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Home My WebLink About2640DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -3 -37 BOX 22 ,Iry IN III .%% .10 Iry J . I NN 1 ` N ti -T : '. .. is L IN �., IN 0 INN .. 02640 1a� %86 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 �i Engineer Must Providel/ i P.C.H.D. Permit #— ✓- Sz. -? -3""�'? CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM at Peekskill Hollow Road Richard H. Denike Formed Owner /applicant Name Y MaWngAddress 308 A Peekskill Hollow Rd. Zip -10579 Putnam Valley, NY T. Putnam Valley 19 . ._...Town or Vu ge Tax Map Block Lot Subdivision Name Denike Subdv. Lot H Parcel 1 Date Permit Issued Separate Sewerage System built by Owner Address Consisting of 10 0 0 Gallon Septic Tank and 375' X 24" x 1 R" n 1 a t P r a l s Water Supply: Public Supply From Address or: X Private Supply Drilled by Norman Anderson, Mesa Barger St. , Putnam Valley, NY Frame As Required 10579 Building Type Has Erosion Control Been Completed? 4 Number of Bedrooms Three Has Garbage Grinder Been Installed? No Other Requirements None I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance th the filed plan, and the permit issued by the Putnam County Department Of Health. I Date 12 December 1986 certified by P.E.__X R.A. RD 9 - Fair Stree Address rmel, NY 10512 License NO. 29206 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a pub": sanitary sewer becomes available and the approval of the private water supply shall become null and void wheq a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Commissioner of 161 alth, w rev tion, molfication or change Is necessary. Titi- Date g� PUTNAM COUNTY DEPARTMENT OF HEALTH Permit #1 /+� Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTI3 ERMIT - FOR 'SEWAGE DISPOSAL' SYSTEM l . Piltnan � aT1e Town or village Located at Peekskill Hollow Road Tax Map 19 Block 2 cot i Subdivision Richard 1-1. Denike Subd. lot #Parcel 1 Renewal -0 Revision Owner /Address Richard H. Denike, 3CSA a )tsetl 1 0110TT�r RZ. .ii.a iT Date Of Previous A pproval 579 Building Type Frame Lot Area 2G -75Q am Fill section only ❑ Number of Bedrooms three Design Flow G /P /D 600 P.C. H. D. Notification Required Separate Sewerage System to consist of 1000 Gal. Septic Tank and 375' X 24" W X 1611 D To be constructed by owner Water Supply: Public Supply From X Private Supply to be drilled by Address Other Requirements Address 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed in accordance with the standards, rules and regu aeons of the Putnam County Department of Health. Date —July 5, 10,&.55 X Signed / P.E. R.A. Address RD 9--Fair St. i. r>le1 NY iC512 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of dometary sew e, /o private water supply only. 1� Date i l !r 1'��ICJ By Title �1! t� Rnv_ Q -R: PUPlNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Richard H- T)anika Owner or Purchaser of Building Building Constructed by Peekskill Hollow Road Location - Street' Municipality Frame Building Type IQ 2 I Section Block Lot Tiani k'i- Subdivision Name T Subdivision Lot # 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 condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the .Certificate. of Construction Compliance" for :_the. sewage disposal system, or-any __.._..__.__._. _..__..