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7
PUTNA111 o
billswi a En*
COUNTY' DEPARTMENT OF HEALTH S ) r_
lronmental Health Services, Carmel, N.Y 10512_ ��
Engineer Must Provi P2
3
P.C.MD. Pe6ift*
PLIANCE FOR SEWAGE DISPOSAL
lrnn• KnM 0 1
STEM T. Patterson
ToYinor Village *."11'
Tax Map --'5-* 'Block - 5 Let 14/15
o'
Putnam`
Lk 7.453-5inc'
yvneF(spplca-t riame L Y. U SOP ,--e @_"
Box 9 5 -" r UrMV 7453-5inc
f � '
ZIP i0i,2 t:liined�-2'/61,85.
..Date Perml
Milling.Addris's,
Tifter'son' NY
Address
Se, Bu ksho lJow Road:, !�Ahop4c, NY 10541
,
Consfthin of Gallon Septle Tank and
Water Supply i Pnblic Supply, From - Address
ors X Mill Drilling,"IhFA Brewster, NY 10509
Prl�at.e.'Sqpply Prilleo, �y dress
As required
-BuIldipg T�fk, lon Control Been Completed?
Has Eros
Number of 116dro6nis thipee 'Hai,Girbkje'Gr*ln:dei'Been No
InstalledT
Other Requirements 'None
I certify that the system(s) as. listo serying the above . pp*isep, were constrticted esientially-as,shown on the plans ,of. the completed work f copies
of which are.att ched),`aiA in• acc6raince with the standards, .:.rules and' r: 71'tions, �ijqcorjangeeW the 'filed plan, and the permit issued by the
Putnam,'County Department Of Hpiltih',
7, F' bruar v 198:7 ,
.Date 'Cartii4cit P.E. X . R.A.
, " St ar" me 29206
RD, 9
-Fair C
Address License No
Any person occupying p . remlsai'sai4ed by the above sySteri (S) L shill promptly takeisuch action as May bO'necessery.to secure the correction of any unsanitary
conditions resulting from, such usage. Approval of -the separate "irigi:iysterh shall become null and void ssjooh as a pub!!-. unitary sewer becomes
available and I the approval of the `prlvate:waiai supply sha 6ac water supply becomes available. . Such approvals are
m �ation'.or change wk.e ln',the, iuderne the
subject to odif I nt 04 i ;pf Health. such revocation, modification or .change Is necessary.
T
Date zz T Ill*
Co
ELLIS A. TARLTON LABORATORY
DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC.
CHEMICAL 34 PLEASANT STREET DANBURY, CONN. 06810 WATER -WASTEWATER
PHYSICAL METHODOLOGY
BIOLOGICAL P.O. Box 246 , 2Q3.--748 -, 7903 _ APHA - WQO - ASTM
REPORT OF BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF WATER
NAME AND
ADDRESS OF
PERSON TO
RECEIVE
REPORT
F Mill Drilling, Inca
Putnam Ave
L_ Brewster N.Y. 10509
DATA
SOURCE OF SAMPLE
Water Supply, Nieniela
Lake Port & Canton
Putnam Lake
Patterson, N.Y.
DATE OF COLLECTION Sept. 159 1984
COLLECTED BY Mill Drilling
Hydrogen ion
Concentration
COLOR
TURBIDITY
ODOR
CORROSION INDEX
LANGELIER
DISSOLVED SOLIDS
(PH)
RYZNAR
NTU
Mg /L
Nitrite
Mg /L
Alkalinity as CaCO3
Bicarbonate
Mg /L
Fluoride (F)
Mg /L
NITROGEN
Alkalinity as CaCO3
Carbonate
Chlorine Residual
CONSTITUENTS
AS
NITROGEN (N)
Nitrate
Mg /L
Mg /L
Mg /L
Ammonia M9 /L
Total Hardness
as CaCO3
Mg /L
Mg /L
Albuminoid
Mg /L
I Iron as Fe
Mg /L
Mg /L
Chlorides as CL
Mg /L
Manganese as Mn
Mg /L
Mg /L
Detergent as MBAS
Mg /L
Sulfate as SO4
Mg /L
Mg /L
M
- -The •arHbMet4a- mean of- a[ I standard samples examined per. month using. -the membrane - filter- technique shall not exceed MEMBRANE FILTER TEST
one colony per 100ml. Coliform colonies per standard sample shall not exceed 3 /50ml, 4 /100ml. 7/200ml. or 13/500ml Coliform Colonies /100ML
In: (a) Two consecutive samples; (b) More than one standard sample when less than 20 are examined per month; or (c) 0
More than five per cent of the samples when 20 or more are examined per month.
