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Home My WebLink About1351DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.78 -1 -54 BOX 13 01351 - i LEI ' ' r I ` liu. 01351 ri pUTNAM CO6N 1[)EPARTMENT OF HEALTH ° Dlvlabn of PSsylroementil;He" Ssnvloea; Carmel; N Y 10512 �� , • Engbreer Mud Provk3e :� c.o O ' 'P C B.D.- Permk N / !( CATE,OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Towrh or VIBW Tat Mep2Blocir —Lot' Owner? t Name J J I J / - Fo . eily Sabdvlelon Name fan �6Gt Q /��70 subdv. Lot MaWo9 Addeeae � � .. .,. Fee 'Enclosed [ AmountQ�: DU Date,Permit Issued Sepieate Se veeaQe System b* by A `! ' . - '' L. � Cv�' Address /n�.1� Cons lsting of ... Septic Tank and-:;5 x%25 �:1 PC) 5 Water- SUPOYs Public Supply, Ftom Address M_ Private Supply Drmed by ` ^ r_ / Address {.GCS Building Zype/�Cin�/ _ Lot '.S zeo?3.� `f,.%�T as .Eros ' - ...... e" Number of Bedrooms Hae.Giibi& Grinder „gem InstalledY /v70 Other Regafremente 1 certify' that the systems) as listed serving the above. pi;emises were cons cted essentially as shown.: the plans of the c leted 4ork ( copies of which are attached), and in accordance with•the standards, rules and-re tione, in accordance with a plan, and. the permit issued by the Putnam county Departments of.9ealth. Data �Q-►"/ off. Corti by P.E. ^. .RA. Address LIpnM No. Any parson .occupying pnmisss swvad by the above systam(s) shall'prompty take such action as may ti- necessary to Moire the correction of any unMnita►y conditions rewiting_ from :,such usaga..,: Aporoyal,of tIN.'sepaiste'sewwa sy}tem sMll beconsa null erred Vold as soon as' s pubs,: swil tary fewer becomes aviilibla nand the approval of the.p lvate wste►'supply, 0011 beeomn: null, n0, void 4han a..publk water supply becomes avalleble.. Such - approvals we auulict .to modification or . changa whin. In the' Judsnint of the.COMMISQ000► of Health, such revocation, modNkatlon.or change Is necessary. Title 3/89 oats a w WELL LOCATION WELL' GUMPLE'11U1N Kt:rUK1 Office Use Only DEPARTMENT OF HEAL'T'H Division Of Environmental Healtfi Services'- PUTNAM COUNTY DEPARTMENT OF HEALTH STREET AOORESS: WNIVILLAGLICIly TAX GRID NUMBER: Dresden Road Patterson, NY WELL OWNER NAME: ADDRESS: .Donald. Mill B anch Rd., Patterson, NY PRIVATE O PUBLIC USE OF WELL 1 - primary 2 - secondary KXRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP 0 ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm.1NO. PEOPLE SERVED 2. — 4 / EST. OF DAILY USAGE gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY g3NEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 365 ft. STATIC WATER LEVEL 120 TftDATE MEASURED 7/10/92 DRILLING EQUIPMENT ❑ ROTARY )CR COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION D OTHER (specify): WELL TYPE 1 ❑ SCREENED XqkOPEN END CASING ❑ OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH 31 — ft. MATERIALS: ](STEEL ❑ PLASTIC ❑ OTHER LENGTH BELOW GRADE 30 ft. JOINTS: ❑ WELDED THREADED ❑ OTHER DIAMETER in. SEAL: CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT ___I q Ib. /it. I DRIVE SHOE: ❑ YES ❑ NO LIN ER: 0YES ❑ NO SCREEN DETAILS _•.... _.. .... .__ : DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft) DEVELOPED? FIRST ❑ YES ONO HOURS - ....... _ SECOND GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM OEM ft. WELL YIELD TEST If detailed pumping METHOD: ❑ PUMPED i tests were done is in- (COMPRESSED AIR , formation attached? ❑ BAILED ❑ OTHER ❑YES ❑ N0 1�l�LL LOG it more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- ing well Dia- neter FORMATION DESCRIPTION CODE 1t ft WELL DEPTH ft. DURATION hr. min. DRAWDOWN It. YIELD gpm. s� lace 5 Bravn soil 1 & Dose ge hard fractured ledge 2 300 2 -1/2 & black granite - 300 12 WATER )Q CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED ?XX YES ❑ NO STORAGE TANK: TYPE Diaphragm CAPACITY GAL. 6 PUMP INFORMATION -7 TYPE ._si� 7 �— CAPACITY __ MAKER 57011 I dS DEPTH 340—'- MODEL 7EHO7412 23n�(� VOLTAGE `BHP WELL DRILLER NAME MILL .DRILL 16/92 ADDRESS Putnan .Ave .. t Brewster, NY ,, 1 1, re V NO PUTNAM COUNTY DEPArffi'- = OF HEALM _... _......._.__._,_._..._...___ _ .'DIVISION OF ENVIROLNME1RM'- fiFALTH`SERVICES _. d C--'- Owner or Purchaser of Building Section Block Lot Building Constructed I,b)s�' e eN f!•�TT u- r1 Location - Street Subdivision Name Municipality Subdivision Lot # 1 Building Type GUARAR= OF SUBSURFACE SEWAGE 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 - ItCertificate -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 the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this Sp' #`day of 19 General Contractor (Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 mk Signature 14 Title ''NSiv'-k Corporation Name (if Corp.) ELLIS A. TARLTON LABORATORY DIVISION OF ELLIS A. TARLTON, ENGINEERS, INC. CHEMICAL 34 PLEASANT STREET DANBURY, CONN. 06813 -2328 WATER -WASTEWATER PHYSICAL METHODOLOGY BIOLOGICAL P.O. BOX 2328 203- 748 -7903 APHA - EPA - ASTM - . _ -- - -- R €•PORT--OF--BACT €- RIOLOGICAL AND CHEMICAL- EXA- MTiTATIO'N - O1:'WATER Coon NAME AND SOURCE OF SAMPLE Concentration ADDRESS OF Mill Drilling, Inc. PERSON TO RECEIVE Putnam Ave REPORT Brewster, NY 10509 tDATA Water Supply, Mill Patterson,NY DATE OF COLLECTION July 13, 1992 COLLECTED BY Mill Drilling Hydroganion COLOR TURBIDITY Coon ROSION INDEX DISSOLVED SOLIDS Concentration GELIER (PH) TR NAR NTU M p /L Alkalinity as CaCO3 Fluoride (F) Bicarbonate Nitrite Mg /l Mg/l. Mg /L Alkalinity as CaCO3 Chlorine Residual NITROGEN CONSTITUENTS Nitrate Mg /L Carbonate Mg /L .00 Mq /L AS NITROGEN (N) Total Hardness as CaCO3 Conductivity Ammonia Mg /L Mg /L Micromohos /cm M,g /L Iron as Fe Mg /L Mq /L Chlorides as CL Mg /L Manganese as Mn Mg /L Mg /L Detergent as M8AS Mq /L Sulfate as SO4 Mg /L Mg /L The arithmetic mean of all standard samples examined per month using the membrane Iiller technique shall not exeeed MEMBRANE FILTER TEST one colony per 100m1. Coliform colonies per standard sample shall not exceed 3 /SOml. 4 /100ml, 7/200m1, or /3 /SOOmI Cotilorm Colonies /100ML in: (a) Two consecutive samples: (b) More. than one standard sample when less than 20 are examined per month: or (c) 0 -_ .. ., -Mora -than five per cent of the samples when 20 or more are examined per month.' " AT THE TIME THE SAMPLE WAS SUBMITTED: 1. The results of the analysis of this sample were satisfactory and met requirements for a potable water. 2. The results of the analysis of this sample were satisfactory for a potable water but certain of the chemical or physical constituents were high. These are as follows: 3. This sample was not satisfactory sines It did not meet the bacterial requiromcn:s for potable water. The presence of organisms of the colltorm g.our• ;-a sample of potable wator is undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does indicate that such contamination might ..ve 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. M4. This sample was unsatisfactory as a potable water because certain chemical or physical constituents were above acceptable limits. These are as follows: COMMENTS The bacterial analysis showed no organisms of the coliform group at the time the sample was collected which indicated the water potable. Cam, _ Certified ........w- .,:. �D [➢ -�o.N �,. ,� Z n :r �_ Y 1 L ..