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Home My WebLink About4790DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.32 -1 -5 BOX 36 04790 r ri Ll Lil- 4 , ` r- kim. -� �1lei :, A 4& 04790 7* p ,'' PEEKSKILL MEDICAL. LABO RATORYi 1879 Crom pod n Rd. ,Barclay Plaza Bldg. P . -Pe"ek6kill,. New York 10566 7-8777 DATE COLLECTED RESULTS OF OF WATER OWNER DATE RECEIVED IV 0 E- rV CITY, VILLAGE, E, TOWN VOR NAME OF SUPPLY DATE REPORTED J 0C f e- AAMPIJNrZ P05INT. BACT8RI A PER ML. (Ajar- plats count. at 35v C). COLIF6RM GROUP (Most probable No, 100m1.) HA DNESS, TOTAL -ppm DETERGENTS PpM NITRATES (as N),;- pl�m IRON, TOTAL ; PPM as S 1:A IK AIR -FRUIC Co of4jNa, 41 440US L L—j NOITI 'o El C, a i A L, OMPPE S D ABY -.4 Cl� mc l0i IV— 'T- We fl) T93; 140 Yid i21 WQ muss PU!"1P @Dj COMPRESSEDW, lk OW, 0 ND SURFACE SIA tit vJFDU.ii T'velp Lamy)", Pl" VI TOA . , 9§0 NO 61lfjAEiER (In GnAY fL WE finch CM 60) FROA -:qfu�l I pock of well With d sfan;oa to os, PIMATION MSCRIPT101 r tia two AerMbnqnt Wf%fmsrha, .. . ....... —Z7 If I M-01"IFF CtAAIO AS Kil MIHLM OF R POH FR P14THAM CQUWTV PEPA"T COUNTYWICE OUILDING."i CARM51., NOW YQA K Wdr 80d submine4 to Co4ntv_H4g&h-DW rtme ♦ fc re pertif icaiai of conqtryFtioii pqmqjj0r,�p@, 1q,,!" A *-4E1 'L PO R l e > k SUBMITTED WIT04IN X DAYs. 6• Comp 10 , �Svo M "A tb . 7A ps mviiiiFrl .7, 5TIC Llf�'T'AW�SHAEHT 44% ; . 1- .,1 1 : -0 FA T94TOW, AIR -FRUIC Co of4jNa, 41 440US L L—j NOITI 'o El C, a i A L, OMPPE S D ABY -.4 Cl� mc l0i IV— 'T- We fl) T93; 140 Yid i21 WQ muss PU!"1P @Dj COMPRESSEDW, lk OW, 0 ND SURFACE SIA tit vJFDU.ii T'velp Lamy)", Pl" VI TOA . , 9§0 NO 61lfjAEiER (In GnAY fL WE finch CM 60) FROA -:qfu�l I pock of well With d sfan;oa to os, PIMATION MSCRIPT101 r tia two AerMbnqnt Wf%fmsrha, .. . ....... —Z7 If I M-01"IFF CtAAIO AS Kil MIHLM OF R POH FR Robert Knudsen Putnam Vahey�_,NoY.a .2059. _ rA dam: r �'rlror uV A ietf IFff 'ing Municipality Robert.Knvdsen Map 185C u ng ons ruotE by Maple Rd & Elm Rd 50 Loca on --- Strait B16ok. .Raised Ranch 121 -128 u ng ype rat . 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 standaz►ds, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sops, 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 follawi. 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.Lronrriental Health Ser- vices of the Putnam County Department of Health as to whether o:r.not the 'a I lure of_, the System t ' ope rate was caused -by the t41lful or `negl`ig ®nt act of the 000upant of the building utilizing the sys em. Dated this .. 21 day of August 19 78 Signature I Title THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS. BEFORE CERTIFICATE OF CORPLETIRN WILL BE ISSN. GU iktANT, -DATE 0' FIRST USE OF SYSTEM. E�EIE - - - a - - - - - - - - - - • - - - - - - - - - - - - - - - - Division of Environmental Health Services,, Putnam County Department of.Health PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OPPICE BUILDING, CARMEL, N. Y. 10512 REVISED DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE-NO. Owner Robert Knudsen Address 2011 Luting Avenue Bronx, N.Y. 10461 Located at (Street MaP1e Rd & Elm Rd. Sec-%p 1850 Block 50 Lot 121.128 �Indicate nearest cross street) Municipality Putnam Valley (T) Watershed Peekskill SOIL.PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS oe Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth.to Water a er v_e No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches (1) l 205 2 :50 15 20.50 23.50 3000 5.00 2 2:54 3 :1.0 . ; 16 19.75 22.75 3.00 5.33 4 5 (2) 1 2.40 2:52 12 15.75 21.75 3.00 4.00 -, 2a57 3x12; _. 