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HomeMy WebLinkAbout3070DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.26 -1 -42 BOX 25 Is m j I 81 1 or Ir j6 jr i 1 �T 03070 Sac USA �C 2 ( I Z °j tN161 NttK''MUS �` PUTNAM COUNTY DEPAR'TMEN'T' OF,•,HEALTH PROVIDE 1 ` L Division of. Environments/. Ailth- Sertnoes, Germ% N: 'Y 1051? PERM -- IT ,2, CERT ICATE TOF CONSTRUCTIOW IC' LIANCE .FOR; SEWAGE DISPOSAL ` SYSTEIN `' Town or Village • .Located at Oil Tax�Map -�: UJI /�i L LIE $ T ' .SWA /�IsO� ` b' /Formerly Tax .kap iot' a s 7 �' subs. roe a /.SS - 171 Owner Separate Sewerage system built by , (^�E RT SIJAn1S0� _ Address OnJaH I[ oft f1t L k Conslsting of 00 G—al.'Septic Tank and S p:0, L.F Or-.: .FT. .In%s D E R'F 1 C E;S N'. Y. J 0174 Other requirements .. Water Supply- Public Supply From Private Supply Drilled By* i1ldaMAA) ' Ny�� CSon! Address E T — w L .1n Q s" Building Type OAI E FAi4Z L Y R F-5. No. 'of, Bedioom$L Date •PSrmit Issued Has Erosion Control Been Completed? Yes Has garbage grinder bee .. nstalled7 I certify that the systems) as listed serving the above premises, were constructed essential%a�i'hc�n,on the plans of the completed work (.copies of which are attached), and in.accordance with the standards, rules an lations, in accothe filed pia and the'peruit'iaeued by, the Putnam County Departinegt•Of Health. _oZ Certified by V Oats P.E. R.A._1S_ 6 Address O DT ." . on N . %j L. . N. O.r I .Lice se No: 1 L 4 S Any ,person occupying premises served by "the above systems) shall promp ly t e such actio`` s may be necessary to secure the c rrectlori of any unsanitary conditions resulting from *such usage. Approval 'of. the separate sevvera em shall b me nultind void as soon:its a pu Iq sanitary ewer becomes available and the approval of the private. water'. supply shall become null and void when putiik: 'water supply becomes available. Such approvals are subject to modification or change When in' the judgment of the Commissioner;of Hdalth, such revocation,,modification or change is necessary. Dater Rev. 6/85 m BY Title 11! 67 r I . ­ _ A 61 Wz1j1j L0Vr1.Cijr1.Lj_VL1q Office Use Only DEPARTMENT OF HEALTH ivision- of. Environmental. Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH P 'STREE DURESS: VILLA 'TAX GRID NUMEIER: WELL LOCATION e.�> � WELL OWNER NA ADDRESS: / �F I d PS'IVATE 0 PUBLIC USE OF WELL fi(RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR/COND./HEAT PUMP ❑ ABANDONED 1- primary ❑ BUSINESS ❑ FARM 0 TEST /OBSERVATION 0 OTHER (specify) 2 - secondary C3 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑ MOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE ?(!