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HomeMy WebLinkAbout3806DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -1 -6 BOX 30 his ' '♦I i7g, 16 11, to. [• r r_ f. PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley Oscawana.Lake Road Filed #1649 Located at jj;l�(Mep Block - Owner Robenat Contractors Lot #2 Job S01807 Separate Sewerage System built by S -AF Septhc . Systems Address New Rochelle, NY' Consisting of 1000 Gal. Septic Tank and 435 L.F. x 24" Wide Trench Other requirements None Water Supply: Public Supply From X Private Supply Drilled By Mill Drilling, Inc. Address M� Building Type Frame No, of Bedrooms Three Date Permit issued —jL 11 , 1978 Has Erosion Control Been Completed? Yes 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, plans fil and the permit issu by 7Putnam County Department of Health. Date 25 July 1978 certified by s P.E. R -A. Address R•p• 9, a�" S eel, Carmel , N 10512 License No. 29206 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the' private water 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 Co mission f ealth, such revo n, mo ification or change necessary. t �2 By '� Date Title PUTNAM COUNTY DEPARTMENT OF HEALTH jrl Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM _ PUttldm Va 11 ey ° r Fi 1 ed Town or Village Located at Oscawana Lake Road XXXMap #1649 Block Subdivision Owner Walnut Knolls Robenat Contractors, Inc. Building Type Frame Lot Area 1.472 A. Number of Bedrooms Three Design Flow 600 Gal . Separate Sewerage System to consist of 1000 Gal. Septic Tank To be constructed by Water Supply: Other Requirements Public Supply From X Private Supply to be drilled by Address None Lot 2 Job 501807 Address % E.A. Rader, Oscawana Lake Rd. Putnam Valley NY 10579 Total Habitable Space 1092 on 1 " Fl . Square Feet and 429 L.F. x 24" Width Trench Address 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 standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved,plan and that said well will be installed in accordance with the stand ar les and regulations of the Putnam County Department of Health. �I Date 1 May 1978 Signed ` P.E. X R.A. Address R. D. 9, Fair St ee Camel Y 1051 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from 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 of construction requires a new permit. Approved for disposal of domestic sanitary sewage, and /or private water supply only. Date rT % / b' By 10at, d U41I1411 -m Title AOfF WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This _report _is to be comple,ted.by ,well driller.and submitted to County- Health. Dep rtment-tooether .with_.laboratory .report of__: , .: aroai� Fs bf �,/atee s in(iie frf 6ating wlater is for saYlstactory bacterial quafity before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION ADDRESS Oscawana Lake Road, Putnam Vall (Town) Putnam Valley ❑ NAME ❑ OWNER Robenat Contractors LOCATION OTHER (No. 6 Street) OF WELL Oscawana Lake Road DETAILS ® BUSINESS ❑ PROPOSED DOMESTIC ESTABLISHMENT USE OF YES YIELD WELL PUBLIC ❑ ❑ PUMPED COMPRESSED AIR 4 30 SUPPLY INDUSTRIAL ADDRESS Oscawana Lake Road, Putnam Vall (Town) Putnam Valley ❑ FARM ❑ TEST WELL ❑AIR LENGTH (teet) ❑ OTHER � THREADED ❑ CONDITIONING WE-CASING (Specify) NY 10579 DRILLING CABLE ER (Spe ❑ ROTARY El EQUIPMENT AICOMPRESSED R PERCUSSION PERCUSSION if ) CASING LENGTH (teet) DIAMETER (inches) WEiuHT PER FOOT � THREADED ❑ DRIVE SHOE �j X❑ ❑ NO WE-CASING Z NO DETAILS 255 6 17 WELDED YES YES YIELD HOURS G.P.M. ❑ BAILED ❑ ® YIELD (G.P.M.) TEST PUMPED COMPRESSED AIR 4 30 30 WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [feet) 1 Depth of Completed Well LEVEL 30 165 in feet below Land surface: 165 SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: DEPTH FROM LAND SURFACE FEET to FEET FORMATION DESCRIPTION 0 15 Clay and boulders. 