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HomeMy WebLinkAbout0734DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -1 -3 BOX 8 1 ru - I.- a 11 0 ..:., 4 his I rr 1, 00734 f MEVL5t�D -17-7 r PUTNAM COUNTY DEPARTMENT OF AL - Division of En vironrrienml,YHea <th Services;. Ca m P N Y ,'�10 P.12 • - CONSTRUCTION PERMIT FOR_SEWAGE .DISPOSAL. SYSTEM 'att' Ori. ✓ Town r II ge'. T Located at West aide of Old RO,ut6 22 SeCt,on Map 69. B1 '.:8ubdivfion 'n/ 3.34 acre• parcel {L_565CP300� l_ot. ` - 2: Job 8 -2 -74 Owner Leonid BOlotine ' dd► -204 W 55th, Street; NY, NY �10CU 'ori Diu Ater &Son- I'n -Taw0 M "r & °Mrs., George Ralik - Br ar= `Road Bwl , m - YPe : Tile Lot Area • _ , - 'Number of Bedrnnmd - ' • t'G7Lfi '� _ otal Hab'ita le Space 1500 quare Feet exisin proposed addition�j -Separate sewerage 'System to coi5sist,of Gal 'Septic, Tarik I, a fee X width tench Y Arthur Eurdck Joe�,s Hi11 Road • To be ,constructed b Address `. ,water Supply. Public'supply'1 tom - }�TeLVS�,er .1,Teit. York' '10509. prlvate,`supply� drilled by. Albert`' M. _Hyat.t Jr. �4real Drilling I Man treet � �'atter•son ``I�Tevr '.,Qr 12, 503 h Address -. z { Other•Requirements a S.., per an, ncode..regur:eents,' etc. i --I represent that i am wholly and completely responsible for the design and Iocatf. of the proposed 'system(s)p 1).,ttiiat the separate sewage disposal.- system above'described•will,b6 constructed as''sh6wn on the a s an regulations o e Putnam pproved amendment there to and m' accordance sw.ith the standards, rule. County ^'Department' of ,Health, and th-k on.•completion thereof a " Certificate of':Construction Compliance. .satisfactory t6.the Commissioner of Health will be -submitted tol the Departrrieht,` and' a written guarantee 'will be furnished Yhe;owner,,,his s6ccessq!sj heirs or assignsby'thebuilder, 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- ance of, the approval of the Certificate .of Construction- ,Compliance of the'original'system or any repairs thereto; 2)'.thaf the drilled well described above will berlocated as'shown on the approved plan and.that said••well'will ` be installed i acc rdance wit •fhe std dards,.;rules ari .r, ula i�`ons .of the . Putnarri •CountyF'Departmenf`.of Health y t .. ". 'Date " Sept ember 3 t _1974 .• signed P.E. X . R.A. s ownR` 5 Bs rg . 43952 addres Mllt R nN APPROVED FOR CONSTRUCTION: This approval exgjre; one •year from;the date issued :unless,cohstruction ' of'tfie building has °'been'.under taken and Is revocable for ,cause or.inay be amended :or modified when considered necessary by .tt_ a yCommissioner. ci Health. Any Change or alteration of construction re ayes a new- er.mit A roved .for `f - q p p v disposal o domest� nary sew et and /or priv ate waters only // Date /� �� BY /� ��`_ Title J�-- /P /. [GG " r �•.v :. ; i._ .z .. ;L - v.�.�� '��, Y e.�^N. -,. .. � � �•: i r' " � ^ -T fir'..:,' F • x+ 0 n WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION NAME ADDRESS OWNER t (1 1 " " � YL e.11� �� � I /� / r LOCATION (No. ti Street) (Town) (Lot Number OF WELL t b ircl BUSINESS ❑ ❑ ❑ PROPOSED .DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ SUPPLY ❑ INDUSTRIAL AIR CONDITIONING ❑ OTHER (Specify) DRILLING ❑ ROTARY ( COMPRESSED CABLE ❑ OTHER .