Loading...
HomeMy WebLinkAbout0248DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 5. -1 -11 BOX 3 00057 II 01 ,I 6 r� MTN r i .i 00057 Divisron of fnviroriinente! Hale /th Set fcea x Carme% 10512 CERTIFICATE :OF TRUCTION COMPLIANCE'_,FO,R - `.SEWAGE ,DISPOSAL :SYSTEM y J. Loeatetl- at' Stagecoach &..Birch :Hi 11; Rds Tax Map 7 L� Y Hermit r T2 -�86" afterson' . Will `V)IUpe - �l p„np R T S. J &G Ga l a l d 6FO:me =lY tax Map rot a 8 subs r or- # x. 4 Separate Sewerage System built by" Owners -Address 1] Leewood Circle Eastchester. NY "`. consliin or 560' ` °x 24 " >w x 18" D Laterals g 1 50O dal Septic Tank and oiner "requlrerrients R 0 B `Fiecon 36" D`ee x:'549 Cu Y.ds 1Berm on West Slde 160`' z(,• y x Deep Curtain Water Supply Dublic Supply From P F Beal• &Sons, Inc s X D_rivate Supply Drilled !BY P 0: Box. B, Brewster, NY,. 1050 Address l Building type "r' FY ame Y No of Bedroom: Five Oate(: Permit Issued As 'required Has Erosion Contrdl Been Completed? i 3fcertify that the•sy�tem(s) as listed serving the above p emises' were constructed .essentially as eiiown o-n .tine plans: of the'oompleted work ;( copies; of ahSch'.are attached), and in accordance with the`etanaarda rules and requlationa:ain accordance .with thesfiled plan and '•the ,permit issued by the Putnam County Department Of Healthy Oats 20 July 1988 h ' R A .h oq t =�AD9 -Fair `St j :scar ANY 10512 29206 Address s s License No Anyf person occupying pre mJses served by the above system s) shall tom tl take such fiction as may be,oeeessar ao sawr�.th� eorr etbn of any unsinitary ' ( p P Y,� Y contlitions; resulting from,•such usage Approval of_the"6a'te sewerage system ;shall' -become'null'and vold_at,soonat "•a Dubllc,sanitary ewer WcomDS a svailable;4nd the; approval' of the ,private water supply shall become _null antl void when .a -public wata►:, supplyr becomes "avatlabti. Such approvals are .. j - sutilect to,' m diffeatlon'or. change when ;in _the Judgment: of the Commissioner of MSalt h, such revocation, motlification or eAinye I� .n�eewiy: Oats 2._ 'Rev. 9-81 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Scott Galeida Owner or Purchaser of Building Owner Building Constructed by Birch Hill & Stagecoach Roads Location — Street T. Patterson Municipality Modular Building Type 7 1 8 Section Block Lot Subdivision Name Subdivision Lot # GUARANTEE 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 o the building utilizing the system. Dated this 29 June 19 88 G6ieral 66ntractor (Owner) - Signature Corporation Name (if Corp.) Signature Title 17 Leewood Circle, Eastchester, NY 10709 Address rev. 9/85 mk Corporation Name (if Corp.) 17 Leewood er, NY KEFe--ss Yorktown Medical Laboratory, Inc. LAB ___ -- 321 Kear Street Date Taken: 6/9/88 Time: 11_ ; ?0am Yorktown Heights, N. Y. 10598 , Date Rc' d : 6 8 : 'R • 95 m (914) 245 -3203 Date Reported : ' 9��me Director: Albert H. PadovaniAf. T. (ASCP) Collected By: Turgati Referred By: T- JOHN PRENTISS P.E. 1 Sample Location: Kitchen Tap RD. #9, FAIR STREET Galaida Sta e Coach Ed. CARMEL, NY. 10512 Patterson, Y. 125b? (T" � - l - -g Phone N Phone #. I Sample Type: L J Repeat Test? _ (check one) LABORATORY REPORT ON T'r'E QUALITY OF WATER X Potable .Non- Dotable INORGA`1TC NON- METALS (mq /L) MICROBIOLOGICAL (CFU /100mL) _ _ STP I'iF STP EFF _ Acidity GENERAL BACTERIA _ Other: Alkalinity —. — — Chloride i Standard