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HomeMy WebLinkAbout3062DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.26 -1 -16 BOX 25 Lc A, 111771 M 19 9 111 01 ''� , , ; 111 r 4 ' ; r ,. , 7 IN '%. � - III , 03062 Rev. 3/8`u PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N.Y. 10512 Engineer Must Provide P.C.H.D. Permit ),S iCATF ,Overj1> MON Cn>yrr.tsNt'F FO?t SEWAGE DISPOSAL SYSTEM Located at Hiawatha Drive Mulling Address 25. Hiawatha Rd Put, Valley 7 1p 10579 Putnam Valley 32 Town or Y llage �4 Tax Map Block Lot Subdivision Name Lk 0 s cv. Lot #101, 10 2 , IO2A Date Permit Issued Separate Sewerage System built b Howard Gragert A aresa Oseawan Lake Rd Putnam Valley Consisting of Gallon Septic Tank and 9 LF of T r i— Ga l l e r i e s Water Supply: Public Supply From Address ore X Private Supply Drilled by Anderson Address Barger u nam a , NY Building Type Modular. HILS Erosion Control Been Completed? Ye 's No Number of Bedrooms 2 Has Garbage Grinder Been Installed? Other Regtdroments 2 ft t ROB Gravel in Septic Area. I certify that the system(s) as liste$.serving the above premises were constructed ease of which are attached), and in accordance with the standards, rules.and regulations, in Putnam County DeI1y4 gntf4Healh1989 Date Certified by 1 Northr Address Any person occupying.premises served by the above system($) shall promptly take such action i'tm $bb�ei conditions resulting from such usage. Approval of the separate sewerage system shall become�ntlo�ncJ��� available and the approval of the private water'suppiy shall become null and void when' a puDlfc °bra subject to modification or change when, in the judgment of the commissioner of Malt , such repo_' Date/ 6 • the completed work ( copies and the permit issued by the X.r•,�,R�• e' wrelhe correction of any unsanitary aibaa pubs'.: sanitary sewer becomes All available. Such approvals are ition or change Is necessary. Title ®��� NYS: FLAP- #110108 COUNTY Of WESTCHESTER t E• 11 Rev. ;88 LAB FIAT' gAND RESEARCH a. OEPARTMENT'Of TO VALHALLA :ANEW YORK 10595; BACTERIAL'EXAMINATION Of DRINKING AND.TREATED. WATERS - ... ,.. .� ,. _, .a,r... .- _ .. � . ?, 4`_-;`= i.: �:�= .»= v��s.:^,.,".�.n>�r�s.r} S ��.�r✓.a�. -t _,. �. ,. �i= +sa #?-� -'-.n� t�--f ..,.- ,- .._.,._�•,....,._ .., Leb,:NO ENT tiDate Colt'd Time Set -Time Submitted ' Tests (Circle)SPC Golllorm MPN CoIllorm,;Membrane .Fecal Other -? t :., p� Co11'tl by - gen�y,CoIr for 1� C011'd from; Name+ dWll (i nil.. Address A -t x. €' il, k4 il •-ISI as 1 .. .ICiry To.n,V,n'pp , . (IW -Coal • ', - IC6w+ryl .. Identification of Source's Sampling Point wlthln;Premisee' , t,4 f e Fit: Refrigerated? Y ' Chlorinated? Yes D No o Free mg /I' Tolal mg /1 pH - RESULTS•OF-EXAM! NAT ION OF.WAT =ER MPN /100 ml. Standard Plate Count .✓�_ •,"1 -13actena,pe► ml. (40 hr) 5 Coldorm Group, t a€ Membrane Method /100 ml N6mIW,0o`sitf4Tubes - n I 'Total Colilorm Y ;t. '*of Coliform Other +, h ' t ' Pa oned b Oau They reaulta lntl(cate •aampl war wart not) olw, p Y f + aati� factory uniury pualiy wr �i1�iaampla wu +h'�"�."£j eolleeled f ..,.. .. 4:x .,:,... 1�.,1i?:Nkvk'.�,'k'.n,. .• Y .. .. .. .xl_..� t' iv: .� .. i ..... ¢I PUI' AM COUNTY DEPARTMERr OF HEALTH _..._...._.