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HomeMy WebLinkAbout2685DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -40 BOX 23 02685 ' IN _ ! :,low lL 1 IN �wirmi T t , , L � ` ; ■ 6 . , .� . - r- rl �z 0 , 02685 ' Y : PUTNAM: COUNTY DEPARTMENT OF ='HEALTH Diwsfon_'of Environmental Health Sep�ces Carmel N Y 10512 T d s ''C RTiF>I�S�►,�'iE' OF"-CONSTRUCTION d0dP'L�Ai�CE'1TO€i Si�yJAQE�DiSPGsAL,'SYSiEWi �w Town ior. Village .. i Located at Seems Block c V /INCA Gd/Q114 ' We! '., • �1 { ;O, Lot !r Job wner Separate Sewerage System builf . b Address Consisting. of 'Gal Septic Tank ' ' lineal Feet -X width trench i . Other requirements ®�� -� '�LTli 1•�r4cwr`�auAft'� �� �Fi Weter SuPPIY P ublic 4pp y From w �e r ° I Private SuPPIy Drilled, 8Y t Address i Building Type 'S of Bedrooms �J Date Permlt Issued r ¢w� ;Has 'Erosion Control Been Completed'+`. VT R 'I certify that ,the systems) as listed serving th'lio: a pre ises w,er n ru ed seritially a hown on the plans of the mpleted work (copes of which are a ml - 1 ;¢} ,-, attached) and,�in accordance with the staAd ==� ules�; _ j�eg��ul�t , pl ns � ed :and t ';permit ,issue�ds;f the 5 Hain County' Department of Health. { Address { `Any, 'person occup ing premise9 serve d by the above system(s.s all . c6ndltlons resulting from such` = usage:, Approval of the ,separate. 4. available and the approval of <.the private water,supplyshall becomi "subJect;.to modification''cor change when, in the`,- Judgment offthe Z4 BY- 3 P E R A: 9 Li cense No 2-7 ti• - .« l mptly take such action as may be necessary to secure the correction of any unsanitary irage system shall•become'nu_ II antl void as;soon,.as',a' public'sphitary,, sewer , becomes ' Il and void° when ;a, ,public water•suppIV comes available Such - 'approvals are j nm'issioner alth, suc revocatlo Nicat,on or change is necessary jl J •� � � NV � Tale • ' F PEEKSKILL MED4I`CAaL LABORATORY z 1879'C Rd Maple Terrace Bldg' �A :.Peekskill N'ew York r: PE T8777 i - -p :r a. -r.x,� .:•, air i:.. .n• ..E�Y ..�:c en .fit .sa . «:. a.+. se � > r••••.± �•J"�-srM �.:4 TS.�.. a -c .<a cr � .-e - • EXAMINATI'OM COLLECTED RESULTS ?OF OWNER DATE RECEIVED i 1 (C Y VILLA.- TO. N & R E F SUPPL_`Y s ~t DATE REPORTED ` ,1 SAMPLING POINT BACT) &IA' P.ER ML. ( gar plate count at 35 °.) s COLIFORM GROUP *(Most probable No /;100m1) RESIDUAL CHLORINE AS RECORDED AT SAMPI ING POfN,T I POINT "OF TREATMENT `CHLORIDES FLOLTRIDE (F) mq /1 1 {These thct the satisfactory quality when the sample was cohected a results indicate water was�� of -a sanitary - y�1, 66, r � Y{ A H.' PADOVANI M. T. (ASCP)' 91 VINCENT PRUCEPALE Owner or Purchaser of Building COMPONENT HOMES INC. Building Constructed By SUNSET HILL ROAD Location - Street RESIDENTIAL Building Type TOWN OF PUTNAM VALLEY Municipality . ... ... �.p :._. ._r.,'.. w>IV. >: @.rw.YW.n ..• +.Y•w.ec�,��i.vm+^.r�`.a cn..R .