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HomeMy WebLinkAbout4673DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.15 -2 -27 BOX 35 04673 IN I IN, 1p No No �, E so y I my . , .� 04673 kF Di. Q. EALTH Y 10512 `' •'<} 23 Block ..yob' 833 -445 Zake Road;;.:'. a_'opac,' width - "Uei nch .'I hr�trh � ari,rl a.` rif f.'►�e`1- "'fl.S+' , . BACTIJRIAPER ML (Agar plate count at 35° C) COLIFORM GROUP (Most probable No /10pm1) HARDNESS; TOTAL ppm . i R #5559', DETERGENTS ppm h YO'RKTOINN MEDICAL LARORATOzRY IBC IRON, TOTAL rppm W, Y p;c¢p d6 /e,�i'1 vL y�j �� X01 K DATE COLLECTED � ;, r'RESULTS OF fEXAMIMATI'ON OF WAT'ERx { -�' � " -r �•` `K `�� , r�.+ �" : ^� =' ai'A��� OWNER f DATE RECEIVED = BONNIEWOODr'DRo BONIELZO AVGUST1 #9 2 l , X7 CITY, UIL�.LAGE TbWN & %Oft NAtv1 OF ,SUPPLY - }_- —�^ DATE REPORTED^ F " _ MAHOPAC NE1r1 YORK F 31 72 , ;3 BACTIJRIAPER ML (Agar plate count at 35° C) COLIFORM GROUP (Most probable No /10pm1) HARDNESS; TOTAL ppm . DETERGENTS ppm h NITRATES }(asN) ppm' IRON, TOTAL rppm W, Y - ar w .�- ..._ �,• `.«�. - ,.:..- �n,�.�w„'^' '.�... +:� mow- �.ti, -..y "'.r� --'° --*.^' �r.�, .yam, F--^'d � °.^°"..�"" ""' ,,4,,.- �- ,P.„..+ •�- T ,; r e - r } 3 A These results indi'cgte that; the wafer wassYESn of a satisfactory sanitary; quality when the sample was collected J t 1 F F � t A H PADOUANI; T.(ASCP)' ' Y Owner or Fur-chaser of Building -• I!',[1n;:i:cdinali;t�7 -- • a'Cfi. A. "•.:...,: "'+`• -•: ".s..• �v .:-C .�.�+ y' i': v�r�+iMef...:i": •- +=.^mow .B.:�ti'._:�,•�'1 '.�r1•• C row C2 .. ...,., y-'." _ � •w': ow . -.. W �t 9 ?:w� .��lri ::: w'^ ;6-rs e. - ZK:- +.°. -.. � a,. � � Building Constructed by Section Location - Sfreet '�. Building Type Block 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 i•t 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 _Phvironmenral Health Ser- vices of the Patna.m County Department of Health as to whether or not the failure of the system to operate was caused by • the willful or negligent ac of tiZ r 9c,;ctina?t.t of tK-6'. building, utilizing the system. ste°m. - -.y.. Dated this day of 1011- Signature 4A If cor ration, .give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF CONP'_,ETION 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 t � J PUTNAM COUNTY DEPARTMENT rOF .IiEALTH �8 Division of Environmenra/ Hea /ih Services I,afine% N Y 10512 I ;CONSTRUCTION PERMIT F.OR,`SEWAGE DISPOSAL ;SYSTEM;, P,iztnam Valley ' 1 Town_ or �lla�e Northerl4 sideF Bona@ Wood Drive �testerly of �' ..y c 'a isIR4•r Rt .�°? v, p0. •o rr•r••• �a .. s - o , v ti+VCL.2Zftl . "° _ectSiSn `'-% Block Subdivision �f?1� A TnToOd '- F'4tat @a 4 Lot o caner Tang:gA Construction Co. '' Address One .Lake` ,Road Ranch l acre Ma o;pac, :N. j Building Type Lot Area r ti ` Number 'of Bedrooms �. Total Habitable Space Square Feet Separate:Sewerage..System to consist o f 00 ;:Gal Septic Tank 72 .Y lineal feef,.,X,. 36tt width trench to be constructed by vsWl '(,'Ant, -3� Address ©rie Lake Ro' ad. . Water )p y:',.::, Public m SupOly Fro ' MaY],OjJaC, N. 