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BOX 9
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1
"AIVISION PiJTNAM COUNTY DEPARTMENT OF HEALTH OF ENVIR0NMENTAL HEALTH SERVICES
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CON UCTION PERMIT # ,P 611
Located at Town or Village PA7r-�- MZ
Owner /Applicant Name ACMR-D f Af Tax Map 12-y. Block 2- Lot 3
Formerly
Subdivision Name F
JLE
Subd. Lot # 3
Mailing Address P961V4 zip / sa 9
Date Construction Permit Issued by PCHD /'01 f tew
Separate Sewerage System built by PWA TC-1 Address
Consisting of 10 a a Gallon Septic Tank and 57 n 4-F PP ye-_ PI PC6-:-
Other Requirements:
Water Supply:
Public Supply From Address
or: Private Supply Drilled by J *4 Address f9f461 4:7.
Building Type ic1 oa p Has erosion control been completed? ye
Number of Bedrooms 'y Has garbage grinder been installed?
/(d
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of
/
of the Putn am County Department of Health.
Date: '7l �(q '7 Certified by 3- C-CUM�c- P.E. -eV- R.A.
(DX�qm- ry ,,l J License #
Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary
to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage
treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval
of the private water supply shall become null and void when a public water supply becomes available. Such
approvals are subject to modification or change when, in the judgment of the Public Health Director, such
revocatio odification or change is necessary. /
B ' /� � �'�.� -G Date:
Y• � Title: � � a"l� /Q�
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
Amkl�. NORTH AMERICAN
� LABORATORIES, INC.
CERTIFICATE OF LABORATORY ANALYSIS
LAB ID NUMBER: 97 -6750
CLIENT: R &R Development Corp
1040 Drewville Rd
Brewster NY 10509
SAMPLING LOCATION:
COLLECTED BY:
DATE COLLECTED:
DATE RECEIVED:,
DATE OF REPORT:
Kitchen tap: Lot #3, East Branch Woods, East Branch Rd,
Patterson NY
M. Rapp
11/11/97 TIME COLLECTED: 9:45 AM
11/11/97
11/17/97
ANALYTE
RESULT`- UNITS
MAX 04tMT LEVEL"
METHOD
ANALYZED
Total Coliform
E. Coli
Absent
Absent
Must be "Absent"
Must be "Absent"
SM18(9223)
SM18(9223)
11/11/97
11/11/97
This sample, as submitted to the laboratory, and as compared to the New York State limits for drinking
water quality for the tests performed, was:
✓ ACCEPTABLE. _ NOT ACCEPTABLE.
Richard W. Emerich, Laboratory Director
- NYS ELAP #11218
CT Lab Approval #PH -0171
" Underlined results are unacceptable according to health department and /or US EPA codes.
"' Maximum Contaminant Level (maximum permissible concentration allowed by health department and /or US EPA codes).
618 Clock Tower Commons, Brewster, NY 10509 -9241 / 914- 278 -7600 / Fax 914- 278 -7754 / E -mail: NoAmLab @aol.com
P. F. B�EAL & SONS, INC.
4 PUTNAM AVENUE
BREWSTER, NEW YORK 10509
Established 1891 - Over 11,000 Wells Completed
(914) 279 -2460 - 2461
(914) 221 -6100
ARTESIAN WELLS .7 WATER SYSTEMS
* * * * * * * * * * * * * **
* I N V 0 1 C E
invoice Number: 017057
invoice Date: 11/01/96
Page: 1
RICHARD KAPP(R - &h llVEL.) SITE EAST BRANCH kll
To: C/O RICHARD RAPP PATTERSON,NY
DHEWV1LLE ROAD
BREWS'TER, NY
10509
Gust l.1) .....: H03087
For your convenience, we will accept MasterCard, Visa,'American Express, or Discover. Please give
us your card number, expiration date, and authorized signature.
❑ MasterCard ❑ VISA ❑ American Express ❑ Discover ❑ Other
Terms... . . NET 30
Card # Exp. Date Signature
-------------------------------------------------------------------------------
10/25- 10/28/96:DHil,LE1) 6" WELL NO.
11817, DEPTH 305', FLOW .4 1 /2GPM, WATER
LEVEL 10'.
F'EE'T OF DRILLING 305.00 7.00 2135.00
B'EE'T OF 6" CASING 3140 8.50 263.50
\1f\j 'j�
30R CHARGE INCLUDES TRAVEL TIME TO AND FROM JOB
A
CUSTOMER COPY
Subtotal: 2398.50
Tax...... 0.00
Payments: 0.00
Total...: 2398.50
Julius I. Cesare, P.E.
64 Blackberry Drive
Brewster, New York 10509
914- 279 -7115
January 8, 1998
Bruce Foley, Acting Director
Putnam County Health Department
4 Geneva Road
Brewster, New York 10509
ATT: Robert Morris
RE: East Branch Woods Lot #3,
East Branch Road, Patterson, NY
Dear Mr. Foley,
Herewith transmitted is the following As -Built Package on the
above noted project:
1. Certificate of Construction Compliance
2. Three copies of a two year contractors guarantee
3. Water analysis results
4. Well completion report
5. Three sets of As -built plans
6. Certified check in the amount of $200.00 to cover fee.
Very truly yours,
AS1 ius u I. Cesare, P.E.
4
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
January 14, 1998
Julius Cesare, PE
RD #7, Blackberry Hill
Brewster NY 10509
Re: Proposed Compliance
Rapp TM# 24 -2 -31
Doansburge Rd
(T) Paterson
Dear Mr. Cesare:
BRUCE R. FOLEY
Public Health Director
Review of plans and other supporting documents submitted at this time relative to the above
captioned project has been completed. Comments are offered as follows:
1) There is no record of a request for a final inspection on that a final
inspection has bee completed by a representative of this department.
