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BOX 27
03341
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11
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03341
PUTNAM COUNTY DEPARTMENT OF HEALTH
e
Rev. 318 Q �* Division of Environmental Health Services. Carmel, N.Y. 10512
CONSTRUCTION PERMIT FOB SE A E DISPOSAL SYSTEM '
.. . v ',.k. .5`h4?`r d'f's7 r;,;v'.ta;• -v'Tx rT:" r.0 .
Engineer to Provide Permit a ` ��
on CERTIFICATE OF COMPLIANCE C //°�J�
Permit q _T
PUTNAM VALLEY
[ocaterl,at_._ CEDAR DRIVE. & HILL TOP DRIVE Toivn._or_.yj11age._
:a.:.•: ':'ri ==.: -- mac•;': ;mss - .r a. ,ttw-rtt.. _...• �aa•:ie._.a�"' <.; v�,:v< .:v.: °. ;:g: ... -,._ .,_ .:_
r� •cM<aa::.:'�:�P..+ -tan. �r�.a;� :.. r .e..:...' �v+� "' :r_.'- °- �s;...r: :a ".:-.
~ Subdivision Names 1 LL'1 UL lid; t Saba. Lot q 1 — U Tax Map 4 Block a. Lot 1 -
Renewal_ ❑ Revision ❑
Owner /Applicant Name_ AUGUST STERLING
Date of Previous. Approval
Mailing Address 50• -09 37th .AVENUE Town WOODSIDErNY 7jp 11377
Building Type ONE FAM . RES . Lot Area 0.730 AC . Fill Section Only Depth Volume
Number of Bedrooms 3 Design Flow G /P /D 600 PCHD Notification is Required When M is completed
Separate Sewerage System to consist of 1000 Gallon Septic Tank and 48OLF OF• 2 ° WIDE LEACHING FIELDS .
To be constructed by M. AMOROSANO Addreu CHURCH STREET, PUTNAM VALLEY, NY
Water SuPP1Y: Pdbllc Supply From Address
or: X Prlvat.SapplyDrilledby N. A��N++DERSON,+�reaa BARGER STREET, PUT, VAL,NY 10579
Other Requirements � I • U• Q FALL 2.EZC f 1'19 J
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 disp sy during the
ance of the approval of the Certificate of Construction Compile ce of the original syl
will be located as shown on the approved plan and that said well will b Installed 'n' acc rda
County De rtme of Health.
Date 4 Signed
Adorers MITRrOOT NO RF 1)
APPROVED FOR CONSTRUCTION: This approval expires'
revocable for cause or may be amended or modified when con
requires a9--3-6+ new permit. Approved for disposal of domestic
Date By
from 91s date sued unless construction of the puilding has been undertaken and is
lee X ry b he Commissioner of Health. Any khange or alteration of construction
/ewage, andAn private water supply only.
Ip system "' 1) that the separate sewage disposal system'
arc with the standards, rules and regulations of e Putnam
>n Co pliance" satisfactory to the Commissioner of Health will
succe rs, heirs or ass" s by the builtler, that said builder will
iod o o (2) years i�ediately following thedate of the issu-
or y r pairs there: 2) that the drilled well described above
wl , "dards, 1q} and regulations oof the Putnam
P.E._ R.A. _XX
11056
License No
Title �51jr
Rev. 3/ 6 PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services, Carmel, N.Y. 10512
Engineer Meet Provide V 4 7 8 7
..�.. to `e. �... :.•F+a.,..uw..sMr..... -.as .r... ....... _...eF ^^9.+T' —�!. _..w.n.�ys•...�.r.m— r.....�.. :....- :�..�..r �...� -.s s_+..... s .,a.�. .r —w.. ,. .�V wi•q_r -_...r
OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM
Located at CEDAR DRIVE & HILLTOP DRIVE
Owner /appBcant Name AUGUST STERLING —Formerly
Mailing Address 50 -09 37TH AVENUE zip 11377 _
WOODSIDE. NoY.
PUTNAM VALLEY
Town or Village
Tax Map 5 Block_ 4 —Let.
B
HILLTOP L,
Subdivision NamC.AMP T,17()11% W Lot # 1 F — 20
Date Permit issued 8 -1.-84
Separate Sewerage System built by M o . AMOROSANO _ Address NY
Consisting of 1000 GAL. Gallon Septic Tank and 400 L„F „ OF 21 WTDF. T.F.ACHTAK; .T)S
Water Supply: Public Supply From Address
or: X Private Supply Drilled by W_ AWDER S ON Address BUGER ST, P UTHA M V A 1,14,. NY
Building Zype ONE FAMILY RES o Has Erosion Control Been Completed
Number of Bedrooms 3 Has Garbage Grinder Been Installed?
Other Requirements
I certify that the system(s) as listed serving the above premises were
of which are attached), and in accordance with the standards, rules and
Putnam County Department Of Health.
Date 7/27/89 Certified by
Address 2 MUSCOOT NO.
