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Home My WebLink About1445DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -2 -33 BOX 13 ININ, t j Ir IN ,'V i--1 ., r r ' �� IN 0 1445 r- .- n- .- :-- .-- ,- , -,.r:n _tea:.- ----: --.71 -r -;r-y- a.-- r- -•F- S"-- F - - - - -- -°- »- o-c— ?�•} r°-- y,-T-r"�^;�-- ' ^-x«R-'. PUTNAM COUNTY DEPARTMENT OF HEALTH Dlvbdoo' EKV honmentaLHealtb'Servloer,C�emel � .. � Mast Peovlde P !i 1 If P:C H D Peimk M CAM OF CONSTRUCTION COMPLIANCE. FOR;SEWAGE-DISPOSAL SYSTEM�'1 ++-S6� Loma �! U Y) V, Tti= Map Aj lock Lot OWOW/ c Foimerly Subdi e l r S vG e Mulling, Fee:''Enclosed Amounf d " Date Permit.Issued.' —50 Sepgrete Seweoge Syerean ballt by 'ic., SSet'hS , �-1 - Addsees� 5�: f . - Com iosi ft of 2A b Gallon Septle Tamk and Water Supply:. PabllaSapply From Address on �^ Private Supply Dr l`a by , �' Address �li'IS�R f'`+�`i�' Lot Size y:e,��o, Has Erosio PS Number of Bedrooms / Hue .,Garbage .Gdmdei been Inetdied? Other Requlremente I certify that the systems) as listed „sewing. the above premises were constructed essentially as shown on the plans of the completed work-( copies of which are, attached)., "and in.accordance with the standards, iules :and re` ions; in acecrd ' with the filed plan, and the permit issued by the Putnam Co 'ty Department Of Health Oats �° Cert(f by P.E. ” RA Address hO "4 i/, .. j i �� License NO. Any person occupying premises served by.the above systernls) shall- promptly.taki such.aation as niay be nec"!y to smre the.emraetion of•any untenitary conditbns: resulting, from such .0 available and this approval of the ivate water l;'My separate a wei. (hall became null and void as soon as a putil,c. Nnttary,Nwer beoofnN ng saps . 'ApprOwl_,of the pr 1 become nu and vo wMn s P _bl ` water supply becomes evailable.. Suck approvals are subl ct to icatkin or Mange when,: Ii theyuagin rit of 00 C of Wealth' iwaoation. modification or change is'necesiary. Oats BY TT. P"` ry 3/89 "n x l CTO� %. �n1.TT1T r�mT A1�T TTTIATT 5/ ay WGLL liVPltLL' 11VLV i\L:rrVl�l Office Use Only -� DEPARTMENT OF HEALTH µ Division-Of Environmental Health Services W O PUITNAM COUNTY DEPARTMENT OF HEALTH STREET ADDRESS: 00 f TAX GRID NUMBER: WELL LOCATION Windsor Oaks Fair St. , Carmel NY Lot #31 WELL OWNER NAME: ADDRESS: ❑ P8IVATE Windsor Oaks Assoc.83 S.Bedford.Rd.,Mt.Kisco,NY ❑ PUBLIC USE OF WELL Zc RESIDENTIAL O PUBLIC SUPPLY O AIR /CONO. /HEAT PUMP ❑ ABANDONED 1 - primary O BUSINESS ❑ FARM ❑ TEST /OBSERVATION O OTHER (specify) 2- secondary O INDUSTRIAL O INSTITUTIONAL O STAND -BY 1 O MOUNT OF USE YIELD SOUGH,f gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR .[:]REPLACE EXISTING SUPPLY ®TEST /OBSERVATION [:]ADDITIONAL SUPPLY DRILLING 13NEW SUPPLY (NEW DWELLING) ® DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 405 ft. 1 STATIC WATER LEVEL 25/9Qt. DATE MEASURED .8/30/90 DRILLING ROTARY GhCOMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING Aa OPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH 41— ft. MATERIALS: OSTEEL O PLASTIC ❑ OTHER CASING LENGTH BELOW GRADE 40 ft. JOINTS: O WELDED ERHREADED ❑ OTHER DETAILS DIAMETER 6 in. SEAL: 13CEMENTGROUT OBENTONITE OOTHER WEIGHT PER FOOT 19 lb./ft. DRIVE SHOE�i YES ONO LINEA: ❑YES CHINO SCREEN HAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? _ _ ❑ YES ❑ NO - -D ETA] SECOND * HOURS GRAVEL PACK O YES GRAVEL DIAMETER TOP BOTTOM ❑ NO SIZI :: OF PACK in. DEPTH ft. DEPTH It. WELL YIELD TEST If det:liled pumping /ELL LOG )t more detailed formation descriptions or sieve analyses are available, please attach. METHOD: ❑ PUMPED 1 tests were done is in- � formation DEPTH FROM Water Well 9) COMPRESSED AIR , attached? SURFACE Bear. Oia- FORMATION DESCRIPTION poE ft. I ft. O BAILED ❑ OTHER ; O YES O NO ing in WELL DEPTH DURATION DRAWOOW4 YIELD Surface 22 1 riliing in overburden clay & bld s . It. hr. min. It, gpm. ock a 22' 405 6 385 5z 22 41 Irilling in rock, set .casing, grout d. :Lng in rock granite. K� WATER O CLEAR J�mp QUALITY ❑ CLOUDY 'HAR��S ❑ COLORED ANACXZE6?rd ❑ YES ONO STORAGE TANK: TYPE Wel lXtrol 203 CAPACITY 32 GAL. ANALYSIS ATTACHED? �O YF8 .'ONO PUMP INFORMATION TYPE G» hm e r s l b l A CAPACITY 9__ WELL DRILLER NAME P. F. Beal & Sons , c . D / 2/90 MAKER Gould DEPTH 36o, ADDRESS PO Box B SIG' r-- MODEL 5ES07412 VOLTAGE2.3 HP3 /4 Brewster,NY 10509 / { f 5/ ay APPENDIX I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 04411isaA 04(6.5 �i55f G Owner or Purchaser of Building Building Constructed By Location - Street Municipality Building Type I& /' /¢ 6ar 31 Section Block Lot- Tax Mao Number `L 50,1_50161,5 iFi,&-' Subdivision Name Subdivision Lot # GUARANTEE 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 assignsr to place in good operating condition any part of said constructed 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 utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental 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 will �1. or negligent act of the *ccupp of the build ing �}t-,1' zVg h Dated this d y of 19 V Signitur- -e--- 6- Title G eral Co' or wner - Signature Corporation Name if Corp. Corporation N' e (=Cork.) Address xc�, ; Aad s P 1J T N A: A 0 v , v If � 0 BREWSTER LABORATORIES Sox 2244 - BREWSTER, N.Y. (914) 279 -44945 SAMPLE NO. 7818 TEST WELL SOURCE: Windsor Oaks Lot #31 Carmel, N.Y. COLLECTED: 9-6-90 BY: P.F. Beal & Sons BACTERIOLOGICAL EXAMINATION Coliform Count, IMF Method This result indicates the source of the sample was of ;satisfactory sanitary quality when the sample was collected. • 0 per 100 ml. .f N /O' 30' 32" E ' 150.02 AREA = 41559 S.F 0.95 Ac N N IW n THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND WAS INSPECTED PRIOR. TO BEING COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK i STATE DEPARTMENT OF HEALTH. 1. ALL SURVEY INFORMATION TAKEN ATOM SURVEY PREFAB® NY NAW A WATSON. SURVEYING A ENGINEERING. P.C., COLD SPBIN3..N.Y. 2. 