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HomeMy WebLinkAbout2988DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.17 -3 -15 BOX 25 I I I I I T I I lot V.- IN go ' r . . ., A , T • t PUTNAM COUNTY DEPARTMENT OF HEALTH, Division of En!, ronmentala Health -Vices, ;Came% N:. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM rr1��j { own or(V liage Putma* m Ua ,Located at WPs QV n ]P "Putnam M VA 11e .r C �7 �3vlslii��.. - • �f rid Lot Job owner_ PptPr RD Putnam Valley, N.Y. --- .— �ll - LlSSA Address Building Type Raised Ranch dot Area 33 700 =$F 1' oo � Ary c Number ,of Bedroorris� Total Habitable Space" r 118 r •5 ``5F ° Square Feet n a Separate ,Sewerage System fo consist of 9(1y k� GalSept�c�Tank lg0+ lineal ,feet X -; 6it ' 5 width trench w'dt ro; be constructed'by _ Sheldon .Gardner'= ­ Address - tevenson Avnve Water Su 1 .Peeks s . Y. 10566 pP Y Public SuPPIy From a Y' i X Private Supply to 'be drilled by u ArtdPrQnn T,Tal1 Drillers Address: !. Other 'Requirements ('represent that ,I .am wholly and completely responsiblefor thedeslgnand location of fff proposed system(s) ,.1 , ��� r� <. above described Will-be con6eli -t-4 .. 0h ♦� .. __ _ _ ) d�O attf 6B a disonsal svatam I" submitted to the Department; .and a written. guar'.antee. will be furnished place ,in good operating condition any, part of said ,sewage disposal .:'system, ante of the approval of the. Certlf.icate of Construction Corn piiance',of` the: wilt be'located as shown on the approved plan and that said well.wlll beiinstalled County Department of :Health ^, Date December 28. Signed Address 1 X brthf jak e a'c1 APP,ROVE'D FOR CONSTRUCTION'° This approval expires one year from the revocable: for cause or maybe amended :or - modified when consideretl necessary,: requires anew permit '.Approved for 'sposal.of domestic r sewage;,. Date By a �• v,ny,inr�ce c6T r o8he i �r of- Healthwill owner his successors, nevs.o as 11 l8id builder will ring the period. of two (2) -'ye i I I in e of the issv- glnal system or;any repairs toe 2j1, d . cribed•,above accordance with the stand` r les the Putnam E.Ox . R.A. 027846 to issued unless construction of th en undertaken and is the Comm' '_' ner'of.Health.•a Any_change,or alteratiori of construction V P t9L5t�CAly oniv Title` v DEP�y1� l.1rIL19 i iii r a a ru i vr�Ivi COiai fi 1� z v } � � Y l U512 ti -� l? '` s D /v�sfon of Environmenfa/ �Hea/th Services, Came% N sf Putnam ` Val ley (T ): Y. CERTLFICATE. OF _CONSTRUCTION COMPLIANCE FOR SEWAGE DJSPOSAL SYSTEM r Town Or• Village "' Mal? 79C Block r West Avenue & 'Star:•Vievr AVenue. section j Located a' A :Peter "& Mary -hou' Russo E '` Lot ZOO JOb 04 2. °"'ne ►_ "" SheldonGardrier Stevensori:AVenue Peekskill' NY Address Separate Sewerage System built -by lg� 3611 width trench 900 Gal Septic Tank lineal Feet X Consisting .