Any person occupying premises served by the above system(s) shall promptly
conditions resulting from such usage. Approval of the separate sewerage
available and the approval of the private water supply shall become null and
subject to modifieatiop or Change when, in the Judgment of the COMMr ifs
2
completed work ( copies
the permit issued by the
P.E. R.A._
1 Lice No. 11056
h :ton as ay be necessary to secure the co action of any unsanitary
is barn so
ull and void as on as a pubs sanitary sower becomes
n a putKIc water supply becomes available. Such approvals are
Health, such revocation. modification or change Is necessary.
Paimm COMM DEPARIIMW OP ' HMTH
DIVISION OF HEm TH SERVICES
.. ..:. -..� �.9- a "`.!tJ&-SH;I*, i -. _�t'�.'sc••: z'.,;" v".::.`'Lr e^�..�r•�. w': n "f ,s.,F.a,:� .,- ..�+s-.r•' ..ta +x°.'+51''.'' � _.:- jai- m';..•-- Ar�.a�.0 .:wm+a.is+: :a :'
Owrles AUGUST STERLING Address.'5Q -09 37th, ST.,WOODSIDE,NY
Located at. (Street) i .:C RE DAR DR., & HILLTOP DR. SW.., '.5.4 Block 4 Lot_ 11 & 12
(indicate nearest cross street)
muniCipalityPUTNAM VALLEY Watershed HUDSON R=VRRR
SOIL PERCOLAZZON TFST DATA REQUIRED TO BE S[J&IIT M WITS. APPLICATIONS
Date of Pre- Soaking Date of Percolation Test : 6/28/86
HOLE
NUMBER CL= TIME PERCOLATION PERCOLATION
Run Elapse Depth to Water. F rora
Water Level
he Time Ground Surface in._Inches......; . Soil Rate
Start Stop Min. Start Stop Drop. In Min/In Drop
Inches Inches Inches
112:00 12:30 30 16 .18.25 2.25 • • 30/2,25=13.3
_
212:31'1:01 30 16 18.25 2 , 25 30/2.25=13.3
31:02 1:32, 30 i.6 1.8..25 2.25: 30/2.25=13.3
4 i
5 •
112:05 12:35 30 is 8.2
21'2:36 1:06 -,� 30 16 1;8.2 ='. 2.'2 30/2.'2 =13.6
'31:07 1:37 30 15 .19.'2 .30/2'.2 =13.6
q
5 ..
3
a..
NO=: 1. Tests to be repeated at same depth uati7.' approximately equal soil rates
are obtained .at each percolation -test hole; • •:All data. ..to* be submitted
for review. - ........
2. Depth measurements to be made from top of hole. •
rev:' 9/85 ,
TEST PIT MIA RD'?UMM TO BE SUBMITTED" WiTFi _APaICma
H0i Imo?. -_ #2
o'y..•.�...<. .i: ..r�.Q.,-:.;{ v r.. _.. - .. .. -« a►z.....a.c.v- '..�cc.�;�MKr.,h :+EC-.i•P��•.vC; "e .lm .. .- w- ....•....a,- .w,.... .ems- .:..- �..e.- g-- ,,T., -z:', •.. ..o
h9'odAo, . 'T'QP SOIL - - — TQR SQI14 - - - --
10 SANDY LOAM SANDY LOAM
20 & MEDIUM STONES MEDIUM STONES
°.. It .
'o
10°
11°
12°
13°
- .
..x.� m_... . v —•6..- o.. <. _... p.. _� .... D.� !.� e.- aG'- .. r... .....a c . -•_ ..T .�q..r..aer.n. _.- ...- .qy -.. —. 0.... ®...a
MICATE LEVEL AT WHICH GROUND DER IS ENOOUNTEPM NONE
=,CATE IEVF.Ie TO WHICH b ATII R LEE RISES AFTER BEING ENMM '1°E M NONE
DEEP HOLE OBSERVATIONS MADE BY: JOEL L. GREENBERG DATE:
- - - -- DESIGN ,
Soil Rate Used 11 -15 .,in/jig Drope S oDo Usable Area Provided 50 00 SF
No of Bedgocms 3 Septic Tank Capacity,... 1000 gals. Type PRECAST CO]
Absorption Area Provided By 400 L.F. x 2480 width .trenc h
DER NDE GRC'�'/
Other 2 f t , BANK RUN FILL
• v ti �
o -
g, .JOEL L. GREENEBRG Signature -
Address MUSCOOT NO., RFD #2, BX 488 SEAL
MAHOPAC , NEW YORK:
.� NEB
THIS SPACE FOR USE BY HEALTH DEPAEMIM ONLY
Soil Rate Approval sgoft /gal. Checked by Da te
PU'P mm qOUN'1'X ,DEPARII4fflT OF, 1 BFALTH
Y a.DIVISION OF F�Ai►TS SFtViCF:
DESIGN , :DATA SHEET- SUBSUFACE
5'EinIAGE DISPOSAL M _..:..:°
.._-. •. r .yam. kq.xm! '�. -.r-.
'ne,,,.a...ep,,. ,+".•a
., .