15 165 14ediura —hard clranite. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE Diameter of well including gravel pack (Inches): Sketch exact location of well with distances, to at least two permanent landmarks. J i� S* DS- G DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) > + ILLING, INC, Y { BREWSTER LABORATORIES Box 224 - BRF:WSTER, N.Y. WATER ANALYSIS REPORT SAMPLE NO. ' 4 0 5 9 SOURCE: Eugene Rader well Oscawana Make Rd. Putnam Valley, N.Y. COLLECTED: June 2, 1978 BY :Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source 'of the sample was of satisfactory sanitary quality when the- sample was collected. June 6, 1978 Roy it P. E. Director I - w 3 .. __. ..:..,�.- ......y:-:<<,:.= r.�-. ... - ,,::.:,k, ....,.: "r;.::.. �:i,......- .rr_:...:r -i - •- ;.:.:.. �. ..a.: - .;•n! —. , ;.i., Robenat Contractors. Putnam Valley er r Purc a er of Buildin Municipality 17- Fi 1 ed 'Map # 1649 uilding Constructed by Section. 0scawana, -Lake Road Location - Stree -t Block Frame #2 .Building Type Lot GUARANTY OF SEPARATE SEWAGE SYSTEM Ujr represent that (ONWwholly 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 '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 aS 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 b the willful-or Ni act of the occupant of t uildi utiliz g th Dated this day o 19:S Signature " Ti t corporation, give name and address) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3)- -COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP.7,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 FIELD CHECK LIST - Date , 16)1419 INITIAL SITE INSPECTIOI`1 Yes . No Comments Property., lines .or corners found Can estimate house location . . . . . . . Will driveway need cut . . . . Q Must trees be removed -note these Is deep hole representative of entire SDS.area Additional deep holes needed. . . . . Sufficient SDS area available considering driveway cut, house location,separation . distances., etc. . . . . . . . . . .DEEP HO= DATA Depth: +- Water: elevation: _ Rock elevation: "7' . :. Soils descriution: Date: FINAL SITE D\TSPECTIOW Insp. by: House located where shown on approved plan SDS located where .approved . . . . . Length of trench measured Width of trench average .Slope of tile line 'and. trench acceptable e Room allowed for expansion trenches. Over 50 ft. from swamp. watercourse . . . Natural s�f3: net :.strippeu ui- SDS area unnecessarily graded o 10 Ft. maintained from prop.line.and 20 ft. from house ' . . . . . ... : Separation of trench from house, well etc. follows plan Number of bedrooms checks Stories, brush., stumps, rubble;-etc'. greater than 15 ft. from nearest trench . . . 15 Ft. of peripheral soil horizontally from trench . . . . . . . . . . . . . . . . . : . Junction boxes properly set. Could surface run off from driveway, roads, ground surface, etc.. channel near SDS . . . . area .. . _ Does lot draina ;e air -ear O.K. in area of SDS FINAL GRADING OF SITE ACCEPTABLE ncvlr.w �,ttlSl.Y. :Iil;ll ;J. ,M(.eLs Strl j Remark-* . : . . G9 O 1� ° �Y U ;. ;z �. . . _• = MCC E ITS . ,.• . ..:. �:.._ .