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HomeMy WebLinkAbout0490DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 14. -1 -9 BOX 6 y 41 ,. 1 00 Ll 1 1 z ,i 16 Ll f Lmy.+ -�'.: 00299 Re Located PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512, Engineer Must Provide P-22-94 P.C.H.D. Permit rE OF CONSTRUCTION C LIANCE FOR SEWAGE DISPOSAL Owner/applicant Name Jon 9chillpr —Forme g Address 200 Watchtower drive, Pattersonzip 12563 (T). Patterson Town or Village Tax map 14 Block' 1 Lot 9 Hal 1 Subdivisloin Name Virtil1id Suhdv. Lot #— Date Permit Issued Aug, 20, 1994 ! Se parate Sewerage System built by . Cliff Canfield —Address - 41 South Street, Bethel, CT Consisting of 1500 Gallon Septic Tank and 670 Ft. of 4 inch. perf. PVC pipe Water Supply: Public Supply From Address or: __!_ Private Supply Drilled by Boyd Artesian Inc. Address RD 5, Rt 52• Building Residential —Modular —Has'Eroslon Control Been Completed? Yes Type Number of Bedrooms 4 Has Garbage Grinder Been Installed? NQ Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as sho on the plans of the completed work copies of which are attached), and in accordance with the standards, rules and iegula7tion , in accordance v filed plan, and the permit issued by the Putnam County Department Of Health. Date Feb 20, 1995 Certified by� P.E. _X_ R.A. Address 200 Watchtower Drive, Patterson, NY 12563 License No. 65884 Any person occupying promises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting, from such usage. Approval of the yst - null and void as soon as a pubt:-- unitary sinver becomes a separate sewerage om*shall become n available and the approve! of the private water supply shall become nulland void w . hen a public water supply becomes available. Such approvals are subject to modification o 'change when In the judgment of the Commis I sioner of Hsslth.�_wch revocation, modification or change Is necessary. X Title Date jW1;LL GUMYLC:TIUN mxvrti DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only Z WELL LOCATION STREET ADDRESS: TOWNIVILLACKIC11Y TAX GRID NUMBER: C' UCk �0r� kji— L01k °f WELL OWNER NAME: aODRESS: � Q „O ¢� -- = , �a. 1�,Jl,ed� l as�3 QL Pg1VATE ❑ PUBLIC USE OF WELL 1- primary 2 - secondary ❑ RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM O TEST /OBSERVATION ❑ OTHER (specify) C1 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED S / EST. OF DAILY USAGE S40 gal. REASON FOR DRILLING .[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY [SNEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH A35� ft. STATIC WATER LEVEL U. ft. DATE MEASURED DRILLING EQUIPMENT ❑ ROTARY L9,COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING LI OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH �. — tL MATERIALS: M STEEL ❑ PLASTIC ❑ OTHER LENGTH BELOW GRADES ft. JOINTS: O WELDED 19 THREADED ❑ OTHER DIAMETER ___j2 in. SEAL: So CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT ___L ____ Ib. /it. DRIVE SHOE 14 YES ONO I LINER: DYES t' NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (11) DEPTH TO SCREEN (it) DEVELOPED? FIRST O YES ONO HOURS SECOND GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in, TOP DEPTH ft. BOTTOM DEPTH ft. WELL YIELD TEST ' If detailed um in -'WELL P P 9 METHOD: O PUMPED I tests were done is in- &COMPRESSED AIR , ! ormation attached? O BAILED O OTHER i O YES ❑ NO LOG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water Bear. ing Well Dia' meter FORMATION DESCRIPTION CODE n WELL DEPTH 1t. DURATION hr. min. DRAWOOWN ft. YIELD 9Cm' Land //1t Ct% a S` A 335, n v A351 o` WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE CAPACITY GAI,. PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME AA LAN �� �-I,L� DATE ` / __b ADDRESS S �� SIGNATURE J C �l -14 l fOS / ' 3/89 ands - -3N,/ - j a WLLL UUr1rLL11V14 nr!rVttl DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only m-2— WELL LOCATION STREET AOURESS: IMNIVILLIGILICIlY TAX GRID NUMSM Uct,- eoa- ( a cTvl WELL OWNER NAME: . '-To n ADDRESS: ;L•©0 Wa. C, ' ,;a -t"dvL Q[L PBIVATE 10 PUBLIC USE OF WELL 1 - primary 2 - secondary ❑ RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND. /HEAT PUMP