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HomeMy WebLinkAbout0317DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -2 -16 BOX 4 iI Ll L Tr- •' ,�1 K I am I 1 1 ,, , . . 00126 PU.TNAM COUNTY Division of Environmen6l..,H CERTIFICATE OF_.CONST,RUCTION : MPLIANCE FOR.:SE TMENT QF HEALTH - , t wrces, Cairn% N Y 10512 Permit q'_ DISPOSAL, SYSTEM Patterson .,,+ales etIM1+M��I� E fe�tq n�rM� r i"1 iIAI" vv- yYJ / Divi4ion ot' Environmental Health Qorviaee COUNTY OFFICE, PUILDINO - CAHMOL, NEW YG This rppon Ill tq•bp mmplmol by well drlllAr and iiibi> 10*4 to C.oynty "Wth Department topther with lotbrotiery ropon of I)ItpiglllA Qf 4ample indlcetinq water Is of satisfactory bacterial quality before certificate of construction pAlmplionoo it IC3WO, REPORT MUST BE SUBMITTED YIIITHIN 30 DAYS OF WELL COMPLETION or tVQN Ne. Creel/ ADDaR33 ... + .. olTn - (i:pr Nurt,9or /�. ATryry mom. V100 4 R� KWW&TIC 1'^1 PUIE.1C iW M pu31NE33 0 ESTAulso w �"" LJ IMpU�TR1A1 (D FARIA t''' 1 AIR E CIONOli1 11tHi El TE;T Win f '� OTHER 1:1 ( ir) flc!66fN0 Qr7pa0Pf ,.1 eRSAlf1f COMPRl33ED AIR PERCUSSIQM ...... j'' CABLE L� 1 PERCUSSION El OTHER ❑ . (tioecIfp) CADINQ GJTnI�S ECa9'" (f{srtj DI A(lnchge) WRIGHT PER MC ((''''�� fl4RfADRD L J W11.011) Y93 HO W" rVA51149 Y13 - V11 aw i1Q V11" TDoi 11 OA ILP (" M HQURS 0 MW OR wl COMPRESSED ,AIR P �, _ . YJAIM Ova W- W01 PsOM IA� 50�ACE— STATIC(Slre�c /ly lase �' DURINQ r19W T4B (to 7y pPpth of Complow Well In feet slaw Land Turfgeo+ RPTAIN LENGTH OPEN TO AC IPEq (190. 40 61111, PIA111 TEO I-40 a IP GRAM PACKED+ Diameter of wail lncludlap gravel pack (inch" IaahoaJ p0f (w) fir,,.* PQQfa LAND 64i' 41 PQN*ATiON 013C11IPTION etch exact looetlon of wall with d/etonces, to at 19aof hro permanent landmarka. FELT to FQQI + 3 ; aECENED" DEPS." OF kill -Tt� If r104 wai mvied Q; 'A eroM th► during drilling, I1Tt below F ^aFfT GAUON3 PER MINUTE 6 IEir TQ OF REPO T PRILLER (blgnetNrol or BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE NO. 4991 SOURCE: T. Dwyer Rt . 311 Patterson, NY COLLECTED: December 28, 1982 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This rtsult indiratts tht sourrt of tht sample was of satisfartory sanitary quality when A# samplt was collected. ECEIE JAN 171983 PUTNAM COUNTY DEPT, OF HEALTH January 7, 1983 Bickwit P. E. Director - Owner or Pufthaser of Building Building Constructed by Location - Street Municipality Building Type ,0 ,den T ix A44P r Block 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 Dated this L, day of � 19- 2 -,s ture ECLJEVVE Title JAN, 171983 Corporation Name if corp.) PUTNA►MI COUNTY Address DEPT, OF HEALTH - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED 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 Lot o )Pn D' Subdivis VIn Name 6 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 Dated this L, day of � 19- 2 -,s ture ECLJEVVE Title JAN, 171983 Corporation Name if corp.) PUTNA►MI COUNTY Address DEPT, OF HEALTH - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED 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 1 3 RENEWAL PUTNAM COUNTY DEPARTMENT OF HEALTH � C�'� i, J Division of Environmental Health Services, Carmel, N. Y. 10512 l CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson own or .Village Located at — Route 311 Tex Map # 10 aleck 2 Subdivision Tax Map lot # 2 =1 3.1 Subd. # Owner Peter 0' Hara . Address Route 311, Patt.erson Building. Typq H i - Ra n.c___h _ Lot Area 75,7_31 s q . f t . Number of Bedrooms _3 _—_ Design Flow t 16 -20 Total Habitable Space ,— ,Square Feet Separate Sewerage System to consist of ._..700 Gal. Septic Tank and 430 ft. 2' trench / (. ) ( X )leaching pits To be constructed by to be d e t e.rm i n e d Address Water Supply: _ —. Public Supply From _X_ Private Supply to be drilled by to be determined Address Other Requirements I represent that I am -wholly and pompletely 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 attachments hereto and in accordance with the standards, rules and regulations of the Putnam County Department Of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commission- er of Health silk be submitted to the Department, and a written guarantee will be furnished the owner, his.successors, heirs or assigns by the.build- er, that said.bu }lder 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 issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the dr113ad' well described above will be located as shown on the approved W and that said well will be installed in accordance with the stan- dards,•rales and rpqulations of the Putnam County Department Of Health. Date J u 1.y 12 1'979 Signed P.E. X R.A. Route 52, Carmel, ew Yo 10512 043880 Address 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 maybe amended or modified when co ' ere nee ssa b tl Commissioner of Health. Any change or alteration of construction requires a w per Tit/. . Approved for disposal of dome is sa ary wa an or ivate water wooly only. /® Date �;�(� — B Title/ ' ✓� /3 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Town or Village Located at � �t� 31 Tax Map 10 Block �- Subdivision Lot t J, r Job s '�t�i� 3 Owner - ��,.