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HomeMy WebLinkAbout3424DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.17-1-32 BOX 27 03424 I ' it' .61 06 r 1 ul . .` I Or ti♦ � _ L I 03424 3 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, 'cirmel, N. Y. 10512 Permit r —CERTIFICATE. _ OF' CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley (T)_ Towr.'.or Village Located at Irma Drive Tax Map ZY Block Owner •Tnhn niMi Ael a Formeriy Tax Map Lot r ! Q Subd. Lot r Separate Sewerage System built by John DiMichele Jr. Address Irma Drive Putnam Valley 1000 375 LF of 241r trench Consisting of Gal. Septic Tank and Other requirements 32 ft ± Rol; arayel placed in SSns area Water Supply: Public Supply From Private Supply Drilled By h stet Puckey Address Sprout ZBRook Road, RFD Peekskill, NY 10566 Building Type Z story log cabin No. of Bedrooms Date Permit Issued eee�ee�e �� • Has Erosion Control Been Completed? Yes 041 *0 rt(p /utf C'IC /IC • Qp S. Rp l • I certify that the system(s) as listed serving the above premises were constructed essentially she completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in acc91 d�c p BIS, and the permit issued by the Putnam County Department Of Health. a vu� e ° Date , June 28 1983 .Certified by � ••� "-' � P.E. X R.A. 1 northri a Rd PeekQki , 2 b 27846 Address p[ �yi`�Wy L!, no No. Any person occupying premises served by the above system(s) shall promptly take such action as may be•n0e�at j% e thi correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null an illae 0*1 as a public sanitary sewn becomes available and the approval of the private water supply shall become null and void when a public wat su DIY becomes available. Such approvals are subject to modification or change when, in the Judgment of the Cornmi er of Health, such r tl , modification or change Is necessary. 0 BY Title Rev. 9 -81 PUTNAM COUNTY DEPARTMENT OF HEALTH 1. Division. of. Enwon.Tepio Health_ Services; Carme %N. Y: 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valley (T) Town or Village 74 Located at Irma Drive. (Off Luigi Road) Tax Map Block None 5.15 Job Subdivision Lot Owner John. F. Di Michele, Jr/ Address Luigi Rd, Putnam Valley Cape Cod Lot Area 43, 866 SF Building Type C 0 Number of Bedrooms # Design Flow 600' gal /day Total Habitable Space " Square Feet Separate Sewerage System to consist of 2000 Gal. Septic Tank and 375 LF of 2411 Trench Kastuk Address Peekskill Hollow Road To be constructed by Water Supply: Public Supply From ,Adams Corner, Putnam Valley X Anderson hell drillers Frusta Supply to be drilled by Address Barger Street' Putnam Valley Other Requirements min 3.5' 'ft' of R:O:B Gr6v61 in place min of 60 days prior to testing over entire septic area. I represent that I am wholly and completely responsible for the design and location of the pray% �y �S); J that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in ac�r St'andbgds, rules and regulations of e Futnam County Department of Health, and that on completion thereof a "Certificate of Constr jia sat isfaetory to the Commissioner'of Healthw(11 be submitted to the Department, and a written guarantee will be furnished the ownesiq�a;e�tres assi�ps by the builder, that said builder will place in good operating condition any part of said sewage disposal system during t eA t ` immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the originaly or the tsf?�1 that the drilled well described above will be located as shown on-the approved plan and that said well will be installed in accopd wit ' a rd , °Xql @s and regulalf ons of the Putnam rf County Department of Health. March 3 0, 197$ ,•. • X Date Signed P. E. R.A. Address 1 Northridge Road Peek il�;j e° License No. 027846 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless �oth of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the CommissiongrO y Ith. Any change or alteration of construction requires a new permit. Approved for disposal of domestic sanit a%�/@, and r' t water �p� / T'1 1s1 D CJII'CK h'I:ST Insp. by : `- i- ..:6:.i+:::i�;1:. _.. ....:35•�::..ti:..