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Home My WebLink About4300DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -3 BOX 33 I ru ru J 1 IL ;'.y ., kP I 04300 fI k PUTr1AM CWWI _3 DiW*10n Hof. Environment CERTIFICA E.OF'C��INSTRUCTION COMPLIANCE FOI Separdte. Sewerage System built by �'>Llel(1:OA lia a 1000` , rPonslsting of Oal' Sep Ac Tank an< Other requirements Doine.s t it Water Supply Public Supply From ., Ar >Prlvate Supply Drilled ey iBarS Address Min ,.I certify thatthe systems) ae_liated serving the above.prec `of which are attached) "and id accordance with the standards'; �am�COUnty Department�rOf Health �.,..� -, � -..,Kp r -�•-� March `23, 11985 North r ' Y - � � •z`� Adtlreu ' conditions resulting from` wch usage Approval .of the separa4 :available' and „the' approval of the:;private` water iupply shall;beco ;subject •to modffieatlon or change when,;:In tIm udgment, g Date gy 7 1 t x 10ARTMENT OF HEALTHF tti Services, Carm% ,N. Y. ,fQ612 rermic U� AGE;DISPOSALSYSTEM :' Putnam, Valley (T s _x11 n`^ � Tax M_ ap ,r + •Block - - MapfLot .� r'' Subd Lot & � " e n Addiess `evenson _Avenue , Peekskill, NY of 4,x 4 Galleries Y' { i�ell aDrillers• ` :� �. � . �' .. bt Putnam ya ley, 'NY T w DaOf BedrOOmS z" � Date Permit laueq' � ' °- ' o.e;eoe•es o construct � %ft the plans of the completed work (copies requlbt �JY .�ccsrd filed plan .and theprm eit,,issued . by.the. x:10566 27846 a.�-. ..:e z I take w eees�lir to seei+n the eoi netk►6 of any un anitary L'system sh d :as soon a a .pub k sanitary ower becomes tl.vold- whap'Soq} u_ ly.be�omes avallabN. Such approvals are i ner •of Neilth,. fMt6��cation' `modlflatioWoi ehanq� rY. /w, s Tits r (ORKTOWN MEDICAL LABORATORY INC. P.O. Box 99 321 Kear Street LOCATIONS: A 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 Yorktown Heights, KY. 10598 ❑ 201 BUTTONWOOD AVE ..PEEKSKILL.N.Y..105GG 737.8777 •t' ❑ 495 MAIN ST., MT. KISCO. N.Y. 10549 666.3335 - - - - - -- —24 5.3203 --- - ;:: ❑:STONEL'EIGN AVE: (NEAR NOSPI_T:ALLzGARMEL-. D!. Y..105,12 278 93JL LAB # . Y46) 4 . DATE TAKEN: 3/18/85 (6 i 1 P.M.) F -- DATERECEIVED3/i9 /85 9:15 A.M. ) JACKIE TIGHE DATE REPORTED* 3/21/ 8 5 SAMPLE SOURCE: KITCHEN TAP PEEKSKILL HOLLOW RD. PUT. RFB ..2, BOX 152 valley, NY • REFERRED BY: LYORKTOWN HTS; NY.1059.8 1. TTGNE COLLECTED BY: LABORATORY REPORT 248_7642 mg /L ❑ ACIDITY .................. ............................... ❑ ALUMINUM ................................................................ ❑ ALKALINITY .................... ❑ ANTIMONY ................................ ............................... •BACTERIA, TOTAL /mL .............................. ❑ ARSENIC .................................... ............................... ❑ BOO, 5 DAY ................... ........................ ........ 0 BARIUM ....................................... ............................... ❑ BROMIDE ................... ..................:............ ❑ BERYLLIUM ................................ .... ............................ ❑ CARBON DIOXIDE, FREE .............................. ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ................... ............................... ❑ BORON ........................................ ............................... ❑ CHLORINE ................... ............................... 0 CADMIUM .................................... ............................... ❑ COD ........................... ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ............ ❑ CHROMIUM (tot.) ..... .............. ........... ............................:.. .......... ............................... ❑ CYANIDE ................... ............................... ❑ CHROMIUM (hezavalent) ...............:.... ............................... ODETERGENT, ANIONIC ... ............................... ❑ COBALT .................................... ............................... ❑ FLUORIDE ................... ............................... O COPPER .................................... .......... ...................... ❑ HARDNESS ................................. :................. ❑ GOLD ........................................ .......................:....... 0 h1PN COLIFORM COUNT/ 100 ml .... ........ ❑ IRON ........................................ ............................... JZ HFT COLIFORM COUNT/ 100 ml `c .. ...... 0 LEAD ........................................ ............................... ❑ CONFIRMATORY TEST .................................... 0 LITHIUM .................................... ............................... :. NITROGgN...AMMONIA .:.. ...,,,. r ❑ MAGN:E�S1UNj _ :c -;:: ,, :.:: .: .. .:... :.... _. >- ❑ NITROGEN, KJELDAHL ... ............................... ❑ MANGANESE ..................:............. ............................... ❑ NITROGEN. NITRATE ... ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ... ............................... ❑ NICKEL ........................................ ............................... OODOR ....................... ............................... ❑ PALLADIUM ................................ ............................... 0 OIL & GREASE ............... ............................... 0 POTASSIUM ................................ ............................... 0 DH ........................... ............................... 0 RHODIUM :................................... ............................... 0 PHENOL ....................... ............•.................. .0 SELENIUM .................................... ............................... ❑ PHOSPHATE (ortho) ....................................... ❑ SILICON .................................... ............................... OPHOSPHATE (condensed) ... ............................... 0 SILVER ........................................ ............................... • PHOSPHATE (total) ....... ............................... ❑ SOOI.UM ........................................ ............................... • SOLIDS, SETTLEABLE; ml /L ......................... 1 0 TIN .. ........................ ❑ SOLIDS, SUSPENDED ... ............................... 4\ 0 ZINC ...................... :.................... ❑ SOLIDS. DISSOLVED ... ............................... ..................... ............................... .................... ❑ SOLIDS. TOTAL ........... ...............:............... ❑ ............................... .}RR. . ............................... ... ... At .9.. .... ❑SOLIDS. VOLATILE ....... ............................... 0 REMARKS:..................... .2.9.. �� ............................. ❑ SPECIFIC CONDUCTANCE 0 .........................�3 ............................... ❑ SULFATE ............ ................:.............. ❑ ......•.:............... ®��.�. ...� a,��Y......................... ❑ SULFIDE .................... ......................:.......: 0 .......................................Lfu$ Q:�ri.......................... ❑ SULFATE .................... ............................... ❑ .. ............................... ................... ...................... ❑SURFACTANTS ............ ............................... ❑ .................................................... ............................... 0 TURBIOIT" ................ ............................... 