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HomeMy WebLinkAbout3383DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.08 -1 -27 BOX 27 III iyti M VOL r .r lok 111 0 00 I. I is el M re Me M as I o,wp,,or,,.-yplage, •-;-width,, renc o f which are hi offlealth. t-7 3�l 1- wLicense No Such ,--,'appr,oXels .,are ti. I z J r + Cs s d��. ai �• . e Y fit. 54 67 6z �7 T. vUT /ir'",,eS A .5 /� G F3 MEW dMVIRQNIl4pN7Al. lf� At i �- 3F��•'!�?,�'` �� s: SU ,� � ` ,� ,7 , : Caner car Pu`rc zasor o'f bu�]_dih Mun�eip.ali oel 2r ... ..•.� .: C : m c 'i'!i'%t , _- - -. - �.•�. i ... +, a...: rt:ri. � ... :,�. �: � :: '�'" �.✓ , _ :- o-i>= f_.`� .. ,',�:e,a ;�w;:J!:: n...r..w�.`'rs'(;•': _ R uila�n Constructed b Section. f �. hoeaton - -Street r Block : : ' e Buildir g 'Type Tot GUARANTY OF SEPARATE: SEWAGE 'SYSTF, I. represent that T am wholly and completely responsible. for., the location, warl<manshp . ma'tc�x',aa_, aostruotaon and drainage of the ,sewage disposal system Serving they above �describ d properfiy and ,that, 'it has been Cgllstru ' ted - as, shown - on the approved. plan or apps ed amendment thereto, -'and ln=ppeordance with the standard rules and regulations of. the `Putnam County Department of Health, and hereby guar�9 y to k}1e owner, ..his ;suceeasors, hears or ,assigns, .to place .in .good . operatano condit:on any part o . said system eonstructeci by. me ;which Ca .1s tg. operate 'for a perigd o: two years .. ijpjnqd1atqf Y . follow�.ng the ate of. initial. use p f the sewage disposal system,, o' any repairs made. by me to'. such system; exeep ,where:,tlle failure to oper,a'tey properly is caused by the .willful or neolient.act.'of .the occupant of. tie btildins.utili.za.ng rip The under. ionet! further agrees to. accept as conplus ,ve the de termipafiion of the Director of the Division o Fnvironinendal HeaIt 5���'vioes a� the Putnam . Count Department. of He as ; o whether' or, nofi the 'fail of _ the - system to..,Qp.erate was caused by 'the will fi ] ar 4 neg7; ger{t': act of the accu ant ofrthe bu i . 1 ". .ut" fling the system. L 't�: ` w-C Dated this day of _C�ck� 19 Signature : _�� enera ConC�actar Signgturea �.> Title Septic G ®r{tt�actor (if corpohatioo, give 'name ah'd ad�dre -- - THREE (3) ,COPIES ARE R_Q111.REU WITH THREE,. (3) 'COPIES QI' FII�rAL PLANS B� FORE GERTIFICAT OF COMPLETION taTLL BE ISIIED, GUARANTOR IS RE UIRED TO...PILE NOTICE. OF DATE OF FIRST USE OF SYSTEM. Division .c{ Environmental. }{ea1'kh Ser�vieeS, Putnam Cpupn y ' fepartment of Health 'i Val Pete Construction Co, Grandview A e 1/4/74 CITY, VILLAGE, TOWN VOR NAMt OF SUPPLY DATE REPORTED, Lot#12,Block 8,Tm 62, Boswell Subdivision 1/7/74 SAMPLING POINT Well BACTERIA PER ML. (Agar plate'count at 350 Q. COLIFORM GROUP (Most probable N6. /100ml -) less than. 2.2. I ITAL - ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL = ppm FLOURIDE (F) - mg. /1. These results indicate that the water was yes of a satisfactory sanitary quality when the sample was collected. A. H. PvADOVANI, M. T. (ASCP) r ,Msab�sster County Department of Health . Division of�Environmental Sanitation WELL CCKnzTION REPORT This report is to be completed by well driller and submitted to Health Department, together with. laboratory report of analysis of water sample.indicating water is of satisfactory bacterial quality, before certificate of constructicn compliance is issued, Well construction to be in accordance with Bulletin 30-62 ®RULES & REGULATIOM RELATING TO INDIVIDUAL WATER SUPPLIES" LOCATION: MUNICIPALM .BLOCK MM CSR: V/;/ /fie c� /mss /C'e �' �/�i o.� �'ui✓�.� %% 1� /� Nam . Address City and Town WELL DRILLER: Cl•- /6ee i wi - -- -- _e!V ,O/e %�i�e. / /'- 1�o,✓6C /t� _Bailed '(measure from land surftce) Length: Feet' or ' 4a t_LPumped Houra:Static: 3 Feet' Make: ■ ■Men Musa ■riot; Diameter: 6/1 Inches'Yield• 3 G.P. &for Pumped 1XZ) Feet Length Ft.tSize Kind: t ' ' Diameter In.' TOTAL DEPTH OF WELL 37,r FEET i.4 i� .: DeP!tih PY___: G _v® -depcs;os?'Qfry forn�wtc�na `penetrated,. such .,ksa peat; silt, sendoval, Ground Surlaee ' clay, hardpan, shale, sandstone, granite, eta. Include size of gravel diameter; ' and sand (fine, medium, coarse), color of material, structure (Loose, packed, ' cemented, soft, hard). For example: 0 ft. to 27 ft, fine, packed, yellow sand; '. 27 ft. to 131_. ft. gray granite. 0 n.to A9 Ft. t nl.& -o igio/� / / Ft.to Ft. t C©•9 P•: try 4* cic: ' t - 4-0 Ft.to.2i4 Ft.' %ck' 4-ca,-- ,744 Ft.to3� Ft. t 67.-r— -P2� gee -car n.to.37J Ft. t 13-1-41e c..L&- Ft.to Ft.' t Ft.to Ft.t r Date Well Was Completed /� 1173 Date of Report Well Driller U& Signature WELL PIT AND PUMP EQUIPMENT Mums lie�aed de Cfioek pit"With to ® Pit with 4 —inch Gravity Drain to Baseunt Pitless Adapter — Casina Min, 12 Inches above grade Others. Describe PMPR Malto Type Capacity— G, P,MO StProgo Tanks Type Capacity Ga2., (42 Gallo Elmo DIAGRAM SHOWNG IMATI0N OF WEII ON PRMSES Indicate location.of..house§ well and s ctage' disposal system with distances, A1so indicate direction of ®lopes§ and direction with distances to all wells and sewage disposal systems within 250 meet, L�)'?'II I certify that the individual water supply indicated above was installed as per the ru1pe and regulations of Bulletin SDo62 of the Westchester County Department of Healtho Property lines or corners found . , a Can estimate house location a e a a a a a. Will driveway need cut a a o A 0 a Must trees be removed =note those., e.. . . Is deep hole representative of .entire SDS area Additional deep holes needed. o , . a :a a . .Sufficient SDS area available considering ..driveway cut: -house location,separation':.. distances; etc. a s a o. o a o_o 0 _.DEEP HOLE DATA Depths' Water elevation: Rock elevation: J • Soils description: V r. S. reif Date: FINAL SITE INSPECTION Ins b i.. -House located where shown-on approved plan. SM Tnca:t d, t; *here appr ie t.r ti /,f. I.