Plate Count, _ Detergents, MBAS (CFU /-1.OmL) Sample Status: — Hardness, Total (check each) — Nitrogen, Ammonia, MEMBRANE FILTRATION TECHNIQUE Nitrogen, Nitrate Outcroin _ Phosphate, Total ;.Total Coliform — Sulfate — HIN 03 — Sulfide Fecal.Coliform HC1 — Sulfite _ _ _ H2SO4 Fecal Streptococcus NaOH METALS Img /L) _ _ Zr.OAc MOST PROBABLE. NUMBER TECHNIQUE ?a2S203 — Cooper _ Other: — Iron Total Coliform Index _ _ Lead - - Manganese Fecal Coliform Index ' Incominc — .Mercury _ � Sodium KEY FOR TERMINOLOGY X .LE 4 0C — Zinc- i GT 4 °C N/A = Not Applicable pH LE 2 MISCELLANEOUS LT = Less Than ( <) _ pH GE 9 GT = Greater Than (>) I — pH GE 12 — pH (units) TNTC= Too Numerous To Count _ Other: Color (units) CON = Confluent ( =TNTC) _ — Odor (TON) NR = Non - reactive _ Turbidity (NTU) REMARKS/COMMENTS (For Lab Use) THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) I (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO T NE YORK STATE DRINKING WATER. STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIRE- OF COLLECTIOri THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) ODR� EET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STAT ING WAT ER CODES, FOR THE PARAMET TESTED, AT THE TIME OF COLLECTION. 2 /86(Rvsd7 /87)RWE Albert* H. i, M. . (ASCP), Director 0 --1— ZW WILL UUrirLZ11U1V AZrUAl DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Onl WELL LOCATION STREET ADDRESS: TOWNIVI'LOGI/ClIr W'GRIO NUMBER: Stagecoach Rd., T.Patterson,NY ig WELL OWNER NAME: 'ADDRESS: Scott Gal I aida RSG Con'st.Co.,PQ 'Rox ]2-,R, White Plain S ❑ - PRIVATE O. PUBLIC USE OF WELL 1 - primary 2 - secondary U RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR/COND.IHEAT PUMP 0 ABANDONED 0 BUSINESS 0 FARM 0 TEST/OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND =BY AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE gal. REASON FOR DRILLING 9 NEW SUPPLY 0 P ROVI DE. ADDITIONAL SUPPLY ❑ TEST/OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 120 _ft, STATIC WATER LEVEL 0*-f- ft. DATE MEASURED 11/7/86 DRILLING EQUIPMENT IN ROTARY 9 COMPRESSED AIR PERCUSSION ❑ DUG. 0 WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN. END CASING. ES OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH 2- tL MATERIALS: F&I STEEL ❑PLASTIG O-OTHER LENGTH.BELOW GRADE 20 ft. JOINTS: ❑ WELDED ID THREADED 0 OTHER DIAMETER 6 in. SEAL: 99 CEMENT GROUT 0 BENTONITE 0 OTHER WEIGHT PER FOOT 19 1b./ft. DRIVE SHOE: 191 YES O'No LINER: OYES ONO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN, (ft) DEVELOPED? FIRST OYES ONO HOURS SECOND GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE, DIAMETER OF PACK in. TOP. OEM ft. BOTTOM DEPTH — It. WELL YIELD TEST It If detailed pumping ,METHOD: 0 PUMPED i tests were done is in- 0 COMPRESSED AIR formation attached? 0 BAILED ❑ OTHER ❑ YES 0 NO If more detailed formation descriptions or Sieve analyses WELL LOG are available, please attach. DEPTH FROM SURFACE N Water Bear- ing Well Oia- mete In FORMATION DESCRIPTION CODE, I WELL DEPTH ft. DURATION hr. min. DRAWDOWN ft. YIELD gpm- Land Surface 11 MillLng in overburden clay and bldrs. I it rock at 3' 1,201 6 100, 30 3 21 ril l-in in rock .set casing ,groutei. 21 T-"illing iri -ronk granite, WATER ❑ CLEAR TEMP. QUALITY 0 CLOUDY HARDNESS 0 COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? 