J .. ... {• icy+'. 2� t ..
-
6 .moo �- �'_4y:— .... - .
i August Sterling
.
Address...: .. 5Q ':09 .„ 37th;` St,..:Waodrdge' -
"
Ioxated at •.(Street) Cedar Dr. &, Hilltop : Dr. $�, � 54 Block 4 Lot 11 &12
'
.
Undicate'nearest ' cross` street) *' ;
Municipality Putnah�' Valley'' Watershed Hudson
•
SOIL PERCOLATION TEST DATA TO •
RDQUIF2E1? BE SUBMITTED WITH APPLICATIONS
Date of Pre- Soaking
` " ' 6/2886,
Date of Peroalat�,on Test
HOLE
• N[�18FR ..: C?AClC TIME..:...
: PIItCL1hATI0N :.PII2COLATION
Run Elapse
Depth to Water Fran Water JAvel
:No. : , TUVe
:Ground Surface . es Soil Ra
..:
N Start. Sto Mina..
P
P
Start „Sto x y` . Dr In Min/In Prop.
P..
• 1 ... :., ...
.. • '- ,t•
,T..,A�
(ales. :, ''... .:'.Inches .. • ,.:,. ..:,InCheS ,.
131
1'12.00 '.12 :30 30.:.
'
1.6 18.,. 25 2.25' 30/2:'25 1 3` 3
°212:31, 1:01 30
16 . 18..25 2 BQ /2: 25_13:3
:._31:02. '.•1: 3.2 ' : 30
16 . 18:25 :.:2.25:', ..,,., , 30/2.25 -13: 3
5. _ ... . .
35 30
16. 18 2 2.2 :..: , ,..., , ..;30/2.2 =13.6:
3 �! 30/2.2
=13. 6
r
.:.31:. :Q,7 ::1:37, 30::. r
.;:• 16 ;: ,. 18:2 �;? .'.•� ': ±2.2 ;',, � : - 3.0 %2.2 =13:6:
..
rn
.;. i 1% iar -
j
e
i t
Sri
r
i
,sts to. ;be repeated`at same "depth :un
.Te approximately, equal soil rates
r : are obtained at
each -kpercolation test hol a All-, data, °; be submitted '
y for' review.
o? b , :to•
S SS"
Depth measurements to be made :'from top of male.
TEST PIT DATA RDQiIIRED. TO BE.'SUBMITTED:.WITH•APPLICATION
DESCRIPTION OF SOILS,,F.[�I000N'TERED `,I1V:''TEST. HOLES
HO? NO -_ #i
HOLD; NO - FiGiIE.-f
_ _ _
r .p.t 'if•. � ,y .!�mr.mn.ip: ` +�i n .+at -- a� w. . R J�wowr w.. AC9' 3r•- Yti..:s.^ll !4 "�w�`�� .- ti ..4`'� � -n ��- .wt -.• y..0+
GoLm , 6n; soil
Top soil_
1 saucy loan
sandy loan
2° & mede` stones
& mode stones
i°
6 0
?.....
c
Ili
8°
i
9° :
1
to
Ail-
1
12°
INDICATE LEVEL. AT WHICH GROUNDWATER IS E.NOOUNTERED None ;
' A
INDICATE IBM TO WHICH WATER LEVEL RISES_. AFTER BEING EN00UNTFREll ; .norie
DEEP ROLE .OBSERVATIONS MADE BY:
Joel L, Greenberg DATE: 4/15/86
fail: Im
DESIGN.
Soil Rate Used `11 -15, Min /1l,
Drop. - S De' 'Usable Area Provided 5000 SF
No a of Bedroci�s 3
o
Septic Tank Capaci, 1000 cone o
480 LoF. x 2
Aba ta.oa� Area Provided B 40° widtia �ireneh
Y
,�
Other 2fta Bank 'run fill
R
�.'
Jp
P
Joel L' - Greenberg
O 0
Signature
Ad�ixess Muscoot North, RFD
#2 .'.Box 488 SEAL
r
Mahop.ac, NY 10541
o
HEALTH DPR T TES SPACE FR ,USE BY ONLYo KK
Soil Rate Approved
sgeft /gal, Cheesed by Date
WbLL UU1'irLL11UL1 BLruAl
DEPARTMENT OF HEALTH
Office Use Only
Division Of Environmental Health Services
STREET ADDRESS: wNi I ItY TAX'GRIO N M8 ER:
WELL LOCATION
rpein r- T _q Eutnqm 1Tq I I szy — —
NAME: ADORESSAU 67- k- Zb . I /
Pa IVATE
OWNER
01 T M;anop
GeElar Lake ]RE12
0 PUBLIC
�
USE OF WELL
_QQ.I4Q;_j1
191 RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIRI.COND.)HEAT PUMP ❑ ABANDONED
1 - primary
❑ BUSINESS ❑ FARM ❑ TEST/ OBS ERVATION.'. ❑ OTHER (specify)
2 - secondary
❑ INDUSTRIAL ❑ INSTITUTIONAL 0 STAND'BY ❑
AMOUNT OF USE
YIELD SOUGHT gpm./NO'_PEOPLE SERVED EST. OF DAILY USAGE gal.
