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HomeMy WebLinkAbout2460DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -24 BOX 21 I Iry 11111111 all I'llsorm Is -. ,I � :I T Is Is Is 0 Is Is 16 III Is Is I I I f r:l ,ti i, �' s L!' Is �'i 'I'~ J i f r i 02460 PUTNAM COUNTY.�DEP�ARTMENT OF HEALTH 'Division of; Enwronmenta/ Health Services Camel :N: 'Y, 10512 CONSTRUCTION : PERMIT FOR SEWAGE 'DISPOSAL SYSTEM �ilog or e Loeated,.at _,T!':.. i • . 1►/ �. 0 Lt �/ .., Section Block., --� .w: <,•w, M, , ,. . Subdivision C� :l. i G,,..h di =c ^. —rte'iY Job s Owner �' Address :. Building Type . Lot Area;,L JlirCS .., M jC r° Number of Bedrooms ,� ` - le Space icy 'rSquare Feet / Total: Habitab �J t� Separate: Sewerage-.S ystem, to consist of / t;L 0 ;Gal Septic Tank lineal feet' X / y width trench To :be 'constructed by Address '-Wate"r Supply: Public Supply From • : . Private .Supply to be drilled by r -, -• : - Address - - - - - Other" RequirementsC� f! -�—-- — _ ,I' represent that I am wholly and completely responsible for the designantl 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' iri accordance with the:standards,�r,ules an regu a ions o t e u nam County Department, of Health, and that on completion thereof a Certificate of Constructibn Compliance^ satisfactory to the. Commissioner of Healthwill 3 :.',be. submitted to the Department, . and. a written guarantee will �be• furnished •th'e, owner hisauccessois" 'heirs or assigns by the builder,'thet'said builder will . place':in good- .operating _condition any. part of saki sewage disposal system during the period of, fwo,(2)'years immetliately following ;thedate . of the issu- ance .of, the' approval of" the! Certificate•,_of .Gonstr_uct,on 'Compliance of,the orig,nallsysterr or any.repairs thereto 2)!that. ;the drilled well, described above :,will be,located'asishown on the approved plan.and ahat.said: well will beMinstalled m a' ordance' tli 'the >standar rules and regu a i—T� ons of the .Putnam County Oepartme of Health y M r r Date y�' 519ned / E.. � . RR:A. 7'' Address �-�pp L•icense No. % Jr--- APPROVED: FOR CONSTRUCTION This approval' exp. P�R111f issu un s construction of the building, has been'.undertaken and is; revocable for ,taujpj.rmitm;, or be ame nded or modrfiadr. Iy orii is ones of ,Health Any cha a terafion of constructionrequires a w' Approved for disposal of; nU nv a ater supply'_only DateBY '/ — Title r i -: PUTNAM COUNTY ENT" OF . HEALTH Divisfon of Envvonmenta/ Hea /th Services, Carme% :N . Y.' 10512 r - r + CERFIFICAT.E OF CONSTRUCTION CO.MPLIA_NCE - FORSEINAGE- ,DISPOSAL - SYSTEM 0 o;) -.•�Q Tow or Wila9'e y74T ® G? Cl' .. Located at Section Blo Owner G.1�%! CS Lot � Job 'Separate Sewerage System built by J/G� �� Address ��70,2W S 44-0, -0, . Z ar '. CL`. Consisting of Gal Septic Tank' lineal Feet ;width french r.... Other requirements ',�� J..,�- �1JJ r-� °•Water;;Supply Publc.5upply'From' , 1 Pnvate Supply Dulled' By Via/ e- Address } Building Type No of Bedrooms - Date :Permit' Issued Has Erosion Control Been Completed = e an �PASe o ,p NEW .. .. � `; L ,M Ea certify that the ?system(s) as listed serving the above premses were constructed -essentially as shown�Q�rh�$�apel6t �gpf�ted' work (copies of which. are attached), _and ,n accordance with the standards, rules.and regulations plans fled; an the parmi °issu by' ty(p eyunfy DepttrtmenL of Health. e bate Certified by r P E. R A. - a yIa oeo ` �! �� Address �i �i'�Gy� /^' nr `L -ense No. Any person occupying premises served by the above systems) shall promptly take such action as ms Y pe °nieces r? fb seetlr�e�'h$ correction of any unsanitary -conditions resulting from such usage. Approval of• the, separate sewerage system shall, become nulfaand. �oid,a,;,sod7i ps a public sanitary sewer .becomes `: :available and the approval of the private water supply, shall become null and void when a public waY6roS.; IY�ti� available. Such approvals are '3 ,subject to modification or.change when, 'in. the Judgment of'the Commissioner of Health, i6u h revo i r!