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HomeMy WebLinkAbout0473DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.08 -1 -90 BOX 6 c ON ON IN In IN INNN ir "i IN I or Is f ,, �.� f I IN I , . ` 00282 PUTNAM"'COUNTY Division W '.Eni&on""i� All i.kTIF Id 71111F.00"A ICAT T. CONSTRUCTION, COMPLIANCE ' '0 k; a Sts Builders; S Cohslsting 6,_ AY YY­bal S14`A�Ak d Water ,'Supply . 7 Public Supply iFrom .,_.�.`,' 74 BpBoyd Aft Prorate '--Supply Drilled By,j, Adrorecs, -a i,,,i 6sloh"CoiWol Been Corppboate.d ? t I cert if y that the system as 318 .6 above of which attibheW) ; aE' 'Pitnai d6uhi� Department.,of "A X4 4 c a l Si Any person occupying pr.mkes,*ierved by the abbve system( ;) shall :ohditio►i resulting fki�r' su`ch, ` . u' p,q­e­ " approval f" vallatAe' and d-the-appr6)al of the 'private water supply �shall.,66_-C_olpe, . L iubJect to modification or ,ange,.,,wtion in ,the lutlgment 'w ib �Vb Date Y Services, �( a b- U 1! ?51+,) 0. ;YSTEM- P atter son Block - ptiIAt f4 'n or.V,111age - # C r iNY 0512 Oil three, . _4 -4/8 0 drooms r�lAl ad cop�ies fed 'shown ted . work ions ih ;,;iith' the liled'pian,: 'and;the_Pdrmit issued,by the All C 920 ilf]­�4 C" License * ch action as may be necessary to secure ,the ,c6qa,410rir 61 any•unsanita►y Ball become nyl,!',i6d s'public sanliary fewer` bec6m'e,s o0hen,:a public water wpply becomes available. -Such approvals, are . - fA6hW, lLch'Aro4o Ica catlo f tloii'.-or'thin_ m y A 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 Boyd Artesian Well Co., Inc. 07 f� NAME ADDRESS OWNER McGlasson Builders Main St. Carmel, NY 1 -0512 LOCATION (No. 8 Street) (Town) . (Lot Number) OF WELL South Ste. Patterson. BUSINESS © ❑ ❑ ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ ❑ ❑ SUPP Y INDUSTRIAL CONDITIONING ❑ ((sspe i f ) DRILLING COMPRESSED CABLE ER ❑ El EQUIPMENT ROTARY AIR PERCUSSION El P PERCUSSION if ) (Specify) CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ® ❑ 5 O "CASING U NO DETAILS 29 6 19 THREADED WELDED YES NO YES YIELD HOURS G.P.M. ❑ ® 2 YIELD (G.P.M.) 10 TEST BAILED PUMPED COMPRESSED AIR 10 WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL 401 total drawdown in feet below Land.:urface: 2251 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) GRAVEL SIZE (Inches) FROM (lest) TO (feet) IF GRAVEL Diameter of well including PACKED: gravel pack (inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 16 overburden r-, rM 1.6 225 ledge ��•'i Q If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) 10/2/81 1,.0/10/8.1.° Boyd Artesian Well Co., Inc. 07 f� I -A' N -,CO-- ENV (:RONMENTAL -SER=VICES;. INC _r UNITY. X. STREET AT ROUTE 376, P.O. BOX HOPEWELL'JUN,CTION, NEW YORK 12533:"_ (914)221 -2485 33:40. NAME: Mahagac Park Terrace ADDRESS (Will pick -up) 10 -14 -81 POINT @' South Street 1Pa'tterson� :NY ,:SAMPLING TREATMENT: CHLORINATED,❑( -- .PPM); SOFTENED o OTHER ❑ SOURCE: DRINKI'NG.WAT'ER El WASTEWATER EFFLUENT uOTHER -- � QLLECTED BY: M•rC'.l finnn TIME - AM PM. DATE 10A4._Rl. Q APARTMENT COMPLEX ❑ INSTITUTION D PRIVATE RESIDENCE'. O' SWIM