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Home My WebLink About2730DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61.08 -1-4 BOX 23 02730 ' PUTNAM �COVN7 Di.visfon of Environments "� EF3TaFlC1�TE.G}FR. Q. $� U TAI IV sCOMP I4N.rE {F4:E h :Located.:.at owns, ; _.Edward &. Myrna: {Cable Ke Contractors; Separate_ Sewerage• System built llco ;by GonsiSting of 12 x1. Septic Tank `� Other. requirements' - Wit& Supply Public 5upply;From Prwate,;Supply 1Dr,illed cBy" e Address S+}?rAtlt ;BroAltt• Rd ' F Building -Type - 'Single family res Y' Has - Erosion Control Been Completed I certify that thesysterii(s) as I�sfed serving the abov m e preises we►e a attaclied), "and in accordarice with the'sfandards; rules -and regu(at c f 3U 7, ;,oats Ada ►ess 245. Maple Plac `,Any person occupying premises served by,the above systems) shallY eondi4ions resulting from such iusage .A. pproval, of tKe separate`'? ' available and;-the :approval of- the pnJate::,water supply_shall become subject to modification o► change when;- �ry -,the .judgment of tlie, 4 1 "6 Y DEPARTMENT OF ---HEALTH I Health Services; Carme% .N K . 10512 cctnJ a�E EISPOS�,•L �YST�M Putnam Valley M sP uti a Sheet ' Town or village a 5 X23 : Block Lotp I �D •Q- _? Job', ,�. cadres :Ganopus :.Hollow - :-Road,. Putnam VAlley N lineal F,det'X- width trench r •�, ...;. t - ' r Pke1ri4:1 NoS of Bed` —bate Permit Issued 11-76 �ilb CR k p�rg9� aructed es n ns f .the completed work _(copies of which are plais,fil an th IPutnam - C unty .Department of Hea'Ith. i v P.E.x Assin �° 31289 License No �mpt5yitake suc, a ssary.to, secur fie correction of any unsanitary stage system.;`shall void as :soon as a.public sanitary sewer becomes III; nd voii7'when a;Rpubi = supply> becomes available. -Such approvals are Im _on lof Health; su rev tion' modification or change "is, necessary. - a F 7 � p BACTERIA PER ML. (Agar.plate count at 35 C)..COLIFORM GROUP .(Most probable N6, /100m1) RDNESS, TOTAL'- ppm' ". Vl• ` j j CLI-) DETERGENTS = ppm NITRATES (as N),- ppm IRON, TOTAL - ppm These results indicate that the water was �1 j t These results indicate that the water was �1 j of a satisfactory sanitary qualitywhenAthe sample was collected. Y A. H. PADOVANI, M. T. (ASCP) V� �^ Putnam Valley (t) Edward & Myrna Cable caner or Purdhaser of ui zng Muni ci.pa i ty- Bull ing . ConsErLatE d by XN R 165, - Sheet South Highland Avenue 1 Eocatibn Street Block single family res. Part of lot 5 13ulidi ng Type Lot. GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for.the location, workmanship, ma.terial,.construction and drainage of the sewage disposal system serving. the above .desc.ribed.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 tol.operate properly is caused by the willful or negligent.act of the occu- pant of the building utilizing tree 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 to operate was .aaused.by the willful or neglig t act of the occupant of the build in utilizing. the system. Dated this 8 ... day of :. Nov., 77 19. Signature Title Owner f corporation, g ve'name and address) . - --- - - - - - - - - - - - - - - - - - -.- - - -- - - - .. THREE (3) COPIES ARE REQUIRED WITH TfffIEE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL . BE 1SSUFD . GUARANTOR IS REQUIHZP REQUIRE TO FILE QTIC -' OF PATE OF F RST USE OF SYSTEM. Division of Environmental Health' Services, Putnarn County Department of Health t s �, w t4PUTN AM COUNTY D TAR Uivfsfon' of Environmenia/ Health.:S - ONS MI rTRUCTION_PERT FOfi. SEWAGE,.,POSAL SYSTEM K DIS jt 4 a LocB�CG�at + icn��' ;Subdivision n n Fat�t`E*a r <' F a Owner '_ Edward & 'Agvrna Cab "e Building TYPe— Site Fgfiilo L'ot Area r87; 362 8a . ;iNumber<:of Bedrooms Y - separate Sewerage System�to consist of 1200 `_� Gal Septic r To be constructed by Anthony CeBarni y $ ter. r ti v Water, SupPIY Public SuPPIY ;From t:l Private Supply,'to lbe drilled by.b Prxe " r F E vAddress S- �1�'.011t' $rOO�S R ®aa:y p+><ek�� I represent that 1-am wholly and completely responsible for :the design and ilocatior ,rabove described will be constructed as shown on the approved amendment there t'?' ;Countyl.L) artment of +Health, and`that on completion thereofkaA';Cert+ficate 1 °be submitted fo the Department; sand a'writteh guarantge will be furnisn I, place in';good operat+ngr +condit ny. part of said sewage disppsaI syst° du ante of "the approval of `rthe Certifbicate -'of Consfructwn r�Compl�ance of x 'orF'I . _' iV:illhb'e`;located <as sROwnfon the a provetl -plan and that se id we11'w�ll tie, instal r =County Department of Health P Date °1 I ��S/76 Sighe ..