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Home My WebLink About1627DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.13 -1 -19 BOX 15 01627 :; �" r� T , A jr �. 01627 PUTNAM COUNTY DEPARTMENT OF HEALTH ' Rev. 3186 Division of Environmental Health Se v ceih Carmel, N.Y 10512. Engineer Mast Provide P 9 2_ 8 6 11 -P.C.H D Permit #,." — _ . _ CERTI> I..ATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE.DLSPOSAL SYSTEM T. ,Patterson . Town-or V e '. Located at Fair Street Ta::Map 73 Block Lot 22 Owner /applicant Name • Ke.vin Curry Formerly Subdivision Name Sonny AC dv, Lot N 39 Melling Address Longview Road,Carmel, NY _ Z)p 10512 DatePermltlsaaed 10/28/86 Separate Sewerage System built by Owri'e r Address Ab o V e Consisting of 1000 Gallop Septic Tank and 25 tri- Galleries ( 200' Total Length) Water Supply: Public Supply From Address or: X Private. Supply Drilled by Rex Hyatt AddrM Rte. 311,• Patterson, NY 12563 Building Type Modular Has Erosion Control Been Completed? As , required Number of Bedrooms Three .Haa Garbage•Grinder Been InetalledY . NO Other Requirements Curtain Drain: 4.' Deep x -'18" Wide x 90': Long w/75' ± Solid.Tail Pipe I certify that the system(s) as listed serving the above premises were constructed essentially as shorn on the plans of the completed work ( copies of which are attached), and accordance with the standards','rules and regulations; in accordance with the filed plan, and the permit issued by the Putnam County Department Of , Heaith. Date 9. May 1988 certined by v,E._X R.A. Address RD9 -Fair St., Carmel, 10512. License No. 29206 Any person occupying, premises served by the above system($) shall promptly take such action as may be 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 pubt ?: sanitary sewer becomes available and the approval of the'private water :supply shall become ;n6 and void .when a public avatar supply becomes available. Such approvals are subject to modification or change, when, in 'the .judgmant of the Commissioner.of Mealthyyteh, revocation, modification or change Is necessary, Date " a -� �� 1_5541 �`6 e Title J PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Kevin : Curry Owner or Purchaser of Building Owner Building Constructed by Fair Street Location - Street Patterson Municipality Frame Building Type 78 1 22 Section Block Lot Sunny Acres Subdivision Name 39 Subdivision Lot # GUARANM 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 siicfi'sjiste3n, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 9 day of May 1988 General Contractor (Owner) - ignature Corporation Name (if Corp.) rev. 9/85 mk Signature n, Title Corporation Name (if Corp.) Longview Rd.,Carmel, NY 10512 Address Caws I-I_1 N-�c_ , Yorktown Medical Laboratory, Inc. 321 Kear Street Yorktown Heights, N. Y. 10598 (914) 2454203 Director: Albert H. Padovani M. T. (ASCP) r -. LAKE CARMEL PHARMACY 149 SMADBECK AVENUE LAKE CARMEL, NY 10512 LAB # 2 ,2. 013 0,9-v Date Taken: 3- .90- ,FkTime: Date_ Rc' d_: 5 - -,?