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HomeMy WebLinkAbout4538DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.05 -1 -18 BOX 34 } {,, UL PUTNAk COUNTY DEPARTMENT; OF HEALTH Diws�on of; Env�ro. "nmental 'Hea /th Services Carmel N.' Y 1Q512 p Putmam Va3.lo� (T) .'�tri i :'9Cnd1tE-'C?E 1�E�s�:Fivd.z iGie+i' L'J�t$ .iiiiPJg;E, F�k e�S �JAGE 01, -0.� Town or, Village l �►ei" :. oQ! °Map. 1319 QQ ' at Section V Block." 'Located - ' - - - 'Pow'® Pascal® C caner a l?a ae E_ot I1e�iaa�a�AT* YO)OtilWN fl®ilghta oee F 1435 Separate Sewerage System built by Address N y Con'sistrng of< Gal "Septw Tank = lineal Feet ,,X, - :w'idth trench _ Other requirements t water Su up pply Public "Sply From are bra W'i11 Arillinq ­Private Supply Drilled BY Address - Daa or�e'powa, Co�tm Burltlrn S e '1�A4 Raffish No of Bedrooms Date P�rfn�ih �i / ` Yp (�n�b 4 �+^ Has Erosion Control Been'; Completed ♦� �, <,. "* s. ? _ $_ _ RO -`4¢a• •••�, ; I certify :that the system(s). as listed serving the abovepremises were const£ucted essentially -.as shown on'_the plaj•}S' t etc pl o�k �pr�s of which are Put. D' rent of .Health. attacheq:), and. in "accordance with' the standards rules andrregulations plans filea, and the permit issued bye i 44 Date�fF - Certified R.A. Address hri�`�®�'`IR* ekekili, {� �i (;�27 ..x any unsariitary ' -; Ahy person ,occupymg,prerii served by the above system(.) shall promptly, take such ai tionas may _be necessary tds�; flYllcdiT� Ai eondrtiohs resulting frorrr"'such ;usege ..A:pproval `of the separate ewerage system ,'shall bec me null pnd void -as soon ! ie rl� sanita7y sewer becomes ` ava lab'le and the approval:of the :private water supply shallbecomernull and. voitl when a,public water supply becomes available: Such,'approvals are. subject to modification o[ change when lin the judgment of the Commissioner of Health such reyocati modification or ;change is necessary Date BY `T Title - � � � "�. L4,Z ✓. d'Y �"��`C .. o��?..�. Fly Ctt ..�...,� Lq i:��5't, ,y' � :. rit5 `- :, °-�' �`z' .i.;Y a-.d kr,.'�,�'A. •1 `� fi.�_K �'r 'YO RKT OWN: MEDI CALL ABORATORY IN.0 P 0 Box99 321 Kear Street � T LOCA IONS O 321 KEAR ST YORKTOWN HEIGHTS N Y- 10598 :245-32 Yorkti Heights 'N.Y. 0598 ILL N 1 78777 K �. Ks �. 4 �'^ q K S ;�'f y: •"` �..n ' .r N,' �( yi!r 'w.^ d q'iT` �.L.� "- `245 3203 495 MAIN,ST MT;' IS( N Y 10549 6663335 ��01 a" Cl STONELEIGH AVE. (NEAR HOSPITAL) CARMEL, N Y 10512 278 -9330 COLLECT RESULTS OF-EXAM INATION.OF WATER' D DATE OWNER CE VED' DATE RE I r 1 WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK p This report is to b�_compl9te�..b ..v!relt.drUlef a�_ s�srlffCet «ooiit9[j�'altii ;,Qaptraa�r�Y,o der- wiith "la6orafcre oi2`rii� au .,- : ; .• . _ ..i. - er.�.• . , , - -. 9 Y p analysiovvater sariple 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 PASCALE CONSTRUCTION CO. ADDRESS SPROUT BROOK DRIVE, PEEKSKILL, N.Y. LOCATION OF WELL (No. & Street) (Town) (Lot Number) BARGER STREET PUTNAM VALLEY PROPOSED USE OF WELL NESS © DOMESTIC ❑ ESTABL SHMENT ❑ FARM ❑ TEST WELL 1:1 SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ O(Specify) EQUIPMENT COMPRESSED CABLE ❑ ROTARY ®A R PERCUSSION PERCUSSION OTHER (Specify) CASING DETAILS LENGTH (feet) 411 DIAMETER (Inches) 611 WEIGHT PER FOOT 171` THREADED ❑ WELDED R SHOE LAYES ❑ NO CSI G OYES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED � COMPRESSED AIR 6 6 YIELD (G.P.M.) 6 G.P.M. WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Speclfyleet) 201 DURING YIELD TEST (feet) 3651 Depth of Completed Well in feet below Land surface: 3651 SCREEN MAKE NONE 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) ITO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 16 GRAVEL. WELL IS EXPOSED 18f. ABOVE GRADE. 