HomeMy WebLinkAbout3005DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
62.17-3-72
BOX 25
1 rm
f
t
T' .;
��: , �
,Wilem
SHERLITA AMLER, MD,'MS, FAAP
Commissiorcr.p/ (le lth,
LORETTA MOLINARI, RN, MSN
Associate Commissioner. of Health
RO�BERTJ. BONDI
...: ....... .- ._... .... »L•iintVNFCe�riiiaL -... .. :.. ... ++ .-...
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT
Director of
ADDITION APPLICATION RESIDENTIAL ONLY
STREET �TOWNj&/Vl AX MAP #�'�`�►_S1~�'2
NAMEN�IM� —�v VlbiLAj?_y PHONESH5 PCHD#
MAILING f
ADDRESS 0' 'j).Au -59,7 14( fit, I�i� . �Utti" Vct ( V
- DESCRIPTION OF
ADDITION K: v VA ( t,q V K &,A 5- VA4 � AU0 0M ,
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS jM
(FROM CERT.-OF OCCUPANCY OR CER ICATION 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.Dent,,.l Geneva Rd;
Brewster, iv r i0509, Phone: (845- 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)
�3. Two sets of proposed floor plan (drawn to scale —, with name, street and tax map #)
/. *Non - professional sketches are acceptable
Cdr +9� ���� 4. Copy of survey showing well and septic locations 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.
1 Copy of Certificate of Occupancy from Town or Certification from Building
Dept. with legal bedroom count of dwelling.
OFFICE USE
COMMENTS
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648
IN
c
(377 ^T p 7� I • p t7 p� a� qT n f ��++ ..� ,1� p�
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health.
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Town Legal Bedroom Count
Re; nT .F A R V (Owner's Name)
Tax Map #: 62.17 -3 -72
Address: 85 Sunset Hill Road
Town: Putnam Valley
Year Built: 1894
According to records maintained by the Town, the above noted dwelling,
is in compliance with Town Code.
is not in compliance with Town Code.
The Legal Bedroom Count is: 4
This information has been obtained from:
Certificate of Occupancy:
Other: Assessor's Records
ul
I►
Date
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
County Executive
SHERLITA AMLER, MD, MS, FAAP
r,..�, -, .a...�.�t�W'.n =a':cr "fir- zC;,i.?zl�,. = y...::;A..e.::�5•• ...... .
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
COVER SHEET
PROJECT (Owners Name):
STREET: 111:� 5j V.3 -e4 OA� f?p • PHONE #:
ROBERT J. BONDI
MUNICIPALITY:'PQ�VV-�v.'-Ucj1 TAX MAP NUMBER
_ .. _T1F�T(FT�( P..ri.;J'C_5ii� i e f%i:..� i i,1► -�' l� :' ".'. r� Sri:: �'?rC ��vf �G'.. :: �....
REVISION
REQUESTED ADDITIONAL INFORMATION
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085
Forly TntorvPntinn /Prnarhnnl (R45) 278 -6014 Fax (845) 278 -6648
SHERLITA AMLER, MD, MS, FAAP
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
Mr. & Mrs. O'Leary
85 Sunset Hill Road
Putnam Valley, NY 10579
Dear Mr. & Mrs. O'Leary:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. B ®NDI
_ ... Co »mty Executive
ROBERT MORRIS, PE
Director of Environmental Health
August 14, 2008
Re: Addition — A- 112 -08
85 Sunset Hill Road
(T) Putnam Valley, TM # 62.17 -3 -72
I have received and reviewed the addition information recently submitted for the proposed
addition to the above mentioned residence. Based on the information submitted, the above
mentioned addition can be approved pending a revised set of floor plans.
The revised plans need to show and note that no doors are to be installed at all three openings
leading to the proposed den/family room.
Upon receipt of a suhmjsslnn, revised to reflect the above comments, this application will be
considered further.
GDR:kly
Sincerely,
-,:g� vze
Gene D. Reed
Sr. Environmental Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
AUG,13.2008e 8:20AM ---- KELSO&COMPANY
'
NO, 0910 P: 1E a1
(um) 739-1291
-
914 j 737�8
UOER, INC. AND SUPERIOR SEPTIC -
SERVIc';
excaucti"a a sac Hoe Work • TOP Soil • FiZI • $and & Gravel 0 Septic Tonki & Cla#2.,- -c 41 Ir L
10 Catherine Street, Conlandt Manor, NY 10967
JL4
I 20
d?j 6 ezllz
f
_..
57
P I
1 .4.
