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Home My WebLink About1600DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -70 BOX 15 01600 Al SITE � M COU,j, PUTNAM OOUNTY HEALTH DEPARTMENT a DIVISION OF ENVIRONMENTAL HEALTH SERVICES d 225 -0310 PROPOSAL. FOR SEWAGE DISPOSAL SYSTEM. REPAIR. o� W YD RI NAME A iU � tA/c I -sor, � �l��ne 01 ��v�, PHONE °7 � �7 6'77/ IAC,FiTION Mark e,-& n1�'oo -d Tm# `71. I — 7_ l MAILING ADDRESS r/ rn,) >o M/ 4:rk� PERSON INTERVIEWED A I A in 1�/ o I -Fs�o p — d wly e- PM Canplaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY q PROPOSED INSTALLER . O h n �-e, r -L- o � G� i �" �U n PHONE .) Pro (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. u 1'Z K a V L&CA J)A\/ tu e / Proposal approved Proposal Disapproved — ZN�-, ---'7 's Signatuf6 & Title r000sal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing:. a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. � JDats /�� (e.g.,house corners). three precast 6' diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, o reported ag t of owner agree to the above conditions. q SIGNATURE _ t TITLE �/ -C /�V � DATE . OAS: ate (PAD); Ydlc w (Tam ST); Pink LgpU,a3nt) DONALD R. STRIFFLER Chairman Alan Wolfson Farm to .Market Rd. Brewster, N.Y. 10509 Rea Home Occupation PLANNING BOARD Telephone 878 -63t9 Routes 164 & 311 Patterson, New York 12563 October 4, 1991 Hr. Wolfson, It was brought to my attention by Hr o . Tom Keasbey, , that you were interseted in using your home for an office. He explained that you area professional CPA. In Section 154 -3'bf the* Patterson Code the use is allowed as a Home Occupation. Attached you will find copies of Sections of the code as they relate to use and signage. If % can be of -any_. f.urther..assis,stanc.e please. call -me.K . - v - :e Sincerely, O Planning Board Ch -man cc s Tom Keasbey t. KJ;(NCtE-AD. '1 - 3'o'r2b "P£Ai•Vi51[ieln I � — - 4� " . _ � I - 7 �xl�!(ttli •wFIL`To.(zENxlrl 't'{alcu. I Wif'._FEW%i.Tl.. _ LA;" fo rLNiWI: Hri^/ TRPU, IK MCI dR PRWI vE. N� 2 12 ¢ \ —Ntm fLtLL N1; 4'461La3P IG b.G �Z? L: :., � ft1GVE4xl5(ING•f•III � - 4'0.6 ¢.�} "PL. s�e+�G. "' = PL7gK7RNiLgN ►¢ � �.. -3 ¢ le 6o -G'Ip bo DbTtl910Pi� ._ j- if�4.L P/•RTITI ._" :. - _ .Irxv. �R�I�•!2,P•G60 a'(r.w vPho'tE¢•(A n>`irA HT.a eK, . tY.M %- M _: LON EFterrx: _ - _ \ \ I �2)4'•O ":r9= G +IfL'RM!•�ELD - -- -- -- FaiEp.��ION . -. - . -. cnsene.lf " ....r1E7•,.1::1 rI5ULA ry awl w/ I ..— C�N1Ari ��— 9iE_ vp�p TRu55gv pp��Ptl;Rt -� T e c w /.d/g "•PL-rw"v v� :— .,Pc - o'.- ��Ti:TM+rrrG�nGaeaa7olHrs - . O _.. ccrl6•MTfcrcn �.57ew3 i 11 r is • d� l: 1 yy4� is i . 7 i ) • 6� a; oml :04 N 7A I_y �jCt�(Irl�st I 4;4nuZ[ JLfK15Di J -- -F+vuti .3j -J.L W.P rte!' 1L�3lfIAT�G -L� P¢R - C15IN(o I J Gufit3� - c�Ofc1L>rLOf Z �i -aftry flLt 0! �' CIGEN�iED--ftJ.lri��dA fAN�!SCT�D A--1 Pa?T�NG.S._fo...pii'fLr1 :.. - o- � _..: ��pr R�E,D.:i71 IteLOw PI �� 31R_P_S[:S_fl1N "N. ZACTJ Flc>7� PLt•N 1�R Q° lei(. I?ay>eur F E% S ?I tCtY�E 2y�� Aele"-f EXTEND " 2e o� �apeND�cuw;� � To Ne•W Gn2KoE. n t PtcAL �B �GDx P6`(uio0 d .. -- 1.r_�9.TAtl._CO1�1. ��•R FL/.51�IrIC� \ .1H^LT'{..,*HIIICAES.. ove-g. x F�L7.. 1 i �•UTH �I.