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BOX 21
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h PUTNAM COUNTY DEPARTMENT OF HEALTH
Rev. 3 .186 Divlslon of Environmental Healtb Services, Carmel, N.Y. 10512
Eq eei Most Provide
\� P.C:H D. Peaimit.N
CERTIFICATE -CONSTRUCTION COMPLIANCE FOR SEWAGE.DISPOSAL SYSTEM
:,li7L.oG�'S aPBlockE vie Lot
at Tax M 3
Owaer /apP licantName Y® avNam / bd N
� v. Lot
rdgftg Address lcw led , zl / 0 � 0
,t P- Date - Permit Issued 2
, Asp W e S T�h'. /V
Separate Sewerage System bdilt by S %EPf/EnJ .l'fiSrv- S,f�. Address v
,.. Conelstlug,of / a7 O Gallon Septic Tank and O� aZSL �� F/ L.
r .
s ;
'Water PPIy= Public Supply From Address
on Private Supply Drilled by . ��✓ ��Jo/� Address
f BnUding Type ' , ;�oo d Has Erosion Control Been Completed?--
Number of Bedrooms -3 Has Garbage Grinder been Installed?
Other Requirements a K f G/tJ� . a/•. j0'
y q premises vets constructed essentially as shown on the plans of the completed work (copies
.I certify, that_the system(s) as listed serving the above
{•_
of-which are attached), and in accordance with the standards; rules and regulations; i ordanc with the filed plan, and the permit issued by the
!,E 'Putnam County De tmant 07 Health.
Date /a2ao.�f Certified bye —: °C.R.A.
Address d r J v�i� License No.
�s Any person occuDyln9 premlies served by the above system(s) shall :promptly rake such action as may be necessary to $*cure the correction of any unsanitary
i'y , : `:conditions resulting, from such usage. Approval of ttie, separate sewerage' stem shall become null and void as soon as a pub;;: sanitary ewer becomes
i ' valiablii'and the approval, of the pr( vale water'supply shalt become: null and void When a public water supply becomes available. Such approval* are
subject to modification or change when, in the Judgment of•the_Commissloner ' of, H Ith, such revocation, modification or change Is necesw►y,
,Date r' � Byr' TItte r
L fi,
.'ni .
I
I
0
W
FINAL ,1'1.t I-Nme A--: —LUN
S'IRE.:T ICC_�TION / ��- C/J` / / £''tii t v � iC Z ��� ' �� � 2 A c �� r �-..o c a•
P-r- T a ✓' - �0 24 s OR- SUBDIVISION LC7C
YE9 NO
CCM- Mt..%ft5
I.. SEM-AG - D.;SPOSA.L Pty
a. SDS area located as per approved plans
b.
Fill section - Date of plac--nent
2:1 barrier. I= W= AVG.DPTH
c.
Natural soil not strir-oe3
I
d.
Stone, brush, etc., create_r than 15' fron SDS are?.
e_
100 ft. from wate_*- co se /wetlands.
let
I
II. S�.GE DISPOSAL SYSTEM
a. Septic tank size - 1,250
b.
Sentic tank install led level
I.
c.
10' mini= from fcur.da4d- on
d.
No 90' bends, clea.ncut within 10 ft- of 45° be-rid
I
e.
DISTRiBUTIM BOX
1. All outlets at saw el evation - wa ter tested
( Q
2. Protected below f-cst
3. Minim= 2 f-'--- oric? Pall sail between box and trenches
I I
I
f.
JCTNC'rION BOX - prouerly set
g�S
1. Len remixed - instal-led
2. Distance to watercourse ►, r-
se Tea a . ft
3. Installed ac ordinq to Dlan
I i-Il
4. Distance center to c_ntez b
I I
I
5. Slone of tench ac_nptlable 1/16 - 1/32 " /foot.
I I
I
6. 10 f--- from Drcue_"r line - 20 feet - fouraHaticrs
I (
I
7. Death of t_ e-nch < 30 indnes Fran sun -lace
8. Roan all awed for excpnsion,
9. Size of gravel 3/4 - li" dimmeter
10. Depth of gravel in trench 12" mini=
( r,
11. • Pine ends c pp-ad
I �`
h.
- .
Pal 2 OR DOSE SYSTEM
1. Size DLiifID c ha =L er,
2. Ove_rflcw tank
3. Ala.=, vi sum /audio
I
4. Pum easilly accessible wanhole to grade
I
I
5. First bcx baffled
6. Cycle w tne=sad by Ham- 1 th Demaru«_*it
(
( I
estimated flow per cycle
a. Eduse loo _''tea per approved plans.
b.
Numb -.r of be^roars I
I
a. Well 1=t--3 as r,--- a=-roved plats
Q I I
b.
Distance fran SDS area ma SUred ft-.
c.
Casing 18" above trade. I
( I
d.
Surface d_— ainace a_rou. ^.d well accentable.
C. OVE-14LAM WORRrL�S ---Tp - •
a. Bates vroce-rly grouted
b.
Ail pipes rar`a.aLy badcLled I
I I
c.
ALI Rives flush with inside of bex 1't
d.
Bar-kfill material contains stones < 4" in dianneter I
SZ
e.
drain installed according to plan
I
f.
_Ctiirtain
Ourtain drain out=all yroter-ted & dir. to eci s t.watercours�
g.
Footinq drains discharge aw-ay fron SDS area
( I
h_
Surface water nrot -ction adequate
i.
Errosion c-,n=o vroviQ°-I on slopes Greater than 15 %.
01 1
Rrp�
- PUTNAM COUNTY DEPARTMENT, OF . HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
�Es�;a :.. . -, .,..,> .n..;.� -. -� -jay,. • - - - -• -.;�; •� - -• . -� �' �' -, ,
Owner der Purchaser of Building Section Block _Lot
Buildirrg Constructed by
Location - Street
Municipality
Building Type
Tax Map Number
Subdivisio Name
a6
Subdivision Lot -#
GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I..
represent .'..that. -I am wholly and completely responsible for the location,
wor anship, material, construction and drainage of, the sewage disposal system
serving the above described property, and that it 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 disposal system, or any
repairs made by we to such system, except where the failure to operate properly._. is•.._ _..._...-
:: ;:..caused, by_ .the _w_i.11fu-- .�_._ ' aeg .1getst ,act..of• the occupant of the building. utilizia
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services 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 day of �v2 19 Signature
Title
G6ner&1 Contractor (Owner) - Signature
tc9-ov
Corporation Name (if Corp.)
