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HomeMy WebLinkAbout2354DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.14 -1 -25 BOX 20 02354 a 11 . , r N,,'. T� Ikm! J } I ' ' I I N.'. � Jr ` � Ali Il 02354 1'1�-77 h�.y. PUT) (� -Rev.. 3186 > Divislon'of. l d COUNTY DEPARTMENT OF HEALTH iroomental Heeltb Seivlces, Carmel, N.9f 10512- ! Engineer Must ProAd® 2 Q 8 to P.C;H D Permit q r UT fA1�TlR+'iJf1D'QWmA/11A MC DACAr eVNirF'.tLt ` '111 \11� r-. -:• U x., t •F=CC Tar Map I :,Block Lot .8 . :.. . Owner /applicant Name {'�rf-r'�N- 4►1tiZ� Formerly Subdivision Namei Ate. LotM�_ MaWng Address. JZ *X-(3' '1 OCe& Zip Date Permit Issned Sepaste Sewerage System bunt by Address Consisting of C000 Gallon Septic Tank and .. Water Supply: Public Supply. From Address Address r or: ` Private Supply Drilled by Building Type. Has Erosion Zontrol Been Completed? Number of Bedrooms Else Garbage Grinder' Been Installed? Other Requirements i certify that the.system(s) as listed serving the above premises were constructed essentially as shown`on the pkfts of the completed work ( copies of which are attached) , and in accordance with the standards, rules and regulations, in accordance with th fi d"pla and the. permit issued by the Putnam County De rtment d Healt . . Certified by • ,/ Date P.E. R.A. Address License No. 8 Any person occupying premises served by_ the above system(s) shalt promptly take such action as may be necessary to ure the correction of any unsanitary conditions -resulting from" such usage. Approval :of the -separate sewerage system shall become hull and void as soon as a pubs:': sanitary sower becomes available and' the approval of the private water supply shall `-b.ecome null and "void when a public water supply becomes available. Such approvals are subject to modification or change. when, In Judgment of the Corrimissfornr of He , su revocation; modlficat {on or change Is necessary.. DateO Title -1L ;2.021 ?'07 r LAB # Yorktown 'Medical Laboratory, Inc. 321 Kear Street Date Taken: I Time' 00fA4 Yorktown Heights, N. Y. 10598 Date Rc' d : -IZ Time: yr �(914)14 5 3�U3�� wDa,.t e- �Re,.part�e:d_ :. - �.. Director: Albert H. Padovani M. T. (ASCP) Collected By : Referred By: 0-rocs ey sQS ekar- S1 C" Sample Location: &A1AntVvu 12 Lmee as' We ®f,. ptovv owk �/Cd L I LABORATORY REPORT ON THE QUALITY OF WATER Phone # =$a -5; ZZ7_ Phone # I Sample Type: Repeat Test? _ (check one) INORGANIC NON- METALS (mg /L) MICROBIOLOGICAL (CFU /100mL) Acidity _ Alkalinity _ Chloride _ Detergents, MBAS Hardness, Total Nitrogen, Ammonia Nitrogen, Nitrate Phosphate, Total Sulfate _ Sulfide Sulfite GENERAL BACTERIA Standard Plate Count (CFU /1.OmL) MEMBRANE FILTRATION TECHNIQUE V/ Total Coliform_ Fecal Coliform Fecal Streptococcus METALS (mg /L) Copper _ Iron Lead _ Mercury _ Sodium Zinc MISCELLANEOUS. pH (units) Color (units) Odor (TON) Turbidity (NTU) MOST PROBABLE NUMBER TECHNIQUE Total Coliform Index KEY FOR TERMINOLOGY CFU = Colony Forming Units N/A = Not Applicable LT = Less Than ( <) GT = Greater Than (>) TNTC = Too.Numerous To Count CON = Confluent ( =TNTC) NR = Non- reactive . Potable Non- potable STP INF STP EFF Other: Sample Status: (check each) Outgoing _ HNO3 _ HC1 _ H2SO4 _ NaOH ZnOAc _. Na2S203 Other: REMARKS /COMMENTS (For Lab Use)_ FLAP #10323 THESE RESULTS INDICATE THAT THE WATER SAMPLE (WASV) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STAT NKING WATER CODES, FOR THE.PARAMETERS TESTED, AT THE TIME OF COLLECTION. Y Albert H. Padovani,.M.T. (ASCP), Director 2 /86(Rvsd7 /87)RWE VILE 4 °C GT 40C pH LE 2 pH GE 9 _ pH GE 12 — Other: REMARKS /COMMENTS (For Lab Use)_ FLAP #10323 THESE RESULTS INDICATE THAT THE WATER SAMPLE (WASV) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STAT NKING WATER CODES, FOR THE.PARAMETERS TESTED, AT THE TIME OF COLLECTION. Y Albert H. Padovani,.M.T. (ASCP), Director 2 /86(Rvsd7 /87)RWE a. a PUTI'NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 4 4Flee5o r T/,. -d Owner or Purchaser of Building 2c er' oveq eS � e Buildifig Constructed by Location - Street +� iONJ V� Municipality Building Type 12:) 1 18 3ectim Block Lot Im Subdivision Name Subdivision Lot # GUARAN'T'EE OF SUBSURFACE SEWAGE DISPOSAL 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 successors, 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 approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any : the, ail repairs:ade, by-me-to- such_ system,. except when e a_ properly. is caused by the willful or negligent act of the occupant of the building utilizing the system.. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services 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 C.J day. of '190 1 Signature Title zldt GEi9!ral ntracto (Owner) - Signature Corporation Name (if Corp.) 2, 41,2, blq Llel Address rev. 9/85 mk tl - - Corporation Name (if Corp j ess a " WELL UU11rLL11UA 1Cnruml ;: DEPARTMENT OF HEALTH 4* i Division .Of Environmental Hea}tls.Services _ c�W. tij�4 PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only > / � �rK y� STREET ADURESS: WN�VI t Y . TAX GRIO NUMBER: Grove Rd. ,Roaring Brook Lake Putnam Valley, NY �J/ �� WELL LOCATION WELL OWNER NAME: ADDRESS: Alfred ala 10469 O PRIVATE O PUBLIC USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS ❑ FARM 0 TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. P80PL'E SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING ® NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 165 ft. STATIC WATER LEVEL 30 ft. DA ?E MEASURED 6�8�88 DRILLING EQUIPMENT 0 ROTARY (3 COMPRESSED AIR PERCUSSION ❑ DUG ❑.WELL POINT ❑ CABLE PERCUSSION ❑ OTHER.(specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. ® OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH 21 ft. MATERIALS: aSTEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE _ 20 ft. JOINTS: O WELDED UTHREADED 0 OTHER DIAMETER i1 in. _ SEAL: ® CEMENT GROUT ❑ BENTONITE OOTHER WEIGHT PER FOOT 19 Ib, /ft DRIVE SHOE ® YES ❑ NO LINER-.OYES ONO SCREEN DETAILS _ _..._... _ ._ . -• DIAMETER (in) SIOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES aND HOURS - SECOND _... _�....._ ... __ ..._._ .... a _ ... _ .�.. _ _. _.._ __.. _,_..