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631- 589 -8100
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BOX 16
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01751
WMAMIDDUMID ZPAMMM . OFE iMiM:
/�`�� r ` ' DtaYn it -2
MY; low
ain a
FOR WWA= DISPOW SYSTM
TowM :of :-F
Lot 8 - Ice Pond. ViL-w Est atnz�4Y716.--W
- IF
7-
Ice Pond Estes . ,
1:7;AW, lilt-# 42-L
o Croniset, construction' RawwW-..�—O .,0
14"m
Daft d
9, Ryan D i,� Hopewell Jct, I
-TY 12533
ram Addrena Town.
;P P
Date Subdivision Aripr6ved Fee Enclosed'-E] Anj,,jjj
,,,R6sidential 1.837
T!M lw Am
FM
011k Yahttas
Design PCHO Nedbeadw Is RWMkM ilikelliill~
Flow G 4 D 600 4 W"
Some" SOWWW Symbin to CMWW d.. 1.00� GaMois Sqpda To* and 500 11' OfS
UWner as
i above
We
U'be: by
Ad&vn
Wider SVIPjFVS' F-- &**'Flees Addrefa.
rin --ft 11,l ft sq,* p," by To .Be Deter—Minadd.
Odw Raqzkeniiiiift
I represent',that I am wholly and cornple�tely responsible for the design and. location of the proposed system(s); 1) that .the
mte saw disposal system
above Am
described will 64 Constructed as- shown on'the ajpprovei arnendment there to and in accordance with the standards. rules ns 0, wtMm
Cou Y- Department - of Plailit, and'that an Corniiatioa.theriof a--Certifitaie of Construction Compsiincw' satisfactory! to.the Commissioner of'Healthwill
be. submitted to the.bepaorlir' *6'11 :be furnished the "ner, his successors; heirs or assimns by the bulkier that said builder will
fiieca nent. a written que4ritee
in Void operating condition any, It sbid systifn during ,the Pori" Of two (2) yews Immediately 'following thedate of the Iseu-
Sri$ of the, app►evol or'. the Car tificate":1 C0.`nikr-U-dl6n.CbM . plishce of the original system or any repairs -drllkd w4if described above
Wereto; 2) that the.
WiN be located as shce" on tM at proved. plan and that saldmeli'will be installed i dance with M_e sta ndard% rules aid rag- Eons of the Putnam
County rt, IF
70*719 0
017 Sioned
Date 9 1 3 P.E. X R.A.
Addren . Day OsW4;d,-`854J route 52 Beacon, Tj j,sl 2OB 0.69646
- 5J
nso No
APPROVED FOR CONSTRUCTION. app► ovalaipiras tw;.,iars ;from .the data issued unless construction of the building has been und'artaken and is
nIVOCIII)IS for Cause or maybe amended -oi modified when considered n ry'by !00 Commftsionir of Health. Any cha , nge or'alteratibn of construction
'Course Ismoved for disposal of domestic sans ivate only.
Rev.
ev Tit
.LVI 00
35 _ � -10
a
v
r ��" j
TELECOPY COVER SHEET
DATE:, December 9, 1994
TO: Mr. Wardell
FAX NUMBER: (914) 381-1038
FROM: Anne M. Bittner
PAGES- 2 (INCLUDING COVER SHEET)
MESSAGE:
FAX NUINMER- (914) 278-6085
Attached is a tabulation of data from well logs on file in your neighborhood. If you have any
furtfie'r questions, please call me at this office. Good luck!
In the event of transmission/reception difficulties, please contact our office
at (914) 278-6130 ext. 167.
TABULATION - O 'wELL DEPTHS °AND -YIELDS IN THE-- VACINI OFD -- , -..
ANDREA PLACE, PATTERSON, NEW YORK
LOT #
1
2
3
4
5
7
21
1
2
4
7
9
13
17...
