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HomeMy WebLinkAbout3059DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.26 -1 -7 BOX 25 03059 I•y~ LL I 1 ' F r � J'-p 9. ' k.' a 109 T ILL r r L 03059 7^.7 - _ ..rvn.•. �� nnri�TTV ns+n � o��t v,n OF HEALTH �lewn or v -: `� e Block' LoY e.: " "-" � -P v� .. For m ��v� on Owner? app llgaat Nam Nam e t q e v Lo MaWng Address - Permit Iss ed O X % .5 0�/ !/ Q f U I Separate Sewerage System bunt by" .t7 Address 1 V. Conelefing of ,! Gallon Septic Tank and — a Water Sapply: 'Public Sapply From Address %� a `.or: ✓ vats 6Qply DdHq by fOn� __Address } g��g Hae?Etoxion Control Been CompletedY Namliei of Bedoome Has tiarbage Grinder Been lnstelledY /VD x Other RegWrements ,I' certify that" the eystem(O as•.liated serving the above premises were- constructed easentially,as ahorn'on the Plana of the completed work (copies of which are'attached), and in accordance with the etandaida rules and iequlatioiis in dccordance with'tlie filed'pl"',! and the permit iseued:by the Putnam County Department f Health z I Q B � , Date — /, /���i�_ bY' T _ Certified t fJ] � .. p t Adders M No.E. O c2 Ca Any person_ occupying premises serves by the above systems) shell promptly ak ch action'is maybe necsissary to secu a cor-licin of any unsanitary conditions resultlny, from such ♦usage._ Approval :of the sepa►�te sswe►a sy em shall become null. and voltl as soon is a pubtt siniti►y pweF'pic"oi?+es•� i a' ' available and. the i0pioval of tqe. Private water supi6ly shalrbecome4'nul ,and v when a •public watts wpDly' becomes I, tile Such ,appCO" SN Iiire; subject tom iflutf n ,or change when,,.,in the Judymenf; of the Co r of Health, su oeatlon,- modlflcation or strings Mcesa►y:' Y AM.a r Date BY T It ¢: PUTNAM OOUNI'Y DEPARTMENT OF HEALTH -- _ rte., -. ..e� rr �.� ��Ci•�'��a1, -PF Lirs�,�^a_�rrL�^ -- - -.._ - - 7. P 3Z ,410'°% le /_ / 10.3 191�? o Owner or Purchh�aserr of Building �o,E le' I 0k" a "Building Constructed by We- V,,e ed Location - Street 4&,4-,W _Il Municipality Buildif'ig Type o" ),•, )-6 -- Section Block Lot Subdivision Name 8S�/� Subdivision Lot GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely. responsible for the locaon, worlamnship, material, construction and drainage of the sewage disposal sy stem tistem 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 successors, heirs or assigns, to place im.:good operating condition any part of said system constructed by me which failsto operate for a period of two years immediately following the date of approval, of. the ' "0e–. tiflcai e'u 1.�flsGrut:t (ail `CUiiij�i icti:c:� ' for 'i:he sewer a -431 � —S 5i:t37t "G Emy repairs made by me to such system, except where the failure to operate properly is�. caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the Director of the Division of Environinental Health Services Department of Health as to whether or not the failure of the caused by the willful or negligent act of the occupant of th e the system. Dated this / day of 19� R neral Co ctor er - Signature Corporation Name (if Corp.) 2 .13 SAW7 HILL RY RD Address %�J y 1 a"F i o rev. 9/85 mk the determination of of the Putnam County system to operate was building utilizing Corporation Name (if Corp.) TTTTT r.nunTLnTrr%iT np nnDT Office Use Only .t DEPARTMENT OF HEALTH * .ri' %: i�ia°: u�itv=! v^::.., �'", yFz3EEb' �: i3-:: a�.' b�`- Ll�c�?o •S�^9�'r�t�}4":3^r2C�i�� �. - :- '3's -z' - -..