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03471
i
a P[TIrNAM CODNTY DiWAY� OF 111 ACTH
Divlala� dEavbe�meatd HaaN6 Scrubs. C mseL N.Y.14M > to Prw ft Pasty g
dis C fflUf OF COMPiJANCE
Cp PMW FOR SEWAGE DWOSAL SYS= Fame / �� 2
Taws or v0qe
Sobdd. � k .� i`. - -c.. - - a., �;.: xi.,. v :::...•:.,�.a'y._._,;':?...�.. ,r z . :•i �." n ..
1 •C4+-
Rfinewnl,k0—Rrv1doo ❑
OwwedAyYcs>< Nswe OElIE2LtiP1VUEN`C _ G - 3 ftt
Date d Previous Approval - --
udiog Addl, lei �- 1 � / Town L-inC 4 ma zip T7 CDC
d T_..., e..1,A4 -4-4-n Annrnvcrl 1` ` (�) L-��) _Fee Encl.osedig Amnfmt lAW
Type t 5 t G� e t /�- _ Lot Area "S C- J - Fm Section Only D,. �S Vdlnme
Nltsbee d Bedroom 3 Doer Flow G P D PCHD Nodlestion In Bigobdd When FN Is eospl ted
Separate Sewesse Slates to comild of t g U Ga81s Septic Took and
To be alostrocted by la it1 �N� �� tJ Adlhea. 1 i11 K pa o cti N
Wets Sapptr: PiBe SW* From Address
of ,Q fthate s ppb Deed by k) kl\4l6� Address
ofber -
1 represent .that 1 am wholly and completely responsible for the design and location of the proposed system(%); 1) that the separate %ewag� disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with the standard; rules au n% o ream
County Department of Mealth, and that on completion thereof a °•Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill
be submitted to the Departnnanl, and a written guarantee will be furnished the owner, his sucoasaon. heirs or assigns by the bulkier, that said builder will
Dyne in }rood operatkg condition any part of said sewage disposal system during the period of two (2) yeas Immediately following thedate of the Isew
ance of the appoval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above
well be located as - -'n on the approved plan and that laid well will be Installed in accordance with the standard% rules and repuTOTOns of the Putnam
County Departins of NNlth. P.E. R.A.
Date q- 3L-I Signed
- %t 1 3
Address ��� ��1'c } C Llcerae No
APPROVED FOR CONSTRUCTION: This approval expires two years from the d issued unless construction of the building has been undertaken and is
revocable for cause or may be amended or modified when considered necessary by, the Commissioner of Health. Any change or alteration of construction
requires a now permit. Approved for disposal of domestic sanitary sewage, and /or private wale► Supply only.
Rev.
10/88 wa By
Title
PUINAU COUM°Y D$PAfrll M OF 1;E"M _
d.� DIvYw d[l�vbwat�el HA�If Seedoeo. Car" N.Y. low � �i�G� OF COIIQIJANCB
LaaMd at 201-1 �.� �•� �Lx'f M p�`�f ` �/A I:E .. K .,
ar VRb v
s�ea.bda. No c.t..t Let I TM MeP `I 3 ,1'b !>t� 1 ■�, 4 `
co t1�4c p"m"' I:°d.ia° ❑
Date of Previous Approval 1 / 16 I of Z
I mftg A drum 2a -1 ?�:LtY S* • Town F EtL12-`(, Na 1't (o4 3
Date Subdivision ARDroved `I 951 Fee Enclosed ❑
Amnnnt
4i+rs Tyr �'` C1�t'�l,C,.l- Lot Area l , °1 PL .t
ff1PCHDN0d&@1IJ=1@ReQdNdWh@oFMkc@mpbI Sectier Dab Deph 3, S Vok � Soo °2•o e
Number d ��■ 3 Design Flow G P D b O y ad
SWsbw SOwga4p Syatts w amidst of loop tie-- Sep* Tw* said
To ba,c 'by %%-AVJ- -A0WIy Add.,,°ss__ uN4CIJ0 W IJ
Walar Sapper: Piddle SIB Fran Address
an 1�1 stings@ Sop* DOW by use � \Vb1..l t�j Add .a. V h1tL1�1t�1LitV
Odw 500 cy o- tt�r�e Ll- a)L ,�►2
1 Mwesent'.that 1 am wholly and Completely responsible for the design and location of the proposed system(s); 1) that these rate sew di YI system
above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a rpu ns o� %ii
County -Department of Health, and that on completion thereof a "Certificate of Construction ComplNnp" Otisfadory to the Commielensr of Health will
to submitted to the Department. and a written guarantee will be furnished the owner, his sw:eofeora. hen Of assigns by the builder. that old builder will
Dyed N 9004 .Operating a+ldRlon any Dart of Sid sewage disposal system during the period of two (2) yens immediately following the "to Of the anew
area of the approval Of the Certificate of Constructions Compliance of the oiginal system' or any repairs thereto; 2) that the drilled well descri0ed above
Will be 16rA*d as sfhdrsm On the aPProved plan and that said wolf will be Installed In accordance w lM standards. rules and rpu a ne of the Putnam
County oepartnNnt Of �Me K
Date �j 1 j%%j 1',f Signed P.E. R.A.
Adar.+r �u�t g�2i a i P. (c, �`�.3'
License No
APPROVED FOR CONSTRUCTION: This approval expires two years from the data i ed unless construction of the building files been undertaken and Is
revocable for cause or may be amended or modifNd wen considered necessary by the Commissioner of NaaRh• Any change or alteration of construction
requires anew permit. Approved for disposal of domestic sanitary e, a r e -water supply only.' �y
in / . ()eta `f� i By '- s �'"�'- -�
7.lt Lf2f2 '- -'- -"-"7 '�T�— yy� --- - -_ Title �
' ..'��+./ v t ♦�^ .M •up ....��•1 r.[..g: O.R.- '�..C3r�.'+i{`n n•Cr�.0 4• ►!.- s. ^.�[- a..�...� ..... a: .f... �'�...: ��r.:�.�ir. -.r ..�. ..q,;�.:n...{sfy. s•.PVC .. �..1'i�•.C'iti •.. .. h� �++�•r
/ PunUt[oovNr) MAld OWIDIPMU TB
,1.. w fSBI= OF
POD' lt0)! =WA= DIWOBAL BlsflBa[
t.•Md�t�
ALA 1 --A gcAC7 Two or va". �. ,
BtiMaltlw xr.. VIIJC�.!�� . � tic / Tills if" j 13 �� � 1 ..�
.0 user/Anhond Hasse. LIN� O�•/r'G1- oPr�EN� Go• NG
Dab d PievMw Affroval
*WftAiliere -_2�1 L1 T. Ll++L-6 �('teY N.a zip
aM .Op
Date Subdivision Q,po� Dyed � �P�1 �I-� Fee Enclosed ® nm� „nr �A�..��+roy
>~■� 4!e ��i l �� lot Ave. .1 `� L�`G } FBI &Rd= Oiab Depth .ULVehim Is -
Pitfi•r d lrie•r . ' DMip Raw, G P D s ftMd'd Wb•. M la eeatyleW
Si""&WNW *ON= is ei.it d t o0o Q” Nv a TO& M"
Ti IM:eMMMW i.by t.,1 K41)t=)hJ1- J Aalihea• uo Kr- Up
WSW Sop* Fain Aalaieea
an �Pdynb.Sa* DMW b L.it..) KNOWJhL -Ad&w
1 represencthat 1 am wholly aria completely responsible for the design and, location of the proposed system(s); 1) that tM a crate awe • dis Dal • stom
above described will be constructed as shown on the approved amendment there to and in accordance with the standards, runs an ►pu ons o •
OouMy D•pa ~t Of M•althr and that on completion. thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will
be fuelnttted to the Oapartlilaet. and a written guarantee will be furnished the owner. his suecea0n. Mks or assigns by the builder. that old buildw will
~ M good ep•ratblg oonditbn, any part of Sim "wage disposal system during the period of two (2) yews Immediately following the date of the Issu-
anle of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto+ 2) that the drilled wait described above
WO N IOCat•d ea shaven on the apprews peen and that aid well will be Installed in accordence with the standards6 rules and ree–US o sT—of the Putnam
County D•pa sTM of IIeeRIs.
Do" Z— Signed P.E. � RA..
Address License No
APPROVED FOR CONSTRUCTION: This a expires yea►t'tro M to Onlesr eoriru�t�n of the building has been undertaken and is
revocable for cause or may be amMided or modified when con ry 'by the C mmissionW of Health. Any change of alteration of construction
V. reeukea a p er�}mit Approved for disposal of don►estk a ego, and /or to water supply only.
AA
(• i
��P�UTN�AT M COUNTY DEPARTMENT OF HHEALTH
:r%- *' -•Y:. =t .; �,� : RG p ��• r. - L '�' �'i :i7' 3Y�%7�] 3 ��° 11
Y 7� a eszT':. ae
. CERTIFICATE OF CONSTRUCTION COMPLIANCE
PCHD CONSTRUCTION PERMIT # fV- I I -1 -Z-
Located at C Kyty-ow Town r V
-Ova= /Applicant Name37 CAff& l Mw gt% CAf-P; Tax Map ? ;1
Formerly.
Subdivision
Subd. Lot #
TREATMENT SYSTEM
Block ( Lot *1
18
Mailing Address 37 Coeo'T P,*1 lXD S5(<✓t.; ' lvq Zip /o`5r.Z.
