Loading...
HomeMy WebLinkAbout3230DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -14 BOX 26 21 i!k 4 so `l. km! am f ` , UL i 03230 M3 ���'Q PUTNAM COUNTY DEPARTMENT OF HEALTH v �-b Permit � f. Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Located at _ Cr k -� al l( t�" �� I �j„t� t= own or illage Tax Map Block I _Lot` -- , S4'.04,"ii is)!3r!- .: 7,r,..�.••- ° —'- --'."... ( -� - 5ubu. Lot q Renewal `_Q.., . Revision Owner /Address -Fr_,Aj,,j6i, F)i2LytJk �" ' li)L�,I vt i;r 6� ii�.{j �,"gi ' �.r'�)Jji4te Of Previous -� Approval Building Type p'` L-/J7�r [7 i 1� t Lot Area _Z- A <f, Fill section Only ❑ Number of Bedrooms • Design Flow G /P /D c C'!ir p P.C. H. D. Notification Required Separate Sewerage System to consist of f L: e! of s• Gal. Septic Tank antl "-al►o 1, -: <1= L =i�J= i+✓ i i' �C -i-f � �i7k' � f � L . To be constructed by t't s4 .vl I ) Icz, i,y�. j Address / water Supply: Public Supply From _ Private Supply to be drilled by Address Other Requirements t"` v "71' 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 an regu a ions o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will place 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 f he a operating condition any part of said sewage disposal system during the &Rod of two (2) years immediately following thedate of the issu- ance of the approval of the Certificate ot. Construction Compliance of the-origin aI syste o` n re �,Jls thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be install�IiEtlh��,wA'�ia County Department of Health, ndards, rules and ►egu a on$ of the Putnam Date /lli�r `T_ / %h �f ASSOCIATES, P.C., Address - i / ,lil9rr�cf ri+ : /L f Cj``st �` /V -4,1 License No. `S*Z APPROVED FOR CONSTRUCTION: This approval expires one year from the date issue Wes construction of the building has been undertaken and is revocable for cause or may be amended or modified when con Bred necessary b the C mmis ' ner of Health. Any change or alteration of construction requires a new permit. Approved for isposal of domesti it y se ge, / wa only. Date._ tJ ^g BY Rev. 9 -81 V Title 7_._ . (4 t1r,05 1 PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER MUST PROVIDE ' Division of Environmental He8/fri Services• Cerro% N. Y. 10512 PERMIT # PV 25 -84 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM T Putnam Valley Town or Village Located at Old Church Road Tax Map 72 Block 1 Owner Antonio Salvato / Formerly Tax Map Lot M 4 Subd. Lot iS.0. 2155 Separate Sewerage System built by . Dam-Fino Const., Co., Inc. Address Peekskill NY 10566 Consisting of 1250 Gal. Septic Tank and 6' x 4' x 4' Galleries w /12" grave l /crushed stone under and on all sides Other requirements Water Supply: Public Supply From X Private Supply Drilled By Norman Anderson Address Bar er St. Putnam Valley, NY 10579 Frame No, of Bedrooms four Date Permit issued March 25, 1985 Building Type no Has Erosion Control Been Completed? yes Has garbage grinder been installed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the Permit issued by the Putnam County Department Of Health. August 28 � 1985 Certified by P.E. x R.A. Date g Address 09-Fair St.. Ca 1 NY 10512 License No. 29206 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public unitary sewer becomes available and the approval of the private water supply shall become Mil and void when a publi afar supply becomes available. Such approvals are subject to modification or change when, in the judgment of the o Is nsr of H Ith, ch rfivocation, modification or change is necessary. Date —� BY - Titb Rev. 6/85 s 0 1642 NEW YORK STATE DEPARTMENT OF HEALTH 128 Hot PAGE >I >N: »: < ::::........... ........................:;<;::: FINAL N A L R REPORT O RT E UTS::<: >:;:::::;:;: >:;:<. >;:. . R _S .Ir _ 0 F EXAM I NAT 0 _ .. _ .. . ----- - - - - -- PARAMETER----- - - - - -- ---=------ RESULT---------- - - - - -- 1~.... <:: 0......::. �............. M .:.:.::::::::::::.::::::::::::::::::::::::.::::::::::::::::.::::::::::: ::::.::.::.::::::: :::::::.::::: �................................................................................ ............................... .. .......... VINYL CHLORIDE < 0.5 MCG %L BROMOMETHANE < 0.5 MCG /L ;::U:.... ME:T :..: N: E:.