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HomeMy WebLinkAbout3659DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.14 -1 -20 BOX 29 '.,' 1 ' :: � i r ` . No No 1.1 in No No or ti . i i No f- r ol �, Is 03659 :'ENGINEER MUST L PUTNAM COUNTY DEPARTMENT OF HEALTH PROVIDE Division of Environmental Hea /th Servioss, Carm% N Y 10512 PERMIT CERTIFICATE OF CONSTR ION COMPLIANCE FOR SEWAGE DISPOSAL :9V* EM J�' {o g 114 Town or Village "'Lncafed` at f y-i f., � l / / Formerly Tax Map Lot # . / /s' Subd. Lot # Owns l Separate Sewerage System built by F. ti✓� ' "� Address Consisting of /Z3_0 Gal. Septic Tank and Other requirements Water Supply: $ublic Supply From Private Supply Or By Address y Building Type�_� Cif' Has Erosion Control Been Completed? le_ Z�' 0 No. of Bedrooms — — ,— Date Permit Issued Has garbage grinder been installed? .r'Y° &- I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. Certifie Dy�� P.E. R.A. Date Address G/! a�'/�G✓m' ti'" +'' s� License No Any person occupying premises served by the ab system s) shall promptly akd-ad aetion as m e.necessary to secure the correction of any unsanitary conditions resulting from such usage. Appr 1 of the separate sewerage system shall b=m call and void as soon as a public sanitary sewer becomes available and the approval of the private wa er supply shall become null and void. when a public water supply, becomes available. Such approvals are subject to modification or change when, in the Judgment of the Commissioner of H th, such revocation, modification or change Is necessary.�i� G Date � By Title Rev. 6/85 CONSTRUCTION- PERMIT-' Located at ✓ e.a 7, Subdivision r►. r PUTNAM COUNTY DEPARTMENT OF HEALTH Permit #�–� —=-=C� Division of Environmental Health Services, Carmel, N. Y. 10512 SEWAGE 1.111SPOSA' SYSTEM1_ t 1/yy ,s Town or Village �� `' Tax Map �° Block r� Lot i4 cep Lot # C. Renewal _ 1:1 Revision _ ❑ Owner /Address 4Yy—i i_ /l 1 A7'7 1 19) Building Type ! , e -'s , Lot Area a " 3 Number of Bedrooms !— Design Flow G /P /D ge(-> Separate Sewerage System to consist of 2 4i Gal. Septic Tank To be constructed by Water Supply: ,-Public Supply From —� Private Supply to be drilled by Address Other Requirements Of Previous Approval Fill Section only P.C. H. D. Notification Required and Address C� I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the stantlards, rules and a ons o e u nam County Department of Health, and that on completion thereof a "Certificate of C pliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a written guarantee will be furnished the heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system i t4aveP'io years Immediately following thedate of the issu- ance of the approval of the Certificate of Construction Compliance of the riginj* °sy Mg s thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be install with( ' County Department of Health. an Y$ �� st Bards, rules and regulaTIons of the Putnam Date __� /� 1 S Signed P.E. R.A. Address • y o ` ' �` � ° ° License NO. APPROVED FOR CONSTRUCTION: T is approval expires one year ;r m th .islre uules c$ti dtion of the building has been undertaken and is 9 revocable for cause or may be amends or modified when considered necessary t}ti�C0 'ist nIr�' !Health. Any change or alteration of construction requires a new pe it. Approved for disposal of domestic sanit ry sewage, ant! r pr e',vJ° er sb(piy only: Date � By ` Title - A Rev. 9 -81 r December 21, 2000 Via Registered Mail, Return Receipt, requested Bruce R :Foley Public Health Director -DOH J1 1 Geneva Road �°/ _•;1 Brewster, N.Y. 10509 �(v Robert Morris Senior Public Engineer -DOH 4 Geneva Road 1 A� Brewster, N.Y. 10509 Vv 0 Gentlemen, 01/1 V eff-11 , �0 �S lam' la I am writing in further reference to my telephone conversations with Mr. Morris on Tuesday December 20, 2000 and January 4, 2001. First, let me start by saying that although, this well issue has caused me a great deal of anguish, all my other dealings with various county officials have been extremely positive as evidence by my complimentary letter to Carmelo Santos dated October 12, 2000 (attachment #1). Let me also state that as a controller, I don't profess to be familiar with the various sections of the health code. As you know, my C.O is still pending the resolution of the well. My well was not built within the approved area. In