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HomeMy WebLinkAbout0452DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.07 -1 -29 093m* it 1 ,',L or i Y N f �� I ,` ; �' • - , oi' -i, ' Imo. T 00261 I . M lllea i;ddsees . , . x . • `tp . bubay. ::Lot 'if- f Fee .Enclosed - Amount Date Permit Issued.• ' Se + parite Seweege $ygtem bout by V r� Adthe�s 5 Conelstin 'G"on Septiclapk °and Watei SapPlys Pabnc Ssipply From Addreei on ✓ Private Sapply Ddlled by� Addr"s Typo <Lot Size = Has Erosion "__Cnntr ii .xPP„ cnmo1'or A.? Number of Bedrooms Has'Garbage' Grinder;Heen fi►etailedY Other Requirameets Icertify that the eyetem(s) as.listed.servinq the above piemises werq of which ere attached)', and in accordance rith.the etandarde,.rules',an Putnam County Department 4 8e6lth:, oats Certif»d by Address Any,pwson'oecupyinp premises -s wved by the above systdm(s) shall'.prorltp conditions !ew!uny-_ from. such, u;pv. ApprovaP of tM•.separate?»waaq available and We approval of. tMTprtvato water supply, shsll become, null a sub)ect to mog)flratlon or change th ,when, in'r )udgm6nt'of tli `C6nim ,onstructed essentially ae shown on plans of the completed work (,copies r io hs, "in '.ad- co idth'th led' Ian and the permit issued. by the LkanM No. V take tai n aetbn °is triay ion nposnary t0 ascun the c6tvedbn of any unaanitary 'fyftem than beC011le null and 461d-pt; 'p' ai a pubc; eanitary sewer bewwomi 1 void when r ,publk watw, si+pP�Y O�oofft�a. it+atMbN, Such, app ovals we: /f� / q�•— donor. of Mwlth, `loch ietiieatbn; nwCMlutlon or change Ja necessary. ' 3 89 Data / / G /LT / /J sy Tli »` /, a , C" m_ BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 855 -1930 - WATER ANALYSIS REPORT - SAMPLE NO.. 8621 TEST WELL SOURCE: 14estchester Modulars Sonnet Lane Patterson, N.Y. COLLECTED: 2 / 2 / 9 5 BY: P.F.':Beal & Sons BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 2/6/95 This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. 0 per 100 ml. ,4A ,ne 4 a' WC:LL UU1"1rL11 1 lUN 1cr rVM1 * * DEPARTMENT OF HEALTH Division Of Environmental Health. Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only -- Z v WELL LOCATION STREET ADORESS: TOWNIVIELAGILIC117 TAX GRID NUMBER: Sonnet Drive, Patterson, New York WELL OWNER NAME: ADDRESS: BOX 2910, Route 22 —Too Westchester Modular Homes, Inca Patterson, NY 12563 RUIBI E PUBLIC USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL O PUBLIC SUPPLY O AIR /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify) O INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY D MOUNT OF USE YIELD SOUGHT 5 gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY [j]NEW SUPPLY (NEW DWELLING) ❑DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 685 ft. STATIC WATER LEVEL 30 ft. DATE MEASURED 12/22/94 DRILLING EQUIPMENT ® ROTARY ® COMPRESSED AIR PERCUSSION O DUG O WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE O SCREENED ❑ OPEN END CASING ® OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH 31 fit MATERIALS: O STEEL O PLASTIC O OTHER LENGTH BELOW GRADE ____3Q_ ft. JOINTS: O WELDED ® THREADED O OTHER DIAMETER 6 in. SEAL: ® CEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT __- lb./ft. DRIVE SHOE ® YES O NO LINER: OYES ONO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST OYES ONO HOURS SECOND GRAVEL PACK O YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST pumping If detailed METHOD: O PUMPED 1 tests were done is in- COMPRESSED AIR , ! ormation attached? O SAILED O OTHER �' O YES ONO IAIELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE 1'nq water Bear- wen oia- neter FORMATION DESCRIPTION woe It. it WELL DEPTH ft. DURATION hr. min. DRAWOOWN It. YIELD gym. Lanli ce 10 Dr 11 rig in overburden clay & boul er 10 Hi r ck at 10' 685 6 380 50 10 31 Dr 11'ng..in rock, set casing, grout ed 31,685 Dr 11'n in rock granite WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE Well Xtrol WX #302 - CAPACITY GAI.