Loading...
HomeMy WebLinkAbout0899DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.39 -1 -2 BOX 10 �r - rA 0. i i� r r ! T - , I . IF F JIM .0 j 0 � i :p! Ld 11:•' PUTNAM COUNTY DEPARTMENT OF HEALTH \ �T Rev. 3186 �S 1 Division of Environmental Health Services, Carmel, N.Y. 10512 \ -. Engineer Mast Provide P7-785' P.C.H.M Permit# AN V __CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Located at Owner /applicant Name —`T c. _ T. Patterson Town or Village Tax Map 51 Block 6 Lot 2 :Lake Subdivision Name Putnam Sabdv. Lot 717- 24 Inc l Melling Address C/O T Sprag)ie Gage. Rd..Brewstanp 10509 Date Permit issued 9/15/80 (By R.W. Laurent,P. Brewster N.Y. Separate. Sewerage System built by John B e r t o c c i Address Rte . 5 2 , Holmes , . NY 12531 Consisting of 1000 Gallon Septic Tank and .342' x 24" w. x 18" Deep Laterals Water Supply: Public Supply From Address or: X Private Supply Drilled by Mai 11 Dri 1 ling- Tnc .Address Putnam Ave . , Brewster, NY 10509 Building Type Modular Has Erosion Control Been Completed? As required Number of Bedrooms Three Has Garbage Grinder Been Installed? No other Requirements R -O -B Fill Section• 24" deep x 5600 sq. ft. (400± cu.yds.) Includes 50% Expansion I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copirea of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. 1 .4 % Date 4 De ember 19R7 Certified by Address P.E. X R.A. License No. 79706 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 sewerage system shall become hull and void as soon as a puW% unitary sewer becomes available and the approval of the private water supply shall become h n k! when a public water wpply becomes avallabN. Such approvals ere subject to (modification or change when, in the judgment of the mml o r •of Health, such ocetkfn, modification or change �is�neeesse►y. Date I / . 'L BY PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES James Sprague (J;M 04 De✓e(o fte"I Z►c �, Owner'or Purchaser of Building Owner Building Constructed by Venice Road Location — Street Patterson Municipality Modular Building Type 51 6 2 Section Block Lot Subdivision Name Subdivision Lot # GUARANM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workTanship, 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 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 operate for a period of two years iumediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any repairs made by me to- such system, eexc a ii where the fail urn to operate properly -'s 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 determination of the Director of the Division of Environinental 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. Dated this 12 day of Nov. 1987 Nl'� • Gen 1 Contract r er) - Signature Bob Developers Inc. Corporation Name (if Corp.) Gage Rd., Brewster, NY 10509 rev. 9/85 mk Signature Title Bertocchi & Sons Excavating Corporation Name (if Corp.) Rte. 52, Box 431, Holmes, NY 12531 ess BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE No. 6548 SOURCE: James Sprague (J;*t gob Deve l o j7nc. we l l Venice Rd. I Putnam Lake T.Patterson, NY (TM S'I -d COLLECTED: May 1,1, 1987 BY:Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. May 15, 1987 Roy Bickwit P.E. Director p per 100 ml. 411 14 W �jo WELL UU111rLn11UV BlzrvAi DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET ADDRESS: WN W / I Y TAX GRID NUMBER: 7_ (� —Z Venice Road Putnam Lake Patterson New York i WELL OWNER NAME: J„it god U�v�(U +�, ADDRESS: James S PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary Cj RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 3 / EST. OF DAILY USAGE ..3 .o gal. REASON FOR DRILLING 8 NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 2 8 5 ft. STATIC WATER LEVEL--! 