HomeMy WebLinkAbout1198DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
25.62 -1 -76
BOX 12
rr
J
'�
Na
�T'k
r
�'.
.r
'�I k
�1-
Fd
rr
T
Na
`.y
'�I k
�1-
,
01198
PUTNAM .COUNTY DEPARTMENT' OF HEALTH
Division of Environmental Health Serroices, .Carmel, N.' Y. 10512
CONSTRUCTION PERMIT FOR. - SEWAGE- .DISPOSAL :SYSTEM 1'o:iU►� ate. PAT1E�'SaI�S
(,. village,
�� �Q �cU)c�t(D(1' Q�. ct r fir"\ '�p� rSlo ^k _4
Town
o
Luw e'a. �_w e�
Subdivision ?L- TIJ'A M LA
Lot Job
owner. — T'-ADDOC< Address
BuUding Type DANCE -1 Lot Area
t' Number of Bedrooms' Total Habit ble Space
Square Feet
r x _Se�- P46- Pt'1'S
Separate. Sewerage'System-to consist of . Gal. Septic Tank — X width trench
To be. constructed by, / -� Address
Water. Supply:, ' " Public: +Supply From -
X "Privete.Supply to be • drilled:° by s -
Address
Other,Requirements
,I represent that I am wholly and completely responsible for the design and location Hof the propo58d system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on the approved amendment there, to and in accordance with the. standards, rules an . regu a ions o . e u nam
`County .Department of Health'., and that on'coinPletion'.thereof a "Certificate of;Construction Cornpliance" satisfactory to the Commissioner of Healthwill
6e' „submitted to` the :Department, ,'and' a written, guarantee will <66 furnished 'the :ownee,__his successois.,heirs or- assigns ,by the builder, that said builder will
place "in _good, operating' condition any part. of said sewage disposal'' system during the : period, of •two, , (2) .years immediately following the date of the issu-
ance of the approval 'of, the Certificate of Construction .Compiiance .of fthe on i Isystem or?any repairs thereto; 2) :thit -the drilled' well described above
will'be located as shown on the approved plan and that said well will be instal orclance.. with the standards, rules and regula ons of the Putnam
C_ ounty: Department of. Flealth. `.'
Date Signe P.E. R.A.
Address License. No.,
.r r
), APPROVED•FOIi CONSTRUCTION. This approval, expires one year from the datey issued, unless constreltho. f the building has been 'undertaken and is
` revocable for cause or maybe amended `or modified when considered•nece nary by -the `Commissioner of Any:- ch ange or alteration 'of construction
requires . new permit. pproded for disposal of. domestic nitary's w ge n /or private water.'supply only.
By Title
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OIL HEALTH
3/71 Division of Environmental Health Services
COUNTY OFFICE BUILDING - CARAMEL, NEW YORK
This-report is to be completed by well driller and submitted to County Health Department together with laboratory report of
analysis of Water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued.
REPORT MUST BE SUBMITTED ,WITHIN 30 DAYS OF WELL COMPLETION
OWNER
NAME
JOHN PADDOCK
ADDRESS
Route #3118 Patterson; New York
LOCATION
OFWELL
Corner
(No. 6 Street) (Town) (Lot Number)
of Newburg & Lakeport, Put. Lk,, Patterson
PROPOSED
USE OF
WELL
fv.w
DOMESTIC
11 SUPPLY
BUSINESS
❑ ESTABLISHMENT
❑ INDUSTRIAL
❑ FARM
❑AIR
CONDITIONING
❑ TEST WELL
❑ OTHER
(Specify)
EQUIPMENT
❑.ROTARY
�p
FT AIR PERCUSSION
❑ PERCUSSION
❑ (specify) (s
CASING
DETAILS
LENGTH (feet)
1
DIAMETER (inches)
6
WEIGHT PER FOOT
17
�
L-J THREADED ❑ WELDED
E O
x ES ❑ NO
OYES
CASING
NO
YIELD
TEST
❑ BAILED
X HOURS
El PUMPED COMPRESSED AIR 2
G.P.M.
YIELD (G.P.M.)
4
WATER
LEVEL
MEASURE FROM LAND SURFACE —STATIC (Speclfy feet)
162
DURING YIELD TEST tteet)
380
Depth of Completed Well
in feet below Land surface: 380
SCREEN
MAKE
LENGTH OPEN TO AQUIFER (feet)
DETAILS
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
PACKED:
Diameter of well including
gravel pack (Inches):
GRAVEL SIZE (Inches)
FROM (feet)
TO (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact
two permanent
location of well with distances, to at least
landmarks.
FEET to FEET
0
11
Clay and
boulders,
a
We6G
11
380
Hard gray granite,
�
If yield
was tested
at different depths during drilling, list below
FEET
GALLONS PER MINUTE
�w Ot/Y�
200
2
380
4
DATE WELL COMPLETED
518/72
DATE OF
15/9/72
REPORT
WELL DRILLER (Signature)
FRES I DENT
BREWSTER LABORATORIES
Box 224 - BREWSTER, N. Y.
