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�a PUTNAM COUNTY DEPARTMENT OF HEALTH S01616, Dwg . 3
Division of Environmental Health Services, — Carmel N. Y. 10512 o Dwg. 4
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR .SEWAGE- DISPOSAL SYSTEM__ _ _,_ -_ - Patterson T Village
.....
QQ own or age
Located at Cameron & Ingleside Rds. Tax Hap ___?9 Block —5
Owner Ronald Karal i s Tax Map Lot It Subd. # 780 -784
Separate Sewerage System built by Paul Lundel i us Address Patterson, NY
Consisting or 1000 Gal. septic Tank and TWO - 8'x10' Deep Seepage Pits w /12" Gravel /Crushed Rock
Other requirements None Around & Under
Water Supply: Public Supply From
X Private Supply Drilled By Boyd Artesian Well Drillers
Address Camel, NY
Building Type
Modular
Has Erosion Control Been Completed? None Reg' d .
No. of Bedrooms Two Date Permit Issued 16 Dec. 80
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 filed plan, and the permit issued by the
Putnam County Department Of Health.
Date
27 January 1981
Address
Certified by P.E. X R.A.
R. D. 9, Fa �� t. Carmel, NY Qb512 License No. 29206
Any person occupying premises served by the above system(s) shall pr y 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 public sanitary sewer becomes
available and the approval of the private water supply shall become null and void when a public wat Supply becomes available. Such approvals are
subject to modification or change when, In the Judgment of the Commis r of Health, such reslocation, modification or change Is necessary.
Date ��� � �'' / By— ' �` P � � Title
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ED-ft-AL LABORATORY
YORKTOWN EDI INC
1
P.0 Box'99 321, Street
LOCATIONS k
YQCoAW1lli#1 10598
❑ 321 KEAR ST YORKTOWN HEIGHTS N Y 10598 245 3203
❑ 201 BUTTONWOOD AVE ;:PEEKSKILL N.Y 10566 73787:77 y
q CC�--
2�T3�3
❑ 495 MAFN ST MT. KISCO N Y 10549 666- 3-33'5
..
STONELEIGH AVE (NEAR HOSPITAL) CARMEL;JN Y 10512 278 9330
ct
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH
3/71 ` Division of Environmental. Health Services
U COUNTY OFFICE BUILDING - CARMEL, NEW YORK
This report is to be completed by well driller and submitted to Cqunty 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
Ronald M. Karalis
ADDRESS
Bronx, NY
LOCATION
OF WELL
(No. & Street) (Town) (Lot Number)
Core Cameron Ste & Ingleside Patterson 780 — 84
PROPOSED
USE OF
WELL
BUSINESS
El DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
1:1 SUPP Y El INDUSTRIAL ❑ CONDITIONING ❑ ((Specify)
DRILLING
EQUIPMENT
COMPRESSED
F] ROTARY El AIR PERCUSSION ❑ P RBCUSSION ❑ (s(specify)
CASING
DETAILS
LENGTH (feet)
o%o
DIAMETER(inches)
6
WEIGHT PER FOOT
19
50 THREADED El WELDED
RI ES O
X YES E] NO
C S G
X YES
NO
YIELD
TEST
HOURS G.P.M.
❑ BAILED ❑ PUMPED S COMPRESSED AIR 2 . 1 0
YIELD (G.P.M.)
10
WATER
LEVEL
MEASURE FROM LAND SURFACE —STATIC (Specify feet)
350
DURING YIELD TEST [feet)
total drawdown
Depth of Completed Well
in feet below Land surface: 150 _
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 (teat)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET to FEET
0
38
overburden
38
150
ledge
If yield was tested at different depths during drilling, list below
FEET
4 GALLONS PER MINUTE
DATE WELL COMPLETED
DATE OF REPORT
WELL DRILLER (Signature).•,.[, -`�.'�
Structure located from surv.oy, by surveypr notsgt belocyvg
VNeii recntod bY: Surveyor, surva.y•_{-1 _
Wait drillero report Sf•-� ._..
Enpineers mesu,r0mdnts...L..t�.
