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HomeMy WebLinkAbout3117DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 63. -4 -5 BOX 25 11 his 61 J .� ' V T 1 9 Lr L L■ 1 1 , � -■ - ■ Mir M701 i L 1' 1 03117 i ;` . p�il�piffi CODFITS DBlA ,OF RMTH OMia t R r g � SAYE 0 AN AFPftovm -FOR C ievocablo for cavooA Rev. 10/88 °8t® niftWnW'of Malthwill that ,pkl'OUIMM will M tMat.;e1 tita 1M. 1 wait is a ftod above 76-Of• tAo Putnam P.E. _ N.A. fs been' undertaken and is aiieration of construction DEPARTMENT OF HEALTH Division of Environmental Health Services } aa. 4 Geneva Road, Brewster, New York 10509 (914).278 -6130 AP- PLI,CATION-.z.T-Q:CQRa,TRIJ.CT ,1• .A:_W_kTER._.WFL-L_._�__.: :. �...�yyr 4 .iVf V +m. ec...s., .. ...- : ..eT �-`; �,. T ,.�. ..ysfw�:'r.�:��'.F^.v.c. a.�ve.ew.••Q,•.rA.vlw+et9V - - :f1�a4M•.v. -.- . ar ...��1R.a.n�cvoeaa. wna\i +e.ce.... Arun DL'DMTM A WELL LOCATION Street Address dew ��G�� Town illage C ty Tax Grid Number �w.� WELL OWNER Name rJ L► �� M*a i i" /�/J'� Address rivate �dO� S'�o ��/1'/ Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY C3 AIR/CdND/1fEAT PUMP 0 ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify D INSTITUTIONAL O STAND -BY 0 AMOUNT OF USE YIELD SOUGHT ;' gpm /# ❑ REPLACE EXISTING SUPPLY WNEW SUPPLY NEW DWELLING) PEOPLE SERVED /EST.. OF DAILY USAGE �dG' Sal O TEST /OBSERVATION Q ADDITIONAL SUPPLY CI DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:- -- Lot No. WATER WELL CONTRACTOR: Name /(�.����h Address:,�s.•l'7��iYJ ® / /sG<,/ T- IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES J/ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH 6 SOURCES OF CONTAMINATION PROVIDED Va. J 4�? VON SEPARATE SHEET i (date') (sig A tu ) 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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or of ise contaminate surface or groundwater. Date of Issue: Z� 19 `� o/�ili✓ /G Date of Expiration 3 2-4- 19 9 f+ Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PC-Y' y •.� �y g� p �07��{�07���ry �0 7�y gs q T �O �• M t �' � � 1L 1R'1 CS►� � ® �J 1� A i iN � �C'� � J1. 1� 8 �L'..o A�1 Jl ®lC A8 L CS 8J i i2L g �, ,.... e �.�..�.. _ . - -R_ SPO ...: ; AP_P_kTCATION _.FOR..APPROVAt ..OF PLAN �T� b �A�__SYSTEM.. , 1. Name and Address of Applicant: del ia'�Gh�Y ,rJ� gyp/' ±/ 5 2. name of Project: 3. Location T /V /C: P&�r���/� 4. ,Project Engineer: ��o � KRW S. Address•.��'� ;icense Number: �'�g Phone: S. f Pro ect• Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park f. Office Building Realty Subdivision, Other (specify) 7. 11 this project subject to State Environmental Quality Review (SEOR)? h/O 4.0 Status (Check One) Type I.. Exempt Type IIo. Unlisted S. I: a Draft Environmental Impact Statement (DEIS) required.. ............. a DEIS been completed and found acceptable by Lead Agency? ........ 10. Mme of Lead Agency ;�: 11. I4 ".this project in an area under the control of local planning, zoning, other offi.ials, ordinanc @s - - ri.:,: �_ .............................. ... 12. so, have plans been submitted to such authorities? .................. 13. His preliminary approval been granted by such authorities? Date Granted: I . 14. Type of Sewage Disposal System Discharge...... Surface Water Ground Waters .t, is. ;�� surface water discharge, what is the stream class designation ?........ 1e. Wters index number (surface) ............ o-oo ........................... 