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HomeMy WebLinkAbout3803DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -1 -3 BOX 30 jm' 191 09 T ' 9 ' T 116 �, 9 IIA ir '. lop '. LILL . 3,c 3 PUTNAM COUNTY DEPARTMENT OF HEALTH F' Division of Environmental Health Services, Carmel, N. Y. 10512 ' QSFVNFICi4,TE -C( ;GIOMSTRU•wT.I N -^O'V'!PLIANU ::FQR, SEWAGE_ 2I5POSo4!_ SYSTEM Town or Villa de Located at SeetFdn j' Block �!a t .! i Job- Owner— Separate r Lot t Sewerage System built by s'T-GA o d>;— Address Z ozc y e7 Consisting of _Gal. Septic Tank — lineal Feet X i �j /� y width trench i Other requirements - �S % a i Y S % 0 A) /'1Ki -aq IYf314- Water Supply: Public Supply From Private Supply Drilled By Address Building Type Has Erosion Control Been Completed? certify that the system(s) as listed serving the abc attached), and in accordance with the standards, Date �`� 71 Address Any person occupying premises .served by the above conditions resulting from such usage. Approval of available and the approval of the private water supply s subject to modification or change when, in the judgment Date /Z22 ,<I-� �' � { [.yam > �� °k" % �� �x'- ,if:.c...: �i.a �• ;•. i No, of Bedrooms Date Permit Issued j (ally as shown on the pla S,of the completed work (copies of which•are u pla nd the permit sued b the Putnam County,,.Departmen�t of Health;.: J P. E. License No. 52- 2--o ., O I Void uch action as may be necessary to secure the correction of any unsanitary shall become null and void as soon as a public sanitary sewer becomes my 1 a when a public water supply becomes available. Such approvals are ssioner of Health, such revocation, modification or change (iiss� necessary. . BY Title- "' PUTNAM COUNTY DEPARTMENT OF HEALTH! Division of Environmental Health CONSTRUCTION PERMIT FOR..SEWAGE DISPOSAL SYSTEM Located at Subdivision eD aAa- Services, Carmel, N. Y. 10512 --+ Town or Village c ` Seck*e Block Lot /�` Lo-T 1z i Job ,+ g �% Owner Address li °� �r✓ 10,1A a.a CaO � LLC-� Building Type p Lot Area Number of Bedrooms Separate Sewerage System to consist of Gal. Septic Tank To be constructed by F C) 6,4&, Na, ter Supply: Public Supply From \\� 7 Private Supply to be drilled by AAddrresss !1 /^ Other. ReQ rt...e.,r� 4• i d D✓ _f7 C c I represent that I ain,wholly and completely r above described will be.,onstructed as shown County Department Oi ", "lth, and that o 4 � be, submitted to the Deparent, and a tt. place in good operating condition any pa ance of the approval of the Certificate of d will be located as shown on the approved plan County Department of Health. Date Total Habitable Space, C7iiczf� t S� Square Feet ,•. a lineal feet X width trench i Addresses 7-0 A'M VA,"E�, L��l ,�4 G ��. •t ion of the proposed systerri(s) ij, -that the separate sewage disposal system` to and in accordance with the. standards, rules an regulations o e u nam of Construction Compliance "'"satisfactory to the Commissioner of Healthwill the owner, his successors, heirs or assigns by the builder, that said builder will • -, during the period of two (2) years immediately following the date of the issu - .. Original system or any repair thereto; 2) that the drilled well described above ; ip accordance with the st Bards, rules and regulations of the Putnam 8 .t P. E. !!