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HomeMy WebLinkAbout0441DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.07 -1 -6 BOX 6 1 ru L I ` r� �.� 16 pJm. f 91 1 UL 00250 ....,,- ..�..,.,,a -,- �^f— -•: _- _ _�- .sue--....-- �•- r- ..,"_- .-T�-9 �T- - -�-- -- --' re'-----? ;- '�-- "- y- -'--- s_'•:- --'7�--�� � �s PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 31' 6 Division of Etivb^onmental Hea1W Services, Carmel,-N.Y.10512 Engineer Most Provide P:C.H D .Permit k TOWN OF CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM PATTERSON . V own or V e Located at SONNET DRS E Tax Map 2 T ' Bloc1" Loi 1.0 211 k Owner /appo ant Name ALBERT ROSSI Formerly Subdivision NameCROSSROA �. Lot p 14 Mailing Address FARM TO - MARKET ROAD Zip In rm c) " Date Permit Issued BREWSTER NY 10509 Separate Sewerage System ballt by •JAME S ROS S I Address 73 BROOK ST 0�-MT o KI SCO , NY 10 549 Consisting of Gallon Septic Tank and 30OLF OF FIELDS Water Supply: Public Supply From Address or: XXXX Private Supply Drilled by P - F. BEAL Address —BREWS TER , NY 10509--,:. Building T poONE FAM RES Has Erosion Control Been'Completed? 3 NO Number of Bedrooms Has Garbage Grinder 'Been Installed? Other Requirements I'certify that the system(s) as listed serving the above premises were co atructed essent al as shown on the, ns of the completed work 1 copies of which are attached), ,and in accordance with the standards, rules and egu i 'tions, in a o d" ' with the fie plan, and the peinit •issued by the Putnam county Department of Health. Date f 1. f �6. Certified by, ,. P.E. R.A. XX SCOOT L.ICSnSe No. 03 6 Addre Any person. occupying premises served by the above system(s) shall prom y to such lon as may be nscessary to socun he correction of any unsanitary conditions resulting" from such usage. Approval of the separate sewer em'sh beco a. null and void at Won as puW! -. sanitary Sewer becomes avalla, b and Sep royal of the private water supply shall become n— 'vo en a ` lic we er $u becomes ovallable. Such .approvals are .fhe sub)ect to it Ica o or change when, in the Judgment of the C salons N It h r lion, rnodHlcation or thongs Is ecessary. Date By AQ Title -t 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 OWNER NAME James Rossi 173 ADDRESS Brook St.,Mt. Kisco, NY 10549 LOCATION OF WELL (No. d Street) (Town) (Lot Number) Sonnet Lane Patterson PROPOSED USE OF WELL BUSINESS L=T DOMESTIC [] ESTABLISHMENT ❑ FARM ❑ TEST WELL SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ❑ OTHER ❑ I DRILLING IPMENT EQUIPMENT -r ROTARY AIR PERCUSSION 1:1 P PERCUSSION El OPe if LI I CASING DETAILS LENGTH (feet) 331 DIAMETER (inches) 6tt WEIGHT PER FOOT 19 1bs � ❑ THREADED ❑ WELDED DRIVE SHOE ❑YES ONO yW IJYES C 5(FJGD- NO YIELD TEST HOURS G.P.M. ❑ BAILED © PUMPED ❑ COMPRESSED AIR 6 10 YIELD (O.P.M.) 10 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 301 DURING YIELD TEST fleet) Depth of Completed Well in feet below land surface: 325' SCREEN MAKE LENGTH OPEN TO AQUIFER (leet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: I Diameter of well including gravel pack (Inches): GRAVEL SIZE ( Inches) FROM (fee:) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to of least two permanent landmarks. FEET to FEET 0 1 Drilling in overburden clay and boulders T4it rock at 1 33 Drilling in rock,set a 33 325 Drilling in rock granite. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL CC�o7 DATJ, gC bb RT WELL DRILLER (Sig nature — PUTNAM COUNTY DEPARTMENT OP HEALTH DIVISION OF ENVIRONNEREAL'HEALTH SERVICES ALBERT ROSSI 2 1 1.21 Owner or Purchaser of Building Section Block Lot IA04gg ROAST BUIcMig Constructed by SONNET DRIVE Location - Street TOWN OF PATTERSON Municipality ONE FAM. RES. Building Type 2 -1 -1.21 Tax Map Nm ber CROSSROADS . Subdivision Name 14 Subdivision Lot # GUARAbn!EE 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 Environmental Health Services of the Putnam Cpunty 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 -J cc* a 19jj� Geneol Contractor (Owner) - Signature Corporation Name (if Corp.) 73 BROOK STMT. KISCO,NY 10549 Address rev. 9%85 mk Signature �� a Title Corporation Name (if Corp.) 73 BROOK ST MT. KISCO,NY10549 Ur ;is BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6076 SOURCE: Tames f ossi dose ribb - Jell :�onnett T r Patterson, COLLECTED: February 20, 1986 BY: P. IF. Deal ons , Inc. BACTERIOLOGICAL EXAMINATION . Coliform Count, MF Method This result indicates the source of the sample was 0, per 100 ml. of satisfactory sanitary quality when the sample was collected. eb. 2�`-, 19c6 - - - - -- 1 PUTNAM C.OUNTI ;DEPARTMENT.'OF HEALTH EN�IriEER,ro- 'PROVtnE PERMIT # 1 �<, ON' CERfkF OF' OMPLI -ANCE `Division of �Environmen'tal Health Services, Carmel, -,N. Y. 10512 PERMIT. CONSTR ION PERMIT, FOR SEWAGE ;DISPOSAL SYSTEM,' Patterson Town or village Located at sonnet-:- Drive Tax Map : 2. Block . 