% � y� � . fi' � Ul .p W N -' .O - ASS 6UILY DIMENSION - -CHART ' - N,.° A A , 3 3 21. 0 0 3 35..5' 2. 5 57. 5 5 0 0 . 3. 5 54. 0 0 7 75.0 4 5 5+. O O 7 78.O 5 5 5 3 O O. - -7 O 5 1 .. 5 5 > >3 2, 5 7 I I O O 51 . 5 b e,> 9 53. O 02 0 1O 1 05.0 111•p 1 02 `O I I co •0 :I .0 1 00.0 1 1 7. O 1 3 99.0 I I •O. 14 91:.v j1 8. 0. 11 G7 )5:0 7 '�, b !QillAll[ CODtft't DWATtiloBi'fr OF MAUR r ttwrt+la.lhslt \` �; Dlelbltso til�m�les~ntal O�aYr ainleaa. Cans d. ILr.1250 all 00 2SWATE OF Comm N. esner It WWAM Drat. gram KA-SFw TM Patterson Dr Now sl>il�etlif■ its.. Putnam Lake fS�_ tat t. 35 ��t D 65 I .3 t.. 35 itnrw•1= 1, �diM O Oatar /A�l1 Mr. & Mrs. Donald Mill June .8;.'1989 Dab of Piovlwe Apgebval East Branch Road Two Patterson 12563 Maiaa pate Subdivision Aonroved Fee Enclosed [3 . emn„nt* lti rs: T*6 Ranch tit Ana 23, 934.6 s. f . FE sedbis omy llltia>r at MiaNaa 3 Daly Flow G P D 600 GPD PCED NdEnden r agamboml WYast 1s Y complubd oaarat j 900 n... s� � 333 LF x 24" tile f ield s 80111110111110 awl To bi'eantiloelai.i� Mayes w/itar SWIM t>tiie b tna Address on X Pdvmb 2a DOW ryMill Welldritle;j&„r =70-1= l am wholly_ and Completely responsible for dasAn and location. of the proposed sydem(ps 1) that the oat• Swwae dispoW system will..11e Constructed as shown on the approved anlendnlent there to and in accordance with tee standerdf6 rules ono rpu . Comity .Dpertment of `NMRh. air that an completion . thereof a "Cartifirate of Construction Coinpliaitoa" Ytidaetory to tee ComnmlYloner. of ""Ithwill N siibmmmllted to. tale Oliertwment. and a written' guarantee -win be furnished the owner. his wmea"Y s. hears or SOAPS by the builder. that old ballast win �a. M glad :ape /atblg Orl"I". any Wt of aid. sawep dial $Vstwn durbA tee period Of two (2) yews Immediately fallowUq thodato of the Now aside of Mlle approwl 'of tlia-. Celt -Nkab of CoMtruction Co 1pliance of the original .system or my repairs therstoi 2) that the drUW well dawned 86000 will be located as dWWR MAIM apprOi M pion and that Yla well will be Installed. In o sta"ards. rules and rquia oiT ns of the Putnam Comely Opeftmem. of ►1Yltli. t , Data June 18, 1991 s+a ` pb�. X R.A. 367 Violet Ave, ; PouQh ensie, N.Y. 12601 ie•me No 041290 APPROVED FOR COMTRUCTIOW, The 80*0981 oup" S from the data ism" union Construction of the building has been undertaken and is nnocable for a. fmmay M anwPiw a narMMd whoa neiesY►y ��2 t mniniOner or Mee1th. Any Change or altwa of eematnmetbn pippubaa a per It.. Approved fir dispo a of seeraga., ater supply only• n Rev: By Title �Tanm. s��•.`, e r r•.