` (._f •r-•1'fr.. .rG.e�:,11Ts-ai 24b 1�idth. of trench average. Slope of tale line and trench acceptable . o Room al1.owed for expansion trenches. a aft liel.CVtL •s a e o r .V` Natural soil not stripped or SDS.area unnecessarily graded o . . o G o. . 0 a . �e � 10 Ft . maintained from prop. line 'and _ 20 o from house . . . o . a ,a , a: o 'o .ft o . Separation of trench from house,. well etc a follows ph n a . o Number of bedrooms checks . o e :' .. o . o o o L� ... .a Stones, brush, -. stumps; rubble, etc. greater than 15 ft. from nearest trench . ... ... o _ :15 Ito of peripheral soil,_ horizontally. from. . trench • . -, . ®. o o . ., o .o .. - o :.:. o..,.. a a' o a o o - Junction. boxes prope�­ly set_* Could surface.run of from driveway- 9 roads, ground surface, etc. charinel near SDS ,: ; �e � 10 Ft . maintained from prop. line 'and _ 20 o from house . . . o . a ,a , a: o 'o .ft o . Separation of trench from house,. well etc a follows ph n a . o Number of bedrooms checks . o e :' .. o . o o o ... .a Stones, brush, -. stumps; rubble, etc. greater than 15 ft. from nearest trench . ... ... o _ :15 Ito of peripheral soil,_ horizontally. from. . trench • . -, . ®. o o . ., o .o .. - o :.:. o..,.. a a' o a o o - Junction. boxes prope�­ly set_* Could surface.run of from driveway- 9 roads, ground surface, etc. charinel near SDS ,: ; . area o o o 0 0 o 0 0 o 0'..* a._ .. a o oo' o' o 0 Does.l.ot drainage appear O.K. in area`of SDS 'FINAL GRADING OF SITE ACCEPTABLE le, REVID4 CHRECK. SBErFT /P I.Femov. Ao-/4-7-7 Meets Std. ( Remarks Yes No House plans O. K. ✓ Design data sheet Peres presoaked? Jjill. 30 perc test depth Const. results for 3 runs D. Role log O-K. C� Corporate Affidavit for other than individual Author*ization for eiigiiieer .Letter from Water Supply if applicable* If variance requested'such noted on plans '& apps.! t4A DETAILS if change is proposed,) Existing contours shown kshow new contours) ✓ Slopes for driveway cuts" etc, shown Water service line location Footing..drain., etc.'locatibn Top .slope, bottom- slope of fill Fill" Percolation tests and deep test pit location Septic tank size and *conformance to std., 3.B,.,R,. house minimum i V. I House setback shown 'ho I . . & -1 -., . kjt77 L J. L, ut b rc wUU,Uv kqi*U11.1.11 D-0 L-L,, . -c-L] bliuwll Plan and profile SW ... .. ..... All S o- o-- other wells and SDS closer 2001 own -refbr'ence grade - Property boundaries (metes- and bounds-clearly shown )i. SEPARATION DISTANCES SPECIFIED ON. PIA N' 101 to P.L. 201 to Foundation walls 1001 to Nearest well 501 to stream, march., lake., etc. (inci.expansion) 15' to Curtain drain 101 to water line (pits-201) 15' to storm drain 10.1 to large trees 01 from foundation to septic tank 51 to pipe from. leader drain & fo*-51=- dralin n 4 J.