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Home My WebLink About1206DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.63 -1 -2 BOX 12 01206 ., d 40 . 1, JL ILL 1 01206 -P My' Wdoldm. -i1bE'PARTNWMj0E-,'HEALTIfl( Cos" Carmel, 4. SEWAGEDISPOSAIST RTIFI X, "Y CQ tTo wn or, VU ,C? 7y ra Sa Ma.,,m J W111 I- T 7i '4 k ." I% C.�Separate Sewerage�System'boilt by�1L� _e Address C66idlion g of __ tj I J "1" 7 1, 7- hife: aUv Suo ft `Supply t)�` Vati S pl�- 6d (A IJ IN' r, V, 77 _uL ro 7 US I certify that the a) ae listed serving the above *;prem sea -,were'. onetructed esaenfiallyf as shorn on,the ,-0I'iris.df the` dbAplefekl- rk copies th_ iili . rd , 'r!d of.-whi 41ftabhed)' -,aind,' j�_ - :Z i, a 'ch. are ii, a* ihe'pe'rdit, ibiued by thtk `D4artiievnt of.Meslth';' P!4ti�apg , q,. 7 Punty�. 1,� 17 T.E." R.A.— ?_7 , I"Am No y x.� r et r Wdde I jal�!110 V _:, �, 4 i -unsanitary 7 pyin ,..\q!�54 . 9,�prarnisev seV"nAYAn6 8,P?ve, SySt0M(S),;IShaIIIProM Y. TBKO RCq.SeSt�,7q!sm4y;oe nemssarv;' tc�rjy;'* pqrspnto, ion. any ps- kiiif, , so Co cbhditi6ns',resulti'ln'g'.",i;6wi,,i4iiK"-�iiige;-;�i,AW A!ks"r!,Af- I �Pu_ mell an private ^axer, supp1y.snr!!,4D6C?m , it:, royals are iWiftation or � change 0 ,tr necessary J. 6st. W • :.+r• .� „r::. � a r ,, F rM <l.°yr 'y^r!.S+ fi :;..:,�fg�?p� , .� n T.TDT T f ALMT L'TTnM DUD11DT �, .. _ Yt14LL VVL'li LL' i1V14 ANLJ Vices DEPARTMENT OF HEALTH -- Division Of Environmental .Health .Services- PUTNAM COUNTY DEPARTMENT OF HEALTH Office, Use Only WELL LOCATION STREET AOORESS. �HV Y TA-i'61110 NUMBER:— ,�&) 0 2 — WELL OWNER NAME ADDRESS: P8iVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) O INDUSTRIAL O .INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE 06 gal. YIELD SOUGHT gpm. /N0. PEOPLE SERVED /EST. OF DAILY USAGE If- REASON FOR DRILLING WNEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH YOE ft. STATIC WATER LEVEL ft. DATE MEASURED DRILLING EQU,IPNIENT ❑ ROTARY COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH it MATERIALS: 9STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE ft. JOINTS: ❑ WELDED IYTHREADED ❑ OTHE9 DIAMETER. in. SEAL: ❑ CEMENT GROUT O BENTONIT'E NOTHEIR WEIGHT PER FOOT. 17 lb./ft. DRIVE SHOE 9YES . ❑ NO LINER: ❑ YES' dNC SCREEN Q I T I LS DIAMETER (in) 'SLOT SIZE LENGTH (1t) TH TO SCREEN (ft) DEVELOPEW FIR57 YES ONO U RS S ONO GRAVEL PACK O YES O NO GRAVEL SIZE DIAMETER_ OF PACK in. TOP DEPTH fL BOTTOM DEPTH It WELL YIELD TEST if detailed pumping l METHOD: O PUMPED 1 tests were done is in- • COMPRESSED AIR , formation attached? • 8AILED O OTHER ❑ YES O NO It more detailed formation descriptions or sieve analyses LOG are available. please attach. DEPTH FROM SURFACE water Bear. i "g wen. Oia= meter In FORMATION DESCRIPTION CODE. fl ft WELL.DEPTH IL DURATION hr. min. DRAWOOWN It YIELD 9Cm- Surface o WATER CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE a- CAPACITY GAL._ PUMP INFORMATION TYPE �� 'p MAKER MODEL ,x CAPACITY DEPTH VOLTAGEgIS-0HP W.ELL�D.RILLER NAME DATE ADDRESS ERT M. HYATT & SONS, INC. �,� Well Drilling SiGf&MRE Rte. 311 R. R. 2 Box 171A PATTERSON, NEW YORK 12563 I �.