O ABANDONED O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL O INSTITUTIONAL O STAND -BY O MOUNT OF USE YIELD SOUGHT S gpm. /N0. PEOPLE SERVED D% EST. OF DAILY USAGE -5-00 gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY . ❑TEST /OBSERVATION []ADDITIONAL SUPPLY ®,NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL a i it. DATE MEASURED DRILLING EQUIPMENT ❑ ROTARY O WELL POINT ft COMPRESSED AIR PERCUSSION O DUG O CABLE PERCUSSION 0 OTHER (specify): WELL TYPE ::'PEENED O OPEN END CASING OPEN HOLE IN BEDROCK . O OTHER CASING .L4i AL LENGTH ��-- n MATERIALS: STEEL O PLASTIC O OTHER LENGTH BELOW GRADE __ ft. JOINTS: O WELDED 19 THREADED O OTHER DIAMETER - _Ia___ in: SEAL: &0 CEMENT GROUT O BENTONITE 0OTHER- WEIGHT PER FOOT ____.t_I____ 1b./It. DRIVE SHOE: Ql YES ONO I LINER:IJYES VNO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST O YES ONO HOURS SECOND GRAVEL PACK 11 No GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH IL BOTTOM OEM R. WELL YIELD TEST If detailed pumping METHOD: O PUMPED tests were done is in- &COMPRESSED AIR , . ormation attached. O BAILED O OTHER O YES O NO 1�IELL LOG It more detailed formation descriptions or sieve analyses are available. please attach. DEPTH FROM SURFACE Water Beef, ' "9 Well ou' nea r I FORMATION DESCRIPTION pot . t. WELL DEPTH It. DURATION hr. min. ORAVIDOWN _4t_ YIELD 9Cm• Surface a S 3 .110 br — O i/ o-� � tJr►.t b � WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? .❑ YES ONO STORAGE TANK: TYPE CAPACITY GAI,. PUMP INFORMATION TYPE MAKFA MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME iam Ce �� DATE / J ,/ ADDRESS r� D S Q� T$�� SIGIIATURE l �j J cal t w 44 ] OS 3/89 a a s- - 3 cck, ANALYSIS DATA SHEET TYPE: PW LOCATION: Couch Rd, Patterson NY REPORT TO: Jon Schiller ADDRESS: Couch Rd CITY, STATE, ZIP: Patterson NY 12563 DATE COLLECTED: 01 -12 -95 TIME COLLECTED: 02:05 PM COLLECTED BY: S. Schiller REPORT DATE: 01 -17 -95 LAB # : 95 -0142 SAMPLE SOURCE: Bathroom next to kitchen ANALYSIS DATE RESULT UNITS METHOD ANALYZED Total Colifonn Absent COLILERT 01 -12 -95 THIS SAMPLE AS RECEIVED AT THIS LABORATORY DID MEET THE REQUIREMENTS .OF NEW YORK STATE DRINKING WATER STANDARDS. 109 % Laboratory Director NEW YORK STATE ELAP CERTIFICATION NUMBER: 11218 618 Clock Tower Commons, Rte 22, Brewster, NY 10509 / 914. 278 -7600 / Fax 914. 297.0536 e A b DATE 3, y DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 FAX COVER SHEET BRUCE R. FOLEY, R.S. Acting Public Health Director TO: / C��� f'� s /� �/— FAX #: q C FROM: Putnam County Health Department Division of Environmental Health Services 4 Geneva Road. Brewster, New York 10509 Number of pages to be transmitted (including cover sheet) NOTES /MESSAGES / ��P�S E' `jG� �f-- -f-I 67 '7 �-S OUR FAX NUMBER IS 914 - 278 -7921 Note to sender: Complete all entries in Fax Log In the event of transmission /reception difficulties, please contact our office. 914 - 278 -6130 2_�� a PUTNAM CCXUfY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Jon Schiller Owner or Purchaser of Building Westchester Modular Homes Inc. Building Constructed by 1/8 mile south of Int. with Couch and Location - Street Cornwall Hill road (T) Patterson Municipality Residential Building Type 14 1 9 Section Block Lot Virclinia fi_ Hall Subdivision Name 1 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 of the building utilizing the system. Dated this 4— day of 19 Signature C1' f Cantieid Title General Contractor-(Owner) — Signature Corporation Name (if Corp.) WOMMM rev. 9/85 mk Corporation Name (if Corp.) y(.SourH 's T. L,CY Address . PUTNAM CODNTY, DEPARTII�+NT OF HEALTH 'a ° Dividon of �svlicomental Setlth Services Carmel. N Y 1OS11; En�Eneee:to Provide Permit M I on CERIIIrICATE OF CO iaAN UCTION PERBUT FOR SEWAGE ,DISPOSAL SYSTEM ;(T) .Patterson -. - Couch Road, .Patterson ;ANY Town or~.vm,8e S Name Virginia• S' Hall Ma�. Iol N Ta: Map 14 Block 1 9 Lot Beoesval O RevieMn ❑ Ovine: /Applicant Napes Jon Schiller Dateot_PrevlooaApproval Subdiylsion'.APproyed° 11/18/8; iisiu�Address 2•'OO Watchtower -Driv:e Town' . ztp / :Patterson; NY. .125'63 J Bmidbig Type `Residential Lot Area 5-06 ar � Section oepti, Volume, :4 Ni' Flow G P D BOO PCH Notl6cation is Regdired W6en1Ftll is completed Number d Bedrooms ' Deatgn Separate Sewenlge $ydm to coms 6 7 O' o f 4 r p P r f P tic i p a 'Of . a To 6e oon.oeted by To be determined Afld.eia water Supply: Ptibilc Sapplj Feom - Address or: 1 Prtirite'Snp�ly Drilled by �'^ be di: termite` Other Requirements , 1 represent :that I am wholly and completely responsible forthe des�yn and location of the proposed, system(s), 'i)'.