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Home My WebLink About1628DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.13 -1 -20 BOX 15 filtow:3 J Ll 1 ■■ ' � J T, �� T� , �L1!I LL '� ` 1 6 �T 'I M ' 1 LI � 1 filtow:3 J 71 6W 0, �t JF rl 6- 8 4 HEALTH, -PUT-N. V N OF Nr -,,9f Environmental p.. Iqi� Se-tiricei, Carm _A-, 0512 J, ICATE:6F -00NST:ftUdT0,N -C-0'MPL- IAN F-0 'SEifA'GE.ZM -SAL.S it TEM T. Pattgrson Town, or Village t 61o'ck • �L- t TA' A -7 ,,,?ca.! .,at N 0 2.144 Owner. "Lot, Job -ppara..P Seweiage System built. by Bryn _o 0tj qo edt. x tv Septic Ta".,% 0OL-a - Consisting of �LY-6--Gil. Width trench % F1 'None er trequirements Water Supply -_ Public, :SUpply Fio�ryr,-'. X;.' dress Building' type o& y ' s*Erd$idn Control Been CCompleted? Y „I certify that the systems) a£ili ;tetl serving the p.bb4p,prpm Is. attached) 'a 6 In accordance with fhw.standards'--!u' an 0 anal regul oat8. December M Address D S� ions, pla the aiidve-sylstirp(s) ",s . shall '-prom person occupy6n'g' -premisei s6rv6d -b y C qpn dltipns resulting' from' such `usage Apprqval o,,tp@ 'separate. sewer I avallable'and the approval of:the private ..watei.,Iiu0ply,s6ali*,b6Eomi)'-riU-lI subJect:'to modification: or change when In the, -,Judgment .. of the Co oo 03 41, re i. of,:Bqdrqoi:p,- TK '-.�Datb ,Pelrmlt Issued 1 2Z 1618, id essentially as.,,shown on'the,plansof he completed work (copies of which are 01166',,ancl ihe,permli' Issued by the Putnam' County Department, of Health. P.E. X R.A.— 10, Licpn'sb 1`40— Vl take --such .-acfibn.ajMay be 'Ole . cessa'ry to secure ' the correction of any unsanitary system &comii-'fiull�ar - id v6I - d,,.'a-s's-oon as' i",lublic sanitary sewer becomes ci YOU '-hen.- er 1, supply . b, rpe v, 'a..publi - C' - wat y eco s a allable. Such approvals are, sionera H da it su x6oca lonIji,M?qifl tion-or Change Is necessary. 61 2 and.`l�rs-. Gerald Fl. 5,u �= Owner or r uc aser of Building Owners Building. Constructed . by; -y Fair.Street Location Street .. Patterson Municipality ?� ff Tex Ilao. 78 Section' 1 Block Lot Sunn4, ' Acres Subdivision Name Modular 38 Building Type Subdve 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 f o the`Putriam.County.Department _ of Health as to whether or not the fail- 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 4th day of .December. 19 84. Signatur Title Corporation Name if corps 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 0 Mr. .'and 'Mrs, G zOd P,, Butler, Jr: Owner or, urc aser of Building 0 Tax Map 78 Section I Owners -., ,. .:1_- K ,. $u��ding•�Cons�tructed -•by �. Fai.r Street Location— Street Pat'tarson Municipality Modular Building Type 21 Lot Sunny 'Acres Subdivision Name 38.,. Subdv: Lot # GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction:,:arid 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-,th-e- -Putrram --County -Department of Health-,,as to whether-or--not- the fail- 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 day o 19 Signature Q Title VP. Corporation Name if corp. pv' 8,0 4/0 S-' lqe&� 6�i Address to C92- 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 YORKTOWN MEDICAL LABORATORY INC. r P.O. Box 99 321 Kear Street LocATlorvs: El 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 3203 Yorktown Heights, N.Y. 10596 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737-8777 45'3203 ❑• 495AAAI '1�5T.iM7. "ICfSCO.'N:Y:`10349 66fi�3�35 •,:��_�",::;.;.�.^�.-�'.•�_.: -le ,TONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278 9 +LAB # o% DATE TAKEN: ��' �" %•�°a b DATE RECEIVED: DATE REPORTED:�t� =[. SAMPLE SOURCE: n ` REFERRED BY: L - -� COLLECTED BY: LABORATORY REPORT mg /L ❑ ACIDITY ........................... ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY `,PP BACTERIA, TOTAL /mL ......... ..J :........................... ❑ BOO, 5 DAY ............................ ............................... ❑ BROMIDE ............................ ............................... ❑ CARBON DIOXIDE, F13EE ........ .................... ............ ❑ CHLORIDE ............................................................ ❑ CHLORINE ............................ ............................... ❑ COD ..................................... ............................... ❑ COLOR ................................ ............................... ❑ CYANIDE ............................ ............................... ❑ DETERGENT, ANIONIC ............ ............................... ❑ FLL10RlDF ............................ ............................... ❑ HARDNESS ............................ ................................ 0,,&WN COLIFORM COUNT/ 100 ml .........nn ................... 'T COLIFORM COUNT/ 100 ml ........................... ❑ CONFIRMATORY TEST. ................. ......... . ._, ❑ NITROGEN, AMMONIA ............ ............................... ❑ NITROGEN,,KJELDAHL ............ ............................... ❑ NITROGEN, NITRATE ............ ............................... ❑ NITROGEN. ORGANIC ............ ............................... ❑ ODY OR:.,,.,,. ...:......................... ............:.................. ❑ OIL & GREASE ............................................ :........... ❑ PH ....................... .............................. ..... ❑ PHENOL ..........:..................... .... ............................ ❑ PHOSPHATE (ortho) ................ ............................... ❑ PHOSPHATE (condensed) ............ ............................... ❑ PHOSPHATE (total) ................ ............................... ❑ SOLIDS, SETTLEABLE, ml /L .... ........:...................... ❑ SOLIDS, SUSPENDED ............. ............................... ❑ SOLIDS, DISSOLVED . ............. ......... .................:..... ❑ SOLIDS,TOTAL ..................... ............................... ❑ SOLIDS, VOLATILE ................. ..................... ........... ❑ SPECIFIC CONDUCTANCE ......... ..................... ........... ❑ SULFATE ............................. ............................... 0 SULFIDE ............................. ............................... ❑ SULFITE ............................................................. ❑ SURFACTANTS .... ❑ TURBIDITY ......................... ............................... THESE RESULTS INDICATE THAT THE WATER WA THE SAMPLE WAS COLLECTED' THESE RESULTS INDICATE THAT THE WATER DID 0 ANTIMONY .............. ............................... .............. ❑ ARSENIC .................................... ............................... ❑ BARIUM ....................................... ............................... ❑ BERYLLIUM ................................ ............................... ❑ BISMUTH .................................... ............................... ❑ BORON ........................................ ............................... ❑ CADMIUM .................................... ............................... ❑ CALCIUM .................................... ............................... ❑ CHROMIUM (tot.) ............................ ............................... ❑ CHROMIUM (heuavalent) ................. ❑ COBALT .................................... ............................... ❑ COPPER .................................... ............................... ❑ GOLD ......................................... ..........'.................... ❑ IRON ........................................ ............................... ❑ LEAD ........................................ ............................... ❑ LITHIUM .............._..........._............ ............................... ❑ MAGNESIUM ................................ ............................... ❑ MANGANESE ................................ ............................... ❑ MERCURY ................... ............................... ............. ❑.NICKEL ........................................ .................:............. ❑ PALLADIUM ................................ ............................... ❑ POTASSIUM ................................ ............................... ❑ RHODIUM .................................... .............: .................. ❑ SELENIUM .................................... ...........:................... ❑ SILICON ....... ............................................................ ❑ SILVER ........................................ ............................... ❑ SODIUM ........................................ ............................... ❑ TIN .... .................................... ............................... ❑ ZINC ............................................ ............................... ❑ ... ............................... .............. ............................... ❑ ................. ............................... ............................ f... ❑ REMARKS: ........................................... ........................ ❑ .....................Xa...b` . 4S.... ............................... ❑ .................................................... ..................:............ ❑ .................................................... ............................... ❑ ............ ............................... ... ............................... ❑ .................................................... ............................... S� OF A SATISFACTORY SANITARY QUALITY WHEN MEET THE SATISFACTORY CHEMICAL'` QUALITY 01" ��yy� YpRK gTATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72). 1!OR PARAMETERS TESTED WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK -; This,, report _is ao�ie;c np(eted_l y ;well ;dci.�l,�t;and „�ubtjiit #ed to,. County Health. Department .to6ather-with Jaboratoray. report:af..» i ....._., 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 OWNER NAME Gerald Butler ADDRESS RT 311 Patterson LOCATION OF WELL (No. & Street) (Town) (Lot Number) _Fair Street Patterson PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑FARM ❑ TEST WELL 11 SUPPLY El INDUSTRIAL ❑ CONDITIONING OPHER) DRILLING EQUIPMENT COMPRESSED CABLE OTHER ❑ ROTARY AIR PERCUSSION ❑ PERCUSSION ❑ (specify) CASING DETAILS LENGTH (feet) 70 DIAMETER(inches) 6 WEIGHT PER FOOT 19 �� `'-11' HREADED ❑ WELDED SHOE ES _❑ NO C'A311T YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED COMPRESSED AIR YIELD (O.P.M.) 20 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) � f DURING YIELD TEST [feet) Total Drawdown Depth of Completed Well in feet below land surface: 225 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 27 clay __._... ... . ............... _......_....,_. _, _ . _ ...�... _... . seams l 27 65 brown sandstone & limestone 65. _ .._ .100. gre_y.. jimes.tone.._._. _.._. __ 100 105 brown broken 05 225 1 grey limestone w/ brown If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 11 -27 -84 DATE OF REPORT 12 -7 -84 WELL DRILLER (Signature) ' '' 1/ 38140' -ors'' V✓ bn I i l I JU F' ICA. L- An: -r'j r 20 1- oe)l 201.08' Putn='County Department of Health Division aj? E jr t V1 Ztn a Rn al Ilealth Servicei 5 SP <' APPrO'Vad A6 tctcd for confofffance with �aPIP31 &aAblc and Regulatio of the Put lth Put lth �Dep tment. Signature 919rilture Tit v✓r--L)- Structure located from survey, by surveyor noted $elowg - - - - - - - Well located by: Surveyors survey- Well Callers report Engineers mesurernentsi-a- Tar k boxes, pith, galleries S laterals to -toted Dy:d. Ontractor: 4. E6g t a cer, +Qlthdept: Field inspection by: Health dept dot 4 )1 4- — Engineer dotd'.