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00074
PUR'NAM COUNTYDEPARTA ENT OF HEALTH `
R iv. i'3/86 Division of Environmental Health Services, Carmel, N.Y. 10512
. Engineer Must Proviae P 1'2-90':
P.C.H D Permit H
CER CATS OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL-SYSTm Patterson
Town or'.Villa
ge
Located at hisa Court off Maple Avenue Tat Map 1 , . Bock 4 Lot 2.21
Grun maw
Owner /applicant Name .'Michael Reiser Formerly Subdtvlsiou Name Reiser Sabdv. Lot N j
M.Wng Address 460 Watermejgon Hill Road zip 10541 Date Permit issued 413190
Mahopac, NY .
Separate Sewerage System: built by D.E.M. Construction AddreiaWhite Pond Rd., 'Stormville. NY 12582.
Consisting of .10000. . _Gallon Septic Tank and 400 L.F. of .4 P f,. PVC in 24" Trench
Water Supply: Public Supply From Address .
u it- snna Address Patterson. NY.
or: X.. Private Supply Drilled by 3i3
Budding Type Residential Has Erosion Control Been Completed? Yes
Number of Bedrooms 3. Has Garbage Grinder Been Installed? No
Other Requirements , L.T. of Curtails Drairl
I certify that the system(s): as listed serving the above premises were constructed essentially as shown o he plane of the completed work'( copies
of which are attached), and in accordance with the standards, rules and regulati s, in accordance with ,filed plan, and the permit issued by the
Putnam ly /D /ppartme /y t/OOf/H�ealth.' Date / 24 / 4 Y P.E. X R.A.
Certified b
Address J. Robert R . ol /Itti . & Associates Licen" No. 051011 .
P.D. Box ". 3.74, :Brewster, NY ' 10509.
Any person occupying premises served by the above systems) Shall prom take, sueh aetbn as may be necessary to rerun the correction of any unsanitary
conditions resulting from such usage. Approval of the separate se rage 'stem shall become null and void as soon ss a pub:'-_ sanitary ewer becomes
available and. the approval _of the private, Water supply shall become ul nd void •when .s' .water_ supply b4cofnas available. Such approvals are
subject to m if•lcat n_ or :change when, in-the Judgment of the C 20f sett , r ocation , modification or change Is �0 Ury.
Date ( gy Title �Jn
4
JAMES F. GRUNDMAN 1078
SPECIAL ACCOUNT NO. 8
469 WATERMELON
MAHOPAC, N 50-1139/219
19
PAY
$
ORDER
TOTHE OF
DOLLARS
2!tZ 2
Lu
c -_NAT Xtm
TH E M A H 0 PAC DUAT fO NAL, WANK
MAH01pAC,
owe—w-,
FOR
u'00 LO?BIi�t019 I 13981:
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Michael Reiser 1 4 2.21
Owner or Purchaser of Building Section Block Lot
Michael Reiser
Building Constructed by
Lisa Court
Location - Street
Town of Patterson
Municipality
Residential
Building Type
Grundman /Reiser
Subdivision Name
Lot #1
Subdivision Lot #
GUARAN= 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
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 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 day of 19 9Q
ee�red �T r
eral Con actor er) - Signature
Corporation Name (if Corp.)
Address
rev. 9/85
mk
Signature `4 y
Title / or 15".
C— Ldz-
Corporation Name (if Corp.)
fox- � y � i. ✓1� �r / �G�
Address
S )6r$"10 / / &--
. �ri ,. ° iotae � .,�:�;���COtJt�,T,Y�OF;,M!l�T�d
,�pVARiMlNT�:Of LAO _ TOIIII
- ��' AL;FIA • q YC
w . - �, : a"� _ ^� INAT.ION'OFSOR KIN
oii...ti.fiM`�n ..
sl`A CO..
.-�
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WL'LL l,VllrLr.11V1V J.CI:.rVnl
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
ryq
f
WELL LOCATION
STREET ADDRESS: WNW TAX GRID NUMBER:
L� S0, . Ra 4@-^s
WELL OWNER
NAME. ADDRESS:
/14; 1-ifGt Ccrnro-#
PRIVATE
110 PUBLIC
E OF WELL
primary
2 - secondary
-
C5 RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND.IHEAT PUMP O ABANDONED.
O BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL O STAND =BY O
MOUNT OF USE
YIELD SOUGHT gpm. /N0. PEOPLE SERVED - _-2=._`/ EST. OF DAILY USAGE 20 Ogal.
REASON FOR
DRILLING
NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
❑ REPLACE. EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH ft.
