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HomeMy WebLinkAbout2558DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 -589 -8100 51.19 -1 -45 BOX 22 02558 i ly, �� -6 L . J .` • T '. f A.36 IL 02558 IN PUTNAM COUNTY DEPARTMENT OF HEALTH ENVIRONMENTAL - HEAL T ,H RERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FO ATMENT SYSTEM PCHD CONSTRUCTION PERMIT # ) %V S � F P o Located at % 141,4 / S D N AIA Owner /Applicant Name .STA� -11-E Y AET£2So'U Formerly_5 �4 Mailing Address a..J 7'1�' . o Town or Village iv M e Y, - Tax Map S-/. /% Block / Loth Subdivision Name J-,� bS C A WA VA - .SEc)� Subd. Lot # 3 0 Ayit 'Wlez Zip /Ds-%% Date Construction Permit Issued by PCHD Separate S verage System built by A.,/Ie oN Address o?/ �✓ATJ�•� kv,1 -J Consisting of / O U o . Gallon Septic Tank and a O D OF 7-4.f" - G4 L1.E -A y Other Requirements: o? , go 'B Water Supply: Public Supply From Address or: ]Private Supply Drilled by fAn/>EeSaA) Address 34R-IrEk AJIJ E-y Butilding Types i� �:✓ %Ey Has erosion control been. completed ?�S Number of Bedrooms 3 Has garbage grinder been installed? Li% I cer*, that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: AX o 2 Certified by ` �• P.E. ✓ R.A. Address License # D (o i40 s% r Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public 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 Public Health Director, such revoc 'on, modification or change is necessary. R By: '� Title: Dat e: White copy - HD ile, ow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PiTTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: �C L- .LL= Town/Village: 0___jj I Tax Grid # Map51 d ?Block i Lot(s) 45 Well Owner: Na e Address: Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment >I'- Rotary Cable percussion Compressed air percussion Other (specify) Well Type Casing Details Screened Open end casing x Open hole in bedrock Other Total length P- I ft. Materials: X Steel _ Plastic _ Other Length below grade /9 /-It. Joints: _ Welded e_ Threaded _ Other Diameter �" in. Seal: 7e- Cement grout _ Bentonite Other Weight per foot /G lb /ft. Drive shoe: -,a- Yes No Liner _ Yes _Z No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First —.Yes—No Hours Second Well Yield Test _ Bailed _Pumped -/-Compressed Air Hours Yield X- gpm Depth Data Measure from land surface- static (specify R) -a .r ' During yield test(ft) ---. Depth of completed well in feet 3,00" Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type ,Kot 4 _e_ Capacity 6— Depth ,A fo Mode _ Voltage 2-30' HP Tank TypZep Volume x -,3 P1ja Date Well Completed Putnam County Certification No. Date of Report We 'Driller (signature) NOTE:/Exaq location of well with distances to at least two permanent lanamarKS to De provtaea on a separate sneeuptan. Well Driller's Name ��,p ��' �= Address:�.i Y r Q.-M 1 a& Signature: Date: White copy: HD File; Yellow copy- Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 3 YML ENVIRONMENTAL SERVICES 321 Fear Street 517`7 7 Yorktown Heights, N.Y. .. .10598 14f­ 245' Albert H. Padovani, Director- LAB #: 3e.�02170 CLIENT #; 553e9 NON STAT PROC- PAGE 1 -------------- - ------ PETERSON, STANLEY DATE/TIME TAKEN„ 03/P7/02 10:45A 21 WATSON WAY DATE /TIME REC'D4 03/27/02 11.35A PUTNAM V'AL.I,'•EY, NY. .10579 REPORT DATE: 04/03/02 PHONE: SAMPLING SITE: 27 WATSON WAY, PUT VALLEYNY SAMPLE: TYPE-- POTABLE KIT TAP PRESERVATIVES: NONE COL'D BY: TEMPERATURE..: < 4C NOTES... COL I FORM 'METH MF --------------- " AIAIAINNAINAI HI AI H' .1, AI HI AI AI DA17E FLAG PROCEDURE. RESULT NORMAL RANGE METHOD PUTNAM CNTY PROFILE 03 J27 /02 MF T. COL -I FORM ABSENT /100 ML ABSENT 1008 0;3/c -27/02 LEAD (INS) <1 ppb 0•15 ppb 9101 03127/02 NITRATE NITROG 0.41 MG /I_ 0 - 10. 9139 03/127/02 NITRITE NITROG <0.01 MG/L N/A 9146 0311127/02 IRON (Fe) <0.060 MG /L 0-0.3 mg/l 2037 03/12!7/02 MANGANESE (Mn) <0.010 MG /L 0-0.3 mg/l 2037 0:9127 /02 SODIUM (Na) 2.16 MG /L N/A o31i27/02 pH 5.7 UNITS 6.5-8.5 .9043 ?3/27 /02 HARDNESS, TOTAL 66.0 MG /L N/A 031,27 /02 ALKALINITY (AS 48.0 MG /L N/A 03127/02., TURBIDITY (TUR <1 NTU 0-5 NTU CM -1K,` BACT Ti-iE;E RESULTS INDICATE THAT THE WATE (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIN HE NEW YORK STATE ANDEPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TE:9'ED, AT THE TIME OF COLLECTION. Pb /Cu L_E:gi limits for p, E:PpLead & Copper t.hp 10% of their -bhri 15 ppb and a -1--rgttment must be p,L-) 10. n t i al iblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn 1-ft)oth iron and manganese are present, their total value 4-_,od)ined shall not exceed 0.5 mg/L. t "Na 1401imits for Sodium are proscribed. Suggested guidelines.stat6 t_-ht for people on a sodium restricted diet,,the water should cz-a•tain no more than 20 mg/L of Sodium. For those on a anderately restricted diet, a maximum of 270 mg/L of Sodium iLssuggested. YML ENVIRONMENTAL SERVICES 321 Kear Street (914) 245-2800 Albert H. Padovani, Director LAB #: 32.202170 CLIENT #: 55329 NON'STAT PROC PAGE . 