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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1 -9 BOX 27 03440 �} rj I n ` �1 0. J,- ` F 616 03440 b�' I- ., PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL,- LIEALTH SERVICES _ r..=- •.'* <'.=r. r.-. aer.. ed-+ sn.«.s. va. �Y ..m"Z.- �.a...�+.-+voo.+...a��•s trr ...nr- .,..iFtr =+ CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE' TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # -PV- t3- q 3 Located at NOX-9 Pia Rp, (Fo-?-MMLY&Rct�, S Or Village fVrU KM VALL(:-Y Owner /Applicant Name 37496 -rota SAM Qli C t7RP Tax Map 73, if3 Block 1 Lot 9 Formerly Subdivision Name L I N C- A,, TZ 3 Subd. Lot # 2 Mailing Address 7 Gr2 c7rp {•J -DAM �°�,S i N C-n N Y Zip t oS 6 2 Date Construction Permit Issued by PCHD )2-2.-98 i Separate Sewerage System built by 3 7 c RoT n N OA4A RD_ CG%>Address -5km E Consisting of 17-So Gallon Septic Tank and S'13 ' LF 2' W 1 DE' i'- gaw c A$S Other Requirements:_ Water Supply: Public Supply From Address L4 PUTN "% A--1E- on Private Supply Drilled by 1? r �Fihg- 4- Sows . gyve-, Address z3REw s- c�, N Y i nso� ^Buildi_ngp3GxpeT F?�F 5�i~T-tlaL Has erosion controlwbeen 1 Number of Bedrooms 4, 3--ftcoi-A VP5144 Has garbage grinder been installed? U� I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: ' ?- 22- y q Certified by ,�� P.E. R.A. Address - TWsiTF FNG,(uC:rg 1 6, f ,St)'ildr 4-4 'V` F' License # ARcp+TEctorr,rPc-.' lq8& R 22 3Rrw5TEK, NY i °Sod Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revoc ion, modific 'on or change is necessary. By Title: Date: -�2'� 9 White copy - HD 'le; Ye ow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 ]PUTNAM COUNTY (DEPARTMENT OF (WEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL C,QMPILLTION REPORT e`C1I ®��Qn ®sa treef Address: Town/Village: Fill ax Grid #�y$otdrs�o tom; 7 a p 7.3,1$ Block I Lot(s) Well Owner: Name: Address: V.S. Co ration, 37 Croton Dam Road, Ossining, NY 10562 Ilse off Well: - g�rittnary 2 -secon any X Residential Public Supply Air cond/heat pump Irrigation T Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling ]Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other casing (Details Total length 33 ft. 'Materials: Length below grade 32 ft. Diameter 6 in. Weight per foot 19 lb /ft. X Steel Plastic _Other Joints: _ Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes _ No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours 6 Yield 60 gpm )iDeptln IlDaga Measure from and surface- static ( specify tt) 100, During yield test(ft) 380' Depth of completed well in feet 485' Well Log If more detailed information descriptions or ie efanalyses:f- . :.• are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 10 Drillinq in over urden clay and boulders 10 Hit rock at 10, ;..�.__l0 ._� 33--- Br llin irf"rogk_ -`set -•ca'si. 6iit6& 33 485 Drillin in rock z�nite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5Q= Depth 400, Model5GS07412 Voltage 230 HP 3/4 Tank Type M02 Volume 86 Date Well Completed 11/11/98 Putnam County Certification No. 002 Date of Report 1/19/99 Well Dr' sign Perry . Be iNflD rz: Exact location of well wttn atstances to at east two permanent ianamarxs to oe provtaea on a separate sneevpian. 