essence, the well is less than 4 feet of neighboring lot. It is my understanding that the well needs to be 15 feet from the property line. At your December 2000 meeting the waiver on my behalf via my builder was denied. Up to this point, all the information you have received has come from the engineer consultants, my builder, and land surveyors; and before any attorneys get involved, I feel compelled to tell you why if this wavier is not granted I will be hurt three times. Here is the reason why, if the waiver is granted, I will be unjustifiably hurt. First and foremost, I still believe that if the county had not made an error back in 1989, I would never have had _...._. _ __.. __... _:... to 3tg a_u1eh:.to begin. wtth.:please_note Lh t.on attachment #2, that a «fell v�as`iii glace back iz 1985. Yen may want to refer to map 74, block 1, lot B, of the "subdivision map of property prepared for Marie & Diana Milani" which was filed in the Putnam County Clerks Office on June 5th, 1985 ". At that time my lot had a good well. Four years later a house was put up on lot C Butterfly Lane. For some reason they allowed the construction of a septic tank to be built within 100 feet of my well. At the time I purchased the lot, I negotiated a price based on this 1985 map under the assumption that I did not have to dig a well. Of course, the septic on Butterfly Lane came to light during the application of a building permit, and we had to abandon it (see attachelmnt #3). It is my position that I have already incurred a $4,000 expense as a result of the county allowing the septic to be built within the 100 feet, forcing me to abandon my well. In this regard, I am formally asking the Putnam Department of Health, under the Freedom of Information Act, and as property owner who has suffered by the 1989 septic error for full documentation on why and how the house on Butterfly Lane was allowed to build a septic tank when clearly there was a well within 100 feet. Lot Con Butterfly Lane is over 15 acres. Clearly there was enough land to figure a way of building a septic that would not infringe on my well rights. Mr. Morris indicated to me that your health department has been unsuccessful in locating the documentation. This is a case of what came first. Before we order the construction of a THIRD well on my lot, the burden falls on the county to justify to me the reason I was forced to build a second well to begin with. On the subject of the septic in the property in question on Butterfly lane, let me point out further that at least one septic drain is currently spilling above ground in my property! (See attachment # 3 showing the septic in my property). I never questioned the neighbor nor the county on how this came about, or why the county would have approve a septic design which literally allows for septic spillage to discharge on my property. Normally, this would not concern me, nor has it until my well location became a barrier to certificate of occupancy. !f j dM January 4, 2001 If the waiver is not granted, I will be hurt unjustifiably a second time. A third well will triple the cost for this p'*tcf the ors *�nrtic.;_ -... .. ... . The third way I will be hurt is by the fact that on the day of week before Christmas, I finished construction of a concrete and cobblestone patio and walkway a few feet away from the well.. The cost of this project is $12,500. (I will be happy to provide you with documentation with the dates and cost for this project). I posed the question of the effects of digging a well would have on the new concrete patio, and was told that "there is a good chance that the pounding of during the digging could cause cracks on the concrete ". Further, as you know the house is built in certain sequence to minimize damage. I will receive further damage transporting the well rigs into and out of my property. Keep in mind that the house is now completely, done, the paint and all the molding will start to show cracks during the well digging. Finally, I have been informed that my well poses no health issue. On top of this, there are no infringement rights issues. If requested I am prepared to get notarized letter from my neighbor on Butterfly Lane to state that he will not peruse an action against me because the will is not set back the required 15 feet. You will note in attachment 4, that the well location is