® 1. The results of the analysis of this sample are satisfactory and meet requirements for a potable water.
EJ2. The results of the analysis of this sample satisfactory for a potable water but certain of the chemical or physical constituents are high. These
are as follows:
3. This sample is not satisfactory since it does not meet the bacterial requirements for potable water. The presence of organisms of the coliform
group in a sample of potable water is undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does
indicate that such contamination might survive to the same extent. The presence of organisms of the coliform group may also indicate that the
treatment was not adequate at the time the sample was collected.
0 4. This sample is unsatisfactory as a potable water because certain chemical or physical constituents are above acceptable limits. These are as follows:
COMMENTS
Certified........................................... .........................t..... ..................
I N�, I
If yield was tt+trd of different depths during dtill;ng• Get below
FEET GALLONS PER MINUTE
300 3
365 15
LAa p® OT
,t9 /5 /84rtelLU on9 %13�84rtt wE:E_L. l ► E� r.l
,Pres. —MILL DRILLING, INC.
L)ivtt,lon or tnvuonmental Itualln ;ier✓tces
•
-' COUNTY OFFICC BUILDING • CARMEL. NEW YORC
This report
is do be cdhipleted by well driller and submitted to County -Hcalth Department together with laboratory report of
analysis of water sample indicating water is of satisfactory bacterial "qu5lity before certificate of construction compliance is issued.
FtEPOR7.MUST BE SUBMITTED WITHIN 30 DAYS OF WELL .COMPLETION
OWHEIt
ESKO NIEMELA
RD #3 Illion Road, Brewster, NY 10509
LOCATION
(No. t Sueel)
(lawn) (Lot N✓moer)
.01 WILL
Lakeport Drive
Putnam Lake, Brewster, NY
•
X aUSINE55
I j
0 0
PROPOSED
DOMESTIC ESTAEItSHMENT
rARM TEST WELL
:USE Of
WELL
a INDUSTCIAL
CONDITIONING OpHER I
.SUPPLY
O
a OTHER
EOUI`PMENT
LJ ROTARY
AIR PP
PERCUSSION
PERCUSSION I
�r>ls {NG
LENGTH (test)
DIAMEILR(inches)
WEwnT PER FOOT
a
(�UMVE SHOE WAS CA t.G •�
7
DETAILS
31
6
17
THREADED WELDED
1EXD YES NOI
L"_J YES
NO
YIELD
HOURS G.P.M.
El a ®
YIE ) ..
ZEST
FAILED PUMPED COMPRESSED
AIR
4
15
1S
WATER
MEASURS• FROM LAND SU,AFACE— STATICfSpaclty tees/
OuuNG YIELD TEST flcetj
Depth of Completed W
tEVEt
20
365
In feel below Land surfo:e: 365
MAKE
L:NGTH OPEN TO AQUIFER {teeU
SCREEN
DETAILS
SLOT S;i:
DIAMETER (inches)
IF GRAVEL
Diameter of well including
GRAVEL SIZE (inches) FROM (teat/ TO (test)
PACKED:
grovel pock (inches):
I
4PT14 P10A tAND 37tFACE1
FORMATION DESCRI?TION
Sketch •fact location of well with distances. to at bast
FEET to
FEET
two pertranent lenantaras.
0
20
Clay & boulders'
f4�4-
20
365
Medium to hard granite
I N�, I
If yield was tt+trd of different depths during dtill;ng• Get below
FEET GALLONS PER MINUTE
300 3
365 15
LAa p® OT
,t9 /5 /84rtelLU on9 %13�84rtt wE:E_L. l ► E� r.l
,Pres. —MILL DRILLING, INC.
I;
Lilli & Eskq Niemela
Own er or Purchaser of Building
-- Btrirding- Constructed by
Lakeport & Canton Roads
Location - Street
Patterson
Municipality
Frame
Building Type
55
Section
5
- Bko ck- _ ..
14/15
Lot
Putnam Lake
Subdivision Name
7453 -5 incl./ 7453 -5 inel-
Subdve Lot #
GUARANTEE OF SEPARATE SEWAGE 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 success-
ors, 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 initial use of 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 occu-
pant of the building utilizing the system.
The undersigned further agrees to accept as conclusive the determin-
ation of the Director of the Division of Environmental Health Services
of -the -- Putnam -County Department..•of•-- Hea-1th- as -to. whether or not the fail -.,
ure of the system to operate was caused by the willful or negligent act
of the occupant of the building utilizing the system.