STATIC WATER LEVEL ft,
DATE MEASURED 5126 G
DRILLING
EQUIPMENT
O ROTARY VCOMPRESSED AIR PERCUSSION ❑ DUG
O WELL POINT O CABLE PERCUSSION O OTHER (specify):
WELL TYPE
❑ SCREENED O OPEN END CASING OPEN HOLE IN BEDROCK O OTHER
CASING
DETAILS
TOTAL LENGTH ft.
MATERIALS: STEEL O PLASTIC O OTHER
LENGTH.BELOW GRADE ft.
JOINTS: WELDED O THREADED O OTHER
DIAMETER in.
SEAL: O CEMENT GROUT VSENTONITE OOTHER
WEIGHT
PER FOOT lb./ft-
DRIVE SHOE KYES ❑ NO LINER: OYES 52rN0
SCREEN
DIAMETER (in)
'SLOT SIZE
LENGTH
(ft)
DEPTH T REEK (ft)
DEVELOPED?
DETAILS
Q111ST
O YES . ONO
URS
SI�CON_D
GRAVEL PACK
YES
O
GRAVEL
SIZE:
DI ETER
OF PACK in. I
TOP
DEPTH ft.
B. TTOM
DEPTH It.
WELL YIELD TEST t If detailed pumping
M§rHOO: O PUMPED tests were done is in-
'COMPRESSED AIR , formation attached?
O BAILED O OTHER ; 0 YES ❑ NO
1�IELL LOG 11 more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE .
Water
Bear-
ing
well
Oia-
meter
FORMATION DESCRIPTION
CODE.
ft.
ft
WELL DEPTH
It,
DURATION
hr. min.
DRAWOOWN
ft.
YIELD
9Cm
Land Surface
Surface
r'
�-
6
�v
WATa O CLEAR TEMP.
QUALITY O CLOUDY HARDNESS
O COLORED ANALYZ D? )dYES O No
ANALYSIS ATTACHED? g YES O NO
STORAGE TANK: TYPE
CAPACITY GAL.
WELL DRILLER NAME DATE 7
ADDRESS SIGFIATURE
�,f
PUMP INFORMATION
TYPE CAPACITY
MAKER DEPTH
MODEL VOLTAGE HP
.07 Col"IMM
4-69 Waterme'.1on Hill Road Teens -MAhgr�ac- all 10541
R 'dential IM, Am
Tu be
County cogertment j-pli-illo.thereofs"6"ficatil Of construction"cirnmianw, satisfactory ib. ths COMMI-S"no!,pf "with will
be vibmam to mebapertinamn. and a written, Ojerantes will " furnished the owner. his su�� hairs or by tha bulklmrj that aid builder will
in On any DW 4t, ' III Sy owns he Ismu.
aom� Of the 41111101 of-Ithe Certificate vt Construction Complionto.of, the Original systqIjn oj'anV.r!j0jrs thereto; 12) that the drilledwell descriti*6 be
wall -will W Instal
Will be WAM n hugs 6m tow up giin'aidiliit aid I, -uses -a" 4"uSTOWS - of. the Putnarn
accords
Pi
D ate
Icense
revocable for cause W oft tfig'Cornijisilon-vi'91 04eelth. 'Any c" of altsirStiOn
671� TJZ)- By Title
`
P'M COG
VFW � 04�
DEPARTMENT OF HEALTH
' Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL-, N.Y. 10512 (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL
P C H D PERMIT 4 I'/�'l D
WELL LOCATION
Street Address
Town i
tege S+tT- Tax
Grid Number
Lisa Court
Patterson 1 -4-
2'.21'
WELL OWNER
Name
Mailing Address
OPrivate
Michael Reiser
469 Watermelon
Hill Rd Maho ac NY OPublic
USE OF WELL
® RESIDENTIAL
❑ PUBLIC SUPPLY
❑ AIR /COND /HEAT PUMP
13 ABANDONED
Ol - primary
0 BUSINESS
O FARM
p TEST /OBSERVATION
❑ OTHER (specify
O INDUSTRIAL
d INSTITUTIONAL
O STAND -BY
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE
SERVED 4 /EST. OF DAILY USAGE 400 gal
REASON FOR
0 NEW SUPPLY
O PROVIDE ADDITIONAL SUPPLY
❑ TEST /OBSERVATION
DRILLING
OREPLACE EXISTING SUPPLY ODEEPEN EXISTING WELL
DETAILED
To provide
REASON FOR
DRILLING
WELL TYPE
®DRILLED
DRIVEN
®DUG
]GRAVEL
®
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: jam _s F. Gran ma and
Michael Reiser Lot No._ 1 O _4 2.91 ) ._
WATER WELL CONTRACTOR: Name Not Yet Selected Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO
NAME OF PUBLIC WATER SUPPLY: NA TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: NA
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
❑ ON REAR OF THIS APPLICATION SEPA TE SHEET
2/21/90
(date) ( ature)
J. obert Folchetti & Associates
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 s.hall:
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.