�VA �o I � � P ; � ,. " (.XiS7'IrJc'� J, New C�►w.G� . I. I M. fl ti� l.on1 IGa' IST. w W.G�aN 1 . M7 , 4 � FLm� FL^N YvtZ N6w wINOOWi NEW;T'Ill �iIDING NPB 4 �Aw To t tti1G}i. - fi�19T Ir1Gl.E'�'+I:Ir�';.g I RI l�fi �"(PItAL r• rl�w A;PIaA LT *HIP'l( LjeF , ro Nti1GN e* I'*'T I I-IG 114 Jape, ¢ col.oR_ r o/ o koe I / Pal HT 10 r+aTG+; e,c I*r . rYP• 41:.lGa:.cT D. b�157 ;WSW NOOUt roR. Ate• +; fap�NOlux i :lDl� rlcAl i _r�ti�PSHr•LY ciNi�l�h_. - -- - -- _ -- - • xlsnN� a iI ...... -fiew: - {� ANO45 Psf. LOA p T7M eVrcANG. — __.��►_D�_ fir; tiwh. • t?R�P Pair+T iONaTGI+ rKlhr. rYP• , :Lp EXIST, N � /S� TP.�NfLE T -�i � °✓iPrnt� "I"SUL. pPc.6a TIP• _ 5GONG, "Or- kropAcr, -- u PAR- iti>✓I'E� IuSVL .i`(P, 14TUC40 CALL eXM:XVD .a. p1• ...��J%T TITLE .-L- LEH:- woL Favu Rg✓(R><PIG1� �>=?D171ctrl_�:R�NoY�TIo_N -j T I GLA loft " iCRH To MAR V-P-T rAT_T- r=- jZ5oN,. PG . -'RWOCT.TlS JGr: =N s 1 'lYt3F � A&-.. yid W 04CJ UN /l �SlDENCe ocn .� New Cvko�os�o� � C C"% rTi n . ,.C. C:) �'. C F � � C v � ('b00% /Yi �t� ��N�a�s3�l ros'�7 oM DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 December 4, 1991 Mr. & Mrs. Wolfson Farm to Market Road Brewster, MY 10509 Re: Proposed Addition: Wolfson (T) Patterson Dear Mr. & Mrs. Wolfson: JOHN .KARELL Jr., P.E., M.S. Public Health Director Review of plans and other supporting documents submitted at this time relative to the above- captioned project has been completed. Comments are offered�agr follows: This Department is in receipt of existing floor plans that are reversed end'a . detached plan showing the proposed addition. A proposed floor plan for the entire house is to be submitted with each room dimensioned and labeled. Upon Receipt of a submission, revised to reflect the above comments, this• application will be considered further. Ver truly' yours, _ Robert Morris Assistant Public Health Engineer RM /jp F] $1 , r4- y ro 10 00 A F L�J. 4. nk- G Mpg-& ffi��N I FEB 71983 PUTNAM COUNI DIEPT. (OF II EEL DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 December 16, 1991 Mr. & Mrs. Wolfson Farm to Market Road Brewster, NY 10509 Re: Proposed addition - Wolfson Farm to Market Road (T) Southeast Dear Mr. & Mrs. Wolfson: JOHN KARELL Jr., P.E., M.S. Public Health Director I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate two offices (11' x 12') and a reception area is proposed in the existing basement,also an extension (11' x 13') that is a proposed third office. The survey indicates that sufficient area exists to expand or repair the sewage disposal system, should it become necessary in the future. Therefore, based on the information submitted, the above mentioned addition is approved with the following,conditionse _ _ _._..._ .__..:. _....... 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be replaced or updated with .water saving devices, i.e., low flush toilets, restrictors for shower heads and faucets, etc. Approval is granted for sewage disposal only. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Southeast. If you have any questions, please contact me at your convenience. RM /jp cc: BI (T) Southeast Ver truly yours, Robert Morris Assistant Public Health Engineer > i f 'PUTNAM COUNTY DEPARTMENT OF HEALTH NO. 344 -87 COMPLAINT OR.SERVICE REQUEST RECORD TOWN PA'ITERSON DATE 6/17/87 REFERRED TO �- TAKEN BY B.F. TELEPHONE CALL XX IN PERSON LETTER CONFIDENTIAL REQUEST FROM .AND ELAINE ALLEN WOLFSON TELEPHONE 279 -8369 ADDRESS FARM TO MAR= ROAD, BREWSTER e � ENVIRONMENTAL HEALTH: Home Sewage RodentsL Refuse Public Water Food Service Migrant Camp Other 38 COMPLAINT OR REQUEST SEPTIC PROBLEMS, REQUEST INSPECTION TO FIND OUT PROBLEM. SHE'S HOME DURING THE DAY TO MAKE APPOINTMRU. FOLLOW U7 INSPECTION (s) DATE �� FINDINGS p� R r (�30 DATE !