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HomeMy WebLinkAbout3420DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.17 -1 -27 BOX 27 - �}`i •' � 'i ti :� r �� Is Is 'J� ` 03420 ti0 Iic,�Supply From. lat' A 11,�vCI FR CONSTRUCTION I?F�z iNumber bf--Be r. Separate sewerage rbysxemY,40 consist ',o f T. 7 % tb be ;c"constru.qedi;_ by V_ iv ,.:Water,i, 5,upp Y�r 6d SUPP Y_. o. �be ` drill LzRrater ­T .41 J p All Other _!14 represent t h a Dqs!bjl�! above described on - the. rj47 : �j(t_­�.—i`fl` �'*v �a meht Hea I hi�l on,. c 0 m P. Le -nil 41 Date APPROVED 4, F� OVED FOR 1CONSTRUC revocable t for cAUsq: . - qr-,,! iyay, A*i�llk R., TMENT Ar DISPOSAL -STEM - a tj Tax Map ° Block OP `4 24n wi.dthEt�8ench J_ !A 7t t_ 7 7 7 KA, 7-77 :7 7Z, B'1917 7" edrooms N�teY it ;Issued r V1, -Z r is P, Oment 0 f H ea I t S. 512'51 LA N' such`laction ash .......... 0- 00, re -ang,' i.�shall ; become correction of u�' rilta ary. -sewer as a° ublic �Avai ab a , . becomes when b - _�f, -`appr�iils 'Such Alf. ­1 ­4 jcatloW_�or change s necessary . . . . . . . . . . Fq, S,� ZTMENT OF HEALTH . •. P ToWn, or 4illagql Tax Map Bloc _of i o Add ress� N7 6are F " 6et ­Tdtal%-Habit-ab`le space Address -system , jtem(sy�>&),%t a J rata,sewage disposal o t Fe-.7-- ion ';o the prop ulations',of Patnam,,' t" it . , - "4 & . _�l t �.46 tq��krl ,-in accords IL . 1-1 ", " to and ss oner.of .Health will he PRMMI theL' of bull er builder �oai' 1­11. �� b I Qty I ' — ' " d -,`tfiat� said will the !0�%LjA�Vj��61i,�iu4es� _­ r �i , issu 4ollowlnj',the ,date , otjhp,*,,, original 'js�b'm diately', AuKing_t,0;"pP!!dd_Ot wO, system 6r' any 11.,,iO1­ P "a, ir,s."t'dfit, o � ;� � 2 I )t"ha'ti , the � dulled wel 1`,d'` e&� s-c r. 16ed' a bov'e �n accordance wjt#; 6 a and Ce gg ations," of' the Putnam ' T., Signetl` j' Pi License ;N6, T this' approval xp�res done year -from the date :issued un_ ss onstruction of the 'a 6 11 d i ng" h i C, been ' undertaken 'an"d, is . , " 1-1, . :, z;. "i. , construction �n,�f *11,".' -.!Ariy,`chan§e or alteration Z "A �1 R 7 PEEKSKILL MEDICAL LABORATORY 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 Peekskill, New York 10566 RESULTS OF EXAMINATION OF WATER 3 -f3 OWNER DATE RECEIVED CITY, VILLAGE, TOWN 6 /OR NAMt OF SUPPLY DATE REPORTED PU+-A0"rn z9 1--t' ^ 5-4 n-5- PE 7-8777 BACTERIA.PER ML. (Agar plate count at 350C). COLIFORM GROUP (Most probable N6../100m1-) HARDNESS, TOTAL -PPm Q DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm FLOURIDE (F) - mg./l. These results indicate that the water was rS of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) 12 - patham;Valley� ..... . �7.:ti -..._ . Owner or'Purc aser of Building Muni cipa ity Thomas Maroulis Building Constructed by Section Luigi Drive Location Street Block Single- Family Building Type 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 :Wade 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- vi.ces__of .t,he-- Du,t.n.am C_oun.ty. Depart ment_.o.f_Health as_. to- whether .or.no-t:_:the fai`lure­of'" t'he sys ein to operate eras caused by °'the wi11I'ul or negligent �'�� - act of the occupant of the building utilizing the system. Dated this, iGt day of March 19 78 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 5 12 - patham;Valley� ..... . �7.:ti -..._ . Owner or'Purc aser