HomeMy WebLinkAbout4631DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
85.11 -2 -2
BOX 35
rm
L
i
; :�
.r
,;
04631
c , PUTNAM COUNTY DEPARTMENT .OF HEALTH �� t
Division o ,Environmental Healih Services Carme% :N Y. 10512 0
CONSTRUCT,IO�N .PERMIT. FOR SEWAGE.DISPOSAL.SYSTEM
Tow of Putnam Valley
Town or Village
JLocated a,one Wood Drive, off Woad, Streit_ ��9 ,�. t:; 1, <<• r . `" ' -
�,,:.y:r- 45 ��•.. .;� —Z -.r i ��_c= .+', `•>.,- '[-. ---- •.,c-- •— �.'ri.'�' Y�Ilba,: .. 'BIOf.I(J
: <, s - a � - 3 833 -409 �
4 ...
Tonie GJood Estate I
Subdivision Lot; Job
owner :Tangus. Construction• Carp. Address 'One. LakeRoad,
Building Type. Colonial Lot Area5G., r C5 S.F.: _ Mahopae_, N.: Y: 1054.1 �
Number of Bedrooms Total 'Habitable space Square Feet
—separate,. Sewerage System to 'consist` "of `12 "�0-` Gal. Septic Tank x{'00 lineal feet x �6 inch
width trench
To be constructed by TAngus Cons_tj uct,ion• Address One Lake Road • MahOpac,- NY
Water Supply: Public, Supply From �
_- Private Supply to be drilled by. TO OS:
rlisch •:Br
.. Address n,
Armo N. 'Y, .. • ... �
Other Requirements
I: represent that I-am wholly and ,completely responsible for the design and location of, they proposed= system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on'the'approved amendment there to and m accordance with the standards, rules and-regulations ` o_ e, Putnam
County Department off Health,�and that on_complet,on. thereof a ,Certrficate-Z•of Construction Compliance ""satisfactory.t`o the Commissloner of Health will
_ ,.:
b'e submitted to` L eh ,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' ,,o wo (2) years. immediately following' the date of the issu
ance of the approval of the Certificate of Construction - Compliance of tli'e.original system-or any,re'pairs thereto;`2)'that the drilled well described above
will be located:as shown on the apprond,plan and that said.welI will -be installed in. accordance .with the standards, rules and regula— 'off the Putnam
County Department of; Health.
Date October-28 1970 Signed P.E. R.A.
AddressBurg66s , & ' Behr -128:; Glenea.da Ave`; armel, NYLicense No. 9845
APPROVED FOR CONSTRUCTION: This approval•expires one year om the date issued- unless construction of the building has been undertaken and is
revocable for.cause or m' ay be amended ormodified when'consider ecessary by ttie Commrissioner of Health. Any change or'Alteration of construction
`requires w p rmi _Approved for disposal of.domestic ry sew/ag� /e/. /a�djor- te'w supply only. '
Date OG' By "' Title
:,n..
Cn
or regulations as promulgated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
PUTNAM COUNTY DEPARTMENT OF HEALTH*
.:- o�::: n. •,:,. _ ..,. <,Y •-r.;.- :�llI1%�SrGiati O ENVfRMMWrA
�' _ � .::...'. ..� .. ':.�... • . 833-409
DESIGN.,DATA SHEET - SEPARATE.SEWAGE DISPOSAL SYSTEM FILE NO.
Owneriangus ConstruetionCo.:.. Address `Lake Road, Mahopac, 'N. Y. 10541
off Woo S reet)
Located at (Street) onie Wood Drive Sec. 13 . Block 1 Lot
(Indicate nearest' cross street)
Municipality Town of Putnam Valley Watershed N. Y. City
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
Hole
Number
CLOCK TIME
PERCOLATION
PERCOLATION
Run
Elapse.
Depth to Water
Water Level
No.
Time :'.
From Ground Surface
in Inches
Soil Rate
Start
Stop
Min.
Start Stop
Drop in
Min/in.drop
Inches- Inches
Inches
(1)
2:20
2:38
18
18 Min.
1
2 :38 :.
2:56
18
18. 19
1
18 "
2
3
.2:56.
3 :14
• 18
18. 19
1
18 '►
4
5
?:20 = .2 =.!0 .::2j _� :`1.8_�_:_d..:_._:r�:.__ _ ._. "-. •_ .20..:.f� _
2 2.:40 . 3-:00' 20 . 18 19 1 20 "
3
4
Notes:
1) Tests to be repeated at same depth until approximately equal soil rates are ob-
tained'at each percolation test hole. All data to be submitted for review.
:j 2) Depth measurements to be made from top of hole.
