The URL can be used to link to this page

Home My WebLink About1865DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35.06 -1 -58 BOX 17 01865 ,. 1' 2 i 0 . L is Ll 01865 PUTNAM COUNTY DEPARTMENT OF Division of Environmental Health Services, Germ% N. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Located at HEALTH EN INEER MUST PROVIDE Y. 10512 PERMIT # P� a�� 8 ATreasoy Town or Village ck Owner �R�Ce =Hlu_ nFV. CLyOD�RA / Formerly S. MONiAScir- Separate Sewerage System built by m RE A & I'� r Consisting of Z4000 Gal. Septic Tank and Sod LH Fr RasoRPrlea ( PLEA l✓/7 Other requirements Water Supply: Public Supply From _,C— Private Supply Drilled By i Address s-+ I N r11 r r 1 " y rX Building Type SA NGL E a1 tL =es Has Erosion Control Been Completed?E5 "ty E- t,U 5' I k k IV % y r Q No, of Bedrooms Date Permit Issued 6- 85 Has garbage grinder been installed? No 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. Date �L - 19 - P5 Address P.E. R.A. 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 approvl of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or ch(an /ge' when, in the Judgment of Commissioner of Health ch revocation, modification or change Is necessary. Date 1�_"- wJ Title (� Rev. 6/95 QU/►1. :_COUNTY DEPARTMENT OF HEALTH _ _ ..... ..,_. Permit. # Division of Environmental Health Services, Carmel, N. Y. 105 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM - own or Village Located atQLd It RL %� Subdivision A A ►+ l rt L tr / J M Dile, A L A subd. rot H A ,, fo G"LGW4y 3 owner /Address ADh)e li.r-AS,Soe , . , ./ -- If -p�GV Building Type �1b, 3. r4i i L!, = Lot Area 41 2k/631 Z Number of Bedrooms 3 Design Flow G /P /D /^ on Separate Sewerage System to consist of � 1Q C3 Gal. Septic Tank To be constructed by k) FGira Wh e Tax Map Block tot Renewal R _ ❑ Date Of Previous Appro 1 Fill Section Only ❑ 9 P.C. H. D. Notification R uired and 2100 L-0 Eb Abs, Address R d ib) LW_1" r r1,%J e WY 1:21902 Water Supply: Public Supply From Private Supply to be drilled by t ' J�� "� L fi S N I Address �_� TOj= p l'! u+y S? A. "!V- 0-k I� y Other Requirements I 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 ancVregulations 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 the date 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 accordance with the standards, rules and regu ations of the Putnam County Department of Health. / Date 3 � Vr Signed �Y P.E. R.A. Address i 0 G- i t ues s H k S W-G r-L idC K iV y License No.11k G 6 3 APPROVED FOR CONSTRUCTION: This approval expires one year from the date illued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when co idered necessary bn he Co missioner of Health. Any chango-e*+,plteration of construction run,iirac a new hermit. Approved for disposal of domestii�ry sewage, 'F /or priv to water supply only. ( \ o � RoaurE_. - zz „�1 . ®_G CD 0 cra' 52°3 °4too9 "E 12 -30 „ G r-- • fo4j;14`:S3 ? °� :ICE SAND St LT G&9tk%lF_L WOL-L 0 '.Q La�3'7�3' s�P'nG A4t'Efi — N fr1 ' '-- 4 _ I _ _ - — 'nn�n► — �-' so --f— — L.1CU► RT=G'D. 30O �-- i®ision of Environmental Health Seriicoa X 1"0 prow as noted for conformance with' gEi s . -ppli le Rule d Regulations of the Ku County ea h Department.. P ASS / signature T Of- IRA �� ocH�nof v wE� 9� �. - ^-x N.Y.UC -ego. 0S WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services 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 qf: water .sem�lgjndicatingyu;�ter,.0 „g �atisfacgry_bpterial quality, b�foag��et�jfiga* P_ a# Lcala :tcucti.pp_cors��ilisnca.is issues+. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME ADDRESS 10 Galloway Hts Warwick NY 10990 LOCATION OF WELL (No. 6 treet) (Town) (Lot Number) Apple Hill Sub -Div. Patterson NY A -' L PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ SUPP LIC AIR Y ❑ INDUSTRIAL E] CONDITIONING ❑ (S(Specify) DRILLING EQUIPMENT COMPRESSED CABLE D ROTARY AIR PERCUSSION El P PERCUSSION ❑ (s(specify) CASING DETAILS LENGTH (feet) t DIAMETER (inches) 611 WEIGHT PER FOOT b ® THREADED El WELDED D 5 O YES NO CASING N YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ® PUMPED ❑ COMPRESSED AIR YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 401 DURING YIELD TEST lfeet) Depth of Completed Well in feet below land surface: 1851 SCREEN MAKE LENGTH OPEN TO AQUIFER (loot) DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (reef) 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 26 Drilling