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Home My WebLink About0520DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 15. -1 -41 BOX 6 i '� 1 00520 ti # PMAM COMM DEPAR`iMEW OF REALM DIVISION OF & IRONLk=AL HEALTH SERVICES cret%joa Cova"tV'gC.+!hA Core• Cwner ot Purchaser of Buildi Building Constructed by sel msiee hs- 14011 ®w Ind. Location - Street Muccnicipality Building Type Se'cEion Block Loth Fde# M6900-9-80 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 mde 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 ut }lizipg the system. The undersigned further agrees to accept as conclusive the determination of the Director ' of the Division of Environinental Health Services of the Putnam 'County Department of Health as to whether or not the failure of the system t:n caused by the willful or negligent act of the occupant of the buuildiny the system. Dated this -�1�, day of QJokf_r 1994 Signature Title Jn k Mirra , Pe, - Signature Name rev. 9/85 5A....� Corporation Name (if Corp.) I 05 106 11:53 P.F.BEAL INC. 4%A, I WELL LOCATION ;:WELL OWNER USE OF WELL 4 - primary -2- secondary MOUNT OF USE 'REASON FOR DRILLING EPTH DATA EQUIPMENT WELL TYPE MING DETAILS WELL COMPLETION REPORT DEPARTMENT OF HEALTH Divis�on Of Envirarmental Health Services CRONPORPT"r-, Off Ice use OUY PUTNAM COUNTY DEPARTMENT OF HEALTH Z--v -3/'- 51A•T ADIXESS; 76*0194111117mr—, TAX PA PUMI&I iringtone Hill Road, Patterson o Now York 41 PAUL. AGON—SL is IVA I Crosepond Contracting Corp., Box 4510 0011pando MY 2051 Piaui X RESIDENTIAL 0 PUBLIC SUPPLY 0 AIRICONO./HEAT PUMP 0 ABANDONED WEIGHT PER FOOT 0 BUSINESS 0 FARM ❑ TESTIOBSERVATION 0 OTHER (specify) DRIVE SHOE SYES LJNU I LINER; UTW01R9 0 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY DIAMETER (In) YIELD SOUGHT 5 Vpm.1N0, PEOPLE SERVED --- _„_j EST. OF DAILY USAGE 121;, 111"am OREPLACE 'EXISTING SUPPLY ❑TEST/OBSERVATION- CADDITIONAL S1VPPLY\`.'-,q'.' NEW SUPPLY (NEW DWELLING) CIDEEPEN EXISTING WILL WELL DEPTH 505 ft.1 STATIC WATER LEVEL '50 ft- DATE MEASURED 93 ROTARY 0 COMPRESSED AIR PERCUSSION 0 DUG 0 WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): DIAMETER TOP -0 SCREENED 0 OPEN END CASING 13 OPEN HOLE IN BEDROCK 0 OTHER C3 NO SIZE. TOTAL LENGTH 25 tL 'MATERIALS: 6 MEL E3 PLASTIC 13 0M, S LENGTH BELOW GRADE 25 tL ; JOINTS: 0 WELDED (3TWRemED n Ow on dumps a It more 811 N' I �e' I w o"a'sfaft stun " h. DIAMETER A. In. 3 CEMENT GROUT 13 BERTONITE MOM" C30TOk SAW a -SEAL: If 3 - b ,-0 CLWAY• BARONESS -{,a =040, ANALYZI101 I3 YES CMD APALYSIS ATTACHED? 0 YES C3 NO b"relble, CAPACM sgpn ANN Gould , 0 L TZAMO 10 – Rr 11, 25 Dr 11 no in roc x# eert C11111122. 0 g 0 , 261605 Dr 11fina in rock Granite Im STORAGE TANK: TYPE err. rr CAPACITY W4 W" 0014W MANE AowA 4 Putnam Avenue SWIM Brokwaterp NY 10509 . . . . . . . . . . . . . . 230 Im sea WEIGHT PER FOOT 1b.ift, DRIVE SHOE SYES LJNU I LINER; UTW01R9 SCREEN DIAMETER (In) 3LOr SIZE LENGTH (#) N M TO SCREEN (N 111"am DETAILS FM SLIM WM GRAVEL PACK Q YU DIAMETER TOP C3 NO SIZE. OF PACX On -rWELL- YIELD TEST It delailed Pumping �Uo* WELL LOG on dumps a It more 811 N' I �e' I w o"a'sfaft stun " h. 0.*M 0 PUMPED tests were done Is In- =0 ED AIR fGMA111011 AtIAC1160 SAW ilia( We" 7 U.. 4to 13 OTHER 10 YES ❑ NO 0 & 011 larl FUMAM KIM , , ..., DURATION CAAWDOWN YIELD, la4 a Dr 1"ng in overburden cla y both' 114 11 141 r cit III 480 sh ,-0 CLWAY• BARONESS -{,a =040, ANALYZI101 I3 YES CMD APALYSIS ATTACHED? 0 YES C3 NO b"relble, CAPACM sgpn ANN Gould , 0 L TZAMO 10 – Rr 11, 25 Dr 11 no in roc x# eert C11111122. 