`that the separate sewage dis `sal system above described wiitbe constructed as shown on the approved amentlment there` o and, in accortlance with ttie standards, rules an regu a �ons'o e. u nam County Department '.of Mealth-. and that on completion thereof a..'Certificate. of Construction Compiiance' sati$factoiy to the Commissioner of Healthwill be suDmitteld'to'the Dope-rimant,'.and a* Written guarantee will,ii` furnished the owner,, his suceerio►s,=heirs'or aisgns by the builder, that -said builder Will . place in gootl operating ,condition.'any, part of••saiii sewage tlisposat system -0uriny; the period of two (2) years (mmedlaiely following ihedate of, the issu• ante of the approval of thsCertificate' "Af ConstrucUOn 'Compliance the; origigai. system.or any repairs' there ';3) that the drilled well describetl above will•be'located as shown on the approved plan and that said well will be.instslled, ecoidance 'with t itindar rubs nd.ragu aT pns of the Putnam County Department of HYlth ry', Date Signed - —�"7! R.A. Jules 5. 1994.. ,... .... _ PE X Addreu 200: Watchtower: Drive, Patters:o NY 12563 c,eon:e NO 65894 APPROVED FOR CONSTRUCTION: This 'approval expires'two Years ,from the. date isivab union construction of the building has'been -undertaken and is revocable for eauSo'or may,ba amanded "or modifie&when consider necessa► 'mjjsioner of.:Meaith. A, ny change or,ajteration'of construction ii ores a w',permit. ' ADD►ov t r.tli fil- of, tlomesUe s dry= _ -e►` wlY:' ' &x,87 Date , y ::. _ Titb �. 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 J_;�?� WELL LOCATION Street Address Coewclll Aoa cl Town/Village/City Tax Grid Number -S a� C/—/ — WELL OWNER game Mailing 41 Address ivate O Public TISR OF WELL primary 2- secondary SIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP 13 BUSINESS O FARM O TEST /OBSERVATION 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specifq p AMOUNT OF USE YIELD SOUGHT�gpm /# O REPLACE EXISTING SUPPLY W SUPPLY NEW DW LLING PEOPLE SERVED 73_< /EST. OF DAILY USAGH;5�Bal O TEST /OBSERVATION CIADDITIONAL SUPPLY EEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE �ODIRIMD DRIVEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: h Lot No. L o cam. WATER WELL CONTRACTOR: Name 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 Cxam -SEPARATE SHEET (date) PROVIDED (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. 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 suc a manner as not to �degrade or otherw' nta ate surface or groundwater. Date of Issue• Date of Expiration 19 ^L Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUrNAM COMM DEPARTMERr OF HEALTH DIVISION OF EWIRCtMVIAL HEALTH SERVICES Page 2 of 2 - DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �N �c/% /�E�2 Ad �- mAr c ,Cv, Located at (Street) 44vatWIL 14,11 Zj a y (indicate nearest cross street) 611doh.47�c,WWL Sec. 'Block r Lot AIYi 7-sd3 Municipality rem o/'- P 125iXSoN Watershed Date of Pre- Soaking Date of Percolation Test 4•- 2 +..7+ HOLE NUiRM CLOCK TIME PERCQL? IO14 PERCOLATION Run Elapse Depth to Water EYcm hater Level- No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 3 14.06 -4:A 36 a• f 2-,9 f1+ 24 i3 24: 30 3 -5 %3 - S f3 30 2-f Z5 I a%- /7 4. - 5 3o 3o 2 4: f2- 5.i2 as % 3p 4 5 1 2 3 4 .DOTES: 1 Tests, to: bea`repeated• at same depth until appr aximately equal soil rates `are' obtai ie3 .at each percolation test hole. All data to' be sutidtttd .;`for:: review,. 