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Home My WebLink About2601DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -2 -47 BOX 22 tor. - k.1 02601 PUTNAM.COUNTY DEPARTMENT OF HEALTH 3 86 V. Division of Envkomnental Health Services- Carliel, N.-C 10512 Tax Map Block Ld MaingAddress "c� . rz--ri-A Cei-a-Te-A.L. Awls zip 1057-3 Date Permit Issued '77 -7 Separate Sewerage System built by (2-,N--%_TP_1iC-MC'J Address Consisting of IZ50 Water Supply: �--_�Public Supply From Address -------- wn Private Supply DrIIud Address. Building Type Has Er6sion,Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? other Requirements 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 a�e attached), and in accordance with the standards, rules and regulations, in accordance with th plan, and the permit'issued by the PutnamCo t MLOfllealth. E6 'I( R.A.- Date Any person occupying prom Isess"erved by the above system(s). s uch action as may be necessary to secure the correction of any unsanitary hall Promptly take s conditions resulting from such usage. , Approval of the separate. Sam stem shall become null and.vold as soon as a pub:!. sanitary sewer becomes WA" SY h approvals are available and,the approval ofthe private water supply shall be6orw6uli Ad, void when a public water s4ipply becomes available. Suc u* 'it orninosiqnsr of Healn"o"Ition, modification or subject to modification or change. when, in the I ligmint of that change Is necessary. Date Title C ' ' --- ----- '--- '---'— —--- --- -- — ' -- 'iVE• 'yam � t x � E � >a; _ �tAL�TFrr DIVISION OF ENVIRONMENTAL HEALTH 'SERVICES 4 f 'i-" ` S4 ,•r beputyCommi sioner-of�Health FIELD:�ACTIVITX REPORT; Sheenof , { , , ..� - .� INSPFSCTION 3 .•, . r - . Org. Routine �{ Org.. Cc�aplan ADDRESS 2' "� Orgy Request TH No: Canpliance Qc i laint� Comp x• .. c - `'P.O. "Boas Post °Office` Zip ;Cade GYbup Illness y Construction strut ion `TELEPHONE E •G R ,inspec -ion- xao S IN 'CHARGE , , � ,, _• , b d, <Sampl ng Only F�.el = r - IfJR - y �• - . Name d`T�.tle �`,� ' z . eren � DATE, f TYPE FACILITYr� e t. �- ` Ot�ier d - T: 3. °•Y' ;2. TIME ARRIVED- LEF Exglai n AA - . a i - . w. a - i'a + 2 X °` _ s _ C 51 �. 3 -= mac., ., T - �.: ,s •,. 0,5. ;: ✓icy. C'/ C'✓, •- �LJ`I n e -- =G - ey _ e ti> •'- '� X 3 } o. - d� �T � _ ice` - v s 1 INSP PERSON IN :.OR i I'ackndwledge this Feld Activity Report SIGNAT[JRE•�' � F 6/86 •T _• ITLE• s "� ,_ Y . c.4, ,yn ,_ � Al \` ► 0r 1 dd WELL UUMYLr,ttUiv rLrUiAJ- DEPARTMENT OF HEALTH PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only STREET AOURESS: TOWN/ VI / 1 I Y TAX GRID NUMBER: f C' ; , e . ��/ �-�� / WELL LOCATION WELL OWNER Na E: - aooaess _ S �,r �� %''� Q PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary ORESIOENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.lHEAT PUMP O ABANO ED -1 ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL O INSTITUTIONAL ❑ STAND -.BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST: OF DAILY USAGE gal. REASON FOR DRILLING KNEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION ❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DEPTH DATA ,� [[ WELL DEPTH �ft- _ STATIC WATER LEVEL ft. DATE MEASURED % DRILLING EQUIPMENT O ROTARY COMPRESSED AIR PERCUSSION p DUG O WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE O •SCREENED ❑ OPEN END CASING. OOPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH 3 ft. MATERIALS: XSTEEL O PLASTIC ❑ OTHER CASING DETAILS LENGTH .BELOW GRADE — ft. JOINTS: O WELDED :;MHREADED O OTHER DIAMETER in. SEAL: O CEMENT GROUT O BENTONITE BOTHER / WEIGHT PER FOOT _ __7_— lb-/ft DRIVE SHOE O YES NO LINER: O YES ONO SCREEN V ETA IL� DIAMETER (in) 'SLOT SIZE LENGTH (1t) DEPTH TO SCREEN (ft) DEVELOPED? FIRST... - ,.. . - - - .. _ _ .._ ,. _. . r O YES ONO a - . �.., .. HOURS GRAVEL PACK ❑ YES O NO GRAVELY SIZE . DIAMETER OF PACK In. TOP DEPTH tt- BOTTOM DEPTH It. WELL YIELD TEST It detailed pumping1ELL METHOD: O PUMPED i tests were done is in- • COMPRESSED AIR formation attached? • BAILED ❑ OTHER ; O YES ONO {1 LUG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE ling water Bear- well Dia- Meter In FORMATION DESCRIPTION cooe It. It... WELL DEPTH IL DURATION hr, min. DRAWOOWN It, YIELD gFm- Land Surlace -" WATER CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ❑ NO ANALYSIS ATTACHED ?" YES ONO STORAGE TANK: TYPE d` '.