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HomeMy WebLinkAbout2688DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -49 BOX 23 I,%L 4 � r ' ' , , oil IF so 0 IN 4til;,��; :m .,� b PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Pu- 4Am L ALLE -Y Located at Su, �t r� Jam•—® Tax Map 5 ` -5 - 4• I Block Owner Jig U l Mjq CS V 1 � ..�.� 11 Lot Job /1 f�U Separate Sewerage System built by � ' K 62N I.J K- � 19ON; Address P I r! L at. VA I Consisting of /000 Gal. Septic Tank and 4,00 or Other requirements Water Supply: Public Supply From ���),�� �y w,ww �`` II /� J ref Private Supply Drilled By 0012 9l ON1 121 CMA Address -gn'i E-P ST, PCtT" Ak VA LL6y 0 H ►r • 192-9,79 Building Type A. R-L-S No, of Bedrooms Date Permit Issued_ 3 90 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, plans fil and the perm' issued by the Putnam County Department of Health. Date u� Certified by p P.E. R. Address US C' 00 71 NO ^ License No, Any person occupying premises served by the above systems) "sha(I,promptiy take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such 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 when a public water supp ecomes available. Such approvals are subject to modification or change when, in the judgment of the Commissioner of Health, such, revocatigor, rrj6dification or change is necessary. Date �© —� —�� By ©� V: �~ Title 3 m WELL COMPLETION REPORT fNPG 3171 This report Is' to be cam plated by well driilar and stibrnitted 'to County -•- - -- analysis of water sample Indicating water is of satisfactory bacterial quality` REPOR;yT: MUST BE.'SUBMITTED WITHIN 96 DA PUTNAM COUNTY DEPARTMENT OF HEALTH, ' Oit�Hion of Emdrontlntltsl Hutth Sadoa COUNTY OFFICE BUILDING CARMEL, NEW YORK � ya e� t t•t�sY,y, tt \ °a t ... v.i' �. �r HNIii1 09pBiITlent together Witl1 laboratory report Of y ,., . •,., , r t before certificate of construction oompllonce is Issued. YS' OF. 'WELL COMPLETION !Xl i'jn { \ari' OWNIIR AN J r!'1 rtyti� t W ". 1. •� ..cc�� F, , X. .. .. .�•.. .e.. ate.. .. ., _ 4� LOCATION 1 $ 8 st�•t) 1 - cam ,� \ 1k I %95rF -t cVc: or wtlu t .•.• ts� 4•.,,C.3c qr WSINiSS ` xtyi� ui �C dnfp} y�'� c y5 t ®DOMESTIC ❑ ESTAIILisHMENT w ❑FARM waL PRO-♦■O/f��90: ,- 2 „ 4 ti use OP WRL - PUBLIC El- SUl:PLY ❑INDUSTRIAL CONDITIONING;' a> (Soetlh? DRIWNG COMPRESSED OTH9 . ' ❑ ❑ ❑• EQUI►MENT . ROTARY A R PERCUSSION PERCUSSWN ,(Spady) CASING LENGTH 0"v t DIAMETER&chea) �r WEIGHT P FOOT'. DETAKS 7 '' " ': ICJ THREADED '❑ WlLDED NO YES" NO,• Noun OL ,. _: YIELD(G.P.M.) YIELQ TEST ❑ BAILED 11 PUMPIE? 0 COMPRESSED AIR WATER MEASURE FROM LAND SURFACE STATIC(3p,""YteeU DIItINO YIELD TEST (feet) ap* Completed WIeN LSWL i foe. below Land surfaces MMLI.. LENGTH OPEN TO AQUIFER 00*0 " MAU' 31.01 SIZE' DIAMlTE! (Ir►etreel;" IP'GRAVEL :' Dlmne�r.of well kxlvdine, VE SIZE ( /neAts) F (IM) TO foe" PACKED: ' jrawl pock DEPTH FROM LAND SURFACE FORMATION DESCRIPTION':`. '' 3Retah asset location of well WiM distances; to at Isesf two permanent lant/tnulle: FEET to FEET i REC I`��rYu, If YWW wog tasted at dilhrets! depths durisq,drildsso,1Rat bsbw;,, L u a r a '� ti y ��s�PUTN A' ,�.,` CDT ( �t5'il k✓f i {� /\ rit11� �1 �Y` FEET GALLONS PER MINUTE,_ '.Z" Lnrw..4} �Mti bSS +�iii '�4�� {# ? 