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HomeMy WebLinkAbout1824DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -1 BOX 16 01824 so t: -'ro rr F-1 - .. 1, am -L to ti I .. I if 16 01824 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel. N.Y. 10512 Engineer to Provide Permit q on CERTIFICATE COMPLIANCE��{ CO TR ON PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit IY,# -- Patterson ��LL Locked at Old Route 22 Town or village e_ Hill «. 1t; Subdivision Name Apple �ubd. Lot M Tar Map ..y Block' « sMr ` Vincent Tomasina & -.` Francine Cavalegenewal —C- Revision ❑ Owner /Applicant Name 6/2/87 Date of Previous Approval MaWng Address 14 Fairview Road Town Carmel , N.Y_ ZIP 10512 Carmel. NY 10512 Building Type single family resiJgnjta 44,777 sq. ft. FWSectionOnly Lj Depth Volume Number of Bedrooms 3 Design Flow G P D 600 I PCHD Notification Is Required When Fill Is completed Separate Sewerage System to consist of 1000 Gallon Septic Tank and 500 lin . f t. disposal trench To be constructed by Art Burdick Aadresa Joes Hill Rd., Brewster , NY Water Supply; PdbUc Supply From Address s ors X Private Supply Drilled by P. F. BeallAd,�� 4 Putnam Avenue, Brewster, NY Other Requirements 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 thedate 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 Install in a cordance with the standards, rules and regu aT73ns of the Putnam County Department of Health. Date 6/2/89 Signed - - P. E. R.A. Address 17 River Street, Wdrwick, NY 10990 License No APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a ew Permit. Approved for disposal of domestic sanitary sewage, a r rivate water supply only. /87 Date -- Title (� PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 3186 \\"\ `' Division of Environmental Health Services. Carmel, N.Y. 10512 Engin eer to Provide Permit N on CERTIFICATE OF COMPLIANCE .... - CONSTRUCTION.PERMIT FOR SEWA LSPOSAL SYSTEM Permit,. # - - Lac" f Old Route 22 Patterson aewn or Village Subdivis Apple Hill ion Name cubd. Lot 111 14 Tar Map Block rot Owner/Applicant Name Loft Corp. Pump House Road, Brews telRjmeWal —❑ Revision ❑ Date of Previous Approval Mailing Address Pump House Road, Brewster,NY Town 7Ap single family residence 44,777 sq.ft. Building Type Let Area FM Section Only Lj De th Volume Number of Bedrooms 3 Design Flow G /P /D 600 P PCHD Notification is Required When FIil Is completed Separate Sewerage System to consist of 1000 Gailoa Septl,, Tank end 500 Lin. Ft. disposal trench To be constructed by Art Burdick Address J-oes Hill Road, Brewster Water Supply; pubilc Supply From Address or: X Private Supply Drilled by Ad r 13 IE t- _Address - JOY ryr. hr) Other Requirements represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 thedate 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 cordance wi the standards, rules and regu a iT oi' ns of the Putnam County Department of Health. Date 4 -7 -87 10 Galloway neig 6b53 R A. — Address License No APPROVED FOR CO revocable for cause of requires a nev/ perry{ Date This approval expireddtwe year from the I or modified when considered necessary I disposal of domestic sanitary sewage, . building has been undertaken and is shah a .or alteration of construction Rev. 