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631- 589 -8100
52. -2 -16
BOX 22
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02575
SHERLITA AA'ILER, MD, MS, FAAP
'Commissioner of Health
LORET'I'A MULINART, R9,1vISN '-` � �' --" - ROBEI
Associate Commissioner of Health Director of
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
J. BONDI
STREET ( / on,_,C.rr'JG, W- f-, 7?d TOWN (Aril AX MAP #
NAME - x I C1. PHONES -1 a b�--'JLj 7 PCHD# —�
MAILING
ADDRESS acawur a- ffts Tcj ern Valle C �QI
DESCRIPTION OF
ADDITION __T� hV< V\ k cA tn-E-
NUMBER OF EXISTING BEDROOMS' PROPOSED # OF BEDROOMS_
(FROM-CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR)
* *Any addition which is considered a bedroom requires formal approval of plans.(Construction permit) prepared by
a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County
Sanitary Code.
Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd,
Brewster, NY 10509, Phone: 845 278 - 6130'.
v'` " ' 2. ` Sketches °of exisfinb`floor plan (drawntoscale alt¢living area including basement, to be
: ..._..,. -. shown "and di nsiGnedanduseof each•ro6mspecified). (See'Se,^tion1c- of.Dulle6W. -= `::.___._......._.._.:..:
I HA -1)
.l3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #)
* Non- professional sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1)
4. Copy of survey showing all well and septic locations. on the subject property to the best
of your knowledge. Include date of installation known. Contact this office with any
questions.
5. .Copy of Certificate of Occupancy from the Town or Certification from the Building .
Department with legal bedroom count of dwelling:
OFFICE USE .
COMMENTS
5.
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention /Preschool (845) 228 -2841 Fax (845) 225a 1580
a i
m .
P-3-HERLITA AMLER, MD; MS, FAAP
Commissioner.of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J. BONDI
.County Executive
ROBERT MORRIS, PE
Director of Environmental Health
DEPARTMENT OF.HEALTH
1 Geneva Road. Brewster, New York 10509
Town Legal Bedroom Count & Proposed Addition Status
Re: Ive z i c (Owner's Name)
Tax Map #. 52'.-2-.16
Address: 125 Oscawana. Heights Rd.
Town: Putnam Valley
Year Built:. 1987
According ,to records maintained by the Town, the above noted dwelling,
its . xx in compliance with Town Code.
Is not in compliance with Town Code.
The Legal Bedroom Count is:
This information has been obtained from:
" - - -Certificate of .Occupancy: C0 # 19 8 7 - 7 0 0 4
Other:'
The plans for the proposed addition are considered:
New Construction
xx Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
4/14/10
wilding Inspector pate
6. '
'Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing.Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care. Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580
Sherlita Amler, MD, MS, FAAP
Commissioner of Health
Robert`Morris, PE
- ;.- ;�,;d•:..�._�. Director- offEmironme €�ta!;Yealth�_..'_...:, __...__._:._:__..�_
Mr. Ivezic
125 Oscawana Heights Road
Putnam Valley, NY 10579
Dear Mr. Ivezic:
Department of Health
I Geneva Road, Brewster, NY 10509
June 14, 2010
Re: Addition — A- 065 -10
Robert J. Bondi
County Executive
125 Oscawana Heights Road
(T) Putnam Valley, TM # 52. -2 -16
In reference to the potential bedroom located in your basement, this Department has determined
that 'both walls of the room need to be removed or the room needs to be reduced to less than 70
square feet, or have a horizontal dimension of less than 7 feet.
l.. The legal bedroom count for the dwelling is four. The potential bedroom count of your
proposed addition is six). Two of the proposed rooms in the basement are considered
potential bedrooms.
2. =The addition of a potential bedroom requires this D_ e artment's approval of a:revised
Q P
septic system. plan from a professional engineer
Please review the proposed floor plan to reflect no more than four potential bedrooms, or have a
professional engineer or registered architect design a sub - surface sewage treatment system
meeting present code requirements for six bedrooms.
