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BOX 28
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03551
A PUTNAM COUNTY DEPARTMENT OF HEALTH ���
Division of Environmental Health Services, Carmel, N. Y. 10512
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
Located .,et. Boswell Road
`Subtl io�'Boswe'11 `Est -. Sec`t "B- Fi�ed�INan 1238 Mg
Owner McGlasson Builders, Inc.
Building Type Frame Lot Area 2.154 A.
Number of Bedrooms Three Design Flow 600 GPD
Separate Sewerage System to consist of 1000 Gal. Septic Tank
To be constructed by Owner
Water Supply: _
X
Other Requirements
Public Supply From
own o� r TYllage
39 Lot _ -- 14 Job S. 0. 1929
Address 93 Gleneida Avenue
Carmel .Y. 12
Total Habitable Space 1160* Square Feet
and 429 I _F_ x 4" wide trench
Address
Private Supply to be drilled by Boyd Well Drillers. Tnc
Address Rte 52; Kent, N.Y. 10512
None
I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam
County Department of Health, and that on corn pletion, thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill
be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will
place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date of the issu-
ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above
will be located as shown on the approved plan and that said well will be installed in accordance with the dards, rules and regu a�iTons of the Putnam
County Department of Health.
Date 18 November 198n Signed P.EX- R.A.
Address R. D. 9 Fair Ste Cam
.11 License No. 29206
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is
revocable.for ca a or may be amended or modified when considered nece nary by the Commis ner of Health. Any change or alteration of construction
requires a new ermit. Approved for disposal of domestic tar s wage, rivate ater supply onl .
Date By , ('
Title
PERMIT #PV 28 -80
_ -PIi.TN4M i�tUN'l; �3E��9It'�� �F_ �`�[1LT1 �..... _.... • _.: -...._ _�. _._
Division of Environmental Health Services, Carmel; N. Y. 10512G19G9 ~ `'
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley
Town or Village
Located at
Boswell Road Tax Map 62 Block 10
Owner McGlasson Builders. Inc. Tax Map Lot # 14 Subd. # 39
Separate Sewerage System built by Owner Address 93 G1 enei da Ave, , Camel. NY 10512
Consisting of 1000 Gal. Septic Tank and 430 L.F. x 24" Width Trench
Other requirements None
Water Supply: Public Supply From
X Private Supply Drilled By Boyd Artesian Well Drillers
Address Route 52, Camel. NY 10512
Building Type Modular No. of Bedrooms Three Date Permit Issued 11/26/80
Has Erosion Control Been Completed? Yes
b
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 accordance with the filed plan, and the permit issued by the
Putnam.County Department Of Health. l7
Date
14 Aug. '81
Certified
Address R. D, 9, Fair S
' P.E. X R.A.
Carmel NY 1d;12 License No. 29206
Any person occupying premises served by the above system(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 sewerage system shall become null and void ps soon as a public sanitary sewer becomes
available and the approval of the private water supply shall bec5!�� vol when a public water u becomes available. Such approvals are
subject to modification or change when, in the judgment of of Health, such revo,at , modification or is necessary.
/ -
NANCC' ENU.
- VIRQ-N,MENTAL SERVICES;} INC
UNSTY STREET AT ROUTE 376 P O BOXr10 4
HOPEWELL JUNCTION NEW YORK 12533 ''�*
RVED
NAME. +4s>S;H7
ADDRESS.
{
ME
r a
SAMPLING POPIVT= �3�3��
TREAT_.MENT:. CHLORINATED❑( _ - .---:,--,PPM); SOFTENED D;ATHER ❑
SOURCE DRINKING WATER,:❑ WASTEWATER EFFLUENT ❑OTHER
} _ z
AM _ '
COLLECTED BY ". _ - # C a ai3Y3 , .:. _- P M .x : DATE
3= - - TPwtE_.
22-4 .
