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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -32 BOX 21 lirs I,y%. 1 1 RVO 6 . :: ,, ■ 16 9p ' % L'. JL lb- 02466 'Y � b 110 `6 " PUTNAM COUNTY DEPARTMENT OF HEALTH Q. Engineer to Provide Permit # (W., 3186 Division of Environmental Health Services. Carmel, N.Y. NY1051? C ' . on CERTIFICATE OF COMPLiANCE WAGE DISPOSAL SYSTEM Permit # V 4 2 . 8 2- — �� C�Si'F;UCTION PERMIT FOR SE �E� 0 � � bdy a 1 1 17 - Located // Town or Village �— . /7 �;��s i } �f✓ti Map -3 `4 trot Subdivision Name Snbd. Lot iY Tat �� S Renewal_ ❑ Revision Owner /Appllcmt Name � ®'7 f j Date of Previous Approval Mailing Address .42, 40 Ze i ra /�g+� �rLr A)C1 /J &' j 0,41 Town Zip Building Type ' I Lot Area —3 - *3 fr FIR Section Only Lj Depth Volume Number of Bedrooms Design Flow G/P/D G PCHD Notification Is Repaired When FW Is complet'e'd .Separate Sewerage System to consist of Gallon Septic Tank and 5 A7 ' r� To be constructed by Address Water Supply � -lie Supply Fro m —Address- or: Private Supplyy Drilled y �'� — Address Other Requirements 7' �1�, n `� > i'2 I represent that 1 am wholly and completely responsible for the design and location of $sue above described will be constructed as shown on the approved amendment there to i8t�cd'001 County Department of Health, and that on completion thereof a 'Certificate ,. Vy6jj %a I be submitted to the Department, and a written guarantee will be furnishe o place in good operating condition any part of said sewage disposal cysts ance of the approval of the Certificate of Construction Compliance of e I system or will be located as shown on the approved plan and that said well will be inst S cc r�wl County Dep&rtment of Health. Date s� / � Signed. • V /1 ��CILi�lil 7� • ,�� APPROVED FOR CONSTRUCTIONZhis approval expires one year revocable for cause or may De amen ed or modified when considered requires a new permit /. Approved for disposal of domestic Data 5 30-$ 0 By system(s); 1) that the separate sewage disposal system 'th the standards, rules an regu a ions o e nce•• satisfactory to the Commissioner of Healthwill Bps, airs or assigns by the builder, that said builder will yvo ( years Immediately following the date of the issu- p i thereto; 2) that the drilled well described above $at Its ards, rules and regu a ons of the Putnam s , ��• P. E. R.A. A' License No � - Li 4 o tion of the building has been undertaken and is Health. Any change or alteration of construction pply only.�� Title - �pAm.•^`II".i:i n '�i31-.v. �•.-r. n .R; -er•�s ^:r ..:w .. ' . •. S t . c - � ..... _., � _...5 r W w,. ,. � w i PUTNAM COUNTY DEPARTMENT OF HEALTH 'permit e °� -2, r $ Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPO; Located at Subdivision lia 1>1' wur Subd• Lot I O j��I Owner/Address e— IZ i3 e [ `4 e Building Type l FAM. ZES. c4 Lot Area 3.44 Aagzs Number of Bedrooms _3 Design Flow G/P /D Separate Sewerage System to consist of .1 Ccxn Gal. Septic Tank To be constructed by ib 79 9-Er- OP- WL)4CO own orOVINE-ga ige - Tax Map 4.3 Block 4- Lot 1 S Renewal _ ❑ Revision Date Of Previous Approval Fill Section only ❑ P.C. H. D. Notification Required and 4Z.4 F X 2 uliD1E Tr cw��} Address Water Supply: Public Supply From izPrivate Supply to be drilled by - - (5 Be 41cTeem) N eD Address Other Requirements I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage dis sal s stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regu a ons o e u nom County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that sold builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years Immediately following thedate of the issu ante 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 said well will be Installed in accordance with he standards, rules and ragu s ons of • the Putnam, County Department of Health.. �s� Date �Q 7(�� Signed P,E. Z• R.A. Address 3 q PAIR <,X, AP- Wt C - -L- [V.�, � C� S i-L- License No. a APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued u construction of the building has been undertaken and Is revocable for cause or may be amended or modified when considered necessary by the Comm i her of Health. Any change or alteration Of construction requires a new permi R Approved for disposal of domestic sanSprs�Alrage, bpd /cg priva afar CONSTRUCTION PERMIT FOR SEWAGE PUTNAM COUNTY. DEPARTMENT OF HEALTH oin of Environmental Health Services. Camel, N.Y. 10512 Engineer to Provide Permit A on CERTIFICATE OF COMPLIANCE � /2— (� u SYSTEM Permit I! tj Located at /! O 4v Town of Village Subdivision Name di' a ¢ ✓'. _ / (j Subd. Lot N Map - Taz p Block LaIt Renewal— D Revision p Owner /Applicant Name ICJ d>• � ��� do" �'. -'�% 7 Date of Previous Approval Mating Address %sue c'.9 61 j��'% Aree Town 4A0' Z1p /Ci'.5 -4% Building. Type Lot Area —?