'Y W. : Private.Sup.ply: to be drilled . bY,', • Adtlress, other Requirements : I represent thatl am wholly and completely responsible for.the design and location of:the proposed systems) 1) that,tfieaeparate sewage .disposal- system f above described will be constructed as shown on the apprgved amendment there to and.in,accordance with the st:an&l ds, rules an .regu a onso e u nam . _ I �n , ,.iCOUnty.0epartment —of ,Health;: and that on completion thereof a .'Certificate of Construction Compliance';' satisfactory to the Gomniissiorier of Health will be subinitted to`, :the' Department,:" and,'.a written guarantee, wall be` furnished the'.owner tiis'`successors;'heirs or- assigns by the builder, that said builder will place, in good operating.,cppdItion any part 'of said 'sewage disposal system during the pei od of two (2) ;years immediately following the date of the issu- y.. .ante of the approval of the Certificate._of Construction Compliance of the on anal system_pr any repairs;;fhereto;'2) that.• the „drilled•, well: described' above y ° L SC:n will be located as'shawn on'the approved plan and that said well willbe installed in accordance 'with the standards rules•,an8' regu a, ons of. ''the 'Putnam County Department of Health.; August- 17 1977- X r Date _ Signed Add.essBur e s s& B hr 8 _. _APPROVED FOR CONSTRUCTION This approval expires one.year from „the date,_issued,;unless revocabie for cause or may be amended or modified•when considered - necessary by,ithe Comm,issio requires a new 1permit "Approved for disposal of "domestic'sanit r ` se and or rivate`wal Date / By P.E 98.5 License No. construction of the building has . been undertaken and is ier. of Health ,Any. change or, aheration of ;construction ar'_suPply'only.• i Title PUTNAM:COUNTY DEPART .W NT-_.Q_�-H AT :L d�,`^v +OW•w �"Y��'c4t••C'„f''��:•, -.r Sy�rR.� .. — := ,..:.—_�.y.. 9�.1 F'3 :. ^ rrer{�."S..^v:.: F:i -r ''r• — >r . c.;- ^c�".�.s.'°�'P.. --v' �. .. _ w•.a �-- '.�:aS ® n.+� DIVISION OF ENVIRONMENTAL HEALTA;SERVICES DESIGN:/DATA. SHEET - SEPARATE: SEWAGE DISPOSAL SYSTEM FILE NO. 833 -445 Owner Tan&u-.g -Address One Lake Roads NglagZac . N„Yo. ` northerly side Bonie Wood Drive Located at (Street)�.�± .� ,Ad end Sec. 123, Block Lot .'ooeee° (Indicate nearest cross street) Municipality Putnam' Valley Watershed New York City r 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) 1 9-'45 10°22 37 18 19 1 37 2 10022., 11000 38 18 19 1 38 3 lloo0 11038. 38 18, 19 1 38 4. 2) 1 945 10023 38- '. _ ....18' 19 1 38 2.10:23- 11-39-- 76 - 18j, 20 . 2.: 38' 4 5 Notes: 1) Tests to be repeated at same depth until approximately equal.soil rates are ob- i tained at each percolation test hole. All data to be submitted for review. Af 2) Depth measurements to be made from top of hole. 721? 8 411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TOCWHICH.WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY BURGESS & BEHR Date 8/4/71 DE S1 GN Soil .Rate Used 31-45 Min/111 Drop: S.D. .Usable. Area Provided 9000# s.f. No. of Bedrooms�I __Septic Tank Capacity. 