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HomeMy WebLinkAbout3974DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.58 -1 -35 BOX 31 I gym I oil ti ' 19 - 6L, .� f r r ti IL - 03974 4, V�4 A V A." TUT t a S77 ►Wat L oeat 6 6 a t WAIA"' e Sewerage'. System built ,Eby ' Consisting. of d Gal. S. .4 i p't I C, ',Qther. requirements -'�'Waitidr Supply 6611c iSupiil�,:-From it � Privat Drilled, Building. TYPe 4. 2'' V,/d Ve $' Hasr E ►OSlon Control Been Completed? T" - &�.certify' that ,t.he:sys. erq(s)�,as,listed - se-, 46g'i"h e"a"i and in accordance .wit �h.' the "stadar' -Address' A py�p_er,.so.,np ' cj;upy1qg.pr conditions ;res from ,such .usage Ap prp aF,oi the priva elwa er, ':iijiilabW andil4e iupp subject ;to '-- �iii tion 0r'..' c fiange wlia , n'.' t- 'he"-j — - rvfr is A NY' -Di6 CarM is 1:P'. '-Town, or' Village 5 F- ck Fib Joti widthtienc Y' B rooms Date -P.&Mit Issued 1�' sen 1 the plans of,the,6610160d wo.rik';(coples o f whi h are., ;°the permit ssup DV A nVPu tnim County Dp a rireni of"-6ilth. yl- A.A. 'A I Icense... may e,necqssar! unsanitary to secure correction of any ystem'ih'all-3'6cofi e!null -and void as as ;.a , p66lic SaN , a ry sewer 60c omes id when 'public : ecpmqs,av allable Such:" approval s are issloner of Health, h r tion modification -'or ,,change ,I s '-necessary. T'Itlb NY' CarM 1:P'. '-Town, or' Village 5 F- ck Fib Joti widthtienc Y' B rooms Date -P.&Mit Issued 1�' sen 1 the plans of,the,6610160d wo.rik';(coples o f whi h are., ;°the permit ssup DV A nVPu tnim County Dp a rireni of"-6ilth. yl- A.A. 'A I Icense... may e,necqssar! unsanitary to secure correction of any ystem'ih'all-3'6cofi e!null -and void as as ;.a , p66lic SaN , a ry sewer 60c omes id when 'public : ecpmqs,av allable Such:" approval s are issloner of Health, h r tion modification -'or ,,change ,I s '-necessary. T'Itlb t R,KC-ii,� -AL"LABORAT 'Ut ] YO OWN-VER IC, RKT 1:�'I'O.:�Bdi"991-`,121, Wflt reit 44-616W. l45 - BACTERIA PER ML-,-., (Agdr plate count f7, HARDNES:S;-,T.OTAL PPM 'kSUL ;;- DATE C ELECTED —x s- OF EXAMINATION CW ''�mA 16. ' TER DETERGENTS :NITRATES :)WNER--'- IRON, TOTAL ppm 7 MATE iREC EIV ED' �j TT '�­` .. . ... ... GAR" I, I Z R, ' ObT --1 4 CITY, YILLAGE�'TOWq "VORIN AW 0 F -SU PPL N DATE REPORTED' N k-101 -IjUTNAM PLING?OINZ, S BACTERIA PER ML-,-., (Agdr plate count COLIFORM �GROUP, (,MpbVpobdble, No ./l 0 Orhl.) HARDNES:S;-,T.OTAL PPM ;:-A 'ES -'THM: -2 -`2. DETERGENTS :NITRATES IRON, TOTAL ppm 7 tt F7LOURPE,(f):-,Og-/L' S These results -frdi cotd�thcd the Water was of it y -qu 1h be 1i ple was c ed. J. DOV.ANI, ..'(ASCF) -�illl w, mi WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK yy Thrs' repo%'' fsto�be�icimpl�4ed�} rwePi° �df' illEr�and�sr�bmittedto��Co�rnty �leaitih�b' e�pa�fii' ierit °togeth'er�al�ith`�'8ff6�8tory re�(frtTf",`" 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 rA I NAME ADDRESS OWNER EDGAR LITZROD OSCAWANA RD. PUTNAM VALLEY NEW YORK LOCATION (No. fl Street) (Town) (Lot Number) OF WELL OSCAWANA ROAD PUTNAM VALLEY BUSINESS ❑ ❑ ❑ PROPOSED OMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING (S(Specify) DRILLING ❑ ROTARY A R ❑ El OPHER PMENT EQUIPMENT PERCUSSION PERCUSSION ) CASING LENGTH (feet) 61 DIAMETER (inches) WEIGHT PER FOOT ❑ 5 ❑ G DETAILS 6 19 #� THREADED WELDED S. NO S NO YIELD HOURS G.P.M. • ❑ BAILED ❑ YIELD (0'.P:M.) TEST PUMPED &PRESSED, AIR 6 10 10k WATER MEASURE FROM LAND SURFACE —STATIC (Specifyfeet) DURING YIELD TEST feet) 1 Depth of Completed Well ' LEVEL 15 feet 145 in feet below Land surface: 145 MAKE LENGTH OPEN TO AQUIFER (feet) NONE NA SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (Inches) FROM (feet) TO (feet) NA NA PACKED: gravel pack (Inches): NA NA NA DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 46 Sand,gravel cz- U_ 46 .85 Light.grey. form. ... ...... _... 