� I Z r FINDINGS PROBLEM ABATED �) DATE !PERSON NOTIFIED —o F/JA IESTIMATED TOTAL MAN HOURS SPENT 4► oG� PUTNAM oouNTY HEALTH pEPrrr'� DIVISION OF ENVIRONMENTAL. HEALTH 'SERVICES. John M.- Simmons, M.D. De t Y Canmissioner of Health •FIELD ACTIVITY REPORT Sheet. of L� . INSPECTION Orig. Routine Orig. canplain 'ADDRESS -' ''° or Request No. Street 4M No. Canpliance 52 _ Canplaint Comp MAILING ADDRESS �?. .', -'.� : Final -P O Boat.. Post. Office Zip Code .. Group Illness — Construction TEE.EPHONE Reinspection PERSON.IN CHARGE E Field, Sampling Only. OR INTERVIEWED Field Conference Nanfe and Title Other DATE TYPE FACILITY TIME 1.��' S' 'TIME LEFT' �/''r ,% .! Explain FINDINGSs y-r New York State Health Department INSPECTION C®RITIRIUAMN SKEET page of Name of Estab?lisllment W � Name of Individual receiving report Type of Establi hment Date of Inspection Time of Inspection Inspected By: (Signature) Report Received By: (Signature) Date Gen Form 512 Remarks M Md LAJ / MM Li ��_ �� _ rl / / OWN 10A MVAM1-- I L { Inspected By: (Signature) Report Received By: (Signature) Date Gen Form 512 W1 PUTNAM COUNTY DEPARTMENT OF - HEALTH 1,, Division of Env�ronmenraC Health Services, Carmel 'N.' Y. 9051 .- CONSTRUCTION PERMIT ,FOR SEWAGE" DISPOSAL SYSTEM Owner_ ? 3— °`Town or village — rTax_Map Block. 7 Lot ob Address Building TYPe T /Y1C.i1'1 Lot Area Nuiriber of Bedrooms Design FI w 1 *. P ' Total H bifableo Sp �e Square Feet LZ 06 . 4 Separate Sewerage Syste to nsist of Gal ;Septic Sank_ and ,To be constructed ..'by Address . Water Supply Public Supply From ,�• p Private' SuPPIY to be dr11 by AdIress L cl Other Requirements )NK I represent that lam wholly and completely responsible for We' 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 an regulations o e Putnam County "Department' of Health, and that on completion thereof a'Tertificete of, Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to,'the Department, and a writfen ,guarantee .wUl :be;,furnished the owner his successoks; heirs or assigns by the builder, that said builder will place in good operating condition -any part -of saio _sewage disposal system during the period. of two (2) years'immediaiely following thedate of the issu- ante. of the approval of -the Certificate of Construction' Compliance of the origi 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 ' ccordance ` ith' th standards, .rules and regulations Of the Putnam County epartmerit of Health _Date I . Sig P.E.Z R.A. ,Address .License. No rr;. - APPROVED:FOR'aCONSTRUCTION: Thi approval expir on yearfrom f ate' issued unless .construction of'the building has been ndertaken and is revocable for cause or may be_ amended or modified wh cons ered.neces ry rf rr er of Health Any than r al eration of construction regw►es a w "pe mit Approved for disposal of do sanitary se ge; nd/o ' twat w er supply only. Date B Title K R,E N EWA.L , � ®J�� ®��ARd��II CF �ALII � PUII NAB ' ` Division of Enliironmental Health' Services Carme% N Y _10512 imitted, to the Department, -arid a written- guarantee wil in good, operatirig: condition any part of, said 'sewage ;d if "the approval ,of the "Certificate, .of ,Construction ,Com County Oepartmen4 of H � �' ' e'alth .. August Dat 15, 1979 e Signed -`t Address Rouge 52 Car.me, APPROVED FOR CONSTRUCTION This - approval expir' fron revocable for cause. or, ay be amended brniodified w con re sided° acei requires a:,ne per i A p oved for disposal of o- a sa y__sev bate' or 12 less consti ml =�gm_ !airs or: assigns by the builder, that sa id ' buiIdar will: ii years'.immediately following . thedate of the .issu- irs thereto 2) :that.;the drilled.well described above andards_rules' and regulations, of _.the ,'Putnam ' X ,P. E. R.A. License Na; :04 3 8;8 0 action of the building has'been undertaken and is - lealth. Any 'iha alt ation, - onstruction ly only. ,, - Title ' I iu EWAL ' PUTNAM COUNTY DEPARTMENT OF : HEALTH REN . Y Division of Environrnenca'l Health Services Carmel .N. Y10512 .CONSTRUCTION PERMIT FOR SEWAGE;;DISPOSAL SYSTEM:J Pa t t e.h S 0)1 Town or Village F a'rm t o M'a r °k e t R b�&d- �:+.e ,mow..- - w.ac -� .a+, r. w....•.. :..: v•rx 4.er +.s++aar .ww.+M'wP.• Located at Map- Block 61- will "e & Collett 'Hal'l Subdivision. Subdivision Lot -Job Owner Mel.vf1,1e` Hall Address Pattii rson, New Yn.rk Building Type Ra:n C h - Lot Area Number of Bedrooms 1.6 ^20 mi:n /"i:ncfi Design .Flow Total Habitable Space Square Feet 900 4301 of 24" ti l`e fi • Separate Sewerage: System to consist of, Gal..Septic Tank and ' e 1 'd $ to be dete' Mne'd Toy be .constructed by Address Water `Supply Public Supply From X Private SuPPIY•.to be Brined by t0 be: determl n e d: 'Address ' other Requirements Curta i n dra n, 6' - deep -pump -w % al arm..- 45.0 yds bank run .fi l l I represent that I am wholly arid 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 regu a ions o e u nam County Department of Health, .and.that on complet,oWthereof a "Certificate -of _Construction. Compliance satisfactory to the Commissioner of Healthwill be submittedao .the Department; and a. written .guaranfee,wilfbe.furnisned the 'owner hs'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):y " ea rs immediately following the date of the issue ante of,.the approval of'the Certificate of Construction :Compliance of the•or al stem..or any repairs thereto; 2) that the drilled well described above will tie located as, shoWn"on. the approved planand.that said well will,be= installs in cordance' with he standards, rules and regu a of the 'Putnam a .: 'County Department of Health. August 1:5, '1`978 X Date. Signed' P.E. R.A. Ada ►es5 Route j 2 C m e 1 APPROVED FOR CONSTRUCTION This approval.exp' "one,y rfrom revocable for cause r maybe amended or modified wh cons ednec requires a w per �t oved' for'disposil "of do rotary" se ' Date NBy- 'N . Y 10 512 license No. 0 43 8 8 0 date _iss unless .construction of the building has been undertaken and is r o of Health, Any change or alto ation of construction an ater' ply only: Title roNSTRUCTION PE It ocated"?t ubdivision Qwner" Building' Type ,r ' INumber'of Bedrooms 9UN T7Y--DEPARTM..ENT is o� n of Environmental Health Services Carmel 'IV. Y: 7 WAGE DIS06SAL SYSTEM Town or village Section -•B lock Lot ®.: Job_ Address 4 • =Lot Area -:• -, -'. -' � ° ` Total' Habitable Space Square Feet Other 'Requirements I :represent, that l•_am - wholly and.completely, responsible for_rthe de above