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HomeMy WebLinkAbout0397DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -3-40 BOX 5 J ■ . A I #$it CI I o # Revue'; 3186 Located at �!2 ° PUTNAM COUNTY DEPARTMENT OF HEALTH Ivielon of Environmental Health Services, Carmel, N Y 10512':, �� Engln`eer Mnst Provide P C.H D Permit q + . STRUCTION COMPLIANCE FOR SEWAGE • DISPOSAL SYSTEM / lxdaJ/II: -(/ (Tt�iQS`%1� : • ` �L �.. � %'� � � X Taz � / :Town :or Map v i7 MaP Block Lot { 1 TV (y Snbdlvision Name Snbdv Lot q �t�1i1�C I�if c'awsoialil ; p.: Date Perm1E lssned Separate Sewerage System built by Address tn T. -G1 .S Gllon SeConsisg g ptc Tank and �- �. . Watei Sa 1 s�Iti/�I, EL PP Y b t Pgbllc Supply From Addreea or ]Mvate Supply, Drilled b jL L 04 U. L 06 JCAddress M A K5: +M AY g type �N� �i� Bglldln J Has Erosion Control Been Completed?4 ' Nmnbec;of Bedrooms Has Garbage. Grinder Been IrstauedY`� ,Other Regnlremerits _ I'certffy thaE''the systems) 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 n- acco rdance :with: the standards, ruled and`reg tiohs, in'accordance with the filed plan, and the permit iasued'by the' t Putnam..County Depa tore t Of Health. �+ �J %6 ~ X� P.E.k_• R.A. Date Certified by .:, Address LIAP, /V7i�' A '�/�1 �E� Llconse'NO. Any person 'occupying piemises;ieivetl.by the above systems) shell pro ptly take such aetiomas mt►ybe. nsee�aory to secure the eorrectlon, of any unsanitary conditions resulting from . such ju;iage. Al proval. bf the' separate sew age,'system shalf,become null and void as soon as a pubt;: sanitary iawer becomes availabli,and, the approval of the- :private- water.suPP1Y shall become 1 and v id. Vy public water supD�Y becomes available. ' Such approvals' area•• sub)ect to mod i.laet n, ,or change when ;. -in the )udyment of, the ms sl er of wch revoFeti n,' modlfieatldn or change , is necessary. .3! - �, Title :I Date. BY t 0 'n BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6060 SOURCE: John MacArtney tgell Corn 'Mall ,Hill Rd. Patterson, NY COLLECTED: January 28 , 1186 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method . 0 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. February 1, 1986 PUTNAM COUNTY DEPARTMENr OF HEALTH DIVISION OF ENVIRONMERIAL HEALTH SERVICES Owner or Purchaser of Building Building Constructed by Location Street Municipality �lf 4, A/C -V Building Type Section Block Lot Subdivision Name Subdivision Lot # GUARA= OF SUBSURFACE SEWAGE DISPOSAL 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 successors, 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 approval of the "Certificate of Construction Compliance" for 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 occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of zr 19 Signature,�� J Titlea�� General Contractor (Owner) - Signature Corporation Name (if Corp.) Corporation Name (if Corp.) Address Address rev. 9/85 mk ----WELL COMPLE, ION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/7111 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 JOHN CARTNEY ADDRESS Cornwall Hill Road Patterson, NY LOCATION OF WELL (No. 8 Street) (Town) (Lot,Number) Cornwall Hill Road, Patterson, NY if PROPOSED USE OF WELL BUSINESS © DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL 11 SUPP Y El INDUSTRIAL ❑ CONDITIONING O(Specify) ER DRILLING EQUIPMENT COMPRESSED CABLE ER 11 ROTARY R AIR PERCUSSION ❑ P RCUSSION ❑ O(Specify) CASING DETAILS LENGTH (feet) 51 DIAMETER (inches) 6 WEIGHT PER FOOT 19 ❑X THREADED E] WELDED DRIVE SHOE R YES ❑ NO WAjS CAST D) YES l_J NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED ® COMPRESSED AIR 4 25 YIELD (G.P.M.) 25 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 25 DURING YIELD TEST fleet)' 335 Depth of Completed Well in feet below Land surface: 335 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 0 321 Silt, sand & gravel ne a ®10, 32 40 Soft brown & white limest 40 335 Medium to hard white limestone If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE 335 25 DATE WELL COMPLETED 111 0/86 DA 55 17 g poRT l/ 4 b w L (' d MILL DRILLING, IN rem CONSTRUCTION PERMIT -'FO_ Located .at• �'�� ���i� L ' Subdivision 'Owner /Address Building Type F� f}tliL� Number;of Bedrooms Ue Separate Sewerage- System to: consis `To be ioAtiucte! by, d A Water Supply Public Su X�Pnvate Su 'Address Other: Requirements F° It represent that I ;am wholly and com f , a t' :�, ..