HomeMy WebLinkAbout2258DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631 - 589 -8100
41.06 -2 -31
BOX 20
02258
ikc
16
t-
oil
02258
T i K
r. �L n ; ?.
PUTNAM`-COUNTY DEPARTMENT` OF HEALTH
Divtsron ofo Environmenta'/ Health -Services- Came% N Y 10512
FRTI,f ICATE-- F, CO_ I�STRl3G! 1f21�i C0119�LiQlalCE FCR SE�'IAGE =UlSBOS�AE SYSTEM,
�'ut�azn _�Ta11eY� , (;T�
Town Zr Village
11 .' - Lake Shor Rd 'Esat (Roaring Book�
LOcated at Section p 3Q8E �' -
a s - _ Block
4 James & Kathleen Heekin 339 &port 3L�0`ii
l Owner t Lot Job
' Valcar (Rudy Valentin } ;a,2Q Woodland Blvd Peekskill N.Y
5eparate?Sewerage_ System; byiJ„py gtldress •
CC 1!
Consisting of Gal Septic Tank 4JQ lineal Feet X - width`. trench
Other, requirements DQmes.,tie Us;Q zQn1y
Water _Supply A Public Supply From
x _ =
An kiell Drillers,
,,Pnvate Supply D,niled By
s� 4
Barger °'Street Putnam Valley,`= NY
Address
•!• .
I Rai sed Ranc
Bu�ld h 3 Des as 4s�s•A11�� �'
mg Type No of Bedrooms
Yes • , `�
x
Has Erosion Control Been, Completed a O,y l •
$•
I certify. that the system(s)+as listed'serving, the above premises were constructed essentially as shown on the i Fhe orp�ie's of which are
attached);, and �n' accordance with 'the stari lards rules and regulations plaris,fI ed,�arid the permit is`suedz ,ld. P. y ilment of Healtfir
- • C •
E J:7,ne 12, 19'7.8 �%� • "' X
Date
a Certified by P,G� R q
` address 13Northr3dge tRoacl eekskill., N.Y: l0 6 027546
i -Any person occupying premises served by the above sy5tem(s) shall - "promptly take such act�oh,as may.6e necessary,to s LIG1�it4M, ection of'any unsopitary
condit�ghs resulting from uch usage Approval of the 'separate '.sewerage; system shall become null and void soon ,as a public sanitary,,sewer becomes
available' =and therapprovaf of theyprwate, water suppiy shall,,become. null a id when xa :public wale, -s ,piy eco:mes available Such ;approJalo are
sub)ect to. modification or change when, in the. judgment ;of the':Com �ssione f H ev-o to odificat'on or than a is necessary
Date (��[ 76,
! a €� gyp ox w Tite
t.
I
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH
3)71 Division of Environmental Health Services
'= COUNTY OFFICE BUILDING - CARMEL, NEW YORK
This. report is. to be;compteted by_well drillgr;�@InA submittedao County ;Health Department .togethe�..with..laboratory report:Af:—
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 I
OWNER
AME
ADDRESS
LOCATION
OF WELL
(No. B Street) (Town) (Lot Number)
�J
�� '
PROPOSED
USE OF
WELL
BUSINESS
DOMESTIC ❑ ESTABLISHMENT FARM ❑ TEST WELL
❑ SUPPLY ❑ INDUSTRIAL ❑ AIR ❑ OTHER
CONDITIONING (Specify)
DRILLING
EQUIPMENT
COMPRESSED CABLE
ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ ((SSpe ify)
CASING
DETAILS
LENGTH (feet)
.2 /
DIAMETER (inches)
r/
WEIGHT PER FOOT
��
THREADED El WELDED
E SHOE
YES ❑ NO
W CASING (n TED?
YES LJ NO
YIELD
TEST
HOURS G.P.M.
❑ BAILED ❑ PUMPED ,® COMPRESSED AIR
YIELD (G.P.M.)
