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HomeMy WebLinkAbout3043DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.18 -1 -76 BOX 25 "I t 9 9. 1 IN` i '�' - x' ' ■ L ' .� ,., 1 J6 -4, ; i �9 -L X 03043 PUTNAM' COUNTY DEPARTMENT OF :HEALTH Divisfon,of Ei?vironmental�Health Services, Carmel N Y 10512';; F 'OF "C0�15 fEil; rT,�t3{� '€ $���;iI CE� FOFi$� EVl i4t • -DISROSA xSYST M "= _ : ,. - F':�tnam: Mal Isy., (T) ` Town or Village S Fuce,-Mt - Drive n ` Nlap 1.18. Located at_ Section Block W. &Mrs: ,Nicholas Domkivr r - 3 Owner Lot Job Separate Sewerage system bu�ilO.b�( Anthony Cesa_rini , Address 21O' Lafayptte''wenue,. Peekskill, _ leach :pits $ 0 dia< x 50. d ®ep� Consisting of Gal Septic- Tank � r 'other .requrements'DOIIleSt,;C Water Supply: public Supply From _ x Anderson well drliers._t ; Private Supply Drilled By 4 Barger Street, Putnam Valley,`N.Y.: Address R6: sed Ranchf� :.,•••_• Building Type �' N dr oms ^ •� ermit Issued 0 of Bg o r ;Yes ti ' x E .•' •� Has, °Erosion Control Been Completed? I certify that the system'(s) as listed serving the above premiseswere. con eructed essentially,As'� 1' h I s'_o, tTe completed work'(copies of which are attached) and in accordance with the standards 'rules and regulations plans filed, and tF .�r it'I he' r 'm C_ounty:Department.of Health. } aVai, ry` ?la 1079 Date Certified by' z: >< Address 5 - At r Northrid a Road Any person occupying ,premises4 served -by,the above systems) shall ,promptly take such acfi conditions resulting. from such',u sage.' Approval ",of,' the separate'sewerag tem_ -shall bi available -and the approval':of,the private water supply shall becoe m nuliy nd voi 'when +a' subject ,to modification •'or change when, in the. judgment of the�Com is si of Healt r 9 9 � 9 } r A I t66 License No Be �o securA rl i�icorreotio ofi nv wn@as.'soo.n as- a public'sanitary w yr 't`1t.FG . Title becomes r.ovals are Y. t 3 { ' z PEEKSKILL ANALYTICAL LABORATORY 201 Buttonwood Avenue t x e i m p 'al, (Cor`n r of 202 ac oss fro Hos rt Pear� 1].1' i.o.l�.JAi if .,.. c y.: ..... ,r .. "t. -a> m .. t I J'U��7 _ N a r .. .. _ _. - RESULTS OF EXAMINATION OF. 1�IATER LE F CITY, VILLAGE, TOWN 6 /OR NAME OF SUPPLY uAl E HEYVRTED SA ` PLING.POINT;' ` BACTERI,k ER ML Agar plate count at 35 C) COLIFORM GROUP (Most p obable No. %100m1 ):• RD OT ppm t DETERGENTS -: •mg /L NITRATES (as Y'. mg /L =: IRON, TOTAL mB /L-1. s •- M1 ., m WELL 'COMPLETION REPORT 6" 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK Th is-report, is; to_be compleedb�(.�wgll dil ,lg� :aqd= subrrlitted „tr&Count4c Health Department, tog® they =withzlaboratorp eeport' of analysis of water sample indicating water is of satisfactory bacterial, quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER ME _ "��� ADDRESS LOCATION OF WELL Street) (Lot Number) (No. B f )A'f p c ' PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM %TFST WELL 11 SUPP Y El INDUST"RIA"L” E] CONDITIONING El OP�ER ) DRILLING EQUIPMENT COMPRESSED CABLE OTHER '7 ❑ ROTARY AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet) p� DIAMETER (inches) If WEIGHT PER FOOT fi� THREADED ❑ WELDED POE L)!5J SHOE YES NO CASIN 1 YES NO YIELD TEST ❑ BAILED ❑ PUMPED ® COMPRESSED AIR HOURS /— G.P.M. YIELD (O.