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,J. r PUTNAM.COUNTY DEFAaTNMNT OF HBALTH
UUU ` rDWidoiotFarvhaaimeetalHeiMSeevloer ,Cmjm d, N.
1OS12
PMmN AH D C P P 90 -.86
` 1
TE OF t oNSTBUCTION COIY PLANCEYOR-SEWAGE-1)ISPOSAL SYSTEM, PATTERSON; - ._ .._ .... ._...
Town or V
Laested at BARNARD ROAD', ' Tas Map 5 5 3 & 4
- Lot .
Owner /appllpnt Name'' A PALLADINQ> Foenieely BARRESS S N� P.UTNAM LAI{E
P 0. BOX 675 ARMONK N.Y. 10504 •7708- 7715 -8 LOTS
MaWng Address r ' �P Su1idV . Lot ��
Fee Enclosed �] Amount- 1 0.0'• , Date .Permit .Issued 6/26/89.
SepoeiW.goweeape Syatem 6M by A 'P,ALLADINO Aa�eaa PP 0- BOX. 675, ARMONK- N
_ 'Y
ContabsfloE a(" 1 ,� 00 Goei Septic Taok'sad 1 5 � . T,TN .A FEET TRI- GALLERIES
. Witer'St+pplye PubUc SuPp�Y From
i P .F RF.AT. Add" EWSTER NY
on X Private Supply DeWed:by Addre a
ONF.. FAM_ RF�ot Size 16,0'0 Has Erosio
Number of Bedrooms 3 Hsi .Gaebaee GrInder Henn Io"Hw? N GR �2
WREN
E
Otbe $egatrsmnnte
CURTA'IN; DRAIN INSTALLED . -
w. A m
I'ceitify that the systam(s) is listed.asr inq the ebope preiises weie cted'eesantia 1 a dawn on line ed k copies
of,which are `attached), -and in accordance: with the standards, rules" r aiions: 'in acco with th pl Mt ss by the
putnan Count� t 0 Ham h 6i �P
Data - 7—T j Cit►tifNd by.
Addrea 4 1CiAlIQi��
Any person' occupyln4.Pmmises,snvea .by the, above Systems) shall pro C aetbn as may be necessary to � any ummnRwy
conditions .resulting from such usiM. Approval of the . spa /at!' St ll'becona'null and void as soon a • afy M11Yr► become
avallapli and;tM. approval of the ,:pr water, supply shall; become Il a vo when a; publ water wpplY 'ATM avallabla. Such approvals are,
>wtt).et to ifkatbn "or change subs
n, i6 the 14ftn It of the om a'maalth, w i � or chaMa Is Oats BY TItN
89
M
PUTNAM C0U9fY DEPARTMENT OF HEALTH
DiVISIOi3 OF ENVIRONMENTAL HEALTH SERVICES
ANTHONY PALLADINO
Owner.or Purchaser of Building
PALLADINO BUILDING CORP..
Building Constructed by
BARNARD ROAD - PUTNAM LAKE
Location - Street
PATTERSON
Municipality
ONE FAMILY RESIDENCE
Building Type
55
Section
PUTNAM LAKE'
Subdivision Name
3 3 & 4
Block Lot
7708-7715 ( 8 _LOTS )
Subdivision Lot #
-GUARANrm OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly. and completely responsible for the location,
worknanship,,,,,materia1 :constru:ction and drainage of'. :;the sewage, disposal system
serving the above described property, and that it has been constructed as shown on
theapproved 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* 1successors, 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 -'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 E.nviror_mental 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 utilizing
the system.
Dated this day of ? �' 19 q I Signature
Title
t—engrel. Contrac or ( per) - Signature
PALLADINO BUILDING•,CORPORATION
Corporation Name (if Corp.)
P.O. BOX 566
KATONAH, NEW YORK 10536
rev. 9/85
mk
Corporation Name (if Corp.)
Address
Y7og 1709 171c) '7711 712 1.7 I TJ 13 7714 °
o I ) L.►tl F TN - 6 T�GL� °
y` g `0
ON E rats t Ly cn
,n 4 -
d a0 R.EaI0EN6 L
StFTt� TAN Y- �
5 os° 5 5 I O ' E � ►Coo : o o' � ��® .�a�
CIE cd�i
Division of Environm a He t S r is
a plicable Rules and Regulations of the
utza;rCnt.yaDgpartment. �cV,GF. STEM oN0� �o
' ` �-+ 1 t
Date
Si nature & Title G,4 h E
pl c,. `SEPTICi olsT: Tai - GA�LtP�-,iEs - AND LpGATg-
—LE
I� ;.:., ...20 22 -17 fro 8o 41 ^77
.. 38 3 5 1 77 z4 ?� �z6
{ ,.
THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL .SYSTEM WAS CONSTRUCTED AS INDICATED
ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY-ME BEFORE IT WAS COVERED OVER.
THE SYSTEM WAS CONSTRUCTED IN ACCORDANC$ WITH, ALL STANDARD RULES AND REGULATIONS
OF THE;;�...:,.'��.. COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF
HEALTH.
TM MAT' Ito, F' T t( N • s s . 3 : 3 4 4-
• ""•' -S. �• S . S . . wi . M. " ` Zgel JOEL LAWRENCE - GREENBERG
ARCHIT_E!CT' - TOWN ' PLANNER
Preis* `� p► "°" �r� MufC00T NOIITM lIFO ♦! !Ox �!•
chlikei �_.,: �?►11T14oNY.:':,- '.�'A1'L��DINO � is MANOMC Ntw ♦011K
`10341
,� A RA — O A (0141 •ts - 041`10
r ''
a
j
7734 7733 7732 7731 7730 7729 7728 7727" .7726.'_
I
7 721
N 05 °55'10 iw 180.00
/ well p
p 7,•720
0 0
p 7 719
7707 7708 77GS 7710 7711 7712 7713 7714;
7 715
7718 "
AREA = 0.367 AC.. LU
/s
19.95
2 poured concrete
p foundation v. 7717
h 0 _
V'
..o o ° DO -
°/3 I o/5 19-90 1 z 7,716
V) 19:2
_ !160.00
S 05 °55 10 E
o.h..ires , _ —guy cable
n pole
I I /� p p /� p culvert O�
CLI ver�t I B. A !1 1 V A fl D I� `� ....:
The premises shown hereon being Lots 7708, 7709, 7710, 7711,
'7712, 7713, 77148,7715 as per mop entitled Eighth Map of
Putnam Lake "; said mop filed in the Pulnom County Clerk's
Office on March 20, 1931 as Mop N2 149 -G.
Subioct to rights of Troy , easements covenants 8 restrictions of record ,
i
if any exlskond any, sfcte -of facts, an accurote examination of title•may.
disclose.'
I
SURVEY PREPARED FOR
A NTHON Y PALLADINO
S I TUATE IN
i
TOWN OFRATTERSON.
COUNTY OF PUTNAM STATE OF NEW YORK
SCALE • J 11 = 30 NOVEMBER 28, 1989
JAMES K. DEVINE
LAND SURVEYOR
493 ROUTE 22
PAWLLING, NEW YORK
12564
{
WAUMOMM ALTMA"ON on ADOmON� • - ..
TO TH19 SURVEY MAP 19 A VIOLATION OF i
SECTION 7208 (2) OF THE NEW YORK STATIZ
•EDUCATION LAW.
COPIES OR THIS SURVEY MAP NOT BEARING
THE LAND 8UAV9YON'9 EMBOSSED SEAL
SHALL NOT BE CONSIDERED TO BE VALID
TRUECOPY.
UNOEROROUNO BASEMENTS. STRUCTURE9
BREWSTER LABORATORIES
Box 224 - BREWSTER, N.Y.
(914) MAX91 855 -1930
- WATER ANALYSIS REPORT -
SAMPLE NO. 7921 TEST WELL
SOURCE:. Anthony Palladino
Barnard Rd.
Patterson, N.Y.
COLLECTED: 12-27-90
BY: P.F. Beal & Sons
BACTERIOLOGICAL . EXAMINATION
Coliform Count, MF Method 0 per 100 ml.
This result indicates the source of the sample was
of satisfactory sanitary quality when �, the sample was collected.
12 -31 -90
F bf/ 0
WELL UUMYLETIUDI tcr,runt
DEPARTMENT OF HEALTH
.Division Of Environmental Health-Services.
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
WELL LOCATION
STREET AOURESS: TUWNIVIL ly TAX GRID NUMBER:
Anthony Palladino Barnard Rd, Patters on.,NY
WELL OWNER
NAME: ADDRESS:
Anthony Palladi:no,POBox 566, Katonbh, NY .10536
❑ PBIVATE
1.0 PUBLIC
USE OF WELL
1 - primary
2 - secondary
E7 RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP . ❑ ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT - gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal.
REASON FOR
DRILLING
.[]REPLACE EXISTING SUPPLY ®TEST /OBSERVATION OADDITIONAi, SUPPLY
®NEW SUPPLY (NEW DWELLING) D DEEPEN EXISTING WELL
DEPTH DATA,
WELL DEPTH 285 ft. I
STATIC WATER LEVEL 0 ftj
DATE MEASURED 10/16/89
DRILLING
EQUIPMENT
® ROTARY 01COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING 19 OPEN HOLE IN BEDROCK O OTHER
TOTAL LENGTH 41 fit
MATERIALS: EI STEEL ❑ PLASTIC ❑ OTHER
CASING
DETAILS
LENGTH BELOW GRADE 40 ft.