� Other requirements N L. J r Public SuPPIY, Water: Supply: From X' Private SupPIY. Drilled BY ;Address M x �C „c _ ��•e�` • Raised Ranch No of Bedrooms — Dater PerjrsiQts Building TYPe r r lC\� P{ SPA e• Yes M 4 • Has 'Erosion Control *Been Completed k ^ `ts 9 e <h a ra ` < O.. D • n esaof which are (.certify that the s_ystem(s) as listed serving the above premiseswere,constiucted essentially as shown on the planspf� c'm a ep ,,�b,t of Health. attached), anal In accoctlance with the Standards, rules and regulations plans filed, and ttie per issued by ,1rh _w c 0 •• .. P R.A. t` October 16 1 Certified by ` a 1 Northridge Ro Peekskill o. Wr 846 Address . E to •e ;upying premises servetl by, the above systems) shall P► ema to ststem shall become null and vo d 'soon -a.$* owmi�la erY sewer becomes -<. qm r 1trig°' from 'sucfi usage. Approval of -the separates sew 9 Y . v1 `approval of the_priJate water supply shall become null and void when a public water Supply, becomer;avallable. Such approvals are 7 �t1on or change w,tien ih'thi Judgment of_the Com stoner Health such _revocation modification or change is necessary., >. .. a UTNAM COUNTY DEPARTMENT OF REAL,TW Division of Environmental Health Seivices, Carmel,. N Y. i062 I.- - _ 1. � fc"o II OGpi�° U " GiilVsi'FiiJC'�IiiiN 'i:�1MYlLaa�lV(� -Khi Srceuvr,GE vaiiey Town or Village St 'View A ro & Vast Avenue p Located at Section - Block Owner Mar & Awylou ' so �«,a — Lot 2� —908 Job Separate Sewerage System buiill/t��by SheUoz Glodn(w Address f$0*8Iadbia Avon -3® isekski� , N�— Consisting of 00G if. Septic Tank 180_ lineal Feet .X " width trench Other requirements - Water Supply: Public Supply From Private Supply Drilled By er$on tell, &-111Q = Address. Bariew h%reato Vfit Padied Raich. J Date Permit Issued Building. Type No. of Bedrooms _ 495 Has Erosion Control Been Completed? ee0 ©illi0 oo Ad —toalf IrAm.. 00A I certify that the system(s), as listed serving the above premises were constructed essentially as shown on the plans of, attached), and in accordance with the- standards, rules and regulations, plans filed, and the permit issued by _tq@ 14 1975 0.� a Date Ce0ified by •'ter " "' °� Address •,�.- -a vnasasa FU..su� c lresrt'7 "laC7t, __I�A m Any person occupying premises +served by the above systems) shall promptly take such action as maybe necessaf conditions resulting.. from such usage. Approval of the separate sewerage system shall become null and void a available and the approval of the private water supply shall become null and void when a public water supply subject to'. modifi tion- or c ange when, in the judgment of the issi rier' of Health such revocation, rt Date B yr Peekskill, New York 10566 iss of which are M.�ent of Health. R.A. to se ure.t a cAgrrect' in ofeany unsanitary }R1 ` nitarfsewer becomes Srach approvals are K1'rfPtB i6Tfi�h Vl��e bs necessary. 0 o6000 ©00 9 Title °EEKSKTT T MEDICAL -LABORATORY. 1879 Crompond Rd. Barclay Pliza B1dg.'A,--A0t. 1 ` RESULTS OF EXAM IN ATION OF WATER 0 -42 OWNER DATE RECEIVED CITY, VILLAGE, TOWN VOR NAME OF SUPPLY DATE REPORTED 17o&�� PE 7 -8777 BACTERIA PE,R ML. (Agar plate count at 350C). /v, COLIFORM GROUP (Most probable No. /100ml.) s-s (-d7li cal • o� RD TOTAL -ppm DETERGENTS - ppm NITRATES (as N).- ppm IRON, TOTAL - ppm FLOURIDE (F) - mg. /1. These results indicate that the water was i 16'S of a satisfactory sanitary quality when the sample was collect A. H. PADOVAN), M. T. (ASCP) UTNAM COUNTY DEPARTMENT OF HEALTH'. ivision of Environmental' Health Services, Carmel, N. Y..10512 - -^ t: ��TIFICHI(r Y�1F'. �1: U�11��FilJ� :I��UI'V`li)11H1'i:IHNI:t� tlJlt �td'Vf+1ti�' ul$Y�l- 9"5l�►"L �fia� "ciy� ..,` :.