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HomeMy WebLinkAbout3755DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.19 -2 -19 BOX 29 03755 F D>vis�on of Enwronmenal , GERTJFICATF:!DF ,C0.RSTRI CTlON CO•!!!sKIAN�E_FORF S Located at Wood Street ( L5' ROW,) Owner' Edward . Smlth Separate Sewerage System built.•by Edw��rd ' tith }_.. j Consisting o ��� f a. ;SepLc Tank �� ! other requirements - I9oT11eS t1C.` USe = -C Water Sup ply; Public Supply Frorri 4 X Ahdersc Private supply Drilled ey _ Addre Barger Stre Raised.. na, i Building. Type n Was Erosion Control Been Completed? ze8 I'.certi , that the system(s)as listed serving the above.premrses: were const attached),-and in accordance with the standards rules antl regulations I August 16; 1983 j Date X Certified l 1 Nor, thrill Addres Any pers_,on occapyrng 1 premises served by the above systems) shall pro conditions resulting from;such . Usage. Approval of.#he separate 5ewe available _and the approval of the`b ivate water supply shall - `become n__ -subject ifo modification or change- when,:, in the .judgment 'of the' Cbr F �. -Date DEPARTMENT. OF HEALTH lea / h Services, Carme% N' Y. 10512 WAG 01SIPOSAL SYS:RAq... Putnam V ley. -•-(T ). -� • a Town or Village P 167 , ( . „- ... 'Section- Block = `. Lot Zd T _ Job Peeksk =ll Hol`low Road- P'Ne Address r1y lineal Feet X 2 ",r width french' z Well` - :Drillers. '.. 't Putnam Valley, N Y. No of Bedrooms D'a Ps•�e•• '- S. Rbyr� 116 • ucte_ 6 essentially as shown on the' I ' s � � f� I etl r�(�pies-of which are rlanf filed an_d the permit issued e , e' nt opertment of Health Q`. X ;e oad:: Peekskill,. NY 0 „� • •; �ansa 0 - 1ptly,'take such action °as may -be necessa�tQQ u1_1freQQ�ection of any unsanitary.,,' age system sfiall become null =and vold as sa ilai.•�oftlic sanitary •sewer becomes and void when a.:public wa ply becomes available •' 'Such ,approvals ,are -,`,- i oner of Health such vocatio • modification or change is necessary _ - Title f Edward Smith Putnam Valley M Owner. or_ Purc aser_o Building Muni cipal_i,ty W <, Edward Smith Ma 167 Building Constructed by Section Wood Street (151 ROW) -- Location - Street Block Raised Ranch 1 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, 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- vices 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 ,ac,t of, the,occupant:, of ,:,the __building :ut liz ng,.the .sysapm. . . _ .. . _ . 5 ,�s u_._�.. August 83 Dated this day of 19 Signature Title If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP1,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 C Er AUG j S. 1983 �, 1.1 1 - s d, i1; :5 i { -c d .. 1. P,,O.Box`9932� K�a(S�ee�y ;Q , ! , 1 ©CA�1 IONS { ° E f, S ey ! a ry �r� L,Fr 3 {. r f K 1. a � � ,, ,k: 0.t $+' � r } [1 9 t KEAp $t Y ©hK3i0WN WFI01(TS N Y �105JQ 245 320) 14 "M YoAlt Heights,kWy- 105913 34 ;, , : �_ .z z # Cr r�r Y,,; , iy t 2 t ❑ 201 BUTTONWOOD AVE 'PEEKSKILL N Y 1056G 7378777 r 4:.. ; S . 