The URL can be used to link to this page

Home My WebLink About3805DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -1 -5 BOX 30 .. IN so 1. or is 7 r . �� -q Nor SEEN 03805 PUTNAM COUNTY DEPARTMENT OF HEALTH Permit a Division of Environmental Health Services, Carmel, N. Y. 10512 i CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Located at 0seawana Lake Road``TM; T�T3:Z..C:LItr.Ctil —s . S'ubdiv)sion �L1Dd' "oc ii owner /Address Ray laCerte Box 162 Walnut Rd Ta e Building Type 1 story:' frame Lot Area 3-98 acres Number of Bedrooms 3 Design Flow G /P /D 600 Separate Sewerage System to consist of 100 Gal. Septic Tank To be constructed by Austin Stellatto Water Supply: X Other Requirements Public Supply From Anderson We Private Supply to be drilled by Address Barger Street P Domestic Use Only Putnam Valley (T) 11 Town qr illage 1 ll Tax Map Block �l tot Renewal 0 Revision PeekskiZ1 Date Of Previous Approval Fill Section Only ❑ P.C. H. D. Notification Required and 430 if of 241, Trench Address Cimarron Road Putnam a ey ri ii.ers m Valley, 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system above described will be constructed as shown on the approved amendment there to and in accordance with IN County Department of Health, and that on completion thereof a "Certificate of Construction Compliance be submitted to the Department, and a written guarantee will be furnished the owner, his successors, he place, in good operating condition any part of said sewage disposal system during the period of two (2) ante of the approval of the Certificate of Construction Compliance of the original system or any repair, will be located as shown on the approved plan and that said well will be Installed in. accordance with the star County Department of Health. pe Date March 18, 1905 Sjg ad o 1 Northaage oa ee ks ki , Address ° D APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued less c rue revocable for cause or may be amended or modified when co ered necessary by the Co missioner o H, requires a new, permi4 Approved disposal of domesti sane 'rytsewage, antl /or.priva a water s ly Date — Rev. 9 -81 r ON 2) Thal tandargs, satistaetE (It NN oAWN-9 _° gRReO ,lissi jid hwill the will tg th issu- i well described above no of the Putnam D VA. x R.A. 97846 bqi0n undertaken and is Ration of construction PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Ormel, N. Y. 10512 Permit s Putnam Valley (T) _. QNSTRUCTION COR�P�IQE�NCE. FFOR�SEiII►AGE DQ8I�OSAL SYSTEP�7_,_. _ Town or V(Ilag Oscawana fake Road 113 4 Located at Tax .Map Block Owner Raymond LaCerte /Formerly Tax Map Lot 4 1.11 B„bd. Xot 1 Separate Sewerage System built by Aus-,tin Stnl lAto Address RD 4 Cimarron Rd Putnam Vall v Consisting of 1000 Gal. Septic Tank and 430LF of 24" Trenches Other requirements None Water Supply: Public Supply From x Anderson Well drillers Private Supply Grilled B 'urger Street Putnam Valley, Address Building Type contemporary Frame No, of Bedrooms 3 Date Permit Issued Yes Has Erosion Control Been Completed? a ° ° ®me y p® °e° �pNAI ENG/tiF °e I certify that the,system(s) as listed serving the above premises were constructed essentially 9� a the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance Qlhe 1i algid the permit issued by the Putnam County Department Of Health. o 1Q fi^'idA yrQ° X ^ � .� ° Date July g ► 1985 Certified by �, � � ° "-' ��'y' �� "= c P.E. x R.A. Address Northridge RoaA) Peekskill, AY, - 2 846 License No. 7 Any person occupying premises served by the above system(s) shall promptly take such action as may tfa f ► } theleor►ection of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become n ) U�` a Imblic sanitary sewer becomes available and the approval of the private water supply shall become null and void who" a publl water i%p ee�ggas °available. Such approvals are subject to modification or change when, in the judgment of the Co lsponer of Health, su revocation, ottif cation or change Is necessary. Date � � 8y Title Rev. 9 -81 o ° Raymond LaCerte Owner.or Purchaser of Building - Section 113 Raymond LaCerte 4 - -= Building' Cons ruct• &-d-.by.. , Oscawana Lake Road Location - Street Putnam Valley (T) Municipality Contmporary Frame Building Type l.11 Lot Walnut Knolls Subdivision Name l 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 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 determin- ation of the Director of the Division of Environmental.Health Services. - - - --- a- f•-Liro-_-PutnariirGouinty- iiepaitrrient -of - Health- ds- tu - _whet'her- or- no . --the -fail ° = _ ure.