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HomeMy WebLinkAbout4635DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.13-1-3 BOX 35 i,yti �r , :% • 1 ; r Ir IL i I r Soffmn- din JMILA 04635 Rev. PUTNAM COUNTY DEPARTMENT OF HE alth M Division ofEnv6=�i-elintalfle Simi` 7 ITH 'Emilip6er Must ProvlderV 0_1 P.C.H.D. Permit VU 01NAY1;:;;VAL Town or Village 1Acated at ARCHER ROAD Tax Map 122 Block 1 Lot N/A Name E - KEEGAN, Owner /applicant —Forme Subdivision Name Subdv. Lot # MallingAddress BX'225 SHRUB OAK -NY 10588,' 10588 Date Permit issued -1 /19/85 - 71P Separate �bujjt: by STEVE KASTUK., dress PEEKSKILL HOLLOW RD, PUT .,VAL,N' sewerage system A 8 iuuu Consisting of Gallon Septic Tank and 3 8tF of FIELDS Water Supplyi -Public Supply From Address NORMAN ANDERSOFAddr. BARGER STIPUT. VA�L,NY it 79 (�Pzivate S ss orl—L Supply Drilled by- 9 .,Type.. ONE FAM. RESIDENCE Has Erosion Control Been Completed? Nunibei, o . f Bedrooms Has Garbage Grinder26enIns.talled? Other Requirements 2FT. BANK RUN FILL' I ceitiiy that the system (s) as listed serving the above jiremises"were constructed essentially as shown'on the plans of the'complete . d work copies of which are attached), and in accordance with the standards, rules.ind:i lations, in ac„ dance with the filed plan, and the permit issued by the r Outnam County DepartMent Of Health. xx Date 7/23/86 Certified by_ P. E.'_ R.A. X. 8 MMO .6 ...,..MTISCQOT, NOo.RF A2 "B 4 PAC,i _iqY J0�&Jsr4,. 1105 Any o" Pe!' s pyJing promises served by the above systems) $hall oc cu conditions from such usage. Approval of the separiie;'l available and the approve . I of:the private water supply Shall'become subject to mod ilication or Change when, in the judgment of the bate &Ce By_ ii-olysil as may be necessary to WcA the correction of any unsanitary 1 I . – ice such 10 rage system shsjJbs1;JAo*null and void as soon as a pubt% unitary sower becomes I'and old A supply becomes available. Such approvals are public water misii or o H we iovoqa V on, modification or change Is necessary. Title 4 1H C ,. ?,�! a :.. «k:. ,Tt.' .. -' .)._�.. i' �;�_ -. ^• 'r,"'., � ".. ' "'t•.� -" .•a_ ".::.::' a:•�- riCi�r, ., "..� '•ee -- ... "c_..%��,at ..''^`• . �v�.n e�sR e urn �► L Owner or Purchaser o B 'lding Muni pa ity �i o Paz Bu'r d ng Constructed-by Section Locat on - Street Block r ( bLU(4/jA 1 1 Building Tylbe Lot GUARANTY OF SEPARATE SEWAGE- SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in.accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to.accept as conclusive the de- termination of the Director of the.Division of E vironmental Health Ser- " • ° "''v ~1 G-v�$°Zvi`'tfi." l ri i1' :1L:1'tuji"" °`perYrGi':vlwit::0 •. c:2ilt r " o "�VJ'flv'l�i°i�.2° " "i31� °n0�i t b ' 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 day of 19,q, Signature Title r If corporation, give name and address) ------- - - - - -- - •��� ~- ----- - - - - -- "0000:::�K 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 Yorktown Medical Laboratory, Inc.. LAB I YK•O2ss34' 321 Kcar Sheet t YorktownNcights,N.Y.I0598 Collection Station Used: - y�� t _ Carmel Peekskill ._ Director: Albert H. Padovani X T. (ASCp) : � •f "� •Wtz - -*; 'f rfy "' i`'" s "Ni& i;' `irty�'" T_ Date Taken: '7- /7,X '2'y/ Z�%JGtJmpzb it? 6-- 0607 Date Received: Date Reported: am 0. 13 X �2A3 ,• Collected By: SA4;e" 3 O/�" ^7 / Id J--e P . Referred By: L / J Sample Source: LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA. VStandard Plate Count. per 1.0 ml fit% (Agar plate .@ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) V Total Coliform t)er 100 ml _ (J Fecal Coliform ner 100 ml Fecal Streptococcus per 100 ml oo0apBLE NUMBER TFC? NTQUE (MPN) :m!PN index- nor ..1.0v'•mi -,. _ ti __�.._...� ._: _._,...; .. - ..:; ...�r.: Fecal Coliform: MPN Index per 10.0 ml OTHER ANALYSES THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) )(WAS HOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE. TIME OF COLLECTION. Albert H. Padovani, M.T. ASCP), Director LEGEND RDS a Recommend Disinfect- ing Water Source < a leas than THTC ■ Too Numerous Too 7 WELL.COMPLETION REPOR;E. DEPARTMENT OF HEALTH Division Of Environmental Health Services STREET ADDRESS: [OWNIVILLAGEICI[Y TAX GRID NUMBER: ,F 4" P 0 S VO�t L - �- -k-- ( - I C! WELL LOCATION N WELL WELL OWNER NAME: ADDRESS: A /00 0" x G;-PfjIVATE _EUBLIC USE OF WELL primary 2 - secondary "ES14NT'IAL ❑ PUBLIC SUPPLY C1 AIR/COND.IHEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST/OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL __0 INSTITUTIONAL 0 STAND -BY ❑ AMOUNT OF USE YIELD SOUGHT gpm.INO. PEOPLE SERVED EST, OF DAILY USAGC gal. REASON FOR DRILLING W SUPPLY = ❑. PROVIDE ADDITIONAL SUPPLY 0. TEST/OBSERVATION ❑ HEPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH � _ ft. STATIC WATER LEVEL QftTDATE MEASURED DRILLING EQUIPMENT ARY 0 COMPRESSED AIR PERCUSSION 0 DUG ❑ WFiL POINT Q CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED 0 OPEN END CASING.. 2"TPEN HOLE IN BEDROCK ❑ OTHER CASING TOTAL LENGTH RA/ tL MATERIALS: 9 STEEL ❑ PLASTIC. ❑ 0 T H ER, LENGTH .BELOW GRADE ft. JOINTS: ❑ WELDED ❑ THREADED ❑ OTHER DETAILS DIAMETER —.in,' SEAL: ❑ CEMENT GROUT 0 BENTONITE DOTHER WEIGHT PER FOOT 1 SHOrE. ❑ YES I LINER: OYES EaN, 0 SCREEN DIAMETER (in) SLOT SIZE LENGTH (11) _aNO DEPTH TO SCREEN (ft) DEVELOPED ? .DETAILS FIRST - ; .. 0- *E& - HOURS GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in.. TOP DEPTH ft- BOTTOM OEM YELL YIELD TEST 1, If detailed pump.ing iETHOD: C�OUMPED , tests were done is in- COMP . RESSED AIR 7 k5! formation attached? I BAILED 0 qTHER 'DYES ONO If more detailed formation descriptions or sieve analyses WELL- LOG are available, please DEPTH FROM SURFACE Water Sear� ing W-11, bia- eter In FORMATION DESCRIPTION COOE -- , It. ft. j- ELL DEPTH It. 7 DURATION hr. min. DRAWDOWN ft. YIELD gpin. Land Surlace ;z 42 TER ❑ CLEAR TEMP. kLITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED, 0 YES ONO ANALYSIS ATTACHED? ❑ YES 0 NC STORAGE TANK TYPE 6) CAPACITY; 0 c GAL. WELL DRILLER NAME DATE ADDRESS SIGPIATURE &n ee.Tj�-- 41,eh 6/c, A, • Y, I - 'I mtmk.�,, 41 C,& ev,- 4P lHF0111MATION E CAPACITY :ER DEPTH EL VOLTAGE — HP 77 - 7 - T-, �j RMIT # LIANCE. of .uwn yr vmaga o". ;:Lotg.�C�e�2:.= :.:�T',�= `v.—,� ��.n�C�.,'�r_'�- .,.°�r- " F.:: �i• a ;.... s �:'.�r TeiKslb�aR'r',.�.. ?.L� -a �"�lq� "' }- `�....4.. <,A,; ELCt..:�.� r� -'; . —': a�� Subdivision 141A SUM. Lot .n Renewal _ [3 Revision ❑ Owner /Address''_ Keegan . Ex 22��, Shrub 0ak - NY ID05S.8. Date Of Previous Approval ' Building Type 1) Fam., Res. Loc Area l0 305 Acres Fill Sectiion ly NUTi)er Of Bedrooms 3 VOO - Design Flow G /P /D P.C. R. D. •Notification 'Required Sep arate sewerage syitem to consist of ""1000 Gal :Septic 'T' ank an 3 $LF ';.of -Fields To. be'constructed 'by Steve .Ka•stuk Address, Pe.ekskill._ Hollow Road Water Supply: Public Supply From, Fl a Ualley ,NY IQ57Q XX Private Supply to be drilled by Norman Anderson Address -Rarer :r Street, Putnam Valley NY 105,39 Other Requirements 2 FT. Bank Run Fill l I represent that l am wholly and completely