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HomeMy WebLinkAbout1668DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.17 -1 -14 BOX 15 oil ps-+ 'o or I6 . ' ' 1 1 r 7 1 , clew �._ -,.� r P 11 80 6 { t PUT1�1;a1M COUNTY' DEPARTMENT OF HEALTH , 501876 ya. { Division of Environments/ 'Health ,Services, Cerrri% N' :'y 10512 r Patterson CERTIFICAT,E.O,Fh,CONSTA, T i ON,,COAAP..LIANCE' =,FOR ,SEWAGE .DISP„OSAL;.SYST.E . Located at Y Hgh' 117�ewK Drive Taxp 78 .Block 1 Owner Josephine �& ;Vincent J Nard'u.11o Tax r�aP �t .15 1; saba +« 36 ,W Separate Sewerage SYstem built by , G asson Bu `l ders:: Tnc. Address 93 `GTO da Ave Carmel , NY 1x000 r .. 27-L F x 24. Wrath -rrench k Cohsisting of - Gal rSeptic. Tank and Other "requirements .=None , Water Supply Public Supply' Frfom =XK , Boyd Artesian W01 'Dr 1.1drs: Private Supply Drilled BY Address._ - None,. Reg d T ree MOdu1 ar Bulldin g T ype No of Bedrooms Date Permit Issued % .Oct. as E Been ;Compieted? r g0 V certify.that the system(s) as listed serving the above premises.were constru cted essentially as shown-on the plans of the completed work .( copies of which are attached) aria in accordancewith'ttie!standards, rules and regulations, in accordance with-the filed plan, and the.permif ii3sued by the Putnam. County Department `Of Health: C 17�,- November 7 980 ,' X Date Cert�fieq by P.E. R.A. R p 9 �a�,r S rmel license No. 29 Address Any person. occupying premises served by tits above system( ;) sha)lzpromptlyaake such action'es may be' necessary to secure the correction of any unsanitary conditions resulting:`from inch usage Approval +of ,the separate sewerage system shall become, null.and void as soon as, s public sanitary sewer becomes available ' and the &pproval'of the private water supply shall become -null and Vbid when a public water supply becomes available. Sueh .approvals are subJect to.,modificstion ' or change `when, im the judgment --of the C&inin ioner*of.Health. uth 'r "e'voca n, modification or Change Is necessa►Y. 1 a Oefe l% BY T itle If- Q! i 6 LL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH `3)71 Division of Environmental Health Services COUNTY OFFICE BUILDING : CARMEL, NEW YORK This report is to be comple,ed by well driller and submitted to County Health Department together with laboratory report of 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 O NAME McGlasson Builders. ADDRESS Main Sto Carmel, W1 OWNER LOCATION OF WELL (No. 6 Street) (Town) (Lot Number) Highview PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL PUBLIC AIR OTHER ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ (Specify) DRILLING EQUIPMENT COMPRESSED CABLE El ROTARY © AIR PERCUSSION E] P PERCUSSION ❑ ((Specify) CASING DETAILS LENGTH 1feet) P 1. DIAMETER (inches) 6 WEIGHT PER FOOT 19 THREADED El WELDED DRIVE O ® YES El NO C G ED YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED © COMPRESSED AIR 2 5 YIELD (G.P.M.) 5 WATER LEVEL MEASURE FROM LAND SURFACE— STATIC (Specify feet) 451 DURING YIELD TEST (feet) total drawdown Depth of Completed Well in feet below Land surface: 300 SCREEN MAKE \� LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT "SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravgl 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 .111 overburden i 1;1, 300 ledge If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED P1 /1;0/80 DATE OF REPORT l l :/19/80 WELL DRILLER (Signature) O NAN-:C� ENVIR.ON:MLNC `SER %ICES, UNITY STREET-* ROUTE,O :BOX 10 3P PEINELL JUNCTIONHO ; NEW YOR1 (914) ;226 5155 or 4200 = r FORWARD REPORTTO NAME C � ;. �- +.Z+- 'C � .. • ,'4, �^r],j s 's iJ 1;:. re.