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HomeMy WebLinkAbout2131DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 30. -2 -10 BOX 19 02131 I IN . . 1 y ' *.Joi , ,. y� F 'I 6� _ I I 02131 PUTNAM COUNTY DEPARTMENT: OF HEALTH s T Division of Environmental Health Services, Carmei, N. Y 10512 3 W Putnam: :a1 ey ERTIF:ICATEa,:OF?CONSTRUCTION COMPLIANCE . FOR SEWAGE DISPOSAL. SYSTEM �. Town or ;Village.` ior..th: side �ickt'owr) Fed, approic 700 :ft west ,. f s+ 1 Located at0 +- ArfRll Rd Tax Map - 'Block 1 owner'' Tax Map Lot,:# Suter; J•107 °613 S & F S® ticla Address ,Cross River, 'N..,: Yo S.: eparate ,Sewerage System built by Sep tics _ Consistlpg of 900 Gal. Septic Tank and �O '1.. f . 2 W6 trench Other requirements all colglied water Supply: Public Supply From X Private Supply Drilled By ' EckerSOn Well Dr'i Address Mi It on N. Y. Building Type * RaiSed Ranch No. of Bedrooms 3 Date permit rswdid 171801 no Has Erosion Control Been Completed? . I certify that the system( a) as listed,serving. the above premises weie.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 jfiled plan, and the permit issued by the Putnam County Department Of Health... April 9., 19,80 L .x Date BC Be [It" a Cgptifieti by P.E. R.A. 1051icenae No98�, Address R D; ;8 HOrsep0"Wid Rd, Carmel, N.Y.: , 5 Any :person occupying premises served by.tho above system(s) shail,.,proTptly take, such action as maybe necessary to secure the correction of any unsanitary conditions resulting from, such usage. ' Approval of the sepa►ate.sewerage ; s m`shall'become null and void as"soon as a public sanitary sewer becomes subject to d the IaL proval. of the private -water :supply strall. become null .an ,.voi whop, a_ public water :su y becomes available. Such *approvals are available and the a modification or change when,' In the judgment of t, e Comm' sioner of ealth, such revocati' modification. or change. is necessary. Date �' . BY ' a Title W #020 YML #6669 YORKTOWN MEDICAL LABORATORY INC. - P.O. Box 99 -321 Kew Street LOCATIONS: Yorls$o�n Hei h4�, �.Y, 1059� 0 321 KEAR ST., YORKTOWN HEIGHTS,•N,Y. 10,599 245 -3203 - ❑ 201 BUTTONWOOD AVE., PEEKSKILL N.Y. 10566 737 -8777 245 -3203 ❑ 495 MAIN ST MT K I SCO, N.Y. < 10.549 L666-3 5 " ❑- STONELEIGH AVE. (NEAR HOSPITAL),'CARMEL,N•Y.10512 278 -9330 DATE COLLECTED RESULTS OF EXAMINATION OF WATER 4/9%80 Mike Amorosano CITY, VILLAGE, TOWN VOR NAME OF SUPPLY 1503 Dover Rd,, MoheRan.,Lake. New York SAMPLING POINT Richardville Rd., Putnam Valley, New York 1TE RE 4%9/80 :1) 4/11/80 BACTERIA PER ML. (Agar plate count at 35 .C). 7 /ML COLIFORM GROUP (Most probable No. /100m1:) 0 MFT TOTAL -ppm DETERGENTS - mg /L NITRATES (as N) - nig/L IRON, TOTAL. - mg /L AMMONIA, FREE (as N) =mg /L pH =. CHORIDES - ong /L) These results indicate that the water was YES of d satisfactory sanitary quality when the sample was collected. ®Y A. H. PADOVANI, M. T. (A��F'� .� _ ' . _ _. -. _.. _• •__._. _.�..3 T�,t�.az+._ _ ._; �y .uA•� (`Jr Wrier or ur aser o Building Muniicipa ity Bui d Cons ruete by Section //ingg, A( 6( l C w i1 POt Location - Street Block Building Type 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 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- _...vi.ces,..,of...:the_ .Putnam County - Department of Health as. to _.whe.tller....or.. no -t the failure of 'the' system to "operate was .caused by the willful or negligent act of the occupant of the building utilizing the .system. 