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Home My WebLink About2677DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -32 BOX 23 rm III III III I L I r �,- 7�I ;I r ti I , T go , . �, , Y Is ` :` � IL . L vuh 02677 �' �,� '.' r '.� t �n rxw ,. ^'iir^"= �"' � er- .. sub• ;� �i .; • .. { .� S t, ;��t'�:p � +�, =��,t,.�� d^.C3 \�t wxr •y`� � r�`1,' izF","�3 Rev 3/ 86 PUTNAM COUNTY DEPARTMENT OF HEALTH s , L?lvision of Envhronmental Health Services, Carnsel,`N °Y 10512 ' y Msst ProvWe t P 'sH D Permit p � :� „ G A ; TlFICATE Or CONS)$UCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM �, . - u - uM - Locsited'sit'� Tai 'MaP_BlsckL Lot'' Owner /appllcanf ,Name ��J /r'� Formerly Sabdivielon Neme�O �+ �� °AJ;6gbdv Lot # .. MaWng Address /Q�ZIP Date Permit i6d Separate Sewerage System bailt by�� ' ` t I q Address ll "427 iti oC Galon Se P dc T �= «�Coneeng of . Wsiter Sapplys blic Supply. From Address Public !qr... Private Supply DrWed:by f74 1 �rf� Address Banding Type. �O�d . i R - . Has'Eroslon Control Been Compieto? :1�p Number of Bedrooms Has Garbage Grinder Been lnstalledY Othei Requirements g; p. of .the completed work ( copies 9 the d I certify that the syetem(s) asJlisted'servin .the above; remiae`s were constructed esaent }ally ae shown on of which are attached), end iq.accoidance with the standards, rules and re ulations in accordanc ith the filed,`plan, and the permit issued by the Putnam County D /epartm�e"nt'.O�f Health P:E. R.A. Date / Csrt,f(ed by f c , Addreu� d�r��- C� 'r/ .License No Any person occupyfng.prsmises served by the above system(3) shall promptly take such action a may bs;necess} ry to "cure the correction 'of any, unsanitary conditions;,resulting from, wch':usage Approval bf the separate sewerageysystem shall become null.and vold as soon'ea a pubt': unitary lower becomes available anii the approval of 41ie.D►ivete water supply shall;become:;rtull and, -:void when 'a^ publfc'wates supply;; becomes avellabN. Such .epprowls are subject' t6 moditicitioin r change when, in the :Judgment of the:Com isai of`Malth, such revo' :,ton .Modification, or'chonge Is neces4ry, Date T .,� By" Title WLIJL L*VrLr.Ur111Vn �rvlxl DEPARTMENT OF HEALTH Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET _170 L ADDRESS: wear .TAX. GRID iVUm8FA-'_ 9. � A ;VA WELL OWNER ADORE"* YV W PBIVATE I ?_%i i a j i r USE OF WELL 1 - primary 2 - secondary REStl�k�N�TIIA ❑ 1 PUBLIC SUPPLY 0 AIR/COND. /HEAT PUMP ❑ ABANDONED �9��C S ❑ ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION 0 OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑ AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE gal. REASON FOR DRILLING ONEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST/OBSERVATION EPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH —ft. STATIC WATER LEVEL _z��ft_ I DATE MEASURED DRILLING .EQUIPMENT KROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCRtENED ❑ OPEN END CASING. XOPEN HOLE IN BEDROCK 0 OTHER CASING DETAILS TOTAL LENGTH 4ile� % MATERIALS: bnT EEL 0 PLASTIC 0 OTHER I LENGTH.BELOW GRADE ft. JOINTS: ❑ WELDED 19THREADED ❑ OTHER DIAMETER in- SEAL: ❑ CEMENT GROUT OBENTONITE)90THER WEIGHT PER FOOT lb./ft. DRIVE SHOF—,tYES ONO LJN ER: 0 YESX NO SCREEN ...DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (11) DEVELOPED? FIRST,—- �--O-YES ONO... 