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HomeMy WebLinkAbout1425DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -2 -11 BOX 13 01425 L 91 `1., I'{ T * 1 k04 . % r'- , ' . �. ra re -� 01425 ' DF Loc qubd Lot -Separate. -Sei�reri. age:Systerh built by - an c hoisting, of Gal.',�Septl dress it I-AS No Liam subject "to ti 4rnehi-�vf the -C. 1111. WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 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 reonrt 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 Tavino Builders,Inc. Deans Corners, Brewster, NY LOCATION (No. & Street) (Town) (Lot Number) OF WELL Fair St. Carmel, NY NESS Z ❑ ❑ ❑ PROPOSED DOMESTIC E TABLISHMENT FARM TEST WELL USE OF WELL ❑ SUPPLY El INDUSTRIAL ❑AIR ❑ OTHER CONDITIONING (Specify) DRILLING ® ROTARY ❑ El El (Spe IPLMENT EQUIPMENT AIR PERCUSSION PERBCUSSION ify ) CASING LENGTH (feet) DIAMETER (Inches) WEIGHT PER FOOT 119 � ❑ D VE 5 O � (' NGj T DETAILS 201 6 t► lb s THREADED WELDED YES NO LXI YES LJ NO YIELD HOURS G.P.M. BAILED ❑ ® ❑ YIELD (O.P.M.) TEST PUMPED COMPRESSED AIR WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL 301 in feet below Land surface: 155' MAKE LENGTH OPEN TO AQUIFER (feet)' SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (Inches) FROM (feet) TO (feet) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET Drilling in overburden 5 cla and boulders Hit rock at feet Drilling in rock,set ri 20 casing-, R E��I �E JUL 2 7 1988 c pDrNA 2 Lilling a If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DEPT HEALTH OF M, DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) / l �- 4/29/83 7/15/83 , BREWSTER LABORATORIES Box 214 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 5147 SOURCE: Tavino Builders, Inc. Deans Corners Brewster, NY COLLECTED: July 15, 1983 BY: P. F. Beal & Sons, Inc. BACTE_RIoLoGICAL EXAMINATION Coliform Count, MF Method Hose Bibb Thir result ixdicatts tht source of the sample was of satisjactery saxitary quality whex the sample was collected. 2 per 100 ml. CEO �E� JUL 2 7 1983 ,DEPT OF r �, �%�Y fi&kT14 July 20, 1983 C Bickwit P. E. Director t�..., " -.:- - _. � -. ... _.- .,.. -� -. - ... _, �y.,.- a`^. _ a,. - rn. ; =� _.:,. ..t .. �•_ ,.. ;'e,x _z e t c� lF '.r. ti is _� -�i UiIJ IHrvi...cv A - C -: 39.3' B -c 27.5' A - D '• SG. 3' B - D 39.5' A- E: (.2.2' a A` F: 4- 8.2' B- F: :'6o.4' A - G 73.g' f? -G 65.4' A - H: ,0.0' B -H: 71.0' ft - 1 58.0' B -N): S3.0 A-T 93.0' B -O: GO.o' A -K : 68.0` ,A -L 72.6` A-M: 79.0 '1 j�5-R: 83.0' aPPlicabls3 t9 - Y„tnam coon - D VIN ;Q B U 1 LL D E R S L O'T- ' 9 -T %,s sewage o5 osa/ Ssfern aS' Si t e TS AS (3uI..1._.T PLAN P y cons tru c fed z 5 Shown on fh %S plan • ?O`r SEWAGE li conforms fo all Ffitnam County O�SPOSAL SY" s M p�Pa, to,enf o{ Health cr%ter%a. TULY 14,,1%983 I I =50' I PETER J.' TAV; NO JR P. E. PUTNAM COUNTY: DEPARTMENT OF HE -� Division of :Environmental Health Services Carmel rN _NY :10512 Q CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Town ttersori f n or Vstla of Pa Westgate Terrace ,. Tow sage 145. Located at_ - Tax _Map Block Clara A.; Pfeiffer ` g Subdivision „- Lot - Job ' j s. Deans Corneas Brewster NY 1050,9 wner T:avin© •Builders, Inc« -; Colonial 101 „571 sf. T � Building Type Lot Area re s i5 r 4 800 : GPD 4 Number of Bedrooms Deslgn Flow Total 'Habitable Spice. '6 square Feet 3 ^0 sf- Separate 'Sewerage system to consist of `^ 1�,0 -QO Gal septic Tank and _X44 .LF Of 2'A W1d2 fkeldS <_ r�:A. Burdick -TO be constructed by = ” Address �. , NY Brewster .10509: Water, supply Public Supply From Mr. Bea X Pnvate Supply to, be dulled by `^ •� Address'. Brewster .Carmel:ve..:''Brewster NY', 10509 Qther Regwrements NOl'1B ,-'' -• .,� - ` 1 °represent that '1 am whollyand eom le'tel : ,res onsible for'the design and