�, e; �: �flddress =�56 Snnth r -Ni nh7�and Avpnui ANT 1`0F 44 5 s Carme% ,N Y. 10512 t Putimsa Valley, :(:t) na Town or Village. - e 2�an Z .1 got Part of 1 ®t 5 yob 3 address 257 Lacust. `Ave. Peekskill, 'NY . T-661 Habit$ble Spacer cater g5.0� 3 Square Feet 3��hneal feet X 24r� -width trench Address WSShingtoi� St. Peekskill; .NY �ipw SCAiTC h w h Qroposetl ystem(s) .) that the se disposal'system i�a '^r�ance °q3i the standards, rules an regula ions o ,..the Putnam ^satisfactory to the Commissioner of Healthw,i1I e "`r` that said'builde' will 'r" ht �su:.ce�Y"s;,, . 'rs or assigris by,,th�, bu�lde.,,, , he'? z per od;of -t(2 ears immediately: following the date i of ,thessu ystem%or�a' y, .air hereto 2j that the drilled well.described,:above µ ilanceN wit the stp: ,ards rules and. t he Put -nam; - fit, g. L License No 38912 fired unl c nstruction �the ldi ng has been undertaken and +s Comm s,o er of Health Any change. or alteration of:constructlon friv tar, Y onlyf e. WELL EOMPLiTION RCPORT PUTNAM COUNTY OEPARTC4E.NT. OF HEALTH 301 Division of Environmental lloaltti Services COUNTY OFFICE. BUILDING • CARMEL.,NEW YORK This rcpo.t is to be completed by well driller and su!- %,sited to County Health Department together with laboratory report of anal sis of water Barn le Indicatin eater fs of• satisfacter, Lacterial_quality.6efore certificate of :construct;on.comh eance. is- issued. a:.:,ti..R.�• • -; REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL CONiPI[TION OWNER NAME dwa d Cable ADDRESS 257---:Locust Ave Peekskill, N Y 10566 LOCATION OF.WELL (No. a Street) (Town) (Lo/NumDer)` Lot South Hi hland Rd. Putnam VAT T e . - a.Y:. - - - PROPOSED . _ USE OF WELL _. _ _.. BUSINESS — _....: _ _... -- - -- ..❑ °TEST - ® DOMESTIC ESTABLISHMENT FARM WELL ❑ ; ❑ SUPPLY ❑' INDUSTRIAL ❑ CONDITIONING El ((SSpeci Y) ' C� COMPRESSED OTHER ❑ (Specify) P ROTARY A R PERCUSSION CASING DETAILS LENGTH_(feet) DIAMETER (inches) WEIGHT PER FOOT �� 611' - - - - - C THREADED : ❑ WELDED DR E S O YES "I ❑ ❑.NO WAS CASING GO� ? ❑ YES L_)'NO YIELD TEST ❑ ❑X PUMPED ❑ COMPRESSED AIR HOU6RS G.P.M. FAILED. YIELD (5P.M./ ' WATER LEVEL MEASURE FROM LAND SURFACE -STATIC (Speclty leet) 35' DURING YIELD TEST (test) Depth of Complelad Well in feet below Land surface: 325' SCREEN DETAILS MAKE LENGTH OPEN TO- AQUIFER (leel)' SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inches): GRAVEL SIZE (Inches) FROM (le et) 70 "'00 ' WPTN FROM LAND SURFACEI FORMATION DESCRIPTION Drilling in overburden - clay and boulders Sketch exact loco tion of well with distances, to at least, two permanent landmarks. 0 uartzite Hit rock at 3 ft. ,3p Drilling in rock -set 2 If yield was tested of different depths during drilling, list below FEET GALLONS PER MINUTE It WELL COMPLLIED DATE bF REPORT WELL DRILLEn (Signatur e t Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH .D.IUIS,T-QN.,YOF .•;ENV- IRONMENTAL�:I�EALrTH Date r/Z Re: Property of OW A- a P A I Q� � Located at G_ / P V li — V A L %,G `I Section_ 23 Block 1 Lot Part�f lot 5 This letter is "to authorize CJ 12n LC�� a':•duly licensed professional engineer or - ct (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 connection with this matter and to supervise the construction of said - system or systems in conformity with the provisions of Article 145 or ,. 1.47, Education Law, the Public Health Law, ..and the Putnam County Sani- tary Code. Very truly yours, Signed Owner of Property Countersignedl, •d� aa. ddr s , - _ P.E ., _ , 8912 -3 1 z _ Y 2 Telephone Address` «,r:�, Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH M _ DNISION...OF..ENVIRONMENTAL, .HEALTH _SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA'.SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner F-0%X.&Zj2 FA71 V4 i�4ddress 257 LOOVIT A VS PCs EICS K Located at ' ( Street IRV& Seca Block -Lot .� �Indicate near` e cross s ree Municipality PurIVAY 1.C1 Watershed C/A NApu C.aL�lc. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 2 'L 5 16 :3 Iy' 7J 2' 4 N ►�. COON� Notes: 1 ARPat *J*ated at same depth until approximately equal soil rates are each percolation test hole. All data to be submitted for review. . .... 2) Depth measurements to b made from top of hole. Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to.Water Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2 'L 5 16 :3 Iy' 7J 2' 4 N ►�. COON� Notes: 1 ARPat *J*ated at same depth until approximately equal soil rates are each percolation test hole. All data to be submitted for review. . .... 2) Depth measurements to b made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. � HOLE NO. G.L. 61► 12" Sawa P &L, L 18" 24" 30" 36" 42" 48" 5)F 60" 66" 72" 78 it 84" Ve` yV � 3. INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY - ,Date DESIGN Soil Rate Used Min/1 "Drop: S. D. Usable Area Provided No. of Bedrooms Septic Tank Capacity Q. -Gals..,, _., Type N Absorption Area Pr vided By L. F. x24" ,;; =' "',^ �� trench. Name . , & - Signa u Addressg7e.So 1A SEAL, J• THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ,`"`` Soil Rate Approved Sq. Ft /Gal. Checked by Date