HomeMy WebLinkAbout3915DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
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631- 589 -8100
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, of � .Y 3 86 Division Envireiimental Hesltb cee9i Carntel N.
-10512
^ Engineer Must Provide N/A,
P CM D. Permit q
CERTiFI 'OFCONSTRUC17ION COMPLIANCE FOR SEWAGE DISPOSAL;SYSTEWi Pu cnarn V alley
Marsh Hill Road T" MaP
Town B ocilr Village
L t
Locates at 118. 2 3. 2, 3: 3 F
Owner /applicant Name Ralph Bonayi Gt Formerly - N/A Subdivision Name N/Y Sabdv. Lot.q 3.4
.
Marsh Hill'Rd Put.Val NY 10579 .
Mailing Address , , ZIP 10579 Permit leaned
Rudolph Valen ini 20 Woodland B1vd.Peekskill,NY
Separate Sewerage System built by Address
1200 500 LF of Fields 105E
Consisting of Gallon Septic Tank and
Water Sa ply: T�Public Supply From Address
- ri-e- EAistingXx P.F. Beal Awe Brewster,NY
' or: Private Supply DTge4 by
11JJrillled 5/26/71
N/A
Bung Type On am i; 1 y. R P c i d a n zlil Eroslon "Control Been Completed?
Number of Bedrooms 4 Has Garbage Grinder Been.Installed? NO
Other Requirements
I certify that :the system(s) as listed serving the above premises were constructed essential) as shown on the pl s of the completed work ( copies
of which are attached) -, and in accordance with the standards, rules and r tions, in acoo an a with the file lam, and the permit issued by the
Putnam County Department Of Health. - _
Date 4/28/86 certified by P.E. R.A. XX
Address
Any pmsOn, occupying . premises served by the above systems) ;hall prorri tly td�CS- c
conditions resulting from such usage. Approval of the separate se ► iyste sha11
available and the approval of .the private wafersupply shall become n 11 d. V when
subject to modification or change when, in the Judgment of the m $ one of N
Date
By
:t i0 a y be neusu ►y to secure thi correction of any unsanitary
ms un and void as soon at a pubs:: unitary sewer becomes
Ipa ub wet wPPI� comes available. Such approvals are
lR such rev tbn, m ificatfon or change Is casury. �•
// d, Title j
(orJktown Medical Laboratory, Inc.
LAB N 4 ��2�Q ®F
321 Kear Street
Yorktown Heights, N. Y. 10598 Collection Station .Used:
245:3203 Carmel Peekskill
sc o ew N _C
--
Director: Albert H. Padovani M. T. (ASCP) —
r �
BONAVIST
BOX 249
PUTNAM VALLEY, NY 10579
L ..J
Date Taken • 4/14/86 (5 P.M.)
Date Received: •)
Date Reported:
Collected By: SAME
Referred By: CY
Sample Source: KITCHEN TAP:
LABORATORY REPORT. ON BACTERIOLOGICAL QUALITY OF WATER
GENERAL 'BACTERIA
V_ Standard Plate Count per 100 ml
(Agar plate @ 35 °C)
MEMBRANE FILTRATION TECHNIQUE (MFT) //11
�Total.Coliform Der 100 ml V
Fecal Coliform per 100 ml
Fecal Streptococcus per 100 ml
MOST PROBABLE NUMBER TECHNIQUF (MPN)
-Total Coliform: Index.. per l0_0.m.l
Fecal Coliform:
OTHER ANALYSES
MPN Index per 100 ml
THESE RESULTS INDICATE THAT THE WATER SAMPL (WAS) (WAS NOT) (NOT APPLICABLE)
OF A SATISFACTORY SANITARY QUALITY ACCORDIN TO NEW YORK STATE DRINKING
WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION.