4 Putnam Avenue Well Drillees Name Address: Brewster, NY 10509 Signature: Date: 1/19/99 White copy: Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 i _ NORTHEAST LABORATORY OF DANBURY '`, CT Cerf: PH -1140 ® 39 -3 MILL PLAIN ROAD - DANBURY, CT 06811 R1� "NY Cert: 14471 (203) 748 -7903 - PAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P,.F. BEAL & SONS DATE SAMPLE COLLECTED: 1/6/99 4 PUTNAM AVENUE TIME COLLECTED: 3:45 P.M. BREWSTER, N.Y. 10509 COLLECTED BY: W. MAYES DATE RECEIVED @ LAB: 1/7/99 TESTED BY: LAB# 11471 REPORT DATE: 1/11/99, SAMPLE SITE: V.S. CONSTRUCTION, LOT #2, WOODLAND EST., PUTNAM VALLEY, N.Y.; SAMPLING POINT: HOSE BIB SOURCE: WELL TREATMENT: NONE TEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL i i BACTERIAL: Total Coliform (Bacteria) PHYSICALS: Color Odor pH Turbidity 0 per 100 ml 0 per 100 ml 0 ND 7.33 no designated limit 0.31 NTUs 5 NTUs CHEMISTRY: Nitrite N <0.005 mg/L as N 1 mg/L as N 11301 -Nitrate N 2.0 mg/L as N 10 mg/L as N - _ n o eesignated liririts -- -- - Hardness 112.0 mg/L no designated limits Iron <0.03 mg/L 0.30 mg/L Manganese 0.011 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 3.1 mg/L 20 mg/L ** Lead, 0.001 mg/L 0.015 * ** ml = milliliter mg/L = milligrams per.Liter ND = none detected NTU =Units * *Notification Level ** *Action Level RESULTS BASED ON SAMPLES SUBMITTED: 1/7/99 SAMPLE, AST . ESTED ABOVE: AMPOTABLE or aOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) LM eUhAiA. Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800- 826 -0105 •OUTSIDE CT: 800 - 654 -1230 PU TNA M COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 37CROToN SAM ROAD C©R� Owner or Purchaser of Building 37 CRdz'oft aAm TZOAP coRF Building Constructed by 73,18 F q Tax Map Block Lot ForAm VAL-t-Ef y TownNillage T3R INA 411 lZoAo (F'0dRAV9J_Y T3rRCbd .41LLRD.5) Location - Street Subdivision Name DES Ia�i�9Tr�,L 2 Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is 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 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 approval of the "Certificate of Construction Compliance" for the sewage treatment 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 the The undersigned further agrees to accept as conclusive the determination o the ublic Health Director of the Putnam County Department of Health as to whether o of e lur f the system to operate s c used by the willful or negligent act of the occupa of ldi ' utilizing the sys em. P � r Dat q: on , `E 1 Day Year Signature: 3 �� :. T d A , Title: . Gene 1 C 4 for weer - ignature 37 G RO T O H Ds4 M Corporation Name (if corporation) Corporation Name (if corporation) Address: 3 7CRoT-ot4 I Address: State d.SS N t N a, N Y Zip r 05 Z State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH -- - -- -- � - -- -ACTH SERVICES �r�.. r..0 •'J'4 y.n..',. .... I� �.f.P � .. �. .i . � t4:. .�. t..i1- ^mle: -'.,— ` �e ATMENT SYSTEM Subdivision name t i ^14q72- 3 Subd. Lot # Z Village 1" V IWAv- d✓A '�`'I Tax Map 771 Block I Lot / Date 'Subdivision Approved `5'0 Renewal Revision is Owner /Applicant Name Z 040 AAvl 4jn A Date of Previous Approval 117 Mailing Address 151 CIM77YJ 9/f7ls1 N!