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HomeMy WebLinkAbout2633DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -3 -23 BOX 22 02633 l . ,. L♦ -. m to rl . mill a 02633 PUTNAM COUNTY DEPARTMENT OF HEALTH gl Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM *PU TN A M V A L. L- I✓ 7 Town er-44MaW <- .Located'at� ` f�/ 1 a"r i'0:...L' - - - Tax °tv7ap Block Subdivision n IV �H j Lot Job Owner , ir7 I�Q,A�) ��~ I Address 1.4010- 0- 6 PEE PEP Building Type 1 0 �" •!Y =• �• Lot Area � • �� � — Number of Bedrooms Design Flow 600 CUP Separate Sewerage System to consist of / A� Gal. Septic Tank To be constructed by A- AST4k, Water Supply: Other Requirements Public Supply From Private Supply to be drilled by Address 0 lowny 19M L� Total Habitable Space 1 p Square Feet and 33 y.!r l- F OF F1 9t. DS All Address PEEKS KILL 14OL OW P—b , PUT, V441"/ 1 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 an regulations o 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 the date 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 installed in accord with the stan ards, rules and regulations of the Putnam County De me /n/t .1 Health. Date •0L °'� Signed P,E. R.A. Address �� License No. �/ ��� APPROVED FOR CONSTRUCTION: This approval expires one yea fro the date issued unless constructi 'of the building has been undertaken and is revocable for cause or may be amended or modified when considered the by the Co issioner of Health. Any change or alteration of construction requires a new p it. Approved for disposal of domestic sanAaW sewage, and /or pr ate water supply o Date1 By ` Title PUTNAM COUNTY DEPARTMENT OF HEALTH C- Division of Environmental Health Services, Carmel, N. Y. 10512 Permit s P V 35-81 CERTIFICATE OF C A19TRUCTION bOMPLIANCE FOR SEWAGE-DISPOSAL SYSTEM - Putnam Valley Town or Village Located at Wiccopee Tax Map 35 -3 -16 Block Owner M. O'Dell Formerly Tax Map Loy jli Sad Lot e Separate Sewerage System built by Marvin 0 t Dell Address yyPllJJut�YlaI[L V a �ey e- NY Consisting of 1000 Gal. Septic Tank and 288 LF of fields Other requirements Water Supply: Public Supply From XX Private Supply Drilled BY Norman Anderson Address Barger Street, Putnam Valley, NY Building Type One family residence No, of Bedrooms 3 Date Permit Issued 9/17/81 Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with.the standards rules and regulations, in accordance w the filed plan, and the permit issued by the Putnam County Department Of Health. ') 8/15/83 XX Date yM� �?ert�}iQed� P,E. R.A. Address •`•aIIQ�arC N1V "]L. 0 OX LI nse NO. 11056 Any person occupying premises served by the above systems) sha1L promptly. take wch'act as may be necessary to secure the fraction of any unsanitary conditions resulting from such usage.'.. Approval,`o� the `separate seVVer6ge;:system shall become null'and void as loon as a pub ie unitary sewer becomes available and the approval of the private water: supply, shall beeome'nulI and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the ludyment' of tDe;Commisstoner of Health, such revocation, modification or change Is necessary. Date u (! ia- BY Title YUHK��UWN MWILAL LAbUKAIUr P.0:43.pz 99 821 Kear Street Yd ktown Heights, N.Y. 10598 245.3203 , >5321 /� LOCATIONS: KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 ❑ 201 BUTTONWOOD AVE., PEEKSKILL. N.Y. 10566 737.8711 ❑ 495 MAIN ST., MT. KISCO, N.Y. 10549 666.3335 ❑ STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278.93: LAB # DATE TAKEN: «' (Z « P1 —� DATE RECEIVED: �'� g3 I L 3 o Prl2- r DATE REPORTED: Qp 11 v SAMPLE SOURCE: �ITiLLE�Y.tL� —rAY REFERRED BY: x7 a5 pk'Tb� l b L J COLLECTED BY: Al % 0' 't�C.0 �j Z� LABORATORY REPORT mg /L ❑ ACIDITY ........... ....................................... ❑ ALUMINUM ❑ ALKALINITY .............. ❑ANTIMONY BACTERIA, TOTAL /mL .... ......................... ❑ ARSENIC ❑ 80,0, 5 DAY .................................................... i ❑ BARIUM .. ❑ BROMIDE .......................................... I....... ❑ BERYLLIUM ............................................................... ❑ CARBON DIOXIDE, FREE .............................. ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ................... ............................... ❑ BORON ................. _ ................... ............................... ❑ CHLORINE ...........:.. _ ..... CADMIUM ............. :_. ❑ COD ❑ CALCIUM :.:................................. ............................... ❑, COLOR ....................... .............................:. ❑ CHROMIUM (tot.) ................,........... ........................:...... ❑ CYANIDE. ................... ............................... O CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ❑ COBALT .................................... ............................... ❑ FLUORIDE ........................ ...................... ❑ COPPER .................................... .......0....................... ❑ HARDNESS ... ............................... ............ ❑ COLD ............ ............................... .......................... ❑ MPN COLIFORM COUNT/ 100 ml, .. . ❑ IRON ........................................ ............................... T COLIFORM COUNT/ 100 ml.... ......... •• ❑ LEAD ....................... ............. ............................... ❑ 'CONFIRMATORY TEST .................................. ❑ LITHIUM ......... ............................... ........ ....... .. ❑ NITROGEN, AMMONIA ... ............................... O MAGNESIUM ........:....................... ............................... ONITROGEN. KJELOAHL ... ............................... O MANGANESE ................................ ............................... ONITROGEN. NITRATE ... ............. ................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ... ............................... ❑ NICKEL .....................'................... ............................... ❑ ODOR ....................... ............................... O PALLADIUM ............................... .......,....................... ❑ OIL & GREASE ............... ............................... O POTASSIUM ................................ ............................... ❑ RHODIUM ......:............................. ............................... ❑ PHENOL ....................... ............................... ❑ SELENIUM .................................... ............................... ❑ PHOSPHATE (ortho . ....... ............................... u SILICON ........:........................... ............................... • ❑ PHOSPHATE (condensed) ............................. ❑ SILVER ........................................ ............................... ❑ PHOSPHATE (total) ........... ❑ SODIUM ........................................ ............................... ❑ SOLIDS. SETTLEABLE, mi /L .......................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ........ ❑ ZINC ........................................... ............................... OSOLIDS. DISSOLVED ..... . ............:............ ❑ .................................................... ............................... ❑ SOLIDS. TOTAL ........... ........ ........................ ❑ .................................................... ............................... ❑ SOLIDS, VOLATILE ............. O REMARKS: ..................................... ............................... ❑ SPECIFIC CONDUCTANCE .............................. O .................................................... ............................... ❑ SULFATE ................... ............................... ❑ .................................................... ............................... ❑ SULFIDE .................... ............................... ❑ .................................................... ............................... ❑ SULFITE .................... ..:.........:.................. O ................. :................................................................. ❑ SURFACTANTS .......... ............................... ❑ .. _ .............................................. ............................... ❑ TURBIDIT;' -. - ....,_..,.,.,...,... _;•c::.._.. .................. .::.._ _ . a. . _ THESE RESULTS INDICATE THAT THE WATER, WAS t OF A SATISFACTORY SANITARY 'QUALITY WHEN'+ .,::THE SAMPLE WAS COLLECTED, THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES-& REGU IONS, DRINKING W ER STANDARDS (PART 72) FOR THE PARAMETERS TESTED. ALBERT H. PADOVANI M.T (ASCP), DIRECTOR.: �� � • `'LiY'�VCWI�L '1/l.� Marvin O'Dell Owner or Purchaser of Building Marvin O'Dell Building Constructed By Wicc22ee Road Location - Street Town of Putnam Valley Municipality TM 35-3-16 Section - Ward Block One Family Residence Building Type Lot GUARAIM OF SEPARATE SEWAGE SYST24 ..I represent that .1. am who 1311 and comp.lete],y. resp6ns ible- for­ -the: loeation-, -- - w- 6­rIr -an s h 1"P - .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 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 (2) years immediately following the date.of com- pletion 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 negli- gent act of the occupant of the building utilizing the system. .. The undersigned further agrees to accept as conclusive the determination of the Assistant Commissioner of,Health for Environmental Quality of the Division of Environmental Quality* of the Putnam County Department of Health as to whether or not the failure'of the system to operate was caused by willful or negligent act of the occupant of the building utilizing the system. Signature;. 00_�� Title Owner If corporation, give name and address) Dated this -day. of Aucf U,9--t - 1983, at Putnam Valley, New York Place &-Stata Form S.D. 50 PUTNAM'.COUNTY- DEPARTMENT OF HEALTH DIVISION OF ENVIRO NTAL HEALTH. SERVICES Date: 9/0l s1 i Re: Property of Muzyo1 j:: 0� DELL" Located at W i o C vP rzt PIP SectionTM-36 -•3- /b Block- Lot: Gentlemen: I This. letter -is to authorize ' , JOEL 4; EEE 6E& a duly licensed professional engineer or.registered architect (Indica.te) to apply- fora Construction. Permit for a separate sewage: system; to serve the above noted.property in accordance with the standards, rules. or` regulations -as i d- by the Commissioner. ofl thei Putnam Count}► Department. of Health, and.to sign all necessary papers : on -my behalf in 4 V /l1lC.l iL1V11 w �n viii ti nod �e� anLi to.. supervise ihe- constr•uc ciun- o: said system. or systems in- conformity with -the provisions_ of Article 145:.or. i 147; Eduoation:' Law, the; Public Health Law, and: the. Putnam, .Sani.-_ tary Code I j Counters I MUSU6T NogZa i Address I Telephorie Very truly ,ours;_ Signed J .Owneg of Property (.fit QC. 0 f r=jF 2-D , PU NAIA VALL -F Address lip g %�.