- 86 PUMP INFORMATION TYPE submersible CAPACITY 5crpm MAKER Goulds DEPTH 400' MODEL 5GS07412 VOLTAGE230Hp 3/4 WELLDRIUIRNAME P.F. Beal & Sons, Inc. I DATE ADDRESS 4 Putnam AvenueSlGrtATURE Brewster, NY 10509 J/69 P y L. Bea/l P[T1NAM COUWY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES yo# n 7 C HLG&,65- V A'6c ??7In G Owner or Purchaser of Building Building Constructed by So n ,P--7 y Location - Street f'4 X250 n Municipality Building Type [",;,0- 1 C91 Section Block Lot PL- oq5 KE-17- Subdivision Name Subdivision Lot GUARANI'EE OF SUBSURFACE SE�MGE DISPOSAL SYSTMA I'represent that I am wholly and completely responsible for the location, worlowship, material, construction and drainage of the sewage disposal system serving the above described property, and that'it has been constructed as shorn 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 Director of the Division of Environmental Health Services Department of Health as to whether or not the failure of the caused by the willful or negligent act of the occupant of th e the system. Dated this 0 day of 19 Signature ?qI0 C, C �I; r 5� address rev. 9 /SS mk Title the determination of of the .Putnam County system to operate was building utilizing 4, S , i::-, Corporation Name (if Corp.) Address P. F. BEAL & SONS, INC. ARTESIAN WELLS 4 PUTNAM AVENUE WATER TANKS WATER SYSTEMS BREWSTER, NEW YORK 10509 COMMERCIAL WATER SYSTEMS JET PUMPS - HYDROFRACTURING SUBMERSIBLE PUMPS Chsta s/rcc� /¢19/- 000 `f/c& 6' lzzll/e, V WATER CONDITIONING EQUIPMENT TEL. 279 -2460 -2461 FAX 279 -6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERVICE January 13, 1995 Westchester Modular Homes Attn: Jerry Hatcher Box 2910, Route 22 Patterson, New York 12563 Dear Mr. Hatcher: Below please find the results of the water analysis which we took at Lakeview Road. Test Results Hardness: 7.000 pH: 7.79 Alkalinity: 9.120 Chlorides: 3.000 TDS :, 189.00 Recommended Limitations 0 -4.00 GPG 7.0 -8.5 14.620 GPG 14.620 GPG 500.00 PPM Test Results Iron: 2.280 Turbidity: 19.000 Sulphates: 1.200 Iron Algaes: Some Recommended Limitations 0.300 PPM NTU 14.620 GPG None , These results do not necessarily reflect the actual quality of the water because the well was just drilled. Please try using it for a month or so, and if at that time you are not satisfied with the quality of the water because of hardness, staining, sediment, taste or odor, let us hear from you so we can take a free sample and make a recommendation. Thank you for doing business with P. F. Beal & Sons, Inc. Very truly yours, P. F. BEAL & SONS, INC. Ch stopher Beal CB /mm i -, ode �T abobw d County be "I N pYC.:M ance.ol "i be . County in ;wh Ily aM completely n fable for detign and location ,of the proposed ,systam(s);'. 4)' that, the separate sewage s stem Is Ze constructed as shown on the approved amendment there to and in accordance with the staedards,.rules an regulations ons o '; e a It -;Of MMRlrr, and; thatoncompletion .,thereof;a "Cenifn:.afe'of Construction Compliance'* satisfactory to tMCornmfsfbnarOf MeaRhwill M DpiRirsaiit,' and a written guarantee will,`be fumhlie0 the owilw, his tucceaora, heirs or assigns by the builder, that mid builder will ritMq.'obndttion any lien ,of .tae 'mwags dispotal sys m, duriip the period: of two (2) yWh.itntnediet•ty following the date of the New rat : "er 2" 'es tHS"N of Construction - COmoll ne- a of .the orginil system or any repairs t#W#to; 2L4h&t OV drilled "I 'described above ' - AAdnfsy ApPROVEO FOR CONSTRUCTION T1, revocable for cause. or.;mai ts, emep0ad .11 nhuires a new per' t. pproved.: or Rev. 10/88 °ate l.insi No_ y� nst►uct n of the building has been undertaken and is of Health. Any change or alteration of• construction supply only. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # �'� WELL LOCATION Street Address To Village City Tax Grid Number q WELL OWNER Name ri - Mailing Address �} ✓ JAg 121,1 . 2// ,U QPrivate DPublic USE OF WELL 0- primary 2 - secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY ❑ AIR /COND/ EAT PUMP O FARM 0 TEST /OBSERVATION 0 INSTITUTIONAL ❑ STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT 1�5 gpm /# PEOPLE SERVED ,!,�; /EST. OF DAILY USAGE 4o gal E3 REPLACE EXISTING SUPPLY 13 TEST /OBSERVATION M ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN DDUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓ NO NAME OF PUBLIC WATER SUPPLY: oh, TOWN /VIL /CITY � %6r DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: NO LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED (DON SEPARATE SHEET 94 LA"VJA Q �-1 (d Ate) ( gnature) 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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 199 Date of Expiration 19� Permit Issuing Official Permit is Non - Tran sferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller Y RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR., P.E. September 29, 19.94 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Sonnet Lane Patterson, N.Y. Dear Bill: Enclosed are the following: LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 8 Milltown Road Brewster, New York 10509 (914)278 -6108 - (FA)Q 278 -2658 CONSULTING SITE ENGINEERS 1. Four (4) prints of Drawing SS -1 "Proposed SSDS ", dated 9- 27 -94. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 9- 27 -94. 4. "Application to Construct a Water Well ", dated 9- 27 -94. 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 9- 27 -94. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 8. "Corporate Affidavit ", dated 9- 27 -94. 9. Cut sheet for Goulds Submersible Pump model 3871. 10. Check in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. c g b Harry W. Nichols, Jr., P.E. HWN:bd 94082 cc: Mr. G. Hatcher w /enc. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of_ Located at (T) Section 1n,dl Block Lot 2 Subdivision of To e, L— E( Sf� L, t Subdv. Lot Filed Asap f .!—j� Dc1te Gentlemen: This letter is to authorize ;, a duly licensed professional engineer or re- gistered,.architect (Indicate) "• to. apply for a Construction Permit for a separate -sewage system, to serve the above noted property in accordance with the standards., rules. or regulations as promulagated by the Commissioner of the Putnam County Department of Health', 'and to sign. a1-1:.necessary papers on 'my :behalf..in connection with this matter and to supervise the construction of said system :or systems in conformity with the provisions of Article 145 or 147, Education Law, the -Public Health Law, and the Putnam County Sani- tary Code. Countersigned: P.E. Very truly yours, Signed , wje�_ OYher of roperty (cJ ¢s-tci i i2 d )O.OV - eM Mvrn2� Address Addres Town Telephone Telephone `� Putnam County Department of Health Division of Environmental Sanitation- AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT. APPLICATION SUBMITTED- TO - .PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health - In the matter of application for represents that.? am an officer or employee of the corporation and am: authorized' to act for. -T4�SNai�e_oT Pi(� corporation) ^� having offices at _ � l _ _ _ e 0 - _ Whose officers -are' President -' Name and Address— —• Vice - President _C ��-/CN . ame and Ad_ dress Secr6tary _ ....._. (Name and Address) Treasurer'......-- �,�' —.- _......_... .(Name and Address) ' and #iat I= am-and will be individually responsible fon any* or all aptp... of. the- corporation with respect to the approval requestgd and-all .sub-1 aets relating -thereto. ' Sword. to before me this day Signed of 19 Title - - Notary Public' • �� -. IMRS QUALM, , N� �'��✓ �'c ''. �. � e•' - .:U l cif Uy*0201[ ,6it!6mE.. A�w,,. :%�_�. Corporate Seal . t • MMY. DEPAMMM OF T. DESIGN DATA SHEET - SUBSUFACE SAGE' DISPOSAL SYSTER . FILE M. ' Owner Address JAI "7TT5 7D Y IOSG'h Lbcated at (Street) Block (indicate nearest cross streetY Municipality 1� = '�"T'T 1 3orJ Watershed SOIL PERC0=W -•TEST DATA REQUIRED TO BE .SU&MCfi.C'ED WITH APPLICATIONS Date of Pre -Soaking `f' /� - 26 _ fah Date of Percolation Test ZOLE, •. • NLfi56ER C= TIME PERC6=C N Pg2CO=C N Ftun Elapse Depth to Water )FYcm Water Level No. Time Ground Surface In Inches Soil Rate Start Stop Min: Start Stop Droo In Min/-In Drop Inches Inches Inches 312:02 00 4 .5 1 2 11 D_ 2 I 0 .3 12-11 , K:Ifl - I 4 NMES: 1... Tests to be repeated at same depth until approximately equal soil rates. are obtained at each percolation test hole. All data to' be m±mitttd for review. 2. Depth measurements. to. be made • fran top of hole. :. . TEST PIT DEPTH HOLE NO. G.L 1' 2r 3' .4, 5' 1 , 6 W .:OF ! TO BE SUBMITIED WITH APPLICATION l7IS E2NCOUNT= IN TEST.' HOLES HOLE NO. HOLE N0. 