Loading...
HomeMy WebLinkAbout2281DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.07 -1 -7 BOX 20 11 IN or 1� .. �� IN IN ,, , L I IN IN If �, � L , '� r. , , I ,` I IN IN , 7 ■ i I am 02281 Rev. 3/86 a PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 EnghteerMustProvide✓ L f�Gj P.C.H.D. Permit N -- —= 1 1, C) I rE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DIS SYSTEM . . _:.,__...,. -1 .• - Town or Village Located Tax Map � Block 1 Lot 1 � • t i Owner /applicant Name n a n, i a y O-u a Formerly Subdivision Name �- Snbdv. Lot 0 o ti� t5_-S4 Matting Address I-- TLW ; N T- =d w p 3A.'✓J Date Permit Issued -- t 0—&-- £R,�i (i, n 0 6 C-- 0Ri;7 Separate Sewerage System built by �•�15� i C�I.VC tVb E-S7h ddress i` 7w/w t✓W L fit-' fle 47-, .!Consisting of -7 -n g r�C� n,t z LYI (�(-, �JG f Gallon Septic Tank and d Water Supply: Public Supply From pA Address or: Private Supply Drilled by Fa�JT� CIS U Address 1S7 _6A - r1 =.tZ. r �yt^ /1✓i t L�r Building Type SZ �3 (lam i1 &L- Has Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? 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 filed lan, and the permit is d by the Putnam County D partm nt Of Health. Oats �/ 1'0 _ Certified by P.E. R.A. Address License No. 3' 9y� Any person occupying premises served by the above system(s) shall promptly take such action 1. 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 lower 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 odificationorcr hange when, In the judgment of the Commissioner oi u h Mealth, s revocation, modification or change is necessary, c Dated i (�, Wl1rA1 [OODlf1!]OaAIllf�lPlPOFl�AL4! soPs®sBde?oaloltB t - LDlalsl� et)��apsmem/al IisdMb 8eedoea. (,1se1.1i.Y. Y961t esa '� OF COMMA= FE' FM UWAM BEFOUL SIRZM r v � Icit. 7,rF� Lewd at U W - U rr a�� — F-�-I- sd - - - -a. jlldotr n,iz li Y��Ii G(ijC < rs:✓ i_ 14t f � Tai M11V Oa11adAP9111" Massa C, Date od Previon Approval Mart i (Z 2 Z T J I J F& T. P,..2! > � � � DF n..a.., 2..UA4 -43 4nrw AnnrnvPd Fee Enclosed ❑ Amnitnt ftgM t Typ Z— STAY rcr in f % Let Awe i Fill Seetlan 0* U Depth Vebtmeoi 14 esioe e[ D�ilndoma Dad& Flow G P D (/ t' -_ PCHD NsMcatlan le What FIB le completed sepaemM s wnwt- tytd.. M eamsist nt �ZSo ryM. Sqa Timb S LA "A9 To be eememow b �► " �T7 N Z� A (1T 1%/� t-t .� ` f wow 9..rin - -tfAie 9"* Fan. Addeea l ---- 'tj � �.� t_ ..tea.. an Spp*DdWby t7ttrdr 1 represant'Ahat 1 am wholly and completegr responsible for the desitn and kncation of the proposed system(r)i 3) that the lo Grate Sawa a disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regu a ors o • n m County Deportment nt of "With. and that on completion thereof • °C"ficate of Construction Compliant" atisfectory to the Commissioner of MaaRhwill be submitted to the Department. and a written suarantee will be furnished the owner, his WCteO►s. hells or assigns by the builder. that said WNW will pate in pod epwatbq coMRion any on of ON a ditpowl system during the period of (2) years Immediately 110110 ritq thedate of the 191111- ant of the appfevel of the Certilkate M Construction Compliance of the o►y system a y epeirs thereto; 2) that the dritled well