� 1 . axl, �
Address
rev: 9/85
mk
Yorktown Medical. Laboratory, Inca
321 Kear Street
Yerktowr Hegllcs.;N.,Y: 14598,.._
(914) 245 -2800
Director: Albert H. Padovani M. T. (ASCP)
Judy DiFrancesco
53 Trail of the Hemlocks
Putnam Valley, NY.10579
LAB # : 2. 0:3(_J520
Date Taken: 12 -18 -89 Time: 5AM
2PM. Date Reported : E U C. 2 1 1989
Collected By: J. DiFraneesco
Referred By:
-1 Sample Location: Slop sink tap
Phone # 28 -6
Phone # 969 -85
L_ J Repeat Test? _
LABORATORY REPORT ON THE QUALITY OF WATER.
INORGANIC NON- METALS. mg /L MICROBIOLOGICAL __T 10
_ Acidity
Alkalinity
Chloride
_ Detergents, MBAS
Hardness, Total
Nitrogen, Ammonia
Nitrogen, Nitrate
Phosphate, Total.
_ Sulfate
_ Sulfide
Sulfite
METALS (m /L)
Copper
Iron .
Lead
Manganese
Mercury
Sodium
Zinc
MISCELLANEOUS
pH (units)
_ Color (units)
_ Odor (TON)
Turbidity (NTU)
GENERAL BACTERIA
Standard Plate Count
(CFU /1.OmL)
MEMBRANE FILTRATION.TECHNIQUE
Total Coliform
Fecal Coliform
— Fecal Streptococcus
MOST PROBABLE NUMBER TECHNIQUE
Total Coliform Index
Fecal Coliform.Index
pH
LE 2
KEY FOR
TERMINOLOGY
CFU =
Colony Forming Units
CON =
Confluent (q.v. TNTC)
LT =
< = Less Than
GT =
r = Greater Than
N/A =
Not Applicable
S/A =
See Attached
TNTC=
Too Numerous To Count
REMARKS
/COMMENTS (For Lab Use)
;Sample Type:
(check each)
_ ✓Potable
_ Non- potable
_ STP INF.
STP EFF.
Other:
Sample Status:
(check each)
Outgoing
_ HNO3
_ HC1
_ .H2SO4
_ NaOH
_ ZnOAc
_. Na2S203
_ Other:
Incoming
�E
7G T
4 °C
4 °C
pH
LE 2
pH
GE 9
pH
GE 12
Other:
ELAP No. 10323
THESE. RESULTS INDICATE. THAT THE WATER SAMPLE Q(NE (Wasn't) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO TH ORK STATE PUBLIC DRINKING
WATER CODES, FOR THE PARAMETERS TESTED, AT THOF SAMPLE aIRING N.
THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Didn't) ET THE
SATISFACTORY CHEMIC QU STANDARDS OF THE NEW YORK PUBLIC WATER
CODES, FOR THE PAR ET ESTED, AT THE TIME OF SAMPLE COLLECT
2 /86(Rvsd7 /8T)RWE
Albert H. Padovani, M.T. (ASCP), Director
I
WELL (;UMYLh11U1V A-Lruml Office Use Only
DEPARTMENT OF HEALTH
Division -Of Environmental Health_ Serer.. s
PUTNAM COUNTY DEPARTMENT OF ij,EALTj� r,
ST ET ADDRESS: WNW f %1*, ' TAX GRID NUMBER: _
WELL LOCATION
WELL OWNER
NAM ADDRESS:
PRIVATE
PUBLIC
USE OF WELL
1- primary
.2 - secondary
Jig RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP ❑ ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (Specify)
p INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT gpm. /NO. PEOPLE SERVED "-- --- 7_EST. OF DAILY USAGE 'gyp° gal.
REASON FOR
DRILLING.
ANEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
' WELL DEPTH ft:
STATIC WATER LEVEL �ft.
TOTE MEASURED 3rd
DRILLING
EQUIPMENT
R- ROTARY ❑.COMPRESSED AIR PERCUSSION ❑ DUG "k� .
❑ WELL POINT 0 CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. AOPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH A ft
MATERIALS: j9 STEEL ❑ PLASTIC ❑ OTHER
LENGTH.BELOW GRADE eft.
JOINTS: ❑ WELDED 9THREADED ❑ OTHER
DIAMETER in.
SEAL: ❑ CEMENT GROUT ❑ BENTONITE ,IOTHER
WEIGHT PER FOOT —' lb../ft.
I DRIVE SHOE YES ❑ NO
LINER: ❑ YES JXNO
SCREEN
DETAaLS
DIAMETER (in)
SLOT SIZE
LENGTH (ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
YES 0 NO
_
SECOND
-
0
yHOURS
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH ft.
BOTTOM
OEM It.
WELL YIELD TEST If detailed pumping
METHOD: ❑ PUMPED i tests were done is in-
COMPRESSED AIR , formation attached?
❑ BAILED ❑ OTHER :OYES ❑ NO
WELL LOG It more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
water
Bear-
ing
Well
Dia-
In
FORMATION DESCRIPTION
coot:,
ft
ft.
WELL DEPTH
ft.
DURATION
hr. min.
DRAWOOWN
It,
YIELD
gpm.
Surface
d
�yPi1/
,
.WATER ❑ CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
❑ COLORED ANALYZED? ❑ YES ❑ NO
ANALYSIS ATTACHED? ❑ YES ❑ NO
STORAGE TANK: TYPE
CAPACITY GAL.
PUMP I FOAM IOH, L �-
TYPE CAPACITY S
MAK DEPTH `�
MODEL VOLTAGE ii— HP B
WELL DRILLER NAME GATE
ADORES / GfIXTURE
`y'
. - COi7D1T - - HEALTH DEPARD1ENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of
w_ � / TAiCDLV'+TT!'1Ai
ADDRESS
MAILING ADDRESS
P.O. Box Post Office Zip Code
Orig. Routine
Orig. Complain
Orig. Request
Campl iance
Complaint Camp
_ Final
Group Illness
Construction
�L Reinspection
PERSON IN CHARGE ,%y S/ / Field, Sampling Only
OR INTERVIEWED � (/ _ Field Conference
Dame and Title
_ Other
DATE 4 TYPE FACILITY
TIME TIME LEFT Explain
FINDINGS:
INSPECTOR: TELEPHONE:
Signature and Title
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE°
6/86 TITLE°
0
VINCENT A. ETTARI, P. E.