31yi$ ..i ryk �-'1? 1' 5.i� �. t ui�5k'�' �x k''. }'J�h; M� 7 1 R.�, l .! :� � '"4i'.45 �` } $, k ^.t'.� , �J;�•�'�t ,+i •• T � T. . � f.,�' X V.' t �✓' 3 i'• '' � tti� 't. ni1Y i'Y , ; 7 1b�' 1�' { �'t )'.('•?� µ 7 }. 'In K ,! G rr `iw� 'a+' �f '"�1 ? Vt. � J• t',• rs'� . 4 .;,, .. 4t •r '. p 7 § 4 t'i. ri ,45 t.yY ^'� '�tbx'�' ;,�i 144�c)�^eS —"'�.� , c {a1-Y\ - .�'.' r ' ,� ' S !� � � •t.. i 5 ��^� F) Y... i 'vai :..ti �, } "� 3.%�j -� 'J, � ¢ 1 . ih'� 1 1 :. ?>, { y�.,y�1; �'�; Nk��`�r i . 'J 1 � . . ). ;f• ,5, t � °,� ! id. i#' �? .ter, � �'�#ai':i"`` `` tt s ?��. ' DATE . c i OATS OF ftEYORT WELL. I.E R (S it)l� 't; 1�e, �v'�t ' \M1\4,7;•f +�T•tr rli ra+.yt I ' i {. r ', Ei t fi ,t; 1+, t,,wr,7#L' l.•f,.�'w.m 1 \t . l .f. • ) 1 , �a Owner or Vurchaserof Building Municipa ity ONO IAA21�� , N v Building Constructed by Location - Street C,w� FiA . R, . Bu— ilding Type _ ice. 577-6-6,1 Section Block Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent t at -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- 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 'toY�operate was caused' by' the willful or negligent act of the occupant of the building utilizing the system. ,1 Dated this 3% day of 19 el Signature r k Tit 1 e ! 4/ iIf or oration, give name owmWs a dreams s S"SNATU" THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. y..�//GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. .7-4' �. - - - - - - - - - - - - •• - - - - - - - - - - - - - - - - - - Division of Environmental Health Services, Putnam4WW..Dept ment of Health rTT �, 141 .y s� A1 PJTt�AM COUNTY Division of Environmental r' - CONSTRUCTION` PERMIT FOR SEWAGE''DISPOSAL,SYS' subdivision ,. ;Owner .• ..:cTn}m -T .s PARTMENT OF HEALTH � 'ih - Services; xCarme! N'� Y 1D512 Pnam Va-llev ut •",,,',Town or Village 1 Lot v t ` Job ' — I 79 M1165 e6ilding TYpel famll'y 'residenceLot Area 2.,;:1381 acres' Peekskill N.Y. 10566 Number,of :Bedrooms 3. Design Flow 600. GPD Total Habitable space . 1 r 500 Para te sewerage'.System to consist of 1 r OOO Gal septic Tanlc .' and .400 LF Of wide trenches i To.'be constructed by Tint 46 Address Water supply Publ,c Supply From * Private Supply to. be drilled by =Tt t o of selec ed � � "Address'- r Other ReQUirements I ,represent, -that I am wholly and com-pl'etely'responsible for the design and location of the proposed systems) )' that the 'separate; sewage disposal system i above described will.be constructed•as shown on the approved amendrrient there to and in accordance with'•the standards rules an regu a ons o e , Putnam.:,,, ;County; 0e art fient ,of..; , -p " y; ..- p - - Health 'and that on com lotion thereof a Certificate ,of Coristructiori Compliance satisfactor to'the Comrriis ;loner of`HeaIthwill :be.submlttetl to the Department, and a written guarantee will be furmshed'the owner his successors,i eirs,or assigns,by'the,builder, that iaid'buiider will place An. good operating condition :any part of 'said _sewage - disposal';system.during'the period of two (2) -,years mimediately 'following ' thedate of tii PUTNAM COUNTY DEPARTM.FN T OF HEALTH . -- _- _D.iVIS.IQN- OF ENVIRONMENTAL- h`EALTI� S^ -� Date__ Aucrg 28. 