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HomeMy WebLinkAbout1505DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -3 -47 BOX 14 !.ti ti .1 .. - 'i ..9 , is 1.` �a - t ' .� k . Al 01505 c ' PUTNAM COUNTY DEPARTMENT OF HEALTH E' eer to Permit N Dlvtslon of aviroumental Health Services Carmel N Y..1051? i on CERTIFICATE OF COMPLLANCE A Permit CONST>t CTION PERMIT,.FOR.'SEWAGE DISPOSAL SYSTEM Located at 1-1. Towu �'ca to u S ®Qt Village . or : o - TaMp Subdvsn Name Bue Lot //^^ 11 lienewal= ❑ Revision p ` Owner /Applicant Name Oct ZCJvt .Coots1'•1`Ue -` �os� Date of Previous Approval 1VIaWng• Addrose " G L' Zip Town a - Eailding, Type -4t `t[ � ULCC Lot =: Area =l t�-� -r Fill Sctino aly e Yolame Dpth Number of Bedrooms Design FIow;G /P /D 06 PCHD Noti&ntioa :is- Required, hen Flll is completed . o- r .. r Separate Sewerage System'to conslsf.of.� .Gall on Septlo Tsnk an " To b8 constructed by ' I n Btu'fF r r: ►`thy. Address' :Water Sa 1 Pdb11c Sd l Flom PP J pp y Address B �t+ 1 @1`f+►r�A • .`,i ort �{ Private:SapPIY.DeWed by n ddrees A p Other R equirements 1 represent -that I am wholly and completely .responsible for the design and location of .the proposed systems) .1)'that the separate sewage - .disposal.- system above dascr,ibod. will.be constructed as'shown on thebjppioJedamendman$ there to :and in accordance with standards, rules and regu a iOns o - o' .0 nam .;County :Department of - Health; sand thaQon completion thereof a Certificate:;,of Construction Compliance" satisfactory to .the Commissioner of Healthwill be submitted to the ,be .and 5 .wntten- guaiantoe will be furnished ,the owner, his successors; heirs or assigns by the builder, that saiC. builder will . _ . -, _ 19 place in. good, operatmg:condetton any;part of,sgit7:sewage disposal;system.duriw the "period of.•two(2j years lrnmediately�; following thedate,of the: 'issu once. of the "`approval . of" -the Certificate of .Construction _COmphsnce ;gf the oiiginaC'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 �ahe� Bards,. rules and_ regu a or of the Putnam - CountY- 6iipartment of Health p �+ Date" Z l' �Sb Signed P.E'R A Add18i5 - Q" ieense No • _ , VIA .. - APPROVED FOR CONSTRUCTION Titis approval "'expires `one year rom th " date -issu unless .construction of_ the building hss been undertaken and I, revocable for -r;au a or,may ended oi.. modified when-co nsidere eces 'by- .the' mis ioner of`" salt y - 'Any change or "Iteration of construction. 'requiros ermrt d`for disposal of domestic sum r ge and/or iva a Date V `BY Title APPENDIX C g- FINAL SITE INSPECTION I f Date Ins cted OWN R LOCATION -S TH # OR SUBDIVISION LOT # �10 '71 IV. V. Vi. NC CCMMENTS, SEWAGE DISPOSAL AREA a. SDS area located as per approved plans b. Fill section - Date of placement 2:1 barrier. LGTH WIDTH AVG. DPTH -21 c. Natural soil not stripped., d.' Stone, brush, etc., greater than 151 fran SDS area. e. 100 ft. fran water course/wetlands. SEWAGE DISPOSAL SYSTEM a. Septic tank size - 1,000 1,250 b. Septic tank installed level c. 101 minimum fran foundation d. No 90' bends, cleanout within 10 ft. of 45* bend e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested 2. Protected below frost 3. Minimum 2 ft. original, soil between box and trenches f. JUNCTION BOX - properly set g. TRENCHES 1. Length required - X ,) 1n !� installed, 2. Distance to watercourse measured: ft. 3. Installed according to plan 4. Distance center to center 5. Slope of trench acceptable 1/16 1/32 !'