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HomeMy WebLinkAbout4519DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85. -1 -17 BOX 34 04519 0 � _ ' im ♦ lee ;1 m %% T J is I f ■ . � 1-46 1 .., a 04519 1.. .�.. ..:...' -: -. - - _....,-:...s:.:.':.:_:- y ,r�.:- ?,.a.. - ,..:..,.�.:. .,. '�,v;, -. .*'- L.- .mot = �- '• € � e-* r:� �. � _ ,� ;... � ".' ..�.: '•� YORKrDWN KEDICAL LABORATORY INC. . P.O Box 99 321. Kear Street Yorktown Heights, N:Y.10598 .245443 DATE COLLECTED , RESULTS OF EXAMINATION OF WATER_. -. NER DATE RE( ROBERT TRISSEE !'Y, VILLAGE, TOWN & /OR NAME OF SUPPLY STEPHEN SMITH DR. PUTNAM.VALLEY, N.Y. APLING POINT WELL iiI RUSTIC VALE DATE REPORTED 7%73 i ,2/20/73 CTI RIA PER ML. (Agar plate count at 35 C). COLIFORM." GROUP (Mostr•"probable N6. /100ml.) LESS ,THAN 2e2 :'HARDNESS*' TOTAL "- ppm 4"e0 GRAINS /GAL. (SOFT) PERGENTS - ppm NI "TRATES: (a's N): -..ppm .: _ ...,..: _ .._ - IRON, TOTAL: - ppm )URIDE (F) - m9• /l• se results'indicate that the water was YES of a satisfactory sanitary quality when the sgnple was collect . x 1 A • A t, i e 4 °:•�L!'S%m swo =''.0 -mom t ':Yi- . =•v�^a'-5�3rti't+S..`O':: �,'�p.��; '.°� -: }ie ^�`. -5: ii •ice 'S'c`1"1:�",'at��..:�pY.�+:��w :''.f�aee srYi; =yj,�. -i't •+'�vi.: "e •��F.7.;, ,.._._... -. �.� ^'l�.'.2 i, Owner or Purchaser of Building A06&47- 12 tsSL'6 z- Building Constructed by ( Location - Street Building Type r -'Vo °T11)AArl ` /AI_IrGy Muni cip ality Z Z- o� Block Z. 7 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 succes- sors, 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- $ant.of the building utilizing-the.-system. �xa. -- , . .-a o -. o - -... _ • ., - _ ..y F -„ - aur -- .. ,-� a -... c -.,_.: _.... -ro, _. u .. ... `. . ' _' � - . -' .. ,. 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 by the willful or negligent act of the occupant of the building utilizing the system. Dated this �L day of 6.6 193 Signature v "' Title la14--loelt. (I 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 IS REQUIRED TO FILE NOTICE, OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health WELL aCOMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Serviees COUNTY OFFICE BUILDING : CARMEL, NEW YORK ;.� .,., ''- #y;S7;o- a��wn�u�t�dd•�6p �a�M' dkt110� '�FY�'S�cs'iCRttea'�o'�(:�fur�' �;3sa)f -`t E8 diti't` Igo'% �tf� •e�f1LF41F1`tLI`i= S8bT5�ai:i3? IiE €r��a%-:= �J'�:•� 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 OWNER NAME I-' ADDRESS LOCATION OF WELL �? (No. 8 Street) (Town) y, (Lot Number) PROPOSED USE OF WELL DOMESTIC ❑ ESTABLISHMENT ❑ FARM j ❑ TEST WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING OTHER if ) DRILLING EQUIPMENT COMPRESSED CABLE OTHER ❑ ROTARY -"AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet), I DIAMETER (inches) » WEIGHT PER FOOT l �J THREADED ❑ WELDED DRIVE SHOE ❑ YES ❑ NO MLAjS CASING ROUTED? LJ YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED ❑ COMPRESSED AIR YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE— STATIC(Specify feet) DURING YIELD TEST fleet) Depth of Completed Well i in feet below Land surface: 3o '..5 — SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET r If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPL TED % alt 7 -? v DATE OF REPORT WELL DRILLE atu►e) 5 4... ..- i .,.' :�4rY 7, 4.',,. ; r riS`_.ti�,ei..w;o - .. r_ ; ty;.:. 1 cw'.'Y` ?;•s.ti^ <Yi..' ei..•�ti+.i g. �.G.ti..i�•r .