J
Albert H. Padovani. M.T. (ASCP), Director
LEGEND
RDS = Recommend Disinfect-
ing Water Source
< = less than
TNTC = Too Numerous Too
Count
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n Al 010
caner or Pnrchaser of Building -' Municipality
_
Old -
t. Building Constructed by Section,
ocation- street =- Block
-
uilding type Lot
GUARANTY OF SEPARATE SEWAGE SYSTEM
I represent that I,am wholly and completely responsible for the
ocation, workmanship,,- material; construction, and drainage of the XiX sewage
:lisposal. system serving the above described property, and that it has been
onstructed as ` shown" on ,the "approved plan or approved. amendment thereto,
nd in accordance with the standards, rules and regulations of the Putnam
County Department of Health, and hereby guaranty to the owner, Iris su-cces-
ors," heirs or assigns, .t4 places in •ga,od operating condition an rpart of
yF
l axd syst4 xn 'constr cted by; rne, why Gh faal s rtQ operate: for a pe'ri.od of two
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(or%.town Medical Laboratory, Inc LAB # 241(o
4 321 Kear Street iZak QV�!
York:own Heights, N. Y. 10598 . Collection Station Used:
(914) 245 -3203 Carmel Peekskill
14t . Kisco . - - New City,.-
Date Taken: �p ^ d o•�j-rJ
Date Received: •o•
/A/ Date Reported:
Collected ay: AT 4fTA7;
Referred By:
L ®Gn✓ i. �// �-y� /1/. LJ, 104 7� Sample Source: ACd✓ tv
LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER
GENERAL BACTERIA
Standard Plate Count per 100 ml
(Agar.plate @ 35 0C)
MEMBRANE FILTRATION TECHNIQUE (MFT) O
Total Coliform per 100 ml_
Fecal Coliform per-100 ml
Fecal Streptococcus per 100 ml
MOST PROBABLE NUMBER TECHNIQUE (MPN)
Total Coliform:
MPN
-Index
ner
100
ml
` "` "_'ecai Coliform:
M'N
Index
per
100
ml
OTHER ANALYSES
THESE RESULTS INDICATE THAT THE WATER SAMPLE
OF A SATISFACTORY SANITARY. QUALITY ACCORDING.
WATER STANDARDS, FOR THE PARAMETERS TESTED, A
Albert H. Padovanio M.T
V E (WAS NOT) (NOT APPLICABLE)
NEW YORK STATE DRINKING
E TIME OF COLLECTION.
LEGEND
Director RDS = Recommend Disinfect -
ing Water Source
< _. less than
TNTC = Too Numerous Too
_ Count
fORKTOWN MEDICAL LABORATORY INC.
LOCATIONS:
P: CJ 321 O. Box 99 321 Kear Street
Q KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203
Yorktown Heights, N.Y. 10598 01 BUTTONWOODAVE .,PEEKSKILL,N.Y.1056G 737.8777
245 -,3203 7 ❑ 495 MAIN ST.. MT, KISCO. N.Y. 10549 666.3335
❑ $TONELEIGH AVE. tNEAR HOSPITAL), CARMEL, N, Y. 10512 278.933
— LAB #
DATE TAKEN, °t- o °
—� DATE RECEIVED:
DATE REPORTED: �G 1A
SAMPLE SOU E:
yy REFERRED BY:
L� J
COLLECTED BY :rf .-
/ LABORATORY REPORT
mg /L
❑ ACIDITY .................. ...............................
❑ ALKALINITY ............... ...:s'.........................
,vfiACTERIA, TOTAL /mL ...42 ........................
❑ BOO, 5 DAY ................... ...............................
OBROMIDE ..................................................
❑ CARBON DIOXIDE, FREE ..............................
❑ CHLORIDE .............. a ..... ...............................
❑ CHLORINE ................... ...............................
❑ COD .:......................... ...............................
❑ COLOR ....................... ...............................
❑ CYANIDE ............................................. :....
O DETERGENT, ANIONIC ... ...............................
❑ FLUORIDE ................... ...............................
❑ HARDNESS ................... ...............................
❑ MPN COLI FORM COUNT/ 100 ml ..........
Kff—T COLIFORM COUNT/ 100 ml .....
❑ CONFIRMATORY TEST ..........
❑'Nl`FROGEN, AMMONIA .:. ..........:..:.::.:::: :..,::::.
❑ NITROGEN, KJELDAHL .........................c ......
❑ NITROGEN, NITRATE ... ...............................
