Loading...
HomeMy WebLinkAbout2265DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -2 -41 BOX 20 02265 .� � is IN tj.6 kJ16 �. PL L L 02265 BRUG R. FOLEY K Public lealth Director �T LORETTA MOLINARI R.N.,, M.S.N. Assocrat'e: Pui1 * °Health Director Director of Patient Services DEPARTMENT OF - HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 tA/DDITION /APPLICATION ( RESID L ENTIA ONLY) STREET 7 ?�C.Gj P 1 TOWN AfPA �4&aX MAP# 1// NAIIvIE 10 ?JP-kz , W41 PHONE 528 -VS30 PCHI?9 t -0 LIAILINTG ADDRESS Sa-0 4 DESCRIPTION OF ADDITION i (L M,'-, �4\v S 1 t_ rY4- Nib—TVIBER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please- sArrmitthis -form and the following to Putnam County Health Dept., 4 Geneva'Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhouseguidelines I - BRUCE R. FOLEYW-4i LORETTA MOLINARI R.N., M.S.N. Public Health Director _..,—� -. r ssocidted Publi�c-�•He "ally' Directo "' � :.• „ate. � ., .•._�. � _ , �• „_.,,,�, ,,.,�, ,� �. ,.._. ,.. Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: �oah<L Residence Tax Map 41.(,— 2 " f ! . Town a-71y A A°► VA f- s ae 7 Gentlemen: According to records maintained by the Town, the above noted dwelling IS , IS NOT . in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER BFhouseguidelines 3 Jacqueline and Greg Canton 76 Gallows Hill Road Cortlandt Manor, NY 10567 New Home: 14 Birch Road Putnam Valley Septic System: 1988 l p -44 Birch Road.txt .- Zf�oo � o At tj sclfvss 01*5' c C4 k E /,U Pumped out on 4/28/08 by Pizzella Brothers Inc., 914 - 739 -3405 Waterproofing system was installed by Contractor's Prep Inc., 2/21/06, 914 - 739 -70469 lifetime guarantee? Eugene Reed,. Enginner 1- 845 -808 -1390 Putnam Health Department ' 1 Geneva Road Route 84 west, exit 19, at light make left- 312 Real Estate, Gerry Diomede Licensed Real Estate Associate RE/MAX Classic Realty 48 Route Six Yorktown Heights, NY 10598 Cell: 1- 347- 739 -4067 1-845- 526 -2134 Page 1 . I... i - - .. BRUCE = R:- fOL:EY'.- •:;.;.: Public Health Director _. "- LURETTA" 1VM0L6aRI R.N., M.S.K. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 November 15, 2001 William Rooney 14 Birch Rd. Putnam Valley, NY 10579 Re: Addition - Rooney -14 Birch Rd. (T) Putnam Valley Tax # 41.6 -2 -41 Dear Mr. Rooney: I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that the proposed addition will consist of the following: A. 14' x 22' Family Room Addition Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: ..J." ._..,,_._.Fjppr_pips for the entire living area, including. basement; are- required:- 2. Location of septic tank must be marked on the survey or site plan. If you have any questions, please contact me at your convenience. ML: kg revision i eours chael Luke Public Health Technician BRUCE R. F6UE rP... Public Health Director a— LORETTA S MOLINARI R.N., M.S.N. < Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 .. . November 19, 2001 William Rooney 14 Birch Rd. Putnam Valley, NY 10579 Re: Addition- Rooney. 14 .Birch Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 41.6 -2 -41 Dear: Mr. Rooney: I have received and reviewed the plans for the proposed addition to the above- mentioned residence. The proposal for the.addition has been approved as per plans bearing the approval stamp form this Department dated November 19, 2001 The addition is approved with the following conditions: __._._ ..:.....:....l. .....The total. number. .bf.,bedro.oms must.remain -at- Three - without - prior - approval -, - by this department. 2. The area of the existing sewage disposal system,. and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly yours William Hedges WH:kg Senior Public Health Sanitarian cc: BI PUTNAM COUNTY DEPARTMENT OF HEALTH Rev . Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Mast Provide 00c/ S' P.C.H.D. Permit N - - -- CA _NS U.CTI, COW..LIANCE. FOR SEWAGE DISPOSAL. SYSTEM.;;—, Q f�7 Town or Village Located at 'Re G 1 ' - V f�.�i /r/ R ®4 Tax Map _L_ Block 2- Lot I Owner /applicant Name Formerly Subdivision Name Subdv. Lot A Mailing Address �4 law � fr a �P v �6 Date Permit Issued --'z! e- , A] - / L Separate Sewerage System built by �� �* r" T" ✓•-� • Address �� D.1" f7 Conslsthtg of d O on Sep c Tank and J= -2- 4f w i Zen 44� Water Supply: Ppbllc Supply From Address ors !,�/ Private Supply Drilled by �� wcs Address L C J?'�ep Building Type P S • Has Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? v Other Requirements Af O V N EW )_ I certify that the system(s) as listed serving the above premises were constructed essentiall s<9� s NICAI s o the completed work ( copies of which are attached), and in accordance with the standards, rules and requl�ations, in acco anc h the ile n nd the permit issued by the Putnam County De rtment f Health. // a 7Q c, Oats � �� a � Csrtif etl by P.E. s" R.A. 1 �.' t �ys Address ^- Lie use No. Any person occupying premises served by the a ,1>6ve system(s) shall promptly take such action as m c r 9 a h%�ytorrectlon of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become nu a�f�jfub(': sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public wa vailable. Such approvals are subject to modifi tlo or change when, In the judgment of the Commi oner of H Ith, such revou on or change Is nee Y. Date �� BY �� Title " �a o. WELL COMPLETION REPORT DEPARTMENT OF HEALTH, Division Of. Environmental HE.,'tlrh Services PUTNAM COUNTY DEPARTMENT OF HEALTH„ A Office Use ,Only ZINE mw. - { rs �i WELL LOCATION ' STREET' ADDRESS:., -WNiV1 / t 3a 4 TAX cRlo NUMBER. { r Urn c r WELL OWNER NAME: ADDRESS: r < 1 . C �1 G S' -.� ti L. b-� r o K Y : K'.PBWTE� PUe USE OF WELL 1 -, primary 2 - secondary RESIDENTIAL PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ..O ABA DON6 O BUSINESS ❑ FARM " O TEST /08SEAVATION ' O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY , , : -,p' MOUNT OF USE YIELD SOUGHT . gpm. /N0. PEOPLE SERVED _ _/ EST OF DAILY USAGE`S gal. REASON FOR .DRILLING EW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY i❑ TEST /O8SERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL... .: DEPTH DATA WELL DEPTH !,. -•,� I ST ;TIC YYATEn LEVEL ft. , `: µ �r� DATE MEASURED.' ,. ,: �( U DRILLING EQUIPMENT O ROTARY ltx COMPRESSED. AIR PERCUSSION .0 DUG .. ❑ WELL POINT CABLE PERCUSSION Q OTHER (specify) t, WELL TYPE O SCREENED ❑ OPEN END CASING. OPEN HOLE, IN BEDROCK, O OTHER J CASING DETAILS TOTAL LENGTH ft. - MATERIALS ::. . STEEL ' O PLASTIC ` 0 OTHER LENGTH.BELOW GRADE ft JOINTS: ELDED 0 THREADED ° 0 OTHER DIAMETER (p "In. SEAL: O CEMENT GROUT, WBENTONITE `' D OTHER WEIGHT PER FOOT Ib. /ft. .DRIVE SHOE: YES ❑ NO LINER: 0 YES XNO DIAMETER (in) 'SLOT SIZE LENGTh 1t) DEPTH TO SCREEN (ft) ,DEVELOPED ?.: - ' ---� ., : _ . YES o No ; \ �. OURS'. ��. ETA1L FIRST SECOND GRAVEL -PACK- . O YES O NO • GRAVEL SIZE - 'DIAMETER - , . OF PACK tn. .. YoP DEPTH s ., OTTOM WELL YIELD TEST "If detailed pumping: METHOD: O PUMPED. tests were done is in- DCOMPRESSED AIR formation attached? 0 BAILED O OTF'cR i O YES 0 0 WELL LOG 11 more detailed formation descriptions or sieve analyses .. are available, please attach. DEPTH FROM SURFACE water Bear- ing Well Dia' meter fORMATtON DESCRIPTION poE. WELL DEPTH It. DURATION hr. min. ORAWOO44WN ft.. Y!ELD QPm. " Surntace `? /`i %; f ; ? •, ;, <;:: r .