` L CAPACITY v _ GAL. PUMP HF RM ATION . TYP ' CAPACITY MAKER Ind irr h DEPTH MODEL 1i VOLTS HP :4 WELL DRILLER NAME r 1 '0' Pj D T 1 ADDRESS .2 7 / SiGfiM /, •iII� N' /C /�-a .�i��.•� ��i, :PEYITM _.,COUNFI'Y DIVISION OF ENVIRONMENPAL HEALTH SERVICES HE-C4n Owner or purchaser of Building Section Block Lot Building Constructed by w/ C c 0 P E-iP C--O U 2 7. Location,- Street W I c- c c) e c- G S 7/} 7'E.I 1 Subdivision Name R17RJ /9,11 % tq 40 /- /,* s Municipality. Subdivision Lot # l Ff}f'1 /LCD Q�'SiDEk)c6- Building Type GUARANTEE 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 con_dition_any part of_ said System constructed by me which== fails•to v. w ........ ,..._ ._ - �opera-te-• for a- perrcid-of. °two "years iirmediateiy'follt ing ' tKd' 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 td 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 Director of the Division of Environmental..Health Services of the Putnam County Depaitment'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 TV 19 �7 Signature 4P Title PC / O C General' Contractor ( Owner) ' _ Signature Ic%� � /� /� 0 EV EELV p r7 ,"fi c 6 A`0- Corporation Name 4 if Corp.) W E'S7= R /n- C.0 NS 7A_ge.lipA) Co". VV kl • C-erntr- a( .Ave- . Corporation Name (if Corp.) r E'Ln S /-o A-. O, N- y 10.r-A3 'V q A.1- C e,% f r a / /4 v�h c(Q ess 3 Address rev. 9/85 mk 4 4 PETER C. ALEXANDERSON County Executive July 6, 1987 DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Certified, Return Receipt Requested Mr. Edward Pires, President Wicopee Estates Inc. 44 H. Central Avenue Elmsford, New York 10523 RE: Wicopee Estates I Lot 6 Wicopee Court, Putnam Valley Official Notice of Non- Compliance JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director You are hereby notified that non - compliance with Article III Section I of the :Putnam County Sanitary Code consisting__ of ,__w.._. M..,..... th 1 uaal�d'vell rig= sekxage- -disposa.l= system and house that has not been constructed in accordance with conditions of such permit i.e., the increase in sewage disposal system and bedroom count of house without review and approval by this Department. As the permittee, you are responsible for such actions. Further action of this nature will make you liable to the penalties provided by law, including prosecution on a charge of committing a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as prescribed by law, in addition to such other action as may be prescribed. It is sincerely hoped that the above - mentioned further action will not be necessary and that you will cooperate by securing the correction of this condition in the future: Very'fjruly Yours, Robert Morris Environmental Health Technician RM:pt Fecal Coliform per 100,n1 Fecal Streptococcus ner'100 ml "OST PROEA.BLE NUMRrP TF_C1,TN'TOUF Total . Coliforr.:_: 1!P:; Index =rer-:1-00 Fecal Coliform: NPN Index per 100,,m1. OTHER ANALYSES ^_'HESS RESULTS INDICATE THAT THE WATER SAMPLEI OF A SATISFACTORY SANITARY QUALITY ACCORDING` WATER STANDARDS, FOR THE PARAMETERS TESTED, "A Albert H. Padovani, M.T. (A CP), Director (WAS) (WAS NOTY (NOT APPLICABLE) O TN.Z NEW YORK STATE DRINKING SHE TIYE OF COLZECTIO'N". LEGEND LAB Q . Yorktown Medical Laboratory, Inc ing Water Source' 321 Keay Screec_ ' Too Numerous To Count Collection StAtion Used: - -. _.._. -T,-� _ . _ .�._.:._.� `orktown Hz�ghcs, N. Y: 10598 -.,_ .,.. .�.... ,:�z ; ..Pew., .s:k.i.la . -_ Less Than > = Mt . Ki sc o X New City '(914) 245 -3203 — Director: Albert H. Padovani 'M. T. (ASCP) Date .Taken : ; T_ Date Received:ic• -� Torlish & Sons Date Reported: PO Box 271 Collected By:�.D. Torlish Armonk, NY 10504 Referred By: .Sample Source:_Tf) P -4,i 5- Ij L �itC'i:sc: c. hf LABOPATQP.Y REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA XStandard Plate Count per 1.0 ml ;Z C, ..