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Peekskill, New York 10566
PEEKSKILL MEDICAL LABORATORY
1879 Crompond .Rd. Barclay Plaza Bldg. A, Apt. 1
DATE COLLECTED - --
RESULTS OF EXAMINATION OF WATER
OWNER J ATE RECEIVED
1. CA
CITY, VILLAGE, TOWN VOR,,NAM£ OF SUPPLY DATE REPORTED
3 -��
/I -f- #i5-
PE 7-8777
BACTERIA PER ML. (Agar plate count at 350C).
COLIFORM GROUP (Most probable N6; /100ml.)
es s d a.
HARDNESS, TOTAL -.ppm
q
NITRATES (as N) - ppm
IRON, TOTAL - ppm
a
a:
Peekskill, New York 10566
PEEKSKILL MEDICAL LABORATORY
1879 Crompond .Rd. Barclay Plaza Bldg. A, Apt. 1
DATE COLLECTED - --
RESULTS OF EXAMINATION OF WATER
OWNER J ATE RECEIVED
1. CA
CITY, VILLAGE, TOWN VOR,,NAM£ OF SUPPLY DATE REPORTED
3 -��
/I -f- #i5-
PE 7-8777
BACTERIA PER ML. (Agar plate count at 350C).
COLIFORM GROUP (Most probable N6; /100ml.)
es s d a.
HARDNESS, TOTAL -.ppm
DETERGENTS-ppm
t
NITRATES (as N) - ppm
IRON, TOTAL - ppm
FLOURIDE (F),- mg. /1.
These results indicate that the water was/,es of a satisfactory sanitary quality when the sample was collected.
A. H. PADOVA!,% M. T. (ASCP)
BRUCE R. FOLEY, R.S.
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Bill Kenney
14 Crescent Lane
Putnam Valley, NY 10579
Dear Mr. Kenney:
May 25, 1995
Re: Addition - Kenney
Crewcent Lane
(T) Putnam Valley
I have received and reviewed the plans for the proposed addition to the above
mentioned residence.
The plans have been approved as per plans bearing this Departments stamp anc
dated May 31, 1995.
The survey indicates that sufficient area exists to expand or repair the sewage
disposal system, should it become necessary in the future. Therefore, based on
the information submitted, the above mentioned addition is approved with the
followina._conditions. :.... ,
1. The total number of bedrooms must remain at three without prior approval by
this Department.
2. The area of the existing sewage disposal system, and its expansion area, must
be maintained.
3. All plumbing fixtures must be replaced or updated with water saving devices,
i.e., low flush toilets, restrictors for shower heads and faucets, etc.
Approval is granted for sewage disposal only. 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.
Ver truly yours,
beal,
Robert Morris, P. E.
Public Health Engineer
'RM/ j P
cc: BI (T) Putnam Valley
N
... _�n -v ° .. _ ..�.c>..- .. ...v-.,, . .. -, ,.,,,. f.. .....c-.. t,.. ,..�...: ».,.. K. =:_. ._ �... - -, -c c. ..ur.:t..+.�. avr- . aa-. 4,'. �. » .,,A.,- .....o..:a :, ... s i7.e.. �.c. a•- .«S�e.:>, :�,w�w - -i.r a'- r..� -m;ww^ .
William Kennev
14 Crescent Lane
Putnam Vallev New York
10579
Robert Morris
Putnam Countv DON
4 Geneva Road
Brewster. N.Y. 10509
Mav 13. 1995
Dear Mr. Morris.
As per our conversation. I am- enclosina the following
1) Floor plan for first floor
21 Floor plan for basement floor, includina proposed addition
3) Copv of survev showing well locatior.
4) Cores rof detail showing septic location, house location.
and well location
51 Cc-o es - ^f 1ra!,vi gs for �?ie ad- 1i'-•iosi
6) Monev order in the amount of S 100.00
Please review and if approved, issue the permit as required
by Mr O'Dell from the building dept of Putnam Valley. If you
have anv questions, please call me workdays at t 9141 235
7000 Ext 509.
Sincer,ellv
Wil ia'm Kennev
............ ..
e-fY\
Ll
W ell
TWO
Y-
OF HEA 4
00
Dc n
i 6 x 13�
IL
in
TITLE NO. LTP t � — / /O/
CERTIFIED TO: +�
WILL /AM J. KE'.'4VEY,
LAWYERS TITLE la'suRANCE CORPORAT /QN
FIRST FEDERAL S,MINGS yF LOAN ASSOf /AT /ON
OF A?06' &ES7tER
IN ACCORDANCE WITH TH�t EXISTING CODE OF PRACTICE
FOR LAND SURVEYS ADOPI$D BY THE NEW YORK STATE
O
ASSOCIATION OF PRF': SIONAL LAND SURVEYORS.