2 ------------------------------------------ PETERSON, STANLEY DATE/TIME TAKEN: 03/27/02 10:45A ?.1 WATSON WAY- DATE: /TIME REC'D: 03/27/02 11:35A PUTNAM VALLEY, NY 10579 REPORT DATE-. 04/03/02 PHONE. SAMPLING S&Ec 27 WATSON WAY!, PUT VALLEYqNY SAMPLE .TYPE. . u POTABLE KIT TAP PRESERVATIVES: NONE COL ID By: TEMPERATURE..a < 4C NOTES...: COLIFORM METH: MF ----------------- - DATE FLAB PROCEDURI:.*. RESULT NORMAL. - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1•14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE 7*0 METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL-HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATES IN MG/L.-THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L. DEPENDS Ohl THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY ..HARD WATER: -70-140 MG /L MG IL ::; M I LL I GRAM . PER- .-L I TER HARD WATER: 140--300 MG/L grain/gallon = 17.8 MG/L) I TTED IF: .Albert hi. Padovani, M.T.(ASCP) Director ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Tj A) E �CT�eso,j Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Town/Village ,? 7 WA T -3 c � �yf9 �/ LX • D•I C .4W qAe 4 - Location - Street Subdivision Name 4rj- /:;� 3 o Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage: treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the - system., The undersigned. further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether, or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day /J' Year D Z- Signab Title: General Co ctor (Owner) - Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: Address: State - Zip State Zip Form GS -97 Public Health Director Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH i Geneva Road Brewster, New York 10509 Environmental Health (914).278 - 6130 Fax (9.14) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (9I4) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278.- 6014 Preschool (914) 2786082 Fax (914) 278 - 6648 OWNERS NAME: TAX 'MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OF (Signature) DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal -E911 address is assigned.by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFRM) BRUCE R. FOLEY Public Health Director April 17, 2002 LORETTA MOLINARI R.N., M.S.N. . Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Vincent Ettari, PE 1065 Spillway Road Shrub Oak, New York 10588 Dear Mr. Ettari: VA f" Proposed SSTS Compliance - Peterson 21 Watson Way, Putnam Valley Tax Map # 51.19 -1 -45 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 0 E -911 address verification form to be provided. Upon receipt of a submission revised to reflect the above comments, this application will be considered further.:.-.. - Sincerely, 54�z_ Shawn Rogan Public Health Technician SR:cj PUTNAM COUNTY DEPARTiiENT OF HEALTH DMSION OF ENVIRON1YIEN TAL HEALTH SERVICES t FINAL SITE INSPECTION :.., I�specte y� � j' Street Loc W Owner Town Permit # TM # Subdivision Lot # 1. SeNtiage Svstein Area a. STS area located as per approved plans :.......................... b. Fill section - date of placement 3:1 barrier . Width Avg.Dpth c. Natural soil ot stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from «•ater course / wetlands ...... ............................... J1. Sewage Svstem a. Septic tank si �eevel .... 1,250 ......... other ................ b. Septic tank ins ............ ... ............................... c. 10' minimum from foundation .......... ............................... d. istnbution Box 1. All outlets at same elevation -water tested................. (� 2. Protected below frost .................... ........::..................... f 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box -properly set......... ............ f. renThes+ T-Len-g—th required 3 Cgtlins a 2. Distance to wate urse measured, Ft.......... 3. Installed according to plan ... :. ...................... 4. Slope of trench acceptable 1/16 =1/32" /fo6t ............. 5. 10 ft. from property line - 20 ft:= foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 - 1' /2 "diameter clean ..........::.:...... 9. -Depth bf gravel in trench 12" minimum ................... 10. Pipe ends capped .................................... :.................... g. Pump or Dosed Systems 1. Size ot pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio ...................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ............................ ............::................. 