0 ft. DATE MEASURED 5/5/87 DRILLING EQUIPMENT ❑ ROTARY Q COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION 0. OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. Q OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH 50 fiL MATERIALS: ® STEEL ❑ PLASTIC O OTHER CASING DETAILS LENGTH.BELOW GRADE 49 ft. JOINTS: K) WELDED ❑ THREADED • ❑ OTHER DIAMETER 6 in. SEAL: ® CEMENT GROUT p BENTONITE ❑OTHER WEIGHT PER FOOT 19 Ib. /ft_ DRIVE SHOE OYES ❑ NO LINER: ❑YES ❑ NO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? t7 t'1 "Ails - PPST .... -. _.... .... _ - - - -- ,. _ ....__. __0 -YES.. 0- NO-_.- HOURS SECOND GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST t If detailed pumping METHOD: ❑ PUMPED tests were done is ht- ❑ COMPRESSED AIR , formation attached? ❑ BAILED ❑ OTHER ❑ YES ❑ NO IFLL LOG It more detailed formation descriptions or sieve analyses are available. please attach. DEPTH FROM SURFACE wafer Bear- ing well Dia- meter FORMATION DESCRIPTION C30E_ tt, tt. WELL DEPTH It. DURATION hr. min. DRAYVOOWN it, YIELD gpm. Land Surlace 30 no 10 T4;4 rrl pan & honldprs 30 38 " to lBrown.we.athered.bedrock 38 285 " 6 Iliard black & grey granite 285 6 - 25.0 15 WATER (I CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? YES ❑ NO ANALYSIS ATTACHED? 2 YES ❑ NO STORAGE TANK: TYPE diaphragm CAPACITY 60 GAL. 16 PUMP INFORMATION TYPE submersible CAPACITY 7 MAKER GOULDS DEPTH 200 MODEL 7EHO5412 VOLTAGE.WHPa__. , INC . �A3 / 8 7 % WELL DRILLER NAME MILL DRILIG ADDRESS Putnam Ave. , Brewster, NY IV. V. Vi. APPENDIX C FINAL SITE INSPECTION Date Inspected b� OWNER TH # OR.SUBDIVISION IDr # YES -11K. - SEWAGE DISPOSAL AREA a. SDS area located as per approved plans b. Fill section - Date of placement 2:1 barrier. LGTH WMIH AVG. DPTH c. Natural soil not stripped d. Stone, brush, etc., greater than 15' from SDS area. e. 100 ft. fran water course/wetlands. .SEWAGE DISPOSAL SYSTEM a. Septic tank size - 1,000 4-1,250 b. Septic tank installed level c. 101 minimum fran foundation d. No 900 bends, cleancut within 10 ft. of 450 bend e. DISTRIBUTION FAX 1. All outlets at same elevation - water tested 2. Protected below frost 3. Minimum 2 ft. original soil between box and trenches f. JUNCTION BOX - properly set g. TRENCHES 'I 1. Length requir ed Length installed--�,'Ye; 2. Distance to watercourse m6asured-. ft. 3. Installed according to plan V 4. Distance center to center �Y 5. Slope of trench acceptable 1/16 - 1/32 "/foot. Y, 6. 10 feet from property line - 20 feet - foundations 7. Depth of trench < 30 inches from surface 8. Roan allowed for expansion, 50% 9. Size of gravel 3/4 - 11" diameter 10. Depth of gravel in trench 12" minimum 11. Pi' )e ends capped h. PUMP OR DOSE SYSTEMS 1. Size of-pump chamber 2. Overflow tank 3. Alarm, visual/audio 4. Pump easily accessible manhole to grade 5. First box baffled 6. Cycle witnessed by Health Departuent estimated flow per cycle HOUSE a. House located per approved plans. b. Number of bedrooms WELL . a. Well located as Per approved Plans b. Distance from SDS area measured 4949 ft. c. Casing 1811 above grade. d. Surface drainage around well acceptable. OVERALL WOPJ94ASHIP a. Boxes properly grouted b. All p pes partially backfilled c. All pipes flush with inside of box d. Backf ill material contains stones < 4" in diameter e. Curtain drain installed according to plan f. Curtain drain outfall protected & dir-to exist.watercourse g. Footing drainsi �discharqe away fran SDS area h. Surface water rotection ad equate i. Errosion control proviT(id- on slopes greater than 15% _•rr en^ .;sn:m- Y'•x^. e v"�' *. i;4 ^ � r- 