� ° -,�'.• .. Town or Village Star View Ave &West Avenue bJ p "C' - Located at Section Block Owner Peter & MeryLAu Russo Lot 2��u" — 20� Job Separate Sewerage System built by Sheldon Gardner Address Stevenson Avenue Pe,ekskM, -N.Y• Consisting of 00Gal. Septic Tank 180 lineal Feet .X 3610 width trench Other requirements Domestic 17eo1 1y Water Supply: Public Supply From X Private Supply Drilled By Ander80n Nell )3ri l l era Address Barger Street, Putnam Valleys N Y Building Type Raised Ranch No, of Bedrooms 3 Date Permit Issued Yes - Has Erosion Control Been Completed? 0000 0 moo's I certify that the system(s), as listed serving the above premises were constructed essentially as shown on the plans ofefi fij '9Jf files of which are attached), and in accordance with the standards, rules and regulations, plans filed, and the permit issued by tqe 0 0u lo$rtment of Health. t +��.. 1I,. 1975 l!o Date Ceotified bar '� �' ° P, 'R,A. Address 1 lv l r jg' r No. e Any person occupying premises +served by the above systems) shall promptly take such action as may be necessa�, to se ure t e c rrect n ofaany unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void asesod' a86i" nitarxesewer becomes available and the approval of the private water supply shall become null and void when a public water supply ,,1111,,,. vas Such approvals are subject to mod f. tion or c ange when, in the judgment of the issi ner of Health such revocation, moddiiAcl xv h e 85 necessary. • J Date • B Title ..- , . _ pEEKcuiI,T� MEDIC ",' L:AER.'`C?Rv,., ..: ...._.._.._....r......_ r 1879 Crompond Rd.VBaccieyi�laia B13g: A; ApI:_......_._ .._.._......._... ...._... _ Peekskill, New York 10566 RESULTS OF EXAMINATION OF WATER 'v �p� PE 7.8777 -Aa - OWNER DATE HEC:EIVED CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED /,{- ?q BACTERIA PEL ML. (Agar plate count at 350C). COLIFORM GROUP (Most probable No. /100ml.) HARDNESS, TOTAL -ppm DETERGENTS-ppm NITRATES (as N) - ppm IRON, TOTAL - ppm FLOURIDE (F) - mg. /1. These results indicate that the water was f�ES of a satisfactory sanitary quality when the sample was collect F, A. H. PADOVANI, M. T. (ASCP) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. >10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.' Owner , Peter & Mary Lou Russo Address PM Putnam Valley, " N.'Y. 10579 Located at ( Street West Avenue (PV) Seeap 79C Block - Lot 204 - 208 �Indicate neares cross street) Municipality _ Putnam Valley (T) Watershed Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse 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 . (1) 1 10:32 10:56 24 18.5 21.5 3.00 8.00 2 10:56 11:22 26 21.5 24.5 3.00 8.67 3 5 (2)1 11:24 11:51 27 19.0 22.0 3.00 9.00 _ ... � ..�_ . _....... 2 _..11:27 " 11:55 , 28 ..._ ..__... � 22 � 0 z.5.� �._ 3 o ii ­903-". 4 5 1 2 3 4 5 Notes: 1) Tests to be repeated at same depth until approximatelyy 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 SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO.. 2 HOLE NO. 3 m ': Cam+. ..•m. }:a'SYti.: Y.oV.a..�..<.L �. :f¢s:nv.. ..b.�i.r .�: rte► =na -r ���.r —.vaa r.