17. h :project located near a public water supply system? .................. Ale 1S. I,,'yes, name of water supplyE' Distance to water supply 19. I=.project site near a public sewage collection or disposal system ?..... 20. Nape of sewage system Distance to sewage system 21. ate observed: 23. Name of Health Inspector: 24. P,;e ject design flow (gallons per day)...... ......o ........................ r 25 2. s State Pollutant Discharge Elimination System (SPDES) Permit required ?.._A. a u� . ./�� T _ _ __ .. -.� ^-•-a n.�- -• - .._ ._._ .. -- «„ : 7 �w —�.• Vii v.i'• vY� 1. 1 �i 1r�N 'Y �.V �IVVi21•� • • • • • • • . . . . cvr e .•. t.� '._ . ...... •. .. i }' -ter 27Is any portion of this project located within a designated Town or State Ye!� r 28.1��Mletland ID Number ........................ ............................... A 29.. s Wetland Permit required? ............... ............................... ,f as application been made to Town or Locaa DEC Office? .................. �S 30;',',es project require a DEC Stream Disturbance Permit? ................... d s or was project site used for agricultural activity involving application '1of pesticides to orchards or other crops, solid or hazardous waste disposal, ,alandfilling, sludge application or industrial activity? ........ YES or NO AXE 32.'x, s project located within 1,000 feet of existence of abandoned landfill, �t 3'hazardous waste site, salt stockpile, landfill, sludge disposal site or zany other potential known source of contamination? ..............YES or NO ESCRI8E: 33. 4s there a local master plan or file with the Town or Village? e_s' W3. community water, sewer facilities planned to be developed within 15 years? 35: 37. any sewage disposal areas in excess of 15% slope? ......................... )roved Plans are to be returned to: ................ Applicant A"." Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this proiMsion may be grounds for the rejection of any submission. SI I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as--a Class A Misdemeanor pursuant to Section 210.45 of the Penal Law. & OFFICIAL TITLES:_ MALNO ADDRESS: Re, of 1)�,-' / G'7— Located at (T) w ,o !iL Section 36 Block Lot % �- Subdivision of Subdvo Lot # Filed Map # Date Gentlemen : This letter- is to authorize V a duly licensed professional engineer kl or registered architect (Indicate to apply for a Construction Permit for a separate sewage system., to s� a the above noted property in accordance with the standards, rules or,:re.gulations 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 tra cons ,L_ z. tioii .qa 45 d : .sy.st.em or systems in conformity with the provisions of Article 145 or 14;7, Education Law, the Public Health Law, and the Putnam County Sani- t;ff7a�gr Very truly yo s, G C.o.uant•ers i gne d : P.E. , U Signed_ Owner of Property 1 0 7- �-e Address /yY /V� /04ZZ Town `-)-( �- Y )- l - s Y1� 3 Telephone Z b'gephone PLASM COUNTY DEPAFM4EM OF HEALTH ~..\ DIVISION OF ENVIRCNMENTAL, HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. ...w= ►va.�= .s...n.:: v,...c�- �r•.w =` w....:Gjrq'^+.':i •irc� +•s•noi� - +- gas �vr� ?T:a -;'- er-=.-... c+ v.+ e�sys:.. �c= a.c'�•,- s,�err•rw�•..:mr4wir: ..wv. -.s .•car +•w.ru•a.v.� %'.,!i•.i:.ar Owner i i�ara� &V lies �.