2. Depth measwrenents to be made from top of hole. rev. 9/85 ' TEST PIT DATA RDQUIRED TO BE SUBMI= WITS APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN ZEST HOLES DEPTH HOLE ND. r�°- HOLE NO. HOLE NO. . G.LZO -1®) 17i9,¢,C' N To�Sc,oL C3�3 %Sy,�, 3e-0- 60, 42411-:'--4 9�1V :51-%7y Zt&l 641-+- Z'S-4, 4' 6' I, 7' 8' 9' 10, 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNUVMTER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: 4 DATE: I Z 4 DESIGN Soil Rate Used Z/ 341 Min/1" Drop: S.D. Usable Area Provided 45 oo <4� No. of Bedroans Septic Tank Capacity �, S"o6 gam. . Type Absorption Area Provided By 6 715 L.F. x 24" width trench Other Nam N IFrllF- Address' ZOG THIS SPACE FOR USE BY HEALTH DEPAR'II M ONLY: Signature SEAL w� '� p W isS1 -0%' Soil Rate Approved sq.ft,/gal. Checked by Date a July 5, 1994 Putnam County Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Attention: Mr. Bill Hedges EVAN G. LESLIE, P.E. Consulting Engineer 200 Watchtower Drive Patterson, New York 12563 -9205 Tel (914) 878 -7000 FAX (914) 878 -2068 Re: SSDS For Schiller's Residence Couch Road, Patterson, New York Dear Mr. Hedges The following documents are submitted for approval of plans for the individual residence noted above. The project consists of a 4 bedroom house. Attached please find a check for $300.00 to cover the application fee. We are enclosing three copies of the following documents: 1. Copies of Putnam County Department of Health Construction Permit Application for Sewage Disposal System. 2. Copies of the Putnam County Department of Health Application for Approval of Plans for a Wastewater Disposal System 3. Copies of the Putnam County Department of Health Authorization letter to allow Engineer to apply for a construction permit 4. Copies of the Putnam County Department of Health Design Data Sheets for percolation tests (PT -1 through PT -4) and test pit data for the two test pits (TP -1 and TP -2) 5. Copies of the following drawing: Drawing Number Tie Dated Stamped _ SP -2 "Site Plan for Jon Schiller" 7/3/94 7/5/94 Mr. Bill Hedges PCDOH SSDS Approval July 5, 1994 Page 2 6. Copies of the basement, first and second floor plans for the proposed residence. If you have any questions or comments, please contact me at the above address. Sincerely, •Z C�ry Evan Leslie P.E. Enclosures Rev. 1/87 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel. N.Y. 10512 Enghwer to Provide Permit / on CERTIFICATE OF COMPLIANCE CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit Loearedat Couch Road, Patterson NY (T) Patte T twin or Village Subdivision Name V i r g i n: a S. H a 11 M c�yd Lot r 7 Tax Map 14 Bloch 1 Lot 9 Otrner/AppllcantName Jon Schiller Renewal— ❑ Revision ❑ Date of Previous Approval Subdivision Approved 11/18/87 Mailing Address 200 Watchtower Drive Town zip Patterson NY 12563 Building Type Residential Lot Area 5'_ n 4 a r Fm Section Only Depth Volume Number of Bedrooms 4 Design Flow G P D 800 1 PCHD Notification Is Required When Fill Is completed Separate Sewerage System to consist of 1, 5 0 0 Gallon Tank and 670' o f 4" s e r f_ P V r p i p p To be constructed by To be determined Addreea Water SapplYs Public Supply From Address or: l private Supply Drilled by To he ri e t o rmlaakildress Other Reoulrements 1 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 and regulations or e u nam County Department of Heatth, 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 origi al system or any repairs there ; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed gvlaev ccordance with t standar rules nd.regu a ions of the Putnam County Department Of Health. P.E. X R.A. Date July 5, 1994 200 Watchtower Drive Patterso , Address 200 NY 12563 —License No 65884 APPROVED FOR CONSTRUCTION: This approval expires twd years 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 necessary by the Commissioner of Health. Any change or_ alteration of construction requires a new permit. Approved for disposal of domestic sanitary sewage, and /or private water supply only. Date By Title .PC -l. PUTNAM COUNTY DEPARTMENT OF H IF— ALTM APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: Jon Schiller 2. Name of Project: Residential House 4. Project Engineer: Evan Leslie, P.E. 200 Watchtower Drive Patterson, NY 12563 -9205 3. Location OV /C: Patterson 5. Address: 200 Watchtower Drive Patterson, NY-12563-9205 License Number: 65884 Phone:(914) 878 -7000 6. Type of Project: X Private /Residential Food Service Commercial, Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (Check One) Type I.. Exempt Type II. Unlisted x 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... 