>:.;:..':)=.t � :E..:N;- ::1;:1;';::::: » »: >: >::; »>:: >:;; ::..............El.......M. G... .............................................................:::::.::.::.:.: :::.::.:.::::...::.:.:::::::::. . .......................................... ............................... 1,1— DICHLOROETHENE < 0.5 MCG /L METHYLENE CHLORIDE (DICHLOROMETHANE) < 0.5 MCG /L :.....::::::�::::; j.... <;.;; i::<:v;i;;i; j :..............0... ..i�1�0 .. �..... .........................:..... . :•i:::.;:v:i:'i :.::.: : iii:•;: v;: .is'ii:i:i:ni::j::;ii::::::i::: 1 L:Qf#1:E.Ti ............ v::::: i:: i::: 1..............:,:.:........:.::.:::...:::::::::..::::::::::::::::::::..:::... ..:.:.......................... 2,2— DICHLOROPROPANE < 0.5 MCG /L CIS -1,2— DICHLOROETHENE < 0.5 MCG /L BFt. .£ RIP, R. METH. AN1.:.:::..; :.::.:::.::.;::.:;:.:;..:..;:.; '.;:' ::.:' ::::.:.:..:::..:.:::.:.... ... 0....::.NiIG.:: ::.:.:....:.:.::::::::::::.::::.::.......:.....::::....................... ............................... i , 1j 1 -• i R•i ChLOROcTHNNE .. .... .. <..0: y ..r CG /L ............. . .•.:.. 1,1— DICHLOROPROPENE < 0.5 MCG /L 1...2....D..[.1�liL. R..E. THAN ................... ............................... ...:. ............... ............. 1.`..........................:::::.:.:::::::::.:::.:::.::::::.::.:::::::::::::::: :::::::.::.:..:;.:;.::.:'.::::. ........................................................................................ ............................... BENZENE TRICHLOROETHENE < 0.5 MCG /L � :.4,1 ��1tV �: L tP.`i.1.:vit�.�i�.G: }:.... +.:41•.: r ..:........::......................................... ............................... ....! .F..:..:f.:..:::::::::::::.: � :. �::. �:...: �:::. �:::::::.. �: ,:.:::::::::...::...::..:: ,..:. ............................... _ . OIBROMOMETHANE CIS- 10- DICHLOROPROPENE < 0.5 MCG /L MR. NOR1!1 E ....:............:..:................. ............................... ...:..:::: ��.:::::::::::::.::::::::::::::::::..::::::::.:.:...:............................ ............................... 1,1,2— TRICHLOROETHANE < 0.5 MCGL 1,3— DICHLOROPROPANE < 0.5 MCG /L .......................... ............................... ................. ..............................� t�`t.l.l<f.1��.0..: �.::.1V.E.XT::: PA1.. E....::::.:::::::::::::..:...................................................................................... .....:::::::::::::::::::::::::: NYS ELAP ID'S: 10762(INORGANIC,NUCLEAR) 10763(ORGANIC) 10765(BACTERIOLOGY) V I R� IVME NTANEALTH;::;::;::;::;:; DIRECTOR 0 FEN 0 ::........................................................................................................................... ............................... PUTNAM COUNTY HEALTH DEPT. l/B3W 5`0 » 7/B3W 5^0 > 3N3ZN380H0lH3|8l-PZ^i ]NVJ0UJO80lHJ-[-0W08R|O-Z^i -- _ 3N3ZN3B0B0lH3|O-Pi l/B3W 5`0 > � l/D3N 5`o > ' 3N3ZN38lAlO8-lB3l ` l/D3W 5`D > ]NUN]80WO88 l/B3W 5`0 »- l/D3w 5^0 > IN ns l/B3W 5`0 » 7/B3W 5^0 > 3N3ZN380H0lH3|8l-PZ^i ]NVJ0UJO80lHJ-[-0W08R|O-Z^i -- _ 3N3ZN3B0B0lH3|O-Pi l/B3W 5`0 > � l/D3N 5`o > ' 3N3ZN38lAlO8-lB3l ` l/D3W 5`D > ]NUN]80WO88 l/B3W 5`0 »- l/D3w 5^0 > ns W G "X4.6 E.4-- �' 1e s PUTNAM COUNTY HEALTH DEPARTMENT Y V DIVISION OF ENVIRONMENPAL HEALTH 5Ef7VI _ PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME J V %2 A I-t N\ kgl SITE i=TION n2 t P � o C-p C MAILING ADDRESS ''"Y U;N ff A-k k f %N L Le' 0 PHONE S724-- � H 3 F( O PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE I 'Z- TYPE FACILITY S PROPOSED INSTALLER *" e� X46 tip- i PHONE � 2,6 02 Pro (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. Proposal approv`� Inspector's Signature & Proposal Disapproved Date Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed ccmponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. [, as owner, or reported a t of owner agree to the above conditions. SIGNATURE TITLE 46 ruq T DATE I 'L Z US: White MD); YeLlcw (Tam HI); Pink (Applicant) Antonio Salvato TM 72 Owner or Purchaser of Building Section Francis Braun 1 Bui-ldif - -CariaYru`cT ed by -- Block Old Church Rd. 4 Location - Street Lot Putnam Valley Municipality Frame Building Type Subdivision Name Subdv. 