� . -._ .._., repairs made by me to sub i Sys n� except where `tile faziifre - to``dperate -proper -y- -i7s 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 Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 11 day of December1986 Signature General Contractor (Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 mk Corporation Name (if Corp.) 308 A Peekskill Hollow Road Address Putnam Valley, NY ��• r1,� WJGLL UUrir11r111V" iu:rvcxi Office Use Only .t DEPARTMENT OF HEALTH f Di�, s;iu n _:Of -_E vxronmental -. Healt PUTNAM COUNTY DEPARTMENT OF ' HEALTH WELL, LOCATION STR ' OORE ILLA I TAX GRID NUMBER: WELL OWNER DRESS' e.P81vATE 40'PUBLIC USE OF WELL RESIDENTIAL O' PUBLIC SUPPLY 0 AIR /COND.IHEAT PUMP ❑ ABANDONED 1 - primary ❑ BUSINESS O FARM O TEST/ OBSERVATION ❑ OTHER (specify) 2 - secondary ❑ INDUSTRIAL_ ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE` —"1: REASON FOR NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION DRILLING O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH /2 ft. STATIC WATER LEVEL �/ ft. DATE MEASURED DRILLING `ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify: WELL TYPE ❑ SCREENED ❑ OPEN END CASING. AOPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH ft. MATERIALS: ,;STEEL O PLASTIC D OTHER LENGTH.BELOW GRADE ft. JOINTS: O WELDED THREADED ❑ OTHER CASING DIAMETER ' ` in. SEAL: ❑ CEMENT GROUT O BENTONITE WTHER DETAILS WEIGHT PER FOOT _1 lb./ft. I DRIVE SHOE -XYES ❑ NOT UNER: CQ YES_;WNO SCREEN DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? FIRST ._.___.D.ETAILS SECOND HOURS GRAVEL PACK ❑ YES GRAVEL DIAMETER TOP BOTTOM ❑ NO SIZE:: OF PACK in. DEPTH —ft. DEPTH ft. WELL YIELD TEST If detailed pumping _ If more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. p Y MVH00: ❑ PUMPED i tests.were done is in- formation DEPTH FROM Water Well COMPRESSED AIR , attached? ❑ 8AILED ❑ OTHER i ❑ YES ❑ NO SURFACE Bear- ing Dia- FORMATION DESCRIPTION CODE. ft. fL (meter WELL DEPTH DURATION ORAWOOWN YIELD Land surface It. hr, min. it. gpm t /" ✓ - WATER CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS _ ❑ COLORED ANALYZED? ❑ YES ❑ NO ANALYSIS ATTACHED? ❑ YES ONO STORAGE TANK: TYPE�j -� Z43 CAPACITY GAL. '-:t, PUMP LNFORMATION WELL DRILLER NAME �/ �r AT�� TYPE �''� CAPACITY -� �. MAKEA � DEPTH ADORESSrt/ —i Yr SIGRXTURE 1-1///4 VOLTAGE�� BHP 'rte MODEL Yorktown Medical Laboratory, Inc LAB I 321 Kcar Street Yorktown Heights. N. Y. 10598 Collection Station Used: �914ra� Carpel .de_ e " Y� ea R(L C Director: Albert NPadoaani tL T. (Asa) v Ci Z' — y ,r Date Taken: /C1,w)f Z) /L9A* Date Received:_ /,I -r -P7_P &S3 Date Reported: �� -gyp jptp Collected By: 7.-'erred ' By L �' . 7'�� JO ti �C C� .%�`y /C � ✓ Sample Source: 7, 4.) LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF .WATER . GENERAL BACTERIA _ Standard Plate Count per 1.0 ml Z-g (Agar plate @ 35 °C) KENIB ATIE FILTRATION TECHNI UE (MFT) Total Coliform per 100 ml Fecal Coliform ner 100 ml _ Fecal Streptococcus per 100 ml `COST PROBABLE NUMBER TECHNIQUE (MPN) Tot -a1 Conform - _LPN- I:n- ,ex:.ne -r y..._ .. _.._ Fecal Coliform: OTHER ANALYSES MPN Index per 100 ml 1'nta Z At60L#TJ 11Vll1'CATt+ TftA 1nL IIA1" ti OF A SATISFACTORY SANITARY QUALITY ACCORDING T WATER STANDARDS, FOR THE PARAMETERS TESTED,. At Albert H. Padovnni, M.T. ASCP), Director wifi viii % All v$` AY 'uiLA�Y.