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Home My WebLink About1603DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -73 BOX 15 ., . , rr. �,, - 01603 is PUTNAM, COUNTY DEPARTMENT. OF HEALTH: > r v w '• Division. of Environmenra/ Hea %ih Services tarme%- N Y 10512 CONSTRUCTION. PERMIT'-FOR SEWAGE, DISPOSAL SYSTEM - Patterson Town or Village - _ ,Farm- to.Market -Road _ ,.. __ .. - -- - -; ......... ,.,....... Melville & Coll.ette'.-Hall t_ DD { Subdivision Lot -4 Job SO1168 � Re'V . C ) Owner` HowaH & Alice Mi han - Hall Seven Corp Agent' .. rAddress %- Hall Seven Cora s .Building Type _Frame- Lot Area: 1 Qc're '�' fanm_A6- Market " Rd. ., Brewster. NY 1QSQ9 r Three l,l . l r Numberr.of Bedrooms Total Flabitable,5pace992 on 1 Square 'Feet Separate ;Sewerage System to consist of 1 OOO `.-Gal: ,Septic Tank. 2 30 •lineal feet X 36- inch width trench 6 i To be constructed. by ss 1 Addre 6 1Nater •Supply -Public Supply -From a Q X ` -Private Supply to'' be drilled b Y i. Atldress' Other Repuirement's l I represent that ( 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 there to and' in acco'rdancii with the`standards, rules:,and regulations of e Putnam nam r Count .De artment: of. Heat and that n "o" f Y P ,. I h, o c mpletion thereo a :'Certificate 'of Construction Compliance "ysafisfactory to the. Commissioner of Health will G tie sub 'mitted' to` the' Department, and a -written, guarantee will.be'furnis-66d the owner, his .successors,'heirs'orassigns by the uilder, that Said builder will place in -good 'operating ,condition any part of rsaid 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 ,'of' the original system,or any repairs.thereto; 2)' that the drilled well described above ! will be located as shown on the approved plan'and that said well'will be,ins led in accordance with the' aids, :rules and regu a cons .of the Putnam i County Department of Health s'Date ` 1 �30�74 Sig s P.E. X R.A. _. Address R: D:. 6, Box ,.. 3.51 tarmdl , .NY 105.12 29206 License No, APPROVED FOR CONSTRUCTION: This approval expires "one. year fromthe date issued. unless`construction of'the building has been undertaken and is y :.revocable;fo�,cause or maybe amend ed:or•inodified when considered necessary by the Commissioner of Health. Any change or alteration of construction. r'egwres ,a new `, � l _- permit: Approved for disposal of domestic sanitary sewage a private wat r•s pIy'only w7 r Date'G��77� =j gy �6'' e'`�'�.-- ►•— �f!�peI� �+ _ ... PUTNAMS-- C,OJUTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH- SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner_ 0 f 7 Co 0- in Address RvIrC44 e76 _ Hdr o Located at (Street Sec. S .46 Block Lot.' 4Ucate nea es cross street) Municipality Watershed�,�, ^ SOIL PERCOLATION 'TEST DATA.REQUIRED TO BE SUBMITTED WITH APPLICATIONS 4 5 5 s.: Notes, 1) T6#6-t6 be repeated at same depth until apppproximatelyy equal $oil rates are obtained a;t_each percolation test hole. All data to be submitted for review'° :..:..: : ...... 2) `Depth "measurements to be made from top of hole. Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water Levei No. Time From Ground Surface in Inches 'Soil Rate Start -Stop Min. Start Stop Drop in PUn. /in drop Inches Inches Inches 1 d9 do 2 0 f o0 0?/j: 3 0 &IL d W 4 5 5 s.: Notes, 1) T6#6-t6 be repeated at same depth until apppproximatelyy equal $oil rates are obtained a;t_each percolation test hole. All data to be submitted for review'° :..:..: : ...... 2) `Depth "measurements to be made from top of hole. DEPTH G:L. 6" 12" 1,8" 241 " 301 36'► 42" 4811 r' 54" .60" 66" _ 1 I TEST PIT DATA REQUIRED TO BE SUBMITTED W DESCRIPTION OF SOILS ENCOUNTERED IN HOLE N0. 