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HomeMy WebLinkAbout2407DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 42.-3-32 BOX 21 02407 .'� r P r `� 1-LJ A ,1 �% I 14 02407 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 -, 6014 Fax (845) 278 - 6648 September 9, 2004 Raimondo 947 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Addition — Raimondo, Peekskill Hollow Rd. No Increase in Number of Bedrooms (T) Putnam Valley, TM #42. -3 -34 Dear Mr. & Mrs!, Raimondo: 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 from this Department dated September 8, 2004. The addition is approved with the following conditions. 1. The total number of bedrooms 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. An ermits or variances required are the responsibility of the applicant and the jurisdiction Any permits �, q P tY PP J of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. i Sincerely, Michael Luke ML:lm Public Health Sanitarian cc: BI (T) Putnam Valley BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 1 Geneva Road Brewster, New York 10509 Q Environmental Health (845)278-6130 Fax (845) 278 - 7921 ' a 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 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET -f'7 9 " - le-'k -It, �/ j,Q 1U TOWN 4 0,g al TX MAPS Y� - 3- NAME !o f 441/`:ll PHONE , j',T - 5%6 `.��63 PCHD>r o? Y - f6u il?o/! MAILI\TGADDRESS DESCRIPTION OF ADDITION � ,ferd, S6,1 26•r it r G&- A6,1011Ah -vti NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS -3 (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 submit this 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. Sketches of existing floor plan (drawn to scale, all living area including basement) 'Non- professional sketches are acceptable. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map) *Non- professional sketches are acceptable. 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. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhotueo tdelines a r 4 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New. York 10509 t Environmental Health (845)278-600 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845)278 - 6648 Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 ROBERT J. BONDI Couryty Executive Re: Ro"i 61 bfj 0 Residence Tax Mpu�nctw 42.— 3— -3 q Town V A 11 e To Whom It May Concern: 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: 2 Building Inspector houseguidelines SITE " U 11 1k01 R -ge -9/v PHONE TKO PERSON INTERVIEWED PCHD Complaint Dame & Relationship (i.e, owner,tenant, etc,) DATE 14 4 TYPE FACILITY PROPOSED INSTALLER S, 6' 2 PHONE Pro (include sketch locating all adjacent wells). MM: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Proposal appro 1 Title Jj-2L?-C Date Proposal approved with the following conditions. 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing. a. Omer ° s name. b. Site Street Name, Town and Tax Map number. c, location of installed components tied to two fixed points (eog.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 61 diam. x 61 deep drywells surrounded by one foot + gravel). e. Installer °s name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or r rted agent-of-owner agree to the above conditions. 3IGNATURE TITLE DATE, 'IES. Tit be MD); YeUcra ( ED; Pink (Ag cmnt.) DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster,' New York 10509 (914) 278 -6130 May 7, 1996 Mr. & Mrs. David Anderson 980 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Addition - Dear Mr. & Mrs. Anderson: BRUCE R. FOLEY, R.S. Acting Public Health Director 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 latest revision date of May 8, 1996 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: 1. The total. number;of bedrooms must remain at five 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. 4. The addition of 150 linear feet of absorption trench to the existing septic system. 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. Sin erely, hga Row Robert Morris, P. E. Public Health Engineer RM /jp cc: BI (T) Putnam Valley BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services - 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 f ADDITION APPLICATION - (RESIDE/NTIAL ONLY STREET: Pef jc k, 11 �1Q�� � TOWN PO tt') Ui1 Y -TX MAP # NAME:iI.V 4 Mybed PHONE 5_)6-35_6(o PCHD PERMIT # ------- �' MAILING ADDRESS 90 0 Pefj�5jq jgc� k3 • I pJN4� (411ey ®"' !. /o��� . Description of Addition Ar` "'i t 16'r �/�r�i�i Number of existing bedrooms 3 -Proposed number of bedrooms 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 submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT, 4 GENEVA ROAD, BREWSTER, NY 10509, Phone 278 -6130 with the following information. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non- professional drawing is acceptable. 