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HomeMy WebLinkAbout2560DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51.19 -1 -47 BOX 22 02560 '1 all IV, a I 6 ' 1 ._ . .9 L I 1. '. C 02560 - PUTNAM COUNTY DEPARTMENT OF HEALTH Permit P_3 "` Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTI PERMIT FOR SEWAGE DISPOSAL SYSTEM P Town or villavu _ Block,. � Lot - y�at:�on -Wa _._. .... - .._Tax• -Map � t - Located at 2$ 27 Lake Oscawana Acres subd. lit N r Renewal Subdivision _[ Revision —0 -'rr ((+� �a �•�•(� l Tl Q1 e n G c Lk_ -Rd- RY i� 7A �t7 t _ �tj Gf Previous Approval owner /Address�� --��_ X10 5 79 ❑ Building Type One,. Fam. Res. Lot Area _43_,4_3j SF Fill Section Only 3 Design Flow G /P /D 600 P.C. H. D. Notification Required Number of Bedrooms 1000 Gal. Septic Tank and 420LF of leaching Trenches _ Separate system to consist of Canopus Hollow Rd, Put. Val,NY To be constructed by Don Heady Address 10579. �. Water Supply: __ Public Supply From xxx Norman Anderson __ Private Supply to De drilled by Barger Street,Putnam Valley NY 10579 A --1 -- - -- — - Other Requirements on of the proposed system(s); 1) 1 represent that 1 am wholly and completely as shown on the approved amendment there to and in accordance with the stand rules an separate regu a sewage ns of disposal 1 It nam above described will be const u County Department of Health, and written completion guarantee will be furnished the owner,uhis wccessors, heirs or assigns by the builder,ithat nsaidf builder w,l be submitted to the Department, ears immediately following the date of the place in good operating condition any part of said sewage disposal system during the period of two (2) Y ante of the approval of the Certificate of Construction Compliance of the original syste or any repairs thereto; 2) that the drilled well described at,y. °rU will be located as shown on the approved plan and that said well will be insta accordan with the standar s, rules and regula i of the Pu' Y County Department of Health. . %r Date 2/17/86 Signed _t., __._ P.E. R.f• I Or Address MUSJC O t_. � APPROVED FOR CONSTRUCTION: This approval expires revocable for cause or may be amended or m�Qdified when cc requires a nor pern�i)ti p�pproved sal of domesti Date —. Rev. 9 -81 PUTNAM COUNTY DEPARTMENT OF HEALTH Permit r PV 33 -83 Division of Environmental Health' Services, Carmel, N. Y. 10512 CONSTRUCTION PER'MJT_ FOR SEWAGE. DISPOSAL_SYSTEM......__. _.. Located at Watson Way_ Subdivision Lake Oscawana Acres Subs. Lot a 28 Owner /Address N. Gods en, .Bx 33, Old Chatham, NY1.2136 Building Type nn Pam, Res. Lot Area 20 00()sp Number of Bedrooms _ 3 Design Flow G/P /D 600 Separate Sewerage System to consist of 1000 Gal, Septic Tank ,.- _.._..P.utnam...Valle-%,* Town or Village Tax Map 29 Block 3 Lot 2 Renewal `u Revision Date Of Previous Approval Fill Section Only P.C. H. D. Notification Required and 420LF of Leaching Trenches To be constructed by.. lion HAarl)l AddressCanopus Hollow ow Road. Put- Valley, Water Supply: _ Public Supply From New York 10579 XX - Private Supply to be drilled by Norman Anderson Address Barger Street, Putnam Valley,NY 10579 Other Requirements I 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 approved amendment there to and in accordance with the standards, rules an regu a ions o e u nam 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 the standards, rules and regu a ill ons of the Putnam County Department of Health. Date ju 1 y 1985 . Signed P.E. R.A. XX Address Muscoot No.,RFD#2,Bx 488,Maho ac,NY 1054tcenseNo. 