Date Construction Permit Issued by PCHD
Separate Sewerage System built by *57 CA'rA� OW 904) i?3!Address SAC
Consisting of 1000 Gallon Septic Tank and 5-00 l-F 'Z' w i tf k654qi tr,J ZKE.-jcK S
Other Requirements: • S ��'�� Fl w
Water Suunly: Public Supply From Address
ME, � Private Supply Drilled by P F 13Y�L � 5�� �.5 0 � NG-. Address S+�e.�s�t� •✓'J I�'%
-Bull 'Type "�-•��'
Number of Bedrooms 2✓ 1364ft 9. Ral &d Has garbage grinder been installed? 6U0
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the Putnam County Department of Health.
Date: Certified by P. E. X R. 7 9r. --
Address /Nf i?r fit/ r.J.�+ ._v „� `, License # 1 �-5 1
f g.6'.5 t�L' � t V,5-4=7 -
Any person occupying premised served by the above s §stem(s) shall promptly take such action as may be necessary
to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage
treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval
of the private water supply shall become null and void when a public water supply becomes available. Such
approvals are subject to modification or change when, in the judgment of the' Public Health Director, .such
revoc ion, modificat' or change is necessary.
lk4 . % _ P
By: �,(` --' Title: Date:
White copy - HD ,ile; Y copy - Building Inspector; Pink copy - ner; Orange copy - Design Professional
Form CC -97
S
A
�UTNAM COUNTY (DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
e9l�oe�ti ®n
�OF ���R �T�YDO���T T�u'ij— ..53�f� �•C".:��:s6�I."�weAY'
Street address:
Church St. Woodland Estates
:]I Tit�lnl�.i ..•
Town/Village:
Putnam Valle
_. _r_�— — �_� —_
Tax Grid # ��
IMap'73.1F Block p Lot(s) .�
Well Owner:
Name: Address:
V.S. Co ration, 37 Croton Dam Road,'Ossinin NY 10562
Use of Well:
1- primary .: ;'
2- secondary
X Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
IlDrilling Equipnnent
X Rotary Cable percussion X Compressed air percussion Other (specify)
Well Type
Screened Open end casing X Open hole in bedrock Other
Casing Details.
Total length eft.
Length below grade 31 ft.
Diameter 6 in.
Weight per foot 19 lb /ft.
Materials: X Steel _ Plastic _ Other
Joints: Welded X Threaded _ Other
Seal: X Cement grout _ Bentonite Other
Drive shoe: X Yes —No
Liner _ Yes X No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes No
Hours
Second
Well Yield Test
_ Bailed X Pumped X Compressed Air
Hours 6
Yield 5 gpm
Depth Data
Measure from land su . ace - static specify ft)
30'
During yield test(ft)
400'
Depth of completed well in feet
465'
Well (Log
If more detailed
information
descriptions or
Ve AiiflSy�P� .. _
are available,
please attach.
Depth From
Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
2
Drillinq
in ove
burden clay and bmlders
2
Hit rock
at 2'
L'.y .
32
32
465
Drillin
in roc
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type sub_ Capacity
Depth 420' Model 5GS05412
Voltage 230 HIP i
Tank Type XW302 Volume 86
Date Will Comp eted
4 /2 /gg
Putnam County Certification No.
002
Date of Report
6/10/98
W I ller (se)
e
N i n';: t;xact location of well wtm distances to at least two permanent landmarks to be p9wcled on a stparate stteettplan.
Well Driller's NgW, P Beal ans, Inc. Address: 4 Putnam Ave. , Brewster_ NY 10509
Signature: Date: 6/10/98
co al; Vrt
White copy: HID File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
- c,<:;'.i�s: s. ,.- ,a.Sa:% :w"QU 3- w <w'",�e..'7si�'r %,�`,+� �..�..:i� ...�-0 ^� ^• norg '..�%n r.a �i»:i:':u v -t ���e "i,�;��'.r:� :�'<ar.�:.� iw- r`s�':m:sv:� :7f- ice' : C:. �..�.; - • rri.:+e : rt
nlanics Analysis Data Sheet
Form I IN
Client Name: P.F. BEAL & SONS Project Name: STANDARD
ETL Sample Number: 188064 -01
Client I.D. V.S. CONST. LOT 18 GMURCH ST PUTMAK VALLEY
Date Collected: 11- JUN -98 Matrix: 1 DrinkH2O
Date Received: 11- JUN -98
Comments:
Analysis
Result
Units
Method Analyzed
Turbfdlty: .:..:.. : 0 85. ::..
pH 8.2
Remarks:
1
7
Ti1::... 8
4500 -HB 11- JUN -98
l
315 Fullerton Avenue
Newburgh, NY 12550
16� AF Tel: (914) 582 -0890
e.... NYSDOH 10142 NJDEP 78015 CTDOHS PH -0554 EPA NY049 PA 68378 M -NY049 Fax: (914) 582.0841
U
-e ,. r:.. er.. r— �.. w...,+ �• c�c.. ..-- ._..�,..- .o..i.- •�_.«s..... e.,.a..- . ...- +wea�.:;�.�.,..s a,..� ...- «�.... <_..,n.. ..v. � ...so..:.� __ ...- . _ _ r r--a
.._ __ _ ., _ __ _ _ _ _. _ _.. ._. n -+•vin .- w— . ^io.,., �,� , �t ...e _
Severn Trent Envirote -st
The following data qualifiers are used to assist in the interpretation of analytical
results.
Unless otherwise indicated, sample passes applicable drinking
water standards.
(1) Parameter fails applicable drinking water standards
(2) Exceeds lead SWDA action level of 15ug /1.
(3) Exceeds copper SWDA action level of 1.3mg/l or 1300ug/l.
(4) The results indicate the water to be corrosive.
(5) The recommended sodium. level for a moderate diet is 270mg /l.
(6) The recommended sodium level for a restricted diet is 20mg /l.
(7) Hardness 0- 99mg /l soft
100- 200mg /l moderately hard
200- over very hard
a part of
Committed To Your Success Severn Trent Plc
NORTHEAST LABORATORY OF DANBVRY
�i,� .;�,,..�� ,,, :' >p'? r :�= �•��••ir,:;; -�,: ,. .�',,•', � ;;:�F'z. E�•:,� -,�� .e. _5_�,;.-•� _�.. -,.��- ., ,�-•« t•..;� ('�.,7(.,�,Prr );'H`(14Q14.. J�s�; =-'
39 -3 MILL PLAIN Roan - DANBURY, CT 06811 NY Cert: 11471
)203) 748 -7903 - FAX )203) 748 -0652
LABORATORY REPORT -- WATER SUPPLY TESTING
REPORT TO:
P.F. BEAL & SONS
4 PUTNAM AVENUE
BREWSTER, N.Y. 10509
DATE SAMPLE COLLECTED: 7 /10/98
TIME COLLECTED: 11:30 A.M.
COLLECTED BY: M. BEAL
DATE RECEIVED@ LAB: 7 /10/98
TESTED BY: LAB# 11471
REPORT DATE: 7 /10/98
SAMPLE SITE: V.S. CONST. CORP., LOT #18, WOODLAND EST., PUTNAM VALLEY, N.Y.
SAMPLING POINT: HOSE BIB AT TANK
SOURCE: WELL
TREATMENT: NONE
TEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL
CHEMISTRY:
Iron <0.03 mg/L 0.30 mg/L
Manganese <0.01 mg/L 0.30 mg/L
[Note: Combined Limit for Iron plus
Manganese = 0.50 mg/L]
_ . ml = milliliter .,., tng/L, = milligrams per Liter ND ° none detected NTU =Units I
* *Notification Level ** *Action Level l - " G _ - ••� _� _ , .:; ,.,
RESULTS BASED ON SAMPLES SUBMITTED: 7/10/98
(PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER)
Laboratory Director
� ra;
Cz-
Cn °N
*NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITHIN CT: 800- 826 -0105 •OUTSIDE CT: 800- 654 -1230
P UT
�* -��•: �,�,.��i� -f �;.::., .,s;;» :f � •.vii
GUAR
COUNTY DEPARTMENT OF HEALTH
E ENVIRONMENTAL HEALTH SERVICES
CIe.r<..,.ssa.A.�....:..t«...�
E OF SUBSURFACE SEWAGE TREATMENT SYSTEM
lub, Iric-
Owner or purchaser of I luilding
c/o 37 Croton Dam Road Corp.
Building Constructed by
Location - Street
Ags t PoiV
Building `type
I represent that I am w
construction and drainal
that is has been construe
accordance with the stain
hereby guarantee to the
any part of said systei
immediately following t
sewage treatment syste
operate properly is cause
system.
