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HomeMy WebLinkAbout1741DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -79 BOX 16 01741 Q �,,:. r ENG :I "NEER MUST PUTNAM COUNTY; D9PARTMENT OF :HEALTH PROVIDE Division of Environmental Heeith .Services, Carmel, N.. Y. 10512 PERMIT .# CERTIFI TE OF CONSTRUCTI,ON._COMPLIANCE. FOR SEWAGE DISPOSAL SYSTEM P -13 -86 Town or Village Old Route 22 4 Located at ,, �G.f""���L+L�. -.+ Tax Map 69 Block owns► Apple HIll 'Dev Crp / P- ..,y J. Monasch Tax Map Lot 0 suba. Lot X18 Separate Sewerage System built by N. Peragine Address RD #1 Wingdale, 'N. .Y. Consisting of 1,000 Gal. Septic Tank and 430 Lin. Ft. Disposal Trench jp Other requirements f Water Supply: Public Supply From X Private Supply Drilled By P.. F. Beal, &Sons a r Address 4 Putnam Ave. Brewster., N. Y.'' Single Family Residence 3 3.6 =86 . Building Type No. of eetlrooma Date Permit Issued �. Has Erosion Control Been Completed? yes Has garbage grinder been installed? No 4 i certify that the system(s).as listed serving the above'premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the`standaids, rules and regulations, 'in accordance with the filed plan, and the permit issued by the . Putnam County Department Of Health.. ,r P:E. RA. Date 5 -14 -86 Certified by Address 10 Gal -lowav 'Heights: Warwick. 'N. Y. 10990 License N ;12 Any person occupying premises .served by the above system(s), shall pro tly take such- action as may be,necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the sepa►afe sew ge system "shall,becorno null-and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become and old G. public 'water_ pply becomes available. Such approvals are subject to modification or change when, in the judgment of the mif ner ea h, 'such revocat n, modification or change Is necessary. �. Date By Titl A�' Rev. 6/65 \._. 5 ENGINEER.,TO..PROVIDE PERMIT # PUTNAM COUNTY- DEPARTMENT OF HEALTH ON aERT FICAi OF COMP L E. Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT � v CONST TION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson Town or illage Old Route 22 Block Lot Located at Tax Map Apple i Subd. Lot # 18 Renewal _0 Revision — C3 Subdivision Apple Hill Dev. Corp. 10 Galloway I? Date of Previous Approval na Building Type Single family res. Lot Area 5�•2iMU sq. tt Number of Bedrooms 3 Design Flow GlPeD 600 Fill Section Only ❑_ P. C. 0 Separate Sewerage -System to consist of 1, 0 Gal. Septic Tank and To be constructed by N. Peragine N. D. Notification Required 430 Lin. FT. disposal trench Address RD Al Wingdale, N.Y. —Water Supply: Public Supply From X Private Supply ,to be drilled by P. F. Beal & Sons `^ � " ,'�P, itnam Ave i Brewster, N. Y. Address Other Requirements 1 represent tFpt,l,ii n"whoily "arid icompletelyresponsible for, the design and location of the proposed system(s); 1) that the separate sewage disposal system above descnted twill be;ctindtructed,as' shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam County Department of>~4Health, and,that on completion thereof s "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a written .guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said 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 installed in accordance with the standards, rules and regu a ions of the Putnam County Department of Health. Date 3/3/86 Signed z,.,Zz-� P.E. R.A. Address APPROVED FOR CONSTRUCTION: This approval expires one year.from the date issued unless onstruction of the building has been undertaken and is revocable for cause or may be amended or modified when co . d necessary by the Com oner f Health. Any Chang tion of construction requires a new permit. Approved for disposal of domestic sanita sewag and /or priv water s ply on[ . - -- By Title Date Rev. 6/85 WE'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 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. d Street) (Town) . (cot Number) Lot #18, Apple Hill Sub., Patterson, NY ey PROPOSED USE OF WELL RX DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑TEST WELL 1:1 SUPP Y El INDUSTRIAL ❑AIR ❑ OTHER CONDITIONING (Specify) DRILLING EQUIPMENT COMPRESSED D ROTARY � AIR PERCUSSION ❑ CABLE ❑OTHER PERCUSSION (Specify) CASING DETAILS LENGTH (feet) 211 DIAMETER (inches) 611 WEIGHT PER FOOT 19 lb S © THREADED ❑ WELDED E O X YES ❑ NO LN YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED ❑ COMPRESSED AIR 6 6 YIELD (O.P.M.) 6 WATER LEVEL MEASURE FROM LAND SURFACE— STATIC(Speclly lest) 301 DURING YIELD TEST (feet) 325' Depth of Completed Well in feat below Land surface: 3451 SCREEN DETAILS MAKE IEMOTH OPEN TO AQUIFER (lest) 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 6 Drilling in overburden clay and boulders Hit rock at 61 6 21 Drilling in rock, set casing, routed 21 345 Drilling in rock granite. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 4 29/86 DATE OF REPORT 5/14/86 WELL DRILLER (Signature) /I V R =25.00' e =4W 11'2 L =21.03' 1� Sr=PT%C AUMA \1 I R- 55CC�� ��00 � D =10 1' 23" L =154 1' ��� �✓\ , StvIt _x31 G8�►. Ce�2 -0 m 5otL LOG Oa- & , 'T'OpsovL. 30 =vol" -InAt WISIuT4 GRANSt. xv-s -n N6 TONE WAIL -L 1 / 1, I 34(o.e9' Moro \ / /k / o �t Putnam County Department of Health SEPTtC SYS'T�1vl Ana - C�U1vr" Dial 1;1ion & En ro al Health Servioes A oved s no a or niormanoe with a licable Rules and Regulations of the am joun rth' D p rtment .� i PA- iTslksow, , vu-r NAM co., W Y. ION. RAM L4 FT f TRENCH PR01 OWD -430. Lure & T tle Dite L T 1 AREA = 6 e WSO SF ± REV 1Se� 3 -'Z� -86ei ( n e TA -D 1 Wr. ,b0x. ) .Iaw,1 LTA - mbata >.a. 1 CONSIa�TIT•IG %N6e11\lEtci� 10 G b. -vOWAY NNARW1C.K ttNY. 1 "= SO' "T�PATE . 5 -13 -860 i�l Y. L1 C. 14-A 0.OSe<0S3 BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6163 SOURCE: J & P Development Apple Hill #18 Brewster COLLECTED: May 14, 1986 BY: P. F. Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method Q per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. n lviay 19, 1986 Bickwit P.E. Director Apple Hill�.Development Corp. Owner or Purchaser of Building J & P Development Corp. Building Constructed by Old Route #22 Location - Street Patterson Municipality 69 Section 4 Block 6.4 Lot Apple Hill /J. Monasch Subdivision Name Single Family Home 18 Building Type Subdv. 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 of the Putnam 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 ,Fl14114 day of May 19 86 Signature �jLt Title Vice Presiedent Apple Hill Development Corp. Corporation Name if corp.) 10 Galloway Heights,Warwick, N.Y. 10990 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 k. 1 i PROPOSEt� Ex�S -C1 NCB SVEPT \C AREA STOt1>= W Au 5 8°42' ► "E 34Co .8°)' h, z -j posE:O NIwe%-X- Yf La \ I R- 25.o0' \ \ \ I I e4 Lam- 94 li 23 \\ /�� �1 ►°�0, ,� Nom' �\ �'y1�.� \ \ _ r S r' , , 61Nh0 5� / �j / / / �' 0 as R less FNE a N'i2° tj 5' S "W 10 . I T N(o °52 N'T I 14 Co° ► OT.1 ��O � p O,Q Putnam County Department of IieajvU 7 Division of Environmental Health Serviceb ApQLE 1-kll r . SO1 L LOG q: 'approved as noted far con•~o��aarce with �%�/�LOPM� �=;,�� Ui ow- Con TOP SG71 L .y ��r .$g�� �� \\ � .� a c�.ti.? E' - es :i Y s .�..:'3rS..°�,.F l Er��'�S i/1 O�iCm �.' Co - SO TAN CLA`C LOAM 4 PA- TE1tSOi.1,17UTA►AM C.O. Ys o6. Be io2" CLAD w IS 1L-r 4 partwat ' GRAVEL r���t �s� . �� Joy -�►t.► L�unnou,�.E. PERCOLATION RATE LOT 16 CoNSULTII.IC-� 'rCNEa1t�1E1cF� 1-7 MUN. / %MC" AFZEA = 58880 SFi' 10 C- �AL`.OW/AY 1- 1E16K�5 LIK.FT (-iR>= t4C�-1 RECD. - 430 W AFzW 1CK LIN.FT fTRENCN pRpVIS�ED-430 5C[�.`�•. 0-S0' : N �!. L1 C.NO. OS4oh53 W0 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. OwnerAppLg N /LL DEV LnPNisvr Address OLD 12nca-- 2Z Located at ( Street )S.pR i U r, K E Sec . Block _Lot (o .4 (indicate nearest s ree Municipality PATT'ER50j -4 Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 'Pa aPoSEQ L a T # 1 8 - - Hole Numberlg CLOCK TIME PERCOLATION PERCOLATION Run No. Start -Stop apse Time Min. Depth to Water From Ground Start Inches Water Surface Stop Inches Level in Inches. Soil Rate Drop in Min. /in drop Inches 10:55 , 1L 114 19 23 3 211:/(6 Z6 a3% Ca 1yg 3 3 112-7-11--.55? 2/ ay %.. ;L7 A. 3 4 0 -11' -rAPSpI L / �. - 36" CLAD/ LOAM k j/S 1 LT C GRAUGL 158 110'.52 - 3(3 19A 2AY4. 2Y 211:2y- 11: Sy 30 -l' /� 3 11:56- 12'Z6 30 1 XV 17 4 O -1Y ToP.sh L 12� "- a 8" C Lny W/S)L-r i GRAVEL 5 1 3 Pl1rNAM 5 .COUNTY Notes: 1) rates are for review 2) Teets to be repeated at same depth until approximately equal soil obtained at each percolation test hole. All data to be submitted 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 NO. HOLE NO. G.L. ToPsn) L- 6" -C 12" 18" 24" 3011 361f CLA 42" CsRAu l._ 48" 54,1 60" 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE.LEVEL TO WHICH WATER-LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY . DEM A Re-ST � j • LEkivYlAN Date DESIGN Soil Rate.Used 17. Min/1 "Drop: S.D. Usable Area Provided 5; Cnp No. of Bedrooms 3 Septic Tank Capacity -, Gals. Type C_on1cR&T-a Absorption Area Provided Byy3� F. x24 - th trench. „ pF NE er bignature Address H F- SEK ` uj)i,1'I 1 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: FQAR ° 66ti P��� OFESSION Soil Rate Approved Sq. Ft /Cal. Checked by Date