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631- 589 -8100
73.- 1- 41.131
BOX 26
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03252
t' PUTNAM COUNTY DEPARTMENT OF HEALTH
k 2 3186 Dlvlslon_of Eavlronme.iiW HiAth Services, Carmel, N.Y. 10512,
P.C.H. D
//�� � - - ErigbieerMaet Provide
All pA{ � . Permit N -- 0.
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM e Fa-
`� �T�own or Village
ted at Y L! Tax Map 3 Block Lot_
1�WP%TTi h �G/dd�r y
er /applicant Name Formerly Subdivision Name / abdv. Lot IY
g Address�� �l%LLt r'� Zip �� �� Date Permit issued /���r-
Separate' Sewerage System built by Fi yG /a G Address 2 7 r 4 -d I er rA-V r, F a • /�f�% ��
Consisting of Gallon Septic Tank and . ew1'I -A
Water Supply: Public Supply From Address
or: — Private Supply Drilled, by ,9G. Address kla Y_ i� f �L G4eat/P-C'
BulIdmg Ty p,,r /'V'64 ' /" 4 / 417 - Has Erosion Control Been Completed? '
Number of Bedrooms +� Has Garbage Grinder Been Installed? A-A#
Other Requirements
I certify that the system(s) as listed serving the above premises were constructed sentially as hown on the plans of the completed work ( copies
of which are attached), and in accordance with the standards, rules and regulatio in acco wi the filed plan, and the permit issued by the
Putnam Count Depr ent of Health.
Date a rY —� Certified by P.E. / R.A.
Address ` / ' t License No.
Any ,person occupying premises served by the -above systems) shall promptly take such action as may be,necessary to secure the c0rrection of any unsanitary
conditions resulting !rorim such usage. Approval of the separate sewerage sy m, hall- become null d void as soon as a publi: unitary sewer becomes
available and t approval of the private water supply shall become null and h �allc w supply becomes vailable. Such approvals are
subleet to mo ffutfo or change when, in the Judgment of the Commi o f Ch /r lion, modification or change is /af //�ppr
Date By Title ' Lam_
rTT]T T - +111A'T1r TTT n1T nnnnnm
Q WALL VVl'1.0 LGliV1T L�rVAl
* DEPARTMENT OF HEALTH
PUTNAM COUNTY DEPARTMENT OF HEALTH
Off a Use Only
�% S -4 - �-
WELL LOCATION
SIRE AOU ESS: _ WNr TAX GRID NUWeER: 0
WELL OWNER
NAME: ADDRESS:
8 PUBLIC
USE OF WELL
1- primary
2 - secondary
13"ESiOENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEA PUMP O ABANDONED
O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify)
O INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY O
MOUNT OF USE
YIELD SOUGHT_ gpm. /N0. PEOPLE SERVED 5 / EST. OF DAILY USAGE tl
. � � gal.
REASON FOR
DRILLING
[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY
(SNEW SUPPLY (NEW DWELLING) O DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 3 05� ft. I
STATIC WATER LEVEL _ft.
DATE MEASURED J
DRILLING
EQUIPMENT
O ROTARY & COMPRESSED AIR PERCUSSION 0 DUG
0 WELL POINT ❑ CABLE PERCUSSION 0 OTHER (specify):
WELL TYPE
O SCREENED ❑ OPEN END CASING 9 OPEN HOLE IN BEDROCK O OTHER
CASING
TOTAL LENGTH L o
MATERIALS: 19 STEEL O PLASTIC O OTHER
LENGTH BELOW GRADE ft.
JOINTS: 0 WELDED ENTHREADED ❑ OTHER
I DETAILS
DIAMETER �2 in.
SEAL: la CEMENT GROUT O BENTONiTE OOTHER
WEIGHT
PER FOOT lb. /it.