° -A Fill Section OdY Li Depth —Volume Number of Bedrooms Design Flow G /P /D e C7 PCHD Notlflcadon Is Required en Fill Is completed Separate Sewerage System to consist of 'A' yGallon Septic Tank and _ F To be constructed by Address Water Supply: Public Supply From Address or: Private Supply Drilled b� ---Address, d ---Address, / Other Requirements 7 / Cs' ,14t'° y o7 +�' I represent that I am wholly and completely responsible for the design and location of tr above described will be constructed as shown on the approved amendment there to and i County Department of Health, and that on completion thereof a "Certificate of Co be submitted to the Department, and a written guarantee will be furnished the o ne place in good operating condition any part of said sewage disposal system duri .tt ante of the approval of the Certificate of Construction Compliance of the orig al sI will be located as shown on the approved plan and that said well will be Installed n co County Department of Health, s, Date Signed Address 2P ,7 � �✓ �"� APPROVED FOR CONSTRUCTION: This approval expires one year from the date is revocable for cause or maybe amended or modified when considered necessary, by the requires a new permit. Appr vad for disposal of domestic sanitary sewage, an or p Date— ®z v, a SWIM 1) that the separate sewage disposal system dards, rules an regu regulations of e Putnam Wit WN actory to the Commissioner of Healthwill a igns by the builder, that said builder will f@ars I medlately following thedate of the issu- q►re►�jo 2) that the drilled well described above 9s, ► les and regu aeons of the Putnam ME,* o P. E. R.A. _ e,��i'Y� License No �, 19�1't a building has been undertaken and is A rl, Any change or alteration of constr tlon only. 9;L_ Title —� � ENGINEER MUST PU TNAM COUNTY DEPARTMENT OF HEALT H PROVI DE v Division of Envi pntmnfal O 686th SWWCW, CIII'r►ei, A Y. 91592 .PERMIT # y` .., r CER PBCA4E L= �ISTRUCVIOii� CORAPLIAf�d E C:OR E_WA3t" ill POSAL SYS4'ERA' / Town or Village . Tax Flap Block Located at Owner t ! ,-e j'5 d / Formerly Tax Map Lot # Subd. Lot # % (. Separate S Over age System built by z — 4 or e_ 'Ac7e" Address *4 ��yy �Y y l Consisting of k"eU Oal. Septic Ta k and C. ��" �� G�� / i Other requirements '� ° /� ���•� e Water Supply: Public Supply From ',/ / � Private Supply.Drilled_By. Address '` Building Type .� Has Erosion Control Been Completed? No, of Bedrooms Date Permit Issued T�f Has garbage grinder been installed? I certify that the system(s) as listed serving the above premises were constructed essentially,.,as:,shown on the plans of-the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with .'the, filed plan, and the permit issued by the Putnam County Department Of Health. Date C,Cer sified by Address ) �� ' Any person occupying promises served by the Bove systems) shall promptly take such ac ct conditions resulting from such usage. App oval of the separate sewerage system shall'm available and the approval of the private water supply shall become null and void when I subject to modification or change when, in the Judgment of the Commissioner of Heal n Date License No r>ay: enoeeBrary 4o's®turo the correction of any unsanitary null and void all, sooR.as a public sanitary sewer becomes C water ;supply ,Docomes available. Such approvals are n.`revocta4ion, nio6i4ication or change Is necessary. '���" T1410.✓ �"�.� DISPOSAL CONDITIONS - TRENCH QTY- HIGH WATER -.1 SLUDGE IN AGGREGATE-YES;.."' '. NO- D�- FIELD SIZE - LENGTH- - DEPTH- PIT(S)- QTY- DE - WATER LE - WELL WATER - YES - � NO- DISTANCE TO TANK - y` � DISTANCE TO DISPOSAL AREA- WATER WAYS -YES- NO -�4 DISTANCE TO TANK- DISTANCE TO DISPOSAL AREA- VOLUMN TEST - Q START TIME- -� END TIME- / `� / APROX. GALS.- DYE INTRODUCED THRU- PUMP TANK -YES- NO VENTED -YES- - LID TO GRA - ES- NO- ALARM SYSTEM -YES- NO- * * * * * * * * ** *SYSTEM ACCEPTABLE- YES -4 NO- * * * * * * * * * * * ** NOTE FINDINGS ARE AT TIME OF INSPECTION AND ARE NOT TO BE CONSTRUED AS A GUARANTEE TO SEPTIC SYSTEMS LIFE EXPECTANCY TECHNICIAN- CUSTOMER- i G. v�a�� f,10 014AL Putnam County A A Health Approved as noted for cohfo*r.rnance with applicable Rules and Regulations of the Putnam Cou fh Department. Signature Title Date 4af7 7' f 4.1 e, ce-e v b -yn Q1 �,' PUIM OOUNTY DEPARTMENT OF HEALTH DIVISION, bF : ` . .. _ HEALTH SFtVICES . DESIGN DATA SHFm -smsu ACE sawiGE -bISPOSAL SYSTEM FILE ICU. Owner �±' //T' "! %/GS�� '- ` ''dreSca 2-/G 6�jC,',.1�'�.`::�`�%v�G �r✓!G'. ,.. Located at,.(Street) lac*- ./f-aeg:V( Sec. Block 4e Lot %/�� \. (indicate nearest cross street) Municipality a - Watershed A1.8'd OD y. SOIL PERCOLATION TEST DATA REQUIRED � HE �TIID WITH APPLICATIONS jDate of Pre- Soaking I I te of� Percolation Test NUMBER CLOCK "$' PERCOLATION Run Elapse Depth to Water From Water Level No.. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 3% . // >U ";?U . Z y �(1 �� ?� /� 12-- 4 5 z- NOTES: 1. Tests to be repeated at same depth until -'apprcximitely equal'.soil rates are obtained at each percolation test.hole. All data to'be submitted for review. . , 2. Depth measurements to be made from top of hole. rev. 9/85 DEPTH 21 3' 41 51 61 71 81 91 10 12' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS EhKXXMUM IN TEST HOLES HOLE NO. HOLE NO, - .2 HOLE NO. -3 -A N 13' 14' DMICAr LEVEL -AT-WEIIM-OOONDWMM -7S'-ENMLTtLrja�m INDICA--TE. LEVEL TO WHICH `WATER iEvEr," 'R'isE-s AFTER BEING MMUNTERED DEEP HOLE OBSERVATIONS MADE BY 64, ki DATE: DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity,/,7-,,$V gals. Type!n�-Ie^ Absorption Area Provided By c5a'6) L.F. x 24" width trench Other 009 ... C17a of NEWN Name Sig om000eoo %Q Address 2i 72, C7 Aa THIS SPACE FOR USE BY HEALTH DEPAMENT ONLY: 24V` 0 0 Soil Rate Approved sq.ft/gal. Check Date 0 f A PUn• •• LWY DEPARTMENr OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET-SUBSUFACE SEPQAGE DISPOSAL SYSTEM FILE_NO. S. 4 Ife - -2 f,' re L Owner Address Located at'tStreet) Sec. Block 4- Lot in di te nearest cross.street) r Municipality Watershed S032; PERCOLATION TEST DATA REQUIRED TO BE SUBMITIM WITH APPLICATIONS Date of Pre-Soaking �Z 2 7-1 /7 Date of Percolation Test al;O&ZI I 1 10, � . /j 30 AI - '12, 3/7 12 4 3 3e 4 o"X—P, ?