of Building Muni cipa ity Thomas Maroulis Building Constructed by Section Luigi Drive Location Street Block Single- Family Building Type 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 :Wade 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- vi.ces__of .t,he-- Du,t.n.am C_oun.ty. Depart ment_.o.f_Health as_. to- whether .or.no-t:_:the fai`lure­of'" t'he sys ein to operate eras caused by °'the wi11I'ul or negligent �'�� - act of the occupant of the building utilizing the system. Dated this, iGt day of March 19 78 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 WELL COMPLET14ON REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH �1 ®itWbn of Environmental _Hoalth Services COUNTY (OFFICE BUILDING r CARA4EL, "NEW YORF( ;� • .a.,;`ifil np;t_.IS_4o be..c� mpleted gy_v�rLdPlller and sL -- .- ;itcd.:Q County Ncalth Dep:utric+n.ti.together with laboratory repor4 of analysis of Water sample indicating water Is of satisfaciory bacterial q al'ity before ceetRica ¢tt�:"of'"construction'.cbT T I nCe Iiizsued; ° REPORT MUST BE SUBMITTED VATHIN 30 DAYS OF % COMPLETION OWNER NAME ADDRESS . .1 . & f 4� Z✓ A- %^ LOCATION (No. 6 Streot ) (Town) (Lot. Number) OF WELL A BUSINESS PROPOSED V�j DOMESTIC ESTABLISHMENT. ' . FARM TEST WELL USE OF tfdEll INDUSTRIAL CONDITIONING (specify) SUPPLY DRILLING }m COMPRESSED CABLE ❑ ,OTHER OTHER " EQUIPMENT li J ROTARY AIR PERCUSSION PERCUSSION (Specify) [ASIhG. LENGTH (feet) DIAMETEC(inchesj V.'EIGHT ^= ' PER FOOT I' ,__� tfacnv E SHOE yyES WAS CA N _ nUT D4 THREADED WELDED. t.) (_J�NO YES L.J N0 ZrtEID El PUMPED HOURS COMPRESSED AIR G P1ll,.. YIEELLLDJ(G.P.M.) HEST BAILED PJ WATER MEASURE FROM LAND SURFACE— STATIC (Specity feet) J, DURING YIELD TEST fleet) 7.DWh of Complefud Well Im feet below land LEVEL surface: MAKE LENGTH OPEN TO AQUIFER (feet) geREEr� ' DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL Diometer of well including GUYEL SIZE (inches) FROM (feet) TO (feet) PACKED: gravel pock (inches): DEPTH FROM LAND SURFACEI Sketch exact locagon of well with distances, to at least FEET to 4CZA FORMATION DESCRIPTION two permanent imadmarks. - --- :_1. -- -- -- - -- .._.f_.. e L . - %S' �_ lc 6 If yield was tested of different depths during drilling, list below . FEET 1 GALLONS PER MINUTE DATE WEII CO.%%FLETED ATE OF REPORT WELL DRILLER (Signature) reA L tA FIELD CIiECK LIST h? Date: INITIAL, SITE INSPECTION Yes No Comments Property lines or corners found . Can estimate house location . . : . . . . . . . Will driveway need cut . . . . . . . . . . .... , Must trees be removed -note these . . . Is .deep hole representative of entire SDS area Additional deep holes needed. . . . . . . _ _ Sufficient SDS area available considering' driveway cut,house location,separation . � . distances, etc., . . . . . . DEEP HOLE DATA Depth: 2 Water 'elevation.- 0 f Rock elevation: .0 Soils descriDtion: Date: -- -- - 'FINA.L SITE INSPECTION Insp . 'by: House located .where shown on approved plan SDS located where approved . . . . . . . . . Length of trench measured Width of trench average S:. pe. of,tile line and trench acceptable , Room allowed for expansion trenches , . , , , O.ver.. 0 ft._... f x..Qm,.stiramp.,water.co�r_se.,_ .....:,.:__ •Mitural -s°ozl•' -not --stripped",uif­Sba unnecessarily graded . . . . .. . . . . . . -- - --" - _ 10 lit.. maintained from prop-line and 20 ft. from house _ Separation of trench from house, well etc . follows plan . . . . ... . . . . . . . . Number of bedrooms checks . . . . . . . . . . . Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench , _ 15 Ft. of peripheral soil horizontally from trench.. ... . . . . . . . . . . . . . . . . — Junction boxes properly set _ Could surface run off from driveway, roads, ground surface, etc. channel near SDS,.. , area. . . . . . . . Does lot - drainage appear O.K. in area of SDS FINAL GRADING OF SITE ACCEPTABLE HIM }. bI CI1ECK Sr , �'T DOCUT/jETITTS - House plans 0. K. Dosi,",n data sheet i Peres presoaked? i Ydn. 30" pert test depth Const. results for 3 runs j -D. Hole log O.K. Corporate Affidavit for other than individual MCts std..! Rema.r. ks yes 1 No A Authorizatio for engineer •Letter. from Water Supply if applicable If variance requested -such noted on plans & apps.: DETAILS Sif change is proposed,) Existing contours shown tshow new contours) Slopes for driveway cuts, etc .. shown j I-later service line location Footing• drain, etc. location Top slope, bottom slope of fill i. Percolation tests and deep test pit location Septic tank size and conformance- to std. Yi j 3 B.R. house minimum House setback shown � L, t f' rpS _ All water wlLnln - u i L . o± FL shoW__1 _ _ ­_ Plan and profile SDS f All other wells n d SvS s.hQt7x� ar= rEerence• c oser X00 • Property. boundaries (metes and bounds- clearly sho-v}n BEPARATIOIN DISTANCES SPECIFIED ON PLAN 10 to P. L. ?0' to Foundation walls )0' to.Nearest well t 4V DO' to stream, march, lake, etc. incl.expansion L5' to Curtain drain LO' to water line (pits -20' L5' to storm drain LO' to large trees LO' from foundation to septic tank L5' to pipe from leader drain & foor*cc If JI 2� �.i r 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 Address i koo-1 qa-U&II-N Located at (Street (, r� Sec. Block Lot n is e neares cross street) Municipality. P�kty\&M Watershed 0 �- SOIL,PERCOLATION TEST DATA REQUIRED TO.BE SUBMITTED WITH APPLICATIONS a '".Hole 2 Number CLOCK TIME PERCOLATION 3 PERCOLATION apse TFp7h to a er a e— ve No. Time From Ground Surface in Inches Soil Rate Start - Stop. Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1• lio:a�� io�o� 5 � � �� � �- . 3�` :� S: . 3 A70 IAl E C�0 5 Notes: 1) Tests 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. 2 3 4 :. 5 Notes: 1) Tests 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. DEPTH 61 1211 1811 24" 3011 3611 42.11, 48 5411 6oll 6611- 7211 78 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TS WHICH WATER LAVEL RISES AFTER BEING ENCOUNTERED �)MA41 TESTS MADE BY. a,[qa6Vt_ )/, Date .--.-DESIGN ±i- hat6---Ug&d C. VA 0 01 No. of Bedrooms Septic Tank Capacity Ian Gals. Type Aas Absorption Area Pr vide 1y_&4LL.F.x24" )( 3b" width trench. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO._ HOLE NO. HOLE NO.Je je, Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved,. Sq. Ft/Gal. Checked by /11711 TO: "- Qrn County Department of Health V DYwirsto�ti`" 6f kikir` dfim rital' Health' Services- Date- ✓ Z� IVL 3 ' -._ e nc %V FY, Fount Kisco Field Office 25 Moore Street ..