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HomeMy WebLinkAbout2283DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.07 -1 -9 BOX 20 02283 �. Ilk .. kv% 1.6 4 ' �ELI - - oLh 02283 j PUrNAM COUrm D1SrAJranstam yr a -sa Dlvldm dzavMonwat d He" Seevlees. Carted. N.Y. low ` ' Ptaodlde Peiotlt g" PERMM FOR SWAM DISPOSAL SYSTEM ring Brook Drive m CERTIFICATE OF CB Parult / .� Putnam Valley oval or ,Village Roaring Brook Subd I L>tr 6 Tax Map 41.7 gawk I W 9 Country-EStateS Sun NLF Limited Partnership ReO°trd—� R"'�O° ❑ Owtaer /AppYaut leaser Dated Previous Approvd 1 1 A 18 1 8 8 A�„ggg 6001 North 24th Street, Phoenix, darn zip Ri;n1 F Date Subdivision ApDroved 11118188 Fee Enclosed Q A,nn,,,,t $300.00 1 Single family resi InACume Section 1 D,,& 2---� -WOO Number d Bedrooms 4 Design Flow G P D S Q-Q PCHD NodGesti e Is Repa4ed Wbm Fill he completed Sepaeats Sewerage System is on" of 1500 Genoa Septic Tonk and To be ceeatruded by Addfeea Water Soppb•: glob& Sappy From Address t an X 1Wva% Sop* Drilled by Address Ofber Regaleemeab I represent that 1 am wholly and completely responsible for the design and Motion of the proposed system(s); 1) that the separate sewage disposal Stsm above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a regu ns o nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance•' satisfactory to the Commissioner of Healthwlll be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the bulkier, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) yews immediately following thedate of the isu- once of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that aid well will be Installed in accordance with the Standards, rules and requ a ns of the Putnam County Department of HNlth. 4--; —_9 , Date 1 2' 97 Signed P.E. y Addrs=2 Dale Avenue, omens, N.Y. 1058�� IieenswNn�7�7�n APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the building .has been undertaken and is revocable for Cause or may be amended or modified when considered nd"sarr nor of Health. Any change or alteration of construction raouires a new emit. Appr or diapoal of domestic sanitary sewage, I>�p1r— only - - -- 0/88 Date G/ � � By /'C ✓`��_ Title .11 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Hedth Services. Carmel, N.Y. 10512 C S UCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM yA,tW at off �Puddiiig Street Subdivision xwRoaring Brook Country snbd. Lot q 6 Estates Owner /Applicant Name Roaring Brook Country Partners Engineer to Provide Permit N on CERTIFICATE 0M0 ICE Permit N •Prttnam Valley Town or Village Tax Map Block , Lot Renewal— ❑ Revision ❑ Date of Previous Malung Address RR #2 , Twin Farm Lane I Town Pound Ridge, NY Zip Building Type 2 Stnry Frame Lot Area Fill Section Only Li Depth Vole Number of Bedrooms 4 Design Flow G P D �p8000� GPD PCHD Notification is Required When Fill is Completed Separate Sewerage System to consist of 125c) Gallon Septic Tank 1�rE anr W LF of fields To be Constructed by K. Fiortino Address Putnam Valley, NY Water Supply: Public Supply From Address or: X Private Supply Drilled by Beal _Address Brewster, NY Other Redul.mente 2`0" .ROB fill I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved 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 a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a written guarantee will be furnished the owner, his successors• heirs or assigns by the builder, that said builder Will place in good operating condition any part of said sewage disposal system during the rind of two (2) years immediately following thedate of the issu- once of the approval of the Certificate of Construction Compliance of the+ riginal sys or any a irs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be install in accord e, wit andards, rules and regu a ons of the Putnam County Depar leant of Health. Date Signed P.E. ? R.A. Adtlress 37 Fair Street, Ca e , NY .10512 License No - APPROVED APPROVED FOR CONSTRUCTION: This approval expires two years fr the date i ued unless construction of T revocable for W se or marYY b amended or modified when considered assar y t Commission r of An requires new mit. /A pr ed for disposal of domestic sanita ow an`� D to r nly. Date / By building has been undertaken and Is change or alteration of construction Title �l�d'; BRUCE R. FOLEY DEPARTMENT OF HEALTH 1. Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 December 13, 1999 Mr. Frank Sullivan, P.E. 2972 Ferncrest Drive Yorktown Heights NY 10598 Re: Auth, Roaring Brook Road Roaring Brook Country Estates (T) Putnam Valley, TM# 41.7 -1 -9 Dear Mr. Sullivan: This office has received and reviewed the renewal plans for the above - mentioned project. We would lik/'8ite er the following comments for your consideration: visit on 12/7/99 by this office found that site conditions are not as shown on the proposed site plan. Please verify. Please also edit-the note on the plan regarding site conditions (changes) from the time of previous approval, the'stat6nent is' lio longer valid'. Show present (proposed) house location. Show present (proposed) driveway location. Verify and submit current perc test results in the area of the SSTS. This is required / due to clearing and operation of.heavy equipment over the area of the SSTS. �6. bimension fill pad area on plan. Trench lengths on a gravity flow system may be no longer than sixty feet (60') in length. (NYSDOH). The plan shows trench lengths longer. This office will continue its review upon consideration of the above- mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:tn INDIVIDUAL W; .