'HOURS' SECOND GRAVEL PACK 11 YES ❑ NO GRAVEL SIZE. DIAMETER* OF PACK in. TOP DEPTH _fL BOTTOM OEM — it. WELL YIELD TEST If detailed pumping METHOD, 0 PUMPED 1 tests were done is in- 0- COMPRESSED AIR formation attached? 0 AILED 0 OTHER 10 YES 0 NO WELL LOG 11 more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE w"" Bear- 1,g Well Oia- meter l FORMATION DESCRIPTION CODE. it. WELL DEPTH It. DURATION hr. min. DRAWDOWN It. YIELD gpm. Ind S"13 18 0 4 KO If WATE)l 0 CLEAR TEMP. QUALITY 0 CLOUDY HARDNESS 0 COLORED ANALYZED? 0 YES 0 NO ANALYSIS ATTACHED? 0 YES 0 NO STORAGE TANK: TYPE 1114&— ji CAPACITY '2 —0 GAL. PUMP In ORMATION TYPE 4,A4,sp— 4APACITY -J' 4 "K__ MAKER DEPTH —9 161 HIP MODEL 7— VOLTAGE13 z —0— HP WELL)RI ER E ADDRESS so� al D'AQUINO and DONAHUE UL " CONS, TING ENGINEERS jJ ❑ John V. D'Aquino, P.E. Daniel J. Donahue, P.E. 314 Oscawana Lake Road 200 Breckenridge Road =:Mahopac, X 1 54 914-52�6-2039' 914-628-7576 TO LIEVVIEM VF VMRSEOUMU DATE J011 NO, ATTENTI ?if RE: 6f e If '6) e, &/- Al.- 4,11 wP f. j1 Li Jrt 11alletl A Jr WE ARE SENDING YOU � Attached ❑ Under separate cover via the following items: ❑ Shop drawings Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION A Jr pie4A e 6 x C414 j- k 4, e, TD-J' Vic V -THESE,, ARE -TRANSMITTEb—ai--'dhddk6'd bdlbW-' For approval ❑ Approved as submitted ❑ Resubmit copies for approval El For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return —corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE REMARKS 19 ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO ",r7 SIGNED: If anclosuras are not as noted. kindly $'fv us at once _ Alkalinity Yorktown` Medical (Laboratory, Inc. LAB # . _ Detergents, MBAS 321 Kear Street Date Taken: Time:, • a Yorktown Heights, M. Y. 10598 Date Re ' d: ;Z �' Time :_. _Time.:-. Nitrogen, Nitrate Repo- rtecri:. ,i, _ Director: Albert H. Padovani M. T. (ASCP) Collected By: Sulfide Referred By: Sulfite T- � ,/� � Sampl Location: Fecal Streptococcus METALS (mg /L) ,60MA/c -W, - MOST PROBABLE NUMBER TECHNIQUE Phone # Phone # Sample Type: L Repeat Test? _ (check one) LABORATORY REPORT ON THE QUALITY OF WATER l/ Potable Non - potable INORGANIC NON- METALS (mg /L) MICROBIOLOGICAL (CFU /100mL) STP INF STP EFF _ Acidity GENERAL BACTERIA _r _ Other: _ Alkalinity Chloride Standard Plate Count _ Detergents, MBAS _ _(CFU /I.OmL) _ Hardness, Total, _ Nitrogen, Ammonia MEMBRANE FILTRATION TECHNIQUE Nitrogen, Nitrate _ Phosphate, Total .s Total Coliform Sulfate Sulfide Fecal Coliform Sulfite Fecal Streptococcus METALS (mg /L) r MOST PROBABLE NUMBER TECHNIQUE _ Copper _ Iron _ Lead .MAng.a:n'e.se Mercury _ Sodium Zinc MISCELLANEOUS pH (units) Color (units) Odor (TON) Turbidity (NTU) Total Coliform Index .