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Home My WebLink About3046DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.18 -1 -81 BOX 25 I I mile IN III ' i V ,# .• , me f- L.'' ' r -� , , ' fir. �; ' �im ; ` me 11 a 6 12 03046 _..._ ... ....� TT . ....................,.,..r..,,T •,:. ..,��.,...r;,,.��...,...:.,.w �.r*, -^'- -�-- .:-=ate =.,, n— `r— . -M+-�� .- �.- _, --.. .. , .""5 t .arc - ,:..fin rp,w�rrcnroaK�^'•,•,�ct,. '4D�.��- -fir PUTNAM COUNTY DEPARTMENT OF HEALTH '/ Division of Environments/ Hwldh SWWCU, Carmel, N. Y. 10612 permit r ! 3 / CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM PQTNAM L)ALLr =— Town Or "0alrapa Located at N1' l W Tax trap 1 Z Block Owne, d®M CQ T "LL, / Formerly Tax Map Lot @ Subd. Lot 0 �? n r l separate sewerage system built by roi>A (? a— rTP —r--LL Address srwegz /Viumm 739... P('.r'TNto FiQ� s—syN Consisting of 000 Gal. Septic Tank and 8652 LF 0E 12' W r ®r' t4c N jis Other requirements Water Supply: Public Supply From _ Private Supply Drilled By Address Building Type ®N Z PAM• GG.r ES, Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. Date Address Certified by P.E.''''R.A. License No.1BJJ//�� ,V_,50A Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void whop a public supply becomes available. Such approvals are subject to modification or change when, In the judgment of the ::loner of Health, w revocat , modification or change Is necessary. Date By Title Rev. 9 -81 )RKTOWN MEDICAL LABORATORY INC. Locarro VP.O.`'Boz 99 321 Kear LOCATIONS: 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 Yorktown Heights, N.Y. 10598 ❑ 201 BUTTONWOOD AVE.. PEEKSKILL. N.Y.,10566 737.8777 2�5'32�3_ ._. _. _„ ❑ 495 MAIN ST., MT. KISCO, N.Y. 10549 666.3335 „ - _ 0- STONELEIGH AVE. (NEAR HOSPfTA-L),C-ARMEL� 1,05:1 ?.278x9330._ LAB # 3096 DATE TAKEN: 11/17/82 ( 11: 10) �- -� DATE RECEIVED: 11 1 ,82 11:20) DATE NANCY COTTRELL REPORTEDKITCHEN TAP SAMPLE SOURCE: SPRUCE MT . DRIVE CROSSROADS PHARMACY REFERRED BY. PUTNAM VALLEY, NY 10579 L COLLECTED BY:N. C_OTTRF.T,T, LABORATORY REPORT mg /L OACIDITY ................................................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ............. .............................:. ❑ ANTIMONY ................................ ............................... BACTERIA, TOTAUmL .............. ................... ❑ ARSENIC .................................... ............................... 13 BOO.5 DAY ................... ............................... 1-11 BARIUM ....................................... ............................... • BROMIDE ................... ............................... ❑ BERYLLIUM ..................»............ ............................... • CARBON DIOXIDE. FREE . .............................. ❑ BISMUTH .................................... ................... ............. ❑ CHLORIDE ................................................... O BORON ........................................ ............................... OCHLORINE ..........:........ ............................... O CADMIUM .................................... .............................., ❑ COD .... ....................... ............................... ❑ CALCIUM. .................................... ............................... ❑ COLOR ....................... ............................... ❑ CHROMIUM Itot.) ............................ ............................... ❑ CYANIDE ................... ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ... ............................... O COBALT .................................... ............................... ❑ FLUORIDE. ...:............... ............................... ❑ COPPER .................................... ............................... ❑ HARDNESS ........... .. O CO. LD.,_.............. ...........................- ............................... MPN COLIFORM COUNT / 100 ml ....... ❑ IRON ......... ...•.......••••. . ......... ............... ............................... MFTCOLIFORM COUNT/ 100 ml ........... ❑ LEAD ........................................ ............................... ❑ CONFIRMATORY TEST ... ............................... O LITHIUM :................................... ............................... :D NITROGEN, AMMONIA . .::... ....::.....:..:...:a...::...... ❑ MAGNESIUM _ ._�•_ - �.,_._.. _•_ ❑ NITROGEN, KJELOAHL ... ............................... ❑ MANGANESE ................................ ............................... ❑ NITROGEN. NITRATE ... ............................... ❑ MERCURY ..... :............................................................. ❑ NITROGEN, ORGANIC ... ............................... ❑ NICKEL ... :...... ................................... ❑ ODOR ....................... ............................... ❑ PALLADIUM ................................ ............................... OOIL & GREASE :.............. ............................... ❑ POTASSIUM ................................ ............................... ❑ PH ........................................ :................. O RHODIUM .................................... ............................... ❑ PHENOL .................. :................................... ❑ SELENIUM .................................... ............................... ❑ PHOSPHATE (ortho) ... ............................... ❑ SILICON .................................... ............................... ❑ PHOSPHATE (condensed) ... ............................... ❑ SILVER ........................................ ............................... ❑ PHOSPHATE (total) ...... . .................. .:........... ❑ SODIUM ........................................ ............................... ❑ SOLIDS. SETTLEABLE, mi /L .......................... ❑ TIN ............................................ ............................... ❑ SOLIDS. SUSPENDED ... ...:........................... ❑ ZINC ............................................ ............................... ❑ SOLIDS. DISSOLVED . ............................... O ... : .................................................................. ............. ❑ SOLIDS, TOTAL ........... ............................... ❑ .................................................... ............................... ❑ SOLIDS. VOLATILE ....... ............................... ❑ REMARKS:.:.................:................. ........................:...... ❑ SPECIFIC CONDUCTANCE ........... .. .................. ❑ ..... ............................... ............................ ❑ SULFATE ....................... O ... ....................... ...... ❑ SULFIDE ...... .. ................................... ❑ .................................................... ............................... .... ... ❑ SULFITE ................................................. ❑ .................................................... ............................... ❑ SURFACTANTS ............ ............................... ❑ .......... : ................... ..................................................... ❑ TURBIDIT.. ............................................... O .............. ............... .........................__. ... _._ _ ....... THESE RESULTS INDICATE THAT THE WATER WASt& OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE (JAS COLLECTED, THESE RESULTS INDICATE THAT THE WATER DID _ D!EET THE SATISFACTORY CHETIICAL QUALITY OF NEW YORK STATE AD ?fINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72) FOR THE PARAMETERS TESTED. W ---- ALBERT H. PADOVANI Af.T (ASCP), DIRECTOR: �� WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This 7e}s�Yrt. s-to = be=66mpfe4ed -by -- well dril.ler.;:and. submitted, to.. County,- Healt#�- �Depar,.tment. together.. v�ciW.laborator. _report 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 NAME ADDRESS LOCATION OF WELL (No. 6 Stree y (Lot Numbq ♦ (!