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HomeMy WebLinkAbout3336DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.05 -2 -17 BOX 27 03336 .T Located 2! _ Subdivision T PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 k PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Val l.ey Lake Drive Town lamp _ LOOk o u t Owner El I o Giusti Building Type 1 fam i 1 y res i den C& Area 1.154 acres Number of Bedrooms 3 Design Flow 6 -7 Separate Sewerage System to consist of 1000 Gal. Sept- ank To be constructed by —not selected Water Supply: Public Supply From * Private Supply to be drilled by not/se Address , ,. Other Requirements Lot Job _ Address Sprout Brook Road Putnam Valley, N. Y. Total Habitable Space 1 500 Square Feet and 300 LF ; of 21 -011 wide trenches NCE I represent that I am wholly and completely responsible for the design and location of the proposed s above described will be constructed as shown on the a ) 1) the the sep swage disposal system approved amendment there to and in accordance wit tide rd is ations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Complia be submitted to the Department, and a written guarantee will be furnished the owner, his successors. '� ; mmissioner of Healthwill place in good operating condition an wilder, that said builder will y part of said sewage disposal system during the period ,of two (2) ye following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original tem or an re will be located as shown on the a p Y pairs t ereto; 2) that the drilled well described above approved Ian and that said well will be installed in ac rd �ce with the an rds, rules and regula l�`Ons of the Putnam County, Department of Health. Date September 28, 197.6 Signed P.E. R.A. Address Box 417 Deer q Pla Katonah 11056 icense No. APPROVED FOR CONSTRUCTION: This approval expires one y the date issued unless co truction of the bu' ing has been undertaken and is revocable for cause or may be amended or modified when considerary by the Commisss Of Health. Any change or alteration of construction requires'a new permit. Approve for disposal of domestic sartRitny fewage, and /or Drive 04a supply only. Date © °�� By Title 34 c, S' 2 { - PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental, Health Services, Carmel, N. Y. 10512 permit s IT CJ• aw C c 'L•rfullAP9C i� C CA I-`1:i',i`71-CaA - ,.1r Gl::� �P:- l.... - �.._.::.;. Town or Village Located at Lake Drive Tax rap_54 Block 6 La Owner Elio G lu s t i / Formerly Tax Flap Lot a subd. Lot s separate Sewerage System built by Wm. Cotrell Address `Putnam Valley . N. Y. Consisting of 1, 000Gal. Septic Tank and 301 LF of Leaching Trenches Other requirements Water Supply: Public Supply From X Private Supply Drilled ByNorman Anderson Address Barger ST., Putnam Valley N.Y. 10579 Building Type ( 1) Fam. Res. No, of Bedrooms 3 Date Permit Issued 10/6/76 Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially of which are attached), and in accordance with the standards, rules and regulations, in accord Putnam County Department Of Health. f� Date 10/22/84 Certified by Address Flu n ULJ LJ 6 lvvi I i• i % Any person occupying premises served by the above systems) shall promptly conditions 'resulting from such usage. Approval of the separate sewerage I available and the approval of the private water supply shall become null and subject to modification or change when, in the judgment of the Commies Date By on the plans of the completed work ( copies the filed 94an, and the permit issued by the - P.E. R.A. X No. 1 1056 ,%5h actin as may be necessary to secure thVC0r►0di0n of any unsanitary all b ms null and void as soon as a public sanitary sewer becomes whe. a public water suppl becomes available. Such approvals are of ealth, such revocatio odificatlon or change Is necessary. Title - TOWN OF PUTNAM VALLEY WELL D/R�ILLERS AND REPORT ALOG ej;. .�.. .- ..- ,7�_.r -. `_ .:<.e_vl.. .V.+ «?��d.`5AC•i,s' ;jFj This report is to be completed by well driller and submitted tdo,~ Bldg. Department, together with laboratory report'of analysis of water sample indicating water is of satisfactory bacterial quality. Well Location Ta ap Street Sec, Bl, Lot Uap Well Owner. G - Na Mailing Address City or Tow Tel. # Well Drille lt.J Name Mailing Add s 61 City or Town CASING DETAILS I YIELD TEST WATER LEVEL SCREEN DETAILS Bailed. 7Y_ Measure from land surface Length or Pumped Hrs, Static: Ft. When Bailed Slot Diameter:i Inches Yield: GPM or Pumped, Ft Length Ft. Size Kind: Diameter In. TOTAL DEPTH OF.WELL aZ.5 Feet WELL LOG '' =Depth from Give description of formatioms penetrated,. such Ground Surface as: Peat, silt, sand, gravel, clay, hardpan, shale, sandstone, granite, etc. Include size of gravel (diameter) and sand medium, coarse), _(fine, cement, soft, hard)'. For example: 0 ft. to 27 ft. fine, packed, yellow sand; 27 ft. to 134 ft. _ iray granite. Feet to Feet Formation Descri tion Date Well Completed 3 a Date of Report Well Driller — Signature BZS 1 -77 I F1 in hiil.cti Owner or Purchaser of 3uilding .1 in riLat-i Building Construct�:d by Lake Drive Location - Street (1) Family Residence Building Type _ Town of Putnam Valley u.