� ❑- EQUIPMENT Llx AIR PERCUSSION _.__.. __ .PERCUSSION (specify) CASING LENGTH ( feet) DIAMETER(Inches) WEIGHT PER. FOOT ❑ I E SHOE EYES NO O ' THREADED WELDED LJ NO YES YIELD ❑ HOURS ❑ G.P.M. YIELD (G.P.M.) TEST BAILED PUMPED COMPRESSED AIR WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST (teat) Depth of Completed Well LEVEL 0 in feet below land surface: MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL Diameter of well including GRAVEL SIZE (inches) FROM (feet) TO (feet) PACKED: grovel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET i` s` i Yir If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE �abJl M DATE WELL COMPLETED DATE OF REPORT JWELL DRILLER (Signet �L Z "h 1" fi• • (3 � /� �»�.j }� (j �Q /' �°f 1�..�'yu. i° R flf. Ft MC. Utif..R 1Y 1�'t 1 f r{ .l> \'��H4 y7 ATh `�Y't4`k�T Y �j jt•. iC ,C'a 4' L 41 �l $' triY q.'34 1!'•� 5 11 Pfftb`t9'SiONtA4lKC31tNR L}kietD MILLTOWN f� O 'D 7bn'tt'kirY`A�t bT'fiR MEW Etft &SSI�W VIOitK_ fCSiY,fk t ' ,t t� ', et'6 �r1x ty� "r \Xt a a t�s I� } •(9 {$): 278 '$980, � xt 1 +,xt7 Z ` +h � s,`��'su� +.r,�'�i *zSel ?:iiu�'��sy��y�`"j"!�a`r 1Sr� { X.1� ' , t * ,},�� w fir+ 't:,p i� \ti rr v. `r N�'� r�t�y'P��'at,'�{S•t�'�iia��+ t _•, .. ,r n di � M. zIS�, � INr��ti7��+rk�t, \it of 'Jt�p{�,, ,¢ y� y, '�f vt 'i�+A It �IF.X tB,CV irokA4b(tr"J vital ea N � �`tii l�,lf�� �l.��C7 �77Cid..b�!�r 'Vr , °i �rtL 7�f 1 r' �Ytn 1 4'�i art \i iyz t� ��\ '��r�N •I } ' i iia46W Fork 10519 u= k fi, 3k1 %yi Ilk ;.. ,�: 4 + ' \; a A A! r•t irlafo f�,i i"! ty � �V�t� +' + ii ci i°23$�-i D Poll. ® ' 31At.: ® r C t3„NlieI� F \ , 1?r. '�,.� �i.�Vjr�iAii� ��y "�^'"rAyY!�V ,/r'p� 'u►�' ': t,e�r � f�v e* , Z:. iJJ1,` i.i s '! ° 1e!k !� � �m 5'4 $i aQ.' p� ¢��y •� p 7�y ..; a 't' a ` •, L67 �'U'L ', �_ with ' �4�e diA� .f,. o��\JV9 � �•fiRlr � 8i7 �, �' z,F.staa V4T I�.''r�t t Sl Wei �1�YP�. i 10I V� .+a M Y P •1 k S t t,�'„�H�i r t �y�•� ,p YY 4., plans, sheets 1 and 2 of '2 of t � �i i ��1"! tf� � ©t•', H r �5 al S+ t a t ,M14 Qarip1eti6A Report fi ` {� �. *ss�ucton Yex7n3.t application, 0 ! o:ri :Uon` form y }i '-page. Rg ohook list t r• ^ NA�`r.. a • t '" •i 74ryt• l L�r � Pl=ease. note. '. I; stlready have discussed the joint use �► :tb, r. 'oYr.ert'.'J ®' Caddell �;',c�. Director 'of Bnviror�ntal''Hep ltib `a�},"� ''�. a S.ery c;os 9 'ai d, 1..be1 eve the notes on plan adequate onvey YI aith ' ritment a Ito "s iticm® rh f d1 a i �1 4 S _ iH ay�k ti x Ku1Yk aPe quite amious to get str arte8 oh: this pro eet, ' a ��5 ®cute' knowing as soon as poss.iale if this aibiss�.k# �rtfi'<,Ft# �.nct�l�t� :Ar '.need revis;i.ons o . r PW < r ��r<✓'ti 1 � 1 ' •s i , t;�`i n � �' th ro and to the review of the at IM ahme ht4,, ,6 Ill,. �jdi +i/.4iiT•srii+� d.' ., t sCt11 ti \ s Very truly yours, r Arthur P. MCLSL 09� t u, A� t,tiul�:%E Pown of Patterson Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Da to Re : Property of Located at Sectio Block Jr Lot �-- . �L & XcLaughlln . This letter is to authorize a duly licensed professional engineer X or registered architect (Indicate)_ to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department,of Health, and. to sign all nece$sary papers on my behalf in UU4111C1:L1V11 wtLIl LlUb maLLev 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. Countersigned: P .E .,_ R.A. # 43952 A fr Address ARTH R P -'AdLAUGHLIN PROFESSIONAL ENGINEER MILLTOWN ROAD, R. D . 