85 -' 145, Dark _grey farm......... :... V. . �tw S L f, - . r 1 If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE 145 10k DATE WEIR 4OMPIETE DpT�p6XPORT WELL DRILLER (Signature) BRUCE W. WRAGG mac rA I — Owner or 'Purchaser of building a M d7/it% 6 144G�. Municipals -y .•........•.^.. .•.. _.. a.�f�...'�v.'4�� •.i••. C'- -•.•.r �oViT�W'P >f'� ^ {'4. .f 0• ^O RM A'�c9{.M :ON.. OC ..P -.. ;�. q•'• [ �,`p�P'.M'fii �1` ^; .. _ ;ZG�2 ire,¢ o ar //. Building Constructed by j,g.x Location - Street a Building Type o/ 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 successors,.'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 tTA7o 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 occupant of the building; utilizing tj1 a P11P --nm The undersigned further agrees to accept as conclusive the determination.' of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused -by .the.,will:ft 1, or - negligent act of the occupant of the building utilizing the. system..' ` Dated this ; day of 19� Signature. AUU111 Title 6?Gc1A451e -. (if corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR TS. REQUIRED TO FILE NOTICE OF DATE OF FIRST USE. OF SYSTEM. Division of Environmental Health.Services, Putnam. County Department of Health W,, PUTNAM COUNTYDEPARTMENT 'OF HEALTH Y J ..: • { �' 3r Division of Environmencal rHealih' Services Carmel ; N' Y 10512 CONSTRUCTION PERMIT FOR SEWAGE. DISPOSAL SYSTEM ��V1 �7�j per' Town or.-Village I �. -:,L vas .r, ..J fY l/I[L�F n" �: aI�/ '%s� r�.yy� ..;e -:.d •lus.. -�.•. f ..i• i�'y'? V'. iias rs. c *r r� x it rr c i,•, ' Located ,Block Subdivision Lo'i JobD/� Owner Ca `�9 r+Z. < n rang °�� Address �E'O' 3 �Io,( Building Type 1s, /n% //tiL =1 LOt Area: r Number of Bedrooms -•� Total Habifable e 5 _S4uare'Feet Separate,Sewerage`System to consist of��' Gal Septic Tank �` + ^% -lineal feet .Xr T ��+ ` width* trench - '! t +• To be constructed byrjrrrl► /���'� Addresst% /% a'/+L�'� /� �Yw- j 1 Water Supplylic Supply From ;Pnvate- Supply to be drilled by , . NtaE a,cr% • 'Address• - LL Other Requirements I. represent thatl'am wholly and completely responsib of '.th c n of the proposed system(s)p 1) that the separate sewage disposal system I above described will be coristeucted':as shown on the' ad apS n m nd in accordance with.the standards, rules,an regulations o e Putnam county Department of ,Health, -and that;on com � - onstrucUOn Compliance' satisfactory to.tha Co mis ;lonerbf Healthwill, "' ) Lie submitted to':the Department' and a `wntten fEr�e w 11 e r sh wne� his successors fieirs'or a'ss� ns b the builder; that, said builder will Dui r� 9 v place in ood o eratin condition an '` 9 P 9` - y'.part of" wag .thSpo� em the period ofawo (2) years immed�atery- ;following theidate of the issu =, ance of ;the a k�c " pproval of ,the Certificate of Con uct n nCQ18tiii a he "lg I system;or any repairs hereto;,2) that.thesdrilleq� well