6. ,Cycle ,Mtnessed by H.D.estimated flow /cycle........... III. HouseBuildin a. House located per approved plans ... ............................... b. Number of bedrooms ....................... ............................... . IV. Well a. Well located as per approved plans ............................... b. Distance from STS area measured (� ft........... c. Casing 18" above grade .......................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .........:.... e. 'Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercours g. Footing drains discharge away from STS area............ .... h. Surface water protection adequate............ ......: ................ 76 NOVJ19 -20171 01:14 PM ETTARIr 245 6335 P.02 ................. PUTNAM COUNTY DEPARTMENT OF EiEALTH DIVISION OF EN`VMONA " SEh"TAL SII:ALTH SERVICIES ATTEN7'I��l �ADAAI 11 GENE REQUE:X POE FINAL, INSPECTI Oty' For: Fill All inforrastloa must be fully enmr -lel:M prior to any Trenches _. inspr ctioo„4 being made. D, / PCHD Construction Permit # Located: �f4 (T) (V) �✓ _� �7w�uer /Applia:wi i4tn:e; � Tr'd Di�Cic mot _ Formerl;r: ,__. _ '__ �. Subd"rtii. I�tune: _ Subdhision Lot # Is system fill completed? Date: .0! Is systern complete? —T Date: Is systern constructed as per plans. 1s well drilled? Is well located as per plans? w. '•�+� f Are erosion control measures in place? I cgrt4 that the system(s), as listed, at the above premiss has been constructed and I bava inspected and verified their completion In accordance with the issued PCHD Constructioc Permit and - - approved plans and the Standards, Rules and Replations of the 'Putnam Coe .ty Department of .. Date: _ l / Certified by: ZRA nesjga Professional: Address: ,/LJ G _i �l w _ ..... _.. Lic. # Comments: r _ Form FIR-99 NDv•'ji19 -2001 01:13 PM ETTARI^ 245 6335 P.01 ~ VINCENTT A. ETTARI,' P.R., P.C. e CONSULTING ENGINEERS 1065 SPILLWAY ROAD SHRUB OAK, N. Y. 10588 (914) 24.5 -6320; Fax (914) 245 -6335; www.ettari.com Vincent A. Ettari, P.E. Licensed Professional Engr. FACSIMILE COVER SHEET Date: �l Sender:- To., C�fJ • �o�i y -- Fax. Number; Attention: Number of pages being sent (including this sheet): °' Comments: DEPARTMENT OF HEALTH Divisi&i.bf Environmental Health Services TWO COUNTY CENTER --"' CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT'A WATER WELL PCHD PERMIT .�ION WELL LOCA' Street Address �� V'llage Cit Town y Tax ,r�v�� Grid N umber /a WELL OWNER Name "M Elling Address Q k 114 X' .: OPrivate O Public '. USE OF WELL l­ primary 2- secondary *- RESIDEN IAL D BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 06 ABANDONED 0 OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED_ /EST. OF DAILY USAG a1 REASON FOR DRILLING I&NEW SUPPLY; OREPLACE EXISTING SUPPLY O PROVIDE ADDITIONAL SUPPLY 0DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING O �7it/ D WELL TYPE DRILLED ODRI.VEN ODUG OGRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot 'No . WATER WELL CONTRACTOR: Name 14A2 '��SOn! Address:- �� f�j9�fT_ - V111 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ,)4�_NO NAME OF PUBLIC WATER SUPPLY: /t� TOWN /VIL /CITY Al r DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION SEPA SHE (date) (nature PERMIT TO CONSTRUCT A WATER WELL i 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 i provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. q Date of Issue: Z 19 l zz� 1: Date of Expiration: Z 19 ermit Issuing 0 fi is ilhite Permit is Non - Transferrable copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner 2/87 Orange copy: Well Driller / A. DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION. TO CONSTRUCT,. A_T.F.,.WELL . PCHD PERMIT WELL LOCATION Str et Address 01,4 cS0 Town /Village/ ity Tax A�� VAOW Grid Number WELL OWNER Name Lc Address sd d 3 �rivate 0Public USE OF WELL l'- primary 2 - secondary RESIDEN AL O PUBLIC SUPPLY O AIR/ COND /HEAT O BUSINESS O FARM O TEST /OBSERVATION ® INDUSTRIAL t3INSTITUTIONAL O STAND -BY O ABANDONED C/ O OTHER (specify; AMOUNT OF USE YIELD SOUGHT��gpm /# PEOPLE SERVED � � /EST, OF DAILY USAGE a�Q gal REASON FOR DRILLING ANEW SUPPLY OREPLACE EXISTING O PROVIDE.ADDITIONAL SUPPLY SUPPLY 0DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE DRILLED 13DRIVEN ®DUG 1JGRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES _Lt�NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. �� B WATER WELL CONTRACTOR: Name_ nesc/J Address: P"-f V14Ap� IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V NO NAME OF PUBLIC WATER SUPPLY: AJIAL TOWN /VIL /CITY IV 1,4 DISTANCE: T:O.,.P..RQPERTY..,F,ROM_ NEAREST -WATER MAIN: - - LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION 0P,,gEPARqE SE 6 23 (da e) (sig ure) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is'granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form pro by the Putnam County Health Dep tment. Date of Issue: 19 Date of Expiration: 19_ Permit Issuing Official Permit is Non - Transferrable 8/86 r mg M •' • 1Lie, 1D'' V• •1 S- •19•. DESIGN DATA SHEET- SLWMCE SEWAGE DISPOSAL SYSTEM FILE.NO. owner `STi9�✓LE�' d1�5-720e•.s0.