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Home My WebLink About2255DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -2 -27 BOX 20 L �. � .. I I , am - ' �� . . 1. '} ' �'�'` : _ y a �ir4 . , . 1'6 Ll ar am a -.- . 02255 PUTNAM COUNTY .DEPART T `OF HEALTIi / a �k Drvisfon 'of Environmental Health Ser" 'Carme% CONSTRUCTION' PERMIT FOUR SEWAGE'= i0c),sAL _SYSTEM putIlain - Valley .(T) . VIII Lake Shore Road West) MaP _ ag — �c?s�ad':at orB�ock, 3,08TOwn Roars Brook _ 344 -'Subdivision _2 - Lot s J:ob Owner ='rank G2'o13i . aaa.ess - 'Box'3110 Pitrl8ia Vallekt. T.Y. Raised -Ranch 22 SF` :5 - "Building - Type` Lot Area Number of Bedrooms _ Total abi ` e Space + 'Square Feet 12Q0 Separate- Sewerage,_ onsist of i_ =Gal Septic ?,3 lineal feet X width,'4rench' lcar _ r- Homestead Avenue To be construct by r A Feeksldll NY V1later'SUppIY Pub SuPPIY F ! x Puckey. rs k fi Pei e _SUp F o drilled b - A ess Oily : "RO I'ee$3 111Y, v Other Requireme five 3 a ter removal` f • • I represent, that -I a hol and. co fetaly responsi or the design and to t ot'the proposer r �'i separate sew disposal system .11 z: above described °wilt' o ructe s_shown o ,tn proved amendment th and m accordaOL' e; an ,regu s o e Putnam, County' Department It nd that on letfon'fhereof a '! rtiticat of 'Construction.0 °the Co ssioner of Healthwill be submitted to 'the t; and a written,guaranfee ill b urnished the owner his Ac r „s �ye:b r,.that said builder will place, in ;good;Aoperating nd�tion any part of `said sewag d's 1 system during the peripd wo'( ialy wing- theCate:of the issu- . ante, of the approval; of'. Certif6te._-of Construction =,C pce of the original system;pr to drilied well described :above - will;belocated as.shown -oir a approved plan and that,sa wel lbe Installed caccordance_'s+0yith @ I egula�fIMF of ";the Putnam -` =County Department ofHea • = Date. veto r 2 !� '�.T I J 5 'ed ?� A6 w� P.E. 1 Mort die'eekslc�illl N.Y:._ r.•7 027846 Address License No t APPROVED FOR CONSTRUCTION This - approval expires one year from the date issued .:unless construct the bu ng has been undertaken and is revocablp'for :cause or.:may be ;amended or modifietl when considered necessary b .,the Commissioner1,of Healy Ariy= change =or alteration of "construction requires 'a new permd Approved for disposal of; domestic sanitary sewage and /or private` water supply only Date ° s gY a s Tit le PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA - SHEET= SEPARATE SEWAGE DISPOSAL SYSTEM FIDE -NO:.."" Owner Frank Groll1 Address )Box 340 Putnam .Valley NY Located at ( Street Lake Shore Road (West lc. Map 308Alock Lot 344 �Indicate neares cross street), Municipality Putnam Valley Watershed Peekskill SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse 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 (1) 1 12:02 12 :12 10 15000 18000 3000 3033 2 12-013 12:26 13 14.50 17 ®50 3000 4033 4 (2)l ``' 12s0'5 12:11 6 15000 18000 3000 2000 2 . "12 14 .12..-25 11 15025 1$025 `. 3a00" - 30 7 . 3: 5 1 2 3 4 5 Notes: 1) Teets to be repeated at same depth until approximatelyy 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. INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 400 feet INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4 °0 feet TESTS MADE BY John S. Romep Date - r4ay 30,. 1975 _ ... ,.. ... ,. ._ . -. 