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f 6 ; PUTNAM COUNTY DEPARTMENT OF HEALTH
O� �'/ al_ H61th :r m Division of Environsry - 0 j
CONSTRUCTION PERMIT -FOR, SEWAGE DISPOSAL .SYSTEM Pdtt @rS011, {
Town or Village T.7 77%. _
Located' at C:ameron., & Tnglese Rds. __ _ Tax MaP 2� Block 5
' Subdivision PUtnam Lake' ('Fftl d Map`�149, Lots .780= 784:? Lot ,oe SOl6l6 llwg. 3
Address
Owner
Ronald - 'Karat fs- - 284.0 Ba Tlev Avenue'
- -
Modular.: 0000tj] Bronx, ,NX 1U463
Building Type . Lot Area -
Number of Bedrooms Twq; Design Flow. 400 Gal . Total Habitable`;Space l0Y0 Square Feet ,
0
Separate ,Sewerage System ,to consist of 1 00 Gal 5 tic Tang nd TWA .�' 0 0e Seepage Pits ;w :12.
Gravel % ROC .Arund " n e . Crus ed
To be-, constructed „by Address
Water Supp ly: Public Supply From
Private 'Supply to' be drilled by q '
i � 1
Address.
Other ReQuirements
I represent that l am wholly and completely responsible for the design and location of the proposed system(s);'1) .that the separate` sewage`disposaI system
above described'will be constructed as shown on the approved amendment there to and in accordance with the standards, rule; an regulations o t e: u nam
County Department of Health, and that_ori- 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 furn.ished.the owner, his successors,aheu's or assignrby the builder that said builder will
place in good .operating condition .any part of said sewage . disposal system- .•durmgahe period of two (2)'years immediately following thedate'of the issu =` `
ance of, the approval of the Certificate of Construction Comp Uance 'of the,origmaFsystem or'any. repairs the'eto;'2) that the drilled well,described above .
.will be located as shown on ttie approved plan Well II be st led : -in Ilan a w' e e standards, rules and regula i ns; , of the Putnam
county Department.. of Health! 'i�)"1�1$ ue"rep�5
15 `Aecember 1980 - X .
'Date Signed P E, R.A,
Address Il. L 9 ` �a $t. C e1 • . N 10512 License .NO 29
APPROVED. FOR. CONSTRUCTION: Thig;approval expires one yearfromtherdate issuetl unless struction_of the - build'ing. has been `undertaken 'and .is
revocable for cause or maybe amended or rnodified when considered necessary;by the .CommiS ` of 11ee,lih:. 'Any change' or alteration of construction
a, ., .
requires,a,: new permit -- Ap �roved forr... iisposal of domestic sa age, ' mate
BY Title
JOHN H. .PRENTISS, P.E.
CONSULTING ENGINEER
R.D. 9, FAIR 'STREET
CARMEL. N. Y. 10512
(914) 878 -8170
15 December 1'980
Environmental Health Services
Putnam County Department of Health
County Building
Carmel, NY 10512
Attention: J. Robert Folchettf, Director
Re: Property of Ronald Karalts (M. & H. Custom Homes,. Inc.1
Cameron & Ingleside Roads, Putnam Lake Subdivision.,
Filed Map #149, Lots 780 -84 rncl:• T. Patterson (29- 5 -1.1)
Our Job No. S.O. 1616 (Dwg. No. 3�
Dear Sir:
1. Original deep and percolation tests were made 8/4/`75 for the original
owners (Jeri-cho Builders, Inc. - J. Bijou), and a permit issued 11
Sept. '75.-
Percolation rates stabilized in 30" deep hole at 3 minutes, and in
60" deep hole at 5 minutes. Deep: hole was dug to over 7 feet with
....- no. -1 edgerock or water, and_ probed to ,a= depth ; - Of_] 3 feet with a bar
—'with, no- Wden•ce of,- other- than the sandrl oam- found- in` depth from"
2 1/21 --7f.
2. Original design (Job NO. S.O. 1616 -:Dwg. 1).called for two - 8'
diameter pits x 9' depth for a 3 bedroom dwelling. Subsequently
March 180 our Dwg. .2 was changed to galleries (for a prospective
purchaser 4' x 4' x 72'.
3. Our Dwg. 3 is a design for a two bedroom dwelling with pits, per
current criteria based on the .5 minute rate (see 1.. above). The
two 101 pits shown wila1.t4en incorporate the 50% expansion area.
Your approval by permit _ s 'requested.
Very truly yours,
,gym°
r'
J n H. Prentiss, P.E.
HP /pr
cc: M. & H.