GDR:kly
Sincerely,
Gene D. Reed
Sr. Environmental Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845.).225-5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026
Nursing /Home Care Agency (845) 278 -6085 WIC (845) 278 -6678
Early Intervention /Preschool (845) 228 -2847 Fax (845) 225 -1580
6May 13, 2010
Mr. Ivezic
125 Oscawana Heights Road
Putnam Valley, NY 10579
Re: Addition — A- 065 -10
125 Oscawana Heights Road
(T) Putnam Valley, TM # 52. -2 -16
Dear Mr. Ivezic:
I have received and reviewed the plans for the proposed addition to the above mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
1. The legal bedroom count for the dwelling is four. The potential bedroom count of your
proposed addition is six. Two of the proposed rooms in the basement are considered
potential bedrooms.
_.. .....:....._Z- ...T.he_ad.dition of a potential bedroorn..requires this Department's approval -of a-revised
septic system plan from a professional engineer
Please review the proposed floor plan to reflect no more than four potential bedrooms, or have, a
professional engineer or registered architect design a sub - surface sewage treatment system
meeting present code requirements for six bedrooms.
Sincerely,
Gene D. Reed
Sr. Environmental Engineering Aide
GDR:kly
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PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER PROVI MUST
x DE
D
N � Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT #,���� �
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Ig5�rAa'.I�7 ca %�
Town or
village
r LOtated aL �.� Tax Hap �Y Block •�
/�
Owner /' /Formerly �% Tax Hap Lot # / •� e✓ Subd. Loot #j
Separate Se .rage System built by z✓ c''� s�} AddressE''f%s/ /�''
Consisting of L- ��_aal. Septic Tank and
Other requirements kve -/-j -d
Water Supply: Public Supply From
Private Supply Drilled By , ~ a'�
i
Address
Building Type _ �—, ^ No, of Bedrooms 4 Date Permit Issued 4
Has Erosion Control Been Completed? 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 atta,:hed), and in accordance with the standards, rules and regulations, in a the filed plan, and the permit issued by the
Putnam County Department of Health. of t
a �� . s. ✓'
Date �' Certified Dy P.E. r, R.A.
rGe:#
Address � � 10 1A 1"iL License No. x7 y >�
r.
Any person occupying premises served by the bove systems) shall promptly take suc . n as ssarit cure the correction of any unsanitary
conditions resulting from such usage. App oval of the separate sewerage system sh me old as a public sanitary sewer becomes
available and the approval of the private water supply shall become null a kt whe b1 water p- mes available. Such approvals are
subject to modification or change when, in the judgment of the CopAlswonor of M lotion or change Is necessary.
Date �L °2/ By Titb ����
Rev. 6/85
4c
WELL LOCATION
WELL t,Uriri'Lliuv azrvrs., office Use Only
DEPARTMENT OF HEALTH
rDivision Of -Environmental Health Services P V— 4��-
PUTNAM COUNTY DEPARTMENT OF HEALTH
STREET ADDRESS: W t Y TAX GRID NUMBER:
WELL OWNER
USE OF WELL
1 - primary
2 - secondary
NAME: E: '�rVAWRESSf BIVATE
FA-POUBLIC
)*-RESIDENTIAL ❑ PURL SUPPLY Y 0 AIR/COND./HEAT PUMP ❑ ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST/OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑
AMOUNT OF USE
YIELD SOUGHT gpm.INO. PEOPLE SERVED EST. OF DAILY USAGE J00 gal.
REASON FOR
DRILLING
19 NEW SUPPLY PROVIDE ADDITIONAL SUPPLY ❑ TEST/OBSERVATION
❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH
STATIC WATER LEVEL ft.
DATE MEASURED A'P
DRILLING
EQUIPMENT
ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
DWELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH tL
MATERIALS: )!fSTEEL ❑ PLASTIC. ❑ OTHER
LENGTH.BELOW GRADE 2!!"k'
JOINTS:. ❑ WELDED )EMREADED ❑ OTHER
DIAMETER in.
SEAL: ❑ CEMENT GROUT ❑ BENTONITEjkMHER
WEIGHT PER FOOT 1b./ft.
DRIVE SHOE. JE
-X S ❑ NO
LINER:
L. )�WO
SCREEN
DETAILS
DIAMETER (in)
'SLOT SIZE
LENGTH
(ft)
DEPTH TO SCREEN (it)
DEVELOPED?
FIRST
=
OYES ONO
HOURS
SECOND
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
LSIZE:.
DIAMETER
OF PACK in. I
TOP
DEPTH _ft.
BOTTOM
OEM — It.
