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HomeMy WebLinkAbout2277DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -2 -64 BOX 20 17%. M.j %I , . '' �� f' � ` �, or oil . ol .� IL , 02277 i r UTNAM COUNTY DEPARTMENT OF HEALTH IVISION-OF ENVIRONM CER FICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at Lyons .Court Owner /Applicant Name Chris Beliveau New Construction Formerly Town or Village Putnam Valley Tax Map 41.6 Block 2 Lot 64 Subdivision Name Roaring Brook Subd. Lot # Mailing Address 11 Lyon Court, Putnam Valley, N.Y. 10579 Zip 10579 Date Construction Permit Issued by PCHD 11 Separate Sewerage System built by j?IR t�"k57pQ4„ ddress �t -- Consisting of 520 LF 24" Gallon Septic Tank and Trench - Other Requirements: NA Water Sup"I : Public Supply From Address or: Private Supply Drilled by 1 ®r an Address „_woh Hill Rd. Putnam Valley, N.Y. - Building. Type Has erosion control been completed? wood ame Yes Number of Bedrooms 4 Has garbage grinder been installed? No I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: 1 -h -AA Certified by ° E. R.A. (Design Professional) Address 2 Dale Avenue, Somers N.Y. Li cer r 7iM-i 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 sewage treatment 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 water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modi atio ha ge is necessary. B�'� Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM C4�,i5 Owner or Purchaser of Building Building Constructed by : Tax.Maap1 Block Lot Town/Village Location - Street Subdivision Name 3 Building Type Subdivision Lot # I represent that I am wholly: and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is 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 successors, 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 approval of the "Certificate of Construction Compliance" for the sewage treatment, 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 occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Day 6 Year CIS-7- Signature: Title: 6 t6,� M General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State Corporation Name (if corporation) Address: Zip State Zip Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street _. _. _ _ .. .: •,_. •. ?..�,;, ._. », `'1�9 �• '�". �-1,U��}_:; -i °. l: :at; �. c' �. },. �r -- '1ti�v 9-i=; _, .... ._ .. .._ .,.r ..r_.. - ..,,.ro- - .... .._.. ___... _ .._. ...... ..._, - (9 :. `-r ) 245 -280t) a Albert. H. PadovanO Director- -AB # s 32.428530 t=L IENT. #: 8257 NON STA T PROC PAGE 1 DEL I VEAU , CHRIS MATE /TIME TAKEN: 11/26/97 1 1 : 0 ) 11 LYON COURT DATEXIME REC' Da 11/26/97 02:4 P UTNAM VALLEY, � �Y 10579 REPORT DATE: 12/04/97 PHONE: (414) -526-8474 SAMPLING SITE: SAME SAMPLE TYPE..: POTABLE KITCHEN TAP _ RE SE R`JA T I VES: ; NONE C� �L ' D BY: SAME TEMPERATURE..: < 4C, NOTES ... , COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL -- RANGE METHOD PU T Nfit °'. =NTY PROFILE 11/26/97 MF T. tCOL I FORM PRESN1 /100 ML ABSENT 1003 11/26/97 }` nr ) h 5 Pob 12345 11/26/97 NITRATE N I TROG <0-E E M /L t.) - 11/26/97 NITRITE NITROG :0.01 0 MG /L N/A 11 /- _•!97 IRON (Fe) <0.060 MG /L 0-0.3 mO/ i 11/26/97 MANGANESE (Mn) 0.015 MG /L 0-0.3 mg/1 11/26/97 SODI}_M Na) 2.99 MG /L N/=r 11/21/17 off 1.0 UNITS -9.5 11/26/ HAR_NESS,T_TAL 38.0 MG /L N/A 11/26/97, AL }' AL I N I T'? (AS 40.0 MG/ L tai H _.. 1.1.'.2L,,, ` --"`- » _._. TUR RIi!i.!'t`•_..(.SUR._.._:_-. -_.:1.._NTU. _.._ , :..•.... ..._. _..:.. �.:_....... 