not in proximity or view of the actual house on Butterfly lane. From the point of view of the owner on Butterfly Lane, it does nothing -it sits behind the wooded area. As this letter was ready to go out, I received notice that a conversation took place between Bruce Foley and Arne Nordstrom, the Chairman for County Legislature. I am told the waiver was denied specifically for the following two reasons: First, it was explained to Mr. Nordstrom that the original well was a test well. The fact is that this is not true. In the certified land survey done by Bunny Associates done back in 1985 its clear that there was a good well dating back to 1985 (attachment 2). This simply was not a test well. Secondly, it was explained to Mr. Nordstrom that the well "was moved 60 feet". Well, this. it true. However, the original location of the septic was relocated to improve the grade from the septic tank to the field. The relocation of the septic tank necessitated the relocation of the well to�"tain the required 50 feet distances. Cronin Engineering did the new location of the septic in conjunction with Adam Stiebeling, the Public Heath Engineer. The well was moved over to compensate for the movifig of the septic tank, in the process it was moved over, and unfortunately too far back so that it no longer conformed to the 15 foot requirement. ^ T In conclusion, we are not denying, that by some unintentional error, the well was not drilled within the 15 feet requirement. However, under the circumstance mentioned above I am asking that you approve wavier in your next meeting scheduled in January 9, 2000. This will avoid me incurring further unnecessary expenses, and will end this entire appeal process that would continue beyond the January 9ei meeting. Thank you for your consideration in this matter. I anxiously await your decision. If you have any question do not hesitate to contact me at work at (212) 410 -8737. Sincerely, AAnthopyMirdita CC: Iry Sevelowitz, Bldg Inspector 9 December 21, 2000 Bruce R. Foley Public Health Director -DOH 1 Geneva Road Brewster, N.Y. 10509 Robert Morris Senior Public Engineer -DOH 4 Geneva Road Brewster, N.Y. 10509 Gentlemen, Via Registered Mail, Return Receipt requested I am writing in further reference to my telephone conversations with Mr. Morris on Tuesday December 20, 2000 and January 4, 2001. First, let me start by saying that although, this well issue has caused me a great deal of anguish, all my other dealings with various county officials have been extremely positive as evidence by my complimentary letter to Carmelo Santos dated October 12, 2000 (attachment #1). Let me also state that as a controller, I don't profess to be familiar with the various sections of the health code. As you know, my C.O is still pending the resolution of the well. My well was not built within the approved area. In essence, the well is less than 4 feet of neighboring lot. It is my understanding that the well needs to be 15 feet from the property line. At your December 2000 meeting the waiver on my behalf via my builder was denied. Up to this point, all the information you have received has come from the engineer consultants, my builder, and land surveyors; and before any attorneys get involved, I feel compelled to tell you why if this wavier is not granted I will be hurt three times. Here is the reason why, if the waiver is granted, I will be unjustifiably hurt. First and foremost, I still believe that if the county had not made an error back in 1989, I would never have had ` x g..aavel� t� -be •vvitdp , Izlces n e ghat on.atta hs er t #2 that a -yell was 4h plate baei; iri -1985 3�o`u sway — : , want to refer to map 74, block 1, lot B, of the "subdivision map of property prepared for Marie & Diana Milani" which was filed in the Putnam County Clerks Office on June 5d, 1985 ". At that time my lot had a good well. Four years later 'a house was put up on lot C Butterfly Lane. For some reason they allowed the construction of a septic tank to be built within 100 feet of my well. At the time I purchased the lot, I negotiated a price based on this 1985 map under the assumption that I did not have to dig a well. Of course, the septic on Butterfly Lane came to light during the application of a building permit, and we had to abandon it (see attachemnt #3). It is my position that I have already incurred a $4,000 