DRIVE SHOE: WYES ONO
I UNER:0YES X10
SCREEN
e QETPQiL�Y
'
DIAMETER (in)
SLOT SiZE
LENGTH (It)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
SECON
0 !A"
HOURS , v
GRAVEL PACK
O NOS
GRAVEL
SIZE:
DIAMETER
OF PACK _�_ it
TOP
DEPTH IL
BOTTOM
DEPTH IL
WELL YIELD TEST If detailed pumping
METHOD: O PUMPED tests were done is in-
t
Q COMPRESSED AIR , formation attached?
❑ BAILED ❑ OTHER i ❑ YES O NO
LOG it more detailed formation descriptions or sieve analyses
are available, please attach.
NWELL
M
Water
ear-
ing
Welt
Dia-
meter
FORMATION DESCRIPTION
p0E
L
WELL DEPTH
ft.
DUBATION
hr, min.
ORAWOOWN
It,
YIELD
gpm.
Surrface
I
Qyt �, U N cl y-a- V O-
0
fret t— V
3
WATER ❑ CLEAR. TEMP.
QUALITY ❑ CLOUDY HARDNESS
O COLORED ANALYZED? O YES ONO
ANALYSIS ATTACHED? ❑ YES O NO
STORAGE TANK : TYPE
CAPACITY GAI,.
a1 PUMP iNFaAMATION
TYPE
MA)a
MODEL
CAPACITY
DEPTH
VOLTAGE HP
WELL DRII IECcR��NAME '12)0 � d r,L-� LU ,� i, / /.'_ DATEg� ^
ADDRESS l� 5 �Sf` 61 i SIGUATURE , x- GLI.t)
a/ 07 a �I �- L 1-�' ,'
r DANIEL. J. DONAHUE, P.E.
CONSULTING ENGINEERS
120 Breckenridge Road
Mahopac, NX 10541
914"628 -7576
September 24, 1996
Putnam County Department of Health
9 Geneva Road
Brewster, N.Y.
Att: R. Morris, P.E.
RE: As Built Sewage Disposal System
Venditti
Lot ##3
Michael's Way
Putnam Valley
Dear Mr. Morris:
Enclosed herewith for your review and approval are the
following;
1. Certification of Construction Compliance
2. Check for $200.00 ( separate cover by owner)
3. Well Log 'and Bacti Results
4. Four. Sets of As Built Plans
5, Two Copies Of Guarantee
•
1 .
Daniel J. Donahue, P.E.
Site 9 Sanitary ® Environmental
- - - - . ..—r -.— . 1, — c- r- I r- . c —
..,riESS COUNTY DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH LABORATORY
-'637
387 MAIN MAL� / POUGHKE9PVE,-- NFW.Y0
4 WA
ENVIRONMENTAL LABORATORY APPROVAL PROGRAM CERTIFICATE # 10189 a LAS No.
BACTERIOLOGICAL EXAMINATION OF WATER
?'WARD PAPORT ASE PRINT)
❑ PUBLIC WATER SUPPLY#
441KIVATE RESIDENCE
0 WASTEWATVER TREATMENT FACILITY
STRIEh7ADDfWSS- toy ❑ BEACH
-
CITY ( I &ATE zip L 1 OTHER;
FACILITY NAME: ADDRESS dwr4 &,�wh
PHONE N
❑ MONITORING SAMPLE
SAMPLING POINT:' lzt - -
O CHECK SAMPLE
$OURCE: V103RINKING WATER; ❑ SURFACE WATER; ❑ WASTE WATER; ❑ OTHER:
TREATMENT- [I FREE RESIDUAL 4V ❑ OTHER:—
❑ TOTAL RESIDUAL
COLLECTED BY'
DATE LAST SANITtZr-i:
DELIVERED BY. RECEIVED AT LAB BY
64E TIME E
J!r
TIME
S
_j
1:;Da No Z-(K �pm. tf Eq 9/ ISt
❑ MFT
❑ MFT
❑ MFT
P/A TOTAL COLIFORM COUNT SA Q- .5
❑ MPN FECAL COLIFORM COUNT
FECAL STREP. COUNT
❑ HVEROTROPHIC PLATE COUNT
THfir THE -WATER SAMPLE Dln
`❑ DID NOT
DRINKING
MEET SATISFACTORY SANITARY QUALITY FOR ❑ SWIMMING
CJ WASTEWATER EFFLUENT
WHEN THE SAMPLE WAS COLLECTED. FOR
TIME
;EPORTED ITECH
C%. / T )4 4 ro I.-
PER 100 ML
PER 100 ML
PER 100 ML
PER 1 MI.
