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HomeMy WebLinkAbout3387DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.08 -131 BOX 27 03387 . 110 ♦ F. L ti. T IL 1 40 i p I +� T 03387 d sb c PUTNAMCOLINTY DEPAR ^TMENT �FHEALTH ' f, ,r3, .. , �� � E a„ '�.- � e -++� , ,,. �;,'; "ES�',`"�; ,m's``�u`a� � `,�it'�`'�v`�''�`r.s" �''e� '`� a f� ` t• ' ' f i � � - + frz ���� � ��Drursron�of, �Env�r�r�Onmental�He�alrh�aSer�vrces �Ca�me/ �N Y f0512� �TRUCTIG�N PERMIT�FOR SEWAGE{ DISPOSAL` "�SYSTNEM' ,���� ��, �;�4g1 fi �� � �� .� ` � r d at '"� S r SeCtIQn ' �, LTdc1C r at -0 Z& z ` A � Rri t � r k t.t n•-. � „�"' €',�'x 1z `..�i �xs. `p' 3 .c'�� '� � °- c� ., _ s ms`s r `� � r ; •. _ , p r„ �3t r .rt ?tr• -kE E y �sv',r� a�:+ h9- s y t z `� �- "' r 'A i '`-.'� A �? `'' §_7 U V er of +Bedrooms * ` Total Habitab)e*Space " Square F;eeY" r ti t" L s j c`^ c?',+. a� ' c >'` �_,+,i +� T ` 4. q 8 .• . ite Sewerage System to consist of Gal Septic 7ankt� lineal feet X - width trench .„ 2 Y �� 4' ..'1v` f \`E az`' .s�" j;S. 'y'•s°£'.. i '. " i 1 . constructed ' ` F ' + z .3 £ _ .. i e ,a' E -', i, a <C,• '` K Y 7 tt R4t. k - „j"'�.° ., ,rp !• ^d,'y "^ e"w s Daly Pdyblic5upplYFrom Winn[[ x reya �n ti v i J . vn Wrl � Private Supply to be t h� s, -' "i.� ,.. E. a � ,r-. ,.' fi r s �. • z �f € 7 ���; d ,a,��”. r.�"""� r N A f � ,l Address � ° •Y �v i y'a fl+ 4d iz5"•t2Y .a�`�ff �'�o �'� r3�:,- f 2 a "� �-�c �_� > tis Yll Requirement3 s a e n . ` 4<1 �,"4 �,,,.` -t .s .��� s �',.#' s ga.: 9 8t81.'?;1'85 onsiti le,for'th'�� fi` �Y';afi" ��'^";t;, .r.�. ss ,t� rS,•.3ui .,e"�.'�;.+ R,�'.,r �,.„ � : i ,mss � _ •� ,. 35enY.that�l am wholy� and comp) y�i4 Rte; .�, ,,,.e� design and location of�the proposed systems) :�l) that�the separate sewage. disposal system. . Fde'scgibed will be constructed;as shown:on thejapproved,atmendinent there_,to and�'in accordance with the standards rules an 'regu a ions o �. t,,e u namti y; Department ,of .Health, -arid that on completion thereof a 'Certificate of Constructlon�Compllance sa4lsfactory to thexGommis ;loner of.Healthw,ill °.'' brritted to�the, Department;�and a w %itten�g�uaranteew�lllfbe furn�shed�the� owner _his successors;; heirsorassign ;�byathe builder that said',builder_ will Irtment, of Health d s it 4C. w 4P �ro Kt i " FOR CONSTRUCTION" Thisapproval explresone year5fromthe date ;issued unless constructionbf theybuilding has beenssundert and';is cause;or may kie amended or modified when consider es .. by they Commiseio -� Any change�or�alteratwn cortstru¢Yion.. w permit Approvedfor, disposal'ofdomesticsa tary ew ovate p only r" r�• � � �'k�tn x fi �. BY x F s 71t1e \ w ° t +"r._ �.'�s r a Y,- � ri " .f.x x > "yr�"2,�SCS� �, '� � ,P'�.� A�, as`r 'SK �'y �' '�r • �zu ' i .u..rr7'�^,x- Y�,"€,ej .3 x..tk. r�.+.. k'..�. "'y.M -.•mss .