described above.. -11 u o xµwill be located as'shown on the approved plan and' id'w II ifi b ed p ordance n -the st rds rules and regu a ions of ;the Putnam. wCounty. OepartmeM of Health . �YY Address "• �� /� �� '7 Li6ense No Z? . APPROVED. FOR;±CONST;RUCTION This approval expires the date issue ..unless construction of .the.bwidmg 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 regwres ' ew per t Approved fo`r disposal of domestic sanitar.y 6ewage antl %or private water.'su I ' only. PP Y y Date • .:9 ' t By l L � w .q..... :hri �.. :.:.�..aa � .->aC .yr ,.c r+R•. -, e+ s-. ..; Cm�.av^cst.�c+. ^ r "...,,- - � .. .,.. a�r.+a' �. ...- r: �. .wr.Rrl �@ %ib �:• :, '..:..qr.;:c „ -Q Y� r.. -s POT' A9 �6MV�- DEPARTMENTf 'OF�} •HEALTH �< DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Res Property of c g,_. L tr Z A Q p i Located at O= A WAO A ' A i4 A -0 kga° a 1 Block n t Lot - Gentlemen: This letter is to authorize STANLEY �� ®�� a duly licensed professional engineer or registered architect (IndicaTe to apply for a Construction Permit for a 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 1JGjJCLrt 111Gl1t Gf HecLltll, and to sign all neuez36ary 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 147,' Education'l�, ',' the 'Publi'c Health Iasi, -arid 'fhe Putnam CountyV}Sani tary Code. Counters, . Very truly yours, 7 Signed 46A, Own of roper y it V 9 '-� �O < / a-7 A &Uy Address s 9 76 e ep one a-- :PUTTAM „ COUNTY :DE.EART•MENT, 0F._HEA -LTH, DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE . NO.� Owner �'o Z.1r�i�odT AddressR,90� , A-,c /079 ,10, -•ate /1411 -�� Located at (Street ,v LA a/9J� 2M . /.� Block C�/ Lot _5� w indica e nearst cross street) Municipality. 16v ,4� Or z�Ti✓ dL��;;�, Watershed PE,cz�ic� , 4,J XrE'aa.rr`. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water WaUer ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches f / 1 922 2 =32, f� 3 2 2,'3 9 .s� 1 3 d'• v ZS�' zs' LfP 21 .7 o- Z 4 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. Mo TEST .PIT DATA REQUIRED TO BE ' SUBMITTED_ WITH APPLICATION - ..... »,_ .. T. = DESCRIY'P1.0N OF SOILS �'NGOUiV� t' lb 114 TEST orlgS�`:n DEPTH HOLE NO. HOLE NO, 1L HOLE NO. G.L. 6" 1 2411 lj 3011 r �► 3 6 11 ,Q 42" '1 48" � 54 � .6011 66" 7211 78" 8411 a INDICATE LEVE L"-AT -WHICH. GROUND-WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WA T R�,�EL RISES AFTER BEING ENCOUNTERED TESTS MADE BY C. � Date- 1­10-73 DESIGN Soil Rate Used / Min/1 "Drop: S. D. Usable Area Provided or No. of Bedrooms Septic Tank Capacity 67,0z> Gals Type Ire c 4zc- Absorption Area Provided By-.3/ L.F.x2411 3b �v; width A NNE R Other Name P, w. Signature A Address .r..wanna, er m V I. ;01 L THIS SPACE FOR USE BY HEALTH DEP Soil Rate Approved Sq.. Ft/ 3 Date y.; ... .a,. •r�... !.�� K•; + ...w -' r,.�`i., ... ,:,rji^.. ,, ri a•�:�,,.... .r .n... �:•:.cv:. •>1= iii: a.. ..:'.if �.:s �. ...-.. t``.�.., r^r:fcc;�:.1ti ±"'•t•�' .. �n;ir...�,::;:i; fIT- ' i�. kLl;:k8� rY RL1r 1' y 1 �t� .gym k-- •°-Dy �iE> -D5 3� 4<f�B#: � 4 2 z 9 9' 1 � ,182 ^9 ;. zi r� St'?a a! a 1 �' +'"iA'QgGf-- >td3�i�• ry. '. 0 1i r - •, j _ �- • � y' i'NAY 2 1974 � { • fi N lt Ur Of ,dEM ' - 4'. i a .. 1 OR. OIVISION OF {1 MYtRON4 lN74L HEALTH SFMW I or a .A..0 i '`� �i A '� �' r �,AA� �•�o'°M?�,Q.���ll JE'L�T.�G,..�..`r^� •-'sTEI"� j s � 1 ,/ �r , E" C.4 ✓t/r�.A�ivK. �G r