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Home My WebLink About3728DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdcics.com 631 - 589 -8100 74.18 -1 -'I 3 BOX 29 + or 03728 L Rev 3/ 6 . PUTNAM COUNTY DEPARTMENT OF'HEALTH D1vlslon of Environmental Health Services, Carmel, N Y.10512' + s r Englneer Must Provide i P.C. HD. Permit N� t CERTIFICATE OF CONSTRUCTION. COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town o'111ageTy21�, . sLocated at �il�1Q :: �'Ii 1 1 Tai MaP_Block• •'Lot Owner /apPUcant Name L M,(Formerly_� Subdivision Name % RY Sabdv. Lot N Mamng Address P.6 1 �y �J +fie ./ "1,` '�'G ZIP /- vL— Date Permit Ieeaed Separate Sewerage System built by "T7 y G�"G3: sj�k"G ,b iA 4' _ Address �� Q✓� Conelsting of,__ �� Gallon ; Septic T ank and Water Sdpply: Public Sappl;y From r ^ Address or Private Sapply'DrUled, by T' �1. ' a 7n �i" c mil' . Address- L Q= . Gi y� °Bdlldlrig Type ?V' Oh G Has Erosion Control Been Completed? n b t 1 Number of Bedrooms 3 Has GerYe Grinder Been InstalledY V a Other Regplrements ` `hi �� y r d► ► y f i.:;C d' to . a,n, f; �� ✓ �,a /� a u--e- I certify that the sp $em(s) as listed °serving.`the above premises.were,coHetruc :ess6ntially.as shown on.the plans of the,cgmpleted.woA ( copies of which are aGiaclied), and in- accordance with the atan3ards srules and :`regal ns, in accord ith.'th led plan, "and ttie:permif issued by the Putnam County De. tmen f Health ' ` Certified by ; Date P E R.A. Q- 1 ' .. Atldresf G ,�—Gf Yi� ..�C l/TC��ii �q i ,- j• :: / c L�ifsn'se No. i`Any' person oecupying. premises sewed by'ths above'system(s) shall promptly'take wch.'actlon as msy be rnegisitry. to teCUrs the corisctlon' :of.any unsanitary conditions resulting from '.such usage A'pprovsl -.of. thseparate <sewersge system'ahall become null and.void aa'soon as a pub(': •sanitary gvwr,` becomes •vailatila. and the' approval of tna - private "water supply shall tiecome null and 'void wiian a ,DUtilic water supply b }combs availabh :,Such.: approvals are ;¢object to _modiflotion 'or change when in the .judgment 'of, the-Commissloi ofrHasldh, su 8 oca ,. flutlon or change it'neceasary. r Date �• /. / lJ,� 8 _,.. .; Tit Qf A�Olr ♦TTT T lt/1LAT%T TTT ALT' T]Tnr%,nT ' Y .e - _ YYJ.;,LL %JWL" i 43 iVL. LV L WL%i DEPARTMENT OF HEALTH 'Divisicr. Off' EnviroriE6&utal ;Healt:h 'Services' PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use .Only WELL LOCATION STREET AOORESS: TAX GRIT NUMBEr WELL OWNER NAME: t` ADDRESS: BIVATE p PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED O BUSINESS 0 FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ . MOUNT OF USE � YIELD SOUGHT --�L— gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING OINEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST/OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL 'r DEPTH DATA WELL DEPTH ft. .STATIC. WATER LEVEL — ft. DATE. MEASURED i t DRILLING EQUIPMENT O ROTARY COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT 0 CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE O. SCREENED ❑ OPEN END CASING.. OPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH ft MATERIALS: STEEL ❑ PLASTIC O OTHER CASING LENGTH .BELOW GRADE ft. JOINTS: O WELDED HREADED ❑ OTHER. DETAILS DIAMETER, e in. SEAL: CrCEMENT GROUT ❑ BENTONiTE ❑ OTHER WEIGHT PER FOOT lb./ft DRIVE SHOE YES ONO I LINER: O YES ONO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? DE -r�l� - .,..:FIRST .. _ . _...... - 0 YES:. T .iu HOURS SECOND 7 GRAVEL PACK 0 YES O NO GRAVEL SIZE DIAMETER OF PACK in. 70P DEPTH R. BOTTOM DEPTH lt. WELL YIELD TEST If detailed pumping t METHOD: O PUMPED t tests were done is in- t • COMPRESSED AIR , formation attached? • BAILED 0 OTHER ❑ YES ❑ NO It more detailed formation descriptions or sieve analyses 'WELL LOG are available. please attach. DEPTH FROM SURFACE Water Bear- Ing Wett Ola' It FORMATION DESCRIPTION caoE, ft. ft. WELL DEPTH It. DURATION hr. min. DRAWOOWN ft. YIELD gFm. Land J tV� f g< fiD o Jt t t WATER 0 CLEAR TEMP. QUALITY O*TLOUOY HARDNESS 0 COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O No STORAGE TANK: TYPE CAPACITY GAL. PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP if WELL DRILLER NAME DATE ACCRESS SIGAAMRE ✓% � �--y A h j4 nom% PUTNAM COU1Vri'Y DEPART OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchatser o Build' g Section Block Lot Building Cons cted by� lk>cadoq - Street 01 ��A!p �, � I I) Municipality 1� rca 4r )f�-M Building 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 immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any _... -re cr s'm.�d1e- b��me- t�- ;ueh- syste�, - .except_ where - the- fail,ure�to . opQxatn_larapezly_ !s.. 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 Environmental 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 of 19 Signature ' Title Gckner'al Con a r (Owner) 'Signature Corporation Name (if Corp.) i Corporation Name (if Corp.) ess ess rev. 9/85 mk . .. "... • � _�_+_ti.t .._ui_ Y ._� --, .t :_:. . �-r' 3. y � ��JM�^ �°' •a".� r.rw PUTNAM COUNTY DEPARTMERr OF HEALTH DIVISION OF- ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE- SEWAGE DISPOSAL SYSTEMS INS�GTIb�tEPORT ` DATE: INSP.: BY: . (Name of Own 6W) (Street Lo tion) INITIAL SITE INSPECTION ' YFS NO C'OIiENTS Wetlands.on /or proximateto..property . ,. Property lines or corners found.:.....:. .. ..._ Can estimate house location . : :....... ......... ...... Will driveway need cut ......................... loll Must trees be removed - note these................. Deep holes representative of entire SDS area...... Additional deep holes needed...... . Sufficient SDS area available considering driveway cut, house location, separation distances,etc.... Adjacent wells/septics ... .. � .. .. .......... Access to Procosed well location for drilling .. D.H. 1 Lot Depth to G.W. Depth to rock Soil Descrinti, 0 ft. 3 ft. 6 ft. 9 ft. 12 ft.s FINAL SITE D.H. 2 Lot Depth to G.W. Depth to rock Soil Description 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: INSP.BY: House SSDS located per approved plan.......... . Length of trench measured '504), Width of trench average �✓ Slope of tile line and trench acceptable......... Room allowed for expansion trenches.............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded...... .............. 10 ft. maintained from property line and 20 ft. from house.. • ....... Distance well to SSDS (ft.) ...... IZ)ZI.7:....... . Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench.. ........... 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set ............................... Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS..,.... ,PTniar. r_aanrr_ nP CTTP'" nrY- 7Vrnur.F ®110 won. - tKCp nvte G.W.