1 19°25 22.25 _ '.3.00 5'00 3 Notes: 1) Tuts 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 1 HOLE NO. 2 HOLE NO. 3 RQ C�r'avel. ROB Gravel. 4. - y.. -ROB Gravel - - - ,.'-Y.-:c- •-- '`17:e ; es-a .: ai- '�- ,...•'r ..-=o y�� •t}.' . -,-;a. 2 !" - i.. ;a ae .e�... .. -%:�tY taci .e�iri- 'e- <en::. salsa i�.:ra" ;`•�� 'dr- •: ti.: c'_".w,s= ar;soa:s -+ia. ea.'. 6,l 12" 18" 24" , 3011 36 ROB'. Gravel 42" 6" Topsoil 48 sandy gravelly loam 54 6o" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED ° TESTS MADE BY John S. Romeo Date July 39 1978 DESIGN -Soil Rate I -Used 1I =15 Min/l. Drop : S . D. Usable Area Provided 5000 'SF + ' No.. of Bedrooms 3 Sept* Tank Capacit 1000 Gals. o °o.��,�0 Masom�y Absorption Area Provided By L. F. x24 0 nch. _o`er M A o S RO q� Name J olan e Romeo - Signature Address 1 N ^rthridge Road ° SEAL o Tee i 9 0 0 ° 0 a ° _ THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: °®�� 0 °DOOOO °° Soil Rate Approved Sq. Ft /Cal. Checked by Date_ IFIELI) CTIECK LAST f INITIAL SITE INSPECTI011 Date., Insp. by: IYes .I No I Comments ,Property lines or corners found . ... . . V _Can estimate house location . . . . . . . . . .✓ Will driveway need cut . . . . . . . Ntust tI%,e: be removed -note these Is deep hole representative of entire SDS area Additional deep holes needed.. Sufficient SDS area available considering driveway cut, house location, separation distances, etc. : ✓ DEEP HOLE MTA Depth Water elevation: o Rock elevation: r Soils d.esc.r.•iDtion: C o ,q ••-o_ 'Date. FINAL SITE T\TS.PECTION Insp . by House located. where shoz,,n on approved plan SDS located where approved .. . Ijength of trench measured Width of trench average Slope of the line and trench acceptable . Room allowed for expansion trenches . . . . Over- 50 ft. from swamp, -• atercourse .. - ;1\Tatzaral- evil nog stripe °d :or SUS uruiecessarily graded . _.. 10 rib. maintained from prop.line.an4 20 ft . from house . . . . . Separation of trench -from- (house; "taell etc. follows plan . . . . . . . . . . . . I\Tumber of bedrooms checks . . . .. . Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench 15 r1t. of peripheral soil Horizontally from trench Junction boles properly set Could surface run off from .driveway, roads, ground surface, etc. channel near SDS area Does lot draiTZr.ige appear O.K. in area of SDS rINAL. GRADING OF SITE ACCEPTABLE 4 I REVIEW CHECK- SI- ; sT !Meets Std. Remarks I es ; No I DOM EMUS 'rouse plans O.K. c/ Design data sheet Peres presoaked? Min,. 