% X" 12... 2 3 HOLE NMM C )CK TIME PERCOLATION PERCOLATION Run No. Elapse Time Depth to Water Fran Ground Surface Water Level In Inches Soil Rate Start-Stop Min. start stop Drop In Min/In Drop Inches Inches Inches /j 30 AI - '12, 3/7 12 4 3 3e 4 o"X—P, ?% X" 12... 2 3 4 5 NOTES: l.. Tests to be.repeat.ed: at same depth until apprmumately 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. rev. 9/85 G. L. . 1° 2° 3' 4° 5°' 6' 7' $a 9' 10' 11' 12° TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF sonS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. HOLE NO. all 13' 14' . _ __....._... - aNDIC�T�- ?,EVEL AT WfikH GROUNI7TMEER-IS ENOOUNTE'REB INDICATE LEVEL TO WHICH WATER-LEVEL RISES AFTER `BEING ENCOUNTERED. DEEP HOLE OBSERVATIONS MADE BY: d,', � J � �049 DATE: DESIGN Soil Rate Used 2-- Min /1" Drop:, S.D. Usable Area Provided p r No. of Bedroarns Septic Tank Capacity gals. Type ®_:rd',-2 r Absorption Area Provided By U L.F. x 24" width trench Other Name O J + Signature e• ".6 � e� Address rr� 0- tejp SEAL I' O THIS SP CE FOR USE BY HEALTH DEPAMM ONLY: Soil Rate Approved sq.ft /gal. Checked by Date .. b PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner f1Arc A2. Pbm INC. Address K�zE� �'iD6fr ��.. Plti=y�lBUP.Csii� t� . 12SS� Located at (Street Ely. 00-.LOW ZOAP Sec. -N-A3 Block 4 Lot 1.115 indicate nearesoss street) Municipality Towle) of t'uTNAPg 1lAL.LE'y Watershed �°_ eo-rb N SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH'APPLICATIONS 1 2 3 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. Hole Number CLOCK TIME PERCOLATION PERCOLATION apse Depth to Water. Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop. Min. Start Stop Drop in Min: /in drop Inches Inches Inches 1 10 :26 — /,5: 44 18 ,2-.0' 2 Lo : 4s- ►1: o4 19 :L0 3 WOS- It;2s .2.o .2- 0h off," I" 0�1 4 11:2 C. 1146 1v to )" 1 " �0 /1 2 1 to;z�' — .�o: t9 I$ y. !q 4 l h l`T %► ._ 2 `- bo' 09 - 11.,21 7n I 0 19 I y 2-0 /1 ' T '1' !� /�•� i 11: S`� Zo 16 / / `I 1 1/ a0/1 5 t►,S2,- ' 1z: 1z` 2.0 1 2 3 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF.SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. L, HOLE NO. HOLE NO. G.L. 611 12'1 . 24" 30 lf �a 36 L oq r4 42" w 1C. L!4 48'1 54 60" 66" " 72" 78 tf 84 l INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE T- EVEL_.T WHICH WATER -LEVEL RISES. AFTER. BEING-E TLC OUNTERED- BY e4 Date SEC. €3 196 L.— DESIGN Soil Rate Used zo Min/1 " Drop: S. D. Usable Area Provided o00 No. of Bedrooms _Septic Tank Capacity 000 Nel Absorption Area Provided ByL. F. x24" ; :�� c . Name G i i N Signature ; Address 37 FAA* _5TRGET- SA THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq: F. /Cal. Checked'by Date _ BRUCE ..R....FOLEY ., - .. y. Public Health Director - LORETTA`, MOL 1NAR1-' R:N:; - N&S` 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 August 30, 2002 Guy Amoroso 146 Bell Hollow Rd. Putnam Valley, 10509 Re: Accessory Apartment- Amoroso, 146 Bell Hollow Three Year Approval - Town:Putnam Valley, TM #51 -1 -32 Dear Mr. Amoroso: I have received and reviewed the plans for the proposed accessory apartment at the above - mentioned residence.' The proposal for the apartment has been, approved as per plans bearing the approval stamp from this Department dated Auggst 3002002. The apartment is approved for three years with the following conditions: 1. The total number of bedrooms in the apartment must remain at one without prior approval by this department. 2. The total number of bedrooms in the main house must remain at three without _ . .prior approval by this department. -= 3. The area of the existing sewage disposal system, and its expansion area, must be maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me. at your convenience. Very truly yo William Hedges WH:lm Senior Public Health Sanitarian . cc: BI BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH LORETTA MOLINARI RN., M.S.N. .Assoclate Public Health Director Director of Patient Services 1 Geneva Road Brewster, New York 10509 Environmental. Health (845) 278 - 6130 Fa:x (845) 278 - 7921 Nursing Services (845) 278.6558 WIC (84' 5) 278.6678 Fax (845) 278 6085 Early Intervention (845)278-6014 Preschool (835) 278 -6082 Fax (845) 278 - 6648 ACCESSORY APARTMENT APPT ICATION Date Renewal ❑ ❑ Yes No STREET 1q6 �x�k �4-j4Tow � .w,�� MAP 3e NA�iE PHON6 CHDD MAILING ADDRESS % �6 MAILING ADDRESS OF APARTMENT NIUMBER OF BEDROOMS IN MAIN ROUSE r NUMBER OF BEDROOMS INt APARTMENT Please submit this form and the requirements on page two to the Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10509, Phone 278 =6130. Approval is effective for a three year period. The applicant must reapply"at the end of each period to renew the legal status of the apartment. ) . I gnature of Applicant roved Date PP to- s Bye-' Title WOW 9 so ZO OFFICE USE S S �?,` I .J I. h 1 Comments ,� l t` i i I BRUCE R. FOLEY Public Health .Director a ORETTA ; M0LI1VARI' RN ; M.S.N. . Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)'278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 608S Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET M Nk k�k-' P TOWN J� ,,,,\(4 TX MAP# :5 1— 1 " 3l NAIL t,rcM :vosd PHONE 84 - PCHD# MAILIN' G ADDRESS N4 1 �0& Ukq,-J O,a DESCRIPTION OF ADDITION NLTINISER 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 Architecf 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. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) ' *Non - professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhouseguidelines YML E�UIRONMENIAL SERVICES u�l Kear 5treet Yqrktown Height,,j#,y,,1f}598 (914) 245-2800 Albert H. Padovani, Director LAB #: 32.204080 CLIENT #: 55604 NON STAT PROC PAGE 1 AMOROSO, GAETANO DATE/TIME TAKEN: 06/06/02 1 LAKEVIEW DR 115 DATE/TIME REC'D: 06/06/02 I1:12A PEEKSKlLL, NY 10566 REPORT DATE: 06/13/02 PHONE: (914)-788-659:t SAMPLING SITE: 146 BELL HOLLOW RD SAMPLE TYPE..: POTABLE : PUTNAM VALLEY, NY 10579 PRESERVATIVES: NONE COL'D BY: GAETANO TEMPERATURE..: < 4C NOTES...: KITCHEN TAP CDLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~v~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE 06/06/02 NF T. COLIFORM 06/06/02 LEAD (NMS) 06/06/02 NITRATE NITROG 06/06/02 NITRITE NlTROG RESULT ABSENT /100 ML <1 ppb 0.32 MG/L <0.01 MG/L NORMAL - RANGE ABSENT 0-15 ppb 0 - 10 N/A COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIN�~T[T=THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. ' Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. SUBMITTED BY: ublic schpols-are�ne& at 15 ppb, Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3mg/L, else water undertaken to reduce the waters corrosive Director METHOD 9139 9146 ELAP# 10323 -SI Dare -- 8'-l� - o z CUSTOMER --_A44 0 1903 a ADDRESS -- �C QGII R TU 4� vj FRAM WJJ� At HOUSE AGE - -- IS_1WXo X SYSTEM AGE -- IJ^ �� y # OF BEDRMS -- ~ S # OCCUPANTS -- 3 LAST PUMPED-- / Ye- TANK SIZE -- 147-0 TANK CONTRUCTION- CONCRETE - K STEEL- BLOCK- CESSPOOL- UNKNOWN- DISPOSAL TYPE- TRENCH- FIELb- PITS 6ALLEY- TANK CONDITIONS- BAFFLES IN PLACE -YES- Y-NO- - -HIGH LEVELICATIONS -YES- NO- k COVERS) dd -- DEPTH - - -FT 2-IN COMMENTS -- L F ------- --- - M. r 64,71 Pon LU V dw ab PN as eta % -4 Z. Go YD Go t4 all 7 70H, 77.gg. 16 41 IL bi tcu out 3 F2 . . . --A..% -- - '6- t -.,.. - - - - - " - . .a. BRUCE R. FOLEY LORETTA MOLWARI R.N., M.S.N. Public Health Director lr;cto; of Patient Services DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 1.0509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278-6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: N- a. (6-4-0 Residence Tax Map 1 . - / - A 2- Town V& Uzi Acc,RrdZo 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 ONANCY: ASSESSORS RECORD: Building Inspector BFhouseguidelines notea ior comorm.ance win HOUSE P-, - p- , - -" L-A ;S Al ': ED ;-;mss end of the BEDROOM, c-Cj-;.. --3 Wate - - Signa-tur-a & "I'itae "awe BRUCE R. FOLEY Public Health Director DEPARTMENT 1 Geneva Brewster, New OF Road York LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services•-^ HEALTH 10509 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 6, 1999 Alex Amoroso 146 Bell Hollow Rd. Putnam Valley NY Re: Addition - Amoroso -146 Bell Hollow No Increases in Number of Bedrooms (T) Putnam Valley Tax # 51-1.1,,2 Dear Mr. Amoroso: 1�a'" 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 December 6, 1999 .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. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley- . If you have any questions, please contact me at your convenience. .Very truly yours,_ William Hedges WH:kg Senior Public Health Sanitarian cc: BI BRUCE R. FOLEY Public Health Director �-. —.. ►.. .. a.. .+ ., S ".0 ..... .... a. v. ..+ rr-p': r. ..•4:-.. "..<....a. :.... -... r. .a.- .. ... DEPARTN LENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY= STREET �� Aef� 111 T ®WNP,-,T% MAP # Cr- o ,5 0 NAME. A k ex W050 PHONE q `V 528?WPCHD # ' 1viAILING ADDRESS 1 tlb Ya u Lk,., NP DESCRIPTION OF ADDITION �\. k_� NUMBER OF IEDISTING BEDROOMS 3 ®POSED # OF BEDROOMS 0 (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 Rd., Brewster, NY 10509, Phone 278 -6130. " Y. 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 Feb 98 i0' °w,. ' R.S. ... F LEY Acting Public .Health Director DEPARTMENT OF HEALTH Division. Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map Town Gentlemen: According to records maintained by the Town, the above noted dwelling IS 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 Building Inspector OWNER .LOCATION SEC /BLK /LC RECEIP" FOR '..'OWN AND COUNTY REAL ESTATE TAXES COLLECTED BY THE. TOWN OF PUTNAM VALLEY V- R:,•T;HE TAX YEAR Th.ru '199'9' _ Receipt Date 01/25/1999 AMOROSO ALEX 146 BELL HOLLOW ROAD 051- 000 - 0001-032 -000 =0000 AMOROSO ALEN. 146 BELL HOT LOW RD PUTNAM VALLEY NY L 0 5 7 9 PAYMENT TYPE : Full Payt TAX AMOUNT PENALTY AMT MAIL CHARGES NSF CHECK CHG TOTAL PAID DATE PAID RECEIPT NO. BILL NO. THIS I3 YOUR OFFICIAL TAX RECEIPT T.AXPAYE.R BILL OF RIGHTS INFORMATION 1439.97 0.00 0.00 0.00 1439.97 01/23/99 00784 0OC130 The Asse sed value of this property as of 03/01/98 is $ 194400. The uniform percentage of value used to establish assessments was 10C.00%. The estimated market value of this property is $194,400 If you feel your assessment is too high you have the rIght to seek a reduction in the future. For further information, please ask your assessor for the book- let "How to File a Complaint on Your Assessment ". Please note that the period for filing complaints iii`i\Ithe above assessment has passed. EXEMPTIONS None Tax Descr PUTNAM CO PUTNAM VA FIRE DIST .TAX BILL IETAILS ption Total Levy �� C g "Tx Vaiue ' Tx Rate Tx '~mount NTY 000000002422985 0.0 194400'0002.87947 559.77 LEY 000000003397281 5.4 194400 0004.00458 778.49 452537 X0.0 194400 .523196 101.71 $Orm (Rev. ga 0 ai H a go m gu ..i a Give this form to -ch 1994) Request for Taxpayer the i equester. DO t of the Treasury - y Revenue Service 0 dentification Number and Certification I 140T tend to IR5. Name (if joint names, list first and circle the name of the person or entity whose number you enter in Part 1 below. See instructions on pa(e 2 if your name has changed.) ALEX AMOROSO Business name (Sole proprietor; see instructions on.page 2.) Please check appropriate box [ I IhdiVidttal /Sole proprietor ❑ Corporation ❑ Partneriamp ❑ Other .................... Address(number, street, and api., or suite no.) Requester's name & adtress(optional) 146 BELL HOLLOW ROAD City, state, and ZIP code PUTNAM VALLEY NY 10579 Taxpayer Identif i cat Enter your TI in the appropriate box. For individuals, his is your social sscirityy number (SSN). For so a proprietors, see the Instructicns on page 2. F other entities, it is your emplcyer indent n number (EIA). If you r10 not hate a number, see w To Obtain a TIE below. Note: If the laccount is in more than one name, see the chart on page 2 for guideline; on whose number to ent6r. Social security number 1 054 -68 -0614 OR Employer Identification number i List account number(s)tiere (optional) 250211-0-1-. For payees Exempt From Backup Nithlolding See Part II Instructions on page 2) ' ' Cert i f icatirZ_ Under penalties of perjury, I certify tha :t 1, The Number hown Qn this farm is my correct ta..epayar identification number (or I am waiting for a number to be issued to me). and 2. 1 am not su tect to backup withholding tecause :(a) I am exempt from backup withholding, or (b) I have not been notified by the Inu rnal Revenue Se vice that 1 am subject ti backup wlthh(iding as a result of a failure to report. all interest or dividends, or (c) the 115 has notified m that I am no longer subject to backup withholding. Certification Instructions. - you ;nest cross o it item L' above if you have been notified by the IRS that you are currently subje:t, to backup withholding bee use of underreporting interest or dividends nn your tax return. for real estate transactions. item c does not apply. For mortgage interest paid. he acquisition or abandonmert of secured property,cancellation of debt, contributions to an individual retirement. arrangement (IRA), and gene ally payments other than interest and clvidend,. you are not required to sign the Certification, but you must provide y(ur correct I1N. (A su see PART III Instructions on page 2.) Sign Here I S"gnature Section Internal Code. Purpose o file an info get your cor you, real es you paid, th secured prop contribution give your co requesting y certify that that you are (2)to cert.if; backup withhi from backup i payee. Giving the approprii Payments froi withholding. Note: if -i a N -9 to requ requester's f this form N9. What is I maklnn certain pay the IRt: 31% are to the Form. -A person wnc, is reculred to nation return with the IRS nest ict TIN to report income paid to ite transactions. mortgage tuterest acquisition or abandonment -!f Ity, cancellation Of debt. o:, you made to an IRA. Use Forn N-9 to ,ect TIN to the requester(th,: person it TIN' and, when applicable (I) to he Tlli you are giving ii; correct for alting for a number to be i.,sued). that you are not subject ti:, ding. Ural (3) to L1aim exenatiou thholding if you are an exenpi you correct TIN and making e certificatinns. will prevent certain being subject to backup quester gives you a form ether than t your TIN, you must use Z•re M if it is substantially s milar to Withholding'?