�STIT:LOCASIQN_, REVTER'ED BY• RNI, GR, A NIB, �' �' __--ll DOCUMENTS EL�MIITAPPLICATION' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH {TER SUPPLY & SUBSURFACE SEWAGE TREATMENT SY EIS REVIEW SHEET FOR CONSTRUCTION PERMIT \ AME OF OWNER'._: ", BH DATE TAX MAP # I if {EROSION CONTROL:HOUSE,WELL, SSDS (( 0 tA 10z SHORT EAF FLANS - THREE SETS 30USE PLANS - TWO SETS VARIANCE REQUEST =EE . SUBDIVISION dkiAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE L C T 2a FILL REQUIRED Z/ DEPTH CURTAIN DRAIN REQUIRED STANDPIPES / QENERAL �C ATED INNYC WATERSHED S SUBMITTED TO DEP GATED TO PCHD EP PPROVAL, IF REQD P ST HOLES OBSERVED CS TO BE WITNESSED y,/APPROVAL SSDS A . OTS . BI/ZBA FLOOD ELEVATION REQ'D PER:IIIT(S) AGE SYSTEM PLAN - (NORTH ARROW) i HYDRAULIC PROFILE MITY FLOW L �STRDATA: P NOTES jj�r --;; IGN DATA: PERC &DEEP RESULTS ro\ rot IRC FYiCTtNI: & PROPMFn PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION LOCATION MAP EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED, PIT & D BOX SHOWN & DETAILED HOUSE -NO.OF BEDROOMS WELLS & SSDS'S WAN 200' OF PROPOSED SYS. PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER -1/4" FT. 4 "0; TYPE PIPE NO BENDS; MAX.BENDS 45° W /CLEANOUT FTLL SYSTEMS CLAY BARRIER 10- FT. HORIZONTAL;SLOPE 3:1 TO GRADE FILL SPECS FILL NOTES FILL CERTIFICATION NOTE I DEPTH GAUGES FILL PROFILE & DIMENSIONS FILL IN EXPANSION AREA TRENCH LF TRENCH PROVIDED 60 FT MAX. PARALLEL TO CONTOURS 100% EXPANSION PROVIDED 7 Tim _ SIB � J Loocc� ON PLAN - FROM SSTS 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS 15'WELL_TO-PL 1'00' TO WELL, 200' IN DLOD, 150' PITS 100' TO STREAM WATERCOURSE LAKE ('inc. expan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (pits -20) 50' INTERMITTENT DRAINAGE COURSE 200'/500' RESERVOIR, ETC. _150' GALLEY SYSTEMS 15'MIN to CDS= >5 %,10'- 4 0/o,25'- 3 0/o,30'- 2 %,35' -1 0/*,100' - <I% 20'MIN to CD discharge /100'with 182 cons day discharge CFPTTr TAM< w-fa CAD `o Y� p.:_._DIV1SION.OF_ ENVIRONMENTAL :HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE F �, REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # PV % 3 - ,9q /40,0/ Located at Town or Village Im air7 �a We-y _ Owner /Applicant Name;-frrryej �6 ? q Tax Map */ % Block % Lot 9 vn/s'y Formerl S)4tere- a14 ! Subdivision Name Subd. Lot # Mailing Address 3 Zip '`J',. L� PUTNAM COUNTY DEPARTMENT OF HEALTH Date Construction Permit Issued by PCHD ,Oe-. (-. / f ' fr Separate Sewerage System built by �a Address Consisting of ,/ Z Ste' Gallon Septic Tank and 3 2 L • d N �-� �► w'i � � T�`G°j�7C�/1� Other Requirements: Water Sunnh: Public Supply From Address or: Private Supply Drilled by Dom- Address"e'X aex Building Type G-Si - Has erosion control been completed? Number of Bedrooms -4 Has garbage grinder been installed? Ale I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: _% ri vv Certified by P.E. R.A. �P pN fessional) >_ q 9- Address 2 ,�'7 7— s e License # Any person ocupying premises se a JJn(s) shall promptly take such action as may be necessary to secure the correction of any unsani se` lting from such usage. Approval of the separate sewage treatment system shall become null and ' a public sanitary sewer becomes available and the approval of the privw water supply shall become null and void when a public water supply becomes available. Such approvals an subject to modification or change when, in the judgment of the Public Health Director, such revocatio modi cat' r c ge is necessary. Title: I'._ Date: �me copy -HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 `a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Weff Local of n` : ~ -" ` et Address: - riY'� T /VillagTj Y Tax Grid # T Block / Lot(s) Well Owner: e` j Address: Use of Well: 1- primary 2- secondary Resi en ' 1 Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details Total length eft.. Length below grade t V• Diameter in. Weight per foot lb /ft. Materials: _ Steel _ Plastic _ Other Joints: _ Welded _ Threaded _ Other Seal: _ .Cement g rout _ Bentonite Other Drive shoe: Yes No Liner _ _ Yes _ No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Field Test. _ Bailed _ Pumped Compressed Air Hours Yield � gpm Depth Data Measure from land surface-static (specify ft) SS During yield test(ft) Depth of complete yell in feet �© Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface h AI G ► If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type T Capacity / b Depth -Z$V " Model 10V v-�r—'f Voltage ?30 HP / �3- Tank Typell/ �� Volume 64 , Date W I Co7106 eted Putnam County Certification No. 4 Date of Report oa Well Driller (signature) v.r lr- nja�L ,eteat,en vi well wiw uisuinces to at least two permanentAanamarxs to oe provtaea on a separate sheevplan. Well Driller's Name �L� ='�- Address: /Y y Signature: n�l _ Date: /�/ q/o / �►� J White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 v PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT rill "Location -~ Stree - Address: � - "� " "� "� - " "' °° �° ' " - ` To n/Villa e: ^� L �Map Tax Grid Block Lot(s) ell Owner: Name: _ d Use of Well: 1- primary 2- secondary ,,Z esi ential Business Industrial Public ply Air cond/heat pump rriga on Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment. Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing yG Open hole in bedrock _ Other Casing Details Total length I ft. Length below grade %°1 ft. Diameter in. Weight per foot _lb/ft. Materials: Steel Plastic _ Other Joints: _ Welded _2-r Threaded _ Other Seal: ; Cement grout _ Bentonite Other Drive shoe: -,,e- Yes No Liner _ —Yes '-No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed _ Pumped 7- Compressed Air Hours Yield /< gpm Depth Data Measure from land surface - static (specify ft) During yield test(ft) Depth of completed well in feet 3 aD Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface q G rr p p �� v 'p 9 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump TypeSmZtt- Capacity / e Depth _?-912 Model /69�- 1 1)�fp Voltage )-3 o HP r Tank Typc $t YS�O Volu e T_ 7 Date We Completed Y� d o Putnam County Certification No. 2 Date of Report / � Ito/ Well Driller (signature) q. . ... .. i F1%.. n2�ucA IM4LIVn ui weu wnn uistances to at least two permar;ent lantimarxs to be proviaea on a separate sneevplan. Well Drillees Name �x,+- C n�� Address/--F_?! Signature: �t'P�r�>�— Date: o �4 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, MY. 10598 Albert H. Padovani, Director LAB #: 32.007854 CLIENT #: 12910 NON STAT PROC PAGE 1 MAZZELLA, JAMES & AMY 3388 WILDWOOD ST. DATE/TIME REC'D: 12/04/00 11:55A YORKTOWN HEIGHTS, NY 10598 REPORT DATE: 12/19/00 PHONE: (914)-245-4316 SAMPLING SITE: 22 RORAING BROOK DRIVE : PUTNAM VALLEY, NY, 10579 COL'D BY: AMY MA2ZELLA NOTES...: BATHROOM TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 12/04/00 MF T. COLIF8RM ABSENT /100 ML ABSENT 12/04/00 LEAD (IMS) 2.6 ppb 0-15 ppb 12/04/00 NITRATE NITROG <0.2 MG/L 0 - 10 12/04/00 NITRITE NITROG <0.01 MG/L N/A 12/04/00 IRON (Fe) <0.060 MG/L 0-0.3 mg/l 12/04/00 MANGANESE (Mn) <0.010 MG/L 0-0.3 mg/l 12/04/00 SODIUM (Na) 5.74 MG/L N/A 12/04/00 pH 7.5 UNITS 6.5-8.5 12/04/00 HARDNESS,TOTAL lUV MG/L m/* 12/04/00 ALKALINITY (AS 88.0 MG/L N/A 12/O4/00 TURBIDITY (TUR <1 NTU ._` 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIN�-19 THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. ! Fe/Mn If both iron and manganese are present, their total value combined shall pot exceed 0.5 mg/L. Na No limits fqr Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. 1008 9101 9139 9146 2037 2037 9043 ' =�� � -�� YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y, 10598 Albert H. Padovani, Director LAB #: 32.0,07854 CLIENT #: 12910 NON STAT PROC PAGE 2 MAZZELLA, JAMES & AMY DATE/TIME TAKEN: 12/03/00 07:30P 3388 WILDWOOD ST. DATE/TIME REC'D: 12/04/00 11:55A YORKTOWN HEIGHTS, NY 10598 REPORT DATE: 12/19/00 PHONE2 (910)-245-4316 SAMPLING SITE: 22 RORAING BROOK DRIVE : PUTNAM VALLEY, NY, 10579 COL'D BY: AMY MAZZELLA NOTES...: BATHROOM TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD PHI pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUMAMA8NESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70_140 MG/L MG/L = MILLIGRAM PER LITER SUBMITTED BY: AlfeA H. Padovani, M.T.(ASCP) Director , ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF REA LTH DIVISION OF. ENVIRONMENTAL -I-IEALT'H-- SER.VICEg RE; Property of LETTER OF AUTHORIZATION Pf `�"`L_ 0.2- Located at y iL 1 \e — "pax Iv1ap # � i ` � dock - -1 Lot Subdivision of C en �je.9 .1e _ �? oaq S J Srbdivision Lot #,! _ _^ Tiled Map # 23f,3.4 Date Filed %` q �� Gentlernen: This letter is to authorize �� I'L. � 4 v If a duly licensed Professional Engineer _e o q Registered Architect to apply for the required wastewater treatment Lind /or water supply permit(s) to serve the above - noted property in accordance with the standards, rates or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my be in connection with this matter and to supervise the construction of said wastewater tretment and /or water supply systems in conformity with the provisions of Article t45 .and /or- t47 of the -.E tucation.Law,AlieTub-lic Malfh" Law, and_the.Piitnam-Gounty Sa tmy C(Ycle. Very truly yours, ,-7 CountersigrF`ccl - -- — ���� Signed: P.E., ., 4 i' n g •9� (owner of Prop rty Mailing Address Mailing Address: Mate `�f i� Lip State Lip elephone: Form LA -9`1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM �U (n e.) -I- P1' fr0i M!2 ZU 1\! Owner or Purchaser of Building 54��,re, :/J� Building Constructed by :a , ocs,c� r;$ DC-% ylc�l Location - Street �l eS:Aer, CQ_ Building Type i Tax �J-� Map Block Lot nct V ct �e Townf Village Subdivisio4 Name Subdivision Lot # 6 I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, 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 Public Health Director 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 system. Dated: Month_ Day-3o Year GU Signature_ 2,j X-1-i-i Z '3,_ ' Title: 0_w nor General Contractor (Owner) - Signature Corporation Name (if corporation) Address: b Zi State y Zip 10-5 D'S Corporation Name (if corporation) Address: .State Zip Form GS -97 - BRUCE Public Health Director - I,ORET''A °' ICSL;YI�fAi 7r RN:� Mi & Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (9 t4) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678. Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWI ERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN:, AUTHORIZED TOWN OF (Signature) DATE: //-/ / �2 00 The Putnam County Department of Health will not issue. a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted rfi with the CPfcate._off Construction Compliance. BRUCE R. FOLEY Public Health Director � OI DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 January 16, 2001 Frank Sullivan, PE 2972 Femcrest Drive Yorktown Heights, New York 10598 Dear 4 AlLe Re: Application of Certificate of Construction Compliance - Mazzella, 22 Roaring Brook Drive TM# 41.7 -1 -9, Town of Putnam Valley This office has determined that the above referenced Certificate of Construction Compliance application, received by the Department on January 10, 2001 is incomplete. Please be advised that the following information is required before the Department may commence its review. 1. Well C pletion Report (WC -97) jomplete location, including E -911 address. omplete tax grid #. omplete well owner address. omplete date singed by well driller. 2. Letter Authorization (LA -97) omplete filed map #. ate filed. 3. Guar tee of Subsurface Sewage Treatment System Form )GS -97) �a. Complete building constructed by..... This office will continue its review upon receipt of the above mentioned comments. Please feel free to contact this office if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj encl. WC. -97, LA -97, GS -97 . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES `GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM �U m e, -V Ja Owner or Purchaser of Building Building Constructed by Location - Street `J �CS-.A -e Q Building Type Tax Map Block Lot Town/Village Subdivisio Name Subdivision Lot # tI I represent that I am wholly and completely responsible for the location, workmanship, material, - construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, 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 Public Health Director 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 system. Dated: Month Day 3v_ Year GU Signature:„ Title: General Contractor (Owner) - Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: ,E :?6 ��� ,.�� Address: State y /I/� Zip /a.S aS � State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION O NVI OENTAL HEALTH SERVICES — l7 OMPLETION REPOR j WellhL-ocatign ..; et Acjdres : bzz� Nillage: Tax Grid,4;- Map Block Lots) Well Owner: e: ess: I—A Use of Well:. 1- primary 2- secondary Resi en ' 1 u$ltc Supply Air cond %heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment 5<' Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length eft. Length below grade __[q_jvvft. Diameter �� in. Weight per foot lb /ft. Materials: _ Steel _ Plastic _ Other Joints: , Welded _ Threaded _ Other Seal: _ Cement grout , Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _Pumped Compressed Air Hours Yield 19� gpm Depth Data Measure from land surface-static specif .y ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter0n) Formation Description ft. ft. Land Surface �j (, '► ' If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type .� Capacity / b Depth Model . d S %r 5 Voltage z30 HP Tank Typ✓f �� Volu _� Date We I Com leted � � �6 Putnam County Certification No. . 1 Date of Report 11- I I °° Well Driller (signature) �'l NO E: E act location of well with distances to at least two permanentAandt6rks to be provided on a3 separate sheet/plan. Well Drillees Name �' ��� dress Signature: _ elk->� Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 s.` MR. J � I'L'TNANII COUNTY DEPA.RTME T OF HEALTH a . DIVISION OF ENVIRONMENTAL HEALTH SER'V'ICES RE: Property of LETTER Ola AUTHORIZATION - -s rr,- -u Ck z Ze.� Located ai��ac} .1.%`' —_.. T ax Map `.