11/26/97 MF FECAL COL I F ABSENT 100 ML ABSENT 11/26/97 E . COL I (CONF I ABSENT 100 /ML ABSENT � COMME NTS BACT THESE RESULTS INDICATE THAT THE WATER (WAS) , AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH NEW YORK: STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. -'b/Cu LEAD limits for p EPA Lead & Copper than 10{ of their than 15 ppb and a treatment must be potential. tbl is schools are set at 15 ppb. Rule for Public Systems requires that no more distribution paints have a LEAD value of more COPPER value � } f 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No.limits for Sodium are proscribed. Suggested 'guidelines state that for people on a sodium restricted diet.the mater should contain no more than 20 mg /L of Sodium. For those on a I YML ENVIRONMENTAL SERVICES 321 Kear Street - _Yor[. -:town Heighr•e iV:Y::...1DJ��:�.._.._ - ( 914) 245 -2800 Albert H. Padovani, Director LAB #: 32.428842 CLIENT #: 8257 NON STAT PROC PAGE 1 BELIVEAU, CHRIS DATE /TIME TAKEN: 12/10/97 08:30 11 LYON COURT DATE /TIME REC ' D : '12/10/97 09:0(--) PUTNAM VALLEY, NY 10579 REPORT DATE: 12/12/97 PHONE: (914) -526 -8474 SAMPLING SITE: SAME SAMPLE TYPE..: POTABLE • PRESERVATIVES: NONE COL'D BY: GAUME TEMPERATURE..: < 4C NOTES...: KIT TAP COLIFORM METH: MF DATE FLAG PROCEDURE RESULT. NORMAL - RANGE METHOD 12/10/97 MF T. COL I FORM ABSENT /100 ML ABSENT 1 008 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATER WAS ,(WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIP THE NEW YORK STATE AND EPA FEDERAL DRINKING -WATER STANDARDS, FOR THE - PARAMETERS TESTED, AT THE TIME OF COLLECTION. SUBMITTED BY: Albert . Padovani, M.T.(ASCP) Direct r ELAP# 10323 ��0\ T.Tt -T T /•. /'11TT ?^ r rr%AT 'D V'nnVq' • -'yn+.LL I� l..Vlir LL.l iva� +�. +... +�� Office Use Only DEPA_RTMENT OF HEALTH c_ Division Of Environmental Health Services •lO� PUTNL %4 COUNTY DEPARTIENT OF HEALTH STREET AOURESS:. ..: 1 wr+ivtt :, c rtY J WELL LOCATION 11 LYON COURT, PUTNAM VALLEY, NEW' YORK 10579.. L 2 „ WELL OWNER NAME AOORESS: CHRIS AND DEBORAH BELIVEAU SIVATE O PUBLIC USE OF WELL O.- IfESIOENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP ❑ ABANDONED 1- primary. O BUSINESS O FARM ❑ TESTIOBSE.RVATION O OTHER (specify) 2 - secondary p INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY O MOUNT OF USE YIELD SOUGHT jZer . gpm -INO. FZ_OPL'E SERVED / EST. OF DAILY USAGE 800 cal. REASON FOR SEW SUPPLY O PROVIDE AOOITIONAL SUPPLY ❑ TESTIOBSE,9VARON DRILLING O REPLACE EXISTING SUPPLY L- OEEPEN EXISTING WELL DEPTH DATA WELL DEPTH + fLl STATIC WATER LEVEL fL DATE MEASURED DRILLING ❑ ROTARY O COMPRESSED AIR PERCUSSION 0. DUG EQUIPMENT O WELL POINT ❑ CABLE FERrUSSION O OTHER (specify): WELL TYPE O SCREENED ❑ OPEN END CASING. ❑ OPEN HOLE IN BEDROCK ❑ OTHER 8 , TOTAL LENGTH .= . ft MATERIALS: Q5TEEL ❑ PLASTIC O or, ER CASING LENGTH.SELOW GRADE — fL JOINTS: p WEL DED ❑ THREADED ❑ OTHE.R DETAILS DIA"hETER _ in. SEAL: 0 CEMENT GROUT ❑ BENTONTTE ❑OTHER WEIGH �T PER FOOT ; Ib.lft DRIVE SHOE O YES 0 N LINER: DYES ONO I DiAME Eti (in) SLOT SIZE LENGTH (it) DEPTH TO SCREEN (It) % .DEYEOFu'i SCREEN FIEST - ❑ TES ❑ 1140 DETAILS SECOND HOURS GRAVEL PACK_ 1 ❑ Yz-s ONO E ?AVcL �� D1AMETTER _.:. . _ .._: -. OF PACK TDP SOTT06t SIZE: in. DE: lrt tL DE.F t-, i K. WELL YIELD TEST 1 It detailed pumping ' WELL LOG 1t more detailed formation descriptions or sieve analyses are available, please attach. METHOM O PUMPED i tests were done is in- for�.ation DE &_ SOM w ,fef W,n • COMPRESSED AIR , attached? ;OYES Q sU'R ACE Seer- 'n9 D•ia- lAtter FOPJdATtOH 0- SCRIPTIOH GCE OBAILED ❑ OTr,E.R tt tt to WELL DEPTH OUFAMN DRAY 100N N YIELD Sur,; -.t S ur:c I IL hr. min. It. t 8.2 I WATER ❑ CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? O YES ONO STORAGE TANK : T Y P E rfzS CAPACITY GAL. PUMP WFDRMATION TYPE CAPACITY ,/ WELL DR:LL!R NAME _ DAT Z MAKER DE?TH AODFzsS srir MODEL VOLTAGE HP- lL��•. tom/ ✓ 21 A . .