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HomeMy WebLinkAbout3137DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 63. -4 -26 BOX 25 ti :- ' . 11r6m :: IN lk f... �. 03137 PUTNAM COUNTY DEPA TINENT . Ol Diiiisron of Envronrrienta/ Health` 8erwr�es, Carmel } a - :CERTIFICATE OF= -CONSTRUCTION .COMPLIANCE FOR: SEWAGE DISPOSALS. LOCatBd, at V v (� r�Tax lisp '/ A "• ' ", OWne/ L i�l� FormerlyTaxgMep Separate Sewerage System built'by Address Conslsting of ��OO Gil Septic Tank and Other requirements c ; Water 'Supply= Public Supply From '` ? Private Supply Drilled •tlddress Bultdiny' TY,Pe s "�H £ �41►��L� <w+ No of Bedrooms }Hai Erosion (Control Been Comptetedt J. I certify that the sy�tem(6) see listed serVinq the above premlaes were gonatruc£ed essantie] of which are .attached) and in 'accordance with 'the standards rules and re o_na `in acct ;:PUtnaai County Department Of 8ealth a Date /� /y� Certified by Address Any person occupying premises se►ved by.the aboJe systems) shall promptly tikesuch action as, lting `from wch .usage 'Approval of the, .siparate,, Fong iYlops resu `sswenge£ system sf ill become ;available and the approval of the: private °water supply shall!become, null and.void when a pubil ,,• -subject ',to .modifIcstlom or change ,when;;. in tlib. judgmen of the :Comm) ;siomr of Mealth..sue Date ^� BY lieu 9 -81 HEALTH " N Y 105.12 permit a' EM LiLf N= Town o1 Village t �a]t •i"` +Y `�6`'Slibd lOt r c L Date Permit Issued y see shown on the plans of.tha completed cork (.copies ' with the filed plan aid the permit aeued by''the , a -iy �i1 P;E R A L.•C� rt rte- �'��]��Liana NO•� � �� y be nec"fy to secure the correctlon of any unsanitary j Ul'cnd void dats loon as a Puling anitary sewar becomes 1 water supply becOmss:avallebls. 'Such•, approvals revocation inodlfication' of Cho n" Is necessary Yorktown Medical Laboratory, Inc. ALBERT H. PADOVANI M.T. (ASCP) P.O. Box 99 201 Buttonwood Avenue 495 Main Street Stoncleigh Avenue 321 Kear Street (Corner of 202, across from Hospital) (Across from Lloyds) (Corner of Drewville Road) arktown Heights, N.Y. 105118. Peekskill, N.Y. 10566 Mount Kisco, N.Y. 10549 Carmel, N.Y.'10512 (914) 245.3203 (914) 737 -8777 (914) 666 -3335 (914) 278.9330 This statement has been prepared to help you interpret the WATER ANALYSIS REPORT you have received. The purpose of this examination is twofold: the determination of the total. number of bacteria present and the specific determination of the presence of members of the CO LIFORM group. The item BACTERIA per ml is a measure of the total bacteria present, One quart of water contains 940 ml. One ml of water is added to a nutritive medium which acts as a source of food for the bacteria. This portion of water sample plus medium is then incubated for 24 hours at 37 0C.; At the end of that time, the organisms which have grown and multi- plied are counted. There is no limiting value for this determination but it is of interest in judging the sanitary quality of the water sample. t The'second determination, the COLIFORM GROUP is of. more importance. This group includes several species of bacteria ,which are, more or less, normal inhabitants of the intestinal tract of man and many other animals. Conse- - a i fou A ;t7- r•emi.indcilr mlir�;_�,���c �n nra• ; attor and p�►�; �,17P_tjtO��ISm�_¢ _.i %,) G' :f, _if ,US1 2���V• iiu_ _S 5 G e t dangerous in themselves but when found they do indicate potentially dangerous contamination since sewage at any time might carry pathogenic :or disease producing organisms. The source of this contamination might be a sewage system which is located close to a well or spring. It might also result from failure to protect the water supply from surface drainage or contamination or the entrance of small , animals. Any time a water system is repaired or opened up it-should be stefilizgd by the addition of chlorine in some form before being returned to use in order to eliminate any contamination which might have been introduced. Our test is done by "MEMBRANE FILTER TECHNIQUE" or MFT. A negative test is indicated by a value of LESS THAN 1. Any number greater•than 1 