3/86 Located PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Mast Provide . P 51-87 P. C.H.D. Permit n - - -= OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSithfd Patterson, Town or Village 0 S S da / Tax Map Block Lot Owner /applicant Name t7C2hILdr'1' Formerly< Subdivision Name Awe Sabdv. Lot 11 14 Mailing Address 14 F a 2-Ar i e ' Rrl. zip- 10 512 Date Permit Issued Carmel, NY Separate Sewerage System built by Address Consisting of 1000 Gallon septic Tank and 500 Lin Ft disposal trench Water Supply: Public Supply From Address or: X Private Supply Drilled by �• Address �t+lTflCtiY�VQi1b1Q �jYQbt:S]Pr N� Building Type Sing l P ram Re s i d Has Erosion Control Been Completed? VP_ G Number of Bedrooms 3 Has Garbage Grinder Been Installed? No Other Requirements I certify that the system( of which are attached), an Putnam County Department D Date premises were constructed essentially as shown on the plans of the completed work ( copies rds, rules and regulations, in accordance with the filed plan, and the permit issued by the Certified P.E. Y R.A. ;'Addresij',�i License No. ^—v sT Any person occupying pram ' qve (s) shall promptly take such action as may be necessary to secure the correction of an unsanitary }s�s serva`d "by= tTiA'ab Y conditions resulting fro m su W'A.segC, Approvitip separate sewerage system shall become null and void as soon as a pub('. sanitary sewer becomes available and the approval of �pSyate'aYaler su Rj all become null and void when a public water supply becomes avallabl& Such approvals are subject to modification or cha t p, ')ti; �� ment of the Commissjoner of Heal such revocation, modification or change Is necessary. Date Title 4 PUTN/>ull C tjNTY. DEhA /lL �COIIikET1.0 0 I#TMENT, OF H� MF6POR.t �W I� y i 'E::.i 1 ` +i'I:;,. I' 7 °s,; ' • i DivWc of Envlronirh+ti� Ntiilth 0-jrvlon'4i� (.. COUNTY OFFICE BOIL OINO - CARMELj' 'NEVN?VtiRK ' i� This report is to be completed by well driller and submitted to County Health De0artment together with laboratory report of, l is: Prater,.&& le. in"tin4w6tcW4tbf lWsfactor-y- Weterial• quality Galore certificate- of- constrLicti6hed 0 lloi�.f3 " REPORT MUST BE SUBMITtED WITHIN 30 DAYS.OF WELL COMPLETION,. '. NAME ADDRESS �W".0 J `& P Develo ment Corp; 10 Gallows Hts, - Warwi'ck .: NY 10990 LtiCAION (No. a Street) (Town) Lot #14, Apple Hill Sub, y Patterson NY ' + BUSINESS L7 ❑ ❑ ❑ • DOMESTIC ESTABLISHMENT FARM TEST WELL t ' ibE .OP •. w PUBLIC AIR ❑ SU PPLY ❑ ❑ ❑ j •' INDUSTRIAL CONDITIONING (OSpeeify) .. r P R EOTHER Cl Op«E 'i,.1EQLll lii[NT 4 ROTARY A R. USSION J PERCUSSION (S ) .•.. • - CASINO LCNOTN (qit) DIAMET[R(fnoA/eJ WEIGHT PER FOOT 1. ❑WELDED NO „. ; ,bETAIIf 211 �. 6 " 19 lb s ,� THREADED T[S Y YWLD HOURS G.P.A. ❑ Z ❑ 1 LD ( ) ]EFT [AILED L PUMPED COMPRESSED AIR 6 v aMATRIt MEASURE FROM LAND SURFACE— STATIC(Speelf feet) Y DURING YIELD TEST leaf .) Dapth of Ceinplefid Well .. ``' :.,.r UvIlt p .: 22 t .. In feet bebw lend wrfaoie . '� ' �• r: MA E 1. LENGTH OP1N TO QUIFIR (l.�fj'; • , . IbEfAIlk IiL07 size bl TER (inch" If GRAVEL Diomet*r of well Including SIZE (inches) f O.