�i.1... TAX MAP 57 Section - Ward 3 Block 6 Lot 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 Westchester 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 years immediately following the date of completion 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 wilful or negligent act of the occupant of the building utilizing the system. The undersigned-further agrees to accept.as..c,onclusive the.determination of the Director of the Division of Environmental Health Services of the. Westchester County Department of Health as to whether or not the failure of the system to operate was caused by the wilful or negligent act of the occupant of the building utilizing the system. I A I I6 DECEMBER 71 r Dated this day of 19 Signature 'ZT C( prey o atRda 3 Carmel, N.Y. (40 Nimham Circle) Title Svob"Oda, t�3 Ong Corp Inc. Place & State If cop ation, give name and FIVE (5) COPIES ARE REQUIRED,WITH FIVE (5) 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, Westchester County Department of Health Form S.D. 50 January 1, 1960 (1971) WELL. DRILL ;RS LUG AND REPORT Well at jn . WI ' C,ounty Vame o ace pity lade `:or own Owner f '/`� /��Iy� %� P.mO address .Stlnsr it:� i.,. Depth of we ameter Yielder as we disinfected'.,? . no ft-0 in© gpm.. yes or no Amt. of casing above .ground �4 elow € ;round ... 11 seal in ft packer, ; cement, grout ! i Draw a X11 diagram `in the space "provi ded belowrt "and~sYiotiv ;rie. depth of c...sing, the w :ll s,.al, kind and)thickriess of formations } enetrated - water (bearing forma-Lions, diameter of "drill holes .1 "w .th dotted lines and ; casing (s) witll..sold ...linen m f, h "... ., ~WELL DIA'-RA12 FORIII TIONS PEa, � -R, T REM,_ ,KS iameter, in; ' epth -:. !rind- th- ieknes's:- and,., yp.e of .-well-_ . 6 ®e in ft, if water bearing 'drilling mithod Grade I: Was well dynamited wuG " D .PUMPING Tl."TS a pwv .' Details 1 _, 2 - Static aater level._ 9 in ft.., �0 125 urd- 'BCcze aeer�, rnvicea 66low •_,rade c u��,tlL'B.lach LUOue ' Pumping rate in i Pumping level in 125-20 lei :�d'o Ocur�C..._...._ ...... _. P g Meru ,280 e,ot Li arA 8 WAUe' to behove ;ra .e . f�, � -. ��..� � ..- Dur`ati�:dri of - - .: • - . : t(: st in hrs o ntd�c�cuLe o .. j' T_i Z AT END y.,._. _ .....• .c�.:� Clear sic- Cloud Turbid �iuzee,� o �.!>l.WRu 0_ 8 , Recommended -depth of pum in well, f eet, bi, lozN trade i 6� • r�r 8 (��e - WJJLLS .IN- � D & GR:��VLL : 200 ; Sand Effo size. mm bnxa® eiViDefaize Length of screen ft, Diam, j of. 'screen_.. 250 Tyne of screen S: r Di. -w a sketcYz ;-of the ra .ert P P y on the back of this sheet locatiog� Drilling- start. :d TtiE W:S'LL 1'= S_;WAGE DISPOSAL Well x Gc.mplet� =dam :.- mazure r PUTNAM COUNTY DEPARTMENT OF HEALTH Dvision of Enwronmenta/ Hea' /th Services Carme /l N Y. ;10512 F 'CONSTRUCTION -PERMIT FOR "EWACE DISPOSAL SYSTEM Ttv�j` o/" i�uT/L j/,Qcccs"J:' ow . :T, n - or Village $ubtlrvision ' L O 2 i7 "Locate —if ilobck I� Towne► D //l/�C71/7 "s-'t e�C o.�'� %.�'tr:�/°.4G� 7� '!.✓fA'6ll�TOst/. ..:i9!/er i Address Bwldin9'TYPe ���•1T /�C lot Area Number.of Bedrooms Total bHabitable Space Zpop "' Square. Feat'.' Separate '•Sewerage System to consist of Septic Tank, in feeY,.XG „/� width trench To be,constructed, by - `CAST'f y�1Q�.tilf Y�.. ;Address il/�- Water Supply Public Supply From s Piwate `Supply 'to 'be` drilled hv. �'• -_,'Address � `Other .Requirements I QA !