❑ *APARTMENT COMPLEX ❑INSTITUTION - ❑ PRNATE>RESIDENCE ❑SWIM POOL
BEACH.' _ D MUNLCIPAL 0:;TIESTALIRAW,7, TEMPORARY
RESIDENCE; - `-
D CAMP ;" q NURSING HOME" p SCHOOL.. ❑TRAILER PARK'.
j
-
) FARM i` -ABOR CAPMP ❑.: PRIVATE COMPANY 0 SEWAGE TREATMENT PLANT ❑OTHER
❑ TOTAL GOLIFORM COUNT M.F T:. PER 100 M.L - -. ❑TOTAL COLIFORM COUNT MP N.'
PER' 100 -M.L
.FECAL COLIFORM COUNT F T PER 100 M.L. ❑FECAL COLIFORM COUNT M P N
PER 100 M.L. '
-M
o FROZEN'DESSERT PLATE -,'COUNT ❑AGAR PLATE COUNT 4 ;'
_
-PER 1 M.L: ,.
' LABORATORYTECHNICIAN r DATE REPORT
L ORATORY DIRECT R
777
t
t ;: _k ;'ti§ ✓ e'`'rr ' _. -
-
t, r x "3;.
DEFT.
.. r
WELL COMPLETION ftEVORT PUTNAM C06NTY DEPARTMENT OF HEALTH
W f . . Division of Environmontal Nualttl Corvicos '
,r .
COUNTY OFFICE BUILDING • CA.RMEL,'NGW YORK
., Thfs report is to .be completed bV well driller and submitted.to County Health Departnic6t together with laboratory report of
analyses of water sample indicating water -is of satisfactory bacterial quility aefore'certificate of construction compliance is'issued.
ih&RT �must4-,Dr': `�u4mrrTEI?`VVIIIAIN -36 I AY9 ELF -�Ett C411IIpL-ETtON.
NAME „ ADDRESS
ow,vEe
McGIvilason B ildey�..�I' Inc 93 Gleneida Avenue" Carmel N.; Y. "10152
LOCATION `
(No., 6 Sb ol) : °• (Town) (Lot Number)
OF1YELl'
'.
B Ili Valley
-4
BUSINESS
�'DOMESTIC.' ❑ ❑
ESTABLISHMENT ❑
�'
PROPOSED
FARM TEST WELL
USE OF
\YELL
{
f t' t i ��7 yx�tf�t; a
I PuBLI+C�r �i _ 1-- 'I'"' AIR OTHER
—
D ❑CONDITIONING ❑
1•_— IN'DU5TRIAL`' - (Specify)
IDIIIttINO
COMPRESSED
ROTARY F PERCUSSION ❑ Q OTHER
EQUIPMENT
LJ AIR PERCLUSSION )
CASING,• '
LENGTH (reel)
DIAMETER (inches)
,'
WEIGHT PER FOOT
®THREADED ' C�'WELDED
1
®YES
CASING R U7ED?
DETAILS'
178 s
°
NO
YES NO
YIElO
_.. HOURS .:.,•. G.P.M.
D ❑
YIELD (O.P.M )
1. •.TEST. ,, '
_ .
BAILED { PUMPED . COMPRESSED AIR
8 Hrsj.
WATER
MEASURE FROM LAND SURFACE — STATIC (Specify feet)
DURING YIELD TEST tleof) '.. ;
Depth of Completed Well '.
LEVEL}
r
in feet below land surface: '525 t
MAKE'' .. ..
LENGTH O tQ.AQUIFEk (l9ef)
SCREEN .
DETAILS
SLOT SIZE
DIAMETER (Inches), _
IF GRAVEL
Diameter of well including .
GRAVEL SIZE (inches) FROW(leof) TO (loot)
PACKED:
gravel peck (inches):'
DEPTM FROM LAND SURFAC[
"o.
FORMATION DESCRIPTION
Skotch exact location of wall with distances, to al least
caFT. • rr -�
two permanent landmarks.
..
..