INFORMATION CONCERNING UNSATISFACTORY SAMPLES
PLEASE CALL THE HEALTH DEPA RTM ENT AT
LAB DIRECTOR
CUSTOMER COPY
09 -10 -1996 10:06AM . FROM DYE BROTHERS MODULAR 9 1 TO
5282702 P.02
ptTIW 00= MEN mop KM=
Michael Venditti 73 1 41.3
owner az MChaW of Ording Section Lot
Cherry sane Michael Way's Corp
x�e► an � Street , subdivis on
Putnam Valley 3
c� ty NO v$onER#
Residential
aum,lfiq up
0 SUSSORFACE. S WACt bTSPtML Ste: ,
I represent that I am wholly and completely responsible for the location,
workmanship,sratarial, Construction and drainage of the sewage disposal system
serving the above descri,bsd propertY, and that it has been const=ctsd as Shawn on
the approved plan or approved amendmnt therato, and in aiccordanca with the
,standards, rules and regulations of the Putnam County Depatrtent of Health, OM
hereby guarantee to the owner, his successors, heirs or assigns, to place in good
operating conaitlon any part ox Said system constructed by me which fails to
oparate for a period of two years i=ediately £ollewing the date of apporoval of the
"Certificate of Construction Compliance" for the sewage disposal system, or dny
_ ra.ir« -:4 t. -oa, to such System, upeDt wham 09 failvxe -to: ,c. e- prep; ly. rR. .
__e us by ttie wiXl.ful yr nag igent' act "ot tFie'ocbup n of sic i�ui�a ngL i it Ing
the sptem#
The undersigned further agrees to accept as conclusive the 4-aterminaticn of
the Director of tho DiVisson Of Invirot"atal Health Services of tha Putnam County
Department of Health U to whether or not the failure of the system to operate was
caused by the wiUfu1 cr neglipnt act of the occupant of the building utilizing
rho ,system.
Bated this
General Contractor (6WTQr) M S gnattue
Dye Bros.. Inc.
c4tycrAtion ar Corp.)
Rid 2, Sox 186, Wingdale, NY 12594
rev.
19�C
Si.gnatur
Title
fX4.
� �f �.f �f r mac, r, ., ^• /% j�
ass JI J! r~
c a� /o, 7
TOTAL P,02
0 ft. I, 0 ft.
3 ft. V'� := 3 ft.
6 ft. l� "� �c �/ 6 ft.
9 ft. ^�
12 ft
i�GVL �
D.H. tt
Depth to G.W.
Depth to rock
9 ft.
12 ft.
95 l .
D.H. Lot
Depth to G.W.
Depth to rock
Soil Descriptim
0 ft. 0 ft.
3 ft. 3 ft.
6 ft. 6 f ..
9 ft. 9 ft.
12 ft. 12 ft.
0
ft.
DEEP HOLE PROFILES
ft.
• U`
y �/
9
ft.
Date:
ft.
D.H. — Deeo Hole
G.W.- Grounawater
D.H. Lot.
D.H. Lot
D.H. Lot
Depth ~ to ~ 1
Depth to rock
C.
Depth to rock
rocky_
Soil Des'criDTticn
Soil Descriutlon
Soil Descriotion
0 ft. I, 0 ft.
3 ft. V'� := 3 ft.
6 ft. l� "� �c �/ 6 ft.
9 ft. ^�
12 ft
i�GVL �
D.H. tt
Depth to G.W.
