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Building Type
Number o Bedrooms .,,
Separate,- Sewerage- system to consist -,df- IG,
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constructed by : --
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-e,.cpnst
4iTo Wat0r".;S- O.Ply'
ato supply to a dr, I led, by
Other -.-Re dffilbmee ts'
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;a m re onsiWcfdr,,AhF(0.' SIT",
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°aboveAesc ' ribed:will tio-�Con c as s c? on -approve affi-i on �t
an
y apa
�'b t" 6 'ariment of Health, -&6bMT "
M r, t jig thereof
i. e..submittea,t o the
I , .[
T.';9 tee
, Department,
.,Iplace' :in-, good -.pperating-,cotiat,i f sa'id. se — 'd
"I W - , Tf.' , I
ca�of the a0iii'dval-bf
r1will ;64b; located as'; _shownionrthe shown —o approved
County , Department ",
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ADaf
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iYPPROVED 'CONSTRUCTION i- 4-h ii-1,
1-
Tevocablej Or CjUjd, dr, �'may'
fequjrps anew permit Approved: f, r, , disposal
.............
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P
August -1,1973
John. gent. ss,; P.E .
R: `5.#6,: 'Box; 3:53
Carmel;; N.Y. 16512
Res LQtr of Joseph I . Ablhdls,:
Map 6 Lot 4299:w4303• -110
Josh S 489s Yates Rd,.; P"t son
and '
e'armine Ahondola J'j 6q
Lot .4304�30t1e:i, Job 012.9 0,
j Xstes Rd.ttc�rson; N.;Y,
Deer. Mr, Prentlaa
I am re3eeting the layou. t plans for the sewage di sposa.l. systems
to serve the Oovd menfiioned properties. The following inada(luaci.es and
noted.
1) This. 'department re"Iret 100 fOet setsaration 'hetuteen wells
a d age d$s ;.:., .:
..ri �Q���� � pc��� Qya�e��.
2) 'the .designet-ed sewage disposal area has evidence of ledge
at lese than 2.(two) feet.
This department requires a minimum of 42 Inches of original soil
over ledge.
If you have any questions concerning this matter, pieaae feel
free to contact me at:- thia'of €ice.
Very truly yours;
William H. Hedged
wMvegs Environmental. Health Technician
G >✓ /� 6 /v a'a �w REVIEW CHECK SL. + ,T
Meets Std.
Yes No
DOCUNITNTS
House plans O.K.
Design data. sheet
Peres presoaked?
Min . 30" perc test depth
Con.st . results for 3 runs
D. Hole log 0. K.
Corporate Affidavit for other than indivi
Authorization for engineer
Letter from Water Supply if applicable
If variance requested -such noted on plans
.ual
apps.;
Remarks
:s
DE TA ILS
Rhow f change is ro osed.1 )
Existing contours shown new contours
Slopes for driveway cuts, etc. shown.
Water service line location
Footing. drain, etc. Location
Top slope, botU slope of fill
Percolation tests and deep test pit location
i �I
Septic tank size and conformance to std.
.3 B.R. house minimum
House setback shown
I �-
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y
1 1 1 Wd l:t- C' w:LL13. u "rig 6110wil
Plan and profile SLS
.
All other wells and SDS closer 200'
.__ __ _ shgtim or reference made
Property boundaries (inetes and bounds - clearly
sho 1-7
i
SEPARATION DISTANCES SPECIFIED ON PUL
10' to P. L.
20' to Foundation walls
100' to Nearest well
50' to stream, march, lake, etc. incl
15' to Curtain drain
10' to water line (pits -20.'
