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HomeMy WebLinkAbout0272DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -1 -1 BOX 4 ti , i' 1�ji t. , .3 IN I 1' 1� 'T� ' ' Y.� T II ,' 1 I -N • ' IN 11111 1 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES 225-0310 "4 ZOO -/C/0 ,PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR /?_0 OWNERsS NAME Mr, & Mrs. Charles De Rham' PHONE 878-6670 SITE LOCATION Cushman Rd. Patterson, N Y TO 12-1-4 MAILING ADDRESS Same PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY House PROPOSED INSTALLER Bottge Septic. Inc PHONE 2279-6069 Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Install 1300ga1 septic, 2001 infiltrators in existing area Proposal ,approved , Proposal Disapproved Inspector's Signa & Dd t F -.1 ,t�*6 Tj Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed ccmponents tied to two fixed points (e.g.,house oorne** r-s) d. System description (e.g., 1250 gal. concrete septic tank, three precast 61cdiamox 61 deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or reported agent of owner agree to the above conditions. 11. & W-dbe MD); YeUcw (T,.vn BI); Pink Lbnliamt) TITLE Pres DATE 8-9-90 TAB MAP cn r;�'% ,D e, 9 hA PvL PPLOP? 411- - �-m Permit # TM #12-1-4 Mr. & Mrs. Charles DeRham Cushman Rd. Patterson, N Y 12563 k. SOA'611'S a A I 31 - -3,-x 41'/ P, 1�5 // Aug. 13,1990 Installed By: Bottge Septic Inc. Sodom Rd. Brewster, New York 10509 (914) 279-6069 y x ,�• Yet t,.. S �� sr bS + x a s w 1 MW s 4t e f' \ k 1. a a wage + rL � A #5 .p 5 �' O�G rr � o r r+ NO s C T� h a t h- d f xs -T r t3 � �� ".t 1 -• x t. F �. _ s •. "� ? 3"! . � r t S, , >_` � r r4• a >vs �� w '� t �'" x tF . � ,�; a H� San MERIP"..11-M BUILD„ DA T A. Structure oc,31ed, trom survey by serve i ur rate .1 0 -a r i i i t; f s red i is-*, -pit )ailertez f0ttiVTJi-S ll�l I #-'I L C, C l' ?J I I r L no ,ear: r;a311h CQ Pt", i n.,%,p-e c t i o n by: H t. a I I h Ao P i 71,11, fa rVI e i! r K! Eng i . . . . . . . . . . . . . . . . . . NOTES iL '.4 D I M E --.N 10 N A F T 'A A .'K WTNIN *Yl RO At. M S-- ­ ' l G N : . + - " ' - 3 1 1 j,F'j T Yl I f �S A N 1. . R' -zv ZF, OWNLO 0.0 'A T 16N� t r 0 dtf Y0 W.A. n L OT, 31 77 7 (NA . 7771 'j, J6 -t e i ob 7-7 W Hi PUTNAM" COUNTY DEPARTMENT OF HEALTH'-- 4 \� s`Division of Environmental Health Services; Carmel, N -Y-10512 06N TGUCTION :PERMIT FOR SEWAGE DISPOSAL: SYSTEM_. Pd_ttel^Soh y = x Town 'or Village s Cushman Road °.(Towners;) 12 1 Located at Tax .Map Blocks Subdivision► Lot • 4 Job 501770 . ;Owner Mr - -:.. & :Mrs.. Charles Denham ;Address Cushman Road Building Type Frame Barn Converse or6t A rea Patterson:, NY { - s 1200:` on `2 F SS Number of Bedrooms Two Design Flow 600 .Gal . Total ,Habitable Space S�Sate Feet Separate Sewerage System to consist. of l OOO Gah Sept�c,,Tank and QQ. �'`r x : :2`f11 {Width Trench _ To be 'constructed by.', Address q 7� Wafer Supply + Public Supply From C ;XPr a ivte Supply to ,be drilled;` by Address Other Requirements None i 1 represent that l am wholly and completely-.responsible for the design and location of 'the proposed systems) 1) that-the- separate sewage. disposal system above described. will be constructed as shown.on tfie approved amentln4nt thereto: and in accordance with the standards, rules an regula ions o e -. u nam County Department, .of Health and that on completion thereof a Certificate -.of ConstructiomCompliance satisfactory to the,Commissioner ' of Healthwill g 11 ; be submitted to the 'Department,' and a written ,guarantee will be furnished -the owner,•his- successors, heirs oc:assi ns tiyahe•builder,_that said .builder vii place. in goo_ d °operating condition -any part of, said sewage disposal ,system during ;the period of two (2)• years immediately tollowing.the.date of the , issu = ance_of the 'approval of the,Certificate of .Construction,Comphance' :of the original.