1979 Re: Property of John Mari cwic Located at Sunset H; j i Road Tax Map 5 -6a1 Block Lot Gentlemen: ' This letter is to authorize .1 a duly licensed professional engineer or registered architect (Indicate) to apply for a'Construction Permit fora 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 Health, and to sign all necessary papers on my'-behalf in' connection with this matter and to supervise, the.,.constr.,uction . of said; - s-:kstem '6r -systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. C, to signed: P-Ee, R-A*, # t �a ?,EN N A R Ce F2 � O A �A �0 0110a �0 F OP NEV (Seal) Adrss Mahopac , New_ York 10541 Telephone Very trul Signed urs, wner or Proper 13 r .2 _T3 Telephone ,P PUTNAM COUNTY.DEPARTMENT OF HEALTH 'DIVISION•OF ENVIRONMENTAL HEALTH SERVICES "COUN'T'Y: OFFICE BUILDING'OARI�IEI�; ro N.''Y: DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner .::.....:....:.:........ Address .3 HjjdSDM_Vi P_id Est- Ret-k kill N -v- 1056E T.M. 'Lot Located at- (Street _ _ fock ss:s ree a e_.neares c o Munic�.palitY' Tanzn_ra ptitnm` uali PT Watershed �iur�san iiuer ...,. SOIL: PERCOLATION'TEST.DATA..REQUIRED TO BE SUBMITTED WITH',:APPLICATIONS Hole Number CLOCK...TIME. PERCOLATION PERCOLATION Run Elapse Depth to Water Water LeVeI, Ido...... ::.._... Time From. Ground Surface in Inches.... Soil Rate Start 'Stop Min. Start Stop Drop in ' Min. /in drop Inches Inches Inches #1 l- 8 -:-00 -8:30 30 16 19 3 -30/3 = 10 Notes: .1) 9e`ts to.be. repeated at same depth until approximate) 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. 30 16 . .19 3 . ..3013 = 1:0' .3.9:.0.2-9, :.32.:. 30 16 19 . 3.: .30/3 = 10 Notes: .1) 9e`ts to.be. repeated at same depth until approximate) 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. w °A. TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO._ 1. -HOLE NO. 2 HOLE NO. Ton Slail Tr Rnil _ 6" Bank Run Bank Run- Bank • Run 12" 1811 Al 2411 .....,.._.,._..,.:, ........ ,,:....,._...._..... . . n " 30„ � 36„ .'4 . 42" 48" 5 It n 60,1 I' 66'� ---�— INDICATE -LEVEL- AT.WHICH' GROUND WATER IS ENCOUNTERED None Encountered __._._. INDICATE - LEVEL --TO- WHICH WATER L TEL_.RISES -- AFTER- -BEING ENCOUNTERED W- TESTS MADE BY Joel Greenberg ate „1 }t 11, 979 . Soil, Rate, Used 8 ,10 � 1 �tDrQp, ° � S o D: Usdble: Area: Sr. ,0v di'd' 5 �OD'G S a F o' f ,.. w v n x.a �7 f- 1} - TT- D,�.. s Address. RR #8 L Muscoot'North ;•.. ' Mahopac, New York 10541 THIS SPACE `FOR`­USE ' HEALTH DEPARTMENT ONLY: Soil- Rate- A roved - -! Sg:.._.Ft /Cal. Checked by Date Pp j it S' 4! L f 1 i 7 J Too A 1-., Y; L? lea, $_ rte �vix 4 ��?3V iFI'- ryi7V�r:��., -r stop AN Run NO !gill vM J 3�M ©fib' b�$Q`E3ti1xQ 3f 't ofs n t� i` e TURN Y y A sP •. 0 F Kill goo ti C 1 �K 2. §}l f f s GRAM" s F'✓ t' p � "Gf0 5�i -4 f 3 � - Y ,3 _. l• # { �.. } ` S I' �'�� `� ". � � »s hky°���'a Asa 1 ' N.:¥� �rTr �� „�"..� t�� �a•a"� 1a i C :r 'S.n ho �.4+,t Ar 0v t Fr ' t l §r -!Y �' Z �.kC�h W .,f 1•. jh 'at f Z ARMS } ` � S ST , z ..� k vy •�� R .�� a $ 5 A - � � �' �• t h�Y�i4 k+y. a`;� :� u f t t +'J _ Y �J i` e TURN Y y A sP •. 0 F Kill goo ti C 1 �K 2. §}l f f s GRAM" s F'✓ t' p � "Gf0 5�i -4 f 3 � - Y ,3 _. l• # { �.. } ` S I' �'�� `� ". � � »s hky°���'a Asa 1 ' N.:¥� �rTr �� „�"..� t�� �a•a"� 1a i C :r 'S.n ho �.4+,t Ar 0v t Fr ' t l