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Home My WebLink About0940DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.40 -2 -10 BOX 10 11.1 . . or � 1L1 7 :. � I ;n 11.1 . 3 ..�.�0 PUTNAM. COUNTY DEPARTMENT OF HEALTH Orvisron of. Envvonmental, Help /th ".40, MOM Carina/, N Y fOb12 pest a mow_ CER IFICATE.' O NSTRUCT.ION COMPLIANCE FOR: SEWAGE DISPOSAL':SYSt% �G�C -- nor To 'Block w V it lay Located at ) , Ownef �� // � / / F r1Y ,�3 f Tax tAap Lot ,# SUM Lot q r orme- - Separate Seweiade SYsteni built by Lam' �_ 1L Mti 44 2• --- Address � � '� 2 Consisting of _ `al. SePtle Tank and �.- Other requ(reme s' Water .Supply. ,,;��Iliiy blic Supply From lih ate SuPD1Y ,Drilled By. Address';: Building Type No of Bedrooms Date Permit Issued', Has Erosion Control Been completed? I certify that the syetem(e),as- llated serving the above premises were construcped essentially as,ahown,on, the plena of;the completed work'( copies. of which are and with,tha standards,' rules and regulafiona, in accordance'with' the fi'led.plan,i.`an3 the permit issued by'the. Putnam County Department Of Health Date Certified by E. R,A Add►eu Lieen No I - ` . "' V9 L� A i Any person occupying, premiies.served by the above systems) shall.piomptly take such actlon'as may be necessiry to secure the correction of any unsanitary* conditions resulting from such u age Approval ;.of the. Separate se - a" _system shall become null and void; as .soon as a .put llc sanitary ewer becomes- , available and the approvai'of'the . private,.vvater supply shall_'become null and''.roId ,when a public water supply becomes available. Such approval$ are subject' a ct to modification oi. ch "anye when, ;in the:.,)udgmerit' <of the ,Commissioner. of`; Health; such revocation; 'i»otlNleition of "change is`necessay. ciate By - Rev. 9 -81 BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225 -2072 — WATER ANALYSIS REPORT — SAMPLE NO. 6443 SOURCE: Thomas F. Kelly 24 Homer Drive Putnam Lake Brewsteri NY COLLECTED: January 2, 1987 BY: P.F.Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method faucet - well This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. /Z r January 6, 1987 Roy Bickwit P.E. Director Map 20 Block 2 Lot 10 & 11 0 per 100 ml. 4- T # NEER, J0,�RRWIDE. -PERMI OF,'HEALT11 �,F.jT.NA.M,.,COUNT.Y,---,,DEPARTM,El4T ENGJ ON -'.PPTbFj-C-A1E F C mpt"I AN E Dfvisfon of -.,ti7viroi?me"ntit,.Health'�Sdrv'ices; carmei -M - 12 Y PER CONSTRUCTION PERMIT I -FOR 'SEWAGE DISPOSAL, SYSTEM Town 7or Village, AJ at Block lot " Renewal 0- on Revision,: Subdivision S ne.al_,�� OwnbrZA:ddiess"".' ;�Sectibn- only ❑ Number" f Be roo Design H• °, D Notification '.Required Separate_ —Gal Septi 'Tank 'and Sew:6raoe :s of - :System -7M b � n t ict- To e id cons jatl -b; Address' er Supply "I 1� -PUblic S6ppl Y F!Orn Private Supply to be jdritled AL-L, Other :Ad ess, ` remen s 5 0& �Y T_ 6m that th'e,"paiat Wage disposal system "rit.thait..1 am Wholly "and _o� the pr6p :Tepresq s -location: ible for cloisigri:ond above dekii6id'iWill be c6nsi;ucfed as shown-on the aopi6."d ir��drhd6t-'t-here,io,,ar!