described above wen N IOtated a$ oval n on ten approved pen and that sald well will nc installed in tdan N t a Ms, rules and repu l3ns of the Putnam County De�artm.n/� of NMRh. P AdWess � Z U litnlo No APPROVED FOR CONSTRUCTIONS This approwl expires two ?Mrs from the data Issued unless construction of the building has been undertaken and is revocable for cause o► nay be amended or modified when con ►y by the Commissioner of MMRh. Any change or alteration of construction reluires a new m}e . Approved for disposal of domestic nit qe, and / wane water wpPly only p� p �«► Titter ~ pUTNAM COUNTY DEPARTMENT OF HEALTH (. -0 \\� + Dlvlsloo of Envtrottaaental $ ealth Services. Carmel. N.Y. 10511 Engineer to Peovlde Peemlt It J1/ oq:CERTII�ICATE.OFCO CE - ' U CONSTRU PERMrr FOR SEWAGE DISPOS* SYcTEf- Permit N r 1 rF • Located at off - Pudding_ Street Town ;,or V_ e Roarn Brook County 5 �j- t`7 Subdivision Name g . ySnbd. Lot N Tai Map Block Lot 7w �. Estates a Renewal____ ❑ Revislon ❑ ti Owner/Appucant Namo .Roarini; Brook Country Partners Date of Previous A' rovai `i .. Meiling Address RR#2, . Twin ,Farm. Lane To Pound R d'ge, NY Zip Building Type 2 Story' Frame,. Lot Area Fm X, Secdon,oni 3't'. y Depth Vobtme Y- ,,; Number of Bedrooms ' . Design Flow G . P D 800 ,GPD PCHD Notification Is Repaired When F kla completed Separate.Sewerage system to.constat of -1950Galion Septic Tank and $00 .LF of fields• TO W constracted.by Ti, Fi -cirH 110 Address_ P t na4tn "Valle' NY Water Suppy.: Public Supply Front Address X 1 B,rewatei, , NY , or: Private.:SaPPIy DrIDed by Address f 3t Qtt ROR I Uili6 Other. Reoulremente 1 represent that 1 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'approyed'.amendment there .to and in accordance with"the.standartls, rules regulations of , County Department of Health; and.that on completion thereof a •Certificate of 4:6 ". ruciion Compliance" satisfactory to the Commissioner of Healthwill . be submitted to the. Department, and. a written guaiantee 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- duriny'the period of two (2) years immediately follovirins the date of the•issu- once of the approval of the Certificate of Construction Compliance of the- original syste- o any pairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and trial sell welbwill be instal in- ac,ordan a ith antlard3, rules and regu a _ens: of the Putnam _• County Oept rtme t of Health i Oats p #; Signed p. E: X' R:A. a ' Address 37 Fair Street, Carpe l•, _New Y rk 0512 License No ,APPROVED FOR CONSTRUCTION: This approval expires two.years from the date issued unless construction of the building has been undertaken and is ,, revocable for cause or may oe amended or modified when consider d,nece ry, b, 'the Commissioner of ' '._ealth. Any change or alteration of, construction !!!� ,requires a new permit. Approved for disposal of domestic se. r age .j Dr' et wa DIY only. JJ'��J % {gg{ 7' Date —� By Title Aal� WELL UUl"1rLh 11ULV a DEPARTMENT OF HEALTH * * -, Division Of TEnvironmental Health Services W PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only .