-- TES: -5.::2 C;" is o IP DIMENSIONS 4, vU A a T J -C"i A iz-12 -B C C A D -.8 A E 4: D :-,5,T 8 E —"T - Tl- - A F -0 8 F 'Z%ofESS10)V4j it - A Q -ed r - A - H 8 A K --B K 1,R4 C 11 i OWNER: H P, I MZ ,, 6;CgkaL L7 LOCATION Street: f-Ale- Tow ri:- I4(5-'j -r - - -Co—unty-: Sto;b': susmyisiqw. j':1 C CF- 6 ize. � �5 7- i; _'boL M a P:LT�t-x I—i& Block.. LOT Builder: C7W��-V_ Surveyor: _gpt!b�C7 '[ Drown app Date: it I j: - Job Nt 214 JOHN H, PRENTISS P E CONSULTING ENGINEER RD CARMEL NY 1,0512 -- -(9141 878 =6170. I i PUl COUNTY DEPARTMENT OF HEALTH Permit a. /V /S /On of Enwroamen[al ;Health <Serwcesx Carmel N :Y 10512 CONSTRUCTION PERMIT FOR SWAGE DISPOSAL SYSTEM J f ?,. a y own or Village T Fa��r S creed_ 78 Block 1 rat 2 Located 'at r Tax Map - _ .•r = , � $ubtlivision Su;nnyr Acres C�1'`1 e: #828; h - °SUbd} lit 3$r Renewal ❑ Revision Q r Aran Marie $1 Gregory Rogers Owner /Address - -- iDate Of Previous Approval V '8uilding ;,TypeFran8l ' � Lot, Area 2000b sa < ft Fill Section Only ❑1 �i h �.. Y Number of Bedrooms Tfirde Ole Flov G /P /D 600 c P C Nj D Notification'Required n0 nn r',F r x "Wade L teral s Separate `9ewerag`e System <to consist of - 1 Ud� T Gal Septie Tank '. and t To be constructed by ' � � `^�' Address; � �' Water Supply ;Public Supply From x « s i.•iPnwate,SuPply t0 be drUled bye �` xy ° ! y - 1.. Address-.- INoneY• w*,Y k .Other Requirements � z � k f' _ I represent that I am wholly antl corbpletely responsible for the destgnr and location of ythe proposed systems) I) that the separate sewage disposal' system above;.described: w:in beKconstru9 , zis showgi; n ihe;approved amendment the %e ,to and ,ih.acco[ dance witfi.,the, standards,, uleslan 'regu a ons o e' .0 nam County •Department of - :Health, and 'that on completion thereof�a Certificate" of, Construction'�Compifance satisfactory to, the. Commiisioner of Healthwill be submitted to the iD,epartmenf .•_and a..written guarantee ;will be furnished •the owner +his wccessori,`heirs or•rassiyns by the builderi; that said builder will , r _0# .submitted s ., _ place iii -good operating ;condiU60i:la :;.part of said sewage`disposaf system +''during¢fheaperiod✓oftwo,(2) yearn immediately following thedate.oUtlie issu -° t, r'.a.nce of the approval of -,the Certificate .of. Construction Gompliance,of,th'e original, „iystemlor any repairs tAereto;,2j that the drilled well. described above wile De located as9shoWn on the appioved plan. and that said well will be installed to accordance with the standards; rules and rdgu Mons the Putnam Y� ,'..County D;epartfnellt Of Health '� T •,."w~� y ': ' !`.��';, �?F.r� i;5: :it's t �.. - ^,t 23 Ma 19841 r °{ Date y P.E.. v R.A t� Signed XX Rb ` #9 Fay ~r St` rmel N,Ys” .10512 29206, " Address -!: ! `' License No APPROVED FO F(-CONSTRUCTION This approval expves;one yearyirom the +date Jssued s consYr,ud n of the building' has been undertaken and ii y r"OcaDl,q for cause or may be amended ✓or,riiodtfiedwhen +consid f_ecessary= by�the"Co mis' over ,o't• Change or alteration of construction; requires a, new ;permit rfipprovetl, for -„ isposal of.domesti ` n r ;;sewn ,_ or ',p t to a er supply only:, Tit 1e w �rRev 9 81' T a it ti PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N:`TY:" `10512" DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. -Owner A ti IJIAtz� Ci Addre s s �St - (Street Lot Z Located at Street SE�a��ERS SeA�MAP _ Ea�e e(�oss s ree ' Municipality. Watershed CTOrI SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse p 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 � 1 � �►�+ u�- 30 2�1- 27 � . 