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BOX 4
00141
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Owner /applicant Name 1
Mailing Address Sad'
Separate Sewerage System built by /.:�'UjeQ /«C.DA%WC-`T/A/4 167V Address' � `%� /V1
Consisting of _ 725 Gallon Septic Tank and i L- t4RX<2e1q74J Ale
Water Supply: Public Supply From Address
or ,'Private Supply Drilled by �I� /� //V //VG { A/ddress �L✓i/l//9/✓� AVE � �JKQ�
Building, Type /�� s / L Has Erosion Control Been Complet V A
Number of Bedrooms 4 Has Garbage .Grinder Been Installedl
Other Regalrements
1 certify that the system(s)as listed serving the above premises we e; onstructed �ess tial ly a shown on the plans of the completed work ( copies
of which are attached), "and'in accordance with the.atandards, rules a d gulationaccor n wi filed plan, and the permit issued by the
Putnam County Depertm_ent "Of .fHealth.
Data '- �i �r'� /Certified ' /� P.E.�fR.A.
AddressG�IA/I/t! rl/✓/:i C =^ /�%S �C.. /a�7C(+t/r /� R. A/ , itente P.E.
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'frem such usage. Approval of the separate sewers bm shall become null and void as soon as a pub±'_ sanitary sewer. becomes
available and the approval of the private water supply shall become nu an kl .when a publ water supply, becomes available. Such .approvals are
subject to modifica o or anQe. when, in the Judgment of the C m r of tli revocatIon, mollification or change is necessary.
Gate
ZY
fY///t_l► BY �� Tit le A G.
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i 1
WELL L:U1"1rLh11U1V lcr:rvlcl
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
WELL LOCATION
STREET AOORESS: 76WNIVILL717cily TAX GRID NUMBER:
Cross Road Patterson New York 3•� Lot 3
WELL OWNER
NAME: & Kathy Murphy, South Streef;SSPatterson, NY 12563
PBIVATE
PUBLIC
USE OF WELL
1 - primary
2 - secondary
Q(RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 3 _t05 / EST. OF DAILY USAGE gal.
REASON FOR
DRILLING
.[]REPLACE EXISTING SUPPLY []TEST /OBSERVATION ❑ADDITIONAL SUPPLY
NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 185 ft.
STATIC WATER LEVEL 261 ft.
DATE MEASURED 7/6/90
DRILLING
EQUIPMENT
❑ ROTARY (COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING AKX OPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH 2 ft.
MATERIALS: )�k STEEL ❑ PLASTIC ❑ OTHER
LENGTH BELOW GRADE 31 ft.
JOINTS: ❑ WELDED VTHREADED ❑ OTHER
DIAMETER 6 in.
SEAL: )g CEMENT GROUT O BENTONITE ❑ OTHER
WEIGHT
PER FOOT .19 Ib. /ft.
I DRIVE SHOES YES ❑ NO
LINER: ❑ YES ❑ NO
SCREEN
DETAILS
DIAMETER (in)
'SLOT SIZE
LENGTH (ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
❑ YES ❑ NO
HOURS
SECOND
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK in.
TOP
DEPTH ft.
BOTTOM
DEPTH ft.
WELL YIELD TEST It detailed pumping
METHOD: ❑ PUMPED tests were done is in-
COMPRESSED AIR , formation attached?
❑ BAILED ❑ OTHER ❑ YES ❑ NO
'WELL LOG If more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
wafer
Bear-
ing
Well
Oia-
meter
in
FORMATION DESCRIPTION
caoE
ft.
ft.
WELL DEPTH
It.
DURATION
hr. min.
DRAWDOWN
ft.
YIELD
gpm.
5 mace
85
6
-
160
30
3
10
Medium to hard grey limestone,
10
30
Medim to hard white limestone.
30
185
Mediun to hard grey limestone,
WATER )q CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
❑ COLORED ANALYZED? )MYES ❑ NO
ANALYSIS ATTACHED ?)Q YES ❑ NO
STORAGE TANK: TYPE Diaphragm
CAPACITY GAL.
PUMP INFORMATION
TYPE CAPACITY _I In
MAKER t;n(11dS DEPTH
MODEL T 9E In74 T VOLTAGE -2-30 H F3A4-
WELL DRILLER NAME h1I LL DRI LLI , . 12/, 0
ADOREss Putncm- .Avenue tG
Brewster, NY R t M , Pre i en
3/89
BREWSTER LABORATORIES
Box 224 - BREWSTER, N.Y.