-m WELL LOCATION S EET ADDRESS:. - • _ NAME: - �. (� I Y TAX GRID NUMBER* %� ADDRE s" ❑ PUBLIC WELL OWNER USE OF WELL 1 - primary 2 - secondary J R SIDENTIAL ❑ 9BLIC SUPPLY. ❑ AIR /COND. /HEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) 0 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT I.� gpm. /NO. PEOPLE SERVED EST_ OF DAILY USAGE ��O gal. REASON FOR DRILLING NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL, DEPTH DATA . WELL DEPTH P2 ;L S� ft. STATIC WATER LEVEL � � ft. DATE MEASURED DRILLING EQUIPMENT ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG . O WELL POINT O CABLE PERCUSSION O OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK O OTHER CASING TOTAL LENGTH fL MATERIALS: STEEL_ O PLASTIC ❑ OTHER LENGTH.BELOW GRADE �'' ft_ JOINTS: ❑ WELDED THREADED 0 OTHER DETAILS DIAMETER G" in. SEAL: O CEMENT GROUT ❑ BENTONITE .06THER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE A YES ONO LINER: ❑ YES XNO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (it) DEPTH TO SCREEN (ft) DEVELOPED? FIRST O YES ❑ NO HOURS, GRAVEL PACK 0 YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH tt_ BOTTOM DEPTH it. WELL YIELD TEST It detailed pumping P P g METHOD: O PUMPED tests were done is in- COMPRESSED AIR formation attached? O BAILED ❑ OTHER ; ❑ YES 0 NO It more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. DEPTH FROM SURFACE water Bear- ing well Dia' In FORMATION DESCRIPTION raoE_ ft ft, WELL DEPTH ft. DURATION hr, min. DRAWOOWN ft. YIELD 9Cm. Lana SuAace 1 A J , WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? O YES D NO STORAGE TANK: TYPE CAPACITY �'d GAL. PUMP Ilif ORMATION TYPE PACITY MAK DEPTH Z VOLTAGE�f's�'� HP WELL DRILLER NAME C, DATE �.• ADORE SIGfrkTURE Illos -9 C��� WELL COMPLETION REPORT/t/10� ��.c DEPARTMENT OF HEALTH a Division Of Environmental,Health Services :;PUTNAM XOUNTY..DEPARTMENT OF HEALTH.. 5 EET ADDRESS: M I Y Q IWELL LOCATION _- _ % ter,.`?'• �� NAMt» WELL OWNER Office Use Only TAX GRID HUM6ER: PBIVATE PUBLIC USE OF WELL` XRESIDENTIAL ❑ 9BLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED : 1 - primary ''' ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) 2 - secondary ' O INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY ❑ MOUNT OF USE YIELD,SOUGHT _ _ gpm. 1N0. PEOPLE SERVED := - -/ EST. OF DAILY USAGE r-o-,o gal. REASON FOR NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION DRILLING ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN. EXISTING WELL DEPTH DATA... S�; c, �� WELL DEPTH ft. STATIC WATER LEVEL -L ft. DATE MEASURED t DRILLING ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE CASING DETAILS ❑ SCREENED ❑ OPEN END CASING )a OPEN HOLE IN BEDROCK D OTHER TOTAL LENGTH LENGTH .BELOW GRADE DIAMETER WEIGHT PER. FOOT DIAMETER (in) GRAVEL SIZE: WELL YIELD TEST SCREEN METHOD: O PUMPED ' DETAILS FIRST ; formation attached? O BAILED ❑ OTHER SECOND ONO GRAVEL PACK O YES DRAWDOWN YIELD O NO GRAVEL SIZE: WELL YIELD TEST ' If detailed pumping METHOD: O PUMPED t tests were done is in- COMPRESSED AIR ; formation attached? O BAILED ❑ OTHER :OYES ONO WELL DEPTH DURATION DRAWDOWN YIELD ft, hr. min. It, gpm. WATEI O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? O YES D