- F-e ca1 - C61.iform-- 1n :d6k KEY FOR TERMINOLOGY CFU = Colony Forming Units N/A = Not Applicable. LT = Less Than (C) GT = Greater Than ( >) TNTC= Too Numerous To Count CON = Confluent ( =TNTC) NR = Non- reactive Sample Status: (check each) Outgoing _ HNO3 _ HC1 _ H2SO4 _ NaOH ZnOAc _ Na2S203 _ Other: `I n'c'obm i ri L- ' _ LE � °C _ GT 1+ °C _ pH LE 2 pH GE 9 —.pH GE 12 _ Other: REMARKS /COMMENTS (For Lab Use) FLAP #10323 4S %AT THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO T YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTIO THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) N /A: MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STA NKING WATER CODES, FOR T F%fn.M TERS TESTED, AT.THE TIME OF COLLECTION. 2 /86(Rvsd7 /87)RWE Albert H. ov-& u M.T. (ASCP), Director PUTNAM COUNTY DEPARIMERr OF HEALTH DIVISION OF ENVIROWWAL HEALTH SERVICES. ^.��c� / �P/'l1 a /t 2�d ! it Owner or Purchaser of Building Section Block Lot C', ale Building Construtt/ed by '0044er /DaGdt Location - Street 6?,jtM Ya lle(4 Ifle • Municipality o� �Zo�y J'c�9le Tamp <y /tore Buildin4 Type Subdivision Name #/ Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship,' 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 �.:-.:_......repa ors made -by. me...to_.sucti- system, except where:the..failure to caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental 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 buildin utilizing the system. Dated this—/7 day of Acank 19 General Contract r (Owner) - Signature Signatur ev Title Corporation Name (if Corp.) Corporation Name (if Corp.) Address /I•F!��C, /(/o�f/e /`tC/lai`![.ry'rlle /�c+i, �arY�lec' /��', /O�fia . Address rev. 9/85 mk - t'imlj SITE INSPECTION Date STREET 1,00ATION 'PERMIT TM a OR SUBDIVISION IOT # Ie II IV. V. VI. Inspect -611-d by OWNER C 0 I YES NO 5EWAGE, D T-SPOSAL -7- a. SDS Area locatecl as per approved plans b. Fill section - Date of placenent. .2:1 barrier. IGTH W_= AVG.DPT9 c. Natural soil not st--irced d. Stone, brush, etc., grdater than 15' fran SDS area. e. 100 ft. fran water course/wetlands. I -S4 S&MAGE DISPOSAL SYSTEM a. Septic tank size - 1,000 rl , 2 b. Septic tank installed leveal__"'�� c. 101 minimum from foundation I/Kl I d. No 90- bends, cleanout within 10 ft. of 45* bend e. DISTRIBUTION BOX at; on -water e ttest l. -All outlets at.samael e-v 2. Protected below frost ............. .. . 3.6 Minimum ..2 ft. oriqr.—:i� soil between box and trenches - f. JUNCTION BOX - r)rouerly set g. TRENCHES rth Len cfc-h instal-led. 1. . L,-nc reaui -,r ed 2.':Distonce to watercourse neasured ft. 3. Installed according to plan - 4. Distance cent--r th-c--nti—r 5.. Slop;d -of trench accent able 1/16 1/32 "/foot. 6 feet fran brobertv line - 20 feet - foundations, 77— 7 Depth of trench < 30 inches from surface 8.. Rom allowed for e_,maznsion, 50% 9. Size of gravel 3/4 - li" diameter 10. Depth of aravel in trench 12" mini= K0 ll.