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Home My WebLink About1953DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.30 -1 -5 BOX 18 ' - I Kmall; 1 J iii I I A ,- I 1 , i i 'r ' ' I'L Vt I ' - ' �I -1 { �� Ir r - 16 IN 1 , 01953 PUTNAM COUNTY DEPARTMENT OF HEALTH \ .. 11 8 1 „� Division of Environmental' Health Services, Carmel, N.Y. 10512 ` Engineer Must Provide P.C.H D. Permit... P= . $ 5 - - -- \ RTMCATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Patterson Valege Located at Fairy e c1' `ISr avilan� Dr .) Taa Map 67 'Block ' 1 Lot 4.1- Owner /applicant Name Frank Dal O —Form. erly Subdivision Name N /A. _ Snbdv. Lot N N/A MaWng AddressNa�' ��hj ��E3x1/��i4TC Qe" Zip Date Permit Issued 4/18/86 Separate Sewerage System built by Patrick 'Smith Address PSC Inc. Farmers Mills RD 'Carmel., NY Consisting of 1000 Galion Septic Tank and 300 LF of 2 ft. wide trench Water Supply; Public Supply. From Address or: x Private Supply Drilled byMill Drilling Inc. Address _ Putnam Ave. Brewster, NY Building Tape 1 Fami 1 v Res J dPn(-P Has Erosion Control Been Completed? yes Number of Bedrooms 3 Has Garbage Grinder Been Installed? no Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the fi d plan, and.the permit issued by the Putnam County Department Of Health. Date October 9. 1986 Cart if led by P.E. x R.A. Address License No. 26008 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 pub!*-- sanitary "war becomes available and the approval of the private water supply shall become null and vofaIL When a public water supply becomes available. Such approvals are subject to modification or change when, in the Judgment of the Commfssloner of H su revocation, modification or change is necessary, Date C.I�J��! l' B '�� T It le �� Owner or Purchaser of Building .Building Constructed by flAlh Location - Street Municipality Building Type Section Block G Lot Subdivision /Name 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- L ation. ofthe.:_Director; of-the',-Division of _Environmental ._Heal.th. Servi ces. of the Putnam.County Department .of Health as to whether or not the p fail- ure of the system to operate was caused by the willf r negligent act of the occupant of the building utilizing the systegi ,,/211 / Dated this day of 19 Signature Title A's.0 Corporation Name /4 if corp. Address 9 5 ✓ � l 99 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 a , COUNTY arFICC oUILO1Nc • CAnmCl.. N This report is to be'eompleted by well driller and submittee to County•Hcalth Deportment together with laboratory rep analy:i :Of witer :ample indicating water t; of wk.faetory bacterial qu3ltty before ccrtlfic:tie of eon:truclion eomplonce is i FI -PORT MUST tIE - 1.111.1d11TTED WITHIN 30 .DAYS OF WELL CO:.IPLETIO:� :flit( Ft:+" la•*• VIIA "tl W7 of FEET FORMATION DZSCRIMON 0 10' Loose broken ledge 10 2.0 Soft fractured bedrock 20 .325 Hard granite... . OAO • .r If yield was te+lyd of ciAt•ent dertno dvru.p d41Gnp• Lot betow ttit GAttONS ?'tit MINUt[ i ti'lll 11r�IrtltlJ I prtTG OV Q'LPOFtT JWLL10& 4/29/86 4/30/86 7 &match tract 1et:81000% el We// rrn 0831111ces. to at #oast two Permanent lanomms. s.� MILL DRILLING• INC. Fairfield Drive Patt rson NY IOCATIOH (ho. A Slrtoy Down) (lot arena of VIAL same. ® ❑ %INESS ❑ ❑ !t0 ►OSLO DO#AESTIC FStAZL SMAI[NT• FI�.tAI 1117 WELL tJSw t 13 SUPP Y El INDUSTzme, ❑ CONDETIONING•� D OTHER I Dl11IIHG D COAPRESSED CABLF ❑ OTHER ❑ f OUIPM.E11T ROTARY AIR PERCUSSION .PLRCUSSION ts�"dUrl• IIAG)M (realj i:lAME1EalMLAaaI wr11.Mt I(a tCO1 l ❑ UI:1 V� $K01 AS L��?�� Ci k lyis LJ 30 6 19 (® THREADED WELDED YES NO 1 YIELD (('''�� 1tQutS G.F. YIELD (G✓.t1.J . Its? ❑ LAI= ❑ PUMPED LXI COMMSSED AIR 6 100+ 100+ 1h•A1FR o4EASUtE rt0 ++ LANG sutlACE— STAIIC(SOacll /feet/ TEo ust 1tal) ouitisG IE � Dipt31 of coTpl.l.d Well tEVLI . 