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HomeMy WebLinkAbout1101DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.54 -2 -43 BOX 11 l `l . WI ..y . r � ti p' r , 01101 { PUTNAM COUNTYr DTsPARTMENT' OF .HEALTH 1� V . :Div /soon f. Environments/ Health, ?Services, i^arm% N';: Y 10512 CERTIFICATE;OF`CONSTRUCTION COMPL'IANCE.FOR.SEWAGE "DISPOSAL. SYSTEM .(T9 Patterson_ �- Town or, Village Located' at RaZidall Road .(north _ sided Put • Lake Tax ;Map 56 sock `� r owner G @orRe & Eli! &beth M. Mardvdl0. { Lot 6 sob Separate 'Sewerage; System built by BOb $dlallks C:onst°uct ©n InCp� dress 24 R ®adin ..-,Rd' Put •. Lake P,att erg 1000 2343 l.f.X 3:Ot trencri.' -son .12563 Consisting of Galr Septic Tank and Other requirements Uel^ plan &Code . water Supply: Public Supply From ` I � Private Supply Drilled .By Edward' Sa�r'og :'Savoy VGell Drillers ' Allv.iew =Ave. = Brewster, New York 10509 Address ' �. b Sin le Tamil Redence P three wlP �. I S EL 1s�6 AYE FI,N.E_.G.fiAV 1 i�iGofAivLo SEELI f 6- ; TO ' -6E ACCOlsued AY'il I.N, SPH I NG. Building Type Has Erosion Control .Beers Completed S 1- certity`that the'system(sj'as I�sted servirig.:the above_ premises were eonstructetl essenti sly as:`s wn on the plans of. the com leted work (copies of which are , ` attached), acid in accordance, with -the standartls, :rules and regulations plans filefl" d.. m¢ ed b the Putn unty Department of 'Health, Date` NIiU�� 1 Q /�! �CerY�fiedaby P. f A: _. 43952 -MI Address icense No. L Any person occupying premises served by the above system(`s) shall :promptly take such action: `J_4 may be necessary to secure the correction of any unsanitary conditions resulting from,: ._such- ;u"sage: - .Approval:4of the separates war ;a; shall become null and,.void as'soor! as a:public,sanitbry sewer becomes ({ available `and' the.,approvaL of the private water supply shall become`, and, v when . lic water supply becomes available.. Such approvals are f subject to mId.icaudin., o c hange° when .in the' Judgment, of the' omm ' net oi::H it lion, Iflcation, or ,change is necessary. K . }` G A Date Y .. I George & Elizabeth Me MUSvelag Owner or Purc aser of Building John Calbo Building Constructe by Randall Road (north side ) Location - Street Single Family Residence Building Type a (T) Patterson Municipality 56 Tax Map . 5 Block 6 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 occur 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- vi.ces .of ::the.. 'Puts' am_.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 sys m. Dated this day of 19 '26 Signature Title owner General Contraotor If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMYLETION 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 ------George - &- Elizabeth -M:- Maraeelas-. Owner ., -pr Purchaser of Building John Calbo Builaing-.C.ons..tructea by Randall Road (north side) Locat.,.on_ - Street Single Family Residence Building Type O • Municipality 56 Tax Map 5 Block 6 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 Jsaid 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 *.Wade 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._no.t.. the ., . failure'oi�'the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the sys em. Dated this �_ day of LWaIIJ 19 7,6 Signature Tit 1 eL- �a_�pnce 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 s WELL,COMPLETION REPORT 3/71 r' PUTNAM COUNTY DEPARTMENT OF HEALTH 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 indi6afitigwater is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAM f ADDRESS 4atw�l LOCATION OF WELL B