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HomeMy WebLinkAbout1855DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -43 BOX 17 I ]UFt�.7f,4'� 01855 V r �. �F � . 0 'L TIf 7 ' IA R MkP 01855 - T. PUTNAM COUhJTY DEPARTMENT OF HEALTH Div sion 'of Envionmen a e_a'lt ivices Carmel, N: Y­'1661-'2;%-' !.PEP WACa DJBPOSAL SYSTEMP'atterson ' . .' ,S'k L acne _ � To n o ` Located: > -at Y. �_. .'.'' Section s> Blockw t Zema c. Owner Lot John Coughlin Brewster; - New^York Separate.' Sewerage System built by Address 1000 conc. , ,r 3 Con3istmg of Gaf =Septic Tank 302 lineal Feet X $ T 6 4 -width trench i Other requirements Water SvPp1Y Public Supply From ` X PF..Beal Private Supply Drilled BY Address Brewster, New York z j Builtlmg'Typefi ReSld6n.ce No: Of Bedrooms 3 Date Permit Issued Has Erosion Control Been Completed? l} OF .NEW yoR a (.certify, that the system(s),as listed'serving th s of thecompletetl work which are attached), and in accordance with the standards rules anal regulations plans fil er P rmit is_ by he Putnam Co ty Department of Health. , Ma 2.rG1972� x f Date y Certified by P E R A Address ° License No- L4_5O�.L. Any person occupying` premises sewed by ,the above system(s) shall' promptly- _ �Qact'on as maxis ebb y to secure fhe correc4ion of any unsanitary_ conditions resulting from,. such usage Approval of the `separate�� sewerage syste, �,9m�giii,N' as sgon as a public sanitary'sewer becomes available and the .appioval of the.;prFvate water supply shall'. become null antl void Bp�p ply becomes available °Such ;approvals4` are: subject to modification or. change when, ,,in the judgment of the.Cgmmissione o t ,ice Gil io doication,or change. is necessary - f Date a -7� .•k. gY - itle ` i _ ► C i .. .._. - - -- - Zerha Ta°no , -Inc: _ . _..,_ . _.. _._ _ _ _ _. - _ __.._._.. _ Patterson Owner or Purchaser of Building Municipality Zema - Tavino Inc. Building —Constructed by _Sky Lan e Location - Street Residence Building Type Section Block 19 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. Dated this day of ' 197.— Signature Title r co orat n, g 4 na. and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,ETION 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 BREWSTER LABORATORIES. WATER ANALYSIS REPORT SAMPLE NO. 2725 SOURCE: Zema - Tavino, Inca faucet - well supply Sky Lane - Plot #19 Patterson, N.Y. COLLECTED: July 12, 1972 BY: P. F. Beal & Sons, 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. July 13, 1972 0 per 100 ml. V oy Bickwit P. E. Director WELL COMPLETION REPORT 3/71. -y PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK Thin. report is.io -.bs completedpby w,,ell,�iriller �n submitted- to-.County Health .Departmeategetherwith liWrMry,report•of analysis of watwsample 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 ZENA TAVINO INC. ADDRESS ROUTE 124 BREWSTER NEW YORK LOCATION OF WELL (No. ti Street) (Town) (Lot Number) SPRING MEADOWS BREWSTER NEW YORE 1 PROPOSED USE OF WELL {�LA.KE BUSINESS I LXDOMESTIC D ESTABLISHMENT 0 FARM D TEST WELL 11 SUPPLY D INDUSTRIAL 1:1 CO ❑ OTHER CONDITIONING (Specify) DRILLING EQUIPMENT COMPRESSED CABLE ER ® ROTARY El AIR PERCUSSION D PERCUSSION (S(Specify) CASING DETAILS LENGTH (lest) DIAMETER (inches) WEIGHT PER FOOT FC 1 THREADED ❑ WELDED DR V SHOE ❑ YES SINO W 5 CASING UTED7 ) YES NO YIELD TEST HOURS G.P.M. BAILED D PUMPED 12 COMPRESSED AIR five five YIELD (G.P.M.) five WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) fifteen feet DURING YIELD TEST !feet) Depth of Completed Well in feet below Land surface:2 4 0 ft 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 fleet) ,DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 17 Drilling in overburden - - i y Hit solid rock at 17 ft. Drilling in-solid rock ... SO 240 Drilling in solid rock - Lrranite 1 k I l I I i i t If yie9 was tested at different depths during drilling, list below j FEET GALLONS PER MINUTE I .I :L COaVLETED 2 DATE OF REPORT 3Z28Z72 WELL DRILLER (Signature) • • 1 . - N Westchester County-Department of Health Division of Environmental Sanitation __ . __..._ ......... .. .. y.._... - - I VIT...'CORPORATE .OWNER APPLICATION - <,._ .. _.._._..