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HomeMy WebLinkAbout4662DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.15 -2 -5 BOX 35 N� qr 16 04662 E p PUTNAM COUNTY DEPARTMENT,, OF HEALTH Division of Enw�onmenia/ Health Services Camel N. Y 10512'' F Putnam �e11ey (T) Cali CIA F.`F•rG�NSR�IJ-T:!':'3!V t" "O'L1:�!L �ORT�EI�,fi�ii� 3lSr"ERS�L oiYl Tilt: :' Town or'- Village Iidiat Ii11 RoadtP 1667 Located at Section Block Arthur _ laeugh Owner - " Lot Jota- Arthur AD®uoth India�.411 Pfd 9 Separate !Sewerage System built by Address __. n: Cons sting of Gal, Septic -Tank a ® lineal Feet X +c width trench r elm®f min3:iaum f"rift „Other requirements 'Water SuPPIY;. T Public Supply From PrrvateSuppl`y`,Dr�lled JBY °u `ri�lR3ri% ®ne 1�:''d�'31 ®rF% <cl } f �` t }+ {7 .:. LIU Address r Ben or.. tree Piita(azn Valley, 1VY. Raffish .... " B B& orris 3 Id mg Type . '• , uetl Mum '. e • • .. Y Has Erosion Control"Been Completed? i S.. Rp i • ktekify that the =system(s)_ as listed serving•the above premises were constructed essenti ly as shown p pla mp ork (copies of which are 'attached); and in'°afccdrdince with the.'standards'rules and ;regulatio,ns, plans filed, and the.permit mis by. m Department of Health. ��ember 21, 1979x., . � -w ,: �': �. � - :. • Date Certified by • P,E. R.A. ' - - - 1 �r'�hrdge . Read ekskill, !�i' • 1 Address _ ense NO. 027846 t • Any ,person occupying premises served by "the above'systeiri. s) shall promptly take iuch action as may be. nec�OW16 �rs�avlb the correction of any unsanitary conditions 'resulting `from such.' usage.: Approval ,'of the .separate.sewerage` system shell .become null and void as soon as a public sanitary sewer becomes available and tfie- app.oval of the private water supply shall become'null'and void when a ,public . ly becomes available. Such approvals are subject'ao modification -or' change when, .m the •judgment+ of the':Co s� er of. Health,' 3 revocation, modification or change.,is cessary.. i Gate .� g; BY Title .� 4 I'.. .- .'.. ;� �. T. < ... ...�h' f y...- r .'. ._._.._.. .t'. •.. .. .,.. .. .. •..• M1a a ...��t. .Y'. -.• � ' ..'.. �f � •..... t wn-I .•• �• ` Y - - 0 YORp(TOWN 0- tuicAL'LAB.ORATORY INC: P;0 Rox.99 321 K A Street LOCATIONS ❑ -321 KEAR ST Y&KTOWN HEIGHTS N.Y. 10598'245 3203 ® VorE�to n Heights, N 1. 10590 _ ❑.201. BUTTONWnOD AVE.;.PEEKSKILL N.Y 10566.737- 877.7 •'a. s 4. -r: ._ '. Sr zr... -. �3 2�5 3203. �. >. :. s ❑ �9 MAPI S MT'KISO~N Y T694-,46-33* z #1 3389 ❑ STONELEIGH AVE (NEAR: HOSPITAL►,:CARMEL,N Y. 10512'278-9330 DATE: COLLECTED (RESULTS OF EXAMINATION. OF WATER OWNER ' D ATE`R .CE . . . ' ART- -MCDONOUGH :. 'CITY, VILLAGE; TOWN 6 /OR NAME OF SUPPLY DATER PO TED 1.0..24, 79 SAMPLING POINT. _. -. BACTERIA PER'ML (Agar plate count at 35 C) C.OLIFORM GROUP (Most probable No. /100ml.) R TOTAL -ppm 1.1 OMFT 'DETERGENTS'-king/L: NITRATES (as N) - mg /L.: IRON, TOTAL.- mg /L . . AMMONIA, FREE (as N) -mg /L .... PH =. CHOR /L) IDES Y09 These results indicate that the. water was+S of a satisfactory sanitary quality when the sample was collected. "ej,Y�'� ®� A. H. P ADOVANI M. T . I - - 0 TOWN OF PUTNAMNALLEY WELL DRILLERS .LAG, AND. REPORT,— 7 CASING'DETAII-S YIELD TEST WATER LEVEL WELL COMPLETION REPORT Length i Ft. Bailed or �Pumed H rs. P. This report is to be completed by well driller and submitted to Yield: GPM Bldg* department, together with laboratory report of analysis of water sampleLicating water is of satisfactory bacterial quality. Well .Lodat o Tax Map Street Sec. Bl. Lot /�7 ei own e,.r e Maild-bg Address City or Town Tel. ,# Well r. Driller .W Nam6 Mailing Add&ss City or Town 7 CASING'DETAII-S YIELD TEST WATER LEVEL T SCREEN DETAILS Length i Ft. Bailed or �Pumed H rs. P. c Measure from ,Static: Ft. and surface) Make: Diameter: LInches Yield: GPM When Bailed or Pumped . Ft!'' Slot Length Ft.Size Kind:Z AU 1`Diameter In. J" Feet TOTAL DEPTH OF WELL WELL LOG Depth from Give description of formations penetrated, such -.drour'td ..Sur ace-.. peat, silt, sandy graye•q...clayg 4ardpan,,!