- Ii 54 Section 6 Block 12 & 13 ' Lot GUARANTY OF SEP :RATE S3 `_GJ S_rSTE: I represent that I a_m wholl -r and completely responsible for the location, worl---n-anshiD, material, construction and draina_.e of the se?•; s'e disDOsal system serve -o- the above, described proper'-;r, and that it has been Constructed as sho ?:'n on the a_L-- )roved ola1 or apDrcvi _d ''are"_' i�':ien - the -ego, and in accordance t:_ tie standards, rules ana revullati -�'e u`n __ o _s o� .,�_. P J a.-� l�O�.�iYl -�T De '. rt, en` Cif __.: d, _ an,; hereby ._ ,gran Jv Jae S .s cce S. � sots, 3��> 0=' ?SS == ?S, �o �l?c° li: = JQtiVOOe_' tyn� !--0= id_t_'On ar-- zD 38.23 SJ Sty.: ^_ CJP_ _'�i �eC b'- __e ?:.�_C:_ =a �� 3 t^� O ^e te for ^_ =ri0 O_ `•:O J years ir_"'ediate-ly fol'1 o 2n' tilt' .a.ate of _n - al use o.^ t% _T.:a -e .•y - �^� l J... V J_ SV L:_v..JV.7� system, or any -S _._clCI3 Der 'Me t- 0 SuC_: S " "S U._c t0. Operate �'op:rly s caused by ,he .._11': l e- ne f _c'•,n- act of tie Deco- .. X-z �l .��. �'e- ...y-stltsJ- w...� -� �.�;.•_'lv.....- .•.'.� -�_ • ........•.........� ..re . .._'ay _,.. or- vi- ;...fie._.. -�... The unders.6-ned further abrees to accept as conclusive the de- termination of the Director of the Division of a.iviror_men Jal Lealth Ser- vices of the Putnam County Department of Health as to Trrhether 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 2 day of Ju ovC 197? Signature Title 0,0f-4TRAe_ o :Signature THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FIiiAL PLANS BEFORE CERTIFICATE OF COiPLETION WILL BE ISSUED. GUAM N ' OR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEi %I. '••sion of Environmental Health Services, Putnam. County Department. of Health YO RKTOWN•M ED ICAL LABORATORY INC. P.O. Box 99 321 Kear Street LOCATIONS: t t� c �1 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598.245-3203 Yy'kt�W -. n�N, °I htS, N Y, 10598 _.❑ 201 BUTTONWOOD AVE.. PEEKSKILL. N.Y. 10566 737.8777 245'3203 ❑ STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278.9: LAB # 1411a DATETAKEN: 9/26/84 10:'30 - �- -� DATE RECEIVED: 9/26/84 1 ne m ELIO GIUSTI DATE REPORTED: 9/28/84= SAMPLE SOURCE' OUTSIDE SPIGOT LAKE.CEDAR ROAD PUTNAM VALLEY, N51 YORK. L 528 -1675 J LABORATORY REPORT mg %L REFERRED 8Y: C"ee SS- / -ed/". S . _ y COLLECTED BY: ELIO GIUSTI ❑ ACIDITY ............................ .................... ............ ❑ ALUMINUM ......................... ... ............................... ❑ ALKALINITY ................................ .................... ❑ ANTIMONY ................................ ..............:................ BACTERIA, TOTAL/ml- .............. ............................... ❑ ARSENIC ....................................... ............................... BOD, 5 DAY. ❑BARIUM ❑ BROMIDE ...... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE ........................................ ❑ BISMUTH ..................... ............................... ... ......... ❑ CHLORIDE ............................................................ ❑ BORON ........ _ ......................... ............................... ❑ CHLORINE ............................ ............................... ❑ CADMIUM ....................:............... ............................... ❑ COD ..... ............................ ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ................ :.............................................. ❑ CHROMIUM (tot.) ............................. ............................... ❑ CYANIDE ............................ ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ............ ............................... ❑ COBALT .................................... ............................... ❑ FLUORmF .......................................................... ❑ COPPER .................................... ............................... ❑.HARDNESS ............................ ............................... ❑ GOLD ....... ............................:.. ............................... ❑ MPN COLIFORM COUNT/ 100 ml ............................... ❑ IRON ........................................ ............................... MFT COLIFORM COUNT/ 100 ml ........................ ❑ LEAD ........................................ ............................... rnp.�crNis- {jav;TFS7 4 ❑:1_.ITHIIUM- - ... ❑ NITROGEN, AMMONIA ......................... .....n.....