-M: _�sn F^' x .. � '� -i' $�• �' ADDRESS SAMPLING POINT - TREATMENT CHLORINATED ❑ ". PPM ,SOFTENED „❑ OTHER - - SOURCE DRINKING WATER C'WASTEWATER EFFLUENT; OTHERS❑ COLLECTEDBY'_¢'C°Q %jjj TIME {i;q P.M DATE -' fJJj / -J� ❑`,APARTMENT COMPLEX 5 ❑INSTITUTION ❑_PRIVATE RESIDENCE” : ❑SWIM POOL^ O ;BEACH = ❑ =MUNICIPAL zp RESTAURANT, -•° ❑- TEMPORARY RESIDENCE O CAMP ti ❑ NURSINGHOME D SCHOOL {_ ❑TRAILER BARK O FARM LABOR :CAMP ❑ PRIVATE- COMPANY O SEWAGE TREATMENT PLANT ❑OTHER . ,_ ❑ 701 AL CQLIFORM`COUNT _ M F T PERj100 ML t ❑ TOTAL COLIFORM' COUNT M P N Y PER 100;M.L. s, - - Q.FECALCOUFORM COUNT` M F T _- ry PER100 ML ❑ FECAL',COLIFORM COUNT M;P N., . ' PER 100 M.L. _1• FROZEN DESSERVOLATEGOUNT "_ ❑AGAR PLATE COUNT PER t M:L. t 1A80RA70RY IR CTOR DATE REPORTED �.. - . THESE_ RESULT$ INDICATE THAT THE WATER SAMPLE ID ❑DID NOT r sue.. '� s T 4 § «• ` - MEET SATISFACTORY= SANITARY OUALITY WHEN' COLLECTED;AND DELIVERED TO NANCO ;F HMTH DEPT C®PY x j x s2 f ; Josephine & Vincent J. Nardullo owner or Purcliase r of Building Modular - Erected by McGlasson Bldrs. Building Constructed by High View Drive Location - Street Modular Building Type Patterson Municipality TM 78 Section 1 Block 15.1 (Subd. Lot DO Lot 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 Putna*n Ccu ty Department of Health. as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 18th day of November 1980 Signature Title Owner If corporation, give name and 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 o'f Environmental Health Services, - - - - - - - - - - - - - - - - / i i Putnam County Department of Hea" ......... ... ... . P r3 log- 'Ifi .. �-7 f"Ofm , LAM AKQIWIM—J� 'us. iv aty- �H OIL, Q to Tom- ­Mp 1 Awl is 1. 'coo A oil 4j tORS, ANY.iv ----------------- . . . . . sit W. . > 100 v wPUTNAM CO Division of Enwrofi'� CONSTRUCTIONt PERMIT LL FOR SEWAGE DISPOSA ` �,f3GAtF}ti at s14y �•4 K,V Subdivision `S`tunnrAEres hot ,o'wner �,`Josepfi��nei�& 11�ncent �7_ Nardi Building Type s Lot Area x Three 600 Ga Number of Bedrooms Design Flow Separate 5`ewerage Systemt to consist Jof To be constructed by il'lCGlasso MOW' 11 ;� Water Supply � ' Pub'�Iic�BuRPIy'�rom 31k, ,. 7 tPrwate Suppl to bQ gilled by dress,: ff , e on Other Requiremehts { ` 3r a� n t I represent that f am wholly and co pletely iesponsiblr 4 e above described will be cohstiucted s shown on the appr ed ai County Department of zHealthan that on complet n there be submitted to, he fDepartmenY a a' written grantee ' place in good operating condition an 'r said sewage ehce of the approval of :the Certificate of Construction Cor will be lo`catedras hown o&the' approved plan and that said well County Department of Health � �'s� ' � -° Date �ERmrr? ►� 1/- $ )EPARTMENT OF HEALTH . lealth Services, Cermel N # Y 1,•:0512 ' _ k EM Patterson J Town or, illage t- Tax Map / _ F3tnc1 �-.• t828' ..- Lot 1 5 •. _ _.'. Job: s�l 876 Address 19 Ann Mar ace { Yon 0703 Total Habitable space 1040 On 1 sa e Feet Septic Tank :ind 429 kL' SF 4 24 ". Wdith Trench Address. , 93 Gl ene�da Ave f , Carmel Nlf 10512 _ rteys4lan �GJeI 1 prt 11 ers ��. 