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Home My WebLink About3323DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.05 -1 -75 BOX 27 03323 PUTNAM COUNTY DEPAR'Il� OF HEALTH.... liivr5iuiv "ur' r;NV 1Fi(JL it iYiliL rri 6r dv l DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner 0 �c�U� �%� Address dun )x;, t7 1' ren' /,;Fof y� V Located at ( Street) �f � � �� Sec . Sri Block 7 Lot % 3 ° /G (indicate nearest cross street) Municipality 1-70 Watershed{ SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking �LZy Date of Percolation Test. HOLE NUMBER CI= 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 13 3zy Zy 232-Y 3 3 3-3YF 4f/ 2- z y > 3 7 4 5 1 2 3 4 5 1. Tests to be repeateff at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to' be submitU d for review. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION G.L. 7-1 2° 3° 4° 5° 6° 7° 8° 9° 10° OF HOLE N00 11° 12° 13° 14° INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING MMUNTERED DEEP HOLE OBSERVATIONS MADE BY: /i DATE: DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided -5��'� Noe of Bedrooms Septic Tank Capacity gals. Type Absorption Area Provided By L.F. x 24" width trench Other 2 ? 9a AS 4/'Q Ye- - .moo=,._. A 0p�E1 �FItl1s Name �u i v- Signature 5 OiIC� d Address l'd, ' THIS SPACE FOR USE BY HEALTH `DEP ONLY:, Soil Rate Approved sgeft /gala Checked by Date PUTNAM C'OUNr1Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - .+.vw. `ruT•- aw`,.r.•:....rt•t:.^. ties:Y o w�c>e.- :;.+on "�' •,'� . ' . .. COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner j,'0,07 17-re i o - /y �9cjyoZ1 Address �%lly�Ysr %n,�;C�y / � /�'ox yG Sys Located at .( Street ��' Sec . �� Block % Lot 1-? Indicate nearest cross s ree Municipality, pinjcr�'J /,/G�,/G j Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION RIM Elapse Depth.to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2 ,32,X.3 `i�F' z 5 Notes: 1) Tdsts to be repeated at same depth until approximatelyy 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. L> TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION _ -. N. -711 , . - - - DEPTH HOLE NO. % HOLE NO. / G.L. 170 6" 12" 18" Sal 24" 3011 361 42" 48" 54" 6o" 66" 72" 7811' HOLE NO. O�Y 84" 'v T'IC -TE I.:EVLL AT WHICH GFcOu�` T�ATLR IS Ei3CuIT�V1EP i' .�- 1NDICATE LEVEL TO WHICH WAT R. EL RISES AFTER BEING ENCOUNTERED TESTS MADE BY -e, Date 7/ DESIGN Soil Rate Used_V _MirVl "Drop: S.D. Usable Area Provided �!/U No. of Bedrooms Septic Tank Capacity leloa Gals. Type ,11/'&jooi► Absorption Area Provided By Ld L.F.x24" ,a width trenc . of of NEW � Other Z• 609000 D�Q yl(Ip Name O a J i v , vp2j Bignaturo, Address THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by "'�` Date -T] APPS -MIX C FINAL S-7L E INSPECTION Date V1 '# OR SUBDIVISION LOT A E21A AGE DISPOSAL AREA a. SDS area located as per b. Fill section - Date of p 2:1 barrier. LGTH c. Natural soil not stipcE d. Stcne, brush, etc., grey e. 100 ft. from water cours Ins t OWNER U, tc,'�av,- by WIDTii AVG.DPI'H 15' fran SDS area. S. II. SBN -GE DISPOSAL SYSTEM a. Seotic tail{ 1,250 _ b. Sept i c tz-_ k ins , ? 