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HomeMy WebLinkAbout1798DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -5 -8 BOX 16 1 INS luho IN IN a J �9 . IN , I � . . '' . . _+. is i r -' �, ti � �i i t ' tii .r s PUTNAM COUNT a1,G z Division of En wronmeii z, f.„ .CONSTRUCTION P .ORMIT, FOR }$EWAGE;,DISPOSALj Located 'at r u 'Subdivision ) r / �j pp S]��ba Owner /Addressr Ufi /h O..i ��LL I'r /�ttQ. //lil�i� �d.14d t3uiltling .Type�,f2Lq[_l� 1 Lot Area_ Number?of Bedrooms ('Design FIOw Separate Sewerage System. to consist of ) O0 o be constructed by r ,T � !Water "Supply PubllC :Supply Fom ` Li Private SUPPly tO be tlnlled by ix ` -Address 4, r ;other Requvements 3 1; represent that 1 am wholly and completely`►esponsible for the .des' above (described will be construeted"as shown on •the approved ameni County - ;Department • of. Health, ,and that on completidn.thereof . b> be- wbmitted to ahe l)epartment;•;and a written `guarantee;w�ll_6 place in:,good .operating, conddion'any part 'i -s-a id- sewage disp ance of :the_ approval of. the Certificate-,o f: -Construction ;Complia `will be' located as shoyYn,on 66 approved plan antl that Said well will County Department of Health Date Sign' s' Address Riots/ a. Y:' iYe3I'i �., APPROVED FOR CONSTRUCTION Th�s;approval:exp�res'one,yi '`revocabl'e for cause or may be amended or modified "when coRsideri requires -a; new permit App oved" for it posal of dom41c Date By •`Rev 9 81,: - < r EPARTMENT OFHEALTH Permit a' U g . �lrti Services Carme/ N Y 10512 E M Pater -son p Town or illage TaX MaP Gi o Block. 2 Renewal �� Revision [3 " b 1✓StreJdPievious Approval a ` e Pi11.5ection P C A D �'NOtification Requrred} Septic Tank and \ L� .OY 'oZe% �i�¢nC, 4C,6 Ai+i f M Address Y�q �c�S1iI-�kar N,.y���l�y_:, location of. *the proposed systems) 1) that 'the Saba rater.sewage, tlisposal system hereto and in accordance wift",toe standertls,'r.ules an raga a �ons:o e - u narn j ic5fe', of CoristrijOi '6 Compliance'satisfactdry ' to the Commissioner of HealEhwill 'Shed the owner, his'successors; heirs`or- assiyns:by the`bu�ider, that <said'buildei will stemduririg'ahe period of two,(2) Years immediately following.thedate of the issu- the_original,system or any repairs thereto, 2) thaf the. lledSwell described above accordance wdh the 4tandiids r and regu a I`ons - of the Putnam A. P E• R j n the' date. issued .unless onstruction'of fhe' building figs been,'undertaken and', is i )saryby the,Comrni er of Health. Any , change,o % = alteration of construction" vag _ nd or.: pnvat T itle J -- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Z �ovembwe3 Re: Property of 'YVYLQA Wri-OCUL Located at Section Block -3 Lot Gentlemen: This letter is to authorize kWi C.�pflf��C�r a duly licensed professional engineer V/ or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system; to serve 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 nece$sary papers on my behalf in C V1111C1: L1VJJ w1 LI1 L111' ma L Lev anU to. supervise the cons -truc ciun of Sala system or systems in conformity with the provisions of.Article 145 or 147, Education Law, th Law, and the Putnam County Sani- tary Code. Pro RUZ - 4 -•,, ®E� d' F HEAL TY Very trul urs YW Signed . i V i wiv YL nor of Property Countersigned: � � ur 1'. Addr ss P .E ., , # D47911'9 279 - G 4-2S 4 1 C- �1'VYt -�+�Yl v 7� (OS2� Telephone Address Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.ENVIRONMENTAL HEALTH SERVICES OFFICE ,.,BUILDINC7- § ;--- CA- -RMEL; DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Jag,,s M. tylarrnh.rc, Address A,R 1—ak nUr lei" �rswst�tr Located at ( Street) �ut 5t aid g o j) Sec. Block _Lot ( ndica-Ce neares cross street) Municipality &: 1 -r. _c O N. Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE.SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth o a er Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 f;2N -1.`5 1 30 /Z16-3 2 l.'Sy -:ZlIg 30 BSI 2(11 2g 2 Ei 3 -2:74 0.43 4 , 1 2 3 DFPT. ±OF J JFALTH 4 5 Notes: 1) Teets 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. 5 !rte 2g 17 y 91,33 . 4 , 1 2 3 DFPT. ±OF J JFALTH 4 5 Notes: 1) Teets 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. V__ TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES .4 HOI . _ P—NO"' _.._...z�E ...- a - HOLE 1 D'1 H Ham: _. NO. V0. G. L. W 12" 18" 24" 30" 36" 42" 48" 54" 60" 66" 7211 78fl 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL T WHICH WATER LEVEL ES AFTER BEING ENCEftTERED TESTS -MADE BY "._�G ���"� c�� Date DESIGN Soil Rate U: >edMin/1 "Drop: S.D. Usable Area Provided '7cv C� No. of Bedrooms J Septic Tank Capac- -by. '1004,0 Gals. Type jaw Hr Absorption Area Provided By L.F.x24 "• ' `. " width trench/ Other Name /`„ ,. !k PF Signature Kke, V FTyv\, a C' •�'� Address 9 SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked bF Date 91� PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environme.-gil - Hesitl► Services, Carmel, N. Y. 10312 Permit # ` t CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEMp� n"x / / Town or Village Owner J. /�/ 4( ��� / Formerly Tax Map Lot # !y / Subd. Lot # �. A Separate Sewerage System b)uiillt� b �( by � ' Address�f Consisting of 1 D�i�Gal. Septic Tank and Other requirements e-3 , �� Water. Supply: Public Supply From T Private Supply Drilled By 46'm Address ��►^ h Building Type � � �LL !�� •a9,fe Has Erosion Control Been Completed? No. of Bedrooms Date Permit Issued-43--- 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 standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. 9 5 - P t& u1lr y a / [►qtl P.E. 100"' R.A. Data Address b1 ! � 1 ,• IV/ 1-0, 5Z-'f License No. 0-/' `7 / Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, In the judgment of the C misslo r of Health, such r , modification or change Is necessary, �-- Date By `� _ ' `�- Title Rev. 9 -81 J James Marrone Rn Owner or Purchaser of Building Section Building Constructed by Block Old Rca d (Hyatt) Location - Street P at ergon - Municipality Lot 01 rl Wnl rl PSt+.q tPC Subdivision Name straight ranch 2 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- . - _ -• - -- _- •...__.__�_...- ....._- - -. �..:o.. _ of the Putnam County Department of Health as to whethe _ r'r n . ot`the fail =- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the syste Qr Dated this day -of 19 Signature�� Title Corporation Name if Corp. 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 ` r BREWSTER LABORATORIES Box 124 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 5521 SOURCE: Classic Homes,, Inc. Well Old Road Patterson, .IVY COLLECTED: August 27', 1984 BY: Mill Drilling, Inc. BACTE_RIOI.OGICAL EXAMINATION Coliform Count, MF Method This molt ixdicatts the tour« of. the sample was of satisfactory sanitary quality tuhex the sample was collected. 