+ )NEW YORK STATE DRINKING TIME OF COLLECTION. LEGEND RDS a Recommend Disinfect- . Ing Water. Source < - less than TATC • Too Numerous Too ., PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES t>,Yi.l a /(,X41 .CIntto INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO COMMENTS Wetlands on /or proximate. to property .............. Property lines or corners found..... ............ Can estimate house location ....................... Will driveway need cut. ......................... Must trees be removed - note these ................ Deep holes representative of entire SDS, area...... Additional deep holes needed...... . .... .... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/septics ... ......................... D.H. - Deep Hole G.W.- Groundwater D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot Depth to G. W. Depth to G. W. Depth to G. W. Depth to rock Depth to rock Depth to rock Soil Description 0 ft. 1 0 ft. 3 ft. 1 1 3 ft. 6 ft. I 1 6 ft. 9 ft. I 9 ft. ,soil uescr 0 ft. 3 ft. 6 ft. 9 ft. 12�ft.� Soil Descri ti 3 S FINAL SITE INSPECTION IDNSP.BY: - / I YES I NOI CAP 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. frcan watercourse .................... Natural soil not strippal or SDS area unnecessarly graded.. ...... ... ........ 10 ft. maintained from property line and 20 ft. from house... ........................ Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. f roan nearest trench .. .......... . 15 ft. of peripheral soil horizontally from trench ......... .......................... Boxes properly set.. . ... ................ Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE .................. 74 ` �O 1. a. g Ck b .. Lai� ,tea t DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services April 30, 1986 John Prentiss, P.E. Fair Street Carmel, New York 10512 Dear Mr. Prentiss: JOHN SIMMONS, M.D. Deputy Commissioner Re: Denike SSDS Construction Permit Application Peekskill Hollow Road (T) Putnam Valley Tax Map 19 -2 -1 Denike Subdivision Lot #1 This Department is in receipt of the second revised plan for the above referenced submission dated April 3, 1986 and received April 24, 1986. Review indicates items 1 and 2 of the April 10, 1986 letter have still not been addressed. 1. Sewage disposal system has not been laid out parallel c-o-nt-o u r s 2. Details as specified in the referenced document for well and septic tank are lacking. Specifically: Septic; Tank a. length to width ratio between 2:1 and 4:1 b. maximum depth of cover :12" c. minimum diameter of opening :20" d. asphaltic coating for reinforced concrete e. location stake f. inlet pipe slope 1/4 inch.per foot minimum Tr Atn r r)i WTV CFNTFR - CARMEL. N.Y. 10512 (914) 225 -3641 John Prentiss, P.E. April 30, 1986 Well 1. Detail "A" and "Note B" are not shown. 2. Well casing must extend a minimum of 10' into rock, not 60' maximum. Repeated submission not in conformance with requirements, results in great delays in permit issuance.. Upon receipt of plans adequately addressing the above items, review will continue. If you have any questions pertaining to the above, please call me at 225 -3838 or 225 -3833. jAH:pt cc: Mr. Denike 308A Peekskill Hollow Road Putnam Valley, NY Very truly yours, mes A. Hodgens Asst. Public Health Engineer DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services April 10, 1986 Mr. John Prentiss, P.E. Fair Street Carmel, NY 1051_2 Dear Mr. Prentiss: JOHN SIMMONS, M.D. Deputy Commissioner Re: Denike SDS Const.Permit Application Peekskill Hollow Road, PV, TM 19 -2 -1 Denike Subdivision Lot #1 4 This