Loading...
HomeMy WebLinkAbout2166DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 30.18 -1 -3 BOX 19 02166 Ir , . N 1 ; 02166 U, zwl 3�•I x 1 fi u�•Y t i, t y . PUTNAM ,COUNTY DEPARTMENT :OF HEALTH �,. rf Drvisron of.' Envrronmen[al Health Services, Carine'l, N:' Y 10512 CERTLFICATE- _OF.,CONSTR:UCTION. COMPLIANCE FOR, SEWAGE DISPOSAL ,SYSTEM y .it Va110Y (TO { Yov n o VJlaga � -. a 'a;-n+ .a r ..,a . < .a..\ • W ®st Located at . `- Tax ",Map Block Owner`'ai1k. "t`iY'Ol� { Lot - Joti Do n ck z cg 'Separate .Sewerage System. built by 1 A�Onti'na " " Address Pw1di 1 treet' 10C pConsistin of, Gal Septic. an 'York ` ,..'rA i ` Other. require ments Domestic War..Su y. pRl Public te SuPPIy !From. ^•� ' i' � x Boyd Artesian Ulell' Co MrsL^ 1 Private Supply Drilled By Address: Rte 52 Carmel, Neva York Buildin g TYPe sed Ranch No `of Bedrooms eg t•Issued • _ ' • "- as,,, rosion,-,Controf Beeo pl n Cmed te.• - �' � • t� - - Yes � •e c� I certify 't_ hat the system(s) as listed'servmg the above premises were constructed essentially as shoYv�ID <the co tOd work'.(copies of. which `are attached), and in accordance with the standards rules and regulaUOris plans filed and the perrpi�s ed utn eunty Department of Health. Date J u7 y 11, 19`76 , ✓'� 6 Certified by P.E RA. 1 °Northridge' Ro Peekskill; ` Q� •� 02'7£346 Address License No. -An- y person occupyIng;premisessewed by the above,system(s) shalLpromptly. take such action-as may be necessary•to secure the correction, of any unsanitary _ucondlt ions ;resuItIng from such usage :Approval °of the, separate aewerage system'ahall become null <and void ;as soon as a `public.sbnitary)sewar becomes 5vailatile and the approval of the private,;.water supply shall become null and void when a:.public water supply becomes a'vallable. Such. .approvals are sub Ject to modify cation or change when,, in the judgment of the Comm sion Health' uch revo n ,modification or change is necessary Dete "tom ,Title - C. J "! PUTNAMCOUNTY DEPARTMENT OF\ HEALTH f y ;Division of Ent!ironmental ;Health Services, Garmel,N Y 10512 "CONSTF(UCTION _REitl�tfliT 0' OR "S'tvyAGE -01 -OSAt 'SY UJl; ' Plrttaam Vs13Ag' `,JET) Town or,. V,Ilage ' n ` 'Map 656 :West° Road section Block Subdivision i - Lot Located at Warren Smadleck (Roaring Brookj u Box `340 Putnam Valley, N.Y. Owner C Address 8u11din9 TY,pe -RaiS.ed Ranch Lot Aree Number - of Bedrooms 3 s Tot` a Habitable p 1200 + . al 5 ace r Square Feet il. Separate'Sewerage System to consist of.' „ "Gal Septic Tank = lineal feet "X t width trench l o be "constructed by �>l1Car COnBtrUCt�On- v Address xOIRCJ3t8aCZ Avenue Peekskill`, N.Y..' 7 .5 )Nater `Supply Public .SUppIY 'From s = x .. `' , _ FuckeyWe11- �Drillera� _ Pnvate 'Supply to be drilled by. a' LL' Stxrout 'k. Ro:d Peekskill, N,Y: ; Address Other- 'Regwrements _' lit "'One , ar!ea to be f'i11ed4 atxi ;'grad®cir atu1 Wade' channeledanto witch & Culy A represent .1, am wholly and completofy responsible for +the design antl location of ,the' proposetl system(s); ls) t 3i•tli�as sewage