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Home My WebLink About0816DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -50 BOX 9 �� 1: , , � � ` ' ` �� EL �� 1: :--- .. =m.�-- .-'^° --s F-- ,+e•---- 7, ;h?'r 7 -r-m. -ate,.. -; -.-°"'�'�-^'--` "^-- -t--7` T•-�- *^'^ --- ,. ,.� �ti. . R x.:3186 PUTNAM COUNTY DEPARTMENT OF HEALTR s Division of Environmental Health Services, Carmel, N Y 10512 � , Engineer Must Provide T ' P C:Rib Permit N — CER ATE Of CONSTRUCTION.COMPLIANCE;FOR SEWAGE�LSPOSA�, SYSTEM PATTERSON 1n Town or VWag Locitea.it East Branch Road - Tax :Map $ Block >� Lot ;1 8.1 oo. S Rlchdrd L Rapp` Formed Subdivision Nso,O E granCYl Subdv. Lot N $ - !OwnerhippHeant Name Y �Malung, addreae D r ewv i:l l e Road p 10 5 09 - BDea 10 / 1 -5 / ,& p Date Permit Is Brews fer:, NY, !Separate Sewerage System bullt by R&R Development Corp Address Drewville Road 1000= 355 L F RPVC Fields Consisting of Gallon Se do .Tank end Water Supply:. Public Supply From ? Address or: X , Private Supply DrWed by P . F : Beal & Sons Aaara�Ba P : 0 . Box B , . Brews ter , NY Bullding Type `Raised Ranch Has Eroslon Control seen Completed? N /E1 �, Namber'of Bedrooms 3 --Has• Garbage Grinder Been Installed? No Other Requireme nt 2 ft fill In place ;I certify that the system(s) ei listed.aervin-g the above premises were construct entialiy as a on the la of the completed work ( copies of which are attached) , and in accordance with the standards;' rules and regul na in accord i the e ' la he pe ; saued by the 'Putnam County Depar nti Of H lth. - °� Certifietl by P.E. R.A. ;gate 832 Address Bali o ]License No: Any person occupying' premises served by the`above systems) !hall. promptly take such action as may be necessary to secure the correction of any unsanitary ;conditions resulting from such usage. ,ApprovaP of the separate sewerage, system, shall become null and void as soon is' a pub,,: sanitary a4wr becomes available and the approval of; the private water'supply shall - become null and;•void when a'.public :water,.safpply becomes available., - Such approvals are subject to difica " " or' change 'when, `in the" judgment, of. the CommisslorAr of Mealt ch re tion,'rtiodification or change Is necessary, y _ Tit i Y WELL COMPLETION REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only X86 -� DEPTH DATA WELL DEPTH 285 ft. STATIC WATER LEVEL 45 ft. DATE MEASURED 812187 DRILLING CTROTARY M COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT 1 O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE 1 ❑ SCREENED O OPEN END CASING. I&I OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS STREET ADDRESS: IMNrvn.lAUXIiT TAX GRID NUMBEd: LENGTH.BELOW GRADE WELL LOCATION East Branch Rd. Patter- -,,on NY Lot 8' PER FOOT WELL OWNER NAME: ADDRESS: R &R Development, /co R.Rapp,Drewville Rd. ,Brewster,NY 01 RIVATE PUBLIC FIRST USE OF WELL PRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED gpm. 1 - primary ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION O -OTHER (specify) GRAVEL SIZE: 2 - secondary C] INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY p MOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED. / EST. OF DAILY USAGE gal. REASON FOR X) NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION DRILLING O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 285 ft. STATIC WATER LEVEL 45 ft. DATE MEASURED 812187 DRILLING CTROTARY M COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT 1 O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE 1 ❑ SCREENED O OPEN END CASING. I&I OPEN HOLE IN BEDROCK ❑ OTHER WELL YIELD TEST � If detailed pumping METHOD: AMUMPED CASING DETAILS TOTAL LENGTH LENGTH.BELOW GRADE DIAMETER WEIGHT PER FOOT SCREEN DETAILS DIAMETER (in) FIRST hr, min, SECOND gpm. GRAVEL PACK O YES O NO GRAVEL SIZE: WELL YIELD TEST � If detailed pumping METHOD: AMUMPED t tests were done is in- 0 COMPRESSED AIR ; formation attached? O BAILED O OTHER ; O YES O NO WELL DEPTH DURATION ORAWOOWN YIELD ft. hr, min, ft, gpm. WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO PUMP INFORMATION TYPE submersible CAPACITY ,.g_ MAKER Gould DEPTH 240' MODEL 7EH05412 VOLTAGE 230 HP �_ 3 ft. MATERIALS: 1) STEEL O PLASTIC O OTHER —_2_q_ iL JOINTS: O WELDED ® THREADED ❑ OTHER 6 in. SEAL :nCEMENT GROUT ❑ BENTONITE ❑OTHER 19 lb./ft. DRIVE SHOE. ® YES ❑ NO I LINER: O YES ® NO 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? O YES ONO DIAMETER ITOP I BOTTOM OF PACK in. ! DEPTH tL I OEM It. 1f more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. DEPTH FROM Water well SURFACE Bear- met er ing met FORMATION DESCRIPTION CODE. tt. ft In . Surface 10 D ill' ng in overburden clay & bldrs . Hit r ck at 10 feet 1 3012851 D4illkng in rock granite. 