HomeMy WebLinkAbout1221DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
25.63 -2 -12
BOX 12
I
am
=-'I'
,.
-
I
IN
IN
q
; -� ,I
IN
L
lit
01221
,.
-,:
j6-
; -� ,I
I
01221
4.
Revs 3/86 " �' zARIIVIENT HEAL K
Dlrision fovlroCrimentalsHealthS 'ervice'�'OCarmel N1Y 10512 r
a
�{ 4
r� �.: , 'fit - ��- a • '-
OF CONSTRUC TIONCOMPLIANCE FOR SEWAGE DISPOSAL STSTEM
S K r a v �+t "r a ~' Stir d r °
1� 1TkialP � ��Block tt Lot�_u
f rvv.
% k
0 r /appllcant?Nsme 1 'ONFormerlys" Su'bdivtel { _ S v�+Lot..gr9
MaWng Address r L• Date Per Issued
y A'A
'' x l S t •,t4 ey ar k F „ ,;i t r * t F $
",•' .. ll1� {_ a [ 1.'4 . , ly.\ .:J' _ P +
}} i
Separate'Sewerage'Syetem bullt,by Address C •
Consisting of ��v�/ dd i7 r 1 e t e 'Ge11onTSeptic` Tankana e3�d�CJ I
t r x
{ ��. Lxsl �`� i t Ly t .. ; Lh kr 7 ✓. .. n f Y � 'S-` ~ r ' � y ' .J
• �x�5 ,,.F$ Y i � z;F � t a �r'R j ,� r jt9, 2 ;» lw �+i=,x t 7 c. t, +?,, w � , � r 4 r � � �i: `t'' �� ;j„ ri . ' y y i r... � L .
;Water Supply: Pubflc Supply From] „ H Address
or r Private Supply Drilled by^ a Address ..t }
fi 4-
W.
ti
;,Number of Sedroome� ° r r �' " 'Hue Garbage GrinderlBeen Insta�edY .sr s
�'� '�'r .r k- v , � 7 I� � " ate{/" ��.: .' t t tix�` t • w r,
'; Other Regalroments ,
{; :J'- a„ ;...,4 ,�.�;a .t�4�a Gs en
:..; L. co ;,tify)thet ";the eyatem`(s) has" Bated° Serving,'the`above;premiaes were�conatructed esaent3ally•as:ahownk!on -the plana.ofttthe completed work (copiespp ,
of which are d£tached) ';'and in .accordance with tfie'standards< rules} and' regula�e ona� yin accordance with ',the filed 'plan` th "permit' issued by,the ,
Putnam County D,epaz ent`OfsH
nr f rP, i T V.,, �cF} T 7 brt 7r• ,� ..+t4 ;:r ,
�, w ✓ w_ Z 1 =9 a A , 'i .x fr3 ,i. �` s �` ..<,k
`Date �yL , e-,j T 4 A, Ce►tifled bY" P E.
,;� �
?, tiu.,, s al�� •;�, �
,.�iu3,,,i�d;.�: t,�N �. iSp ,..,.,.. r,.. ¢a r�i "� °,4 ,. .!'. r�,. �J� dli.-r:� �- F�f��t. r.r.. t�Tl.'•, _4}�.,:. - . C'�a .�:t... i -:. ...1�... y -`•Tf nits ►? a
Anyrpe_ rsotlfoccCipyingapromi ses!served�by thei above systems) shatl!!promptly, take.w._ actioh:af may be ,nedrrar o acure the corn, Aon _O any :unfa y
contllt�ons resuft)nq� from sucli':usage A_pprovdC_ot Rhe sepfarate�iuwerage sjlstem'.shall5awmme null and void �s won,as a Dutft;., sanlUry avvir'bacomes i
... -oi .. rr, -. ea...: ,
available, ar)d the app►,oval�ofhe`'.private water supply shall,becomenull�an0'voW .when a•�publkwata wpply beeoma available. k4 Such approvals
sublect `,to'modif,iution.or,change when; fn }the ) udgmenf ;of`t1ie,,Commisllonerroi °, d �.wch revocation, modlfl 1:10 or ,change If Mc�ssny„
z
Oats e x / � � � BY� z w ` � TRN
•x 15 a ka-r. rcs'"- rya+ wi _�7 'I't'F + i
0
;Pt 52,; r t�.r "., -'•� . }'-0 . �' �. •, r < e� v.