* -.Pipe . en as 'capped h. Pu*'OR DOSE SYSTEMS 1. Size of t)um ciz _r 3. Alarm, visual/audio 4. Pump easily accessible ranhole to grade 5. First box baffled 6. Cvcle witnessed by Ht�all th Derex-tnent . estimated flow per cycle HOUSE, a. House located per approved plans. b. Number of bedrooms a. WeU located as per approved plans b. Distance from SDS area m_-sured C. Casing 18" above grade. d. Surface dra-iinaae around well acceptable. .OVERALL 4u0PJQq0HIp a. Boxes vrope_rl arcutt-ed b. All. pipes parta-ally bacidilled c. All pices flush with inside of box d. Bar-kfill material contains stones < 4" in diameter e. Curtain drain installed according to plan f. Cuftain drain outfa-U vrotected & dir.to exist.watercoursr= g. Footinq drains discharae away fran SDS area h. Surface water protec-tion adequate i. Errosjonn controi provided on slopes greater than 15%. Rev. 1/87 OF HEAMt n DfAid6mi 4-Etiivlionmentiil CkffU?iCATE CONSTRIICTION PERMIT FOB Permit .q SEWAGE DISPOSAL SYSTEM -PA .:—T 4* SUIA.- Letl Subdlvhdon Name ;A- Reiewal T]. --a Am Owner/A4ipUcnpt, Name f ' -4 jDate :it - PreA Naulm AAdi 1%Alo4 /e Town z1 4b' Bafidin- Lai FM S ;d V 0 I ia Number of Bsdiooph Destgn ilow G P D PM Noaflcatlon �IsRO40ioWbbh FUIacompleted Se'p'arate Sews, Sysoo I!p consist of Garton Sapdc,Tahk rag4k, elf T6 be eqnsiiu'h6d by Address d" Water Poly. PW ;:Su pply From or, -Private- Sz001Y,DdUed y j- oth. Reikdriz"pts' 411- above doicribid"willbe"cdnitiu6iti6 issh§vvn�-,�- '.t",#Or,04ed a-r 6u, nl�y bo . iubrnitted';t6, tho Department, and., a' vvrlt!en u#r ta� an place in-96oC;6p'eritln— ' any, 9 COdTP-tI 0!1 pny, anZe of the approval of the Ce "rt�ficate '01 Constiuct�on Con will be'locaied as-sh6w6,o,n',.';P0ppr a plan a4'thatiiid vviW - �� .. . "qv, County D par -nt UFje"M'r Date Address APPROVItD-F6.A,,t6NSt.FiUdflbN: Thii.a6pr(i4al.expires.tvvo revocable for cause oi,rfiay tie-amended of modified.'wlien coast reauires a new per it.. ' foi di p I �v s ojsa o do est Ic Date— zo Z& By ti P v C) ri-and. location ,.gi, th,i 6iopo�ed...iy�i'-r�('s),.:,i,),ikit,iiie.,sep,ara-ieLSOWa907 disposal system Went there to and . carith the stano6rds rules regu aeon tne vu.tharn Com!rissig6er, §!:HGaIthWII1 turmshetl he owner his successors, heirs of assigns'Dy`the buildii; 'that'sbld 66iidir Will system tai, system; during "the period''ot'tvro 12► years Immetliately followJng thedats of.the Isw• ice; of the or ginal repairs .thereto;'2) that 'th driiiii well described above t" rom the +date Isiued unless con ruetiori of 'the building has been undertaken and Is `Co y, the'Cb, Is on of Health. Any change or alteration of construction a a supply. only. TIM 4 ON CONS cn PERN7IT EC on �PYp ®Y�0PUI'ai0,1 8018 6-1 , 4�oj Number of -bedroom" 400 be comift -04er $UPP13,: or:. Pel 1 -q0eSant that-1 am wlioI(i'-a County qpa rfin "b ., be 'r iubmdteG ;to the peparfi place.�'m19ood,operatmg con anee,:of the; approval' of; tree will tie 6Catid isih'dlvh -t h County Depart 68 AP �� 0 V fD..'