3. Sketch of proposed floor plan. Non professional drawing is acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. OFFICE USE Comments and /or conditions application August 1995 Yorktown Medical iLaboratory, Inca 321 Kear Street Yorktown Heights; N. Y. 10598 (914) 245 =2800 Director: Albert H. Padovani M. T. (ASCP) l L At 32/ ABORATORY REPORT /Yy J ON THE QUALITY OF W INORGANIC NON- METALS mg /L- i Acidity _ Alkalinity _ Chloride _Detergents, MBAS Hardness, Total Nitrogen, Ammonia Nitrogen, Nitrate Phosphate, Total _ Sulfate _ Sulfide Sulfite METALS (mg /L) Copper _ Iron Total Coliform Index Lead _ Manganese _ Mercury _ Sodium Zinc j LAB # '. '32.02;: : :4V I4 ,Date Taken: 9 JV Time: ,Date Rc' d : c:— Time Date Reported: OCT. 021989 Collected By: ble, .BAUD JaAJ Referred By: Sample Location: Phone(�S'— �S Phone # I Sample. Type- Repeat Test? _,Z (check each) MICROBIOLOGICAL CFU 7100mL GENERAL BACTERIA _ Standard Plate Count (CFU /1.0mL) MEMBRANE FILTRATION TECHNIQUE ATotal Coliform Fecal Coliform _ Fecal Streptococcus MOST PROBABLE NUMBER TECHNIQUE MISCELLANEOUS _ pH (units) _ Color (units) Odor (TON) Turbidity ( NTU) _ ✓Potable _ Non - potable STP INF _ STP EFF Other: Sample Status: (check each) Outgoing _ HNO3 HC1 _ H2SO4 _ NaOH ZnCAc _. Na2S203 _ Other: _ Fecal Coliform Index Incoming A..,-LE 4 °C KEY FOR TERMINOLOGY '` ' ' CFU = Colony Forming °Units_,• ._ GT 4 °C CON = Confluent .(q v ' TNTC) = PH LE 2 LT = C = Less Than _ pH GE 9 GT = > = Greater >Thah� pH GE 12 N/A = Not Applicable .' _ Other S/A = See Attached ` TNTC= Too Numerous To', Count REMARKS M /COMMENTS (Fo•r Lab. Use) ELAP No. 10323 THESE RESULTS INDICATE THAT THE WATER SAMPLE (Was) (Wasn't) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH NEW ORK STATE PUBLIC DRINKING WATER CODES, FOR THE PARAMETERS TESTED,�AT THE TIME OF SAMPLE CO CTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Didn't) (N /A MEET THE SATISFACTORY CHEMICAL.QUALITY STANDARDS OF THE NEW YORK PUBLIC DRIN NG WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF SAMPLE COLLEC x - 2/86(Rvsd7/87•)RV' Albert H. Padovan i M.T. ASCP Director ,' /�' *k• 'lt; /ji WILL UULvLrLL 11.ULN r�ZrUAI Office Use Only a, •G DEPARTMENT OF HEALTH Division Of Environmental Health Services 0 PUTNAM COUNTY DEPARTMENT OF HEALTH ST VZ "T AO ESS WN /VIL (Y TAX GRID NUMBER: WELL LOCATION {. e ADDRESS: PRIVATE WELL OWNER o PueLlc USE OF WELL 1 - primary 2 - secondary 1WRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT J� gpm. /N0. PEOPLE SERVED EST. OF DAILY USAGE y gal. REASON FOR DRILLING it NEW SUPPLY, ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA ` WELL DEPTH 360 ' ft. STATIC WATER LEVELS ft. DATE MEASURED 3 1&2 DRILLING EQUIPMENT 19 ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. J2 OPEN. HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH . a I ft. MATERIALS: ;3 STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE �7 eft. JOINTS: ❑ WELDED JB�THREADED ❑ OTHER DIAMETER �"__ in SEAL: ❑ CEMENT GROUT ❑ BENTONITE OTHER WEIGHT PER FOOT % Ib.lft. I DRIVE SHOE.-�OYES ❑ NO I LINER: ❑ YES .UNO SCREEN DIAMETER (in) SL07 SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? DETAILS FIRST ❑ YES ONO HOURS SECOND GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping M HOD: O PUMPED 1 tests were done is in- COMPRESSED AIR , formation attached? O BAILED O OTHER ; ❑ YES ❑ NO tions or sieve anal ses WELL LOG are available, please attach. p Y DEPTH FROM SURFACE Water Bear- Ing Well Oia- meter FORMATION DESCRIPTION CODE, ft. tt. WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Surface WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE CAPACITY G PUMP INFOR TION - rr/ TYPE APACITY V MAKER DEPTH [fDEL �.1~/7� / 3 VOLTAGEZ3-0 HP •�. WELL DRILLF�t NAME 0 AODRES, .. SiGfTATURE 1 P JOEL LAWRENCE CRanner RG LIEUTEQ OIL UG°�QII�SE�UM Architect •Town Planner Two Muscoot North • RFD #2 MAHOPAC, NEW i YQRK 10541 (914) 628.6613 • FAX'(914) 628.2807 DATE ' °B " ° Town Planner • Putnam Valley, MY 10/30/89 (914) 526 -3740 TO BILL HEDGES PUTNAM COUNTY HEALTH DEPARTMENT OLD ROUTE 6 CARMEL, N.Y. 10512 > WE ARE SENDING YOU C* Attached ❑ Under separate cover via the following items: ❑ Shop drawings CX Prints ❑ Plans ❑ Samples ❑ Specifications KI Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION i THESE ARE TRANSMITTED as checked ��10 -86 -351 ATTENTION RE: DAVID ANDERSON PEEKSKILL HOLLOW ROAD PUTNAM VALLEY,..N.Y. 10579 TM 18 -4 -3 P.C.H.D PERMIT # PV -57 -87 For your use > WE ARE SENDING YOU C* Attached ❑ Under separate cover via the following items: ❑ Shop drawings CX Prints ❑ Plans ❑ Samples ❑ Specifications KI Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION i THESE ARE TRANSMITTED as checked below: KI For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 0 PRINTS RETURNED AFTER LOAN TO US REMARKS ENCLOSED PLEASE:FIND AS BUILT DRAWINGS FOR FINAL APPROVAL. i is i 1 PERMIT Q I. II �v J C tip_ V. VI. Ins p--- TM a OR Su'BDIVISION LOT 4 i YES NO a-WAGE DISPOSAL AREA a. SDS area located as per approved plans b. Fill section - Date of placement 2:1 barrier. LGTH W-= AVG.DPTH c. Natural soil not stri d. Stone, brush, etc., grs- ter than 15' fran SDS area. e. 100 ft. fran water course /wetlands. { S5-rE DILPC§AL SYSTEM a. Septic "ze - 11000 1,250 b. Septic tank installed level I c. 10 °_,minimum from foundation d. 'No 90° bends, cleanout within 10 ft. of 45° be-rid { e. DISTRIBUTION BOX 1. All outlets at same elevation - water tested I I 2. Protected below frost I 3. Minimum 2 ft. oricinal soil bet-wem box and tren(±ies I I I f. JUNCTION BOX - vrocerly set I I .9- EzFnZEE . 1. L,—n required - Len th installed to& { 2. Distance to water-course 3. Installed according to plan 4. Distance cent_- to ce_*iter I I 5. Slone of trenc� accentrble 1/16 - 1/32 "/foot. I I 6. 