JOINTS: ❑ WELDED El THREADED ❑ OTHER
DIAMETER 6 in.
SEAL: O CEMENT GROUT O BENTONITE ❑ OTHER
WEIGHT PER FOOT ? 9 lb./It.
I DRIVE SHOE: ER YES ❑ NO
I LINER: G YES 17 NO
SCREEN
DETAILS
DIAMETER (in)
'SLOT SIZE
LENGTH (it)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
o YES ONO
HOURS
SECOND ._
...:... -- _
.._.._....
..
GRAVEL PACK
O YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACX in.
TOP
DEPTH K.
BOTTOM
OEM It.
WELL YIELD TEST ' If detailed pumping
METHOD: O PUMPED i tests were done is in-
COMPRESSED AIR , formation attached?
O BAILED O OTHER ❑ YES O NO
tl`f ��L LOG 'If more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
water
pear-
ing
well
Dia-
meter
FORMATION DESCRIPTION
cane
WELL DEPTH
ft.
DURATION
hr. min.
DRAWOOWN
ft.
YIELD
gpm.
Surface
2
D
it
ing in overburden clay & bldr
.
t
285
6
265
20
411
Drilling
in rock,set casing,groute
.
.25
LL1
2A c;
nwilling
in rack granite.
WATER O CLEAR TEMP.
QUALITY O CLOUDY HARDNESS
O COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES O NO
STORAGE TANK: TYPE WellXtrol 250
CAPACITY 44 GAL.
PUMP INFORMATION
TYPE ci3 r sir1 P CAPACITY _ 79
MAKER Caould DEPTH 180
MODEL 7EHO5412 VOLTAGE 230 HP
WELL DRILLER NAME P.F. Beal & Sons , In .
AoDRESS PO Box B SIGintTURE
Brewster, NY 10509
DA /28/91
3/89
PERSON IN CHARGE ORINTERVIEWED:
I acknowledge this Field Activity Report.
SIGNATURE:
TITLE• ; __:
PU NAM COUNTY DEPARTMERr OF HEALTH
.; DIVISION_OF HEALTH SERVICES
_ DESIGN ..DATA._SHEET- SUBSUFACE..SEWAGE DISPOSAL - SYSTEM._._ - .... _ ._ __..__FILE NO.
Owner d r r P r-!5 Address
Located at (Street) eul / G A/tA Sec. 53 Block .3 Lot
(indicate nearest cross street) ;}
Municipality /fo-c >1 • s ` �3 .'�.� X70 r S Watershed / � %�-r.- Sa^7
SOIL PERCOLATION TEST DATA RDQUIRED TO BE sUB umm WITH APPLICATION �'=7
Date of Pre - Soaking %� /�� 9 Date of Percolation Test
HOLE
NUMBER CLLR TIME
PERCOLATION
PERCOLATION
Run Elapse
Depth to Water'Fran
Water Level
-No. Time
Ground Surface
In Inches Soil Rate
Start-Stop Min.
Start Stop
Drop In Min /In Drop
Inches Inches
Inches
2
3
4
3
4
5
5 T
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 submitted
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`SOIIS ENCOUNTERED IN TEST HOLES
_DEPTH HOLE NOS _ HOLE NO. HOLE _NO
G.L.
1°
°
.2 _
3' (f2
40
r
0
6°
7° �� r
gg
r
10° Z_
,:S5)
1 L
13°
14°
INDICATE LEVEL AT WHICH GR IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: DATE.
DESIGN
-Soil Rate Used Min /1" Drop: S.D. Usable Area Provided
No. of Bedroams 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.'DEPARRMU ONLY:
Soil Rate Approved sq.ft /gal. Checked by Date
PUTXAM COUNTY DEPARTMENT,OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
_ COUNTY OFFICE BUILDING, CARMEL, N. Y.+ 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM
FILE N0:
Oiarier JOANN BARRESI Address 2 PARK STREET, BRE'WSTER,"NY' 105'09"
Located at (Street GBAdicate RNARD RORD` "':' Sec. 55 Block 3 Lot :3 & 4
nearest cross s ree
Municipality PATTERSON Watershed CROTON
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole,
Number CLOCK
TIME
PERCOLATION
PERCOLATION
No.
Start -Stop
apse
Time
Min.
