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Home My WebLink About1577DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -20 BOX 15 qpo ad i, ' „ ■ i , IN ■ `, ., IN ININI wr { 6 I ,` , r - I i 01577 ■ in PU'TNAM CO _TM DEPARTMENT 0FHEALTH i..'. Rev. 3186 Division of Environmental Health Seivicist Carmel, N.Y. 10512' Engineer Must Provide P.C.H.D. Permit 7?��-7 -. Z�CE` - - _ AkMCATE.dF... Located at VI .1 e151 (/6 W D 25; AGE DISPOSAL SYSTEM --- 0 r�vfflsge Tax Map Block L `7 P't , 'Owner/applicant N - J JWM 1 rT 1 r-L-L-rir -Forme Subdivision. am OU ame y N,--e Subdv. Lot 12 MaillingAddress 6-61ak �7JP_ 57 Date Permit Issued Separate Sewerage System built Consisting of Gallon Septic Tank and 6:727 L fl Bea ri -OA) Water Supply: Public Supply From Address or:- Private Supply Drilled by.14W, 0( 01 ill, IP 6-1, bJL Address _ZJ-/Jj'9-/-4 Building Type i?e5ivarri tq-L- Has Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? Other Requirements I certify that the system(s) as listed serving the above premises were cons cted essentially as shown on the plans of the completed work copies of which are attached), and in accordance with the standards; rules and re laiions, in accordance with Uef ed plan, and the permit issued by the Putnam County Depar ant Of Health. Date Certified b 2 Q_A I P.E. too'.� R.A. Address Pya"Z-5.-Llcense No. Any person occupying premises served by the above system(s) shall promptly take such action as maybe necessary to secure the correction of any unsanitary conditions,resulting from such usage. - Approval of the separate sewerage, system shall become null and void as soon as a pubs :sanitary tower become available and the approval of the private viater supply shall become null ,and � id vo when a public water supply becomes available. Such approvals or: subject too rn modification or change when, In the judgment of the 60milusloneflof Heal , • tki, such revocation..modification or change Is necessary.. Date Wl tC��ll, rrr..r r nnwimr r+m7nAt DVDnDT �r �l wr.LL %jVPLr LjrJ11VL4 L \L'1 VL \1 DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only Y = WELL LOCATION STREET ADDRESS: wNl IL 1 Y TAx GRIO NUMBER: Ice Pond Road Patterson, New York WELL OWNER NAME: ADDRESS: Classic Homes Inc. PO Box 385 Brewster,_ NY 5F81VATE tO PUBLIC USE OF WELL 1 - primary 2 - secondary 3filif ESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) O INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY O MOUNT OF USE YIELD SOUGHT 5 gpm. /NO. PEOPLE SERVED 3 to 5 /EST. OF DAILY USAGE 500 gal. REASON FOR DRILLING AOAdEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 345 ft. STATIC WATER LEVEL 8 -0. ft. DATE MEASURED 7/25/88 DRILLING EQUIPMENT ❑ ROTARY ,[R)COMPRESSED AIR PERCUSSION ❑ DUG D WELL POINT O CABLE PERCUSSION, ❑ OTHER (specify): WELL TYPE O SCREENED ❑ OPEN END CASING. xX3 OPEN HOLE IN BEDROCK D OTHER CASING DETAILS TOTAL LENGTH 21 ft. MATERIALS: A} STEEL O PLASTIC D OTHER LENGTH.BELOW GRADE 20 ft. JOINTS: O WELDED :kRRHREADED O OTHER DIAMETER 6 in. SEALxZCEMENT GROUT O BENTONITE DOTHER WEIGHT PER FOOT 19 Ib. /ft. DRIVE SHOE ❑ YES O NO LINER: O YES O,NO SCREEN DETAILS _. DIAMETER (in) SLOT SIZE LENGTH (it) DEPTH TO SCREEN (ft) DEVELOPED? FIRST - - 0 YES ONO NO URS . SECOND-'"'-"--- ... _.._._... � _ .. ., _. �_ .. __........ GRAVEL PACK ❑ YES O NO GRAVEL SIZE; DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST It It detailed pumping t METH00: ❑ PUMPED tests were done is in- OMPRESSED AIR , formation attached? 0 8AILED ❑ OTHER i ❑ YES O NO WELL LOG 1f more detailed formation descriptions or sieve analyses ]iY are available, pleaase se attach. DEPTH FROM SURFACE water Bear- ing Well Dia- In FORMATION DESCRIFTION cooE. ft. fL WELL DEPTH It. DURATION hr. min. DRAWOOWN ft. YIELD gpm. surface 4 Silt, clay & nobbles. . 4 6 Loose bedrock. 300 2 - 300 3 6 345 Medium to hard grey & pink granite. 345 6 - 250 40 WATER BLEAR TEMP, QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? x6RES ONO ANALYSIS ATTACHED ?Ag YES O NO STORAGE TANK : TYPE piW ra tt CAPACITY 62 GAL. 17 PUMP INFORMATION TYPE submersible CAPACITY. 10 MAKER Goulds DEPTH 200 9 MODEL 10FJ07412 V0LTAGE230 HP 3/4 WELL DRILLER NAME MILL DRILLING j DATE r ° .8 8 88 ADDRESS Putnam Avenue S ' ; Brewster, NY 10509 1 Presi en 'x'1'11 PUTNAM COUNTY,DEPABTMENT OF HEALTH Rev. 3/8k Division of kuvironmiitad Health Services Caemel, N.Y. ' Engineer to Provide Permit q on CERTIFICATE OF COMPLIANCE i 6 CONSTRUCMnON'P FOR SEWAGE DISPOSAL SYSTEM Permit q T. Patterson L� Ice Poiid . Road ' Town or viusge Subdlvteion Nome John "Breillier . ° _ . 5. TazMa{I '79 Block `3 ., t 8...15,;.. ^• . , Subd. Lot q Lo Stephen a. _Abels. & Patrick Wa1sh .. Renewal— ❑- • Revision 0 Owner /Applicant Name Date of Previous Approval MaiungAddress c /o. S.A:. Abels, Esq. , 154 .East Main Strt" Brewster, NY ZIP 10509 Building Type Frame Lt Area 1.836 Acres Fib Section Only IN o Depth -volume Number of Bedrooms Three Design Flaw G/P/D . 600 PCHD. Notiflcadon Is Required When Fill Is completed Separste Sewerage System to consist of 1000 Gsoon SeP»c Tso§ ana '500' x 24" ,wide- x 18" deep latera.lS To be constructed. by Address Water Supply: Public Supply From Address or: x Private Supply Drilled by 9 Addreaa Other. Requirements Nnnt- represent that I am wholly and completely, responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of o Putnam County. -Department of Health, and that on completion thereof a "Certificate 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 part of said sewage disposal 'system during 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 _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 install in accordance with standards, rules and regu aTEiom of the Putnam County Department of .Health. Date 13 March 1987 Signed Lk. r p.E._X-_ R.A. — neeras� ' RD 9_ Fair License No 29206 4 - _ APPROVED FOR CONS RUCTION: This approval expires am year from t 'date issued u e s construc io f the building has been undertaken and is revocable for use or m y ��FFF amended or modified when considerednecessa ' by a Comm io or ny change or alteration of onstructlon requires a ne permit. Adp ed for disposal of domestic sanitary sews an or private a pP ly. 1 �' LA Date jiy By ° le lw/ DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 .._.,_. a, ..._...:..,.....:_: -.:_:, �:.. .APPLICATION TO° ("ONSI'�tUC.'I':.