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HomeMy WebLinkAbout1002DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.47 -1 -25.2 BOX 10 J�-6 r IL IN r t . i ' ' NO �r� , . � , `, ill r F , r, - ,le IL _ . 01002 Rev. 3/86 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Mast Provide \� v.. .a .PermitH -. 1 RTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM / Low at 0 Gi Tax Mapes _P Town or VMW 4754 *D Z Block (g Lot_ � Subdivision Name Name . d Snbdv. Lot N Mailing Address ROXeA45 d a zip 'Z'!�x,' 3 Date Permit Issued _7 ± 516 Separate Sewerage System built by (/ V. (:(/ I k (,lkEt61-1 je r! C Address Consisting of d () Gallon Septic Tank and —! Water Supply: Public Supply From AA LL'' Address or: // Priva Supply Drilled byLA� hI a4 T p° IS Address �t� Building Type Has Erosion Control Been Completed? ZS Number of Bedrooms — Has Garbage Grinder Been Installed? Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and reg tions, in accordance witJthe..led p n and the permit issued by the Putnam County Depar ant Of HealQtth. �s/ © i i9 Certifiatl b v 1: P. E. R.A. Date � - -� Address 7 jy ird UCi O License No. 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 sewerage system shall become null and void as soon as a pub "_ sanitary ewer becomes available and the approval of the private water supply shalt become null' and .void when a public water supply becomes available. Such approvals are subject to modifica ion or change when, in the judgment of the Comraliaieper of Health, such revocation, modification or change is necessary. /��_ T Itls 0 Date T- By iu y �1 �4� - u •�. )DIY � �1' t •iW1��1 • .1 DIVISIOL1.OF_IIWM01NMWM- REALTH - -SERV -ICES _ _ ._.__•_.._. .. -- - -. --- .. -..._ _ _ owner or Purchaser of Building Section Block Lot Building Constructed by Location — Street Subdivision Name Municyi�pality Subdivision Lot # Je� Building Type GUARANTEE OF SUBSURFACE SERAGE 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 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 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 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 utilizin the system. 44 A Dat this I day of 19 cl 2-- General tractor (OwHer) - tune Corporation ► s ► t ., v rev. 9/85 mk 3/ Oil Wt LL CUDIrLtIlVIN AZXVt�,t DEPARTMENT OF HEALTH Division Of Environmental Health Services V- PUTNAM COUNTY DEPARTMENT OF HEALTH , Office Use Only WELL LOCATION 57REEi ADDRESS: WNIVIL ! 1rY TAX GRID NUMBER: T tvo I 1 1 WELL OWNER NAME: ADDRESS: T. V c ML"f 6 � PRIVATE ❑PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. 1N0. PEOPLE SERVED / EST. OF DAILY USAGE � gal. REASON FOR DRILLING ❑ EPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY ONEW SUPPLY (NEW DWELLING) [:]DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH a�s ft. STATIC WATER LEVEL :T9—_�ftDAT`EMZSU8ED a 1 DRILLING EQUIPMENT ❑ ROTARY COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH ft. MATERIALS: FSTEEL ❑ PLASTIC ❑ OTHER CASING DETAILS LENGTH BELOW GRADE ft. JOINTS: ❑ WELDED YTHREADED ❑ OTHER DIAMETER in. SEAL: 9CEMENT GROUT ❑BENTONITE ❑OTHER WEIGHT PER FOOT 1Y Ib. /ft. DRIVE SHOE YES ❑ NO I LINER: eYES ❑ NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST YES 0.40 No RS ECONO GRAVEL PACK OYES O NO GRAVEL y SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping P P 9 METHOD: O PUMPED tests were done is in- eCOMPRESSED AIR , formation attached? O BAILED O OTHER ❑ YES ❑ NO Yy CLL LOG If