� PUT[VA�M GOON � `hHE�►L�THs DEP,�T` PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONME UAL HEALTH .SERVICES ,1i 10 W /..1' • - • - . . td ea . ... - _ .- I3 / Section Block Lot Subdivision Dame Subdivision Lot # GUARAI E OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, w8rlianship, 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`vy n►e t6 such system, *except where the failare-ta' operate properly is caused by the willful or negligent act of the occupant. of the building utilizing the systems I. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environkental 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 • n al Signature . 4Crp/ora_tiXon1=a1a4�_ �(if C�®rp.)�� ess Title • •• ration Narffe- • •. rev. 9/85° mk "all W ' YML Environmental LAB NUMBER 32, 3313- Services DATE /TIME TAKEN 321 I��a treet; crk.awn Y., , Irs; NY 105° . F"DATEMMt RC'D _ 119 _ ELAP #10323 (914) 245 -2800 DATE REPORTED 1 1-23-91 5 JV Con- 6- tauction Hanmony =.Rd:: Patten.a on Ny COLD BY NOTES X RESULTS OF ANALYTE RESULT UNITS PHOSPHOROUS ALKALINITY mg/L. mg/L SILVER AMMONIA mg/L mg/L SODIUM ,CALCIUM n-g/L mg/L SULFATE CHLORIDE mg/L mg/L SULFIDE COLOR n-g/L Units SULFITE CONDUCTIVITY mg/L umhos /cm TURBIDITY COPPER NTU mg/L ZINC DETERGENTS n-g/L mg/L FLUORIDE mg/L HARDNESS mg/L IRON mg/L LEAD mg/L MANGANESE mg/L SPC MERCURY per 1.0 mL mg/L TOTAL COLIFORM NITRATE per 100 mL mg/L FECAL COLIFORM ' NITRITE per 100 mL n-g/L E. COLI ODOR per 100 mL TON FECAL STREP. pH per 100 mL S.U. SAMPLING W"Aton P.Cace SITE Patte,%a on, Ny Kite h For Lab Use Only XXX Potable _ HNO3 _ pH LT 2 _ <4C _ Nonpotable _ NaOH _ pH GT 9 _ <20 >4C _ HCI _ Na2SO3 _ >20C XXX STAT! H2SO4 ZnOAc COLIFOR R,METHORUSEb X RESULTS OF ANALYTE RESULT UNITS P PHOSPHOROUS mg/L. SILVER mg/L SODIUM n-g/L SULFATE mg/L SULFIDE n-g/L SULFITE mg/L TURBIDITY NTU ZINC n-g/L SPC per 1.0 mL TOTAL COLIFORM per 100 mL FECAL COLIFORM ' per 100 mL E. COLI per 100 mL FECAL STREP. per 100 mL These results indicate that the water sampl WAS [WAS NOT] [NA] of a satisfactory sanitary quality according to the New York State Sanitary Code, for the eters tested, at the time of sample collection. These results indicate that the water sample [WAS] [WAS NOT] [NA] f a satisfactory chemical quality according to the New York State Sanitary Code, for the parameters tested, 'at a of sample collection. G9 ��ri�i�(.i f F = = Not Applicable N = Not Present (Negative) • SUBMITTED BY: � P = Present (Positive) SA = See Attachment(s) = Also done because Total Coliform was present Albert H. Padovani, M.T. (ASCP) TNTC = Too Numerous To Count Director > = GT = Greater Than < = LT = Less Than - - - - PUTT M-1� -HE?&M -1)EPA1k1:;t!3M4T- -- DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simnons, M.D. Deputy Cimmissioner of Health FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME �=�Orig. Routine Orig. Complain ADDRESS Orig. Request No. Street Town IM No. Compliance Complaint Comp MAILING ADDRESS Final P.O. Boat Post office zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, sampling Only F OR INTERVIEWED Field Conference Name and Title Other DATE TYPE FACILITY TIME TIME LEFT Explain FINDINGS: .. ' -00-0-1 -7 odd INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: ... - ....PtFnNAM COLT." FY - : :LT€?