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- ;: -.. - .a.t.ion. of., the,.. D, irector- • - of- .- the.. Div- is ion •- of- - ,Envlronmental .Health. Services 'of ' 'the"Putiiam''County - Department of Health' as to whether or not the fail- 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 6 day of August 19 85 Signature * There were minor changes in original. Title president design by Mr, John H,Prentiss,consulting engineer,but all were approved in preseni� Dam -Fino Constr,Co,Inco of Mr,WoC, Jamison, Corporation Name if corps) Peekskill, N.Y. 10566 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 Antonio Salvato Owner or Purchaser of Building Francis Braun TM 72 Section 1 ,Building Constructed by Blo -c__ bid ChurchRoad . . _ --4 Location - Street Putnam Valley Municipality Frame Lot Subdivision Name Building Type Subdv. Lot #E 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 Services ..o.c..th.e'._ Putnam. -- County Department.. o.f;.- Health - -as • to .whethe o-t w " �T ure of the system to "operate' was caused by the willful or negligent act of the occupant of the building utilizing the system. 6th August 85 � _ Dated this day of 19 Signature Title owner Corporation Name if Corp. 140 Tuckahoe-..Rd., Yonkers, NY 10710 Address l 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 i'orktoWn Medical Laboratory, Inc, LOCATIONS: ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245 -3203 32i KCar StfC2t *9 01 BUTTONWOOD AVE., PEEKSKILL. N.Y. 10.566 737-8777.- - Yorktown Heights, N. Y. 10598 ❑ 495 MAIN ST., MT. KISCO. N.Y. 10549 666 -3335 (914) 245 -3203 ❑ STONELEIGH AVE. EAR HOSPITAL), CARMEL, N. Y. 1 0512 278.9330 Director: Albert H. Padovani M. T. (ASCP) DATE RECEIVED: /J G�i1C�iv.r DATE REPORTED: SAMPLE SOURCE: L a # J �� • fi�i✓C: l� Dam �OC�'i'�.d Ok�,� �Gi , Gc,i REFERRED BY: L �0'j &0 1 Collector: y1f - 6 l LABORATORY REPORT mg /L ❑ ACIDITY ................... :........ ............................... ❑ ALUMINUM ................................ .........................:..... ❑ ALKALINITY ; P= ......:...... A= ....................... ❑ ANTIMONY ................................ ............................... P*ACTERIA, TOTAL /mL ............ RS.e7 .......................... ❑ ARSENIC ....................................... :........................... ❑ BOD, 5 DAY ............................ ............................... ❑ BARIUM ....................................... .....................:......... ❑ BROMIDE ............................ ............................... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE ........ ............................... ❑ BISMUTH .................................... ............................... ❑ CHLORIDE ................................................... :....... ❑ BORON ........................................ ............................... ❑ CHLORINE ............................ ............................... ❑ CADMIUM .................................... ............................... ❑ COD .................................... ............................... ❑ CALCIUM .................................... ............................... ❑COLOR ( units) ................. ............................... ❑ CHROMIUM (tot.) ............................ ..............................: ❑. CYANIDE ............................ ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ............ ............................... ❑ COBALT .................................... ............................... ❑ FLUORIDE ............................ ............................... ❑ COPPER .................................... ............................... ❑ HARDNESS ............................ ............................... ❑ COLD ........................................ ............................... ❑ MPN COLIFORM COUNT/ 100 ml ............................... ❑ IRON ........................................ ............................... 6 C1'COLIFORM COUNT/ 100 ml ....0 ................... ❑ LEAD ........................................ ............................... ONFIRMATORY TEST ............ ............................... ❑ LITHIUM .................................... ..........:.................... ❑ NITROGEN, AMMONIA ............ .....................:......... ❑ MAGNESIUM '................................ ............................... ❑ NITROGEN, KJELDAHL ............. ❑ MANGANESE ......................... .........I..................... .............................. ....... ❑ NITROGEN, NITRATE ............ ............................... ❑ MERCURY .................................... ............................... ONITROGEN, ORGANIC ............. .._..... ...................:..:. ❑: NIGKE,L. , ......... . ❑ ODOR ..`,anits) ::.:........ . ............................... ❑PALLADIUM ............................................................... ❑ OIL. & GREASE ........................ ............................... ❑ POTASSIUM ................................ ............................... ..................................................... ❑ RHODIUM ❑ PHENOL ................ ............................... ❑ SELENIUM �: :......: :,. ............... ............................... ❑ PHOSPHATE (ortho) ............ ❑ SILICON D << ❑ SILVER ❑ PHOSPHATE (condensed) ........ ............................... .... "*•, r^.��. .... .......:..... .......................... 1 �- ❑ PHOSPHATE (total) ❑ SODIUM ❑ SOLIDS, SETTLEABLE, ml /L ❑TIN Z� .. -._ rte,, -r .............'v }........,::_.: T:........... .............................:. ❑ SOLIDS, SUSPENDED ............................ ❑ ZINC . .f. .............. ............................... ❑ SOLIDS, DISSOLVED ............. ............................... ❑ .................... �..........__f--:........... ............................... ❑ SOLIDS, TOTAL ..................... ............................... ❑ ..................................... ::............... ............................... 11 O SOLIDS, VOLATILE ................ .........:..................... ❑ REMARKS:...... ZaD............................................................ ❑ SPECIFIC CONDUCTANCE (uhmo s / cm) ❑ .................. ............................... ❑ SULFATE . ....................... ............................... ❑ .................................................... ............................... ❑ SULFIDE ............................. ............................... ❑ .................................................... ............................... ❑ SULFITE ............................. ............................... ❑ ..........................:,........................ ............................... ❑ SURFACTANTS ..................... ............................... ❑ .................................................... ............................... ❑ TURBIDITY ( NTU)............................................... ❑ ..............................................:..... ............................... THESE RESULTS INDICATE THAT THE WATER WAS " OF A SATISFACTORY SANITARY T QUALITY WHEN THE SAMPLE WAS COLLECTED. i- THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEM- .I,CAL QUALITY OF THE NEW YORK STATE ADMINISTRATIVE RULES & REGULAT.IONS, ()D,'R NK YNG ATER S ND RDS (PART 72) FOR THE PARAMETERS TESTED EN H r AMPLE AS OLLECTED. N/A = not applicable Albert H. Padovani M T_ (ASCPI Mrpmnr ,.. -- WELL. COMPLETION REPORT . PUTNAM COUNTY_ - DEPARTMENT OF HEALTH 3/71 Division of Environrnontol Health Sorvices COUNTY OFFICE BUILDING - CARMEL. NEW YORK This report is to be completed by welf11•4ler and submitted to County Health Department together with laboratory, - report of, analysis�.of water _.am f satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION NAME ADDRESS OWNER e LOCATION (No. Ir etj . w (Los Number) / OF WEII. BUSINESS ❑ ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WEII ❑ ❑ INDUSTRIAL ❑ CONDITIONING ❑ SUPPLY (Specif ) DRILLING RT COMPRESSED CABLE OTHER ❑ ❑ ❑ EQUIPMENT ROTARY AIR PERCU,$SION . PERCUSSION (Specify) LENGTN (leel) DIAMETER( /irMesl WEIGMT'PER FOOT' CASING ❑WELDED TES. NO DETAILS / I THREADED TES NO YIELD HOURS G.P.M. ❑ BAILED ❑ PUMPED 0 COMPRESSED AIR YIELD IO.P.Y.) (� TEST I WATER MEASURE FROM LAND SURFACE— STATIC(Specily leaf) DURING YIELD TEST (feel) r Depth. of Completed Well LEVEL in fe•Ybelow land surface: Q MAKE LENGTH OPEN TO AQUIFER pesfi SCREEN DETAILS SLOT size DIAMETER (Inches) GRAVEL SIZE (Inch" ROM (lost) TO (Ie•I) IF GRAVEL Diameter of well including , ►ACKEDS gravel pock (Inch"). DEPTH. FROM LAND SURFACE fORMA110N DESCRIPTION Sketch exact location of well with di.Stoneaa, to of INaef two permanent landmarks. FEE1 4o FEET I .. T� - . �i "i, • , 1 T ��� k » ur is 1 .. iE!'I}r'�1� '1.. x E��'t} �tyy-f}Lia�`E ki(. tc'F'�''7YJ f '� b• ! flr� H 1 �9��) f5 r •� 1 5 4 /`� 2.' Y l 5rvf, 1Y•z r }51 `Y 11� rr...Ki�kl 1 ✓}'sea ltd r i r s ' t�+ 5 b'' r If yield' was tewd pt difFaranf da tlh� during drill „ r4 FEET ]h1U1E Y t 5 s tY a 1 .