CONSULTING ENGINEERS
. _ ...._...... r.., ,. ..:; }..� .... 1=065 SPILLWAY ROAD
SHRUB OAK, N. Y. 10588
( 914 ) 245 -6320
Vincent A. Ettari, P.E.
Putnam County Department
Division of Environmental
110 Old Route Six Center
Carmel, New York 10512
Attention: William Hedges
Licensed Professional Engr.
of Health
Health Services
August 23, 1989
Re: FILL SECTION, DiFRANCESCO SITE
Dear Mr. Hedges:
Per your request I am formally writting this report to
confirm the results of our site investigation earlier this
afternoon. Two percolation tests were run in the area of the
fill section which was overturned. The results of the tests
were 4 min /in and 6 min /in. Moreover, a sample of the fill was
taken for a sieve analysis by your department. During the
course of the site investigation it was noted that the left side
of the fill section was about six inches lower than the right
::... = _._._... siiggested -. tlaa -t" .when..-,-t-e- - sys•tem• -- .is-- ...in•sta- lled��•..&n.-
additional truck load of run -of -bank fill should be brought to
the site for the purpose of "fine- leveling" the fill pad. I
have passed this information on the the owners, who have
indicated that they will follow your suggestion.
Sincerely Yours,
ncent A. Ettari, P.E.
0
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
Vincent Ettari PE
1065 Spillway Road
Shrub Oak, NY 10588
Dear Mr. Ettari:
August 17, 1989
ENID L. CARRUTH, M.P.H.
Public Health Director
Re: Fill Section - DiFrancesco
Trail of the Hemlocks
(T) PV - TM #24 -3 -6 & 7
Permit #PV - 48 -87
JOHN KARELL Jr., P.E.
Director
Review of the sieve analysis and perculation tests results submiited relative
to the above captioned project has been completed. Comments are offered as
follows:
1) Perculation tests in the fill section will be required to be
witnessed by a representative of this Department.
2) This Department will conduct its own sieve alalysis to verify
youi�- f..indings.,
If our findings concur with yours, it will be necessary to remove the existing
fill section and replace with fill suitable for sewage absorption.
If you have any questions, please contact me at your convenience.
Very truly yours,
Lawrence C. Werper
LCW•jr Assistant Public Health Engineer
•ENGINEER TO PROVIDE PERMIT #
y PUTNAM COUNTY DEPARTMENT OF HEALTH ON CERT FICATE of COMPLIANCE.
Division of Environmental Health Services, Carmel, N. N. Y. 10512 .PERMIT Aj a8, 8%
CON4C_T_110N PERMIT FOR SEWAGE DISPOSAL SYSTEM
Number of Bedrooms J Design Flow G /P /D &:01 0 0
Separate Sewerage System to consist of T 000 Gal. Septic Tank
To be constructed by
Water Supply:
own or. Village
Tax Map Block -•.� - t �.•�� ......,..�..
Renewal _� Revision ✓_�
,bate Of Previous Approval
Fill Section only ❑
P.C. H. D. Notification Required
and l 6C) / Ov, ew
Address �V T YA LL�y
Public Supply From Q
Private Supply to be drilled by 1L LPL ��y —Doe
Address �p c ,.—
Other Requirements �� �� t?u P. %f}��✓ ��ff7�✓ / 3 S l T / L — �L7« /��5� I;V S 7-4 LL915�P
GENT %Fr'r./�7o,✓ � SuPE� v/.s io ✓
I represent that 1 am wholly and completely responsible for the of the proposed system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on the approved amentlment there to and in accordance with the standards, rules and regulations of e Putnam
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 wi the standards, rules and regulations oof the Putnam
County Department of Hea tn. /
Date /r���8/ 'Unnad P.E. !/ R.A.
Address �� ��� License No Q 6 �O�
APPROVED.FOR CONSTRUCTION: This approval expires 6risyear fr m the dat 'issued unless construction of the building has been undertaken and Is
revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction
requires a new p rmit. Approved for disposal of domestic sanitary age, and /or private water supply only.
Date BY °'G� �� Title T ^
Rev. 6/85
PUTNAM COUNTY DEPARTMENT OF HEALTH
Rev. Division of Environmental Health Services. Carmel. N.Y. 10512 En&eer to Provide Permit 0
on CERTIFICATE OF COMPLIANCE
Permit 0 ��
Vn%cTQrIRTInAT v &BMST FnR cV.WAV_ nrcunesr. cvclrcna -
Located at o/9 �`'L me ZnVE 11'em-40 d&S
Subdlvislon Name /� ubd. Lot # �i O
Town or . Village
Tax Map -BMck <= Lot
Owner /Appllceat Flame AM "o 0,V �/ I iWlfail� -"_S Renewal_❑ Revision ❑ .
,,� Date of Previous Approval
Melling Address �' � -A/ ��'• �/ • / �� Town ,- �ST��EJT��_ Vp /070-_
Building Type Wo U f? FX ��eLot Area Zallg Fill Section Only Depth a. 5- VOlame 0 / @ f Y.
Number of Bedrooms 3 Des4a Flow G /P/D Do PCHD Notification is Required When Fill is completed
Separate Sewerage System to consist of 000 Gallon Septic Tank aa�1 I o,F
To be constructed by Af0T C- W0()S4N � %- Address
Water Supply: Pdblic Supply From Address
or:__&::� Private Supply Drilled by ----Address
Other Requirements t4 • X . L cS 'j�Ti°U
I represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sawage';'disposal system
above described will be constructed a$ shown on the approved amendment there to and in accordance with the standards, rules and regulations o the Putnam
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 h standartls, rules and regu a�lr ns of th utnam
DateDepa ►tm�ftt Ot� Health. 6 /,lAi✓`
Date I a.T I Signed A� P.E.- R.A.
