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HomeMy WebLinkAbout1740DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -78 BOX 16 I IN j 116 go I go i T .g I, .- �. 01740 j R /ev. 3/S r E� lV Laceted'if : .Owner /apppcant'r �tca� 01'. -- Bullding Type Naunber.of Bediootns Other Requirements - I Certiify that he syeteuij .of.`which; are attached),_an Putnam County Department'0 Date, t Any person occupylnq pr err conditions resulting from', available and the approval subject. to a modification ,o[; Oats < Town or V. e Zap Block _Lot vision Name abdv. Lot N PermltIsened_ .3 3�r r �F.'VSjr1�1t4't7F�1 �,% 7 K u Py`-NAm Rimer`— �tA,�e V y _ shown the plans of the completed work;( copies `,withahe filed plan,'and, the peimit issued -by the P E. z-, L lLicenre No _neceaiary the corrictlon `•of any unsanitary id void -as soon .'as a pubt.: son itary sawe►. _becomes wpPiy. i acomes. available.' Such approvals are Cation ;'modification or change IS.neCeaaary. - Titls �` 77777 r T• +' -'r' -i i'� _"v ;�- t'°"�`. -nt,,, .,tea• i s 'M- 7777,7 F " zENGINEER TO PROVIDE;:P,ER IT # P.UTNAM COUNTY DEPARTMENT OF HEALTH - ON CERT,FIC OF ` OMPANCE, Ofvfsfon of :Environmental., Health Services, Carmel N ,Y 105'12 PERMIT,, t CONS• _ UCTION PERMIT?F:OR SEWAGE DISPOSAL SYSTEM;. " "Patterson To vin 'or, Village _ Old ROUte. , 22. Block' ;TLat . Apple Hill .19 Subdivision Subd. Lot N Renewal Revision Owner /Address Apple Hill' D.ev -:Cor:p.. -10 Galloway Hts bate of Praviope Appioval Single Family Res. ' �otWA ea iicck, ; N Y T0990 Fill Section only ❑ Buildm9. -Type D+�i S.q- -— Number.of Bedrooms` 3 Design Flow c /rjti' cnn- P. C. R. v bloSificitibn Required 375 Lin. It disposal trench Separate ;.Sewerage System_ to consist of 1 U00 Gal. .Septic, Tank and N. Pera g-; ine RD:; #1 Wngdale, .N`.y. To be. constructed by Address Water Suppi" Public SuPPIY From, X Private Supply to be, .drilled by P.'-'.F Raab 9 Cnns 4 P, utna m Ave. Brewster Address N' Y Other Requirements 1 represent that 1. am wholly and completely responsible for the design and IOCation of the proposed , system(s) 1) that t- separate sewage disposal system . , . .. ..,- _, .•. :,.•v . .. eq ions o e'_, u nam above described will be.eonstrucfed as shown on the approved amendment thereto and in accordance with.the standards .rules an ► u a County Department of Health, ,and that,on completion thereof s "Cerbficate. of Coristructioni,Compliance :satisfactory to the Commissioner of Health will be submitted to; the Department '.,and a written _guarantee will be furnished' the owner hls successors, heirs or,amigns by the tiuilder,,that said builder will place in:lgood operating 'condition any part of said sewage. disposal system during 'the per rod of two (2).y ears immediately following thedate of the issu- ance of the approval of :the Certificate of., Construction Compharice of the original. system or any.repain tAereto;;2) that the drilled .well described above will be. located as. shown op the approved,plan_ and that said well will be installed 'in accordance with ' th'e = standards,' tulles ,and regu eons ', f the, Putnam