�A rya ra PUTNAM COUNTY bEPARTMENT OF HEALTH F k CY 1 ; , Divlsloti of Envlrunmental.Health Servioea Carmel N Y:10512. Engineer ) oPnrmitCERTIFI ATE OF COMP Permit q q CONSTRUCTION P k, SEWAGE.DISPOSAL SYSTEM _ P 6 `H1 tiAN Dresden ad _ Tovn er �ivaee Sgbdit+telon Name Putriam ;Lake Sdtid. Lot q 35 Ta= Map 6+5 clock Lot 3 3 5 Ownoi(AppucagiName `.: Mr. & Mrs, Donald Mill. Renewal Revieio . oae �l ,Date of Provl Approval" MaWcg Address East Branch Road Town Patterson ztp 1256`3 $fig Typo Ranch Lot Area' A h' c ; f FIll Section Only Depth Rohtme �� QR Number of Beflraome 3 Design Flow G P D_,__ 600 .GPD PCHD Notl[icatlon 1s;Regalred yVben Fill ie completed 900 Separate Sewerage system to couelet of Gallon Septic Tanis an8 333 LF X 24" t lie f I el'.d S To bo constructed by Mayes' f Address Water Sappy Pabue}Sapply From N A ddreee , or 1 1 I i l ,tea e , Other RSail" mente I represent th5t:1 am wholly and completely responsible for -the design and location of the proposed systein(s) 1) that the separate sewage disposal system.. above' described wi11 bkconstructed as shown on thetapproveC amendment there; to and in accordance with tie staridartls rules "an _regu_a ions o.. e. u nam County''DepSrtment ,of Health :antl that,_on compleGOn theieof a sCertdwate -. of Constr,ucbon Compliance sat�sfactory;to the Commissioner of Health will be.suDmdted;;to the, ;Department and a .wrvttan guarantee will be furnished the owner, his`wccessors lielis or assigns, by the builder; that said bwltler_ "will i'puce •m gooq.,oporating condd�on any,; part of said sewage tlisposel_ systo,m;dunng ,tTe periotl of two (2) years immediately following thadate of the -isw- ance of the rapprova( of the Certificate "•;of Construction Gomplian'ce;.Of. Ahe::ori9inaCSyitem or any repairs thereto; 2) thatt.I rilled, well descnDed''atiOVa wJfbe located as shown,_On the approved plan and ttiat� said- well;w County bepartmeint of. Health Date May 1'2 198:.7 s. 367' Violet" •A AdGre APPROVED FOR .ONSTRUCTIDW _ revocable foe "cause C or may be amen. ie4liires a new permit. " Apbroved'.;I Rev:G! h P; �� A% 1 /8l Date' Ill sy rdance with the stariderds .Pules and, regu vions - of `.the. "Putnam R.A. pse ;NY 12601;:, LIcense No041290 hied unless:construetlon.'of'the building has: been undertaken and is - 'COmRMSfioner of ".health. Any.change or, alteiation of, construction private water supply only.. Title _.; _- y�-_.,,,- a.- , -�,r,. .,rv-a^,,..,.,„.. y,..,v,...,,; ?a°-.r. ^.-�•- ,,, --_>^,z•� •�-... �....-. . r -.. PUTNAM COUNTY DEPARTMENT OF HEALTH A:N ! Engineer to Provide Permit N Division of Environmentail Healtti Services Carmel, N.Y 1051? T[FI on CERTIFICATE CATE OF COMPLIANCE ERMIT FO R.SEWAGE DISPOSAL SYSTEM Permit p.6: 8i Patrson resden Road Town or vulage Putnam Lake 35 '65 Sabdivislon Name Snbd. Lot N Taz MaP Block Lot _ .. 1'. Owner %Appliewt Valme Mr. &Mrs Donald" Mill .Renewal= �� Revision 0 Date of Previous Approval jL1nE 3 " 1987 MaWog Adttreee :East Branch Road To�,,o.-Patter-son �p . 1256,3 Ranch 23, 934'.6._ S f : Aff'Section On! De tb. ' Valtmte . Bulldlag TYP, Let Area . Y p .. Ngmlier of Bed Fl rooms 3 Design ow G P D 600 'GPD G• ' PCHD,Noti9catlon is Required Wbeti FIR Is completed 900 - " 333 LF;x 24 ". the fields Separate Sewerage System to oodslst of Gallon Septic Tank and To be constructed by es Address Water SuPPb ' Public: Supply =From Address or: X'. Private Snppl ybrWed by Mill Welldrill'exa Other Requirements'• 1 represent` trial I "am.whblly and Completely responsible for thedeslgn and location of,the proposed systems) 1)'_the the •separata sewage di'sposiliyste`m above described will be constructed"as.shown on 'the approved amenAment there ,to ;and in.accordance with the standerds,iules an regulations o, ; e.: , u nam County Department of ' Health,. and. that- dncompletion thereof a 'Certificate of _ConstructionCompliance satisfactoryto.theCOmmasionerof , tiealthwill be submitted- to the Department, and a written guarantee' "will be' "furnished the owner his successors, heirs or assign's by the•buiider, that "said' builder place in good "operating - .condition any ;:part of said sewage disposal system duringL, -, per,ioG•of two .