✓ Address Box �f�9 iP. a.3 �L1T. 1�i9��y Located at ( Street) 1411�117 3o.v J41,4/1", A W I =i l Sec. Block 3 Lot .� • y (indicate nearest cross street) Municipality LT. Watershed dsch'w,4W,, :TOIL PEROOLAT".LON TEST DATA REQUIRED TO BE SUBMIT= WITH APPLICATIONS Date of Pre- Soaking i 7 Date of Percolation Test HOLE NUMBER C1= TIME PERa ATION 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 F:4)0 - 2:5-0 sv 104" IZ/ 023 5 -/A 3 2-.z7 - <f ..7/ .f��•* -yr o?/ 023 �� �� /N 4 5 3 L3 4 112 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 fran top of hole. rev. 9/85 V.2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL,HEALTH.SERVICES Date May 19, 1983 Re: Property of Nancy Godsen, Administratrix; Estate of Lucille S. Godsen Located at Watson Way (T) 29 Section - Block 3 Lot Subdivision of Section One — Lake Oscawana Acres Subdv. Lot Filed Map # 367 A Date 1/8/51 Gentlemen: This letter is to authorize Joel Greenberg a duly licensed professional engineer or registered architect XX (Indicate. to apply for a Construction Permit for a .separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by,the Commissioner of the Putnam County Department of Health, and to sign all necessary papers.on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law is Health Law, and the Putnam County Sani- tary Code. Countersigned; P.E., R.A., NCE �RF�c•5,�� ti Q �Oxl 56 Muscoot Nrth., RFD #2, Bx 488 _ Address Mahopac, NY 10541 914.628 -6613 Telephone Very truly yours, Signed Es�a c Lucille S. Cgods Owner of Property Box 33 Address Old. Chatham NY 12,136 Town 914 628 -3100 i Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Re: Date ��Z3/7 Property of Located at ;Z' 7's 0A) "W 4 (T) Section Block Lot Subdivision of i�A� D �-- � OcSC°fl���✓/¢ Subdv. Lot # Filed Map Gentlemen: This letter is to authorize a duly licensed professional engineer! / or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said ..Sys t em, _.Dr }�stes s - coziformity..wi hi.- he- p.roi.isa,or:..s- . -._ _. - - 147, Edlacation Law, the Public Health Law, and the Putnam County Sani- tary Code. Very ,,r Signe Countersigned' /�� / P . E . , 327x. , # �� Address Telephone 2'!:K Est Tel phone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVIC''' "' Date 71 Re: Property of Located at h1W % S(iA.1 (T) `J Section E Block Lot Subdivision of�� Subdv. Lot # 20 Filed Map # g4!;�7 X Date S Gentlemen: f This letter is to authorize =sL Z 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 s stem or . s, st " _........__ _�_.._........:_ ......, y'._ . �. �s' _..lp.._conf.orm�.ity.::w:i -th� -the �provi'sions -'- Art2•c1e ,1..5_..or.._...__. 147, Education Law, the Public 'Health Law, and the Putnam County Sani- tary Code. Countersigned P.E., R.A., # Very truly yours, Signed. Owner roperty '6�'-x 21t t9L • �. Address / o Address Town Telephone Telephone (T) `J Section E Block Lot Subdivision of�� Subdv. Lot # 20 Filed Map # g4!;�7 X Date S Gentlemen: f This letter is to authorize =sL Z 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 s stem or . s, st " _........__ _�_.._........:_ ......, y'._ . �. �s' _..lp.._conf.orm�.ity.::w:i -th� -the �provi'sions -'- Art2•c1e ,1..5_..or.._...__. 147, Education Law, the Public 'Health Law, and the Putnam County Sani- tary Code. Countersigned P.E., R.A., # Very truly yours, Signed. Owner roperty '6�'-x 21t t9L • �. Address / o Address Town Telephone Telephone PUTNAM COUNTY HEA T8 ' DEP NT _ ..._:._. _. -• _.. -. _.._.__ _ .._ -,. -- -_ - -._ DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Canmissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME '::P-1WN P6769 -SV A) Orig. Routine Orig. Ccmplain ADDRESS WA' j36iU W q t% Pow lo, VAaG41 Q9-3--1-1 Orig. Request No. Street Town '1 No- 3 Canpliance Complaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED 5-0 ,Aev Field Conference Name and Title DATE" TIME ARRIVED % y FINDINGS: TYPE FACILITY 00 TIME LEFT / C Other Explain INSPECTOR: PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: h /RF TITLE: 0 I ~� PUTNAM COUNTY HEA T8 ' DEP NT _ ..._:._. _. -• _.. -. _.._.__ _ .._ -,. -- -_ - -._ DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Canmissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME '::P-1WN P6769 -SV A) Orig. Routine Orig. Ccmplain ADDRESS WA' j36iU W q t% Pow lo, VAaG41 Q9-3--1-1 Orig. Request No. Street Town '1 No- 3 Canpliance Complaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED 5-0 ,Aev Field Conference Name and Title DATE" TIME ARRIVED % y FINDINGS: TYPE FACILITY 00 TIME LEFT / C Other Explain INSPECTOR: PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: h /RF TITLE: e PrTn?A -M -- COUNT -Y` - HEALTH DFFAR'JwEWI DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health W III D- 6—A AJ - FIELD ACTIVITY REPORT - MAILING ADDRESS . P.O. Box Post Office Zip Code TELEPHONE PERSON IN CHARGE OR INTERVIEWED Name and Title DATE -?