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HomeMy WebLinkAbout1617DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.13 -1 -6 BOX 15 01617 11 rrm „ Il 16' -� ,I . AIL 1 01617 ¢ ; rj } 1 VtS ;T, { r .n £ & ✓,'S. }b ",;_`` ,-* '4- T = n t r, tNVlNttR:,ua)� T""" kl* `w� `; r PUTNAM,�COUNTY �DEPAR ®T14IENT��OF HEA L"TH ID PROVE` 1 7 Division of -.Environmentsl�� H�loh; Serwoes,'�Cerm% N • : Y 4 fOb12 �.. , : ''R -MIT #'P Z9`85 PE CERTIF,ICATErrO,F, CONSTR.UCT_ION COMPLIANCEFO.RSEWAQE SDI$POSAI''SYSTEM Paayr.T= eSorh. AV d �... Owner A.IJbitCl�l �-OP�P / eormaziy ,s a Tax Map Lot Y- P�. .IB aubd dot Y Z w f �.,• Separate 5eweroge System built bjr Mo•�Hi, Q6At =Ty �bRP �� - �Atldress 'eT 29Z = �Ot_N1t?J� s�J11� IMtss'I r Conilsting�of. iOOC Gal. Septic Tank and ` 375 �- ABsotiPTlowJ �RswLGa1 {- r rW. •" f +i n.�Er.." at4 a t� etn r..r.� +. Other requirements .0 a ub ter Supply Plic Supply From W ax Private Supply grllletl BY \� RArsiisCa B2oS w P. w 'Atldreds + Y G $o1c 5'!$1i -TOIJ Cv.� .o6t341 Building ..Type Q t3S i D G hIGE No `;of Bedrooms 3 to per issues;''? Z'6 0 85' . Has Erosion Control Been Completed? YES Has garbage grinder.been'inatalled? t�D. , a , I certify that the syetem(s) as 3lsted serving the aboveypzesdsae: were cotiatructed essentially as shown on the• plane of the completedWwork• (copies of which are attached) and int`accordance with the standards `rul'ea and equlatone in accordance with the filed `plan, an8 the ,permit.i'ssued by the e Putnam County Department'•Of•'Health. 1 Date. ; Ceitified Dry P E.1 R.A. Z Adeleess i�T FS ^ .r ;IiZ. t y l_(cenN No '?loCp$ Any person bccupyfng premises served by the above'system(s) ishall - promptly, take such action as may W neee�sary to aeun th�,eo ►redion, :of any u gnitary congitions resulting from;sueli ,usage Approval. °of the separate sew`erape system shall become null and vdld:as soon.0 a; pub'Iie Nnitaiytsivwr becomes available, and the::approval of the ,prfvste water supply stiall5becomenull and avoid whey +a �putilie wafer supply: becomes ava)litila, Such ipprovab are subject- to modtf,ication,:or,change when,'•in th`e'?judgment §Cth6tommIssibnsr of;Hsalth '' such reVOcation !r 'or change is n ecessary. Date . Title ,Rev. 6/85.- DIVISION OF;ENVIRQI�NI'AL HEALTH SERVICES Owner or Purchaser•�of ildin' Section Block Lot Building.Construct y C.._ Location - Street Subd vision Name Municipality Subdivision Lot # GUARANTEE OF SUBSURFAC8'.SEWAGE' DISPOSAL SYSTFyI :. . 1 represent that I am wholly, arid completely responsible ,fo•r 'the location; workmanship,.. material, construction and.drainage'of the sew.age.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'Depaitment ,of •Health, and hereby guarantee to the.owner, his successors, 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 approval of 'the _ "Certificate of. Construction Compliance" for 'the sewage.•ditposal: 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. occupant of the building.utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director ,of the Division of Environin?ntal Health Services of the . Putnam County Department of Health as to whether or not the failure of the system to operate was caused by,the wi4ful or negligent act of the occupant of the- building utilizing the 'stew. Dated,. this - i day of 19 Fr7 �3�_-&ral Contractor (Owner) - Signature Corporation Name (• Corp.) Abdress ' rev. 9/85 mk Signature ,Title ���a ✓i` � �A26� Corporation Name •(j.f Corp.) .