1. }} .�� F P h� t _ i {� it � `�'± > s3 !� {,� F". it ❑ 495 MAIN ST MY. KISCO; N Y .10549 666 3335 . e -F 1 Ord 245 3zo3'���.:: rre''+`ci'T J�'�r ail'"d'Lti} x41 F.:µ ys� ..... r �... :..f f. s °T�: ,. I. t _ . �❑ STONELEIGH AVE (NEAR HOSPITALI C'ARMEL, N Y;•10512 278.931 ., f Yi ''� •G 4 E.dyi .,- a P {,_ Y'§ i j N ' iJi1'� it 9` 1 ,.. -._-s. 3'-. { e. ; f i x �: 0�:. DATE TAKEN Y �.. , s� F,, °n + � n ;t DATE RECEIVED a4 s %/ ,� .{• /� . §� °f` v r f ,° 0 4C uy �, � rSrt -1 y z x:, a -_ `V : /y /�iC,L �i��ts G. #; DATE REPORTED d ! $ SAMPLE-SO URCE 1. ,- i 7i''rr,�.t� '.�f rw ^'� ` r �}t� ;i ,•',�taF• t;n ��s�i �i d.K• r } s`.•r� r f j' .,,, t (/{/ 6 F �/, " \i1 t, �., t ..i1 � rl ! �". ,�li .. r r :i ?v, "� �' I. E , /C�% d /�M! �' /� !rh rE REFERRED BY ,e'" S , / //��7.(i�t t' �/� '� /�� ( ! `p 'gyp r ` a -.. ?� K t ! Oaf "[.� �� ;rY, r °d _4� %."l ''" ti+u;.t" !} C` b[ F�w� { `� _ 4 ry COI:LECTED BY :' /�' - - I � 9p f, `' , LABORATORY REPORT / / /�r I 1­1 a`f C d 1+, w z�, d { ^ �cyy jA ^{ '9 �'+ r�`k`, � 7 ili 1"% L ry ,J�`L ��/ J /�! Q%�t Q FF,u �°"'.. id7 ° A . mix • . #f c. 4� f a} y - - a t , a �i /p"% �NJ� 7"i Av y ��.. ❑ ACIDITY'.. �r vim{ i ❑,ALUMINUM �❑ ALKALINIT n� s n s ,� � a * b-" ANTIMONY ��,+, ., ) .� ,re^ } ">+ �3 { i5 5, .: EJ+s + s ti} }' t •: ��L,. k .s• r. TERIA TOTAL /mL '° r4 ❑'ARSENIC y O`.BOD ,5 D�Ay, .: s * ,, �,❑' BARIUM �� , ❑ BROMIDE`: ...... .... •� qr �� } ❑ ^B s • , _ , , RfiY E GLI UM ,-. � , C �4 6 . F ❑CARBON DIOXIDE FREE r' r� ❑BISMUTH O�CHLORIOE 5 v: 7`r�F '� ❑iBORON', a f `� �. .. rM «' If , a a� ti❑ CHLORIMEa e r Y a r 10 v❑ COOS ' j. kc ❑CADMIUM 11 4 -mot f ❑:CALCIUM ?_ ❑ COLOR 1 fay rl 4' �,�'tOCHRIDMIUM (tot) � x ., �� n­ SCYANIOE• �" '� '❑ CHROMIVM (b xavalent) ❑,DETERGENT ANIONIC Y�- --., -! c`t � ❑ COBA4LT { r � a 0 5- r p » s} s' f �� j 7 < k u� 5 't•' C ;�°,, r: e 'J-3 s hs r. c. ❑'FL'UORIOE h� �i4Y .. r ,.-� = rr '❑ COPPER_ x 4 S � f + ❑HARDNESS ,r s � r OLD - �{a GO F b T� r. '� Y ❑ MPfV COLIFORM COUNT/ 100'ml ° *' A <� rC❑ IRONS' t ' r Y 2 Apa ,! n1 05; 9 .'end 2 l '4�y. ;f p, ti. , >• + �MFT'�OLIFORM CUNT/ 1700 ml ; °® LEAD a z s s f ❑CONFIRMATORY TESL �'� 'r❑ LITHIUM "` ❑ NI7AOGEN° AMAAONIA i c� r r r� �s kf? x` ,., sY : a�.xla a Gc ��M y ��x0 � AGNESIUM� 'v„ ! r. ❑ fVITROuEh KiFl.DAHL .: �,, w C s iL g ❑ivlAfvGAN SE s a x > 77 j 4 n:❑ NITROGEN- NITRATE .,. g;�T 1r ` ❑ MERCURY r �� t . ". .. ii } wJ{ V I ❑'NITROGEN, ORGANIC ❑NICKEL" � ' ` - `� ❑ODOR k ! ` a❑ PALLADIUM „ ' 4 F J <� , 11 ❑'OIL b GREASE , . a Q. POTASSIUM .. ...... :` ,7 r ._, ❑ PH. ❑AHOOIIJM ' r # . 1 ❑ ,PHENOL ... ..,. ❑'SELENI:UM sal ❑ PHOSPHATE (oriliol� i ❑' -A., ON ... ... .,,..... ,. ' ' �� ❑PHOSPHATE (condensed) ❑SILVER { i� r • ❑ PHOSPHATE (total)' 1J ❑ SODI M', � . . . I .� " C '�**­* :1 ! I ❑ SOLIDS, SETTLEABLE ml& .. ❑TIN. „•• , ,,,, , ,,,,, � e ' 'e„ :� itl_lll� ❑SOLIDS SUSPENDED ❑ ZINC l ❑ SOLIOS`OISSOLVED .... ❑ : .. .. G.,1$.��53. Ix' #x ' %� { /{ ❑ SOLIDS. TOTAL .... .... ...... ..... /"1 1 ... - ❑ SOLIDS VOLATILE ..... ,,... V1• his CJ REMARKS . 