POOL 0-BEACH, ❑ MUNICIPAL'' 'gib RESTAURANT '- :; ❑ TEMPORARY:RESIDENCE 4 CAMP ❑ NURSING HOME 0 SCHOOL.. . ❑ TRAILER PARK -❑ FARM LABOR CAMP. E3 PRIVATE COMPANY d SEWAGE TREATMENT -PLANT q OTHER ❑ TOTAL COLIFORM COUNT M *. -T. �" _ • PER 100 Ml.' El TOTAL COLIFORMCOUNT M.P.N. PER 100 M.L. FECAL'COLIFORM COUNT M.F.T. _. PER 100 ML. ❑ FECAL;COLIFORM COUNT; - M.P.N. PER 100 M.L. r t O FROZEN DESSERT, PLATE COUNT - - ❑ AGAR PLATE COUNT -PER 1 M.L. / LABORATORY TECHNICIAN DATE REPORTED r 8 RA ORY DIREO -R� ,HEALTH DEPT. f McGlasson Builders, Inc. Owner or Purchaser of Building Owner Building Constructed by South & Oak Sts. Location - Street Patterson Municipality 4 Section 7 Block Modular 1 Building Type Lot GUARANTY 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 guaranty to the owner, his succes- sors, 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 :Wade 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 de termination of the Director of the Division of Environmental Health Ser -' vices .of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful o e ligent act of the occupant of the building-utilizing the syste 14th October.-' Dated this day.of ;- 9.4jl4J4) 19 81, - Signat Title McGlasson Builders, Inc. If corporation, give name and address) 93 Gleneida Ave., Carmel, NY 10512 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 Enviro i6 th "Services, Putnam County Department of Health o jtiti I' .. Number;of. t3edrooms•,,g,9'51 ueslgn, riow. . Separate: - Sewerage system t0 doniist Of. -f be, constructed by r Water Supply y _; ',Public•;Supply From a • Private, Supply -to be Address Other Requirements ,,None above'descnbed will be constr' County `•Department of Hea' be =submitted ,to' ,the Departs Cplace Jin :good operating'con, - ance'•Jof the approval:of: the will be located as.shorvn on.ih, County, Department of kealtl Date 31 :March" 1:9 PPROVED FOR:CONSTRU n revocable for cause or maybe requires a new p • mit pF Date r-._ a t i( s): 1) <that -the separate sewage disposal 'system ,assigns Eby the builder,'that said builder will s immediately following thed ate of the iss6- reto6 2) hat the drilled `well described above !s rules_and r:eguiaons of the : Pufnam .E. ^' `RA. of the building has been undertaken and is Any',change: or alteratIon'of :construction ,. Y Title q - F ='. • COUNTY,DEPARTMENT OF HEALTH rt �� ' k.; "', ,t r NDwision ofEnvironmenialy ,Health. Servrces, i✓aimel N _ Y 10512 r CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM } Fl4tterSOn Town{ Or Village South St 7 Located at * � � Tax .Map 4 Block Subdivisidn Lot r1 Job 501843, Owner McGlassgri Builders, Inc Address 93 Glene�,da Ave. i SF:raine w` "1 y250`' 1 . ` PtY 10512 Building Type s Lot Aree Carmel ,Three 600 Gal 841+ Number ofBedrooins Design Flow Total „Habitable Space' Square Feet R r L 1000 " 250 L F:' x 24 "'wWidt h. Trench Separate Sewerage - System - c consist of Gal Septic Tank: and - r r Address Tobe constructed by 7 • Water pl Supy Rublic Supply From Prrvate,$upply'to be drilled by ' Address . None Other, Requirements. ` I