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Speclfy teetJ DURING YIELD TEST feet) i Depth of Completed Well • Z .7 � 1 S in feet below land surface: 7 SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (fee() I TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET MIA �. i j l DIEFT. OF HEALTH .l �3z)l If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELV COMPYETE DATE OF REPORT WELL LLER ( g.at/ur�) Q.. + IS ,y._� .{y a .a:<�.w sa- .,. �y + rte �f ".+' ►:..:.F-<s -.a}n �..._.. _ Owner or Purc aser of Building Municipality nic holcs DmkAv a . Building Constructed by Section sTruca Mt. Drive 4 Location - .Street Block Building Type 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 made 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- _ vi-c- es-= of• -t-he- P- utna�m- 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. 23 day of Feb* eb* 19 79 Signature � S A�e�" If oration, give name an 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 EnViironmental.Health Services, Putnam County Department of Health r... •�,, s e t _ Division of: Enwronmentel 'CONSTRUCTIONPERMIT..,FOR SEWAGE ,.DISPO,SAL,SV Located at r S�i'110e ^4l7x'i�re• SubdWision SpmC8• tie N3lsolaus & ;Hal -MA Domkiw Owner Raised Ranch Building.Type ! Lot Area? Number of Bedrooms Design Flo A, Separate �Seweraye � � ��� � •�' �' ©�'�� � �` System.to *.cohslst of'. �` y ;( Sheldon 'Gardner To Ybe constructed by Water Supply Fubllc Supply From x "Prwate Supply to be drilie�d�b �j` r t A' dress ' Other Requirements DomAiitc u l represent that -I -am wholly and.completely responsible for tFie design' above'descilbed, will be constructed as shown on the approved amenGM County Department of Health, :and that on completion*th'ereof a C� tie submitted to Department , -.and' a` written- guarantee ,will be f :place 'in`: goo d= opera ting conddion' Any -part of >said sewage dIsposa a;nce of• °the approval of she Ce►tificate,of Construction .Gompllanci will be located as'shawn onthe approved plan and that said well will be �, County Department ofY Health _ ;� � � a•�t -k +t. August; r Date Signed- Address r- APPROVED FOR CONSTRUCTION _This approval- expires,: '�i`. V6 f r clause or maybe amended.or.mod�fied when c sidere_ requires ew 'permit Approved for °disposal of;`dome is n ry Date By ARTMENT OF HEALTH � `� , C. V ' r Servrces, Carmel ,N. Y d�0512 PutnamValley(T) Town or iIlage , o�rrss c� cK +a „o Tax,Mapn 770 Block > 1. ,. t � k Lot 3 r_. Job Lee �veneu 'Putnam Valley,', NJ t - ?Adtlress 72 SF TotaF Habitable Space + Square Feet i }1� Isaoh pits ag.0, a `x :> 5 e 0, sleep t tic Tank antl s Stevenson Avenue Address ", .. Peekskill' �n Well- 1h�17.ers: u G i ONpI ENGINE lion of she proposed systems) :'1) that j}i s sal system to and an accordance with the standardi,* e0bla cb Putnam, of Construction Compliance satisfac r 5 119alth.will the owner his successors helrsior ass�� Ao it t sa tloutder will during the period of two (2) years'irnlh ly.f da e'.he`issu orig�nal'system;or any repairs thereto, the de dh `above . !n accordance with the standards r r Of a !Putnam 218 &6. i Skill, date issued construction -of the buitding'.has been undertaken grid is f of k lthp Any,,ch-a oc a teration: of construction - /or pnv e= t suPPly only ` Title - .w,.. .. . • .. • � wa.