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Home My WebLink About3159DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 72. -1 -15 BOX 26 03159 76 61- J , ;T I T ' - W 1 03159 ,x wsys•: 'r:. y� � 1F m -�� 4 � t '� � q �t , e , f w ` a �� 1 7 r� /7 3 i� PUTNAM COUNTY DEPARTMENT :OF :HEALTH Dfwsion of Environmental: Hea1.tti Services Carmel N" Y_ 10512 CERTIFICATE.OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL'SYSTEM Tr1 Putnam Valley Cocated.at I �dlar Sake ROaA'i East Tax ":Map Block j Owner' :- Job Separate Sewerage _System,_built by D P+�l �mi n)z Ad ss�n?t l�K2_ YOrktOwn He3hts s NY dre "1 2, 300-1 n. ft...2 ft._ trench Consisting of -- - Gal , Septic Tank and Other; regwrements(�lT1P Water Supply. Public Supply From - n,, a, Private SupPiY Drilled BY O3] _ Address ` c Building Typef�8i�er�` m�� ; No ':of Bedroo Date Permit Issu Has Erosion Contr'o_ I Been. :.Completed I certify that the system(s)'as i�sted serving the above premse4were constructed essentially as shown on the plans'of the completed worfc'(copies ot;whieh s ►e attached) `_and inj5ccordance with,the standards rules and, regulations plans fi , and the permit issued the Putnam County Department,,of Health r Date �AV 2 Sid., Certified by P.E.~R A Address T��g��}T.�1 1 .License N Any person occupying premises served by,the above._system(s) shall promptly;.take such acUon.as may be necessary to secure the,correction: of any .unsanitary i _: conditions resulting frorri:isuch, usage Approval ,of, the' separate sewerage, ystem shall become null.and void as soon as p;public sanitary'ssVVSr becomes -. available,and the approval of:.the;'pnvate water supply sliall.,become "null an'd avoid .when a public ,water'swpply becomes available. Such „approvals a, re { subject to modif;iwtion or change . when,;•in the judgmeht'of the•,:Commi' of Health such rev n,: ificatIon or change f ;,necessary ` Date' "" 8Y Title In ` OMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH, WELL 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK *s report is to be completed by wel driller and submitted to County Health Department together with laboratory report of ater is of -satisfactory bacterial quality before certificate of construction compliance is issued. o!y�is of water sample indicating w REPORT N 30 DAYS OF WELL COMPLETION MUST BE SUBMITTED . � / /' ADDRESS owfoR ILOCAjON (No. "rest) (Town) (Lot Number) BUSINESS D.FARM PROPIFED DOMESTIC ESTABLISHMENT EST WELL WI PUBLIC AIR OTHER El CONDITIONING El (Specify) SUPPLY INDUSTRIAL D"L COMPRESSED CABLE OTHER JiKROTAR EQUIPtErNT Y AIR PERCUSSION PERCUSSION (Specify) CA LENGTH (lost) 1011AMETER(l hes)�EIGHT PER FOOT, VE SHOE - IN CASING GROUTED? 'PUMPED -7 BAILED COMPRESSED AIR WAj.ER MEASURE FROM LAND SURFACE —STATIC (SP �Clly YIELD TEST fleet) Depth of Completed Well "L in feet Wow Land surface: MAKE ENGTH OPEN TO AQUIFER (feet) ScRiEN DET#ILS OT S IZE DIAMETER (inches) IF GRAVEL, Diameter of well including CPR VEL SIZE (I . aches) FROM (feet) TO (feet) PACKED: gravel pack (inches): DEPTH F4M LAND SURFACE FORMATION DESCRIPTION Sketch exact location at well with distances, to at least two permanent landmarks. FE11ftr FEET If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COA�PLETED. DATE OF AEPORT LL DRI / /' 'ORKTOWN MEDICAL LABORATORY INC. 6 P.O. Box 99 321 Kear Street LOCATIONS: Yorktown Heights, N.Y. 10598 O 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 ❑ 201 BUTTONWOOD AVE.. PEEKSKILL. N.Y. 10566 737.8777 - ; - 245'3203 _.. ❑ 495 MAIN ST., MT. KISCO. N.Y. 10549 666.3335 _._._ Lc•! y n.y . ZNE-AR HOSPITAL). CARMEL, N. Y. 105 12 278 9: LAB # DATE TAKEN: -CPL.: -d, GATE RECEIVED: // - d(o - i y S DATE REPORTED: J/ 'A d' p SAMPLE SOURCE: REFERRED BY: L`}`'�•." cs�r �� ) COLLECTED LABORA ORY REPORT mg /L ❑ ACIDITY .................. ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ............... ❑ ANTIMONY ............................................................... VeACTERIA. TOTAL /mL . .........11 ..................... ❑ ARSENIC ....... ............................... ......................... ❑ SOD.5 DAY ................... ............................... ❑ BARIUM ....................................... ............................... OBROMIDE ................................................... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE. FREE .............................. ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ................... ............................... ❑ BORON ........................................ ............................... ❑ CHLORINE ................................................... ❑ CADMIUM .................................... ............................... ❑ COD ........................................................... ❑ CALCIUM .................................. ............................... ❑ COLOR ........................... :........... .I............... ❑ CHROMIUM (tot.) ....................... ............................... ❑ CYANIDE . ................... ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ODETERGENT, ANIONIC .. ........................ ...... ❑ COBALT .................................... ............................... ❑ FLUORIDE ............................................... ............................. ................ ❑ COPPER .................................... ............................... ❑ HARDNESS ................... ............................... ❑ COLD ........................................ ............................... ❑ MPN COLIFORM COUNT/ 100 ml ......../�............ ❑ IRON ............................................ :........................... VHFT COLI FORM COUNT/ 100 mi ....0.......... ❑ LEAD ........................................ ............................... ❑ CONFIRMATORY TEST ... ............................... ❑ LITHIUM ................................. :................................. .._❑,. NITRGGtAJ,`?. 1h! 0NIA. . ..........:...a.,......_:.,,,. -.e u ifi:.. Sdc:SiSAQ, .....-..:.: ❑ NITROGEN, KJELDAHL ... ............................... ❑ MANGANESE ................................ ............................... ❑ NITROGEN, NITRATE ... ............................... ❑ MERCURY ................................:... ............................... ❑ NITROGEN, ORGANIC ... ............................... ❑ NICKEL ....................:................... ............................... ❑ ODOR ....................... ............................... ❑ PALLADIUM ................................ ............................... ❑ OIL d GREASE ............... ............................... ❑ POTASSIUM ................................ ............................... ❑ PH .......:................... ............................... ❑ RHODIUM .................................... ............................... ❑ PHENOL ....................... ............................... ❑ SELENIUM .......... ............................... ❑ PHOSPHATE (ortho) ....... ............................... ❑ SI,LICON .................................... ............................... ❑ PHOSPHATE (condensed) ... ............................... ❑ SILVER .................................................. I..................... ❑ PHOSPHATE (total) ....... ............................... ❑ SODIUM ........................................ ............................... ❑ SOLIDS. SETTLEABLE: mt /L .......................... ❑ TIN ............................................ ............................... OSOLIDS. SUSPENDED ... ............................... ❑ ZINC ............................................ ............................... ❑ SOLIDS. DISSOLVED ... ............................... ❑ .............. ............................... ............................... ❑ SOLIDS. TOTAL ........... ............................... ❑ .................................................... ............................... ❑ SOLIDS. VOLATILE ..... ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE .............................. ❑ .............................. .................... ............................... ❑ SULFATE ................... ............................... ❑ ............................. ............................... ................... ❑ SULFIDE .................... ............................... ❑ .................................................... ............................... ❑ SULFITE .................... ............................... O .................................................... ............................... ❑ SURFACTANTS ............ ............................... ❑ .................................................... ............................... ❑ TURBIDITY ................ ............................... O .............. ............................................... ... _._ _ ....... THESE RESULTS INDICATE THAT THE WATER WAS OF A SATISFACTORY SANITARY QUALITY WHEN THE SAMPLE WAS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY OF NEW YORK STATE ADMINISTRATIVE RULES & REGULATIONS, DRINKING WATER STANDARDS (PART 72) FOR THE PARAMETERS TESTED. p� e 7 RFRT 1-1 PAnO( AN IT M. T (ASCP) . DIRECTOR: 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 guaranty to the owner, his succes- sors, 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 immediate7_y follow -, 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 de- terml.nat ion -.:O f the--.Direct-or:--)f the Division of ErLviiorL ental Healtki Se- vices of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 28 day of November lCb% Signature Title Owner If corporation, give name and address) 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 qII6 bcl� PUTNAM COUNTY DEPARTMENT OF HEALTH Pexmill 1 _g Division of Environmental Health Services, Carmel, N. Y. 10512 i CO TRUCTION PE3MIT FOR SEWAGE DISPOSAL SYSTEM 'Town of-Putnam Valley flown or village '- - - viated= a.G�.: ..4:: _ _ ...G- !.9C"a r.o� .� c. - - -;..t.... -.. e`• mil- .=.?': :o ` �i aX ''i�y ,...,.`. �s1d.. ^_' �►-- , .wa.,........_ �!. -�_: r .- .. '- '� Subdivision T Powhr�attan Estates Sind• Lot a C Renewal —M d Revision JO� p Owner /Address D. C:. 1 . Flemming, PO Box 452 YorktownDate Of Previous Approval iL..y 1 V, 1983 Building Type RnsidantiP3 Lot Area - n6 D nra a Pill Section only [3 Number of Bedrooms 3 Design Plow G /P /D 600 P.C. H. D. Notification Required �+ Separate Sewerage System to consist of 1,200 Gal. Septic Tank and 300 Lin. ft. 2 1 t. treach To be constructed by E. Polhemus Address Garrison, N.Y. Water Supply: Public Supply From X Private Supply to be drilled by Erickson Address . Y• Other Requirements None I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during the period of two (2) years Immediately following the date of the issu- ance of the approval of the Certificate of. Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be Installed in accordance w4h the standards, rules and regu a— oTf nsof the Putnam County Department of Health. Q r Date Sept. 7. 1984 Signed P.E. $ R.A. Addre55A(ir'��L1P T�Tl Pntic�m, �T . y .T12527 License fV 78 53 APPROVED FOR CONSTRUCTION: This approval expires year from the date issued unles ruction of the building has been undertaken and is revocable for cause or may be amended or modified when co side d n essary by the Com loner of ealth. Any change or al ation of construction requires a new permit. Approved for disposal of domesti sanit ry sewage, and/or p iva water ply only. Date _q — �> By w' Title Rev. 9 -81 PUTNAM COUNTY DEPARTMENT OF'iiEALTH DIVISION OF ENVIRONMENTAL ' HEALTH-- SER'!rICES" Date ire )q \l Z 3 Re: Property of / U Q F L!=_ 11-1 ll`I y )Q f� Located at LEA l� � Section Block Lot Gentlemen: This letter is to authorize IC�A ) 1-1 -4 DkJY � () i�� a duly licensed professional engineer , or registered architect (Indicate)'. *to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated,by the Commissioner of the Putnam County Department of Health, -.and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity.with the pro- visions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sanitary Code. _ .. Very.truly yours, Signed 4c,_X� Owner of P` operty l? a Address Countersigne 74- 1. �U4 P.E., ► *$ 4 X79.6- Telephone glLl- Z CIS -73 9,, S Ad Telephone MAY 11 1983 -PUTNAM COUNTY DEPT, OF HEALTH F1lsT,D CJJT.CI; I; L' ST. . Date: ' z i.va W -♦ LLB.... <R..e_a T'..4:..1.