Department is in receipt of the revised plan which was revised 7 April 1986 for the above referenced application. Review of the application materials indicates that the following items have not been provided on the,.plan as set forth in "Program Review and Policies ... for Single Residences'': 1. Sewage disposal system have not been laid out parallel to existing ground contours. Details as specified in the referenced document for well and septic tank are lacking. I. Required basic.construci.ton notes are lacking. 4 . Locati:ori of "st'r'e'am' °w"ith-in ._10-Or. fee °of roperty� I.in -e ,has not been shown or referenced. %� Additionally, item 1 of the 7 November 190 letter has still not been addressed which states: VV 5. The percolation test data.on the design data sheet appears to be in error as the water is-rising in the hole. and 6. Two sets of house plans are necessary. Upon receipt of the above items, review will continue. If you.have any questions pertaining to the above, please call me at 225 -3838 or 225 -3833. Very truly yours, James S. Hodgens Assistant Public Health Engineer JSH:amm cc: Denike, 3,08A, Peekskill Hollow Road, PV File T%A /n r'ni IKITV r'FNTFR - C'ARMF1 MY ini;l? (q14) ?7;, -iA41 � 5 DAVID D. BRUEN County Executive Mr. John Prentiss, P.E. RD 9, Fair Street Carmel, NEW York 10512. Dear Sir: 9 ...: � ":i:�a .. e: . -• :,., . ... .,. , , . .. Jb�HFI'SIt��NON$: M.Z$.'.r , . ' Deputy Commissioner DEPARTMENT OF HEALTH Division Of Environmental Health Services November 7, 1985 RE: Richard Denike Peekskill Hollow Road (T) Putnam Valley Review of Department files relative to an application for a construction permit for a subsurface sewage disposal system and well to serve the above - captioned property indicates that on August 15, 1985 Mr. Hodgens of this office car=icated his catments to you in a telephone conversation. To date, a revised submission has not been received in this office. J For your information, the following items are required or outstanding: (1. The percolation test data on the design data sheet appears to be in error as the water is rising in the hole. y . 2. A prof ile drawing is not provided'- in- the SSD9. ` -..-_ - 3. The driveway is not shown. A section at say 200 scale should be provided, showing the house, driveway and Peekskill Hollow Road. 4. A note indicating no wells or SSDS's with 200 feet of the proposed wells and SSDS's, etc., is not provided. 5. The terminus of the well casing is not indicated a minimum of 12" above grade. If this project is no longer active, this Department shoul=Mr.HodgE If you hav e any questions, please call the writer at ext. 241 o ns at ext. 242. yours, hn Kaxblll Jr., P.E. irector Environentanl Health Services JK:mk cc: Richard Denike JK JH T /O. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 '0;ie ` INDIVIDUAL �++ )F HEALTH - DIVISION OF ENVIR & SUBSURFACE SEWAGE HEALTH SERVICES SYSTEMS Ate - CONSTRUCTION PERMITti L - �.... _.._.,. �.�,; _„..«_.........r.. . E - W SHEET __ TE ';R BYL (Name of Owner) (Street Location) DOC[ MEWS Permit Application Corporate.Resolution 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 RBQUIRED 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 Holds Located Representative of Sewage & Expansion Area - .Expansion Area - ;shown;gravity flow,suff, size If Pumped. - Pit..& .D. -Box °Shown & - De-tailed -•• . House - No. of Bedrooms Wells & SSDS's Win 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 (inc. expan) . 