�'R.A. Address & �•�� �� �// lF /' �r c' I License No. 2� APPROVED FOR CONSTRUCTION: This approval expires one year frorh the date issued unless construction of the building has been undertaken and 'is' revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration f c g,� truction requires a new permit. Approved for disposal of domestic spnitary sewage d /or pre ate water supply only. 9 nara 19,7c9- ,7c1" By r -�'✓� �� I.C� -� QJ Title 1535 z YORKTOWN MEDICAL LABORATORY INC.. Yorktown Heights, N.Y. 10598. H•0: Ooz 99 '321 Kear St`ee - ,245 -3203 DATE COLLECTED RESULTS OF EXAMINATION OF WATER OWNER DATE RECEIVED - EDGAR ZITZRODT, 54-1 CITY, VILLAGE, TOWN & /OR NAME OF SUPPLY DATE REPORTED R.D. #3 BOX 107A .Putnam. Valley 5 -19 -73 ,S:AMPLING POINT 1, dell BACTERIA PER ML. (Agar plate count at '350 C). 7 COLIFORM. GROUP (Most, probable N6. /100m1.) Less than 202 HARDNESS, TOTAL - ppm DETERGENTS - ppm NITRATES (as N) -ppm IRON, TOTAL - ppm. FLOURIDE (F) - mg. /1. These results "indicate that the water was Yes of a satisfactory sanitary quality when the sample was collected. A. H. P.ADOVANI,M. T. (ASCP) WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING CARMEL, NEW YORK ytAis`reporf is to`be compl'Aiif weirBPilier'and�su6i - tteS''to'Cbtfnty i eai nien�t tdoettfdr-ORK iabbTatbry rep'brt`O analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NMr. Edgar Litzrodt ADR D. #3, P.O. Box 107A P$tnam Valley, New York LOCATION OF WELL (No. 8 Street) Oscawana Lake Rd.,Putnam Valley, New York (Town) at Number) iAI 'W # PROPOSED USE OF WELL BUSINESS © DOMESTIC ❑ ESTABLISHMENT ❑ SUPPLY ❑ INDUSTRIAL ❑ FARM AIR CONDITIONING ❑ TEST WELL ❑ OTHER (Specify) DRILLING EQUIPMENT COMPRESSED ❑ ROTARY AIR PERCUSSION CABLE ❑ PERCUSSION if ) El (Specify) CASING DETAILS LENGTH (lest) 301 DIAMETER (inches) 611 WEIGHT PER FOOT 19 /ft. ® THREADED ❑WELDED �R E S OE L](1YES NO CAS G 7 YES LINO YIELD TEST nn ❑ BAILED ❑ PUMPED LX I COMPRESSED AIR HOURS 4 G.P.M. 12 YIELD (G.P.M.) 12 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) Overflowing well 1/3 G.P.M DURING YIELD TEST (feet) 951 Depth of Completed Well in feet below land surface: 1450 SCREEN MAKE LENGTH OPEN TO AQUIFER (test) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) - FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 01 251 Clay& Sand Cl�I 251 1451 Light Gray & Brown Rock If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE W AWN L-.IAKk . DATE WELL COMPLETED 2/1/73 REPORT ll/T3 IWE* O L R (Sign r r �ros. y 1 i in 72 Danbury Rd., Wilton, Conn. - �.- vm --..y r..,..c.. ..�....... �f- s��s -r.�. ...: ,. .. -. m....., .:.a.- ..r- �s.:.. a »�a �.a .. : - ... -.o+.. _.v- - �.�- �,e,.. .�. i r — d.`....a .. �o,... .._..• a. .�x ..r �a .-.. Building Type Municipality l Block 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:. b.u- =lding 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 act of the occupant of the building utilizing the system. Dated this 9a, day of 19 Signature Title o"6Pd (If corporation, 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. Division of Environmental Health Services, Putnam County Department of Health Owner or Purchaser of Building Building Constructed by jJ C✓if�4�v` -t ��e�"L �c�� Location - Street Building Type Municipality l Block 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:. b.u- =lding 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 act of the occupant of the building utilizing the system. Dated this 9a, day of 19 Signature Title o"6Pd (If corporation, 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. Division of Environmental Health Services, Putnam County Department of Health (� 1/ Very tvaly yours:.