�..._ ._ .._DIVISION OE ENVMOVWEWA_L.HFALTH SERVICES.. Sam Juliano 32 2 4 Owner or Purchaser of Building Sam Juliano Building Constructed by ' Hiawatha Road Location - Street Putnam Valley Municipality Frame.MOdular - 2 bedroom Building Type Section Block Lot Lake Oscawana East- No. 1 Subdivision Name 101, 102, 102A 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 nr,pr 2! "i r ,t? G (' `? a,IIG� L�i1. COITlpliallCE'" or the— sq.yea e diap�Sal SVStERI, _G�r 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 F;nvironinental 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. 10 Dec 89 ;Dated this day of .19 General Contractor (Owner).- ,Signature Corporation Name (if Corp.) Address rev. 9/85 mk Corporation Name (if Corp.) A swc4t ess Mmot Vkj(ey ►VY.1 o.rI 9 ,.;_ ��� CO(I. rTnT T AALdT1T TTTAAT nTTI /ITT YYLLL DEPARTMENT OF HEALTH on.-Of Environmental- _Hea_lth..Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET AO RESS: eq Y TAX GRID NUMBER: � d �^ WELL DINNER N ` RESS: 0fl1VATE ?0PUBLIC USE OF WELL 1- primary 2 - secondary 'ORESI V IAL ❑ PUBLIC SUPPLY ❑- AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSI . ❑ FARM ❑ TEST /OBSERVATION • O OTHER (specify) ❑ INDUSTRIAL INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE --°°❑ YIELD SOUGHT. gpm. /N0. PEOPLE SERVED '---'T EST. OF DAILY USAGE ®c� gal. REASON FOR DRILLING EW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA � WELL DEPTH 366 ft. { STATIC WATER LEVEL ` ft. DATE MEASURE I DRILLING EQUIPMENT IOTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING, OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft MATERIALS: 9fSTEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE ^eft JOINTS: ❑ WELDED HREADED ❑ OTHER DIAMETER in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE 66THER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE , YES ON07 L1NEA: ❑YES NO SCREEN RETA ILS - DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (f t) DEVELOPED? FIRST NO HOURS GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTN ft. BOTTOM DEPTH It. WELL YIELD TEST It detailed pumping METHOD: O PUMPED tests Were done is in- OMPRESSED AIR , formation attached? O BAILED O OTHER ; ❑ YES ❑ NO WELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear. ing Well O!a- meter FORMATION DESCRIPTION CODE. ft. I IL WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Land / I WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? ❑ YES . ❑ NO STORAGE TANK: TYPE �- CAPACITY /�"O GAL. PUMP IRIF RMATION s TYPE & CAPACITY � � MAKER DEPTH �-b MODEL A. © VOLTAGE ��HP / WELL DRII.IEvAME AOORES •-� SIGFXTURE c� �'/ /A e75P STREET ICCATION 'A PE II IV. V. VI. FINAL SITE INSPECTION Date . acyag'T Tnsp--'-ed by CWNER L 10 IM im OR SUBDIVISION LCT # WIT # FIZ— 'r I YES NO CCKMENTS a. SDS area located as per amroved plan--, b. Fill section - Date of placement 2:1 barrier- LGTEI W-IMH AVG-DPTH c. Natural soil not st--ivced d. Stone, brush, etc., greater. than 15' from SDS area. e. 100 ft. from water course/wetlands. SE,'.',&.C-E DISPOSAL STEM a. Septic tank size -A'O, r qe 1,250 b. Septic tank. instal led level c. 10' mininun fran foundation d. No 90' bends, cleanout within 10 ft. of 45* bend e. DISTRIBUTION BOX 1. All .outlets at same r elleva t i o n water tested —E 2. Protected below frost 3. Minimum 2 ft. original soil between box and trendies f. JUNCTION BOX,-� pE2ce--ly set* g TREN= 1. Length rewired Len gr-h installed 2. Di'stahca to watercourse measured ft. 3. Insta 1 led according to Dlan 4. Distance center to c--nte-- 5. Slo'r_,_= of trench * ac'cettable 1/16 = 1/32 "/foot'. Iv. I 6. 10 feat frcift otobe--tv line - 20 feet - foundations, 7. Depth of t=ench < 30 inches frcm surface 8. Roam allowed for emnansion, 50% 9. Size of gravel 3/4 - li" diameter 10. Depth of gravel in trench 12 minimum 11.