1 1 E STORAGE TANK: TYPE Well Xtrol 250 CAPACITY 44 GAL. WELL DRILLER NAME P.F. Bea 1 .& Sons , I c . DAT n /A/2 4/87 ADDRESS PO BOX B StGJAFTtlRE j/ Brewster, NY .10509 BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6716 SOURCE: R & R Builders. East Branch Rd. Patterson, NY COLLECTED: September 17, 1987 BY: P.F.Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method hose bibb -well This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. September 22, 1987 Roy Bickwit P.E. Director 0 per 100 ml. PUTNAM COUNTY DEPARTME Yr OF HEALTH DIVISION OF ENVIRONiZOML HEALTH SERVICES ( Owner or Purchaser of Building-. (6- , Building Constru ted by A/pill lei Location - Street O Municipality r Building Type Section Block Lot Tax Map Number AMVCA wdocOs ubdivision Name Subdivisioh Lot # GUARANTEE 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 swage 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 County Department of Health '&q to whether or not the failure of the system to operate was caused by the willful or negligent.act of the occupant. of the uild' ti ' 'ng the system. Dated this 2 3 day of 197? Signature Contractor (Owned) /- Signature Corporation Name (if Corp.) Q Sd' -Rkrr, ra. Address �� S rev. 9/85 wk Title r-e .tS v rev Corporation N (if Address . _f , ��-"'- •. i r r.*+5+:.,., ,,.; - xs,� wra. ,..� x.t r, • . t.-x .t - ?•n .r;n7"r.,t�- • --: -. --- r'--, s C! PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 7318. 1� Division of Environmental Health Services. Carmel, N.Y. 1612 Engineer to Provide Permit N on CERTIFICATE OF COMPLIANCE CONSTRUCTION F OR SEWAGE DISPOSAL SYSTEM Permit b PatteT.SOn Lied at East 3 n C h Road Town, or Village Subdivision Name E . Branch .Woods Snbd. Lot # 8 Tax Map 1 8 Block 1 Lot - 18 Rihard R a Sr. Renewal_❑ ' ' Revislon ❑ wn Oer /Applicant Name c p p f c 0 ScoutRealty Date of Previous Approval Mailing Address R t. 22',- B r e ws t e r., NY 10509 Town ZIP Building Type Single. Family Dwelling Lot Area 12-.727- Ac. Fill Section Only X Depth 9 Volume2 8 Q Number of Bedrooms 3 �1Design Flow G /P /D '600 PCHD Notification Is Required When FM Is completed Separate Sewerage System to_ consist of si 0 0 Callon Septic Tank and To be constructed by T o b e. d e t e r m' i n e d Address Water Suppb't Public Supply From Address or: X Private Supply Drilled by To . be Ci?tE?TfTlli g ddeess Other Requirements repr . esent that 1 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 there to and in accordance with the standards, rules an rregulations o e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department,' and a written guarantee will be furnished the owner, his successors, 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 of two (2) years immediately following thedate of the issu- ance of the approval of the Certificate of Construction ,Compliance of the /or* final system �V� A.- epairs thereto; 2) that the drilled. well described above will be located as shown on the approved plan'and that said well will be instal accordance e , rules and regu aT o�nlof the Putnam County Department of Health, Date 9/4/86 Sigried Address For r B& C, R D 6 Fft 2, B r e. s t ex , N Y 5 0 9 Ter;Se Nd / APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless eonst►uetion of the building has been undertaken and is revocable for cause or may be amended of modified when consldered.necessary by the Commissioner of Health. Any change or alteration of construction, requires /a}new ,permit. ' Approved for disposal of domestic sanitary sewage, an private water supply only. Date Title �S r Permit Application f Corporate Resolution Plans - Three-sets Engineers Authorization' Design -Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) Other Hole r� House Plans - Two sets t, - Letter ariance Request REQUIRED DETAILS ON PLANS Sewage System Plan _ Sewage System Hydraulic Profile - Gravity Flaw t Fill Profile & Dimensions - Volume ' D or J &;Trench /Gallery; Ptmp pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two-Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Glitter Curtain Drains Perc & Deep Holes Located Representative of Sewage•& Expansion Area Expansion .Area; shown; gravity flow,suff. size -- - --.. If Punk Pit & D Box Shown & Detailed House - No. of Bedrooms ":$ Wells & SSDS's w /in 200 ft. of Property Lcc % Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 201*to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. erxn). 