❑ NITROGEN, ORGANIC ... ...............................
DDOOR ......................................................
OOIL& GREASE ..............................................
❑ pH ........................... ...............................
❑ PHENOL ....................... ...............................
❑ PHOSPHATE (ortho) ....... ...............................
❑ PHOSPHATE (condensed) ... .......................:.......
❑ PHOSPHATE (total) ....... ...............................
❑ SOLIDS. SETTLEABLE. mt /L ..........................
❑ SOLIDS, SUSPENDED ........... :......................
❑ SOLIDS, DISSOLVED ... ...............................
O SOLIDS. TOTAL ........ ...............................
❑ SOLIDS, VOLATILE ...... ...............................
❑ SPECIFIC CONDUCTANCE .......................::.....
OSULFATE ................... ...............................
OSULFIDE ................... ...............................
❑ SULFITE .................... ...............................
❑ SURFACTANTS ............ ...............................
❑ TURBIDITY ................ ..............................,
❑ ALUMINUM ..... ............................... .......................
❑ ANTIMONY ...............................................................
❑ ARSENIC .................................... ...............................
OBARIUM ....................................... ...............................
❑ BERYLLIUM ..............................:. ...............................
OBISMUTH .................................... ...............................
❑ BORON ........................................ ...............................
❑ CADMIUM .................................... ...............................
❑ CALCIUM .................................... ...............................
OCHROMIUM (tot.) ..................:......... ...............................
❑ CHROMIUM (hezavalent) .................... ............................... I�
❑ COBALT .................................... ...............................
❑ COPPER .................................... ...............................
OCOLD ...................................... ...............................
❑ IRON ........................................ ...............................
❑ LEAD ........................................ ...............................
❑ LITHIUM .................................... ...............................
OMAGNESIUM .............................•........ ............................... ,..._,...
❑ MANGANESE ............................. ..........................
❑ MERCURY .................................... .............................:.
❑ NICKEL .....................:.................. ...............................
❑ PALLADIUM ................................ ...............................
❑ POTASSIUM ................................ ...............................
❑ RHOOIUM .................................... ...............................
❑ SELENIUM .................................... ...............................
❑ SILICON
❑ SILVER ..........................RECtj �•� .............
OS ODIUM ............................... ................Je/............
❑ TIN ................................. f:,... ...............................
❑ ZINC .........�.i .
.. ............................... .
O .................................. �41�1t ..ep�......................
❑ REMARKS: ..............................
..QR 1 NT.y ...............
❑ .............................. ..........................�!LTh ................
❑ ............................ ............................... ....................
❑ ............ ............................... ..... ...............................
O.. ............................... ....... ............................... ...
❑ .................................................... ...............................
❑ ......... ............................................. _.. _ .......
THESE RESULTS INDICATE THAT THE WATER WAS V��OF A SATISFACTORY SANITARY QUALITY WHEN
THE SAMPLE WAS COLLECTED,
THESE RESULTS INDICATE THAT ThE WATER DID JIEET I SATI CTORY CHEMICAL QUALITY OF
NE14 YORK STATE ADMINISTRATIVE RULES � RE13U N D �tl<Ir /,IWATr, ST ANDARDS (PART 72)
FOR THE PARAMETERS TESTED. 1 -7
AT.BERT H. PADOVANI M.T (ASCP), DIRECTOR:
CONSTRUCTION PERMIT
Ali COUI�TY. DEPARTMENT OF HEALTH[
tf Environmental Health Services, Carmel, N. Y. 10512
151SPOSAL SYSTEM
Subdivision N/A .
Owner Ralph & Linda Bnna'vi at-
Building Type l family r aid _nceot Area 4-97 acres
Number of Bedrooms 4 Design Flow 800 GPD
Separate Sewerage System to consist of 1.200 Gal. Septic Tank
To be constructed by not- selected
Water Supply: Public Supply From
* Private Supply to. be drilled by not selected
n�
Address
Putnam Valle
Town 3r lil14e
Lot Job
Address
Total Habitable Space I T nklu Square Feet
and 500 L.F. of 21011 wide trenches
Address
Other Requirements
" C3
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 approvetl amendment there to and in accordance with the standards, rules and regulations of the 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 Sys te 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 accordan with the stan rds, rules and regulations of the Putnam
County Department of Health.
