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Home My WebLink About2938DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -78.1 BOX 24 I,y'L Or j 6 61 11 too -go 1 'I� I go 11 `' r , l't ti I'V 1 16I ' ` . WJL-J.ItLl AIL 02938 Q,1s'� PUTNAM COUNTY DEPARTMENT OF HEALTH p- Division of Environmental Health Services, Carmel, N.. Y. 10512 Permit a ` LION COMPLIANCE FOR. SEWAGE DISPOSAL SYSTEM ,� �/`i'70 Town or Village % / Formerly Tax Nap Lot # Subd let a Separate Sewerage System built by C' Consisting of `� Gal. Septic Tank and Other requirements ~� 1 Address G -3 cn`'� d `p e, o 7 Lr '� r 4 1.8 4i / c 4/", , 7 4.e-- Water Supply: O � / Public Supply From t y/ Private Supply Drilled By 4enI. Address �� Yr S ►1 !/� Building Type `a ,No.nof- Bedrooms - — � Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constru of which are attached), and in accordance with the standards, rules and'regula Putnam County Department Of Health. Datet C rtified by Address V ` � ` Any person occupying premises served by the above system(s) shall promptly conditions resulting from , such usage. Approval of the separate se "rage available and the approval of the private water supply shall become 11 antl subject to modificat on or change when, in the judgment of the "momisssi Date By -- on the plans of the completed work ( copies the filed plan, and the permit issued by the P.E. R.A. _ License No. be n' y to secure the correction of any unsanitary ar` as soon as a public sanitary sewer becomes ly becomes available.' Such approvals are n, m Ification or change is nseeasa Title Rev. 9 -81 ... PUTNAM COUNTY DEPARTMENT OF HEALTH Permit # S' / Liivisior: _or. Environments! Hea!th._Services, ,Carmel N.- v .10512. _ _.. ..... CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM /( / /��1 Town or village 3 / // Tax Map Block 3 G / Lot Located at ` J Subdivision Subd. Lot.# owner /Address �'� t� °_'�fe Building Type Lot Area Number of Bedrooms Design Flow G /P /D Separate Sewerage System to consist of±i P Gal. Septic Tank To be constructed by ` ;) W. ,V�— Water Supply: Other Requirements Public Supply From Private Supply to be�rr�lr�Alledt by Renewal _[3 Revision _0: Date Of Previous Approval Fill section only P.C. H. D. Notification Required- and Z Jg, /� 7 r Grp G / ��• . Address t V ` �. A I/ _ 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 an —regulations 07 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 a cans of the Putnam County Depart nt of Health. �� - , P.E. y R.A. Date S Signed Address 2. y - �o C-,r -e �' E' License No, - APPROVED FOR CONSTRUCTION- This approval expires one year from the date issu9d unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when sidered necessary by Mprivat sioner of Health. Any change or alteration of construction requires a. new ' 2ermit. A (pR.r -ovad for disposal of dome c n: y s age, a water supply only. l Y / r� � = O ^` ._ _. - Title wv TMENT Q? ��FA�Tkj r;T;C?Pi FICPQQT POTNANI COUNTY DEPAI 3 Division of C-nvlrpnrmntal Ho*Ith G4rvI04& COUNTY OFFICE 13MVINQ • CARMEL, NEW YQRK 'U� f0pol 01 tq ba Fnm a b W! -r.viW--I4L 0ito -y 0�a I-!! �p " 1,c i %4 viol V p .!v0q of t,qpr sa!nplo indicaing water Is of sotisfa6tory bacterial quality before certificate of construction pomplipnq is Ig REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF INELL COMPLETION P%VNQ L] AODRESS 1 COCATI01 i vlot 4 8 4,TOO' PIL4 f APOSE VS2 0? r/44, ro UN PO4;-!Tlq FOCLIC SUPPLY Q fu4ppsnm4ta INPUST*AIAL ❑ fARA AIR CONDITION.INQ EIW€4T WC-4 OTHER DWW"a FOV011115K RQTABY COMPRESSED AIR PERCLISSIOti El CABLE PEPuSsION OTHER ❑ (SPOCIfy) PvrAM 1.14119T 0g) JPIANICTERflnchoq) lir PER f00T R�ADED Ej wupm QL1_VE SKQE 0'ygs 0 iYAIS r.A51N.q 1z lee YT9Wj, N 9 TEST EISAJJ.1�0 El put ; 0 COMPRESSED Al a 6'�4'Mg FR0.14 k0p 001AGP—SWIC Y14LD TEST float) so/ i Popth of Complated Wall In feet below Land surf 51 qpo To �1qvlro (1101) VETAK4 awl &Izv —Pr 1.4 1.7 0 V P f A C E FEET to FUT IF GRAVEL, PACKEDs FORMATION DESCRIPTION P1.0m Me, of well including grovol pack (inches, Sketch exact location of o-4111 with dietanoos, Jo el 1q;g? two parm4nq0t landmarks. bve 10 41' 65U e g C; if IfIcId wo:. 