Dated this 25 day of April 19 85 Signature
Title c9lyner-
Corporation Name if corp.)
Box 95 - Lakeport Road, Patterson, NY
Address
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM.
Division of Environmental Health Services, Putnam County Department of Health
■
PUTNAM COUN'T'Y DEPARR —M OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Lilli & Esko *Niemela 55 5 14/15
Owner or Purchaser of Building Section Block Lot
Building Constructed by'
Lakeport & Canton Roads
Location - Street
Patterson
Municipality
Frame
Building Type
Putnam Lake
Subdivision Name
7453 -5 incl. / 7453 -5 incl.
Subdivision Lot #
GUARAN= OF SUBSURFACE SEV�GE 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 Environinental Health Services of the Putnam County
Department of Health as to whether or not the failure of system to operate was
caused by the willful or negligent act of the occupant aofhuilding utilizing
the system. ^
Dated this
� day of 19 �� Signature,; AA
Title NAM
General Contractor (Owner) - Signature
Corporation Name (if Corp.)
Box 95 - Lakeport Road, Patterson, NY
Address
rev. 9/85
mk
L6 fed at.'-- ki
Subdrelsion Puti
owner /Address'
,building `Type
Nurhbbr, o f Bd&o6r
Separate,. SewerageA
o':-be,.,cohstructed
Water ter upply:
Other e qu I i e e�n t
represent that I - an
ove escribed will
County.,, - k- "
6e6irt in, e,
be submitted to th
p.Ilice-in'. j`ood bper
zancp, oi, the ;appro
will 6:
'V
County' Depart
Date Decembedi
APPROVED FOR -C
-'revocible-for cause,,
, ..'requires :a new .:peri
�
Ca
Permit
"0 - 2.100.
:PUTNAW COUNTY DEPAR
i\. � ? Qivisfon of. {Enwconmental Healih Si
CO TRUCTION. PE- RMIT., FOR: SEW*llt.DISPOSAL_SYSTEM
' 4 Located lat Lakenorti' *f; 0a.h. of Roacls ,, a
k subdivlttcn Putnam 'Lake .E«
4 M:r Mrs -Esko. Niemela Box95 :Lakepsrt
e `Owner /Address + --
Frame; f _15560 sQ +:ft
Building.Type
a
Number.of Bedrooms 1 ree ,Design Flow G /P /D 6aA
1 OC1b a
Sepa►atewSewerage. System to
consist of Gal Septic
z rr 14
To be constructed by ? ° r`� -
1 j
c.w, s c •, d
�aWater Supply ; aPutihc Supply From r
Private "5`uppiy to be driIletl t x
Other_ Revui'reme.— Th t S l S._a Pe)')Tf l i traCl$fer �uai'a
1 represent that.l'am wholly and completely respohsible for the design and location
raboye described will be constructed as shown on th'e_approved amendment there to
'County.,;0eparfinent ot, - Flealth, ;and thaf on completion thereof a' Cert�ficatetoi
ibe wbmittetl to {the Department .and a dwritten,guaianfee will +be `furnished the
place in';gootl.'- operating conddion',any; par; of said�sewsge disposal system du
=�ance of•.'the approval of` the Certificate of Constiuctioe - Compliance` qf' the or
Qwlll- bWlocatis of shown -on the approved plan anC`tAat said well will;be InsLalletl �n
ic6tinty bepartment of Health a c k
oats December 20, 1ag84 } ~ k r Y
2
S d
� �gne
j Address RD 9- Fa t r S t r,eet , C aT
APPROVED FOR CONSTRUCTION This_;approval expi►es'one yeas from the da
revocable:for cause or may be amended or' modified when a "tl necessary ,by
reduires a new permit Ap rov ifor disposal of; dome is sa i ary sew ge' am
U
++.�� 5 'h
r G Y K
,Date ,,1 � ° x
1 4 F !t
Rev
W
KENT OF. Permit - Permit
ices Carmel N: Y 10512
y r
,.-.Town or VTllage C,
r��Tax 'Map } 35 � � ti:Block 5 Lot � 4� 1.5
Revision Q
��Patterso arm: =156?
