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HomeMy WebLinkAbout0667DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.10 -1 -15 00667 - I I I ' I I 17ME 1161 Lb Y .I ol J +'� f i �,r. + ��■■ �� �i . .` 1. VMS . I 1. ti r 1 ?, 00667 Bt!ilding Type "TT06— No. of Bedrooms ✓ Date,Permit Usued. Has Erosion.Control Been Completed? s listed'servirig the aboire I certify that the system(p) a premises were' constructed essentially as shown on the plans of the completed work copies of'which are attached), and In. aFqor'danc'.e' -with the standards ," ruie4.and.regulations, in accordance with the filed the permit issued• by the Putnam i:ounty.'Depaiiment.Of:Hea,lth. IN Date OL Cirtiflid by P.E. RA. Addre Any parso n occup'ying"premises.served' by the above systems) , $ . hall promp . t ly, ,ta C Such a. . C. -1 t 11o.n : aims'' a . no 8 ry conditions r eiulil6l; from such usagq. hpprova I -of the , Npa r oto, p go system shall become n I nd void as available and theapordvil of thou private water supply ifiill biC666'null I vo — *NiOP a .public t � P0, subject, to modification,or. change Ahen, 'in the. Judgment of _th es- of Hialth,'iuch revocatl lot Date I .iiri the correction of any unsanitary as.4.public sanitary. sowii,, becomes vies" a, iallabli. :'Such sopiovals- are ition,or change-is, necessary. Title ♦1, 4 V, f` CONSTRUCTI,ON PEflMIT FOR` A r e, ~Located' at f `,Subdivision Y' "� � S s Number of Bedrooms _, Design Plow G /r /D m Separate Sewerage System to conskst of To De constructed by Water Supply L` Public 'Supply :From -,'Pr vate il t a 'c>,� Addies3 '4" x�Other, .Requirements'` t >I represent that` -am wholly antl completely respons�l 3., €:. n above d_escrjbed wjll be tonstructed as shown on, the-Ai ''?County ' Departmment ot`'Health; and thafron compte be submitted 'to the . Department sand_ a --w ten-:gu ,,place.;in good :pperating ' conadionany- a par t of laic ance of.ahe' approval of the Certificate of Constiu ej will be located as shown on the approved plan and that <County Department of Flealth -� � � cs �x i..Alr 17 r` ''Date 6 . Address � APPROVED FOR CONSTRUCTION approval revocable for abuse or may be airiended;of,modifI60"I srequiresµa� pw:ipermlt ';Approved for disposal of < f F aDate`°� •�� ...mow t+_ K. Y � Y� DEPtARTMENT;;OF HEALTH 5 Permit # WA oral Health Services Car 1' 12 )SAL SYSTEMS ' ' i a y Tax' Map. ' lock, LO _Jr s i -• r ,� •,; F i Sulxl _Lot N— Renewal Revision , r ;. �'' _• •� 4 -u Date Of Previous , Appzoval ' ;a Fi_ ection ll S ,Only ❑ -' P C -'�N D Notification Required Il Gal Sep �Icl ankA - �) � Y t � Address„ e e i _ > ' �-- Z7, r t lK..c a r +' the design and IotaUOn aof the proposed systems) 1) thatahe separate .sewage disposaLsysfem II Bd amendment the "re to and �n accotlance w,tth the st5ndards ;rules an regu lat ions o e u nam Iiereofza Cert�f,cate of Constructio_ n Compliance vsat�sfac4oiy to }the Commifsi0ner ofiHealtfv✓�II I se wilt'Ge furnished theROwne► his-- �wcce'ssors hefrs�or ss;igns�by the,,bwlder that said.bwlder will . lige disposal system during the.per,' two ) yearsi` mrtieilmtely,follow�ngahedate.of tAeissa` %:l ;Compliance of the ongln`'al sys or an #Yepa r thereto 2jahst the drilledrwell describetl,a "ve well wail be installed m c d ce'-w t the ardi rules and r'egu sTf ons of x ,the nam s Sign P E R A r License No 3 ,s a one y r froms4he date issued unlesi .constr Lion of the';building hss been and [taken ar►it. is <: ,.; ;onsidere'G necessary by tt a ,Commiss ner of Health Any .change br alte' ation of:.construction r r: , yW ti ar ewsge n or pnvat' ter ly only.'_` t i i " Y ` Title � F _ ... . Vre.e.r.r r ► ... r......, rear . J • _ COUNTY DI'FICC BUILDING • CAiiMEL. NEW YORK This,. report tis to bc'eompleted by well driller and submitted to County+ie3lth Department together with laboratory report of snaly :i: of water sample indicating water I: of satisfactory bacterial qu61 lty before eertlficiite of eon :truetion compliance is issued. REPORT MUST BE SUBMITTED VJITHIN 30 DRYS OF %YELL COMPLETIO.