$ .n Iyp CKm er o Prriper 616 Oot I � f n ell low TOP Wn."UnlIq A, cl °i f j' d 1) 1 i� �4 +r ii r •i J 1` "I .i VNFj N`sN ED LtvaNMY 4. 0a. Go-ptivat 1 E M ENT San I -F- 6 PEA N /9 ':C, H r 1 FO® $ i i i� i• ': 't . ?� ,. ii: '14 .� ;� w "i �p �, :� t: .s !t ,.'r .; Kj .� ';, s� .S 'F a. . k .j .l i 4 if •;4 :I� d �; e'er PUTNAM COUNTY_DEPARTMENT_ OF HEALTH DIVISION OF ENVIRONMENTAL BEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. �( Owner E DG A V. L a'T Zo ®T Address TAx M4 n Located at ( Street D6c'Aw A;d iOkIF A19D geen ti :5 Block A- Lot _lb Lo-c �m I �Indicate neares cross street) Municipality r LYT-OAPA `!AI —L-6:`J Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Number CLOCK TIME PERCOLATION PERCOLATION RUM apse No. Time Start -Stop Min. Depth to Water From Ground Start Inches Surface Stop Inches a er ve in Inches Drop in Inches Soil Rate Min. /in drop 24 4� -37- 3 54- 4'rb S'l'Z; 4 5 _.. 2 4. r-5 4-34 7 t. i /�- 4 76 1118 -3 4-1. 65- 3 34 4-3/4- M 5 1 2 3 5 Notes: 1) Te'�ts to be repeated at same depth until approximatelyy 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. Address e THIS SPACE FOR USE BY HEALTH DE Soil Rate Approved Sq. I. ure by Date TEST PIT DATA,REQUIRED.TO BE.:SUBMITTED WITH.APPLICATION . _...� :. ..., ...� _.:..1.. _ � .:_,...,:.:=- -DESCRFTION' OF -`SOIIw • NC'i7UVr!'�;REI).'`IN TEST `HOLES::= _.� .•..; _�- -- . - -- - ,. - _ .. �.,,f DEPTH HOLE NO. R HOLE NO. z HOLE G.L. lo/��z_ ?'oP -NO.����' / a0�� 6" ti 1211 �y1 L- gN" L G,1 y X I )4 1811 24" a d/ at 301 3611 42" a� 48tt Tri r'' If 60" if If y °y 7811 84" -I DICATE LEVEL AT_ WHIICHs; GROUND WATER IS : ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER. BEING ENCOUNTERED TESTS MADE BY Date S-- / 7 - `7 Provided F7° DESIGN Soil Rate Used .g Min/1 "Drop:' S.D. Usable Area No. of Bedrooms 7-1,1,eee Septic Tank Capacity. '51" Gals. Type 1K.4-S'veR`1 Absorption Area Provided By . L.F.x24" width trench. Address e THIS SPACE FOR USE BY HEALTH DE Soil Rate Approved Sq. I. ure by Date SURVEY OF PROPERrY for E0(0r L,- r,2KODT situate in 7'OWN OF PU rN.4 W VALLEY PUrNAM coUN rY, . N Y. Scole / = 40 Noy 30,1972. a h S- h 2 'OPQ J. Henry Carpenter a Co. Civil Engineers, 3 Land Surveyors Yorktown Heights, N.Y 431 H.E. FROMMHOLZ, P.E.a L.S. 3 93 0 o J O J _ p3 - w r q M h S- 51-45-50-W //.18 w 2 no O O R N w � 6 OZ w m ` / - 1.742 Ac:- . o �e o � � W � h w \ �w h � ".. � 2. �. �..... .. ... ._. ..0.. q° -a�� .� ..�..... ._ . c ... �..r . .. .... ......... .,... a r ,........ � ..�_. �.. ..". �ra... a�a s.va. _ 10. U LQ 9O�ry Or ti'y L ti s 0 ll� t h SURVEY OF PROPERrY for E0(0r L,- r,2KODT situate in 7'OWN OF PU rN.4 W VALLEY PUrNAM coUN rY, . N Y. Scole / = 40 Noy 30,1972. a h S- h 2 'OPQ J. Henry Carpenter a Co. Civil Engineers, 3 Land Surveyors Yorktown Heights, N.Y 431 H.E. FROMMHOLZ, P.E.a L.S. 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'� n ,� t t 7 aa'" '�'•w,'%', t fait A �, > y { "MRS 11 gs i St Y,j A 1 � '{a „t }'s' 7. s ad,,, � r z" r y - �+"`""iQ'"^ -+•r a r to 1 � S now; WWOW ai Ry 'e�'A' t?" `fy,.x'A ��,a S �t _�� +�,"� ;? b „ ' 1 g�yr t >• e n4,. f 05 W Pm54i Rs c Z1L Y \L �. 1 ; µ t } VII u t_...�' 1�_4�........•�K��...a... �.s...a�..a � .51:.._e.. s. i_r�'....� � 1 � 7 � .i}"�s3 �.i. -� `S � .. '14 A u31 li 7 ] APP5R4EEDq,,. 16 497 3 HEALI, ..... ........ ..... ........ DIREMOR, DIVISION OF egjWKWAL HEALTH SERVICE, '14 A u31 li 7 ]