Date O Ptev ode pprova � ��•' r
Fi11 Section Only ❑
P C -'H D Notification Required NO
300,x' x 24z' artAde x 24" D. ' }a:te ra 1,s
ik antl
Address
i
f 6 proposed systems) i) •that.,. the, soparate.'sewage disposal system
d in accordance with the standards, rules and regu a ons o e u nam
onstruction Compliance' ' %satisfactory .to the Commissioner' of'Health will
caner, his successors; heirs,or. assigns.byx�the� builder; "that said'tiuilde ►wi11
g -the period of two (2) years immediately'followinq fhetlate'of the, -fssu l
a4 system or any repairs thereto, 2)':that•fhe Arilled.well described. above
cordance ;with the: standards rules and 'iegu aTTons of the Putnam
P.E: � A.A.
N1' iasl2 _ License No.' ;2 20.6. _
tisued unless constructiore -of the ,b6ilding,has been undertaken and is
i ' mm ionerrof Health: Any',chan" ov1MwAt ion.oi- construction
private ater supply only
u Title
a ti
r
...`L ®Itls�Yt '{.I"V UjO�itl Ir�Y71tl10� ��YV �s�Vtl Y'llH� riD��
Located at Lakepora CO td Roads
Pd-tot-taker, z
Subdivision s
-Owner /Address John .Guardo,�= 27 Newbu1:7)
°Frame --4
8wlding Type Lot P
Number of Bedrooms hree Design stow G /P /D —�
Separate, Sewerage System to consist of -
?
To be constructed,by,
x
*Water Supply " ; Public Supply From
;private ,supply to " drilied
Address'
tither 'Requirements 11 "One
1 ..above,descr�beC arill3be con "stru�ted'as shown on the?ap
::County = 6epartm ®nt of Health .,snd that .on corripleti
be submitted to'the'Department ,and -a written gua
place. in :good operating . - condition any -,part of laid
?,_- anee 'of the approval of the Cer;Yif�cate •of- Construe
ia�ll be located as shorn orythe approved plan and that
County Department of Health }
:oaten % 'November 1983 4
' Add ?ess.RD
APPROVED FOR CONSTRUCT191N This .approval „e
,revocable 4or cause or.may;•be amended or modified w
requires a new permd Approv for disposal of d=
Date -
;•e
Rev 9 8 1' .rf
1 _ S
®��; ®��A��1�'�� ��' ��'��.�� Permit p
f
ronmenial5 Health Seivrces `Carmel N ' V f05`f2
rPatterson
Town or iilage
pn Ta #. Map 55 lock 5._�t14/15_'`:
721 25 `1 Revision Sux] 0' ..o - . G
` 00 '
�d.9 } �� � T,nC0a0e;Of SPrevious Approval '
a_4' Fill Section Onlyy❑
r P C R D ftti f3cation. Requi red o
Gal Septic Tank' antl 300 f+: x 24” ,wide x : 24" . deep lateral s
o Address
rthedesignand lbeition of themeprpposed system(s), 1) that the separate sewage_ 4ispo>iil, system
etl,amendmeht there to and in accordance with,the standards,,rules an :cegu a ions o e _ u nam
hereof a Cartif,cate- ot- Construction Compliance �satisfactoiy.to the' °Commissioner of H®althviill
ee,.w,ll o
'De. -fuin� shed the w hi
ner s successors; heirs;gr assigns by the . builde'r, -that said builder will
age Gisposal system_during:ahe period of,two`,(2) years immediately following .thedate'o4the issu-
Compl�ance of the'originaF- stem 'o` rent'" r® pausth' eieto'" 2)- thatthe :drilled;welIdescribed.abovis
well will be installed ,n 4ce6rUn =ce with the ,standards rules and regu a ions ons of the, Putnam I
4
��
.Signed' • � ;(
License -Mo
e s one year °iron the' date "issued unless- constru chon,rof the building has been undeitakerl and is
considered necessary by the.Commisir of Health:" Any-C hange or? alteration of construction .
sti art' swage and /or ', pnvate ' per
pply onl !,
°���'
PUTNAM COUNTY DEPARTMENT:OF HEALTH.
DIVISION OF ENVIRONMENTAL HEALTH SERVICES'''
COUNTY OFFICE BUILDING, CARMEL,' N.-Y. 110512
ry.
t
DESIGN'DATA SHEET - SEPARATE SEWAGE DISPOSAL'SYSTEM j `FILE'NO.
Owner Ca Address i . Jo �► n ' �t, o
Located at Street 4 yyam�•ji ea` nw. M.
lck
indicate neareess �rocs � s
E aSl Block
indicate
f3 -S Q• d ie&7441 .
