The URL can be used to link to this page

Home My WebLink About1876DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36. -3 -21 BOX 17 ii r �1 ' or N16L ,N. 01876 Q(y Division of Environments/ Hsg/th'� rviolir Carmel, N. Y. 10512 Permit x P 29-84 CERTIFICATE CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM T. Patterson Town or Village Located at East Branck Rd. 3�. ) Nap 81 Block 5 . Owner M/M Lawrence El 1 i 0 rtFormerly Tax Nap Lot # 2 subd. rot•I# _ Separate Sewerage System built by .TOSE?1 �arri a 71 Address i Ori Rd. , Patterson, NY 19563 Consisting of 1000 Gal. Septic Tank and 500 ft x 2411 wide X 18" deep l atera 1 Other requirements 5000 sq. ft.f x 24" deep rim -of -bank fill (450 f cu yds.) water Supply: Public Supply From X Private Supply Drilled By P.F. Beal & sons. Address Brewster NY 10509 Building Type Frame No, of Bedrooms THree Date Permit Issued8/31 /95 Has Erosion Control Been completed? jreS I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the'rplans of,the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed`plan, and the Putnam County Department Of Health. permit issued by the Date 20 AllQllSt 1985 Certified by • P.E. x RA. Atldress RD9 -Fair St.,C rmel, NY 10512 29206 License No. Any person occupying premises'served by the above systems) shall promptly take such action as may be necessary to secure the correction ;of any unsanitary conditions resulting from such usage. Approval of the separa sewerage system shall become null and void as soon as a public sanitary sewer bocomas available and the approval of the private water supply shall bec a ul sub)ect to modification or chang en, in the judgment of e C and void when a blic water supply becomes v i • Such approvals are rn oner of Has h, ch re ± ll.I+ikJ L. ' Rs- rrrb8Tf)upon or cha a necessary. Date T JJ B Title Rev. 9 -81 t PUT .NAM COUNTY DEPARTMENT OF HEALTH Permit a -2984 Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM T. Patterson Town Cor village .East Branch Road Tax Map 81 Block 5 Lot 2 Located at S.O. 212 3 — — — — — — — Subd. Lot li — Renewal Revision _[] Subdivision �,1 Mrs. Rd. Brewster No 10509 8/31/84 Owner /Address !•lr• & '.7rs Lawrence E11 IOt , Date Of >;revious Approval Building Type Frame Lot Area Number of Bedrooms /� 6.03 acres Fill Section Only ❑ Comp] etedySat isf actor i l three Design Flow G /P /D 600 P.C. H. D. Notification Required Yes 1000 5001 x 24" wide laterals s Separate Sewerage System to consist of Gal. Septic Tank and To be constructed by Address f, Water Supply: Public Supply From X ? Private Supply to be drilled by Address j Other Requirements 5200 sq ft x 2411 deep R -O -B Fill l sect ion (466 cu.yds) , I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system: above described will be constructed as shown on the approved amendment theie to and in accordance with the standards, rules an regu a ions o e u nam , -'., County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill ; R be submitted to the Department, and a written guarantee will be furnished, the owner, his successors, heirs or assigns by the builder, that said builder will , place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of_ Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed in accordance with the standards, rules and regu ons of the Putnam a County Department of Health. r``• Date January 21, t 198rj Signed 1 , P.E. x R.A. ! Address RD - Fair Street a rme l NY 10 2 License No. 29206 S APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued s construction of the building has been undertaken and is, revocable for cause or may be amended or modified when considered ne ssary by the C mi loner of Health. Any change or alteration of construction requires a new perrgj� A roved for disposal of domesti ry wa e,. d/ or ry wat�r�upD1Y- oD�Y_. -_ ; �_--s \T Date By T it Is �1.. PIPINAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10612 ONSTRUCTION PERMIT FOR SEWAGE DISPOSAL .SYSTEM .orated at East Branch Road ;ubdivision pp - -a Subd. tot k .twner /Address Mr. • & Mrs • Lawrence Ell- tott',Hannyer Rd RrF Building Type Frame, Lot 'Area N Number of Bedrooms three Design Flow c /p /D 600 Separate Sewerage System to consist of 1000 Gal, Septic Tank To be constructed by Water Supply: Public Supply From i { # T. Patterson own or village Tax Map 81 al—a 5 tot 2 Renewal ['] Revision _ 13 rsterf previous Appproval Fill Section only 141 P.C. H. D. Notification Required yes and ,5001 X ' 4� ' - Ae 1 Ateral c 'Address X Private Supply to be, drilled by ? - Address Other Requirements 5200. s . ft x 2d D - 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 11 that the separate, sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standiards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Heaithwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal System during the period of two (2) years immediately following thedate of the issu- ance of the approval of the Certificate of. Construction Compliance of the original system or any repairs they ®to; 2) that the drilled.well described above will be located as shown on the approved plan and that said well will be installed in accordance with the standards, rules and regu a 1 of the Putnam County Department of Health. Date 17 Jul y 19$5 Signed. Y-� P.E.-)L— R.A. Address RD #9 Fair St armel N.Y. 10512 License No. 227Qb APPROVED FOR CONSTRUCTION: This approval expires one,year from the date issued ess construction of the building has been undertaken and-.is revocable for cause o► may be amended or modified when consider ecessary � the Co mis lone► of Health Any change or aeration of construction — requt►es-a new rmd, proved fo disposal of domestic , nitar se age, and /or pri to pply ontry, ,..._ Date _. �.._By . )' n�- -r✓�,, k Title Rev. 9-81 + .%. 4 � WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK ..This..report is to be_ completed_.by well _driller .and submitted to County Health Department together with laboratory, report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME Lawrence & Kath Elliott ADDRESS 10 Hanover Rd., Brewster, N.Y. LOCATION OF WELL (o. & Street) (Town) (Lot Number) Old Putnam Lake Rd. , Brewster, NY PROPOSED USE OF WELL BUSINESS ® DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL 11 SUPP Y El INDUSTRIAL ❑ AIR ❑ OTHER CONDITIONING (Specify) DRILLING EQUIPMENT COMPRESSED CABLE ® ROTARY ®A R PERCUSSION ❑ PERCUSSION ❑ . ((Specify) CASING DETAILS LENGTH (feet) 761 721 IAMETER(Inches) WEIGHT PER FOOT 19 lbs. ® THREADED ❑WELDED DIVE SHOE kJYES ❑NO CASING YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ® PUMPED ❑ COMPRESSED AIR 6 75 YIELD (G.P.M.) 75 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Speclty feet) 81 DURING .YIELD TEST (feet) Depth of Completed Well in feet below land surface: 1551 SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 0 55' Drilling in overburden clay and boulders. _ .. _........ .. _... ..._ ......._ _.. _... - -- - - .�._.. f it rock at 55 feet 55........72 - Drilling in rock, set casing, . grouted;.-- .. _ _.. _.._._ Drilling in rock. granite. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 12/17/84 DATE OF REPORT 1 I WELL DRILLER (Signature) �Z' , , /,/ w .._ BREWSTER LABORATORIES" BOX 224 - BRElWSTEIR, N.Y. (914) 225 -2072 SAMPLE NO. 5822 SOURCE: Lawrence Jo Elliott Old Putnam Lake Road Brewster, NY 10509 COLLECTED: June 18, 1985 BY: BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method Faucet - Well 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. June 21, 1985 ti Mr. & Mrs. Lawrence Elliott 'TM 81 Owner or' urc aser of Building Section Building Constructed by Block East Branch Road Location - Street Patterson Municipality .2 Lot Subdivision Name Frame Building Type Subdv. Lot # GUARANTEE 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 guarantee to the owner, his success- ors, 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 determin- a t ion-.'.of. the D•irec:tor- -.of �the..Divisi6h :of..Environmental__Health Services of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. c Dated this �' day of May 19 85 Signature Title e Corporation Name if c o r ) •:7 3 rJJ 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 SerEyi.ces, Putnam County Department of Health Mr. & Mrs. Lawrence Elliott TM 81 :inner or Purchaser of Building Section Building Constructed by Block East Branch Road Location - Street Patterson Municipality Frame Building Type 9 Lot Subdivision Name Subdv. Lot # GIIARANTEE 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 guarantee to the owner, his success- ors, 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 determin- 'a -rion'of-the-Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of May 19 85 Signature.' 