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PUTNAM COUNTY DEPARTMENT OF HEALTH ,
Rev 3/86 �p µDivision of Environmental Iiealtlt Se`rvlces Ceimel N Y.' 10512
e r �,' on CERT�I
CONSTRUCTION .`PERMIT;F SEWAGE DISPOSAL SYSTEM, 4i *. Permit N =,
,
Put,
Eir.ch' Road t Zake Store Drive Toy;
. , Roara.ng•. ro.o :>,. 7
Sabdiylslon Name;, Sabd Lot N - Tax Mep _ , Bli
f_ ` °J. Micheal Dolan. Renewal -°
;Owner /Applicant Name �
* %9 Oak ,Ridge Drive Putnam Vagey Date of P vtons Approval a
,blauhtg'Ada,reee ., j j Town P.�t� am Val:
Y k Mod 441arx t-F k5 tE.. t r .t AeU 4
Bsdlding sType µsr Lof' Area ' Fi� Sectlon Only r
�O R 4
,Nmnbe'of Bedrooms �� � `� 1)eeiga Flow G /P /D � � ° PCHDNotifcatlonlei
t F- f ,� f f�_.
"Separate Sewerage Systemao conelef of 100 on Septic Tank and ' ��00 �F Of iZ4il
To be conshvcted rd. Gragert r Aaareea0 wana I+akeR�
r sca
Water SaPPI] Public Supply From µ t Address
or= X Private Sup ly D ed by A21der'son Vel ddreea :Barger ,StretE
j$ o raven ` zn place .min o
Other Requirements F ` 2 oa
f n f thed ro Osed ste Q
I, represent that i, "am wholly and completely °iesponsiD le or the "design uric locat�o o .,p p sy �s� 1iC
'above described will be'conitructed�,asshown "on theiDProved amendment theri to andinticcordahce . w ith0� :d
County''- +Department of Health `and that on completion thereof a Cedtif�cate of Construction Comp' cti
bo= submitted to; the Department :'and a written guarantee wilt` be furnished the" owner his succissdrs r a
- ••place`in good.operatmg.cond tion °any 'part'ot SaiG,sewage'°disposal systemdunng they periodto}Avo,j£;i _
,. ante of, -tn a. appioval of'ftne Certif+cate of +ConsVuction Compliance .of the or�gmal system orah .r�.i sal t�
will be located of shown on the approved plan and that said well_will be installed in accord` ce� wit:h,, t ndai
.County "DePe$tlgerlttOt h 1987" ti� { ��t716
s� �j
Date ' r 2, S ea
`Z INorthrx'�g ,.,
• Ada =ess - _
o
APPROVED FOR CONSTRUCTION This�approval;exp�res one year from the date issued untessy con
'revocable for ,caii3e or may be amended or mod�fiedwhenconsidered necessary: -by the'Commissiorier o
requ+res.,a nowr,perm�t Approved_ for disposal of domesLC sanitary sewage and /or private water supply — lw* w:
` Date
s.v.�Y
Iiptovide.Permlt tY
)P COMPLIANCE
alley {T)�
y
;uh�e .18 -�_
Lot
loo o
10579;
ti* 1
,
1 2+ S > r •a w
� F
x;
IWhen Fill is completed C
�tnam Valey, NY
�tnam Valhey, ,:NY 1057
s Pro o ins
is rite- sewage.'disposal system
O u a ions,o o u nam -'
A `missioner p( Health will
I('ahat said' builder will
owitiq thedete'ot the issu
n I well described above i
►, pans of the Putnam i
ense tvo r` �+
a s a
i�jrMs been undertaken andI 1
' r,-alteration of construction w
r +
PflTER C AIEXANOERSQN
County Executive
Mr. John Romeo
1 jlorthridge Road
Peekskill, NY 10566
DEPAR ► N ENT OF HEALTH
Division Of Environmental Health Services
1-10 Old Route Six C =zcer, Carmel. New York 10512
(914) 225-3310
- September.20, 1989
Rte: Construction Permit - Dolan
Birch Road & Lake Shore Drive
(T) PV
TM #7 -3 -18
LN10 L C-AaRUTH.. M.P.4.
Pualic Heartn =i's,
,CNN 'CARE I-1 -t_ P.S.
C:rac-.ar
Dear Sir
Review of my files 1ndiCates no activity on the above CaGtiane' d project fur sC'me
time.
. Pie= se..advj,.qa.:tchq:...wr..iter as to the status -•of this- projec without delay:*
Failure to receive a response by October 16,1989 will result in the file-being
returned to you, DISAPPROVED.