� r3 Address ELLIS A. TARLTON,LABORATORY DIVISION OF ELLIS A. TARLTON, 'ENGINEERS, :INC. . CHEMICAL 34 PLEASANT STREET DANBURY,, CONN. 06813 -2328 MATER' - WASTEWATER PHYSICAL METHODOLOGY • • BIOLOGICAL P.O, BOX 2328. 203448 -7903 APHA -,EPA -.ASTM LAME AND SOURCE Of SAMPLE Water Supply ,DDRESS of Wragg Brothers Healy -,Model Realty ,ERSON TO i, ' Lot #? Fair .St.. tECEIVE P.O. Box 5 -18 Patterson] N.Y. tEPORT Wilton, Ct. 06897 I DATE OF COLLECTION 8/.6/87 , DATA COLLECTED BY Wragg Bros.. ydrogen ion COLOR TURBIDITY ODOR CORROSION INDEX DISSOLVED SOLIDS oncentration LANGELIER RY2N AR- . , NTLI Mp /L Alkalinity as CeC0.3 Fluoride (F) 'Bicarbonate Nitrite Mg/L, Mg /L Mg /L NITROGEN Alkalinity as CaCO3 Chlorine Residual Carbonate . ONSTITUENTS Nitrate Mg /L Mg /L Mg /L AS 41TROGEN (N) Total Hardness., as CaCO3 Conductivity Ammonia Mg /L Mp /L' Micromohos/cm Mg /L' Iron as Fe Mg/.L Mg /L - Chlorides - as CL- _ Mg /L .Manganese as Mn.... _ .. _ ._ _ _MeiS. _ ' Mg /L Detergent as MBAS Mg /L Sulfate as SO4 Mg /L. Mg /L 'he arithmetic mean of all standard samples examined per month using the membrane filter Iechnfque'shall not exceed MEMBRANE FILTER TEST ins colony per 1flpml. Col)lorm colonies per standard sample shall not exceed 3 /5dmi, 4/100m1, ' 7/200m1, 'or 13 /500MI Collform Colonies /t00ML Two 'consecutive, samples :'. (b) More .theq.oge ptangerd eamDle, when less, than 20 are examined per'month: or (c) More than live per cent of the samples when 20 or more are examined per month. i THE TIME THE SAMPLE WAS SUBMITTED: 1. The results of the analysis of this sample were satisfactory and met requirements for a potable water. 2.. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high..These are As-follows: ] 3. This sample was not satisfactory since it did not meet the bacterial requirements for potable water. The presence of organisms of the coliform group Ina sample of potable water is, undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does indlcete that such contsmingtion might survive to the same extent. The presence of organisms of the coliform group may also Indicate that the treatment was not adequate at the time the sample was collected. 4. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above acceptable limits. These are as follows: COMMENTS The bacterial analysis showed no organisms of the'.coliform'ejroup ' at the time the sample was collected'Oh.ich indicates the'water•pptable. Certified .. .. ., .:lrL:.�'�.%.......a........ a EL.LIS A. TARITON LABORATORY' r DIVISION OF-ELLIS A. TARLTON, ENGINEERS, INC. CHEMICAL 34 PLEASANT STREET DAN BURY, CONN. 08813-2328. WATER = WASTEWATER PHYSICAL ' ' METHODOLOGY BIOL061CAL P.O. BOX 2328 .203- 748 -7903 APHA ; EPA - ASTM ``:�° ; =82 P ®RT- �F �A gEtt10L0� ➢CAL AND..CWE- MIC-AO - •EXAAMNA lO - -0F JAME AND SOURCE OF SAMPLE Water ,Supply . ADDRESS of Wragg Brothers ' .. Healy Model Realty 'ERSON TO Lot. #2 Fair, St. tECEIVE P.O. Box 518 Patterson., N: Y. . ydrogen Ion COLOR. TURBIDITY ODOR CORROSION INDEX DISSOLVED SOLIDS oncentration LANOELIER .If) RYZNAR NTU Mg /L Alkalinity as CaCO3 Fluoride (F) . Bicarbonate Nitrite Mg /L Mg /L Mg/l. NITROGEN Alkalinity, as CaCO3 Chlorine Residual ONSTITUENTS Nitrate Mg /L Carbonate Mg /L Mg /L AS 41TROGEN (N) Total Hardness as CaCO3 Conductivity Ammonia Mg/ L Mg/ L M icromohos /cm Mg /L Iron as Fe Mg /L, Mg /L, Chlorides -os CL- -.... _ . _ . _ _. _. Mg /L.. .Manganese.as.Un. _.. _ _... _. _... _ . Mg /L_ .... .