I IT
SHERLITA AMLER, MD, MS, FAAP
Commissioner (Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
Mr. & Mrs. O'Leary
85 Sunset Hill Road
Putnam Valley, NY 10579
Dear Mr. & Mrs. O'Leary:
ROBERT J. BONDI Y
- County Executive
..w . ..��:..- ..:.:.�s,- e.ias.•i -'w_ ....: - u <.�.w..- ..vr- r- .•w-- *+,..+i.4i." e.....: .wa a...y
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re:
ROBERT MORRIS, PE
Director of Environmental Health
July 22, 2008
Addition – A- 112 -08
85 Sunset Hill Road
(T) Putnam Valley, TM # 62.17 -3 -72.
I have received and reviewed the plans for the proposed addition to the above mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
Per this Department's engineering meeting on July 21, 2008, the following determination has
been made:
1,..The 1Pgal.bP — jom.court forAbnh ,dwelliTic js four. The potential bedr-oo –m ccwn.,t- of.�c�u_r..... -
.:. _
proposed addition is five. _ The room titled new den%family room is considered a potential
bedroom.
2. The addition of a potential bedroom requires this Department's approval of a revised
septic system plan from a professional engineer
Please revise the proposed floor plan to reflect no more than four potential bedrooms, or have a
professional engineer or registered architect design a sub - surface sewage treatment system
meeting present code requirements for five bedrooms.
GDR:kly
Sincerely,
Gene D. Reed
Sr. Environmental Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
SHERLITA AMLER, MD, MS, FAAP
-,4omr 4&nerofHealth- -
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
John S. Tegeder, RA
226 Buckshollow Road
Mahopac, NY 10541
Dear Mr. Tegeder:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
R®BERT J. BONiDI
ROBERT MORRIS, PE
Director of Environmental Health
June 25, 2008
Re: Addition — Application Incomplete
85 Sunset Hill Road
M Putnam Valley, TM # 62.17 -3 -72
Review of plans and other supporting documents submitted at this time relative to the above
regarded project has been completed. The following information is requested in order to
complete a full review:
1. One set of existing floor plans showing the cellar, with all rooms noting their dimensions
and use. Also please provide the cellar ceiling height.
2. Two sets of proposed floor plans. The plans must show all proposed changes as a
finished product. These plans should also reflect all floors in the home including the
basement, with all rooms noting their dimensions and use. Please also include the
proposed cellar ceiling height.
Upon a receipt of a submission, revised to reflect the above comments, this application will be
considered further.
GDR:kly
Sincerely,
Gene D. Reed
Sr. Environmental Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
... ... "a _ .,.... _..:+{y �'... .., - . v. �.�... o.• :.i:.. r ,. + _
john "A. Older, R.A.
Aditeaure e• Planning e• Winton Management
July 1, 2008
Mr. Gene Reed
Sr. Environmental Engineering Aide
Putnam County Department of Health
1 Geneva Road
Brwewster, N.Y. 10509
Subject: O'Leary Addition
85 Sunset hill Road, Putnam Valley
Tax ID# 62.17 -3 -72
Dear Mr. Reed:
Thank you for your recent review and letter regarding the above referenced application. Per your
request I am herewith submitting 1 copy of the existing floor plans showing the full cellar plan with
its Floor to Ceiling height noted, and 2 sets of the proposed addition showing the final condition of
:__ ._...<_......: _ the en e- _ho.ne.; &L'.ai, First Floor.--d Second -Fluor: trash t;ie,i iforrLi grrproviae .�7crili et Ule
you to complete your review. Please note that in order to provide the requested items, it was
necessary to show the proposed conditions on three new, separate sheets, labeled HD2 thru HD4.
I've taken the liberty of renumbering the existing condition sheet HD1. Please advise if you require
any additional information.
Thank you for your assistance in this matter. If you have any questions, please feel free to contact
me.
Sincerely,
JhtnT er, R.A.
Cc: Mr. & Mrs. O'Leary
H: \My Documents \letrolearyhealthD.wpd
t16 0 u ( k s h o I I o w RoadaMahopac•aNew York410541
phone•(g14) 618 .1S76. (ell phone- (914)S7t•gz4t
!`�I� I`•��(1$"� (�I � �,`� ��!�il`����� "�. l •o,! ��1; � B � tl til. d.�, a� I
CONSTRUCTION PERMIT FOR-SEWAGE TREATMENT SYSTEM
PERhU ' # 17 Cv ../ 0
J � .
Located at � o
Town or. Village 6 ,�.
Subdivision name Subd. Lot # Tax Map Block "' Lot.
