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03391
Permi t PU27 80
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F h HER PUTNAMS ;COUNTY EDEPARTMENT, OF ;HEALTH
x . r+ Orwsfon of Enviro�menlal 'Health Services, Carme% N Y 10512
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GE�J'FOR.,SEWAGS4.M405S4 L ,....�..W
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' - Boswell` Estates "Su & ,page Filed Mai
r Z
' x Bwell Road �`ry� s 4 i t �k #1238 21 os * r' i(aEc�tax Man 62 P':1 a A
fi e Located at
• 5 ,
}r+ta�n A & `al. r , r -� 'M ohs_ < a.• S 0� .x1937 °
owner �'McG1 -ii, Bu�'lders; :Inc y 1 y dot ���1�" b Doti
x r r 93 Gl enei da Avenuet Carmel ,NY 1051
, 2
�Addr.,S ) '
Separate Sewerage System built by a
is 4 1.,,t (,� 1 x+� -� � �
l k.'_ e2� k...k...�2 ,`M1Mt3.O:J; vi li., ,:,..we.. ��.'.v'�.roN 1 ';" Lr.:.,J i.h �f244 �� Sr'7.)�i" iT. iS :✓_'fit?`* ,
5 Consisting ;of Gal zSeptic Tank 1 al ,Feet, X
t w* tine .3` -
width. trench
None � '
Other requirements
i.
x v t
ts
J.. Water SuPPIY �` `x.r F `Public SupPIY:,From
:+ + i F §
w rjX jBoydWe31,1 SDrmxllers Inc:, 'j
PrvVate{ SUPPIy Drilled'' By �� y
J R'te52 Kent N.Y 105'12 x
_. n Address Y' f n 4 d fY erz a Yy m 9 "�i. NOV
'Y
Z166-
Buildin T e -. `of B oms � x D ,
Has Erosion Control Been CompletedN
�. F. .
eted.,wo %kco les of which are,,
l dcertif +that he s stem s) as listed serving the aDovepremrses were constructed essentially as, showneon the plans of the comp) ( P .
Y y ( « `" `5' r ``ulation ' lens filed °`land ",the7permiY° issue :" the "Putnam i,County, :Department of-+,Heakh.
r 7 a s in accordance with the Standards, rules and eg s, p
attached) and
"¢
1a08te 3 d c ro h e C @ftified by Y „ .. c k . ;P E
,N :ry { y r. �f� n"1 i � 3 r ,, � @M A � � a J xi •.. g t a%s � i ��t �� �;� �� ria^4 .c .R'?*f'`�`�11r r Y rl�O.�V a x ^did 1 Y'
rme N 2t 2920
r F rY Address'„ License ,No
` -` Any ,person occupying °premises! °served by the above�system(s).shall promptly take suchaction as may be necessary to severe the correction oYany unsanitary
" ' ' a "" `rV �� `were a "~stem`shalt'Decome,null andrvoid soon as aspublic ^sandary•'sewer,.become;
conditions resulting from such usage `Approyaarof^the, sepa ate se g� sy v x a x•.a_as y M1 - r
.- i��availab�'le..aritl' "ttie �8 "`rrovals'ofw�the-: iv t %water`._supplyshall�b Ce ome +�Ulf'and �void�`wtien ,a public` waterEsu y ecbmes 'available "' Such,,, approvals -'are"
subject' to modification or change when in the judgmentofttieCommiss�ofHealthu "revocat' otiif�cation.or change. isinecessary
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NANCO ENVI`RO'NMENTAL SERVICES; 31NC
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�= UIVITY.STREET,'A1 ROUTE
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ADDRESS �46UUt?IiA ieW `,Ga +de opts, 32 dli �z3r�:eA�i1lI `�rco
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SAMPLING POINT ®seWl EStat�,�4$tatn�to-in
TREATMENT:- CHLORINATED ❑( `PPM) 'SOFTENED ❑ OTHEfl' ❑
OURCE DRINKING WATER`❑ WASTEWATER EFFLUENT ❑OTHER -
Y
COLLECTED Bl �IcGtascca .TI.NAE : P M` DATE <S 1 R S21 _
Cl, APARTMENT COMPLEX o: INSTITUTION . ❑ PRfVATE'RESIDENCE ❑, SWIM POOL' '
'BEACH: OlMUNICIPAL ❑ RESTAURANT _ OTEMPOHARYRESIDENCE
❑ ,CAMP x;c ❑ NURSINGHOME a ❑SCHOOL " va ❑TRAILER PARK n
{
`;FARM LABOR CAMP', O PRIVATE COMPANY O SEWAGE TREATMENT PLANT R ❑OTHER
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_
_
TOTAL COLIFOFiM COUNT M F T .� PER 100 M L,' ❑ TOTAL COLIFORM COUNT M.P N PER 100 MI.