/foot. 6. 10 feet from property line - 20 feet - foundations— < .7. Depth of trench < 30 inches fran surface 8. Rom allowed for expansion, 50% 9. Size of gravel 3/4 - 11" diameter 10. Depth of gravel in trench 12" minimum. < :capped h. PUMP OR'DOSE SYSTEMS 1. Size of pump chamber 2. Overflow tank 3. Alarm, visual/audio 4. Pump easily accessible manhole to 2rade 5. First box baffled 6. Cycle witnessed by Health Department Ile estimated flow per cycle HOUSE a. House located per approved plans.. b. Number of bedrooms WELL a. Well located as per approved plans b. Distance fran SDS area measured 0 ft. C. �sR5q 18" above grade. — 1001,141- 01- "r d. Surface drainage around well acre table. OVERALL WORKMASHIP a. Boxes properly grouted b. All pipes partially backfilled yn C. All pipes flush with inside of box d. Backfill material contains stones < 411 in diameter e. Curtain drain installed according to plan I/, r -v, f. Curtain drain outfall protected & dir.to exist.watercourse g. FootiE2 drains discharge away from SDS area h. Surface water UO-tection adequate i . Mi�roslon control 5r'ovided on slopes qneater than 15%. j ;PUTNAM COUNTY DEPARTMENT OF HEALTH DISTISION`:OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN- DATA `WEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Address Located, at :° (Street) Sec. Block (Indicate nearer cross street) • Municipality, _ Watersheds. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole e Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to`:SWater Water Level No. Time From Ground Surface 'in Inches Soil Rate Start -Stop - Min. Start Stop Drop-in Min. /in drop Inches Inches. ' Inches a scq Pre -4 2 ' lo:;is 30 2r) 15 ZL rb6 i 1 -3 � �� �{ 14 E 5 1- 1 Notes: 1) Tests to be repeated at same depth up.til approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. i 1 yea;''` �°' r. a7,} �': Ai, �. i�; ��''„ �R�' �: �', a:' t" 9' ��r�°" �'' �+ �,: �' �S�. Y��' ��', f+ �J�?? ��$: t��' �st Y?ni� 'sn�'''�'��✓_�^��a�1�`�„`w»�+ � �s+�r n -- s•1+I.x�,. .,rF :�x,.3:e? � �,.3w.x- ...,� . ..: x: �..... r. ..- �.s..�sti..,.��c�;.- :,�1....e ...�' _ __ o...: ,: ��:., �. PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE S3ng1GE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT (Name of Owner) (S COMMENTS I YES LF trepch provided Z- required?' 60 ft. max. J 4Nv" -P:--'/, A BY: Permit Application Corporate Resolution_ Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION L-6 Deep Hole Log Perc ! -)5' Consistent Perc Results (3) Fill "t_-- 30 ".Perc Hole cd Other Mouse Plans - Two sets If PWS - Letter /well appl< Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data �..J Two -Foot Contours Existing Proposed - Driveway & Slopes Cut "ng /Gutter Curtain Drains Per & Deep Holes Located epresentative of_Sewage_& Expansion Area Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessa House Sewer - 1 /4 " /ft. 4" � :�Pnout i w SEPARATION DISTANCE'S SPECIFI P Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Cartain,Stonm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' fran Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same Putnam County Department of Health Division of Environmental Sanitation. AFFIDAVIT - CORPORATE GWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health - In the matter of application for - - -- Burdick Glen _Lgts- 1.L,_ZandB-------- - - - - -- Ed