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HomeMy WebLinkAbout3475DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1-46 BOX 28 1 11 1 titi 1 J�1 1■ 1 1 J 1. 03475 ' hslh >la�e�os nwn�aa a�eaa�tis>� ___C14laR�c1 "D Ri M OWN. W VY ...- . a. .r- �e_u .r:.r.i_...a.�._wa.l n•r.. « «h.... _._ w._... _._— ..- _.. -... �_� __- -__—�. A._ _ _ _�A .A ^ ♦ .� e..a ro.e•• -�- .. .... / ?•.. - ...._.... .... -. (1tlmdA~ r� Li NC/SE D�YEt<o`�(�.l f' C'�►, . Drib of Plow Ajpgraval )i - 113Eaff, sh Tow.Lifitl.i✓ A----.. —A e4irml9a 6;L -8r0 FAA F.nr•1n%%P" D++rs Tr gESi Ni1AL [A Am i .1 AL I' [iiS1,01.0* LJ DWO ' Vd.r thl•bar d Nadia ■ s =3 .Dam Flow G P D �-� P ®Nfl�ratlr b=a�M WYE I� b atapMMA Sopmet. Sow~ S,.t.. r OWA t Of Icy Slip& Tnb .-a F. To bwaainifti ded.lp UNfCNOW 4 walar sbmain S"* F"Nk Adhm an X '`-� S�wb Dori h111J tJOiAIP� A ftess olbrr dgltir�sda Pvn') /° /r'TT i re0 88 - :th.t l am whony ane comomoy raponsais for the dawn and location of the PropOnd sy.t-410i t) that the . a as save a du osel s scam . Move dace a" win,be aorlllruded as dawn an the approved amendment than to and in aeeordana with the standards, Fula TI M o eaunty oMMtmaat of helps, aM that on ComIII at»n.o weof a "Certifkate of Construction Compllehce" satisfactory to the Commhelorar of IWlthwill M submMtM t0 tit OapMbllMl% aM a smitten "Won" win be furnia" the Owner. his sutaabwa6 Nabs or assigns by the builder, that old builder win g1MCa N 98M. p -W4 COMMON My pR of laid uWaN d"MM system during the period of two (2) years bnhledNWIF followin tMdata Of too hau- alas of tit agpravN' of tit CwtMka a of Comtrottlen Compliance of the orMinal systMn OF any Capin tlleratai !) that the drUkd well desorll" a`OIN ww as faceted as illunia as tit spprovW PON sad that am WON will be Installed In with the Kandards. rules and rpm the Putnam cawlty 040dMt .""t. °'' sa P.IL _j( P A. 16 l IGN • 06 �i A*dmn IS, LiNnN No APPROV90 FOR CONSTRUCTIONI This adOFOgI eMF the date Issued unless construction at the build»/ figs been undartaltMl and le 1wacMN for Cause or may be au s"" or modified by the Isatorla► of Health. Any Change Of alteration of Construction sawing . for adage of a e w supply Only. Rem,.YM» ILO/. 80 . Rev. 3 PUTNAM COUNTY DEPARTMENT OF HEALTH Division d Environmental Health Services, Carmel, N.Y. 10512 Engineer Must Pro « .r. .-.. ...... .4'.. ..., ¢...•. ...+. �... v +v..�.r�.Ort.r. +.:_�.V'+�Y ^..o ♦ •.were.. CE ATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM PvrlyAm LALi—Ey U2C, Town or Village Located st Tax Map '7 , l 8 Block Lot —� Owner /app Name AD%rj,/- C�2 - ?ryC ' Formerly Subdivision Name AQ - Subdv. Lot N �- MaWng I"- . 4-/MA FG•s%lO AAT Zip l7 0 -1 Date Permit Issued Separate Sewerage System built by Idah '✓rS �Qd�A Address _ 17 2- Ae kk __i* La • t•-4 .,«t /!D 4 lZSgt Consisting of 1QV0 Gallon Septic Tank and SooG •f Flgr_o s!' pe'M`13 P/T• Water Supplyt Public Supply From' Address or: X Private Supply Drilled by AyA09k-_z0^1 Address Building Type 44E /6&yTI/9y Has Erosion Control Been Completed? tiy Number of Bedrooms Has Garbage Grinder Been Installed? Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accord a with the filed plan, and the permit issued by the Putnam County Depar ant Of Health. Cate Z Certified by P.E.