- /S TYPE FACILITY TIME ARRIVED TIME LEFT FINDINGS :_ Sheet t of INSPECTION Orig. Routine Orig. Complain Orig. Request Compliance Complaint Comp Final Group Illness Construction Reinspection Field, Sampling Only Field Conference Other Explain INSPECTOR: P, o Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: TELEPHONE: — — ®ftf'j it �i I ®� i �- � s - J, '• i p C =IDLC g Purr -A C :"-, -- OF fi✓zL - Dr1TSiC1 GF �ti i. TL' � EE-I=-= S� '7lC -S LDr17f.L-m� 4?T' = Su-PDLZ & Suc ?^: S�'ittS =. DI�i:.fi�L Si�L�'+"S of Cr-_T; (St: = Lccr' p C_:._., � I )S I NO I I r A A/ An I ell I U i I I I. I I I I yv !` I I I i I I i I t I I i Ih I to ft_ I I I == notes I rXz I I AV I I I I I I _o v-r_ f I cc z_: ;- i I I I I I - I I I I i II I CCU •• �.rrr' P e ---L, t per_; C:r-- crat=- :-eso st-:-cz Dssi^t DcL 5�� == •(ACS) S�tD���yc -r•,- D�_ ac_ e Lcc _ =rc Ccr�' S ��r L PC r;^ r�� a �_ (3 ) t I Per. Cale Dr- i-1 C= Wes'_ _; c;::. G•-Ct�: fir. ' Y SEES : -- Lc-*L-=- =:_f LC Cil 4L.. P G -� C - -? SG.- D (r: Jr EC; " = �i �"nv-_T; P! G° ectic LG::=) Drive-fay & �w� ?ccL t:•�L1LC� � ��� uric F_ x_ = ==�_ Fcct_ecfC_ ° =r,C „-°_mil F=-rc & Dom_ Ec1=- LCC _-- Rsp ra.santai yr cf pr=L ana =t_=a 's_c- ac - -a sica 3r�;:= CHt1;_�GV:. _! L_C`•v,SiL_. 5+.�� L F.-- Pi t & D Ecx SiZCWL ficL Cf Weis & 5-=': 200 L c= :` c-r-cS=-�—' . (T7 ) F: =ice„ - 10' to P_rl_, Dr T= `',Tc; C_ 20' to Fcc.- c =t-ic:1 Walls a �� 1Jo' to Well; 200' in D.L.O.D, LW ,. = {� (Tr-c. ems: lad' .s .1.'��... =_ii, ��G:.= '=c, � 131 tC l7ic? RS-r"�'"�: rl� Ir=L FGCt'_rIC 35'tc =-.=-.=:-I .I �.=�;_1�S�C? =ice ?T7�^_1 -1+ Wct =T -- 10' to Ra t=s' L E Qr it 2rJ' ) 10' all t� c, iz PETER C. ALEXANDERSON County Executive F , I)J?, 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 July 7, 1987 Mr. Matthew Xoviello 9D & Elvins Lane Garrison, New York 10524 RE': Proposed. SSDS Peterson, Watson Way Dear Town of Putnam Valley, TM 29 -3 -3.12 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. House plans not submitted 2. Standard note 4 not shown on plans 64.1 3. Minimum distance from a driveway to a SSDS isl0,feet. Proposed plans show driveway one foot away from the ends of the trenches. -= - - - -- -.4— _Minimum distance from a. curt- in. _drain, to. .a_SS,DS.'.is- 1.5 feet. 'phis ^critera should" a'1 "so "Be�k�n' in a�ct�nL `for -t1Te- prop-ose • - -° expansion area. area. 5. Check for $100.00 payable to the Putnam County Health Departmen not received. U Upon receipt of a submission, revised to reflect the above continents, this application will be.considered further. 7rruly yours, r� kobert Morris RM ::pt r Environmental Health Technician 7 ,I i� APPENDIX B PU'TNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENV1aM4ENML HEALTH SERVICES INDIVIDUAL WATER SUPPLY REVIEW . -. (Name of Owner) COMMENTS LF trench provided required 229 60 ft. max. Parellel to contours . eD & SUBSURFACE SEWAGE DISPOSAL SYSTEMS CONSTRUCTION PERMIT DATE LAI BY: Location '- DOCUMEN'T'S Permit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep Hole Log Perc Consistent Perc Results (3) Fill Perc Hole Depth cd House Plan Two sets Well permit; PWS letter Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Pexmi.t 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- tes 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;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 ft. of Proposed System-c roperty Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout EPARATION DISTANCES SPECIFIED ON PLAN Fields ,,; --- 10' to P. ,Driveway, ge ^Trees,Top of fil 20' to Four` ion Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expar 15' to Drains - Curtain, Leader, Footing 35'to catch basin,stormdrain, i watercourz SHEET - (Street YES NO �E 10' to Water Line (pits -201) 50' intermittent drainage course 'Septic Tanks 10' fran Foundation; 50' to well 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 N. Godsen Address Box 33, Old Chatham, NY TM Located -at (Street Watson WaV ZNX. 29 Block 3 Lot 3 6dica e nearest cross street) Municipality, Town of Putnam Valley Watershed Hudson River SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 'R-oTe- Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Water Water LFv--eI No. Time From Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop in Min./in drop Inches Inches Inches #1 1 13:00-8:33 .33 16 19 3 33/3=11 2 Q:-34"9:07 33 .16 19 3 33/3=11 3 9:08-9:41 33 16 19 3 33/3=11 4 9:42-10:15 33 16 19 3 33/3=11 5 #2 1 8:05-8:38 33 16.'