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O COLIFORM COUNT M F T r { PER 100 M L; O FECAL CQLfFORM COUNT M:P N PER 100 .
:FECAL _WL.
I O: FROZEy "DESSERT PLATE COUNT -` -e ❑AGAR PLATE COUNT PER •1 MI.
LABORATORY TECHNICIAN ;; _ T DATE EPO TED: LABORATOR DIRECTO R ,�
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I
LL COMPLETION REPORT PUTNAM COUNTY. DEPARTMENT OF HEALTH
Division 9i Environmental Health Services
COUNTY OFFICE BUILDING CA13MEL, NEW YORK
1ltls report is to be completed by well driller and submitted to County Health Department together With laboratory report og :s
,$ analysis otF inlater sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is Issued. '
�.o- •,:.m.�,.;�>.• - .- �' S?�-•' B��UB{ yil�` PC-, �' 3<- IAIF' T"ritiV�3�i'= "�:tfNi6�'I?'fiP(� �;: .. :Q�..> .'�'Y
"`
NAME
ESS
OWNER .
M G1 son Builders Inca
7D'
3 Gleneida Avenue.,Carmel, New York 1061
40cA>I� �x
(NO & Street) (Town), (Lot Number
a tKr� y r •,:_ ' " 'z •�) ? .Fi r•, ,g C
> �} , _,, .c.� . .w,
,, �
.,: i,• ti i •: -
' :.;s
- if am
® ❑ ❑ ❑
P1d9®OSE®
DOMESTIC ESTABLISHMENT FARM TEST WELL
We of
W&B11
❑ ❑ ❑ OTHER
SUPPLY CONDITIONING
I
COMPRESSED OT
❑
D'
.'EqU D�1EN4 0.
ROTARY AIR PERCUSSION PERCUSSION l
CASING
LENGTH (lest) DIAMETEP(Inchos) WEIGHT PER FOOT
1 E SHOE S NG p
�
... `d &TAt!S
--
WE
_ .
!v.l'.1.1,
Y:iwE9
� (( II HGi'i25
�J E-AiLED PUhtPEA LJ COMPRESSED
i •, ILL:i ju.A,,til,j
Tr SY
l?J AIR 8 hr
18 18
+u's•
�frt
MEASURE FROM LAND .SURFACE
DURING YIELD TEST.'leaf)
t�.pth of Completed Well
�VATR
''
? ,'
total drawdown
below Land, surfaces 4101
I.A." a
MAKE _.