Date Subdivision Approved j, Renewal Revision
Owner /Applicant Name1f6 A'&jr'7(Uw � W Date of Previous Approval
Mailing Address
Amount of Fee Enclosed
MMP� ay'l
Building Type, e Lot Area
_ Zip
No. of Bedrooms Design Flow GPDt2,V
]Fall Section Only Depth Volume
PECHID NOTEFIOATION IS REQUIRED WHEN IR LL IS COMPLETED
Sepsirate Seweirage System to consist of 4?.,Vo/J gallon septic tank and
Other Requirements:
To be constructed by Address
Wake Sun- y- Public Supply. From , de-ress
OT: jb Private Supply Drilled by W p /W /4,1 Address
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a. "Certificate of Construction Compliance" satisfactory to the Public Health Director will 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 treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
Signed:
P.E. v--'
Address
Date
# 407W 7g2
APPROVED FOi CZW� W This approval expires two .years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new permit. Approved for discharge of domestic sanitary sewage only:.
Title: Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy- Owner; Orange copy - Desig6 Professronal
Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION. OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO ABANDON A WATER WELL
please print or type
PCHD PERMIT # AWA� 'Q t
Well Location:
•
Address: TownNillage Tax Grid #
/
rP /vWlf Ma lock 6 Lots)
,
Well Owner:
Name: I C7W
A�d�drress:
Well Type:
YP
t
Drilled Driven Gravel Other
Depth Data:
Well De p t h' ft
Static Water Level � ft
D ,
Use of Well:
Residential Public Supply Air /Cond/Heat Pump Abandoned
1- primary
Business Farm Test/Observation Other (specify)
2- secondary
Industrial Institutional Standby
Water Well'
Name: Address:
Contractor:
,
Reason For
Abandonment:
Description of Work To Be Performed;
PAO AO-7
Date: ��
Applicant. Signature:
�,
PERMIT
This permit, to abandon one'water well as set forth above, is granted under provisions of Article 10 of the Putnam
County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and/or Part 75 of 10 NYCRR
and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall
submit to the Department a certified statement that the information delineated on the application for this
permit has been completed.
Da f Issue Permit Issuing - Official Title
White copy: HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WA -97
J
4
IIDRK cC®nnnmane lzndlmee n
7.. �ala_A 4�ari,� P: _CntrPrS. NN 105-89-
914 -248 -7726, FAX 914- 248 -7726
TRANSMITTAL
TO: Putnam County Health Department
Geneva Road, Route 312
Brewster, NY 10509
Afro. Therrica Nimes
We are serding: _ attached
0 plans
specifications
❑ shop drawing
reports
COPIES DATE
1
o under separate cover 17 FAX
0 approval of subcontractor
E3 order on contract
C3 samples
Septic Application
NUMBER
DATE: 5/20/20011 JOB NO.
RE: Thomas & Tamara O'Leary
Sunset Hill Road
Putnam Valley, NY
TAX MAP #: 62.17 -3 -71/72
0 photograph
C3 copy of letter
o FORM
® CHECK
DESCRIPTION
INTERNATIONAL MONEY ORDER # 346- 4211 -422 IN THE AMOUNT OF $100.
0 Continued on the attached sheet
THESE ARE TRANSMITTED A:
for approval
0 for irdormation
0 for action
a as requested
REMARKS. THE
14 -164 (2/87) —Text 12
PROJECT I.D. NUMBER 617.21
Appendix C
SHORT ENVIRONMENTAL ASSESSMENT
For UNLISTED ACTIONS Only
PART I— PROJECT INFORMATION fro be completed by Applicant or Project sponsor)
FORM
SEOR
1. APRLICANT /SPONSOR 2. PROJECT NAME,
THOMAS AND TAMARA OTEARY
3. PROJECT LOCATION:
Municipality County Piitnqm
4. PRECISE LOCATION (Streel address and road Intersectl6ris, prominent landmarks, etc., or provide map)
85 SUNSET HILL ROAD
PUTNAM VALLEY, NEW YORK 10579
845 - 526 -8176
5. IS PR OSED ACTION:
ew ❑ Expansion ❑ ModificatioNalteration
6. DESCRIBE PROJECT BRIEFLY:
Development of _-___ ern-d' septic system
7. AMOUNT OF LAND AFFECTED:
Initially 1 , 0 acres Ultimately 1 _ n acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
X Yes El-No 11 No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
X Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space
❑ Other
Doscribe
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE OR LOCAL)?