NO PUMP 14fORMATION TYPE '�'f� CAPACITY f / MAK DEPTH MI �� VOLTAGE1210 HP T ft- MATERIALS: )d STEEL ❑ PLASTIC ❑ OTHER e? ��' ft. JOINTS: ❑ WELDED THREADED ❑ OTHER G" in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE ,OTHER Ib. /it. DRIVE SHOE: • YES ❑ NO LINER: ❑ YES V'NO 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft) DEVELOPED? O YES ❑ NO IDIAMETER I TOP I BOTTOM OF PACK in. DEPTH ft. DEPTH It. WELL LOG if more detailed formation descriptions or sieve analyses ��/ are available, please attach. .DEPTH FROM Water well SURFACE Bear- Dia- FORMATION DESCRIPTION CODE ft. (L ing meter In Land Surface . ✓ n i A _ STORAGE TANK: TYPE %il.>r CAPACITY /ZO GAL. WELL DRILLER NAME ADORE SIG1lif7URE �, DATE PUliM CO"M DEPllMiMf OF REAL111 DIVISION OF ENVIRORAERM REALM SMICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTl'FM FILE NJ. Owner i�z�� ,zc1►�c� <1lddress Loca Led at (Street) u r„_, 60 u zr— Sec. 5 Block Lot 170' y (indicate nearest cross street) t iunicipality . �cf7- Np�ti. -� (�i>t (_�`f Watershed. _ SOIL PEtOMATION TEST DATA MQUIRED TO BE SUMITIM IM11 IIPPLICi Date of Pre- Soaking 2 Y Date of Percolation Test Z �� BOLE 10 Z4 Z-- 7 NLAMm CLOCK TIME Zq PE.ROOLAT10N PERCOLATION Run Elapse Depth to Water Frcm Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Indies x 2-7 2 I� SI Z�ZI 3� 74 Z7 ��z 3'r2 S� 3 7q 7`7 . Qz 4 5 x I' ZI l �I 10 Z4 Z-- 7 .3 Z: Z Z `• S3 O Zq Z� i 5 tK7TES: 1. Tests to be repeated* at same depth until approximately equal soil rates are obtained.at each percolation test hole. 1111 data to'be submittbd for review. 2. Depth measurewants to be made fran top of hole. rev. 9/ ©5 11' 12' 14' INDICATE LEVEL AT WHICH GROUNDRATER IS ENCOUNTERED NA INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED NA DEEP HOLE OBSERVATIONS MADE BY: Howard Kelly DATE: 9/29/87 -- DESIGN Soil Rate Used 11 -15 Min/1" Drop: S.D. Usable Area Provided 6000. S.F. No. of Bedroams 4 Septic Tank Capacity 1250 gam. Type Concrete Absorption Area Provided By 500 L.F. x 24" width trench Other 3.0 -.ROB /625 cv fill Name Howard Kelly Signature Address 37 Fair Street Ste+ >' Carmel. NY 10512 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date LAB ll .._. Y; 1• YorktoWn Medical. Laboratory, Inc. 321 Kear Street Date-Taken: 1/5/90 Time : 9:55 AM Yorktown Heights, N. Y. 10598 Date Rc' d : 1/5/90 Time: 10:30 AM Date R steel: r�I, Director: Albert H. Padovani M. T. (ASCP) ~� Collected By: MARK KRESSNER Referred By: j- —I Sample Location: BATHROOM TAP: ROARING.BROOK COUNTRY ESTATES LOT 115 .LYON COURT PUTNAM VALLEY' NY RR 5, BOX 42, TWIN-FAWN LANE y ^ I / 2 ^J� POUND RIDGE, NY 10576 Phone N 764 -5932 Phone # Sample Type: L .J Repeat Test? — (check each) LABORATORY REPORT ON THE QUALITY OF WATER INORGANIC NON- METALS mg, /LT MICROBIOLOGICAL CFU /100mL) Acidity . _ Alkalinity _ Chloride Detergents, MBAS Hardness, Total Nitrogen, Ammonia Nitrogen, Nitrate Phosphate, Total Sulfate _ Sulfide Sulfite METALS (mg /L) Copper _ Iron Lead GENERAL BACTERIA _ Standard Plate Count (CFU /1.OmL) . MEMBRANE FILTRATION.TECHNIQ,UE Total Coliform Fecal Coliform Fecal Streptococcus MOST PROBABLE NUMBER TECHNIQUE Total Coliform