. 19 3 33/3=11 2 8: 39-912 33 16 19 3 33/3=11 3 9:13 -9:46 33 16 19 3 33/3=11 4 9:47=10:20 33 16 19 3 33/3=11 5 2 Notes: 1) T6E ,�ts to be repeated at same depth until a roximatel� equal soil rates are obtained at each percolation test hole. Affdata to e submitted for rEWiew. 2) Depth measurements to be made from top of hole. Address Muscoot North RFD #2 Box 488 EAR Mahopac, NY 10541 THIS i KS 'BY HEALTH DEPARTPENT N TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION Rate Approved DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. DTH MOLE NO. HOLE N0. G.L. Top Soil 6" Sand, Small Stones - 12". & Some' Clay 18" 2411 30.. 361f . If . 48" 5411 It 7 78 tt If 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 4 Ft..• - INDICATE LRVEL�TO. W RICH -WATE .�LEVEL..RISEa �R HEING _ENCOUNTERED :�4 .FtQ_ -. y -� ✓ '�� TESTS MADE BY Joel Greenberg Date May 11, i983 DESIGN Soil Rate Used 11 --15Dn/1 "Drop: S. D. Usable Area .Provided 5;000 SF No. of Bedrooms 3 Septic Tank Capacity, 1 000 Gal e Pre -cast Conc, Absorption Area Prov d By 400 L. F. x24" enc n� Address Muscoot North RFD #2 Box 488 EAR Mahopac, NY 10541 THIS SPACE FOR USE 'BY HEALTH DEPARTPENT ONLY: Soil Rate Approved Sq. Ft /Gal. -Checked by Date m E- N T DINIIUG om 1 s r-Lolmer L o o L A 44 A L L - - - - -- - PUTNAM COUNTY �DEPARTMENT OF HEALTH Permit a r Division of Environmental Health Services, Carme% N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valle Town or MX. Located at ti►atson .Way Tax Map 29 Block 3 rot 3 Subdivision 14ke 0$CaWan$ Acr3�s subd it a 30 Renewal; ksvieion Xy fit- ac La- to _ _ O: '...._ _❑ Q,,.Jer %Address +_ ©1d" -Cl'1'$ "Z `i'ldillivY 12136 Date Of Previous Approval Building Type. One 'Family Res. Lot Area 18, 000 SF Fill Section only ❑ �III Number of Bedrooms 3 Design Flow G /P /D 600 P.C. H. D. Notification Required Separate sewerage system to consist of 1000 420 LF Of. Leaching Trenches. ` ` •-..J -- Gal, Septic Tank and To be constructed by —Don He - -� Add a ey S 74 Water Supply: Public Supply From XX Private Supply to be drilled by Norman Anderson Address Barger Street, Putnam Ial l off' NY 1 0579 Other Requirements 7 Ft. Curtain Drain I represent that 1 am wholly and Completely responsible for the design and location of the Proposed system(s); 1) that the separate sewage disposal system 1 above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regu a ons o e u nam . County Department of Health, and that on completion thereof a'•Certificate of Construction Compliance" satisfactory to the Commissioner of Health`will� be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder .will E place in good operating condition any part of 'said sewage disposal system during the perio of two (2) years immediately following thedate of the.issu ante of the approval of the Certificate of. Construction Compliance of riginal syste or any repairs thereto; 2) that the drilled well describetl'ebove will be located as shown on the approved plan and that said well will be in Iled accordant th the stand s, rules and regu aTi)ons of the .Putriain j County Department of Health. Date June - 24, 1983 sign € P.E. R A X i Address usC Ot NO FD ox 488 Ma pacp License No. APPROVED FOR CONSTRUCTION: Th s approval expires one year rom t e dat issued unless construetio of the building has been undertaken and. is revocable for cause} or may be amended or modified when considered etas ry D the Commis o r of Heal Any change or alteration of construction requires a new permit. Approved for disposal of domesti rani a age. 9 /Or priv or {ypply only. Date -- �J\ By tai Title Rev_ 9 -91 rJ PUTNAM COUNTY DEPARTMENT OF HEALTH Permit a PV 31 -83 Division of Environmental Health Services, Carmel, N. Y. 10512 - �ONSTRUCTION 'PERMIT-'FOR SEWAGE DISPOSAI SYSTEM Putnam Valleor eilage ;a �T . T.t Tax Map 29 Block 3 rot 3 f Located at Wat:ac)n ay Lake Oscawana Acres subd. rota 30 Renewal ] Revision _❑ Subdivision 4 owner /Address N. Godsen, Bx 33, Old Chathami NY12136 Data Of Previous Approval Building Type 1 Fam. Res. Lot Area 18 ► OOOSF Fill Section Only ❑ � ' ' Z Notification Required D H P.C. H. D. Number of Bedrooms 3 Design Flow G /P /D 600 •! 