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Home My WebLink About1349DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.78 -1 -52 BOX 13 Vz X, r 01349 ,.., ,..- .K.- c�9;�`- near,, .=,w„ev..- „,,:,e r... .•.-rnr i t t,r _ t . �a t 3"£'• .”. "'_',,- "_'- ,` "�:•' 7, 7. T s p k. C0UPITY DEPARTMENT OF HEALTH Engkaeer O Provide t?etaslt q s Dtvtelon of Envlronmeai4 i elt6 Service® Carmel N Y:1051? CE ..; - o RTIFICATE F OMP r CONSTR ON PERMIT 06' .SEWAGE'MSPOSAL SYST M Permit 'q, Town P atter"son esden Road Putnaln,':Lake Town or v 11-a Located at — - J a Snbdivielon Name Putnam 'Lake Sabd Lot q Lot #1&'.#2,,' Ta: Map37240065' Block 3 `' Lot 1. & 2 Renewal Owner /Appll N ca at ame DONALD E. MILL Revlstlon p Date of °Provioae Approval AlaWng Address Box 304, East Branch Road Town Patterson, NY_ ZIp ` 1256'3'. , gatldjug Suck_ Built RanCli' Lot A 943: ACRES "' e Only Depth = Volttme Number oEaiedroome 3` Design Flow G .P D .600, PCHD NottBcatlon,le Regafred When`FW le completed Sepaiute 'so em System to cdnalst of 1000 Gallon Septic Teak and 412; L F: Of.:Feld To be to-be ermne dteid '. conetracted by' Address - Watii S403 ` Pabllc Sapply From Address o be 'determined iadreea or: X Private "Sapply "I)rllled by , , , ;, , Other Reooiiements 1 represent- that'1 am wholly and completely resDOns {ble for.'the design and location Of: _the proposeG systeni(s} ",4) that the. seDarate> sow age'.dispoial system above described will te:co istructed is shown on the approved amendment there o and in,$ccordance with;the standards rules an regu let ions of e ., .0 nam County "Department of; Health,- and tt;at'on completion thereof a Certificate •,of ConstrucLOn Compliance satisfactory`to fns Comm�ssioner..of Health will be submitted- to the' Department, and a` written guarantee .wJl De furnished the owner; his wccessors 'he {rs or assigni b'y the builder, that said bwlder Will ,place..,in' good'. operati ng condition any, part ofsa:id sewage; disposal system:.dur�ng ;tha r ance, of the :approval of. the •Certdwate, .of Construction Co'mpliark' the briginal system will;be locatetlas show, n on theapprove0 plan and that said well will beinst ed''n accord_ anc� County Department of H Dace' March 17,..1989 Signetl ` " Address 6. Albermi3c .,.Court ,Pawhn a'4 ew _ k APPROV,ED'FOR CONSTRUCTION: 'This approvai; expires two years from the•�•d t issu u revocable for cause or may be; amended or;moddied 6enconsidered necessatiy;:by the ,'tomrr 'requires as new pe(rmmit:'. Appro4etl for disposal of'domastic'sandary sewage and /or pri Rev. eY-- -- 1/87 Date � T, od`of two'(2)+years.{mmediately following thetlate of the.issu- or:any rapa�rs thereto; 2) that, the'tlrilled well described .above with I standards rules and regu a cans of : the Putnam •..'� P.E._ R.A. License No- .: • 61468 loji,construction.of the building has been undertaken and is ssioner, of +lealtW,--Any change, or alteration of construction •water 'supply -only. - PUTNAM CIXJNL'Y DEPARTMENT OF HEALTH DIVISION .OF ENVI1MRM4ML HEALTH' SERVICES LOT #1 DESIGN DATA SHEET- SUBSUFACE SEPgAGE DISPOSAL SYSTEM FILE NO. owner DONALD MILL Address Box 304, East Branch Road, Patterson, NY Located at (Street) Dresden Road Sec. Block .3 Lot 1 &'2 (indicate nearest cross street) Municipality Town of Patterson Watershed ------ WIL PERCOLATION TEST DATA REQUIRED TO BE SUBml= WITH APPLICATIONS Date of Pre- Soaking 3/12/89 Date of Percolation Test 3/13/89 HOLE N[1MBm CLOCK 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 LOT Inches Inches Inches 1 1 1 2 n 27 24 3 6.6 2 27 24 3 13.6 3 42 27 24 f ;� 3 14.0 4 5 2 l 40 27 24 3 13.3 _ _.. 