�R.A. Address !/v G License No. K 3 2T z'�- /3512- iOSv Any person occupying premises served by the above systems) .shall promptly take such a tlon as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate saws r stem shalt become null and void as soon as a pubs;: unitary sewer becomes available and the approval of the private water supply shall become nul and void when a u Iic water supply becomes available. Such approvals are subject to modificatio% or change when, in the judgment of the Co sr of Heal eh revocation, modification or change Is ne ' ss►y. h /9.T /41V -.. Title GCT 20 '94 15110 FROM PAGE 02 YML ENVIRONMENTAL SERVICES 45trV ?t N.-Y. 1 0519c ( 914) -�i` °J c�i�� '� •`s" _ ter` 1 n : ` Albert 1.1. peldovani, Dir -e tQ LAB #: ?L. 403: S9r CLIENT 4259 . /yN IJ IJ /JN II + /fy wJ /J fy /J /JJy NfJ N�!J l +IJN ✓y /J!f /I ry I+ ✓J I+Y�•N /! /JI +3V II l.• +J De RGINDA - DENNIS KRAMER S POND RD P tTNAM VALLEY+ NY 10579 SAMPLING SITE: CHURCH RD PUTNAM VALLEY ! KITCHEN TAP CoLeD By: D. LeRONDA N0TES...s NNf/MNryIV �✓N /J NIJ wI NIJNryw1 /rNNIJN✓'y Iy NII M✓ /+IJN/ +N/ +w✓f+ /✓N!I MATE PLAQ PROCEDI.-IRE NON STAT PR+ fir: RAGE i wJNMJ/•�/JN/' +✓' /N/. /NI /MJN wJ.JM /J /I�'I /+�J IJNNfI ► /IJ PI IJ / /MN MfJ .V PJ N. DATE /TIME TAKEN: 10/14/94 11:40, tlATE /T I ME RE C' r3. 10 / 14 /94 12. 1 211 ( REPORT DATE: 10/19/94 PHONE: SAMPLE TYPE..; POTABLE PRESERVATIVES % NONE TEMPERATURE. , a <{ 4C r_ OL I PORM METH I MF - NwI +J wIYJryN NII Nfy Nfy /I n +MNN N /+NMNNA•✓'JN /Dry NNwy IJ N.J Nfy l4r RE'_ 3_iLT NORMAL 10/17/94 MF T. C,;3_ILIFORM AS tN*r / 100,1iIL. ABSENT cOMMENTS: • BAIT THESE RESULTS INDICATE THAT THE 4,lATE : (4.`A.:: + (WAS NOT) C1f= A SATISFACTORY BAS! I'CARY QUALITY ACCORD _: THE NEW YORK STA ; E l�11?i1 EPA FEDERAL DRINKING. WATER STANDARDS, FOR' THE PA�i�;l'�4 T�ftiS JESTED, AT THE TIME O - Albert H. �•adnaarri Dir4e ctnr EL.AP*l ! PUTNAM COMM DEPARTMENT OF HEALTH ITTNA _- IL!95FR` CFS Lope MlivE oeV Elt- -41 Co. tAt C_. Owner or Purchaser of Building Building Constructed by Location - Street Municipality P-E 5A C > e- P- " `c&'V-= Building Type -7 a. « 1 9 Section Block Lot W Y. I Subdivision Name 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 inanediately following the date of approval of the - 8`Tertlrlcate �Ul t:UTrS iilC:i:iVli° �.UTll lictil%E° fir i 16;:setiage disk—,sa sy* zt na ` any. repairs made by me to such system, except where the failure to operate properly is caused.by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this sb day of 19 e4_ Signature p {� Title General Contractor (Owner) - Signature 17z 62-F04,657- Corporation Name (if Corp.) rev. 9/85 mk Corporation Name (if Corp.) Address .CO�,� WELL .COMPLETION REPORT J Office Use Only lyre DEPARTMENT OF HEALTH 't 0 TisL�T cliv.YoimenLa `fteal`f:n "'J`�e`tvlcea ' -' "y`4 �! ci4. x,'.;,' *c':iY'xo* .'4 �Fw YOB PUTNAM COUNTY DEPARTMENT OF HEALTH SiREZT AOURES S:,,'' , WNIVIL u / 1 Y. TAX GRID NUMBE� WELL LOCATION WELL OWNER NAME: ADDRESS: 1—P$IVATE I v O PUBLIC USE OF WELL ESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /CONO. /HEAT PUMP ❑ ABANDONED 1- primary ❑ BUSINESS O FARM ❑ TEST /OBSERVATION O OTHER (specify) 