0 g 0 , 261605 Dr 11fina in rock Granite Im STORAGE TANK: TYPE err. rr CAPACITY W4 W" 0014W MANE AowA 4 Putnam Avenue SWIM Brokwaterp NY 10509 . . . . . . . . . . . . . . 230 Im sea 95- *16671: 53"P�F�BE-,AL INC. --,",,, kpl- I I WELL COMPLETION REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services CR9=W--F5-,-ZZ=2P- W.." ra; Only flee PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATIO? GRAVEL PACT A111116. .,WELL OWNER USE OF .WELL Hill Road, Patterson* Now York 1'• primary NA&L, AG69SL CrOMpOnd Contracting Corp. # BOX 451, Ciampando MY 2051 .2 • secondary "N! R!.MOUNT OF USI 0 PUBLIC SUPPLY 13 AIRICOND./HF.AT PUMP ❑ ABANDONED "'REASON FOR ❑ BUSINESS DRILLING WELL LOG DEPTH DATA C3 INSTITUTIONAL ❑ STAND-BY 0 DRILLING YIELD SOUGHT EQUIPMENT WE�L- TYPE' CIREPLACE EXISTING SUPPLY ❑TEST/OBSERVATION (3ADDITIONAL Svipiiyv, available. $6310 attach. PINEW SUPPLY (NEW DWELLING) EXISTING WELL CASING WELL DEPTH DETAILS DATE MEASURED 4,/&71/24' SCREEN 3 ROTARY DETAILS 0 WELL POINT WELL COMPLETION REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services CR9=W--F5-,-ZZ=2P- W.." ra; Only flee PUTNAM COUNTY DEPARTMENT OF HEALTH ''GRAVEL PAC9 GRAVEL PACT A111116. TAX VA XUWM 391315tofte Hill Road, Patterson* Now York 0 NO NA&L, AG69SL CrOMpOnd Contracting Corp. # BOX 451, Ciampando MY 2051 IVA BUF. OF RACK k to IL 13 RESIDENTIAL 0 PUBLIC SUPPLY 13 AIRICOND./HF.AT PUMP ❑ ABANDONED 'a a t -0 •FSTI"ifto" ❑ BUSINESS ❑ FARM 0 TEST /OBSERVATION 0 OTHER (specify) WELL LOG 0 ❑INDUSTRIAL C3 INSTITUTIONAL ❑ STAND-BY 0 YIELD SOUGHT 5 gpm.JNO, PEOPLE SERVED EST. OF DAILY USAGE tests were done I.% In. CIREPLACE EXISTING SUPPLY ❑TEST/OBSERVATION (3ADDITIONAL Svipiiyv, available. $6310 attach. PINEW SUPPLY (NEW DWELLING) EXISTING WELL WELL DEPTH .13DEEPEN 605 - ft. I STATIC WATER LEVEL 18-0 ft. DATE MEASURED 4,/&71/24' WA, 10.1r wou 3 ROTARY 19 COMPRESSED AIR PERCUSSION 0 DUG 0 WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specffyl: FUMAWN ff=L"ft 0SCREENED 0 OPEN END CASING 13 OPEN HOLE IN BEDROCK 0 ME TOTAL LENGTH LGL:-tL MATERIALS: 3 STEEL 0 PLASTIC . t Doi �,. LENGTH BELOW GRADE a- tL JOINTS: C3 WELDED 13THREADED .06110 J%u 11 DIAMETER 1-in, SEAL: 3 CEMENT GROUT IOBENTONITE C30fHW 4 WEIGHT PER FOOT 19 lb./ft, DRIVE SHOE WYES 13NO UNER: DYES AKO 4A. DIAMETER (in) SLOT SIZI LENGTH (Al W" To Scum (M Vail xtroT =900 4f. MALY= ATrAcmi a YES C) No STORAGE TANK: TYPE MONO 101; IIFORMATIO LVIO CAPACITY ''GRAVEL PAC9 GRAVEL DIAMETER TOP 0 NO SIZE. 1 25 Dr ill OF RACK k to IL KPM.. L r 3 c Tc 'a a t -0 •FSTI"ifto" -VELL. YIELD TEST 'If detailed pUMPInq WELL LOG it more del fermillon- —0811al ptions or' 12 I ng'Tn- rock !U40, 0 Pumm tests were done I.% In. available. $6310 attach. 0 IWO ED AIR Iss formation Attached? U C. WA, 10.1r wou C3 Uto 0 M1JI 10 YES 0 NO FUMAWN ff=L"ft OF Wl�!. 10111 OMTIM OFAWDOWN YIELD J%u 11 Dr i Vng in overburden clay bo 4 L-',,' hr. MADNESS 4A. 480 81111 t 1 25 Dr ill in r 3 c Tc 'a a t -0 •FSTI"ifto" X Dr 26 505 D 11 I ng'Tn- rock g ran ite �41, g lvilk� - - rr �, j 74". 7 - � j` :-0 CLOUDY. MADNESS 1 li' .�43 COLORED " "ALYZIO? OYES ONO Vail xtroT =900 4f. MALY= ATrAcmi a YES C) No STORAGE TANK: TYPE 101; IIFORMATIO LVIO CAPACITY JVK Gould CAPAWY 59FM mu� WUWAW"f r ONO OW04 0 FA AawA 4 Putnsm.Avenus nor= T= - YOLTAW 13. W Brewster, NY 10509 C 00 V Dos ANY �\401 Rev. 10/8 101i�lAll[ CODM7f DEPAWITAM OF KMTH Dl�lti� of Hd�lm Senloee: Cfa�e1; N.Y.1RiU _ ,��,� �o ?wvldo lui�111, MW FOR 7�aI1[�If<Stit��L1?�ia�i� � WMIN M_ i alert • ,�..a ��.0, �ox �Si :Ci2.ertPoua�h0, �j Y f� Down TYR Let Aroa Numbed! of Henn a J ,�.� /Z �"�'' Design Flow G P D �0 0 PCHD NoMosdob b Q6ga4e4 Whed Pf0 b o�pleted SWU'"' WMW.SYw to "as d of T000 Wass SQL* Tack ad _3 3 3 —4 C336'S;"06 ) To be ossexha bd by J lu t L Aridead Water S F�IIc Seippk/ Ftv� Addtere act k, by ? ..