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 L,,",^QL 19 Signature ez y ✓��Z�" T i t l e Q LJnQ.V- •• 6 DC4/"4�f&r' Corporation Name if Corp. tw %' Address THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TQ FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Division of Environmental Health Services, Putnam County Department of Health i 'COMPLETION REPORT PUTNAiM COUNTY DEPARTMENT OF HEALTH 3 Division of Environmental: Health Services ?� COUNTY OFFICE BUILDING. CARMEL, NEW YORK report is .to be completed by well driller and submitted to County Health Department- together with laboratory report of ysis of water sample indicating water is of 'satisfactory bacterial quality before certificate of construction compliance is issued. r' RPORT IvIUST"$E °80BfYllfi ED` WiTHFN 30' UAYS'0' UYLi–Cn(i✓iPLEi lO( - ow N Q GL— C'Jl/l ADDRESS LOCH 1 OF (No. d Streat) ' (Town) (Lot -ift or �A/, �� iJ e C� j�) J. 7 �> PROP . U USE WE% LZJDOMESTIC : ESTABLISHMENT I BUSINESS FARM D TEST El PUBLIC AIR OTHER 11 SUPPLY El INDUSTRIAL CONDITIONING (Specify) IJRI Eau IU T n COMPRESSED . CABLE OTHER VJ– ROTARY AIR'PERCUSSION a. PERCUSSION (Specify) CASK DET LENGTH ( .feet) / DIAMETER(Inches) �j f r . WEIGHT PER FOOT �i ! THREADED EI WELDED _lam DRIVE SHOE Z-YES '. � NO A ING QBDUTED 'F- L_J YES HMO — YIE. TE _ j�— BAILED El PUMPED. ,I�OMPRESSED AIR HOURS G.P.A. �j YIELD (G.P.M.) CJ yyA ' MEASURE FROM LAND SURFACE– STATIC(Speclly(set) DURING YIELD TEST lest)' l .. Depth of Completed Well in feet below Land surface: SCR MAKE LENGTH OPEN TO Ap41FER (test) DE T SLOT SIZE DIAMETER (inches) `. " "" �- IF GRAVEL PACKED:: ,.... � Diameter of well including gravel pack (Inchos): GRAVEL SIZE (Inchaa) FROM (loaf) TO (too f) DEPTH FR LAND SURFACE FORMATION DESCRIPTION Sketch exact loco lIon of wall with distances, 101 at least two permanent landmarks: FE o 'FEET ......... . yield wos tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE W COMPL TE /� DATE OF REPORT W ELD&It� E R'(S ign tUre) Yorktown Medical Laboratory, Inc. LOCATIONS: 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 -3203 321 Kear Street ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737.8777 Yorktown Heights, N. Y. 10598 ❑ 495 MAIN ST., MT. KISCO, N.Y. 10549 666 -3335 (914).245-3203 ❑ STONELEIGH AVE. (NEAR HOSPITAL). CARMEL, N. Y. 10512 278 -9330 Director: Albert H. Padovani M. T. (ASCP) _ � � a.�:- . -,,, �.: , -• ::- :,;,.. -. ...- . .., - � ..... - �.,. ,.- _ � DATE TAKEN:: ,� yDATE RECEIVED:� /'5:. %��40 Al 6 �%e %` DATE REPORTED: SAMPLE SOURCE: Lab.* ^4091 1 x � 2.— A G' REFERRED RRED BY: Collector 04�'% L '0006L. 7W4771- • LABORATORY REPORT mg /L ❑ ACIDITY ............................ ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY i P= ................ A= ....................... ❑ANTIMONY ................................ ............................... BACTERIA, TOTAL/mL !! ...... ❑ ARSENIC ❑ BOD, 5 DAY ............................ ............................... ❑ BARIUM ....................................... ............................... ❑ BROMIDE .......................... ............................... ❑ EERYLLiUM ............. ............................... ............... ❑ CARBON DIOXIDE, FREE ........ ............................... ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ............................ ............................... ❑ BORON ❑ CHLORINE ............................ ............................... ❑ CADMIUM .................................... ............................... ❑ COD .................................... ............................... ❑ CALCIUM ❑ COLOR (units) ................. ............................... ❑ CHROMIUM (tot.) ............................ .............. .................. ❑ CYANIDE ............................ ............................... ❑ CHROMIUM (hexavalent! .................... ............................... ❑ DETERGENT, ANIONIC :........... ............................... ❑ COBALT .................................... ............................... ❑ FLUORIDE ............................ ............................... ❑ COPPER ...... ............................... .............................. ❑ HARDNESS ............................ ............................... ❑ GOLD ....................................... ............................... ❑ MPN COLIFORM COUNT/ 100 ml ............................... C3 IRON ........................................ ............................... MMrT COLIFORM COUNT/ 100 ml ......0 ................. ❑ LEAD ........................................ ............................... ❑ CONFIRMATORY TEST ............ ............................... ❑ LITHIUM .................................... ............................... ❑ NITROGEN, AMMONIA ......................... .............. ❑ MAGNESIUM ................................ ............................... ❑ NITROGEN, KJ.ELDAHL ............ ............................... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ............ ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ............ ............................... ❑ NICKEL ......................................... ............................... ..1_1 Di-OR_ _(.Ll�? .1_ t S�._ a a ..,.a.. <...._.. -... , ...,. ❑ P�:�LAQ'— �JM.._ ...Y....,... >.... . ... ..:...:...r...�.........:�:.... •.<.r �_ -..._ ..: .. ❑ OIL & GREASE ........................ ............................... ❑ POTASSIUM ................................ ............................... ❑ PH (11I1 i t S ) ...................... ............................... ❑ RHODIUM .................................... ............................... ❑ PHENOL ................................ ............................... ❑ SELENIUM .................................... ..........................:.... ❑ PHOSPHATE lortho) ................ ............................... ❑ SILICON .................................... ............................... ❑ PHOSPHATE (condensed) ............ ............................... ❑ SILVER ........................................ ............................... .❑ PHOSPHATE (total) ................ ............................... ❑ SODIUM ........................................ ............................... ❑ SOLIDS. SETTLEABLE, ml /L .... ............................... ❑ TIN ............................................ ............................... ❑ SOLIDS. SUSPENDED ............. ............................... ❑ ZINC .................................... ........................................ ❑ SOLIDS, DISSOLVED ............. ............................... ❑ .................................................... ............................... ❑ SOLIDS, TOTAL ...............:..... ............................... ❑ .................................................... ............................... ❑ SOLIDS, VOLATILE ................. ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE (uhmo s / c m) ............... ❑ .................................................... ............................... ❑ SULFATE ............................. ............................... ❑ SULFIDE TNTC = Too Numerous To Count ............... ............................... .............. ❑ SULFITE ...................... = less than (below detectable limits ❑ SURFACTANTS RS = Recommend Sterilization of Source ..................... ............................... ❑TURBIDITY (NTU) ......................... FSBT = Filtered Sample Before Testing THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DI MEET THE SATISFACTORY CHEM- ICAL QUALITY OF THE NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72) FOR THE PARAMETERS TESTED WHEN THE SAMPLE WP COL CTED. N/A = not applicable _2Z .