11 -level- C. 10 minka —m fran foundation a. No 90° bends, cleancut within 10 ft. of 45° bend e. DISTRIBUTICN BOX 6. Cycle witnessed by Health Dertrent 1. A11 cutler= at same elevati en - water tested estimated flow per cycle 2. Protected bel caw frost - 3. Mi nirman 2 ft. original soil beraesn box and trenches - f. JL%CTION BOX - properly set Number of bedreans F V. 4v-= l . L&nc=L-i r=.� aired - 22%( Len=,, i_ns taller , a. 2. Distance to watercourse mers-ar= u ft. b. 3. Installer according to plan " 4. Dlst�-z^.ce center to center d. 5. S1Grz CS tre-n acceptable 1/16 - 1/32 " /fcxt. -_' 6. 10 fit fran prot✓Erty lire - 20 fit - feurcaticns 7. l epth cf t=ench < 30 inczES fran sur-fac_ 8. Roan allaHed for e .=sicn, 50% 9. Size of gravel 3/4 - 11" diame -ear - 10. Deotn cf gravel in trench 12" minim 11. Pile ends gipped .,tn -R :DC'E.:S� STEMS 1. Sie '(5f 'ct`%nicer VI. OVERALL WORT LASHIP a. 2. Overflew tank -{ All pipes partially backf illed 3. Alan, vis•Lial /audio All pines flush with inside of. box -� d. 4. Pump easily accessible manhole to grade e. Curtain drain installed according to plan 5. First box baf::, Curtain drain cutfall protected & dir.to exi.st.waterc g. 6. Cycle witnessed by Health Dertrent _ Surface water protection adeouate estimated flow per cycle Erosion control provided on slopes greater than 15 %. IV. HOUSE ' a. House located per approved plans. b. Number of bedreans V. 4v-= _ a. Well located as per approved plans b. Distance from SDS area measured ft. c. Casing 18" above grade. d. Surface drainage around well acceptable. VI. OVERALL WORT LASHIP a. Boxes properly grouted ' b. All pipes partially backf illed c. All pines flush with inside of. box -� d. Backfill material contains stones < 4" in diameter e. Curtain drain installed according to plan f. Curtain drain cutfall protected & dir.to exi.st.waterc g. Footing Drains discharge away fran SDS area h. Surface water protection adeouate 1 . Erosion control provided on slopes greater than 15 %. 11Z, 47 ej S ' JOHN , KARELL- Jr.. P E.. ' th• _ ,fir, ~ , Public�He;Ii D for �. DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 May 12, 1994 Mr. & Mrs. Villanova 14 West Avenue Putnam Valley, NY 10579 Re: Proposed addition Dear Mr. & Mrs. Villanova: Review of plans and other supporting documents submitted at this time relative to the above - captioned project is in progress. 1. Formal approval of plans, prepared by a professional engineer in accordance with applicable sections of our submission guidelines, is required. Plans will provide for the installation of additional subsurface sewage disposal system meeting present code requirements for a four bedroom house. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. I may be reached at ext. 166 to discuss _.. .., ... _.anY r11_!y1`i'�Qlls: i r�r;de.r_rljn.' ha. ab6,Ve .i Cc: TrGi? Ver truly yours, bz'-ov %%,11V Robert Morris Public Health Engineer RM /jp ijvcs All 4:38 LOUIS AND PATRICIA VILLANOVA 14 WEST AVENUE PUTNAM VALLEY, NY 10579 . (914) 528-9447 April 21, 1994 Mr. Robert Morris Putnam County Health Dept. 4 Geneva Rd. Brewster, NY 10509 RE: Special use permit- accessory apartment Premises- 14 West Avenue, Putnam Valley Tax Map #073-005-0001-075 Dear Mr. Morris: Enclosed please find a sketch of the floor plan of the above referenced property. I have indicated in the proposed basement the location of the bedroom and bathroom. Would you be so kind as to check your records regarding the well and septic and thereafter provide us with a letter documenting that they are sufficient to service an accessory apartment pursuant to Putnam Valley Local Law 3-1988. T h khX- ydu for yoU t -d b 6P 6 f Wtlo f eftd Udr fe - Y. 