�.. otwa 3,f 5-r, x 2.9� `t d, 1, ; Se- c,o,,1 T %� �Pna -v. -1 -94 I represent that l'am,whopy and completely responsible for the design and k►cation of the proposed system(:); 1) that the separate aw dl sal s stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a rpu ns o na County Department. of Fasaftl% 'and that on COn) i0,thareoi "Certificati of'.Ccinitructlon Compliance" satisfactory to thei,Commissbher of Meelthwlil be 'submitted' to the Depertme nt, and a' written guarantee will be. furnished the owner,: his successors, heirs or assigns by the builder, that said builder will Wce in good .operating condition any pert of,sail sewage disposal system during the period of two (2) yews Immediately following thedate of the ism- ante of the approval of thAe,Certificate of Construakm CompGanca,,of „the original system or any repairs thereto; 2) that the drilled well descr"d above WIN be located as Mown on the approved plan and thaiiski well will be Installed accordanq with t , standards, rules and rpu ores of the Putnam County Depntnrant of Health. �[ Dab. q—.,7- 94 Signed PnE.lo N.A. �/ r Address /2, D c% 1� �T �_ COQ SIC �Lt Y 10 M Z— License No 'a_ µ1D APPROVEO FOR CONSTRUCTION: This approval expires two years, from the date. issued unless construction of the building .has been undertaken and Is revocable for Cause or `ay be amended or modified when considered netis mmissioner of Health. Any change or afters n of construction reouiras eve per Approved for disposal of domestic sanitar age wpply only. 8 Deb 8 Title 0 Nk i !'!� FOS FEii MUINAM COUPfrr MWAW%&N ' OF 8ZALTH DteWaw e[ PWVldo teastit Leaatd a Rr i mctnna Hn 1 1 riw Rnari•" A. Brimstone Hollow SWW_W0. 2 e• CENTUICATB OF OODUUANCS Fa.vi r P3.1 -83 - vmll�e . Tau Map 15 . ll 1 41 OwAa /AsprcaatNfio Crompound Comstruction Corp. Ae°°"'' -° ° ... Date of Fsavlom.. Approval 10 % 17 /83 & . 9 / 4 / 8 5 AdMen P.O. Box 451, Cromound, NY ' 10517 Town adwkt i'7Pe Frame Lot Areal Fm sawall Depth Valotas . Nobae d eeiwl.g Three Desist, Flow G F D 60 0 PM IS RegmW t Wbw F® Is c..plptea S"Waft Saweaee. syaaaa to Guam a[ 1000 .� � T� -ad 333' x24 ".W . x cep a era s own U be once elsd bs awl@ Adlinne water s.ppf : 2doft, spy Fnm A.&W e an X pdvab sup* Dave M NA Addm.. otsae ampbumnb lone. (,represent that I a n •wholly and completely responsible for the design and "tion, of the 'proposod system($); 1) that the. separate ,sews a dispoYl s stem above described will be,constructed,as shown on the arpproved amendment there to and -in accordance with the standards, rules an regu a Ohs O e am County - Department of Mtnitt% and to on *completion thereof a. "Certificate, :of Construction Compliancg".satisfattory to the Commissioner -of Mealthwill be submitted to the Department.' and a written, quaianteo will Op. furnished, the owner, his succolasors, heirs or assigns, by the builder, that said builder will pica in good Operating condition My part of Yid sewage disposal system during the period of two (2) ya►$ immediately following thodate of the Im- am of the approval of the Certificate of, Construction- Compliance of the original system or any repairs thereto; 2) that the drilled well described above wIN a located as shown on the • approved' plan and that Yid, well will be instal in accordance with the standards, rules and reeu ns of the Putnam County Department of kianh. Cate Signed ,_RE. X R.A. --p J �rl.r 1964- , -- Address—' R q Fa i r qtr - License wo 29206 APPROVED FOR CONSTRUCTION: This approvatl.expires two years from the