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HomeMy WebLinkAbout0442DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.07 -1 -7 BOX 6 00251 {� " 4.0 2 his tan so L.D , 00251 3/86 PUTNAM COUNTY DEPARTMENT OF HEALTH R Division of Environmental Health Serviced, Carmel, N.Y: 10512 . Englneei Mast Provide P 18 -86 P.C.H.D. Permit ll - - - -- 77 CER TE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM T at rnnn Town or Village Located at Sonnet Lane tii Tai Map 1 'Block 7 Lot .7. 13 Marianne & Joseph Fordmerlo Subdivision Name Lot # 13- Owner /applicant Name �— y , Mading Address Rte, 2 Box• 1 79 . Sonn T.ane _Zip 19561 Date Permit Issued 1 1120I86 Patterson NY Separate Sewerage Systemballtby o RO°,.�. * Mayer. onstr.Co. Inc. Address PoufzhquaQ, N.Y. Consisting of 1000 Gallon Septic Tank am14001 x " npe? T atPra 1 a Water Supply: Public Supply From IIAdddCCress or: —x Private Supply Drilled by�rd ArtPaian WP1 1 A�dreesRt-P 52, Carmel- N.Y. 10512 Building Type Frame Has Erosion Control Been Completed? As required Number of Bedrooms Four Has Garbage Grinder Been.Installed? No Other Requirements R n R Fill section- 94" it e e b x 4250+ sq ft- (2-70+ r- Wei a i I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and , ations, in accord th the filed plan, and the permit issued by the Putnam County Department Of Health. 1 Date 14 July' 1987 - certified b ' P.E. —R.A. Address License No.2_990 + Any person occupying premises served by the above systems) shall .promptly take such action as may tie necessary to secure the correction of any unsanitary conditions resulting from such usage: Approval of the separate sewerage system shall become null and void as won as a pub, unitary sever becomes available and the approval of the, private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Commissioner of heal "ch revocation, modification or change Is necessary. Dated 0 s�C 6Y �--- Title M PUTNAM COUNTY DEPARIME T OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Marianne & .Tncenh Ginrdann Owner or Purchaser of Building Owners Building Constructed by Sohnet Lane Location - Street Patterson Municipality Frame Building Type 7.13 Section Block Lot Crossroads Subdivision Name 13 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 we 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 6 day of July 1987 Signature Title Gen al Contractor (Owner) - Signature Corpo ation Name (if r-orp.) s MIUM, - � rev. 9/85 mk Own Pr Corporation Name (if Corp.) 8P2. Box 179C. Sghnet Lane Address Patterson, NY 12563 co WELL COMPLETION REPORT office Use Only at DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH STREET AOORESS: WNIw ! l Y TAX GRIO NUMBER: WELL LOCATION O/377EFR501V NAME: ADDRESS: 7/C 60,55T'122AleSr. Ix—PSIVATE WELL OWNER � 7olfr6rco . A�Lr �-.,V PUBLIC USE OF WELL RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED -1 - primary ❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) 2 - secondary ' ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT _ gpm. /N0. PEOPLE SERVED �� / EST. OF DAILY USAGE -900 gal. REASON FOR NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION DRILLING ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA ` WELL DEPTH 0 r ft. STATIC WATER LEVEL L ft. DATE MEASURED DRILLING ❑ ROTARY IPf COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH ft. MATERIALS: STEEL ❑ PLASTIC ❑ OTHER CASING LENGTH.BELOW GRADE ft. JOINTS: O WELDED THREADED ❑ OTHER DETAILS DIAMETER —� in. SEAL: IPLCEMENT GROUT ❑ BENTONITE ❑ OTHER WEIGHT PER FOOT 1b./ft. DRIVESHOE:PAYES ONO LIN ER: ❑YES XNO SCREEN DIAMETER,(in) SLOT SIZE LENGTH (f t) DEPTH TO SCREEN (fq DEVELOPED? FIRST `` ' O YES ❑ NO DETAILS HOURS SECOND GRAVEL PACK S GRAVEL'. .