.O
, h ,
4
)' Sly r�
_.. .:._ ,..._.
,o..
...... s. ?-'...: [ t• '1:
1 } M t h ylk
If plaid
wot totted at different depths during drilling, list below
FEET
GALLONS PER MINUTE
" 7
DATE WELL.COMPIETED ATE OF REPORT_ WELL ORILL£R (Signature)
G
7 -3 -81 7 -7 -81
W
9 ro _0T` uilding'. Minfc#stlity'
..Owner yen map 62
GOA Nctldn
mudins Or
swell Road
V0
Modular
tot
Boswell Estates Subd.9 Lot. 4o. 39
GUARANTY OF SEPARATE SEWAGE- SYSTEM
rippresent that I am wholly," And completely repponp-ible fq
workmanship, material, construction and drainage of the saw
Ag@
diepp4gl pyptem serving the abov'e deaq . ribed property, and that it
has boan
. constructed as shown on the approved plan or approved amendment t h. are o,
and In aqpordanpe with the standards9 rules and regulations of the
Putnam
County Department of Health, and hereby.guaranty to the owner., his u
hp,irs or apsig4s, to
place in,good operating condition any part or
said syatom constructed by -me w4ich fails to operate for a period of two
ypgrp bimp4l4tely following the date of initial use of the sewage dispQpa�
system, or any repairs made by me to. such system# except where the faildr*
0
t, ppoi4tq p negligent act of the occua .
properly is caused by' the willful or n
pant or the building utilising the s
yster..
The undersigned -further agrees to accept as conclusive the do-
tqrM1n0iQA of the Dir ector t r of the Dixision of Environriental Health 4ep-
Putnggq County . Department, : -as . to whe ther_o'r 11
.0 'ot" the"
-14M,141fa ..qi"-vh0_4yatefa an
act of. the 000up4rit or than 'building ,p .illzing the system,
I t 'd 140 day of August 1981 Signature
th
-.Is
Title
(If cor5pFatlon,, giVe ''5ame
And address)
Wl assoh - BI drs. �9
P. 93 910selda Ave. Camel My,
- - - - - - - - - - - - Imo. - -- "lost
THR94 (3) COPIES ARE REQUIRED WITH TIML-2 (3) COPIES OF FINAL PLAN
COW.749TION WILL R1 ISSUED,
GUARANTOR IS REQUIRED TO FILE NQT1CF- OF DATE OF FIRST USE OF SYSTEM.
- - - - - - - - -- - -
Nvi.alqn or E�iviroamental Health Services, Putnam County Department
4.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES-
Date— 29 October 1980
Re: Property of McGlasson Builders, Inc.
Located at Boswell Road, T. Putnam Valley
Section 62 Plat II- Bloc k10 Lot 14
Gentlemen: Boswell Estates Subd., Sec. "B ", Lot #39.
This letter is to authorize John H. Prentiss, P.E.
a duly licensed professional engineer x 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
1,:U1111CLL1V11 w.LLfl L1116 1j1aLLCt• a11Li to. supervise the cUnstiuct1un of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, . the Public Health Law,. and the .Putnam Counfy..Sani, _.
. _ .�.._� •-- tary Code, ..,dn.._ .- .P,,.. _.- �...•.. _.._ ..
9 FESSI(Nq� r
P.E., R.A., # 29206
R.D. 9,.Fa1r St.
Address
Carmel, NY 10512"
914 - 878 -6170
Telephone
Very truly your,
sighed—,",.
ner of ftdodrity
93 Gleneida Avenue
anal. NY 10512
Address
914 - 225-7964
Telephone
THE OFFICERS SHOWN Ohl,THE CORPORATE
AFFIDAVIT ON-FILE.-WITH THE PUTNAM:
.,COUNTY HEALT DEPARTMENT HAVE NOT
BEEN CHA SI E SUCH FILING.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
;.COUNTY. OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE 110.
Owner McG1 asson Builders, Inc. Address '$pstAlea I Road .
