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03318
PUTNAM COUNTY DEPARTMENT OF HEALTH
f' ~. Division of Environmental Health Services, Carmel, N. Y.' 10512
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnmi. Valley (T)
Town or Village
Located at West Avenue 79C ... _•
Subdivision i' Lot ' rlVs_=49 onX
owner Philip Sasso 1004 an es ,
Address
Building Type Raised Ranch Lot Area 28!000 SF +
Number of Bedrooms 3 Total Habitable Space 1400 Square Feet
Separate Sewerage System to consist of 900 Gal. Septic Tank line 1 f t X width trench
To be constructed by Heady Pros Address prM 9rook a
Water Supply: Public. Supply From Putnam - :Valley
X Private Supply to be drilled by nFuekey well Drillers
Address. Sprout Brook Road RFD Peekskill,, NY
Other Requirements Curtain drain 61 Deep required to drain area If area does not drain., RXIBI
graved will be required get n 51 above e au-9 Water d ®�mgQ
1 represent that I am wholly and completely responsible for the design and location of the proposed system(s)
�el ��D..
a sewage disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with thaL9t a ions o e Putnam
County Department of Health, and that on completion thereof a "Certificate of Construction Complianoe' issioner of Healthwill
be submitted to the Department, and a written guarantee will be furnished the owner, his successorsr �, /! that said builder will
place in good operating condition any part of said sewage disposal system during the period of two12�e a in thedate of the issu-
ance of the approval of the Certificate of Construction Compliance of the original system or any repakift eret e d i ell described above
will be located as shown on the approved plan and that said well will be installed in ccordance with the a`'hi rds, u of the Putnam
County Department of tHUeyalth. ,,f o
Date N1ay 1, 19 /2 Signed o X
E. R.A.
Address 1 Northridge Ro eeakakill N.Y. �' ® 27$!,b X-X
APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction' 0 revocable for.cause or may be amended or modified when considered necessary by the Commissioner of Health. e � l►aI undertaken and is
or alteration has been a construction
requires a new permit. Approved for disposal of domestic sanitary se age, and /or private water supply only.
Date
–/T -- By Title /
-6-7
PUTNAM 'COUNT TY !?F-P R TMFNT OF HEALTH
Division of- Environmental Health Services, Carmel, N. Y. 10512e
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Putnam Valley
Town or' V illage ge
Located
Wiest Avenue Section Map 79C Block
at
Owner islii 1 i n Sagan Lot 220. 222 Job
separate Sewerage system built by
S Aldnn GArdnAr Address Steven son Avenues Peekskill., N.Y..,
900 - 249 lineal Feet x 36t1
Consisting of Gal. Septic Tank width trench
Other requirements Curtain drain installed behind house, =ior to seDt a ssvatem
water Supply: Public Supply From
x Private Supply Drilled By And;wsinn We-11-Drillers
Address Barger Street ?utn9m�y�.Y. n
E
Building Type Baise Rsanrh No. of Bedrooms 3
Has Erosion Control Been Completed? �� $. Rp���i v
Yes ea ,o o ��+
I certify that the systems) as listed serving the above premises were constructed essentially as shown on the 81£x. f th wo K-�cOpies of which are
attached), and in accordance with the standards, rules and regulations, plans filed, and the permit issued Qpt a I; my Otp of Health..
r
Date On Abpr 27 19z Certified by-
Address a ° ® �.�— R.A.
.1 Northridge Roa Peekskill, N.Y ®�,9�EQc ur1idL�Os No. MIA — --
_ o —+ NI o
Any person .occupying premises served by the above system(s) shall promptly take such action as may be necessary toost�BrE wa 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 sanitary sewer becomes
available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are
subject to modification or change when, in the judgment of the Commis ' of Health, such revocation dification or change is necessary.
Date By ® Title
�/
♦ V
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES-
x COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
- DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO..