11056 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issue construction of the building has been undertaken and is revocable for cause or may be amended or modified when idere necessary by the ommission r of Health. Any cha or Iteration of construction requires a new permit, p d for disposal of dome is it ry se e, and /o private _supply only. Date __J�� By Title Rev. 9 -81 Y PUTNAM COUNTY DEPARTMENT OF HEALTH Permit 41 PV 34 83 " ' Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCW)OIV.- PERMIT.- F_,OR- SEWAGE DISPOSAL SYSTEM Located at Watson W Subdivision Lake QSCawana Arres SUM. Lot a 77 Owner /Address N. Godsen_j.Bx 33,01d Chatham, NY12136 Building Type 1 Fam< Res. Lot Area 24, OOOSF Number of Bedrooms 3 , Design Flow G /P /D_6nO Separate Sewerage System to consist of 1 000 Gal. Septic Tank To be constructed by Don Heady Water Supply: Public Supply From Putnam Val 1ey Town or village n1 Tax Map 29 Block 3 Renewal _ M Revision Date Of Previous Approval " Fill Section Only ❑ P.C. H. D. Notification Required and 420LF of Leaching Trenches Address Canopus Hol o Rd, Put. Val, NY 10579 XX Private Supply to be drilled by Norman Anderson Address Barger Street, . Putnam Valley,NY 10579 —Other Requirements I 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 qr; above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e Arnim T 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 - u 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 shogun on the approved plan and that said well will be installed in accordance with the standards, rules and regu aeons of the Putnam County Department of Health. ,,,,July 31, 1985 xx Signed P.E. R.A. Address Muscoot No. , RFD #2, Bx 488, Mahopac, NY 10541LiC.nl. No, 11056 APPROVED FOR CONSTRUCTION: This approval expires one year fr m the date Issue nless construction of the building has been undertaken and is revocable for cause or may be amended or modified when consi r tl es y by the illi6n.r of Health. Any change or alteration of construction . "u requires s g�pe► � or disposal of domestic pply only. "} Date _�_� By Title Rev. 9 -81 Rev. 3 86 `�\ V 0 C Located i, PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services Carmel N.Y. 10512 ._ _ ... -. ' .'.._ _..-_EiigineerMustProvide- 3 -g.3 t N Y.. OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM j own V e :son W a y Tax Map 9 Block Lot 2 Y' Owner /applicant Name Melling Address J. Cardinale 347 _ vision Name LK Q s k ap A,. Lot if 28, 2 Date Permit issued 2,L28/86' Separate Sewerage System bnilt by Don Heady Address y ; Consisting of 1000 Gallon Septic Tank and 3851f of leaching trenches INY 10579 61 O.C. _Water Supply: Public Supply From Address ors xxx Private Supply Drilled by Norman Anderson AddressBarger Street Put, /:1- P- B�Ilding Type one family r e s ade n CAs Erosion Control Been Completed? yes Number of Bedrooms 3 Has Garbage Grinder Been Installed? no Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the comp ted work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with filed p , and the rmit issued by the Putnam County Department Of Health. Date 2/10/87 Cortifled by R.A. xxx Address Muscoot North, RFD #2 Box 488 a op c LI 1056 o r, ill Any person occupying premises served by the above system(s) shall promptly take such action as may bo note y to >�curo 0 o correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as roan as a pub(': sanitary Gower becomes available and the approval of the private water supply shall become null and void when a public water supply becomes availablo. Such approvals are subiert to modification or rhanne when" in the iudament of the Commissioner of Hanith_ such ravoention- modifirntinn or rhnnne Is noresonrv_ !r ; �3 PUTNAM COUNTY DEPARTMENT OF HEALTH Permit a y?