Heelan_______ —_ ____ ___ represent that I am an officer or employee of the corporation and am authorized to act for Horizon Construction -- __-- _� —(naTe oh �co /rporation)----- -� - - -- having offices at Y'1�b %/_ -- _3 6 Whose eoofficer s are President i •��G��1' 17� _ =��1� _ /_• (Name a nA�d�dress) Vice - President d� C'S'T" _ _ �_/�i_ �'� ` _ — _ ' (Name and Address ) Secretary (Name and Address) Treasurer __ _____ i _ __ — — — — — — — . (Name_,.and. - Address_)- and that I am and will be individually responsible for any or a ac of the corporation with respect to the approval requested nd sequent acts relating thereto. Shorn to before me this b day Signed of 19 Title _ _ _ 11 1 Le I. GOLDSAND State of New York ,g792o ty. No 19 .U1 IQ T 6 u L 0 C.orporate Seal a a TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN `.LEST HOLES DEPTH HOLE NO. 7 -1 HOLE NO. A (:. L. 6" 12" 3.811 2411 3011 it 42t1 48" 5411 60" 66" 7211 7811 8411 �c,"t Loaw. ®. _ s. iVo C�.s� D k Rrooin s; ow Pont � tick L, r_ 1, W, r) 4 {?nr� HOLE NO._ 3 �G N i l_.C'�ra rye., Jc1^0� ini ry r VC) :T.NDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED . INDICATE _LEVEL TO WHICH WATER LEVEL RISES AFTER_ BEING. ENCOUNTERED MADE .BY- _.-­.- ___.:_._...._�.__- - -____ ------- - - - -- - -• �aa�� -f f-�- t��- .- . -_. - -- - - - - --- - - -- DESIGN Soil Rate Used ®Min/1 "Drop: S.D. Usable Area Provided S�c� No . of Bedrooms 4 - Septic Tank Caps city t Z 5C) Gals. Type PCC ..Absorption Area Pro— vied By of r RkM width trench. Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: SEAL Soil Rate Approved Sq. Ft /Cal. Checked by 0 6 ;io � y 717 7- V PUTI�IAM COUNTY DEPARTMENT OF HEALTH ° nR D x;3/86 Divlslon of Environmental Health Services, Carmel, N.Y. 10512 P Must ust rovide �� :' � �! t' ► C- IY� �/�M, -47i P.C.H:D. Permit N=-- =�• - -- V� CER . CATE O _ CONSTRUCTION: COMPLIANCE.FOR', SEWAGE.DISPOSAL.-SYSTEM - _ I Townoro e Located at Tea Map Z3 Block — :3, 3 Owner /applicant Name } iZ!zrxv 6ON6217 Formerly Subdivision Name — Subdv. Lot k - Malling Address . -d`�R 1(_=( zip It7s0!q Date Permit Issued } Separate Sewerage System built by Address Consisting of `' f I Z. 6-V Gallon Septic Tank and Zei t Vr 011r-- :Mk (;;3AJL-jE;�:( F ' 1 Water Supply. Building Type Number of Bedrooms Other Requirements I certify that the of which are attache Putnam County.Depart Date R ;Supply From Address Private - Supply Drilled by 'k a MILL_ D21LLEr2S Address E7 is L:_L Has Erosion Control Been Completed? Has Garbage Grinder Been Installed? ik . stem(:s) as listed serving the above premises'vere constructed essentially as shown on the plans of the completed work ( copies ), and in accordance with the standards, rules and regulations, in accordance with the filed Is nd the permit issued by the ant Of Health. AS 17Ar I P3 !7 l Certified t -3-741 Address �© +��X P,E.. -)(— R.A. License No.0! 1d 1 I Any person oeeup (ying premises served by the above' system($) shall promptly. take such action as may be neeasury to Secure the correction of any unsanitary conditions resultHig. from such usage. Approval of the- separate sewerage system shall . become null and void as soon as a pub(': sanitary Sever becomes available 'and'the (tapproval of the private waiter supply shall become null and void when a public water supply becomes available. Such approvals are subject to motlif�Icatlon or change when, in the judgment