14 Dated this day of �7` 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, Seryices, Putnam County Department of Health �ELL �Or�PLET0N RE PUTNAM DOV0TY DEPAR��E0T 0F HE/\LYH u/n ^ oiwuoo of e^�m^memu nmxx S,rwcc` � COUNTY OFr|Cs uUu0wG 'CAVmEL' wEVJ Y0RI,' / |n ywderond�ubmicd ^ County o|�punnttoqed�mvid` bbom�nry report of' is \obo*omp � analysis of wmie/ smp|u indicating water is of satisfactory boxiorio| quaUrybufUxe ocrh[ioa\o ofoonw1uotiun oomy|ionoa is issued. AN 30 DAYS OF WELL C01"AWLET'10.1\1 ' ! / OWNER OF L L (Town) (Lot Number) Road - Forest Park Subdivision 0 ent Int # -1 PrOPOSED USE OF WELL DOMESTIC ESTABLISHMENT FAPIIA TEST WELL PUBLIC A IR OTHER 11 SUPPLY El UNDUSTRIAL CONDITIONING (Spc-cify) DNLLiN.G COMPRESSED CABLE OTHER CASING LENGIH (/Cot) 20 ft DIAM P.flnchLsj WEIGHT PEP, Fool' I DRIVE SHOF 6 El-a—_L�1 I WAS CASING GROUTED? TEST 11 BAILED ILI PUMPED KI COMPRESSED AIR 25 25 Depth of Completed Well 122 ft. in feet below Land surface: WATER LEVEL MEASURE FROM LAND S URFACE —STATIC (Spe . city feel.111 DURING YIELD TEST fleol) SCREEN MAKE ENGTH OPEN TO AQUIFER (trol) DETAILS SLOT SIZE PIA14ETEP (inches) IF CRAVE PACKED Diameter of well includ gravel pack (inchos): RAVEL SIZE (inches) FROM. (toot,' TO (fool) DEF1rH FROM LAND SURFACE FORMATION-DESCRIPTION Sketch exact location of h,c// vfilh distances, to at least two pctmanenl landmarks. FEET to FEET 4 122 Granite Ifyield was testud at different depths during drilling, list below FEET GALLONS PER MINUTE 3/20/80 3/26/80 �� jamad T. Fc�qr�e^' prqp,/ J. T, F�Q�erson' ipg~ ljiItop, IN`Y, i bg L �Wmv� 'S Q 2 Q .0 W y 3 p� � \ 3 r� Z � � � j: •. woe•, LU IK y o w W 0 Q V 41 QK i m LL ku Sa 2 jZ• fA �: 13� z� a I � •N z '. u< ai F V w� L�jV�L�IX_ 1 this application super ,des that of 11/15/78 at which. time a fill seetiori us �q .. : AM COUNTY DEPARTMENT OF HEALTH approved 7. Division of Environmental Health. Services, Carmel, N.' 1'..10512 CONSTRUCTION` _PERMIT FOR SEWAGE g SPO$yl„SY, TE_M_ down, of .Putnam Valley . _ st Of own or -Village Located at• "Td$ '137e'3 &11:- `I1F�e-• - - -�v. Subdivision Forest Park owner Michael 'Amorosano Building Type A Frame Lot Area 2.46 acres Number of Bedrooms Design Flow 16-20 Separate Sewerage System to consist of 900 Gal. Septic Tank To be. constructed by Dominick Siniscalchi Water Supply Public Supply From >TSX•Mab^ Lot 3 ajob 1107-613 1503 Dover Address a� Mohegan ! N. Y. Total Habitable Space 2 v09 ®3 F quare Feet and 430'1- f . 2 inc trench AddressOld Albany Post Rd, Peekskirrin X And rson Well Drilling Private Supply to be drilled by Barger t5treett rut-nam YK1107V W. Y. Address Complied 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 an regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory 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 issu- ahce' of the approval of the - 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 regulates of the Putnam County Department of H6alth. Date March6! 1980 hr P.E. R.A. Buries S �e�$s� pound R , armel! N. . 10 12 9845 Addre License No, APPROVED FOR CONSTRUCTION: This approval expires one year from the date issue construction of the building has been undertaken and is ^trevocable. for, cause or may be amended or modified when conslder_ed necessary by the C missio or of Health. Any chang or alteration of construction requires a new permit. Approved for disposal of domestic tnita y,wwale, a�tlllQr pr11vat�s -app aR Y. Date .