18
31
ICE POND VIEW SUBDIVISION
DEPTH (FT) DRAW DOWN (FT) YIELD(GP"
605
40
5
1000
5
1165
85
5
285
30
5
685
5
6
545
100
5
225
40
6.5
STEINBECK ESTATES SLBMISION
465
30
7
205
15
900
30
5
325
5
45
425
3-4
15
300
?0
700
_....3�. __...::.:_..
5.
..... _ ..- .'30.......
125
,.
280
35
60
j I WILL HAND DELIVER MYSELF
PLEASE SUBMIT TO THE SPECIFIED DEPART: T FOR HE
SIGNATURE
TO:
APPLICATION FOR PUBLIC ACCESS TO RECORDS
REMD ACCESS OFFIC R DATE:
y�, 4
N me.of Agency JOSEPH L. PELOSO, JR., ,PUBLIC
Address
I HEREBY APPLY TO INSPECT THE FOLLOWING RECORD:
Sigfacure
Rep r sentinj
_
... Mailing Address
INFORMATION.OFFICER
FOR AGENCY USE ONLY
v
Da t e
7Z41
PROVED
D IED
Record of which this agency is Legal Custodian cannot be found.
• Record not maintained by this Agenc
L
Signature ' Title Date
Y
NOTICE: YOU HAVE A RIGHT TO APPEAL A DENIAL OF THIS APPLICATION TO THE PUTNA`i
COUNTY EXECUTIVE.
Name Business Address
WHO MUST FULLY E.t?LAIN HIS RE.ASONS FOR SUCH DENIAL IN WRITING SEVEN DAYS OF RECEIPT
OF AN APPEAL.
I HEREBY APPEAL:
Date
. ._. .. �...� _ .1 r. �...:�. t .... . �. � . � � • _ _T - y • �- ......� �. .< � [r .�..•r _ t;. .a .... � w .. e.. • r - N.•4T_ .. •L. :-_. t .m.t..w• ♦� r_ v
(/r •_
J
fv /
t I'LL
�
Ze
COMPLETION REPORT
RT
Office Use Only
-DEPARTMENT OF HEALTH
Division Of invir6nmetital Healgh'gervice's
PUTNAM COUNTY DEPARTMENT OF HEALTH
__Irk
4r'.:
z TAX GRID h"E&_
WELL
W
R
A
Andrea 'FMce;Patt0r8on Jr®� 91--
j
WELL OWNER
' A 0 GRESS:
Aser
❑ P91VATE
0 Cons't. C orp...9,Ryan Dr., .Ho" Jet., KY ,12533
n Fueuc.:=
USE OF WELL
D PUMP BANDONED
6 b O'd b L 16 SUPPLY OP L Y U _ 61CON EAT_ '0 A
I -primary
'j3 BUSINESS ❑ FARM TEST /OBSERVATION 0 btHb (specify)
2 -secondary
❑ INDUSTRIAL b INSTITUTIONAL 0 _S"TAN 0-8
AMOUNT OF USE
YIELD SOUGHT .-5 gprn.INO. PEOPLE' SERVED. T. 01 F'_ 6 A I L j 50 gail.
YJUSAGE �. A_
REASON FOR
El NEW SUPPLY ❑ PROVIDE ADDITIOhAl. SUPPLY :0 TEST/OBSERVATION
DRILLING
❑ REPLACE b(JSt!NG SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 600 ft.
STATIC WATER- LEVEL !L6_L'_i7DATE
MEASURED 11/30/93
DRILLING
❑ ROTARY (2 COMPRESSED AIR PERCUSSION . ❑ DUG
EQUIPMENT
❑ WELL 501NT ❑ CABLE PERCUSSION ❑ OTHER
WELL TYPE
❑ SCREENEII ❑ OPEN END CASING r&I OPEN HOLE IN BEDROCK ❑ OTHER
TOTAL LEUGTH 45 tL
MATERIALS: -43 STEEL ❑ PLASTIC ❑ OTHER
CASING
LENGTH BELOW GRADE 44 tL
JOINTS: 0 WELDED .13 THREADED 0 OT H EIR
DIAMETER... 6 in.
,
SEAL: -0 CEMENT GROUT El ❑ BENTONITE OTHER
DETMLS
WEIGHT PER FOOT 17 lb./ft.
