Loading...
HomeMy WebLinkAbout3488DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.20 -1 -13 BOX 28 %Mol'Feo� Mal . , �, 96 ` %Mol'Feo� PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 1 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Tew. ., Village - Located at ` Tax. Map, Block Owner Separate Sewerage System built by Consisting of Gal. Septic Tank and Other requirements Water Supply: Puprrc Supply From' ✓ /Private Supply Drilled. By Addre Building Type Has Erosion Control Been Completed? Tax Map Lot $ Subd. # of Bedrooms Date permit Issued I certify that the system(s) as'listed. serving the above piemises were constructed essentially as shown on a plena of the completed work ( copies of which are attached), and in accordance with the standards, rules and regu ons, accor ce wi a fi plan, and the permit issued by the Putnam County Departmentt Of Health. Dat Certified by p " P.E. R11.A. Address LI nso No. v 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 uiage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the pr vats water supply shall become null when a public water supply becomes available. Such approvals are sub)ect to modificatioh'pr chanlKwhen, in the Judgment of the C YK-Isslonei of Health, such Mocation, modification or change Is necessary. Date _ BY. Title C#"—� nl' rOwN MEDICAL LABORATORY INC. P.O. Box 0 321 Kear Strut Yorktown Heights, N.Y. 10598 245 -3203 RESULTS OF EXAMINATION OF WATER LOUIS MALLUZZO !L I GE TOWN 6 /OR N A DATE REPORTED - { LOCATIONS: PUTNAM VALLEY., NY ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 -3203 11201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737 -8777 11495 MAIN ST., MT. KISCO, N.Y. 10549 666 -3335 TAP-. PARTRIDGE ❑ STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278 -9330 DATE COLLECTED COLI FORM GROUP (Most probable No. /100m1.) HARDNESS, TOTAL -ppm 2/10/81 (11 A.M.) 4 0 MFT DATE RECEIVED 2/10/81 (12 s 12 P.M.) ,: NITRATES (as N) - mg/L DATE REPORTED - SOMERSET LANER PUTNAM VALLEY., NY 2/12/81 'LING POINT TAP-. PARTRIDGE LANE PUTNAM VALLEY NY 'ERIA PER ML. (Agar plate count at 35 C). COLI FORM GROUP (Most probable No. /100m1.) HARDNESS, TOTAL -ppm 4 0 MFT :RGENTS - mgJL NITRATES (as N) - mg/L IRON, TOTAL - 'mg /L f� )NIA, FREE (as WL pH= CHORIDES - (mg/L) COLLECTED BY.* JOE SEROLIMO e results Indicate that the water was YES of a satisfactory sanitary quality when -the sample was collected. ! A. H. PADOVANI, M. T. (ASCP) i TOWN OF PUTNAM VALLEY II� WELL DRILLERS AND REPORT L This rep^rtlis to be completed by well driller and submitted to Bldg, department, together with 'laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality. Wall Location : �°° A i :rg.ra ► t: C.' `�I Well Ow��er Name Well Driller Name CASING DETAILS Length Ft. eet Sec.. B1. Lot ..ld�✓are��� Cl�c,e._, ,t�G�uLrn L Mailing Address City 45r Town Tel. # Mail g§ Address Y City or Town IELD ailed i (Measure from and su or umped Hrs. Statics Ft. Makes ace When Bailed Slot Diameter_a*? , Inches Yields GPM or Pumped Ftj Lenath Ft.Size Diameter In TOTAL DEPTH OF. -WELL OU Feet WELL LOG Depth from -Give description mf formations penetrated, such Ground Surface ass peat, silt, sand, gravel, clay, hardpan, shale, sandstone, granite, etc. Include size of gravel (diameter) and sand (fine.,_,. medium,_ stru -a;o ,-; as ; .paciceci.