`system or any'Yepairs thereto 2).tha't the drilled well described above_ will be located as shown on the approved plan and thit,saia well will be installed ' ri' accordance with the ;stan rules. and -regulations,, f the Putnam County Department of Health e r Date; 1J AUgU$t J1 ,377- Signed P.E. X R.A. RD. 6 Box 353 ar el NY- `10512 29206 Address' ",License No. APPROVED•.FOR CONSTRUCTION: This approvaI expires one.yearJrom the :.date issuetl unless construction of the.. builtl�ng has. been undertaken and is revocable for :cause or may be "amehded or modif ,when considered necessary -;by `the' Commissioner of Health. Any.change or-alteration of construction ` requires a new ermit Approved for disposal of domestic ndary sewage, and /or private water supply only. Date ,.© . 7 6y Title. 0 CM -A t r..r JOHN H. PRENTISS, P.E. CONSULTING ENGINEER R. D. 9 • )s)ox) xxxPix =x Fair Street CARMEL, N. Y. 10512 (914) TRINITY 8.6170 14 October 1977 Environmental Health Services Putnam County Department of Health County Building Carmel, NY 10512 Attention: Mr. R. Tutoni, Administrator Re: Property of Mr. & Mrs. Charles DeRham Cushman Road, T. Patterson Dear Sir: As required by your Director, in late September we ran a six -hour well test to, establish a ten gallon capacity. This was required because of,the conversion of the barn on this property to a second dwelling. The results of this test: 7.1 gallons per minute at conclusion of test. The Owner thereupon approved the installation of a new One H.P. pump, which work was performed on 5 October. On 6 October we ran a second.six -hour test with the following results: Meter Reading (Ft.3 ) 5 Gal. (No. Seconds) Start 1000 hrs 470 28 1200 hrs 635 29 1400 hrs 795 30 1500 hrs* 872 31 Stop 1600 hrs 941 31 *Bacteriological Sample taken - Report attached The results prove the well as having a capacity of 9.67 gallons per minute, which should satisfy the requirements of the Director. Having satisfied this requirement we would appreciate the Construction Permit, which has been too long delayed. Very truly yours, ahn H. Prenti JHP /pr cc: Owner File r'� NANCO ENVIRONMENTAL SERVICES, INC. P.O. Box 10, Hopewell Junction, NY 12533 Laboratory Unity Street & 376 Hopewell Junction, New York 12533 Phone (914)- 226 -5155 New York State Department of Health Certified. Laboratory(914) -896 -8250 Bacteriologic Examination of Water . Sample No... 77 =615 Received. 10/06/77 /3:30PNtxamined. 10/07/77 9:OOAM Forward. Report To Names John-E. Prentiss, PE Add.resst RD #9, Fair St. , Carnel, IVY 10512 Sampling Point & Ad.d.ress: Cushman Road., Towners Owner /Buyer Name: DeRahm Addre s s :. A.bove Tel. No. Treatment: Chlorinated Softened. Other Source t Drinking Water X Other . Collected. BytB', Filippini Date- 10/06/77 Timet 3:OOPM Bacteria per ml. (Agar Plate Count at 35 C, 48 hrs. ) Total Coliform Group (Most Probable Number per 100 ml), Less than 2 Total Coliform Group (Membrane Filter Number per 100 ml) Fecal Coliform Group(Most Probable Number per 100 ml) Fecal Strep (Most Probable Number per 100 ml) These results indicate that the water was YES XXX of a satisfactory sanitary quality when the sample was collected.. NOT Nancy Barna d, Bacteriologist Linda H. Wilson, P.E., President 01'�T i 1977 All tests were performed. in accordance with the current edition of "Standard Methodss ►. The results of these tests represent a physical and chemical analysis of the samples as delivered to this laboratory. This laboratory assumes no responsibility for the identity of the sample or for the sampling technique or storage procedures employed. prior to receipt of these samples at this facility. I s 01. rrr ,D C TECK LIST Date: Insp.by: INITIAL SITE INSPECTION Yes No Comments Property lines or corners found . . . I . . . . .. I ✓ ✓ Can estimate house location . . . . . . . . . . Will driveway need cut . . . .. . . . . . ✓ � - Must trees be removed -note these . . . ... . . ✓ _ �" Is deep hole representative of entire SDS area Additional deep holes needed. . . . . ✓ ✓ Sufficient SDS area available considering driveway cut, house location, separation distances, etc. _ -✓ _ �.___- .- _.__.