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HomeMy WebLinkAbout0191DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 4.10 -1 -31 BOX 3 so Is or y. ra i • �. t ti. Li r } 00191 x � PiJTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIItONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION CO�M�- P-LIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # U 9 PLocated at Town or Village ' Ae Owner /Applicant Name tc.c v,42� Ca kLI Tax Map Vld Block I —Lot-y/ Formerly 1"t-subdivision Name Subd. Lot # Mailing Address PATU;�,-rlvN Zip Date Construction Permit Issued by PCHD-,. 7 /xi 6h Separate Sewerage _System built by - s � Address !f Z • ZS3j Consisting -of /2-63 Gallon Septic Tank and 66lc Other Requirements: Water Supply: Public Supply From Address orb: A- Private Supply Drilled bye Address���^' Building Type k-0 a p Has erosion control been completed? Number of Bedrooms Has garbage grinder been installed? /la I certify that the system(s), as listed, serving the above .premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: _ Certified bye - g r / . t..� rA,rtg P.E. <r- R.A. c� `/ Tesig Professional) Address / �' % °nf Cr`rdd� / /t g i License # 9 - I 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 sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals ar bject to modification or change when, in the judgment of the Public Health Director, such revocation o icatio hange is necessary. By: Title: Date: l6 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 y 1C MIAAIMiP�NeM1M. A AYAAe MI PN A+.MI 11 ® hill I S� N m a NO V) M OD F_ N O m t, Z w I w Q w U n b 4 •�{?II1Y[COQ1!l��AisS f /ini ftAlbo lAw`ewtolddauassawk u.Cawnt.N.T. V= =Wi =STOW Rev. 10%88 N6n onQlnrxM lhlfwYr NOW OwaselAffintlfan Mf IT _ x=wiVL_D slur. r3 DaoD6.41tlpaMwp d/lMpr 20 WOOWA.t Date Subdivision Aovroved i EIA Enclosed Amrnnr 300 *AM. Ty.. Wtloa tae w6.4► 972 SI? MUM ula ORgh Dg11 v411Ra1. Howb4K or D..AV flow G l 0 - J'0 FM Noolftmou b Supdr d Wbw pa b omgkud SapMdo Srwu p Slnrr6 M soma Rr %?fin'bw sera Mwk .A TV~ L co-ca'—c- A;k/o � Ti iw eaoaa6�pat id anl. Warr Said ld& Sofro Pt Ad+ltle6 �-. - '^ ✓ "' 5 os b DdWd by Oda 1 rwpraaet 061 1 am wholov MW oew4ewtay roan, Belo for tM aM ttlaraoa/ and 6-91— of Ma praODMd MM-(p4 1) that the t w w7 pa �r400006"d d a shoed ow w a obad M Accorearroe waft go atordarol. �w y ONMte MI of "Wits% awe tfto. towpMbw a Corillbat f rab i Yi%w/ a / isp�e,a'al � oYilwtonieF h CawtMMOiow G—WW -" oatodaottxy to the Coaww41a11ofta► of Maaltftwo M +lwrwrOW to too o4owtw -- . and a wrRtow pa►antao wi4 a f�lfa/aftad tia owar. 1416 wloeow % &A*$ M ~a ry tM WNW. that Lid otYldor will 06109 M good eWagq owoltaow ally fort of mid oawaga Wp-" WWW" during tM go"d M two ill yore YwawMLtMy fe11pw11y tMOato d tin fwla awn of too atlp,w,N 4N 11,a CoRlti6ato d C4w4Rh4aQtow Cpw01 M tM plg' ,>ti or •any b tllaNRO= Zi t14aR tM dN116e ,tall dMitpptead i004.a wbl N located at.afr— ew too aoerawN Nap sag Iftat sold wNI wool II,d M waft 16 ruwa and nWTii 44 of the p4Awawm Casty Oapwtmom of w4enk Wtse 9/Ki S»'yd V.E. APPROVED FOR CONSTRUCTI000:Tftkago ► ew4a ir"twe a fr tM dot. hK" uwleo$ cloNfucAft of tM tw4iftwM he$ Mon NeOOabMaw Sod is r4waoabM for oa.r - way a aw nCled or owilltW warn cow . e l►a Conuwiaaiowar or loo6hft. Awy u4a44fo ea aRwatio4l of eoihEr4letloa r wi-1 a -ft. ApWo4od for di"waal of dowwak lanawy . ono aumov ally. oat* 00010 y Tltoo ,Julius I. Cesare,.P.E. 19 Washington Court Pawling, New York 12564 914- 855 -3208 FAX 914 -855 -3216 Aug. 8, 2000 Bruce Foley, Director Putnam County Health Department ATT : Robert Morris 1 Geneva Road Brewster, New York 10509 RE: Quaker Manor Lot 7 As -built t. of Patterson TM # 4.101 -31 Dear Mr. Foley, Herewith transmitted is a completed As -Built Package for the above noted project. Thank you for your cooperation. Very tru y yours, Julius I. Cesare, P.E. BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: 7c4 V m 2- Y L- e(5bjcAn TAX MAP NUMBER: 41--do f E911 ADDRESS: 2 0 Q L4 Ui L e.