WELL YIELD TEST If detailed pump in
METHOD: 0 PUMPED tests were done is in-
0 COMPRESSED AIR formation attached?
0 BAILED ❑ OTHER ❑ YES ❑ NO
'it more detailed formation descriptions or sieve analyses
WELL LOG are available, please attach.
DEPTH FROM
SURFACE
Water
pear.
lng
welt
012-
meter
FORMATION DESCRIPTION
CODE
it.
WELL DEPTH
DURATION
hr. min.
DRAWOOWN
It.
YIELD
gpm.
Land,
Surface
A.
-7
WATE)l ❑ CLEAR TEMP.
QUALITY 0 CLOUDY- HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? 0 YES. ONO
STORAGE TANK: TYPE
CAPACITY GAL.
—
PUMP INFOR ATION
TYPE
MAKER,,
MODEL
'r.0 I
"A G-1.
nrcrru
DEPTH t
VOLTAGE-7WHP�1—
���
WELL DAIRILL NAME —jeo*m-4—, DATE
493
S '3 R E
ADORES /7y
lo
Yorktown Medical Laboratory, Inc.
LAB
321 Kear Street
Date Taken: U /- TI m
i e
.._._. _. . -- �.:...�Da.ter•-R,c._.d
- r , .,.::..-
�(o{k: own- Heights, N.Y. 1.0598 _ . ,
.
- 4-.7,
(914) (914) 245.3203
Date Reported:
QCT. 0 3 jqA7
Director: Albert H. PadovaniM. T. (ASCP)
Collected By:
T_ -�
Referred By:
J 86 � S jX� C�o'AJ �1e P,
Sample Location.
I %A�'I°; ACC
�
`�
�9 �S e-'PA Ivc hte -1-
0 ,Ld % '7
N
/ ll 7 .B�i Vic
G� `S,
Phone N
L J
Phone N
Sample Type:
y/ l (J�fl 02
Repeat Test? _
( check one)
Potable
_LABORATORY REPORT ON THE BACTERIOLOGICAL QUALITY
OF WATER
_ Non- potable
STP INF
STP EFF
GENERAL BACTERIA
Other:
1,,,-'Starkdard Plate Count (CFU /1.OmL)
j
d
(Agar Plate,@ 35 0C)
Sample Status:
(check each)
MEMBRANE FILTRATION TECHNIQUE ('MFT)
`fTotal Coliform (CFU /100mL)
Outgoing
Na2S203
_ Fecal Coliform.(CFU /100mL)
Incoming
_ Fecal Streptococcus (CFU /100mL)
�E k °C
MOST PROBABLE NUMBER TECHNIQUE (MPN)
GT 400
Other:
_ Total Coliform: MPN-Index (per 100mL)
_
_ Fecal Coliform: MPN Index (per 100mL)
OTHER ANALYSES
I KEY FOR TERMINOLOGY
REMARKS (For Laboratory Use)
RDS = Recommend Disinfec-
tion of Source
TNTC= Too Numerous To Count
CON = Confluent ( =TNTC)
LT = Less Than ( <)
GT = Greater Than (> )
N/A = Not Applicable
LTC = T.paa +'Han er eeual to
THESE RESULTS INDICATE THAT THE WATER.SAMPLE (WAS) (WASN'T) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO TH NEW ORK STATE DRINKING
WATER STANDARDS, FOR THE PARAMETERS TESTED, AT-THE.TIME OF COLLECTION.
Albert H. Padovani, M.T. ASCP , Director
12 /85(RvsdT /8T)RWE
For Lab Use Only:
H/C to
LAB OFFICE HOURS (Main Lab):
9AM -5PM, Mon. -Fri.
9AM -NOON, Sat.
> fi M""�.: yiT'rliy
s. rtiai'c c p r
',
< PUTNAM COUNTY DEPARTMENT OF HEALTH to Provide Petvilt q
Rev. 3186 t Dlvielon of Envirorsmental Health Services Carmel N Y. 1051? Etsgbteer
a CERT[FI OMPLIAN
U.:.,. _
CA
TE OF C CE
Uf
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM
Permit
Located at Toroin of 1 age
Sabdivision Name O Solid Lot q Ta: Map /� Bloch Lot
• y
. Renewal C] Revision
Owner /.Appllcarst N
;ame `-
,: Prevloas Approval -
Maltingt Address " �� 1'� ti Town �p
t'
F ,
Baildtng °Type�/� • Lot Area •� ��G . FID Secdoa Ody Depth vobtme
Nmnber of Bedrooms Design Flow G /P/D C�
aired Wbk Flll
® P NotlBcatlon Ie Req en 1a completed
Separate Sewerage System to corselet oGallon Septic Task eu
To tie contracted by Address
y
Water.Sappl� Pabllc 5npply Fraai Addrose
or_ Private Snpply Dillled br ..
