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HomeMy WebLinkAbout2357DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.14 -1 -32 BOX 20 Mirme rmm oil' ME 1111 Mi or 9F 1 1 02357 l PUTNAM COUNTY DEPARTMENT OF HEALTH i Divr�sfon of ;,Environmenbl: Healtti Services Carm% N Y 10512 . CERTIPICATE 'OF CONSTRUCTION.COMPLIANCE FOR_ ,SEWAGE DISPOSAL_ SYSTEM tnAin Val l e-y- t. 1 own or Village Pt�c�c�i ncs Str•PPt - 13 " -1 14 Located ati Tax Map Block {i KPrinP h: S l#`al?ffPr ! Owner - Lot Job .Separate.5eweragw. Syste `built _bY K?�,t>>k '& SOT1S r IT1C Address HOl 1.OW RL3 _'y Piet._ �La1 1 P :,N•:Y m 1 Conslsting of _Gal 'Septie tank and. .- 1,�f_Af 2 n �� WldF' t� esilGheeS j Other . requnements - i + Water Supply = Publ�c5upply From k Nor -Tian ;Anderson' P.nvate tSuPPIY orI led by; Addres! Ra�C Pr St Putnam Ual 1 Pv N :Y l nr;7A Building Type �? faml �a�7 rP4l C�PnC'P 3 _ { R All- �7 % No of �edrodms Permit Iswstl �] 1 Has Erosion irdntcoi 8�it COrrtpleted7 Ea4� D '4 R 1 4 t i 'certify thAt the Yyctem(><) 1►s #shed esrving t 6bbir6 irei"Ises were cbiis�rueteei easenttaily; b ` th n>i, bf _ pteted worki(copiss of :which are ettaeheei), .and Inkaeeordaiiee v3irli :the standards, riiiesrand regulatioh9, pl�ns`filao, find t i County ,Dpp`rtment;ot Health II 9 _ 1 Date 4 /lOf = %�� Certifletl bye #a PE R A 'Y 4 Andresi< �icsnss No 1 Z n 5 1 6 Ahi perton occupyini# premises serf d by tlse above system(3I shall piomptt ite such actio tLta 6 n thf eor►ectibn of any =unsanitary conditione.resultivig frdnn euch `usasie Ailproval 6f: the separate.saweraiie system shall beeom dp(jgQPi _f ai a'publk. inn #tart' avypr.bseomes ;av8 #table: and the approval of the private watbr atlpR #Y shall become nui# and voW When a puDtic , aCbrlia giiillrtele. Such ipprovali .are sUb#ent ib modifioption or 7itange, when, °iri the ludgnient,;of the CG . isstonerr of=blealth; such 444 W" or change is necessary. Date PEEKSKILL MEDICAL LABORATORY, 1879 Crompond Rd' Plaza „Bldg. A l -Apt. 1 Peekskill:. New To .1 Q666 s ;: : ;..T ... 7-87. PE 77 DATE COLLECTED RESULTS OF EXAMINATION OF WATER /--/ 3 7 S OWNER DATE RECEIVED - r CITY, VILLAGE, TOWN & /OR NAME OF SUPPLY BATE REPORTED SAMPLING POINT BACTERIA:PER ML. (Agar plate count at 350 Q. COLIFORM gfmp (Most probable;No. /looml.) ?, TOTAL ppm: DETERGENTS - ppm NITRATES (as N) - ppm IRQ: TOTAL•- ppm, FL:OURIDE .(F) ;mg. /1. These results indicate that the water was % Es' of a satisfactory sanitary quality when the sample was collected. A. H. PADOVAN , M. T. (ASCP) @#44 "Wk I RT MINT Of "FAL" DivNiAn of onpirgamental Hoolth SAr k" COUNTY OFFICIE PUILpINQ - CAIR1194, {IEIM 'VrORli This r4pptx ill t9 kfl !campletlad by woll driller and submitted to C t_t?�parima[>t._W�sthar.With Ili - - 0 11� i q>�w�it $nipha inidic�tinp'W tei�fsrofi aiisfaet ©ryr bacteria) quality sfpr certificate of construption;*mp iptt REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION PAIR W6bL F IkiF, QAT9 OFF REPORT MJgLL, ILLFR IS gatllr 61 141 ®t� (Ala, 4 . rear) T n let Nor,79or 4f!