Depth to Water
From Ground Surface
Start Stop,
..Imbes. Inches
Water Level
in Inches '
Drop in
Inches
""Soil Rate
Min. /in drop
1 •1•_.9:45' 10:15
2...•.10:19: •.• :: 10:49.
30.
30
.15'
15.
-� .17.75
17.75
2.75.:'
.2. 75
.1072.75 =11 --
30/2: 75 =11-
.3- 16-:53
.
1 .', •
o .
15
17'_ 75
_7'5
'3012.75=11
r1
PTH #2 , 1• .9': 50 : "Ad:
20•
30
16
19.
3
`:%W3=10
U
3n..
I
�3 ' l n -'r,? :.=
11 s 22 :
30
16*
18.75
2.75' • :
30/2._75 =11
Notes:. 1) Te ts.to`be repeated; at same depth until a roximately equal soil
rates are obtained -at each percplation' test hole. All data tole submitted
for.review.
'2) Depth measurements to be•made from,top of hole.
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
_.____.DESCRIPTION OF S_.OILS..E NCOUN`CERED IN TEST HOLES__,......
DEPTH HOLE NO. DTH #1 HOLE N0. DTH #2 HOLE NO.
G.L. ....TOP SOIL :._..TQP.. SOIL
P!
6"
_ 12"
_
18" GLACIAL TILL GLACIAL FILL
24 CtAYEY WTTH SMATJ CLAYEY IdTTH RMAT,T.
30" STONES STONES
42"
48" If it �.
5411 If u
If to
66"
ij W If — of
7
78"
84"
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED- .41
" INDICATE -LEVEL TO WilICH.WATER- i;E — 'RISES -AFTER- BEING ENCOUNTERED
-
TESTS MADE BY Date 5/5/86
DESIGN
Soil Rate Used 11-15 Min/l "Drop: S.D. Usable Area Provided
5000SF
No. of Bedrooms 3 Septic Tank Capacity 1000 PePREC
ST COMr-
Absorption Area Provided By ----- L.F.x24 " -- ___ trench
.
V����R GRFc
r 150LF. of
3' fill required. 0
trj-ri;;11P_rJes
-Name JOEL L. GREENBERG Signat o
Address MUSCOOT NO,RFD #2,BX 488 ate_
THIS SPACE FOR USE BY HEALTH DEPARV ENT ONLY: °F NEB
Soil Rate Approved Sq. Ft/Cal. Checked by Date
s
Pu:tnam' Lake �� -77 S : y� 55 3 ,� 3 5A
r 1
poMdw�iort [IrrAn t• . � . P a 7 1 a ci i n ci `� . '� ❑
Dat•„,,,;��ctober 290 1987
Barnard PH ad Tei a Armorik , , N. Y. zki .10504
Date Subdivision Avg roved' J Fee Enclosed ® Ammint
,>
5:■ 114 TA* .0n'4*,, Family ;'Reso Let.Aasia 18 OO�F 0* X :2o Vokm 350c
14 d d nmmiv a®e , 3: Dao%p R" G P D .600. PC® mis&mtiom to Regn 4 Whole m In
sd� sef�..p s�eos eli assist a.
1000 0 r g yg' ,,� 1 0 F' o f Tr 1 Cal l e r, P s
T.h. Bob .Brill A�Brewster, New York ? 0509'
W"W SQgm*f «Ile !ice Frr•
Ad&,m
=. � XX w 1.,�, Sop*. Dd W by P . ' erh�eaa � i York. 10 5 0 a
F _ RPaI a�ictar' TTc�d
•
repra•nt;tMt l amt am wholly anA•.cornpNdly responsible fa. tM Msipn anA bcation of! the'' tyst•m(s)i 1)' that the rate sew di col Astern
.
aboi• dperi0•d will be eonstruotid as shown on the o00!o�d amendment then to.and in a . n with tM standards• rules, a reyu ns.o
CooMy. 000rtMent :•of MaeltK' and that on compietbn thgoof a'•Catificata of ,Construed n .0 lianca" satisfactory to the COminlssloner of Health will
be submitted _to the �Dipaftment. and a written guarantee will be furr4shQe the gwnor. his su a. heirs or assig s.by the builder, thit said bulkier will
Wp in pod epentbq :uwndlklod any but of sold sawap :Alsposal }tist•m du►gp the per two (t) yea: Im, lately following thedate of the Is u-
aoa. of= en• app►oval,.ot•atN C•rtHtute. W, COnstructI CO�+plNircs -. elites! system or repair s tb reco 1_that the dunned wen wwib•d above
will be bcate it it on.theipproved Plan and that said will will 64 in Iled acre a• sw h st rde. a ropuBlEns: of .'the, Putnam
County�Oapartinent of ►lalth.