-Pine ends cauozd h- MN2 OR' DOSE SYSTEMS 3. Alarm, visual/audio 4. P= p= illy accessible manhole to grade 5w' First 'box baffled 6. Cycle witness� by * Heall ti De=e—rtmetnt estimated flow per cvcie MUSE a. House located T>--r zCmroved plans. b. Nmter of bedroans J .WML a. Well located as per a =roved plans b. Distance from SDS area m-in—sured U ft. c. Casing 18!' above grade. . d. Surface drainage around well acceptable. .OVM;UUL WORKA-MISHIP a. Boxes protx---ly grouted b. All p rues partially backfilled c. All pi-pes flush with inside of box d. Bar-kfill, material contains stones < 4" in diarmter e. Curtain drain installed according to plan f. Curta.in drain cutf all protected & dir. to exist.watercourse g. Footinq drains discharge away from SDS area h. Surface water vrote—c-t-ion adequate i. �osion ccn-Ero provided on slopes greater than 15%. PUTPTAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Service®. Carmel, N.Y. 10512 Engineer to Provide Permit # J on CFRTMCAT� F COMPLIANCE CONSTRIJ�&HOPI PERA4[IT FOR SEWAGE DISPOSAL SYSTEM Permit N rty/�' P.Ut t _ r -Town or Svufte �. subdivlotonP=J_jak 0sc o East #1 subd. Lotx10 ,102,102f Map 32lBlcli 2 Lot 4 X87 Owner /Applicant Now Sam Juliano Malling Address, 3 Maple D11ive Putnam Valley Renewal_ ❑ Revislon ❑ Date of Previous Approval Town Zip Putnam Valley. NY 10579 Building Type Modular Lot Area 21 s.0 0 0 , F Fill Section Only Li Depth volume Plumber of Bedrooms 2 Design Flow G P D 40 0 Pc» Notification is Required When Fm la completed Separate Sewerage System to consist of 10 0 0 Gallon Septic Tank and 96 LF. of Tr i r =a l 1 p. r i e s To be eoastrueted by Howard, Gragert Address Oscawana Fake Rd, Putnam Valley Water Supply. Public Supply From Address or: x Prlvato s� I Drilled by Anderson uir -Address Barger Street Putnam Valley, l Other Reouireloents2 ft of MB Required, to level area f x.jt i galleries 0 I represent that lam wholly and completely responsible for the design and location of the Yp,�hat the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in Q r� artls, rules an regu a ions o e u nom County Department of Health, and that on completion thereof a "Certificate of Cons rriplia IPry to the Commissloner.of Heelthwill be submitted to the Department, and a written guarantee will be furnished the owner. Silts bto" w no by the builder, that said builder %*III place in good operating condition any part of said sewage disposal system during &h 9. twit 2}�j� ear im�e lately following thedato Of the issu- once of the approval of the Certificate of Construction Compliance of the originaPs or f here a.2) he the drilled well described abovo will be located as shown on the approved plan and that said well will be installed i acc r c w' �S stun ds rutespand ragu aeons of the Putnam Count a rt e t of th. ® (' .;i a' r Date ytf'"ary l2br 1988 S' netl :: P.E. _ R.A. 1 Northrge a e, s License Ne 2786 Address APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued rt % y o&the building has been undertaken and is revocable for cause or may be amended or modified when considered neceWry by the Com $s'o ploy® Any change or alteration of construction requiresss anew permit. pproved for diissppossa�l of domestic � sanitary sewage, a pr' wadjasupp'�Only. C `�� itle�3 PUTYAM COUN'T'Y DEPARTMENT OF. HEALTH _DIVISION OF HEALTH SERVICES DESIGN DATASHEET- SUBSUFACE SSIAGE DISPOSAL SYSTEM _ NO _ -- - - - - - -- -•.: �. =�•_ cr is '+,.;.>v_.Q+wt� .o-. U1'- ,.c- •-- t.�- �..;.� c,{».'