®POStrp al;0 m tJ6 � IJt�4TIC MOW . RUB$tll R 1tARv 1-,-1 ESTAS ISf4MSP1T INQU$YRIAL -COMPRESSED L:J AIR PERCUSSIQ4 FAp� AIR CpNgIT141IdiMf3 CABLE Q 1E11GUSAIO1,1 OTHER E -1$Pstcify) 'OTHER .,- {Sppcifrj VmLuNQ tQ41PI i CAlSIIaA IP07AILS EI�t TRI plu op CIAMETER(1ncho8J '' WEIGHT REa FOOT / � LxJ TI#READp Q 4bEAPEP YES NQ 1111' NQ 70EQ,D TOO CQ RAIM MQURS ('' 0 Pumplip .COMPRESSED AIR � G.P (a1, . : YII I D (A.P.kf.1 WAIL , 4 S (L1¢, 0...4 FRO* LAND, SIISPACE- STATIC(SPeallyt@er) DURIN4 YIELD TEST /agtJ l Depth of Completod Wall in feet Itglaw land �IUrfac*t O f sc =4 VGYAt¢Q ERR Lt:NgTlt 9011tH T 11Wfpge ((9et� BOAT 6174 aIAMETEe: (InghGwJ OF GRAVEL PACKEDS Diameter of well incluslln R grav @I pock (Inchoo): GIIAY L E peo4aal fR41 foal (U�"'"""� p$¢TN FC" LAMP SURFACE f9RA1ATION DESCRIPTION ShercA exact 10C,tlan of Woll rJlth ttlatanOga, )o AI (g{ 1 two pormanant Ianomarka, FOOT to FEET i I U ZLO LV If yield who tcstmd of di$orent dopths during drilling, list balOw FEET GALLONS PER MINUTE PAIR W6bL F IkiF, QAT9 OFF REPORT MJgLL, ILLFR IS gatllr KENNETH'SCHAEFFER TOWN OF PUTNAM VALLEY Owner or Purcriaser of ui irig Municipality :S.C- HA:E.EF EER BuildIng Constructea by action PUDDING STREET Location StrseE Block ONE FAMILY RESIDENCE 9 Mullding Type Lot GUARANTY OF SE.PARATE 21�WAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewag® 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 tY:e 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 willf 1 or negligent act of the occupant of the buifld � utilizing the syst Dated this"" =day ofNovember. 19 77 sign tur _...._ - Titl - - - - CONTRACTOR e corporatilon, gi ve nam® d addre s) JA�S� IC, TJO �S f'YC n T P THREE (3) COPIES ARE REQUIRED WITH THREE (3). COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE . ISSUED GUARANTOR IS REQUIRED TO F'ILP4 NOTE OF DACE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Division of Environmental Health Servioes, Putnam County Department of Health I DEPARTMENT OF --HEALTH,- PUT, AW,COUNTY�� of S&Vkek, :Ckmel�.­:&­ �Y 40512-- :io' q y NSTRUCT :SEWAGE -PERMIT ��S A A SYST e _110N FOR a WK 01 E�. 9 R rc )0 Lodltiid XAX TIA I 6 Af Subdivlsior�,_� — Roar ip, rook ; Lake Schaeffer ,�._.utham­ a ey e 83 _i�� #.f.,� `-Zwnee K" hi4f; Ad&es -75) ­N,.� Y_ 105 6- i� 4� �n Tarn R oms Total. Habitable Space" , ,L Soo- 1--re 'Feet . N6-mber`of'be�ro' J al.,,Sept! Heal A6''Co Separate S 'd, iw�i�age Syiii" S To �be ,constructed % Address i "Vik r a er. L!Ppiy: Public Supply, rbrn h selected : —Private -to bme-drilled-bil 7', Other uir6nients A tj P �,o �a jetei�,,rpsp6fii!4@f h OR.�,p the_ prop system (,represent that 9M,Wh?I,Iyr p�.It the andAocati' __ o t'. separate d i s `dsa C. stem !the,jprp above deiIribed will be constructed _as ifiovvii Iin'the approved -amendment �rjA­­'. - �o -ik! jn` , pre aFcor h a U"414 ions of.