Owner Philip Sasso Address 1004 Van Nest Avenue Bronx., NY 10462
Located at (Street West Avenue Sec aP 79' Block Lot 220 221 222
�Tndicate neares cross street)
:.._municipality Patnem Valley Watershed Peekskill
SOIL PERCOLATION TEST DATA - REQUIRED TO BE SUBMITTED WITH APPLICATIONS
w
Hole
Number CLOCK TIME PERCOLATION PERCOLATION 1
Run apse Depth :Eo Water a er Leve
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min: /in drop
•'Inches Inches Inches
(1) 1 Hole filled with water within 6" of s -afaee` d
n
L
3
s
(2) . 1 Hole filled with water within 1*" of Top�W
s
�r
(2) . 1 Hole filled with water within 1*" of Top�W
3
M
■
5
Notes: 1) Tests to be repeated at same depth until ap roximatelyy 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.
r
.j -� �
pry
Y4
a
' f .. f�,
.• f
(1
_T
3
M
■
5
Notes: 1) Tests to be repeated at same depth until ap roximatelyy 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.
r
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTI.ON_OF:SOILS ENCOUNTERED IN TEST HOLES -- -
'.EPTH HOLE N0. 1� HOLE 110. 2 HOLE NO. t3
:.L. 30 Topsoil 48 Topsoil 411 Topsoil
,► fine loam fine loam fine loam
211
3"
411
o11
5"
�n
311
', 11
�n
�n
311
4
. i
'DILATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED Hi�1® prey di water almost to to
DICATE LEVEL TO WHICH WATER'LEVEL RISES AFTER BEING ENCOUNTERED �' !
]STS MADE BY John SO Romeo Date April 29* 1972
j
)il Rate Used 11 ®15 Min/l "Drop: DESIGN S.D. Usable Area Provided 5000 S
�. of Bedrooms 3 Septic Tank Ca.pacity 900 Gals. e masouxy
)sorption Area Provided By 240 L.F. x24" x� , , . ench.
Design based on tests prey made on adjacent lot for Cola,nielo o C
.me Jopan S � Roffieo
.dress 1 Northridge Road
Feeks=117 77.
:IS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
ure
00"rW0tj
e
it Rate Approved Sq. Ft /Gal. Checked by bete
Lij
n
ea °s If= ,...
vh
oo
oo
6A8'- 3/9y
$. >:�
I
� e• '-'a7�C {� �N'WA �'7 � •'° �Ywi6 14k la'+�y'"« Ilu. -`� `' � u •.
yyla Pra` y ett of arry perms � ib�
a. F o a ice°.
b. Site Street Nave , TMn atvi Mo n!.vn r.
C. I,Ztion of installer —led, to ttrn : vws ) .
d. SpEtem description- fe q-, I,, �_. ,uocre ���t�� � �r�a , ���� .�C ecai4t dig &IM. x a° dW1
;:cam.
�.
Installer's name and
3. System repair to k
I, as rnmer, or pob i Lr _.'r.»�ua?t.
9
°r (include skstdh locating all adjacent Wills) s
ME: impair must be in same location and of same tyye as original senge disposal Memo
Afferent lomtion may require submittal of proposal from licensed profe i I "ir4w or
:eggstered architect.
co"rsigm
�rogl Disappraved
%n title Date
NLxmved with the followin conditions:
to n of any sari permi a if'ap a b .eo
20 BuimUsqion of as built repair, match in l.imte tn►ing.-
a. Owner I a raft. bo Site Street 300
4 and ''fie lip n �o
C. %motion of installed cmVwents tied to two fixed points (eogo nhcuse corners).
System ftecription ieago, 1250 gal. Crete aeptic tank, three prat 61 diamo x 61 dwp
v�
drywalls sur byyq� one
�pfoot + grovel) o ..
e. Installer l ler I s aiR���+.: and dNJ1 doe a
3. System repair to be Perfoxwced in accoxdance with the above propoml and conditiona.
10 as yea or (&Porte t of owner agree to the alb coati .
BRUCE ' R. FOLFAI
W—kc-1-9ialth Director
LORETTA MOLINARI ILK, M.S.N.
Associate Public Health -Virector.