disposal system' above described .wilt be constructed as, shown on the approved arnendmentthere to and in accordance with the stan�f3Y, ions o e Putnam . County, Department of, Health, and tfiat on coin pletwn_•thereof a Certificate of Construction Compliancel ",s$tis sio,ner of.Healthwill be' submitted to the Department, and ==a, - written °guarantee wiil_be furnished the owner 'his; successors heirspr b t tat said builder will place in good operatin g 'condition any .part .of' :said' sewage disposal systempduring the period ot"two (2) °yea t'edate of the lssu- Yance of the - approval, of .the Certificate of ; Construction = Compliance3of: the original system or any. "iepau'�'*h�e - li drill eN: described above ,will belocated as -shown on the approved pian,-arid that said well will,be installed m accordance- with:.tHe stagd. s rul a i f. the Putnam County Department of. Health 106t-'21' , 1975 . r x Date i a , Signed P'iE R.A. t _ 1 Nortliridg® Road eek�kll;'N.Y. I ©5fi W� 7946 Address-.. APPROVED FOR CONSTRUCTION "This approval expires one year,from: the dateissued uules "con_ struction of !W been 'undertaken and 'is revocable for.cause or may be amended`or'modified where consdered nec nary by the Com ` S. or of Health. AAjg�he aiteration of construction requires .a ne /w 'permitC.�App�rjoved for,djsposal of domestic ry wag an 'r ry pply only G BY Title BACT8RIA-PER ML (Agcy plate count at 351-C). COLIFORM GROUP.(Most probable No. /100m1:) TOTAL =ppm ,. LE$S THAN 20 2 , : �`� M DETERGENTS - ppm NITRATES (as N) ppm IRON;'TOTAL.- ppm. ' ca y < OD tanY N. US .aY D _ ' 0 W ..� ' � � �'a b� . . � ,r � \ \ � X40 �"• � ...,. ,. y z O Ul m t ` � F o' ( V r;' I .. C.... rm 0 . 20 N of- Id E` . .... ._ ... _. . •ys�KY. .sj: l 4.r Wt .✓ �it! bKi+ k b •b - Y � i Y a' y� ��, � • 1 M f •t»r K. .� t ; �� �+�, y�Y"Y ,e Fe +�+ ,+vh ,Sc. pa. -. 'a �x:.. �- ' �'� �l � � .� s ^.'` nest * �'+�:t�tW �• �.���+aY3�,y ''"Sk3.4��'+�yi �'�tra t t r S„ t rw "a .�tei' .: r.fl �`� s•S �a i t � � `{ to �,� �" v _�.j v s �' �t r't% a �`i.d�} ���,�t st ��` �3�' •'"+�`n ( "� a � • �, 6,� � � � r y 4 Y* L � M1 � u 5t ';e9 S'Y _ 1 .,C •a � 'v� N V; - 1 . ���� �� �� ��+� �� � a � � r �r�.. S .'��� � �� {��� t�s ��i a� q+ � �u�•`,i� i� t�,tt ��''k � � ` a A ,�a ` cif ! . , ,. rf, a F " n % " r, _ a1 11 `I T . 11 • f st S `P,� d klr °Y:�m J ¢ n �,- :,�j Fi... A few n .'.e i%f , 't�.> dd'4T I 'j I I� 1 4s i „'. o 'q a n [ -,o r sH - `t },. P 'Z 3„ '76 i .f '. ,.k.. �V ":f °:, u 1i . ” ? , , t, w w. = Y y 71+.. ,., P``�jp� a °`� } 1¢ 7 t 1 T 4 'I }: . �'h� a "'. ., �'. , ,� o t �ti tl:, >, max•, �, .1 4 . , �Hir ht 5 " t $ § rryvt t s :, , S�3 Fy *+ja,,'• 3t, i 1. i a• i ..f M ;A Y) t '.."q 4 -Ry {7 ,itS 5 1 '' f �p e �' -..�. w . ', 6 � ^v ` qqqqqq A-1��r��r • 0 Y l 14 q, f v +4 ; ,h 11 }, ­t4! t s'w 1 'I t "r o x ` W "^ x1 { . I v . g ,r y • •Fa 1. a a � I Ida � 11 I. 5 3-: } ° x �gti � a , 1 y+.: 1 t I 1 P 7 y ,, 3 �,�� 1�'rI � , 4k P, y' m , :,� d 1 A � I "t , 1 tit .;' U" C t ' , mt a I a 1a a. {, 11 P' i ill y i 7 6 .. X Y "•3 L t',. 