WATER
LEVEL
MEASURE FROM LAND SURFACE —STATIC (Specifyfeet)
DURING YIELD TEST fleet)
Depth of Completed Well
in feet below Land surface:
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 (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET to FEET
`
/
la l
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE WELL COIMPLFTED
✓�
7f
DATE OF REPORT
I
WEL ILLE=1at e)
V4
James & Kathleen Heekin Putnam Valley (T)
0 woe r -7- Mun i c 1 p a.L i t y -------
�_or' q_rOhOer or Building
Map 308E
d n CP truct6a Dy Nction
1�0�0� 14 ;5t*0'P8_t__" Mock
339 & Port 340
BU11din4 T d
Lot
GUARANTY OF SEPARATE .SEWAGE-SYSTET-4
I represent that I am wholly and compl etaiy . reappnoiblf. for the
Jqqgt1Qn, workmanship4 material, cons ti-,,Ac t lon and dr4inaae of the sew-ge
disposal system serving the above described property, and that it has been
U.
constructed as shown on the approved Plan or apprr.)ved amandment th ."t
and in accordance with the standards, rules and r - i. i
egulatons of the Putne-M
County Department of Heal.t4, and hereby guar.,an *
..ty to the owmer, his succea-
sora,.heirs or assigns, to place in good operating condition any pA.-t of
Said system constructed by me which fails to op -rate for a peri* . . ro
"i od of ty�.
years immediately following the,date of initial use of th'a sewag I e d1spopp-I
system., or any repairs made by me to such system, except
Ire the failure
to operate properly is caused by the,will-ful or negligent. act of the
ocru.-
pant of the building utilizing the system.
The undersigned further agrees to accept as cone"ugive -, de-
termination termination of the Director of the Division of a-,;.r . 4
LrorLn.ental Health fir_,
vices -of the -Putnfpn - County. Dep*artmont of Ilibalth as to whether or
r no-t the
failure of -t'hb-system to 0pOrata Was ea -tie will - fu_1 or nag� i, ant
a d bye ILI
act or the he . system.
pant or the buil.d
Dated this day of 13 9 �( signature
D
Ti 'le :2C JL/ DIV
(11, corporation.- g, ire name
and address)
- - - - - - - --- - - - - - - - - - - - - - - -
THREE (3) COPIES ARE REQUIRED WITH TI EE. (3) COPIES OF FINAL PLANS. BEFORE
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICF. OF DATE OF FIRST USE OF SYSTEM.
-P, q
Division of F
Health Services, Putnam County Department of Regith
Qf
FUTNAM COUNTY DEPARTMENT OF HEALTH
- DIVISION L._BEALTH_ SERVICES ,,--_;;,-.--
M_ -ENVIRONMENTA
....COUNTY OFFICE BUILDING, CARMEL,,- N. Y. 10512
DESIGN 'DATA''SBEET SEPARATE SEWAdEbiSPOSAL SYSTEM FILE Nb-.
Owner* 0" & We, 'lame I s Heekin Address 54 G.R. Fenny Drive Wallkill, Now York
Located at (Street Lake Shore Road, Seft 3.08E Block Lot -339 & Port 3
4n-TIc-a-f—e nearest cross
muhicipality Putnam Valley Watershed Peekskill-,.;,
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
5
Notes: 1) Tots to be repeated at same depth until t LYY . rox imately equal soil
rates are obtained at each percolation test hole. A data to be submitted
for review.
2) Depth measurements-to be made-from top of hole.
Role
N-unber CLOCK
TIME
PERCOLATION
PERCOLATION
PET—
90.
Start-Stop
E.1apse
Time
Min
Depth to.Va-ter
From..Ground Surface
Start Stop
Inches + 'Inches
water EFV-3-1
in Inches
Drop in
Inches
Soil Rate
Min./in drop
(1) 1 2:.062:'28
22
27.50
30.50
30
7.33
2 . 2,05 2:59
24
27.75
30.75
3.0
8.00
r
4
1. 0.
26
28.75.-
�,Ql.75
2:40 3:07
-27
280.25
31,25
3.00
."
9.00
3
5
Notes: 1) Tots to be repeated at same depth until t LYY . rox imately equal soil
rates are obtained at each percolation test hole. A data to be submitted
for review.
2) Depth measurements-to be made-from top of hole.
