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Home My WebLink About2535DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51.19 -1 -16 BOX 22 L T� r - r �, ,, IL 7r77 CE MEN MEN fT 02535 r t..Nl r r r r i i , ' T � r L , 11 L r ' 02535 16 jjsj�,-3 CERTIFICATE OF CONSTR Sl.tci PUTNAM COUNTY DEPARTMENT OF HEALTH' Divisllpn of.,krivironmentol Health Services, Carmel, N. Y. 10512 dolopiw4etz'PeRs. Permit # PV 33-81 Putnam Valley Town ovV947--- Located at Watson Way Tax Map ----z9-Block 2 owner— G. Krapf i Formerly TAX Map Wt # 9 & 10 Subd. Lot Separate Sawerago System built by D. Heady Address Canopus Hollow Road, PlIt Valley ConsistIn of 1000 Gal. Septic Tank and• 456 LF of 2 •ide Fields.. Other requirements Water Supply: — Public Supply From XX Private Supply Drilled By Norman Anderson Address Barger Street Building Type — (1) Family Residence No. of Bedrooms 3 Date Permit Issued ll/l/82 Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were conat ct 4 essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and r gu ations, in accopdjuice with the filed plan, and the permit issued by.the Putnam County Department Of Health. Date 12/27/83- Certified b. P.E. R.A.XX W #2 Box 4 88 MY8 t Nort Address —M opa6f New Yofk License No. 110 5 6 \J— Any person occiupylnq. promises served by the above system(s) shall promptly tak-;uch action as may be necessary to secure the correction of any unsanitary conditions resulting frbm-464i usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void whell a public wat poly becomes available. Such approvals are subject to modification or change when, In the judgment of the Co 0 of Health, such rev on, modification or change.1s necessary. Date Title Rev. 9-81 TiNAM,C-OUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512-------- CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valley r Village Located at Watson Way Tax map29-2-9&10 Block Subdivislor,L.Ajke oscawana Acres—Section 1 Lot Job 81-137 Owner G1 en Kra f Address Alt) Waring Auenue Building Type 1family residence Lot Area 33.583 S.F. Bronx, New York 10467 Number of Bedrooms 4 Design Flow 800. GPI? Total Habitable Space 1825 square Fee Separate Sewerage System to consist of 1200 Gal. Septic Tank and 444 LF of 2 10 11 Wide leaching To be constructed by Don Heady Address Canopus -Hollow Road Water Supply: Public Supply From Rii i-mim ValleV New York 10579 ti A Private Supply to be drilled by Norman AnderAnn Address Barcfer Street, Putnam Valley, New York 10579 Other Requirements 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 ancrr—egu (at ions of the Putnam, County Department of Health, and that an 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 ;Ssu-:. ante of the approval of the Certificate of Construction Compliance of the original systeT 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 Installed in accorda with the standays, rules and reguiaTilonsof the Putnam County Department of Health. t—% 71 - Date 8/3/81 Signed Address K KIFM This approval P. E. — R.A. License No. 1 10 5 6 building has been undertaken and is PUTNAM COUNTY DEPARTMENT OF ]HEALTHi Pe ra:it p Division of £r-rrir6nMent.al Health Services; -i-armel.- IV. Y: 7 7'1151 - CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Located at N A TIS O M WAY Subdivision LA K E QS:' -4 i -d AN 6 0C`.F ES' 3 rr7 /suns. tot a lC� Owner /Address G L EN - (i (d j W� 0 Building Type \�) F-Py1ty1 ' k a .• Lot Area ✓ Tj � S• - ?L"rN Ajyk L)tI LLB.Y rG- 7T- c1 *1C0 Town Tax Map Block tot Renewal _)( Revission _ [] Date Pf PzOvious Approval Fill Section only ❑ Number of Bedrooms Design Flow G /P /D 4 P.C.1H. D. Notification Required Separate Sewerage System to consist of I2uF� Gal. Septic Tank and 1 H i-4 LE QE / -0l1i VV1Qi; KEI,4(2 f To be constructed by -D <2 t' 0 g�jy 7 Address Water Supply: Public Supply From nn a�� /� /j TLJTd'Jd7%/� LIALL -F—V.s !� 8W )10QK !t,?