I DRIVE SHOE. 0 YES ❑ N 0
,L!Nlj:b YES 2 NO
SCPk-EN
.-DWAETS rin)
'SLOT SIZE
LENGTH
(ft)
DEPTH TO SCREEN (it)
:_'DEVELOPED?,.--
MST
0 .-YES- -0 No -.
DETAILS
SECOND
HOURS
GRAVEL PACK
'3 YES
GRAVEL
TOP
BOTTOM
10 NO
.
OF PACK in.
OEM fL
OEM IL
WELL YIELD TEST if detailed pumping
IWELL LOG
11 more detailed formition descriptions or sieve analyses
are available please attach.
METHOD: 0 PUMPED
19 COMFRESSEdAIR'
it tests were done �s.h,
f0fiiatiOn af6ic* hed7
-DEPTH FROM
_SURFA
wat�j
Well
Dia.
O'BAIL0 0 OTHER' 0 YES ❑ N,
gar.
ing
In
DESCRIPTION
FDRM
Me
134.
WELL DEPTH
DURATION
DRAWOMM
�MELD
Larkd
suriace
34
_Overburden
IL
hr. mh
fL
qpm
�34
600
j
:6.
Granite
t' fiOO
5
WATER 0 CLEAR
TEMP.
QUALITY 0 CLOUDY
HARDNESS
0 COLORED
ANALYZE4 OYES C)No
ANALYSIS ATTACHED? 0 YES ONO
STORAGE TANK: TYPE WX-250
CAPACITY GAL. 44
PUMP INFORMATION
TYPE Submersible CAFAM 5.
WELLORILIJUINAME J. T. Eckerson, Inc. DATE
. . 12/14/93
MAKER Goulds
5ES
MEATH 580
I
ADDRESS 1613 Route 9W _200MR . x
Milton, NY 12547
MODEL
—'VOLTASE_L30 Hp
Vice President
4r'.:
TABULATION OF WELL DEPTHS AND YIELDS IN THE VACIIYITY'OF
ANDREA PLACE, PATTERSON, \TW YORK
ICE POND VIEW SUBDIVISION
LOT #
DEPTH (FT) DRAW DOWN, (FT)
YIELD(GPM)
1
605 40
5
2
1000
5
3
1165 85
5
4
285 30
5
5
685 5
6
7
545 100
5
21
225 40
6.5
STEINBECK ESTATES SUBM'ISION
1
465 ; 0
7
2
205 l;
l:
4
900 30
5
7
325 5
45
9
425
15
13
300 25
20
17.
_..700 �., -
...
18
125
30
31
280 35
60
REGISTERED MAIL
RETURN RECEIPT REQUESTED
I
Date 9/10/93
-----------------
Building Inspector
Mr. Frank Blasi
-----------------------
Town of Patterson
Town Ball
Route 164 & 311
Patterson, NY 12563
Re: Construction Permit for single family
residence
Applicant -- -
Croniser Construction
---------=--------------
Street °lames---------- - --
Town Jtersoa----------- - - - - --
Th# --------------------- - - - - --
Dear --1'•Ir. -Blasi :
------------ - - - - --
This Firm (I am) submitting an application to construct a sewage disposal system
serving a single family residence on the above captioned property, to the. Putnam
County Department of Health. In order to process this application the Health
Department requires that the following information be obtained from your office:
1. Prior to your issuance of a building permit
A) Is Zoning Board approval required for any variances?
Yes No
-- - - - - -- --- - - - - --
B) Is any portion of the parcel located within a regulated vetland or its
control area, and if so is a vetland permit required?
Yes-- - - - - -- NO --- - - - - --
C) Is any other local permit or approval necessary?
Yes - - - - -- - No -- - - - - --
If the answer to any of the questions above is yes, please contact the Health
Department in vriting or by phone, 278 -6130 within 15 days of the date of this
correspondence. If the answer is no, you need not respond to this
correspondence.