10. Name of Lead Agency NA No NA 11. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ............... Yes (Subdivision Approved 11/87 12. If so, have plans been submitted to such authorities? Yes 13. Has preliminary approval been granted by such authorities? Yes Date Granted: 11/87 14. Type of Sewage Disposal System Discharge:..... Surface Water X Ground Waters 15. If surface water discharge, what is the stream class designation ?........ NA 16. Waters index number (surface) ............. ........................... NA ' 17. Is project located near a public water supply system? No 18. IT yes, name of water supply NA Distance to water supply NA 19. Is project site near a. public sewage collection or disposal system ?..... No 20. Name of sewage system 21. Date observed: NA Distance to sewage system NA 23. Name of Health Inspector: 24. Project design flow (gallons per day) ...... ............................... 800 RPd 2. 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. No 26. Has SPDES Application been submitted to local DEC Office? ............... NA 27. Is any portion of this project located within a designated Town or State wetland? .................................. ............................... Yes 28. Wetland ID Number ........................ ............................... 29. Is Wetland Permit required? .............. ............................... No ..Has application been made to Town or Local DEC Office? .................. NA 30. Does project require a DEC Stream Disturbance Permit? .......... :........ No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ........ YES or NO No 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 No DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... Yes 34. Are community water, sewer facilities planned to be developed within 15 years? No . 35. Are any sewage disposal areas in excess of 15% slope? ........................ No 36. Tax Map ID Number 14 -1 -9 37. Approved Plans are to be returned to: Applicant x_ 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 form is true to the best of my knowledge and belief: False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: 11; MAILING ADDRESS: 200 Watchtower Drive, Patterson, NY 12563 -9205 PUTNAM COUNTY DEPARTMENT OF l-IEALTH DIVISION OF ENVIRONMENTAL I-IEALTH SERVICES Date July 6, 1994 Re: Property of Jon Schiller Located at Couch Road, Patterson, NY (T) Patterson Section 14 Block 1. Lot 9 Subdivision of Virginia S. Hall Subdv. Lot 1 filed Map # 2279 Date 11/18/87 Gentlemen: This letter is to authorize Evan Leslie a duly licensed professional engineer X or registered-architect 7 (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 all 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 Ilealth Law, and the Putnam County Sani- tary Code. Very truly yours, Signed, Countersigned: .. /� Owne of Property �4L' P . E . , R . A . , # 65884 200 Watchtower Drive Address 200 Watchtower Drive Patterson, NY 12563 -9203 Address Town Patterson, NY 12563 -9205 (914) 878 -7000 Telephone (914) 878 -7000 Telephone PUITMM COUNTY DEPART -M� 1T OF HEALTH DIVISION OF-EWIRCUMMIM HEALTH SERVICES Page 1 of 2 DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �av S .4• //F•z Address Zoo 1,d41ehk&,4z Paver, ; oX;Wu.v A)J 17,5W3 dole 5�+N Located at (Street )l•,Q,v.csq,G4 1-Ji/ je/ cw �h ,9 V Sec. /'¢ Block / Lot q (indicate nearest cross street) Municipality jow.y o/ f�� T�2 c:4'4 Watershed Date of Pre - Soaking 6''-18 -- 594, AM Date of Percolation Test Z•- /9'-- !' ;*I HOLE NiII= . CLOCK TIME PF_RCCL*A=C1q PERCOLATICN Run Elapse . Depth to Water FYau hater Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches P-/ 1 2 : /a -Z 40 3c Z� ZS�� / 3/9' /7 2 Z: ?'Z - 3: IZ 30 2� Zs' �q- %'J'¢ / t 3 3•'i9' - 3. It SO J7 4 5 1 2:37 2 2 40- 3 g.'/? - 3'x-9 4 1 2 3 4 5 -SOT S: 1. Tests to be repeated' Are obtained ,at each for' review. 