2) Guarantee has not been fully completed. (Enclosed).'
3) Well log and the required water analysis has not been submitted.
4) The well is to be located using two fixed points, preferably measured
from the foundation.
Upon receipt of a submission, revised to reflect the above, this application will be considered
further.
RM:tn
Ve truly yours,
i
Robert Morris, PE
Public Health Engineer
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner or Purchaser of Building Tax Map Block Lot
Building Constructed by Town/Village
Location - Street
r2
Building Type
Subdivision Name
3
Subdivision Lot #
I represent that I am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is 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 treatment 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 Public Health
Director 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: Month %r/ Day / Year /W7� Signature:
Title: P s t 6h'
General Contractor (Owner) - Signature
Corporation Name (iff corporation)
Address: / l) Y0 fire "L it f _ �y .
State Zip y/ ro y
Corporation Name (if corporation)
Address:
State Zip
Form GS -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well Location
Street Address:
East Branch Road
Town/Village:
Patterson
Tax Gri „
Map 0 Block Lot(s) 3
Well Owner:
Name: Address:
R&R Development, Drew-ville Rd Breclster, IVY 10509
Use of Well:
1- primary
2- secondary
x Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
x Rotary Cable percussion x Compressed air percussion Other (specify)
Well Type
Screened Open end casing x Open hole in bedrock Other
Casing Details
Total length 31 ft.
Length below grade 30 ft.
Diameter 6 in.
Weight per foot 19 lb /ft.
Materials: x Steel Plastic Other
Joints: _iWelded x Threaded Other
Seal: x Cement grout _ Bentonite Other
Drive shoe: x Yes No
Liner: Yes x No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes—No
Hours
Second
Well Yield Test
_ Bailed x Pumped x Compressed Air
Hours 6
Yield 5 gpm
Depth Data
Measure from land surface- static (specify ft )
10'
During yield test(ft)
265'
Depth of completed well in feet
305'
Well Log
If more detailed
information
descriptions or
sieve analyses
are available,
please attach.
Depth From
Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
15
Drillin
in over
urden clay and boulders
15
Hit rock
at 15'
15
31
Drilling
in-rock]
set casing, routed
31
305
Drillin
in rock
granite
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type Capacity
Depth Model
Voltage HP
Tank Type Volume
Date Well Completed
10/28/96
Putnam County Certification No.
002
Date of Report
1/23/98
Well Dri 1
al
NuvrE;: exact location or wen with aistances to at least two permanent ianamarKs to De provVgon a separate snceupian.
Well Drillees Name P. F a , In . Address: 4 Patrw Ave., Brewster, NY 10509
Signature: Date: 1/23/98
Perry L. al
White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
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7.
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c-=L—`a i I rrcta ct= & c_= _ to
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bo
January 14, 1998
.Julius. Cesare, PE
RD #7; Blackberry Hill'
Brewster NY 10509
DEPARTN ENT OF HEALTH
Division of Environmental. Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278 - 6130 Fax .(914) 278 - 7921
BRUCE R. FOLEY
Public Health Director
Re: Proposed Compliance
Rapp TM# 24 -2 -31
Doansburge Rd
(T) Paterson
Dear Mr. Cesare:
Review of plans and other supporting documents submitted at this time relative to the above
captioned project has been completed.. Comments are offered as follows:
1) There is no.record of a request for a final inspection on that a final'- .
inspection has bee completed by a representative of this department.
2) Guarantee has not been fully completed. (Enclosed).
,-"--3) Well log and the required. water analysis has not been submitted.
4) The well is to be located using two fixed points, preferably measured
from the foundation.
Upon receipt of a submission, revised to reflect the above, this application will be considered
further.
1 . s
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner or Purchaser of Building
Lie-
Building Constructed by
4- Ile&
Location - Street
R/2
j.
Tax Map / Block Lot
Town/Village
Subdivision Name
Building Type Subdivision Lot #
I represent that I am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is 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 treatment 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 Public Health
Director 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: Mont %/ Day / Year 1%/'2 Signature:
General Contractor (Owner)
,� signature
Corporation Name (if corporation)
Address:/ Drf -vOV I< . 1Cd ,
State S Y. Zip y/ ro i
Title: f0�'es r
Corporation Name (if corporation)
Address: /v ro !� re
State IJ � r S i� . �Y. Zip Y
Form GS -97
YML ENVIRONMENTAL.SERVICES '
321 Kear StKeet
YorktoW Heights, NA. [{598-
(914) 245-8800,
Albert H. Padovani, Director
'
LAB #:'93.015562 CLIENT #: 8481 NON STAT PROC FAGE 1
R & R DEVELOPMENT-CORP ` DATE/TIME TAKEN: 01/27/98 10:45A
1040 DREWVILLE RD. DATE/TIME REC'D: 01/27/98 11:45A
BREWSTER, NY '10509 -�� REPORT DATE: 02/03/98
^ PHONE: 1914>-279-4496
SAMPLING SITE: LOT 43 EAST BRANCH WOODS SAMPLE TYPE..: POTABLE
' , : EAST'BRANCH RD. PATTER�ON, N.Y. PRESERVATIVES: NONE
qQL�DJYg MICHAEL H. RAPP TEMPERATURE!.: < 4C
NOTES...: KITCHEN TAP � COLIFORM METH: MF
DATE FLAG
PROCEDURE
RESULT
NORMAL - RANGE
`
METHOD
PUTNAM CNTY PROFILE
01/27/98
MF T. COLIFORM
ABSENT
/100 ML
ABSENT
1008
. 01/27/98
LEAD (IMS)
<1
ppb
0-15 ppb
12345
01/27/98
NITRATE �V1TRU6
�
0.7,
MG/L
0 _ 10
909
01i27/98
NITRITE.NITROG
<0.01
MG/L
N/A
9146
0147/98
IRON (Fe/
<} . 060
n G/L
0-0 . 3 m' g /l `
2037
01/27/98
MANGANESE (Mn)
0.032
MGjL
0-0"3 mg/l
2037
' 01/27/98
SODIUM (Na)
99.0MG/L
N/A
0|/27/98
pH
7
UNITS,
6.5-8.5
' 9043
0027/98
HARDNESS,TOTAL
290
MG/L
N/A
01/27/98
ALKALINITY (AS
94"0
MG/L
N/A
01/27/98
TURBIDITY (TUR
0
ATU
,
0-5 NTU
.