0 YES 0 NO STORAGE TANK: TYPE CAPACITY GAL. 11 PUMP INFORMATION TYPE MAKER Moo E CAPACITY DEPTH VOLTAGE — HP WELL DRILLER NAME P.F.- Beal & Sons,,�Flnq-F PO Box B f /8/88 ADDRESS S:lGflMRE Brewster,Ny 10509 ZW II. IV. V. VI. FINAL SITE INSPECT-ION \ Date � Inspec ed y •;CATION OWNER �-c. i 'R4 4 OR SUBDIVISION LOT 4 f. JUNCTION BOX --properly set g, LRENC ,ES _ 1. D-angth remAred installed 2. Distance to watercourse measured. ft. 3. Installed according to plan 4. Distance center to center f .� 5. Slone of trench acceptable 1/16 - 1/32 " /foot. 6. 10 feet fran prcverty line - 20 feet - four_dations 7. Depth of trench < 30 inches fran surface 8. Roan allowed for expansion, 50% x 9. Size of gravel 3/4 - 1 " diameter 10. Depth of gravel in trench 12" minimum 11. Pipe ends canned h. PLAT OR DOSE SYSTEMS 1. Size of pump chamber 2. Overflow tank 3. Alarm, visual /audio 4. Pump easily accessible manhole to 2rade 5. First box baffled 6. Cycle witnessed by Health Devartlnent estimated flaw per cycle HOUSE ' a. House located r approved plans. b. Number of bedrooms WELL a. Well located as per a proved lans , b. Distance fran SDS area measured ) ft. c. Casing 18" above grade. I �. d. Surface drainage around well acceptable. OVMIALL WORKMA.SHIP �-yp ✓ �° a. Boxes properly grouted b. All i s partially bar-kfilled c. All Ripes flush with inside of box d. Bar-kf ill material contains stones < 4" in diameter e. Curtain drain installed according to plan f. C.irtain drain outfall protected & dir. to exist.watercours g. Footing drains dischaFc a away fran SDS area h. Surface water 2rotection adeauate i. E=oszon controi providedo n slopes greater than 15 %_ 1 YESI N NO � �S SE+RGF. DISPOSAL AREA a. SDS area located as per approved plans b. Fill section - Date of plac nt 2:1 barrier. /( LGTH WIDTH AVG.DPTH c. Natural soil not stripped' d_ Stone, brush, etc_, greater than 15' fran SDS area. e. 100 ft. fran water course /wetlands. SERRAGE DISPOSAL SYSTEM a. Seutic tank size - 1,000 1,250 X X b. Sentic tank installed level , ,E- c. 10' minimum fran foundation d_ No 900 bends, cleanout within 10 ft. of 450 bend e. DISTRIBUTION BOX 1. AU outlets at same elevation -water testes 2. Protected below frost C C? , 3. Minimum 2 ft. original soil between box and trenches ' ' 1 �y Izke \ cs/P l PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES . John M. Simmons, M.D. Deputy Cainissioner of Health - FIELD ACTIVITY REPORT - Sheet of �� INSPECTION NAME � _ Orig. Routine ,�J \C). �a.�6� 0 ig• Complain ADDRESS g. Request- No. reet TM No. Canpliance Complaint Cam MAILING ADDRESS Final P.O. Box Post Office Zip code Group Illness Construction TELEPHONE ✓. Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title DATE CQ //C) _ TYPE FACILITY TIME ARRIVED Q'. of TIME LEFT o� n 30 FINDINGS: e J Other . Explain R , INSPECTOR: ` ,(,l�/j`� /��/Y�Q_.�,�//��//� TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: Z. Az .. Structwe located from snrvoy'•by surveyor n ito.d belo4DL._,� -» t1 ... • -, f 6 II tacato d by'. Surveyors sure y._ ..-_. - 'a Wolf' _dnlfora report . n .,. Enamo,oro mesruromonts __ - q Gtx.L. 1 GSA' Tank, (Dozes, pttd, ealloriea d 1Qtierals lo•catod by:Contrl5ctor: B2�AY ¢tgel.lC> PIPS 1t�K Enea+eers, 63`•f�B Health dept: )' - �_- Pteld inspection by; HeOltb dottl® dote:��o Eneunoor Tra da4o 660 r0_T*A_L1 TSis is to certify khat the ae a E^ :1 Ciro I disposal system was constructed. as jZ,0. 