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HomeMy WebLinkAbout2701DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 61. -2 -10 BOX 23 INN i,yti i ' i 19 IP A ; r MIIIIII } No ,� ■ iI'i, T so IW INN. kz. I I JA 02701 f-certify that the system(s), as listed serving the abo`V6"Orernise's were cons DEPART, MENT-76F, HEALTH'.' ealth, SerW470s, • Carmel; A 10512 Putnam Valley -(T MA6,91-IMS-POSA Y TEM qr oilag-e 7 Block Job Address Cherry, P e- lae lake. Feelcakill lingpi Feet Ix width trench on 'Qell- drillers -'.. "No OT Bedrooms V ucted essentially as shown on c�l, �copies of which are -0 attached), and in accordandd with the standards, 4rUles and regulations p 6fis'fiied,, and the , permit r, it -issue! t W� un y, artment of Health. -Z �Deceib6r�. - 36. 197 e 7 P E R.A. -- I ' r . , ' � , ' j . 7i � ice n sb jqo 027, 4 6 Address A n y . p SDr occupying premises bV-the.above,sy ens) �hplt. r qn p 5 ctiofi of any unsanitary nitary conditions •re sUlti n fronsZ. hAsage. Ap rd4l`o f th6'sdpirit3..ikWera lic sanitary sewer becomes available 'appr6val of the 'private water, supply'shall eco e, L y comes available. Such, approvals are s6bjbto nod ifi cation or thange.when, in the of rn if ication or change is necessary. bate- . , r wr f Health; ' tly ge�'system _hall .become ,riulf is n NA S, Title F PEEKSKILL MEDICAL LABORATORY �` 5 ` 1879 Crompond .Rd. Barclay Plaza Bldg. A., Apt. 1 eek�klll; .- Ne L-.: ork- 19.566 _ _ .... - - .....__. -- : _ p� ?�s?r DATE COLLECTED RESULTS OF EXAMINATION OF WATER OWNER DATE RECEIVED ,.CITY, VILLAGE, TOWN '& /OR NAME OF SUPPLY DATE REPORTED SAMPLING POINT _r-A -:,4-7 of ;, IJ s" 7 �- BACTERIA PER fAgar plate count at 35 (f. CQLIFORM ROUP Most probable'N6. /100mL Le 5 5 x161 Z N AL - :ppm:.. . DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm FLOURIDE (F) - mg./I. These results indicate that the water was G 'S of a satisfactory sanitary quality when the sample was collected. U i��Gi.r.�•t1'7J`/ �A4 ' A. H. PADOVANI, M. T. (ASCP) t' Gentlemen: PUTNAM COUNTY DtPARTMFN T OF HEALTH DIVISION OF ENVIRONMENTAL _HFALTH. Date November 2, 1977 Re: Property of John Carelli Located at Canopus Hollow Road Section S w Block 7 Lot�r This letter is to authorize John S. Romeo a duly licensed professional engineer x or registered architect (Indicate)• to apply for a Construction Permit for a separate sewerage system; to Y.0 serve the above noted property in accordance with the standards, rules' ``oar regulations as promulgated by the Commissioner of the Putnam County ��Deparment of Health, 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 147, Education Law, the Public Health Law, and the Putnam Count y.Sani- tary .;Code . Very truly yo s, �;. Signed X � OwnV of Property A ^ J Y Countersigned: /✓(/ �,"/1`+•/�"r_r Add ss P . E . , UM, . #. 0278416x. .S L -7 1 Northridge Road °o� ° ° ° °00 ©, Telephone Address (Seals NV P0,�� Peekskill, N.Y. 10566 U i. �trc..• , 737' - 1056 Telephone o 278116 ® JI' ° �Ew'6� 00 ® ®eaoo ®9 er or.. urc..as r o1r Mulldlng uhic pa ity John Carelli C d hg 'Constructed ec on danopus Hollow Road LOOM= .. SErpif . 1L0C'i,. Raised Ranch f u� cat GUARANTY OF SEFARATE SEWAGE SYSTEM I represant 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 booed 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, anal hereby guaranty to the owner,. his succe @_ sops,. heirs or assigns, to place in good operating condition any'part of paid system constructed by me which :fails to operate for a period .of t?ro gears immediately following the date of initial use of the sewage disposaI 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 ocpu� punt of the building utilioing the system. The undersigned farther agrees to accept as conclusive the do. termilgatlon of the Director of the Division of Environmental _ffpglth_ r ``vices -`of t Ze ' Putncim--- Coun-ty-- Degaax°tmeht of He�];th as to whether or not the failure of the system to operate wad caused by the willful or negligent act of the oopupant of the building utillf4i.ng the system. DAteO this 10 day of Dec 1977 9i natured S Title corporation, give ?game and address) THREE (3) COPIES ARE, RE(4UIRED WITH THREE (3) COPIES OF F'INAI, PLANP DEFOG CERTIFICATE OF COMP LETION WILL DE ISSUED e GUARANTOR ZS REED TO FILE QTICr, OF DATE. OF FIRST USE OF SYSTEM, Dlvision of Environmental Health Services R Putnam County Department of 99al. 