.. ..
n
.--Ii -.,.l.l I
r
10
WELL LV11r1jL11VL'4 A-Z,17VAI
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
WELL LOCATION
STREET AOURESS: 1twNiviLUCTICIII TAX GRID BEd:
Tyrone Rd. Putnam Lake Brewster
WELL OWNER
NAME: ADDRESS:
Mario Barone� 7 Pi Pvne ]place, malho-par.—Ny
❑ P81VATE
0 PUBLIC
USE 6 WELL
1 - primary
sec.Ondary
0 RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND. /HEAT PUMP ❑ ABANDONED
0 BUSINESS ❑ FAR ' M ❑ TEST /OBSERVATION 0 OTHER (specify)
❑ INDUSTRIAL- 0 INSTITUTIONAL 0 STAND-BY ❑
AMOUNT OF USE
YIELD SOUGHT gpm./NO. PEOPLE�.SERVED EST. OF DAILY USAGE gal. •
REASON FOR
DRILLING
[]REPLACE. EXISTING SUPPLY ❑TEST/OBSERVATION []ADDITIONAL'. SUPPLY
FL]NEW,SUPPLY, (NEW DWELLING) .0 DEE'PEN.EXISTING WELL
DEPTH DATA
'WELL DEPTH 245 ft. I
STATIC WATER LEVEL --3-0 ft.
/ 9/
I DATE MEASURED 10 92
DRILLING
EQUIPMENT
91 ROTARY 0 COMPRESSED AIR PERCUSSION ❑ DUG
C1 WELT ODINT ❑ CABLE PERCUSSION 11 OTHER (Specify):
WELL TYPE
C1 SCREENED ❑ OPEN END CASING 4K] OPEN HOLE IN BEDROCK ❑ OTHER
CASING
TOTAL LENGTH 41 ft.
MATERIALS: EI STEEL 0 PLASTIC 0 OTHER
LENGTH BELOW GRADE _40 ft.
JOINTS: ❑VELDED IN THREADED 0 OTHER
BET-AILS
-DIAMETER' -6--
-SEALf-U-CEMENT_GROUT_-0 BENTONITE- O'OTHER"
WEIGHT
PER FOOT 19 1b./ft.
DRIVE SHOED] YES ONO
LINER: ONES ONO
SCREEN
DETAILS
DIAMETER (in)
"SLOT SIZE
LENGTH (ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
❑ YES ONO
HOURS
SECOND
GRAVEL PACK,
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
I
OF PACK In.
njTC
TOP
DEPTH ft.
eanut
DEPTH — N.
WELL YIELD TEST If detailed pumping
METHOD: 0 PUMPED tests were done is in-
0 COMPRESSED AIR formation attached?
0 BAILED 0 OTHER 0 YES ONO
If more detailed formation descriptions or sieve analyses
WELL LOG I are available, please attach.
DEPTH FROM
SURFACE
'Water
Bear-
ing
Well
Dial
meter
In
FORMATION DESCRIPTION
tooE
It .
ft .
WELL DEPTH
It.
ON
DURATION
hr. min.
DRAWDOWN
ft.
YIELD
9pm.
Sur Lanface
27
Dx
ill
lng in overburden clay & boulder.,
I
H't
rDck
at 271
245
6
180
15
27
43
D:rilling
in rock, set casing, grouied,
41
2
iiiing
in rock granite.
WATER 0 CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS . ATTACHED? 0 YES ONO
STORAGE TANK: TYPE Well Xtrol 203
CAPACITY 32 GAT,.
PUMP INFORMATION
TYPE glihmp-r-sib"!
MAKER
MODEL
P CAPACITY
DEPTH
VOLTAGE — HP
WELL DRILLER NAME /I , ,
1 9.11 J� V OA / Af
ADORE
al 87
r
BREWSTER LABORATORIES
B 02224 - ®REWSTER, N.Y.