Director of Patient Services
DEPARTMENT OF HEALTH
I Geneva Road
Brewster, New. York 10509
Environment2l Health (845) 278-6130 Fm (945) 278 - 7921
Nursing Services (845)278-6558 NVIC (845) 278-6678 Fax (845) 279 6085
Early Intervention (845)279-6014 Preschool (845) 278-6082 Fax (845) 278 - 6648
ACCESSORY APARILYENT-APPLICATIONT
Date Renewal Cl 0
Yes No
STREET 1J0 66A �ut-, TOWN U TX MAP 0
NA�iE1 t' Qt PHO�IE�`� PC14D#'
MAILLNG ADDRESS
Y oS
MAILING ADDRESS. OF APARTMENT— SAVZ, AS
NTMIBER OF BEDROOMS ENT MAIN HOUSE
NTMBER OF -BEDROOMS IN -A
PARTM EN,�.
Please submit this form and the requirements on page two to the Putnam Co_ unty Health Dept., 4
Geneva Rd., Brewster, NY 1050% Phone 2784130.
Approval is effective for a three year peziod. The applicant must reapply . at the end of each
period to renew the legal status of the apartmeat.
Sigrlal4af Applicant
2
j2t—Approved Date to
By Title
=E USE
Comments
a 'a
��
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
October 30, 2002
Phil & Lorraine Sasso
23 West Ave.
Putnam Valley, NY
Re: Accessory Apartment- Sasso
Three Year Approval- 23West Ave.
Town: Putnam Valley Tax # 73.5 -1 -67
Dear Mr. & Mrs. Sasso:
I have received and reviewed the plans for the proposed accessory apartment at the above -
mentioned residence. The proposal for the apartment has been approved as per plans bearing the
approval stamp from this Department dated October 30, 2002 The apartment is approved for three
years with the following conditions:
1. The total number of bedrooms in the apartment must remain at One without prior .
approval by this department.
L1_ 1 °..'f`iiTrS(.i?ji�
Cpr.;;r,
approval by this department.
3. The area of the existing sewage disposal system, and its expansion area, must be
maintained.
4. 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 Valle,
If you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
WH:kg Senior Public Health Sanitarian
cc: BI
Ir on
TM F=LM
Santore & Api: Excavation, Inc.
YI TAI1 43 90(iitainvie�t Rd: �� 9 :.. _„ . ' �
t ?titrtam valley W
,t.
;'r : t include skgtc�r CL" -a 14.
�' Repair:; must be in Gems location at:d of same type as original sttwage disposal systm.
►iffert laation may require "subnittal of proposal i>raa i Ged profeeaiastl.rginesr 4�!'
906ter4at architect.
proposal
r�
Proposal Dissppt:o ad
ftr�oe�tl . a roved with the % Sa time
. Ocvr' anent arty Tom perms , f A cable.
Z. Sibmission nF as built repair sketch in duplicate shcuing:
a.' Owner's Haute.
_b. Site Street grams; Tb nm and Tic Map n .r.
c. L&ztion of installed cw9ments tied-to two fixed'Wints Wg.,hcm" eotimm).
d. System descriptt=r -(e 4•, 1250 gal. concretA septic tank, thras precast 6' divn. x �' deep
&q,.,el la Jur=W,&d by one too" gravel)
e. Installer's name and number.
3. System repair to be performed in &. ccorddnce with the sbOVe proposal WA OOnditions.
I, ae owner, or sported t of owner agree to the abon oonditioas.
9It3NllZV1tE Tttz -t.� GATE .�f • �% -• y..�
N 40
sw
Proposal Dissppt:o ad
ftr�oe�tl . a roved with the % Sa time
. Ocvr' anent arty Tom perms , f A cable.
Z. Sibmission nF as built repair sketch in duplicate shcuing:
a.' Owner's Haute.
_b. Site Street grams; Tb nm and Tic Map n .r.
c. L&ztion of installed cw9ments tied-to two fixed'Wints Wg.,hcm" eotimm).
d. System descriptt=r -(e 4•, 1250 gal. concretA septic tank, thras precast 6' divn. x �' deep
&q,.,el la Jur=W,&d by one too" gravel)
e. Installer's name and number.
3. System repair to be performed in &. ccorddnce with the sbOVe proposal WA OOnditions.
I, ae owner, or sported t of owner agree to the abon oonditioas.
9It3NllZV1tE Tttz -t.� GATE .�f • �% -• y..�
=
HOINBYDIPPRRO ENVIRONMENTAL SRRVICHS
Q. Box 230,.Port Jervis]( X27_71
b Pee sccill, NY
Tel. (845) 856 -2314 Port Jervis, NY
DATE
INVOICE.
