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HomeMy WebLinkAbout1851DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -38 BOX 17 01851 all ,�, A i * , ` Lm .,. In OWL 01851 L:;F--DPO<DM 5 1 DD E- N1 c- E Vil 4-S' .3.5, 9011AT- 7 ARF--A 711" 0 N AS BUILT SEWAGE DISPOSAL SYSTEM SHEET .. ...... ...... 10T . ............ . ........ �uSL"T- 24 --Ave-spril4e, FIELDS REQUIRED= k-77 FT. 3<- IN, WIDE TRE,".'CH FIELDS INSTALLED= : •7 F-, 3,- IN. WIDE TRENCH SYSTEM INSTALLED BY: DATE:• Ate, 21; t9?.:t. SCALE: V-20' Toe A- APPROVED, NOV 2 21972 12MV11 411.IEA.LTI EMRONMMAL HEALTH SERVICES ,. PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental: Health Services, Carmel, N. Y 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE. FVR"SEWAGE DISPOSAL SYSTEM Patterson Town or Village Located at Lake spring .Drive Section Block Richard Lnqus.t,` sublot #24 Lakespring.Meadows Owner Lot Job Separate Sewerage. System built y. Address BreWste , N.Y. C conce 177! 36►► Consisting of 900 Gal, Septic Tank lineal Feet X width trench ;Other requirements Water Supply: P.ubhc Supply, From X P.F. Beal & Sons Private Supply.- Drilled BY Address Brewster, '.New. York Building Type Residence No. of Bedrooms 3, Date Permit Issued Has 'Erosion Control Been, Completed? . y' y se. of the "completed work (copies of which are I. certif )that then stems as listed.servm the above premises were constructed esselSYially a rr£_a t�R Putnam County ,Department ;of Health, attached), and in accordance with the standards, rules and regulations; plans filed and 't J ` :Q November 22, 1972 ; Date Certifies! by P.E. R.A. t. :_Address Any person occupying premises served by.the above system(s) :shall prof conditions resulting from such usage., 'Approval of the separate ,sewe available and the approval of the private water supply'shall become nul subject to modification or change, when, _in the_judgment'•of the -Cor Date /e/t� / / By m License No.-1 " o4s2 tly take su ;ac on as yi r ' & urwthe correction of any unsanitary e,.system s I,t om@ flull'end i'' a as 'a public sanitary sewer becomes nq Jo. id wh, ublic wafer s pp mes available. such approvals are issioner of H, �. rW6eys ib" 3 nation or'change is necessary. { WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK ' >Thiy report =is to-be completed by well drikler and submitted to County Health Department-togetKdi; 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 PATIL ON BUILDERS IM. ADDRESS LAKE SPRING MEADOW3 T019N OF PATTERSON LOCATION OF WELL (No. & Street) (Town) (Lot Number) MEADOW, TOWN OF PATTERSON NLV YORK PROPOSED USE OF WELL NESS ® DOMESTIC ❑ E TABLISHMENT ❑ FARM ❑ TEST WELL ❑ if ) SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING El (Specify) DRILLING EQUIPMENT COMPRESSED CABLE HER ❑D ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ OTHER ) CASING DETAILS LENGTH (feet) 20 DIAMETER(Inches) WEIGHT PER FOOT Ib THREADED ❑ WELDED tlE SHOE YES ❑ NO CASING YES ED? TI NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED ® COMPRESSED AIR f ive 12 GPM YIELD (G.P.M.) 12 GPM WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [lest) Depth of Completed Well in feet below land surface: SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS 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 3 Drilling in overburden - earth Hit solid rock at 3 ft. 3 20 Drilling in rock - settin 20 1240 Drilling in rock - If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 7/20, DATE F REPORT 11%21/72 WELL DRILLER (Signature) B L tQG O IN Richard Lindquist Owner or Purchaser o . Bui idi.ng Paulson Builders Building Constructed by Lake Spring Drive Location - Street Residence Building Type Patterson Muni c ip al i ty Section Block Sublot #24 Lake Spring Meadows 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 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. S,,6J'ec4 Dated this day of J E V" 19Z Signature�� Title If corp ration, give ame 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 of Environmental Health Services, h. pPutnam County Department of Health T W"11 h a� je, to des,,�Ie, �or L4am,& je.0 ci one. �a i ve k)4Y -� 4 IcAt, h x lnconve-n,'ehee�_ �1)��wfioh Or e)64 r;, AP411?? UI�t �Q rte°, BREWST,ER LABORATORIES WATER ANALYSIS REPORT SAMPLE No. 2832 SOURCE: Paulson Builders, Inc. hose bibb - well supply Lakespring Meadows Lot 24 Patterson, N.Y. COLLECTED: Novo 14.. 