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HomeMy WebLinkAbout0554DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23. -1 -21.1 BOX 7 00554 �. �' , Lo r ;&{ rr . 1 . ,. �r r . -6- ��% I I . I r 00554 'Ir � e • 1 / 1 Z . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PC D CONSTRUCTION PERMIT # f!- I ",7 -G] & 1, 11 1 ,1 �1 Located at _aRhJW LL a J L.L fg�2 V cvrzN��w Owner /Applicant Name kQor— to jr C G Formerly Town or Village OL- a>✓950 N Tax Map 9- 0, Block 1 Lot 21 . Subdivision Name CpNl/5lA�LL Subd. Lot # Mailing Address 12 S. PLAN K- /�i tAe6 y5 Qgg Zip 2,95;D Date Construction Permit Issued by PCHD Separate Sewerage System built by A712MFDL4W:2Er- I NC. Address g12ANJ5Q&��o N`( Consisting of 1290 Gallon Septic Tank and _�-l�0 (rl; A03 "Tr Other Requirements: Water Suu ®Iv: Public Supply From Address 1&0 1 TH 16W or: Private Supply Drilled by T:-r r:z l SVZ --�1 Ll I M C. Address h/(1 LTO N M I Building Type Kr;ESI r%1`WTAL Has erosion control been completed? �F=-s Number of Bedrooms !I Has garbage grinder been installed? t� 0 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulatigns of the Putnam CountyA)epgrtnlent of Health. Date: - Certified by Address P.E. )k R.A. License # 5 &12-4 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval `, of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocationjTdification pr change is necessary. 3y: Title: 1401-C ejA • Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS November 24, 1997 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Compliance - Lot #1 Cornwall Ridge - Lot 46. Cornwall Hill Road (T) Patterson Dear Mr. Morris: Enclosed are the following: 1. Four (4) prints of Drawing S -1 "As -Built Plan ", dated 9- 17 -97. 2. "Certificate of Construction Compliance for Sewage Disposal System ", dated 11- 24 -97. 3. "Guarantee of Subsurface Sewage Disposal System ", dated 11- 11 -97. 4. Well Completion and Well Log Report, dated 7- 24 -97. 5. Water Analysis Report, dated 9- 23 -97. 6. Money order in the amount of $200.00 payable to Putnam County.Health Department. If there are any questions concerning the enclosed, please call. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Ni ols, Jr., P.E. HWN:TR:b 93071 -1 11-04 -1997 08 :54AM FRCM LAURENT ENGINEEPING ASSOC TO 95690372 P.02 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGt TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot sA M 2ATT5-920`l. Building Constructed by Town/Village 411,L- 9121-4,P- (�2;KgINALLLI Location - Street Subdivision Name - Building Type Subdivision Lot 4 I represent that I ant wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is 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 successors, heirs or assigns, to place in good operating condition any part of said system constructed by nIe which fails to operate fbr a period of two years imm:diately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or auy repairs ;made by me to such system, except where the failure to operate properly is caused by the willful or negligcD.t act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whetlh it the failure of the system to operele was caused by the willful or negligent act of the 0 cupant � the building utilizing the system. j Dated: th 11 Day i Year G ontra or (Uw er - I ature U it Corporafion tc.._Ue, (if~ oration }+Y 12 , K �i Address: S Title: _ sAm Corporation Name (if corporation) Address: State �� Zip __ ` State Zip _ Form GS -97 TOTAL P.02 W Y WLLL UWv1rLL',11Un Nmrv1C1 DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY.DEPARTMENT OF HEALTH Office Use Only 0 WELL LOCATION SiREEi ADDRESS: wNIVIL ! I Y TAZ GRID NUMBER: Cornwall Hill Rd., Patterson — Lot 1 j WELL OWNER NAME: Harry Lipstein . ADDRESS: Cornwall Builders Corp., 12 So. Plank Rd., Newburgh, NY 12550 ❑ PRIVATE Q PUBLIC USE OF WELL 1 - primary 2 - secondary Z RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED 0 BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING CY- NEW SUPPLY 0 PROVIDE ADDITIONAL SUPPLY 0 TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 204 ft. STATIC WATER LEVEL �ft. MEASURED 7/18/97 DRILLING EQUIPMENT ❑ ROTARY CR COMPRESSED AIR PERCUSSION ❑ DUG 0 WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE 0 SCREENED ❑ OPEN END CASING. 