�,.k. �,,,�t*'. _. _ - - - Gentlemen: PUTNAM C011NTY DEPARTI'MNT OF HEALTH DIVISION OF rNVTRO\,'MENTAL 14F:.ALTH .SF.RVTCES Date 2 Re: Property of D 8,4 N Located at �eC \nnt Section G 2 . Block Lot l S This letter is to authorize 4o," Az b Il L� a duly licensed professional engineer 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 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. Very truly d Counters gned:. Q O� P °E . R.A ., # S I A- of Property aaaress Telephone PUTI`AM COUYTTY. ; DEI'ARTMEV'1' OIL HEALTH , DIVISION OFF' ENVIROT,,METITAL HEALTH SERVICES >UUNTY `OFF ICD' M'!! LD TIT G� ;- - CArIff I DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Al 1 5e\wn► e%4Q Nq Address�� Located at Street 'J Q_ Sec. Block Lot 1 La ( e �r� G .�� Rdicate nearest cross street) Municipality � i�` � � t� � ��,e Watershed C XL. o O -W SOTT, PERCOLATIOIIT TEST DATA RE U.IRFD TO BE SUBMITTED WITH APPLICATIONS Hold . Number CLOCK TIT.1E PERCOLATION PERCOLATION h1un Eiapse Depth Lo tea er water-Level No.'. Time From.Ground Surface in Inches Soil'Rate Start -Stop 14in. Start. Stop Drop in Min. /in drop Inches Inches Inches G u r C; � �r ; tj 5 .. 2 3 - 5 Notes:. 1). Tests to be repeated at same rates are obtained at each percolation for review . 2) L-pth measurements to be: made depth until approximately equal soil test hole. All data to be submitted from top of hole. TEST PIT DATA REWIRED TO BE SUBMITTIM.WITH APPLICATION T ry''( llES�CRIPTlOPa Or' SOTLZ i,;•;CCUj ",!T RFD I TEST IIOLESS J�A'li -. _-- 1��ltlii� .. TL'. :'ii ^= - H�J1.is .•-i 0.. - - - - - _ — I:V'.l L�a''iev. 'a. _ .. _.. .. . 6 1211 24" 36" 4211 r 48" 54,11 L6 V� -fY� ' 6o". b 66" 72-11 INDICATE LMEL AT V1I1ICH GROUND WATER .IS. ENCOUNTERED YIT�ri�TCA7:E::I,L E-�TO:� fi[C s 1�A`l'ER I�'VEL jRISES AIT'TER BE.ING•ENCOUNTE Fi TESTS MADE BY - A ey AK o Date DESIGN Soil Rate Used MirVl "Drop: S.D* Usable Area Provided 900.0 No. of Bedrooms 3 Septic Tank Capacity 16 0 . Gal -: Types.., M A5. Absorption Area Provided By _L D L.F.x24" 3 �ridth`�twrench. .Other Y. I !31 .1 Name A i�na ur ; };, + Address SEAL THIS SPACE FOR USE LY'HEALTH DEPARTWgt T ONLY: _ Soil 'Rate. Approved Sq. -Tt /Cal.. Chocked by Date a moon, J-1 ow- "".9, PLAN i. 12 ' I I •I. MANHOLE COQ. LEV 1 JUNCTION BOX MrN. 12. N. ;`.rrevrr l /// /(.r�" •: - - - �..'_ .-s. tai _ - EXrr�i A-LIQUID LEV CIA . - ✓cG�to. - 1,41N. �: CAST IRQjd .� -� SECTION •� SANITARY. TEE �` ,.. 48 1 .. / SfPTrC , <. ; .; soxES/�7— ti. TYPICAL CONC. �' 1, ?RE -CAST •.SOS/ �i' �- • SEPTIC TANK '� RFINF. 8'C.C'.i a /w. •I' /r. i '� ' /fd�� r • GRLL LEVEL . iri., �. EARTH =.VER BACKFILL 5 -15iii; / IV, -30' BL DG. PAPER /' r • �r °` - NOTEa. OR HAY 2,. �. e / � / �(/NC`;�•✓ � r M \,��c,,�r e' - PERFORATED 5" O l j _ �.,fb..,r, Sir�r . _ " 4' i;l.�' ..10,(" ✓-L'c; •SfT p ®..� PIPE e` 6" d. 2 / FQlj3(rC 24'MIN 36 CLEAN GR4EL OR / J"E ��'.PA iiO•�/ ,lifSl.I�/�'f- .5',Jr'� %O CRUSHEC• STONE / 5 .;'Sa'sY'•, l6vt�srY ©ae�v , %Sfis �lfifi y' ABSOiRPTION TRENCH. o r OQ`' " %i�OSAG ilArrf %d�.� �P6.i�OGdCJ. NOTES: j 33 1 SYSTEM TO BE CONSTRUCTS J�1 A� QRDANCE WITH THE RULES AND ��. REGULATIONS OF THE v COUNTY: QEPARTMENT OF HEALTH. Ex /sfruc /v °' �r ��OP Q ,{ SYSTEM SHALL NOT 8E BACKFILLEb UNTIL INSPECTED BY DESIGN / .LQ'T 11 -DZ ,� ENGINEER AND THE LOCAL HEALTH DEPARTMENT IF REQUIRED. SYSTEM TO CONSIST OF A -GALLON SEPTIC TANK to AND /*0' -- FT. QF FT. TRENCH WITH A MAXIMUM o I PiIT OF. I/16 PER FOOT. DVSPOSAL SYSTEM GRADES REFERENCED TO FFNISH£D FIRST: FLOOR ELEVATION ,UNLESS.OTHERWI6E NQ•TEO. ' APPR VE© S.S.D SYS'�°'�Bc� FOR �A!