'ea -cr don't hesitate to call if you require anything further in this regard. Very truly Louis & Patricia Villanova Encls. 4 rr PoRmck- SCcof\/D COVA PUICK its sp-r) A5 FLDOR - 3A --M 9C0 NN Z)1,91 K Wle-LL, CLOSE,- DO J� ft4 e 1�_ I I A f. Ct4AM&r=.:- -D 0 F- m �P, bAli�ROOM F7cD>RDov\. DORMER VA LOUIS E` ?ATTZ1ctA VII-LANOVA r\ ()Q OF[:: t c FLDOR - 3A --M 9C0 NN Z)1,91 K Wle-LL, CLOSE,- DO J� ft4 e 1�_ I I A f. Ct4AM&r=.:- -D 0 F- m �P, bAli�ROOM F7cD>RDov\. DORMER VA LOUIS E` ?ATTZ1ctA VII-LANOVA 3L F/ J sS FLOO2 r i t � I • O CPA -N EE i AMC 'PA-rzicra iJILLA -NIOVA I� O FO SO ( t,oI -F�4 A0rF c, C, nR y d vAr>-rnAf7 h LnruS I�f fA-TRIC4A- VILL4.-nJAVA. �XisTiNC- S:, PLAYROOM 0 D 0 'r 0 6 3/4scmENT 0 UPFI N IS 14CD ccmcAj -r WALL- UTILI f-Y Az EA co C— TI 03 -BOILEIZ , AOT tdAI-eP- 11111 A-,\JeiVA- Yorktown Medical Laboratory, Inc. . 321 Kear Street Yorktown Heights, N. Y. 10598 (914) 245 -2800 - .. a...._. �rc�i:�;:-1•iiicr L`—i7�vvUiii'iVl:� %jliJ(:IP� - - ,.. .?>. F -1 Louis Villanova 14 West Ave Putnam Valley, NY 10579. IjAB # Date Taker: 2 -9 -94 Time _OAM Date Rc' d : 2-9-90 Time : IOAM Date Reported: FEB. 1 21990 Collected., .13y: _ IT Vi anova. Referred i y: Sampling .51.te : Tap @ tank Phone ( ) 528- 9t�+7.. ql J (For t Lab.;.Use ) REPORT ON THE QUALITY OF�; WATER ' .y SAMPLE -TYPE: __(_Cbec � PntaY�l a �.4 Alkalinity __. Standard Plate Coiznt I + Non - potable Chloride -f" (0FU /1 mL) — — Copper = Greater Than NA = Not Detergents, MBAS Membrane Filtration Method Hardness, Calcium = Too Numerous To Count __. Hardness, Total 'Total Coliform c — Iron Lead ---Fecal Coliform _ - Manganese Fecal Streptococcus ,.i Mercury Nitrogen, Ammonia Most Probable Number Method _ Nitrogen, Nitrate Nitrogen, Nitrite Total Coliform — Phosphate, Total Fecal Coliform Silver — Sodium — Fecal.Streptococcus — Sulfate _ Sulfide roc �,Ah:Gense_•iTQA .:PrPsP� — Zinc Total Coliform P PHYSICAL MISCELLANEOUS — PH (S.U. ) — Color (Units) Conductance (uhms /c) Odor (TON) Turbidity (NTU) KEY FOR TERMINOLOGY CFU = Colony Forming Units F11l LT = -f" = Less Than GT = > = Greater Than NA = Not Applicable SA = See Attached TNTC = Too Numerous To Count — REMARKS COMMENTS For Lab Use THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) SATISFACTORY SANITARY QUALITY ACCORDING TO TH NI WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIM TIiESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW ING WATER CODES, 0 T PARAMETERS TESTED, AT THE /x Albert H. Padovani, .T. AS P , Director OUTGOING: (Check Each) HNO HC13 _ H2SO4 _ NaOH ZnOAc _ Na2S203 _ Other: INCOMING: (Check Each) .GT 200C _pHLE2 —pH GE 12 Other: (WAS NOT) (NA) OF A YORK STATE PUBLIC DRINKING OF SAMPLE 2;0 TION. (DID NOT) MEET THE YORK STATE DRINK - TIME OF SAMPLE COLLECTION. 