/- -Y-' Time Date Reported: APR. .1988 ....,. Collected By: SAME Referred By: LAKE CAMEL PHARMACY_ Sample'Location: BATHROOM TAP, KRVTN CURRY, FATR ST -, CARMEL- NY Phone # 995 -4,A1;5 Phone # I Sample Type: L J Repeat Test? _ (check one) LABORATORY REPORT ON THE QUALITY. OF WATER INORGANIC NON - METALS (mg /L) MICROBIOLOGICAL (CFU /100mL) _ Acidity.. Alkalinity _ Chloride. Detergents, MBAS Hardness, Total Nitrogen, Ammonia Nitrogen, Nitrate Phosphate, Total Sulfate _ Sulfide Sulfite METALS (mg /L) _ Copper _ Iron _ Total Coliform Index _ Lead _ Manganese _ "Fecal" Coli'for'm Index Mercury Sodium KEY FOR TERMINOLOGY Zinc GENERAL BACTERIA .Z'Standard Plate Count (CFU /l.OmL) MEMBRANE FILTRATION TECHNIQUE Total Coliform Fecal Coliform Fecal.Streptococcus MOST PROBABLE NUMBER TECHNIQUE MISCELLANEOUS pH (units) Color (units) _ Odor (TON) _ Turbidity (NTU) N/A = Not Applicable LT = Less Than (C ) GT = Greater Than (>) TNTC= Too Numerous To Count CON = Confluent ( =TNTC) NR Non- reactive REMARKS /COMMENTS (For Lab Use) _,,4ot,ab1e Non- potable STP INF STP EFF Other.: Sample Status:. (check each) Outgoing HNO3 HC1 H2SO4 NaOH ZnOAc Na2S203 _ Other: THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDI.NG'TO.T YORK STATE DRINKING WATER STANDARDS,.FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) (N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF.THE NEW YORK STA D KING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF.COLLECTION. Lx i L &z4(L -61'_. /.P' e , Albert H. Padovant, M.T. ASCP), Director 2 /86(Rvsd7 /87)RWE 4 °C _ZLE GT 4 °C _ pH LE 2 _ pH GE 9 pH GE 12 _ Other. THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDI.NG'TO.T YORK STATE DRINKING WATER STANDARDS,.FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) (N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF.THE NEW YORK STA D KING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF.COLLECTION. Lx i L &z4(L -61'_. /.P' e , Albert H. Padovant, M.T. ASCP), Director 2 /86(Rvsd7 /87)RWE Ao�� ,y • ,P(n!NAM COUNTY . HEALTH. DEPARTMENT DIVISION OF ENVIRONMENTAL'- HEALTH SERVICES .-,-.John M. Simmons, M. D Deputy'.Canmissioner of Health.'' FIELD ACTIVITY REPORT - Sheet of INSPECT 0 NAME lh ��/v`� r.^ ?rig. Routine Orig. Canplain ADDRESS j �Y- G— 7` .3,�1 Orig. Request No. Street_ Town TH No,.'" Campliance Carplaint Carp MAILING ADDRESS Final P.O. Box Post :Office: Zip' Code Group Illness Construction Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIflWED�� i"�'9v'"�` =• - Field Conference and Tit] e . ` Met- DATE ® TYPE FACII,ITyi►i TIME 3 _ %_ TIME LEFT Explain 5 m s. bi Y-y prr a. SDS area located as per approved plans b. Fill section - Date of placement .. 2:1 barrier. LGTH WIDTH AVG.DPTH c. Natural soil not stripped' =t d. Stone, brush, etc., greater than 15' from SDS area. e. 100 ft. f ran water course /wetlands .. II. SEWAGE DISPOSAL SYSTEM ` :- a. -Se tic tank size ,:.,- ,000 1,250 i k1rd�.h b. Septic tank instal level ' c. 10' minimum from foundation •.y Via+ d d. No 900 bends, cleanout within 10 ft. of 450 bend T e. DISTRIBUTION BOX -= 1. All outlets at same elevation -water test 2. Protected below frost �.. - 3. Minimum 2 ft. original soil between box and trenches c-*' . "j J f . JUNCTION BOX - properly set g. TRENCHES 1. Length required Length installed %'' _ 2. Distance to watercourse measured- ft.. 3. Installed according to plan 4. Distance center to center fit, _ 5. Slope of trench acceptable 1/16 - 1/32 "/f �( 6. 10 feet from property line - 20 feet - foundations _ 7. Depth of trench < 30 inches fran surface 8. Roam allowed for expansion, 50% 9. Size of gravel 3/4 - 1j" diameter - 10. Depth of gravel in trench 12" minimum , X 11. Pi" e ends capped - h. PUMP OR DOSE SYSTEMS ump- chamber - - - -- 2. Overflow tank - a 3. Alarm, visual /audio 4. PL= easily accessible manhole to grade ePe"'. % .