- .V•.:I.�.i ...- iii: rer,ii io::.o-�.., .v.. ..••Y�ira. �..a. r.... i.'.:'. ::.:r :. _.......:d: � .... w= r.%r:%: -�•;<i : ne�t'si 6..i. w �..'••+....�:.r'4:.::.r. 11`I C`.l'TA.L SITE, 1 TJSP sCTT.O; Yes • No Cotnnients Proporty .line.: or corners found Can estimate, house location ... Will driveway need cut ;. ... , Nft treeu be removed -note these S Is.deep hole representative of entire SDS area - Additional deep holes needed. , Sufficient SDS area available cohsiderin driveway cut, hou.,., location, separation distances, etc.. DEEP HOLE DATA • Dep'L'1i: 3 l �- • • -Water elevation: Rock elevation: 3 �� Soils descr_i.,)tion:� DDt?- _ FINAll SITE INSPE'CTIO�, Insp. by: Hou.,e located .there shotrn on approved plan SDS located where approved . . . . . .1iOngth of • tronch measured Width of trench average J. Slope of the line -and trench acceptable . Room allowed for expansion trenches Over 50 ft. from stump, watercourse a........Nai cira3 oil -i ot_ str � -)p-, &.or S-LS area �:......... _.. -._. - .-- .._ .. -- ;:.... liviecessarily graded . . . . . .10 rt. maintained from prop.line'and 20 f•t . from house . : • Sep:Lra•tion of trench from house, well etc. follows plan . . . _ Number of bedroo.ns checks Stone-, brush, stwnps, rubble, etc'. greater than 15 ft. from nearest trench . . . 15 h't. of peripheral soil horizontally from trench. . . . . . . Junction boxes properly set Cou).d surface run off from driveway, roads' • ground surface., etc. channel noa.r SDS . i area . . . . . . . . . . . . . Doer lot drai.nl�gc app.-Iar 0. K. in area of SDS FINAL GLIDING OF SITE ACCEPTABIX f / I _ e"— 0-- 4..) ,� J'11. , •C- ►'z'!' i( , '�• /M��+i —.Z— 1. q! I w ! a J John DiPdAi4 o a 4 1�u�r cr Valley T, Owner or PurcFiaser;or Building Municipality John Dirdcheles, "fir 7 Building Constructed by Section a Drill y Location e Stre'et Block 2 story log cabin 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- approve.d 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 s.ucces- 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 oc.cu- 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 -. r- ri es of the" Ptxt rain -'Coi ty' Department" of- "Heal"th =as to whetYie "off rift ;JhC' failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the sy Dated this 15 day. of �1983 Signatur " Title, / rporation' :give 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 I T USE OF SYSTEM.. -- - - - - - - -----------JUL1-------------- Division of Environmental Health Servjc TAMP team y County Department of Health COUN DEPT. OF 'HEALTH YUR %I UWN-MEDICAL LABURAJURY INC. P.O. B2% 99 `821 Kear Street Yorktown Heights, N.Y. 10598 r s�o61` L_ J� 245 -3203 LOCATIONS: 0 321' KEAR ST., YORKTOWN HEIGHTS. N.Y. 10598 245.3203 LO-201 BUTTONWOOD AVE.. PEEKSKILL. N.Y. 10566 737.8777 ❑ 495 MAIN ST., MT. KISCO, N.Y. 10549 666 3335 „ .,Q,S - Qtq.ELE1G-t:9VE..lN6AR OS ITAL) CARME.L,r ,Y ,1.051 - �6Oj LABORATORY REPORT mg /L LAB„ # // Z->. ( "4-- U DATE TAKEN: - I DATE RECEIVED: 1 DATE REPORTED: SAMPLE SOURCE: REFERRED BY: COLLECTED. BY . HL ' IILZ� ❑ ACIDITY .................. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ............ %%�� ❑ ANTIMONY BACTERIA, TOTAL /mL •.... ..,1.( ......................... O ARSENIC .. ••.............................. ............................... ... ❑ 6.60. 5 DAY ................... ............................... Q BARIUM OBROMIDE ................... ............................... O BERYLLIUM ................................ ............................... . ❑ CARBON DIOXIDE, FREE .............................. ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ................... ..... ........................... ❑ BORON ....... ............................... '❑ CHLORINE ................... ............................... O CADMIUM .................................... ............................... " ❑ COD ... .................... ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ........................................................ ❑ CHROMIUM ( tot.) ............................ ............................ .... OCYANIDE " ................... ............................... ❑ CHROMIUM (hexavalent) .............. ............................... ❑ DETERGENT, ANIONIC ... ............................... ❑ COBALT .................................... ............................... OFLUORIDE. .................................................. ❑`COPPER ....................... ......... .............:................. ❑ HARDNESS ................................... :........ :....... ❑ COLD ................:....................... ............................... O MPN COLIFORM COUNT/ 100 ml ........... .. ❑ IRON " ..........................•.......... ..............•........•....... MFT COLIFORM COUNT/ 100 ml ❑ LEAD ........................ .... .. ❑ CONFIRMATORY TEST ... ............................... ❑ LITHIUM .• ONITROGEN, AMMONIA ... ............................... ❑ MAGNESIUM ........ . ............ .............. ................. . .- r��Nl7fiOGEN� KJELD:4HL :..::.:.:::..:.`.... .... :.........:.....�.......... ... ,.....O..K7IANG'AFIESE ° ... .... ONITROGEN, NITRATE ..: ............................... ❑ MERCURY .................................... ..............................• ❑ NITROGEN, ORGANIC. ... ............................... ❑ NICKEL .. ...........:................... ............................... ❑ ODOR ...... .......... ...............4............... ❑ PALLADIUM ................................................................ ... . ❑ OIL & GREASE .................... ❑ POTASSIUM: ............... ............................... ❑ PH ............................................................ ❑ RHODIUM ........ ............................... ........................ OPHENOL ....................... ............................... ❑ SELENIUM ................. .................................. :................. OPHOSPHATE (ortho) :...... ............................... ❑ SILICON .................................... ............................... ❑ PHOSPHATE (condensed) ... ...........................:... ❑ SILVER ...................................:.... .......:....................... ..................... ❑ SODIUM ..:........................... ❑ PHOSPHATE (total) ....... ..:......: .... ❑ SOLIDS. SETTLEABLE, mt /L . .......................... ❑ TIN ............................................ ............................... ' ❑ SOLIDS. SUSPENDED ... ............................... ❑ ZINC ................. .............................`.... ....c.�...11:{{................. ❑ SOLIDS, DISSOLVED O ................................................. ��C:••1 •F 83........ ... ❑ SOLIDS. TOTAL ........... ............................... ❑ ............... .................................................................... :. . ❑ SOLIDS, VOLATILE . ...... ...:.......... ❑ REMARKS: ............................. RILITNAM-40UNTY•••••• OSPECIFIC CONDUCTANCE .............................. ❑ ..:.......:.............. ..........:...:....DEPL.W..HFAUR...... ❑ SULFATE ................... ..:............................ ❑ ..........::............. ❑ SULFIDE .................................................... ❑ ...... ............................................................................. ❑ SULFITE .................... ............................... O ............................................................. ...... .... . ❑ SURFACTANTS .......... s .. ............................... ❑ .................................................... ............................... ❑ TURBIDIT .. .............. ....................... .......... .......... ............ ............................