Stye ( (T wn (Lo Nu r) lfv�V�Y ),q. PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM TEST WELL ❑ SUPP Y El INDUSTRIAL ❑ CONDITIONING ❑ O(Specify) DRILLING EQUIPMENT j�� MPRESSED ❑ CABLE ❑ OTHER L ROTARY AIR PERCUSSION PERCUSSION (Specify) CASING DETA ILS LENGTH (test) DIAMETER (inches) WEiUHT PER FOOT _ R WELDED E❑ O ❑ NO CASING S NO- � YIELD TEST HOURS HOURS G.P.M. El BAILED LIMPED ❑ COMPRESSED AIR IJ YIELD (G.P.M'� WATER LEVEL MEASURE FROM LAND SURFACE— STATIC(Spec /fyfeef) 4C- d DURING YIELD TEST [feet) j �5 Depth of Completed Well �� in feet below land surface: SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well includingGRAVEL gravel pack (inches): 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 (C If yield was tested at different depths during drilling, list below GALLONS PER MINUTE JFEET DATE WELL OMPLETE p/�TE F FIT WELL DRILLER (Signature) r KENNETH J. KOHLHOF - -- ANALYTICAL & CONSULTING- CHEMIST--- _.._._ 7- WAKAN DRIVE, KATONAH, N. Y. 10536 MEMBERSHIPS: Phone: [914] 232 -9050 AMERICAN INSTITUTE OR CHEMISTS AMERICAN SOCIETY FOR TESTING MATERIALS ' AMERICAN PHARMACEUTICAL ASSOCIATION Si0ClATt AMERICAN PETROLEUM INSTITUTE j O,� ' AMERICAN CHEMICAL SOCIETY AMERICAN ORDNANCE ASSOCIATION ASSOCIATION OF CONSULTING CHEMISTS 9 CHEMICAL ENGINEERS 9 �� ��J1S4CNE� CERTIFICATE OF ANALYSIS CLIENT George Maravelas SATE March 10, 1976 SERIAL- B6 -09 -029 MATERIAL well water ,The sample of well water submitted by George Maravelas was bacteriologically examined as requested. The water sample was taken from Lot 6954- 6961'on Randle Road, Between Java Road and Newburgh Road in Putnam Lake. The results of this analysis are as follows: Total Plate Count, 48 hours @ 350 C Coliform, 24 hours @ 35 o -E.' Coli - Iron. KJK:1gc 1000 col /ml 0 col /ml negative 0..4 mg /1 Respectfully sub ' tt ',. Kenne J. fCohlh , .A.I.C. This professional report is confidential and must not be used for general publication or advertising purposes without an official written agreement. P.UTNAM COUNTY DEPARTMENT OF HEALTH, IY . - 'Division•. of En0onm.'enta/ Health Services °:Camel;. N Y. =10512. CO RUCTION PERMIT FOR SEWAGE' DISPOSAL; 'SYSTEM,atx'BQhi f Town or Village Located, at north slide. ,- OfaCT2la l0�C9 :section ri�/1 5� 131ock E hth." Ma of Put ®,'fake _Lots 6954 ®69.61, :_ 6 Subdivision, p'; —. - _ -° _ Lot- n Job' owher = 1VTr.' John`. Calbo (Contract Vendee Address 'Sa zn:aw� 'Road,Put...Lake 13 • single family Ret� Area 16 ° 000 S °Pane san~ New York' 125:63 uildin9 Type Number of: Bedrooms three 3 _ - ai Habita le'Spac vndPrl.50Q�- .gf Square Feet 2 h Separate, Sewerage System to consist of,_' �oO Ga Sept Cc T 3� i 4 360+ an a X width trench To be constructed by _to be determilned - Add'e A A Water .Supply:- Publlc,Supply,- From - `yPrivate 75upply"to be drilled by'r -- ._Qi; "Address: A,114ier AQe • Other Requirements S:ee p3an' Shts_o 1.&2: Of I represent that 11 am wholly and completely respon£�ble for.the de< above described will _ be`constructed�as shown on the,apo r-- amen County',Department of ':Health;' -and thataon completion;thereof ' a be submitted'- to.the Department; antl a;= written :guarantee will ,I place in good operating ;. condition any parttof said sewage dsF "'ance of -the approval `of •the ,Certificate ;of Corist7uct�on.