AEASON FOR
771
5D NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST/OBSERVATION
DRILLING
0 REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH .4oQ ft
STATIC WATER LEVEL _49— ft.
[DATE MEASURED _b! 15/8
DRILLING
El ROTARY 0 COMPRESSED. AIR PERCUSSION ❑ DUG
EQUIPMENT
❑ WELL POINT 0 CABLE PERCUSSION 0 OTHER (specify):
WELL TYPE
1 ❑ SCREENED ❑ OPEN END CASING.. Q OPEN HOLE IN BEDROCK 0 OTHER
LIU
TOTAL LENGTH tL
MATERIALS: 3P STEEL 0 PLASTIC 0 OTH ER
LENGTH.BELOW GRADE ft.
JOINTS: ❑ WELDED READED ❑ 0-1 H ER
CASING
DETAILS
DIAMETER in.
SEAL ❑ CEMENT GROUT ❑ BENTONITE jP OTHER
WEIGHT PER FOOT 1b./ft.
DRIVE SHOE- P Y
LINER: OYES PNO
DIAMETER (in)
'SLOT SIZE
LENGTH
(It)
DEPTH TO SCREEN (It)
DEVELOPED?
SCREEN
FIRST
0 YES ONO
PETAILS�
GRAVE L
HOURS
BOTTOM
GRAVEL PACK
0 Y ES
DIAMETER
I
TOP
0 NO
SIZE.
OF PACK . in.
DEPTH ft-
OEM — It.
WELL YIELD TEST - If detailed pumping
It more detailed formation descriptions or sieve analyses
WELL LOG are available. please attach.
METHOD: ❑ PUMPED tests were done is in-
formation
DEPTH FROM �
I
� Water
well
❑ COMPRESSED AIR
attached?
SURFACE
gar.
Dia
FORMATION DESCRIPTION
COCE
ft.
I It. ling,
0 BAILED ❑ OTHER 0 YES .0 0 NO NO
meter
in
WELL DEPTH
DURATION
DRAWDOWN
YIELD
Lan
juriad cei
Fill
ft.
hr., min.
It.
9PM_
1 r,11
Granite
5
400
7+
WATER 0 CLEAR
TEMP.
QUALITY ❑ CLOUDY
HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS, ATtACHEDI'O YES 0 NO
STORAGE TANK: TYPE
#250
PUMP INFORMATION.
CAPACITY GAL.
TYPE Submer.
CAPACITY
WELL ORIU.M NAME Norman Anderson EFATE
MAKER ,.earn ind-ppm DEPTH
3 wire
ADDRESS 152 Barger St SlGfffMRE
VOLTAGE VOLTAGE — H p3 _/4
Putnam Valle
I y4jny
JOEL IA1'fl REACE GREENBERG
Architect D Town Planner
Two Muscoot North o RFD #2
MAHOPAC, NEW YORK 10541
(924) 628.6613 D FAX (914) 626 °2807
TO PUTNAM COUNTY DEPT. OF HEALTH
110 OLD ROUTE 6 CENTER
CA.RMEL ° N.Y. 10512
DATE JOB NO.
_7/_ 28 89 _ _ l ?..- i35. --^ 7F
LARRY WERPER
RE:
AS BUILT SSDS
MR. STERLING
CEDAR DRIVE
WOODSIDE N.Y.
> WE ARE SENDING YOU DI Attached .❑ Under separate cover via _the following items:
I >
• Shop drawings IR Prints ❑ Plans ❑ Samples ❑ Specifications
• Copy of letter ❑ Change order. ❑
COPIES
DATE
NO.
DESCRIPTION
4
7/28/89
AS BUILT LAYOUT FOR SSDS
THEJE `ARE'TRANSMi i 1 ED a"s* checked befow.'
* For approval
❑ For your use
❑ As requested
❑ For review and comment
❑ FOR BIDS DUE
• Approved as submitted
• Approved as noted
❑ Returned for corrections
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS ENCLOSED PLEASE FIND 4 COPIES OF THE AS BUILT LAYOUT FOR
MR. STERLING °S SEPTIC SYSTEM, ALSO PLEASE FIND THE
APPLICATION FOR A CERTIFICATE OF CONSTRUCTION COMPLIANCE.
VERY
TRTTT,Y
VOTTRS�
COPY TO
SIGNED:
PRODUCT240 -2 nEes Ina, Cmron, Man 01471. If enclosures are not as noted, kindly notify us at once.
I-
C. ----� 87.011 230
'Yorktown Medical Laboratory, Inc. CAB # -r
321 Kear Strect Date Taken: 2L lef Time!
,Yorktown
r« �'`•' e. ..% sue. =a War+..► He�,+h. ts �N:.