15' to storm drain
101. to large trees
0' from foundation to septic tank
5' to pipe from, leader drain & fooLa_n
j
.expansio
r� °moo
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date
Re: Property of �e/rsa,i.,P AW O"'.IoZ . J-
Located at
Z Siv
Section ocks' Lot9 -�30�
Gentlemen:
This letter is to authorize Jahn -H;:OiMU5Sp P.E.
a duly licensed professional engineer or registered architect
(Indica�—
to apply for a Construction Permit for a separate sewerage system; to
serve the above noted property in accordance with the standards, rules
or regulations as.promulgate� by the Commissioner of the Putnam County
DcpS f ei -meit o TT- -1 and to sign all necessary papers on my be'ha'lf 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 t
C.AM I - Nftj yffla t l (157'2
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE'BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owne r ✓ 61,a Addre s
Sx� �s DF P•►2�s►a L
Located at (Street 6,dicate �ee� ^sec. Block
Lot ¢199 -¢ e3.T��
neal"est cross street)
Municipality ,z Watershed
ch,
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole.
Number CLOCK
TIME
PERCOLATION
PERCOLATION
Run
No.
Start -Stop
apse
Time
Min.
Depth to Water
From Ground Surface
Start Stop
Inches. Inches
water ve
in Inches
Drop in
Inches
Soil Rate
Min. /iri drop
2//0
3. /ao9 s /LX/
5
2 / /sj /mss-r�
Y¢
ys-
r
5
1
2
3
5
Notes: 1) Tots to be repeated at same
rates are obtained at each percolation
for review.
2) Depth'ieasurements to be made
depth until approximatelyy equal soil
test hole. All data to be submitted
from top of hole.
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE' NO. NO. HOLE NO.
G. L.
611 O arJi cS
12"
1811
24" S
3011
3611
42"
48"
5411
60"
6611
7211
7811
84
INDICATE LEVEL AT WKICH GROUND WATER IS ENCOUNTERED A4,
ZNDTCATE LEVEL -'TO WHICH WATER TEVEL RISES AFTER BEING ENCOUNTERED A4 p ` / r 14.w pis
TESTS MADE BY /�r+er. 7�9 -1,3 &W &g jDate Z % /7j
Soil Rate Used / /- /c-MirVl "Drop: S.D. Usable Area Provided ^�►oo �!,$ ' `
No -of - Bedrooms Septic Tank Capacity ®p® Gals : Type , r
p By 1 0 L.F. x24 - -3` b" ✓ width trehcFi���
Absorption Area Prov ded
/.. Other
�� (e0v
john. " ren S', . L100_'-V
Address R,., D.'. 6. Box -'353 s:
H• FRS
Carmel , We Yoft, 10512 - r . '�:.�`'. + 1. 1 .1
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal. Chet b.
of e 29
THE STA
Date
t FIELD CHECK LIST
f
Date:
- -- - - • I_ - - - = -- - —
•�:.•- nsp by
INITIAL SITE INSPECTION lYesl No I Comments
Property lines or corners found ._
Can estimate house location .
Will driveway.need.cut . . . . . . . f
Must trees be removed -note these. . . . . . . .
Is deep hole representative of entire SDS area
Additional deep holes needed. . . . . . . .
Sufficient SDS.area available considering
driveway cut,house.location,separation . . .
distances, etc. . . . .
DEEP HOLE ELATA
J_
Depth • -?
Water elevation:
Rock elevation: 6
Soils description: ,
Date:.
FINAL SITE INSPECTION Ins p. by.
House located where shown on approved plan.
SDS located where approved _
Width of trench average
Slope of the line and trench acceptable . .
Room allowed for expansion trenches . .
Over 50 ft.- from swamp; watercourse _ -
Natural soil not stripped or SDS area
unnecessarily graded _
10 Ft. maintained from prop-line and
20 ft. from house . . .
Separation of trench from house.:well
etc. follows plan .* . . . . . . . . . . . . .
. _
Number of bedrooms checks . . . . . . . .
Stones, brush, stumps, rubble, etc. greater
than 15 ft. from nearest trench
15 Ft. of peripheral soil horizontally from
trench. . . . . . . . . . . . . . . . . . . . .
Junction boxes properly set
Could surface run off from driveway, roads,
ground surface, etc. channel near SDS . . . .
area. . . . . . . . . . . .
Does lot drainage appear O.K. in area of SDS.
FINAL GRADING OF SITE ACCEP'TA=
V-
4plool 10
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