�� 1 I represent that I am wholl and com letel res onsible forthe `yl c� Y P Y P sed,,system(s); 1) that the separate;.sewage disposal system, above deicribetl will be constructed as shown on the ;approved a ant �¢). n n ac ce w,ith the standards, rules an regulations o e - u nam ,.'County pepartmerit of Health;. and that.on completiomthere a,.' ert� Mate of ruc iovl ortipliance'. satisfactory,'to the Commissioner of. Healthwill . be submitted to 'the Department, and a ,written guarantee • 1 p •fur ' P#4hja -_ yt h, su essors, he�ks.orassigns by the builder; •that said builder will place in good operating•konditi'on any,jpart of said sewage 1 S em gftrl he "o ofvtwo (2) years immediately, following •thetlate of •the issu- ance, of the approval of i,the Certificate 'of - Corstructiori..CO` ian v, f ys ariy;r airs thereto '2)'.that the drilled well described above will be locatetl as shaven on the approved plan and that saidlwell tea dlle ac ce dh t standards rules an regulations of .the'' Putnam County Department of Health �A Date jai: � Signed R.A... i.- - - Address License No. -3 Z9Lo . APPROVED,FOR, CONSTRUCTION This approval expires, one year from ttie date issuetl :unless construction oft the- building has been undertaken and ,is; ! �revoea6le:for, cause or„mayrbe amended or modified when considered necessary by the Commissioner ,of Health Ariy;rcharige`'o alteration 'of construction r ?equires new permit Approved for disposal of domestic s nitary sewage I a d /or jP veil water upply only i at BY } �' Title x Pate .J.4f z,eJ _7 %97% Re: Property e f/1/�� <�f° `� rervc L . LOCa v d atJU*S,j 1ZG Ile --. -� /OlY�fiy of U %.N 1.144eec)�' $Be Block Lot 1410 Gentlemen: This letter ? s to authorize STANLEY. a duly licensed professional enz_-i- °r V or -- ste »ec' architect (Indicate) t0 apoly for a COnSt_'..::,t10n _Jr a S• system; t0 serve the abo ,e noted prooer`y -_- accordance the s'landaras, r` -,les +- • ,-� a p.n r-•.•1 ted by t- ^..-5 ^ _i ; i1 ?^3y o f th-e Putnam Co1.- t-i Or Y'e�UIa�IOLLS S _ _O_.�a._y_..1� ..� .,.- V0�_ SS_�__ .�l v. U.ii'ii�i �„ Department Of lea�t ...and .O Si cm all ne3eSsar7 papers on my .behal�' i n~ COnnaCtlOn .Z•li ta tL'?iS -matt . and t.. supe-r%rise tthe CO. Ste_ X10__ O_ S ild Sy3tei'1 Or Sys to S _n COnfor ="? ty . :;i �'''_ tti'_e pro': --ors of Article 1415 or 1IL7, Education Lair, the Public Health.. La., and the Putnam County Sani- tary Coda. CO _ter48-n m, ei*Apii ry 0 o A-ddre %Y 991 245-2W m - Very tru S »e AC= S S Te.1 e _en P[JTN'aM COUNTY DE ?ART:•TENT OF LTH DIVISION OF EXV1 0N.•CNTAL HEALTH SERVICES ' 'DESIGN DATA SHEET— SEPARATE SE:a.AGE . DIS ?0SSAL SYSTE." FILE . \0. Owner Address (v 79 wA.e6we7i, •rte � . Located- at (Street).Su4/sc-,r ///,cc :CoIW ._� Blo Lot (Indicate nearest cross s tree L) Municipality ;ate luS h V SOIL PERCOLATION TEST DATA TO BE SUB;.iI'ITED j';I'TH APPLICATIO \' REQUIRE Hole , N`zmber CLOCK TI`IE PERC0LATI0NT PERC0U, ZION R.tn. Elaose Dept- to (rater dater Level No Tine Fro.:: Ground Sur-:a in Inches Soil Rate Start Stop `Min. Start Stop Drop in Min/in.drop - Inches Inc:,es Inches 3 Z,' .ga 2- s o za 4 • 4e .. 