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HomeMy WebLinkAbout0838DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24.18 -1 -17 BOX 9 17--FX L �. el All� I 7 1 1 ,` { dL '-I d PUTNAM ° ^ 0 _ DivisidW ,6f Entvron CERTIFICATE:OF CONSTRUCTION COMPLIANCE t ;t - Located at t� wner..._ ,.^=ZJ411.LO ,Separate sewierage. System buulit, 6y Consisting of ;9,c�o Gal. Septic "Tank OfFier •requirements Water_Supply Public. "Supply' From Private'Supply Drifted ;ey. f � Address :wilding Type•t�N 4 Has Erosion Control -Been Completed) - } „I certify -that thesystem ), ea listed serving the above remises•a ro attached), and in accordance` with the, standards rui s and�re 4 rDate� r w Addre 13 ss -.Any person occupying premises served by•the above systems) °- condit Ion's :re'sultirig 'from- such usage. Approval,':of th9,,sgp, available and to approval of thenprivate ;:water;supplyksha(if.b subJect=So molif,ication =or change when, in the ,judgmentc rx T�Date - - �� -r• s �y` h. �,�F �r „r y:. Tom° •y� � �. wig q t � X? A JtTMENT. AF HEALTH I ' W Services Carmel /1/ Y ,:10512 AG E DISPOSAL SYSTEMS -� Town or Village.. .. h 'Section Block got: 3', 604 as e. r ti i Address t e e f • •- � width trench ? ; ;•' A 0 '� License No r yk.0 - Tit15/ •� t . a many un itary +.: sewer: ecOmes approvals are gcessar .:" ' AEMA ZEMA TAVINO INC. WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services ` r 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 ZEMA TAVINO INC. ADDRESS ROUTE 124 BREWSTER NEW YORK LOCATION OF WELL (No. & Street) (Town) I (Lot Number) SKY LANE PATTERSON NEW YORK - LAKE SPRING MEADOWS LOT 15 PROPOSED USE OF WELL NESS ® DOMESTIC ❑ E T BLISHMENT ❑ FARM ❑ TEST WELL PUBLIC AIR OTHER SUPPLY ❑ INDUSTRIAL ❑ ❑ ❑ CONDITIONING (Specify) DRILLING EQUIPMENT COMPRSED ® ROTARY El AIR PERCUSSION ❑ PERCABLE CUSSION OTHER ) CASING DETAILS LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ® THREADED ❑ WELDED VE SHOE YES []NO YES NO YIELD TEST n HOURS G.P.M. ❑ BAILED 11 PUMPED L$ COMPRESSED AIR —half YIELD (G.P.M.) HPM WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 2y 0 f t • DURING YIELD TEST (feet) Depth of Completed Well in feet below Land surface: 6 ft. SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (feet) TO (teat) 'DEPTH FROM LAND SURFACE ' FORMATION DESCRIPTION w enact of well wltfi dlatances, to of leash to permanent two permanent t landmarks. FEET to FEET 0 30 Drilling in overburden- cla and boulders -. �it rock at thirty feet 30 40 illing in rock- setting 40 565 rasing-mrouted illing in rock anite If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 6/8/73 DAT OF EPORT 6�15l3 WELL DRILLER (Signature) • , 7 ," • P. F. SEAL & SONS, INC. ARTESIAN WELLS 4 PUTNAM AVENUE JET PUMPS GRAVEL SCREENED WELLS BREWSTER, NEW YORK .10509 SUBMERSIBLE PUMPS WATER SYSTEMS n SUCTION PUMPS WATER SOFTENERS &&M" 1991 -- (ooez 6120 gVdIs dompteud CELLAR DRAINERS WATER CONDITIONING EQUIPMENT MOTORS - TANKS - BELTS - ETC. TEL. BR 9 -2460 - 2461 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERVICE ~Tune 12, 1973 Putnam County Department of Health County Office Building Carmel, New York 10512. Gentlemen: On January 3, 1973 we drilled a well for Zema- Tavino to a depth of three hundred twenty (320) feet on Sky Lane, Town of Patterson, New York. This well produced a flow of two and one -half (236) gallons per minate with a ten (10).foot water level.. We. hit solid rook at eights ®n (18} f ®et and;.installed thirty -(30) feet of six inch