CERTIFICATIONS SHALL RUN'ONLY TO THOSE INDIVIDUALS
AND INSTITUTIONS SHOWN �iEREON UNDER THE TITLE POLICY
NU.NBER SHOWN ABOVE.,,!,AID CERTIFICATIONS ARE NOT
TRANSFERABLE. , ,I
.le
PREMISE5 SHOr'L N HEREO/V BEING LOT / -S
AS SHOWN ON 15USD /V /S 101V MAP OF-
B /RCH H /LLS� ?£CT/O/V I % 5A /O MAP
F /LEO /A/ TNE'bPUT/VAAi, COUNTY
CLERK'S 0,17F111. E- ON MAY. 1, /973 AS
14AF7 lVo. /$/7,'
is
c�
!i
Sa
.�I
All cerrificamions hereon e.s: Valid for the map and copies
thereof on:y B said to :lid
boor the impressed
seal of the sarYeyar m., 6>se denature appears hereon.
SURVEYED ;1 PREPARED BY
SUNNEY ASSOCIATES
LAND rURVEYORS
RURAL ROUTE rs2+ FIELDS LANE
NNO�ORTHHSSALLEE%I NEW YORK 10560
w� )
N. V.5 /t +1C. No. 49322
i
LOT 16
LOT lf±� .
r _
/ STORY
FRAME NOOSE i
C% It l
• ` eea ®���� e��� b�6��EL�s�
Z15.00.,
��.s� ioSONaLT ,
'••: S, B.�a54 w' �ASPNALT PAVEMEN T�
—,---LANE y
A E - - - --
Cp�sCCN /
. 1-07 /5
AREA = I. 005 AC.
= 43,775s.F
Unauthorized alteration or addition loo survey
map bearing a licensed land surveyors seal Is
o violation of Section 7209, sub - division 2, of
the New York State Education Low:;
The location of underground improvements or
encroachments, If any exist, are not certtfted
.32S.08,
r Rg
A
<C'i`
/3
SURVEY OF-
S1 MATE /N THE
7��-:WAI OE PUrN VAL LE'P'
PUTMAM GOUMT)"
NEW YORK
SCAL FFr /" = 40' OATS: .JUNE Z9,1969
I'
CERTIFICATION REVASE'O LJUL Y 6, /9£35
FILE No. P36 -/ -
P38 -4 -- - - - - --
l�
TITLE NO. LTP t � — / /O/
CERTIFIED TO: +�
WILL /AM J. KE'.'4VEY,
LAWYERS TITLE la'suRANCE CORPORAT /QN
FIRST FEDERAL S,MINGS yF LOAN ASSOf /AT /ON
OF A?06' &ES7tER
IN ACCORDANCE WITH TH�t EXISTING CODE OF PRACTICE
FOR LAND SURVEYS ADOPI$D BY THE NEW YORK STATE
O
ASSOCIATION OF PRF': SIONAL LAND SURVEYORS.
CERTIFICATIONS SHALL RUN'ONLY TO THOSE INDIVIDUALS
AND INSTITUTIONS SHOWN �iEREON UNDER THE TITLE POLICY
NU.NBER SHOWN ABOVE.,,!,AID CERTIFICATIONS ARE NOT
TRANSFERABLE. , ,I
.le
PREMISE5 SHOr'L N HEREO/V BEING LOT / -S
AS SHOWN ON 15USD /V /S 101V MAP OF-
B /RCH H /LLS� ?£CT/O/V I % 5A /O MAP
F /LEO /A/ TNE'bPUT/VAAi, COUNTY
CLERK'S 0,17F111. E- ON MAY. 1, /973 AS
14AF7 lVo. /$/7,'
is
c�
!i
Sa
.�I
All cerrificamions hereon e.s: Valid for the map and copies
thereof on:y B said to :lid
boor the impressed
seal of the sarYeyar m., 6>se denature appears hereon.
SURVEYED ;1 PREPARED BY
SUNNEY ASSOCIATES
LAND rURVEYORS
RURAL ROUTE rs2+ FIELDS LANE
NNO�ORTHHSSALLEE%I NEW YORK 10560
w� )
N. V.5 /t +1C. No. 49322
i
LOT 16
LOT lf±� .
r _
/ STORY
FRAME NOOSE i
C% It l
• ` eea ®���� e��� b�6��EL�s�
Z15.00.,
��.s� ioSONaLT ,
'••: S, B.�a54 w' �ASPNALT PAVEMEN T�
—,---LANE y
A E - - - --
Cp�sCCN /
. 1-07 /5
AREA = I. 005 AC.
= 43,775s.F
Unauthorized alteration or addition loo survey
map bearing a licensed land surveyors seal Is
o violation of Section 7209, sub - division 2, of
the New York State Education Low:;
The location of underground improvements or
encroachments, If any exist, are not certtfted
.32S.08,
r Rg
A
<C'i`
/3
SURVEY OF-
S1 MATE /N THE
7��-:WAI OE PUrN VAL LE'P'
PUTMAM GOUMT)"
NEW YORK
SCAL FFr /" = 40' OATS: .JUNE Z9,1969
I'
CERTIFICATION REVASE'O LJUL Y 6, /9£35
FILE No. P36 -/ -
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0 or Purc aser uil ing
Building Constructed by
Location - Street
Building Type
Section
Block
_ Lot
GUARANTY 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 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 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 de-
termination of the Director of the Division of Environmental Health Ser-
vices of the Putnam County Department of Health as to whether or not the
failure of the system to operate was caused by the wil u or n li n_t
act of the occupant of the building utilizing the sysm'
Dated this day of 1- S Signature
Title J►�,
If corporatF, on, give
and addres )
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.