Date of Issue: 4/3 19 ,'
Date of Expiration: 19 a it Issuing fficial
Permit is Non - Transferrable Mite copy: H.D. File
Yellow copy: Building Inspector
2/87 Pink Copy:
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner ^/ i G 1. e 1 R i s Address _ �j I,.J�� e.� n. e1 o h i 1 A4 G 4 c.
Located at (Street) Li s c, C0141,4- /N n f le Ave) Sec. Block 41 Lot 2.2
(indicate nearest cross street)
Municipality a e,rsoh Watershed
Cro4-ok,
Date of Pre- Soaking Date of Percolation Test
�? a 8
SOLE
NUCER CLACK TIME PERCOLATION
PERCOLATION
Run Elapse Depth to Water Fraa
Water Level
No. Time Ground Surface
In Inches
Soil Rate
Start -Stop Min. Start Stop
Drop In
Min/In Drop
Inches Inches
Inches
9 ;3:�-"? 3 %9-7 13 0
PR-112. a 4:co 'f:30 30
P4,
"31 Y:1-3 11
5
Pr-0- 5 Q L-
Iz
3o
3 :ay `f, �I
%2 2 Y2-
31
71
1/1 (r /2
J
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 nmsurements,to be made fran top of hole.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
L I
DEPTH HOLE N0. D k _ HOLE NO. (.� - P(/ '(, t� � n" 0p-.
« rr EP!!� NCB t 'f
,-0 �rt . D n -9? . D k.�,
r
4-1 V t ^1 V If
a Olive
� YO �✓
A*T SA clr "at., S
le
"r- GL SA-
0
Em
F S asp
ell" jZ o ck
,kT`" 92 O
Mid-
6 , -vel
El'k (--) go it
A-lo (l o c k-
INDICATE LEVEL AT WHICH GROUN�"� IS ENCOUNTERED t f,4 t Q-- 4 bs e-r, y 6o &
Pre2or.e4e i le" ;a )"cc's 064 2 2afgo X14 -1) N .,0@ 36" 0 -1 � PxO & 94rr
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUN'T'ERED 36r, - tf
DEEP HOLE OBSERVATIONS MADE BY: `T 1= V ( p; e- zo h, a4-r s '. PA L I DATE:
Soil Rate Used j) 15 Min /1" Drop:
No. of Bedrooms 3
DESIGN
S. D. Usable Area Provided S, o 00
Septic Tank Capacity 1 QQ O gals. Type PC L
Absorption Area Provided By al 0 L.F. x 24" width trench
Other 175- L , F:
t
Name 7r FZ Po1c1,9_44,* d- Assoc a - Signa
Address P t y. a o x 37 (I SEAL
6rt'L., 0e-' !✓7 /0 so a 19
SPACE FOR USE
HEALTH DEPARTVYM ONLY:
F 4"
y
Soil Rate Approved sq.ft /gal. Checked by Date
Pre-
APP-r'\DIX B
,PL7_-NTTAi COUNTY DEPARLVIENT OF HEALTH - DD -ISICN CF E!' -TRO&MRNMaL h=.:�LTH SERV-=
IiDIVZDL -.L �T*-:_",R SUPPLY & SL_..SURFACE S3 GE DISPCS _L SYSTEMS
REVT=K S!" =T - CC1'STRU T_ION PEPMIT
BY:
ner Y--,. (street Lo:.=_ticn )
YF._S NO DOCTM —EE 1TS
s ► Permit ADOl i cation
® - Corporate Resolution
- - - --- Plans - Three sets s/S
Engine°rs Authorization
Design Data Sheet (DDS) SLT_DZ -iSION
Deep Hole Log Perc
I COPSis 'lt Perc Results (3) Fill
I ;%I Perc Hole Depth cd
.wired _
0 ft. Max.
ara11_1 to
100% am. _
con'. o'ar s
FILL, S 'STS
cla - rri r
1 it
f ' notes I i
n soec. i i'
100 yr. flood elev. I -'I' I
200 ft. reservoir, etc.