_S7� Private Supply to be drilled by N40jz r4q AND ec of 4 Address'61 G Z J T i2irc T` . P U T N Ab/1 L/� L l a✓ T— c7`5 ] 7 Other Requirements I represent that 1 am wholly and completely responsible for the design and location of the proposed :sYstem(s); 1) that the separate sewage disposals stem above described will be constructed as shown on the approved amendment there to and in accords nce with the standards, rules an regu a ons o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Comipliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his suecawwrs, heirs or assigns by the builder, that said builder .will place in good operating condition any part of said sewage disposal system during the periodl of two (2) years immediately following the date. of tie 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 installed in accordance w ith tihe standards, rules and regu a ons of the Putnam . County Department of Health. Date ICJ��Ie''�- signed .L- / 0. P✓iU�G0j)T' J�OJ,T 4 �d� _ P.E.- R.A. Address + OX �� f tt E! � /Ti 454. f' License No. //a56 APPROVED FOR CONSTRUCTION: This approval expires one year from the date Issued unie construction of the building has been undertaken.and is revocable for cause or may be amended or modified when considered n eessary by the Commis ner of Hea ny change or alteration of construction requires a new permit. Approved for disposal of domestic sa ry age, a rivate a ppiy only, Date -� ~® BY ' Title Rev. 9 -81 ' ;F is p .I :F ++ 04- 1 :(�OfXi =ysL, • . Peon. \,� iV T_ i •,� n -t Doti wa.Y .. ._ __ - fk�,� P u i t^T 4 YO un,. _CA: -F : 1 = 34). 00 �I i ,• 111.1 Putnam- Division of Wilt 1 i r Mia 1 . �• �, , y _ .A� =�,:LO'CATI`,Q:N MA{ VtFD..,4' �\ �i Elm is 1 .fs 4 L J . Kai tt5 `c GIALCON PtECAS EP7 A-, -T m u I L-T - I p" �A, -4?"" -05- 416 6 k; SEWAGE.: DIS POS —,—I i s en :ire -q L 'Th"' AI M "i&P wa i app. tt5 `c GIALCON PtECAS EP7 A-, -T m 7 k; SEWAGE.: DIS POS —,—I i s en :ire -q L 'Th"' AI M "i&P wa i app. t11t rules ands, p4q t=e., 2! va, e.. I a3spe te pi �Nk Vu C < Yxc4va�tedi`pvrth.- tb be a "low, ....................... -a 4 C- a c as ru 2'�j IVA k- Uz C 7, :.,-v ,- , ar h rm 'Ir e , V E.41, o ri aj� t. liere to an -- , I ralations of tine pe,rpit Assuij k; SEWAGE.: DIS POS —,—I i s en :ire -q L 'Th"' "i&P wa i app. t11t rules ands, t=e., 2! va, e.. I a3spe te pi �Nk Vu C < Yxc4va�tedi`pvrth.- tb be a "low, -a 4 C- a c as ru 2'�j IVA k- Uz C 7, :.,-v ,- , ar h rm 'Ir e , V E.41, o ri aj� t. liere to an -- , I ralations of tine pe,rpit Assuij UCTi -tal Agency. GW,,'�'-,CF JTRj j3 4"'be rooqI 3:6n' -7 4V jo�e,as .cone a 4th tprrktobe *s 2. ..pe a) e3aily flow no gallon. .6edr 'p 800 'JaIs Je each S ea- PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. OwnerGleri Kra= f Address T.M.29 -2 -9& 0 Located at. (Street Block.. Lot n Ica e flares cross street) MunicipalityTown of Putnam Valley Watershed Hudson River SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS :. o e Number CLOCK TIME PERCOLATION PERCOLATION: apse p o Water ..Water ve .. No. Time From Ground Surface in Inches Soil Rate, Start -Stop Min. Start Stop Drop in Min: /in drop Inches Inches Inches #1 1h:22 -6:46 24 16 19 3 2443 = R 2 6 :47 -7 :13 24 16 12 3 2443 = 8 37:14 -7:38 24 16 19 3 2443 = 9 Notes: 1) Tuts to be repeated at same depth until approximately 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. • - - • - • - iEht,'�ol1�' �. • • _ c,, New.Yogk THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: NE`�'� Soil Rate Approved Sq. Ft /Gal . Checked by Date SEP 4 1983 PUTNANI COUNTY DEPT. OF HEALTH TEST PIT DATA REQUIRED TO BE SUBMITTED WITH.APPLICATION DESCRIPTION OF.SOILS::ENCO RED IN TEST' HOLES DEPTH HOLE NO.� HOLE NO. HOLE NO... _._ L G.L. _S912 Soi 1 Tn Sni1 6" Sand,& Small Stones Sand & Sml1 _Sand & SM411 s S n o P 4 12" - . 1$" 2411 30 36" .: 48 ". 60" ; 66" 72" .7811 8411 INDICATE LEVEL.AT,WHICH.GROUND.WATER -IS ENCOUNTERED. None. INDICATE LEVEL TO WHICH WATER LEVEL RISES.AFTER BEING ENCOUNTERED N/A TESTS MADE BY.Joel Greenber g Date - . T _ DES IG Soil Rate Used 8 -10 Mi4/1 "Drop: S.D. Usable Area Provided 5000 S.F. No. of Bedrooms Septic Tank'Capacity 120Q Gals. � Absorption Area Prov ded By 444- L. F, x24 * 3b" a • - - • - • - iEht,'�ol1�' �. • • _ c,, New.Yogk THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: NE`�'� Soil Rate Approved Sq. Ft /Gal . Checked by Date SEP 4 1983 PUTNANI COUNTY DEPT. OF HEALTH •a STREET lq W 04-T S TOWN,,U_'*ArVN TAX MAP # ' NAME,' 1 C4,CV, GOLD) PHONEgLI'S-52 -0117 PCHD# k, -0 " MAILING ADDRESS 1 y W AT < A_`., ?J�� 10 DESCRIPTION OF �* - ADDITION NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) **Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Bre,x ter, NY 10509, Phone: (845) 278 -6130. A Certified check or money order for $100.00. 