❑ Yes X No If yes, list agency(s) and permit/approvals
it. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
[j Yes X No If yes, list agency name and permitiapproval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes X • No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant/sponsor name: Donald Knapp
Date:
Signature: _7Do,_ a�2 K':7,�
1z:
If the action is In the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
1
DEPTIi
G.L
0.5'
1.0'
1.5'
2.0'
2.5'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
10.0'
TESST PIT "DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
OWNER: Thomas and Tamara O'Leary
ADDRESS: 85 Sunset Full Road, Putnam Valley, NY 90579
PROPERTY DATA
LOCATED AT: 65 Sunset Full Road TAX MAP: 62.17 -3 -71172 BLOCK: 3
MUNICIPALITY: Putnam Valley Section: 62.17 LOT: 71172
DATE OF DEEP HOLE TEST: 4/6/2001 DRAINAGE BASIN: Husdon River
HOLE NO. A
HOLE NO. B
HOLE NO. C
HOLE BOO. D
14" TOP SOIL
14" TOP SOIL
14" TOP SOIL
8" TOP SOIL
26' silty /sandy loam
26' siky /sandy loam
26, silty/sandy
loam
26" silty/sandy loam
22" Coarse sandy loam
sandy loam
sandy loam
sandy loam
sandy loam
small stones
Root to 3T'
Root to 48 ""
Root to 53"
Root to 6' -2"
Root to 6' -5"
7' -10"
1
7 " -3"
No Ledge
No Ledge
No Ledge_
No Ledge
No Groundwater
No Groundwater
No Groundwater
No mottling
No mottlinp
No mottling
No mottling
VtT
1 u-nGroundwater
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL AT WHICH MOTTLING IS OBSERVED
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: DONALD R. KNAPP, P.E.
DATE: 416101
DESIGN PROFESSIONAL NAME: DONALD R. KNAPP, P.E
ADDRESS: 2 DALE AVENUE
SOARERS, NEW YORK 10589
914 -248 -7726
FAX 914- 248 -7726
Signiture:
License Number. 72770
�S
F t1�Ti�F►liii �►�'�Li+��'oi i�tr"' %s1't[iyl�1��NT' OG= `�`E'�c�T�i �� _ '"
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
OWNER: Thomas and Tamara O'Leary
ADDRESS: 85 Sunset Hill Road, Putnam Valley, NY 10579
PROPERTY DATA
LOCATED AT: 65 Sunset Hill Road TAX MAP: 62.17 -3 -71172 BLOCK: 3
MUNICIPALITY: Putnam Valley Section: 62.17 LOT: 71/72
DRAINAGE BASIN: Husdon River
DATE OF PER - SOAKING: 415101 DATE OF PERCOLATION TEST: 416/2001
HOLE
NO.
RUN TIME
NO. START
STOP
LAPSED
TIME
(MINUTES
DEPTH TO WATER
WATER LEVEL
DROPINCHES
(INCHES)
PERCOLATION
RATE
MIN /INCH
START
(INCHES)
STOP
(INCHES)
A
1 12:00 PM
12:40 PM
40:00:00
10
7.00
3.00
13:20:00
13:00:00
2 12:40 PM
1:22 PM
42:00:00
10
7.00
3.00
14:00:00
3.00
3
1:22 PM
2:03 PM
41:00:00
10
7.00
3.00
13:40:00
3.00
4
2:03 PM
2:49 PM
46:00:00
10
7.00
3.00
15:20:00
.. :►
= ,.iC-
5
2:49 PM
3:35 PM
1 46:00:00
10
7.00
3.00
15:20:00
B
1
12:03 PM
12:42 PM
39:00:00
10
7.00
3.00
13:00:00
2
12:42 PM
1:21 PM
39:00:00
10
7.00
3.00
13:00:00
3
1:23 PM
2:03 PM
40:00:00
10
7.00
3.00
13:20:00
4
2:02 PM
2:45 PM
43:00:00
10
7.00
3.00
14:20:00
._ _:r,
. ,5 w';
n :�
c v-f�ivi
.. .:
';~ c7 Y?tvi ~�4�.uv:Sv
i' =a
- _. r�1u-
= .•� r r�'
•. -0z
.. :►
= ,.iC-
-
C
1
12:04 PM
12:40 PM
36:00:00
10
7.00
3.00
12:00:00
2
12:40 PM
1:19 PM
39:00:00
10
7.00
3.00
13:00:00
3
1:19 PM
2:05 PM
46:00:00
10
7.00
3.00
15:20:00
4
2:05 PM
2:53 PM
48:00:00
10
7.00
3.00
16:00:00
5
1 2:55 PM
1 3:43 PM
148:00:001
10
1 7.00
3.00
16:00:00
D
1
12:10 PM
12:45 PM
35:00:00
10
7.00
3.00
11:40:00
2
12:45 PM
1:24 PM
39:00:00
10
7.00
3.00
13:00:00
3
1:24 PM
2:09 PM
45:00:00
10
7.00
3.00
15:00:00
4
2:09 PM
2:56 PM
47:00:00
10
7.00
3.00
15:40:00
5
2:56 PM
3:43 PM
47:00:00
10
7.00
3.00
15:40:00
NOTES: 1. TEST TO BE REPEATED AT SAME DEPTH UNTIL APPROXIMATELY EQUAL PERCOLATION RATES ARE
OBTAINED AT EACH PERCOLATION TEST HOLE. (I.E. LT 1 MIN FOR 1 -30 MIN/INCH, LT!2'MIN
FOR 31-60 MIN /INCH). ALL DATA TO BE SUBMITTED FOR REVIEW.