�- _.._... The undersigned further
Director of the Putnam (
to ooerate etas camas d b
e
General
Corporation Name (if cc
c/o 37 Croton Dam
Address: 37 C'rnton
State ossini
73t 10 1 4
Tax Map Block Lot
L%
Town/Village
G t,JcA 2 3
Subdivision Name
Subdivision Lot #
illy and completely responsible for the location, workmanship, material,
of the sewage treatment system serving the above- described propt:rty, and
d as shown on the approved plan or approved amendment therett'), and in
trds, rules and regulations of the Putnam County Department of He and
vier, his successors, heirs or assigns, to place in good operating c)ndition
constructed by me which fails to operate for a period of m o years
date of approval of the "Certificate of Construction Compliance' for the
or any repairs made by me to such system, except where the f iilure to
by the willful or negligent act of the occupant of the building utilizing the
agrees to accept as conclusive the determinatio 0
aunty Department of. Health as to whether ci of e i
the willful or negligent act of the occupan�t.�of b
the Ptablic Health
lur t the system
ldi gtili:;ing the
Day 2 4 thyear 1998 Signature:
a
;) -Signature
Club, Iric,
Qration
oad Corp
am Road
dip 10562
Title: President
Corporation Name (if corporatio:i)
Address:
State Zip,_
Foim GS -97
TOTAL P•02
PUIJTNA M •V 1C' rOJl� U ♦ N iTl\ RY D� EP'A1.� Rr T A M � •E. N�T .. � OF HEALTH
`R wr ifVlrlVN' E`
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # P��' (f -�ZZ
Located at G Kyrr� Town r Village KvTN.tu'l► A
owner /Applicant Name-37 CAKM thw 9P, C,00.¢; Tax Map 73,19 Block Lot 4'1
Formerly Subdivision Name
Mailing Address 37
Date Construction Permit Issued by PCHD
Subd. Lot # 18
Separate Sewerage System built by e &AdM� Pbq ftre Address SttV
i//
Zip /oSr.Z
Consisting of Gallon Septic Tank and 500 L.F 2 y< A-65041-2r,l 7�.-JGK�
Other Requirements: -&-s' O� �S� Fl f✓t,-
Water Suppb: Public Supply From Address
4 f tMa4L. ,
or: X_ Private Supply Drilled by .5, t N6-. Address BKews T� g
Building Type /rD�sJ77KZ Has erosion control been completed~?
Number of Bedrooms �; gM %4n i9e5i6dHas garbage grinder been installed?
M
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the Putnam County Department of Health.
Date: Certified by
Address l vsI .X
/? Po"
Any person occup
to secure the com
treatment system
of the private wa; '
approvals are sul.;
revocation, modif:
White copy - HD Fi
i
For-
a
:~ Cl -Cash
Check r .,
LTH DEPT ` 017 8 4 7
'8 -6130
n6 +o _�� '
, �. 1c!
Fl, a
! Y
0-
;J
NAM COUNTY DEPARTMENT OF HEALTH
DIWSION-.O.F-ENVIRoNMENTAL.UAL7H-SERVICES-
ZZ n:r.Y'vr�
CONSTRUCT PERM R SEWAGE TREATMENT SYSTEM
PERivltllll N
v
Located at C U CI P. or Village &vrr ✓RLr y
Subdivision name 4 C ?2 subd. Lot # _ ax Map 7316 Block I_ Lot _
Date Subdivision Approved q qf� /1Q- Renewal _ Revision
Owner /Applicant Name' 0QoTON PAPI Roi4D CBRh? Date of Previous Approval Mow, I
Mailing Address W C,00foy Q -/A kaa oZWIyg &&14161K Zip
Amount of Fee Enclosed i✓��1
Building Type ES /Ot�ITT1A1- Lot Area No. of Bedrooms 3 Design Flow GPD &0
FBI Section Only Depth � Volume
Seumte Sewer�ae System to consist of Ago gallon septic tank and r0Q 1-F a' wipF
.a �BsoR �N �,�AKHFS
Other Requirements: ,
To be constructed by Address Ui AUWA/
Water Supply.. Public Supply From Address _
- __- t': - z"- '........ _.,�. o..�._. ,....
®g._ Pnvate Supply Drilled by Address
1 r I
I represent that I am Wholly and completely responsible for the design and location of the proposed system(s) and that the
arate.sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will 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 park of said sewage treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
`- , . .
AddressX� IT - -syAy ING A LANt?S hfe &cjQ2&&e PC. License # aq3)
-zz fSfz&wST&iz lv toSo7
APPROVIEID FOR C0NS?3t.TC 101: 'I'�is a�proval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new pe it. Approved for ischarge of domestic sanitary sewage, only.
By: �.2�i' Title: r �' L. Date:
t)
White copy - HD File; ello co - Building Inspector; Pink copy - ner; D ge copy - Design Professional
\ - Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
W ►� ,jQ,FJ ENV�R, MENTAL HEALTH SERVICES _
f - .�z�':t:�:': •_ .a.r - ::Y v.�.Se's.:�.�.isi�.•* :7• «,fir .��'•�",�i:- ':.�.:�'- ..�'.�'. .n..:._.,:: -@ °' "'— -
/ aa+�••.t=_ , iT,.. rxTi 7^��!%"iw*^ii`iir`a�:Sa= s•t'$
CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PERMI
Located at 66c)PZ41 AQA Q Town or Village Pvr, l�n 1/�+'r- �-45`i'
Subdivision name LIAlcA2 S Subd. Lot # Tax Neap 73. /9 Block Lot
Date Subdivision Approved T ��9 Lic,gn Renewal _ Revision
Owner /Applicant Name 3-7CRp7b,, I A4en yAQ <g&A Date of Previous Approval
Mailing Address 37 j5Ag � ,OAM &AD Zip /056,2
Amount of Fee Enclosed 300,00
Building Type riAL Lot Area No. of Bedrooms 3 Design Flow GPD 60th
Fill Section Only Depth , S Volume % C•
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage Syltem to consist of Moo gallon septic tank and
Other Requirements:
To be constructed by i /I�;� t�u�✓ Address GknO
:...._.teic Sttnu . - Public Supply Fbor Address
Private Supply Drilled by _ Address
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will 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 treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
Signed :.
Address
P.E. R.A. Date L2088
G - License #
lqov-t#,� R' 'rd<- NY 1.0S0
APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new pe it A roved for di harge of domestic sanitary sewage only.
By: Title: sr.��' �} Date: 2j to e
White copy - HD File; Yellow copy - Btu ding Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
e VTNAM COUNTY DEPARTMENT OF HEALTH
DnqSRON OF lENWI18ONM ENTAIL HEALTH SiEIf W CES
<.. - ? f $, SON T �G�21`s?�,'I' LfJOC A- WA'1r'IER WELL
t,. z PCHD Pe'r - u .
'please print or type - -. _. ,. — . - - rmlt # ...����
WeR Location:
Street Address: Town/Village Tax Grid #
ckbfzz �l � Pur�g,� 11AL 9Lf Map 73,10 Block Lot(s)
WeH Cwimeir:
Name:
37 UaZv bAm AMO 401t,
Address:
37 eAa7cv✓ 44&1 R.,/J . OSSWI44-1 A-Y /DSK�Z-
U
Residential Public Supply, Air /Cond/Heat Pump Irrigation
- ms�
Business Farm Test/Monitoring Other (specify)
2-secondary
Industrial Institutional Standby
Amount of Use
Yield Sought gpm # People Served 4 Est. of Daily Usage ,2O gal.
Reason ffo>r
Replace Existing Supply Test/Observation Additional Supply
DrflUng
New Supply (new dwelling) Deepen Existing Well
Detained Reason
ffoir HDnUing .
WeU Type
Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ...................................... ............................... Yes_ No
Name of subdivision 4./,u CcmL 71 Lot No. AR
Water Well Contractor: +✓ '."4r t r✓ Address: !/ wi✓
Is Public Water Supply available to site? .................................. ............................... Yes No
Name of Public Water Supply: Town/Village
Distance to property from nearest water main: %y
Proposed well location & sources of contamination to be provided on separate sheet/plan.
v
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and 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 or their designated
representative 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. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED. FOR CONSTRUCTION.- This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam
County.
Date of Issue 101 q 5 Permit Issuing Official: .
Date of Expiration ® Title:
Pe>r>m>iit is Ikon- Tirensff irrra e
White copy - HD file; Yellow copy - Building Inspector;— Pink copy - Owner; Orange copy - Well driller
Form WP -97
//� �N S
T
�/ E
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_LA NDSCAAFAfidPl C.
July 29, 1998
Mr. Adam Stiebeling
Assistant Public Health Engineer
Putnam County Health Department
4 Geneva Road
Brewster, New York 10509
RE: Lincar 3 Lot #18
Church Road
Tax Map #73.18 -1 -41
Town of Putnam Valley
Dear Mr. Stiebeling:
This letter is to respond to comments in your department's letter dated July 10, 1998, and
subsequent discussions with Michael Budzinski, P.E. Due to your department's concern with the quality
of the R.O.B. fill on the above - mentioned project, our office visited the site to perform two additional
percolation tests in the fill pad. Stabilized percolation rates of 5 min. /in. and 8 min.An. were obtained
(data sheets attached). An additional visual observation concluded that the full 3' /z -foot depth of R.O.B.
fill was clearly brought to the site, and was typical quality R.O.B. gravel. In conclusion, we believe the
R.O.B. fill is clearly better than the underlying soil and has a faster percolation rate than the underlying
soil. The previously achieved 30 min.An. perc rate was obviously an isolated pocket.in the fill pad and not
representative of the entire fill pad.
Should you have any questions or comments regarding this information, please feel free to contact
_. ......, -: }Very truly yours,
l
INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C.
By:
Jeff ontel o, P.E.
r ineer
JJC /JMwfjms
Insite File No. 91147.318
07N98as.doc
1485 Route 22, Brewster, New York 10509 (914) 278 -4990 Fax. (914) 278 -6392
❑ 7 D ®Lavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -1742
www.insite-eng.com
DEPARTMENT OF HEATH
.Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278 - 6130 Fax (914) 278 - 7921
July 10, 1998
John Watson
Insite Engineering & Survey
Route 22
Brewster NY 10509
Re: Limcar III, Church Road, Lot# 18
TM# 73.18 -1 -41, Lot 918
(T) Putnam Valley
Dear Mr. Watson:
BRUCE R. FOLEY
Public Health Director
This office has received and reviewed the most recent set of construction plans for the above
mentioned project, on July 8, 1998; we would like to offer the following comments for your
consideration.