0 OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH 20 ft. MATERIALS: :0 STEEL 0 PLASTIC 0 OTHER CASING DETAILS LENGTH.BELOW GRADE 19 ft. JOINTS: ❑ WELDED ® THREADED ❑ OTHER DIAMETER 6 in. SEAL: 0 CEMENT GROUT ID SENTONITE ❑OTHER WEIGHT PER FOOT 17 lb./ft. DRIVE SHOE: ❑ YES ® NO LINER: OYES ®NO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH If t) DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ❑ NO HOURS SECOND GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft BOTTOM OEM It. WELL YIELD TEST If detailed pumping METHOD: O PUMPED tests were done is in- COMPRESSED AIR ,formation attached? ❑ BAILED ❑ OTHER i ❑ YES ❑ NO WELL LOG it more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- ing welt Oia- In FORMATION DESCRIPTION it. It. WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Land 6 Sand 6 204 x 6 Granite 204 g 0 160 5 WATEII O CLEAR TEMP. QUALITY O CLOUDY HARDNESS ❑ COLORED ANALYZED? OYES ON ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE CAPACITY GAL. WELL DRILLER NAME J. T. Eckerson, Inc. oatE 7 / 24 /97 ADDRESS, 1613 Route 9W StG" / Milton, NY 12547 Vice President PUMP INFORMATION . TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE HP ENVIRONMENTAL LABWORKS, INC. PO B" 73d,, waftcm New lft* 12FQ {91A] 236-7s2a'T ` raa ta. +1 cave w. a L\ ELW IDS 1MA r SCULEiJW5M BACTERIOLOGICAL EXAMMATICNN OF WATER PWS0" owkmlp iY 7QA1i W �OFWORIFA NO 7& nell ` 1n� L 7 )0:;c)AJ /� tD pWn ]EXACT OMLIECTbNrowl SANIfte cans w Mod 7ELEP}IONE 0 � I PL93UC SUPPLY O MVATE SUPPLY awcANOOR LOCArcm OF WfATM SOURCE WROMTD SG NAawTO �AK El L%!D 5-te; r) Ec- so A _ Sc> w 1 i3 RT9k) o BACTVM i ML AT SSO TOTAL OOlfOI1Ml/ f0O4 OVEN TE37S PEMMR3 ABSEM IAkZY�OD Oi f,){AM/NTgN PJA O WHO MF O ColUart THESE. RESUL'T'S INDICA77 THATTHE WATER WAS OF A SATISFACTORY SANrrARY QUALM IN RESPECT TO THE ABOVE TEST, WHEN Tim SAMPTA WAS CO ECTIM REPORTED BY - �,ZILtT �- AL DATE 9- 23--97 7. PUTMAN CODIfI'Y DgrANITAEM OF HEALTH Orb r MwklmdBxvbvmmwWd Raft Se WN& ClNM> B.. "-Y- 10$1? Cie I . CROUPWA TE OF CDIWUAWR ZyM .lsl7� ��I 10 peps Vdaeo Nobae d Botiea�a Deaf Flow G P D PCHO NotlBraflao 6 B Wheb FIR is awpMbed SOPMON Ssw}aW Srga fie catch d -G Sop&Teok . slid watalr sa b: ° `. S** Fit Address; W )0 ftha s Siip*.Ddled AtBdieY of >e...a. i.twesent-thet'i am wholly and, Completely responsible for the design and location of the proposed system($): 1) that the :separate sawago di$yonl system above doscribod will be constructed as shown on'tha apProrad•pme"'n nt th®►e to and in accordance with the stand.►d; rules a rpq ,qs oT-E t RiT 11 County OepastMint of MWRK and,that on : completion tnereot i.- Certificate Of Construction Compliance" satisfactory to this Commissioner of MeaRhwill be tubmRtad to :the- ppait neitt, and a :writton:giwnntse will eo furnishod.the owner. hit successor; heirs orbs19" by the builder; Mat sold builder will pleat in good otleptlesg condition any part of tald:•sewags disposal syste during the pegiod of tiir0.(2).Yaaln medNtely- following the date of the issu- anq of. the .appteiial of ;tile. CertHkata.. Of Construction Cornpllence of - e Original system or any repairs them O; -2) t PtdrUl"wella est Rlsd o6oae will be located as ahouva on.tha'approved plan and that Yid well will alnstal ,in accordance with stendird rule n$ of the Putnam County rtm/entQ[o�R 4sMKh. iDate' C SgneO P.E. .A:A. — AdWt k1cp P) License No APPROVED FOR-CONSTRl1CTIOW This approval eupire$ two years from the date i unbp construction Of the building 1180 then undsNgken and If nyocaple for caun or may a amended .oi vnoaftied wMn,coesidered•nscasaary py the tommissioner , Of MoaKh, Any ehorlga or aKaratgn of construction rpuires a eve permit. ppi" ' far disposal of dome k sanitary so"i. and /or � �1ra a only. __._....,- 10/88 Date ®y ' Title M ti ;Q T-3 `S' rT -a- M C CD T_T N '1C' -�Z" APPLICATION FOR APPROVAL OF PLA14S FOR _A WASTEWATER DISPOSAL SYSTEH Name and Address bf, Appl scant: t 2. Mane of Project: > -D�aSG7� .5� 3.