(2) yearilmmediately followi4ihedate.of.the issu- ance of the_ approval of the Certificate of Constructiori •Compliance of ihe'origI - system or any repairs thereto; 2) that the .drilled well described above ,.will be iocateC.as'shkwn on the approved plan and of said well will be installed '�n accordance' "with the sf�nCrrds,'rules and regu a ions of the 'Putnam County Department of Health, - Date May 18, "1989 " 'Signed P.E. % R.A. 367' Violet Ave.', ou eepsi.e123�1 License No 041290" .. , Address - _ 1 APPROVED FOR CONSTRUCTION. This approval expires, two yeais;fromthe' date issued unless construction of the, building has "been undertaken and is revocable for cause or maybe amended or modified when considered necessary .by the • Commissioner of Health. Any change or alteration of:con ;truction requires s, w Dormit. prov /gd for/- /d'iQsposa_b of dbmeriic sand�ysewage;�a nd o r ,'gra05te 'Water wpply .only ��'/"' ' Rev. -�� ,! ��' Title �` 1/87 Date - BYE'," IE 83 �l'""."' ; ?�^m.-R.. .,: —r- -r .,;sv.�' ;- -•F"Y- z --xy.. ` °'5^�-t.a' °_4 •� _ �ry p Renewal L PUTNAM COUNTY DEPARTMENT OF, HEALTH .Pew r _' it q eJ'� Dfvrsfon of jEnwronmeniaf Health Services Carmel N Y40512-, CONSTRUCTION :PERMIT 'F.OR SEYVAGE DISPOSAL SYSTEM Patterson � - Town or Mage Dresden Road 65 Block 3 mot= '35 Located at _ -" Tax Map Subdivision, PUt11am' Lake ' Subd Lot X Renewal [� Revision ❑ ' Mr =& Mrs: Donald Mill: Owner /Address - Date Of Prev ous Approve - l 5 16`,83 i Building Type' Ranch Lot Area• 23,934 6 Sg ft W Fill:Seotion`Only {/ 3 600 = :gal /may P C ^H D Notification Re9uired NumberOf Bedrooms Design Flow G /P /D' - - separate'sewe►age system to consist of `900.L Gal Septic Tank - antl X 24" Tile 'Fields j11 Mayes.: Adders >. To be ,constructed by water Supply Public .supply' From M111 Well Drillers s X Private Supply _to be - dulled by Address;. Other, Requirements 1.rep►esent that I am wholly and ;completely~responsiblefor thedes�gn -and location Of the proposed, system(s), 1) that. the, separate- sewage,tlisposal system above descrtbed'will be constructed as shown on the approved ,amendment there - to and :ih accordance with the standards, rules an ;regu_a ions o • e < ,u_ npm County.- 'Department of Mealth and that on completion;Ehereof a Cbrtif,cata: of Coristructior. Compliance'. satisfactory to th'e'Commissioner of;Heaithwill lie -submitted,_to the Department;'and a written,guarsntee will Ge•;furnislied` the owner hissueeessors; heirsor,assigr&by . the ' builder 'that said :builder will place in good operating .coridition� any part_ cif Bind• sewage disposal system, during the periotl of two.