� gal. REASON FOR 29 NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY 0 TEST /OBSERVATION DRILLING 'OSEPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft.1 STATIC WATER LEVEL --2 —ft. DATE MEASURED DRILLING `ROTARY 0 COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH ft MATERIALS: %STEEL - 0 PLASTIC. ❑ OTHER CASING LENGTH.BELOW GRADE JOINTS: ❑ WELDED ❑ THREADED 0 OTHER DETAILS —DIAMETER in. SEAL: ❑ CEMENT GROUT 0 BENTONITE ❑ OTHER WEIGHT PER FOOT lb./ft. DRIVE SHOE 0 YES 0 NO LINER: OYES ❑ NO SCREEN DIAMETER (in) I 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (It) DEVELOPED? FIRST - ❑ YES ONO DETAILS---. GRAVEL PACK ❑ YES GRAVEL DIAMETER TOP BOTTOM ❑ NO SIZE OF PACK in. DEPTH ft: OEM - it. WELL YIELD TEST I If detailed pumping 11 It more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. W METHOD: 0 PUMPED tests were done is in- OMPRESSED AIR formation attached? A DEPTH FROM SURFACE SURFACE Water gear. Well Dia- 0 BAILlfO, 0 OTHER OYES ONO ing M ter Ile FORMATION DESCRIPTION CODE I WELL DEPTH DURATION DRAWOOWN YIELD Surface It. hr. min. It. 9Pm_ WATER 0 CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O,COLORED ANALYZED? 0 YES 0 NO ANALYSIS ATTACHED? 0 YES ❑ NO STORAGE TYPE CAPACITY RAL. j PUMP INFORMAT[ON TYPE 42� o,, CAPACITY Is WELL DRIUA NAME %���eoo' V AJ� MAKER a DEPTH MODEL VOLTAGE �t Ii _)Ao t�ADORE 67 r I . ­ _ A 61 a rktowrn Medical Laboratory, Ins. 321 Kear Street _.. Yorktown Heights, N. Y. 10598 Director: Albert H. Padovani M. T. (ASCP) T- L J LAB 1 87.0 678 Date Taken: 2- l��d' Time: � .Date ..Rlc!d:_ _ _ Times �•� fn Collected By: �• �'1t,� /J�� Referred By: .Sample Location: Phone I J -� Phone I Sample Type: Repeat Test? (check one) LABORATORY REPORT ON THE BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA 4 Standard Plate Count (CFU /l.OmL) (Agar Plate 8 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) V Total Coliform (CFU /100mL) Fecal-.Coliform (CFU /100mL) _ Fecal Streptococcus (CFU /100mL) MOST PROBABLE - NUMBER TECHNIQUE (MPN) _ Total Coliform: MPN IndeX (per 100mL) Fecal Coliform: MPN Index (per 100MO OTHER ANALYSES V J �otable _ Non- potable _ STP INF _ STP EFF Other: Sample Status: (check each) Outgoing _ Na2S203. Incoming VLE 4 ° C GT 4 °C Other: KEY FOR TERMINOLOGY RDS = Recommend Disinfec- tion of Source TNTC= Too Numerous To Count REMARKS (For Laboratory Use) CON = Confluent ( -TNTC) LT = Less Than (C) r GT = Greater Than (>) Al .� --IN /A = Not Applicable Cl �t Less than or equal to 1. - THESE RESULTS INDICATE THAT THE WATER SAMPLE 'jWAS) ,/(WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THkI,11-EVF YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT'THE TIME OF COLLECTION. Albert H. Padorani, M.T. (ASCPj, Director .2 /85(RY3'd7 /87)RWE For Lab Use Only: _ H/C to LAB OFFICE HOURS (Hain Lab)..s 9AM -5PM, Mon. -Fri. 9AM -ROOK, Sat. 3 =0 JOEL LAWRENCE GREENBERG bArrhitect ® Town Planner Mus000t North a RFD #2 o Box 488 MAHOPAC, NEW YORK 10541 (924) 628 -6513 _ 19141 526.3740 U'oWn Manner o Putnarn Valley, Nt TO Putnam County Health Department Carmel, NY ELEETTEa ors UIMaRZOMDU L DATE- '� -- JOB NO. 5 -85 -198 _1/12/89 ATTENTION Bi 1 i Hedges ` RE: Mr. & Mrs. Albert Swanson SSDS As -Built Plan ~t ruct ion com liance for Sewaa e > WE ARE SENDING YOU ached ❑ Under separate cover via the following items: • Shop drawings U_Pdrff's ans ❑ Samples ❑ Specifications • Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION ~t ruct ion com liance for Sewaa e Disposal System., Laboratory Report 3 Guarantee of Separate Sewage System Sewage DisXlosal System Plan THESE ARE TRANSMITTED as checked below: r approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 REMARKS • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US } r 6 ALBERT SWANSON Owrier or Purchaser of Building 32 Section Building Constructed by Block WENONAH ROAD Location - Street . TOWN OF PUTNAM VALLEY Municipality 5, 6, 7 & 8 Lot LAKE OSCAWANA EAST # 1 Subdivision Name nNF Ferr r LY. RER1 DENCE Building Type Subdv. o 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.._ cone lus1ve -thP. de.terwi.Dr, eo, -cam -of •t 'Divis or u ° EriJ'1rUIlmenLai tfealttl- Services . • �I of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or negli ent act of the occupant of the building utilizing the system. Dated this 23rd day of NOV. 1998 Signature_•• i Title OWNER & CONTRACTOR WENONAH ROAD PUTNAM VALLEY, NY 10579 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 f 3 MAL SIT9 INSPECTION Date Ins-ad by j,OCATION C f t - b ., ; 1 �� , ' :.• = > ... k 1i `i 'lO 061, l ICN LOT SA i I'. a 1•� IV. V'• Scy[�CE DISP01, AREA d. SDS dre3 1ocated ds aDDroVed any '" 151 YES NC( � CC�.Q�Y . b. Fill section - Date of place-Tent 11 2:1 barrier. LGTH W� H AVG.D �-� c. Natural soil not stri I I.- d. Stone, brim, etc., greater than 13' f_ar, SDS are:--. e. 100 ft_ fran water course/wet—lands.,, SD.vtC✓ DISPOSAr, SYSTE1 a. SeDtic tacit size - 1,000 1,250 ` h. Seotic tarn_-, installed level I c. 10' minimLm from foundation d. No 90° bends, cleaneut within 10 fn. cf 45" bend e. DISTPIBLTICN WA 1. A11 out-,e--s at same ele,, ti Cn - •.vate_r teS t-..1' f 2- Protec te--; below frost l l 3. Minim -mi 2 ft. oriainall soil ber,;e--n bcx acid tre_ncies f . J'UNCT'ION ECX - prouerly sei- c . U ' —s r 1. LiFan&n re-cuirad L__ct^ ir•� -;. 11 %U I 2. Distance tc wa-tar m =. s-a _ e^ f =. 3. ac--crdinc to plan I 4. DistGnc= cs -,itcr to c`ntar 5. Slone cf t_e_ncn accept -=le 1/16 - 1/32 6. 10 feet—f=an prccertr lire - 20 ie=_ - fcunca -ions I I 7. Depth c_ t_e_ncn < 30 inches fran s-urface I I 8. Roan allowed for eYDansicn, 50% I I 9. Size cf cravel 3/4 - 1_" diameter I 10. DeDtn cf c avel in trench 12" minka -am A.- _._._ 1 Pine Erb S4"'DDe1 ._ -1 . 1. Size of DL"'1ID chamber 2. G`vex -f l cq t-=rik I I 3 A1ammi, visual /audio I I I 4 PLnD e?S?lV aCCesslble manhole to c=?C_e I I 3. First bac baffled 6. Cvcle w_L_nessed by Hea I Ln Der;a ,-renL I I eStllild -- ficw r cycle I _. �:CLLe 1CC t orr aoprCVc'.:.' Dlans. _. N'l7Le= of b =.