�. Address O G r /✓ GV Located at (Street) Sec. Block Lot . (indicate nearest cross street) Munich Date of Pre- Soaking // 1� Date of Percolation Test HOLE NUMBER CLAM TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches /e 3a 21b // — 3a >2.. :2 4 5 s 77 A-0 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at each percolation test .hole. All data to-be suhdttbd for review. 2. Depth measurements to be made from top of hole. rev. 9/85 G.L. 1' 2' 3° 4° 50 6° 7' 8' 9° 10° 11' 12' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCMUMED IN TEST HOLES "k - •st•.'d .d a :rceia<,:wa:_''`__ . ___ry_._ :. - r ,- r.- �.. *- :+- �nms•.u•. :.i::. �, -o°. �. rr_. ss.. � .:- iwo +:vwu.`.'.y;^::neic..:.. °:�%: ' ,'. ..;:e `ixv,.,� ewe � �'F�,:r� = e =^ - ns1r�•y n: c� 13° _... _ 7Z. ..._...- INDICATE LEVEL AT WHICH GROUNUKATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: G ��l� /� �W�% DATE: DESIGN - Soil Rate Used Min /1" Drop: S.D. Usable Area Provided �OoG No. of Bedrooms Septic Tank Capacity gals. Type Absorption Area Provided By c5 d e9 L.F. x 24" width trench Other Name Address )J,,�I,,4 /,///i FOR USE BY HEALTH Soil Rate Approved Signature t� ,Pi; SE i o ONLY: sgoft /gal. Checked by Date a raj JOSEPH F. SULLIVAN, P.E. eonsu.CEiny �n9�t . t.. .a'.....- r.�•.. -. �:c4 .,;:,,r= -"+ '. - :_,. ... � ...- . _�. _. ��... _. .._ ._. - o-y;�. - �s�•oT7 cGP. PEE F_5T DRIVE:- .� a• s _.._ , :-,. .'+r. o._. .�.> . ; -. v ... ....:c:-- .�_..r .. -- owa ..- .�i;.a c. n_ey , e .. ....w._,.. - ... . � •.`v : �os %..�.-..tv..a. u YORKTOWN HEIGHTS, N. Y. 10598 (914) 962 -4248 July 7, 1992 Putnam County Department of Health Route 312 Geneva Road Brewster, N.Y. 10509. Re: Refile of SSDS Emanuel Metz Wood Street Putnam Valley N.Y. 120 -3 -7 (6.9. f Gentlemen, Enclosed please find application forms for the proposed sewage disposal system proposed for Mr. Metz' -.s lot on Wood Street in the town of Putnam Valley, approved by your department in 1990. From a field inspection of this lot there appear to be no changes in the'surrounding properties to adversely affect this design. Very truly yours Joseph F. Sullivan P.E. .. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .��•••J -4- • ..� � Y.T.V "��t ..-- +C.ii- `•�+�'. .b"_..:'�%alYFi_ -_, '.T �. -.'V`= ?�-�^' ^✓:a-�SJOt �KSn vt�..u�r. \ .-- �^- �-? Vn: iRS .v- .F ^4"KG�:IK�.YQ9G»>^CO(Y.Ii G- :��i..rw1�•S�~:'CT.I'+ -rte{ } �r• . . ' This letter is to authorize a duly licensed professional engineer P.-I" or registered architect (Indicate to apply for a Construction Permit fora separate sewage system, to ,.serve the.above noted property in accordance with the standards, rules qX, regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in c:onnectiom with this matter' axnf-to supervise the construction of said � � ~tom' = a • y °,�tm�a ° =ita a;un a� eaicy- wa'i x � ®��irov sioaas Rof Article 1 5 or :1.4;7, Education Law, the Public. health Law, and the Putnam County Sani- A, Very truly yo s C:®Wxtersigned c of yys P G E C , p, re, Signed. Owner of Property 15-0. F— Address ' Town 112- y) - /-- I YY Telephone 1* DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 :,:W_ .e+..r.+- ax:+CC ^ac APPLICATION TO CONSTRUCT A WATER WELL // g PCHD PERMIT tf 7 WELL LOCATION Street Addres e� e_e_ L Town/Village/City Tax Grid Number 7 145, WELL OWNER Name Ma .1. g Address Pr vite 'V' V , e✓ 0 0 Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL O BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT UMP D ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# ❑ REPLACE EXISTING SUPPLY ; NEW SUPPLY NEW DWELLING PEOPLE SERVED /EST. OF DAILY USAGE k7o gal (3 TEST/ OBSERVATION GI ADDITIONAL SUPPLY O DEEPEN EXISTING LL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN DDUG GRAVEL OTHER IS WELL SITE SUBJECT'TO FLOODING? YES p-' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION. -- Lot No. — WATER WELL CONTRACTOR: Name 1V - 000 d Py___56 7 Address: Ier-"!