File
/ (� / S01616 -Mg No. _2 -�
FF 7
PUTNAM COUNTY ;DEPARTMENT OF HEALTH
n✓ Dwfsion of Environmental Health ,Services CarOO N Y 16512
CONSTR,UCTIO,N_REi3MfT FO,R - SEWAGE, DISPOSAL SYSTEM`. PattQrS011 .
--Villa •
Cameron :& Ingl es440- Rds . 2,9 T 5
. Coca ed�.a4 s map- orBlockg
' Tax �M
vin a �-
- Subdivision
&4 '146 .,(.F4aed Map 149 :Lots 780 1941W, ,fit .]. 1 ,ob 50161'6
oWre► Jericho 'Builders, `:Inc Adtlress East `Bra "nch Road
Frame 1000Q:'�]:: = Patter`son,:NY 12563_
Building Type _ Lot Area
Three 600 Gail 960
Number of'Bedrooms peslgn Flow Total Habitable Space Square Feet ;
10.00
.Separate Sewerage System to consist of Gal Septic Tank and
To: be constructed by","
y ?`, ' Address
Water SuPPI,Y Public Supply From
yPrivate Supply to,.be drilled by
_Address
Other Requirements
72' ;4'x4'x4` Galler.'es .w%12" Crushed Stone %Gravel `Under & }On All Sides'
C represent ;thet•l am wholly and completely tesponsib,le for the desigmand location of .the proposed system(s); 1) that • the separate- - sewage disposal - system
above desciibed will be constructed as shown =on the approved amendment there °to and In °acco ►dance with'the standards, rules an ; regula-ions,o . the r^ u nam
County Department of Health, and that on completion thereof a Certrf�cate 'of
Pon, satisfactory,to ttie:Comrnissioner 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 bwlder will
place �n'_good operating condition any partf: said "sewage ,disposal system,_during'-,the periodof two (2) years immediately following the date of the issu -.'
ahce of the approval of'the Cert {ficate of `;Construction:Compliance;'.of, the original `system or any repairsthereto; 2) that the drilled Well describe
Will be located'as shown on =the approved plah`and that saitl well will be installed. in. accordance with the standards, rules -and regulations of the .-Putnam
County Department of Health Origi na] Permlt Issued 1 124/75
—i
20 March 980e-,
Date' G- S19netl _ P E. n R.A
77, Re deli gn Adel ►eas R D. '9 Fair: St Ca • ; el •NY. T0512 Llcense'No. 29206
APPROVED FO.R CONSTRUCTION, This'approval" expires one year.from.th ate issued .unless - ;-t ion of the building has been undertaken and is
revocablefor-cause'or maybe. amended or: modified- whencon "sidered, necessary, by the;:Comrnissio er Ith. AnY'change or alteration of construction
requires, a -new permit Approved for disposal of domestic son w e, and /or priv e r only.
Date 66, BY M Title
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
,COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Own L �� Address
n ._ er %�o g �,c
Located at (Streeter o G} �. Sec. Block �� Lot
ca a nearer cross . s r o f /��y, 0/#- 78o-¢ -Ziel.
Municzpalit Y. a rsa ..Watershed.
sh d e rz.
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH,APPLICATIONS
.
Hole
Number CLOCK.TIME PERCOLATION PERCOLATION
Run apse. Depth-to Water Water ve. .
No....:'....... :.. Time From. Ground Surface in Inches Soil. Rate
Start =Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
1 D
2. .3.
�¢
5 y� Go
1 ...
Notes: ,l) T§t -its to be repeated at same depth until a roximatelyy 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.
DEPTH
G.L.
101
TEST, PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION
DESCRIPTION'OF SOILS ENCOUNTERED IN TEST HOLES -
HOLE NO. HOLE NO. HOLE NO'.
n
THIS SPACE 'FOR USE` "BX"`HEALTH DEPARTMENT ONLY: * 1
Soil Rate.Approved° Sq. Ft /Cale Che F
Y"ti
PROVINCETOWN STANDARD FEATURES
Double floor (1'/4" thickness)
31/2" wall insulation
61/2" ceiling insulation
Insulated metal exterior doors
Front and rear entrance lighting
Interior lighting fixtures
Wood windows with storm sash and screen
Fiberglass shutters on front windows
4" aluminum siding
Aluminum gutters and downspouts
Wall to wall nylon sculptured carpets throughout
Vinyl flooring in kitchen and bath
Broom closet in kitchen
Power kitchen range hood
Formica laminated wood grain kitchen cabinets
with laminated counter tops and ..back -
splash
Stainless steel single bowl kitchen sink
Main bath with color coordinated fixtures, —
fiberglass tub, linen closet, and vanity
Door chimes (front door)
Smoke detector in hall
Choice of heating system; forced hot water, oil
or gas; electric baseboard
Prime - painted interior walls
Wide range of color sei ctions
L. E
Model No. A- 40- 3- K5 -1 -F
24'. <0
The floor plan shows inside dimensions.