7211 7811 84" INDICATE LEVEL AT WHICH GROUND ti INDICATE LEVEL TO WHIJOH WATER LEVEL RISES AFTER TESTS MADE BY /4� h� i2. C . A. T.3 /fie /i� APPLICATION ,T HOLE Alvin e 3 ENCOUNTERED lib -se W.Pa Soil Rate UsedjZ:j/fMin/l "Drop: S. D. Usable Area Provided <7V No. of Bedrooms Septic Tank Capacity /Oa0 Cats Type ✓spa _ Absorption Area Provided By_ F.x24 � width trench. Other 61-11 reg!60" 00 Name John H_ Prentice_ P_F_ igna u y�� , Address R.D. 6, Box 353 Carmel, Net.► York 1053 THIS SPACE FOR USE BY:HEALTH DEPARTMENT ONLY: Soil Rate Approved:::: Sq. Ft /Cal. Checked b e� : �� tME S�►tE� I t PYJTI IAP� ;C ®�JNTY ®E1PA I1�1EN T Of ` IEAI,'TiI ~: Division 'of Envi[onm "ental Heahh� Services, Camel; N. Y. 10512 ' _Pt RS'I;RIeAlE;:OF ,CONSTRUCTION COPAPLM -NtE P.OR SEWAGE..DISPOSiAL SYSTEM . . .,Paterson-. z. Town or Village Located 'at Farm -to— arket',ROaCI Section Block owner: Howard & -Alice �+f han Lot 4 Joti S01168 ` Separate Sewerage System bu�lt!.by, S 'ft F S,eptic S�/$'tem$ - Address New Rochelle NY consisting: of 1250 Gal. Septic; Tank 300 lineal Feet X 36 :1 nCh ' - Width "trench Other requirements None Water Supply:, Public Supply From X, Private Supply.. Drilled ey Rohe�^t `Tucclo I3E3$1g13S Uta111riited Address n / /l Building Type Frame Three Date Permit Issued ' 1 �3� 7`I No: of Bedrooms Has Erosion Control Been CompletedfE -NOne Re� d . , hat,the's stern s ',as listed serving *the above premises were constructed essentially as-shown on the' plans, of -the completed work (copies of which are certify t Y (_ ). _ attached), and in. ;accordance with the .standards, 'rules and regulat;ions,- plans fil ,and ;the permit issued ~ by the;;Putnarii. County Department of Health. f Date 2't - September, x.974 if b `F e 'PE n. R.A. _> 29206 Address `1] 6 License No AO, Verson occupying premises served by -the above systems) shal - °promptly take.such action as "may,be _necessary to secure the correction of any unsanitary ,. I � conditions resulting fro_m.:such.,usage ;Approvalr'of the •separate sewerage`system;shall become null :<and void as 'soon as a public Sanitary sewer becomes r .available` and th'e?appro4al of: the` prrvate!water`supply. shall become nuII,and yoiC when "a publ�r water aupply becomes available..' Such approvals are { subject :to modification_ or change wh in jn the:)udgment of the - Commissioner ,of Health; such revocation;, modification or- change �s` necessary Date BY . . in o' `�r.9 . e� lv �?... ? . �r'a .. WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 f Division of Environmental Health Services 0 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 analysis of water sample indicating watirli oflatisfac#ory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION NAME 6'� h ADDRESS OWNER TTowarO �: 1 t ' 1 A.,. '.cam P-atte.rson LOCATION (No. 6 Street) (Town) (Lot Number) OF WELL 'Fclrm t0 T'Cla.r' TP?ti'nrrC?11r TT�Y� 4A ., . c N Hone S REE DETAILS SLOT S DEPTH FROM LAND SURFACE FEET to FEET 0 4 4 225 . - - .._._......_..__, :.., ,.o�i . ..... �.00., ... IF GRAVEL Diameter of well includin g PACKED: gravel pack (Inches): I I L FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. Crave). 2 O- �C Crav Cra.r.,i tl If yield was tested at different depths during drilling, list below FEET I GALLONS PER MINUTE 5 Fcr m k o vnI& �� I DAT /7 E OF REPORT I WELL GRILLER (Signat� t�" `►'\ \i /74 /74 Tzol,ert ne --i_cros TTn3 in tf- ra ❑ E BUSINESS ❑ F PROPOSED D DOMESTIC ❑ ESTABLISHMENT ❑ FARM T TEST WELL USE OF WELL ❑ ❑ SUPPLY E El I INDUSTRIAL ❑ ❑ C ❑ O OTHER) C CONDITIONING ❑ DRILLING E ❑ ROTARY ® ®A R COMPRESSED C CABLE ❑ ( OTHER EQUIPMENT ❑ R P PERCUSSION O (Specify): CASING L LENGTH (feet) D DIAMETER (inches) W WEIGHT PER FOOT j j� O O C CASING D? DETAILS � �' L t F n 1•'7 T THREADED [ YES NO Y YES YNO YIELD H ❑ BAILED ❑ ❑ P HOURS G G.P.M. Y YIELD (G.P.M.) PUMPED COMPRESSED A AIR ' G 1.1/2 ( (; 1,/? WATER M MEASURE FROM LAND SURFACE —STATIC (Speclry feet) D DURING YIELD TEST (feet) D Depth of Completed Well LEVEL ' 'S t ! ! > !T t i in feet below Land surface: 22 r t MAKE L LENGTH OPEN TO AQUIFER (feet)' S REE DETAILS SLOT S DEPTH FROM LAND SURFACE FEET to FEET 0 4 4 225 . - - .._._......