Index --M a.n g.a n-e-s.e, - Fecal Coli-formu°Indez' _ Mercury _ Sodium Zinc MISCELLANEOUS pH (units) _ Color (units) _ Odor (TON) Turbidity (NTU) KEY FOR TERMINOLOG)' CFU = Colony Formi na Units CON = _Confluent (q..v. TNTC) LT = < = Less Than GT = > = Greater Than N/A = Not Applicable S/A = See Attached TNTC= Too Numerous To Count REMARKS /COMMENTS (For Lab Use) Potable Non- potable STP INF _ STP EFF Other. Sample Status: (check each) Outgoing IINO3 IiC1 H2SO4 NaOH ZnOAc Na2S203 Other: LE 4 °C GT 4 °C _ pH LE 2 pH GE 9 _ pIi GE 12 _ Other: ELAP No. 10323 THESE RESULTS INDICATE THAT THE WATER SAMPLE (Was) (Wasn't) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH NEWJI'ORK STATE PUBLIC DRINKING WATER CODES, FOR THE PARAMETERS TESTED, AT THE CIE O.F SAMPLE COLLIECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Di dn't) (N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK PUBLIC RI ING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF SAMPLE COLLECTI X l��7'�- t -� >1ti %�. / 2 /86(Rvsd7 /87)RWE Albert H. Padovani, M.T. (ASCP), Director f �4a�"1 �fVir/r 1.U�9n� Cj jgleJ �� aim y%���i owner—or +urcha.ser df wilding Muni c ip a ity BuT17ing Construcbed lby / Section /U 74, 117eq,- 411. Location Street Bloc Bu ilding Type Lot GUARANTY OF SEPARATE SEWAGE- SYSTEM I represent. that I am wholly and completely responsible for the location, workmanship` ' aterial, construction and drainage of the sewage disposal system serving- :,..the above described property, and that it has beer: 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 guaranty to the owner, his succes- sors, 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 :Wade 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 de- termination of the Director of th:; Division of Environmental Health Ser- vices 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 this �j day of D_11(, -1 ­7h*rY 19,P� Signature Title f corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPIJETiON 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 Healt 3 N h 0 h; �Oo • I S8B'Ol'Sl "W 4 j SUIzVF "r" )F- U/ ?UPERTI'' 'WO I.Rr:C FOR ROARIINIG SR0(-'1K G0UNTRY ESTATES si rv,. rF IN rHE TOWN OF PUTNAM VALLEY PU7- 1`1A1�1 c- UIJTY -gcole V= CIO, JA 3 4 rn a 3q Z8' SR.S 57 90' 114 0 y O % L Il Q1- � h 'SIONE U3'42' U' MA50PIARY �1 t HE40WALL Z. 'f6A2 ulllifyboxf p• G0 L) gowARD A. I/'.T-:-LL`r cv►�w�- T1I.X1 �ylC. I1J�F�L C-4 e-klz-- 105, 1 Z y OCULILaw I:oUIILy lielmrrmenL U1 nbal Li. NS'�I�.1 - �`•• __-� Viv,iQsion of Environm tal Health Servioe. 1µ1b 16 To GP1tTlF( tHb1 1µE (�vaG6 vlsaexeL 6(itEM %vns 5�- '�-�✓i /�!/�1` 1�% COP4 'TeLvaw A5, INGICdTEV GM MS. PLA-0 AIJC TPAT 1µt 1pproved as noted for conformance with applicable Rules and Regulations of the si4TF� �vAS INyc�REV "'� �icldaao A, 1�+/ P`°ZC ?utnam County Health Department. 1j �vps CorEQtO ovEa. 1µE t`(�s1EM %A&S aaJ�T�tufTEV 104 6C44 C'.w4c! WIN ALL STONOAQC qLM -F-5 A-wo KBGULST10,J6 �VoF Tut FUT► =AM CCU041'( L7f-PA1CTM1'dJT of µEoLTµ "4cp 1E `icnatura A T .. s/ ete FAPv `fcaK STOTO v&pA- Mme.MT tF Arm+ -114. I T` WELL LOCATION `l Street `'Address Town Village City ra i { Tax, Grid Number off 'Puddia ' Street ` " P.utriam Lots WELL 'OWNER i �w`' Name } ? Mailing: Address���;yt, 0Private ' •Roarin Brook Count . Partnera .. RRp2 Twim TaFm .La a' .. 