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Home My WebLink About3356DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.05 -2 -67 BOX 27 I I 11 9 I I ' � � � '�' i Ito 81 or �, ' � or ` i ±'I: T r , r., Nor orl Till .�nxel PUTNAM COUNTY DEPARTMENT OF HEALTH n Division of Environmental Health Services, Carmel, N. Y. 10512 :. ....Putnam... Valley" (T)' __..- CERTIFICATE•• QF'- CONST.RUGT-ION-- C0MPLi'ANCEi-+0R SEWAGEaDISPQSAL SYSTEM'' ' r -`w• t,dti�r Town or Village Cherry Lane 59 2 Located at Section Block Edward Dioda 202 Lot Job e Owner i Roger Heady Caro us f ?ollow Road Putnam Va1le,yr Separate Sewerage System built by Address 278 3611 Ii Consisting of IOOO Gal. Septic Tank 270 lineal Feet X 36 width trench Domestic Use Only Other requirements Water Supply: Public Supply From X ?Uckey Well Drillers Private Supply Drilled By Address Sprout Brook Rd Peekskill hTew.York 10 ®'et n ® e c Building Type RaiSCi Ranch No, of Bedrooms ® itsls • 3` O Has Erosion Control Been Completed? Yes o � 1�4 O • `�a,....c;• • $ s I certify that the system(s). as listed serving the above premises were constructed essentially as shown on the p%! the a wor (lies of which are attached), and in accordance with the standards, rules and regulations, plans filed, and the permit issued Liy th PtfneftL�Canty a�tment of Health ax Date October 22, 1976 Certified by ' • ,6 Q X R A *' Address 1 idorthridge Roa Peekskill, Tdew Yoz^°4CAAo. 027846 } .' 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 becomeV,r , available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals:_aie;,.,. ',• subject 'to modification or change when, in the judgment of the loner of Health, such rev modification or change is necessary. Date —! ti `�� v BY V� Title 4._.,. ,. .-,..,^.— -.,.. ,4_r --r- ti� T._.. ..- r,- ..,..- .�..,--- '<.- ..;..'- - .-,F'. "''�-•^- --at^r.... m;±.- ,r'�m.T. a^,1- .a' �,t 4a �l ✓�? " `U, ' PUTNAM COUNTY, DEPARTMENT OF HEALTH I vision of Environmental ,Health Services, Carmel, N. Y. 10512 (ONSTR- lJCTION :PI�F39IIl.j..rFUhEl ^JGE` DISPOSAL :SYSTEM-. Cherry ` Lari@ y, Town or Village r Located at Section Block 2` Subdivision Nona Lot •Z' Job Owner Fdward &- Frances Dieda Address . , RFD 2 Oacawana T-ake Road Raised Ranch 42 000 SF Fatnam Valley , N. Y. 10579 Building Type Lot Area 3 1350.. Number of Bedrooms ' ' Total Habitable Space Square aF..eet 1000 Separate Sewerage System. to consist of Septic Tan 240 lineaAlp.� x 3 6n witlth To be constructed by Roger Head Adtlress Ciano flow Rd ` a, Water Supply: Public Supply From a N Y 0,," X Private Supply to be drilled by ll Dr �. r , S' Out Brook FD ®o `' { Address 11 566 aF$ Other Requirements Minimum 0$' 50 feat with oute o Septic . a om high water of I represent that I am wholly and completely responsible for the design and Ioc5VA of thl proposed system(s .1 a r ge disposaPsy"s" te m: =' above described will be constructed as shown on the approved amendment there to and in 11ccordance with t egulations o t e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliareel R mmissioner of Health wilt= be submitted to the Department, and a written guarantee will be furnished the owner, his successor-s4% lder, that said btulde►';wIll'' place in operating 9 P ' good o eratin condition any part of said sewage disposal system during the period of twm i *ing the date of the,;issu ance of the approval of the Certificate of Construction Compliance of the original system or any y@ ttlie t 14d well describedYat will be located as shown on the approved plan and that said well will be installed in accordance with ttp dard t ns of the Putnam. ... .. ® il County Department of Health;' .March 8, 1,976 " } Date -,.Signed • . - �... g - ...... •. _ . P.E. R A.