2 - secondary ❑ INDUSTRIAL O INSTITUTIONAL O. STAND -BY ❑ MOUNT OF USE YIELD SOUGHT S� gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY DRILLING w SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH a ft. STATIC WATER LEVEL ft. I DATE MEASURED DRILLING O_RBTARY O COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE O SCREENED UDPEN END CASING ❑ OPEN HOLE IN BEDROCK O OTHER ' TOTAL LENGTH ft MATERIALS: O -STEEL O PLASTIC 0 OTHER CASING LENGTH BELOW GRADE i �►a ft. JOINTS .'0 WELDED &T1%IREADED O OTHER DETAILS DIAMETER in. SEAL: C 1eKtNTGROUT, 0BENTONITE ❑OTHER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE: O YES U� Wj LINER: DYES CM SCREEN DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft) DEVELOPED? <.I?AILS FIRST - _ _ _ _ Y T JL'V V171/•.. ,._.. ...w .. - .�-... w{ .y e.. .-. ..v.w.ai. V..e... h.+.r - u,:+.rnr•.•...r c.vw..... .- ...-- ter.... -. r�r-.. - .�.. o.. ..Orrr . GRAVEL PACK o Nos GRAVEL DIAMETER FDE.OTMH BOTTOM SIZE: OF PACK In. It. OE, iH It. WELL YIELD TEST IYdetafled pumping VEIL LOG If more detailed formation descriptions or sieve analyses METHOD:- O PUMPED tests were done is in- are available, please attach. I DEPTH FROM Wale, Well �RESSEO AIR , formation attached? SURFACE. Bear. Dia- FOR +dATtON DESCRIPTION p0E O BAILED O OTHER 0 YES ❑ NO ft fi in9 Inner WELL DEPTH DURATION ORAWOOWN YIELD Surlue Fi a i ft. hr. min. ft, gym. S )--ad ; s WATER O CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? ❑ YES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE t, /j � r - y — I Ye ( a Sn PUMP INFORMATION CAPACITY GAL. TYPE s I, � �,r �C l�l< 'CAPACITY WELL DRILLER NAME DATE MAKER 2 1'wti. d LS DEPTH ADOREs� Vu u c '" ' st MOOEI VOLTAGE , �'HP �` Ux Cam, 711f�J,f r = 1- _'SC'f✓IJT?Y �'� := ="'I' C: F'_ -Jl - Ll . _r1C.r CF G =Y � L Cr.�_•':�� t � � _._.- ;,�s�cl i � sic: � 6•J �. a r• ex- C--rperale Resole. -cn Z :re°_ sa'-s - -- _-i Ji n"rs •�'.;.1_']Gr_Zct -? Cci _ Den' HGl� ?c:C FGle 0°Jth (3) r -- Ca 0152 1?r'g - Two scams 1 IS Well rerma V=Iri ance Win^ -_Lec ` Ds R & D) ��h Z.^i•� vr3:.. ill ? G'1 — \: �= C_"1 C_ --.i w C G_ _ D Cr J Ecx i•- _. - _ i =r� _ca __�� ; = over val =il, _ CO -------- & J_00,=S l��t r a 'D:]__:5 (•C ch v1) �Gres....- Lam:'... 0—F V_.l �j C Z� ��� �� T tea_— Pit & D Scx S ,7--a & D-= i j';� =?s & SS�S'_ �; /in 200 __. G= �= _xs= s�e:s C C - _ cawer S C7L- . ON D_-Y 1.01 La=e 20' 100, to i-ll; 200' In D.L.0_D, to stz-n�am/ jti=L�= �'i -�n/ Lase (_ _` �:l) ,tL/�G •,•^i-c5iil/c�7= :r�c_II,Gl"'_ ^=-_"'''_ =_ JJ L✓ G 6'•6'•• i 01 -G water Line 30' il:l�?_Tt= = = =-lt G.c '?"° 101 ir=L 1 1 well r.G ?r DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX.CENTER, CARMEL, N.Y.. 10512. (914) 225 -0310 �. ..- r . y ^ . _ . .._ . t q. at .ate.• w! u q • 4 . . APPLICATION TOrCONSTRUCT.