Loading...
HomeMy WebLinkAbout1873DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36. -3 -10 BOX 17 01873 .. T MahTl L ' 4 01873 Rev. .3186 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Mast Provide P— 3 9 8 6 - -- �� P.C.H.D. Permit Ij- CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM _ Patterson " Town or Village Located at East Branch Road Tax Map 67 Block 1 Lot 2 Owner /applicant Name Michael Davies Formerly Subdivision Name Subdv. Lot N Mauing Addroas East Branch Road, Box 312 Zip 1.2563 Date Permit Issued 7/8/86 Patterson, New York Separate Sewerage System built by Robert Brill Address M i l l e r St. , R R 2, Box 506, Consisting of 1250 Gallon Septic Tank and 1, 0 0 0 :,­gal. septic tank Pawling, NY Water Supply: Public Supply From Addresa ors x Private Supply Drilled by Hyatt Address Patterson, NY Building Type Single Fam. & 2 Bedr. Garage Has Erosion Control Been Co4npleted? Y , •, ON o Number of Bedrooms 5f 2 Has Garbage Grinder Been Installed? Other Requirements I certify that the system(s) as listed serving the above premises were of which are attached), and in accordance with the standards, rules and Putnam Cou y De /rent ealth. essentially as gbpwn on_tV plans of the completed work ( copies , in acl;oX4hn a 7p aA, and the permit issued by the Date Certified by 4CGT / &116t;S1E— (P.E. R. A. le 7 Address Baldwin & Cornelius, P.C. ,Brews er, NYLIcense No. �� Any person occupying premises served by the above system(s) 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 null and void when a public water supply becomes available. Such approvals are subject too modification or change when, in the Judgment of the Contmisslonerrooff HH Ith, suychhrrevocation. modification or change Is necessary. Date /', ire 4 _3. /7-D 2 g/��� �2�G / �i� � Title ` y� PUTNAM COUNT t DEPARTMENT OF HEALTH Rev. 3186 a l 1%� r' Division of Environmental Health Services. Carmel, N.Y. 10512 Engineer to Provide Permit N % ( on CERTIFICATE OF COMPLIANCE CUNSTRUt1TI0N PERMIT FOR ! GE DISPOSAL. SYSTEM. . _ Permit # I, ,twist East Branch Road Patterson Town or Village Subdivision Name Subd. Lot # Tax Map 67 Block 1 rot 2 Owner/Applicant Name Ann & M i c h Q e1 Davies Renewal_ ❑ Revision ❑ Date of Previous Approval MalljmgAddress East Branch Road Box 312 Town Patterson zip 12563 Building 1�pe6 -� C roX„yr �rw�tyt Z2- aal 4i Fill Section only Depth volume Number of Bedrooms 5 a n d 2 Design Flow G /P /D 14 0 0 PCHD Notification is Required When FIB Is completed Separate Sewerage System to consist of 1 2 5 0. Gallon Septic Tank and 1000 gal septic t a n k > L�vi� To be constructed by To be determined Address Water Supply; Pdbllc Supply From Address or: X Private Supply Drilled by T o b e d e t e r main &Asi Other Requirements 1 represent that 1 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 an regulations o e Putnam 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 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 d ing the per.od of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the inal syste r any pairs a to; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be Inst 1 actor h X st s rules and regu ads of the Putnam County Department /off Health, Date Date (6'_ `e— yf /_ Signed P, E. R.A.