Other Regairements : r a x 3
ion_of the; proposed system s) 1) that the separate sewage disposal system
ro edarnend "menI tAeie' 9��+
represent a .1 am woolly antl completely: responsible for the tleslgn "and local �ypy _
above described will berconstructed as shown on the.app v " ante) ltn he stantla►Gs rules an ►egu a IOnS O H iry N m
County Department of <Heatth and that on completron thereof a CertdifnG timDlance•' rsaNsfattory to the Commissioner of ea
be submdted Yb, the Department and a written guarantee will DeMfu► ih fg dbMdrld�s, - rs heirs or,as`signs by the builtler that said' builder: will
plsce.:.in good operating:�condition any 'part of se�8 sewage "diiposal s{�me8 t'fo „o_ rs immediately._followinq thodats of the,;issu-
ante qt the ap''proval of< <the Cert�f cafe ot- Construction Compliant, of t ' rigmsl yst its an epai►i thereto, 2) that the tlrilled. well Cescribed above
will De•located.'Ss� shown on the approved plan and that said well will be to ins ante iEh and s rules and' egu aiifons of .; thy P..ufnam
' County Depart -gent of.H Ith
� a
` � Address e` � License No � � S
APPROVED FOR NSTRU TION 7hi ,approval expires oils y rt Qp �ssu�t n' strucG of the bu�ld�ng has been unCertaken arse is
revocable for ,tau or may basntled r -mod Aged when con ;ode d nt _ "`fit,,,,_& change or al atwn of .construction
requires a n p r -AD ro a or diiposal of Comeriic'sa tar e w r y` nl -
�.(�
.Date - BY
Title
DAVID D. BRUEN
County Executive
JOHN SIMMONS, M.D.
C il, Oti Deputy Commissioner
�V
DEPARTMENT... OF --- HEALTH
Division Of Environmental Health Services
- .August 8, 1986
Mr. Frank Sullivan, P.E.
2972 Ferncrest Drive
Yorktown Heights, NY 10598
Re: J.Y. Construction SDS Con. Permit Revision
Putnam County H.D. Permit #PV 75 -86
Oscawana Heights Dr., PV, TM 35 -2 -7.18
Yadgaroff Lot 8
Dear Mr. Sullivan:
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. Dosed systems should feed entire field at the same time.;.
accordingly, proposed drop box series is inappropriate.
Equal distribution of flow to equal trench lengths is
necessary.
2. Frost protection of sewage pressure line requires at least
four feet of cover. + _
Construction details and notes are lacking.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Very truly yours,
-q
mes S. Hodgens
Assistant Public Health Engineer
JSH:amm
cc: File
TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
DAVID D. BRUEN
County Executive
4.
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
August 25, 1986
JV Construction Corp.
165 A.R.D.I.
532 Madison Avenue
New York, New York 10579
Dear Sir:
JOHN SIMMONS, M.D.
Deputy Commissioner
CONSTRUCTION PERMIT # PV -45 -86
Oscawana Heights Road Proper y
Town of Putnam Valley
The Department has this day approved the above - captioned permit
to construct sewage and water supply facilities serving this
property.
As is our policy, the approved materials have been forwarded.to
your engineer.
However, since you are the permittee, your attention is directed
to the attached notice relative to construction of these
facilities in accordance with the approved plans and occupancy of
the completed structure. A similar notice has.been forwarded to
-your engineer..._.. _ _.
If you have any questions, you may call Mssrs. Budzinski, Morris
or Hodgens of this office.
JK:pt
Enc.
cc:Engineer
V ry tr y yo ,
J n Karell, Jr., P.E.
Director,
Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
DAVID D. BRUEN .
County Executive
r
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
IMPORTANT NOTICES
JOHN SIMMONS, M.D.