(fNf) Ft , ,..t PACKED: grovel pack (Inc/IN):.. , . , ;n bli to F26M LAND SWAC/ Y Skotcn exact /oo.flon of war► wIth clhtaeeei, a. t $k* i t,r f1R to FEET FORMATION DESCRIPTION two retanenf /endenalce. pea :i•i Drilling iii ovetburden :. Hit . rock . at 6t Drilling in rockF set : 21 cOLgin e -21 A5 prillintz in rock --rani t e • If yield wet tested at dlAerent depths during drilling, list below FEET', GALLONS PER MINUTE ATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) 4 X10 8, 14/86- /.. �.., COT- MY'DIM R'iS4F'NT...O�, °` DIVISION OF ENVIRONNOWIAL HEALTH SERVICES Owner or Purchaser of Building Building Constructed by 8&L -S,, L Location - Street Municipality S 10L°� [eve 4 Building Type Section Block Lot Subdivision Name Subdivision Lot # GUARAb= 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 good operating ':condition `an�:.part: of._said system constructed- by- me- which- a' is t operate for a period of two years immediately following the date of approvaA the; "Certificate of Construction Compliance" for the sewage disposal system, or 'gny 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 utii. ng _ the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental 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 day of 19 Gener Contractor (Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 mk Signature Title Corporation Name (if Corp.) Address C, LIE - _ O'er ~` :a::. = -_� - ....;- �4- z2;.C�;.,...t..�- ._ �..K .�.>.._.,.. _. �I. _�� :..��.:.. • C:.i��r y ... D c-c r -= c5 '' c�JL Chi C� -" • - b_ F= t � sj ca - Dat-a c= p1ac =r = .ciC_rPTH; C- Tc --.L -� C_ E--e, �rSL e--c:- r C = —L='_ -=-a I wa— ai 11 — :_ F= cam_ - ---- -'� -• =c -�' scT? � = ="_ =� �L-z � = �-= = -- -=s 2 = _ - c r _ T_ La1L_CN _ Tom- Tc =Cth D;_= 7z = -_c= _ -- - ' .1 __ _ F � mac._ E '•.sue- _C =--' - - - - - .... ... .. �j h _ —F-:f CR DS = 5_ Cf c_u C== /a7 C - _ c? = tc c First h-c. _C'4 ca c c_, e c_ _ � I .4-- c_ h-7-6d i 1 1 u. tr�i 1 1 = a1 C`r = =i 1c SAC:. ^_ES < A . in .�7 C-= C-.crC° c��cV :52` a I 1_ �__ =ce we __ C.CL= r -.�ca =cE =�.�•' . _Y �__., � =; _ 1 r WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 .. Division .ot..Enviraninenteil'Naelth "Services �Y. 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 SUBMITTE® WITHIN 30 DAYS OF WELL COMPLETION DRILLING NAME COMPRESSED CABLE ADDRESS EQUIPMENT OWNER J & P Development Corp, 10 Galloway Hts, Warwick NY l( 0 LOCATION (No. A Street) (Town) (Cot Number) OF WELL loot #14, Apple Hill Sub, 9 Patterson, NY 19 lb s a XD NESS ❑ ❑ ❑ PROPOSED DOMESTIC EST BL SHMENT FARM TEST WELL USE OF DURING YIELD TEST fleet) 1 LEVEL 301 WELL ❑ Y ❑ INDUSTRIAL ❑ CONDITIONING OTHER SUPP DRILLING COMPRESSED CABLE EQUIPMENT 91 ROTARY AIR PERCUSSION ❑ PERCUSSION CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT K, THREADED ❑ WELDED DETAILS 1 T 611 19 lb s a YIELD ❑ HOURS ❑ ❑ TEST TEST BAILED PUMPED COMPRESSED AIR 6 WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST fleet) 1 LEVEL 301 2251 SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: DEPTH FROM LAND SURFACE FEET to FEET FORMATION DESCRIPTION Drilling in overburden Hit rock at 6.1 Drilling in rock, set If yield was tested at different depths during drilling, list below FEEL I GALLONS PER MINUTE ATE WELL COMPLETED I _. DATE OF REPORT `WELL DRILLER (S 1. /- -. /_. r_ , r.. OTHER (Specify) YES LJ NOl L-N YES LJ NO Depth of Completed