14)245.320:: Y � ,_11.y? .. R . Date RR'e.up:o?r': t.e:d � •a'_ �r.. ,;: Aiq 3 ;;•� T — ' �;•>
-
Director ':AlbcrtH.PvdovanilSl.T.(ASCP) Collected By:
Referred By:
Sample Location: /(C 70P 7)2 /1/6`
S dp •-0
L 4/0 0.0 h,6
LABORATORY REPORT ON THE QUALITY OF WATER
Phone # Py'L
Phone #
Repeat Test?
INORGANIC NON- METALS (mg /L) MICROBIOLOGICAL (CFU /100mL)
_ Acidity
Alkalinity
Chloride
Detergents, MBAS
y Hardness, Total
._ Nitrogen, Ammonia
Nitrogen, Nitrate
_ Phosphate, Total
Sulfate
'Sulfide
Sulfite
LIALS (mg /L)
GENERAL BACTERIA
_ Standard.Plate Count
(CFU /1.OmL)
M'EM /B$ANE FILTRATION TECHNIQUE
V Total Coliform
Fecal Coliform
_ Fecal Streptococcus
MOST PROBABLE NUMBER TECHNIQUE
Copper
Iron Total Coliform Index
Lead
"•� ii'uu�t _ _�� Pedal- Coliforms Index'
Mercury _
_ Sodium KEY FOR TERMINOLOGY
Zinc CFU = Colony Forming Units
MISCELLANEOUS*
_ pH (units)
_ Color (units)'
_ Odor (TON)
Turbidity (NTU)
N/A*� = Not._Applicable
LT = Less Than (< )
GT = Greater Than ( 5)
TNTC= Too Numerous To Count
CON = Confluent ( =TNTC)
NR = Non - reactive
• /�V;
Sample Type:
(check one)
Potable I
__.Non- potable _•
STP INF
STP EFF
_ Other:
Sample Status:
(check each)
Outgoing
r HNO3
_ HC1
H2SO4
_ NaOH
_ ZnOAc
_... Na2S203
Other:
}Incoming .
v LE k °C
_! GT 40c
pH. -LE .2 - -.
pH GE 9
pH GE 12
_ Other:
REMARKS /COMMENTS (For Lab Use) IELAP #10323
THESE RESULTS INDICATE THAT THE WATER SAMPLE @TI(OF (WASN'T) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO TH YORK STATE DRINKING WATER
STANDARDS, FOR THE PARAMETERS TESTED, AT THE COLLECTION.
�HESE RESULTS INDICATE.THAT THE WATER SAMPLE (DID) (DIDN'T) ( /A )fMEET THE
SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK S TATEkZ22NKING WATER
CODES, FOR THE ,AMETFAS TESTED, AT.THE..TIME OF COLLECTION.
Albert H. Padova
, M.T. (ASCP), Director
2 /86(Rvsd7 /87)RWE
PUTNAM COUiYN DEPARTMENT OF HF_'ALIR
DIVISION OF ENVIRONMRIM HEALTH SERVICES
Owner or Purchaser of Building Section Block Lot
.S 1 e-iLIiUG 1-lic,D104, (Inz?.
Building Constructed by
Location - Street
Municipality
ONE FAM P.5:
Building Type '
,5-�- 4- - / /q /2
Tax Map Number
UAtp t.v ®g-� au r
Subdivision Name
�d
Subdivision Lot #
GUARANM 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
repairs made by me to such system, except where the failure to operate properly is
caused by the willful . or - ne- licrent act of the :�:�,:p��nt : of the -bin d rr utilizing
_ _ . - - -- -- - -
The undersigned further agrees to accept as conclusive the detenni .nation of
the Director of the Division of Environcrental 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 buildincr utilizinq
the systems
Dated this _ day of 190 Signature
�--- Title
Ze-nexdl Contractor (Owner) - ignature
W -A
Corporation Name (if Corp.)
Q`�7> 09 37 4VF .
Address W p o D SI D is /l y i 3 i 7
rev. 9/85
mk
rporation Name (if Corp.)
/LI&I'y C_ /sett ._
Address /V-Y
t uvey �l_r. L��rrt. "!'1l N Date i i•('� .i�
- Ins b
STKE.T ICC3TION CWN -R Y
P tmMIT y -v q - TM a OR SUEOMSICN LOT a
13
N.
V.
CL. bur.
VI. OG�.LL
a. &x,
b. Ail
C. All
d.
e.
f.
g-
h.
i.
g3ctcflU ua—lc rial contains stones < 4" in di.auy-ater
YES NCI EN S
k.P "yG�.t�YT�T? -^ -. r.- e�bL+�.r,�h.w'.b�
a� x"5175 area loc3te3 as per a�rove3 plans
_
b. Fi11 section - Data of placement
2:1 barrier. I W—= AVG_DPTH
{
c. Natural soil not sari =,Ded.
I
d. Stone, brush, etc -, greater than 15' from SDS area_
e. 100 ft. from wat-*- course /wetl rids.
