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Home My WebLink About0278DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 11 -1 -10 BOX 4 . : }�� . }Ji t 'T. ' INN e"' IN I 0' A WE r T I NMI . , f 4 L i IP "I MEN :OF .HEALTH v R-4 3 = 8 4 f Jth _:Services, _Cain% N ;Y 10512 IAG,E DISPOSAL °SYSTEM Pat;tel"SO11 (T� Town .or= 'Village Taz `IViap Block: Buing Type Si 60 1 e F a'1111 1 y No, of Bedrooms ' `4 ild Has Erosion Control •Been, Completed? ye'S� OF Nfy syP('ORl V 1p.cer'tify' that the system(s) as listed serving the above premises were constructed res iaf ,zrs sh attached),'and in accordance with .the standards rules and regulations, plans fil ` n e "m V March 11 , '1QBri` Cert�f�ei9 by Date � Address K a' dh A v e t a °. Any person occupying premises served by the above`system(s) shall promptly take a�► conditions resulting' from,,such usage Approval of the separate sewerage system available and the" approval of, the „private water supply shall become null and Joid whe &lQ iub)ect to modification or change -when, an,the`'JudgmenY:of the,Commissioner, of HeaIt , Date Permit I ssueda5 / 1 J 84 _ �p n v-t Arco °mil �wqt* (cppies of w m hich are W, VT hB y' st f ent of Healtfi'. _ PE X RA 77777777'� ° Y 0 � � Ucense No. � gpe r}y to seel Ig tDp corfection of any unsanitary - pate^ �:� ^, gym TdIF 71 if WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3)71 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 NAME Lorraine Paterno Xavier ADDRESS OWNER Orlando Xavier 24 Parsons St. Harrison, N.Y. 10528 LOCATION (No. 6 Street) (Town) (lot Number) OF WELL Cushman Road Patterson im BUSINESS ❑ El ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ SUPPLY ❑ INDUSTRIAL ❑ ❑ Specify) CONDITIONING DRILLING • COMPRESSED ❑ ROTARY AIR PERCUSSION E] El OTHER EQUIPMENT P RCLUSSION ) CASING LENGTH (test) DIAMETER(Inches) 7.19 HT PER FOOT Ri ❑ O I I X1 ❑ t`A�TR- TYES DETAILS 195 6 THREADED WELDED YES NO NO YIELD TEST HOURS G.P.M. 11 BAILED ❑ PUMPED ® YIELD (G.P.M.) COMPRESSED AIR 12 WATER MEASURE FROM LAND SURFACE — STATIC(Specifyfeet) DURING YIELD TEST J' lest) Depth of Completed Well LEVEL 10 Total Drawdown in feet below land surface: 505 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (Inches) FROM (lest) TO (lest) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Skefch exact location of well with distances, 'to of least two landmarks. FEET to FEET permanent 0 15 clay overburden Of NEW YO 15 180 sandstone 180 201 white limestone 201 brown seam 201 230 white limestone 230 300 dark blue limestone 300 505 same ORE C-1 If yield was tested at different depths during drilling, list below o. 51`Zy� pROFESS10NP' FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) 9 -8 -84 10 -12 -84 Lorraine Paterno Owner or Purchaser of Building Lorraine Paterno Building Constructed by Cushman Road Location - Street Patterson (T) Municipality Section Block Lot Ludemann Subdivision Subdivision Name. Single- Family #5 Building Type Subdv. Lot # GUARANTEE 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 standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his success- ors, 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.determin- ation of the Director of the Division of Environmental Health Services of the Putnam County Department.of Health as to whether or not the fail - ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. C GS os I e � Dated this 11 day of March 1985 Signature � F!c� tc. Title owner Corporation Name if corp. c/o Putnam Iron Works, Inc. Address P.O. Box 401, Brewster, N.Y.' 10509 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE1REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION 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 ORKTOWN MEDICAL LABORATORY INC: ' P.O. 8oz 99 321 Kear Street Yorktown Heights, N.Y. 10598 245 -3203 F L ��- 6iI► LOCATIONS: ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737.8777 ❑ 495 MAIN ST., MT. KISCO, N.Y. 10549 666.3335 ❑ STONELEIGH AVE. (NEAR HOSPITAL), CARMEL, N. Y. 10512 278.9: LABORATORY REPORT mg /L LAB # C _3 .3 DATE TAKEN: — �� DATE RECEIVED: DATE REPORTED- SAMPLE SOURCE: A � REFERRED BY: COLLECTED BY: ❑ ACIDITY ............. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ....... _ ... ❑ ANTIMONY ............................................................... t1ACTERIA, TOTAL /mL ...........I .................. ❑ ARSENIC BOD, 5 DAY ........................................... .t• ..... ❑ BARIUM .... ................................ ............................... ❑ BROMIDE ................... ......... :....,................ ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE ...... .................... ❑ BISMUTH ........... ............................... ..................... ❑ CHLORIDE ................... ............................... ❑ BORON ........................................ ............................... ❑ CHLORINE ................... ............................... ❑ CADMIUM .................................... ............................... ❑ COD .: ......................... ............................... ❑ CALCIUM .................................... ............................... ❑ COLOR ........................................................ ❑ CHROMIUM Itot.) ...................... ...... ............................... ❑ CYANIDE .................. ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ... ............................... ❑ COBALT ...... .......................... ............................... ❑ FLUORIDE ................... ............................... O COPPER .................................... ...... ... ...................... ❑ HARDNESS ................................. :................ ❑ COLD ........................................ ............................... ❑ MPN COLIFORM COUNT/ 100 ml ....... .......... ❑ IRON ....... ............................. ............................... T COLIFORM COUNT/ 100 ml ..... . ......... ❑ LEAD ............. ............................... CONFIRMATORY TEST ... ................. ............... ❑ LITHIUM .................................... ............................... ❑ NITROGEN, AMMONIA ... ............................... ❑ MAGNESIUM ❑ NITROGEN, KJELDAHL ... ............................... ❑ MANGANESE ................................. .............................". ❑ NITROGEN, NITRATE ... ............................... ❑ MERCURY ... .........:...... :.............. ............................... ❑ NITROGEN, ORGANIC ... .................a............. ❑ NICKEL ....................:............... ............................... ❑ ODOR ......... ❑ PALLADIUM ................... .............. ............................... ............. ............................... ❑ OIL & GREASE ............... ............................... ❑ POTASSIUM ......... ....................... ............................... ❑ PH ........................... ............................... ❑ RHODIUM ........................: ........... ............................... ❑ PHENOL ....................... ............................... ❑ SELENIUM .......................... ................. ............... ...... ❑ PHOSPHATE (ortho) ...... ............................... ❑ SILICON .................................... ............................... OPHOSPHATE (condensed) ... .....y .:.....:...:..:.......... ❑ SILVER ❑ PHOSPHATE (total) .... .......... ................ ❑ SODIUM ........................................ ............................... ❑ SOLIDS, SETTLEABLE; in1 /L .......................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ........... ..:.................... O ZINC ......... ............................... .... ............................... ❑ SOLIDS. DISSOLVED ❑ :................................................................................... ❑ SOLIDS, TOTAL t...... ............. ❑ .................................................... ............................... .... .......... ❑ SOLIDS, VOLATILE ::........... ❑REMARKS .. .......... ......O SPECIFIC CONDUCTANCE ................. ❑ SULFATE ................... ............................... ❑ ..... x4......... ^... ' '� :;. .. ... "�.. O SULFIDE .................... ............................... ❑ .........b lam... �),, .�......� ........................... ❑ SULFITE ......................... ❑ �.. ..... .. ............ ................. ❑ SURFACTANTS ........................................... ❑ ............................:....................... ............................... ❑ TURBIDITY ................ ............................... ❑ .............. ................. ............................ ... _._ ......... THESE RESULTS INDICATE THAT THE WATER WAS vjP OF A SATISFACTORY SANITARY.QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFA TORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & RECU TIONS, DRIN C W •R STANDARDS (PART FOR THE PARAMETERS TESTED. 47 :df-�, Envir6nmentiil. Health Services, 'N. Ila Block Ma —Lorraine .'Patern6 A-- rewsrer, MY 7 1,0509 'A dress Water,.SLiOplyl. Public Supply From x Private.'Supply to be drilled by Torlish County 'Departryient � of Health, and that on porripletion thereof a ertificate of n ion Ila h nei of Healihwili 6e submitted to the Depahi�ent, and% a wrlti�n,`guiiiinte'e -will be_J�irriished the wn I& aUC r n!�V or igns by the builder . 'thit, iai4 "ilder will ance. of 'the approval of Ahe Certificate. of:Constr6ction Compliance "of-'Mi i rs t �at'the diffled well iieicrlbe� ab will'be located as shown on'tlie approved 'plan and ihat"said well:will be' initillid cc danc n I S, u s.,an regulations Putnam County, Department of, Health. 23 i484�i, Al me R CONSTRUCTION: This app I one year from the date I . ssued ctio - n -of has been. u fidertaken an m —b e- I change or alteration of con revocable for cause-or ay ,.e-:a-m'' nded or modified when nsi ed p� y by �6e C6Mrnl h siruction ejessa� mm !9n6 of Healt Any requires a ne �Qropecl for disposal of dome c an>ft jsew�q��and private te ply only. Date By Title, ` ^ 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 N0. Owner Lorraine. Paterno Address Located at (Street Cushman Road Sec. Block Lot Sub. #k5 �Indlcate neares cross street) Municipality Patterson' (T) Watershed New York City SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS ... ALL TEST HOLES WERE PRESOAKED PRIOR TO RUNNING TESTS .., Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse D_eptft 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 2:12/2:23 11 18 21 3 4 2 2:24/2:.36 12 18 21 3 4 3 2:37/2 :48 11 17 20 3 4 5 0 1 1:50/2:03 13 19. 22 3 4 2 2:04/2:15 11 18 21 3 4 3 2:16/2:28 12 17 20 3 4 4 5 1 2:27/2:41 14 18 21 3 .5 2 2:42/2 :58 16 17 20. 3 .5 3 2:59/3:14 15 17 20 3 .5 4 5 Notes: 1) Tests 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. 'Name-S-alvatore V. Riina, P.E. Signature Address 186 Katonah Avenue is xafnnah, New York 10536 THIS TEST PIT DATA REQUIRED TO•BE SUBMITTED WITH APPLICATION BY HEALTH DEPARTMENT ONLY: DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DeepTest DEPTH HOLE NO.