914 -245 -3203 YORKTOWN MEDICAL ZaBCPj TORY
YGRK'IOWN HEICHTS , N. Y. 10.98
A. H. PADOVANI, M.T. (ASC*)
The Meaning of the Water Analyrsi s Rrt
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 coliform group.
The item bacteria per ML (Milliliter) is a measure of total bacteria present.
One quart of water contains 940 milliliters. One ML of water is added to a
nutritive medium which acts as a source of food for the bacteria. This port-
ion of water sample plus medium is then incubated for 24 hours at 370 centi-
grade. 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 sample.
The second determination, the M.P.N. (Most Probable Number) is of-more
importance since it is a specific test for one group of organisms, the Coli-
form Group. The Colifnrm Group includes several species of bacteria which
are, more or less, normal inhabitants of the intestinal tract of man and
many other animals. Consequently, they are found in tremendous numbers in
fecal matter and sewage. The organisms of this group are usually not danger -
our in themselves, but, when found, they do indicate potentially dangerous
contamination since sewage at any time might carry pathogenic or disease-
4
producing organisms. Tyre source of this contamination might be a sewage
system which is located too close to the well or spring. It might also re-
sult from failure to protect the water supply from surface drain: -r o or con-
tamination or, the entrance. of small anJmalsa t ^nT time a water sy -tem is
-
rep-aired ed olo -oponed up; it should "be •sterilized•by the addition of chlorine
in some form before being returned to use in order to eliminate any contam-
ination which might have been introduced. MPN is a statistical term which -
is used to estimate the concentration of those Colif orm organisms. A stat-
istical evaluation is used since several portions of varied size are sepa-
rately cultured. A negative test is indicated by a value of less than 2.2.
Any value other than this indicates the presence of Coliform organisms and
gives reason for stating the source of the sample is not satisfactory. This
test requires a minimum of 48 hours and, very often, 72 -96 hours.
It must 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 effect on the
sanitary quality of the water. Consequently, analyses should be made as
often as circumstances warrant.
There is a Government pamphlet, available-from the Supt; of Documents, U.S.
Government Printing Office, Washington 25, D.C. which give more information
on this and related subjects. It is:
Individual Water Supply Systems
Public Health Service Publication No. 24 -256
Individual Sewage Disposal System
Gentlemen:
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION Or RIVVI.KUIVNILNTAL` 1i iL'I'H SERGICR5 -.
Dated M so
Re:* Property of
Located at
Section Block Lot J'j
This letter is to authorize vv \`- k { OA ��v�" R ''r
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
L W111CL 11V11 w1 i.I1 Oils uma L i ev ani-1 to. Supervise the coristruc iui n of said
system or systems in conformity with the provisions of Article 145 or
LUUlitltiOii- uc'iGv' .21C cliul-.C: 1.0 a1L11 °'1:.aW; _.c4'il! �lle- tUlllcim'c.OlxllLy' Jc111Y- .
tary Code.
Address
Telephone
ry truly yours,
gne d
Owner of Property
Address
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
COUNTY °OFFICE �BUILDING, y1CARMEL, N.. Y. 10512
DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owne r ")*�y.3 Q o��� S Address
Located at ( Street �ftv��� �- t,l ^Sec . Block Lot J
�n-dica e nearer cross street)
Municipality��t,�&vv\ 0 Watershed
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run Elapse Depth to Water Water Level
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
cL 20 Z2 2 to
3
4 3 .1 '`� � l� l� ICi 5
k9
2.0 -z;-z_ -z -7
5
Notes: 1) Tests to be repeated at same depth until approximatelyy 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.
7-
2
20
5 I.L. 4-5:
cL 20 Z2 2 to
3
4 3 .1 '`� � l� l� ICi 5
k9
2.0 -z;-z_ -z -7
5
Notes: 1) Tests to be repeated at same depth until approximatelyy 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.
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION 1
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. 1 HOLE NO. HOLE NO.
. i!. _t... -e. ...otv � � r ' r ... - � �.:4 �� �.1w'�� r - . • ... yr _. .....- ....... -J . _ - -. �...n.�. x:.14 f...t... �... O . �tM^ . .. a.._ _ �-. .� a_. a . •.'f �T .:..r � - . • Y" • .r .. ........ _- J'. _... ... .
6"
12" 6,1
2411
3011
3611
36"
4211
48"
5411
60"
66"
7211
7811
no
INDICATE LEVEL'AT WHICH GROUND WATER IS ENCOUNTERED X--JC)4
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTE �
TESTS MADE BY WPL VZ- Q- Date , i 7 a (o[_��7 3
Soil Rate Used i� Min/1 "Drop: S.D. Usable
A.
No. of Bedrooms _Septic Tank Capacity IW-�3 PM e
Absorption Area Provided By Z,! � L.F.xN" th ' nc .
ure
Address
Nc, 4s,'.
PROFLSSIO�
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved Sq. Ft /Gal. Checked by Date
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