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -20,') 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. s® M mm ME DOC[ MEWS Permit Application Corporate.Resolution 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 RBQUIRED 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 Holds Located Representative of Sewage & Expansion Area - .Expansion Area - ;shown;gravity flow,suff, size If Pumped. - Pit..& .D. -Box °Shown & - De-tailed -•• . House - No. of Bedrooms Wells & SSDS's Win 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 (inc. expan) . 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -20,') 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. �- RGVII3J C1fl:CY. SI[IiGT phig gjT:j - IMccts Std.1 Romarks• 1703 O i FI>r;Ui:�i -ITS SEF:AI2ATION DISTANCES SPECIFIED ON PLAN 0' to P.L. House plans O.K. _sign data sheet , Peres presoaked? , ✓ I F in. 30" perc test dept i to Foundation walls to Nearest well to stream, march, lake, etc. incl:expansion to Curtain drain to water line (pits -20 to storm drain to large trees from foundation to soptic tank to pi }?e from leader drain &.fdouane, t rain TD ."TtI► QRSIti1 WELL Ta 0 .SEPTIC. TRlJK TG WELL. • SC)ttUcry` O cv, in`CLv0CE_b / + ' onst. results for 3 runs 1 -I t (I�t Hole log O.K. ✓ Must trees be removed -hote these . . . Corporate Affidavit fo other t • r n individual u - 1 uthorization for engineer — I. Letter from I -later Supply i app icao e I f variance requested -such noted on plans & apps.: 'T ti 3? '° ''IGIJnTUtiE E bERL OeJ PLA r DETAIL S Imo. F'1LL DFPTN I AREA' sROW14 LVj NOTE' PLAN TO O£ rft%;,yez' Existing contours shown (show new contours) Slopes for driveway cuts, etc. shown DERP 11OLE DATA , 4_T-ter service line location Footing drain, etc. location I j Top slope, bottom slope of f11T Percolation tests and deep test pit location ✓ I t i Seotic tank size and conformance to std. 3 i3. R. housa minimum j 1 House setback shown `p', . I Distribution box ftg. below frost t t kll water within 5' Tt. PL shown .. ✓ i nof. 0(.L_'CASING 12" PRE- OOVP_ADC - Plan and profile SDS All other wells and SDS closer 200' Y, shown or reference made ! �� Property boundaries (metes and bounds- clearly ow ; ►� �Fea� s;aoluslo�, I � — — SDS .located where approved . . . . . . CEALTy - length of trench measured Width of trench average Slope of tile line and tree -imitable . . . 7A•i: - i RI i E FIELD CIIECIC I;[ST. Date: Insp.by:_ INITIAL SITE INSPECTION C __h'C'3'1 rt .. _.. -•- .. -- - - - i�t WETLAND m, S - 1 - - - - SEF:AI2ATION DISTANCES SPECIFIED ON PLAN 0' to P.L. Can estimate house. location . . . . . . . . 101*/ c-0 00' 5' -0' .5' .01' .0' 5' n 15' ^Q' to Foundation walls to Nearest well to stream, march, lake, etc. incl:expansion to Curtain drain to water line (pits -20 to storm drain to large trees from foundation to soptic tank to pi }?e from leader drain &.fdouane, t rain TD ."TtI► QRSIti1 WELL Ta 0 .SEPTIC. TRlJK TG WELL. • SC)ttUcry` O cv, in`CLv0CE_b / + ' Will driveway need cut . . . . . . . . (I�t Must trees be removed -hote these . . . - Is deep hole representative of entire SDS area — I. 7A•i: - i RI i E FIELD CIIECIC I;[ST. Date: Insp.by:_ INITIAL SITE INSPECTION C __h'C'3'1 No a. Cointient:s Property lines or corners fouu-id Can estimate house. location . . . . . . . . + ' Will driveway need cut . . . . . . . . (I�t Must trees be removed -hote these . . . - Is deep hole representative of entire SDS area I. Additional deep holes needed. . di . s' Sufficient- SDS area available con9.dering driveway cut, house location, separation dist•anccs, etc. . . . . . . . . . . . Imo. DERP 11OLE DATA , Dapth: .Water elevation:. — — -- -. - Rock elevation: soils dC:scri'Otion: te: FINAL SI'L'L' INSPEC1_'ION 'Ins p. by: Y, House located where shown on approved plan — — SDS .located where approved . . . . . . - length of trench measured Width of trench average Slope of tile line and tree -imitable . . . Room allowed for expansion trenches . . . . . Over W-ft. from swamp,watercourse _ natural soil not stripped or SDS area i ulccc::,sar:ily graded . . . . . 10 Ft. maintained from prop.line and 20 ft. from house . . . . ? SeIxtration of trench from house, well etc.- follows plan . -. ... . 11tuuUer of bedrooms checks . . . . . Stones, brush, stw ^ps, rubble, etc: greater than 15 Ft. from ncar•ast. trench . . . . . . i 15 Ft. of peripheral soil horizontally from trench. ... . . . . . . . . . . s.. Junei•ion boxes properly set -- Could surface run off from driveway, roads, ground surface, etc. channel near SDS . . . , area ' - Does l.ot dra:inng in, area of SDS FINAL GRADING OF SITE ACCEPUAIMB • of ' pl Si / _L N -1 / 1 W r_77 a. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _. _ ._COUNTY° 0`PICE $UiIFWG, 'CI ,':'iV. ° °i� 105I2 _- DESIGN DATA SHEET= SEPARATE SEWAGE. DISPOSAL - SYSTEM FIVE NO. Owner i�� P'( -fie j4i k� - Address Located at (Street. W:_of Tic. �.,g - (Piw6cy-_ -Sec. I % Block a hot '.. 7na.1 cate, neare cross s ree Municipalityg:s�i �4 rev Watershed fee SOIL PERCOLATION TEST:DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME ' { PERCOLATION PERCOLATION.. hun water Leue -L No. Time From Ground Surface in Inches Soil Rate Start -Stop . -:Min. -m Start- Stop Drop in Min. /in drop Inches Inches Inches i w a, 9 Wf 7-4- a-'% 2 1 132A 30 �- 3 0* 34 a� 1 M-6 �-4 3 33 5 2 r' " Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. ERUCE R. FOLEY, R.S Acting Public Health p:rzCt DEP�.ti T I`1_� 0; HEALTH Divisi„ 0 Enviro:-- ..;n;a! Hea!i:h Services Gene,_ Roazi, B: : :s;er, Nev; York 10509 (914) :78-6130 -_ 'J :TIC :. r.. , _ TIC.. IAL O,�;L Y) s-iR== i : Se i 4 CW Tx M =?L 037- 0 D64 L./i.0 q L18-. l"i/I ab PCHD PERMIT T 71g Description of Add i t.i c -1 t x A0jyhk k OX CA; ' 11&l re & .8110 d 2M jW A%s>e2bA44 n f � _,-bs, of existc bed-c��s — from Certificate of C- cua_n :y or Certification fro:' E'_ Idi.r,_ Ins:a�to- y a'1 tion Mh1Ch 1S COriS.��reC a bc. __ °, rE�U1reS fOrl`aal apprOVal Of plans (Construction Permit), rrep_-Ed t;' a R,34_ssional En;ineer o'= P,agistered Architt=_-t .rl accordance with applic i_ s:. :ions of the Putnam County Sanitary Code. P i eas_ subni t this f o -,- ar l= the f of 1c1 :. -; to PUi Pi=:i CrYJ ?i iY H1,LTH DcP�4TM =Yi , F� D, ..E? riS T.E ., P;.� _105r�9., �r; l� .�__27E- ;,1.30 -'-Vii th •trie•. fol -1 cirri ng° i of r l L . o nation. i. Certified Check fo- $10,.00. %. S' 'ch of eY,istin- f o-,r plan (all living area including basement, i f any) Non- professional dra-rrin2_ is acceptEtla 3. Sketch of proposed floor plan. " '5 e 11 Koh professional G -cNln; is accept =bier / 4. Copy of survey shaving well and septic location, to the bast of your -krtc'rrledge. Include date of installation if kncr.