7 /87(Rvsd1 /90)RWE PUTNAM COUN'T'Y DEPAR'IMENr OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchaser of Building Section Block Lot Building Constructedd by Location - Street Municipality Building 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 'Tert if i.ca to of .Construction . Compl.iance" ..for . the setaage disposal .system, Cyr any repairs made by me' to such sysffem, except where U e failure to ope `rate, properly 'is 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 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 /A l° 19 �v (56M e ) General Contractor Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 mk r Corporation Name (if Corp.) Address 14�7�,�� . k-, . . I WLJLjlj uurLrj zllun rtzrual DEPARTMENT OF HEALTH Division Of Environmental Health Services.- PUTRMI•COUNTY i�iPXkkgk -Of HEALTW__ Office Use Only I WELL LOCATION STREET AOURESS: WNr l TAiGRIO t1UNISER I WELL OWNER PSIVATE 0 PUBLIC USE OF WELL 1 - primary 2 - secondary J& RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR/COND./HEAT PUMP ❑ ABANDONED 0 BUSINESS ❑ FARM ❑ TEST/OBSERVATION ❑ OTHER (specify) 0 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY 0 AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE 00 gal. .REASON FOR DRILLING � NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA 3 WELL DEPTH ft STATIC WATER LEVEL 2 ;/ft. DATE MEASURED -DRILLING EQUIPMENT JK ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG 0 WELL POINT. ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING. ❑ OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ;24' ft_ MATERIALS: )5 STEEL 0 PLASTIC 0 OTHER LENGTH.BELOW GRADE A M—n-f L JOINTS: 0 WELDED _WHREADED 0 OTHER DIAMETER in. SEAL: 0 CEMENT GROUT T 0 BENTONITE �KOTHER WEIGHT PER FOOT ib./ft. DRIVE SHOE<.YES 0 NO I LINER: ❑ YES skNO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (it) DEPTH TO SCREEN (ft) DEVELOPED?. FIRST ❑ nt.'O NO GRAVEL 0 YES 0 GRAVEL V L SIZE. E7 DIAMETER OF PACK in. TOP DEPTH.,,-tL BOTTOM DEM.' It. WELL YIELD TEST If detailed pump ng i METHOD: OPUMPED tests were done is in- OCOMPRESSED AIR formation attach ed? ❑ BAILED ❑ OTHER ❑ YES ❑ NO more detailed formation d's-criptions or sieve analyse§"- WELL LOG 'are available, please attach. e DEPTH FROM SURFACE Water sear- ing Well Dia-,* meter FORMAT16N DESCRIPTION cooE ft. IL WELL DEPTH It. DURATION hr, min, DRAWOOWN ft. YIELD gorn• Surface urface 16-- // 0/'/' I L WATEP ❑ CL E�9: TEMP, QUALITY ❑ IXOUOY HARDNESS ❑ 60'.60RED ANALYZED? OYES ONO ANALYSIS ATTACHED? ❑ YES ❑ NO 4 STORAGE TANK:: TYPE CAPACITY GAL. PUMP NF MA I TYPE A_ MAKER APACITY DEPTH VOLTAG;�30 A E WELL DRIL9 N DAJ o ADDRESS . . I _ - _ � - - - a. Yt. :,i tf .'yam �fm t�:�•_ _ . Mountainview Rd. Box 46 Putnam Valley, N.Y. 10579 April 6, 1987 Ms. Anne.Bittner Putnam Count Environmental Health Dept. �; RECEIVED Y P �� tj; ±� °.!'MTh,' County Office Bldg. Carmel, New York 10512 RE: MacDonald /Villanova septic pla7re"�ti�or' �� West Ave. Putnam Valley Dear Ms. Bittner: I am enclosing herewith a copy of a modified Sewage Disposal System which had been approved by your office in 1985, but which approval has expired. 