(2).'yeais immediately following thedatis of the issu= aInce, ot'the' approval :of "the.Certificate o1, Construct�od „Compliance of the,,o(iginaisystem or any'repays,theieto 2),thatthe'drilled well described above „ .. wbe,locate,d as;shown on the'approved; plan and that said wall will be, installed'. �n accordance ,with the!standartls rules and regu a�ioni of- the Putnam County Departnient of Health-"”- ; , C N �/l May, 11 19 84-.. ! p E; X R A " � : Si netl Adtlress 12 Fair Street, Carmel, New rk; 10512 'License'NO 48983 - , j APPRONEO FOR CONSTRUCTION; Thi3`approvaf expires one year from the date..is ued unless .construction .of the`building has been:untle►taken and. is revocable for cause or may be ame Wed or'modifled when co iderea necessary by ,t e' ommi'ssioner 'of Heaith. Any change' or alteration of construct "ion V. requires a -new-. permit ' . Approved f r disposal of _domesY d y s ag and or Date ; . By Title �• Rev. 9 -81 r' W P -0 _ M".' w PUTNA Division of.._Environmental Health erwces Carmel V, FOR t RUCTION, PERMIT 0 R -SEWAGESYSTEM , , W7 z_XMP ner x t o;;ii Lot C'Located, at --V i �4i Tax -Map, �Block OirAJA subdivision X7 b dress -Type Lot', Area Ad �u IgIP9 'Cw -6f Bedrooms - �7 vn N 6r, Design Total Habitable Spacq Square Feet f Separate Sewerage System '- 0 consist of j7-- a Op Tank nd 7 constructed, 2'1 T. . be istructed,by 'L, e Addr ess —.7 Water 'Supply' Public Supply From wirag Private . S u Op I y to_ be 'd r� i I led- by ------------- -Address- Men tt repr ni ila Other 't m a T_RUC Og WrA F 1 1 ANpg�� "l—AMEEMMORMERE� In f `License: No es onst ru ct ion of, the l.bu i Id ing -,hai s"bijeri _Ljj rn of lth.� -, �- e!pt io-i n-- only. f3 Renewaal PUTNAM COUNTY DEPARTMENT OF HEALTH IV/S/ on of Environmental Health Services Carmel N. Y",10512 f / C - CONtfRUCTI'ON PERMIT .'FOR SEWAGE - DISPOSAL, SYSTEM "r Pdtt2rSOn s Town or V�Ilage Dresden• Road - - 8 65: 3 Located at Patnam Lake: '. ,, log Subdivision - Tax`Map k Lot 35 ..Owner Mr & 'Mrs D0na1 d.. Mi 11' yob Address , Ranch Bullding: Type Lot Area o N46mber of Bedrooms 3 Design `Flow '600 ga110n$�ddY Totaf Habitable Space Square Feet 900 " 33X..F.x2411:, 116 Fields Separate .Sewerage. System to consist of Gal; Septw.Tank and T6-be constructed by Owner Address Water. tu'piplyv, Public Supply- From' r X Private Supply #o be drilled by l` Dr1 T1 ers S. : Address.. - Other Requirements 1, represent that I am wholly and compietely;,iesponsible foi the desighand location of -the :proposed system(s);' 1) .that the separate "sewage disposal system above described will be constructed as shown -on the- approved amendment thereto and in accordance,.w th'the standards, rules -an .regu a.ions o e ..Putnam .. . Cgunty.Departmenf of Health and that on completion thereof a "Certificate, of Construction Compliance" satisfactory.to :the Comrtiissio�erof.Hea'lth'will be submitted' to the Department, and a„ wiitten, guarantee will be; furnished the ,owner -his - .successors,, heirs or assigns by the Builder, that said , builderwiil -i plat`s, in'good' operating condition any part of 'said 'sewage disposal system during the pe iod of two (2I years.immediately. following thedate of the issu ante of the approval -of the Certificate df-Consiiucti6n Compliance of - "the original system or y.Yepairs theret6;,2)'that' -the drilled 'well describe ,above will be located as shoriin on the a pproved plan and that said well will be install n ccor ce'w h th`e. standards,'rules and °regulatwns of 'th .Putnam County Department ooff Health. ®: Date Signed Route 52 Carmel,, :New or 10512: PE RA Atldress - License N0. 