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HomeMy WebLinkAbout0997DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.47 -1 -5 & 25.47 -1 -6 BOX 10 �.. go I -p,ri I IA ur .�� .y� .LL:r' = L Jil g fry', PUTNAM COUNTY EPARTMEN ,.,yOF H +EALTHSI 1 _ : f E wces, r vision o tnvaonmenta% Health Ser Cam% Di CERTIFICATE OF C0NSTR;U.CaT1ON_ C.OMPLJANGE FOR_ t-WA0 DI_SPOSA'L' SYSTEM, �T Pa tBrsOn G Town or Village f . kst Located r'at hkymrf: _ f Tax +IVIa PI 1,17 5 +Block> 1 Ire ' cow,ner�ra -C� Nlrg a °'''�t��.f3 �%. J:lil:s� 1 - _ &roll_i�vland °Add ass Se�avaod Road yPaterson: NYl'2.5 Separate Sewerage. System,'Dui1t' +bY , _ _ - _ _.3 ' =1 ©00 ri S�1 Conslsting of Gal Septic Tank and; Y_ = a p s rate Other requirements � � ` � - - - f Water Supply Public 'SuPPIY ,From X P,nvate Supply illed By'. 7gzard > dyo9 = SaVOy Dell Dr3.11srs. ;AllvieW Ave., Dr Address €3rBau81;A�+ New Ya r1r l �509`y _ ' `L } sin is farnil rssidBnce hrBe y' 6 9/76 !BWlding Type - Nos of Bedrooms Date Permit (Iss`uedt ` Has Erosion Control Been`.Completed� Yes fine grddi , g' & aeedl:llg to be :aeeompli.shed in spring ' - = - I certify (fiat the >system(s) as listed serving t'he,above,;premise ;;wale constructed essentially as, shown on "the plahs;tofAkq completed work. (copies of: Kich, ~are ;iattached) :and in accordance with,'the standards :rules ;and iregulat o`ns plans,fi,iled, "drthe. a it 1ss" by' a aPutnam` my :Department,, Healfh Date k'ebraary 9# 1977 Certffiedaby _ _ PrE X7L- A 1 Address i,6 A License No 0435 k Any person occupying premises erved bywthe aboyeSsystem(s) shall jpromptly take such�actton as may be necessary to secure the correction of anyLunsanita►y K zi conddions° resulting from +`such usage Approval`;ot the separate - sewerage system slallzbecome nul —ef,.void +as soon!as a public san:itary"sewer fbe"co' es -:, - iavailable .and the, approval "of'Qhe private .water supply shalFbecome. null and: void when a pubUc wa_'tei 'supply be _ e's available Such, :approvals are subJect to modification or change when 'm the .j'udgment of the Commiss Health, 'such revocation,. m fi ion or °•change Is. necessary Boy v a Title - � y 11 DI JS ///3 u W4 IC,<QM IP TION IR.g?QRT IPPTNAM PQUNTY iJEfA RTM -N T of 09 kT l �liT Dlvi ;)on Qf Envirgnc�entel lieralih �1K1Ftl COUNTY OFFICt; BUI pl111Ci - AljM L, INEIM Y90K This Tapp. is W be c- cf>Faplex,sd try wall d►iller and submittal to bounty, haaith Qepartment t4gethel with.ladQrafpry r@p,.Q,,rt fp# analltsie! of wa�t�ar san!ple indicating water is of satisfactory bacterial quality befgre certlflCate fAf co.nstructian cstlnpli�r" !4 IggygQ, REPORT MUST OE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETIOM QrMNI M.& H Custom Homes Inc Deacon Sm.itha Hill Rd. Patterson NY LOCATIQItI (NA. 4 eaU ieehi . 44t N!1mo .. . of W.