HomeMy WebLinkAbout3539DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
74. -1 -14
BOX 28
�,�L �, ;:
or i
IN Ikc
�{�
IN
03539
PUTNAM COUNTY DEPARTMENT OF HEALTH
,^ "Div+ - on of . En vironments/ Health Services, Carmel N..Y. •' 1'0512 Y.
GE�iTl,FICf TE::OF CONS1CkVbTibN, COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley (T
_ -at+ i 3ae�r .L.w.n :.i _ 1•��i- -mow_° ..
r e s' Town or Village
{located at Boswell : Road _._ ; section 6`2 'Block 10'
Vince Morelli 3 ww •=2
nt
Owner - Lot` Job
s
d
_ 8is Sprout Brook.. Road _Putnam Valle
Donald
eparate sewerage system built 'by Head y qd
�A 1200 4 w {
Consisting of GaL Septic Tank lineal -F.eet X width trench
Other requirements Curt61 - Draihs tl31st7 led
'Water, Supply: ,. Public 'S'upply From `F
<� _Private Supply. Drilled .By, Norman Anderson, Tne
- -
.Address
Barger _Str'eet `Putnam . Valeyp, N. Y...10579 r
Building Type 2 Stor fraMe No„ of Bedrooms Date `Permit.lssued
Has Erosion Control Been Completed Yes =3 0
..I; certify -that the ),,as, listed serving'th`e above premises we re' constructed essentially as shown :op:f s:81F t� +work ,(copies of which are
attached),' and in, accordance :with the, standards, rules and regulatio`ns,' plahs" filed „and.thb permit "ilsu� .' t u fy Department of Health.
y , � � O � r � • •�3 .1.,• o �
Date' Majt 2% 1-9 2 Ca'r't
1 ` Northr is
Address
F s -
Any•person occupying premises served by the above systems) shall
_'i-Conditions resulting-from, such usage.- Approval',of the separate'
available and the approval of theprrvate water' "supply shall becom
subject =to difi
.mocation ,or change when <`,in the; judgment of tfie
Date BY
X . R.A. -
R d .Peekski7:,
.' 6 027846
r
L i—Ose No
mpfly take such action is.mayi thesorrection, of any,unsanitary
erage,systemshall become null °a
blic sanitary, sewer becomes
Wand'.-
I and void when a;- public' water >V pig m gs�wailable. Such approvals are
rrimi'ss r of; Health;; such ,revo
do CAI F tTon or• change pis ,necessary,
Title
'ORKTOWN M ED ICAL LABORATO RY IN C.
LOCATIONS:
PA. Box 99 321 Kear Street f(VN I IC I( I I i
J.Y. IO�!fl :•15.3:03 xTX 371 KI:All S T., Y(lK
Yorktown Heights, N.Y..10598 1..) 201 BUTTONWOOD AVE.. PEEKSKILL. N.Y. 105GG•737.8777
245 -3203 .la 405 MAIN ST., MT. KISCO. N.Y. 105.10 6GG•3335 .
I.I STONCLCICII AVC. (NEAft IIOSPITAL). CAfIMEL, N• Y. 10512 270•
- -..LAB �� �HV #0822` .: ._.�- . =�•-, .. .
DATE TAKEN: 4 P.M)
DATE nECEIVED: 5/20/82 P.M. )
r DATE nEPOnTED:
VINCENT MORELLI SAMPLE SOURCE: TAP: KITCHEN
20 BOSWELL ROAD REFERRED BY: _ CRCISSROADS PHARMACY
PUTNAM VALLEY, NY 10579
L- _ J
COLLECTED BY : V
MORRELL.T
LA130RATORI• REPORT
.._ mtJ /L
❑ ACIDITY ......... I ......... ... .......................... CI 1LUMINUM .. ............................... ........
❑ ALKALINITY ......................... ......................... Cl •1NTIMONY ......... ............................... ...................
BACTERIA, TOTAL /mL ... .......j ......................... E.1 •,11SENIC ...:.........................
.............................. CI !IAnIUM ....................................... ...............................
❑ 80D. 5 DAY .....................:....... .
❑ BROMIDE .......................... .... ............... _ ... CI !i nYLLIUM ......... ....... ............................... .
