The URL can be used to link to this page

Home My WebLink About2602DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -2 -48 BOX 22 :: { qj� �1p ' '1k �? rim In . ' 6 Ir Li I' a 02602 PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 3186 Dlvtelon'of Fn.,t.�nmentAl'A.;.Ith Services Carmel, N.Y. 10512 1 01 a Located at t 0 ar Engineer Must Provide 7 . P:C.H D Permit li SEWAGE - DISPOSAL SYSTEM R r .o��'�" .: ...sit....: \+....... �..::.s....�., .�._..yy r..::c. ..r. ,..:YV a.,, Tu Map -S Block toot y�i GGU e Subdivision Name Subdv. Lot N cY 9 . ZIP %C�J�' / . Date Permit Issued �i C r n� �rP✓ t ormerl Owner /applicant Name _ � Y Mailing Address Separate Sewerage System bullt,by // / ""� r � Address Consisting of 6, a, —Gallon Septic Tank and Water Supply: Public Supply From `' ` Address or:— A--� private Supply. Drilled by '35L& f Address /Y �• Building Type �l` �� ' Has Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? � O Other Requirements W Y0 I certify that the system(s) as listed serving the above premises were constructed sent ae ".shs the lane of the completed work ( copies of which are attached), and in.accordance with the standards, rules and regulation in rd 4th it plan, and the permit issued by the Putnam County Department Of Health. vol ___ 5_L��'� Ce► ified by P.E. R.A. Date _ Address License No. Any person occupying premises served by the ova systems) s shall promptly take uch a R. cure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sew rage system shall b Ei n as a pubt% sanitary sewer becomes available and the approval of the piivate water supply shall become n 1 and vokt when a p 1 11100-1 stoma avallsbW Such approvals are subject to mods lion of, change when, in the - Judgment of the' C missio r of 1 modification or change is nseagry. Datef1 !YO�Y�) .. ` By Titls PUTNAM COUNTY DEPARTMENT OF HEALTH - - - - -- - DIVISIOi�i OF ENVIRONMENTAL ..HEALTH..SERVICES_.. Owner or/&urchaser of Building Building Constructed by Location - StreetK Municipality Building Type Section Block Lot Subdivision Name Subdivision Lot # GUARAN= OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate fora period of two years immediately following the date of approval of the "COrtificate. -a-f- Gonstfudtior. - Cc:npfiance "= f.or -. the- .sewage.:dispo 3. system a.nr::at?y......_._: -.. 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 Director of the Division of Environin?ntal Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. I , Dated this ,'1" da f a 19 Signature Title General Contractor lOwner) - Signature Corporation Name (if :)rp.) �4�/ Address rev. 9/85 mk Corporation Name (if Corp.) X04P Address '0" mary ail.*! A-LIX"RILN BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 225-2072 - WATER ANALYSIS REPORT - SAMPLE NO. 6778 SOURCE: Mary Ann Arrien hose bibb-well Wiccoppee Rd. Putnam Valley, NY COLLECTED: November 4, 1987 BY: P.F.Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 mi. d This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. November 7, 1987 7 b, Bickwit P.E. Director AnT TmT^xv T, "'n ^'n m DEPARTMENT OF HEALTH Division Of Environmenta e PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION 5 TREET ADDRESS. Nivlt IfY TAX GRID NUMBER*. Wiccoppee Rd. Putnam galley, NY WELL OWNER NAME: ADDRESS: Maryann Arrien, 23-29 31st Rd.Asto-ria.My 11106 PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary [3 RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND. /HEAT PUMP ❑ ABANDONED 1 0 BUSINESS ❑ FARM 0 TEST /OBSERVATION 0 OTHER (specify) [I INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑ AMOUNT OF USE YIELD SOUGHT —1— gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE gal. REASON FOR DRILLING M NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY 0 TEST/OBSERVATION 0 REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA r 245 WELL DEPTH _ft I STATIC WATER LEVEL 0 • 1 • ft. —Fi DATE MEASURED 10/23/87 DRILLING EQUIPMENT IN ROTARY a COMPRESSED AIR PERCUSSION ❑ DUG 0 WELL POINT 0 CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE 0 SCREENED 0 OPEN END CASING .13 OPEN HOLE IN BEDROCK 0 OTHER CASING DETAILS TOTAL LENGTH _11— ft- MATERIALS: OcSTEEL 0 PLASTIC 0 OTHER LENGTH.BELOW GRADE 30 ft. JOINTS: ❑ WELDED U THREADED ❑ OTHER DIAMETER 6 in. SEAL: 13 CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT 1-- 1b./ft DRIVE SHOE: [3YES ❑ NO LINER: 0 YES 6 NO SCREEN DETAILS' DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST. HOURS SECOND GRAVEL PACK OYES 0 NO GRAVEL SIZE: DIAMETER TOP OF PACK DEPT H ft. BOTTOM DEPTH WELL YIELD TEST It If detailed pumping I METHOD: LFUMPED i tests were done is in- Q COMPRESSED AIR formation attached? 0 BAILED 0 OTHER 0 YES 0 No WELL LOG if more detailed formation descriptions or sieve analyses are available. please attach. DEPTH FROM SURFACE [Land water Pear- " well Dia meter in FORMATION DESCRIPTION coce It. M WELL OEM IL DURATION M. min. DRAWOOWN ft. YIELD gpm. Surface CI Drilling in overburden clay & b1dr5. *t I.Ock at 101 24 6 225 50 1( it in in rock set casing,groute 11 24 rril L anite. -ing'in WATE9 0 CLEAR TEMP. QUALITY OCLOUDY HARDNESS I OCOLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? 0 YES O.NO - L STORAGE TANK: TYPE Well Xtrol 250 CAPACITY .44 GAL.- PUMP INFORMATION TYPE . submersible. CAPACITY 7 9 MAKER Gould DEPTH 2001 IAODEL7EIIQ5412 - VOLTAGE 2-10- lip ILQ WELLORILLERNAME P.F. Beal & Sons, In L ADDRESS PO Box B SlG?jXM 87 Brewster,NY 10509 i'r-Y • 1 \fy� tisr """'- n-r^nv � �„ 'P - 77777-7- ,,� ^a'."^ -`;' T` - r — ''i 771771., Uj PUTNAM COUNTY DEPARTMENT OF HEALTH Dtvlslon of Environmental Health Services: Carmel NY 1051 ? F Engiuee._ to rl r Provide Permll q CERTIFI . \ _ CATE OF COMP CON UCTION PERMIT FOR SEWAGE' DISPOSAL SYSTEM Permit - k lCO. %7i�G O Or Town or - e _ Located at _ Subdivision Name ry A s , l G Go . _ Sabel: Lot N - ..Tai Mrap Renewal_ ❑ Revision ❑ Owner /Applicant Name �I"J �� ` ' Date of Provioas Approval Malllng Address Town 7jp _ Building Type- Lot Area FWliotion Only. Depth Volume Namboi o[ Bedrooms `�; Design Flow G P D b 0 YCHD NotlBcatlori is Required When FW'le completed 4 Sepanite Sewerage System to consist of Gallon Septic Tank and ` To: be constructed b Address .y Water SuPpIT : Pab11c1Sapply From Address ors Private Sapply Dulled by Address ' Other•Ro+iuiroments'..' -. ItiepreseAt that`I am wholly, and complatgly respon3ible for the deAgn' ^and IocatiOn of the proposed �hVW! 1�t the', separate sewage disposal system above described' will be constructedasshown onaheapprovedamendment theie to antl.�in accordan r les an regu a �onso e u nam County DeDactment'. of Health ,and,tfiat.on,complet�on'thereoi a Cerbt�ute -. of Conitructio ,�ae�f�e sj5c o.the Commissioner of Health will be submitted ,to Me 'Dspartmerif and.a .writtenc'guarantee wJl be `furnished. the owner h' is' cC� />�>�n .` yji ti , he builder =that said builder Place in good ,operating condition any.`part of sakjAiwage disposal, systeiet durnni "tha pe d ol'. o (2) yeaii � iat following',thegate of 4he:isw- ance of the pproval' of the Ceitdicate_of Constl.ucbon Compliance of the onginat syste c laps` orator �h a,drillad. well described above will be located ;as showmen the approved plan and that ssitl well will De'instatletl In .cc,5 an w; he 5 ru end sgu a_ ens of ;the Putnam .. County' Departmen; "of 'Health a r -• Date 7 /J Signed P.E. �1 R.A. ' Address ._ ..O //- .. ,.