5 _ 1( i SPECIFIG'CONOUCTANCE ....... ....... ...... �❑. .. CJEBS s. 1. ..... ...... ,. �� Qf.� ._ ❑ :SULFATE' ry .• .. :. .- '- . -. .. ❑ SULFIDE . ❑ SULFITE l .... ❑ .... .. i . 11 . ❑. SURFACTANTS L. h❑ TURSIDIT�.' ` ..... .... ..... ' }... ..... ... ........ ._` ., .. .. .. . THESE RESULTS INDICATE TNAT T13E WATER WA OF A SATISFACTORY SANITARY QUALITY WHEN THE SAT PLE 1JAS. rCOLLECTED ' ;' .. THESE - RESULTS - INDICATE, .THAT_:Tlll; ,WATER _DID fG •T TIIE.- SATISFACTORY' - CHEMICAL QUALIT OF ,Ntw YORK.STATE ADMINI`STRATIVG RULES & REGU�� IO DRIN dAT. 'STANDARDS .(P T 2: ,j-4 1. FOR THE - PARAMETERS TESTED. t t �' � j ALBEkT' H• -PADOVANI M.T ,(ASCP), DIRECTOR: ld -1-- .. t . .i TOWN OF PUTNAM VALLEY WELL DRILLERS LAG AND REPORT _ This report is to be completed by well driller and submitted td!; Bldg, Department, together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality. Well Location vt-� Tax Map Street Sec, Bl. Lot Well Owne Well Driller.KJr`2_1-- ' Name ng Address Tel, # ty o 1V11iL Ur-rlri Ur Wr-Ll. /&T S r eet WELL LOG Depth from Give description of formatioms penetrated, such Ground Surface as: Peat, silt, sand, gravel, clay, hardpan, shale, sandstone, granite, etc, Include size of gravel- (diameter) and .sand (fine,. medium, coarse).­... - color= o--:m. terial fl , st�ructu e", (i�or�se,...=packed•9_ ._ „�. a. s� cement, soft, hard). For example: 0 ft, to 27 ft, fine, packed, yellow sand; 27 ft, to 134 ft..orav aranite. Feet to Feet IPormation CASING DETAILS YIELD TEST WATER LEVEL SCREEN DETAILS Length '7/ Ft, Bailed or Pumped Hrs, Measure from Staticz Ft. land surface � °�� Diameter:(/ Inches N 'eld :.30 GPM When Bailed or Pumped Ft Slot Length Fto Size Kind: n Diameter In, 1V11iL Ur-rlri Ur Wr-Ll. /&T S r eet WELL LOG Depth from Give description of formatioms penetrated, such Ground Surface as: Peat, silt, sand, gravel, clay, hardpan, shale, sandstone, granite, etc, Include size of gravel- (diameter) and .sand (fine,. medium, coarse).­... - color= o--:m. terial fl , st�ructu e", (i�or�se,...=packed•9_ ._ „�. a. s� cement, soft, hard). For example: 0 ft, to 27 ft, fine, packed, yellow sand; 27 ft, to 134 ft..orav aranite. Feet to Feet IPormation Z. /1Description AUG 18 1983 Date Well Completed Date of Report Well Drillers y- ---�”' Signature BZS 1 -77 I!iJTNA'M COUNTY - 'DEPARTMENT OF HEM ('. g Drvrson of'nwronmentai' Health Services, Carme/ N 2 ,_CONS,T;RUCTION PERMIT,;F,OR `SEVY' E'.:DISPOSAL ,SYSTEM v jl OCn(i . Ci ' -z _'✓ t TL 'r4ap -� -� t Smith -: Subdivision Lot' ;Edward Smith Owner Address 2 Modular 1.128 Pu Building T -ype Lot Area Number of Bedrooms 3 `Design Flow 600 Gal da p Total- Habitable 1000 375 Separate Sewerage ,System to consist of - Gat - Septic Tank and 11 ?To be co►i'st:uctedt,by Do27ald Heady ` Address Cc Water Supply Public: Supply Frbm Putnam' x Anderson Well 'Drill" Pnvate' Supply to be drilled by Address,. Barger Street,'` Putnam .Valley 7 r k L 'H V 6� utnam�Valley (T) ,Town or Village _ 4. Peek�ki l . Hol l _�W Ra lam _ Valley, .NY' 10579.. 