/ /L7 EANN4�U.Vl -C AROAC..K REVISkda$ M�� ASSiAiEFs tIY J t SKI, 1Ndt 1� ►"fir` -•W Subp F / % s *� NU DATE BY' CARMEL N W YORK ,J s. [/ // , DEC 161974 -- 0.uew . rw'rJ W/qD• TAX MAP NO.02 BLK.NO ',OT NO. /f P M �DilWlilGoNrOHF B f } tYTOWN OF ``.' _ �.'1 g [NY rnwn Y/ Scale M41afi0l IRONMENTAL HEALTH S£RYIMP �. \ — - ClikdDom �/ 22TQ O owing No. q . - \ -• '-"„ / 5 Truced� ApCrd •,� �. 4' r' C Iter supply; Type !I - idj n 9 whed) Ict to mi 5 A!, T! Kz' MRII P 'j n— - A u. i. A 4-Ak-Ex", 'A -A m 241 to k Lot b'_ r—o" yyl.. i A. ,Fm b_u It by Al`,.'111��w fes .' Septic ,Unk * acid ' 'o i a jiierii6iits c,supply .,F C _Prate , Supply , Drilled -No. of Bedroom's -Date Oiimii issue (j) 'Si liste'&servi64 t d essentially, as shown on the 'Olan (cpp!e.s Of 4 P. the completed work. -,which .,'&re jinco'wi h' he.s'iandards.niul6's:and re gy la t ,i ns: Iqs, ile eJpe r sued by' 'the' PUtnA m County D6partm6nt.6f Wealth 7,6' Certrf'ied by E. R.A� Address r Nb xemises served by the above system.(s) shall promptly take such �action as may tie necessary to secure the correction of any unsanitary m wch wage Ap p 0 f ' t he,Se`pa,r"4te ' q,!ge stem. shall become s6o n as• a public sanitary sew er•becomes h the,prrvate water supply shall become null and void when :A.public 4iiei iu06iV 6ecomes -available ;Such 'a pprovals are cfii6je when in judg 0!, th is id er of-Health 'such' 041ficatidn or cha 1ge or is nece ry.. By 'T ft'le 7 WEL COMPILETION REPORT PUTNAM COUNTY DEPARTMENT OF ' =Si1 Division of Environmental Health Services COUNTY OFFICE BUILDING -- CARREL, NEW YORK _- .._..._... This.ca�rfn is io- •becQrn feted ,r -vv ll .d ijlKa q!1d•Jubm ,itted. -xo: County. Hpalth -,pgpartment� together ..with- labbratory 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 NAME ADDRESS OWNER David Ea.nnacony Elisha Purdy Road, Amawalk, N.Y. LOCATION (No. & Street) (Town) (Lot Number) OF WELL Jeanne Drive XX Putnam Valley PROPOSED ❑ DOMESTIC El BUSINESS ESTABLISHMENT ❑ FARM ❑ TEST WELL USE OF RCUSSION if ) CASING LENGTH (feet) WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ OTHER (Spefy) DRILLING ❑ ROTARY © AIR PERCUSSION ❑ P ❑ (ve EQUIP MENT RCUSSION if ) CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT a El S O El W C G j T D7 DETAILS 1 25 6 19 THREADED WELDED WELDED L J YES NO L"J YES LJ NO YIELD ❑ ❑ a HOURS G.P.M. YIELD (G.P.M.) TEST BAILED PUMPED COMPRESSED AIR 1 6 12 12 WATER MEASURE FROM LAND SURFACE — STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL 45 1 100 in feet below Land surface: 1 5 SCREEN DETAILS SLOT SIZE DEPTH FROM LAND SURFACE _......_._.- - -•-_ -, I IF GRAVEL PACKED: FEET to FEET I FORMATION DESCRIPTION 0 100 Hardpan & boulders. 