4 APPROVED FORCONSTRUCTION Thls,a revo €'f, ,. pproval.expires ;one year from the date. issued :unless construction, of, the - building has, been unde'rt :ken and is table or cause or may be amended ormodified when considered necessary by _the Commissio Ifh. `Any "change or ration of construction requires a new pe'rmrt` Approved: for disposal of domestic y- wage, tl/o rivat ply, only. - Date r y By e Title m { 1 °PUTNAM COUNTY• ®EPARTMENT - OF "HMALT x , Fermity P 6' =81 a Division of; Environmental' Hlth Services t^arir►el K. Y ,10612 3 `_ CONSTRUCTION PERMIT FOR,'SEWAGE.tDI' PO.SAL ,SYSTEM ; < `Patterson Town or loge r Located at Dr2sClen Road, Tax Me 65 =Block 3 cot 35 Putnam Lake ., - E SubtliVffion Renewal Revision Q Mr &Mrs DonaYd , 11 - subs Loc a Owner /Address - - -- -- - •• : �' DaEe.of Previous Appro4al 4 26 82 Ranch ; 23 , =934 6 sg. ft e Fill ,Section 'Only ❑F Building Type Lot Area' r 3 600' ga� /y P C. H. D Nofification^Required- Number if Bedrooms Design Elow c /F /n 900. 333 h F x" 24" Tile Fields Separate.;Sewerage System• to consist of Gal Sepfic Tank and To be eonstructed by Mayes ' Address u. _1 Water SuPPIy PublK Supply From x Mill 'Well Drillers Private :Supply to be.. drilled by ' Address - Other Allquirements - `- I represent that l am wholly antl completely responsible for 2iie design :and location of the proposed system(i); 1) that She separate - sewage disposal stem .above`doseribed will be constructed''as shown on the approved'.amendment there.to•and'in accorCance with. the.standards, rules an regulations o e u nom v County •Departm'ent of ,Health, and that on completion .thereof a Certrficafe' of Construction. Compliance" satisfactory to tlie'COmrniss(oner of Health will be submitted to `'the Department','••and a;, written. guarantee, will De;furm, the owner his' uccessors; heirs or;asiWhs by the builder,'that safd'bufldec' will place in good '.operating conort on. any _part of :said sewage disposal system }during the period of tvJo (2) year$ immepiately followfip the date thoiW once oiwthe approval of ;the Certificate o(: Construction ; Complance of the original systen%or any;iepays thereto 2) that the - drilled Will described above -. will be Jocated as shown on the approved plan and that said well will be;installed'. +in accordance `with the standards rules'.and ►egu aTf onf the" Putnam County Department of Health Uate May `10.� 1983 Signed �. ' P E--'- R.A . Fair .•Street, •Carriel °Ne York .10512 4Y8983 Address • License'No. APPROVED FdWtONSTRUCTION This- .approvaFixplies: me'year.:from the` date Issued unless 'construction of the building has-been undertaken and'ii ., - :revocable or cause or may:�be - amended o► modiLeC when considered`nocessary; Dy the inner of Heal ft Any, _change -�o r;:alteratlon- of construction requires a new.permit 'Approved for disposal of "domesti ►y: sew -s rivate' ate' ". % e - r Date B Y . Title. E. .. Cr 7. PLJYNAM COUNTY DEPARTMENT OF HEALTH ENGINEER TO PROVIDE: PERMIT #. 'ON CERTIFICATE OF'GOMPLIANCE. Division of Environmental Health Services, Carmel, N. Y. 10512 'PERMIT P -6' -81 CONST CTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson Town or Jlage Locateu at.-* Dresden -Road. - i - -- - b Tax neap ^ 65 ' _. Block- ._3 _......