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Home My WebLink About1401DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 33. -2 -22 BOX 13 Ir i ,4 iF ! 6 - . 'r � i.l I r 16 MA r� ` 01401 PUTNAM COUNTY. P ,'PARTMENT OP IiT^ALTii ` DIVISION. OF ENVIRONMENTAI, WALTH 'SERVICES ! »CoLwil OFFICE BUILDING CARAftFI , N. 5$ N Y. 10512 . { j..s.4- IQN ETA SKEET - SEPARATE SLRAGF DISPOSAL. OYSM FILg X110... . Addreab Air e. ^ oaated at," ( Street Blook, $ " ce-S --Watershed i SOIL CQI ATION TEST DATA PEqUIPM TO BE SUBMITTED VITH.- owa �nbaa GLo K TIME PERCOLATION. 0 ®%,A Y aped +� �a er a ,er Npm From Gr. o=d Surfeme • in Inch ®� 061-1 to .. Start op P9 �A Start Stop Drop in N1i�P _ . Ir�e�iee Inchgs Inches... f• i. :.. '!. Note 1).. Teete to rep�atec! at ears dept until a te1 ua: ralea are obtalneo At each percgl�}tion tot bpi &. A. 0 to o � � A..Or ra lew..: ` Mpth nioasuremeats to be,rm4q,frM top TEST PIT DATA J�jFQtjjj-,,;,j- [,o y.,j 1`11, TTIT APP.L-FCA'.!' ON 1. -,.) . -D 1--' DE11-21GRJ111.1110TI 01-1 ;,", 11OL1i DEPTH HOLE, NO.— HOLE Pl.!O.-- HOLF, NO. G. L. 611 rd 4b; U 1211 1811 2411 3011 3 it 6 4211 48 5411 6011 6611 ---------- 7211 78" 8 84 f6 INDICA E LEVFL AT �Mlcjl GME WATER IS EMTC0TLTj%)TjQ-C-17 None INDICATE =E L TO WfaCH WAT]ER TESTS MADE By TEVEI� RISES F: TER LI.T-;'!P�TG�E�l,!C�OUi�'PL,RE, D t ed/ DESIGN Soil Riit-e* tjse-d-* Z4-X2,--, gji n/l " Dr o p S.D. Usable Area Provided No. of Bedrooms -_/,(,Septic Tank Capacity 00 Gals . Type Absorption. Area Provided BY_4nM L.P.x24."_--,,, TT- width rengcf�&� Other A10,6j. 1vame P.4i Address R.-D• 93 Fair Sit r c e t T ", r—W-T 01 1 1 -T*TZ THIS SPACE For' USE BY I'l-EAMT1 DEPARTMENT Soil Rate Approved Scl. pt/Gal. THE ST 1 Ti 1 Date 7- 4 ktMENT OF:14EATA, TUTNAM.-COUNTY DEPA Diksi6n of Et*ifdiiiIenW Hiirlith* Seridces, Caitnel,:- N.,-Y. 10,612 P6.ttbrsom'. CA - SYSTEM'. CERTIFI TE OF CONSTRUCTION -COMPLIANCE FOR SEWAGE. DISPOSAL Viilag® Town jjr'� , Fair Street Tax Map Located at ne d:1 Tax Map Lot # 8, # owner in a NY, -.10 1-8 5 'jit '6y 16,SYit -Bo,�.141, Cros.�-.j separate Sewerage* System '6U Address,. K Consisting of 1000'. -.24 Width Trench Gal.. siptic_'ta�k --and 'Other requirements water supply: Public Supply ,'.F DU, .ri_4vi A Mill U. Tnt- Private Supply Drilled B-. Address Brewster NY 10509 buildin . 9 Type Frame,: Three. Date Permit Issued 8/3-1/78 No. of'Bedrooms Has . Erosion Control Been Completed? Yet I certify that the system(s) as listed sending the above Premises were constructed essentially as shown on the plans of the completed work copies of which are'attached)o 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 Healih. Date 22. Oct; 79. Address Certified. by P. E. X R.A. Fair License ?�iirm`el -,NY 1051 No. 29206 above ' Any person occupying promises ser4irki by t he syitem(s) shall- promptly take such action as May be necessary to secure the correction of any un such iB Wulf 'a a public sanitary sewer becognes conditions resulting from , h usage-. I Approval 'of thO."para, e.,sqwprage systern shall becom u void as soon as e w and - -void when a, public we 0 , r su " I becomes available. Such approvals are available,..,and tho�approval of the'pirivit' Mar— supply Iiecome'nuil,in' h -AP Y. � -A modification or change Is necessary. "in' judgment ' __9 Kodificall(in or J i f h iydc subject