%L )-O'z2e IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓ NO NAME OF PUBLIC WATER SUPPLY: �" TOWN /VIL /CITY -DISTAN r - TO PROFEk —L - -ROM ri ST -WATER'--MAIN': LOCATION SKETCH 6 SOURCES OF CONTAMINATION PROVIDED SON SEPARATE SHEET d ta) O` (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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drill_Ang operations be contained on this property and in such a manner as not to degrade or of rw contaminate surface or groundwater. Date of Issue: 19 -12 �. 1&4f1:2 Date of Expiration 19 67 L/ Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller �^_'_'__ "' `TG..T,...,i4"'"';sT' 5i'— �''�3+r.Y- j .i.�'a�,'"}^'at�.�'R¢ v:j•P:ShTM1 C •�:y°86T4'"°"'��^_'1,T•Y_'"'"T_ T3_ -°n''Y 'r" —.�° '— �'y'^�•' r t � J l� o r r 5�•' , i �� tk`acr-.��-'�Y`� 1 r Si -4 9 F 1 Z 1 (� PUTNAIVI COUNTY DEPAHTAfNT OF' EWALTH r to Prodlde Permlt IV DIvleltin Fmvhonmental Healm Seevkea Caemel. N. Y 105Y1 CERI7FICA OF COMPLL+IN- � • , .'. '` Permlt CONSTRUCTION FOR SEWAGE DISPOSAL SYSTEM • `t a..�iL2�' ,. r.K -:'� "a. � tf -� ? . a.^ � ,r..n c- c:.� � �!3FRi° �Pc.,iz� .�m c-.i ti - -�'1' -•t .r - u-•m � SnbdlvletoID Name a... �abd -'•Lot q � Tau A9ap '� � -'Block �' Lot, �� .� c Renewal ❑ Revlaton ❑ Owner /Appllciat Name �'iL$9'%.Ll Date of °Prevlon Approval Mme Aaaa Y: -Town � t .t Zlp, Bnlld6l�� �v /� �/� LOt Atee ` �iJ Flll,$eCt10n.0O1 - g }' De m' VOlame 1 r. p I�dttmbee of Bedirooma _ 'Dealgn Flow G P D ® PCHD`Notl6tstltinla Regdied Whe' '•FIR le completed Septic Teak <imA SoPam'" Sewerage Syetom to conolet o[ Gallon' . • To be acted by .. Address ` , WIItbL SuPPh ' Supply Ftom � - Asldreei; oes Rivals Suply •Dewed bydd[eaa • ' Othe%Reotiirementa � � / � G,� �+� ��� ��� �6° �iAi ��� � � � �' ® . I vepresent tftat I am wholly and,'complately responslDla for,fhe design °end loeaf on of tna oposed systems) 1); -that the , separate sewage idisposal: system above deser�beA will be constructed as fhowneon 'the,'approveelYamendment there o }and;in$aceordanee witA the standards rules an regu a wns o i e u nsm County Cepartment x - H"lth, sand that on completion the +eofta Cort�ficate of Constructioo;COmplianee satisfactory to the COmmissioner,Of Heplthwill be submittetl ;to`tha Department -an a; written guarantee will De furnished the owner hts`sue i+i or assgns by the DuJder that fatid builder Will pbc @` m a w i 1 gootl';oparat�ng condition any, pert of said sewage disposal syriem;durinq the per "' . ftIL�P. rs;immediateiy following the date of the issu once; °of the ° "aDProval'of the CerGUUte of Construction 'Compliance of the ortgInal Sys t 'to 2) that the dr`Illed welfdetcribed,,above l z will.De located as shown'on ins approved plan and that aid well wtll bezinstalleq; mraccord 911 and `rules aril regu anions of,* the Putnam � Mi County De a %finent of.:HSalth 1; Date', '� P E R A tip W w C - Address License No APPROVED FOR CONSTRUCTION �s approval;expir64%Wo years :rem thevdate is 4 s } ~ he building has been undertaken. and is revocable for cause or'niayiDe ansn ed o►. 