'm-'b; ze- ifu'"'"f '' .:£. N �"' 3 y:,� i� Y:r'-'+ � .,,,.r � �..',. PUTNAM COUNTY DEPARTMENT OF HEALTH Rev -, `3186 ` Divlslon of Environmental Health Set ices Carmel N.Y.105i Engineer to''Provlde Petvtlt N `' on CERTIFICATE OF Permit CONSTRUCTION PERMIT FO& GE DISPOSAI fSYSTEM; �%% d�� d ' A7�n i c Ck Town . ar- i49egee above-described will County,. Department be submitted 'to; th place. in good ,oper ante of t he approv, will be located as sh County Department �e76 / 6�' 2Ji G� s•- s:c,CU/ ...:7�w,iocr /•e r., a - �J 1) that the separate sewage disposal system „ and In accordance with the standards, rules an regu a ions o e 'Putnam J�/�� v P� Construction Compliance^ satisfactory to the Commissioner of Heelihwill / Y+`r,- owner; his successors, heirs o► assigns by the builder; that said tiuhder'will to ring the period of`two p years immediately.following : thedafe of.the,issu• GOAJfrr.� final system or any repairs,thereto, 2) that the drilled well described a. bove I accorgainee with th st ridards rules antl regu aTfions 'of, the Putnam Dates ` t e4 to h ilD L9 C6 ?_ Signed _ F, iCtldress�� Q;,. C�. ...Y I� APPROVED FOR, CONSTRUCTION:. This =approval; expires r from the date issue revocable for. cause or may be arriended of modified when considered necessary by the CC reQuires.�aa new permit: /Approved fordisposal of domestrc'sandary sewage a or ri Date 1] ,,. •1 ; P.E. �.A, License No d unless construction of the building has been undertaken and is immissiOner of Health . 'Any change or alteration of construction rate water supply only:' Title a PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 3/86 (.y►l� Division of Environmental Health Services. Carmel, N.Y. 10512 Engineer to Provide Permit p ,. { on CERTIFICATE OF COMPLIANCE CONSTRUCTION P%ERMITFOR SEW(AGGEE DISPOSAL SYSTEM Permit H Subdivision Name n C —, Owner/Applicant Name 01 m eLg. Tax Map Block Lo7f7 Subd . Lot # �Q nkss ff Renewal_ Revision Date of Previous Approval � . I Mailing Address L /) o" h. due Town Zip �/ � Building Type , f=5 jCic VL f- `4 Lot Are `fW'v 1111 ;T,-,: Fill Section Only " Depth —Volume Number of Bedrooms Design Flow G /P/D d PCHD Notification Is R When Fill )s completed Separate Sewerage System to consist of Won:S6# Tank mom` To be constructed byanwPs Address Water Supply: PdbHc Supply From Address or: aPrivate Suppl,Iy ted y Other Requirements I �'(���� r"�� /� ©/� Z(� �� ./ . If 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules and regulations of e Putnam County Department of .Health, 'and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written 'guarantee will be furnished the owner, his successors, heirs or assigns by the builder, 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 riginal ystem, or any repairs th o; 2) that the drilled well described above will be located as shown on the approved plan and that said well will ns lied acc anc wit the a d rules and r u ions of the Putnam Count Department f Health Date '!/• // K \ 'Si9 P.E.= R.A. _ Address License No.. y e APPROVED FOR CONSTRUCTION: This approval expires one year from the date iss ed unless construction of th building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by -the Commissioner of Health. Any change or alteration of construction tf T requires a new permit. Approved for disposal of domestic sanitary sewage, and /or private water supply only. a rl Date % / / 4Ya BY �r yi yltle�_ I7 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. Owner t4,-i- HQ� J M Address Located at ( Street) Sec. Block Lot !y7/2 t.47aq indicate neared cross street Municipality Ru-r LpV.g f 2h']�12A�Watershed w".Q SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS i Hole Number CLOCK TIME PERCOLATION PERCOLATION 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 Inches Inches Inches. 