- nEpzU RIIVIE1i' _ ... _ ...- - -� . . .. . - DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Camnissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME / AO BAAA 6l ZW EL a-61 ' 38 Orig. Routine / Orig. Canplain ADDRESS V � -5qc ►ptotz Def ut Orig. Request No. Street Town TM No. Compliance Canplaint . Camp MAILING ADDRESS Final P.O. Baas Post Office Zip Code Group Illness Construction • i� Reinspection PERSON IN CHARGE e Field, Sampling Only OR INTERVIEWED W I &-iicd L Field Conference Name and Title Other DATE (0 0 41 TYPE FACILITY _ TIME ARRIVED 'TIME LEFT Explain m FINDINGS: INSPECTOR: ture and Title TELEPHONE: PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: _ 6/86 TITLE: _ ni a i tt mz j� ap � f .11 �tlre �t® { Lvat✓�vQiL� �. YD �,�yy� Enclosed M Wall" UMMP-* to ti '11EY � D� '� �•� � a� � 'v%..7 � 4 Y - �' NhY�[iI_ "�' ,.7 � �t N �'r . . r r +'.� {r lw � �� _Y � r s r y ^'Fa> FY ••,.�, � _.. t -� _ O PvaNeeQ Quit I am avhollq anm eanOS4o0yr vpPpoP+eiipb 4ov tOw mssn aa�DOCa4ioh oP tho ,®PO�o isy88pm(�i ,E�, that �@ii�i vaa4 ® -pw ;di asl? sQeiel . ti0�®VO 6ifs►ide® will ®i c®ntt "ruc@a® as tROleva oao the ap®vova� a/haltd 9 ra altP @o i"M"t tw ro m raqu 1t.o h _® o6 ' : C�a?i�8g ft1P1011t'`Ot tdilllt�, a11® t11Dt 001 c91e01atiow tiiaaaot q'�'CartiPitata of Coell�PUe4ioco CovFi80i�rrue' �t®QI$Pac4oPY�to ¢hm'Conlmi�iiov 09; P�litRztlU , saeoPVlitQOm' Qo the ° +papartneahQ, 9'11tl. m I;dPif @ai 9ua►ave4 a arlU iw PUmiaMA @i�s'ownor hi8: ¢me ti,:G�EvB'oP iptgwu the: P, thsQ's�t� ®uiliQe? i i00 f�`i r goo® OpM�tllp o "atim *fy 1sYPt 'a !mid abiAi@,a tlitY0Y1 •Ytt98i1 durMp {thp pev0®® oP @c `tgD Yeti hsoaa®s9i� @ ®IY Poalowi� modate ®t�Qhe llil- �1y51mOr,,oB 8h®'�blp►o11al-�ot tha :CavtWi¢a@ ®� ®P C ®vartvuetiool Comol�efca iot !ePN OPiOilea�sys@®Pw Qry aPwy oP�a Q ®. 3D 890®4 @Ap OiNISO:arotO:�s�f 8�tso' is7N009 laecltif at fllaerar®w flier talea� ate, @Rat �id'av011 Wili+ h _ iw OCCAP�G14000 iri40e @ e _ vmla8. atib® oP�oB @RO ,E?1aQpotii� _ P@WONI� Ot (piNBtBJ, " 8 t x ' t 0 s @2Q° dLS At ..y c gPm�x �Jl / e i keY0C0 PDO �6 C9 z... Af B ®�HtF ®'ROW C0 4titIC BOn9 Yhln atsrrsoiril ®m�hat tao yo t Paom_4M ®aQ® i"s_g boPi OP tko cQuital vq�A84 0eeim uR�ev@®4 "aw -i4 r b POP 'Q:OYt'a �.yWICY �(� DPI ®P nlodlti66 OIhaP1 :COP1tiAafaB Ploesel�,Y ray �tl1e' CommlgsborgP 04'ICCaflB@R. t8lP1y Comm o or, el@Q6@1011 OP Oorw2rtmuon PgaedeES €snvmlB. 6l@�P POPi1i81som�0�oP, ®owlaa4tx vBtav �yago a o wat®P tie . (�Ma 10 %88 n. 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 #' WELL LOCATION Street Address To V ct v N 2 'v` `D r t %/ ct e C4t-y Tax v-s or, Grid Number WELL OWNER N�°e Mailing Address rivate ,va0Ov%C v CGY�LD►1 GU OPublic .,USE OF WELL PRESIDENTIAL 0PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP _ [ABANDONED - primary O;BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 2.