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Home My WebLink About0927DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.40 -1 -27 BOX 10 I Wol yti 1 9 6 9 90 ' T- v r, I a'r9 r !' ,. I 00927 ` ry BAGTI✓RIA PER ML. (Agar plate count at 350 .2 COLIFORM: GROUP '(Most- probable No. /100ml.) . LESS THAN 202 , ARDNESS; TOTAL - ppm DETERGENTS. ='.ppm NITRATES (as N),_ gpm - IRON, TOTAL'- ppm PLOURIDE (F) m9• /1. .. These results'indicate that the water was YES of a satisfactory sanitary qualit y when the /a P le llected. t' % r �c m ..WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL. NEW YORK This repo, is to be completed by wcdl driller and sut r,:itted o County Health Dep�rtment_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 Paragon Homes ADDRESS Rt 6 Mahopac N.Y. LOCATION OFWELL (No. 6 Street) (Town) (Lot Number) Jordan Rd Putnam Lake Patterson A.Y. PROPOSED USE OF WELL BUSINESS O DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ SUPPLY El INDUSTRIAL 11 CONDITIONING (PH ;f ) DRILLING EQUIPMENT a ROTARY t = AIR PERCUSSION PERCUSSION ❑ RCUSSION ❑ (Specify) ) CASING DETAILS LENGTH (feet) 201 DIAMETER(inches) WEIGHT PER FOOT 26 THREADED . l.) WELDED DR VE SHOE Q YES ❑ NO WAS ASING GROU EDT DYES ❑ NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED 1� COMPRESSED AIR 2 15 YIELD (G.P.M.) 15 WATER LEVEL MEASURE FROM LAND SURFACE — STATIC (Specify feet) Total Drawdown 251 DURING YIELD TEST fleet) Dcpth of Completed Well in feet below Land surface: 140 SCREEN MAKE ' LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) FIF GR AVEL CKED: Diomote, of well including gravel. pock (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE' FORMATION DESCRIPTION . overburden Sketch exact location of we// with distances, to at least two permanent landmarks. tcci iv ,�c 0 5 C`Ydd Art ' 5 12 sandstone l 140 g7r -ay - grant If yield was tested of different depths during drilling, list below FEET GALLONS PER MINUTE 82 2 134 13 DAT WELL OMPLETED D cE F REPORT WELL L R atur R- D. t G -r t e Owne or Pur aser of Building Buil,,ding Coprstructed by Location - Street Building Type 1p-ixw- /%'rrxetwli� Municipality Section Block Lot GUARANTY OF SEPARATE SEIPIAGE- SYSTET-4 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. p Dated this 7_ day of 1114�Gl;� /11 19� Signature e1j" 2eS�1zY Title If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP.TTETION 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 'z:1 Jerre -& George Maldonado Owner or Purchaser of building Paragon Burlder�--Inc: Building Constructed by Jordan Drive Location Street Patterson Municipality Section Block Frame 36424 Ind. 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 tli`standards, 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 is caused by the willful or negligent act of the occupant of the building utilizing 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... A Dated this 27th day of November 19 74 Signature Title (if corporation, give name and address; r ----------------------------------------------- `1��__b ------------------ 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 � �•�� ; "' �� r �� .'�E� �� , �� PU AM COUNTY DEPARTMENT OF HEALTH � � °; ,�� . , # � _ -� r s � � '_ ' ' Drvis�on of'�Enwronmenta/ Health Services Came/ N� Y 1Q512 } �� r }`4 `"" ��,�,.4`- r - r s .'. �`V' a .3.� £ F .:' : t ,„. t y.. �.� � .. � � r °• .:. 3xa° 'CONSTRUCTION PERMIT FORSEWAGE ;DISPOSAL SYSTEM .- pdttel SOn -` I + Town or Village �rP aL Gated at Jordan Drive XE. M Secton.w Block F r Subdivision Putnam "Lake y -y} trot 3642 `8 Incl,ob �S01433 Owner Jaerri* & Geor a Ma donatlo z�� y _gddre55Forest ^Haven�;_Bu11-et Hole Rd� p Frame.w 14000' Carmel,�NY 10512 i' Bwld�ng Type Lot A rea ` r r s! .f - }s Three x 3 _ 1000 . + Number of Bedrooms - Total Habitable Space Square Feet 1000 r Separate - Sewerage sy tem, to�,consist„of{ - ' ` Gal Septic Tankk' 3 �x lineal feet X width trench !p r3 k ,:.z` -,�' " 'vr.3' Y F y,�+ �.r- 11 To be constructed bye /� 5 i - Address F ' +, t PUbIIC SL I From r^:a '' ra e, 'ic" 'x�t`' -•5t sK 4 4 ` s-. - � Water�,supply � , PP Y Private Supply to be dried by r nsi Y Y %t d ,> ^_ � "s'[�+'' r x Address Other Requirements Two ' 6 1 /2 x y6<' Deep Seepage Pi ts: r 'R .. � -' . ;'ry r °- Vii, represent that'l, am Wholly and completely responsible for the design.and locatron.:`of the proposed- system(s),;;1) that the sBparate,,ssewage .disposaI system ' _ abOVe de ;tribed •Will be'COnStruGted.a5 Shown On the,approvid amendment there t0 ands; accordance with the standards -- .rules an -,regu a ions;o e- u nam County Department of .;F eaith and that o "n completion thereof a.,Certif;icafe ofiConstruc4io_n Compliance . at�sfactory_to'the Commissioner;df Healthwili tie Submitted to .the Department -and 'a written: guaranteecwill tie ;furnished the owner, his {successor hei; ;'r assigns by th$ budder;; That said bu�ldei;wrll �.. 