�.- _ -_... ___..........,._....�_ ,___.... _. FOR PERMIT REQUIRED BY WESTCHESTER COUNTY SANITARY CODE (Please type or print in ink) TO: Commissioner of Health - In the matter of application for _ t; S �vACj IF _ C AJ S 7?i J D — �� � r �— = �! L�}I�L�Sf� i 1�1 C� i�1 CA (DO los P c j C, - — �tft°n_ -�v— — _ _, represent I'— — — — — — — — — — — — — — that I am authorized to act for the (Name of Corporation) ��c � f C �;' 71 \1 �Y'�t having offices at — S1:'C�'rJ-' +.. L. f�:,'�l I T i-�_ _ _ _ _ _ _ _ _ _ ------------ 7HC�ANWOOD, N' _ _ _whose officers are President �� _.t=om - _______ — _____ —_ (Name & Home Address) Vice -Preso -- �,tir'L7�rL_' — — — — — — — — — — — (Name & Home Address) Secy., — — — — — — — — — — — — — — — — — — — — — — — — (Name & Home Address) Treas, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Name & Home Address) by Resolution adopted 7individually _ _19 76). and that 1 am and will be responsible.for any or. all acts of.the corporation with respect to the approval requested and all subsequent acts relating thereto. ST. CHARLES REALTY Cop. DUKE BLDG. Sworn to before me this day Signed _c/_O WOOD/ N. Y of 19 Title — — — — — — — __ — — — — Notary Public Form S�.D,. 28 September 30, 1969 .9 I'm COUNTY OF WESTCHESTER DEPARTMENT OF HEALTH Division of Enviromnental Sanitation _ : ' -DESIGN` DATA SI ETV = `SEPARATE SE6JAGE SYSTEM: Tx FIIE_NO0. _,,. �. . —'- 0wers1`'. C4A2i �; gP Addre ssDvlI-C B LP �jl > Located At (Street)5� , hert?00(o jakix ggApSec.Mock Lot ZTua c nearest street) a ' iii SOIL PERCOLATION TEST DATA REQUIRED TO BE SUMMED 14ITH APPLICATION Hole Number CLOCK TIM PERCOLATION PERCOLATION No. Time From Ground Surface in-Inches; Soil Rate :Mart Stop Nino Start Stopt Drop in )WinAmp, Inches Inches Inches a ®®r 2 !r -10 /f ® & Vor / m /F# 5 4 5 1 Notes: 1) Tests to be repeated at one depth until apprami ate7,v equal soil rates awe 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 DATA REQUIRED TO BE STMTTED WITH APPLICA-'TION DEsCRIPTIOA OF SOILS ENCOUNTERED IN TEST HOLES' HOIX-- Nd- How DEPTH 0 ,36h AV 48" 1 54 "I 60" , TO 66 72ff- 78" -84" .INDICATE LEVEL AT IMCH GROUND WATER IS ENCOUNTERED'' INDICATE LEVE7023TU AV3MPpM*S 4FTER BEING ENCOUNTERED TESTS MADE BY I : DATE I e--- rr r-j r-- I NJ r- 17 P-S DESIGN Soil Rate Used 0 Min/I" Drogs SZ a Usable Area Provided No 0 of Bedrooms Septic Tank Capaci I?- (ko: Gal p t4EW pF Absorption Area Provided By L.F Other Signat, CON!§0LTING ENGINEERS Address: SM, w, Pir lFf Westchester County Health Department Soil Rate Approved Sq. Fto/Gal. Chocked by S.Do 27 ©6 (Rev. 5-24-.66) (February 18, 1969) c- 1000 CAL • PRZCAr.7- C-O-,C-. .J �JtalN C`� C oK -v"� Z: "o -re 9 ORICa1114^1- 1-0fz- ob, OUT-- CL; STDC -NGI? APPROVE0 j u 719712 _pj u, Htp PUT UN al. OF H,ALTK B 'y Y. E, DIVISION OF ENVIRONMENTAL HEALTH SERVIM AS BUILT SEWAGE DISPOSAL SYSTEM Z E- -FA\/ 1-4 CD , I KI L. SHEET .. ... .. .............. LOT 1.01 ... ............ FIELDS RE311,110� 300 FT r, 34= IN. WIDE TRENCH FIELDS INSTALL---[)- 302 . _FTx 3(2=, IN. WIDE TRENqH SYSTEM I.NSTALLED BY: C-0 L-1 C-1 tA DATE. SCALE: 11-201 CONSUL -TING NGJ