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02780
c PUTNAM COUNTY DEPARTMENT OF HEALTH
0 Division of Environmental Health Services, Carmel, N. Y. 10512 #PV -22 -80
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley (T)
Located at Peekskill Hollow Road Tax Map Block
Owner Bonnie Brusky Tax Map Lot # Subd. # 2
Separate Sewerage System built byB. Catrel Address
Consisting of 1000 Gal. Septic Tank and 300 1. f . x 24" width trench
Other requirements none
Water Supply: Public Supply From
X Private Supply Drilled By Anderson Well Drilling
Address
Building Type Single— Family No. of Bedrooms 3 Date Permit Issued Oct. 30, 1980
Has Erosion Control Been Completed? yes
I certify that the system(s) as listed serving the above premises were con eg a NEeta!•br shown on the plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules and r Za with th iled plan, and the permit issued by.the
Putnam County Department Of Health. c� V Q•
Date January 8, 1982. X
Certified b P.E. ' R.A.
Address 186 Katonah A n , , N Y. 536License No 51251
Any person occupying premises served by the above system(s) shall prompt) <� uc ction 1pt� cessary to secure the correction of any unsanitary
conditions resulting from such usage. Approval of the separate sewerage Ib�'ta� u� void as soon as a public sanitary sewer becomes
available and the approval of the private water supply shall become null and v Qt fop supply becomes available. Such approvals are
subject to modification or change when, In the Judgment of the Commissioner ocation, modification or change Is necessary.
r
Date—t By (y L.InM_
Title
_ .. Bonnie Brusky
Owner or Purchaser or-Building
Bonnie Srusky
Building Cons tructe by
Peekskill Hdi low Road.
Location Street
Single - Family
Building Type.
Put am Vai1ey (T)
Muni ci.pa ity
Section T
Block
Sub. #2
Lot
GUARANTY OF, SEPARATE SEWAGE SYSTEM
I represent that I am wholly and completely responsible for the
location, workmanship, material; cgnstruction and drair_age.of the sewage
disposal system, serving the above described.property, and that itihas been
constructed as shown .on the approved.plan or approved amendment thereto,
and in accordance withi' the standards.,.r'ules.and regulations of the Putnam
County Department of - Health, and hereby: guaranty to the :owner, his success
sors, heirs -or assigns; to place: ri. :good,.operating- condition any part of.
said system constructed by me i'hich. fails to operate' for a period..
eriod of two
years immediately following the.date of...initial use of the sewage disposal
system, or any .repairs :Wade. by. ine- to :such system, 4xcept where the failure
to operate properly is. caused by.the.willful,or negligent act of the occu-
pant of the building utilising the..s.ystem:
The undersigned further agrees to accept as conclusive the de-
__t , the..Director. of....the .Dive. :aion -of.._ E viror -menri 1 Health. Ser-
vico8' * f-, the "'Piatna.ia County DeparcmeaL of-t ea to as to whe.ther"' or'.not 't4 `
failure of the system to operate was caused by the willful or negligent
act of the occupant of the building utilizing the system.
Dated this day of 19q*'-° Signature
Title owner
f corporation, 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.
w - - - - - - - - - - - - - T - - - e - - - - - - - - - - - - - - - - v
Division of Environmental Health Services, Putnam County Department of Health
CI
JAN 1 � -1982
PUTNAM COUNTY
DEPT. OF HEALTH
WELL COMPLETION REPORT - PUTNAM COUNTY DEPARTMENT OF HEALTH
3/71 Division of Environmental Health Services
COUNTY OFFICE BUILDING - CARMEL, NEW YORK
This report is to be completed by well driller and submitted to County Health Department together with laboratory report of
analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued.
_ .:.... ::__... 5hIT F�_V1Totj. D h' C01" "LET;Oti
. .:REPORT BE E
NAME
ADDRESS
OWNER
B. BRUSKY I
I.
LOCATION
(Town) (Lot Number)
PEEKSKILL HOL (OO)OU' Wb
OF WELL
; ,
BUSINESS
❑ ❑ ❑ ❑
PROPOSED
DOMESTIC ESTABLISHMENT ISHMENT FARM TEST WELL '
USE OF
WELL
❑ OTHER
SUPPLY ❑ INDUSTRIAL ❑ ❑
CONDITIONING (Specify)
DRILLING
COMPRESSED CABLE
ROTARY ❑ ❑ F] ((Specify)
EQUIPMENT
AIR PERCUSSION PERCUSSION
CASING
LENGTH (feet)
t
DIAMETER(lnches)
WEIGHT PER FOOT
15
� ❑
T281 E S O
CASING
DETAILS
20
6n
THREADED WELDED
YES
NO
YES
NO
YIELD
G.P.M.
HO7+
1:1 El
YIELD (G.P.M.)