1092 apace: Square Feet LF Hof _ 2�F ", Treneh • , • _ ;opus .Rollow. Talley, s NY 1057 "O`ther'Requirements Domhstc_,.Use Only z. I,,represent',that t ^am wholly and comple6i' ' esponsitile for the design antl location of 'the proposed systerri(/s�o,e �bT �q��•• ®_ sewage tlisposal system :above de scribed'.i5,iil be constructed as shown on the approved <amendment there',to and in accordance with tt�b at ions o t�e� nam,_ :County, Department of Health, =and that onccompletion thereof a 'Gertrfrcate; of Construction' Compliang& ct r' .�8 m issioner.of Health will be- submitted to the Department,; and ,.-a written guarantee''will be 'furnishedahe owner his.successors,.n si t r*thet card; builder will. . place. in good operating conddron any `part of said Sewage,. qP sal system >durmgahe period of twoat i t y fo ov�yn�ahe_date of the issu �ance of the approval of': tFie Certificate 'of Construction "Compliance of theorigrnal'system or any re Bret e i rvell'described. above. will be loeated as shown on;the approved plan(antl thatsard well writhe installed an accordance with thud rqr;� eg„ . of the= Putnam + County Department of Health Nov ii 16 ' , 1981 : _ x Date Signed P Address 1 Northridge Rd e&ill, NY 105 `�rutL`se1VO 027846 . - APPROVED FOR,CONSTFtUCTIQN: This aFrproval expires one year from the :date issued unless c sfructron .apfthe pyiedi4 has been undertaken -and is reJocable or .,cause or may be' amended or madrfretl when considered cessary.,by the,;Commissio of Health. - Any change or alteration of construction'. Ir- v. requires .a;, new permit_. Approved tor' disposal of',domestrc ary a "' nd o priv ` ter I Date_` Title r BY.. . r• PUTNAM COUNTY DEPARTMENT OF HEALTH ;Z;7: 7) F ''E� "IQI�IENTAT�' ~hEATH'ER�ICES Date November 16,.1981• Edward Smith Re: Property of Located at R.O.W. off Wood 'Street Sectioryap 1674 Block - Lot 1 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 fora 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._ construct ion .-- ,of-.-s °a�t'��,:,':`a._�,:oo � _.-- 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. Very truly yours, Signed &.4,,Z,,-C Owner of Property 206 Peekskill Hollow Road Putnam Vall( Countersigned: Address. P °E., Jill., # 027846 a ® ®0 ®ep® Telephone 1 Northridge Road (Seal)a0 11AWU /NFFA o °° �� J Ad ress o Q�4 S. Ro �lq° "�E�;,,,K-WED Peekskill, N. Y. ' 10566 NOV 1.7 11,81 737 — 1056 0"' Telephone 27846 D a Ps`;r�`;;, . '� T. OF HEALTH �o Of CIE` +V 11e° l' PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH ..SERVICES r _. _._....._. . .._..__..; ...�. ��. ,- a.�i <: •.••e. �._ s:= :...... ..: .+. e- -. v-. �:•.rr .. d.._ .� r....�_,.,_..,.. -+- .-. ,..- �r — .,a.. w.... .. .,s ....