'I y "P'x �. ' d R w a P ,'t, a ,dn7 %` r 0. ,, d ,.'` ,;;,t % 1 r'„.aX. 'Y t t S`" J 4 , M �Iq //��4 % F yI'-1 I s`� a 3•.__ �fA� Y -:_ . �,ut 'zi, . /1d a� "� „ ;W�� -4Jd 1±p ran :'q. r, Itw., W` i.b .,,, ,,m, "iq0 �: ' o ,fir.. ., dt a r; 4 w^ P" } lr� 8 w 4 , - ', wey 1, .3 I f F . t' , 3 . kv• ,.. }. ., _.... ,.t }.: ,{ o.'.r t e e I.I Q uv{Yµ 't" 1 '.r 4 l3 � JI , fH� R k r gto SfRV«fS pLAL " H °'C e t'% ;l '� �r r � I . ,' 4 I, l , t t Ilf . � ,v r ii y, µ•.. I >. Y a 0 f. 1 4, { t i i i f' ti s" t. �F � , jtw, t s 1•. 1. 1 � `W Ie,�}„ �R S yrk W %. f i l t 5i 1 i �� * ! 1 �I C 0 q ''T R6 }...x i ,bv id. , IAV :tW� v ,""" ,,.' Jt FI j. ti" 1. I , k ? n h} N'"�a 2k,'2 ,i~'"b,F. '' I `a, 1.}t :..� ," bt a e �} S Tai }r� }z }. > t , 1 S J } 1 i t t I- t �t$ d. hr ,� t' tad` a, I ':y , j r +.k^t + i — — ....._.—. - -._ - --....._..... - -- -._. _ W }; '� 11 L �;,° }4 ;} y 1 ,) "' 1t }3'�I Y fir; •3y r P u- 1 F e b ! ! F: 1 9 1 1 4 i y A xanp;t A ., a i S a /07 - i . =t i � , } J 44 ..lpr+4q_MM AI NFi44V 3ERN.9�l. i, SEPTIC SYSTEM.. SIGNED & SUPERYISED._BY y _ .BEDROOM HOUSE FOR EO- ROMANELLI'- AMICO, Soils RATE, E _ NSULTI'NG - ENGINEERS F: ,_ -, 1 GAL ;TANK = r ».a� TAW i°Od�e, NCO NTY NORTHRJDGE ROAD L;_F. =3 TRENCHES. _ _ PEfKSKiLL N. Y _ M1 'NEW YORK = ORIGINAL _ dC r " SCALE , . FINAL NY. S.. PC NO.'..bl�Y S 3' � •• ti xl It I YY i. of 4. ; v • 1006 6j 24 Rl-LOW TYPICAL SECTION SCALE: 1 10' t D. M NAM Cr'1'`:'1'1' BI:PA!\'T! -1t NT Of HrAr,Tii . DTVTSTnN of f'` :Vf" :*- ;F.NT:1G 11FALT11 SITkI[CrS ,,•L' -. ...,..�.- ...., ..._. ... ..... -..,. ... ... .-r ,.. ...n.: .... ....you............ _.,... -_.�." Date October 20' 1975 Re Property of Wank Grolli • Located at West Road - Robring Brook Section Map 656 Block " Lot D Gentlemen: This letter is to authorize John S. Romeo i"duly licensed professional engineer X or registered architect (hndicate) 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 pro.^ulagated by the Commissioner of the Putnam County -Department of Health, and to sign all necessary p.apers on my behalf in connection with this matter and to.supervise the construction-of said - system or systems in conformity with the provisions of Article 1115 or 147, Education Law, the Public -.Health. Law-,­and-the 'fiery Code. _. Very truly yours, Signed / xyVk Owner of Property ountersigned: .E., Mme, `027846 Address �j� 1 Northridge Road •' p�1t�1 Errv�,yFf � ° S� � 9 •. Telephone ]dress ,' �� ,��F qy • ' Peekskill N.Y. 10566 •z g 737 --1056 27 SO VF ITEM ' e 'lcpholle °b n e o 0 a� i; Is' 9 Frank GroM Patnamun(w (T) owner or Purrc" aser off' Building Municipality Frank Grol i 656 Building Constructed by Section Vogt RNA 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 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- the of the Director of the Division of.Environmental Health Ser- X.,- -vices of the Putnam County Department._.of Health a_s_ to whether or not. -the { liar � of 7t- he�-- .e-st-.e� -t-o- - -opal a_te._ was­<c -a:u -s-ed --by ­t-1ra--wrlrfti1 °o-r- n�egli-gen , _.. . �� act of the occupant of the building utilizing the sys . Dated this 30 day of 'TOM 19 76 Signature_ �. Title tir_corporation, give and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPuETION 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 t i �3• PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CQUN�-- QEF.IC.E .BUIhDIN:G:;�.