-) 5. First box baffled 6. Cycle witnessed by Health Department estimated flow per cycle IV. HOUSE a. House located per approved plans. b. Number of bedroans _ V. WELL a. Well located as per approved plans b. Distance fran SDS area measured . ft.-• c. Casin 18" above grade. d. Surface drainage around well acceptable. +. VI. OVERALL WORKMASHIP a. Boxes properiy grouted b. All pipes partially backfilled c. All pipes flush with inside of box ;p �.� d. Backf ill material contains stones < 4" in diameter �. e. Curtain drain installed according to plan s f. Curtain drain outfall protected & dir.to exist.watercours g. Footing drains discharge away fran SDS area h. Surface water protection adequate a i. Errosi.on control provided on slopes greater than 15 %. FINAL SITE INSPECTION Date' Inspected by 12ION �Gl %' >!� OWNER Ci .�.. T # o ' TM # OR.SUBDIVISION LOT # SEWAGE DISPOSAL AREA k WELL COMPLETIUN tt!✓kUMI O Office Use Only WELL LOCATION STREET AOORESS: wNwtl ! t TAX GRID NUMBER: WELL OWNER K NAME. ADDRESS: P PRIVATE USE OF WELL e eRESIDENTIAL ❑ B BLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED MOUNT OF USE Y YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR N NEW SUPPLY. ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION DEPTH DATA W WELL DEPTH 6 ft. S STATIC WATER LEVEL � 6 ft. D DATE MEASURED DRILLING ❑ ❑ ROTARY COMPRESSED 'AIR PERCUSSION ❑ DUG WELL TYPE ❑ ❑ SCREENED O OPEN END C. ASING. 06PEN HOLE IN BEDROCK ❑ OTHER CASING L TOTAL LENGTH / ft M MATERIALS: f STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE_ ft. J JOINTS: ❑WELDED f�THREADED ❑OTHER DIAMETER 7 in. S SEAL: O CEMENT GROUT Ga"6ENTONITE ❑OTHER WEIGHTIER FOOT Ib. /ft. D DRIVE SHOE 19YES ❑ NO I I LINER: ❑YES eTNO DIAMETER (in) ' 'SLOT SIZE L LENGTH (it) D DEPTH TO SCREEN (ft) D DEVELOPED? SCREEN F FIRST - - .. - . ._.... _ _:..._ __., ❑ ❑ YES' t7 NO .. _ Y PUTNAM COUNTY DEPARTMENT OF,HEALTH 3186 x Divislon of Enviionmenfid A lth Seivlces Carmel N Y.10512 Enghteerto Provide Permit ll f r on CERTQ KATE OF COMPLIANCE �J6 0 1?ermlf q'= b C TRUCTION PERMiT FOR SEWAGE DISPOSAL SYSTEM T: Patter5oil Located at F a 1 r: $.t r e t _ n • : . a _ :Town . or village ...� Sunny Acres Sabd. Lot q' SabillAs on Name 3 1 2 2 9 K ~ Tax M8p % 3 Block Lot Kevin Curr Renewal❑ Revision' ;' 0 Owner /Applicant Nam' Y Date of Previous Approval M' Address_ •Longiriew Road .. Town ` C•.'i l'mP 1 s `NY Zip l n 51 7 Modular. 21225 Sq.. 'Pt. Type Lot Area Section - Volume N Depth -- -- Three. Number of Bedrooms Design Flow G /1? /D 600, PCHD Noiffi -tlon is Required When Fill Is completed 25 Tr,-,Galleries (200t Tota1 Len th) Separate,Sewerage System to consist of 1 000' Gallon Septic Tank and g To be'conet; acted by. Owner Address Water Supply: Pabilc Supply From Address X Prlvilte Supply Drilled by Rex Hyatt- or,— Ad"' Rt e . '311' ; Patter Sys • NY 1 9 S Fi j l Curtain Dra•i:n 4.: Deep X 18" Wide` x <90' Long W/75' +Solid Tail Pipe Other Requlremente 1 represent that I am wholly'and complately responsible for fhe'design and location of the proposed:systenl(s),,1) that'the separate sewage disposal System above tlescribed will be constructed is shownon,tne approved amendment there to and. in accordance with the standards, rules and regulations of e Putnam County Department of Health, and that'on completion '_ihereof'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 gooC,operati