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HomeMy WebLinkAbout1852DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -40 BOX 17 i I y'L ., 1 1. 1 �Q%r ` I w III r 6m 1, . 6, 4 i 01852 _ Pu PUTNAM, COUNTY DEPARTMENT OF 'HEALTH �.• Diwsion - -or. Environmental Hea /th Seryrces, 'Calms %, N Y- 10512' 1 CERTIFICATE OF „GQNSTRUCTI.ON,.CO,AAPLIANCE F:QRvSEWAGE,_:DISPOSAL`SYSTEM P!attersori;: , Town' or 'villa`ge Located at T akP r1nC� Dr1Ve Section Block f r rn "Meadows e„ S Thomas Hughes Lot 22 P owns n b glob , John Coughli Brewster, New York' Separate Sewerage System uilt-�,by Address Cons,sting:of 1:200 6 I /Sept c�Ta k 33 f lineal Feet x- — 24'r width 4_rench 2 j4 Y Water Supplyi' Public` Supply' From ' Private Supply- DnlledBy P` F Beal & Sons Address Brew =5ter,`'New ``York Du I Re s idence ' Building Type p • - of Bedrooms Date'.:Permrt 1. 5�ued four NO Has Erosion Control Bieri Completed? t �� a ns of 'the completed work (copies of which are f 1 certify that the system ing the above premises s) as listed sery were constructed, es I (oGrrj� '�fi attached), and -in accordance with fhe tandardS, rules antl'regulations, plans fi �ja e' e t i b e Putnam C unty bepartment of Health: i Date ~r . . Auqu St. 2 -2 19 72 cetified py— R A _E% `1 s � Rout; 22 ` _ Golide`; r w •Y k 35022 Address =License No � Any person occupying premises` brved by the above systems) she'll promptly t , ac i`Hies m b roc ry toaecure the correction of any unsanitary ? conditions resulting from such usage Approval of the 'separate sewerage syst orl3Q b? d as soon as a:public sanitary sewer, becomes i available and the approval of tfie private water,;3upply shall become riulliand voi_ D` pply becomes •avatlatile. Suq. approvels are } subject';to modification.;or. change when, in the judgment of the Commissioner o I {F66E1� tion modification or change is necessary. I Da '. BY /''iG %' ���J Title ':; PT: TNAM COUNTY DEPARTMENT OF" HEALTH - S ®parate Sewerage S;ysterri J Municipality y .."CONSTRUCTION PERMIT Located at AICES PRilV j2dI VE Section Block Subdivision ( PRt, rr %7F14gnta1. Lot Job Owner fiR, #Rtr � Address 6,j /f 5OVe -e yLot Area j �{ '7(90 . . Building Type -PU f-2L F )< RF'51.26-1V c E- No . of Bedrooms t'att� Total Habitable Space p� sq.ft Separate Sewerage System to consist ofj. Septic 'Tank aS lineal feet' b .width trench. y `� To be. constructed by Address Water Supply Public Supply from Private Supply to be drilled by Address Other •Requirements ,, , J?v .I represent that.I am whol y.and completely respons.ible'for. the design • and`�lo_cation of .the_propo�ed.syotei4(s.).:.l) that..the ss_eV_a_raattee �s.ewwaage._dis- ...._..__ __... _poo &II syste��rt above described will be construct d:'as s own on ie' approved p -man or approved amendment thereto and in accordance with the standards., rings and regulations ,9I-f- the Putnam County Department of Health, and that . `on completion thereof a "Centificate.of Construction.Compliance".satis- fa'ctory.to the Commissioner of Health will be submitted`to. the Department, and'a writt.en'guarantee will be furnished the owner, his''successors,: heirs or assigns by the builder, that sa'i'd builder will place in goo d.operating condition.any part of said sewage;`disposal system during the period "of..two (2). years immediately following th -3 date of ,.the: i'ssuran'ce of the approyal of 'thejI-V,,ertif icate of C(instructior* Compliance . of yt , a� gi al system any rapA"irs thereto; 2) . that the drilled well ; dP-;sc"ri,.e,, r h`pve will be located' as shown on the approved awn and' at }dt wsl ws: be installed in accordance with the standards, rules and re�gu ati s df% tide Putnam County. Departmen f Health. yy Date 20, /% 4.igned { APPROVED 0 CONSTRUC`ION.. This . °s:zpproval e:� o _a��'�''rom the date issued unless cons tr ct 'c n of tie building has xM' -2 n' en and is re- vocable fo'r cause o.r ms.y .be amended or modified whi6f?r- cdrisi9ered necessary by the Commissioner of Health. A-,:�y change or alteration of construction requires a new permit. Approved _'or disposal f domestic sa.itary sewage. Date R4, 117' 13, as /mil a(l i APP lzoVED SEP2 01972 PUTNAM COUNT' orpl* OF HEALTH VISION OF CNVIRONNIENTAL HEALTH SERV'ea E31BBO ►SSDOATES CONSULTING ENGINEERS GOLDENS BRIDGE, N. Y. A' v - I - ..