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Home My WebLink About2246DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -1 -28 BOX 19 1 11 rm i ■ F. w r v 'AIL JLl 02246 PUTNAM COUNTY DEPARTmERr OF HEALTH LNS7RUCnON Division of Eoviraementd Hedtb Services. Carmel. N.Y. 10512 Engirum to Provide CATE on CERTIFI OF PERM FOR SEWAGE DISPOSAL SYSTEM L IlGrGyyA "-1 ,•LCf1r��?s c�fy:� owe or Village Subdivision Name Qcll'l 1 ?4 %JT�s' %1 Cabd. Lot N / / Tas Map >% glad �� Lot ' r3 Renewal— ❑ Revidon ❑ Owner/Appllmt Name C' `�, /� / 'Daft of Previous Approval Matling Address 2, !'✓ �5 l l e` /.''i �'� +��d/ Town � a Al. f Zip �® yam% % f? Building Type ! jc,s: Lot Area G =rte Pill Socd -n Only Number of Bedrooms Design Plow G P D PCHD Notiflcadi Separate Sewerage System to consist ofd Gallon Septic Tank an '01 f Depth Volume leaalred When FIR Is completed To be constructed by Address Water SnPPb': 1h&II0 Supply From Address or: _Private Supply Drilled by — Address Other Requirements 1 represent that I am wholly and completely responsible for the design and location of t ' ystem(s); 1) that the separate sewage_ disposal system above described will be constructed as,shown on the approved amendment there to a �gG®iildtdp the standards, rulesand regu�f�o e u nom County Department of Health, and that on completion thereof a "Certificate of e" satisfactory to the Commissioner of Hoalthwill be submitted to the Department, and a written guarantee will be furnished t o �K h s or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system ri the of (2) ears immediately following thedate of the issu- once of the approval of the Certificate of Construction Compliance of the igi s a Y. ire hereto; 2) that the drilled well described above will,be located as shown on the approved plan and that said well will be Installed r hr, an rds, rules and regu aZTrons of the Putnam County Department of H4ealm. f Date f�/ �/ �y Signed l.a - P.E.f_c,R.A. ,or `✓'7 SnL%�1� `."� / 6% r License No Address /G ' A' APPROVED FOR CONSTRUCTION: This approval expires two years from the date RuIpa" Suc ion of the building has been undertaken and is revocable for cause or may be mended or modified when considered necessary by the Ith. Any change or alteration of construction requires a new per t. D o f r disposal of domestic s swage, and /or priv wat y only. Date By c Title DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 <APPLICATION. TO.; CONSTRUCT -A'-::WAfiER� -iWELL-..,•:„ PCHD PERMIT # WELL LOCATION 84y- IS WELL SITE SUBJECT To FLOODING? YES J*' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: OO I-n /vo Lot No. 37 3 S WATER WELL CONTRACTOR:, Name /1/• Address:A "F740,14, IS PUBLIC WATER SUPPLY'AVAILABLE.TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE�TO PROPERTY-FRO M NEAREST- WATER- MAIN:.. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED O ON REAR OF THIS APPLICATION O ON SEPARATE SHEET (date) A'. nat ) ,,0 PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as s.et 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 Putna County Health Department. Date of Issue: ' 19 Date of Expiration: 19 Permit Issuing OffTcial Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller Street Address Town Vill ge City Tax Grid Number �° Iii 1✓ _ 4&&,/ 1/ -O WELL OWNER Name Mailing Address P?�/ nr� ivate h/-j /��/� ' 21 �%� ��Jr. N'�s� O Public USE OF WELL 1 - primary 2 - secondary --,W Q'RESIDENTIAL O BUSINESS- 0 INDUSTRIAL 0PUBLIC SUPPLY ❑AIR /COND /HEAT PUMP ❑ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify, ❑ INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT c_lr gpm /# PEOPLE SERVED 4- /EST. OF DAILY USAGE �iGO gal REASON FOR DRILLING EW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST OBSERVATION (:]REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED 13DRIVEN ODUG GRAVEL O OTHER IS WELL SITE SUBJECT To FLOODING? YES J*' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: OO I-n /vo Lot No. 37 3 S WATER WELL CONTRACTOR:, Name /1/• Address:A "F740,14, IS PUBLIC WATER SUPPLY'AVAILABLE.TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE�TO PROPERTY-FRO M NEAREST- WATER- MAIN:.. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED O ON REAR OF THIS APPLICATION O ON SEPARATE SHEET (date) A'. nat ) ,,0 PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as s.et 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 Putna County Health Department. Date of Issue: ' 19 Date of Expiration: 19 Permit Issuing OffTcial Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller STRET ICCATION 47 lc S_t I w l PEFtM?T s P''�'• �� & y 24 'Irl OR SUBDIVISION LOT a I I: IV. V. v2. / / - /` /e/ b. C. d- e. f. J- h_ i. Ail pipes pauti.z All pipes flush Bar -kfill nSateric O=ta1n drain it Curtain drain ou Fcotinq drains d Surface water Dr E_�osion crnEo YES NO DISPOSAL . ARF-k a. SDS area located as per aooroved .plans b. Fill section - Date of placement 2:1 barrier- I=- W= AVG _ DPTH c. Natural soil not s `iroe3 I I d. Stone, brush, etc-, cr=ate_*- than 15' fran SDS area_ e_ 100 ft. from water course /wetl I -- G..�.-" DISPOSAL SYSTEM a_ Seotic tank size - 1,000 1,250 b. Sentic tank instal-led level I •I c. 10' mi n Tm n fran foundation _ I 1 d. No 90° bends, cle=nout within 10 ft-_ or 45" be-rid I X I e- DISTRIBWICN BOX 1. A11 out-lets at sampe e evation - water tested 2. Protec*---d be? cw f_cst I IA 3. Mini= 2 ft orici n? soil between box and tr_*iczes ( Q f. JUNCTION BOX - vrooerly set - g• 1. Length rem iced - 0 6J L-ngth i.nsta-11 red l ,60q 2. Dis- Lan =e to avatar -=u se mas "`=3 : ft. I I I 3. Instal-led according to plan Kz 1 1 4. Distance center- to ce+hter 5. Slone of t=ench accentaale 1/16 - 1/32 "/foot. �C I 6. 10 fit frcm orcoe: �_,r line - 20 feet - found Laticrs 1 I 7. Death of t_e-hch < 30 inches fraa si race 6Z I I 8. Roan a1?aved for excension, 50% _--4-4-4- ,o�j 9. Size of gravel 3/4 - li" diameter I sz I I 10. Death of gravel in trench 12" mi nirm�rn I se- - ll. Pine ends grad I I h- t! OR DOSE SYST Y-S 1. Size. of- v= ch,crber I c 2. OverrlCW tank . , I I ...... .. 3. Mare, viszm-? /audio I I 1 4 P= easilly accessible aanhole to grade i 5. First bcx baf fled 6. Cycle w_tmesSe3 by Health Deoa 'uTent I I I estimated flow per cycle I ( I a. Eouse locmted Dar aovrove3 Dlans. b.' Ni mber of bedrocros ILt TNr•' T• I a. �� l loc-- t=...1'' as re?' a=roye'3 vlans � I I b. Distance frcn SDS area re sured / U D ft. �_ I C. Casing 18" above grade: I d_ Sur-face d_-air ace areun", well accenr ble_ OV_E_--tA.LL WORKMA.SaIP • ' I a. &^xes properly grcul"--:d ` b. C. d- e. f. J- h_ i. Ail pipes pauti.z All pipes flush Bar -kfill nSateric O=ta1n drain it Curtain drain ou Fcotinq drains d Surface water Dr E_�osion crnEo PETER C. ALEXANDEHSON rj ' 4 tj ENID L. CARRUTH, M.P.H. ..._ �.,.,e..�..,.. ...� _ •.- t,..,.,... Publia�Healtj t,,:QLrRS, ?or::� ; -ry, . ,... JOHN KARELL Jr., P.E. DEPARTMENT OF HEALTH Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Mr. Frank Sullivan, PE 2972 Ferncre'st Drive Yorktown Heights, NY 10598 Dear Mr. Sullivan: I December 30, 1988 Re: proposed Addition Hirsch (T) Putnam Valley TM #11 -1 -14 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) Minimum distance between galleys and wells is 150 feet. 2) Proposed SSDS is less than 100 feet away from Roaring Brook Lake Shore line. Shore w_�..._...:..... 7. _.�_ ....:.._ _:.line. and pr,Qp.osed..SSDS.. mt�set.., be...staCed_ by, a licensed surveyor to insure a 100 foot.distance. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. LCW:jr Very truly yours, Lawrence C. Werper Assistant Public Health Engineer MARVIN O'DELL ' Inspector TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT December 279 1988 Dept. of Health 110 Old Route 6 Carmel, N.Y. 10512 TOWN HALL PUTNAM VALLEY-,'*N.Y. (914) 526 2377 Res SSDS Repair or Expansion TM #PV / - I -_IV Owner s .4/;rsch Dear Sir or Madams The proposed alteration of Sewage Disposal System as shown on drawings dated // -3 -1'� have been reviewed and determined to be in compliance with 1. Wetland regulations. 20 Information on file in Building Department. 