Loading...
HomeMy WebLinkAbout0900DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.39 -1 -8 BOX 10 2r - r siI lWrb . 1�jENE } r� �� �r ry `tea.. �,. ,,.•� , �. �. .� - ��P-� �� A'M CO�UNfiT' DEPARTII�I ?ENT , 0f SHEA`L.'TH x �se 4 j �� �Drlisron of ;,nvronmental (l%ialth 'Services, �Ca/mels N 'Y ,fp5.12 s r' t N,'"y,�y� ° °`w •t`' ; `"r'. a �. '+ "3 r - e x+ : r „� �a p .:b t a-:. h - . ` �dCONST UC�TION „PERMIT_'F,OR SEWAGE, DISPOSAL_S�%STEM f ,�'F POt'�eZ' t3 t �” i ' ; �+. -'1, a •.(� ,r� -: a � rte- -. ,. � y�' a - . - � � Town er "�!�F�i,�ge .. _ - a Located ate t ffi l'ed Ip 1149E B.racic - n'r; r p� Ru,u�cfce . sr 41 8U�8f T: SO.11J�2 *ii ESUbdiVision a zk -{ r s '� Vie' w� =d Yvt - - r Y. ' ^ a-ti "p' i ' ` l; -n a �:- r�;J�a'a �':";- v a evp�i2t'1'•J i�� '�` 'IF'l7 ^� �, ;Owneriy i cQ:l y� s = �� Atldress y Building TsYpe - Lot Area �y y 13 r, w^ 7, n� dotal Habitaple Space F 5q�lare Fleet .r5 •�' s" :• ,, ,.' r �' "t?'.. r:�_i::,l's ` ' k. ¢ ...i k -54w, 5 ,, y�..,� r, ' :'^p,,,,. -�iy EMU i 7 � SeparateSewerage ;Systemtokconsist�of Q�Q,Gal Septicr Tank - -_ lineal Meet �X; —_`► w�dtE% trench•. g' ,�'�. . t'•�- ,.'?.n "Sry, ,,� s 'ti. y �To Abe constructed ,by : - l'"FY '{ } i n1 gym. Water SuPPIy Public SuPPIYFrom t _ - ''.' w.�. x - '� a .t,�F` ,.?...TY^ �, a : c �. r r u �� 'k ci k +� ^• t '.F R -, y' d z s P,rivatefSUp�ly t0#1be jd -llle ejby,? '!' 9 { .?"�hs;,� ��si,fY, .;'" "u z z r` °• ^.:€- .,-qua •`' _ - - 1 p '+� r "F''eFro y IRS— ' k.a W ;t Other x iR � 'F r?„�M 'f •`.`", d'�d i" ` y,. : r a."`r' �z2sy,''�_Y ' 9 F ¢ 1 ty akx2 t t c Y fir° f a# s:•. 4 -- `„-e .I�.represeritfthat il. 5m wholly •and. completely Lresponsibl orLNeydes�gn and location - of�Ati -q (proposed sy'stem(s), ;1)k thaY,the ysepaGate,�,wkof Coloo_sal Isy_stem r ;above de'scr bed will be con'sWUdted`•asshown�on thbopprovebi4imendment there to andrin accordance,w4th the.sta tdards rulesta' _Frew +l4ns o, " • -'s <_..0 nam I.yr— -- +u- .v...__ •.. ,. ...A.�!•' >_a;, `.. ,.;a, _ �..e. -• __�;F__.., W -.,i County ,D,epartment .;of- ,Health, "r;and that on.comptetion�the�eo #qa C-ert wteg�of,iConst u�t�on Complli'a lsatlsfaCtOry1to.•IfFlegCon miSSio 8r4Gf;.1H&11thW,il1,•' ,., .v� v a_o *.rr. ;+> ,ins- �:+`.•� �� S -.:i , ..:.e x_.'r. r _..kv'a^` �`,9r , >�. .%..,. 1ti „a.'i'. M. _ , 7-T- }fib r r be submd4ed •to xthe' +Department; and�a ,wyitten guarantees`willgbe _ furn shed theiow_ner„h1s ?successor,,° heirswor ass�grl �bY4the,,bu�IC, fttat• saiQ''bu�ld'e_r •wile f Vplace' In ;z, operating, condition' any part iof Bald 3sewagt dispo "sal system: during:'the peflod of- two,(2) :years immediately foliowing,thcdate,tof the :Jssu. _ ance of =the papproval oYhe .Certif�catexof �Construct�ion iCompliance of ,;fh'e origina'hsystem. or anydiepairs' thereto, 2) =,that the drily well descrfbed above: a . ,aywilhbe locatedNas?shown on the approved +plan and that se +dwell will be i ^stalled, �n ceordance yviCh,fhe stantlards, AMU esl.and ,regu a of . Fi Putnam; ' County D`epaartmerit` ofrHealth pr1�Q1na'I iP,er j Tssve 411 Q% 1 ~'i = 0)yit�] na1,A ,ate' ° ksY•t }t` ,,,+,�: .fix,' y;5'r i .. s'r4`�.[, lab 1 :7'• fI `.'i :. tir , •�' r` `t j Date t �e� ember. 1975 _ � ° - ' 15iyneda ?. % _ p E 'iW s �, t"{' s�' k} p': ".a r f i.E"t`.� F•� �K ,,�i ,}' �, Trr ,=' - +'.'.. - - . .a(�...,,fm's•r r Y '{ a ` { 4.