-04 Patterson:. Tax Map # 5 Block 2- 3 pRpPp; D_ " �STIC �—i EsTAeu$r1MetT Q FARE Q TEST w14 0 {' Pulw; (('^��j AIR OTHER eSUPP 11 11 I"PUOTRIA El 4T acifY) ORII hIN4 COMPRESSED CAKE OTHER EQy1PMI NT 99TARY � AIR F9RCI!SSI9.N q PEItCU.S � (oppcify) CASINq tENI IM (f t0 P.IAMETERt Inches) W�14tti PEA FOOT I�'�l ff��ii OWE w9l:� WAS D1iTA11L'� 43. TIIREApEP t_J wEWRD Yi S NQ YES . P19 HOURS G.P.M, YIELp 1f1�IQ (t#.P.M,1 TE4i I~Al1RtI I'UMPIEh COMPRESSED AIR 2 20 20 yATE1 MEA$04 fNGM IA�IR StfRfACE $tATlf(SPeclf X taell PAIRING "YIE�Q TEST ff t1Et) Depth of Completed Well 45 fatal drawdown in fpnr kelow land wNce: 220 LEI %v" OPqN TO ( yIi'li? SCRI111A META$$$ SOOT Rlatli DIAMETER (lnofe) f@ 6RAVg1 pigmatpr of well inslvsjln� G "y.? 512E ( Inches) Rom paef) TQ fleet) PACKED) aravet pock ((riphe;r): Q4,t1TM FROM 4lNQ SURRACE Sketch exact location of well with dlatenpea, to of h!e9f FEET fo FEET F913rtiATION DE$CRIpTION two Permanent Igntlmarka. 0 21 clay overburden 221 3 ,2 _ 1220 If rlek 6;4.. 7 9 sandstone limestone. F"i- .rte � a/ i ..• �,� � . PQ13T Yy t.L DF!14 LE R iSlgnoturR) ...., Charles VV* 4r, Mam� Tucker Owner or Furctiaseror Building John Calbo Building Constructed by Saginaw load (south � c3® ��� car 1, 6 Location - Street c 4d) Building Type (7) Fattors Muni cipa ity 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.regulation's 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 •- Pu*tna�n- County - Department o-f- Health- a•s 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 r l 19 Signature Title If Corp ration, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMTLETION. 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 BACTERIOLOGY - PARASITOLOGY VIROLOGY - 4 W-220 ANTIRI TIC USED ` SOURCE OF MATERIAL Ox REQUEST 9[ 0' $ ood a 3MEAR JZ CULTURE o putu+n © Routa e Q Nose Q T. B. Ej Throat ❑ Whtheria 0 pin- Fluid 0 Fungus a rine [Q G. C. p eees ;_ IQ Q/Pus From n her Q' El POLYMYXIN , B Q Ova and Parasites 0 Viral Studies Charles Tucker 2€3 Sagznww Rd., Patterson 3 N.Y. Date: 1/27/77 [dater Culture DOXYCYCLiNE 1 VISRAMYCIN j LINCOMYCIN OXYTETRACYCLINE METHICILLIN AMPICILLiN NAFCILLIN ZACITRACIN +Net- InIVIr nffln PUTNAM DIAGNOSTIC LABORATORIES 10 STONELEIGH AVENUE - CARMEL, N. Y. wIEWATE I S I I I e CEPHALOTHIN FURADANTIN / MACRODANT CHLOE AMPHENICOL, OXACILLIN CLINDAMYCIN PENICILLIN G COLYMYCIN POLYMYXIN , B ERYTHROMYCIN STREPTOMYCIN GENTAMICIN TETRACYCLINE KANAMYCIN VANCOMYCIN MANDELAMINE DACTR IM "Non - Antibiotic Agent CHART COPY � o/,00� L let, V4, yaYI21 2'uo�er - _._..__.__.__ --- ^--__._.�� ___� .. _.__- .__— -- .._..--_- (T) Patterson Owner or Purc a,ser of Building Municipality Jobn Calbo 5 Building Construct. by .440444M Tax Map Saginaw load (south side <, mar Rd t w Location =. •-Str..eet lock Single Amily Residence 1 & 11 Building Type. Lot 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- sots, 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 followir_g 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 day of e C 192/ Signature Title -If- dbrporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,ETION 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. 