—Ca s I I I b. Dist =r.Ce f`an s7-- ' _ -_- ;I= _:S'�IrE^' __ C. Casino 18" abcvec: =ce I d. Surface dra n -ace ar un we! 1 dCCeDL =C__ I I I C'TERAT•I, Vn RMS = _P a. Ecxes rcce= =v crCUzec E. A11 Dices lied ( I c. A11 Dines flush with inside of bcx d. Eackfill mGte_riG ccntains stones < 4" in dlZreter I I e_ Cartain drain installed accordinc to darn --� f . Curtain drain cut =all roter-ted & di r. to Exi s t_watercours�._L I c. Fcotin drains cisc-iarge awav fran S- S are=. I h. Surface water Drcte lion ade-T,,-.te I i. E_rosion cccnE provicri on slcoes c= ez-te_r L- 15 %. PUTNAM COUNTY DEPARTMENT OF HEALTH permit a Division of Environmental Health Services, Carmel, N. Y. 10512 C S RUCTIOPERMIT FOR. SEWAGE DISPOSAL. SYSTEM _._..:.. _.. Putnam Vallev QN T. - . -PERMIT - - ' i own or ,V lllage Located at Wenonah Road Tax Map 3 2 Block 1 Lot 5,6,71&8 Subdivision �R N/� Subd. Lot p Renewal _1 [ Revision _ owner /Address M , • & Mrs. Albert Swansen, Spruce Mt. �e�Of Previous Approval One Fam.. Res. Put.Val.�T. Building Type Lot Area � 1 section only ❑ Number of Bedrooms. 4 Design Flow G /P /D 800 P.C. H. D. Notification Required Separate Sewerage System to consist of 1 ?on Gal. Septic Tank and -- 50OLF of 2ft wide Trenches To be constructed by Don Heady Address Canopus Hollow Rd, Put. 'Val. , NY 10579 Water Supply: Public Supply From XXX Private Supply to be drilled by Norman Anderson Address Barger Street, Putnam Valley, NY 10579 Other Requirements I represent that 1 am wholly and completely responsible for the design and locLacrda above described will be constructed as shown on the approved amendment ther County Department of Health, and that on completion thereof a "Certificatc be submitted to the Department, and a written guarantee will be furnishei h place in good operating condition any part of said sewage disposal systeonce of the approval of the Certificate of Construction Compliance of the will be located as shown on the approved plan and that said well will be installeli County Department of Health. 6/24/85 Date Signed rlaarau+ APPROVED FOR CONSTRUCTION: This approval expires one year from he ate issue un revocable for cause or may be amended or modified when considered necessa y the I requires a new permit. A proved for disposal of dome c ni ary sewage, and /or riv Date^' gy Rev. 9 -81 a)• that the separate sewage dis o"I system ith rds, rules an regulations o e Putnam liancl ctory to the Commissioner of Healthwill heI igns by the builder, that sold builder will e rs mediately following thedate of the issu- irs t , e ; 2) that the drilled well described above and s rules and regulations of the Putnam XXX P.E. R.A. 10 4 License No. 11056 is construction of the uilding has been undertaken and is oner of Health. Any change o s ation of construction ft--) supply only. 01:� Title PUTNAH. COLN TY D EPAR'T%. MX T OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Res Property of Mr. & Mrs. Albert Swansen Located at Wenonah Road ('T) 32 Section - -- Bloch- 1 L ®t 5,6,7 &8 Subdivision of Subdv, Lot # Filed May Date o. Gentlemen: This letter is to authorize Joel L, Greenberg a duly licensed professional engineer or registered. architectxx (Indicate to.apply for a Construction Permit for a separate.sewag.e 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 provisions of Article 145 or -�- � �_ ;'�.,v> _.�:._ �.. -_ : _� ;`.,__ :.:-:� .. -..: - :•: �.... _� _��...__ e.�.:- ,;;..rte -: -� � �'...�. � "�::. r:...- .::.-�.