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED Novae
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY John S. Romeo Date June 14j 1976
- -_ —_ -,- - DESIGNS —�
Soil Rate. Used 8-10 Min/1"Drop: S:: °D. Usable Area' ;'Provided 5000 S
No. of Bedrooms. k Septic Tank Capacity 3200 Gals. Type. MaSOM r
Absorption Area Prided By 1A5 L.F. x24" x'— wic�.tih'
Name John S.. Romeo. Signatur e
Address 1 Northridge Road SEAL h .:
ftekbkill i..' New, fork 1.0566
• s
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY. • °
•n •.�
Soil Rate Approved Sq. Ft /Gal. Checked by Date
.y
PU`J'NAM CGUNTY DEPI1RTINIF"r ()F }(1;11r,`1'►i
DIVISION Or FNVTRONMI ENTAL HEALTJI SERVICES.
Date Junel09 1976
Re:. Property of Mr. & Mrs'; James Heekin
Located at Lake Shore Road, Roaring Brook Putnam Valley
% 308E Block : Lot
Section P 339 & 'Portion 40
Gentlemen:
U
This letter is to authorize J M. S. Rodeo
a duly licensed professional engineer X or registered architect
(Indicate)
to apply for a.,Construetion Permit for a separate sewage.system; to
serve the above noted property in acc.ordance.with the ;standards, rules
or regulations as promulagated by the Commissioner of the. Putnam County
Department of Health, and to sign all nece$sary papers on my behalf in
�1fr�f•rinip W17:t1 't'hiR n1Ai'I•(AY• "TI(I. i'n Rusnr-rvicP rhi? nnnci-ri.,nrinn n•r cai6
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, • and the Putnam County Sani-
tary Code
Very trul yours,
•• Signed
Owner of erty
Countersigned: 54 C.E. Pere Drive Wallkill., New York 125
P.E., # 7846
Address
02
1 Northridge' Road: Telephone
Address ♦... .♦
Peekskill., New York . 0566, � � � Rpy °� •'
• �S �. .
737 - 1056...
Telephone ��`
.3.
5'x IO'CONCRETE PORCH
--7
Fn
UTILitaLl
REA
TWO CAR GARAGE STORAGE
AREA
DIMENSIONS ARE APPROXIMATE
PLAYROOM
13'. 2"x 20'• 2"
m
9 =6" x 13'- 6"
P R E S 4
D E N T
28* X
52* B/- LEVEL
it
IO'x 16'WOOD DECK
C�l
F11
w6
BEDROOM
I
BEDROOM 4
KITCHEN
DINING
12t1 "x 14'.4".
s
9 -0 "x 9:9'
1116"x IZ I"
10-'0'x 12--1"
HALL
BEDROOM 2
BEDROOM 3
LIVING
ROOM
4 11'- G" x Il'- 7
10'-Z'x ll'-7**
do
14'- 11" x
17'- 2"
EOYER
.3.
5'x IO'CONCRETE PORCH
--7
Fn
UTILitaLl
REA
TWO CAR GARAGE STORAGE
AREA
DIMENSIONS ARE APPROXIMATE
PLAYROOM
13'. 2"x 20'• 2"
m
9 =6" x 13'- 6"
4 . ° - 4m.8 '',.aa � s * ,�,a,s,,, wh � � �, , : _ �, rt" �, .r 4 ....} �' :`S• '' *t''r*E�P rte.. "' �-
z_ �� fix"" a i l r u a r C 3
5k a s y 3 ¢ ys �AcY3 y e k�� ' r ,-Jr j 5r1 Y , �' u , j ^ i s r r .
es F
S y 'fi r ,rt - 7 r.
�, -� - 1, -..i 2° I� of d, >.S d {� f:: u. I {.. .
t t
i 3v
•, i. -< r b [ iF Y 7. t. r Jx 4 ` -- ��l .iS�S S Y" r G erT, : ,... _ .. . _.. .
u..,:s _„ 5 q �, s�sr ,o,�, 3.4tii,iPW �9Rj'iC .gu. - 11 i L
a Y
N {. 1 .� 6 N i 4}
r ^� >„ _ ..
e to r �.�L�� ., ' "`. - v.; „"'^�,,,- KPS�.., E 6 /'2 11
''a . � ; --"r- r r
.. -. ..
n k`
X,
x
-.
j E Cf .r � � rr ,�Y �(L '
. Si Q�}Pyry 4 j ty. 1.
r ] h W- �Lt 1.µi[ •tj, '*� 1.
t 1 1 Imo" E .? fr` '•
d. 1 ttr 4 �. K� " -' L r
.