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. CHARLES TUCKAddress g1NGTON ROAD BREVSTER N.Y. Owner MR. 8c MRS. _�,1. KEN Located at ( Street qG IN 4y+ ROAD sec. 57 Block t Lot t 8c 1 I. 6S dicate nearest cross street) sideh-111—f-3 swamp-to s ream - . which runs to the east branch of Municipality ((Z) Patterson Watershed th,- C:rntnn- 'River -the Great Sv+rair SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION apse Deptti 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 HOLE #1 111:20 -11:32 12 21 2« 6 /in. 211:32 -LL :37 5 2311' 23.75" .7511 6.67/in. 311 19 2111 23.5" 2.5" 7.6 /in. 5:: 27'.5�z2�.ir ti 5 /in. 19 18" 21.511 3.51' 5.43/in. HOi,'_ 111;22 -11:23 1�. 18.5" 20,511 211 5.5y'in• 5:: 20.& 51t 311.-41 -12 :00 19 18" 21.511 3.51' 5.43/in. 412 :00 -12 :10 10 210511 22.5" 1't 10 /in. 5 12:16 -12 :29 13 17.7511 '2001,917 1.2511 _7.43/in. 1 2 3 Conclusion: Use 8 - 10 min., design rate 4 . 5 � , Notes: 1) T6gts 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. TEST PIT.DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN•TEST MOLES' DEPTH HOLE NO.--. HOLE NO. HOLE NO. Wgodd& Lot 611 Rich Topsoil & 12" Decayed Organics 18" Sandy Brown Loam.. �1 24 iI I 1 i 36"' Sandy Clay 42" 48" .60 Increased Clay 66" Content 8411 ° INDICATE AT w13I %FA%UNDWATER IS ENMUNTERED n a INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED n/a TESTS MADE BY nPAn N�� r� - .ToGenh Garcia Date 5,8,/76 ... Re3=01.ati -on - Ni cir CDbq p�GN - 4 , /76- Soil Rat, Used 8--;10' MifvT "Drop,: " `S.D:-• Usable Area Provided sufficient area avaliable No. of Bedrgoms three Septic, Tank Capacity 900 Gals. Typeapproved cone, Absorption Area Provided By 266 L.F.x24" 36" g width trench. 12R f, to be nstalle how • er• F N Name . .: lgna ure P P dc ARMUR re Address PROFESSIONAL ENGINEER S. L * �JPQP Mc`9G t • Y. 10609 r ¢ I THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:. �N A ^�G• 43 °5 Soil Rate Approved Sq. Ft /Gal. Checked by \ R 2 AR`s UR P. MC LAUGHLI v REVIEW CHECK SHEET P'2DFEiMONAL ENGINCCR MILLTOWN ROAD, R. D. 5 �': � ;�? ale 111gii for �wr� BREWSTER, N. Y. 10509 � ,l; rs, 01-ar1 es Fucker Sa ;i now °u Omar 'Roads., - Bil sots 1 8" . 1 House plans O.K. ' Design data sheet Peres presoaked? Min. 30" perc test dep�F'° Const. results for 3 runs D. Hole tog O.K. Corporate APfidav or oar Authorization for erigirieer - letter from Water Supply 07 If variance requested -such nol .cable on plans & apps.: DETAILS if change is proposed,) Existing contours shown show new contours) Slopes for driveway cuts, etc. shown Water service line location Footing drain, etc. location Top slope, bottom slope of fill Percolation tests and deep test p ocaEion Sept ic tank size and conformance t std. 3 $.R. house minimum House setback shown DistrilmlitUha box All 1leater within 50 ft.-of PL shoo it s 8e 8 X µ under ..1500 ....s f — ------- ---- -- floor plan submitted 4 n a In vidual n' a n a no change proposed n a h ECG U.li.Vcl11 (� _ . �s..W� ._�...., _ .. 0 /_ Plan arA profile SDB x :.... :..:.: _ .:... All other . veils and. closer or-reference made -_ _- ` = :. .._......._..... Property boundaries (metes and bounds- clearly shown SEPARATION DISTANCES SPECIFIED ON FIAN 10' to P. L. 20' to on 100' to Nearest well 501 to stream, march, 15' to Curtain drain 10' to water line pi: 15° to storm drain large trees ito gI I , etc. kinci.expanslon 0 i 41 a/. a no proposed X ° ref to Cod X I see noteV. X re7. to Code -AMP M P. INC LAUGHL.I PROFESSIONAL ENCIfV ek AULLTOWN ROAD. R . D . 