-ij--i'n'a'cco ndalds, rules and r.egu lat ions. oT-We . Putnam C66nty. De;;artment' , of an d that _ 0!.Cc rti icate, �oi-toistr, actory,to the Com Mistioier of'Health Will _"id�bullld ' ' be,,.subMitted_ to ;the Department, - and I'NWritten' 'gijiriniei wiir,6ltjlu'rniihed iW6wne' 6 the- builder iiiat i er will place K. 9PS y in 46o hibn sfrem.-I.d" 2)" ed iateiy�.foqow j!,.9 f opera o"g. �,!�jdate,o 1he issu • 4'fiii'thi drilled Well'descri - ance.'o ;Cert i. icate of: Construct idjn_`Co'rnpii' ij 0441hal he,:�approva,l of he f ��' k r p e_-"iq!jhe1 :; ove j cour ty D, I 61i.iitmeilt of HiWih. I j Dii .4 -AP Address �D -CO _A0PAOVEb�' R Th C f u!e r _Pbr i� Is revocable.f6r., use. 0 may -be amendlblig requires a n , d for Date Rev... 6/SS:-.j 91 Qin'� Srid hai��ild well ,Wifl` a ns &I ed, :aic I I o S JU OnS M Signed R R.A. P. E. �AfiZ 5 R Rj, &L V V14 is- a0provm'dioRes y year-f I d date-- issu S S.- h Licin i,moclifie�clfWhen-co e eiei Y Y h6-60 i i so 3 3a Any -change or aiteratio,n`.Of,construction PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT_ f DATE: INSP. BY: (Name oflOwner) )"(Street Location) INITIAL SITE INSPECTION YES NO COMMENTS Wetlands on /or proximate to property........... Property lines or corners found ................... Can estimate house location ......................... Will driveway need cut ............................ 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 ............................ L.n. - nu1C G.W.- Groundwater D. H. 1 Lot D.H. 2 Lot D. H. 3 Lot Depth to G. W. Depth to G. W. Depth to G. W. Depth to rock Depth to rock Depth to rock 0 ft. 3 ft. 6 ft. 9 ft.�: 12 ft Soil Description 4i �! is J I , „ 0 ft 3 ft 6 ft 9 ft 12 ft Soil Description Soil Descri tion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. NO COMMENTS 1 -I DATE: FINAL SITE INSPECTION INSP.BY: - `YE 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 fran property line and 20 ft. fran house .............................. Distance well to SSDS (ft.) ...................... Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally frm 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....... PTNAT. MAnNG OP . TTR WrRPTART - _ _ _ _ _ _ _ _ _ -V. ,/ �. X �> L Soil Descri tion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. NO COMMENTS 1 -I PmMM COUNTY DEPARTMENr OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES 24DIVIDUAL WATER SUPPLY & SUBSURFACE SEKAGE DISPOSAL SYSTEMS REVIEW SHEEP - CONSTRUCTION PERMIT DA .Y• u (Strebt Location) (Name of Owner) Permit Application Corporate Resolution Plans - Three sets Engineers Authorization' Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAJIS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench/Gallery; Pump 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/.Gutter Curtain Drains FP1 6-', 1 " Deep I H,61 I e Lo('Ja'! , -sion Area Expansion ravi is size If PL,,', Pit '0,- Clk TI-t--iled .p,A — & D �- House - No. of Bedrooms Wells & SSDS's w/in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1/4"/ft. 4110; Type pipe No Bends; Max. Bends 450 w/cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 101 to P.L., Driveway, large Trees 20''to Foundation Walls 150?' pl, --k; 10 Ur! D 100'`to Stream; c%0Ur , Lake inc. expan). 