Address �s t7� �° License No � lly_r
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is
revocable for cause or may be amended or modified when cons: necessary by the Commissioner of Health. Any change or alteration of construction
requires a n pearmit. Approved for disposal of tlomestIc n' a sewage, and /o vale water suDP1Y only. //,
Date .3 � � � By Title ° 7
DESIGN DATA. SHEET SUHSUFACE. SFWAGE DISPOSAL SYSTEM. FILE .10.7...
Owner �,efJ�i/��SL'� Address ��Y r��G -`.i/ ,,, �fj�:s�C/7�CJ�'.
Located at (Street) T, lq /L OF P47 ll Ld sec. Block 3 Lot 7. 7��
(indicate nearest cross street)
Municipaiity Ile Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking Date of Percolation Test Z,-:!t d
HOLE
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
/�. � � -i-z -• �.r
��. � " asp N
3 „
S �7 � %.�,.,.
4
5
3 13G y!/E,e TV ,ei✓�� 1��y,P
4 RNs- �4i•fG SI�ST�•1
5
1
2
3.
5
NOTES: .1.
2.
rev. 9/85
Tests to be repeated
are obtained at each
for review.
Depth measurements to
at same depth until approximately equal soil rates
percolation test hole. All data to' be submitted
be made fran top of hole.
DEPTH HO
G.L.
2'
TEST PIT DATA REQUIRED TO BE SMAITTED WITH APPLICATION ,
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
NO. HOLE NO. HOLE NO.
INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED�
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY. DATE.
DESIGN
Soil Rate Used Min /1" Drop: S.D. Usable Area Providedvv
No. of Bedrooms Septic Tank capacity /dC)Q gals. Type G0�C
Absorption Area Provided By �y00 L.F. x 24" width trench
Other GL �v�Tffis� ��if /s✓ /i�ISTf LG�� f} G��1� `7
Name 11(61�e-1411- hi- Signature,.--
Address SEAL''
r zi
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLLY.
Soil Rate Approved sq.ft /gal. Checked by
VINCENT" ......
CONSULTING ENGINEER
1065 SPILLWAY ROAD
Shrub..Oak, NY 10524'
(9 14 ) 245 -6320
Date
SIEVE ANALYSIS
Re: :Property of
Located at ZZ,2 7a
Town Section Block Lot -7
Name of- Subdivision 06�o&
Subdv. Lot No.*3y -0f0 Filed Map No.
?�d- Permit No.#10144-F—,87
Percentageby weight passing a' No.
12 sieve
.Percentage by weight passing a No.
40 sieve t'Z
Percent-ag(T--by-weigh-t pas'sing 'a"No.,
100• 'sieve
,Percentage by weight passing a No.
200 sieve
oil
1,zx
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Property of
Date
Located at _22L/'j//' T�/Z ,2/G- coe�5
(T) '&_ . Section a2 -Block 3 Lot V/
Subdivision of ei%WI41 /,/ //ALLEY
Subdv. Lot # .39 � � Filed Map # % Date
Gentlemen:
This letter is to authorize
a duly licensed professional engineer t1 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 conforrriity "with `the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code. p�`w�� NL51"
i'yL• �. ¢
Countersigned:
P.E. , R.Ae , # OG
Very truly yours,
Signed
r of Pr p rty
/ Address
Address Town
Telephone \ ,
Telephone
PUTNAM COUNTY HEALTH DEPARTMENT--
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Commissioner of Health - FIELD ACTIVITY REPORT Sheet of /
NAME / ��� G� S C G INSPECTION
Orig. Routine
ADDRESS Orig. Complain . Request
n
No. Street Town qI No. Compliance
Complaint Camp
MAILING ADDRESS Final
P.O. Baas Post Office Zip Code _ Group Illness
Construction
TELEPHONE
Reinspection
PERSON IN CHARGE _ Field, Sampling Only
OR INTERVIEWED Field Conference
Name and Title
DATE
i
TIME ARRIVED ~ 6 U
TYPE FACILITY
TIME LEFT 2
Other
Explain
INSPECTOR:
l•
Signature and
PERSON IN CHARGE OR INTERVIEiM:
I acknowledge this Field Activity Report. SIGNATURE:
6/86
TITLE:
TELEPHONE:
r/ a 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 ,#
WELL LOCATION
Street Address
Town /Village /City Tax Grid Number
WELL OWNER
Name Address rivate
' �s2 N� c•e (o L� 0*,rTe.11SJPZFZ O Public
USE OF WELL
1 - primary
2 - secondary
SIDENTIAL
® BUSINESS
0 INDUSTRIAL
O PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP O ABANDONED
0 FARM 0 TEST /OBSERVATION 0 OTHER (specify:
b INSTITUTIONAL O STAND -BY
AMOUNT OF USE
YIELD SOUGHT
gpm /# PEOPLE SERVED e," OF DAILY USAGE300. gal
REASON FOR
DRILLING
;MEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ❑TEST /OBSERVATION
O REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
WELL TYPE
BILLED
DRIVEN ®DUG ® GRAVEL ® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES _NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: d j NP SgAly eX-VQX_
/..j ���� /%�.L L� y Lot No:
WATER WELL CONTRACTOR: Name S® aj s Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ NO "
NAME OF PUBLIC WATER SUPPLY: A2/ _4 TOWN /VIL /CITY
DISTANCE.,TO_PROPERTY FROM NEAREST WATER MAIN :_ -. .' „_ - -
. . . . _e �. _ =_. _ . . .. . .
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
[]ON REAR OF THIS APPLICATION SE S
/E %
(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: 60— 19
Date of Expiration: 19 Permit Issuing fficial
Permit is Non - Transferrable
A.
PUTNAM COUM Y DEPAFaKE it OF. HEALTH
DVISION. OF: HEALTH SERVICES
DESIGN DATA SHEET- SUEISUFACE --SEWAGE DISPOSAL SYSTEM__ _ _ .. FILE NO.
Owner A4,Z o,v d Caress GL'Av`. �i�IJT _ TS/� 1�70y
Located at ( Street) JW11- off'` `7 a- h��10 Sec. ` Block 3 riot G
(indicate nearest cross street)
Municipality LLc y Watershed
SOIL PERoaIAZ'ION TEST DATA RDQU= TO BE SUBMI = WITH APPLICATIONS
Date of e-Soaking
Date of Percolation,Test
HOLE
NU-lSER TIME
PERCOLATION
.