(914) 855 -1930
�1l'� I:�F' ;a
i 'E�LYSIS F�EmF''ORT —
SAMPLE NO. 8463 TEST WELL
SOURCE: Mario Barone
Tyrone Rd
Putnam Lake
COLLECTED: 11 / 2 8 / 9 2
BY: P.F. Beal & Sons
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
This result indicates the source of the sample was
of satisfactory sanitary quality when the sample was collected.
11/29/92
a
j`
1
Thomas Meyer
Director
per 100 ml.
PUTNAM COUN'T'Y DEPARTMENT OF HEALTH
_ .__._.... _ _... -- -..- ... _ ...., :.. _._ ..._ ...w......_..OIVISION •-OI'- I'�'NtRO�AL HEALTH •SERVICES .. .. _ . - . .
L "0,1/ &tl�dtlloe_
Owner or Purchaser of Building
2V-0f 110 Afl�y eo y``
Building Constructed by
7-1% Z0d1,C,
ion - - Street
'?,t: a _ a_ /s 'o,
e2j -4 -1 — .30
Section Block Lot
1xtXv.4�_.._ 1A 6Y-7A
Subdivision Name
C on/ Gt. Qf 6!5! f Gf�s' to f ���
Municipality Subdivision Lot
Building Type d
GUARA M OF SUBSURFACE SEWhGE 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 "Coristr'uctioa, Comp! ianc:e "-"for the sewage uisE*sal systa►i;- 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 the system to operate was
caused by the willful or negligent act of the occupant.of the building utilizing
the system. A
Dated this _day of 19 9-Z Signature . &tt�
(Corporation Name (if Corp.)
61/ ` i" 9"A r-
rev. 9/85
mk
Title
Corporation Name (if Corp.)
Gam• p��R��� �°C
ss
l�5yi
._. , . ....�. ... .. _,......_ ... .. .. ... -. ' .. .- .. ... .. ... .. : .. .. ,,. . .,e«;' { `fin °W t�
DEPARTMENT OF HEALTH
��. Division of Environmental Health Services
TWO COUNTY CENTER.- CARMEL, N.Y. 10512 (914) 225 -3641
RUCT" A WATER WELL
APPLICATION TO- CONST, Q
PCHD PERMIT .# 15/04"
WELL LOCATION
Street Address
Town Village City Tax Grid Numb e
WELL OWNER
Name
Mailing Address
rivate
O Public
USE OF.-WELL
1 - primary..
2 - secondary
A42SIDENTIAL
0 BUSINESS
0 INDUSTRIAL.
O PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
C3INSTITUTIONAL O STAND -BY
O ABANDONED
0 OTHER (specify,
O
AMOUNT OF USE
YIELD SOUGHT_J�gpm /# PF . SERVED /EST. OF DAILY USAGE Op gal
REASON FOR
DRILLING
>WW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST OBSERVATION
O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
G o
WELL TYPE
MRILLED
13DRIVEN
E]DUG
GRAVEL'
Q
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL.IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: w 40r Wt L
%T 0-1-1. 451P P /_ uu. e0_99- G f(ol. Gii iC9, _Lot No.
WATER WELL CONTRACTOR: Name /Qj�-j¢L Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: .YES. NO
NAME OF PUBLIC WATER SUPPLY: A�l TOWN /VIL /CITY
,._..
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
Q ON REAR-OF THIS APPLICATION ET 'k,
d--
(date) (s gnature)
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 perm' .
3. Submit a Well Completion Report on a form pr 'd d the Put am County
Health'i_Diep 'rtment
Date of Issue:
L. rmit Issuing Official
Date of Expiration: 1 `%' 19 - --
Permit.is Non - Transferrable :. mite copy: H. D. File
Yellow copy: Building Inspector
Pink Copy: Owner
2/87 i Orange copy: Well Driller
DEPARTMENT OF HEALTH
Division`of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (91-4)-'225-'3641
- -•-- -.. -- ,- APPLhGATION -TO-, CONSTRUCT- A - WATEP. -- WELL--
PCHD PERMIT 0)02)0_r51/
WELL LOCATION
'. Street Address Town Village City ax Grid Number
WELL OWNER
ame - Mailing Add 'r ss
/ w
e i -
VPTiVitte,
' ❑Public
USE OF WELL'..',.