Well In feet below land surface: 7 ), K t Diameter of well including — gravel pack (Inches): Sketch exact location of well with distances, to at least Two permanent landmarks. YML Environmental LAB NUMBER �g3 •oa590 :.. a Services DATE /TIME TAKEN f I3 � , 3 0 ..:32,1-:Kear:.Street Yorktown.:Hei hts ,.NY IOSg8,;.:_ D.1QDATE %TIv S- FLAP #10323 - " ' (914) 245 -2800 DATE REPORTED N. 0 1992 13LpSSUrn COLD BY I C ,A &,,e NOTES P-� e - '? / 3 ;L D K "-1 -� ? -- 355 X RESULTS OF ANALYTE WATER TESTING RESULT UNITS pH ALKALINITY S.U. mg/L PHOSPHOROUS AMMONIA mg/L n-g/L SILVER CALCIUM mg/L mg/L SODIUM CHLORIDE mg/L rrg/L SULFATE COLOR n-g /L Units SULFIDE CONDUCTIVITY rng/L umhos /can SULFITE COPPER rrg/L rr�;/L TURBIDITY CORROSIVITY NTU LSI ZINC DETERGENTS mg/L. mg/L Y - FLUORIDE mg/L HARDNESS mg/L IRON mg/L LEAD mg/L ISPC MANGANESE per 1.0 mL mg/L TOTAL COLIFORM MERCURY mg/L per -100 mL NITRATE FECAL COLIFORM mg/L per 100 mL NITRITE E. COLI mg/L per 100 mL ODOR FECAL STREP. I TON per 100 mL SAMPLING SITE For Lab Use Only Potable _ HNO3 _ pH LT 2 X <4C _ Nonpotable _ NaOH — pH GT 9 _ <20 >4C _ HCl _ Na2SO3 _ >20C _ STAT! H2SO4 ZnOAc COLOR IET11?# USl~1"3 X RESULTS OFWATER TESTING ANALYTE RESULT UNITS pH S.U. PHOSPHOROUS mg/L SILVER mg/L SODIUM mg/L SULFATE n-g /L SULFIDE rng/L SULFITE rrg/L TURBIDITY NTU ZINC __._..... mg/L. ISPC per 1.0 mL TOTAL COLIFORM per -100 mL FECAL COLIFORM per 100 mL E. COLI per 100 mL FECAL STREP. per 100 mL These results indicate that the water sampl [WA ] WAS NOT] [NA] of a satisfactory sanitary quality according to the New York State Sanitary Code, for the ram rs tested, at the time of sample collection. These results indicate that "Codersr mple [WAS] [WAS NOT] (NA) f a satisfactory chemical quality according to the New York State Sanita the parameters tested, at e ti of sample collection. SUBMITTED BY: Albert H. Padovani, M.T. (ASCP) Director NA = Not Applicable N = Not Present (Negative) P = Present (Positive) SA = See Attachment(s) ' = Also done because Total Coliform was present TNTC = Too Numerous To Count > = GT = Greater Than < = LT = Less Than _-,a ` � PU'iHAM COUTITX DEPARTMENT OIL HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -.:_. _ �. r:.. �:.,. r..e.�_,�.�:�.,_�..;.- �,C`Ot��= OFD' I�E�- ••BUII�DIT3�r'o� <��T�I��j:.:,1� Y•.�- �-- �.0.�1�_.,.. _ -a -._ ... ;.urw_=,F.._�... <�. �...,..._.,.. y . - DESIG14 DATA SHEET- SEPARATE SBIAGE DISPOSAL SYSTEM PILL; NO. — Ow'ner �l.�is2�►A4� —. Address pi- 2Z Located at (Street �'IEI_lcar,e �y6�FLAA L- JF __,) • tU`3 - 131oc1c_ �s� Lot nearer cross s� z °eet Mun.Lcipality Watershed SOIL PERCOIATION TEST DATA RE0UIR';'D TO BE SUBMITTED Wl`. H APPLICA'T'IONS II-o-1-0 __ . -- -I �? 1-w -0 14._ 1\1 Li bm CLOCK TIM]". PERCOLATION PLRCOIATIOAT lzLin -aa.p3 DepLii ;a� 1 ei:�. Level 140. Time. 'Time. From Grourid Surface in Inches Soil Rate Start -Stop Ivti_n. Start Stop Drop in Min./in drop Iriche:s Inches _[riches 33: -41, — 0. 2:!L_ _Z4 ___t_ wh 11 9 3 - Il Notes: 1) Tests to be repeated at sate:: cieptlz until :.,ml >roximatel."y equal soil. rates are obtained at each percolation test hole. Al data to be submitted for review. 2) Depth measurements to be made from top of hole. yr.Y ' TEST PIT DATA REQUIRED TO BE SUBMITTED W1111I APPLICATION DI{,SCR IPTICN OF SOILS ENCOUNTERED IId `.