151 to Drains-Cartain,Storm,Ioeader,Footing 251 to Catch Basin 101 to Water'Line (pits-201) Septic Tanks 101 fran Foundation 501 to Well 151 Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex-approval SSDS Adj. Lots Checked Wetland (Tbwn/DEC Permit R & D) Data On DDS Plans & Permit Same . • • WLV, 11U LV T M!tx rEmns 1. Outlet 2" beicw inlet 2.- - Mhib= 3" ba:Vcf paa del 3. Y nimLm dgkh cE liquid: 4' 4. Iar3th - mini=m ba a width to maxim= fair tins; width. 5. Mmdmm 12" cover. 6. iomtim sue. 7. Mx� - cpazinq - uanimm 20" in dr ter dmaisirrt. 8. Baffle edzil 20% cf licgzid dqpth above ligd level (c3=41, b=10 ", cl= 51,b -12 "l. 9. If lex th G.T. 9 feet - use 2 cmparhmts. 10. Mirrim= tank qty 1000 ca1/3 be3roan; 1200 gal/4 ke3ron134 co Ixlrtn;161 cf/4 bchm. 1l. A4±131t1c coating fcr relrtfcrcEd Cl1=ete. .2. Inlet teeB.ffle 16" below flay line. 13. Qitlet tw/baf fie 18" belay flow lane. 14 nteL pipe s1 cpe P per foot non. (2%) . 15. Inlet pipe cast ism, 4't&. 16. (10 pipe s1cpe 1/8" per foot min. (A). 17. Odknd pintas for sanitary tees. utitt• r. � � :� •a►• t 1. Id ft incest min. 2" above aztlet invert. 2. Alt aztlets at , eleatlrn. 3. Outlets 1" to 5" above tank bottan. 4. Minim=12" ba33ing clean sand ar pm gavel. 5. Inlet inffle. 6. MDdmtn 12t1 mgr. 7. Fariomble cover for 8. :_alai pipe joints (asl-Bl tic c r mil). S'l pe cutlets at 3/8 ir�/ft , (1$) 10. Est P : - - -- r;+au 1 ,am , clan: •sw: t 1. aq:e 1/16 in. /ft- to 1/032 in. (0.5% to 0.25$). 2. 1/4" to 1P crud-ea stc a ctr wad)e3 grail 1 4" nnnim n lateral di weber. 4. 2T1 minlnlln aggx to mer latml. 5. 6" mini=m aggzegate ='Lmr lateral.. 6. (iztxtaatai b l di ng Fir c r 2" of st mw over te- 7. 6" mdnimm, 12" UEodnun earth baddill. 8. ORE'i11. to allow fog settling, 411 --G'. 9. 2'manimm from tre rh botfon to water- 55ft.92ae 10. Train.fran t2erich bottan to 7 ft. grade. 11. amxh =in.6'0.G(24 "trerrh). 12. L =nac-ks3 lateral ells mist be plugga3. 13. Fill - 2:1 sl,ges man. 10' bayad t rexh. dq:th:3j'mmLcver ends +;2'max.cver pater p b�z3er. 1. Rp cf casing 1811 a om %urx . 2. Mqp cf a surg 21 above HC ar Wit. 3. - -Mir: mm, -20' ®..sing cE .steel cr wrc#t iraL 4. 10' mini=m g= t into, rock, 5. O.ttlet 41 belcw O.G. min. 6. Sanitary smis 7. Gmxxi gm5ed a ay fm a cell. - • •tt• i r,• i .mac• t 1. CverfiU to allcw fcr settling: natmal. soil .xk 3. Ulzeated hOdirxg pper. S. Min. perfcmted • •- 7. : •- boanch. Dq-th a5egEte- 9. fnm U. arm 151 idn. i••• •• t ►may o� - • _, t n APPENDIX D CONSTRUCTION NOTES SUBSURFACE SEWAGE DISPOSAL SYSTEMS & WELL WATER SUPPLIES SERVING SINGLE FAMILY RESIDENCES Basic Required Notes . 1. All trees within 10 feet of the proposed SSDS shall be removed. 2. SSDS to be inspected by the design engineer /architect and the Putnam County Health Department after construction and prior to backf ill. 3. No trucks, machinery, building materials, nor excavated earth shall be allowed in the sewage disposal area. Construction of SSDS to be in accordance with these plans, any revisions thereto, and the rules and regulations of the permit issuing governmental agency. 4. Minimum well yield of 5 gpm is required. Yields less than 5 gpn will be im!nediately reported to the Putnam County Department of Health. Notes Required When Fill Proposed 1. Fill must be allowed to stabilize for 60 to 90 days following placement and be inspected by the Putnam County Department of Health for acceptance, prior to installation of the sewage system. Date of placement must be reported to Putnam County Department of Health. 