� -�3 Division of Environmental Health Services, Carmel, M_ Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam .Valle - . Located at Wat.Son 'Way Tax Map 29 alock 3 tot 2 Subdivision Lake Qseawana Acres Sued. 1.ot # 28 Renewal _❑ Revision - E) Building Type One: Family Res. Lot Area 20,000 SF Number of Bedrooms 3 Design Flow G /P /D 600 Separate Sewerage System to consist of 1000 Gal. Septic Tank To be constructed try Don Heady Date Of Previous Approval Fill Sectiom Only ❑ P.C. H. D. Notification Required and 4 2P LF of eachin2 T enches fsuau Address u n Va ev. 10579 Water Supply: __ Public Supply From Xx Private Supply to be drilled by Norman Anderson Address Barger Street, Putnam Valley, NY 10579 Other Requirements I represent that I am wholly and completely responsible for the design and location of the proposed syztem(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance w itih the standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compl- dance" 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 od two (2) years immediately following thedate of the issu- ance of the approval of the Certificate of. Construction Compliance of the original system o ny shown thereto; 2) that the drilled well described above will be located as shon on the approved plan and that said well will be ins t in accordance the standar s, rules and regu aT ions. f the Putnam County Department of Health. Date June 24, 1983 Signetl P.E. R�. Address Musc0000t North D #2 x 488 Maho ac License No. APPROVED FOR CONSTRUCTION: Thrs aepprovsl- erzprres one year r m e date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when co d er:e sary by the Commis ' ealth. ny change or alteration of construction requires a new permits "AA proved or disposal of domestic sanitar sewag antl pri y oni Date!t� By Title -':.) Rev. 9 -e1 t rPt7TNAM:: COUNTY..DEPARTMENT...OF._HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam - Valley` Located at Watson Wa Subdivision kE: O cawans3_.Acx S Sued. Lot # 27 W %.A a�c—se3 Owner /Address Old Chatham, NY 12136 Building Type One Family Res. Lot Area .240000 SF Number of Bedrooms 3 Design Flow G /P /D 600 Separate Sewerage System to consist of 1000 Gal. Septic Tank To be constructed by Don Heady Water Supply: __ Public Supply From Town or i loge Tax Map 29 Block 3 -Lot Renewal _❑ Revision _❑ Date Of Previous Approval Fill Section. Only P.C. H. D. Notification Required and 420 LF of he&tQin2 T enches Address U n a ey,. W"10579 _2._ Private Supply to be Arilled by Norman AndiaYsl-ln Address Barger Street. Putnam Valley, NY 10579 Other Requirements I 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 approved amendment there to and in accordance witlh the standards, rules an regu .ons o 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 succeaws:, 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 the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system any re?pairs thereto; 2) that the drilled -well described above will be located as shown on the approved plan and that said well will be in al ad In-,accordance l'w t the standards, ules and regu aTl�ons of the Putnam County Department of Health. (\ /4 Date June 24, 1983 Signed P. E. R.A. 29L Address MuSCOot North FD #2 BOX 488 Maho CLicense No. �7 APPROVED FOR CONSTRUCTION: This approval expores one year ro the date issued less construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered ni nary by the C„ , mis loner osf Health. Any change or alteration of construction requires a new Permit. Aooroved_ for disnnsal of dnmwcflr &n bwve.noianAandinr ee f ' G 4 �J�i °Ii. TTT:TT T AA7lATT TTT/1TT 77 L�i/1DT _. WLLL �J VL'1L LLIIVLY L \JLL VL %1 Office Use Only DEPARTMENT OF HEALTH * 7Ar Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH STREET ADDRESS: WN /vIL ! Y TAX GRIO NUMBER WELL LOCATION WELL OWNER ADDRESS: E. � PUBLICE ig RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ' D ABAN NED . ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ USE OF WELL 1 -'primary 2 - secondary MOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED —/ EST. OF DAILY USAGE gal. REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION )9REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL ft. DATE MEASURED DRILLING EQUIPMENT 0410fARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft. MATERIALS: ' )KSTEEL . ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE —L�— ft. JOINTS: ❑ WELDED ,N�I'HREADED ❑ OTHER DIAMETER — �, in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE7`90THER WEIGHT PER FOOT lb. /ft DRIVE SHOEg.YES O NO I LINER: ❑ YESWNO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST ..... _ - - -- O YES ONO HOURS- SECOND -. _ _..... _....._.. -- GRAVEL PACK 0 YES ❑ NO GRAVEL SIZE.. DIAMETER OF PACK in. TOP DEPTH fL BOTTOM DEPTH It. WELL YIELD TEST pumping If detailed METHOD: ❑ PUMPED 1 tests Were done is in- COMPRESSED AIR , formation attached? O AILED ❑ OTHER ; ❑ YES ❑ NO It more detailed formation descriptions or sieve analyses IELL LOG are available, please attach. DEPTH FROM SURFACE Water Bear- ing Well Dia- meter In FORMATION DESCRIPTION cant ft. it. WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Surface WATS OTLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ❑ NO ANALYSIS ATTACHED? O YES ❑ NO S.TO.RAGE TANK: TYPE Alelt flyel_ CAPACITY GAL. PUMP WFORMA 'ION TYPE CAPACITY i MAKER J DEPTH O MODEL VOLTAGE 210 HP WELL DRILLER NAME / DATE pooRES�3 Z G � SIGrIMRIE O sf' AV r A wner 6r Purchaser of Building Building C nstructE by Location ,- Street a" wilding . Type f Mu icipa ity e G Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material,.construction and drair_age 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 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 made 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 __utiliz.ing the_ - system. _ _ - _ -- The undersigned further agrees to accept a.s conclusive the. de- termination of the Director of the 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 th building utilizing the system. Dated this 2_ day of , 19° . Signature Title- (If corporation, give name P and address) THREE (3) COPIES ARE REQUIRED WITH THREE t3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION 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 Health eorkto.wn Medical Laboratory, Inc. " a 321 Kcar Street a Vorkt4;wn Heights, N. Y. 10599 (914kN S.3203 Directoi: Albeq-fd Ndoa+ano k T J-6S4770 d CAWAia*1-Ac L: LAB / YK.027442 Collection Station Used: Carmel Peekskill _ Mt. Kisco Rev City. Date Taken: /u r —f', 9/Py Date Received:,/a-17- Z Date Reported:l�- ia_yj, Collected By:-a-, CA -;s-,p yl� Referred By: �dss/�c•e�s �°id�+¢x.��r t'}! Sample Source: ou y���� -� LABORATORY REPORT ON. BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA Standard Plate Count per 1.0 ml t� (Agar plate @ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Tot all Coliform per 100 ml Fecal Coliform per 100 ml Fec,etl us per 100 ml. MOST PROBABLE NUMBER TECHNIQUE (MPN) Total Coliform: MPN.- I -nde -x ner 100 - -m1- Fecal Coliform: MPN Index per 100 ml _, OTHER ANALYSES, THESE RESULTS INDICATE THAT THE WATER SAMPLE. WAS '(WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING. 0 NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert H. Padovani, M.T. ASCP), Director LEGEND IDS = Recommend Disinfect- ing Water Source < • leas than TNTC a Too Numerous Too Re: Property of Nancy Godsen, Administratrix; Estate of Lucille rodGPn Located at Watson Way (T) 29 Section - Block 3 Lot Subdivision of Section One - .Lake Oscawana Acres Subdv. Lot # L7 Filed Map # 367 A _Date 1/8051 Gentlemen: This letter is to authorize. Joel Greenberg a duly licensed professional engineer. or registered architect Xg .