Name Mrj_Bi21-H2jzes___
Health Department Inspector
JK /jp
vetland bb
Very truly yours,
M k A. Day, PE
Engineer,,
REGISTERED MAIL
RETURN RECEIPT REQUESTED
Building Inspector
Mr. Frank Blasi
-----------------------
Town of Patterson
Town Hall
Route 164 & 311
-
Patterson--NY _ 12563__
Dear r'ir. Blasi:
--------------- - - - - --
Date 9/10/93
----------- - - - - --
Re: Construction Permit for single family
residence
Applicant __-roniser Construction
------=----------- - - - - --
Street Ap�eea mil- ass------- - - - - --
Town - 7�Secsca---------- - - - - --
THt
--------------------- - - - - --
This Firm (I am) submitting an application to construct a sewage disposal system
serving a single family residence on the above captioned property, to the.Putnam
County Department of Health. In order to process this application the Health
Department requires that the following information be obtained from your office:
1. Prior to your issuance of a building permit
A) Is Zoning Board approval required for any variances?
Yes -- - - - - -- No --- - - - - --
B) Is any portion of the parcel located within a regulated wetland or its
control area, and if so is a wetland permit required?
Yes No
-- - - - - -- --- - - - - --
C) Is any other local permit or approval necessary?
Yes- - - - - -- - ., No -- - - - - -_
If the answer to any of the questions above is yes, please contact the Health
Department in writing or by phone, 278 -6130 within 15 days of the date of this
correspondence. If the answer is no, you need not respond to this
correspondence.
Name
Health Department Department Inspector
JH /jp
wetland bb
Very truly yours,
Mark A. Day, PE
Engineer,x '�� :0"
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NJ.
s
owner Cron -iser_Construction, Address 9•Ryan Drive, Hopewell Junction, NY 12533
Located at (Street) Andrea Place Sec. Block Lot 791
(indicate nearest cross street)
ftm cipaiity Town of Patterson Watershed
Date of Pre - Soaking 9/1/93
Date of Percolation Test 9/2/93
HOLE
33
24
27
NOMEOR C T TIME
P RC O=CN
3 9:18 -10:23
PERCOLATION
Run Elapse
Depth to Water From
Water Level
21.7
No. Time
Ground Surface
In Inches
Soil Rate
Start -Stop Min..
Start Stop
Drop In
Min /In Drop
Inches Inches
Inches
18:W-8:43 13 24 27 3 4.33
2 8:44 -9 :17
33
24
27
3
11
3 9:18 -10:23
65
24
27
3
21.7
4 10:23 -11:29
66
24.
27
3
22
5
1 8 P 35� :'S3
18
24
27
3
6
2 8155 -9:49
54
24
27
3
18
3 9:49 -11:16
87
24
27
3
29
4 10:53 -12:26
93
24
27
3
31
3
4
5
NOTES: 1. Tests to be repeated' at 'same depth until appradz tely equal soil rates
are cbtained.at each percolation test hole. All data to'be submitted
for review.
2. Depth measurements to be made from top of hole.
ray. 9 /RS
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO.
0 -4" Topsoil ;..0 -4!1.-- Topsoil
G.L.
1' Sandy Clay Loam
Clay Loam
2' Clay Loam
Clay Loam
3' Clay Loam
Clay Loam
4' Clay-Loam
Clay Loam
51 Clay Loam
Clay Loam
61 Clay Loam
Clay Loam
Clay Loam
Clay Loam
7'
Clay Loam
Clay Loam
8'
9'
10'
12'
13'
14'
_........� - -. INDICATE :.LEVEL,_AT...WHICH- _GROUN0WA=.
IS .ENCOU@i'I'ERED - -.-... D1one Encountered.
INDICATE LEVEL TO WHICH WATER LEVEL
N/A
RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY:
lurk A. Day, PE Dom: 9/2/93
DESIGN
Soil Rate Used 31 Min/1" Drop:
S.D. Usable Area Provided 6000 s.f.