0 per 100 ml. l� September 1, 1984 Bickwit P. E. Director WATER MEASUR: FROM LAND SURFACE —STATIC (Specify feel) DURING YIELD TEST fleet) LEVEL 30 365 SCREEN DETAILS SLGT S;15 DIAMETER (Inches) IF GRAVE PACKED: ATH F10A LAND SJQFAt;1 FEET r. FEET ; FORMATION DESCRIMON 0 6 Clay & boulders 6 365 Hard granite It Yield was trstrd of dinerent depth6 during drilhnq, list below FEET GALLONS PER MINUTE 200 2 300 V1 365 7 it 8/27/84 I Di�Jl>�3`6T nT Depth of CornplNed Well o in feet below land surfo:e: 365'5 L:NGTH OPEN TO AQUIFER ; :eetl GRAVEL SIZE (inches) FROM (root) TO fleet) GRAVEL Diameter of well including I grovel pock (inches): Sketch enact location of visit wrrh distances. to at least two permanent lenamaras. O �4 t �0 ".I : 1 1, T b Ltd ,Pres. -MILL DRILLING, INC. • — CODUTY OFFICC. BUILDING . CARMEL, NEW YORIC This report is to be eompleted.by well driller and Submitted to County -- Health Department together with laboratory report Of analysi;of water sample indicting waters, of sati:factorV bacterial qu5lity`before'eeruficate of construction.eomplianee is issued. REPORT MUST BE SUE:MITTED.WITHIN 30 DAYS OF WELL COMPLETIO.d ADOttE15 --- _ OWNER Classic Homes, Inc. lRoute 22, Brewster, New York 10509 LOCATION oFWILL (NO. i Streetl Old Road (Town) (LOI N✓ntoer) Patterson, New York BUSINESS ® C] 0. !<><OPOSED. DOMESTIC. ESTABLISHMENT : FARM, TEST WELL USE OF WELL SUPPLY tNOUSTEIAL D R CONDITIONING [SSpH ) DRILLING ROTARY OTHER � EQUIPMENT u AIR PERCUSSION PERCUSSION (Specify). • CASING Ut-GTM (1001) DIAMEIERfrnchesl WOLPHT PER FOOT ((� U11YE SHOE 0 ((WAA5 LA iNG CJ1�UTED7 DETAILS 20 6 17 THREADED WELDED ; n TES NO C"1 YES LJ NO YIELD HOURS G.T MI. F1 YIELD (G.P1.M.) _ . T EST LAILED LJ PUMPED COMPRESSED AIR 4 7 WATER MEASUR: FROM LAND SURFACE —STATIC (Specify feel) DURING YIELD TEST fleet) LEVEL 30 365 SCREEN DETAILS SLGT S;15 DIAMETER (Inches) IF GRAVE PACKED: ATH F10A LAND SJQFAt;1 FEET r. FEET ; FORMATION DESCRIMON 0 6 Clay & boulders 6 365 Hard granite It Yield was trstrd of dinerent depth6 during drilhnq, list below FEET GALLONS PER MINUTE 200 2 300 V1 365 7 it 8/27/84 I Di�Jl>�3`6T nT Depth of CornplNed Well o in feet below land surfo:e: 365'5 L:NGTH OPEN TO AQUIFER ; :eetl GRAVEL SIZE (inches) FROM (root) TO fleet) GRAVEL Diameter of well including I grovel pock (inches): Sketch enact location of visit wrrh distances. to at least two permanent lenamaras. O �4 t �0 ".I : 1 1, T b Ltd ,Pres. -MILL DRILLING, INC. I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONI;IEN'ISAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE N � -0 Owners ��1 Q�,�y,Y�yl.� Address�.'� Located at (Street Sec. 0U Block Lot n icatt nearest cross street) Municipality, �:�-U/% Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water a er eve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2 2��4� --3:ol 2I 2� 27 7 3S©1 3:22 21 27 3 _. 12:2/— 31? /e7 ,. � 2`7 2 38 z 55 I 2-4- -7 �C . 4 rn a Notes: 1) Tests to be-repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 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 SOMS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. :w. 12" 18" 24" 30„ 3611. : 4211 48„ 6011 7 84 INDICATE LEVEL AT WHICH GROUND WATER IS ENCO E INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTE C li' TESTS MADE BY to DESIGN Soil Rate Used P% —6M n/1 "Drop: S.D. Usable Area Provided � (� No. of 'Bedrooms Sep 'c nk Capacity Gals. Type Absorption Area P ed By�L.F.x24 � width tre hl. -77 (her as `�6 u .Name Address SEAL, THIS,SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal.... Checked by. �:�; s 4s,t�� t r',. ."'{'.'2•}.737- t',^'+'. 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