__ GRAVEL PACK O YES ❑ NO GRAVEL SIZE DIAMETER OF PACK in. TOP DEPTH -ft. BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping METHOD: ❑ PUMPED 1 tests were done is in- t EkCOMPRESSED AIR , formation attached? O BAILED ❑OTHER ❑YES ❑ NO It more detailed formation descriptions or sieve analyses 'WELL LOG are available, please attach. DEPTH FROM SURFACE Water Bear- in9 well Dia' deter FORMATION DESCRIPTION CODE. tt. it. WELL DEPTH ft. DURATION Ar, min. DRAWOOWN ft. YIELD 8Cm Land Surface 1 it in in overburden clay & blctr H t 4ock at 1 foot 165 6 14 0' 1 21 Dr 11 n in rock set casing,groute . granite. WATER O CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? O YES O NO ANALYSIS ATTACHED? ❑ YES O NO M I STORAGE TANK: TYPE Well Xtrol 250 CAPACITY 44 GAL. PUMP INFORMATION TYPE submersible CAPACITY 79 MAKER Boil1 DEPTH 140 MODELZEHO5412 VOLTAGE_4tPs_ WELL DRILLER NAME P.F. Beal & Sons, DA PO Box B /1 /88 ADDRESS SIGFnMRE Brewster, NY 10509 II. V. FINAL SITE INSPECTION Date 7 - y Inspect by , ;G�TION l'G'G� /� / CWNER / - -���= a_ S-wS area legated as per armrove3 plans b. Fi 11 se--ticn - Date of placement 2.1 barrier W-= 5 AVG.DPTH c- Natural soil nct stripped d- Stone, brusin, etc-, greater than 15' fran SOS ares. -. oC e. 100 ft_ fran water course / wetlands. ' SaCiv-.0 DISPOSAL S'YSIEM a. Septic tank size - ,000 1,250 b. Septic tank irm .1_ =gel I }e c. 10' mininnrn f_an fcundation d. No 90° be --reds, cte =recut within 10 ft- of 45° end e. DISTRIHLTIGN EOX 1. All outlets at same ellevaticn - water tested 2. Protects belcw frost 3. Minimum 2 ft. original soil betwe°n box and trenches f . JO CTICN BOX = nrec,4-.--ly set g- Z?S Le.*ic`h r=te rw -- G s Ls —nq t2l installed 2. Distance to waterccurse mes- :_=urn ft. 3- Installer .ac =rd? ncr to plan I 4 - Distance. center- to .canter ... �: (.. . 5. Slc of t_`nch accent=_ble 1/16 - 1/32 " /fcct. 6. 10 feet f=are nrc--t---'Ly , line - 20 feet - fcur^aticns �. 7. Dent:' cf t encz < 30 i*id-ies fran surface I I 8. Rcau allcwz:E fcr exc risicn, 50% I I ° . Size of cravel 3/4 - 1�" diamete -r I 10. Demt*1 cf cr L'ell in trench 12" m i n i mrnn L. -Pine ends cn i h. FT-M-P OR DOSE, S'YSM�-S. ( 1. S i z`- flf P=M- -E 2. O Te_r fflc J tank I I I 3. Alain, vis-al /audio 4. Pump easily acc- Ssible manhole to grade, 5. Firs t bcx b1� G. Cycle witne_ red by He=lm Der'.a.rtinent estimted flag T cycle a_ Ep-ase lcc—=ted pe-- annrcved plans. b. of bedroens ( I W7 i. a. wf-ll1 locat as per aDDroTie3 plaris b. Distance fray SIDS arc measured JZI ft. I c. C. =sing 18" abm-e grade: I d. S--face drainzae arcur_d well accentable.. or I: M'E?.A r.'. 4vCRKM� c- a. fees roceerly grouted b. At? pipes parttially bacdilled I I c. ALI pir.-es flush with inside of box d. ;'dill matarial contains stones < 4" in diameter I e- C=* -gain dram installed according to plan f. C=Ttai,n drain cut =all rotected & dir. to exist- waterccurs� g. P-,ctinq drains d:.scza.rae awav fram SIDS area h. S=. ace water Prot- --ticn adecuat_ I . i. E__oszon conrrei provider cn slopes greater than 15 %. -^v*i'+.°m "RaR,+*r�*'* .- ,.