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Home My WebLink About2443DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -3 BOX 21 02443 ■i■ S T PUTNAM COUNTY DEPARTMENT OF HEALTH Division of � Environmental Health Services, Carmel, N. Y. 10512 :RTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM 1��i(VAge Town mated at �••�r� LLB , AOL_( ✓(Aj RCDA 1 , Tax Map f-� Block d•_"�.��1� �� 1 t I r�/�, Tax Map Lot # c_ Bubd. # Nner •-�i��,a��_ wir4 i-T��i[::tyC'� lei 1 ) i �' 7 '� • �c;►�.. �11L� � �f'r� l Address � l parate Sewerage ystem buAlt by Consisting of Gal. Septic Tank and Other requirements ater Supply: Public Supply From AZ Private Supply Drilled By ,.� �-� ,� �a -- — N y' i O'er l� Address l . �� / wilding Type , 47A0 1L4 No. of Bedrooms J Date Permit � ed _�" as Erosion Control Been Completed? certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies f which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the utnam County Department Of Health. A late �° ti`Tl►J Address P.E. \el R.A. kny person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary onditions resulting from Such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes vailabie and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are ub)ect to modification or change when, in the Judgment of the Commissioner of Health, such revo on, - odification or change is necessary. m By Title )ate PUTNAM COUNTY DEPARTMENT OF HEALTH �r r, Division of Environmental Health Services, Carmel, N. Y. 10512 Permit # _PV-15 -81 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valley own or village . Located at Bell Hollow Road Tax Map 23 Block 3 cwt P /03 -1 Klondike II Subd. Lot # Renewal Revision Subdivision _� - (3 Owner, Address Adolph Casden 8 Northridge Peekskill, N.Y. Date Of Previous Approval May 8, 1981 Building Type 1�V Res .i Bence Lot Area 20 • 451 acres Fill Section only ❑ Number of Bedrooms 3 Design Flow G /P /D 60n P.C. H. D. Notification Required Separate Sewerage System to consist of 1000 Gal. Septic Tank and 3,1 LE 1+ of 2 1Wdde tr -ench Septic ,1 To be constructed by SAF Se p Address Katonah, N.Y. Water Supply: Public Supply From X _ Private Supply to be drilled by Boyd Well Drs l l P^rG Address Rt. 52, Carmel, N.Y. 10512 Other Requirements See Dwg. H149K -1 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 and regulations e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 thedate of the issu- ance of the approval of the Certificate 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 installe=accodance ith th e standards, ons of the Putnam County Department of Health. Date July 22, 1982 Signed '�� X R.A. Address 37 Fair St., Ca L�N -Y• 10,512 1 __._ Li( Se No. 38998 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unles struction of the building has been undertaken and Is revocable for cause or may be amended or modified when considered necessary by the Comm inner )of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domest wage, and /or rivate wate su 15.383 j ; z i MANHOLE COVER �- JUNCTION BOX L---------- --- ----- - - --I' PLAN ,GROUND LEVEL c LIQUID LEVEL ` S� ti%L CAST IRON ' SANITARY TEE ?: a - SECTION 1 ,1trvn y v �l N / TYPICAL CONC. SEPTIC -TANK `— GROUND LEVEL 1 EARTHiJ�€�.r n 35 BACK FILL BLO.G PAPER OR. HAY �, I • .. ''�'.�'� c ..F � PERFORATED` i - ODI co PIPE +E4, . L. CLEAN GRAVEL OR 1� MIN. 24° 24 CRUSHED STONE I G.W. ABSORPTION TRENCH 4 #;f 8 `t' !o I( t2 NOTES t le4 loz tai 9� 5:72 IJUNCTION BOX f00TING SET BEL01Rl FROST LINE. (D' 47 7u ut9 3�4� /�C��N3' i// py io3 9� 2.' SEPARATION 'DISTANCE —S.S.D TO LEADER DRAIN I 15FT. MINIMUM,. 3. ALL LARGE TREES,WITHIN LOFT. OF' DISPOSAL AREAJO BE REM.OVED. , CONSTRUCTED F E O RRA WITH THEaTLtS A R5O ACCORDANCE Proeosect. _t t • .'