�¢` 4% DIAMETER TOP BOTTOM SIZE: O NO ' OF PACK in. DEPTH ft. DEPTH tt. WELL YIELD TEST I If detailed pumping ELL LUG tf more detailed formation descriptions or sieve analyses are available, please attach. METHOD: O PUMPED i tests were done is in- DEPTH FRO M well COMPRESSED AIR ;formation attached? SURFACE g atrr Oia- FORMATION DESCRIPTION 000E. O BAILED O OTHER i ❑ YES ❑ NO tt. ft. ing (meter WELL DEPTH DURATION DRAWOOWN YIELD Lar Surfl ace W � ft. hr. min. It. gpm- lv To ra 12 ' 3 A/6-11 A,/, av S' WATER ❑ CLEAR 'TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED ?. ❑ YES ❑ NO ANALYSIS ATTACHED? ❑ YES ONO STORAGE TANK: TYPE PUMP INFORMATION CAPACITY GAL. TYPE CAPACITY WELL DRILLER NAME "r MAKER DEPTH A ARESSA && SiG MODEL VOLTAGE HP Cafl'ir�i�X 4/y /QS/ a� BASED ON BOYLE LAW, WHICH HAS HELD TRUE FOR OVER 300 YEARS, IT INSURES THAT YOt}R SIZING WILL BE BASED ON FACTUAL PHYSICAL LAW, -NOT A THEORETICAL PERFORMANCE STANDARD SET BY TANK MANUFACTURERS. Uffid I I► 1 11. WELL- X -TROL, TANK VOLUME .37 .31 .27 MODEL NO. IN GALLONS 20140 3Q./50 40/60 e"iR EPLACES� PLAIN TANK (GALLON) (SIZES) 101 2,0 17 .6 ,5 102 4,4 1,6 1,4 1,2 12 102_I11 4,4 1.6 1,4 1,2 12 103 8.6 3,2 2,7 2-i 3* 20 104S 10,3 3,8 3,1 2,7 25 'r 104 10,3 ? 3,00 3,1 2,7 25 200• JT -14 14,0 5,2 4.3 3,3 30 200 -UG 144 5,2. 4.3 3,3 30 201 14,0 5,2 4,3 3,8 30 201 -Iii 14,0--, 5.2 4,3 3,8 30 202 20,0 7.4 6,2 5,4 42 202 -114 20.0, 7,4 6,2 5.4 L12 202 -UG 20,0 7,4 6,2 5,4 42 203 - 32., 0 1118 9.9 8,6 82 250 44,01G,3 13,6 11,9 120 250 -UG -.. 44,0 16,3 13,6 11,9 120 251 62,0 22,9 19,2 16,7 160 251 -UG 62,0 22,9 19,2 163 160• 252 a6.0 31,8. 26,7 23,2 220 350 1 44.0 31 277 32.1 360 23 220 LAB # Yorktown Medical Laboratory, Inc. 321 Kear Street Collection Station Used: Yorktown Heights, N. Y. 10598 Carmel .� Peekskill _ S Mt. Kisco _ New City _ (914) 245 -3203 Director: Albert H. Padovani M. T. (ASM Date Taken: (� / Date Received: olu T- do S?/1 , Date Reported : - i Collected By: �(�,(• "��Q� �� P i� 7 e%C Referred By: Sir " ►fQ' . Sample Source: i LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA Standard Plate Count per 1.0 mlV (Agar plate .@ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform per 100 ml Fecal Coliform ner 100 ml Fecal Streptococcus per 100 ml MOST PROBABLE NUMBER TECHNIQUE ( MP;7 ) Total Coliform Fecal Coliform: OTHER ANALYSES MPN Index ner 100 ml MPN Index per 100 ml THESE RESULTS INDICATE THAT THE WATER.SAMPLE A) (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert H. Padovani, M.T. (ASCP), Director ELAP #10323 LEGEND RDS = Recommend Disinfect - ing Water-Source TNTC = Too Numerous To Count CONF = Confluent < = Less Than > = Greater Than Our practical experience with numerous wells of similar characteristics suggests that this well should provide an adequate, safe, and reliable water supply when equipped with a properly sized pump and storage tank. In support of this opinion, the following points are noted for your consideration: 1. WELL DIAMETER = 6" 2. WELL DEPTH = 605" 3. STATIC WATER LEVEL = 38 FEET 4. PUMP SETTING = 580 FEET 5. NET PUMP SUBMERGENCE FROM STATIC WATER LEVEL = 542 FEET 6. WELL BORE UNIT VOLUME = APPROX. 1.5 GAL /L.F. 7. THEORETICAL MAXIMUM WELL BORE STORAGE CAPACITY = 567 GAL 8. 