•�'yf ,1. .,y %'kJ/• ry ASS 1 9 i t t j l Y� �l jr4f �xti'}8frr lr l�t:.r4�5rix'1 1�A�hLu'. Z. e kr }tfrSw }$�t'kY`tdf are wT5! Sin.+4 jX 2 , •, 1 1 h t DATE' ELI CO '►LETS . i ; ' DATE OF gEPOpT V RILI.ER ( ns use) :t PUTNAM . COUATT DI:VIISION- :.OF E .VIRONMENTAL .HEALTH SERVICES Date Rem Property OZ,, 11t-74U4�) Located at Sec'tior ' / 7L Bloc WILLIAM A. KEANIM Gentlemen a Assoc, ^ T7-7% P.Ce 4 PROFESSIO �� �':IOR4TION This letter is to authorize A�y'i�2�%Z�Ll ®� x.�a duly licensed professional engineer or registered architect (Indicate) to,,gpply fore- a:.Construction Permit for a separate sewerage system; to aer..ve <the`.above:.noted property .in „ac:cor dance :,faith °the's4tandards 4 or regul&tioh&....as 1proml- gat,e'd by:T the = 'Comm` ss�oner of stYie Putnam Cot nt ” 7 Department of Health, and to sign all necessary papers on my behalf in k connection ,with. this .matter.anc _tiz p �r tise ahe - n- struetivrr -©-f °sairi _ .....: _ .._ ......, _ v _.� . _....._ . system or systems in conformity with the provisions of Article 145 or 47., Education Law, the Public Health Law, and the Putnam County Sani- tary Code. `` - Very truly urs, FOR 4 dillLL.IAM A: KBA14k Ksigned ASSOCIATES, P.C: A PROFESSIONAL CORPORATION weer .o Property —7 ✓�atJOlEE Countersi•a ": - ___TA_f ep hAn e r �.v a - ... — n A 's ANDERSON WELL DRILLING RD 3 BARGER STREET BOX 244 ""'T�Ci'P CL "ESf; `NEYi/•c:—fO�tK"'�t75'j9�° LAKELAND e.e69B MAY 7, 1984 MR. TRAVIS re; well for Mr. Salvato Dear sir; MR.Anderson says he can get his well drilling rig in to drill a wellat the proposed spot. This well will be for Mr. Salvato on Old Church Road, Putnam Valley, N. Y. Sincerely yours Y Civil & Environmental Consultants 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 (914) 2412235 May 25, 1984 Mr. Robert Tutoni Putnam County Health Department County Office Building Carmel, New York 10512 RE: SSDS Permit Braun Putnam Valley, New York Dear Bob: Attached please find revised permit for the above. As you are aware, re- testing was performed and inspected by Mike'Budzinski earlier this month. In accordance with your review, the following revisions are shown 1) New test hole location. 2) Letter from the well driller indicating accessibility of well .site. 3) Location of adjoining well access on Old Church Road. It . is-. not =chat' tFiia.. well ;location was °:po`i rated oit- by' tle owner of that residence. 4) As you are aware, the possible subdivision of this parcel has been dropped and, therefore, adequate area is available for system expansion. We trust the above revisions meet with your approval. Very truly yours, ATT:mah Arthur T..Travis Attach. Senior Field Engineer PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. T. 10512 DESIGN DATA SHEET;-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. GLNiL7�J1G7 VL''1aCS�. Owner 2>904UN Address <,o &&W= C RD�J'S . Ng2'rSCWt.E �N•y. Located at (,Street ) OLD 614WG44 L04M Sec.TM 72 Block, _j _Lot L� (Indicate neares cross' s ree Mun c3_pality :PuTNAM VA I LuP y - Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS r Hole Nuin'6er CLOCK TIME 'PERCOLATION PERCOLATION Run Elapse Depth to . a er Water Devel. .. No. Time From Ground Surface in Inches.-.,.: ..Soil Rate. Start -Stop Min. Start Stop. . Drop in Min. /in drop TnnhPS Tnches Inches i 4_' tf . - "FT, Wj 4 _ ..'r , fi. .., ..R:.......k` y. r. 5' M y�c Y �•t '1 m.d1�, ..icw .� Ga .�'y;w(^� �% �i� W".{�, d- .+!n�'..+t . -. ..i.`�?ari ^r?. > i'...4... _- .J v� .� .J, _ T. 2 15 Al ,, �a ! $ -n. ..... 3 40, - ZIL i b DEPTH TEST PIT. DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. / HOLE NO. HOLE NO. -A .....