more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- in9 We,t Oia" In FORMATION DESCRIPTION t DoE ft. ft. WELL DEPTH it. DURATION hr. min. DRAWOOWN ft. YIELD 9Fm. Land Surface t Z - r� WATER CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO V STORAGE TANK : TYPE 60d�/ / ✓ tro�C� CAPACITY 30 o�t !'ate crary� GAL. C�Q PUMP INFORMATION TYPE r CAPACITY %-/d MAKER t�� -rL1 h DEPTH aQ4 LM ODELr�Us — y VOLTAGE�UA HP wELtA�Rb 4 At HYATT & SONS, INC. DATE/ O f �� ADDRESS Well Drilling SIGir:tTUAE Rte. RS R.R. 2 Box 171A PATiER3rJN, NEV-1 YORK 12563 ACe-1-11 3/ Oil NORTH AMERICAN LABORATORIES, INC. ANALYSIS DATA SHEET COUNTY: Putnam LOCATION: Tivoli Rd. REPORT TO: J.V. Construction ADDRESS: Box 449 CITY, STATE, ZI DATE COLLECTED: TIME COLLECTED: COLLECTED BY: REPORT DATE: SAMPLE: P :Patterson, NY 12563 9 -30 -92 10:00 AM Client 10 -02 -92 DW 8072 ...SAMPLE.'-SOURCE.:.... :.. _..._ _ _.�_._......, ... DATE ANALYSIS RESULT UNITS METHOD ANALYZED Total Coliform Absent COLILERT 9 -30 -92 THIS SAMPLE AS RECEIVED AT THIS LABORATORY MET THE REQUIREMENTS OF NEW YORK STATE DRINKING WATER STANDARDS. tory Director NEW YORK STATE ELAP CERTIFICATION NUMBER: 11218 618 CLOCK TOWER COMMONS, RTE 22, BREWSTER, NY 10509 / 914- 278 -7600 / FAX 914- 278 -7754 E PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Ccamnissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION IWE Orig. Routine R � Orig. Complain ADDRESS ®({ �y ?Aa`��� �4 Orig. Request No. Street Town TM No. Compliance Complaint Comp MAILING ADDRESS Final P.O. Bcx Post Office' Zip Code _ Group.Illness Construction TELEPHONE Reinspection PERSON IN CHARGE, n� Field, Sampling Only OR INTERVIEWED �'� ate+ &4 Field Conference Name and Title Other DATE 'J�6 TYPE FACILITY TIME ARRIVED °0 6 TIME LEFT 2. 3 4) FINDINGS: Explain INSPECTOR: ture and Ti s /� A ?H t TELEPHONE: PERSON IN CHARGE OR INTERVIEWED- I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: ale r: RMWATBOF - i -t; 1 f V01.i,. mod -E ""d— ° s.vwal Degiac PNOW Anievhl ,tg..s Adk.ee echo MP 125(03 ARRrove . A t j t�s Subdivision. i ,,,ft TAP mss,d ez e- I" "..J�, dam.. �r� � ii s.�., 0.4 w.>... Ebr G P D ® PCB r�.uera�. !• > wwt� rr� 1. «.lira souvb ftwenw'srNW to oadW 4 : l6$� e.. s.*ue Took Adlirew wows sasKbY �lrfie s�r,y, tea. Adikeea .. an War 1 rypraaalP Ihet,I am wholly end C"pi"' !h.►!WOh1610fp the "n and location of the proposed system(sls .1) that the n , ate' as�i di s1i1 stern some dalaKfed will Is constructed ae shown on tMOpp►ow0 atn"wniant' there to and in L aceonun0a with the standards, rum one resulax ions or InG County Oepartaniad- Of Haalth, and that oncow4lietlon.tMnef a "Certificate of Construction ComWlanfw',astisfaactory t0 the CanmlMioher of IfaaKhwlll be valor" bd to the OepMtnIdInt and s vrritt�Pn �uanatee wiRAef► furnished the owner, his sucpssarS. he"or anions by the builder. that aid builder will fW M;post .ofre►►ptono f7011dKlon;,arija pint of ni0'fwpN dN00Y1 systina surly the parked of two:(2) years knPnMlatNy fo110vrlrf/ tM,date "ef the haute Mao Of the O1KIrOie�' Of the- Cenik :ate' -of .Construdiew ConnWYnp .of t. original �j DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 105].2 (914) 225 =0310 APPLICATION TO CONSTRUCT�A WATER WELL - PCHD PERMIT WELL LOCATION Street Address Town/Village/City Tax Grid Number -f �G 0 eo A P /f77;6 - S"n_r � - � - f 7N T� 4701 WELL OWNER Name Mailing Address G[Private �-vS �i�I� G� �/¢I.