2 �� ilk " /AI 2 �° V .97 5 I ii✓ 1 ' i /-D ale 1 Q ­2I Zo - -- - 4 //V 46,82 1 q is 94 -s 22 < Z �a �'�,� ate✓ 1 2 �j5 l CAS A 2.2 2:" f�J t4,1 3&4S 2S 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 from top of hole. L TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. if HOLE NO. fie- HOLE NO. G.L. 12" 1811 30 36" 42" 48 54 60" 6611 F 7211'- Q 78" 8411 Pig 1z ata INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ' INDICATE LEVEL -TO WHICH WATER LEVEL.RISES AFTER BEING ENCOUNTERED _ _ _ _ ..__ TESTS MADE.. - .gy..._- : - -- - -- - -- -- - - D� to DESIGN Soil Rate Used �iMin/l "Drop: S.D. Usable Area Provided F No. of Bedrooms Septic Tank Capacity /26 'Gals. Type Absorption Area -PTI-ovlded By L. F.x24" 37- __width trenc . 6�'�ic/ is �( �� / v eto OtY T �,7 . �/, Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ZZ 12545 Ty£ STATE Soil Rate Approved Sq. Ft /Cal. C y Late Vi5-�IjIfG I I -OIL �iG• 1-1 [,!:,OX IQ P1ri5�r Putnam County Department of Health Division of Environmental Health Services Approved as noted for conformance: with .Yl^ applicable Rules and Regulations of the :z p ounty Health Department. sfEJy &.1J1,91 Signature &Title Date "AS BUNT'` DATA. Structure located tram survey by surveyor noted below®_ _ _ _ _ - _ ell located by: Surveyors survey_ Well drillers report Engineers masurementaD-- Tank, boxes, pits,golierles 9 laterals located by:Contractor: Eng+neers C H.alth /da.vt: C Field Inspection by: Health dept dot e: JD _ 87 Enganear dote, This is to cetttfy that the sewage ' disposal aysrem was constnirted as NOTES: indicated on this plan and t)iar the system was inbpecred by me he Core It waS covered over. The system was .constructed in accordance with all standard rules and regulations of rhe V. C. N. D. S the N.\'. S. 1). It. D 1 M E N SION S.�w %' ° P C A T- 0 u11 -o A J ■_r27_- �? 9 _ J ■__ - A- L 5- L- 5ANITAEX SY M IG "AS QUILT tt OwtoR:--;r:�/'--I.�c�'JiO> QC�- OLG _ //C- LOCATION Street: Town :_/�/?�7- ounty:�1/^��_ /� SUBDIVISIO MaXL Block.­ _ _ �Q_ _ LOT Nit Budder:_ 'Surveyor�:_.�'1j�1 Drawn: f�, L7� Data: �2_ ¢ -$ Swls: �/� O, G� J NQ JOHN H PRENTISS PE CONSULTING ENGINEER 7; c �jU¢vEY� e V7 E.cz'r'�{ W ILLIXr -A Woop te- JA.W I W �ASSi 4�oc�v LOT klo% 41111412J4 ,dam •SHCJV-3N CJK" SEJEt.1T� I ^��o� Pc1Tf-14M t EKE r 1LEf� Ma�*t1yCiF FILED -3-,- 3) 'Tt7tt.�IV of po-rrf-::�, P-'5 OP--j nu T't` AAn all�caLE I" ' .50' Ma2LH 31 , 1987 - 4"�21L �,RP��.�i'ROP. �iCU�re�SE Aric> JiJ1J�. IS \9rS'1�G'oc>rJO. �c�,. uwEngeK- Zo, tq8� (Fit,tAL� GETL'1"IF1Ep 8'(r �c.tii�ETtS TPA -+S-t" ALSv Moves�fz 30. ig8�(�EerS� GE�-r1�1E� � Tlt'IELT "[ITLE S��VILE "F02 -Nrr -112 FoLIe--r camC1cAnoW,IuDIc11.TED wEzeow 5i6,utP4 "r"-F TW,t- SUfZVEY WAh PejEPAZF.D to AGGOeDAXT- UaW -WF- IEXiSTILXa C�OOE. CC FCACrr -E. Lot LAA.WD '5LJ \Y'i ADOPTED a4 -NE uEI[J -1=4 6=7e- AFi6o[- tATlaQ of Peoc6V?oUaL. LAmp Suwxer.QS. 9AtD ar --=RcA l *j/? AWAl.L a.UQ oWL,4 '[O TUF- Pez--0 j Poe k" -TWE -A. r. ME.YAQED AUO oL! WV, .BEiL1LF "TO "RIE j T -E. coArIPALN ALib LEMDW6 %kk%nTLMou LISTED 4ezeo". C-r--MPY-&naLK Am IYT•i'2-.41.-1'SCE�ASt� -iD r ADOTnoL1AL tLY3T tNT101.1S S-a5EMUE.tr c- *IWEj3r. LI.LdLni=eIZF- -> A E- Z4TICU o>' AMMOQ -ro-WklS AAIP Ih A VIOLA MOU = SEsn-noLJ-ii, T7o9 d 'T11E LIE\Ll KoeaG OrAkTE EC L�W Licr 644okju. ALL 4EpE13ki e¢,E \/AL_lp POZ Tiny MAP AAip Cn_ PIES TUEMECr OQL:l tC A7AID MAP oe C-OPIEei eEAe T11E IMtPOEAP6£D 4FAL. CF-rWe \4141c-f,E -5-46A GMF- APIg=� 1 @ Elm 11. of vl. eEE5- 1iaX �_���y,� 151 E . M41 i,l IT2L� "C- klo Nu DBOOJ bt'EV1STt=_� UE1c! YOeiL