1t,Avd of eiffarans depth} during drilling, list balow r-tEr T GALLONS PER MINUTE 0 yy p d nano® labs, Inc. UNITY STR EET AT ROUTE 376, P.O. BOX 10 p \\\ /// "` B 13689 I HOPE:WELL JUNCTION, NEW YORK 12533 sAWLE 0 M 14, 221..2485 _ NAME: _ eft• SrcVE1J '13Ru rJO • . CCam/ ADDRESS: RT- 6A PLAZA LA GCA IO1✓r-v I LLE Nki 1 as 4o SAMPLING POINT" M (L.L Ro A-D ` Q' i ns V LUF � V 105-19 TREATMENT: CHLORINATED❑( PPM); SOFTENED ❑; OTHER ❑ SOURCE: DRINKING WATER@NASTEWATER EFFLUENT ❑ OTHER COLLECTED BY: SrrC.F TIME 9"30 A.M. DATE 5 2-1-9(, ❑ APARTMENT COMPLEX RIVATE RESIDENCE ❑ SCHOOL ❑ SEWAGE TREATMENT PLANT ❑ BEACH ❑ RESTAURANT ❑SWIM POOL ❑OTHER TOTAL COLIFORM COUNT M.F.t PER 100 M.L. ❑ TOTAL COLIFORM COUNT M.P.N. PER 100 M.L. FECAL COLIFORM COUNT M.F.T. PER 100 M.L. O FECAL COLIFORM COUNT M.P.N. PER 100 M.L. ❑ FROZEN DESSERT PLATE COUNT ❑ AGAR PLATE COUNT PER 1 M.L. Z" LA TORY TEUHNICIAN DATE REPORTED L - -PoFCABORATORY DIRECTOR 4e--) LAB X10 a ,^a MLA 7F'�,�,?u°F.,,.k.,s„, n ML �i. i� asp^ `^ i 0, ", . LACT. 24 LACT. 48 B.G.B. .24 . B.G.B. 48 E.C. 24 E.C. 24 4e--) LAB PUTNAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRCNOWAL HEALTH SERVICES ��. 5-lmetj e Rove Owner or Purchaser of Building PEtJN L7-10N kMEe, OXiaULAK) Building Constructed by deliLU RokD Location - Street . -'o TNPh�t i kwf,\f Municipality SPLIT -LEVEL, Building Type I 3 Section Block Lot Subdivision Name Subdivision Lot # GUARANTEE OF SUBSURFACE SEWNGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, kVorkmanship, material, construction and drainage of the sewage disposal. - system erving the above described property, and that it has been constructed as:'.sfiawn on the approved plan or approved amendment thereto, and in accordance with:th,e 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-ears immediately following the date of approval of the ��Cerj- ' 4' ^ c` Cons_ truction Compliance" for the sea-age dispnsa]. system; . or any � �.at.e �:.;. repairs made b "me to "such s ste�i, exce t where -the "failure to o erat' pa y y p p 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 Environinental 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 �_ day of 9,4" Y 196% ba,,, I l General Contractor (Owner) - Signature ( Oc.� 1�X Corporation Name (if Corp.) Address rev. 9/85 mk Signature y Title Corporation Name (if Corp.) Address PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 2� Re: Property of _Ld'il�Y�i� >,iG/� e-9 Located at (T) c Section - Block Lot, Subdivision of Subdv. Lot # Filed Map # "" Date Gentlemen: This' letter is to authorize a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve! the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said 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. Countersigned.: , P.E. , R.A. Address Telephone Very truly yours, Signed Owner of Property -' Address dd dr e s s Town Telephone _ -.. .. ' BRUCE R FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Steven Bruno 10 Saw Mill Rd. Putnam Valley, NY Dear Mr. Bruno: July 2, 2002 Re: Addition- Bruno- 10 Saw Mill Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 62.15 -1 -78.1 I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp form this Department dated July 2, 2002. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at Three without prior approval by this department. ...- ......_.. 2... .-Thvarea of the- xisting- aewage dis pv8ai-syS�Ciii, quid iis- irxpausion firea, must 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 yours, William Hedges WH:kg Senior Public Health Sanitarian cc: BI BRUCE R.. FOLEY -- Public- Health •.Di�ee�or c.: = • • - r ,_. DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Associate Directo Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 78 - Early Intervention (845) 278 - 6014 Preschool (845) 26082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLYi AtU kCN., M S. N. Public Health Director of Patient,. _Services.. -- STREET 10 5AW MILL. 90AD TOWN fV7?JA A 0141'hX MAP# 6 9 15 -1- 7 8_1 NAB 90 SLO N D PHONI P,N Z - 131g PCHD #�.3 - (� MAILING ADDRESS 60 5kW �L 1 LL &D Pv NAk 1(A-uf y fJ*-4 105:h DESCRIPTION OF ADDITION_Wiro A11 si1-f 0 bM 144T ^ 1 >4 + I 1,,y '8000A NTMIYMER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS_ (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) . prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10.509, Phone 278 -6130. 