1 - primary.
2 - secondary
PRESIDENTIAL CI PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP
O BUSINESS ❑.FARM ❑ TEST /OBSERVATION
0. •INDUSTRIAL [] INSTITUTIONAL 0 ST� D -BY
C3 ABANDONED
❑ OTHER ;(specify
13
AMOUNT OF USE
YIELD .'SOUGHT_ gp'lit PEOPLE SERVED oe; /EST. OF DAILY USAGE to OO gal
REASON FOR
DRILLING
/21-NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ❑TEST OBSERVATION
❑REPLACE: EXISTI G SUPPLY OD9EPEN EXISTING WELL
"DETAILED
REASON FOR
DRILLING
!�✓
,mil✓ 0'k.S -�
WELL TYPE
RILLED
DRIVEN
aDUG
[36RAVEL
OTHER
IS WELL SITE SUBJECT TO FLOODING? iYES '�PC NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME.OF SUBDIVISION:. 2J d
!a39 C / G o/ 9 SfL0'
.,WATER. -WELL .CONTRACTOR: Name Address: ...l�,�E�✓J'7 _
IS PUBLIC'WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY:
TOWN /VIL /CITY
IiIST4NCF .Tn. PtPFR'►'Y FROM NFAREST .._WATER_..rIAIN.;..._.... ..' .. __...._..._.._.. _ .. _... .... _._...__.___ - -- ... .
LOCATION SKETCH & SOURCES OF CONTAMINATION
ON REAR OF THIS APPLICATION
5;P
a
PROVIDED
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.
2.
3.
Pump the well until the water is clear.
Disinfect the well in accordance with the requirements of
County Health Department attached!to this permit.
Submit a Well Completion Report on a form provided by the
Health, Department.
el�rmit issuing �fflcia���
Date of Issue: 19�
Date of Expiration: 19_1"
Permit is Non - Transferrable
2/87
the Putnam
Putnam County
White copy: H.D. File
Yellow copy: Building Inspector
Pink Copy: Owner
Orange copy: Well Driller
d4 %
1W
in
on
BED RM I
I
ro: PD or jiP &ILS
�TTERSON, N11 W Yc
S
l;Ti .REAS, a public hearing on application. number. 881 vial,
held. by the Board. of Appeals on July :1.1,1975 for a vari_-).r.ce for
Nelson i3ec }t to construct a di-rel7.inp on four lots m.imbered C398-
6399 -6400 -6401 Hilton F`l.ace and Tyrone Road., Putnam Lake, N.Y.
i0 �srREAS, at ca.id. hearing the aplAica.nt appe fired. in
support of said.. - Lpplication. ar.)d thc- .Do,.Lrd of ltppcals. in riakingr a
decision in no w:ay intends to legalize- -said. roads as Town roads
fir_, thr: To;-Im -of P,tt:t0r.3on or to impose rany responsibility upon the.
Town of for. any maintenance whatsoever of said roads,
T'rI12-1EFORE, BE IT liIsSOLVISD, that, the variance is hereby
C7 anted, including other. conilitions :a s statod on the applic:a:t i.on
not referring- to said roads, a.nd upon.ac ce- 1ptance of the followink
conditions:
1. That the'app7.icant recognizes the fact that th>'
access roads to his Property are not town, county or state roads,
recognizes the fact that the: Town of Patterson ha.s�no responsibil
ity -for the maintenance, improvement or plowing of . sa.id roads,
recognizes thy; fact that the Town of Patterson has no intention ,
of accepting said. roads ins town roads and waives any plain that
he ma have against t s
_ - . -... - _ ... Y __ -- K_ he Town-_ of rztterson for any red _on what.soct
based on the .gTanting: of this variance o
20 Thrt of the two -roads mentioned,. at the opt &on of
the: applicant, one be selected as the acoess' roiad- to the premise:
and t' hl s selected',.rnad.be, zw Artained and of su(%h cier_sity. es. -to.-
).11.ow ingress and eegr.ess of fire. trucks, am.ulances, police,
utill -ty trucks, doctors-and other emergency vehicles nt all titres.