10 feet from prcop tv line - 20 feet. - four..,HPticrs f I I 7. D-mth of trench < 30 incries fran sJr"ace 8. Room al-1 awed for er.,arsion, c 9. Size of gravel 3/4 - 11" diameter I I I 10. Depth of aravel in trench 12" mi ninnnr+ I L. • Pire ends capped h. PUMP CR DOSE SYSTEMS 1. Size of pug chance -r �I { 2. Overflow tank I I 9 Alain; visual-/audio I . 4. Pump easily accessible iranhole to grade First box baffled 6. Cvc1e witnessed by Health Demp--unent I I I estimated flow r cycle I I f HOUSE I a. Eduse located per approved plans. I b. Number of bedreans { a. Well located as per approved plans b. Distance from SDS area mp-a-sure3 ft. c. Casing 18" above grade. d. Surface drainage around well accepta=ble. OVER AIL WCRKMASHIP a. Boxes properly grouted I b. All p ipes r�art.ially bac filled c. All pipes flush with inside of box d. Bar -kfill material contains stones < 4" in diameter e. O=tain drain installed according to plan f. Curtain drain outfall protected & d.ir. to exi stwatercours� { � g. Footinq drains discharcre away from SDS area I h. Surface water Prot_ -ction adenuate i. .Eirosion c--ntro vrovi.de....,' on sloces greater than 15 %. i PUTNAM COUNTY DEPARTMII T OF HEALTH DIVISION OF ENVIRO'i' I rAL ' HEALTH SERVICES DAVID ANDERSON 18 4 3 Owner or Purchaser'of Building Section Block Lot DAVID ANDERSON Building Constructed by PEEKSKILL HOLLOW ROAD Location - Street Subdivision Name TOWN OF PUTNAM VALLEY Municipality I Subdivision Lot # ONE FAMILY RESIDENCE Building Type GUARANTEE OF SUBSURFACE SEVQAGE DISPOSAL SYSTEM I represent, that I am whc-rl-ly= -a-rr Lple_tely 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 of Construction Compliance" for the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful for negligent act of the occupant of the building utilizing the System .Y u�r'((., it,•, "� n- r.' >rs�n.- ;t � �r •. ,� /C�'. {' /iriyL' 7' L1l L:L - i �_ �'rl_ �/ /� ti I .I i.(i it .i i V1�: t✓ -, i 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 building utilizing the system. Dated this y ( day of :y`' 19 U Signature Title General Contractor ;(Owner) - Signature Corporation Name (if Corp.) 195 CHASE AVENUE Address YONKERS, NEW YORK 10703 rev. 9/85 mk Co poration Name U1 Corp.) - v- . #.(.(( r2�P ��fe 6S') Address d1J V vn I:'aclmowledge this Field Activity Report. SIGNATURE° TITLE-. TELEPHONE-. PL TNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIROAL HEALTH SERVICES :, °._JOhn -M .Simmons,, M.D. bepuhy "Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAM '� /' S ,,1 Orig. Routine A�attl AAL _ Orig. Complain AD13RESS , (1,J Orig. Request No. Street Town TH Noe Compliance Complaint Comp MAILIM ADDRESS Final P.0. Box Post Office Zip Code Group Illness Construction 1 Reinspection PERSQN IN CHARGE «- Field,, Sampling Only OR INTERVIENED L` A� eaA Field Conference Dame and Title Other DATE F "� TYPE FACILITY TIME ARRIVED J TIME LEFT J � < y� Explain 1i / V/ A r rr— i d1J V vn I:'aclmowledge this Field Activity Report. SIGNATURE° TITLE-. TELEPHONE-. 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 May 20, 1988 Mr. Joel Greenberg RR #8 Muscoot North Baldwin Place Road Mahopac, New York 10541 Dear Mr. Greenberg: ENID L. CARRUTH, M.P.H. Public Health Director JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL Jr., P.E. Director 4Q t4T 0"j Re: Proposed SSDS - n (Peekskill Hollow Road (T) Putnam Valley TM #18 -4 -3 Review of plans and other supporting documents submitted at this time relative "to the above - captioned project has been completed. Comments are offered as follows: 1) A revised construction permit must be submitted to indicate a pump system. 2) StandpiPes should be on tank side of curtain drain. Upon receipt of a submission, revised',to reflect the above comments, this application will be considered further. Very truly yours, Lawrence C. Werper Assistant Public Health Engineer LCW:jz TO tl@96b bPl00 YCb93Qlb �0 \bb1967b0 \qA Architect o Town Planner Muscoot North o RFD #2 Box 488 MAHOPAC, NEW YORK 10541 (914) 628 -6613 (914) 526 -3740 Town Planner o Putnam Valley, NY WE ARE SENDING YOU Attached ❑ Under separate cover via_ ❑ Shop drawings 12- _Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ LrE TTIE[B OF I � DATE J /J / V6 `y JOB NO. ATTENTION i 1 41 . v 't r . )A. R �l 7 G the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted • For your use ❑ Approved as noted • As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ REMARKS COPY TO PRODUCE 240.2 Inc, Gmtm, man ow ❑ Resubmit copies for approval • Submit copies for distribution • Return corrected prints RETURNED AFTER LOAN TO .1" i &Zu PUTNAM•COUNTY DEPARTMENT, OF HEALTH r COMPLAINT OR SERVICE REQUEST RECORD TOWN L DATE 0 - -Pp REFERRED TO TAKEN BY ia'' TELEPHONE CALL IN PERSON_ LETTER �J CONFIDENTIAL _ 1 REQUEST FROM �' h�Ea S TELEPHONE��'� Z� ADDRESS ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public ate ood Service Migrant Camp Other / (, i c .