1 Lot 1 -. 21 Subdivision Crossroads Subd. Lot N . 14 Renewal _Q Revision (]` Owner /addressA Rossi, Farm to Market , Rd reWster NY Date Of P.revious,-Approval - -10509 One Fam. Res. Fill.Section.Only ❑ Building —1 yp Lot Area' Number of .Bedrooms Design Flow G /P /D � (;on PC. N. D. Notification Required Separate Sewerage System to consist of 1000.. Gbl Septic Tank :and 6.00LF of Fields To be constructed" by Not SeleCteCZ ` Address Water Supply: Public Supply From XXX Not Selected Private Supply to be drilled by Address Otrier 'Requirements 1 represent that..l 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 thereto and, in.accordance with the standards, rules and regu a ions,o e Putnam County Department of. ` Health, and that on'completion'thereof a "Certif.icate _of, Construction Compliance satisfactory to the Commissioner of `Healthwill be submitted to the Department, and a written guarantee will be furnished.the owner his succe rs, heirs or assigns by the builder, that said builder will ? place, in. good operating condition any :part of said sewage disposal, system. during the period i�wo (2) years immediately following thedate of the issu- ance of, the 'approval' of .the, Certificate of Construction Compliance of the original, system oylaany repaiis thereto; 2) that the drilled well described above will be located as shown on the approved plan and tha4 said well will.tie:iestai eC'.in accordance wia.. the standards, rul and regu aTo s of the , Putnam County Department of Health. Date 8/29./85 Signed � / P.E. R.A. XXX MUSC'oot No_: ; RF 2 x 488 ' ahopaC, NY 10541 / 11056' Address ' License No. APPROVED FOR CONSTRUCTION: This approval expires one.year rom the dat issued unless construction of the building , has been undertaken and is revocpble'for cause or'may be.amended or, modified when considered n s ry y the-- Commission i Health. Any chanye.or alteration of construction requires a ew permit. Approved for disposal of Pdomestic .sa se ge,..an -private, wa ly only. s Date By Title Rev. '6 /65 �. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM Owner Albert Rossi FILE NO. Address Route 22, Patterson, NY 12563 Located at (Street Sec. Block 1 Lot i_�i 6dicate neares cross-street) Municipality Town of Patterson Watershed New York City' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse. Depth 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 PTH #11 -7 : 45'- 8:0 3 18 27 30 ' 3 ' 18/3=6 - 2 8':04 8:22 18 27 ' 30 3 18/3 =6 • . 4 8:42 '9:00 18 27 30 3' 18/3 =6 5 9:01 9:19 18 27•: 30 3 18/3 =6 2 8:09 8:27 18 28 30 3 18/3 =6 3 8: 28 8:46 18- 28 30 3 18/ 3 =6 4 8:47 9;05 18 28 30 3 18/3=6 5 9-:06 9:24 18 28 30 3 18/3 =6 l 2 3 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. DEPTH G. L. 6" 12" 18" 24" 30„ 36„ 42" S 54 �► 6011 66" 72,. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. � HOLE NO. HOLE NO. -.. _ INDICATE LEVEL AT =H GROUND WATER IS ENCOUNTERED NONE INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NONE TESTS MADE BY Date DESIGN Soil Rate Used 6 -1 Min/1 "Drop: S.D. Usable "Area Provided 5000SF ; No. of Bedrooms 3 Septic Tank Capacity 1000 Gals, recast Conc. Absorption Area TProvi e By 300 L.F.x24" 6" Name Joel L. Greenberg Z51gnature Address Muscoot No. , RFD #2, Bx 488 SDAL Mahnpnr. _NY 1 n,;Ai THIS .SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date i PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIROMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO 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 '2` % -/. Z./ Depth to G. W. Depth to rock Soil Descrintia 0 ft. 3 ft. YES NO COMMENTS 6. ft. rit/�i i /1 3n 9 ft.�, 12 ft. Slope of tile line and trench acceptable......... D �.2 Lot Depth tQ ;.G.W. Depth to''rock �/w ' /-V a Soil cri tion 1`0 't. 4#3 ft. i 6 ft. �-r 9 ft. 12 t DATE: INSP. BY: D.H. - Deep Hole G.W.- Groundwater . D.H. 3 Lot -Depth to G.W. Depth to rock Soil Descr /Of t. 3 ft. 6 ft. 9 ft. 12 ft. DA . FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... 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.) ...................... Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxes properly set......... ................... Could.surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS. FINAL GRADNG OF SITE ACCEPTABLE..-....-.--.,-.-..:.,.*.*.*: ` lei; 47 C/, 7-1Z Se- La CP 1510- 19 i- 101'W 1 I >1 An .1 VV\ Z8 P7 Wo" 4,715 F A .1 cr ", 1 17TO2y' ",--) F: ZA r-1 E; ,ePric rAIVK Pvc L CTlo ?,j -5 /4"IE " / M L°� y i A SEWAGE C)ISPOSAL 5Ysatrl ww'T. M OTF-- -. NO 6ARbACAF- aRIWOER WAS INJS7ALLf--✓ IDS I TA NY- 14W�i 1`b i � 4ti 4 I i 4$ 4 g .........._ - -- , _.. 9 T-1 ►o 84'8 , %� � IDS I TA NY- 14W�i 1`b i � 4ti