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02126
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Address
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County 041eolrt o..,t//))MM1Qth
a"
' .'Aadres3
A PPR O,V E O RO R .:CONSTRUCTION': Ti
rev"$" for "tames or. may be -b Web'
"auk" new 'Per �l Apatovau.'fo►
- --- Vii`- ,'. ->�"�
lia
p'bYtigaCtory to the Commismorwr of Health will
heirs of Sisijns by the'bullder, that said builder will
2) Yuri bnnwdlitely' followbp thOdOto of tM MOP
Nis tlieietoi that tM drilled well desoribest a6ow
tandariI4 t and. {p�f Me 'Putnam
AA:
tst- Y Utensil NO 2-4-008 '
uetlon;of the building has been undertaken and is
W
Flth. ° Any Cnanee'Or siteratke i'of. Construction
sy only..
Title
DEPARTMENT OF HEALTH
Division of Environmental Health Services
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 Villa a City
1 P -rtjA
Tax Grid Number
I - to. -L
WELL OWNER
Name Mailing Address
v"sa. 57S .d %j
'Private
0 Public
USE OF WELL
1 - primary
2 - secondary
RESIDENTIAL 0-PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED
0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify,
13 INDUSTRIAL E3INSTITUTIONAL 0 STAND -BY
AMOUNT OF USE
YIELD SOUGHT bdij 5 gpm/ # PEOPLE SERVED I F,t, /EST
0 REPLACE EXISTING SUPPLY 10 TEST/ OBSERVATION
NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL
. OF DAILY USAGE ,O° gal
12 ADDITIONAL SUPPLY
REASON FOR
DRILLING
DETAILED'
REASON FOR
'DRILLING
WELL TYPE
WDRILLED
®DRIVEN
®DUG
®GRAVED
0
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name L�_- � aeb Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED �.
ON SEPARATE SHEET
(date)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted Linder 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 s.hall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of
County Health Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the
Health Department.
Date of Issue: 31 19
Date of Expiration :_ J 19 ermit ss n9 %
the Putnam
am County
4,_ O z� }
cta
Permit is Non - Transferrable White copy: H.D. File
Yellow copy: Building Inspector
Rev. 10/88 Pink Copy: der
Orange copy: Well Driller
. DIVISION OF AE7i M SEIiV M '
--DESIGN DATA SEiEE SL LTFAU SEMa ' DISPEL SYSr"M 1-- FILE NO.
Owner Address 3-is RAVES =s�o� D2'. I3e� ti1Y,►.1?f iooZE,
Located at (Street) Sec: ---:A_ Bloch ^_' Lot to.z
(indicate nearest cross street)
muaicipality �� r►�1.oM
\�,au_�Y
Matershed.
�eo y on
_8OM PtRC0LATION
TjEST DATA .PMWMM
TO BE SUBMI71ED VIM APPLICATIONS . .
Date of Pre -Sq&h g 9 • zA .- ee
•
Date of Percolation Test
•
g• Z •88
1
HOLE
1
NU i 3M CI= ZEE
PE RCO=CJN
PERC0tATI ON ' • . •
Run Elapse
Depth to
Water From ' Water Level..
No. ''Time
Ground
Surface In Indbes
Soil Rate
Start-Stop Min..
'Start
Stop Drop In
MbVIn Drop
Inches
Inches Inches
•
21
24
2 BSI
3 :q�45 -�0: Sq . S9
.. 21
2q 3 °'
• IP,
4
5 '
2-1
zq 3 . •
��
2 9:01- 9:55
7-1
29. 5
18
3 g * 55 - to :Q9 51A
2'1
r r'
214 3
8'
41o•9911: SA
z'1
214 3
18
5
2
3
4
5�
- -'-
NOTES: 1. Tests to be
repeated' at same
depth untdl ,appraadmately
equal Soil rates
are'obtained.at each percolation test hole. All data to'be.mibmitted
• for review.
2. Depth measurements
to be made fran top of hole.
TE T PIT DATA BEp= TD BE Sumnvrw wrM A.PPLICATIM
DESCRIPTION OF SOILS EZMUNIERED IN TEST BCLES
DEPTH. -HOLE -NO. HOLE NO. Z HOLE• No.