- - ' s VT WATER LEAR TEMP. QUALITY CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO a STORAGE TANK: TYPE -,.. CAPACITY GAL: PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WEA` NEff"VIIELLDRILLI.NG ADDRESS Clapp Hill Road s'rrt>fTtIRE - LaGrangeville, N.Y. 12540 oiw- cc�•��r� d , PUTNAM COUNTY DEPAR'IlKENT OF HEALTH DIVISION OF M IROiAL HEALTH SERVICES ._. _.. _.. _. _ .. _ ._. _ ._ ..... __...... Owner or Purchaser of Building Building Constructed b / i/f :4%'v'G Location - Street 1'111111�a i �. L ' /. Section Block Lot Subdivision Name 3 Subdivision Lot # GUARARM 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.e.of_.Construction Compliance" for- the sewage disposal system, or.any repairs made by me to such system, except where the failure­to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of'the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the bui ' g-- utilizing the system. Dated this 1.0 day of 9k- 19 M rA-4 mss. i L�e1J rev. 9/85 mk Signature Title AW' as J" Ir Corporation Name (if Corp.) yy Address A W_*75t� _ � rirrr�vlilX l; FINAL SITE INSPECTION Date / Z Inspect6d by STREET ioakTION S11 OWNER PERMIT % V S 'TM. # OR SUBDIVISION LOT # 2� 1 a II. ken VI. 10 - R�WAGE DISPOSAL AREA a. SDS area located as per approved plans b. Fill section - Date of placanent 2:1 barrier. LGTH WIDTH AVG. DPTH c. Natural soil not stripped d. Stone, brush, etc., greater than 15' fran SDS area. e. 100 ft. fran water povuzs e /wetlands. SEPMGE DISPOSAL SYSME a. Se tic tank size -\J,,00 1,250 b. Septic tank install evel c. 10' minimum fran foundation d. No 90° bends, cleanout within 10 ft. of 450 bend e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested 2. Protected below frost 3. Minimum 2 ft. original soil between box and trenches f. JUNCTION BOX - properly set g. TRENCHES 1. Length required - Length installed d 0 2. Distance to watercourse measured: ft. 3. Installed according to plan 4. Distance center to center 5. Slope of trench acceptable 1/16 - 1/32 " /foot. 6. 10 feet fran property line - 20 feet - foundations 7. Depth of trench < 30 inches fran surface 8. Roan allowed for expansion, 50% 9. Size of gravel 3/4 - 1 " diameter 10. Depth of gravel in trench 12" minimum 11.-Pipe ends capped h. PUMP OR DOSE SYSTEMS 1. Size of pump chamber 2. Overflow tank 3. Alarm, visual /audio 4. Pump easily accessible manhole to grade 5. First box baffled 6. acle witnessed by Health Department estimated flow per cycle HOUSE a. House located per approved plans. b. Number of bedroans WELL a. Well located as per approved plans b. Distance fran SDS area measured 16 d4- ft. c. Casin 18" above grade. d. Surface drainage around well acceptable. OVERALL WOR1Qg0HIP . . a. Boxes properly grouted b. All pipes partially backfilled c. All pipes flush with inside of box d. Backf ill material contains stones < 4" in diameter e. Curtain drain installed according to plan f. Curtain drain outfall protected & dir.to exist.watercours g. Footing drains discharge away fran SDS area h. Surface water 2rotection adequate i. rosion control provided on slopes greater than 15 %. 10 -- altr ,r Ot�edALLt �- 6 Ntimt6er o[ Hedreome" St>peate sotrtuag® system to onmefetd - To 6e gibed by_ Water Sgpplp r err I� y.t.,mr.Ag� iY G Ot6ee f t rop�nt loaf am wholly and,com above descritrotl' will De constructed'a; County Department of;`tieeKb ?antl be sutrmitted to the Department,ai • Piece :in� yoodY:,operatxy eonditidn-s an��ef' tAa '.meernvsl�:nf "�al�e:- 'Eeitifii Date', /` �� Signed Address �' APPROVED FOR CONSTRUCTION Thy5pproval expires two y rs 1 revocable for cause or may a amend ormodifled;wpen consi re0uires a n,e r `- A roved or disposal of�domestir ary, 1 4 1//87 Dale — -- BY r B �(✓ " )UPOSAL SYSlBB� — oe y ,d�% - � B®Re�WB� f arlt i .. Let Atea Date', /` �� Signed Address �' APPROVED FOR CONSTRUCTION Thy5pproval expires two y rs 1 revocable for cause or may a amend ormodifled;wpen consi re0uires a n,e r `- A roved or disposal of�domestir ary, 1 4 1//87 Dale — -- BY x a .6-^t (p 3PUTNAM COUNTY`'DEPARTMENT OF HEALTH r Permit N i t, Division of EnwronmeniaLiHealih .Services 'Carmel = N -Y 10512 FF CONST UCTION PERMIT FOR SEYYAGErU1SP6SAL SYSTEM Town or ,Village {.. Y,� acatd at Tax MaP B lock ­Pt - _ +.