1. Sketches of existing floor.plan (drawn to scale, all living area including basement, to be shown and dimensioned- 'aiid-use ofeach- room-specified). -(See SmtionS:c-ofBulletin - HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin i HA -1) ,4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any / questions. A Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE COIVE\4ENTS 5. 6 ' SHERLITA AMLER, MD1 MS, FAAP Commissioner.of Health iOPIETTcA MoI.114AR1 RiN; ViS Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF. HEALTH 1 Geneva Road. Brewster, New York 10509 Town Leizal Bedroom Count & Proposed Addition Status Re: GOLDBERG (Owner's Name) Tax Map #. 51.19-1-16 . Address: 14 Watson Way Town: Putnam Valley Year Built:. 1985 . According to records maintained by the- Town, the above noted dwelling, is X in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: 3 This information has been obtained from: Certificate of'.Occupancy: ('0 �� S 4 - 6 40 9 . t l . Fami 1 y) Other: The plans for the proposed addition are considered: New Construction xx Addition to existing house only allowed under Town Regulations � a.2_ 'Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing.Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care. Fax (845) .278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225. -1580 SHERLIITA AMLER, MD, MS, FAAP Commissioner ofHealth ROBERT MORRIS, PE, DJi 6ctor of Environinental Health . Mark Goldberg 14 Watson Way Platnam Valley, NY '10579 Dt r Mr. Goldberg: DEPARTMENT OF HEALTH 1 Geneva Road, .Brewster, New York 10509 Office (845) 808 -1390 Fax (845) 278 -7921 or (845) 808 -1937 PAUL ELDREDGE County Executive July 12, 2011 Re: Addition- A- 084 -11 No Increase in Number of Bedrooms 14 Watson Way (T) Putnam Valley, T.M. 51.19 -1 -16 I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval staanp from this Department dated July 12, 2011. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. ...2...The..area_of.the exis *h sewage disposal system ar�d its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets etc. 4. This Department recommends you contact your Building Department to ensure. setbacks and other current codes can be met. 5. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Putnam Valley. If you have any questions, please contact me at (845) 808 -1'90, ext. 43261. Sincerely, Gene D. Reed Senior Engineering Aide GDIR:cw cc: 131, (T) Putnam Valley TOWN OF PUTNAM VALLEY X083- 6886 5/20_/83 19_-- - �C®RD Date g -3 IT, R PERM, at once - Zone . District • ' Permit Work to start B i Application is hereby made for ,e/p to 11/13/84 19 Zone District TOWN OF PUTNAM VALLEY M -84- 0 2 j 5 Application is hereby made for Renewal Permit Work to start cont d i Description renewal of permit # 83 -6886 KRAPF, CLEM TM 29 -2-- - � ,lermit # 83 -6886' - " /Ix %j & ONE FAMILY APPROvrD REQUIRED PAPERS R ENE HALS Footina: �. _3 AS Built_ �� c � z - Fram ncl; w Well Loa: i asulat zon Driveway: °"`��i'aF�� CBBTIFiCATE OF OCCUPANCY Certificate of Occupancy No Cir :.. Applicatiaa No.. .' ' j x Loataan =f Pramises �a� 5�. ` .. � �. .. . .. .. �18�lilg 4 hertafore, >iaedsin',a piication fora building permit pursuant to -the Zoning Ordinance, Sanitary �... Gud � nd tie, 3Law effect in the Town of: Putnam Valley, Pu#>aam County New York; havuyg ... ne saia� %wvrx- „tbmiea�'. lrevns ... Plumbing Well ._. -.,_. BZ5 -1982 L.�r.a APte. oWN oF_� U-rNAM VALLey Owner or Purclaaser.of Building Municipality Building Constructed by WIM n z Location - Street U- c D ;p�. AM Co. �� ONE d�M 11.V 1lDENC HE ?l! Building Type 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- t "ermination 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 willful or negligent act of the occupant of the building utilizing the system. Dated this z Y day of _ p� 19 Signatures X CO NTaA Q If con o a , give name d addre s,� - - - - - - - - - - - - - - - - - - --- - - - - ✓ I G -` '� - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION 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. (ORKTOWN.MEDICAL LABORATORY INC. P.O. Boa; 99 321 Ke SAeA,. LocAr)oNs: N� � 0 321 KEAR ST., YORKTOWN HEIGHTS. N.Y. 10598 2.15.3203 Yorktown Heights, N. 1OS9� D 201 BUTTONWOOD AVE., PEEKSKILL. N.Y. 10566 737-8777 .4.' O 495 MAIN ST.. MT. KISCO,.N.Y. 10549 666-3335 . 