31
60
.7°
9°
10° '
12
13°
a
INDICATE LEVEL AT WHICH GROLJNDAATER IS ENCOUNTERED
INDICATE LEVEL- M MUCH WATER LEVEL RISE $ AFTER BEINd ERMLKEEPM
DEEP' HOLE OBSERVATIONS MADE BY s ' DATES 9.2-o-88
DESIGN -
Soil state Used 1® Min/1" Drop& S.D.. Usable Area Provided s000r
No. of Bedrooms 3 Septic Tank . Capacity i o 0 0 9 Tj'Pe Nw RY •-
Absorption Area Provided By 4-ac, L.F. x 2411 %iidth trenc
(lei 2 z 2.0.8 FILL 7srelBu -rion�
Name C �1_I �w� /� - \SSdC /AYES �• C S.agnatdre
Address S'L i S' \ G� • ,r $rC�� .. _ `'',�f
a SPAIt
THIS SPACE FOR USE BY EMALTH •DEPA ONLY-
Soil Rate - Approved, sq e f t/ga,, .. Checked by Date
��m
vU
. PUTNAM COUNTY:DEPARTMENT QF. HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
i
• .nar c. a ... .. r . va.. •. .- ...ro.. .. - �._ - w�.... w...... , ..... a.�. �•— ti.x- �..J.,wy�F'. �.. .rru . .+�. .. u .. . s �...- ..- a-r�.•n .r .n . .....»....r.. ....n.wni r •.r x+v �Y�...
Dateµpei2 ISM 1988
Re:. Property of PAL U
Located at KOA -7 At:- -30
• i
(T) Section q Block Lot %o. -L-
Subdivision of
Subdv. Lot # Filed Map # Date
Gentlemen:
This letter is to authorizeS'NI /I�� �SSO�'.i RTES
a duly licensed professional engineer V or- registered 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 promulagated 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 . -43L . ;..}�e . provisions of A ticl 0 145 bi ` `
147, Education Law, the Public Health Law, and the•Putnam County Sani-
tary Code.
Very truly yours,
Signed
Owner of Property l J
Address
Town V
Telephone
u5 —0n®8
Telephone
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CASHIN ASSOCIATES, P.C.
HUDSON VALLEY DIVISION'
'A_i6fi66 —ti • Engineers � suiveyors
Route 52, Carmel, New York 10512
(914) 225 -8088
February 28, 1989
Mr. Larry Werper
Putnam County Health Department
110 .Old Route 6 Center, Bldg. 3
Carmel, New York 10512
RE: Paulette Miller
Dear Mr. Werper:
Please find enclosed for your information and disposition, four
copies of the proposed fill section only SSDS Plans for the above
mentioned project. In response to your February 14, 1989 letter
the following comments have been addressed:
1. Septic tank, pump pit, and overflow tank are shown on the
fill only plans.
- i
2. Expansion area is shown on the plan enlargement.
3. Proposed contours have been placed on the plans.
4. Contours have been labeled on the plan enlargement.
- -- Should - - You- - -i,av-e_ - -_any -questions or
contact me at this office.
Very truly yours,
CASHIN ASSOCIATES, P.C.
Christopher B. Maravelas
CBM /jlp
Enclosures
comments, - pleas-e--fee-1 fr -ee to-
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Mr. Christopher Maravelas
Cashin Associates
Rt 52, Seavey Plaza
Carmel, NY 10512
Dear Mr. Maravelas:
February 14, 1989
Re: Proposed SSDS - Miller
Route 301
(T) Putnam Valley
TM #4 -1 -10.2
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Review of revised plans and other supporting documents submitted at this time
relative to the above- captioned project has been completed. Comments are offered
as follows:
1) .Septic tank pump pit and overflow tank must be shown on fill
only plans.
2) Trench layout and plan enlargement do not coincide.
3) Expansion area not shown on plan enlargement.
4) "'Plan enlargement must include well location. -
5) Proposed contours must be shown on plans.
6) Label contours on plan enlargement.
Upon receipt of a submission, revised to reflect the above comments, this application
will be considered further.