7 r r s, i location of .the proposed: systems) ° 1) that_ the separate`-',sewage disposal system there to and in accordance with the standards „rules art , re gu a,ions,o . e: - u nam ” rfdCate `of';Constr.uctioh bm Tian e'"satisfactoc `to'the omm'3sio "e`r of „Mealt will ' iishetl the owner, his''successors, heirs or aesigris'by thebuiidei,1hat said builder'wt11 ystem rduring` the period of. two (2) years immediately e. . following thdate of the -issu- if tKe origihal system ;or any epairs thereto 2) thit the - drilliia well described above felled meccordance with the standards, rules and, regulations; of the Putnam r P.E R A Vt'ate is 7” :� a y BY t Title vv j .. .. .,. JOHN H. PRENTISS, P.E. CONSULTING ENGINEER R.D. 9, FAIR STREET CARMEL, N. Y. 10512 (914) . 878.6170 13 August 1980 Putnam County Board of Health County Building Camel, NY 10512 Att.: J. Robert Folchetti, P.E. Director of Environmental Health Re: Property on High View Drive, T. Patterson Tax Map 78 Block 1 Lot 15.1 - Sunny Acres Subdivision, Lot No. 30, Filed Map '#828 Josephine & Vincent J. Nardullo, Contract'Vendees To the Members of the Board: As shown on,our Dwg> No. 1 (Rev. "A" - 8%13/80), Job NO. S.O. 1876, it is not possible cons tderi.ng the locations of surrounding wells and sanitary disposal systems and the extent of.the pro osed disposal - -- system for thhis-property to locate the proposed -.wel in any other- location than that shown on tfie drawing. _..___. We request, therefore, on behalf of the applicant, that you grant permission for the S OM ',i seventy- �fii -e foot shown on the drawing. _c S Respectfully yours, dhn.H. Prentiss P:E. OHP/pr cc: Owner Builder File N• PRf- V.� X. o � v N0..292��'� Of THE S1Ot ,.. . �.. yr: :,�'t .: ,. •:., >. ...t.. SERA ( tt5 1^•. •Y' R L ,. � .f l S h. 1 .:.4,r "• t ) .k1.Ai f SERA Y ivy ly:• liGi G�`; lilS tJ i'; ., tS� t p r� , 'I RAT tt ''!` q A� �' 3 :TO Q 1"' Sxr ,- r . •y,��y` j�q'I+�ry !may( y� �ro •� (� ( TT . I I Y . 1 5 5 K �` ; ✓r li3�.1 I r� I M� { l �1 .¢' ,.(j,'�'IL ] 4A �i� ' • rt.+. �.i,.i.. . :1. - , . ' t'n.4.::(� y}�• ^�f•`� �S ':� Nt �. v�'� �(+• }� YYry�+ .. f { � �{, J�•� � � .P •Fy�'K,�'.% �r_...,.� / . L:.ihYP. L? d'.4 a �''S I fV:_4'1 4 .:..� -l! V '•�' '. M.}wF 7L� J •� T « i • ' r c _ '�7`• y, .Lne 1, I.F.: IAi�]t LV_ p. Lta be repeated 'at same dept.;ht until eq a� l i. .nl L}trt ,`aj.,.ed, at fc7ich percolation t:.'t- §? i.•i1 (_pa A {:I .... :s (?asl'.ii.'eF':`ti?I:ts to be zmai of r` > m � 5 a{ CONSTRUCT u Lo a:o °a ' °Subdivision f ' f PUTNAM$� COUNTY DEPARTMENT OF 'HEALTH . Drvrsron of Environmental Health Services irarme/ N: Y 1.05,12 T FOR SEWAGE `DISPOSAL SYSTEM t k Patterson Town or village N Drive., 0. s s' Tax =Map # �" Block 1 res K a + Tax'Mapt Lot :# 1 1 : Subd # 30 , dy r Y '� D ng,,l Rd :{ 7 s' k� " r ' Address i a r` 21000' Carmel NY 10512 Lot 11 „61 �e Design`i +Flow' 600 Gal z "i Total Hebitabte�Space _� 'Square Feet ' 0 L.� sty 4 L Sepjrata. Sewerage System to consist of 1 Gal Septic Tank 2 ft 2 _trench / "( k( ^ x aching -pits 00 4 9 To be constructetl y x Aq ress w b 5 v Grsw x f a n � Water Su_ PPIY aPUbIIC SuPPIy Fromm - '— ; �• {�l Y /� ;Private SuppIY to be tlrilletl by �? x t ft }'{ t: - t. •t f `t t k 4 Other Requ vements None _ 4 T•+k �s k F *," r .- '. ,�,.:.;I:represent, that ?I am 'wholly and completely reapbnsible -,for the design and location'o£ the proposed 1 Vtki� se rate sewage disposal' 1 �Vvl i 'Date `` 16 3JU1' 4 APPRO /ED FOR COQ -- revocable' for cause.oi . requires a newt p !.Mjt ,Date r n. be .constructed as shown on the approved attachments hereto and in accord''nnc��eppw-i� rules and regulations tent'Of Health and that on completion thereof a Certificate of Conatrucgymnlanactory to the.Commiesion -' C ed'to, the Department and a wr>tten guarantee will bG furnished the'owne; his successors heirs or assigns ,by tlie'tiuild =':{ lace'in good operating condition any part of'said agivage.disposa, system ;during the.period•of two (2)'years immediately 1 suance of the approval of °the Certificate of?COnstruction Com_pliance_of the original system or any repairs retoi 2) bed above will be located as shown °on,the appd plan and id Installed ordancewh the titan= rove Hof the Putnam County Departmentf0f - 7,9 4 X P.E R A. Aadrass R. D,. 