Depth to rock
9 ft.
12 ft.
95 l .
D.H. Lot
Depth to G.W.
Depth to rock
Soil Descriptim
0 ft. 0 ft.
3 ft. 3 ft.
6 ft. 6 f ..
9 ft. 9 ft.
12 ft. 12 ft.
0
ft.
3
ft.
6
ft.
9
ft.
12
ft.
D.H. Lot
Depth to G.W.
Depth to rock
So;l Description
0
ft.
3
ft.
6
ft.
9
ft.
12
ft.
D.H. Lot D.H. Lot D.H. Lot
Depth to G.W. Depth to G.W. Depth to G.W.
Depth to rock Depth to rock Depth to rock
Soil Description Soil Description Soil Description
0 ft.
3 ft.
6 ft.
9 ft.
12 ft
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
`j ` DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 2,78,-:6130
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #�
WELL LOCATION
Street Address Town/Village/City Tax Grid Number
WELL OWNER
Name Mailing Address
felt, e_ &eA)A% 1 -/ r- / J!'l3ev- se&Jat
Oprivate
OPublic
USE OF WELL
primary
- secondary
(RESIDENTIAL O PUBLIC SUPPLY - O AIR /COND /HEAT PUMP
OBUSINESS O FARM O TEST /OBSERVATION
0 INDUSTRIAL O INSTITUTIONAL O STAND -BY
O ABANDONED
O OTHER (specify
O .
AMOUNT OF USE
YIELD SOUGHT�_gpm /#_A v AED /EST. OF DAILY USAGE_al
❑ REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13 ADDITIONAL SUPPLY
9NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
4 AJ E ed
WELL TYPE
DRILLED
ODRIVEN
[]DUG
OGRAVEL
❑OTHER
IS WELL SITE SUBJECT TO FLOODING? YES _Y NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
'1 /Glr/1�G�S 4t'A Lot No.
WATER WELL CONTRACTOR: Name (f'il1A1,0AJV Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _�� NO
NAME OF PUBLIC WATER SUPPLY: Ill %� TOWN /VIL /CITY
r. DISTANCE TO PR6i'2RTY FROM NE, i S1'`
LOCATION SKETCH A SOURCES OF CONTAMINATION PROVIDED
ON SEPARATE SHEET
date) (sig ture)
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
Department attached to this permit.
3. Submit a Well Completion Report on a form
requirements of the Putnam County Health
provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drillin perations be contained on this
property and in such / manner as not to degrade or otherw.s ontamin surface or groundwater.
Date of Issue: ( 19
Date of Expiration 19�_ Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
APPENDIX 3
PUTNAM COUNTY DEPARTMENT OF HEALTH -_ DIVISION OF ENVIRONMENTAL HEALTH SERVICES
•i ^• . r. :.r�..x:,m .�•� Yl \LYY 1L �i t11: "t'��:l i� �Y ai i'i ir' -'`:a. JGa:vv1''[ti �.i.'v L. iI [�:�:.. �'►:i� �a..i. .r:..�T�•_L.�.�r.'.<•.��•' - s+..-.� <
REVIEW SHEET for CONSTRUCTION PERMIT
STREET LOCATION litum f NAME OF OWNER !140
BY B. HEDGES R.MORRI OTHER DATE It /i TAX MAP # - -
DOCUMENTS.