� ' •• .. ;. _ • ense No APPROVED FOR CONSTRUCTION Th' approvsl_expvei:two j!ears`4rom he `tlate. issue .un _ ct .o(�t� ding has been undertaken 'and is revocable for cause or. may be.amentled or- motldied;when'.co. idere see y,,by'.t e, -o si er - Yny ange oTalterition of construction requires :a new per it.'. p ov'ed for disposal of domest,i ry d r r a f' Rev. 1/87 Dats(� BY. Tale JAL MI e DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641 APPLICATION TO CONSTRUCTA1ATER WELL RX PCHD PERMIT 4 1 y WELL LOCATION Street Address Town/Village/City Tax Grid Number 1' f 3. WELL OWNER Name Mailing Address W.Pfivate Alnr Uh riezz 2_3-111— � vim% Xr,4 A/ ` O Public &SE OF� WELL - primary - 2 - secondary RESIDENTIAL 0 BUSINESS ® INDUSTRIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT 41UMP O ABANDONED 0 FARM O TEST /OBSERVATION 0 OTHER (specify, O INSTITUTIONAL 0 STAND -BY AMOUNT OF USE YIELD SOUGHT c gpm /# PEOPLE SERVED 2 /EST. OF DAILY USAGE 4o& gal REASON FOR DRILLING KEW SUPPLY 0 PROVIDE ADDITIONAL SUPPLY 0 TEST /OBSERVATION OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE ✓DRILLED DRIVEN ®DUG ® GRAVEL ® OTHER IS WELL SITE SUBJECT'..TO FLOODING? YES 1--' NO IF WELL IS LOCATED IN A REALTY 6UJ501v1s1uN, NAM ur bUJJV1V1b1U11: rr -/ c- c-sae! c Lot No. c" WATER WELL CONTRACTOR: Name .6-s't'r? 0 7 047_.s a r7 Address: r�y� IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED / []ON REAR OF, THIS APPLICATION ON SEPARATE SHEET -e_ R _'" (date) (atur 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 s.hall: 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 per 't. 3. Submit a Well Completion Report on a form pro ide y Putnam Cou y Health Depar ment. Date of Issue: °2— 19 Date of Expiration: 19 ermit Issuing Official Wldte 'Permit is Non- Transferrable copy: H.D. File Yellow copy: Building Inspector '/87 Pink Copy: Owner Orange copy: Well Driller PUTNAM COUN'T'Y HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES �� .�L�� -10:? I 225- 3838/225- 3833/225 -3641 >- PROPOSAL FOR SEWAGE DIS?OSAL ;SY€TEM•'REPAIR�. -: "-,.-;....�-�, > =rt -�, ... . . OWNER'S NAME ,r'��r" �`,�^a '�/✓ PH�IE ..��?Zi 74 20 SITE LOCATION e=e X-a d Tm# 3 -1--- / 3..Y T, MAIIJNG ADDRESS . �°� r C W1 CccaP /0er. 2Dfj-1D , Pun AM VA- ,t, , N211 105711 PERSON INTERVIEWED PCHD.Complaint # r, Name & Relationship (i.e, owner,tenant, etc.) DATE 9 -7 TYPE FACILITY Ne' 51D CNCC PROPOSED INSTALLER PHONE Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Proposal approved Proposal Disapproved Inspector's Signature & Title Date. roposal approved with the following conditions: 1. Procurement of.any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name.. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I as owner, or eported agent of awn agree to the above conditions. f SIGNATURE r TITLE k- DATE / f 7 OPIES: V& be (POM); Ye1]aw (Tam BI); Pink (AppUMr t) n,...fi 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 Marvin O'Dell Building Inspector Town of Putnam Valley Town Hall Oscawana Lake Road Putnam Valley, Ny 10579 July 21, 1987 RE: Construction Permit Wicopee Estates - Lot 8 (Arrien) Putnam Valley JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Dear Mr. O'Dell: This Department is in receipt of a construction permit for the above captioned property, the plans for which show a modified septic system location. ls.h2le it apepars - 'that the revised location ' is acceptable'�'si,rice' - this was part of a subdivision approval, I.would appreciate your comments, especially regarding the existence of Town wetlands, if any. If you have any questions, please feel free to call me at ext. 304. i Very truly yours,: John Karell, Jr., P.E. Director Environmental Health Services JK:mk cc: F..Sullivan,PE BM JK File. JOSEPH F. SULLIVAN, P.E. 2772 FERNCRr-ST YORKTOWN HEIGHTS, N. Y. I0598 (914) 962-4248 'oo�5e �F- 'v 00? .'