• Locationc/V /C: " acv 4. Project Engineer: 1 -Ika)e, 5. Address: Millbrooke "Office Cent Brevister, , MY . 10509 License Number: ��/7 � Phone: (914) 278 -6103 6. Type of Pro "iect: �- Private /Residential Food .Service .•..Commercial Apartments Institutional P.6bile Hone Park " "- Office Building Realty Subdivision Other (specify) 7. Is this project�subject•to State Environmental Quality.Review (SEQR)? Tvoe Status (Check One) Type I.. EXenpt _x Type II. Unlisted. 8. Is a Draft Environmental Impact.Staterinient (DEIS) required? 9. Has DEIS been completed "and found acceptable by Lead Agency? ._- ......._.. JU /W - 10. Rare of Lead Agency N24 ;I. Is this project in an area under. .the control of -local planning ", zoning, or oth,,er officials, ordinances? ......... 2. 1:f so, have plans been.submitted to such. author .s ties" ....................... A/A 3_" Has preliminary approval beeps 'granted by such authorities? Date Granted: All Type of Sc,�age Disposal: System Discharge...... " Surface water r _Gound waters 5. If surface eater discharge, what is the stream class designation ?........ _ / i• Waters index number (surface)__ Is project located near a public water supply system? )Yo I f yes , na ,e of eater supply Distance to water supply Is pr -oject i_e nenar .a public sewage collection or disposal s sty m ?..... 1 ;ar,r� of seu2ge system /� /�� Distance to sewage system �V1 Da'e 23. Narr,e of Health Inspector: 8�n�iyc. �,___.._ ' roJect desisn r -low (cal Ions per day) ...................... 2 Is State Pollutant Discharge Elimination System (SPDES)'Permit required ?.. f✓o 25. Has SPDES Application been submitted to local. DEC Office? .............. 27. Is any portion of this project located within a des i gnat ed'Toun'Ior State wetland ? ............... ........ N°. t 28.. Wetland ID hu�mber ..... 29. 'Is Wetland Permit •required? ..... ...• ............. ..... .............. �. � ?* ..._..... .Has application been. made to Town or Local DEC Orrice. .... 30. Does project, require a DEC .Stream Disturbance Permit? 31. Is or was project .s_ite used To.r..,agricultural activity involving application OT pesticide$ to orchards•or other crops., solid or hazardous waste disposal, land-Filling, sludge application.or industrial activity? ........ YES 'or 0 Aa 32. Is project located-within 1;000•feet of existence of abandoned landfill, hazardous waste site, salt stockpile, 1and.fiil, s1udge.djsposa1 site or. any other .potential known • sou rce of contamination? ..... " .......... YES or NO a DESCRIBE: 33. Is there a local raster plan or file-with the Town or vi11a'ge? ... 34. Are co,-, :munity water., sewer facilities planned to be developed within 15 years? A/() 35. Are any" sewage. disposal areas. in excess of 15% slope? ........................ ._ ..S. Tax fap ID Numiber . ....... ............................... ................ Z3 37. Approved Plans are'to­be: returned to: ................. Applicant Engineer the application`is signed by a person other than the applicant shown in Item .1, the. °pplication must, be-accompanied by"a Letter of Authorization: Failure to comply with this Drovision may be grounds for the rejection °of any submission. I hereby affirn•, under- penalty of perjury;. that information provided on this f'or,77 is true to the "best -of u-,y inox7e8ge end be ief. Fa Ise sta`terents "made herein are punishable as a Class A Hisd &7raanor ursu nt to Section 210.45 of the Pena 1 Lair. it 11 ;J 7-G,,IATUP,ES & OFFIC.IAL TITLES:_ iliillvooke Office CenVe L Ifi'G ADDRESS: Brewster, NY 10509 _. PUi'NAM COUNTY DEPARTMENT . OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner LArkfwAL Hors -ic- Address Z3g INDInK• NAX-F�ost I> a) Located at (Street) C.orm, ,,ALL- N , L-4- Ro aj, > Sec. z 3 Block �_ Lot Z: b (indicate nearest cross street) Municipality -ro w , o i�,�, .