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Home My WebLink About1596DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -56 BOX 15 . ' ko-v It: 1 •I61 PUTNAM COUNTY,.DEPARTMENT OF HEALTH Division ••of Eniiironmeiital Health Seryices, Carmel, N. Y. - 10512 CERTI;FIGATE OF.'.CONSTRUCTION CeiMPL-IANCE FQR SEWAGE DISPOSAL SYSTEM Patterson T"9wn:,or FU.illage Farm to-Market Road Located at Section Block owner— Francis G. Balmer Lot" Job SO400' Separate Sewerage System built ey John —C Inc Address Oak Brewster, N.Y. 10509 1000 _ 375 36 inch Consisting of Gal., Septic: Tank lineal Feet, X width trench 24 Ft l lr :Over Disposal Area p v ,Other requirements - • - - - -• -• - water supply: V ',:Public. Supply From' Private Supply; Drilled BY P_:. F Beal A. Sons; Inc Address Brewster, New •York 1`0509 ,Frame Three 10/7/70 Building Type - "_ . No of 13adrooms Date hermit Itsued Has Erosion Control Been Completed? I certify that the systems) 'as listed serving the atiove premises were constructed essentially as shown on the plans' of'the completed.. work (copies of which are attached), and in accordance with the - standards; 'rutes and regulations plans filed,.and the permit issued by t nam County Department of Health. Date 5/23/72. Certified b E. X. A.A. Address ' Q:.:6 B 353 ;C el New York '1, 12 No. 29 Any person occupying premises served by the abo9e, ;ysteni(s) shall promptly take such action.as may be necessary, to secure the correctionr of any unsanitary conditions resulting from such usage. Approval .of the .separate. sewerage systain shall become null and void as soon,as a public sanitary sewer becomes available and the approval of the private water supply shall become null',and void when 'a public we y becomes available. Such approvals are subject to ,modification or change' when, in the'Judgmant'of the'Commissio f Health, -such re cation, otlification or change is necessary. Date _ BY 0' . Title i el N BREWSTER LABORATORIES Box 224 BRF-WSTER, N. Y. SAMPLE No. 2657 SOURCE: Palmer — Macomber — Tavino hose Bibb — well supply Farm to'Karket Road" Brewster9 No Yo COLLECTED: May 3 1972 BY: P. F,. Beal & Sons, Inc* BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 nil. This result indicates the source of the tam le was of satisfactory sanitary quality when the ;amplt was collected. dQH—N H. PRENTISS, May 59 1972 C r Roy Bickwit P. E. Director WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK _...T. his: M.....r., T... eport. is.. to.. be .completed,,by.weI -driller.. and. submitted_to;;County.Health Demnt- o --With a „ t r ;aboraiory.:report of _. analysis of water 'sample indicating water is of satisfactory bacterial quality before certificate of construction tornipliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME COMBER-PAUM-TAVINO ADDRESS EAST STRUT BREWSTER, LOCATION OF WELL (No. 8 Street) (Town) (Lot Number) FARM TO MARKET ROAD BREWSTER NEW YORK PROPOSED USE OF WELL BUSINESS ® DOMESTIC FI ESTAB ISHMENT FARM TEST WELL PUBLIC AIR SUPPLY El INDUSTRIAL CONDITIONING O(specify) DRILLING EQUIPMENT COMPRESSED CABLE ❑ OTHER ROTARY AIR PERCUSSION PERCUSSION (Specify) CASING DETAILS LENGTH (feet) 55 DIAMETER (Inches) E 1X WEIGHT PER FOOT 19 lb ® THREADED ❑ WELDED . DRIVE SHOE ❑ YES a NO W CASING X YES NO YIELD TEST HOURS G.P.M. BAILED PUMPED COMPRESSED AIR ten Ve YIELD (G.P.M.) ten WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST (feet) 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 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. FEET to FEET 0 45 Drilling in overburden - c a and boulders - . _. _.: �.. _ .... _. __ ... _ ._. _...... _ _ . _ ...... .. 45 Hit solid rock at 45 ft. .45.. � - - 55.. Drilling in rock - setting'; casing = routed . 55 95 rilling in solid rock - ranite If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 1 28 2 DATE OF REPORT 3/28/72 WELL DRILLER (Signature) P. F. & SONS INC. U Oauner..o -r Ptacha_s,r -.o .. B>>� dg .n_,�..< Buildi g Constructed by Section Location - Street Building Type Block. Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, wor�cnanship, material, construction and drainage of the sewage disposal s "ystem 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 auarar_t- T to the owner, his succes- sors, r.eirs 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 furth -er 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.ap.erate was caused by the willful or negligent -act of the occupant of the 'building utilizing- the - sy;ktervj j Dated this J�; day of 19 Signa T_ "Title THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,,ETION 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 PUTNAM 'COUNTY DEPARTMENT bf ''HEALTH w, Division of En.✓ironmenfa! ' Health S irlifces, f„ armO_ N. Y. 10512- �CQNSTRUCTION PERMIT FOR SEWAGE' DISPOSAL SYSTEM �d a.. r. wn To or illage Located at Section �_ Block' "^ ;tSubdivision `60t. Job 'Owner 05191C; s M� ej Address Building Type Lot Area i ,`Number of Bedrooms'e Total Habitable. Space Square Feet Separate Sewerage System ,to. 'consist of ®a� Gel ;Septic Tank lineal feet X width trench t To be 'constructed by Z Address Water Supply: Public.Supoly From - Private Supply to be :drilled by _ Address Other Requirements ,f r! I represent .that I am .wholly. and Completely responsible for the design and .location -of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment thereao arid;in accordahce with the standards, rules an regu a ions a e u nam County 'Department of , Health, and that on completion thereof a' "Certificate of Construction,Compliance" satisfactory to the Commissioner of Health will be submitted to the - 'Department; and 'a writfen guarantee will'be furnished the'_ he owner, his'successors,. heirs or assigns by the builder, that said builder will place in good, operating condition any part, of'.sa'id sewage disposal-system during the period of two (2).years immediately following the date of the issu- ance of. the approval of the Certificate ,of, Construction. Compliance, -if the original system "'or. any repairs thereto; 2) `that the drilled well described above 'Will be'aocated as shown on the approved plan and that said" will.tie installed 'n accordance with the sta Bards, rules and regula i� ons of the Putnam Courity'Department of'. ealth. Date If P. E. R.A. / 1 ai Address ./Q nucense No, � - APPROVED FOR CONSTRUCTION: This. approval expires one •year he date :issued unless -construction of the building has been undertaken and is revocable f Y.cause or may. be.•amended or modified-when•considered necessary. by the Commissioner -.of Health. Any change or alteration of construction requires a w. p mit. '.Approved for tliDsposaf of- domestic sandary sewage,' andjor •private. water. supply only. Date' 7 BY Title' Notes:' 1) Tests to be repeated at same depth until approximately equal soil rates are ob- tained at each percolation test hole. All data to be submitted for review. 2).Depth measurements to be made from top of hole PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH'SERVICES DESIGN DATA .SHEET - SEPARATE SEWAGE DISPOSAL :SYSTEM FILE NO : Owner. / �tx>ici's: Address _,312...X9 ti k:J "i Located at (Street)%-gr�i, -�a - /LJa��e- `,P> .a s' rh" "Block �--- .. '. Lot. ._ (Indicate. nearest. cross. - .street) Municipality Aq Watershedi�z�ah SOIL'PERCOLATION TEST. DATA'•REQUIRED:TO BE'SUBMITTED'WITH'APPLICATION Hole - Number CLOCK TIME PERCOLATION. ', � PERCOLATION Run Elapse.., Depth to. Water. Water'.Level No., '. Time"- . .. From Ground Surface . in Inches c . Soil Rate Start ...Stop' Min - Start Stop Drdp� in' -. �. Min/in.drop Inches Inches -,.; Inches'.' Of . 2 o 9¢3 /'v y�. Notes:' 1) Tests to be repeated at same depth until approximately equal soil rates are ob- tained at each percolation test hole. All data to be submitted for review. 2).Depth measurements to be made from top of hole 77777 • � � � \x/664. Bl.l•- i Or �AIJIiAV�• p' 5Y5T : r1 j�4u. ?- ��rL.l•. <,E.`foP,'�est'_,.�A.iiiAS]�(-j � •��P•a cc�c.:cr) osac t or t f 145 , 5 17 156- 3' t TO MAR S. E. -T 2- - - - - - - ------------------------- - - --------------