COMMENTS:
i
BACT THESE RESULTS
INDICATE THAT THE
WATER
AS NOT) OF A
SATISFACTORY SANITARY
QUALITY ACCORDING
'O THE
NEW YORK STATE
AND EPA FEDERAL
DRINKING WATER
STANDARDS, FOR
THE PARAMETERS
.TESTED, AT THE
TIME OF COLLECTION.
Pb/Cu LEAD limits for p
EPA Lead & Copper
than 105 of their
than 15 ppb and a
treatment must be
potential`
ublic schools are set at 15 b
� ppb.
Rule for Public Systems requires that no more
distribution points have a LEAD value of more
COPPER value of 1"3 mg/L, else water
undertaken to reduce the waters corrosive
Fe/Mn If both iron and manganese are present, their total value
combined shall not exceed 0.5 mg/L.
Na No limits for Sodium are proscribed. Suggested guidelines state
that for people on asodium restricted diet,the water should
contain no more than 20 mg/L of Sodium. For those on a
moderately restricted diet, a maximum of 270 mg/L of Sodium
is suggested.
°�- lc0l
'
' YML ENVIRONMENTAL SERVICES .
321 Kear Street'
-- - Yorktown'Heights, N.Y. 10598
� (914) 245-2800
Albert H. Padovani, Direclor
`
LAB 4: 93.015562 rLIENT`#: 8481 NON SYAT PROC PAGE 2
R & Fk DEVELOPMENT CORP DATE/TIME TAKEN: 01/27/98 10:45A
1040 DREWVILLE RD. / ^ DATE/TIME REC'D: 0107/98 11:45A
BREWE;TER, NV A0500 1O509 REPORT DATEr � 02/03/98
PHONE: (914)-279-4496
'
SAMPLING SITE: LOT#3 EAST BRANCH WOODS SAMPLE TYPE..: POTABLE
: EAST BRANCH RD, PATTERSON, N.Y. ' 'PRESERVATIVES: NONE
COL'D BY: MICHAEL H. RAPP ` TEMPERATURE..: < 4C
NOTES—:.: KITCHEN TAP ` COLIFORM METH: MF
DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD
/
�
�
SUBMITED BY ~-
--' ----'
ELAP# 10323
r. b.•a.�.a�.ati to be determined Ate.. -
� -wow - ATOM .
DdW br t ° be de t n ed
4' 1 rop►•sart; that 1 am vilrolly and comptet•b nsponsibb fw the design and location of : the proposed syst•cn(s) 1)' Ghat the lepers ter saws" dif ofal s stem
1 above dsssc ibssd will tir tonstruit•d as's"wn on the approved amendment tlie►a to and in accowd nce with the standards, rules an regulations i o s I m
County, D0pWtmsnt,:of HeaRh, and'that on,compl•tion,t.heroof a,'•Cirtificate of .Construction Compiistnce",.Ytisfattory to the Commissioner of Hasithwill
a' -plbmitted: to tM.- Department, and IS written 'ouarantee will be furnished the civner, his Success ors, h•In or assigns by dh• builder, that ,ass builder will
jMe• M good op rsitii» Condition eny part of.Nld sewage tllfpoeal tjistem during'.the period of'two l=) Years IinlnWlsitely following tMdete.of tM Issue
Moss o1 tM'fst00►arat of tM C•rtifitet• of ConstruCtiora Com of the orgi Fsysteiet any rgla thwetol Z) that the drilled well deso a" above
wed, be lotit•d�as fhorrn on tM appoiwd plan end that fate wwll wHl Installed ie, rdahCe; lM ` a rds, ruNS end rpu ps of the putnam
CptintY Oopartnnnt rif MMlth.
'.I Oita `, Q r, :. SM %' � P E � P.A. -
o ,,nn
l
►tla►• B.1 ck e ' e e 05'0 License No 4'1126
APPROVED FOR CO NSTRUCTIONe his appoyel expfre;,two 1 is f► m the date isswd, unless Construction of, tM building has been undertaken and is
1 revocabN�fa.,uus� oi' may be ainssndatl or modifi d when; onsid n "Ury by -the Comn_Hsslonir ,of Health.' Any change or alteration of construction
DD,,..,, 1 e iter
"Quires a now, per it. Approved: ; o n»ii,lt sanitary sew"e, a " 'supply only.
10/88 Dat sr T
i
DEPARTMENT OF HEALTH
Division of Environmental Health Services'""
4 Geneva Road, Brewster, New-York 10509
(914) 278 -6130
APPLICATION TO CONSTRUCT A WATER WELL f_YP CHD PERMIT # _
WELL LOCATION
Street Address Town Sege G1t7 Tax Grid Numb r
Doansburg Road Patterson 15 -3 -4.3
WELL OWNER
Name Mailing Address Wrivate
Richard L. Ra Drewville Road Brewster NY 10509 OPublic
USE OF WELL
1 - primary
2- secondary
® RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED
D BUSINESS O FARM O TEST /OBSERVATION 0 OTHER (specify
D INDUSTRIAL O INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT - _5gpm /# PEOPLE SERVED__ /EST. OF DAILY USAGE 500 gal
U REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION 13-ADDITIONAL SUPPLY
NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
App
WELL TYPE
DRILLED
®DRIVEN
[]DUG
GRAVEL. 0OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
East Branch Woods Lot No.