['.CST HOLES ... . - ., .. DI;PTI•i•.rK._ THOLE:- :.Np;, r ....m...._.. t- .o . , . .. .. r ''ROLL" �V�. — G.L. `TOQrz!o l l- • .- 1211 i8'' 24 3011 -t"i�J C_I...d Y 4/V 3611 42" 4811 V(11 60" 66" 7x)L 11 7811 8) 11 INDICATE, LML AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO .ITHECII SLATER .LEVEL RISKS AFTER BEING ENCQUNTERED . TESTS Inl1DE BY :2Gt jR.ElSt � 4. �..�" L Date. 1Z I � ► —� DESIGN Soil Rate Used 3o Min, /1 "Drop: S.D. Usable Area ProJided -rl75�,Q No. of Bedrooms 3 Septic Tank Capacity 1 000 Gals. Typo 5z. �, Absorption Area Yrovidcd D 50a L.F.x21l" �6'r� _cr dt i trench. t. _• ,tip, .1c�L Sign lure L� � A.adress io �e�.�� o��'�S' SIAl, cr ` RIS SPACE FOR LISE 13Y 1IFALTII DEPARTMI,I T ONLY: Soil. Rate Approved. Sq. Ft /Gal. Checked by O: G E '.CeinrdP�, Date - PUTNAM COUNTY DEPARTMENT OF HEALTH . . Division of Environmental Health Services APPENDIX L AFFIDAVIT — CORPORATE OWNER APPLICATION - - '� : �- •FOR'PER,`S�AE.PL- iCAT.LONr SUgaITTED TO _... .,..- PUTNki COUNTY HEALTH DEPARTMENT ..__ TO: Commissioner of Health In the matter of application for: represent that I am an officer or employee of the corporation and am authorized to act for L O i- 1 `. e ►'t (Name of Corporation) having offices at Whose officers are: President: Vice — President; Secretary: ;��a e tip... (Name and Address (Name and Address _._...____.._ Brame ana aaaress) _.._.... Treasurer: and Address) - and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts-relating thereto. Sworn to before me this a day Signed: of 19 Xf Title Notary Public ANNE M. MAHONEY Notary Public, State of New York Qualified in Putnjn County Commission Expires lurch 30, 19 8/84 %-,urpucaLe meat R LNL).LV.LUL1ftLj YVM-LrAr. OU� REVIEW SHEET CONSTRUCTION PERMIT I.. . ,, A, . I ..0 DATE BY: 'Owndr) (Street Location) ) Ea., _ I).. ...DOCQMENTS —Peraut rPOrate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep Hole Log Perc S Consistent Perc Results (3) Fill Perc Hole Depth cd LF trench provided L3 required 60 ft. max. Parellel to House Plans - Two sets Well permit; PWS letter Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex-approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & -Dirrensions - Volume D or J Box;Trendi/Gallery; Pump'pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes .Design Data: perc and deep results Two-Foot Contours Existing & Proposed Driveway & Slopes Cut Footing/GLitter,Curtain Drains (discharge OK) --Perc-&-Deep.Holes Located Repiesehtative of prinoxy. and,_ expansion Expansion Area; shown; gravity flow, suf f s:Ci6 - If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells &.SSDS's w/in 200 ft. of Proposed Systems, Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1/4"/ft. 4"0; Type pipe No Bends; Max. Bends 45" w/cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 101 to P.L. Driveway, Large Trees,Top of fil; 201 to Foundation Walls 1001 to Well; 2001 in D.L.O.D, 1501 pits 1001 to Stream, Watercourse, Lake (inc. expan, 151 to Drains-Curtain, Leader, Footing 351to catch basi'n,stormdrain,piped watercourse 10, to Water Line (pits-201) 501 intermittent drainage course Septic Tanks 10' from Foundation; 501 to well 151 Well to PL 9 T!