.... - - ._......a- .._rte.... MARVIN O'DELL Inspector TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT August 6, 1987 Putnam County Health Dept. 2 County Center Carmel, N.Y. 10512 Re: Proposed SSDS & Well Lot #8 - TM #35 -1 =3.8 Wiccopee I Subdivision To Whom It May Concern: Having reviewed the proposed well and SSDS drawings by J.F. Sullivan (modified 7/8/87), it is found not to affect the adficent wetland or stream.. Loor TOWN .HALL . PUTNAM . VALLEY, N.Y. (914) 526 2377 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 Marvin O'Dell Building Inspector Town of Putnam Valley Town Hall Oscawana Lake Road Putnam Valley, Ny 10579 July 21, 1987 RE: Construction Permit Wicopee Estates - Lot 8 (Arrien) Putnam Valley JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Dear Mr. O'Dell: This Department is in receipt of a construction permit for the above captioned property, the plans for which show a modified septic system location. the.. revised „location, i;s _ acceptable, since ; this was part of a subdivision approval, I woui(f appreciate your comments, especially regarding the existence of Town wetlands, if any. If you have any questions, please feel free to call me at ext. 304. +Very truly yours, h John Karell, Jr., P.E. Director Environmental Health Services JK:mk CC: F..Sullivan,PE BM JK File PETER C. ALEXANDERSON County Executive June 29, 1987 DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Frank Sullivan, P. E. 2972 Ferncrest Circle Yorktown Heights, New York 10598 RE: Arrien Wiccopee Estates Lot * 8 Putnam Valley, NY Dear Mr. Sullivan: JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Review of plans and other documents submitted at this time relative to the above captioned project has been completed. Comments are offered as follows: 1. minimum SSDS design for this lot will be for a 3 bedroom house. Thq� - alternate SSDS area for this lot approved in the _ ..... subdivision is at the rear of the lot, 100 feet from the wetlands. You show the SSDS in the wetland. Plans should be revised to iFeflect the above. Ver � i T t�luly • � i John Ka,rell, Jr. • 6irector, Environmental Health Services JK:pt cc:JK File PUIU M CUJKI'Y Ut: AIU1411,11' OkN I t t.l\ U111 DIVISION OF HEALTH SERVICES, DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner tr 'M r7ri' i ee Address" t / Located at ( Street) i cG �ge e A 0 oC Sec. 4"`". Block �_ Lot (indicate nearest cross street) Municipality Ci� Watershed SOIL PERCOLATION TEST DATA REWMED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking Date of Percolation Test HOLE NUMBER C1= 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 Inches Inches Inches O , 12 z ;Z s° 4 5 Ae- 4 5 1 NITS: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to*be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 'IEST PIT DATA ROQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIP'T'ION OF SOUS ENCOUN MED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. jG.L. � ao "' �:• <� .r . tl,.... v. , . . ! i 21 ✓e t 1. 3' 4' 5' 6' 7' } 8' 9' 10' 11' 12' 13' 14' . --, - - - INDICATE LEVEL, AT WHICR GROUNDWATER I5 ENCOUNTERED jINDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENMUN EKED -.�- DEEP HOLE OBSERVATIONS MADE BY: l'.