2. DEPTH MEASUREMENTS TO BE MADE FROM TOP OF HOLE.
Signiture: License Number: 72770
�7�,�7•�c _�� 1�7��•�y,�1 �A T �! ,�'�-�T!�' A�.?T �1�r� �.n1µT -��T �'r� q �7��(`� �I
7. -.. ,- r,.;;. ... ,..... -_ ;.0 u �Fl�� -�� .!; .`�eb�' �S r� y°.13 -L � ..1.:; ._ _ �'^.1 -- �.s�'_ ��? %'`�.-�y"����. •.C✓ Y• ��� .. •. -. _. .
RE: Property o
Located at
LETTER OF AUTHORIZATION
M
L
TN t ,& Tax Map Block - — Lot
Subdivision of
Subdivision Lot # Filed Map # Date Filed
Gentlemen:
This letter is to authorize Donald R. Knapp
a duly licensed Professional Engineer New York - 072770 apply for the required
wastewater treatment and/or water - supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and to supervise the construction of said wastewater t_r_etm_ent and/or_ water supply systems in - 4
.' A '/ bt tl....] _". ._.. T.. -.. �� h � -• Y'T 7 S •-
"' °'--" - -G lltuliili' '�Ji[1TifiC'piOv'isTOiis -Vi Iii i�I� "14 ailZiiSi 14-�of ire iuucatrcrrLaw, the rafrio He 11111,
Law, and the Putnam County Sanitary Code.
Countersigned:
P.E. # D ��
Mailing Address
2 Dale Avenue, Somers
State New York Zip 10589
Telephone: '(914) 248 -7726
Very truly yours,
Signed:
(Owner of Property)
Mailing Address:
State. Zip / oS
Telephone:
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH .
DIVISION OF ENVIRONMENTAL HEALTH SERVICES �.
RE: Property
Located at
LETTER OF AUTHORIZATION
r
i
TRV' j , f9AMi VA( !, Z,Tax Map # 1 '7 Block Lot
—T
Subdivision of j'400;4
Subdivision Lot # W,4 - Filed Map # Date Filed
Gentlemen:
This letter is to authorize Donald R. Knapp .
a duly licensed Professional Engineer New York - 072770 . apply for the required
wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and lo supervise the construction of said wastewater tretment and/or water supply systems in
_.__ .comformity.wth.the.provi.sions of Article 145 and/or 147. of, the.. Education.. Law,.the..Publiq,H alth
Law; and the' Putnam County- Sanitary Lode.._ .. _......,
Countersigned:
P.E. #
Mailing Address
State New York
Telephone:
2 Dale Avenue, Somers
Zip 10589
(914) 248 -7726
Very truly yours,
Signed:
(Owner of Property)
Mailing Address: �� �y�S�/ /,/,// �f
State Zip / oS
Telephone:
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
�.� . -. ,y.+.. .n say ..... .'� ..a. `.a_ . ...,,.. • ^..: �iy b -.,. .. �- "_:�s,:'" Ka•� � :�.i. i.w ��i� .... .. �'.p' -.�. ��.. _._._: ,..� -�.w ^... ""•�"�'.:i..'..?� �..�.�. R i-� v....°..a r-
Y APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWA'T'ER TREATMENT SYSTEM
1. Flame and address of applicant: _ THOMAS AND TAMARA O'LEARY
85 SUNSET HILL ROAD
PUTNAM VALLEY, NEW YORK 10579
J ' 845 -526 -8176 /
❑ CARMEL ff PUTNAM VALLEY
2. Name of project: V `L y 3. Location T/V: o PATTERSON ❑ CARMELL
DONALD R. KNAPP, P.E. ❑ PHILPSTOWN
4. Design Professional: 5. Address: -2 DALE AVENUE 2
SOMERS, NEW YORK 10589
6. Drainage Basin: � aagre &Z (914) 248.7726
7. Type of Project:
X Private/Residential Food Service Commercial
Apartments Institutional Mobile Home Park
Office Building Realty Subdivision Other (specify)
S. Is this project subject to State Environmental Quality Review (SEAR)?
Type Status (check one) ....................... ............................... Type I Exempt
Type II x Unlisted x
9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... ❑ YES, [-GO, ❑ NA
10. Has DEIS been completed and found acceptable by Lead Agency? ............... '❑ YES, ❑ NO, W44A
11. Name of Lead Agency PUTNAM COUNTY DEPARTMENT OF HEALTH
area �ind'e tlh _i�nritrr -0 ocq-1_rl?_r�3;ig�
-- a..�,
officials, ordinances? ........................... ...............................