5 BREWSTER, N. Y. 10509 (914) 279 -6986 Telephone Very truly!'yours, Signe df�, Owne of Property Telep ss G - 71 yr LZ /1) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 rrepared for Mr. & Mr's. George Kulik (Son -in -law and daughter of owner) DESIGN DATA SHEET- SEPARATE SEWAGE-DISPOSAL SYSTEM FILE NO. 204 West 55th Street Owner Leonid Bolotine Address New York, N.Y. 10019 west side of Old Located at (Street 4dicate oute 22 Sec. TM 69 Block 5 Lot 2 nearest cross street) Overland to a pond on property Municipality Town of ratterson Watershed & thence from overflow a stream (intermittent) to Ureat mp SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole's dug 30t' deep minimum & saturated before testing hoiie Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop MIAJ ou 4�di WA SO Inches Inches Inches 4 26, 2 Z.D - 43 23 3 +3 so` - 66 Z2,5' 2-5 z 3 7,,!9 5 3 �+ 5 Notes: 1) Tuts 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. 3& 25 ?%z 2%z 12. 2_36- 34 25~ 27 2- l? 3' 0 _ �� 2„1 2'S 26 %a 1 j2 14. 4 26, 2 Z.D - 43 23 3 +3 so` - 66 Z2,5' 2-5 z 3 7,,!9 5 3 �+ 5 Notes: 1) Tuts 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. DEPTH G.L. 6" 12" 18" 24 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. L®-A H . HOLE NO. 5, +' ("6) r] HOLE NO. e (WJ 30,E 361 42" 4.8" 5 it 60 " ANA Y ^ 8411 _ 07 1 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL.RISES AFTER BEING ENCOUNTERED TESTS MADE BY --DF =1P k$ o Is E — Ayk-r '8 u 1 C K, Date / -7 4- 'PER.0 TES-r5 N.-CA0,P%S 4- DESIGN Soil Rate Used 11455 Min/l "Drop : S.D. Us bl Area Provided 13 u T:r- + r- ) F W 7 m�lat. No. of Bedrooms -rioo Septic Tank Capacity - Gals Type Absorption Area Provided By L.F.x24" 36" width trench. Other Name P. PROFESSIONAL EN01NF-9R- Address / ¢ ' ► 17 r�. h s THIS SPACE FOR USE BY HEALTH DEPARTMENT Cr ' Soil Rate Approved Sq. Ft /Gal. �Yle.ekq &Ab' 2 Date 0 + t .. AM caurnto A i r V. gALTN . r �biv }slbn bi�Eaylro .fiej}w`1;�3��t'k,��cirviF'iti Y � Ct tlP17Y 1 t�36 1!'llQtlliG`. "CA4Rl i!✓,'t: E.w YORK r +#Ivdr0,j #�rrnd wrais 1s'of s raLgtaii� fore i {cagef ctcco�sA�dT{7'�1��tu¢ i 1sC9:' r Xz t,::•ygi.� �? 'F'S' Y -P i7 'k tY t < .,a{ � it ,., J � h .:.k _ a` - r � � �.. • --�� E�..... {u �•, r � a .,, ` r� "➢VYAf : 1 } l!r!l 1F+8 i t e '�+ ' + N y r t aP ry • :xft�`'•�`' •yt t -:��� � r. ,c: 4. Jr a .L- r 14 + • !k 'r�, ���}2�� y r 4 ix� f y�� t' �^ � Tl�,�tlRbtB Y +,� Y �v...� r `er Y, y. `S' _( t�� . i+t ..5. ''S .�i! "' ..�'. .:H•t •k �.�..,_. �Jy� .:. "' -.v.., �%. �:r :C"�',. : AMY` • ,+w' . =+''a. q.. .::,�Y � �µ t ;yi "tti Y 1 L ` *fib a✓ t i�r'(rii[ ��k Ql ,F � �KQ,�,.� /, Q�� �.« +'Y - r �a (� 5.., ''F'- �'•s�'tW t rr'IN' t' t i1{4:� r�"��tc� k�.,,, +� !1(�5 � @��i i`'..'. .J.� 1 .+ ', �i . 1tVgr ►t • �iiylf + tM" r t 'ii. i�, 1 ME F RdP� IApV$ 8E{t2�yGlt STAtt¢(sooGi 'f a lt1Ald ti !Ci lSi (feat) '` ,� `' � �'`r��W�1 "I r. ti ���� + `MA •elf ,. �«C. ;14 `M } i. �. .. L�R Nom! WE�l7l IiOTW h -. TrT t s �.