WATER WELL CONTRACTOR: Name To be determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION
(DON SEPARATE SHEET
R -30 -94
(date)
Blackberry Hill
(si narmte)
ster, N 10509
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirt;- (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such manner as not to degrade or otherwise n_ t surface or groundwater.
Date of Issue: Z� 19 / 5 - E�
Date of Expiration 19 7z Cr Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
4 4 x. s
�°'" 7 • DEPARTMENT . OF. HEALTH
T Division of. Environmental Health Services._
TWO COUNTY CENTER CARMEL, N Y., 10512 '(914') `225 =3641 h ; k, u
APPLICATION•TO CONSTRUCT A.WATER WELL
oo
P
_. •:.`. CHD PERM IT # . .... �
WELL.' LOCATION
-Street.Address
Town Tax. Grid. umber
obt=
p {
':
: Name,,-,.,,. .
Mailing: .Address ." ;'' (Private `
WELL OWNER
RichArd L.
Drewvill . Road .Brewster ' . NY 11520 O Public
USE OF WELL
® RESIDENTIAL
O PUBLIC SUPPLY. O AIR /COND /HEAT' PUMP O ABANDONED
1- 'primary.
0 BUSINESS
O FARM O TEST /OBSERVATION. O OTHER (apecify
2:- :secondary
;. O;INDUSTRIAL'
O INSTITUTIONAL :,.., O'STAND -BY ::: p .'
AMOUNT 'OF. "'USE
,'YIELD SOUGHT
5' �.gpm /�� PFOPLE SERVED. 5 /EST. OF DAILY USAGE'SOO'K g81
REASON:: FOR. .
s NEW SUPPLY
- OP.ROVIDE ADDITIONAL ,SUPPLY OTEST OBSERVATION
j... DRILLING ,
.0-REPLACE 'EXISTING SUPPLY``.-'' C3 EXISTING WELL
` DETAILED
licarrt
:.water ` fare a new home to' be built' on lot..
REASON `FOR
?DRILLING
+',WELL
®DRILLED .
DDRIVEN. DUG �GRAVEL,�. � OTHER
IS WELL; SITE : SUBJECT <TO FLOODING? YES ' X NO..
IF WELL IS LOCATED IN -A REALTY SUBDIVISION, NAME OFF SUBDIVISION::
:.17 t Brd17t'h'.WDOdB. t . _ , r Lot No.,
WATER WELL' CONTRACTOR. :'Name.' TO be Deteamined Address
,.
CIS PUBLIC WATER, SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF .P.UBLIC WATER SUPPLY.: N/A TOWN /VIL /CITY ..:.
DISTANCE TO PROPERTY'FROM.NEAREA ST. WATER MAIN: N/A
LOCATION..sk9tCH''& SOURCES OF.CONTAMINATION PROVIDED k
' ❑ON. REAR OF THIS APPLICATION )I�N S ARA T
7- 29-92. .
(date) (signature)
rt. l
PERMIT
TO CONSTRUCT-A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and
provided that within-thirty (30) days of the completion of water well construction,
the applicant.s,hall:
1 Pump, the well until the water is clear.
2. Disinfect the well in accordance with the requirements of.the Putnam '
County Health Department attached to this permit.
3. Submit, a Well Completion Report on a form provided by the .Putnam County
Heal'th`Department. .�
Date of Issue• c.�1 19
Date of Expiration. 19 Permit 'Issuing ficia ' �.
Permit is Non- Transferrable. White copy: H.D. File s,{
Yellow copy: Building Inspector
h'1`{
., i..� Pirtle re-."F. /1.s _" ..
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—0
A
4-12-90.
DoW4 P
Owner
To"
-'E
10 ;
,
Dqp& —yaw
4 C .M Settles 011b
.4 wboa is canoes"
lo
Big is zr,
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V 60(
y owd
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....................... . Dasip Fw 500 ik
Tow,
of
to com"
To
wow MUMMY
x:,
Mftd by
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an I switwn
411
Separate NOW
he'.1w n, a, Who
of HealthWill
that the i 11
'261j'fo� the d*SjjhL and g_atioct, of nCe With the standards. ru
a" COMPWIMY.L-00' to and a C~ to the COMMIG1110"W
an -.that I Own 9 &Wved a Is 144"10ftt there ruCtIon lancif. 121111factory OdW Will
~n, On th by the IbUlldw- IWO Said bw
coinowlen thwW *Gcwufksts of const - his Wcow-l- halls OF *~* Gov f*IWWWO the
above Str4ded , OWsaites WIN be fur the ownw.,
of: am that 00 1 two (a) yews iontn"Ist
COMIM"Y mud
to the' and a WWMO dispowl Ven durinil'thO-11willd of co, 2) that the Or
400 a repairs OAM rAfn
so" any Pact -.0f Mild' "am of the Ofill Uws and resub,'"S C" 1,
am in sood flicats at congtnwoon ComPlis W t 111111AW"
SO �Vall be
ora* of. the plan WA that old will
."I. :— . I � ... " . � I L . . - L - X17- MA.
sta"ad Iw
will Iw~ as dumm P.E.
County Owerlwam of "OR1% 6epoi 41126
slob," NY ► CMU '1--29-92L 11520 "a —
n rAwUkOn and I$
Ion Of the building JWS bell
4jon1tfUCt of, alierst4oli of cordaruction
STF.E, 'South
40 t6o:� date, Iftwed un Any Change
of Health.