�A.WATER WELL PCHD PERMIT # WELL LOCATION. Street Address CNu Town/Village/City , VALLEY Tax Grid Number 15., 0- 1­9 -WELL OWNER Name LINCh Dr_- ELLS Mailing _ Address ENt CO. INC. M UbEAZt'5t- LI-t MfPrivate tj 0 Public USE OF WELL - primary 2- secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL D PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP O ABANDONED 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify 0 INSTITUTIONAL.. O STAND -BY O AMOUNT OF USE YIELD SOUGHT . j. gpm /11 PEOPLE SERVED /EST. OF DAILY USAGE &CO _gal REASON FOR DRILLING O REPLACE'EXISTING SUPPLY O TEST/ OBSERVATION' ONEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL G ADDITIONAL SUPPLY DETAILED REASON FOR DRILLING WELL TYPE DRILLED ODRIVEN ODUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES `X_No IF'-WELL IS LOCATED IN A REALTY SUBDIVISION, NAME'OF SUBDIVISION: LWOW 2 510D1 53 Lot No. 2 WATER WELL CONTRACTOR: Name LA04JOW lU Address: E IS PUBLIC WATER SUPPLY AVAILABLE.TO SITE: YES __)�__NO NAME OF PUBLIC WATER SUPPLY: WA TOWN /VIL /CITY [iLsll�rlLE ' U Pk PBRT FRG --r ivEAREST MATER XAIN-c LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED O ON SEPARATE SHEET s (d e) gn ture) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirtir (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 drill operations be contained on this property and in such a manner as not to degrade or of rwi contaminate surface or groundwater. Date of Issue• 4P11 L 19 2 i /41�4 Date of Expiration 19 7 7 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller toll -4 ENGINEERING 11 & DESIGN, P. C. Pump Pit Design for SSDS for Lincar Development Co., Inc. Lot 2 of the Lincar 2 Subdivision Design Flow = 600 gallons per day Use.peak hourly flow 10 times average daily flow Opeak = 00)(16� = 4.2 gpm (24)(60) Static Head = ± 14 feet C = 150 d = 2" L = ± 120 feet GPM = 30 gpm Equivalent L (Bend & Valve Losses) ± 50 feet Total L = ± 170 feet C d Total Dynamic Head (14 feet + 3 feet) = 17 feet Use Gould Pump model # 38714/10 HP (or approved equal) This pump will pump 30 GPM with a total dynamic head of 17 feet X I r849, Route 6, Camel, New York 10512 ❑ 7 DeLavergne Avenue, Wappingers Falls, New York 12590 Fax: (914) 225-6438 May 14, 1992 (914) 225.6200 (914) 2971742 3871 r- � .r FEATURES SPECIFICATIONS MOTOR Impeller: Thermoplastic Semi- Pump: • Single Phase: 0.4H P, 115 or 230 Vortex design with pump out vanes for • Solids handling capability: Volt, 60Hz, 1550 RPM, built in over mechanical seal 'protection. 3 /a" Maximum load with automatic reset. Casing and Base:,Rugged • Capacities: Up to 55 GPM • Power Cord: 10 foot standard thermoplastic design provides superior • Total Heads: Up to 24 feet length, 16/3 SJTO with Nema 5 -15P strength and corrosion resistance. • Discharge Size:1 1/2' NPT 3 prong grounding plug. Optional Motor Cover: Thermoplastic cover • Mechanical Seal: Carbon -Rotary Head /Ceramic - Stationary Seat, 20' length, 16/3 SJTW with Nema 5 -15P 3 prong grounding plug. with integral handle and float switch Buna N Elastomers. • Fully submerged in high -grade attachment points. p • Temperature: 140 °F (600C). turbine oil for lubrication and efficient Power Cable: Severe -duty rated Maximum. heat transfer. oil and water resistant. • Fasteners: 300 Series Stainless ... < :..�.a......:.. ri o;.,y: I?rn� /lrJG�,f;nciti. \; lV .�OM�IY�y, = :.�.�.; �..��!�?i]i _ `_,^.� ._.A:... ... ...._.:i- ...._ATV....- ......,.e , w.,.. .. ... �.. ! ...... � `•� -� ...... v,+ 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 Pumps inc Effective December. 