•.....� ❑ MAGNESIUM ....................................... .......... ....::....: ❑ NITROGEN. KJELOAHL ............ ............................... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ............ ....................:.......... ❑ MERCURY .................................... 0......................:....... ❑ NITROGEN, ORGANIC ......... ............................... . ❑'. NICKEL ........................................ ............................... ❑ ODOR ...... : ...... . .................................... ............. ❑ PALLADIUM .............................. - ....................... ......... ❑ OIL & GREASE .... .. ..................................... :........... ❑ POTA$SIUM ................................ ............................... ❑ PH .................................... ...........0................... ❑ RHODIUM ..... :................................ ............................. ❑ PHENOL .... ............................ .. . .......... .:................... ❑ SELENIUM .................................... ......................0........ ❑ PHOSPHATE (ortho) .................... ............................ ❑ SILICON ❑ PHOSPHATE (condensed) ............ ............................... ❑ SILVER ....... ..... .................. ...0........................... ❑ PHOSPHATE (total) ................ ............................... ❑ SODIUM ........................................ ......... ....................... ❑ SOLIDS. SETTLEABLE, ml /L ..................................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ............. ...................0........... ❑ ZINC ............................................ ............................... �. ❑ SOLIDS, DISSOLVED ........................................ ❑ .................................................... ...................0........... ❑ SOLIDS, TOTAL ................................. .................... ❑ .... :......... . ................................... . ........................... . .❑ SOLIDS. VOLATILE ................ : .............. .................. ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE .......... . ..................... .......... ❑ .................................................... ............................... ❑ SULFATE ............................. ............................... ❑ .................................................... .......0....................... ti w ❑ SULFIDE ....................................... .................... ❑ .................................................... ............................... ❑ SULFITE ............... ............................... .......... ❑ .................................................... ............................... ❑ SURFACTANTS ............ .......... ..............::. ❑ ❑ TURBIDITY ......................... ............................... ❑ .................................................... ............................... THESE RESULTS INDICATE THAT THE WATER WAS - OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED.' NpTHHE�ESE��RRKKESSULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY 01' N,%YPARAMETEADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72). ,.A . I 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 Elio Giusti Address Sprout Brook .Road, Putnam Valle , N. Y. Located at ( Street 6dicate Lak? :Drive See. S4 ` B1o2_ �3 Lot neares cross street) Municipality Town of Putnam Valley Watershed Croton SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS "'Role 5 _ 1 Number CLOCK TIME 3 PERCOLATION PERCOLATION HUM Elapse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop DIophin Min. /in drop Inches Inches nc 1. 1 4:oo --4:18 22 25 3 18/3 =6 2 4:19 - 4':37 22 25 3 18/3 =6 3 4 :38 - 4:56 22 25 3 18/3 =6 4 5 2. 1 4:05 - 4:23 24 27 3 18/3 =6 . 3 4:43 - 5:01 24 27 31 18/3. =6 4 5 _ 1 2 3 4 5 Notes: 1). Tuts 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.. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. 3 �. T - C A.,�j;.r ter., l 1. Sic np-c Canal G� $m3 j 1 �;'_{?n o: .�a_�`i j' �r;�� 1 1 Stones ^ _ U' 6„ 12" 1811 ,; 24„ r. 3011 3 42" " 48" 5411 60" 66" 72" 7811 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED none encountered INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED not applicable TESTS MADE BY Joel Lawrence Greenberg Date September 8, 1976 E- GE V Soil Rate $sed 6= `7 Min/1 "Drop: S. D. Usable EP rp d 5000 S. F. RFiNCE GR Cyr No. of Bedrooms 3 Septic Tank Capacit 1000 �,` �'ls. F Absorption Area Provided By 300 i.F.x24" )kid enc . Name Joel Lawrence Greenberg bignatu 6 Address Box 417 S �A 4, °' 0110 56�0� Deer Park Plaza OP NF-%p Katonah New York 1053 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date