WATER ANALYSIS REPORT
SAMPLE NO. 2677
SOURCE: John Paddock - hose bibb - well supply
Newburg Road
Putnam Lake:, N.Y.
COLLECTED: May 26, 1972 -
BY: Mill Drilling, Inc,
BACTERIOLOGICAL EXANIINATION
Coliform Count, MF Method
This result indicates the source of the sample was
of satisfactory sanitary quality when the sample was collected.
May 28, 1972
0 per 100 ml.
Roy Bickwit P. E.
Director
July 23, 1971
Mr. Robert J. Caddell, P.Co
Putnam County Dept. of Health Re: Sewage Disposal System
Putnam County Office Building Lots 1133 thru 1138 - Putnam Lake
Carmel., New York 10512
Dear fir. Caddell:
I am the owner of the property noted above and have commissioned
Howard A. Kelly, Jro associates to prepare the necessary plans for
approval of the sewage disposal system and well location.
Because of the size of the porperty, the well is only 90 feet from
my sewage system. I realize that this distance is less than the distance
required by the Putnam County Health Department and that there is a
possibility of contamination of my well from my own sewage system.
In vier of this, I am willing to assume all responsibilities should
this occur, having been adequately informed by the Putnam County Department
of Health.
Very truly yours,
John Paddock
r
PUTNAK..COUN_T_Y_DEPART NISI: ..OF_. LALTH_..__._..---._...:._ ..._..._,_._..__....- ...
' DIVISION OF ENVIRON =7TAL HEALTH SERVICES .
DateM-
Re: Property of C, 1.•5 ,, f ; i yL n' �`� y� 1.C:
Located at �;' C. Ij.',.. i� kcu'•/
Section Block Lotto ,/% n' ll. c7
Gentlemen :..
This ;letter is to authorize r/u t.y r1 sD %;.� !.
a duly licensed professional engineer.: ✓ or registered architect
(Indicate)
to apply for a Construction Permit fora separate sewerage system; to
serve the above noted property it accorcance,with the standards, rules
or regulations as promulgated by the Commissioner of the Putnam County
Department of Health, and.to sign all necessary papers on my behalf in
..connection .with.,this_matter and, to supervise the construction of said ,
system or systems in conformity with the provisions of -Article 145 or
14 7, Education Law, the Public Health Lava, acid the Putnam County Sani-
tary Code.
Very truly yours,� /
Signed^
Owner of Property
Countersigned:'` ,1
�°�� �- Address
P.E., R.A.,
Telephone
Fj TNA C --'-LE�:T C lj T 1-1
VT
Dil TS-, OV
FTLE- ��O. C-
D El S I G N D A T SH E E, E ?A SG A!--: --E' D T :ZA L S S T
AL—S-dPQ- k
Ad&r-
j
L o c a a t SAC
3
Munic p a y \v &I f: E p- 5c, Le- cn*
S
P-: sy 2
m
V7 r'-TD77-- -�o LIT .T! 2 p p - {C1
TT
Ole
3
j
C C1`1
lalrl
s
'-0
'No
T i e
r. o m r o u
Soil
Star t
Stogy o
M irl/ i
In. c e z
S
P-: sy 2
m
NN 0 tes:
s s o !-, e r-
2 a Jam. e d0 i lu n I' pr. c:,- s c e s 1z: r e C.
a i ri. e �2 c`, e- z: c o c. n cE; S d e `=c) -o
3
4
r-7
5
NN 0 tes:
s s o !-, e r-
2 a Jam. e d0 i lu n I' pr. c:,- s c e s 1z: r e C.
a i ri. e �2 c`, e- z: c o c. n cE; S d e `=c) -o
TEST PIT DATA PEOU D -j 2E'
5-�.;3\!TTTED
rl LJ
T T �-r ppr
Li
M, !C�TIO.\
7
DE-CD'TPTI 0\ 07, LS
—L - -*-
!' ': -7�-
HOLES
DEPTH
HOLE NO..
H O'L-':' ?N'O
HOLE NO.
G.L.
UU
6rl
It
L:ji—
-4?:
2 W!
30`
36"
LL2--'
84
41
IND.ICATEE
1.1LEVEL
AT
j ! TER S T\
G ZR C "-I N D T
A COL'S
T. T'l M
-T, TO Ivi""
,-. --EL R__=7 AFTER
� �.A rE TEE RZ I
C C)UL\T E IRE D
TESTS WADE B
Date
Soil R-=!-L-n "sc-
L S.D. al;;'�
—�Mlin/l" D1 Offiv ,
N
No. 0-f-, '— T sel)tic Tan'k CGS Z) �90 -0
Veal
Absorp.-tion r*'%r--a.Pro%,ddeQ-' S�y L F.x2'-"-' 36
r c n
44 S i 2:-7 a -tu re
7
PE 041�-..-
Addr . ess SEAT ........
PUT.N.A'.[ CC7*\*-,'-',' DL"P`-L'T-,LENT 0 -10 H TE A\ L Ti
So 1 Rate Sq. Ft./Gal. Chec':\-el lb-.- Date
W 4 T htL VI
�� .S -t34 ° OO �SO �{�� • ' � � /70.04 � � I
t
0
;I - � �E_Apt�astou ; •! , - I ,P - � ,� .