SEE YOURSELF IN A WESTV/L�E HOME!
PROVINCETOWN OPTIONAL,FEATURES
7" red cedar shingle siding
Insulated sliding glass door
Colonial bay window
Casement window over kitchen sink
Snap -in window mullions
5/12 roof pitch r,
17.2 cubic foot frost free refrigerator
30" electric or gas continuous clean range
Dishwasher
Garbage disposal
Double bowl stainless steel kitchen' sink
Thick plush pile carpeting
Fireplace opening
Building code options available .
Ruve se floor plan
I
lb
Kum ES C "r TIC`N P.O. BOX 1, WESTVILLE, NEW HAMPSHIRE 03892, PHONE: (603) 382 -6505
Alpstvi!le Homes Corporation reserves the right to change models, standard features, prices, and options at anytime without further notice! 4 -75
1
State of New York Re: Sanitary Disposal System - S01616
County of Putnam .._�..a.. ,..,...,'We11 Location
For Miscellaneous Land Records
For Parcel Located On:
Cameron & Ingleside Roads
In The Town of Patterson
Tax Map 29 Block 5 Lot 1.1
(Putnam Lake Subdivision,
Map No. 149 Lot Nos. 780 -784 Incl.)
As Owner /Builder of the Sanitary Disposal System proposed for the noted parcel,
permission has been granted by the Putnam County Board of Health to:
1) Locate the well on the parcel at less than the required 100 feet
separation to the disposal system on this parcel (80 feet); but
no closer than 75 feet.
A copy of this document with the County Clerk's stamp is to be delivered to the
Health Department prior to issuance of a Construction Permit; with a copy to
the Applicant.
(Must be
Signed % Notarized)
Printed Na �%IS�p /0• r-04*
60
Address oeAP / 401/
U �
;JOSEPHINE CAMPANAR61
Notary Public, State of New Y
Qualified in Putnam Courity' '-
Commission Expires March 30..141.01.
F
v `
e � "
: .
S:tate..:of; N-eVP.4ork
County of Putnam
For Miscellaneous Land Records
i
iA-
'Re: -in :: System = 501616
Well Location and
Two Bedroom Construction
For Parcel Located On:
Cameron & Ingleside.Roads
In The Town of Patterson;
Tax Map 29 Block 11 Lot No. 5
(Putnam Lake Subdivision, Filed Map No. 149,
Lot No. 780 -84 Incl.)
As Owner/Builder of the Sanitary Disposal System proposed for the. noted parcel,
permission has been granted by the Putnam County Board of Health to:
1) Locate the well on the parcel at less than the required 100 feet
separation to the disposal system on this parcel; but no closer
than 75 feet.
2.) -Design and install a disposal system for a two- bedroom dwelling,
instead',of a three - bedroom system required by Health Department
standards:
A copy -f-thisAocument with the County Clerk's stamp is to be delivered to the
Health Department prior to issuance of a Construction Permit; with a copy to
the Applicant.
Sworn to before me this
14t�XDay of December,_1980
14914100E T. 'JT'td$(7t__
MaW0 ubtic. State of New:'YarR
9.. Putnani. County
GQmmrBori Eacpi3e$ March 30;,
(Must be
Signe�� Notarized)
Printed Name Ronald Karalis
Address 2840.Bailey Avenue
Bronx,.NY 10463
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services,-Carmel, N. Y. 10512
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Patterson
_ Town or Village
hocated:at;" Cameron. & xnglesIde Ads.......Map-
_. '..Map_ 14..9 .
.. ., Bloc k <..
Subdivision Putnam Lake Lot 780-784 NO Job S01616
Owner Jericho * B01 ders Inc ��jj Address East Branch Road
Building Type Lot Area 10000, IJ Patterson, NY'
Number of Bedrooms Three
Separate Sewerage System to consist of 1000 Gal. Septic Tank
To be constructed by ?