% Zip 10 -5z-z-- Amount of Fee Enclosed Building Type t�r,�lst?i Lot Area 177A,No. of Bedrooms 4- Design Flow GPD � L. Fill Section Only Depth Volume PCHD NOTIFICATION IS-REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of MS-0 gallon septic tank ands I Other Requirements: To be constructed by 37 G1 -Am>j pf► /OV, W". Address Wat Public Supply From Address e,ow Addrress' . �.b ..... �..; :.:. or_ Private Supply Drilled by tom, %✓ ~�' I I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will 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 treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. `C-- R 4 e Date b &I q -urilief- K. License # 61931 170J Rr`rr.1GKr, fir -7, IV-J -j APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pArmit. Approved for discharge of domestic sanitary sewage only. By:.' 4fTitle: 3)+e&croe..C)r Eno- ,,jjQ,w,— Date: 17-102 White copy - HD Fi ; Yello co y - Building Inspector; Pink copy - Owner; Orange copy.- Design Professional Form .CP -97 r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION - ff Inspected by: Street Location Owner Umcftl Torn TMr Permit # Subdivision Lot 1. Sewage System Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank size -1,000 ........1,2" .....other ................ b. Septic tank installed level ............................................... c. 10' minimum from foundation .......... ............................... d. istribtuion Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2.ft.Original soil between box & trenches Junction Box - roperly set .............. . Lengt required 5'00 Length installed 2. Distance to watercourse measured Ft........:. 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 - 1' /2" diameter clean .................... ! ,.,Depth of grav-cl ip.trench 12" minimum........ .................. g. Pump or Dosed Systems I ize ot pump chamber ................ ............................... 2. Overflow tank ..............:.............. ............................... 3. Alarm, visual / audio ................ I ........................... ....... .4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle.witnessed by H.D.estimated flow /cycle........... III. House/Building a. House located per approved plans ... ............ .................... b. Number of bedrooms ....................... ............................... IV. Well a: Well located as per approved plans ............................ b. Distance from STS area measured ©p ft ........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... —11— Rev. 1/97 - i r r T(i l I t. a ' i 1i -ol zz- T d 7 e a V. �1. WELL LIO Li ZZ HIP �ALU. L(,. t; Y G. P9 i� ?. � tam 0 vT 1 Ur �:�� � E t'•l4:�ti'S al F Ialr' 1I 7 i3 � d � UM,4aLna �f P:4e.tm.a:n.•rwd,.l Y.i. +.a!mfi °,rt +4.e♦ l at��1 � 1 IQ: I; 15a�yit�e =+.+r n::: I "r-m. L•t :� t`x�urc::lr. 1 Wh.�if Illf'11 T} 017CORMAMCIZ . u w.s u n ur ti r raz+nTlrr F'ur p »r "s s lctr: ro,ia7no s a "am r nisi lsc.ad rr i -4 A- L- s.adl =i.b.. tip: L�� 1l . e ne a Revolt= ■ v DAe SubdiVision •• • '• ► • -• She r Matti'Ma,i{ 1 , px Im um , y Fm S.n.oLnrm ilr n11. � Ilt�� ah N:nteoe e! F3ccirvarw. I DmIMm Flow G P 'ip rl= NCZRMOE83 li MOMMONSO wl hM I'll i 10 03003&Z 1cl:oea♦ fr. 4. � \ . row r. ba 0=2!:A C21Z5-61 •ate \C; I . m L una /p I _., _ s+ �. 0 ♦ ..► To t<x ,...a.m,.,..b•d by 1 roproaant that t am wholly; and eompiotoly, rosDOnaililo f ho tlospg. and location of to abovo. d=ritlotl will bo CCnst►IICt6d ai shown on tho aDD tlotl ar11®nd� 6ht tliero to and. in County DODOrtmult oP 6Ca1?h, and tAat on`complo4 loovooP o' Cortificato of Consl to mcbanittod 0:6 100 Dc=rtnscn4 and a writton Oup oo wil o furn tho' own ®loco ka q¢ad oD�a eoh4ition any pnrt of old a®oaal systom tluri Onto oP too Opwoaaf P tho Cortifkato of COnat lion, O Dlioneo oP .two ov 1 a! w600 two loeaQCd as eta tho DODrcvoaL nd l id 11 will Do inatnllod _ egary County Dopovtonot of Ito. ���� � Data AMROVEO F OR STItu IoR1: Tiiifi oppfoval sl r<xoaiolo for eauao Or (ride* or mwificd e rc�uiroa�a nocr Dovmit. 