LENGTH OPEN TO AQUIFER (feet)
+
SOY SIZE
DIAMETER rMches)
GRAVEL SIZE (Inches) FROM (leaf)' TO (too()
t F
IF, GRAVEL
Diameter of well including
PACKED:
gravef pack (Inches):
a PR01d LANG 30fACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks., e '
; HE
�+
,
i I
t
If yield was tasted at different' depths during drilling, list below '+
GALLONS PER MINUTE;,
+
f.i
� afi
TED DATE OF REPORT' WELL DRILLER (Signature)
i.9 27 ` 19 1
e
I I
Owner JVu.rq4Akqe:i1 Of Puilding'
cipality
ec, on r _Saw6t.,
,iAipll RrUa+-r. S11hd JQ-t-#49
Filed Map # 1238
LP t
GUARANTY OF SEPARATE -SEWAGE- SYSTEM
I represent that I -am -Wh011Y And completely reqponp
tble for th
location , w anphip, material, construction
,qrkm e
d drain.age of the se waaA
disposal syptem serving the above described p.roperty, and that it has 1"77
constructed as shown on the approved plan or approved amendment thereto,
and 14 Accordance with the standarda, rules and regulations of the p-utnajM
County Department of Health•t end *hereby .guara
nt7 to the corner, his succes-
sors,'. heirs --or assigns ' to
place in. good opeirating condition any 'part of
said system constructed by me mhich
fails to operate for 4 period of tw
o
years impd1ately following a initial date of ihit.L use of the sewage
disposal
system, or. Any repairs ma4e*by-me to, such
_7 system, except where the failure
to operate properly is caused by,the willful or nag "occ'
negligent -Act of the U..
pant of the building utiliz�ng the'systam.
The undorsigne'd further agrees to accept . as conclusive the do-
tippmInation of the Director. of the Division of Environmental Health !rte
vices of the -.Putnam-_.County--Dsprtm -
a arilt. -of Health a-s i to wh or
a 8 ph
fkflfli�o- of - -tho i t fz� caper
ate exi .6 8 willful or 'e Agent
Act Of the ooqu. -e cyst, .pant or the building utilizing th
4qtp4 this, fourteertt4y of August 19 81 signatu
Title
T"corp,
And address)
VjR94 (3) COPIES ARE REQUIRED WITH THRE4 (3) qOP194 OF FINAL PLANS.
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR -IS RE, SUIRZD
TO FILE
NOTICE OF DATE OF FIRST USE OF SYSTEM.
DIvlpiqn of -
nviroamental Health Services, Putnam County Department o.04 Noptith
M'cGlassoiTde�, 'T"
OL
'6r;.01r1.FU,r-0.u44er or BU-1- TEE
c 1p4lity'.
wner Boswell Estates, Sect.B",Lot #49
_1 AIA 36ctlon Filed #1Z33
_56tz_a By
Boswell Road Tax Map 62 Plat II---- -Block 9
Frame
Lot
GUARANTY OF L SEPARATE SEWAGE- SYSTE1,11
U -ly and completely re.,,4poq4.ible for this
ropre4ent that.. I am whol,
loc.WonR workmanphip, material, construction and drainage cf the
sewage
disposal syptem serving the above described propertyS and that it has been
constructed as shown on the approved plan or approved amendment thereto,
and In accordance With the standards, rules 4nd regulations of the Putnam
CoiAnty Department of He Iths and hereby guaranty to the owner, his supces-
spra..heirs or 4psigns, to-place in good operating condition any part of
said s.y4tpm constructed by me which fails to,.operate for a period of two
yoO,Lrs immediately date of !nitial use of th
.qdiately following the a sewage disposal
system, or any repairs, made by me to such system, except where the f . ailure
to oper4tq properly is caused by the willful or negligent, act of the occu-
pant of the bt;ildipg utilizing the system.
Thp, undersigned further agrees to accept as conclusive the do,-
termination of the Director of the. Division of Environmental Health 4er-
-mant. of Haa'th a _'�to -`tAi6'thar' _1
I S. - no t' the
,n .-Co-iin ty �Dspart
#�� or
failure of the system to opeArate was caiiRsd by the will,ful or
ell fgbnt
act of the oqq" ant or the building utill4ing the s yo t
e
dated this day of August
1981 Signatu
Title
it corporation,,
01vo name
and address)
THREE (3) COPIES ARE REQUIRED WITH T1 MU-2 (3) COPIES OF FINAL PLANS, PEFOR
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILIE NOTICF. QF DATE. OF FIRST USE OF SYSTEM.
.7,
- - - - - - - - - -
D vision of aiviroamental Health Services, Putnam County Department o!j' l3pg1th
i'
"AS BUILT" _0ATA.