� E �so,� Watershed SOIL PERCOLATION TEST DATA-REQUIRED TO BE SUBMITTED WITH APPLICATIONS ... ©,olt�j94 ,ojzeJ94, Date of Pre - Soaking „� z. 1 g 4 Date of Percolation Test HOLE NUMBER CLOCK TIME PERCOLA'T'ION PERCOLATION" Run Elapse Depth to Water From Water -Level LOT No. No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start. Stop Drop. In Min /In Drop O Inches Inches Inches 1 10:16 - �o.z4 E, Z3 ZG Z a 2 3 ii :4a - 1.9 4 ,2:0, -, Z. 1 4 13 zz..2 :..- - Z 5 2 3 4 5 - 1 ;A l >>,09 IT Z1 z4 3 5;7 2 U.'.Z7 - I, :43 1 Zo z- Z-3 Z 3 S 3 3 1, '.4 s- i Z'o i ) o Z 1 z z4- L 3 S 4 5 1 2 3 n 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 from top of hole. rev. 9/85 Name H A1ZiZv W; lK,l , Signature Address j.�,e�$rzoo\cc �F\cC C�'NZRC SEA Trn T, 5 THIS SPACE .FQR USE BY HEALTH DEPARZNIEEN Na. T ONLY: ':��`�,� Soil Rate Approved sq.ft /gala Checked by Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: ?-,Pd `-7 `J J Inspected by: Street Location p/`Nc�c /�I �t�� ' Owner e0"�y �. S Town Sc11-� Permit # - /a PG TM # ,2 3,— / -a 1, 1 Subdivision Lot #. / 1. Sewage Svstem Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ............. ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank -size _ 1 ,000 ..... 27. ......other ............... b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... .....................:......... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost ................. ............................... 3. Minimum 2 ft.Original :soil between box & trenches: e. Junction Box - properly set ............. :............................ f. Trenches T-Length required X00 Length installed 2. Distance to watercourse measured 3. Installed according to plan ......... ...................:........... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property. line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1 V2" diameter clean .................... 9. Depth of gravel in trench 12" minimum .......::.......... 10. Pipe ends capped ....................................................... g. PumR or Dosed Systems Size ot pump chamber ................ ..........:.................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio ...... :.............................................. 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. House located per approve plans............ l b. Number of bedrooms......... f IV. Well a. Well located as per approved plans .......................... b. Distance from STS area measured /'-O ft..1 ! c. Casing 18" above grade . ............................... I d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ........... ..................... b. All pipes partially backfilled ..:........ ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev. 6/97 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION . Street: Address Village City Tax Grid Number WELL OWNER Nine Mailing ddress RESIDENTIAL ..:: O PUBLIC SUPPLY O AIR /COND /HEAT PUMP BUSINESS O FARM O TEST /OBSERVATION ® INDUSTRIAL O INSTITUTIONAL O STAND -BY JUPrivate O Public O ABANDONED 0 OTHER (specify O E OF WELL C primary -.2 - secondary .AMOUNT OF USE YIELD SOUGHT gpm /# O REPLACE EXISTING SUPPLY ItNEW SUPPLY NEW DWELLING PEOPLE SERVED T =, /EST. OF DAILY USAGE gal ❑ TEST /OBSERVATION El ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN []DUG ®GRAVEL ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: CAN h-124,44'— Riv /� r Lo�S/6 ?} Lot No.