indicates the presence of COLIFORM organisms and is reason for stating the source�of the sample is not satisfactory. The test requires a minimum of 14 to 48 hours and very often 72.96 hours. It mush be understood that the results of this test apply to the water source only at the time of sampling, Unusual conditions, such as heavy rainfall or drought, flooding, changes or additions to the water system, installation of septic tanks or cesspools to the nearby area might all have an effect on the sanitary quality of the water. Consequently, analyses should be made as often as circumstances warrant. REcEivE D AUG - 2 1983 .PU7NAA4 COUNrY DEPT, OF HEALTH INC. 9RKX; WN M.EDJC4 LABORATORY -P.0: Box`99 321 Kear Street Yorktown Heights, N.Y. 10598 245- 3zo3.: -- r M Any RN F 00 S T I��LL(1 box - oc t L -� LOCATIONS: 1 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 ❑ 201 BUTTONWOOD AVE., PEEKSKILL, N.Y. 105G6 737.8777 D 495 MAIN ST., MT. KISCO, N.Y. 10549 666.3335 (-1 STONFLE CH AVE: INEAR HOSPITALI, CARMFI: N: Y, 10512 21 LABORATORY REPORT mg /L LAB # DATE TAKEN: _ I DATE RECEIVED: DATE REPORTED: SAMPLE SOURCE: REFERRED BY: 0/ E emu. Iu-,- COLLECTED BY: M< Ffl'LC,p !J L. ❑ ACIDITY .............................. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY .................... ..: 1.............................. ❑ ANTIMONY .............. ............................... ................. XBACTERIA, TOTAL /rhL ...... D ARSENIC ............ ............................... ..................... ❑ 800. S DAY .... .................... ............................... D. BARIUM ....................................... ............................... OBROMIDE .............................................................. ❑ BERYLLIUM ................................ ............................... O; CARBON DIOXIDE. FREE ........ ............................... O BISMUTH ................................... ............................... ❑'CHLORIDE ..........................:. .:............................. ❑ BORON ..................................:..... ............................... ❑ CHLORINE ......::.................... .. ❑ CADMIUM ............................. .................................... ............................... ❑ COD ............ ....................... .....:......................... ❑ CALCIUM .................................... ............................... ❑ "COLOR ..... ........................ ............................... O CHROMIUM (tot.) ............................ ............................... ❑ CYANIDE ........................... ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ............ ............................... D COBALT ............................•....... ............................... DFLUORIpF ............................ ............................... D COPPER .................................... ............................... ❑ HARDNESS ........................................................... O GOLD ............................................. I......................... ❑ MPN COLIFORM COUNT/ 100 ml .'...... .. ❑IRON ........................................ ..........................:.... _ ................ ,'*�IiFT COLIFORM COUNT/ 100 ml .1 ...................... ❑ LEAD ........................................ ............................... • CONFIRMATORY TEST ............ ............................... ❑ LITHIUM .................................... ............................... • NITROGEN, AMMONIA ............ ............................... ❑ MAGNESIUM ................................ ............................... 0.Ni.TpA6cN, SE' 0* .:. ,. ... ....� . _. ❑ NITROGEN, NITRATE ............ ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ............ ............................... ❑. NICKEL ........................................ ............................... O:ODOR ............................. ❑ PALLADIUM ................................ ............................... QOIL & GREASE ........................................................ ❑ POTASSIUM ................................ ............................... 