5' 1 2 3 4 Notes: 1) Tests to be repeated at same depth until approximately equal soil 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. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN .TEST HOLES DEPTH HOLE NO. HOLE 'N0. HOLE NO. G.L. 6" 1211 181t 24" 3011 3611 42" 4811 54 it 6011 Mel 72" 78 b4 A0 INDICATE 11E AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LE_ VEL TO WBCH-WATER WATER- -LEVEL RISES AFTER BEING ENCOUNTEREDp4 E,Ap� g TESTS MADE BY... A T py E y 7 Dgt e DESIGN Soil Rate UsedIV2.0 Yir�,"Drop: S.D. Usable Area Provided 4-nod tb-± No. of Bedrooms -Ct-kRike' Septic Tank Capacity 1 ®0 ® Gals. Type ►M& . I U tj Absorption *Area, Provid6d By_32.f L. F.x241V 3b" width trench. AddressR 6 9 THIS SPACE FOR US914 Soil Rate Approved Sq. Ft/Gal. 1.4 AY 2 5 '1984 PUTNAM COUNTY DEPT, OF HEALTH CONSTR Uocited�4 -SUb.divisio, Z ARTMENT-9 HEALTH' Permit )UNTf_r-.;DE ..,PUTN:A*M-'C(. "qivision of nvrpoTonp, Health 'g&wkis Carmel ; Y, 105,12. UCT16N ,PERMIT ''FOR ::ttYVjkGt,,-O'ISOOSAL',SYSTEM - Patterson -Towr! or Village Tax Ldt 8", ' t6nh Acres'. 'T gubd I Re-ne Riwi.iic. .0 t,,��rsdih:,, jNpY' 12$T3�'+-5,344, G6ra Td ;Owner /Address —er/Addr �8_, "':J AN _— b u er. ,,Separate Sewerage of �77 9 be constructed by '-water Supply "; Public Supply, From sf `,1Rrhfate I'Supplj,. to lbe�'. drilled b W � - Address 06ei: Ai4t � ii�e 4en '6n " Z; that I am, who " _,�Iiy',and �completely responsible for 'the !deli above d 'bed "bt,i�6iiiiruttddlas5t!4�wnton i66,,aop,pov �)arherii . qsqn, will --'County Department', of .Health, and fhatron cO!np!ej ti6n thereof p,_-subrn!ttecl- to'.':the Dbpartrnent,liand a writtk4UaFrante i.,ANi ff. ,place- snlgood -dis6r, ,_ai?cq of i approval of ;the 6e_riifi6fe - tht �Will; be located -ai sficwn' o'fi the approved 'plan A County bepa rtmerit. -of Health. , P, '1 45,84 Mate December l ,gn, _APPROVED 0641,6 N�; Q TR. CT approval expires' n 'f- !evqodle for cause, or may,`bo, arrfejjded or rncj_d,f,j&j,:� s V FA requires am ra8new pe r m I t, - 'App *o y'id, f or dI" Sp ' o,SA! �?rrt tlomesti s. R, v."qj v 21 0 x. c Fill §ection;Only' 44gt i fi 17r, j ui red'' No', d i e ' Laterals: ress Zlw r v t foal 1y f'i'led, for;, r: -Ann, Marie roposed`system(s);1)sthat the.'.separate sewage disposal systeml IN, a -, n the itandaids,,rufes,and regulationsi-F—IFT-7,UTF—am .fqn.Como,liantellj',,satisfactory AO.the CdOrimlisioner of Healthwill ,Sro► assignsby'the builder, that-saidbuilder will ! iod 'o Awo,(2):year$ immediately' following the'date of the. IssuT, hat the deill� 1, descr,lbed' above m �pr' aly.repairs'ther !!e! ' d +with rules and' regulat ons of the Putnam !P% E., R.A. License N!o,, 29206' unless ','consfroctidn of the 4u4cling,bas been undertaken and Is missioner, of Health. Any change° erat Idn- of, construction �nwa ;'K, Title _� r PUTNAM COUNTY DEPARTMENT OF HEALTH • - • 1..:��, � { � _ i ;.. .-... Vii? Subdivision of Subdve Lot # Filed Map # t Date Gentlemen: This letter is to authorize a duly licensed professional engineer I- registered architect_ (Indicate) to apply for a Construction Permit.for a separate sewage system, to `hserve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said , 145_ conformity with, the._ provi,.ipns:: o_ A or... . system...or _systems 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. C untersi , R.A Very truly yours, -� Owner o/` -A.•- '/ �! �► c —�- Address JOHN H. PRENTISS. P.E. Town R09 FAIR ST 914- 878 -6170 CARREL. RJEN PORK 10512 4. o A f �� Telephone Telephone }: N - -1994 PUTNAM COUNTY DEPT. OF HEALTH