- secondary D'INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE /EST. OF DAILY USAGE '/'go SERVED' -j T ' REASON. FOR LXNEW SUPPLY OPROVIDE ADDITIONAL SUPPLY ❑TEST OBSERVATI0:9 DRILLING. OREPLACE EXI ING S PLY O DEEPEN EXISTING WELL DETAILED e.wl REASON FOR _ DRILLING WELL TYPE EDRILLED ODRIVEN ODUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES __,!?�_NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: N A _ Lot No. WATER WELL CONTRACTOR: Name '�'�: 6 ,.D, Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC'WATER SUPPLY: NIJ9 . TOWN /VIL /CITY 'DISTANCE.''i.0_- PROPERTY- FROM'NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED O ON REAR OF THIS APPLICATION !I (date �ON IPARATE S T (sign ture) 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 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 provided by the Putnam County Health Department. Date of Issue: 19 I lop, Date of Expiration: 1g -1? / ermit ssuing c a Permit is Non - Transferrable � White copy: H.D. File Yellow copy: Building Inspeo or 2/87 Pink Copy: Owner Orange copy: Well Driller ILI SUPERVISOR Lawrence M. Lawlor .(914) 878 -6564 TOWN COUNSEL Judith M. Goldberg (914) 878 -7106 (203) 792 -3050 Fax (914) 878 -6343 ROUTES 164 & 311 PATTERSON, NEW YORK 12563 June 27, 1991 Mr. Randy Laurent Laurent Engineering Associates ?3 Fairfield Drive Patterson, NY 12553 Res Property of Mr. J. V. Coughnett Dear Mr. Laurenti TOWN BOARD Antoinette T. Gillotti Thomas T. Keasbey William Peragine Deborah W. Taylor . TOWN CLERK Josephine Campanaro (914) 878 -6500 I have inspected the surrounding property of Mr. Jo V. Coughnett at the corner- of Warren D_°ive and Weston Place and I have determined that ,the small wetland area to the north of this site is less than two acres in size and therefore is no-k; regulated under the Patterson Wetland Code. In addition, it appears that you-- -gave located - -the -aSDS- _. :sure than ZUO"3e�ti -from 'tnzs -pie �� grid edg o __... . Sincerely, d- c( CQCCs'!�G( Ted Kozlows;:i, E aC o I a TK/ ec s I +Iro Robert Morris, Putnam County health Dept 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 # - D� WELL LOCATION IS WELL SITE SUBJECT-TO FLOODING ?. YES _NO ,IF WELL IS LOCATED IN A REALTY.,SUBDIVISION, NAME OF.SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name8. Address: IS. PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME.OF PUBLIC WATER SUPPLY: N /A TOWN /VIL /CITY DISTANCE' TO 'PROPEl TW"VRbM NEAREST WATER VMAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR -OF THIS APPLICATION ON SEPAKYE S t5 g ( te) ( nature) 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: I . 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 Expir on: 19�. Permit is Non - Transferrable 2/87 eerrmitIssu Issuing Of is . White copy: Yellow copy: Pink Copy: Orange copy: H. D. File Building Inspector Owner Well Driller &eet dd ess Toi Village City Tax �\ E Grid Number, WELL OWNER Name Mai in Address L U 6M t 1 "k C IV WPrivate OPublic USE OF WELL T>- 'primary 2' - secondary Gi RESIDENTIAL ' O PUBLIC SUPPLY ❑: BUSINESS O FARM ,. 