�_. - YML ENVIRONMENTAL SERVICES 321 Kear Street (914) 245-2800 ' Albert H. Padovani , Director -�� �� ��^�v ��=- _. _�_� LAB #: 32.428530 CLIENT #: 8257 NON STAT PROC PAGE 1 ~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~ BELIVEAU, CHRIS DATE/TIMETAKEN: 11/26/97 11:00 11 LYON COURT DATE/TIME REC'D: 11126/97 0043 PUTNAM VALLEY, NY 10579 REPORT DATE: 12/04/97 PHONE: (914)-526-8474 SAMPLING SITE: SAME , : KITCHEN TAP COL'��BY: SAME NOTES,..: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE SAMPLE TYPE.': POTA9LE PRESERVATIVES: NONE TEMPERATURE'.: < 4C COLIFORM METH: MF ---------------------------------------- RESULT NORMAL - RANGE PUTNAM CNTY PROFILE 11/26/97 MF T. COLIFORM PRESNT /100 ML ABSENT 11/26/97 LEAD (IMS) 3.0 ppb 6-15 pob 11/26/97 NITRATE NITROG <0.2 MG/L 0 - 10 11126/97 NITRITE NITROG <0.010 MG/L N/A 11/26/97 IRON (Fe) <0,060 MG/L 0-0.3 mg/l 11126/97 MANGANESE (Mn) 0.015 MG/L 0-013 mg/1 11/26/97 SODIUM (Na) 2.99 MG/L N/A 11/26/97 pH 6.0 UNITS 6.5-8.5 11/26/97 HARDNESS,TOTAL 38.0 MG/L N/A 11/26/97 ALKALINITY (AS 40.0 MG/L N/A 11/26/97 MF FECAL COLIF ABSENT 100 ML ABSENT 11/26/97 E. COLI (CONFI ABSENT 100/ML ABSENT COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATER (WAS) OF A N SATISFACTORY SANITARY QUALITY ACCORDING TO TH2 EW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. 'Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a METHOD 1008 1224'f YML ENVIRONMENTAL SERVICES 321 Kear Street (914).245-2800 Albert H. Padovani, Director LAB #: 32.428530 CLIENT #: 8257 NON STAT PROC PAGE BELIVEAU, CHRIS DATE/TIME TAKEN: 11/26/97 11:00 11 LYON COURT DATE/TIME REC'D: 11/26/97 02:43 PUTNAM VALLEY, NY 10579 REPORT DATE: 12/04/97 PHONE: (914)-526-8474 SAMPLING SITE: SAME SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COL'D�BY: SAME TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. SUBMITTED BY: Albert H! Padovani, M.T.(ASCP) Director ELAP# 10323 YML ENVIRONMENTAL SERVICES 321 Kear Street _ Yorktown Heiohl��. `1V�\/��ƒ�ILJ��--�'`�`--~��--�- (914) 245-2800 Albert H. Padovani, Director LAB #: 32.428842 CLIENT #: 8257 NON STAT PROC - PAGE I BELIVEAU, CHRIS DATE/TIME TAKEN: 12/10/97 08:30 11 LYON COURT DATE/TIME REC'D� 12/10/97 09:00 PUTNAM VALLEY, NY 10579 REPORT DATE: 12/12/97 PHONE: (914)-526-8474 SAMPLING SITE:' SAME ' SAMPLE TYPE..: POTABLE : PRESERVATIVES: NONE COL'D BY: G4UME TEMPERATURE..: < 4C NOTES...: KIT TAP COLIFORM METH: MF DATE FLAB PROCEDURE RESULT NORMAL - RANGE METHOD 12/10/97 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 COMMENTS: BACT THESE RESULTS INDICATE THATTHE WATER (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIK��]7] THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS _ TESTED, AT THE TIME OF COLLECTION. DirecUr. ELAP# 10323 Septic System Warranty The septic system located at 11 Lyon Ct., Putnam Valley NY, parcel #41.6 -2 -64 was purchased by Chris Beliveau from Sun NLF Partnership "as is" on 7/30/96 after close inspection by the purchaser. Inspections included the uncovering and visual observation of the main septic tank and each of the 13 septic covers. The field was observed to be. adequately constructed using gravel and bank run soil .to surround the leach-pipes. The field has subsequently enhanced with additional topsoil. The owners Chris & Deborah Beliveau expressly warrant the septic tank and system against failure for the period of 5 years and hold the prior owners and the county of Putnam Valley harmless for failures during this period. Signed, Q� DtLX January 6, 1998 Lod � ,,,�• , !� /t�� I �. 1. ,� Fi —•----- �4�y�') /• � � `aN, � , ., , / -.• r ,� �`_= •-� ==- t,o� ,� _ ' I cr oe LAY 1% Cf Lt 1q G G^ PUTNAM COUNTY DEPARTMENT OF THH ' Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer to Provide Permit N on CERTIFICATE OF COMPILA NCE �y CONS ON PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit N Putnam Valley Lo¢atedat nff Pudding Street Town or.