3, l �Lr �D�`� F° 'NOTES: ind't.cated on this plan and that thm .f Q - t aystem was inspected 'by ne b4ore a4; �4 was covered Dear. 171e syatedS was ,r tonatrnr_ted in IICcordau°e trit6r.- .S F. a• i staaderd roles and regulaCtan of the F'.C.H.D. & the N:Y.S D.N., pury � N p I ME Po S10td.S y J wl.l�Lll-'U A - 8 92e °37 A - E a4 v-, -- �. a E - 12 .t - 7r -- A- _TL- a 2-018 ' n - r' �'LZI - (Q7r._ 1 9o,e bIW z3! o� bzoe2 -�0 2��,9'g, A -=��° x -��a - d ' --Tar &-1/- 2 oo•!Z -6.7-14 C G iA � A -r i�6 - H a__ aZP A _ M 87,_x„ SANITARY SYSTEMO DE 519N owl A_ C . LOCATION Streeta�AyG coAct ,_ v. _ Tow n:p���G�r?oL`� _County:�iJ ? I`� to: - . SUSDI /1SIQN — -- - -- -- -- n f SlodesJ —. LOT NsL_ _ C^d .. - tluillam uouna;a- Uepar>weuc ui noelL.. Surveyor: •!�,.„��_ _.... ..._ _ ,ivislon of kavjr6nineutal Health Servic - ., 1 Orotzn, bat ®: Scale II 01 .., ipproded as noted �or,confoimancb, with Applioable i{ulee and Regul atione of the 4 Q H �N H PI P {� . E N T (` 5�.. P. Putnam'County Health'Department. seN•s'tt.i.�twa- �ettat�iarmm... 4 .. . R,-,v. 31'-86 31 c CONSTRUCTION PERMIT FOR Located PUTNAMCOUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y. 10512 AGE DISPOSAL SYSTEM ill Roads Subdivision Name Subd. Lot q Owner /Applicant Name R. , T. , S. , J. , & G. Ga 1 a i d a Engineer to Provide Permit t� 6 on CERTIFICATE OF COMPLIANCE Permit q T. Patterson Town or Village Tax Map 7 Block 1 Lot 8. Renewal_ Revision �[ �r✓��o/rro Date of Previous Approval 1/3/86 N ningAddress 17 Leewood Circle Town Eastchester, NY ZIP 10709 Building Type Frame Lot Area 2.7884 A ¢ F�U�Sen o U lr- e Yds .. � ,1 tDepth •� - �Volumo °;h� ,� •• Number of Bedrooms Five Design Flow G /P/D 1000EGNo on 'gip plated tiHc'sti is Required �Itemin le coin Separate Sewerage System to consist of 15 0 0 Gallon Septic Tank and x 24" wide x 18" deep l a t e r a l s To be constructed by Owner Address Water SaPPIy: Paibl(c Supply From Address or: X Private Supply Drilled by Other Requirements K— U —15 : .D 4 V 4 6Q. Y t . ✓tAezp represent that 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 completion 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 thedate 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 accordance with ths.—st4ndards, rules and regulates of the Putnam County Department of Health. Date 17 March 1987 Signed P.E._ R.A. Address RD 9 - Fair StreCV, Carmel NY 10512 License No 29206 .APPROVED FOR CONSTRUCTION: This approval expires ear 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 necess �ry by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic sanitary sewse, antl /or •ate water ply only. ' A / Date �,7 By ' Title Pi �D t' YITT M COUNTY LIG T E T OF HEALTH ENGINEER TO PROVIDE PERMIT # �-V - '� ON CERT FIC gIANCE, �( Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT CONSTRUC ION PER FOR SEWAGE DISPOSAL SYSTEM T. Patterson Town or Village Located at Birch Hill & Stagecoach Roads Tax Map 7, Block 1 Lot 8 Subdivision — — — — — — — Subd. Lot M — — — — — Renewal _® Revision �.p S.O. 2306 owner /Address Scott Galeida et f4 al, 17 Leewood. Circle, ats�t�,.1., xY,�1QTD9 `� �3�'17%80 Wdi iio pproval --.,, r j» Building Type MOdular Lot Area 2, 78841dcrei ` Fill Section Only Number of Bedrooms. fntt]Design Flow G /F /D 1900 _ y, M F C' N:�D BotllSaitt oe iRequired Separate Sewerage System to consist of 1250 Gal. Septic Tank and .x., 24" w.,,_.x 18"-- deeP �l�aterals To