- Per.,ons is to you must withhold and pa.v tc Date 9/09/98 of such payments under certain conditions, This it called 'backup withholding." Payment., that could be subject To backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay. and certain payments from fishing boat operators. keal Estate transactions are not subject to backup withholdina. If you give the requester your correct. TIN, make the proper certificsrions, and report all yOm' taxable interest. and dividends on your tar. return, ,your payments will not be subject to backup withholding. Payment,, you receive will be subject to backup withholding if: 1. Yuu dv uvi furnish your TIN to lht requester, or 5. You do not certify you TIN. Sea the PART III instructions for exceptions. Certain Payees and paymen s are exempt from backup withholding and in ormation reporting, Sec the PART 11 instructi ais and tht Separate• instructions for the requ ster of form W -9. How To Obtain a TIN . - If you do not have a TIN, apply for on immediately. To apply. get Form SS-! , Application for a Social Security Cardtfor ndivlduals), fr(nn your local office of the . ocial Security Administration. or Form: SS-4, Application for Employer Identificati-n Number (for businesses and all o her entities). irtmr yuw• iucoi IRS off i,; . If you do not have a T 11. write `Applied for in the space for the TIN it Part 1, sign and 2. The IRS tells the requester that you date the form, and give i to the requester. furitished an incorrect NN, or Generally. you will tnOt rave 60 days to get a IIN and give it. to the •equester. It the 3. The IRS tells you that1 are requester does not receiv• your TIN within sub,fect to backup withho.l ¢ becauzE.•7rti 60 days. backup withholdl g, ii applicable, did not report all your interest and . divideends "' wi11 begin and continue a ti you furnish on your tax return (for repo41able in�er2s¢ 8ti 51., •.. your TiN. dividends only!, or .:,;y 4. You dig not certify to the requester that you are not subject to backup withholding under above (for reportable interest and dividends) accnunts. Opened after 19:3 only), co, :160403 CITIZENSHIP AFFIDAVIT Premises: 146 BELL HOLLOW ROAD PUTNAM VALLEY'' NY 10579 Mortgage Amount : $69, 000.00 STATj OF NEW YORK Ste. OF WESTCHESTER The undersigned, being duly sworn, depose(s) and say(s): (He /she /they reside(s) <<t the above address and is /are the owner(s) in fee of the premises listed above, waich is subject to only the following encumbrance: A first mortgage in the slam shown above held by GREENPOINT BANK. Purchaser (s) represent : s) and warrant(s) that the purchase price p iid by he /sh /them for said Premises is 100; 000.00. he undersigned has /hf ve not been known by any other name(s) for We past ten y ars and he /she /they affirm that he /she /they about to occupy the prem: ses as his /he • /their home and acknovrledge(s) receipt of copies of the Note and Mortgage, he undersigned is /are citizen(s) of the United States, and over the age of eighte n (18) years. Ther � are no judgments, warrants or liens again it the under igned in any court of this State or of the United States. The under signed has /h never filed any petition in 'bankruptcy, nor have the undersigned- '.ever' been �de ju dicated bankrupt - There -`are -nti federal fax claims or liens -asses.;ed or- = -: filed a atnst the 'undersigned . 4 i i ALEX AMOROSO V Sworn �o before me this 9 day �f SEPTEMBER, 1,398 4 4 1 ~� Notary Public r� 'lE �•;,'3 C A L � 0 oil :} w m C r l` OL,G Off/ Ail ��. OA 40 5 Pt ME a b 4A t .r ti p 4 bd ,r' a' �� 0 / tib R �k . u _ ! ,q 1 ti ti �y w _ - - a ti 4 Ib- 0 -09 r 3 i 8 i. k Ii PUTNAM COUNTY DE.rjART?,, NT OF HEAI�7[°H -- HOUSE PLAH'S Aflfi' - "i ".. BEDROUTi C.i iv;; T ' ���EDRO��'•'� Signature & Title D �. a .......... AN Cl,'7 l-' � w� IT ae, er-\ r...�rP�:�:.,r ...' 2 � •cam :. i. 4t w..0 � �- ,��� `�' _______ �-- �� 1 �� �, ������ - � ,� � � � �i � � s. � � �m�r �.h/ 9 l �, .�a� °� �a���. � .L } v r' 1. i i 4 �l �LJ r �,C . i t' f -q 1 � ;t 1 C� f1 t 11 1. u i . i. i ? i a j ' Y. C WELL UUr1rLtT1UW &LrVA1 Office Use On y DEPARTMENT OF HEALTH 0j / _.._ _. <Di.vis -ion. -Of- En i- =3nmental Health Services �w �0 PUTNAM COUNTY DEPARTMENT OF HEALTH STREET ADDRESS: WNfVII I v TAZ GRID NUMBER: WELL LOCATION WELL OWNER NAME'. aooRES pgIVATE p UBLIC USE OF WELL 1 - primary 2 - secondary KRESIDENTIAL O PUBLIC SUPPLY ❑ AI /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS O FARM O TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT J gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE— - gal. REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DEPTH DATA ' WELL DEPTH �6 f ft. STATIC WATER LEVEL ° tt. DATE MEASURED DRILLING EQUIPMENT ;K ROTARY ❑ WELL POINT O COMPRESSED AIR PERCUSSION 0 DUG O CABLE PERCUSSION O OTHER (specify): WELL TYPE O SCREENED O OPEN END CASING. OPEN HOLE IN BEDROCK 0.OTHEA CASING TOTAL LENGTH fL MATERIALS: RSTEEL ❑ PLASTIC O OTHER LENGTH.BELOW GRADE ' ft. JOINTS: 0 WELDED MTHREADED ❑ OTHER DETAILS DIAMETER in. SEAL: ❑ CEMENT GROUT O BENTONITE THER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE;!fYES ONO LINER: OYES XNO $CREED. - D ETA I•l�S_ DIAMETER (in) SIOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST :_. . -.., _..:.....:: : _ _.:..._ _;:: O YES -:ONO . . _ _. _ _ SECOND .... _..- _..__......__...._... _. _ .. _ _. _._ ..__ _ . .... _ _ ..........._. _._..... ..._- - .......... GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH It. WELL YIELD TEST It detailed METHOD: O PUMPED a tests were COMPRESSED AIR ,formation O BAILED ❑ OTHER ; O YES pumping done is in- attached? O NO WELL LOG it more detailed formation descriptions or sieve analyses are available. please attach. DEPTH FROM SURFACE water Pear• ing WeII met meter FORMATION DESCRIPTION CODE. ft (t, WELL DEPTH It. DURATION hr. min. DRAWOOWN ft. YIELD gFm. Surface ' �� //6' .;1f �•.R3S ', WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ANALYSIS ATTACHED? O YES ONO ONO STORAGE TANK: TYPE a4g/—_3C - _/,/la -ra* >'f CAPACITY / Z d GA v PUMP INFORMATION TYPE CAPACITY MAKER DEPTH VOLTAGE J� _ i d HP " WELL DRILL NAME OA G°_ AooRES �`� SIGTtA7URE /� 1 101993 • ^ r r .S,- ,1N7y' `:�1te •L'41 ti. \ .