Deputy Commissioner
1. SEWAGE SYSTEM CONSTRUCTION IN ACCORDANCE WITH APPROVED.PLANS
PROVISIONS OF ARTICLE III OF THE PUTNAM COUNTY SANITARY CODE
REQUIRE THAT THE INDIVIDUAL SEWAGE DISPOSAL SYSTEM, AND WATER
SUPPLY IF A WELL IS PROPOSED, FOR WHICH THE PERMIT TO CONSTRUCT
HAS BEEN ISSUED BE CONSTRUCTED IN ACCORDANCE WITH THE STANDARDS,
RULES AND REGULATIONS OF THE STATE AND PUTNAM COUNTY HEALTH
DEPARTMENT, AND THE TERMS AND CONDITIONS OF THE PERMIT ISSUED OR
APPROVED AMENDMENTS TO SUCH PERMIT.
CONSTRUCTION OTHER THAN AS SHOWN ON THE APPROVED PLANS OR NOT IN
ACCORDANCE WITH THE AFOREMENTIONED APPLICABLE STANDARDS DOES NOT
COMPLY WITH THE ABOVE REQUIREMENTS AND MAY BE CAUSE FOR APPROPRIATE
ENFORCEMENT ACTION AS PROVIDED BY LAW.
ANY CHANGES IN THE LOCATION OF THE HOUSE, WELL OR SEWAGE DISPOSAL
SYSTEM OR ANY OTHER CHANGES THAT MAY AFFECT THE WELL, SEWAGE
DISPOSAL SYSTEM OR ITS EXPANSION AREA SHOULD BE DISCUSSED WITH THE
DESIGNING ENGINEER OR ARCHITECT AND THE HEALTH DEPARTMENT BEFORE
ANY CHANGES ARE MADE.
2. USE OF SEWAGE SYSTEM (i.e. OCCUPANCY OF RESIDENCE)
PROVISIONS OF ARTICLE III OF THE PUTNAM COUNTY SANITARY CODE
REQUIRE THAT THE OWNER OF A PROPERTY FOR WHICH A PERMIT TO
CONSTRUCT A SEWAGE SYSTEM HAS BEEN ISSUED SHALL NOT USE OR PERMIT.
USE OF THE SYSTEM UNTIL A CERTIFICATE OF CONSTRUCTION COMPLIANCE
IS ISSUED BY THE PUTNAM COUNTY DEPARTMENT OF HEALTH.
THEREFORE, NO DWELLING MAY BE OCCUPIED UNTIL SUCH TIME AS THE
DI3PARTMENT ISSUES SUCH CERTIFICATE. YOUR ENGINEER SHOULD BE
CONSULTED REGARDING SUBMISSION OF AN APPLICATION FOR A CERTIFICATE
OF CONSTRUCTION COMPLIANCE.
ASK FIRST — AVOID PROBLEMS
3/24/86
TWO COUNTY CENTER — CARMEL, N.Y. 10512 (914) 225 -3641
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services
AFFIDAVI -T -: CORPORATE:.,( KO.ER--A-2- R4..ICA -ION.-
FOR PERMIT APPLICATION SUBMITTED TO
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health
In the matter of application for:
r
I, Joseph Yadgaroff
represent that I am an officer or employee of the corporation and am authorized
to act for JY Construction Corp 165 A.R.D.I. New York 10579
(Name of Corporation)
having offices at 532 Madison Avenue, New York, N.Y.
Whose officers are:
!�4_7i e_ v
President: Joseph Yadgarnff 532 Madison Avenue, New York, N.Y. 10022
(Name and Address)
Vice - President:
(Name and Address
Secretary:
(Name and Address).....
Treasurer:
(Name and Address)
and that I am and will be individually responsible for any and all acts of the
corporation with respect to the approval requested and all subsequent acts relating
thereto.
Sworn to before me this /3 day Signed:
of 19 K Title:
Alh-
Notary"-fu-blic
;riL} PvWic, 5'ale of No%r Xor
No. ','8205,97
Oralifind is d'�-w 'ork Couni;+
Corporate Seal
8/84
i�
L.
II.
AA
V.
VI.
APPENDIX C
FINAL SITE INSPECTION Date ' Z
�\ Ins ted b
OWNER J . V
4 1% Q TM # OR SUBDIVISION :L.C7r p :
YES
NO
CCM_MENTS
SEtivAGE DISPOSAL AREA
a. SDS area located as per approved plans
b.
Fill section - Date of placement
2:1 barrier. LGTH WIDTH AVG.DPTH
_
c.
Natural soil not stripped
d.