15' to Drains -O tain,Stoun,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL �-- Legal Subdivision G Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same 77 t -7 PUTNAM COUNTY DEPARTMENr OF HEALTH DIVISION ORENVIROMERM HEALTH SERVICES,.' Z- e' F= INSPECTION REPORT DATE: r. BY: (Name Of Owner) (Street Location) INITIAL SITE INSPECTION -YES -.NO.. C—CMMENTS. ,�--.TM-�-.Wetlands'on/or:proximate-'to property. L .Property lines or corners found. .................. . .Can estimate house location ................. I ........ . Willdriveway need cut ............................ 0-57 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 ............................ Access to oronosed well lonatinn f nr e3ri 11 i ncT , zz D.H. - Deep Hole G.W:-Groundwater D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot Depth to G. W. G D Depth to G. W. Depth to G. W. Depth to rock Depth to rock Depth to rock 0 ft. Soil De* cri ion 0 ft. S "e- 3 ft. 3 ft. 6. ft. 6 ft. 9 ft. :9 ft. 12 ft.1 112 ft. Soil Description boli uescri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: 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. fran house.... .................... Distance well to SSDS (it.) ....................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ft. of peripheral soil horizQ;1i�***—*—* 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....... IFINAL GRADNG OF SITE ACCEPTABLE........... . Utrt%K I Mr-111 yr nCAL 1 n Division Of Environmental HVIth Services TWO COUNTY CENTER — CARMEL, N.Y. • 10512 (914) 225-3641 APPLICATION TO CONSTRUCT A WATER WELL :LL LOCATION STAEEI East Branch 10MIRILLAGEIC11Y IAX GAW NUMBER. Road Patterson 18 - 1 - 18 �p VELL OWNER NAME. • ADDRESS: ' Richard Rapp, Sr. Drewville Road P9IVATL ro PUBLIC ISE OF WELL 0 RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /CONO. /HEAT PUMP ❑ ABANDONED I - primary O BUSINESS ❑FARM • . O TEST /OBSERVATION ❑ OTHER (specify) - secondary O INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ IOUNT. OF USE YIELD SOUGHT, 5+ gpm. /N0. PEOPLE SERVED 3 -5 / EST. OF DAILY USAGE ' 450 gal 1EASO11 FOR ®_NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION DRILLING O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL WELL TYPE Q DRILLED DRIVEN' CJ DUG GRAVEL F] OTHER S WELL SITE SUBJECT TO FLOODING? YES R NO F WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:E. Branch Woods LOT NO.: 8 ATER WELL CONTRACTOR: Name Address: S PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES x NO l!-1E OF PUBLIC-WATE R SUPPLY: TOWN /V /C ISTANCE TO PROPERTY FROM NEAREST WATER -MAIN DCATION SKETCH & SOURCES OF CONTAMINATION. 10/8/86 (date) ! (signature PERMIT ' TO CONSTRUCT:A WATER WELL r This permit to cons truct•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 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. Date of Issue: G %`/% -19G Perm t Issu ng f al Permit is Non - Transferrable �?� �..,; ;r i � e4�� $:rts•.; 'NAT: 4 iy� a` I WELL. . o----� � oP��s6J'�� oAD �•S •�•s• �L-�►J �� • �� TA'rbuE of t4c,-&,f6►aU-,rME. *LT f, 96 G ? .-7 37 d � Z(o.o 33.3 .� ,•.:. ra� 1 i� "TfV ,S, � �i1 1)y�'A,`(�i}`i'K �1 nYR•ia '`yY ��. (. • � � �'" ��"�N} tl., l') �. b, k.'�� Y[Y fad ~`� � i��'"R� ,' sa S:.t �'r t a �.,'� .r5�c. p.. i r � a "'^S.�Et `�r '� ,� 9 ^,.. Cam`• i,�."tif ..r. ?`t�'' °tf.. �4 ist, ° � •e�,w� s, �� r >a �i` 7.7�"/SC� 7• %'. V I I � 7 `.k�. 4�" "°fi4, ,i�• 7 rk `t� f-t � F �,� 'i��" e J� <iY.`,., t � j�Y7� �'J. vLl�t „S.'Z°+''T a� ��'"y ,•u.tr l� �;��.',� �,� 7�y�'��y��'4�4J tF�� tw tt3'i ��',P�•i�b�aa4�,�,��y^��i�;f'�1 1 y r i�� wh k .N ( rw :.ado a O o' t o I l w`� .. 0 r• � 37k O.4' of `� i >`1 173. � 14�C� .q- • .•-_:.•�,• N 90.5 9 (p.1 G7 104. I 1b3.o, s 4 4 . L \ 3 R