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HomeMy WebLinkAbout2736DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61.08 -1 -22 BOX 23 02736 fit, ' ! -� �ti T NJ f , Zr Rim 02736 �Y .' 'h, i ° - ' ' '� a � . `` PUTNAM • "GOUN.TY.- DEPARTMENT OF- ';HEAliTH . I Division :of Envionmenial.Health Services, 'Carmel. 'N K.:'1,0512.' ' i CEFiiIF[ICA7E,"OF CbNSTfi'i1C7"ION GOMPLW -E FOR ,SEWAGE ,DISPOSAL SYSTEM ley' -T) VaT mown o`r. v.illaye ter- - Trail of the les Map 9A j�q� i Located ,at t Section Block Virginia Versland 26 Owner; Lot . Job separate.5ewerage system buil/t� by Donald Heady ° Address Canopus Hollow '.Road, Putnam Valley width'trenc i. .'7 h Q9 . Consisting of Gal.- Septic .Tank lineal Feet X 36t) " - .Other requirements Domestic --IIse Only Water Supply 'Public supply From ; 't % ,Private' Supply Drilled By s PuCkey We11 drillers ti 1. _ ._ . A 1 ,. • .a `hy ;� ...,g ., ' Sprout Brook Road, Peekskill, NY ,0566 Address Building Type R9YIC�1- No: of Bedrooms Date Pejrti u • Has Erosion Control Been Completed 'Ygg t ; • �(, , 9 • ' ff bF l9 e I certify that th'e systems as listed serving the above premises were constructed essenti • r y O, ally as shown on'the plan' to I or iaa�� of which are ' attached), and -in.- accordance with the standards,` rules and_ regulations plans filed and the permit Issued .by et utn Der�nt of Health. P4 0 pry t �% x`F date January 21, 1974 aCerfified :by 4, Address zl Northr f'-_%': An' y - person occupying premises served by the above system(s) shall' 'conditions, resulting from such, usage. ' ,Approval of the separate's i 'available .a' nd the approval- of the. private,', water supply shall_ become subject'to mod ification,or change when in the = judgmerit of the` oats �d /�79 ey Q3 r ° �Y • 2 s �N` �027W •. npt'ly take such action as maybe necessary to Td t��Ro�t9�cjiOn of any unsanitary raga system shall become , hull -and void as soon two nitary .sewer becomes I and void when a' public water supply, becomes available:.., , Such approvals are loner of,,rHealth such revocation,. modification or change 'is necessary ILLS '�'L�ew�/.%fi7 r - Title z` �y7i w .. .K-�-, PEEKSKILL MEDICAL LABORATORY 1879 Crompond Rd. Barclay'P1'az,a Bldg. A; Apt. l Peekskill, _ New York 10566^ PIs,187 7. . 40836 DATE COLLECTED RESULTS OF EXAMINATION OF WATER 1/15/74 :.. . OWNER DATE RECEIVED Virginia Versland 1/15/74 CITY, VILLAGE, TOWN VOR NAME OF SUPPLY DATE REPORTED T 1/17/74 SAMPLING POINT Well BACTERIA PER ML. (Agar plate count at 350 Q. 3, COLIFORM GROUP (Most probable No, /100m1.) less than 202. HARDNESS, TOTAL - ppm DETERGENTS. - ppm NITRATES (as N,) - ppm IRON,' TOTAL - ppm FLOURIDE. (F) - mg./l. These results indicate that the water was ire; m I Virginia Versland Jens Versland Building Constructed-by Trail of the Maples Location - Street Ranch Building Type Putnam _V ^`- ^ uni c ip ali it Map 139A Section Block 26 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 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 :Wade 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. to_ operate :was caused ` b.y:•..the•. willful ..or - •negligent act of the occupant of the building utilizing the system. Dated this 18 day of Jan 19 74 Signature 'j7 Q -- Title (� ( corporat'fon, give name _��. and address) - - - - - -� - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) 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, Putnam County Department of Health r i WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH j 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to..be cgrttpleted b .y.welll,driller and 50.1nitied:.LO C¢unty. Heaffh l9epartttie►t4 tege ier wi¢h labarat�r"y pdit'o`f' "' "' aiialyMs of water sample in icating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT. MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COIiflPLETBON OWNER NAME ! L' 4 ADDRESS Fz a l,v, LOCATION OF WELL 5' /V I' (No. 6 Street) RR 0 0 U-r*# A4 (Town) A (Lot Number) PROPOSED USE OF WELL DOMESTIC SUPPLY [] ESTABLISHMENT ❑ INDUSTRIAL ❑ FARM ❑ CONDITIONING ❑ TEST WELL ❑ (specify) DRILLING EQUIPMENT ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ CABLE PERCUSSION ❑ OTHER (Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) j WEIGHT PER FOOT ® THREADED ❑ WELDED I E SHOE YES ❑ NO Lnj CASING YES TED? NO YIELD TEST ❑ BAILED HOURS ❑ PUMPED L4 COMPRESSED AIR � G. P.M. IS— YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE — STATIC (Specify feet) DURING YIELD TEST feet) l Depth of Completed Well in feet below land surface: SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (teat) TO (lest) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET T - Aa l _........