'pH ... ............................... ..... ❑ RHODIUM .................................... ............................... ❑ PHENOL ................................ ............................... D SELENIUM .................................... ............................... ❑ PHOSPHATE (ortho); ................ ............................... D SILICON .................................... ............................... ❑. PHOSPHATE (condensed) ............ ............................... O SILVER .......................... , ......... ............................... ❑ PHOSPHATE (total) ................ ............................... ❑ SODIUM .........................� ....... ❑ SOLIDS, SETTLEABLE, ml /L .... ............................... D TIN ..... ..............................� ,......... O SOLIDS. SUSPENDED ............................................ D ❑ ZINC . ............................... ......... SOLIDS, DISSOLVED ••••• ........ ............................... D ••••• .. ..........................!by, ........ ............. K OSOLIDS. TOTAL ..................... ............................... ' ❑ ... ..............................` ................... �:�1 ............T- 0 SOLIDS. VOLATILE ................. ............................... ❑ REMARKS:............... ....................................... . O SPECIFIC CONDUCTANCE ........................................ ❑ ............................... l C SULFATE ............................ ................•...•.......... ❑ ................ ...........................�...�. . ?!$rpy/ , j .......••,......,. .,, O SULFITE............................................................ ❑ ........ ............... ............................... ...............y ..... ❑. SULFITE . ............................. ............................... ❑ ....:............................................... ............................... ❑ SURFACTANTS ................... D ....................................... ............................... ......... ❑ TURBIDITY ..:.................... ............................... O ......... ...................................... ............................... THESE RESULTS INDICATE THAT Tlli' WATER WAS 4OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED; THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 12). FOR PARAMETERS TESTED / ALBERT H. PADOVANI M.T.. `P), DIRECTOR:,_ WELL COMPLETION REPORT "'� PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller_ and submitted to County Health Department together with laboratory report of •� • - - {- - - ^�' --- - — - r:: � , i��I -:.: �nlii- - 5...n'.,':. `rti `r. :�> `r,.•�.*- srrti.::•': ir•- '+a�i �oit 'a � "' �, ecuF? i5c {�'�vd`���•fi�e,��tii?i ^'. +��5�. �. SAC: �.' K, s:,... �.-...•,:,.;: �.,.• e.. ��,.,.e:'..'�....P.- .....�36::: �..,.ln,SSSa 'u::SR.r �:...,. i�ilu���15'•..,..�.... r-%•- v...,��,: REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER N ADDRESS LOCATION OF WELL (No. & Street) (Town) n/ (Lot Number) PROPOSED USE OF WELL DOMESTIC PUBLIC ❑ SUPP Y BUSINESS E] ESTABLISHMENT ❑ INDUSTRIAL 1:1 FARM AIR ❑ CONDITIONING El TEST WELL ❑ OTHER ) DRILLING EQUIPMENT t ROTARY COMPRESSED ❑ AIR PERCUSSION CABLE ❑ PERCUSSION ❑ ((Specify) CASING DETAILS LENGTH (teat) Z >' I DIAMETER (Inches) �r WEIGHT PER FOOT �, THREADED ❑ WELDED O YES ❑ NO C'T$TFTG YES NO YIELD TEST ❑ BAILED HOURS -1 PUMPED © COMPRESSED AIR '7 G.P.M. �- YIELD (G.P.M.) d- WATER LEVEL MEASURE FROM LAND SURFACE -STATIC (Specify feet) DURING YIELD TEST [feet) Depth of Completed Well in feet below Land surface: 021e) SCREEN MAKE LENGTH OPEN TO AQUIFER (feet)' DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inches): GRAVEL SIZE (Inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact two permanent location of well with distances, to at least landmarks. FEET to FEET ECEIVE AUG " 2 1983 PU T NA DEPT. M c °UN��. OF MEALTH If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL CO LETED : - 7 DATE OF REPORT WELL D R ISig net u 7 7 �� Fwc Owner or 'purchaser o f Building di by. -.. _w - -- Location - Street ' Municipality Building Type V 'L.I. I