2. Run of bank fill shall be suitable for sewage absorption, be free of fines, or other unsuitable material and shall have an in -place percolation rate _ at. _leas_t__equal ;to that in the Natural soil after the required stabilization period. The engineer /architect ' shall - perf u.Lii► -a-- f r,-al -- - percolation test in the fill after stablilization. 3. Impervious fill, clay barrier, shall be a dense clayey soil with little or no sewage absorption capacity. APPENDIX D CONSTRUCTION NOTES SUBSURFACE SEWAGE DISPOSAL SYSTEMS & WELL WATER SUPPLIES SERVING SINGLE FAMILY RESIDENCES Basic Required Notes . 1. All trees within 10 feet of the proposed SSDS shall be removed. 2. SSDS to be inspected by the design engineer /architect and the Putnam County Health Department after construction and prior to backf ill. 3. No trucks, machinery, building materials, nor excavated earth shall be allowed in the sewage disposal area. Construction of SSDS to be in accordance with these plans, any revisions thereto, and the rules and regulations of the permit issuing governmental agency. 4. Minimum well yield of 5 gpm is required. Yields less than 5 gpn will be im!nediately reported to the Putnam County Department of Health. Notes Required When Fill Proposed 1. Fill must be allowed to stabilize for 60 to 90 days following placement and be inspected by the Putnam County Department of Health for acceptance, prior to installation of the sewage system. Date of placement must be reported to Putnam County Department of Health. 2. Run of bank fill shall be suitable for sewage absorption, be free of fines, or other unsuitable material and shall have an in -place percolation rate _ at. _leas_t__equal ;to that in the Natural soil after the required stabilization period. The engineer /architect ' shall - perf u.Lii► -a-- f r,-al -- - percolation test in the fill after stablilization. 3. Impervious fill, clay barrier, shall be a dense clayey soil with little or no sewage absorption capacity. •PU NAM COUNTY DEPAMMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL MUM SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIE:LD INSPE=ION REP( ZT DATE: INSP. BY: (Name of Owner) (Street tion) INITIAL SITE INSPECTION - - - - - I YES I NO, CCMMEN 'S Wetlands on/or proximate to property... ....... Property lines or corners found .................... Can estimate house location ........................ / Will driveway need cut. Must trees be removed - note these ................ / a 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 or000sed well location for drillincr..... D.H. 1 Lot D.H. 2 Lot Depth to G.W. Depth to G. W. Depth to rock Depth to rock Soil Descri tic 0 ft. 3 ft. 6 ft. r. 9 ft. 12 it 0 ft. % 3 ft. 6 ft. 9 ft. 12 ft. 5011 Descrl ti DATE: _ FINAL SITE INSPECTION INSP.BY: 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 (ft.) ...................... Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set ............................... Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... VTMAT r_onn *r_ nV cTgVP hfY+ nnT V D.H. - Deep Hole G.W. - Groundwater D.H. 3 Lot Depth to G. W. Depth to rock Soil Descrl 0 ft. 7' 3 ft. 6 ft. 9 ft. 12 ft. ..,..