�.._...._. _ cemented, soft, hard).' For examples 0 ft. to 27 ft. fine, packed, yellow sand; 27 ft. to Date Well Completed / a -/7 �/ Date of Report ' Well 'Driller BZS 1 -77 Signature TOWN OF PUTNAM VALLEY WELL DRILLERS LOG AND REPORT r WELL COMPLETION REPORT This.rep�rt is to be completed by well driller and submitted to Bldg, department, together with laboratory report of analysis of water sample indicating:water is of satisfactory bacterial quality. Well Location Tax Map Street Sec. Blo Lot Nell Ow er il� � (!'.J . Name Mailing Address City r Town Tel. # Well Driller& Name CASING Bailed :(Measure from and surface) Lengthy Ft, or Pumped HrsoiStatic: Ft a Make: "t When Bailed Diameter:1 Inches Yield: GPM or Pumped Fta Slot Ft. Size Diameter In TOTAL DEPTH OF WELL ;- :_� 4-10 Feet - WELL LOG Depth from Give description of formations penetrated, such Ground Surface as: peat, silt, sand, gravel, clay, - hardpan9 ,,_ -- ,:_.. _ hale, sands tc:�e..4.wgarante; e;c °o Include size of gravel (diameter) and sand (fine, medium, coarse), color of material, structure, (Lose, packed, cemented, soft, hard). For example: O ft. to 27 ft. fine, packed, yellow sandy 27 ft. to 134 ft. gr y _granite ;fee' to Feet Formation Description Date Well Completed %1 `v / i ` Date of Report f Well Driller__ 2�.7��,�C'`r�, B ?S 1. -7? Signature �Ii:_' Divfs�on of xEnvironmenfa/ He CO TRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEI a _u tr on n 6uilCl ype" S� Lot Area ' r$ NUmi f Be&oOTS s Separ ewerage`System to consist wf Galri TO be structed by �/- 45 Water ply ,�PGtil�c "Supply (From " ay r Prrvate,zSupply to 1be'dr,illed by � •, � s :Address - ` ' nP' � Other ' liutrements - I repress that i- am wholly and tompletely responsible for the tlesign andi vvunry�pepartment�of Health r •- , r q:; sAPPROVp FOR CONSTRUCTION: Thin apprgval� expires one year from 4h -- xrevocable far cause or may be amended or: modrf'ied when considered necessar Iequires .a riew• permit ?Approved for disposal of domesti y sewage n � kRTMENT`OF HEALTH i; Services, Carmel At. Y 1 U512 ' h - Town or .Uilloge LOL- S g ;Address % / i.70 7 WC245 r, L 09AI.- ;s cyi�•evB o:.r N Y �` Tofal Habifab`le Space ��� Square , Feet tiaEankt �� y neal feet 'X L ' _width Srench r x, q Address � R.t�rS ition;., Of the proposed :Syste -w sp ,1), that wage ,disposal_ system : to'anii m accordance;wdh thestandar N95 U6� s'o a urfnam 3-of uction CompUance Constr'"sati 9 t � r�ritiis or of Health will I the owner his successors �he�r; or ny. th'e bw R Yha aid builder' will , l during the7period of•,�,two (2) y ihi la`t!ft,#p VWih to of theJssu j or,igihal system or any!repa�rs f r t t, rl WWII ' cribed above; I m accordance with the stand tl{; ule ns �c :"the 'Putnam tk ° t ci's "•� o� °p P. R.A. O 7"0 N License gyp e e date- issued unless construction o e ndertaken; and "Is. ' y'by then Isslonerrfof,AHealthi A. h 6#.Cf1t,. iorrof, construction:'' a1tl or prtyp.e water supply only PUTNAM COUNTY DEPART. MINT `?OF HEALTH _- nTVISION OF J NVIRONMENTAI: HEALTH SERVICES _.. � � —_L _. ."•.- J..a -.. ...� -e �. .-4 :..3uw. J`�.. ..» ... iL�.� •._-• . _ .• _ _ _ � -... ._aa+. _. '.t, -- =•a. ., �.. • . ..t :w -b•. .4:•+ ,•_K COUNTY OFFICE BUILDING, CARMIEL, N. Y. 10512 ,.. .:: DESIGN DATA S..TIEE''- SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0: Owner levi3' /rlpce viz zo , %1A Address gd, egg- !l'/ ZA Al. Y. ' Located at ( Street ,a,�s���G� LA. Sec . 