No. of Be3roccrts 3 Septic Tank Capacity 1000 ga: = T�_ concrete
500
Absorp`ca r=--aa r c=ited B
L.F. X 24w width trench
Othe 7' Deep Curtain Drain
Name Barger, Day & Oswald Sigrat=e
Addr 894 -J Route 52, Beacon, NY 12503 X, A
ess
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ,q�oFss�p�lt*�
Soil Rate
Approved sq.ft /gal. - Checked by Date
r
P UTNAM COUNTY D E PARTMENT O F HEALTH
APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
1. Name and Address of Applicant:
Croniser Construction
9 Ryan Hrive
Hopewell Junction, New York 12533
2. Name of Project: Ice Pond Estates — Lot 8 3. Location T/, Patterson
4. Project Engineer: Barger, Day & Oswald 5. Address: 894J Rte 52,
Beacon, New York 1 2508
License Number: 069646 Phone: 914 - 838 -2020
6. Type of Project:
Private /Residential Food Service Commercial
Apartments Institutional Mobile Home Park
-Office Building Realty Subdivision Other (specify)
7. I.s this project subject to State Environmental Quality Review (SEQR)?
Type Status (Check One) Type I.. Exempt
Type II. Unlisted X
8. Is a Draft Environmental Impact Statement (DEIS) required? No
N/A
9. Has DEIS been completed and found acceptable by Lead Agency? ...........
N/A
10. Name of Lead Agency
11. Is this project in an area under the control of local planning, zoning, Yes —Bldg. Dept.
orother officials, ordinances? ........................................
12. If so, have plans been submitted to such authorities?
13. Has preliminary approval been granted by such authorities? Date Granted:
14.
Type of Sewage Disposal System Discharge......
Sub- Surface Water
6ti'lii
15.
If surface water discharge, what is the stream
class designation ?.... .....
N/A `t
N/A .
6.
Waters index number (surface) ............................................
7.
Is project located near a public water supply system?
..................
N/A .
N/A .
8.
If yes, name of water supply
Distance to water
supply
_
N/A '.. `.
9.
Is project site near a public sewage collection
or disposal system ?.....
0.
Name of sewage system N/A
Distance to sewage
system N/A
1. Date observed: 23. Name of Health Inspector:
500 GPD
... .,... ........
4. Project design flow (gallons per day) ....................
40. 11 04440 ruIIUI.GII I I, NIQI.I InI•yC C I I III 111al. I NII ur -2L.%m �%jrw%.%jj .c.. u.... .- 4........
26. Has SPDES Application been submitted to local DEC Office? N/A
27. Is any portion of this project located within a designated Town or State No
wetland? .................................. ...............................
1'1 /A
28. Wetland ID Number ........................ ......................•........
29. Is Wetland Permit required? .............. ...............................
Has application been made to Town or Local DEC Office? ..................
30. Does project require a DEC Stream Disturbance Permit? ...................
No
N/A
0
31. Is or was project site used for agricultural activity involving application
of pesticides to orchards'or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ........ YES or NO No
32. Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or No
any other potential known source of contamination? ..............YES or NO
DESCRIBE:
33. Is there a local master plan or file with the Town or Village? ....... No
34. Are community water, sewer facilities planned to be developed within 15 years? No
35. Are any sewage disposal areas in excess of 15% slope? .. No
36. Tax Map ID Number .......................................................... 791
37. Approved Plans are to be returned to: ................ Applicant x Engineer
--if {.f hG ti{:Ip i i Cat i Ol' u 1-i'.,ant' Sh wn• n
application must be accompanied by a Letter of Authorization. Failure to comply with this
provision may be grounds for the rejection of any submission.
I hereby affirm, under penalty of perjury, that information provided on this .
form is true to the best of my knowledge and belief. False statements made
herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of
the Penal Law.
SIGNATURES & OFFICIAL TITLES:
MAILING ADDRESS:
ting Engineers
Barger, Day &Oswald 894J Rte 52, Beacon, New York 12508
V �9-o �''
C yM T.