in overburden clay and boulders ,1 it rock at 26 feet 26 41 Drilling in rocktset casing, routed 41 185 Dvilling in rock aranite. If yield was tested of different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 10/ zo 85 GATE OF REPORT 11 /5/85 WELL DRILLER (Signature) r s V Apple hill Development Corp. Owner or Purchaser of Building 69 Section r J. & P. Development 4 Building~ Constructed by Block Old Route 22 Location - Street 6.4 Lot Patterson Apple Hill /J. Monasch Municipality Subdivision Name Single Family Home 3 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- a•tiQn- .of__ +he- D.i- r.ec.tar_,.o`' -the .D.ivi_s.ion .ot .Fr>Ivix:onr�en.tsl.. i galth._Servi:ces of the Putnam County Department of Health as to whether or not the fail- ure of the system•to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 19 day of November 19 Signature Title Secretary _ f) _- Y((`}eyy�� — — — — — — — — — — — ix3eMO �„u O tt4£� •.'. �,.�.. it — — — THREE (3) COPIES ARE REQUIRED WITH THREE (3) CERTIFICATE OF COMPLETION WILLBE ISSUED. Apple Hill Development Corp. Corporation Name if corp. 10 Galloway Heights,Warwick,N.Y. 1099 Address COPIES OF FINAL PLANS BEFORE 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 Box 224 - BREWSTER, N.Y. (914) 225-2072 WATER ANALYSIS REPORT SAMPLE NO. 5989 . SOURCE: i & P Development Corp. Apple Hill Sub. #3 Hose Bibb - "Plell Brewster COLLECTED: Nov-ember 8, 1985 BY: P. F. Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. November 11,-1985 MW-dill ;r boa cs SOIL LOG OLD R ou TE ZZ / d'-12" TOPSO 1 L 529 °4aos'E 1e -30" GLAI( LOAM WI tos'1 ' ►aE s = tS.00 SAND & SILT Sq,o 3'2 50 E �Oq' IAA 33T�� — �. � ` � `\ � - - — 3® JCi SANO`( LOAM W I FE VO.S as 4 >> 1 1tt4sm !County 13epartmen't o 'l.t� ;,� N Vision: of Environmental. Health � 3�•13'ob�w d� COMMON Di nit �t 1ta$TLcq of - the t fo! a0 Z PERCOUN -InO l RATE 5 m1w. / I Nc" LIM.PT./TRE•KC" 300 1..1 W.1~T.f TjZemCA YTt0NIIDSI> - 300 UD-S' 3 AREA = 413105 SFt 8 LA 1 L-T APPLE "ILL DEVELOPMENT . Po'TTERSCpt, PUTNA A CO., N.Y. GOrtg�t_Tl1.lG ENG1tvE�pC 10 C,A -LOW AIN 1d�t61X'r5 W ARW 1 CK I N.Y. ,! CA.L E- 1'= sd D Azme; __ 11 -4 - 155 N.Y. L1C -N0. 06"S-3 O4 a S*3VI4; — 5c t0 L =37.33• ��F°:�G AREA.` N - — -- - -- COW .30 • Se'�)Flc ^TAI�k \ r oe rR FE VO.S as 4 >> 1 1tt4sm !County 13epartmen't o 'l.t� ;,� N Vision: of Environmental. Health � 3�•13'ob�w d� COMMON Di nit �t 1ta$TLcq of - the t fo! a0 Z PERCOUN -InO l RATE 5 m1w. / I Nc" LIM.PT./TRE•KC" 300 1..1 W.1~T.f TjZemCA YTt0NIIDSI> - 300 UD-S' 3 AREA = 413105 SFt 8 LA 1 L-T APPLE "ILL DEVELOPMENT . Po'TTERSCpt, PUTNA A CO., N.Y. GOrtg�t_Tl1.lG ENG1tvE�pC 10 C,A -LOW AIN 1d�t61X'r5 W ARW 1 CK I N.Y. ,! CA.L E- 1'= sd D Azme; __ 11 -4 - 155 N.Y. L1C -N0. 06"S-3 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY_ OFFIQE_.BUIQ N DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. ikiapt.e_ H; LL O,,mer J, 1-jo Address- 6 Coe 2L Located at (Street - -Spr-i 1:1 a, L adre Sec. _ 6 cl Block 4 Lot q �Indicats nearest cross street) subdivis/0,N Lath Municipality. Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Lot M3 Hole__ Number CLOCK TIME PERCOLATION PERCOLATION .Run Elapse Depth to 'Q—ater WaE_er_TFveT No. Time From Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop in Min./in drop Inches Inches Inches',- 3A__ 1 j ixsz i s- 216 2 1 :oo 1!16 14 I.9 -3 3 4 5 2 Notes: 1) Tuts to be repeated at same depth until a roximatel� equal soil rates are obtained at each percolation test hole data to e submitted for review. 2) Depth measurements to be made from top of hole. Address p Cp,Q1' Lak.a ti H k c W o— u-t.,: c.k M . Y THIS ti BY =M INH DEPARTMENT TEST PIT DATA_ REQUIRED TO BE SUBMITTED WITH APPLICATION Soil DESCRIPTION OF' SOILS ENCOUNTERED IN TEST` HOLES D9P- H HO11�. -NO ;_ ...... - :... HOIM 110": G.L. 611. 18" Stiff S L E, 24" 30" 36 nd Loa n% io,� 42" .. Gre.VcL 48" 54 60" 66" 72.. 78" _ 84" INDICATE LEVEL AT WHICII GROUND WATER IS ENCOUNTERED INDICATE LEVEL, -TO B ICH WATER LEVEL RISES AFTER BEING ENCOUNTERED__ � �Dat ' TESTS MADE: BY n /ski" 1 e s J L p=� a R,�' r ..: - e ,� - Soil Rate Used $' Min/l "Drop: S.D. Usable Area Provided No. of Bedrooms 3 Septic Tank Capacity j pop Gals. Types _ Absorption Area Provided, By. 00 L.:F. x24 " � . rend = . ., 0 Address p Cp,Q1' Lak.a ti H k c W o— u-t.,: c.k M . Y THIS SPACE'; FOR USE BY =M INH DEPARTMENT ONLY: Soil Rate Approved Sq. n /Cal. Checked by a Date