� ,, � ' • � _ , , l i� fir% 1 L ACTION • �� FOLLOW UP INSPECTION (s), DATE A - 16 ` P3 E DATE PROBLEM ABA DATE v PERSON NOTIFIED �I /ETIMATED TOTAL MAN HOURS SPENT e, PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 June 21, 1988 CERTIFIED MAIL RETURN RECEIPT REQUESTED Cherry Pickers Inc. P.O. Box 424 Yonkers, New York 10710 Rusty, ENID L. CARRUTH, M.P.H. Public Health Director JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL Jr., P.E. Director Re: Anderson Oil Spill Peekskill Hollow.Rd, PV, TM #18 -4 -3 D.E.C. Spill No. 88 02205 PCHD No. 347 -88 As stated in telephone conversation held 13 and 20 June 88, as the. party responsible for spilling petroleum products at the subject site, Cherry Pickers must remove and appropriately dispose of all oil contam- inated soil and debris at a licensed disposal facility. Any off -site transport of contaminated material must be performed by a licensed hauler. Enclosed is the requested waste hauler inventory provided by the D.E.C. Please notify the writer at least one day in advance to allow for on -site inspection to verify the adequacy of contaminated material removal at the time of removal. Expediency in contaminated material re- moval is necessary to prevent its spread and possible contamination of ground water. It is expected that this material will be removed no later than 1 July 88. If there are any questions please contact the writer at ext. 321. Very truly yours, mes S. Hodgen Assistant Public Health Engineer JSH /jz Enclosure: Waste Hauler Inventory cc: w/o Enclosure: John O'Mara - DEC NP File V C ° The Reporter Dispatch 11 FAIR STREET Westchester Rockland Newspapers CARMEL, N. Y. 10512 (914) 225 -5503 June 15, 1988 John Karell;'Director Putnam County Department 110 Old Route 6 Center Carmel, New York 10512 Dear Mr. Karell: of Environmental Health Under the provisions of the New York.Freedom of Information Law, Article, 6 of the Public Officers Law, I am hereby requesting department records regarding an inspection of a crane accident in Putnam Valley. Building Inspector Marvin O'Dell said fuel leaking from the toppled crane may have an environmental impact. The site is on Peekskill Hollow Road, north of Seifert Lane, at the David Anderson residence. A Mr. Jay Hodgens from your department told me Tuesday that I would have to,file a Freedom of Information request. As you know, the FOI law requires a public agency to respond to a request within five days of receipt. I would appreciate hear- ing from you -as soon as possible. Sincerely, S veLali, r Staff Writer r 40J 4 [A o+ A GAMIEf •wa�nawrsum WMR1 NIf00M f1y. llf 11 R 1� � p� 4V%R&O. dreanuoavoaQse a71nr =lvomnu Architect o Town Planner Muscoot North o RFD #2 Box 488 MAHOPAC, NEW YORK 10541 (914) 628 -6613 (914) 526 -3740 Town Planner oo Putnarrn Valley, NAY TO 4 WE ARE SENDING YOU Njj Attached ❑ Under separate cover via • Shop drawings ❑ Prints • Copy of letter ❑ Change order LLETTIEQ @[F QQU1�t1W DATE `^� w JOB NO. ATTENTION `" RE: ,/j / e y/.f� Vo . ` I i/ i the following items: COPIES I DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ Fo view and comment ❑ FORBIDSDUE 19 REMARKS /'i41 rf _ ') i '._ �14l !Jfi" COPY PRODUCT 20.2 es Inc, WK Mm 01071. • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS` ETURNEEDD AFTER LOAN LOAN TO US SIGNED: N It enclosures are not as noted, kindly notify us at once. DAY,PHONES NIGHT PHONES 914 965 -0470 914 779 -8565 914 965 -0440 914 476 -7950 0 212 562 -8677 '"'63� §SC ; TRUCK CRANES - HYDRAULIC CRANES - HYDRAULIC TRUCK CRANES - CONCRETE PUMPS P.O. BOX 424, YONKERS, NEW YORK 10710 July 22, 1988 Dept. of Health Division of Environmental Health Services 110 Old Route Six Center. Carmel; New York 10512 Att: ;James S. Hodgens Re: Anderson Oil Spill Peekskill Hollow Rd. P . V . , TM X618 -4 -3 D.E.C. Spill No. 88 02295 PC 4D No. 347 -88 Dear James: In,response to your letter dated June 21, 1988. Enclosed please ;find a copy of the receipt from Chemical Pollution Control Inc., for the contaminated material. When Chemical Pollution Control Inc. actually disposes of the material, they will send me a receipt of disposition. When I . receive the receipt I will forward it to you immediately. Very truly yours, CHE YPICKERS, IN . Georg, "Rusty" Meinel Vice President GM/ kp Enc. Certified Mail - R.R.R. For A Saferr EwpAronm.epag Permit 0 EPA- NY0062765429 120 SOUTH FOURTH STREET N.Y. D.E.C. IA -042 BAY SHORE, N.Y. 11706 N.J. D.E.P. 5371AL (516) 3M4333 Conn. D.E.P. CTHW 163 Mass. 159 r` �, i ► �-�� Date: % B �J � Q f_ Sd iJ fM i IL Jt 1 UFR !�� • Customer P.O. v: _- Q �j �) IV ' 0-7/6 Manifest 0, L -1 Terms: Net _,Days TERMS ARID CONDITION& MET 30 DAYS Interest will be charged at the rate of I'i, % por month on past . due accounts. In the event of any default on poynient you shall - ._ Driver: be liable for reasonable attorney lees and cost of collection. QUANTITY REMOVAL A DISPOSAL: DESCRIPTION AMOUNT 3 q l. cii Ev s Jb° CcAI7 a p N � Pd //'j (2 h --V c, V / j WC. REFERENCE DATE A,%1OUNT DISCOUNT DEDUCT REMARKS NET AMOUNT �d Alo. 3 -o 41 ,e TOTALS CHERRYPICKERS, INC. - 1015-SAW MILL RIVER -ROAD- YONKERS, N.Y. 10710 _moo Scarsdale National - - - - - - s�M� 0003543 rt W Tf" Ca�mq . smwd4 MY wo 50.10191219 DATE CHECK NO. AMOUNT 7/1 S/rf 3_5 Va PAY� ORTHE • ORDER OF • ' SUM .