�:.. °:a . _...o-- :�: -�. :�_: _:.�._.:..,. -... _ 147, Education Law, t BRED ,4R c Health L,aw, . and the Putnam County Sani- tary Code. �vNCO Countersigned. P. E. , R - A. , • 1 056 E A Very truly yours, Signed 50 fV E `N Muscoot No..RFD #2,Bx 488 Address Mahopac,NY 10541 628 -6613 ' Telephone ner of,� Property ruce Mtn, Drive Address Putnam Valley,NY 10579 Town 528 -9155 Telephone PUTNAM COUNTY DEPARTMENT OF IMALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - 4". .w __-,.c •'+9m�wa.._�:+i••Rr maw. .- .ae.."�."rnl. T•�sr 'wr6 >•wa+•.vFe�z.lrlr :a�aw.: ..a W :.... COUNP3`C°C 'Y(:E BUILDING, �CARMEL, N. Y. ° 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSJM SYSTEM FILE NO. Owner Mrz WPs Ai eet'S�ANS�N AddressSPr�ucE MTk. 2v.. i'ct'rNAM L&-,:L�y N•Y 10570 Located at (Street WQ�• Cw, AN ' • y,' Sec. ' 32 Block I Lot S,• 6, 7 4$ nearee cross street) Municipality::, — o I uT •� i�� Watershed :..SOIL PERCOLATION TEST DATA REQUIRED -TO BE SUBMITTED WITH'APFLICATIONS oe Number :_....CLOCK..TIME PERCOLATION PERCOLATION Run Depth to a er a er ve No ....::....... ._..,:..... Time From. Ground Surface in Inches Soil Rate Start -Stop ..Min. Start Stop Drop in 'Min. /in drop Inches Inches ..Inches .. PTH #1 -1...9:45' "� 10:15 30 •15 17.•75 2.75 30/2.75 =11 2....10 :19• 10:49 30 15 • 17.75 , .2.75 30/2.75 =11 •3 10:5.3 - 11:23 .30. 15 17'_ 75 2.7'S 3022.75 =11 4 PTH #2 ' .1..9'.: 50 . - 10 : 20 30 16 1. 9. 3 '30Z3=10 _ _ _ - _ __�..._ r .w .�. n .' T�,w - � .,,�sr °_r ... �.� w• •M �..•v: Tan•�.T,�_.. .,::�- P:�'.. ��.._Jr r..+a. -.. �aw� :•_,�_i,n. s� 11:.22 30_16 18.75 2,35 • 30/2..75 =11 Notes: 1) TeAts to. be• repeated; at same rates are obtained-At each percplation for review. Depth measurements to be'made depth until approximately equal soil test hole. All data to be submitted from. top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH �r HOLE N0 . _D P HOLE NO., �HOLE�IVO. G.L. 6" 12" _ .. 181 . 24" 30" 3611 4211 4811 60" 66" 7211 7811 84 INDICATE LEVEL AT 1!H[CH GROUND WATER IS ENCOUNTERED ? � 'E`- I'L L: TO WN CTW,,WkTE -g : ti .vPtTSE :FTEI? ;BT'.T�fGr.FNCO TB J�- ►�i o .. :`.:. - TESTS MADE BY - a � � C, 2.E � � a E l2.G Date 6 h,3?19 5 DFSIGV Soil Rate Used - /,,,�MirVl "Drop: S.D. Usable Area Provided A o o a 51= No. of Bedrooms Septic Tank Capacit 120 el Gals. T CoNc.. Absorption Area Provided By !oo L. Fex24" 36"- . ToP Soil, SAND, 15-TONE-5, CGLAY ivame biL64 ,C6 t., . Joel Greenberg- Architect it Muscoot RFO.N2 /Bx 488 Nw Address Mahopac, NY 10541 $ THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by, c i 0110,D_ 0 O \NEW Date s \D • N y r � 19 l 14 22 N \V� _ 5 E'PT lC _TANK. X 5 1 2 °' 27 1-4 . a9ro �1 1, Q � � � t i � / r Ail _ ..::LO, C_y T_.1_0.:N ,S.. A 8 A 5-EPTI C_ TANK 51'-6 27' LOCATION 83'V -#Z 49 43' "15 901". ft3 d4° 10" 47 =C; 3i t.4 ' _8$' d9' _ *4 ALV 52=2" 59' - zy6 38' 57' 3" mat, .. 84' 9A' 6 36,-Y'. (2'- 4" 8 4' 97 -4' �� 34 =3" ��•_Su mfg '83=)'• loo -ro., 6 9., 72',r 83 =8° to4_gl, 73' -4 65' 9'. lo8'-m'' i0 35 Li" *85' -d" 1 N 38' -3.. s9'-6" AZ2 (v7' )64' i rr