�w <�ce.: PUTNAM COUNTY DEPARTMENT OF HEALTH STREET AD RESS. WN/YlL C I IIY TAX GRID NUMBER: WELL LOCATION We, 0 VA J a, �� _ /_ WELL OWNER NAME: AOOR S: f rno 3 JJ /Q _ �'�,d &fSIVATE 0 PUBLIC USE OF WELL 1- primary 2 - secondary ESIDENTIAL O PUBLIC SUPPLY O AIR /COND. /HEAT PUMP O WRANDONED O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify) O INDUSTRIAL O. INSTITUTIONAL O STAND -BY ❑ MOUNT OF USE i YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY'USAGE gal. REASON FOR DRILLING ❑R PLACE EXISTING SUPPLY ❑TEST /OBSERVATION [JADDITIONAL SUPPLY ANEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 'too ft. I STATIC WATER LEVEL 10 ft. DATE MEASURED DRILLING EQUIPMENT CV6TARY p COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT .❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE OS CREENED D CkN END CASING ❑ OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH �' ft. MATERIALS: 93- STEEL. ❑ PLASTIC O OTHER LENGTH BELOW GRADE ft.. JOINTS: O WELDED ED- THREADED O OTHER DIAMETER _fe — in. SEAL: Me ENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT lb./it. DRIVE SHOE.O YES OL- LINER: DYES MO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (it). DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ONO GRAVEL PACK OYES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DE.. fL BOTTOM DEPTH ft. WELL YIELD TEST It detailed pumping METHOO: O PUMPED tests were done is in- U'CCOMPRESSED AIR , formation attached? O BAILED ❑ OTHER ❑ YES 0 NO 1�IELL LOG it more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water 8!ar- ing Well oia• peter pF.1AT10N OESI AIPTIDN gtlE it . f� WELL DEPTH It. DURATION hr. min. DRAWOOWN It. YIELD gFm. Surface rl '� fo 9 U♦ 6 u .l r WATER O CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE: TANK: TYPE CAPACITY GAIL. WELL DRILLER NAME �] ADDRESS /' �.' ✓m u— Acje," ar...z'itGtr nM /71 PUMP INFORMATION / TYPE - S to M^ j /S % ti f CAPACITY 'MAKER bri �Q isc DEPTH 3 S� [MODEL VOLTAGE 3 HP 3 / Ott // / 1 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ��-r..<'ti•, ..�... •...Z,P,..._ .. ... v1 .a- .. .. rr a...- ...✓r. y - sc ._•... M. Y. .s rR..< v�..y, • ... .N �. •r r . .......... .ra ..w.�IYV .•CC!'4.•/N •.K.•.:en .-.- 4vaVY•'•v.r...vr. —•.r er '-p.•~ 'f" •a Date Re: Property of Located at— `/1/L`_= /�/ O A1,4X1 .e 019- (T) Section___&Z Block m2 Lot 1-3 Subdivision of ��}� -�' USCf'IL+�i4i✓A �. /(/o. / Subdv. Lot # �s. 8�o Filed Map # gL Date Gentlemen: This letter is to authorize •�i�%%'T'f/E�.t/ �.. /!/OdiL:LGO P %J°.C. a duly licensed professional engineer 4_ 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 promula.gated 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 n'coriformi`ty w th a the provisions of Article __fk4 7or - ~ 147, Education Law, the Public Health Law, and the Putnam County.Sani- tary Code'. Very truly yours, `S,igned Countersigned: Owner o roperty . P . E . , 8=9., # Address 1AR 4- An 2 Address Town GAa.�is��v o�oz LIZ*— .� Sao, vZf�S -G�dt o Telephone Telephone DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 I - .� APPLICATION TO.CONSTRU.CT...A_WATE PCHD PERMIT # WELL LOCATION Street Address Town/Village/City Tax Grid Number 13 WELL OWNER Name L7;k 6-_ Address rivate X -3 O Public USE OF WELL 1 - primary 2 - secondary SIDENT AL 0 BUSINESS ® INDUSTRIAL ❑PUBLIC SUPPLY ❑AIR /COND /HEAT P c�> ❑ABANDONED 0 FARM - ❑ TEST /OBSERVATION ❑ OTHER (specify O INSTITUTIONAL ❑ STAND -BY AMOUNT OF USE YIELD SOUGHT— S--- gpm /# PFOPLE SERVED __ /EST. OF DAILY USAGEr,,00 gal REASON FOR DRILLING SEW SUPPLY OREPLACE EXISTING SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ®TEST /OBSERVATION ®DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING L= ooe G'4✓ VS L= WELL TYPE U315RILLED DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: -7.w q_i9 6Uo Lot No. g 8 G WATER WELL CONTRACTOR: Name dJO e:!,loofAC-AV Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES �0 NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE .-TO-PROPERTY -FROM NEAREST_ WATER - MAIN : LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION SEPA E SH ET (date) (si urekK PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: Date of Expiration: Permit is Non - Transferrable :: 19 19 Permit Issuing Official NORMAN ANDERSON, INC. WELL DRILLING ,':s= • r �, c� �.._. �.a;;w;.ai•;,R' :•�•'_�"w ==._ �`_cc��,o:.��:P8D�,3i:BLL[�.�e E�E. °• SST••!' �: �',' ET: ��Q�:+�.��g>�.�.:o;.a.`.�;�,:-� �:, .a.— w�+��..m- _xse.:v.•'.o�:`._ PUTNAM VALLEY, NEW YORK 10579 L AKELAND B -13$98 Putnam County Department of Envir. Health Carmel.,, New York REi Well For Site on Wenonah / Peterson.Site January 15, 1988 Dear Sir: I Have checked the proposed well location for the above referenced site for Mr. Stanley Peterson of Putnam Valley. I fell that with a little help from a Bach -hoe we should be able to access the well location. ..�_ - - _..... ... de i'Cl S�_ _ Sin Norman Anderson PETER C. ALEXANDERSON County Executive •^Pa+c :^"rm. n..,. <. q„ . e _- + -f^9s' �na�r '- xr�m:.'w.�..:c y r�:.. r. �� JOHN SIMMONS, M.D. Deputy Commissioner DEPARTMENT OF HEALTH JOHN KARELL, Jr., P.E. Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 M. A. (914) 225-0310 December 29, 1987 Noviello 9D & Elvin Lane . Gar.rison, NY 10524 Rea Peterson Wenonah Road (T) Putnam Valley TM #32 -2 -13 Dear Mr, Novielloa Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: / 1. Deep test holes are not representative of proposed SSDS / area. Additional deep test holes required upgrade from existing holes. 2. A letter from a well driller is required stating the proposed well locaction can be accessed. 3. Remove septic tank from under driveway. 4. Trigallies are to be specified as H -20 loadnge .5. On 12/11/87 a field inspection was conducted by this N ^l' writer, at that time water was recorded at 3 feet in deep .hole 2. The need for a curtain drain will be decided after the additional deep test holes are due. 6. Due to the tightness of the lot the proposed SSDS is to be staked by the engineer or a surveyor prior to construction. This is to be noted on plans. , Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ver truly yours, Robert Morris Sr, Environmental Health Technician RM /Jp -. DE. SIGN" �. ;:Sii�r ^1�•�.�"'v'�:�= ���1�"u'= O�S�'?�.,��- S�T�11� -._ T , , r �[,E� '6 ::- -- - -` . :.. Owner ST � Sav�Address oax 4,r5�9 .e.-> . e vatown Located at (Street) Aw, ,Q Sec. 3a Block a Lot 3 ( indicate nearest c oss street).,t. A,# Municipality i Nf� /�� Watershed. D -Td,1W ,v,¢ SOIL PERC7J=CN TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test HOLE REBER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 4.•01 .. o?.a2 � � /,�;' o?/ �� 3 �� 7/�r/ ' 5 3 J 4 �, 5 J 2 Of oZ sue,. 3„ _4 5 NOTES: I. Tests to be repeated at-same depth.until approximately equal soil rates are obtained at each percolation': test Pole. All data to' be submitted for review. 2. Depth measurements:to be made from top of.hole. rev. 9/85 i TEST PIT 1 WITH A: IN TEST INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENUOUNTERED DEEP HOLE OBSERVATIONS MADE BY: I �C(.�` DATE: i �a DESIGN + Soil Rate Used 5-10 Min /1" Drop: S.D. Usable Area Provided coo ..., Noe of Bedrooms Septic Tank Capacity gals. Type &v,✓ C-;' Absorption Area Provided By ' 136 L.F. o 776- MI-L11 � / ESP M Name Address 4,-L> g=d SEAL THIS SPACE FOR USE BY HEALTH .DEPAR ONLY: m' Soil Rate Approved '' sq e f t /gal o Checked by Date F^if. ti+ PETER C.. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 M. A. Noviello (914) 225 -0310 December 29, 9D & Elvin Lane Garrison, NY 10524 Re: Peterson Wenonah Road (T) Putnam Valley TM #32 -2 -13 Dear Mr. Noviello: 1987 JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. Deep test holes are not representative of proposed SSDS area. Additional deep test holes required upgrade from existing holes. 2. A letter from a well driller is required stating the proposed well locaction can be accessed. 3. Remove septic tank from under driveway. spe,•_ f ;_od: µ _.i —2 -0 ]Lsa -d 5. On 12/11/87 a field inspection was conducted by this writer, at that time water was recorded at 3 feet in deep hole 2. The need for a curtain drain will be decided after the additional deep test holes are due. 6. Due to the tightness of the lot the proposed SSDS is to be staked by the engineer or a surveyor prior to construction. This is to be noted on plans. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ver truly yours, Apno Robert Morris Sr. Environmental Health Technician RM /jP APPENDIX B PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SBMGE DISPOSAL_ SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT DATE REVTBVM,: I 42--� 'Pe,-re- r 5 0 A) n 0 n CL BY: (Name of Owner) (Street Location) CCMMEN S, YES NO D0CUMM 2 Permit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep Hole Log Perc Consistent Perc Results (3) Fill Perc Hole Depth cd House Plans - Two sets Well permit; F;n7S letter VarianRequest GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked "etland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same LF trench provided 136 REQUIRED DETAILS ON PLANS required Sewage System Plan - (north arrow) 60 ft. Max. Sewage System Hydraulic Profile - Gravity Flow Parellel to contours Fill Profile & Dimensions - Volume 100% exp. NO D or J Box;Trench /Gallery; Pimp pit details Septic Tank - Size, Detail Well Detail, Service, if. over. , "u7n5u'u� .limit ivllCe5 1�L'lfiu'Y rdCel Design Data: Perc and deep results Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located FILL SYSTEMS Representative of primary and expansion cla barrier Expansion Area;shoan; gravity flow,suff. size 10 ft. If PmgDed Pit & D Box Shown & Detailed fill notes House - No. of Bedrooms new spec. Wells & SSDS's w /in 200 ft. of Proposed Systems depth puqes Property Metes & Bounds House Setback Necessary (Tight lot) House Suer - 1 /4' °/f t. 4"0; Type pipe 100 yr. flood elev. No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 200 ft. reservoir, etc. Li 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 150 ft. trigall /gall. 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse 10' to Water Line (pits -20') 50' intermittent draina a course Septic Tanks 10' fran Foundation; 50' to well 15' Well to PL 9 00 84TH 10 KD M ... KITCHEN BED RM'l- A. PAC 82 LMNG RM am RM BED RM 23.. BED RM'3 4' LAKEWOOD 24'x40' I= ov I A 1TN A 0 " �.lw MC 7 : N." KIRK WOOD' 27 z4O' HOUSE PLANS. APPROVED -.FOR. BEDROOM COUNT- 01M*'',".'-""."'.-` BEDROOMS <i7 Signature & Terle AL." 1 I =0 aJ" I .8 H' I MIS LIVING RM N, I q4' r. N�w qi '.gA tAAM DINING KITCHEN iT N E TIT . . ..... ... 94TH 2 Pp MANCO CONSTRUCTION C Routel'= . P.O.- Box 863 Mahopic, N.Y. .10541-056 Phone ,(914) 628,4.400,' AL." 1 I =0 aJ" I .8 H' I MIS LIVING RM N, I q4' r. N�w qi '.gA tAAM DINING KITCHEN iT N E . . ..... ... 94TH 2 KITCHEN AL." 1 I =0 aJ" I .8 H' I MIS LIVING RM N, I q4' r. N�w qi '.gA tAAM DINING KITCHEN iT N E . . ..... ...