of. the Commissioner Health, such revocation, modification or change is necessary, Date - t • f COUNTY D FICC DUILDIuc • CARMEL° N This .Report is_ tb be'eompleted by well driller and subrr7ittcd to County+icplth Department togcTher with laboratory rcp �dlaaly:i; of water :ample indicating water t: of smi;faetory bacterial Qu5litV before eertifiote of construction compllince " i FICPORT If UST BE SUCtdITTED WITHIN 30 .DRYS OF WELL COMPLETION f!1% ItG.c tai :Y37tfaClr — iSsllch vrael IocoNon of well .rrM,Vt31Jncei. to a( lead /E[T ea P[E7 FOCMATION D:SCRI77ION rsro pormanenr Ofnimaras. 421 Silt ,*sand Qravel & boulders 42 260 Hard grey granite • .r , c 11 ySeld roe tread of oine °enf demons dw:no d.ilCnq, Let below L F[ti GAttons.f [R` MINUTE u(� f • � 250 20 . ° .. Cwe I( 64 gk� 0- -'V1 VIL 5 o 71 M'[ll tl�•��rttilJ i Df%TG OI' A(:(Ur%T IwCLL O. 6,4186 6/13/86 0 MILL DRILLING, INC CFWHLL HORTZ CQNRTR17CTTOR CO- Route 6 , &rewster, NY 1OC1,T10N (ho. A %gloat) (J own; (lel tirnW GFwILL Burdick woods Bullet Hole—Rd., Patterson 8 DOMESTIC D LSTAtL SHMENT• � tJ�xA ❑ TEST WELL PiDPDSLD vst of .. ° V! SUPPLY Y L� mousmA' CO►dDRIONING•, l�J ISoe Yl IntutH0 ROTARY COMPRESSED L}EJ MCL'SS1ON CA>SlE D OTHER � 1iQUtNl.[l(T'. AIR ..PERCUSSION 9SP -410. lt►.G1M (,eel; I L'uxElEYancnesl wcfurtl ►E1 tool i ( ® D WELDED ((U�I:I VL $010! '� ^� s tea' —a�HG :•� J� 'FXJTES E-NoI L1 L' V � u I THREADED TES Ylttb t:Al= h9uts D G.P-W. YILLD (G.J.U.) " TEST • PUMPED COMPtESSED Alit 6 20 20 1hATER NEASUC3 /&OM LAND SUtfACE- 11A71C(SFeulrleer/ OUEir:G 711LO JEST leer) / Deptif of Cornpieled well 1:EYE1 . 10 2t?0, o !n feat below loud svriou: 250 KALE l:r[G1ti O PEN 1U AC MIEN brimLS SIGI 5:4,: + O1AxE7Et (vncnea/ 1F GRAVEL D :on+eter of well inclvd�ng I GLAVEI SIZE Irncncs) ILOM l+•erl 10 It. I PACKM provel pock (reshet): I f!1% ItG.c tai :Y37tfaClr — iSsllch vrael IocoNon of well .rrM,Vt31Jncei. to a( lead /E[T ea P[E7 FOCMATION D:SCRI77ION rsro pormanenr Ofnimaras. 421 Silt ,*sand Qravel & boulders 42 260 Hard grey granite • .r , c 11 ySeld roe tread of oine °enf demons dw:no d.ilCnq, Let below L F[ti GAttons.f [R` MINUTE u(� f • � 250 20 . ° .. Cwe I( 64 gk� 0- -'V1 VIL 5 o 71 M'[ll tl�•��rttilJ i Df%TG OI' A(:(Ur%T IwCLL O. 6,4186 6/13/86 0 MILL DRILLING, INC _ BREWSTER LABORATORIES - Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6187 SOURCE: Horizon Construction Go. Lot 8 Bullet Hole Eck, Patterson, NY Udell COLLECTED: June 5 1986 , , BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. June 119 1986 0 per 100 ml. s PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchaser f Building Section Block Lot Locat' - Street Subdivision Name ,�- 0 Municipality Subdivision Lot # 0 , / . S 4� Building Type P 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 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. 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 b ing utilizing the system. 4. Address rev. 9/85 mk Signature Title Corporation Name (if Corp.) Adaress�a•� ^ PUTNAM COUNTY DEPARTMENT OF HEALTH - s K V. 3/86 Division of Environmental Hf*th Se N.Y. 1051? Engineer to Provide Permit III on CERTIpICATE_OF COMPLIANCE ;_ ONSTRUCTION PERMIT FOB,SEWAGE �DISPOSAL_SYSTEM. ' .Permit .