- -,: �.., muse plans 0. K. f Design data sheet Plres presoaked? ,l ► I%in - 30" pert test depth • ' 'Con4t . results for 3 runs r D.. Hole log O.K. Corporate Affidavit for other than individual I Authorization for engineer IFtter from Water Supply if applicable .if variance requested -such noted.on -plans & apps.. a D: AILS _ if change is proposed,) misting contours shown show new contours) I Pot Slopes for driveway cuts, etc. shown Xater service line.location Yopting drain, etc. location Tod­ slope, bottom slope of fill .Percolation tests and deep test pit location .- Set"tic tank size and conforr:ance to std. 3 B.,R. house minimum House setback shown _Distribution box ftg. below frost All -water within 5Q ft. of PL shown Plan and profile SDS __ :.:. ✓..... 4_. A:11_: o th-r: well s: =any -SDS .closer 2- ii? , I f t shown.or reference made Property boundaries (metes and bounds clearly s �1 WARATION DIMOCES SPECIFIED ON.PLAN .0' to P.L. 0''to Foundation walls J' to Nearest well 0' to stream, march, lake, etc. incl.e 5' to Curtain drain 3' to water line (pits -2-0 ;' to storm drain ' 'to large trees )' from foundation to septic tank to pipe from . leader drain & ,foo 'ing :pansion 't Ira�iri ,. , PUTNAM COUNTY DEPARTMENT OF HEALTH CE IT Date I May 1978 ,Re: Property of. Robenat Contractors, Inc. Located at Oscawana.Lake Rd.' Walnut Knolls Subd., T. ';Putnam Valley Filed Map #1649 Block Lot 2 Gentlemen: This letter is to authorize John-H.. Prbntiss, P.E. .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 promulagat6d 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 system or systems in conformity with the provisions of Article 145 or 1.47,1. Education-.Law,_ the. Public Health:. Law, and the -Putnam --County-Sani tary Code. Very trul :(o urs, Signed Co tersigne P ' n v D .E . R.A., #29206 HUMMUZU R.D. 9, Fair Street Address Carmel, NY 10512 914-878-6170 Telephone 0 ESSIO)V41 PRF FAG, *0. 29 OF TPAE 91 Os a*" L� Ee PK6W r ty Putnam.Valley, NY 10579 Address 9,14-LA8-7664 Telephone ;. I I l . ti I i' i li 'a` - i .. t jr It 1 —.1I u'!)au y- 5wI pt t i,Lt r�'y 1_f - - n . . '^^ti:.'"'• '+' q a a -M�. 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Ne Y. 70512 ; 1 SBEET- SEPARATE SEI IAGJ� DISPt Uw 1sys- Tu FIX$ HQ Q •$4 r0dd �l.�l�s'.E�f�G� La.�.► �. 6t (street) rte: Block Ina ca, a pe4rost cross s F807 War '► /dam.:; r "ti Watershed t ,► SOIL . COLATION TEST PATA RE UIRM TO BE SUAMITTED WTH AtaggAVZ -LPM=LATIQW b PERCOIATIOV C ap p o water water !gym Fi►►om 'to Surfeme in Inahea . . v to rp in.Start -St ®p Start Stop d oop / Inches InchQs Inches:. ! ® 2� nic IL 409. A 9L `r.. Hat,!e1�/1d���. : 1) 'fasts to he repeated at same depth' unti X a .. root ®I lual x i1. MM W obtaaod �,t each pQi'cQlt3oa� toe$, k�Q�p �l�l �a' t ®® , , A. , QUlmpth nioasurementa to be ,made • fr ma top . sag hole o '°.1' i DEPTH T.E,ST PIT DATA RE-QUIREfl) TO Pl�: 1,.'1rPJT APPL-I.-CA'TION 011-1 B01L."', 1-im-L', NO. '611 1211 241.1 3011 3 11 6 alp Latm^�- teg 4211 4811 5411 60" 66" 7211 78 ti 84 if INDICATE LEVEL A�?�1ILI xROLTIM IJATER IS EYC0'LT1,1THRE--,-) No ov Lo INDICATE LEVLL TO WflICH WATER LEVEL RISES AFTER PLE, '.-P vTG ENCOURTERE D Aobve TESTS MADE BY 9. rj 4L1.% 2 1;,A A , Date _161 DESIGN F)oi!,Rate Used/jUp min/1"Drop: S.D. Usable Area Provided 0 No. of Bedrooms 73ope Septic Tank Capacity /60g? Gals. Type Absorptiol-i- Area --.Pi�6-V-ld—ed By_+19 L.P.x2ll-" width trenc h. Other 90fESS1 44 Fflo or - 7.7 t C, 4 Address Pair Str,�v ,it l 77,7 F,175,17- THIS SPACE FOR USE 13Y 11EAU.1111 DEPARTMRTNIT 0 7,�bod 0'0 Soil Rate Approved Sq. Pt/Gal. Chi�T Date 4