--rte- --rt - mr--- +fir,t- -,^----,.. s. rs- c--- r- '�+- •`^-'-- s'< ^,--r- ^-. r < k ., " f ' ENGINEERETO PROVIDE4. PUTNAM COUNTY DEPARTMENT 61 HEALTH rON� CERT ?t.F TE OF ,CO 17lv/S %On of.'Enwr6iihental`. HWt ' Services Carmel N Y !0512 PERMIT CONSTRUCTION PERMIT F.QR SEWAGE DISPOSAL SYSTEM own• oRsr �Ilage yTax MaPF &iock A Lot Located at 0 Subdivision n ,Snbd Lot q R enewalion r� .owner /Aress ' Date OP:Previous App dd roval ° a Builtling T.ype�u3 o`'ly Fill Section f Number of Bedrooms Design Flow G /P /D o� P.C. "H. D Notification Required Separate r Sewerage..System' to consist of ®y� Gsl .Septic Tank and U' AQ To be' constructed'. by „ -- Address Water Supply Public Supply From Private Supply. to be drilled by Address Other.. Requirements ., - a tlesign and location of She Proposed systems) 1p that�the separate. sewage �system I represeritr'het INaim enolnetructed:as "shown onahe ab18roved artiendment•there;to and in accordance with.the standartls ,rules an .regu a ions:o a u nsm y P Y P above desc b tl b co PP ti County , Oepertment of Health, and thaYon complet,fon thereof s Cetdicate ;of Construction Compliance satisfactory to the Commissioner of Healthwill be submitted to. the Oepa[tmenf, and a :written guarantee will be furnished= the owner his successors;. heirs or assign y the builder that said builder will place'in -'good operating cond�tionisny; part of said; sewage 'disposal system,;duriry the pegod of tw0, '(2) yearsa e_ately followmg'thedate of_the issu . Af- Date ^- +.L/O�[� . 0 S',. P E ddress � . ® ' � License',No ON This,a prove! expuesesre -year from the ;date issued nless consVucUon,.of 0, lding has been undertaken a tl �s en'ged or modified when considered necessary by the :Commisslondi, of,;Health.'" Any-:cliange or_,'alte►ation of construction ed -for disposal of domestic sanitary sewage and %oats water suppl o. PUS® A APPROVED FOR CONSTRUCTI revocaDle� for cause�or may-be am requves a -'new permit. Approv Z Date . .. a.. .... o.... ... a -. �- _..... ...... ... .+..e' n .�. a.•a. .. r .. � ... . �_ ... �. - r.. .. �. .._.a ..- ..na.w -..a ...r.........s- ,� -.... ...... ... • .. i.r .a. .. +� .. .e. .. �._ 6 �... n .. .. ..- +,..- ..... -.-.. �.. .....r MI _ - n 7-- 7`7 .t 'vim a ENGINEER TO PROVIDE PER MI, PUTNAM COUNTY , ARTMENT 01 HEALTH 4QN,,CERT FICAT 0 MPL Division "of Enwronmena/ Health Services Carmel N 'Y J0512 PERMIT #. CONSTRUCTION PERMIT FOR SEWAGE- .:DISPOSAL SY STEW r�,lO T � or VjIlaq, Subdivision dAPl iAi SUM. Lot N t Renewal —0. Revision 1J� Owner /Address DateOf.•Previou8 Approval Building Type i� t f sA%� Lot Area af'}�( v Fill Section only t7 Number of Bedrooms —. ,Design Flow G /P /D �'v P. C. H. D. Notification keeqqu-irreed- Separate Sewerage System to consist .of l E?t i Gal. Septic Tan*and ) -_yo t—1 ©l­ �•(��.L��� To . be constructed by i y '' 7 Address Water Supply: Public Supply From: -� ✓ Private Supply to be 'drilled by 'J', Address 1 Other Requirements �` �•C�- `7i f�� r :] t. ©� 1.7',Li°. . I represent that 1 am wholly and completely-resporisWe for the design and location of,-Ihe .proposed system(s),: 1) - that the separate, sewage. disposal system above described' will be Constructed as shown on t ie.approvetl.amendment thereto and in accordance.with the�standirds, rules an regu a ions -o e Putnam County Department of Health, and thaE on complet on thereof a 'Certificate.' "of Constructwn' Compliance . sati factory'to .the Commissioner:of Healthwill be' submitted to the Depa tment,'and a.written.guarantee will ite,furnistied the owner his successors „heirior, assigns by the builder, That, said builder will place in good operating condition any part of said sewage; disposal .'