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HomeMy WebLinkAbout1415DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 33. -2 -37 BOX 13 01415 ., Qr k.-ir4 . �` j ` 01415 m����—^ �n*w�__-o -'-_'�~--_''—_' Date of previous Approval Mailing Add... To. Building type :14K. /-Vj 6 i�� AA— Let A 84,, Fill Seed6u,ouli'l Depth L4��Vohm,. PCHD Notificition Isloquired When FIR Is completed Number of Bedrooms Design Flow.G/Vb S, Separate Sewerage'System to consist of Septic Tank and ww-L Ad dresi To be constructed by Water Supply: Pub . He Supply From Address or: ",late Suilply Drilled by ___Address Other Requirements ' I represent that I am wnoiiy and completely responsible for -the design and location of 94 proposed system(s); 1) that the separate sewage disposal system above described will be constructed as"showh on the approved amendment.thitie to and in accordance with the standa , rds. rules and regulations of the Putnam County Department of I Health, and that on'completion thereof a "Certificite- of' Construction Compliance" satisfactory, to the Commissioner of Haialth.will ' be submitted to the Departrriiiilt, . and -a written guara ntee wili be - furnished the owner, his successor$, heirs,6r ass4ns by the builder. that said builder will place in good operating ' ance of the approval' of the Certificate of Construction. Comp ance of. AND, original syst m or on s t: eret , 2 Ythat the drilled well described above ' °wbli County Depar ' undertaken revocable for cause or ' be amended - � "*"°es a now permit. Approved for disposal domestic' sanitary sewaget5dgj.W private water- supply only. ~�o" ruw ^ /� PUTNAM COUNTY DEPARTMENT OF HEALTH r Rev. 3186 Divisl ofEnvironiziental Health Sirvl6" on. es Carmel, N.Y. 10512 Engineer to Provide Permit CONST I 17 11 OR WAGE DISPOSAL SY�TEM Town L.t.d at or Village Subdivision Name Subd. Let # ax Map BI Lot m����—^ �n*w�__-o -'-_'�~--_''—_' Date of previous Approval Mailing Add... To. Building type :14K. /-Vj 6 i�� AA— Let A 84,, Fill Seed6u,ouli'l Depth L4��Vohm,. PCHD Notificition Isloquired When FIR Is completed Number of Bedrooms Design Flow.G/Vb S, Separate Sewerage'System to consist of Septic Tank and ww-L Ad dresi To be constructed by Water Supply: Pub . He Supply From Address or: ",late Suilply Drilled by ___Address Other Requirements ' I represent that I am wnoiiy and completely responsible for -the design and location of 94 proposed system(s); 1) that the separate sewage disposal system above described will be constructed as"showh on the approved amendment.thitie to and in accordance with the standa , rds. rules and regulations of the Putnam County Department of I Health, and that on'completion thereof a "Certificite- of' Construction Compliance" satisfactory, to the Commissioner of Haialth.will ' be submitted to the Departrriiiilt, . and -a written guara ntee wili be - furnished the owner, his successor$, heirs,6r ass4ns by the builder. that said builder will place in good operating ' ance of the approval' of the Certificate of Construction. Comp ance of. AND, original syst m or on s t: eret , 2 Ythat the drilled well described above ' °wbli County Depar ' undertaken revocable for cause or ' be amended - � "*"°es a now permit. Approved for disposal domestic' sanitary sewaget5dgj.W private water- supply only. ~�o" ruw ^ /� PUTNAM COUNTY DEPARTMENT OF HEALTH ^� NO. 262 -89 -20 COMPLAINT OR SERVICE REQUEST RECD -TOWN 'pAT,rTrgsr T - DATE- April 28 ; 1989 REFERRED TO..