— Address - C. L ense No APPROVED FOR CONSTRUCTION: This approval expires Un m the to su d unless constructto of the building has been undertaken and is revocable for cause or may be amended or modified when co essary t e mmissioner�o Health, Any change or alteration of construction requires a n w er ,t, Approved for disposal of domesti wag tl/ r pri to we r w ply on ;URVEY RIFF N ,12-50 GAL � SEPTIC TANK 9 'Owe o T S.S.DS. PLAN SCALE: I"=Po' - .o� °� mod; AN I - 5 BDRM HOUSE LOCATION PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -WFLL- COMPLETION RE-P -ORS' Well Location Street Address: rd 9n Town/Village: f Tax Grid # Map Block Lot(s) Well Owner: Name: Address: P1 0 P_ i� i :N 2L cd S Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing _X Open hole in bedrock _ Other Casing Details Total length ft. Length below grade �20 ft. Diameter % in. Weight per foot j�Ib /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: X Cement grout — Bentonite Other Drive shoe: _X Yes _ No Liner:_ Yes _X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First — Yes—No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours � Yield m Depth Data Measure from land surface- static specify ft) 29 4J' During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve anal ses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land surface t f l - If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information (� O Pump Type 4t r-. Capacity Depth 660 Model Voltage XO HP Tank Type XJ& f Volume 6 Date We I Comple ed 7P7/97, Putnam County Certification No. OD7 Date of Report 7 Well Driller (signature) M�r4,v' lmyrh: EX ct location or well wan alsiances w at teasL Lwv penna[ 111 ►a11,111dM5 W UO FI V Y�I }LLGu Vll a JN�Ia=aaGr•���r - =�= �,% Well Drilller's Name !� "�"`J4� ' , Address: l 6 + c7k 1( f //C rsS . 1 Signature: Date: _7 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 . T ". MV DEPARTMENT OF.HEALTH -Services- PUTNAM COUNTY DEPARTMENT OF HEALTH —1v Office Use Only ggHealth WE, LL LOCATION STREET ADDRESS: 70N, 710 013 11, W GRID NUMBER:'- bra. WELL OWNER NAME: ADDRESS: PBIVATE ❑ PUBLIC USE OF WELL 1- primary 2 - secondary RESIDENTIAL 0 PUBLIC SUPPLY ❑ AIR/CO ND./HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM' OJESTIOBSERVATION ❑ OTHER (specify) C3 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY - ❑ AMOUNT OF USE YIELD SOUGHT gpm./NO.- PEOPLE SERVED EST. OF DAILY USAGES 0_0 gal. REASON FOR DRILLING NEW SUPPLY 0 PROVIDE ADDITIONAL SUPPLY 0 TEST/OBSCERVATION ❑ REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 70 ft. 1 STATIC WATER LEVEL �trItTDATE MEASURED DRILLING EQUIPMENT 0 ROTARY KCOMPRESSED AIR PERCUSSION ❑ DUG 0 WELL POINT ❑ CABLE PERCUSSION 11 OTHER (specify): WELL TYPE 0 SCREENED ❑ OPEN END CASING OPEN HOLE IN BEDROCK 0 OTHER CASING TOTAL LENGTH ft. MATERIALS: STEEL 0 PLASTIC ❑ OTHER LENGTH.BELOW GRADE ft. JOINTS: * ❑ WELDED k(THREADED 0 OTHER DETAILS DIAMETER '— in. SEAL: [9CEMENT GROUT ❑ BENTONITE 0 OTHER WEIGHT PER FOOT 1 1b./ft. I DRIVE SHOE MES ❑ NO LINER:0YES NO -SCHEEN DETAILS —` DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? .'- -FIRST­- _Q YES HOURS SECOND GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE. DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM OEM it. WELL YIELD TEST 'If detailed pumping MVHOO; 0 PUMPED 1 tests were done is in- 19 COMPRESSED AIR formation attached? 