(914) 279 -4945
- WATER ANALYSIS REPORT -
SAMPLE NO. 7757
SOURCE: Michael Murphy
Cross Rd.
Patterson, N.Y. 12563
COLLECTED: 7 - 6 - 9 0
BY:Mill Drilling, Inc.
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
TEST NEW WELL LOT #3
This result indicates the source of the sample was
of satisfactory sanitary quality when the sample was collected.
7 -11 -90
0 per 100 ml.
PUTNAM COLUEY DEPARTMENr OF HEAL-IH
DIVISION OF ENVIRONIWWM HEALTH SERVICES
Owner or Purchaser of Building
Building Con tructed by
W�A4
U>ccjation - Stxeet
Municipality
Building Type
i� ;
Section Block Lot
0' f1
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 Environirental Health Services of the Putnam County
Department of Health as to whether or not the failure of the systeu to operate was
caused by the willful or negligent act of the occupant of the building utilizing
the system.
Dated this day of IWk 19C/
General Contfactor (v ) - Signature
Corporation Name (if Corp.)
�ar7� i. , �,Ir ���! ,125.6.5'
Address
rev. 9/85
mk
Signature
Title
Corporation Name (if . )
Address
le
1
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C7 /
O
/ - -� 1,250 GA LOr l A Ot JQt,) \
EXPANSION AREA
�A' g�
LOCATION C"A2T
BALDWIN. & CORNELIUS, P.C. OWW '-
MICHA
SOUTH
CONSULTING ENGINEERS -LAND SURVEYORS PATrE1
BREWSTER, NEW YORK
r
..
.-
M'
BALDWIN. & CORNELIUS, P.C. OWW '-
MICHA
SOUTH
CONSULTING ENGINEERS -LAND SURVEYORS PATrE1
BREWSTER, NEW YORK
r
lUMM 00DM'i DWAZPMMr OPOEAI?H
DNYw d[Davhw�taelld Srllr S�edeis. C7mad N.Y.; twit 7 e a
clamromm 0 pwal [rta�IN `. L,
1 rapaNnt tlNt 1 nt a `wh011y,1
above davow will be condo
_ CowntY D.Wrtwnant :ofd. t'Ir!
M wbinittW .to tM:_Ospartl
EMCn'
in tined .otMratMnS_ eoa Ifte
Will a ioeae.e K M�awneq`e
County O ' artwnaax
Deli
APPROVED POit OONST.RIJ
revocable foi. Cause of _n4y'6
"Mmirea a Mw oernlit Ap
mod. Q..O
4/88
y
0
6irs "0i' aiiYaM. uiklol , that Will buililw vrill
2) ' nwd oflowing thedato of ttw l w
Itrs, 0 21 E" well dNOilbid above
to rNU s': of the Putnam
P.E. ,X R.A.
M. 1050 ;Licen N, ' 38329
uctbn of `tha building has been undertaken and is
Multh.. Any ehmfw or, alteration of.eondructlo l
ply only.
- —
Title
POTNAM COUNTY DEPARTMENT OF HEALTH
: Dlvhdon °opt EnAroemental HealthAini..em Gomel N.Y. 1051? _ Eo eer to Provide Peeeolt N
on CERTIFICATE OF COMPLIANCE_
Peamlt N
CONSTRUCTION PE>:1N>T FOR SEWAGE. DISPOSAL '.SYSTEM' T
Loafed sit. �� � own or:,'VWage::� •
Subdivision Name 1 �� -dam cttbd. Lot 0 3 Tax Map. Hlock 3 ''.*
�.J Renewal — D Revlalon E)
Owner /AppUcant Name
Date of Previotte:Approyd
Malllag Atbhbaa �T 1 �• Opl� 5c Z8 Z Tewni�.-Tr�— t?r -�O.0 ' � t "L SYa
Bu11db% Type T, k Lot Area r (o FkC— Fig Section Only Depth 1_Vohrtiie G,W
Number of Bedroouta Deatgn Flow G .P D ®.mod PCHD Notl6catlon Is Required Wiled F91 le compieted
Sepsieate Sewerage System to ooaialat of septic Taub -a-
_T0.60 '4.Od 1.__I a
conete ew by Address
water Supply: Po�llc Supply From Address
or: ` Private Supply Drilled by T° : 3 • Address
Irepresent that i am,wholly and,compietely responsible for the design and location of the proposed systems) 1) that the separate sewage disposal system .