responsible forAhe design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the 'standards; rules an regu a on, o the Putnam County Department of Health, and that.on completion.thpreof, "Certif.icafe_.b Construction,. Compliance" satisfactory to the Commissioner of Healthwill be submitted fo. the Department, and a written guarantee will -be, f' urnished 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 ,per, iod of two (2) years Immediately following thedate of the issu- ance of the approval of the Certificate -of Construction Compliance of the'original system or. ny repairs thereto; 2) that the drilled well described above will be located ad shown on the approved plan and that said well will be installed in accordance f the 'standards, rules and regu aT ons of the Putnam County Department of Health. Date Signed. P.E. R.A. XX Address O t -NO .R'FD 2 88 M O -aC NY 10 541LI license No. 1 1 n 5 h APPROVED FOR CONSTRUCTION: This approval expires . one'-year from, date :iss` d unles construction of th ilding has been undertaken and Is revocable for cause or may be amended or modified when o tired necessary. by -the Co m Slone of'• Health. Any change or erstfon of construction requires a ne permit, . Ap r disposal of -dome ic. San sewa and/ privat - .watei Date ey Title Rev. 6/85 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES � "'r:ti .e._ ��•:. >,, o-: '+;� -,� .d'. vi: :.�T'�.�;v c tw�'E . :''"'.: �.. .. :,,¢t, .,;? ..:n. :c ".. i.q`{�iaz..a- r'.• °.F =.:c s. si�.c� -.. ,�i�,e.;_'�''.:T:u�:: ".. Date Re: Property of Mr, & Mrs. Ed Keegan Located at Archer Road J (T) Section 122 Block 1 Lot19 Subdivision of Subdvo Lot ## Filed Map ## Date Gentlemen: This letter is to authorize Joel L. Greenberg a duly licensed professional engineer or registered architect xx e (Indicat 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 Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and system or systems in conformity 147, Education LO\G��IrlVeN D c G CE ' F� � tary Code. Q4V o 011056�0�� C unt rsigned: 0P NE`�� P.E. , ReAe , ## 110 6 Muscoot North,RFD #2.,Bx 488 Address Mahop ac,NY 10541 628 -6613 Telephone .to supervise the construction of said with the provisions of Article 15 or 3ealth Law, and the Putnam County Sani- Very truly yours, Signed 'e, C1,1- Owner of Pro erty P.O, Box 225 Address Shrub Oak,NY 10588 Town 528 -7537 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ .COUNTY OFFICE.BUILDING CARMEL N Y. 10512 w . L•.- J i� • wa :.1: x L- - .t' -z. C. `!. '•'1- .RJ:oL .r`- .. -0 }Jr w i': R•• w.�3.r- , .. " . DESIGN'DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM. FILE NO. Owner Mr. & Mrs. Ed Keegan Address P.O. Bx 225 Shrub Oak NY'10588 Located at (Street Archer Road Sec._ Block 1 Lot 19 6TEcate nearest cross. street).. Municipality Town of Putnam Valley Watershed Hudson River'" SOIL PERCOLATION TEST DATA REQUIRED TO -BE SUBMITTED WITH APPLICATIONS Role Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse. Deptn to Water - Wa er Lev e No. Time From Ground Surface in Inches Soil'Rate 'Start -Stop Min. Start Stop Drop in Min. /in drop Inches. .. Inches Inches PTH #11''9:45 10:15 30 16* 19.33 3.33 30/3,33 =9 - . 2 10:19 .. 10:49 30 16 19- 11 1-11 :' ,. -30.13. 33 -9 3 10:5°3 11:23 -30 16 19.33 3.33 3013.33 -9 Notes: 1)' Tests to be repeated at same depth until approximately 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.- TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION. DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. DTH #1 HOLE NO.' DTH #2. HOLE NO. .ee-�'a t' 'w� a. ➢ ."