✓ .99,4 041 4 1rAC�S110I ?,c ,0P 01 �� �VyD Public USE OF WELL primary 2 - secondary A,RESIDENTIAL ❑ PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP ® ABANDONED ® BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify ® INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY AMOUNT OF USE YIELD SOUGHT gpm/ # PEOPLE SERVED 9 S /EST. OF DAILY USAGE D0 al 13 REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION 12 ADDITIONAL SUPPLY 9kNEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING ; Z3 WELL TYPE MDRILLED 13DRIVEN ®DUG ®G-RAVEL 0OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION:, NAME OF SUBDIVISION: Lot No. 2- WATER WELL CONTRACTOR: Name 7-9 -12 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN c ' ' "�'" " " " '" ' -" � ; "' � �-� � • -_.. __, ._.._.._.__ . _. . LOCATION SKETCH & SOURCES OF CONTAMINATION M ON SEPARATE SHEET !a �3 S9 (date)' PROVIDED j �,4-elj 4, ignature) 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 the Putnam County Health Department attached to this permit. 3. Submit a'Well Completion Report on a form provided by the Putnam County Health Depa ment. Date of Issue: 19 ` Date of Expir on: 1 --;e ~rmitss g n c -- -- Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector Rev. 10/88 Pink Copy: Owner Orange copy: Well Driller DIVISi,,0 OF ENVIRCREYM MLTri SEFZU,- S DESIGN DATA SHEETSUBSUFAC.E SUgAGE DISPOSAL SYSTEM FILE N.D. _C wner Acldress�} t-Sl i©Y2C 1 Located at (Street) • Tyout .Sec. z5-Z- , z5 Block : �o 78 ( indicate nearest cross street) Lot Municipality - �/��fT'C�YLSc� Watershed 62j-004 SOIL PERCOLATION TEST DATA RWJIPM TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking Date of Percolation Test SOLE NU-IBM CT-= T72E PERCOLATIC N ..PERO ATIC R Run Elapse Depth to Wader Fraa Water level i No. Time Ground Surface In inches ; Soil Rate . Star Stop Min. '_ Start '. Stop Drop In 4u Start-Stop In. Drop Inches Inches inches 1 F3- 1 - I0' -o3 �33(� Z A - la- 40 Z 2 4 zZ7 7 41 j`t : 3�. 2' 3 tZ.v 4 l Z7 2 (c):02- 10,35 `'33 2C -Z7 3 Ii, o 4 5 1 2 ... 3 4 5 `NOTES: 1. Tests to be 'repeatedt at same depth until apprcximately equal Soil rates are obtained .at each percolation test hole. All data to' be. =i nitttd . for review., 2. Depth measureaditts' to be made fran top of hole. TEST PIT ,iATA 'REQUIRED TO BE SM41TTM W15H APPLICATION DESCRIPTION OF SOILS ENCOUNFERED.IN TEST HOLES . DEPTS HOLE M. HOLE M. 2 HOLE NO.. G.Z. 21 3' 4' 6' • 7a 4 - 9t • 10' 11' A7l �4O WY-- i i 12' . 13' 14' INDICATE LEVEL AT WHICH GROUNI7FMM IS E.N9WNTERED Z�- (r n/ �, O n INDICATE LEVEL TO WHICH WATER L1:'VEL RISES AFTER BEING L i DEEP HOLE OBSERVATIONS MADE BY:—"V>( DESIGN Soil. Rate Used 11- (5 Min/1" Drop: S.D. Usable Area Provided No. of Bedroans 3 Septic Tank Capacity 1000 gals. Type 112�1� Absorption Area Provided By *7G L.F. x 24" width trench i Other Name 1AQQfUJ7 Fd&WE6D/U& PL. Signature Address DLtyE SEAL l �, NO.661 '24 -- - _ 9�FESSIOK� THIS SPACE FOR USE BY BEALTH DEPART ffM ONLY: Soil Rate Approved - ,q.fVgal.. Checked by Date t:Y.0ULUn tL1:4.—Il DI, 3- OF ENVIlUZENTAL HEALTH SL DESIGN DATA SHEET—SUBSUFACE SUqAGE DISPOSAL SYSTEM FILE NO. Address Z-4h',�-J /-/02 -..Cwner-. -ie 771il 70 Located at (Street) T1 ✓o 4 Sec.. --"2- Block 6c Lot �7B/ (indicate nearest cross street) Municipality 7 watershed SOIL PERCOLATION TEST DATA PBOUIPM TO BE SUBMITTED WITS APPLICATIONS Date of Pre- Soaking g z Z f3 Date of Percolation Test Z?. 7.0 HOLE 2 9: NUMBER CT= PERCOLATION 31 %„ PERCOLATION Ran Elapse Depth to water Frcm Water Level No. Time Ground Surface In Indies Soil Rate Start-Stop Min. start stop Drop In Min./In Drop Inches Inches Inches 4 //-/6 //40 Z?. 7.0 .5 2 9: 241, 31 %„ T/ 4 73 2 3 7 %¢,, -3 314 Z8 4 419" 7-0 4 //-/6 //40 7.0 .5 JD 2 7 %¢,, -3 314 3 4 Z- 041, 3 4 5 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 subdttlad for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 DEPTH G.L. 1' 2' 3' 4' 5' ... 