� vP. �^i -'G.W 6••-� •aelr'n _- - 1 � . � Yt ii- � ..�, t..l �.�s.' V.. ..fc.... �t�...n. —.y ,�° •.�. rP.'rS�rS'•k R"Vr��4. nom. � -'Y. -..�.. Y. II` IT7h.L SITE D'3PECTInO?` � � Yes • No Comments ,Proper.•t.y lines or corns-r3 found ... . . . . . . Can estimate house location . . . . . ... . . . Will driveway need cut J'Iu>t tree3 be removed -note these . Is deep hole representative of entire SDS area -- Additional dc--p holes needed. . . . . . . _. E Sufficient SDS area available considering driveway cut, house location,separation _ distances, etc. . . . . . DEEP HOLr DATA Dapth: I -later elevation: Rock elevation: Soils descriDticn: ' Date: FIi1r ^.L SI`D'E U TSP.' C'� IG�; Insp. by: House located Where shown on 'approved plan • . SDS located whl"I re approved y :Iength of tronch m:;asured : 0 Width of trench aver? ge S1gpe.of the line and trench. accept able_ liGGI7 u..:-�VWC- for ex -D nsioii vJ t.ii.,lii:.� Over 50 ft. from s;•:anu. atercourse Watural soil not - stripped or SDS area iuu-iecess,rily graded . . . . ... . . . . . . _ - 10 Ft. maintained from. pro and •t 20 ft. from house . . . . . . . . . . . _ Sep*! ration of trench i'roiii house, well -- etc . - follows ' plan . - . -. - -; - ,- -•,- ; -;- ,- ; -- -; -; - - -- Number of bedrooms chocks . . . . . . . . . . . Stones, brus1 , • stu;.!ps, rubble, etc. greater than 15 ft. from nearest trench . .. . �► 15 Ft. of peripheral soil horizontally from trench ... .... Junco -ion boxes properly ,,.set Could surface run off from driveway, roads, ground surface, etc. channel near SDS Docs lot draii,n� ,,e avrdar 0. K. in area. of SDS FINAL GRADING OF SITE ACCEPT1A): E BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 May 21, 2002 Joan Meagle 74 Indian Lake Rd. Putnam Valley, NY 10579 Re: Addition- Meagle- Indian Lake Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 72 -1 -15 Dear Ms. Meagle: I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp form this Department dated May 21, 2002 . The addition is approved with the following conditions: 1. The total number of bedrooms must.remain.at T ee without priorapproval. by tms� depaftinelic........_ ... _ . _ ..... .. _ prior_ approval. 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. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley . If you have any questions, please contact me at your convenience. Very truly yours, Michael Luke Public Health Technician ML/ks cc:BI BRUCE R. F_OLEY F;rilic' iiearti3�11iiecloF' ' Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET 7 �.�6 %ig' � z4 kC_ TOWN obh a h-t V,1 04� # 72-1-1-s' ti'AG, (' PHONE MAILING ADDRESS DESCRIPTION OF ADDITION Po feu (fi a I1 rep n, d a t}W NIU:MBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS 3 (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. W Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept'. with legal bedroom count of dwelling. OFFICE USE Comments Feb9g _ BFhouse;uidelines ICY i-oa kn-1 s BRUCE R. FOLEY F LOjR- , TA, -.MO—T-N Associate Public Health Director Director of Patient Services DEPART1VIENT OF HEALTH I Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678. Fax (945) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278-6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map Town Gentlemen: I � According to rec . rds maintained by the Town, the above noted dwelling IS in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER UBuilding Inspector. . BFhouseguidelines A04�'/ LOT 3 0 aN � • N d LOT 1 S 2D OS IS E ,' VSAO c I/ r .�5TE1Yi Tt� C,LNS_45'�`• -cbe' PAU y L ti ..._. i — —•—z. —. 1 G G ,/,.r - y � �� . 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