HomeMy WebLinkAbout4834"r'1 ;'A` _ YUTNAM UUUM'T VbrAK-1- bJN'1'. Ut HILA1:1.1i
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T Division of, Environmental Health Servi Carmel, N. Y. 10512 Permit # �=-�
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DIS L SYSTEM FA 77 -E-Z5-0 J4
`` II Town or 1041 age
Located at �[d D r W E-L L- De/ V r & Db ,V f n RD • fax clap a '61-ock �
Owner&4y `�� -lGif� iAdBANCAI Formerly / Tax Map Lot # C q $y subd. --t-#--L4:9 -Cs
Separate Sewerage System built by Z -oscs> E 669 -c IA Address 11 -io —u 'P�7`— J.6AtZ.9►El.0 •CAMQ_,
Consisting of Gal. Septic Tank and �� �/�t- t_�►%S
Other requirements
Water Supply: Public Supply From
Private Supply Drilled By i� -111.i 'i7 It.0 MCI' CO.
Address L2=151
Building Type I �AtN O"C -5- No, of Bedrooms' Date Permit Issued 3 Z
Has Erosion Control Been Completed?
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 H /ealth. ///
Date L Y I Certified by P.E.— rL R.A.
Address tg S; a Akv License No. 16
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 approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are
subject to modification or change when, in the judgment of the Commissioner of Health, such revo ion, modification or change Is necessary. r�
Date L By Title
Rev. 9 -81
A .& Contract Vendees on Rytell Lots 2928-29)
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services, Carmel, N. Y. 10512
/ CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM ( T) FattexSon (C) Putnam &
peg jia; mA,,A-i f 1 a3riield
o eas corner o o e and �T- - - T6wl+�r Linage -T
Located at u�_Aiti—I 11 T) 1.--vp (4th Ifinp nf '•Pty :n Tn T, ke')Tax Map # 23 Block 05
Subdivision. Lots 2918 11iru 2922 & 2928 &2929 Tax Map Lot # 2 & 2 subs. # 14 a -r
owner---: 'FranTr & 'F el i pi a T,aRanea (2218-22)* Address RR # 2—Box.. 380
Building Typo
I farm I y resi de t,�ot Area 7 lots New Fairfield, Connecticut 0681
Number of Bedrooms ThrAP__ Design Flow 600 gad— Total Habitable Space 04er 150Q_ Square Feet
Separate Sewerage System to consist of ._.. I nno Gal. Septic Tank and 72- ft. 2' brene + x leaching pits
To be constructeq. by Address l i nn Bond
�
Water Supply: Public Supply From � @w Fairfield-,,Connecticut-068-10
X'
_ Private Supply to be drilled by to be' • determined
Address -
Other RequirementsRe}1!—sp-PT -0 d plan, rules and Fags, etc.
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 attachments hereto 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" satisfactory to the Commission-
er of Health ii�ll be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the build-
er, 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 issuance 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 stan-
dards, rules and regulations of the Putnam County Department Of Health. .,," n
Revised: e: K a
Date _ Janaa�_, 1991 Signed P.E._ R.A.
Address P.O. BOX 1106: Alfred Y 14 02 License No. 043952
APPROVED FqR CQNSTF3VCTION: This approval expires one year 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 ;ssioner of Health. Any change or alteration of construction
requires a new Permit. Approved for disposal of domesti sane a y sews e,,. /or rig to wate,_r supply only.
Date �� r �— By l�i��. Title
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WELL• COMPLETION REPORT PUTNAM COUNTY DEPARTMENT .-.OF HEALTH
3/71 Division of Environmental, Health Services . .
COUNTY OFFICE BUILDING - CARMEL, NEW YORK
This repoq 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 SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
NAME ADDRESS
OWNER LA BANCA Frank RR *21 Box 382, New Fairfield, CT 06810
LOCATION (No. 6 Street) (Town) (tot Numbed
OF WELL Corner of Andover & Hopewell, Putna: -tz Lake, Patterson, New York
BUSINESS
PROPOSE(
DOMESTIC ESTABI SHMENT El FARM I TEST WELL
USE OF PUBLIC WELL r] SUPPLY n INDUSTRIAL (� AIR OTHER
�J CONDITIONING �j (Specify)
OTHER-
EQUIPMENT DRILLING COMPRESSED CABLE
ROTARY D AIR PERCUSSION PERCUSSION D (Specfy)
CASING LENGTH (feet) DIAMETER (inches) W.EitiHT PER FOOT (D II S OEj
DETAILS 41 6 19' a THREADED WELDED L"J YES E1 NO L"I YES NO
YIELD HOURS G.P.M. YIELD (G.P.M.)