P �'
3. That the Town of. -Patte:rsoh shall riot -bi:'h&1d` 1ta.b1
for any accidents by reason of the user of said private roast by t:}-
public at large or the applicant, members of his family, his gut.;
invitees or licensees,
Dated: September go 1975
ACCEPTED: '
Nelson Beck
Eryfest Holze Sr, Ch:x' - P-rnan
1 .1
•'••' . . . . . . . . . N • b
Eal RI=
/emu APO INSP. BY:
(Name of Owner) (Street Location) 6011
Da=. SITE INSPECTION NO -Y MMIMa m
ATS!,
Wetlands on/or proximate to property..............'
e,
Property lines or corners found ..................... C/ A-1.01 I
Can estimate house location .......................
Will driveway need gut...... o* .......
Must- trees be removed - note these. ..........
Deep holes represeuntative of. entire. SDS area......
Additional deep holes needed..... ......... o .......
Sufficient SDS 'area available considering driveway.
cut, house location,, separation distances,etc., .
'Adjacent w6lls/septics ..............................
D.H. 1. Lot
Depth to G.W.
Depth to rock.
0 ft.
e.
.3 ft.
6 ft.
9 ft.
r ft:
D..H.,(r2- )Lot,.
Depth to G.W..
Depth to. -rock
0 ft.
6 ft.
9 ft.
Soi-I-DescriDtion
D.H. - Deep Hol
G.W.-GroundwatE
D. H ,-� Lot
DeptH-to G.W.
Depth to rock-
0 ft.
ft.'
6 ft.
9 ft.
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
camMENM
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.,fran watercourse ....................
Natural soil not stripped or SDS area
unnecessarly graded .......... ..................
10 ft. maintained from property line and
20 ft. fran house ......................
Distance well to SSDS (ft.)....... ........
NLmber of bedrooms checks ....................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. from nearest trench ................
15 ft. of.peripheral soil horizontally
from trench ......... o ...........................
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.. il ...
FINAL GRADNG OF SITE ACCEPTABLE... ; ..............
0 Ie
&
(',: .rrp_ cf Cvra--)
RUA= CF BE—PlUTHT DrIISICN QF DUMCNAMMU EO'=H.
L IN-AT—r SUPP-r-a & 5Zv7k_r-- • DIEPCEAL SYSTEmS
R_F;T_,E,-! S= CONISM= lCN PEFMIT
CATE,
BY -
S r- - t Lcc
I Yom- ,
NO D =7 MS 5
7 :2
Cccrzanata Rle-salutz"Ca
/7
Plans Thrae sa=- s/._
reservci_-,
,varl-En-ce
GM_ 1 AL
"CIE-:zkad
SSiZES
Dat_- Ca OCS Plans & Pe=-it Si-ma
CLq
Per
c.Z
k
an P-lar
Vc zz-z
&
r
Sectic Ttmk _Z
Well LI-71E Iff cver
Ees --*, cn Dat-_ : perc andr- desc 'ratul t-c
Twia-7-ccl: CcntcurS Exi_c��`ag & P. _CC,
_Dr.:.'l.Taqav & Slopes Cat
(d'I'Sc=ace CK)
,Pc-rz: & De_g tales
Recraser-ta-ti've CF pr-.-, ana
Size
If Pit & D Bcx Shcwn &
Hcusse - No. cf
Wells & SSOS's w/-i--,. 200 cf: Pro ccEed S�YStE
prccer�tv Metas &
Ecusse Setimck, Necassary Mic.ht lct)