casing. We groated the casing.at this point. We feel, even though the well-is less than-one hundred feet from any sewage, septic tanks ::or the fields, that it would be very unusual to have this well become po at ®d: If you wish, I would be glad to discuss this with you in further detail at your convenience. Very truly yours, P. F. BEAL & SOB'S, INC. M. T. Beal, Sr. Awr BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE No. 3355 SOURCE: Tauino Builders - faucet - well supply (formerly Zema - Tauino) Sky Lane - Spring Lake Meadows, Lot 15 Patterson, N.Y, COLLECTED: Dec, 20, 19 ?4 BY: P.F.Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality' when tht sample was collected. .Dec. 21, 1974 oy Bickwit P. E. Director BREWSTER LABORATORIES Box 224 - BRMSTF-R, N. Y. WATER ANALYSIS REPORT., SAMPLE NO. 286_9 SOURCE: G ema -Tau i no, Inc. - well Sky Lane Patterson, N.Y. COLLECTED: Jan. 4, 1973 BY: P. F, tea l & -S'ons, Inc. BACTERIOLOGICAL EXAMINATION Coliiorm Count, MY Method an. 8, 1-973 This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. 0 per 100 ml. -- ........ :.. l Roy Bickwit P. E. Director BREWSTER LABORATORIES Box 224 BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 2-968 SOURCE: Zema- Tavino, Inc. - faucet - well supply Shy Lane Lake Spring Meadows, Lot 15 Patterson, N.Y. COLLECTED: June 11, 1973 BY: P.F.Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the rample was collected. June 13, 1973 Si -t P. E. Z E M A T A V I N 0 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 OWNER NAME ZEKA T 0- I ADDRESS ROUTE 124 BREWSTER NEW YORK LOCATION OF WELL (No. a Street) (To'4n) (Lot Number) SKY LANE BREWSTER NEW YORK PROPOSED USE OF WELL . BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM TEST WELL 11 SUPP Y El INDUSTRIAL ❑ CONDITIONING ❑ (Specify) DRILLING EQUIPMENT COMPRESSED CABLE OTHER 0 ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) g ' rWEIGIHT PER FOOT lb ® THREADED ❑ WELDED SHOE YES ❑ NO X A G j YES LJ NO YIELD TEST HOURS G.P.M. ❑BAILED ❑PUMPED COMPRESSED AIR ve 2 f i YIELD (G.P.M.) 27h GM WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) ft DURING YIELD TEST (feet) Depth of Completed Well in feet below Land surface: 320 f SCREEN DETAILS .10 MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) EIF GRAVEL ACKED: 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 with distances, to at least two permanent landmarks. FEET to FEET 0 20 Drilling in overburden cla y and boulders Hit solid rock at 20 fte 20 -- 30 Drilling in rock --setting.- casing - grouted 30 320 Drilling in rock - granite If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED Jan 3 73 DATE OF REPORT Jan 15,73 WELL DRILLER (Signature) o F. BEAL & SURS9 /- � i `.. wn or V�Ilage {ti L Section Block V1 h C l 17 GT 4f f n qq 4 k ` r �� %"Job ' k �5'ubdivisionr� Lot +� a� O 1.� PUTNAM COUNT i< �'�E1�ARTMENTOF aHEAL�TH �` ,t Address 5 ` YZ 't<t1 L:a }Build�nga, ��rF -v~ ; rl ` t Type: l_ot Area �fJumber DI* vision of Enw�onmenta/ Hea /th Services N Y 10512 ' Total Habitable Space Feet Separate` Sewerage System to consist of ® Gal Septic Tank £ iCarme/ r 1 a 3f .constructed by :;;• Water Su p yi Ajblic Supply From ' sw , �CONSTRUCTIQN PERMIT FOR SEWAGE 'DISPOSAL SYSTEM `.. wn or V�Ilage L Section Block ,Located Oat iii d rf � C f n qq 4 k ` r �� %"Job ' k �5'ubdivisionr� Lot +� a� O 1.