facilities are necessary such facilities shall be professionally designed at the
expense of the owner or owners of this project. Plans are to be submitted to this agency
and the Health department for review and approval, and facilities shall be constructed and
maintained at the expense of the owner or owners of this project.
17. All material removed from the area of the failing subsurface treatment system shall be
hauled and disposed of in accordance with all local, state, and federal laws or regulations,
including those of this Department, pertinent thereto.
NEW YORK CITY DEPARTMENT OF
ENVIRONMENTAL PROTECTION
Determination made by:
Date: June 27, 1995 J s W. Roberts, P. E.
Program Engineer
Environmental Programs
Recommended for Approval:
igmeer
Environmental Programs
CADATANISCIKEASBEY 4
t �
.r t
t
4
1=
4
\ 4
ff
17'�NJENSJ` N
, N
2o5
_
20 7
3 2095
1075.
5 ` /56 5
i
:•
�8 / Z 0
9 y
� •
ro..
r� S3 5
5 7
,
. t
Z(N
�j
y
� �ug' 999 594,1
{
a
sTONE WAL L
i � � Screen
/ I Porch
I / h
Zx
/ T
kI I
BR /CK WALK 7
/ VE
N�,, I m
nti
�>O
n
n
4
N
n