PUTNAM COUNTY DEPARTMENT OF HEALTH
�-.._.. <.._, DIVISION OF ENvIRONMENTAI;-<`HEPLTH SERVICES
Date 9/10/93
Re: Property of Croniser COnstruction
Located at lot 8 - Ice Pond View Estates
(T) 791 Section
Subdivision of Ice Pond View Estates
Block
Lo t
Subdv. Lot # 8 Filed Map # 2403 Datel /11/83
Gentlemen:
This letter is to authorize Mark A. Day of Barger, Day & Oswald
a duly licensed professional engineer X ) CXdC bf "M0Cx CiX=t= XXXXX
(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 witli -this matter and to supe`rvise'tfie�const'ructiori -oI`�'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-
tary Code.
Very truly yours,
Signed
Countersigned: Owner of Property
9 Ryan Drive
P.E., R.A., # 069646 Address
014- .R3Q-2020
Telephone
Hopewell Junction, New York 12533
Town
914- 221 -1802
Telephone
DEPARTMENT OF HEALTH
Division of Environmental Health Services �b
110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310
APPLICATION TO CONSTRUCT A.WATER WELL
PCHD PERMIT #
WELL LOCATION
Street Address Town/Village/City Tax Grid Number
Andrea Place, Patterwon 791
WELL OWNER
Name
Croniser Const.
Mailing Address
Corp., 9 Ryan Dr.,
®Private
Hopewell Junction, NY 1253l}Public
USE OF WELL
1 — primary
2 — secondary
® RESIDENTIAL
® BUSINESS
® INDUSTRIAL
® PUBLIC SUPPLY
O FARM
U INSTITUTIONAL
O AIR /COND /HEAT PUMP ® ABANDONED..
O TEST /OBSERVATION O OTHER (specify
O STAND -BY
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE
SERVED /EST. OF DAILY USAGE gal
REASON FOR
DRILLING
O REPLACE EXISTING SUPPLY. O TEST /OBSERVATION 13 ADDITIONAL SUPPLY
® NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
New Home
WELL TYPE
DRILLED
®
DRIVEN
®DUG
LJGRAVEL
OOTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Ice Pond View Estates Lot No. 8
WATER WELL CONTRACTOR: Name J. T. Eckerson, Inc. Address: Mi ton, NY 12547
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
D•IST":NCE -TO PROPERTY FoOM- :E�'1P.EST.L ►AmEp.. * *,�,I.:.; .._.._.. _ _..,..._.,. _..._... .: -
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED File Map 2403
O ON SEPARATE SHEET
10/14/93 Vice President
(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
Department attached to this permit.
3. Submit a Well Completion Report on a form
requirements of the Putnam County Health
provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a manner as not to degrade or otherwise contaminate surface or groundwater.
Date of Issue:
Date of Expiration
19
19
Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
<.• APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT 4 7L�
WELL LOCATION
Street Address 1j,,UD2e�-`f, Town Village City
Lot 8 - Ice Pond View Est Town of Patterson
Tax Grid Number
WELL OWNER
Name, M3ilin Address IRPrivate
Croniser Construction �3 Ryan Drive, Hopewell Jct., NY 12533 O public
USE OF WELL
1 - primary
2- secondary
(A RESIDENTIAL D PUBLIC SUPPLY Q AIR /COND /HEAT PUMP ❑ ABANDONED
O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify
D INDUSTRIAL O INSTITUTIONAL O STAND -BY Q
AMOUNT OF USE
YIELD SOUGHT S gpm /# PEOPLE SERVED 6 /EST.
O REPLACE EXISTING SUPPLY O TEST /OBSERVATION
NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL
OF DAILY USAGE 450 gal
16 ADDITIONAL SUPPLY
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
In order to provide water for a new house.
WELL TYPE
®DRILLED
DRIVEN
[]DUG
GRAVEL.
0
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Ira Pond Viavt FGtates Lot No. 8
WATER WELL CONTRACTOR: Name To Be Determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY N/,�
^T TO PROPERTY FRO'r1 t",A ^�ST *ATER i3AZ: �/A DISTE1
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
9/10/93 Q ON SEPARATE SHEET
Q/
(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
third, (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.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a anner as not to degrade or otherwts'e contamin to surface or groundwater.