13JNDUSTRIAL O INSTITUTIONAL (3 AIR /COND /HEAT PUMP O TEST /OBSERVATION. O STAND -BY _ O ABANDONED ❑ OTHER (s.pec ify O , AMOUNT OF USE YIELD SOUGHT J 'PEOPLE SERVED 3 -5 /EST. OF DAILY USAGE 5Ogil REASON FOR DRILLING NEW SUPPLY OPROVIDE ADDITIONAL SUPPLY [3REPLACE EXISTING SUPPLY .0 DEEPEN EXISTING WELL OTEST OBSERVATION . DETAILED `REASON FOR DRILLING E WELL TYPE ODRILLED DRIVEN ODUG [:] GRAVEL C] OTHER IS WELL SITE SUBJECT-TO FLOODING ?. YES _NO ,IF WELL IS LOCATED IN A REALTY.,SUBDIVISION, NAME OF.SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name8. Address: IS. PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME.OF PUBLIC WATER SUPPLY: N /A TOWN /VIL /CITY DISTANCE' TO 'PROPEl TW"VRbM NEAREST WATER VMAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR -OF THIS APPLICATION ON SEPAKYE S t5 g ( te) ( nature) 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: I . 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 Expir on: 19�. Permit is Non - Transferrable 2/87 eerrmitIssu Issuing Of is . White copy: Yellow copy: Pink Copy: Orange copy: H. D. File Building Inspector Owner Well Driller i m a t ' Putnam County Department of Health Division of Environmental Sanitation AFFIDAVIT -_ .CORPARATE..91NER A.PPLTCATTON FOR PERMIT. APPLICATION SUBMITTED TO PUTNA,M COUNTY }[EALTH DEPARTMENT; The Commissioner of Health - In the matter of application for —. S Srf represent that I am an officer or employee of 'the•• corporation and arrr authorized t® act for _ ..�! _ �-�� L:i.�.�2. .,.. o m m ® _ - d (name of corporation) having offices at _ Whose officers are __m__m__ >__�a._�:m� _- President _ �%ei Cang y .�,I�m - 'id�dres� Vice - President _ _ _ — — — — Name and Address) Secretary _ _ -., _ _ _ m (Name and Address) - Treasurer - _..:.. _... _ _...._.... . -. _ , ... ..(Name- and Address) and that I am anti will be individually responsible for any or all,acte ok the corporation with - respect. to the approval requested and all - rub- .. Sequent act$ relating . t}iereto, ' S�orn to before me this 1 day Signed �� APPENDIX B PUTNAM COUNTY DEPAFMMU OF HEALTH - DIVISION OF MWIROMM9TAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE I SEK9GE DISPOSAL SYSTEMS i REVIEW SHEET - CONSTRUCTION PERMIT - DAB - (Name of Owner) (Street Location) COMMENTS YES NO DOCUA MUS Permit Application Corporate Resolution Plans i - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep Hole Log Perc Consistent Perc Results (3) Fill Perc Hole Depth cd Ho Plans - Two sets permit; PWS letter Variance Request LF trench provided c� required 3� 60 ft. max. Parellel to contou Minos . L_71"Mtzi W1P GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked 1 Wetland (Town/D2ermit R & D) G ? r Data Chi DDS Plans & Permit Same c REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) ,,Sewage System Hydraulic Profile - Gravity Flow ill Profile & Dimensions - Volume D o(J�ox;Trench/Gallery; Pmp pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder notes) Design Data.: perc.and.deep re I-+! Two = Foot.' Contours Existing Pibposec _.....__...........,..