„ {. y� Wr 5 aed.at �° 1' C y` ±L7 Town " di6 Vlllage Sabdlvfelon Nam e �� C J . -�� Snbd. Lot IY Ta: or Z M1 Map Blk Let - `` .Renewal p .. Revision ... ❑ Owner /Applicant Name �-� uz,1- N ` o N s-ry v C.T I o N ,++ ,,' A,, 11 Date of, Previous Approval MW H ang Address C/O e6 LYi�1 �EA L:ry " t�� !n rTown Zip BuRding Type jZes i paw G Lot Area 41: 115 E" I ; FW Section Only Depth V.olnme Number of fiedroome 4 .' Design Flow G /P /D 'R da PCHD Notification is Required When FN to completed Separate Sewerage. System to consist of o6t> Gallon Septic Tank and To be constructed byec D U� `n�TTE R 1 1 Address Water SaPplr Pabllc Supply From Address or:� Private SapPly,Drllled byl i✓�M�reas Other Requirements �!- N t7 l t�l._ 1 represent that 1 am wholly ands- completely- responiible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed shown on the. appfoved.amendment there to and in accordance with the standards, rules an regulations O e Putnam County Department of .Health, "'arid that on completion thereof a' "C,ertificate- "of' Construction. Compliance" _satisfactory to the Commissioner of Healthwill be submitted to .the Department, and a .written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition` any .pact of said: sewaga di sposal. system d6iing the period of two (2) years Immediately following thedate of the issu- ance of the approval 'of the'Certificate'of Construction Compliance of the original sy-tel or. y repairs theieto; 2) that the drilled well described above will be.located as shown on the approved plari` and that said well willbe in' led irn. accordance w' the standards, rules and reguls oo of the Putnam County D,,ettp rl1tment of Health. Date f1 �s 1 I SfC� Sign ° P.E. R.A. _ ' Address r _ ' •4° ` ' ` License No�5� l l APPROVED FO CONSTRUCTION: This approval expires one yearf om to date issued nless construction of the building has been undertaken and is revocable for ca se or ma .b ended or modified when considered c ssar by'.the Co issionerMp, ny change Or alteration of cons uction requires a e ed for disposal of domestic samtar. wa bndjor prix a ter ly o Date By Title TRANSMITTAL #- 1 _ T0: Putnam County Health Department Date: April 15. 1986 County Office Building Job # Two County Center Carmel, NY 10512 Attn: Mike Budzinski SubjectT Horizon Constructio — The following items are herewith transmitted: f--X/ Attached Separate Cover % / Delivered Item Copies Description 1 1 Construction Permit _- 2 1 Letter of Authorization 3 1 Design Data Sheet — Drawing — Septic System Design 4 4 2 House Plans For: X Approva l Lf Use Remarks: / / Review and Comment Record As requested L:::/ Other cc: File Si gned J.-Robeft Folchetti & Associates lTeph3orye # (914) 279 -3346 P. 0, Box 374 279 -3155 Brewster, NY 10509 -0297 PUTNAM COUNTY DEPARTMENT-OF HEALTH • DIVISION OF ENVIRONMENTAL HEALTH SERVICES Gentlemen: This letter is to authorize J. Robert Folchetti & Associates 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 provisions of Article 145 or, 147, Education Law, the Public - Health Law, and the Putnam County Sani- tart'. Code. Very truly yours, - Signe �s Countersigned- er of Property Cl H el n Realty & Development Corp. P.E., R.A., #_ 051011 Root Avenue Address P. O. Box 374 Brewster, NY 10509 Address Town Brewster, NY 10509 --t-914) 279 -3346 :Telephone (914) 278 -2111 Telephone yPUT -M-Af COUNTY DEPARTMENT OF HEALTH x f, Irpo t r i{ r pi!