` . ,Yy Address �, torn, D� ple Rd Aknld l l ' Ili ors� �>' ?7866 Litems eNo. 0 27TLE APPROVED FOR CONSTRUCTION: This.approval expires one year from the date issued Inu ess construe b1NRlingehhas been undertaken `a revocable for .cause or may be amended or modified when considered necessary by the Commissioner of Hea a or alteration of const u requires a new permit. Approved for disposal of 'domestic sa�n' y wage, anlld /Co,r� aat+e dater supply only. Date _ v��'��j. BY /ICY '1(aLa!l Title PEEKSKILL'MEDICAL LABORATORY -1870 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 Peekskill, New York 10566 PE 7 -8777 DATE COLLECTED RESULTS TS OF EXAM IN. AT,ION OF WATER TIER ER DATE RECEIVED "I lc'ao' 7/,9 (,VILLAGE, TOWN VOR-NAML OF SUPPLY DATE REPORTED acrro kare-. � tt�oaun Vxncd PLING.POINT TERIA PER ML. (Agar plate count at 35"C). COLIFORM GROUP (Most probable No.1100ml.) HAKLJNLbb,'1TJTAL-pprn h SS Q ERGENTS-'pp- NITRATES (as N): - ppm IRON, TOTAL - ppra URIDE (F) - mg./I. se results indicate that the water was of a satisfactory sanitary quality when the sample was collected. PADOVANI, M. T. (ASCF) Qwner or Purchaser o `Building 2Municipalit Ir Building Constructed by f ct on Location - Street Block Bu ding T ype ._. .__ Lot GUARANTY 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 guaranty to the owner, his succes- sors,'hei,rs 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 de, termination of the Director of the Division of Environmenral` Heal th Ser- vic.es-of try Putnam Coun,i;yrD:0partjrAent -oi Health ".as..: o�`whe: Yier, ° -or rot e- °- 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,_ day of OCR: 19 Signature' Title (If corporation, give name and 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: J / � r COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH Y Division of Environmental Health Services r,-',QFFICE- `W2 Cr1'KfG' CAtiIVIEb -f�hE W'=YaFt� -:�'.. �,. This report is to be completed by well driller and submitted to County Health Department together with laboratory 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.. ` //) �� / L- %%� ADDRESS! �lC J Z L /—/� 1 Li1,%� �/ / "� + LOCATION (No. 6 Street) (Town) (Lot Number) OF WELL " R V ZANE , J j ❑ ❑ ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ El ❑ (S(Specify) ❑ SUPPLY INDUSTRIAL CONDITIONING DRILLING j�/j a COMPRESSED a CABLE ❑ OTHER EQUIPMENT ROTARY AIR PERCUSSION PERCUSSION (Specify) CASING LENGTH (feet) DIAMETER {inches) IWEIGHT PER FOOT [V ❑ DRIVE SHOE [EYES ❑ W�/�� S, C� SING nUTED DETAILS J�-' THREADED WELDED NO IL'YI YES U NO YIELD HOURS G.P.M. ❑ ❑ YIELD (G.P.M.) TEST BAILED PUMPED COMPRESSED AIR WATER MEASURE FROM LAND SURFACE — STATIC(Specify feet) DURING YIELD TEST [feet) Depth of Completed Well LEVEL in feet below Land surface: MAKE LENGTH OPEN TO AQUIFER (loot) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (inches) FROM (feet) TO (lest) PACKED: gravel pack (inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET D i L �A)VD P,VTk � { �i 3 v �i C S01,1'9 T / r Yti G If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE 3j lop E DATE WELLCOMPLETED of 710 DATE OF REPORT : To � .