❑ YES, 0"NO, ❑ NA.
13. If so, have plans been submitted to such authorities? ❑ YES, ❑ NO, C7'NA
14. Has preliminary approval been granted by such authorities? Date granted: ❑ YES, ❑ No, IR A
15. Type of Sewage Treatment System Discharge ................. surface water groundwater
16. If surface water discharge, what is the stream class designation? .................... ak---
17. Waters index number (surface) ........................................... ............................... ❑ YES, ❑ NO
18. Is project located near a public water supply system? ❑ YES, ❑ NO
19. If yes, name of water supply _
Distance to water supply 1 +, MILES
20. Is project site near a public sewage collection or treatment system? ................ 1�,l,0
21. Name of sewage system Distance to sewage system 1 ¢ MILES
22. Date test holes observed 23. Name of Health Inspector
❑ 400 GAUDAY ❑ 00 GAUDAY b 1200 GAUDAY
24: Project design flow (gallons per day) �1 ❑
,,,,,,,,,,,,,,,,,,,,,,,,,, ❑ 600 GAUDAY ., [�]' 1000 GAUDAY
25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... ,❑ YES, o
26. Has SPDES Application been submitted to local DEC office? ......................... ❑ YES, 191NO, ❑ NA
Form PC -97
DRK CONSULTING ENGINEERS
�: -� 2_,QALE AVENUE,�SQ��ERS.. ^!E`JV YQBK 105$9 F_f14' }2.4R -772Fi
F Q •. P :hY� +'a 'R • e mn e^ w.^. 3-. e/ t s� .� n. i.� .- M •� n1 =-.-r m.4 \�
Thomas and Tamara O'Leary
Property Location 85 Sunset Hill Road, Putnam Valley, NY 10579
Tax Map #: 62.17; Block: 3; Lot: 71/72
May 7, 2001
Revision 0
ENGINEERING REPORT
DESIGN DATA
1. THE TOTAL SEPTIC SYSTEM CAPACITY SHALL BE FOR A 6 BEDROOM SINGLE FAMILY RESIDENCE.
2. THE SOIL PERCOLATION RATE IS 16 - 20 MIN. PER INCH OF DROP IN WATER LEVEL. A PERCOLATION
RATE OF 1" IN 16 MINUTES FOR A 6 BEDROOMS REQUIRES 833 LINEAR FEET OF 24 -INCH WIDE
TRENCH. THE OUTLET BAFFLE SHALL BE BITUMINOUS COATED TO PREVENT DETERIORATION.
3. MINIMUM SEPTIC TANK SIZE REQUIRED IS 2000 GALLONS.
4. MINIMUM PUMP CHAMBER SIZE REQUIRED IS 1000 GALLONS
PUMP CHAMBER SIZING
1. HOLDING CAPACITY OF A 4" PIPE = 0.6528 GALLONS
2. TOTAL VOLUME OF 4" LEACHING FIELD PIPE:
VOLUME = 0.6528 GALLONS X 865 LINEAR FEET OF SEPTIC TRENCH = 423.5 GALLONS.
3: - DosiNu VvLIJi\nc = 4[ i:5- iiKaci � X U. is = 31 1.w GALL' NJ /UUSE
4. ONE DAY STORAGE VOLUME = 6 BEDROOMS X 200 GALLONS BEDROOM =1200 GALLONS.
5. PUMP CHAMBER SIZE: 8.0 X 4.33 = 34.64 CUBIC FEET
6. PUMP CHAMBER VOLUME; (INTERIOR DIMENSIONS): V X 34.64 CF X 7.48 GALLONS / CUBIC FOOT =
259.11 GALLONS / PER FOOT OF ELEVATION.
A. ELEVATION FOR THE REQUIRED DOSAGE OF 318 GALLONS =
318/ 259.11 /PER FOOT OF ELEVATION =1.23 FEET =1' - 2.73 ""
B. ELEVATION FOR THE REQUIRED FOR ONE DAY STORAGE VOLUME =
1200 GALLONS /DAY / 259.11 /PER FOOT OF ELEVATION = 4,63 FEET = 4'- 7.57"
7. PUMP SELECTION:
A. PUMP SHALL BE GOULD PUMP CO. SUBMERSIBLE TYPE WE 0311m,1/3 HP, 115 VOLTS, T.D.H. OF
15 FT. OR AN APPROVED EQUAL.
8. BAFFLED DISTRIBUTION BOX AND JUCNTION BOXES: PROVIDE SPEED LEVELERS, BITUMINOUS
INTERIOR COATING BOX.