0 BAILED 0 OTHER 0 YES ONO WELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. -DEPTH FROM SURFACE Water Bear- ing Well Oia` meter In FORMATION DESCRIPTION CODE. WELL DEPTH ft. DURATION hr. min. DRAWDOWN ft. YIELD 9pm. Land surlace 85 YOO .36 70 .-70 0 6rg n i te, WATER ❑ CLEAR TEMP. QUALITY 0 CLOUDY HARDNESS ❑ COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? OYES ONO STORAGE TANK: TYPE CAPACITY" GAL. WELL DRILLER NAME BAT, ADDRESS SIGOXTURE C2193h 9 e rson PUMP INFORMATION TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE — HP_ PUTNAM COLWY DEPARTMENT OF HEALTH DIVISIOU OF ENVVIRONMEN.PAL HEALTH..SERVICES r JCA9,e l t"I es Owner or Purchaser of Building L. K��t, � a, a- Je_ � Building Constructed by Location - Street Section I Block Lot Nto Subdivision Name &.71 fe,rs0 ,K N 0 Municipality '�j� Subdivision Lot # A--s (c�e_y) / I O�'I Building Type 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 perate for a period of two years immediately. following the date of approval of the "Certificate of Construction' Compliance' " -,f°or -the --sewage--disposal= system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the Director of the Division of Environinental Health Services o Department of Health as to whether or not the failure of the - caused by the willful or negligent act of the occupant of the the system. Dated this 2 day of 19_�2 Signature Title Anera/e& tractor (owner) - Signature Corporation Name (if Corp.) A Address rev. 9/85 mk the determination of f the Putnam County system to operate was building utilizing Corporation Name (if Corp.) ess g Waterfield Farm, LLC East Branch Road Patterson, NY 12563 \�/1 -r 1��zi =lti c�,� 1r'�'Z.,v, /�c��.►,�,z -S �c9 ffv� /h�!,� N,srrG�.. - ,k� -�.. ��Zv,�os',�- _l a �_�- /r �r�, __.._ .... X 4 l�-�# _l o r3' i4 -r3QvF F.x.�`714 - �'�,Zr . .G;� _ ► r,e F.As, . k�,�r,�rur �Zc � ��� ►z, y i o U�irri ,_. ,1 +.. ,� �L ?r�4 RrtAS; Z.. c/X,/Z. . AA�d f l01c /L! AS r�v%�b vN i11 -� �'ur3rz+r �J t���9.h1� �t✓M?��rr,�`+� �-�+L�. �, i..L. /`��o'� L`pNl.�+'t% 114Gt-u bas' 7.i F-/,v e- iT� F44 -;4 l 't ?.. i3�7i -2�ut 1 N %a �fE- .-. r�1 /7N6 �f�L Sgr, /7G FN k �i dGr7S �ir�Z2�X��Y Sr2vZrr� /- 'rZhz. �' 442.*,(e LAL ,7.69u/ A -1-77,ke /!a f)' J wpi k r Z i�3 97 r 0 r' p oaf 5�0�� I / ip ��,4a g{pj,�WPNL1- .H7.20' ovr \, \N i ,rmfii eO F-#-mo4; X,44 S 7 r Is-- i-' U N ► ~ i4 -4OLT �K$�c2T � N f' SaI� �-- NA-roc `� jLM`� -, ��}3%' 1�►21H+�l� !�?�, 7 CyU�.1J erg Stv�l)t1Z K6-- iZ&,vor �L r g GG@ r% r 7� i C ON l �o A ONE- LIA, )Zew-1 "-//7, T?5 C .� 4d c — . --- AHD Grwcen� SITE LOCATION MAILING ADDRESS PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR PERSON INTERVIBIED PM Complaint $ Name &Relationship U. e, owner ,,tenant, etc.) DATE TYPE FACILITY PHONE REGISTRATION # 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 frcan licensed professional engineer or registered architect. /,::::, ,I Proposal approved '01-0100— Proposal Disapproved ZZ Inspector's Signature & Title Date Proposal approved with the followinci 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 Marne, Town and Tax Map number. c. Location of installed components tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank,, drywel.ls surrounded by one foot + gravel). e. Installer's name and number. (e.g.phouse corners). three precast 61 diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, Jr re rted agent of owner agree to the above conditions. SIG TITLE �7ES: Write (PAD); Yellow (Ibnm EI) ® Pink (Applicant) DATE 7L,?4? ._.._.... w. �_... � .......