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 dnllgr end sub_mitted.lo. County- Health. Department together-with -lab ratoF- j,r pgrjR " analysis of wafer sam''le indicaiin ' p g water is ofsatisfactory bacterial - quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER PV�ME ADDRESS LOCATION OF WELL (No. 8 Street) (Town) (Lot Number) PROPOSED USE OF WELL � DOM STIC 11 SUPPLY F] ESTABLISHMENT El INDUSTRIAL ❑ FARM CONDITIONING E] CONDITIONING ❑ TEST WELL ❑ OTHER (Specify) DRILLING EQUIP MENT 1:1 ROTARY . AIR PERCUSSION ❑ PERCUSSION OTHER ❑ (Specify) CASING DETAILS LENGTH (reef) / DIAMETER (inches) WUUHT PER FOOT X THREADED ❑ WELDED O YES ❑ NO G YES NO YIELD TEST ❑ BAILED HOURS ❑ PUMPED COMPRESSED AIR G.P.M. YIELD (G.P.M.) 15 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST fleet) Depth of Completed Well in feet below land surface: rs`c SCREEN DETAILS MAKE ; LENGTH OPEN TO AQUIFER (lest) 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 � r # A,14 If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL, MPLETED DATE OF REPORT IWELtD ILLER (S a na ure) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION._OF ENVIRONMENTAL ._...., HEALTH SER VI E � COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner John Carelli Address . Cherry Place Lake Peekskill, NY Located at (Street Canopus Hollow Road Sec. 57. Block 7 Lot 1 �Indicate neares cross street) Municipality Putnam Valley (T) Watershed Peekskill, N.Y. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to 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) 1 4 :30 4 :50 20 18.5 21.57 3.00 6067 2 5002 % :23 21 17.75 20.75 3000 7000 3 4 5 _ (2)'l '4 :40 5 :01 .21 19025 22025 3.00 7.00 2 5004 5s27 23 c 18.75 ~ 21075 3000 7067 �r 3' 3 4 5 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. DEPTH ..-G..L. 611 1211 18" 2411 30 3611 42'1 4811 5411 6off 1-66" 72 A 781, 8411 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 1 HOLE NO. 2' HOLE NO. 3 R.O. -B .-Brave INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None ,INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY John S. Romeo Date November 20 1977 6 DESfVN 'Soil.` -Rate Used S. D. t6a­1A.e- -A­r"e_a__ '_Provid4d 5000' SF + No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. Absorption Area7Provided By 300 L.F.x2411 1 -Northridg Address e Road fit THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: .00 Nrw W 00060,06 0 Soil Rate Approved Sq. Ft/Gal. Checked by Date Located r �} 1PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 UCTION PERMIT FOR _5eWAGE`..DISPOSAL SYSTEM ,`- �-y�►�:�,"� ?[J+4'�=Titi�� Iic'r�i� -. `v''d3'I�A -33 - -- Subdivision /' _ Owner ,044 tj ',°a° A R IF Lil,'! ��yy Building Type M-S Lot Area fa.,,_,; Number of Bedrooms Design Flow 66c. �' r Separate sewerage System to consist of ! 6 �3 ra Gal. Septic Tank To be constructed byt%f"� �- EjL• r Water Supply: Pyblic Supply From Private Supply to be drilled by Address Other Requirements I represent that I am wholly and completely responsib above described will be constructed as shown on the a County Department of Health, and that on compl ere be submitted to the Department, and a written g an a wi place in good operating condition any part of sal 's$ . ge ante of 'the approval: of the Certificate of Constru ion orsr will be located as'shbivn on the approved plan and that id I,v County Department!'of Health. Date r" Address APPROVED FOR CONSTRUCTION: This approval expires one revocable for cause or may be amended or modified when consi requires a new permit. Approved for disposal of domestic Date~ By 4i I V . _ TO_wdl - -O_ s•- Y.1119 B. • -.. •. — ._ __ •- Tax Map �y R- Block M Lot �p } Job L i u j Address d.)X La A ,4F, ��.je,L ie a t s.71 C� Total Habitable Space O V `99: -- }, `�� Square Feet and 3�T L3e�[► rT �,„f ������•/.0 Address 41 the proposed system(s); 1) that the separate sewage disposal system h re accordance with the standards, rules and regulations o e u nam i o ruction Compliance" satisfactory to the Commissioner of Healthwill the r, his successors, heirs or assigns by the builder, that said builder will ` e du ing a period of two (2) years immediately following the date of the issu- e or' ystem or any re irs thereto; 2) that the drilled well described above i ac rdance� with th�andards, rules and regula i— oT ns of the Putnam Att P. E. f"°-11, R. A. r �1 License No.J ' m the date issued unless const tion of the building has been undertaken and is 8ssgry by the Commissioner f jrfealth. Any change or alteration of construction Title P UTNAM rm.1"ARI'MrNT or irmulf DTVTSTn\, or. rx'i1*rRO%.-;FNTAr, UFAT.1111 qFRVTCPS 71 Date 79 Re: Property of /Oi4m Located at CAvOPU. ' /71 X44. 'A) 141413 Block l Lot Ag. 4-1 All Gentlemen: This letter is to authorize S- IANI EY ANDER duly licensed professional engineer or registered architect Cp (Indicate) to apply y for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulacrated 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 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- Jar Y Code. Very truly yours, • Signed UOwner of Property , Z4 ele- un rsi e 2- Address P.E.9 IM*9 --3 2- -7 STANLEY J. LANDED les.s AMAWALK9 R. Y. .10501 - ft in 1- 0%n a F. Telephone will M1 � MAN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,y, .�._r _r. ro CDUNTY`OFFICE `SUIIIN �ARP�ti;" 1V: Y.r -- '10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Jo�f�.{ �.�a ems% Address,5i+X' Zq / Z,4g� � �lsrcic[ , /6, V, Located at (Street� Sew.. -- Block LLot IndIcate nearest cross s r e Municipality_ VW,o) D r P1)T A-i1j I I Watershed C 1400ptis 9LLC,;J SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 5 3 la =54- iD -4 -6 12. 1 4- o 4 lof46 .''12- 5 .a 1 2 ACL 3 5 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. Role Number CLOCK TIME PERCOLATION PERCOLATION RdH Elapse No. Time Start -Stop Min. Depth to Water From Ground Start Inches Water ve Surface in Inches Stop Drop in Inches Inches Soil Rate Min. /in drop 2 4- f l rs 3 3 102, �= s i4 i 4n 1 5 3 la =54- iD -4 -6 12. 1 4- o 4 lof46 .''12- 5 .a 1 2 ACL 3 5 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. 7211 Uc'nJIN► �I J l /1' 111.1 ..� 1'.i. .1J1!1: 1 .!'.1'i!'.1) J i" '1'i',: ,'I' II(�1 i!'n i DEPTH 110T.l: 110. Pt MOLL xo. G.L. P5 �� II\'D.ICATE L, ` L T WHI TIC I 01`0 "1`D r T ,IZ IS E; TC� -rIT .,,, - II \DICA`i'E LEv�L 20 .NLTGti 1211 TESTS I•.RDE- BY ,5-- LANOe rte.. Da -e i0- - ✓ DLSIG, Soil .Rate -:Us ';3. %.S. ydR /1 -'Drop: - . D.-UsableNA.'a i- No. of Bedrooms Jam' Septic Tank Capacity Ga }:1° ls. Ty 6 C-'Rq; cjc-. .Absorption Area Frovidod By' [ L. I'. x2 " ate '—. width) . trot —11.. V- S` � LEY L LANDER 0tt)e:r, -- 3611 54 6011 66" . 7211 84" II\'D.ICATE L, ` L T WHI TIC I 01`0 "1`D r T ,IZ IS E; TC� -rIT .,,, - II \DICA`i'E LEv�L 20 .NLTGti j,r: l i',.rc� L•��. � L RISES Ai�'r-';?I-I 13 -,!1 i`13; Li;,VM;'isPI::D . TESTS I•.RDE- BY ,5-- LANOe rte.. Da -e i0- - ✓ DLSIG, Soil .Rate -:Us ';3. %.S. ydR /1 -'Drop: - . D.-UsableNA.'a i- No. of Bedrooms Jam' Septic Tank Capacity Ga }:1° ls. Ty 6 C-'Rq; cjc-. .Absorption Area Frovidod By' [ L. I'. x2 " ate '—. width) . trot —11.. V- S` � LEY L LANDER 0tt)e:r, -- !Address THIS SPACE FOR USE BY 1.C."A `.PII DLI111 ''I/ Soil Fate Approved Sq. T'l: � a N0. 3 �2�,� of cI by Date Y $, :e 1 50' , 3.4 L,/6 " E . .. �. r. -r. . a.v....v. _,...p _ ..- y �.. .�.. ' � t. ... � . , a n-. ..� . .. "'^.•T ^^ _. -._.:a ... �.sr -..r.. +....na r . 1 � a. s.. Y. : .. r ♦ ..Nr . ` 'F-j ►l R l_ L d c A-r ► <. r.a.s 3 441 ° 171 1n� i uz 63' 4, I2 . 5 Z1,% 41 Iii: L4 Hl 147 5 V r `V I l 0 �r o� I-...)EI---,IGNED & ROMEO- ROMANELLI -AM ICO CONSULTING ENGINEERS 113. � eq4Z- OM HOUSE E -5 PAIN. NK // "r, v i J ' 11 '' V <4 o') v <) lk) N3, < ly VISION OF, 0:44 .:k TAI M! 9 TH !Sf RYV.7Z, SEPTIC SYSTEM. FOR CA7eELLI TOWN OF Pc)T-xjAkm X .A COUNTY