-Village -- Subdivision NameRO Estates aring -Kfd-o -CEstat ti 3 Tax Map Block 1Y Lot es Owner /Appueant NameRoaring Brook Country Partners Renewal— ❑ Revision ❑ Date of Previous Approval Mailing Address RR #2, Twin Farm Lane TownPound Ridge, NY Zip Building Type 2 Story Frame Let Area Fill Section Only I X Depth Volame490cy Number of Bedrooms 4 Design Flow G P D 800 PCHD Notification is Required When Fill is completed Separate Sewerage System to consist of 1250 Gag Is Septic Tank and 500 LF of fields To be conatructed by K. Fiortino Address Putnam Valley, NY _ Water Supply; Pdblic Supply From Address or: X Private Supply Drilled by Beal _Address Brewster, NY Other Reodroments Fill Section 2.5" ROB 490 cy 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 ham 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- ante of the approval of the Certificate of Construction Compliance of the on ;net system or any irs thereto; 2) that the drilled well described above will be located as sh n on the approved plan,and that said well will be Installed in ccordanc w th andards, rules and regu a ions of the Putnam County Depart ant f alt Oats �' M Signed P.E. .X R.A. . Address 37 Fair Street Carm , NY -1&112 License No APPROVED FOR CONSTRUCTION: This approval expires two year from the pate issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when consider neces by a Commissio or of Ith. Any change or alteration of construction requires a' new permit. Approved for disposal of domestic sun' y se e, a r iva e u only. Rev. V 1/67 Date By Title nr+r -.. +z`. +� z k3'�'K's^..n"�'�va`' "�' `c"',� ,7'.. "RUfc '"°'F - ^..,�•+ 1� � � y„ 1 1k ' C 1 .'E,.N ; 't ^�f � - , WV�Ygi Yid -- Vs •i - ..• / ,V .'. 1iO:L6i5i6 . .. ' .. z ti ° Z l:iil� ... rLk_ 2y)y Tam Np Date— ibd ivis ion : A'n' roved Fee.Enclosed,�.: Ivy Nyat &+�° lift aq II t Fled G P D PC�:fY' II+M ' rte ta[ 1100 Slim, ylry Adhm INA D 40 Clam 1 ropaMRt:.ellle 1 am wtwlly end.eompleN, ly reepaeitole fOrSM 110fbjn'oM1 taemtiOn Of the p.opOS9d cyst®inmvl) that tiw _caret ®.,iawago 6 0pOeal syuem asove . i0 will bb eonstruelod as shown on tla app!oved amendment i" to and iwateorOanee ai4h;tho stariAOrda, rules a�rpu s,o nar ., 1. AMY: �a0®ttmel4 ;00 ti`aakh; and that completion th ►etif a 'C6rtirieipt�` of Coes4rudtoai COrnplgwco" satisfactory to.4he CorrirniesbRav of MNltliwill' M siilmRteA'to tM Qrpartnis t anm a'written`gwrantso; will Oer umbhe0;4no owner hie eu awe; twivs or assigns by tho wilow tMt;feld Ouilde vulll place M MoA OM►atUi! 0000ttlan any pat oR ssa eawaM OkpoYl eyttent ,durbp tho period_ h4-m years hnomiateiy fol00aiinB the -date or tho; isat- atncq of tM a0proeal of tM t 6rt10tiate or Conetrudion `COmplao'Am of t a Original ° syetOM - y reppMa tt oreto; t) that the, Mi11aA well.eleaorif�:.ebgra wlll M IOCat� as eftatm(ow tM adprove0 plan and that ssid wall will ee;lnet in ice , the - staaslarAS, rubs a" raaui�`Ea GWs --at the f➢utMn4 Y f} t e Oaai Rh S�nir� . A.d,..s ^1lticom Plo ' APPROVED FOR COPISTRUt:YIOPI This approaal.exphee two years C►om the data ifeued uiilops construction or the buildMg lws - ndartakan and is .Dean ►6110Cat110 Ip vY4o od: may; 00.eoY1lTd00- er,Ynediti wMn�eon �naCeS�ry' -Oy the' COmn11a8ionar of MWIth.' Any Chango Or Oltoration of construction ro9ui►ae a mtk:: l\pprove® "for- ditpoeal of Oofoest ► �: aewa�a aied/ ' rWate'4ar wpphr only. Rev. os A p� Ey Title m JUL -15 -1997 12:01 PUTNAM COUNTY RECORDS CTR a DEPARTMENT OF HEALTH f �MIRIShIs(ar of 1XV NW MM s .,j,,, T R A N S M! T Y A L 4 dews Rona W" Yo* 10309 T'et. (924) 278.6130 FM(914)278-7921 to: Nancy Smith hx #; 218 -4865 W. Records Retrieval date: 71011f P69": 1 , including this cover sheet 914 276 4665 ` P.02 " This is to request that the fbIlowin records be retrieved from storage: Record: Our Box # /Y-1- Y'7Yow Box # Circle one: Commercial Addition Repair Realty Subdi " " Ind &M Other ( ) satca a: ro1.Eir7. Acdog ftN c Heft MmQ" Name of Original owner (if available): ,gyp gam.14YO1 4 -t r 0 deft A -To. ` i°i � �w I &V Tau Map # Add A j Year Built Other identifying information 0to t 0/0,101 Special Instructions: FMM Vwannia ot.. Pool n� ,r, Putnwn County H=Ith D WiOttont <ceam RAW t3+e►r4tOr . HtNr Vodt 10306 914,27843130 a# t 153 711 f Fax: 8td- va/i"� l �% ' ► boll- CX/tJt V �'vv`1 J� TOTAL P.02 t ! iVL-'y Jl.:L 11 \.