`� .:PUTNAM COUNTY DEPARTMENT OF HEALTH.: Permit a _ Orvision of. Environmental Health Services Carmel N Y 10512 { 4. R SEWAGE.�'DISPOSAL .SYSTEM.: _ ' � ?TE�;zx v+ 1 „; �r� , Town or Village t t•LL lT� 3' «: Tax Map 'alock Lo t• } IQ7'�y�nElJ�+.4a Lot N Y <• Renewal Revision �[] 7 Ii C o,9 E ,id ✓ N 1 % Date Of Previous Approval Cot Area ` r Fill Section Only ❑ t 4 P C '�Fi D Notification Re Hired ' sign Flow G /P /D 9 j;'O O D t of '' ,Gal SePt�c Tank And LTE��lI�yCD 'Address f PPIy From w PPIy. to be drilled by f pletely responsible for the design and location of °the proposed ,system(s) , 1) :that', Ahe separate se wage.,disposal' system aoovi e , aesenoeo wul De conscrucceD as shown on the approved.amehdment there 1'9:.a ,q ' r accordance with the standards, rules an regu a ons b ' e ' :u Ham a County Department. 'ot `.tiealth,'Jild that, on corr pletibn thereof a "CerLficate of Construction Compliance .satisfactory t6-the Commissioner of Healthwill . f -be submitted to Yhe,, Department,; and j' - wriiten ;guarantee'Nw�ll De - furnished the owner his, successors, heirs or assigns by the builder, that said builder• will ` `place in`•good operating. :;con dition any?,part °of ;said sewage disposal system dunng. the r,iod of two 2)^yearsimmetliafel follovvi� the date ofahe issu -:, ance .'of .the approval ,of the''Certi icate -.o Construction ,Compliance of ;the orlgmal system or.any repairs- thereto; 2) that-the drilled''•well described above (s will be located,as shown on the approved plan antl -that said well wilf;be insta accordance 'with "th standards, rules 'and regu aTfrns of the, 'Putnem County:Dgp;rtment / Hea h , eQ "vv p.E R A. Date `�� Signed' A.�... % Ti9�r—%�Fr L/ %zt �'Q 3 r Address `° r /� Ticense, No. _ 3.. APPROVED FOR CONSTRUCTION: This approval expnes one yeas from'the date ;;issued unless construction of the - blinding has ,bee and is revocbble for cause or may be amend d:or.modifiedwh en. consi ered'necessary by the Corti ssionei-of Health: Any change or.alte ation.of construction requires a evv 'p and -APp etl for disposal of domestic n Lary swage, and /or;;pnv a ply 9r►IY — , Date' ^ B Title D lu .1 5 �r _ PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS J` 2, FIELD INSPECTION REPORT Z DATE: /� oS 5��i c�-, a�� �// % // `; INSP. BY: (Name of Own (Street Location)' INITIAL SITE INSPECTION YES NOI COMMENTS Wetlands on /or proximate,to property .............. Property lines or corners found ................... Can estimate house location... .. Will driveway need cut ............................. Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed..... ....... ..... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/ septics ............................ D.H. 1 Lot Depth to G.W. _ Depth to rock Soil Descri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. U. n. - ueeY nuie G.W. - Groundwater D.H. 2 Lot D.H. 3 Lot Depth to G.W. Depth to G.W. Depth to rock Depth to rock. boii uescri Lion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. boil uescri DATE: G �. FINAL SITE INSPECTION INSP.BY:' G YES NO COPTS House SSDS located per approved plan ....... � Length of trench measured 3 1' G t� Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. X Over 100 ft. from watercourse.... o ......... o ..... Natural soil not stripped or SDS area unnecessarly graded.......... .............. 10 ft. maintained from property,line and 20 ft. from house.. ... Distance well to SSDS (ft.) ....... d,.� ��. / ....... iD? Number of bedrooms checks ......... .... . ... .° Stones, brush, stumps, rubble, etc., greater l than 15 ft. from nearest trench ................ ®� 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxes properly set ................................. Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... l FINAL GRADNG OF SITE ACCEPTABLE...... .... Tax;Maph } p � Builtling;TYPe /S /DE�e>'�A� -_Lot A►ea "" t16�� Fill section only ❑ ; ,Number of Bedrooms -�' � - '�Design -`Flow G /P /D � Q � r P c, H D Notification Required 3 Separate .Sewers g e- System to consist of PodL 5ept!c Tank and constructed by be Address water; SuppiY Public' Supply From: Private?Supply to be drilled by j n t: t- Addres9' a 5) her:. Requirements I represent that"1'am wholly antl,,completely responsible for the des�gri'and�locat�on``of_.the proposed systems) 1) that 'the separate sewage :disposal system above described will'be,.constructed'as shown. orl the approved amendment there to.a'nd In'�aCCOrdance. with -the standards, ►utes.an ►egu a Ions O e U ni m •'l county.,Depa►tment " of Health,, and that `on compietion'thereof a ,'Certifwbfe of'�Conitruction Compliance' `satisfactory to the. Commissioner'. of Health will be ,submitted -to the Department„ and a written guarantee will be- .furnished theowner his: successo►d heirs or assigns by the builder, that said builder will ' -place i in good'. operating condition any,.;part of -;said sewage disposal system• "di": uring the period of two (2) years immediate) following ;the date of the issu- `ance' oi- .the' °a rove) of = the Certificbte_;of Construction Com liance of. -the on mai. s stem-or an above PP p 9 Y ;with the; standards, rules'andYregu a� os. of the 'Putnam ' y repairs thereto 2 that the drilled well described wUl b` eJOwted as,shar non the approved plan and -that said well will be installed m accordance County Department'ot Healthy 1 ,v J, F _ P E' Si A 1 �` Address r^ :'APPROVED FOR CONSTRUCTION This approval expires one yeaifrom e date - issued unless cons ructi .{revocable for cause or may be amended or.modified whe idered necessary by,the' `isswner -of H ;'requves °a new .ppeermrd ;'Approved for A�sposal o1_.dom is tart' se gem and /or private water supply' Date�'f -s. 2 S3 3 License k,8_ - on of the, buiidirig has been' undertaken and is eaith. Any change or teration of construction } only- Title �C. LTH � � Permit ✓ ;'10512 Town ''or ., illage - 'Block Revision _ _;Q _ i Approval ' ' -_Lot A►ea "" t16�� Fill section only ❑ ; ,Number of Bedrooms -�' � - '�Design -`Flow G /P /D � Q � r P c, H D Notification Required 3 Separate .Sewers g e- System to consist of PodL 5ept!c Tank and constructed by be Address water; SuppiY Public' Supply From: Private?Supply to be drilled by j n t: t- Addres9' a 5) her:. Requirements I represent that"1'am wholly antl,,completely responsible for the des�gri'and�locat�on``of_.the proposed systems) 1) that 'the separate sewage :disposal system above described will'be,.constructed'as shown. orl the approved amendment there to.a'nd In'�aCCOrdance. with -the standards, ►utes.an ►egu a Ions O e U ni m •'l county.,Depa►tment " of Health,, and that `on compietion'thereof a ,'Certifwbfe of'�Conitruction Compliance' `satisfactory to the. Commissioner'. of Health will be ,submitted -to the Department„ and a written guarantee will be- .furnished theowner his: successo►d heirs or assigns by the builder, that said builder will ' -place i in good'. operating condition any,.;part of -;said sewage disposal system• "di": uring the period of two (2) years immediate) following ;the date of the issu- `ance' oi- .the' °a rove) of = the Certificbte_;of Construction Com liance of. -the on mai. s stem-or an above PP p 9 Y ;with the; standards, rules'andYregu a� os. of the 'Putnam ' y repairs thereto 2 that the drilled well described wUl b` eJOwted as,shar non the approved plan and -that said well will be installed m accordance County Department'ot Healthy 1 ,v J, F _ P E' Si A 1 �` Address r^ :'APPROVED FOR CONSTRUCTION This approval expires one yeaifrom e date - issued unless cons ructi .{revocable for cause or may be amended or.modified whe idered necessary by,the' `isswner -of H ;'requves °a new .ppeermrd ;'Approved for A�sposal o1_.dom is tart' se gem and /or private water supply' Date�'f -s. 2 S3 3 License k,8_ - on of the, buiidirig has been' undertaken and is eaith. Any change or teration of construction } only- Title D. Petruziello, PE Proposal The purpose of this proposal'is to submit the water supply and sewage disposal system designs for the J. Macartney and Bonnie Kessma.n two lot subdivision and the desing details for Lot No. 2 of that subdivision. Deep test pits were dug to determine sub sutface charac- teristics of the soil. Percolation tests were conducted to determine soil absorption rates. Refer to data sheets for results'of these tests. Refer to the property plots for details of design. S 7 S .. .. /. r'J sTJ) ClIEC�K h .2'U. �. Insp. by: ,�- �.. 