'At the time this plan was originally approved, the lot in question was only one - half acre. Subsequently, my husband and I were able to purchase the adjacent lots giving us total area of nearly one and a quarter acres. There is also on record an approved septic plan for a four bedroom house which requires substantially more fields, fill and expense. When this plan was submitted, the Building Inspector, Mr. Marvin O'Dell, had advised us that because the family room or den had a closet, he was forced to consider it as a bedroom.. , th•e_re rn.g...,t.h -P %. septic. .r- equi r.ements_ z- -as ir�g` with "aur 'bui"1der; we realized` that it would ~ be no problem to remove the closet and make other minor ; changes in the floor plan so as to permit this room to be considered as a den. I have given Mr. O'Dell a copy of the revised plan which he has approved for the bedroom count. This plan is on record in the Putnam Valley Town Hall. It is my understanding that all that remains is for me to send you the enclosed drawings for your files. If you require anything further, please do not hesitate to contact me. My home phone is 528 -9447 and I can usually be reached in the morning or after 5:00. PV: P1 Very truly �yours, PATRICIA VILLANOVA DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL 4 _ ... .....r'... ti "' _.+ �r:'v o:v�a,+:�. n�z::.T'-. .a t-'r'... -+t n ,.. :r�•...: �A. -_ . - .. u- .. .r. _a. - '+W-. "�.<i -l.:v s .. _.f ... •.> , .! Yom" ' /• �•+•I WELL LOCATION Street Address Town Village /City Tax Grid Numberl I've WELL OWNER Name Address .0Private O Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY D ABANDONED 0 OTHER (specify 0 AMOUNT OF USE YIELD SOUGHT 7 gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE�AG gal REASON FOR DRILLING )Zz, SUPPLY 0 REPLACE EXISTING ❑PROVIDE ADDITIONAL SUPPLY SUPPLY O DEEPEN EXISTING WELL ❑TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE DRILLED 13DRIVEN DDUG OGRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: C�-_ Lot No. IS L7 — l 9Z WATER WELL CONTRACTOR: Name %� �-° ��'o� Address IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES 4-'�N0 NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE To PROPERTY FROM NEAREST WATER MAIN: !-7-7 {� r. -a+•. _ < «� _ rJ rr. .,. ... -b_t ... ..D• ....on r/ ...... n n- �.. .. _, .... ..�> "u G.rsr-.a .-.... W. 6»•.v �xw.....w.. L'.�. .. -...r n. 'O rw[D... -...w LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED�^-, ON REAR OF THIS APPLICATION AJON SEPARATE SREET ate) gnature) 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: 19��;�-�� / Date of Expiration: 1<_ 19 G1 % Permit Issuing icia T Permit is Non - Transferrable PUTNAM COUNTY DEPA024ENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REV.IE�W 1 SHEET - CON S TRUCT ION ^ PERMIT .a Tw �• . -.'. . . .3•_^..... BY: _ ` ,• .V Tf _ W"/.^^ _ _ _ �- Fj(vr• i'z'ru ° � 1. ( � (Name of Owner) (Street Location) . DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter 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 _ cpansioa.. rea.kzhoiem, -a �� .i .. L.M._ ..l•.. — " "'�'rPumPed Pit & D' Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' 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 & Pen-tit Same �0 WAI',M MM MM MM MM M� MM AIM MM MIM ®_M /Ai MMM M/ M A� a no= a •� DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter 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 _ cpansioa.. rea.kzhoiem, -a �� .i .. L.M._ ..l•.. — " "'�'rPumPed Pit & D' Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' 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 & Pen-tit Same MhP LOCA';'o"� /� C D C Jat1� House-plaq.) O.K. Design dat, sheet Peres presoaked? 