4 NY ..._ 'O Public USE 0 Fin1ELL 1 prim$ry a° r " q 2$RESIDENTIAL O :PUBLIC SUPPLY 1 A O AIR /CO.ND /HE T :!PUMP Q ABANDONED t, O BUSINESS �`, a. 1 ' OTEST /OBSERVATION;"',�",�!�' 0 _ . ;0'FARM OTHER (specify, D 2 secondary: ti �INDUSTRLII. K dINSTITUTIONAL r OSTAND BY ;4 E; Q .. ., . 1, ,�E i l AMOUNT OF USE ,..; tY� YIELD SOUGHT gpm/ PEOPLE ;SERVED S /EST. OF DAILY USAGE 800..gal REASON=',:FORAw, WNEW SUP PLY _, OPROVIDE ADDITIONAL 'SUPPLY ❑TEST OBSERVATION_ DRILLING OR$PLACE EXISTING.,SUPPLY ®DEEPEN EXISTING,'WELL 'DETAILED t;v'�' ;REASON FOR �^ Nsw sidenc :' y' :. DRILLINGS';' WELL TYPE; E]DRYLLED. ''DRIVEN °: DUG GRAVEL ®OTHER: _ IS WELL r SITE >,SUBJECT ��TO.:FLOODING ?:.: t :' ` YES : NO IF WELL;;IS,aLOCATED�'IN A .. REA.LTY SUBDIVISION., NAME OF' SUBDIVISION Roaring Brook Country Estates : k.4sa - Y r Lot No. 5 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,.PROPERTY:.XROM NEAREST WATER MAIN: LOCATIQN,.SKETCH & SOURCES OF CONTAMINATION PROVIDED PON,REAR. ,OF THIS APPLICATION []ON IKA TlBeHEET (date) (signature) r PER up _u V o :11? TO CONSTRUCT A WATER WELL This permit:-to construct one water well as set forth above is granted under the provisions'ofSubpart 5 -2 of Part 5 of the New Yorkj;State Sanitary Code, and provided that ,within thirty (30) days of the completion of water well construction, the..; app..l.i cant ; s,hal l 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 y the Putnam Coun y Health Department. �. 7; � Date of . Issue:, � - � 19 C� ,� .: nation: 1 rmit Issuing Official Date'of Ex p' � - Z i • White copy: H.D. File Permit is.Non- Transferrable Yellow copy: Building Inspector /er Pink Copy: 0.4ner /�MI�N/tA M,w,e L7ei i f1 :_i a �» SZ° T -iCCATION LM a OR _ S"u7EDIVISICN LGT a I. SEW71.GE DL'. POSP -L ARFA b- 1 secaen - Date of plac--r--nt . 2:1 barrier - IG7R W= AVG -DPTH c- Natural soil not s trirced d. Stone, brush, etc- , great--- t'lp-n 15' from SDS e- 100 ft- from wat_*- course/wetlands. II _ S1 E-' DISPOSAL SYSZ ~M a. Sent; c ta_rik size - 1,000 1,250 b. Septic tank insta led level C. 10' miniim.-n fron fcuneatiCn d- No 90° bermes, ale =pout within 10 ft- of 45° be e. D I S=Tj-�ICN BOX 1. All Out-lets at Saar_°_ e! =4c won testa- 2. Prot ==t--� belcw f =cst 3. Minim= 2 ft. orici r=1 so; i be_riaeri bcx and f. LTu =ICN BOX - properly se 7_ 1. Iarlq- -iz rezii red - I,a*:a =th ins ta? 2. DzS t...riCe t7 we °T"CcL =a IC =° s'r ft- 3. Ln -st 1 1 ar-._":.rC_? nq to D1c'Il 4. Di stzr?ce cent--ter to c°Tite- 5. Slcce of t= =-IcZ acceptale 1/16 - 1/32 ° /foc 6. 10 feet from urcoert-v 1 f rie - 20 feet - fc=.E 7_ Depth o= t_aach < 30 ir2czES from 8. Rcam all aged for e.�c� arsion, 50% 9. Size of a avZ 3/4 - ii" cia-n_=�T 10- Dentn of aravel i_ri L re -rich 12" m; .n; nm L. - Pine e_rids c-=�---3 h. OR DOSE SYSIIyS 1. Size of y=, 2: Over- =lcw tank 3. Ala=, vi seal /aj di o 4 Puam e?sTiv acc`ssible ranhole to arGde 5. First box -- 6. 6 . cycie by Health De Oc_ ui:ant estizza-tec, _! ow ZcL- CJCIe Ct+v7.R /? Y by ;q -r== I I - i _.... _ I IV. ED a. L.