(Agar plate @ 35 °C) MEMBRANE FILTRATION TECHNIQUE (M FT) '1. Total Coliform ner 100 ml L: Fecal Coliform per 100,n1 Fecal Streptococcus ner'100 ml "OST PROEA.BLE NUMRrP TF_C1,TN'TOUF Total . Coliforr.:_: 1!P:; Index =rer-:1-00 Fecal Coliform: NPN Index per 100,,m1. OTHER ANALYSES ^_'HESS RESULTS INDICATE THAT THE WATER SAMPLEI OF A SATISFACTORY SANITARY QUALITY ACCORDING` WATER STANDARDS, FOR THE PARAMETERS TESTED, "A Albert H. Padovani, M.T. (A CP), Director (WAS) (WAS NOTY (NOT APPLICABLE) O TN.Z NEW YORK STATE DRINKING SHE TIYE OF COLZECTIO'N". LEGEND RDS = Recommend Disinfect- ing Water Source' TNTC = Too Numerous To Count CONF = Confluent = Less Than > = Greater Than 383 128 C49 1 u CEIP T FOR CERTIFIED MAIL ':O INSURANCE COVERAGE PROVIDED NOT FOR INTERIiEATIONAL MAIL isB° �j °'JBBE,I - -e a In0 c a, r• V.' _i Sep' la "e- /$ . ire° and ND ! Fea zee I I L'. r T,)7 (� (o , f L S P ; I � - �� I PETER C. ALEXANDERSON County Executive July 6, 1967 I"- DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Certified, Return Receipt Requested Mr. Edward Pires, President Wicopee Estates Inc. 44 H. Central Avenue .Elmsford, New York 10523 RE: Wicopee Estates I Lot 5 Wicopee Court, Putnam Valley Official Notice of Mon - Compliance JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director You are hereby notified that non - compliance with Article III -. <: -- Sect° ionz - I_ =of= the- Putnam County Sanitary Code - consisting. of -. the construction of an individual dwellingsewage disposal system and house that has not been constructed in accordance with conditions of such permit i.e., the increase in sewage disposal system and bedroom count of house without review and approval by this Department. As the permittee, you are responsible for such actions. Further action of this nature will make you liable to the penalties provided by law, including prosecution on a charge of committing a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as prescribed by law, in addition to such other action as may be prescribed. It is sincerely hoped that the above - mentioned further action will not be necessary and that you will cooperate by securing the correction of this'condition in the future. V truly yours, Robert Morris Environmental Health Technician RM:pt __ . j =�' '�e - - [a. .., y c A. ; ,� _ t: - - - R�� t jt DEFAMMEM - . ,r,W `i o DIVISION "C)F' AL HEALTH SERVTCFS 11 I John M. Simmons, . M D. = Deputy CaOdd0ioner' off Health " -' FTEGD ACTIVITY ``REPORT - Sheet ^of . r/ ' rt °_= INS I ; PEE ON. NAME' _ , �. Orr, 4 iRout I ne Ori _, g Camplainti ADDRESS rN %4 �. � UY 9 ^ / � Brig. Request ..ON No. Street Town -1 NO ; ' T'S Canp].ance Canpla nt C mp - MATLING ADDRESS :_f - Final, P O. &sac Post Off ice °Zip Cade Group .linhess - Construction TI:L,EPIONE - - Adinspection' PERSON ,V J RGE Field, Sampling Only oR INTE�iIEED = :. = IU/I/: : ., Field Gonfe$ ldhee .. Maine and'i e Other . j -DATE: , °l:- ... : , TYPE ,'FA LITY 30 _ 45 TIME i-ARRI�ED TIME - LEFT C = E xplain ;FINDINGS: .: ' -P I R Ov5� LT LIB\ 5 5 - , -Minx xh T: . _ �r k 1� SID ,1ii�s tl?9G �; I�: . , -. - _,.. .,_ _._ .. u r �. u. - � i. _n. _ f _ - -- _ s - _ , ;. ; /r ' ,. - -, j•. ,: �: -- _ .� f - '. INSPDC'I�OR: � &� . TE6EPHONE: _. Signature and Title : fiori1 `. Al _.. .,.. ._ _; .. PERSON IN C&RRM OR INTERVIEWED: : _. .. =. - - Iacknowledge this Field Activity Report. SIGNAZUREt . . - : .. 6/86 TITLE: 3-^'-.,,,. ----- a � _, a-'w -ter «°s -�-"�'�`°'- ^.-'°°- -r-- -- of --^-1t s.,.+� � s,, �'�`_"r."• ....c . i �� z r PUTNAriY COUNTY DEPARTMENT '� z Dlvielodof Environmental Healtservb as Carmel, N Y 10511 y v Englaeer to:Provide Permit q 4 c s E r on CE$TQrfC�A7TE /OF COMPLIANCEQ Permit q CONSTRU PERMIT FOR SEWAGE DISPOSAL SYSTEM _ Loested'at e� 1 t b` t'. s Town or Yili_a Sabdivlsion Name cCA?pQ P . -`SU 9 e5 Je Sabd. Lot q - r+Ta: Map :- Block l Lot Z. ;Renewal ❑ Reviriion p� Oweer7Appllcant Neme %ICO t?