��wyy,- ,.•.rsJrtani:..i i..wca-. ". - .ua.ns.wb+- iS..vauu.n...r -w,+.- -_'-" z. 1_ wslu. e: waw,:.._.. u. v.., a.. w..._>.......... A. L. o-ux. J..:: a ......u...w.a..w.s....,... - ..«........ ... _v.-. p= M MINTY DEPAR2M?r OF HEALTH - DIVISION OF ENVIRUZE EAL HEALTH SERVICES INDIVIDIIAI, WATER SUPPLY & SUBS[If2FACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT - _.. N (DDB F2K�cc (Name of Owner) ( Street Location) COMMERrS NO DOCUMED M Permit Application Corporate Resolution Plans - Three sets Engineers Authorization' Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 9d W 30" Perc Hole Other°` House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or _ -J Box;Trench /Gallery, PmV pit details Septic Tank Size, > Detail y ,Well Detail, Service Line if over -07M)A9, Construction Notes'; Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains S -�' L.�e =ADD �Perc & Deep Holes Locatexi ` Representative of Sewage & Expansion Area E]xparision.. Area; shown;.gragity:: flow, suff;, size_ ...., , If Pimped Pit & D Box Shown & Detailed House - No. of Bedrooms ells & SSDS's w /in 200 ft. of Property Loomed 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 ^Alp 10' to P.L.,'Dr � Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan). 15' to Drains- Cartain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked EEx- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data,,.On DDS Plans & Permi� Sallie' ' aJ ° . Ull`It Y•1 wunri urXIAKIPIM1 Ur' HEMA11 - DIVISION OF MIRMOUAL HEALTH SERVICES ' INDIVIDUAL WATER SUPPLY & SUBSURFACE SEDGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERKT' ' �-- DATE REVIEWED D OLV f P� ADS L':R� B�anC n oaA BYo (Name of .Owner) (Street Locat o DOCUMUUS Permit Application - Corporate Resolution Plans - Three sets Engineers Authorization --- Design Data Sheet.(DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - volume D dr J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail ' Well Detail, Service Line if over Construction Notes Design Data Two--Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow,suff. size If Pumped Pit &'D Box Shown & Detailed House. ---No. of Bedrooms Wells &' SSDS's w /in 200 ft. of Property Located ' Property Metes & Bounds House Setback Necessary (Tight lot) - House Sewer 1 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; 2001 in D.L.O.D, 150' pits 100° to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Storm, Leader, Foot ing 251 to Catch Basin' 101 to Water Line (pits -20') Septic Tanks 101, from Foundation '501 to Well 151 Well to PL GENERAL Legal Subdivision Subdivision Approval Checker] Ex- approval SSDS Ad j . Lots Cii Wetland (Town /DEC Permit R & ,'6. Data On DDS Plans & Permit Same 1,4%,1- .y CQAB3i4qvGTBoN, N®YMS ?.+0 + Gi'�ec& X54- done,. by .WSI+ . ® 0 0 Q � �0 min WM= WE moo= Nom QOM INN 0 � Q� DOCUMUUS Permit Application - Corporate Resolution Plans - Three sets Engineers Authorization --- Design Data Sheet.(DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - volume D dr J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail ' Well Detail, Service Line if over Construction Notes Design Data Two--Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow,suff. size If Pumped Pit &'D Box Shown & Detailed House. ---No. of Bedrooms Wells &' SSDS's w /in 200 ft. of Property Located ' Property Metes & Bounds House Setback Necessary (Tight lot) - House Sewer 1 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; 2001 in D.L.O.D, 150' pits 100° to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Storm, Leader, Foot ing 251 to Catch Basin' 101 to Water Line (pits -20') Septic Tanks 101, from Foundation '501 to Well 151 Well to PL GENERAL Legal Subdivision Subdivision Approval Checker] Ex- approval SSDS Ad j . Lots Cii Wetland (Town /DEC Permit R & ,'6. Data On DDS Plans & Permit Same 1,4%,1- .y CQAB3i4qvGTBoN, N®YMS ?.+0 + Gi'�ec& X54- done,. by .WSI+ . BALDWIN & CORNELIUS, PC. 1'7 SUBJEC F-- L-OATE-(�� SHEIET NO.---L-----O CHKD. BY------ DATE-------- ---------------------------------------------- JOB NO ------------- = -------- - ----------------------------- ---------------------------------------------- ----------------------------- Ij H ol N 1 J. )S L; ll�a 0 ti i �:T'� I b! C ,TIC' t 6 6 It I c- 5! t 2-1 (2-0 c>/q Ali T- lvl,E /V T i 4P' BALDWIN & CORNELIUSs P. C. BU9d_EG,T- _.___4 wes ..5_cs"l)-, SHEET P!O _---__OF -- — -- _,._. DATE- - - -- _ - -- - ° - -- _ ------ _. _. _ ... - CHPCD BY------ DATE-------- --- =---- -------- -- - - -- JOB WO.--------------------- g-- -- -- -- ----- -- ---- -- ------------------------------ - ( I L - C i s I i�Qy _ I II 0M.- c7 1 � i f 10r ccanl.;__ 1 - - - -- - - 77 i : i. - .. -... I _._ _... _!.... 1 ._._ 61 -sl I � II is Gil ; At, ; rL r4tJ.A, - - -- �! � f {{ 00 ivy _. 2— A op, i ' ' ►__.Lf.� i�! i '67 �.'' ,� '�4` �,"r' t _ (� G l� -D _.{ ! I ' I � I Z I / j tLI�C J �, P/✓ :G �'� � ( f � U. L _+ p , I Ifl 1' �,� rUTHAM CUU111'Y DEVAlMIENT Ulr IIEWfil DIVISIUN CF BHURON1,1611TAL MAIMI SERVICES CUU111'Y OFFICE BUILMHU, CAliMEL, N. Y. 10512 DESIUN VA'1'A Sl r T- SLFAIIATH SL'WAUB -VISI'OSAL SYSTEM FILE IIU. Uwnei, navies Address East Branch Road Located at (Street EAS-r BF-Adc-H IZD. Sec. 67 Block • 1 - Lot 2 11fidi-EREU lleareeC. cross reiQ 11wt1cil�aliEy Patterson Waterelied SUIL 1'LeHOULATIO11 TEST VA'1'A JILQUIRED '1'0 BE SUDMITM WITH AI'1'L1CA'1'1U113 11510 Number CLUCK 'l'IN3 I'E11C0LATIUII 1'MICUlA'1'lU11 11WI Blepse WpL•li-Eo Water WaLEFLovel No. 'Time lii,om Urowid Burl •see iu II rues Boll V ate SL-art -Stop Mlu. Start Stop Drop In I.uii. /in drop 1�ichee lucl�es luclies A 1 1055 1125 30 21 23.0 2.0 15 2 1125 1155 30 .21 22.;5 1.5 20 3 1 155 1-225. 30 21 22__5 1.5 20 it B 1 '1n5( 117r, 30 21 22_„QY,, 1 n 30 2 1126 115.6 30 21 22.0 1.0 30 3 1 156 1226 30 21 22.0,,._ _ 1.0 30 II C 1 1058 1128 30 21 _23.0 2.0 15 2 1128 1158 30 21 22.75 1.75 17.1 _ r. ®n,t ; a C) .0 Ilute,1 1) 1'ests'%� � e repeated at same vnLes are obtain b each peregletlon • ful• rev owe 21 Vepth measurements to be tirade depth until e > vroxin�ately eclimi.l sul� test Bole. All data to be submltte from top of Bole. 1'U'1 HAM CUUII'1'Y DEVAH'1'HWIT UIP 1 '1'!l VIVISIUlr OF EM11101IM ITAL 1 Lill SERVICE-3 CUUIII'Y OFFICE BUILUilltl, CARIMM, H. Y. 10512_ LL81011 VATA Sl MT- SLI'AIIATH SHWnUI; -DISPOSAL SYSTEM FILE IIU. Uwsiei'`pavies nddreee East Branch Road Located at (Street EAST 5",jam P-o. Sec. 67 Block • 1 - Lot 2 . 11fidl-cREU iieareet u— oee re6L•j 11w►lcll)ality Patterson Waterelied Bulb I'EliOU1ATIUll TEST L11 TA MQUIRED '1'0 131-3 SU131,111"1' WITH AITL1CATIU113 11u-10 lluillb 1. CLUCK '1IMB rElICOIATIUII 1'EIICUlA'1'IUII Ilui: lslise 1»pCli�o taster WaLei� Level 110. 