�,OR.,,,CO�1`4STR!J. - " - revocable for cause orfnjy ,# ►ad as a. nq permit ADt i�97 t v ,age it isoo"I 4'ystarm ins of -the:- Putnam that �thq4OJO! toa9iisu. S '70f, Ifi pi m ertaken. and is P,jonsfruction D9AQUINO and DONAIIUE CONSULTING ENGINEERS ❑ John V. D'Aquino, P.E. Daniel J. Donahue, P.E. 314 Oscawana Lake Road 200 Breckenridge Road ..... _ - . Putnam Valley`N Y. -1.05 /9., . Nlatiopac, :Y..10541..� 91/4 -526 -20/3^9 / �991�4 -- 66278 -7576 TO c I i�/ I / v or • v Imo., / //„ LIEU EM OF MUMO MMU DATE JOB NO. RE: 0 G It /I 4s /P -.� WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings f Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION For approval ❑ Approved as submitted ❑ Resubmit copies for approval For your use ❑ Approved as noted ❑ Submit copies for distribution — ❑ As requested ❑ Returned for corrections ❑ Return. corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US 'THESE ARE' TRANSMITTED` as checked below: AI For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution — ❑ As requested ❑ Returned for corrections ❑ Return. corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS G /' J 4 r2 l � / te li%C 4rrlvjc� e-4 1i or e e 1, G v� e lye 14 4 fr . COPY TO SIGNED: If enclosures are not as noted, kindly notify us at once. __ AIDURMEC B PUMA!,! CCL�iir`! =ARTZ�Tr OF EF-- ,TLI - DIVISIC'N CF E�Z'tZCI�Z —TILL HE-L -:. S�VIC�S DMDI :,CaL S--A.1-EM SUPPLY & Sum .RFA - S'cTV? DI PC EAL S'tSTEm-c REV T ry SE-- -- - CDVSI:'iCrTCN PITT (LL11 e W E77 1 D17 --re- Of C:VTlar) ( i= t Lccz --i. cm) YE. ( NO ! provic�� 50 f 1 --7 :% 100 Iii — c-, aV rr =er 10 f-_ Pe =r :liy R.OD1 iCaticn Ccr--crate � Rescluticn Plan= - Thre= s`ts FnciLears Au-th- crizat_cz DeSi Data Si:e°_t ( Cs) Deco Fcle L,-,c Ccreste_^t Pe=c Re_=;ii t Ps--c Hole Deoth SUED I v_SIC_y- PsrC C" Hc,.'`ce Plans - T.wo S_t_ Weil VariS`cs Rc -,west =fir. Le=ai Ste: v i =icn EU=1 r_'sicn Accrcova' C_ -_k_ - E:� -= rc4a_ SSi,S rte-- We _ and (Tc-wn /DEC Pe:,_ _ R & D) Dam CA DLS P.cSiS & P°__:::i = .Cac7 DES` c C J Pte, S Cv s t`m Pia_^ arrcw ) Fi i i FrOf 1= & D er J S C T sik - Si ze , re'_ i 1 tiVe 1 DE' =1 , Sear ica LlInc if C'J-- Ccn_t_-ucticn Votes rat-=) tC-esic:7 Data: yrerc anc�de=p ra =•:..__C LCllra fay & Slcces Cat~ Drains (.^._ =C_' a--ce C;1 P°_rc & Loco mole= Lam,.: t ReprEse- r1t;t.lVe Or pr'. "ta =y ar ci` P.SiCII S_.csZS1CY2 Ar =?; shcwi1; _ra -7it- i_C:ti,s-af_. sizes If P -nm d Pit & D Ecx Shcw, & Lti Ti? 1 HceSe - No. Of Ee^_'r,--Cuc Weis & S:,DS's w /in 200 ft. cf r orc=ed SvSt= Prcce_'' ,•T Mst- s & ^LIL CS - Hcus` Set c't Necessary (Ticht Ict) House Seer - 1/411/ =t.- 4"0; �T_;_ e pipa NO Band-s; Maw c - Fends 45'3 w /cis. =n-cut SrP�RA.TICN DIS= -N S'==(-T- PT---I Cti pr: V F'e_'(Lc 10' to P.L. r 'I'_ zs jcc c- _ 20' to FcL. c -is 100' to We-11; 200' in D.L.O.D, 150' pit= 100' to Stream, Watcr^cur_e, LF-ka (inc. e:,:-- 15' to Drams cumin, Ieacsr, Fcoc-inc 35' to Cat—C= t~ Sln, S �CZTf1rc? i � ^1'"^C WcL =-rC 10' to ;vat-=r Line (pit = -20' ) 50' interra-Litt`nt errainace coarse Seotic Tanks 10' Lxm Fcund- t�.cn; 50' t'c -.l We-11 t pr, L a 15' 0 DNM�-10 and DON HUE �' A L CON UNIING ENGINEERS ❑ John V. D'Aquino, P.E. Daniel J. Donahue, P.E. 314 Oscawana Lake Road 200 Breckenridge Road . 