❑ CARBON DIOXIDE. FREE ........................ .............. CI BISMUTH .. ........... ............. ...............................
❑ CHLORINE ........................................................... CI IIOnON .... ............. ............................... .................
....................... .............................. ;AOMIUM .................................... ............................... ❑ CHLORINE .....
❑ COO ....................... ............................................... LI.(:ALCIUM ........................... ........ ...............................
❑ COLOR ...... ........ .. .........................+:.... ..... Cl c:linoMiL(M (tot.) ................... ...................
❑ :CYANIOE ......................... .............I................ Cl CIInOM1UM (hexavalent) .................... ...............................
❑ DETERGENT, ANIONIC ............ ............................... Cl I:OBALT .................................... ...............................
❑ FLUORIDE .......................:.... ............................... Cl COPPER .................................... ...............................
❑ HARDNESS ................. ........ CI COLD .................. .......... .... ...............................
❑ MPN COLIFORM COUNT / 100 ml ................ .......... Gl IRON ....................................... ...............................
�PrFT CO LIFOR:'N COUNT/ id0 mi .... :.� ..................• ... Cl I.EAD .................................:...•.. ...............................
CONFIRMATORY TEST CI I.ITI(IUM
❑ NITROGEN, AMMONIA ............ ............................... ❑ MAGNESIUM ...................
-. ..❑. N'TRRPGEN.- KJELDAHL _ ................................. ❑ MANGANESE ...........................
...... ..... _, ....
.
❑ NITROGEN, ORGANIC ............................................ Cl NICKEL ..... ............................... ...............................
❑ ODOR . ......................................... CI I`ALLAOIUM ....... ............................... ..
❑ OIL & GREASE .......... ............................... .. . .. CI 1`6TASSIUM ................................ ...............................
❑ PH .................................... ...........................:... Cl 11110DIUM .................................... ...............................
❑ PHENOL ....................................................... ......... 0 SELENIUM ...... .............................
❑ PHOSPHATE (ortho) ............. ............................... 0 ';ILICON .............................. ... ...............................
❑ PHOSPHATE (condensed) ........ Cl ..ILVEn .......... .......................... ...............................
❑ PHOSPHATE (total) ................ ............................... CI :.ODIUM ........................................ ...............................
❑ SOLIDS, SETTLEABLE. ml /L .... ............................... CI fIN .. ............................... ...........:............
❑ SOLIDS. SUSPENDED ............. ........:...................... Cl /INC ... .
❑ SOLIDS. DISSOLVED ............. ............................... CI ....................... ......................... ...............................
❑ SOLIDS. TOTAL ..................................... n ........... ... .. ............................... _
l ............
HEMARKS:....COY, TO „CROSSOA?S 1RI . ❑SOLIDS, VOLATILE .................................................
O SPECIFIC CONDUCTANCE ... ..............................
LI .............................................. v'
❑ SU,LFATE ............................................................. (_l ............ ........................ .........................Q:.... ......
❑ SULFIDE C.1
i ................................... ....i NO5❑ SULFITE ................................ I........................... ................................................. .
,.
❑ SURFACTANTS ............. ........ ............................... CI ...... .. .
❑ TURB101T.. ........................................................ Cl ............. ........................................ �.�.1:.: }i •;3 !r��r.•�I'
THESE RESULTS INDICATE THAT THE 14ATER WAStj1,4 OF A SATISFACTORY SANITA KURW I
THE SAHPLE WAS COLLECTED,
THESE RESULTS INDICATE THAT THE WAtER DI _ MEET THE SATISFACTORY CIIETNICAL QUALITY OF
NEW YORK STATE ADMINISTRATIVE RULES & REGU.I \TT.ONS, DRINKING WATER TANDARDS (PART 72)
ALBERT 11. PADOVANI N. T (ASCP) , DIRECTOR:
i
TOWN OF PUTNAM VALLEY
WELL DRILLERS IAG AND RI:I'ORT
-• - -. _........._:: _. -_
WELL COMPLETION REPORT
'; :� i ;�xcrrxt y � -�o ybe comp %� eel':: ��. �,:.,: wc�l: ��ira. 1• "-'xe�:�,and:- ;�.�ub�,i.:1:�cd �or�.. -= - . - .�. ...