4L 4ti Title.�'/� Corporation Name if corp.) %1 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 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner K LtywreAcge E11io -ft Address Ears.& jgjw ,c jzj. TU M.rp Located at (Street (gee Block�_Lot 2 nearest cross s ree Municipality_ -P��d„ Watershed Cire{ah SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION apse Depth to Water a er ve No: Time From Ground Surface in Inches Soil Rate 'Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches C . ?..1100 11 33 33 24 i� 3 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. 4x TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. G.L. -To-pso; I 611 12" 18" IF 1� 2411 30" 3611. 4211 vexv PME 4811 5 if 4 6011 66 7211 Rocks C". V& I 7811 8411 hi INDICATE Iffl'h AT400H�ROUND WATER IS E COUNTERED 41 q;rgo. T .=CATE - IEVEIi-TO. WHICH. WATER, LEVEL, RISES AFTER BEING. ENCOUNTERED PX F1,6 TESTS MADE By D-ems hf. F. r. -J. F4. e,) iojftVl!� Date joJI&M4. Soil Rate Used_ZLO Vftr4/1 "Drop: S.D. Usable Area Provided oms Septic Tank Capacity f0Q0 Gals. Type a Pte a Provided By . F. x24 �5b" L width trench. Other kene r77/1 AT �lit1D. I'm V. V Im I I I %.: %Z W I;Nli o-nn tn f"in : —7-� . ? 1 F -C - 9? Ff ! R ST. $ WANA-1 (F A� 'VO. 29' LL, i Y R-, I -.. i THE SV�ltt-�� FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. lit/Cal. Checked by ' Z ,A U" y DEPI O� "--f H ' Insp.by: INITTAL SITE IIdSPECTION Yes: NO Comment: ,Proper. l-,y dines or corn,-,P.3 found . . . . . . .. Can ostim.a.te, house location . _ Will driveway need cut -- hjust trees be removed -note these _ Is deep hole represen 'a "Give of entire SDS areas Additional deep holes needed. - -- Sufficient SDS area available considering. driveway cut, house location, separation , distances, etc. DEEP HOLE DATA -- -- - -- - - -- DDpth: Water elevation: . •Rock clevation: Soils d.e:scr:i.�)t i on: Date: I�'II�tAL SI TE ITNI P ��C`1 TG? Insp .y : House located uber.•e shorn on approved plan SDS located whlore approved :Ini-Z.th of tranch m- -asured -- - -- W:idtil of trench aver ere Ll ' v _- Slope: of -wile- -line. and, Room allowed for ex u_nsion trenches i Over 50 ft. from stamp, �-:atercourse Natural soil not-stripped or SDS area unnecessarily graded - - 10 I't. maintained from prop-line and - 20 ft. from house Separation of trench from house, well - -etc. - follows plan :- :-- ,-- ;- ; - -, -; - -,- :- ;- � - - - -- - - - - -- Tluaiiber of bedrooms checks . . . . . . . X Stones., brush, • stumps, rubble, etc. greater than 15 ft. from nearest trench 15 Ft. of peripheral soil horizontally from trench Junction boxes properly set Could surface run off from driveway, roads, • ground surface, etc. chat -uiol near SDS — arc.. . . . . . . . . . .. . Docs lot draJLn:.l fie appear 0. K. in area of SDS - FI1\AL UADING .OF SITE ACCEPTADTE \ \ ;roOoP4�locaietl from cdrvay Ay sutgeyoz •noto9 lholowzL Y? 61116ditoQ by;, •Survrayo•t,u survoy r^t v \ Well -drillora report � _�(t'_'t�_ EnglaQGre 39� - ro "� �3�• 35 \ \ Tank,bouos, pifz,gotiorlan r 101e1`016 1ocof*4 gti:t:onfrQOtAr, � htiaith pox 24¢- �// i' 1' -f ('o la 1�3•ro�' Field tnopoctwn bp: Health depi doYO: Enga floor Kv dole 1 g`� f 3 12 lez- 11 ' Putnam County Department of Health r 01� y\ NOT g : 01v1sion_ of Environmental Health Services, x Approved as noted for conformance with a 1 cable Rule and egulatione of the 1 poa fllsL. �G GAS I 3 \ F County a Department. 9 (� 4OL11% I iFe a 4t afore R tla Onto LAT�2A Lra -o o.c. a y D I ME Pt SION S Y o ri 10 fhl. Lr I Gt"1�1' of 500 -o I o �\ A 6,p a l) z4V P `(L e, o,� • r A - o =_ -�Q'�e - Q .,_ A .. -- �-� - If I Ld, �r-G`f 10 r, E 16 _ _.tug E A G n i I,_B G a ---64: I' _ 6 e - a A, • � 7�.z4 ANITA R -T � _ l "A SW °z' -<s6 5z e owc ggj /.'�qI a�fe I �we��`�' _ 47, LOCATION Streot:4&aiG_ 40/k-0 (A/Kgi e_ T- �Ii � 1 _ "� Tow n�_r,4iT�E ?01_ vCoUntY .,�J�T1-4A —t L Stole --t4--y— � ._ _.. . BOG SUBDIVtIS1 Pl A� X52,06 Map;_LiL4 -) ( Block.. _ _ 'L'OT N4 LL f+ x/ALGAc� �� v Bultdor:, 01" Surveyor: i Droatn;.. G7 171X tioto�8 - 1 -85 Scvlo_ �P � � jof'�+ 0.2, 1 23_ JOHN N, PRENTISS P.E. ; r