above described will be construCtag as shown on the a,DDrovad amendment, there to and in accordance with the standards, rulevan regu ions,o e Putnam
County Department of Ha1th. 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 wiil 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 ofIthe issu-
Ones of the approval of the Certificate of Construction Compilance of • tha original system or _any regain ther' �2) that the drilled. welt des eribed above
i' wily be,louted Ys shewn.on the approved plan andfhit said well will be Installed in accordance wit the tlar s, u and 'regu a i� ons of the Putnam
County 00 rtmsnt'•of Health ¢
Date j \�O� 5gneel. lilY!!� P.E.I/ R.A.
Address • tA_ License No
APPROVED FOR CONSTRUCTI'OWThis approval expi es two.years from the date issued unless construction. f the building has been undertaken and is
revocable for cause or may be amended or modified when considerIad` necessary by the Commissioner of Health. Any change,or alteration of construction
requires a new permit. 'Approved �foi disposal of domestic sandirwsewage, anandd/ /or rvate water supply only. -
1/87 Date /?mod!/ 2 � eve —� Title
J�.. i�
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512" (914) 225 -3641
APPLICATION TO CONSTRUCT A WATER WELL .
PCHD PERMIT # Ij�'
WELL LOCATION
Street Address
GG
Town/Village/City Tax Grid Number
�o-
WELL OWNER
Name
Mailing Address
o I-D o-b oX 5 2-1: ,-rove-x)
ePrivate
O Public
USE OF WELL
'1 - primary
2- secondary
b nSIDENTIAL
O BUSINESS
0 INDUSTRIAL
❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
O INSTITUTIONAL O STAND -BY
O ABANDONED
O OTHER (specify
O
AMOUNT OF USE
YIELD SOUGHT gpm /# PEOPLE SERVED_& /EST. OF DAILY gal
REASON FOR
DRILLING
[MEW SUPPLY O PROVIDE ADDITIONAL SUPPLY
OREPLACE EXI TING SUPPLY 0DEEPEN EXISTING WELL
O TEST /OBSERVATION
'DETAILED
REASON FOR
DRILLING
WELL TYPE
[D&ILLED
ODRIVEN
DDUG
OGRAVEL
®
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No. 3
WATER WELL CONTRACTOR: Name T F-S -b Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
YES ✓ NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
OON REAR OF THIS APPLICATION Uri- SEPARATE S
C s�0%A��GTii
(date) (signature
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 shall:
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: 19
Date of Expiration: 19
Permit is Non - Transferrable
2/87
Permit Issuing Official
White copy: H. D. File
Yellow copy: Building Inspector
Pink Copy: Owner
Orange copy: Well Driller
A pP=` EC B
P'=j. ? ^_ C'L-L\Trf DE.°ARM= OF =ALI'ii - D1z1ISICI OF E ,ry C.NP`f�M`a.L f P- n 5---RV7!CES
RHDI ", UL L WA= S-JPPLY & SUESSUttS�'= St-T.Y1 DISFrtiyL SE=—c:
r ,0,/
(Narue of C'.ynar)
REVL,N - CGN1S ECICN PFFMIT
(Street, Lcctica) .
I I
I
DATE
:G „3
Pe -i= A -ppl i cation C,)
Ccr-...cr to Re =oluticn
Encineers Authcr?zat'-cn
Des_ n nat. Si —Zi ( 'CS )
Coen Ec_a Lcc
C --rs scent Perc RE =-,:!, _s (3 )
Perc Sole Deot_?