E.cusa Eeier - 1/4"/-4=T--. 4"0; 'ZTe ci.-,e
No Ba,_5z; Max. Eenc:ss 45' W/cleancut
SEPARA-TIC-N DIETTLN =- S-Z-ZfT7= CV PAN
Fields
101 to P.L., Drlive.ja%r, TIzsEs,Tc-_ of Z
20' to F cn allis
c:uid---L-'i- W
1001 to Well; 2001 in D.L.O.D, 150, Pi ==
1001 t_0 S, a-:,
inc-
131 to
351tc =-tch
10' to Vat Lin Q7,its-20,
Z-=:-: �C Z
-
_I
Encineers ;_L-E-icrifzatZ.C,,l
�J acle - Lca,
C2r_;__ ``^ C t Perc Res.Il t_= (3)
Depth
reservci_-,
,varl-En-ce
GM_ 1 AL
"CIE-:zkad
SSiZES
Dat_- Ca OCS Plans & Pe=-it Si-ma
CLq
Per
c.Z
k
an P-lar
Vc zz-z
&
r
Sectic Ttmk _Z
Well LI-71E Iff cver
Ees --*, cn Dat-_ : perc andr- desc 'ratul t-c
Twia-7-ccl: CcntcurS Exi_c��`ag & P. _CC,
_Dr.:.'l.Taqav & Slopes Cat
(d'I'Sc=ace CK)
,Pc-rz: & De_g tales
Recraser-ta-ti've CF pr-.-, ana
Size
If Pit & D Bcx Shcwn &
Hcusse - No. cf
Wells & SSOS's w/-i--,. 200 cf: Pro ccEed S�YStE
prccer�tv Metas &
Ecusse Setimck, Necassary Mic.ht lct)
E.cusa Eeier - 1/4"/-4=T--. 4"0; 'ZTe ci.-,e
No Ba,_5z; Max. Eenc:ss 45' W/cleancut
SEPARA-TIC-N DIETTLN =- S-Z-ZfT7= CV PAN
Fields
101 to P.L., Drlive.ja%r, TIzsEs,Tc-_ of Z
20' to F cn allis
c:uid---L-'i- W
1001 to Well; 2001 in D.L.O.D, 150, Pi ==
1001 t_0 S, a-:,
inc-
131 to
351tc =-tch
10' to Vat Lin Q7,its-20,
Z-=:-: �C Z
-
_I
Pui• m COUNTY. DEPARnOW . OF, HEALTH
DIVISI0N-.-,OF ENVIRCNMERML;FIFALTH SEWICES...
DESIGN-DATA SHEET-SUBS SEWAGE DISPOSAL- SYSTEM_ FT19 NO.
-Owner 2a4klo _A�ieo^llif Ad&es s 7 _Ae
-Located at'(Street) 71X 6A✓ Sec. f,9 Block 02 Lot S�Kar
(inclicate.,nearest cross street) P, 19.
f
,7
municipaiity Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO, BE SUBMITTED WITH APPLICATIONS
.Date of Pre-Soaking Z.2Zj�__41-acr Date of Percolation Test dr
HOLE
PERCOLATION PERCOLATION
Run
Elapse
Depth Water'Frcm
Water Level
No."
Time
Gr6dto dd Strface
In Inches Soil Rate
Startr$to p
Min.
Start stop
Drop In Min/In Drop
-Inches Inches
Inches,
2
3
43
13,0k� al
4
pot' i,64 7
2
-of
• z .
NOTES: . j. Wp", to be p e repeated at sage depth until ap
, p * r admately equal MD rates
are ob t a ined at each peroolationtest, -h. 1 '
All data to' be suhdtt�d
review.
2. Depth weasurements...to be made fran top Of hole.
rev. 9/85
TEST PIT DAT&'REQUIRED TO BE. 7SUBMITTED WITH APPLICATION
DESCRIPTION OF Sons -ENCOUNTERED IN TEST HOLES
49
5
69
71
91
101
121
13'
141
LEVEL Ai WMCH GROON -DWATER IS'-Mmuqu
INDICATE-I.EVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY sue// �� DATE
DESIGN
Soil Rate Used Min/l." Drop: S•D• Usable Area Provided. 000
Septic Tank Capacity 4 0 00 'qa1s, 'T
No. . of ::Bedrooms Sept Type 61d.•
Absorption Area Provided By
Other
AL
Name
Address
THIS SPACE FOR USE BY
Soil Rate Approved
L•F• x 24" width trench,
mwv��r:flr�Ar=
2r/.esignature
SEAL.