71. 8' 9' 10' 12' Tr,JT Y1.T L ILf . rj-' JU n r.0 1y t.u, DESCRI 'C )F SOUS ENCOUNTERED IN TE * q . S� HOLE NO. HOLE NO. HOLE NO. 13' 14 �. INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOtTNTERID N,' l� -INDICATE -LEVEL TO- WHICH WAS LEVEL RISES AF M BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: 47,- &ral(,, r2 G RA w5 DATE: Iq SS DESIGN Soil Rate Used /G =2 Min/1" Drop: S.D. Usable Area Provided Soo No. of Bedrooms Z Septic Tank Capacity 10o— gals . Type C D Arc. Absorption Area Provided By 286 L.F. x 24" width trench ,4 Ts'a Name r Signature # (I , ') Address 72 17A1,t'1c71.E6.O tOR l V,� SEAL ' J'F A L/ /1 T T,�P 5 c /V �v / 2- 3 0 A No. 56124 AOFE55 10NP�. THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:. Soil Rate Approved sq.ft/gal. Checked by Date r • • r• • I� v •I �• gg «a. _ ...._DESIGN DATA SHEET SUBSUFACE SEWAGE DISPOSAL, SXSTDI -.... _.. �. _ FILE_ Imo.. Owner Address Located at (Street) o1� le 'd , Block Lot (indicate nearest cross. street) Municipality Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test a3 HOLE :D % NUMBER CLOCK TIME PERCOLATION PER OLATION 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 x.30 2 .5% 9 3/Y 9, 4 f/: io l/ - y0 30 0 5 1 9:13 -�11 13-0 3 /'4'.7-1/ :D % 30 )W / %Q 4 303�y 5 1 2 3 4 5 NOTES: 1. Tests to be repeated - are obtained at each for review. 2. Depth measurements to rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to'be submitted be made from top of hole. DEPTH G.L. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES —HOLE-NO. . _ - - - -- HOLE. NO. _.HOLE,- NO. ... 1' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED c� OBSERVATIONS MADE BY: �ffla /f L� �/y� i, DATE: 3 DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity gals. Type Absorption Area Provided By L.F. x 24" width trench Other Name Signature Address SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq<ft /gal. Checked by Date WINAM OXMY DEPARTMENT OF HER'''E., DI 31' OF ENVIRCa4E= HEALTH SE_ 1i DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. . _...... _ Owner Address - G 9/f S - tc. �✓ �. 4 77� rd Located at (Street) ji ✓&, L t %lo A SZ Block Lot �781 (indicate nearest cross street) Municipality ty T T Ei?5 0 %/ Watershed C%?v T. SOIL PERCOLATION TEST DATA RBQlnW;T0 BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking g z Z�B Date of Percolation Test g z 3 z9. HOLE 4 - 2 9: �C -1b : 38 :-58 N[FMER CL= TIME . PERCOLATION 31 � " PERCOLATIC N Run Elapse Depth to Water Fran Water Level -3o No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 9.09 -9: z9. 4 - 2 9: �C -1b : 38 :-58 2.¢ `' 31 � " %33q ` 7,3 _ 3 /0;39- 11.:69 -3o z�'' 20- . ��9" 7.0 5 CIL4 11 3 a 11W � z s % /7 0 c - //; 38 20 5 l 2 4 5 NOTES: 1. "'Tests't6 be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to' be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 '1'k�'1' Yl'1' LHl't+, 1[;'' u' �'•' • tv nu .vu•u11� ��.. DESCRI" C )F SOUS ENCOUNI�R IN TJEa- DEPTH HOLE NO. HOLE NO. `L HOLE NO. G.L. 1' 2' 3' r-✓ (�7 S! LZ'-( 4' (,n AYP% LIOA -161 5' ... 