'modified when considered necessary. by t Co ' ioi6%�6titi' h�! - ny charge or, alteration of conatrllction requires ew pe►mdr proved for dispofal & domestic sanity yFsewatfe and /or ;prwate �. O v + Rer. _ JF 1/81. Oats • y6Y • IS WELL SITE SUBJECT'TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN'A REALTY SUBDIVISION, NAME OF SUBDIVISION: —* Lot No: WATER WELL CONTRACTOR: Name Aoiogrrrz -alorf 0,9 Address: .60rg0/ IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓ NO NAME OF PUBLIC WATER SUPPLY: "' TOWN /VIL /CITY LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED�, ON SEPARATE SHEET ` R '�f /.� (date) (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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: ^� 19 / G Date of Expiration 19� Permit Issuing Official - Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller '- r-- -"• —.; Y ti. V ?r: ' ,:r^ -s SW "A do OF HEALTH i 1 eer to Peovldo Permit q, t Dlvislon oftEnvlromnentel?Healtlt Semees Carmel N Y 1051? Engin • � � � _ -+� - � ' _ k ou CERTIFICATE_OF COMPLIANCE � CONSTRU PERMIT FOR §EWAGE DHSPOSAL SYSTEM Y 1 // •,.,, i „r- d rq `'�". -� ;- yy,, kc 3 149 3 0 -� '9.: °�t �•'® '� •. '�. r i� ice'. aY � '�`:! a yr -tt "Sr 1 •1 aAlt${W at � �' �J �xri � li n. �" t r- � ram *t � w `'' �' Sabdlvlelon Natnec a x Snbd A& t N Taa Map Block- -1At'- 5 t Renewal O Revision O i x }Ownei /Applicant ;, �, - N -� � Date of Previous'Approval 3 y ' PX 4.1 A AA p' rfkV 1`" x t F Ball "ng Type / Lot Area' C FW Sectlon Only Depth LL Yohmte P Hired Wben F H le completed , CHD '' Number of Bedrooms _ �cf 6n �' , Ileei Flow G P D; NotlBcatlon Is Rey , ` ;'• ,� -f r►� Separate Setveiage System to conelst of Gallon Septic Tank +an To be constiiueted by L»e(st',i7�i✓!/e4/�s/ i¢Ti9 Addroee !� .- � t�T t; r� ws• -per Ah `ttia .rZ � � r4 � i Water Snppl� Public Sapply,F�om - Address �� X �- C ori- Pilvate SapplyDrilled by 'Address' ;: 4 r > Other Renairemente ` * z (t copiesent that 1 am wholly and'completely responilble for,.ahe deslgq` and location rOf the Dropps'ed systems) 1) -,that the separate,; sewage -d ispfisal•_system � 11 will- tie >co ilfucted'at shown omthe approved amendment thereto and in atebtaance,,wdh; the star ards ruies and ,regu a 1ons,o e u Ham w abOVe •desc.�bed a z: - s . ,.; _; wawa - Count : =De artment- of Health and•that on completlop. thereof a Certlflcate` of Construction Compll$nce satisfactory to the .GOmmissioner;of Healthw111 m d to .the.a)`e fitment •and,.a. written guarantee'w111 be iurmshed the ownei h1s wieesso►s 'heirs or:asslgns by the,bullder that saitl builder =will :bSUb itt0 _ t o erSt n coriil 4ion an ". ' rY ii/:asald sewage Cisposal sYStem: dunnq:;ltne perlotl of,tvvo_( -) years'bmmedlafely following theydate of the -lsw . 1n .good. D ...9> .. �<: -. y Y -.Pa -� .�,:;: _ - sue ��s .��. w , .�.: - A- s.... ; , _ - r • qi -'` � e w - ::. <.x e ; ns s. •� bove t t fiance, of the kapproval `of the CertA {cafe, n'ot Construction Compliance o /rithe♦o�.ig1 ally em„#or'•sny cepafrs thereto 2) that'the' drilled wel),descnbe vv�ll'De'lorated:as shown n�the a`pDroved: plan and that saldg well w111 besinstall cc i nce with the,;st ds;. -r sand requ a, ons of t Putnam r « 4 t` County Oepartm nt of; eslth r ' F ��' %'.' � � P.E.- 'R A- �: _ r Add►eu . License No _ e APPROVED;FOR:GONSTRUCTION This a royal expires two yeari Irom he =date niued unl s construction f, the bu11a.1ng has,:been •undertaken4nd 1s , z . - :T�� ,revocable for, wuse.,or� may be amended o mod1 ed when considered necessatry;,by the Commissioner of Health 'Any change or alteratlon,ol conatruct{on � ( �e,+�,'>;'`. ��,t w.:.ra�.a „,,r, r.