�p�;:WATE "n—L - _:r�,.,.;: ._ ;. �� Q� PCHD PERMIT # 1' WELL LOCATION Street Address Ice Pond Road Town/Village/City Tax Grid Numbe T. Patterson 79 -3 -8.15 WELL OWNER Name Address OPrivate Stephen.Abels & Patrick Walsh, 154 E. Main St., Brewster, NY O Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY (] AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION ❑ OTHER (specify b INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT Five gpm /# PEOPLE SERVED Six /EST. OF DAILY USAGE 400 gal REASON FOR DRILLING ONEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Residential Supply 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: John Brenner Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY -DISTANCE TO PROPERTY FROM NEAREST 'WATER MAIN: Over -one mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED (See Dwg. #1, Job No. 5.0.2397 by John H. ®ON REAR OF THIS APPLICATION ®ON EP HEE Prentiss, P.E.. 17 March 1987 (date) (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 W 11 Completion Report on a form providefidd b th Putnam Cou, y Health Dep rtment. Date of Issue: Z 19 /h, Date of Expiration: 19 Pe r t Issui g fficfa Permit is Non - Transferrable 0 APPF�NDLY B PLr�IAM COUNTY' DEPARTM��T OF HEALTH - DIVISION OF ENVIRCN"��NrAL REACTS SERVICES IlQDaTtTI_DLLAI, WATER SUPPLY &SUBSURFACES CE DISPOSAL SYSTadS REVIY, Sci T CONSTRUCTION • PF'RMST DATE BY: &-n;- w ( -of ner) (Street Location) CC M-MY -- TS YES ' NO DOCUMEN'T'S I Permit Annlication — Corporate Resolution I Plans - Three sets er Engines Authorization I Design Data Sheet (DDS) - - Deep Hole Lcg REVIESKED . s/s I I Consistent Perc Results (3) I Perc Hole Depth Perc1= �c Fill ca - ! / � House Plans = -ij Iwo sets ue11 p= r;nit; P, -S letter Variance Request COAL Legal Subdivision Subdivision Pmoroval Checked -- Ex- approval SSDS Adj. Lots Checked 'Wetland (Town /DEC Pennit R & D) Data On DDS Plans & Permit Sam REQU= DEL-' S ON PLANS Sewage System Plan - ( north arrow) Sewage System Hydraulic Profile - Gravity Flcw Fill Profile & Dimensions - Volume D or J Box;Trznch /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data: Perc and.deep results _ Two -Foot Contours Existing.& Proposed Driveway & Slopes Cut Footing /Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shcwn;gravity flow,suff. size If Pam Pit & D Pox Shown & Detailed House - No, of Bedroans Wells & SSDS's Win 200 ft. of Proposed System Property Rtes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe . No Bends; Max. Bends 45' w /cleanout SEPARATION DISTP.NCI;S SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fi' 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. exta 15' to Drains - -Curtain, Leader, Footing 35'to catch basin, stormcdrain,piped watercour I -� �. I I __,,I- I I LF trench provided '"l!' required Q�Ajj 60 ft. zrax. Parellel to contours I I I� / .I, 1.) A i Y t I- / ' I 101. to Water Line (pits -201) - 50' intermittent drainage course Septic Tanks 10' fran Foundation; 50' to well 15' Well to PL /! �{C.1 -k In ;: -1 J ' _P'UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 gg DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.- Owner Address �� 11<?41 Located at (Street L Sec.BlockLot Indlcatd nearesE cross s ree Municipality Watershed el-0-6n I �3GA SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Role Number CLOCK TIME PERCOLATION PERCOLATION Elapse. p o Water Water Level. No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches. Inches 1- 1330 (30 2-9 Z% >4 3 4 0 5 1 il; Notes: 1) Tests to be repeated at same depth until aroximately equal soil rates are obtained at each percolation test hole. All pp data to be submitted for review. 