expense as a result of the county allowing the septic to be built within the 100 feet, forcing me to abandon my well. In this regard, I am formally asking the Putnam Department of Health, under the Freedom of Information Act, and as property owner who has suffered by the 1989 septic error for full documentation on why and how the house on Butterfly Lane was allowed to build a septic tank when clearly there was a well within 100 feet. Lot Con Butterfly Lane is over 15 acres. Clearly there was enough land to figure a way of building a septic that would not infringe on my well rights. Mr. Morris indicated to me that your health department has been unsuccessful in locating the documentation. This is a case of what came first. Before we order the construction of a THIRD well on my lot, the burden falls on the county to justify to me the reason I was forced to build a second well to begin with. On the subject of the septic in the property in question on Butterfly lane, let me point out further that at least one septic drain is currently spilling above ground in my property! (See attachment # 3 showing the septic in my property). I never questioned the neighbor nor the county on how this came about, or why the county would have approve a septic design which literally allows for septic spillage to discharge on my property. Normally, this would not concern me, nor has it until my well location became a barrier to certificate of occupancy. -2— January 4, 2001 If the waiver is not granted, I will be hurt unjustifiably a second time. A third well will triple the cost for this part of tbe. :cor1strUc1:012 :... . ... ... ..... .....- ....... The third way I will be hurt is by the fact that on the day of week before Christmas, I finished construction of a concrete and cobblestone patio and walkway a few feet away from the well.. The cost of this project is $12,500. (I will be happy to provide you with documentation with the dates and cost for this project). I posed the question of the effects of digging a well would have on the new concrete patio, and was told that "there is a good chance that the pounding of during the digging could cause cracks on the concrete ". Further, as you know the house is built in certain sequence to minimize damage. I will receive further' damage transporting the well rigs into and out of my property. Keep in mind that the house is now completely, done, the paint and all the molding will start to show cracks during the well digging. Finally, I have been informed that my well poses no health issue. On top of this, there are no infringement rights issues. If requested I am prepared to get notarized letter from my neighbor on Butterfly Lane to state that he will not peruse an action against me because the will is not set back the required 15 feet. You will note in attachment 4, that the well location is not in proximity or view of the actual house on Butterfly lane. From the point of view of the owner on Butterfly Lane, it does nothing -it sits behind the wooded area. As this letter was ready to go out, I received notice that a conversation took place between Bruce Foley and Arne Nordstrom, the Chairman for County Legislature. I am told the waiver was denied specifically for the following two reasons: First, it was explained to Mr. Nordstrom that the original well was a test well. The fact is that this is not true. In the certified land survey done by Bunny Associates done back in 1985 its clear that there was a good well dating back to 1985 (attachment 2). This simply was not a test well. Secondly, it was explained to Mr. Nordstrom that the well "was moved 60 feet ". Well, this it true. However, the original location of the septic was relocated to improve the grade from the septic tank to the field. The relocation of the septic tank necessitated the relocation of the well to maintain the required 50 feet distances. Cronin Engineering did the new location of the septic in conjunction with Adam Stiebeling, the Public Heath Engineer. The well was moved over to compensate for the moving of the septic tank, in the process it was moved over, and unfortunately too far back so that it no longer conformed to the 15 foot requirement. In conclusion, we are not denying, that by some unintentional error, the well was not drilled within the 15 feet requirement. However, under the circumstance