� ._ Driveway & Slopes Cut Footing /Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size --° - -If R, roped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells'& SSDS's Win 200 ft. of Proposed Systems Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 1'0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields' 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits X00' to Stream, Watercourse, Lake (inc. expan) 15! to i"ai Dr"�'ins-Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse 10' to Water Line (pits -201) 50' !intermittent drainage course 10' - ran Foundation; 50' to well 15' Well to PL 9 i PUTM M= DEPARTMEV-."OFIMAXTH DIVISION • F ENVIRUMML FMALM SERVICES' DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Add ress2t•,t0� Located at (Street) ��1VC Sec. _ (.p0 Block Z Lot {o22- 4t, -e,+ (indicate nearest cross street) Municipality Watershed SOIL Pk�CLA'I.-ION TEST bATA RDQC= TO BE SUM= WITH APPLICATIONS Date of pre - Soaking -7 /2j6/67, �; Date of Percolation Test ,HOLE , 'NUMBER CLOCK TIME PERCOLATION PIItOO=CN Run ` ..'.Elapse- Depth to Water Erma Water Level No. Time :- Ground Surface In Inches Soil Rate .Start =Stop Min. Start'- Stop Drop In Min /In Drop P _ Inches Inches Inches 13 03 - 3 20 27 � �• � _ 2 3'. 21 _ T41 ZD 24 271 33 -'4 -y;pZ :?.d 711147 4 5 1 AF -4.E -7 • IS 24 27 G. n 3 0 !2-6 ?z- . (..o • i Mm 3 �.� -i :z m 4 tT 5 tr 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.sutmitte3. :., for review..... - 2.-' Depth, measurements ' to be made -fran top of hole. 2° 3' 41 HOLE NO. I 51 89 90 BOLE NO. WITH APPLICATION IN- TEST HOLES HOLE NO. 3 loo 11 ° 12° 13' 141 INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED - -- INDICATE. LEVEL TO WHICH WATER I.E'VEL RISES AFTER BEING ENOOUNTERED (�(� f DEEP BOLE .OBSERVATIONS MADE BY : DATEo P� DESIGN L Soil Rate Used (O-% Min/1" Drop: S.D. Usable Area Provided �g0� No. of Bedroans 3 Septic Tank Capacity gals. Type Absorption Area Provided By ... ' L • F • x 24'° width trench Other Name l & I N CM& SAC „X.0 Signature Address rz-q SEAL, 13-66-3 ``THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: NO. 56124 Soil Rate Approved sgaft /gal. Checked by To be_j6wistructed Pb y - - .Address Water- Supp)Y - t ublic Supply om - I IL r.' J xriT x M II r—. Il z. Private:bupply to ibe, drilled, b' _ a - 1 Address *M •. _ l r Other. . e irement � IF 1 represents ME— wholly c mpletefy responsibfefor h sign and IocaUOn of the ,proposed` system(s), 1) ,that t sepgrate iwage�disposal isste1 esc bori ructe ?a show on the approv as endment thene`to and In accordance with the's_tandar�di; :u es anregCi ons o t e . u•r�a4l» County D partme of "Ith;f s hat' R compiet�on e e f a ',CertIf�Cate, of Construction Compliance" satisf5ctory to the: a of Healthwl�ll =a % — . s e-, submitted fp t e ,Dep rtme �; d JVritte guarantee:. II be .furnished' the owner, 'his 'successo[s heirs -b- assigns by'the;bui der; that said - ;builder w II place 3�n gp d ".;op at�ng' coM any it sai8 `age; isp�osal system. during_the, period of two (2) .years immediately following__fte of the iss - ance `of ;th` a "ppro al o t'h Certrficat'e " n e of the original stem or any ,repairs thereto; 2) that the'dr Iledkw,ell descr9bed abo '0 will"be loca ed as s a on ;the appro Ian and 'that id.w I will be; installed in rdance'+wlt ,1 the ndar, rules and• regU!a, s", of the Putna% n