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 N0. 'Y ` G.L. To 6" Or��►�s _ 12" 18" 24" 3011 3611 211 4811 5411 6011 66" .1211 INDICATE. LENTL AT tiCCii'GROUND WATER TS ENCOUNTERED No he INDICATE : -LEVEL TO. WHICH WATER LEVEL. RISES AFTER BEING NCOUNTERED fJo yp TESTS MADE BY T_ Pe ►zs.(FfffT:�-Date� �u84 DESIGN Soil Rate Used )-t-36 Min/1 "Drop: S.D. Usable Area Provided op' f` e Septic Tank Capacity o o o Gals. Type &"4.s 4.s_ _h_r_4 No. of Bedrooms TA f Absorption Area Provided By L.F.x2w' width trench �' Other Mo he Name bignacure Address JOHN H. PRENTISS, P.E. SEA ry'�� N PReNrfy��ye` 1(V9 FAIR S1 9171716-6110 4r , CARME1, N9W Y81'g 10412 ,v �o THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by OF E SIP10- � a_. County . Deportment of Flaalth, and that on- 'eotnpletan thereof a 'Certifiwti su0mitted •to the OmparttYietnt in a: written guaranCao will pe'furptsfiei place in I "d operating c6n;i0ion, any-: psrt- of .mid ssuiags dispoisl. syite" ance of the approirel oP tlea l:ertificate. of Constiruction `C ompliance' of 'tAi will, bocicated et shown on the`aippra,,0 lan and that said welt will' - County ®oaisrtmant`Of:keeltlt. Mato`(, -�'. tis`i� � l � AP�7!ROVEO FOR ,CONSTRUCTION Thisf .p oval expues two years,from;tfi' revocable for cause w: may _be'amenped'or modified when cgnsiaerG4 nbcitsail vr<Auiues a new permit: A*Oved," for'disposel'of domestic sanitary <s®irage ev 1�/8) 4L 52_ onitruction,COtnpliarico" Satisfactory; to the Commissioner of Health will inner hit ivco®sf0rs,, heirs or assigns by the DuiWer ,ti%d .said btiiidev,will tlro period of taro (2) 0i.Ws hilm"iately foliowirq the 4 ito of the isti it syitem.or any rein" th"' o. 2) "that the drilledwefi described ihov0 coraenaa'.ariYR Yh6 sta rules -and i6quBMS ok,. the:,' Putnam P.E. RA: ,License No :issued unless ; construction of; the building, fist been uttdertaken.and is Ile Com111isSionBr'ot F9�Ith, Any change a! aneration;of�COn84 /Ut4bn yam. ate wat r supply on 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 Stre Addre �. T Tax Grid Number �o� WELL OWNER Name Mailing,.., ;Addy -ess - County Health Department Private 0 Public USE OF WELL 1 - primary 2 - secondary 19 RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY - O FARM_ t3INSTITtJTIONAL ❑ AIR /COND /HEAT PUMP 0 TEST /OBSERVATION ❑ STAND -BY 0 ABANDONED 0 OTHER (specify 13 .AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE av gal REASON FOR DRILLING NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL ❑TEST /OBSERVATION . DETAILED. REASON FOR DRILLING white copy: H.D. File 6 is Non - Transferrable Yellow copy: Building Inspector 2/87 WELL TYPE Pink Copy: Owner DRILLED ` ODRIVEN ODUG aGRAVEL C] OTHER IS WELL SITE SUBJECT TO FLOODING? YES X _NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name'rd be J4_UN%;v fd Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: 0A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: V 2 Y-`)� ~ LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 1 OON REAR OF THIS APPLICATION [DON SEPARATE SJVT (date) (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 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 permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Date of Health Department. Issue: ��, % 7— <19 Date of Expiration: 19 Permit Issuing fici white copy: H.D. File Permit is Non - Transferrable Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange cony: Well Driller DEPARTMENT OF HEALTH l Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL._ PCHD PERMIT # I IG• S WELL LOCATION Street Address Ice fond Road Town /Village /City Tax Grid Numbe; T. Patterson 79 -3 -8.15 WELL OWNER Naive Address Wrivate Stephen Abele & Patrick Walsh, 154 R. Main St., Brewster, NY ❑ Public USE OF WELL 1 - primary 2 - secondary M RESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ❑ ABANDONED ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify 0 INSTITUTIONAL ❑ STAND -BY AMOUNT OF USE YIELD SOUGHT Five gpm /# PEOPLE SERVED Six /EST. OF DAILY USAGE 400 gal REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION ❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Residential Supply WELL TYPE XJDRILLED DDRIVEN ®DUG GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: John Brenner Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER''�S.UPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER_MAIN: Over one mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED (S ®a Dwg.1, Jab No. 5.0.2397 by Jahn H. 1 []ON REAR OF THIS APPLICATION [30N EP4RATE HEET�J Pr ®ntiss, P.R. 17 March 9 7 ''- (date) (signature) i PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as s.et 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: Date Date 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 W 11 Completion Report on a form provided by the Putnam Cou y Health Dep rtment. r . / of Issue: 19T / " : /,_; /.....- of Expi ration : 19 Per0ii ssui g ff c a / Permit is Non- Transferrable a 8/86 PiJI'NAM CWMY DEPARn4fflT OF HEALTH .:,DIVISION OF- ENVnICNMENM HEALTH SERVICES. e .._- DLF�Sr�I „GN L1A SF�F F- S(JBSUFACE.;SF3alAGE DISPOSAL- SYSTEM- ...__ -. ...FILE NO-. _ �._.... _.. Uy Y*Yact v 2-Ad - -e- 6avrre oav� s1,5�E�t +e l6 f Vic. Address?, 'X; 35 1” v !' Located at (Street) $- 3 1i Sec. Block Lot st k,S (indicate nearest cross street) Municipality TCX:'CT L y r� " ` Watershed C -JiP7"D r. S011 PERCOLATION TEST DATA REOLT11M TO BE SUPMI= WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test 'HOLE NUMM CI,OC:R TIME PERCQLAZ.'ION 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 :0-) 4 .. 5 — q-%2- .. _ 2 s,` .._ .__ .. 11. 4 5 2 l f' aZ_ a j(F lP d Y110 -10-i4r 2 / & C? .4 h /l 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 suimittbd for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRUE)TION OF SOILS ENCOUNTERED IN TEST BOLES DEPTH HOLE NO. HOLE NO. HOLE NO. G.L. 21 �J �' ,tom ri3tit.'r� t I �JL� b41 3° 4° 5° 6° :t 7° 8° 9° 10° 11° 12° 13° 14° INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED —" DEEP HOLE OBSERVATIONS MADE BY N.�';,L.6.i DATE: -- DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided Noe of Bedrooms Septic Tank Capacity . 0 _ gals. Type Absorption Area Provided By L.F. x 24°° width trench � A Other of tf ,, Sigril � z �r Address �� '!Y d �6 Y t' S H ' A NO. 0 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY Soil Rate Approved sq,ft /gal. Checked by Date NOM r7. V. Date FMIAL SITE EFrECTI-;241 L S 23 — Cl �( CRIER Tr N LC T 2.! 