0 Lt. tr
House Play - Two sets
Well pornit; PWS letter
`-Vr'-"-riance Request
_ . ry
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
itietland (To VDEC Pe` ni t R & D)
Data On DDS Plans & Permit Sam,--,
R=`'Qlili DETAILS ON PL.a \S
Sewage System Plan - ( nor `n arrow)
Sewage System Hydraulic Profile - Grp "_ty F1_cw
Z ill Profile & DL-mansions - Volur:e
D or J Box; Tren - _-llery; ~ pi t ails
Septic Tan's IF Size, : t3i l
lti`li Detail, . -r�iee Line i f over
Construction Notes (grin der rat-)
Design Data: perc and deep results
T`wa -Foot Contours Elci sting & Pr000sw
Driveway & Slopes Cut
rooting/Gutter,Curtain Drains (disc.= =e OK)
P=rC & D_ °O Holes Located
Representative of pr;rn ry and ax-,
,p on
Ex-�.ansion Area; shorn; gravity flow, sue:. size
_If wit & Shawn & Detailed
rious - No. or BedrC,
Wells & � in 200 ft. of Proccs e Syst- ns
Property -Mletes & Bounds
-House Set!,ack Necessary (Tight lot)
House SEF er - 1 /4 " /ft. _4"0; Tyre pip
No Bands; Max. Bends 450 w /cleanout
SERRATION DISTArNC<'S SPA_,," IFI- ON PLAN
Fields
10' to P.L., Driveway, Large Trees,rop of fill
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Str=-,, WaterCo[LrSe, Take (_.c. eh--an)
15' to'Drains-Dartain, leader, Foot_'n
35'to Witch basln.storT6raln.DiD d 'wateYco'Use
10' to Water Line (pits -20')
50' int- .nittent dra_rLce course
Septic Tans
10' free Foundation; 50' to will
1J' Well t.7 PST °
. w
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225-0310
March 22, 1990
J.. Robert Folchetti, P. E.
P. 0. Box 374,
Brewster, New York 10509
Re: Proposed.SSDS: Reiser
Lisa Court
(T) Patterson, TH #1 -4 -2.21
Dear Kr. Folchetti:
0<
JOHN KARELL Jr., P.E., M.S.
Public Health Director
Review of plans and other supporting documents submitted at this time relative to
the above - captioned project has been completed. Comments are offered as follows:
1. Plan and permit show and note 240 L. F. by 24' wide trench. For a
percolation rate of 11 -15 min /inch, a minimum of 375 L.F. by 241 wide trench
is required.
2. North arrow not shown on plan.
3. Septic tank size not noted on plan.
4. Humber of bedrooms to be noted on plan, i.e., proposed 3 bedroom house.
5. In order to verify that the curtain drain has been constructed to the proper
depth and is serving to lower the groundwater table in.the sewage disposal
area, all curtain drain installations will be required to provide vertical
stand pipes of 4" perforated PVC to depth of 7 feet, installed 5 feet from
the curtain drain, on each side. These standpipes must be shown on the plan.
Upon receipt of a submission, revised to reflect the above comments, this
application will be considered further.
Very truly yours,
Robert Norris
Assistant Public Health Engineer
RM /jp
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Philip Leger . -
FOLCHETTI ASSOCIATES
PO Box 374
Brewster, New York 10509
Dear Mr. Leger:
December 19, 1990
JOHN KARELL Jr., P.E.
Director
Re: Application: Reiser
Street: Lisa Court
Town: Patterson
Fee Due: $100.00 CERTIFIED CHECK/
MONEY ORDER
This department is in receipt of the above referenced project.
A review of your application will not be made until this, office
receives the required fee.
/ V�y tr,61y your ,
/ John Karell Jr., P.E.
Public Health Director
Christine tJo nson'
JK: CJ Intermediat ` Clerk
Note: Enclosed please find your clients check in the amount of $25.00.
ER
E L2-
;)RAIN
I
•
WALNUT- -rPF-IF
, p�
LNUr 'iREJ!
Di�t�n.ce •: ��r1
Pt. B to
165
168 1/2
173
177
181 1/2
138
143
148
152 1/2
118
158
124
130
136
142
Nol -,e': All distances measured in feet to the
nearest 1/2 foot.
Distance from
Pt. C to
127
132
137
142
147 1/2
110
116
122
128
134
106
112
118
124
130
7.'
S
Distance
from
Pt. A to
i' "1` •:
98
2:.
103
3' :.
108 1/2
4''
114
5-
119
86
92
98
;99
104
X10
110
err
l'1
90
96
3
102
1�4
10 8
Di�t�n.ce •: ��r1
Pt. B to
165
168 1/2
173
177
181 1/2
138
143
148
152 1/2
118
158
124
130
136
142
Nol -,e': All distances measured in feet to the
nearest 1/2 foot.
Distance from
Pt. C to
127
132
137
142
147 1/2
110
116
122
128
134
106
112
118
124
130
gaps - 100�.t
ND �tLS /
oR SsDS F-
I
i
t
N
I0C
/ cl
I