�_�...._n.. c..,.?'i��e.e'tr ,: •set_r. -•�.. ::t_ _ ..�.. -:r 18 JA Vj> 2411 E� raju�� 3611 Loose- 46 LO�� iii ►uti� Gs��a t::�5 < iv /` :::. 54111 SANOS OF a"-a3 CoA,2SF_ Lac��44 ;78"r.. M "INDICATE': LEVEL: AT WHICH GROUND WATER IS ENCOUNTERED INDICATE, LEVEL: -TO WBICH.WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS,, WE BY K r4a-m � Assoc. .. Date e >, -T _.: D ._ ..:..�,.�.:�...�oi3--�e�- •�#sed ..�°:yr��1�.iD K._.i_..�.�.- .,3-.�. t�:�able. Ar�ea._.Provideti �': ..._ __- ...... No. of Bedrooms 4 Septic Tank Capacity Gals. Type `Absorption Area Provided Byh,F.x2�F " - -- Y width nth. �z C ' Roa... 0th .t.� yap. -.--r# _ WLLV A KEAVE , .: . : Address - t t : 2m. 1`aC . ASSOCIATES. P.C., _ $�I20FErSS10NAL CORPORATION THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ' Jt Soil Rate Approved Sq. Ft /Gal. Checked by Date f co - � pia ERUCE R. FOLEY, R.5 Acting Public Health Q:r, DEPART•',_ \T OF HEALTH 01 Health Services Gee; Roa., 6'_,:s: -;, New York 10509 (91 =- %78-6 130 -.�0 TIC? r'. =- ^ ^.i�C?� -_ (R= SIDDNT I k 0, -Y) a y3 TX P' =.c =7.. o " -•Grv/ r� =�sE �Juzavun �, �9-Mn P„o ?:E 52 & - si 3 Y P C' J PERMIT I M I ��o ��0 : y V ��jj - ADDRESS aqj Otd �twrcl� Rod,. 'P(4 0-m. a- M 1, tes ' 79 Description of Additi,-r, Ses) RANI, a7' -o? X 20 =-04- aN 2kj0 R, t,`-,mber of existing 3 11 rom. Car•tiflCate Of CccUp_. -,::y Or Certification frc:.m E,- lair= Insrctor rc_osee number of bedroa�s my a_dition which is conS':Csrez' a bE_ - rcyllres -1ori:ial. approval OT plans (Construction Pcer,,,it) rrE; -_.ed by a Pro-_ssion_l Engineer or Registered Architect n accprd?nce t; i th e�:c i i c i e se.: icr.z o; the Putnaim County Sanitary Code. Please submit this 10- a:. the f of i �.. , to Ps CWT, .HEALTH :,DEPA%RTMcI1T raT =?,_ Q 79 ",,_P :'�-.' _ �.7E "15134 4!"i tiY' Y(1 " i of icv`ri 9 nlornation i. Certified Chec', for $101.00. S' -'ch of existinc ficcr plan (all living area including basement, if any) Non- professional dra-�rin-z is accept;- :''le-3. Sketch of proposed floor plan. Ilion professional drawing is ccceptailcC 4. Copy of survey shcming 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. 5. Copy of Certificate of Occupancy frc :. Twin or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments..and /or conditions application August 1995 July 1996 (Revised) DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 April 22, 1998 Suzanne Weyn 243 Old Church Road Putnam Valley NY 10579 Re: Addition - Weyn, Old Church Road Increase in Number of Bedrooms (T) Putnam Valley, TM# 73 -1 -14 Dear -Ms. Weyn: BRUCE R. FOLEY, Pubbhc Health Director 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 April 21, 1998 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: 1.• The-tot_al namber,of hedr..00ms:.mu.st_ rema tnat' thre'o�witl^iout•= DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: U) tvvk_ Resid6nce Tax Map 73 " VC'C'u, To�vr► cL'kkk -"- Gentlemen: BRUCE R. FOLEY, F Acting Public Health D-e:t,. According to records maintained by the Town, the above noted dwelling iS ✓ IS NOT in com lance with ToxNm code and the total number of bedrooms on record is A" 3 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER CV c Building I , s lector I N/F ARENA L ?C9 P36d *.M.77-•-6.3 0 I 04ro a ). k, OL *4 Wo "w 32 (7F . 'i, %'R Lrr k 9;0 01 " TV. ?&-f)-a AW400 19 k Ar AREA ft 2.4331 AGNES I/ e4 j -'iS700K� F 8.7(;' '�O" ti AIP BRAIN L 840 P20J IV rM 72-1-4,1 LOrioNFAf.pjj4 "ev U 41 E el r RoAD "-Z " Suzanne Weyn 243 Old Church Rd., Putnam Valley, NV, 10579 fax.Er phone —(914) 528-5138 Cyr < t. s , t .' • t t ' 1 i t> — 92 BUILDING PERMIT Location of Premises Old Church Road - TM #73. -1 -14 Suzanne Weyn having •; heretofore filed an application for a co ermit pursuant to the Zoning Ordinance, Sanitary Code,:,: Building Code and the Laws in effect in the Town of Putnam Valley, Putnam County, New York, and having'. paid the required fee in the sum of NBC it appearing from the said application that the . proposed improvemeni is intended to and will comply with the requirements of the law as aforementioned, . a commence permit is hereby granted this 8 day of December work Additional information Septic Repair i NOTE: This permit `expires one year from TOWN O AM VALLEY, * �'�'• date of issue. By r.. i:' 01 PUTNAM COUNTY HEALTH DEPARTMENT t DIVISION OF ENVIRONMENTAL HEALTH SERVICES 225-0310 PROPOSAL FOR SHOM DISPOSAL SYSTEM REPAIR OWNER'S NAME e, \.