1991 •e t 10 - _ 8 ---__ 6 ---�" 9 5 4 3 - 1 ---� 2 ✓ PARTS 1. Impeller 2. Rugged thermoplastic base 3. Rugged thermoplastic pump casing 4. Mechanical seal 5. Ball bearings 6. 0 -Rings -c ..7. - ::PQWeF �,• •�` -mil 1`III8C1 (1101'01' "`•... '._V >.- .. `•.,. �j 9. Cast iron. motor housing /stator assembly 10. Thermoplastic motor cover & r r I I: i a �,.fk ,'�Tyy 4a`i.a+w Iq�•ei.i aK ''����": 1 b 4 DIMENSIONS (All dimensions in inches. Do not use for construction purposes.) PERFORMANCE RATINGS Total Head Gallons (FT of Water) Per Wis. Minute 5 53 10 46 15 36 20 21 24 0 DEL J MODELS Series HP Volts Phase Max. RPM Solids Power Cord Wis. Amps Handling Length (lbs.) EP0411 115 12 10' 20 EP0412 230 6 10' E P0411 A 4/10 115 1 12 1550 114, 10' 21 EP0411F 115 12 20' 20 EP0412F 230 6 20' 20 EP0411AC 115 12 20' 21 SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U.S.A. MODEL: 3871 SIZE: 3/4" SOLIDS V RPM: 1550 METERS FEET 8' 25- 7- LIJ 6- 20- 2 5- < 1 5 Z 4- -j 3- 10 0 2- 0- 01 1 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m3/h -CAAAMY- [QGOULDS PUMPS, INC. SIRCKA FAILS NEV YORK 13148 Effective October, 1988 01988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.&A PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services FOR PERMIT APPLICATION SUBMITTED TO PUTN,kM COUNTY HEALTH DEPARTMENT .1 TO: Commissioner of Health In the matter of application for: Ooo�& YVAZI/0 llliZA represent that I am in officer or employee of the corporation and am authorized to act for Name of Corporation having offices at 1Z?>j UBE42*y 5f a Whose officers are: President: Vice— 'resident: A"Ve-'Ne-L— - Name and Address (Name and Address) (Name and Address) Treasurer: (Name and Address) and that I am and will be individually responsib corporation with respect to the approval request thereto. Sworn to before me this day 0 f I 190 'Notar' Public ARLENE FAUSTINI -,,NOTARY PUBLIC OF NEW JERSEY M,, Commission Expires June, 24, 1996 C 'S' si� Ti Corporate Seal I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES I .. s.; - a,.1°�x`` %.;`_ .;y: .':` ,SR ai�_:�'v;.'i*•a�e..w•;s .s :ri ::r`•i�<'.... "h e <. Date._ Re: Property of. Ot4M I'_\l��l.bMEA'4i W. WC.- Lo c a t e d a t Cku WA (T) 15A13-1-9, Section Block Lot 9 Subdivision of LINGAL 2 `3i.IWN60N Subdv. Lot # 2 Filed Map # 2205ft Date _ Gentlemen: This letter is to authorize 11451- F-1461KE90 N4D LEjaU-_ a duly licensed professional engineeror registered architect (Indicate to apply fora 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 Yin conformity with the provisions of Article 147, Education Law, the Public Health'Law, and the Putnam County Sani- tary Code. Very truly Signed Countersigned;: P . E . , 1?4--.-:A de J. coNt�l.MD p� 1N�11� �-Aun w_, AND GSIGN . Address &NR CA�P'l�L► N�( ►t�l? q4 -2 1=51& oo Telephone er'2 property OD. wc. Address Lk tl. - MEL ILA 11(v4�) Town '?- 0 J 4-.0 •- 47 d 0 Telephone VVm Oat) mm DESIGN DATA SF T- SUBSUFACE SSTAGE DISPOSAL SYSTEM - FILE NO. ie -::pr > „�'r rC'r�:d.a: • c: ddr., 3,. s. ..�'fx`.'v`r,oi'=r:',°•: "r.c�.: f,.,e�. '�. r:�y •_ .- :�.e�: "�`'.+.sr - »�s :^r� .w ;.i..a c. • .::i... +..:- 9`+- :..�o�e ... ........:...:. ',f,, . .