AppVtOVED Orbot-co"STRUC Ifled W 'Pets wstw t!VpIV only.
4 Dwondea or nood
WOVOCOU for Caw" or May to i
f ducieft, of is San V
^pgreved Of TRIS
Rev..
C. I
MO) TO BE SUMITM) WPM APPLICATION
DESC SOILS ENC0UMERED IN 'MST 110LES':
IUMON Or
I 1011r, NO.. 110LE I3O. HOLE no.
'611
1211
1811
2411
3011
3611 IR,
4211
481''
5411
6011
6611
72"
7811
64"
INDICATE LEVEL ATWIC[i GROUNUMM IS ENOOUNTERED
JITDICATE LEVEL M VMCIJ WATER LEVEL RISES AFTER BEING ENODUNTERED
DEEP ROLE OBSERVATIONS MADE BY: J, ce wcc DATE:
DESIGN
Soil Rate Used Min/1" Drop: S.D. Usable Area Provided
Do. of Bedrocms Septic Tank Capacity —gals. Type
AbsorpLion Area Provided By L.F. x 24" width trench
Other
rime JL-litus.l.-Cesare, P.E.
Addres_<Dlac barry.'f(ill
Brewster, New York 10599
Signature
13.111S SPACE FOR USE BY HEALIli DEPkMIENI! ONLY:
Soil Rate Approved sq. f t/gal.
SEAL
Checked by Date
,« . D
Julius I. Cesare, P.E.
Blackberry Hill
Brewster, New York 10509
914- 279 -7115
November 10, 1994
Bruce Foley, Acting Director
Putnam County Department of Health
4 Geneva Road
Brewster, New York 10509
Att: William Hedges
Dear Mr. :Foley,
Enclosed herewith are required documents for the renewal of
SSDS permits on Lots 2 & 3 of the East Branch Woods Subdivision
in the Town of Patterson.
very truly yours,
Julius I. Cesare, P.E.
asoiw7doalbed will be oanRruetaA aagrown on;tlN ll 6WOd A 41i iait t1Nra tO ind in aCcdr"nC4'iWith tlWstandsrds.,►ulas a ,rqu ns . ,
CwMy Oaalart111a11t Of. t'NaN" M�OaA t.onswApNtioq,ttiwtaot'a -.c tip of`.Co t{on CoiiNMiiu"`Ytlshe(o►y to the CoininlMlOnar of MMlthwlll .
M 'wrbwNee -t' mie a written vifido me wilt;ba ia"m hasi,the iiwaw,` his_ weoanors, MMS.oi. S"16 OY the b iilsw►; tWO old burr. will
~,in 'pod APMAMN.abMt 6" any Ml +e/ aid sawja ANPooi;'sYttNn tluii!N tM:YM1o0 of t*o,(=) YNrs irnniuMtely f6110wivill theslate of the' Now
s1U1a e/:; tM ab/iaril of , tIN wCirtNkita M'.CeaRructloii Complanp o Or : dt� Or ahy ripts t p that the dr"lad well 11 0 ftM 0""
vwIM.M IsNtdd N a110rNr °M tM ppei d WM anA tMt YW well wfll'Na In 1 fn a, t f. rYM! ►NY�ai�o f ' Of ,tK6 ",'put4m
�tY.lO!Mrtn�ant 0/ Ilattlr. t, r � �
.,- ..; •:: - its ,
oaM S�nM
ft.A
Addnts 13 1 rinii nTTIp i r i� WcaiMa Nt►. _r 66674 .
APPROVtO FOf1 CONSTAUC f10N TAN gpOMl axOMas two s 1 Ma dati' ism" Wilass construction, of the, buildin/ has been unddrtake i and is
fwfo blalor:c m OF initl a anNneM w niodHiad whin con - y Oy tM Cammisfionar "-vf.,;M ipd. :Any'ChWW' Or "altwatpR.Of aeforuetbn, "
IMYi►N a M►111 Afltl►'OIIM k10r dlapoYl .f do~ ,
Re vi..
It Mwap, nd/or at ws♦tw wPVb Orb"
' TitM �!
a
tf it
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Re: Property of Richard L. Rapp
Date July 22, 1992
Located at East Branch Road
r
(T) Patterson Section 15 Block 3 Lot 4.3
Subdivision of East Branch Woods
Subdv. Lot #/ 3
Gentlemen:
Filed Map ## Date
This letter is to authorize Julius I. Cesare
a duly licensed professional engineer X or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Signed
Countersigned: Owner of Prope
Richard L. Rapp
P ..E . , R . A . , ## 4112 1040 Drewvi lle Road
Address
Shah Trans /Environ En neering, P.C. Brewster, New York 10509
Address `"� Town
101 S. Bergen Place, Freeport, NY 11520
516 - 868 -0900
Telephone
914 - 279 -4496
Telephone
DEPARTMENT OF HEALTH
.Division of Environmental Health Services
110 OLD ROUTE SIX CENTER,.CARMEL; N.Y.. 10512 (914) 225 -0310 t
APPLICATION TO CONSTRUCT A WATER WELL
PCHD'PFRMTT
WELL LOCATION
Street, Address
East Branch Road
Town V Tax Grid Number.