Located at-. (Street Sec. 62 Block 10 Lot 14
a nearesU cross street)
... .... .
Putnam Valle Sub�l.: Lot ..39,
Municipality Y Watershed .:te
..:.SOIL PERCOLATION 'PEST DATA REQUIRED TO BE'SUBMITTED WITH,APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run apse Depth to Water Water ve
No.. Time From Ground Surface in Inches ..Soil Rate
Start -Stop Min. Start Stop Drop in Min. in drop
Inches Inches Inches,
� ,p
1
i
Notes: '.l) Tuts to.be repeated at same depth until approximately equal soil :I
rates are obtained at each percolation test hole. A11 data to be submitted
for review.
'2) Depth measurements to be made from top of hole. �:
TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES..
DEPTH HOLE. NO HOLE NO. ..HOLE NC
�.YV c .. t < - rs i v _.t?,.,. s.. r .�i. .. a` %i ,..�,. •:. ti A r fu A =.'z" K ...r =✓ Vin, ii-�u "': .r,:.�.
6"
12
THIS S
SPACE:' FOR. USE '
'BY "HEALTH DEPARTMENT O
ONLY.
Soil- R
Rate, Approved S
Sq: Ft /G�1. C
Che �
i
t
"a
I A f, T -
PA
BnrPs
i.
tZ. 37 57-00
L --
1P
p
N
.605WELL
wet! tocare-o o-y; purveyors surve y..-,
Well drtllors report 7
So -
; esuremerto
Tc;n k, Boxes; pits, galleries B lateraI5 In-cated by: GDnt!uctor;
Enotneat:
He a Itt, qapt:
Field 'inspection- b.y: Health dept do I e:. L+
Engineer ED date'.
NOTES: -0 L q+—*1 Len,j�.s As .` -how
5 ,C -vutfiamireag"' .0
71i tFTb`CP!PfnZ;�t of Heai4t
Division Of Environmental Health Servioes.
Approved as noted for conformance with
applicable Hui and Regulations of the
Co ty e Ith Department.
B
lal,,
A E B E
A - F 8 F _ft:
- �-
A. 1�719
A. K -B -K
A
SANITARY SYSTEM QES1G.U.,"a,SQtaL
OWAER':
LOCATION Street'.
Town 1-4 C 0 u n! Y: �?o t-^ State:
SUBDIVISION':
Me 0:
Block. L o-r N
Builderc
Surveyor:
D r o; 7 P Date:
JOHN H, PR E N T1 S S EE.'.1-
CONSULTING ENGINECR
RD A R M E L NY 10!512 (914 1 878 -6170.
P
/fb 60
P-t
It
tZ. 37 57-00
L --
1P
p
N
.605WELL
wet! tocare-o o-y; purveyors surve y..-,
Well drtllors report 7
So -
; esuremerto
Tc;n k, Boxes; pits, galleries B lateraI5 In-cated by: GDnt!uctor;
Enotneat:
He a Itt, qapt:
Field 'inspection- b.y: Health dept do I e:. L+
Engineer ED date'.
NOTES: -0 L q+—*1 Len,j�.s As .` -how
5 ,C -vutfiamireag"' .0
71i tFTb`CP!PfnZ;�t of Heai4t
Division Of Environmental Health Servioes.
Approved as noted for conformance with
applicable Hui and Regulations of the
Co ty e Ith Department.
B
lal,,
A E B E
A - F 8 F _ft:
- �-
A. 1�719
A. K -B -K
A
SANITARY SYSTEM QES1G.U.,"a,SQtaL
OWAER':
LOCATION Street'.
Town 1-4 C 0 u n! Y: �?o t-^ State:
SUBDIVISION':
Me 0:
Block. L o-r N
Builderc
Surveyor:
D r o; 7 P Date:
JOHN H, PR E N T1 S S EE.'.1-
CONSULTING ENGINECR
RD A R M E L NY 10!512 (914 1 878 -6170.