—. Y:1- AC,-- DISPOSAL THOMAS H'J,-a', a s -T F1' L)S REQUIRED= i99 -T- 2- 4 iN- VODE TRFtj('F: Fj-1 DI; INSTALL' -D7 ZIB FT< 2.4 iN. WIDE TRENCH 'YSM0, ALIG. 22, 1472 :!GALE: r.2.rP FORMERLY ZEMA TAVINO, INC. sonw �...... ..,._...,_�. ,., Owner or Purchaser of Building Municipality Thomas Hughes Building Constructed by _ Lake Spring Drive Location - Street _ Duplex Residence Building Type Section Block 22 - 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- vic�s„ of .the, ,Puana��n .CoL;nty. Department. of..Health- as to whether or- not- -the= failure of the system to operate was caused by the willful or n 9 11 t .act of the occupant of the building utilizing the sy em. Dated this %' day of 19 /Signature Title If corporation, give name 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, Putnam County Department of Health WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This *epo�t is to be completed by Well dFN{er- 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 Thomas Hughes rep acin ZEKA TAVINO INC. ADDREssLa e Spring rive, yews er, N.Y. ROUTE 124 BREWSTER N.EGi YORK LOCATION OF WELL (No. & Street) (Tgwn) (Lot Number) SPRING OWE STER YORK 22 .___LAKE PROPOSED- USE OF WELL BUSINESS FARM ® DOMESTIC. ❑ ESTABLISHMENT ❑ ❑ TEST WELL AIR 1:1 SUPP Y El INDUSTRIAL ❑CONDITIONING OPeER ) EQUIPL ENT ® ROTARY ❑ A R PERCUSSION ❑ P RCUSSION ❑ O(Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) s i WEIGHT PER FOOT 1 lb © THREADED ❑ WELDED RIVE SHOE [:!YE � NO WAS CASING U ED? ® YES ONO YIELD TEST HOURS G.P.M. j� ❑ BAILED ❑ PUMPED � COMPRESSED AIR five fifteen YIELD (G.P.M.) fifteen WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) thirty five feet DURING YIELD TEST Meet) Depth of Completed Well in feet below Land surface: 4 0 0 f t m 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 8 drilling in overburden - f r d . Hit solid rock at 8 ft. . 8. _ - 20. ri ing n Solid rock IS etting casing - grouted 20 400 Drilling in rock If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED %72 DATE OF REPORT 3/28/72 WELL DRILLER (Signature) N y ' COUNTY OF WESTCHESTER DEPARTMENT OF HEALTH - Division of Environmental Sanitation "DHSIGN BATA SHEET - SEPARATE S" E' d- iE SYSTk�M FIIE NO. Over R i k R DE 5 0 �t /1 Address Iy0�� Ail ' S A 1� S a ,9\1.1 Located At (Street)1AK Sec. Block �Lot-2z- (indicate nearest cross street) Muni aiPali -tYo, R A �l Watershed NEaV ya re je r i - ... SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTE1Y 14ITH APPLICATION Hole. Number CLOCK TIME- PERCOLATION PERCOLATION No. Time From Ground Surface: in Inches Soil Rata Start Stop Min. Start Stop. Drop in Kn/in.drop Inches Inches Inches 1 lil Notes: ' 1) Tests to be: repeated at one depth until approximately, equal soil rates am 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 DATI REQUIRED TO BE SUBMITTED WITH APPLICLTION. DESCRIPTION OF SOILS ENCOMMRED.IN TEST HOLES Y) FTfi " HOIE NO: .HOLE "NO: OIE NO e' �OLE Nt3 84p . INDICATE LEVEL AT iMCH GROUND WATER IS ENCOUNTERED' INDICATE IEVEL %,1 1 ' TER 13E NGOUNTERED TESTS MADE BY �+ DAVE Sbil Rate Used (D— Min/In Drop. Ste® Usable Area Provided'. f ® Q No. of BedroomaSeptic Tank Capacitor D Gala. Masonxy) Absorption Area Provided By J LoFox24." Other Westchester County Health Department Soil Rate Approved. Fto /Gala Checked by Date.:.. . SoDo 2706 (Rev, 5- 24-66) (Februaxy 189 1969) BREWSTER LABORATORIES X-."- 24 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 2767 SOURCE: Thomas Hughes --faucet - well supply Lake Spring Drive Lot 22 Brewster, N.Y., COLLECTED: BY: Thomas Hughes BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when th` sample was collected. August 26, 1972 6 e Ro 'Bickwit P. E. Director