'AS-BWLT' MEASUREMENTS WERE TAKEN 9/6/90. DESIGN INFORMATION 3 BEDROOM HOUSE PERC RATE= 30 MIN. /INCH LATERAL LENGTH RBQUIRED= 500 LF LATERAL LENGTH PROVIDED= 552 LF R 055 STRUCTURE / POINT SEPTIC TANK X JUNCTION BOX C JUNCTION BOx D JUNCTION DOX E' JUNCTION BOX F . JUNCTION am G JUNCTION BOX H JUNCTION BOX 1 JUNCTION 80XJ JUNCTION BOX K POINT L POINT M POINT N POINT O POINT P POINT O POINT R POINT S POINT T CONTROL POINT 80' -11' 44' -2' 88'-6' 87'9- 88'-6' 41' -11' 28'-4' 47' -1' 26' -7' 61' -9' 23'-4' 57'-4' 63'-4' 77'-B' 103' -6' 77' -10' 98' -1' 72' -2' y 9 LATERALS R APPROXIMATELY 90-3- 79'-2' L M NO P o n s r 86'-0' . 60'- O "EACH 1250 GAL. 86' -10'- ✓UNCTION BOX (TYPJ SEP77C TANK e F H / ✓ K 3 P7-A- vK" Pr's° i� /0' 4• 1 N 1 3 B= FRAME DWELLING 45.94' O M � m � NEIL Ij$ 150.00 S 09' 38' 33" W H/GHV/EW DRIVE THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND WAS INSPECTED PRIOR. TO BEING COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK i STATE DEPARTMENT OF HEALTH. 1. ALL SURVEY INFORMATION TAKEN ATOM SURVEY PREFAB® NY NAW A WATSON. SURVEYING A ENGINEERING. P.C., COLD SPBIN3..N.Y. 2. 'AS-BWLT' MEASUREMENTS WERE TAKEN 9/6/90. DESIGN INFORMATION 3 BEDROOM HOUSE PERC RATE= 30 MIN. /INCH LATERAL LENGTH RBQUIRED= 500 LF LATERAL LENGTH PROVIDED= 552 LF R 055 STRUCTURE / POINT SEPTIC TANK X JUNCTION BOX C JUNCTION BOx D JUNCTION DOX E' JUNCTION BOX F . JUNCTION am G JUNCTION BOX H JUNCTION BOX 1 JUNCTION 80XJ JUNCTION BOX K POINT L POINT M POINT N POINT O POINT P POINT O POINT R POINT S POINT T CONTROL POINT Putram County Department of Health Division of Environmental Health Services Approved as noted for conformance with app aR and Regulations of the P Health De artmen �0� ..�� ignatu re 4 Title at FLED MAP # 2194, FILED 1212186 5 FAIR S7REET SUBDIVISION LOT 3/ TOWN OIL PA77FRSON NEW YORK �i MALVERN£, N Y. 11565 Y f5 /1J Err -sedb RIDGE N.Y. / /96l �aG r' - 30'/' X6939 -3/ DAII' SE717 1990 / OF / �,. 'AS- 81#1T" SSDS B WELL ` woo r i i 80' -11' 44' -2' 88'-6' 87'9- 88'-6' 41' -11' 28'-4' 47' -1' 26' -7' 61' -9' 23'-4' 57'-4' 63'-4' 77'-B' 103' -6' 77' -10' 98' -1' 72' -2' 77' -0' 90-3- 79'-2' 88' -11' 81'-4' 86'-0' . 83'-6' 82' -0' 86' -10'- Putram County Department of Health Division of Environmental Health Services Approved as noted for conformance with app aR and Regulations of the P Health De artmen �0� ..�� ignatu re 4 Title at FLED MAP # 2194, FILED 1212186 5 FAIR S7REET SUBDIVISION LOT 3/ TOWN OIL PA77FRSON NEW YORK �i MALVERN£, N Y. 11565 Y f5 /1J Err -sedb RIDGE N.Y. / /96l �aG r' - 30'/' X6939 -3/ DAII' SE717 1990 / OF / �,. 'AS- 81#1T" SSDS B WELL ` woo r i i Ww a t0iat�0 of stttssrw on is �ploasfo�pon •nY anac r�a;vro� wm w ma m ,t o< MlMith. Data, (J j(jS 9 • S APPROVED FOR CONSTRUCTION TfK apfrovil axPNas;tvve yaNf from tM As NraCa>!M for cause 6c may a' m�nd�0-_or mo0ifi�dIN ; qn ty ..OY nsluNas a no OMIn ApINOirad for' ditPOaal 0f doniastk afy fa an Rev. �. 