GoUnty# De artme t�` ��` Date f Sign 'P f P E ~R Ar e cafy `s ,,r r ' Atl ress License No r Ap�PROri [� tO CONSTRUCTION This approval�h.n._,�Ssiglered ne year:from the date ,issued unless construction of ,the 'building has been' uncle taken, and. is revocable ;for, caUSe or may be amended or modified necessary by the' Commissioner of Health. Any ,change •or alteration of.conatrugti n uores 'a new , :'; .. ,:: Yer�l permd, Approved for disposal of domestic sanitary sewage, and /or private water stipply only Date = By Title _ .. Y. ` _ ♦wL' -(' .r:� :R.� Cam' tfy y< � - I. PUTNAM COUNTY: DEPART ti LTHi .9 �1 Division of tEnwronme�tal Hearth Ser ices, Carmel N. Y CON$TRUCTIONPERMLT. FOR SEWAGE SYSTEM. , :DISPOSAL_ i o' " r. Located at Tax ,SUbdivisiori� _ _ �LOt _ s r Address BUilding Lot Area Type `'A� n Number of Bedrooms . "Design. Flow ! lJ `�� >�� Total_ Habitable Sgice Separate ''Sewerage,'System to consist of - - -- - G I. Septic Tank and - To be_j6wistructed Pb y - - .Address Water- Supp)Y - t ublic Supply om - I IL r.' J xriT x M II r—. Il z. Private:bupply to ibe, drilled, b' _ a - 1 Address *M •. _ l r Other. . e irement � IF 1 represents ME— wholly c mpletefy responsibfefor h sign and IocaUOn of the ,proposed` system(s), 1) ,that t sepgrate iwage�disposal isste1 esc bori ructe ?a show on the approv as endment thene`to and In accordance with the's_tandar�di; :u es anregCi ons o t e . u•r�a4l» County D partme of "Ith;f s hat' R compiet�on e e f a ',CertIf�Cate, of Construction Compliance" satisf5ctory to the: a of Healthwl�ll =a % — . s e-, submitted fp t e ,Dep rtme �; d JVritte guarantee:. II be .furnished' the owner, 'his 'successo[s heirs -b- assigns by'the;bui der; that said - ;builder w II place 3�n gp d ".;op at�ng' coM any it sai8 `age; isp�osal system. during_the, period of two (2) .years immediately following__fte of the iss - ance `of ;th` a "ppro al o t'h Certrficat'e " n e of the original stem or any ,repairs thereto; 2) that the'dr Iledkw,ell descr9bed abo '0 will"be loca ed as s a on ;the appro Ian and 'that id.w I will be; installed in rdance'+wlt ,1 the ndar, rules and• regU!a, s", of the Putna% n GoUnty# De artme t�` ��` Date f Sign 'P f P E ~R Ar e cafy `s ,,r r ' Atl ress License No r Ap�PROri [� tO CONSTRUCTION This approval�h.n._,�Ssiglered ne year:from the date ,issued unless construction of ,the 'building has been' uncle taken, and. is revocable ;for, caUSe or may be amended or modified necessary by the' Commissioner of Health. Any ,change •or alteration of.conatrugti n uores 'a new , :'; .. ,:: Yer�l permd, Approved for disposal of domestic sanitary sewage, and /or private water stipply only Date = By Title _ .. Y. ` _ ♦wL' -(' .r:� :R.