HomeMy WebLinkAbout3490DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
73.20 -1 -15
BOX 28
03490
•`
.
L9
�'
' Lmou
I A
a
03490
'Located.at�jj
Owner / %/Q
` Y
`. ✓ser�ii C f
Separate .9e_ System busft by_7
` Consisting Zof �2UU Gal;` Septid Tank
Other requirements_
water :Supply - = IPUblic ,Supply trom
e
Pnvate'Supply Drilled Sy n
Address ;�Q ✓�1 �r r J
.)1
'Bgilding TYpq,'. D •,S�r� .d /D�'l rQ
Has Erosion Control Been ,Comp)eted�
I certify that the systems) as liste8 serving ;the above premises war,
attached) and in accordance wltfi the standards rulestand•regul
b •
CE
{Address _
F "Any person occupysng. premises served by the above systems) sh
conditions resulting from: such usage ,. Ajpproval of the separal
r:; aveilatile and 'the approJaI of tfie °prrv5te;water` supply shall becc
subject,ito modification:.or change when` m the "judgment of #�t
d 4 7 r
CY �DEPAiRTMENT Jb F:HEALTH .
�l Health Services, Carme% N Y" `10512' -
ti _ :�1L�.tr'�•u�i C....iM�) :i � rS:. �i�' i �VL[ ✓� !/� / :(/%��)t//fi %�!/'��0►tj
x Town ;or 'Village
PG:9 T
LoSeTen 7/ J -
,/_
,Address
xlmeali Feet X ' 'width trench
- - -
4 sa
r � -
4
-; _p of'Bedrooms,' OL// Date Permit Issued � _
ter
onstructed a ntia y as shown I a plans of the; completed work ,(copies.of Which are
>ns plans f ed d the per s i' ed by- t utnam. County Department of Health.
had by ��11CCll - 'F E R.A. •
- AA—I—W . License• No
promptly take such action as may -be necessary tor�secure 'fie correcton',of:arty unsanitary
< Z n -_;. +
sewerage systemsshall becomenull and s' soon as ,a ;publi'c.sariitary, sewer becomes
null and voidywhen axpubl�c water supply becomes available Such approvals are
Comm r.? f Health; such re`vo tiori; odrfication,or change;is, necessary.
Title
c-• ,'�a::c'- i':�o..,e�- ��:x�_ _. • ;�"' ,g- �,.'o",.r ": :�-°;.:u..;.b��::a��.'9 -+ a,- ,'�:z�r��<'�.a`�r. ^..7"�"� -- �^. . "�:,
October 29, 1973
Mr. Robert J. Tutoni
Putnam County Department of Health
Division of Environmental Health Services
County office Building.
Gleneida Avenue
Carmel, New York 10512
Dear Mr. Tutoni s
This is to advise that I spoke with Mr. Falcone of Partridge Lane,
Putnam Valley, in connection with the location of his septic fields
in relation to my well.
He has a reed to make the Lfollowing changes to his septic systems
1� He will cut back on his 4 lateral field lines
so they will end no closer than 75 feet from my Drell.
2)-He will join the open ends of the 4 lateral lines to
a closed pipe running perpendicular to the.4 lateral
pipes and extending in either direction a sufficient
distance so that the open ends of the closed pipe will
be no closer than 100 feet from my well.
3) Both open ends of the closed pipe will open into a dry well.
If Mr. Falcone will comply with this change, and if this arrangement
meets with
y _. your approv 1, I will have _no objectia tta. .
a wi � e n the shoo
a,..s_ � >.._.- - r_ ..t.00��• CL..:�..g�• tC ii18' �vp ti:; f�.v' s o __ _ •- - .... ..
Very truly yours,
HERBERT KAMPF
Three Arrows
R D 3; Box 262
Putnam Valley, New York 10579
I`
K .,' rn.. L�;. �i..,;;•: �...,:'. �s�d3s .��L�'_a-�
Owner or . urc aser -of Building
'RUlding Constructed by
�i^fIi�gQ
Z ov e
Location -'Street
Building Type
Municipality
T1 PG .
C%!o q -d QUA
jM
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-
var.es...of ..the. Putnam...County Department of Health. as to whe.ther or not the
' iai°iui.c; - or` "uf0 system- co operate °�Nas caused by the wliiful` °or' negligent"
act of the occupant of the building utilizing the system.
Dated this 2 7 day of 19 73 Signature
Title
If corporation, give name
and address)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMP,ETION 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
77
COLIFORM.GROUP (Most probable.No. /l00mI.)
R TAL - ppm
lest tha x C y ~
ETERGENTS - ppm
NITRATES (as N) - ppm
IRON, TAL -ppm ;
r
,
PEEKSKILL MEDIC AL'ILABORATORY.'
i
i A. H. PADOVANI, M. T. (ASCP) .
rr,,• r ` , 1879.Crompond R4 Barclay `Plaza Bldg A; Apt, 1
t
`a4+
R ",
1'eeklu, ari,TL L '! r�
i
PE 7777 .. .