_ �t - 3 5 . Subdivision Putnam Lake Subd .Y. Lot q . Renewal JEk Revision 0' Owner/Address--.Mr- Iv Mr. _ l�nna1[3 Mi11 Building Type- Ranch Lot Area 23,934.6 5.F. Number of Bedrooms 3 Design Flow G /P /D 600 gal /day Separate Sewerage System to consist of - qn0 Gal. Septic Tank To be constructed by Mayes Water Supply: Public Supply From Date Of Previous Approval - Mav 22 , 1985 Fill Section Only ❑ P.C. H. D. Notification Required and 333 L.F. X 24" .tile fields Address X Private Supply to be drilled by Mill Well Drillers Address CR Other Requirements a,rl I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the sepaate sewage d�spOSal system above described will be constructed as shown on the approved amendment there to and in accordance with the stanGa%ds, rules an regu a ions of e u dam County Department of Health, and that on completion thereof a "'Certificate of Construction Compliance" satisfactory to tnd regulatissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or, assigns_by.the,6uilder, that'said builder will Place in good operating condition any part of said sewage disposal system during the period of two (2) years irnmediately,:fol low Ing the date of the issu- ance of the approval of the Certificate ot. Construction Compliance of the original system or any repairs thereto 2) that the drilled well described above will be located as shown on the,approved plan and that said well will be'installed in accordance with the standards, 4rules`and regu aTiions of ,the Putnam County Department of Health. 4J Date May 19, 1986 Signed P.E. X R.A. Address 367 Violet .Ave. , Poughkeep , NY 12601 License No. 041 29n APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may, be amended or m. Odified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires:a new permit. Approved for disposal of domestic'sanitary sewage, and /or private water supply only. Date By Title _ Rev. 6/85 - -s PUTNAM COUNTY DEPARTMENT OF HEALTH DIVT-SI ON- OF ENVIRONMENTAL HEALTH SERVICES_ COUNTY OFFICE BUILDING,_CARMEL, N. Y. _ 10512 DESIGN 'DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE 190. C N, n' e r /VZ Address D��=,SZX�j ;e�410. T4 MAP _:S Block Lot Located at ) indicate nearest cros s street Municipality,..:::. -Watershed .:.SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION h1un No. Start-Stop Elapse Time Min. Depth to Water From Ground Surface Start Stop Inches Inches Water Leve-L in Inches Drop in Inches . .•.Soil Rate Min. /in drop ... 5 41. 3 /0 -/0- 2 5 /0 L11 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 submitted for review."* m .'..2) Depth measurements to be made from top of hole. .30 ... 5 2 L11 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 submitted for review."* m .'..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 HOLE NO. /:. HOLE NO. ...HALE. NO.=- -- G.L. 6" 1211 me .) � 0 9 's l�u + 1. ��P� + i ►� gnature . SEAL THIS SPACE`FOR -tSE"BY-'HEALTH DEPARTMENT ONLY: Soil- Rate,,*A roved -Sq: Ft /Cal. Checked by te AM COG DAVID D. BRUEN ,— �� JOHN SIMMONS. M.D. County Executive *_ Deputy Commissioner DEPARTMENT OF HEALTH Division Of Environmental Health Services June 9, 1986 Morris Associates Engineering Consultants 367 violet Avenue Poughkeepsie, New York 12601. Re: Proposed SSDS Permit Renewal Mill Dresden Road (P) TM 65 -3 -35 Dear Mr. Morris: . Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comnents are offered as.follows: 1) A.letter of Engineers authorization must be resubmitted with renewal. .Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Yours very truly, I Robert Morris Environmental Health Technician RM/jP TWO Cni 1NTY f FNTFR - rARAAFI KI v -tnr,1') r01n Al rte_ =E � 64 Npgp��. II I : i i I + ; i, i' � I, 'r2 U•Y`� // � _ � _ !'I II I I y- ,-�--•-I='�11 =�' •I'• •I:rr' A+ //� /,• •m.�'- -- I'�I ' .: I' ' 1, 51 I `��•�,`'•. `�`6 •� �}/ galls \; \•} -- '�__ -'�_ . 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