TEST D BAILED O PUMPED n COMPRESSED AIR A 12 12
MEASURE FROM LAND SURFACE —STATIC (Speclfy feet) leet) DURING YIELD TEST
WATER l Depth of Completed Well
LEVEL 20 160 in feet below Land surface: 160
MAKE ILENGTH OPEN TO AQUIFER (feet)
SCREEN
DETAILS
DIAMETER (Inches) IF GRAVEL
PACKED:
DEPTH FROM LAND SURFACE .�
FEET to FEET FORMATION DESCRIPTION
0 12 ISiltil Sand, Gravel
.12. 30 LEose Sand And'Gravel
30 160 ' edium -Hard Granite'
i
I
If yield was tested at different de
FEET
100
160
Diameter of well including GRAVEL SIZE (Inches) FROM (feet) TO
gravel pack (Inches):
Sketch exact location of well with distances, to at least
two permanent landmarks.
ro
rd
0
(x
0
�I
•ing drilling, list below O
GALLONS PER MINUTE rd
311
�C
1.2
10' j Well
10'.
Dwelling
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v
v
A
H o p e w e 1.1 R o a d
DATE WELL COMPLETED DATE OF REPORT W VK (SI na �Ir l Wf •
3/23/82 3/2'/82
Robert l30 1 -Ii1 , President -MILL DRILLING . CO.? INC.
4
4.
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BREWSTER LABORATORIES
Box 224 - BREWSTER, N. Y.
WATER ANALYSIS REPORT
SAMPLE NO. 4769
SOURCE: Frank LaBanca Well
Andover & Hopewell
Putnam Lake Patterson, N.Y.
COLLECTED: March 23, 1982
BY: Mill Drilling, Inc$
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
Thir rtrult indicattr tht rouret of thr sample war
of ratisfactery taaitary quality whra tht ramph war colltctrd.
0 per 100 ml.
2t c7 :j
March 27, 1982 Bickwit P. E.
Director
9
d'
r'"- C A kL(CiA LA CDANc_A_
Owner or Purchaser of Building
Build''i''ng Constructed by
H'OPEuV ALL !/P-1 V ��
Location - Street.
_ I.r5AM �.
Build ng Type
Municipality
Section
Block
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 :Wade by me to such system, except where the failure
to operate properly is caused by the such
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 7_2- day of�i _ 19 ""Signatures. j ►-
Title Pali.
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
Gentlemen:
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date Au st 1 1980
(& Contract Vendees on Rytell Lots 2928 & 2929
Re: Property of Frank & Felicia LaBanca (Lots 2918 thru 2922.) /
Southeast corner of Andover Road & Hopewell Drive
Located at Putnam Lake (T) Patterson
Section TM 23 Block 05 Lots 2 & 3
This letter is to authorize Arthur F. McLaughlin
a duly licensed professional engineer. X or registered architect
(Indicate)
to apply for a Construction Permit for a separate sewage system; to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers :on my behalf in
l Vll!!Cl 41V1!' W 1 Ln Lli-LS mac Let• and to. supervise Lhe cons truc C1Uf! of said
system or systems in conformity with the provisions of Article 145 or
147, Eduoation. Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned:
Very truly_, yours„
Signed L(6 k'
Owner of Property
Frank & Felicia LaBanca
2- Rnx : Conn. NAw Fairfield
Address 06810
P.E., # na�q•��
04 4.0
Address
ARTHUR P • MC LAUGHLIN
PROFESSIONAL ENGINERE
MILL TOWN ROAD, R. D. 5
6Riu\/5TF Y. i96F .
(914) 279 -6936
Telephone
19-03) _ 746 -4509
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
..::.COUNTY..OFFICE BUILDING, CARMEL, N. Y. 10512
....... ...:.... :. ...:.:.:.......
DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0.
R R Z 130
Owner FJiL -iClA I.�, _BA Nca Address New F_Ajp;;jELD 06g IU
Located at ,(StreeN r v�. Sec. Block 05 Lots• ?�3
T( a nearest cross street)
A PO {Zri o w
Muni palit�E� . ,.N ��r1 �� FA':!Rc� ��� _Watershed �Lri-taa M LA ; �z
,.....SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH,APPLICATIONS
:,Hole
Number. _.CLOCK. TIME PERCOLATION PERCOLATION
Run Elapse Depth to Water Water Level.
No... Time From Ground Surface in .Inches •.. Soil Rate
Start -Stop Min. Start Stop Drop-in, min./in drop
Inches Inches .Inches
2_ MAP coa ais `r' `Uy
1..e7vS o 'K_ ��t� T use
2
5..
1 _
2
4.
3
Notes : l) Toos ` to be 'repeated at • same
rates are obtained at each percolation
for review.
2) Depth measurements to be made
depth until approximately equal soil
test hole. A11 data to be submitted,
from top of hole.