� •6 �jo 11800 3 54 3u'- 1:0 2 L9 1,049 51: u' 3 11 6000 300 Sun .4b DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y, 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT WELL, LOCATION Street Address Town /Village /City Tax Grid Number PEEKSKILL HOLLOW RD. PUTMAN VALLEY 18 -4 -3 OWNER Name Address :IPrivate .WELL DAVID ANDERSON 195 CHASE AVE ,Y0ffj-<ERS , NEW .YORK O Public OF WELL. ® RESIDENTIAL ® PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED primary ® BUSINESS 0 FARM ❑ TEST /OBSERVATION ❑ OTHER (specify, - secondary ® INDUSTRIAL 0 INSTITUTIONAL ❑ STAND -BY AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE 300 gal REASON FOR 11NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ❑TEST /OBSERVATION DRILLING OREPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL DETAILED REASON FOR NEW RESIDENCE DRILLING WELL TYPE DRILLED ®DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES XX x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name N. ANDERSON Address: BARGER ST, ,PUT "VA7.,N� IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES XXX NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 7/20/1987[-] ON REAR OF THIS APPLICATION N PA (date) ( ,ignat PERMIT ` TO CONSTRUCT A WATER WEL2 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 prov' ed by the Putnam County Health Department. Date of Issue: 0 19 fJ 1 Date of Expiration: 196g Permit Issuing Official Permit is Non - Transferrable .. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 1h, )Lo Re: Property of DAVID ANDERSON Located''at PEEKSKILL HOLLOW ROAD (T). PUTNAM VALLEY Section 18 Block 4 Lot 3 Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize JOEL L. GREENBERG a duly licensed professional engineer, or registered architect XX (Indicate to apply for Ia 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 iu 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, Public Health Law, and the Putnam County Sani- tary Code. `'� Sy tW E Very , truly yours, Counter igr�c��i' ��Iq � / 0. P NE.. P. E. , (R. A. �/ ' 11056``-z__ MUSCOOT NORTH, RFD #2,BK 488 Address MAHOPAC, NEW YORK 10541 628 -6613 Telephone � iSigned , I/ Owner of Property 195 CHASE AVENUE Address YONKERS, NEW YORK 10703 Town 965 -2586 Telephone PETER C. ALEXANDERSON County Executive r JOHN SIMMONS, M.D. Deputy Commissioner DEPARTMENT OF HEALTH JOHN KARELL. Jr., P.E. Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 September 16, 1987 Mr. Joel Greenburg Muscoot North, RD #2, Box 488 Mahopac, NY 10541 Re: Proposed SSDS Anderson Dear Mr. Greenburg• Peekskill Hollow Road (T) Putnam Valley, TM 18 -4 -3 Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. Comments transmitted on August 21, 1987 (see attached). 2. During field inspection by this writer on September 14, 1987, ground water was recorded at 1 foot and 4 feet in deep hole 1 and 2 respectively. 3. The above captioned application for an SSDS was received by this office on July 29, 1987 and field inspections were conducted on June 8, 1987, August 3, 1987 and September 14, 1987. No attempts have been made to escavate the test holes deeper, nor were revisions proposed addressing the problem of shallow test holes. In regard to your comments, the deep test holes have filled with sediment. It is acknowledged by this Department that deep test pits have a tendency to fill in after a period of time. But, if the deep test holes are dug a substantial period of time before this Department is notified and a reasonable estimate of the original depth of the deep hole cannot be determined, the test holes are to be escavated to the depth as indicated on the design data sheet. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. very,truly yours, Robert Morris Environmental Health Technician RM : amm Enclosure s 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 August 21,'1987 Mr. Joel Greenburg Muscoot North, RFD #2, Box 488 Mahopac, NY 10541 0 JOHN SIMMONS. M.D. Oeputy Commissioner JOHN KARELL, Jr., P.E. Director Re: Proposed SSDS Anderson, Peekskill Hollow Road Dear Mr.'Greenburg• (T) Putnam Valley, TM 18 -4 -3 Review,of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. A field inspection by a representative of this Department recorded deep holes at a depth of 5 feet and 3 feet to ledge. This was not recorded on the design data sheet nor taken into account in the SSDS design. 2. Weil detail missing. 3. Standard note 5 not noted on plans. 4., Footing and gutter drain discharge not shown. 5. Location of percolation holes not shown on plan. 6. Deep test holes are not respresentative of expansion area. 7. Expansion area not.shown. 8., Al.l' wells within 200 feet of the proposed SSDS and all SSDS within 200 feet of proposed well are to be noted or a note stating none exists. 9. House sewer to be noted as sloping a minimum a inch /foot. 10. An explanation is requested'on how the first junction box invert is noted as approximately 7 feet below existing grade. Upon receipt of a submission, revised to reflect the above comments, this,application will be considered further. Ve_rZ truly yours, 6.&/v Robert'Morris RM:amm Environmental Health Technician 15i-A i COUNTY DEPARDENT OF HEALTH - DIVISION Ur' ENVIRUWEXIAL ffi!A1 ,1H 5r tcvll'M INDIVIDUAL WATER SUPPLY & SEWAGE DISPOSAL SYSTEM REVIEW SHEET - CONSTRUCTION PERMIT • -- -- -, N � � - DA BY: TE Iff REV 4­1 "�- cation) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc Hole Depth s/s . SUBDIVISION Perc (3) Fill cd House Plans - Two sets Well &e4 permit; PWS letter Vari e Request GENERAL J Legal Subdivision Subdivision Approval Checked �U E�x- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump'pit details Septic Tank - Size, Detail Well Detail, Service Line if over ,"Construction Notes Design Data: perc and deep results, Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter,Curtain Drains*(discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shcwn;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds --House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 110; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fil 20' to Foundation Walls 100' to Well; 2001.in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake Unc. expan 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped waterccurs 10' to Water Line (pits -20') 50' intermittent drainage course Septic Tanks 10' from Foundation; 50' to well 15' Well to PL 9 10 PUTNA.M COUNTY DEPART OF HEALTH - DIVISION OF ENVIRONMENMU HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS 4.