�.r.:l__1l.iV ua :.° .��.:�/'"• -- sZ'A.Fs:T 1CC3TION a OR Su�DrJISICN LOT a YES NO ..- a. SDS are: locates as per approved plans b. Fill se; on - Date cf plac_z�t 2:1 barrier. . LGM W-= c. Natural soil not s tri=e:.i d. Stone, brush, etc-, great= than 15' fro e. 100 ft. from w,-=t--- course /wetlands AVG.DPIE SLS ar =ea. . I? . S_ r- DISPOSAL SYSIY , a. S✓ot;c tank size - 11000 (16�1-0'rµ b. Se_..3' tic tarrik i nst' ul ed level - c. 10' minimum from foundation d. Po 90° be--n s, c-le =*tout Within 10 f =- of 45° be*ld e. DIST rj-iICN BOX 1. P21 outlets at same el evEti on - water tastea 2. Prot_ct� be-'Icw frost 3. Minim= 2 ft- oric; n_1 so L l be ri _n bcx and t_ _.cmE f. J -u=ICN BOX - L3rCD�ly se 1. 4 -� re= - q-= �'' 2. Dist? nc-= to watercourse f t. 3. I--st 1 1 eA according to elan 4 Di stance_ Cent-sr- to C.°T1ter 5. Slone Of t_ _-iez acc_otable 1/16 - 1/32 " /=cot. 6. 10 f —t from prcpe.: tv line - 20 feet - foun-d`= ors 7. Dentn of "encn < 30 inches from s-r=:-- 8.- Reap al cw- d for eYi -a_ns i pn , 50 C. Size or a yel 3/4 - 12" diamet— er 10- Depth of gravel in tremcn 12" mi ri r-am L. - Pipe ends c=ad h. OR DOSE Sys= I Size of ==, c'=aT-ber • A1 7OVe_rfi w L^I1K 3 =, V? su 1 /aucL o 4 Pumo easily ac=assible iranr_ole :o crane 5. First bcx baffled 6. Cycle by Health De u ,nt estiunated- flow p� cycle IV. EO-L - a. F=--a 1='Le l per a:=reye3 plans. b- j`;- nbp-- of bearocn s V. --T r. a. WEE lccat- as peer a- corcved plans b. Distance from SrS area men arm ft. c. Casing 18" above grade. d. S=face d--,d^—ace around well accentar?l °_. VI. O4E-1-U L WOPMUASBIIP ' a. B -mes Droop? y arcu tea b. All pipes parts a l y ba-6= 11 ed c. P? 1 pipes fluc-1 wit_'R inside of box d. ;�=ckr.ill material contains stones < 4" in diaryetar e. C=*-tain drain i_n- =tzl.led according to plan f. C_rt,_a? n dr i n cutfall Drotected & di r. t0 eKi st_wat_rcoui g. Footing drams ns disc*arae away fran SDS area h- Si mace water orote --ticn ademmte i_ = -oszon r7ncro provide' cn slopes cre=t_r than 15 %. mil i I I �1 I el I ' 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. `C 1 is Countersigned: P.E. ,- R.A. , # 37 Fair Street Address Carmel, New York 10512 914 - 225 -7221 Telephone Very truly yours, Signed Ot . t1A o Owner of Property �AAr e sx /��< Town C�lV) 76 V -ff3z_ Telephone PUIM4 ODURI"I DEP11RUTRr OF F 1 F AVM DIVISION OF aTVIPaVaTM.11EAL1T1 SERVICES DESIGN DATA SEIEET- SUBSUFACE SEWAGE DISPOSAL SYSIR4 FILE NJ. Owner vt tzt b�Q(L Cs�c -c a7z y Address Rte #- z �( /�/Z'TNI��S Located at (Street) LLYvp Cour,- Sec. Block i Lot (indicate nearest cross street) 3 t iunicipality �� �av �L- yla2(� �� Watershed SOIL PERCDLA'ION ZEST DATA PJWIRED TO BE SUBMI= IM11 11PPLICNrIONS Date of-Pre-Soaking �?i I �j Date of Percolation Test HOLE lu-mm CUOCR TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches l I o( o3( 10 04 z 4''2 64 - 2 I)-7 7to7 u z .4' Z5 4 -7. S� 3 Z�Oq Z-'3V 7o ZA Z_� 4 `7.� 0 Cl- . 3 Zl IH 2141 3l) Z q 4 5 �*TM 1. Tests to be repeated• are obtained At each for review. 2. Depth measure ants tc rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to* be subcnittlad be made fran top of hole. ivf kg. 4 Rock .,5 i� 61 . .. ....... 