� - `..�a.�¢:•�. -_s... i:.t, �...:� ,:- �.•..•_- _,.;:.osv�- .:...( <•..;i: •. A�Owner Sam Juliano Address 34 Maple Drive Putnam Valley9 NY Located at (Street) Hiawatha Road, Sec. 32 Block 2 hot 4 (indicate nearest cross street) Municipality Putnam Valley Watershed Peekskill Date of Pre- Soaking Jan 49 1988 Date of Percolation Test Jan 59 1988 HOU NUMBER a= TIME PERCOL LION PEA MIMION Run Elapse Depth to Water Frcm Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches �1) 1 3 :49 3 =57 8 51050 5650 3000 2.67. 2 309 4-08­9 .. 5.3.0.50. 56.50 100 3100 3 4 :10 4 :19 9 53.50 56050 3a00 3000 4 _. 5 (20 1 4 :12 4 :23 11 60000 6 3 oo 3.00 3.67 4 2 _ :. 1;;��. , .. :: l. .. �.:. , --60o Ov: _. U, _ 3 4. 63) = i 3 :50 401 11 �1108o50 111050 3.60 3,67 2 4:03 4:15 12 108.50 111050 \ \\ 3.00 4000 3 017 4:08 11 108050 __ 3;.00 , 3o67 4 5 - n NOM: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to* be sutmi.ttod for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE: SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS . ENCOUNTERED IN TEST HOLES Pere ep Deep DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. 4 `i1 ° ro Vsoil� Of - - - -- lo _ sandy gravel sandy,gravel sandy9gravel sand.y,grav r a° 4° 51 1 6° 7° 8° 14 °. ` INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED Nono DEEP HOLE OBSERVATIONS MADE BY: Sean Patten (J. S. ROMEO) DATE: Jan 49 1988 DESIGN Soil Rate Used 0-7 Min /1" Drop: S.D. Usable Area Provided 5000 SF + No. of ` &booms , c Soptid -hIlk Capacvt�- 11000 11 gj fA TS?�e ( Masokl�y Absorpti�on 'Area Prox6ded By #/C .1_CI, °F° x (24" viidth trendK 96 LFCQg,,Tri® Gaj 'q:qkgs C C 1 11 a Other Name Jahn S ° Romeo Signature e Address 1 Northridge Road. SEAL V ° o ° a f 4�F f978A6 NEW � e a PeekskillQ NY 10566 ° °°°°aa °° THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq °ft /gal° Checked by Date a 0 V 9° 10° 12° 13° 14 °. ` INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED Nono DEEP HOLE OBSERVATIONS MADE BY: Sean Patten (J. S. ROMEO) DATE: Jan 49 1988 DESIGN Soil Rate Used 0-7 Min /1" Drop: S.D. Usable Area Provided 5000 SF + No. of ` &booms , c Soptid -hIlk Capacvt�- 11000 11 gj fA TS?�e ( Masokl�y Absorpti�on 'Area Prox6ded By #/C .1_CI, °F° x (24" viidth trendK 96 LFCQg,,Tri® Gaj 'q:qkgs C C 1 11 a Other Name Jahn S ° Romeo Signature e Address 1 Northridge Road. SEAL V ° o ° a f 4�F f978A6 NEW � e a PeekskillQ NY 10566 ° °°°°aa °° THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq °ft /gal° Checked by Date a 0 V APPENDIX B PUUINNAM COUNTY DEP_AR'I'+ NT OF HEALTH - DIVISION OF MIROlMI ML HEALTH SERVICES INDD=UAL WATER SUPPLY & SUBSURFA- -CE SaPE-E DISPEL SYSTEMS .:R=dv S'H= - CONSTRUMON _PERMIT._ DATE REV 1 ,v7ED :. ,'e A4 c ,.r/ ,4G 1 BY: (.dame of Cw-ne-) StreetLCC._ticn) C 71'S YES NO DOMOM Pe.mit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization < 4 e54 �-- .- �-•- -- Design Data Sheet (DCS) Sb DIVISICN Deep, Hole Log Consistent Perc Res -alts (3) Fill Pero Hole Depth c:: I 1,H ans -Two sel- LF trend prOv1C d rwai r� _60 ft. 1rL 7 Parallel to contours 100% ex-o. FILL SYS clav' 'er 10 f• . fi notes a spec. entn auges 100 yr. fl elev. 200 ft. reservoir, 150 ft. trigall /gall. -dm Pe-�ni t; r ? ;vs Variance Reauest Leval Subdivision Subdivision Azoroval ae--ke Fx- approval SSDS Adj. Lots Chec'c_5 Wetland (Taw-n/DEC Pe i'- R & D) Data Cn DDS Plans & Psrmi t S1-= e REQU= DFTATT 4 ON PL2LINS Se.Yage Syst-an Plan - ( north arr- ) Sege Svstem Eydraul i c Profile - Gravi ty Flc Fill Profile & Dimensions - Vol,, =e D c ; Trencz /C-=llery; Pump pit de --i is Septic Tank - Size, Detail Weil Detail, Service Line if over Constructicn Notes (grinder rat=_) Two-root Contours~ Existing & Prorosed Driveway & Slopes Cut Fcotin /Gutter,Curtain Drains (discharge OK) Perc &' Deep Holes Lccatei Representative of primary and e- xpansion Expansion Area; shoran; gravity flnw,suff. size I If Pied Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS' S Win 200 ft. of Proposed Syste Property ;!motes & Bounds . House Setback Necessary ( Tight lot) House SeArer - 1/4"/ft. 4 '0; Type pipe No Bp -,Os; Max. Bends 45° w /clea —mmut SEPARATION DISTANCES SPECIFIED CN P=N Fields 10' to P.L., Driveway, Large Trees,Top of f 20' to Foundation Walls 100' to Well; ZN.L -ln D.L.O.D, 150' pits 100' to Stream, Watercourse, Lak(inc. e--<-, 15' to Drains - Curtain, Leader, Footing 351to catch basin, stormrirain,pized watercoL 10' to Water Line (pits -20') 50' intermittent drainage course Ser)tic Tanks 10' fran Foundation; 50' to well 15' Well to PL 9 DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER:- CARMEL, N.Y. 10512 (914) 225 -3641 R'O 0NST9UC7 A. �x,�i PCHD PERMIT # WELL LOCATION giaw&ad ad gu ,unam ya�.� y9 'Y T G i Number WELL OWNER Name Sam Juliano 34 Address Maple Drive Putnam Valley,NY 1OPrivate ❑ Public USE OF WELL 1 - primary 2 - secondary 0 RESIDENTIAL ® BUSINESS ® INDUSTRIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM ❑ TEST /OBSERVATION O INSTITUTIONAL O STAND -BY ❑ ABANDONED ❑ OTHER (specify .® AMOUNT OF USE YIELD SOUGHT 4 400 5 gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR DRILLING :ANEW SUPPLY OPROVIDE ADDITIONAL SUPPLY ❑REPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL ❑TEST /OBSERVATION DETAILED REASON FOR DRILLING For new Home WELL TYPE DRILLED O DRIVEN ®DUG ® GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: La e Lot No. SC 9 WATER WELL •CONTRACTOR: Name Anderson Well Drillers Address: Barger St Putnam Vall IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: �. TOWN /VIL /CITY DISTANCE- TO -PROPERT Y _JFROK_ NEARE, T_.XATw.R- .1Ai r_tljsD- ft - ___ =4 e_..._._ _...._ -= =• •- .., _-oa . .�. __: : I LOCATION SKETCH & SOURCES OF CONTAMINATION Q%&EAR OF THIS APPLICATION Jan 259 None (date) PROVIDED ®ON EPARA E S ET 41 (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above_is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion 'of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. �� Date of Is s u : t 19 �____..- --- - -- Date of Expiration: 19 /�`� Permit Issuing ffic' Permit is Non - Transferrable PUTNAM COUNTY DEPARTMENT OF HEALTH rT'9,7 _ 'laa:� 111 A%l•J'�y ('•..._ � n,T -� _��'•1'ii r Tr C'.. iC'y ..i�L�.i Date January 22, 1988 Re: Property of Sam Juliano Located at Hiawatha Road, (T) Putnam Valley Section 32 Block 2 Lot 4 Subdivision of Lake Oscawan East - # Subdv. Lot # 101,102,102A Filed Map # 94A Date Gentlemen: . John S. Romeo This letter is to authorize a duly licensed professional engineer X or Wxxxxx =x 2_ (Indicate to apply for a Construction Permit fora 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 (r CQTLileC .;�1,.1i1,s _ila TA-i: '�,'il,(� ".i;n cur4r�'is^. t�;-C., Cii.stl'u%tiiil 111c1SC1 - od - r 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. Very truly yours, o Signed caner of Pr rty Countersigned: • P.E.1 )ZXUI # 27846 _� .�cf ° °. Address 1 Northridge Road. I o . r Address of y;`- D - Town Peekskill, N.Y. 10566 ®= 5? 6- 07 8 737 - 1056 o ©�lq 79A ° m Telephone Telephone