Date Auqust 6 1979 Signed P,E. R.A.
Address RR 8 Muscoot N Ma O aC N.Y. 4l License No. 11056_
APPROVED FOR CONSTRUCTION: This approval expires one year f m he dat issued unless construction of the building has been undertaken and is
revocable for, cause or may be amended or modified when considered nec ry by he Commissioner of Health. Any change or alteration of construction
requires •a new pejmit. Approved for disposal of domestic sapdtary sewjpe, and /or private water supply only.
Date By Title
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISI.ON OF ENVIRONMENTAL HEALTH SERVICES
;.COUNTY.OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
OwnerRal,ph & Linda Bonavist AddressMountain View Road Riltna_m VAlley., N.Y.
T.M. 118 -2- 3,3.3,3.4
Located at (Street RR. Block Lot
ca a
nearest cross s ree
Municipality.- T�wn.._�f. Eutnam V;;jje L Watershed_ Mid -sign R zer.
SOIL.PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
hole
Number.:...CLOCK..TIME
PERCOLATION
PERCOLATION
Run apse
Depth
to a er
Water ve
.
No.. :...... :... .:..: :. ` Time
From Ground Surface
in Inches.—
... Soil Rate
Start -Stop Min.
Start
Stop
Drop -in
Min./in drop
Inches
Inches
Inches
#1 .18:.00,- 8..:.33.: - - 33
16
19
3
33L3 _ 11
Notes:
rates
for re
be repeated at same depth until aroximatelyy equal soil
at each percolation test hole. All pp data to be submitted
surements to be made from top of hole.
ate.
TEST PIT DATA REQUIRED TO- BE SUBMITTED WITH APPLICATION
DESCRIPTION OP' SOILS ENCOUNTERED IN TEST HOLES..
DEPTH HOLE NO.
HOLE NO. 2 HOLE. NO -.
G.L. A Top Sni l Tnz Sni 1 T6Z) Rni 1
z
6"
_Sand and .1 y Sand and C1 ay Sand �Ancl M iAu
12" ;
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None Encountered
IIDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED N/A
TESTS. MADE. BY Joel Greenbercr Date ,/ .
DESIGN
Soil Rate Used 11 -15 Min/1 "Drop: S.D. Usable Area provided ..-.50000 S . F .
Noo of: Bedrooms .,. Septic Tank Capacity. ` Ga �a
Absorptson:Area�Prov,de By 500 L.F.x24 * -1. 1 fib" a dt c c.
I�Tame
Joel "Green �r� Signature MY
Address...
_ RR #8��ji1 S�6 t North S �
_ _- Mahopac, N.Y. 101;41
A ti 6
°• 01105 O
fi NE
THIS SPACE'FOR USE BY HEALTH DEPARTMT ONLY:
Soil Rate Approved Sq. Ft /Cal. Checked by Date
A.
Gentlemen:
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION O,F'-- :EN- V- IRONME.'NTAL "HEALTH 'SERVICES
Date Ajagust 6, 1979
Re: Property of Ra nh & Linda Bonavi st,
Located at _ Marsh Hill Rggd,,'Putnam Valley., N'.Y. 10579
T.M. 118-2-3.2,3.3'
X ,Iock Lot
�
This letter is to authorize anei'Greenjaera
a duly licensed professional engineer or registered architect
(Indicate)
to apply fo.r 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 cons truct:ion,of:�said
system or systems in conformity with the provisions of Article 145 or
147, Education i,a Public Health Law, and the Putnam County Sani-
tary Code. o,� �yyR�NCE GRF<` A
Countersigne
P *E., R.A., #__ I -I n"r,
:::: a .. ►.
914-628-6-613
Wom-
Very tru1 yours,
Signed Lv
Ownle/r of I Property
Address
�� (0 -,� '? �,- �;—
Telephone
P4 C
140A
to O\'V 14
Z7 a.
-777�
ICY
A401' -fop,
00
Wi�
2.
. IN,
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