� l AI ert H. radovani M.T. (ASCP), Director RwEg 5 PUTNAM COUNTY DEPARTMENT OF HEALTH r DIVISION OF ENVIRONMENTAL HEALTH SERVICES . <.� .a 4.. :.- � J t ..— :�...t - �... +T�4 tT .. �. r h. f -. .. ... �. t. ♦ - ,�+e.� . .. �..� m\ :. 1T .. tta. _�. r N f March 5, 1985 Date Re: Property of Ray LaCerte Located at Oscawana Lake Road (T) Putnam Valley(T)Section 113 Block 4 Lot 1.11 Subdivision of Walnut Knolls Subdv. Lot # 1 Filed Map # 1649 Date-4-18-78 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 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 w "° ` " ` y`szem �r systiems` "iri� confor "mitt' "wi °th °tYie p`rovis`ions of -Ariicl:e i45--or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, /► _ Signed a /�v Countersigned: 9kier of P p rty P.E. , X , # .27846 a ° ®m ®oocoo ® INFF�P Address 1 Northridge Road e ®Q� ��, S. R j Address _ ; a Town Peekskill, N.Y. 105650 737 -1056 6 D 846 9 Telephone Telephone ®Epr r01dAWip • ®F HEALpi P PUTI�U'IM COUNTY DEPARTidENT OF HCALTH DIV:I:SION OF ENVIRONMENTAL HEALTII SERVICES ..... .:� �QUNTY - OrFIG??, PU 1G' %A iiI' u:I� - ._ . .• .... � ,... .. r _ :.. DESIGN DATA SHE, ET- SEWAGE DISPOSAL SYSTEM FILE NO. Owner Ray haeerte Acldres-s'- Box 162 Walnut Rd hake - Peekskill a NY Ldcated a.t (Streei; Usc Lake Road :Se C*.* 113 Block 4 Lot Indicate nearer cross s °r et Municipality Putnam Valley (T) Watershed Peekskill'. ` SOIL PERCOLATION TEST DATA REQUIRED TO .13E SUBMITTED WITH APPLICATIONS 1101i Number CLOCK TIT.T' PERCOLATION PERCOLATION Run apse Dep -nom do Ater Wa -er evei No. Time From Ground Surface in Inches Soil Rate Start -Stop 1-4in. Start Stop Drop in Min. /in drop Inches Inches Inches 10:22 10 :47 27 25.5 X8.5 3.00 9.00 2 10:50 11:2.0 30 25.5. 28.5 3.00. 10.00 7 11:23 11:53 30 25.5 28.5 3...00. 10.00 (2) 1 10:28 10:58 30 25.75 28.25 .... 2.5 120.00.. :. 2 11:03 11:33 30 25.75 27:(5 2.bO 15e00 � 3 11:37 12:07 30 25-75 27.75 2.00 15. o0 5 2 4• 5 Notes: 1) Tests 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. TEST PIT DATA REnUIRiEID TO BE SU114ITT'I;D WITH APPLICATION DESCR11`T :ON OF' SO11Z E,I1CCU'lTP RF.D 7.N TE5T HOLES DEJ1 T-H ,i�IO a : TIC?, -1 - T IIOII', .NO.. ?_ I G4. L. Topsoil Topsoil Topsoil 611 ,� , 1211 ' Sandy,stoney,loam saridy,stoney,loam sandy, - stoney loam 18" some traces, of silty .clay some traces of `-some traces of silty 211 < 3011 36" _ 42n ? u 66" 7211 8411 INTICATE LEVEL AT LTHICH GROUND WATER IS ENCOUNTERED None, .ul� ti T I� �V .:.RI E T-NQ,,F ITE TEST'S ' hLgDE BY John S : Romeo Date March- 15 , _ 19$5 DESIGN Soil Rate Used 16�-20hjirvi "Drop: S.D. Vsable Area Provided 5000 SF + No. of Bedrooms 3 Septic Tank Capacityl0GO Gals. °000 Masonry Absorption Area Provided 'By �3o L.F.x24" x j '— ®®° Tench. Name Jon S. _Romeo- __ Signature 1 Northridge Road U Address g SEAL Peekskill, N.Y. 10566 2�sa6 ±04 . + ++ m T �,1 HIS SPACE FOR USE BY 11EALTH DEPARTP T .ONLY: m ®Dom° Soil Rate Approved Sq. Ft /Cal. Chocked by Date ' APR 0 2'1985 PUTNAM r,.OUNTY DEPT. ®F HEALTH T, f� t •, b 'F 1. ``4lc�o` J �.. � • -'� r odd � j l Die Iq +lPl,i W1,104�`r. ~'`+.•� .. � is {' \\ ,i ` _ ° t: - �' ' -_ -' •' / � is •' � P'�eiFn r � 13 1m.84' i� i'uLt1ao i',cnoL llepsale nt It So V\ ' tl� t` _.� _. al Se oes °' /nngl- tl!,,,,..._ �� Divit3aoa of + Health ( .1 cY 1 i for ce with 7 -ions of gap7IC YL�'iTEm - v Y 1 1 i prt eat.. FOR � c r 33 ' 3 ._'BEDROOM HOOE' —' ut DESIGNED :fie SUPERV ISED BY ( o :.�;;�` _.,••fr °•, M SOILS RA`Tt `• e s a to l.00 0 C$AL TANK TOWN O PUT })AM :V6' f.Y Co CONSULTING NGI.NI ERS F i4F TRENCH S PuTNq .` U rater rE 1 .NORTI°iRiDC$E ROAD + �/ c :NEW YORK e6 °o'dlf„ ik�_ ',ORiGrNAL`' MiZ04 Ids .70r „SGi4LE'1 - dJ0