TEST
BAILED PUMPED COMPRESSED AIR
5
WATER
MEASURE FROM LAND SURFACE —STATIC (Specify feet)
DURING YIELD TEST [feet)
Depth of Completed Well 400'
LEVEL
in feet below Land surface:
MAKE
LENGTH OPEN TO AQUIFER (feet)
SCREEN
DETAILS
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
Diameter of well including
GRAVEL SIZE (inches)
FROM (feet) TO (feet)
PACKED:
gravel pack (inches):
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmark..
FEET to FEET
11
101
hardpan overburden
101
4001
bedrock granite
JAN 11. 1982
PUTNf- M COUNTY
DEPT. OF HEALTH
�� y0''
P p R E, y'
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
�
�o. 5125�`�����
PROFESS I0
DATE WELL COMPLETED
DATE OF REPORT
WELL DRILLER (Signature)
8/27/81
(ORKTOWN MEDICAL LABORATORY INC.
P.O. Sou 99 321 Kear Street
Yorktown Heights, H.Y. 10598
.245-3203
LOCATIONS:
❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 -3203
O 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737.8777
W.495 MA.IN.ST., MT. KISCO, N.Y. 1.0549 666 -3335
❑ Sl'U�NELt3)taH A�/E. INEAR�HO §PITALI, CARNY! L, PV ""� . 101`2 278 9330r
LAB # _�v 1:--
t;: DATE TAKEN: LC/
e 4Ner 00 YEAR t, s �.
Of n.an_' hrCCrudS DATE RECEIVED: j.11/1-2-
��----��` j/�'t' Yt�l 107 IiA Ci' „^i,y F1'ENiE� :vier,
1✓� DATE REPORTED:_
,iJIal7PuAHz fENV, 'tORt( (05 SAMPLE SO BCE:.
ss • I>�L�.� ul - �d�
REFERRED BY: - N`Sl�7N
COLLECTED BY :_.
LABORATORY REPORT
mg /L
❑ ACIDITY ............................ ............................... ❑ ALUMINUM ................................ .....:.........................
❑ ALKALINITY ....................................................... ❑ ANTIMONY ................................ ...............................
,XBACTERIA, TOTAL /mL ...... V .. ............................... ❑ ARSENIC .................
. ................... ...............................
❑ B00, 5 DAY ............................. ............................... ❑ BARIUM ........... ...............................
............................
❑. BROMIDE ............................ ............................... ❑ BERYLLIUM ...............................................................
❑ CARBON DIOXIDE, FREE. ........ ............................... ❑ BISMUTH .................................... ...............................
❑ CHLORIDE ................... :..:..:.................. ............... . ❑ BORON ......... ..............................:
❑ CHLORINE ..................:..:..:... ............................... ❑ CADMIUM ................:
................... ...........................:..:
❑ COD ............................ :..:................................... O CALCIUM ............................. :........................................
❑ COLOR ................................ ............................... ❑ CHROMIUM (tot.) ............................ ...............................
❑ CYANIDE ..................... :...................................... ❑ CHROMIUM (hexavalent) .................... ...............................
❑ DETERGENT, ANIONIC ....:...:... ............................... ❑ COBALT .............................:...... .......................... .... ...
- - - -❑ FLUORIDE ........................................................... .❑ COPPER ............................... ...............................
❑ HARDNESS .. ............................... ................. ❑ GOLD ........................................ ...............................
OWN COLIFORM COUNT/ 100 ml ........................... ❑ 1RON ................................. :...... ...............................
YKMFT COLIFORM COUNT/ 100 ml ... ................. ❑ LEAD
.. ......................................... ...............................
❑ CONFIRMATORY TEST .............. ❑ LITHIUM ..................................... ...............................
❑- NITROGEN,AMMONIA ............ ...............:............... ❑ MAGNESIUM............. ........,.................. ..
EJ `dl li(]f'.�N, K.J.F_l�"l9f -li ......., _..�....:o..... ....:.,t.........- ❑ NA.w6ANESE ... ..........: .:. ..:..............:::::::::.. ::: ::....... .° ..�
❑ NITROGEN, NITRATE ............ ............................... O MERCURY .................................... ...............................
❑. NITROGEN, ORGANIC ...:........... ..... ❑ NICKEL
OODOR ................................ ............................... ❑.PALLADIUM .......................
❑ OIL 6 GREASE ..................... :.. ............................... ❑POTASSIUM .......................
❑ PH .................................... ............................... ❑ RHODIUM ................. . .I............................. �o ....
❑ PHENOL ................................ ............................... ❑ SELENIUM ... ............................... .........................
❑ PHOSPHATE (ortho) ................................................. ❑ SILICON ............................ ......,�AN. ..f98?.........
OPHOSPHATE (condensed) ........................................... ❑ SILVER ............................. ... ...............................