- ^ �--=- -^T= _'. ---- •'r•— '--- ''- -r-r'r�'- �v* - --c +s., ,s..c =a••e h-- mse®wYy„ryn, yrazn -max v --s :-r- ,•z .r:. ' ,sub d: Lot ii Renewa3' Revision Subdivision .� �O 1 Date Of Previous Approval v =��y= Building TYPe r�` -.'• c LLx Lost Area P�11 Section ony ❑ Number of Bedrooms Design Plow G /P /D� P C NY` D Not ificat ion, .Required Separate Sewerage System to consist of ' ®� Gal` Septic Tank antl � r�r I To be co ±nstructed by t Address Water SupPIY . Pubhr Supply F -tom . ° Private SuDPIY to be drilled by i Il, y d 'Y Address - Other Requvements� ' x' �'` 1 represent that ,lam wholly' anG4aompletely +,respohsiblefor•thedesignand location of he proposed.system ( s), that the rseparate.sewage_Cisposal system i atiove:de_scr�bad`wll be ;coristructed,as show the approved amendment there =to and iri accotdbnce %with t�he's�antlards rules an cegu a ions o e. u nam County' Department of Health, ,and that onicompleUOn:ttier_eof a Certificate; of ,Gonitrucf}on_COrQplfa i!sVory to the Conimissloner:of Healthwill tie •submitted to "the Department, 11 nd a _written gupranteecwtll be furnished the owner phis ucae6 iF% 0m,5 ss r:by the builder that said'buildor will 11 +x- _ �.. @place in; good operating ;conddwn; any part of said sewage disposal systemdurmg the perivdo- baT oir: iatel y`follow�ry.ftiedate'otethe isfu= ante of the approval of.the Certificate of,'Const►uctton'Compliance of "1original ;ystem�or =arty r. tt at..the dM16d well described above will be located as shown on he_approved plan and fhat said well will be installed in acco�dancg5wi a;he standard Wes A regulations .of the:, Putnam County Department of Health. A Be Date P E `�' RA os Address ��/rJ"1 C/s'f a% e� i'W! ieense,No APPROVED'FQR CONSTRUCTLQIV This approvalexpues; one year from the date issued u ,ass, corrstivationw:ofat a bwltling has been- undertaken and is R revocable, for cause or may be amended or inodiLed when eonsidered neeesSary "by the Commisslon`ofQhfe'avlh " °YR�hange or alteraffon of construction requires a new permit Approved`5for disposal of domostie sandary's ag `a /oar private watesuppl ;only r Date a ��ae Tale 3tev 9 81 M ti `.I �.vJS7�ff � 1 /YPPF revoc requii Oate Rev. `1 _,.., ='Z IfOS 'fU1C5 dnO�f9gUldi1011S oi - if10- J�,:UindR1 . acto►y,-to the;gommissioner of k4ealthwill signs by the builder that salldbuilder will• mmediatety following the date of4the Issu 0 2) that the drilled _wel'I "Sdescribed above' rules and regu aTiions of� the :Putnam'' 'License the building has been undertaken and is Any change or`alteration of construction %' L. iS ti :I Title` >' s � w DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -36,41 .= �._�,:;:�.- ..:�- Y.. -:.:_ �B.P�ICAT�.ON= T> 0-_,. GONS7' �2L�: GT, � ;A.,:�nTATER�_WEL-I.z,r:•::._ -, -_- -- - - - - -• -��:% � PCHD PERMIT WELL LOCATION Street Address / To /Villa eZit Tax Grid Number 0 9 cZ v X3 -7 WELL OWNER Name Mailing Address J rivate �y`j�j,ir� ��nC� re /G O Public USE OF WELL 1 - primary 2- secondary WHO,, SIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify O INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT_ gpm /# PEOPLE SERVED /EST. OF DAILY USAGE dOO gal REASON FOR DRILLING WEW SUPPLY O PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION OREPLACE EXISTING SUPPLY ODEEPEN EXISTING WELL .,DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN ODUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES 1" NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: /J-- j Lot No. 2 3 � WATER WELL CONTRACTOR: Name A /t Xy • G1-0r2aV 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 O ON REAR OF THIS APPLICATION (d te) , PERMIT ON SEPARATE SHEET 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. Pump the well until the water is clear. 