�j����� :a m...wA'fm.rA:i.� ^v...�...�: '.ar_�9�1 "U' ��.n e.+:de ^�..v.•wM•. Nt.++ +l.. 6" 4" Topsoil 5" Topsoil 4" Topsoil 12„ sandy, fine loam sandy,fine loam sandy., fine loam 1811 some small. stones some small stones -. -some small stones 2411 _ 301f 36" 42" 48" 54 60" 66" 72f' 78 8411 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_ . ..July,,, 14, 1973 • ......... . Soil Rate. Used -10Mi- 1 "Drop: S:D. Usable Area Provided -5000 SF 900 �:. No. of Bedrooms 3 Septic Tank Capacity Gals. ' . ;�a�t�. Absorption Area Provided By 180 L.F. x24" �j' '— x ,G . Name Tnhn Q -nmPn Signature � 4x�;�:��;� • Address I Northridge Road SEAL _P_ eekskill, N.Y. 10566 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date f�h.. %I "(/ e PUU" COUNTY HEALTH DEPAMM DIVISION OF ENVIRONMENrAL HEALTH SERVICES r PROPC►SAL FOR SEWAGE �DISP06AL SYSTIIrI REPAIR `�L- qt3 -4m _,�. r: r,au.,.,��.. i.ahui.•� •.v; u.•. ona�sn'e +a �.'•� OWNERI S NAME Ch r ;s Fc,,u r e,- PHONE SITE I=TION 7 Y Scar ve'ew ✓t• , Aft,7,X r V�,l i�� . Ny cus79 TM# MAILING ADDRESS S ct, n, e a. s as HC 1 voce, i v PERSON INTERVIEWED C:� r�.S Fccu rt_ �j itin e r PCHD Canplaint # DATE s'- 17-7(o Name &Relationship (i . e, owner, tenanpE etc.) Q R R cc..3 E• _ a J R4 -ic,►, PROPOSED nsTALLER Rf9.<T ��l� /-� 17 +� PHONE -73q-- 2-52-4` REGISTRATION # Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal fran licensed professional engineer or registered architect. Yr VA 0 ,ro'S U f � i W e P, O ILL- F0 coH NSrii r--D ro hPl:�: /=holy` Proposal approved S Proposal Disapproved Date Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6 deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or reported agent of owner agree to the above conditions. SIGNATURE C Wooft %��� TITLE C% w, a I" DATE; S-1(6-76 MS: White (PCHD); YeUc w (fin BU; Pink (Applicant) I rq olga.5, 1(90 k �o wv Ql-e %40%/ rA 19 vv IA , rori X i �y� fj� ... /V® wws /00 /Vt GINS S AA V IZ'r-, 4' 7 q 5 -rA (Z. t/i Fes' A I 1-1;r;: -- - I Re: a Gentlemen: PUTNAM,COUNTY DEPARTHOT OF HEALTH • DIVISION OF ENVIRONMENTAL HEALTH SERVICES 77. 7 Date Dedeiftb.t 29,' 1173 Property of Peter & %ry Lou Russo Located at West Avenue, Putnam Valley Section �p 790 'Block Lots 204 . 208 This letter is to authorize John 49. Rorheo 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 I or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and. to sign all necessary papers on my behalf in L:UI.IjII=VL_LL#1j W-LLIL L111.1 mdLLL-I-.dIiU LU. bUPeVV_LSe she COiIb'LI.'UQ'LxO!'I UJ.' SaILI 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 MP-&.MQAA4_&P Owner Property Cou*ntersigned. ,/j RD.Putnam Valley, N.Y. 10579 P I E., R.A., # 027846 Address 1 Northridge Road Telephone 'Address all Peekskill, New York 10566 Op Zi .737 1056 Telephone a. elf b b F. 6 ,1 TOWlT OF PUTNAM VALLEY W-= DRILLERS LOG AND REPORT � WELL DOCATION - street :section Block lot WELL OWNER— MR „ Russo R _ D- Pii9TN AM VALLEY Y _ name . address: city or town TELL DRILLER ANDERSON WELL DRILLING R.D. 91 ZJTNAN vAr.rBv N y jQ5;q name address city or town CASING DETAILS 'YIELD-TEST WATER LEV SCREED DETAILS, ai ed Measure from 1 d surface Lengh: 35' feet or # Pumped 7¢H . Static �ft Make: When Bailed slot Diameter: 6" Inches Yield: 5 GPM Dic, PR ed -ft Length Ft .,size K:ir.