�___ DEEP HOLE DATA Depth: - / 0 t r Water elevation: O Rock elevation: C Soils descrint.ion: ctea Y Lore" Date: 'FINAL SITE INSPECTION Insp . 'by: House located where shown on approved plan SDS located where approved . . . . . Length of trench measured WidthAof trench average Slope "of the line and trench acceptable . Room allowed for expansion trenches . . . . . Over 50 ft. from swamp, watercourse . . . Natural soil not stripped or SDS area uru-iecessarily graded . . . . . . . . . . . . . 10 Ft. maintained from prop.line and 20 ft. . From house _ Separation of trench from house, well etc. follows plan . . . . . . . . . . . . . . _ Number of bedrooms checks . . . . ... . . . . Stones, brush, stumps,. rubble, etc. greater than 15 ft. from nearest trench . . . . . . 15 Ft. of peripheral soil horizontally from _ trench. . . . . . . ... . . . . . . . . . . _ Junction boxes properly set Could surface run off from driveway, roads., ground surface, etc. channel near SDS area. . . . . . . . . . . Does lot drain e a fear O: K. in area of SDS +INA GRADING OF SIW ACCEPTABLE m�y� �i�,Rw.�.,. -s� � �• � �1+ i .,a .n.,Y!' "'>fa""•C} � f�� etc "LJ �i»! i Y Mots StM Remarks C" 1'Ja House plans 0. K. DoSi�n d�.ta, sh °t✓t Peres presoakled? i hin.. 30" perc test depth � Cont. results for 3 runs I D. Fole log O.K. Corporate Ai'fidav:it for. other than indJLvidua.l N A I Author? zat -.on for engineer Intter. from; ',-later Supply if' applicable If variance requested -such noted on plans & apps.' a�( DETAILS if cha•nGe is prop' aed,) I Existing contours shown show nerd contours) ✓ Slop -s for drivevay cuts, etc. shoein ,-later ser�r_Lce line location ! j FootirZ, drain, etc. location Pop slope, bottom slope of fill w�p Percolation tests and d.een test pit location �/ peptic tank sire and conformance. to std. _ ✓ 5 B.R. house minin;um J ouse setback shown I I X11 Z•,a•t;er.wl•GC11i1 "VrI � ' � shown �_. �•._._._._ �_.._........._r.. —_ Plan and profile SDS All other wells and 3DS closer 200' I shown. or reference made ✓ j I Property boundaries (metes and bounds- clearly show-n) R -ATIONI DISZ:!1NCFS SPECIFIED ON PLAN )' to P.L. ✓ )' to Fo-Lmda t i on wall s )' to Nearest well I )' to strum, march, lake, etc. incl . expansion )' to Curtain drain !_ v )' to water lire (pits-201 — )' to storm drain )' to lark trees )' from foundation to septic tank )' to pipe from leader drain & fd— i I v I I ! � i drain a PUTNAM COUNTY DEPARTMENT OF I-U ?,l1LTH d DIVISION. OF rr4'VIRO1�Tf4HP1TAL I-M, t,TII SERVICES COUNTY OFFICE BUTLDING, CARW -,I.,, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner M�/y Address �4rdi•�+ �� ��/ /Tr�.,e� -r� Located at (Street ,� Z Block / Lot .dic /�_ �izdice neares cross s ree Municipality /0�► �- s.a,,, Watershed C1_0 SOIL PERCOLATION TEST DATA REO,UIRED TO BE SUBMITTED WITH APPLICATIONS 5 ��_ 2 ,.: Hole Number CLOCK TIME PERCOLATION PERCOLATION­ Run apse DeeptTi Lo -,,a er 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 /01�• /0 Y� I Y� . 3�° / 5 ��_ 2 ��,` `:/.,'' • M' ¢�* Notes.: 1) Tests •titb ::I�&- *`repeated at same depth • until aPproxlmately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Iepth measurements to be made from top of hole. ,.: az. ��,` `:/.,'' • M' ¢�* Notes.: 1) Tests •titb ::I�&- *`repeated at same depth • until aPproxlmately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Iepth measurements to be made from top of hole. TEST PIT DATA RI QUIJUM TO BE SU11M.1 -TIED WIT11 APPLICATION DESCRIP'I'TO14 Ole SOILS 7'-!COUJT.['.J{,Rf; ;D IN, TI?ST IIOI:?,S DEPTH. HOLE. NO. i HOLE NO. HOLE. NO. G. L. p 12" � 18" 2.4" 3011 „ 3 6 It 42" 48" S h L a 54 i Off 66 72'1 . . 7811 84'1 jj fo c& nTD-TCATE Lt,�VEL A TH�CH GROUND WATER IS ENCOMgTERED /Vona INDICATE LE`vEL TO WBICH WATER LEVEL RISES AFTER BEING ENCOUNTERED Alone TESTS 14ADE BY �ieff� :/.� P. ��� -� %� ��.c. (H.l�7.jDate DESIGN Soil Rate Used V,?99 Ydn/l "Drop: S. D. Usable Area Provided No. of Bedroams 7�vp Septic Tank Capacity, /0.012 Gals. Type ® i Absorption Area Provided By 7 ?� L.F.x24" width trench. 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