-Jay, Hodgens TAKEN BY Jay Hodgens TELEPHONE CALL X IN PERSON LETTER CONFIDENTIAL REQUEST FROM R,,p Wilson TELEPHONE ADDRESS ENVIRONMENTAL HEALTH: Home Sewage Rodents Migrant Camp Other_ 241 -3325 (W) Refuse Public Water Food Service • I' •' • -• u•• • �• 1- • • • u •• �- • •• • • WARM ,, �- ?�i /�� •lam /C _ r An.. �v `t ACTION TAKEN BY /(/ y- �.-+ ,✓� <o�` DATE FINDINGS l i� - �_�� /� ✓ �/ i ,�/ % —� t� ode FOLLOW UP PECTION (s) _DATE _.. FINDINGS z;�/ y . _ wi -- 5 .%- - .e% C " / /mac / r�✓ G �� S �� � w.f�,.- .via %� _ /moo i� •.� 24 DATE 6 :? S- FINDINGS S G!/'�GC � i- �, /v�iC s>• /�r 1c � icy � C- G�G��� -r/.yt �� S �"�jQ ` �! f l-a__ 2� To a Q !ter/ -e // c ':::7 s / S 7' `,/g( �-°► = -. PROBLEM ABATED �`�r /j � -� RSON NOTIFIED eel A-�? '.ESTIMATED TOTAL MAN HOURS SPENT 77 PUTNAM COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS (Name o Owner) REVIEW SHEET - CONSTRUCTION PERMIT DATE REVIEWED: 2 6 BY:� (Street Location) DOCUMENTS-- Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log /G f 3,5-- Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow FF'�'ll P ofile & Dimensions - Volume D,br ;Trench /Gallery: PuYnP Pit details -Septic Tank Size, Detail Well Detail, Service Line if.over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity_flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Cartain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same LT = Less Than T = Trace NA = Not Analyzed &/�Reported By: Date Reported C -02 WESTCHESTER,COUNTY DEPARTMENT OF LABORATORIES AND RESEARCH VALHALLA, NEW YORK 10595 NYS- ELAPjNO. 10108 Lab# 4070 Bottle# 23 Date /Time Received 5/20/89: 2:47 Date /Time Coll'd 6/20/89 :12:00 ,Agency Coll'd for PCHD Coll'd by J. Luke Sample Location Subdivision off Type.of Sample ',. Fair St. in Patterson ,Rash /L:•��G�� [ ]Potable Water '- `..Sample Site Backyard Stream L-eL [X]Non Potable Water [ ]Other VOLATILE AROMATIC AND UNSATURATED ORGANIC COMPOUNDS ( I=PA 503, 602 ) RESULTS IN UG /L FOR WATER, UG /KG FOR SOLIDS Results Results 1i c Benzene LT i 0.5 NA Styrene Toluene x N. A 170 Bromobenzene n But,v l benzene NA 1, 2, 3-Tr °s-chl- o= rbbe.nzerie sec`-Bultybenene ;.f NA 1,2,4- Trichlorobenzene .. NA tert -Butyl benzene NA 1,2,4 Trimethylbenzene NA C t� Chlorobenzene x L T 0 5 1,3 ,5 Trimethylbenzene ? 4 f'-2 -Ch l oroto l uene Xy l ne e LT O 5 - t oroto 1 uene °' NA m -Xy 1 erie LT 0.5 1,2- Dichlorobenzene LT 0.5 p-Xylene LT 0 •5 _ ._.. 1; 3'- DichIorobenzene LT- 0.5 - - -- - -, -- - -.__. 1,4- Dichlorobenzene LT 0.5 ;:,.. Ethylbenzene' LT 0.5 Hexachlorobutadiene NA Isopropylbenzene NA 4- Isopropylto.luene NA n- Propylbenzene NA LT = Less Than T = Trace NA = Not Analyzed &/�Reported By: Date Reported Putnam County lk-partment. of V&BIT'h Division of Environmental Sanitati6n 'C OR PORA TE [I �N E R A P M I C A -110 N' ATT] DAYT T r- 01 R - I L ?"0 T -.A P PIL I CA N S%.!!�MYTTED TO '^ F M C O-U N T Y HEALTH -1) U T E PA R. TO: Cr�rwniss-%Onev of. '.-r-a-th 1rj e r,,B +.t e r c) f a p p cation 0 r +� e� Gy (, t�� _G�n Aj _? represent Lha t i an, or em­C. ccr p 0 r E-. --lor and an -a-ut%)orSzed i3 yet 0 0 t 4 n T',g 0 —T I cf?s a + I o :mot i«' rose of ficcrs are rre S E- 7. t Kj i A T /i,/( IdA 4;' r 7-3 6;j.r'C' SE7 -3i'T Rik. 2o e r r ,( "d - * -pLgN -AAA DUNTY -,bF7H1A I � 1. ;'. or all acts d r B -t 075 ft, C; acts a - n to be.fore t"his 16 Z:=y r, f gn e d le LINDA R. BURPEE Notafy Public, State of New York No.4808377 Qualified in Westchester County Commission Expires Ma Corpnrste Sea, PUTNAM -COUNTY ..DEPARTM.ENT . OF HEALTH DIVISION-OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Located at (T). _Sec t ion --.