Name .did /`�`A®"�'
r4
-
Street •;,� . ,Lt/
G3%
City Q v7/1*4r4 . &/AGL f Stater . Zip�rf
Telephone
DRIVER p
TANK SIZE
2°
COVER
TYPE
CONDITION.
MOSE FT.
40
LOCATION
JOB-ID S IPTION `
YES
. _CHARGE
::
YES
: CHARGE .
Located TanK
Tank Level;Normal
Labor..,
Power Snake=
i
(leaped :tic_ Tank
Porta -John ,Rental
Sewer un�:Ciear'
Cleaned Dosing Tank_
Snaked Line
Cleaned. Grinder Tank
TAX�j�
IO TOTAL
s
REMARKS
TERMS: Net 30.da s..1.5 %'monthly service charge on past due accounts
4,
CUSTOMER'S SIGNATURE
----- — -----
i�
YML. ENVIRONMENTAL SERVICES
321�Kear Street
'.-�k i7. I cam`- y';;N't,:
(914)w245 -2800
Albert H. Padovani,- Director.
LAB #: 32.207243 CLIENT #: 559S6 NON.STAT PROC. PAGE 1
sVNNNIVNNIVryNNIVNNry NMMNNNNNNNN ry NNIVNryNNNNNN NNNNNNNNN NNIVNIVNN/VN-- IVNMNIMNMAI IVNNry NNIII IV IV INN
. SASSO, PHILIP I. DATE /TIME TAK8N:• 10/03/02 09 :00A
23 WEST -AVE. DATE /TIME REC'Dn.:10 /03/02 09:50A
PUTNAM-VALLEY, NY 10579 REPORT DATE: 10/07/02
PHOME : (845)-t26-2942
.SAMPLING SITE: 23 WEST AVE PUTNAM VALLEY N.Y SAMPLE TYPE..: POTABLE:
F'RFSERVATIVES': NONE.'
-COL'D BY: PHILIP SASSO TEMPERATURE..: < 4C
NOTES :.:: KITCHEN TA11F' COL I FORM METH: M.F.
ry Nry NNN N NNryIVMN NNM NNN NIV N-/VNMMIVNNIVN/V NNN IVNNNNIV IVNNNNN Nry MNNNIVNNN NNIVNNNNIVVIII NIII NIV AI AI AI
DATE FLAG PROCEDURE RESULT NORMAL --.RANGE METHOD
10/03/02 MF . T .. COL I FORM - ABSENT- ! 1.00 . ML ABSENT 1008
COMMENTS: '
BACT THESE RESULTS INDICATE THAT THE WATE fWD;'HE (WAS NOT) OF A
SATISFACTORY SANITARY,QUALITY ACCORDI NEW YORK STATE
AND EPA FEDERAL DRINKING WATER STANDARDS.- FOR THE PARAMETERS
TESTED, AT THE TIME OF COLLECTION. - --
.... ..- ry ..�.. �.. a � - • .- ..-�... -.... r. ..-< .- .�. ..-. �- ..- -. -.n.w � Y ..w. w -rc*LT S_ w/.+..u- .....ww +.w •r. ../R .wt_ -I w� � _ •.... r..s.v.� i
• ' . •�.v �..... . _
�A{-Rw wJf
SUBMITTED BY:
Alber• , Padovani, M.T.(ASCP)
Director EL.AP# 10323
Peekskill, New York 10566
Uzi
PEEKSKILL MEDICAL LABORATORY
1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1
38330
DATE COLLECTED
RESULTS OF EXAMINATION OF WATER
OWNER DATE RECEIVED
Lorraine Sasso 9/17/73
.�,,CITV4 VILLAGE, TOWN VOR NAML OF SUPPLY DATE REPORTED
15—D 2, west Avenue, Putnam Valley 9/19/73
PE 7-877?
7.," 35° . COLIFORM GROUP (Most probable No./100ml.) 1-iAk1lJNhZ6,:1TJ'I'AL-ppm
FRI A 'PEP, ML. (Agar plate count at 35' C)
7 less than 2.2
ppm NITRATES (as N) - ppm IRON, TOTAL - ppm
1D1RIDE iF) - mg. /i.