Stone, brush, etc., greater than 15' from SDS area.
e.
100 ft. fresn water course /wetlands.
SEWS DISPOSAL SYSTEM
a. Septic tank size - 1,000 ,250
b.
Septic tank installed level
c.
10' minimum fran fcundation
d.
No 90° bends, clear-out within 10 ft. of 450 bend
e.
DISTRIBUTION BOX
1. All outlets at same elevation - water tested
1LJ
( ,
2. Protected belcw frost
o
3. Minimum 2 ft. oricinal soil between box and trenches
>
f.
JUNCTION BOX --proce_rly set
g-
1. Len reared - Length installed b
-
2. Distance to' waterrcourse mea=sured _ ft.
3. Installed according to plan
4. Distance center to center
5. Slope of trench acceotable 1/16 - 1/32 "/foot.
6. 10 feet from rcr-ex-ty line - 20 feet - foundations
7. Depth of trench < 30 inches fran surface
8. Roan allcwed for expansion, 50%
9. Size of gravel 3/4 - 1j" diameter
10. Death of gravell in trench 12" minimum
ends-capped-.-
h.
PUMP OR DOSE SYST&MS
1. Size of puTp ch-a-*nber
ff1v
2. Overflcw tank
3. Alarm, visual /audio
4. Pump easily accessible manhole to grade
5. First box baffled
n J 'i <
6. Cycle witnessed by Health Department
.
estimated flaw per cycle
HOUSE '
a. House located per approved plans.
b.
Number of bedrooms
WELL
a.
Well located as per approved plans
b.
Distance fran SDS area measured ft.
c.
Casio 18" above grade.
d.
Surface drainace around well acceptable.
OVERALL WORKMASHIP
a. Boxes properly grouted
I
b.
All pipes partially backfilled
c.
All pipes flush with inside of box
d.
Backf ill material contains stones < 4" in diameter
k
e.
Curtain drain installed accordin to plan
(bq
f.
Curtain drain outfall protected & dir.to exist_watercours
g.
Footinq drains discharge away frau SDS area
h.
Surface water protection adequate
i.
MHosion cont-rol provided on slopes greater than 15 %.
PUTNAM COUNTY DEPARTMENT OF HEALTH
•' • �• •' I� V
RFALTH SERVICES,
DESIGN DATA SHEET- SUBSUFACE.SEWAGE DISPOSAL SYSTEM
FILE NO.
09 Address
`' ®rJ�
`� /v
Located .at - (Street)
Sec. Block
- Lot Z.
(indicate est cross street)
Municipality
Loe
Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO HE SUBMITTED WITH APPLICATIONS
Date of Pre - "Sgaking Date of Percolation Test
HOLE
NCIrM CLOCK TIME; PERCOLATION
PERCOIMON
Run Elapse Depth to Water Fray
Water Level
No. Time ;.-,Ground Surface
In Inches
Soil Rate -
Sitart -Stop Min. -$tart Stop
Drop In
Min /In Drop
Inches Inches
Inches
5
1
2
3
4
5
NODS: 1. Tests -to be repeated at same depth until approximately equal soil rates
are obtained.at each percolation test hole. All data to*be suimittod
for review.
.2. Depth measurements to be made fran top of hole.
rev. 9/85
TEST PIT DATA .RDQUIRED TO:BE,- :SUBMITTED ',WITH.APPLICATION
2'
3'
4'
5'
6'
7'
81'
13'
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING.ENOOUNTERED �—
DEEP HOLE OBSERVATIONS MADE BY: (�7 Go // /���� DATE: i
DESIGN
Soil Rate Used Min /1" Drop: S.D. Usable Area Provided O
No. of Bedrocmn, Septic Tank Capacity gals. �TA29:�4 �- y
Absorption Area Provided BY4�5 —e L.F. x 24" width trench
Other 7c, 3-1 a� / A / & / ,07,1017W .,-
Name
Address
THIS SPACE FOR USE BY
Soil Rate Approved sq <ft /gal. Checked by
PC
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Located at'�?
(T Section __17 _,S Block Lot �• /C✓
Subdivision of c' .ir"� YO 6
Subdv. Lot #%r
Filed Map # -Date
Gentlemen: r
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
`- syst'c�m `dr "sys't-erris "in-corrfarmity with -t-he- -prowYS,i'ons-of- Article 145 •ar- - -
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Sign e
Countersigned:
P. E. R:1 , #
7�
Address
Telephone
r OwAW Property
Address
All
Town
Telephone
is
Date
`
Re: :Property of
Located at'�?