- Groundwater D.H. 3 Lot. Depth to G.W. Depth to rock Soil.Descri tion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. E7, E - Y AC" A' T-7 -M P _JTNAM COUNTY O v� i Orvisi�n of,;Enviraomental J CONSTRU ,ION PERMIT FOR SEW.jaGE DISPOSAL SY' $ubdlVlslOit Sulxi L 1 'Owner: /Address��! �L- 4 Building Typerll� �+ l'otLArea o Number�.of6edrooms § � �� ±Design Flo�.�c� /�/D �`v�� Separate Sewerage rySystem to consist of To De -con bys`'�� •Lr f + r Water Supply � ,.,,Pu`blic Supply F }on � � � 'f Prwate Supply to. be tlnlled by Adtlre�s_ ' OTher .Requirements R r - • r'C� � � ?�! .<� I represent ,that 1 am wholly'and completely responsible for the design ;^ above desC►Wed will be constructed as shown on the`agpr&ed A ngm County 'Department of Health, and that om.<omple`_ton thereof a C! i_ be 'submitted t0 thq Oepsrtment, land a. written guarantee will De f place in:•gootl_operratrng cond,tion.,any part: of said- sewage d�sposa ante of the approval of :th Cert,f.icate of ;ConstFuction Compliance Will be locatetl ss -ifiown ont'he approved plan'Snd that said wellwill be. County Departnl ritof H Ith - /� Date i• �' '` - � ; ,a4 S�gned� .AP.PROVEO FOR CONST °RUCTION: Tanis: approval expires I one year, revocable` ?or cause ,or mayrtie amended o► mod ified wfien con`si8ered r re4Wres a new mild - Ap r ved +fo d�sposfl of dome mta N.. -. _ ,S - 2:3✓ _. ..��Y x2" -.: aid ..._ .. _ r S 1 m t -DEPARTMEriT OF HEALTH °4 Permit _ L H alth 3erviees,'� Carme/ N ';Y� 10542 r s R r j p Town' or V,Ilage _ �i ax Map :Block 'aeIS. _ 3 C,.,# _RevisYOn r-- `/"+' �Y/ J�/- i l�t/JDateOf'�Previous:Appzoval" �` - •'� �# ;:,�' fiL �.�F 1115eotion"Dnly ❑ {"�� -� �Z�i�.i �Arli:,(.�'�. Q�' -r ` ;.I nd IocaUOn of the proposed system(s)! 1)';that the separatq sewage d,sposal,.system ,= nt there. to and in;accorganee'with the standaidsw►ule ;;an .'regula ions of e'. ; u nam ` s rf rfiCate of Con`struet,on Compl,arice saUstactoryxto the :Commissioner of Health will% iimshed the owner; hrs successors,: hers or ,ass,gns by`_the builder, thataa;d builder wilt ,system tlunng the;penog6fatvvo'(2) years�'immediately following -the dais of• "the issu'-- otthe onginal,syslem!or : bny repairs thereto,2),that the tlrillod- w.ellLd'_scrlbed above<.. ;� nstalled ,n eordahce wit standards r Ies and regu a i� o s of thee Putnam ` ^) :. �T - j _ L�eense No iom the tl to issued unless consf uetwn� of£t�ebu�ld,n hasbeen" undertaken and is . cessa►y 'try i om �issioner of 'Health, 'Any cha a or, alt n of construction r d Sawa a_ Vd `/ Qj .. aTdle 3:�1'x%Myr -{ -"'�, r•r �L. Chk .+S"� C Y_ M-. v+, S _ .. ... - � . .' ..., a. _.... - .-.- �.. ........... -..,. Y ... .mss....-- ._�.y.a. DIVISION OF ENVIRONMENTAL HEALTH SERVICES - - � .. r � � .r ._ C�^.i -Y.r nwf•r 'v .rr _•:..3 �:.a�� _ ..). ,,:.� ��- � .w?'� °_ r .r�wYaw.�-r.s ... DateY Re: Property of L / 2 '/ /�� /�'j��d(i (,V , Located at OX I A.) 6 (T) PVT %i7 /ate 91 A1 Bl o c k_� Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize 40e) &41� a duly licensed professional engineer Of or registered architect (Indicates 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 �pst;een -�r� sys-t-e�ns - in °^ c-oxr£ormity with ° °tYi� `pi C3 i'1 S-3u11S of--Article . 14-5-'-Or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very tr1il v vniirc - Signed Countersigned* R.A. , # 7 Address Telephone Address i Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - - � .. r � � .r ._ C�^.i -Y.r nwf•r 'v .rr _•:..3 �:.a�� _ ..). ,,:.� ��- � .w?'� °_ r .r�wYaw.