� i tQ�es 17 .: Date of Prevtoae A grovel '� �• d g � 7 Maillus Addnse: a?i_ i /C►/' ( �, . C�'nfra �. .: QVt: Townes Banding Type 9 �I f►► a �V Q2�1 [1 PJL C g Lot Area `J 8 $ ` FW Seotton Only Depth Yolttme PCHD Yea a' R Wben Fill Ia comp lotid °`�' Des n Flow G 0',D,_,8 No, catlo to eq " Namber of Bedkooms _. iB , d' L Y Separate Sewerage System to consist of d Z� Gallon Septic Teak W f t�e Tobe coastrtt¢ted by tC 6@ n a Q'Q/` °r►hl'/i Address water:SapplJ Pdbl C, il"ply Address, or: ✓ 4' Prlvste'SaPPIy D'eilled by �O ?� u,�- Address :' f Other: Rea alrements I represent that_Iam wholly and completelytresDonsiblef or'thadesign:'antl location of the proposetl systems) 1) that theseparatesewage7disposal =system above' deacnbed will be constructed as shown on the spprovetl amendmentthere to and in °accordance with'the standards, rules:an regu a-ions o e .0 nam County 'Department of . "Health 8nd that'on completion thereof a Certificate ,of Construction Compliance' sat�sfsctory to 4ha Commissioner of Health will be submitted. to the Department; and 'a be :fUin4tie-d the ownai;:h�s successors; heirs•or,eisigns 6y.-the builder, that safd =bwtder �4i11 place" in good operstihy' conddion any part of said sewage�.d�sposal system'dwmg the period of two (2) years immediately following thedate of the.fssu- _ ,. .. ante `of' the approval ,ol' the Certiiicate of Construction Compliance .of the,originaI's ystem or: any ropa:i s thereto; 2), that.the drilled well desciibeG above willbe.locatedas ShawrtROn the approvetl, plan and that saitl well will be.lnstallod, in accordance witF. the `standards,. es and,regu a. ns of the PutneM County Oepar``tmant Of- ,Health - s Date �J S i9ned P E ✓ R.A. �l i n Ct es Qt. S Ct,crr�� 6o,oS AaAress License No APPROVED�FOR CONSTRUCTION This Spproval expires two years;iroM the date issued unless" Construction, 0f.,the budding has, been undertaken and is revocable' for cause or'may'be amended or modified when cons, etl.- necessary_ 'by the. Commissioner of Health. - Any change or alteration.of. construction requires a new per' m'it. Approved for, disposal of, dome st ry „sews d /or ,private water supply. only.'. 187 R/v. Date ey Title ' ' -s P[T!'NAM COUNTY DEPARTMENTP OF HEALTH - DIVISION ' OF ENVIRONMENM HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS - CONSTRUCTION._PERMIT,. DATE iti �J BY: (Street Location) Pet Application Corporate Resolution l Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion_.Area;$hown gravity- flow. ,:suzf..size If Pumped Pit & D Box Shown & Detailed House - No. of Bedroams Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 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 (i.nc. expan) 15' to Drains-Cartain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' fran 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) Data On DDS Plans & Permit Same ;t"j- I'V DESIGN DATA SHEET- SUBSUFACE SE KYAGE DISPOSAL SYSMM FIEZ NO. Owner �(Copee-- E -s fd �e s I n r Address 44 o rf� le � fora i Le- E !wr sk r 4 Located at (Street) GDILL 14 Sec. 3 S Block / Lot 3 -s- (indicate nearest cross street) L I Municipality Ila ryt Watershed JUu c Solt SOIL PERCOLATION TEST DATA RD(Xn:PM TO BE StTBNIITrID WITS APPLICATIMS Date of Pre- Soaking ai A '9'-7 Date of Percolation Test & 5- 7 HOLE 3 I t= 3 2 " -� "it' -6 ::24 NU4BER CLOCK Mm v PERCOLATION _ PERCOLATION Run Elapse Depth to Water FSrcm Water Level No. Time Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 2 3 2 3 4 2 (t: )0- 11 :26 ( 3 6 3 If: 27 =( / :s y 23 22 z z SZ 3 8 4 ((: SZ -IZ 18 26 22 g 2s -am 6 2.-7 2-'3 2-6 .2 ((:1.7- 11.37 zo Zzyi 2S�z 3 7 • 3 (( :31?"/2 =O o 21 2 Z4 2S 7 4 1202 =12.26 24 CZ 24 S 5 [,Z_.'2-7-12;6-1 24 2-S 0 1 ((:02 ='11. (► 4 :. 23 3 3 I t= 3 2 " -� "it' -6 ::24 v 4 Ir`-�-12 =2.`f _ NOTES:' 1. Tests to be repeated are obtained.at each for review. 