-. .. Owner G �Acm ,ogniA7_a P& I w. . Address "7-A IT r40AY Located at (street) CHtiI 90, Sec. > ,/ Block % Lot (indicate nearest cross street) [Municipality PLT ,0 ✓,jM t -A j L L51 Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking Date of Percolation Test HOLE NUMBER CLOCK TIME PERCQLA 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 - - -.4 �L��'il +t/ / LGo1.�17'lpYt✓ IzA32E Or- 1 2 3 4 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. 0 /O^ TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION IN TEST HOLES Ad t,r�.i• R.�,�^,�.- Y1��",j -D �. Vii:, �. c ^y" - � ''^ �'ii� -' ._ a.. T' :�e.•.� �- ,.�r`��•:H`...... V 4 ._. UEF'iH G.L. 1' 2' 3° 4° 5° 6° 7' 8° 9° 10° 11' 12° 13° R,,Y� 5:S ft C:> , 0- S Ao4K & 7 " INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: dd ,afP4 Z11&5*k,1 sZ AI,S. DATE: / DESIGN cgoigRate Used _ Min /1" Drop: S.D. Usable Area Provided S �, Lt )o. ,`of Bedroc�ns 5 Septic Tank Capacity ! 40c,>o gals. Type 0 L' - .bsKption Area Provided By SC0CD L.F. x 24" width trench , cthez R ! 1✓L. p1/.► -r!i� /Jl gE �rl�'r F�ignature , Address /� 1"��" 6' SEAL �,•q�m�.3? /' ✓� ltd; /-Z- % A gloO THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft/gal. Checked by Date PC -1 • PUT NAM COUNTY D E PARTMENT O F H EAL TH a•�.r+ ...' e•w..��..t7.� _ S. _y'o- i'.��wn. �'rC' ��)F `�.r.: ���, .�.. •w Ly �.�i .. .. o• .. :v. 111'iYL1Zl'11 lvl� �`�ii \`�hr"� ��li`�n� v'i . .:ti.'i.�"�Q v`�.rf'��..^ti.. '�+'.�,�. ro'�..a�. .�a.:L.:a,• �r .. 1. Name and Address of Applicant: UNCAVV 1EyF:.OPM%f CD, INC. � -IttL� FERRY+ N�. ►�7(og3 2. Name of Project: f�6Db Vc? Ut4CK- MYU}a15141 3. Location T /V /C: Rl13k1 ALLEY 4. Project Engineer: !N01* RhUI EP O AOD I 1C 1.5. Address: ifl4q Pte. (v P G CAP -MEL, iCEi2 License Number: 010131 Phone q 4- 225-&2n0 6. Type of Project: Private /Residential food Service Commercial Apartments, Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is thi.s project subject to State Environmental Quality Review (SEAR)? Type Status (Check One) Type I.. Exempt Type II. Unlisted_ 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... WA 10. Name of Lead Agency 1:1, J- <dis: i�roje;.L� it -i _aft �s�ca ��der the coiitrcl cf lsxa? planning, xo "i "�,+ 2i.Df�. i✓EPF• fOR or other officials, ordinances? .......... .............................. 12. If so, have plans been submitted to such authorities? .................. WD 13. Has preliminary approval been granted by such authorities? 0IR Date Granted: PJA 14. Type of Sewage Disposal System Discharge...... Surface Water _Ground - Waters 15. If surface water discharge, what is the stream class designation ?........ N 16. Waters index number (surface) ........... ............................... N 17. Is project located near a public water supply system? .................. 1`b 18. If yes, name of water supply WA Distance to water supply NfA 19. Is project site near a public sewage collection or disposal system ?..... trip 20. Name-of sewage system N1k Distance to sewage system _iA 21. Date observed: UNKNOWN 23. Name of Health Inspector: 1Jt4Y-1`a9N 24. Project design flow (gallons per day) ...... ............................... .Zarn G'PD 2. 25. Is State Pollu't ant "Oiscnai=ge-1 iiminati "1Cin "4S-­yti:i4r (�pwS; ��• �� ���• _ °�•� = =- 26. Has SPDES Application been submitted to local DEC Office? ............... 