Review of percolation test data.of (April 30, 1998) in fill placed on the above
referenced lot show results in the design range equal to that of original recorded perc
results in existing in situ soil, (21 -30) minutes per inch.
n1 mu Qfe'Withih the 2Y-30 minutes per inch design range, with hole 91
at primary, 15 minutes per inch and hole 92, expansion at 30 minutes per inch.
Original record of percolation rate "Design" is at 22 minutes per inch.
Putnam County Health Department current polices and procedures require stabilized
fill percolation rate to be equal to or less than the soil percolation rate upon which the
design is based.
Caution should be noted in the adequacy of fill material being placed in area of
SSTS, to be in compliance with current Putnam County Health Department Standards
on fill material.
Please feel free to contact us if any questions arise.
ASB:tn
cc: Robert Morris, P.E.
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
ENGINEERING, SURVEYING &
LANDSCAPEARCH.ITECT(IRE, : . LETTER OF TRANSMITTAL
�.. s ".li'.5�:�: .,.0 •Z . -. .=P.C'• i.��:; ...- ai.�.._�+- �v w.�- .i'....R.•c'�0 ._Ri�G,.a„'1 >S +i�.. *.
Route 22 (914) 278-499(Y' ^ • -
Brewster, New York 10509 (914) 278 -6392
7 Del-avergne Avenue (914) 297 -1742
Wappingers Falls, New York 12590
TO:
WE ARE SENDING YOU
❑ Shop Drawings
❑ Copy of Letter
Date:
Job No. R 1 9 7 '5 ( 8
Attn:
Re:
[�ttached ❑ Under separate cover via
01-prints ❑ Plans
❑ Change Order ❑
COPIES i NO. DESCRIPTION
�°crr►srRvcrc
OD �i'1 pti51 DA�A- 5(4F-Cr
3� 8 cP -��
the following items:
❑ Samples ❑ .Specifications
THESE ARE TRANSMITTED as checked below:
_ . '�7 1- cr•appiovz' Gnpro Ngrl:1 Si ;il)i ltieO_. ,.. I1 RESUDiTIIl y R`1 ?lei ?:r•aL�pfCV21 - ^- .
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
REMARKS:
COPY TO: SIGNED: v
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
Lot98.dot
0
PUT NAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES --
AFFIDAVIT - CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT
To: Public Health Director
In the matter of application for: 37 Crnfnn nam RnAa ror'p
I, Val Santucci
represent that I am an officer or employee of the corporation and am authorized to act for:
Name of Corporation: 37 Croton Dam Road roxrp
Having offices at: 37 Croton Dam Road', "7r;0_Si ni ncr _ My 1056.2
Whose Officers Are:
President - Name: Val Santucci
Address: 37 Croton Dam Road, Ossining,. NY 10562
Vice President - Name:
Address:
Secretary -Name: Michel a Sariticci
Address: - ~37 Croton Dam Road, Ossining, NY - -10 -562
Treasurer - Name:
Address:
and that I am and will be individually responsible for any and 411 cts f th ora with respect
to the approval requested and all subsequent acts relating th4r�t I'lic"IP
Title: .
Sworn to before me this 1 3 ttday of
January (month) 9 8 (year�j
Notary blic
MeryAnn, Diamond
otary Public, State of New York
Qualified in Rockland County Corporate Seal
lNo. 487-1934
34
Commission Expires
Form CA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
L:r1 �i- �a.
T T Ea .Rir r.�. a' ey..a..... J sf..�:...,.Ey.'... v- n!r..+, as'N. a'.- y.•. n +.:iY:r.w<+- '.- +...:. : ��y:�.i.
LETTER OF AUTHORIZATION
RE: Property of St Theresa's Subdivision (�J-,Linear III)
Located at 4CRVACE AOAn
TN PM/pn IIALLZY Tax Map # _7 3,1 g Block Lot �. _
Subdivision of I-Jn/Co L
Subdivision Lot # I Filed Map # 24'33, Date Filed
Gentlemen: -
This letter is to authorize Insite Engineering & Surveying, P.C. (Jeffrey J.Contelmo, P.E. )
a duly licensed Professional Engineer — to apply. for the required
wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and to supervise the construction of said wastewater treatment and/or water supply systems
y` ...' F „1 :j A �....� ..it'7` rotiC�,� acxi hP
Qac.1'i' visions.. c) .,.e ., ,'u,,� -or -I..
Law, and the Putnam County Sanitary Code. T T t
Very to
CountersigneS61 Signed:
P.E., R.A., # A - E
Mailing Address Insite Engineering' & Mailing Address: 37 rre)4i6n•„n81m,-Road
Surveying, P.C. Ossining, NY 10562
Route 22
Brewster
State New York Zip
Telephone: ( 914) 278 -4990
10509
State New York
Telephone: 914-739-7362
Zip
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS
i'. - ;:rii��'.: _ t(r�. 66 ... T♦ ��S "�i�
i
STREET LOCATION NAME OF OWNER
REVIEWED BY �Wiqjak- c 7T, 4, P, 6L DATE 2
��ERMIT DOCUMENTS
APPLICATION
WELL PERMIT _ PWS LETTER
UTTER OF AUTHORIZATION
DESIGN DATA SHEET (DDS)
C`0 TE RESOLUTION
SHORT E , 1
PLANS - THREE SETS
HOUSE PLANS - TWO SETS
VARIANCE REQUEST
1-1 J
SUBDIVISION
SUBDIVISION
'ISION APPROVAL CHECKED
PERC RATE C
FILL REQUIRED - DEPTH
C TAIN DRAIN REQUIRED STANDPIPES
GENERAL
1,06ATED IN NYC WATERSHED
P NS SUBMITTED TO DEP
r EGATED TO PCHD
EP APPROVAL, IF REQ'D
DEFPTEST.HOLES OBSER :'ED;. =,
ARCS WITNESSED, IF REQ'D
APPROVAL SSDS ADJ. LOTS
WETLANDS (TOWN/DEC PERMIT REQ'D ?)
I TA ON DDS PLANS & PERMIT SAME
1969 NEIGHBOR NOTIFICATION
L ER BI/ZBA
I YR. FLOOD ELEVATION
Ji3'fHER REQ'D PERMITS)
REOUIRED DETAILS ON PLANS
SEWAGE SYSTEM PLAN - (NORTH ARROW)
SSDS HYDRAULIC PROFILE_ GRAVITY FLOW
CONSTRUCTION NOTES
DESIGN DATA: PERC & DEEP RESULTS
T CONTOURS EXISTING & PROPOSED
DRIVEWAY & SLOPES, CUT
FOOTING /GUTTER/CURTAIN DRAINS
� 9 1� jt� 'bat , ,
TAX MAP # -7 3• I g
PERC & DEEP HOLES LOCATED
REPRESENTATIVE OF PRIMARY & EXPANSION
f6CATION MAP
Pf ' AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
DUMPED, PIT & D BOX SHOWN & DETAILED t,�O
FUSE - NO.OF BEDROOMS
WS & SSDS'S W/IN 200' OF PROPOSED SYS.
P, PERTY METES & BOUNDS
PUSE SETBACK NECESSARY (TIGHT LOT)
HOUSE SEWER - 1/4" FT, 4 "0; TYPE PIPE
BENDS; MAX.BENDS 45" W /CLEANOUT
FILL SYSTEMS
2LAY BARRIER
P- FT. HORIZONTAL;SLOPE 3:1 TO GRADE /
FILL SPECS FILL NOTES`
FILL CERTIFICATION NOTEa
DEPTH GUAGES
/ILL PROFIL DIMENSION
VOLUME
FILL IN EXPANSION AREA
TRENCH r�
LF TREN ^I I P. ^.,VID n � (bO FTTvi X ®;P
PARALLEL TO CONTOURS
100% EXPANSION PROVIDED
SEPARATION DISTANCES SPECIFIED
ON PLAN - FROM SSTS
1' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL
:rO' TO FOUNDATION WALLS _15'WELL TO PL
100' TO WELL, 200' IN DLOD, 150' PITS
}00' TO STREAM WATERCOURSE LAKE (inc. expan)
50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
10' TO WATERLINE (pits -20')
50' NTERMITTENT DRAINAGE COURSE
200'/500' RESERVOIR, ETC. _150' GALLEY SYSTEMS
15'min to CDS= >5 %;10'- 4 0/o,25'- 3 1/o,30'- 2 %,35'- 1%,100' - <I%
20'min to CD discharge /I00'with 182 cons day discharge
SEPTIC TANK
10' FROM FOUNDATION; 50' TO WELL
FORM ST -2
.. _1
1
INSITE-0 SURVEYIN(ENGINEERING &
- P.C.
Route 22 914 278 -4990
Brewster, New York 10509 Fax: 914; 278 -6392
.�i"�' 2
Wappingers Falls, Ne! w rk 12 91 "Kx '".�
TO: ! �✓ l IIO
LETTER OF TRANSMITTAL
DATE
Jo
AWWtM N
CJ~- CKJ
RE:
Lr.vcA2 4a5Mtb5 1-67' /J6
/ /59% F104 3 -7
/Jn as 49x-a.°
❑For your use
❑ Approved. as noted
❑
Submit copies for distribution
WE ARE SENDING YOU Attached ❑ Under separate cover via the following items:
❑ Shop Drawings (� ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order ❑
COPIES! DATE NO. DESCRIPTION
..... ..... ...................... :........ ........... ...................... .................. ....... ............................... ...................................................................................... ...............................