7' 8' 9' 10' 11' 1.2' 13' 14" INDICATE LEVEL AT WHICH GROUNDWATER IS E )UNTERED n1,li. ' -1N`i IC TE W1m .TG- WHICH PiA= LEVEL RISES ,A BEING MMXXXJNTERED . DEEP HOLE OBSERVATIONS MADE BY:�>, ��a�, t2� L �,a�,c n s --.D=: DESIGN Soil Rate Used /G -2v Min/1" Drop: S.D. Usable Area Provided So- No. of Bedrooms 2 Septic Tank Capacity /0.)- gals e Type ✓� . Absorption Area Provided By -286 L.F. x 24" width trench Other Name t/ /? ANT" Exle RIA Signature Al afft, 4- Address 73 r,41,e Flz'L. 2 t9R / y,f SEAL k _ P/I 7-T� 1 5 C /�/ IV Y � LS( � O No. 56124 A9OFESS10NP� THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq -ft,g - Checked by Date 5 Z9. %a'' S%z ' S.3 29--/x:. SL Z¢�. ..: Z ?3/¢�' 33/¢„ %3 S 3 10,--37- l/- D7 so 3 /o ; 39 - >l : e9 ; 3o Z¢'' 7.0 5 29--/x:. SL Z¢�. ..: Z ?3/¢�' 33/¢„ %3 S 3 10,--37- l/- D7 so 1 V 3 5 NMM: 1. Tests'to be repeated'. at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to' be submitted for review. 2. Depth measurements to be made frcm top of hole. TEST PIT DATA � ■• �• • X11 �• .. i ICATION No. of Bedroans Z Septic Tank Capacity loo— gals. Type � D IV'C, Absorption Area Provided By .286 L.F. x 24" width trench Other 5 Name z ggA1r gi4 /G1AIz-4R/�iie { 4.s5 6 c -Signature e� Address 73 SEAL _ No. 56124 /3/17- T,�P 5 c /V A,, L/ / tSG 3 ��� AR�FESSIONP� THIS SPACE FOR USE BY HEALTH DEP 1T:'gMY- Soil Rate Approved ., sgeft/gal. Checked by Date TEST PIT DATA DEPTH HOLP. -NO.. - G.L. 1' 2' 3' 4' 5' 6' 71 l $, 9' OF YLC—(—L WA�7ff- AcZ Z' - -& 111S ENCOUNrEREp IN TEST .HOLES HOLE-NO.— --96LE NO. C) s 10' ' 11' . 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS EN000NTERED Z -- (( �` �n l �"J f ' O INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED /A DEEP HOLE OBSERVATIONS MADE BY: �A CU-� Vi (64)us J L. DATE: -23'' 87 DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided 'g. No. of Bedroams 3 Septic Tank Capacity ► 00(p gals. Type LeAf02e-r� Absorption Area Provided By 3?,G L.F. x 24" width trench Other ,� /n� M4 Name i� ")Lj ('.FdbWE6DA)& *5oe -., PC. Signature Y L� 2I Y S O� �ti D Address SEAL i + - t 'Po w1 o .5614+ AA ®FESS10��� "y THIS SPACE FOR USE BY HEALTH DEPART ONLY: Soil Rate Approved sq.ft/cral. Checked by Date PUI'NAM' OOUM Y DEPARIMEIJT OF HEALTH DIVISION OF ENVIPMOML HEALTH SERVICE DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FiLE'NOo owner X WC- 6<W Address 4774 Located at (Street)' -I\JOUk sec. Block Lot 4707 (indicate nearest cross street) Municipality �/�'CZ�-YLS�c� Watershed SOIL PERCOLATION TEST DATA RDQUI.RED TO BE SUBMITTED WITH APPLICATIONS Date of Percolation Test Date of Pre - Soaking 4-27-t -7 HOLE NOMSM CLOCK TIME PERCOLATION . PERCOLATION Run Elapse! Depth to Wader Fran Water Level No. Time :- Ground Sgface In inches Soil Rate Start-Stop Min. '- Start Stop Drop In Min /In Drop Inches Inches inches 1 3I r I� 03 �F32, Z `C` 2-7 I b,-7 - 1 2 io'•04 -- ion 2� '2-7. 3 10'41 - 1'.1 -Z 4 5 Z 2 x.02- 10,315 3 24 -7-7 5 , 1 ' 2 3 4 "NOTES: 1 Tests to be 'repeated• at same depth until apprcocimately equal soil rates are obtained at each percolation test hole. All data to* be.submittW . for review....., . - 2e Depth measurements to be made frcra top of holed ` �' PPPENDEC B P:� r^Tr. "_ �.�, -� *n,- D 1. 7r OF b�?i,' - DrP_"F1G1 GF ENti .0ZiE7E;.L sr`"c.Ur.. SERVICES Lit r`i�`1j1SuP °I,� & S:J:J1't F ?�Sr. DIS�.�L SiS'�S ._ _.�,...._. ....._..�.._'__-__- -____ ... _._ _.._......_ ._ -. _.�C- S/i -^�;y. C'•.:�"-'Y .