7 8' 9 10 12 13 14 DESIGN Soil Rate Used 'LL-: S.D. Usable Area Provided 6000 S.F. s. Min/1" Drop: No. of Bedroom 4 septic Tank Capacity 1250 _ gals. Type Concrete S-101v Absorption Area Provided By 500 L.F. x 24"'width tren Other 2.5' ROB 490 cv fill 701x75' - Irc:P Name Howard Kelly Signature Address 37 Fair Street Carmel, NY 10512 THIS SPACE FOR USE BY HEALTH DEPARDEM ONLY: SEAL --A 9S8 "".0, 1, �ej _-4,0:� Soil Rate Approved sq.ft/gal. Checked by Date i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF., ENVIRONMENTAL - HEALTH-SEA-VICES Re: Property of Date Roaring Brook Country Partners Located at off Pudding Street (T) Putnam Valley Section S Block Lot �*� �7• ` Subdivision of Roaring Brook Country Estates Subdv. Lot # 3 Filed Map # Z563 Date 0, 363 Gentlemen: This letter is to authorize Howard A. Kelly 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 ....._ :.. „ _.conneet.ion- _wi.th •this- .ma.tt.er and• -to supervise, the, c ons truc-ti on 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. Countersigned P.E., R.A., # 37 Fair Street Address Carmel, New York 10512 914 - 225 -7221 Telephone Very truly yours, Signed acU�j✓ G/v►» i f Q-r�/ O epr of Property r e,?L ��� Yl 1-� �v►� C. IVY 10.r 4 Town C�lV) 76 V- f9.32 --- Telephone J-3 DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPI;ICATION` 'TO CONSTRUCT A WATER WELL PCHD PERMIT *I WELL LOCATION Street Address Town/Village/City Tax off Pudding Street Putnam VAlle , NY Grid Number Lot 3 WELL OWNER Name Mailing Address �X-yz bHnA fiw(9C diiPrivate Roaring Brook Country Partners RR #2 Twin Y.4m La., -i NY O Public USE OF WELL 1 - primary 2- secondary ]&RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O A.IR /COND /HEAT PUMP O FARM ❑ TEST /OBSERVATION M INSTITUTIONAL 0 STAND -BY 0 ABANDONED ❑ OTHER (specify, O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 800 gal REASON FOR DRILLING QNEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL O TEST OBSERVATION DETAILED REASON FOR DRILLING N &w Residence WELL TYPE ®DRILLED ❑DRIVEN DDUG 11 GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISIONI 6 Roaring Brook Country Estates Lot No. Lot 3 WATER WELL CONTRACTOR: Name PF Beal & -Sons Address: Brewster, NY IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTf FROM"NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED O ON REAR OF THIS APPLICATION ❑ ON $EPjqE S ET (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 pro d d th Putnam Cou ty Health Department. Date of Issue: 3 �-Z% 19 Date of Expiration: 19� ermit Issuing fficia Permit is Non - Transferrable � te copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy; Owner Orange copy: Well Driller APP-IMLY B PUt�M COUNTY DEPARTMENT OF HEALTH - DIVISICN OF ENVIRONMMU HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SQAGE DISPCEAL SYSTEMS REVIE W SHEET CONSTRUCTION PFr'RMIT REdI vM (i�Tat;e of err) (Street Location) DC 7j"MMM Pernit Application Corporate Resolution Plans - .Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUEDIVISICN Deep Hole Log Parr // - / 5 i Consistent Perc Results (3) F1?. AA Peso Hole Depth ca House Plans - Two sets Well pe_rmu t; PAS Variance Re�raest G'r:t�P.L le—cal Subdivision Subdivision A-pproval C_ ec ced ac- approval SSDS A_j. Lots Checked Wet'-and (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS CN PI.NS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flcw Fill Profile -D?,-nensi —c - Vol&,e D o J ; Trenc. _1_ m- ery; P p pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder rate) Design Data: perc and deep. resul=s,.„_ _ v;�o= -Foot Contours txi•sti ng Proccse Driveway & Slopes Coat Footing Gstter,Curtain Drains (discharge OK) Perc & Deep Holes Locate3 Representative of primary and expansion Expansion Area; shown; gravity flcw,saff. size If Puped Pit & D Box Shown & Detailed House - No. of Bedroans elm &~-SSDS' s w in of Proposed System Prc_ MB�u House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 110; pipe pipe No Bends; Max. Bends 45° w /cleanout SEP.AYATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large TreeS,Top of fil 20' to Founda Walls 1001 to Well,, 200' 'n D.L.O.D, 150' pits 100' to Str..3m, tercourse, Lake (inc. ear: 15' to Drains - 'rtain, Leader, Footing 351to catch basin, storn-drain,pine'3 watercour= 10' to Water Line (pits -20') 50' intermittent drainage course Ser)tic Tanks 10' from Foundation; 50' to well 15' Well to PL 9 YES NO i IT1•5 -F I I Ceps 41 I i Al I LF tre. ca provided Sa b o reauirad Soo 60 ft. max. y- Parellei to contours-- 100% e-=. I I. T— I z s,D 5 FILL SYSTEMS f/ clavbarrier I i 10 ft. / fill notes new spec. I death Qau es 100 vr. flood ele . I 200 ft. reservoir, etc. 150 ft. trigall /gall. DC 7j"MMM Pernit Application Corporate Resolution Plans - .Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUEDIVISICN Deep Hole Log Parr // - / 5 i Consistent Perc Results (3) F1?. AA Peso Hole Depth ca House Plans - Two sets Well pe_rmu t; PAS Variance Re�raest G'r:t�P.L le—cal Subdivision Subdivision A-pproval C_ ec ced ac- approval SSDS A_j. Lots Checked Wet'-and (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS CN PI.NS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flcw Fill Profile -D?,-nensi —c - Vol&,e D o J ; Trenc. _1_ m- ery; P p pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder rate) Design Data: perc and deep. resul=s,.„_ _ v;�o= -Foot Contours txi•sti ng Proccse Driveway & Slopes Coat Footing Gstter,Curtain Drains (discharge OK) Perc & Deep Holes Locate3 Representative of primary and expansion Expansion Area; shown; gravity flcw,saff. size If Puped Pit & D Box Shown & Detailed House - No. of Bedroans elm &~-SSDS' s w in of Proposed System Prc_ MB�u House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 110; pipe pipe No Bends; Max. Bends 45° w /cleanout SEP.AYATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large TreeS,Top of fil 20' to Founda Walls 1001 to Well,, 200' 'n D.L.O.D, 150' pits 100' to Str..3m, tercourse, Lake (inc. ear: 15' to Drains - 'rtain, Leader, Footing 351to catch basin, storn-drain,pine'3 watercour= 10' to Water Line (pits -20') 50' intermittent drainage course Ser)tic Tanks 10' from Foundation; 50' to well 15' Well to PL 9 PUTNAM COUNTY. DEPARTKENT. CF HEALTH DIVISION'OF HEALTH SERVICE DESIGN'_.DATA- SHEET- SUBSUFACE.SB9AGE DISPOSAL SYSTIM FILE NO. OWnerRoaring. Brook Country Partners AddreSSRR #2, Twin Farm'Lane, Pound Ridge, NY Located at (Street) off Pudding St. Sec. Block Lot -#6- (indicate nearest cross street) 5cJl70iv1Si4-! -S Lot 3 Municipality Putnam Valley Watershed Date of Pre- Soaking 10/3/87 Date of Percolation Test 10/3/87 HOLE NUMBER CI= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water EYom Water Level. No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 1 10:40 - 11:10 30 24" 28`y 4" 7.5 2 11 :12- 11:42 -30 24" 28" 4" 7.5 3 11:43 - 12:13 30 24':` 28" 4" 7.5 4 5 1 10:44- 11:14 30. 24" 26.5" 2.5" 12 2 11 :15 -11:45 ­30 - 24" 26.5" 3 11:46 -12:16 24" 24" 26.5" 2.5" 12 4., 11 -15 5 1 2 3 4 5 NOTES: 1. Tests to be repeated'at same depth until appro =* etely equal soil rates are obtained at each percolation test hole-All-data to•be suYmitttd for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO IN DEPTH HOLE N0. 3A HOLE NO. 3B HOLE NO. G.L. 1° 0 -8" topsoil 0 -8" topsoil 21 8 -24" loam - �gloamrown 3° 24 -60'.' sand 20 -56" sand 4° 5' Rock oc 6° 7' 8° 9' 10' 11' 12' 13' 14° INDIGENE` LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NA DEEP HOLE OBSERVATIONS MADE BY: Howard Kelly DATE: 9/29187 DESSIGN Soil Rate,USed 11-19 Min /1" Drop:- S.D..Usable Area. Provided 600-0 S.F. No. of Bedrocros 4 Septic Tank Capacity 1250 gals. Type Concrete. Absorption Area Provided By 500 L.F. x 24" width tren QRoFESS,o Other 2.5' ROE 490 cy fill 70'x75' �� PLO A. KF�t�< Name Howard Kelly U Signature Address 37 Fair Street SEAL 88'g'$ ��{ Carmel, NY 10512 ?� � THIS SPACE FOR USE BY HEALTH DEPARZMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date '10 5 2 5. LION iTO 'CONSTRUCT WATER WELL .'PCH PERMIT.,# 0. `6 ' WELL L 0 mber ::,..,,.. :Tax ,Grid N-u. f f Puddi 'Stre `Putnam VAlley NY: Lot ` Wtllj�bWN ;Mailing ..,Address. &Xyt diPrivate.'.'. 'Bro 61�1'c uritr a.!�� 0 NY Roarin _y Partners RR#2 ,,,Twin Yam L;­ 13 Public K US9,:. 