24-5.3203 DEC-28-198'. ❑ STONELEIGH AVE. !NEAR HOSPITAL). CARMEL. N. Y. I'W2' 778'9 i COUNTY -LAB # � DEPT. OF HEALTH . DATE TAKEN. DATE RECEIVED: �3 AXA') DATE REPORTED: SAMPLE SOURCE REFERRE0 0Y: L J COLLECTED BY: A/?. ,,1r;kw/ 3e, 31 LABORATORY REPORT mg /L ❑ ACIDITY .................. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ....................... . ................ ❑ ANTIMONY ................................ ............................... BACTERIA. TOTAL /mL ................ ❑ ARSENIC .................................... ............................... BOO. S DAY .................................................. ❑ BARIUM ............ ........................ ............................... OBROMIDE ................... ............................... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE. FREE ❑ BISMUTH .................................... ............................... OCHLORIDE .......................... . .................... :... ❑ BORON ....................................... ............................... OCHLORINE .................................................. ❑ CADMIUM ........................................... ........................ ❑ COD ........................... ............................... ❑ CALCIUM .................................... ............................... . ❑ COLOR ....................... ............................... 0 CHROMIUM (tot.) ............................ ............................... ❑ CYANIDE ............. i.................................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ... :.............................. O COBALT .................................... ............................... , ❑ FLUORIDE ................................................... ❑ COPPER .... ............................ ............................... , ❑ HARDNESS ................ . ................. :................ ❑ COLD ......................................... .......................'....... OMPN COLIFORM COUNT/ 100 ml ...................... (D IRON ........................................ ............................... �(] 2TT COLIFORM COUNT/ 100 ml .c ............. ❑ LEAD ........................................ ............................... ...;❑ Cl'YAIFJiiM��TOfiY.TESI- .» ...» ........ .0 LIT.FI:L!M..: ... . ....... ...... »..:........_.. ... ......,...........r....,....... __._.... ONITROGEN, AMMONIA ... ............................... , O MAGNESIUM ................ ............ ............................... ❑ NITROGEN, KJELOAHL .......................... I....... O MANGANESE ................................ ............................... ❑ NITROGEN. NITRATE ... ............................... ❑ MERCURY ..:................................. ............................ :.. ❑ NITROGEN. ORGANIC ................ ❑ NICKEL .. ........... .................. ............................ ............................... ❑ DOOR . .............:......... ............................A.. ❑ PALLADIUM ................................ ............................... ❑ OIL & GREASE ............... ............................... ❑ POTASSIUM ................................ ............................... OPH .. • ....................... ............................... ❑ RHODIUM . ............................... ............................... O• PHENOL ............... ............................... ❑ SELENIUM ....:................. , .......... ............................... ❑ PHOSPHATE (ortho) ....... ............................... ❑ SILICON ........ : .................................. ........................ • OPHOSPHATE (condensed) ... ............................... ❑ SILVER .............................'