- - -'- _ -- - - ---,. _ Mg/L, Detergent as MBAS Mg /L Sulfate as SO4 Mg /L Mg /L the arithmetic mean of all standard samples .examined per month using' the 'membrane riltir Technique shall pot exceed )no colony per 100ml. Coliform colonies per standard. sample shall not exceed 3150m1, 4/1100m1, 7 /200m1. ,or 13 /SWMI '- —rif fa) Two �conseeutive samples; (b) More than one standard sample when less than 20, are..:examinad. per.,month; or. (c) More than five per. cent of the 'samples when 20 or more are examined per month. MEMBRANE FILTER TEST ' Collform Col6nies /10OML ' 0 T THE TIME THE SAMPLE WAS SUBMITTED: 1. The results'of the analysis of this sample were satisfactory and met requirements for a potable water. 2. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high. These are as follows'.. 3. This sample was not satisfactory since it did not meet the bacterial requirements for potable water. The presence of organisms of the colllorm group in a sample of potable water is undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does indicate that such contamination might Survive to the same extent. The presence of organisms of the coliform group may also indicate that the treatment was not adequate at the time the sample was collected. 4. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above acceptable limits. These are as follows: COMMENTS The bacterial analysis showed no organisms of 'fhe coliform-group. at the time the sample was collected which' indicates, the water potable. Candied .......��- C.:.....a ... ... ...:.. , ... � x•17',' %� II ' V. SITE INSPECTION' Date Insoect .��TION OMERAICl L /Ip TH # OR SUBDIVISION IM # w. 10 7SEWAGE-DISP69AE 'AM' a. SDS area located as per appro plans b. Fill section - Date of placemnt c. Natural soil not stripped d. Stone, brush, etc., greater than 151 fran SDS area. . e. 100 ft. fran water course/wetlands. SEXAM DISPOSAL SYSTEM b. Septic tank inst26Ued 10el d. No 90' bends, cleanout within 10 ft. of 45b bend e.' DISTRIBUTION BOX 1. All outlets at same elevation water tested 2. Protected below frost .3. Minimum 2 ft. original soil between box.and trenches f. JUNCTION BOX —properly set ry TRENCHES 1. Length required - 3 2 * Distance to watercou-r�e measured-- ft. 3. Installed according to plan re-, -To O-CJ cc 'A 4. Distance center to center �Jtll > 106' 5. Slope of trench acceptable 1/16 - 1/32 "/foot. 6. 10 feet fran property line - 20 feet - foundations- 7. Depth of trench < 30 inches,,frcm surface- .8. Roan allowed for expansion, 50% 10. R�p� of gravel in trench 121, minimum h. PUMP OR DOSE SYSTEMS 1. Size of pump chamber 0verflcw tank 3. Alarm, visual/audio 4. Pump easily accessible manhole to grade 5. First box baffled 6. �ycle witnessed Health Department estimated flow per cycle HOUSE a. House located per approved plans. b. Wmter of bedrocms a. Well located as per a22roved plans b. Distance fran SDS area measured /G,�S ft.