Very truly_ yours,
Larry W. Werper
Assistant Public Health Engineer
LW /jp _
cc: Owner:J. Michael Dolan
49 Oak Ridge Drive
Putnam Valley, NY 1.0579
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
December 22, 1987
Mr. John Romeo
1 Northridge Road
Peekskill, New York 10566
Proposed SSDS Dolan
Birch Road & Lake Shore Dr.
(T) Putnam Valley
TM #7 -3 -18
Dear Mr. Romeo:
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
Review of plans and other supporting documents submitted at this
time relative to the above - captioned project has been completed.
Comments are offered as follows:
The proposed SSDS area is not acceptable for the following
reasons:
1. -- Water. ,at.1. foot -_in- deep hole 5. _._.. _- ..... -...
2. Standing water " in* proposed SSDS` 'area':
3. Proposed SSDS is within 100 feet of a wetland as
determined during my field inspection of 12/21/87.
If revised plans are submitted the wetland boundary is to be
shown.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Very truly yours,
Robert Morris
Sr. Environmental Health Technician
RM/jp
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
.J. Micheal Dolan address 4.9 0ak'� Ridge' Drive. Putnam Valley, NY
Located at (Street) Birch . Rd, &bake Shore Dr... Sec. 7 Block 3 Lot 18
(indicate nearest cross street)
Putnam Valley Municipality Watershed Peekskill
SOIL PERCOLATION TEST DATA RDQUII2ED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking Aug 17.9 1987 Date of Percolation Test Aug 18, 1987
HOLE
11:11
7
16.50
1950
3,00
NUMSM ClaM
TIME
11 & 27
PERCOLATION
PERCOLATION
Run
Elapse
Depth to Water Fran
Water Level
No.
Time
Ground Surface
In Inches
Soil Rate
Start -Stop Min.
Start
Stop
Drop In
Min /In Drop
Inches
Inches
Inches
-
(1) 1 11x01
11:06 5
16.00
lg000
3,00
1067
11 :10
11 :17 7
16000
19000
3000
2033
2
lls20
11&28 8
16.00
19.00
3,00
2067
3
4 11 :32
11s40 8
16000
19000
3000
2067
5
(2) 1 lls04
11:11
7
16.50
1950
3,00
2033
1 & 18
2 1
11 & 27
F _9
16.0 5C...1g.3
-0 ..
..
30 00....._ .....
_ 30 00° : _....,._ ._ ....._. _..._.._
3 11 :34 lls43 9 16.50 19050 3000 3000
4
5
1
2
3
4
5
NOTES: 1. Tests to be repeated'at same depth until ai'ppricxubmtely equal soil rates
are obtained at each percolation test hole. All data to'be submitted
for review.
2. Depth measurements to be made fran top of hole.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
Pere DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES . d. e e p
DEPTH 1
G.L. Topsoil Topsoil Topsoil Topsoil Topsoil Topsoil
1, sandymgravel sandygravel sandy sandy sandy sandy
gravel gravel gravel
2'
3'
5'
6' y
7'
8'
10'
. 12,
13'
14!
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED None
INDICATE LEVEL TO WHICH 4ATER LEVEL RISES AFTER BEING ENCOUNTERED None
DEEP HOLE OBSERVATIONS MADE BY: Carmine LaPine (J Romeo) Dom: August 179 87
0_ - DESIGN -- - SOOOSF +
Soil Rate Used 7 Min /1" Drop: S.D. Usable Area Provided
No. of Bedrooms 3 Septic Tank Capacity 1000 gals. Type Masonry
Absorption Area Provided By 300 L.F. x 24" width trench
Other m •
•
Name John S. Romeo Signature
1 Pio thr ' d e Ro d
e
b
Address r z g a SEAL
Peekskill, N.Y. 10566
e Jf 27BA�'
01 IMP
O iC
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: •.,,,,o«
Soil Rate Approved sq.ft /gal. Checked by Date
COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
1
\
(Name o Owner) (Street Lc
D Tz
BY:
DOCUMENTS
Permit An
Corporate Resolution
Plans - Three sets
Engineers Authorizaticn
Design Data She--t (DC.S)
Deep Hole Log
Consistent Pe.-'c Results
Perc Hole DeOth
i
s/s
SUBD?ti%� ICN
I Perc
(3) Fill -
ca
Souse Plans - Two sets
Well pe-rmit; P' S letter
VariaUce Reques-It-
GENERAL
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Tcwn /DEC Permit R & D)
Data On DDS Plans & Permit Same
REQUIRED DETAILS ON PLA ,,S
Sewage System Plan - (north arrow)
Sewage Systern Hydraulic Profile - .Gravity Flcw
Fill Profile & Dimensions - Voltme
D or J Box;Trench /Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Ser�Vice Line if over
Construction Notes
Design Data: perc and deep results
Two -Foot Contours Existing & Proposed
Driveway & Slopes Cut
Footing /Gutter,Cur'� in Drains' (discharge OK) -
Perc & Deep roles Located
Representative of primary an---- ex --arsi cn
Expansion A.re7.;shcw-n;gravity f'_cw,su= size
If Pounced Pit & D Box Show: � Detai l
House - No. of' Bedroans
Wells & SSDS's Win 200 ft. c= Propcsed Svst_..E
Property Rtes & Bounds
House Setback Necessary (Tight lot)
House Sewer - 1 /4 " /ft. 4 "0; "_'- --e pipe
No Bend--,; Max. -15 -nds 4 ^ c w :--Ie .Out
SEPARATION DISTti' -S - CN PL, `+
Fields
10' to P.L., Drive a %,, Z;�-.r, Tr =_, _
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Lake (ic.