2. Disinfect the wellA n accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form prov' ed by the Put am County, Health De ment. par Date of Issue: 19 Date of Expiration: 19__!�� T.Fe-rmit Issuing ff i White copy: H.D.`File Permit is Non - Transferrable Yalow spy. Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller e a PUTNAM COUNTY DEPARTMENT OF HEALTH Re: Date Property of 'J-4-1'4 =' Located at (F,7'_ S (T)T4, r /Yip Section 7 Block Lot_ Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: � f This letter is to authorize a duly licensed professional engineer ;1-11 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 conxlec ion ,wi- - i_.:ata.. __ L -P[ . -- -_ o - supergis.e.- e. 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. OF Counters 10 Telephone Very truly yours, Signed Owner of Property 37 � A / % -vef Address Town /-3 t7 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. COUNTY`OFFICE •:.BUILDING',,- :- -CARMEL - "rN. `Y: .. -10512 DESIGN.DATA SHEET = SEPARATE SEWAGE DISPOSAL SYSTEM' FILE NO. Oianer _/� �N��s Address �dw�j� //� ....Located: at - ( Streeti/d/J . ,/%�oa . Sec.- Block Lot: Indicate neares cross street) Munici lit �'��? Watershed Pa Y SOIL PERCOLATION TEST DATA RE IRED TO BE SUBMITTED WITH APPLICATIONS 5 1 _ . 2 3 Hole .. . Number CLOCK TIME PERCOLATION PERCOLATION No. Start" -Stop Elapse Time Min. Depth to Water 1water From Ground Surface Start Stop Inches Inches Level in Inches Drop in Inches Soil Rate Min. /in drop 12 .� 3 5 1 _ . 2 3 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. TEST PIT DATA REQUIRED:TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES. DEPTH HOLE NO. HOLE NO. �^�? - HOLE �NO. �FK G.L. 6" 12" - 18" 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED�'� INDICATE--LEVEL-TO WHICH WATER LEVEL.RISES AFTER BEING ENCOUNTERED TESTS MARE BY • . .....:_c�:..�.� . _..._ - .. z DESIGN Soil Rate Used--_7 _MirVi "Drop: S.D. Usable Area Provided _:5�0 No. of Bedrooms Septic Tank Capacity Gals. Type z � Absorption Area Pr— o —� By Sao L.F.x24 " fi'- width Trench.- Other . Name - Signature �e• -wso Address 2-97 THIS SPACE FOR USE BY HEALTH DEPART16T ONLY:,: Soil Rate Approved S . Ft /Gal < Checked P q Date s JOSEPH F. SULLIVAN, P.E. &m"Ang engbzt 2972 FERNCREST DRIVE YORKTOWN HEIGHTS, N. Y. 10598 (914) 962-424B February 4, 1988 ,Putnam -i County. Department of Health " , 110 Old Route:6 Carmel N.Y, 10512 Gentlemen, Enclosed please find .a renewal construction permit and plans for a proposed sewage disposal system for Mr. Steve Lubb . ers on Birch Road in the town of Putnam Valleys. These Plans were approved by the PCHD in July of 1985.0 From a field inspection of this.lot there have been no changes in the surrounding ares to adversely affect the location of the proposed well or sewage disposal system, Very truly yours 71h �,/ L .Joseph F, Sullivan P*E* J/ RL J1,-! CIECK SI[I;I:T (Meets Std .1 Remarks es No DOrUI��;IITS - t �� . -�_-, - , •_�,•� - - -- - . ,.._ -_ � , , .,.- -a - - ��-_._ MI;p i_ocA� . House plans O.K. ✓ 7 11- Design data sheet Peres presoaked? i -in. 30" pert test depth Const. results for 3 runs D. Hole log O.K. � I ✓ 1 Corporate Affidavit for oth p than individual NC_ ! Authorization for engineer ✓ I i Letter from plater Supply if applicable !v If variance requested -such noted on plans & apps.