ng icondition any part of` said, sewage disposal system during the. periodbf twoa2) years lmmediately following thotlate of the issu- ance .of• the approval of :the Certificate of. Construction Compliance' of the, system or any repairs eto; 2) that the drilled well described above will be located as shown on the approved plamand that said well will be Installed l accordance with, he di s, rules and regu a'Tf%ni of the., Putnam County Rpyqpari ant ppf Heal l� Date ZL U.CtODer ��86._ Signetl / P.E. _ R.A. RD •9 -Farr 'Stree ;,. arme•1;," NY 10 29206. .Address License No APPROVED FOR CONSTRUCTION This approval expires ;one year.., m the'.date, issued unless' construction of the building has been undertaken and Is revocable for 'cause or may be amended' or'm0dified when considered necessary by ,the Commissioner �of Health. `Any change Or alteration of construction requires a new permit. 'Approved for c,�ddiissppo�sal of domestic sanitary sewage, 0 rivate water supply only. Date L � / Z2 By S !?/ - Title �7T—� PUMAM COUNTY DEPARTMENT OF REALM • ' DIVISION OF ENVIRCNMERML HEALTH SERVICES 4 N,y.r DESIGN DATA SEWAGE DISPOSAL SYSTEM ;.�.x,..,,..,..9. _. .. _ r.._ FILE ....•` ^.'."�.. _"'^'^.... ' -..:j.• ,..:w...�....swr_v...._..xx:. ...•..,....+•, vw�•c.,_e =..: s....,.a... ,.,. e«.�.� - _ - _ �_ Owner 4 Address FA te S'� . .,..s. ��,.......,..., ...,.._..b,...� Located at (Street) Owl It 94 Sec -T 7S _ Block 8 Lot (indicate nearest cross street) Municipality ea-fie -:w Watershed Date of Pre - Soaking 2-3 G Date of Percolation Test 2 $ e HOLE NEEBM CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Vbter bevel No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Kin /In Drop Inches Inches Inches 24 2 11A ma- 33 f I r 3 3 4 a 0 3 a a° 'el),; •; . 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 suhidtted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 0 TEST PIT DATA REQUIRED M BE SUBMITTED WITH APPLICATION OF SOILS DEPTH HOLE NO. I HOLE NO. G.L. L) 21 Grown Lo 3' 41 51 61 71 83 91 10, 12' 13' 141 INDICATE I LEVEL A . T, . WHICH GRC(JND�1AMIS EbiCaikktED IV on e INDICATE I" �L 19 -WHICH WATER LEVEL RISES A47M BEING ENCOUNTERED e DEEP HOLE OBS f RITIONS MADE Bits Pct-p (14. F Ili, 4 f L>, JS C P.,4-, ( 14• F T DAM. fZ> -31196 0" DID I g mInJULOLO, 0.':-1 DESIGN Soil Rate Used -Min/l" Drop: S.D. Usable Area Provided-37:5P I rft No. of Bedroams rep Septic Tank Capacity '10 00_ gals. - Type - Hit -io i 4 1 r, "I, Absorption Area Provided By ;i�"Fefepl- tt4,--- Other -64K�- a ivi Po'o 4' Oq-Y'9 vof E- SSION 41 1)'1! ,O PRE- � X116/14A Name JOHN N. PRENTISS, P.E. Address RD9 FAIR ST 914-878-6170 *: : . I ' 1 'k : * t t THIS SPACE'iURTFE Soil Rate Approved ct:v. 6:. HEALTH DI I., V,: lml(:.�-Iy fl so. rates r" T 1. . . . ; : I J!, 1. 111 , „I f'. .1 - :' — sq.ft/gal. Checked by Date PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS _ _FIELD- °INSPECi'ION'i2lIT�, M DATE. J e o ° ,,'�/ � /® a INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION ]YES NO CU,2' NTS - - Wetlands ' on /or` proximate -to== property Property lines.or corners found.... ..:.......... Can estimate house location .................. Will driveway need cut ............................ Must trees be removed - note these................. Deep holes representative of entire SDS area...... Additional deep holes needed..... ...... Sufficient SDS area available considering driveway cut, house location, separation distances,etc.... Adjacent wells/ septics .......... ................... D.H: 1 Lot (® Depth to G.W. Depth to rock — Soil Descri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. FINAL SITE INSPECTION D.H. 2 Lot Depth to G.W. Depth to rock Soil Descr 0 ft. 3 ft. 6 ft. .9 ft. 12 ,ft. DATE: INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded...... ... . .............. 10 ft. maintained fran property line and 20 ft. from house ..........................e... Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench .......... ..... 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxesproperly set ..................... e......... Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE......... .1 . . . . D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descri tion 0 ft. 3 ft. 6 ft. 9 ft. a._ . 12 ft. PUi'NAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL-JSYSTEMS F= INSPECTION" REPbRT DATE: C�uY TZ�•�f See INSP. BY: r (Name of Owner )J (Street Location) INITIAL SITE INSPECTION YES I NO CON2N=S Wetlands on /or proximate to property .............. - Property lines or corners found..... .............. Can estimate house location ... ..................... Will driveway need cut ............................ Must trees be removed - note these................. Deep holes representative of entire SDS area...... Additional deep holes needed..... ... ...... .... Sufficient SDS area available considering driveway cut, house location,-,separation distances,etc... Adjacent wells/ septics ............................ D.H. 1 ;1, Lot Depth to G.W. Depth to rock Soil Description" 0 ft. 3 ft.'"� 6 ft. 9 ft. I I 12 ft. FINAL SITE INSPECTION D.H. 2 Lot Depth to G.W. Depth to rock 12 ft. L---� DATE: INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded...... ... .............. 10 ft. maintained fran property line and 20 ft. fran house.. .... hDistance well to SSDS (ft.) ...................... Number of bedroans checks ........................ �. 'Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ `.5 ft. of peripheral-soil horizontally E i,from trench ..... ............................... )xes properly set ............................... Auld surface runoff frog driveway, roads, T,round surface, etc., channel near SDS area.... s lot drainage appear OK in area of SDS....... 1L GRADNG OF SITE ACCEPTABLE.. M D.H. - Deep Hole G.W. - Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descri % 0 ft. Y2- 3 ft. 7� 6 ft. 9. ft. 12 ft. NO mmms Soil Descri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. L---� DATE: INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded...... ... .............. 10 ft. maintained fran property line and 20 ft. fran house.. .... hDistance well to SSDS (ft.) ...................... Number of bedroans checks ........................ �. 'Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ `.5 ft. of peripheral-soil horizontally E i,from trench ..... ............................... )xes properly set ............................... Auld surface runoff frog driveway, roads, T,round surface, etc., channel near SDS area.... s lot drainage appear OK in area of SDS....... 1L GRADNG OF SITE ACCEPTABLE.. M D.H. - Deep Hole G.W. - Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descri % 0 ft. Y2- 3 ft. 7� 6 ft. 9. ft. 12 ft. NO mmms 3 DESIGN DATA' smw -smsu ACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner 1�� , Cwrry Address .wee S� Located at (Street) gu ► I�-E .I-�e le 1�t• Sec..TI 78 Block .I Lot (indicate nearest cross street) 0 39 Skh�y ,r�s ,.S�14W — t Municipaiity Watershed -�N SOIL PERCOLATION TEST DATA REQiTIRED TO BE SUBNII= WITH APPLICATIONS Date of Pre- Soaking .. �- G Date of Percolation 'Test $ z3 0° G .ti .s HOLE NUMBER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches .Soil Rate Start -Stop Min. Start Stop Drcp'In Min /In Drop Inches Inches Inches 2 11,6q n4,1- 33 1. 