be constructed by 9 r Address ` Water Supply: Public Supply From X Private Supply to be drilled by 7 J Address ' other Requirements R-0-B Fill Section: 36" (479 cu. yds.) I represent that 1 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 completion thereof a'!Certificate of Construction Compliance" satisfactory to the Commissioner of Health 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 disposal .system during the period of two (2) years immediately following thedate 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 i accordance with the standards, rules and regu a cans of the Putnam County Department of Health. n 1 _•.., Address RD 9 -Fair St.. Carte, NY 10512 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issue onstruction of the building has been undertaken and is revocable for cause or may be amended or mgdified when co 'der necessary by the .mission r of Health. Any change or alteration of construction requires a n w per Appr7 for disposal of dome is nit ry se e, and /or rivate w er supply only. Date— BY Title Rao. A /RS \ .__. PUTNAM COUNTY DEPARTMENT. OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES FIELD INSPECTION REPORT 1 DATE. �j C" �? ✓ i� e i r �- '� ° " A-' fey! INSP . BY: ( Name of Owner) (S tr t Location) " INITIAL SITE INSPECTION YES NO C Mmam Wetlands on /or proximate to property.............. S " Property lines or corners found ................... Can estimate house location ....................... Willdriveway need cut ............................ 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 .......... ....... ......... D.H. 1 Lot - Depth to G:W. Z -V Depth to rock 4-t "S�- f Soil Desc-ri 0 ft. 3 ft. 6 ft. 9 eft. 12 ft. FINAL SITE INSPECTION C .H. 2 Lot Depth to G.W. Depth to rock Soil De! 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: _ INSP.BY• dies l`� House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable:........ Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... Natural soil not stripped or SDS area unnecessarlygraded ............................ 10 ft. maintained from property line and 20 ft. fran house .............................. Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxes properly set.. . ...... .... Could surface runoff fran driveway, roads, ground surface,.etc., channel near SDS area.... Does lot drainage appear OKJn area of SDS::...... VTMAr. r_s�n,nMr. OF SITE A(=PM=t ................. D.H. - Deep Hole G.W. --Groundwater D.H. 3 _ Lot = Depth to G.W. Depth to rock Soil Descri tion 0 ft. 3 ft. 6 ft. 'A 1 0 G 3l1¢I X103 2.1 4 1203 121-5 Z2 Z4- ¢... Z`7 3 T -e 5 rev. 9/85 1. Tests to be repeated.at same-depth until apprc imately egaal 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. PU1IW COUN'T'Y DEPARTMENT- OF HEALTH. DIVISION -OF; RVI11aMMM HEALTH ; SERVICE'S DESIGN DATA SHEET- SUBSUFACE S3aACE DISPOSAL, SYSTEM FILE. NO. Owner C&47767 � 1 ek- 4' Address _Bird, • u, )a& 2di TO Located at- ( Street) k4 e , t2- • Sec . TM 7 Block �_ Lot . (indi.cate.nearest cross street) r Municipality � ,,-ga„ Watershed Cr-b-6 SOIL PERCOLATION TEST DATA PXUIFtEQ TO BE SUBMIT= WITH APPLICATIONS Date of Pre--Soaking. 