'L CF, Sur-or ISICN p- 'I 1) A I YES NO c2 as par ar-mroved u1;=15 b. 1 ]Dam= of 2:1 L =71 -------- c Scii C_ `acne, e- 100 f f::--,. wazar- DjS7=C-SZT. SJze - 1,000 1, 2H h. ssrtic t---1-: ev c 10 1 min.Lanum f G. iC goo h��n s, c---=—=--cut wjt,Jim 10 t-. Gf dc:,3 band e. L I J- I ALI ELS-7a%tliCn-I Wa'-er —Ij 2 cr: c c::-n- e s f. u1.1{,-r-Tc-N ECX -"'7 E=-- L Diztanc= rreasur=,4 4- ca=ar L..:) canzeZ 1 (-.Ce C -- le 1/1, 1/32 ' 10 f -1c n s Cc 20 7 < 30 Lndnes sur-;- S. Rc= allcwet -zcr 0 9. Size cf: c7--a-ve-l- 3/1- c-= c—.,;.e in trench 12" nilimlLro-m, 1L. Pire enass h -.EC-S--z El:s S ze cz r- c: � 7=. E --- L 2. Cverfffl c-w NI I/ v F, Ts tcx 6. C-,,-cle bv ESZ-11th r-ar c,;c-,e ECU.-H a. Ecusa lcc= DE-- a=Zrcvea plan-s- af b�'ca-LIS as Car ar-=Cve:-a clans h. :-= SD5:z === me D-;Stz-:rlci= f: . _cur ea c- C----:Lnc 13" L:czve trace - arcznc waul acce=za c wc P. F z -.: k IS H =1- a 5,cces rrc==-.rL-7 C7-CUtS;� b- AL-I picas C. 'ALL. vi=es wit.-1 inside of tc-lc c. =kf f.ns st nes < 4" in d-4alre-=- mat e- � accordinc to )Ian n Czt a-in F cafall crct2g— & dir to C_ . z,--cr-z.-ric aWav f::an SDS h. ce wat= crztac-t--,:C--1 a6-&c.' ta Box 224 - BREWSTER, N.Y. (99 4) 225 -2072 SAMPLE NO. 7027 SOURCE: Classic Homes, Inc. Ice Pond Road Patterson, NY COLLECTED: July 28 1988 BY: Mill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method well 08((3 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. July 30 1988 11 n' Lv-�- Roy Bi wit PE. D ector I f�, DIVISION OF ENVIROIMAL HEALTH SERVICES a M IT:? : TEU . , J t ; 3 Location - Street Section Block Lot � p I-fN Prz e2wj P_ 2 Subdivision Name Vrr-7-16725�,er S Municipality Subdivision Lot # tDMTjO-L Building Type GUARARM 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 lmu6diately. following the -.date of approval.. of,: the "Certificate of Construction Compliance" for the sewage disposal system, or any repairs made by me to such'systen, 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. Corporation Name (if Corp.) p0 Rzex ;3s • (O6 lw) 'eIDGE NY /d57(,, Address rev. 9/85 nk Zwo W_n W, rAM-122 /7' D. Corporation Name (if Corp.) Mfr .�t f I; eX►�T. W LL • 4N —JUNCI ON O'OX ((YP) t i d n 7 WS It C7 tf `` 0 T� 1� r , 2} as �G 27 28 zy . F I1*5Mt; O &It AP(-- RE(v10 � BI.E GOVE12� �, � AI.L 0UTL, ETS A? SAME EI-EV. OUTRIOW SGT I O N A -A� 4 " To 6 NIGH 14" MIN LNG. FOOTI t�1G SID � a f-- -4CXo 0 �P9D 4'4'1' 61.F t°20jr�a� 'TA N K A5- L5 LA I LIT DIMr,NSIDN GHAKI X 17E� ff TAI V NO. p G �� 2 R'�" ►�.5� . T►�Y THAT THE 3 115.5• GON5TKUCTEP A5 IN - `f" 11- 10 .5 AND THAT THE 5Y5TEM 5 ' IZl III IE 6��OKE IT WA5 � 125 Il�i'.5' 5'(STrM WA5 60WG, -T LACrol? -7 129' I1 .L le2TAN2AKl7 KIALZS AND 13 .5 120.5' UTNAM COUN-Ti 00rAK2 - 19 THE NEW iOKK rvTAT>✓ 10 10&.5 8 Tit• I 1 101, �O V2 ql.5, LOCATION -TAKEN PIeOM It? 92' -7 5 ;'Or JOHN LWE2 NNE12 I� �q�' X05.5' `VIED 12 -x-00 13Y EN[>lNEE121N(, , P.Y. Ilo l Iq� I l ►" 11 i2�' III'• I� 1 27..5, 11 -7 Iq 151.5' 120.5' 20 13/a. 21 Iq I 12? 5 22 131.5 25 I(o5.5� I1oO.5� 2(0 llol • ✓ 157.5' _. _ _ .. : ti ._. _ -_ :..:b•: 2S-. '158:x,._ . 15.5, SID � a f-- -4CXo 0 �P9D 4'4'1' 61.F t°20jr�a� 'TA N K