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Home My WebLink About0025DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 1 -1 -29 BOX 1 ' ' lal. 1 Is , I H MEN IN moor 111111m '4.1 PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER MUST \ Division of Environmental Halth Services, Carmel, N. Y..10512 PROVIDE PERMIT # 1 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM A MCgwAl lrr' /f Town or Village Located at AZ 2V mODK�-y n/<< -A Tex Map I Block Owner Zr`V COA4 RULTION cO , / Formerly Tax Map Lot # I Z Subd. it N Separate Sewerage System built by ROVE2 i')'1A965 Address PaU r.H Q0.46 Al, V, Consisting of/,000 Gal. Septic Tank and Other requirements Water Supply: Public Supply From —le� Private Supply Drilled By 4 FDA" 4V14 WE" PA-l" LV 6 Address rya l wT • to `—,J Building Type "SPUT LEVEL AdAICH Has Erosion Control Been Completed? N1,4 No, of Bedrooms 3 Date Permit Issued Has garbage grinder been installed? NO I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. I A „ J Date � I Address P.E. R.A. go ` �2 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public unitary sewer becomes available and the approval of the private water supply shall beco ?nd void when a public su y becomes available. Such approvals are subject to modification or change when, in the judgment of a Com1�nor�ofHealth, w revocs n modification or change Is necessary. Date s� By Title Rev. 6/85 47 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 Permit N CONSTRUCTION .PERMIT FOR SEWAGE DISPOSAL SYSTEM . Sdn/ /V y. Town or viliag e Located at 1)I(,10q/C�• /tlGC /Zl7 ¢ /}]-� /2TE, z�2 Tax Map x Block Lot �Z Subdivision M ooyri Hi u EsTi -rex S.M. It # Renewal _[]_Revision _ 0 7c"iv, Building Type. $;D4.17-LE ✓EL RANCH Lot Area 436 /OGRES Number of Bedrooms 3 Design Flow G /P /D 600 Separate Sewerage System to consist of 119 00 Gal. Septic Tank To be constructed bl Water Supply: Other Requirements Date Of Previous Approval Fill Section only ❑ P.C. H. D. Notification Required and 421 L, F; 7'1c,9- F /EC Ds i 1 represent that I am wholly and completely responsible for the 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 regulations o e Putnam County Department of Health, and that on completion thereof a "Certificate of Corstruction Compliance" satisfactory to the Commissioner of Hea.lthwill be submitted to the 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 of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed i accordance 'with the st ards r les and regulations of the Putnam County Department of Health. Date _� /� /V S igned� P.E. R.A. Address '� 0 License No. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the m issioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domesti sa sew and /or prove a wa niy. - -- Date— BY Title— Rev. 9 -81 , WELL COMPLETION REPORT 3/71, PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME ADDRESS LOCATION OF WELL (No. & Street) (Town) o (Lot )Number) PROPOSED USE OF WELL N-11 DOMESTIC 1:1 SUPP Y BUSINESS ❑ ESTABLISHMENT El INDUSTRIAL ❑FARM ❑ CONDITIONING ❑TEST WELL ❑ OPeEfy) DRILLING EQUIPMENT ❑ ROTARY COMPRESSED AIR PERCUSSION ❑ CABLE PERCUSSION ❑ OTHER (Specify) CASING DETAILS LENGTH (teat / ER as) WEIGHT 7 O -D PER FOOT J? rb THREADED ❑ WELDED E SHOE � YES ❑ NO 41YES CASING U D? NO YIELD TEST ❑ BAILED ❑ PUMPED COMPRESSED AIR HOURS G.P.M. �� YIELD (G.P.M.) U WATER LEVEL MEASURE FROM LAND SURFACE -STATIC (Specify feet) DURING YIELD TEST (feet) j� Depth of Completed Well in feet below Land surface: SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET i� t tv 19 J If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) , Yorktown Medical Laboratory, Inc. J' 321 Kear Street Yorktown Heights, N. Y. 10598 (914) 245 -3203 Director: Albert H. Padovani M. T. (ASCP) LOCATIONS: ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 -3203. ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737$777 ❑ 495 MAIN ST., MT. KISCO. N.Y. 10549 666 -3335 ,VCSTONELEIGH AV /EE.. (NEAR HOSPITAL), CARMEL. N. Y. 10512 278.9330 DATE TAKEN: [ r , DATE RECEIVED -3 005— - f DATE REPORTED: % SAMPLE SOURCE:. Lal _ . a_ 9 4.2 . REFERRED BY. - .Co.1l.ecto.r LABORATORY REPORT 8-- 7 63 mg /L ❑ ACIDITY ............................ ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY i - ❑ ANTIMONY ACTEPIA, TOTAL /mL ........ .3� ............................ ❑ ARSENIC .................................... ............................... BOD, 5 DAY.........: .................. ............................... ❑ BARIUM .....•.•••.••••••.••..•................ .............................. ❑ BROMIDE ............................ ............................... 11 BERYLLIUM .................. .......... ............................... ❑ CARBON DIOXIDE, FREE ........ ............................... ❑ BISMUTH .................................... ............................... ❑ CHLORIDE • ........................... ............................... ❑- BORON .................... .................... ............................... ❑ CHLORINE ............................ ............................... ❑ CADMIUM .................................... ............................... ❑ COD ................ ......:.... ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ( units) ................. .. .............................. ❑ CHROMIUM Itot.) ............................ ............................... ❑ CYANIDE ............................ ............................... ❑ CHROMIUM (hexavalent) ................................................... ❑ DETERGENT, ANIONIC ............ ............................... . ❑ COBALT .................................... ............................... ❑ FLUORIDE ............................ ............................... ❑ COPPER .................................... ............................... ❑ HARDNESS ............................ ............................... ❑ COLD' ........................................ ............................... ❑ MPN COLIFORM COUNT/ 100 ml ............................... ❑ IRON ........................................ ............................... 211 l' C0 L; FC RM COUNT /100•ml- _ � LEA 0-1-- 'CONFIRMATORY TEST .. ............................... •..... 0 LiTH1UM.... ..... .::. ............................................................ . ❑ NITROGEN, AMMONIA ............................................ ❑�MAGNESIUM ............................................................... ❑ NITROGEN, KJELDAHL ............ ............................... ❑ MANGANESE ............................................................... ❑ NITROGEN, NITRATE ............ ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ....... ............ ❑ NICKEL .............:... ........................................ ............................... ❑ ODOR (units) • ............... ............................... ❑ PALLADIUM ................................ ............................... ❑ OIL & GREASE ........................ ............................... ❑ POTASSIUM ................................ ............................... ❑ pH ( Uri i t S) ...................... ............................... ❑ RHODIUM .................................... ............................... ❑ PHENOL ..............:................. ............................... ❑ SELENIUM . .................................... ............................... ❑ PHOSPHATE (ortho) ................ ............................... ❑ SILICON .................................... ............................... ❑ PHOSPHATE (condensed) ............ ............................... ❑ SILVER ........................................ ............................... ❑ PHOSPHATE (total) ........... ❑ .SODIUM ........................................ ............................... ..... ............................... ❑ SOLIDS. SETTLEABLE, ml /L .... ............................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ............................................. : .......... ❑ ZINC ............................................ .............................. ❑ SOLIDS, DISSOLVED ............. ............................... ❑ .... :.............................................................................. ❑ SOLIDS, TOTAL .....:............... ............................... ❑ .................................................... ............................... ❑ SOLIDS, VOLATILE ................. ............................... ❑ REMARKS:.. :......... ❑SPECIFIC CONDUCTANCE (uhmos /cm) ............... ❑................ Y....... �:.....` r .Z1:�;:`:`:{.1E::��?'1...•.•••• ❑ SULFATE ............................................................ ❑ ............ },�n.•; y�/.. /I ... / .... .... ❑ SULFIDE ............................................................ ❑ .............��:3h:. . •�..:l... �:...d.�?�..11- ��....... ......... . ❑ SULFITE ............................. ............................... 0 .................................................... ............................... ❑ SURFACTANTS ..................... ............................... ❑ .................................................... ............................... ❑ TURBIDITY (NTU) ............... ............................... ❑ .................................................... ............................... THESE RESULTS INDICATE THAT THE WATER WAS OF A _SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. *9 THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY-CHEM- ICAL QUALITY OF THE NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72) FOR THE PARAMETERS TESTED WHEN THE SAMPLE WAS COLLECTED. N/A = not applicable PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE - BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner JV Construction Address Harmony Hill Rd. Located at (Street 4Mdicate oone Hill Rd. Sec. 1 Block 1 Lot nearest cross street) Municipality Patterson Watershed Croton 12' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Lot #1 o e Number CLOCK TIME PERCOLATION PERCOLATION No. Start -Stop apse Time Min. Depth to Water From Ground Surface Start Stop Inches Inches Water Level in Inches Drop in Inches Soil Rate Min. /in drop 1 110 - 40 30 21 24 1/8 3 1/8 9.6 min /in 241 - 11 30 21 24 3 10 min /in 312 - 42 30 21 24 3 101 rain /in 4 5 2 111 - 41 30 21 222 12 20 min /in 242 - 12 30 21 22 3/8 1 3/8 21 min /in 313 - 43 30 21 222 12 20 min /in 3 5 1 _i n -'40 30 241 -10"` 30 21 23 2 15 310 - 40, 30 21 22 7/8 1 7/8 16 4 5 Notes: 1) Tests to be repeated at same depth until a roximatel equal soil rates are obtained at each percolation test hole. All data to e submitted for review. 2) Depth measurements to be made from top of hole. DEPTH G. L. 6t. 12" 18" 24" 30" 36" 42" 48,E 5411 60" 72 :.7811 8411 . I All' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HODS HOLE NO. 1' HOLE INTO. A/0 HOLE N0. Sandy Loam Rock INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTEBa /85 TESTS MADE BY John Eberle Date i /1 DESIGN Soil Rate Used 16 Min/l "Drop: • S.D. Usable Area Provided 5000 No. of Bedrooms 3 Septic Tank Capaci'4 `3 Op 8.e °F Absorption Area Provided By 429 L.F.x2411 x. t i,-th -tr & Address R r) 6 Rte 22 % SF�� Brewster, N.Y. 10509 •'�'� wj ARC E S�NF�` a . THIS SPACE FOR USE BY HEALTH DEPART?41NT ONLY: Soil Rate Approved Sq.'Ft /Gal. Checked by Date THIS IS TO (-F.KTIFY THAT -rME SEWAGE DISP05AL SY5TEM WAS CONSTRUCTED AS INDICATE[) ON THIS PLAN AND TFiA'T- THE SYSTEM WAS INSPECTED UNDER my BEFORE IT WAS COVERED 0,VLI,. -rF-4E 5YS-rEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STMOARD -RULES AND REGULATIONS OF THC- ,PUTNAM COUNJ X.QEPARTMENT OF HEALTH 4,I�jOWUORA I v YORIC OWNER: --'V CONSTRUCT/O/V Co. I HARMONY ROAD PATTE:IZ50N, N.Y. 12563 WdAPDN, POINTS .WELL ib. -t;"3-7" TANK4 15 .D-2 - 53*6" A-i C-3 - 49'87 ,A=4 - 50' 4 A-5 - 52' lo* 0-5 - 47'6' p -'e A-7 0 C. 7,- - 4-8t2" A�8 60' A-9 68-'8" C-9 - 52'10' 0 .d \t-r MOONEY HILL ROAD OADS CPO. SS R BALDWIN & CORNELIUS. P.C. D�Tli- .CONSULTING FNGINEERS-LAI�4DSURVEYORS �f 1 ! .;7 N. Fl;) Yol", TV � r r - LDT 1 AK�y�y ACRES ~ r t •i lam. �.%� �s a , j ✓� + �� ate" �t•,: Y .E G :;Cpjz t 1� vg''X' V 44 °