1972 BY: Paulson Builders, 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. Nov. 18, 1972 0 per 100 ml. s Roy Bickwit P. E. Director PUTNAM COITNTY DEPARTMENT OF HEALTH Sewerage,-System �IV Municipality CONSTRUCTION PERMIT Located Section Block Subdivision J,Aar- sa& iV&. ft_/iPc VS Lot Job ' Owner h�,Q '� R. f Sit R�i> AddressAop/ L�IVF, . S2MF T ;VLot Area Building Type No. of Bedrooms ¢Qu2) Total Habitable Space -0 �' sq.ft. Separate .Sewerage System to consist ofIZOO Gal. Septic Tank 23 lineal feet width trench luo be constructed by Address. 'dater Supply Public Supply from Private Supply to be drilled by Address Other Requirements I repr-e.sent -. that ..I am. wholly and completely responsible: for the-design and location of the propoded system(s)': 1) that the separate sewage �a dis osal s stem above described will be constructed as soon "t - pro eed p. an ,or approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satis- factory 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 assurance of the approval of the Certificate of Construction Compliance of�rgnal system or any repairs thereto; 2) that the drilled well ��cr�b�e� �bDve will be .d located .as shown on the approved awn and tFiat% ' wel'1 �Ta4.T1 be installed in a.c and ca with the s.tandards,prules and r�e�, a.t�e��`so��{ th'e Putnam County Depart nt of Health. Date !.L Signe' APPROVED CONSTRUCTION: This approval expi e q ua from the date issued urLYess construction of the building has` b .b eV a.ken and is re- vocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or.alteration of construction requires a ne permit.. Approved for dispos .of domestic sanitary sewage. Date � �TG' By ASeparate PUTNAM COITNTY DEPARTMENT OF HEALTH Sewerage,-System �IV Municipality CONSTRUCTION PERMIT Located Section Block Subdivision J,Aar- sa& iV&. ft_/iPc VS Lot Job ' Owner h�,Q '� R. f Sit R�i> AddressAop/ L�IVF, . S2MF T ;VLot Area Building Type No. of Bedrooms ¢Qu2) Total Habitable Space -0 �' sq.ft. Separate .Sewerage System to consist ofIZOO Gal. Septic Tank 23 lineal feet width trench luo be constructed by Address. 'dater Supply Public Supply from Private Supply to be drilled by Address Other Requirements I repr-e.sent -. that ..I am. wholly and completely responsible: for the-design and location of the propoded system(s)': 1) that the separate sewage �a dis osal s stem above described will be constructed as soon "t - pro eed p. an ,or approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satis- factory 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 assurance of the approval of the Certificate of Construction Compliance of�rgnal system or any repairs thereto; 2) that the drilled well ��cr�b�e� �bDve will be .d located .as shown on the approved awn and tFiat% ' wel'1 �Ta4.T1 be installed in a.c and ca with the s.tandards,prules and r�e�, a.t�e��`so��{ th'e Putnam County Depart nt of Health. Date !.L Signe' APPROVED CONSTRUCTION: This approval expi e q ua from the date issued urLYess construction of the building has` b .b eV a.ken and is re- vocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or.alteration of construction requires a ne permit.. Approved for dispos .of domestic sanitary sewage. Date � �TG' By COUNTY OF WESTCHESTER DEPARTMENT 'OF HEALTH - Division of Enviroinmental Saz d.tation DESIGN DATA SHEET - SEPARATE SEWAGE SYSTEM FIIB NO. Oyer flR EA% 9.1 51,AF12 dress Af ®Pt 4 NgF. SO .� Located At (Streetw c Mock Lot (Indicate nearest cross street) Municipality°. `E AN" p Watershed +. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMLTTED W� TH APPLICATION ftn - Elapse Depth to Whter water Level. No. Time From Ground Surfam in Inches' Soil Rats Start Stop Min.. Start Stop Drop in Min/in.drop Inche.T Inches Inches l a 3 0: /0:7 1 A:,1 4 5 19, 30 Notes: 1) Teats to be repeated at one depth until approximately equal soil rates acre obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole . 24" i 60", . F i x/.15 ro DE GN ; ;;.. Hbil Rate IIsed �!` - q,r,MMnA" Dropo :. 4o4- Usable Area Provided Noo; of BedmsF o,, ;; �Sptic Tank Capacity 0 , Gals., Nlasoruq R a : Absorption Area Provided By& LoFac 36 ". N€i+�e Other. `v0 60 Name—B1859 ASSOCIATES. Sift CONSULTING ENGINELRU Address: C2oLDENS BRIDGE, N. Y. may, . r'�F•ys ha .:35022 ����a '. We:stchester Count► Health Department Soil Rate Approved Sim < Ft. /Gala Checked by Date S,Do 2706 (Rev. 5 ®24®66) (Febraary 189 1969) r—