Date of Issue: 6'� �'a 19
Date of Expiration 19 C� Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
wt►1 4odifiea Ion or Monte when in tM;luegmsn4 "o1 the Commlubna of'lleel4h, fi+eh ►evoeetbn; �notlNlcetbn or ohen0e It rifteetpryr.
3/89 woe`s', T14»
S Q!d
ZOADDO-x. C
Y�4
WELL GUMYLh*11ULV ZLrUAI
DEPARTMENT OF HEALTH
Division Of Environtiienta H�a1it�t3s'
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
�-�
WELL LOCATION
STREET AD HESS: WNIVII l Y, ,�/ TAX GRIO NUMBER:
Andrea Place, Patterson _225 . —yQ 791
WELL OWNER
ADDRESS:
Croniser Const. Corp. 9 Ryan Dr., Hopewell Jct., NY 12533
❑ PRIVATE
❑ PUBLIC
USE OF WELL
1 - primary
2 - secondary
El RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL 0 STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 6 / EST. OF DAILY USAGE 450 gal.
REASON FOR
DRILLING
El NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION
❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
` WELL DEPTH 600 ft.
STATIC WATER LEVEL 51611 ft.
DATE MEASURED 11/30/93,
DRILLING
EQUIPMENT
O ROTARY CR COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
O SCREENED ❑ OPEN END CASING. ®OPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH 45 ft
MATERIALS: 4:1 STEEL ❑ PLASTIC ❑ OTHER
LENGTH.BELOW GRADE 44 ft.
JOINTS: O WELDED ® THREADED ❑ OTHER
DIAMETER 6 in.
SEAL: '0 CEMENT GROUT 0 BENTONITE ® OTHER
WEIGHT PER FOOT 17 Ib_ /ft_
DRIVE SHOE: ® YES ONO LINER: O YES ®NO
SCREEN
Dc fr11t•J
DIAMETER (in)
SLOT SIZE
LENGTH
(it)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST:_ . -._
- .....
-
HOURS
SECOND
GRAVEL PACK
0 YES
® NO
GRAVEL
SIZE
DIAMETER
OF PACK in.
TOP
DEPTH ft.
BOTTOM
DEPTH It.
WELL YIELD TEST ; If detailed um in
P 9
P
METHOD: O PUMPED tests were done is in-
® COMPRESSED AIR , formation attached?
❑ BAILED 0 OTHER ; O YES O NO
/ELL LOG It more detailed formation descriptions or sieve analyses
are available, lease attach.
.DEPTH FRO!+
SURFACE
Water
Bear-
ing
Well
0'a-
,peter
FORMATION DESCRIPTION
CODE.
ft,
ft.
WELL DEPTH
It.
DURATION
hr. min.
DRAWOOWN
It,
YIELD
gpm.
Surface
34
Overburden
34
600
x
6
Granite
600
.5#
WATEP 0 CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
O COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES O NO
STORAGE TANK: TYPE WX -250
CAPACITY GAL. 44
PUMP INFORMATION
Submersible 5
TYPE CAPACITY
MAKER Goulds DEPTH 580
MODEL 5ES VOLTAGE 230 HP 1
�
WELLORILLERNAME J. T. Eckerson Inc. DA12/14/93
AOORESS 1613 Route 9W SIGU;XMRE
Milton, NY 12547 ✓!�"7��,
Vice President
_ P, 02
i;
'AMO LABORATORIES,
POUGHKEEPSIE, NEW YORK 12601
)DOH #70310 Tel. (914) 473.9200
,t Cert.: PH -0593 Fax (914) 473-1902
BACTERIOLOGICAL EXAMINATION OF WATER
Mail To: _ f!P`( J e,
op
Bottle No. !`" Date Colyd _Time f✓ Time Submitted —
Ml. sample SPC
Job No. CAMO Log No. 4cility Type _ _ Bacteria Count
Tests Requested �t u, t- 1. w` 1'i L e. Refrigerated? ML Sample Membrane
Collform Count!