€ SMn� P.E. _ RA: -
l ate• R A _
Addrefd ML s c ci ra t: Nn _. Icento No 1 1 0 5 6
y F•
Af TPPROVEO FOR CONISTRUCT10N: Thli :iPproeal ixpires two "yens rom the to 't 'unless construction, of. the bu inn .has been undertaken and Is
revocable for Ouse w_ may be'omended or modified whon'considered ry t Commissioner of Moans; Any c r" or alteration of eonstruetbn
raouN•s a';n vv' paint` May . f, OispoW o4 domoslk• saMtary 1 Wato amts ' ppl only:
Rev.!gyd
10%88 b
m
v
�I
• r
PITPRIAM COUNTY DEPARTMENT OF HEALTH
XNJ . Dlvlsllon of Envieonm ®ntnl �eolth S®evlcep. Ctientet, RI.Y 10512 ; Eagine®r to Peavlde permit p
PCERT�ICAT'E OF CORh[PLIAINCE
erimt
CORISIlIRUCFI ®RI PE]�IthIT FOIR <,SEWAGE DISPOSAL SYSTEM
Patterson
.Barnard Road Tq,rn or •:Vinne®
LocaW at . _
StabdlvlolonBlo®te Putnam Lake. Sabd.4;04 7'708 7715 . Tr3a1 p 55 "Bloch 3 Lot '.;
enesrd_ ❑ Revl ®lon ❑
Ow aeriAppllca Name ijbl i n?? _� a r r e Q
1R
Dade-of !Prevloa® Approval
iBAaae�a® 2 :Park Street Tee .Brewster; NY " :: Zl� 10509
�n>tnB One: • Family ot A1ei3.16 : O O O S F Fill Secdoa Daly Depth . Volume CU
Number of Ii®deaa ®o "Deaistt Flow G P D -Ei (7 0- PC�D Rlotlflcntlon la I;e>aale®d V84► ®n'I W in co�plet®d
Seph¢n(e Setve e S Ist®tin to cog0gt of 'Giilloa Septic Tonle nad - `
10:0 0
� y 15OLF of Tri Galleries
To be conati¢cted by f Rnh $T �1l 'Address® ArPt�c+ 6r. �NPti YOr�C .10509
Watei Su�Pb': ; Public Supply From >Addret�
oel Peh+ote Sa I DrWed 7'. R o R a a 1 Add°ea® t F' 7
... $rPC�G rTV .10509
Otheu:I;�antal ® ®nte. `_'S ° Curtalri �Draln
(.represent that I am wholly and. completely, resDOnsible for the design ,-and location of the proposed systems) •'1) that the separate sewage,disDOsal 'system
above,doscrilied will be as shown on the approve0 amendment thereao.arid in' accordance with the standards, r,ule3 an Jegu a ions o e ' u nam
County, Department: of� Hgalth, 5nd thaYOn completiondhereof a :'Cert�ficste, of Construction CorimDliarice satisfactory, the Comrnissiorier of Healihwill
bo submitted -to the DeparCmerit and .a written_ 'guarantee_will,be- furnishedahe owner his successors, hevs'or assigns by ,the builder, that said builder will .
place :m good,'operatmg condition any part of said sewage, d�spospl system.dunng tfie period of two. (2) years immediately following thadata of the isEU-
once- of the°approval,of the Certificate. of Constr.uctron Compliance of the original iystem.or any repairs thereto, 2) that the drilled well,describod. above,.
•.r r a ' the staindardk: rules and': rcgu a ons of tho ,Putnam `.
will bo located,as shayvn on the approved plan and that said well will ba'.Installetl ".in accordance w
County Department of Health ;
Date 10 %13/8 7. signed' . 'P E R.A.
X
ACaress MUSCOOt NO o BRED #2 a BX 488 y MahopaCa_NY License No 11056
APP..ROVED FOR CONSTRUCTION This approval,expues two years from the date niued unless conshucL6n-'of
the bu�ldi,ng has' been undertaken and is
revocgDle foF' cause or'may be, amended or?moddi0,when considered necessary, by the `Commissioner of Health_', ny change or &Iteration of construction
?- iopuiros• a new permit roved for di�sp%osal ofdomestic�samtary`:sewag� rand /or ato supply only.