24 --HOUR PUMPING TEST DEMONSTRATES WELL YIELD = 2880 GPD 9. AT A DEMAND RATE OF 100 GPD /CAPITA, HOUSEHOLD WATER DEMAND WOULD BE 500 MATELY 17% OF THE DEMONSTRATED WELL AT A SUITABLE PUMP CONTROL SETTING, FROM THE WELL IS MORE THAN ADEQUATE SIGNIFICANT INCREASE IN DAILY HOUSEI THE GIORDANO GPD, OR APPROXI- YIELD. THEREFORE, THE WATER SUPPLY TO ACCOMMODATE A -TOLD WATER DEMAND. 10. TO FURTHER ILLUSTRATE THIS, IF WE ASSUME THAT THERE WERE NO RECHARGE TO THE WELL FOR 24 HOURS, BUT HOUSEHOLD DEMAND CONTINUED AT THE ANTICIPATED RATE OF 500 GPD, THE WELL WATER. LEVEL WOULD BE LOWERED BY APPROXIMATELY 335 FEET. AS THE WELL HAS A DEMONSTRATED YIELD OF 2880 GPD, OR A WATER LEVEL RECOVERY RATE OF APPROXIMATELY 80 FEET PER HOUR, THE WELL WATER SURFACE WOULD RISE TO THE STATIC LEVEL, 38 FEET BELOW THE SURFACE, AFTER APPROXI MATELY 4.50 HOURS OF NO PUMPING. -- 11. OF COURSE, IN ACTUAL USE, ANY PUMPING FROM THE WELL WILL CAUSE SOME RECHARGE TO THE WELL FROM THE AQUIFER, TO: JOHN PRENTISS, P.E., CONSULTING ENGINEER FROM: BOYD ARTESIAN WELL CO., INC. ;f SUBJECT: DOMESTIC WATER WELL YIELDtGIORDANO- SONNET LANE, PATTERSON, NEW YORK° "" Our practical experience with numerous wells of similar characteristics suggests that this well should provide an adequate, safe, and reliable water supply when equipped with a properly sized pump and storage tank. In support of this opinion, the following points are noted for your consideration: 1. WELL DIAMETER = 6" 2. WELL DEPTH = 605" 3. STATIC WATER LEVEL = 38 FEET 4. PUMP SETTING = 580 FEET 5. NET PUMP SUBMERGENCE FROM STATIC WATER LEVEL = 542 FEET 6. WELL BORE UNIT VOLUME = APPROX. 1.5 GAL /L.F. 7. THEORETICAL MAXIMUM WELL BORE STORAGE CAPACITY = 567 GAL 8. 24 --HOUR PUMPING TEST DEMONSTRATES WELL YIELD = 2880 GPD 9. AT A DEMAND RATE OF 100 GPD /CAPITA, HOUSEHOLD WATER DEMAND WOULD BE 500 MATELY 17% OF THE DEMONSTRATED WELL AT A SUITABLE PUMP CONTROL SETTING, FROM THE WELL IS MORE THAN ADEQUATE SIGNIFICANT INCREASE IN DAILY HOUSEI THE GIORDANO GPD, OR APPROXI- YIELD. THEREFORE, THE WATER SUPPLY TO ACCOMMODATE A -TOLD WATER DEMAND. 10. TO FURTHER ILLUSTRATE THIS, IF WE ASSUME THAT THERE WERE NO RECHARGE TO THE WELL FOR 24 HOURS, BUT HOUSEHOLD DEMAND CONTINUED AT THE ANTICIPATED RATE OF 500 GPD, THE WELL WATER. LEVEL WOULD BE LOWERED BY APPROXIMATELY 335 FEET. AS THE WELL HAS A DEMONSTRATED YIELD OF 2880 GPD, OR A WATER LEVEL RECOVERY RATE OF APPROXIMATELY 80 FEET PER HOUR, THE WELL WATER SURFACE WOULD RISE TO THE STATIC LEVEL, 38 FEET BELOW THE SURFACE, AFTER APPROXI MATELY 4.50 HOURS OF NO PUMPING. -- 11. OF COURSE, IN ACTUAL USE, ANY PUMPING FROM THE WELL WILL CAUSE SOME RECHARGE TO THE WELL FROM THE AQUIFER, AND TYPICALLY, HOUSEHOLD'WATER USE IS NOT CONTINUOUS, BUT OCCURS IN SEVERAL PERIODS OF PEAK DEMAND THROUGHOUT THE DAY. DURING THIS TIME, THE PUMP WILL DELIVER WATER AT 5 OR MORE GALLONS PER MINUTE FROM THE STORAGE IN THE WELL BORE, AND AS THE PEAK DEMAND SLACKENS, THE RECOVERY WILL CONTINUE AS OUTLINED ABOVE. 12. IN A TYPICAL 24 HOUR' PERIOD, INTERVALS OF LITTLE OR NO USE MAY COMPRISE A TOTAL OF MORE THAN TWELVE HOURS, DURING WHICH WATER LEVEL RECOVERY CONTINUES AND WELL BORE STORAGE IS REPLENISHED. 13. IN REVIEW OF THESE POINTS, IT SHOULD BE APPARENT THAT THE DOMESTIC WATER WELL IN QUESTION CAN PROVIDE AN ADEQUATE SUPPLY OF WATER, WITH AMPLE MARGIN FOR FUTURE WATER DEMAND GROWTH. 