0 ........................................................... _.. _._ _ ....... THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DID/7 I MEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WAT STANDDS (PART 72) FOR THE PARAMETERS TESTED. � '/Y f1 �f ._ WELL' MPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3171 Division of Environmental Health Services COUNTY OFFICE BUILDING • CARMEL. NEW. YORK s report.is to be completed by well Viller. and submitted to County Health Department together with laboratory report of "°" igsis of vvfersarx+ple= iittlicating rlater.is of satisfactory, bacteriahqu�l ity. before certificate of construction compliance is issued. FRIEPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION . OW NAM 7T7 LOC OF N LL /n 1 Q(NoB Strss �% wn l (Lot NumDaJ PRO US, ED DOMESTIC PUBLIC ❑ SUPPLY D ESTABLISHMENT ❑ INDUSTRIAL ❑ FARM ❑TEST W AIR ) ❑ CONDITIONING ❑ (Specify) 0 EOUI G ENT [j ROTARY DAR PERCUSSION CJ PERCUSSION ❑ OTHER w Y) D G lS LENGTH (lest) DIAMETER (inches) WEIGHT PER FOOT [[��• E?�J- THREADED ❑WELDED YES NO �R ES r- NO — BAILED ❑ PUMPED COMPRESSED AIR HOURS G.P.M. �� YIELD (G.P.M.) W R l MEASURE FROM LAND SURFACE — STAY IC(Specify feet) DURING YIELD TEST (feet) Depth of Completed Well In feet below Land svrfocs:�t7 EN ILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including grovel pack finches): RAVEL SIZE (inch") FROM (feet) TO (feet) DEPTH M LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to of least two permanent landmarks. ro FEET I....... 1.i (, I 2 0 . � A^ DEK. OF HEALTH if yield was tested of difFerent depths during drilling, list below FEET GALLONS PER MINUTE 0 A ,WELL COMPLETE GATE OF REPORT W ignatur ) David Gardner Owner or Purchaser o Building David Gardner Buald;in.g{ :Canst,uc_ted:;}�fy. Peekskill Hollow Road Location - Street Putnam 'Valley Municipality 2 story frame Building Type 118 Section _Block, 15 Lot None Subdivision Name Subdve 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 Pay- tnam•�Co�irtt3r:IIe:pbr.tment:: o %_.Health- as -. o -whe:ther.. or, „not. ;th"e ;.: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 22 day of arch 19 $5 Signature Title Corporation Name if corp. C, y �� Addr e s s - - - - - - - -- � - - - - - - - - - - - - - -. - - - - - - - - - - �� 0 THREE (3) COPI � REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF M LETION WILL BE ISSUED° GUARANTOR I'S REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM., Division of Environmental Health Services, Putnam County Department of Health sy �� Am `73 7-46 r ♦r7 , l x 3 ' oi'�ii J'J�Jr `73 7-46 r ♦r7 , PUTNA'M COUNTY DEPARTMENT 'OF HEALTH. Permit G Division of Environmental Health 'Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT, FOR SEWAGE DISPOSAL SYSTEM. . Putnam Valley . (T ) _ Pe_ekskill .Hollow Road .11 w" o or lags 15 _ �' `LdcateBV at., ... Tax- Map +v :.x r•slock.; Lot' Subdivision None Subd. Lot H ` Renewal _❑ Revision _[3 Davdid uaraner Owner /Address Date Of Pkevious Approval 2 story. contempory o.65 Acres Fill Section only 13 Building Type of Area Number of Bedrooms 3 Design Flow / �� P.C. H. D. t ti R it f �8 `�� x ' allerles Separate Sewerage System to consist of Gal. Septic Tank and To be constructed by .Sheldon Gardner Address Stevenson Avenue Water. Supply: Public Supply From Peekskill, NY X Private Supply to be drilled by Anderson well Drillers Address Barger Street Putnam Val.ey, NY Other Requirements Domestic. Use Only. o ®o0Oe0e�oa 1 represent that I am wholly and completely responsible for the design and location of the proposed. �1 sewage dis oral system above described will be constructed as shown on the approved amendment, there to and "in accordance with theta $ ons o e u nam County Department' of..,..Health, and.that'on completion thereof a " Certificate of,. Construction Complian4' onSy td' ntissioner of Health will �•: be submitted to the Department, and a written guarantee will be'furnished