:_�c�. depaztcr:cnt, together with laboratory report of analysis of
,•:;,ter sa-rpl.e i-ndicating water is of satisfactory bacterial quality.
Diameter �[^
'-G -AL DDPTr: OF 'ABLE �3a ' Feet
".% ?FLL LAG
Death from _ e Give description of formations . penetrated, sl.4ch
Ground Surtz.ce as; peat, silt, sand, gravel, clay, hardpan,
shale, sandstone, granite, etc. Include size of
- gacavel (diameter)-and zan .(fa.ne, medium, coar6Q )
color cr3. �a V" .StrriC^tur ;� (-I Se -Packi
cemented, sort, hard). For example; O ft. to
27 ft. fine,. packed, yellow .s:u-id; 27 .Ct. to
13A ft. orav o anite
�� �•�t t� Fc;: t Formatinn
JUN P
OF R
AL7
irate: W(-11 CGmple
01 of Report
Well Driller .
Signat"re
Tax Map Street..
Sec.
B].. Lot
Fame
Mailing
Address
City or Town
Tel. #
;•; c 11 Dr i 1 It r
a y � �1�,� �U�,; �% y.
,�iV�
Naire
Mailing
Oldress
City or Town
CASING DETAILS I
YIELD TEST
WATER LEVEL
SCREEN DETAILS
Bailed
Measure -from
surface
Ft.
or
X Pumped Hrs..
Static: Ft.
Make;
°.7; Izcr _ &_ Inches
Yield s- e GPM____
Men Bailed
Pumped Ft j
i .Slot
Length Ft . Si z'Q
Diameter �[^
'-G -AL DDPTr: OF 'ABLE �3a ' Feet
".% ?FLL LAG
Death from _ e Give description of formations . penetrated, sl.4ch
Ground Surtz.ce as; peat, silt, sand, gravel, clay, hardpan,
shale, sandstone, granite, etc. Include size of
- gacavel (diameter)-and zan .(fa.ne, medium, coar6Q )
color cr3. �a V" .StrriC^tur ;� (-I Se -Packi
cemented, sort, hard). For example; O ft. to
27 ft. fine,. packed, yellow .s:u-id; 27 .Ct. to
13A ft. orav o anite
�� �•�t t� Fc;: t Formatinn
JUN P
OF R
AL7
irate: W(-11 CGmple
01 of Report
Well Driller .
Signat"re
4-
PUTNA
2, M. VALLEY (T)
ding Municipality
Map 1238
Building Constructed b Section
Iff44 /0
Eocation Street Block
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, hisl. succes.-
Sors., heirs or assigns, to place in good operating condition any part of
said system constructed by me which fails to operate fora period of two
years immediately.f . ollowing 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-
the Director of the Divis,ion.,,of...Ma,v,,r t;
.onmenal Health ,,Ser-
vices"'of"the Putnam- -uo-unty7Departyrierzb",of,-H6a!-th-a�d--�to---whet-h6r*"-5fi"'ff6t"'th-6''--
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 19 F1 Signature _Agr,�"
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.
grio
Division of Environmental Health Services, Putnam County t v Sealth
JUN - 2 1992
P! COUNIly
D0_f- OF HEEA01-H
r Vincent Morelli 62
Owner or Purchaser of Building Section
Vincent Morelli 10
e, a•�t,i1`l {.�111�� tI V�J. r7�t.l a.l��Gl.l ...ryy.. f�..r. >a. �s .. �.. .. 4 '. • e.. ...� a.��VRV �r.�•... w— W' /� wh, •�:Y .. �� .•1" l• al• ... ..• .. .t.
Boswell Road RJ 2
Location - Street Lot
Putnam Valley (T)
Municipality
2 story frame
Building.Type
Boswell-Estates-Sec A
Subdivision Name
20
Subdv. Lot #
GUARANTEE 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 guarantee to the owner, his success -
ors, heirs or assigns, to place in good operating condition any part of
said system constructed by me which fails to operate fora 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 determin-
ation of the.Director of the Division of Environmental :..Health., Services.
of"the T1uth:Ahf- "County ' Department `of-of 'as"`cei ivh tiretr ter "ho: the - ail-:
ure of the system to operate wa_s caused by the willful or negligent act
of.the: occupant of the building utilizing the system.