(T Section __17 _,S Block Lot �• /C✓
Subdivision of c' .ir"� YO 6
Subdv. Lot #%r
Filed Map # -Date
Gentlemen: r
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
`- syst'c�m `dr "sys't-erris "in-corrfarmity with -t-he- -prowYS,i'ons-of- Article 145 •ar- - -
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Sign e
Countersigned:
P. E. R:1 , #
7�
Address
Telephone
r OwAW Property
Address
All
Town
Telephone
is
ti
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
October 16, 1987
C
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL, Jr.. P.E.
Director
Mr. Frank Sullivan
2972 Ferncrest Drive
Yorktown Heights, NY 10598
Re: Certificate of Compliance
Y -R Construction, Oscawana Hgts. Drive
(T) Putnam Valley, TM 35- 2- 7.18,Lot 8
Dear Mr. Sullivan:
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:
Attempts to reach you by phone have been unsuccessful. An
explanation is requested on why the curtain drain shown on the
approved subdivision plan and construction permit has not been
constructed. ...If _ the _.above is incorrect, verification is requested
- - -by this' Department "and the- curtain"-in is to be shown on the "
as -built plan.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Very truly yours,
,,,R0bz4_,,V -Kffy�4
Robert Morris
Sr. Environmental Health Technician
RM: amm
ReV 3186` ' Dlvlslon of Environmental Health Services t rmel N Y 10512 ` CERTIFI Ineer to provide Petmlt N
7. on CA MP
F CO LIANCE
CONSTRLIC170N`PERMIT FORSEWAGE DISPOSAL SYSTEM''' Pehmlt N k '� 'tai
—w� — : t ♦,
Located at Town or Vlllag �^�
Snbdivlslon Sabd M` N Tat Map S Block Z" Lot
s
Owner /Applicant dame r.. r'
i.
Date of Prevlons Approval
MaWng Addreee 3� `` �•+ :' D '� Y'�• Town Z)p
-
Building :Type ` S • Lot Ares � .` /T =Fill ietmm Oniy , Depth Volume
Nttmber`o( Bedrooime -O Design Flow G /P /D d� PCHD Notiticadon le 'R When Fill is completed
,.
Separate Sewerage'System to conaidt.'df Gedon Septic Tattle ana -
To be` ronstracted by '� Address
Water. Supph k Pabdc Supply From Addroee
or Private Supply Drilled by _Ad }
Other Regalremente
Ya ae
' represel —fin That I aim wholly and completely repgns�ble for tha'des�gn and. to io o�C1�iAi �oled;? s m(i) 1) that the., se paibte,.,sewage Cisposat system,
above:Cescr {betl will be coristructed'as shown on the approved amendment;t a t' �� In accordawith, e'standards; ►ules a _ regu a eons o '. e u ,nam,
.County. rDepartment of `Wealth, and that on:eompletion ttieieoi a Cert�ti ` onsf c ion Clfmislian "satisfactory to the Commissioner of ',Hell.. will
be .submitted 'to the`Department,.;and :a written guarantee ..will be furni edw r, s" ecefsois,ati [s of assigns by;the` builder; that said builderwill
place rri 'goof operating,cond�tion`.any .part r "of said. sewage disposal sy em ing 01'1�ex�0 (21�years immedintely'aollowiny thedate'of the. isw•
ones of.the` approval of tFe Certificate'of" Construction Corripl{ance,_;o_ Yre rigina r'any rapair�_thereto;2) that.the dr{Iled well deter ibed above
. "will,be''located as shown :on!the apprOVed oiah`and that- siId.. well will be Inft n ac. tth;
m
I ,
,� Putnam County Depariirtent of Health
4. 2e.yr /-_3 /Z j `� ' a Division of Environmental Health Services
r5�^iYt
Approved as noted for conformance with
1 PP icable ules and `Re
ut am Co lations,of:th0
/�t• ,� i0er.� � .'j.F�� / 'r^ ' Healt a rtment.
•e ti
ature & Title _ " late
c
d/ J%,r� rr- r? - �Cy r { ,iii `� ._. f I ^� r • _.___ ......._ .— _... _... - - - - - -..
�6.Of NEW
� ►?fi r ,lr , �