_.. _..._ -di,�i% I s1 i= c i If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE { I / 1� DATE WELL COMPLETED 1 DATE DATE OF REPORT /2 WELL DRILLER (Signature) C 1 %J v OU PUT me f 06 Caw Other equirements-;,,-,- :des4ribed will be.c6nstruiited as show o me p ace-.An good opera ing,,cop I ion any _pari of., sa'Id -sewagb 'd 'County Department of Health.- - JIN -.Address 1 ` ~ Y. HD BlocW Van nd o" 'poser d tyitem(�) '1).. that wage dispomf system a I ca rite se W there to,an1J1'i!j_,acFordanC'e with the'i hdar SAWariff lationsof :the, Putnam if the lisu- eas Undertakeif and Is FIELD CHIPECK LIST Date.: Ins p. b Tl\TTTTAT, STTR TTI9P7nTT0N IYes I No I Comments Property lines ,or corners found.. ..o o . . . Can estimate house location . . . o 0 0 G o . Will drive way need cut Must trees be removed -note these . . Is deep hole representative of entire SDS area Additional deep holes needed. . . . . . . . Sufficient SDS area available considering driveway cut,.house. location, separation distances, etc . . . . . . . . . . . . . . DEEP HOLE DATA Depth: Water elevation: Rock elevation: Soils description: -- - Date FINAL SITE INSPECTION Insp. by;e,>, g&j4z l L _. House located where shown on approved plan. S%s located where aprrptrAO , Width of trench average 3' Slope of til line and trench acceptable . . . Room all.-owed for expansion trenches. Over 50 ft . from swamp.,-,watercourse Natl.re _ - ' pP ; ... _ ? ,1 soil not.. stri Pd of :.;.ADS unnecessarily graded. . . 10 Ft. maintained from prop.linl.. and 20 ft. from house . . . . . . . . . . Separation of trench from house, well etc. follows plan . . . . . . . . . . Number of bedrooms checks . . . . . . . . ... Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench . . . . 15 Ft. of peripheral soil horizontally from. trench. . ... . . . . . . . 0 . . u . Junction boxes prope_-ly set Could surface run off from driveway,. roads, ground surface, etc. channel near SDS.� area. . ... . . . . . . . Does lot drainage appear O.K. in area of SDS' I -J -L FINAL GRADING OF SITE ACCEPTABLE. Gentlemen: DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date July 99 1972 Re: Property of Virginia Verslamd Located at frail of the %ples Section 13ap 139A Block - Lot 26 This letter is to authorize John Se Romeo a duly licensed professional engineer x or registered architect (Indicate) to apply for a Construction Permit for a 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 T'% --.. y 4- .n TT_. 7 11_ 1 _ '� '. Lcpal tUJC;jiU C)1 ne al h.1 and o sign all ueuussary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformityrwith the provisions of Article 145 or 147; Education .Iaw' -the -Public Heal•tl�-Iaw'; , and 'the Putnam.. County. Sani tary Code. Countersigned: P . E . ,. R . A . , # 27$46X.% t - 1 Nortbri8ge Road (Seal) ress Peekskill, N.Y, PE 7 - lo56 TeTe—plaone Very truly yours, Signed . 6"'o (X/YZ . Owne o Property Addr'ess 623- s 19 a . e ep one . oy.fee 0 * 0 0 ° ° �� \p�1A1. ENG.iNFF�,o .. e u` � $ RO�Fpw��J e � o ?7846 0 -O 4' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION-.. OF • ENVI-RONMENTAL� HEALTH= SERVZCES - COUNTY OFFICE BUILDING,,CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Virginia Versland Adaress: :2k9 No. l ddletown ..•Nanuet,,- N.Y, Located at ( Street Trail of the= mplvbc : Ya'P -139tLock Lot 26 6dicate nearest cross street). Municipality 'Putnam Valley Watershed Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Vater a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 442 1:57 15 244 27.5 3.0 5900 2 1%57 2:13 16 27.5 30.5 3.o 5.33 3 4 ° 5 _... ._ 1 201+ 2s22 18 20,25 23.25 - - 3.00. 6.00� _ ••r 2'` 2s2z' ' 2s42 20 23.25 26.25 3x00 6.67 3' 4 5 1 2 3 , 4 5 Notes: 1) Tests 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. TEST PIT DATA REQUIRED TO BE SU3MIT-551%'TH & LICATION :;17 � 7-,17 , -, : 1. - . - :z DEPTH HOLE NO. I G.L. _Toposil 611 Toposil 121' fthdy graved.... 1811 some larger stones 24 3011 3611 4211 4811 5411 6011 66" 7211 7811 8411 HOLE NO. HOLE NO. 3 Topsoil Topsoil 3 Topsoil 3 Topsoil sandy gravel sandy 0mviel some larger. qtoixw�z-A some t r stones � 16 � INDICATE.I=L AT WHICH GROUND WATER.IS ENCOUNTERED None 79 F;-LEV RISES -AFTER T -INbICAT'E` LL-, TO-WHIM? VATER-- IZVE-D -RISES-�' -,BE-1NG-­ENMATERED- -.1ESTS MADE BY John S. Romeo Date July 99,1972 DESIGN Soil Rate Used 8-3-0 Min/l "Drop: S. D. Usable Area P VQ 9#,,.5000SF 3 S 900 sonry. No. of Bedrooms Septic Tank Capacity Gal Absorption Area Provided *__I$0 L.F.x2411 5b" Name Bonn zi, Itomeo bIgnature kD1M*-L , wiwlm Address I Nartbridge Road SEAL-0% P� Peekskill. N.Y., THIS SPACE FOR USE BY HEALTH DEPART?MT ONLY: Soil Rate Approved Sq.:'Ft/Cal. Checked by Date JAI 4E J E l _ Ric IN ' A,d p. 3 y t IM CooL. .. .1 ..... , .. y� _. �.� .. y� �`.. �y "J i �, 1- i t ^� _. � � ....... • w. ..:..mot V y_I � . .. .� t } I f v ry .n k � h