2. Depth measurements to rev. 9/85 9-to ^-, & (I at same depth until approximately equal soil rates percolation test hole. All data to' be submi.tteci be made from top of hale. TEST PIT DATA REQUIRED M BE SUBMITTED WITH APPLICATION DEPTH. HOLE -.NO. HOLE NO. G. L. 21 D IN TEST HOLES HOLE NO. 31 41 51 61 71 81 10, 12' Z� 131 INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNUMED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EIMUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used 9-10 Min/1" Drop: S.D. Usable Area Provided -Pvo No. of Bedroaris' Septic Tank Capacity gals. Type 14OK017r, Absorption Area Provided By L.F. x 2411 width tren 130AL ,Other' 3 r GZ (j (L V-e- 0 1 -S ff, Ibu ft an 13 6*1 K Zq icy Name Gcoo t,1A S S"Occa Signature Address SEAL THIS SPACE FOR USE BY HEALTH DEPARDENT ONLY: Soil Rate Approved sq.ft/gal. Checked by Date PUI14AM COUNTY ' DEPAR'IIr OF HEALTH DIVISION OF 'ENVIRONMWAL HEALTH SERVICES Date • Re: Property of Located at Lai- - W c c-c-o P P -et- (T) _j Section 35 Block Subdivision of Subdv. Lot # `S Field Map # 2II2 Date MAP�_H 13, '00 Gentle xn': This letter is to-authorize A,SN -A a duly, liceizsed 'Profes6iw I a inner or. Re istered Architect to . ICA,IE�: •.:.. 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 promulgated by the Gzamissioner of the Putnam County .Department of Helath, and to sign all necessary papers on my behalf .in connection with this matter and to supervise the .construetion of said system or, systems in conformity with the provisions of Article 145 or 147, Education Law, -the Public.. Health- I:a a , and the Tut nam Count}i` Sanitary' Code.. Countersign P.E., R.A., '3 �J' �; k1dress TelepIrme Very truly yours, 1AcEDM '-r-9 SIGNED x. Owner of o'perty ess Telephcne Putnam County Department of Health Division of Environmental Sanitation AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health - In the matter of application for I' -- ia19_-- �LRE3---------- - - - - -- represent that I am an officer or employee of the corporation and am authorized to act for --- t�=- p -Lj�2- - - - - - - - ---- - - - - -- (name of corporation) having offices at _ _`{`}_ Whose officers are President ED5u_pe-o_ 14 - 1- i_� _ (Name and Address) Vice - President _ - - (Name and Address) - - - Secretary _ it_AAc-Z-_4fAL1M1 _ �_rc _PL- _A4k -.•A. 0_1 _ .(Name and Address) Treasurer _ _ _ (rlarrr ' _d-- Add�^eSs)� - _.� _� �, - V __ - ....... and that I am and will be individually responsible for any or all acts of the corporatio with respect to the approval. requested and all sub- sequent ac s rel ting thereto. Sw r.obefore t _day Signed _- L _, _ BRIAN A T ..T NG — — — -" P ;� t w o oPk q - -� --- - - - - -- f . .a 1 e Titl r 4- lified %junuffixWw. Notary Public Corporate Seal DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT,. J: WATER-WELL-.----- -- - - -- - PCHD PERMIT # PV 43 -86 WELL LOCATION Street Address Wicco ee Court Town/Village/City Tax Grid Number Putnam Valley 35 -1 -3.5 WELL OWNER Name Address JaPrivate Wiccopee Estates Inc. 44 North Central Ave., Elmsford ❑ Public USE OF WELL 1 - primary 2 - secondary Iff.RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ❑ ABANDONED 0 BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify; ❑ INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY D AMOUNT OF USE YIELD SOUGHT min 5 gpm /# PEOPLE SERVED 1 Fam /EST. OF DAILY USAGE 600 gal; REASON FOR DRILLING JRNEW SUPPLY ❑REPLACE EXISTING ❑PROVIDE ADDITIONAL SUPPLY CUTEST /OBSERVATION SUPPLY ❑DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING New Residential SWply WELL TYPE DRILLED DRIVEN ODUG GRAVEL D OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Wiccopee Estates I Lot No. 5 WATER WELL CONTRACTOR: Name to be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: NSA TOWN /VIL /CITY .._.:- _- .D.IST XCEZO ROPERTY- EROM=.NEAREST._.W.ATER - MAIN.:..;....Gxeater LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED �c` a �1 Q ON REAR OF THIS APPLICATION F[K SE A ffi - (date) (s 