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
INDICATE LEVEL TO WHI,CH.WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY Burgess & Behr Date 10/26/70
DESIGN
Soil Rate Used 16 -20 Min/l ".. Drop. : _ S.D. Usable. Area Provided 79000 SF +
No. of Bedrooms 4 Septic Tank Capacity 1250 Gals. Type Pre ®Cast Cone.
Absorption Area Provided By 400 L. F.x24" 36tt width trench. Other EZ Well
Name R oy A o Burge s s, Signature 9845
Address Burgess & Behr SEAL
Gleneida Ave0 Carmel 9 No 'Y, 10512....
PUTNAM COUNTY DEPARTMENT OF HEALTH
Soil Rate Approved Sq Ft. /Gal,...Checked:by Date
hf
PCJTNAM C
' 6
Lil' n n
en r,
B
:.Located- at
angu s-d, 'd ns f,'- Co.
f,. V,',' !Owner -
rat6Sew a r S '
Y�stem built b
Y.
Ta
"off Wood Stj
bus t
DEPARTMENT ,`.OF., HEALTH
-I!,-
Wh6 Seivi-c'es.-,". diim61, N. Y; 10512
f ;V 1.q7,
Town or v.mage t
36t
'
ectl n Block
i; 8
qtot - roe 0-13 =409
Address a Lake Rd, „Mah6Daq,,: N Ye
Meal— e-t-
L- -.71i' Fi� A5 Width Arench -
”. ., - ' ' -`1_ ' .1 ;. ia ' ' I i .,: . , 1 7 ., . , . - . - , -.' I ,
�, - 't ' ' ' , A�,-: a4d 11 �buf f e
8 ft 6�.,�.�ifora,,, e -Piib'e,.Ao� .b6,. removed to �.zr.'OVd'
Othqr-raqM!rem0*, —, . . - -,'%, -1d 'and d1rt drain
"77 ,,;end �,,UIG
�!qeh
water 'SUpply: Public 'Supply From. • x Private Supply Drilled BY
,"Addreis
" I
Building Type 0. 'of -Bedrooms. Mate Perm t ss ad
Has'Erosion Control Been Conbleted? -no �COM 1 e
d Aqit W13/,72 `
r, -itertify-thai7the-systihifs)-is'liitidserving the above- premises were constru cted esserittally -as ihoWri'on the
`
' '
-plarii�of" the,comp' leted,work:(coplei,of 'which are
attached) and in -accordance With the stanaards,�,�ulesand regdIafldn4;-pI"s i Iled, and the perml f issued byfha Putnam County. Departfient of Health.
, — . .
Date i197 Certified by P.E. PF� R.A.
M
dA. -Ave.'.
Address Licefise •No..,
Burge'
SSr
to c correction' occupying prpm!ses served 6y'inte"ab'b*Ve'"s*ysteni(s).-'itiiill'.prompti� t4ikisuch action as maybe . necessary secure the 6 rr tion of any unsanitary
Any _person
ng rom �--s , u werag : a . sqsierii...sh rne..n6ii an -'-,o soon is a public *,saniti,ry sewer becomes
ti
�.,condlt Ions, result h age. Approval �o -,the, s�par�a q.,sp
such` si f `
available, ii6d the 4 f water ' up ly shall dkorh&h' I... a 6 d, void eh'..a',, ublic. a su ply becomes 'available. , Such',approvals -are
approval .the` w s P
subject:� to mod if lcation'�r,'cha nge when, In the-judgm ant ;of ., . tthe ss on f.H ealth ch r o odificatiori or change'ls, necessary.
��r 7
Data T
q
lu
'ITY, VILLAGE ,yTO &.OR NAME OF SUPPIrY DATE REPORTED__
its:
;AMPLIN -P(DIUr :.
SACTIrRIA PER .M (Agar plate count at,350C).
CO QGROUP (Mbstr probable No. /100m1.)
HARDNESS, TOTAL ppm
DETERGENTS .ppm
NITRATES (as N) ppm
IRON, TOTAL ppm
I , '4
Westchester County. Department of Health
Division of Environmental Sanitation
.. ..
WELL COMPLETION. REPORT
This report -is to be completed by well driller and submitted to Health Departments together with
laboratory report of analysis of water sampie'indicating water is of satisfactory bacterial
quality, before certificate of construction dompliance.is.iss.usd.
Well construction to be in accordance with, Bulletin $D-62
*RULES & REGULATIONS - RELATING TO INDIVIDUAL WATER SUPPLIES".
LOCATION:MUN I A=
WM-T OWNER: //Y* �(Uj
Nam
WELL DRILLER: b/ / 0 '1'1�4/3 / "J, Q"vj
SECTION ..BLOCK la.