Dated AAL / f
Dated this 27 day of. May 1982 Signature ,
Title
Corporation Name if core.
_Y Address
- - - - - - - - - - - -P� i WAf�ti � - - - - - - - - - - - - - - - - - -
DE��
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
'T
.#Ev�
'CONSTRUMr-li
Located A
Subdivision
WLT
I!UTNAM.� 0 NT,`0F_zHEA TH-,
an o
'" - Division of.. Environmental sHealth "Services,. 'Carmel _ N'. Y. jo5,12
Putnam
Town aor
swell Road
1'223 r
Sbrd.dg,�
kq
Ad ress SF
00 ,-
D 10 WUY +
1650'
Total :Hat
nnnn
—7777=�
Separite'Sewera4e.Sy "Stir� to 'd" Septic Tank
-and-
Tr
ei
Ed Btishe�r glbany ,Post :Road"
7
T-,
p,.' constructed :rby "Address
Water ,4Supply Public
r
nCroton on H-6d o
x
0 r 4:.i
.,;P iv e Supply to b,e',. drilled :-by�,l-,
S
Minimum 7
-."Other iRe4ui
L.represenf that I am wholly and completely responsible
above d'Will be constructed js shown -drl the
Appr
- ,County '-,pqpartnjentof Health, and that on completwl
be submitted to the :iiid -V written guars
_place , iq,,q said s(
ante of tK,, approvaIY 'i ;the 6it'i cats of si�,
Pon,rq!: tc
,
ate.,,
1 X02
e
Square -Feet
osai.systlim
Ee,u rem
i,:*ke-,a It h , wi I L'
of'.06, istu
ribed above
Address e 'No.- f
r
11.1 – T�
APPROVED , FOR
;CONSTRUCTION i"-
�unless 64:S!"fru lkL7?
'jdi.ng.has . b- p'i6' :u'i6diitaken,and is
revocable' -for r cause or maybe -amended necessary C 6m L %an§e t alteration of lop
- requires% new permit - v4d for disposal of domestic sanjW&
Date —_
Teti
Subdivlslon
owner
BuilQing ,Type
NUMbdr 6U06dr'6`6
,U T AM-C
D;vj 1on ,Of.. Environm
swell.Ro"lad-
orpy, dame
Lot Area
.80,0.
Y.
i ei s u pp I P�
ublic -Supply From
7=__
X�
Prhite -Supply. to be, drill9q. ii
Ad
Other Requirements &A ': s require.
1, represent that I arri- wholly . ana.cVmpieiely r.ip.n,&6 des'
above . destribe,d '%h!i_l_ ,. b b constructed
.. i i, n` ic e as ' s
how n ' on the
'approved a. m
enc
County -bepartTentof, Hpal and that on completion ihiii6f.a,
,be i6briited t6: the Department; and a written'
guaraq, e'v 'kill b,
place 19, 'goo d 'dpi6tini'conia-6 on ar�y
'part, of said sewage k .
lia
will be located as shown on'the approved plan and that said well will'.
4
DEPARTMENT -,",'OF HEALTH
yealih Services ', j Carmel ff
05
EM 7n
Putnam Valley
Town
Lot 20 'Job:'
.15 g d ge Road 1
"Address;
Bronx, New York
Total !Habitable S 46, so uq r'e .•Fe,6i.
I Septic 2
k
beet
Putnam
water , a "k
id-location . .;of.the �pro�oied, s�ii
em(g)e 41% 4jhe-1,s6iiarate sewage. ,disposal systern
_d r - . 6 1
�fl" and regulations of the Putnam
t't here to and Wat�oid�bte wit A
e Commissioner, of Health will
rsa ss 4f I
pyi der. that W
, 6 builder wilU
j
YNPW,,the period ofofyti9erfollowing
thel
,dat6 of the issu•
of the e ai Iled 4 a il described abov e
is a cd
,I c t 49W. Ioff' ns
the ."Putnam
R
7� n* 7 E P�A
e No
is
,APPROVED FORi:CONSTRUCTION This approval ekpkes o�ne,Ve?r from the :date 'issued Vin has been undertaken and IS
dor modl led w �pn or. - ' f'. ' consider Id ry ssi ei 0- f alteration of construction
,r= or�!:ayse,?� Tay".e.amende n e
disposal of d 6 mest Ic �aijnjt�ry, va a
new p,erT!t. :Approved -foi'61s . n
ell
Date
Title'
•
A.