� - -- - - -- Block _� _ Lot o trl \1S10r1 Subdivision Lot T Filed Map "'Dare Filed Gentlemen: YT "Phis letter is Lo auLllorize _ �? e h v f / i Vail a duly licensed Professional Engineer �oY Re isterzd �cllitect to apply for the required wastewater treatment and /or water supply. pennit(s ) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the PL tnam County H.ealtll Deplrrtm�rll, and to si;n all necessary papers oil illy behalf in connection with this matter and to supervise the construction ol'said wastewater tretment anTor water supply systems in conformity with the_ provisions ol'Article 145 and/or 147 oCthe Education Law, the Public Health Law, and tine PLItrlarrl CoLlnt)' Sanitary Code. �/✓ l�% / Very trul;' I: ours, . Countersigned:�NE Srblled: l VC4117 z P.E., Hsi'., r Prop rr) ) ha v�r�C� Mailing Address � i' Mailing Address: SsEk State % 1% _Zip l�� y State Gip �S`t Telephone: — � /-/ a . y � Telephone:.L1 ) Y �.f Fonn LA -91 07/24/2000 06:33 9149624248 JOSEPH SULLIVAN PUTNAM COUNTY DEPART:NENT OF 3EALTR ,:�. e. � . � . -, , . �.�.. m. _ _. , i>,lC1'hil4�t 4DM• E:�i'tRON!�tE.'��'A1: i�E�►j:,TFt-�ERVDCE:S . ATTEN''TION ZADAM L1 GENE F{11'EST_rQj L'�d1. L\ 'f t.'TlQ.S AJ1 iTu 'ormatton to tst be fully completed pries to ar;y inspections being ma It. 0 For Fdl ,__. -_rHUt . nl Trenches. _.e_ _ __,_, POID Construction 1'ermit T t N fwd r•" vG %1c t t. ) __ --- Chwnz:: —Lot Former),, �? M� -• .�/ d Subdivision Name � � •'� C! «.. �f1� �i a ✓��� Subdivision Lot is system 1111 cornpletae? G-y Date: _ �... is system ccarnl�lete' __ ... .._� _._ _._ Date- ,u� is $Vstem cowuucted a; per pi�' _ c... �% .. is well driilyd'? -- Y xe -,4 Date. Is well located as per P! Arc erosion control me:«sures :n place' I cettil that the system(s1, as iisted, at the 4bove preur srs has beer, cunstructed sad 1 have inspected and verified their comActt m in accordance with the issued PCHD COnl ruction Permit and approved plan: amid the Standards. Rules and Regulatiuus of tl a Putnam Ct unty Department o: Heath Date. yl dd Certified bti . , PE, RA Desie.n Yrutessional _ Address Ye Form FIR -99 spa Too, N., r �3 1 C)C)@S, wj Mr PUTNAM COUNTY DEPARTMENT ®F EAI,'I"H DI SIGN ,OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEW NT SYSTEM rt. PERMIT # i�J'' /�y� 9 ��,., -� e ��,%) /C�'P [( (b Located at Town or Village Subdivision name � � j Subd. Lot # f, Tax Map oV 7 Block / Lot 5' Date Subdivision Approved .�7 .'`w Renewal k-' Revision Owner /Applicant Name Date of Previous Approval /may'',% Mailing Address '57 :5 C�U ��� � �r�1� ,cva r//V`W "4 , ', Zip /mss Amount of Fee Enclosed 3 ® ev Building Type ;eA97e,e Lot Area • % No. of Bedrooms -I/- Design Flow GPD Yrl', a Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED J� Separate Sewerage System to consist of / 21 S'el' gall /on septic tank and ,� ;? 2 /- de Other Requirements: ' /' -y ,�5 ,-e-1 04;-11 To be constructed by D W .,9 l - Address :-1 e Water Supply: Public Supply From Address or: Private Supply Drilled by Address 4, � /1e= I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: (7` 0-,2Vj-Z// Address - APPROVED )F R CONSTRUCTION: This OF NEW iCl3 �� < R.A. Date License # P the date issued unless construction of the sewage treatment system has been completed and inspectecland is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Ap oved lWrge domestic sanitary sews a only. By: Title: wfr— Date: i co White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design P ofe sional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL ii Q .,lease print orrype .....� ... ... .. "PCH'D °PeiTliit # Well Location: Street Address: TownNillage Tax Grid # )�/ dar^Jrr • ' -e" f SY ���m /' 01l Map 7 Block j Lot(s) Well Owner: Name: Address: Use of Well: _�lResidential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought' gpm # People Served _- Est. of Daily Usage s'-vv gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling ;New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes " No Name of subdivision Lot No. 15� Water Well Contractor: /1^, Address: Is Public Water Supply available to site? .................................. ............................... Yes No P/ Name of Public Water Supply: TownNillage -- Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: r/ ... _. %%C...._ _.Applicant.Signature: 7 ,,._� - ' ___ _ PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and 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 or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue O/ tr oa Permit Issuin Official: Date of Expiration ©1 10 o Title: Permit is Non White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner /A/ Y Address Located at (Street) &ef 1;7 0 Axel 0� Tax MaP41.7 Block Lot (indicate nearest cross street) Municipality. )/.a //may Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking /4— 9 Date of Percolation test 12— . . . . .. . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . -:-: .......... ...... . I : .... Depth to Water Water From Gr' und:.' 0 Level Perc6lit"O .:i ..... Terre Xl aDse Time Surface (Inche s) :StarSto Dr o n PAtt ' ;Hole N Run i­ Start . p ne es ...... ... 2 3 id fog 3 4 2 lei 3 Ila - 4 5 ...... ....... NEW 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained -.ateach percolation. test.hole. (i.e. s I min for 1-30 min/inch, :5 2 min for 3-1-60 min/inch) All datdtd-be submitted,fou'review. -2. Depth measurements to be made, from- top of hole. Form. DD-97 PUTNAM COL]NTY DEPARTMERr .OF HEALTH.. DIVISION.OF. ENVIRONMENIAL HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEPgAGE DISPOSAL SYSTEM FILE NO. „ �.. �.,. �,. d ..R..