Water Supply: Public Supply From
Private Supply to be drilled by
Address
Other Requirements TW0 ^ 81 x 9' Deep Seepage Pits
Total Habitable Space Square Feet
lineal feet X — — — — width trench
Address
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 o 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 tlards, rules and regula i�'ons of the 'Putnam
County Department of Health, v
Date
11 Sept. 1975 Signed P.E. X R.A.
Address R. D. 6 Box 353 el, NY 1051 License No. 29206
APPROVED FOR CONSTRUCTION: This approval expires o year fr the date issued unl construction of the building has been undertaken and is
revocable for .cause or m y be amended or modified when c sidere ecessary sio of Health. Any change r I of construction
requires a new ermit. Approved for disposal of dom c ary sewage n r priv a supply only.
Date Tit le
-!nom
REVIELV CIII�;CK Sh T °
Meets Std. ( Remarks
es • No
DOCUMENTS •,;
House plans 0. K.
Design data sheet !
Peres presoaked? t
Alin. 301t pert test depth j
Const. results for 3 runs
D. Hole log O.K.
Corporate Affidavit for.other than individual i I
Authorization for engineer ! i
Letter from Water Supply if applicable i j
If variance requested -such noted on plans &apps.:
DETAILS
if charge is proposed.,)
Existing contours shown show new contours) S J 00A
Slopes for.d_riveway cuts., .etc. shown
Water service line location
Footing. drain., etc.. location I +
Top slope, bottom slope of fill A I +
Percblazion tests and deep test; pit location !
Septic tank size and conformance'to std. Id ! I
3 B.R. house-minimum I I
House setback_ shown i
11 • L •. r 1 .n1_ .» '_ 1 I f......-. L
H11 wa L&_L- wi d1.: n ,V j- -u.% 'FL a1iUW11 ' __ -... _.1... -.... _ ... '. - •- - -- -
..Plan end px'oiile. SDS
All
her wells and SDS closer 200'
shown or:reference. made
Property boundaries.(metes and bounds- clearly show
SEPARATION DISTANCES SPECIFIED ON PIA
10' to P.L. +
20' to Foundation walls I + I
100' to Nearest well f 1
50' to stream, march, lake, etc. incl.expansion ;
15' to Curtain drain ! I
10'' to water lir_e.(pits -20' ) ! !
15' to storm drain +
10' to large, trees. ! +
10' from foundation to septic tank I i
5 to pipe from leader --dr
._. ••. a ,�
'roj)-r. ty :l_i.nes or cor.•ncrc3 found 4 0 0 0 0 0 0 .•
;tin .a5timat;: ho, c
location.
n d cut
•la.1a. dr•vci���•iy ^c .
;•u�a trees be removed -note these
.s deep . holc mp., -�:Sjen ua•ti_vc of entire SDS area
:C,tli -bona. docp I ?olcs noodcd.
:i.cicnt STS. area available consi dori2]
driveway cut, house location, separation °
distan,,ces, etc.
I 4 T'T 110M. Ih 1t�
lk;pth : 11) -PCT 12.
Water elevation: B
]wcY, elevation: ®1
So_11s descri cation:
J
VO
ITdAL SITE IT?SP C`PIOD Insn. bq: j
Ouse located where shown on approved plan
l�� lO;:a tec; "trh..ere appro :red
V v� •
r
lope of ti Le, lire an y{• trenc.-z aCcCep able : "....:
Dom allowed for expansion trenches
ver 50 ft. from swarn-L). vatercourse -
itural soil not strippod.or SDS area
unnecessarily graded ... .
FLA. it -ainta ir.ed fro,;, prop . line . and
20 ft.. from m ouse
� pal at -- o1- of " .H:-nc h from house, wel.l
etc.
. .
follows plan 0 0 ,
.giber of b`droc-ms checks . . . , ,
;cnos, bn sh, stumps, rubble, etc. .greater --
t:ha.n l5 ft. from near °st trench . . . . . .
i 1i'L . of yaripheral soil horizontally from
trench . • :
mction boxes properly set
)uld surface run off from drive lag, roads,
ground surface, etc. channel roar SDS
area .... - . . •. _
�e:j 1bt d r. aina -e anrcar O. IC. in area of SDS
:r1~AL GRADING OF, SITE ACCEPIBIBLE ti
0
t-
l 2
PUTNAM COUNTY DEPARTMENT OF HEALTH =
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0.