3 3 2.',31 z` 47 4 -- - - 1: 2 . 4 1, ar_•a-. A..11.- v.....c1M[D'cc...� :'3..:W .1.A: : N'. - . r....:' a_-..• rr*.:_ emr•.. ..'c- ':..e.n.i...,a•v- i:. >.ar r.VYS`.i:.- .c..HVLJ +.0 a.s aw:il1nd's. u.•L�•. •.•[. ..r4.... N tJ. .J• K. Notes: 1) Tests to be repeated at same depth until approxi -ately eau al. .soil rates are ob- tained at each percolation test hole. all data to be subM'i`.ed for reviec:. 2), Depth measure �:ents to be -made from tnp of hole. .. n TEST PIT DATA PEO_UIP,ED TO PE SUBMITTED' ;,'ITH APPLICATIO \ DESCRIPTLOy OF ' SOILS E` :: OLVTE ED I': :EST 'HOLES DEPTH HOLE NO. .�/ .HOL ; . 0: "�Z HOLE \O. C: G. L. Tde!:" " X14 6't 121' '18'T 2 4't lio owd- Z5 To av G .3 0" 36" 48 5 4'j !� 60" 66" 7i i 2:. . %S.. _ Al 8 4.. - ..ILDICATE.. LEIEL AT WHICH GROU \D WATER IS E \COUNTER.ED INDICATE LE L TO WHICH rvATER LEVEL RISES AFTER BEI'�G ENCOUNTE RE D TE -STS N_ADE 'B-v,,.. .i, cl4y'a �2 Date 1' Area S-000 Soil Rate Use ^ AP Min /1" Drop: S.D. I Pro ".'L No. of Bedroo-:':S 3 Septic Tank Cap _c 1-cy %Oo Gals. Type Absorption Ares ov ided By " f77 L -: t ., fr width trench. Other Q. ' � O / STA.NLEY Name Address B 67 �,. w.n :. i:v....: ..o -:: vr_u... .:.- -_ -a.-.: a,rr: \ �r aa a o y: u . .. ..� : fC..c...._- .a..•v. -1 ♦.. ...',...+. u:.... >... .. '.av .. .. • -. -'A w.oLS. m - a +t> Ta':- - ,. i.A.....cs s Soil Pate Approved Sq. Ft. /Gal." Checked by Date f ..(�,w"'� c v,r+, t ,e .. - r:..._a,'i�ay.,`.'H- 7+?- :;.rt.aa. �.(rY;+e rr;A;YF�,�T �+;i,J;�'S.xQh,�3+a.. :vk',�n;rccrr tN/ { icy . t,y r *s) v I° jr x'z�' i�x Dept ;4of Health of the �' on ,a grade rof, 1/4 inQb tight and root •proof.,.. t y 3 Pr¢vide'4" approved pipe, or equal 't C/ juntt slopes as required to < "; �3 ,• conditions :: -. ¢b °sorption fieid,s• s p ofl + +' open'joini or pe ,v{ r impregnated fiber pipe 1/16" per•.foot in wash stone of 'uniform size ^° Pile shall'.be laid in ` } thdt'Its -invert shall 3 .I, bottom of the' trench.' 911' 5'• - < „�', gravel shall be .5 "• min i t , the ;minimum cover shal poSStble.. ., Disposal fields sha of the length }shown., on 6 For details' of� sept distribution bna and j 'see Co�antY Standards': v trees in field 1r s 10,' thereof `shall be r. Durin 'any construc r; �i'js!'GiE Tx! g off field area.. s 9 Leader and footing i s h'6r g. awe from s:e . Y ( � � 10 We11', 1, •`and wat`or subeii`tted`: to'H.ealth De ,{ Certificate. of Constru f l will 'he issued, ! r f h �` ���� �' � ,.,.•'}'tl' . �' .t (. � �� ,. '�� ,: .'e t � Y k T i (arm. ty> s lr� ?, /� PPI A. - y. , U.L Pull .OV fA -•r !! ta7� :. 'k \•�,' �t `.. -v' ^'ENVIRONMENT f4'1:C,iJ `1 .: Y // - os�• L2} ^ M .r W ..a�..�� ✓�-� •4th � � �i \ 1tt x ✓^ Z y "Y ` `�frC:..�"lY'L ��'.� 0, � , •��' � ji; zr r - .. 3 � .G�S,�PiS�G.Z- J i f� /��/�r'% � 1^ fh �.'.•�,++w.,,. ..MY `1�ivSrJG �'Lrt. /.RM.�i � .,, .. � - _ V. ,' ..� N 4-14 W, A,, p- X s- 4", ti 1 47 1464"': 1 5 q �4111 IL M; ail . :tbt r4les., kuu-�-, cum Mq 14 Mlil APIL . . . . . . . . . . . . . . . . . . . 01972 ORI �'Ax"�4 L