�.,�_- ,.,,......,.,. -_ > -,= .�_ _.r. -; �, m�,..,.._ ,..:t���- �.�.�.�:- __,.,..,..��- .mot,.,...- ..,..... ,�...,�.,,�.a.,.,.,�..:,...,.._ _,::- ::•�__..._,.K�. r�.:,_..,,..-„.:._.:._-- �.... ,�..,..:.....,,.....:,,- :�,� -�. Qwner Roaing Brook Country Partners Address RR#2, Twin Farm Lane, Pound Ridge, NY Located at (Street) off:Pudding Street Sec. Block Lot -49' IT7. (indicate nearest cross street) cstz i7i UPS (c.A-J Lot 6 Municipality Putnam Valley Watershed Date of Pre- Soaking 10/3/87 Date of Percolation Test 10/3/87 24" 26" 2" 15 HOLE NUMBER CIS TIME PERCOLATION 4 :03 -4 -: 33 PERCOLATION Run Elapse Depth to Water From Water Level .15 ....... _ _ .._ ..... - - No. Tune Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 1 3:30 -400 - 30 24" 25.5" 1.5" 20 2 4:01 -4:31 30 24" - 25.5° 1.5" 20 3 4:36 -5:06 30 24" 25.5" 1.5" 20 4 5 1 3:32 -4:02 30 24" 26" 2" 15 -2- 4 :03 -4 -: 33 .:30 .-... 24!-'- - :..._. 26!.:' 2 �,�. .15 ....... _ _ .._ ..... - - 3 4:35 -5:05 30 24" 26" 2" 15 4 .. . 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 subnitted for review. ,.2... Depth measurements_to be made from top of hole. rev. 9/85 y. ENVIRONMENTAL DIVISION OF HEALTH RE: Property of LETTER OF AUTHORIZATION "-e 67a A Located at TNJ /�i �r_ q Tax Map Block �_ Lot Subdivision of - " "& 4 ij � Subdivision Lot # 45 Gentlemen: Filed Map # This letter is to authorize ✓ 0,5 -',rz� Date Filed a duly licensed Professional Engineer ' or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in __..._ ._.... conformity- -with .the provisions of Article 145 and /or-.14,7 of the- Education.Law; the Public Health Law, and the Putnam County Sanitary Code. State ;�':Z Zi p — State �!� h�� t � zip I'd S�G Telephone: T G/ N Telephone Form LA -97 A �1 •y C i� t r. E. i '5 j Rev. 10/8 A •...........Th PUTNAM COUNTY DEPARTM12ff OF HEALTH 6 Dlvisisn of Bmilrooseutol Bed& Sorvloes. Carmel. N.Y. 10512 Engineer to Provide Pefsp °n CERTQ+iCATE OF CS CONSTRUCTION PERMIT. FOR SEWAGE DISPOSAL SYSTEM Pest _ 2 Putnam Valley Roaring Brook Drive Yo" W village Lot Name oarin Brook ,La 6 MAP— Block I 43.7 9 T » Country Estates .ba On /AN. Sun NLF Limited Partnership ReO°wd —� RO`�•n o Date of Pr A., Approval 11118188 MafagAddaem 6001 North 24th Street, Phoenix, 4Z,, tip R5ni 6 11 °1_ � 18 88 $300.00 Rate Subdivision ADDroved_ - Fee Enclosed � amn„nt Single family residence .�� �� Type Let Ares Flu Section only Depth 2 Vohlme 8 8 4 Nober of B°atoonaa 4 Design Flow G P D A QQ PCHD Notification Is Required Wbm Fill is compbfted Sepurase Sewerage System to madd of 15 0 0 Gallo. Septic Trek en To be constructed by Address WOW Sgppiy: Poblic Supply From Address on X Rt$afe Supply Ddiied by _Address Otbes Reaahemeats 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate fewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an rsqu .Onf O • nam County Department of Health, and that on completion thereof a - Certificate of Construction Compliance" satisfactory to the Commissioner of Heatthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns: by the bulkier, that said builder will Place in good operating condition any part of said sewage disposal -system during the pert d of two (2) years Immediately following the date of the Issu- ance of tM approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled wall described above will be located as shown on the approved plan and that fail well will be Installed in accordance with the standards, rules and requ a�T TMns of the Putnam County Department of Health. 1 Date 912197 Signed_ 09 P.E. x :10ft Addrep2 Dale Avenue omens f: Y. 1058 license No 07 -7770 APPROVED FOR CONSTRUCTION: This approval expire$ 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 whih considered necessary nor of Health. Any change or alteration. of construction require$ a new rmit. A/pQ�r�� or disposal 01 domestic wnitary sewage�ir / etppiy- only: - - -- Date �G �i / _ By Title Pump Characteristics Pow p /Meta UW1 sohmas6le po" Mw8h SD2SA1 SD33A1 Nasepewa 1/4 1/3 Feb Load Amps 8.0 10.0 Motor Type Sbttt w gob (4 gob) R. ►.M. 1550 Phase 9 1 Vdhge 11S Nat: 60 Opaatioa lntaadtteet Tarpaatere 120 °F Aetlikat NEMA Desfgte A iasalafiea Class A Size Natst bg 14 /2" NPT 1/2- that w i* 30 bs. Power Cad 18/3, S1TW,10' std. Materials of Construction Naede Shad Leirk m" (w Nekdrk Og Motes NuAg Cw If" Pomp CWR Cost k a Shaft Steil Me4b=W Shah Soul Seel Faces: Canoes /Ceramk Son! tiodp: Ano&ed Stool Sp Shile6ss Steel w:: 8aae -N WOW ihermoplestk Upper Bearing belle Sleeve In* Lower 0004 Sho Row Bd habg Strainer /Base Plestk eaerf �s. Sidalas Steil s s 0 0 CAPACITY -U.S. G.P.M. Total Nood (foot) 4 6 8 10 12 14 16 18 20 22 24 ,GPM 1/4 NP 44 41 36 33 29 26 23 18 12 6 0 1/3 NP 47 43 43 40 37 34 30 26 22 16 10 Dimensional Data I. AN Aneseiox in iaahes '3-1/2 &7/8 —►{ :. Canpoomrt oas. - , 4-12 wary i I/f inch {� 3. Not Ierr condtudw purpose 1-1n NPT U01VA "W 3 -1n 4. Moslem and wei ft are oppran4twte — 5. 