1. Certified check or money order for $100.00.. 2. Sketches of existing: floor plan (drawn to scale, all living area including basement) *Non - professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) *Non - professional sketches are acceptable. . 4. Co0y of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments ,4 :.-1 BRUCE R. FOLEY `- Public •Neoirlr Dato; .„ � 0." Assoetate Publfc Health Director Director of Patient Services DEPARTMENT. OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 June 26, 2002 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: 10 Saw Mill Road Residence Tax Map .62,15-1-78.1 Town of Putnam Valley Gentlemen: According to records maintained by the Town, the above noted dwelling IS xx -- . in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: xx ASSESSORS RECORD: XX Mr, i BFhouseguidelines Deputy Zoning `Inspector BY PENN LYON HOMES INC. FIT St . LA, 44 A A -1 A .11A SPLIT ATIE111"FT 44 A A -1 A .11A 146 1- 0 VowVA I -T-C? 411e'�51 or x co ul Lo () Lf) Z cl X?4 COM F -T-C? 411e'�51 or x co ul Lo () Lf) Z cl IN E Ln F -T-C? 411e'�51 or PUTNAM COUNTY DEPARTMENT OF HEALTH , DIVISION OF ENVIRONMENTAL HEALTH SERVICES OFFICE 130ILDING;..__CARMEL; N.' Y.. 10 DESIGN'DDATTA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. ` Owner Address_i�/ Located at �� (Street� / Sec. - J Block s �. Lot_ indicate nearest cross street) Municipality SOIL PERCOLATION TEST DATA REE Watershed TIRED TO BE SUBMITTED WITH APPLICATIONS 5 1. 2 3 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. 'Hole-, Number CLOCK TIME PERCOLATION PERCOLATION _...._ . No. Start -Stop apse Time Min. Depth to Water 'Water ve From Ground Surface in Inches Start Stop Drop in.. Inches Inches Inches Soil Rate. Min. /in drop /' 1300 3452 22> 7 23 2- 3 z . _30 4 5 1. 2 3 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQ?JIRED'.TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS EENCOUNTERED IN TEST HOLES DEPTH HOLE NO. / ._ HOLE NO. _ HOLE NO. G.L. 6" 12" 18" 24" 3011 36" 42" 48" 5411 60" 66" 72" 7811 8411 4( .. ` INDICATE LEVE ThTJCA'rE- .:LEI,E TESTS MADE M DESIGN Soil Rate Used_MirVl "Drop: S. D. Usable Area Provided e�C� No. of Bedrooms Septic Tank Capac y G✓c9c/ Gals. Type Absorption Area Pr— ovided By L.F. width trench. 7-C7-- Other @!S� { OF A� c 1 ;K c f_9 a P4"1 , l �'Yl<n -F.R �a5 „m®moe Pn Address m THIS S' CE FOR USE BY HEALTH DE RTP99NT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by h, Date PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES , INDIVIDUAL VTP= SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT _ �jtt _ t _ _ `,`yam. .. 1z�.! �R -- 154 l .lb /°�) LL INSP. BY: '(Name of Owner) (Street Location) INITIAL, SITE INSPECTION YES NO CANTS Wetlands on /or proximate to property ..:........... Property lines or corners found ................... Can estimate house location ....................... Willdriveway 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. 1 Lot Depth to G.W. Depth to rock Soil DescriAtic 0 ft. 3 ft. 6 ft. 9 ft. D.H. - Deep Hole G.W.- Groundwater D.H. 2 -Lot D.H. 3 Lot Depth to G. W. Depth to G. W. Depth to rock Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. .12 ft.1 12 ft, Soli Descrl 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. Soli uescrl DATE: �., FINAL SITE INSPECTION INSP. BY: YES NO ,• }. COMMENTS.— House SSDS located per approved lan... .. .... Length of trench measured : L , E- • Width of trench average Slope of tile line and trench acceptable......... ✓' - "'Z v_ Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped 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. from nearest trench ................ 15 ft. of peripheral soil horizontally fron trenc h .................6......... ........ Boxes properly set .... ...... ......... ......... Could surface runoff fron driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE.. % -- A -IF Cat -1-7��,� Pit - 1�(V.-b 37 `;zg �78 ?8 ,� U