- :,..a� :Y -,,w. �?.,,._. ..,. ' °},:s. �. - �; �.:� �. r ..,.a. .'s..; ,� .,:. ,, � '�: � ry � ,..y,, �'�.. � h '• L;,,. t # ,�.`«� reguves a., new permrt.���Approved for`�dlsposal;�of,domesl {e sandary sewage ;and /or ;;prrvste`.wster�wDPIY o�lY., trr��� >, � , -s , � +::, } AY ”" iC�,'' �'« �• °r`; ``1 s M4 e '��`,..- y+y?+3 4.? i `^,s .v,!;;� "? r� �.� x �'tr;: a; 2 ui.�wx���� ,wtf��'t? fir,.,. t,�` a �3ti... �'d,,,,1,d�S -. r�. "�''�- j;- ;;',�,. . „.$"a. t :.: _ ,rr, ,x t • DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 ..... .. F. .�-t, v'.6:•v:•:.Y.'.ii -r _._. _... _ . A7o0j)- et Address Town Vi�l age City Tax S 4/ V& (�i4L Grid Number — 3 — Z 4ELL OWNER Name ALIAI Address ud amqw /¢lj,�r_R% D rivate OPublic 7 LL - pri - secondary PCHD PERMIT # JELL LOCATION A7o0j)- et Address Town Vi�l age City Tax S 4/ V& (�i4L Grid Number — 3 — Z 4ELL OWNER Name ALIAI Address ud amqw /¢lj,�r_R% D rivate OPublic 7 LL - pri - secondary &RESIDENTIAL O BUSINESS ❑ INDUSTRIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT P14 O FARM TEST /OBSEVATION O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O kMOUN,T OF USE YIELD SOUGHT J*'* gpm /# PEOPLE SERVED, /EST. OF DAILY USAGE 0® gal REASON FOR DRILLING OINEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE RILLED 13DRIVEN ODUG O GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES L,--' NO IF WELL'IS. LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name -/0 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓'"NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY ,_` _ ._......�__.- .._...... _....._... t. M DISTANCE �TO PROPERTY F1ZOM• N'EAlth'31 wFii E� riAiiv : -- -_ - - - •- �---- ...-- ..- _......_._.___ ,� LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED f O ON REAR OF THIS APPLICATION S P TE SHEE (date) (signature 1 PERMIT j 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. i Date of Issue: 19 Date of Expiration: 19 Permit Issuing Official Permit is Non - Transferrable n Inc PETER" C.' ALEXANDERSON County Executive C ., •, r . „ ._.._ ' : EffIU L. CARRUTHv M.P.H. Public: Health• Director t. JOHN SIMMONS, M.D: Deputy Commissioner JOHN KARELL Jr., P.E. DEPARTMENT OF HEALTH Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 April 289 1988 Mr. William Zeiler Concord Road Mahopac, New York 10541 Re: Proposed SSDS Annunziata Wood Street Metz Properties R.S. (T) Putnam Valley TM# 36 -3 -12 Dear Mr. Zeiler: Review of plans and other supporting documents submitted at this time relative to the above — captioned project has been completed. Comments are offered as follows: This Department has witnessed soil Dercolation tests on Lots #1 & Z •o-f+ 'the 'above referenced subdivisiun on OeLuber' 309 - i.9o7. Tire results of the percolation tests in the proposed SSDS area were in excess of 60 minutes /inch on Lot #1 which is unacceptable for subsurface sewage disposal purposes. The testing on Lot #2 did not conform to Putnam County Health Department requirements for percolation testing. Consequently, the proposed subdivision as submitted is unapprov- able by this Department. Kindly advise if there are any questions. Very truly yours, < " 1� -21 Lawrence C. Werper Assistant Public Health Engineer LCW:bck cc: E. Metz :. ..DESIGN _DATA..SHEET- SUBSUFACE SEWAGE DISPOSAL SYST I... p . _:� ^ - _ - _.. ..s.. VT�.4 mvl' 3 — �.