............ ............................... ❑ PHOSPHATE (total) ....... ............................... ❑ SODIUM .. :............................ ......... ❑ SOLIDS. SETTLEABLE. ml /L ............... ❑ TIN ......... - ........_.- ..- ...... ❑ SOLIDS, SUSPENDED ..... ............................ . .❑ ZINC ...................... ............................... ...... ...... . OSOLIDS. DISSOLVED ... ............................... ❑ .................. ............................... .............................. ' ❑ SOLIDS. TOTAL ........... ............................... ❑ .................................................... ............................... ❑ SOLIDS. VOLATILE ....... ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE ............................... ❑ .................................................... ............................... ❑ SULFATE.................................. ................... ❑ ................................................ ............................... ❑ ................................................... .....................O SULFIDE ................................................. .......... ❑ SULFITE .................... ............................... ❑ ................................ .................................................... ❑ SURFACTANTS ............ ............................... ❑ ................................:................... ............................... ❑ TURBIDIT.. ............... ............................... ❑ .............. ............... .........................__. ... _. . _ ....... THESE RESULTS INDICATE THAT THE WATEiR WASC ;_4 OF A SATISFACTORY SANITARY QUALITY WHEN THE -SAMPLE WAS COLLECTED, THESE RESULTS INDICATE T11AT_;:T11E WATER D MEET TITS SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER -STA DS (PART 72) vno IrUP PAPAMPTRPS TESTED. s-? - / 17 �1' r , WELL COMPLETION REPORT 3/71 '00M PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK _ This iepo.rt.is..to..be completed.by well driller and. submitted to_County Health,_ pepartrnent, tpgeth�r .e,,ith�labRrataty.. repo rt.bf _ analysis of "'00 'WRIg water is of satisfactory bacterial quality before certificate of construction compliance is issued. EPO T T BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION PUTt`s OWNER N —TTM-r%-_—r. ADDRESS LOCATION OF WELL ' Z (No. 8 Street) ✓% (Town) (Lot Number) PROPOSED USE OF WELL D DOMESTIC ❑ SUPPLY BUSINESS ❑ESTABLISHMENT ❑ INDUSTRIAL ❑ ARM ❑ CONDITIONING ❑ TEST WELL ❑ OTHER DRILLING EQUIPMENT S ROTARY COMPRESSED. E] A R PERCUSSION CABLE PERCUSSION ❑ Ope E y) CASING DETAILS LENGTH (teat) ��i DIAMETER(Inches) r, ' r WEIGHT PER FOOT �' THREADED ❑ WELDED DPILVE SHOE [! J YES ❑ NO G OYES NO YIELD TEST El BAILED HOURS El PUMPED COMPRESSED AIR G.P.M. / V YIELD (G.P.M.) /V WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Spec //) feet) DURING YIELD TEST j feet) Depth of Completed Well j� r in feet below land surface: tf SCREEN MAKE LENGTH OPEN TO AQUIFER (lest) 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 j t S41 / - If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL O ED DATE OF REPORT WE L RILLER igna re) I Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH Date 7%31/81 Re: Property of Glen Kranf Located at Watson Way T.M.29- 2 -9 &10 1 Block Lot . This letter is to authorize Joel �(',rpenhercj a duly licensed professional engineer or registered architect (Indicate) 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 promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in Lu,tsa��it�tr wiLrl iiils mai--Ler a;id to. supervise, ine cunstrucciun of said system or systems in conformity with the provisions of Article 145 or °i:dw,-_. the-" r ^abl'.rc--Y{e-a1-tI1'-iLaiv," end--- the _.'Patiftam-Caufity "san= ..�'..._ .. - - -. _........ tary Code. Ea E D 4 0 \0 'JAVLE.NCE GRFF•S�J� ti Ov � n �IE'S!IM11 .y. oil 5 '0 . Countersigned: P .E ., R.A ., # RR#8, Muscoot North Address Mahopac, New York 10541 22A.-628-6613 Telephone i Very truly yours, Signed owner/oYOroperty AM Waring AvPni =a' Rrnnx N_y_ 10467 Address 212- RR1 -18Q2 Telephone RECEIVED SEP 4 1991 PUT NAM COUNTY DEPT, OF HEALTH