2. Depth measurements to rev. 9/85 - at same depth until apprcociinately equal soil rates percolation test hole. All data to "be sutmittiad be made fran top of hole. a. • • • a• r• ar • air . • • v •. DESCRII'TION OF SOILS FI CI UNIERED IN TEST HOLES DEPTH HOLE N0. 7TH"'-/ HOLE NO. HOLE NO. G. L.GJ� /o`��jln,� �/�•cuN%p So.0 �3��- - %O �'Q� 3' 41 5' /Uv UJI4 i4T �o 6' 7 8' 9' 10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDA= IS ENC XN'IMM INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENJOUNTERED DEEP HOLE OBSERVATIONS MADE BY: �1%/i1f /�E" DATE: Ile DESIGN Soil Rate Used 21 -3o Min/1" Drop: S.D. Usable Area Provided 4-900 SF No. of Bedroaas 'g' Septic Tank Capacity /Sob gals. . Type Absorption Area Provided By 474 L.F. x 24" width trench Other f (�, U if Frw Name , -V//�y Signature Address _76o "Az4, >`O w- erL ,'L ye= SEAL.r- w= C. W /47/2;;z1 6 ✓. /�y /LSE'3- 9ZDS' w THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: A9�FESSIONP�' Soil Rate Approved sq.ft,/gal. Checked by Date Page 2 of 2 DESIGN DATA SHEE - SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Address 200 Ll14A f cam. 746,er fiq' %, .t Ny, ZS "d 3 Located at (Street) 4avcuALL 141-1 Zd ev Za'&A 4*4 Sec. Block r ' Lot (.indicate nearest cross street) Municipality /pcctN o% p 7/ XsoN Watershed Date of Pre - Soaking +-,23-7+ Date of Percolation Test 4--:Z+-- % HOLE NU,,MER' Q.0.R ME PmCOLkTIO?J PERCOLATION Run Elapse Depth to Eater Frau Water Level 'No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches -3 14,0 2--,-6 !'4 2 /4- 13 3 30 4 3 5,'12 - S'9-2- 3p • .. 2$ Z,S 3 6 4 1 2 3 4 5 J�TES: 1. Tests to be repeated'at same depth until approximately equal soil rates ara obtained at each percolation test hole. All data to' be sutmitU4 ..for review. 2. Depth measurements to be made fran top of hole. rev. 9/85' TEST PIT DATA RBQMED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOCNYIERED IN TEST HOLES DEPTH HOLE NO. T/� Z HOLE NO. HOLE NO. . G.L.6v-�oN/ 3 4' 5' All i cJf2 6 d 'r 6' DTF' n/L CoLG.e /= .2c�.-� /�%ril/V�FGG �v• 7' 8' 9' 10' 11' 12' 13' 14' 'JI r !1• • • 7P DID INDICATE LEVEL TO WHICH HATER LEVEL, RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: � VIIW .�51/� DATE: 'tZa 4 4 DESIGN Soil Rate Used Z/- .3U Min/1" Drop: S.D. Usable Area Provided 5'00 No. of Bedroccns Septic Tank Capacity ;OG gals, Type LoNG . Absorption Area Provided By 6 70 L.F. x 24" width trench Other Name Address 260 Gl, �r Taw P/2iV6 A1Y /2 —</3- THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Signature * z <� SEAL w y W ti 06sw V 9OFESSIGNP Soil Rate Approved sq.ft,/gal. Checked by Date t 1-3o46 To 7 IR ro�v/ c 11 A X 10, 3y D 2.j r,o vj"F I � � O I � o V- 771K 13r 3 0 BF30 ro < D (o BEDROOM 43 13' 0 '12- -'504(" EbROOM 2— X 1-7 C) K 1 3 0 Dec-cow +� t. . 2 - 304 6 —' | � � ��� "u //—� ' � / . / 2 C.) ov w " "o � � , ~ fr f?'~~ o July 5, 1994 Putnam County Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Attention: Mr. Bill Hedges EVAN G. LESLIE, P.E. Consulting Engineer 200 Watchtower Drive Patterson, New York 12563 -9205 Tel,(914) 878 -7000 FAX (914) 878 -2068 Re: Water Well For Schiller's Residence Couch Road, Patterson, New York Dear Mr. Hedges As noted in Subpart 5 -2 of the State Sanitary Code, attached please find an application to construct a Water Well, along with the attached Sketch SK -A showing the proposed well loaction. If you have any questions or comments, please contact me at the above address. Sincerely, Evan Leslie P.E. Enclosures 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 # I WELL LOCATION Street Address Couch Road Town/Village/City Tax Grid Number Patterson 14 -1 -9 WELL OWNER Name Jon Schiller Mailing Address 200 Watchtower Drive Patterson, NY 12563 CIPrivate O Public USE OF WELL 1 - primary 2 - secondary 11RESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL ❑PUBLIC SUPPLY OAIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 13INSTITUTIONAL O STAND -BY 13ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR DRILLING ONEW SUPPLY ❑PROVIDE ADDITIONAL .SUPPLY O REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL 0 TEST /OBSERVATION DETAILED REASON FOR DRILLING To install supply for new residence