These results indicate that the water was Yes of a satisfactory sanitary qualitX when the sample wap coil
A. H. PADOVANI, M. T. (ASCP;,
Division of Eji;ii-onrv�ewal
COUNTY 01 -F-ICE bUl"DING • OARMIC!_, \r'o
This report is to be completed by we!! driller.and submitted to COW)ly Health Department together with !aIx)rjlc;rV o'l
'Xm. C"4 1 S
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
OV,li4ER
DDPE:M���
rt 1; -
7,,�,U;qe L,,to
j
—
v (No a St of) (Lot i.'itmbor)
OF WELL
BUSINESS
n.opoy.)'.0
l4i DOMESTIC ESTABLISHMENT 11-1 FARM TEST WELL
USE of
WrlL
PUBLIC AIR OTHER
SUPPLY 11 INDUSTRIAL D
CONDITIONING (Specify)
IV
COMPRESSED 0 CABLE OTHER
E,QL!'. ,",ENT
ROTARY
AIR PERCUSSION PERCUSSION (Specify)
D E MILS
r'.0
LENGTH (loot) XWE' TER hos) TV GHT PER 1; C.". 1!.
JOOT
ir
tL-j THREADED ❑ WELDED kf�j YES ONO Oyrs i.. -_I I,.)
YIELD
TEST
'. I" HOURS G.P.m. YIELD (G.P.M.) P.M.)
11 BAILED E] PUMPED COMPRESSED AIR
1
7 -,A /J
WATL'k
MEASURE FROM LAND SURFACE — STATI(; (Specil
G YIELD TEST fleet)
Depth of Compleled Well
UVEL
in feet below Lond svifcce: rJ
MAKE LENGTH OP.114 i0 eQLWCR !1vo.
SCREEN
DETA(LS SLOT SIZE DIAMETER (inches)' IF GRAVELJ Diambler of well including RAVEL SIZE (inch s). FROM (Icfjt)., •'to (,eo!)
PACKED; gravel pack (Inches):
OLPTH !;:0M LAND SURFACE Sketch exoct location of well with dis6nco4. io -,,I /oz-1
FORMATION DESCRIPTION two permanon( landmarks.
FCC.[ to - FEET
I
If yield was tested at different depths during drilling, list below
FEET T GALLONS PER MINUTE
LIXIFE OF REPORT I WL*LL DRILLER (Sionatuto) L. /`
0
Philip Sasso
Owner or Purchaser of building
- Phili D
Building+Constructed . by
I West Avenue
Location - Street
Raised Ranch
Building Type
r
_ Putnam Valley (T)
Municipality
Map 79C
Section
Block
2209 221 222
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 t:we�'Stan dards,
rules and regulations of the Putnam County Department of Health, and hereby` guaranty
to the owner, his successors, 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 occupant. of the building utilizing
Vhn .,Gy^1-ram .
The undersigned further agrees to accept as conclusive the determination
of the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
aua
e se . bv- t-he =G ill,-- Ru --,or ne i`t act if� r_ Ju-:;dit i1tili7 -fcg_ L;=._, �iL Ii
_w. system.
Dated this 27 day of October 19 73 Signature
Title
(if corporat on, g' a name and address)
THREE (3) COPIES ARE REQUIRED WITH. THREE (3) COPIES OF FI14AL 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
PUTNAM COUNTY DEPARTMENT OF HEALTH
t.� May 1, 1972
Re: Property of MiliA Sasso
Locatied au
West Avenue, Putnam Valley, NY
Section MaP 790 Block Lot 220 p 2219 222
r
Gentlemen:
This letter is to authorize John S. Rom ®o
a duly licensed - professional engineer x or registered architect
(Indicate)
to apply for a Construction Permit.for a.separate sewerage system; to
serve the .above noted property in accordance with the standards, rules
or regulations as promulgated 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 _i45.or
147, Education Law, the Public Health Law, and the Putnam County San4.-
tary Code.
Countersigned:
P . E . , R . A . , # 27846 &.X
1 Norttbridge Road
•Addresa�:'. � :_.: i
Peekskil12 N.Y.
PH 7 _1o56
Aih
Telephone
Very trul yours,
Signed
Owner qf roJ54rty
I lliw' 2V v4
Address ..
.
Telephone
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