__. _.. _. :. THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS 'INDICATE THAT THE WATER DID MEET THE SAT FACTORY CHEMIC L UAL OF -NEW PORK STATE ADMINISTRATIVE RULES RECU TIO S, D K WATER STANDAR (PRZ --72) FOR THE PARAMETERS TESTED. ALBERT H. PADOVANI M.T (ASCP), DIRECTO U l� WELL COMPLETICYN REPORT 3171 PUTNAM (COUNTY DEPARTMENT OF HEALTH Oiiffmtion of -Environmental Hoalth Sorvices COUNTY OFFICE .BUILDING • CARMEL. NEW YORK `ibit report is to be completed by will driller and sul,%:itted to County {iealth D45,irtmcun4 together with laboratory report of __....w- Ftaiysif'm vvatet r ple`6ndiwatirgl:r� tRr rs,,s�f-;F:;isfai:r;,r .Wcteiial qualiiy'bcforc.ceriificatze of canstrlict.icn �;oi^ Eian a s.issupd.;; REPORT PAUST BE SUWAITTED V11THIN 30 DAYS OF <YELL COMPLETION OWNER` NAME Al c/ A ADDRESS &OCATION OF WELL (No. & Straot) 19 ' (Town) (Lot Number) PROPOSED USE OF WELL L1%j DOMESTIC SUPPLY BUSINESS ESTABLISHMENT INDUSTRIAL O FAR)A D CONDITIONING ® VEST WELL ® OTHER ) DRILLING EQUIPMENT ROTARY Q COMPRESSED AIR PERCUSSION ❑ CABLE PERCUSSION ® OTHER (Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) VrEIGHT PER FOOT )s ® THREADED. [:]WELDED . DNIVE SHOE YES ONO (WAs A NG G-'O�� ? Ki YES L__J NO YIELD TEST (� BAILED HOURS PUMPED COMPRESSED AIR G.P.q. 0 YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE— STATIC(Specity Lett) DURING YIELD TEST (feet) Dcp& of Complefod Well In 4ao4 below fond surface: SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including grovel pock (inches): GRAVEL SIZE (inches) FROM (lest) TO (feet) DEPTH PeOM LAND 7 FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. 'SURFACE --'— V RE ` EVED JUL 12 1983 ©Epic. - 26 Po ( 6 I F` T'V k •(i Of yield was tested of different depths during drilling, list below FEET GALLONS PER MINUTE %Ot 3 4- A4, DATE WELL COMPLETED DATE OF REPORT WELL ORILLER (Slgnatum) PUTNAM COUNTY DEPARTMFN T OF HEALTH DIVISION _O,E. IIVVZRO. NP�LFI�TA�FiAJ ,TH�:= SER�TICES'K'`;' - "y' "f -�'= �'- ... Gentlemen: Date March 25, 1978 Re: P.roperty of John Frank DiMichele, Jr. Located at Irma Drive (Cff 'Luigi Drive) Section 74 Block 3 Lot 5.15 This letter is to authorize John S. Romeo a duly licensed professional engineer x or registered architect (Indicate) to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated 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 - tY�= pr6�rsoris" ti�''t1ce 'T� or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: Very truly yours, Signed a� Owner of Property Address P . E . ; R =X, # 027846 / 9` - S" o ate Telephone I� Northridge Rd. ( Seal) ENG /�FF,p Address o ®�o��' S.� Ro�'F��q°o Peekskill, N.Y. 10566 a G, 737 - 1056 -."` , a ,s a Telephon© o� tlr2•�sWa �0�� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL BEATTH SERVICES =CO li ,-`bi RICE"BUILDING CAMEL, N.. Y. 10512 r'DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL' SYSTEM FILE NO. ' Owner John F Di'Michele, Jr. Address Luigi Rd., Putnam Valley, Located-at (Street) Irma Drive Sec..74 Block 3 Lot ica e nearest cross street) Municipality' 'Putnam Valley, (T) Watershed Peekskill N.Y. 5.15 . . . SOIL PERMATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION No. Start -Stop Elapse Time Min. DepEh to Water From Ground Surface Start Stop Inches Inches Water ve in Inches Drop in Inches Soil Rate Min. /in drop (1) 1 _12,:_30 1207 27 23.50 26.50 3.00 9.00 2 1 :01 1 :31 30 23.25 269'25 3.00 10.00 3 1:34 2 :04 30 23.50 26.5o 3.00 10.00 5 (2) 1 12:35 12:59 24 22.50 25.50 3.00 8.00 :23,50 3 1:38 2 :06 28 23.25 26.25 _ 3.00 9.33 3 4 5 Notes: 1) Tuts to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 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 -, . G.7�,. _ a _ opsoil. _ _Topsoil • - - � - .,.� - - lop-q94;7- 611 6" Topsoil $'I Topsoil 7" Topsoil 12" Brown silty loam brown sandy, silty loam brown sandy silty oa$ 18'r' 241.1 ,grey sandy loam 30" grey sandy loam 42� -rock 11 48" 54" 60" 66" 78" 84" •. - INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED - TESTS MADE BY Joyn S. Romeo Date 3/25/78 -DESIGN. :.... -- -- .�:.'Sai�� Pi r ® ®v °aa1000, S. No. of Bedrooms 3 Septic Tank Capacit 100 Gals -O`�� y Absorption Area Proved 13y_275 L,F.x24 " 3611 Address 1 Northridge Road Peekskill, N.Y. Sag 6 Zi gna ure ° SEAL ®Jf 27846 0 ®m 9�OF NEW 9" ®Qom ®® THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date