40 250 , In (col 6olov loud •vrio :r 325 /aAtE L:NGTM OPEN TO AG MEEH SLGI Sl&: DI wEt(t (/ncaeaj I IF GRAVEL I Oiornete► or well including GRAVEL SIZE Irncnct) 11004 u• Onulj PACKEDt pro.el pock (lntnetl: lltOM Ito :flit( Ft:+" la•*• VIIA "tl W7 of FEET FORMATION DZSCRIMON 0 10' Loose broken ledge 10 2.0 Soft fractured bedrock 20 .325 Hard granite... . OAO • .r If yield was te+lyd of ciAt•ent dertno dvru.p d41Gnp• Lot betow ttit GAttONS ?'tit MINUt[ i ti'lll 11r�IrtltlJ I prtTG OV Q'LPOFtT JWLL10& 4/29/86 4/30/86 7 &match tract 1et:81000% el We// rrn 0831111ces. to at #oast two Permanent lanomms. s.� MILL DRILLING• INC. A BREWSTER LABORATORIES Box 224 - BREWSTER;—N:Y: (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6149 SOURCE: Frank Dalo Fair Field Drive Patterson COLLECTED: May 1, T 9 8 6 BY: iy_ill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. May 5, 1986 PUTNAK COUNTY DEPARTMENT OF HEALTH ENGINEER TO PROVIDE PERMIT # ON CERTbFICATE OF COMPLIANCE. Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT.° CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson_ Town or 44 l _,.:..�..L-- aaated:� mow._- _ .:.� _ � - _..',. -.:. .. _ = �aii:::Map.' _ _ .6.� • glvck _: _ lag �t _ ........ .. _ W Subdivision N/A Subd. Lot N N/A Renewal _0 Revision _U 4 .11S/86 Owner /Address Frank Dalo Date Of Previous Approval Building Type 1 Fa1i . Residence Lot Area 1 13 2.845 acres Fill section only Number of Bedrooms Design Flow G /P /D 600 P.C. H. D. Notification Required Separate Sewerage System to consist of 1 000 Gal. Septic Tank and 300 L.F. X 21 wide trench To be constructed by to be determined Address Water Supply: Public Supply From —X _ Private Supply to be drilled by to he dinti- rmint- Address Other Requirements 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 there to and in accordance with the standards, rules and regulations or e u nam County Department of Health, and that on completion thereof 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 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 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 an regu a— I�fTons of the Putnam County Department of Health. %� Date 1 S° i'f7 Signed '�'= f P.E. X R.A. Address tcl ;n I If Hti APPROVED FOR CONSTRUCTION! This approval expii revocable for cause or may be amended or modified when requires a nety Perm(it. Approved for disposal of dome ` Date ` r nw/ By - Rev. 6/85 el N.Y-License No. 26008 the to s unless a nstruetion of the building has been undertaken and is a►y t e C mis *oner of H Ith. Any change or alteration of construction ige, d/ r r ate ter apply only. Title pUrNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS -TION--REPORT. DATE: INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO Ccmmam Wetlands on/or proximate to property .............. Property lines or corners found ................... Can estimate house location ........................ Willdriveway 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 ............................. Access to proposed well location for drilling ..... I D. H. Deep Hole G.W.-Groundwater D. H. 1 Lot D. H. 2 Lot D.H. 3 Lot Depth to G. W. Depth to G. W. Depth to G.W. Depth to rock Depth to rock Depth to rock Soil Description Soil Description Soil Description 0 ft. 0 ft. 0 ft. 3 ft. 3 ft. 3 f 6 ft. 6 ft. ft. 9-ft. 9 ft. 12 ft. 12 ft. 1 f DATE: FINAL SITE INSPECTION INSP.BY: YES NO VCCMMENrS- House SSDS located per approved plan ............. �/� Length of trench measured (o C) Width of trench average -17, q Slope of tile line and trench acceptable......... 5 /`i C Roan allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarlygraded...... .................... 10 ft. maintained fran property line and 20 ft. from house.. ........ •.• .