date :issued unless construction of the buikline .has., been undertaken and is revoeeAle for cause or may be amended or modified when considered necessary by t� }" Commissioner of Health. Any change or alteration of Construction "Quires�w permit. Approved for disposal of domestic sanitar -W-- e, Jor rIvate. water supply only. Rev. DatO � f � � By Title =_S 10/88 - - – — - -- - - - - - -- 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 6 January 1994 Re: Property of Crompoind Contracting Corp. Located at Brimstone Hollow Road old: 18 2 1.2.3. (T) Patterson Section new: 15 Block 1 Lot 41 Subdivision of Brimstone Estates J Subdv. Lot # 2 Filed Map # 1839 Date Gentlemen: This letter is to authorize John H. Prentiss a duly licensed professional engineer X or registered 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 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 Health Law, and the Putnam County Sani- tary Code. Coun P.E Very truly yours, Signe er of Pr perty P.O. Box 451 Address Address RD9 FAIR STN914S878 -6170 CARMEL. NEW YORK 10;:•'_2 Telephone Cromooa d. NY 10517 Town (914) 528 -6906 Telephone 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 # ~31 -� WELL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name Mailing Crompound Contracting Cbrp.. Address P.O. Box 451.Crompound, NY OPrivate Public USE OF WELL 1 - primary 2- secondary EkRESIDENTIAL 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O BUSINESS 0 FARM O TEST /OBSERVATION O INDUSTRIAL U INSTITUTIONAL O STAND -BY 0 ABANDONED 0 OTHER (specify, O AMOUNT OF USE YIELD SOUGHT Five gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE 450 gal REASON FOR DRILLING 13 REPLACE EXISTING SUPPLY M NEW SUPPLY NEW DWELLING O TEST /OBSERVATION GI ADDITIONAL SUPPLY O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Potable WELL TYPE ®DRILLED DRIVEN DUG [3 GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Brimstone Hollow Road Lot No. WATER WELL CONTRACTOR: Name NA 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: Over 1 Mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED- See drawing #2, job #5.0.2085 by John H. Pr [DON SEPARATE SHEET Prentiss PE 6 January. 1994. P (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 thirt;, (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: �,c h 199 Date of Expiration 19�� Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller AFPLICATT_ON FOR APPROVAL OF PLANS FOR A WASTEWAI_ER DISPOSAL SYSTEM 1. Nase and Address of Applicant: Crdmpodnd Construction Corp. Box 451 2. N of Project: Residence Crompound, NY 10517 3. Location T/V /C: T. Patterson 4. Prciec. Engineer: Dohn H. Prentiss, P.E. 5. Address: RD 9 Fair Street Carmel NY 10512 License Number: 29206 PE Phone: (914). -878-617 9217 6. Tvice of Pro.iect: _y Private /Residential. Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is th'.s project subject to State Environmental Quality. Review (SEAR)? Tv,.,e Status (Check One.) Type I.. Exempt Type II. Unlisted _X_ 8. Is a Craft Environmental Impact Statement (DEIS) required? NQ 9. HEs DE-TS been completed and found acceptable by Lead Agency? ......... 1 10. Name cf Lead Agency 11. is t'pis project in an area under the control of local planning, zoning, or ot`ler officials, ordinances? YFI; Zoning 12. If so, have plans been submitted to such authorities? .................. 13. Has preliminary approval been granted by such authorities? YES Date Granted: 14. Type cf Sewage Disposal System Discharge...... Surface Water X Ground Waters ;5. If Sjrf?ce water discharge, what is the steam class designation ?........ 6. Waters index number( surface) ........................................... 