(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 necOssary 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 or 147, Education Law, �� p gR is Health Law; and the Putnam County Sani- tary Code. Countersigned P.E., R.A., ELeNCE GR � � 2 ° Very truly yours, Signed EE +mom Wc.i (4,5. G045e4W 6 Owner of Property NE 56 Muscoot Nrth., RFD #2, Bx 488 Address Mahopac, NY 10541 914 628 -6613 Telephone Box 33 Address Old Chatham, NY 12136 Town 914 628 -3100 Telephone Re. Property of Nancy Godsen, Administratrix; Estate of Lucille S.. Godsen Located at Watson Way (T) 29 Section Block 3 Lot 2 Subdivision of Section One - Lake Oscawana Acres Subdv. Lot- Filed Map # 367 A Date 1./8/51 Gentlemen: This letter is to authorize Joel Greenberg a duly licensed professional engineer or registered architect XX (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- regu.lations 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 or. 147, Education Law is Health Law, and the Putnam County Sani- Sfk p 41% tary Code. �R6NCE GRF yid 4V ��� I tiv ° -4 Very truly yours, na,,, .�Zo- sl�vu% �4d wt e }v'v'i x Signed G's+b,4 4 LvciU S. Gods Counter signed • Owner of Property P.E. , R.A. , # / IX056 Muscoot Nrth., RFD #2, Bx 488 Address Mahopac, NY 10541 914 628 -6613 Telephone Box 33 Address Old Chatham., NY 12136 Town 914 628 -3100 Telephone ,I i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -Date 1/13/86 Re: Property of Joe Cardinale Located at Watson Way (T) 29 Section --- Block 3 Lots 1 & 2 Subdivision of Lake Oscswana Acres Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize J061'L. Greenberg a duly licensed professional engineer - - or registered architect xxx (Indica-t-e7— 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 inconformity wi th the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, signed Countersigned: Owner of Property P.E. , R.A. # 11056 Oscawana Lake Road,BX 387A Address Muscoot.North,RFb#@ BX 488 Address Mahn P;4(-'My insAi 628-6613 Telephone Putnam Valley,NY 10579 Town 528-1505/528-9109 Telephone _._ ___.._............ ....:..._._,::.�.._ :.:. ��, �. a- ,.,:F;[s;:::;.�sv�.- ..::..:,.f hi-. ..:4..,r�.•Fr�"4'.t:.n�e+e.•+.r �.'"'. ?,"T,ty,y. ' ray.. d;"'?' �Y" 3�$'..'YS.?'c-;.,+`,tl'bt..aAtr �°.b. r.:�+.�a� 'f:"�'r�,�'s�.• � y ...^..ii•:±�_.:_,,,F- •:x.:,.�,. (•;,,,.""�. s -. s.17.u+o:- s-�..+�i +". _,.'.€^.'x+.d'x' 0.4 sks'."^"'.'°[* '.- 3'cS`l�t.f'y2t�"�,- �r,,,;ar +°'- "..•:.c_ . PU-rNAM CouarY DEPARlmERr OF HEALTH - DIVISION OF ENVIRONMEwAL HEALTH SERVICES TNDTVTnriAT. WATER snPPT.Y SUBSURFACE. RT.M w.. nrcwzcnT. cven7VMC FIF,U INSPECTION REPORT .�..zv � • � al`s -,.� �,� �- Mane o-L-- Owner) (Street Location) + INITIAL SIrCE INSPECTION YES I NO Wetlands on /or proximate to property ........... Property 11hes or corners found.. . .. . Can estimate house location . ....................... rWill drive<nray 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 ............................ Access to p:ronosed well location for drillin .. D.H. 1 Lot ^ D.H. 2 Lot Depth to G.W. Depth to G.W. Depth to rack Depth to rock Soil Descri tion 0 ft. 3 ft. 6 ft. 9 ft.- ~ ~12 ft 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. boll r- D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Description 0 ft. 3 ft. 6 ft. • •9 ft. 12 ft. Util'Z: — — . FINAL SITE INSPECTION INSP.BY: YES NO CCMMERrS 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.. ...... .line � ,. 10 ft. maintained fran property and 20 ft. from house.. Distance well to SSDS. (ft.) ......... a ........ Ur Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................, 15 ft. of peripheral soil horizontally fromtrench....... ......................... Boxesproperly set....... . ............. ...... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... I 1 'does lot drainage. appear OK in area of SDS....... T7.1T T /'T1T TAV+ /'1Cs [-TfT10 T r'Y—L"YfIT DT -m - v` s .a P DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE 140. Owner V.: Godsen Address Box 33, Old Chatham, NY 12136 TM Located at (Street) Watson Wa . 29 Block 3 Lot 'I �. ca a nearest cross s ree Municipality_':_Town `of` Putnam: Valley Watershed Hudson River. ....:..SOIL PERCOLATION TEST DATA REQUIRED TO BE 'SUBMITTED WITHfAPPLICATIONS ...... . hole Number, CLOCK-TIME PERCOLATION PERCOLATION N to " "' Start -Stop apse Time Min. Depth to Water From. Ground Surface Start Stop Inches Inches Water Le ve . in .Inches -..... Drop in .Inches. Soil Rate nn. /in drop #1 ..1.,.8.c.0.0.= 8::3.3 -`.- 33 - 16 19 3 33 3 =11 8:.:..34- 9 ::0,7.. 33 :. .16 19 3 33/3 =11 33 16 19. 3... 33/3 =11 4_9.',:.4 10.::15..: . 33 . 16 19 3 :.:. ........33/3 =11 #2..1::.8.,0.5- .8ft.3$:'t.': ` 33 . 16 19 3.' 33/3_,11 2 8'°39- 9:•1 -2 33 16 19 3` 33%3 -11 3.9:13 -9:46 33 16 .19 3 33/3. =11 2Q... .:33 :. :1.6 19 3. 33%3 =11 2 ,.. Notes; 1). Tuts to.be repeated at same depth until a roximately 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. 84„ IA]DICATE IMTEL AT WHICH GROUND WATER IS ENCOUNTERED 4 Ft. INDICATE =L'`T0 WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4 °.Fto TESTS.K-�DE BY Joel. Greenberg. Date May ll: 1983 - - - D SIGN Soil Rate :Used 1 x�/1 "Drop: S.De Usable Area'Y?rovided TO sF Noy of Bedrooms . >' 3 - -Septic Tank Capacity 1 000' E'D` a Pre -cast Conc. Absorption .Area Prov de By 400 L. F.x24" * R� "�fa enc . `r Mane. Joel Gr6enbi--rcf 3! gnat urej=9ftfill Address-�-Muscaot­ North, RFD #2, Box 488 S Mahopac, NY 10541. 'N THIS SPACE FOR USE BY HEALTH DEPARVENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date . b O PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY. - OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN I11TA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner `N...' 'Godsen Address Box 33, Old Chatham, NY` TM Locate Si leck Blvd . 29 Block 3 Lot 2 Indicate neare` stcross s ree Municipality.:.: ::TQwn 'of Putnam . Valley Watershed Hudson River: SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH,APPLICATIONS 4_q ::'4.2 -10 _15 _ 33 16 19 3 - 33/3 =11 hole Number •..:.. _CLOCK TIME PERCOLATION - .. PERCOLATION No.....:, ..........;.._.:.:: : :.._:::" Start -Stop apse Time .. Min. aepth to Water From Ground Surface Start Stop Inches Inches Water LeveT . in . Inches Drop -in Inches ........ Soil Rate Min. /in drop • #1 ..1::8.:- 00= 8.:.33.: '33 .16 19 .3 33/3 =11 2...8.:.34.= .9..:'O:7.. 33 16 19 3 33/3 =11 .3..9::..0.8 "9- :.41.:.., 33 .�, 16 .19 .3. ... 3313 =11 4_q ::'4.2 -10 _15 _ 33 16 19 3 - 33/3 =11 5- #2 .1::181::,05 =, .8:!:38:1,3;; : ' 33 . 16 19 1: 33%3 =11' 2 8.39 -9. ,12 33 _..i6 19.. 3 3:.9..:13 -9 :46 33 16 19 3 - 33/.3. =11 _11 20 ..: .33: 16 19 3 33/3 =11 1. • 2 3 _ Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obte,ined a,t each percolation test hole. All data to be submitted for review. .'2) Depth measurements to be made from top of hole. N. J TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES. DEPTH HOLE: NO. DTH HOLE NO. HOLE NO. -G.L. Zop Soil: . 6" Sand..Small Stones & :Some :pla y 12" m1i 72" 72 8411 " INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 4 Ft. IIITDICATE T 'L TO WITCH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4 .Ft, TESTS MADE BY Joel Greenberg Date May llj 1983 -DE iGN _ _... Soil Rate Used Drop: S.D. Usable Area provided 5'rpp SF No: of Bedrooms - `Y =3 Septic'. Tank Capacity 1 000* Gals , Type Pre- ast Conc, Absorption Area Provided By 400 L. F. x24" * r Flame Joel Greenberg Signature. Address_ - -, Muscoot North, 'RFD #2, Box 488 S L Mahopac, NY 10541 THIS SPACE FOR 'USE BY-'HEALTH DEPARTMENT ONLY: 4� moo'. F oPr NEyr Soil Rate- Approved Sq.- Ft/Cal. Checked by 0