I DEPARMENT,ONLY o
sq.ft/gal• Checked by Date
Re.
- - DIVISIOTv OF -EN 'RCNMENTAL- - HEALTH SERVIC'ES.7 _... - _ _ .. .._ . _ .......... .� _ _..._..
Date-
Property of
Located at' Noe-
(T) f f�Q„foti/ Section Block Lot 1�7
Subdivision of h1i9P OF �dT Lf}JfL�
Subdv. '.Lot # Filed Map Date t! D .11
14 I-AA
6'13 9, Gym 6319 6398,
Gentlemen:
This letter is to authorize I ���✓ 7 �� �� /Q,
a duly licensed professional engineer ✓ or registered architect
(Indicate
,,to apply for a.Construction Permit for separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulation's as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
_...co--mectior .with..this- ma•t -tc -r and-- to—super-vise. -the. construc.ti-on- o.f..«air', -- -• - - --
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yo s,
Signed
ountersigned: Owner of P21operty
P.E. , R.A. ,
Address
dG j i
Address
Telephon�
Telephone
'Rom IMN FOUND --� / m -�
Y •�N \
_ N 1728'00"
lave'
pT \ �^ .Ins
S 820 1 ' O
1 \ W000 �0�(v G it
06
Y �
j• b pb � ! I / 0 �O °4 b / % �, i moa Pws set
/ b p^ L 0.217-+ ` ACRES 5,.
/ �T/ O.B43 f ACRES z2
, S '81'41 'D�
� A `
9 6.80•
�`j,
47�
o. ' a�L ���a / SU�VkY OF PROPERTY
�. �6y, r , �^ ?? 9p0 b� PREPARED FOR
O
1 p
� 5 , ' JOIN P. - CVIT -KO VIC JR. -.
BT" OT
AND
LINDA CVITKO;VIC
1 / ;Oy>o �— �✓ * �pF ®ir7� LOT (/'S 6454, 6454, 6465, 6468, AND 6407 (0.217 :1 AC.)
0'�' ' - FOUND LOT 'S
IRpI P 64,79. 6440, 6401, 5400, 6399.'AND 6:198 (0.24} ;} AC.)
- IN � "Q � / (' L / ..
• \� % , J �' 4v4` �l L SITUATE IN THE I
WN OF RATTERSON
{` TNAM CO UNTY, INT. Y.
:'FER TO MAP ENTITLED "EIGHTH MAP OF PUTNAM LAKE � � ' Ir.� T
.ED IN THE PUTIJAM COUNTY CLERKS OFFICE ON MAR. SCALE. .I — 13O
7, 19J7 AS MAP # 149G.
GCe(, SSQ
.7H THE CA7 5 HEREON SIGNIFY THAT TH/$ SUR' +EY WAS PREPARED
PTE I!! ACCORDANCE �(O4 THIS IS TO CERTIFY THAT THE SURVEY ON WHICH
TI1 TH£ EX/571NG CODE OF PRACTICE FOR LAND SURtEYS ADOPTED BY THE NEW YORK •. REVISED: �,6 {r.' {°jL THIS MAP IS BASED WAS COMPLETED 8 -10 -97
ATE ASSOCIARON OF PROFESSIONAL LAND SURWYOPS. SAID CERTIFICATIONS SHALL I 1J WSED: AND TMAT THIS MAP WAS COMPLETED 8— Iii -92.