�``., � '�. ..'.�.,',. -. +s;_ >. 1r r. a"• ao=ec w.d—" • . °= ri'`.. s i Top 6" Sandy Loam 12" 18" i 2411 .3011 3611 42" „ 4 Sandy Loam n. . 5411, n 60" „ 7811'' 8411 INDICATE LEVEL AT WHICH GROUND WATER IS'ENCOUNTERED NONE INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NONE TESTS MADE BY Joel L,- Greenberg Date 11/1/85 Soil Rate Used 8 -10 MirVl "Drop: S.D. Usable -Area Provided 5 000SF -No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. Ty st Conc, Absorption Area -Provided By 375 L. F. x24 xxx 6 w 1:2 , �y 2 FT.`Bank Run Fill v .� F Name Joel L_ Greenberg Signature­ h AWA 1A ` Address Muscoot No, RFD #2, Bx 488 THIS .SPACE FOR USE BY =— TH DEPARTMENT ONLY: �R NEA. Soil Rate Approved Sq. Ft /Cale, Checked by Date ZMI COUN'T'Y DEPARIMM OF HEALTH - DIVISION OF HEALTH SERVICES 'INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPO/S/AL/� SYSTEMS n.. .� . �.1 •� .:I- 'Oi�• . -. - 4.• - r -- d •r . .'7 ... A� �:i.LCal" nF.i7Pwr'cSV'i�`t'9 �Y 4Y r/• //y `.. .�., a ,4.,�"��M �i !i^ DATE: r e �61 ^� �! G � cy. ? � SP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO. COMMENTS Wetlands on/or proximate to property .............. Property lines or corners found ................... Can estimate house location ........................ Will driveway need cut....:... .................... Must trees be removed - note these................ Deep holes representative of entire SDS area...... Additional deep holes needed .:.................... Sufficient SDS area available considering driveway cut, house location, separation distances etc... Adjacent wells/ septics ............................ D.H. - Deep Hole G.W.-Groundwater D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot Depth to G. W. Depth to G.W. Depth to G. W. Depth to rock Depth to rock Depth to rock doll uescript.ion 0 ft. 3 ft. 6 ft. 9 ft. _ -.. 12-•t Sbll Descri 1 0 ft. 3 ft. 6 ft. 9 ft. Soil Descr 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: FINAL SITE INSPECTION INSP.BY: YES NO CU44a I'S House SSDS located per approved plan ............. Length of trench measured Width of trench average a Slope of tile line and trench acceptable......... Roam allowed for expansion trenches............... Over 100 ft. from watercourse .....- ............... Natural soil not stripped or SDS area unnecessarly graded...... ................. 10 ft. maintained from property line and 20 ft. from house........... 71:p- .. ... . ........' Distance well to SSDS (ft.)....d . .......... Number of bedrooms checks........ ............. Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontallye fran trench ................................ Boxes properly set ............................... could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... I FINAL GRADNG OF SITE ACCEPTABLE.... 0 ............ . A--IV z;,V X y - X (, AI0100�1� r - ,/( f NOW D ' (P N KERLY DANIEL F OW OR FOF NJ 105 1'60."E ' 1E." 17 36 V% ON, -�4 r. I STORY F� A WELL of Ao. 110 _0 C-3 - f' 1000 CAL wt wi 0 ............ 2 4792 07273-9w�,Vc ' OR P-ORMF-RLY,..-.'*,. FRED -RiC J. I NGA HE SEMI q )SA-L SYSTEM O-FE r -F - �iO aARNACE- (:::iJZfNC�F—Q WA,�, IN, ALL,(D'. Ail -ID t. A 3 155,40 -4" i34 '3 14 37' /:5 -72' ------ --- - 5r/' -4" 16. /7 1? 64' 7- L4 NOW D ' (P N KERLY DANIEL F OW OR FOF NJ 105 1'60."E ' 1E." 17 36 V% ON, -�4 r. I STORY F� A WELL of Ao. 110 _0 C-3 - f' 1000 CAL wt wi 0 ............ 2 4792 07273-9w�,Vc ' OR P-ORMF-RLY,..-.'*,. FRED -RiC J. I NGA HE SEMI q )SA-L SYSTEM O-FE r -F - �iO aARNACE- (:::iJZfNC�F—Q WA,�, IN, ALL,(D'. Ail -ID t.