Patterson 15 - 3-- 4.3
WELL OWNER
Name . Mailing
Richard L. Rapp, Orewville
Address
-Road. Brewster New York 10509
®Private
O Public
USE OF WELL
1 x-x primary
2- secondary
0 RESIDENTIAL O PUBLIC SUPPLY. O AIR /COND /HEAT PUMP
0 BUSINESS O FARM O'TEST /OBSERVATION
0 INDUSTRIAL 0-INSTITUTIONAL O STAND -BY
O ABANDONED
O OTHER (specify
Q
AMOUNT OF ' USE
YIELD SOUGHT 5 gpm /#
PEOPLE SERVED 5 /EST. OF DAILY USAGE 500 aal
REASON FOR
DRILLING
O REPLACE EXISTING SUPPLY'
AQ NEW SUPPLY NEW DWELLING)
O TEST /OBSERVATION 11 ADDITIONAL' SUPPLY
13 DEEPEN 'EXISTING WELL
DETAILED
REASON FOR
DRILLING
ApP1 i rant rani ii rac iAmf Pr
ci'i0pl ) fnr .a npw hnma to ha hi ii
1 t nn 1 nt
WELL TYPE
TO
DRILLED
DRIVEN
ODUG
GRAVEL
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES xx NO
'IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
East Branch Woods Lot No.
WATER WELL CONTRACTOR: Name To be determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES kx NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
®ON SEPARATE SHEET
4/1/9n
(date) -signature).
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirty (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of
Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the
the Putnam County Health
Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drillin operations be contained on this
property and in such a manner as not to degrade or oth wis contaminate surface or groundwater.
Date of Issue: 12 19 qt
Date of Expiration 19 1 qL Permit Issuing Official
Permit is Non - Transferrable White copy: HD File. Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
are
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date April 1, 1990
Re: Property of Richard L. Rapp, Sr.
Located at East. Branch Road
(T) Patterson Section 15 Block 3 Lot 4.3
Subdivision of East Branch Woods
Subdv. Lot # 3 Filed Map # 2074. Date
Gentlemen:
This letter is to authorize John F. Eberle, P.E.
a duly licensed professional engineer x or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Signed Gzll
Owner of PvWerty
Countersigned:
Dremille Road
P ..E . , R -A. # 66674 Address
Baldwin & Cornelius, P.C.
Address
RD 5, Route 22, Brewster, New York
(914) 279 -7115
Telephone
Brewster, New York
Town
(914) 279 -4496
Telephone
i
s -
^rP`,... � .�F ",..s. "�` ;'- �,"�."rr- ,."'° -.. "` �`aamt-r•'- '^.i�'�j�"'rti`�^� _ ""F��:.'" s' :..,•-5 ; .. ,
77 ,
` � � `{ i • . ., K_, ` . fit. ; _ '. ':-
. ENGINEER TO PROVIDE PERMIT.#
PUTNAM COUNTY 'DEPARTMENT OF HEALTH' oN cERT FICA of oMPLIANCE.
Orliisfon of EOyMonmenial Healih Services Carmel N Y (0512 PERMITS',+
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
own 7 or village.
'Located at Cl n a ri h l l r,� R 0$ d Tax ;MaP 'S eloCk'.. 3 Lot 4
5 ..
'Subdivision F a c t R T A b r fi iW O O d•• Solid. Lot q 3 Renewal Revision 0.
Orewvlle Rd B'rewst'e,r ' 'N'Y
Towner /Address R i c h a,r d Rapp ,.•i f' Date Of Previous Approval
Building :Type 1=1 n i i c o LOt Area/L - 9 4 A Fill Section'Only ❑
Number of Bedrooms Design Flow G /P /D- tD�. P.C. H. D. Notification,Reyuired
S 9', 5 Y of.. / &DD Gaf .SePtic.Tank and SUd
eparate Sewers e stem; to consist
,To be constructed, by
Address
Water Supply: Public Supply From
✓,Private.5uPPly to'be drilled by P F Req -I. :& :Son ._'Inc.
,P
Address .
4:.utnam Avenue, Brewster, NY 1,0509
:Other' Requirements
I represent thatI ain wholly and completely responsible for the design ,And location' oi.the_ proposed system(s);.1) that.the separate sewage'dlsposal,system
above'described will 6e'Conitrucfed as show n. on the-approved amendment there to and in accordance.with the standards, iules an regulations o " e
Putnam
County . Departrerti of Health, arid''thaf`,on completion thereof a C`eitificate of Construction Compliance " 'satisfactory to the Commissioner of Healthwill
be submitted to the Department, :'and, a ;written guarantee :will be furnisliod_ the owner, his successor;,' heirs or assigns by the builder, that said builder will 1. place �n 'good operatmg'condit�op ;any part of said sewage disposal' system•'during the period of two,_(2) yeais immediately-following the date of the Issu-
ance.'of'Ahe approval of the Certif.icate'ot, Constr,uction,�CompHe a of the original`systern . or any.: repairs.' thereto ;��2j'thbt�the' drilled well ;dascr,tbed` above
will be located as shown on the appioved plan and that said well will b stalled. in s c - rdince .w the ds, rules and regu amens "of the Putnam
County Oepaitment.off-HHealth.'
Date W Sign P.E. X R.A.
Address'. RD '6 Rout 2 Brewst,;er NY 10509 Llcense'rt,. 41126
APPROVED FOR CONSTRUCTION This'approval.expires one eai fr m the, date issued unless struction of the building has been undertaken and is
revocable for.cause or ma
- y be amended or modified:when�coris; n' sary.. y the Commis , , �w�- ct�angA.o alt lion of construction
'requires a new permit. pro Arf6'P dkposal.ot domestic mti 's age .a d/ p ivate.' er. ly .only.
Date 8, Y Title
D
so
, 0
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date August 8, 1985
Re: Property of Richard L. Rapp, Sr. & Richard L. Rapp, Jr.
Located at Do.ansburg Road
(T) Patterson Section 15 Block 3 Lot 4
Subdivision of East Branch Woods
Subdv. Lot # 3
Filed Map # Date
Gentlemen:
Julius I. Cesare, P.E. of
This letter is to authorize Baldwin & Cornelius, P.C.
a duly licensed professional engineer •X or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145_or
147, Education Law, the Public Health Law, and the Putnam County•Sani-
tary,
Code.