❑ PHOSPHATE (total) ................ ❑ SODIUM .............................. 8PBP�.q:.�3sh`j,4..co Iq
❑ SOLIDS, SETTLEABLE, ml /L .... ............................... ❑ TIN ................................... 1s!f,P-,1,..GF•.H fALr q.......
❑ SOLIDS, SUSPENDED . ............................... ....... ❑ ZINC .......................................... .......................�.......
❑ SOLIDS, DISSOLVED
❑ SOLIDS, TOTAL
............................... ................ ❑.:....................................... . ............ ..............................
❑ SOLIDS. VOLATILE ......... ............................... `? .....:0 REMARKS: ................................... ...............................
.... ..
❑ SPECIFIC CONDUCTANCE
❑ SULFATE ............................. ............................... ❑ ,.........:.....:.................................... ...............................
.❑ SULFIDE ............................. ............................... ❑ .................................... ......6........................
................
❑ SULFITE ............................. ............................... ❑ .................................................... ...............................
❑ SURFACTANTS ..................... ............................... ❑ .................................................... ...............................
❑ TURBIDITY ......................... ............................... ❑ .............. .................. ........................_.. ... .........
THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN
THE SAMPLE WAS COLLECTED,
THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY OF
NEW YORK STATE ADMINISTRATIVE RULES & REGU TIONS, DRINKING WATER STANDARDS (PART 72)
ALBERT H. PADOVANI M. T (ASCP) , DIAECTOR 8 & Lt�L �;��
011• • 3 PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health .Seivices, Camel' N. Y105.1
CONS?.';(UCTIO.N PERMIT FOR SEWAGE.D,ISPOSAL SYSTEM ' Putnam Valley (T)
Town or . Village ..
.RoaC_ Tae tAap 910
Subdivision 1h Za - -see note on survey Lot Sub,-•. #2; Job
Owner. . Bonnie Brusky
Adore - Soinerse. Lane',:_ Putnam .Valley, NY
Building Type • -S!h4le- Family Lot Area 7.112.6 acres "
Number of Bedrooms 3 Design Flows 300.; 1. f . Total Habitable Space Square Feet
200
0
Separate Sewerage.,System to consist of 1000 Gal. Septic Tank 2.4 "- Awldth „trench
and' ..
To be constructed by S A.'F. Septic Systems,. Inc. dad ►ess P -:0 B0"41,' Cross, River, N.Y.
Water Supply: Public Supply From
Private Supply to be drilled by Tor l i sh &, S ' hs , I nC .
Address Maple -- Avenue, Armonk; )New York
Other Requirements none
cc
I represent that I am wholly.-and completely responsible'for the design and - locatio ttOe' em(s); .1) that the separate` sewage disposal system
above described will be constructed as shown on the approved amendment there afQr a standards, rules and regulations of e Putnam
County Department 'of. Health, and that on completionthereof i ” Ceifificat' o ' ctio lia " satisfactory•to the Commissioner of, Health will
be submitted to the Department, and• a written guarantee, will be•'furntsh th a' ner, uccesQe h s'or assigns by the builder, that said'buiider will
place; in.good- operating condition any part of said sewage disposal sysf d Ig. t�ev, 2� ears immediately following ±thedate of the issu-
an�e of the approval of the Certificate of Construction Compliance of o igina, t9di e r .hereto; 2) that the•.drilled well described above
will be located'as shown on the approved plan and that said well Will be instal t act dAY�L'e' wit he a and ;, -rules and .regu a on of the Putnam
County Department of Health '
bate October. :8. .198.0 „S,yned. P.E.X R.A.
- �,
F. „ ._ •; �� ' �� 512 51
Address License No.
APPROVED FOR CONSTRUCTION: This approval expires one year from the dat �Ib it may st►uction of the building has been undertaken and is
revocable forYCause :or may be. amended or modified when considered necessary. by the Sner of Health. Any change or alteratioh of construction
.requires a new - permit. Approved for disposal of domestic dry sew ag and / r p►iv to
Date ! By Title w
r PUTNAM COUNTY DEPARTMENT OF HEALTH
41
DIVISION OF ENVIRONMENTAL HEALTH SERVICES .
. �..[:' -. r- [Y...�.. _�. - ..- v_r. -."-. • �.. .. ..t z...:+c -L. n.•. • .•. rf>.. -. v:��- - wti :' ..N::.•e •_• xiy.; :..
Date October 3, 1980
Re: Property of Bonnie Brusky
Located at Peekskill Hollow Road, Putnam Valley, New York
Section Block Lot Sub. #2
Gentlemen:
This letter is to authorize Salvatore V. Ri ina , P.E. a duly
licensed professional engineer X or registered architect
(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 pro-
visions of Article 145 or 147, Education Law, the Public Health Law, and the
Putnam County Sanitary Code.