^• ..J' V rM.}Yir .i+.S- rPO�V.r]..ti_..a rnt�. YF•.._K��'Y�' ^:.... \'+.w._..w.. r•t..ailO.. .O Vf.. wO V'y:w Owner �d i�Y 4A-W -/N a-1 *-r4 Address Located at (Street) A)Vd -0 �T Sec. Block _ Lot (indicate nearest cross street) Municipality Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking /Z elf I Date of Percolation Test --� 7,// 9/,p 7 HOLE NUMBER CI= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches. Inches Inches 1 9. OS' 1:3r 30 -Z y ZS'X, 30 Zy Zy� 5 on 1 % :o7 q :37 30 ZZ/ zi- /s! /% . zv.0 3 /0•'©.S" %0.3s"- 30 3o -2-y 2y% 30 Zy Zy� 5 on 1 % :o7 q :37 30 ZZ/ zi- /s! /% . zv.0 4 5 1 2 3 4 5 Z Zy /y 1 Ki NOTES: 1. Tests to be repeated: at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 3 lo:47 10-'37 3o -2-y 2y% %y `o-' &0 4 5 1 2 3 4 5 Z Zy /y 1 Ki NOTES: 1. Tests to be repeated: at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION OF soils F-9 Nn_, oy Z No G.L. -role- Solt, 21 lodd4 WQ-&- 31 41 51 61 71 81 go 10, ill 12' 13' F 79, INDICATE LEVEL AT WHICH GROUNDMTER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: Al'(4t-1,401 DATE: jZ DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided No. of Bedrocms Septic Tank Capacity 0 49 0- gals. Type "107-� Absorption Area Provided By 0 o L.F. x 24" width trench Address AFD,�6Z Z& 2Y)-- m. acew.Ln LmrruC1 ,=au vmu.L ; Soil Rate Approved sq-ft/gal. Checked by Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 2�- Re: Property of Located at (T) Subdivision of Subdv. Lot # tion ' - Block 3 Lot /2- Filed Map # Date Gentlemen: This letter is to authorize a*duly licensed professional engineer V 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 147, Education Law, i gcp1iiiiiic tary Code. Counteisigned: P.E. R-w-A. # Address 411&1 Telephone .,A.4ione.- of-Artiece i41 alth Law, and the Putnam County Sani- 'Very truly yours, Signed Owner of Property Address 1,9dw -A Town �-e_>dp_ Telephone 4 OI �I -I F 9 NOOK 91 DINING LIVING RM 1t I ®..� _ p IL i1 a 1(—� Za3� -o L, i- 0 KITCHEN = ` BED RM I =' '� - ' BAT . I �,. � • HALL ' �q' 6ED RM ` eta. BED RM 1� 2 lit 1. s § ' V; ti -.i . 0: -Lz . I DETER C ALEXANOERSC 11 County Esccutive DEPARTMENT OF HEALTH Division Or Environmenral F:ealth . Services 1-to Old Route Six C=enter, Carmel. New York 10512 (914) 225 -0310 September 19, 1989 EMIO L ClaRtrTH. &q.p.y. iuctic Heetth Qiree;ar V01 KA;tE'—P jr _ P.:. Cirec=r Re: Construction Permit - Annunziata Wood Street Mr. William Zeiler, PE (T) PV - TM #36 -3 -12 Concord Road - Mahopac, NY 10541 . 2 Dear Sir Review Oi my files indicates no activity on the above C2GtionE_ prc jec4. fcr s..,Tte time. Please advise the writer as to the status of this project without delay. w.....'. . •. - - e —.» 9 - �.. ».. � .r•` ♦ K. .. .. ei.+ - t. v •.. - .. � ac .. » .. -a >.se• ..... ..... -- - .-, .... tT. .. .r...... ... ..v. » . a.. e.... - ., . .. . _ Failura to receive a response by October 16,1987 will xresult in the file being retuned to you, DISAPPROVED. Very trul}� yours, awrence C. Werper LCW:jr Assistant Public Health Engineer CC: Owner Eddie Annunziata -Wood St: Mahopac,NY 10541 JK File ? P = =?mr-r a PUITE_A C ll": C` � `:T OF Ea-lr i CF r_VG= ,. r *-- - L�L _L.r 4uA;� Su -F°ry & S = .SMFIC: G� of CNr.= rY _ ' ..�- —� (S� =_ Lcct_=ca) C -` m—PNTS ( � NO DM. 4--.J I Pe t_cn A IV Resol'st_c:z Plans - ralree sets c e i I De=_cn Cat Si:c =_- ( Cr )�Cv acis L .