911 ERMIT APPLICATION
L W S LETTER
GINEERS AUTHORIZATION
DESIGN DATA SHEET(DDS)
LT ORPORATE RESOLUTION
LANS THREE SETS
HOUSE PLANS - TWO SETS
m VARIANCE REQUEST
SUBDIVISION
LEGAL SUBDIVISION
SUBDIVISION,4PPROVAL•CHECKED
RATE D
REQUIRED DEPTH
CAIN DRAIN REQUIRED MSTANDPIPES
GENERAL
EX- APPROVAL SSDS ADJ. LOTS
WETLAND ( TOWN/DEC PERMIT REQ? )
DATA ON DDS PLANS & PERMIT SAME
T. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE
PUMPED PIT & D BOX SHOWN & DETAILED
- NO. OF BEDROOMS
& SSDS'S WAN 200 FT. OF PROPOSED SYSTEM
METES & BOUNDS
MOUSE SETBACK NECESSARY (TIGHT LOT)
HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE
NO BENDS; MAX. BENDS 45 W /CLEANOUT
FILL SYSTEMS
(10 FT HORIZONTAL: SLOPE 3:1 TO GRADE
FILL SPECS m FILL NOTES
FILL CERTIFICATION NOTE
DEPTH GAUGES
FILL PROFILE & DIMENSIONS
IN EXPANSION AREA
TRENCH
LF TRENCH PROVIDED M60 FT MAX
i.6 = %iEIv�IBOI�'ie0i LATI�'N
RA-I,;.:FLTOCONTTCURS -
1ER BI/ZBA 100% EXPANSION PROVIDED
100 YR. FLOOD ELEVATION
SEWAGE SYSTEM PLAN - (NORTH ARROW)
SSDS HYDRAULIC PROFILE m GRAVITY FLOW
CONSTRUCTION NOTES (GRINDER NOTE)
DESIGN DATA: PERC AND DEEP RESULTS
�WO -FOOT CONTOURS EXISTING & PROPOSED
DRIVEWAY & SLOPES CUT
AIN DRAINS
EROSION CONTROL; HOUSE,WELL, SSDS
�ROSION CONTROL NOTE
PERC & DEEP HOLES LOCATED
REPRESENTATIVE OF PRIMARY AND EXPANSION
'10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL
20' TO FOUNDATION WALLS fli 15' WELL TO P.I
100 TO WELL, 200' IN D.L.O.D., 150' PITS
100 TO STREAM WATERCOURSE LAKE (INC.EXPAN)
50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
10' TO WATER LINE (PITS -20')
50' INTERMITTENT DRAINAGE COURSE
200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS
15' MIN TO C.D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %,35'- 1%,100' <1%
20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS.
LU J 10' FROM FOUNDATION; 50' TO WELL
COMMENTS:
OROM DEF NEW ROCHELLE 10.12.1995 11 50 P. 2
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Re., Property of h / GAG 1Vi3AAD
Located at e5"-PoeY G�
(T) �/44GLW j"S e c t ion Block ��® Lot e7-4-1 c.?
Subdivision of lwe /yw6G
Subdv. Lot # 3 Filed Map #_ � __pate
Gentlemen:
This letter is to authorize
a duly licensed professional enginoer 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
Depar.tmP. s #_. nt'_H.e.a.t +h: ,stick to all necessary pap a,ti o r:iy ;ehai it,
connection with this matter and to supervise the construction of said
system or system$ in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Count•erisi.gned: �fL[
POE., R.A. ,
Addreas
-0` 7'
Telephone
Very truly yours,
S i e d�G
Owner of Property
Addro A a
11��.4sF /'J
Town
Telephone
_i , _
._iw� <n:•:.'1:+•iv ?'.•a :w :tc wvir.y'utt i"iti.::: '- i -:::�� or- . + ":H�v�R:.�..'«.<.;�sr.� :w;:., ,.
BRU' Vi?
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 December 11, 1995
Dan Donahue
120 Breckenridge Road
Mahopac, NY 10541
Re: Proposed SSDS: Vendetti
Cherry Lane
(T) Putnam Valley
Dear Mr. Donahue:
Review of plans and other supporting documents submitted at this time relative to
the above - captioned project has been completed. Comments are offered as follows:
"The construction of this sewage disposal system may be subject to local wetlands
regulations. You should contact local wetlands officials in this regard."
1. Erosion control measures for the house, well and SSDS are to be shown on the
plan along with a note stating all erosion control measures are to be
installed prior to the start of any construction.