9. ALL PIPE SHALL BE PVC SDR. 35 TYPE WITH THE.EXCEPTION OF THE 4" CAST IRON HOUSE LINE TO
THE SEPTIC TANK.
6'
Goulds
:..,7- 7: VhMersible
Effluent
Pumps
.3885
ETL LISTED
�I SUBMERSIBLE
1I1 PUMP
CLASS I'AND II DIV. 2 AND
G1086131480 CLASS III DIV. 1 AND 2
ETLTESTING LABORATORIES, INC.
CORTLAND. NEW YORK 17015
I
TA® Tr =Q
I
dank tertu i 1 i6WS0 .-
GENERAL DESCRIPTION
The Tank alert I is an easy -to- install
.' ._ �_. �+�:?A� -,,, -_ �hyitnrt liftili[•„iPV�I•�,�irt _ ;
system cltsigned specifically for lift
pump chanbers, sump pump basins,
holding wilts, and water and sewage
systems
The Tankklert I alarm system
includes n alarm panel, alarm float
and splic Wi.
APPLIC�'IONS
level rises (high level alarm) or lowers
(low level alarm), the Sensor Float tips
ard. activates. aloud hotp on the alarm
warning light is activated. The horn can
be turned off, but the waming light will
remain on until the condition is reme-
FEATURES
0 Can be used with any UL Listed
switching mechanism rated 1 amp,
24 VAC minimum.
® System operates, when properly
installed, even if pump circuit fails.
M Switching mechanism operates on low
voltage and is isolated from the 120V
power line to reduce the possibility of
shock.
Gl Direct wire option (knock out holes
provided on panel back and bottom)
M Entire unit — alarm panel and float
switch — is UL Listed and CSA
Certified.
R Alarm Panel — This NEMA 1 metal
panel features a red warning light, a
green "power on" light, push -to -test
alarm button, and a horn silence
switch.
® Alarm Float — SJE's Sensor Float
control switch (Model 15SWI).
M Splice Kit — This UL Listed splice kit
provides a safe means to make a
strong, waterproof splice connection if
additional cable length is required.
M Two -year limited warranty
SPECIFICATIONS
Voltage: Secondary 12V 60Hz.
Watts: 5 watt alarm condition
"
died. An added green "power on light Alarm Panel: 6 In. (15.24 cm) x 4 In.
assures you that there is power to the (10.16 cm) x 2.5 in. (6.35 cm) NEMA 1
alarm panel. metal enclosure with 6 ft. line cord and
The Sensr Floate control switch is
lowerecl ito the tank and secured at the
desired atrm level. When the liquid
ORDEEING INFORMATION
When used with a pump application,
the Tank Alert I should be connected
to a circuit breaker other than the pump
circuit. This allows the Tank Alert I to
operate even if the pump circuit
should fail.
Part 1�4c
Voltage
Description
Ship wt.
(Ibs.)
PW217,15
120V Primary/12V Secondary
Tank Alert I Alarm System - Indoor
4
electrical knock outs for direct wire
options.
Alarm Switch Connection Terminal:
1 Amp, 24 VAC.
Alarm Float: S.J. ELECTRO SYSTEMS,
INC., Sensor Float Control Switch
(Model 15SWI).
Housing: 3.38 in. (8.58 cm) diameter x
4.55 in. (11.56 cm) long, high- impact-
resistant, non - corrosive PVC plastic with
internal stabilizing weight. For use in
liquids up to 140 °F (60 °C).
Mercury Tilt Switch: Hermetically
sealed steel capsule features mercury-
to- mercury contacts.
Cable: 15 ft. (4.57 m) long, 16- gauge,
2- conductor, SJOW -A (UL), SJOW
(CSA) water resistant, Neoprene.