6. " Soil Rate .. Used -7 Mi' l'TDrop: - "S- D. Usable Area Provided 5000 SE No. of Bedrooms Septic Tank Capacity 1000 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION ' Absorption DESCRIPTION OF SOILS ENCOUNTERED IN.TEST HOLES DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. 3 • �� O Name John S. Romeo Signature 1 %rthridge Road 121 15" Topsoil 1411 Topsoil 12" Topsoil 1811 gabdy, gravelly. saizdy gravelly ` sandy -gravelly 24'.. ;� loam loam ..: loam 30„ THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: 09e °'e °o•• 3„ 1 26 `h " 4811 5411 60„ 66" 72„ 78„ 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 400 feet INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 4 °0 feet TESTS MADE BY John S. Romep Date - r4ay 30,. 1975 _ ... ,.. ... ,. ._ . -. 6. " Soil Rate .. Used -7 Mi' l'TDrop: - "S- D. Usable Area Provided 5000 SE No. of Bedrooms Septic Tank Capacity 1000 •o•o Gals. ° °. • ° °•�sonr Absorption Area Provided By 154 L. F. x24 "� • �� O Name John S. Romeo Signature 1 %rthridge Road Address SEAL ° .. ee • . 10566 27846 0° 0 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: 09e °'e °o•• Soil Rate Approved Sq. Ft /Cal. Checked by Date Gentlemen: rUTNAM M-1,11' DT :P RT�TMNT of fif'Af.Tii DTI?TSTn\. nr UF.:1M-11 ST P% fCT;S Date October 21, 1975 Re: Property of Frank Grolli Located at I-ake Shore Road' (West) Section �6p 308 E Block °' Lot 344 This letter is to authorize John S. Romeo i•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 pro.^ulagated 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. Very truly yours, Signed Owner of Property ;ountersigned: o'° 3�l0 �� /� M7 Address . L '.E., R 7816 ' 1 Northridge Road. 00Al �' EN f,�� °.a,elephone ►ddress . �Q . Rtp Peekskill ° . lq� ° Q ° z w., o . 6 �•` C 737 —,1056 �® �f 27846 m, ' 'elephoiie . #T. . ` d' 4SDO00094 fi T Dty .CONSTRUCTION PERMIT, FOR SE _t�ocated, a - Lake Zhore Roy Subdivision Roaring Brook Frank Grolli ;Owner Building Type Raised `Ranch Number of Bedrooms 3 Design Separate .Sewerage �5ystem`to consist ` Rtady To:_ be constructed b y ' Water Supply Publec Supply F X Private Supply.t A_ tldress M; Other Requirements d as sh !UTNAM CQUNTY 'DEPARTMENT OF HEALTH- W 06h of = Environmental., °Hea7tti Services Carmel W."' Y ,10512 ? vAGE DISPOSAL SYSTEM, Putnam Valley�(T) Faa" 9yY� Town ur Village A r - +pas7ps Pd. pv(F 61ock tike'-' Nfep No 2 Loi F lbe° 2 Box-. 340 Putnam Valley N.Y r .> ., ,Address. _ Lot Arnean rf7�22� 500 SF W 60o GPD Total Habitable Space` 12 _ Square Feet -3 fi 00 %F of 24 trenches " Gal Septic Tank � and falentni µ `Homesteed Avenue A Address Om Pee ki Packet' Well drillers � be tlrllletl by � - _ _� -. 5' out Brook Road .Peekskill - NY..10566 , :. � nestle - responsible for the design and location of =;the ,p-roposed sy,sterr�se;�1�• ( � ;re separate, sewage disposal system r on the approved amendment there to and m accordance wifR Ilan regulations o ,. e : -urn-am .County- `Department of+ "- Health, aril that on completion the►eof a'- 'Certifieat'e •of Construct�on'Com�' be 'submitted the t tbe:Commissioner of}iealthwill �tC to, Department, and a WeAtten gUaiAnt6e = will be furnished the owner, his.succesiOr .o $a wdouiltler, that said,buildgr will place in good operating „condition >?any part of, said sewige-aisposal system- 'during the period ofit foilowing•thedate of the ksu ante` of the•'appro4al of.ithe Gerfificate of ConstcucLon Compliance; of the origirWl iysterii or -afl er ha 1�@ drilled well described above located as shown onahe approved plan and that said. well will beanstalled 'in accordance :wit$ tan an ylations ;. of ah "e' Putnam' Counts y Department., of Health c . Dais September :16, 197'% .Signed " ' 1< Northridge Road kskill N.Y =. ! P E R.A. 2re�6. 