P CATION
Run Elapse
Depth to Water Fran
Water Level
No: ime
Ground Surface
In Inches Soil Rate
Start -Stop Nfi
Start Stop
Drop In Min /In Drop
Inches Inches
Inches
1
2
3.
4-
5
1�
2
3 ..
4
5 r
Aj
1
2 y r• ,
3 r`�
4
NOTES: 1. Tests to be repeated.at,same depth until approximately equal soil rates
are obtained at each percolationtest, hole. -All data•to`be submittbd
for review.
2. Depth measurements,:.to.be made from top of hale.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. HOLE NO. H01Z NO.
G.L. CeIPWIOZ (2e 6:�llll C
1
1' ZM4—'*f',-5*-0 12
29 441, 0-11-ft God
31
40
51
6' 4.�6;6- of 7-
71
81
9
10,
11
12'
13'
141
'INDICATE LEVEL AT WHI01 -MOUNUQTEEC'IS'.-ENCOUNTEREa'
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: DATE: 7 zzz
DESIGN
Soil. Rate -Me4-_ Min/1 Drop: S.D. Usable Area
No.. of Bedrooms
Absorption Area Provided By
Other
Tank Capac'-
gals.
L. F. x
Name 7 - rW,-- AIME� / ,r. Signature
,4 VIA15 SEAL
Address cc
THIS SPACE FOR USE BY HEALTH DEPAR2M ONLY:
Soil Rate Approved sq-ft/gal. Checked by Date
u Pi 'Vol
�r
POST OFFICE ADDRESS
RFD 2. PUTNAM VALLEY, N. Y.
10579
TELEPHONE
526-3333
TOWN OF PUTNAM VALLEY
NEW YORK
PAUL J. KASTUK, Highway Superintendent
October 9, 1986
Mr. Raymond De Francesco
C/O J. & E. Associate's
1065 Spillway Road
Shrub Oak, N.Y. 10588
Dear Mr. De Francesco,
As per our phone conversation on October 7, 1986, you are
foomally granted permission to install a catch basin and extend
Town drain pipe in front of property (Tax Map # 24-3-6-7) to the
brook.
Please be advised that all cost for this project will be at
Francesco °s -expense and not -the--Town -of- Putnam Valley
Highway Department.
St.ncerel
P Jo X4,1�rOK,Irig-K way -Superintendent
PJK/cc
PUTNAM COUNTY DEPARTMENT OF HEALTH
I. - a, ... ...,. . ..•..:. �� , �,. �3I PSsI9N <:OF dENVIFtONMENTA- ; TIEALTH "SERVL.CES
Date
Re: Property of
v a
Located at,Q /L
(T) ection Block 3 Lot K ��
Subdivision of— �_�¢%17jo �$KNNjr 9,4too/t
Subdv. Lot . ( 00 Filed Map # /39 e. Date //4?
Gentlemen:
This letter is to authorize �i�� l�✓ 21"
a duly licensed professional engineer I/ 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
this- matter --and to --sup r�v2se- the�-constrizctio�r �f--saxch _ --- — -
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 AC. , # APf%l
1,p
Address
j Sao
Telephone
Very truly yours,
Signed
0 er bf Property
6 p GL.E,v CT.
Address
��ST�iyEST��� Ally 70?
Town
9�/- 5-23
Telephone
.7;
DAVID D. 'BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
Noviello Associate November 25, 1986
Elvins Lane
Garrison, New York 10524
Att: Vincent Ettari
Dear Mr. Ettari:.
RE: DiFrancesco
Trail of the Hemlocks
(T) Putnam Valley
Tax Map # 24-3-6 & 7
JOHN SIMMONS. M.D.
Deputy Commissioner
Re * view of plans and other supporting d ' ocuments submitted at
this time relative to the above captioned project has been
completed. Comments are offered as follows:
submit a revised design data sheet.for 3 bedroom design
due to the tightness, wetness and depth to bedrodk of the
-lot in the.vicinity of the SSDS area, percolation tests
must be withessed.by.,this.Department.'
another deep hole should be excavated in the SSDS area
design based on a 4.5 foot fill section is not advisable;
a maximum 3.5 foot fillsection may be installed,
. submit 2 copies of house plans
Upon receipt of submission, revised to reflect the above
comments, this application will be considered further.
Very tuly yours,..
cr Anne Bitter
Asst. Public Health
Engineer
AP: pt
cc: JK
AB
File
TWO. COUNTY CENTER CARMEL, N.Y.. 10512 (914) 225-3641
0
It
DESIGN
Owner
LoCatM at
PUTNAM COUNTY DEPAFOMDU OF HEALTH
DIVISION' OF ZN HEALTH SERVICES
Al. Wkv-
X'DISPOSAL.. SYSTEM_ ........ FILE NO..
Yc..Addre'ss
(st±eet)7,z,olG _011C, 71-64--c- AF19,40asSec. Block 2 Lot
(indicate nearest cross street) - . - e J7
Municipality ItI4,001, Watershed
'SOIL -PERCOLATION TEST DATA P3QUIRED. TO BE SUBMITIM WIZii.APPLICATIONS
Datb of'-Ipre-Soak'in r, Lze le"? Date of Percolation Test', 6-lxf�E7
Ago -d
21 =1
PEROOLATION
Run
Elapse
Depth to Water From
Water Level.
No.
'14aps
"Time
'
Ground Surface
In Inches
Soil Rate
Start -Stop 't Irlin.