17 Dt c . '85' Date of . Percolation Test 17 HOLE NUMBER CI,OC'R TTME PGERCOLATION 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 1 trio 112-2. /2 2,7 w 3 212 3 1136 -1 r SB i0 , 3l1¢I X103 2.1 4 1203 121-5 Z2 Z4- ¢... Z`7 3 T -e 5 rev. 9/85 1. Tests to be repeated.at same-depth until apprc imately egaal 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 SOIIS ENCOUNTERED IN TEST -HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. G.L. 2' 3l. --- 4' 71 8' . ae 10' 11' 12' 13 ... u... , 14' A\ �t �c{�ge,✓btlE � �� " � fib" a• Ol ti a - I�"f� ti :l C INDICATE LEVEL AT MIC H GROUNDWATER IS ENCOUNTERED No" e INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED AA e 3 DEEP, -HOLE OBSERVATIONS MME BY: µ/2, T iEa !i DATE; 3 80 pa. .. "Soil Rate Used 8-1f) Min /1" Drop:,'.Y� S.D. Usable Area Provided a �• f No. of Bedroans Septic Tank Capacity , I 1: p gals. Type Md s °"e,, Absorption Area Provided By L.F. x 24" width trench Other-. - k -A-A e: # 1 <6 e+-•, j% t. ' 31 No,, d. 9. YJ Name o nab JOHN H. PRENTISS Address RD9 S. P.E. RMEI. NEW YORK '10512 0 �F �; . y.. •_ 292 � THIS SPACE FOR USE BY HEALTH DEP ,4!.1 Soil Rate Approved sci -ft /gal. Checked by Date PiTTNAM COUNTY CAS OF HEALTH - DIVISION OF ENVIRONMENTAI, HEALTH SERVICES SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS DATE REVIEWED: / BY: : -- -_ NO DOCENENTS Permit Application Corporate Resolution Plans - Three sets- Engineers Authorization ' Design Data Sheet (DDS) Deep Hole Log. Consistent Perc Results (3) / 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS. Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume or J Box Detail Septic Tank - Size, Detail Well Detail, Service Line if Pvt _ Trench /Gallery Pump Pit Two -Foot Contours Existing & Proposed Slopes for Driveway Cuts Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow ' .If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary House Sewer - 1 /4" /ft. 4 "0; `pipe pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) - -- Septic Tanks REVIEW SHEET - CONSTRUCTION PERMIT. 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same CONSTRUCTION PElf; run,-, uor-iijam i- alror f-r- ft': A" r: I dLocated at--'5: -R L-c-0A -Tax MA ' Subdi vl sion L 6 Owner. Address; Od 'Building Ty 'Lot •A rea :Number of rooms, 'Design Flow Total. Hatikable-S .System' st - of Separate Sewerage to consist Gal. Septic Tank, and To" be -constructed by Address Water Supply: Public Supply From Prliiate,,Supply. to be drilled by Address Other. Requirerhe*nts. I represent that v'am'.wholly I and completely responsible for the design and location of the proposed systems) .. i) that the- 'siip­a-ritc ii�kd .1 i6 11 , I the ove described will be constructed as shown on Approved amendment there to'and -in accordance With the standards ,I_rules.4pq.re t: P-,dmmls'U rn County - Qepak' erii hat,on completion thereof a "Certificate of Construc ion.'Compliancel satisfactoiy.td.thiii, S oner tie. bit 'submitted to-.the Depak'm int,% and a Written guarantee. will furnished the owner his sttccessci * r.s hei�-s` or -assigns 'Ider* h- ff pIace in goo - oviitrating Kl�-! d condition :a -part of'.sald '-sewage disposal syste m. during the ,;i6rio&oj-two Ir :any inei - Of the approval of-ihe. Certificate,*of o 6 -nw*06.n .Cdmpilance the original system `or Any repairs thereto; 21). that ,t e-; wilU be located as shown on the appro* vid plan And that said well will beinstalled.in accordance with the standards, rules and-remulatioRs-17 f 1! couhty Depirtm6it of Health. "k Date 'l, k r , Sign6 r AN j License, No APPROVED FOR CONSTRUCTION. This Ap proYal, expires one -ydAr'ficirn the d Ale is ss"donstruction -of the - tiuildmg-Fias been `undl revocable foe..ca-uW..60 may .6i-amended-.or*modif!61. when of Health, Any cha ngia or'. 