�-r.s ... DateY Re: Property of L / 2 '/ /�� /�'j��d(i (,V , Located at OX I A.) 6 (T) PVT %i7 /ate 91 A1 Bl o c k_� Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize 40e) &41� a duly licensed professional engineer Of or registered architect (Indicates 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 �pst;een -�r� sys-t-e�ns - in °^ c-oxr£ormity with ° °tYi� `pi C3 i'1 S-3u11S of--Article . 14-5-'-Or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very tr1il v vniirc - Signed Countersigned* R.A. , # 7 Address Telephone Address i Telephone •1 �4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH '�-ERVICES COUNTY OFFICE DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM Owner! .� - Address 'TA Located at (Street' n -i y; ca. e nearest cro Municipality FILE NO. h.O^- Watershed �� .. SOIL PERCOLATION TEST DATA RE< W/ t RED TO BE SUBMITTEDWITH APPLICATIONS 5 Ct ID AP Off 3 t 4 5 F .SLP-u,9I984 e ;2 . - SEP 1 o 1984 PUTNAM CGUN N 3 OUTNAM CO U'lF `Y . DEPT, 1OF MEAL R 4 DEPT, OF HEAL k H. 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 from top of hole. 11bIe Number CLOCK TIME PERCOLATION PERCOLATION RM apse De p t h t o Va7 er Water Level No. Time From Ground Surface in`,Inches ,;- Soil Rate Start -Stop Min. Start., Stop D�op''in � Min. / "drop Inches.:: Inches Inches // ZY,� 4 5 Ct ID AP Off 3 t 4 5 F .SLP-u,9I984 e ;2 . - SEP 1 o 1984 PUTNAM CGUN N 3 OUTNAM CO U'lF `Y . DEPT, 1OF MEAL R 4 DEPT, OF HEAL k H. 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 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 NO. G.L. 6 ".. J'UI L 1211 18" 24" LIW71 96. 14 6 dU Lj 30.. �a� 3611 42" 48" �- 54 ", 60" It 84 it INDICATE LEVEL AVWHICH GROUND .WATER IS ENCOUNTERED .': INDICATE... Lt- �-WH,ICH.'WATE IL=L., RISES AFTER BEING .ENCOUNTERED, ESTSY MADE BY<9"� ®� is`d dC .... �._. _ .. Ikte ...... DESIGN Soil Rate Used �Min/1 "Drop: S. D. Usable Area Provided 6-0 No. of Bedrooms�Septc Tank Capacity ��. O� Gals . r a0 g Absorption Area Provided `By r ) L. F. x'24 q, .3b',' — PdJ ,g0 a4— 4;-d X-i i f ' aL �,o, /4h e o'Lle xeini tvame - 0 p,-" s 13- igaT e: f n o AW Address ~SEAL. . .a THIS SPACE FOR USE..BY'HEALTH DEPARTMENT ONLY: OF NEV4 Soil Rate Approved Sq. Ft /Gal. Checked by Date_ r PERMIT NO. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 3084 -0727 PERMIT UNDER THE ENVIRONMENTAL CONSERVATION LAW " ] ARTICLE 15, (Protection of Water) HARTICLE ARTICLE 25, (Tidal Wetlands) ARTICLE 24; (Freshwater Wetlands) 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO William Drina ADDRESS OF PERMITTEE 12 Boniello Drive, Mahopac; N.Y. 10541 Attn: Tim Drin LOCATION OF PROJECT (Section of stream, tidal wetland, dam, building) Adjacent area of FW -ML -4 On of Qrina lane appproximately x,000 feet from Dosoris lane. the .north side DESCRIPTION aF PROJECT Cnnstrurt a hnu-<P, driveway, well and septic system within the adjacent area of Freshwater Wetland MI in accordance -with the materials suhmittPd as part of the application for -4 this permit- COMMUNIT NAME (City, Town, Village) TOWN Putnam Valley COUNTY. PlItriarn FIA COMMUNITY NO. DAM NO. PERMIT EXPIRATION DATE ember 31 1986 GENERAL CONDITIONS 1. The permittee shall file in the office of the appropriate Regional Permit Administrator, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work., 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has ac- cepted expressly, by the execution of the application, the full legal respon- sibility for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, .actions, damages and " r.o`sts of eve(y narfie and- desCrfption resulting from the said project 4. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plain or deep boles that may have a tendency to cause injury to navigable channels or to the banks of the waterway. S. Any material to be deposited or dumped under this permit, either in the waterway or on shore above high -water mark, shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads,.such as will prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. That if future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood.flows or endanger the health, safety or welfare of the people of the State, or loss or destruction of the natural resources of the State, the owner may be ordered by the Depart- ment to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure, fill, excavation,, or other modification of the watercourse hereby authorized shall not be completed, the owners shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 8. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the .State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorized is not otherwise provided for by law, such lights and signals as may be pre- scribed by the United States Coast Guard shall be installed and maintained by and at the expense of the owner. 10. All work carried out under this permit shall be performed in accor- dance with established engineering practice and in a workmanlike manner. 11. .If granted under Articles 24 or25, the Department reserves the right.--_„ to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as may be found to be just and equitable. If upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense. to the State, and to such extent and in such time and mariner. as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in.a person not a party to the permit. . 13. The permittee is responsible for obtaining any other permits, ap- provals,, lands, easements and rights -of -way which may be required for this project. 14. If granted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part 501) of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards — Building Permits) and in no way signifies that the project will be free from flooding. 15. By acceptance of this permit the permittee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse side. 95 -20'4 (9/75) (SEE REVERSE SIDE) SPECIAL CONDITIONS 16. To satisfy the requirement of General Condition No. 1, the permittee or a ; repr.esentattve shall.- :.contact. by�.tel.epho.ne,;:t.he Division; of- Law_.Enforcement_ _._. ._ in New Paltz (914/255 -545j) 8 hours prior to he of``any portion of the project authorized herein. 17. The permi.ttee shall require that any contractor, or other person responsible for the overall supervision of this project reads and understands this permit and all special conditions. - 18. No excavation, disposal of excavated material, or.any other disturbance is permitted on the eastside of the stdnewal;las shown on the submitted drawings. 19. The septic system shall be,,constructed.in, accordance with plans as approved . by the-Putnam County Health Department. 20. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable.vegetative cover is established. SEQR NOTE: Under the State Environmental.Quality Review Act (SEQR), the project asso- ciated with this permit is classified-as an Unlisted Action.and the Department of Environmental Conservation (DEC) has determined that it.will. not have a significant effect on the environment. Other involved agencies may reach an independent determination of environmental significance for this project. DISTRIBUTION: el er.. J. Steeley Law Enforcement / Putnam County Health Department✓ Putnam Valley Planning Board PERMIT ISSUE DATE ERMIT AD. I TPA ADDRESS $1 SOUTH PUTT CORNERS RD. Vim __PAT m7 Wrir 9 /FIEND C1II;�;l: I; L ST % /�� /Y4AIJE l 1- 2� • ��Y U -.' . �s -D CC Date: Z �� • I� .L.. Iin3p . by � INITTAL SITE, Ji�`3PECTTO' y Ycs. No 4 Commcni.s ,Properly lines or corners" found _ Can cstim tc hous location . - Will drivcway need cut . . . . . . . . . . . . Must trees be removed -note these Is deep hole representrtive of entire SDS area Additional deep holes needed. . . . . . . . . . Sufficient SDS area avt:.ila.ble considering driveway cut, house location, separation distances, etc. DEEP MOLE DATA Dpth : 1;Tatcr elevation: Rock elevation: t/ Soils descriT)t•ion: �'rYr2: c� /�� tr✓� ? s�c�. " , j��,�,�%%r i✓ Date: FINT L SITE I1,1SPECTI G� Insp . by P,'rn- k�ily✓Jc� 2� House located ubjere shoi-.,n -on approved plan SDS located 1rh�re approved 'Irn th of tr en., m a s,, LL -�- Width of trench avel-a�iz .,3_u Ue line and trench. ac=ota le Room allowe* d for expansion trenches Over 50 ft. from s a- mp, l:aterc ours e Fatural soil not . strii)-::ed or SDS area =1ecessarily graded 10 Ft. maintained•from prop.line and 20 ft. from house .' Separation of trench f.roiii house, well . - -- -- - -- etc . follows- plan . - -. -: -• - -. - :- -:- ,- - -_: _: - — - .- - -- - - - - - R1Jliber of bedrocmns checks . . Stones, brush, • stun,:ps, rubble, etc-. greater thall- 15 ft. from nee-rest trench . . . . . . 15 Ft.. of peripheral soil horizontally from . trench . . • . . o Junc ion boxes properly set Could surface run off from driveway, roads, ground surface, etc. chamiel near SDS , area .. _ Does 1.ot. draii -In :e am ar O.K. in area of SDS i FI1�T�1L cI'J1DTr,c ` QI' SITE ACCEPT- ,T i�ypt, t C.. F, D'AQUINO and DONAHUE CONSULTING ENGINEERS Site ® Sanitary ® Environmental New York State Department of Conservation South Putt Corners New Paltz, N.Y. Att: John Feltman 7 April 2, 1986 RE: Property of Drug Dring Lane Putnam Valley (T) 914 -526 -2039 914 -628 -7576 Dear Mr. Feltman: The above captioned property was issued a freshwater wetlands permit to allow the construction of a sewage.disposal system to serve an individual house within 100 ft. of a designated wetland. The original plan showed the sewage disposal system 40 ft. from the wetla4 ; however requesting s the owner is re asage q ng permission to locate the end of the she system 20 ft. from the wetland. This does not appear to be a significant change and it will enable the owner to save a number of trees on his property which presently act as screening. Enclosed is a copy of a sketch of the proposed change. Your consideration of this request would be appreciated. Sinc ely, Daniel J. Donahue. . P.E. cC o T. Dring .. y. - P.C.H.D. 6kzlp� WIT �11 file R D # 2 Box 89 Putnam Valley, NewYork 10579 D R IN ( -.b4t4F- FPO P&S, &S Renewal_ Revision ❑ Owner /Applicant Name " , P Ql tl► - " r " Date of Preyons,Approva Mailing Address `n .d O n % 6 �Y ✓'c Town Zip PA I. la Building Typed G, Lot Area , ]FHB section Only Depth, Vohame Number of Bedrooms - — Design Flow G /P/D d� q A PCHD NotlBcation is Repaired When FIB is completed . Separate Settersge System to ci mist of Gallon Septic Talolt,..a L /. ` C To 6.. tb s 4 Alto C1. construe t Water SuPPV: _ Pablic Suip PlY Prem Address _ or: _PdvateSnpplyDrWedbY, n` 164 Address . a,4 Ik Otte; Regnlremente > d c �i / D vet r SJ` la $ le t V^ .7 tom' -0 f l a. .o i�7-7' represent tha f am-wnolly and completely responsible for.the design and locatio of,, the" proposed" system(s); 1) ;that he �separat6 sewage disposal •system - above descr bed "will be`constructed,as'shown on` "the approved amendment there to and ,in accordance "withAhe standards, rules an regu a ions of, e . u nam .1 PRES,SU; County Oepartnient of Health, and fhat on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health,will �N be submitted to the Depairtment, and a wriCten .guarantee. will ;be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of. said sewage disposal system during the period of two (2) years immediately following thedate of the.issu- ance of I the approval: of the Certificate of C:onstiuct,on.:Compliance' of the oiigina systern or any'repairs thereto;,2) that the drilled Well dexribed above , will be located4s shown on the approyed plan and that said well will be installed in rdance with the. st a s, rules d regu a ions of. the Putnam County Department of Health. 04. a P.E. R.A. Data Address. O y �o Z) eL C0 _icense,No APPROVED FOR CONSTRUCTION:_ This approval.expires one year from the date_ 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 �h requires a new peerrrmit. Approved for disposal of domestic sanitary se age, / private water supply only. Date 7 / -0� _ By Title �• D'AQUINO and DONAHUE CONSULTING ENGINEERS TO ❑ John V. D'Aquino O Daniel J. Donahue RD 2 Box 17 Breckenridge Road Put. Valley, N.Y. 10579 Mahopac, N.Y. 10541 526 -2039 628 -7576 DATE JOB NO. ATTENTION ' A AE: _ WE ARE SENDING YOU Attached ❑ Under separate covervia ® the following items: • ❑ Shop drawings I Prints ❑ Plans 0 ❑ Samples ❑ Specificaoons ❑ Copy of letter ❑ Change order ❑. COPIES NO. DESCRIPTION Nff�DATE THESE ARE TRANSMITTED as checked below: �I For approval O Approved as submitted ❑ Resubmit copies for approval t1 For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ ,For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS ' !::: 114 `4 n ✓.7 Q!:- d �� 4 1 e �/ `9 P ale COPY TO - "" .as•. ,... .' PUT'NAM COUNTY DEPARTMENT OF HEALTH APPENDIX K DIVISION OF.ENVIRONMENTAL HEALTH SERVICES Vil e Juri ; _3'9 •':... ti. -. < ti, - ,., Re: Property of Ms. Jane'Johnson , Located at Dingle Ridge Road, Southe'a�t,;New =orlrr (T) ' Subdivision of Subdv. Lot ## 3 Gentlemen: Section 87 Block '1 Lot 1 May O'Connor Ratchford Filed Map # 2094 Date 9/23f85 This letter is .to authorize pPdar W_ Sent- a.duly licensed professional. engineer XX r registered architect (Indicate) to apply for a Consi;ruction 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 an-, conformity with .th -e.. Provisiohs -,-of :Art"i -cle -I- 5 -.or 147, Education__Law, the-.Public Health Law,.and.the Putnam.County..Sani- tary Code. Very truly yours, S i gn a d% Countersigned: i Owne of rro rty South Street P.E. , R.A. , ## 059346 Address Route 116 Address North Salem, New York 10560 (914)669 -5104 Telephone Roxbury, Ct. 06783 Town (Za3 - 35T Telephone D'AQUINO and DONAHUE CONSULTING ENGINEERS TO ��i �.,7 Br M ey ✓ e f �s /%[.A! /�� b T /7,eda �! he ❑ John V. D'Aquino � Daniel J. Donahue RD 2 Box 17 Breckenridge Road Put. Valley, N.Y. 10579 Mahopac, N.Y. 10541 526 -2039 628 -7576 GATE �• y - - - JOB NO ATTENTION 14 /i& P_ 1? (4 D 2i 1 A-),Pk it WE ARE SENDING YOU . Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints Plans ❑ Samples ❑ Specifications G Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION of C d -c.r G 41 0601 s 41 6[ / - PI► L� Y ��.-e THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted a For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ ,For review and comment ❑ ❑ FOR BIDS DUE 19 REMARKS 449,42,ju&I 4) 4X IJ'Xkeel 12 • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US ;:y 4- -// 'r «AAh COPY TO SIGNED: Cp ro (oA DAVID D BRUEN t .............. ....... ..... QA C2�, DEPARTMENT OF HEALTH Division Of Environmental Health Services Date Engineer's name and address , Do,�&Rot Dear Mr. MD Deputy Comm.s3soner _iFMWP1P5,P5 COO SM. PP2A41r AM. Re P C, Review of plans and other supporting documents submitted A* 611 at this time relative to the above- captioned project has been m,p I e t e d. C o mme:n t,s.. `are o f f e.re d . a s f o 11 o ws* - 60� us mli'k r D _k�"MI— tA �,u 3t �g p/o - I - 9 ubmission revised to reflect the nhnva comments, this application will be considered further. Yours-.very truly, TWO COUNTY CENTER CARMEL, N.Y. 10512 (914) 225-3641 P �_" PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMENTAL HEALTH SERVICES. COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARA'T'E SEWAGE DISPOSAL SYSTEM; FILE NO. Owner. % /!'�j r�/i�/ NG _ Address ;U-� 4/a Ql /via Ace tic Located -at (Street e) ,� U17 (f Sec. Block Lot n icgte nea,re-t cross street Municipalit )14, / e, Watershed �! -G�f� ► �� SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Eiapse Depth to Wa e water lFvel No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in - Min. /in drop Inches Inches Inches 2,51, Ir 4 5 1- 2 1 - 2 3 • 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. Ali data to be submitted for review. 2) Depth measurements to be made fror..,i top of hole. _ `�'.GJ'1' i1'1 J..�ti11i i1C+_y%111.1..L./ j•/ J• -J,j I./VL /L'11111.IL •yll.l A11L.lVA 1'1 V1• _ ; DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO: HOLE NO: -: G.L. _ 12" Av i /l 18" 24" 30" 36.. 42" 48" 54 60" 66" 72.. 78 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Date 6 L., �Zi li DESIGN -_ Soil. Rate Used 3 D Ndn/l "Drop : S . D. Usable Area Provided r,006 No. of Bedrooms Septic Tank Capacity D00,, Gals. Type Absorption -Area Provided By roU L.F.x2411 x w c • Quo Ta me e e d ?. a W K < Signature Addre s s oeF4 9 SEAL ° `` P, �`�; �} �, . QY •(t �!n /� {. fP .L /`7ri/iO,o/iC .%V � .. J. , i x�+i2,,: _ ..J, - i THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: qTF . 4aas OF N EWE Soil Rate Approved Sq. Ft /Cal. Checked by to v4< dow0r,12t o 4 OF As '9" if P/0,7 Ti rn o4 by -r Dr ins Z)P- I ri S /- e,• - (,8 P44-na,n V,. dell! P.,..,14 ..f fy *Aa7L T-A,x i x 4-- --,-e 1 / 5,eVV7,& dir Syxie," ;6 /,1 "4 ied, on '1- � "r P ""' 0 Y.rie,-.j Waj IA,,,oz_-1e.' ZyMe 4-ff,,,e � '4-w dLeeec over. –r.5e �rqj_fel� lefe 4,r C e' , cc evd&�c C W"41 a r44 -J. —W A4.0 4 <L -the r.c,,qV- 4,: X e7,4. NOW Avision of Environmental floalth Services Approved as noted for conformance with applicable Vules and Regulations of the 6.')4 Putnam_County HgAlth Department.. 4C'-, -CO Signature & qlftio S 6-49-0c E At rys Corsi 4s IX's; a/• a' S `7 L, F 0,,e;.- A ah I- 01 00 129 0 0 paa T5 - AC_ 0,I/ kvA L-L AREA 2.00A C. L ,Lit FR. fuo FILL Co k. On 41- DWELL 6 229.82' 4CC-()C 1 170. 18" '--IRON PIN 6-49 -DOW DRIK 1 -01 Un,,nprO\,,e16 uhi��p,o\jed) POLE po L GRIN NOW OR FcRMI ERLL� C�RP_