...............................
.......... .................. .....�_? -p .................._.........__................... F! _.._.. .. ....... _ ... ..... ........__.... _..............................
1: _.................................:..............
... .8......... .......... ........ ...1 ..... T....................................................................... .............................. ......................:........
3
r
..._ ........ __........._ .. f �F'! v� °-_ Q.!, ►' ___�._.__.. ___... _.__._ .._ _.._ _._.......
............................. .................._.. c..:........... ....0 ..... _ ... u�► r,a,y ,�lti _ __. _...._.._.__.._ _ . _ ..._ .....__ ........ _......
l31...�
THESE ARE TRANSMITTED as checked below:
�<For approval
E] Approved as submitted
❑
Resubmit copies for approval
❑For your use
❑ Approved. as noted
❑
Submit copies for distribution
❑ As requested
[] Returned for corrections
❑
Return corrected prints
❑ For review and comment
❑
❑ FORBIDS DUE
19
❑
PRINTS RETURNED AFTER LOAN TO US
REMARKS:
COPY TO:
OR &u, ,
�I JAM
SIGNED:
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
r/
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
TT (914) 278 -6130
^ /,•C�i� 1..^� Bpi s�y..r "iil• � i �/ t:U`la J l��i:rf i°'71j ::..'@.:%. Yl>r _:+::i'.i Y'- .a�«ari.,:_, y,��a:..1 "'se�l n5?:i.
PCHD PERMIT .
WELL LOCATION
Street Address
CHV P4-
P
Town/Village/City
�.
Tax Grid Number
01 --- -- 41
.WELL OWNER
Name
W
Mailing Address
c.. ?_6f L.I
L 704-- Wrivate
,D Public
USE OF WELL
..l _ primary
secondary
RESIDENTIAL
0 BUSINESS
0 INDUSTRIAL
0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ® ABANDONED
0 FARM 0 TEST /OBSERVATION 0 OTHER (specify
O INSTITUTIONAL 0 STAND -BY
AMOUNT OF USE
YIELD SOUGHT gpm /#
® REPLACE EXISTING SUPPLY
EW SUPPLY NEW DWELLING
PEOPLE SERVED /EST.
® TEST/ OBSERVATION
® DEEPEN EXISTING WELL
OF DAILY USAGEaI
EX ADDITIONAL SUPPLY
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
DRILLED
®DRIVEN
ODUG
®GRAVEL.
OOTHER
IS WELL SITE SUBJECT TO FLOODING? YES __NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:1✓f��
Lot No. 1,45
WATER WELL CONTRACTOR: Name( Address:_
IS PUBLIC MATER SUPPLY AVAILABLE TO SITE: YES ___X_NO
NAME OF PUBLIC WATER SUPPLY: 9L TOWN /VIL /CITY
--,1
_ .. MTANCA TO PIPPERTY.. FROMf. PIEAREST WA:TER_. MAIN : �-
✓:.. —
LO TI0 SKETCH & SOURCES OF CONTAMINATION PROVIDED
0% 30 q N SEPARATE SHEET
(date) ( gnat r )
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
thirt3• (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.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a manner as not to degrade or otherwise contaminate surface or groundwater.
Date of Issue:
Date of Expiration
Permit is Non - Transferrable
3/89
19
19 Permit Issuing Official
White copy: HD File Pink copy: Owner
Yellow copy: Bldg. Insp. Orange copy: Well Driller
1
.. .w v: �S•r..JI•. C:.IY`_a: ..[ r � r,i �' li � w.. v �'. -..t.r �e �rti'.aiw•w.:': .`ia_v.iJ�.:.sc. f, •
1849, ROUTE 6
CARMEL, NEW YORK 10512
(914) 225 -6200
May 19, 1992
Pump Pit Design for SSDS for Lincar Development Co., Inc.
Lot 18 of the. Lincar 3 Subdivision
Design Flow 600 gallons per day
Use peak hourly flow 10 times average daily flow
Qpeak = (600)(10) 4.2 gpm
(24)(60)
Static Head ± 17 feet
C = 150
d = 211
L = + 190 feet
GPM = 22 gpm
Equivalent L (Bend & Valve Losses) _ ± 50 feet
Total L = ± 240 feet
Hl _ - f.e
_....... __._.- ,10.44 /Tnta�, C =P�h .5 t _ _
7 z
..,., .. .. _ ... , .. c,.; .. . `.i� Ste; ; ..,. � � .. _. , ., .. � .a. — .. .., r---. w.,. , ...� _ a.=. •v . ..... . �,..,__ ... .
Total Dynamic Head (17 feet + 2.5 feet) = 19.5 feet
Use Gould Pump model # 38714/10 HP (or approved equal)
This pump will pump 22 GPM with a total dynamic head of 19.5 feet
. ,i ,
F � 6
,MODEL
FEATURES
SPECIFICATIONS
MOTOR
Impeller: Thermoplastic Semi-
Pump:
o Single Phase: 0.4HP,115 or 230
Vortex design with pump out vanes for
o Solids handling capability:
Volt, 60Hz, 1550 RPM, built in over
mechanical seal protection.
3/4" Maximum
load with automatic reset.
Casing and Base: Rugged
o Capacities: Up to 55 GPM
o Power Cord: 10 foot standard
thermoplastic design provides superior
o Total Heads: Up to 24 feet
length, 16/3 SJTO with Nema 5 -15P
strength and corrosion resistance.
o Discharge Size:1 ' /z" NPT
3 prong grounding plug. Optional
Motor Cover: Thermoplastic cover
° Mechanical Seal: Carbon -Rotary
20',length, 16/3 SJTW with Nema
with integral handle and float switch
Head/Ceramic- Stationary Seat,
545P 3 prong grounding plug.
attachment points.
Buna N Elastomers.
Fully submerged in high -grade
Temperature: 140 °F (600C).
turbine oil for lubrication and efficient
Power Cable: Severe -duty rated
Maximum.
heat transfer.
aad_water.r . resistant.
p- FasteDers.�.3Q0,Series,Stainless
..___...�..�a ..
No gaskets to replace during
Capable of running dry without
Available for automatic and
maintenance.
damage to components.
manual operation. Automatic
Stainless steel fasteners.
models include Mercury Float
Switch assembled and preset
at the factory. .
APPLICATIONS
Specifically designed for the
following uses:
• Effluent systems
• Homes
• Farms
• Heavy duty sump
Water transfer
• Dewatering
r..,". c.,.- -.- t,,. Et'eytive December. 1 ?'-.
ti
10
8
9 -------------
4
3
i
2
PARTS
1.
Impeller
2.
Rugged thermoplastic base
3.
Rugged thermoplastic pump
5
casing
4.
Mechanical seal
5.
Ball bearings
-6.'
O-Rings
cord--
8.
Oil filled motor
9.
Cast iron motor housing/stator
21
assembly
10. Thermoplastic motor cover
PERFORMANCE RATINGS
GU 's
I L 1 ca, I)
6
Ix,7
d MODEL
;3B7
DIMENSIONS
(AJ1 dimensions In Inches. Do not use for cons"ion purposes.)
MODELS
fft I k , V
1 1/2 INPT
3 3/a .,
Series HP
Gallons
Total Head
Per
(FT of Water)
Minute
5
53
10
46
15
36
20
.21
24
1)
GU 's
I L 1 ca, I)
6
Ix,7
d MODEL
;3B7
DIMENSIONS
(AJ1 dimensions In Inches. Do not use for cons"ion purposes.)
MODELS
fft I k , V
1 1/2 INPT
3 3/a .,
Series HP
Volts Phase
Max. RPM Solids
Amps Handling
Power Cord
Length
Wis.
(IDs.)
EP0411
115
12
10,
20
EP0412
230
6
10,
EP0411A 4/10
115 1
12 1550 1/4,
10,
21
EP041 1 F
115
12
20'
20
EP0412F
230
6
•20'
20
EP041 1 AC
115
'12
20'
21
�7- ^,t C!.., r ",7 - , "n.n., SPECIFICATIONS APE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U S.P.
METERS FEET
MODEL: 3871
SIZE: 3/4" SOLIDS
0.
8
25
7
wg
20
5
95
4
®.g
90
2
5
9
0
0
20 30
40
50
GPm
0 90
10 12 m3/h
CAPACITY
�....
�G ®UL ®S PUMPS° INC.
SBC-CA FALLS NEW VCW 8148
l
Effective October, t 98E
p •c: c cyper P -'"rnr Inc SDFCIFlClTION.S ARF SUBJECT TO CHANGE IVTHOUT NOTICE PRINTED IR U.F t
PUf L'-,M COUNTY DEPARTMENT OF HEA H
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date SZK
Re: Property of 1114CAF M \,LDPjE14A C2. IWG.
Located at (X-}(,) P17, ,j''j %UEY
(T) 1�4,TA-Am ection '73,1F. Block Lot
Subdivision of L1NG/ `3UP�P1�%1�1pti1
Subdv. Lot # I�'j Filed Map # 2433-3 Date C1 29
Gentlemen:
This letter is to authorize INN-1. EVA 611AEEP1U AND LE5W EL
a duly licensed professional engineeror registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
c;oni—ctioii_ rim. M `t? iro mato er, and. to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,,`
Signed
Countersigned:
P.E. , R=A- ,
JE�f � �N1�LMb,PE.