'Pima lil-om Growid Surface 1.11 L (.,liee Soll IIAU SL-art -Stop Rhi. Start Stop Drop ill I.u:i. /iu drop Iiicliee lttcltee litches A 1 1055 1125 30 21 23.0 2.0 15 2 1125 1155 30 21 22..5 1.5 20 lip 3 1155 12,,5. 30 21 22..5 1.5 20 B 1 '1 5 1 126 30 21 22_„� L„ 0 30 -_ 2 1126 115.6 30 21 22.0 1.0 30 3 1156 1 1226 30 21 22. Q 1.0 30 5 - C 1 1058 1128 30 21 23._0_ 2.0 15 2 1128 1158 30 21 22-75 1.75 17.1 _ IlOtea: 1) 'featsqAi)!a r "4�eated at same rites are obtaiuel �seach pereplgitlo:4 •1'011 review. ';� 2) Wptli wea4i; /I e:tte to be made Ll depth until o > >roxlnatel� ecliml hall test hole. AVY data to be submltte from top of Bole. PUTHAM UUUU'PY ll PAIUMMIT OF 1 r '1'11 ll1V1SIUI1 OF LIIVIIIUNMCNTAL 1 � L'1'll SERVICES CUUNTY OFFICE BUIIDIIIU, CARREL, N. Y. 10512 DES1011 DATA Sl MT- SLI'A11ATH. SMAUE - DISPOSAL. SYSTEM FILE IIU. UNUei_ Davies Address East Branch Road Located at (Street CAS-r B " -JCH Q.D. Sec. 6.7 Block • 1 - Lot_ 2. _ 6fidl-cREU ttearest cross e);t'e -W I.luidelpality, Patterson Watershed SU1L VEHOUL11T1011 TEST 1ATA REQUIRED '1'0 BL SUDMITED WITH AI'I'L1CATIU11:3 llcily 1125 1155 - Ilumhal, CLUCK '!'11.113 I'CIICOLATIU11 I'MICU1ATIU11 11w 'I E15ja I tlito Wafer Water Level Ilo. '1'11ne From Urowtd Surface fit It rlles Sol.1 Hate Start -Stop, Wit. Start Stop Drop In 1.11u. /iu drop 1tlCllee 1.IICIIee IIICIIee A 1 1055 1125 30 21 23.0 2.0 15 0 2 1125 1155 30 21 22.5 1.5 20 3 1155 1225 • 30 21 22..5 1.5 20 1 105r 1126 30 21 22,.( -.y 1.0 __30 _ 2 1126 115.6 30 21 22.0 1.0 30 1 156' 1226 30 2'1 C 1 1058 1128 30. 21 23.0 2.0 15 2 1128 1158 30 21 22.75 1.75 17.1 1158 1228 30 21 22 75 1 -75 17.1 II J - fir � llotea: ;a repeated at sums 1 aLes � e abtwl IIed ; each percpletlott fe . • 1'or i•ev'�ewr. •:' 2) Gasu jiletlts to be made Ids.. `�� rbdN { l depth until ©> >roxhately e(III(O hall test hole. All data to Ue nubmitte Cro1n top of dole. EEPT11 1" 2" .811 ?411 i 2" IV" TEST PIT DATA REQUIRED TO BE - SU1BMt',['7.'r.,D 14ITH APPLICATION DESCRIFTT.OII Or' SO11Z B-31000I!TERED I1; TEST HOLES HOLE NO:. 1 HONE 110.- 2 HOLE NO. 3 o s o .1 L _ V A". sapid i0" jJ 36" ,I, r2" 5.5 to GW ' 6' to GW 34" 612 to GW INDICATE LEVEL AT MI MI GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY William Hurley Date 5/.9/86 Soil Rate Used 30 Min/111Drop: S.D. Usable Area Provided '13200'sf 1250, !lbsorptiodrorea ro � e SeByptic TaLkFCXp4cityX , �1000rGals' width trench. DX . _ M me Address RD 6 Route 22 1/ rewster, NY 10509 SAS, i 1980 T1113 SPACE FOR USE BY 11=11i DEPARTMENT ONLY: �cFESS�oN�` Soil Rate Approved Sq. Ft/Gal. /'' �•�� ` _.` _ C �4)p, i, nn dannnn Checkod by Date ;P`IJ1 . ..L. 3" ,if ,n 3" TEST PIT DATA REQUIRED TO BE -SUBMITTED 111TH APPL•ICAT'I011 DEZSCRIFTIOII UP SOILS E11COUPTERED III TEST 1101,1333 1101r, NO:. 1 ROLE 140._ 2 • • 1IOLE N0. 3 topsoil to soil I" sand pit ?" 5.5 to GW 6' to GW 61 to GW HIMCATE LEVEL AT WILLCII GROUND WA'T'ER IS ENCOUNTERED 0DICATE LEVEL TO W11IC1I WATER LEVEL RISES AFTER BEING ENCOUN'T'ERED ES3T'3 IME BY William Hurler Date 5/.9/86 oil Jute Used 30 �lit:/1'�Drop: 'S'e' Ares Travided - 13200 'sf 12509 o. of Bedrooms Septic Tank Capacity 'byy, Type conc. bsvrption Area rov a By '1173 L.P. x24'.' x b" :'` /'' -.Wi �3;mell.Gh ame ddress RD 6 Route 22 Brewster, NY 10509 yy980 G M •,SEAL NEW Y , ,ejrrlrniun33N,, FES.