. E -- . E DISPCOM SYSTR4
a. Septic tank size - 1,000 1,250
b. Septic tank instal -I vii
19 •I
c. 10' : m, n = fron fcur_aa`a on
(� I
d- No 90° ben s; cle=nout within 10 fu. or 45° bend
I I I
e. DIS=T -=TIC% BOX
1. All curets at sa1-ma el evation - avatar tested
2. Prote`tE-d' bel cw f_cst
I I
3.. Mini= 2 ft.- crici PF soil between box and tr_nches
f. JEJNC'rICN BOX - rroc,---7ly set
( I
g. 1. re= ire ins ta? ? e3 D
( I I
2. Dist=ance to weterCOLrse a 'r-e -d ' ft.
3. Ins =al1-2 ac=rdinq to clan
4. Distance to ce_'lter
I Szl I
---
5. Sloce of trench accent able 1/16 - 1/32 " /foot. (�)
6. 10 f --t from vrcrertv line - 20 feet - four -Aa- l ors I
I I
7. Death of t=ench < 30 inches fran sarace
Wes) I
8. Roan al amad for ertarsion, 50% Imo-
I
9. Size of travel 3/4 - 1j" di ammeter 1
I I
10. Denth of Gravel in trench 12" minim= I
111. - Pine ends eccad
h. PLUX OR DOSE, SYST=MS
1. Size of v= chamber
- -
3. Alarm, vistr=l /audio
4.'Pumm e=_si?v accessible aanhole to grade 1
I
5. First bcx ba==led
( I
6. Cycle wi `ne_=sed. by E _._l th De^a-- u, °nt I
( I
est- t�— f 11 cw crcle I
I {
a. Eduse located rpr a =rcve3 clans. -,
k -
b. Nu=mber of bedroa rs
T.—Wall locates as rp-- a =_ roved plans
'
b. Distance from SDS area neasured 125 ft- I
I
c. Casing 18" above grade.
CL. bur.
VI. OG�.LL
a. &x,
b. Ail
C. All
d.
e.
f.
g-
h.
i.
g3ctcflU ua—lc rial contains stones < 4" in di.auy-ater
Csrtain drain installed according to plan
I
Car'ain d -c i n cutfa I protected & dir.to exist- watercou.rsd
{
Footing drains discnarce away fran SDS area
I
Surface water rrotection adenuate
erosion cc..ntro Drovsded on sloces crreata+r than 15 %.
PUTNAM COUNTY DEPARTMENT OF HEALTH NO. 734-88/24
J
COMPLAINT OR SERVICE REQUEST RECOIR U
TAKEN BY K. Vanacoro
CONFIDENTIAL
REQUEST FROM
ADDRESS
TELEPHONE CALL X IN PERSON LETTER
Mrs. Karen Cucher TELEPHONE
31 Hilltop Dr., Putnam Valley
ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public Water
Migrant Camp— Other
526-3467
Food Service
COMPLAINT OR REQUEST Neighbor is trucking in fill for landfill and dirt
2reyish color and full of garbage. She wants it checked out.
DfftESIONS: Rte. 6 to Mill St, Put Vly turn right continue on this to
t3F&994:e light eFess evpr- tQ ghwr-Q]; RGI
QQnti;p-;Q on- chu=ah to
sign turn right at stop to Oscawanna Lake Rd, stay on Oscaw. Lake Rd.
on left is Santos Country Store (Getty Gas) From.Oscawanna continu--e sfralg4E
b%jng built)
ACTION N DATE 6 - Rq
FINDINGS
FOLLOW Up INSPECTION (s)
DATE
Lq
FINDINGS,
PROBLEM ABATED
DATE 12 - ko-8E PERSON NOTIFIED
77
60
ESTIMATED TOTAL MAN HOURS SPENT
DEPARTMENT OF- HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
-- - AP-PjaICAT ON TO CONSTRUCT A WATER WELL
- ..> -._,- ^Y"-.. F. _ 3" r.. .;ioG .. n ±� � .. ..•,fir`.- -�;-: `s'.. -:�'.. „.. ^- r ^:'- �- -"^"". ., .... .,. .«. .,�. ' _...- _. ;,. :., ass ��^,':. -:.fie :•<
PCHDA PERMIT #�
WELL LOCATION
Street Address Town/Village/City Tax
Cedar Dr. &Hilltop DR. Put. Valle
Grid Number
WELL OWNER
Name Address
August Sterling 50 -09 37th Ave.
®Private'
0Public
USE OF ' WELL
1 - primary
2- secondary
®.RESIDENTIAL O PUBLIC SUPPLY •Q AIR /COND /HEAT PUMP
0 BUSINESS O FARM O TEST /OBSERVATION
13 INDUSTRIAL O INSTITUTIONAL O STAND -BY
'D ABANDONED
0 OTHER (specify
O
AMOUNT OF USE
YIELD SOUGHT 5 gpm /#
PEOPLE SERVED 4 /EST. OF DAILY USAGE 300 gal
REASON FOR
DRILLING
ANEW SUPPLY
OREPLACE EXISTING SUPPLY
OPROVIDE ADDITIONAL SUPPLY .
0DEEPEN EXISTING WELL
OTEST /OBSERVATION .