Start S top
Drop In
Min/In Drop
Inches Inches
Inches
2
3 .2 9C
4
5
4
7
Mf,j
5
2
3
5
NOM: l.' Tests to be repeated at same depth until apprcximtely equal soil rates
are obtainedat 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
a. «• r •
WITH APPLICATION
DEPTH HOLE NO. HOLE NO. sZ HOLE NO. -�
G.L. e24 C�. 26:1-AW/ r-
1 ° 7P � So i. L ESQ iG r�e°.So /
2'
51 Lje:PGr "fT. 15;0S� �fT �� ��"�G f7 S/
6°
7°
8°
9°
.10 °
11°
12°
13°
14°
__._.._.- '- INDTCATE -LEVEL AT-WHICH GR�ATER IS'-
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EN00UNTERED
DEEP HOLE OBSERVATIONS MADE BY.* V4- j�7�ij' DATE
DESIGN
Soil Rate Used 0? / . Min /1 °° Drop: S.D. Usable Area Provided O O f
No. of Bedrooms 3 Septic Tank Capacity gals. Type
C! �e✓e
Absorption Area Provided By (� Do L.F. x 24" width trench
Other e. 'x-/�L. y` -e� (f Au S;f,-ry
Name 00-oESignature
Address SEAL
THIS SPACE FOR USE BY HEALTH.DEPARTMENT ONLY:
Soil Rate Approved sq.ft /gala Checked by Date
!+ J•' , r e•• �- t. t �+ ,.., t.. ��'.i \.fir � � rCi $I �. �, �"' -- ':
..,J, �� � ' ;- ,15�'�l't�7'.I�1X�'•r 3L yj r Y'. T ..': • '9 Z :' :'•A.'i,
,
zt � t �•`' /nq 110 —�93i � ., � ��,�'q •,off
r r
� � i � rr Rla�r/ °, '�,�L •,b > y ti l�E��'��i.t�!% -. /; '.;. `_ m r • .r:��'��a` 10 Y S.r} 7 ...,� _, .r... ✓•<, s., , ... � , .. ,r �.... ,. � � ,
',•,��rrz W�j� i,. 1
U� 13:
:11 ` W^ {:y ',•c „ 0 ..
r RKS :OFFICE ` \` a3•a. a c' 12
/439p..
who •..mode rhis map, -. � r . O _ �e,�• . � � ,/ .:�i � o. -
y Al fhe p OLerty • P P .� 1 61 �1 /I s s: �� :
iere/nlxr Z0, . 1930 c
•o/%uory /,
19N. 1 4! ti Ph
_ _ �.. '�• �'- d^�,��1!�
• t •Op b \ rr \ � . aSrAl . P\
V`J 37 \ 4
_ "►�.�,�_.....i Sao ti` o�, \`'
35'
aei
P• R•85 �A \
' ? : �� . -. � , _ t, c� _ , ,�. � � �!� „ Ay1 •.. �\ Vic, q � w . - �,e'• \0 �
�1 k00 ;. o.'+, ���'�y•� - Vii/ \ `js,�( °�� \`� 0!
0 d 110 /97 0 - a•ss•u.ro' _Il �
_ o
�N. /942
'; • . � �� Aso'
v..
� h !
>-
Z
C-A-L, . i � ,7 lm-f 'i
#41
rte— -7-7
---- -- ------------ -
_rIT
W6ol
_.. .. ,.. .. .. �.: y. : 1^: J: tx ..::Gi,:...r.'...:.....unl".0_ :...i.;.tS.hti:Y.vt•:ia:._ _..., .. . JU: u. m .uYL.i1::a..`:es.Y1.:. +�.ul.L.. .n .........
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES �
INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS
. INSPECTION - .•REPORT
(� P - DATE:
INSP. BY:
(Name of Owner) (Street tion)
INITIAL SITE INSPECTION YES NO CONMETFI'S
Wetlands on/or proximate to property........ .....
Property lines or corners found ...................
Can estimate house location .......................
Will driveway need cut....... .....:.............
Must trees be removed - note these .................
Deep holes representative of entire SDS, area......
Additional deep holes needed...:.. .. ....
Sufficient SDS area available considering driveway .
cut, house location,, separation distances,etc...
Adjacent wells/ septics ............................
D.H. - Deep Hole
G.W.- Groundwater
D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot
Depth to G.W. Depth to G.W. Depth. to G.W.
Depth to rock Depth to rock Depth to rock
Soil Descri tio:
0 ft.
3 ft. j,)
6 ft.
9,ft.
1
12 ft
Soil Descr
0 ft.
3 ft.
6 ft.
9 ft.
0 ft.
3 ft.
6 ft.
9 ft.
_. _.:..:.12-ft-.
Soil Description
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
COMMENTS
House SSDS located per approved plan .............
Length of trench measured
Width of trench average
Slope of tile line.and trench acceptable.........
Roam-allowed for expansion trenches ..............
Over 100 ft. from watercourse.
Natural soil not stripped or SDS area
unnecessarly graded .......................:....
10 ft. maintained from property line and
20 ft. from house ..... ........:...............
Distance well to SSDS (ft.).. .....................
Number of bedrooms checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench.. ............
15 ft. of peripheral soil horizontally
fran trench .......................... ........
Boxes properly set ...............................
Could surface runoff from driveway, roads,
ground surface, etc., channel near SDS area....
Does lot drainage appear OK Jn area of SDS::......
FINAL GRADNG OF SITE ACCEPTABLE::..
PUTNAM COUN`T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY SUBSURFACE S39 GE DISPOSAL SYSTEMS
FIr LD IINSPECTION `REPORT' _
.. - IA. P DATE:
INSP. BY:
(Name'o .(saner) (Street Location)
INITIAL SITE INSPECTION YES NO COMMEN'T'S
Wetlands on /or proximate to property...........,.,
Property lines or corners found.,.., ............ 0..
Can estimate house location.— ...................
Will driveway need cut..
Must trees be removed - note these...,........
Deep holes representative of entire SDS area ...
...
Additional deep holes needed..... ............. ..
Sufficient SDS area available considering driveway
cut, house location, separation distances,etc...
Adjacent.wells /septics.. —. . ......
D.H. 1 Lot
Depth to G. W.
Depth to rock
Soil Descri tion
0 ft.
3 ft.
6 ft.
9 eft.
12 fte.
D.H. 2 Lot
Depth to G. W.
Depth to rock
0 ft.
3 ft.
6 ft.
9 ft.
Soil Description
D.H. —Deep Hole
G.W.- Grouter
D.H. 3 Lot
Depth to G. W.
Depth to rock
Soil Description
0 ft.
3 ft.
6 ft.
9 ft.
_ -12- fta ' _ -
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
CCMM ENTS
House SSDS located per approved plan .............
Length of trench measured
Width of trench average
Slope of tile line and trench acceptable.........
Roan allowed for expansion trenches ..............
Over 100 ft. from watercourse ...... ....°.........
Natural soil not stripped or SDS area
unnecessarly graded.......... .e. >. ........ .
10 ft. maintained fran property line and
20 ft. from house... ......... > ...............
Distance well to SSDS (ft.) ......................
Number of bedrooms checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench.......... .....