9' 10' 131 , i `e c . z . CD FTI INDICATE LEVRt, AT WHICEi �tOUNIYr�TER IS 1►, � i! c� — . INDICATE LEVEL TO WHICH' WATER LEVEL RISES AF M BEING EN:7(IUNiF DEEP HOLE OBSEiZVATTONS MADE i BY: DATE: 12- )�2' S s DESIGN Soil Rate Used � Min/1" Drop: S.D. Usable Area Provided. t No. of Bedrooms _ Septic Tank opacity gals. Type Z,-0 ` . Absorption Area' Provided By L.F. x 24" width trench Other Narce `ice ►N f\11 .' Signature u Addr_ SEAL' YDDK t I�1'1 C-`'� 7� 'Z 2 I✓t I Lr`CoW N �2v q D - \� �.: 4 THIS SPACE FOR USE BY HEALTH DE _DARMM ONLY: . Soil Rate Approved sq. f t,%ga�I Checked by Date pU'X'NAM COTCJNT'SX" ]DEpA, JZ0CME III 'DC Off' 11 E.AL.IXX_C APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM Name and Address of Applicant: a 2. Name of Project: f t'�IPD�a%t� ��D�v 3.._._Location TC/V /C:�'fT%d�o+;) 4. Project Engineer: Op Vj� � w. III GKOJ�s _. 5. Address: .Hl MaVr:g 1"(-0 OJT, License Number: Phone: 211< _ 6hob 6. T e of Pro ect: Prri•vate /Resi dent i-a1 Fobd.Service ....Commercial Apartments Institutional Mobile Home Park. office Building; :S Realty Subdivision Other (specify) 7. Is this project subject•to State Environmental-Quality Review (SEQR)? Tyoe Status (Check One) Type I.. Exempt, ✓ Type II. Unlisted, 8. Is a Draft Environmental Impact Statement (DEIS) required? ..... ... 1J U 9. Has DEISM been completed and found acceptable by Lead Agency? nJ 10. Name of Lead Agency NVA 11. Is this project in an area under the control of•local planning, coning, or other officials, ordinances? ....... ............................... K) t) 12. If-so, have plans been submitted to such author .sties ?.. ................... 0/A 13. Has peeliminery approval been granted by 'such authorities? NSA Date Granted: 14. Type of Sewage Disposal: System Discharge...... Surface Water Ll Ground Waters 15. If surface water discharge, what is the stream class designation ?........ A :6. Waters inde4 number (surface) ........... ....................... ......... J. Is project located near .a public water supply system? N o S. If }es, name of water supply Q Distance td water supply , 9. Is project site near a public sewage collection or disposal system ?..... U0 ,0.. Name of sewage system K) /A Distance to sewage system _ i. Date observed: °f —A _ i-Ik 23. Name of Health Inspector: W1U.16.+� 4. Project design flow (gallons per day) ...... ............................... �%� t� . 2. 25. Is State :Pollutant Discharge Elimination System ( SPDES) Permit required ?.. pJp 26. Has SPDES Application been submitted to local DEC Office? r,1p 27. Is any portion of this project located within a designated Town or State wetland...................... ............................... ....... �)�) 28. Wetland ID Number ............................................ '........... u� 29. -Is Wetland Permit required? ............. ...... .......................... 'Has application been made to Town or Local DEC Office? Q/.�. 30, Does project require .a DEC Stream Disturbance Permit? x.14 31: Is or was. project site used for agricultural activity involving 'application _ of pesticide$ to orchards or otFier crops, solid or hazardous waste disposal',• - landfilling,'sludge application or industrial activity? ........ YES or NO 0 32. Is project located .-within 1;000•feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or . any other potential known- source of contamination? .....'. :..... YES or NO k)d DESCRIBE: 33. Is there a local master plan or file-with the Town or Village? .......... 34. Are community water, sewer facilities planned to be developed within 15 yea.os ? M:. X00 35. Are an - y sewage disposal areas in excess of 15% slope? ....................a-.. Cn 9 36. Tax Hap ID Number ................................................. ...... 37. Approved Plans- are' to be: returned to: Applicant Engineer If the application is signed by a person other than the applicant shown in Item.1, the. application must be: accompanied by-a Letter.of Authorization: Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury,• that information provided on this forn is true to the best of m y knowledge and belief. False statements made herein are punishable as a Class A Xisde✓%eanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: '"aAILING ADDRESS: ti 00 h 7 1 i a a Ile qh �re dye anti / � t i I �1` ACCESS ' I R. O. W. I XS�o� 2 /000 GAL /c�50 Gig[ . 1 Z'/ 1P Cf�9l'JBER L TANK p C. /.P. is EX /ST //v 4 BERM I RES /DEN I 1 0� h N AS - 8U /L T D /MENS /ON CHART (/Nfr) N° A B l 270' 4301 2 P/. 0' 54.5 3 86.0 805' 4 80.5 81. 0 " 5 76.0 64.0 6 77 5' 90.5 , 7 775* 96.0, B 77.0 ' 42.0' 9 0.5 , 40.5 , /0 610' 41.5' 11 53.5, 45.0 l2 112.5' 129.5 13 H-3.5' 133.5 , 14 114-5, 140.0