Very truly yours,
Signed- i
Countersigned: caner of Property
P.E., R.A., #61126 Julius I. Cesare, P.E. Drewville Road
Address
Brwester., New York 10509
Town
RD # 6 Route 22
Address
Brewster, New York 10509
279 - 7115
Telephone
279 - 4496
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH gar # 3
DIVISION OF ENVIRONMENTAL HCALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 .
DESIGN DATA SHEET- SEPARATE - SEWAGE DISPOSAL SYSTEM FILE NO.
Owner Richard L. Rapp Sr Address Drewville Rd Brewster, NY 10509
Located at (Street4ndicate . d Sec.15 Block 3 Lot .4
neares cross s ree
Municipality Patterson Watershed Croton
SOIL
PERCOLATION TEST DATA
REQUIRED TO BE SUBMITTED WITH APPLICATIONS
II lo}
Number
r
CLOCK TIME
PERCOLATION
PERCOLATION
Raff . . B lapse
No. Time
Start -Stop Min.
Mpth to Water
From Ground Surface
Start Stop
Inches Inches
Water ve
in Inches
Drop in
Inches
Soil Rate
Min. /in drop
1 44
- 57 11
28
31
3
3.66
2 00
- 20 20
28
31
3
6.66
An 3 20
- 45. 25
27.75
31
3.25
7.69
11 45 - 74 29 28 31.75 3.75 7.73.
1 13 - 43 30.> 24 25 1.00 30.00
2. 44 - 80 36 24 25.25 1.25 28.8
11 52 - 13 . 31 24 25.00 1.00 31.00
5 24 - 60 36 24 25.2 1.25 28.8
1 r .. •
Notes: 1) Tests to be repeated at same depth until approximately equal soil
.rates are obtained at each pereglation test hole. A11 data to be submitted
for review.
2 Depth measureMentsjo be made from top of hole.
DEPTH
G. L.
611,
` 12" -
1811
2411
-7.011
J
j6" SANDY
•42" LOAM
4$" W /CLAY
5411
60"
66"
72"
7
84"
r `
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED - No water encountered
- INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS I4ADE BY Richard J. Zapp Jr. Date 10/19/84
DESIGN
Soil Rate ,Used 30 Min/1 "Drop:. S.D. Usable Area Provided 5000 s.f.
No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. Type Maso
Absorption Area Provided By 500' L.F.x24 6
. R "— width ret nch.
Other
Name Baldwin orne ous Signature
Address Route 22 SEAL
Brewster. N.Y. 10509
TEST PIT DATA REQUI EED TO B. SL'3T:ITTF.D WITH APFLICF,TIOIJ
DESCRIPTiOIJ OF SOILS 1 N -111'?TLRED IN PEST HOLES
HOLE, NO; Lot # 3 , HOLE N0. HOLE NO.
TOPSOIL
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal.
Checkod by
Date
APPM MIX B
PUMIAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SaPGE DISPOSAL SYSTEMS
REVIEW Sisk' P -
(Street Lecaticn)
(Name of Cwne--
CCI'S YES I NO
�
I
,P
f I
I
I
I
I
LT- t=ench provides
� req:i rea
d5" "5 60 ft. trax. S
' to contours
00% eto.
I
I
i
t
-SCI
SYSTEMS
- barrier
10 t.
fill 'notes _.
new s
depth craw s
100 . flood elev.
200 ft. reservoir, etc.
150 ft. trigall /gall.
X
PERMIT
DATE REV_ - ,v7E:D
DCC'5 , S —~
3— �.�
Penait Application
Corporate Resolution
Plans - Three sets s/s
Engineers P_uthorization= d�si`�,�
Design Data Sheet (D�) SUEDIVISICN
Deep Hole Log Perc
Consistent Perc Results (3) _ 11
Perc Hole Depth c
H Plans - Two se�S �,
G-- =r
We! pe-Ymi t; F;v� 1_:.:.__
ante Reauest
SAS, -
Lecal Subdivision
Subaivision Approval Cnecke
Fx- approval SSOS Psi! . Lots Chec :ce-`
Wet'-and (Tcwci /DEC Permit R & D)
Data On DDS Plans &,, Perm t Same
REQfj= DETA T S ON PL� -yS
Ce.VGge.System Plan - (north arrcw)
Se1dage Sys ton Eyd�raull is Prof i le - C= a v t i F' C
Fill _ file & Dimensions - Vol =me
D o J� ;Trench /Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Service Line if over
Construction Notes (grinder rate)
Design Data: Perc and deep result=
T o -Foot Contours Existing & Prcccsed
Driveway & Slopes Cut
Footing/Gutter,Cur1�ain Drains (discharge OK)
Perc & Deep Holes Located
Representative of primary and expansion
_ Expansion Plea; shcwn; gravity fled, Buff . size
If P=ed Pit & D Box Shcwn & Detailed
House - No, of Eedroans
Wells & SSOS's w /in 200 ft, of P- rowsed Sys-t-
Property Metes & Bounds
House Setback Necessary (Tight lot)
House Seger - 1 /4 " /.-t. 4 "0; Type pipe'
No Bends; Max. Bends 450 w /cleanout
SEPARATION DISTANCES SPECIFIED CN PL.AN
Fields
10' to P.L., Driveway, Large T'rees,Top of
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Take (inc. ex-.
.15'. to Drains Curtain, Leader, Footing
351to catch basin,stormdrain,piced watercci
10' to Water Line (pits -201)
50' intermittent drainage ccurse
Septic Tanks
10' fran Foundation; 50' to well
15' Well to PL 9
pYnty .Oaoartetant .