3o Separation to adjacent water supplies. Applicants that receive permits shall advise the Putnam Valley Building Department when construction is to commence_ .and again prior. to .backfill .for inspection same. An 1°As Built" drawing of said work shall be submitted to the Putnam Valley Building Inspectors office upon, completion of work. Bui in Zoning Inspector PETER C. ALEXANDERSON County Executive ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. DEPARTMENT OF !HEALTH Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 December 13, 1988 Joseph F. Sullivan. 2972 Ferncrest Dr.. Yorktown Hts., NY 10598 Re . Pro�posed�Add 4tion-�s rs,ch °, Lake Shore Road (T) .Putnam Valley TM #11 -1 -14 Proposed Addition —Rinaldo New Hill Road (T) Putnam Valley TM #35 -4 -15 Dear Mr. Sullivan: :-Revi•ewof- •plans and other supporting documents submitted at this time relative to the above- captioned'project have been completed. Comments are offered as follows: A written approval from Marvin O'Dell will be necessary before this Department can grant its approval. If you have any questions, please contact this writer. Very truly yours, LCW /kv Lawre;nce C. Werper Assistant Public Health Engineer v / .7.1 Tel. MAhopac 8-4526 Joseph Mantovi rop. Septic Tanks and gesspesYm- Cleaned Septic Tanks and Fields Rnstalled and Repaired MAHOPAQ, N. Y. oar/ P-7 1VO*i1l,P�52-- L44WA'S, -3 kPO Jq PIAJ 6 Aeo 0 /r 133C, ' PEnNAM COUN'T'Y DEPARTMENT OF HEALTH y.. DIVISION OF ENVIRONMENTAL H &VM SERVICES - DESIGN DATA SHEET.SUBSUFACE SEWAGE DISPOSAL SYSTEM ._ FILE ICU. Owner c�/i.� /fLi'i'S��% - Address �' �j/° .'r a r"e- % ✓ Located at (Street) ci�% . S 611-e_ Ia. --I t?,O Sec. X> Block o / Lot (indicate nearest cross street) Municipality / V u Watershed SOIL PERCOLATION TEST DATA RDQU= TO BE SUBMIT= WITH APPLICATIONS i Date of Pre - Soaking Date'of Percolation Test HOLE REM Q= TIME PEROQLATION PERCOLATION Run Elap No. Time Start -Stop Min. Depth to Water From Ground Surface Start Stop Z z- 4 ._ 2, 2 1 g- 44a 2 32" 4 5 1 Water Level In Inches Soil Rate Drop In Min /In Drop Inches _S�_ 3. :� S so" 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 frat top of hole. rev. 9/85 U TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO. 47 HOLE NO. . �_.. G.L. ' � �, "♦ .. .'� _ . il! i .. . 1' 3' 4' 5' 6' 7' 8' 9' 10' 11' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED rJ� INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING�ENOOUN'I'E' DEEP HOLE OBSERVATIONS MADE BY: d v ��/ ��'� / DATE: DESIGN Soil Rate Used 7 Min /1" Drop: S.D. Usable Area Provided ,O U No. of Bedrooms Septic Tank Capacity 61 gals. Type �%Ciji1� v y Absorption Area Provided By )6t� L. F. cht^ MMMMA � Name U )IVCL/O Signa a Address �� a •� o� ROFFSSIO14 THIS SPAa FOR USE BY HEALTH DEP ONLY: Soil Rate Approved sq.ft /gal. Checked by Date Y PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION, OF ENVIRONMENTAL - HEALTH SERVICES- �- . >•- Date 03 1 T Re: Property 'of � AJ it 4 L LC, (f ",0 A-4 /Z s G W Located a t /— % /zlC cYl-Fo & e I (� � J e f /,C! e s7" ;?OAKIVl 4401/ - �/OKC i t-G � (T) Section' Block Lot i Subdivision of op4Ki�1� gKct�� tlly <<P. Subdv. Lot #3%. 3! Filed Map #c�U 4' Date i ! i9•� Gentlemen: This letter is to authorize a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit fora 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_w th; th s_.,mat :ter. and to.'supervisc the cons truction -•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. . - P.E., Add ess 4%% Telephone Very truly yours, • -• /, /a /� _ /iii Telephone We, 1 4- 'Ib I A & I "=-.v Matw = e' Ag. R A., I've A4 k A de. A i a % P7 'So/d. dip Mg .0 J. kk "�Yi fAY Aft 7 -V- 'Putna. COufiitY'Dapar*fmen-e of'ReeLlTh or. of Environmental Health Service& 'dpproved as noted 'Jkoyj;Vor conformance with applicabls,Eules and Regulations Of the' Putnam County Health Department q -title ;RIM /-,Po or 115 S-wa;, Di rot DI'071-10.for inata"li'tion"Di a garlb!�,T--,* grinder. Such'Lns;pllation requires' L": the approval cf t:2e Putnam County Department of Health. OF Nom. ti'ORE I PROPOSED SE1NA E DIS POSAL SYSTEM rV. .1 "Oki JOSEPH_ F: P.E. R, YORKTOUN HI EIGHTS, sN If- `--''R K- } a i i wK s 4 { // O i-? 'p- i? OA D ti I � / 9l' Re .� • � ' � ' Nc. n/Q SC GS$D,S C!J r 60 1 bIY ✓�/ a v" Y400 i A/ well 4