�,'.,.. •shale, s 0 heg granite, etc. include size' of+ gravel (diameter) and sand (fine•, medium- coarse), 9 color of material, structure, (L�ose, packed cemented' 9 soft, hard) . For example: 0 ft. to 27 ft. fine, packed, yellow sand; 27 ft. to �j BZS 1-77 Well Driller ::: -, Signature 6 A rv1� -F'�a '.. Owner or PurcFaser.of Building Arthw &Donovgh Building-Constructed by Qy Wian Hill Road Location ...Street Building Type Municipality, Map 1667 Section Block D Lot n I GUARANTY OF SEPARATE SEWAGE­SYSTEM 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 Environmental Health Ser- o 'Tice,d- ot,..:` t- iie-. Rutnlam ...Couiityl�Dppaitment,:of = .HP^lth_as tdtwYie k er =:or no`'t_'t'he�` failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system A Dated thi s /Am day of 190 Signature. 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. t; - - - - - - - - - - - - - - -- - - - - - - - - - - - i - - - - - - - - - Division of Environmental Health Services, Putnam County D.ep._rtm_ent of Health NN��t a4�l. I`11 O v 2 ;: -1979 F PUTNAM GGujN i Y ' ET. 06 H- EALIE1 wv x `" PUTNAM COUNTY' DEPARTMENT OF' IiEALTH: Ofws>on of Environr»ental Health Services Camel �N Y 10512 { «." tnam Valle T CONSTRUCTION PERMIT F.OR SEWAGE 'DISPOSAL SYSTEM ''° y. �. }• �11 ►wc ris+� own or yllage �p •��`�O. / .4a�, s,' ° � tii' Y.'."'s. 4 ti' w- .,�'."' * u. T'ax'^IVf'ap Block ; Tamaccio Estates i.B Subdivision Lot fob Arthur McDonough Perry Street Je'ferson Valley ,NY a Owner Address Raised Ranch SF + Building Type Lot Area 1 800 gal /aay 1500 + Number of Bedrooms Deslgn Fiow Total Hab�tatile Space Square' Feet n 1200 LF odf 24 - Trenc Separate Sewerage System';to consist of . ' Gal Septic Tank an I Sheldon Gardner Gtevenson Avenue 340 To be constructed by 5 ' Address Pee s.kill.: 105 Water Supply. Public-Supply From x '- `Anderson Well Drillers. y Pnvate Supply to be dMied ,by _s I Address Barger treet Tutnam V&11e�r NY Min of 100 ft from stream Other Requirements t I "represent that I am wholly and completely - responsible for the design and lowt�on'of the proposed system(s), 1) Ni �� wage disposal system m en her to in r n with e o e u nam above:descrybed.will be constructed as shownon the approved a endm t t e and acco da ce w the starq� a ns o • County Department of 'Health, sand that on completion thereof a Certificate, of Construction Compliance Tsi{' WA isyoner of Health will. be. submitted •to the' Department, • and a' written guarantee'will be'furnished'the,owner his successors, heirsFor� t said builder will place. in good .operating' condition ;any'part of -said sewage+ disposal system - ,during; =the period of two ,(2) -3e�.' at f II �rkpth'�tlate of the issu- , ance�of the approval of .the .Certificate of ;Construction Compliance of theyorigmal `system or any repairsif o; 2 rill l6descrlbed above .will be located as1sh`own on'the approved plan and that said well will bdAnstalled,rin accordance- with the = sta'Ai1 5 rule a. n� f the _ Putnam e. County Department of Health Sept 30, 1978U ° o X`' LL Date Signed P, R:A. Address 1 Norihrld Road ekskill A1Y 10 :• q��,o.