// PROPOSED USE OF WELL V BUSINESS ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ T WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING, ❑ O�Efy) DRILLING EQU PMENT ROTARY AIR. PERCUSSION PERCUSSION ® ❑ COMPRESSED ❑ CABLE ❑ p�ify) CASING DETAILS LENGTH (feet) L / DIAMETER (inches) IWEIGHT PER FOOT /�(/ i � THREADED ❑ WELDED YES NO YES i -V- NO YIELD. TEST HOURS '' G.P.M. ❑ BAILED ❑ PUMPED D COMPRESSED AIR 'f %a f YIELD (G.P.M.) Ao WATER LEVEL MEASURE FROM LAND SURFACE — STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well in feet below Land surface: a y o SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (test) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inch"): RAVEL SIZE (Inehea) FROM feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, Io at least two permanent landmarks.. FEET to FEET �.. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL CO P yyyyEEEE DATE OF REPORT JW"ILLER ( tur I C 0-TT V,r__ L.L T M 62 -- 91 a Owner or Purchaser of Building Section i' - n- ..............._..,._..... ._r_ Bl k _. _... Building Constructed b - oc !9MU c:E I&UffTA/I `DRJ of Location - Street o w M A L.L Municipality O MILY Building Type I Lot G PP-0 Q a /WAOU N-rA /N L. A I<E Es TATS' Subdivision Name Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 determin- - ,at- ion.;..of. the D rector-:,of -the Division .of Environmental .H__ea.l_t.h.. S.er -vi_ ces..•.: _ of the "Putnam County Department 'of Health -as to whether or not the fail - - -- T ure 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 %D U 19 83 Signature Title 0U.lNr-_P_ Corporation Name if corpo !9PP_UQJE 11AQU /yT rl..l PF,111-r- Address PU7144AUAUEy�11 Y. la5j� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 I i i — '_°-_�'�;�T' .� -'- � �"- -� -:,, . , •. , "-ice' .— .�u- -s- � r } ,� . %[��,r� +�,�,�g� * s5 v '� ; ^y .'s.:�,.. �' I - �;-� .k -`•.., , ;, .., I I SCP is } f �. t x. '• � '�. A 5�.. �a , � ;i�'.`�. 7 � %. u� '�i hr f A � �� • - ' {, s. '$, .ip1 `- 4 + ",�' rs $_ 3�� },,�G'.5. �:"a�s`b" �,l•�X+gs�j �� +Y"� *• et. :ski '.1'� -' a,t+� ° � g�w�p_ r 1 xK, 'S • 20'.0" - �: �� i PIN 14 ktm K.ITGNEN:, 00 *4"A' Gl PJEVit.OoM - � z n u io x12 - s GL04 LIV.i: QN1 llP 6�DfZCO1V� IED.2oo 19'- 4 x 13 �� lo' q x 11 fo" 10 -4 - :Z= _. � <, r r •�� .} -f - - �c rr� � -rig ., f - �{ -. .:� .. - •- ,,.. s -. t.. ., . � �----�� . yr- a r ,�:- , s - r -= �,i s >_'i. _ 3- � .. :: «., ('. +,ffi� G•� �- -i: '- .. 5.: � .. :. �•c. iSsY c)•_ .�. ;� ',L- '� � � S" -4 .. ;.: ..,.. •/... -.. ,.. -. ... ,�. .. a ._ -- $'4,. -�'�. - .',.. -. �, ..,2 < -a' s .. .. �-:. ,; -�i r. S' of t to ;:-�-s y .. .. .�. _rr.S1, -.. -� . -... G. / .:5... L,w'" -.�v' .r.. ,Y :•3•. f•.3 V f F 1:. i, scz ,4v �'i� ,.,_.. �. - , .__ -t „ ,_.. Y+•t a zY , , tF • .� T= 7. " � r�'; '� Ili- , r s- J � y � `' s $N ,x. f:'ir�`•� �. ,-. . ti.. :.. ,i' f' ,�,., ��' r,: ..,r 'F 3. z. Y.. su �. +:��' - ..i -*��_ c ,"�z..• • • -r r' -t -�5. � ^r- �`�r -1� , -< •s - -� + - -� • •;s, ,e -;�-. �. -'�.F. 't.,':.i �.•�, r- .�..'z'F ' .vF`•-'S` 1 -� = -`��t t* �r µ.ms'. j'..s'4 y,. � • : '..... •Tyr . ,- � •d ... .. _ c^i '.�.••, �- � � fi �r `��.,�r"�'- -,4�.� �- aa. :: � 1- .. `�r �� = Fsa.a' xs:- '.�.,,� � .. �' "l. -`;r `stiilf � ��.ttf t �, PUTT Division` 1 CONSTRUCT(ON PERMIT T'OR- SEWAGE `0 TN /9 •ITV O lW Y+'t.N Located at._,_r. z ` D � � ubdivisi^onn– caner y .=c'bL�e Number of Bedrooms Design Flow sepiirate,•sewerage system to consist 'of r t To ISe,construeted by �✓ ®�Z�. f! Water: Supply. Public Supply From:- Private Supply to.be d A. AddVassf y 6th ®r Wi qui►emenfs ' I.represerlt�tt(at.l sm'vvholty� and completely respol above described will be consfructedas shown- on`thi County. Oepertment of "Health,. and that on =corm be submitted rto' the: Departirtent,- ,and'a.w.ritten place °id" good operating :condition - any.1part of_,. ance_. of the'approvai, of the.' Certificate of• Cons will ba ocated Bs Shawn on th®,approved plan and t County De(pgnaJrt nt .of Health G 1 E " Address�y�� JTY DEP�IRTMENT O� HEALTH. - "> �G� �� l " ental Health Services, Carrnel, N. Y 10512 ` a SYSTEMS pt AT>�A. Z ZlY f Toy n a 00 " Ice;of the originafsystem or pny repairs thereto 2) tht"i the drilled�'Wi described above ae ristalietl �n accordance thaxthe tandards rules and Pegula N s ?of�:the Putnam L ®.Y ! License No' "ON! ar from the date issued unless construct n of .the building has b98 undeit$ ken and is i'necesiary.