- . • 4 iTr ... r .. • .M Z • n. •. e. .n .. .a .. � ✓• •. ... a . t �.. . ...... •. •....t. .. IT•.•. .. ti �. 1� n-• . •. . ,r.... �.. ... �a • .. � w . •, w w . . '1 n JOHN S. ROMEO. P.E. & P.LS. JAMES L. ROMANELLI. P.E. ` SALVATORE J. AMIGO. P.E. 1 NORTHRIDGE ROAD FOLEY ROAD RFD #1 RFD #30. BOX 375 PEEKSKILL. N.Y. 10566 BOX 239. KATANAH. N.Y. HOPEWELL JUNCTION, N.Y. 737.1056 248 -5755 226.7652 . -. -.,.: :.,._ -.,. - ..,.-r_•x .. .. -ar.: ....- .•, .... ..- r. �• - ... -c., nH.<..- �. :.. -_. .., . ,,. - --yp °�y -�qa. ROMEO, ROMANELLO, AMOCO, P.C. CONSULTING ENGINEERS & LAND SURVEYORS 1 NORTHRIDGE ROAD, PEEKSKILL, N.Y. 10566 MEMBER OF NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS MEMBER WESTCHESTER PUTNAM ASSOCIATION OF PROFESSIONAL LAND SURVEYORS Putnam County Dept of Health Division of Environmental Health Services County Office Building Carmel., Note 10512 ATTENTION: Mr. R Tutoni Sanitary engineer Dear Sirs July 169 1977 RE s SSW & We11 for Yr. & Yrso Domktw Spruce Mt Road 11�atnam Valley., N.Y. ... Enclosed find revised SSDS' plan'for the above client,, The plan meets an criteria for Health Depertnent approval with the bkoept16n that the future reserve area is located within 75 feet of two adjacent wells. The subdivision involved (Spruce Mt lAke Estates) Map 778 indicated where all wells and septics on adjacent properties should be oonstructed, However., over the years, the adjacent owners have constructed their homes with the applicable wells and septics and did not follow the plan for_the area. Mr.....Client..has owned this propeety for over 20 years.and now'-wishes to' . - - d'onstrudt` th6it` W!66.4 "With the - soil irate `found iri , this" are'a9 I do" not beilie" - that.the dxpansion area will ever be required. I therefore request that the permit be approved in accordance with the plans hereby submitted. Very truly yours., John S. Romeo P.E. & P.L.S. °.00000000. JSRB Clr a °���\���. °e e ° O. 0 2790 a .Q ' PUTNAM COUNTY DEPARTMENT T OF IIEALTH , DIVISION. OF 1 TNTRO)\TKs TTAL HDALTIr SERVICES CO�JN�l'Y OFFICE BUTLDTTIG, DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM. FILE. NO. Owner Nikolaus & Halyna Domkiw Address Lee Ave, Putnam Valley 01579 Located at (Street 4Sdicate ioe Mt. Drive :. Sec.. 778 Block Lot 3 nearest cross street) Municipality Putnam Valley (T) Watershed Peekskill " SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS . Notes: 1) Tests to be repeated at.same depth until aP.Proximately equal soil rates are obtained at each percolation test hole. All data to be submi,tte:d for review. 