69 D1ock_I,ot - Indicate scares cross street) Municipalitypyr^o " e,1.44 Watershed SOIL PE RC01XVION TEST DATA RRQUIRED TO ICE STJ13MITTED WITIT APPLICATIONS Hole ..Nu' ber CLOCK' ':CIM!? l'I?:RCOIJITION PERCOLATION Rai, aPs'0 Do, pt i to Water Water, lovel t, No: '.Came From Ground Surface in Inches Soil bate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 /'a •oca- �o �30 �� 20'' ZG �, n G �. �, ¢.6' 7,-V / a 2 rp 3s' J /'os' 30 20 '' 6h " G �4 ' 4 B /,V A/ 4 5 ' \O TEST PIT DATA REQUIRED TO BE SUMITTED WI'�7fl APPLICATION`,, LAPPLICATION`,, DESCRIMON OF: SOILS ENCOt a'Ci:RT. IN T:ST f'OLi?S _ , -: `., r_s ;.s 3:...r = °.,Y�_.::.. ,; ' '-, =z:- - +.,...:'a� el+ a _. ` ' <�.y «"�,.c 's. i..:• -r' P ::.irt..\. -° 3._. �:i; ..:._ �i..� ...�r�:.a '' -.� c.v _ :vi_rs W DEPTH 810LE NO. _ ® 11OLE 'N'D, HOLE'. ISO , LE R.O e .� ���„� ' COLo �/J •4oiL :70d -50 6°° . it N -- �---°� Il 20B 1�&T ,�o c.�n0 'SAN ,0Y � p'll" �.u17 24'0 - 3010 0� 3600 • ri 4290 4800 v 5400 6000 R.0 eA- 6600 7200 m 7600 8400 INDICATE Y.)aVEL AT WHICH GP.OUND WATER IS EUCOUNTERED INDICATE LEVEL FOR WHICH WATER LEVEL RI S AFTER BEING ENCOUN72RED e�✓� iG DAT ��. A lf ® C TESTS MADE BY DESIGN Soil Rate Used Drop:. S.D. Usable Area Provided 5ca(" o S1 No, of Bedrooms Septic Tank Capacity 115700 Gala. Maaaonry tt meta2,�eO,,_, Absorption Area Provided By L.Y.x2400 360° width trench. Other �.�.. 77. F ME Name, km,, t �9 eez eai ?g�,g jr,� . Signature SEAL ddirosa �. 1 2'00 �p i'utrlcn Co�neety Health Department ° "ac.frGlnEE "b Sall Rate Approved 0 sq,Yto /Gale: Checked day ®ete TOWN TAX MAP,DATA Sec.1jobQ9 Block 4 Lot B NOW OR FORMERLY PERRY N-299361 W E 189.15' c� cli ft LAi 309 _J0 EXISTING 1.1021 Ac. o WELL A PP (48,009 S. F) t 16.6 jQO!W AG. duo a FEB 11� 0 Ti 3494- -,w 55.Z4 Fr. 0, g . ger. -0 Southerf sL �fo,th rA (I EM y. 301110reet Line 0 , , — , . 1,64 0 E. , r., 71JI177. -e IAJ (N 0, NVI I 'bl 1 r' 34 IVA 6t'L:S H OWN HERE . ON KNOWN AS LOT No.39 lb MA ENTIT LED SEC. B OF PUTNAM ACRES" FILED'IN: C(iUNTY, LLkkd OFFICE AS MAP' No. 815 A. itf BJECT TO E' T91CI AND/OR TELEPHONE CO. LE6 CERTIFICATIONS INDICATED HEREON SIGNIFY THIS SURVEY'� .,EASEMENTS,IF ANY; FOR OVERHEAD AND/OR WAS PREPARED IN ACCORDANCE WkTA.THE EXISTING UNDERGROUND; SERVICL 'ADOPTED BY THE NEW OF PRACTICE FOR LAND SURVEYS YORK STATE ASSOCIATION OF PRUFESSIONAL LAND SURVEYED AS IN POSSESSION,(No Linesof Possession SURVEYORS. Other than Indicated). SUBSTRUCTURES AND/OR THEIR ENCROACHMENTS SURVEY OF PROPERTY BELOW ,GRADE, IF ANY, NOTSHOWN. -HOUSE OFFSETS TAKEN TO FOUNDATION'LINE. PREPARED FOR PROPERTY CORNERS STAKED FOR BLDG. CONSTRUCTION PURPOSES ONLY. MALLUZZO REALTY CORP. 'CERTIFIED"ONLY-TO: LOCATED IN LMALLUZZ11 REALTY CORP. 2 3• ,-TOW W OF PUTNAM VALLEY J. HENRYURPENTER 8 C PUTNAM COUNTY, N.Y. Fdl V 11 ENGINtERING. &.LAND SUR VE , 10b . iYORKTOWN HEIGHTS NY A ;.1 M fifications Hereon are Valid for'This Map. and Copiss Thereof HeoTy Carpenter 8 Co. Do Hereby Certify Tho I OnJ I nly if Said Map or Copies Bear The Impressed Sect of The Surveyor a Survey of The Premises Shown Hereon Wo Made and ThotThis Map Whose Signature Appears Hereon. is 'made in 4ccordpace ith The eld Notes of Soid Survey. Alterations of This Map Other Then by a Licensed Land Surveyor is illegal :: SCALE 1 " =60' DATE:' i.jIly30,1976,976i 'A', 41C HARD A.- SEABOL-PTJP: o.49010 2. !i 5' S U R V E Y 76 it:126, - �VJ __ter w t ia ioo 91� m 1 � 6': 36 W 272.6 It d v N Ja ,ice � t • > sli '� o O wx� y g4 ' ;ii _ /� t _ ___ '��r y-�� -✓ � f � �O�a. //���f 000 vi r a