DRK Consulting Engineers
— 2ai_e. Avenue. JS.omers -I TS'
.S Y v14 r. .tC...1 ;;,a- .. Io�l.•�'i1glP 4r- :.+ec. ;�q ^O•.O,v, .'cs.�"..wa:..e.nH,q?uv ^•��E;. F.u... :.Y~'.'.�:i.'rCY{.r��t ri :.� ai Ylv. ��.r.P� ^S/Yr L.r^c+•�:•.1't�r�wt�0l. Kra•.. f.I ..� % }I.4aaJ.A+.��i�n .Na.n. � EC
914 - 248 -7726, FAX 914 - 248 -7726
LETTER OF
TRANSMITTAL
TO: Putnam County Health Department
Geneva Road, Route 312
Brewster, NY 10509
We are sending: _ attached
D plans
D specifications
D shop drawing
_ reports
COPIES DATE
under separate cover D FAX
D approval of subcontractor
D order on contract
13 samples
_ Septic Application
NUMBER
DATE: 4/25/20011 JOB NO.
RE: Thomas & Tamara O'Leary
Sunset Hill Road
Putnam Valley, NY
TAX MAP # : 62.17 -3 -71/72
D photograph
D copy of letter
D FORM
DESCRIPTION
i INTERNATIONAL MONEY ORDER # 346-4211-354 IN THE AMOUNT OF $200. (NO WELL IS REQUIRED)
3 SEPTIC PLAN
�_ t.... -
_ _ ... ..._ d9. HiTEs.Tl1RA:. -9�t�
1 WA -97, APPLICATION TO ABANDON WELL
1 CP -97, CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
1 PC -97, APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM
1 LA-97, LETTER OF AUTHORIZATION
1 SHORT ENVIRONMENTAL ASSESSMENT FORM
1 ENGINEERING REPORT
1 PUMP DATA
1 SOIL DATA
t SURVEY
D Continuedon the attached sheet
THESE ARETRANSMITTED AS NOTED BELOW:
_ for ap;roval
D for irdormation
D for action
D as reiuested
D no exceptions taken
D note comments
D for correction
D for review and comment
D resubmit copies for approval
D resubmit copies for distribution
D return corrected print
D
REMARKS: THERE IS AN EXISTING WELL IN USE AT THIS SITE, THEREFORE A WP-97, APPLICATION TO CONSTRUCT A WATER WELL IS NOT NEEDED.
Public Health Director
- ... r�A�C7�; �. "9.F,�T• T?J-��.T� D pj � A -•y �• wtt���� ._.._
�. .. �- .y :rr;,�+%., Y.a:.•:nt•. :�' iDci -1 '1- w^.x._Y >.x:`.r,.: .. _"
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
REQUEST FOR FIELD TESTING
ATTENTION: ❑ ADAM STIEBELING ❑ GENE REED
All information below must be fully completed prior to any scheduling. DATE:' t
ENGINEER OR FIRM: DRK Consulting Engineers PHONE #: (914) - 248 -7726
2 Dale Avenue, Somers, NY 10589
REASON:
DEEPS: Y PERCS: ❑ PUMP TEST: ❑
ROAD/STREET:
TOWN: 07A TAX MAP#:
ZO
SUBDIVISION: t; 1
YES NO
P_renosedSSTSwithin -the drainage h2.S�r f: est,D apc$ or %yds Corner Reservoirs.
Proposed S -STS within 50U feet`°ol a er suvo r, -rese u me artbriii,i take: - =• �= -� -
❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland.
❑ �, Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required.
�� ❑ Proposed SSTS fora Commerical Project.
y It is the responiibility of the design professional to provide the above information prior to soil testing.
This Department will determine the NYCDEP project status (Joint or Delegated) based on the
response. If you answered yes to any of the questions, NYCDEP must witness the soil testing. This
Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design
Professional and W(,CDEP.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates NYCDEP is required to witness the soil testing, at will be the sole responsibility
of the design professional to schedule re- witnessing of the soil testing with NYCDEP.
FOR COUNTY USE ONLY
DATE: TIME:
COMMENTS:
(FIELDTEST)
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
August 27, 2008
Mr. & Mrs. O'Leary
85 Sunset Hill Road
Putnam Valley, NY 10579
Dear Mr. & Mrs. O'Leary:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Addition- A- 112 -08
No Increase in Number of Bedrooms
85 Sunset Hill Road
(T) Putnam Valley, TM # 62.17 -3 -72
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
�, ac1C1�t'ytl_t8 - with
tr�_f41�0�V1n�
• -. #aa
conditions:
1. The total number of bedrooms must remain at four without prior approval by this
Department.
2. The area of the existing sewage disposal system and its expansion area must 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.
4. The approval is for the proposed changes only. This approval does not validate any,
construction shown as existing that has not obtained proper approvals.
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 (845) 278 -6130, ext. 2261.
Sincerely,
1� VQ�
Gene D. Reed
Senior Engineering Aide
GDR:kly
cc: BI, (T) Putnam Valley
Far n
Water Supply Section (845)'225 -5186 Fax (845) 225 -54ig
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC(845)278-6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648