15 ft. of peripheral soil horizontally
fromtrench .......................< <., ........
Boxes properly set......... .... >. >............
Could surface runoff fran driveway, roads,
ground surface, etc., channel near SDS area....
Does lot drainage appear OK\,in area of SDSe'o....,
FINAL GRADNG OF SITE ACCEPTABLE:.:.. ... ..
Vol
PUTNAM-cowry DEPAFDaw OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS.,
, ...._ .., FIELD INSPECTION.-REPORT:-
�.p,.. DATE:
��� INSP. BY:
(Name of Owner) (Street Location)
INITIAL SITE INSPECTION YES NO COMMENTS
Wetlands on /or proximate to property............. .
Property lines or corners found...................
.Can estimate house location ........................
Will driveway need cut ............................
Must trees be removed - note these ................
Deep ,holes representative of entire SDS area.......
Additional deep holes needed..... .................
Sufficient SDS area available considering driveway,
cut, house location, separation distances,etc...
Adjacent wells /septics.............................
D.H. 1 Lot
Depth to G:W.
Depth to rock
Soil Descri
Ott.
3 ft. ✓ 71,IJ rA 1- °l J-
6 ft.
D.H. 2 Lot
Depth to G.W.
Depth to rock
Soil Descri tia
0 ft.
3 ft.
6 ft.
9 eft. 9 ft.
12 - =ft: ,....„._ ...
D.H. - Deep Hole
G.W.- Groundwater
D.H. 3 Lot
Depth to G. W.
Depth to rock
Soil
_ . 0
ft.
3
ft.
YES
6
ft.
House SSDS located per approved plan.............
9
ft.
Length of trench measured
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
COMMENTS
House SSDS located per approved plan.............
Length of trench measured
Width of trench average
Slope of tile line and trench acceptable.........
Rosen allowed for expansion trenches............ .
Over 100 ft. fran watercourse. .. ..................
Natural soil not stripped or SDS area
unnecessarly graded........... .... .........
10 ft. maintained fran property line and
20 ft. fran house... ........................
Distance well-to SSDS (ft.) ......................
Number of bedrooms checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench ................ .
15 ft. of peripheral soil horizontally
fran trench ..... ...............................
Boxes properly set... ..... ..................
Could surface runoff fran driveway, roads,
ground.surface, etc., channel near SDS area.... l�
Does lot drainage appear OK Jn' area of SDS.-:.....
FINAL GRADNG OF SITE ACCEPTABLE:... ..
Re: Property o
Located at
(T) Block .� Lot (o '
Subdivision of /"A/
Subdvo Lot # c3,9,-eVA Filed Map # 10,9 G Date � o
Gentlemen:
.This letter is to authorize���
a duly licensed professional engineer. t/ 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, rule's
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 with.the
provisions, of�Article 145 ^o
147, Education Law, the Public Health Lass, and the Putnam.County
Sani-
tart' Code.
fill
Very truly yours,
�
Oag ne d
Owner of ProjAerty
Countersigned: CV
rC
PoEo, R.Ae, #
r
Address
--fee
Address
c_ "_% `r,'
Town
i
Telephone.
Telephone
—�
gg
e
0 0' OF I' •; ' E W HEALTH SERVICES
..... _ DESIGN DATA SHEET= SUBSUFACE SEWAGE _ DISPOSAL. SYSTEM
FILE IAA.
-
Owner
Address ��
�L�N ,ErfsT
N�}/. l070
Located at (Street) 77 -IflL r' &OW" 6s
Sec. `' Block
Lot
(indicate nearest cross street)
`
prlro
7,p,-Alo /y 71
Municipality
Watershed
r.
SOIL PERCOLATION TEST•DATA.RBQUIRED TO BE SUBMIZTED WITH APPLICATIONS
Date of Pre- Soakin '� c
g � Date of Percolation Test % /�dLP��
HOLE
'
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
4
3'P9 - jt.3G .. 027 .. �! ��(
3
% .Aiip✓�:V
•
ri
1
a .-aa -a.s� . 3� s•, .-mar �a
�
.3� ��.� / -:�
z .•
5
10 101
lag
4 sA..
NOTES: 1.
2.
rev. 9/85
Tests to be repeated at same depth until'apprcximately equal soil rates
are obtained at each`percolat on: :;test':hole. All data to- be submitted
for review.
Depth measurements to be made from top of hole.
a
00
AN*-
coo
V
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION 4.
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH
HOLE NO. /
HOLE NO. .2,
HOLE NO., -3
�._ G. Lo �...
0,��%7�/✓i ,�
42 2 Cr
®
ry,�eSO /Z-
21
1,
11°
12°
13'
14' -
INDICATE LEVEL AT WHICH GRO MMATER IS E[=UNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: Z NC'., mil• 7— � �i9��, DATE:
DESIGN
Soil -Rate Used Min/1" Drop: S.D. Usable Area Provided 3 000 s
No. of Bedroans Septic, Tank Capacity / ®ov gals. Type A457 =.Ff6
e-o•✓e
Other.. ZX
Name Ae, *i1V Signature
Address
THIS SPACE FUR'USE BY HEALTH DEPARTMENT ONLY
Soil Rate Approved sq.ft /gal. Checked by
.p
Qo
. - .it
a F u.
> �0. 7 8
SAP
Date
PUI'NAM COUNTY DEPARTMENT OF HEALTH
> DIVtSICN ` OF.,.' HEALTH: `SERVICES
DESIGN DATA.SHEET- SUBSUFACE- SEWAGE DISPOSAL SYSTEM FILE NO.
Owner ,QAS/wo�•� ,4%r ndESCa Address .,OP .__ oe� Elt.s 9: N
-'T_
Located .at . (Street) reA /L Qe- . 771,o- /i�E•�lLcr•E�. Sec. Block 3 Lot 61,7
(indicate nearest cross street)
Municipality Watershed
SOIL, PERCOLATION TEST DATA REQUIRED. TO HE SUBMITTED WITH APPLICATIONS
Date of Pre - Soaking �O�p6 Date of Percolation Test ,� 6
HOLE
NUMBER CI= 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 .
3 3 -. -•o� �a -a%
4
5 '
2.
1 .
-4
.1 71W
1
2
4 0 CP
5
s
NODS: 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
TEST PIT DATA MUIRtD TO: 'SUBMITTED; W
rp' 1 a,
DEPTH HOLE NO. -t NO. �...