described will be'constructed -as shown on, th "e' approved ame County -- ,. Department of ',Health,, and that'on comp')etion'thereof., ='be submitted ao the Department; -and a written: guarantee will'. ! place ''in, 'good condition any part of said sewage 'd is ante of the approval of the Certificate -of, Construction `_Compl -.will be::located•a's shown :on the approved plaWand" that sa�d:wgll wi County D partme `t of "Health Date' _ � i� .Sig Address APPROVED FOR CONSTRUCTION This approval e res_one revocable 'for use or may be amended or odrf = mied en conside VII, a' a .•',permit '; "`Approved for disposal of',dome` Date - By Cri ,3 y, i:and location of the proposed:system(s) `1) that'the: separate sewage disposal system lent there to and, in accordance with the standards •rules an, regula Ions o the Putnam certificate of Construction Compliance satisfact6&,,.to the.Commissioner of,Heaithwill furnished the owner his'_successo "rs, heirs,.or assiggs by tlie_ 6uilier, that said builder will al system during the period of; ;two (2.) years immediately. - following the date•of the issu- ce of:the or mal system;gr any'repairs thereto 2)-that the drilled `well described above e �nstalie accordance the standards rules and regulations• .of the Putnam RIE � R A (from: the date 'ssued unle ction,\of the <.buildin9:has been undertaken and is necessary tfie omryii 'h Anychiange- or alteration of construction y sewage; and / ;, ate, :s' only Jz Title ' r. --R — -: .. _a ,_ — — — PUTNAM COUNTY HEPARTME1 iT,: HEALTH . �! Division ,of Environmental Heahh Services Carmel, N Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL � GTi la .f ,f/� Town or ge ""ocated't _t,7_"u... :81ock Subdivision y' G Lot Job/ Owner dl Address r Building- TYPe v _Number, of Bedrooms G L•� `� Total9Habitable Space Square Feet .' Separate:Sewerage._System 'to ':consi ;t`of� =Gal. Septic Tank ' lineal -feet X = u�• " `width trench To be • constructed by � � °'t rA .Address Water Supply Public S' 'I- "From Pnvafe, Supply .to be drilled by r Address' Other Requirements .R • I -represent that I am wholly and completely responsible for.the deiign. and location of the 'p-roposed system(s); .1) .that the 'separate sewage disposal system above described.wilL be constructed asshown or 'ttie approved amendment =4here to and ii `accordance witfi the standards, rules an regu a ons o e u nam County Department- of Health,• and that on completion thereof a "Certificate =of Construction 'Compliance " - satisfactory to the Commissioner of Health will be submitted to the Department, .•and a written :guarantee will be-4urnished the owner, .his successors,`tieirs or assigns by the builder, that said builder will '.-:place in -good' operating' condition any part •of`said sewage disposal iystem during,th period of two,(2). year s•immedlately following the date of the issu- sZ ante of the approval of the Certrficate ..of Construction Compliance of the on stem.or any repair s thereto; 2) that the drilled well described above r will be located as shown on the approved plan and that said well will be installed ortlance'w t standartl les and regu anio�so f: the .'Pu nam County: partmen of /Health > oofz F pate(✓ « f c� i , i�t? Signed . R. A. Address r W License No ? APPROVED, FOR CONSTRUCTION: Thi approval expires9 a year om the date issued unless