914-526-20,39 914-628 -7576 TO Ile LIEU EN Ofd UMMOMMUL DATE J01, "0. �9 "AfTFNTI6w Ala- 4(l RE. lolew C. .e lj�,Of aeeay, d4oll AV /,qon jo . zo,, 14 WE ARE SENDING YOU ;(Attached ❑ Under separate cover via the following items: ❑ Shop drawings Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter .0 Change order ❑ COPIES DATE NO. DESCRIPTION ❑ Resubmit copies for approval ❑ For your use ale Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return —corrected prints ❑ For review and comment, D'_ ❑ FOR BIDS DUE _19— ❑. PRINTS RETURNED AFTER LOAN TO US THESE ARE TRANSMITTED as checked below: .. .. ... ...... REMARKS 40' COPY SIGNED: For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use 0 Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return —corrected prints ❑ For review and comment, D'_ ❑ FOR BIDS DUE _19— ❑. PRINTS RETURNED AFTER LOAN TO US REMARKS 40' COPY SIGNED: Dl! �Q INO and DONAHUE EONSULTING IENGRNE ERR ❑ John V. D'Aquino, P.E. "C Daniel J. Donahue, P.E. 314 Oscawana Lake Road 200 Breckenridge Road Piftna7ri Valley; N:Y.-10579- — ,Matiopac, N.Y. 10541 914 -526 -2039 914- 628 -7576 TO 2�4 sit rG�/ /e, UEUTEIB OF VURSED"TUA L DATE JOB NO. ATTENTIO RE, J WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION J A.0,14 C'e, e:� THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted • For your use ❑ Approved as noted • As requested ❑ Returned for corrections ❑ For review and comment ❑ • Resubmit copies for approval • Submit copies for distribution ❑ Return corrected prints ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US d REMARKS ,/ -'t 4.0 %,S ' 4° 4' AAA i" Jf,�� 3.1 s'� .- Jtt 4VI J `�'�✓ /' �+ ( `i^ � i t - t � S' /•_!r ✓-f� Zzl,ve .•✓ <'�", - -ri .6 e 'lfi2 46 COPY TO SIGNED: It oneloctorea PIP not Pa noted kindly notify im at nnre- o.. PQnMM. COMM-r- DEPAZMW (g` HII�T$ i x DIVMCN CAF E099 IS SE 71SM: A:PP.ENDIX::.` r ,.. . • y�,' , • .'7�; tri ; C � 1 � `' J�� ^'"��'� -� ,�"'."."� a5„1, f n � y` ;, . .r z.� � rye„-, zLocat "��. £' r•� �Zo xic,YUT�lkxax7%.++ - "+.ti. E: nC!�]L1f l:.LWrs :`laL•'Ll: !�a[-F��1 `- '✓.e1.ut:_�ie�.i.•Pltn. ."f'�`b1 Y�.�.'.c. cnrr �tvrrirnmr� m�rr>-nn Date of "Pre- Soaking ItLB'41:5� iM� �i141- 171111 ... - ,.r+1.G�J�C Kt►4u�.•-.ly- na�.r._t.:.riG1R- -• . /1 No . Time " 11Gr d �Saiface "' Start. - Stop.. Mui Start Stop Soil Rate mWin. Drvo 4 . , ..:........... J'' .5 livoT a Ue��da�c 2nGd hl4f4� ih d,a9/na Doc, �� /r,r 2 rl! GAL , • �j`.' /"Cx. 14 `, e.. i.4Jf C ed rtkJ"f'� 3 St d t t.vr. ii a�.raro� /oN a�t4 I �►o�t� M � • V� ' .l• • !t' 01� • I� '� ' Latta r Y: � 11• • DFSCI�TION OF SOILS ENCOUNTERED IN TEST IIOLES _ G.L. 10" '1 7V`�- , 14t° ,.T �7�.� ..�e�t. t��QT�eQ �,�}••{�r, t}r� � '�'c IlveDICATE L�'41EL A WHICH GROIAYI.J►Yl].LL[1 I � INDICATE- IIVVE� TO WHICH MkM LEVEL RISES. AFTF:Et :BEING Af B Al ,?,, DES SOLE OBSERVATIONS MADE BY _ DESIGN .. . Soil Rate "Used A, -Drop: SeDe Usable'Area,:7Provide3 Noe of Bedrocans .Septic Tax* :Capacity Absorption Area Provide3 T;.Fa -x'24 °° ' widtia `.t�6cfi ,�TL •t! . yJ.:'."L4 Y1aA �� fa . '� J d t;. � ,� f .i.. �� . •'.