3 PLAN
7.
- 1 -.. ..
—
J NCTI4N BOX GR IEVEL
-
• - i AtiN.i2;�. MANHOLE CO
�1
•,-i 3t
}
4 }
! i
SEC CT ION M�+I 1 ; SAN TARTY DfEE
�iE:S. _ - , gym, _ _. 3`~.• J, - - -.
TYPICAL WK. I' PRt ono( cQhcl` id
5A seEpnAt SEPTIC TANK RE tNF.e 'cc DI/Al y `i
-T 1\U tt z
G,2r�vEt GR0 LeVLL
EARTH -
.o - BACKF ILL' 46d wT
_p BLDG PAFfR COV @f}
(. Ofi HAY
's
EQ
i o N
VA PRANGE jRG y if
5a LG - vGR I "T K' o,2 PIPE
T k
1 ABSORPTION TR.,*N.GH�
NOTES. • .._.
SYST£M TO.B[ CONSTRUCTED IN AOCOROANCE WITH:
'J REGULATIONS OF. -THE j2uT.QA;htZ T R c Pd
OF HEALTH.
_
W I SYSTEM SHALL NOT BE BACKFILLED UNTIL 'INSPECTsFt} Y 13E ,�rRt f
ENGINEER AND THE LOCAL HEALTH OEPART$4E•NT fti 6i Ctl%> t
' SYSTEM TO CONSIST OF A GALLON EIpTi v-
2 APPRLgx. AND FT, Of FT.' T��R NCH WITH' ktril.}-'� lu �S
SEP"iK:- .PITCH OF 1/16' PtR F10 T. ,
LCIC1c10tL ANr� TNttEE. C3) 5 *K 8' SE
Epk.G
TL: P\a.
y� \rr\Q(E OF hfl� jji Na Date 8Y C ARMEL N Y tQ
*�po�F0.�HUny�GlO��Y t Uj ¢tilt /fi L K+: OW
4 v
a , LAKt,P ?aT .ri(tive I .Ne\�l�,�R(i;W(irf �-
( t'. � _ : -T Ik.
5�5%ojEv f.3terio3�" - i
04ti nE a3s�%�'v 4 C Wd _ DOte i%{S T14 r 9
9pFz�__• -.• r \J. i _ Cv /21 t%1
Tatced APPA
q f
_
f
-
``
PLOT
(Batt,•'.
PL/\�'
}
1N I ul. � - �-
YUA
YY -;.. P E . • _
' - DIRECT. R, OtV S 7N'OF ":
F - ENVIRONMENTAL REALTH StRVICES. - -
-
. - ice._. _ _ � •.. r
•
3 PLAN
7.
- 1 -.. ..
—
J NCTI4N BOX GR IEVEL
-
• - i AtiN.i2;�. MANHOLE CO
�1
•,-i 3t
}
4 }
! i
SEC CT ION M�+I 1 ; SAN TARTY DfEE
�iE:S. _ - , gym, _ _. 3`~.• J, - - -.
TYPICAL WK. I' PRt ono( cQhcl` id
5A seEpnAt SEPTIC TANK RE tNF.e 'cc DI/Al y `i
-T 1\U tt z
G,2r�vEt GR0 LeVLL
EARTH -
.o - BACKF ILL' 46d wT
_p BLDG PAFfR COV @f}
(. Ofi HAY
's
EQ
i o N
VA PRANGE jRG y if
5a LG - vGR I "T K' o,2 PIPE
T k
1 ABSORPTION TR.,*N.GH�
NOTES. • .._.
SYST£M TO.B[ CONSTRUCTED IN AOCOROANCE WITH:
'J REGULATIONS OF. -THE j2uT.QA;htZ T R c Pd
OF HEALTH.
_
W I SYSTEM SHALL NOT BE BACKFILLED UNTIL 'INSPECTsFt} Y 13E ,�rRt f
ENGINEER AND THE LOCAL HEALTH OEPART$4E•NT fti 6i Ctl%> t
' SYSTEM TO CONSIST OF A GALLON EIpTi v-
2 APPRLgx. AND FT, Of FT.' T��R NCH WITH' ktril.}-'� lu �S
SEP"iK:- .PITCH OF 1/16' PtR F10 T. ,
LCIC1c10tL ANr� TNttEE. C3) 5 *K 8' SE
Epk.G
TL: P\a.
y� \rr\Q(E OF hfl� jji Na Date 8Y C ARMEL N Y tQ
*�po�F0.�HUny�GlO��Y t Uj ¢tilt /fi L K+: OW
4 v
a , LAKt,P ?aT .ri(tive I .Ne\�l�,�R(i;W(irf �-
( t'. � _ : -T Ik.
5�5%ojEv f.3terio3�" - i
04ti nE a3s�%�'v 4 C Wd _ DOte i%{S T14 r 9
9pFz�__• -.• r \J. i _ Cv /21 t%1
Tatced APPA