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HomeMy WebLinkAbout0820DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -55 BOX 9 IIs 5 .:,Loeafedy f] W nar Cohsisting Other, regi Water Supply r X. Building_ Type, . _ _ Has Erosion Control B, wnv�ugns available a Subject to Date h■ i.yaaaia „va ,u.n "uw Y­ wvaa % W.Ll- led plan aad the. permit Ageaued by', the V. P E._X R A L'tense No' ?,,9200 --- a. secure the eorredion ,oi any,ununitary. i Dublic tanitery ,ewer .becomes omen avitlabh>. :S�u-c-h ipp rov a s � ere �i�Frthsll�' S.1 nec�i/afy h - Title, Robert NiefeI Owner or -Purchaser oT Building -�' Robert "ef Milding Constructedby East Branch, Road Location treet Modu 1 ar u ng Type Municipa.ity.. 8 Section Block 14.1 GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 guaranty to. the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use.of the sewage disposal. system, or any repairs :made by me to such system, except where the failure to operate properly is caused by the willful or negligent. act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- 'termination of the Director of the Division of Environmental Health Ser- vio.es._o.f .the ..Putnam.. County. D.epar.tment. of Health as -. -to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of e? k 19'1 r Signatu Title If corporation, g ve name and address) THREE (3) COPIES ARE REQUIRED. WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED.' GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of.Health DECEIVE® S E P -1 1982 �+�j NA EOUNTY DEPT. OF HEALTH WELL COMPLETION. REPORT PUTNAM COUNTY .DEPARTMENT OF HEALTH .' 3171 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. OWNER NAME d E? ! !J �'►! O Z4 ADDRESS ,3 57 2 ._57` Net-- 1 C 1 n. LOCATION OF WELL St (No. d Street) (Town) (Lot Number) East Branch, Road Patterson, New York PROPOSED USE OF WELL BUSINESS a DOMESTIC ESTABLISHMENT El FARM TEST WELL SUPP Y INDUSTRIAL' a AIR ❑. OTHER . CONDITIONING (Specify) DRILLING EQUIPMENT ROTARY A COMPRESSED CABLE R PERCUSSION PERCUSSION OTHER a (Specify) CASING DETAILS LENGTH (feet) 61 DIAMETER (inches) 6 WEfuHT PER FOOT Z'7 a THREADED ❑ WELDED 0 SHOE X YES ❑ NO LNG U YES L_! NO YIELD TEST HOURS G.P.M. BAILED PUMPED COMPRESSED AIR . i 4 8 YIELD (O:P.M. 1 - 8' WATER LEVEL MEASURE FROM LAND SURFACE = STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well 20 385 in feet below land surface: 385 MAKE LENGTH uPEN TO AQUIFER (toot) SCREEN DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well W/th distances, to at least two permanent landmarks. FEET to FEET 0 50 Hardpan & Boulders Dg re s��� RECEIVE[ JUN 81982 PU FNAM COUNT DEPT, OF HEALTi 50 385 Black & White Granite- If yield was tested of different depths during drilling, list below FEET GALLONS PER MINUTE 250 2 355 4 375 8 385 ail DATE WELL COMPLETED 5/12/82 DATE OF REPORT 5/25/82 JW DRILLER (Signature) Robert Pile miii, /President —PULL muu iNu CUe , im. 'L . 0 i- BREWSTER LABORATORIES Box 214 BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 47 90 Rv 6 P rf c�-- D 1 cc y, �°. 64 C)41 O SOURCE: Robert ZWiefel Well East Branch Road Patterson, NY COLLECTED: May 12, 1982 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result ixdicatts the sourct , of the sample was of satisfactery saxitary quality whm At sample was collected. May 17, 1982 0 per 100 ml. Bick or P. E. Director VECEIVED JUN 81982 PUTNAM COUNTY DEPT, Of HEALTH Owner or.,ur.c aser of Building Robert Wefel Building Constructed by East Branch Road Location - Street Section 1 Block Moo 14.1 Bui ding Type Lot GUARANTY OF SEPARATE SEWAGE-SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 guaranty to the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs, made by me to such system, except where the failure . to operate properly is.caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the.Division of Environmental Health Ser- vices.of the- Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. - Dated this 27 day of August 19__8a Signatures ry� Title If corporation, give name and address) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health RECEIVED S,EP -1 1982 PUTNAM COUNTY DEPT. OF HEALTH g! Located at East subdivision`' Robert Owner •- Robert tuiltl;ng .Type MQdU1:a Number of. Bedrooms Separate - Sewerage - Syster. ToT be constructed, by,'_ Water Supply �f1 Ot" Requirement S ". IM r '`ter :V a _ - Y': t PJTNAM COUNTY DEPARTMENT OF HEALTH' �- SO 1173 Ohiision of` EnvironmentW(. Heaith .Sertgces, Carm',e! N .Y 1:05.12 FOR SEWAGE 'QjSPO_SA_L SYSTEM s Patterson Town or. village �h Read ' 18 `Tax Map -Block efe1. Lot , #1 got _ 14 1 Job 501973 - e e1 'Address R D ; 3,.'Eas.t, Branch Rd: �t Lot - 'Area• 490-Ml k N =. Patterson'. NY, 12563 �e 60Q Coal 1,1'44 Design FIoW •- Total�laabitable Space - Square .Feet E 1000 4 500 L sF 24" Width : _Trench , ohsist of G'al Sept�c.