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Home My WebLink About1554DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 34. -4 -53 BOX 14 01554 , ., 1 ` i IL �. T 1 is Emr ', 61 rD ;:, 01554 Mr lirs. Edwrd D. Par di,se wner . o'r' urchaaser ld -ding Owners Building Constructed =.by Tammany Road Location - Street Patterson Municipality Tax , )Jjjp 79 Section 2. Block . 11. 213 Lot st0neh" estates. Subdivision Name Log T 13 Building Type Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 determin- ation of the Director of the Division of Environmental Health Services .of_ the Putnam, C,ounty..; Department of Health.. as., to, whether_ or__not_th.e...fai1.= ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 13th day of Noye6ex 19 84 Signature Title Love Corporation Name if corp. 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 fir. &'Mrs. Edward D. Paradise Tax Map 79 Owner or Purchaser of Build�i:ng''' Section, Owners 2 s.truc,ted_.by:.T�..._, Tammany Road Location - Street Patterson Municipality Log Building Type 11.213 Lot Stonehedge Estates Subdivision Name 13 Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 determin- ation of the Director of the Division of Environmental Health Services •of -the - Putnam. County- •Department- of Health-as-,to whether -or *not the fa.il.- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 13th day of November 19$4 Signature �)l 0.4 Title Instal r Corporation Name if corp. Cage Road, Brewster, NY 10509. 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 WELL COMPLETION REPORT l 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 report of analys"f water safnple'iridicatiRg water -is of satisfactory bacterial quality before certificate of coristrucfiori compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAMES �// A1-A C °lS—L� ADD ESS < �i f f ; .,i✓� c%j° /r LOCATION OF WELL (No. 8 Str leaf) (Town) A� (Lot Number) PROPOSED USE OF WELL BUSINESS ❑ ESTABLISHMENT ❑ FARM ❑ DOMESTIC TEST WELL - SUPPLY ❑ INDUSTRIAL AIR OTHER ❑ ❑ CONDITIONING (Specify) . DRILLING EQUIPMENT ❑ ROTARY AIR PERCUSSION ❑ PERCUSSION ❑ ,�Pe ER CASING DETAILS LENGTH (feet) �Q% DIAMETER (inches) tE> WEIGHT PER FOOT �� THREADED ❑ WELDED E . SHOE YES ,;NO s5.. -` I GAD? YES, °. L_J NO YIELD TEST HOURS GPM ❑ BAILED ❑ PUMPED COMPRESSED AIR YIELD (GPM.) } ^f WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Speci /y feet) �'� DURIN G YIELD TEST �� Depth of Completed Well in fast' below land surface C7 SCREEN MAKE LENOTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inches): GRAVEL 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. u: FEET to FEET w 38' „ill s lqo .b 14-Al odiae If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE /.- DATEYF,LL CO PLET dam' DAT OF IXER V T /j WELL DRILLER (Signature) I YORKTOWN MEDICAL LABORATORY INC. P.O. Box 99 321 Kear Street LOCATIONS: ❑ 321 KEAR ST.. YORKTOWN HEIGHTS, N.Y. 10598 245 -3203 Yorktown Heights, N.Y. 10598 - -- ❑ 201 BUTTONWOOD AVE.. PEEKSKILL. N.Y. 10566 737.8777 245-3203 ,495 MAIN ST.. MT. KISCO. N.Y. 10549 666.3335 ❑ STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278 -9330 LAB ; -- DATE TAKEN: DATE RECEIVED: _ c-, t�M c� \ DATE REPORTED: SAMPLE SOURCE: REFERRED BY: L J COLLECTED BY : I--, LABORATORY REPORT mg /L ❑ ACIDITY .................. ............................... -O ALUMINUM ................................ ............................... ❑ ALKALINITY ....... ......:�...................... ❑ANTIMONY ................................ ............................... BACTERIA, TOTAL /mL ❑ARSENIC ......................... ............................... .. • BOD, 5 DAY ................... ............................... ❑ BARIUM ....................................... ............................... • BROMIDE ................... ............................... O BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE . ❑ BISMUTH .... ............................... ❑ CHLORIDE ................... ............................... ❑ BORON ........................................ ............................... ❑ CHLORINE ................... ............................... ❑ CADMIUM .................................... ............................... ❑ COD ........................... ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ....................... ............................... ❑ CHROMIUM (tot.) ............................ ............................... ❑ CYANIDE ................... ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ... ............................... ❑ COBALT .................................... ............................... • FLUORIDE ................... ............................... O COPPER .................................... ............................... • HARDNESS ................... ............................... O COLD ................................................. :...................... ❑ MPN COLIFORM COUNT/ 100 ml .. • .......... ❑ IRON ........................................ ............................... 'AMFT COLIFORM COUNT/ 100,.I � ............. ❑ LEAD ................................. ............................... ... • CONFIRMATORY TEST ... ............................... ❑ LITHIUM .................................... ............................... • NITROGEN, AMMONIA ... ............................... ❑ MAGNESIUM ................................ ............................... _... -❑ N•ITROGEN;•KJELDAHL ...... ............................... .Q MANGANESE. — ........ ..._........... ... .....,...._,......... ,......... ❑ NITROGEN, NITRATE ... ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ... ...........................:... ❑ NICKEL .....................................:. ............................... ❑ ODOR ....................... ............................... ❑ PALLADIUM ................................ ............................... '❑ OIL & GREASE ............... ............................... ❑ POTASSIUM ................................ ............................... • PH ........................... ............................... ❑ RHODIUM .................................... ............................... • PHENOL ....................... ............................... ❑ SELENIUM .................................... ............................... • PHOSPHATE (ortho) ....... ............................... ❑ SILICON .........:.......................... ............................... • PHOSPHATE (condensed) ... ............................... ❑ SILVER ................................. ....... ............................... • PHOSPHATE (total) ....... ............................... O SODIUM ........................................ ............................... • SOLIDS, SETTLEABLE, ml /L .......................... ❑ TIN .. .......................................................................... • SOLIDS, SUSPENDED . ............................... ❑ ZINC ............................................ ............................... • SOLIDS. DISSOLVED ..... ❑ ......... .......................................................... ................ ❑ SOLIDS. TOTAL ..... . .......................... . ... ❑ .................................................... ............................... ❑ SOLIDS, VOLATILE :...... ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE .............................. ❑ .................................................... ............................... ❑ SULFATE ...... :........................................... ❑ .................................................... ............................... OSULFIDE .................... ............................... O .................................................... ............................... ❑ SULFITE .................... ............................... ❑ .................................................... ............................... OSURFACTANTS ............ ............................... ❑ .................................................... ............................... OTURBIDITY ............................................... ............. ............ ............................... _.. _._ .......... THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DID _ MEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & REGULAT DNS, DRINNKING AT TANDARDS (PART 72) FOR THE PARAMETERS TESTED. ALBERT H. PADOVANI M. T (ASCP) , DIRECTOR: 'VJSt� Title_ f t�M1` Wt I I PUT M COUNTY DEPARTMENT OF HEALTH � DIVISION OF ENVIRONMENTAL HEALTH SERVICES i .—COUNTY. OFFICE-BUILDING.;- ,CARMEL, -< _N ,:y,_..:..1051.2...__ ........ _... _ ........ - { DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE VO. Owner � S e Address jj4gXa j ct Located at (Street Ondicategu�(e -� 14a (e Qa , M'p Block Lot ` nearer cross s ree Municipality — P '�E�rs o .� Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water Water EFv31 No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches N 2 3 4 5 1 2 3 4 3 1 Flto (tiJ �/ Z7 3 2'1131 [ 33 4 y4 i' 3 Notes: 1) Tests 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 ENCOTJ I'ERED IN TEST HOLES -,b2PT1r 14018 .L. G 611 1211 18" 2411 30" 36„ V 42" 48 fl 0 5411 6011 6611 7211 7811 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED /* INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING'ENCOUNTERED* DESIGN Soil Rate Used A:k—Mdn/l'f Drop: S.D. Usable Area Provided No. of Bedrooms e-ee Septic Tank Capacity 000 Gals. Type M*SeKry Absorption Area Provided By _L.F.x2411. ✓ 56-- width trench. -' Other Name Signature J OHN Address -ST THIS SPACE FOR USE B9144'MZ&j"?4E-NT ONLY: 40 -1' Soil Rate Approved Sq. Ft/Gal. Checked 29, Date APR 1. " 19Q4 F I , .1 UI NA!l 1-Y 'A EM %DES w L L c AT X, OCATION t t 49 -T'own*.,*:�,�-rfc��F �r ounty— ., T AT, SUBDiVISI.QN*w, M a p L i4 Builder; Surveyor: LK;- 41 a. ob J O�H N H, P R E N't i.S s :Et AR CONSULTING ENGINEER RD,,9, Ptta, Siva tA'AMEL MY 10 512 —(914