--- .C.1NSL.L�TCV__DL'r1ViT'�' ... _. a= c`.. -__r) (S�= -r Lcc ca) C =' YES NO I — I i i I I I I I y I t y I I I I I I 0 I I I I I I 6 e Ev 10OZE I I I I I I I _ i ( I I I I I V1011 I i I to V �_ I P.Qt as I I I i I I I flccc elev. I �I oe I i 2CC. fr_ r=s=vci -, .r= U I 150 f t_ I/ I I I P � P cl_�ccn C-- r- -cr3t-- ResoiutiCl Pins - Three sari. Lr..ia.ln�nr.7 t>'.' � .•lC.ri2c l.iC:, Oat— Cl_CCt (:i C—I ) C L: Ec- = Lcc s/ Ccrsistant Pere ^re=p t= (3 ) P=rc able DeDt�i c= Sties'_ variaace CC =-fir. Data Ca OUCS - FEQUL -7 D=-:1 CN- D c i SCX; T, en, _' _i ; r I t de tE-_ = .se=.LC mank — Size, Detail S-rvL cs L_'c if C'vc= Dr- veiav & S l c ce= Cat - 'CI G_ ., C.—K,FcCL F °_:. De=n . s F Pi t& D Ecx S-ILcW« & ficLe - I�Tc. C-J Ee✓rccros SE-S's riIi'. 200 L C. Ce:VC' No s; Ma :c- Eer:Es 4-55' S =- ; R8=-N Dl-cT3L\= SP =C- CN Fi =" 10' to P.L. , CL 20' tJ F c undaticn Wa 1s i-0r i -- 100' t•.0 Pie_1; 200' in D.L.C.D, P - -- 100 t0 5 i._- ...=f1 Wat=- 'C✓Jur_c, - {� (;r�c• E` 15' t'c Dr`i^s C.lT =i 1, Lacs -f 10' t0 t.r Lin (cite - ='3` ) 10, FS { t i} I iAI ^AiMIMIMIMI ^AIMInJ1;MIMIML.A% MINI ^nlnrin AlnflMlMln .r1�`:rl•JIIMIirinAin:A(i AIMI ^rIMIMIR ^I ^nl ^.ninAl i^I I fiy `^ nIMIMIMI ^rl ^AIMIMI ^,/�IwwlRnliAIM! /11 r MIMIM:MIMIMIRAIM'�AI^Al l�l^ Alnnl^ r% ® 1 NO { t i} I � ---- ----------'---------���� / ` PA--1 PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of. Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 014) 225 -0310 November 1, 1989 Laurent Engineering Associates, P.C. Harry W. Nichols, P. E. 73 Fairfield Drive Patterson, New York 12563 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Re: Proposed SSDS: Braun Tivola Road Patterson, TM #52 -6- 4774 -81 Dear Mr. Nichols: 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 letter is required from the Building INspector of Patterson stating that- the above- captioned lot is a legal- building lot. 2. Deep hole test results not provided on design data sheet. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris Assistant Public Health Engineer RM /jp PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 March 6, 1990 Laurent Engineering Assoc., P. C. Harry Nichols, P. E. 73 Fairfield Drive Patterson, New York 12563 JOHN KARELL Jr., P.E., M.S. Public Health Director Re: Proposed SSDS: Braun Tivoli Road (T) Patterson - TM #52 -6- (4774 -81) Dear Mr. Nichols: 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. Percolation test is to be witnessed by a representative of this Department. 2. It is suggested the proposed well is relocated so it is not in close proximity to existing well. 3. Proposed expansion area is not acceptable due to excessive slope. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris Assistant Public Health Engineer RM /jp PETER C. ALEXANDERSON County Executive JOHN KARELL Jr., P.E., M.S. Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225-0310 Mr. Harry Nichols 73 Fairfield Drive Patterson, New York 12563 Dear Mr. Nichols: March 30, 1990 Re: Proposed SSDS: Braun Tivoli Road (T) Patterson TM 052 -6- 4774 -81 Field inspections were conducted by the writer on March 21, 1990 and March 26, 1990. The following was noted: 1. Drainage course adjacent to property has not been shown on plan. Determination must be made, i.e., whether it is a stream or a intermittent drainage course. In either case, this issue must be addressed and plans revised accordingly. 