6 lte4i &1;6i 1, 'fier r e-46ires a new permit..Approyk'd- for dispo ial ci f Oat. —3 Tit domestic By v 11 0 -i 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 N0. Owner A ddress 57-Ab C COACH L�,_/ ye Located at (Street > 6,y. a o Sec. -- Block Lot IMIcate., nearest cross. street) _ .1 a ..Watershed_ SOIL PERCOJATION TEST DATA.. REQUIRED TO BE'SUBMITTED.WITH <<APPLICATIONS o e CLOCK.:...TIME PERCOLATION . PERCOLATION Zun EIapse Depth to Water Water Level. No. ... ....:...:.............::.....<, . Time .. -. -. From Ground Surface, in _ Inches - _......,Soil Rate Start =Stop ' Min. Start Stop Drop in min./in drop Inches. Inches Inches ...__'1_..__,37_. z.�s •` 8M /e/ -. ._.. .. Z� 2 �. .�lN _.:.._...8na J / /�f 2.... z:_:.4G 2;;,'52 �� / �✓ Z4 .. 2 S / N . 6"�j 1i✓ .3. __?E.....� ,: D. /...._�; Qa' �ML� .....; � S - 11/./.. ' . •. -. .. ,awl / r/ .. .. Ar_ ..1 - . 3 . 5 • Notes'o.`,l) Tp`�ts to.be' repeated at same depth until approximately equal soil rates are obtained et each percolation test hole.. All data to_ be submitted for review.,. . Dep'tl measurements, to be made from top of hole. TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH 9PPLICATION .- DESCRIPTION OF' SOILS ENCOUNTERED IN --TEST HOLES DEPTH HOLE NO.- % HOLE NO. - HOLE NO. G. L. 6" 1211 �. GiaiT� �'cft > -, ��rT7f �t�tY -4, - 24 3011 .:. 36r' r7r� C«a y -zoo. . 42 rTTy CcAZ- Z�4,,, .. ,� roc /c 48" �ocK 5411 60" 721► � 84 r INDICATE LEVEL: AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL-U WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY . Date DESIGN Soil Rate:.Tsed >.:1d..n%1 "Drop: S.D. Usable. Area provided No. of Bedrooms-' !° Septic, Tank Capacity ooa Gals. Type Absorption "Area Provided By 33 6 L.F.x24 5b". 'width rent" . ..,_ ... ...... ..... Other Fame _ Signature Address­ ........ ... SEAL THIS SPACE FOR USE BY HEALTH DEPARTPMT ONLY: Soil Rate Approved Sq. Ft /Cal. Checked'`-.by Date �: ,�. ovswP w.w mw.,...1 w ... yr I'II E- T Dint pros from sopt�c honk 10 boi and betwfn ail box®e T CAL CURTAIN DRAIN TYPICAL F1 LL' SECTION FOR SI 4 eo fes tnotAI * eeplal.dret►rbWion engy b• riqu) rod, P6 N SE CTIO . ''` DUI 'flo ;P�oX -NP. "• r:LL ..Zd ��31E•OULE N// / y` ' h'E'W� Gt G a Tank insrdolengthJP, _ o _ Tank -inside wr 9 s tiquid lave I Capderfy_ /- - Field R.r®dd - --.0 r LA 1'cgiGA Lh Y. wii t . i WidtD L � ECACv' O_"I ° c. Nalaterals -� 3q ow.�oss��c,, fGc�O t u; + +, p N�bogZes °a IM /LYI.vl t I'lA (lal2.1A.1 ' • �r �? Fill c Ion Gol rGal /SgFtA -,SqR Req 4 r� CJ 1<.r _ long H y ' °>Or- wide D e _ , . .. -.. - /V z.;�o .�ij. Mri .« :rr +i,, zM :� � `#,' w - `R'� u•:,ru •t _ � :.� s.}-- cam;-'' — ....�., n 3a l . The current Ht?d Go v which h nsti \ ':r i 1` with inal.l're5 1 appr0 val7.ppmM1,F' r r r n + lation. 12. plater Su t r a. Tda er is: frc �T.eG'! b. If a private ca 6Zv -z ._'¢.'- -- -- , cordanee wit n• i Village /City 5 7" �l -Gj C— Cr7 � C !Zo d s? Qo r. " drillga.;rdto" required wei cation is to y_ Putnar Lt Zoo o° G ° Faguia ". ' ¢ �SoL Ip IPG_ a. HATer Oate l50o ciAL, ion OW N ER h_ 3 -o r �PTic Tq+,/K 1076 LOCATION Stroat . h D�E%'��lY lo7a Town: AT(0t��1 —J`. t e - - -- i ++ 11 t-LC r�Of.l4J;lLrcf6> _ /c).¢ Sueul ISI N� "�` m 'p ?ax — Js–o +v.