^Le looted p -r approved plans. b. N-,- aL%-r of be^rcors V. -� r. a. Well locate+ as r-e-- a-coroved vlars b. Distance from SrS area jr:am sr-ed / j/ f`- c. Casing 18" above a=ide_ d- 5'—'-=ace d- -c.** .ce around well acce!a'L"=Ele. Vi- 014-=-R1-LL PkMKM-A-1z=-lp ' ' a- Fixes uroce-mly crcut= b. All pipes PF--rt-i �Ily ia6=Led c. AU pines f • =z wit:,l inside of box d. -ckrIll cont=ains stones < 4" in diameter e. 0-- tai_n drain installed according to plan f. Curt,-Lin drain cutfaLl orotecte3 & dir.to ex s -- Wat=rc g_ rroting arai nc d i stria rcre away tram SDS area h- Surface water prot_y-ticn ad 1 to i. E=osicn c--nI provided cn slopes cry. =t_Y than 15 %. Eel �I. _I _I .I i I I DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICi TI`ON TO CONSTRUCT "A'WATEk WELL PCH D PERMIT #r WELL LOCATION Street Address Town/Village/City Tax off Pudding Street Putnam Valle NY Grid Number Lot 5 WELL OWNER- . Name Mailing Address Y2� r,� 6G9y�c� Roarin Brook Country Partners RR#2 Twim Fpm La. NY. It MPrivate O Public USE OF . WELL 1 - primary 2 - secondary n RESIDENTIAL ® BUSINESS O INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0 ABANDONED O OTHER (specify AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 800 gal REASON FOR DRILLING NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING New e WELL TYPE ®DRILLED DDRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Roaring Brook Country Estates Lot No. 5 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 PROPERTY FROM " NEAREST WATER LOCATION SKETCH & SOURCES OF CONTAMINATION [ON REAR OF THIS APPLICATION (date) PROVIDED ®ON iyS�� ;A�A� T (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 y the utnam Coun y Health Department. Date of Issue: -Z 19 Date.of Expiration: 'Z `? 19 rmit Issuing fficia White copy: H.D. File Permit is Non - Transferrable Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller fI) �•• tlr �c L oT :-A6' � PLMNL M'i COUNTY DEPP.RT = OF HEALTH - DIVISICN OF ENVTROIE.2tTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SAGE DISPOSAL SYSTEMS EVIEW S= BY: (i3ame of er) • (Street Lorca icn) DOCCl.ENI'S Permit -ADpl cation-- - Corocrate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep dole Log Perc Consistent Perc Results (3) F'_i1 3, Perc Hole Deoth cd. House Plans - Two sets Wel 1 _ F��i c; D?;�iS letter Variance Re✓.iest QMAL - Legal Subdivision Subdivision P -ooroval Check E�x-aoor ,val SEDS Adj . Lots Checke: We-t and (Town/DEC— PL-.nit R & D ) Data On DDS Plans & Pe--mi S=--ra REQU= DEL'I rr c CN MANI S SCaage System Plan - ( nor h armor) Sewage Systrn Hydraulic Profile - Gravity Flcw Fill I-orile & Dimensions - VoliLae D or'J ;Tr=ncn /C-a? � 3 ti v oh :TC7 800- �O Y 588.01'51 "W 77.80' AREA . 120,819 SQ•F".. . or 2.77JAC5. 5 7 h Ri M 4 SURVEY OF PROPERTY PREPARED FOR ROARING BROOK COUNTRY ESTATES srrVATe IN 77-M .. TOWN OF PUTNAM VALLEY PUTNAM COUNTY Scb /e - `7"= 60' h 0 U) 0 tie Ow to J3 ptF he -( ."r V jG+��q., v Q9 • el �t I,R /CHARD H. GORR, the surveyor who male this mop, certify that the survey shown hereon was complete! b) me on Nov, 22, 1989 and that this mop was completed by me on Oec. 4, 1589 and that this mop has been preparsd to nocordonee w/M the existing Code of Practice for Land Surveys Adopted by the Now York Sto/ Assoc. of Professonal Land Surveyors. RICHARD H. GORR ,P.L.S.,N.Y,S. Lie. no. 40513 RGUr[. 