�. -��r -. - .t -. _, - - _ — . a•- .cY ^., - COUNTY OFF -ICE BUILDING, CARMEL, N. Y. 10512 DESIGN. -DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE Owner Edward Smith Address 206.Peekskill Hollow Rd Putnam Valley NY Located at _(Stree$ Off Wood ' StreetSeXP.p 1674Block - _Lot 1 lndica a nearer cross-s ree Municipality Putnam Valley, (T) Watershed Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS _ Hole.. Number CLOCK TIME P PERCOLATION P PERCOLATION RUH . .apse p p o o. a er 'Water L Level Time F From Ground Surface i in Inches S Soil Rate Start -Stop Mira. S Start S Stop D Drop in M Min: /in drop Inches I Inches I Inches (1), 8 8147 8 8 156 9 9 1 18.75 1 19.75 1 1.00 9 9.00 2 8 8159 9 9109 1 10 1 18.75 1 19.75. 1 1.00 1 10.00 3 9 9112 9 9 :22 1 10 1 18.75.. 1 19.75 1 1.00 1 10.00 5 (2)l _ _801 .:_ 9 901 01 . . 10 2 22.75 2 23.75 1 1, oo ' 1 10.00. .7 2__ Notes: 1) Tests to 'be repeated at same depth until aroximately equal soil rates are obtained at each percolation test hole. All pp data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUB�MITTED.WITH APPLICATION DESCRIPTION OF- SOILS IENCOUNTERED .:.IN :TEST- HOLES :p. -.r ; ..� .- ,��,�'- �a_"�I - , - ,-��"(� -�_ :�??�� • • ::�= - _:s;- , ..._I��LEr.'N.Q,r:.r,.,. -, 2 ,=-- .� a..:.=.., . �£i0��?_0:;;� ,.F_.- �.'.r' =:x --- ::�z,: G. L.- Topsoil-.- Topsoil -, Topsoil 6" r _ 12ii Topsoil Topsoil Topsoil sandy; gravelly, sandy, graelly,_ -.. sandy gravelly, loam ... 1 oam ; :: loam. foam 24 30- . sandy gravelly loam, some silt 84" _ INDICATE LEVEL AT WHICH - GROUND WATER: IS ENCOUNTERED ...None. INDICATE.LEVEL TO WHICH-WATER LEVEL RISES AFTER BEING ENCOUNTERED -- TESTS�.,MADV Nay 11 -15 DESIGN Soil Rate .Use Mir�/1 "Drop:, S.D. Usable Area Provided 5000 SF + °0000® ©0000 y 1000 ,Q © Masonry No. of Bedrooms 3 Sept�S Tank Capaci:t Ga 1 Absorption Area Prov d ..By ...... L. F. x24 7- .5b ~ m $Wch. o Rome o ure Address 1. "NOrthridge Rd SEAL`' " o ' Pe s Pkki.l N: Y: l 0566. ® 27846 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Late ` \\ �i • ; i � :� i 3• -ir L.F - � rT- . t`n.sr -,r�kr 1 Gr a r \v \\ spa \ \\ . -W i /{idrt F, @: i� \ \. ,S..n� \i�. ��, t S i.Q. t • - _ _ -O.', Ir1AC_ — f GA l -7)4 LO 8-1,40,r 8-14- Iaf . t A a- 4r.r ij if a` ; " °, - �.>.1.S�ia•.G \. 's_ 4L 19 `9G.J` L. - -CB' ,$.1a3 Putnam County Department of H881tL 7- .S 4.. i F - Io7, w - 1I +- + Division of Envirn ^rental Health Services w- tli -t 9 7!j-Y dppzOVe as t',, ,: - 0' Mance with 9- GIs 2l lr� I. Qpy�lioa o mid E-�+nlations of the /Q rate { SEPTIG SYSTEM fit: Y i tUk9 �N: J '• \1 E GN & PERV4 Y." w.f✓ i ✓�., E3EDROQty� I`CO1dSE„ .DES! ED 5U $£{f,± B d.i 1 � r te.o� ..�" '� ` r o i,, � �/� %r�•� A </�) ��,,� tt ,t, o°O.'•. , -.. r :a7EF' �.....,f. »z hi rxt' ,.,2•., .,w- '�'a• "�e;':r;.. GWNSULTfNG ENCoiNEEI�TS tti r �l. AL TA'M11K y '• W �'ll 1 NORT•FRIDGE ROAD =h.. m s 3.9 L. F 2�' TR�►vC►is�. ,lM "' PEEKSKILL. N Y. 8:g o: _ o fc 1pe/ $ to t a 2 �g83 NEW YQRK 0FIA +INAL N U � � pUGl { :�.s FfIVAt {' J.ut_y 9$3:,, •!_- XL._ -_.•_- _ - • •. 1 �8 1 6.1L Nu i7 2 a _ t , k, •�J - f:J .f- :5� s - l'f C ;:.t- . -'?„ iTri(•• Y` ,Pe -r - - i . a Y F!j ry: 1; ' 4 G, �l I;