�24tii t� `�i .rr.N y •;: ��D , r SION OF ENUTR�iVMENTAL > HEALTH: `SERVICES. i ° N S CARMEL` :;'N; Y. 0512 i�r, M xCOiiNTY OFFICE BUILDINGS , ES(1T, �A'1,'A SHF>ET SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO S a ✓ r nGY a Y z ?. ,` �ktyy{•'z t4 r. - Isr. y• psr 4d .. �",c►cated Sty ?Street Sec: B:I.ock Lot Ara;�,rs��I ca a neare : cross.' street) '�ytvJS, lh ,t" �X •S,'! �. ✓a;Y, 4 ,r� f t �.. - °I ;`" F n> Mun'�cripall.ty Watershed PERGOLATION'`TEST DATA�1 REQUIRED TO BE SUBMITTED WITH APPLICATIONS `;;Number`s .. .`:CLOCK.'TTME : PERCOLATION PERCOLATION' ap3e p o Water: a er ' Level " k No`. / Time From ound Surface in Inches :Soih Rate Start Stop Miz: Start Stop Drop in Min. /in' drop Inches Inches Inches � '�!ryy.� J � - /✓ � ` �•'] / ri ,may {1��j.�4S� +yif'1 2 t.rs.nol► ti:��C�4o'd '' "°'�.• xNA ;TI': �dY farJi t I0 y{/`~/r;< 1 1 ,11- dY•Y;� �. dir' t ! J. i 3t t' t'FIr.��� ki5 i / : -•, d �'. } }r !� (""i .. _ _. ♦ T__] ad � -fir. � t,i ,:t�•.- .. c4 �,.�!�.� •!` _ u+'t ",•; i �. �y✓►+ �x 1 idf •%J ..7 Y � IIK�`�Y'� +�' �� �- . �.h� �. �; l! i i ' �o.� �yj +..K /d'~ ll�'� n d �?%,Y1 � M.....�.: � a';, %f;':rIY..F , ds -: n r ":. .. ..1`i1. nik` .Sf" „...��. `r•.: -. . '..,. �, .,�_ °��"'�,, . �. �,n 4 L` �'•+ rF`f•J Gtk1 "!p'�y }' / /y�{5P r^ �< I,(a9 16 w/1 .. ,�� �.ala , 0,4 lqvw C1 ,a t' yN 10j \�D L • -Notes: .1) Test`s to be repeated at same depth until app roximately equal soil rates are - obtained at each percolation test hole. A11'dat6 to a submitted 3A M0, _al. REQUITED i�-T'Oi BE. ZUBM19 IPIT, _2 R "VI .�Q.-nlu DESC M.P71 OF SOILS R lid OUNTEI A Ak 30' 4BIl' aw gym Mll_ Tun .wn*i� .n,.­. D WITH APPLICATION IREQ k IN TEST HOLES HOM "No. 71. all vg tA ti. VNA. 0 .4 �-s 7 y Putnam County Department of Health Division of Environmental Sanitation .... �_.. _ .....,�._ ...._.__... _ �,AF -FI• DAVIT. -=.. CORPORA .TE�.OWt�ER-- ARPEICAT'FON:: -" - -- - - -- FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT T0: Commissioner of Health - In the matter of application for ____Burdick Glen _LQts,9_,L,_Zand. a_ - - - - - - - - - - - I, __ Ed Heelan_ ____ __ ___ ___ ____ -__, represent that I am an officer or employee of the corporation and am authorized to act for _ _ _ _ Ho_ri_zo_n_Const_ruct_ion_ _ name o corporation) - having offices at _ whose officers are President __ Nj` � %2 . -' ame aid �KdUr_es__s)_3� Vice- President Name anO Address _ Secretary _ _ - - ! .d _Z� �(jL Name and Ad ( dress) Treasurer (Name and Address) - - and that I am and will be individually responsible for any or a ac of the corporation with respect to the approval requested nd s sequent acts relating thereto. CD Shorn to before me this b day Signed of 19 Title 111411/ f 7 NojWry Public RICHARD I. COL.DSAND Notary Public, State of New York No. 6573920 Qualified in Putnam Cty. No. Term Expires Mapch=S , 19 6c*i - 3 Corporate Seal DAVID D. BRUEN County Executive .... ....... .. �.. .. .........:. .. nn..s..: �...•:.f'�..;��i.:. �:. ...:..:...Ii :. t'%..f.�r..e.:«3l:>Y'.c..n. N:.tt! w..ea!r. .. ,. ....�Mli_ : v.r.a. r.-S rr. ,�. .. � .:. .8...._ _.aT .,..:v. .<..� .z .f .,t t DEPARTMENT OF HEALTH bivision Of Environmental Health Services April 24, 1986 J. Robert Folchetti, P.E. & Associates P.O. Box 297 Brewster, New York 10509 Re: Proposed SSDS's Burdick Glen (T) Patterson Dear Mr. Folchetti: JOHN SIMMONS, M.D. Deputy Commissioner Review of plans and other supporting materials received relative to the above - captioned projects have been completed with coiNents offered as follows: ots #7 5,1 1. A corporate resolution must be filed authorizing the applicant to act on behalf of the corporation. 