1 . INITTAL SITE IN ,PECTIO -N Yes No Comment: ,Property lines or corners found _ Can cst imate house location . . - Will drivoway need Cut: . . . . . . . . . . . Miust trees be removed -note these 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 Water e.l.evat:i.on: ,. Rock elevation:; ry Soils do cr_i. ot.i on • i - Date. 1+IVIAL SITE II,Si'}-ECTIO Insp. 'by: Houso located where shot;n on 'approved plan. ,• . SUS Located where approved . . . . . . 0 'Iong,th of -trench measured. Width of trench average Slope of the line and.trench. acceptable . Room allowed for expansion trenches . . . . . Over 50 .ft. from swa.mp,watercour•se Natural soil not . stripp -ed or' SDS area iuuiecessarily 'gra.ded : .. . 10 I't. maintained from prop.line and 20 f-t . from house . . . : Separation of trench from house, well -- e c ... follows plan ;_ - -- - -- --- - - - - -- - - - -_ - -- -- -------- �._�.... . . . . .. . . . . . . . . . Ntvnber of bedrooms .checks , Stones, brush, * sturmps, rubble, . etc.-. greater than 15 ft. from nearest trench . . . . . . 15 FL. of peripheral soil horizontally from trench • . . ' .. Junction boxes properly set Coiild surface run off . from driveway, roads, ground surface, etc. chalulel near SDS area. . . . . . . .. . . . . . Does lot dr. a:in��,e aprd:�r 0. K. :i.n a.rea of SDS FINAL grMDING OF SI`1'E ACCEPTABLE 2.2 G- ��� e 4r,6 1. 4 4 S \ M 533�4S 4ojg'�`' �.Z� "�'- •\ y` mss; 44t 4 .► Al- 7,- .' A/o A1.6411 Qa Sew, D/SR J rS7EMJ A/7N /n/ - 200' OF Pzapo3fO SYS7eWS. SEF SNe6T FP LOE /Hn/ O1674/L$. L .c-AT. /on/ 11444 5cA4E:�r ALL LArrrRAt_5 4 "OJ,A PVC PezF. AOe(ryP) L 2 rrP A ®--� Putnam County Department of Healtb Division of Environmental Health ServicGb i owed as ncte3 = r s= ..=--anca with c�mailmma � ':' -1 •a ilia" .o rl 07" Qf JN4CAe7M(i} ,R4X"VMA.11>! ,°��Q4�EESSIONA� •a CO,-,Y v ,Y ' -4u 11114. X T►�4 /0.ir •� i nd 4•ti € Ad, A 5 � ' 'y� f 4.�" W '" .° ye 7 a �' dt �• Y � t', C t nn ` ,� v+ . e r q i P„vE z ; L .c-AT. /on/ 11444 5cA4E:�r ALL LArrrRAt_5 4 "OJ,A PVC PezF. AOe(ryP) L 2 rrP A ®--� Putnam County Department of Healtb Division of Environmental Health ServicGb i owed as ncte3 = r s= ..=--anca with c�mailmma � ':' -1 •a ilia" .o rl 07" Qf JN4CAe7M(i} ,R4X"VMA.11>! ,°��Q4�EESSIONA� •a CO,-,Y v ,Y ' -4u 11114. X T►�4 /0.ir e, N \vW w \ o f T N/F KESSMAN F. M. 2016 LOT Ns. I 238�� 00 1'►t N 40-22- :1.0368± acres F M. Na 2p1 Z AREA well LO r N I 755.. 2 , t 1 m I ` rh. ,W ranch 0 I 3 I,ppen porch with /h A w DO 0 0 m i pole N/F TOWN OF PATTERSON m_ \\ \ °/s m 123.4 0 J \rn_ \ \ 1731 62.86' 92. 48' S 33-45-40E S 29- 47- 50E —�� 30E 36.81 5$- i — ASSUMED ROAD L1NE Certified To John Macortney & Bonnie Kessmon People's Funding Corp. Ticor Title Guarantee Co. for policy No. TCE 86-45 SURVEY PREPARED FOR JOHN MACARTV EY 8 BONNIE KESSMAN SITUATE IN TOWN. OF, PA T T ERSON COUNTY. OF PUTNAM STATE OF NEW YORK SCALE I" = 50' JUNE 19, 1986 JAMES K. DEVINE LAND SURVEYOR 4 CHAS. COLMAN BLVD. PAWLING, NEW YORK !2564 84C, UNAUTHORIZED ALTERATION OR ADDITION To THIS SURVEY MAP IS A VIOLATION OF SECTION 7209 (2) OF THE NEW YORK STATE EDUCATION LAW. Copies of thb coney map net DMdrlg the Land Sun"= emhaa>� Mal 61111111 net be Considered m be vaad b. GoRA now "Guarantees or Certifications indicated hereon signify that this surrey was prepared in accordance with the existing Code of Practice for Land Surveys adopted by the New York State Association of Professional Land Surveyors. Said guarantees Or Certifications shall run only to the person for whom the survey is prepared, and on his behalf to the title Company, governmental agency and lending institution listed hereon, and to. the assignees of the lending Institution. Guarantees or certifications are not transferable to additional insti. lotions w subsequent owners." 3'e) 1 89 vv 4't3, /o./o