3 II¢L W 39 4 fiu (3,m __3 9 L1 y4- 3 311.E )-,, 4 I t 4 -1`1. 4 L L7 ?L� ti .. 3 F 3 NOTES: 1. Tests to be repeaterd4t same -depth until approximately equal soil rates are obtained at. each:.percolatio' test hole.. All data to'be submitt0d for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA I ED TO BE SUBMITTED WITH APPLICATION SOILS ENDED IN TEST HOLFS DEPTH HOLE NO. HOLE NO. 2 HOLE NO. G.L. .g ; 6" 29 (trmeNal �® 3' 48 5° 6° 7° Ill® Le s v ®dix 8° 9° 10° 11° 12 13' 14° INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED No Me INDICATE LEVEL TO wHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED c PJ e Ke DEEP HOLE OBSERVATIONS MADE BY: �e ��-(.� T:� �1 � 4 R,, Fi•f�. DATE: f/1-3/846 DESIGN Soil Rate Used JI Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms 1-7k rep Septic Tank Capacity 9 0 00 gals. Type Absorption Area Provided By —— L.F. x 24" width trench Other K%e 9ROFESSIONq� m `� Or „k Iris n a Name JOHN H. PRENTISS, P.E. Address RD9 FAIR ST 914- 878 -6170 SAME, NEW YORK i0mr. �O Pop. •29 0 E� THIS SPACE FOR USE BY HEALTH DEPAM= 0 Soil Rate Approved sq.ft /gal. Checked by Date ` U. F'(TITTFIM .COU UY DEPAFMMU OF HEALTH DIVISION Of ENVIRONMa1TALlHEALTH SEMCES~ - • INDIVIDUAL WATER SUPPLY & SUBSURFACE SEA DISPOSAL SYSTEMS -ces7 /Ij REVIF37 SHEET -- CONSTRUCTION PERMIT J - - _ DATE REVIEWED: _ . � :�•� -� (Name of Owner) (Street Location) arglam YES NO DOCUMENTS . Permit Application Corporate Resolution a" L/ Plans - Three' sets -- Engineers Authorization' �- Design -Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole House Plans - Two sets f If . PWS - Letter Variance Request REQUIRED DETAILS CN PLANS _Sewage System Plan Sewage System Hydraulic Profile - Gr4vity Flow Fill Profile & Dimensions - Volume D or J Box;Tren6 /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over f' Construction Notes Design Data Two --Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Arm.. 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 Looted Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° 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 100' to Stream, Watercourse, Lake (inc. ern). 15' to Drains- {irtain,Storm,Leader,Footing _ 25' to Catch Basin 10' to Water Line (pits -20') Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GEN�tAL Legal Subdivision .v}Subdivision Approval Checked Etc- approval SSDS Adj . Lots Checked (Town/DEC Permit R & D) Data On DDS Plans & Permit Same ✓ .. L� �i r _ e . � � _ f , 1 DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 _ ._.. ..:APPLI.CATION TO CONSTRUCT A WATER WELL PCHD PERMIT #_ fol _ G� //,,WELL Street Address Town /Village City Tax Grid Number L6JCATION Fair Street T. Patterson WELL pQniNER Name Address Private Kevin Curry Longview Road Carmel. ❑ Public USE OF WELL 02RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ❑ ABANDONED 1 - primary 13 BUSINESS O FARM ❑ TEST /OBSERVATION ❑ OTHER (specify 2 - secondary ® INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 M,jEST. OF DAILY USAGE 450 M %41 REASON FOR UNEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ® TEST /OBSERVATION DRILLING ❑ REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL DETAILED REASON FOR Residential Supply DRILLING WELL TYPE 13DRILLED DRIVEN ®DUG ®GRAVEL [:] OTHER IS WELL SITE SUBJECT TO FLOODING? YES K NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Sunny Acres Lot No. WATER WELL CONTRACTOR: Name Rex Hyatt Address: Rte. 311, Patterson, NY 12563 IS PUB11 C WATER SUPPLY AVAILABLE TO SITE: YES K NO NAME 01 PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTAN( TO PROPERTY FROM NEAREST WATER MAIN: LOCAT I(DT SKETCH & SOURCES OF CONTAMINATION PROVIDED (See Dwg. #1 Job #2339 By John H. Prentiss, ®ON REAR OF THIS APPLICATION 00 SEP E SHE P.E.) 22 October 1986 (date (signatu 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 Well Completion Report on.a form provided by the Putnam County Health Department. A Date of Issue: e?jC;o0L 2,g 19 Date of Expirationzlw —zs, 19� Permit Issuing icia Permit is Non - Transferrable IS WELL SITE SUBJECT TO FLOODING? YES K NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Sunny Acres Lot No. WATER WELL CONTRACTOR: Name Rex Hyatt Address: Rte. 311, Patterson, NY 12563 IS PUB11 C WATER SUPPLY AVAILABLE TO SITE: YES K NO NAME 01 PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTAN( TO PROPERTY FROM NEAREST WATER MAIN: LOCAT I(DT SKETCH & SOURCES OF CONTAMINATION PROVIDED (See Dwg. #1 Job #2339 By John H. Prentiss, ®ON REAR OF THIS APPLICATION 00 SEP E SHE P.E.) 22 October 1986 (date (signatu 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 Well Completion Report on.a form provided by the Putnam County Health Department. A Date of Issue: e?jC;o0L 2,g 19 Date of Expirationzlw —zs, 19� Permit Issuing icia Permit is Non - Transferrable ructure located from survey..by snfvoyor- notod Wolf located by: Surve yore ourvoy, 1golfidnNaro ropgrt - - • Enginoo.rb moour9monta� `� ,.,� a3;. ,�.. ,�..�,;; Tana. boaoa, pits,gallonoo B latorols lo•cati blr: - Er%$ CZ s �3`� °0 %�!� /OS•57� o Ho ®ifirdo,Qt _ WeLL ! Flolb Inspection by: Health dopf ® dato:'_ �d -� —4 , oO Enganoor $_ a t This is to �irtLfyhRChg °s <bd'r` dieposal system was.4onStRlreUJ ae - 1 1 NOTES: irlAcat.ed'bn thiA 131an �Bndr`, off 't21r. =' O 1' iov @ rcteThe ID 9 +waetcovered eyat vQrt`1 �.I-onstr"ted in.-accord anC at3 —� = standard rules and •reSUlahtye$ the' P.C.H.D. 6 the `.t� Y ' j.�Jv17e017"{ • I• .._ Dv✓GI�LI ¢D n i i' 3S `b I ME N SION s °�,AM'•`dr,�se� - A - D °-2L7/- 0'(-'s _ 0 0 0 $ erg A E B E -_� •291o'¢�.""i:c P0 . a�'r % _ = s - A F 1-1 S F - - , , _ .y a' ME SfRt4 x_• - 8 / Putnam Count iepacwuo..c uY heap - A - H °�g7- 6 - H ° -- �t --y/- �ivlelon of r^.ay.ircri.+c•r.? al IIoalth Servi t A - °� - �� ® - ° �fLL—GiALLF�{�� •t7 ++ + an Yc-r a, TdT l o _o o,C. ' Yg6AL— �/ ,/ +K ..ipprovr%! r.cica conformance wit i tpplicaLle };t:ias z.na Re�•,lationo of Putnam County Health Department.., = , 1 ! 4 CiOn gtllrn A Tit:l �� m00% TJe I T Y S l {J Ilk oo LOCATION S fro et:��_��2 Yean: tj glZ6-County: .lj / ✓i57: /'� StAfo V SVa01VI +S1O �� /vr�, L9��Se��C i9-s ---• P Me JQrK't;L 1`�a Block-. LOT N _�� ,q //2 S T 2 , Buddor �/� y ,z, 7 /� .-7. Droan:OO.Q• Dote: ;�_� _ Seale: �n -3a' J a;�'• 3g. JOHN H, PR ENTISS_PE °- - CONSULTING ENGINEER _ • i + ,1