County'Department of Health 3/3/85= Data Signed - P.E:k"', R.A. Address 10 Gal'loway $'e1ghts Warwick , .N : Y I nQ9p License No. APPROVED FOR CONSTRUCTION T' his.a , pproval expires one ear . rpm the date issued a construction of the building has been undertaken and is revocable for ca, use o► may-b' e amended or mod�fieC. when con ;i er d n e by the Co i loner of Health: Any change or alteration . of construction \ requires'a� new 'permit. "A'pp ved tor' disposal of.'tlomestic- n aryl wag " a r.'^pr a ` r su• - ` ly_--- - - -_ -. - `�� 1 Date By Title y Rev. 6/85 In WELL -COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME J &+P Development Corp. ADDRESS 10 Galloway Hts. , Warwick NY 10990 LOCATION OF WELL (No. A Street) (Town) (Lot Number) Lot #19, Applo Hill Sub., Patterson NY .. PROPOSED USE OF WELL SINESS © DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL 1:1 SUPP Y El INDUSTRIAL ❑ CONDITIONING O�fif ) DRILLING EQUIPMENT COMPRESSED CABLE K ROTARY ®A R PERCUSSION ❑ PERCUSSION El CASING DETAILS LENGTH (lest) 21 DIAMETER (inches) 611 WEIGHT PER FOOT 19 lb S ® THREADED ❑ WELDED 29LVE SHOF,__ PXJ YES LJ NO CABIN X YES Lj ?- NO YIELD TEST HOURS G:P M. ❑ BAILED ® PUMPED ❑ COMPRESSED AIR 6 YIELD (O.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 30" DURING YIELD TEST (feat) 2651, Depth-of Completed Well in feet below land surface: 2$ SCREEN DETAILS. _ MAKE _ SLOT SIZE DIAMETER (inches) _ IF GRAVEL Diameter of well including ~GRAVEL SIZE (Inches) PACKED: gravel pack (Inc heal: LENGTH OPEN TO AQUIFER (feet) FROM lest) TC (feo't) —.- DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 6 Drilling:° i.n _; overburden clay and boulders ,r Hit rock at 6t 6 21 Drilling in rock, set casing, routed 21 285 Drillina in rock ran.ibe If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 3 6/86 DATE OF REPORT 5/14 86 WELL DRILLER (Signatur 1. //Z- /)z /,.. r BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6322 SOURCE: Apple Hill Lot 19 Well - Hose Bibb COLLECTED: September 26, 1986 BY: P. F. Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. September 29, 1986 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Apple Hill Development Corp. Owner or Purchaser of Building J & P Development Corp. Building Constructed by Old Rout 22 Location - Street Patterson Municipality Single Family Residence Building Type 69 4 6.4 Section Block Lot Apple Hill Subdivision Name 19 Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL 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 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 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 occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental 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 willful or negligent act of the occupant of the building utilizing the system. Dated this 2 day of Septembe!Lg 86 Signature Title eral Contractor (Owner) - Signature Apple Hill Dev. Corp. Corporation Name (if Corp.) Secretary Corporation Name (if Corp.) 10 Galloway Heights,Warwick,NY 10991 Address 10 Galloway Heights,Warwick,NY 10990 l,drsss rev. 9/85 mk I, S PUTNAM COUNTY 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 f>P - H l L l�l). CoRpAddress nLj R7- - 2-2- Located at Street S (AJei. Sec. Block Lot !,! k indicatene are —dross sf-r-e-eTT Municipality PAT'T�i2S0W Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS P RnPnS -F_-n L - 1 - Ho e Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Dep o 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 IoR�� -1/•07 2y Y�7% Z%2 2 IL44 - 11 :3g 30. 