30 pF;rc test depth Const. res; ;•lts for 3 runs D. Hole lorz 0. K. a Corporate Alrfidavit i'or other than individ Authorizati.on for engineer Metter fror1' Water Supply if applicable If varianed-requested -such noted on plans TRQ1 ng WF 'Nr ru Ren' n FDMAIl6br� pRER "Id A1HTURE 1 begL . Ch3 PLAti2�2, D3TAIIS • •' \ . FILL DEPT N Rx'EW sNoww( 60 'fir PLAN To 6fi r Existing cce- .tours shown (show new contours Slopes for driveway cuts, etc. shown Water service line location Footing drai.n, etc. location Top slope,:rottom slope of fill Percolation tests and deer test pit locati Septic tank'size and conformance to std._ rD Remar]<s � A House setba.3c shown Distributiorr•box ft,. below frost I All water wj.thin fit. of. .PL shown WfiLL.'CASING 12" O)ZOVE GepDe r Plan and 11�rofile SDS ............... . All other',wells and closer 200' shown o'ft reference. made Property 'l);Oundaries (metes and bounds - clearly �s�wn ; t6CTgL � ?oro�slo� - A �. /�xlr�Tl1�(a t APPeoVAL - IREALTY �rJSDidiStoiJ v _.. 10' to P.L. ;; - 20'� to rounda'ti: ion walls i 100 to Neares'i" well 100' to stream;: march, lake, etc. incl:expansion 5' to Curtai? drain 0' to water "Ane (pits -20 115' to storm 6main ya �0''to larca roes 0' from Iburnlsi.ion to septic . tan c 5' to pipe i;.:om leader drain &.1'ooLinj L rain. 125 To .cgTt4 15' W ELL Tt) . PL ✓ c/j �' � ep-nc. -iA IJk TO • wELI_ C FIELD CITIsCK MST. bate • l " ( Co Insp.by: IN SITE InSPECTION Yes No Cotm»cnts Property lines or corners found . . . . . . Can ei;timate house location . . . . . . . . . Will•.drivoway need out . . . . . . Ot< Nrust 'I:rees be removed -hote these Is der -.p hole representative of entire SDS urea AddiLiional deep holes r_eeded. . . . . . . . . . n Sufficient- SD3 area available considering driveway cut, house location, separation _.p.-�dist;anccs,_.. -etc. �. . . . . ILU- 4;&Lus r SE WTI CS CrIE ' 1% _. — _ DEEP ' ] OLE DATA Water elevation:. Rock elevation: /F Soils descri,tion: Ff' fa CD-M . - te: _ FINAL, SITE INISFECTION lInsp. by: House :Located vhere 'shot:n on approved plan SDS located where approved . . . . . . . 1ongUa of trench measured Width.. of trencli average S�.ope''gf the line and trend acceptable . . . Room 't.,- flowed for expansion trenches . . . . . dver',14, ft. from swamp, watercourse h'atur.� soil not-stripped or SDS area _ _. irrur'�c:essarily graded 10 lit•. -maintained from prop.line and . 20 fl'.. from house . , , , Selilra ion of trench from house, well _--etc.-.follows follows plan . . . . . NLUnber of bedrooms checks . . . Stones,r brush, - stumps, rabble, etc'. greater tharY•15 ft. from nearest trench . . . 15 I't. ;'of peripheral soil horizontally from trench _ — Jtnnctic'i boxes properly set Could ,�3iirfaco run off from driveway, roads, •grrnrn4l surface, etc. channel near SDS area' . Does 1o;t drairn :e ar. mar 0. K. �i.n area of SDS .FINAL NRADINO OF SITE ACCEPTABLE ...�,.. _vw"JL a 1/i:.rt 1%AIVIt.1 \1 VT nZALIn CI\VIPICrK 1U rKUVlllt rtKI'll I It ON CERTI�FICAT OF C MP IANCE Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT # CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM �k /n Ong %• le } _ ��SM +, Town or Located at —/ , v,�> Fes- Tax Map clock Subdivision Aieg C/ y{ /�� / 7 f?