cc nstru n of the buiiding'has been undertaken and is i. ►evocable for'.cau or may be•amended,or modified when'cd ides necessary oinmtssio a ef- ealth.' Any change or alteration of construction requires a . new ermit: pproved for disposal .of'do est dary sewage and/ rivate at : su ply only. Date ✓ 7. Title PUTNAM COUNTY DEPARTiMENT OF HEALTH DIVISION OF ERArIRONMENTAL HEALTH SERVICES "':'COUNTY .OFFICE_ bUILDIPI,G;. ;CA_fiIL,Y:1V -._Y. K. -- DESIGN DATA SHEET-SEPARATE SD AGE DISPOSAL SYSTEM FIE NO. Owner �_ Address _ Located at (Street � 75 67, W Block Lot t n _l ,a eenneLres W, cross street Municipality Watershed A` SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION ^ FM— apse Depth to Water Water eve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 3 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 from top of hole. TEST PIT DATA REQliIRFn TO BE SU13,"I ITTFD WITH API'LICA'PION DIPPSCRIPTION OF SOIL IN TEST IIOLES • a DEPTH HOLE NO. HOLE NO. HOLE NO. G. L. 611 112" 18" - 6 _ 3011 36" 42" 4 - 54 60" 66" 72 11 - - -- 781 MN 70 A LL' 4LL Ai ir; rLECH GROTLMDi WATER IS ENICOUNTERED e I11M, -L V!"l L INDICATE LEVEL . ` CH WAT' R LEVEL R SES AFTER BEING ENCOUNTERED TESTS I�lADE BY �; Date — DESIGN ..Soil. Rate- Use416:- � Min/ -1 "Drop: S.D. Usable Area Provided ,: c- Q �l No. of Bedrooms Septic ,Tank Capacity c} Gals. pe�'//'�rr,J,�'11 Al Abso tion Area Provided F 'c> L. F. x21 " 1,\\ t� Pjrt� enc i. (&iVIk Name � �sl' �� :.•' , igna ure � �- � :� �, "� = - Address - _. TI1IS SPACE FOR USE BY I.DLALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date WELL dbmpLkt . im h00" M T . OUTNAM COONTY iDE00TMENt 00 4ALtk D141slon of Cnvironithidhtoi keilth SOVIcibi COUNTY OFOICC' BUILDING ' CAAmeL; NEW YORK Tkii report Is to be completed by Well driller and Submitted to Bounty Heakk beiJaitirrien't togethe'f Witil labbratbfy koodft of andiV!N.6f water iarnpie.1ndicating water is of satisfactory bacterial t Hal tIuallty before certificate' of coMteUdfidIicdMiJkaHcd it ksUbd' hEPOFft MUST 13E 8613MiTTO WIT"HiN 30 DAYS 60 WELL COMPLETION owkik NAME ADDRESS Pea ea load, Br 1,76tpk i46ti Ybrk cerlich donstructJ611 Coe d ble Hill A iot:Ail6w (No. a Street) (Town; (Lot Um or) 60. WELL Farm-lo-11arket Road Brewster, Ne%4 Yt)rl-. BUSINESS PROPOSED lJ bomiitlt ❑ iSTABLISHWkY H WiA rl LEST WELL USE 60 OTHER sup LY (SpscIfj) WELL PUBLIC 114DUsTkiAk DR U110 COMPREtttb OTHER R10 07 AIR PERCUSSION (Spec1#0 10 A Y PikcusMow WiNd -T-EN—GTK—(1oot) DIAMETER (inbhds) W111AT 1E1 1001 RAI-YE SHO U�SINO QBQUTEV? bEfAILS 51 6 17 tHkEAbED WELbtd IXJ YES ILI NO M • ED NO ❑ YIELO� HOURS G.PA YIELD (0,pim.) TES) 9AILEb FuMoEb COMPRES .ED AIR MEASURE PRO LAND SURFACE" STATIC (Soebft�f6et) DURING YIE Lb TEST feet) bepth of Compieied Will LEVEL 5 400 iA fool below LAJ 1-6tltdilii 40 0 kokk DETAILS SLOT SIZE DIAMETER (Inches blomet0 of well Ihd0jin-4 rl1A—VFE1 Z ► (1,4064 FROM (toot) ITO (to, I IP PACKEDi grovel pack (Inchei): H FROM kAk.b 31,19FACE Aot6h oxict 166dliah ot Well with dlild4cft id 9i 440 I PO1RAATiOi4 bEkkkibW two Oorthenohi Idndmatka. PEET W PEET I I 0 3 Top Soil J 85 Sandy Gtavei Boulders .35 44 Sbit Safidy Ledge 44 51 Maid Granite leclqfe 51- 400 Flakd Grey Granite with Seams Of Soft Pihk & Wh tau -iktt 0 If Ylislj Was 6ifeJ of J1#6rant depths jUiino jAlIhj, list 66low 20 260 3-dO 400 5 wt Rctt Lill tl'zt "DAiF F Q • - 4/30/(-1 ._ JP j tt i to If 'ert vi. 14118 President-14ILL DPILL.17 sAMPUkoi4643 Cerildh* doh8triibtion Coe well Farm -to- Market Rd. Patterson; WY CbLL.t&,Eij:May 4, l 98 S'k:mIll Drilling; ift, bActtkfbWGICAL EXA i&Al7dkt cdWdttH CoUNC MV ith oii 0 Thii htdiratiri ihd joeirei 61 thr jdPipld ibdi May 9; 1981 . 