IN OA•LY TO THE PERSON FOR WHOM THE SURVEY IS PREPAREO, AND OJI HIS BEIIALF','D
IE TITLE COMPANY, GO•+ERNMENTAL AGENCY AND LENDING INSD;UDOJI LISTED HEREON, �` — J _ /P. ;7_'91Z IT IS HEREBY CERTIFIED THAT THIS SURVF -% WAS
ID TO THE'A$SICNEES OF THE LENDING INSTITUTION. CFRTIFICA77ON.S ARE I/OT 0 -�,� �Y,C P/�O� T /��C17 PREPARED BY ME, AND IN ACCORDANCE WITH THE
'ANSFERABLE TO ADDITIONAL INS^TUDONS OR TO SUBSEQUENT OWNERS.'y/�j Ga7Ci`efe.__, CERTIFIED TO: EXISTINQ. COD£ OF PRACTICE FOR LAND SURVE' ✓S
ADOPTED BY £ -NEW YORK ST ASSOC7A TION
JAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICEN5ED LAND 1. JOHN P. CV77KOWC ,A2. Ar OF P- FE I AL LAND S V R
JRWYOR•S SEAT. IS A VIOLATION/ OF SECTION .290. SUB-- DItIS10N 2• OF �E' NEV � LINDA CVITKOVIC
IRK STATE EDUCATION LAW. 2. 7171E SERV, INC.
40CRGRCJND EASEMENTS, STRUCTURES ANDIUR ENCROACHME,'IT$ IF ANY, .vOT SHOWN HEREON. S MORTGAGE ACCESS CORP. __. _'_
YLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED '+NTH AN OWCIJIAL OF THE ,. FOWLER BC DICKINSO
WD SURVEYOR'S INKED SEAL OR WS EMBOSSED SEAL SHALL BF CONSIDERED TO BE ENGINEERS / PLANNERS / SURVEYORS
IUD TRUE COPIES - -
DOVER PLAINS, N.Y.
/0-1 /.SURVEY
a
6�
rn
a
m
N
D
W
6452
g/ O O 685`3 \ '@ 2 it
6473 t'\� `�� 9o. 03o O OQ,So` onr
r/e
k'est rh q
'i 6.q,5.9 / /5. g >' /5.2g0 5p OO
O
6472
m
647./ O
O AREA =0. 2166tacres
N 0�
O
6470 6469 6468 ` 6467 6466 6465 6464 j P D
z o
S � %
° w0jr FO V
e O ° O
Q Q
y
V pipe found O 6 South &
S65 - 54 -OOW
z= 81 01' 1 0,9_ East,
SLATER ROAD
(
unimproved)
— P
NOTE:
Premises sruw, he,eo,, he,op. SURVEY PREPARED FOR
Lots 6454, 6464, 6465,6466 8646.' I
as per " EIGHTH MAP OF PUTNAM LAKE
MAR / O BAR ONE
solo moG, (ilea March 20, 1931 as Map ap
N°. 149 - G.
S TUATE IN
TOWN OF PAT TERSON
COUNTY OF. PUTNAM STATE OF NEW YORK
SCALE 1 " = 20 ` DECEMBER 5 ,1988
JA MES ' K. DEVINE
LAND SUR VE YOR
493 ROUTE 22
PAWLING, NEW YORK
12564
.en nri n '
piiemoe� AL m MIM on PBX"=
A "W ORM NO MIA VWIATM OF
ecT, 7ei00rne MewranterAm
- - ar"=eu+rerMMMOTw.# Mo
TM wm 6UPMO" eMG0NW eea
emu MOT ee W Wt061® TO M YAM
Tm cm.
rasa AMr. MOT
i
I-V -- - -- Ile
r - {
opy
.43
s 08 Is -oa C,E
�A
So.
t
Do' I
- -NE
Tf. _ �r n�►4
YF?c z
.• � o t .... t n.. � x 4� 43 � p �, �-xs> y „.z k .n`Ey=" f. X .. s. i
1 _ f/� t' � 'r`. � L � `tea O- •,
i � 1 't � 0 � _�•- � � 0 Gfi`L. .� Y... j'� r �,i-.. �•2 �c �,��y.UP� ` ��
00 � /" j�f✓;� i
t_ ..- _: � - .:, -.• .,::� .tom. ,,y. _ � _ - {
oo
1. � t r4 i h- f .::�•
r
-.. .._sir.:. -> - -- -- _.. VEl �- ...•
i
. r.
J'
gO. ' I'
:i