30" pert test. depth Cont. results for 3 runs v i D. Hole log O.K. Corporate Affidavit for other than individual- Authorization for engineer L s-tter from Water Supply if. applicable v I if variance requested -such noted on plans & apps, NAILS ` if change is proposed,) Existing contours shown show new contours) Slopes for.driveway cuts, etc. shown Water service line location Footing drain, etc. location ✓ i Top slope, bottom slope of fill Percolation tests and deep test pit location Septic tank size and conformance to std. 3 B.R. house minimum House setback shown Distribution box ftg. below frost- I All -water within 50 ft. of PL shown Plan and profile SDS v All other wells and 'SDS closer 200' shown --or.:refor. - Property boundaries (metes and bounds - clearly shown SEPARATION DISTANCES SPECIFIED ON PLAN 10' to P. L. 201*to Foundation walls .00' to Nearest well 00' to stream, march, lake, etc. Intl 15' to Curtain drain 10' to water line (pits -201 15' to storm drain 101•to large trees 10' from foundation to septic tank 51 to pipe from leader drain & . foo -Gin, .expansion) v tooe SIR SAS w4 e Z _.. •— - - a... _ __--- 81 19° i j RsF �CCV j Clo 17 '3p B Eno 0% EL axA cw � , ,P1 IV ( k I tI- i V Y PUTNAM COUNTY DEPARTP1r.1J T OF HEALTH DIVISION OF 1'NVIRONMENTAL HEALTH SERVICES Date October 249 .1977. Re,* Property of Robert Knudsen Located at Elm Road do Maple Road Section Map 185C Block 50 Lot s 128 Gentlemen,* This letter is to authorize John So Romeo a duly licensed professional engineer x or registered architect ( Indicate ) to apply for 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 o-f :sa -id„ 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 truly s, Signed ,p / ✓, Cpl /cal 13x .rD` Countersigned: Ad.dres s P . E. 027846 2,1 o, ';00-ojelephnne 1 Northridge Road (Seal)0C pt F goo A ress Peekskill, Now York 10566 �� ° o 0 moo. 737 - 1056. a = , Telephone .. o 2794e o 00 ,ef NEB r0� �° O.0p b00 PUTNAM COUNTY nrPART E, T OF I EALTH DIVISION OF rt��roNr�r'1`1TAI l ''1I `PIi SFRVICFS COUNTY OFFICE Bl1TLDING, CARMEL,, N. Y. 10512 . DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM_ FILE N0. Owner Robert Knudsen Address 2011 Urting Avenue Bronx, 'flew York 10461;,' Located at (Street Maple Road &•E].m Rd SecMap 1850 Block 50 'Lot 121 128 �Indicate nearest cross s ree Putnam Valley (T) Peekskill... Municipality. Watershed ' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 2 5 :49 6 :21 32 20.25 23.25 3.00 3m.67 3 4 5 Hole Number CLOCK TIME PERCOLATION PERCOLATION =' Run Elapse Depth, to -.1a ter 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 5 :15 5:45 30 19.5 22.5 3.00 10,00 2 5 :49 6 :21 32 20.25 23.25 3.00 3m.67 3 4 5 3 4 5 .. Notes: 1) Tests to be repeated at same depth•u.ntil a roximately 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. • rot �• - _. Li. a t f ill Nr� £.t'� t i. -.t ',� fA,,.a'r i Y•Y �.1�6�,Y ` - � Y ,. si yI, / 2i G t t 'ci w .�y Cs��T�� .'1 hn } •� Q - `�1 � t .. - ,•... .a,.. :.; .,.. ': .... •. •. r�(J�' ^R.. a. .. r , -..wr :_,..,. .. «:... _ ♦ _ �t 7&1'4Lt.7 a r:F t r.t �•, r+ n4 ! t > r r£ � �O �yJ -../B1 30. ;S'; i31. �Ar:' . t 4. ," ...q,.�ie, ^ :� :% - 7 /.. •�.. t s F ., ` die .. i '..:.�• ^�' _ �,j '� / - � r t a • _ v /j. �! emu• a< T } 'E'= 691; 17 •• _ { �( s a . Jo; � � , !gip 41 zle 5: l7a- / t Iav /yrrha t7 > x r: �'� ,.• a _ 7, � Ali �l SYSTEM l`^ a t wry +ainv or, . SEPTI d HEB7BHl DESIGNED & SUPERdISED BYS _. BEDROOM HOUSE FOR: ,; <�aHa� ChrciFF�. ROMEO- ROMANELLI- AMIGO RC. ,• °a��aa 'O \ SOILS RATE I_ISi�,10"13r ,JT N q. CONSULTING ENGINEERS L 1004- GA TANK TOWN OF i�urj1.)Rlhia