�L•% /i a� �l;i DATE: i 1 1 i DESIGN Soil Rate Used 11�_ Min /1" Drop: S.D. Usable Area Provided 3720 v No. of Bedrooms Septic Tank Capacity gals.. Type /./ Absorption Area Provided By G L.F. x 24" width trench Other Nam �' ` Signature Address SPACE FOR USE BY ONLY: Sol' Rate Approved sq. f t /gal . Checked by Date + PUI'NAM CUUN'I'Y UJ,-1A,,- .MfVf OF HEALTH DIVISION OF ENVIRCNMENML HEALTH SEMCES '- DESIGN DATA SHEET- SiJBSUFACE SFWAGE DISPOSAL SYSTEM FILE ND. j Owner' r1 `- ' j r-r> � Address `' 3", ryu Located at ( Street) J � t= yJ �f' e /�l v, Sec. Block Loth (indicate nearest /c'ro/ss street) Municipality �rWatershed SOIL, PERCOLATION TEST DATA RBOMED TO BE SUBMITIM WITH APPLICATIONS Date of Pre-- Soaking Date of Percolation Test HOLE REBER CL= TIME . PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches % l je -._ /0a i � _:� I ?- X-S-- � -,;g 4 5 4 5 1 N 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately dual 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 7 4 5 4 5 1 N 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately dual 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 TEST PIT DATA REQUIRED TO BE SUBMITIM WITH APPLICATION r, DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES i DEPTH HOLE NO.. / HOLE NO. HOLE NO. G.L.j 3' 4' 5' 6' 7' 8' g' 10' 11' 12' 13' 14' INDICATE LEVEL AT WHICH mouNDWATER IS ENOOUNTERF;U INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUN7ERED DEEP HOLE OBSERVATIONS MADE BY: o� /f f �` DATE: �d DESIGN Soil Rate Used 67--s Min /1" Drop: S.D. Usable Area Provided e.h No, of Bedrooms Septic Tank Capacity gals. Types'�'��'r� Absorption Area Provided By 6 CP L.F. x 24" width trench Other Name ///J,,; `''0 Signature 0% AE 6 Address r'' THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: a 0 Soil Rate Approved sq < f t /gal o Checked by �°�°��`�� Date PUTNAM COUNTY DEPARTMENT OF HEALTH - .;.;.., :::,.:.- :�:..:.:r�..:.,.�.:.,.:...•;.. DIVISION OF ENVIRONMEIVTAD "H'HALTH"'SERVICES :d--.....:,. r Date Re: Property of NIA-R%A-1A A RR IC N/ Located at W ICC OPLE ROf-D (T) ��/l�l dt� !��/ !V Section Block _____Z Lot = o Subdivision of WICCOPEY L51-A-21-PS T Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize��`'� /�� a duly licensed professional engineer k-,*" 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 conn'6etioh' 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, the Public Health Law, and the Putnam County Sani- tary Code. E Countersign P.E., Very truly yours, Signed A4t4 ` Owner /of Proper y ;23 3 I 20710 Address 1�1 -, N1510 WO6 Town 6-7 t �� 2� - 10 g I Telephone PUINAM COUNTY DEPARTMEI4T OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVCDUAL VUTF.,R SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIFL,D INSPECTION =6ngT NAP INSP. BY: (Nacre of Owner) Scree VLccation) INITIAL SITE INSPECTION YES NO cailE TTS Wetlands on /or proximate to property .......:...... Property lines or corners found ................... Canestimate house location ....................... Will driveway need cut ............................ Dist trees be- remved - note these ................ Deep holes representative of entire SDS area...... ,Additional deep holes needed ...................... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... adjacent wells /septics ............................ Across tn nrcnos2d well location for drillina...._ D.H. 1 Lot - Depth to G:W. Depth to rock Soil Descri tic 0 ft. 3 ft.� 6 ft. 9 jt. 12 ft D. H. 2 Lot Depth to G.W. Depth to rock Soil Descrit)tia 0 ft. 3 ft. t 6 ft. 9 ft. 12 ft. DATE: _ FINAL SITE INSPECTION INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable.......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... Natural soil not stripped or SDS area unnecessarlygraded ............................ 