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HomeMy WebLinkAbout0049DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 1 -1 -93 BOX 1 111' t9m ,%p r . r X1 , 1. F I. , I, 41 -, I I`� I ti r 111' r � _ PUTNAM COUNTY DEPARTMENT OF HEALTH 5017$5 108 DiviowHel Se CERTIFICATE .0F GONSTRUCTIQ COMPLIADJCE FOR -SEWAGE DISPOSAL- SYSTEM P?titt�r�a.n L 9 Town or Village Cross Road Located at � � � �- > - c -,� xTax Map• _ slock� Owne► Tavno'Buder_.s .inc: fi Tax'.Map �t 3uba °(c' -3- v _.: Arthur ,:gurd�ck Brewster, N Separate ;Sewerage Sys-,am built -by Address 1000 500„ L F x 24" wide trench COnilsting .of Gal Septic Tank and Othei requirements Water Supply Public. SUPPIy F.eom X P` F Beal'and Sons Prwate supply Dniled By Address Brewster, NYF, frame. r' Three`'" n $77 ti Building.Type No._ of Bedrooms —_—� bate Permit Issued YeS m ,. FIas�Erosion contiol 138ej Copleted? } certify thatethe syatwals) as „istedservinq the abova':prem: essentially as, shown on the p];ana ofed ises were constructed ahe complet work (copies.-; of which' are attached), ;and "in`accordance.with the'-standards, rules an3 regulations,.in accordance wfth`the filed plan 'and th' p.pfiit Ti sued'by, the Putnam County:Depaztment:.Of Health Z. 9 November_ 1978.: , < PE X R A. Date Cert,fUed by R D 9 Fai r S r: Carmel >, NY 1r0 2= �i 'Address s tense No L 29206 x a L1ny person occupying premises ,;eryed by the apove, systems) shall :prgmptly take sucl+ a�tiori as maybe necgssary tq secU►e the corredton of any unsanitaiy �- conditipns resulting from wch'usage.,,',Approval of the separate'sewer'a`gesyftam'shall become. null °and:void;as soon)as a pucsariitary sewer becomes available' and the `approval of the'.prrvate'water supply shall become,'null and void .when a .pubIi `.water ply beegmes available Such 'approvals are subject,to moditi Lion of change When 'in the, judgmeni.;,ot the Comm _ r ner ot" Health such re cstion modification or :change'i ;.necessary` rA � I 3 4 V WV Date 8Y' Titb a i. 1044k"MTFATIM R9PQFIT • e"TNAM COUNTY DEPARTMENT 00: J?RA� W71 _ Division of Envirpnmental. Haolth Sefillooa COUNTY OFFICE BUILDINQ - CARMEL, NEW :YORK . Th111 rappr8 14 14 00 pornplated by Woll driller and submitted to County Health Department together with lghoratory report of $nQjV §1q A? Wqi�QT tiampie indicating water is of satisfactory bacterial quality before certificate of construction ggrr pliRncg.jq Illygd, REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL CQMPLETION 6Ah1A ADDRk33 DvON Tavino Builders, Inc. IDeans Corners,. Brewster;.:NY..,1.0509 ... 6OCATIOtJ .. "04A . trasU l 4tYn (tat NymOer of VVIVA Cross Rd, , Pataerson, . NY 3 PROPOSIR f1USikE$S t ;J �0+4�1=?iiS r ;iTA t ISHMEhI> (�'j 1--J FARA ❑ €4T tr .. psi OP �AENd ❑ ❑ IPIPUSTRIA4 AIR OTHER s ❑ ,SUPPLY• l�i C(JNDIi1QNiid(3 {&p9dfy) . . AItltllfdfil 11 Q COMPRESSED R.QTARV CABLE OTHER ❑ EAUIPME.NT LXi AIR PERCUSSION ?ERCUS$IOt4 (Specify) CASINO (,4119TH (tofu ' ." DIA?arTER(Inchga) WE1QtIT rEti Foor (� TyREADEDr ❑ YE$ t30 INq t9 T�1it 3 ( 1 lb S . '^ °+ INRLDED Y99 . L� J F49 Yf:Lt! ((--�� : ((�'� HAURS G.P.M, . . ❑ COMPRESSED '7t.:. YifLD (R.P.r}f,1 TE" t_:.l OARF,A , i�-i QUMPEb AIR ( . 7+ WATER (�pkpo.R FRO)A I414A eiU 44C - ST411C($PP40y foot) OURINQ: YIELO TEST [tool) f Depth of Completed Well l 20 9 in feet tyelow Land aurfpcq� .2151 LI;NOTd QPE N TO BAUI(i s ((9911 - sctass;d ' psTAlt$ ?4AT 0174. pIA*CTER (InQhf; � IP GRAVEI, 08AyEt &iZE (ncttoa) FROkt ((gvI) iP (foffl pipmetor of well inclvdlnp PACKED1 gravel pock (Inches): OffTH FEOm LAND SURFACE " fORMATIQI�I RESCRIMPN Sketch exact fOCPUon Of well wlth Q /sfsnt es, l0 6.1 1914f 1 two permangnt landmarks, FEET to FE @T Dril1 3L in :.overburden - 0 10 . E 4 :. ck at '10 feet Drilling.. i•n..rock -.set Ca sing U outed. t __._....__ .. __. _.._.. _ ".... -- -- " - ._ __ 30 Dr 11 i an:'rock- schist .. -------- - - -.." ..... "_. - -... _ _ 8: BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 4.279 SOURCE: Tavino Builders hose Bibb -well :Fairview Acres ;_,ot 3 Cross Rd. Patterson, Fj,Y. COLLECTED: April 2 ,1 9 7 9, BY: P . n . Bea?. & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This rrtult indicates thr source of thr rample wai of ratirfactery sanitary quality when thi sample war collected. 