�.: STEEL Diameter In. _ ' Y `.OTizL DEPTH OF YELL #W# 290' Feet Dep-,:L Yrom ' Uive description or rormazi.on penezrazeu, such d5: Peo.u, Ground Surface, 'silt, sand, gravel, clay, hardpan,'`shale, sandstone, Mranite, etc. Include size of gravel(diameter and sand ine, medium, course), color of material, structure (Loose, packed, cemented, soft, hard) ®(Exo . Oft. to .27 ft. _ .. fine ry�asked vell.ow saris 27 ft to T34..ft bra ranite l' , _ _ , _. _..�,. T"je tio'ree'e��Pormatien D"escri t on Sketch -exaci locaiion of well to __.. at .least two j2ermenant Landmarks 1' - 20' hardpan . . 201 2901 bedrock white granite Date Well Completed 6/14/74 Date of `Report Well Driller r � signature 0 Peter & Marylou Russo Owner-or Purchaser of Building Peter Russo Building Constructed by West Avenue & Star View Avenue Location - Street Raised Ranch Building Type Putnam Valley (T) Muni c i.p al i ty Map 79C Section Block 204 - 208 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 by the willful or negligent act of the occupant of the building utilizing the system.. Dated this 17th day of October 19 74 Signature d Title If 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. Division of Environmental Health Services, Putnam County Department of Health PUTNAM COUNTY DEPARTMENT OF HEALTH .242-91-19 COMPLAINT OR SERVICE REQUEST RECORD / ,.� ..,u,3 : . <� � 1..�4?'i "— _ ..sS^`px -.+= _.. .. • �r �- '- - .i+l ulci:iJu V ' ..' .. . TAKEN BY B i l l Hedges TELEPHONE CALL IN PERSON CONFIDENTIAL REQUEST FROM P C H D- W .Hedges TELEPHONE ADDRESS LETTER ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public Water Food Service Migrant Camp Other COMPLAINT OR REQUEST Ned & Eve Arnold-79 Star ViewAvenue has failing septic system, running onto road. DIRECTIONS: Oscawana Lake Road to Mt. View Road -Near xxxxxxx Santino's Deli to Starview Drive. FOLLOW UP WPECTION (s) - - T DATE FINDINGS PROBLEM ABATED DATE 2 s PERSON NOTIFIED 77 ESTIMATED TOTAL MAN HOURS SPENT PHONE SITE IACATION TM� ' MAILING ADDRESS � "��"°' �% 9 a61 Ave- ,N ,.. Vim„ c PMSpN IlJTERVIEwED d r r1 0 PM Camplaint # Name & Relationship'(i.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLER D, wn e r% %' r— �L S0. vj +0 PHONE 5a - 3 1 Pro (include sketch locating all adjacent wells): NO►I'E: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from.licensed professional engineer or registered architect. OR be...- co-p rrsr*� 1 �~ ,e A--_ k o sue. ek.h.y Q Al Proposal. approv9d 's Signature & Proposal Disapproved Date toposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywalls surrounded by one foot + gravel). e. Installer's name and number.• 3.. System repair to be performed in accordance with the above proposal and conditions. I, as owner,, or reported agent of owner agree to the above conditions. SIGNATURE a—z- �'z- . - TITLE TP16: White (PC D)f YeUcw Mbn Ell); Pink (ApAla9nt) DATE SANTORE A API EXCAVAMON, PNC. DATE 1wr 994974 Quantity Description Amount k P 'A Z- 71 /100 Y7;k q "Vl*ta TOTAL Not to bo hsW rib1® for blasthg &X underground lince: cabb, waftr, c--erW, Cie. wgcM op=Wcd DEPOSIT a. BALANCE