�' f 't^ Tit, �1a�y�r f �', �VK� �Y + +�0r c` 'IF' 'rnetr o! wall triclut�mgr`• ,r tuuvaca a -• FORMTL�i0l1i Eg1 t n �t t ! pM1r �la�cneoe to.'gttr dt' OWRa% rDiar�d+� 4A a r • ., t . r( t`i'p+ � i.' {'P k L� � '. f i' � I i �. i l,.y y �" ✓. i> i . k'. { q. ". .. r„ ,. ..V•!. •.t :�.� .� y+i } y ..t:.'rt.::. , ` J4 yiost +rice aastgd at dl .4fofi7ntitt(s dtniag drtp t, ltdd baaty �F 1 r. yv, � ,DATE 0 f' ftE�A;R� tN�R1_ t�sttt4��'ts'igl>�itclr�a} ,;T+ _-jp �� I* m,-�s Goorqe Yullk t-) Writ side MECIK 517=01 i slrxeet a:9'--,,upp1-iPe1 .c) U s use pla ns - _xs- Desi,-gri data sheet, Peres presckaked.? Min . 3b 10 pert test —dept—h-- Cont. res'ults for 3 D, Hole jqgBO.K. - Corporate Affid,-_:V11 —for ot_E7EF_t1, Authorization for e,.igin*eer :fitter from Water S1_1pP:LY iT­a-Pps If variance requested-such noted see note W on plan (sheet 2 of 2) indi"l. §UR P L LAN T' A11Am.To1?"j$P0 Iffl-TIVIlk ;?.- E , ca at. -e- on plans Lj_ rVa: ,.IPP,3 &_1 bedroorav r Re D W-A 11-S cif cha,-,-kve is proposed., t.) lcontours no change in Existilng contmirs shown tsl-mv new contours) Ix I,, Neaxest- vrell plahned Slopes for driveway outs, etc. shown -to __4 15' Water 8ervice line location Curtain dra--l-Il c Z_drain, etc. locat-ion Footir 17, 151 t-o Top slope., bott-om olr' fdi.i') a en situ � tajj�,ti. t,,.,) Tt p- Percolation tests and d�e U L 10 c a t i o.� C) f !a,,, Septic tank size an�i conform.,anCe, to st(J 15 f or .2 be r_U dmi I 3 B. R. house minim,,m,- 1 retirirqent ho House setback shown n/_ 1 1 __ 1 1.1, 511:J ii -PCPA -1-.n :dil- ow-all -A. ell -it4t.1rop- there is. no surfac water v..,,7iT-.hin 100 f C, par t- of s ado so Plan and profile Sir) _A].-1 other, we"j-1-s and Only viell close is shomm or r(f_:_fere_nce ty b - -dari es (:-ijetes and! bou-nds-c-lear-11,; It- o Pe r owl J_ n see d a�­, Survey is alco 2"W.Inished, (-r ,Y A+­noli I `­­p deed. cnonform SEPIA.PIATION DIS'L4110E'S GT P-T 101 to P. L. 201 t.) *i-00 o Neaxest- vrell -to streall ri -.a rch a etc. 15' ILI o Curtain dra--l-Il 10, to 1 7 @6 t e, r 1 i n e p xaady_ 151 t-o storm drain 10, t,,.,) iarga trees C) ­-orr, fau-neLation to &�,,p—c- tai k i X 15 Uri pirp�­, from, 11,e�n_der �_`: -_­a.in 8; fcZTf iaQ -4 & Mrs a. George NuIlk t9 Wost side sheet 2 of 2 Hou. 'arson FIELD L I K" % Date Seot ember 34 Is"'. -Lnsp.by:_.A p ili INITDI SITE iNSP ECTION ! Y es No Cornents north 11no to stone *-ld Property lines or corners ]"ound •. . . . . . . .. i. . w. a ---. Can estimate house location . . . . . . . .. Will driveway need cut . . . . . . . . . . . ... . Must trees be re moved-note these . . . . . .V& , H�D glib deep hole c.r.epr-esentative, of ��,nt,ir-, E, area X Additional deep holes needed.. . . . . . . . . . .. W- Sufficient SD3 area available cons-.`Lrdc�rinn driveway cut..,house locat-lion.,s--,,nai-a"�iio-ri distances., eL ... . . . . . . . . . . . . . . DEEP HO.T2 DATA_ i Deepthe I I Water elevation., Rock elevation: See design data Soils description: 1 sheet FI•M, SITE INSPECTION ,,ot n e.0 consri-ot Ion aj. addit Aoi * I'ol I a 1 r � e a 01j Hou5e. located ,,here shown on approved plan r. it is partiaLly in -ST.)S lonpted i'Ar-ere lvulwh LJJUc1bU1't=-U Width of trench average Slope of tile line and trench acce ,c�1 Row allowed for expansion trenches 0ver -50 ft. from swamp., watercoi-urse . . . . . Natural soil not stripped or SM area unnecessarily graded . . . . . . . . . . 