location-:6 f the ;proposed systems) 1) that the separate •sewage disposal; system'. above'desc.ibed will be to as shown';on the',approved, amendment there to and in accordance with the standards ;rules an r_egula ions o e u_nam County Department of Health, ,end that on completion thereof a CerUficate`: of Construction`Compi4`nce satisfactory to the`Commisiioner of) lealthwill tie' submitted to .the Department _ .and a ,written guarantee wilt be furnished `the owner his successors; heirs or <ass�gns by the builder tti'at said tiuilder, will place m .good operating cond.tion' any part of said sewage disposal' system- tlurmg:,the perad of two (2) years immediately folaowing 4hedate of the is;u, u, ance of,.the approval of „the Certificate of ;:Construction Compliance of, the original• system "or any repa�rs;thereto 2)''that the`drilled well desc'fi ,a ?Ve fi a . will be located as'snoyvn on`.the approved plan:antl$ that saotl well w�IGtie installed • m accordance w_ dh the; standards rules -•ands regula ions of the: P,.utriam -. e County Department of Health " January 31; 1983 /J �f // /► Date signed !! : �c -h -(G� x PEI R A Address 117 West 58th Street NY, NY 10019 56782 Lic en se No APPROVED FOR "CONSTR'UCTION' This approval expires o_ne year from the date issued unless construction of the building; has. - been'` undertaken and, is revocabte`for'caUse or maytbe' amended ormodif�edLLwhen'con_sitleretl necessary -by the „COm onerof Nealth,:-Any- change -,or alteration of construction requires a new permit Approved for disposal of., omest ar� avr�@�g7e�-;, ar /or pr v e” ater sup 'I of rily BY E Title m PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONML'NTAL- HEALTH SERVICES _ -- COUNTY rT r Oi VICE - -BU=1 a:_rN�:, CARMELj— N •-Y. - 10512 __._..- DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM Owner Tav na, Builders Address Deans' Corners FILE NO. Brewster NY 1fl509, Located at (Street �Indicate Westgate! Terrace Sec. 1.456 Block 4.8C ' Lot 9 neares cross street) Municipality Town-of Patterson Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION' Elapse Depth o a er Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 5 l 10`05 - 10r: :40 5 13.- 188; 1�1_ 4 2 10':40 =10 x43 S 183. 19h li: 4:4 3 10:45=- IU :50` 5 193 2'03 -; 7- 5.7 4 10:57011.0:55- 5 2 8:. 21. 8 FF9 s 4 8. 1a:55-11:0& 5 21 21h 10 6 R 11 :00- 11:05- 5 21h. 2234 6.7 7'N 11 :05- 11 :10'• 5 22y 2`3v. 5, 7 8 1.1 :10- 11.:15 5 23j, 24h 3 13.3 g - 11115 - 11:20 5 2 33E 24 'h 10 Notes: 1) Te',�ts to be repeated at same depth until aroximately equal soil rates are obtained at each percolation test hole. A11 pp data to be submitted for review. 2) Depth measurements to be made from top of hole. 3 a ,; FF9 s 4 Notes: 1) Te',�ts to be repeated at same depth until aroximately equal soil rates are obtained at each percolation test hole. A11 pp 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 _ Subc vi�ion F ales. ., ROLE - - . DEPTH HOLE _._ N 0 .:.: _ - HOLE' . yP HOLD" NO.', G. L. 611 Top- Soil 1211 18" Sandy Loam W/ Clay 2411 301 3611 Gravelly.Yoam 42" _ small:. stones: 48" some clay 54" 60" 66" 7211 7811 84" Not encountered` in - subdivision INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED hole: or pPerc test hole INDICATE LEVEL TO WHICH WATER LEVEL.RISES AFTER BEING ENCOUNTERED TESTS -MADE BY- ret:r -- Agviro - -ro Date January 27s_I981 - „ Soil Rate. Used 1 Min/1 Drop: DESIGN .: 2.500 s-f S.D. Usable Area Provided. 18000. ...:.; a Concrete No. of Bedrooms 4'. Septic"Tank Capacity Gals. M Absorption Area Pro ded By_'44. L. F. x24" x jb width trench. Other .: Name Tavino Jr. , P'_F:_ Peter J. ure Signature g Address 1:17 west' 58th Street SEAL New° York 9 NY 10 THIS SPACE FOR USE BY HEALTH DEPARTMNT ONLY: Soil Rate' Approved Sq. Ft /Gal. Checked by Ibte