5 BREWSTER, Na Y. 1050♦ S t � • ,, f 1, t J - :.e- - or - .: Y Ica : -@ found Can cot m` : :.• .sr_ location Mn (`� driveway need r I d i t=°^C hole representative of , US &rag A,:1 i 1 t 1 ii„ _' deep p is ` 1 E? :.lf r fi ,_, d driv • r_e cut ..i du C-t' l �•� � �-'' t i . ' � 1 R r -' i.fi T'Fi T . � : 1 1 f9 �,.fi.IiN'f_� 8 y (ate Eck r1E�at�n: 0 0 0 0 0 oza located Yl•Sf= ;'t= 8 hmm on approved plan ltku_.t l[ M1� .[� trench g:. ;,ter_ - — — '= @nLT`.1F -d for expansion trenches tIIZ` 1 dG g i fi6t t i p e i i I' 0 Y t3 ' . VG tU: of tLCr t � %.w L'en Gt c . f, l l !:1.a.n ``�ht • b3 s I` 18 h 1 ° 'N I'ibb1,_ q at &m � 5 �, . t t ., .h 15 P't . oZ p� x • • - r�.1 >s it !:�cr1LuntaL_v .fr,. 1. t xQM h Faq. �F�Tr1[A i e A :�>I,�.',i% i P 4 A..�� �►?_ :mss Date--- 4 23%'76" $ p;bye, Xicholas-, S. Chapis' Yes INo see note d see design data sheet =K LIST, , S , design ' i or Mr . & inns., Charles IJ. pucker' L Sag, iftati -&' Oarnar ad- 9..Put sake , Pattei�pon9 •r,, e 57 - : 7 Lot- s 1 8-1 - 11 PECTION _ t � • ,, f 1, t J - :.e- - or - .: Y Ica : -@ found Can cot m` : :.• .sr_ location Mn (`� driveway need r I d i t=°^C hole representative of , US &rag A,:1 i 1 t 1 ii„ _' deep p is ` 1 E? :.lf r fi ,_, d driv • r_e cut ..i du C-t' l �•� � �-'' t i . ' � 1 R r -' i.fi T'Fi T . � : 1 1 f9 �,.fi.IiN'f_� 8 y (ate Eck r1E�at�n: 0 0 0 0 0 oza located Yl•Sf= ;'t= 8 hmm on approved plan ltku_.t l[ M1� .[� trench g:. ;,ter_ - — — '= @nLT`.1F -d for expansion trenches tIIZ` 1 dG g i fi6t t i p e i i I' 0 Y t3 ' . VG tU: of tLCr t � %.w L'en Gt c . f, l l !:1.a.n ``�ht • b3 s I` 18 h 1 ° 'N I'ibb1,_ q at &m � 5 �, . t t ., .h 15 P't . oZ p� x • • - r�.1 >s it !:�cr1LuntaL_v .fr,. 1. t xQM h Faq. �F�Tr1[A i e A :�>I,�.',i% i P 4 A..�� �►?_ :mss Date--- 4 23%'76" $ p;bye, Xicholas-, S. Chapis' Yes INo see note d see design data sheet i. 'A TABIR OF OFFSETS FROM HOUSE CORNERS: (tape distances in feet - level) Location by theodolite, tape and stadia methods, 189*0 l.f. X 3.01 wide trench Installed, 177 l.f. called for. (8-11.0min. rate 6 time of approval) "This is'to certify that-the sewagis disposal A neral Contractor: owner Septic System Installer: Harold Hav: Kenwood Roy Patterson,' Aell Drillert Savoy Well Dri no ra A! Ave*, Brewster, N.Y. ARTHUR P. McLAUGHLIN Professional Engineer • Land Su Milhown Rd., AD # 5 414 279= > SCALF t-, I J-�Jlz i. 'A TABIR OF OFFSETS FROM HOUSE CORNERS: (tape distances in feet - level) Location by theodolite, tape and stadia methods, 189*0 l.f. X 3.01 wide trench Installed, 177 l.f. called for. (8-11.0min. rate 6 time of approval) "This is'to certify that-the sewagis disposal A neral Contractor: owner Septic System Installer: Harold Hav: Kenwood Roy Patterson,' Aell Drillert Savoy Well Dri no ra A! Ave*, Brewster, N.Y. ARTHUR P. McLAUGHLIN Professional Engineer • Land Su Milhown Rd., AD # 5 414 279=