mentioned above I am asking that you approve wavier in your next meeting scheduled in January 9, 2000. This will avoid me incurring further unnecessary expenses, and will end this entire appeal process that would continue beyond the January 91h meeting. Thank you for your consideration in this matter. I anxiously await your decision. If you have any question do not hesitate to contact me at work at (212) 410 -8737. Sincerely, i Anthony Mirdita CC: Iry Sevelowitz, Bldg Inspector _ lWriirtta _ - 38 Park Drive Pubiam Valley, NY 10579 October 12, 2000 Carmelo Santos Town Supervisor 265 Oscowana Lake Road Putnam Valley, New York 10579 Dear Mr. Santos: I am in the process of moving from the Bronx to Putnam Valley. My wife and I, after a long search process finally were convinced that Putnam Valley would be the best place for us to raise our four children, all under the age of ten. OF course, building a new home would present many additional challenges. It actually produced more challenges than I could have imagined, I am however, happy to report to you that the one area during this project that I always got complete cooperation was from many of your departments. In dealing with the various agencies to get questions answered, I was expecting to get caught up in the agency bureaucracy that I have been accustomed to. On the contrary, all my calls were returned, the questions were answered to my satisfaction, and I never got pushed to another department. I would be remiss if I did not specifically mention Iry Sevelowitz, the Building Inspectors who guided me through the inspections process; Carl Sandburg, who answered all my questions as far as the methodology regarding town and school taxes, and Ms. Mendez for making the school transition very smooth. As Controller of a nursing home, I always stress the fact service differentiates us from our competitors. Certainly, your staff has already embellished this concept. 1 congratulate you and them for the extra effort they have shown to my family during this transition. Once again, thank you for your personal attention. Sincerely, �nthonyy Mirdita PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of�i� Located at (T) 4o,A �Aa Section 6 Block Lot / t Subdivision of Subdva Lot # Filed Map # Date Gentlemen: This letter is to authorize a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a. separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated 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 at'etti `uf' "S %�nl ""Y ��Ti7CClririit ` tii. :e..:- `rovisioris' "oi K`r`it"icT'e' 1 5'_or: _._. ..._ 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: g ''1 as OF A P.Ea, , Telephone Very truly yours, Signed Owner of Property Address Town Telephone I 7W Date: -7- 1=p. by i INITIAL SVJTE 1.11SPECT1011 YC'3. No Commontn Property l.inu. or corrv.•s foul-irl . . . . . . . .. Can estimatr-1 house. location . . . . . . . . . . Will driveway nec:d cut . . . . . . . * Elust trees'', be removed-bote these Is deep hole. representative of entire SA. area Additional-deep holes needed. . . . . . . . . Sufficient ;SIB area available considerinf, driveway- �cut, bou,-c location, separation . . . dis•artccs,4 etc . . . . . . . . . . . . . . . . DEEP HOLE ]1Vrh Dapth: Water el 'e,,mtion: Rock elC�-Xicn: Soils Date: FIJI. L SITE Insl-.). by: House located where *shown on approved plan S113 located 'yhero approved . . • . . . . . . . Inn Lh of trench m3asured Vidth of trench aver-n-e Slope of tilo line and tr_ei)_cF._acccptable Room allowc(f for expansion trenches . . . . . Over 50 ft.-•from swailip,watercourse •1atural soil,, not stripped or SDS area Ulul rily e raded . . . . . . . . . . . . ecessa� 10 111t,,maijitai e maintained from prop.lin and 20 fr.6 ill house Se1x1a,at J. on of trench from house, well otc. folloi',?s plan Rumber of 15carooms chocks Stone::, brush, - stu-.!ps, •ubble, etc'. greater than 15 ft. from ncarest trench . . . . . . 