- t 'r 4A.2a.y,z t >. 4 `�w.,{ .zyca'xfv. p -4— ,� " , [� p
y
j x ds x ,"
f k{a �' dS a j rb� A��rc s j, -4 j4f(,kiJ r,�1 .
f t { L_ 3$- X �� '— : <r C ' s'"`'_ .c c' �s .. �' + •.ZS'1�7J +pry r .
'2 cJ "v i '2' y' w 4' i r! -2cT uI T - "zzc. x y o a J� � r
K. �. F.:- '' w ¢ �S.-• "�' I',c ?".I t"I"� ;�¢'fr i' +'.A... .� � rte. � � ki Y•r Y �'� y� �yI �+ � � �`^_A .
,y t,• (,p. r tG� ,er' 'j .,7 f�5^4�','�•a+. `'�f�x m5j y F.t / 1 .1.�..} '¢'r .r 9
r"4C t r"4": � 3i - . ?•d4 ) — ,1sU y Te �r��. Y ""A' 4.,+o!' Y.+ a— a �.i' _ 11 ,v.r -, r } r s .i. `C+�•' )? a'' -"'a )'z • . ' ", t �s �1 .tze „'zG l '_ ->�` � : f t : s.. [fit �;,� ;� .
i x x � s x.� .. c x rr' s'? a FL 'M >L k ; t 6 a w : ,7n ,
' S 1 r^ - rtrYn) '1 . z s $•4•'a- rr,[ d' y, . Q. !1114- r # C�- 1.
r � • $ '� - , ttv a� i`) z- .St,� .. . j� x arc r i ..t h . xl-
Y, , rr < .ar err x I tr tft C.
{� C .. Kf x -11 r' i T +' f t kk M r,s „ji ft S t � � .
'' 4. 9.: t 1xi _ 6 '�" ti) r `'we , - .5" 7 Asa':
-•'�
P "
1 ,e -.�+' a k � -+A -r.1 $+{Y+3zl�. T ten: r
' r y. a..C' C�,., D, t '' F
i
`� � 'y , "1r�o+$y . c!� '...• --s "' off{ rc
a,� 4 z r`a v 2
v '. t . � K rk 3 =" " , r'r nr 'r F n
s r - :t � ``'to- ; , a : n ',ti r a .,%, R. - n ~ � FuYN-L �OuA'T�rr«
T,+.'ry� r a .s+ --^,•^ j�`'f.` > ., . � ,- rf^ 1 i�,.ri` -' . "'a'e�' .v , µ, r ] li I.
s;.' I:,A c -cY ;i %^� to } g ��>i 0 •f a
t <•
n (aF�341�: 3
'.f x s4`
.:►, G t
r a jz'
t 9, °r ;.1
� r• '. _
.
r,
R $ A Si . .
Fr., of '�^� 5 Y
x
2
n
: �F h >. i } t 3 1 c 1
P F' V �raF k 1 r P' 4 A
S
L
u ; J
F r c
y r r ..s* ,�" s Yy l i ? h z r ""` +.r r
JU 5 T9 ,
�al z 1' c t. •' n aY"74frx ,,}, 9`�, F �' J �. t. s F ..d
.1 I f r r t U h ,,, ?yYiT Fnr ',�* t "t V ,�` s t _ +, ;N' .,;. [ ti y �>? sz rat tit . i
l % r -�° �s >} _1 # =a-a i' s35C a ur•'3., r... :c..fr c r r f75_. G I — " .� k;..i i. t ;x -.�J'" & - Y'[ya.
~, - ,k .> r {r do � h + t,, a`a
- OIVg10N Or T Y' n l Cs, * Y.-i 1 ' a r , 4 4H toti 5.,, ;, 11 e,- . { n3 `C �, lsF 11 E z I 1T 1� 4 f ` G• �„�f Y§J Y i i `,.,- I fb. 11.1.1
� .. ` h. D }�l•EPl � •�- ,Y � 1 •y': r �^' {/ F �-,�S t.ir .it '
C X' r. L .(� r- t i �7 4 .I iti.. 1=Vi i }. 11 Ix est#
4 t
�r
2 - ,r4` 1. 9� � r r r t+ILiNt Yit�fC c • ;
'se.• ORI�NAL.- — JIw ! Ji.V ', - a:- . 411.
.. 11. .+.: f. s _ '�'` _.. ... " F GY�rF S.r 4�� _ �.(•'}1...,..