15' to Drains -Cur Z n, Le---der, Footing
35't0 catch basin, wat_rc^ -1—
10' to Water Line (pits -20')
50' inte_m- mi.ttent drainace course
Septic Tanks
10' fran Foundation; 50' to will
15' Well to PL
a. r
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
_.__._- .APPLICATION. TO .CONSTRUCT A WATER WELL
PCHD PERMIT 4
WELL LOCATION
Street Address
Birch Rd, & lake
Town/Village/City Tax Grid Number
Shore Dr. Putnam Valley 7 -3 -18
WELL OWNER
Name
J Michael Dolan
Address JpPrivate
49 Oakrid,ge drive Putnam Valley p public
USE OF WELL
1 - primary
2 - secondary
19 RESIDENTIAL
O BUSINESS
❑ INDUSTRIAL
O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP D ABANDONED
O FARM O TEST /OBSERVATION ❑ OTHER (specify
❑ INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE600 gal
REASON FOR
DRILLING
®NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY OTEST /OBSERVATION
❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
WELL TYPE
DRILLED
DRIVEN
DDUG
GRAVEL 0
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Roaring BrooX 171ap
Lot No. fD
WATER WELL CONTRACTOR: Name Anderson Well Drillers Addressi3arger St Putnam Valley
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: - TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: None
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED None
OON REAR OF THIS APPLICATION ON WSA T E SHE T
Sept 29, 1987 �
(date) ✓ (signature)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under 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 shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam
County Health:,Department attached to this permit.
3. Submit a Well ,
Completion Report on a form provided by the Putnam County
Health Department.
Date of Issue:
Date of Expiration:
Permit is Non - Transferrable
8/86
19
19
Permit Issuing Official
PUTNAM COUNTY DEPARTMENT OF HEALTH
Date August 5, 1987
Re: Property of J. Michael Dolan
Located at Birch Road. and, Lake Shore Drive
(T) Putnam Val ley Section 7 Block 3 Lot 18
Subdivision of Roaring Brook Map 2
296 308E 1946
Subdv. Lot # Filed Map # Date
Gentlemen:
John S. Romeo
This letter is to authorize
a duly licensed professional engineer (X) 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
c'onhec`t'ion--with"- -th: s "matter' and' t'o-supervi'so�- the nor struetion-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.
Very truly yours,
Signed
Countersigned: - Owner of Property
p. E. xJM # 27846
Address
1 Northridge Road,
o
AddrePe Town
ekskilloNY 10566o'��c�o`, �� `0
r9 1141-�
737 -1056 °
elephone
Telephone
oo.e°oo
1
. 13` -1" VO'-2` 12-9
10"
• �" � -6 °WIDE x 7" DEEP ,
-2 GIRDER POCKETS
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R.EINF. AS RE'p' D. ,� -i + -{� R FOGTING TYP.
FRbSTWALL AS RGgUIRED
ANCNOR BOLTS !o `- O. C.'•
4" FROM OUT51PE EDGE MIN. 10' GONG. WALL �
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DESIGNED 8 SUPERVISED BY
JOHN' S. ROMEO, PC.
CONSULTING ENGINEERS
I NORTHRIDGE ROAD
13//c
A P'PN Lo 4 61-1,
BEDROOM HOUSE
SOILS RATE
/o o- GAL. TANK
74 L 2- 1
0 Vfi-,L /. U' -t-v
N
2- 4 s*. '2
C!
x V 1� -
Aj;"
SEPTIC SYSTEM
FOR
J. WICNAEL DOLPH
TOWN OF PU74AI') v A I- 1. f-'l
,Pt/-rH M COUNTY,