- FIELD INSPECTION REPORT I' DATE:j No t5- o _ ���CG1�l�I��LG %� ]NSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO OOMM&NM Wetlands on / or p roxima. to to property .............. 5 A/A :> io6 7 f�osn dP S�1Z' Property lines or corners found .................. Can estimiate house location ............... ..... Will driveway need cut."........... . ............... Must trees be•remve3 note these ............... Deep holes representative of entire SDS area....... A6ditional deep holes need ..................... Sufficient SDS area available considering driveway' 7 cut, house location,' separation distances,etc.:. Mjacent wells /septics.... d. D.H. 1 Lot - Depth to G-.W. Depth to rock ^= 0 ft. 3 ft. 6 ft. 9 ,.ft. 12 ft Soil Description SkJb D. H. 2 Lot Depth to G.W. Depth to rock 0 ft. e 3 ft. 1 i 6 ft. 9 ft. 12 ft. Soil Description su, b 3 a D.H. - Deeo Hole G.W.- Groundwater D.H. 3 Lot - Depth to G.W. Depth to rock'"'! � Soil Description , i 0 ft. 3 ft. t ° 6 ft. IT ft. 2 ft. 5eT L0ft s n� cam "CX DATE: FINAL SITE INSPECTION: INSP.BY: YES NO CCl'S House SSDS located per approved plan............ Length of trench measured Width of trench average Slope of tile line and trench acceptable.......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse...* ................ Natural soil not stripped or SDS area unnecessarlygraded ......................... 10 ft. maintained from property line and 20 ft. fran house .: ......................... Distance well to SSDS�(ft.) .................... . Number of bedrooms checks ................ .... Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally fromtrench.... .......................... Poxesproperly set ............................... Could surface runoff fran driveway, roads, - ground surface, etc., channel near SDS area.... L ' Does lot drainage appear OK-,in area of SDS:•:...... FINAL CRADNG OF SITE A- =:TABIIB . a .. i Rev, 3186 J�\\ W� OF Located at PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Must Provi _ 5 7 — 8 7 P.C.H.D. Permit # —tV COMPLIANCE FOR SEWAGE DI! SYSTEM PUTNAM VALLEY Town or Village Tax Map 1 8 Block 4 Loth_ Owner /applicant Name DAVID ANDERSON Formerly Subdivision Name Subdv. Lot N MaWng Address 195 -HASP• AVFNUF Zip 10703 Date Permit Issued 5/26/88 YONKERS, NEW YORK Separate Sewerage System built by TYNDA .T, SEPTTC SYSTEMS Address TVY HILL ROAD i. RFbJST.ER.r_ N v . Consisting of 0 Gallon Septic Tank and S71 T.F OF T P A CH T TG F T FT D S 1 0 5 Qq_ Water Supply= Public ,Supply From -Address ors XX Private Supply Drilled byNnRMAN ANnPRSnN Address RARrRR ST .� PTITNAM VAT T FV r Building Type ONE. PAM. Has Erosion Control Been Completed? YES N.Y. 10579 Number of Bedrooms 4 Has Garbage Grinder Been Installed? NO Other Requirements PUMP C-14AMR-PR I certify that the system(s) as listed serving the above premises were constructed assent ly a shown on the lens of the completed work ( copies of which are attached), and in accordance with the standards, rules and tions, in ac with the f ed plan, and the permit issued by the Putnam County Department Of'Health. D Date . 1 0 / 2 3 / 8 9 Certified Is P,E. R,A.XX— Address 11.icense No._ 13 0.5b Any person occupying premises served' by the above systems) shall prompt to wch action as may be necessary to incur the correction of any unsanitary conditions resulting from such usage.' Approval of the separate sewerage . tam shall become null and void as soon as a pub:': sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, In the judgment of the Commissioner of "Ith Is revocation, modification or change is necessary. Date "✓ /a��'�— �S ay� PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y. 10512 Engineer to Provide Permit p on CERTIFICATE OF COMPLIANCE \ CONS CTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit N PV-57-87 --`T PtTTtQAM STALLFV locatlocated , at PEEKSKILL HOLLOW ROAD Town or Village Subdivision Name Sabd. Lot N Tax Map Z8 Block Lot 3 Renewal_ 0 Revision —t Owner /Applicant Name DAVID .ANDERSON Date of Previous Approval Melling Address 19 5 CHASE AVENUE Town YONKERS NY Zip 10703 Building Type ONE FAM , RF.S , Lot Area Q0 7RA AC Fill Section Only Li Depth Volume Plumber of Bedrooms 4 Design Flow G P D 800 PCHD Notification is Required When Fill Is completed Separate Sewerage System to consist of . Z...Q. Gail on Septic Tank and S 7�F ^F T F ruTWC FIELDS To be constructed by DON HEADY Address CANOPUS HOLLOW RD,, PUT. VAL o ,NY 1057! Water Supply; Pdbllc Supply From Address or: XXXX Private Supply Drilled by N o ANDERSON Address BARGER STREET , PUTNAM VALLEY , NY 10579 Other Requirements 7 FOOT Ci1RTAIN T)RATN 7 FT OF RANK RTTN FTT T FY PIIMP C_T-LAMRF.R` 1 represent that I am wholly and completely responsible for the design and location of the pro po d system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there tc and in accord c with the standards, rules an regu a ions o e u ham County Department of Health, and that on completion thereof a •Certificate of ConstrI to C mpliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner,. his cc ssors, heirs or assigns y the builder, that said builder Will place in good operating condition any part of said sewage disposal sy during the peri d o tt o, 2) years Imme ately following thedate of the Issu- ance of the approval of the Certificate of Construction Compliance f the iginal system r rti`y re 'its t ereto; 2) at the drilled well described above will be located as shown on the approved plan and that said well will be in ailed in accordance wi th n �► , ule ndliegu7aTlons of the Putnam County Department of Health. Date 5/24/88 , Signed P.E.