Structure iocoled trom survey by surveyor noted beIOtv�._
° W66 located by: Surveyors suryey:_- _.-
/q3e o W611 dnilers're.pert
— See 1.4
m.esuIer6ants.� -- - - - --
•�,;1a � G�6'octors
T�
14r it, boxes, pits, aallenee'8 1pte,r•ols,iocoited• by: ContioWit:
£ n'q cn eei.
i H aOlth d Pt:
III \ / "'• Ptald inspection by: Hegllh dept
❑ date �1.^
!�i�rT.., /reJ- tf•'ni�ex4'tL. [a .+f r .. -_.__
(i� {\ w /r "'d�•t.✓�� 6'c-cAAr Enq:i_nenr : d.ot�
T �..� • -v_ I I { � I ., :,: , , .. fir .
3 ✓M�a.'o.,B.,e, n4 I'I'��
R � I, ' I � I 1 �.p� • t S h, ex NOTES -V T �' I ot• �'th
"" M
y�
Division of Environmental Health Services
IF
P;,
.r�
o at` SI Approved as noted for conformance with
cable H a Regulations of the
¢�Q.GT,pr• °• Putn County ealth Department.
gnatur D.a L+
e A C _- --31'_ -6 - C
A - F - -9 F - �lT --
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IV
ft
R I � o.' O ':S 2 g o • oo "!u - .99.58 • ������, �' --- - - ' �
o�.�IE L �' t2C A1� (5a r�•.� -w)` SAN RY SYS1 EM: UESIGN "��
t OWNkE? ` 1
Ii OLATION Street �12F,
To;tii'n.as}jr�gj/ i Go my =:al yre Setai!»
i *_ t
sua'oiyy.i�sloN�e �essss <''4(b1�1�$�eo43
81otk o� L, OT Ng_.
t ur
oQ a fad n 8x>"rsl s+ St s
ao.H.aaT's�.��: S'urveyoc.t Wilcst._ a fi tta T <
D.rdwn Rii•i�FDote�..�.�.8�lp�� Sce1s j�l �-�t JoipJeS019 7r ="v
` .I �l.ONN. H...PR!- ItilTISS
CONSULTING EP {6,Pf@irE�es`tfi.�aF
o pg2QaL
P
i;
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is
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PUTNAM COUNTY DEPARTMENT OF HEALTH
�+ Division of Environmental Health Services. Carmel. N. Y. 10512
CONSTRUCTION PERMIT' FOR SEWAGE DISPOSAL SYSTEM
LOCatad°at -- - Boswell, Road....:.... - - -�
Subdivision Boswell Est: 'Sect. "B" Filed Map 1238 B Lot 4,'
Owner McGl asson Burl ders , Tnc.
Building Type Frame Lot Area - -T3'J9 A
Number of Bedrooms Three Design Flow 600 GPD
Separate Sewerage System to consist of 1000 Gal. Septic Tank
To be constructed by Owner.
Water Supply:
Other Requirements
Public Supply From
f 1/-W ;I- S 49
Putnam Valley .
Town or Village
:_TPxrMap_62 -Plat. II.. 9
Lot 11 Job S-0- 1937
Address 93 Gleneida Avenue
Carmel , N.Y. 10512
Total Habitable Space 1160± Square Feet
and 375 L E. x 24" wide .trench
Address 93 G1 enefda Avenue
Camel, N.Y. 10512
X . Private Supply to be drilled by Boyd Well Drillers, Inc.
_Rfe 52, Kent, N.Y. 10512
Address
None
1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations o t e u nam
County Department of Health, and that on completion thereof a "Certificate of Construction Compliance "_ satisfactory to the Commissioner of Healthwill
be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will
place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following thedate of the issu-
ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above
will be located as shoimn on the approved plan and that said well will be installed in accordance with the standards, rules and regulations of the Putnam
County Department of Health.
Date 18 November 1980 Signed 3k OE P. E. _X— R.A.
Address R.D. 9 Fair t et, Carmel , .Y. 1-0512 L• ense No 29206
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued un
revocable for cause or may be amended or modified when considered necessary by the Com
requires a w permit. Approved for disposal of domestic star sewage, an or priv e
Ilk
Date Rio By M J
is
truction of the building has been undertaken and is
Health. Any change or alteration of construction
pply only.