�b0thOD,. ,om►o° oner� of, Health ;Any Change or elte ►atit�o of ccnstructlon r .sewage /or pr �wdter ".wpDly only4 u �� f ,.•+ s 4:�`:s"�u::i_st+$3 .. 4 �.'aL°' » .2..,.:. x,,aa i 4r �rL. �: , Lot Job Address 1 � 1 •. � wY fE PD "Square Tbial .Habitable, space. -YF Feet " ��H L �Y �t3al.�Septic "Tank and Addr`es �� d . s o . c r esignarillocation of pro"' iy_stem(s)1,ij` 4f that the,Separate sa agexdl vii iystem ,the endment there'4o and.in accordance with the standards, rules antTrequTai it6 o`ii nam a 1'Certiflcate °of Construetion;Compliance satisfactory to the Commissiinir fit Healthwhf '. I, be'fumished;'the,owiier, his iii I'll censors, heirs or assigns =lij the builder that fiatd'byilder, will . sposaf system- during She per`iod'of t*o (2):yeari,immediately folloWlhg:thedat®_of the issu- Ice;of the originafsystem or pny repairs thereto 2) tht"i the drilled�'Wi described above ae ristalietl �n accordance thaxthe tandards rules and Pegula N s ?of�:the Putnam L ®.Y ! License No' "ON! ar from the date issued unless construct n of .the building has b98 undeit$ ken and is i'necesiary.�b0thOD,. ,om►o° oner� of, Health ;Any Change or elte ►atit�o of ccnstructlon r .sewage /or pr �wdter ".wpDly only4 u �� f ,.•+ s 4:�`:s"�u::i_st+$3 .. 4 �.'aL°' » .2..,.:. x,,aa i 4r �rL. �: , TM'b -, _ .e-. v.C,-•os .. - :sv,ay..., rY.. -c .nevv ... a ,., .. = ^sN.. -.Nr ^ a. .,yn'r. � ....0 +.r:. -. .. •- a . _ .:. .r •C- ..s .....vnr ... - _. -P,UTNAM :COUNTY DEPARTMENT OF HEALTH 'DIVISION OF ENVIRONMENTAL 'HEALTH'SERVICES -.Date Re: Property of . TpM Located at PP-0 CZ f &T, OR, _ Section7M"_4V'9 Block Lot Gentlemen: This letter is to authorize JO�L M9 9 A duly licensed professional engineer or registered architec ( IndicaTeT -- 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 i�.. v+.. y L .P TT.. 1 11. 1 L .! 1 1 - y behalf. Lv -lrai t211GLtl. o1, : ncrs Ott,'_ aiiu Uu :.s gri £i." -- necCSSary. papers. on -my .in connection with this. matter and to supervise 'the construction of -•said system or systems. in conformity, with the provisions of'Article 145 or 147, Education Law, the.Public Health law, and the Putnam County Sani- tary Code. �V 4 -A REN C E 4V vu. G) -1 Very truly.yours, X Signed Owner of roper y 0,A D PUS HOL4,Ot,A.) - 2D R.A. # -� w - E uQj 111 US c o o '� j�l. (� �T ( Seal) . Teiephone Address RF, � BOX 46 9 - NSA 40PRe- N,-\ i D�4! Telephone ED NTY vas:f 3E 1. H i + ? p 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 T. COTTR -ELL_ Address PUTNIQk VAL(r--y N •Y. Located- at -1 Street DW, Vr= Sec .1 / Block, Lot 6dicate nearest c. ss street) Municipality T)wN pF_ PumjQ SOIL PERCOLATION TEST DATA Watershed #Ubsom P_/ .V Ems, TO BE SUBMITTED WITH APPLICATIONS Hole . . Number CLOCK T TIME P PERCOLATION P PERCOLATION .. a apse D Depth to-Water a a er ve No. T Time F From Ground Surface i in Inches S Soil Rate Start -Stop M Min. S Start Stop D Drop in M Min. /in drop Inches Inches I Inches i .. . . 1�' 37.13 - 7:4(a 3 33 ' '7 ° °)I 6:48 4 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. B . . ,-* TEST PIT DATA REQUIRED TO BE SUBMITTED _WITH APPLICATION DESCRIPTION OF .SOILS-ENCOUNTERED IN TEST -HOLES DEPTH HOLE NO. HOLE : NOj G.L. �! X011.; ®P. " `O.1 L 6" SAND 4 Sroig aS S A'4 b j s7bN V6 12" 1811 24 it 3011 . . 3611 ., 42" 4811 5 it, 60" 6611 72. 11 7811 8li 11 INDICATE LEVEL AT WHICH GROUND. WATER IS. ENCOUNTERED -N NOW eNCOUAd E2 ED INDICATE LEVEL TO WHICH WATER' LEVEL RISES AFTER BEING ENCOUNT - l,r�4 TESTS MADE BY ,1 D � _ rcN�'� _: _ . bate . _ /7 .1 �.. 'D IG Soil Rate Used//- /9' MirVl "Drop: S.D. Usable Area Provided �5 0Ob SP No. of Bedroo Septic:Tank Capacity D 0 q e EECASr' Absorptio ,� ded.. By aj. _;L. F. x24. "• . NCe F renc \�•( �RENCE Addre - N;'; -` S 'tee, d04 0106 O. ',': � :.' '. OF Nwd , THIS SPA �`�' LTH DEPARTMENT 'O1VLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date :J• 4