9, Fat r St �i^me1, NYr10512 � 29206? License No CTI, This approval expues one yea rfrom�sthe datedssued unleii cori uction of the.building has been undertaken Arid Is s amended' or.;modified when'considered nec @ ;sary Eby the CommissionQr'. of Health Any: change or alferatiori, of ,construction rroved for disposal of domestic sandary sewage and /or pnvate, water supply only 1 y�. T -ills t ! 9y _. r. 2/,060 '01 jJ U I y P Notes:.'.1) Tuts to:be repeated at same depth until approximatel� equal soil rates are obtained-at, each percolation test hole. All data to e submitted .for . review ...'. Depth . measurements to be made from top of hole. TEST PIT D4TA REQUIRED TO- BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES. DEPTH HOLE NO. — ROLE .NO .;�. __. .. _ o �HQT:;F rIO.,. IN _ G. L. 6 4�P " O iC s 121f. 30 " 36" 4 rr 60" .fe h t 4 AN r 72 9; �, INDIC;A. E LEVEL AT TMCH GROI�ATER IS ENCOUNTERED JVoMc INDICATE LEVEL-70- WHICH WATER WBL RISES AFTER BEING ENCOUNTERED NV4e rf�%r 7Y.ffrs TESTS I��rD, E By . JC T -J. M•/� .. s < � to 6��` o DESIGN :, .. Soil -'Rate,- Used %6' Min/1"Drops S.D. Usable Area p'rovid'ed dD'�'?� No., of ;-Bedrooms r Septic Tank Capacity` OG Gals. Type Absorption Area Provided By_L.F.x24" , wat'l ranch. Ilame o n - ren 1 ss :igna ure - Address R: °D. -9;-, Fai r St.' Carmel, NY 1;0512 THIS SPACE FOR USE -BY'HEALTH DEPARTMT ONLY-fl Soil Rate Approved Sq. Ft /Gal. Ch . v N, PREN Date LrH 29:Sl"�:I:t State of..,New.York Re: Sanitary Disposal System - S01676 County of Putnam Well Location and /or Two Bedroom Construction For Miscellaneous band Records For Parcel Located on: High Vieii Drive In The Town of Patterson Tax Map 78 Block 1 Lot No 15.1 (Sunny,,Acres' Subdivision, ik Filed Man 1828, Lot No. 30) As Owner /Builder of the Sanitary Disposal System proposed for. the noted parcel, permission has been granted by the Putnam °County Board of Health to: 1.) Locate the well on the parcel at less than the required 100 feet 5' t separation to the disposal ,,system "on,:.thi s., parcel ; but nn. closer than 75 feet. • .. 'stall �a dis�"��,em fowo- bedroo• " .. .v.rtnvl �n•C •. +b,vnn_i�iiriv.nnnui�� - •M . cii�t� S. A'copy of this document with the County Clerk's stamp is to he delivered to the Hea .th Deriartment prior' t o ._issuance :of:;a.. L onstructi.on - Permit; with a copy to •the. Appl i,cant. G . J �- � ��4`' -' •�'.;.. Vic_. f ,, (Must be Signed Notari zed ) Printed Name Ann Dunont Address Dinaley Road <<;J Lake Carmel, NY 10512 I � tt t. 1� .�t :y Well • ' ,v+� F Tank inside length- O i atath -01� WOW love I _ 4/oPror ' Capacity -- 10 o a .roc ;'� sa�s... �a 11 - o.r-S.D•s - _ tl>e• t 'Nrlottrals !Z. Length eo _, #-1 N Goxes =� 7 I i Section i �ryry;c «u Gat':. Ga /SqF • j l - f- aFt F 1' - to Wlae • I f Q!'F.': j^iNi✓Bj/OrY P/e70 - • /Y ��� - �� .. .�laO � 'tf O T?LtD� 1� �/- .. - - Ttt �t T -i S -�'� rrvi �wvi red + Ll- 1 tiny i:s; Ali- ! \. t PR qI /O ? - TII Lvferaq lS ! I . . . Ik ,San Ou S, d, /B6 (i bb N ♦: f( .JU St Lb i:/MON-3ir SL�1 '1 6 lyd+s s. . 1 - ' /.f, � „30 � ' %°,`Lai• ..- ,. .. $ fre'x •- '-- --- _�- ` i _._.., --- ---� —' � �y'Q- �'�3- • -'�?' .5:.: -� :, I -. � _ .` :: ��QA��E � Al E,�� �;, �$UEu4 +v7K ',�.���i