WELL TYPE DRILLED DRIVEN ODUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED 1N A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTR.yCTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: NA TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED [:)ON REAR OF THIS APPLICATION ©ON EP TE = July 5, 1994 (See attached Sketch SK -A) (date) (s4 nature) PEPT1,I T TO CONSTRUCT A WATER WELL This permit to construct one wat ;:r well as set forth above is granted under the provisions of Subpart 5 -2 of Fart 5 of t1he New York State Sanitary Code, and providee th"t within thirty (30) days or the completion of water well construction, the applicant s.hall: 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 Issuing Official Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner 2/87 Orange copy: Well Driller 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 # WELL LOCATION Street Address Couch Road . Town/Village/City Tax Grid .Number Patterson 14 -1 -9 WELL OWNER Name Jon Schiller Mailing Address 200 Watchtower Drive Patterson NY 12563 CIPrivate O Public USE OF WELL 1 - primary 2 - secondary JaRESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL ❑PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT 5 gpm /J PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR DRILLING NF,,' SUPPLY OPROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ODEEPEN EXISTING WELL OTEST /OBSERVATION DETAILED REASON FOR DRILLING To install supply for new residence WELL TYPE DDRILLED DDRIVEN DDUG EICRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED 1N A REALTY SUBDIVISION, NAIIE OF SUBDIVISION: Lot No. WATER WELL CONTkACTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: NA TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED DON REAR OF THIS APPLICATION © ON EP TE FE July 5, 1994 (See attached Sketch SK -A) (date) (si nature) P r, PJ�I I T TO C014STRUCT A ? WATER WE_TL This permit to construct one wat;:r well as se;: fortis above is granted under the provisions of Subpart 5 -2 of Part 5 of the Hew York State Sanitary Code, and provirec.' thLA within thirty (30) days of the.compietion of water well construction, the applicant s.hall: .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. J Date of Issue: 19 Date of Expiration: .19 Permit ssu�ng icia Permit is Non - Transferrable V.,Vt� e �°PY: -7H•D. File , 'Yi l!.11 }copy :V Building Inspector 2/87 Pink Copy: Owner Change copy: Well Driller 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 # WELL LOCATION Street Address Couch Road Town/Village/City Tax Grid Number Patterson 14 -1 -9 WELL OWNER Name Jon Schiller Mailing . Address 200 Watchtower Drive Patterson, NY 12563 (3Private O Public USE OF WELL 1 - primary 2- secondary ja RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION b INSTITUTIONAL O STAND -BY O ABANDONED '- ❑ OTHER (specify, O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR DRILLING ONEW SUPPLY OPROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ODEEPEN EXISTING WELL OTEST /OBSERVATION DETAILED REASON FOR DRILLING To install supply for new residence WELL TYPE DRILLED EIDRIVEN ODUG 11 GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NA14E OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: NA DISTANCE TO PROPERTY FRO :4 NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION July 5, 1994 (See attached Sketch SK -A). (date) PE R111 I111 TOWN /VIL /CITY, ©O%PE P TE $E (si nature) TO CONSTRUCT A WATER WELL This permit to construct one wat.-ir well as se;; forth above is granted under the provisions Of SUbpart 5 -2 of Part 5 of the 11evi York State Sanitary Code, and provi &.