2 - 41 13.6 .27 24 3 14.0 3 42 4 45 27 24 3. 15.0. 5 45 27 24 3_ .. 15.0 1 2 3 4 5 NOTES: 1. Tests to be repeated: at same depth until approximately mival soil rates are obtained .at each percolation test hole.. All data . to' be sufmi.tted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUMED TO BE SUBMITTED WITH APPLICATION LOT #1 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH. HOLE NO: 1 HOLE NO: 2: HALE N0. G.L. TOPSOIL TOPSOIL• 1' SANDY LOAM SANDY LOAM WITH TRACE SILT WITH -TRACE- SILT 2' 41. 5' 6' 7' 9 . ._� Of Q �c c • 12' Q 13' 14. - INDICATE LEVEL AT WHICH GROUNI7RAM IS ENCOUNTERED. NONE INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED n/a DEEP HOLE OBSERVATIONS MADE BY: Joseph Zarecki, P.E. DATE: 1/30/89 DESIGN ^Soil Rate Used 15 Min/1" Drop: S.D. Usable Area Provided 5,000 S.F. MIN. No. of . Bedrooms three Septic Tank Capacity 1000 gals. Type Lowboy- recast Concrete Absorption Area Provided By 375 L.F. x 24 width trench Other Name JOSEPH ZARECK I , P.E. Signature ! " Address 6 Albermac Court SEAL 6146 1 Pawling, New York' 12564 0 SS1_ . THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER; CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL Q PCHD PERMIT # / °!T- / WELL LOCATION S eet Add7____1 as Town/Village/city Tax Grid Number PS 4 C/ " 't L /,) e- WELL OWNER Name Mailin A djess 17 -C g. �/ OPrivate OPublic d�!5OF WELL primary 2- secondary RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O BUSINESS O FARM O TEST /OBSERVATION O INDUSTRIAL U INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT _gpm /# PEOPLE SERVED 3, 5-/EST. OF DAILY USAGE_ 0 REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13 ADDITIONAL SUPPLY §LNEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL e REASON FOR DRILLING DETAILED REASON FOR .•DRILLING WELL TYPE ODRI.LLED 13DRI VEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES XLNO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name) ` Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ C NO NAME OF PUBLIC WATER SUPPLY: /y!% TOWN /VIL /CITY DISTANCE' TO PROPERTY FROM-- NEAREST WATER MAIN: ..... ..._. -.. :.. LOCATION SKETCH SOURCES OF CONTAMINATION PROVIDED SEPARATE SHEET ( ate) (si ature) 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. 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 ze-' % �✓ �ermit suing fficia Date of Expiration: 1 9 _� Permit is Non - Transferrable white copy: H. D. File Yellow copy: Building Inspector Rev. 10/88 Pink Copy: Owner Orange copy: Well Driller 1. zlr_r:---Nfr,r7 R .T CF DI-VISICI Gf =.Ll --- N =TT Z-1 Ec ............. f--.Cc--4 eiS77. 1;10 f7-_ reS= rvcl.r, C _Flz ac cat.a ca CCE P_,_=n_S F F: :of I'le & D D sl'ze, CE4_.-Zail L IqCzt: S p=rZ: and d==Zl & FCct-*�-,-�S,'C-�----�-=-r,Ca---taR Ferc & uee:: ECies L-ccat-2 ZraVl S P =., Pit & D Scx S-lcWzl & Er-use - Tc. c' Sedr-cans & Ecun-E-s 7117 c, r 'I S_ ck Necass—a ;- (T Ecu-Se NC Bends; m=_-C. RE =- n = ° °v; c F_4=1 10' t.:) Err-;'vexicay, Ear— T_-SEErTcg OZ 201 to 1001 to 200' Ll D-L.-C-D, 7 3-r-lt2 =zz-H 10 1 to 'rQ;a E r L 1' 1 -- N=e (of C c_==cWit: Re*SO__.,_,t_*,_-.-1 Plans - Thre�_ sat-2 S/ ---------- C=S Dat_ S la ee- cta7�:_-, ac Lcc Fern Per:: ac clec-L-1 Z-1 Ec ............. f--.Cc--4 eiS77. 1;10 f7-_ reS= rvcl.r, C _Flz ac cat.a ca CCE P_,_=n_S F F: :of I'le & D D sl'ze, CE4_.