� l'i ylo WELL DRILLER (Signature) r� �� r1i�� ° PUTNAM COUNTY DI PART,"40T OF HL''ALTf{ DIVISION OF F,NVIRONMEL TAL HEAL'TII •SPRVICF_.S. Date March 1, i976 Re: .. Property of Edward & Frances Dieda Located at Cherry Lane Putnam Vaney Section �'`j Block Lot Z,Z Gentlemen:.�. This letter is to authorize •John S; Rom ®o a duly licensed professional engineer x 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 promulagated by the Commissioner of the Putnam County Department of Health, and to sign all nece$sary papers on my behalf in 'I�II'ffl'i�.!• V 11111 ti/ -I 1-M 44 ;4TI ! 1'n Cnninrwi CP Vhrl n'nnR TY+t 1r., i on nr cai n . system.or• systems.. in- conformity with the provisions of Article-145 or 1.47, Education Law the Public Health Law, and the Putnam. County,_ Sapi= �..:..... •... �. .r •- _. -. .- r,..., -. �.v... _..,.... ... ✓_,�- 'c...-w....�,- r' -l'.. ..:.•. -.t ... r_.. _.�.n._.... .r :..'s+r -. �.._. .. -�. -. w... a.. .w., ..,.Z- .- ,.'y.. .a ... I. .«•..._ Lary Code. Very tr yours, - Signed O<linerof Property Countersi ned •��''..(� Address,, P .E ., RMIXT # 027$46 Z 1 Northridge Road _;,gym „gym Telephone Address ga �SS�pN�. �NCIyfF "m® . Peekskill, N.Y., 10566. 737 - 1056y Telephone, -�. 10 U PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CAR MEL, N. Y. 10512 DESIGN DATA,SBEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner 'Edward4 1?rawes Dieda Address #2 Oscawana Lake Rd Putnam .Valley 10579 Located at (Street Cherry Lane 'Sec..3'"9 Block Z Lot 21 �7n_dicate neares cross street) Municipality Putnam Valley (T) Watershed Peekskill SOIL'PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number' CLOCK TIME PERCOLATION PERCOLATION Elapse p o a er Water Level No'. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in. Min. /in drop Inches Inches Inches (1i l 4:32 4:.59' z7 1705.0 20.50 3a00 9000 2 5:02 -5:32 30 17.75 20050 2.75 10e91 3 .__ 1 2 3 .5 Notes: 1) Tuts to be repeated at same depth until aroximately equal soil rates are obtained at each percolation test hole. A11 pp data to be submitted for review. 2) Depth measurements to be made from top of hole. 60" 66" 72 78" 84" INDICATE LEVEL AT WHICH .GROUND WATER IS ENCOUNTERED over 70.0 feet. INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 6 °75 fine.t TESTS. MADE BY John S. Rom ®o Date Marsh, 1,"1976 Soil Rate Used 1715 Min/1 "Drop: S. D. Usable Area Provided 5000 SF No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. °Goo Mssmry Absorption Area Provided By 240 L.F.x24" � x o®° gnc . e Name_ John S. Romeo SignaturET a 1 N„rthridge Road 23 Address SEAL o x""'. ,<2J8�6 0 ° N[t a .� THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ° °ao,,,, g Soil Rate Approved Sq. Ft /Gal. Checked by Late 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 � „opsoil, T Topsoil` -` 6” 12" 12" Topsoil 1211 Topsoil 1211 Topsoil 18" sandy loam,. som® sandy loamo som® sandy loam som® 24" stones & silt stones & silt stones & silt 3 36" 42" 48" 54,. 60" 66" 72 78" 84" INDICATE LEVEL AT WHICH .GROUND WATER IS ENCOUNTERED over 70.0 feet. INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 6 °75 fine.t TESTS. MADE BY John S. Rom ®o Date Marsh, 1,"1976 Soil Rate Used 1715 Min/1 "Drop: S. D. Usable Area Provided 5000 SF No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. °Goo Mssmry Absorption Area Provided By 240 L.F.x24" � x o®° gnc . e Name_ John S. Romeo SignaturET a 1 N„rthridge Road 23 Address SEAL o x""'. ,<2J8�6 0 ° N[t a .� THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ° °ao,,,, g Soil Rate Approved Sq. Ft /Gal. Checked by Late