1000 420LF of Leaching Trenches Separate Sewerage System to consist of Gal. Septic Tank antl Address i won Heady Canopus Hollow Rd, Putnam Valley, To be constructed by water Supply: Public Supply From - " "; New York 10579 , Private Supply to be drilled by Norman Anderson Barger Street,Putnam Valley,NY 10579 Address Other Requirements I represent that 1 art; wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system: '• above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam 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 own'e"is.successors, heirs or assigns by the builder, that said builder will . place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date 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 the standards, rules and regu a ons of the Putnam County Department of Health. XX Date July _23 1, 1985 Signed P. E. R.A. AddressMUSCOOt No. , RFD #2 , Bx 488 Mahopac , NY 10541 License No. 11056 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when consid ece ry by the Comm .ion r of Health. Any change or alteration of construction requires a new permit. Approved fo iposal of domestic sa nary age, and/ privet wale supply only. Date By Title IJ �� �-PV Located at _ Subdivision PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER TO PROVIDE PERMIT # ON CERT FI ATE OMPLIANCE, Division of Environmental Health Services, Carmel, N. Y. 10512. PERMIT g' PERMIT FOR SEWAGE DISPOSAL SYSTEM Subd. Town or village % .,–Tax_.Map :...Block Lot_ '"• / Renewal Revision _ ❑ / Date Of Previous Approval ,� %P TY 7 Building Type �l/,�,� f Lot Area Fill Section only Number of Bedrooms '-3 Design Flow G /P /D p� P.C. H. D. Notification Required % �% Separate Sewerage System to consist ooff^ /i Gal. gSeptic Tank and —2 OP / f!p °���y To be constructed by _,do / ( – &Q a`S��° G -Address / Water Supply: blic Supply From Private Supply to be drilled by f�i✓,�_ �QA1 Address ®° `� ,y � Other Requirements I O' / )c S., ewrleAl I represent that I am wholly and completely responsible for the.Ae9igrr'arr of the Droposod syslem(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam 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 said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date 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 shamvn on the approved plan and that said well will be installed in accords n with the standards, rules and regu a tions of the Putnam County Departmen • of Health Date Signed P.E.° R.A. Address 1/0&5 `°G� License No. (Z APPROVED FOR CONSTRUCTION: This approval expires r r eeessahe ate issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when consider d nr by 4he Co issioner of Health. Any Change or alteration Of COnttl`rttion requires a ne{[,jgO" permit. i roved for disposal of domestic sa ' ar sews ,and/ pr water sup only. - DateJL_ By Title i Rev. 6/85 PUTNAM COUNTY DEPARTMENT OF BATH P Rev: i, 3186 Division of Envb onmental Health Services. Carmel, N.Y. 10512 Engineer to Proves Permit N on CERTIFICATE OF _ -. D :. - .. Permit q r _ CONSTRIICTEON,PERMIT. F 7. ORS )DISPOSAL SYSTE)VI Located at eld�%n7'S d� �%/rir ' Town or Vtilage Subdivision Name 1-14 O.s e/9r✓A�✓A Snbd. Lot_R �0 Tax'Map —,Lq — Block Lot 3, is Owner/Applicant Name 1STf�/yL.r PETE aN Renewal ❑ Revislon ❑ Date of Previous Approval Ma)llag Address ed OX 4"V �. 3 Town OW 77 llw d L E ZIP N t {'/ Building Type Ad � ���/%� Lot Area Z-04 000 0. * Fill Section Only LJ Depth Volume Number of Bedrooms 3 Design Flow G /P /D d PCHD Notification Is Required When Fm is completed Separate Sewerage System to consist oi, /,, poo Go on Septic Tank and c� �o GlG TA /. To be constructed by NOT G.S/ 0 OS46;,j yEi Address Water Supply.Pdblle Supply From Address or: ✓Private Supply D Mod by � C T A•ldress �� Other Requirements 2 �• 0• .0 • ` C /LG I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam 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 said builder will place in good operating condition any part of said sewage disposal system during the period of two`(2) years Immediately following the date of the issu- ance 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 install n accordan a with the standards, rules and regu a ;� ons of the Putnam County Depart ant f Health. //q� ' / Date 6 o $ Signed (�� P. E. ✓ R.A. Add E �aJ , O License No ✓P /�� APPROVED FOR CONSTRUCTION: This approval expires y " from the date issued unless Construction of the building has been undertaken and is revocable for cause or may be amended or modified when c sidered ecessary by the CQjnmissioner of Health. Any change or alteration of construction requires a� w�pe� it��App�rOVed for disposal of dome is ;Nags, and /o • at afar supply only. – S, , Liu un.. 2. ne 1,11• M- 40 ro (•sl 32 W . 30 It W Lrvw tDw TKr LnAD ou 20 Far "I,,= Lrw too XLI-n IS., od WAM KIGIR tDw tDW 40 rSf 4 ;21 • 10 ,AE.Apv fl0t ilas I - 25 FSK VMIFT- Mor as (21 so ro vMdv0- - Maas MJCA MI6 [C =111.0 C—log f6„ lIS1O .WA §wsW "mammod- 0009 W CMO OW • •do rMaLT MM STA"'. ,.c CMC tout MTIOM ruptsim; CDM co.dWrIcur WSW MILDUC COME (CTI Kx MW SITE Kjr- O(ME) (M I IM STATE III.M. Cow��. COWT. C(Ex NIN vow ST.T`- ENE= STATE WIIDIPG CCEE ITZ KAIGRG COLE rM4S,S 1900.1 L 4910 .1 M 424.1, BIT 0 I "ICAI,MD COMS I M TI-FN LT ,E Itcs AS -MICA E- Orcur"11 W L IW FMIL' 0%KLL111GS IMILI MMI-GS ff41S1 PIKE S. 