�r.' thLA within thirty ( 30 ) days o;' the completion of water well construction, the applicant s.11all: 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: Date of Expiration: Permit is Non - Transferrable 2/87 19 19 Permit Issuing Official White copy: H.D. File Yellow copy; Building Inspector P 1 :Copy -Own Orange copy: Well Driller 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 # WELL LOCATION ' Street Address Couch Road Town/Village/City Tax Grid Number Patterson 14 -1 -9 WELL OWNER Name Jon Schiller Mailing Address 200 Watchtower Drive Patterson NY 12563 CIPrivate 0 Public USE OF WELL 1 - primary 2 - secondary JaRESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0PUBLIC SUPPLY OAIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY 0ABANDONED O OTHER (specify O. AMOUNT OF USE YIELD SOUGHT 5 gpm /;l PEOPLE SERVED /EST. OF DAILY USAGE _gal REASON FOR DRILLING NF,,' SUPPLY OPROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ODEEPEN EXISTING WELL OTEST /OBSERVATION i DETAILED REASON FOR DRILLING To install supply for new residence WELL TYPE DRILLED DRIVEN ODUG DCRAVEL � OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED 1N A REALTY SUBDIVISION, NAME•OF SUBDIVISION: Lot No. WATER WELL CONTILiCTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: NA TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION © ON EP TE ZE July 5, 1994 (See attached Sketch SK -A) (date) (si nature) TO CONSTRUCT A WATER WELL This permit to construct orie wa.t,7%1- Well as set fortis above is granted under the provisions Of Su'Dpart 5 -2 of Part 5 of thc- Nlew York State Sanitary Code, and provi6ee th,t within thirty (30) dFys 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. -- J 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 gppy:. Owner orange copy, Well Driller oi, H I DRIVEWAY DETAIL \ \ \ S P-21 IV I 5 .Dy�� 0 dh L. \ I T NK o \ 9 / \ Survey Data ProvidtA By K.w, to \ Topography Provided By I3¢rt W b $ I 1 and Shown 1 reon Known Ac Lor I 6 I I i9o. p \ Final Pla+ S rbd v s o+ of prottrt+ ! , Filed in the ru +n O^ County U¢rk S EL "�_ 19.0 \ 1 _ To as %p No. 2279. L ! EL• I Dal un : A,...-CD 200. AT Po ENO Ey�Gt ^SCE \ q i S`+ aF exl iT�N In / I \ \ 00 Zo \0 o• 4 s. s, DD h ; 2 E� ! I LL �� _ 0 o\y 0 :+ �0 i N I K � 1 W 'f 200 NO 0 o• GAK 190.0 -- - -- -- +y 1, _ I$0 , G1 q DRIVEWAY PROFILE P- 2 SCALE: HORIZONTAL ' I -?0 VERTICI I : I,. °IO �I 6- s�e -/4 EVAN G. LESLIE, P.E. Consulting Engineer 200 Watchtower Drive Patterson,, New York 12563 -9205 Tel (914) 878 =7000 FAX (914) 878 -2068 February 20, 1995 Putnam County Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Attn. Bill Hedges Dear Mr. Hedges Re: Schiller's Residence SSDS Completion The following documents are submitted to obtain the certificate of construction compliance for the individual residence noted above. Attached please find a check for $200.00 to cover the application fee. We are enclosing three copies of the following items: 1. Copies of Putnam County Department of Health Certificate of Construction Compliance for Sewage Disposal System. 2. Copies of Guarantee of Subsurface Sewage Disposal System, signed by e installer �i C_ 3. Copies of bacteriological analysis results from North American Laboratories, Inc. showing compliance with New York State drinking water standards. 4. Copies Well Completion Report 5. Copies of the as -built Drawing SP -2 entitled "Site Plan for: Jon Schiller" showing as -built dimensions. Kindly process the enclosed application and if you have any questions, please contact me at the address shown above. Sincerely, Evan Leslie P.E. 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 SYSTEM WAS CONSTRUCTED IN �. ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF \ HEALTH TABLE OF FIELD MEASURED DISTANCES A -1 33' -6" B -1 54' -6" \ \ \ A -2 41' B -2 65' -4 A -3 43' -6" B -3 71' -6" \ A -4 46' -8" B -4 77' -8" A -5 50' B-5 83, -4" A -6 54' B -6 89' \ \ \ \ \ \ A -7 59' B -7 95' \X A-7 A -8 63' -6" B -8 100' -6" A -9 68' -8" B -9 106' -8" o A -10 74' -4" B -10 112' -10" A -11 79' -6" B -11- 118' -6" \ \ \ \\ \ \ A - 12 85 B - 12 125' 13.---90'7 8'.'_ - -.._ B - 11131 \ \\ V A - 14 96'- 4" B- 14 137' - 6" \ \ \ A- 15 102' - 6". B - 15 143'- 8" 1, A -16 18' B -16 66" \ \ \ \ \ \ \ \ \ A -17 69' B -17 117' A -18 96' B -18 116' A -19 122' B -19 149' I I ev \ \ ` 5EE ?A01P or- ,o FiKD MEA h dl �u s 1 1 I 1 D�597}NGFS I TINKI \ 9 \ Survey Data Provide, TaFogrghy Provided R I � (• �aG�tcd S�wwn Hercon Kn i7 I I 190. \ I leA in TF 1,A+no Co aP��. � � \ � � � inTl,a Pu+na►� Co �To as Ma? No. 2299. i / / 1 I �`yy e�• _ \ l .. o_ Dart.•",: A. :,.Mco �!o•o \ \ \ , NO � ,DQNCE oa ' \»00 $ o x I \ / o Z0O < 1 I