$lON '1113 SPACE FOR USE BY 1 MM DEPARTr ENT ONLY: !oil Rate Approved Sq. Ft/Gal. Checkod by - a Date TEST PIT DATA REQUIRLD TO BE DESCRIP7' T ON Up SOJW %1.7 aPT11 110M 140:4 1 ..L. topsoil JTTED 14ITII APPLICATION 110.1,E 140. 2 HOLES 140. 3 sand 5.5 to GW ' 6' to GW 411 61 to GW 11DICATC LEVEL AT WHICH GROUND WATER IS ENCOUNTERED HDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EIMUNTERED ESTS 19ADE BY William Hurley Date 5/.9/86 oil Rate Used 3 0 Mil op:- `` _.S'.D. " -Usable -Area. Provided- 13200 'sf - __•..___ -__ 1250, o. of Bedrooms Septic Tank Capacity. ,­-.100 �7�it.. �F r .tdE�' ".w:. bsorption Area rov eT By -1 173 L.F'.x24" X lame Raldwid & CnrnRjhi _q_ P_f'_ aJ�,zs�Lu ,; ,ddress RD 6 Route 22 SIL y ��• -'' _- "F�'~` Brewster. NY 10509 07 %• % �3 b . �J, 0 J . \l JFZ 1113 SPACE FOR USE BY 11EAIJkJ1 DEPARTMENT ONLY: r�: J )oil Rate Approved Sq. Ft/Gal. Checkod by Date a 41 d 1j 07 %• % �3 b . �J, 0 J . \l JFZ r�: J '% ':rS °�'� y^� �. S4 'iY'�ia ��,i°4`7:ft r � f.• °.'t ti �tSJ•' � 3'Si i, � , � r � - � , ��¢��p r "� ;� �4�6�' i.' „:der :'i LY O i 44 r 3 '1 r d L. Y. T AK L. 4zw G. .. _ FLEL D INSPECTION RED (Mue of.Owner) (Street Location) INITIAL SITE INSPECTION i YES ( NO Wetlands on/or proximate to property .............. Property lines or corners found ................... Can estimate house location ........................ Will driveway need cut......... ......... ........... Must trees be rived - note these................. Deep holes representative of entire SDS area...... Additional deep holes needed ...................... Sufficient SDS area available considering driveway ,,4.- cut, house location, separation distances,etc... ' jacent. wells/ septics ............................ Access to prorsosed well location for drilling..... . 1` hot Depth to G.W.►/ Depth to- =rock Soil Description, d 3 ft. 6 ft. L�4AA 9 ft. 12 ft FINAL SITE INSPECTION D.H. 2 Lot Depth to G.W. (O `/-7 Depth to rock Soil Descri tio1 0 ft. .�..,. ' 3 ft. 6 ft. p'� 9 ft. DATE: INSP.BY: M House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse....... .............. Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained from property line and 20 ft. from house .............................. Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft, of peripheral soil horizontally from trench ..... ............................... Boxes properly set ............................... 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. 7 I1ATE:. �a�- INSP. BY: COMMENTS D.H. - Deep Hole G.W. - Groundwater D.H. 3 Lot Depth to G.W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. DEPTII G. L. 6"' 12" 18" 24" ,On i 36" 4211 4811 5411 60" 66" 7211 78" 84" TEST PIT DATA REQUIR%D TO LSE SUl'f ,IT TED WITH APPL•ICATIOII DESCRIPTT011 OF SOYI,S �;CG111 ?I'IRED III TEST HOLES HOLE 110:. ( . HONE I10. Z HOLE NO. 3 toeso +O Sorl S1-11, d . S Cl o., d INTDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED Il`IDICATE LEVEL TO WH�CH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS 14ADE - BY W ! r sn i-a l y Date. S- /� /.'6 DESIGN Soil Rate Used Min/1 "Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity Gals. - Type Absorption Area rov ded By � L.F.x24" —"jb" width trench. Other flame Signature Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft/Gal. Dav( e S SS C) -S SEAL Checked by & Date