7. Is prciect :located near a public water supply system? .................. NO 8. If yes, ;name of water supply Distance to water supplyover 1 Mile �. ?5 S '�te, near c .pub : S:'ra9 ;;•! i_ 0P. Or C'. :05 «'=- ° -r.. ... . NO 0. pia:._ c: s�wag� system:' tc Sawag- �� .;;,Over 1 Mile 1. Gat, ctserved: 1f0/83 & 9/85 L3. game of : nspeoto�-. R. Tutoni 4. Prcie-t de -sign flow (gEllons per day) ... . ............................... 600 z 2 5 . Is S Pollutant Discharge Elimination System (SPDES) Permit required ?.. NO 26. Has SPOES Application been submitted to local DEC Office? ............... 27. Is any portion of this project located within a designated Town or State wetland? .................................. ............................... NO M. Wetland ID Number ........................................................ 29. Is Wetland Permit required? ... Has application been made to Town or Local DEC Office? .................. 30. Does project require a DEC Stream Disturblance 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? ....D... YES or NO Nn 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any ether potential known source of conta:�i.nation? ..............YES or NO NO DESCr;IBE: I3'. Is ti=re a local master plan or file with the Town cr Villa -e? ........... YES �3-'.. Are community water, sewer facilities planned to be developed within 15 years? ? 15. Are any sewage disposal areas in excess cf 15-M slope? NO i6. Tax Map ID Number ......................................................... 15 -1 -41 J. Approved Plans are to be returned to: ............. .. Applicant, .X Engineer f the application is .signed by a person other than the applicant shown in Item 1, the .pplication must be accompanied by a Letter c; Authorization. Failure to comply with this ,rovisicn 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 rry know7edge and belief. False statements mad herein are punishable as a Class A Misd6reanor pursuant to Section 210 NEWZV the Penal Law. John H. PK- Ktiss, P.E.Tper attache ,.?, I N,C .= ;DDP =SS : See #4 above FUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY. OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN ,1ATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. rn l.lrt. C nS Y�Y `Oh (:o Owner Address (3(Zt M sT',onti� H o L L o t&) RD Located at (street) u�t�N Vr- /8 Block 2. Lot • 3. _..:..t.Mdicate nearest cross s ree IrtgToNr TE GAT '►1' STA S -,. MqP 1 834 Municipality. .,a=,s= so r, 4 Watersh6d , P-0-r-0 : 11 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH'APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to water water Lev e No.. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2. .1 1. S _ 1 (30 3 i.o -t► S t5� 4 - JU23 203 - 122 1 ly 2 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. TEST PIT-DATA REQUIRED TO•BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. l HOLE NO. HOLE NO. G.L. L, -0 P.So 611 QRd Soil S.D. Usable Area + No.- of- Bedrooms `� ......Type .64,9ELr— Septic 1 Tank Capacity, l000 Gals: M 0 Absorption Area Provided By 336 .L.F.x2411 4 b" width trench. 0 IV q D 6*�rr X -3 ... Othe �iessjW 66-. q , R r. hlT- Nme Address:. PAIR ST. THIS' SPACE - FOR " USE 'BY-1?1E� NWR%, T Soil--Rate- -Approved-, Sq.