_.. .! I . _rte I ;jctn'pc. 7Amik, fjiZAbG ►1r,7ts : , I. Dana a To GE ,> Nytiu,xA7i4 F;yl ^Et::ikl Su.N? CA4= +i'Ln' aF P•., iw ;.,,.)v i6�u GPH !tr Al A -T p1{ !aF "L5 .' (or e'Vj .f� a �. %i 16tt LEUc; L. ALIkOAA To 21E LnCA,';; fi �f� 1 }oJ`_+ -'�•' 2" N.v.c. ru�c:.4• :H.nI 'u" tic 1NjT%iccr.;: lets vj Be .CApei,,tx aF I �iU C•�A LLatJ T>OriE Cal th . I Dic,i Aggro : r Fo ane i with , r , :.i1 „ i cns oY the Go -lt,� _ ; D Via. t ent. (�nature Tit ( _ � ti. Y r''!jj'''J Le 4� c.a �G�_ •Cry I.r Y' 1: {f 1 `PP'J p f lip y.2`fot'r.GMc�.trl • � �ss'a;� -st +4 � r ttf F(a 151.1 t 111 r l t( l (fit �A 0 Q :z i WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of 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 OWNER NAME Stephen Rocco 1146-01 ADDRESS 17th Ave, Whitestone, NY 11357 LOCATION OF WELL (No. 6 Street) (Town) (Lot Number) Bell Hollow Rd, Putnam Valley PROPOSED USE OF WELL BUSINESS C DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL SUPPLY ❑ INDUSTRIAL ❑ AIR OTHER ❑ ❑ CONDITIONING (Specify) DRILLING EQUIPMENT ROTARY LJXD�qIR COMPRESSED CABLE OTHER PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet) 1151 DIAMETER (inches) 6 WEIGHT PER FOOT 19 2"a1Sl THREADED ❑ WELDED YES NO CASING f YES NO YIELD TEST HOURS G.P.M. ❑ BAILED NMPED ❑ COMPRESSED AIR 1 8 10 YIELD (G.P.M.) 10 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specifyfeet) 20 DURING YIELD TEST (feet) total drawdown Depth of Completed Well 355 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 0 15 bankrun . 30 105 clay 105 355 grey granite If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 1/13/84 D T F PORT �. V14 WELL DRILLER (Signature) r � z. f 1 3 1 0 TOWN OF PUTNAM VALLEY WELL DRILLERS LAG AND REPORT WELL COMPLETION REPORT this repeirt is to be completed by well driller and submitted to Bldg. department, together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality. Well Location Bell Hollow Rd. Tax Map Street Sec. B1. Lot Well Owner Stephen Rocco 146 -01 17th Ave. Whitestone, NY 11357 Name Mailing Address City or Town Tel. # Well Driller Boyd Artesian Well Co., Inc Rt 52 Carmel, NY 10512 Name Mailing Address City or Town CASING DETAILS 1 YIELD TEST WATER LEVEL SCREEN DETAILS Bailed i (Measure from and surface Length 115 Ft. X or 8 20 Pumped Hrs. Statics Ft. Makes When Bai4 o° Slot Diameter: 6 Inches Yield :10 GPM jor Pumped Ft4 Length Ft.Size TOTAL DEPTH OF WELL 355 _Feet WELL LOG ameter In Depth from Give description Af formations penetrated, such Ground Surface ass peat, silt, sand, gravel, clay, hardpan, shale, sandstone, granite, etc. Include size of gravel (diameter) and sand (fine, medium, coarse), color of material, structure, (Lnose, packed, cemented, soft, hard). For example: 0 ft. to 27 ft. fine, packed, yellow sandy 27 ft. to 134 ft, gray granite reet to meet Formation Description 0 - 15 bankrun - 30 sand clay Q5 355 grey granite Date Well Completed 1/13/84 Date of Report. 121/84 8ZS 1 -77 Well Driller ! ;- & ure Owner or Purchaser of Building Building Constructed by Location - Street Municipality I 'F=AOA!L-y �-� �, Building Type GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for A-ha location, workmanship, material, construction and drainage of the sawage disposal system serving the above described property, and that it has bee - constructed as shorn 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 succe.- .,.-:- ors, 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 dispose,:. 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 ation of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or•negligent act of the occupant of the building utilizing the system. Dated this Z7 day of -TAM 19 Signatur Title 1,;7, _" '71, Corporation Name if Corp. Ad e • THREE ( 3 ) COPIES ARE REQUIRED WITH THREE ( 3 ) COPIES OF TIN."::., LF.i ?: ": CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE'OF Division of Environmental Health Services, Putnam County Da-pa--t,:;-ant c.. -.._ G � ' v Section Block __..._........._._...... Lot Subdivision lfElme #� Subdv. Lot GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for A-ha location, workmanship, material, construction and drainage of the sawage disposal system serving the above described property, and that it has bee - constructed as shorn 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 succe.- .,.-:- ors, 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 dispose,:. 