�� +'y 4 t y �� Y: ✓d4 ! I _11 Th'IS `SPACE .MR USE BY EMSE , WAS CMYe \ qTF � as •� OF NE � , Soil . Rate Approved _ " Sig ft/gal.' Checked 'by Date ..2,16 ws ` PUMA14 CCUN Y DEPAR T OF HEMTH - DIVISICN OF ENVIRC1 4E= HEALTH SERvICES INDrj =UAL W7= SUPPLY & SUBSURFACE W7AGE DISPOSAL SYSTEMS s : - of Cwne_T ) C. r,.A]- I`S r -.x-u_4 = = 60 ft. rmic. Parzllel t:. 100% e-'Co. RE=54 S= CONSM=ION P-RMIT -"7/ BY: �„� (Street Loc.3ticn) YES NO DCCfMi -aM I-:0 Permt Application rporate Resolution Plans - Three sats Engineers P_uthorizaticn Design Data Sheet MCE ) Deep Hole Lcr Consistent Perc Results Pero Hole Depth s, s SuEDIVISICN Pere % (3) Fill cd � Hcus2 P1- s - Two set= Well � Fe_�:nit; P,'lS 1__-s_ Variance Request -_' _L L, 1 Sa:division Sundivision Approval Checked Ex- approval SSCS Ad L cts Chi': Wetland" (Tcw-r -/DEC Permit R & D) Data: Cn DDS Plans & Per«i t Sane REQTj= DET-Tr c CN PT?`S Se -wage Sy s t - m Plan - (north a==4) Ce.gace System i%vcraulic P_ot_l: - Gravi tv F_cr Fill Profile & Dimensions D or J Box;Trench /Gall _ry; .F_- W pit deg... ils Septic Tank - Size, Der..r._l Well Devil, Service LJ%e if c er Ccnstr- ucticn Notes (grinder r ts) Design. Data: perc and deep.- rest is Two-Foot Contours �Existing &Pr;;_csed Drive:vay & Slopes cat FocLi n�Catter,Curta i n Drains (discharge CK) Pero & Deep Holes Locat- Representative of primary ar_d er..ansicn E•<mansicn Area; shown; gravity flog, ssff size If Elea Pit & D Box Shen & Detailed House -'No. of Bedrooms Wells & SSDS's w /in 200 ft. cf Proposed Syste- Property Metes & Bounds House Setback Necessary (Tight lot) House Saver - 1 /4 " /ft. 4 "0; Tape pipe No Bends; Max. Bends 45° w /clerout Sr Pa1=0N DISTANCES SPECIF= CN PAN Fields 10' to P.L., DriveAay, Large Tre s,Tcp of f_ 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. et-'a 15' to Drains - Curtain, I, der, Footing 351to match hasin,storadraia,cirpei waterccur 10' to Water Line (pits -201) 50' intermittent drainaae course Sectic Tanks 10' fran Foundation; 50' to well 15' well to PL 9 o PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES A PPENDIX K Date ev Re: Property of .-P R. lreiyo 4'? Located at DO-44e-j- (T) 4M - -11ev. Section _j Block3/ Lot Subdivision of /P0 A-1 e, 7 Vj Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize Daiv 1,e.1 a duly licensed professional engineer 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 conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned::. P.E., R*A*j # Address Telephone Very truly yours, Signed caner of Property 46,077 04 Address Town PV, eq13 Telephone I - . - . - - - 1. 11 D'AQUINO and DONAHUE CONSULTING ENGINEERS ❑ John V. D'Aquino, P.E. 4T Daniel J. Donahue, P.E. 314 Oscawana Lake Road 200 Breckenridge Road „ Putnam ;Ualley,:N.Y 105 " /.9 n° , ,Mahopac.;N.Y. 10541. 914 -526 -2039 914 - 628 -7576 TO _ WE ARE SENDING YOU Attached ❑ Under separate cover via ❑ Shop drawings ❑ Copy of letter ❑ Prints ❑ Change order RJEU EM 0F'TRUSEDUML DATE JOB NO. 'ATTEN ION^ ,. .... -.... -...� .