�! the tHam !�_!Carjifiate,'�of n, o4n Department p he'Cd isidher �6f:, it r Hqa��pi In t.oat�.,qq�� be' subrhittiDd:�'t6f,,thii.'-Dei3-ait'me'rit, .,And jryU"!VhhjSph`40id--,- ',owner, hi u asso nV, y e�, u i t at ' iidrl il er ill ;`66n it `,th 4z to fd,i I t he'date' the issu. place in good� 60iIrati69 a—ion- any said prip e,,p -tt ""d ny" 2, at 611 dei- 'i" ,,ance of the- approval* of :.the Certificate -.-p , Construction ,-. - - - ­ 1,,j r I , _of' ompliance o -Ane I I all stel p drilled d - i�`bf-,Ahp )' ,above -will be, oba'tiid as il�Idwn_�oi an arid ihit.,41ii.v, well will 6-�Aiisi;116& �ordaqc on approved 01 -of. the _ Putnam ile regulations Co6nty Ciepadmefit. Oi7 H'Oith' P He Date "k6t 'S'-s A Or -7 �66* 41, 5 Address - . No 6N'1_,T year from the. date issued. u_ s_.Oo�nstr tion.of., the .building, has ,b n unddrtal�erf and 'it APPROVED ,".� FOR CONSTRUCTION I qe. "b de fi es orn Issioner ealth.- -An hi e or' a teiat n of'e6ristruction , , , 1 9� by :the :c' revocabib,foV ysip. or maybe amended p6i�mlt. ��_kpproVe I or., -it f disposal i4tiik6i A -hbw, a Date ......... . . . . . . . . . . Title 77,6, #2 1 7:47 -8:05: 18 23 .26 3. -2 8:o6 -8:24 :. 1.8 ;. 2.3 _ 26'' 3.. 3 8:25 -8::43 18 23 26 3 4 5. .l 2 >. 18/3 =6 .18/3 =6. 18/3 =6 5, PTot; rTc t . Lq �)t? 1 C'jY.7 l "C'ti 17'r .`;f1Pie CZCI)1; }1 tlllt:Ll Il „�r rn s rciLcs zaac c,bt� !ir*d ��( cctc}, .1,�z:'co.l_uL;ion ti ��i; hole. A11 dada to be U:111. W-tl foie rbv:iew 2') U:pt:11 `li)-a ui,cmcrij -.s to tic n.�dc from top of'. hole. y , I'U`I'HA14 0011 1'}'}T PT'.:P.ARTN, E}' +'1' 01" 1 F.z'T TIi DIV7"IOTd OF 1 ?i; \rT}10 ,ATr ;P 7'AL 11FAL` H ST-1W. C 3 DLSIGN EATA 'SIIEET- SErAr,A.TE SEINAGF DISPOSAL SYSTEM FILE.. T,O. . Owner Kenneth Schaeffer Address %283 A Route #1, Putnam Valley- N'. Y. .10579 Roaring Brook Lake __ -- I,ocatC, at (Str'cet Pudding St. �`i��S._ Blocs. Lat_ 9 (].n i'lc ut c. nea.restcross strrE , -- Town of Putnam Valley Watershed Hudson. SO T f l- •., f' +'^'�rTl n E � `t 1 -;;�j T.T r'�`�'• -P L I'':.;T OL',1_IC�;: :�71 T»Tti RT<'OiIIR_.D 70. B. Si7BI`L ".l�..i l )• T— tL:CC' :s_ : Ho - P�urrer CLOCK TIri -', PEKOTAT101,,T PERCO' =.T =" I Buz ? _' �1.apse Depth to 1a�er ;�iJ�,, Laz e I' o. Time From Ground Surface in Inches SOL' En Start -Stop Min. Start Stop . Duo in Piro. /ir dry.:., :Inches Inches irches -. #1 7:45 -8:03 18 24 27 3 18/3 =6 2 8:04 -8:22 18 24 27 3 18/3 =6 3 8:23 -8:41 18 24. 27 3 18/3 =6 4 #2 1 7:47 -8:05: 18 23 .26 3. -2 8:o6 -8:24 :. 1.8 ;. 2.3 _ 26'' 3.. 3 8:25 -8::43 18 23 26 3 4 5. .l 2 >. 18/3 =6 .18/3 =6. 18/3 =6 5, PTot; rTc t . Lq �)t? 1 C'jY.7 l "C'ti 17'r .`;f1Pie CZCI)1; }1 tlllt:Ll Il „�r rn s rciLcs zaac c,bt� !ir*d ��( cctc}, .1,�z:'co.l_uL;ion ti ��i; hole. A11 dada to be U:111. W-tl foie rbv:iew 2') U:pt:11 `li)-a ui,cmcrij -.s to tic n.