►gdifit�atIon or change is necessary. tli�'c1i 7 PUTNAM COUNTY DEPARTMENT OF HEALTH OFD �. V1RQN. N.TA.L.-jHEALTJ1[ _SERvaCES,_....­,...� Date June 3, 1974 Re: Property of Mr. Edward Farrell Located at Bell Hollow Rd. , Putnam Valley.,:­. N. Y. Section Block Gentlemen: Lot This letter is to authorize George Haughney 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 � uAwt!c Liu„ w-. Lr1 Liiis nia e i ev ani-I to. supervise iine construe ciun of said system or systems in conformity with the provisions of Article 14S or 147; Education Law, the.-Public.. Health--Law-;- and the Putnam County San - tary Code. Very truly yours, F ���" Signed ' Owner of perty pRS►drWig i Countersigne ;Qj m• Address P.E., .A'.$ _ �� o Pf 043a8� °'�� \�\\. ,. F "'� Telephone A ress Ila? /o? S - 63 3 Telephone 5: o-- -W�� ? Tj t'1 1.'0:l TTc� __(:otta�rc.zn x,.13 Prop;;rty :rocs or corners found . a e o e _ ✓ _ -- _- -_ __� -r< Can estimat -1 ho' ,;r-- location . . 0 . O 0 o 0 111,11 driveway need cud; . . . . o . 0 . . . . M'U.clt trees be r-e moved -note the-se e is deep hole of ontir. e STDS area ;c > hu.d:i_i ;:i.on�.]_ cic n• 1��o1.el 1 dcd. Lon . e . . ►� Suf'*.fJ.cient SDS area wtTa:i_:I_a.ble cons i.de,ring - r - -~ drivei.,ay cu[[t��, hssouse location, separation . d:is "i;al1CGJ li , tV e 0 Tj -011" ROLE PAl111' D"pth: ..` I -later elevation: Rock- elevation: SOils, descri T3ti on: (� FIVAL SITE PISPECTIODT Insp. bV: House located t-rhere shown on approved plan STS) leca.tc d''where approved . . . .. , . . • 1 - -- -" /:.•.�V.— v... vim. .: i��.•:� ...vC:r .�.. L:iv �w. .. .. ... .. . Slop 'of tile Ii r_e and' tr. ench acceptable e -. Room allowed for expansion trenches . . . . •' r Over 50 ft. from strarlu, l•;atercourse Natural soil not stripped or. SDS area unn.e.ces.sarlly .graded__:. __ -- lG L inuaivai n from p� op.lirill 20 ft . from �louse . o . . . . . 0 . . Separation of trench from house, yell - etc. follows plan . . . o . o , , o , 0 0 Number of bedrooms checks Stcnes, brush, stumps, rubble, etc. greater �- than 15 ft. from nearest trench ? 5 II'L . of peripheral soil horizo.— -L-' - from .trench . . . . . . . . . . • o 0 0 o a a . Junction boxes properly set 9 Could surface run off from driveway, roads, groLuzd surfaice, . etc. channel near SDS , area . • 00 . . . . . o . 0 0 . . o llo '-s l6t drainage anrcar O.K. in area. of: SDS I FIRU GMING OF. SITE ACCEPMBLE 0 REVIEW C11ECK S1= DOCUMENTS House plans 0. K. Design data sheet Peres presoaked? Min. 30" pert test depth Const. results. for 3 runs IMeets Std.'! Remarks Ye s` I No A.tf.• -,1'w. •�Y •..v ..a ..�'T = -Y�.��..Y�_ -...:� I � .ate n,e t. . f D. Hole log O.K. i Corporate Affidavit.for other than individual Authorization for engineer I Letter from Water Supply if applicable A., If variance requested -such noted on plans & apps.; t &U-1 DETAILS if change is proposed,). Existing contours shown show new contours) .Slopes for driveway cuts, etc.,shown Water service line location Footing, drain, etc. location Top slope, bottom slope of fill Percolation tests and deep test pit location. Septic tank size and conformance to std. 3 B.R. house minimum House setback shown I 7 Cty?b:Mi'l r.;1 '1l(1�4 f1 O 'lel 4- .. -+,- •-C? ° .... _.. -. - - .a.._.- .5.�. d! water wiLnin Du fu. -or rL snUwti Plan and profile SDS All other wells and SDS closer 200' -shown or reference made .... Property boundaries metes and bounds- cleaVly shown j I _ - .._..ate...._... �► I ! �, I —._.. .......