DETAILED
REASON FOR
DRILLING
Domestic water supply-
uppl
for new house
WELL TYPE
=X DRILLED ®DRIVEN
®DUG aGRAVEL
11 OTHER
IS WELL
SITE SUBJECT TO
FLOODING?
YES xxx NO
IF WELL
IS LOCATED IN A
REALTY SUBDIVISION,
NAME OF SUBDIVISION: Hilltop block on amended
map
of a portion
of camp lookout.
Lot No. 16 -20
WATER WELL CONTRACTOR: Name N. Anderson Address: Barger St. ,-Put. 11 Va]
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
NAME'OF.PUBLIC WATER SUPPLY:
YES XX NO
TOWN /VIL /CITY
,.:._,DISTL�_NCE: TO .- P- ROPEPTY. FROM vISI kREST wATED
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
[]ON REAR OF THIS APPLICATION ® S ME
Ae
(date) = ( igna_- re
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 ofjwater well construction,
the applicant shall:
1.
2.
3.
Date of
Date of
Permit
Pump the well until the water is clear.
Disinfect the well in accordance with-the requirements of the Putnam
County Health Department attached to this permit.
Submit a Well Completion Report on a form pro 'ded by the Putnam County
Health Department.
Issue: 9-3 19 G�
Expiration: Fj —3 9 Permit Issuing Official
is Non - Transferrable
PUMAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMFNMAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS
vr:- �'...o�: -:,. .::.��t�i* =e'er :�z *.2':i�"�'.. `,-: •- -- /���.,,�;a.�.W6n. ..- }rc...,... !s � �nr .,,';, - ¢ ... ....-
'` —'�4 uis'9rvYi". R':A$ i11.[ �[ �,:- u. �3Jr�si -d�:•..!'.t`ii..a� }�i. \�1M � .i /~....
DATE.
INSP. BY:
(Name of Own ) (Street ion)
INITIAL SITE IN ION YES NO COMMENTS
Wetlands on /or proximate to property.....
Property lines or corners found ... ................
Can estimate house location .......................
Will driveway need cut ................... ........
Must trees be-removed - note these ....... .......o.
Deep holes representative of entire SDS area......
Additional deep holes needed..... — ..............
Sufficient SDS area available considering driveway nn
cut, house location, separation distances,etc... 1�✓ �'`'
Adjacent wells/septics .......... ..........o....
D. H. 1 Lot- D. H. 2 Lot -
Depth to G-.W. A Depth to G. W. �✓ A
Depth to rock Depth to rock
DATE:
Soil Descripti on
0 ft.
- /
0
ft.
House SSDS located per approved plan...... .......
.
3 ft.
3
ft,
I 6 ft.
6
ft
9 ..ft.
Roan allowed for expansion trenches ...............
Over 100 ft. from watercourse ....................
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
COMMEM
House SSDS located per approved plan...... .......
Length of trench measured
Width of trench average
Slope of tile line and trench acceptable.........
Roan allowed for expansion trenches ...............
Over 100 ft. from watercourse ....................
Natural soil not stripped or SDS area
.unnecessarly graded........... .<e ..............
10 ft. maintained from property line and
20 ft. from house.... ... ........<............o.
Distance well to SSDS (ft.). ........
Numberof bedrooms checks......... ......... eal000. .
Stones, brush, stumps, - rubble, etc., greater
than 15 ft, fran nearest trench......°.........
15 ft. of peripheral soil horizontally
from trench ........ .....o.e..... >...o...<..o...
Boxes properly set.... ........ ..e...00 —c o — Go ..
Could surface runoff from driveway, roads,.
ground, surface,. etc., channel near SDS area.oa. .'
Does lot drainage appear OK Jn area of SDSeo,...,
FINAL GRADNG OF SITE ACCEPTABLE 0 0.
h-
PETER C. ALEXANDERSON
County Executive
1
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
June 23, 1987
Mr. Joel Greenberg
RFD #2,. Muscoot North
Box 488
Mahopac, New York 10541
RE: Proposed SSDS
Sterling
Cedar Drive
(T) Putnam Valley
Tax Map 54 -4 -11, 12
Dear Mr. Greenberg:
JOHN SIMMONS. M.D.
Deputy Commissioner
JOHN KARELL. Jr., P.E.
Director
Review of plans and other supporting documents submitted at this
time relative to the above - captioned project has been completed.
..- ....._.. ....L.t_ua��fitEi'�r•rC o ire .: •as , 01 ews.:, ... _.. ._ - -•- -. -. ..
1. Plan does not provide north arrow
2. Percolation and deep test hole locations not shown on plan
3. Standard notes 1, 3, 4, 5 and fill notes 1,2 and '3 not noted
on plan.
4. Deep test hole soil information not noted on plan.
5. Proposed contours must be shown on plan
6. Permit application notes not size to be 0.730 acre, actual
lot size is 0.572 acre.