�dc from top of'. hole. y , PIT DATA RT'011l:}„ ;l'1 TO PT; ;',t.'1'.i'1'1 "i'I,I) ;!.17'11 hP };,*rC "x'1'7:0:: I)ES`,C;}i7.I''{':TON 01' ;:�Q'I,:: i?;:CC;I "D 7f'. `i;::','i DEPTH HOLD I\0. _ 1 I1012s 1,:0. 2 "'° 1I0I2 TIC. 3 G-L. Top Soil- _ Top Soil Top Soil r Sand Clay Sand & Clay Sand & Cl.ay _ 3611 it _^ 42211 � 48„ 54" II.; 60" " 6611. = 72,. . aY 781' _ 8411 j IP'DICATT LEIEEL AT WHICH GROU -105 '?LATER IS Ej- }MOMTTERED None zr,UlcaT1 I.� =r',L TO b(�LCCIi ti1ATL,R Li1,i1TL RISES AI`T'ER BElidu - TESTS IiA.DI±; BK Joel kGreenberq Date July 28, 1976 i _ s' 11 IJLS 1`� Soil la to `TJsed 6 -7--Mn . 1 "Drip: S. D. Usable. A e ?ro:�i:ae 5 , 000 d%rar�et e r 3o. of Bedrooms 3 Septic Tank Capacity 9.00 Cry T-,;r I:e recast concrete Absorption Area Provided By 300 L. F. x24 If ----36"-- d` ;rid C f Vauie eo ore Laurence Strauss 6igna ur. i 4 Associates, P. C. Address Box 417 Deer Park Plaza x 9c. _ Katonah New Mork 10536 o OA - : THIS, SPACE FOR USE-Di LLAIii OIT': Tti E ST Ale Soil Rate Al: proved `'�q. ILL- /Cal. Checked i A i RI TN, \`1 Cr['NTY n[:1'A!;T.%Mi.�:T 0r fff'Aul[ DTVTS'T�\ RT +i`` °elf ^') "'; ^\T1i', AIF'.. L H SFRV[CF:S *Date Re Property of Ket,& ETP ,55: Located at �e191An�%• Gentlemen: This letter is to.; u�thorize USs '14450 C . a duly: licensed professional engineer or re?istered architect .. (Indicate) to, apply fora Construction Permit fora separate sewabe system; to serve the above noted property 'in accordance with the standards, rules r ; or regulations as promiulaoated by the Commissioner of the.' Putnam Couri ty Department of health, and to sign all necessary papers .on my behalf irl "" ' . connection with this matter and to supervise the construction' of said`•. system or systems in conformity, with -."the provisions of Ar ticle 115 oar. 1117, Education Law, the Public Health Law, and the Putnam County Sani Lary Code. RED A&C �XURPNC y/F 4V 0 x ' Z Y Very truly your G k^ r e �OA_ No S O Oqn Property Countersigned: aa� k3 -t ..� „�N� .� A Address Telephone Teleplione we-LL ri , V5 or7,- \j r A '0 cp PAV-K AR&A 431 7 tXfA I-A S I O-W o la ac"T. 1" Q vj -b 0 30-0 1 1-m- 'FT, - .2'-,0" VVI'Dt--.71L 2. 3.;. 5. 7. 8. 9 10. 1 S ILA S;EWA E.T DI S QSAL SyBTFx -,W-T This &&fire septa 6 76 s,t fit- ;l' nsta i d t�nde,r the' <s�ipe-rvis o-n -;off t,i1e:: Arcl ztec.t accordance with. the approved pl= -h and the rule and regulations of the ;Putnat -COuMty Dept. of Health. DE.SIGq..CRZT;ER3A 1. 3 bedroom .', •ous:e - 900. gallon pre -cast co'ri- crete septic tank installed. 2. Daily. Flow � 200 gallocs per bedroom..2°00 x 3 bedrooms ;:t.600 gals . . _. Soil: 6. -7 rein /in. 1..0 gal /sq.-ff. A. 600/1. -0 600. sq, ft. lea 'hinq afea.• re- quired'. L. 600/2= 3.00 lin. ft., of 2 ft. wide _tile fields .ins'talled„ L --T A B c. 271 3" 01-9" ^:211 3 " 417:176" - 631 -9 "". 56,` -V, 70i-6" 604 3111 771 65,-5!1-.