. j
a
PUTNAM COUNTY DEPARTMM T OP HEALTH
I.,.. :- .,.... '��jZTS.IP —D !T�t�0Tv r ?1 T; •1E-Ar�2i= cr�t ,: ,��•. -... -..
Date December 19 1977
Re: Property of James & Millie Morelli
Located at Boswell Road
SectionMaP 1238 w Block Lot 20
Gentlemen:
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
- 'Systc3n cr• -.sy:s gems in conformity' with the "pr`ovision's of` Article 145 or
1479 Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Signed
Owner of Property
Countersigned° lei, res,s
P . E . , =X 9 # 027816
1 Northridge Road Seal
Tel ep one
(
Address
Peekskill., N.Y. 10566
0
0
. s
° 2 ��..k
737 - 1056
Telephone
�..�f 279 4s
OF hi
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
Located at
Zames & Millie Morel]kdress 3150 Kingsbridge Road Bronx, N.Y.
Boswell Road Map 1238 - 20
(Street Sec. Block Lot
6dicate neares cross s ree
Municipality. Putnam Valley (T) Watershed Peekskill
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Role
Number CLOCK TIME
1
PERCOLATION
PERCOLATION
RM apse
p
o Water-
Water ve
No. Time
From Ground Surface
in Inches
Soil Rate
Start -Stop Min.
Start
Stop
'Drop in
Min. /in drop
Inches
'.Inches
Inches
(1) 1 4:03 4 :24 21
17.50
20e50
3.00
7.00
2 4.:29,4:51 22 18.25 21.25 3.00 7.33
3
5
C2) 1 4 :12 4:35 23 16.75 19075 3.00 7.67
_. _2 _.4`41:. 5s66 - 25 : -..
16- '77: 19:50 _ _3,00. _ 8.33 ., .._.__._..__..........
3 5 :08 5:321 24 -17.00 20.00 31.,00 8.00
4
3
4
5
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.
1
2
3
4
5
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.
TEST PIT DATA, REQUIRED TO BE S'UBi%�ITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. 3
rev
12" silty.gravelly loam silty gravelly loam silty gravelly loam
18"
24" _
30"
3611
42"
48"
54
60"
66" .
7211 '
78 ►1
8411 .
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED`
INDICATE LEVEL TO -WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY John S. Romeo Date .December 159 1977
5000 SF
Soil.Rate Used Mi 1 Drop: S.D. Usab e Area Provided
No. of Bedrooms 4 Septic Tank Capacitv r 1200 Gals. 80@Y19@0,- Masonry
Absorption Area Pro dad By � L. F. x24"
name J oAn 6, Romeo' bignature
1 NortYxidge Road r Y.
Address SEAL
Peekskill, N. Y ° 10566
27846 Je
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal'. Checked by Date_
R P 1'� V_
Kv
% T qf
�M
t, NI-3; i
h. DI T
444• Z--f
4'
tYi SECTION
'n ?
5 1 44 10
sc
AL 1 _1 0 2. t S
JZ- 43 "q�
4
rd r
4
14
w -4
4-r
st
f
4
-j-
Z
Y
A
..... ......... .
-elf.
71�
vp-
i4
xl�
Y",
yyy
s EPTIC'SYSTEM
5
, bvj�
ur
i4
xl�
Y",
yyy
s EPTIC'SYSTEM
5
"HO[jSE
FOR
so ILS RATE. 1.5
r_'�s
5
11
C.EV"lz. 9q Tl �.
-T WN'.OF L
6,
A", .COUNTY.
, bvj�
ur
i4
xl�
Y",
yyy
s EPTIC'SYSTEM
5
"HO[jSE
Y",
s EPTIC'SYSTEM
5
"HO[jSE
FOR
so ILS RATE. 1.5
r_'�s
5
11
C.EV"lz. 9q Tl �.
-T WN'.OF L
ED
A", .COUNTY.
s EPTIC'SYSTEM
5
"HO[jSE
FOR
so ILS RATE. 1.5
r_'�s
5
11
C.EV"lz. 9q Tl �.
-T WN'.OF L
ED
A", .COUNTY.