10 ft. maintained fran property line and 20 ft. fran house .............................. Distance well to SSDS (ft.) ................. ... NmTber of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench... ............. 15 ft. of peripheral soil horizontally frantrench ..... ............................... Boxesproperly set .. • ............................ Could surface runoff fran driveway, roads, - ground surface,. etc., channel near SDS area.... Does lot drainage appear OK jn area of SDS:....... T-imr r. 7nnrur_ of STTE Ac%zEpTA=.,- ......... D.H. - Deep Hole G.W. - Groundwater D.H. 3 _ Lot - Depth to G.W. Depth to rock 0 ft.' 3 ft. 6 ft. 9 ft. .:12 �ft. Soil Description YES NO C� APR -13 -2004 11:31 FROM:PUTNAM COUNTY DEPART 845- 278 -7921 r - FOLEY- :h Direaar TO:95287420 P:3/3 t , • LORETTA MOLINARI R.N., Ksx, Associate Public Health Dbwar ' � • • D►rector of Patient StrvEes ' DEPAR NT . O HEAr.,7H 1 Geneva $Load . Brewit", New York -10$49- , , Snrlronmeatrl Health (94$)371.6130 Fox(14S)179.1911 Nursing Serilecs (845)178 ••6558. VnC (845) 278. X672 'Fax (845) 291.60!5 Esrly InterMtloe (845)278-6014 Presebool (145) 278.6011 • Fax (245) 2yi • 6641 �l1iYl11m �un'tp 3�srpi: CS��E�,ti'1> '. ., '"' :•;.. ' . _ � . Brewster,NY.105.05 ,.. „ . � �� • ' Residence •. �- .. . Tax" axM Town- Gentlemen• Acc'oe&fig toxecords, maintasTmd, -by the fVoWhilhe abdVe °nafed•d�volling ' is NOT - tn compliance with Town code and the'total number of bedroom.s on recoxdis This lTl£o=adoa has been obtained fToril; , ' CERTIFICATE OF OCCUPANCY: ASSESS'OKS REC.ORD! OTBM „ Buildiag InApectoz , , housejuldelines ' YML ENVIRONMENTAL SERVICES 321 Kear Street ��orktowo-Heights»&.Y"�~10528,, (914) 245"2800 Albert H. Padovani, Director LAB #: 32.402664 CLIENT #a 57452 NON STAT PROC PAGE; I ARRIEN, MARYANN DATE/TIME TAKEN: 04/16/04 09:10A 93 WICCOPEE RD DATE/TIME REC'D: 04/16/04 09:45A PUTNAM VALLEY, NY 10579 REPORT DATE: 04/19/04 SAMPLING SITE: 93 WICCOPEE RD SAMPLE TYPE..: POTABLE : PUTNAM VALLEY NY PRESERVATIVES: NONE COL'D BY: MARYANN V. ARRIEN TEMPERATURE..: < 4C- NOTES...: KITCHEN TAP COLIFORM METH: Ml:-- DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 04/16/04 MF T. COLIFORM ABSENT /100 ML ABSENT, 1008 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. SUBMITTED BY: o A'10L /v Directo ELAP# 10323 VOGLER BROTHERS INC. Septic Tank Service 39 North Street Katonah, N.Y. 10536 phone(914)- 232 -5535 Mary Ann Arrien 93 Wicopee Road Putnam Valley NY 10579 INVOICE Date Apr 21, 2004 Arri2 Bills due when received... Interest of 2% per month charged on past due accounts. -------------------------------------------------------------------------------- Date Service Amount 04/20/04 Cleaned & inspected 1000 gallon precast septic tank 250.00 Baffles in place, water level good system in working order .00 Total Charges 250.00 Sales Tax 18.75 Credits - 268.75 Net :Due .00 Thank you for doing business with VOGLER BROTHERS INC. -------------------------------------------------------------------------------- PLEASE TEAR OFF THIS SECTION and return to us with your payment to insure proper credit to your account. WE NOW ACCEPT MASTERCARD,VISA,DISCOVER Arri2 Mary Ann Arrien Amount Paid 93 Wicopee Road Putnam Valley NY 10579 �.:.:.. ......,.,.....,., _ .... ....... .:......,�,....... ..., L ense #b�0 021 ........�....� .. .: ...., .