—Block Lot / Subdivision of i6,v Subdv. Lot Filed Map # T-MUCHA EL P Gen t I emer.: '7. n P. 0. BOX 243 This I-etter is to ajjtjjcrize___ HENOR OCK, N. Y. 10587 a duly licensed Professional engineer i/1", or registered. architect (Indicate) .to apply for_a. Construction Permit for. a separate..se,-wage system, to serve the above noted property in accr-rdance &a r d s rules ox..regula t ion s as PrO17-o-11ag,ated by. :the Co_mm4 ssi or re Putnam C Nf -b Department of Health, and to sign all necessaWUTRA N. ORTTY behalf in DER]-. OF HEALTH coxinection -witi-i—ti-.iis-`matter and to supervi.se the construcfion of said System or systems in conformity with the provisions of Article 145 or 147,: Education Law, the Public Health Law, and the Putnam County Sani- tary Code. TI.. MICHAEL M Y, P,E.. -U-INSULTING ENGINEER . Countersigned: P, 0. BOX 243 P.E., R.A.,,.# ROCK, N. X. 10587 Tci7dress Telephone Very truly yours, S i g n e d 64 e, 4 J_4'e -Owner of Pi-operty Address Town Te'l,ephonq DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION,- .CGN- STRNC- T- -- A— WATER - WELL.-- -- _ -. ., .....- -• -. _ ... _,. PCHD PERMIT i WELL LOCATION Street Address Town Village City Tax Grid Number (0 WELL OWNER N e e G . Address p JV?rivate o O Public USE OF WELL 1 - primary 2 - secondary GRESIDENTIAL ® PUBLIC SUPPLY (D AIR /COND /HEAT PUMP Q-ABANDONED ® BUSINESS O FARM O TEST /OBSERVATION ❑ OTHER (specify ❑ INDUSTRIAL - O INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED /EST. OF DAILY USAGE 600 gal REASON FOR DRILLING NEW SUPPLY ❑REPLACE EXISTING- SUPPLY O PROVIDE ADDITIONAL SUPPLY ® TEST OBSERVATION ®DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE mbRILLED DRIVEN ®DUG ® GRAVEL ® OTHER IS WELL SITE SUBJECT TO.FLOODING? YES NO IF WELL IS LOCATED IN .A REALTY SUBDIVISION, NAME OF SUBDIVISION : 140 Lot No. WATER WELL CONTRACTOR: Name T'o �;.'� Address:- IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY_FROM NEAREST WATER.MAIN,.. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED. ON REAR OF THIS APPLICATION E36N 1® Z JOP (date) , -- PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart.5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: e/z;/4_- 9 Date of Expiration � 19 ermit Issuin ff' Permit is Non - Transferrable 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. Located at (Street) 17 4-3 -r � r �6 Block 1 Lot 14 In icate neared cross street ) Municipality �n-�pc> Watershed Crvt_ SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION 'lapse Dth t Water Water Levei No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 O - a0 3 l 3 0 'C7 l a . 4 5 'i 3 V M 5 1 OCT 2 PUTNAM C0Lmy 3 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. App 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. 1 HOLE NO. HOLE NO. G.L. 6" 12" 18" "! 2411 30" 3611 �t 42" 48" 5411 4r 60" 66" 72;' 781, 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ...... 'INDICATE°L'EVEL "_TO` WHICH- WATER LEVEL RISES7- AFTER BEING ENCOUNTERED_. TESTS MADE BY Date DESIGN �- Soil Rate Used 30 Min/l "Drop : S.D. Usable Ar No. of Bedrooms 4- Septic Tank Capacity Absorption Area Provided By ' dth <o + ch. u Address THIS SPACE FOR USE BY . HEALTH DEPARTDMT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date toilTO to 1 l i << ip ag �' �i it. � �I J! (II �� �� 41� QI� � Ei Qi� �-� Q1 Z toilTO to 1 l i << ip ag �' �i it. � �I J! (II �� �� 41� QI� � Ei Qi� �-� FA 4 7Z 7:) Q1 FA 4 7Z 7:)