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 provided by the Putnam County Health Department. Date of Issue: f�� 19� Date of Expiration: 19 00019_ Peffit Issuing, fficial Permit is Non- Transferr le M. CASHIN ASSOCIATES HUDSON VALLEY DIVISION Architects . Engineers . Surveyors Route 52, Carmel, Now York 10512 (914) 225 --8a Y 88 2 9 1987 9 Mr. Robert Morris Putnam County Health Department 110 Old Route 6 Center, Bldg. 3 Carmel, New York 10512 CABLE: CASHASSOC MINEOLANEWYORKSTATE iV RE : Prop.osed SSDS "UN ' Wiccopee Estates I, Lot 5 Wiccopee Court„ Putnam Valley Permit # PV 43 -86 Dear Mr. Morris: Approval for an SSDS for a three bedroom house on the above referenced lot was granted by Mrs. Bittner on May 12 of this year. It now transpires that a four bedroom house has been built. This submission contains the plans for a suitable SSDS. Since the proposed system is in a fill section, we felt a further detailed site inspection was required. The principle results of which are: 1. The fill section is located as shown on the revised plans. 2. The average of 3' ROB fill was required to provide a__ maximum slope of 15 %, No earth berm was required at .the top of the fill section. In light of this information, 445 LF of trench was located as shown. Should you have any questions or comments, please feel free to contact me at this office. Very truly yours, CASHIN ASSOCIATES, P.C. by:�� u-titi T. John Cannin TJC /edb Enclosures I� PLM M COUNTY ' DEPAit24ENr OF HEALTH DIVISION OF F.NVIRONMWM HEALTH SERVICES'- Z 7 %NCO Re: Property of ��C�=��''E� �`�T /'��j , h1G_ Located at At NA EZg kT�- . • noh1? (T) VALLFLiSection 3S Block i Lat Subdivision of L'3L��LXL- > Tt S"T AtT'ES �- SubdV. Liot # Field Map # —Z W6 Date 1,U1 V Gentlemen =: Zhis ' letter is to - authorize C a dully licensed Professional Engineer or Re istered Architect 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 proaiilgated.by the Commissioner of the, Putnam County .Department of Helath, and to sign all•neCeseary papers on my behalf . in cannection with this matter and to sispexvis°e the .conetsvati.on of said system or systems in conformity with -the�pravis -of -tide 145 l�ii,sctiori I;aw; _._.. ......... �_..._.........� _..... _...... the Public Health Law, and the Putnam County Sanitary Code. Countersigned �P.E�, Rf sZ. err --rte -rte --- c' A33 ess - , °3 lg - 2Z Y3t3 Telephone Very. truly. yours, SIGNM p, -- of Property 4Y 4-ty ess 0S. L3 clty. s97A 9&70 o ; Putnam County Department of llealth �\ 6 Division o f Environmental Sari! Cation � ® AFFIDAVIT - CORPORATE (XINER APPLTCATTON FOR PERM.T.T APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of }lealth - In the matter of application for E — — — — - _. I' -------- - - - - -- represent that I am an officer or employee of the corporation and am 'authorized to act for — I L_PQL _ l-?-2 — — — — — — - — - (name of, corporation) — — - - -- - -- —"� -- — — — — — — — — — — — — — having offices at Whose officers.are President t_Dlb�F1,') Y - (Name and Address) Vice- President _ _ - - — — — — — (Name and Address) -- — — — — — - - — — Secretary _ l « - preZ —+- �'� 1 — arc�'Q Pt.._ — A40.. — (Name and Address) Treasurer :..�.:_�� _ _ :........_:W- .�.. :.�. - _ ...R y . _ _ •_' , —_.- _..- - (Na��re� -aa�� Add�es-s�- :_:..._._ - - ...—.a � - w._ —, _-. - -_.. _.-.:.r and that I am and will be individually responsible for any or all acts of the corporatio with respect to the approval. requested an all sub- sequent ac s rel ting thereto. Sw o before e th y% day Signe &__ _.�. ` BRIAN A F T NG — — — of p , work 1 Title Ilfied in N Notary Public Corporate Seal PLTINAM OOUMT DEPARTMERr OF DIVISION OF I' •' ' 1N Y• HEALTH SEWICES T�'.SFiEEr SUB.SUFACE .SEWArS_DISPOSAL, SYS .. ;: �., ;� Ii .