HOLE NO. ,� HOLE
G.L. G,¢�� Q
1 °
70/SA�L °
3° 01/
49 �' 1E7>GE d7' �r
69 �E fIT SSA
8°
9°
10°
12'
13°
14°
INDICATE LEVEL AT WHICH GROUND4MM IS ENCOUNTERED
INDICATE LEVEL TO WHICH DATER LEVEL RISES AFTER BEING ENOOUNMED 3 S
DEEP HOLE OBSERVATIONS MADE BY: �/ �3�fi DATE: rlvl�
DESIGN
Soil Rate Used Min/1" Drop: S.D. Usable ovided .
No., of Bedroans Sep ank Ca gals. Type
Absorption Area Provided By L.F. x 24'° w.i erich-
Other
GVkXN4 •-
Name Signature
Address SEAL
Pl�'
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: FFSS10
Soil Rate Approved sq.ft /gal. Checked by Date
PUZgiM COUNTY DEPARRMU OF HEALTH
4• ' DIVISION.OF HEALTH: SERVICES
DESIGN DATA SHEET- SUBSUFACE S3gAGE DISPOSAL SYSTEM
FILE NO.
Owner QAJO.�a v� �� Fk'A seo Address 9
GL�.v Ei��s' ?_ Al.
Located at (Street) T��iL...oi" ..7rHC /i��1S
Sec. Block
Lot 41,2
(indicate nearest cqF street)
Municipaiity /4 Up 1�i9`Lt �/
Watershed
SOIL PERCOLATION TEST DATA RDQUIRM TO BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking Date of Percolation Test
HOLE
NUMBER CLOCK 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
1 9 g 0/0.1
2 /0,' 1 1
56/3
3 1014q
9
5
2 /0=0 2 /01 - 4S 3
3 ., � I1:3 l3
5
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.submittbd
for review.
2. Depth measurements to be made fran top of hole.
rev. 9/85
TEST PIT DATA RBQMM `r0 BE .-SUBMITTED: WITH APPLICATION
DESCRIPTION OF SOILS EWOUNTMM * IN TEST HOLES
'Soil Rate'Used ---14irL1" Drop: S.D. Usable Area
No'. of Bedroans Septic. Capacity
Absorption Area Provided By x.2411 wa 'trench
Other'
Name Signature
Address -/oc -r f SEAL
V
THIS SPACE FOR USE BY HEALTH DFPAJMTM ONLY:
Soil Rate Approved sq.ft/gal. Checked by
gals. Type
4C -0
z i Ir
ui
<)
Date
DAVID D. 'BRUEN
County "Executive
DEPARTMENT OF:. HEALTH
Division. Of Environmental , Health Services
Noviello Associates November 19, .. 1986
Elvin's Lane
Garrison, New York- 10524
Att: Vincent Ettari
Re; Proposed SSDS
�.`, TDi Francesco
Tax Map P# 24-3-6 7
rail of.Hemlocks
A
rww_
rd
JOHN SIMMONS, M.D.
Deputy Commissioner
Dear*Mr. Ettari:
Review of plans and other supporting documents submitted at
this time relative to the above captioned project has been
COMVP�le ed. -'.Comments are offered as follows:•
submit 2 more copies.of well permit - application
-:=Mow design data'sheet''i's for 4-bedroom':design,
application and plans .are for 3 bedroom design.
Confirm and update design criteria on all documents
s' v detail of . curtain,, rpip
11P
o it details drawinge not used n system
AT
all electrical work in pump chamber.sh6uld be to NEC
codes
COK
storage in pump chamber should be one day storage
over high level alarm.
6K,'show town drain pipe extended beyond proposed well
location to stream
d1(.___show detail and specification for town drainpipe
under-drivevay
Upon.receipt of a submission, revised to reflect the above
comments,.-this application will be considered further.
Very truly yoursP
n B
e Bi t ner
Asst. Public Health Engineer
AB:pt
TWO COUNTY. CENTER - CARMEL, N.Y. - 10512 (914).225-3641
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEW
"IL4 -
Mime of Owner)
COMMENTS
LF trench provided
required
60 ft. max.
REVIEW
SHEET
-
CONSTRUCTION PERMIT
...._.DATE. REVIEWIP:
BY:
cation)
DOCUMENTS
Permit Application
Corporate Resolution
Plans - Three sets S/s
Engineers Authorization
Design Data Sheet (DDS) SUBDIVISION
Deep Hole Log Perc
Consistent Perc Results (3) Fill
30" Perc Hole cd
Other
House Plans - Two sets
If PWS - Letter if welllpwnit
Variance Request
REQUIRED DETAILS ON PLANS
Sewage System Plan
Sewage System Hydraulic Profile - Gravity Flow
Fill Profile & Dimensions - Volume.
D or J Box;Trench/Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Service Line if over
Construction Notes
Design Data
Two-Foot Contours Existing & Proposed
Driveway & Slopes Cut
Footing/Gutter Curtain Drains
Perc -,& Deep Holes Located
Representative'of Sewage & Expansion Area
Expansion Area;shown-gravity flaw,suff. size
1:
If Pit &D Box Shown & Detailed
House - No'. of Bedroans
Wells & SSDS's w/in 200 ft. of Property Located
Property Metes & Bounds
House Setback Necessary (Tight lot)
House Sewer - 1/4"/ft. 4 "O; Type pipe
No Bends; Max. Bends 45* w/cleanout
SEPARATION DISTANCES SPECIFIED ON.PLAN
Fields
101 to P.L., Driveway, Large Trees
201 to Foundation Walls
1001 to Well; 2001 in D.L.O.D, 150' pits
1001 to Stream, Watercourse, Lake (inc. expan)
151 to Drains-Curtain, Leader, Footing
351to catch basin,stormdrain,piped watercourse
(Stree
YES
1,,-W
Ir
4Z
/4
101 to Water Line (pits-201)
501 intermittent drainage course
S2aic Tanks
01
1 Ean Foundation; 501 to well
151 Well to PL
GENERAL
Legal Subdivision
Subdivision Approval Checked
Ex-approval SSDS Adj. Lots Checked
'Wetland (Town/DEC Permit R & D)
Data On DDS Plans & Permit Same
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