• --.84% i APPROVED FOR :CONSTRUCTION_ This approvai. -expo one ye 'from t ate issued unless �construction,ot�Eq�.: &11001�j n,.undertaken a nd Is evatila.for- cause`lor may "be amended or.modifiedvine consider nece s ner,of Healfh, Anyti4lon of construction requ s ne permit ,A p v f disposal of. do e• itary =s age nd /prw ater supply only ,Titl ° I PUTNAM COUNTY DtPARTM T OF HEALTH D-1 °FrEA= 'U,I Date August8,.1978 Re: Property of Arthur McDonough Located at Dian Hill Road., Putnam Valley., ' N.Y, Map 1667 B Section w Block Lot Gentlemen: This letter is to authorize John S. Romeo a duly licensed professional engineer R or registered architect (Indicate) to apply fo.r'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 Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said or_ S Qtcm "'; -n `do': cri�i'ty wi' th -chp'provi`s�ibh!r'of "Articl`e 115 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tzry Code. Very truly yours, Signed Owner of Property Perry Street Jefferson Valley NY 10535 Countersigned: /,/� ��� --�_ Address P .E., $X 027846 245 - 2580 1_ Northridge Road Telephone rK ` (Seal) Address Peekskill, N.Y. 10566 • o M'- 1056 F° r. Telephone T I m .27846 ti�� 9fFOf NEI PT -TTNAM COUNTY DEPARTMENT OF HEALTH DIVISION•OF ENVIRONMENTAL HEALTH SERVICES OF' PICE 18T DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM - FILE NO. Owner Arthur McDonough Address_Perry,Street Jefferson.Valley, NY 10535 Located at (Street 6dicate Indian Hill Road Sec. P Block Lot B neares cross.s ree Municipality Putnam Valley(T) Watershed Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS. (2) 1 12:44 12:47 3 27.00 28.00 1.00 3.00 o e Number CLOCK TIME ".3 PERCOLATION g PERCOLATION No. Start -Stop Elapse Time Min. Depth to Water From Ground Surface Start Stop Inches Inches Water Level in Inches Drop in Inches Soil Rate Min. /in drop (1) 1 12:22 12:24 . 2 17.00 38.00 1100 .2.00 2 12:26 12:29 3 37.00 38.00 1.00 3.00 3 12:30 12:33 3 37.00 38000 1100 3.00 4 12:35 12:38 .3 37.00 38.00 1.00 3.00 5 V (2) 1 12:44 12:47 3 27.00 28.00 1.00 3.00 - - ;8:;12:..51 ".3 27.00:... 8;00 :100.: 3:00 3..12:53 12:56 3 27.00 28.00 1.00: 3.00 4 5 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. �Y 18" 24" 30" 36". 42 INDICATE- LEVEL AT WHICH GROUND. WATER IS ENCOUNTERED None INDICATE LEVEL-TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4. TESTS c1�p.I7E;.3G1, S; :Rnm_ne` `apt 309r 18 <_ DESIGN = Soil Rate Used O65 Min/1 "Drop: S.D. Usable Area Provided 5000 SF + 3 des as 4 1200 No. of Bedrooms Septic*Tank Capacit Gals. Absorption Absorption Area Prided 1y340 L.F.x2411 3b" 3 c . -- ure 1 Northridge Road vo Address SEAL U Peekskill, New Y,,rk 10566 0 ©J/ o THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: © 000 p0a O ° g Soil Rate Approved Sq. Ft /Cal. Checked by Date_ TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTIryON OF SOILS ENCOUNTERED IN TEST HOLES .: :. ,LLB "lt'i _AOLh 'fit _ _�. riOLE-NO. U G.L. Topsoil Topsoil T..psoil 6" �! Sandy' Gravelly ROB Sand" gravelly ROB Sandy gravelly ROB 12" 18" 24" 30" 36". 42 INDICATE- LEVEL AT WHICH GROUND. WATER IS ENCOUNTERED None INDICATE LEVEL-TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4. TESTS c1�p.I7E;.3G1, S; :Rnm_ne` `apt 309r 18 <_ DESIGN = Soil Rate Used O65 Min/1 "Drop: S.D. Usable Area Provided 5000 SF + 3 des as 4 1200 No. of Bedrooms Septic*Tank Capacit Gals. Absorption Absorption Area Prided 1y340 L.F.x2411 3b" 3 c . -- ure 1 Northridge Road vo Address SEAL U Peekskill, New Y,,rk 10566 0 ©J/ o THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: © 000 p0a O ° g Soil Rate Approved Sq. Ft /Cal. Checked by Date_ FIELD C.ITLCI; LIST •Ins -P , : by • " r � .P'.i.?.. :..... '. VK .1. -�, !. v.i'r: n..', Ll •L'!bn ti•L.