10 Ft. maintained from prop.1-ine, and 20 j:'-. from house, . . . . . . . . . . Separation of trench from house, we'll etc. follows plan . . . . . . . . . . . . . . . .. Number of bedrooms checks Stones, brush., stumps, rubble, etc. greater than 15 ft. from nearest trench . . . . . . 15 Ft. of peripheral soil horizontally from trench . . . . Junction boxes properly set Could surface run off f-r,om drive-7.-iav roads, ground surface., etc. channel nea-r"StS area. . . . . . . . Does lot*drain�jze av-Dear O.X. in area of SIB FINU GRADING OF ST-- ACCEPTABLE PUTNAM' COUNTY DEPARTMENT OF 'HEALTH Division of Environmental Health Services Carme% ;N Y. "10512'. CE_RT,IiFLCATE_ OF_�CONSTRUCTI`ON,;COMPLIANCE FOR-`- SEWAGE;DISP,OSA'LNSYSTEM' c • ' Town or Village yocated at YueSa: s.a ".: "..f v� a °:R ;,�-n �J� T ,Vi9 5 v-oz�e of- iddRb�cvq -err 9Cetfen . Block owner rlj,c7 'R616 i n for iight-Ipr Rr ion —fib _Ia 'n Lot `�. " lob ; Sea te, �e raijerS"ysiem Z iTY '�e ALl11k ;; Ji�•e�3 —�� 1 P r ur C Address IRd- TBi.'e yhtier� VY _: Consisting of, Q(�Q Gal. Se , ptic'xTank - lineal Feet X �2��' 1'OItftiT 'drench ` Othe'r requirements' per' plan- & Healsth - Dept::" ReQs • i y ei SupPIY• Public Supply from Private Supply Drilled By " Albert ..M" :'_H�ratt Jr - Well Driliin� l Address Nfai n Ste• "z Patter�or°+' NY` I PS F! a a --- s Bwld!ng•Type F$+i� additvion No, .of Bedrooms t�tb (� Date Permit Issued 9 .17 74 Has Erosion 6oritrol Been Completed .: �E3e7_f' Y]Ahadi`ing &" seeding do ,b8 S(i_eomplished next spring: I certify that the'system(s). as; listed serving the above premises were ':constructed essentially as shown. on dhe -plans of the completed work (copies of which are - "attached), and in accordance witfi the standards; rules and regulations plans f.iled� tR ', mit %i ued .by dhe, .utnarn my *Department of Health. t Date September 22, 1975' :; _ Certified by P:E R.A. • a - e o. Address Lic en PYin9.Premises served by. the above �• 7 (�o • ? 439 G •Any person occu system(s) shall promptly take "such action, as maybe necessary "tltQAQIL correction of any unsanitary r conditions resulting from-, such usage. Approval of, .the.separete sewerage - 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'.nuil'and void "•when''a public water supply becomes available. Such approvals are subiect -fo modification 'or change" when; in the''judgment of the issioner''of Health;. such cation, modification or change is necessary. �t Date - By ® C'i�ti) Title n u ti }_�•i T.�I ,T¢• { r I 1 - s---�' � 1 ,I f .L. ! .p- 1 � 1 �� i }-} 1 r .. � t j r"T „T_�; I - �f_t._�., _ _F -! -L_t t t 4 'j_._� `+, `- -I- ^ ^I-- '�- -t--F_ ..�_ y r �� - } L� 1r1 � r - �-- -:-.� -- 1� y-- 1- �•-�'- - -�-� � t 1 1} 4 4 T F.! � 1 I I_._ -' i.. I I } ;. ✓,-.T � I �( __{�,�,r j, I I •....}�� e� F-r-. 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