- Ft/Gal. �\ PUTNAM COUNTY DEPARTMENT' OF HEALTH �' ENGINEER :TO PROVIDE PERMIT # !7 \ AN CERTj,FI.CATE'OF COMPLIANCE. '' Division of En Division Hdo Services, Carmel, N. Y. 10512 •,PERM�,T. p '31 -83 �. CONSTR CTION: PERMIT FOR SEWAGE DISPOSAL SYSTEM T. Patterson own or. illage Brimstome Hollow Road 18 Block- ;2, rAt 1.3.,•2 Located at Tax Map Brimstone Estates, Lot 2 Map, 1$39 Subdivision - Subd :Ldt Renewal Revision ose,e QQ in o i y 12/18/83 Owner /Address D.reWS er, 1 - - Date Of Previous Approval - Frame 4.051 acres Fill. section onl Building Type Lot Area yyi_ll Three 600 P.C. R. D. Notification Required yes Number. of Bedrooms Design Plow c /P /� s Separate Sewerage System to consist of 1000 Gala Septic Tank and 336' X 24" •wide lataralS To be constructed by - Address Water Supply: X Public Supply From Private Supply to be drilled by Address Other Requirements 24" deep R -0 -B fill - _section; 3456 k. ft: (256+ 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 tie constructed as shown on the approved amendment there to and in accordance with the standards, rules and regu a ions o e u nam County Department of Health,, and that oncompletionthereof.a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a written guarantee -will be furnisIhe'd 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 tie installed in 'accordance with the standards, rules and regu aTons ' of the Putnam County Department of Health. Date SeTtembPr 4, 1985 signed i P.E. x R.A. Address Rn9- Fair S- treet, r1ne1, NY ,1U512 License No. 29206 APPROVED FOR. CONSTRUCTION: This approval expires one' year from1hw date issued :unle s construction of the building has been undertaken and Is revocable for cause or maybe' amended or modified when co, e essary by the Co ssio r of Health. Any change or alteration of construction requires a new permit. Approved. for 'disposal of domestic age, a or riv to 'wat —� Date — By Title .Rev. 6/85 I 0 �PUTNAM COUNTY DEPARTMENT "QF HEALTH Permit a " r Dfvisfon of Enwronmenta/ Health Services Carmel N= Y 10512 CONSTRUCTION PERMIT 'FOR SEWAGE :DISPOSAL SYSTEM T: Patterson . y mown or Village _ t 'located at Brnmstarte H'o11oW ' °ld�ad =a Tax Nlap 1$ :Block 2= acBx 1 .3 2 ' ;SuDdwIsan Brimstone Estates Lot #2 _o IotJl Renewal Revision _ r .T •owrner /Address Rosebeth &_COI i n Ho114 Mi r - Date Of" Previous APProval Frame 4 057 >acres F111-Section Onl Building Type Lot Area Y three 600,. Number .of Bedrooms. Design •Flow G /P /D P.C. H D Notification Requited Separate`.rSeweraye System to con --st of :;. 000 ° Gal Septic Tank; ano' ? a Farm to Market Rd = $ To be constructed by Ad , E , Y X150 �1dre �alst ter -A 1 9 'Water Su_ pply — Pubicc Supply From ? Fi' 1 Seeti on .On7 Y C: DA H . NCtI f 1 Ca't I on Prate• Supply.,to be-drilled -b,Y Regd.,1J w Address Total Hab:astabl a 'Space 2242 Square': Feet .: Other Requvements 24" Dee: R 0 -B Fi11 Section* and 336' ;of 24" w Trenches ;3456. 'sq. =ft. 256 cu yds 4 I, represent that I am Wholly 'and completely respohs ble for, he design and location of -the proposed system(s);'1) that the separate sewage disposal system ;above deSCr� bed awilbbe onstrutted;as shown on the'a`pproved; amendment there to and in accordance with the Standards rules an i regu a ions o e: Putnam t County `:Department 'of'- ;Health,,"and thaton completionthereof a `Gertifuate: of Construction•Compl ance 'satWactory to I' County Health will be submitted•ta' the ,Department;,and - -a written `guarantee ' wcll tiejurnislied' the owner his'successors; heirsor sssigns;Dy the buclder;'that said builder will place :in;.good, operating condition any `,part -.of _ said sewage disposal system d6r11ng She pe_rioC of ;twoT(2) years immed ately,followirig the date: of the- issu gnce of 4he' approval ;of:the- Certify cafe !of Construction 'Compliance of the, onginal.'system'or any repairs.fhereto 2) -that the "drilled well dedcr{tieG,a_boye' will be'located is shown on "the:approved'.plan anG thatsa�d'well,will' lie installed. in