SL�DIJISLCi1
c-
lc_ter
Variance iiC .�1C�t
C ZRLTI
L�1 S�lviSiC:l
S •r sicn Ancroval C-.=_:ced
SECS A^- Lct= ..-_-
-we and (Ta /rEC Pe__: i = R & D)
Dc_ Ca DCS Plans & Pe- —i t . =-
j�IJL t� D� ., 1 c CIN __,tiy .-
Fill Profile & D?Ten=_Cns
D c ;7ren n /Caller_r; r w Pit cc_ils
S�=ct -.0 r0.nK - ^Size, Dee it / --> 4;
Well l Dei--L -r Line i= C4e
_
ccnstr- acticn Nct_s (cr_nc r
Le-ian Data.: Perc ana+ae_p r2=_-� _s
Twc Fcct Contours Exi =tinc & Prcccs
Dr vev v & Slcces Coat. J
FCOt_[i /C- atte'",�`Sta_ i Dra_ns (C_sC?ar�e C� {}
Per:. & Deeo Holes L,cc :tom
Repr= esentative cr pr=.- _r% and e.Y-- ansicn
Fxpaanslcc A-re ;shaN-?;=ravltr size
Pit & D Ecx S,zcwn & Dei- :.ilea
Ecuse - No. of Bear
Wells & SSCS � s Win 200 ft. cf r vCCSed S s
PrCCe_* tT Metes & Ex.^unds
Ecuse Setcac'{ Necassari (Ticzt let)
Ect:.Ge SePer - 1 /4 " /it. a110; yTe pi e
No Bands; Max. Bends- 45' W/ c_== ,..ancL't
S= RA=C -N DIST sN=- Chi PTT I
Fie? dr
10' to P.L., Drivewav, Lr_- T_s- :s,TC_ Cf f
20' to Foundaticn Walls
100' to Well; 200' in D.L.O.D, 1S0' Pi-s
100' to �,at_r=urse, rc {? (?I1C. E`C.
13' to Drains= =ta- - ;.^., LcC2_'r FCCtlilc
3E'tc C?tch bcsin,Si=C=L= ;nrti=ed water -cc i:
10 to water Line (pi tS-2, is-2, 0 )
SJ' 1IIt?T ILLt'S_'1L Q_r'7 =CZ � �'.L:Sa
S =ct' -c Tanks
10' S_CIl Fcund=ticn; 10'
I
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__
! t==nC. ^,
ra:c.
it
cCn tour _
I
I �L
I
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I'
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10 ft
fill t -¢
ra; S1.
I
i
Ceoth AUCeS
I .
100 vr. flccc e,
I
I
210 ft_ reservoir, etc.
150 ft. t= 4ga_l;'call•
I
I I
I
DATE
:G „3
Pe -i= A -ppl i cation C,)
Ccr-...cr to Re =oluticn
Encineers Authcr?zat'-cn
Des_ n nat. Si —Zi ( 'CS )
Coen Ec_a Lcc
C --rs scent Perc RE =-,:!, _s (3 )
Perc Sole Deot_?
SL�DIJISLCi1
c-
lc_ter
Variance iiC .�1C�t
C ZRLTI
L�1 S�lviSiC:l
S •r sicn Ancroval C-.=_:ced
SECS A^- Lct= ..-_-
-we and (Ta /rEC Pe__: i = R & D)
Dc_ Ca DCS Plans & Pe- —i t . =-
j�IJL t� D� ., 1 c CIN __,tiy .-
Fill Profile & D?Ten=_Cns
D c ;7ren n /Caller_r; r w Pit cc_ils
S�=ct -.0 r0.nK - ^Size, Dee it / --> 4;
Well l Dei--L -r Line i= C4e
_
ccnstr- acticn Nct_s (cr_nc r
Le-ian Data.: Perc ana+ae_p r2=_-� _s
Twc Fcct Contours Exi =tinc & Prcccs
Dr vev v & Slcces Coat. J
FCOt_[i /C- atte'",�`Sta_ i Dra_ns (C_sC?ar�e C� {}
Per:. & Deeo Holes L,cc :tom
Repr= esentative cr pr=.- _r% and e.Y-- ansicn
Fxpaanslcc A-re ;shaN-?;=ravltr size
Pit & D Ecx S,zcwn & Dei- :.ilea
Ecuse - No. of Bear
Wells & SSCS � s Win 200 ft. cf r vCCSed S s
PrCCe_* tT Metes & Ex.^unds
Ecuse Setcac'{ Necassari (Ticzt let)
Ect:.Ge SePer - 1 /4 " /it. a110; yTe pi e
No Bands; Max. Bends- 45' W/ c_== ,..ancL't
S= RA=C -N DIST sN=- Chi PTT I
Fie? dr
10' to P.L., Drivewav, Lr_- T_s- :s,TC_ Cf f
20' to Foundaticn Walls
100' to Well; 200' in D.L.O.D, 1S0' Pi-s
100' to �,at_r=urse, rc {? (?I1C. E`C.