LCW: jr
Very truly yours,
J '
Lawrence C. Werper
Assistant Public Health Engineer
)_ �11
cashin associates, p.c.
design professionals
route 52
carmel, new york 10512
(914) 225 -8088
TO EJ1T1 M _o�1a17`f -DEPT OF 1 �r,4t_TN
v s,
LETTER OF TRANSMITTAL
DATE
JOB. NO. I
ATTENTION
er
RE: •�
• Return
corrected prints
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2
WE ARE SENDING YOU Attached ❑ Under separate cover via
❑ Shop drawings J Prints Plans
❑ Copy of letter ❑ Change order ❑
❑ Samples
the following items:
❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
• Return
corrected prints
2
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THESE ARE TRANSMITTED as checked below:
*or approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
• For review and comment ❑
• FOR BIDS DUE
• Resubmit
copies for approval
• Submit
copies for distribution
• Return
corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
I
COPY TO:
SIGNED:
If enclosures are not as noted, kindly notify us at once.
cashin associates, p.c.
design professionals
route 52
Carmel, new york 10512
(914) 225 -8088
TO F `-�mI M GF 4plc-rH
110 0-� 'ouTB /o C A/MC S1-U15, 3
I--I-T' l o s m-
LETTER OO F Tim ITTAL
DATE.--: � .� a ... ... .. ' .
g, 8.89
JOB. NO...
ATTENTION
RE:
WE ARE SENDING YOU XAttached ❑ Under separate cover via
❑ Shop drawings ❑ Prints Plans
❑ Copy of letter ❑ Change order ❑
the following items:
❑ Samples ❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
THESE ARE TRANSMITTED as checked below:
'For approval ❑ Approved as submitted
• For your use ❑ Approved as noted
• As requested ❑ Returned for corrections
• For review and comment ❑
REMARKS
• Resubmit copies for approval
❑Submit copies for distribution
• Return corrected prints
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
COPY T0: nn
SIGNED: ��'latadeO
If enclosures are not as noted, kindly notify us at once.
cashin associates, p.c.
design professionals
route 52
carmel, new york 10512
(914) 225 -8088
TO Fu rrJ,am Couy-ry of= Aer, Lrr N
110 oun {zou-m Co 3
►-JsH/ YoI.K 10-5 Iz
LETTER OF TRANSMITTAL
DATE
24.89
DATE
JOB. NO.
ATTENTION
JAI
,�j
RE:
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'� /oo . o0 o E1' b►ao
i
WE ARE SENDING YOU (Attached ❑ Under separate cover via
❑ Shop drawings
❑ Copy of letter
the following items:
• Prints Plans ❑ Samples ❑ Specifications
• Change order
COPIES
DATE
NO.
DESCRIPTION
I
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xs-f �g1
'� /oo . o0 o E1' b►ao
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THESE ARE`TRANSMI`iTED as ch'ecked'beYow:—
❑ For approval
❑ For your use
�<As requested
❑ For review and comment
❑ FOR BIDS DUE
REMARKS
COPY TO:
• Approved as submitted
• Approved as noted
• Returned for corrections
• Resubmit copies for approval
• Submit copies for distribution
• Return corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED( s,_
If enclosures are not as noted, kindly notify us at once.
cashin associates, p.c.
design professionals
route 52
Carmel, new york 10512
(914) 225 -8088
TO <2-u^/ZY 1✓EFR. OF 9=—^- 7 A
11 o 00> P-o u-rT Co T3 3
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'LETTER OO F TF'�1��4a �TT�L
I. 13.9
DATE
ATTENTION
►,-� �.. l..st�e-
wl ors
RE:
1 13 • $
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.aTIJO IY..a�-tOnl L.-E H
WE ARE SENDING YOU XAttached ❑ Under separate cover via the following items:
❑ Shop drawings Prints Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES
DATE
NO.
DESCRIPTION
I
1 13 • $
� STf2c/C � ea:titl T
I • 13 • 8
Ems. p�.M t-e'
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THESE ARE TRANSMITTED as checked below:
)ifFor approval ❑ Approved as submitted ❑ Resubmit
• For your use ❑ Approved as noted ❑ Submit_
❑ As requested ❑ Returned for corrections ❑ Return _
• For review and comment ❑
REMARKS
COPY TO:
copies for approval
copies for distribution
corrected prints
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED: l • L . —fy)cmxkj ad
If enclosures are not as noted, kindly notify us at once.
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