� A iii vL o y Z ei n 2 TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) DATE: 63 Zoov The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFRM Ed rw c r:• an lrV � FW Y0 DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH l DWELL LOCATION STREET AOURESS: TOWNIVILLJuiCily TAX GRIO NUMSER: so. QuHKER N�GL PRrrFR.So�I ,t�,qP� g �, .co r# / WELL OWNER NAME m/� ADDRESS: t-oFT eo�tsiP Tiorl gOOSE R- - 3eEW57-E-2 5i'PBIVATE O PUBLIC USE OF WELL 1 - primary 2 - secondary 0 RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /CONO. /HEAT PUMP O ABANDONED O BUSINESS ❑ FARM ❑ TEST/OBSERVATION O OTHER (specify) O INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm.1NO. PEOPL'E.SERVED -S / EST. OF DAILY USAGE gal. REASON FOR DRILLING XNEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / 08SERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH __L"5 ft. I STATIC WATER LEVEL ft. IDATEMEASURED DRILLING EQUIPMENT O ROTARY COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE O SCREENED O OPEN ENO CASING. ,'OPEN HOLE IN BEDROCK ❑ OTHER . TOTAL LENGTH ; �_ ft. MATERIALS: ZSTEEL O PLASTIC ❑ OTHER CASING LENGTH.BELOW GRADE ft. JOINTS: O WELDED ''THREADED ❑ OTHER DETAILS DIAMETER in. SEAL:.i9CEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT Ib. /tt. DRIVE SHOE- P1YES ONO LINER:O YES 1ZN0 SCREEN DETAILS OIAMETER (In) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ONO HOURS SECOND GRAVEL PACK o YES O NO GRAVEL SIZE DIAMETER OF PACK 1n.1 TOP DEPTH tL BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping METHOD: O PUMPED tests were done is in- COMPRESSED AIR �� formation attached? O BAILED [3 OTHER ; ®-YES O NO 'WELL LQ It more detailed tormztian descriptions or sieve analyses LOG are available. please attach. DEPTH FROM SURFACE Water ecir. ing we►I Dia- meta FORMATION DESCRIPTION C30E IL IL WELL DEPTH ft. DURATION hr. min. ORAWOOWN It. YIELD gpm. Land (7L A ic19 Sct/is r To?-AL- 1 1 Y fie�9GTU.eES: �a = 5 WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES ONO STORAGE TANK: TYPE CAPACITY GAL. PUMP INFORMATION TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE HP WELL DRILLER NAME 4% qb .4,e7 ;f�,,q U zjEz_L CIO, Z-A/(f OAT , ADDRESS `UCJTE 'ESL SIGiIATURE [� -30 /r -� j�' I'G ��l t d1).- S- -'�1911� v x YML ENVIRONMENTAL SERVICES 321 Kear.Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 93.001083 CLIENT #: 12368 NON STAT PROC PAGE 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COBDEN, TURNER 231 TOWNERS RD. CARMEL, NY 10512 DATE/TIME TAKEN: 07/12/00 07:00P DATE/TIME REC'D: 07/13/00 09:00A REPORT DATE: 07/18/00 PHONE: (914)-228-1064 SAMPLING SITE: 26 QUAKER MANOR LANE SAMPLE TYPE—: POTABLE : PATTERSON, NY PRESERVATIVES: NONE COL'D BY: TURNER COBDEN TEMPERATURE..: < 4C NOTES...: TANK COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHTBE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L ' MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) ` C~~~' SUBMITTED BY---~=-- Albert H. Padovani, M.T.