13' to Drains= =ta- - ;.^., LcC2_'r FCCtlilc
3E'tc C?tch bcsin,Si=C=L= ;nrti=ed water -cc i:
10 to water Line (pi tS-2, is-2, 0 )
SJ' 1IIt?T ILLt'S_'1L Q_r'7 =CZ � �'.L:Sa
S =ct' -c Tanks
10' S_CIl Fcund=ticn; 10'
DESIGN DATA SHEET- SUBSUFA1CrE SEWAGE DISPOSAL SYSTEM FILE N0.
Owner 1'� O` kl AzA Address ► t -,P6t-,M SL S6
Located at- ( Street) O Block 3 Lot a
(indicate nearest cross street)
Municipality Watershed
• / . I OR am om. / • Y . I. MO • : Ivy
�� •'
Date of Pre- Soaking it r�
�py Date of Percolation Test
t t I t l8C
HOLE
MJ BER CLOCK TIME
PERCOLATION
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
t 2 - �0 3n
�� "Z i�2
AV12-
3 0 - �r� �o
= = - - 17 - -- = - 1
6
1 iO
3
' t
ta.
4
� �ar�a�>��ct•t
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.
rev. 9/85
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.
1'
2'
3' t
4'
5, , r
-6'
7'
8'
9'
10'
11'
12'
13'
14'
INDICATE LEVEL, AT WHICH GROUNDWATER IS ENCOUNTERED %
f
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED _ Jj
DEEP HOLE OBSERVATIONS MADE BY: DATE:
DESIGN
Soil Rate Used 0-7 Min /1" Drop: S.D. Usable Area Provided
No. of Bedrooms 4- Septic Tank Capacity k 2,�o gals. TyW ,
Absorption Area Provided By L.F. x 24" width trench
O F �!F
Other I t� • 1" ��i .� �� �, M f GN
Name C_ A drm• 72-� r Signature � '�� ` ✓ �
Address Y �j�Q -� SEAL
0346
THIS SPACE FOR USE BY HEALTH DEPARZMENP ONLY:
Soil Rate Approved sq.ft %gal. Checked by Date
DEPARTMENT OF HEALTH
Division of Environmental Health Services
110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310
APPLICATION TO CONSTRUCT A WATER WELL P/. i _?
PCHD PERMIT #/ U
WELL LOCATION
Street Address
CROSS ROAD
Town/Village/City Tax Grid . Number
PATTERSON 10 -3 -3
WELL OWNER
Name Mailing Address Wrivate
Michael Murphy, 1049 Van Buren Ave. Franklin,Sq., NY 11010 O Public
USE OF WELL
1 - primary
2- secondary
® RESIDENTIAL
O BUSINESS
0 INDUSTRIAL
❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O ABANDONED
O FARM - p TEST /OBSERVATION 0 OTHER (specify,
O INSTITUTIONAL O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT
5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 600eal
REASON FOR
DRILLING
El REPLACE EXISTING SUPPLY 13 TEST /OBSERVATION GI ADDITIONAL SUPPLY
® NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL
DETAILED
REASON FOR
bRILLING
To provide new
supply for new 4 bedroom residential dwelling.
WELL TYPE
OX DRILLED
DRIVEN
ODUG
GRAVEL.:
0
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
O'Hara Subdivision - Section 1 Lot No. 3
WATER WELL CONTRACTOR: Name To be determined Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES x NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: >1/2 mile
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
® ON SEPARATE SHEET
1/26/90
(date) (signature)
PE
TO CONSTRUCT A WATER WELL
- This permit to• construct one water well as set forth above is granted unifier 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 shall:
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 : prov by the Putnam County
Health Department.
Date of Issue: 19� vJ%�
Date of Expiration: 7--114 19 mit ssu�ng icia
Permit is Non - Transferrable White copy: H.D. File
Yellow copy: Building Inspector
Rev. 10/88 Pink Copy: Owner
Orange copy: Well Driller
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punum cajarY DEPArMERr OF _ HEALTH
DIVISION OF HEALTH SERVICES
DESIGN DATA SHEET-- RMSUFACE S&gAGE. DISPOSAL SYSTEM FILE NO.
Owner O'Hara Address P.O.Box 282, Patterson, N.Y.