- -: �. -Ce "::�c� 1 t ^m,: �sw .. >d�ce - : , • PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Dated y.5 7° /j / 9 7Z - Re : Property of 80 gz A-r :FAISSc6'P_' Located at Sn= EMIT _1>21 VIE l�Vja/ -rAX MAP •won iVZ Block OZ- Gentlemen: :"4 Lot Z7 ' jar' / This letter is to authorize STANLEY I LANDER, a duly licensed professional engineer V or registered architect (Indicale7- 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 Department of HGC11.t 1, and to sign all rleueasary 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 Law, the Public Health law, and the Putnam County Sani- tary Code. i Y Coi rsigned: P.E., P#n*vf=* SZ7 Ad res�rija? - - - ` Very truly Signed Address Telephone io dw 0.. ..- i .,.' :�4rY 7, 4.',,. ; r riS`_.ti�,ei..w;o - .. r_ ; ty;.:. 1 cw'.'Y` ?;•s.ti^ <Yi..' ei..•�ti+.i g. �.G.ti..i�•r .- -: �. -Ce "::�c� 1 t ^m,: �sw .. >d�ce - : , • PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Dated y.5 7° /j / 9 7Z - Re : Property of 80 gz A-r :FAISSc6'P_' Located at Sn= EMIT _1>21 VIE l�Vja/ -rAX MAP •won iVZ Block OZ- Gentlemen: :"4 Lot Z7 ' jar' / This letter is to authorize STANLEY I LANDER, a duly licensed professional engineer V or registered architect (Indicale7- 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 Department of HGC11.t 1, and to sign all rleueasary 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 Law, the Public Health law, and the Putnam County Sani- tary Code. i Y Coi rsigned: P.E., P#n*vf=* SZ7 Ad res�rija? - - - ` Very truly Signed Address Telephone io dw 4a PUTNAM COUNTY DEPARTMENT OF HEALTH 1) isInN by ih�i 6h$a�IaLTH SEFRVI E COUNTY OFFICE BUILDING, CARMEL, N..Y. 10512 Lc 7' / DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. i Owner VoBap_7` ,I SSL.EP Address x 2�4� _ .3trF� � ®ak N� to�@43 I iA`F mAP Located at (Street )6]Ce � c5mi -r1 Pem . I27- Block 0'2- Lot (TH-dica e nearer cross street) Municipality l a aAj A-� v F= ` v °T�JAM VAur )Natershed /pF..zes?,o /7'ozioW ton 1pae . SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to "Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inchess Q 3 f!O V q.,fq /0 14 3 3. 4 4 5 .. 2 3 A Notes: 1) Te'gts 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. Address THIS SPACE FOR USE BY.HEALTH Soil Rate Approved Sq. Ft /Cal. cked by Date a TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION } v .._ _ .:�.... n. , =s•: --DE* SCRTPT101,1,.OF SOIL.;: ENCOUN`fE'RED,-rN .I'ES`F DEPTH HOLE NO. �� HOLE NO.' 'r 2- HOLE NO. De60 G.L.O« ✓ �f�c>i� / o��c.. 6" 12" fJ/l'oyCe '�AYg,%�' / a�i�cE -.�J / A.c✓[y "'Y;C�.Sz�c='A 18" "' u 3Q." 3 42" 48" 5411 � 60" [ 1 66" 72.. 78'► 84 tt IP?DICATE- LEGTEL AT WIiZCH--GROUND WATER I.S -ENCOUNTERED .. -" '-- INDICATE LEVEL TO WHICH WATER LEVEL RISES ASTER BEINGENCOUNTERED TESTS MADE BY Date : - 3!— -72 ± Soil Rate Used A DESIGN Min/1 "Drop: S. D: Usable Area Provided F No. of Bedrooms %Wry Septic Tank Capacit %S Gals. Type AYO-Setl^ Absorption Area Pro ded By /ZD L.F. width trench e a e,se,rn .O as�i\ Other Address THIS SPACE FOR USE BY.HEALTH Soil Rate Approved Sq. Ft /Cal. cked by Date y e Q \k 0 S'%TPPMPN t5Ao!f/7)W `�A0i4 1VE i N 73 /-7 E f —, 39 76' I s TAP G I V� ti t' ' PR�/y/ /SES SHO�'1/N HEREON .BEJNCa GOT' / As :Sf/0.A'ViV ON q->Ap ENT /TL ELF; " /iY/PRoVEiy/ENj pLF�N pF�EOFJREO �OF� Rvsjic yAL �Roo�RrrES N sio k iYlRP F /LEp /NTh'�' �UTNA//�/ COUn!i''y ! 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