7. All wells within 200 feet of the proposed SSDS and all SSDS
within 200 feet of the proposed well must_be located or a
note stating none exists.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Yo very %truly,
Robert Morris
Environmental Health Services
RM:pt
cc:RM
File
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
.Ua -... R .:6�x'"i"e .. .�aS .. .J'r -'?�: Yr�..aA �?1'i'�fwF.s+ —. . - � -r,.+. ,_ '�:'�y"., :, a... a-�••: :a ax. .,��.� .�+a .:�'�e.*..%9:,;yr i�r-. -a,ra ..T�x,cY^..a...--Aa�mwi�ua
Date May 20, 1987
Re. Property of August Sterling
Located at Cedar Drive & Hilltop Drive
(T) Putnam.Valley Section Block Lot
Subdivision of Hilltop Block on Amended map of a portion of Camp
LooKo:ut
Subddo Lot # 16 -20 Filed Asap # 121B Date 5/4/31
Gentlemen:
This letter is to authorize Joel L. Greenberg
a duly licensed professional engineer or registered architect XX
_ (Indicate
to apply for a, Construction Permit.for a separate sewage systems, to
serve the above noted property in accordance with the standards, rules'
or regulations as promulagarted by the Commissigner of the Putnam County
Department of Health, and to sign all neceassary papers on my behalf in
_connection with this matter and to supervise the construction'of said
_......_..w _.
system or systems in conformity with the Provisions of Article .145 or
1.478 Education Law
d�{OEO f }•ddo AS , # .
lic Health Law, and the Putnam County Sani-
_aEO a .
�RENCE
s
011056
Muscoot North. Box 488
�cxaress
Mahopac, NY-10541
414 _ 628 -661 3
Telephone
Very truly yours,
Signed liell J_ L '
( r of P ,party
50 -09 37th Ave.
Address
La ) i
Woodside, NY
718 -651.= =6744
Teleg�ione
-y
COMMENTS`
OF Hh:LU11Y
WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
(% REVIEW SHEET CONSTRUCTION PERMIT V
�- DATE
BY:
'. .. _. (Street Location)
trench provided
required
60 ft. max.
Parellel to contours
S
Permit Application
Corporate Resolution
Plans - Three sets
Engineers Authorization
Design Data Sheet (DDS)
Deep Hole Log
Consistent Perc Results
Perc Hole Depth
s/s .
SUBDIVISION -
Perc -
(3) Fill -
cd
House P1 s Two sets
Well permit; PWS letter
Variance Request
GENERAL
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Town /DEC Permit R & D)
Data On DDS Plans & Permit Same
REQUIRED DETAILS ON PLANS ...°..__ -.°.._,.__- .- -_._.,
Sewage System P1 north arrow)
Sewage Systan Hydra is ro 1 e- - ravi.ty 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: perc and ee res
Two-Foot Contours Existing*& Proposed
Driveway & Slopes Cut
'c�tinq.GGittPr,Curtai:: Drains :.(di.scharge.. OK)
,
Perc & Deep Holes Located
Representative of primary and expansion
Expansion Area;shown;gravity flow,suff. size
If Pumped Pit & D Box Shown & Detailed
House - No. of Bedrooms
Wells &-SSDS's w /in 200 ft, of Proposed Systems
Property Metes & Bounds
House Setback Necessary (Tight lot)
--House Sewer - 1 /4 " /ft. 4 "0; Type pipe
No Bends; Max. Bends 450 w /cleanout
SEPARATION DISTANCES SPECIFIED ON PLAN
Fields
10' to P.L., Driveway, Large Trees,Top of fil
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, Leader, Footing
351to catch basin,stormdrain,piped watercours
10' to Water Line (pits -201)
50' intermittent drainage course
Septic Tanks
10' fran Foundation; 50' to well
15' Well to PL
I
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERV.ICM
Date May 20 , 1.,987 s'
Re: Property of August Sterling
Located.at Cedar Drive & Hilltop Drive
(T) Putnam Valley Section Block, Lot
m
Subdivision of Hilltop Block on Amended map of a portion of Camp
Loo out
Subdva Lot # 16 -20 Filed.Map # 121B Date 5/4/31
Gentlemen:
This letter is to authorize _Joel L. Greenber
a duly licensed professional engineer or registered architect X� X.
(Indicate .
to apply for a Construction Permit fora separate sewage systems to
serve the above noted property in accordance with the standardaa rulasi
or regulations as promulagated by the Comsissigner of the Putnam County
Department of Health a and to sign all necessary papers on eny behalf in
connection with this ,natter and to supervise the construction' of said
system or systems in conformity with the provisions of Article 145 or
14 ?, Education Law
taary Code
5
o to siSILO
:Zubiic Health Lawa and the Putnam County Sani-
.(BRED -4Rc
ENCE
n
�A'v ° 01105. {
Very truly yours,
S1griEsd i,o•
�L
j 0wr er of Pi
59-09/ 37th Ave.
Address
RFD#2 / MuscootN_orth, Box 488 Woodside,NY
Address Toaasn
Mahopac, NY- 10541
Telephone
718 - 651 -6744
Telephone
a
4f