� r Ownerf{✓ (Aci Address 5 ` YZ 't<t1 L:a }Build�nga, ��rF -v~ ; rl ` t Type: l_ot Area �fJumber Y IBS 'i5quare ' of Bedrooms Total Habitable Space Feet Separate` Sewerage System to consist of ® Gal Septic Tank 1 1 ZQ Ilneal feet X'N ,width trench ' } .. u.: .. � ' , , 1 Address,, .constructed by :;;• Water Su p yi Ajblic Supply From ' sw , r,y- Prrvate SuPPIy fo be drilled by' ° J,' y 'oV r t y � � �� Address •' OtherkRe4uirements ja represent that 1' am wholly and completely responsible for, the design and location of the, proposed systems) 1) that the seperate•,ISewage _disposal system above7descr� bed will be constructed,as shown on the;approved amendment there to and m accordance with the standards Yules an regu azzons•o e u nam ' , ,. County�Department of Health,;entl that "on completion thereofra Certrf�cate of,.'Gonstruction Compliance' saLsfactory to thei Commissioner of IHealthwill -,' �k tie subinittedhto. the Department; and a written guarantee; will be.;furmshed the• - owner, his,succes ;ois heirs.or assigns by the builder; that said'builder: will ' ., e( .�. s,�place im,good'.operat�ng.'condition any part of saitl sews a disposal system during' ne' period of -twb (2) years immediately,follow�ng the date of the issu,: 9 'ancek of;;the approval of the Certificate ofrConstructioh Compliance of th'e original system,.or any'repaics thereto 2),that' the drilled' well described above Itwill lie located as shown on the approved plan and that said well will >be installed 'accordance" wdh tha stand" ,'' rules a regu a ons of the Putnam <'. . :•County !Department of Health a; f ; a w. Date Signed it n t t f/ ,�9.�Q/ill W \P ti Address, License No; I aPP'A6% D FOR, CONSTRUCTION �Th�s approval expires: one ear from the date `.issued unless construction of .the.bwlding has been undertaken and is. •� evoWble for cause or may be amended or. modified when considered` necessary by the Comm�sswner ,oi Health ,Any change .or alteration ot,constructlon.` I 1. }{ n (ryegwres a ,new .permit ..;Approved for diposal of,domesfic sanitary sewage and /or private! water supply only Date,, By at �y Title 0 N. .PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM . FILE NO. S''a.t0- (604_ Owner *Z � A - l AV f K10 IV'.-C-. Addre s s �L' 4 �'2r�e }� t��w5 7 P�� Located at ( Street bC�j -! 9-t J G sec. _.0 Block Lot �Indicate nearest cross street) Municipality ��}- �--1� -nS�rJ Watershed�'p�o� SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS oe Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water a er ve No. Time From Ground Surface in.Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1_11: Sc� rr. s S 1 A. r 5/ 2 1 i'. 5 �� : 02. 1 t 4- 3 1" 2.. OIL- 1 i2, 10 '+ t2'. t t l a.'. zz 10 i(0 -1'1 t 1 2 3 5 1 2 3 5 Notes: 1) Te'�ts 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. A , ' TEST PIT DATA REQUIRED TO BE S6MITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO.�_ HOLE NO. HOLE NO. G.L. 6" 12" 18" 24" 3011 36" 1 `F 2 ►► 48" 5411 60" 66" 72 it 78" '84 ►► -- -- INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHIC WA ER LEVEL RISES AFTER BEING ENCOUNTERED , -, PESTS MADE BY 1z = C_ Date p DESIGN Soil Rate Used t I —t !rMin/l "Drop: S.D. Usable Area Provided No. of Bedrooms r_Septic Tank Capacity© o_- Gals . Type IAA k Absorption Area Provided ByL4-o L.F.x24" 5b" width trench. Other LA.) Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Chec i IV KI-1 j IV,, Date RL A N 4-ww. JUNCTION BO . X G D, LEVEL MIN. 12 MANN L 4"MIN• L 'h MIN. ' A CAST IRON SANITARY TEE SECTION -TYPICAL CONQ 'AST CONC. 4F I NF. 8%. SEPTIC TANI< C. a., W' , L". 