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HomeMy WebLinkAbout3143DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 63. -4 -36 BOX 25 i .�i 9 lQroi IN I IN I IN oil IN IN 03143 a w PUTNAM COUNTY DEPARTMENT .)OF HEALTH Division of Enviionmentel�Hea�lfh Sert%ices,� Carm %"N; 'Y 1,0512 "M' �� `.. ' • ' _ ,� ! CERTFFICATE',OF,. CONSTRUCTION COMPLIANGE_FOR -. SEWAGE, DISPOSAL SYSTEM ! � �. , - G .Located .at Tax ',Map Block Owner Lot Job •!Separate:,Sewerage System built by Add► ss Consisting of ! Gal.' Septic „Tank and°' ' i Other requirements. '`Water _. Supply °Public .Supply. From Private Supply. Drilled `y Address 'Building Type . of Bedrooms Date Permit Issued �• A- - yHas Erosion Control Been Corripleted7 I certify that the'3ystem(s) as Iisted serving he above premises were constructedaessent bll shown on the plans of the completed work _(copies of which are attached), and °;in accordance with' the standards F rules and regulations plans filed a per it d by. ; Putnam County Department oi.HealtR ., !\ Date Certified � •�al ti �"�� t License No 0310 Q •.' � -' Address � ” ' Any person occupying' emises served byCthe above systems) shalt promptly take such actin'` s may a necessary t ' secure the .eorrectlon of any unsanitary conditions resulting from- wch `u age •'Approval ;ot the 3eparate'sawerage system hall 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 v C.'when a .public water _supply becomes available .,Such''approvals are sub)ect�to motlification';or change when; an the_. judgment` of the Commis over . Mealth su h reJo on .modification or 'change` Is necessary. 'Date � BY • Title #688 (914) 666-3335 Mount Kisco Medical Laboratory 344 East Maid Street G1, DATE COLLECTED RESULTS OF EXAMINATION OF WATER OWNER' DATE RECEIVED Mr6 -Redman ,.Redh rt Builders 1/16/78 CITY, VILLAGE, TOWN VOR NAME OF SUPPLY DATE REPORTED Wood Street,Putnom ValleyNew York 10579 1/18/78. SAMPLING POINT Block 3. Lot 9 Water Tank BACTERIA PER ML. (Agar plate count at 35* Q. COLIFORM. GROUP (Most probable N6./100ml.) OWT HARDNESSI TOTAL - ppm DETERGENTS - ppin NITRATES, (as N) ppm IRON, TOTAL - ppm. I FLOURIDE (F) - mg./l. These results indicate that. the Water was Y es of cc satisfactory sanitary quality when the sample was collected. 6Per: James Torlish A. H. PADOVANI, M. T. (AS P) IE GUARANTY OF SEPARATE SEWAGE- SYSTE14 X represent that I am wholly and comp,letoly reoppnolblo for the joqqtjoq#*'wq rknnqLnahlp, material,, construction and drainage of the peVagp disposal above described property, and that it has begin system serving the abq ponstructpo as shown on th' o approved plan or approved amendment thereto, and in , 4peordAnce-wIth the standards, rules and regulations of-the Putnam County Department of Health, and hereby guaranty to the owner, his 41PP004- qQr4 r .:ei' place in good ppera.ting condition any part 0 , I or assigns, to pl . said system constructed by me which rails to operate for a period of pWo - yqap.4 ImmodIgtely following the date of initial use or the sewage 414poo Al' I system: or.Any repairs made by me to such system, except where the failure to opqrgtq properly Is caused by the .willful or negligent, or the . oc 9 pu� pant of th e m building utilizing the system. The uqderpi$ned further agrees to accept As poncl4sivq t4a op" ers it a t of the Director of the D men lth r-. .1vision of Eny 1.ron TI) failure of. tk�o- -a sod by the willful or neglioent system to operate was o4.1; act or the qqqgpont or tho'building Ut1l1z1Pg the system. C!4.V of. /I'- A2kag r VIZ.