(,. rA _. �F'-.. .< ..v..yT .••= <.7. 1...- .. .�_. z -- •`r._.iqc, n,: C. 'i:v: •t"..rt..�.._- .._ .... Yom[} - .- ',i¢. -:✓�T S vv" •• w. - yi• T i PUTNAM COUNTY DEPARTMENT OF HEALTH" DIVISION OF ENVIRONMENTAL HEALTH SERVICES` Date Q Re: Property �- P co ' p y of �. ►� Located at Section Block : ,Lot Gentlemen: This letter is to authorize \ a duly licensed professional engineer or registered architect (Indicate). .,..' to apply'for'a Construction Permit for a separate sewerage system; to serve tie above noted property in accordance with-the standards, rules or regulations as.promulgate� by the Commissioner of the Putnam County r lj,... Ti...... �..... .. ...L L, TT.. .. 1 11_ :l 1 •1 '1 " . L�N�,rU�,:��1u V1 nca..LUu, aiiu �o sigh d11 necc5sary papers on my benali in - .connection with this matter and to supervise the construction of said system; or systems., _in conformity with the. provisions of Article 145: .� 147, . Education Law,. the Public Health Law, and the. Putnam County `Sang- ' ' tary.Code. Very truly your , Signed Countersig r <i P.E r 1' %eal) 7EdressQ Teepo11__ — e ep one Q PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES " n ='•,%` _ :. :i...: =:%:. �a• .. ., ,�' .. _aq3." �'v:��3i',;t +�` ^r::; osi'. "t?'..':t -i jai - -�. COUNTY 'OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DA A S 4T -SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0. Owner - �r 1p, Address ,. M Located at (Street ve Sec : (�'� Block �{ _Lot 2- Indicate nea es cross s ree Municipality V Watershed`1'ae. SOIL PERCOLATION TEST DATA RE AIRED TO BE.SUBMITTED WITH APPLICATIONS. Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water water. Level No. Time From Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop . Drop in Min. /in drop Inches Inches Inches 1 t o . K '�S Qrl orb CA _ + 2 11' n5 -11 '. oq 1 v. 14- 5 4 ►114 `t 5 lt14 Z Tt Notes: 1) 'Te'E�ts to be repeated at same depth until.approximatelyy 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. 3 5 l �2 3 5 ._ Notes: 1) 'Te'E�ts to be repeated at same depth until.approximatelyy 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. r . I TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE/ NO. HOLE NO. HOLE NO. INDICATE L AT WHICH GROUND WATER IS-ENCOUNTERED INDICATE L TO WHICH WATER LEVEL RISES ,rTER BEING ENCOUNTERED TESTS MADE 'BY P) Date Soil Rate Used__k2_Min/l"Drop: DESIGN S.D. Usable Area Provided No. of Bedrooms 4- Septic Tank Capacity. Gals pe Absorptio� Area Provided By Z o L. F. x24 trench. Address ure THIS SPACE FOR USE BY HEALN+--nEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Checked by Date "4 - _r"'Q -e � ' 3, +•�C �� •f � ngq� C�.y,`a �' J t �"� �`°f� �'� ao } iY MWA AIM 1-1 x. . Ay " 1: MY TOM } - :w _.