10/88 Data w coal hir Y�epoor .� MNS oW`attiitns sY. thautlder.Ahat:uid builder Will j ;tM iviod efawo, (2).years bnnw0lably`folkiwin, tM;dati •ef tIN htsY- it syRww 4w any ►ayMs tM►ato; 2) tMt tha ArNNO "Weil Aouria0. above xwda W Kh tM : stanea►ds, IYMa ands ►M06M f—of � tM ,PY:1Nm PEI =Q GR M'>7)- oj'`lr r Ligntu No ns / `O�� issYW. YnNSS qn oft - Ouil I ' ' I iaf't►aan undtr►titkat and is 0. tominissionat of Health. Any ch4n0a or aKtration of comtructgn i o►ivate - want . sitoPb only. Title DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT JA WAFER "WELL PCHD PERMIT _/V WELL LOCATION yC_ Street Addre s f Town Village City Tax Grid Number Z1 ►�" S"�D'2e y��lU1Sjoi, ._ 1 - -- WELL OWNER Name a l ng Add�gss 83 5 � r '�'f /o� -fP" cep �a-�c M� E/_kc 41 luiy°jO • Private Public 'D%P % +�'�� g , USE OF WELL �)a RESIDENTIAL 0 PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED L primary 0 BUSINESS O FARM O TEST /OBSERVATION 0 OTHER (specify 2- secondary 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY _ o AMOUNT OF USE YIELrl SOUGHT 5 gpm /0 PEOPLE SERVED /EST. OF DAILY USAGE_gal O REPIJ,CE EXISTING SUPPLY 0 TEST/ OBSERVATION 12 ADDITIONAL SUPPLY REASON FOR DRILLING =NEW :;UPPLY NEW DWELLING ® DEEPEN EXISTING WELL DETAILED. 'IV�I REAS�N FOR P ! %S!v =, DR LLING� WELL TYPE DRILLED ® DRIVEN []DUG ® GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Fel it- _)+. I0 Sto�, r- Lot No. WATER WELL CONTRACTOR: Mane Address:43rei,.S4er &/x %� 1 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: M TOWN /VIL /CITY 'PI +-k'Sw, DISTANCR TO PROPERTY FROM'NEAREST WATER MAIN: IT LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET 412 - v (date)' (signatur PERMIT TO CONSTRUCT A WATER WELL This permit to coristruct 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 0a11: 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 pro a by the Putnam County Health D��pa tment. ` Date of Issue: 19 �� it ssui g is a Date of Expiration: 19 4 s/� Permit is Non - Transferra le White copy: H.D. File Yellow copy: Building Inspector Rev. 10/88 Pink Copy: Owner Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH Division.of Environmental Health Services APPENDIX L .AFFIDAVIT.— CORPORATE OWNER APPLICATION FOR. PERMIT APPLICATION SUBMITTED TO PUTNA.M COUNTY HEALTH DEPARTMENT . TO: Commissioner of Health In the matter of application for: up- 454+ee_; ' 540chu'Sl0&I l ndluldUcy ( S5D S IA-4 -der- 5u IX ..spy -- Lo+ AJo; I, P�L 4 f >��14e represent that I am an officer or employee of the corporation and am authorized to act for le 7D.2ue /o p�-�" co • O4 10 Name of Corporation) having offices at C� .7._. SOU�"LI_ _8- 2dTU►'U 11L. ILI 0 Ah/ l U 5 Whose officers �are: I `President: r` Q U ( �, Vice — President: SGN'lue Secretary: e(` 4�01•e Y: (Nam and Address Treasurer: ?C((4 ( 1 rC _0 (le Name 1.e 8 3 Sou-�� 3cd-�ard l�o4c,� Kisco &1-� 1 U ScI `7 Address) Address,) G,3 Soy-- .,.... fir. A -4-P.. 4sco ill 1osq lm and Address):. ": •: and that I am and Will be .individually responsible for any and all acts of the corporation With respect. to the approval requested and all subsequent acts*. relating thereto. Sc:ora to before me this ; l j day Signed: 9 eu-In of 19 Title: Or �SI(�e� . A16AL Notary Public _ MARIA HARDMAN Notary public, State of Mew York ¢ualified n West Westchester Cogn Commission Expires May 31, 49�� 8/84 Corporate Seal PUTNAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN...0 TA._S=.7S1, UFACE.SEWAGE DISPOSAL..SYSTIM e velopplef Cv Owner, f 4erSo• -1 1 r+c . Address 3 Located at (Street)/ 1vrew 15r f FCl r r SJ- . (in 'cate nearest cross street) rv�-y 1 Sec. 7(.O Block Lot % 4 Municipaiity -PA, h Cfi ) - Watershed Date of Pre- Soaking Date of Percolation Test HOLE NUABER CLOCR 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 Inches Inches Inches 1 2 I�CC� I°1' lD�'1 -eS -> YCS u II-S = -3 D 1'7 C 3 Gc�Jjprave�j S U�qd J U1 St o>1 ID T>re�J�rP aj 1. 5 1 � - 2 3 4 5 1 2 3 4 5 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. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCO TERED IN TEST HOLES .. ,. DEPTH - :HOLE Imo. HOLE .NO. - HOLE..NO. _ G.L. 1' 2' �2Q p 3' 51 6' 7' Y" �Y'vU ?� Si,I%G�I V 1 SIaYt '74!'1 7YP 81 I Co 012 11 ui s' C . 9' 10' CD c 11. w : s; INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL To WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms _ Sceptic Tank capacity )2,')'L) gals. Type Absorption Area Provided By 15j J L.F. x 24" width tren �P�� pF NcK' YQD Other 5 Name 546U01 _T Signat Address �j`Sa �� ?. S 1-��' �- SU/ SEAL '"yam do $� OJT► f og) �' `� 117? Fo • o59a • �,� AR�fiFS THIS SPACE FOR USIA BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PUTNAM COUN'T'Y DEPARTMERr OF HEALTH LoT DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA -SHER17 UF ACE - . - t ie Y D i o � Owner Address Located at (Street) Sec. Block J lot (indicate nearest 'cross street) � Municipa.Lity r (7) Watershed SOIL PERCOLATION TEST DATA REQMED TO BE SUBMITTED WITH APPLICATIONS Date of Pre-Soaking Date of Percolation Test ROLE NUCER CL= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. start stop Drop In Min/In Drop Inches Inches Inches 1 + 1/43 2 � 3 4 4— ,1- Od"inp) u e 10) _t i T-41 oA '�r rev. 9/85 2 3 4 C F11 5 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. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA RBQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS EN(OUNUERED IN TEST HOLES DEPTH HOLE NOS _ HOLE NO. ,... .-_ �..y 4 HOLE NO. G.L. 1° 2' 31 4' 61 l I %1 r r ct 7' g. P n�� 91 o 10' 11' 12' 13' 14' INDICATE LEVEL AT'NHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms _ _j rSeptic Tank Capacity /—"S L) gals. Type Absorption Area Provided By. =1 4 () L.F. x 24" width trench Other Name 1J 14Y9 Signatur l ,j SEL Address Y in i 2 � THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date