• .. .... .... . -. .., -.... ... RE. /9 dY in! 4-0 PWA fV / ❑ Plans ❑ Samples !J the following items: ❑ Specifications COPIES DATE�y NO. DESCRIPTION dY in! 4-0 / Q i q1 r4 r_e ru S'D/ - wzil ��r-C r��.,rrfQ 4 .r' 4 C- ,('c cy UV/✓ %) yG In is l c 7i dh 1Z 4' -7 x j �NJ. , ,� s a� �� -' FL THESE "'ARE'TRANSMITTED' as checked below: (, For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution — ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE REMARKS PA eh tt-- �ftdljrc �cdh 19 e2 � ��(+/ "fir ❑ PRINTS RETURNED AFTER �, // wdJ' d!G��a( LOAN TO US f/a dY in! 4-0 Q i q1 r4 r_e ru S'D/ - wzil ��r-C r��.,rrfQ 4 .r' 4 C- ,('c cy UV/✓ %) yG In is l c 7i dh 1Z 4' -7 x j �NJ. , ,� s a� �� -' FL COPY TO SIGNED: ` < If enclosures are not as noted, kindly notify us at once. DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 . APPLICAT20N '�=TO-=CONSTRUCT4�;A' WA-1ER'`WELI; ry Prun UPPMTM 4 WELL LOCATION Street Address 411villageRity Tax Grid Number yturblic WELL OWNER ,,N�ame Ce. '' II Ma' tin .4 Address Mic ✓ ° k1/ e CC -.-M � ivate USE OF WELL primary T-_ secondary RESIDENTIAL BUSINESS ®.,INDUSTRIAL 0 PUBLIC SUPPLY 0 FARM []INSTITUTIONAL ❑ AIR /COND /HEAT PUMP 0 TEST OBSERVATION / 0 STAND -BY 13 ABANDONED 0 OTHER (specify AMOUNT OF USE YIELD SOUGHT S_ gpm /�� ED /EST. OF DAILY USAGEgal REASON FOR DRILLING NEW SUPPLY REPLACE EXISTING SUPPLY ❑PROVIDE ADDITIONAL SUPPLY 0 DEEPEN EXISTING WELL ®TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE 14DRILLED ®DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF W;�L IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: r-� Lot No. WATER WELL CONTRACTOR: Name _ea f Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY - DISTANCE-TO PROPERTY FROM NEAREST WATER LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION t]ON SEP4FXTE SHEE J' (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 s.hall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided y Health Departmt. Date of Issue: �- —7) 19 Date of Expiration: 19 P761-1mit Issui Permit is Non - Transferrable 2/87 White Copy: Yellow copy: Pink Copy: Orange copy: of the Putnam H. D. File Building Inspector Owner Well Driller `Al- V, /� \\ i t. ;v _jq k -�ftrnn Of LO // fIc • J` i Putnam County Department of Health Division of. Environmental Health Services Approved as noted for conformance ns of the applicable Rules and Regulations Fu t Cou t3 lth Department. �.. Date ignature &Title 1� F, 3 Z n �f 4 a�n1 Q 20 D Q 0 �- \ �6 / 270,0 A�516M AQEA \\ �t4VEL DrDnH_ _ _ r • .yam °' �'��'' S' � F /e � /� __- 9 0 a9s FFL }�I N m U k _ T N L 4 4. CZ 4- .5 0 a cd 7ZI.0 to, 14 4- %2-0 0 � t U4 p -1 -M V,' 4- 4D 1140) 4 a 4- I qj 0 CD In 0 v P 14 -TI A� li q lk e II 6 0 II it it ij O .-D.o_ A n- -e-r.--Pa-f-h SCL,je C-40, SO/ Ji V" 4;" mspr"fej 67, b c 6 71 -e- 6L As PLAN WELL prope'-'r F BY Dorwcrt Pal� :Do,,ie.i j, 4',1600t' i,/c PE ,�DA TIE— YV POIN7,S Q3 j //.S- e,- a7i: y4. r, NOTE ALZ JUNCTION S6Y,'J 63 Go yG.r Are F* D. 0 uj?z C it- S-8 S'Z S-9 60 (r f 9 END of r I ej 4,J at 3t AD 36 .20 'kj- 31 r4- (.3.5 bpi 13 i 23