�J Iz- PHONE 71,, -7-1 SITE LOCATION E a n = C. i-4 ri- C7 4 1z oi TK# MAILING ADDRESS A PERSON INTERVIEWED Pam Cauplaint # Name & Relationship (i.e, own6r,tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLER PHONE 2 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. 15-, v 5 Lt 4 H /C U.0 .1 r7l' :4 4e t /V J— Proposal approved Is Signature & Proposal Disapproved 4.1 Date roposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submisqion of as built repair sketch in duplicate showing: a. owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed ccmponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 61 diam. x 61-deep drywells; surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. as owner, or reported agent of owner agree to the above conditions. 4 SIGNATURE T ITLE DATE PIES: White (MD); Ydlcw (fin BE); Pink CkpUaint) vo 70' — A k4 man ---a- 49am-.,, eea 4r lot= i 4 Im a%" fa 0ow is dp f4m W Al OM AWN016 v OTOW o WA16 IWAIPL W 4.rV"7 Jar k" 1 40 0 V02,16 "m 4 9 Com I "MUM Sri" B DELO LR Oft "a EL SUBJECT To UTLrry B W m IN amm 14 WO Livam 337 wac 1702. REFERENCES: LVAP ENTITLtD'5WWViWW MF OF MIX MILLS. ritc-mm j• b, Al ExANUR UUNNIT. LA ON AN 3;. 1973.AND "ST RfvisEn ON MAT S. lwy3 AF40 I 'LLD IN rmf PmTkAff COUNTY Gan O"irt ON wA• 21,jg?3 A9 MAP 40, W7. Z WAP LNV: fLED "IUSCAMON P49PAW FOR FR&N:19 RRAIJIN JR." BY GFOROE M. &~R$, PE. a L S. ON A0, 1 1 -9ft A'6,• PI; F2 IN TNF PIJTIVAM COUNTY CLLOKS OF Mt ON #Jjr. •,1466 AS MAD Nro 2344 TULLY r 8, sm "V. Mt. WIP Ra, on .4 *"Opk N.Y. 10924 0% ENGINEERING AND WRVEVING, A f- I cc., 181,10" SURVEY MAP PREPARED FOR SUZANNE WEYN TOWN OF PUTNAM VALLEY PUTNAM COUNTY, NEW YORK r70f,Lp � W i b t:: as„r...�. c •y. i':.YJY V • a.a.0 a , r -�... ..:: = -�,.•. _ v. .... ..... . _ ......._ _.. . __ -.. y n Lgr 8&B r t09 a: pfA s.,y e.t�e wrLM Ae.{Ie� Ow" K' D VWA Iw o r M •o « 32 n2 AREA te a. 4 ,33k ACRES v �T eQ °i<,°c "F �O 41 q � WP ARENA �. L Y'C9 P36d ° 7: M.7? - 6.3 QV V h /f' BftdLIN °N L d46 P204 +l 71M 72-1 -4./ torfONF.AI.P390 Qv —assn C 'a m.a Jf "FO '^`y.' -�0 :x � • � •�: v 0° jc lol'.py R d t? N r ,A• 6i ROAD cl -, --. .- .__.___ -..� .�...� �..«. u•., oar• F,- 'Xi7r'. +M9%L i• rswrs mh No. All that lot4 parcel or pi#" of JAad sita4to 14 th* Tovn Of Putnam Valley, county or Put4as,.state of Nov Yortc, and being more particg;4ri,y dest ibed as fol; qvs: Beginning at s p4irt 4q a atone vall on tho westerly 1346 of old Church Road, aetd point being the southeaetsrly corner of lands n; -w or tormerVy Braun as shown on a filed map no. 2334, to Lot *1) thenes from said point of beginning along the • +esteriv line of Old t«horeh Road, and along said stone wall, the following ssveA courses and distances: (1) South 18= 27',55" Cast 38.02 feet (2) South 0_`- 001-45" East 17.60 fee; (3) South 11'- 00' -08" East 78.68 feet (4) South 03L54' -24" EaSt 25.84 leet (S) South 0648' -12" East 92.16 feet (6) South 011t-011-4911 East 50 . i s feet ( 7 ) South 00%.301-271, West 60.22 feet to a point; said point being the !northeasterly corner of lands now or formerly Arena; thence along the northerly line of lands now or formerly Arena and generally along a stone wail, the following five courses and distances: (1) North 76t.151-34" -West 120.47 feet (2) North 78°- 27, -00" West 40.80 feet (3) North 74°- 48' -00" West 32.02 feet (a) South 8 - 08, -0o" West 19.23 feet (S) South 00- 191=00" West 10.31 feet to a point; -thence continuing generally along a stone wail and a- long the ii:ae of lands now or formerly Lee, the following four courses and distances= (1) North 64•-35' -00" Kest 108.65 feet (2) North if- 26' -40" East 110.74 feet (3) North 08= 54' -20,• East 16$.9; feet (4).North 0541'40" West 21.68 feet to a point, . oi.rat.. being. on:.::the.- souther) 11 -nw are,�tavfd* -,*&6w or �rsiinf as' Z'hown on file; map no. 2334 as Lot dlt theACe along the southerly line of lands now or formerl? ltduh tM following three courses and distances: (1). South — 17'424" Ust 41.3? feet (2) North 57° 09' -00" Easb` $.