2) Depth moasurements to be made from top of hole. Hole Number CLOCK TIME PERCOLATION PERCOLATION Run No.' Start -Stop apse Time Mina ae p to IvAter From Ground Surface Start Stop Inches Inches a er ve in Inches Drop in Inches Soil Rate Min. /in drop (1) l 5 :25 5 :36 11 21050 24.50 3000 3.67 2 5:40 5:53 33 20.75 23.75 3.00' 4.33 4 (2) 1,;.5 :30 :5:38 8 19.50 22x.50._ .. - 3:00 2.67 12.. _ .... ... 20;0(5... -- '.00�.�:.._.. 3.00 - :: ;,. .:4oQ.:..... ... _� 3 -5 058 6 :11 13 20.25 23.25 3600 4.33 .4 5 2 3. 5 Notes: 1) Tests to be repeated at.same depth until aP.Proximately equal soil rates are obtained at each percolation test hole. All data to be submi,tte:d for review. 2) Depth moasurements to be made from top of hole. TEST PIT.' DATA 1?IQiJIRFD TO BE SU13M1:T'T']M W):T1t APPLTCATION DESCRIP7'I014 01? SOJ*LS 1e,1�ICOU1\'.Ilj,PPD IN ''EST HOL13S 1 3 DEPTH HOLE. 'NO. HOLE . NO...... HOLE N.0 = 1TOpso3' ZopsoiY To rr w "G e L e psoil 12n` O J1. 1811:• sandy gravel 11 .Topsoil � 24 �' s and �r gravel ' —— 30�� -3211 Topsoil a 1. -- — sandy grave 9 some anger 36" stones _. 42" jt- ,;. tt „.. 66 72 tt st 6 '8411 "INDICATE LEVEL AT WHICH GROUND WATER. IS ENCOUNTERED None INDICATE LEVEL TO WHICH WATER'LEVEL RISES AFTER BEING ENCOUNTERED 'TESTS . MADE, BY -John So Romeo Date_ Jtiie 17¢ '197-7. .. ..... - -- DE• : • . • - .. '8011 Vate. Used. 0-5 Min/l "Drop: S.D. Usable Area Provided 5000'3F ;i No. 'of 'Bedrooms 3. Septic Tank Capacity 1000 Gals-. o ©o.` Masoz!ry Absor tion Area Provided B 250 L.F.x24" �b"- P y o �@ s ame Jehn S. Remee Signature Address.' 1 Northr�ge Road SEAL o � ;- Peekskill, NJ, 105 on 0 0 0 �IEI ,.. A :THIS SPACE FOR USE`BY HEALTH DEPARTMENT ONLY: 0 000o0o0d" Soil R oved Sq. Ft/Cal.' Checked by Date ,. .- .,1�.•6' .`r.�C.r ! • n�•! {yFj1 Y jj Ppt" ay.Y `Q') . \� 7 - F �r.,1 lS,�/ i! ) t �'7 jQ let 1 4 c..r i G �• "'T *T� i ¢i i. 1977 rw Cowvyd _ .0 (EAR . c SNITXIL ~ST`.Cr TTdSPrCTXbPT" : r Property lines or corners found . Can estimate house location . . . . : Will driveway need cut . . . . . . . . .. Trust 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 HO r, DATA Depth: `. -' Water elevation:'► Rock elevation: Soils description: Date: 'FINAL SITE INSPECTION Insp ; by: House located where shown on approved plan. . SDS located inhere approved . . . . . . . .. .length of trench measured Width of trench average Slope of tile line and trench acceptable Room allowed for expansion trenches . , , , Over 50 ft. from swamp,watercourse . Vatural soil not stripped or SDS area unnecessarily graded r minairied'roni prop. line and 20 ft. from house Sep�'�ration of trench from house, well etc. follows plan . . . . . . . . . . . . . . Phunber of bedrooms checks . . . . . . . . . . . Stones, brush, stunps, rubble, etc. greater than 15 ft. from nearest trench . . . . . . 15 FL-. of peripheral soil horizontally from trench. . . . . . . . . . . . . . . . . . Junction boles properly set Could surface run off from driveway, roads, .ground surface, etc. channel near SDS,. , area. . . . . . . .' . . . . . . . Does lot. dra,ina[,e appear 0. TC. in area of SDS FINAL GRADING OF SITE ACCEPT_AME, i .I I�.te : • 1 to �i � Insp . by: Yes No Comments tiT wU X. Mc -t^ Stri . P Remarks • c:3 1'Jo DrOCT?1/i, 11` S , ...: ... 