> -r 2a e: a•r 8. Hae NAM,. ? �' +�yy Ae •z": -has £ ��. '�, '' yp;�'f� fy��2 v ya p� ern = 'r C - t F ;s s ,i.S =� �F ��,+•�s �. ?� -. �A .�•a'`. '- �s-..r �. � ».u.,es�...,� -.a. �{ � `' :'t �c.*t-Y �v..._ � a�.a_ `�`,�:_ , z N 1 � ..+n.� `��, ,�'�X~- »�.: �'� f +�.'�F��++•:i>nz ��. i 6 K.a: T s = f t2 kn "vY ri � 9, -E�,7" .3Y'%I - �''�.•L,�`�� "'` ,r"..c- -.� ww �"`�F� ..'8= :�y".`� � _,� Vic*, ` ;4''�4 ,F�� -, _r�s• w }�?'. - .J �..: _ . -. �^ . -.. .'�'� a ��-„ ��,. -s?" ..u� .. r . , _ , t,• Kr .. ... } <.�q . '` ..$` t.. .. �..u�.. . �.:.• 3 -. a ''. .; •:..:L n.. :" ...' ....,s_'? ,k \:_. 4 . _ LNG 4>�h. *rhos.'. Y S �f ?s*'6'' '� - ^F � _,,4. x `\='= .:, f 1( ��v}3 -�°^' 4 cy�'_'.•F =� lu :�''" ,'� � :.fir`. $. � �- t te`a' �;°° ' .4 a •* "t.... , _.. }'�'1r =' - z;s "f. 4 ii 2 z r ` .�• t C.,. ..F_ {{ ., �- •�`�.� >^-•.'�. _ �':>',+. -r4. was.- - a,'.:•... __ � ..�- -e _ _ F` �`t - �, p »: t I � 't � 'rs 1 � 3, -c a- ,Iwo 4' 1 s r" FPP. . c� S' ��<- � ��'�'�` - 8 ��- Ey' »' - r ,. '" i 4 'S:�e�i .,y � � �r4.��i";L� •�?� 1T F �..,�. ,f —cow -`� z« �"a', ,.� -,� _:�q��s�: `K �h��' �,r �-"n`''r;� .,t•� •e. p�• ;,; .;�„'�'��w,;�._ �v�-� a - z^x,,�*�e ",'7y���; ..•t'» ''ia� �{�� �•..5., .�':tr. °"° _ ,� 4= u��. <, � � ,.::1+�A1_�.i.i"� „,���.' �`�-' _.xz� M/TNAM CO NTYtDEVI �Ui HEAL i �� r ^`1. �•'�'`i'fsj #r�r ,� ''" '?3" � ��' •� �- " .s<.# a DIBEGI(!R.- +WYISION -BF ��.n, � - _ Yf3- y�. ,•�-. `� �_� � r -�• o* MEN eviRoNMENTALINEALTH SERVI(`H.� • � � � � * �._FF \.� •u •"�- :�� 'a -.. >`, 'polozs yY +� �c3•e•, fs�` t "�-' 3'� '�.:: .x @•� �-,^ � , �; s ;a'-h ?c "�.. my #''-4r -3 'O.. w I" :Ek e }w*�% " p s,$!2T? �5 :.• .'fir -y§"� �. 4 s:k v ,s, ts' 3 k sue` ii- a ? g w � '* s't� `m � _ - �,;k,� -�.,. F z.��j�, ..,�-. _'��•�.. ��.�- f•Ci��±�',��t��iifF��� t-, �±f[{�t r%gi ' S d /4E Y P! AN t-fi=- L.T' t % jw4c,riCN HOX o /1 p Ap V1, 7 ilA C A)r, . . . . . . . . . . 40 41 Al I MIN" SECTION TYPICAL CONC. SEPTIC, TANK Z�A 1�_Awi ('kFINF H'C r 'y OVER if, 1) P�., 9. _� 11 (�;R - T, P It f, I 2f; MIN '1P-,Of;IITMN 'r R E N H -E N4. r f 8 E CON;!, Ut I (;'l E 0 IN ACCCORDANCF. WITH r I i E, R t L:', A NO 8A sqf,.0 2-9L) lit] 'd jv— sform fo hit leld.5 - A-0TE5 0 x T"o"rt f-4c, -5 t =-r b*1 U5 w f- r) L e A. o oz,�wi - 15 AA 1 14 1 &k XA: -ALL LA..LcqE -f Li _,v.s Weft ji�.( cF p sp,-A.L JwVC7,0,1 cl­ Rf­.,,W,,A*TIONS OF 'rHF Df�PAR K41F, N T Elor OF HFALh-1. Sy -ITEM ,t*VLU_ NOT 10, BACKVILLED UNTR, INSPECT01 t•Y DESIGN ANl DC46L iEA[,-'Mr)F_PART(,4cN'r if PL..c,,tjIRFr? SY5;1 EM TO CONSIST Of- ' A -'i GALLON AULON SEPT Ir TANK AND F'r ? r F 1'. R- , N C H W ITH A IM 4X I M U M �A" Al I c PITCH YF I/ r. I PLR FOOT D I s P,".1 s At. 3ys I'E% PINI'3HED FIR-"Y' FLUOR ON LES!! 0TW-_RWQ5; N 1 E D - PETE C qvrl�k caq - S., S, SYS T EM V4L MAP HGWARD A. KELLY, JR, 1 ASSOCIATES L < DAY{_ By CARME1 N_W YO RK 'r4x ;,AA N0.GZ OLK,NO, 6 LoT 1,11U. k A AA L L TOWN OF UT tics -64b A