6.P.O.VOX 916, 11AHOPAC, NEW YORK, :094! fob no 66 • 315 -ZS' • • ° •� OPEN WOOD DECK GARAGE UNDER ' 3 SEP77C TAW --0 c e� 0 STEPS 74.73' 1pR1 119.77' N o OPEN WOOD 2 DECK NOTES: (\ all certifications are valid for this map and copies thereof lei ? ROCK BANK \ SLAB A o ) only if said maps and copies bear the Impressed seal of the Yhose signature hereon. Q. R, 1F R.R. JUNIPER / P Surveyor appears 2.Allerotion this lhsreof,excep/ Sy' lice PLANTER�� Di p G1 of map and copse: sed illegal. M p ® land surveyor, is —� OPEf✓PORCH ,.•° 3. This mop and copies /hereof are cerlifled to the above , :me i x'330' ,9 ROOF OVER owners, title company and fending institution(s) shown hereon WELL `2 :�0 Op Q•� and to thses parties only. "ROARING 0 R'915 STONE 4.LOT 5 is shown on mop entitled BROOK COUNTRY 03'42 OT. MASONARY ESTATES" filed in the Putnam. County Clerk's office, as mop �u1BlfyDox HEADWALL no.2363A. •SZS� rjo, .3Roucmr r° DATE 4, _ G 01J h 0 U) 0 tie Ow to J3 ptF he -( ."r V jG+��q., v Q9 • el �t I,R /CHARD H. GORR, the surveyor who male this mop, certify that the survey shown hereon was complete! b) me on Nov, 22, 1989 and that this mop was completed by me on Oec. 4, 1589 and that this mop has been preparsd to nocordonee w/M the existing Code of Practice for Land Surveys Adopted by the Now York Sto/ Assoc. of Professonal Land Surveyors. RICHARD H. GORR ,P.L.S.,N.Y,S. Lie. no. 40513 RGUr[. 6.P.O.VOX 916, 11AHOPAC, NEW YORK, :094! fob no 66 • 315 -ZS' Owner Roariri� Brook Country Partners Address RR #2 Twin Farm Lane Pound Ride NY (%, t. Located at (Street) off Pudding Street Sec. Block I Lot 1+8— (indicate nearest cross street) Sui�Dlvisk -J Lot 5 municipality Putnam Valley Watershed Date of Pre- Soaking 10/3/87 Date of Percolation Test 10/3/87 SOLE NUMBER CLOCK TIME 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 1:28 -1:58 30 24" 2614" 2.25" 13.3 2 2:02 -2:32 30 24" 2614" 2.25" 13.3 3 2:33 -2:53 30 24" 26V '2.25" 13.3 4 5 1 1:29 -1:59 30 20' 26Y" 2.5" 12 2 :0'4 =2:34 -"'30' 24 ..._ . 6 2t' - - �� 2- 2.5'Y 1._._.. 2 - 3 2:34 -2:54 30 24" 26Y' 2.5" 12 4 5 11 -15 1 2 3 5 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. rev. 9/85 3' 4' 5! 6' 71 TEST PIT DATA RE) HOLE N0. 5A HOLE NO. 5B HOLE NO. topsoil 0 -8 topsoil 0 -8 loam, sandy 8 -26" bright brown. 8 -36" bright brown sandy loam 26 -40" grey sand 36 -66 sand (grey) oc Rock 12' 13' 14' _ .._ ..INDICATE' LEVEL -AT *kC H -- GROUNDWATER IS 'ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED NA DEEP HOLE OBSERVATIONS MADE BY: Howard Kelly DATE: 9/29/87 DESIGN .Soil Rate Used 11 -15 Min /1" Drops S.D. Usable Area Provided 6000 S..F, No. of Bedrocros 4 Septic Tank Capacity 1250 gals. Type- Concrete. Absorption Area Provided By 500 L.F. x 24" width trench "1 Other Name Howard Kelly Signature r, r �N Address 37 Fair Street SEAL 21 Carmel, NY 10512 THIS SPACE FOR USE BY HEALTH.DEPARr ONLY: Soil Rate Approved sq. ft /gal. Checked by Date