� Cam' tfy y< � - I. 0 April 27t 1071 Hr. Oeor-ge Maughneyj 0'4o Route ,52 Car, mel 4 ftw York 10512 Re t Frederick Weston & t1arren Prive Pear W,- HaugWY-6 The proposed submittal for constructics of a sanitary Dewage, di- 1 ea- s4rVo the aboye .pt pposeO reside=e has baeA :.Veviewed spo". gytt -to by this d0paftmw# The propo961 has $ome sdrious problems in bi�iag able' justifiably.c. tneA c O-Unty Rules & ReoUlat ions - -lot the 1 -4on Sal in -hit -followi, l inaw ti 11) 4xisting. swampy, area at the sr(MW of the propoted - 'ar" .00 9 away, tfig. pro 10�. lot-' t�q 00 �O be I SOMP -101 eal isyft fts p not PlOU'Aw- On, 'Plan" 2) Adj�C@ t 41 but ebt eve O,:�.n fleld by this WI t lac -Ozopoi - Well IW46 tha4 100 feet iWay pod'sibly in direct line fleaiksip: t4w' tact �-hlz of Ace, if, you' haft ahy. questions, joelati to this matter,, Vevy truly yourS9 Robert Y, Tutoni Publi c Health Admiastratdc sd1h Re: Property c- Located at Section f/q. G' Block Lot Gentlemen: This letter is to authorize George A. Haug h n e y a duly licensed professional engineer X, or registered architect (Indicate) 'to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated 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 pro- visions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County. Sanitary Code.- Very. truly yours, r� {.Yf��,, _ , Countersigned: .�` , P 3 q J 4 P.E. R.A.; # "'.il'Ai,� .� 9 �r�rrii�t��t�T Route .52 Address Carmel, N.Y. 10512 (914) 225-9353 Telephone �io-� `owner of Pro-pert awl Ad ress Telephone F PUTNAM COUNTY DI,PARTMENT OF Ii1!�,41,'PIi DIVISION. OF ENVIRONT,1Tv `TTAL IIE LTIT SERVICES COUNTY 0FICka L'1JILDII +G, dARMrL.L N. Y.- 10512 DESIGN DATA . SIIFE IT- SEPARATE SD1 4AGE DISPOSAL SYSTEM FIL{ NO. Owner Ci Address 7 Located at (Street Sec. 10 Block G; Lot n Ica e nea,res cross street) Municipality. //% Watershed SOIL PERCOLATION `PEST DATA REQUIRED TO BE SUBMIT D WITH APPLICATIONS. Hole.- Number. CLOCK TIPS' PERCOLATION PERCOLATION,•. Run. Eiapse No. Time ..Start -Stop. Min. Depth.to •;a i,er From Ground Surface Start Stop Inches Inches WaLer-LeVel in Inches Drop in Inches ..Soil Rate,;. Min. /in drop 2 / %f - /-' /D d?�' a; ZD /rrV2 /� �� (JI � /5 1 i2�r CIV• /y /.5 - 0� 5 2 Notes: 1) Tests to be repeated at same depth -until approximately equal soil rates are obtained at each percolation test hole. A11. data to be submitted for review. 2) Dopth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO DE SU13t41-TT-P0 W19111 APPLICATION'. DESCRIM'TON OF S01'Lc3 .11i'l-MOUN" 1.TRED IN TEST HOLES DEPTH HOLE. No. HOI2,' NO. HOLE, NO. G. L. 611 1:211 1811 2411 30" 3611 4 it 2 '481.1 5 it .4 .6o 66 72 60' 78 0 INDICATE LEVEL AT WHICH GROUND WATER IS tNCOUNTERED X-)026�, INDICATE IMEL, TO VBICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS 14ADE BY Date Soil ].late UsevA-/5— Min/l "Drop: S.D. Usable Area Prbvid,d,-<006�� No. of Bedrooms V Septic Tank Capacity?M Gals. Type .Absorption. Area Provided Bj-?�--L.F.x'2)411 b" width trench. Address ure .SEAL THIS SPACE FOR USE BY BEALTH DEFAIMIRMT 'ONLY: Soil Rate Approved �Sq. R/Gal. Checked by M U.J UF�SS . . . . . i O d TN13 IS �f0 GERi1FY "CI -IAi TN Pi r✓f;W.°loE DISPOgAL SiS"fEM Wits coNSTRV�Seo '� r. ... A../� T�1.iT Tt-FG Z`(STEM wii.S INSP�GfEt7 PAY ME �; }I i �i S AS �.0 I LT ; t011vl �N510N,.GH�t�T • . sNa` � � zN•a• A , , i RM1 f , ilk-� fit -. f V Y J° lb; AN � 5'f I � q1 :0 -O' S AS �.0 I LT ; t011vl �N510N,.GH�t�T • . sNa` � � zN•a• A , , i 5'f 1 Old q1 :0 -O' ~f-I .0` G5 0' a8 ; t33 °o t3o o`� i� :81;0 52.01 q` � t3,2.5 ;128 0' 10 5 r V