2 AC ZfPT I <, TA 1.1 < L_ 0. LEVEL o. Z ......... COVER P "' xl/ cc) A". EARTH 7z t AMIK, S BACKFILL JOI N'T 1 c' T C IA 30, BLDG. PAPER OR MAY j PFRF.RA"' 5 /t, j PIPE 0 P.-F-Si rjE.,mc c- Ao' cj I C)XA V . . ..................... CLEAN GRAVEL OR 0 24"MIN CRUSHED STONE ABSORPTION TRENCH - 40 NOTES: L APPROVED SYSTEM TO BE CONSTRUCTED IN ACCORDANCE WITH THE RULES AND REGULATIONS OF THE 'Pt j"AtA COUNTY DEPARTMENT 13 OF HEALTH. . ....... . C) SYSTEM SMALL NOT BE BACKFIL4ED UNTIL INSPECTED BY DESIGN Vs. ENGINEER" AND THE LOCAL HEALTH DEPARTMENT IF REQUIRED. OCT 2 01972. sys-rEm TO CONSIST OF A GALLON SEPTIC TANK AND 40 FT. QF FT. RENCH WITH A MAXIMUM SUTNAM COUNlY DLFI Of HEALIF PITCH OF 11163 PER FOOT. DISPOSAL SYSTEM GRADES REFERENCED TO FIN ISHED FIRST DIRMOR.-D SION Of FLOOR ELEVATION $11VIRONMOYAL HEALIH SSr �lf'. UNLESS OTHERWISE NOT-ED. S.S.D. SYSTEM FOR ZL-IAA, AViNa Nr_ A. ne N� REVISTUNS, HOWARD A. KELLY, JR., PLOT. _P L� A W Nl). DATE I By ASSOCIATES CARMF L, NEW YORK '5CALU, 330' 1 TAX MAP NO. 10 BLK. NO. LOT NO. !> -T .2 TOWN OF A:—, 3 D,o.ri By scol mato,iol cl J. 4 ch), d Dote 10,0­)L Drawing N.. — —WO-6040 H L Covp 4-ww. JUNCTION BO . X G D, LEVEL MIN. 12 MANN L 4"MIN• L 'h MIN. ' A CAST IRON SANITARY TEE SECTION -TYPICAL CONQ 'AST CONC. 4F I NF. 8%. SEPTIC TANI< C. a., W' , L". 2 AC ZfPT I <, TA 1.1 < L_ 0. LEVEL o. Z ......... COVER P "' xl/ cc) A". EARTH 7z t AMIK, S BACKFILL JOI N'T 1 c' T C IA 30, BLDG. PAPER OR MAY j PFRF.RA"' 5 /t, j PIPE 0 P.-F-Si rjE.,mc c- Ao' cj I C)XA V . . ..................... CLEAN GRAVEL OR 0 24"MIN CRUSHED STONE ABSORPTION TRENCH - 40 NOTES: L APPROVED SYSTEM TO BE CONSTRUCTED IN ACCORDANCE WITH THE RULES AND REGULATIONS OF THE 'Pt j"AtA COUNTY DEPARTMENT 13 OF HEALTH. . ....... . C) SYSTEM SMALL NOT BE BACKFIL4ED UNTIL INSPECTED BY DESIGN Vs. ENGINEER" AND THE LOCAL HEALTH DEPARTMENT IF REQUIRED. OCT 2 01972. sys-rEm TO CONSIST OF A GALLON SEPTIC TANK AND 40 FT. QF FT. RENCH WITH A MAXIMUM SUTNAM COUNlY DLFI Of HEALIF PITCH OF 11163 PER FOOT. DISPOSAL SYSTEM GRADES REFERENCED TO FIN ISHED FIRST DIRMOR.-D SION Of FLOOR ELEVATION $11VIRONMOYAL HEALIH SSr �lf'. UNLESS OTHERWISE NOT-ED. S.S.D. SYSTEM FOR ZL-IAA, AViNa Nr_ A. ne N� REVISTUNS, HOWARD A. KELLY, JR., PLOT. _P L� A W Nl). DATE I By ASSOCIATES CARMF L, NEW YORK '5CALU, 330' 1 TAX MAP NO. 10 BLK. NO. LOT NO. !> -T .2 TOWN OF A:—, 3 D,o.ri By scol mato,iol cl J. 4 ch), d Dote 10,0­)L Drawing N.. — —WO-6040 aaner or Purcha�cr..of building d ` w Building Constructed by Location- - treet Building Type e Municipality 70 Section Block Lot GUARANTY OF SEPARATE SLVAGE 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 I he approved plan or approved amendment thereto, and in accordance with the standar.ds., rules and regulations of the Putnam County Department of Health, and hereby guaranty 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 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 ss caused by.the willful or negligent act of the occupant of the building utilizing the. 8t, c i-om The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental 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. willful or. negligent act. of the occupant of the building utilizing the system.. „ i1 s /► : Dated this day of 19-13 Signat Title ss I THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE . CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS RF.OUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health.. Services, Putnam County Department of Health t