- Titlet J�r corporat ion, Amd and address d WE'S (3) QOKFI.4 ARE R.EqUIRED WITH THWE (3) COPIES QF , IN.A PLA . N Q9R T 1FTqAT9Q- QQNFLF TION WILL BE ISSUED. GUARANTOR TS RESUIR9D TO FILE VOTIC4 OF DATE OF FIRST USE OF SYSTEM, tea„ XviOqn. Pf Environmental .041th $qrv1qeq# p4t;lara Ppunty Departmopt of 91041th - ­ L �a;m5_ weer.oF or MITER& 1 "54156 R. GUARANTY OF SEPARATE SEWAGE- SYSTE14 X represent that I am wholly and comp,letoly reoppnolblo for the joqqtjoq#*'wq rknnqLnahlp, material,, construction and drainage of the peVagp disposal above described property, and that it has begin system serving the abq ponstructpo as shown on th' o approved plan or approved amendment thereto, and in , 4peordAnce-wIth the standards, rules and regulations of-the Putnam County Department of Health, and hereby guaranty to the owner, his 41PP004- qQr4 r .:ei' place in good ppera.ting condition any part 0 , I or assigns, to pl . said system constructed by me which rails to operate for a period of pWo - yqap.4 ImmodIgtely following the date of initial use or the sewage 414poo Al' I system: or.Any repairs made by me to such system, except where the failure to opqrgtq properly Is caused by the .willful or negligent, or the . oc 9 pu� pant of th e m building utilizing the system. The uqderpi$ned further agrees to accept As poncl4sivq t4a op" ers it a t of the Director of the D men lth r-. .1vision of Eny 1.ron TI) failure of. tk�o- -a sod by the willful or neglioent system to operate was o4.1; act or the qqqgpont or tho'building Ut1l1z1Pg the system. C!4.V of. /I'- A2kag r VIZ.- Titlet J�r corporat ion, Amd and address d WE'S (3) QOKFI.4 ARE R.EqUIRED WITH THWE (3) COPIES QF , IN.A PLA . N Q9R T 1FTqAT9Q- QQNFLF TION WILL BE ISSUED. GUARANTOR TS RESUIR9D TO FILE VOTIC4 OF DATE OF FIRST USE OF SYSTEM, tea„ XviOqn. Pf Environmental .041th $qrv1qeq# p4t;lara Ppunty Departmopt of 91041th WELL COMPLETION RE-PORT 4 a PUTNAM COUNTY DEPARTP,ENT Or HEALTli 3171 Division of Environmental lloalth ::nrvicos COUNTY OFFICE FJUILDING • CARAMEL. NEW YORK Thic report is to be completed by w0l driller and sut••.:410 °o County Health Depirtment together with laboratory report of analysis of water sample indici,ting seater is of satisfactory bacteria[ quality before certificate of construction complionce_Is issued. �.• _ S' rcruT'.' i:V a i'' °il'' � i"Ai 1' El) L'iITH�� -I'j*O DAYS OF t.ELL COP.iPLETIOtJ OWNER NAME ADDRESS .Z. /fd LOCATION o (No. 6 Street) (Town) / _ OF WELL wo OA D CO (PROPOSED DOMESTIC ESTABLISHMENT. FARM TEST WELL USE OF Vd Ell SUPPLY 1 D AIR INDUSTRIAL CONDITIONING El OTHER ) DRILLING a ® COMPRESSED a CABLE Q OTHER EOUIPME14T ROTARY AIR, PERCUSSION PERCUSSION (Spe:ify) EASING LENGTH (feet) I DIAMETZF.(inches) Y�EIGHT PER FOOT DP:YE SHOE- - (�' El I'DYESN DETAILS J �j /7 L:! THREADED WELDED YIELD TEST D FAILED ® HOURS PUMPED (� COMPRESSED AIR G.P.M. O (Lot Nuit01) YES u ko --- YIELD (G.P.M.) WATER MEASURE FROM LAND SUnFACE— STATIC(Specrlylect) DURItvG YIELD TEST (leer) Death of Completed We!I LEVEL `�-d in feet below land surface: 4411p. MAKE LENGTH OPEN TO AQUIFER (feet)_ SCREEN DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL GRAVEL SIZE (inches) FROM (loot) TO (tool) PACKED: 'TH FROM [AND SUCFACEI - -__ FORMATION DESCRIPTION rccr i.