4. .... may. .. _ ,,, c ,.. - - -,. -c • •-, s .. ..: _ - e.- ., , r: - z , _. — .. �': House plans O.K. D-.i n data sh °et Pares presoalYaUd? hue. ,0" perc test depth Co nst. results for 3 runs I D. Hole log 0. K. I Corporate Affidavit for other than individual I Author l za,ti•on for engineer ! letter from Water Supply if applicable If variance requested -such noted on plans &: apps. A) DETA ILS Rf ch arge is prcpo sled, Existing contours shown ow new contours Slopes for driveway cuts, etc. shown I I•,ater serv_Lce line location Footir.�, drain, etc. location i } Top slope, bottom slope of fill 11j I . ! Percolation tests and deep test pit locat •ion # K Septic -ank size arid conformance. to std. 5 B. R. hcuse rninimum I ! 'rouse setback shown ! j 'r)i l 0. fro - —• -. __ . _ �_ ui vater�wiTmiil ."u i u . o.i' PL siwl•ui Plan and profile SDS All other wells and SDS closer 2001 I _ ..:e :. shozrra or..r- _efer.e�n�e. -.ma�� .... __ � :.. -..�. _ :.. - �- -•�- . _. �,_ Property boundaries (metes and bounds - clearly show); EPATIZ TION] DISTANCES SPECIFIrD ON PLAN 0 0' to P. L. 0' to Foundation walls 0' to Nearest well 0' to strum, march, lake, etc. in 5' to Curtain drain 0' to water lire (pits -2U' 5' to storm drain 0' to lame trees 0' from fotuldation to septic tank 5' to pipe from leader drain & foot; If iOT J "6vJ Y7 � -� S � o w Y� �• I. } '/ I 6L .expansion)_, - ! _IV L I r I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISIOU .0F. ENVIRONMENTAL HEALTH SERVICES :,. ;.,•,:.�F .:. Date June 18, 1977 Re: Property of Nikolaus & Halyna Domkiw Located at Spruee Mt Road Section MaP 778. Block Lot 3 • This letter is to authorize John S�; Romeo a 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 nece$sary papers on my behalf in VU1111C1: L-LU11 W-L L11 L1LL6 III& L LeJ.' dilki LU. ,UUei'.vise. ifle -.cons i:ructlon o1 saia. system or systems in conformity with the provisions of Article 145 or 1,47; Education 'Law, tary Code. the Public .Health Law, ..and . -the Putnam. County Sani Very truly yours, Signed Owner of Property Countersigned: ,� I � -'�-�✓ e� ale-, Ht Address' P . E . , WM, # ­027846 027846 1 Northridge Road •ee04Tvjephone Address e \�l1al ENS /c9'�; Peekskill', New York 10566 737 .1056 • Telephone y , s • :, i �J w i "4 � Y e yi p& a � <N C 6 a �*r: T a Awn t .. t u '' � 7"'. u +3�Y 1.$i4�ri�" �+Ls* a� d•-r:: _ .,;mil ;t,` t .. VF, 4 � x - - rfi �, i it ,lt ,.a i , p,, ,'4• ^"kyk.+ td.S i ,, t is t. .' _ J r A "`1, ;4rjy ,,,, <:' >cT ,x n" i-� ) ' ^r a p t y^ h N y-?V" �yY ­:.;1J , . �� O JIB C , - ". , . .", �tl .3 ." �.f.,,�,4� - a ... A " , y U m . �` I ;, a- .� oh 3,1 s, W.' " U I�My -it a P :.�...,. '.y fY ►� r iY n N'w r Y (A s� G d O ti .• v ,,. , r. r ..,. rx, , n - J V I ti: O 61. , } . iA � 4 i.` 1 { \3. :Q ,,. .y t ; 01 ..Ni 4:. h +;,', r s ,� >s! V. i !L e. �i < "7' ; � 1 J +� 2 Q r. 2 A .� to z "Yt r S 1L.. ' .4 Q _ u i 1. t x `_ Q y y ''74. ,;,, 7 ei� '' �t 1. F 1 a 9 4 L v) �`• , 4 ",,- r f} 3 + ', O , ."; T, t _� . , "" , 7 , .; . � , � , — N . � i ( . 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