25 27% 2: Yzi 3a 2 /8 1 y 4 e' : 9 J1 - rnmsr1,i L(JAN1_ -_1AJ_IS; ,5 1 --- . y ; .. a 3 _ b� Notes: 1) T4:�ts to be repeated at same depth until approximatelyy 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. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION -n -70TNT�--y-IF 1:!r1ILS, 1�P'11TCCUNTERED TEST-HOLE- DESCR-LD..A. DEPTH HOLE NO. HOLE NO.— HOLE N0. G.L. 611 r-LP,4 Lnr-4+-1 12't 1811 24'1 3011 r-Lq�l WISILIJ 3611 C-,-PAV E L- 4211 -.48 54" 6011 6611 72" 7811 .8411 'ENCOUNTE 1- JND R-IS N.D!C-A,Ti..TFVF,!..-A.T--WHT.CTi....GRQI-.-,--WATI� INDICATE LEVEL TO-WHICH WATER LEVEL RISES AFTER BEINGENCODNTERED TESTS MADE BY A2 Date 'j Z J? P DESIGN Soil Rate.Used.14 Min/1"Drop: S.D. Usable Area Provided nn_ No. of Bedrooms 3 Septic Tank Capacity) Gals. Type jzg?ET, tz th trench. Absorption Area Provided ByB-77_L-F-x2411 .5b" () her Name. \ rNH IQ L- E 14VIAW, P-C - Signaturolg�/AA Addresslep G-A L(-.n LL) PA E I G. 14T-,s I C g, ki. L76 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Checked by r 0.. C rt, Date ` PLTTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMEN'T'AL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT DPN;.. _I, INSP: BY. CO. ( ame of 'Owner) C (Street cation) INITIAL SITE INSPECTION YES NO CCMMENTS Wetlands on /or proximate to property .............. Property lines or corners found ................... Canestimate house location ........................ Willdriveway need cut ............................ Must trees be removed - note these................. Deep holes representative of entire SDS area...... • Additional deep holes needed ...................... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells /septics............................ D.H. 1 Lot Depth to G.W. Depth to rock Soil Descri tip 0 ft. 3 ft. 6 ft. 9 ft., 12 ft. D.H..2 Lot Depth to G.W. Depth to rock Soil Descripr 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. - 1JEH1'r:: FINAL SITE INSPECTION INSP.BY: YES NO House SSDS located per approved plan ............. Length of trench measured 3 3 6 Width of trench average Slope of tile line and trench acceptable......... Roam allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... Natural soil not stripped or SDS area .. unnecessarly graded...... .... .............. 10 ft. maintained from property line and 20 ft. fran house .............................. Distance well to SSDS (ft.) ...................... Number of bedrooms checks......... ............... Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally frcm trench ..... ............................... Boxes properly set.......... .................... Could surface runoff Iran driveway, .roads, ground surface, etc., channel near SDS area....: Does lot drainage. appear OK in area of SDS....... `IlgAL QADNG OF SITE ACCEPTABLE--'--- �j- D.H. - Deep Hole G.W. - Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descrintion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. �;Wi 1W_ , , I MY-M I MR - Z 1 ,Rim MORMEMM Z ,I' J /�� -% �. ,� ��, ` ,��� . , Ar 0 -2 fl>. _4-- � OG rp 6\ 0 z z �Z nT > z c e,*S -125.39 98 a D ffiv -3o' po N 5 L=WTI C'rA.MK Fe 740,0 r\��T44Z•46 �t n 6, NI. -1 CP IN 740 01 (I i r 0- 1 1 \N\' 00 o ro r r (( ��\\ \\ \\ , > 6) z r > ro, G, N 0 Oil � m � � � � s 20`�o2o "W _ _ s ,..5;00' N 6\ m s Of r ER VAP 444fl-4 IXI ri 0 0 0 r rgr 0 P c e,*S -125.39 98 a D ffiv -3o' po N 5 L=WTI C'rA.MK Fe 740,0 r\��T44Z•46 �t n 6, NI. -1 CP IN 740 01 (I i r 0- 1 1 \N\' 00 o ro r r (( ��\\ \\ \\ , > 6) z r > ro, G, N 0 Oil � m � � � � s 20`�o2o "W _ _ s ,..5;00' N 6\ m s Of r ER VAP 444fl-4 IXI ri 0 5E+PTIC L.00ATIQIJ "PL.AI.I 5c-Ai-r=,. 0" 30' 1 Ce°a 10 . INV.IN� -[20.g COMMON DRIVE LOTG —i•1°.�.20�21 • loo { •51✓PT1G LO CATIOI.1 �GNE.DUL�c ;;1 THIS IS TO CERTIFY THAT t FROM yuucTloN -esox TO C.RNAAA. TO CRNP15e, FROM TO -�O TO „: TO CRNP AA CRNR 55 FROM CRNaL AA CRNR 55 42' THE SEWAGE'•DISPOSAL SYSTEM I 49' 46' IA 32 I40 j15 t9t; WAS CONSTRUCTED AS INDICACSD I 2 I Ea 5t ZA 3A a9' -TV 25 83 ?; 4a 18' 515 85'.: S3' .ON THIS PLAN AND THAT THE 3 4 59' 65' Sy &W 4A as' 51' 82 4e, 891 59' SYSTEM .WAS INSRECTED''dY I i 5 to' To' 9,N 51' 8b se 0 i mss' ME BEFORE IT WAS COVERED ph i I / �° � I / i i l l 1 � � t OVER. THE SYSTEM.WAS j u• �v�a, ly unybr, wo„I ut neu1L� CONSTRUCTED IN._ACCORDANCE . ' ivielon of Environmental Health 8ervioee WITH ALL STANDARD RULES .• AND REGULATIONS OF THE 4 3DDroved as noted for oonforeeaoe with PUTNAN.000NTY DEPARTMENT APP11aable Rules and 8 os the OF HEALTH. j P44" County Health De mt. 5E+PTIC L.00ATIQIJ "PL.AI.I 5c-Ai-r=,. 0" 30' i i c r P APPLE: D El/ El.. -( PA'- l'��R50N,PUTNAM C�O.1 N•`!. Jo NN LENMAN , �.Ef: r CONSUL`!'1NG L:.NC�IN,�ET� IOC':�ALLOWAY HEiGH'CS WASZWICK,N•V• !' aSi�.L.E'.1=500 i70.T'r =: 8- 22 -8to N -Y -LI C.NO.O5(oCoS3 �, b, t i. v� I Ce°a 10 . INV.IN� -[20.g COMMON DRIVE LOTG —i•1°.�.20�21 • loo 24 " -�4 OCLA`( WI SILT 4, GRAVEL OUT—j ie, c. �S•t I t; i 14MIN• /INCH i 11 566 °4215•'E ` I: - I % JEp-L,CAREP- 0 NY � U � Iy I � � �? JUNCTION / I P Hoxes�•q.c "a P i �'Y3 24 l34 1 1 � t_. ph i I / �° � I / i i l l 1 � � t j TANK 734 I �J � sO,F 566 °az•IS••E � / ^ -" _ -. i i c r P APPLE: D El/ El.. -( PA'- l'��R50N,PUTNAM C�O.1 N•`!. Jo NN LENMAN , �.Ef: r CONSUL`!'1NG L:.NC�IN,�ET� IOC':�ALLOWAY HEiGH'CS WASZWICK,N•V• !' aSi�.L.E'.1=500 i70.T'r =: 8- 22 -8to N -Y -LI C.NO.O5(oCoS3 �, b, t i. v� I \, • (o' -2FF" CLAY LC?o.M 24 " -�4 OCLA`( WI SILT 4, GRAVEL i PEF�['ALATIONh'A-fE• t; i 14MIN• /INCH i Llt�1. S• %!}ZENCIA RECjla — 15T5 Ll N - V=r/TRE9C! -1 PROV ('DE D - 3 ?5 I: ' AReA= 54,°51 SF't' i i c r P APPLE: D El/ El.. -( PA'- l'��R50N,PUTNAM C�O.1 N•`!. Jo NN LENMAN , �.Ef: r CONSUL`!'1NG L:.NC�IN,�ET� IOC':�ALLOWAY HEiGH'CS WASZWICK,N•V• !' aSi�.L.E'.1=500 i70.T'r =: 8- 22 -8to N -Y -LI C.NO.O5(oCoS3 �, b, t i. v