(ASCP) Director ELAP# 10323 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padoyani, Director LAB #: 93.001083 CLIENT #: 12368 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COBDEN, TURNER 231 TOWNERS RD. CARMEL, NY 10512 DATE/TIME TAKEN: 07/12/00 07:00P DATE/TIME REC'D: 07/13/00 09:00A REPORT DATE: 07/18/00 PHONE: (914)-228-1064 SAMPLING SITE: 26 QUAKER MANOR LANE SAMPLE TYPE..: POTABLE : PATTERSON, NY PRESERVATIVES: NONE COL`D BY: TURNER COBDEN TEMPERATURE..: < 4C NOTES...: TANK COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 07/13/00 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 07/13/00 LEAD (IMS) <1 ppb 0-15 ppb 9101 07/13/00 NITRATE NITROG 2.74 MG/L 0 - 10 9139 07/13/00 NITRITE NITROG <0.01 MG/L N/A 9146 07/13/00 IRON (Fe) <0.060 MG/L 0-0.3 mg/l 2037 07/13/00 MANGANESE (Mn) <0.010 MG/L 0-0.3 mg/l 2037 07/13/00 SODIUM (Na) 3.02 MG/L N/A 07/13/00 pH 5.5 UNITS 6.5-8.5 9043 07/13/00 HARDNESG,TOTAL 52.0 MG/L N/A 07/13/00 ALKALINITY (AS 16.0 MG/L N/A 07/13/00 TURBIDITY (TUR <1 NTU 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WAT (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. PUTNAM COUNTY DETARTIVIE F Oli 1­1EIAL "I -I-I DIVISION OF ENVIRONMENTAL I-II AL'm SERVICES GUARANTEE. OF SUBSURFACE SEWAGE TREATMENT SYSTEM C1 �4y Owner o: Purchaser of Building Building Constructed by location - Street Building Type L1. ( © - - -- _4_ s Tax Map Block 1,01, ";�PAWC,� — TownNillage v C1 Q-4— 0-,e\0 (f— Subdivision Name Subdivision Lot # 1 represent that I am wholly and completely responsible for the location, workmanship, material; construction. and drainage of the sewage treatment system serving the above- described property, and tinat is 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 guarantee to the owner, his successors, heirs or assigns; to place in good operating condition My Hart of said system constructed by me which fails to operate for a period of tivo years iilmediately following the date of approval of the `Certificate of Construction Compliance" for the �e vage treatment system, or any repairs made by me to such system, except where the failure to eperate properly is caused by the willful or negligent act of the occupant of the building utilizing the rystem. ?he undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system D operate was caused by the willfiil or negligent act of the occupant of the building utilizing the ,vstem. ?ated: Month Day Signature: —Day Title: ieneral Contractor (Owner) - Signature – �C_/L'7 � �� i S � cc� � ACC /4,. -:� ��a.• .orporation Name (if corporation) Corporation Name (if corporation) �ddres�: Address: 'late ----- ...l.ip._... - - - - -- State .---------- Zip � -� ,, � Form US -97 W. J. T & Marg 26 Qua Patter Toi Qua r � k o� h TABLE OF DISTANCES AS -BUILT LOT #7 Pt. M is on corner Property Line Between Lots 6 & 7 @ East Property Line of Common Driveway (Quaker Manor Lane) Pt. N is Iron Pin on Property Line Between Lots 6 & 7 600 feet from Point M. Pt. 0 is on Property Line Between Lots 6 & 7 700 feet from Pt. M. OA 112 OE 92 OD' 74 OH 82 OH' 126 NA 160 NE 154 ND 82 NH 75 NH' 36 R - Septic Tan PR 15 OB 107 OC 102 OD 97 OA' 92 OBI 86 OC' 80 OE' 68 OF 93 OG 88 OI 76 OF' 134 OG' 130 OI' 122 OJ 66 NB 156 NC 156 ND 155 NA' 89 NB' 86 NC' 83 NE' 78 NF 82 NG 78 NI 72 NF' 48 NG' 42 NI' 30 NJ 73 Tank S - Pump Pit PS 132 IQR 50 QS 130 a ,o A Scale 1 "= 100' °M OLAYiTi�MIT M^ r N29°e '40'W a a �0 4� M1 9a. 1� U� N ° 0 R= 325.0' a : n8 °44'i8 L °a %.Go' 295.74' r.% n i� .,- kea a - �J i I S pump 1U .�n o� a� ? TABLE OF DISTANCES AS -BUILT LO Pt. M is on corner Property Li Property Line of Common Drivewa Pt. N is Iron Pin on Property from Point M. Pt. 0 is on Property Line Betw Pt. M. OA 112 OB 107 OE 92 OA 92 OD' 74 OE' 68 OH 82 OI 76 OH' 126 01' 122 NA 160 NB 156 NE 154 NA' 89 ND' 82 NE' 78 NH 75 NI 72 NH' 36 NI' 30 R - Septic Tank PR 15 PS 132 0 0 0; U 0. Nt N: N: N] N. Ma