* C. (!gs�inglV above grade. d. Surface drainage around well acceptable. I OVERALL WORJOWHIP a. Boxes properly grouted b. All pipes partially backfilled c. All pipes flush with inside of box d. Backfill material contains stones < 4" in diameter_______,;_ e. Curtain drain installed according to plan h. Surface water protection adequate i. Errosion controi provided on slopes greater than 15%. 10 W54 COMPLUM 1119PORT ?1JTNAM COUNTY 'OEPARTMENT' Of N�A4.Tk� 3/79 � ' , , • . ' plvhlon pP l:nvlFOgtTt•ptpl Halth I�TVIas COUNTY OFFICE SU10INQ. • CARMEL, -NEW- YORK �..........r ;�.�1l4 C+ A6tA! ��1�4 ..ts1:�.�1�.�;_wglf�drlllsr� and= oybmlttac�'tct�{:obiity 1�'® alefi• �De�atBrri® riteogeeherryvirtriat�ar�tory -� ®po"rt -of' `.' gnjIV114 of w#for sample indicating water IS of satisfactory.bacterial quality before certificate of construction complipli0i Ip Iguo, REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION . OWNE(1 MAAbb Model Realty Cor ADORES$ .. ' P.O. Box 92, Holmes, N.Y. WCATIOH Of wig 0114, 4 Ito6U alrn •• gel NNeIA®► . Fair Street Patterson 2 PR s® SIG W16 ((V� BUSINES4' =004 @sTl4 4...! E�TABIISHMf:Ni L--I F�1Rb4 L.J .T €4T Wes, PUBIC AIR • NINQ. OTHER ¢UPPLI INPU$TRIAE CJ.IrQNDITIb b—I (SprtcifT) DRILLING EO4IPMENT . (yam COMPRESSED CABLE OTHER RATA9Y C: J AIR PERCUSSION h J, EERCUSSION Q„ ( ;P•df�) GATING PETAIIS IENGTM lltfU 50 DIAMETER(lnchQ4 6. WEIG(iT l!ER TOOT 17 R THREADED D WELDED yE$ NO CASIN YE$ ►J NQ YIELD TEfT LJ OAII HOURS G.P•M, pUMPEq COMPRESSED All 6 12 r1Et0 ((LP.t)L) 12 WATEp ArVEL MEA$uRE FROM LAND URRACE-5TATIG(SpoQ!/y tool) 30 DURINQ VkLD TE6T Io61) j _ 165 Depth of Completed Well in Feet below Land sudq"I 16 5 seRESUe DETA14 MAKi None LENGTH QPF,N TO ARY1114 (!4611 None SLOT of None PIAMETER (inghtN None IF GRAVEL. PACKEDr Piameter of well Including' gravel pock ((ncheel: tJgAY k .$lzt lna4PN F.0!M•llwt Y (f!W"�.. ". None None None )tFTH FROM LAND SURFACE FORMATION DESCRIPTION SkofeA exact location of w611 with dbbnCeo, fool lq►q( sketch - — -= -= . 0 , 35 Clay ; 35 165 Granite, Limestone If yield was tested at di ferent depths during drilling, li.t below BEET GALLONS PER MINUTE Tg 10 i 15 Eb' DflT �F11 � tf b w�l_� pNl�ieR (slanalura) Wragg • Bros . s n_ -- k �PUTNAM COUNTY DEPARTMENT OF HEALTH:` Pe�►t`'a " Division of Environmental Health Services Came/ N` Y J0512 . CON$TRUCTION.,PERMIT FOR SEWAGE_'DISPOSAL SYSTEM,`., Patterson Town or village . p /0_p -- ..a.,Locateil „at F��l1Y' "�t'1''PPt p 7,b• _ .•elock .1 _ ,Lot. - 'I8 Tex ,Ma Subdivision A711 n� 1 C'OTDOTa t10 SubdLOt H 2 Renewal 0 Revision u - Ownei /Address '- l (l l C t7Y' l t711 Date- Of Previous Approval `t. Building, g} ^'S. lot Area' 51 at till Section Only _ 60 ,N o Bedrooms 'Design Flow G /P /D 0 G P C N D Nofification Required ° A 3.7,5 ,:L . F ... x. 2 ! , Idde 'trench Separate Sewerage System to -'consist of x[7110 = — _Gal. Septic ^;Tank' and:' To be constructed by. TO be deteiTRlned Address a Water Supply Public. Supply From 'Prrvate'Supply'.to De drilled by TO be determined ., 0 4 Other Requirements' 1 represent that 1-- am,wholly antl completely responsible for -the design and location of; the;.pr431pose(3;.system ( s),,.1)- that �tAe separate sewage •disposal •System ' above.described . wiWbe constructed as Shown on the approved amendment there to and in accordance with the standards; rules an regulations o e Putnam County :Department of%,Health, -and thaf;on completion thereof a .