0 per 100 ml. April 6, 1 9 7 9, Bickwit P. E. Director PUTNAM COUNTY DEPARTMENT ,OF HEALTH_ Division of Enwronmental. Health Services Carmel `N._ Y 10512 CONSTR_UCTIO PERMIT FOR SE1lVAGE :DISPOSAL SYSTEW ..Patterson r Town or Village i Cross ross Road T C axLmap z Block 1 i Fair -Acres 3 fob SA `1765 it Subdiv ision Lot Owner Raynor zenecker. Address Crass dad Frame 5038 Sd_ Ft P­` tterson NY Building Type Lot Area - } Three 600:G61 Da 1512 Number of Bedrooms Deslgn Flow y Total' Habitable Space' Square Feet _ . 1A00 1,14 .1 T . Separate Sewerage`System to consist of Gal Septic, Tank = and : 500, 1; Fi'_II'.W1 de •.Trench _t To be constructed by Address _ water Supply." Public Supply .From i > X Private 7SuPPIY to be drilled by ;,. 1 Address Other R60,urements ° . a . - - I'ripr6siiniAhit-I am wholly and completelY`iesponsitile -for the design and location of the proposed, system(s) l) that the separate sewage 'disposal system j "above descr�bed`will be constructed as shown on the approved amendment thereao and in accordance with the'standards, rules an regulations o t he u Hain a.H County Department of Health, and that on eonipie4�on.tnereof a Cert�ficafe of Construction" Compliance satisfactory to the`Commis "sinner of .Healthwill be subm�tt'ed' to the ",Department,. and a written''guarantee will be furnished, the owner his successors, hejrs or'assignsby the builder'ahat said builder will F } place m good operating'condition' any ;part of -said sewage disposal system dunng' the Per iod'of two (2 'art immediately fo_flowing thedate'of the issu ' ante of 'the, approval.-of the Certificate,of" Construction Compliance of`,fl e`originalsystern or 'any repairs tnereto 2) thatthe,.Willed well described`;above will be located as shown on the approved plan:and that said well will be Installed 'm accordance with the' stand s rules and reguiaa ons of the Putnam County _Dep4rtment.of Health. Date 3August 1977:: Signed P:E._ .R A Address -RD6: BOX 353. Cdr ' Y 1051 :' L6nse l'vo. 2g- A00R6VED FOR CONSTRUCTION This approvaL_expires one. y m fhe date issued .u�les construction 'of the building has been undertaken and' is- revocable for cause, or may be amended or modified when consid_ necessary by the`Commi o er, of Healthc Any change'oc alteration of construction requires `a; new perms Approve .for disposal of domest�e, ita s age antl nvat w d pply only. Date By' Titl e ie PUTNAM COUNTY DEPARTMENT OF I RIALTH DIVISION. OF ENVIROWYEDITAL 111,ALTII SERVICES COUNTY OFFICE PUTLDING, CARIM ?L,, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM. FILE NO. Owner rv�� r Address ?**_AA Located at (Street Z� Block Lot�,r off° 9J n i.ca -e nearest cross s r e Watershed G_.0'G� Municipality. �dl'�,/s or► .. SOIL PERCOLATION TEST DATA REOUIRED TO BE SUBMITTED WITH APPLICATIONS 3 JIM / ?A /9 L� / Notes: 1) Tests to be repeated at same depth'u.ntil ap.Proximatel 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. o e Number CLOCK TIME PERCOLATION PERCOLATION Run No.. Start -Stop Elapse Time Min. Depth. to va ter From Ground Surface Start Stop Inches Inches Water ve in Inches Drop in Inches Soil Rate Min. /in drop 2 /0 NZ l 4 /wf 5 1,7,0 ao ¢ /Z 2 3 JIM / ?A /9 L� / Notes: 1) Tests to be repeated at same depth'u.ntil ap.Proximatel 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 DE SU13MITTED 1419'}{ APPL.ICA`.I'ION DESCRIMON 01 SO1"L:0' IN '' EST HOI � S DEPTH HOLE. NO. � HOLE N0. `,, HOLE NO. G.L. of 6" �� 4'hits 12" 18u L /. 24" 30, G�It 361 4211— 48�� 54 66 72„ 78,; 84" Lec.7,c,E . • INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED /1Io�P INDICATE .LEVEL TO. WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED Alo.;e TESTS 14ADE BY PmA f��?T�L�P f�� .e. (✓.tee.) Date �j >> �� DESIGN Soil Rate Used�Min/l Drop: S.D.' UsaUle Area Provided lDOeu No. of Bedrooms 7;�~ Septic Tank Capacity OG O Gals. Type. Absorption Area Provided By L. F. x24" A 3b width trenc Other Non e ame i;na ure Address R.N 6,00X 353 sio �. ti .�'y .1.� N PREVp������ THIS SPACE FOR USE BY BEAD.PH DEPARTKEAT 014 Soil Rate Approved Sq. Ft /Cal. IA Zi OI �Oc I-0 a -7