� �° t d'+ 'h :jt3•.*,. ,q i4h i ! y' mot, a rf 'c { h w � . .� 4 s •a y 4 �� 1 `ate •i;ta + 1 .. ��7.y�`rp' 'M`e� •�i yw� if .,�!'�" t MFi.Yri },Ct" xY^ R�'F1 _ '.R d O6J'a-di on'Stat4on use 3� �•+ r }. 321 KlOt Scnec {r p riir� �� +r.r�.r� t . xr'�_ �lorktoerA Heights, N Y 10598 a ,` �' " " �acel Peekskill ''�' �, i"'+ -••.F' r'v tiros t,� i s �.'r.�. • i T'a t v i Y' r;' E� <'sr ,r-ey r4 i „ysk4t „ ,Mt Kisco Rev k DW 6p8 : AUvt'hi PadotkaniJ� 1: {ASS) w era ' `� ,` ' taAe Taken r ' date Re * delved ,, � {� >�f t�""� �,e�e•�' Nutt of nr+ i Reported 4"' jr ¢ - �,,-43� Ly i FF i'I �(R / .. �'� , rtl f 4F 'v t,,2 ,�CiQllect�ed By•' ... ` {/1R�t�1 •. 9 44- 1 ie4'erre�d B' ''• :" Y Samp1 e . 8ourc a ja _ H A Y f y •` �� �� f i J �'� ' r � �� A �•, Z WATER' HRATORY REPORT a ,. F. " �L GENERAL-BACTERIA' Starndard Plate Count per 1.0 ml (Agar�pl 'te'@ 35 0C) MEMBR NE- FILTRATION TECHNI UE (MFT) Total Coliform Der 100 ml Fecal Coliform ner 100 ml Fecal Streptococcus per 100 ml MOST PROBABLE NUMBER TECHNIQUE (MPN). _ Total Coliform: MPN Index Der 100 ml Fecal. Col.iforan: r OTHER ANALYSES I MP9 Index per 100 ml THESE RESULTS INDICATE THAT THE WATER SAMPLE OF A SATISFACTORY SANITARY QUALITY- ACCORDING, WATER STANDARDS, FOR TH.E'PARAMETERS'TESTED, AT Albert H. Padovani, M'-'T'.:(ASC -P); Director • 7 { 1 ?AS) (WAS,.NOT) (NOT APPLICABLE),` TH NEW YORK STATE DRINKING rn TIME OF COLLECTION. LEGEND RDS = Recommend Disinfect- ; ing Water Source: < = less than TNTC = Too Numerous Too' Count s PUTNAM COMP DEPARnvWT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner 6r Purchaser of. Building Section Block Lot Building Constructed by�j Location - Street Municipality `51�%si Building.Type Subdivision Name i� Subdivision Lot # GUARAi+M OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, 'and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by -me which fails to operate for a period of two years immediately following the date of approval of the "Certificate 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 -or iiegYigeht act - of-'the -occupant of the-built iM utilizing- the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental 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 day of 19 Signature "'A Title eral Contractor (Owner) - Signature Corporation Name (if Corp.) rev. 9/85 mk Corporation Name (if Corp.) AdcItess COMPLAINT: ,,o V I e/, G U love, )< / %O ' . GU �'7�o,'�i q�rd i `n d .o �, j�io�i moo✓ -- ' DIRECTIONS: TAKEN BY: REFERRED TO: •-BArTE : w PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEMkGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT DUE: �/3'YV(n Q-YV INSP. BY: (Name of er ) (Street Location) INITIAL SITE INSPECTION YES NO COMMENTS Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Will driveway need cut ............................ Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed...... .......... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/ septics ............................ D. H. 1 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. Soil Descr I-- D. H. 2 Lot Depth to G.W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft, Soil Descri D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. -. -.12 .ft. -. Soil Descrl i 14 3b (� 60 . DATE: /0- 0 03 FINAL SITE INSPECTION INSP.BY: NO CAS House SSDS located per approved pl ............. Length of trench measured Width of trench average i Slope of tile line and trench acceptable......... . Room 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.) ........ I.Q ; Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ L5 ft. of peripheral soil horizontally from trench ..... ............................... Boxes properly set....... . ........ ........ 3ould surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE AIXEPTABLE.. ..... (—r7 /C. an di I out, :DAVID D. ", , - ;Cny Executive s DEPARTMENT OF HEALTH Division Of Environmental Health Services May 22, 1986 Frank Sullivan, P.E 2972 Ferncrest Drive Yorktown Heights, New York .10598 Dear Mr. Sullivan:. y s JOHN SIMMONS, M.D. Deputy Commissioner Re: Amirosso SDS Construction Permit Renewal PCHD Permit PV 42 -82 Bell Hollow Road, PV, Tax Map 23 -4 -1.115 Rosenberg R.S. Lot 10 Review of revised plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. Plans do not reflect design based on 20 min /in. soil rate obtained from original tests for permit in 1982. _ 2. Ti-1 i r ribtes ..a re, -st'i1-1,-1a-cki.n- g._... _._ .- ..__...., _._.._ - ....._ ...._ ....... 3. Detail of interceptor ditch lacks considerations for erosion resulting from near 20% slope. Rock lining as previously discussed is recommended. 4. Revised submissions containing revised applications should indicate "REVISION" in the appropriate box, even if a permit has not yet been issued. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. ours very truly, es S. Ho ens JSH:pt Asst. Public Health Engineer cc: G. Amirosso JK JH Rcgev. TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 y PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.ENVIRONMENTAL HEALTH SERVICES Date 43 , _ .... Re: Property of 'ay Located at (T)! «/i�0177 l Section 23 Block .,f— Lot Subdivision of Subdve Lot Filed Map , Date Gentlemen: This letter is to authorize }-e�h a duly licensed professional engineer or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said stoms--- i„_.- oenfor -cr ±y kT tlz the •pro-Tisi•cns .-of Ar or- _..._.. 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, c ti Countersigri�e,. PeEe, R,A, �a 4O N • �P Address Telephone Telephone PUn M COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS �� 7 FIELD INSPECTION REPORT -8G INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION G M9 � YES K01 CAS Wetlands on/or proximate to property .............. C) � Property lines or corners found... .. ............... Can estimate house location ....................... Will driveway need cut ............................ Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed..... ... ...... 0 PI Sufficient SDS area available considering driveway cut, house location, separation distances,etc... ✓ Adjacent wells/ septics ............................ k D.H. 1 Lot Depth to G.W. Depth to rock 0 ft. 3 ft. YES 6 ft. � t 9 ft. 12 ft. D.H. - Deep Hole G.W.- Groundwater D.H. 2 Lot D.H. 3 Lot Depth to G.W. Depth to G.W. Depth to rock Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. Soil Soil Descri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room 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 bedroams checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ..... .......... 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxes properly set.... ..... ................... Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE................... C•7_ PJPNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS . (14INSTRUCTIOA PERMIT ,�. (Name of Owner) CONENTS TA LOT-klts 4* 11-1. �i ILL Gt IPA L� br-PTW S'6 T S �- P r sko ©P, tN (0-r- G I f �- Property Metes P' 42. S� i (Strut Location) YES NO DOCUMENTS _ Permit Application �-- Corporate Resolution Plans -Three sets Engineers Authorization Design Data Sheet (DDS) s' Deep Hole Log Consistent Perc Results ---- 30" Perc Hole Other House Plans -Two sets � If PWS - Letter 1. frc.c.. fi;07Es Variance Request P ITC K DETAIL- ROCK REQUIRED DETAILS ON PLANS `I �'� Sewage System Plan — PLRG� n+'c4f �4r Na? TV %0� Sewage System Hydraulic Pro - Gravity Flow Fill Profile &Dimensions. Volume D or J Box;Trench /Gallery; Pump pit details eptic Tank -Size, Detail Well Detail, Service Line if over Construction Notes Design Data TC-) L o Two -Foot Contours Existing &Proposed Driveway &Slopes Cut Footing /Gutter Curtain Drains Perc &Dee Holes Located Representative of Sewage & Expansion Area; shown; gravity 7r£- Punk' � Pik .& . D� Box_.Sh .._ House - No. of Bedroans Wells &SSDS °s w in 200 ft. o IPQ� s -zz -�� Expansion Area flow,suff. size.: own � Property Located House Setbac ecessary Tight lot) House Sewer - . 4' °0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20° to Foundation Walls 100' to Well; 200' in D.L.O. D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains�irtain ,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -20 °) Septic Tanks 10° from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) 03,R62- "4 ZCIX,, Data On DDS Plans &Permit Same FCMe~WA'�- PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES• Date 11 -30 -82 Re:. Property of Hagar Homes Inc. Located at. Bell #follow Rd. T/0 Putnam Valley (T)Tax Map #23 Section Block 4 Lot 1.115 Subdivision ofd- Klondike 2 13998 Subdv. Lot.# 10 Filed Map # Date Gentlemen: This letter is to, authorize Cashin'Associates a duly licensed professional engineer �/ or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards,.rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said -system-or systems.. in 'conformity with the provisions of Article 145 or r. R. 147, Education Law; the Public 'Health Law, and the Putnar����^y;��� tary Code. Countersigne .. ; P.E., R.A., 1' 7 FA i IZ riff- Address Very truly yours, U. Signed wner :o ropgrt CAKM E7L , I�E_W 0P,9 )0S)2__ Telephone Address F-IAGAR HOMES, 9� . 9 Frozen Ridge Road. Town Newburq:i, N. -... Telephone I, //, , A -, "Y 42- le, ro. l3 7 Putnam County Departmen-t or healt i ' Division of Environmental Health Serv: tpproved as noted for conformanoe wit) applicable Vules and Regulations of t] Putnam Count );ith De pS;ment. -'anckture A T1t.1p A's is to certify . tha�,,;I- ,x t I e 4 .,. zg*A-tA N004ir4�tOd R, indicated: w.aO 471090*od b 'b e f S x%4 ass ��6 k.- t V 14�1,1 z AV 29 3o 5-4 7& g 7 Putnam County Departmen-t or healt i ' Division of Environmental Health Serv: tpproved as noted for conformanoe wit) applicable Vules and Regulations of t] Putnam Count );ith De pS;ment. -'anckture A T1t.1p A's is to certify . tha�,,;I- ,x t I e 4 .,. zg*A-tA N004ir4�tOd R, indicated: w.aO 471090*od b 'b e f S x%4 ass ��6 k.- t V 14�1,1 z AV ex- I i. fi