^/ fi✓ Subd. Lott # Owner /Address J,rO � c;a % / �(%s� (d/ /�D%r /9,� l' e Building Type ✓ � �S Lot Area _ y`y (7 V C Number of Bedrooms Design Flow G /P /D �dC*> Separate Sewerage System to consist of r yCS /a Gal. Septic Tank To be constructed by V Water Supply: Public Supply From —Le-private Supply to be drilled by Renewal , O Revision Date Of Previous Approval I Fill Section Only, P.C. H. D. Notification Required 11 t and :3 3-4 ` F Z � l: W f Q•C' Tf`YM��_S Address Address l f Other Requirements — 7 1 R V a. _-:5 ct 0 ar a V ry � 2 `p 0 C� I represent that I am wholly and completely responsible for the design and location of the above described will be constructed as shown on the approved amendment there to and in a County Department of Health, and that on completion thereof a "Certificate of Constri be submitted to the Department, and a written guarantee will be furnished the owner,( place in good operating condition any part of said sewage disposal system during t ance of the approval of the Certificate of Construction Compliance of the original & will be located as shown on the approved plan and that said well will be installed in acco8'd� County Department of Health. - Date Signed Address APPROVED FOR CONSTRUCTION: T approval expir one year from the date issued revocable for cc��ppuse or may be amended or modified whe cons) erKnecessary by the m ,reauires.•a _n_evl, Vi"uurrie5j.0 5ai`ityary sewage- A' ly�rivate. _ Date r. By Rev. 6/85 Rev. 3/86 Located at 1) that the separate sewage disposal system Bards, rules an regu Ions o e Putnam ctory to the Commissioner of Healthwill ns by the builder, that said builder will Aar i ediately following thedate of the issu• pilto; that the drilled well described above 11 qu s and regu aTfions of the Putnam r P.E. R.A. License No. Z V fthe building has been undertaken and is yr IF_ or •a.!zr :ar.— " s:lat.'u ;,�� Title PUTNAM COUNTY DEPARTMENT OF HZAIXII Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Mast Provide P.C.H.D. Permit N OF CONSTRUCTION COMPLIANCE FOR SEWAGE Owner /applicant Name Melling Address U✓7 G SYSTEM �u /77 G e Town or Village Tax Map > V- Block_ Lot Subdivision Name Subdv. Lot N Zip 'L571 Date Permit lssaed V 0 Separate Sewerage System built by ( 0' .+�/ �Addresa Consisting of / er d O Gallon Septic Tank and 3 4-0 2- 4 Water Supply: Public Supply From Address or: Private Supply DrIU d by Af A27 j Address zr77 G' G'.S Building Type ,.� / Has Erosion Control Been Completed? Number of Bedrooms —3 Has Garbage Grinder Been Installed? Other Requirements 21 RCS' /a o'e / �`%7 OF w I certify that the system(s) as listed serving the above premises were constructed es t the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulati filed plan, and the permit issued by the Putnam County Department Of Health. Date Certified by ° ( P.E. R.A. a ar ,� if° Any person occupying premises served by the above�system(6) shall promptly take wch a i g r to secure the correction of any unsanitary y a soon as a pubt;. Unitary Sawa► becomes 'conditions resulting from such usage. Approval of the separate sewerage system shall tie%f�ib 5 Y available and the approval of. the private water supply shall become null and void when a pL iivdlei ly becomes available. Such approvals are subject to modification or Change when, In the Judgment of the Commissioner of Hoe such Yevoehtion, modification or change Is necessary. Date �— �� \4 PUTNAM COUNTY DEPARTMENT OF HEALTH Health Ce*s-icea Carmel, N.Y. 10512 Engineer to Provide Permit R CONSTRUCTION PE 4 FOR SEWAGE DISPOSAL SYSTEM N/ Q'Ile Located at Town or Village Subilivision Name � -' �� 6� Snbd. Lot '# � 1F2k`_ V V Tax Map Block - _" Lot P ! Renewal— ❑ Revision_ Owner /Applicant Name �6.