0 A GUARANTY OF SEPARATE SEWAGE-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 guaranty to the owner, his succes- sors, 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 initial use of the sewage disposal system, or any repairs :Wade by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser • vi-c-e•s - o €.• -the - -Puatnam -- County Department- of Health- a-s-- -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 F day of .. 19 V Signaturec , � -+ Title - , G 'e4�a If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health Owner or Purchaser of Building MuniGi.pali.ty Building Constructed by Section -1,4,0 ,en, 75' M1WX er Q,4 Locati = Street Block Building Type Lot GUARANTY OF SEPARATE SEWAGE-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 guaranty to the owner, his succes- sors, 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 initial use of the sewage disposal system, or any repairs :Wade by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser • vi-c-e•s - o €.• -the - -Puatnam -- County Department- of Health- a-s-- -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 F day of .. 19 V Signaturec , � -+ Title - , G 'e4�a If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health 'o Owner or Purchaser of Building Building Constructed by Municipality Section Location - street Block ';4' Xf -/J i Building Type Lot GUARANTY OF.SEPARATE SEWAGE 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 guaranty to the owner, his succes- sors, 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 initial use of 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 occu- pant of the building utilizing.the system. The undersigned further agrees to accept as conclusive the de.- _.._ .termination of the Director of the Division of Environmental Health Ser- - vices 'of the' Putnam County Department of 'Health •as *to whether or riot- '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 da y g of t �' 19 < Si nature, r✓e Title, If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP1,ETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health 3 43' 51V 62' -55 14' A*' 9 226 28 �4 V/11W/ /00' or 7VA2 ' SYS rEa aso5 wIlrAlW loci or rM/`5 W,4z - 2,6ad C6-46rfaJ67760 As I-D&R I�ZA45 A,,10 X�JAO ro. 11EV-1-11 Dq:;7.- Putnam County Department of Health Division of Environmental Health Services Approved as noted for Conformance with applicable Eules and For ogulati of the ea County t h Depa rtme n 72 67 Ignat re Ti I.,e DVte 12UO' 40', C., I f r REVISIONS OF NE' H 43B ssl ',A" M4, \\7 . , I GEORGE- A. HAUGHNEY, P. E.: CONSULTING ENGINEER, Route 52 Carmel, New York 105112"!., TITLE,' DRAWING NO 4SCALE DR. BY 4E DATE ck,b. -8,? gr/�/.t.�r V / 4 � /{�+� "y //'[�y` �+ �t� y,( %t .. /0 /qp ,n.• M. n•qr. m •, rr. .t: 'OY 4� �StT r I /yl� MR s `,� .�..,, ,•...�. /�� %��'f1x� �^' /� � oaf° [ld.,J A rr 'aJ�B 11 �a y G y 4 a ,r Cr177 r t �yld. fr. � .. A •., r 1 rE•y'� f irCy t t ''". 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