-Certificate of Construetlori Compliance .satisfactory-to the'Commissione► of Health will. :be Submitted to :the ;,Depart nent, ;and a 'written _guarantee` will be furnished the owner ;_his,wccessors, heirs oi' assigns by the builder, that said builder will' . 'place, in good :operating condition any. part of.saitl sewage tl�sposal system during "the pe ►rod of two (2) yeaq.lmmediatelyfollowing thedate of the Issu- " p g y the, drilled. well described above arice`;'Of the aDProval of, the Certificate ;of Construction• :Com liance of =.the on inal,system., an Oiiirs'tnereto; 2) that will •befocated asshorvn on theepproved plan and that said well will'be °Installed in .,accordance with 3fie, standards, rules nd' regu a ons of .the Putnam County ,0epaitmeni of Health Date ' B s; 7 l%GC 7 SignediGtilc.`° P.E. X R.A. Cashn Associates P ' C 37 Fairy° t armel'N Y Address f License_ No. APPROVED FOR CONSTRUCTIONS This approval expires one .year frorr'the date'issued•.unless constructlon.,.of the building has been undertaken and is revocable for cause or may tie amended or'inod,fied when onside►e' necessary Dy Comm stoner; of Health. Any, change .. eration of construction . .._ :. requires a n permit...: Approved ,for disposal.:of` dome is ni ary e _ e, a /or .privat ., at j5t ate ` 9y Title Rev .9 781 ; .. r r K. PUTM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 " SIGN DATA . SHFET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner_,A N U I C� tr (' 2 j> Address )SENT NuRS1!U(„ bQMC-- , HoLMgS N -Y Located at ( Street FAQ (� STr Sec.'- %�o Block Lot 18 40-rmz �Indicate nearest cross s ree .. ��unicipality , . t��4Trr-E Zs ©,N Watershed �1 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED, WITH APPLICATIONS ii01e' :.umber CLOCK TIME PERCOLATION PERGALATION' Run Elapse Depth to Water Water Level No. Time From Ground Surface in Inches Soil Rate Start. -Stop Min. Start Stop Drop in Min. /in drop Inches. Inches Inches 1 122( -qty z 17 z y 3 2/.Z-t,4-,--// 7 33 17 z� 3 zo 3 i 41,s-9 - z,q 1 Z. .p 5 2)y 7— [10 `33 f 8 2 m,NN 5 2 ' 3 fj, OF HEALTH 5 Pdotes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted .for review. 2) Depth measurements to be made•from top of hole. DEPTH .2 2, -7.011 3611 4211 4811 5411 6011 6'6" 7211 TEST PIT DATA R&,,.YIRED TO BE SUBMITTED WITH APPtICATION. DESCRIPTION OF SOILS ENCOUNTERED IN TEST-HOLES HOLE NO. HOLE NO. HOLE NO. 'j8 .8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL'TO WHICH WATER LEVEL RISE$.AFTER.BEING ENCOUNTERED TESTS MADE BY. z Date /:.z :Soil_' Rate Used H—/_5_Min,/l "Drop A)ESIG. S-D..Usable . Area Provided. o' <n CxO Si— No of Bedrooms Septic Tank Capacity -Gals* N --k Absorption Area rovTd-e By_z2s :'L . Fl. x24 A M me Address 3 7 t-141 62- S"; ' SEAL THIS SPACE FOR USE BY HEALTH DEPARTPENVONLY' YE _2S76 0? A 0' V z, 3oil Rate Approved S.q. Ft/Cal. Checked by Date . . w . a . . . . . . . . ............... 11114� V-W its WARR le, Elko too, n? oil . . . . . . . . . . -f-5113 - Are Aa. . ......... — tsF4 SO MEA L--bJ, SS 'F, �