'A ` for dispoial of l 10 I Dalai -r .. ..... �.. �. c�� ..e- ,. _., �- _,.,.�.. a,...•e -, i;..,, ,cam -� ,- opoiad systA)pQ)W) hat bn;ComVHO Wtisfactory'to tho SUcaiaOa14 Ao 4rq OSsfbha by 1110,1 wd of two (81ygara,ivnmCtli000iy tt 1' ovaony roia0�a thgroQO; 2) thaq tho with. tho standards, rubs OAV rc IPOfllth will Iulesm will tho Imu- Ow 'SL R.A. Cainty Depwinent. of ►sh;' Si- All"OVEO FOR ,CONSTRUCTION TnN appfoiral hcpiraf two ' r ►s rom tM °da r6"10 for G "or y N a or nwdifed con fy: ny muMes a ow0' for;dieposil;,of elonNStIc ry sawao. ru Rev •, , 1Q/88 tat. his`fucossifirs, Mks or asips by the Ouwmr. tftit aid twUdM will OMIod Of two`(2) years MnnNOiiNly, followl112 the date of,the NIU- m or, any famifs;tMnto{ 2).t"t the d►UeO wNl aaglhad above Ip ;wNh'tlN�stofa:r4a, fYNf andI »ufiifonT:Sf tM Putnam P.E. l.ic�nn No 6�9 T. p/ TC�r -vim/I up s obnsirueibn bf the buildinq,ras bean undatskan and Is �iniisfionfii.'of MasiRh Any change or-afteration of construction p`supply only. Title 6 �8 v a - � ±� ► 1 11 Pi 1-i-i U1 _'.: �S I I "Al [ ['rir�ia�• �s a1 t •a ^ i rw � °=e.- •s:w, un mr� -4>w- l►nrwerel. N � I t�'3 1 ? t= s�y6►vvuc to Prv+ lady fax amk 1 �� .a W(!i�Li71F'id A i-F !IS F 4 ► +¢�i""_ in�:wl I�(►l; <.: 7`?I- fT:>tllr F'.. "IT,r.iC ?':i`� '3.+. f. 5'�' ii.� •�yl�.. � t<,, -;,,� _ � r- �e:a�aad i +tr.4i'-rtska� ''4snu+r ♦ „ WE - "� ! r.: ft P T •u �Aap FSI..r -1 1 a ��� �.�NGL� -� b E�/ E l.-� pM Et�T Gcv. � t o`tG ❑ ❑ ` � LiT'rLE FE12R�f , N.a Zb v (1 Co Li 3 Date Subdivision Anroved I /510 l�LYpj) Fee Enclosed Amnl,n� Tr+ , rc+a I' ilfl tic. < �Ihn;,. . III . � n8aia�o �vh Mmi►x4 Rrt a� M1e�emaa a !I a 1':ti,. !P 1 F" W(.41G7 letNfL �b — M Knaq a,'7S V' 97-- 1 F4 i1 I,x •oen� .isUo-J ffin r'�a+sn; 4a c.�au�� wf R ,ak'1x.,� `�s:ray. ...� .so. • T • h. ma�.,aw+wzd !� • { r•Luii,�rsna • ai eu ♦ `� lr S`�..w.- e•�y ,+iC, �' ;,.ra � rSF�.'e.cw w � pr'+t� r�+{�2v PMrlikx�l 'z 1�k'rra � I ro®rorent that 1 am Wholly and cornobtoly tba"nsible for the desian and location of the ®roQoB d Systom(a)1 1) that the eoporato aaWa�o dI!VI systom Cbova dcacril" will be constructed as gown on the a®9rovoll amendment there to and in accordance With the Standard% rules a re,ou S rulnUm coun¢b 00"Me at 09 "Maher, and that on comilietion.theroof a ''Certificate of Construction Com®lianco" otisfectory to tho Commisftnv of NwIthwill DO ambanttted to the ®ebortmant, arrd a written grearanteo will' be furnished tho oWnw. his fAlc60IIE.w% hoi7o a assiano by tho buitdaar, that &19 buitdp Will 0tDzG IN ( e®alratft condition any govt of e5d t=8p ®iepos91 ayotom ourino tho per too of two (8) VMS Imafeedlatoly folw win* tho®ato 00 tho IMu- 00 Me appma0 011 the cestillemo Of Construction Compliance of. the orlgirlal SyS110M W any ropbs tPX7020l $) that tho orilbM Weil deswWo dbovo C0 b Os7aidtett Os &4= on M tOMWOW talan and that mid Well Will bo Installed in aeeorde0co with tho clofttarda„ rubs and rqu of tho AARam CouWtp lbcFSartw d 00,t l"p f4ulo '2 z I Ck 3 Slanod ®.IE. G9.A. __ IA:.SiTF Fhil tl�ls =.EtiE1 f C. Af OM(E0 ROCS COMTORUCTOOF41 VMS'aWov&I cupires two yccsrs MMCMD O for Cauca or may 00 0 or m"Ill" Whan con"l'r, b3�, MOU&0o o nwlW t .. AM76ZKV for Cfello(191 of a]DOWMts Ma nar Rev, 10 /88 l K t Lico.so No data t .leas construction of tho building Aso Won undortatten awd is by tf►o Wlsftom of Mcn0t10. Any chdrMo or oreOOtion of construction : sup" only. 