-Zail L IqCzt: S p=rZ: and d==Zl & FCct-*�-,-�S,'C-�----�-=-r,Ca---taR Ferc & uee:: ECies L-ccat-2 ZraVl S P =., Pit & D Scx S-lcWzl & Er-use - Tc. c' Sedr-cans & Ecun-E-s 7117 c, r 'I S_ ck Necass—a ;- (T Ecu-Se NC Bends; m=_-C. RE =- n = ° °v; c F_4=1 10' t.:) Err-;'vexicay, Ear— T_-SEErTcg OZ 201 to 1001 to 200' Ll D-L.-C-D, 7 3-r-lt2 =zz-H 10 1 to 'rQ;a E r L 1' 1 -- P, z .77 7 7f 4 1 Rev-, 3 /Sti PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Ebvlronmental Health Services, Carmel"_Nxi 10512 / Engineeir_Must proAde P -18-89 q P.C.H D: Permit q ` 4999-TAX MAP #25.78-1 51 6 '25.78 =1 -52: CER A OF CONSTRUCT[ ON .COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM TOWN OF PATTERSON Town or V lllag e , . Located at OR ROAD. PUTNAM LAKE Tax Map * Block Lot Owner /applicant Name DONALD MILL.. Formerly SAME Subdivision Name PUT NAN LAKE Subdv. -Lot q1 & 2 Mailing Address BOX 304, E. BRANCH RD., PATTERSON NY Zip 12563 Date Permit leased RENEWED 6/10/91 Separate Sewerage System built by NEAL J. PERAG I NE Address EAST BRANCH -ROAD, PATTERSON, NY . 12563 Consisting of 1000 Gallon Septic Tank and 378 L. F. LATERALS Water Supply: Public Supply From Address or: Private Supply Ddfl d by M I LL DRILLING CO., INC. - Address Putnam Avenue; Brewster, NY 1.0509 Building Type ST 1 CK- BUILT_ Has Erosion Control -Been Completed? YES Number of Bedrooms THREE (3) Has Garbage Grinder Been IuetalledY Other Requirements I certify. that the system(s) as listed serving the above premises,were of which are attached), and in accordance with the standards, rule's'-an! Putnam County Department.Of Health. Date June 18, 1992 certified by as shown on the plans of the completed work ( copies nce with the filed plan, and the permit issued by the JOSEPH ZARECKI P.E. X R.A. 6 ALBERMAC COURT PAN- NG Address, ' .:i� 61468 2564' License No. Any person occupying premises served by the above system($) shall promptly takl} suchlactio as may be necessary to secure the correction. of any unsanitary conditions resulting from such usage. Approval of the _separste sewerage system shall become null and void as soon as a pub;;_ sanitary sewer becomes available and the approval of the private water supply shall become null and -void when .a public water supply becomes available. Such approvals are subject to ywdificatlon_o► change when, in the Judgment of the Commissioner of°Fiealth, such revocation. modification or change is necessary. Date„ / ��i �° By . —� Title p -� W .10 WALL Vvrlr1,z11vry nr,rvni DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET ADDRESS: WN/ l Y TAZ GRID NUMBER: Dresden Road Patterson, W -;Z 'f�r- - 7-e WELL OWNER NAME: ADDRESS: Donald & Ann Mill East Branch Rd,, Patterson, NY PRIVATE o PUBLIC USE 'OF WELL 1 - primary 2 - secondary >RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED 0 BUSINESS ❑ FARM O TEST/ OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ . MOUNT OF USE YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 2 t0 4 / EST. OF DAILY USAGE gal. REASON FOR DRILLING .