the owner his successors, h:e r gnu i jr,Rahet said builder will place in good operating condition .any part of said sewage disposal system during .the period 6.Utwo s1l e f II igahedate of the issu r ante of the approval of the Certificate of Construction. Compliance oT the original system or any rei re t o e dr I Well described above will be located as shown on the approved'plan and that said well will' be* Installed in "accordance -.with the bt�a ds r I 0 1 u so of the Putnam w County epart a of Date Signed „' o tE: 278 1 Northridge ad. Peekskill,'. 9% Address e o �" s o 0&. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued' unless construction 8fatpe Id g %as been undertaken and Is revocable for cause or 'may be amended or modified when c ered ecessary. by the Co' of Health. A bt0ge or alteration of construction requires a new permit. Approved _ for isposal of domest sa ita ,.sew e, and /or pply' only. Date ' 6�('SS %% By Title Rev. 9 -81 a f-O l�'1TsT.�T) C1TC,ri: h'[.ST. AD?t� - ... ...........;A+y. .. .y- :a....riica :: :.,r - •r' -. } .- .+ �.. .«.°6��.3 _.r .+.p..- ).t - :.�. ..- q .S '� ew •L•- ..M.. }.. ,rp� ' Insp.byo' INITTAL SITE ITISPrCTIO'N � � Yes NO Comments ,Property lines or corners found . . . . . .. . .. _ Can est_in: -sate house location . . a . o o . o Will drivcwa•y need cut . . . . . . . . . -7 Must trees be r- .moved -note these . . ` . . •. . . __. Is deep ,hole representative of entire SDS Brea -�- Additional. deep .holes needed. . . . . . Sufficient SDS area available. considering driveway cut, house location, separation . distances, 'etc. DEEP HOLE DATA - - -- - DD- p'i,h : Wa-er elevation: Rock elevation: Soils d.escr_i:btion: ' D a te: / F I YA L SI _�. 111,33PEC`_Tr Insp. bay: t �+� r ry � ;. a on' approved House loeatcc� z h�r, � o1,n on approl, ed plan • . o SDS 1oc3tcd 4T�lry;p .wp moved . . . . . . . . Inx;ch ,.of trenc�y�rc�,su��ed W idtiL..of tree ell aver tgz Slop, aof�t� 1eli'ne.and Lreneh. •acceptaUle : :�. _ :> Room allowod i o n•. exp2:ns on trenches Over 50 ft. from swam p, watercourse `. _ --__ - - Natural oil, ,r_o�; stripe° or SDS area - - tuuIecesse:rily graded ;. 10 FL. maintained from prop line. and 20 ft. from "house... :. . . a :. o . . a o Separation of trench from hous,e,. well -- etc.-- fo]1o1•7s p7_ari Num, ber o ' bedrooms - checks . . . . , - Stone:, brush, stur:ps,- rubble, etc. L greater than .15 ft . from nearest trench o . . . --- 15 Pt. of peripheral soil horizontally from trench •. . • . o o . . o . 0 . 0 Junction boxes properly set Cou].d surface : rtuz off from driveway, roads, •ground surface, etc. chaniael near SDS area• . o o . o . . o a . 0 o o K0 ao eo -a Does lot drain.. ce al)Dar O, :-ra o f n SD S pINYAL GP,ADING OF SITE ACCEPT= f V OF J )=10 4 Rome bw1�7-//Lme-g7 7-0 .F, j ?(P& PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Sept ~1, 1983 Re: Property of David Gardner Located at 'Peekskill Hollow Road (T) Putnam Valley Section 118 Block 7 Lot 15 Subdivision of None Subdv. Lot # Filed Map # Gentlemen: This letter is to authorize John S. Romeo Date a duly licensed professional engineer X or registered architect (Indicate to apply fora 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 system., ®r`- cystem,s -.4h _-conformity .wit -h3 the: provi=sions; -:o f- Article "�45 147,.Educati.on Law, the Public - Health Law, and the Putnam County Sani- tary Code.. Very truly yours, Signed VAAXO (A) S Y2 U Countersigned: 7 ISA wner of. Pr erty P . E . XNM # 27 846 ® ®ao ® ® ®�® Address F 1 Northridge Road ® ®s° EN6 /yff9 ®•e A)4 � � Address R >FO lq� ` Town Peekskill, N.Y.' 1056�p , N 737 - 1056 ®r` Telephone e �• r, ,. RECEIVED Telep=hone % • �q�•� • Ik�k� • ;;�r o J SEP 141983 PUTNAM COUNTY DEpt. OF HEALTH PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY' OFFICE' BUILDING,' CARMEL, N.