Located at (Street) Route 311 /Cross Road Sec. 10 Bglocc 2 Lot 11
(indicate nearest cross street)
Municipality Patterson Watershed Croton
SOIL PERCOLATION TEST DATA REOUIPM TO BE SOB[ WI'18 APPI,ICA=ONS
Date of Pre - Soaking 7/24/86 Date of Percolation Test 7/24/86
LOT 3
HOLE
NOnER . C= TIME PERCOUMON PERCOLATION
Run Elapse Depth to Water From . Water Level
No. Time Ground Surface la Inches Soil Rate
Start-Stop 'Min. Start Stop Drop In Min/Th Drop
inches Inches Inches ��`P
1 1
2:24
- 2:40 16
21
24
3.0 ;' /
5.3
2
2:40
- 2:58 18
21
24
3.0
6.0
3
2:58
- 3:15 17
21
24.
3.0
.5.7
4
5
2 1
2:24
- 2:32 8
21
24
3.0
2.7
2
2:32
- 2:39 7
21
24
3.0
2.3-
3
2:39
- 2:46 7
21
24
3.0
2.3
4
s
5
.
1
2
.• OR
of ht
S
M t�
P
3
..
5
l •. I [`�. L4
\" ��� Gam?
NOTES:
1.
Tests to be repeated at sane depth
until appmcimately equal soil rates
are obtained.at each percolation
test hole_
All data to'be submittl2d
for review.
2.
Depth measurements
to be made from top of hole.
rev. 9/85
DEPIU
G.L.
1'
2'
TEST PIT DATA RMUIRED TO BE •SUBtUIT D Wl U"APPLICNI'l'.ON
HOLE M.
DE,SQ2IP7.'ION OF SOILS EtXS?UN E RIM IN TEST 1101.1
3A 11oLE N3. 3 B uor,l 1J3 .
a
3C
Topsoil Topsoil �— Topsoil
3' Sandy Loam Sandy Loam .
41 Water @ 5 ft.
Sandy Loam
Loam
5'
6'
t
Rock @ 6 ft. Rock @ 6 ft.
81 ' No Rock
9'
10'.
11'
121.
13'
14'
INDICATE LEVEL AT VMC H GROUNUV TIIt IS ENO0cINTEI13) Water @ 5 ft. (3A only)
INDICATE LEVEL TO P1111al {VIII= LEVEL RISES AFTER IH-N NG ' ENOOUmiE im - -
DEEP HOLE OBSERVATIONS MADE BY: John E b e r I o juYl'1; , 4-22-87
DESIGN -
Soil Rate Used 6.0 tdit)/1" Drop: S.1), U able Area Providod 4800
1I6. of Bedroans 4 Septic Tank Capacity 1200 _ ga lz . Type Masonry
Absorption Area Provided By 400 L.F. x 24" width trench
Other
11ame BALDWIN & CORNELIUS, P.C. Sigi
'kd kx1��
Address RD 6, ROUTE 22
SEAL s
BRPWSTr.R , NY 10509 =0°' 19$0 $.
111IS SPACE MR USE 13Y 11MU111 DEPAMMENr UILY: ter' y � ESSIUNPV �
Soil flat e Approved ";,•;''`` n,+
_ -- _ _ - sq.ft / gal. C7f��tJcr�� Yx.
/i
X
EP TEST
RCOLATION TEST
ISTING TOPOGRAPHY
OPOSED TOPOGRAPHY
OPOSED LATERAL
1. All trees within 10 feet of the proposed SSDS shall be removed.
2. SSDS to be inspected by the design engineer /architect and the Putnam
County Health Department after construction and prior to tackfill.
3. No trucks, machinery, building materials, nor excavated earth shall be
allowed in the sewage disposal area. Construction of SSDS to be in
accordance with these plans, any revisions thereto, and the rules and
regulations of the permit issuing governmental agency.
4. Minimum well yield of 5 glm is required. Yields less than 5 gpn will be
iun niiately reported to the Putnam County Department of Health.
5. The sewage system design shown hereon does not provide for installation of
a garbage grinder. Such installation requires the approval of the Putnam_
County Department of Health.
2
i
t. f
R L /
VD -q
PROPOSED /
SSDS
J
0
PROPOSED
WELL
LOT 2
R
°0'\ O kk
o 1� \ WELL
R= 175.00_ 1 i
\` L= 102.34 \ } / N58 °15'54 "E
33° 30 27" ) 18.86'
(50%
PROPOSED �° / / — — — /� �/ 901
WELL R= 25.00'
L= 38.64'
�S \ SSDS;, o0`p0 1 PO A =88 °32'49"
AREA,
LOT 4
IN EXISTING
WELL