27. Is any portion of this project located within a designated Town or State wetland ? ................ ................ ............................... No 28. Wetland ID Number ........................ ............................... NVA ems, ?9. Is Wetland Permit required? .............. ............................... y �� Has application been made to Town or Local DEC Office? .................. 30. Does project require 'a DEC Stream Disturbance Permit? ................... No 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 NCB 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 DESCRIBE: 33. Is there a local master plan or file with the Town or pillage? ........... YES 34. Are community water, sewer facilities planned to be developed within 15 years? No. 35. Are any sewage disposal areas in excess of 1'5X slope '.... . ".... e .. 36. Tax Reap ID Number ......................... ............................... 118-179 37. Approved Plans are to be returned to: Applicant _X_ Engineer If the application is signed by.a person other than the applicant shown in Item 1, the applic igq,must be accompanied by a Letter of Authorization. Failure to comply with this pro .0bn Way be grounds for the rejection of any submission. �A w _J va 0 -,.- 7 6,r'herLbby affirm, under penalty of perjury, tat information provided on this LUrs true to the best. of my &noodledge belief. ]se statements made : _Z: here i are punishable as a Class A K* anor p t to Section 210.45 of ``= tie Pena 1 Law. _ SIGN 'RE &Z& OFFICIAL TITLES: `i 4AILING ADDRESS: 2tl ubp_gj -i Cjf. LIME FAY, N j 1-1&43 1 LOT 3 128-36 N 8636'24 E I N 83'34'59' E 76.16' 99.76' N __: WELL DNT kA SWI� LOE �Vllll LOT 2 AREA 1.142 ACRES V Der-K Aar>./E f �w CO""�67S M OA/ L+ 4! A1T LOT I CATION OF THIS DOCUMENT, UNLESS UNDER THE DIRECTION LICENSED PROFFESSIONAL ENGINEER, IS A VIOLATION OF ON 7209 OF ARTICLE 145 OF THE EDUCATION LAW. A AS —BUILT MEASUREMENTS NO. C D REMARKS 1 10' gA PtiL iM.iK 2 2S 29,5' PUMP PI} tJO. A REMdW{h 3 Is3' - obt. eox 9' IAo' 13' END tRE.xH S �oA' 115' u 94' l03' q 7 III' i3' i Putnam County Department of Health Division of Environmental Health Services Approved as noted for conformance with applicable Rules and Regulations of the Count sith Department Qy t S gnature & Title o RECORD OWNER: LINCAR DEVELOPMENT CO. INC. 281 LIBERTY STREET LITTLE FERRY, NEW JERSEY 17643 TOWN OF- PUTNAM VALLEY PUTNAM COUNTY, NEW YORK TAX MAP NO. 73.18 -1 -9 NOTES; 1. THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY INSITE ENGINEERING AND SURVEYING, P.C. BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONS7RUC7ED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULA77ONS OF 7HE RJI 9 COUN}Y DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. 2 ALL FACIL177ES EXISTING, UNLESS N07ED 07HERWISE. J TOTAL LENG7H OF FIELDS REQUIRED 500 L.F. TOTAL LENGTH OF AELDS PROWDED SW L.F. b rn cn c' _ m N m 2 < cn _, m N DATE I REMON rP 7-7 E INSTI 1 SUR 1491 Route 22, Brewster, New York 1050£ PROJECT SSDS FOR LINCAR DEVELOPMENT CO. INC. LOT NO. 2 LINCAR 2 SUBDIVISION DRAWING: AS -BUIL T DRA WING PROJECT 92135.'bo2 PROJECT JJC BY N0. OF NEW YO V J. rON,-, DRAMNG NO. I SBEET