4 - place° in good operating` condition any part of said Sewage disposal system Burin' -the period of two 2 - r 9. _ ( 1 years immediately,following ; thedafe of ,the issu- r fiance of�thet °approval of,�the Certificate; ,of Cohstruct�on,iCompliance of -Ahe original system ,or any repairs thereto 2)'that the drilled;`well described above, 2 �wi ll belocated as'shawn`onthe approved plan and that said well will be installed in accordance'w�th the rds rules and regula if `Yhe Putnarri County Department of Health � ` j x�. r 4 = ` �.xMay 31: F�1974 j( # Y t _ to 4 �F R Q 6: Box 35 `C 1 N 105 2 29206 Address License No 7 .:.. L #sue sfi e.p �. - -: s• rj f t o r f th �^ � in h °been untlertaken an � � " J PiPPRO,VxED FOR.CONSTRUCTIQN Thi; *approval, expires :one _- rom he date issued unless c nst uction ,o a bu Id _g as, r revocable• for -cau3e or may, be amehded o'r.modrfied__whentc_onsidered. necessary by.aheaCommss�oner of Health Any £change, or ateratwn of ;construct_ion . r req Tres a new permit Approveq for disposal of'.domestic nitary se ge rid /or; prniat er supply only R - ¢'' 4Z I A6111 v Dated- By n • TC1 O U 1!0 /a 00 '4Q7 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA STMT- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner,/Ii 6F 4&0rj& &W6,y4 Address �► ev"O%vor 4wAr AvAW. Located at (Street '/, Dr,,Ae _ k Lot_ 5 . - 8 r n ica -e nearest cross-street davr) Municipality ±aeoa40 Watershed 4_6-66i,, SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITTi APPLICATIONS o e Number CLOCK TIME PERCOLATION PERCOLATION apse Depth to Water Water r-evel . No. Time From Ground Surface in Inches . Soil Rate Start -Stop Min. Start Stop Drop.in Min. /in drop . Inches Inches Inches 2Z 3 4 - 4 2 4 Notes: 1) Te':t's,�to be repeated'at same depth until approximately equal soil rates are obtained a,t,each` percolation test hole. All data to be submitted for review. 2)- Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE 'NO._� G.L. 6" 12" —' Soil Rate UsedMin/1 "Drop: 118" S.D. Usable 1 `2411 1 3011 Tank Capacity . /J ®® 3611 Absorption Area Provided By � 4211 4811 5411 60" Name J09n M. 66" 7211 78 8411 g INDICATE LEVE TESTS MADE BY -- - - WATER IS ENCOUNTERED EVEL RISES. AFTER BEING ENCOUNTERED 6�0 Address R.D. 6, Box 353 �aMel, New York 10512 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Ch Of THE Date —' Soil Rate UsedMin/1 "Drop: DESIGN S.D. Usable Area Provided /®®®° No. of Bedrooms Septic Tank Capacity . /J ®® Gals . Type Absorption Area Provided By � L.F.x24115b width trench.. Other Name J09n M. re 1 SS � F.t. Address R.D. 6, Box 353 �aMel, New York 10512 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Ch Of THE Date r- I� l'4U N � _N74e4 IA' 1 to 10"W -�--- I � ° e) (D M CO 0 M M /44.00 p r 6 rem well-, 4 p 16.44 deck she O ` / story f ome dwelling (D {M 6.42�i I q) j N Co 1 N (o rn rn re) re) S74e47 574- °4740 E JORDAN ( 50` wide) /4U UU y SURVEY OF PROPERTY PREPARED FOR GEORGE 8 GERALD /NE /SAL DONADO BEING LOTS 3642-3648 INCL. SHOWN ON "SIXTH MAP OF PUTNA44 LAKE" F TE /1a TOWN OvrPATTERSON ' PUTNAM COUNTY, NEW YORK SCALE / "= 30' Sold mop filed March 20,/93/ as Mop N2 149 -E Legend wire fencex x Y stone iron pin —o drill hole —,o" Certified only to: George 8 Gera /dine Maldonado, and to Paragon Homes, Inc. 1, James C. Edgett, the surveyor who made this map, do hereby certify that the survey of the property shown hereon was completed Aug. 29, 1974, Revised Nov. 20, 1974. ?.bYN-t -o ' .- �Lv- New York License No. 3�f2 Office of James C. dgett Land Surveyors 88A Oak Street, Brewster, New York W D Z Q Note: All certifications hereon are in accordance with the minimum standards for surveys as adopted by The New York State Association of Professional Land Surveyors and are valid for this map and copies thereof only if said map or copies bear the impressed seal of the surveyor whose signature appears hereon. Unauthorized alteration or addition to this map is a violation of Section 7209 (2) of The New York State Education Law. JOB No. 74091