�_ �� ..... , , _ .._ ...... VOGLER BROTHERS INC. Septic Tank Service 39 North Street Katonah, New York 10536 (914) 232 -5535 To Whom It May Concern: April 21, 2004 On April 20, 2004 VOGLER BROTHERS INC. cleaned and inspected the septic system at 93 Wicopee Road, Putnam Valley, NY. The tank is precast concrete. The capacity is approximately 1000 gallons. The water level was at the proper working height. Both sanitary inlet and outlet tees were in place. There were no visible signs of any sewerage leaking above ground from the area of the drain fields. At the time of inspection, the system, that which was observable, appeared to be in working order. This inspection report has been prepared for your sole use for the purpose of inspecting the present physical condition of the sanitary disposal system (septic -system)-.: -The, report covers only.those portions of the system or grounds as were capable of being visually inspected and does not include any portion not actually seen, or capable of being seen. This report as to the present condition of the system is not to be construed as a guarantee or warranty, and is not intended for the purposes of estimating the value, or as to offer an opinion as to the advisability or inadvisability of (purchase) (mortgage) of the residence which it services. It is assumed for the purpose of this report that the system is wholly located on the premises to be (purchased) (mortgaged). VOGLER BROTHERS INC. is not a land surveyor and renders no opinion as to whether the system is wholly located on the premises. Respectfully, VOGLER BROTHERS INC. ,IV k� Harold Kiley President APR - 13-2004 11:31 FROM:PUTNAM COUNTY DEPART 845 -278 -7921 LORE77A MOLINARI Public Health Director T0:95287420 P:2.3 DEPARTMENT • Or, r,. HEALTH, 1 Geneva Road, Brewster, New York 10509 Envtrommatal Health (845) 279 - 61.30 Fax (645) 278.7921 NurslnR Sorvices' (845) 278.6558 W. 1C (845) 278.6678 Fax (845) 278.6085 Earty Interventlon/Prescbool (84S) 278.6014 Fax (845) 278.6648 A,.CCF� ORY �p R TMx�;�,L Date o • • �tenewal ❑ C� Yes tro. STREET q3 WICGOP To TX NSAPZ , -a I -� NAME MA�Y,�Nr>' A-P.r° i �N PHONE y� -S3•� �yz� • • . .. .. PCHD ri MAILNGADDRESS q3 pttl .� ey lv n�yio ".. MAILNO ADDRESS OF APARTMENT q3 1,,heCOP& PAD eV7VhK ; ' 7 NUMBER OF BEDROOMS ri MAIN 11OUSEjV- ; NUa14SER Ol'"BEDR04MS INN APARTMZN Please submit this form drld the xequirements on page two ta_t'ne Putnam- County-liealth--Dopt;,A .. _....:_ :�.. �.:. � _:Gellevz Rd,,•Bre- w�tor; NY 105n9 Phorie 278.6130. . • • ROBERT J, BONDI County Executive Approval is effective for a three year period. The applicant must mapply atthe end 6f each period to renew the legal status or the apartment, Si ature of Applicant ,2�A'Prove" ate f B Title . Co ents,S.. , . , • ,', , .. .. ' ". • : .. ; ' . ' . • • 1 s r 1 I s LORETTA MOLINARI Public Health Director 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 April 23, 2004 Maryann Amen 93 Wiccopee Road Putnam Valley, NY 10579 Re: Accessory Apartment — 93 Wiccopee Rd. Three Year Approval (T) Putnam Valley, TM #52 -2 -48 Dear Ms. Arrien: ROBERT J. BONDI County Executive I have received and reviewed the plans for the proposed accessory apartment at the above - mentioned residence. The proposal for the apartment has been approved as per plans bearing the approval stamp from this Department dated April 22, 2004. The apartment is approved for three years with the following conditions. 1. The total number of bedrooms in the apartment must remain at one without . -prior approval by this department. :- 2. The total number of bedrooms in the main house must remain at three without prior approval by this department. 3. The area of the existing sewage disposal system, and its expansion area, must be maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Sincerely, William Hedges WH: lm Senior Public Health Sanitarian cc: BI (T) Putnam Valley j tii