7 _..T v 31,66 V\ VCTD'iTfTrAN PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y. lOS12 PERMIT FOR SEWAGE DISPOSAL SYSTEM V Sonnet Lane Engineer to Provide Permit N on CERTIFICATE OF COMPLIANCE Permit b T. Patterson Located at Town or Village Subdivision Name Crossroads Subd. Lot N 13 Tax Map Block Lot .13 Owner /Applicant Name Marianne & Joseph Giordano Renewal_ [X Revlslon ❑ R n 919 4 Date of Previous Approval 1 May 1986. Mailing Address 37 W.1 li am S Pt Town Carmel, NY Zip 10512 Frame 40850 sq. ft. FILL SECTION COMPLETED Building Type Lot Area Fill, Section Only Lzi Depth - 24 Volume 2 7 0 Number of Bedrooms Four Design Flow G /P /D 800 PCHD NotlRcad.on is Required When Fill is completed Separate Sewerage System to consist of 1000 Gallon Septic Tank and 400' X 24" deep laterals To be constructed by Roger Mayes Address Carmel- NY 10512 Water Sapph': Public Supply From Address or: X Private Supply Drilled by ? -- Address Other Requirements R -.O -B .Fill Section;. 24" deep X 4254.•sq. ft. (270 cu. yds:) I represent that I 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 an .regu a ions of e Putnam County Department of . Health, and that on completion thereota "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 the stanstaLds, rules and regulaons 'of the Putnam County Department ,of Health.. ILI Date 10 November 1986 Signetl P.E. X R.A. - RD 9 -.Fair Str t armel, NY 1 12 29206 Address License 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 of may be amended or modified when'considered.necessary by the Commissioner of Health. Any change or alteration of construction requires /aa nneew�) permit. Approved for disposal of domestic sanitary sewage, and /or vats er sup I nly. Date /f' 6� L✓ .G- // 7J 4r o. �z��� �� fl PUTNAM COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Will driveway need cut ............................ Must trees be roved - 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 D.H. 2 Lot Depth to G. W. Depth to G. W. Depth to rock Depth to rock Soil Descr 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. boil. uescri Lion 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: INSP. BY: D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descriptio 0 ft. , 3 ft. - 6 ft. 9 ft. 12 ft. DATE: J FINAL SITE INSPECTION INSP.BY: -- YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured 0 Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... ; �` .'l, %'c t -� Natural soil not stripped or SDS area unnecessarly graded.......... ... ........ Y 10 ft. maintained fran property line and 20 ft. fran house... ........................ Distance well to SSDS (ft.)...:....... ........ Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. f ran nearest trench ................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set . ............................... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... Lf FINAL GRADNG OF SITE ACCEPTABLE.. ... ....... RMPM COUNTY DEPAR'DOU OF HEALTH DIVISION OF ENVIROMM7M HEALTH SERVICES .r ! DESIGN Dm smer- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. (MnerMdridmile A,16 90hCriarJOLAM Address P Located at (Street) R%e 31I Sec. _ Block �_ Lot (indicate nearest cross street)CrossrawS sa�e(.,141e�No�#l012.6�1,f. Municipaiity Pof f %s e m Watershed rym4,5 U Date of Pre- Soaking #I 0,%Iy :-/y4%86 Date of Percolation Test HOLE NUCM CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Frcm Water Level No. Time Ground Surface In Indies, Soil Rate Start -Stop Min. Start Stop Drop In 'Min /In Drop Inches Inches Inches .0J.kP 2 3 4 0 SSOC i 3 1 t�o8 1117 9 1.4 21117 111B 3 U4 OA 17 4 ( ?