�e,.�! Address 1�� Building Type LAl r Lot tAr_ea- �1�aS( t�l rF.k►tCJGaV l�•�. Number Of Bedrooms 3 D" es'ign Flow w La✓ Total Habitable Space �1 ;�r�, -, arc `pSquare Feet Separate Sewerage System to consist of G©c� Gal. Septic Tank.- and 44�r X Z`"t�� I.G�v�x.t -t y 11 1%4 To be constructed by �)� Address Water Supply: Public Supply From Private Supply to be drilled by —b L��wLN—Je J Address Other Requirements 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 and regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 a period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of :5 accordance system or any re the 2) that the drilled well described above will be located as shown on the approved plan and that said well will be in Iled accordance sta tls, rules and regula ions of the Putnam County nDep'artment of Health, f / Date �C-A>i' 1-2, %5 t? Signs P.E. .�/ R.A. OOF Address License No, o4� 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 Commissioner of Health. Any change or alteration of construction requires a new ° permit. /Approved for disposal of domestic sanitary sewage and /or private water supply only. Date � �r�_� 4 Y By — Title vC I PCiER D N/��' REVIEW CILI CK SI J•JT jZDv7 -C 3» CAS a� DOCiJI+ ErITS Elouse plans O. K. Design data sheet p.c L. Peres presoaked? + I,in. 30" pert test depth Const. results for 3 runs D. Hole log O.K. Corporate Affidavit for oth -.r than individual Authorization for engineer Letter from Water Supply if applicable If variance requested -such noted on plans & apps.: DETAILS if change is proposed,) Existing contours shown show new contours) Slopes for driveway cuts, etc. shown %later service line location Footing drain, etc. location Top. slope, bottom slope of fill n»-ep na, Percolation tests and deep test pit location S °Dtic tank size and conformance to std. 3 B.R. house minimum House setback shown .Distribution box ftg. below frost All water within 50 ft. of PL shown Plan and profile SDS , All other wells and SDS closer 200' 'shown or reference made i Property boundaries (metes and bounds - clearly s 6xp• ,PARATION DISTANCES SPECIFIED ON PLO )' to P.L. to Fotuldati on walls to Nearest well ►' to stream, march, lake, etc. incl.-expansion ' to Curtain drain ' to water line (pits -20 - - -- ' to storm drain ''to large trees ' froiil 7'011ndation to septic tanl; ' to pipe from leader drain & . i'oo zng bets Std. es ho OR / Remarks' . >w )j S3 �G • ✓L r�- 9 'C 'l cTee 0) 11,6,_4 j2v W, S/ Cr/ t04tTFAf0 J FIJ Tin CIIT,;CI LIST Date: -Insp. by: �. INITIAL SITE INSPECTION r Yes. No Comments Property lines or corners found : Can estimate house location .: Will drivcvay need cut . Must trees be removed -note these le 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 DATA 644 4. Depth: Water elevation:' Rock elevation: Soils- description: .0 `"3' �- _ Date:- FIMAL SITE INSPECTION Insp. by House located where shown on approved plan. _. SDS located where approved ... . . . . . Length of trench m asured Width of trench average Slope of the line and trench acceptable _ Room allowed for expansion trenches.... Over 50 ft. from swam p, watercourse Natural soil not stripped or SDS area unnecessarily graded ..._. . 10 Ft. maintained from prop.line and. 20 ft. from house . ... - Separation of trench from house, well etc. follows plan .. . . ` . . . . . Number of bedrooms checks . . . . . . . . . Stories, brush, stumps, rubble; etc.:. greater than 15 ft. from nearest trench 15 Ft. of peripheral soil Horizontally from trench . . . . Junction boxes properly set Could surface run off from driveway,. roads, 'ground surface, etc. channel near SDS . , area Does lot. drains ;e appear O.K. in area of SDS FINAL GP,ADING OF SITE ACCEPTABLE 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 &'1.. Al2A Address 120 i E _60 Located at (Street Sec. Block Z Lot V3, -- 6E[icate neares cross street) Municipality, "f�i� �.j Watershed KN.C.. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION apse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 3 Z . ci'z.. - Zi 02. zo 260 4- 07 iCii V1 2(0 5 3° lq - I tv UP Z1 1 tp 1 326 - 3,5 l Lo ZCo 3 5 2 3 4 5 Notes: 1) Teets 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. 2: 30 1 2 Cn T7 � -t 2 Z:zu -- -z;4'Z tZ 2[P, 'n i t 3 Z . ci'z.. - Zi 02. zo 260 4- 07 iCii V1 2(0 5 3° lq - I tv UP Z1 1 tp 1 326 - 3,5 l Lo ZCo 3 5 2 3 4 5 Notes: 1) Teets 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. HOLE NO. HOLE NO. G.L. 6" 12" 18" 2411 30" 36" 42" 4811 5411 60" 66" 72'1 7811 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH.WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY --r,�/ Date ?) /(0/-1 ♦ 4 llL''�1(i1V Soil Rate Used 6°20Min/1 "Drop: S.D. Usable Area Provided x®00 No: of Bedrooms 3 Septic Tank Capacity a(-)p Gals. Type Absorption Area Provided Byc�50 L.F.x24" i�aidth trench. Address' SZ �Z 9.l �P� ... C7 .•'pgTH( THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. 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