- r i . si0 : A t� k a+„ •,�•" /�h�j/� !v # �' F „•- :* '., 'g lti.4{ st rx Address �'� Di k j6 .H �UW.V .35" -:1 ' I s r�' U i' ` rx�-. i `k J v G.7GV6 - - iL lcense No _,- ,,sAPPROVED F0R'- COrySTRUCT,I;ON Thisiapproval ^exp!resgonee year fromtthe date ,issued ,unless con- itructlon; of t•he, ibullding; (has been untleYt*Wrir and ,is zyrevocable for cause or }may` +be amended or modified`�when cons�deraa necessary by the�COmmi "ssionei ealth. A^yr change. oY`alte►ation vc(i '_rtst�uction• _? - yrapuiresha�new„�permit pproved•, for tlisposal; �f'�domestic�'sa ary�sew e; a " _F �, to a -''` ly !only�,�;��y,� •�:`�c frrt� � r '� r- ``,.r.�r �3 x"���tir".ar'- �,•-s -'�- �+tt�• rc� g c�,�`:" y.,,� -"3 �a T,n ���� � ;rr,. :ter � 7•r 1 �, "� aayr r - s dr =r% ., .< '.."'. o ;kc -�.. i 4''��`,�.f '£"'fir l f' �'� � 'F 1•... * . ..-y r � � '�� +� c''? .� •r s. �"-„ ! ,� •G`'� i'+ cKa''r �F° ,fit x .,u:� X r� .r.�' � r �'� - 9 ^'�(Iµ.L �-aR &�� v ,� "� '_T' F�"'".r .y ,c ?. E� q.� ��� t �, ,J. �t� x r Date cxr t � ^�� 3•x� -..F �"F�'r�,`gyyy�. � a < n a� _ �.. Title � "„+` n �,.,:.,'p •t 4. f + ? 'Y``�. -' 'V i '"u' +--..q " L " " 2�. , `�,.. , -" a a� S'i ri Z,:;.;. ' ,'c.t _ c �• ` �_ , c - s`T..!� 3 t " fl # e y p f ' ..`'ag. +� ,fi'N? 'Arz. r. ..tw TkR -..1� Ex . .3i . 'ii t °` Z . s'.•••s A : • • S - I -4 WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Divisioi4 of Environmental Health Services ` COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is. to ;be,completed.. by, well-driller and submitte&to- County - Health -Department -together-with laboratory -report of y 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 e1? 05_ "r4iU� D )F%% /CD ADDRESS �t'J/ V G / >� • rev %riAi+�l LOCATION OF WELL .� (No. & Street) (Town) y'(Lot Number) D. popT?*H Aif A). PROPOSED USE OF WELL oV DOMESTIC ❑ SUPPLY BUSINESS ❑ ESTABLISHMENT ❑ INDUSTRIAL r ❑ FARM ❑ CONDITIONING ❑ TEST WELL ❑ ((Specify) DRILLING EQUIPMENT ROTARY' COMPRESSED AIR PERCUSSION 1:1 CABLE PERCUSSION El (Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT (� j Ad THREADED ❑ WELDED PALYE KYES SHOE ❑ NO SI G YES GROUTED? - NO YIELD TEST ❑ BAILED HOURS ❑ PUMPED COMPRESSED AIR G.P.M. YIELD (O.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE —STATIC F f; DURING YIELD TEST [feet) i Depth of Completed Well in feet below Land surface: n V SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack Onches): 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 4,00 If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED '76 DATE OF REPORT 1 WELL DRILLER (Signature) 3c' t a BREWSTER- , LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO.3 791 SOURCE: P,h t l t p komed # co ► faucet We i t SUPAY n6ot t Road Lots 4184 to 4186 Pat t orsOn N1 IN COLLECTED: D904 4j 1976 BY: Ph t i t(O 4, mimed t o© BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method Q per 100 ml. This result indicates the source 'of the sample was of satisfactory sanitary quality when tht sample was collected. C - ,sec *. 8.. 1976 oy Bickwit, P.. E. Director PHILIP LOMEDICO - Owner or Furchaser of Building SHERWOOD HOMES Building Constructed by TIVOLI RD. Location - Street PATTERSON Municipality MAP 149E Section Block RES.. 4180 -4186 INCL: Building 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 syste . Dated this 15 day of OCTOBER 19 76 Signature vlw e r W I r oo r nc� TitlePoughqua n. y. 12570 If corp, ation, give ame 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 Philip Lome..dico - - -- Owner or Purchaser of Building Sherwood Homes Building Constructed by Tivoli Road Location`- Street Frame Building Type .Patterson Municipality .Filed Map #149E,.Putnam Lake Subd. Section Block 4180 4185 Incl. 