-ND. Owner &Sfcrtes Anc_ Address 44 fior f h C e •, �rcx ( V Located at (street) Ut cp o- (o u r t Sec. 3 S- Block I Lot.3-S- (indichte nearest cross street) tjtcop_e-e- T- t-,f 5- Municipaiity RJ,1410L ucd i e q Watershed Cr o fo A SOIL PEROOIAZ.'ION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking ,t `? T7 Date of Percolation Test Qprcl ID S7 3 HOLE NUMBER CIDCR TIME PERCOLATION 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 3 Inches Inches Inches 1 !c�•oo - Jv:l� iS 3 � 2 !d -1�-7- I0:43 2� 3 14 -'44 - If' 11 27 3 A 4 I( =12- 0:42- ,3b 3 to 5 11.43- Q:t-1 30 (b 5 16 3 5 NUM: 1. Tests to be repeated are obtained at each for review. 2. Depth measurements to rev. 9/85 to at same depth until approximately equal soil rates percolation test hole. All data to'be submitted be made from top of hole. 157 2 1•2- r - 1: 2-1 3 31:43 -LIC) 2-7 3 `% 4 2 -1I - 2 =38 /L7 3 Q 5 16 3 5 NUM: 1. Tests to be repeated are obtained at each for review. 2. Depth measurements to rev. 9/85 to at same depth until approximately equal soil rates percolation test hole. All data to'be submitted be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF sonS ENCOUNTERED IN TEST HOLES --DEPTff--.: . "'ROLE NO., G.L. 11 21 31 41 51 61 71 81 91 10, ill 12' 13' 1<7777--- INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENODUNTERED DEEP HOLE OBSERVATIONS MADE BY: E L DATE: DESIGN Soil Rate Used J?- (0 Min/1" Drop: S.D. Usable Area Provided 6-000,4 No. of Bedrooms 3 - Septic Tank Capacity 10 0 0 gals. Type Mo-iLvio Absorption Area Provided By 3 3,5' L.F. x 24" width trench Other :� I q 0 e P ( (( Ca V-2- ) AS fir- ( � Lj f/ 0 A 60A Name C"L� Ocsoct-afes Signature. ,-"�*r Address SEAL CaIr tk3�-,!'O. 2600-0111 THIS SPACE FOR USE BY HEALTH DEPARDEZU ONLY: Soil Rate Approved sq.ft/gal. Checked by Date :�P �".W. -.„, ✓ ;•.- gmr..v ?cYa+� S`q' '..?^ M ., T^ 'Je's'+'Y'+ Y •FI 1 ,.fie # .M�. J 1 PUTNAM COUNTY DEPARTMENT OF HEALTH" 386 Division of Envhronmental,Health Services Carmel N Y:10512 Eriglneer,to.Provlde Permit N 1 i CERTIFICATE OF COMPLIANCE `� Permit A PV 43 J 6 STRUCTION PERMIT FOR_ SEWAGE, DISPOSAL SYSTEM Putnam Valle Located of W1CC0p @e Court-. " Town or ,VNage Snbdivieloa Name W1CCOpee' ESt ." I ` Sabd. Lot q T_5 Tau Map4 S« Bloclt 1^ r„t� 3.5 Renewal " O Revision - 0 Owner /Applieanf Name WTccOpee. Estates, Int. Date of Previous Approval M.iuog Address' 44. North Central Avenue Town—. Elmsford .10523 1 Famil Res. S. +/, Ac. Building Type' Y Lot Area FID Section Only. Depth Volume Number of Bedrooms 3 Design'Flow G/P /D "" 600 PCHD Notification le Required When Fall is completed 1000 335 LF of 21 wide- absotption trench Separate Sewerage System to consist of Galion Septic Tank and to be conetructei* - •lei etePM to Q . Address Water SnPPiyt publ :aa�ea. or: X Private to be determ rwL Other. Requirements 3'.ROB fill; Dstributori;Box . represen tha f am wholly anti 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. Putnam County -Department oi.. Health. ago that,on completion.thereof a ••Certificate of Construction Compliance" satisfactory -to the Commissioner said be. `submitted, to the:; Department;• and•'a..writfen. guarantee..will be furnished the owner,' fits successors,, heirs or--assigns by the builder, that said. buildef. will place in good operating condition any, part of said sewage' disposal system- during' the , period of two (2).yeers Immediately following thedate of the issu- an�e 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 locafed as shown on.the, approved pl$n an0 "that saitl well will be Installed in. accordance, with the standar s, rules and regu aaf the Putnam County Department of. Health: Date ^ c` . Signed P.E. X R.A. J - Address Cashin Associates P; � C:.Rt - el NY 10512 t_itense No 26008. - -. _ ._ - . APPROVED FOR CONSTRUCTION:. This apprmia'vexpires wt from the date issued. unless construction. of the .building has been undertaken and is revocable for cause*' or maybe amended or modified when considered netessary..by the Commissioner 'of Health, Any change or alteration of construction reCuires a nep�eirmAi/t._ Approved for ,tliG /S ??sal of domestic san itar se a or private water "supply only. Kee/ rp�1 Date s'i�/Y ��/ V- By title'V� V /y ' PUTNAM COUNTY DEPARTMENT OF HEALTH 'r k Rev 3/86 Division of Environmental Health Se'ei tees Ceeme! N Y 1012— Engineer to Prov�deYermlt fi on CERTIFICATE OF COMPLUINCE� �J® ONSTRUChON.PERMIT FOR SEWAGE:: DISPOSAL SYSTEIVT :.