--c Pare Bole rc-= - -- Gep`Z t=ench 60 ft. I.- -- ,,OT ; 1 note= 1"0 1 =J fi. t 0 -- r• •C° RI—Mst Dcta CJ1 -,,CC Ply ^_S & =S='i rata? 1I C °-S_cn Data_ �'_-^ and C =G.7 r$c' Dr Tiev.V & S1c_ G C,2t Fco =Lc -.-_,C2r__:l r,�_nS VGT� & D=o L''Ol�s �rC✓�� =: r�cc ^_�C3'r7C Ct D___ .=,-1C wzs & ESCS' S w/ Z 2 '00 cf s= P_' 3e-r,. 7 : t°T�S & EcunF : HC' c -:B Se— 3c Nc'`.'�c c= d (' ich t 1C t ) EQLZ Saar - 1/4" /ft,- d" a oica No Ber= 43" w/ c__w: L SER RMCN, DISr =ti= Sp -- C_l? *.z F' s1 cs t t � 10' to P.L. , Dr14cvc_l, �''C° Z'_ se.,, �'CD cf A. 20' F`JL'*1C? �i Cn .WV I is 100' to well; 200' i:-i D.L.O.D, 1-50' pi 's 100' to St= aara, tic t__'�Lr_2, L (* rc. Er 1:' tt7 rr1C , 3;:z'tc W=%- --=cc 50' C ILt �rll? ^.r. _r':'= Gent? C ,-,J �- 10' f=--n Fcunda=_cn• 50' to WZ: 1=' irk? tz prJ o PUTNAM �MENT OF HEALTH ki4 jj L Ctv DIVISION OF' i9V4--R'&b E'141UL HEALTH SERVICES Date Re: Property of 'r/t/ 41e,'17 4, Located at Al el;7"- M&A= /PX1"C4J Section Block y Lot 2 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 sary. papers on my behalf in --connetc-tio ..with th:* s matter -and--t.o.-.,..s t --.qp--er.v.ise..t h o . n truction -e. c 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. -j; i9"JXL-�. Countersigned: Ag.F7NEjy yo 1-1 0 W !.tX� 0; P.E., Addr Cr Telephone Very truly yo rs-..777 4 Signed, .- Owner of Property Address Town �-i ` L X13. Telephone Inspector TOWN HALL - - PUTNAM VALLEY N.Y. (914) 526 2377 TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT August 27, 1990 Department of Health 110 Old Route Six Center Carmel, N.Y. 10512 Re: Emanuel Metz - Wood St. TM #36 -2 -12.1 Att: Wm. Hedges, Jr. Sr. Public Sanitarian Dear Mr. Hedges: Per your request of August 20, 1990 regarding status of above noted property, please be advised: This property consisting of approximately twenty -four (24) acres is r•onsider -ed- a pr - .exist -_nom lot - `iocat'ea within zoning district R -1: v Permitted uses within the R -1 zone would include one family use as proposed. Meeting all local, county and state regulations for a permit, this lot could be considered legal for one family use. Very truly yours, l P ARVIN 0 DE MO'D:es Building & toning Inspector PUn M COUNTY DEP HEALTH DIVISION OF , SERPICES f H VCS S? rF' FT- ScJRSr_icF__SFWACk:.PISPAJ�. Owner Address Located at (Street) Wao, c/ Sec. Block Lot l$. f (indicate nearest cross street) r SOIL PRKMAMON TEST DAM RW MM TO BE SUR41= WITH APPLICATIONS Date of Pre- Soaking - S �� Date of Percolation Test �� �49 HOLE 3'2 23 0 3V NUMBER CLOCK TTME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches. Inches Inches 2% 3'0 2, 3e; 3'2 23 0 3V 4 5 410 30 a4 >-,y 1/Y-' ;�`/�5- 1d- 4 5 2 3 4 5 1. Tests to be repeated are obtained at each for review. 2. Depth measurements to rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to'be submitted be made fran top of hole. TEST PIT DEPTH HOLE NO. HOLE NO. HOLE NO. 2° / 31 a 4° 5° 6° 7° 8° 9° 10° 11° 12° 13° 14° iivLlu'ii 1.k.Mrw tir l INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: fi )llvool DATEe DESIGN - - - Soil Rate Used Min /1" Drop: S.D. Usable Area Provided zl�epe No. of Bedroans Septic Tank Capacity gals. TypeQ Absorption Area Provided By L.F. x 24" width trench Other /" G ',�,i1 / �• �� ��� �' °r�� Name Address THIS SPAP3 FOR USE BY HEALTH Soil Rate Approved ONLY: Signature ,P OF NFW y� - � S sq• ft /gal • Checked by Date