�..w...rr.�.�..r- .Y 1 INITIAL SITE INSPECTION Yes. No Comment Property ].fines or corners found .. Can estimate house location . . . . . . ... . _ Will driveway need cut : ... Must trees be removed-note-these Is deep hole representative of entire SDS area Q Additional deep holes needed. . . . . _ Sufficient SDS area available considering driveway cut, hour° location, separation % distances; etc. _. ✓ _._..__..._. DEEP HOLE DATA Depth: $ Water el evation: d G , Rock elevation: � Soils descri, ption:, 't , FINAL SITE MSPE0TION- Iris 'by: House located where shown on approved plan _. SDS located where approved . . . . . length of trench measured Width of .trench average Slope of the -line and trench acceptable . . . Room allowed for expansion trenches. . .. Over 50 ft . from. stramp, waterc ours e -sei - rt �t ipped br ISMS d'pe -�. - -.-- unnecessarily graded . ' . • : _ 10 Ft. maintained from prop.lineand. 20 ft. from house . Separation of trench from house, well etc. follows plan . Ntm)ber of bedrooms checks*. . Stories, brush, stumps, .rubble; etc . greater than 15 ft. from nearest trench . . . . . 15 Ft. of peripheral soil horizontally from trench . . . . . . . . . . . . . . Junction boxes properly set Could surface run off from driveway, roads, ground surface, etc. channel near SDS . . area ' . . . . . . . . . . . . _. Does lot. drains ce a pear O.K. in area of SDS t FINAL. GRADING OF 'SITE ACCEPTABLE j nc,VXj,w ti.l111JUA :.,I If, jI A' 0 aY��i1t�T1 ITS _ , . ti • • ;;i'r <° - i.� -.. -., t' -i_i. j.r eat `. •:: + -4 • •%.ari cc rouse plans 0. K. D°sign data sheet Peres presoaked? 11 n.a 30 pert test depth - ; •Coast ° results for 3 runs Do Hole log O.K. Corporate Affidavit for oth-_2 than individual Authorization for engineer Letter from Water Supply if applicable if variance,requested -such noted on plans & apps. °_ if change is proposed,) Efisting contours shown kshow new contours) Slopes for driveway cuts; etc.,- shown Niter service line location -Footing drain, etc location Tod slope, bottom slope of. fill Percolation tests and deep test pit location 'Septic tank size and cenforrna.nce to std. 3 B.R. house minimum Lj9 d Eoue setback shown Distribution box ftg° below frost � Ali -water within 50 ft. of PL shown i • � a Toota Strl J Remarks ' c� O Y i I B� ,i�.�• ,kV G 0-w i Plan and profile SDS Al2. o P.l 14Z,11, 200' i o shown or-reference rrade ,� i;, r, tua �p Property boundaries (metes and bounds --;clearly sh i EFARATION DISTANCES SPECIFIED ON. PLAN OP to P.L. O4- to Foundation walls J' to Nearest well )' to stream, march, lake, etc° incl 51 to Curtain drain Y to water line (pits -20 ?° to storm drain !P'to large trees V from foundation to se.ptic* tank i° to pipe frow leader drain & .foo tin .expansion i �; rain a e. ^i7 3 • V1 �1 Nov 2t, 1979 P.UTNAM H U O EALSB TYPICAL SECTION SCALE: 1 ° =1 O' � r - 1pO v d �o 9i gx 1 4 4 4 c .}I ePttN r.: q 40 y /24- 'r Y�v,s�.s � c � ! i 'r i Ski tt, 3 BF- f�soo.. a Yoo'� Gqo Gav �U , a •i• N fl} ,2 . �- --vim•; �� . TOY C} ,1Z- em , ja is L ' f 345 '95 ' 1! j 15- B41- B¢- r.: .1 /24- 'r O .1 �• Y�v,s�.s � c � ! i 'r S �-! - Tr• -.-..- 1v[ } Ski . 3 BF- f�soo.. a Yoo'� Gqo Gav �U , a •i• t ,2 O .1 �• Y�v,s�.s jst . 3 BF- f�soo.. a Yoo'� Gqo Gav SEPTIC SYSTEM FOR zj r. t i t• r