[]REPLACE EXISTING SUPPLY ®TEST /OBSERVATION ❑ADDITIONAL SUPPLY Q1EW SUPPLY (NEV DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 900 ft. STATIC WATER LEVEL ft. DATE MEASURED 4/30/92 DRILLING EQUIPMENT ❑ ROTARY )(4 COMPRESSED AIR PERCUSSION O DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE O SCREENED ❑ OPEN END CASING 1 OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH 30 . ft. MATERIALS: MSTEEL 0 PLASTIC O OTHER LENGTH BELOW GRADE —2.9— ft. JOINTS: O WELDED X2THREADED ❑ OTHER DIAMETER --6—in. SEAL: XX CEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT _ — Ib. /ft. DRIVE SHOE )WES O NO LINER: OYES ❑ NO SCREEN -DETAILS. ._.. DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (1t) DEVELOPED? FIRST _._ - ...:....,........._...._ O - -YES- -ONO. HOURS SECOND GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK Tin00CPffH ft. BOTTOM DEPTH It. WELL YIELD TEST It detailed pumping METHOD: O PUMPED i tests were done is in- §WOMPRESSED AIR , formation attached? O BAILED O OTHER O YES O NO 'WELL LOG 11 more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE. Water Bear- ing well Oia- meter FORMATION DESCRIPTION CODE ft. tt WELL DEPTH It. DURATION hr. min. DRAWDOWN ft. YIELD gpm. Surface SO t 't sol.l 1 900 Me iLm to hard grey & IDIOCK grani o 300. 1 30 300 -1/2.1 500 2 - 500. 3/4 700.. 2. 151 600 1 .1 -1/2 900 6 - 500. 5 WATER )(X CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? )()(YES ONO ANALYSIS ATTACHED? )Q YES ONO STORAGE TANK: TYPE Diahram CAPACITY 42 GA.. PUMP INFORMATION TYPE submrsibie CAPACITY 5 MAKER ou s DEPTH S MODEL IS ) 0 VOLTAGE 230 HP I WELL ORILI.EANAME 0 ADDRESS Putna -A m LLI S� : Ca.: Brewster, NY - `' R ert a 11 , re 5 a/ 07 a PU`i'NAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIROiTrAL HEALTH SERVICES DONALD MILL firm L - New Tax Map #25.78 -1 -51 & 25.78 -1 -52 Owner or Purchas& of Building Section Block Lot A S I LL_ Building Constructed by DRESDEN ROAD PUTNAM LAKE Location - Street Subdivision Name TOWN OF PATTERSON 1 & 2 Municipality Subdivision Lot # C /4b t"C. (Stick- built) Building Type GUARANTEE OF SUBSURFACE SEMGE 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. k 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. Dated this day of �' 191-1- Signature Il bola A 1 9 �itle i1-- QSobi�Sof (Owner) - Signature Corporation Name (if.Corp.) Corporation Name (if Co .) ZA ; T A I�-60 0 21 A 6rAtncJ4 Address 6 �" Address rev. 9/85 mk s 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 DRESDEN ROAD Town/V1114guielty Tax Grid Number T. OF PATTER80N 37240065 -3- 1/37240065 -3 -2 WELL OWNER Name DONALD MILL BOX Mailing Address 304 ' EAST BRANCH RD. PATTERSON .NY 12563 MPrivate 'D Public USE OF WELL )- primary._. 2 - secondary (3 RESIDENTIAL El BUSINESS ® INDUSTRIAL ❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 FARM []TEST/ OBSERVATION C]INSTITUTIONAL O STAND -BY O ABANDONED p OTHER (specify AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 3 -.5 /EST. OF DAILY USAGE 600 gal REASON FOR DRILLING NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL ® TEST /OBSERVATION DETAILED REASON FOR DRILLING 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. 1 & 2 WATER WELL CONTRACTOR: Name MILL DRILLING, INC. Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES, X NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION. D 0 SEPARATE SHEET WITH SUBMITTAL OF 5/89 d e) (signature) 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. 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 provk d y the P tnam County Health Depart ent. Date of Issue: �v 19 Date of Expiration: A 19 %, ermit Issuing Official Permit is Non - Transfers le White copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner 2/87 , ___ __ _____ . _t ...__.,, .t`I N N N N �,l IL IL LL iL IL iL IL 1L IL .� 1 111 . li- Q�u4wu- I i Q I w Z ® Z — rd f g "Ai it Pee LL (b :l i & Zia