= TR Omr4 L_C w (T_r4 R 3 O<:) D TAITZ , .;P01 TiG -pTH RIQER' sl{o4u Existing contours shown (show new contours) Slopes for driveway cuts, etc. shown - i•U.ter service line location Footing drain, etc. location Top slope, bottom slope of fill �.! Percolation. tests and deep test pit location I i Seutic tank size and conformance to std. ! 1 3 13. R. housa mirrr,um P'ouse setback shown Distribution box ftg. below frost All water within 50 ft. of..PL shown .• . = I f �, ! ✓ u1EL�� -CAGING IV' t�ZOv✓ G- P-ADC Plan and profile SDS :✓ All other wells .ana -- SDS__- c1o:ser 200 -'- - - � shop, �.. _ _.__..,... _._. shown or. reference ffaaz Property boundaries (metes and bounds- clearl shown LEGOL Sc:gD1U iS iDti� `' 1 t,?P>?ov4L i^(E! -ALT`( Sv�DivlS101� _ `�n�.�r,�Y�, P�Rlvu ✓ . SE'PARgTION DISTANCES SPECIFIED ON PLkN '10' to P.Z. nQ _" rt►\jEI ) i201 i to Foundation i alls - 100 to Nearest well ice` to stream, march, lake, etc. (i . 15' to Curtain drain X1.0' to water line (pits 720 �5' to storm drain to lar`,e trees �0' i'rolii 1'o�uicj:li.ioc1 to septic tank 5' to Pipo from droin &.1'b-o- 15 T o. cf}TC 4 PsA S 11.3 , 15' W E'_ L TLS it so . sEP T IC. TR n3K rG . \.a E t_ e,:pa.nsion i nC, kii,ai -ii r FIELD CJ1E,1C h'LS`r. . INITIAL SITE 111SPECTION. uti�: � ( � � Xes� No Comments ,Property lines or corners found Can estiinate house location Will. driveway need cut ✓ -- Nrust trees be removed -hote these •. -- . Is deep hole . representative of entire .SDS Brea. Addit:ional deep holes needed. -" -- ' Sufficient SDS area available 'considering driveway cut, hous-- location, separation - distances, etc. ' • DEEP. HOLD DATA Depth: 1 Water elevation.:. — Rock elevation: t Soils descr_:i_;�t ► on: : Date: FINAL SITE IX,63PEC`_1'ION !Insp. by: House located vdiere 'shown on approved plan SDS located whlere approved . . . . . . . . . . :Iength of trench moasureu Width of trench aver. -,e Slop; of the line and trench. acceptable , — Room allowed for expansion trenches - .0ver..50 ft-..'from .swampiraterco-dr•se lgatural soil not . stripped or SDS area iu'u-iecessarily graded . 10 Ft. maintained from prop. line and 20 ft. from house -Sep ration of trench from house, well -plan _ ... —_ .... - - -- - -- - - - - -- - - - - -- -- '_-etc---follows . htunber of bedrooirs checks . . . . . . . . . . Stones, brush., stumps, rubble, etc,. greater than 15 ft. From nearest trench . . ... . . 15 It. of peripheral soil horizontally from trench .. J1ulction boxes properly set Could surface ruin off fro!n driveway. roads, ground surface, etc . cliannel near SDS ` ELI Ca . . . . . . . . . . . . . Does lot dr. aii-Y.i f;c appdar 0. K. in area of SDS -- FINAL Gr&DING OF SITE ACCEPTABLE PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Located at �i /G'� i�d s� o (T )/""�'d� G f Section Block Lot Subdivision of �dc/�i �� ��1��� !�°��� 0,0 Subdv. Lot # ��i-� Filed Map # - '(f'S4C Date Gentlemen: �r This letter is to authorize 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 sys£ems in4 con formity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. 7':;�4 �� CountersiLrn( AA P.E., R.A., Address a d� 910�� a 7 Telephone Very truly yours, Signed Owner of Property Address �' e °�e/'�X; / Town Telephone AKNI oil • 7 77. Jl uA&I ................ ... ............. . . . . . . . . . . . W9 Sit vivo yet 1 W oil, XV-s"TT " - - - - - - - - - - - J" �e 7_7 IV off To T, Wow OFESSIONPF An --------- uw. AKNI oil • 7 77. Jl uA&I ................ ... ............. . . . . . . . . . . . W9 Sit vivo yet 1 W oil, XV-s"TT " - - - - - - - - - - - 7_7 IV AN 1, OFESSIONPF An --------- uw.