- Y. 10512 DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Da'v'*'ld Gaj�dner Owner Address 2 Box 152 Yorktown Ht. s, NY 10598 eekskill Hollow' d" 118 7 15 Located at (Street M .. I P� T . - Block Lot r-Indicate nearest cF6s's street) Municipality, Watershed Putham Vallet (T) Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 5 No "s:` 1)�16s'ts to be repeated at same depth until a roximatel equal soil rates are obtained at each percolation test hole. All data to L submitted for review. 2) Depth measurements to be made from top of hole. Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse No. Time 'Start-StoD Min. 'Depth toiWater From Ground Surface Start 'Stop Inches Inches Water Levei in Inches Drop in Inches Soil Rate Min./in drop 10 :32 lo s45 13 18.25 21'.25 3-00 4-33 2 10,47 1ls02 15 .18.25 91.25 3-00 x.00 1104 3 11 o20 16 18.25 21..25 3.00 5- 33 11,23 4 11!39 16 .18.25 21.25 3-00 5-33 5 (9) 1 10:36 10,50 14 M50 23-50 3-00 .4.67 1-0- 16 --2'0i-50---- 5.35 3.1111.3 lls29 16 20-50 .23-i50 30-00 -5.33 4 5 2' 3 4 5 No "s:` 1)�16s'ts to be repeated at same depth until a roximatel equal soil rates are obtained at each percolation test hole. All data to L submitted for review. 2) Depth measurements to be made from top of hole. DEPTH G.L. 6" it 12" 18" 24" 30" 36" 42" 48" 5411 60" 66" 72„ 78" TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOTLS ENCOUNTERED IN TEST HOLES HOLE NO 1 HOLE NO. 2 HOLE NO. 3 Topsoil topsoil Topsoil 4" Topsoil „ . - 4" Topsoil 4 "• ,Topsail„ Sandyagravel Sndy,_gravel. Sandy, gravel ROB'. ROB ROB 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED ;rP INDICATE LEVEL�TQ;Wf CH WATER ;LEVEL: RISES-. AFTER; BE - TENS MADE BY John-' s. Romeo DESIGN Soil Rate Used6 -7 Min/1 "Drop: S.D. Usable No. of Bedrooms 3* Septic Tank Capacity 1000 Absorption Area Prided By L.F.x24" 36" 80 LF of 4x4 Galleries Romeo Address 1 Northridge Road Peekskitt, New Turk ±0566 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. ure SEAL None Date August � Z7-t` `1983' Area Provided 5000 SF + _ Gals . Type Mas onry width® °'0 - lye °° ly Checked by #5� /kyg SEP 141983 PUTNAM COUNTY DEPT. OF HEALTH 0 6 � O ° ° 2784 c °m�aana0o Late #5� /kyg SEP 141983 PUTNAM COUNTY DEPT. OF HEALTH t i c ' a E i TYPICAL SECTION; -SCALE: T" = 10" , jj} MEN }1 r a.v: a.f 3 , G'7,n /ZA7Fy' I09_SA.��3F - -. �S s�7�''q✓ > �.hr{ � ,:1). � ,.b,f� f>.w '' � � ... bSE �fiGCE� /b.5 8o LF�di4 °- .3LO�S trA 3Le x Z' "s,v6s= G4os� �r t4� .`1 1 .. ♦ � _- _'"'.` _...: -; �i: "� f ?�7•."r` -. f'" jn:��'b` ;:. 'Af` �._�. ,"�`. �. per'.."' A�.•r- •n%- r,- ••'�-'. -�i� - ,c : -.n„r7 f4<p yr €.:.:f.. .fir!`- �.4... -e _ 2� v ly V. V. • C�ti2 � ` ti,l }; f -�ao;l s.� !�~�� 1�5� do i ! � �` . � ... ,'SOa G�9- t.`lo-itl .. a \ -.6•.. tN P' �.l•. Y' `�i i yt t t... v vY �� .Z_i/4F.✓I"F- y' s._..�. "_F 'f ..- z �,b� t •� '��.. _2 -- +F ;. t'• is y �. �f. 7/ �A., ",9 c s T ti+ a fQ t t i v w xi/v !7T t y ,E. 4 s V, •;1o2A4ai J•a 'li n _ }1tf � t � J7 �zY� �•: - -1.1 +V� �,2* r.,�� r +. y J5 u;'+} y : F ;' -, ,f - .L h� ,„, u... -i �1 ... \.*, 1. % :, �� z'` _ �j) •i` - r .• J�V111 �s..; .�"Tt.. {.. '. 4-? ' 4 � 4 .. - _ •.. , •.� s �iy/.� �, `�' �L \ r. � ' ` r, rd , R 7-b ��:, E c i7a,Pc p°!! Sup, :. ♦ `�� S s � J 4-. r e r r o Y S ��,�-� �`"h ,.. s` 7/o M.J y - °•� °�hs�: F - r 8y. +� -�.+ F < r. ... y !.F �. p 'tii eyM T -�' i' k' t�• fi,� °if�� 2 t,j:f ,t; + .r E_r 3 �4. > „' �. 5,,..t i•'� `.,� -,•�xc 1 '" ,^sir 7. 1 =�, • :�. -. n. n. ,_,:.v ,.....F ?- a��'3i:. . .:- ' > -- `:3.F:� »ds .. ... ,�. ., ..� .,� -,.. ru.. ,. :. t-. ....<.., .L. _ .. -�' ... _ .s _ ,-, .. ... ..h v. ..a •., ,. +, �f. .. ,.,.- �..�,.S"x.�itY.