'y TIM CpG DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 * * (914) 278 -6130 ...L_ ��• -•.. «`. •.. iv...w�re, .. .. � -. fe %'t- 'rr.". "..a::n.= "",..•c r _. a +..t'.ri..+iV-se- r-•».....:.eJ wv.l�.— ....+r -... APPLICATION TO CONSTRUCT A CATER WELL PCHD PERMIT #/' WELL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name Mailing Address Li` _ c r Lr- E' _a ( rivate � O Public dU E ,OF WELL - primary 2 - secondary XRESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION b INSTITUTIONAL ❑ STAND -BY O ABANDONED O OTHER (specify O :AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGES Bal REASON FOR DRILLING E3 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION LI:ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL, TYPE MDRILLtD DDRIVEN []DUG [-]GRAVEL _ OOTHER IS WELL SITE SUBJECT TO FLOODING? YES / NO IF.WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: L-IN Lot No. ^L WATER WELL CONTRACTOR: Name, Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO "'NAME OF PUBLIC WATER SUPPLY: Ivy TOWN /VIL /CITY BOA ._..DISTA- NCE7 -TO.�PROPF,RT�'- FROM - NEAREST ••WATEP�•.RMAIii: LOCATION SKETCH,& SOURCES OF CONTAMINATION PROVIDED ., A - ON SEPARATE SHEET �`i' - (date) (s nature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions; of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within third-00) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: �Gi��� 19 Date of Expiration Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller C pG . DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914).278 -6130 .. ® -i ' :' °^C`s '�. oa - _....�".nap•r�'�' asv....S�...�::..+,r -. ..,:rt�s.w.,Si�•�$`2ep �..Y ��'!'�,y4 _cC- ::�-(':YP+. [. �c ,...'.:�r:ow�.:.i.d+ai++..l�. APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION Street Address r &C lira. KVA-A jC,0i Town/Village/City Tax POrNAM VALi '73, Grid Number WELL OWNER Tame OevEtv�nzV !, 1Ar Mailing Address L,src-E7 F,e liaA Ze" 44992'l" 5 NS 04±3 ovate 0Public SE OF WELL - primary 2 - secondary tESIDENTIAL D BUSINESS ® INDUSTRIAL []PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ® FARM 0 TEST /OBSERVATION O INSTITUTIONAL ❑ STAND -BY ® ABANDONED p OTHER (specify AMOUNT OF USE YIELD SOUGHT ` 7 gpm /# ® REPLACE EXISTING SUPPLY NEW SUPPLY NEW DWELLING PEOPLE SERVED + /EST. OF DAILY USAGE 3al ® TEST /OBSERVATION 12. ADDITIONAL SUPPLY 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE JADRILLED ®DRIVEN ®DUG ®GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: I- ! Al GA- P _rj= Lot No. Z WATER WELL CONTRACTOR: Name lJIV ,)044)11) Address: L11E)iVV04J1V IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: A.) �i`i TOWN /VIL /CITY lut DISTANCE; T6--PROPERTY FROM NEAREST-WATER: MAIN:-- N LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (date) (signa tu e) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such manner as not to degrade or oth w se contam' ate surface or groundwater. oieta, Date of Issuer - 19 Date of Expiration CILL 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PI7TNA11�I COUNTY DEPARTMENT, OF HEALTH DIVISIO €eN OF ENVIRONMENTAL HEALTH SERVICES ` • "1 57'x_.4' '•;� ' H.. :4. DESIGN DATA: SHEET - SUBSURFACE SEWAGE' TREATMENT SYSTEM Owner Address 37 'Cof . OfSc"'' "►'�j Located at (Street)_�,G„ 6r,¢cNr p�ct� rzc,P� sain{) TaxMap 73dl3. Block . Lot . Cl (indicate nearest cross street) Municipality 14 -c Drainage Basin �l o s ,� ✓ SOIL PERCOLATION TEST DATA Date of Pre - soaking aJ tA- Date of Percolation Test �r¢-•— ,Hole No. Run No. Time Start -Stop Elapse Time Min.) De th to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percol on e n/Inch , l 2 4 5 l 6V11.