�10 )set (3) i6fjM Q4L.01' -SON East 223.09 feet to the point or place of iAN as shown on a survey map prepared by LANC & TTILLY, A.Z., Alit . eComber 12, The above described parcel contains Lot 8, of 41clo$ 1. Section 72 as shown on the tax maps of the Town of PvtDAM V%JJgj(, Putnam County, New York. Subject to a utility easement as described In recorded deed liber 337 on page 202 as filed in the Putnam County Clerk's Office,Carme' New York. Subject also to any other rights- of- way,easement,aovenants or restrictions of record. The policy to be issued under this report will insure the title to such buildings and improvements erected on the premises which by law constitute real property. FOR TOGETHER with All the right, title and interest of the party of the first party, of, in and to the land lying COMONLYC in the street in front of and adjoining said premises. Pass 2 w, Pam 4 NIF ARENA 1.'1109 P356 a Jv At ellJ 4Jr, O C J (6A b.M qxa• . nf lyptM I\ � ri; 1. bEI C 14 Ap"o 4 NrA. • ti 4L IN 15c. SJ° '� ,R0A b ✓ J , N E oL0 --.�_ 50.15, 56 48 12,1E 9z �.._ _ _ ..slr °aoo�'r RoAt e 6t ' :T J C,,,_.,, hW sw*S ME N �O PM AcrdA6�Ft�sr CQWLg CM egg. , $vZANNE WEYIY FINST AMERICAN TITLE INSURAMCE COMPANY INDEPENDENCE ONE PURTOACE CORP CHN�E9 w WALLACE 0. E K Y 9. LICENSE IYO. 49069 33 A::CAL w \t g 9Ee YAP 'i2.7oAC.CAL ?�; I . ' ' y P1O 619ISAC. t � J• 4 C. ' •' ` t 37.916 aC:rr 't'Ne' -i 7.14 • AL `` 3 ACz 36 C AC. et vi .. 1 .. 13:1 T � I6 � „� � • .aa • S ± 4u.17'+0. 10.725 AC. 9.4 0 _i• S 7.1 •.a 123 ' 23 AC ci S 2329 AG !s •9IA z J ' i % 9.1 "� 13'3 • �.n� s �6�A ' O2:OAC 3424C Y1C � C�•., �, t',. �: 6.t = xe• t 122 �i+ y.•.. 6.15 AC :rw�cN oA 3f� b 4.27Ar- Na ��VVVit 9 9'/9AT8.�.•�? a= �1' t ++, s • 10 g 22 �/ q. 9°, , �,SO — - CA:. .• � '•,, f 13.5 1; 3•r:•.3;► 171 • L3sv •�cd? - .wa IC wl ?� p2 • IAC. f 4 i ♦o 3 1 r•.•� . + � t2 „LOJ` ,ti , ti=. 2. 13.94.. CAL 192 22.1 ACC r.9 _ 1ti 6 , fib' ja i RRAMERS {� '341 1AC 1Ji1 »0 1.25 A- r � .�•o : 11 3 ,a.. � ?t� s e •�. T.4 F `•, t� 13.x /: • Ca- tAG P yPAt CA, Af. �-1YY \° 7. � tit. 72 na A, Los ' jc zA- • � `o , - - s . y ' f'': `� .086 AC / ” a f, dr T ' g.' 2 4.0 e3 AC. j' a 196 iC 8. I:P At. 14e1 23 • 14 - - � • �`v 10 ��r , t rf I d 22A>:CAL .16 �• e 74.744AC, 7162 AC. CAL �o �•� . AC. .�'. L� �,f,:i.'. 7'. a .ff�' �07as:� ^•� `�. :.. .. • t+ , DEPARTMENT OF BEALTH Division of Environmental Health ",Services 4 Geneva Road Brewster, New. York 10509' Tel. (914)'278-6130 ' ;Fax (914).278--7921 April 13, 1998 �/t o�r� Louise Seidel n 5 ake- Slier- e-Drive C ovc ,0 4e PIC Vz teLso NY 1 6-3-' SUBJECT: VOLATILE ORGANIC SAMPLE Dear Ms. Seidel: BRUCE R. FOLEY Public, Health :Director Attached is a copy of a laboratory analysis done on a sample of water collected at your home on March 31, 1998. The results indicate that the drinking water meets the standards of Part 5 of the New York State Sanitary Code for the parameters tested. Nevertheless, one compound is present in trace amounts below State standards: parameter, Result(mcg /1) State Standard(mcs /1) methyl . tert.butyl_�ther_(MTBE- )_.__ -___.. _ - - No treatment or further action is required at this time. Should you have any questions, please contact me at this office. LW :tn cc: D. Lince, NYSDOH V. McCabe, NYSDEC New Paltz Sincerely, Larry Werper Assistant Public Health Engineer Structure located trom survey by surveyor noted belowo: -- - - - — Well located by. Surveyors survey.— 0 Well drillers report masuiements-0— Wriar "65 Tank, boxes, pits, galleries Sk laterals lo-cateid by: Contractor: Eng,tneers. Health dept: Field inspection by: Health dept date: Engineer date NOTES. rut.. county Department 01 11"11 Division of Environmental Health 68"'oed as noted :Ear conformance with 's noted of the pu ,ppjlo�ble Rides end Regulations ty th th Departm=t.... 116'1%4 I A. B A C - 011 -B C 1 A D 13 D -1 -7 Ai- E E A F --B F A Q G _—=— - -- _ PRE'V A H H J J K K 29 5ANIT'ARY SYSTEM DESIGNUAS BUILT" OWR6R: A&J-roHlo LOCATION Street: OL-l::-, 4:�L:l C - - f7-j-fP,4:i:1 oun ty SUBDIVISIOI M a P Block., LOT, N lt7�Z Builder: � -- Surveyor. )fawn: P7, L7 Date: o 00 N!L JOHN H PR E N T1 S'.S P. E