chande �vi4ri, u gmen. ,of the Commissioner -Health such . r ,,)ate Z9- -WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3J71 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 D epartment._togetherENth,l3bora± cry 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 NAME ADDRESS OWNER 1�obenat Contractors Oscawana Lake ?goad Putnam Valley, P;Y LOCATION (No. 6 Street) (Town) (Lot Number) OF WELL fair Street Patterson PROPOSED USE OF rz DOMESTIC BUSINESS ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL WELL SUPPLY ❑ INDUSTRIAL AIR ❑CONDITIONING ❑ OTHER (Specify) DRILLING EQUIPMENT El ROTARY COMPRESSED CABLE r` ❑ OTHER AIR PERCUSSION PERCUSSION ❑ ) CASING DETAILS LENGTH (feet) 30 DIAMETER(Inches) WEIGHT PER FOOT � I S O I G j_ 7 6 17 L �,'J THREADED ❑ WELDED YES ❑ NO OYES 1 NO YIELD TEST ❑ BAILED HOURS ❑ KI G.P.M. YIELD (G.P.M.) PUMPED COMPRESSED AIR 4 10 10 WATER MEASURE FROM LAND SURFACE — STATIC (Specify feet) DURING YIELD TEST fleet) LEVEL 2 3 3 � 5 Depth of Completed Well in feet below Land surface: 365 MAKE LENGTH OPEN TO AQUIFER fleet) SCREEN DETAILS SLC DEPTH FROM LAND SURFi FEET to FEET 0 5 5 365 - - -- — - IF GRAVEL Diameter of well including UKArtL site (Inches) FROM (feet) TO PACKED: gravel pack (inches): FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. Tlardpan. Med. -hard 'lack & white mv�l�ar� If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT I WELL DRILLER (Signature) 7-17- 1 7- 24-79 -AA14 04 MILL Dl ILL II! G F INC. � � w BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. SAMPLE NO. 4347 SOURCE: Robenat Contractors Fair at: Patterson, N.Y. COLLECTED: July 18, 1979 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method well This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. July 20, 1979 0 per 100 ml. l� Bickwit P. E. Director Janet- & B&--hard'i ane _, ......... . OwnerQQ or Purchaser of ui ding �R14�� ec-A. Building Constructed by Fair Street Location - Street Frame Building Type Patterson Municipality TM 73 Section 1 Block 8 Lot GUARANTY OF SEPARATE SEWAGE-SYSTEM Wf. represent that �Te a9lewholly 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 VW which fails to operate for a period of two years immediately follo wing the date of initial use of the sewage disposal system, or any repairs made by " 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- tine -- system 'to operate was caused - by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of & � 19� Signature T i t l e-R-c IfIcorporation, give name and address) S.A.F. Septic Systems - - - - - - . - - - - - - - - - - - - - - - R. Ot Box -141,, Cr=oss River, KY a 0518. 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 e i Ot *Janet ,& Bernard Kane. Owner or Purchaser oT Building obenat Contractors Inc. Building Constructed by Fair Street Location - Street Frame Building Type Patterson Muni cipa ity V 73 Section 1 Block 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 system. October 79 Dated this day of 19 Signature Title If corporation, give name Robenat aNdOMM U 0scawawi Lk. ;w l., , Ptitymai Valley.-MY-10579 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 1 -7 Ln I- ZZ ui it CL w Z10 1 - kj) tT co 0 Co n wt� -7,t o { o I t ,_t t_ m Y �:� 1S A k: q. amAd 4w`3: w 14. AP CL Uh .ti 1 -7 Ln I- ZZ ui it CL w Z10 1 - kj) tT co 0 Co n wt� -7,t