027846 x Address ,x,05 i se” No ' APPROVED FOR CONSTRUCTION:-, This approval expires on ear fr the- a ssued u s con u o for + �V7L�drng has been :undertaken and :is .. - revocable cause or may;be amended or modrfied when con` dare cessar" by Co Issio ;of.fl ang to ion of construction n regwre a .' w per, it Approved for disposal of domesti ar y sewa /or pr ate w sup o �� • • lit Date' gy i2 Tdle In I INITIAL SITE IPISPECTT.Or, ' des No Comments ,Property lines or corners found . . . . . . . . Can estimate house location . . . Will driveway need cut . . . . . . . . - Must trees be removed -note these . . . ... . . Is deep hole representative of entire .SDS area Additional deep holes needed. . . . . . Sufficient SDS area available 'considering driveway cut,house location,separation . distances, etc. DEEP HOLE DATA Depth:. , D , , d0 Water elevation: Rock elevation: Soils descr.•:i_;)tion: IUA . Date: FTP?AL STTE Dq? PEOCTIOXi Insp. by: v -- House located where shoi.rn on approved. plan - SDS located where approved . . . . . . . ... . - inngth of trench measured Width of trench average Slope of the line and trench. acceptable Room allowed for expansion trenches . . . , Over 50 ft. from swa -mp, watercourse_ ., ....._ Natural soil not stripped or SDS area - unriecessarily graded . . 10 Ft. maintained frog, prop.line and 20.ft. from house .. . . Separation of trench from house, well etc. follows plan . . . . . . . . . . Number of bedrooms checks . .. _ Stones, .brush, stumps, rubble, etc '. greater than 15 ft. from nearest trench 15 Ft . of peripheral soil horizontally from trench . . • . . . .. . . . . . . . . . . . . . Junction boxes properly set Could surface run off from driveway, roads, • ground sur. face, etc. channel near SDS ,• . , area Does 3. ot drainage appear 0. K. in area of SDS FINAL GLIDING OF SITE ACCEPTABLE I REVILW CI sCK Sl sT !Meets Std.! Remarks I es ; -No 1 `DOCUIPENTS House plans 0. K. T-,sign data sheet Peres presoaked? MJn,. 30" perc test depth - Const. results for 3 runs D. Hole log O.K. Corporate Affidavit for othe2 than individual Authorization for engineer Letter from Water Supply if applicable If variance requested -such noted on plans & apps.: DETAILS if change is proposed,) Existing contours shown kshow new contours) Slopes for driveway cuts, etc. shown �a.ter service line location Footing drain, etc. location Top slope, bottom slope .of fill Percolation tests -and deep test pit location. Septic tank size and conformance to std. B. R. house minimum 'ouse setback shown ' Distribution box.ftg. below frost All water within 50 ft. of PL shown Plan and profile SW All other wells and 0 close.r_..200.', shown or..reference �rnade Property boundaries (metes and bounds- clearly show I� - I SEPARATION DISTANCES SPECIFIED ON PLAN .3,01 to P.L. 20 " to Foundation walls 1-00' to Nearest well 140' to stream, march, lake, etc. incl.expansion 15' to Curtain drain _! 