�Compli Will- be located as shown on the approved plan and That said well wil County'Department of= 'Health }�' 3- 31/16 - Date S¢gr Address Millto��n RC!, , APPRO'VEIJ FOR CONSTRUCTIQN This approval expires oney ..revocable for cause or may be,amended or•modified -when consider regwres a +new per it .Approved for disposal of domestic :Date h By 2 and Code I soon 'of. the prop d , system(if; 1) that the ;separate. sewage' disposal system e to an in d accor nce with the standards, rules.and•regulations.o -the Putnam e ".' oOOConstruc . on Compliahce" satisfactory. to-'th'e' Comrriissioner,:of ,Health will i the =owner Wsuccessors 46i -6r assigns-by the.builder,;tha; said builder will du61ng't per' -iod of two (2) years immediately following theda'te o °f the issu- ezorlgi. ystem,or any xepairs thereto; 2:) Via t'; the; =drilled well. described-Above rdance:witfi ~tie standards, rules,a regulations of the Putnam P.E R.A. ` 5. rewster¢ ~0509 License ►VO. 4395r2� e date issued unless construction of the bujlding' has been undertaken.• and is by,•the -Commissioner; of =Hggaith Any?,change'.or. alteration of construction rid %or private' water supply only } Tale .P i ! Insp. by: III, ,. TTlL SIlD ePLCTI0:3 Yes h o Ccrrmento, Froport y lines or corners fc•,:.nd Can estimate house location ... Will drive-way reed cut .: ... : • . Dust be rergo,� ed -note these . .. '. arwys� mad l� ,troes Xs deep hole :,cpresent`t:Lve of entil ro 'SDS dr a Additional deer) hc1es .'-'2°e-ded. Sufficient ai,e_ -a avai-lable. cors�derin _,rr,, dr:ivev Tay cut, house lOCat1.On,.separat] On distances; etc.' • • • • • • •. • • • • • � DEEP HO r D.yTa . . D�pth :. 3 , 5-, n 7112 fv 9 "Le 'Water elevation: Roc]: ele=��ati�n: 7/L . . Soils descrinLion: f, Date: RIMAL SITE 'I"TSPECT IO?.r Ins.u. by j H6use loci Led; where srovin_on approved. plank . • . _ w,y er ._,i ti•L. vw,.v v.•yi -V Uypr. vv..L: . • . . . . • •. . . i 1 ... Width of trench a v er•a c7e . Slope of the line-and trench aC. ce pt- ab1e RZoom aJ.Io,,Tea for e nSi on t erne ees Over 59 ft. from swami), •.:o tercojrse _ ?Na",tlu�ra :11 s�o+il. _not s -r-lp "jed• or SUS- -area• 10 ..t`it . maintained front prop.lin.- and 20 ft. from house . . . . . .. Separation of tr e ich from, house, Yell etc. folic'Us nia.n AfLLrDEr Of b:;drocrns cheC'�S Stones, br l;S , StL:'? L''S, rubble, e UC . o »eater i:ii.n 15 ft . - rom nearest trench • 15 It • of peripheral soil horizontally from trench Junction boxes prene_­1 y set Could surface run off from drive�•-ay. roads., • . groLuld surface, . etc. channel near SDS / area Does Tot, drain-a re atinoar 0. K. in area of SDS FINAL GR:'1DINIG OF SITE ACCEPM112 ' •. R. �VIEtJ CIIL'CK SHM, T Meets Std. es No DOCUMENTS . " '� House plans 0. K. Design data sheet Peres presoaked? Min. 30" perc test depth Const.. results for 3.runs D. Hole lob O.K. Corporate Affidavit for.other than indivi Authorization for engineer Letter from Water Supply if applicab e If variance requested -such noted on .plans .Ual apps._ DETAILS if change .is proposed.,) Existing contours shown show new contours) Slopes for driveway cuts, etc. shown I U Water service line location Footing. drain, etc. location I ;/ Top slope, bottom slope of fill ! Nl 1 Percolation.tests and deep test pit location. ; �f Septic tank size and conformance to std. ✓ ! _ 3 B. R, house - minimum House I ,/ House setback shown I ✓ i.1 ii r. !n K • . i ie _ Ow f • .3 u All Wa Le-L- 1! L LI11I1 JV i U. V1 . [ -L -3LW W* 1 i Plan and profile SDS • All otier -wells and SDS closer 200' shown or'. reference made -Property boundaries (metes and bounds- clearly showpl SEPARATION DISTANCES SPECIFIED ON PIXi 10' to P. L. 20' to Foundation walls :00' to Nearest well 50' to stream, march, lake, etc- incl. 15' to Curtain drain 10' to water lire (pits -20 15' to storm drain 10' to large trees 10' . from foundatior. 15' to pipe from lE .expansion); T. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES T COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM .. FILE NO. 3'ON RACT VENDEE: 312 Haviland Drive MWrZ MTr. John Calbo Addre.ss Patterson, New York 12563 RANDALL Ro - between Located at (Street Fairfield & Garfl9glc9. TM '56 Block 6 Lot 6 �'Tncticate neares cross street) (Reference: : B I .�-VSTEI ua : Putnam Lake nfiap Noo­3.Subdivision opined near drainage saddle, Municipality Lots 6954 - 6961 Watershed flows toward LITTLE POND) SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS toles saturated.belore testing, on hdovem er iLj, by 11. t, ap s, , oe 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 -So 1. 10:07 - to : 21 14- 3 Z6 3 +.to7 SHA,LLO W low ,M iaDL`� 2 10.22 of A s.D.s. s3'3 - 10 =58 1,) 724 i3 lo_ 33 ARE 3 ' 0 5 IN WEST 1 10:1 o - 10:q -0 30 4F zd, SEEP ..... .. .__ __ ...... P RrPQRel> 3�4Et,i 3 11 :13 - 11 -%33 4-5 5 N S E'EP NOI� 2 10 :4-'Z - I : i 3o +5 4-6 l 3 o R EPARE-3) 3 i s 3 11 '36 4 9 1 30 4 S o t P ERC S AR,E IRV_rTe F?. A-PP M®A C H F3 �0 10 m it r-E RATE , 7DeiFPER PEP-cS (AS St4k LLO ui P 177 c.o-o rE-MPL `Y'�) ARE 1J0�'- AS CoOD, � APPADACH ' 30 kik; . RAr� , . 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. AS 0,3 Av 1'Q_AGIr PATE LL6 U.)� cram S rr>E- �PeGiG, J P- A-rE AS. H --o 15. as 1wuiES. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION W DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. EAs-r HOLE NO. WEST HOLE NO. NO it k) G.L. wgo3g_D LoT M)Iro RCH 6 It I1 L RIGS! 1211 dL 1811 CL AY 0 2411 S is 's 24X Ale Y, 0 SMA.LL ANDONT 0 30 j 36 SAV47 . cz>WTGI'%Tr: 42 % W. 16 E-A G5_5 iy hi 48 s® Ira C GP 05411 to _j 6011 A i,33> y C, Ale < 6611 wl som 0 X 0 7211 P, AN EL J 78 84 • INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED - Isa trr em c o u NTS-Q_f:Z> INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED - O_ TESTS MADE BY -1> e e P t-k 0 LE9 - ik/ 17/ 7!;'- . Date rbsePm 0rOMIA Flirckc.0'. L. kr 10 N.7 15 DE31GN Sdil- Rdt61-. U6Eid S.,D. Usable Area p No. of BedroomsTmteek3 septic Tank Capacity calme Absorption Area Provided ByL2,.'30 L.F.x241 ze-E o5ld-ETCH PLA.M�' 'POP- Si Lynature_:;�, ­—AMOR P. INC UUMIM Address PROFESSIONAL ZNWIN99R mmmoWll, ROAD# R , .0K1:yV31!R#NeYe i THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq.Tt/Gal. SEAL V­Nz.ek �QN44aGLReo,) ml V A R I A �Xi!- 439511, Checked by Date 0 E HEAD 17 75 0 E HEAD 17 (PAIRTA 92 'Itang as }u fact • lbvel'). Qaasaetal Coma tTq] CR C� •, Std SE Septic Bybtm Zt9lle)� n8 on • •� w !+Yl 4M 07 2 .t1 e 6 6'0 6t •, 63'91 Dr4114*1 $dro pda �S Well Dr9ller#i ,. Brewetor Location by theodolite, tape and stadia methods. $5408 lefo X 3*01 aide trench installed e VED I DRAWN l Rw�Sto- oa'*e REVfBEo 'DATE ^� —W --.p 46 10\ 9, pC� Er e . o , �L- sThib� Is .-to oertify that 'the a ©wage disposal e 8jam vas bonstrubted as indioeted an this plan and, that thsT4 gitom was insoeot®d by me before it ti®s oovb red ovepo The asystem %so oonstrnoted in s,6rordanee with all,the rules 'and regulations of the Putnam Copiaty: Department of Health.,, 1 - -. - -' .. .. ;1e. < t2 I atr�rsanb;, oF'r�sl, �,�u�, RSV- i EY A LIG£rlSiD P^pFESjIJtVI gyp. -'`9 yt f AreatoR't`i .i WUa bii8 al0 e. ifltDOdS D. .a DRAWN CHECKED Rw�Sto- oa'*e REVfBEo 'DATE 4 O 4 J J 3 p6� catA°rle iv k ATT = Irl _ 230 LF ati:vaooeH x t'i �T� wIS�C k ►J sY r+1eo- voj:1T �6TA7�t.A M&7Mo . 7-E.%\ 5£E "OT' C I-TR. arD M/ 19 / 75) UAi3 - F T QU,AtL:ASL AL. 5ysreo rlR% 5 , PARCEL ®' .A 6UT No-r am MtPLEG -T FROM u- PMI.&,L SEPTIC-- - ioN PROPOSE A j1 v V. Iz FRr, ay Iti f Q,i s y