..
•
_.. +. .. .. .,• �.... . S , �� w .. - - ." .. .. v +... r
- 1V
y CEO LTS OF EJtAM.INATION',OF, WATER
..
_
DATE COLLECTED
't:r
r
8/29;/,-
- ( l4"
1
DATE RECEIVED
3 a! cone
TY, 'VILLAGE, TOWN. �&/OR. NAME OF SUPPLY "
DATE REPORTED
„a
I' tv e1 g,2 i;:uIe Ra tna zil , Va116 y ,. ?i,�r
�1�,•�,�
'A.
�MPLING POINT.
1
� 1, lti
• s � �
�
15T A'PER ML,...(Agar plate count at 35 Q.
COLIFORM.GROUP (Most probable.No. /l00mI.)
R TAL - ppm
lest tha x C y ~
ETERGENTS - ppm
NITRATES (as N) - ppm
IRON, TAL -ppm ;
TE?S , of -a satisfactory sanitary quality when the sample was collected. }
LOURIDE (F) '- mg. /1.
;
1%h se results indlcat�e that the water was
TE?S , of -a satisfactory sanitary quality when the sample was collected. }
i
i A. H. PADOVANI, M. T. (ASCP) .
�a
i
r��+ a .• ♦ .�...
..
•
_.. +. .. .. .,• �.... . S , �� w .. - - ." .. .. v +... r
- 1V
..
_
! 1N�
I*t
- ( l4"
1
rf;`.
+ n ,
� 1, lti
• s � �
�
.Rt 143 ' +'
� •, f'..'
4
,
+
} •'`fY. .+ _—
,�f ss k
-
— .o.. "yam„'.. .mac Y. .. ., u
F
LOG XNI7 RE 0RT-
_.,fir =/ ,_ 7, ,
i " xtr' .' 1' .. +�"o^..`:bY -� i.+ r- of..'.. '[,., � . ^ _, .-: �"�.'.. ;...:..� ^' r ��• •, .... ir.��Y.aw
iz: � t' of
Tame of Place Gi y,llage or, own
P.O. Address �
Lepth oaf wc13. ir Diameterl ,1_ _ , _ as woll aisinfected7 - -- n
ft. in. gpm .yes or no ,[
of casing above ground Id'" Below - ;round Voll seal
in ft packer, cement, grout
I
Draw a :::11 diagram in the space provided below and show `:;he depth of '
.1; =; �;, the w::ll s,.al, kind and thickness of forma'ions ,,.enetrated, water
b ; e.rin� forma . uionst diameter of drill holes with do'�ted lines and
cxs_1i-I, s) with solid lined. �
FOIY.iiTIuNS PELT ;TRAT1:,D - REPL,.',KS '
Dai;leter, in. Depth hind, thickness and ype of well
in f.t. if water bearing drilling wit''A.od _
Grade Was well dynamited.;
25 PUMPING T:.�.JTS
Details - #1 - _;�2 r7 r
Static eater I
level., in ft.
50, below �rade
pumping rate
in gpm
i,
75. PUMPITIg level in
t. below ,,rade '
100 tc;st in hrs. �i..
Clear Cloudy .'urbid%
Recommended ..depth of pump in
well, feet b-low .trade
WJ:/LLS IN SViD VL GR1:V; L' Mw
i
200 j
Sand Eff. sizo �mrn
Hamel. eftefsize `
Length of scro en f t ., i
Diam. of, screen
250 Type of screen _
Screen O-penin�s x r
C OFILOI T S :
f
i
a ;,ketch of the property
Dn the. back pf this sheet locatiog Drilling started _ C,.zplet ::d is� J3
D S.-,WAGE DISPOSAL SYS Z
Well Dri lher
�.
Si, ;nature
F-7-7
CONSTR
Locate .-,a
Subiiwtsion
Owner
%
.Water - Supij!r:
k
Other, ROul 6mirll
ab6WdesjrA$ed. *il
-b
'�bii 'iub ffi lft6d5' , it
-%.APPROVED FOR Z(
reVocqbtq- or-,ca4sp,
rqq4,res a jajjmVer
Date
0
YPP--Y From
;Cipply.lofiodriq!(
:TMENT OF HEALTH
Z
lervices, arme
v
----- - or village
-14 Job'
Z7.
A
Tbtal-y';HabitfAble Sp
Square :Feet
,
width lirenc
i 6
7
x
rate sewage
Idispolsal,: system
�-`
egu 14t ions of, A he , PUtna m
a rules
r ornmossioner, o.! dhithwili,
i+ u at said!,`b de i
.., L?