100 125. Weathered - ledge. T25 1 -135 Hard granitee Diameter of well including gravel pack (Inches): Sketch exact location of well with distances, to at least two permanent landmarks. pwELk1NA � r i If yield was tested at different depths during drilling, list below i FEET GALLONS PER MINUTE W01 Y AEP DATE WELL COMPLETED �� OF EPORT WELL DRILLER (Signature) AT 7- 15-76 �-7� IEILL DRILLING, INC. President BREWSTER LABORATORIES— Box 2 ST N. WATER ANALYSIS REPORT SAMPLE NO. 3716 SOURCE: David Eannacony - new well Jeanne Drive Putnam Valley, New York COLLECTED: August 18, 19.76 BY: Hill Drilling., Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. August 21., 1976 Ulrector This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. August 21., 1976 Ulrector l� _I` * VALLEY Owner or Purchaser or Building Municipality je:� 'AVAJA L0AJ V Building Constructed by Location - Street 6?,4 AJ C, W Building Type 7.-Ad . 42 l Block 1.5 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, 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 conclusive the de- termination of the Director of the Division of Environmental Health Ser- :vice,. _of . thePu m_.C.ounty Department °o.f *:' ealth: as " to - whether 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 / day of 50007- 19 %C Signature K 0, Title f d ulG 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 q CIA-* Nn. 7,411 10 3 3 PArr. r, c3 Z 164- <AeA /V N 6 'wet I—00041tpo , Ov off x, lip was asso-AW WAT oil Z, �'j 0 r a ! d / ?'r S � ty A "o 4 LAW Nrml. —NMI YM V RzWAF1J77S ILE, 74 W8 MIN YE I A � 'yo ��AP 7A- iv 56,ff-PAGIF PATS Dili; ,��� VIA= ; — -- '71' coy .I '• .,. " 1 ` PLAN i, 93- /= 20'66' l.�yyy' - I 4��l= -d. :1: _1 4` i____J.i• �: °< - °\ RD LFVEI d JUNCTI 80X N' } 9 M! 1. 12' -I� A FGI, % to T LIQUID I!i LE ,;:.Fa,N +hrvT - .:; - ".,.• -- - - - - MIN. .. .. >,*::.� f - r w•c, r •CA "ST IRbN 1 .:SEC'TION •,_ SANITARY +EE i- b 5, S TYPICAL CONC,' -4• � PRE -CASTbCQNC. �l' EPTiC ,4RlK BiW 1? g T r I: �., G -R D. LEYEC `/ - + •`! i. c.' - .EARTH • / . r .x - - _ .l C]• "BACKFILL' JQfNT 5 IS" BLDG. PAPER COVER,_ - y�'�^ "� .. f• •,r,S�_.. ,.� ;tY I_ "p /S��lUrl O�CirtTi/�' '•SfT - ".* ; PLRi, D TR pipe, S' t6 ZOQ Favri �� ✓ ! s fjfcaW' -° •SS 'r ��'!/E' ' CLEAN "GRAVEL OR 24 MI K r. ' • _ "'�- . • CRUSHED STONE t Oeg(r. �' X r 6' S.c?ERx�YQV' .r�isl`'ak�f- SS.0 To O• for t5` !e.<�err IJ.P �/v / '•!r%� ili! /,t/ �. ABSOPPTION TRE.ryCH �'• xzz NOTES;_ • o 3 Q ° SYSTEM TO BE CQNS7'RUCTEp�*L�� ORDANCE WITH :THE RULES AND TT REGULATIONS OF THE COUNT , Y DEPARTMENT HEALTH Erisfi�is „Pig e `$Y6TEA9' "SHALL, NOT 9E. BQCKFILLED UNTIL INSPItC ED BY DESIGN Gl�rrc kOINEER K, 714E -LOCAL 14£AL:TH DEPARTMENT ;IMF REQU {RED: l f f• i N SYSTEM TO CONSIST 'OF A %° GALL N "SE Q� IC TA14K -1 �!]j AND.3 S c"e'as.cya P;­s O,ISPOSAL SYSTEM GRADES REFERENCED''TO FINISHED FIRST, FLOOR '£.LEYATtOSV UNL! 3S OTHERWISE NbTED. j.5�YSY� FOR 'APPROVED fE s REV19loN8 0 ARD, A. KBLLY, - _ e o ^ . KF� q<, Na . oasE G'ARAdE 1 SOC IA YQR w 19 TAX MAP No/ y62 6LK.NO / dL06 NO /S (N/�,i' TOWN - F h.i3r a{ 389�38.;P 4 Ohkd Dote' // 22,14`awirca'r /w �Te TIM, ov ntw t ftE111111 B�ftl�l. � c00% + A1. yi