•... Distance well to SSDS (ft'.) ...... rca? . Number of bedroams checks ................ g —1Z Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally fromtrench .................................... Boxes properly set ......... ...................... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area .... 4Z Does lot drainage appear OK in area of SDS ....... FINAL GRADNG OF SITE ACCEPTABLE.-.-. . ....... PUTNAM COUNTY DEPARTMENT OF HEALTHE��I ®4 DIVISION -OF ENVIRONMENTAL HEALTH SERVICES C1'05 APIZ1L (980 COUNTY OFFICE BUILDING; CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE• SEWAGE DISPOSAL SYSTEM FILE. NO. Owner /?zZANKQA�d Address 6 M.AiZSHALI— RD• Located at (Street i V\yI X17. o.. Sec. 67 Block Lot �. indicate nearest cross street) MiLini c i pal ity jam/ 'j"r�� Watershed SOIL.PERGOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Nu177ber'' CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Wat er Water ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in'drop Inches Inches Inches lIEY, -ray 3. 1� z 3 2 21v 3, /9Z -•157, 7 3Ui� �� s7 --,�� /�• � 7 20 )2 /g I Iso - )33 2 3, /9Z -•157, 7 �� s7 --,�� /�• � 7 20 � 3 � 52)5_— 233 / 7 0 3 60 1• 2 ' 5 ' Notes: 1) Tests to be repeated at same depth until approximate•ly' 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. THIS SPACE FOR USE BY BEAUPH DEPARTP4ENT ONLY: ,3o:. Rate Approved Sq. Ft/Gal. Checked by Date TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION 'OF .SOILS ENCOU'NTERM IN TEST HOLES �..._ .,...,DEPTH.. ,....IIQE.. :::NO:. ,..�:L..w .._,•:.�_ :� .....- HOi�E-.NO;: F . _ :.THOLE NO':r:_.: G.L. 12' 1811 24 I� S/�I�l D i y 36,E , 42" 48" 0011. CZ-A Y 66" Z-L.A (41,11 72�� w StD 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO-WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Date / i�- DESIGN Soil Rate Used!?j �Mir�/l "'Drop: S.D. Usable Area Provided C�CJL�1�s r= No. of Bedrooms Septic Tank Capacity Gals Spar+ R E Absorption Area Provided By 3�c�L. F. x24" o��S nc Ha me CAs mj M A T�C,S Signa ure Address -3 7 1 SEAL �Q� kO• 26009 'a THIS SPACE FOR USE BY BEAUPH DEPARTP4ENT ONLY: ,3o:. Rate Approved Sq. Ft/Gal. Checked by Date J PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY, OFFICE:. BUILDING, - CARMEL;,.:N. - Y. ---1-'0512--. DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. G Owner fTAIMIG, -DA� CpM72gLT VENoAddress G MRiZSHALL- RV. PATS *r=,9 N r Located at ( Street HAyio& ' . Sec. �% ' Block r Lot 4. � i 1 indica e neares cross street) Municipality PATr�se� Watershed e --Rcs 1 p /QA SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to a er 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 1106 - io9 3 /8 2-1 3 1 2103 -11a 9 Ig 2A �. 3 3118 -r 1341 2 /� �, 3 4 413c� -- 14 z 1 2 / 21 3 5 113p- 133 _ ...__...._ 2133 _442- 3142 -I57 4 1.57- 21, /8 17 1 _7 Aj Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted . for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES _. ..:.,:. - z_..,_�.....z.... _ _ _ ..__. BOLE -NO HOLE'.,- NO - � - - - -� �. -�:.� HOIlE`-N0 ... ..,,. .... -..., - G.L. 611 12" 18" 2411 30" 36" .4211 48" 5 11 60" 72" 7811 8411 a i �I�ILI U i LOAM SAD INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO -WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED .Date- DESIGN Soil Rate Usedfo�Min/l "Drop: S.D. Usable Area Provided .6C )CX-: � (= No. of Bedrooms Septic Tank Capacity %�U Gals. (2 Absorption Area Provided 3C5oL.F.x241 P By bignature Address J7 FH %, � i SEAL CR iZM�L y / CIS Z J: % . A' THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date co�sa �s "c• u 3J, 4 Tn�lk e � Il. a `lip Ne�� 9� J` .r.7. VI 1� S510o.�'• 7 � I a y tt, w 7:� ' t J ll —OU Tom( QU � T (FLT �UO� rj 2 5 4 . Co 7 8 tU rl 3S �4 79, 73' �7 C�2 �5�' 140' 124' 21' 73 l07 5' S0' 40 /19 /0 3' 73 59' ML U111 147 t32 ll�' toa' �5 rj