# r��r J- 1'0 3,ed 41 .4, v C Of yield was tested of different depths during drilling, list below FEET I GALLONS PER MINUTE Diameter of well,including grovel pock (inches): :ketch el2et loLalion of well with aist3nces, to at least two permanent landmarks. � t 1LL COMPLLILD DATE OF SlLE'Onlr JwELL OnIL.LEn (Slgnatura) �® 7 0 �.o l ''"c��".•. .,,- h.• d S 5 .. t R. 5 C �3 '2lft� :7 s 1 HYkJ r', w T K, v Y y t ,+ T r 97 ` _ a :.. �'n..` {. . •,- �..x. a._.�....o.�..... : ,:•� �•.c r .. u ....+o �� � ;n.. -.. n ta, +:. ram " ryr•' -aie �.` x y��.tE'� . � !. , v, , .Y ., a fk•Ij goo 4;A4 IV W, e -/, 4, — S 1 %o0` { 7,o, &-:' , ryre7" , -1,4s ,age G'z ,sTR4ICT�p AS /0 FEB 1 v 1978' __ -WO 0./::) eS ` OUT OIVISiON OF 4Ot1.Ifi0NMIENTAL HEALTH SEPV" REVISIONS GEORGE A , H;4UGHNE -Y, P. E. CONSULTING ENGINEER Via` S.-� f �Sti11 ) f,. . � F 5•.,` .' `. !. Route 52' Carmel New York 10 1 `J. + TITLE y{!� r(.!'•111'.�Lf ` i � 1, -.• t'-r �^ ,`.' rya p� �`�) sSCALE DR.— BY .. i DRAW &W D,, BY •R�� • - e}. - _ STAN P.AT PRODUCTS C�QOY r 2 �•, a: r k. •rit eft r y j: r Q rhfl� ti ti yySM giflot. N.Y. FF LTI .,Town 'or, Village 7 77 resi ScjUard-� Feet NurnbWc be t6nstruct Water_t(jp Y, re as,shown o" an a License PI Tit m PUTNAM COUNTY D PART sl T OF BF,'ALTH DIVISION. OF ET VIRON CTITAL I-ILl1LTTT SERVICES CuUiG'i'Y O2''FI`Cr, YUILuIJ`iCr %AI�Nl,i.,;,.N:.• 112t DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM. FILE NO. Owner Address WD ©� �1CSET Located at (Street Sec. Block JP 'Lot 6ndicate neares-.cross street) Municipality. Tic -1q�1 11AL4�" Watershed SOIL PERCOLATION TEST DATA REOIIIRED TO BE SUBMITTED WITH A PPLICATI OPTS Role Number CLOCK TIME PERCOLATION PERCOLATION Run No.' Start -Stop Elapse Time Min. p i. Lo -.a -er From Ground Surface Start Stop Inches Inches water Level in Inches Drop in Inches Soil Rate Min. /in drop 2 /�'- /; X7.5 i© Ufa wllo 4-� 4 AV 3 /;'S� -�'O� 4 • 5 • Notes: 1) Tests to be repeated at same depth•until a roximately equal soil rates are obtained at each percolation test hole. Al data to be submitted for review. 2) IX;pth measurements to be made from top of hole. TEST. PIT DATA REQUIRED TO -TTE DE SU13M] 0..WI'9'11 APPLICATION DESCRIPTION OF SOILS IN `.VEST HOLES DEPTH HOLE. NO. HOLE NO. HOLE NO. 611 1.2 777 1 Id 8 24 �6 4811 5.4 60 66.. 7 211 7811 8411 n INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE 'LEVEL TO WHICH WATER LEVEL RISES A T R BEING ENCOUNTERED TESTS MADE BY Date 17 -.-' Soil Vate. Used MirVl"Drop: S�.D. Usable Area Provided �No. of Bedrooms Septic Tank Capacity 0 Gals. A VP Absorption Area Provided BY-2f490 L.F.x2w, 5b" width trench... Other ame SigHature LC Address IPA THIS SPACE FOR USE BY HEALTH DEPARTM, T Soil Rat*e Approved Sq. Ft/Gal. Checked WIT tz bw PUTNAM COUNTY DEPARTM T OF HEALTH vr" Ev V 1tiuN°i TAL ff8kfr H SERVICES - Date 77 Re: Property of �E'p fiAl2 r Located at V I-a -r Mpl� / " Section 3G Block 3 Lot_ Aped 00 SuB P1016/0'i DaR cdr+-. G Gentlemen: This letter is to authorize George A. Haughney a duly licensed professional engineer X or registered architect (Indicate) 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 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 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. CountersigrX P.E., R.A- ,`: #`V Q43.8, Route 50.% °2:„ k(Seal) A ress F Carme.l,. :N. Y.''10'S'l2 , (9 14 2.25 -9353 Telephone Very tr y yours ED /fR T l714 i4DE7eJ XA) C. Signed Owner o Property Address .Telephone