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HomeMy WebLinkAbout2780DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62. -1 -52 BOX 23 I ru NIL, Is IN, Mir is aNlill is is MIN 61 i f L , �'� NN ,, y 6N �- +' - , I 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