Owner
Address
AtV
/Dam+ Oos9�6t .asl�4
Located at (Street �a�e Si i%& � . ock Lot X80 —
a e
nearest cross -5-We-WET
Municipality /�e� L��-so �, Watershed C_a
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
1
Number
CLOCK TIME
PERCOLATION
PERCOLATION
Run
Elapse
Depth to
Water
Waterlevel
No.
Time
From Ground Surface
in Inches Soil Rate
Start -Stop
Min.
Start
Stop
Drop in Min. /in drop
Inches
Inches
Inches
2
/ A,�-f 11tV
Z'
/
3
14-31 41?
sA> ® B&e
Notes: 1) Te's�ts to "tie repeated::- a t' same deptri until approximately equal
rates are obtained at'each:�id? 61ation test hole. All data to be submi
for review.
2) Depth measurements to be made from top of hole.
soil
tte'd
1
2
Notes: 1) Te's�ts to "tie repeated::- a t' same deptri until approximately equal
rates are obtained at'each:�id? 61ation test hole. All data to be submi
for review.
2) Depth measurements to be made from top of hole.
soil
tte'd
r
-.ZESTjIT DATA. REQTjTREP TO BE SUBMITTED WITH APPLICATION
:"-°'"DESCRIPTION''OF 'SOILS 'ENCOUNTERED� IN "`PEST-
DEPTH.
G.L.
611
12"
1811
'2411
3011
3611.
4211
4811
5411
6011
66"
7211
7811
Ron N.
e-
.!-XDIGATE---- AT GROUND - WATER -3S - -ENC OUNTIEREb - Alto 5 ..21 *m
INDICATE LEVEL TO WHICH WATER LEVEL! RISES AFTER BEING ENCOUNTE13EDVo4p /�-
-.-TESTS MADE BY 7- -e A,#.otMate,6//v-Y7Jr
DESIGN
Soil Rate Used 6 -7 Min/1"Drop: S.D. Usable Area Provided— /3-2 'O
No. of Bedrooms Septic Tank Capacity /000 Gals. Type
Absorption Area ProvIded By---I.,.L. F. x24" , — q
,�b" width trench.
Other
0
Address p Box 353
Fp
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: 114(
�
Soil Rate Approved Sq. Ft/Gal. Ch eVl&b Date
� �?
1 *.-2970�
91111%
1 Zte - - �s a'
�00, iml $I
September 12, 1975
Putnam County Dept. of Health
County Building
Carmel, New York 10512
Att.: Robert Caddell, P.E., Director
Environmental Health Services
Re: Well Separation Variance
Dear Sir:
I'hereby request that you grant exception to the 100'
well separation regulation, on my property located at
Cameron & Ingleside Rds.., Map 149, Lots No. 780-784 Incl.,
Putnam Lake Subdivision.
This well separation.and proposed sanitary system are
shown on Dwg. 1, S.O. 1616 by John H. Prentiss, P.E.-
All papers necessary for sanitary design approval are
attached.
Very truly yours,
JERLgffl BUILDERS, INC.
Joseph Bijou, President --
JB/pr
2V
r
MARGUERITE DAHNCKE
Notary Pcblic, State of N.Y.
Quafifir,d in Putnam County
Commission Expires Marches
_, 19 _Z ;7
LITNAM Cnt•N'rti• n(:i ART�MNT or {tn'r,Tll
DTVTST6N
. -:.� .. Date 11 Sept. 1975
Re: Property of Jericho Builders, 'Inc.
Located at. Cameron & Ingleside Rds. , Putnam Lake Subd. , 'T. Patterson
8O &A Map 1.49 Block Lot 780 -784 Incl.
Gentlemen:
This letter is to authorize John H. Prenti , P.E.
a duly licensed professional engineer % or rebistered architect
(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.promulaoated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction-of 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.
Oountersign. .
P.E. R.A., T 29206 �.
R. D. 6, Box 353
Address
Carmel, NY 10512 11*
914-878-6170
Telephone
Very truly. yours,
Signed 404<. _
W?ner r operty
4�st Branch Road , •.
.Patterson. NY
Address
914- 279 -3987
- -__ - Telephone
� T
1-1 18
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PROVINCETOWN-.
:STANDARD`FEATU.,RtS�--`
'Double floor 0 1/4". thickness?
,,
3 16;' wall insulation,
51A ceiling insulation
L
insulated metal extetior doors
'a
(/dr,7nr cans Liquid
capacl
Pit 6014
6 ChL8�
# /Q/ ;.
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