16*T -- WONeMNa AND G�iGN .
Address
CirA - 295, (jp?c o
Telephone
r r ,poperty,.
POEM 00 INC.
Address
Lk #tx-- BEY, N� 1 tyl -
Town
:-)0/ 19+0 --f-1700
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date 5zgz��j.
Re: Property of OWCAr i�EVEL-bt" MEI-4i CO.
Located at Cj�{,j {� R.ttNAM YA U, ,EY
(T) /°&TNA/n Section. 73, / Block Lot
Subdivision of LIPIG/ �IiVriQl�l
Subdvo Lot Filed Map # -24.535 Date Q 29
Gentlemen:
This letter is to authorize MOW RI_
a duly licensed professional engineer or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards,,rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or' systems' iri'coritormity 'w"ith the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours
Signed
Countersigned:
PoEo, e, #
INaS WO NEEMWIJ AND MSQ4 , W
Address
VA 6
Telephone
Address
LIME MAY, W J INA?,
Town
:-> 6 / 440 - %-700
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services
AFF CORPORA`
FOR PE14IT APPLICATION SUBMITTED TO
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health
In the matter of application for-
ONO)?- PeyEwmwi WAW,
represent that I am an officer or employee of the corporation and am authorized
to act for
Name of Corporation)
having offices at %!)I LA?)tF*y fAj
!gjaWdU0ar r
Whose officers are:
President: 0 A,,,4 L/_) /V Ll &k G-C
(Name and Address)
Vice-?resident: (Name and Address)
Secretary:
(Name and Address)
Treasurer:
(Name and Address)
and that I am and will be individually responsible for any and all is of
corporation with respect to the approval requested and all subs nt t ing
thereto. F I-,
Sword to before me this day o
o f fyLa A
V
Notar--, Public
E QFNOTARY P UBLI -N"
EW jER
Mi qRMM'ssion Expli-es.
une 24,
Title:
Cnrnnratp Spa
J:
PUTi.GCM COUNTY DEPARTMENT OF HEA_ aH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date
Re: ]Property of 1N E PL\1E1,C� Ew Co. luc
Located at b-UWAA P7• V-41EY
(T) /° rA-Am koJL-L � Section %1, / Block Lot
Subdivision of L�1JIP�1Vl���l
Subdv. Lot Filed Map # 243313 Date q rN ,
Gentlemen:
This letter is to authorize W50t-
a duly licensed professional engineer or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
�._ system or systems in conformity iC? ^.• - 'iz"" i
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Signed
Countersigned:
P o E 0 9 9
deffm--f d-
Address
TACA ' Co
C40EL I1V '0512
Ctvf� - 2q5e (,OM
Yelephone
tm (X-) INC.
Address
LIME Efl?f, W 1 h&45
-Town
0/ 140 - �7op
Telephone
PoaAM COUNTY DEPARTMENT OF HEALTH `
Division of Environmental Health Services
AFFIDAVIT - CORPORATE OWNER APPLICATION
V/ii�� �PEf4111 111\` tU17�11111i�
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health
In the matter of application for:
I,
6,,111,4 L,6 A.1U&k,Lr7 _
represent that I am an officer or employee of the corporation and am authorized
to ac: for LINCAV- DENt-.1.�NJ CG INC.
(Name of Corporation)
having offices at U��,'�(:
Whose officers are:
Pres -cent:
f _ E ,.
(Name and Address
Vice - President:
(Name and Address)
Secretary:
. r '( Name and - Address) -
Treasurer:
(Name and Address)
and that I an and will be individually responsible for any and all is of
corporation with respect to the approval requested and all subs nt actuating
thereto.
Scorn to before me this _�_ day Signed:
of
]Rotary Public
NOTA AR PUBLIC FAUSTIM,
M! Commission Ex ,, , �EW JEV'
G e June 24. 1gcj,j
r 'C
Title:
Corporate Seal
.r.
` DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New .York 10509
_
914 278-6130 _
APPLICATION TO CONSTRUCT A WATER
PCHD PERMIT # Py 114 ? --
WELL LOCATION
Street Address
C."09C_1.4 races
Town/Village/City Tax Grid Number
13 . b - l - 41
WELL OWNER
Name Mailing
Ltwo -"r- 0e'4EwR -tit CO' jrt
Address LortLE r-ee-p_-f, OPrivate
Z4b1 Ue*_= _Tj St 1-A3 V1 b43 0Public
USE OF WELL
.0- primary
2 - secondary
&RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED
0 BUSINESS 0 FARM O TEST /OBSERVATION 0 OTHER (specify
0 INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY
AMOUNT OF USE
YIELD SOUGHT S gpm /#
0 REPLACE EXISTING SUPPLY
KNEW SUPPLY NEW DWELLING
PEOPLE SERVED 4 /EST. OF DAILY USAGE 600 gal
0 TEST/ OBSERVATION. ADDITIONAL SUPPLY
® DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
®DRILLED
®DRIVEN
"DUG
®GRAVEL.
OOTHER
IS WELL SITE SUBJECT TO FLOODING? YES ")< NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: L.VNCL�tZ -3
Lot No. l Q>
WATER WELL CONTRACTOR: Name k--XNKNDW t� Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES VC NO
WAX OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER N1Aily
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
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.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a manner as not to degrade or otherwise contaminate surface or groundwater.
Date of Issue: 19
Date of Expiration 19 Permit Issuing Offici
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
DEPARTMENT OF HEALTH
Division of Environmental Health Services
10 OLD ROUTE SIX'CENTER, CARMEL, N.Y. 10512 (914) 225 -0310
,--�. r .. r . ��,�,�= - �_ • "` �{'�'�Sr�?R�iC'T �'�:tnl��� -�r;Is
PCHD "�:�.....p ERMI T -.-: x..-- ,-, ., • /
# '� "
WELL LOCATION
' Street. Address
CA
.,Town/Village/City
Tax Grid Number
'FuiUAM MALLPY 7 _
WELL OWNER
Name
s
Mailin g
Address �
- RYLI
Nd 11A5
rivate
A3 Public
.USE OF WELL
�- primary
2 - secondary
RESIDENTIAL,
0 BUSINESS
O. INDUSTRIAL
O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP
O FARM p TEST /OBSERVATION,
D INSTITUTIONAL O STAND -BY
O ABANDONED
p OTHER (specify
Q
AMOUNT OF USE
YIELD. SOUGHT gpm /#
PT:OPLE SERVED /EST. OF DAILY •USAGE (lO Jgal
REASON FOR
DRILLING
17 REPLACE EXISTING SUPPLY
gpNEW SUPPLY NEW DWELLING)
0 TEST /OBSERVATION D.ADDITIONAL SUPPLY
13 DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
WELL TYPE
SDRILLED
aDRIVEN
OGRAVEL
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES - -NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME'OF SUBDIVISION: L INCAR N6V V)6)
Lot No. 1Q�
WATER WELL CONTRACTOR: Name Address:
IS.PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: WA TOWN /VIL /CITY
DISTANCE, TO...PROPFjtTY,FRQM. NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
I/A? MON SEPARATE SHEET
(date) INJ G949mleture)l
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.
During all well drilling operations, the applicant shall take appropriate action to•assure that
any and all water or waste products from such well drilling operations be'contained on this
property and in suck / a anner as not to degrade or he se contaminate surface.or groundwater.
Date of Issue: Gb 19 E
Date of Expiration! - 19 ermit Issuing Official
Permit is Non- Transfe rable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
10
�,��V ENGINEERING
& DESIGN, P. C.
yb Brewsw Awnue, Carmel, Neu, York a o3 j a
DATE
JOB NO.
PTIf Nl to
. � '.�a,. L =C
11
@•.Cj�j'r�; •n T: r +awl o: - .� -S•.' -
RE:
F1 t..L 19AM -�
T5
Or- 'LINCAE
iYl
Cc j lC1(GN t7tAWING /SOPy Flu— 0AAi- 3 conie.S
WE ARE SENDING YOU VAttached D Under separate cover via the following items:
O Shop drawings
O Copy of letter
O Prints Plans 0 Samples .0 Specifications
O Change order 0
COPIES
DATE
NO
DESCRIPTION .
F1 t..L 19AM -�
3/-j-6- 92-.•
CO-1
Cc j lC1(GN t7tAWING /SOPy Flu— 0AAi- 3 conie.S
l ett or- AU1"6? -I M0N A�AD AFf-IDAVIt • cWNE,R3}p1P
—.
--
)kPPU CNM14 VW- AFMAL 01F A 1r SMMIEP I >P> L 5�`�5tEjj
1
S s Z
'914
CflWK- IN tNE AMCWt O •.,, acozo
-
--
De5ic,4 PAPA 5ftj�t
t
s a
A Ic toN t) gL-* et- A WR WaLL
a,
THESE ARE TRANSMITTED as checked below:
For approval O Approved as submitted
O For your use 0 Approved as noted
O As requested 0 Returned for corrections
O For review and comment O
O FOR SIDS DUE
REMARKS
0 Resubmit copies for approval
O Submit copies for distribution
0 Return corrected prints
99 O PRINTS RETURNED AFTER LOAN TO US
COPY TO:
S�Gti'ED �
e
N "� __ ENGINEERING &
S 1 / L.0 SURVEYING, P.C.