- R.A. Address MTTCOOT NO C" I_IC nse No 16 APPROVED FOR CONSTRUCTION: This approval expires two Years the ate i u �n ction of the buildi g has been undertaken and Is revocable for cause or may be ar+lgndetl or modified when constdared sary� the m i her o Health. my change or alteration lo'f''' construction - - - -L.:• a.t.,�aGLnjror' disposal of domestic sanity ay P/� iv e w er IY o PUTNAM COUNTY DEPARTMENT OF HEALTH Rev.' 3186 Division of Environmental Health Services. Carmel, N.Y. 10512 CON9T]RUCTION P RMIT FORS AGE DISPOSAL SYSTEM ac :PEEKSKILL ALLOW ROAD Subdivielon Flame - Subd. Lot q Ownlae %�.ppueantPTame DAVID. ANDERSON rt�awn8 Address 1.9 5 CHASE AVENUE Engineer to Provide Permit q on CERTIFICATE OF CORRPLIARTCID Permit Al PUTNAM VALLEY Town or Village Tax map '18 Block 4 Lot 3 Renewal_ ❑ Revision - ❑ Date of Previous Approval Tom .YONKERS , NY ZIP 10703 , Building Type ONE 'FAM o RES. Lot Area 9.784 AC Fill Section Only Depth -Volume--- Plumber.of Bedrooms 4 Design Flow G /P /D 8,00 PCHD Notification Is Required When FIII is 6ompleted Separate Sewenge System to con sist of 120 Gallon Septic Tank and 5 71LF OF LEACHING FIELDS To be constructed by DON HEADY Adllrese CANOPUS HOLLOW RD i PUT o VAL o , NY 0579 Water SpPP1J': Pdbllc.Snpply From Addr i or: xxxx private Supply Drilled by N ANDERSON ARGER STREET , PUTNAM°-VALLEY , NY105 79 Other Requirements aur-ml o . ZVAi . represen that I am wholiy•arid completely responsible for the design and location of the prop above described will be constructed as shown on the approved amendment there to and in accords County Department of Health, and that on completion thereof a "Certificate of Construction be submitted to the. Department, and a written guarantee will be furnished the owner, his su place in good operating condition any part of said sewage disposal system during the peril ante of the approval of the Certificate of Construction Compliance of the original system d will be located as shown on the approved plan and that said well will be Ins Iled accordan w County .De artme t of///���Health. Date o i Signed. /// Addre APPROVED FOR CONSTRUCTION: This approval expires, a fr the ate revocable for cause or may be amended or modified when co ide► d c scary y t requires a new permit Approved for disposal of domestic sa and %/i Date 9 a��J /� By (/ system(s); 1)' that the separate sewage disposal system with the standards, rules and regulations of the Putnam pliance" satisfactory to the Commissioner of Health will rs6thgandards, heirs or assigns by the builder, that said builder will' 2) years imme0iately following the date of the issu- irs thereto; hat the drilled well described above rune and regu aTrons — of the Putnam unless construction of the bui missioner of Health. Any cha P.E._ R.A.XX rse No has been undertaken and is or alteration of construction a�� e a�r�j,/w�pDly only. Title V�' 134 23 sub f.R "OF KENT E. tOWN c' S P � —TN A W---V —AL —LE, TIJW N 19 14 M- 7 alt ajz Till ic 0 to 3 30 17 19 as c I'S 24 2 2 m 145 of ..12 Of FOR TAX PURPOSES ONLY REVISIONS NOTE - Ixt 18. 8 1-, NO PRELIMINARY..: TCW'; OF F,; NAM VALLEY r; S ONLY J o NZ iF , .4.� , �i q � a • C 00 � cs I � wn, �A c 1 ' X11►. Vo FYI' 50 jr R,! �. v r(; ... l �- a, • i 1 1 �,1 • �'� � r �� i 1 r�l �_ I ,°,�1 l r jj ,� I_ it l_ 1 t r -_ i y5 D / 5'06 �jv T—� WOO 46L. per�cesr cowc. sar•nr. � pCtM(� G,1GMA6a -. �w� 2 e• . 4. v U y7- 45, 2e ucnou -. - 3oxES As . &ULLT . L -0 GALT L4 -Alm._ A -3 134 B-3-.!- iS1 4 1.25 4 144 S 117.6 5 ".1:35.6 6 111 6 130 7 104 7 123 -8 -99 -8. 1.16. 9 90' 9 . 108 10 82.6 10 101 11 76 11 94.6 12 1'33.6 12 156 13 126 13 151 14. 121 14 147 1S T16.6 15 142 16 112 .16 138 17 106 17 133 ts. 101 18 126 19 93 -19 120 20 129 20 141.6 21 123.6 21 135.6 22 .117 22 129 23 112 23 122 24 104 24 114 25 98.6- 25 108.6 26 89.6 26 102 C- 1 16.6 D- 1 49 C- 2 24 D— 2 52. Putnam County Department of Hea1tL Davis � on of Environmental Health Serviooe ipproved as noted for conformance with applicable Rules and Regulations -of the - .utnam County Health Department: =1anatura X T1 . o !' TO CMTIPY 4i814�. !1418,= SSUA4E' D1380SSi.- SYST M bA8 CGN- +Ei 7 . .(F.aEO 4. J�pE14CE Bq E a ~o o° �. s r Z n � 1t o L 3 OF, L c n 3o to z z (� 9 i iZ 16 X X �' 3 30• �3 5 4 As . &ULLT . L -0 GALT L4 -Alm._ A -3 134 B-3-.!- iS1 4 1.25 4 144 S 117.6 5 ".1:35.6 6 111 6 130 7 104 7 123 -8 -99 -8. 1.16. 9 90' 9 . 108 10 82.6 10 101 11 76 11 94.6 12 1'33.6 12 156 13 126 13 151 14. 