- CARMEL; " =•N.- Y <.. 10J12-= _'. °_., °° , '. °"''.° '< -- _._._ >_..... DESIGN DATA,SH'EET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.-, Owner Frank Grolli Address Box 340 Putnam Valley j, N.Y. 10579 Located at (Street west Road Sec. Map 656Block Lot D 6dicate nearest cross street) Municipality Putnam Valley (T) Watershed Nekskill N.Y. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION NEE apse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches (1)l 4 :58 5 :05 7 15.50 18.50 3.00 2 5 :06 5:14 8 16.00 19.00 3.00 3 4 2.33, _ 2.67 5 - (� }1 -"4 :59 5 :11 12 21000 2/+600 3.00 4100 2' 5:12 5:26 14. 19ofi5 - -2477.5 __ .� _ _3_,. -M0. - t. ._ 4 67 —._.�_ -3 .. 4 5 3 5 Notes: 1)- Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. 3 5 Notes: 1)- Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. DEPT 6" 12" 118" ' 2`t" 3011 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Q H HOLE NO. 1 HOLE NO. HOA �IV�_ }± 611 Topsoil 3t° Topsoil SCR CEirapi,oi�i�� brown sandy gravel brown sandy gravel °row with some larger with som® larger some Lrger stones stones stones 3611 42" 4811 5411 60 66" 72" C 781 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None ; INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS. MADE BY Sohn S. . Romeo, .. , Date _ ,.,Sep temb®r 179 1975 ` Soil D Used °10'Nii1 /1 "Drop: °', Rafe No. of Bedrooms 3 Septic Tank Capacity 10� Gals. °Tun Masonry Absorption Area Provided By 1$0 L.F.x24" 3b" X ° ° m @ %ench. ivame John S. Romeo bignature Address 1 Northridge Road SEAL o {' o Nekskill 9 ° ° a 0 27800 THIS SPACE FOR USE BY .H ME Cr HEALTH DEPARTMENT ONLY: p0° 00 °° 000 Soil Rate Approved Sq. Ft /Cal. Checked by Date 1� M TOWIT OF PUTNAM., )L LEY.- _.. ._.,., µr.:.._ .........- ..,. _., .... GT.,JLL�DRILLERS ^LOG AIND REPORT riELL LOCATION Q 0r-. street section block lot BELL GWNER Frank - q`a elLake ,Shore Dr. Roaring Brmok, Putnam Valley, NY name address city or town WELL DRILLER BOYD ARTESIAN WELL CO.,INC. RTE 52 CARMEL, NY 10512 name address city or town Lerigh: 23. feet or :Pumped- 2 EX L'_ame_ter : Inches Yield: '0 GPM br ,00,-, DEPTH OF WELL 120 Feet easure i.rom land surrace Stati ,; 1.5 ft i Make ed ' `" ft 1 L it ot Ft� ize In ., 'Give description of forma .lion penetrated, such as: peat,' �.Tround Surface 'silt, sand, gravel, clay, hardpan, shale, sandstone, ranite , etc. Include size of gravel (diameter and sand fine, medium, course), color of material, structure , (Loose, packed, cemented., soft, hard) . (Ex. Oft, to 2'i it. I.- __.2 : ft to�.�f_ : �r�a�_ tch exact location of well to least two permenant Landmarks Date :Jell Completed_ 3/36 i Date of Report 3/10/76 Well Driller r ature i