Municipality, .Xsbm Watershed 6 ot-ar,
SOIL PERCOLATION -TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
"Hole
Number. CLOCK TIME IYERCOIATION .- TERCOLATION
.Hun Lapse 1)eptn -to water water Level
No. Time From Ground•Surface in.Inches,:,,, Soil Rate,
Start -Stop Min. Start Stop Drop,in Min. /in drop
Inches Inches Inches
1 ( 310 yi4 '2-7 3
Notes: 1) Tots to be repeated at same;depth until approximately equal.soil
rates are obtained 4t each percolation test hole. All data to be submitted
for review.
2) Depth measurements to be made from top of hole.
TEST PIT DATA REQUIRED,TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS, ENCOUNTERED'IN'TEST HOLES
DEPTH.. HO.LF _NQ,...
HOLE N0:_' HOLE__NO.. .
G.L. g tace
6t' ®� a
12" _
UP k4
24 4
3011 r
36..
42
4811r
54 Am
60"
66"
7211
78 ;
8�+" e�o� -'
INDICATE, LEVEL AT WHICH GROUND. WATER. IS .ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED W*m9 err 50pg
TESTS. MADE... PT 0 N R IPA, Al Date
- _ Y
DE GN ..
Soil Rate Used 6-77 Min/1 "Drop :' S. D. Usable Area Provided
No. of Bedrooms °RT�;e Septic Tank Capacity ®® Gals. Type
Absorption Area Pr— ovIded By L.F..x2?+ ". ?..� width trench.
�.. �p ssio q�v Other W2a 19.
O.. PRE '!'�,
TT_...__ - _ _. _- L. ...,r. .P J7,
AddreAsUAk MILL, hY 1tA61 f �
THIS SPACE FOR USE BY HEALTH. TMEN
"DEPART ON �i NO. 29206
Soil Rate Approved Sq. Ft /Gal. C Date
Structure located from survey by surveyor -noted below($_ -
ell.located by: Surveyors survey.-
j Weil drillers roport
Engineero mecuremeotsLI-_
Tank, boxes, pits, gallones d laterals lo- cato.d by:Contractor:
Enp►nser:. ❑
- Healthda.pi: ❑
Field inspe'ctlon by: Health dept ® do t e:�
„ Eng-ineer ® date
• /�/$�• � OQ _ � G -^ -ft/- /00.00 • -
Q6.,r L'J Thfa is to ce.rcifv kha[ the sew"agC !
Q _ _ - disposal. system_wns,const.rocced as -
- N
1
p - - - NOTES: - - ind'icared om this plan- and -chat the
k• Grrcgaf6 �0 N system was inspected b•; me before it
was covered over. The system wab.
constructed i;n accordance with all
- 1 - - - - - standard roles and regulations of
\ al.11- ICTIUrJ R3cK p�El%(Zap the P.C.H.D. 6 the N.Y.' 1
�x rfP .
YV r� pOft!4SN)AA( I
O,aPRRFF'.y
:�Al.� !o D I ME N SION S 4r4o/ '�r,nprsj \y�A
it
_oil roTAl�. ¢ti c —� A - C $,_�n� - c = 4 r _���
C r - -n T -- -'TT -
S , PtP I 1 A - E _ 4 B - E
rA ,boo 610(. S G��.k A - F °_� T —r, F
_ 7 -( A -
A - Kr? OJJT-
1 ` p
N i� f —�Q I �•� -
ro'r(Pr�a� SANITARY -SY M [2ES1 "A 5 DUI i
584' p¢r_ 70,i N/ ,d..� / O• , T
LOCATION Straat:Ji �12Z �rO��Qoavim__
LAI��i pD(ZT D IZ I VG Town:��# ountY: %1e9 Stote: -Z
I SUBDI No' ISION: 1- �`/•QcL�AAffcT�(?�I�ST¢�5�[Nc�]
—
Block..— —� -- —_ /LOT 142_4�_ ! - - - - --
nutnam County Department of Realta S u r v e y or: -
ivision of Environmental Health Servioett —
Drawn: t DA Dote:Z_8� Scalo: �__ � Job N�•U,, /00
;,proved as noted for conformance with Ow plicable Rules and Regulations of the JOHM R ENTISS E g' 4
.Q P_
utnam County Health Department. CONSULTING E N G I N E ER
a a T�± not �� RD 9, Finl-�;_ r,, CA R M E L 'MY 10512-(9141 8TS -61TO.
a
L tY t$r ItYib 1 Y "
Std '
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155.00`
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