Street Address City and Town
Name Street Address- City an
WATER MET, Sc
DETAIW T EST .
Bailed '(measure from land surf ice)
Feet' or
Hours'Static:
'/m
Pumped 4i Feet9 Nake:
. I cWhen Bailed I Islet
Diameters
In c he s 1Y i e _14: G. P.& for Pumped Feett Length n. tsize
KjWt Diameter
TOTAL DEPTH OF WELL 0 FEET
M_11W4Fr_k_1F11
-Depth From
t
Give description of formations penetrated., such ass peat,, silt'. sand, avels
Ground Surface
t
clays hardpan,*
shale,, sandstone,, granite, ate. Include size of gravel diameter)
and sand (fines
medium, coarse)p color of material,, structure (Iaosep packed,
camentedp soft,
hard). For example: 0 ft. to 27 ft, fines packed# yellow sand;
27 ft. to M ft,
gray granite..
t
n. t. //_�
n
//J
Ft. I
Mto Ipt, I
FtAo, Ft.
Ftsto Ft.
Date Well Was Completed Date of Report
Well Driller
Signature
v ' r
q� p^ WELL PIT AND PUMP WJIPMENT D�`TA %%S ,
lI' -✓ Y9 ®� Wf�JI.JL:+. -`'� e';�'.. �c ...;i= �"•�t4}•. -. � .a .. .. .:w � _ .,s-.. _. ,- _.:.;., ..
.. ;:.�- iL'ai� i� ° a � e c 1'1X i`�h'-F --fri c'� G•rav�� "i�i��i�a �c��Pe :�;'° �- -� , =:»�:� - �ti:=. �:.:.::�' -, � : t.::.;
rte
k
Pit with 4 -inch Gravity Drain to Basemen%
Pitless Adaptej A Casing Kin,, 12 inches above grad®
Dthers�Describe-
Pumpa . F4akp TypeCapacity G. P.P[a
Storego Tank.- Type Capacity Gal. (1,s2 Gaga Xin
DIAGRAM SHOWING LOCATION OF WEIL ON PREMISES
Indicate location of house., well and
sewage disposal system with distances.
Also indicate direction of slopes, and
direction with distances to all cello
and sewage disposal systems within 250 foot.
I cortif�, that the individual eater supply indicated above was installed as per the
m1pe and rogulatiom of Bulletin SD.62 of the Westchester County Department of Health.
3- a
AS GUILT_ PLAN
6. Vvr
r
P v ,p ,•�4P�
Ai /A�
_ fir/ J� 5 �, ' a• .n �y.�3 `P% \?1i�� Io' r
k
m
a^ �• ° � a
s °
,
I
855— 4o°J
i NOTE :. THIS. /S TO CEClTiFY TI-/A7" THE SF_ lh'ACiE D1SNidbSAL
SYSTEM WAS CONSTRUCTED AS PV01CATED ON TPiS,ttpL.AP!
AND THAT TWE SYSTEM WAS INSPECTED BY ME 0Ef" ,<'7E /T
WAS COVERED OVER. T<IE 5YSTF_M WAS C01V,5TRU�7 E D
! IN ACCORDANCE WITI -1 ALL TPE :2ULES AND aLGU 4i17'IONS
j OF THE PUTNAM COUNTY DEPARTMENT Of" )IEALTI-!
I EXCEPTIONS TO T{-IE ABOVE, ✓FANY NOTED BELOW_
'T'r2c nlc. -i J. _ �F pe RpGQAr CD �IPE TO C',E w.E nn 0'1
(AS SH
OwnI I _ P <ov +oC J{S >p +11b�jPl:
$UFF Ems l3 eTweE,.1 Ent0 OF
�I. Cowwp. { eD �v{T�1• �a III117"
I
AS 'SUILT PLAN
T/E MEASUREME/VTS OF SEWAGE DISPOSAL SYSTEM, :!
A B LOCAT/O•N L-o-r 13
SON I WCOC) D -'STAT E.
41 L_.: wi T_'
T PUTNAM COUNTY N.Y.
TOWN OF PUrMAM VALLEY ,
Scales os no.ec> ,AUG /3,
APPIP
6b•6 91• j . - .UoK .. ._ i`� -- JA' 1672
C�b.0 I oo.0 I.iO Y �•r.t~ - ✓\ �--� '"'— YUTN 1 i!}+i... ._. EALTN
_ _.. _ _ _. �a ;' .•v•: RGESS �i MENU �,. r ,
�'.s4r ,t t "• O y r , $VISION OF ,
__ _ i /' ._ ✓ _r% WMRONM TAL HEALTH SMIMS
f :2B C�IPn�ico .4�e.�ciB Ci�i•rnE,� !e: .�'
I n.
�h