'TINE %I AVIS HOMES IM �PORATION P.P.S.-Corporation ACCEPTANCE REPORT NO. !,:854 12 Plans certified to comply with all applicable codes and regulations of: PUTNA-M C6 614-TY DEPARTMENT OF HM VA. NJ, PA, MD, CT, Rl, MASS, BEL, NY HOUSE PLANS 0"OVED FOR BLDG. CODES 5/4/85:. 8 ELECT, E3.8. HEAT' 7 ELECTRIC WRING E. PLUMBING' 5 CROSS SECTION 4 ELEVATIONS 3 FOUNDATION 2 FLOOR PLAN I COVER 5 H,E"E T NO DESCRIPTION DRAWING INDEX Avis HOMES CORPORATION AVIS,PA. AVIS MODULAR SYSTEM ;NJ.- AVIS HOMES CORPORATION AVIJN. AVIS MODULAR SYSTEM /vO.TE CXTERIC�' L /Or"ITS /• EXTERIOR SHOWN IS SUG - SHrr'PED GO^SE e 2ZS" FiBERGtgSS SHrNGLES GESTrvE ONLY. F/ECD /NS- -ficLEP OVER P(-Y DRY Z• SEE /NDrVrDUAC fzooR PcAN FOR LENGTH OF I-/OUSE f LOLATIAN OF DOORS IWINDOWS• _5 •rooPS/ 5 rEPS . 8Y.^*NERS . _ 1 /�oOULES S /Dr A/G - FIELD /n/STr9CGED HT Zp /D E — L9 V. �17 � ® GUTTE,CS owNSPou� OT SliowNgBYOTr+E� P SNuTTF1Z$ SHowil .4RE OP_T /on/.4L -510/A/G TYVE PER sy -C' �:^ LUS7 -oM�,Q REQUEST -BRLCK woRK .. 'B Y OTNEA /`10 Du L 65 StomlG -E' /Eta 1usr�LLED \ . ;i L E/n- • Sin — E- v. t NO. J ,R IED TO: F 2DANCE WITH THE EXISTING CODE OF PRAC. LAND SURVEYS ADOPTEb BY THE NEW YORK iOC. OF PROFESSIONAL. LAND SURVEYORS. t 't i� n r ations shall run only to those individuals and institutions ereon under the title policy'No, shown above. Said cerfi- s are not transferable SURVEYED & PREPARED BY BUNNEY ASSOCIATES LAND SURVEYORS AL ROUTE #2 ,�� FIELDS LANE 0 0 0 0 N C 0 0 � V 3 w o0 O O N Z r e WA N 51000 E. N 1 i N ' N `a o; l :� W O (Y) J m 5.70000,w. 75.00' Subdivision Map preparec/ for Or Donald fl. Fischman & Dennis & Catherine T. Donovan Filed (June 15,1984 - 11fap No. 1979 -All certifications hereon are valid 10r the -al, and cops there,,f only if said map or conies hear the impt esse�.1 —al of the surveyor whose signature appears hereon." aPremises Shown hereon being Lot 30 os shown On "/00,,0 01 SeCf1017 017e - Lake Oscowana Acres' said mao filed in the PU lnom Couniy Clerks Office on <Jan. 8, a' 1951 os Map No_ 367A. t SURVEY OF PROPERTY SITUATE IN THE PUrIVAA,4 COUNTY, /V Y SCALE: =.30' DATE ./ULY 09, 1986 tj 'y d { I The /ocafion o {underground improvements or encroachments, if any exist, are not certified. Certifications shaft run only to those individuals and institutions shown hereon under the title policy No. shown above. Said certi- ficatior.vare not transferable SURVEYED & PREPARED BY BUNNEY ASSOCIATES LAND SURVEYORS 301 F"IELOS LANE we H 1 fLE . NO. N "All certifications hereon are falid for the map and cop "- thereof only. if said map or-copies bear the impress " seal of the surveyor whose signature appears hereof ERTIFIED TO: ♦ PAVEMENT AIPHALT i i. WATSON.-WAY l I ACCORDANCE WITH THE EXISTING CODE OF PRAC- , N. 70 °00'E. SPOLC 100. OD' CE FOR LAND SURVEYS ADOPTED BY THE NEW YORK 1' 'ATE ASSOC. OF PROFESSIONAL LAND SURVEYORS. j OI 0 copYR/GNT G /999 - 2 00/ I OI O 3UNNEY ASSOCIATES, ALLOR/GHTS RESERVED a Oj O N , 41no14f/70riredd,WPHCQAi0n is a viO10HOM Q o oFQpp /icab /e /ows CD Q1 �a qJ � � f � W ALK � O _PORCN ;� 20-21 t Premises shown hereon beilg Lof 29 os OD N oectc P s to y O o ci$ shown on "Map of Secfion:One - Lake O 269 Fhame House Oscowcano Acres ;' sold mop filed in the -arEq - Putnom Counf ark's Office on clan. 8, Q 1951 as /Clop No. 367A. . Unauthorized alferation or addifion to a 0 v .0 survey map beoiin a /and surveyors sea'/ is a or Section 7209, sub- division 2, of Me New York Stofe = Q 2-9 ' Education Law. The /ocafion o {underground improvements or encroachments, if any exist, are not certified. Certifications shaft run only to those individuals and institutions shown hereon under the title policy No. shown above. Said certi- ficatior.vare not transferable SURVEYED & PREPARED BY BUNNEY ASSOCIATES LAND SURVEYORS 301 F"IELOS LANE S.70°OO' W. 100.00' Subdivision Mop prgoored for Dr. Donolol A. Fischrnon Be Dennis; • & Cofherine T. Dono vor/ Filed Lune /5, 1984 - Mop.Mo. /979 i a' l i v i t ei SURVEY OF PROPE1 T Y SITUATE IN THE +' TOWN OF PUMA A4 Vi LL EY PUT /VA M COUN T Y, N. Y. t SCALE: /'I = 30' DATE : JULY 29, 1986 BROUGHT rV DATE TEPr- 25, 200/ WELL ADDED DEG`[ /l , 2001 i; i- t. Si we H N Vi S.70°OO' W. 100.00' Subdivision Mop prgoored for Dr. Donolol A. Fischrnon Be Dennis; • & Cofherine T. Dono vor/ Filed Lune /5, 1984 - Mop.Mo. /979 i a' l i v i t ei SURVEY OF PROPE1 T Y SITUATE IN THE +' TOWN OF PUMA A4 Vi LL EY PUT /VA M COUN T Y, N. Y. t SCALE: /'I = 30' DATE : JULY 29, 1986 BROUGHT rV DATE TEPr- 25, 200/ WELL ADDED DEG`[ /l , 2001 i; i- t. Si ------ 7-71 t-v if Ah: . . . . . . . . . . . . . . . . . . . ....... ell . - S" 4EI DES ne" LAW ING 2'-4" BPTa6 jai