Route 22 (914) 278 -4990
Brewster, New York .10509 Fax: (914) 278 -6392
7 DeLavergne Avenue _ (914) 297 -1742
"4.sagil ' . r��x;... .�..r^i''1��.:•�''.�rn�'.ir*A•� ..Q•w"'t{'i� c:: �.:.i ti i ♦ -..sue ;._:,�..u`. ::i
TO:
LETTER OF TRANSMITTAL
DATE
r�
JOB NO. q �I Z%, jU Z
cl t 47' 318
ATTENT N
-. �. ry�. i. vwS:.!* v. � .'M1= �i•`,.r..- `,.+pl'.;.snrn -. r:.w�r��`I�i ..s'a'ri -•c,. . .�
RE:
❑ Approved as submitted
LOT—
Resubmit copies for approval
❑ For your use.
WE ARE SENDING YOU Attached ❑ Under separate cover via the following Items:
❑ Shop Drawings JM� Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order ❑
THESE ARE TRANSMITTED as checked below:
,�Eor approval
❑ Approved as submitted
❑
Resubmit copies for approval
❑ For your use.
[] Approved as noted
❑
Submit copies for distribution
❑ As requested
❑ Returned for corrections
❑
Return corrected prints
❑ For review and comment
❑
❑ FORBIDS DUE
19
❑
PRINTS RETURNED AFTER LOAN TO US
REMARKS:
COPY TO: lJ�
SIGNED:
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
` PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTR SERVICES
FINAL SITE INSPECTION
Date: -7 13
.rte T p , i'�' '� n f.1 f. r__•�
.�i:ocati :•. _1 �_:.. ,"�'...`i +Afa•:- :..ten_... _ r �.�} r�bY f.. r'l ".;Y^.1..l.K q' IM�V. w••�ev, ae.r t'-A1F
Street Lli.��11.3"v'�rs'Cl•U�'`. ,� C. +'•'
n C wv rz( V1 i
g 4
Owner � t V4C'd)1_ ►mot t
Town Permit #
TM #. (, T I Subdivision Lot # is
1. Sewage System Area
a. STS area located as per approved plans ...........................
b. Fill section - date of placement 4
3:1 barrier Lgth. k'O Width R8 Avg.Dpth 3.,,5
c. Natural soil not stripped ................... ...............................
d. Stone, brush, etc., greater than 15' from STS area..........
e. 100' from water course/ wetlands ...... ...............................
II. Sewage System
a. Septic tank size - 1,000 ......... 1, 250 ......... other ................
b. Septic tank installed level ................ ...............................
c. 10' .minimum from foundation ........... ...............................
d. Distribtuion Box
. All outlet at same elevation -water tested .................
2. Protected below frost .................. ...............................
3. Minimum 2 ft.Original soil between box & trenches
Junction Box - properly set.. .................... ...............................
I - �ngtFi required � Length installed M
2. Distance to watercourse measured Ft..........
3. Installed according to plan ......... ...............................
4. Slope of trench acceptable 1/16 - 1/32" /foot .............
5. 10 ft. from property line - 20 ft.- foundations..........
6. Depth of trench <30 inches from surface ..................
7. Room allowed for expansion, 100 % .........................
8. Size of gravel 3/4 - 1%" diameter clean ....................
9. Depth of gravel in trench 12" minimum ...................
g. Pump or Dosed System
ize o pump mp cha 66e s
r ................ ...............................
2. Overflow tank ............................. ...............................
3. Alarm, visual/ audio .................... ...............................
4. Pump easily accessible, manhole to grade .................
5. First box baffled .......................... ...............................
6. Cycle witnessed by H.D.estimated flow /cycle...........
III. House/Buildin
a. House located per approved plans ... ...............................
b. Number of bedrooms ....................... ...............................
IV. Well
a7-Well located as per approved plans . ...............................
b. Distance from STS area measured ft...........
c. Casing 18" above grade .................. ...............................
d. Surface drainage around well acceptable .......................
V. Overall Workmanship
a. Boxes properly grouted ................... ...............................
b. All pipes partially backfilled ........... ...............................
c. All pipes flush with inside of box ... ..............:................
d. Backfill material contains stones <4" diameter ..............
e. Curtain drain & standpipes installed according to plan..
f. Curtain drain outfall protected & dinto .exist watercourse
g. Footing drains discharge away from STS area ...............
h. Surface water protection adequate ... ...............................
i. Erosion control provided ................. ...............................
Rev.. 1/97
onn
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS
REVIEW SHEET FOR CONSTRUCTION P_FRINIIT
STREET LOCATION My 2�tf -� - R . I.mr'I 8 NAME OF OWNER aC2m �� N�/ F4W� X61
REVIEWED BY NO A-vv\. . S�i✓� Lt t-k DATE ?-16 q TAX MAP
I- V DOCUMENTS
ERMIT APPLICATION
WELL PERMIT _ PWS LETTER
LETTER OF AUTHORIZATION
DESIGN DATA SHEET (DDS)
CORPORATE RESOLUTION d
SHORT EAF) u�
PLANS - THREE SETS
HOUSE PLANS - TWO SETS
VARIANCE REQUEST J T l
FEE
SUBDIVISIONS 1 �i vivo
LEGAL SUBDIVISION
SUBDIVISION APPROVAL CHECKED
PERC RATE
Y"" REQUIRED '3 EPTH
CURTAIN DRAIN V.FNERA:i STAMP S
/ , R /
TED IN NYp WAT
S SUBMITltD TO
D E ATED TO CHD
APPROVAL, INUOD
RVED
,f,EP TEST HOLES v:), D, It
- APPROVAL SSDS A.D.J. LO
ETLANDS (TOWN/DEC PERMIT
DATA ON DDS PLANS & PERMIT
PRE 1969 NEIGHBOR NOTIFICAT.
LETTER BI/ZBA
100 YR. FLOOD ELEVATION
OTHER REQ'D PERMIT(S) /
SYSTEM PLAN - (NORTH ARROW)
)RAULIC PROFILE_ GRAVITY FLOW
RESULTS
DRIVEWAY & SLOPES, CUT
FOOTING /GUTTER/CURTAIN DRAINS
COMMENTS-
Y N
CONTROL:HOUSE,WELL,
PZRC &DEEP
REPRESE TATIVE OF PRIMARY & EXP
LOCATION MAP
EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
IF. PUMPED,.P,IT�& D BOX SHOWN &-DETAILED
HOUSE - NO.OF BEDROOMS
WELLS & SSDS'S W/IN 200' OF PROPOSED SYS.
PROPERTY METES & BOUNDS
HOUSE SETBACK NECESSARY (TIGHT LOT)
HOUSE SEWER - 1/4" FT. 4 "0; TYPE PIPE
NO BENDS; MAX.BENDS 45° W /CLEANOUT
i' FILL SYSTEMS
CLAY BARRIER
NOTES
s
& DIMENSIO
i (00 O G y
C
EXPANSION 3. S
THE OR PROVIDED 60 FT MAX.
A : L E L Tv O l T it,jR33 .
400% EXPANSION PROVIDED
SEPARATION DISTANCES SPECIFIED
ON PLAN - FROM SSTS
10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL
20' TO FOUNDATION WALLS _15'WELL TO PL
100' TO WELL, 200' IN DLOD, 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
2 ETC. _150' GALLEY SYSTEMS
15'min to CDS= >5 0/o,10'- 4 %,25'- 3 0/o,30'- 2%,35' - 1%,100' - <I%
20'min to CD discharge /100'with 182 cons day discharge
SEPTIC TANK
m 10' FROM FOUNDATION_ 50' TO WELL
FORM ST -2
VI COUNTY DEPARTMENT OF HEALTH
DIVISION; OF ENVIRONMENTAL HEALTH SERVICES
'DrE15T : T:1_� 5 +^ri =� T+� '�T- . �TT7ucTT?�F r_• :Cr, c�.7r� .°r N m3- �: R'� �'= =? :' ' '1�: ;:-_ _
Owner e- I&Tbrl P97n /LecW Address 37C�oro�✓✓bAz* -rte ,I1/r7
Located at (Street) `g*yj-p Tax Map 7�'<<� Block Lot `f'I
(indicate nearest cross street)
Municipality Avo-e/^m I/ Drainage Basin
SOIL PERCOLATION TEST DATA
Date of Pre - soaking -7 S Date of Percolation Test 77 Z-3
Bole No.
Run No.
Time
Start - Stop
E14 6Y Time
n.)
De th to Water
rom Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
Z7SZ
2
t of
Z4'z 7,- 71Z
3
�--
3
1: n y
(5
2 Z7
3
-S-
4
5
`7- C7C
12
- - --
- ,
l Z Z:_
3
3Z - I: SL
-Z*
4
5
s
1
2
3
4
7►Tl1TTl�_ 1
5
: i. iests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. ,s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) Alb data to be
submitted for review. t '
2. Depth measurements to be, made from top of hole.
Form DD -97
V1f
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST MOLES
DEPTH HOLE NO HOLE N0�nF 0. =
.�- .yi a�-��- '=.a- ii�-S'e+z. F:- _uait:.r'�sOy4s- : -ss.�, sve•::?�.n:
s--�'= ra.�:a:r:�ri:�i.'F3'FFyr.� .; ;:r�.n�•;;t:- .a- �:.�ue v'. �m -.ate ..
0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
....� --..< _...-- ._ `-•.• -. - -:: -- _ s....r — sm .ice_ �A' -
..:� -• --- ~10.0'' � ' _ _ �, . , _,./ �_ �....... _
Indicate eve oundwat
Indicate level at which mottling is
Indicate level to whic ,
e observations made by:
is encountered
es after being
Design Professional Name: Jeffrey J. Contelmo, P.E.