*11e, m-_durinq'the period of two (2) yeais'immediat y: following'thedate:of the issu- ance of :the .approval of the Certif icate of Construction CompUance, of the original,system.o►any repairs thereto 2) Y he drilled welUdesciibed above Will be located as shown onahe approve d "pan antl thatisaitl well will tie:lnstalletl• in .ac'co a ith •the tanda►tlr ul an reg ans r.of _ Itie Putnam County Depa merit of Health JU �; 1% �"- (` Date Signed P.E R.A. Addreu icrt✓ `�'+ `l L' is se No. APPROVED FOR CONSTRUCTION: This a . y �♦= ^•pprovat expves -_one year from the date issued unless construction of the building has been undertaken and is revocable for cause or maybe amended or modified when considered necessary by t Commissioner of Health. Any 'change or alteration of construction requires `a new perr°{ni t. Approved % for disposal of domestic A.iary sewagafi and priv to water supply only. Date Title�� Rev. 6/65 al n. _� . yr - PERMIT NUMBER y Thies is . to advise the Putnam 'County Health Department that fill has been planed on the be" ow captioned prcpd`ty (S `t et: `location') � { (T o'wn) ('Permit. ee) n. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, *—*-N-.-"Y-.---",ItF51L-j-----'-"'-----"-,!-,- DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. owner NAR51 5AL_,4A1X7_R0 Address e, Aej "N' Yl 6 _41V jq1A OL Located at (Street � &RO Vr OF. 8-trC'J3 Block Lot TH-Ulcate nearest cross street) Municipality, &rNAM 14 L49- Watershed �C, .SOIL PERCOLATION TEST DAT/ REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION RE No. Start-Stop Elapse Time Min. Depth to water From Ground Surface Start Stop Inches Inches water Level in Inches Drop in' Inches Soil Rate Min./in drop 1 1-2— 2, 0 -2 4-Z 30 40 i 13 ZZ 30 j2, 40 X3 23 1 2 )_ 13 . /? 4i Notes: 1) T6qts to be repeated at same depth until a yroximatel equal soil rates are obtained at each percolation test hole. All data to L submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION --. _- DEPTH HOLE NO._ HOLE NO. 2 HOLE NO. G.L. 6" 12" z,10, 18 " d� 24" ,r 3011 , r 361 81f 5411 /I r 60" . 6 If _ 72„ �i • 7811 e < 8411 INDICATE LEVEL AT ,WHICH- GROUND WATER IS ENCOUNTERED /4-""P'% �?�'�r� -r3 INDICATE LEVEL TO WHICH WATER LEVEL TESTS MADE RISES *AFTER'BEING*ENCOUNTERED..: Date "C) BY DESIGN Soil Rate Used 6"7 Min/1 "Drop: S.D. Usable Area Provided SS`��g_ No. of Bedrooms_ 3 Septic Tank Capacity /000 Gals. :50 Absorption Area Provided By 1 d0 " N h. 2 ° S d. S �-s�� - °TR 641- L Cs YS Name / , i' Gitfi4ELL. Signature , Address 100 10 X13 SEA � A��c° D Roo< /VV /OS THIS SPACE FOR USE BY .HEALTH DEPARTMENT T ONLY: Nr3r Soil Rate Approved Sq. Ft /Cal. Checked by Date �...... _;, DAVID: A �BRUEN County .Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services JOHN.,SIMMONS,_.M.D. .. ;<._. Deputy Commissioner Mr. Michael T. Daly Box 243 Shen orock, NY 10587 Re:. Salanitro SDS.Construction Permit Application, Grove Street, PV TM 13- 1--.8, Roaring Brook Lake R` :Realty (Slibdivision, Map 1,Sec D, L2 Dear Mr. Daly: `? This Department has received the above referenced /,application dated 4 November 1985 and peeved --9— eeebe198�— Review indicates IS6D '%' R 8(0 V R EG -IVED M4C to the following items have not Teen ad ressed on tie pl+kiis in accor- dance with the Program Review and Policies for Single Family Residence sent to your office 8 October 1985X, oorz v is c_uss,o>J O,J q sA&) Sb , .