% C / / �/ �G� s9 ?�� /� Date of Previous Approval __ /J j . s Mailing Address �fi+a✓i s1 %"-y - h� i'' 62,- / l e qi I/ Town � Zip Building Type Lot Area FRI. Section only Lj Depth Volume Number of Bedrooms � Design Flow G /P /D ®��p PCHD Notification is Required When Fill Is completed \ Separate Sewerage System to consist ofZ: �I_Galloa Septic Tank and f y To be constructed by " Addresa Water SulkPly: Public Supply From Address ors P�rlvate Supply Drilled by �_Address I represent'that'd 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 asshown on the approved amendment there to and in a the standards, rules an regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Co �i�k " satisfactory to the Commissioner of Health will be 'submdted to *the Department, and a written guarantee will' be furnished the o 1 s, r assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system dur s immediately following the date of the issu- once' of the approval of .the Certificate of Construction Compliance of the or' naI or ,a to; 2) that the drilled well described above will be located as shown on the approved plan and. that said well will be-install i c ce, he and rule and regulations 6f' the Putnam County Dep tment of Health. Date �r Sign P.E. R.A. Address •' License No APPROVED FOR CONSTRUCTION: �s approval expires one year fror»f[he�da�e" tl . ess corl�truc��tYR'- f the building has been undertaken and is revocable for cause'or may be amend or modified when considered necessary, by'rz�; o m�asigrtyofnHeatth: Any change or alteration of construction s requires a new. permit. Approved for disposal of domestic sanitary sewage, and PrAfe vtllter sFipplyaoicly. " Date g Title r _ - -4, /cr 'This is tb certify tbO-4,, t�e Seav () ajepo6" system was y constructed so indt St4 )n 4 hj. ,p j.aj_&nd r.h&t the 878teln was inspected by me before It 'iVks over. The �Or - a-13 �,,andpr,' system was 1.-n ac�, aa�i, e w! !ib rules and regulatior-.8 of th 8 Pu tnp-n S -b and the 7f-;Ir :Ork ' tz(te -ry P `� C. go kv,12"naf CO'mt7 I)8PartmenT or RBaLTIU 0" of L'nvir=mental Health S 4ppr6 vad as noted for cOnformanoe applicable Rules smA Q-- with 6 cel-j—_ .14 / O i ------------- > Jf i j�J} to Onl i � T r tYI jm--- '. `.�°-r`•- ^..'-.,*'^ vat., . • ,.a� a- j A . lJ e c r J! /i r fz /h�i •_^'ff_._..._...__•__.._ ..�_. . 'mac._' SS _ ! I VV -- 1( C c S i t'F T G' �- .'C • K ,., 1 ' 0• i ljo v -= __. _�.._... _._.. _.. _.__ _. _ / S _ t 1� { T � � i - _� _, ..._......- ,v_..... .'F,. ... _.. ... -.tea -. . <��..�....�,..s, :.. . _ .., _ ... w's: -..:. •c -.. t . _ _... ".�r_3`_J_i�..f."?�. �..._,,._.. .�.��- ..��.A.,....mo...•- r..... _.._.. ,._ ._ SC 3t7' a' Ca /c ' Ll /Z / _Je3;, YY ;Zlzl•l Z., s *5 BPI 1 GM4 m so ganr n2aa pm caTa soma-sm-inoo JOS RaVa - V4AOzddl UNYP—S q9lT_H lnum=XFAUK jo =TgTATO zo 4-mveaK 4=3 Wnua A /V ty C7 t.4 ILA /V ty C7