Address:Insite Engineeri.ng & Surveying, P.C.
Route 22
Brewster, New York 10509
Signature: _
Design Professional's Seal
PC -1
PUTNAM COUNTY DEPARTMENT OF HEALTH
- A•.•PP..-�-LI. •-�•Cw„ A, 4T . �O- N : 4 �1F:•=•O. oR : APPROVAL-OF.
PPRO VAL .+io• O>�FY ' :. :PLi:A� N+ S zv .r.FO R z • � rKASTEWATER DISPOSAL SYSTEM
°._ � r�f�.°.�s`r sa+... -,I •" t. �..' .. ... ... .. •�•....
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1. Name and Address of Applicant: _ LINC/lk= LVELOPMC►•It Ca. INC.
2. Name of Project: !95M_ UNCAR- tY�lCIEIJt 3. Location T /V /C: RI11�1lIli.EY
4. Project Engineer: I01'1k AND Lf5leH,5. Address: j 9
PG C P-ME , NY ic2
License Number: 100151 Phone AA- 225te2CO
6. Type of Project:
Private /Resident
Apartments
Office Building
7. Is this project subject
Type Status (Check One)
ial Food Service Commercial
Institutional Mobile Home Park
Realty Subdivision Other (specify)
to State Environmental Quality Review (SEAR)?
Type I.. Exempt
Type II. Unlisted X
8. Is a Draft Environmental Impact Statement (DEIS) required? .............
9. Has DEIS been completed and found acceptable by Lead Agency? ...........
10. Name of Lead Agency 1�%A
11. Is this project in an area under the control of local planning, zoning, QQ ��
�c;•r- '- stheK•ef a�.. Als; y. CIr4. ,ninee1'��'_oe...,= .aT.:.a�,
12'. If so, have plans been submitted to such authorities? ................... WD
13. Has preliminary approval been granted by such authorities? NICE Date Granted: WA
14. Type of Sewage Disposal System Discharge...... Surface Water _Ground Waters
15. If surface water discharge, what is the stream class designation ?........ RIA
16. Waters index number (surface) ................ ............. ......... NA
17. Is project located near a public water supply system? ..................
18. If yes, name of water supply WA Distance to water supply ,_
19. Is project site near a public sewage collection or disposal system ?..... _ �D
20. Name-of sewage system Distance to sewage system_
21. Date observed: UNKNOWN 23. Name of Health Inspector: _ (JNYAiOWN
24. Project design flow (gallons per day) ..... k . ............................... Caob
2°
Poll�.�tant Discharge Elimination. System ( SPDES) Permit required?.. NO
.., ... ..,,. .. _ -.
26. Has SPDES Application been submitted to local DEC Office? ° ° ° ° ° ° ° ° ° °. ° °.. _�jfj�_
27° Is any portion of this project located within a designated Town or State
wetland? ................................................................. ND
28. Wetland ID Number °°°°°°°.°°°°°°. e ° ° °. ° °....... ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° °. °o.... K/A
1-9. Is Wetland Permit required? ° °.. ° °. ° ° ° ° ° °° °e o °°°°.°°°°°°° ° ° ° ° °. °. ° ° °..... ko
Has application been made to Town or Local DEC Office? ° ° ° ° ° ° ° ° ° ° ° ° ° ° °. °°
30. Does project require a DEC Stream Disturbance Permit? ° ° ° ° ° ° ° ° ° ° ° °.. ° ° ° °. KID
31. Is or was project site used for agricultural activity involving application
of pesticides to orchards or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ° ° °..... YES or NO NO
32. Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or
any other potential known source of-contamination? . °: ........... YES or NO No
DESCRIBE:
33. Is there a local master plan or file with the Town or Village? ° ° °.... ° ° °° Y
34. Are community water, sewer facilities planned to be developed within 15 years? b
sewage .d soo >a-1 _draws -_in• excess- o�:f- 115%. slope?.,;; .:
. _ ..._._. _ ._ .......__ .._ .. ......_..... °yp.., AND _
36. Tax Map ID Number ° ° ° ° ° ° ° °.. ° ° °. ° ° ° ° ° ° °. ° ° ° ° ° °. °° ° ° ° °. °° . °. ° °. °...'..° 73. /g
37. Approved Plans are to be returned to: ................ Applicant _X_ Engineer
vs
If 1-hip apRication is signed by a person other than the applicant shown in Item 1, the
natipq must be accompanied by a Letter of Authorization. Failure to'comply with this
�ai`sion may be grounds for the rejection of any submission.
w';_,.
'C -) r ' hereby affirm, under penalty of pegdnd hat information provided on this
tr i.:_.. --irorh is true to the Hest of my knoal belie se stet nts made
Ahern are punishable as a Class A o su t to Spc on 210.45 of
�thigpena 1 Law. /
_ A
SIGNATURES & OFFICIAL TITLES:
4AILING ADDRESS: ribs U t� C
LIME MWY, V,�j N&A3
4
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
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Owner. 37CUa g DAM R6�Q COkA Address 37 CRarg Dr�l�1 gQAQ, 6 IN�,1/, ; JI /.y los6o2
.Located at (Street) 0#Ug 1?9A,9 Tax Map 73.ff Block 1 Lot
(indicate nearest cross street)
Municipality &Wg. VJ _ Drainage Basin !�(/D.SdN le/lifR
Date of Pre - soaking
SOIL PERCOLATION TEST DATA
Date of Percolation Test
ivvr�;a:fr t. y Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
f percolation tesf,hole. (i.e. ,:g 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) Alt data to be
sub'mittedfor review. '
-2' , De A nh 'easuremenfs'to be' made from top of hole.
-97
Form DD
D?'th to Water
Water
From Ground
Level
Percolation
Time
Elapse Time
Surface (Inches)
Drop In
Rate
Hole No.
Run No.
Start - Stop
kmin.)
Start Stop
Inches
Min/Inch
1
s^
30
2z,!- d? ,(
��
s
2
6'
iL l
f
3
.4
5
1
Si 7 -6 -'
20
a2" - a3"
P
6
4
5
1
.2
4
ivvr�;a:fr t. y Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
f percolation tesf,hole. (i.e. ,:g 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) Alt data to be
sub'mittedfor review. '
-2' , De A nh 'easuremenfs'to be' made from top of hole.
-97
Form DD
G.L.
0.5'
1.01
1.5'
2.0'
2.5'
3.0'
3.5
4.01
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.51
8.0'
8.5.'.
9.01
10.01
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
Ewa—
any
■
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered
Deep hole observations made by: Date
Design Professional game: Jeffrey J. Contelmo, P.E.
Address:Irisite Engineering & Surveying, P.C.
Brewst N-P 9%
'Signature:
-1 liv
'Design Professional's Seal
' PViNAM CORM DEPARTMENT OF HEALTH
DIVISION OF HEALTH SERVICES
DESIGN DATA SHEET— SUBSUFACE S5gAGE DISPOSAL SYSTEM FILE .a
� .. ..•...- :. .:- ..- � . - T-.:o- '. •:,�,.:.•..w..�,: +`•r+s. n'i.j �.gnt�:.:Sd. .r. .i uhav't. s4 ..�_..rPe.• •�9. a- „7..
..- .. .. -
W
...._ m as a.-s .. - . •.... �. •--�,C- � • ,
::F >. ,•,a.., her oft t_'zcoOMDq cry. Address ?.R/ u &mty
s1 47'17re- fCL4 f' AIJ
Located at (Street) <�#!/.2c# 2DAZ Sec. 7.'. /P Block / Lot
(indicate nearest cross street)
Municipality Watershed
Date of Pre- Soaking Date of Percolation Test
HOLE
NadAm.. CLOCK TIME PERCQIAT ON 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
1
2
3
4 Aj 882kcoo2•Arrml - -2
1
•I
v < a. . ye +r> a s .. . p:'•.v.... c . .�w...w...r�� 1. a •� • r _
3
• 4
5
1
,. 2 .
3
4
5
s
NOTES:, .1. Tests-t& be repeated at same depth.until approximately equal soil rates
are - obtained ..at each percolation test hole. 'All data to•be sutmitted
for:: review.
2. Depth masuremnts to be made fran top of hole.
TEST PIT DATA REQUIRED TO BE SUEMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
:. DEPTH HOLE NO ....... _, fiiY..t =: -_ �.�• 31-
G. L.
1'
2'
3'
4'
5'
6'
7'
81
9'
10'
11'
12'
13'
./10 cat <:P- s
�►...,._... �.. ]-;!e ... ....,. . _ - _ - .J: - . -.,._d �n.,e....s_.�...,Y.......... tea. -_a-�. a- re�r%�.:'._'e. ...;. .. .. .._.. -.:.�. .. ..._......�. .�..,
INDICATE LEVEL AT WHICH GROUND ATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: PGA/, `3L Z4- DATE: // J
- — DESIGN –
Soil Rate Used Z 2, Min /1" Drops S.D. Usable Area Provided 0<90 Sf'
No. of Bedrooms 3 Septic Tank Capacity /peo gals. Type erca'
(Qnseghtion Area Provided By Soy L.F. x 24" width trench
1
�btYler 3.5 X13 LI LL -
:> C? _
UJ __j CV
�-vs l4/& /-O&S/ v Signature
w
CL-
yldrss f �y �PLs { SEAL
L
Uj cr, ivy''
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Rate Approved sq.ft/gal. Checked. by ^ Date -