87 Date
V
! : /w• / .'n.'' <'� r �-. `rt. `_'Y .. `tom :-- '.1 .• Y. .:�. —_. _ ..
f Q Rev. / ✓
PUTNAM COUNTY DEPARTMENT OF HEALTH
86. Division of Environmental Healtb Services: Caemel, N.Y. 10511 Engineer to Provide Permit N
LIANCE
on CERTQ�7CATE• OF COMP
. ' ' , . • � `Permit M
CONSTRUGTION.PERMIT FOR SEWAGE DISPOSAL SYSTEM
Iocdted ! Patte rs T
at Barnard "Road ..ar Vie
Subdivision Name Putnam Lake Su- bd. zot a 7- 7 0 8 - 7 715 Taz M 55 sldek 3 I oc 3 & 4
Renewal-0 Revision
Owner/Apphcant Name .JOANN BARRESI _
Date of Previous A royal
• .� PP
2 'Park ;Street Brewster NY' 10509
Mulling Address Town • r. ZIP
Building Type 'One Family,. ]Res.:'
es ; • Lot .Area 16 ; 0 0 Q S F FBI Secaon Only . De p 3"'r volume
Nam6er of Bedrooms 3 Design Flow G /P /I) 6 0 0 40ibbNotification Is Required When FIR Is completed
Separate sewerage System to causist of 10 0 0 Gallon Sepac Tank and . 15 0 L F O f ';,T
Galleries.
To be rnnetructed•by 'BGLrLR i 1 „1. Add er Rr -wAf _r` r New York 1 0 509
Water•.Sdpply: ! .Pdbllc Supply'From ' Address.
or!'_ XX ' Pdvate Supply Drilled by P Address . R r Pw s fi Pr.-N6t4 York 10509
I represent thst'I am wholly and .completely responsible for the desigkand loea4ion of the proposed, system(s);'1)' that, the separate .sewage disposal system
abdVe'deSCribed will be constructed as' Shown om,the approved'amendinent there to and in' accordance With;[he standards, rules an regll a .Ons o e' Putnam
County Department of Health; and -that on' completion thereof a "ceitdiuta':of Const%uction. Compliance" satisfactory to the Commissioner of Health will
be submitted to the..Department, ; and a written' guarantee will De furnished the owne ,.his wceessois, heirs or assigns by the builder; that said builder will
place in good operating Condition any part: of said 'sewage: disposal systemduring- the'period of,two.(2) "yeari immediately following thadate of the issu-
ance of the approval of the Certificate of .'Construction Compliance_ of the'oreginal, system or ly.repiirs.thereto; 2) that the drilled well described above
will be located as shown on the approved plan,and that said well will be Install in accordance t the standards, r s and regu aTrons f the Putnam
County Oepartment of Health
Date 6�2�86 Signed P. A.A. XXX
Muscoot 'No RFD x .4$8 ahopac` NY 11056
Address r r 1. ns No
APPROVED FOR. CONSTRUCTION: This +approval expires 'one yearjro th 'date isi d 'unless Construction' of the Duiltlin s been undertaken and Is
revocable for cause or. may. be amendetl or modified when considered nicer Dy the Commissioner of Health. Any Change or alteration of construction
requires a new permitn'Appioved %for dispo I'of tlomaslic samtar,y sewaye;.and /o %, private ' a v.su y 01)4y
Oat
�---
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #P -90 -86
WELL LOCATION
Street Address
Town/Village/City Tax
Grid Number
WELL OWNER
Name Mailing Address
Joann Barresi
UIPrivate
0 Public
USE OF WELL
1 - primary
2 - secondary
0 RESIDENTIAL
0 BUSINESS
O INDUSTRIAL
O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
O INSTITUTIONAL O STAND -BY
® ABANDONED
0 OTHER (specify
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 2 /EST. OF DAILY USAGE 150 gal
REASON FOR
DRILLING
0 NEW SUPPLY OPROVIDE ADDITIONAL SUPPLY
❑ REPLACE EXISTING SUPPLY "O DEEPEN EXISTING WELL
®TEST /OBSERVATION
DETAILED
REASON FOR
DRILLING
Water supply
to new residence.
WELL TYPE
®DRILLED
DRIVEN ®DUG GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL.IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Putnam Lake
Lot No. 1708-7715=8 lots
WATER WELL CONTRACTOR: Name P.F. Beal Address: Brewster, NY
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 5 Miles
LOCATION SKETCH & SOURCES OF CONTAMINATION
[]ON 'REAR OF THIS APPLICATION
10/16/86
(date)
PROVIDED
PERMIT
®ON SEPARATE SHEET
(signature)
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 rov'ded by the Putnam County.
Health De artment.