121 14 147 1S T16.6 15 142 16 112 .16 138 17 106 17 133 ts. 101 18 126 19 93 -19 120 20 129 20 141.6 21 123.6 21 135.6 22 .117 22 129 23 112 23 122 24 104 24 114 25 98.6- 25 108.6 26 89.6 26 102 C- 1 16.6 D- 1 49 C- 2 24 D— 2 52. Putnam County Department of Hea1tL Davis � on of Environmental Health Serviooe ipproved as noted for conformance with applicable Rules and Regulations -of the - .utnam County Health Department: =1anatura X T1 . o !' TO CMTIPY 4i814�. !1418,= SSUA4E' D1380SSi.- SYST M bA8 CGN- +Ei 7 . .(F.aEO 4. J�pE14CE Bq E a ~o o° �. s Putnam County Department of Hea1tL Davis � on of Environmental Health Serviooe ipproved as noted for conformance with applicable Rules and Regulations -of the - .utnam County Health Department: =1anatura X T1 . o !' TO CMTIPY 4i814�. !1418,= SSUA4E' D1380SSi.- SYST M bA8 CGN- +Ei 7 . .(F.aEO 4. J�pE14CE Bq E a ~o o° �. s 117y �e elk��hk l�i� r ep IL'G Rcpl �T�ix _ �I ��,�I��Im j(L��,G L �c•- '_I_y_� �N I��i I� I I I -1—i I i_ � I � I � �- -� —�y_� 1- �- I � � u5 •i` I p" � 't ��, Ff_A�r / t_ I � —r //A _ I -� ' I____ --+ � � —r- _I_ — :- T_ , , -�-1- � ; JL IF r 291 ' I : t- - ' l ' J_:..�_ _1. _) •� .4 _ , _� (- � �_ - -- I i .� -� _ IF , a II I , �F — �_ I �. 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JL- I � I PITrNAM COUNTY DEPART OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS P FIELD INSPECTION REPORT ( � DATE: G $ AilMPsyJJ �yc.i L 4 9V[1 L/ t1,.J 1'� INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION. YES NO], MKIE TS Wetlands on /or proximate to property............:.. Property lines or cornets found ................... Can estimate house location ....................... LAAS Will driveway need cut .. ......................... ' - ®L NvT Dist trees be-removeff, , note these ................ Deep holes representative of entire SDS area...... AID G Ns Additional deep holes needed ............... /V 0 4AiTS Sufficient SDS area available considering driveway cut, house location', separation distances,etc..., Adjacent wells %septics . ..... .......... ...... AccPSS to nronos,-a wPll'lnration for drilling_____: Q.H. 1 Lot. p G:W. Depth to rock 0 ft. 3 ft. 6 ft. 9 eft. 12 ft. Description Q -tLot o G.W. Depth to rock 12 ft. Soil Description �IDWr� c,vu.w.- 7YZ r• D.H. - Deep Hole G.W. - Groundwater ID. H. Dt�o Lot ° G. W. Depth to rock _�C ' Soil Description 0 ft. ft. 6 ft. 9 ft. 12 ft. S� L ROCK el C S� DATE: 0 ft. FINAL SITE INSPECTION INSP.BY: -YES NO CC'S 3 ft. 6 ft. Length of trench measured Width of trench average 9 ft. Slope of tile line and trench acceptable........... 12 ft. Soil Description �IDWr� c,vu.w.- 7YZ r• D.H. - Deep Hole G.W. - Groundwater ID. H. Dt�o Lot ° G. W. Depth to rock _�C ' Soil Description 0 ft. ft. 6 ft. 9 ft. 12 ft. S� L ROCK el C S� DATE: FINAL SITE INSPECTION INSP.BY: -YES NO CC'S House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable........... Roan allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded.;......... ................ 10 ft. maintained from property line and 20 ft. from house.., ........................ Distance well to SSDS (ft.) ..................... Number of bedrocros checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripherallsoil horizontally fran trench...... ............................' Boxes properly set..', . .. ........ ......... . Could surface runoff fran driveway, roads,- ground surface,.etc;, channel near SDS area....; Does lot drainage appear OK•,ih area of SDS::.... (i FINAL GRADNG OF SITE ACX:E P'r'AR ... �i i. N�, f tx Roof 0 3 I i PUTNAM COUNTY DEPARTMENT OF HEALTH DTVISTON OF ENVTRONMCNTAL HEALTH SERVICES COUNTY OPPICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA'SHEET- SirPARATE SEWAGE DISP94L SYSTEM FILE NO. OWne DAVID ANDEASON Address 195 'CHASE AVE , YONKERS , NY- 10 70 3 Located at (Street EKSKILL HOL. RD-See. 1$ B1o�'k 4 Lot 3 r�n d 3ca a nearesf cross s rep MuniCipality •PUTNA.M VALLEY `''" Watershed -HUDSON RIVER SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole- Number CLOCK TIME PERCOLATION PERCOLATION Run ' M apse p o a er PEW Le ve No. Time From Ground :Surface in Inches Soil Rate. Start-Stop Min. Start Stop Drop in Min. /in drop Inches ,Inches Inches PTH #1 1 3: 00 3:30 30 16 i7.75. 1.75 30/1.75 =17.14 2 3:31 4:01 30 16 17.75 1.75 30/1'75 =17 14 .4 4. Gina 30 �6 ,, 5 • PTH #21 3:05 3:35 30 16 17.625 1.625 30/1.625 =18.46 2 3:36 4:06 -: 30 16 17.625 1,625 30/1.625 =18.46 - 3 4:07 4:37 30 16 17.625 1.625. 30/1.625 =18;;46 # 4:38 5:08; 30 16 . 17,.625 1.625 30/1.625 =18.46 Notes! 1) Tests to be repeated'at same depth until'approximatelt equal soil rates are obtained 4t,each percolation test hole. A11 data to a submitted for review. 2) Depth measurements to be made 'from top of hole. r TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HODS DEPTH HOLE NO. 1 HOLE NO. .2 HOLE NO. G.L. TOP SOIL T OP SOIL 1° SANDY LOAM & SANDY LOAM & 20 SOME CLAY SOME CLAY it 3° „ 5° 6° % ° " I I' B° 9° 10° 11° 12' 13' 14° INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED N.0NE1c INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EEt0001MEIM NONE DEER HOLE OBSERVATIONS MADE BY: JOEL L. GR:? +,>T!3?RG DATE: DESIGN Soil Rate Used 16-20 Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms 4 Septic Tank Capacity 1250 gals. Type PRECAST — —=NC. Absorption Area Provided By 571 L. F. x 24" width trench Other ER E,— ° Name JOEL Lv GREENBERG signature � MAHOPAC, NEW YORK j'��• .. • _� THIS SPACE FOR USE BY HEALTH DEPAMifM ONLY: Soil Rate Approved sq <ft /gal. Date