accordance. with'_the standards; rules. and regu a ions of the, Putnam_ County Department of Health p s� be Date 7 Octor' 1983 6 #.. - - P E. X R.A. Address`RD #9 .Fair S °t , me], N Y .1A512 LicenseNd 29206.,' 'ROyED FOR CONSTRUCTION This approval. expires ,one year from the date issued unless -- construction• of the ",building. has been 'undertaken and is �, le, for cause or may be amended or modAlei when consctlered necessary by the of Health. Any change or alteration of construction a new ,permit :Appro'd for disposal of';domestiitefy sewag` aid /or;, riv t FwaterSupDly only _AA fv ' i v PUTNAM COUNTY DEPARTMENT OF HEALTH e DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 25 September 1983 Re: Property of Rosebeth & Col i n Hol l i day , Located at Brimstone Hollow Rd'. (T.) 18 Subdivision of Subdv. Lot # Gentlemen: 2 Section Block 2 Lot 1.3.2 Brimstone Estates Filed Map # 1839 Date joh_ This letter is to authorize John H. Prentiss, P.E. a duly licensed professional engineer X or registered 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 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 ublic Health Law, and the Putnam County Sani- Q�pFESSIONq� N PRE,yrs�� /y�E` Ar tary Code. Very truly yours, G � Signed crj� o ers' g ci �� Owner of Property f7fTHE STAT�� JP'. E. , X(XIAK,XX #.29206 Farm -to- Market Rd. Address R.D. 9, Fair Street' a�� Patterson, NY 12531 Address '��' ,:y Town Carmel , NY 10512 ` � C 279 -6552 - 878 -6170 �zy.'1i; Telephone 914 Telephone \' I I r e � a ?W-Z41n 7�:j /�•gI�ZZ tv o �, ._. ..... I i, .:a� >, � yJ OQ•a � 4 g l.. N s. �A. II • Q I I , L ' I �i� l�,r �. IipF �! I�I .O 11 Irk' - - PPP \ 2 -�b2 'Z -4tYhZ 1 X lZ�' ~i i` G1cr dlw+jn^' F� _ f r• Three i3edreo.., co/, { Ruse 6e,'h a 3n.r+:7�onC }follow 2e.u! CTM -1 ti mc(p *083 i` G1cr i � I 1 N LL i k J Y dlw+jn^' F� _ f f� r Three i3edreo.., co/, Ruse 6e,'h a 3n.r+:7�onC }follow 2e.u! CTM -1 ti mc(p *083 CJ Z4 z 'gFrB _ S � h i � I 1 N LL i k J Y dlw+jn^' F� . f� r Three i3edreo.., co/, Ruse 6e,'h a 3n.r+:7�onC }follow 2e.u! CTM -1 ti mc(p *083 i � I 1 N LL i k J Y 5hee - 2 of 3 dlw+jn^' F� - Three i3edreo.., co/, Ruse 6e,'h a 3n.r+:7�onC }follow 2e.u! CTM -1 mc(p *083 5hee - 2 of 3 � deposit %tepee. Be-drool" 1JCue�l /�q For - /�oSC- beTh_�III n ' / go khda�y, erl -jfDne Road. 7- f a''ierslon CT-/" Idr 2 - 1. 3. a/ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ..COUNTY..OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.' Owner ®Se Ad Mess "D of a Located at ( Street 40 ��® . r of, Block Lot a nearest c- s ree • _.Municipalitg.: MOO Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS oe Number.,.... CLOCK .TIME PERCOLATION PERCOLATION Run apse Depth to Water Water Level.. No...:*__ ....:: Time From Ground Surface . in ' Inches .....Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches .Inches s. 1 2 T ` .. \�A � is ^.. °' ��' J . _ . ^1�� •�� i' Notes: l) Tuts to be repeated at same depth until approximatel yy equal soil rates are obtained At'each percolation test hole. All data to be submitted for review. i 2) Depth Measurements to be made from top of hole. 8 1 , t - Address , v THIS'° SP:' EOR`." USE "'` °HEALTH DEPARTMENT-,( Soil' Rat ,Approved a '..., ' .;.Sqe Ft /Cal . ®.. "CROW5- AP Date . OF'THE S1011E 04 04ins JO Pit" a IA1138rjS J . u CA O.L OlIV3 01 U3MMO m q due iyM cc� V 0 lo 41i�6N"OtO" I cl- pojinboi oq ADW uoiinquSuip 1.0fibo oinoul of polMDEJ t, colloci JjD uoom$oq puo iroq ca slut) 8 314doe woad oded Suiol z DAIS uoipRjpuo3 a6ojao** jo �Uwoow popoidieSDA(Z • • it 3xiC tro:jdzt 14d -#rain -CUmng 4.Y aurvoyor • notpd 8oloe oll:focafft® 6,n:.Sesr',voyora vurvoy•_ - - n . t9oli dtllofa s4port.,,.:_ ..