ection 3 -_ 3. Lot Subdivision Name Subdve Lot # GUARANTEE OF SEPARATE SEWAGE 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 success- ors, 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 initial use of.the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept.as conclusive the determin- ation of the Director of the Division.of Environmental Health S.ervicPs e.. --'-•- .ie"•iPui:,Luu:-.,v�:.L�y -LCjsui �.,,.cri��• vt- ilea.i f:�i dA" 1.0 wilel.Ilei• o 21uL i:11e•,•Ia1.L- ure 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 J'4•, 19 RECEIVED"' AUG - 2 1983 Signature 'L .,_ ( - )P,", Title Corporation Name /if corp. Address —'� ; qPU s vAM G4 UN - - - - - - - - - - -DEPr CFF`TU1i..7 'j - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED° GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health v­­ A'. — ,CONSTRUCTION 'PEI : l L 3E-'.CiISP,OSAL,',S,Y'$TiEM�,'.w ,' Subdivision 11 AC ..okiier/Md_rqOq, EY" • -T 6f - Number of Bedrooms Design 'Flow G /P/o 771, �,Separato SeWaragitSyttem to 'consist of ­0111i; Septic.'Ter! y. To be constructed by'- ���i.'C.1z61i� . ...Sj .Water ' �,eubli�* From ro � Supply :- PrWite "Supoly:40-in drille'd, by,'A 7 Other.'MeQuire W A represent that J'arrii'wh6lly and completely'responsible forthp dpsign and a ova, escribad,v� iill,r­p'i constructed as:showh_on 4i the ap`p'r6­ ypd, ,amonompl_t ' t­-h`pi, e to and n d County Department of "H41th, and thit on completion thereof a!CerfMi of ti.. , 66`submittec, to Ae bopart menO'- an a'wrl!teWguaran qe:w1lVbe,,fUrnished. the ov -Pace ,on good %operAtlng conzijioh 'any part'o f- said sewage 'disposaijsystem duriris al the 66rtifkate•:6f "t r 1 4- once: (?, he I a pprov t6d as shown on the approved said -ell,will-balfistill C�l -will lie'loca plan that �W P,Wlty Department "of .Healthy . Date All 'APPik6�,td-FOR ':CONS,TRIJCT16N:--.Ttils approval expires,o ne `yeanfrom ',the ..-, date revocable .r,, cOnsiderqjj; for disposal Ap" p r 0�­ aii ' Posil,;�f domestic r ;i� a Date }J -requires a, new.�,p , arm- it U4� BY T 777 .V Rev. 9=81 'F'. ... ...... . NT, OF y HEALTH` permit ?17 2. Town W.Village, Renewal ­�� k,'; ROvisiOn ' LDate"Of Previous Approval ' Address + g' Q: 7" rN V he proposed k I oposed systairn(s) . 1)''t that the separate sewage die sal sxstem t accordance with the itaridaids, rules -a-nT'regulat ions o , the - P,,uznam truction Compliance set�sfactriry to the Commission - or of .Health will sr, 'his successoF ;, heirs;or 69-thei�'blulld".1thai'sold builder.wil pir hd,perlo�4_ViW6 imriwWiaW_j,followl1iO thedate:of4hi itsu 'Yste- or a nca the standards rules and regu a ons:,• of the Pufnam License No ueaT 'unless,coristructionrof the building fiai•boe"n undertakin'and Is` 0 0 hinge or alteration ofoons.66d ion Health. c p044 to K $uppl on • Title 0 5 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ .�.:.+, a ._� �..s`w "_. � .. - ....: -:ti c- .:n...Y.:�- <�:,sa;Y .=�:.: ^�a..a ��.. %mss' ....o's- ._-.;... .,.- ...c'�.�..-:w•`_. w. K-.. -...,.rx. c..n,...eri.: -�. '...�.,.•v.. e Date Re: Property of Located at (T) ' ty'�ry.}�: �.. Section 5 Block Lot J Subdivision of;u- Subdv. Lot # -3 Filed Map # r7�� Date Gentlemen: • r This letter is to authorize �' +� R- / I l t i�7Z <'c -.c'. E c c a duly licensed professional engineer 1.' or registered architect (Indicate to apply fora 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 Public Health Law, and the Putnam County Sani- is OF "E {v tary Code. A� C. PZ7�� - a ^' Very truly ours, � a ;'.,fir.::_ • , Signed ° Owner Property Countersigned C o DEPT. qq�V\ AH�.gY��p�S4{ Y'y P.E. , IC:Ao , # � Cj10. Address 0S I Telephone Address Town Telephone -- 'q' r-, OCT 9 mg t. PUTNAM COUNTY DEPARTMENT OF HEALTH LA DIVISION OF ENVIRONMEN.TALL HEALTH SERVICES �i a:.eF- -�'�°' li1l1�1L'+�:..'i^::...1 . 1�J`�1 L..-.•. ;.:`n`�:: 'a. ..-. o.��.mivc:� •::cn ::��.. -..«.o ..�. Y' Ur1LL'""60== DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner PF) sgJtikx -f ARy FiltrvNf Address Located at (Street . W o r, Y77--.c i— Sec.a,5' Block T ' Lot c9-3- J 6dicate neares .cross street) Municipality N't- N rt +A VA Li Y . Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Water Water Levei No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches. 2 �°.io 5 3 C -G � 2 - (4' 5 Pt 5 C -G � 2 (4' 5 Notes: 1)' Tuts to be repeated at same depth until approximatel e ual soil rates are obtained at each ercolation test hole. A11 data to for review. p 2) Depth measurements to be made from top of hole. �I C a ; rf 1982 -DEPT. OF HEAL y HI -------- F77- TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESQRI-ZTION. Or,- SOILS ENCO " IN TEST HOLES__ UPTERED DEPTH HOLE NO. TIOLE NO HOLE NO.- G.L. 7-vrsc w t, 6 1 1211- (-,A 181, 24 3011 3611 4211 4811 5411 60" 6611 7211 78" 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED N!L ICAYMLIHWEIT #1 "0. j 27 , �2, 0, C_ 9 J 27 TESTS MADE BY 11 C, pi4 C_ (-.,E 9, Date DESIGN Soil Rate Used Min/l "Drop: S.D. Usable Area Provided S—COO No. of Bedrooms Septic Tank Capacity /00 G1 Type yp OF IVZ t Absorption Area Provided By _.Z Z1 L. F. x24 th trench. t 0 r name �_,7,.4 Address /L THIS SPACE FOR USE BY HEALTH DEPARTPENT ONLY: Soil Rate Approved —Sq. Ft/Cal. Checked by Date rnrn 00 of Gd LOT 11 LL FPZ 205E27 TAvwM q OESSGrt 35 4 -23.Z ,4rNisy DECEIVED AUG 1983 UG - ;,UTNAM COUNTY OF JiEALTIJ, 4T W. 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O&W t I am.wholly, and complatjjy the doilign ala,� co he proposed, om(s)f I). that the separate to sewigo ii;nendmaht there to aind'An accordance with the standards. - rule$ and regulations or above described will. be constructed as shown on t a approved 'thereof A ofCOnsti6ction Complian6al!',utisfactory to the Commissioner Of H•althwill !!%ntV�. man� qj!� JJN. and that qncc�mpletion iurniifiid the owneir, hi ccow . s . hairs oi aisigns by'the builder, that'said bulkler will ri and a written'quiiintee will be place in tiperativill .'condition any part. of _ laid I'Mage -dii"! *1 once of C I ertificite of Construction, . Cp , mpilancp I Will be located as shown on the app4ov ha plan and tt mid we . .1 *Will "Irish county Departmeept if'!fiilth. Date b A Signed Addre APPROVED FOR CONSTRUCTION: This i60010111 expires revocibi• for cause or may be amended or modiflisil When consi e0 maces ires a no permit. Arpor W for disposal of domestic i ry Rev. I I to Sy 10188 7 91 per * f two (2) years immediately following the "to of the lUu- or n , repilrs,thiroto,2f that the drilled will described above - n to rogu%Tons .;of, th . • Putnam P.E. RA. 0 .. License* No O i C kid unless 4 st tiction of the building buildi has been undertaken and it I issioner of HI Ith. Any change or altwati I on of construction wit -'supply nly• Tit -7, ^-Rev. 3186 PUTNAM COUNTY T NTY DEPARTME OF HEALTH '. Division of Environmental HealifiSer;4"N' Carmel, 'N.Y. 10512, Zrialn"r Must Provide P'C..H;D. Pirnflt CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM 1-ZTJ1 0�; Located at Owner /applicant Nme.*m Mallift Address Separate Sewerage System. built by_ Consisting of Tax Map block 'T' Lot 4 r4&---_F 0 Subdiviiii on fjame� CIPI�Subdv. Lot # �_IA&Zlp_ Date Permit Issued Gallon Septic Tank and a f—• Water Supply: Public Supply From Address or: Private Supply Drffiedby �)4esn"'4q- Address Building Pe H . as Erosion Control Been Completed?- Ty Number of Bedrooms Has Garbage Grinder Been Installed? Other Requirements I certify that the system(s) as listed serving the above premises were construct e t. 1 as hown on the plans of-the completed work copies of which are attached) , and in accordance with the standards, rales and'regulat s,' in cc'r anc with thiifiled plan, and the permit issued by the Putnam County De I parPnent qf Health. P.E. A_A__ Date Certified by --------------- 7­7 Address Licenso No. Any person occupying promise& served by the . above SyStOM( h 11 0 ptl such action as may 1)9 necessary to eacuro tho correction of any uneanitory r1m conditioi . is resulting from such usage. Approval of the sopart!", iplilllrii jysto shan become null and void as won as a pUbl,: OnItary s0wor boCOMOS avaiGbie .and the approval of the, private water supply shall beco I me null _V . 