00off level Amble 6. We reserve the right to 3-1n mdse rovisi n to our I 4 -1/2 products W their sperifitotions without notice I—� 5.3/4" ------ 11 -ve 1x1(8 7 -7/8 PUMP DISCHARGE ON HEIGHT 3.318 3 PUMP OFF AURORA /HYDRO TIC, Pumps, Inc. 1840 Bantisy Road, Ashland, Ohio 44803 (419) 289-3042 ��G NM(lf CEP-r--:=!E�7r CF EE:--r':::- EE.1—T= SUP= --r=vIcarz 60 Z= C- :: =- =_ -i n C, z L,-NG t C C C E' 7- S ps A-97-1 tizn t PI•ns - C Iza=C71 -CC !F- , i I per �c = Dom= l Perc cz. ECUSS P A var C-= NEFII —7. C:l ca C--S- T'El= CN Lf; & D cr tic Ttr we l! cr--:a -L L:: C-.-,Er NLC t a ra�=) ces, �n er.= and -T-wc-Fcct C:2:" , P CE Cr-2-M. EX= S;Cn & D B c x 5z la 04 L 4 Pz==ea Pit Ecuse - Nc. cf 2 0 C-= Ptc=cs ch 1c=) W/ No 45 F4 =IAA c 20' to Walls loo, tz ro�l; 2001 in D.L-C.D, c. 6=r 100, t--. st---eam, jaca =C. 3-'t= 10' 50, t2 WaLl ;jaLl tz: =r Mcr- AIM I Lf; & D cr tic Ttr we l! cr--:a -L L:: C-.-,Er NLC t a ra�=) ces, �n er.= and -T-wc-Fcct C:2:" , P CE Cr-2-M. EX= S;Cn & D B c x 5z la 04 L 4 Pz==ea Pit Ecuse - Nc. cf 2 0 C-= Ptc=cs ch 1c=) W/ No 45 F4 =IAA c 20' to Walls loo, tz ro�l; 2001 in D.L-C.D, c. 6=r 100, t--. st---eam, jaca =C. 3-'t= 10' 50, t2 WaLl ;jaLl tz: =r 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 February 8, 1988 Mr. Howard A. Kelly, P.E. 37 Fair Street Carmel, New York 10512 Re: Roaring Brook Country Estates Application Fee Dear Mr. Kelly: I am returning your check in the amount of.$600.00 for the individual applications in Roaring. Brook Country Estates as the fee was paid for the Realty Subdivision. (See attached copy.of receipt). Very truly yours _ � Christine Johnson R File M 96"Putnam County Savings Bank Route 6 & Drewville Rd. Brewster, N.Y. 10509 ENID L. CARRUTH, M.P.H. Public Health Director JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL Jr., P.E. Director N° 59910 II °000 599 1011° 1o0 2 190 2 3 5 2im 78"I 1 101 1 211° 50 -235 219 PAY �: t "t'� L.c• :,:.I�1'� 'I( Il Illplli I! I hu III IiiUfl Jl'f l ,, {fI„I, I lluf I l!' f 11 w U cr W TO THE : ORDER OF Putln= County .Department of Health DATE Feb. 19 1989 :1 k A\ a i /�/� M 600. W BANK OF NEW YORK COUNTY TRUST REGION \REWSTER, N.Y. 10509 Roiarin. Brock — Kressner II °000 599 1011° 1o0 2 190 2 3 5 2im 78"I 1 101 1 211° PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF, ENVIRONMENTAL HEALTH_.._SERVIC-ES:.._; ..� Date Re: Property of Roaring Brook. Country Partners Located at off Pudding Street (T) Putnam Valley Section 5 Block .1 Lot Subdivision of - roaring Brook Country Estates Subdv. Lot # 6 Filed Map # 21-56-5 Date z'3 63 A Gentlemen: This letter is to authorize Howard A, Kelly a duly licensed professional engineer X or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with,.this matter and- to - super.yise ,the c.ons_t.rucfi_'on' 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. Countersigned P.E., R.A., # 37 Fair Street Address Carmel, New York 10512 914 - 225 -7221 Telephone Very truly yours C. Signed 4 ' rv"f Owner of roperty ddregs ox PQ C, ,a Town ��I(o Telephone rg DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PrWn PRRMTT $ / v l > -/ WELL LOCATION Street Address off Pudding Street Town/Village/City Tax Putnam Valley, NY Grid Number Lot 6 WELL OWNER Name Mailing Addres�0_y4L r,1141 p4 u.( t OPrivate Roaring Brook Country Partners RR #2 Twin ,Fawm La. , -]w 0 Public USE OF WELL 1 - primary 2 - secondary JMRESIDENTIAL ®PUBLIC SUPPLY QAIR /COND /HEAT PUMP 0 BUSINESS O FARM p TEST /OBSERVATION 0 INDUSTRIAL 0 INSTITUTIONAL O STAND -BY C7 ABANDONED ❑ OTHER (specify AMOUNT OF USE YIELD SOUGHT 5 gpm /# PFOPLE SERVED 5 /EST. OF DAILY USAGE 800 gal REASON FOR DRILLING QNEW SUPPLY O REPLACE EXISTING O PROVIDE ADDITIONAL SUPPLY SUPPLY 0 DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING New Residence WELL TYPE ®DRILLED ❑DRIVEN []DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Roaring Brook Country Estates Lot No. 6 WATER-WELL CONTRACTOR: Name PF Beal & Sons Address: Brewster, ,NY IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY " DISTANCE tO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS,APPLICATION []ON r (date) S ET 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. 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 t e Pu nam County Health Depart nt. Date of-Issue: 19 Date of Expiration: 19 er 1t Istuing Official Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Cramp mT)v' wal 1 n­; 1 1 ear all a d f Y N � r d . W '.ti �• 11 « No: 101��q�80�/t jC•O• 81�Yb1" SZ.O. («i��i9� Q. o. ,:.•:., SvJtTUI Fo4 i.J.TtJ rot W C.JC, r I fr •- 9,�4« Ex7.is.SD0-tt. . « 2 0 4,' O At4 t��.J 4 IZ, '+j Pt�S �' . I M �7 1 In in v� o 3 1 1 M w t<�45. K�TC4i,E,.1 ?r O o i �' w���a� f o 0 3 I I 1 � 1 r !� t�q. M•IT. EvER�k `I' I;C4CfJC l � IN O t I/'� 1.[4S �'o %y 7 I kVOSot 1 'yStl - ~RIoJC .JT. =N iTst31.24 W'tili1S i0'�o t; 'Pl8iA6T,CbA isE 1+ 'f1WCT 414sr. u tC.