2. Well permit has not been submitted (enclosed).
3. Well detail is to shown casing a minimum of 18" from grade.
4.. Current codes -a requires that_ the absorption trench can_be:.geotextile_ material.
�
R'r;sJc I IOIL- -C; V11 .4 t; La` 1 1 ..qU -r , Ply -paN r s v-rawr
Upon Receipt of a submission, revised to reflect the above comments, this
application will be considered further.
Very truly. yours
Robert Morris
Public Health Engineer
RM /jp
i
pUTI�Ai�A C ®iTNTY I3EJ��R�'M}E:I+T°lC` 0V
'tiNf-L1vF1 t "1GIr rtJl'< AFrrtivvr�c ±uP" F�r;tr5° run"'ti'�r��i cen'i cn � uioi'�1;��' o � � � LM o
Name and Address of Applicant: G Q f -r7
/- / S..._. r;� _. ./ S-_7"
y
. Name of Project: = aN:T''�cTiarr or Z S w 3. Location T /V /C:
Project Engineer: Z2AY:;�'4� J. D6'V4'fuF_ 5. Add ress: 1�,PFG,rF--( S/D4f 6,0
License Number: _fs 100/ Phone:
Type of Project•
_ Private /Residential Food Service Commercial
Apartments Institutional Mobile Home Park
office Building Realty Subdivision Other'(specify)
Is this project subject to State Environmental Quality Review (SEAR)?
Type Status (Check One) Type I.. Exempt
Type, II. Unlisted X._
Is a I Draft Environmental Impact Statement (DEIS) required? ............. /V D
Has DEIS been completed and found acceptable by Lead Agency? ........... AJ.14
Name of Lead Agency 14 A4
.:._.:.IS_thls..proje.ct in an arPa.�,ndec- thQ ^trnl..�f lcal,.p1,� ^Wing:. zoning -
or otner "ofttciai's, ordinances` ....................0..... .......:..:..
If so, have plans been submitted to such authorities? .................. /q b
Has preliminary approval been granted by such authorities? 61A Date Granted:
Type of Sewage Disposal System Discharge...... Surface Water Y _Ground Waters
If surface water discharge, what is the stream class designation ?........
Waters index number (surface) .......... ...........:.................
Is project located near a public water supply system? .................. Q
If yes, name of water supply`'. Distance to water supply
Is project site near a public sewage col lection ',oe.'disposal' -system ?..... 0
Name of sewage system /� %F :.; Distance to sewage system A/
Date observed:SFF liG 23. Name of Health Inspector::
Project design flow (gallons per day) ...... ...............................
C
DANIEL J. DONAHUEq P.E.
CONSULTING ENGINEERS
ENGINEERS,
120 Breckenridge Road
Mahopac, NX 10541
914-628-7576
November 14, 1995
Putnam County Department of Health
9 Geneva Road
Brewster, N.Y.
Att: Robert Morris, P.E.
RE: Proposed Sewage.Disposal System
Propoerty Of Venditti
Lot #3
Michael's Way R.S.
Putnam Valley
Dear Mr, Morris:
Enclosed herewith for your review and approval are the
following:
1. Form PC-1
2. Construction Permit
3. Check for $300' ' 00
4. Design Data -Sheet
5. Letter of Authorization
6. Two Sets of House Plans
7. Four Sets of Construction Plans
Sin el ;�9�1
Daniel Donahue, P..E.
Sites Sanitary* Environmental
1MI!1'NAM CDDNTI[ DZFAz111wr OF REACTS
` f D He" Sairwhoo: cai" N.Y 1512 : � O Pwvld� Fwtalt
F Co.