1200 Gals. Type Precast . Absorption Area Provided By 672 L.F.x2411 3611 X width Other --7 e�,jE OF ar Name Roy A. Burgess _ Signature �R Address_ BURGESS & BEHR, P.C. SEAL ��' 128 Gleneida Anue, Carmel. N. Y. 10512 PUTNAM COUNTY DEPARTMENT OF HEALTH R °Fessvo ,I Soil Rate Approved - Sq.:Ft. /Gal. Checked.by Date 'Vestchootor County Department og Health Divibio'n 'of'-Environmental Sftitaticaa dill CO' TIC NMI= This report io to be ccmplotad by well driller and submitted to Hetlth DeyartzentD'togathar with la,boratory report of, analysis of water ,eample indicating.:watar is of oatisgactory bacierial qualityq before cortificate-of construction compli&nce ig issued. Well construction to be in accordince' with' Bulletin ZD=62 "RULES l& REGULATIONS RELATING TO INDIVIDUAL:,WATER SUPPLIES&I SECW BLWK xM LWATIONs XUNICIPALITr LO M M1 ON= s A Street Addreab-• City mid Town bELL DIL331M Street C � an saran I Bailed 9(measure, from land surface) FeetO or 1 9 Qom' 111-1 6 HouragStatics 30 Feet G Makes - DeptRI "(S u uive aescrilnion ox xormm-Gionw penwrwiaw% uucn "s Paa'&,g D.I.L.3t.9 W&W9 WrSVW.Lp. Ground Surfaco clmqo hardpans shales sandstonej, granitOD QtQ1 Include Aze of gravel (diameter) and sand (fines mediums coarse),q color of materials otructure (Loosep packedg o camentedg softq hard)® For examples 0 9to to 27 fto fines packedD.,,yellow gands, 0 27 k6&9 13 4 6AQ je� i,,s Ft to �o N A y. A- ji. ic:. &AQ 26 Q. Date Wall bYas Completed 21 Date of Report Well Driller swaturo WELL PIT AND PUMP EQUIPMENT DhTAILS .Grh:. ..' -y;_ r. : d<< _'� -moo v„_ .._ sa' C�j^ j+ .;rtG= Sn�e.;��+"F.,- :w.x,' -. (L':,A,`- na�Ta�R�;�. KY �?n� •:{�.-�:o�• —y v. �i vsi_dF.i.vm i•a�',rpavr:GO:E+'ea iaT.itf....�'w ^iiiC. ice. b.,a;;! Finished Well: Check pit with 4 -inch Gravity Drain to Grade Pit with 4 -inch Gravity Drain to Basement J Pitless-Adapter - Casing Min. 12 inches above grads Other: Describe Pump: Make Type Capacity G.P.M. Storage Tanks Type Capacity Ga1.(42 Gal. Min.) DIAGRAM SHOWING LOCATION OF WELL ON PREMISES Indicate location of house, well and sewage disposal system with distances. o ;lso.. ,dcate- direction- f slo es ,l ari - direction with distances to all wells and sewage disposal systems within 250 feet. I certify that the individual water supply indicated above was installed as per the rules and regulations of Bulletin SD.62 of the Westchester County Department of Health. AS B ILT PLAN ` 1 - WOTE ' THlS;:IS.TO `CERT /FY T9AT TN'E SEWAGE DISPOwAL " =30 pw� p - . TED4,ON SYSTEM; WA'S CO/VSTRUCTED AS`;IND /CA TN15 PLAN K.ST,ac ` z e A. ND TNA.T TNE.,SYSFEM WA,S INSPECTED, BY <ME BEEOR� /T , WAS COVEl2E0 OVER THE SYSTEM tNAS _CO/VST..RUCT�`D IN ACCORDANCE WITN ALL 'TNE RULES AND REGULAT /rYS :, . .. •_ - +r--- -to.6. S.I' cn�ar.Nr..saPT :c�- w...i�.:EALTH -- OF THE PUTNAM COUNTY D�•PARTMENi OFN .JVU'cTtt�N aGR, d EXCEPTIONS TO THE .A8OVE�./, /VOTED BELOW. e 9 _` 9.11• 9i 1 t ' t - .. - f S Y x y— 22' TBoxFS CToi' -L) .' f 4;5 U /LT PLAN Us. 4 OF AE D,r POSAL. sy r T/E `A9EASUREMENT .S ; F k 9 zt LO -.' ,. LOCAT /ON T.4 ,. 64 o ra�r . .O :TD`S S 3.7 sz'Gt' 1- Sa TQWN OF, PUTa/VAM'E�ALL�j� RtiTNAAI/ G,D�t1NTY,N Y. s noted 4.0 , b ,¢�, 4.3 o -48,7 t.ar ss ` 10;v1. 2. . :, OUT n 3 3 4 70 o yrY taq lt W.a. %aS aw �R4A9PrER :x F 75 '46 751• - .1 _ ': .. ,„ .. .: •... .- '. - .... ..'. -c. ^... .. '•• f { _ t ri i �• 4,