2. It is apparent material cut from the hill on the east boundary of the property has been pushed to-the SSDS area. Additional deep test holes -are required to determine the original grade. Please contact this office to arrange a time that a representative of this Department may be present. 3. Expansion area is not acceptable due to excessive slope. 4. Assuming a three foot fill section, the fill section must extend horizontally 10 feet from ends of trench and then slope 1 :2 to grade. Therefore, the ends of the trenches must be 16 feet from the south property line. Upon receipt of a submission, revised'to reflect the above comments, this application will be considered further. der truly yours, h,�:r' `0*11W Robert Morris Assistant Public Health Engineer RM /jp C "' -SUPE-RVISOR_. __.- Lawrence M. Lawlor (914) 878 -6564 TOWN ATTORNEY Raymond M. Maquire (914) 878 -6500 r ; ROUTES 164 & 311 PATTERSON, NEW YORK 12563 .T OWN BOARD Thomas Bubenicek Antoinette T. Gillotti William Peragine Frank Schmalz) TOWN CLERK Josephine Campanaro (914) 878 -6500 PVIr. John Calbo - Building Inspector Towan of Patterson Town Hall, rtes 164 & 311 Patterson, New York 12563 :Gear Mr. Calbo May 12, 1987 In regards to your recent query concerning driveway placement on a property owned by I,Tr. Joseph Braun, Sanborn Rd., tax number 52- 6 -6.1, I offer the following comments: Upon visual site inspection of said property, in your company, it v.-as determined that the effects of a driveway cutting the southern marginfof the wetland in question would be minimal. This conclusion is based u-!)on the size of the wetland, and-the area of the basin that drains into said wetland. I.do recommend that the driveway be confined to the corridor as you defined'it to me, and that the contractor minimize impact as much as possible. Further, I recommend the placement of a culvert not less than eight (8). inches in diameter at the lowest point in said driveway to eliminate the possibility of sheet flow over the road surface during flood periods. In regards to development upon the remaining area of this lot, please keep in :Hind that the pending wetlands ordinance for the town Will recuire 100 foot setbacks from wetland marginsfor both hoinesite and SSDS locations. The setback shall be 50 feet from the ten .(10) year highwater ini ark of any stream course. I realize that this iraposes severe limitations upon further development in the Putnam Lake area; future projects in this area will have to be dealt with on a case by case basis with waivers or permits issued by the Environmental Conservation Ins -oector where - deemed appropriate. Thank you for bringing this matter to my attention. Resp ctfful su tted, /Ken S. o iu , Geologic Consultant, BCC, Patterson LAURENT ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE PATTERSON, NEW YORK 12563 (914) 278.6108 -(FAX) 2782658 RANDOLPH W. LAURENT, PE. HARRY W.NICHOLS, JR., PE. CONSULTING SITE ENGINEERS Date: June 12, 1990 Job: 8748 To: Putnam County Health Department 110 Old Route Six Center Carmel, New York 10512 att: Mr. William Hedges Project: Lorraine Braun SSDS Tivoli Road Patterson, NY Description: Construetios Permit "or two Z2) bedroom house. Floor plan deleting sewing room. 2 copies) Sent Via: Hand Delivery Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Ha W. Nichols, Jr.,P.E. 8748 /map cc: Mrs. L. Braun w/ encl. Rev.No. /Date - ti .. . ; F. l�O�� ���� - ---_ -. ol S { t y y r. - i - j : _ , t ' t w • ' ^2 - � 1. 7T iP to o. �� /� /a, oo; ofi.6g � uN o _