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- .L C e S Ci the i u Glia.m Count Depar tent vJ. ttaal Uii as t0 whe'he2' oi' not lJ'' -e failure of the system to operate was caused by the. willful or negligent act of the occupant of the building utilizing the sy tem. Dated this f�_ day of 19 76 Signature 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 I i \ r 41. 3e. i' �i o i? _ —� S<a�t�r�tc.Tnyiv I `N r I APPROVED h1Ar 197 qi U'�iS;Ut7 OF �OlxlFieN rAl N¢xt4H' �Yl!78 m Structure located trom survey by surveyor noted below -'t-_ �- Well located by: Surveyors survey_ Well drillers report — Engineers mesurements -0-- - -- — _ Tank, boxes, pits.galleries 9 laterals located oy:Contractor: Engineer: Heath de..pt: Field inspection by: Health dept ❑ date:—__- - Engineer date'— NOTES: l) 1 5 O x 3 X.. m OWNER: "a , -k_M - LOCATION Street:— rk t,.v� — �?yo�ti�11�— Town : -P'—'N — County:Svz-.aa_ry— State: hS v Ya, SUBDIVISION :— SwYr�Ka —�_L�r Map:— Lrii�— — — Block., —_,_— —._ —LOT Ns�i1JU0- I:I-X. Builder:— Surveyor: L.±L1 - Draw Date; Scale: " Job s JOHN H, PRENTISS PE. DaS CONSULTING ENGINEER RD 6 Box 353 CARMEL NY 10512 — (91'11878 -6170. DIMjFNSIONS A _ g A _ C , 2Y' B - C ' A D _ `— � . -B - - D ` - -?2 -- - -I Y — A - E ` _ _ ?� _ _ B - E I B - __- Q00ff.S510Mj( A - F A - 6 ` -- �=3! - -B - `- - - =- -B F G Z - - -- �W' A - K ` — - - -B - K — -- - aFT14F S10, m OWNER: "a , -k_M - LOCATION Street:— rk t,.v� — �?yo�ti�11�— Town : -P'—'N — County:Svz-.aa_ry— State: hS v Ya, SUBDIVISION :— SwYr�Ka —�_L�r Map:— Lrii�— — — Block., —_,_— —._ —LOT Ns�i1JU0- I:I-X. Builder:— Surveyor: L.±L1 - Draw Date; Scale: " Job s JOHN H, PRENTISS PE. DaS CONSULTING ENGINEER RD 6 Box 353 CARMEL NY 10512 — (91'11878 -6170. PUTNAM COUNTY DEPARTMENT Division of Environmental Health Services, C iCONSTRUCTION . PERMIT'- FOR .SEWAGE '.DISPOSAL .SYSTEM `Ti„J'� Located a t - 1 Sec F Putnam. Lake . 4 Subdivision Lot :;owner Johh G. Cahill. - Ad Frame ,2 A� .Building Type Lot Area ree Number of Bedrooms Th s Tot 1:000 g ;Separate Sewerage'.Systemj to consist of Gal Septic Tank To'be construtted by ? Ad 1Nater supply:. Public SupclFrom ✓J V aas�, F3 T fi ^ Private Supply i'i be drilled byI � ddress u i p 2. ;Other .Requirements One ' 0 1 represent that 1 am whoz y and completely,re risible for`the tlesign and i cation of ahe pr above described will be co ructed4s shown o e approved amendment t� re =to and in acct County department of.;H t,rand,tha 'n co plet ion.thereof a "Certifi t@ of. Construct .be .submitted to the - Departmenf;�ar tl' a written guarantee. Ill .be furnished the- :owner, ht; ;place in good operating-co ndition any ,•pert of- ,aaid, sewage disposaiz,system during the -pe, ante of the approval of the Certifwate:.of Construction Compliance of .the original syster will be located as shown on the•approved ,plan and That said well will be installed in 'accortlanG 'County Department of Health ' p �Date `1,7ry!73 Signed f 'Address D r.6 `.Box s3 APPROVED FOR CONSTRUCTION This.approval expires_one year from qfb date issued-11 revocable -for cause•or' may be amended or` modified when considered necessary by the. Coml requires a new permit. , Approved for disposal of domestic sanitary sewage; and /or, pnvat bate �/o "K� gy M T .. y OF HEALTH r Patterson . Town or- Village foSlXth Map t x Map #149E J_ jj ' 6 Inc1 ,;b Tess 50 : Came:ron.