epresen 'that I'am wholly and completely iesponsiblefor,thedesign�and locat;on of _t. he proposed tvstem(s),d) that the separate sew5ge' disposal• tystlilm atiove:Gescr�bedrwill be Constructed as shown' fhe approved amendment thereto and 'in accordance -with the standards, rules and. regu a ions o ems' u nam - _County Department of ?Health, :and that;on completion thereof a Certificate of Construction` Compliance saf�sfactory to the Commissionerof;Healthwll w i be submitted to the .Depa %tment and a written guarantee will be furnished`ahe owner his :successors, heirs or assigns :by the_liWlder, that said builder.;will place in?good operating conddion :;any :part of said sewage disposal system "durmgtthe period of two4(2) years immediately_tollow�ng the date of•tlie issu -`' ance of the approval of-the Certificate of.Construction` Compliance of the or�g16al;;system or any.repairs.thento 2)ahat file drilleil',well described . above: will be located as.sliawn ons4he approved plan and that said well willibetinstalled. m accordance ,wdli tK` andards rules and regula i�s : of fth'e Putnam ;:Gounfy Department- of ,Health y Oct 1 X78 P E X R A Date lO Signed Y 7. air w� yR_ D. -9., St rmel `NY.lO 2 'License No. 92 06 -y " l�APPRONED'FOR' CONSTRUCTION , This approval c'expues one yearlfrom the date ;issued .unless constructioncof the tiwldmg his -be en undertaken and ;is C ,Ef .-. w. .., evocable.,for cause. or may be amended o► modified when 'con ;idered necessary by, the :COm caner of Healfh. A'ny "change pK,alteration of construction ' r cegwres a:'new permit Ap rov for disposal of domes, c` da 'sew n or pri to -ly only s Date :.I' - BY Title Y i DEPTH G.L. 611 T I � 11. 11 Il J . . -1-C TEST PIT DATA REQUIM',l) 'J'0 YT 31FP1 "T'.111M 11 A11M.A.M'PION HOLE NO. - -"T- --* 1211 24. 3011 3 6 if 4211 4811 5411 6011 6611 7211 78!1 0, INDICATE LEVF�L-o AWTP-Iff'- SOUUM INDICATE LEVEL TO W1-1ICH WATER 11VEL TESTS - MADE, BY Lz/v NP, AFTER PEILLNIG ENCOUKERED A/ooj ArDate A 7- DESIMIT Soil Rate Used 10-4- Min/l "Drop: S.D. Usable Area Provided' POO No. of Bedrooms —m Se pt ic Tank C apacity 04o Gals. Type Absorption. Area Provided By0 L. ..X24 width tr6nc-hft. -V Other Al hTm Address R.D. 9, Fair Street Came!-,—_ R 10512 T11IS SPACE FOR USE BY EEAMIH DEPARTME-11T Soil Rate Approved Sq. Pt/Gal. THE SIN' Date _ _ .. .. .e a.F. :. _ Y _ _ _ X_ _ �• Et : ;' '� _ - Ate, .BUILD;_ °Dl�TAV . 1. F _�- —A `i r '� f ,' trgcture located from survey O /'.sur.Yeyor noted °;'6el0iir® _ ` `; ° i - Weil iccaTeu Gy: .Sur repa'rs survey, - ° 7. - we(A -d siters report _ �.��> 1f,5' r. _ _ St ( e < . a, ,r masuref.11, . _C4 "il ,- _ _ -_ Tarrk, Doiss, p& gotlerte8 E InferaGS locafedfby:.Con ?racror Enq f veer 1 . - - - . tiaouhd¢:pt C� 1. i - PieIG iMpeci4on. by 4' iith depi.�esJ date If �BD , _ _ r ,, Enganarrt rry dote rl(8u _- �9K s-�t 1 F ;.� ---- "+^4�. .,,,3�.2A,...•!/i'f�sa_ -T2 M eQ 1 ;,A,. - - - .. .. �. ,�':° _ ^' NOTES :Q Se c Trtt IOoo!4Vt .i {v a tie 1. �j� l+i" 1' . I ... .. 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