-- ' I © By 1� ' ` �~ Title .r•� � `vim/ •'�.,. PUTNAM COUNTY DEPARTMENT OF HEALTH !. DIVISION.OF ENVIRONMENTAL-HEALTH SERVICES eptOmbelr .20., _ .. Date !' Michael Amorosano Re: Property of Located at North sid Dicktown Rd, approx ' 700 ft +est • Water 1janj, Section 4 Block Lot I ...Gentlemen: Lot'3 .of Forest ark. ..Town of Putnam Valley This letter is to authorize Roy' A. Burgess a duly licensed professional engineer �x or registered architect (Indicate to apply for a Construction Permit fora 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 ' s - Department'of- Health; and -to sign all necessary papers U" MY behalf in i connection with this matter and to supervise the construction of said ' system or systems an conformity with the provisions of Article 145 or 147, Eduoation Law; '.the. • P'ublie_ Health,:Law, . and the •Putnam County - Sani- tery cone: , • ' • . , I ; ' .• .. j� • •, Very trul our • . , Signe owner of Property j 1'503 Dover Road I i • Countersigned: 9$4S.' Address % P.E., R.A., # .'Mohega.n Lake .',' X. Y., 10547 NI ' Burgess & Be br I. P le C* Telephone Addres 52 8.. 7'16 0 R D - Horsep'ouzid Road I' Carmel,. N. Y.. 10512• 3j r 225-3312 "Telephone �` ti t' S• 1, tl tij f� �4,�� . • w� PUTNAM COUNTY DEPARTN ENT OF HEALTH D`VISION OF ENVIRONMENTAL HEALTH. SERVICES CGLUPYr OFFICE BUILDING, CARMEL, N. Y. 10512 - SEWAGE DISPOSAL SYSTEM FILE No. 1107 613 'Michael Amorosano Address 1503 Dover Road, Moh6gan'Lake, NY North side DicktogeneRd 4 1 1503'' Local"Ied at t�Zitreet) Block ,Lot (Indicate nearest cross street Lot 3 Forest' Park ,Nhw,icipality Putnam Valley Watershed New York City SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 2-11-.15-w,11:30 - 15 -1 15 311:30-11:48 18 24 25 1 18 It x+11:50 -12:08 18 24 25 1 512:10 -12 0.2 8 -18 25- 1 18 it 1 10t.08-10-28 , 20 21� 25 1 ..2 10:30-10:50 20 24 25 .1 20 310:50 -11:10 20 211 25 1 20 4 5 2 5 Notes: 1) .Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole; All data to be submitted for review. 2Depth measurements.to be made from top of hole. .7 Hole Number CLOCK TIME PERCOLATION PERCOLATION RLM Eiapse DepEh t o Va er Water Level No. Time From Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop in Min./in drop. Inches Inches :Inches 111:03-11:15 12 . 25 1­ 12 Min. 2-11-.15-w,11:30 - 15 -1 15 311:30-11:48 18 24 25 1 18 It x+11:50 -12:08 18 24 25 1 512:10 -12 0.2 8 -18 25- 1 18 it 1 10t.08-10-28 , 20 21� 25 1 ..2 10:30-10:50 20 24 25 .1 20 310:50 -11:10 20 211 25 1 20 4 5 2 5 Notes: 1) .Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole; All data to be submitted for review. 2Depth measurements.to be made from top of hole. 1107 -613 i TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION ......._._._�. - -,.:- - -.- -- -,��. -- - •DESCRIPnFI01�T• OF SOILS ENCOUIdTERED .IN'.,TEST=�HOI���.'`..",� _ ,.��",A.,:�. ._..• ..- . . ;DEPTH HOLE NO. 1 HOLE NO.- 2 HOLE NO. G.L. topsoil topsoil 7i i PP 11 6t1 12" ••••Sandy clay with small stones...... - i. - ;`C 24 11 A.3011 If If 3611 it if 4211 1f i II 4811 PP 11 5411 PP If 6011 6611 It 7211 „ 11 7f� 11 v 1P 1t _84!r__ 'IlVDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED2 ft. INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 2 ft. ;.TESTS MADE BY Burgess & Behr, P. C. Date 4/15/76 E SIGN Soil Rate Used 16 -20 Min/l "Drop: S.D. Usable Area Provided 6.9000 ?F + No. of Bedrooms 3 Sept c� ank Capacity 900 Gals. Type Precast cone Absorption Area Provided By 43 L.F.x24 x width trench. *10 laterals @ 431, 3 distribution boxes Other - aame lkyy x. nurgess 6rgnature °— Address Burgess & Behr, P. C. S s 8-horsepouna Roaa arme N.Y. 10512 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: �"i y O' SURVEY���aG Soil Rate. Approved. Ft /Gal. Checked b R �.: ..Date -Installation of run of bank gravel of good quality re ed in"an area 60 ft by 50 ft and 23g ft deep, settlement required - 60 -90 days with new tests made in this area prigs. to construction. of system and completion of this plan. Plan is subject .to al'1 .notes, restrictions ar4,,conditions of approved subdivision plat and integrated plan.