Very truly yours,
OF "c w y
Countersigned:
0
0
P.E. , R.A. , # 51251 ,
186 Katonah A's'�u',-"�
Address ��......._....._.
Katonah, New York�10536
232 -7408
Telephone
Signed
Owner of Proper
Somerset Lane, Putnam Valley, N. Y.
Address
232 -7921
Telephone
���ly�a• ��•tit -�
j od +^
SALVATORE V. RIINA, P. E.
Licensed Professional Engineer
Valley Pond Road
(914) 232 -7408 1 (914) 248 -5815
October 24, 1980
Putnam County Department of Health
County Office Building
Carmel, New York 10512
Attn: Robert Tutoni
Re: Property of Bonnie Brusky
Peekskill Hollow Road, Putnam Valley (T)
Dear Mr. Tutoni:
As per your telephone conversation with this office on this
date (October 24,.1980), we are, herewith, attaching revised
copies of the above referenced SSDS design. As you advised,
we have shown a 7' deep curtain drain.
f. every th -ing is in order, could you i ,Iea.s.e., i.s.sue - -an , approved. .
SSDS /Private Water Construci�ion Permit.
SVR /j lr .
Attachments
Very truly yours,
j- '. 4 "-, �-
Salvatore V. Riina, P.E.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
^.•�T7�TR?�' (�'T,Tnn FTTTTq�Tp�i.. :n�Tr �T
—. .,. •-
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner 'Bonnie Brusky Address Somerset Lane, Putnam Valley, N. Y.
Peekskill
Located at (Street Sec. Block Lot Sub. #2
4d1cate nearest cross s ree
Muriicipality. Putnam Valley
(T) Watershed
New York City
,,SOIL..PERCOLATION TEST DATA
REQUIRED TO
BE SUBMITTED.WITH APPLICATIONS
... ALL TEST HOLES WERE PRESOAKED
PRIOR TO RUNNING
TESTS ...
Hole
16
19 3 7
Number CLOCK TIME
PERCOLATION
312
PERCOLATION
Run Elapse
Dep to Water
Y • •
Q
5 , R•... 'min !
Wate r ve
3
No.. Time
From Ground
Surface
in Inches
Soil Rate
Start -Stop Min.
Start
Stop
Drop in
Min. /in drop
Inches
Inches
Inches
1. 111:20/11:39 19
18
21
3
6
211 :40/11:57 17
.19
22
3
6
311 :58/12:15 17
18
21
3
6
5. .
2 111137/11:57 20
1.7
20
3
7
2i.YvSR /-1.2;20
22
.18.
2i. 3,. 7.
19
22
3
7
312:.21/12:42.
21
16
19 3 7
312
:36/12:56
20
Y • •
Q
5 , R•... 'min !
''
3
7
°2i`
7
3 111:50/12:12
17
20 3
212:13/12:35
22
19
22
3
7
312
:36/12:56
20
19
22
3
7
4
Notes: 1) TdE�ts to be repeated at same depth until
rates are obtained at each percolation test hole.
for review.
2) Depth measurements to be made from top o
Allydalatn�bm' ted
P._U.TNAA4 COUN.IIfi
f ho1DEP1?., OF NFA(:Tq
ivame Salvatore V. Ri ina , P.E. signature
Address 186 Katonah Avenue SEAL k'
Katonah, New York 10536
_1
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Cal. Checked by Date
11
TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH
HOLE N0. 1 HOLE NO. 2
HOLE NO.3
D.T. Hole
t3 ? 3 ��C r C 1 ^
... ...,- ,`� 1.F? C k- _ 7 r a:rl:
6"
topsoil w/ stone topsoil w/ stone
topsoil w/
topsoil w/
12"
stone
stone
18"
sandy loam w% ,sandy loam w/
sandy, loam
sandy loam
24"
traces of clay traces. -of clay
w/ traces
w/ traces
30"
of clay
of clay
3611
s
andy loam
42"
w/ boulderE
48"
encounterec
5411
60"
66"
72"
7811
84"
NO GROUND WATER OR
�LEVEL
RED „ .
INDICATE
AT WHICH GROUND WATER IS ENCOUNTERED
NONE
INDICATE
LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NONE
TESTS MADE BY Salvatore V. Riina,.P.E.
Date October 4,
1980
" Soil Rate Used 6 -7 Min/1Drop: S.D. Usable
Area Provided 5 , 000
sq /ft . +
Noe of Bedrooms 3 Septic Tank Capacity 1000
Gals. Masonry
Absorption Area Pr— o ded By 300 L.F.x24" X 3b" dtif-11t
e
ivame Salvatore V. Ri ina , P.E. signature
Address 186 Katonah Avenue SEAL k'
Katonah, New York 10536
_1
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Cal. Checked by Date
11