�...ly �iY SS�nR 1 • I IS I . ! awv.Ce w�►t� 1 tA 1 L%%j%4(n QP) UP ' FOYfm 'rj►•Jlnl&Q- T -4 t 4o SMJ�Tt.I V*04, ExT: S✓ Z — ;�o hoo4toMJj Tl 0 V- 4" ,r PUTNAM COUNTY DEPARTMENT OF HEALTH QQ brook C ova f "r � --r1 to S HOUSE PLANS APB ROVED FOR 1�OA,P /lU(r /�,Q ©vNTR �sf� C : BEDROOM COUNT ,�NLY; OFF f'oay- /-/ _ J �1�-O f " �co r �a All DRaor�s I y � /S6 S%% 6 ctL A Floor) gnature & Tip e � I s •f �kr f 1 �• 11 « No: S!�1��� {y4•�F ,:.•:., zr .. III It ^fK zr .. PUTNAMCOUNTYDEPARTMENTOFHEALTH Romr;,13 6rooK :.:: //rr HOU E ; 1.AN5 APPROVED FOR figex/ �,r aak` Cmxlx,� ZsZ BEDROOM COUJVT. ONLY;: OFF%�UvAiiUG St -/ /pkI, - sup. Z, Cove -'r y Es�'ateS . ; Flo 0 f"r 14 f] 3 gri tiir I Ti 1e' e iC 7.;Cv 3 0 r' d a i 1•• nt` .I III It p seti:. mgrs r f ►' �e -4" ,,,L °,.dye" _ -1 1 _p., is z JAT Z gg M 1 Lon:.1 �ARN1•e9 1 1 , T 1 41 49 I _ I 1 .e► � N1 STQ t��Q N9 W�u 1 0 wo 1 j -ry $ D R 1✓i -A 1 I lot 1 ! w q'e O 11� -4" 11'•ala © ,9e -,u c PUTNAMCOUNTYDEPARTMENTOFHEALTH Romr;,13 6rooK :.:: //rr HOU E ; 1.AN5 APPROVED FOR figex/ �,r aak` Cmxlx,� ZsZ BEDROOM COUJVT. ONLY;: OFF%�UvAiiUG St -/ /pkI, - sup. Z, Cove -'r y Es�'ateS . ; Flo 0 f"r 14 f] 3 gri tiir I Ti 1e' e iC 7.;Cv 3 0 r' d a i 1•• nt` .I DEPARTMENT OF HEALTH`" Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 76130 = 'AP-PLICATION -T0 -CONSTRUCT -A- WATER WELL ` PCHD PERMIT 4 /r✓ -,( �7�! WELL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name Mailing Address CkPrivate O Public USE OF WELL 1 - primary 2- secondary ® RESIDENTIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O BUSINESS O FARM O TEST /OBSERVATION 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT 14_gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE_8j _gaj. REASON FOR DRILLING O REPLACE EXISTING SUPPLY NEW SUPPLY NEW DWELLING O TEST /OBSERVATION 12. ADDITIONAL SUPPLY C] DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING residence, public water supply not avaiiabte WELL TYPE DRILLED DRIVEN ODUG GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES _X _NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Rnari ng Rronk C'nnntrY F....t: -as Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO..PROPERTY.FROM NEAREST WATER.MAIN.: - A LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED NA O ON SEPARATE SHEET (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 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 operation contained on this property and in such a manner as not to degrade or otherwise contam groundwater. Date of Issue: �G%�G%' 19� 1 Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller P a PC -1 n. ''`'APPLICATION FOR APPROVAL PUTNAM COUNTY DEPARTMENT OF HEAETH OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: Sun NIX Limited 6001 North 24th Street, Suite A Phoenix, AZ 85016 2. Name of Project: Roaring Brook Country Estates3. Location T /Vft Putnam Valley 4. Project Engineer: Donald Knapp, P.E. 5. Address: 2 Dale Avenue Somers, N.Y. 10589 License Number: o7277n Phone: (914)'242.7726 6. Type of Project: _x Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (Check One) Type I.. Exempt x Type II. Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. b1n 9. Has DEIS been completed and found acceptable by Lead Agency? ........... NA 10. Name of Lead Agency NA 11:� _is- thi.s:..�prg .ect. i n. an area -up o.r. ";:the; control ' pf l4.ca_ planning, zoning, _ _ ...__........_ ...... _�.e.. or other officials, ordinances? .......... ............................... Yes 12. If so, have plans been submitted to such authorities? .................. No 13. Has preliminary approval been granted by such authorities? Date Granted: 14. Type of Sewage Disposal System Discharge...... Surface Water x Ground Waters 15. If surface water discharge., what is the stream class designation ?........ 16. Waters index. number (surface) ........... ............................... 17. Is project located near a public water supply system? .................. No 18. If yes, name of water supply Distance to water supply 19. Is project site near a public sewage collection or disposal system ?..... No 20. Name of sewage system Distance to sewage system 21. Date test holes observed: 11118188 22. Name of Health Inspector: NA 23. Project design flow (gallons per day) ....... ............................... 800 11/93 0 n °' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 912197 Re: Property of SUN NIT Limited Partnership, a Delaware limited partnership Located at Roaring Brook Drive, Punham Valley, N.Y. (T)Putnam Valley Section 41,7 Block 1 Lot 9 Subdivision of Roaring Brook Country Estates , Subdv. Lot # 6 Filed Map # 2363 A Date 11/18/88 Gentlemen: This letter is to authorize Donald Knapp, P.E. a duly licensed professional engineer X or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system'or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. SUN By:_ Very truly yours, limited partnership Countersigned : SunChase Land Fund, Inc. Managing Ge eral Partner of P.E. , MKXA . , # 072770 Sun Partners, General Partner 4ddTL,-_ss- 6001 North 24th Street, Suite A 2 Dale Avenue Phoenix, Arizona 85016 Address Town Somers, New York 10589 (914) 248 -7726 Telephone 602- 468 -1090 Telephone