D
N4114�
ate of Issue: 0 1991- C� -
Date of Expiration: 19
Permit Issuing Official
Permit is Non- Transferr ble White copy: H.D. File
Yellow copy: Building Inspector
2/87 Pirilc Copy: Owner
Orange copy: Well Driller
DEPARTMENT OF HEALTH
Division of Environmental Health Services
d
J•
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION_ TO _CONSTRUCT A WATER WELL
t PCHD PERMIT #
WELL LOCATION
gtreet Ad r
wn Village City Tax Grid Number VSCXA 8o4
WELL OWNER
J@xQk
Name 6, Address rivate
O Public
USE OF WELL
1 - primary
'2 - secondary
RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED
O:BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify,
O'INDUSTRIAL 0 INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
Y ELD SOUGHT �j gpm /It PEOPLE SERVED 2 /EST. OF DAILY USAGE 15U gal
REASON FOR
DRILLING
VNEW SUPPLY' O'PROVIDE ADDITIONAL .SUPPLY OTEST /OBSERVATION
CIREPLAJCE EXISTING SUPPLY O•DEEPEN EXI TING WELL
DETAILED
REASON FOR
DRILLING
wk) he
WELL TYPE-
DRILLED
QDRIVEN
DDUG
GRAVEL
OTHER
•IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No. p
WATER WELL CONTRACTOR: Name r% IJa&,,C Address: ; t)KeU,71;re,V , WJ.4 +
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:_
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
[]ON REAR OF THIS APPLICATION ON SV TE SHEET
f
(date) (s ure)
PERM
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 Department.
Date of Issue: 19
Date of Expiration 19 Permit ssuin ffi
Permit is Non - Transferrable
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #F- 'fO "5
WELL LOCATION
Street Address
Barnard Rd,
Town/Village/City Tax Grid Number
Patterson 55,303 &4
WELL OWNER
Name
Anton Palladi
Address
Q PO Box 675 Armonk,I 10504
ERPrivate
❑Public'
USE OF WELL
1 - primary
2 - secondary
U RESIDENTIAL
❑ BUSINESS
❑ INDUSTRIAL
O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP
O FARM 0 TEST /OBSERVATION
O INSTITUTIONAL ❑ STAND -BY
0 ABANDONED
❑ OTHER (specify
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 2 /EST. OF DAILY USAGE 150 gal
REASON FOR
DRILLING
(ANEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY
❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
®TEST /OBSERVATION
DETAILED
REASON FOR
DRILLING
Water supply
to new--residence.
WELL TYPE
®DRILLED
®DRIVEN ®DUG ®GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: P„ }n am Lake
Lot No. 7708- 7715 =8 lots
WATER WELL CONTRACTOR: Name P. F. Beal Address: RrPwGtPr. NY
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
NAME OF PUBLIC WATER SUPPLY:
DISTANCE TO PROPERTY'FROM NEAREST WATER MAIN: 5 miles
YES __X__NO
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
® ON REAR OF THIS APPLICATION ON S
9:9/16¢86- 6/26/89
(date) —�
PERMIT
TOWN /VIL /CITY
ture
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 tment. ��-
Date of Issue: �s�9
Date of ExpiA ation: 19 ermit Issuing ff�1 1
Permit is Non - Transferrable
e
.... , .��,..�.......u�..wuL�WSJ6:Nw= - •�'....a��wiir.J•e.�. WYi.rw"l urtuv�'. a. 1LiY4. aw. w1.J L�:: kl. b�eni• na�+ uR++ i�: a. w4Yvaur ...au�irvraw.�uu-..r.ffisu:.. —_ w.• r.n�... w.. .�rw..
M = DEPARTMENT OF •I.'M• D
SUPPLY &
REVIEW SHEET - CONSTRUCTION PERMIT .
DATE &
(Street Location) BY: �m
DOCUMENTS
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 DETAILS 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
Pere & Deep Holes Located
Representative of Sewage & Expansion Area
'Ex{�ansion Area;shown;gravity •flow,suff. size
If Pumped Pit &- D Bok'-Showri - &• Detailed
House - No. of Bedrooms
Wells & SSDS's Win 200 ft. of Property Located
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
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Lake (inc. expan).
15' to Drains- Cartain,Stom,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
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Tbwn/DEC Permit R & D)�
Data On DDS Plans & Permit Same
INDIVIDUAL WATER SUPPLY /SUBSURFACE SEWAGE DISPOSAL SYSTEMS
FIELD INSPECTION REPORT
Pd
(Name of Owner) (Street Location)
INITIAL SITE INSPECTION
Wetlands on /or proximate to property ..............
Property lines or corners found ...................
Can estimate house location .......................
Willdriveway 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 ..................:.........
D. H. 1 Lot
Depth to G. W. ZTT
Depth to rock
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
Soil Description
�.eY� 9 Y� • „y
D. H. 2 Lot
Depth to G. W.