-OD aAY LtTtt2 eF t 5 JAIZQAraI/ IqS(�° "-A<: Sufficient deep hole tests to adequately ascertain depth to ledgerock over most of SDS. Please allow several - ._•:_..:._ days:- •n,ota=ce. •to- permit•- � �-nspect- ion• -of- add t oval -required__. w excavations.to permit Departmental inspection while equipment is there. l ( A minimum of five feet from bottom of trigally trench to ledgerock has not been provided. For trigalleys, this amountsto nine feet of soil. In accordance with our discussion on 9 January 1986, it will be permitted to vary the depth of gravel below the trigalley from the normal 12 inch requirement to six inch. 2, �3. Layout of sewage disposal system showing expansion area. See cited reference pages 2.and 3. If the ultimate depth of run of bank is less than 34 feet, than a separate "fill placement only" plan will., not be required. Details of system components shall not be placed on "fill plan ". See Appendix C in cited reference for required details and Appendix D for required notes which must be placed on the plans in their entirety. continued- TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 M.T. Daly Salanitro SDS C.P.A. 1/15/86 Test data is lacking for deep hole and percolation tests. Footing and gutter drain discharge is lacking.. 3• 0 Well locations south of parcel. If.none exist within 200 feet, this must be noted. To`further clarify items of our discussion on 9 January 198 it will be necessary for submissionsto conform with Putnam Count - Health Department requirements as set forth in the cited pub /l�icat ,on. mrr (ssLAI \XC rtfese (T x "-, OE►¢c- c(.)AAM asurc- -r EK4'60 +T� F� t L� Upon receipt of plans addressing the above items, review will continue. If there are any questions, you can reach me at 225 -3838 or 225 -3833. Very truly yours, James S. Ho gens Assistant Public Health Engineer 'JSH: amm- :. cc: Alfred Salanitro, 147-4- Anew - Avenixe`, Bronx, 10469 ,/File F i 1 e � %V� PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY /SUBSURFACE SEWAGE DISPOSAL SYSTEMS FTVrn INSP ECTION REPORT SAL AN qRc) INITIAL SITE INSPECTION � k ►3 - v Property lines or.corners found..... ...... Can estimate house location ....................... Willdriveway need cut ............................ Must trees be removed - note these ................ Deep hole representative of entire SDS area....... Additional deep holes needed ...................... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells /septics .............. D. H. 1 Lot D. H. 2 Lot Depth to G. W. Depth to G. W. Depth to rock Depth to rock 0 ft. �3 9 ft. 12 ft. Soil Descr 0 ft. 3 ft. 9 ft. 12 ft. boll Desc DATE: INSP. BY: YES (....NO I COMMENTS V D. H. -Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. boll Descri DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Rocm allowed for expansion trenches .............. Over 100 ft. from swamp, watercourse ............. Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained from property line and 20 ft. fray house .............................. Distance well to SSDS (ft.) ...................... _ %umber of bedrooms checks ........................ atones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ L5 ft. of peripheral soil horizontally from trench ..... ............................... 3oxes properly set ............................... :ould surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... )oes lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE.. ... rev /9/85 mk -,��I---,,---f,,,- - '--�`,-,- 7-7--,-- ,.----,-,",�i��-�,�*�--!T--�7�,-7';7--�—'7-,�-.�----':'��7-7- �, - � - , .- , - .""I* -- !$-,", '� ,--,� -,. � -- --��--f ,-�.----,� - - �, � -, -,.- '. " , - I.- �! - - ; - - , ��; , . - , - _- . ,�, � - - ^ � . ,- : ..' 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DATE REVIEWED: 1s BY: r7 Permit Application _ Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter.. Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flaw Fill Profile & Dimensions - Volume D orCJ)'Bcx Detail Septic Tank - Size, Detail Well Detail, Service Line if Pvt Trench /Gallery Pump Pit Two-Foot Contours Existing & Proposed Slopes for Driveway Cuts Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion. Area _ Expansion Area; shown; gravity flow. If Pumped Pit & D Box Shown & Detailed .House - No. of Bedrooms Wells & SSDS's -w/in 200 ft—of Prd ty; PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL- HEALTH SERVICES Date. Nd Re: Property of 67A Z, A A) _T- Located at 6ro ye. -5 fp,t� -� L`. Section 13 Block Lot Subdivision of Subdv. Lot # C� Filed Map # 301B L> Date . Gentlemen: This letter is to authorize 7, / / / C14-14cz_ �j9 ��/ L® • a duly licensed professional engineer 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 Department of Health, and to sign all necessary papers 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 145 or 147, Education Law, the Public Health .Law, and the.Putnam County Sani- tary Code. Counter.si P.E., Very truly signed L,,-�ef of Property Address P01 BOX 4�3 ��� r �6g Address. S4�ew vgqvn 0 R OCR � NY / 0S$� 4� � 2 � � � � - 3-7 t� , Telephone 06-0-7 Telephone ,'fit? r~° P ®EEC r�r +�f� . r Y lZEQU1RBp Pdl[� I�b�`pL1_ED � ' , I600 G4L- TAtJK F LOApl1�6� Iw LW FT OF 71?1) .GAIWLE -0 V-511 r-ad FIJI, I�CJtE ' F r ti 1- {pLl6E , yJFit, At.{Fa DRIVIr �/a7 tr�V.�+ c6 rEx 5ucVPY DY` -15, ROMEO UaTi-0 : JGUJLa4R ( ICS, lye LCXAT Ib kr=:, - -� TQnI 24:' 44' _ r c I! / 7P!tS 6 TO CC-MFi THAT TN6.6O^ k'S DGPCFaAL. G-S-EA NAS CD r M_4CTED As IUOiCATED 00 THIS FLAiJ AnlD THAT" TP.S 5'it;T6M WA5 ��ISP6c T6o 8Y MY ?br sE�TArNB �EFOZE 1T WA5 60,IaR-P—D 04e.2. TNe SISTSM Wt6 i.J A<ZoaD4,t IcF_ 01 -TH ALL THE eoL,95 A�JD C6a,(AATICA -I of THE PUTt,"A GUU�1T`( DEr4\W ?i\Si -JT CIF REALTfk, Putnam County - Department of- Health jiv/iJei /o /n of Environmental Health Servioe. / 1 1pproved ad noted for oonfobmeace with 1 / X 6[Y.6 OF l� `off O,E ...A = 0.3178 04° r"v 00 a yd Are �?.L.r✓ : III =2a' r � 6AL Ml£U�1t2`( . 1,20 L F OF tpplioable Rules and Regulations of the ?utnam County Health Department, T T 74Qn4*nTA ,t T1t7A z I I AG t�aILT 5r,- ' IC 5`(61EM v i g � Fort TM* 13 -1 - I.QT- 2 FAO 308D �� o C6iZDVE st�T T0nt1.1 OF ftXNAA VAU.JE( I)iSTfZ.IELST10�.2:0X } �, F r0 0 v i I l2 , 2Z ryes 9P • eo 1989