C0 Ii F !OS UVAM SYS1M
jf/t� u j
n.. �i.. +n..r:s,�, .. �..•.:....... - r a- ..., ..si. , . r- n x -'.-. . , ...�....+ -, Kn..�.,_.:. .. _ .. `..s@ =�. -� W -.i�.eve+i�. t.. T711-01-1.� �� � �Yj� �.n�i �•�.':ae::c+... -.;rw• c� •n
Immod at— or dvillose-
stdea.w.H. �9/c�»sc �^'Ar -f ��Ap�.ga ctr � ru � .. �
j'
_'o n°.�.° ° -
Date of Prevloai Appeovol
Maia6 A dross is" e .s err- r� �y Taws, �LGe Rosh �1 zp
nntn ¢„l,rii -tricinn Annrnvari... `7� /2lP,. pp F.nnlnSeA ® e;.,,,,, ,,.SOD.
above tlasCritNtl wlll tie constructed of shown on t
County Dipertinint ;of. Meeltl, .anA that on c
be submlltetl: ;to the'Depart lent and •a wrltt
tiNca in tioo0' operating condition My.'pert,,of
afire: of the approval of th* CortNkato,`o/ .Co
rill M Mtceted es shown on tlie.approved Plan and
County' DSiPsAmem of NealtM
Date
Address POW
APPROVED. FOR CONSTRUCTION: This appro
revocable for Caw s or ay be amended or modif
requires a now rmit pproved for disposal
REV.
10/88 �a
he approvatl amendment there to and in accordance With thastandards, rule$ a _ rnd _ulafTOnf`of 'tom Putnam
ofnpletion thareo/ a "Ce►tificaio of. Construction Compliance" satisfactory to = CommisZn@r of. HeaRhwill
en gwrantno; witl be'furni shW the owner his sucgssws,'MMs or essigns by MrbuikNr, that said. OuIWw will
said sent tlispotaI system'durirg the period'of two (2) years Immediately following thedate of.the inu-
nstruction `Compliance of 'throriginal s stem or ,any repairs thereto; 2) that the diilled well described above
that said Will Will be installed in ac nce witn, andaril r Ns and rsqu ads, of the Putnam
-Signed P.E. -4— R.A.
a l e License No
eiipiros two years the date issued unless construction of the building .has been undertaken and is
red
"when consider n ry ;bY the C issiomr of Mealth. Any change or alteration of .construction
of domed IC darer$ r drib /or' a water supply only. _
By Title �`'
PUTN• M •• = DEPARTMENT OF HEALTH
PIVISION OF ENVIRONMENTAL FNALTH SERVICES
SY
DESIGN-U -SHIMP-S RSUFACTI, SFINN-73, DTSPOS-AE. IS
Owner 0 is 4u, Z V-- n Ji Address -4r 02- rl died x1le
Located at (Street) Sec. Mock Lot
(indicate nearest cross street)
Municipality -,01"Ilve I'Al Watershed
Date of Pre-Soaking Date of Percolation Test
Holz
NUMBER CLOCK TIME PERCOLATION.
PERCOLATION
Run Elapse Depth to Water Frcm
Water Level
No. Time Ground Surface
In Inches
Soil Rate
Start-Stop Min. Start stop
Drop In
Min/In Drop
Inches Inches
Inches
2
3 Z,(
4 0 '7
N=S• 1. Tests to be repeated at same depth until apprcximately equal soil rates
are obtained at each percolation test hole. All data to'be subaittod
for review.
2. Depth measurements to be made fran top of hole.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. HOLE NO.} - R - HOLE NO.
G.L.
1'
2'
3'
4'
5'
6'
7'
g,
9'
10'
11'
12'
13'
iZ
INDICATE LEVEL AT WHICH GROUNMATER IS ENCOUNTERED JV�a Al e—
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY:,YPe- f Lip /yrJ /oN F%rGE DATE:
- DESIGN -
Soil Rate Used Min /1" Drop: S.D. Usable Area Provided! J-'256
No. of Bedroans Septic Tank Capacity IODIJ gals. Type
Absorption Area Provided By L.F. x 24" width trench
Other
Name Z).#Alr Pie- CI yGW.9��� Signature
Address fd.a f��PE�,r�'.v R r i2 .e'er SEAL
q 0.48
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: N _
Soil Rate Approved sq.ft /gal. Checked by Date _