- G NOTES: `l. Tests to be repeated at same depth until apprcximately equal soil rates are obtained at each percolation test hole. All data to'.be suimitto?d for review. 2. Depth measurements to be made fron 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. 3' 4' 6' 71. 81 o L� vu-* ak 9' .10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDRATER;IS ENOOUNTII2ED 7 71._ INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: o T o i DATE: 16 / %9 -- DESIGN Soil Rate Used 6 "7 Min /1" Drop: S.D. Usable Area Provided 6 o'jb 4 No. of Bedrooms `� rep Septic Tank Capacity ( 0 Op gals. Type Absorption Area Provided By L.F. x 24" width trench SQ1 ESS101YAJ F Other ►Z -o -6 Iii Se�; y4 "fly x 3 110 $ p PRE �y4'i Name Signature JOHN H. PRENTISS, P.E. o AIR ST 914 - 878 -6170 S Address R Ga 1., NRiI YBR�E t69 � Mo. Z9a06 �OF tkf SZnjEO THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PUTNAM COUNTY DEPARTMENT.OF HEALTH E y 318 Division of Envlreni mentai Health Services. Carmel: N.Y. 10512 Engineer to Provide Penult # r on CERTIFPCAfE Og gOMPLIANCE CONSTRUCTION PERA9T FOR SEWAGE DISPOSAL SYSTEM Permit q T. Patters in Located at Sonnet Labe Town or Village'; Sub dlvislon Naue C r o ss r o a d s Subd. Lot M 12 Taut Map 1 Block 7 r„t 7. 13 Renewal R9 ; Revision p S-0. ' 2 3 24 Owner /AppllcantName Marianne & Joseph Giordano Date of Previous Approval March 10', 1986 Mailing Address 37 William Street Town Carmel, NY 7 105T2 Building Type Frame Lot Area 40950 Sri : ft Fill Section Only X Depth 'Volume Number of Bedrooms Four Design Flow G /P/D 800 PCHD Notification is Required When Fill is completed Separate sews 1000 400' x 24" deep laterals p ,rage System to consist of Gallon Septic Tank end , To be constructed by ? Address Water SaPPb': Pdbllc.Supply From Address e� or: X Private Supply Drilled by Address / Other Requirement a- R -O -B .Fill Section: 24': -deep x- 40Wsq, ft. cu. yds. ) represent t at am wholly and completely responsible for the design and location of the proposed system(s); 1) that the sepaiate'sewage disposal system above described will be constructed as shown on the approved amendment thereto and in accordance.with the- rules an . regulations ions ci e u nam 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 tlisposal; systgrn during the period: of two (2) years immediately following the date 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 shorvn,on the approved plan and that said well will be installed in accordance with the standards, rules and regulations of the . Putnam County Department of Health, Date May, 1, .1986 Signed (. V P.E. X R.A. orig. Approval 3 Z"8 RD 9-Fair Street' rniel, NY 10512 cicense'No29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date ued unless construction of the building has been undertaken and is revocable for d cause or may be amended or modified when nets rye by t e''• Commissioner of Health. Any change or alteration of construction reQuires a. new peFmit. proved .for disposal of domestic $ari r s age,. and iv t 7 poly only. Date — By Title II 1404 PUTNAM COUNTY DEPARTMENT OF' HEALTH ENGINEER TO'PROME PERMIT ON CERTLFICAT OF OMPL A E,. !1 Division of Environmental Health Services, Carmel; :N.. Y.. 10512 PERMIT # CONSTRUCTION PERMIT FOR SEWAGE DISPOSALSYSTEM T. Patterson Town or Village Located at SOnnet Tax Map 1 Block 7 cot 7.13 Subdivision Crossroads. SUM. Lot M 1 2 Renewal _❑ Revision _❑ Amer /AddresMAri Anne .Tncenh Giordano, s 37 Wi 11 ialy Rt Ca d�,Pr*Yol9+U% vat Building Type Frame Lot Area 40850-9q. ft. Fiil "66o£ion Only t1 Number of Bedrooms Three Design Flow r /P /D 600 P.C. H. D. Notification Required yes Separate Sewerage System to consist of 1000 Gal. Septic Tank and 300' x 24" deep laterals To be constructed by 9 Address i Water Supply: Public Supply From I X Private Supply to be drilled by Address Other Requirements ]R—C)—$ Pi 11 Semi on a '24" .deep x 3414 s4. ft: -, (220 cu. yds. ) I represent that 1 am wholly and completely responsible fort)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 an regulations o e u nam County Department of Health, and that on completion thereof a .,Certificate of 'Construct ion 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 the date 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,Ce Installed in accordance with the standards, rules and regu aeons of the Putnam County Department of Health. I . Date � areh 105 1986 Signed P.E. X R.A. Address RD - License No. 29206 APPROVED FOR .CONSTRUCTION: This approval expires on year* he date issued unless 'construction of the building has been undertaken and is revocable for cause or may be amended or modified when consi rr h'd/or the Commis �'oner of Health. Any change or alteration of construction requires a n pe Approved for disposal of domestic sa i g ri t r sup ly only. t� Date 3 !� By- Title��U� Rev._ 6/85 _ . PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRON09TAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS (Name of Owner) REVIEW SHEET - CONSTRUCTION PERMIT i DATE v l� �JU�I BY: 2 Z (Street Location) DOCUMENT'S Permit Application Corporate Resolution Plans - Three sets _ Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole G ._ 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 D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff. size 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 (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 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 10' from Foundation 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 �s x 0 1 0 "'D `' ► P ,0 'J a , i� v — _ 3W � �. rutna i deunty UOPS" ®eat 01 lie&l." Jiaision Plrivironmental_Health 3ervioeo 'approved as noted for oonformanos with applicable Rules and 8eolatione.of the Putnam County Health Department. 4"*+ MA Ar Two � 0 a 0 C Structure located from survey by surveyor noted below_ _ _ _ - _ _ Well-located by: Surveyors surviby•,_ Well drillers, report Engineers mesurementsD_ Tank, boxes, pits., galleries 8k laterals located by:Controctor: '1e3i Engtnew l He a lth da.pt : ,Field inspection by: Health dept ❑ data: —�2= Eng,t nee t. ,❑ date -.-Y L-= .L � NOTES: A - A - C A - D A - E A -1= A - G >� —K • This is to certify that the sewage disposal sYstem was constructed as ' indicated on this plan and that the,' system was inspected by me before,it was covered over. The.sy "stem was constructed in accordance with• all standard rules and regulations' of the P.C.H.D. & N.Y.S.RilL DIMENSIONS `,tit► -8 -462-7 o all E @ -�i, T- A 7 B - f 6_ — �o� 4yf 8 - N -� -7/- _8 — K =— - — — — -- i .. 11A C mi I 1 1 -r" OWKER LOCATION - -- Tow n:,P,�� _County`�'/ : tote SUBDIV SION- 1 zZ0.4 Block. _ LOT N4,_ 7'C - - -- Builder:����j Drawn: D,0 Date: 7/7 67 /1 50' Jobl..2.3�i4 uwg.ws JOHN H, PR ENTISS PE. CONSULTING ENGINEER RD 9, F-t(c;, a i.-� CARMEL NY I0 512- -(8141 878 -6170. AJ .