-J — - NAM[ ADDRESS owult CLASSIC HOMES, INC, PSB Bldg,, Route 22, Brewster, NY 105090• LOCATION (tie. A 301001) jI orrt) (tot b✓tnoer) orrnu McManus Road Patterson, New York BUSINESS ❑ ❑ ❑ " rtorosED L" J DOMESTIC ESIAt LISKMENT MIA1 TEST WELL USE Of WELL ❑ SUPPLY ❑ INDUSTCIAL ❑ CONDITIONING EOSw6 .1 l..J DPILLING �} COMPRESSED CABLE D OTHER fQUiPN.EtIT ROTARY LJ AIR PERCUSSION PERCUSSION I WING ( LELGTM (pert) ir1AME1ERltncne31 WiIt+M1 6 Pit root 19 j CJ Ut:1VE SMO`_j� I w ^!S CA�NC. t;--, 'n 07 D E- U u DETAILS I) 26 THREADED WELDED YES NO 1 YES NO iIFID i O ❑ X 0 HOURS ❑ 4 G.P M. 5 YIELD IG.i.U.) 5 TEST tiA1LED LUMPED EOM• RcSSED AIR WAtER MEASURE FROm LAND SURFACE— SIAUCISDecltyleetJ DURING YIELD TEST fleet) Depth of Compieled Well LE YEL . 30 600 In feet below Land svrtace: 600 —eJ MALE L:SGTM OPE!I TU ACUIfEi ;Rte_ s'CREEN JDfiTAI S SIGT Si..: DIAMEILR (inches) IF GRAVEL ( Dion+eter of well including GRAVEL SIZE (inches) FeOM (1001) TO floor) t PACKED: orovel pock (incrto I I PIK PRO" ILND S7riACEf � Stlatch •zacr location of -ell -Irn 01stances. to at least fIn to FEET ; FORMATION DESCR17TION rwo parman►nt lanimaras. 0 11 Loose-bedrock & silt. 1 600 Hard granite, at Yi018 was tes+rd at ainerene depth$ civrint4 drill:n0, lire brio. fElt GALLONS rER MINUTE 545 21-2- 600 5 7/18/85 17 - 11 '� ,Pres.—MILL DR ILL INC ' CHEMICAL PHYSICAL BIOLOGICAL NAME AND ADDRESS OF PERSON TO RECEIVE REPORT ELLIS A. TARLTON LABORATORY DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC. 34 PLEASANT STREET DANBURY, CONN. 06810 P. 0. Box 246 203 - 748 - 7903 WATER - WASTEWATER METHODOLOGY APHA - WQO - ASTM REPORT OF BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF WATER F Mill Drilling, Inc. Putnam Ave Dreiister, N.Y. i o5nA DATA SOURCE_ OF SAMPLE Water Supply, Classic Homes Inc. McManus Road Tower Patterson, N.Y. DATE OF COLLECTION July 9, 1985 COLLECTED BY Mill Drilling Hydrogen ion COLOR TURBIDITY ODOR CORROSION INDEX DISSOLVED SOLIDS Concentration LANGELIER {ph) RYZNAR NTU Mg /L Alkalinity as CaCO3 Fluoride (F) Bicarbonate Nitrite Mg /L Mg /L Mg /L NITROGEN Alkalinity as CaCO 3 Chlorine Residual Carbonate CONSTITUENTS Nitrate Mg /L Mg /L Mg /L AS NITROGEN (N) Total Hardness as CaCO3 Ammonia Mg /L Mg /L Mg /L Albuminoid Mg /L Iron as Fe Mg /L Mg /L Chlorides as CL Mg /L Manganese as Mn Mg /L Mg /L Detergent as MBAS Mg /L Sulfate as SO4 Mg /L Mg /L The arithmetic mean of all standard samples examined per month using the membrane filter technique shall not exceed MEMBRANE FILTER TEST one colony per 100ml. Coliform colonies per standard sample shell not exceed 3/50ml, 4/100MI. 7/200ml. or 13/500ml Coliform Colonies /100ML In: (a) Two consecutive samples; (b) More than one standard sample when less than 20 are examined per month; or (c) 0 More than five per cent of the samples when 20 or more are examined per month. © 1. The results of the analysis of this.sample are satisfactory and meet requirements for a potable water. 0 2. The results of the analysis of this sample satisfactory for a potable water but certain of the chemical or physical constituents are high. These are as follows: 0 3. This sample is not satisfactory since it does not meet the bacterial requirements for potable water. The presence of organisms of the coliform group in a sample of potable water is undersirable and, while not necessarily indicating the presence of any disease - producing organisms, does indicate that such contamination might survive to the same extent. The presence of organisms of the coliform group may also indicate that the treatment was not adequate at the time the sample was collected. F] 4. This sample is unsatisfactory as a potable water because certain chemical or.physical constituents are above acceptable limits. These are as follows: COMMENTS Certified .......[ ............................................ �`'C .........................r 1-;*1.......... John Nelson Jr. Owner or Purchaser of Building Classic Homes Inc. Building Constructed by McManus Rd Location - Street Patterson Municipality Tax map 12/2/9.4 Section Block Lot Subdivision Name Straight ranch 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. Dated this 17 day of July 19 85 Signature del/, RZOL Corporation Name if corp. Address 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 Zoe 0 Z81 o" 5 24 o A' -47 t a e ,3, — 4 3' DOW Ilth autnam Comfy at ea of -b :Eor oonfmmn" With ed SB n0tai,15111]d I a as e 8, AeA 14, fc;�-, 7 th 41 ov, 117 20 Ice. L'T . 5CAILE- ---------------- - -- r - C', 7V 1",-,4 0'2- -==A- Ki virocA c-0 IV 2 262'-20' 1- -1- (0 15' � L o-I 2 i