�.•. -•� —._ .___,.._ _ Jrnotneoro mosuromonts:i-.ef-�� _ - -- -- — — _ T' ' Qono' lo•ola.tad DiGl6oaftractorc A: S$p�4 tioolihdej : " 1, r 9 srs , Fioid IaopOatiOF) bV: NOGIM Ao ®1 ®. Aa!•o. tee= �'� _ _,.. i �, Yhia La to ceW rtt�y�tbat -the v} i �d • t 0 n6tr 'udicatedsontbie 81aoµctE� io y ;atom Wei 'inapeet$r atl y ib F + was cove red ove't3 .+constructed In ai:W�4aas�a i44i �'< Bya p ��iandard rules and KQgulttoGoiD the F.C.H.D b the ii R !.8 9 If * r Or'ts A-- Al 5 a EILRI e 1 _ t A > OGAIOP15troot: _ • `. 101Tn -iR4• _COUQtYi LZL*ELq_ iUB;i aim s l� --- - LOT Nn! -t? LPavm oar rota- County Department of HealtS ' 8eraoyor: �� Jivieion of Enviionmen'tal Health Servioes �ar - - •% * tEigps Dato _ ,: Scolo: �, �i.b,: doD ��-• OPrp -d as noted for conformance with ,pvliaabie idea and He�atione of the X #� ..M -P R E:T1 S 5' P E _ o. _ 'utnam co 10 �� th Department. ,... SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS. PE Director of Environmental Health DEPARTMENT OF HEALTH DRINKING AND RECREATIONAL WATER Boyd Artesian Well Co., Inc. c/o Henry Boyd 1054 Route 52 Carmel, NY 10512 Re: Proposed Well Krempler 102 Brimstone Rd. (T) Patterson September 22, 2008 Dear Mr. Boyd: A field inspection was conducted on the above referenced lot by Mitchell Lee, Public Health Technician. The application to drill a new well is approved with the following stipulation: 1. A Well Completion Report (WC -97) shall be submitted no later than 30 days after the well completion by the permittee. Please contact me at (845) 225 -5186 ext.2233 if you have any questions. cc: 6 S erely Mitchell D. Lee Public Health Technician 110 OLD ROUTE 6, BUILDING 3 - CARMEL MY 10512 (845) 225 -5186 FAX (845) 225 -5418 W-03" PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL / please print or type PCHD Permit # l/V q Well Location: Street Address: Town/Village Tax Grid # Map < Block Lot(s) Well Owner: Name: A ess: � Use of Well: Residential Public Supply Air /Con eat Pump Irrigation :1- primary Business Farm Test/Monitoring _ Other (specify) 2- secondary Industrial Institutional Standby ' Amount of Use Yield Sought gpm # People Served Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well �� L Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No_ Name of subdivision Lot No. Water Well Contractor: 0-442 A� i�f z0 Address:] Is Public Water Supply available to site? .................................. ............................... Yes o Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL - This permit to construct one water well as set forth above, is granted under provisions of Article 1. of Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code alid prdvided that within thirty (30) days of the completion of water well construction, the applicant or their ddmgnafed representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and 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. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD, and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision r alteration of the approved plan requires a new permit. Well to be constructed by a wager well driller ce Ied by Putnam County. A Date of Issue Permit Issu g Offi 'al Date of Expiration C-) Title: Permit is Non - Transferrable / White copy - HD file; Yellow copy - Building Inspector; Pink copy VOwner; Orange copy - Well driller Form WP -97 Boyd Artesian Well Co., Inc. 1054 Rte. 52 6 LA"a, Carmel, N.Y. 10512 (845) 225-3196 /A13fUT1\Y1 Fax (845) 225-8420 e MIS IS6 a 4-6 ABILITY cj Boyd Artesian Well Co., Inc. 1054 Rte. 52 Carmel, N.Y. 10512 (845) 225-3196 Fax (845) 225-8420