0 when -a 0 p ly bocomos available. Such approvals are Subject of change when, in the judgment of the Cib" I - of Health. uM,* 11unp. modification or chongo Is n9SOGEary. to 0 ification Date T7 By T It to 0 _ BRLICE- R.: FOLEY_ -R�S� •- _ - " ""'�' Acting Public Fieal4h Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 November 15, 1995 Pasquale Falcone 360 Wood Street Putnam Valley NY 10579 RE: Addition Falcone - Wood Street (T) Putnam Valley TM #35 -4 -23.2 Dear Mr. Falcone: 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 latest revision date of 11/09/95 and this Department's approval stamp. Based on the information submitted, the above - mentioned addition is approved with the following conditions: 1. The total number of bedrooms must remain at four (4) without prior approval by this Department. 2. The area of the existing sewage di- sposal system and its expansion area must be maintained. 3. All plumbing fixtures must be replaced or updated with water saving devices, i.e., low flush toilets, restrictors for shower heads and faucets, etc. 4. A total of 120 LF of additional absorption trenches are to be installed and replacement of existing 1,000 gallon septic tank with 1,250 gallon tank is required. Approval is granted for sewage disposal only. Any other permits or variances required are the responsibility of the application and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. MJB:mk cc: BI (T) Putnam Valley R. Fredrickson, PE Very truly yours, i M chael J. Bud 'nski, P. . Sr. Public Hea th Engi r PUTNAM COUNTY HEALTH DEPART DIVISION - OF FNVIRAL .HEALTH- SER a•..[}', .ate .. ..- _ au...K...s... _ � _ .. - _ v'.Y GZm.'C..". .ilaror.�S 9�ays�� OWNER'S NAME k L e PHcNE 5 - 4 /6 D SITE LOCATION D d & TO MAILING ADDRESS DATE ° ® PCED Complaint # Name & Relationship (i.e, owner,tenant, etc.) TYPE FACILITY PROPOSED INSTALLER 'D - P-0— Dig.— 14 /a•.1 PHONE REGISTRATION # Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. 2 Pr dr log— � L approved c! 4,4, Proposal Disapproved Inspector °s Sighature,&'\Title Is V-P U-q-flc- Date 'roposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 20 Submission of as built repair sketch in duplicate showing: a. Owner ° s name bo Site Street Dame, Town and Tax Map number. ca Location of installed components tied to two fixed points (eogo,house corners). do System description (e.g., 1250 gala concrete septic tank, three precast 61 diamo x 61 deep drywells surrounded by one foot + gravel). eo Installer °s name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or ported ent of er agree to the above conditions. SIGNATURE TITLE e44rL- , ATE d / . 1CM: ftte (END) S Yellrsw (fin ffi) B Pink Lk#iaant) Re: Pro Loc (T) PUTNAM COUNTY DEPARTMENT OF HEALTH �a— ..m ..... ... -..:. n..r .. ..._�. ..0 ..... .. v _T•T vT :�'Y �, 11T� l_: L' Fi•T T. n'I`i;11RTTT�1?.A "Y _'fT.r'Ar v!, ^..J ..ti �.: :j•i<4. iii is •. a' Subdivision of/ 4 6.4 t4 Subdv. Lot # 3 Filed Map # L� Z, Date Gentlemen: This letter is to authorize a duly licensed professional engineer t- 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 CO;i1�12rrt:7rJ: &iY.._thl_..111a_1 be 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., # C PA� C) &x Address 9/ -1�f- Telephone Very t %,97 Signed Owner of Property dress Town Telephone DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Ft.71 T! : O FOLFV P.S. - Acting Public Health Director ADDITION APPLICATION = (RESI�DEENTIAL ONLY ) �+ STREET -3.6U /YG �✓��� S/ TOWN /fi r. �/��� TX MAP #�' NAME: �' �CU /� PHONE �Z��� PCHD PERMIT It j 'A MAILING ADDRESS Description of Addition Number of existing edrooms g Proposed number of bedrooms <54�: Any addition which is considered a bedroom requires formal approval: of plans (Construction Permit) prepared by a Professional Engineer or Registered Architec. in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT, 4 GENEVA ROAD, SRE4STER, NY 10509, Phcne 278 -6120 with the following information. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non- professional drawing is acceptable. 3. SKe-ich of proposed fluor plait. Non professional drawing is acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. OFFICE LISE Comments and /or conditions application August 1995 t