— �l '­` WATER WELL CONTRACTOR: Name -fin Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ENO k,, :t .NAME OF PUBLIC WATER SUPPLY: MIA TOWN /VIL /CITY µ.w >:. DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: `\µLOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED/) ®ON SEPARATE SHEET 1 (date) ignature) PERMIT TO CONSTRUCT A WATER WELL Vs permit to construct one water well as set forth above is granted under the provisions f Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within -Lrty (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 Completion Report on a form provided by the Putnam County Health Department. ng all well drilling operations, the applicant shall take appropriate action to assure that ind all water or waste products from such well drilling operations be contained on this s rty and in such�a manner as not to degrade or otherwise amen e s or groundwater. f Issue: " Expiration 19 -��— Permit Issuing Official Ls Non - Transferrable White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE R . AM Route 22 8 Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E: (914)278-6108 _k —) 278 2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS August 21, 1996 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Cornwall Ridge Lot #1 of Resubdivision of Lot 46 Patterson, N.Y. Dear Bill: Enclosed are the following: 1. Four (4) prints of Drawing SS -1 "Proposed SSDS -Lot V, dated 8- 21 -96. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage.Disposal System ", dated 8- 21 -96. 4. "Application to Construct a Water Well", dated 8- 21 -96. 5. "Design Data,Sheet ". 6. "Letter of Authorization ", dated 7- 29 -96. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 8. Money order in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. a) . �-n [rcj1o40-i 4 " - 13i0 0 Harry W. Nichols, Jr., P.E. HWN:DJ:bd cc: Mr. H. Lipstein w /enc. .93071 -1 r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRON2- LENTAL HEALTH SERVICES Date Re: Property of Located at (T) Section .2,� Block Lot • y. / Subdivision of Subdv. Lot , Filed Map r 7 a,7 Date Gentlemen: This letter is io authorize HAEg)- , 1V/Cl-vz -sj—e. a duly licensed •px-ofessiona]_ engineer or registered architect ( Indica ,e to apply for. a Construction Per - mit for a separate sewage -system, to serve the above noted property- in ac-cordazlce ii-D-t1i zhe standards, r>_il_c5, ox- regulations as proalulagated by the Corl1lissiomer of. the Putnam CouT 'U -1, Of }1calth, and. � :G s :i_�Il. c.l! 1 "l.'CC S r }' papers on L•1 }' }Je 1a Y _ mc,. is :' a -lacl. i;U ::1G' Co sTruCtlOn Of saj.':' S} S iCi.i OI' . E _ i }e �'O 't1C� e 1L�. . .Or 1V. _ I 0:,. a.47, Educes tio3l. )JG'K, the Public Health Lai;, and the Putnam County Sa.li -- tam-} COde _ ---- - - - - -- c. c:3s l Very t Si71ed o•.;„ ♦•: i. . •r .J. 48 BATH BEDROOM .t !� ]1' 8" x 12' -0'• -J DRESSING. BEDROOM 3 . WALK 13,-o" x 10.x.. - ! N CLOSET - MASTER BEDROOM BEDROOM 2 - ' OPEN 17 '-0 x 16'-8- 11' 0- x 15'•8"' [ STUDY SECOND FLOOR 4828 = .•1344S F 1 48' oc 1 , • r L fj 6CtTG1tEN DINING HOOM MORNING 1#OOM 1 13' 0" sill • -4 ._ 0rEN . r ABOVC ' LIVING '100M ' v � ,..� FAMILY HOOK -t 1 J' O" i t3'•0" 10* 0 m 17' 0" i FOYEfl) �- 1 } _ . :�:C•:!•:•/ •. :'S is %.. .•.t•.•..;`,:��r + '•:L:::•' :::j::': i :•i:•:• :•:•'• :•i . J . 48 BATH 4' �. �•� , m .�� BEDROOM •a ORESSING• BEDROOM 3. WALK 13' -0" x 10'-0' I�\ j — ! r1 CLOSET L MASTER BEOROOM ESEDROOM 2 r _ OPEt4 17 -0 16,-8— STUDY • ���° �" '"°���."'"°�°`"'°"'�'I`�"'.�,�_ . `. j ..y�. �.._.. _ � �..�d�.a �� �.�.:,,�;,,,..,.,.,y SECOND FLOOR _ 4828 = ••1344SF - 48' -j 1 �) h KITCHEN 1> 9R � � � . I M •CJ'/ 1 DINING ROOM � %•HORNING Iloo A � 13' 0" n 12'.0— ...... �'��n- r.?�:•.. ... x,�.�n4st' . tsc� : '. iii L���'se� _ _ t I : X UY A %-41 L Y �1 0-0 1 0 ' x i li ' •0' O' ) 7' O' I A ' ' Ii (454)-- INI 41 A 6 C2 ol loin) ... / /�� /i jj bal