-�:v. �5..gay. 2 -+)w. ..— .- �.u.4� s -- :. a .r.. P . ...a -r-- -e K..e -• G:v.�•. -N .n...g.a Tr.�..,.- 4v +... -. • �. . Gev '. I.w 3 4 y 5 1 2 3 , 4 ,5 Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 DEPTH G.L. 2 TEST' PIS' DAT 1®ESCI 'VO OF -SOBS EIV60UNTEREiD IN TES's' HOLES HOLE NO. HOLE NO. HOLE NO. 0.5' 1.0' 1.5' 2.0' rj{�NO 2.5' l.t 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' M ' 7.5 C C 8.0' m 8.5' .... ... iP- ..Y`2:J'.a -- c- cxo -..�: ..._ ...e -.r .�.�..._'.r.. --. �.? .mom. : >. .. .... -. .. «.. -... «. iP .�.'.- w�.. -..m -- — c- sw.-- .c,•.: -�. e.. «..w. -r T. ev.�.- ...i�„cy.� •. r..� ,.. • 9.5' >. .�._, ns c� -t 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed N0fj E o.�C- Indicate level to which water level rises after being encountered f Deep hole observations made by: -6" rv, - tJA-c -J Date Design Professional Name: Jef f rev J. Contelmo , P. E. Address: insite pxoi- Bering, , surveying & Landscape Architecture, p. c.- OF NEW {�p\ 1:�!$5:=route 22 Brewster, New York 10509 LA. ,A$1 Signature: "fq Design Professional's Seal DEPARTMENT,OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO :'COMSTRUCTfp► WATER WELL PCHD PERMIT WELL LOCATION Street Address Town/Village/City Tax Grid Number S1�2C.i�-l• HiLA- 1z'/ht> SGUTN P�sY�idMl va11�Y WELL OWNER Name Mailing Address Li�LE F �� caPrivate , u,N �vELo ErV1 co. w4c, 2� L15e2� S.-r=-ET NJ i -7 (c43 OPublic USE ; OF WELL �- primary 2- secondary 9 RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP , O ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify M INSTITUTIONAL O STAND -BY O AMOUNT OF USE- YIELD SOUGHT gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE a,00 :gal t] REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 13 ADDITIONAL SUPPLY KNEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN [DDUG []GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO i IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: LiN�i� ai SUi3Pi�iSlOf�l Lot No. Z WATER WELL CONTRACTOR: Name t)NKi40 W F4 Address: �1�14Ci�1f74s1� IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE ..TO..PROPERTY FROM..NEAREST. WATER' MAIN.: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ©ON SEPARATE SHEET 3 /ZZ /Ct3 (date) ( gn ture) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt -y (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. ,Disinfect the well in accordance with the requirements of the Putnam County Health' ,Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such manner as not to degrade or other a contaminate surface or groundwater. Date of Issue: 19 Date of Expiration 13 Peridit Issuing Official Permit is Non- Transferr ble White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller Jeffrey Contelmo, P.E. Insite Engineering Route 22 Brewster NY 10509 Dear Mr. Contelmo: DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 1)) 80509 21 Tel. (914) 278-6130 Fax,(9t1% 16791y98 Re: Linear III, Lot #2 TM# 73.18 -1 -9 (T) Putnam Valley Permit# PV -13 -93 j BRUCE . R. FOLEY Public Health Director This office hereby revokes Permit # PV- 13 -93, construction permit for construction of sewage treatment system, on the above referenced lot. It has come to our attention that an existing well exists on property to the west of subject lot (TM# 73.1.8-1-4, N/F Orlando) which is less than 100 feet from the previously approved SSTS area. uiXntr�;tiltQt r��} u. the.zn#iumum:separaton:distarice from.a;well_upgradient tp_'a.septic ~to be 100 feet. � �+ Any and all construction associated with Permit # PV -13 -93 must stop immediately until such time as an approval has been granted by this office. Please fell free to contact this office at (914) 278 -6130 ext. 157 if any questions arise. ASB:tn cc: VS Construction Corporation (T) Putnam Valley BI ale Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer i i M Cp a DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York' 10509 Tel. (914) 278-6130 Fax (914) 278-7921 FAX COVER SHEET Date: lD l C To: Dtfv.t� �c 5 t r t- k G—. From: Adam*B. Stiebeling Asst. Public Health Engineer BRUCE R. FOLEY Fax #: 2��pG,29Z No. Pages ` 2 (Including cover sheet) _...;.,Forgo r-iallrm tion For your review Attached as requested As discussed Please call Notes/Messages '4 C" L —1� 0 T Z. RA-4 115 rVC>tj47-- i7 nc 1, L J rL I.L i.► TZL s ti-T In the' event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 157. LAIVDSCAPEARCHIT�'CT R/C INSITE FNG/AIEER/ E, r J Mr. Adam Stiebeling Assistant Public Health Engineer Putnam County Health Department Four Geneva Road Brewster, New York 10509 RE: Lincar 3 Lot #2 Briar Ridge Lane (formerly Wayne Drive) Tax Map #73.18 -1 -9. Town of Putnam Valley Dear Mr. Stiebeling: October 20, 1998 Enclosed please find revised Construction Drawings and appropriate documents for an SSTS Revision. Please note that the SSTS was redesigned due to a new well being drilled on the adjoining property. Should you have any questions or comments regarding this information, please feel free to contact our office. Very truly yours, INSITE ENGINEERING,,.SURVEYING & LANDSCAPE ARCHITECTURE, P.C. NVU JJC /jms cc: Val Santucci Insite File No. 91147.302 101698.doc 1485 Route 22, Brewster, New York 10509 (914) 278 -4990 Fax. (914) 278 -6392 0 7 DeLavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -1742 www.inslte- eng.com N DEPARTMENT OF HEALTH Division of Environmental Health Services 10 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 --v=.. %'�.�*�i �':;�i.:..- .'.�,::: a►� e��MS�w�- .an�sr�:a'Yiw`- x-'t�. mom+' n: �'<' s'. S: ov :o�,:o= .%ro�i�vi+y�vs's�. -.'' :+a :.� �; APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT. #h1- 209-'9 WELL LOCATION Street A dre s � 1� *I To Village Ci y Tax Grid Number a Pal-4 a c�l�e WELL OWNER Name Mailing Address APrivate, D Public , USE OF WELL 1 - primary 2- secondary %RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM 0 TEST /OBSERVATION O INSTITUTIONAL O STAND -BY 0 ABANDONED ❑ OTHER (specify O AMOUNT OF USE YIELD SOUGHT: gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal REASON FOR ,DRILLING ❑ REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION M ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING EEPEN EXISTING WELL DETAILED REASON FOR DRILLING 47,%, Goaa Qex WELL ,TYPE DRILLED DRIVEN []DUG GRAVEL C] OTHER ,IS WELL SITE SUBJECT TO FLOODING? YES _ NO ; IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME-OF SUBDIVISION: �(f 0 Lot No. WATER WELL CONTRACTOR: Name Ct' h 2/` S 0 pCt n C�rtt Q yj Address:. , IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X_NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: i LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (dat ) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: 19 Date of Expiration: 1g� ermlt ssuing a Permit is Non - Transferrable White copy: H.D. File Yellow Copy: Building InspwWx Rev. 10/88 Pink Copy: Owner nranrrtc rrmrnw- Wcl 1 nri 1 1 nr TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT December 13, 1988 �.� Department of Environmental Health 110 Old Route 6 Carmel, N.Y. 10512 Re: Proposed Well TM #74 -4 -29 LL _ EYE "IV:Y`: y`rr '377 Gentlemen: The proposed Water Well site as shown on the attached drawing was inspected on 12/9/88 , and as could be determined was found to be a minimum.of one hundred (100 ") feet from any reported sub - surface sewage disposal area. R6asons for drilling - Existing well dry. Applicants that receive permits shall -upon completion of construction, submit to the Town of Putnam Valley I Building Department)a copy of the well drillers Log (a.nd.Wa >ter a•na -lysi s .re,por-- - abe,fQ e said w.e- 111x-:.s "`in, service. . - f , G�- MARVIN 0 D Building Inspector MO'D:es s i L 1W_-AK 1U -LDT 'Z PUTNAM COUNTY DEPARTMENT OF HEALTH ;:.APPLICATION FOR APPROVAL .OF PLANS FOR A WAS TEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant.. L INCA1- DES K4?PMEt4 CO., INC 261 U � t e Fag`( , Rd. 110" 2. Name of Project: 95D5 FOR. LINCA?- l" 1f NL6?tJE, 4 3. Location T /V /C :. R.1tPAM VALt,EY; 4. Project 'Engineer: INOU1'E EtJCatNE R4► AND DESIPPh 5. Address: G CARMFL, IRY 10512 License Number: 6191 -1 Phone: Ctor 5 l&Lbo 6. Type' of., Pro ect:. . Private /Residential Food Service Commercial "! Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR) ?. Tvpe;Status.(Check One) Type.I.. Exempt Type II. Unlisted 8. Is a'Draft Environmental Impact Statement (DEIS) required? ............. NO 9. Has pEIS been completed and found acceptable by Lead Agency? ........... N 10. Name; of Lead Agency 11. Is this progect in an area .und`e'F_t'he contFol "6- T- 1acal "iTlanning, zcinirid; °- ° V4• W- - . or .ot'her'officials, ordinances? ......... ....... . :..................... ° . buo• pF,RJ°IIt 12. If .sb,-1have plans been tubmitted .to such authorities? ................... ND 13. Has preliminary-approval been granted by such authorities ? WA Date Granted:_ t► 14. Type of Sewage'Disposal System Discharge.'..... *Surface Water X Ground•Waters 1 15. If surface water discharge, what is the stream class designation ?........ 16. Waters indek inumber'(surface) -: °.. ... .. .. . ...... NZ .17., .Is_project.,.located near a - public water . supply systen? ... .... ... ND 18. If .yes; name of water supply.: N%A ` - • Distance to water supply N _A- 19. Is project ,site near• a public' sewage. collection ot'disp`osal 'system ?..... NO 20. Name:�of sewage system1p►' '. Distance to sewage system_ 2.1. Date observed: 23. Name of Health Inspector: UN, KNNcSY5k 24. Project design flow (gallons per day)...................................... &db 4PD 4 2. 25 :YS State Pollutant Discharge E- limination System ( SPDES) Permit required ?., 'L:.♦ _ - .- ., t .'W�ti.�C7L:'tc: nrV•,. dMa,+:: +r. i -...._ .. ..,. _?-- ".�.� ^ _ .. - ,....t i . 26. