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Home My WebLink About0720DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.12 -1-45 �� I koir rp it-P X0r I 00720 G PDTNAIYi'COUNTY DEPARTMENT OF HEALTH /. Dlvlsion of Pwtronmentdl Hedtb Service`., Caemel, N:Y 1OS12 esimillit Q , Fb86i V 5� ,P'C H D CATS OF CONST8UC17ON COMPLIANCE FOR% SEWAGE DISPOSAL 'SYSTEM �AI`a^�►` 1. Town or VIOaBe -.p Block ., � Owner /appllciint Ns,me ~`""" tR Foemerly Sabdivleion Name Ads subd' :..'Fee 'Erielosed .. ,A)noun 2 rmit Issued �;- /M� Date; • P e �j Separete Se1441 System ballt by L 5►►1 Y � ' �� Add><ees � c � ` Con�lstlng of ~ ( DO, Gallon Septic Tank and 3 % �� I�G1J�, t Water Supply= ' Pnblic Supply From ' t . r Address or: In y m Privite Supply Delved by ��' Address uT� �M T4 PC �%� Lot Size Has Erosion` ('nnYrnl R'Pan ,C'mm�l atpri2 �_ Nnmber of Bedrooms Has Garbage' G der Been InstelledT � Ofher Regdremente' Z :�U'' �L W'h, r a > I certit thaf'.the,eystem ( s) es liated- iservin" the above • y. q, premises weie conetruc " _ een i lly ae�ahove on a plane'o! the ecetpleted.work''(�eopiae of which are attached); and in;aec6iance with .the Standards, rules an ` p£ ` s; o nce,ritA'tti filed plan, and the permit issued by the Rotnea Coon Dep ztaen O! Health Data 7 Corti lewd _ �' '�` ;.i Add►ess�.t • ✓, •`� .:�4oC�lid�� G � � 22. � � �. LlosrnN No. Mafte Any par oCCUOYIny :pramisi Jwrved'Dy the atwve fystem(s) shall promptly take such actbe as may.bo neoswry to secure tM co►►eetbn of shy ununnary eondttbh, •iewnhq' from wch usage `App►ovaj ;of the `wpa ► ate' null and voad as soon'as ,a,,pubt "itory p ww beoomaa 4vallobte and the app_r -fk of 4M p►tvat water iuP01y fh 11 become null en0 voW vvlian a .public. water s wPply baot►nws wa1MbM Such a0piovats are wbjief to modlileatbnu O► ehsnpa when in the Ju401;i Mt o1 tM C ssbMro ueh revocatbh� modttleatbn .a . I{ .MlatY►y `. haw,: 3/:89 o.t. 71 1 r /�. For,J +c ' ❑ ECash' ❑ CheckK M O ❑ CredEt Card B. ` _ ,^ _ - 0 —e C�G� WELL COMPLETION REPORT Office Use Only * * DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH 2'31 4Z STREET ADDRESS: WNr I TAX GRID NUMBER: WELL LOCATION Flintlock Ridge Patterson NY Lot #3 WELL OWNER NAME:' ADDRESS: O PBIVATE Greenspan Builders, PO Box 330, Biarcliff Manor, bi ❑PUBLIC USE OF WELL JQ: RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED 1 - primary ❑ BUSINESS O FARM ❑ TEST /OBSERVATION O OTHER (specify) 2 - secondary ❑ INDUSTRIAL O INSTITUTIONAL O STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR .[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION _ ❑ADDITIONAL SUPPLY DRILLING NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 185 ft. I STATIC WATER LEVEL ___30 ft. DATE MEASURED 8 DRILLING ® ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING ® OPEN HOLE IN BEDROCK D OTHER TOTAL LENGTH __ 10 ft.. MATERIALS: 19 STEEL O PLASTIC O OTHER CASING LENGTH BELOW GRADE _ 29 ft. - JOINTS: O WELDED -- ® THREADED ❑ OTHER DETAILS DIAMETER 6 in. SEAL: [3CEMENT GROUT ❑ BENTONITE OOTHER WEIGHT PER FOOT 19 Ib. /ft. I DRIVE SHOF-EYES ❑ NO LINER: DYES UNO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? DETAILS FIRST O YES ONO SECOND - -.. _..__. .. HOURS .... GRAVEL PACK ❑ YES GRAVEL DIAMETER TOP BOTTOM ❑ NO SIZE: OF PACK in. DEPTH It. OEM It. WELL YIELD TEST If detailed pumping WELL LOG it more detailed formation descriptions or sieve analyses METHOD: O PUMPED , are available. please attach. tests were done is in- DEPTH FROM waler Well XXCOMPRESSED AIR ,'formation attached? SURFACE Bear- Dia- Fap6tAn0N DESCRIPTION case O BAILED O OTHER 0 YES 0 NO tt. ft. ing In WELL DEPTH DURATION DRAWOOWN YIELD Land 7 Dr 11 ng in overburden clay & boulder It. hr. min. It. ggm. Hi ck at 7' 6 0 Dr ll n in rock set casing grout d. 30 85 ri li g in rock granite. [MAKER ER O CLEAR TEMP. LITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES ONO STORAGE TANK: TYPE MP INFORMATION CAPACITY GA],. E CAPACITY WELL DRILLER NAME P.F. Beal & SO. riC GATE 0/18/93 DEPTH ADDRESS 4 Putnam Ave . SIGNATU l EL VOLTAGE HP Brewster, NY 10509 PCTi'NAM COUNTY DEPAPM ENT. OF HEALTH DIVISION OF &NVIRONMEqj!AL HEALTH SERVICES c s r-1Pw1N Owner or Purchaser of Building Building Constructed by Location - Street Municipality Building Type 2 •12 J -1-5- Section Block Lot 'F r.( NyrLo 1?-( �. Subdivision Name Subdivision Lot # GUARANI= OF SUBSURFACE SEt&-A-GE 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 iumediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal systen, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environirental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the syste -n. Dated this -t'A � 1, day of / ,S 19 ' Signature X Corporation Name (if Corp.) Address rev. 9/85 mk tle Corporation Name (if Corp.) Address C 0 P Y WL.LL UVrlrL[S11ULN rlL•rUIN1 4 DEPARTMEN'r OF 1IEALT11 Division Of Environmental Health Services PUTNAIM COUNTY DEPARTMENT OF HEALTH. Office Use Only Ro� WELL LOCATION STREET AOURESS: Wrlrvtl I Y TAX GRID NUMBER: Flintlock Ridge Patterson NY Lot #3 WELL OWNER NAME: ADDRESS: Greenspan Builders,-PO Box 330, Hzarcliff Manor, NY O PBIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary PRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSE,RVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY -- ❑ MOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING ❑REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ ADDITIONAL SUPPLY NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING.WELL DEPTH DATA WELL DEPTH 185 It. STATIC WATER LEVEL __30_:ft. DATE MEASURED 5/9/87 DRILLING EQUIPMENT 23 ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (Specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING ® OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH 30 ft. MATERIALS: ® STEEL O PLASTIC ❑ OTHER CASING DETAILS LENGTH BELOW GRADE z2 ft. JOINTS: ❑ WELDED ® THREADED O OTHER DIAMETER 6 in. SEAL: 0CEMENT GROUT ❑ SENTONITE OOTHER WEIGHT PER FOOT -12_ Ib. /It. DRIVE SHOE ® YES ❑ NO LINER: ❑ YES LINO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (It) . DEVELOPED? DETAILS FIRST _ O YES ONO SECOND HOURS GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH M. WELL YIELD TEST It detailed um in p p 9 METHOD: O PUMPED tests were done is in- 1 - CkCOMPRESSEO AIR ,formation attached? ❑ BAILED ❑ OTHER ❑ YES . ❑ NO YY EL� LOG If more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM suRFACE Wa1ef Bear- ing Well O'a- meter FORMATION DESCRIPTION CODE It ft WELL OEM It. DURATION hr. min. DRAWOOWN It. YIELD 9Cm. Surface 7 Dr L ll ng in overburden clay & boul er Hi ck at 7' r 6 165, 0 Dr 11 n in rock set casing,grout d. 30 185 Dri -liilg in rock granite. WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS. O,COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? O YES ONO STORAGE TANK: TYPE CAPACITY GAL. PUMP INFORMATION... TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME P.F. Beal & So nc DATE ADDRESS 4 Putnam Ave. , SIGf1ATU 1 0/18 9 Brewster NY 10509 J/ U7 C 0 P Y DEPARTMENT OF 11EAI,TH Division Of Environmental health Services Uw', Office lJse Only PUTNAM COUNTY - DEPARTMENT OF HEALTH STREET AOURESS: TD WN1 / 1 Y TAX GRIO NUMBER: WELL LOCATION Flintlock Ridge Patterson NY Lot #3 WELL OWNER NAME: ADDRESS: Greenspan Builders, PO Box. 330, B±arcliff Manor, NY Q PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary PRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT _ gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING ❑REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY 0NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING,WELL DEPTH DATA WELL DEPTH 185 ft. STATIC WATER LEVEL= 0 -ft. DATE MEASURE�J191 87 DRILLING EQUIPMENT 23 ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG ❑ -WELL POINT ❑ CABLE PERCUSSION- ❑ OTHER. (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING 0 OPEN HOLE IN BEDROCK 0 OTHER TOTAL LENGTH �� ft. MATERIALS: ® STEEL ❑ PLASTIC ❑ OTHER CASING LENGTH BELOW GRADE _ 22_ ft. JOINTS: ❑ WELDED ® THREADED ❑ OTHER DETAILS DIAMETER 6 in. SEAL: 0CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT _?_9_ Ib. /It. DRIVE SHOE ® YES ❑ NO I LINER: DYES 9NO SCREEN DIAMETER (in) 5107 SIZE LENGTH (fl) DEPTH TO SCREEN (11) DEVELOPED? DETAILS FIRST _ ❑ YES 0 v0 SECOND HOURS GRAVEL PACK ❑ YES _ ❑ NO GRAVEL SIZE: DIAMETER OF PACK in- _ TOP OEM ft. BOTTOM OEM It. WELL YIELD TEST I If detailed pumping METHOD: ❑ PUMPED tests were done is in- AXCOMPRESSED ! ormation attached? ❑ BA AIR BAILED ❑ OTHER ; ❑ YES . ❑ NO WELL LOG If more detailed formation descriptions or sieve analysts are available, please attach. DEPTH FROM SURFACE Water Bear- ina Well Oia- meter In FORMATION DESCRIPTION CUE It fi WELL DEPTH 11. DURATION hr. min_ ORAWOO'NN It. YIELD 9Cm• Surface 7 Dr ' ll ng in overburden clay & boul er Hib rxick at 7' 7 30 Drll:-ng in rock set casing,grout d. 30 185 )ri-lijig in rock granite. WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? ❑ YES ❑ NO ANALYSIS ATTACHED? ❑ YES ❑ NO STORAGE TANK: TYPE CAPACITY GAL. WELL DRILLER NAME P.F. Beal & So nc OAT o/18 9 ADDRESS 4 Putnam Ave. SIC;HATU Brewster, NY 10509 PUMP INFORMATION .. TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE HP 3/ 07 IT NYS ELAP *10108 7K) COUNTY OF WESTC RZTER Ell-'Rev q 1 V �j DEPARTMENT OF LABORATORIES4 D RESEARCH VALHALLA, NEW YORK 'N �M5 BACTERIAL EXAMINATION OF DRINKIN4ND TREATED WATERS Lab No. W PWS ID. No. 7 Bottle N 0. ------------ Lab No. Ent Date Time Time Set Time Submitted Tests (circle): sp C, C.bliform P/A, olifom�M P ,:Fecal Other Coll'd By r\J AgencyColl'd For Coli'd From: (Name) 4 tj ' A.2 Address (FIT, H o R U (Street) Identification of Source 6_ L L (City, Town, Village) (Zip Code) (County) . i A-P Sampling Point within Premises -Refrigerated?. Chlorinated? Yes — No Free mg/1 Total mg/1 - pH RESULTS OF EXAMINATION OF WATER P/ATest/1 00 ml. MPN/1 00 ml Total Coliform Total Coliform E. Coli Fecal Coliform Standard Plate Count Other Bacteria Per ml (48 Hr) These results indicate sample( was was not) of satisfactory quality when sampl�ewas'collected. Reported by: Ann-Made Bury Date: Fo u�vo /. /? 5_S D S � m ' 30 SACAR/NCrS ASASE0 ON . SU,QUIV/SI0IV OLAT DATED JUNE 28, /978 FILED /N TDWA/ OF PA TTE-RS On! DwE�_LIN6 =OuNO STS►K '� I CERTIFY To CIIAS. KINWIN THAT THIS PL A T /,S' A N ACCURATE REPRESENTA T/O/V OF MY F /E"LD SURVEY Q-' T14IS PROPERTY. ,` Co w4TGoy ro lvec Opt'. P- 4 r-rEV,5QN, Al Y � o ARG 7.00 . n� JE RoA v LOT 2 ,535. o8 LOT 3 SET S SET STAKE SET S S 11`39 "W 111.84' AS-BUILT SURVEY A S U 8 V E Y OF L O T 3 OF 7_11E FLINTLOCK R/DG—c- SUPDIV /S /ON //V 7-/-/E -ro w 1l OF PA T TER5 UN., PO TIVAM C OLIN T Y , - /VE -P,/ YORK TAX MAP SHT. 45 81- k-. Si L O T AUG; j� 19g4 a: C 0 P Y PM �o WELL UUMrLL11IJ11 ME -rvAi Office Use Only DEPARTMENT OF HEALTH Division Of Environmental Health Services Yo4 PUTNAM COUNTY DEPARTMENT OF HEALTH STREET AOURE55: TOWNIVILLAGLICIlY TAX GRID NUMSEA: WELL LOCATION Flintlock Ridge Patterson NY Lot #3 WELL OWNER NAME: AGGRESS: Greenspan Builders, PO Box 330, Il#.arcliff Manor, NY Q PRIVATE O PUBLIC USE OF WELL 1 - primary 2 - secondary PRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED O BUSINESS ❑ FARM O TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT - gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR GRILLING [-]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY E]NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING . WELL DEPTH DATA WELL DEPTH 185 ft. STATIC WATER LEVEL 30 ..ft. DATE MEASURED 5/9/87 DRILLING .EQUIPMENT ® ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT O CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING ® OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH , 30 it. MATERIALS: EI STEEL ❑ PLASTIC O OTHER LENGTH BELOW GRADE 29 ft. JOINTS: O WELDED ® THREADED ❑ OTHER DIAMETER 6 in. SEAL: 3CEMENT GROUT ❑ BENTONITE OOTHER WEIGHT PER FOOT 19 lb./It. I DRIVE SHOE D YES ❑ NO LINER: CJYES (ENO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST O YES O NO SECOND _ HOURS GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM OEM ft. WELL YIELD TEST ' If detailed pumping METHOD: O PUMPED i tests were done is in- jCXCOMPRESSED AIR ,formation attached? O BAILED ❑ OTHER ; ❑ YES . O NO Ir�ELL LOG Ire detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE. wale, Pear- Ind well Dia- In FORMATION DESCRIPTION coal It. ft. WELL DEPTH It. DURATION hr. min. ORANIOOWN It. YIELD 9Cm• Surface 7 Dr ll ng in overburden clay & boul er Hi Ck at 7' 6 165, 0 Dr 11ing in rock set casing grout d. 30 L85 ri li g in rock granite. WATER ❑ CLEAR TEMP. pUAUTY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? ❑ YES ❑ NO ANALYSIS ATTACHED? ❑ YES O NO STORAGE TANK: TYPE CAPACITY PUMP INFORMATION...' TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME P.F. Beal & So riC DATE 0 18 9 ADDRESS 4 Putnam Ave. SIGNATU 1 Brewster, NY 10509 3/89 " I 0esint,that-l-din wholly k c6M kN IV- r, * sp l - " - -io"f f '4. "nirw ocitioin-4V the �Ooposlk ,Wstsn s)".1) that the isiarstl nii* dii"I, syst County -DoWn I writ- of. Health. afWAhat o#i.iornO.Mi",th4O•Ofig.'.C•rtitkatii' of-Cdn - struction-Compliance!' Wtj5faa0frV to the Commissionsroof .Meefth will a t�uiidsr- tiiiibid'b�illdor will �:iobmlftid to Alta p•Pertment. wiii bs`fuinishod the'' Mks W�,sssigns.by, . p "Oollowi; -ihoiftii Of tits Isau- -,Ysposs!�`Y—ern ul "I J1. l'y4WS:, MInedists'ly 0060, ift.Vood opw4t*�,i64dki6n1�jiiy li,,sW o i -56 �Mwao,,dk- it -0 ncto . 1, - theiit i6i, - - *1 of ---tfio apoievs! of t6i wtif6he'itconsi is - s ii Ij that'lihi diillai�wiil iii rftoll above will located as 104 Inds I 1 01 with �ativiciirds.:Fuiss and 'res-MIgn—sof .the , Putnam HURK,% Date :Sisned P.E. 0 M Addrins OAM License'No i" from V been of the bUi undertaken and Is *hd U'ris'si. cog,it . Ou : ctib,ii, J�PPROVIED FOR CONSTRUCTION tio of construction 0140i,A"�Io foi;ia6i6 or a 4 err i4d iv of, 04sank. Any he here nd/ iiiti wet reoulres; a pairnit Ar a Rev. Oath / BY TitN 10/88 -4. f vuTNAM COUNff DWARTNEN ' OF ■BALTH _ 1 a , , DLYw d Drl+rwdl HeoMhS.evloa. C�es•1. N Y l0.SU w18 O COIIQIlANCB ,V. -- - --- - -- UmW 1r.�.1r..a■a 1 repr•aiAt,;that'l am wholly and 'cornpleNtaiy nsPon 1'4 fa 1A• d•siq'n and location of the above dsicribie win be constructed as',- n on the aP064W sm•ndmant there o a" Ji ,*I t ounty -fihpartment. ;of Hm-Rt% and,that on con+pNtion tAi►•of a . C•►tifieat• of Constrt Oi aubrnRt•d •to tM':OePartmarit aiW i written' iaragt• 'will ba "lfurniihed tM owner. wC• , in /oid oP•ntinP tAnditton airy Hart or ts!td sewage disposal syst•m'durHp flee avers .of Ih0 :&PP►araf or tM'CMtificato- of Construction- Compllemc• of th•'orlgjiL�a M idiate i is N,Co. Ion tha 0004 •d.plen and that said wN1 w1110i- 1nstalNO wiN County OimOartm•ni" of *lth.' Date z5r_7 __ Add APPROVEO`FOR CONSTRUCTIO 'rw*ocable for taut• or may Ili ornal n0ufr•s.a , law .Pam APproael tev. .0 /88 litistactory to, the Commissions ot. Niatthwill w'aoi2na bti .thi builder. that ii10 builder will W.S,lMmedistely foltowinl that• Of tlis Im. o-. 2► that . the drIlled well diacrlb•tl 06ow rules and rpy a ons of ' tM Pu/ttnam P.E. RJ\ - i LIc•nsa No n of ale buiginq he been undaftakie and is th.. -Any Change dr anwation of constiuction Ply' ' won DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM Fir NO. Owner Kt r—VV 1 r J Address V doyE;r7 (L LS Located at (Street) Sec? 3 : 1 2 Block E Lot A (indicate nearest. cross street) Municipality Watershed SOIL, PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test Holz NE7 -MER CL= TIME PERCOLATION PIIZ =LATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In.Drop" Inches Inches Inches l 2 3 4 -7 5 2 3 _ 4 5 1 _2 3 rev. 9185 n TEST PIT DAM RDOUI RED TO BE SLTBMI'I'I'Ep WITH - APPLICATION DEPTH HOLE NO. f HOLE NO. 2 HOLE NO. G.L. -- 1..., ._ I 3. 4 5' ' 6' 7' 8' 9' 10' 12'• 13' 14' INDICATE T,F'.VP L AT WHICH GROUNDWATER. IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES A= BEING ENCOUNTERED I�1lr� DEEP HOLE OBSERVATIONS MADE BY: Tom+" 41 DATE: ZO DESIGN Soil Rate Used �j Min/1" Drop: S.D. Usable Area Provided.. '36�� No. of Bedroans Septic Tank Capacity jCZ5n gals. Type C4.--j,= Absorption Area Provided By 3� L.F. x 24" width trench , Other lZ L L(, 2Z7. GY Name 7��C?? Signature - Address 22- SEAL Z: ` 016 084.1 r � THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: r NEW Soil Rate Approved sq.ft /gal. Checked by Date � � � �. I ' � h f• � �1' alt !� tl : y' is NO • 4301KNON ' ®: i� Y :1�r• is `13�' r� DESIGN DATA f�' �: ��Ip. ��1: �' �t�.[ rat. 'L� ^f��c��y� +'�•��.��'flyay ar■ . • owner C4AqE!L_� r,(F_VV t lJ Address 1 V�aovf5z7 (W. ,s Located at ( Street)®v�I��N . •. `' sec: L�7 : 2- Block I Lot (indicate nearest. cross street) Municipa r ; ty �ib TTI�* Watershed G OTC Date of Pre - Soaking Date of Percolation Test a HOLE NUMBER CI= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In "In Drop Inches Inches Inches 1 2 3 �� M I N/ ( ref 4 5 T D9 2 2 NCT=: -1. Tests to be repeated at same depth until approximately equal soil rates are cbtained•at each percolation test hole. All.data to 'be submitted' for review. 2. Depth measurerents to be made fran top of hole.. TEST PIT DATA REQUIRED TO BE, SUBMITTED. WITfi;:APPI,ICAT'CJN DESCPJPTION OF SOILS ENCOUNTERED IN DEPTH HOLE NO f HOLE NO. f;;; HOLE N0: G.L. sj 2' _ 5' 6' 7' 8' 9'. 10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDRATER IS ENCOUNTERED V INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED �fr� DEEP HOLE OBSERVATIONS MADE BY: DATE: 2-O DESIGN Soil Rate Used _ Min/I" Drop: S.D. Usable Area Provided No. of Bedroars Septic Tank Capacity CZS� gals. Type GO•nj c Absorption Area, Provided By-�o L.F. x 24" width trench Other F� Name Signature' VT.. 2 Address � z SEAL o•Q Lz�� L� `r1q� 01e 084 - THIS SPACE FOR USE BY HEALTH DEPART<ENT ONLY: NEW Soil Rate Approved sq.ft /gal. Checked by Date � s• � x r r. • i� �• •iy r: -��- tea. DESIGN DATA SHEET— SUBSMCE SEWAGE DISPOSAL SYSTEM FILE No. Own& Kt rVV 1., Address [ V�6o rtRry 14 (1,t _S Located at (Street) ?9V� H6r-t,4..: .. Sec? 3 : [ 2 Block f Lot (indicate nearest.cross street) Municipality lib Watershed X216 ,u C61kab Lute of Pre - Soaking Date of Percolation Test SOLE NUMBER Cl= TIME PERCOLATION : PERCOLATION Run Elapse Depth to Water From Water Level. NO. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Mi.n/In.Drop' Inches Inches Inches 1 2 3 4 I -7 5 1 L+ -s `sy 1 2 9/85 DEPTH G.L. 1�. TEF TOP sd l L- 21 _ 31 4' 5' 6' 7' 8' 9' 10' 11' 12. 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED V INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED ice(r� DEEP HOLE OBSERVATIONS MADE BY: Kirij DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided No. of Bedroans Septic Tank Capacity C�Sn gals. TypeC�1n� c Absorption Area Provided Byv L.F. x'24' width trench Other TEST PIT DATA RE HOLE NO. � 0' 710 • : � Y71• Y' • • • 71 •• Y71' 71• � Y7ti Name Address Soil Rate Approved sq.ft /gal. Checked by Date 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 Town/Village/City Tax Grid Number ,C V f,� 'P oi,o 15-5464, WELL OWNER Name Mailing Address (�Ae�5 9W 10 � ►nJ ®tv6►7 H( Private U,6 FAiTY64ercM Kq 2S(,30 Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL O PUBLIC SUPPLY WBUSINESS O FARM 0 INDUSTRIAL O INSTITUTIONAL O AIR /COND /HEAT PUMP O ABANDONED O TEST /OBSERVATION O OTHER (specify O STAND -BY Q AMOUNT OF USE YIELD SOUGHTfjLjL_!�rgpm /# PEOPLE SERVEDj_CAj/EST. OF DAILY USAGE6OO gal REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 12, ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING 13 DEEPEN ' EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ADRILLED DRIVEN DUG GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO I WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: %L(1G� --91D4f=e Lot No. t?j WATER WELL CONTRACTOR: Name !re 136 Ir/�� P—P—) Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: W/A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED f0 �3 O ON SEPARATE SHEET IiII1111,111 (date) ature 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 thirti, (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: Date of Expiration 19 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 o moC)- ��, I FP o � M.N. l . �/ / ►° l a Pl- �o ��NT FAH r� o o to 93 Cashin Assodates, Pe C4 Fu t�T LLZ K r I rte=- e LJOT#3 RD A, Route 22 � = I -� 30' Brewster, New York 10509 Water Sapp1T.' Pabllc SaPP�I From Address s ors'Prwvawe Sttp Iy Dtitled by Addreee owee� eegtdre ®Bata �'y'. 4 l , � -r , x 1 40resent thit 1 am wholly and' coMpletity rispbhiible f6i, tAi diis'iK.: location of .the pr '( abov'e descnDed will be` constructed as shown on'the approved amendment there. to and in _ n a County Department 'oi Health,' antl,that.on completion thereof s Certificate' of Con Tr QOttb�i> -. W submdted;`to Msr.Departmont snit s'wrdten;querantse, will De turnishedahe ow, hi ' ssois, t place, 'in good; operating condition any_;part of 'said sewage disposl system. during he o (; ancd o/ the approval of the Ce►tificate of Consttuction Compliance of the;origi sy will. be logted:as fhownjon the?aOProved plan`and tli'st Ss id well will�bo;install'edS'in�rt, *a P", I County DepirEment of Healthz= Oate S A Signed ! l►dtlressf APPROVED FOR CONSTRUCTION This approval ,expuestwoYears'fromthe:,date issue li6plBFE� ►G l revocable for cause qr.-.Tay be- amond`ed or modiUed when eonsidered necessary by the`Com rspulies/a new permit-Z,5pp oved for:disDOSaI of, domestic sandary'sewage 'a /or wa 1 K } t .lj Sthat the''separate= sewage di oral :system?; $n'dards rules ano requ a ions'o._, itne -.Putnam: Zisfactory tO:tne Comrnissioner,of Health will., aayns by the builder that -said builAu► wi1L,; ' immgd{etely foilai4inq theilate- of,ths•kfti hf!) that`the, drilled well Qseribed above �s ?rules nit requ aT43ons of ,Elbe Putnam ' PE RA License No dl "t building has been undertaken and is , . !h e " Any chsh9e Or slteratlonot constructlon� ly Title 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�D WELL LOCATION Street // Addr s 2own/Villa e City Tax Grid Number Ste• - 04- WELL OWNER Name �oi'`��! OL19 Mailin Address /l ��✓-5 />v J�o 33�. r�QrftVi OPrivate AndlOPublic USE OF WELL 1 - primary 2 = secondary SIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION C]INSTITUTIONAL O STAND -BY D ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT —,-6 gpm /# PEOPLE SERVED /EST. OF DAILY USAGE 70 gal REASON FOR DRILLING EW' SUP PLY OPROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL [3TEST OBSERVATION DETAILED. REASON FOR DRILLING WELL .TYPE DRILLED aDRIVEN []DUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING.? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 7,' 77 i Z E Lot No. 3 WATER WELL CONTRACTOR: Name %3G¢ ��S . Address: Al IS PUBLIC WATER SUPPLY AVAILABLE TO SITE :. YES /-"' NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY. DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED []ON REAR OF THIS APPLICATION SEP T EET 1P/4r_/ (date) (signature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one-water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State`Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant s.hall: 1. 2. 3. Date of Date of Permit 2/87 Pump the well until the water is clear. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. Submit a Well Completion Report on a form provided by the Putnam County Health Departm nt. Issue:. 5 19 a Expiration: 19 —; ermit Issu g ffici is Non - Transferrable White copy: H.D: File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller APPENDIX B PE RM CCUNiY DEP.AR`EIGM OF HEALTH - DIVISICN OF RNIRCIEf.PAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSJRFP.CM SEMOi DISPCEAL SYSTEMS REVIEW S''= - CONSTRU=ION PE'RM.IT (Name of Cwn`r) CCt�T.PS 12 Larch provided required 60 f t. max. Paralleel to contours_ 100% ems. cla fill notes new spec. / DATE REE'l vr'D :*-, ' - BY: (Street Location) YES NO DOMOUS Permit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet MCS) SUBDIVISI-CN Deep Hole Lcg Perc I Consistent Perc Res alts (3) Fill Perc Hole Depth c3 100 vr. flood elev. I �_ 1 , etc. t. tr Plans - Two sets W pe_''mit; P;vS Variance Reouest L Leval Subdivision Subdivision P.nproval Oie -ciced &C- arvl SSS P? Lts C. e'*p Wetland (Tcwn/DEC Per-zii R-& D) Data Cn DDS Plans & Psrmit Sla-ZIM_ REQUIRED DETA TT S CN PLMI S S=gage System Plan - ( north a.= _ -cw ) io!Sta in Hycraullc Profil_ - Gravity Flow *- ile & Dimensions - Voi1M 1,� r J Eox;Trench /Gallery; Pump. pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder rte) Design Data: perc and deep re =_•alts Two-Foot Contours Existing & Proposed Drivegay & Slopes Cat Footin /Gat' r,Cur-"Lp -;n Drains (discharge OR) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flcg,suff. size If Pmwe3 Pit & D Box Shcwn & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 'ft. of Proposed Systrn Property M°tes & Bounds House Setback Necessary (Tight lot) House Seger - 1 /4 " /ft. 4"0; T:vice pipe No Bends; Max. Bends 450 w /clernout SEPARATION DISTANCES SPECIFIED CN PLAN Fields 10' to P.L., Driveway, Large Tre°.s,Top of fi. 20' to Foundation Walls 100'.to Well; 200' in D.L.O.D, 150' pits 100' to Strum, Watercourse, Lake (inc. eNx: 15' to Drains - Curtain, L.-z---der, Footing 35'to catch basin,stormd.rain,oiped watercour. 10' to Water Line (pits -201) 50' intezmittent drainage course Septic Tanks 10' fran Foundation; 50' to cell 15' Well to PL 9 /• •• • 91• • ' 1 lam • im / • • a 1' 0" la Y• 1 DESIGN DATA SHEET- SUBSUFACE S&gAGE DISPOSAL SYSTEM FILE NO. l Owner Address �D /3O N � 1/ 1� 3317 /3i^� o ro i G�rIO/ . Located at (Street) /�� Od Sec. L`_ Block Logo (indicate nearest cross street) D / Municipality T) / �1 Y,/fU✓� Watershed SOIL PERCOLATION TEST DATA RBQCT.gtID TO BE SUBMITTED WITH 'APPLICATIONS Date of Pre- Soaking &�,-22 Date of Percolation Test o 3v HOLE NUMBER CLOCK TIME PERCOLATION OLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches �2 Z 4 5 L 9 2� 3�992- 4 F, 3 4 5 NOTES: 1. 'Tests to be repeated at same depth until approximately equal soil rates. are obtained'at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 5 .1 F, 3 4 5 NOTES: 1. 'Tests to be repeated at same depth until approximately equal soil rates. are obtained'at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE. NO. HOLE NO. v 2' �� "�o�� -r�' �� l � � •mod 3' . .. 41. 5' 6' 71 8' 9' 10' 1T' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED j •� / INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED �5a W DEEP HOLE OBSERVATIONS MADE BY: p< /�/ � DATE: DESIGN r Soil Rate Used Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity %�S7J gals. Types y Absorption Area Provided By L.F. x-24 width trench Other /sV �D /4 ✓v°/ �i // "T � Name Vii! / V�� Signatureos ".w°��, Address �% Zr� C�l'�l` —,�/r • 4 _ THIS SPACE FOR USE BY HEALTH DEPAR2,0gT ONLY: "^ `� 4 �°• 2459 � �PpOFES�10V A��`, Soil Rate Approved sq.ft /gal. Checked w " Date ' A-M PW 1 OHIO ----------- art tT 4� 'j �4ffi At lat� K, WIN, JYM6AL• Mn ,qa OT Woo, A W Yd W Now W pvqq , I zoo CUM, 1 111,010, x. 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V" -vi It i` 1 iif i i Yl'lob s, rt ! -.D16f M� zrt -r •As `�ul�� Note - ;- • .� � rr:.taB.3 I , 'Ttiha Ib ro cEItTIFY'TN4'( ,TIFF -6Ewolo6� GIgGbSAL v(STEI -t \vA5 conic ifUcTeV Ay Wvtc&T6v aN VAIE, PLAN W46",711t>.T TI}G- r T 9{S;tEi"1 ,v65 INbGTEA ^t3�( GASNIN n�sxIATE/6 P.G. 6EFoP..E "'.. - _ _ .. 5 4 f r -tt 12r -) 4hr I{ t . f --i. i0(I O.i,�}C: C,,,geeo ov62. Tt1E - 'S`(�/TEM . \vAS eCW, CUA TEV IN L �Ftt i 6CG!Gi2DbNC@ tVITN ELI- STPNDatZD JhULES OIJPJECZXJLAT1oNS Gir14r - '.rFr i[ _iJtsf.`p4 - ._.. i 3• ?.'_ �r�f �` (1 / .J J , � `r 4 2. .:OF.:TtIE PUTNAM C_otJN1,(' I7E.PA=ML JT _ `A -A s 'ti t � . .N 4 ' 1 � V f ( • � Y J is �6; OF ry s r � . iM1-Pf r v + +- L b° . My, 1� � 4. ,1 � .✓y. �.,_, �y,�,PK�}'+u_- xf +AS... yY�w.'jrrn4 ., n - ,4 . - `�: rte+ "� f �.' •!Y ��' t ' 1,,1 J �. %^ 4 ?t rx '• � �„+ s v�•'�° l��w ,+,'^,tom � y�y+ Y�`�, tY J i `4 � � d e. • .. " - ,b- a v+ �a,.r ✓' ry,,� t nr F •^ ,"� A t• 'Syt bl ,. t' �,y �;� °r"1��- G- ,�;�..� ��•fa .:� n'y � + t +,c�(I ' �� f"'n � sab ..:$PG�r<d 4a�8 1r� j l �, : ? ,, � - � t U ,;g A n °( } r .f r � n R AG s•r' 't",�, q.- '�`P� �vp r r , Y_,,r z y v rr a ( \9 �9. 24898: 1. Fill,,muet be'$ilowed,,to stabi,li a for§O to 90 days folio aing,piaceme6t and be inspected by the Putnam County Department 6, Health fogy acceptnes� prioF;to:installation'oP the sewage`syste>d bate oY placement mus b2. reported to Putnam County Department''oP xealth 2: ''. Eun of bank fill shall be suitable for sowage 2bsorption a be free or other unsuitable "material'and'sh?a3 have a'n,in' place perca'at;bn1,ra•tm at 'least equal to that in the.natural soii. after the r,g41 e3 r 'stabilization period The eng!neer/arahitect'shall : per£o n a PiZab a percolation test in the Pill a£ er stabilization aft++ 3 Impervious £111 clay' barrier; shall ,lie a dense clayey soil wi {th llttis c� a I ,� no, sewage absorption 'capacity. - ! y Additional F111 Hotes� "� µ z p �- . Ao$th gauges will be required on corner of fill sections 8 one'iII the center ,o£ -,the Pill.. Fill - suitable Yor, sewage 'absorption' more IM should contain no re.thau d " 5� preferably,no more' than 296 Pines ^,by' weight' Fines; are clay & gilt.particles that pass a 200 sieve`.- stem design hereon does .not provide 'for up Sewage Diepdsal ey, i a of IL garbag e gr7.ndei Sucfi installation requires �6e approval of the Put'aM,70unty Department of ;Health ,:} -1 Fa W 0 E- � 00 K- N Ito '99, IA/ 77 AV lu K LU b I 10 t, I A I zx go"e-s"o r) 1 P't - bu I L: M A :L) U1z, E M E N � X 2 3 4 5C� A i 2%Z � 2 18 24 57 '58 -39 4Z g3 Z4+ AS- BUILT, 1. This is to certify that the sewage disposal system was constructed as indicated on' this plan and that the system was Inspected by Cashin Associates, P.C. 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. 2. The SSDS consists of the following 1000 gallon precast concrete septic tank, '33(0-1,f. of 24' wide absorption trench , additional requirements CASHIN ASSOCIATES, P.C. ENGINEERS - ARCHITECTS - PLANNERS RD 6, ROUTE 22, BREWSTER, NEW YORK 1200 VETERANS MEMORIAL HIGHWAY HAUPPAUGE NEW YORK 11788 01 NEI r� r i`. •'-°t =-- --c—"- ,�. "'C.r •:... a�..— e -Rf-�. ... -y.. _n � F __.. —. w tH.+, :. 'F PUTNAM.COUNTY DEPARTMENT 0 Division of "AronmentaiNtWth Services: C CONSTRUCTION RMIT FOR SEWAGE DISPOSAL SYSTEM Located st Belie 164 Sabdivleloli Name ,Flintlock Ridge Sabd. Let p (lwner/Appueant Name Arnold Greenspan Ming Address PO Box. 330 F HEALTH trm . el; N Y 10512 Engineer to Provide Permit p on CERTIFICATE OF CO CE. Permit' ,q_ai� Patterson To or ,Village' Tax Map' 15 Block 5. Lot p/ 0 4' . Renowel_ ❑ - Revision Q Date of Previous Approval ' Te;vn `triar.cliff Manor zip 10510 standing Type 1 Fam . Res . Let Area 0-,96,1 acres FW section 0ely Depth . Volame 750 CY Number of Bedroems4 Design' Flow. G P; D 8 PCHD Notification Is Repaired. When FIII Is completed Separate Sewerage System to consist of12SO Gallon Septic Tank,end 495 hF Of. 2) trench Te W consteacted.by t0 be dt'ternuned . Address Witer SnpPlrs Pdbl(c Snpply From ' Address o = =- ' Private'Sapply`DA ed by `to be det Adaresa . Ot6eaReoalremente - I'represent that 1 am: wholly and completely responsible for the,desig"K location ,of the „proposed sy,sterh(s): 1) that the separate sewage disposal system -,above described will be constructed as shown on thcapproved amendment there to'and,in accordance with the standards, rules an regu a Ions o e u nam COUnty Department of , Health, and that'on completion thereof J • "Certif icate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the ,Department, and• a written`;gua'rantee will be furnished the:owner; his successors,'helrt or assigns by the builder, that said, builder WIII 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- wice -of, the approval of the Certificate of Construction Compliance of the original system or any repaiis* thereto; 2) that the drilled well described above will.be Located as shown on'the approved plawandytliat said well will be Installed in accordance ;with .the stand rds, rules and regu a 1i lions oof the Putnam County Depaartmen/t►'o�f t+H�ealtth. - ' Date IZ Signed P.E. _ R.A. � .� - T- 1 f'.acl 71 ASSCIC '1 License No APPROVED FOR.CONST.RUCTION:This aDDroval expires •two 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 requ f” ! ires a new permit, Approved for disposal of domestic sanitac*. sewage, and /or private�w/ater'supply .only. 1/81 Date '� B ��-T;tle PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of 4V,940 Cy,�CF- l�SipLl� Located at cr off` 00v <s /6� (T) Section Block .'d Loth Subdivision of /1Z /.c/TL4Y_;,<C Subdv. Lot #_ Filed Map # ! % Date �•�~O Gentlemen: This letter is to authorize /�,5,%�,� AS;0elAreS Pei. a duly licensed professional engineer ✓ 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. Countersigne P.E., R.A., WaelrE 54 Address Telephone Very truly yours, Signed er of- Property A dr s s Town Telephone �� F. polvo • a r • ry v •ry �: a• «ar DFs1GN DATA SHEE SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE ND. Owner _ Qr/1 o(d G reeve sea,& Address PD, 80X 320 -9r(a-rc 11)q Nowto- Located at (Street) Rf ( 64- Sec. (S . Block _ Lot r04 (indicate nearest cross street) Muni.cipaiity POL e�so watershed GO ton • • • a•,�• • �a` � • v • a• r a� • � vas r• •: Date of Pre - Soaking fytcL 7 �R7 Date of Percolation Test lfia,4 7 107 'ZZ -2- 3 � 4 f:42 -2 :0 Z a HOLE 27 52:24 - Z<s( NUMM C= TIME zy2 252 ? PERCOLATION PEItOOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 tZ, 3► - 12:5-2 '1 / 2 2S" j 2 IZ: 93- t: 14 21 224 ZS¢ 3 7 3 i:!6 -- l :40' IZ4 'ZZ -2- 3 � 4 f:42 -2 :0 Z a 3 27 5 1�2= 4o_I:n -3 Z 3 23 Z� 1 —to M, a • , ROM.-, 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be subnitt�d for review. 1 2. Depth measurements to be made fran top of hole. rev 9/85 4 I. �"6 - 23 27 52:24 - Z<s( - 2Z -:- : ..... zy2 252 ? 1 —to M, a • , ROM.-, 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be subnitt�d for review. 1 2. Depth measurements to be made fran top of hole. rev 9/85 '% b TEST PIT DATA RDOUIRED TO BE OF DEPTH. HOLE -NO. i HOLE NO. 2 HOLE NO. G.L. 1' 2' 3' 4' 5' 6' 71 8' g' 10' 11' 12' 13' 14' 4 +0P So r / V? tropsor t led 41p eo rn =L INDICATE LEVEL AT WHICH GROUNUMTER IS ENCOUNTERED 3 INDICATE LEVEL TO WHICH DATER LEVEL RISES AFTER BEING MML)NTERED 3 2 DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN] Soil Rate. Used '..V -f0 Min/1" Drop: S.D. Usable Area Provided Sb00 No. of Bedrooms 4 Septic Tank Capacity t 5-0 gals. Type Absorption Area Provided By L. F. x 24" width trench Other OR T-5-0 cy �i Name SS oc.�_Z� Signature Address f SEAL .S ;�/ N0. 2608 a THIS SPACE FOR USE BY HEALTH DEPARTMFM ONLY: r Soil Rate Approved sq.ft/gal. Checked by Date •l.. IA 1/ PUTNAM COUNTY DEPARTMEN!r OF HEALTH - DIVISION OF ENVIRONMENIAL HEALTH SERVI*W-- INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT ,p DATE REVIEWEQ.• 4�- 45- _r /'.'� L (Name of Owner) (Street Location) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc Hole Depth ,�3ou-chq-4qans - Two sets Well" permit; PWS letter -Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder notes) Design Data: perc and deep results Two -Foot Contours Existing &-Proposed- - Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds . House Setback Necessary (Tight lot) House Sewer - 1 /4" %ft. 4 110; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse s/s SUBDIVISION Perc (3) Fill /y cd e'4'e 10' to Water Line (pits -201) 50' intermittent drainage course Se tic Tanks 10' fram Foundation; 50' to well 15' Well to PL V saw _ . /,Ki m M_M_ NOM_ trench LF . -. _• _• • Parellel MM � == ®M .. - MM ®M DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc Hole Depth ,�3ou-chq-4qans - Two sets Well" permit; PWS letter -Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder notes) Design Data: perc and deep results Two -Foot Contours Existing &-Proposed- - Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds . House Setback Necessary (Tight lot) House Sewer - 1 /4" %ft. 4 110; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse s/s SUBDIVISION Perc (3) Fill /y cd e'4'e 10' to Water Line (pits -201) 50' intermittent drainage course Se tic Tanks 10' fram Foundation; 50' to well 15' Well to PL V ( ) I WILL HAND DELIVER MYSELF ( ) PLEASE SUBMIT TO THE SPECIFIED DEPARTMENT FOR ME SIGNATURE APPLICATION FOR PUBLIC ACCESS TO RECORDS T0: RECORDSAC�C ®�S �O��CER M nr3y�11LSIS N.Y. RU -ress DATE: JOSEPH L. PELOSO, JR., PUBLIC INFORMATION OFFICER I HEREBY APPLY TO INSPECT THE FOLLOWING RECORD: F t N � Lod( 4 4x Ss�s ignature Representing Mailing Address FOR AGENCY USE ONLY APPROVER - DENIED _ /0- 'q s 3 Date Record of which this agency'is Legal Custodian cannot be found. Record is not maintained by this Agency Signature Title Date NOTICE: YOU HAVE A RIGHT TO APPEAL. A DENIAL OF THIS APPLICATION TO THE PUTNAM COUNTY EXECUTIVE. L-0I. *I el t d c MFAN .1 64--l" 4,4 0 S i 3 co 4, d / propas h In In .4 � M frFM 1 - pro noSe clot (0 o / rc je f flop l we. ,J Abo \\ � ` *4 0 f Hof 12 Proposed frefi A Lajou, Or FL 14 f l o c t< RLd z_ Lo f. IS 0rnoid Gree-ospa0-1 Rf IG� 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 # �o WELL LOCATION Street Address Off Route 164 Town/Village/City Tax Grid Number Patter -son 15 -5 -p /o 4 WELL OWNER Name Arnold Greenspan Address PO Box 330, Briarcliff Manor AuPrivTte O Public USE OF WELL 1 - primary 2 - secondary MRESIDENTIAL ❑PUBLIC SUPPLY QAIR /COND /HEAT PUMP 0 BUSINESS 11 FARM (]TEST/OBSERVATION 0 INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ABANDONED ❑ OTHER (specify O AMOUNT OF USE. YIELD SOUGHT min , gpm /# PEOPLE SERVED 1 faM/EST. OF DAILY USAGE 800 gal REASON FOR DRILLING IDNEW SUPPLY O REPLACE EXISTING SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ DEEPEN EXISTING WELL ❑ TEST /OBSERVATION DETAILED REASON FOR DRILLING New residential supply WELL TYPE ®DRILLED DRIVEN ®DUG OGRAVEL C1 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Flintlock Ridge Lot No. 3 WATER WELL CONTRACTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL/CITY DISTANCE T0- •PROPERTY FROM NEAREST WATER MAIN: Greater than 1 mile, LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION 0 SARA ITAN al . (date) _ I (si 1 A PERMIT A. 26:0 e' TO CONSTRUCT A WATER WE 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. z Date of Issue : �"_c -• el' / 19 /x -��— =✓ / > -, � _ ----- Date of Expiration 19 �' ermit ssuing'" ff V'61 Permit is Non - Transferrable 8/86 PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 June 11, 1987 Cashin Associates Route 52 & Seavey Plaza Carmel, New York 10512 RE Arnold Greenspan Route 164 Flintlock Ridge Lot 3.(T) Patterson I -. .- - -.Dear Sirs: JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. The scale of the plan (1" =501) make it difficult to see the details. If possible, make the scale larger or details more legible. 2. A new house has been constructed directly across route 164. Please note the location of the SSDS system in relation to the proposed well. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Very truly yours, William Hedges, Jr. Public Health Technician WH: mk