License
struction of the bwldmg 'has 'been *u underta
It py
change or alteration` f construction
.tea
:', �:. �° ��.:%...,+: �:_-+:; �-'`°` a, ya::.:. .°.-'. �• rsn.•'<' �; �' �3rr. z;{°. iy: �, Xrh�'. r'. :'wmora:ie;a'�.+r ®:..+aric.: ^�- ���• er+ ti-• X.y; �ip. a�' a+ �: �.:: a+. S ..?3,rr"•+,.uic�ia"•�i•:» -'�� �d:i,
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date F 7 /� 73
Re : Property of /'//r 0 /''��S �'N �,�. �l�L c anir
Located at "41", 'eT '04 6 "*/Vg
R
n -06 Lot
Gentlemen:
This letter is to authorize 49yz1,O'1Z X
a duly licensed professional engineer P.X or registered architect
( IndicaTJ-
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
Iepartment f HCaith, 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 with the provisions of Article 145 or
147, Education Law, the �Public ~Health Law, and the Putnam County Sani-
tary Code.,
Countersigned:,
Very truly yoikrs, p�
Signed Ora4a
26r of Property
dn SIX, a!,rp_-j Address
Z Ifal- �� ax ( Sea of roet�
Address P�� P 0
x//144// /1// o
y a0
Telephone
�ysFC r Y NO. 39
� ' 9fESSIONp
or nno
41
...+
PUTNAM COUNTY DEPARTMENT OF HEALTH
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. +/
Owner J u s "N �� I-C-_4 -,1 E-- Address Z �{ y u 2 S it Y G ►� n r �'
Located at ( Street PA 2:T R-r o c, S L;a-,r E BI_eek Lot
�Indicate neares cross's ree
Municipality, 2VTN Ae1 "LL-cY Watershed
SOIL PERCOLATION TEST DATA REQUIRED-TO-BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
RM apse p o a ter Water ve
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
4
5
2
2i `/L
2-
2 /y 36" !/' oG ?c
3
1 /'(2- �� �4 Z.
4
4
5
2
2i `/L
2-
3
1 /'(2- �� �4 Z.
4
5
0-3 1
o /a,'jj r 3o
2-2 �XI
/o y
3
U:0 - U: s-) 30
/�.:
21
2-
Notes: 1) Tests to be repeated at same depth until approximately 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.
" 4.
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLI
•� �. s� ..._..�c �.-. h ��.rr sTv l+ T ! .. c� t ry � n T<
....s- �,�-'3 -'i�r -v.v :.fF�. l..s'ii�'a�'�:�+. ..CJU•tii� u�,a�- �-.�'l�FFTr rr�: F+it•1P���t7hWX:.I��iL•1
DEPTH
HOLE NO. j HOLE NO. HOLE NO.
G.L.
f Sci
6"
S/1--d #3 . CfZA ✓ E c� S ,L.
12"
1"
� 4
18
2T"
` y
301
36"
�L y
40
C.1.
48"
iC n c:K
5411
60"
66'►
72
78"
8411
:.... :......
T AT
INDICATE
LEVET Z0 WHIM WATER LEVEL RISES AFTER BEING ENCOUNTERED
'PESTS MADE
BY _ Cr I 9-!(-7i_U CC E, z Date Aio 0, / � , r
Soil Rate
DESIGN _ -
Used//-/S- Min/1 "Drop: S.D. Usable Area Provided
No. of Bedrooms
Septic Tank Capacity 135-1 Gals. Type
Absorption Area Prodded By z`f o L.F. x2411 3bj ,q-. c.� trench.
OF N
Name D il t V rt c. rc.7-7z. � c-c z- r
Address `Zi 14-4Ls i y Ao- C-L
✓tc. '0�1 Z'LA3 A,/. Y. / o j�—/ 3-
THIS SPACE FOR USE BY . HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal. Checked by -... Date
CA
cl
':C_ ... v.. , r•�8•» } :a__; ;';r,',:��r�, "�n /�,..s :�t Fro 'Z _ �• = 1*. , a'�. K %;:..rc 8 �''" v i -.+� �. °'�:.e _ .i:.:i'•:v;.'ri+�:y.�i:� fir., ".:.
�
- a ,
ZE
�� t v
tlZ
vi
Q.
�e
d
S 02E 43�40*w
' 611)
>
0 7"
/Foo
I
Lq'
a
O
m.Lq
07h
7it
-5 It
31
ra ve\
fl\
OF 'Wrip /-5 ur
7
//70 5,�eA4--y e C Q
are a,',lC7' 1-hallhl
The
3
7-M. 065.9— )4-049
G./6L-5 4-'51-61CAZCI 1;'2
2- A NE
7h' R 7y 52,e
/e U'o o 4 PAI rR 4 r P6JTA,14A,7 CO 7:,v AlleK/ YORK '6e V, 5 Auk.
APPROVELI
s7zs
1114
PUT, li':AL71
ONVIRONMENTAI. HEALTH SERVIrM
Z2-7-57A MBE
A
4417
35.3
3 7. 5
31.3
JrCJ CJ