- 1 HOLE NO. 2 HOLE NO. 3 Hole G.L. Blk. organic Blk. organic Blk. organ. Blk. organ 611 topsoil Vtopsoil Vtopsoil topsoil 1211 sandy loam sandy loam sandy loam. sandy loam 1811- subsoils subsoils subsoils subsoils 2411 3011 36 rr 4211 4811 54. 60 6611 72 78" 8411 ... NO GROUND WATER OR RUCK -LEI)GE KNCM NTERE INDICATE LEVEL AT =H GROUND WATER IS ENCOUNTERED NONE ' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NONE TESTS MADE BY Salvatore V..,Riina, P.E. Date April 9, 1984. DESIGN Soil Rate Usedo 5 MWl'.Drop:: S.D. Usable Area Provided 5','000 sq.ft.+ No. of Bedrooms 4 Septic Tank Capacity 1200 Ga mAonry M Absorption Area Provided By 333 L.F.x24" 9—j6' �- OF N t �a-on�ry enc c E 0 none 'Name-S-alvatore V. Riina, P.E. Signature Address 186 Katonah Avenue is xafnnah, New York 10536 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved - . Sq. Ft/Cal. Checked by I Date A y , - P 5 Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date April 17, 1984. Re: Property of Lorraine Paterno Located,at Cushman Road Section Block Lot 5 This letter is to authorize * =._ . Salvatore V. Riina, P.E. a duly licensed professional engineer_ X or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all nece$sary papers on my behalf in LU1l1ICltLiU1J w-LLI1 Lllis maLLev aria to. SUpeI•ViSe Lne construction of Said 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 Signe d 42tQ C�r..2. rJ Owner of Property Countersigne Qp P.E., 2XA-;c :�511251 186 Katonah Avenue Address . Katonah, New York 10536 X32 -7408 Telephone c/o Putnam Iron Works, Inc. Address Old Mine Road, P.O. Box 401 Rr q4*°- New York 10509 PZ p R c V. R� r+ �. pROFESS��P,,r SCALE /' =ZO"U "'HUR/ZONT.4 L• ... � ... L.a. 16 IRS� ,. � i � 7 � p' - ' j //� .', � � , . 730 "�.+.►.,�,,,� j . Food n i' cEw� " - nrscHe.�s f • rob 77e J0 /v loo:`o /200 : GdL. G�CJ.(!C j 6 sr Putnam L'ounty:Department of HealtL Division of Environmental Health Servicd. k 1; /j Approved ac noted for conforreanoe with sg cable P ca d .. °.egolaticns of the ?u ua:,t Hea th Department. rx ansturr• In DAtA c 6 u s. e ERi r:_i:o r tiST/(1L - "F 'ERCOLAT /ON TEST RESULT =.I "LJRUP /.'✓ MINUTES 20 FT. Pd'n,', ?:LVI FROI.�CJ(?FE� �?.�/(7 F /EL ✓; t- "_L L. C,.1N C./T;'UN_S } EEI- TEST FOR ROCK OR WATER = _ _, -_ ___�. .AWAA /MUM, L -Nv I-H ('F S; N� Lf !r< rC NQNQ _ o BE !NS.' ] L! EU _ FT /Fn`RArE_LQO GALS PER 'S.rPET1l7AY. MA /NTA /n %,A::nr,q:'N':. VI HO.K /C?rvTgc SPfi, ?, {A�•J /J C'F iDl=T pEF "4 ?F_` _. `., ., .. -._ -. t i -S 'OTES 4 377.0 /- `i { � 1 { sIoo�_ I.o,�'a-ri O W V,&TA -.1 x I. Y >" RE!?COLgT /ON TEST RESULT / "OROI� /N •r M /NOTES. OEEP TEST . FOR`ROCK OAI WATER •_ - � MD Nb >PLICO RATE= / QOGALS, 'PEF? SF. PER DAY, Wl.MUM 300.GALS. PER S.F. FkR DAY. PT /C TANK. CDES /GNAPACITY= NQ SCO.RO,OMS x 300 GALS. GALS. TA,G L /NEAL FT. OF TRENCH - L: F. rA/!EN FR TABLE LAST'QE'V/SEo BULLET /Al SAAZ` 9A3ED ON PERC TEST 'N/NtgA4 TRENCH OEPTF/ =.P4,, r,;ikCN W/OTH - Z4'. .+...+.dr.n., ...r. ,.c rn uc rn•i.cTCIICTFn nc Q ",vGIOFARATED f- z V�.y / LJUWC-TI r-4 P7ox :�, I '0 S)1 ®1,4� ,. O / a I.No LEG ENO " DEEP TEST P/ T „��^ ,.^ • PERCOLATION TEST h'OLE 00 Pr AflAlIMUAf i MAX /MUA,f AAtD FIELDS. 60 FT. J4g4t F /LL COND /T /OHS MA /NTA /N A MINIMUM HORIZONTAL SEPARAT ION OF /O FT ,y!'`aDEPTH OF FILL TO BE /NSr4LLED FT. FA'CA4 ALL PROPi{'RT>'LINES, TREES AND WATER SERVICE DATE OF FILL /NSTALLAT /ON LINES. i r SEPT /C SYSTEM INSTALLED WHERE CURTAIN DRAINS ARE EMPLOYED THEY MUST BE A IN F /LLED AREAS F /LL MUST EXTEND /S FT. MIN /MUM DI.ST,SI,I/CE,,OF IS'FROM ABSORPTION FIEL OS. BEYOND THE LIMITS OFp /SPOSAL AREA, MA 1N7AIN A NlW, /MUM DISTANCE OF /00 FT FROM ALL GAPER FI[ L TO EX /STING GRADE ON 3:I SLOPF BROOKS, MARSH 41 ANDS OR OF°EIV WATER COURSES, TOAI AID lI S4OpE)5 FT, FROM ENDS TRENCHES