$ermit N . Putnam Valley - - - - ..�•. :rd� orLY34age Subdivision Name Wi nnP.P : FS to f?PS 1 Snbdr Lot q 5 Ta: M4 35 Block 1 Lot 3,.S Renewal_ 0', Revielon ❑ owner /,APPUeBnt Name Wlccopee Estates, ..'Inc.. - l @ Date of Previous Approval Mailing Address- 44 Nort i tiarttral--'Avenlif Town Elm�fcird zip 1052.3 lloudtug Ty0e .:' T',.Fain Res Lot Area 5-849-k +, F(q'Section only Dept& 3t Yolame440 `CU yds. Number of Bedrooms 3 Design Flow G /P /D 600 C. PCHD Plodficadan is Required When FWdo completed - Separate Sewerage System to consist of 100 Gallon Septic Tank end to be deteit ned To be.constracted by Address - Water S nPPUr Pabltc'$aPP1Y From Address or: [ Private; Supply'Dr111ed,bY to 'be determ neLa> . Other Regnlmni nts Y 9 represent t a , am wholly and complete) responsible for the des nand location of the proposed system(s) 1) 'that the separate wage disposal system - above`descnbed wtlhlie' constructed as shown on the,app!oved amendment there o and in accordancewiih,'t66 standards, rules an regu a,ions o ' e Putnam County Oopartment - of - Health: and that_ on completioq thereof a "Certificate of Construction Compliance' satistactor'y_to the Commiss,onei;of Healthwill be submitted to the 'Depart ment and ;a written guarantee,,will be furnished the owner, his'wcceszors heirs or a4igns'by the builder; that said builder will place_ m good :operating condition any 'part of said - sewage disposal. system ;during .the period of.two (2) years' Immediately'following Yhedate of the issu- ance of the approval of the ,Certificate of construction Compliance, of the original system or any: repairi thereto; 2)`that the drilled well described above .. will be located as shown op approve tl plan and that said well'willbe installed -in -accordance: with. the'.standa s, rules and regulations • of, 'the , Putnam County Departm ant ; of Health - Oats 1��j Signed P E. X R.A. �. �Vt� C� a) ?Address License No 26008 . APPROVED FOR: CONSTRUCTION Thts_approvat:_expues one year f 'the` to �ssu unloss construction of the building' has been undertaken and is revocable for'caus or may amended or;motltl)ed when considered n ce r y the s_s' MV r th. Any change of alteration Oi construction requires.a w, rmit p ed for�aisposal of •domes(ic•sanitar 's a ,:antl /or;' i e Date - ey Title_ 0 PUTNAM _)UNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL BEALTH.SERVICES . COUNTY OFFICE -BUILDING, 'CARMEL, -,10512 DESIGN DATA SHEO"S'EPA RATE SEWAGE DISPOSAL SYSTEM FILE OwnerwA�rFe_ fi_el�e_Ar/�':Address' Located at k Street )Q _�cf}wA►\j Hf!s. Er,> Sec . -Block" V kindicate nearest cross Municipality-P LLB , wat'r, she d <f P-e 'j SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS .707 e Number CLOCK TIME PERCOLATION PERCOLATION Run No. Eiapse Time Depth to Water From Ground.Surface ..._-W—ater Level -In Inch Rate Start-Stop Min. Start Stop • Drop in ,:Soil ]a, , �an drop Inches Inches. inches 2 Lln3 3 7 45- 27 4 1 1. 2 /t N Notes Tests to be repeated at same depth until -a imatedy*. equal soil rates are obtained at each percolation test hole Affrdaxta to,be'., submitted for review. 2) Depth measurements to be made from top of*ho'ld. iJ��1li1V Soil Rate Used - /OMin/l "Drop: S.D. Usable Area ProvidedSid 5 No. of Bedrooms 3 Septic Tank Capacity ��ov GeTs. Tyl9 /7% N Absorption Area Provided By 3 L. F. x24 �;� widt k 2'BriC. •a. Y !Name Signatu Address SEAL; f , S .y a t. •.r t id r a r 2.5 a j ' •� P � 1 J� \pvD ,3 �,Ro,6 F•I�C'Y 37' Yt Raf' g xlol i \ VJ IN /S� L c�T AV-Fq WIDE P'2Polle D -, �� , S• X49 + \ ,: i,�' , Da•a�narejE eoSEN.E*+[. 11 I �`= �`Io,[a�� ''' � , i I I�-7 �f3 a �XTENSIC•a OF \ *� I ., � F� , t II LI ExIST�, awA T Pa�1�osEa IICA I 3 Zo w �C.. veoffa srn Ji, u, i -� I I:J ' �AiNsyFEd5c�1FNT -8 /S a 1 t I Vi ,� II RAP