01 PUBLIC CKRESIDUTIAL' , ABANDONED. IC.:SUPPLY _(3AIR/COND/11EATPUMP� C3 E3..,,;BUSII FARM 0 TEST/OBSERVATION jI OTHER ,(specify,; Y, eco 11INDUSTR INSTIT ONAL': 0 STANDw :13 AMOUNT.7,.,OFUSE i -,iYIELb; SOUGHT 5': gpm/ UPEOPLE SERVED /EST. 'OF DAILY USAGE 800 gal; REASON FOR 0 PIP PLY WID *ADDITIONAL, #ww'SUP 60* QA-`EPPR1 SUPPLT,,,� 13 TEST 76BSERVATION.-I DRILLING EIDEEPEN EXISTING 13 REPLACE 'EXISTING SUPPLY' WELL DETAIL ED .J.• REASON FOR 0 NV 'Re v sidefice. IL DR LING WEM":,TYP.E,-_V"W DRIVEN -]DUG J]GRAVEL 0 OTHER' .: is WELL. SITE."SUBJECT"TO YES "FLOODING? X NO IF WELL IS.-LOCATED;j,IN,.A:-REALTY.SUBDIVISION, NAME OF SUBDIVISION1 Roaring; Brook Country Tatatei Lot No. Lot 3 WATER WELL.CONTRACTOR:,. Name PF Beal & gone Address: Brewster, NY IS PUBLIC.",WATER'.SUPPLYIAVAILABLE TO SITE: YES X NO NAME: OF.:PUBLXC4 WATER '.SUPPLY: TOUT/VIL/CITY DISTANM.MPROPERTY.-TROM NEAREST WATER MAIN: LOCATION,.SKETCH'&SOURCES OF CONTAMINATION PROVIDED ❑ON REAR. OF THIS APPLICATION ❑ON P�A E SJIF6ET -(4ate),I. (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,*app,jicant-&hall:.. 'Pump the well until the water is clear. 2. Disinfect the well in accordance with the County Health Department atta ched to this 3..'. Submit a Well Completion Report on a form ..Health Department. Date of Issue.: '5' - 7. % 19 Date of Expiration: 2 19 requirements of the Putnam permit. prodded by th Putnam County ermit Issuing Officia - - I - 104 1 Permit is Non-Transferrable VULLre copy: H.U. Yellow copy: Building Inspector 0) /0-7 Pink Copy: Owner t a ; # G o, c F Iti r i F-1 ISO I i 7 o . gpgt l_1 rea Pw►t�'4 1 1 o LL - ,� ti a LINTY DEPARTMENT OF &MTV ; a Sdn s ds �i k3 1 4 r nom,_.s x� l� rs,,:O,arsnc 8�'CO COvntr� �:Stat�S HOU5E PLAN5 ADPROUED FORyS. 4-14, BEj?ROOM COUNT ONLY; pFF : /� /�UV1>(illGS�"��'t� !f%y.� of ° S•tor Floarplan ED'�OOMS - �rrX /�IA� Jam- / / % // �' ► "' °�•:;, x - 1 I S� F l�. £a c Signatur6:-&,T itli _.. _..1. . .. . i r --- -i r�'•3" � uL4 "1 y�r ,tz UUOCA gy 6LOC. LST� ®ti� i F-1 ISO I i 7 o . gpgt l_1 rea Pw►t�'4 1 1 o LL - ,� ti a LINTY DEPARTMENT OF &MTV ; a Sdn s ds �i k3 1 4 r nom,_.s x� l� rs,,:O,arsnc 8�'CO COvntr� �:Stat�S HOU5E PLAN5 ADPROUED FORyS. 4-14, BEj?ROOM COUNT ONLY; pFF : /� /�UV1>(illGS�"��'t� !f%y.� of ° S•tor Floarplan ED'�OOMS - �rrX /�IA� Jam- / / % // �' ► "' °�•:;, x - 1 I S� F l�. £a c Signatur6:-&,T itli _.. _..1. . .. . i V A Cx: ps 14A Its -in Ouo: tZoorl •50 is-If L L UZA L! Cl/O rp WALL O•CA(a A %J#.%A. F -vfl PUTNAM C.0jjN Ty DEpARTME�' T OF HEALTH �.rRtAks-:A PFROVED FOR oarinq c Olfn 1: S A S S 4 -.(COUNT ONLY, tFstl'-- Oil -tory Flo '07 o6 _q -4A Fleor) I S. -Signatu La &title te oa skx KrrLAC4 epw1prvr Lj— 040014 310 A 11-de-1 I 10c, W.0014 We PIN. tl Ibfd �ASgEIt �E,OR�. 114• f6 432 PgICRO6�o� (�O.Gai BOA) dlet6tZ•ppgpf�w'J41 ofr'fua wtL,t� gy bt.o2• 1 POOI. 1^ L _ J vo571 O � p►1. lJt�ru►Jt: gV. 604. -� Ls `%IrLs PUT'NAA4. COUNTY DEPARTMENT OF HEALTH f� — • - - -... 9� D u. r' I n c B e' c HOUSE PLANS APPROVED FOR .l'0We6& 12�x�D0e OFf IV COUNfi ONLY; � 5� J t o ry FI o p r p Ctrl -- BEDROOMS /i'X /Y/�/°# 5— i— 17 4 Signature & T; ti o -. _.......... ; v1 rag la4iVIb!(4 I� ti ji e �• �• 4':, is rag la4iVIb!(4 I� LOT VIA �Np tdo Mc�A ft .fo FxP/�rls�o,J \/ ol oe LAY DO I s 0 L � °� C,` OPEN PORCH tS' F 4CIP 6) PER i0f MINIMUM 1000 GALLON SEPTIC TANK SEE DETAIL B- SEE DETAIL A 6 T 9 10 �.\ R= 70.00' �• L=2 00.00' O =1630 52'30" too \VQ� LYON COURT 11 IEE � +• r F t t3.. CROSS SECTION VIEW DETAIL B 1000 GALLON SEPTIC TANK NO SCALE i I i - i 1_ 2 3 4 5 6 7 8 9 W_o.. 11 12 OQUID 14 15 3 "MALLS :;' LEVEL 46 51, :l 61' 66=6 TI' t t3.. CROSS SECTION VIEW DETAIL B 1000 GALLON SEPTIC TANK NO SCALE i I i - i 1_ 2 3 4 5 6 7 8 9 10 11 12 13 14 15 A 41' _ 46 51, 554' 61' 66=6 TI' 20 =60 B 32' -6" 29!-4!' 29' 28� 2" 30 32' 35' 39' 43! -2 "'; 48' 53' 58 63! -6" 32' c 36= 9" 33=9" 31'-6" 30 =2'' 30=6" 31=9" 34' -2" (4TH