Coll'd by: _ t —.Agency Coll'd for Fecal Count _
�. l j .1 } f' �-^� � � Time Time
Identification of Source: t I f R i $elephone #: � °'�•G• Setup I� Read _
r,�.... — Date
.hpling Point: se: y� _ Sample Reported by:
Supply Chlorinated When Sampled: YesX No ❑ Free Comb, pH _
RESULA0 0-F-ExAMiNATi'0N- 7i= WATER ;_ ..
MPN /100 ml. MEMBRANE FILTER METHOD /100 ml. MEMBRANE FILTER METHOD /100 ml.
Col iform Group Total Collform: Not Present
Fecal Collform
Total Coliform: Present' ( )
Fecal Collform _ STANDARD PLATE COUNT
Fecal Coliform Indicated:
Yes ( ) No ( )
Bacteria per ml.
These results indicate sample was,' . as not) of satisfactory sanitary quality.
Date Reported: Amount Paid: _ r
Reported By: �a' _:% rfi erx f,�••._,, Amount Due:
Client Notified: Check Number: { —
COMMENTS:
PUTNAM COUN'T'Y DEPARTMENT OF HEALTH
,. __
....:: . ... ..rr ..- ..... -�.:. .:n r..-. HEAL
Ll V 1.�lULV � Ul � rlV V l.L�lJiVi 1L',LV 1 tl���in
Croniser Construction
Owner or Purchaser of Building.
Croniser Construction
Building Constructed by
Location - S t .2`
New York _
Municipality
2 Story Colonial
Building Type
3
Section Block Lot
791
Ice Pond View Estates
Subdivision Name
Lot #8
Subdivision Lot #
GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it has been constructed as shown on
the approved plan or approved amendment thereto, and in accordance with the
standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good
operating condition any part of said.system constructed by me which fails to
operate for a p riod cf two years i=edi.ately following the date of approval o_ f the
"Certificate of Construction- Compliance" for the setaage 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 Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful or negligent act of the occupant of the building tilizin
the system. /j / '/
Dated this 15 t h dqv of F,
Croniser Construction
Corporation Name (if Corp.)
1994
- Signature
9 Ryan Drive, Hopewell Junciton, NY
Address
rev. 9/85
ink
Signature
Title
Croniser Construction
Corporation Name (if Corp.)
9 Ryan Drive
Address
12533 Hopewell Junciton, NY 12533
JOMARDAV CORP., �.
602 604 606 \8
• 600
598 R
58 588 590 .592 594 E /
.4 :
S6 94.51'
/ •47'38 606
17 6.27
S58'04'0 0 "E �� =- S�7'28,a�
26
.7
604
1 00 GALLON SEPTIC T.x
- -; \ STREAM
/ \
STONE.
'4„ 0 PVC 15' (MIN.) OF WALL \ 604
4" 0 CAST IRON
PIPE ® 2% SLOPc ��
100% EXPA SION �/�
PIPE P ® 1% �W'
O AREA i \�
06 i i FOOTING DRAINS
i TO DRAIN.AWAY
FROM SSDA.
LOT NO. 9
PsEM 606 ICE POND VIEW ESI ATES
°; FILED MAP N0. 403
/Q6 E P v� 'IS T. BOX h
/ = 1 837 ACRES-+ \--, �
D6 X-1
r.
598
= 325.00' L =2
600 NDREA PLAICE
604
{{' SEPTIC TANK
606 / ,,, ' h X608 HOUSE I,
/ � /�, ,�''� � / "610 � ;, � •�
N85'57'59"V`l�j 608 �-�_`•
14.00' THERE ARE NO SSDA's
EITHER EXISTING OR 15' MIP,I. 4" DIA. C.I.P.
PROPOSED WITHIN THE
SITE PLAN 1 DIRECT LINE OF DRAINAGE
FOR THE PROPOSED WELL.
1' = 40';.
r.
i2
.I 4}
'I is
I.
1;