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 ation of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or•negligent act of the occupant of the building utilizing the system. Dated this Z7 day of -TAM 19 Signatur Title 1,;7, _" '71, Corporation Name if Corp. Ad e • THREE ( 3 ) COPIES ARE REQUIRED WITH THREE ( 3 ) COPIES OF TIN."::., LF.i ?: ": CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE'OF Division of Environmental Health Services, Putnam County Da-pa--t,:;-ant c.. -.._ PftNAM COUNTY DEPARTMI T OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date- Re: Property of Located at 'I��?. � l�ovi Q� Section 3 Block Lot Jig 3 1 Gentlemen.- This letter is to authorise �.� S,�1lh! 'Src�� a duly licensed professional engineers V/_� or registered architect (Indicate) to apply for a Construction Permit for a separate-sewerage system; to serve the above noted property in accordance with the standards., rules or regulations as promulgated by the Commissioner of the Putnam County Department of Healthy 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. Countersigne P.E.) R.Ao, reir�. (Seal) A ress Telephone . Very truly yours, Signed Owner Property o Address Telephone P,O, Box 99 321 Kear Street LUL:H I IUIVJ: 0 321 KEAR ST„ YORKTOWN HEIGHTS, N.Y. 10598 245.3203 Yorktown Heights, N.Y. 10.598 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y, 105GG 737•8777 245"3203 �0115 MAIN ST„ MT. KISCO, N.Y. 10549 666.3335 STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N, Y, 10512 278 t LAD # 58 -- DATE TAKEN: l—A-3 -Sy I �Oa u4IL1 F '❑ DATERECEIVED: K O/1/►� DATE REPORTED: SAMPLE SOURCE: EFERRED tlY: L r'i V�UQc�I J - �� COLLECTED BY.: �j• D LABORATORY REPORT I mg /L OACIDITY .................. ............................... ❑ ALUMINUM ................... ............................... ❑ ALKALINITY ❑ ANTIMONY BACTERIA, TOTAL /mL ... .....I ......................... ❑ ARSENIC ..................... ............................... OBOO, 5 DAY .................................................. ❑ BARIUM ................... ................ ............................... ❑ BROMIDE ................... ............................... ❑ BERYtLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE ❑BISMUTH .................................... ............................... '.; ❑ CHLORIDE .............................................. I... ❑ BORON ........................................ ............................... ❑ CHLORINE ................... ............................... ❑ CADMIUM . .................................... ............................... ❑ COD ........................... ............................... ❑ CALCIUM ..................................... ............................... OCOLOR ....................... ............................... ❑ CHROMIUM ( tot.) ............................ ............................... OCYANIDE ............. :.................................... ❑ CHROMIUM (hexavalent) ..................... ............................... ❑ DETERGENT, ANIONIC ... ............................... O COBALT .................................... ............................... ❑ FLUORIDE :.................. ............................... ❑ COPPER .................................... ..........................:.... ❑ HARDNESS ................... .............. .................. ❑ COLD ......................................... .......................'....... ❑ MPN COLIFORM COUNT/ 100 ml ❑ IRON ........................................ ............................... COLIFORM COUNT/ 100 ml .......... O LEAD .............................. ... I ❑ CONFIRMATORY TEST ... ............................... ❑ LITHIUM ..............................:..... ............................... ❑ NITROGEN, AMMONIA ... ............................... , ❑ MAGNESIUM ................................ ............................... ❑ NITROGEN, KJELOAHL ........................ .I....... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ... ............................... ❑ MERCURY ............. ............................... ................... ❑ NITROGEN, ORGANIC ❑ NICKEL ........................................ ............................... ❑ DOOR ....................... ............................... ❑ PALLADIUM ................................ ............................... ❑ OIL ,& GREASE ............... ............................... ❑ POTASSIUM ............................................................... ❑ PH . ........................... ............................... ❑ RHODIUM ❑ PHENOL ....................................................... ❑ SELENIUM ............................... . ............................... ❑ PHOSPHATE (ortho) ....... ............................... ❑ SILICON ................. ............................... ............ ❑ PHOSPHATE ( condensed) .. ............................... ❑ SILVER ......................................... ............................... ❑ PHOSPHATE (total) ....... ............................... ❑ SODIUM ........................................ ............................... ❑ SOLIDS. SETTLEABLE, ml /L ❑ TIN .................................. ....0.......................... ❑ SOLIDS. SUSPENDED .... ............................... ❑ ZINC .. ............................... ❑ SOLIDS, DISSOLVED ................... ' ............ ❑ ....................................... ............................... ' CTSOLIDS.TOTAL ❑ ................... ................................. ...................r........... ❑ SOLIDS. VOLATILE ....... .................:............. ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE .............................. ❑ .................................................... ............................... ❑ SULFATE .......................... . .......................... ❑ ................................................... ............................... ❑ SULFIDE ................... ............................... ❑ .................................................... ............................... ❑ SULFITE :..... ❑ ..................................................... ............................... ❑ SURFACTANTS .................... ❑ ................................... ............................... ............. ❑ TURBIDIT`. ........................................... ❑ .............. ........... ............................... _.. _ ........ 'THESE RESULTS INDICATE THAT TIIE WATER, WAS U15 OT' A SATISFACTORY SANITARY'QUALITY MIEN THE ISAMPLE WAS COLLECTED, THESE RESULTS INDICATE T}IAT,TIIE WATER DID 1fEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADS iNIS'1'RA'I'IV1: RULES & RECULATIONS, DRINKING WATER STANDARDS (1•'AfIT 72) FOR THE PARAMETERS TESTED. 1� ALBERT H, PADOVANI M,T (ASCP), DIRE'C'TOR & &a,,t o' PUTNAM COUNTY D%PARTMENT OF HiL:ALTIi / DIVISION, OF rN /IRON N�' AI, Jr!ALTH 'SERVICEfb . •.00UIM OFFICE BUILDING, CARNfEL, No Y. X12 .;:' •'T� SEW- SEFCRATE S94AGE DISPOSAL. 8yST7"m FI 111Q4 ��M 6t '( Street l ..i di 16 A Sec 4- Bloch Ca'. p peax`st cross s rep _ . I ' ,.rf Y y �. �. Watershed 301 M OLATION TEST DATA RE . IM •& TO BE SUBMITTED UITH ' b Alaw Dgpth to hater Warm, �.evpi Ed�v" MAO Prom Ground Surface-In Inched• . :' 8 1 ate start Stop Drop in,:.,. • . 'gneh ®s irauhes � Ina~he�►:. • . .. • (,.II. to �• � • Cj �nlT MOftiiid �o� .W �C 0.5 .`Oe P r�m� Pi C �. � P, .. .,, �a � w � 'e0 • � � � .. - : �,• � � �' • • #� ,Ra3 R9 a'. P'iRP�d ;'_� I� F , 6�/utsRd3' bo r'HUit'dd at 1'aaY:`yI YYJ/h•NN4Yk$N ♦`, VdLA4, V ®l YKa�,p• ��® ��a ob.tala�ad a6t each pgrCQ14jt�+�� a �0 a ' A� deb � row ge!±m2r,a �+�A°Q`0 I�� h top nio stai�e�ne a to Waad®• om w `"i..-= .ice +.a'�.�cC•.- -Asir _.u+:i..- '��..•�...r_:.�•,�'�. .._... ... ... DEPTH G.L. '611 12" -18l' 2411 111.1mg, 1?,rT 1)11, TIA 'L' )TJ1 ]"I"J'! 7.) W.1711 APPL'[CWTION . HOLE 1 -O. HOIJ-11 NO. 30 3611 4211 48" 54 It 6011 6611 7211 ra 7811 84 If INDICATE L AT WME CH GROUED WATER IS ENCOTUTITERED INDICATE Am TO/WRICH WATER 10TEL RISES AFTER F-EING ENCOUNTER TESTS MADE BY Date -4- . DESIGN Soil Rate Used 10 Min/l "Drop: S.D. Usable Area Pzp*i-de 4, No. of BedrooMs septic Tank Capacity -1 G-b tD Gs Absorption. Area Provided By '33 V. x24- raper` Signtur Name CM, 4 � m A su)r- A m-- 5 a- - Address SEAL r- At THIS SPACE FOR USE BY E-EAUVii DEIIARTMENT ONLY: Soil Rate Approved Sq. Tt/aal. Chockoc] by Dste