2. Tw o sets 'of house plans are not provided ~' The number of bedrooms proposed does not appear on the plans A key to the deep hole /percolation hole designations is not provided. 5. Fill section must slope from top to toe 1:2. Horizontal distance between top and toe for a 4 foot fill section is 8 feet, five foot, 10 feet, etc. o't #8 1. The extent of the fill top to toe is not shown on the / plan drawing. /2. A 1250 gallon septic tank should be provided TWO COUNTY CENTER — CARMEL, N.Y. 10512 (914) 225 -3641 ._................._ .. �,..._..+....... ��. �..............,......,.,, �. N. �.... a.. �..._._... �,...,_. w.... w.. s+......... �. z.,... �. ea. as.+ Mwo.<.....: �cauvss. s�: ��. m2; x• xas�: ns�. xr�.: a: utirn±_ �r.: xrwes�ci« e: 3gact_ m?_ �r: Ex+ r.'. s-•;.: v= .�......�t. >.t1i.`._�..,.. -.... '. ,...... J. Robert Folchetti, P.E. & Associates April 24, 1986 3. See comments 1,4 and 5 above Upon receipt of submissions revised to reflect the above comments, these projects will be considered further for approval. JK:pt cc:JK File V4VlY /ItrQlY. YV4jrq, if Karel I, J"r.1, P. E. D rector, Environmental Health Services '1�f+ ,.J ' , u Putnam County Department of Health Division of Environmental Sanitation �- AFFIDAVIT - CORPORA.TE, OWNER .APPLICATZON..._. -.. FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health - In the matter of application for Burdick Glen =,Tj9 _1_, 5,_-L $--- ----- - ----- I, — _ Ed Heelan_______ ____ ______ _ — — , represent that I am an officer or employee of the corporation and am authorized to act for _ _ _ Horizon _Co_nst_ru_ct_io_n_ (n /am-e) o corporation) — having offices at — 1 Whose officers are President _ _ Qe Aft ^- J"• _ Name a d Addnr-ess) Vice- President Cs���T - Name and Address ( ) Secretary — _ �D lJ_ o ZZ� (Name and Address) Treasurer { (Name and Address) and that I am and will be individually responsible for any or a of the corporation with respect to the approval requested nd sequent acts relating thereto. Sworn to before me this ?",--day Signed _ of ^ff] HARD I. GOIDSAND Notary Public, State of New York No. 6573920 Qualified in Putnam Cty. too. Term Expires 19, 19 19 Corporate Seal PU'MM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIROMMAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET CONSTRUCTION P T -- ...., %�1cGi u V S BY:. (Name of Owner) (Street Location) COMMENTS YESAI NO DOCCS Permit Application S� u Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter fiance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over .,� 3'► Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains ' Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion .Area;ihown;gravity= flow,suff. size If Purnped Pit &'D Box 'Shown & Detailed House - No. of Bedrooms Wells &'SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls. 100' to Well; 200' in D.L.O.D, 150' pits 4 100' to Stream, Watercourse, Lake Unc. expan) 15' to Drains-- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same Q 2 SGIiFDUL.f OF Ifu 4 54.d 57-0 67,5 :53.5' /0 WALL A) 4 K raAclee7z, f1-4 (-ryp) rrRoNT YAkID Li 2 21- STORY R6saaE�vc E q io 1 \ ti/ ifo u5B CovKEcT /crV � NoT /NSf 2-CAR G�ARA61E- rar�K 3 YS, (-rYQ) SZ.S 48.0 53.5 44.0 59.Q, 46.0 P /A4RA pF %moo %vT I�EsrG %VA7 iaNS (HO Sr- A1.0 nv1 Apr i.. Dpl ' 'uta, N S r'T7G SYST9M Dos fc rJ'.- As tau i�7' FOR. GaT 777= SC,qFDU1..E OF D/5rA /VC A5S 17 57,5 ; 48.0 /0 s- WELL U50 coVME� 7,lc?,v V1 fANK m �