Title
Gentlemen:
PUTNAM COUNTY DEPARTPIEN T OF HEALTH
-OF - .ENVIRONMENTAL HEALTH SERVICES
Date 29 October 1980
Re: Property of McGlasson Builders, Inc..
Located at Boswell Rd., T. Putnam Valley
Section 62 Plat III Block 9 Lot 11
Boswell Estates Subd.., Sec. "B ", Lot #49
This letter is to authorize John H. Prentiss, P.E.
a duly licensed professional engineer X or registered architect
(Indicate)
to apply fo.r a Construction Permit fora separate sewerage system; to
serve the above noted property in accordance with the standards, rules
or regulations as promulgated 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 supq.ryise the construction of said
system or systems in conformity with the provisions of Article 145 or
14 7, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
s E e, R o A e, #_299206
R.O. Q, Fair St.
Carmel ,.NY 10512
914 -878 -6170
Telephone
Very truly o s,
Signed_
Owner of Property
93 Gleneida Ave..
Carmel, NY 10512
Address
914- 225 -7964
Telephone
THE OFFICERS SHOWN ON THE CORPORATE
AFFIDAVIT ON FILE WITH THE PUTNAM
COUNTY HEALTH OtPARTMENT-NAVE NOT
BEEN CHANGED SINCE SUCH FILI�
I
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF. EUVTRONMENTAL HEALTII SERVICES
Y_
DESIGN DATA SIEET- SEPARATE SEWAGE-DISPOSAL SYSTEM FILE NO.
Owner McGlasson Builders, Inc. Address Boswell Rd..
Located at (Street Sec. 62 Block_ 9 Lot
�Indicate.neare.st 11
-
cross street) - Subd. Lot 49
/160'0-±
A 33 9 -4.
�C3NL1�'_ OF;ICE . BIZI I:ILI G;: CAI;L; _N
Municipality Putnam Valley Watershed Q� 'il _
.SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH AFPLICAT1:Oi °�
Hole
Number. CLOCK TIME PERCOLATION PERCOLATION
Run Elapse Dep h to Water •,ater Levei
No. Time From Ground Surface in Inches Soil Rate
-Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
2�OG7
3 1,016
/D
.4 p y.
o Z
-
5
La/9
1,630
Z-
4_-o5c /D¢L /Z > 4-
1
Notes: .1) Tests to be repeated.a,t same.depth until arr.�roximatel equal soil
.rates are obtained at each percolation test hole. A1y data. to be submitted
fo :.- rev .-i -ew. .
2) Depth mcasurements to be 'made from top of hole.
i
TEST PIT DATA REQUIREM TO RE SLR(. PPfTTFD 1:'_I:TIF AI�PLICA'.f'ION
DESCRIPTION OF SO7L::> .F?t'JCOUT ?'.i.'!;F;i.,D I11 i'1?ST HOLt?S
DEPTH HOLE NO» HOLE NQ. HOIT N0.
6"
12"
18"
24"..
30"
361
42"
48"
5411
6o"
66"
All
a
7211 VVI
78
84"
INDICATE =TEL AT 1,J` IICH GROUND WATER • IS ENCOUNTERED
INDICATE LEI1 L TO WIFIICH' WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY �Q,� f7- (/f ,� 7`✓ f�, /�� Date_ 11f
-~� DESIGN
Soil Rate UsedjLjLT._Min,/l "Drop: S.D. * Usable Area Provided
No. of Bedrooms r Septic Tank Capacity p0 Gals. Type /�cyse,,,, -�
.Absorption Area Provided By_��L.F.x24" width trench.
Q1�0FE` --- Nql� Other / o4e
Name
o�Q166
Addr. ess �i! w .0 Fair St
» . Q a Q �c
THIS SPACE FOR USE BY FEAUI'H DEPARTME-111T
Soil Rate Approved Sq. Ft; /Gal.
a
% 2920"
0 Z_I" l•.. ;,F
;cf.ed bwf
Date
`+ ., .