�• Telephone....: nn��� Ev SE;f 1"t"1997.1 PUTNAM- COUNTY DEPT. Of HEALTH„ 'k TOWN OF PUTNAM VALLEY WELL DRILLERS LAC AND REPORT WELL COMPLETION REPORT This report is to be completed by well driller and submitted to ?Idg. department, together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality. Well Location Tax Map Well Ownerw Name Well Driller Name ec. B1. Lot ess City or Town Tel. # ss ty or /0-5'7 -� CASING DETAILS YIELD TEST WATER LEVEL SCREEN DETAILS Bailed Measure from and.surface Length Ft. or T Pumped Hrs.lStatic: Ft. ' Makes When Bail'ea"'- ..:_! Slot Diameter :6 Inches Yield: /6* GPM or Pum ed Ft, r Length Ft.Size Kind: Diameter In. TOTAL DEPTH OF WELL &00' Feet WELL LOG Depth from Give description of 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, (Loose, packed, cemented, soft, hard). For examples O ft. to 27 ft. fine,.packed, yellow sand; 27 ft. to r. 134 ft. gray granite Feet to Feet Formation Description — 0 Date Well Completed S 6 y-` Date of Report _..=Well `- Driller �..�._. - .- .. - -- -- - - -- Signature BZS 1 -77 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. Omer AAA F-yaq 6t)r=LL Address- QACCoEF E o 77)& Located at.• (Street�WaOeEE�- Sec. M-ock Lot indicate nearest cross street) I Municipality T bwN or- eu-r SOIL PERCOLATION TEST DATA Watershed gL/D-S.00 ZvEg_ TO BE SUBMITTED WITH APPLICA 7"Hole Number CLOCK TIME PERCOLATION PERCOLATION REF— - Elapse pth to Water Water_U5_ve1 No. Time From Ground Surface in Inches Soil Rate Start=Stop Min. Start Stop Drop in Min./in drop inches Inches Inches 61,00, 2 34 q. 0,7 33 3 32:o .93 5 + 2; ..3 4 Notes: 1) Te'�ts to be repeated at same depth until approximately eaua' .j"'oil rates are obtained at each percolation test hole. All data to be ubm'111stted for review. 2) Depth, measur'empi�ts to be made from top of hole. DEPTH G.L. 6" 12" 18" 2411 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS.ENCOUNTERED'IN TEST HOLES HOLE - NO. —]— ..'' : HOLE::NO. :1 ''.'S _ HOLE NO. SAND, SIL-r 5A.N.D, SILT.. B&Lj L DE 2 20 CkC c� :,, " 30. 36!! 42" 48!' 5'+ 60" 66" 78!! 84" INDICATE LEVEL AT WHICH GROUND..WATER .IS ENCOUNTERED -NON F . FN COUN -Tr=� R-C-p . INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED )V /,p TESTS _MADE BY -L 2E-/V ,915 Date DESIGN Soil Rate Usedjj-/.< Min/1 "Drop: S.D. Usable Area Provided 6,000 5 P. No. of Bedrooms Septic Tank Capacit X00, 0 Gals, TvpePZ9Cjq5T C0140, Absorption -Area .Provided By.3 c th n �`' asi RFF. �A_ • �i , # 1z / A M SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ��_PN�F- THIS -0 Soil Rate Approved Sq. Ft /Gal. Checked by Date .. a � �• s��ifr�"r vv I u u r- r- r- rN u u s F-w AG E DISPOSAL LAYOUT "A`3 nl-1 3 j cl Ol oeu; amo Dk SP 'I"' s to pro -As .� r� �'p�,,+a sl+.st to-.lie ��s�a3led ` seder `fie scitseV�i o€ thercii.EeaY end in ,:aac�atdan+ee wad tlle`approu��d p1an �rnd�`tte reifies, and rEgu3 �taobs a� C3ae Putnl3m Goun-ty Hie F17. y�eht :1 ep`ai' a:.Y y f 2 A 31 work 'tt, eted ,prior C© Sieng bao]r= 3 X �trucks,',maCh- la6ty, betildih,': materials "r ' e-,c 7'ated a[8ith be a1lowe,d in tT�e sewage,, :d3apsrsai areas Constxuction of 'the spstem to be' in aetordance with these plans sand revasions' ' theret® and the rules <and �regu at ions of the:` permit Sssuirig Goye,rrnmeit ;, i Agency. DfiS '�H,: CR.I*.TER3A '� 1, bsdrobm M—e,; lOgD ga3. pre'- cast; concrete sep�i� tank., . 2. 'Soil 11'15 mi� 'Vi 0,.8 gal/sf. `.' a..15aily f16W 206 gal, per. I: edroori; _206iv4' becisaoms'.Sob Al 0;8 gal /sf,7000 sjf of leaching are requlrk. b. ,-*88 1Jf of 2''' wide 'tile f eld'.provided. P ROF ILE ,A- p v 1 :L-r LO c A.T,.I a r- h_ _.. ..._ ; ._:3.: 4 � aev�sro►.s RED .4,t? I� _ I,kF y�� / ^`._.✓ MAHOPAC, NE ' !',ORK 58541 AO BUILT v`g��RENCe a oaY n -- -&--r4r jgo� Putnam County Doyar6 ant of Health VIVIeicn of Environmental Health 80rvi 4yroved as noted for oonfgrm=ce with- syp ble Fulepiated Rexalations of tha' I= JOE1. LWENCE GREEMERu ; % ARCHITECT PLANNER � aev�sro►.s RED .4,t? I� _ I,kF y�� / ^`._.✓ MAHOPAC, NE ' !',ORK 58541 AO BUILT v`g��RENCe a oaY n -- 108 N .. Nai t 0.0„015" {0� Op NEB I ^I {GGo �%n'y,'i�.�IIR✓..' ".`r -�"\ . 4 'i Ski �"''.•` 9:, -