�a.......�- SEPARATION DISTANCES SPECIFIED ON PLAN 10' to P.L. 20' to Foundation walls 100' to Nearest well ' to stream, march, lake, etc. incl. 5' to Curtain drain 10' to water line (pits -20 15' to storm drain 10' to large trees' 10' from foundation to. septic tank 5' to pipe from leader drain &-foo ine on) i PUTNAM COUNTY DEPARTMENT OF HEALTH Date Re: Property of /mss'.ry������'� Located at��� �/� ys��, �` �✓ Section J Block Lot �a Gentlemen: f This letter is to authorize a duly licensed professional engineer d✓ . 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 `:uiwt!vL1Vil w1Lri Lllis maUev anti to. supervise the construccion of Said system or systems in conformity with the provisions of Article 145 or' Fdu afnoi =Law the - Public He al:th ' a - and -the Putnam County =Sani- tary Code. Countersigned° �p�Se�o����W� ° °�A,• P.Eo9 RA, Address tq, � V- k 7 xi� Very truly yours, 4 A Signed Owner of Property 011, C16-Ij &Z'Ijeu� "I", ��,& Addres /os� Telephone 2 Telephone � - a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Locat Munic c. 2' -' Block Lot s street) Watershed2 64 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to.Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2k. '3j &,1.3 3 5 3 4 5 1 2 3 4 5 Notes: '1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. s }' �.��y�sti i g ' � 1 @y C p � � 4 j�`:• �9 ��..9.��,( /� i��y+e/gy Q� -ty� 7�y i try.. 1jX ' � � t < F. Y a'1tTgiW�''��l�a{ ��? tC2!'Y� EiII'i 4A +•a,!L�A7, W 1l IE' �S� &��Nj,+ �. ,, r� Tq� �1✓a7U,LL'3,PT Z�lV �.S ����lr�J `��i�iSl3Y`��.yllfi3J; ;1'if `+ 8 �`r,V -t4 � `�, j� - •�: � 144 �T� >• �. a � - J ryY. 4 4 y r{'.P trial �� i+� .�.4 ;'S },�q !{.'l..S :_.�,5 d. < p¢ rw, �h >rl :. v-.s •+�a- ^z�N a v-, w. �..... mr AT.. F '• 1� V a - G Yr t fi 1• .y,� J i, T J ,�' S " ? fir: -� 1 ;' � ' ) •'r ' .,+ r .. ° 3F IC L t AT WHIG i OROUND" ,1 t is `1 xCA ' . FOR WI G ''t �t ' RZS 'S AF`�'�R BRIPdO C� �R � •. y- ��yy}�� '. 'IkM!:r W.•'r.'o YM,;'Y e. f ,ya �Pw"q'�+ (kt i Y -'Aare YPseck: ifaa /fir lD:rc�p'aDa tYsie Area prav;d' °� `�' i4�1 a off.° $Bt gUOZAB �.p�tc Tifik C,ap&A-ty Ab+sr' tan ��»�a;ra�ic� b�oWidth treneha Qet I �5.�.�1iat"e,,_., 19�f arr.4 .+ - o- • e .;p. �' T' a -'• b a+ f•^ o: a � 6 k s �` y 1�6i' ��.�''•Y Ir ,, ry tt,- ,, :. k.. r �.. ®J'�Lfy aaeeef ea`eer � a90 y `p°���'i'�irpTFS� a, e 4 ppt,,6i 4-,. ��¢��elRbr��d. a�' ieh SY�� ��0.�V1' .• �. . `� _ 'dtc aBaeb A'. o Y6�o BRUCE ' R'... FOiriY.........._,.,._mr....... . ._ Public Health Director - , . _.. ' I;ORETPA •hIOT;INaRi •R:N.; 1vI:�:N .. . ,," Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 WIC (845)278-6678 Fax(845)278-6085 Early Intervention (845)278-6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 January 7, 2002 Lorraine Tully 194 Bell Hollow Rd. Putnam Valley, NY 10579 Re: Addition- Tully- Bell Hollow Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 51 -1 -24 Dear Ms. Tully: I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for-the addition has been approved as per plans bearing the approval stamp form this Department dated January 7, 2002 The addition is approved with the following conditions: 1. I._.... '_­_ _ _2. 3 The total number of bedrooms must remain at Three without prior approval _ by this department. The area of the existing sewage disposal system, and its expansion area, must be maintained. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valle,. If you have any questions, please contact me at your convenience. Very truly yours, Michael Luke ML:kg Public Health Technician cc: BI(T) BRUCE R. FOLEY Public Health Director _ h LORETTA MOLINARI RN., M.S.N. - • -- A.:sociate °ub'Cc -Health ; Director Director of Patient Services DEPARTMENT OF - HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 6130 Fax (845) 278 - 7921 Nursing Services (845) 278- 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONL)o I qq 5 / STREET -BELL HOLLOW TOWN I V NAN1 TX MAP# 2-3-4-44, VA LLB NAME k0V,R A i NC ILILL� PHONE T4 - s2-b -y l2_9 PCHD# MAILINTG ADDRESS 19q -BELL 0 OLLO W LLB kyi 1&0r� 9 DESCRIPTION OF ADDITION ;-e4mILy ROOM l/Ni.sya W/rm BAT7lrrdeln ASCR urJl-lry 0 60M NLti1BER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. 1?1Pase. submits&. s -form and the folloNvL4g.- to- Putr- .am- Cot�Health- Dept -,-4- Genera- R©ad;..BieWster; -NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhouseguideaes WELL COMPLETION REPORT 3171 ; PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Dgpartment.together with laboratory, report _gf_watersample indicating water is of satisfactdry tiacteriiil quafityrtieior certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION DATE WELL COMPLETED I DATE OF WELL DRILLER (Signature) NAME ADDRESS OWNER A U0 LOCATION (No. 6 Street (Town) (Lot Number) OF WELL y iii► v BUSINESS �tI ❑ ❑ ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL ❑ ❑ ❑ ❑ SUPPLY INDUSTRIAL CONDITIONING (specify) COMPRESSED CABLE ❑ ❑ EQUILPMENT ROTARY AIR PERCUSSION PERCUSSION ❑ ((SSpe ify) CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ❑ E SHOE I VYES ❑ CASING MES DETAILS THREADED WELDED NO IE NO YIELD HOURS G.P.M. ❑ ❑ YIELD (G.P.M.) .• TEST BAILED PUMPED COMPRESSED AIR 2.0 WATER MEASURE FROM LAND SURFACE —STATIC (Specify leet) DURING YIELD TEST fleet) Depth of Completed Well LEVEL in feet below Land surface: MAKE LENGTH OPEN TO AQ FER peat) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) GRAVEL SIZE (Inches) FROM (feet) TO (feet) IF GRAVEL Diameter of well including PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET s ; 101) CA&V '2/0 Adost Rock 6A kDii 3.61 s e Tip, If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE es* s DATE WELL COMPLETED I DATE OF WELL DRILLER (Signature) caner or urc ser or-Building Municipality •,,; T ....SGf�oonJ/I'I�r� ,;.,1�-. _ p,.�C -S`- .. >. - ..n... :.,,,,/.1 -�,. ... -.z . - ....... :...,._. ffuMdIng Constructed by �'eo ion X11 tf�l��w R L�6ca tion °- Street B oc �vucN u ng Type o t GUARANTY OF SEPARATE SEAGE SYSTE14 I represent that I am wholly and completely responsible gor the location, workrianship, 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 guaranty to the owner, his succes- sors, 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 initial use of 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 or negligent.act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de.- termination of the Director of the Division of Environmental Health Ser- vices of the Putnam.County Department of Health as to whether or not the failures of the system to operate was caused by -the willful or negligent act of the occupant of the building utilising the system. - Dot ®d this /.3 day Jo1'� . 19 �7 Signsture —..�. Title corporation, give name and address) - .. - . - - - .- - - THREE (3) COPIES ARE REQUIRED WITH THREE (3). COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRE REQUIREP TO FIL14 NUTCE AF -.ATE OF FIRST USE OF SYSTEM. - - - - - - - - - - - - - - - - - - -• - - - - - - - - - - - - - - Division of Environmental Health Services, Putnarn County Department of Health I--. - - . . ­ . .- 4; ESTABLHELEVAitON A, LOIAlEfiI FIXTURE, T SEWAGE VISNSACI 'R $11AIN, UN0ATUN8Ep�jALL-,.dOjjSTMja ION- TW-bdXF6RIl,-.T.O; VIA AN "49 o 0-, 491 d-, f 7�7-- U J�- 3 r Pppo, ED INA DIRE f HE I TW T-SEPARATE SEWAGE, DISPOSAL STEM 0 SE AN YST U E AND LO- 177 .5 VIP 4/ ? 1: 1 . �. .8e // Ile 'OF MN 4e i ' -4, CbU NEW. YORK 14-s TAW, -1-JOB #10.. 77r, J* A - SCAL .177 I. GACLON'SEPTIC TANK r BS-.,..TRENCH, 1 V: i.