�n. Include all wells and septic syste;:.s within 200 feet of property line. Any questions please contact this office. 5. Copy of Certificate of Occupancy frc:- Tarn or Certification from Building Department of legal bedroom taunt of dwelling. OFFICE USE Comments and /or conditions application August 1995 July 1395 (Revised) BRUCE R. FOLEY . ,... Public °ikziltht Director' DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 April 23, 1998 Richard Denike 799 Peekskill Hollow Road Putnam Valley NY 10579 Re: Addition - Denike, Peekskill Hollow Road Increase in Number of Bedrooms (T) Putnam Valley, TM# 52 -3 -37 Dear Mr. Denike: I have received and review-ed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the latest revision date of April 23, 1998 and this Department's approval stamp. Based on the information submitted, the.above mentioned addition is approved ,vith the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. • • The- ar- e&- -of -the exi3tina" sewage disposal - system, and'--its expansion area, - rnust"be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly your William Hedges Sr. Public Health Sanitarian WH:tn cc: BI (T) DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health . 4 Geneva Road i rewster, `Y 10509 Gentlemen: BRUCE R. FOLEY, P.c Acting Public Health DireziO• Re: 'DE'N ► K t Residence X 99 .zK Tax Map osz-00o -0603 - 037 - ODO— 0000 Town Pu1-�pnl V,ni1 According to records maintained by the Town, the above noted dwelling IS �C IS NOT in comm Ii'ance with Town code and the total number of bedrooms on record 1s" /fit This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER Building Ins ector DEPARTMENT OF IEA-T" U T N IM A C CW 1� "f jjoLiS- PLANS APPITOVE vD, COUNT EDRGGY3 0 Sigratu'-re &Title N /L SI-2 3 IDP PUTNAM COUNTY DEPARTMENT OF IJEAtTfl "OUSE PLANS APPROVED FOR BEDROOM COUNT ONLY; Signature & Title ate p i i 6 ,f it Lrv�N� Rm, �O N a M i 1 1 CL 1 t i i fl, r� D 6 , AT ARE d ^/ 7 %� 0. t rip.. a JS R �7'a0h,1• Q6. le 8�•�0 / $ � Cyr c Jt ' \ ,� r.a' °•t' I` • 7'i9 floe 0 ,� �� ( p "�� if _, •vi Jbi fwd`. 3' /��: �a�. /..140 � 3 75' To ?'d Lr o � 4 pW_G l.l.;l" �<a. :1ltaam l;ounty Department or: Healtt aion of Environmental Health 3ervi / dp roved as noted for aonformanoe with PuMass nes and Regulations of th, �p ,Count Health Department.. 914 t v a ' Well drillers report — mesurementsB— vH/NGIL "5 — - -- — — — — Tdn k, boxes, pits, galleries 89 laterals located by: Contractor,: Engsass s C Health dept: C Field Inspection by: Health dept ❑ dot s:._ 1Q =��? —_ Eng,ineer ❑ date This is to certify that the sewage' disposal system vas constructed as NOTES: - ind "i.cated on,ah41s- plan and that the system was inspected by me before it was covered over. The system ,was constructed in accordance wi.,th all standard rules and regulations,.of. the P.C..H.D. S the N.Y. . cSRra .. A - 8 'b I ME N -_ �lP% OrI SION SM�N SION S v A- C z 28 d b- A D - a— 31 �_ D A - E' u._s '- -4¢_Q- B E ° —r1'� —_ —_ A - 6 a— 6A--(P- -B - G A - d a— --- -.0 - J `-- - - - - -- ti A - K °,,.- r -- - --8 - K °-- --- - -- 5ANITaf3Y SY T SIG "A U .00ATION Street:�ELC� 0 wn: /,yMEounty:�(J��9/?�State: — /�/ - -- UBDIV SION:2 /Ct/Ggi�L7��i/_+��`iG Aop:�T,4�19— -- - - - -- ilockc— -- - - - - -- LOT N$_ /5— - - -- Surveyor: C�, 2. rown: 4, Dote:/Z /Z -gi Scale: Job NY 22f`3 JOHN H. PRENTISS PE. o• CONSULTING ENGINEER I "W RD cl F— ot. SrF CARMEL NY 10612 —t914l STS -6170. 6111 — � t