Depth to rock
0 ft.
3 ft.
r 6 ft.
9 ft.
12 ft.
Soil Descri
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. from watercourse. ...............
Natural soil not stripped or SDS area
unnecessarly graded...... .. ..... ..........
10 ft. maintained from property line and
20 ft. from house... o ........ o ........... o ......
Distance well to SSDS (ft.) ......................
Number of bedroans checks... o ....................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. from 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.......
FINAL GRADNG OF SITE ACCEPTABLE ..................
NO
DATE: Ani la d
INSP. BY:
CANTS
D. H. - Deep Hole
G.W.- Groundwater
D.H. 3 Lot
Depth to G.W.
Depth to rock
Soil Descri tion.
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
Nr� 5 5�• toy' w l �`` \'-` - t Go.oD
-- OE ; -. _ jRoposeD
Wow
zz
r _ o MIN, w RA,
qu
{! I
l/ Go t
�% Q � � � �� � - .'�- -• � i .4 � _ �.!'' -f �- –'-' �' � 200
�- � I -i_ ---- • —�Xja, u �i-- . � boT. pd.L �T�, 6Ed�eltS. � � --- - ,
F�8
-
VkGAMT
Qu Ll
T';u - cpILLePiEs Iso IN_KT• —_ -- ME -CAST GONG- W41TS (e jtl'9y 7(�ii 4t ^w` �``' �lYi q" 20� � __ _ is, _ 2010 Z
fV_QY'IDE bAn K. Q-UN `',.� if (r
DE;FP- (MGIL)DR Ex�aw�,�Ni
Ti
T7uP�' 77o"J Zit ` 7711 �, II13 7714- 71s -
'
10 -' — _ fONGr• 5!^ FG TRIJK. - -- - -- — 214
(wG. OC
f ) A' t� � �1' f 1� A V� A Tc w rt P-,
o
!-
IL
224 ZYZ f 220
t7DGE -1R F n v E M c N r: - -- - - —
°C u
, / V ' ��'! f ` � % � <a .•`,>'� � • � It �� - � ` t
t
- i
t
f -
i
T� s;
D 7 `
P 1 it
J
7733 7732
7731
7730
7729
7728
7j27 7726
7721
—
N. 5°55'10 "W
,Iron pipe
160.00
/iron pipe
{
p 7720
O
0
7708
7709
7710
7711
7712
7713
7714
>7715
6
o
S
7719
_
stoae
wa //
e
a
7718
p
c
0
Q 7717
IQ
O
=
7716
ran pipe
wires S_• 5°5510'E.
c
pole — ��- -guy cable
0
&A RNA / ?D
u'
I
_ cross cut found/
- F - 160.00'
ROAV.
SURVEY OF PROPERTY
- NN BA FOR
J -
OAN �!' ESE
- S /MATE INT THE
.TOWN OF PA TERSON
PUThlAM COUNTY , NEW YORK
SCALE : I " 20 f DATE: OCT. 17, 1985
FILE N° Pa_ l/3 T
TITLE N°
Area = 16, 000 Sq. Ft.
- - - - - - - - ( 0.367 Acre)
The premises shown hereon being Lots 7708, 7709, 7710, 7711,
7712, 7713, 7714 5 7715 as per map enfitled " Eighth Map of
Putnam Loke "; said map filed In the Putnam Couhty Clerk's
Office on March 20, 1931 as Map N° 149 -G.
an the angina/ of this survey rmrked w, /n on mgin l of /he /ano CerJdiwlions hereon s+gni fy JJh/ /nis survey was prepared in (X&Youme•wi /h the
ed sent at his embossed seat shall be considered to be wltd excslmV Cave of P ml ce Aw Low Surveys oobpJed by /he New, Yank State A,swc-
/olrO J0 of FfV& s W/ Land Surveys. Sold ro- /MCO /iCWS sholl run only to the
person fc whom me survey rs p-epered , rd on his-behalf Io the /i/ /e cwnp" ,
D} NEW Wv nmental agerxy onu lerldbq tnsfihd/ listed hereon, and to the ossiynees of
•lt' r0 //n lendirg tnsJifulion. Cer/tficofiom are m/ transferable to aG/ihcv+o/ insff /uti s of
BAXTER Q ASSOC. 51p �R� E. Bqx� �F ta sabsbvmv owners.
/ Land Surveying woe F-P
298 �} umulhwized ot/a-olidh of oddthcn to o surve y rup bearing on o /ceud to sw veyor's
N. Y. 10541 sea / s o I Aabta of Section 7X9, Sub - division 2, of ax, New York Stale Ed" -
LkI Q•
494 tic» Low.
LAND S