*Tank .sand - xa G � Supply From 3 r�x." ti �'t.sr x �^'F � u �.,z, x �.s..,t7 p�� it �` � ex's ,� � ,»•N � - i '� ^ completely r "esponsible for the design and loc5tion of tAe proposed system(s) 'Yj that. tfie separate sewage tlifposal system ted a'shown;on the ap.provetl amendment there;,to and?�naccordance withahe standards rules an .rp.gu a eons o the:-,:, u ream K t'isfactor to the Commissioner of ?Iealthwili and`that on "completion thereof a Certificate of Cohstrction Compliance sa y be`subm.itted to the Department "and a written guarantee will ibe furnished ;the owner his successors;; heirs o►^assighs,by thei6uilder; th5t`said builder, will C. -place in good operating cond�t�on,'any part;< of -- said ',sewage`disposiC"'tem�dunng the period; of two °(2) years immediately,followiny he date :of the s ;u= ance. of` the approval of the Certificate of,tEonstruction Compliance'i of th -' original system or any ►spans ttiereto 2) that the drilled well described above• 1. 1 will be Ibcafed as,shawn on'the approved plari; and that:said, well wdl be ihstalle in accortlance with the sta s rules"-and regula i�`ons, ;of Mw Putnam County Department'of Health a- 7/15�ffi1 Date Signed, -_ P E, RA 4 RD 9_ Pater St e1 NY 10512 Address License No _ ;2920:6 . ,APPROVED FOR',6 NSTR'UCTIOtVe` This approval-,6pnes one year,from the ;date ss'ued unles t on: of the building has been undertaken and 'is revocable for-cauie. or may be amended or'modified: when considered necessary'by the - .'Comm loner of Ith:.." Any change or-.alteration of :cohstruction requnes a' Mew permit Approved for disposal of domesti • ani y w an o nv water =� Data,, Sy Title 0 PUTNAi4-.COUNTY.DEPARTMENT.'OF.HEALTH -'DIVISION OF ENVIRONMENTAL' HEALTH C OUNTY.10FFICE BUILDING, CARMEL, N. X. .10512..;",. ... ... .... 'SEP DESIGN DATA-SEPARATE ARATE SEWAGE DISPOSAL SYSTEM PILE No.'. ' Owner ; e& ddr6ss T94vm' Located dt Street4,'V ow _St Block Lot 4lcate,ne 71' " ares ross.stree Municipality Watershed Cjijk-6 AM -TEST...MTA..MUIRED TO BE SUBMITTED. WITH -,:APPLICATIONS Number...:...._ :._...CLOCK_-_TIME. .PERCOLATION.... PERCOLATION Run Mapse Depth to., Wateri Water ve7 Time : From Ground Surfac 6, in,,. Inchesw w Soil Rate Start Stop --Min. Start Stop Drop in Min. /in drop.. Inches Inches' Tn�chegq.. tit E. .... .. . ........ .2 . . . . . . . . . . R ECIE 3 My U,*,V, 11" IZIC) I .. .... .......... .. C PVTNAM�, COUNTY 5 DEPT: OF-HEALTH �*i'6 t b6.'repeated at same depth until Notes': 1 0� appro�Kimately equal soil rates are obtaihed.':s6t. each percolation test hole. -All data to be submitted -for, Dep7thlbeasurements . to be made from top of hole.- DEPTH G.L. 6'1 1211 u TEST PIT DATA REQUIRED TO-BE SUBMITTED.iITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED'IN TEST HOLES THIS SPACE-'FOR USE' BY HEALTH DEPARTPMT 0 / i No. 2920°/ Soil Rate°Approved :. Sq: Ft /Gal. ��`` Date Structure located. tram ;surrey by surveyor note'C beloW(g_-_ Well located by: Surveyors survey•_ Well drillers, report.— Enginoen'e ma,serementa -0 -- _ — Ton k, box os, p'ila, gollenoa 9 Iate,roIs Io•co.t-e.d. by:Ccntractor Al .Haaw da.Pd* /r/ /��r✓ie e� a Field inspection by: Health . dool -® data AtQ —_ /. , y •i,""'s' ,� •�.aa.. Engo poor. ® do4e fieo ?I cif NOTES. 4) SW(ie-ra Ic - I000 Gal. Fee .ca:fiCa., 1 p w» b J La {a+al s S 5^20 r x -A.4 "1✓, x 24" D. l @A E N stoN'S A - D z�• f,�r k �a A - E __.0 - E a— _?fzg + -- -- $EF _ A 6 6C'10 _B - G avtSS10 �K- °°� A ''H °-- Z-2 M -8 ---'B - N ° -- " - -- � p0.`' °Rep � �e i .. Ns °¢9'iy "'d°- /✓6 °�3' s- "/++.:- / ;S'.c7 = N /�' °fi' f1 jy'e- - r • 9-9./j' , 96.97•... Ne °. }7yf "E- S ✓o' - - _.- _..__- - SAN ETA RY SYSTEM DESIGN 0z UILT�� d - V — — — -- — -= — - — — — — -- - LOCATION Street _�TGne�3� �l�q �eln5p4y Town: — A 4;,=,L_ -- County: — �C�a. _— Stato: tJ� ✓— — SU'BDIVISLON- �'�Wi� t%af- --- - -- -- Map:l-r73.) — — — -- ' Putnam County Department of $ealtfi `` _ Block. — - -_ —__ LOT Na_„_1_,i — — — — — Division of Enviroryental .Health Services -Budder: I. ?t may, Surveyar -- ed as -o' ^o ^3ormanae with appli b1e '.r. ations oY the '_ Drawn: R �. Date ;2 82 Scolei ,g• �; Job N�0.197 Pu Co ty Hea th uey �tm w g. J O H N H, P'R'E N TCS'S' P E_ • ignature Ti a Date CONSULTING ENGINEER .:_. RD.R, F-41 R- Sr., CARPAEL NY 10812 —(8141 828 -6170.