�...:::z:,. .;. �,..�...._,��.., :.a...;....,..c..::.c,...c: ..., - .,- _... +, ..�...,...::.: .o. i_..rm , ..,K,a n..fi:- ...,,:�; :, ::._ cv - •,cr ': awe. •s�+y» - s.:5ka:.:,. _' DAVID D. BRUEN County Executive Mr. Howard A. Kelly 37 Fair Street Carmel, New York 10512 Dear Mr. Kelly:. DEPARTMENT OF HEALTH Division Of Environmental ,Health Services May 12, 1986 Re: Proposed SSDS Kelly Allen & Homer Drive (T) (P) TM 20- 2- (10 -11) JOHN SIMMONS. M.D. Deputy Commissioner 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•. A field inspection on May 2,1986..raises concern as to whether the deep holes are located .in SSDS area. 2.. All wells and SSDS-within'-200' of property to be located,. or a note stating none. exists. 3. A discrepancy exists between distances from existing well across Homel Drive and Kelly's property line. The plan .show this distance to be 73 feet. I taped this distance on May 2, 1986 and found it to be 56 feet. Lets get together -on this. Upon receipt of a subnni.ssion, revised to reflect the above comments, this applicationwill be considered further. Yo e�rytruly, ko= Morris Environmental Health Technician RM/jP /• •• • �1• i 1� • NZ -- - -. - - -- DESIGN DATA- SHEET= SumuFACE_SEWAGE DISPOSAL SYSTEM_ -_._ .-._.�— __ FILE ..1�U.- - - ---- - -- — -- Date of Pre- Soaking 7U AP -/L. Date of Percolation Test 26 -47W/L- HOLE NUMBER CLOCK TIME PERCOLATION PERCOLATION Run - Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches i iz � ►2.,.3� �g �� 21 3 � 2 1233 IZI -4 6$ 2-t 3 7 3 ��s� 2t tg 21 3 7+1 ' rl hr 3 /2 5� ev 5 > _ l 1 lob �z3Z 17 -2 /Z 3D /Z 63 7+1 ' 3 /2 5� ev 40, 19 5 � l= G Z �. 1 2 3 5, �,.R 2 St P UDC SAM •OUNTY AEPLT QE HEALTH NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at 'each percolation test hole. All data to be submitteod for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. Q HOLE NO. HOLE NO. G.L. 1' 2' 3' 4' 51 6' 7' 9' 10' 11' - 12' 13' 14' -TIOP so iif -p i9► cu.,Ay -J INDICATE LEVEL AT WHICH GROUNDRATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used Q0 Min /1" Drop: S.D. Usable Area Provided '9® No. of Bedrooms 3 Septic Tank Capacity -1 gals. Type t- Absorption Area Provided By 1 -5( L.F. �Ov ssr Other. 15F 37, FAIR STREET NVA Name Signat Address ,.: THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq <ft /gala Checked by Date n \ ai F leotj PIW SUeVE Y OF P20PE2TY PZEP^eEn �� THOPIAS KELLY mi >,G97" _8355- 'LOT FJO&.5535- --352G AS SNOW" om SIXTH MAP OP PUTI�IAM LAKE FILED MAP st 1.49!5 TOWM OF PATME!SOM Fli -rMAM CO., N.Y .SCALE 1 "= 30' FEB. 28, 198ro SEArEMS�>� 9 . 19a1, Cv�u. LOL.) C-GMTIFIED 'rb P4.v./l..lkd(„ L.th.Vj k.S. MA V— b.JD TO GOMMONISJ6'4F -71-( LAJUT7 TITLE W60ZM%GE Z- oMPAw1Y roe. TWEIL PbucN Jw 2(o)CP 7UP895. GE2ncic.Ltn0►.K ILIDICATEp NEPJ=CIJ sIE.IJIKY "T4LQT LAJALJTIIZ)V-IZ-F-D A13E VAT'ICIU op 4CC>MoLl T441-7 VJAFi GQEPlI ycn 1Ll eCrroea?a 1cE 4YM -ro �nll5 MAP M� A �I1oL �Cncxl cc SECno�J^* TUE EXMSTIL1Cs GopE c� PPrdCT ICE FOe LAAID MEYS A.00PTb> B-( '744E UEW `Obg 1 -S h AAP9,6rJA nMj TZDS cr -roe LF-Vl VOzv erAT =_ EDtK.aT101, of .. P?l-':CEA0%ctJ&L LA"I> SuDJe C-nM. 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