10' to water line (pits -20 15' to storm drain 10''to large trees 110' from foundation to septic tank to pipe from leader drain & .foo ink; n PUTNAM COUNTY DEPARWMI T OF HEALTH O -DIVISION FTVIRONMEI�TAL HEALTH SERVICES Date September '159 1977 Re: Property of Frank Grolli Located at Lake Shore Drive Section Map 308E Block Lot 3" Gentlemen: This letter is to authorize John Sm Romeo a duly licensed professional engineer x or registered architect (Indicate) to apply for a Construction Permit for a separate - sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated 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 the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, B� Signed Owner of Property Countersigned: Address P • E • , F . , # 02781+6 " Telephone 1 Northridge Road ( Seal) , . • �� ®0® Ad re s s •. `��AL ENS /NfF ®® Peekskill, New York 10566 , �y�O�` �, s, R® '�l `• • ( C/j • Te ephone r: • =" o 27aa� 0 e sf . ' ®e �fFAf z I r ate, I., I Nq" Orr 1 cf. I IC V _LK Cl- 4 mpJA 'L 3 C7 0 ti uw 17? 2t LM �iN Lj 3 L1144iki at 154. 444 r . pt: PUTNAM COUNTY DEPARTMENT T OF I RALTH DIVISIO]V.OF rrwlroNr�r,NTAZ, JI1?ALTII SERVICES: ` COUNTY OFFICE, BUILDING, CAW -U.,, N. Y. 10�112> .� •�' �' . i�fT DESIGN DATA SHEET- SEPARATE SEWAGE-DISPOSAL-SYSTEM. FILE.N0.. - Owner F'r'ank Grolli Address Box 340 Putnam Valley., NoYo 10579 Located 'at (Street) Lake Shore Road See. Map 308 §1ock _Lot 344 . n ica -e nea.res • cross street) Municipalit Putnam Valley (T) .,Watershed MW Peeksk%11 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS . Hole Number CLOCK TIME PERCOLATION PERCOLATION' Run Elapse Depth to -a er water eve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches (1) 1 12-002 12:12 10 15000 18000 3000 3.33 2 12 :14' 12 :27 13 3.4050 17.5,0 3,,00 4033 3 12 :31 .12,45 14 15050 18050 3000 4067 4 5 .(2) 1 12005 ,: 12013 8 15025 18625, 3000 2o67 2 .12 -017 12 -028 ' 11 15,50'. 18050 3000: 3067 3 12 :30 12 :42 12 15000 18000 3000:. 4000 5 o , 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 moasurements to be made from top of hole. TEST PIT DATA 1�� QTJIRED TO 13E SL93M1:`I'VED ZaJ:T1i APPLICATION DESCRIPTION .01" SOJ -LS ;;dCOtJN'.(.'JsRED IN `1'1'-,ST HOLES. DEPTH HOLD. N0. 1 HOLE NO. 2 HOLE N0. 3 G.L. Topsoil ; - -- Topsoil .� . _ . < .Topsoil 611 Topsoil Topsoil Topsoil. 12" 15° Topsoil 1411 Topsoil. 12'r Topsoil 18 11 ., $and Y �aVell .... sandy ravelly sandy gravelly ftl i,' . 24!' loam loam loam 3011 36" 42" 481, :.:. 5.4 11 6011 66" .. _ 7211' 78 _ y o 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED None INDICATE LEVEL TO WEIGH MATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MI.I.DE, BY John S'. Romeo Date September ]1,., .1977 Soil bate DESIGN .Used 6-7 Min/1 "Drop: S.D. Usable Area Provided . 5000:81p_ + 3 Capacity 1000' • a Masonry No. `of Bedrooms Sept c Tank Ca Ga%, %9 Absorption Area Provided By 00 L.F. x24'" x .• `�►� `•Grenc , Name John a.. Rmwo Signatu Fe • ULMOL K Address 1 Northridge Road SEA1Z Fee Mill, New York 10566 �.. y 27M6 THIS SPACE FOR USE BY HEALTH DEPARTME11T ONLY: °••..••' Soil.Rate Approved Sq. Ft /Cal. Checked by Date.: .. ,.�... � .:.. _... -... .. gyp._ _� � �- � - - - -- -- _ _ _ . � _ ` _ ..... , ... _ .'� - o.. ,-...: .._.r.- __��.._:...__----- - --- -- - - - - - -- • - -- �p2 lot- RE SERVE 00 L 1 A loo