_..__, :.., ,.o�i . ..... �.00., ... IF GRAVEL Diameter of well includin g PACKED: gravel pack (Inches): I I L FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. Crave). 2 O- �C Crav Cra.r.,i tl If yield was tested at different depths during drilling, list below FEET I GALLONS PER MINUTE 5 Fcr m k o vnI& �� I DAT /7 E OF REPORT I WELL GRILLER (Signat� t�" `►'\ \i /74 /74 Tzol,ert ne --i_cros TTn3 in tf- ra - - .._._......_..__, :.., ,.o�i . ..... �.00., ... IF GRAVEL Diameter of well includin g PACKED: gravel pack (Inches): I I L FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. Crave). 2 O- �C Crav Cra.r.,i tl If yield was tested at different depths during drilling, list below FEET I GALLONS PER MINUTE 5 Fcr m k o vnI& �� I DAT /7 E OF REPORT I WELL GRILLER (Signat� t�" `►'\ \i /74 /74 Tzol,ert ne --i_cros TTn3 in tf- ra t•� Howard & Alice Mihan Owner or Purchaser of.Building Hall Seven Construction Co., Inc. Building ConstructE by -Farm -to- Market Road Location - Street Frame Building Type Patterson Muni cip ality Section Block 4 (Map #1217) Lot GUARANTY OF SEPARATE SEZ-.IAGE SYSTEM I represent that I am wholly and.completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system servir_g.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 nogligent act of the occupant of t P building utilizing the tem. Dated this 1S..jday o 19 Signa ure Titl — If cor rat�.on, give ame an addres �C - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -� 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 BREWSTER LABORATORIES Boiz 224 - BREWSUA, N. Y. WATER -ANALYSIS REPORT SAMPLE NO. 32 78 SOURCE: Howard & Alice Mihan - well supply Farm to Market Road Map 1217 Brewster, N.Y. Lot 4 COLLECTED: Sept, 6, 1974 BY: Melville Hall BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. Sept, 11, 1974 0 per 100 ml. 1l \ A Roy Bickwit P. E. Director v caner or Purchaser of Building Building Cdn�structed by TV �v 40z) Location - Street Building Type r7lE 456 Al Municipality Section Block / 4.1 -7 of 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 ne ligent act of the occupant of the building utilizing the system. Dated this day of Ll QAT 191 Signature Title iA A 1 �NA'Z' con oratio gi e a (!rdress) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP-TiETION 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 tructure - located I surve.y:; by surveyor noted •4'61ot b e.li loc<ftod D'Y. SurvaywrS surda'y Wall drillers. re0a fnb,nee:rh,mesuremebta,0 _! a Tank, p.oxae, p0s, galiories,a?I taterats Io :cot _eD by Cain 6 . H�aftti"' a r . Piel4 inspe;tion by HaclRh Dept Batas rr i Ertganoer Da4�', W t �t MENSION 5 Yt 11j In o n A - 9 ._ —L C 66 -,^-B 7 Ar - D a t337U� _9: - D a_ 94 ` O' „A A H o�� 0` _ 8 H �l:c�y' O`_ t APPROVEQ ! SAN TARY S. EM E- lGN "A SEP25.1974 i lL! outs, I� l: ,5 ' LOGAY65; srreer - a v n.« cu _ t j 4 t xsY �� sue. r �* mt _zsnc_ ,County �yr�v S4ata ..pt R`DIVISION-OF." '.[.J�; •. Wsirj,RMNre NEAM 91MICO' ' R H j • "G A00oG :�: Sir r. _ SU8Di.YiS1O[d; �.]G 1=11-.m Crime Eck• ..: G U ✓� i✓Y o /J J G r I 1 l .5 ° O .� � N e 91 oGk {' I OT � D "¢ - - - y -- •` -R6 � 6UIIde•r � ra `� Se- �+�= �t -+z�r� l't2.� � i—�� y y-a - '$UfY &y Of �._O• Rl..L Z1: i s�'i" sZ1 tI,l nt fi 1' t Draw:ri Orate / i+. Suslo2= 30' '� r qY - � \�3' 'Ssr{.�L.�� p, 1 •C v T r y JOH'N;, H P::R ENT1S8. Ed' rp GONStIt;TiRf:6 :EPIGItdEER o.,,aaa r•eauvi uv inctt� —taw i.nva mm,,