15 Ft. of periplicral soil horizontally from trench- * ... . . . . . . . . . . . . ... . . Junction boX§s properly set Qoii3.d surface rim off from driveway, roads, -ground surface, etc.. chaff -mel near SDS . . . . area Dz)c,.,--. lot drsllfm "midar* O.K. `in* area of S*DS, FIVAL GRADINC Or SITE ACCEPTAME DOCIJV�IITS U.9,3 ;.plans O.K. D,-sif,,n data sheet Peres ; presoaked? Pere tool; depUl Const..' results for 3 runs I D. Hole lor., 0. K. Corpoiate Affidavit for other than individual Authorjization for engineer Letter from I-later Supply if' applicable�; If variance requested-such noted on plans & apps.: _18QY_44 LSWITIA R r- C" 0 ::r rv-D 7 D-7TABIS .;-ILL D6P­ItA RREA' Sjjot.W( Cf) MM'"PLAN ro me- rao v'__ Exist-�pg contours shown (show new contours) _d Slopes'for driveway cuts, etc. shown I•Later service line location Footift` drain, etc. location Top slope, bottom slope of Pill Percolation tests and deep test pit location SeDti&7 tank size and conformance to std. B.R. hpuse minimum House: setback shown Distribution box ftg.. below frost All w4ter within 39,'�'ft. of PL shown We,.L- -12 SING IZII fizove- GP_A-C>C Pliniand profile SDS All other wells and _SUS closer '200s-1 qhbwn or reference made Property boundaries (metes and bounds-clearly s 1 PEA04 b IQ I < , I SEPA13AT !ON DISTANCES SPECIFIED ON PLAT 10, toA,%L. )pkNiqu_)Ptj ,201� to walls 100 tol earest well IOU' to stream, march, lake, etc. (incl 45' toXjurtanin drain O to. water line (pits-20 5' to.&�torm drain {10", to 1"Irce trees 10, F1,0111, 1,01111datioll to %11}111_11C. 15' to ryij)c from leader 0_0 U1 —5 IM TV, ETC14 QASII3 15' WEiL TO 0 E6P IC. TRMk, TC, on I 14A A PUTNAM COUNTY DEPARTMEff OF HEALTH v DIVISION OF ENVIRONMENTAL HEALTH SERVICES a INDIVIDUAL WATER SUPPLY SUBSLktFACE SEWAGE DISPOSAL SYSTEM d.: F= INSPECTION REPORT l '� DATE INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO CMENTS Wetlands on/or proximate to property .............. Property lines or corners found ................ Can estimate house location ........................ Will driveway need cut ..................... Must trees be removed - note these................. Deep holes representative of entire SDS area...... Additional deep holes needed... ... .... .......... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells /septics ............................ D.H. 1 Lot Depth to G.W. Depth to rock 0 £t. 3 ft. 6 ft. 9 ft. .......12 -ft Soil Descr I- D.H. 2 Lot Depth to G.W. Depth to rock Soil Descril 0 ft. 3 ft. 6 ft. 9 ft. D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descr DATE: / 7 `•, FINAL SITE INSPECTION INSP.BY:/ % >�'� 0 ft. COMMENTS 3 ft. 6 ft. 9 ft. v Soil Descr DATE: / 7 `•, FINAL SITE INSPECTION INSP.BY:/ % >�'� YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over-100 ft. fran watercourse .................... Natural soil not stripped or SDS area unnecessarly graded .............................. 10 ft. maintained from property line and 20 ft. fran house .............................. Distance well to SSDS N=ber of bedroans checks ................. brush, stumps, rubble, etc., greater Stones, UIi�S, than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set. . .............................. Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE .................. v /-S > W IJ 2 Yorktown .Medical Laboratory, Inc 321 Kear Street a Yorktown Heights. N. Y. 10599 (914k14!0203 Director:, Albert H. Padovoni AL T. (ASCP) L eh✓'_ . L fl, -7)V J LAB I Collection itnVion u- sed:�i` Carmel _ Peekskill Mt. Kisco Bev City _ Date °is"i"eri. Date Received:` Date Reported: //a Collected By: Referred By: Sample Source: ' Gc LABORATORY REPORT ON-BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA bl Standard Plate Count per 1.0 ml (Agar plate @ 35 °C) YEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform per 100 ml Fecal Coliforr, ner 100 Ml Fecal Streptococcus per 100 ml YOST. PROBABLE NUMBER TECHNIQUE (MPN) Total Coliform: 14PN Index ner 100 ml �J �,/ - '2 (,,,' 72-- Fecal Co1i e ..-p.. fru--Ml �` •- form. t�PN_.Ynd. x e ..�. OTHER ANALYSES THESE RESULTS INDICATE THAT TAE WATER SAMPLE (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY' SANITARY QUALITY ACCORDING 0 T NEW YORK STATE DRINKING WAT STArRDARDS FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. LEGEND Albert H. Padovani, M.T. ASCP), Director RDS Recommend Disinfect- ing Water Source < • less than TXTC • Too Numerous -Too Count f� N ---ti 1 THESE RESULTS INDICATE THAT TAE WATER SAMPLE (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY' SANITARY QUALITY ACCORDING 0 T NEW YORK STATE DRINKING WAT STArRDARDS FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. LEGEND Albert H. Padovani, M.T. ASCP), Director RDS Recommend Disinfect- ing Water Source < • less than TXTC • Too Numerous -Too Count A/ 1`•='0/1\ WELL UUFrLLT1UI,N , ALrUZ -1 DEPARTMENT OF HEALTH Division Of Env_r- onlnental Health Services �wD PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only STREET ADDRESS: TOWNIVIL alcill, TAx GRID NUMBER: WELL LOCATION . WELL OWNER NAME. A ESS: - Z P8IVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary %RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS ❑ FARM ❑ TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑. INSTITUTIONAL O STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED EST. OF DAILY USAGE gal. REASON FOR DRILLING ANEW SUPPLY O PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DEPTH DATA � .WELL DEPTH / ft. STATIC WATER LEVEL TftDATE MEASURED % 3 DRILLING EQUIPMENT 14,�OTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG. . ❑ WELL POINT. ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING.` OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH �'r ft MATERIALS: ,STEEL O PLASTIC O OTHER LENGTH.BELOW GRADE U ft. JOINTS: O WELDED 01HREADED D OTHER DIAMETER in. SEAL: ❑ CEMENT GROUT O BENTONITE ETHER WEIGHT PER FOOT / S� lb./ft. DRIVE SHOE!�YES ONO LINER: 0 YES vo SCREEN DETAILS - DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST OYES ONO GRAVEL PACK YES O NO GRAVEL SIZE.: DIAMETER OF PACK in. TOP DEPTH tL BOTTOM DEPTH It. WELL YIELD TEST It detailed, pumping METHOD: O PUMPED i tests were done is in- [COMPRESSED AIR ,formation attached? BAILED O OTHER ; ❑ YES O NO 1A1ELL LOG �f more detailed formation descriptions or sieve analyses Y J are available, please attach. DEPTH FROM SURFACE Water Bear- ing Well Oia- In FORMATION DESCRIPTION qOE. ft. (t, WELL DEPTH ti. DURATION hr. min. DRAWOOWN ft, YIELD gpm. Surface Z r2 3Y % WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES .ONO ANALYSIS ATTACHED? O YES O NO l / STORAGE TANK: TYPE CAPACITY �a o GAL. PUMP INFORMATION TYPE `�� CAPACITY .S MAKER DEPTH 01-010 MODEL /4 — VOLTAGE 7-3u HP ` WELL DRILLER NAME DA ADOREA� SIGRMRE ��� "-:;IP7Y- z2 o� %. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchaser of Building Section Block Lot 4 Building Constructed by Location -,Streef- Municipality �GJ • Building Type Subdivision Name Subdivision Lot # GUARAN'T'EE OF SUBSURFACE SEWAGE DISPOSAL 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 successors, 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 approval of the "Ce.r- tificate.. of. - Construction. Compliance" for the selvage: disposal.. system; -• or -any repairs made by m6 -tb !such system; except where "the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environin?ntal Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. 0 �-• 0, Dated this .2) day of Oc G lr&191 General Contractor (Owner) - Signature BRESC.IA BROTHERS CONTRACTING Corporation Name (if Corp.) 0, rati ame (if Corp. Alfdf es 07 21 Lafayette Ave, New Rochelle, N.Y. 10801 Address rev. 9/85` mk PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.ENVIRONMENTAL.HEALTH SERVICES :,._;. _...,. COMiTy ,OFFICE: BUILDING; CARIZt; .:N.: Y: 10512 °. DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner /Vas , ; Address Located at ( Street 1 � � �� Ll,,,.-, e,.Sec : �. Bloc kLot 45dicate rilarest cross street) Municipality b, 6zn i, t � e_'U Watershed SOIL PERCOLATION TEST DATA RE UIRED TO BE SUBMITTED WITH APPLICATIONS 'Hole Number CLOCK TIME PERCOLATION PERCOLATION._ Elapse -Deptft to Water Water Level No. Time From Ground Surface in Inches Soil Rate•.: Start -Stop Min. Start Stop Drop. in Min. /in drop ':' Inches Inches Inches 30 IS' 4 5 5 - 1 2 3 5 Notes: 1) Nlkts 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. DEPTH G.L. .24 3011 3611 421 1 48" 54-11 6011 66" 7211 7811 TEST PITDATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST-HOLES HOLE NO. Y J HOLE NO. HOLE NO. 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED iT -EF T QH-'-WAT- WATER --LEV-PL'-RI*g�.L,,�F..TER-BEING-ENCOUN TESTS,- MADE BY Date ` DESIGN Soil Rate Used v/' Min/l Drop: S.D. Usable Area Provided ao-us No. of Bedrooms ej- Septic Tank Capacity Type �y 14 Absorption Area Provided By4��<-- L.F.x24"- 110.�"� width trbnch. Other 4'a , I ij VICsAA Address . THIS SPACE FOR USE BY HEALTH DEPART14ENT ONLY: ... tv- Soil Rate Approved Sq. Ft/Gal. Checked by Date, i is it 1-13 L)e - 74-: e. 19 i e.5 --A---- , 7Y :iw y ill 72 41 i is it 1-13 L)e - 74-: e.