16 41 GRANITES SANDSTONE, GRANITE. -411­-­­365- " �,*� T -. _ GRti1vlTEe If yield was tested at different depth: during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 7/14/79 D T PORT ��19� WELL DRILLER (Si at r) WRAGG BROS. TAff DRILLING CO. e_. e ems. ��� �. _• � �® � ..r R r. � s .. "... �. " � _ .... � <_ _ <. ♦ � �y*,,q�+�g ... r ...r. v... = .. -^ y.:�.. - Y .�•.�::ir:; it:$ —�.. ' ���itLl ®•, •s- :�:.". 'ae .�:��r� -+i.,. __;::�:;.`.�:�'iS�ei�11 9". .r. '•e;.oe =" :'_'ee:".. ;:�:i� -+� Owner or. _ .urc aser of Building Municipality- Pedro Pascale lap 1319 Building.-Constructed Buildina.-Constructed by Section Barger Street LocatiQij..77. Street Raised Ranch Building Type Block 25 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- 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. Env- ronmental . Health . Ser- ....__ '' dices "off "" fie- "Patna n °County D "epartment 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 24 day of Sept 19 79 Signa Title 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 IS REQUIRED TO FILE NOTICE, OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health u. 9 Type To be con ru ja ~ }'U1'N�1M COUNTY DET'J1RTh[EN'1' OF iiEnLT({ ' DIVISION OF ENVIRONMENTAL .11EALT}'I SERVICES :J_� y.•.m w.eb :�.y. °`'iir .ham • .s.cM�,'Wl,.. •1 .;;R 1, �•iC�r-Pk?ti:- 4.•Vtatl�r o3• ''RaytCrS:~ .P`i'i1 1 ...: �e,..r�;A:,'r�•. : 'xC- �� =x-•. July g9 1977 .. i Date Re Property of Pedro A. Pascale . Located at urger Street Tap 1319.. v 25 .Section. Block Lot Gentlemen:. - �Ohn S.-Romeo . This letter is to authorize a duly licensed professional engineer, 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 promulagated.by 'the`.,6mmissioner of the Putnam County N Department.oi Health, and to sign all',.nece$sary papers on my behalf in 0OTOfif4f• U i fin vri Y'h •rh i R MA171'R.r• "Tid i-n simpryi ca the r?n».i-ri.ir•i-i r%n n cn i ri 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. Very tru urs, �. Signed - Property Countersigned: A/ Address jP # 027846 1 Northridge Road Telephone, Address °'0'C GO* Peekskill, Nor York 10566 ® ° ®\��� E�6 /y �• ®® S..q 737 - 1056 Telephone ?756 m . 0 PUTNAM COUNTY DEPARTMENT OF I EALTH DIVISION. OF' ENVIRONA'[Psl`I 11, , INIT SERVICES l r. n _ r� - r Fes:% =; . =• ., is _ `COUNTY OFFICE BUTLDIPIG,�`CARICL, N. Y. 10512 DESIGN DATA - SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM.. FILE NO. Owner: Pedro .A. Pascale Address Gallows Hill.:Road, Peekskill ,N.Y. 10566 Located at ( Street Barger Street Sec . MOP 131%lock Lot 25 . Indicate neares - cross street Municipality Putnam Valley (T) Watershed Peeksk311. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 5 (2h lhs ;04 11s31 23 .17.75 .10.75 3;00 7.67 . 2 11 :35 11:59 24 18,00 21.00 3.00 8,00 Notes: 1) Tests to be repeated'at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. Hole Number CLOCK TIME PFRCOLATION PERCOLATION Run No. Start -Stop + apse Time Min. Depth.to Vater From Ground Start Inches Surface Stop Inches Water Eevel in.Inches Drop in Inches Soil Rate Min. /in drop (yh 11 :03 11:22 19 18050 2140 3.00 .603 211:26 11:48 22 17.75 20,75 3.00 7.33 311:51 12:1.4 23 18,00 21.00 3.00 1.67 5 (2h lhs ;04 11s31 23 .17.75 .10.75 3;00 7.67 . 2 11 :35 11:59 24 18,00 21.00 3.00 8,00 Notes: 1) Tests to be repeated'at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. �, a " S 3,J •- Z. y i \. o rj r• "~ t w • :•,t „- `. :. -. .. r .,. } �.. ».._. -.-SVY -.SAL ^•z+4',-T� ...'W �•- �. .. ,, 1' Ol +.Tn 4 'i � (.d � ! rtA IX '._ t ,� l i, Sl'� / r� i ,�`� ♦'3 5 r' ;��ra. .:1. -�hr�` c `�, ';� ` � ;may - � •• /. �i T.,7f �f � ,ii. t V M:� ti+. !_..Y� w ^•�- °}�(�([� :rte �'. G ALI 'V, A, t / r'' .c !!! r , �rga. t PPR oVEL - ,t: SEP2 7 1979 r ' � a pga{ttiNM At ” SEPTIC SYSTEM FOR '••. ti BEDROOM Le DESIGNED &. SUPERVISED BY\ -S HOyQ�•. :: SPILS:.RATE� �C 'TOWN OF Puc+�,A;fa VN�LLEti' ROMEO- ROMANELLI- AMICO,F?C. e'.:. IOCk.'GAL. TANK _7 U; hLAM COUNTY �. _. •1