M sw6i tid to 'tlio,
. rtaaa M 'looC 1tinM
0
anplianer•.:saiw ac m to tM:_Con- wawo"W of "Withwill
Mors, 141irs or nisMnt'6y�,the.,twlktw; tl*A iiId Oiipdw will
dtwo (2) yews hnniadiata4r f6llaww4 tlwd"wOf the two
�ragks titirato 2) that the Willed woll d w Wall abori.
t ataneards. rules; and nd-ui oraiT �s ;,ot thi hdnam
X
rt:; NX. X11'520' �kas Ns '41126
cogst►uttien of'M eutaNN leas Qtun undatikae "ana' is
nw or knith.. Aiyr,CMImi or sliwatioft. of construction
W. r+aotv only. A
Title
DEPARTMENT OF HEALTH
Division of Environmental Health Services y4 .1��
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL '0
PCHD PERMIT 0 1_,,<145
WELL LOCATION
Street Address
Doansburcr Road
Town V444ege Gi+y Tax Grid Number
Patterson 15 -3 -4.3
WELL OWNER
Name
Richard L. Rapp
Mailing Address (SPrivate
Drewv'lle Road Brewster NY 11520 O Public'
USE OF WELL
1 - primary
2— secondary
® RESIDENTIAL
O BUSINESS
O INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED
O FARM O TEST /OBSERVATION O OTHER (specify,
O INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 500 gal
.REASON FOR
DRILLING
MNEW SUPPLY OPROVIDE ADDITIONAL SUPPLY OTEST OBSERVATION
O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
Applicant requires
water supply for a new home to be built on lot.
WELL TYPE
1X DRILLED
QDRIVEN
DDUG
GRAVEL
®
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN,A REALTY SUBDIVISION) NAME OF SUBDIVISION:
East Branch Woods Lot No. 3
WATER WELL CONTRACTOR: Name To be Determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY - --
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE
ON REAR OF THIS APPLICATION ARA T
7 -29 -92
(date) (signature)
01 So. Ber ` Le11
Eree-port. N.Y.
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and
provided that within thirty (30) days of the completion of water well construction,
the applicant shall:
1.
2.
3.
Date of
Date of
Permit
2/87
Pump the well until the water is clear.
Disinfect the well in accordance with the requirements of the Putnam
County Health Department attached to this permit.
Submit a Well Completion Report on a form provided by the Putnam County
Health Department.
Issue: 4 ems- /p 19 7z
Expiration. 19� Permit Issuing icia�'
is Non - Transferrable White copy: H.D. File
Yellow Copy:
Pink Copy:
Orange copy:
Building Inspector
Owner
Well Driller
Y
1-
ll�
t
November 10, 1994
Julius I. Cesare, P.E.
Blackberry Hill
Brewster, New York 10509
914 - 279 -7115
Bruce Foley, Acting Director
Putnam County Department of Health
4 Geneva Road
Brewster, New York 10509
Att: William Hedges
Dear Mr. Foley,
Enclosed herewith are required documents for.the renewal of
SSDS permits on Lots 2 & 3 of the East Branch Woods Subdivision
in the Town of Patterson.
Very truly yours,
Julius I. Cesare, P.E.
o
TEST PIT DATA M- I
DESCRIPTION 4
-.,»
.Z rm 111'111 APPLICNribN v
:RED IN TEST BOLES
DE-P111 110m. No. IIDLE N0. 110LE NO.
G. L.
6"
1211
18"
30"
36"
42"
48"
54"
60"
66"
72" li
7811
134"
INDICATE LEVEL, AT MCIi GROUNDFIATER IS ENOOUNTERED V�
114DICATE LEVEL TO WHICH JMTER LEVEL RISES AFTER BEING EN3DU `1T.ERFD
DEEP BOLE OBSERVATIONS MADE BY: < ( S W g- DATE:
DESIGN
Soil Rate Used 14in/1" Drop: S.D. Usable Area Provided
1.76. of Bedrooms Septic Tank Capacity gals. Type
Absorption Area Provided By L.F. x 24" width trends
Other
Jjame JUJIUS-1. Cesare, P.E. Signatur
Addres d31 a c kbe r r y Hill SE'? {F r
Brewster. New York 10509
'1111S SPACE LUR USE BY H ALM11 DEPARIDIENP ONLY: �. 1
Soil Rate Approved sq.ft,/ga.l. Checked by
Date
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Date
R
Q
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DEG K
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EXI 5TI N C7
14
HOUSE
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WA
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EXIST.
Q W ELL
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TABLE OF DISTANCES
AC
28
BC
28'
AD
39'
BD
84'
AE
41'
BE
85'
AF
46'
BF
87'
AG
51'
BG
90'
AH
56'
BH
93'
AI
26'
BI
35'
AJ
29'
BJ
3 9 1
AK
34'
BK
43'
AL
40'
BL
48'
AM
45'
BM
52'
AN
73'
BN
28'
AO
74'
BO
33'
AP
75'
BP
38'
AQ
78'
BQ
43'
AR
80'
BR
4 8'
WELL - S
7/ r
j.
,
ALL SURVEY DATA AND HOUSE LOCATION
by TERRY BERGENDORFF COLLINS, LS
MT. EBO CORP. PARK
BREWSTER, NEW YORK 10509
Survey dated Oct. 14, 1997
NOTE:
This is to certify that�the SEWAGE DISPOSAL SYSTEM w
constructed as indicated on this plan and that the s
inspected by me before it was covered over. The sys
constructed in accordance with all standard rules an
of the PUTNAM COUNTY HEALTH DEPARTMENT and the NEW Y
DEPARTMENT OF HEALTH.