= Road' Brewster. NY `105019 (_Habitable Space 12001 i fin- -1 ii 51 Square.Feet`: .1.80 3`6 inch- lineal feet X width trench ress posed ,system(s) 1) that- the .separate sewage .disposal system tlance: with the standardse;rules an regu a ions,o e - u nam P•n'Compliance°-sitisfactory to the'COmmissioner'of.Heaithwill- successors, heirs or assigns by. the builder,.that'said' builder will 44,of two (2),years immediately- following3he date. of the issu-, br any repaIrs4herpl o 2)'.that the drilled - well :described above :with •the - standards rules and regu aTf ohs ofy the .,Putnam. z ° e PE R A 2' License No. - . - less construction. of the _building has bebn undertaken': and Is issloner of Health Any change or alteration of construction water _supplY,'.onlY, Title Gentlemen: PUTNAM COUNT DEPARTMENT OF HEALTI{ DIVISION OF FNVIRONMENTAL HEALTH SERVICES Date X 17� Re: Property of 1/0`407 Located at Tya /' ��, „LLB %�r 047 Sec_tionS,Xfl, /%qp Block /J' Lot �/77�5 This letter is to authorize John H. Prentiss, P.E. -a duly licensed professional engineer XX or registered architect (Indicate) to apply for a.Construction Permit for a separate sewage system; to serve the above noted property in aceordance.with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in corinection with triis matter anti to supervise the construction of said system or systems in conformity with. the provisions of Article 145 or 1..47, Education Law., .. the Public Health Law, and the Putnam County-Sani- tary Code. Very truly ur , e; ---At of Property 914- 878 -6170 Telephone ',6 Cdns rtlIn W. i T Address /- Z)9 �S'Z¢- Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IMALTH SERVICES COUNTY.OFFICE BUILDING, CARMEL, N. Y. . 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner J �� Address � Located at (Street �ea��/ ec . Block t�j)) indicate n.0arest cross s ree Municipality f%,!t,,, =04 Watershedd��� ` SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse 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 4 5 2 -- 3 /04 4 5 1 2 3 F O Notes: 1) Td #,s`to;be repeated at same rates are obta1,n6d .'a,t• -each :percolation for review. 2) •Depth measurements to be made depth until approximatelyy equal soil test hole. All data to be submitted from top of hole. P I LUav II Soil Rate Used 8 °10 Min/l "Drop: S.D. Usable Area Provided �. No. of-Bedrooms ?%Ooe Septic Tank Capacity. ® e) Gals. Type Absorption Area Provlde Bye &L.F.x24" b�'— width trend Oth6i Name lobn H. ,fin 55.a P.E. igna. Address D; C., Box r3 H, PRfN c, Vamp.T;7.7. 10512 Nor THIS SPACE FOR USE BY HEALTH, DEPARTMENT' ONLY: ' Gy Soil Rate Approved Sq. Ft /Gal. Che b 6 Date s�o� raft $10 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION '•DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE, NO. HOLE N07 G.L. (,r e Y 1811 _ 3011 3611 42" 48" 5411 �s 60" 66" 72" 78" .. 8 -� __ -- INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE -LEVEL TO WITCH WATER LEVEL RISES AFTER BEING ENCOUNTERED ®�L * TESTS MADE BYA.iV .C,6 �j Date eo4 I LUav II Soil Rate Used 8 °10 Min/l "Drop: S.D. Usable Area Provided �. No. of-Bedrooms ?%Ooe Septic Tank Capacity. ® e) Gals. Type Absorption Area Provlde Bye &L.F.x24" b�'— width trend Oth6i Name lobn H. ,fin 55.a P.E. igna. Address D; C., Box r3 H, PRfN c, Vamp.T;7.7. 10512 Nor THIS SPACE FOR USE BY HEALTH, DEPARTMENT' ONLY: ' Gy Soil Rate Approved Sq. Ft /Gal. Che b 6 Date s�o� raft $10