-Mount Kisco, N. Y. 10549 Gentlemen: Re: Property of Located at Section Block Lot `1 This letter is to authorize a,duly licensed professional engineer 'v/ or registered architect to apply for a Construction Permit for a separate sewerage system; V private water supply; to serve the above -noted property in accordance with the standards, rules, or regulations as promulgated by the Commissioner of the Westchester 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 pro- visions of Article 145 or 147 of the State Education Law, the Public Health Law, and'the Westchester County Sanitary..Code. Coui}tersigned : _ ✓` V P.E., R.A. #� (Seal) (Address) .•cF�� of NE:v rc r � V �r (Telephone). Very truly yours, i Signed - (Owner of Property) (Address) (Telephone) 3 [ o`��sFa �o• 5125 P ����`v OFESS��N LA -4/76 This letter is to authorize a,duly licensed professional engineer 'v/ or registered architect to apply for a Construction Permit for a separate sewerage system; V private water supply; to serve the above -noted property in accordance with the standards, rules, or regulations as promulgated by the Commissioner of the Westchester 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 pro- visions of Article 145 or 147 of the State Education Law, the Public Health Law, and'the Westchester County Sanitary..Code. Coui}tersigned : _ ✓` V P.E., R.A. #� (Seal) (Address) .•cF�� of NE:v rc r � V �r (Telephone). Very truly yours, i Signed - (Owner of Property) (Address) (Telephone) 3 [ o`��sFa �o• 5125 P ����`v OFESS��N LA -4/76 Q _ / V ow COUNTY BOARD OF HEALTH JOSEPH P. CORIZZO President DANIEL SELDIN D.D.S. Vice President PAUL ROLAND Secretary GERALDINE A. ZAMOYSKI M.D. ALFREDO F. GARCIA Jr. M.D. PAUL CHANG M.D. JOYCE•MILLER M.D. WILLIAM ZURHELLEN M.D. HON. THOMAS BERGIN r 11 20 "/i i Dear &- Putnam County DEPARTMENT Of HEALTH County Office Building Carmel, New. York 10512 914/225 -3641 JOHN SIMMONS M.D. Deputy Commissioner J. ROBERT FOLCHETTI P.E. Director Of.Environmentat ".Health -Services ,.,,,ELAINE KRUEGER R.N. M.A. Director Of Patient Services Date ! i rM A review of the submitted application to construct a sanitary sewage disposal system for.the proposed premises has been concluded by "this department. The plans are being returned to you for'the'following reasons. REQUIRED INFORMATION MISSING' (1) Completed application _._._.._ .._.._ :f.— •A- siga-- da_a-= sheet--:.___ (3) House plans (2 sets) (4) Authorization for engineer (5) Layout plans (SDS) (a) House location (b) Plan and profile of SDS (c) Location of driveway (d) Location of well or public water main (L Contours of property v QfY Location of any,water courses, ponds or lakes on property I� or within 100 feet of property (g) Location of deep test holes and percolation test holes Location of all wells and ,sewage disposal systems within 200.feet of property lines (i) House setback Footing and leader drain location K ZTc) 10 feet to property line (1) 20 feet to foundation walls (m) 100 feet to nearest well (n) 15 feet to curtain drain (o) 10 feet to water line (pits 20 feet) (p) 15 feet to storm drain (q) 10 feet to large trees (r) 10 feet from foundation to septic tank (Is)D 15 feet 6o ne , from 1 ader dra nd footing drain Sf Other: s9,1 -�or q,`�( — t}. 5 _ $33 GF 1GJi1V 6 -7 coo ®Pere wkrl AQve 3 Cons r A n S" If you have any questions concerning this matter, please feel free to contact me at this of f ice. Very truly yours, .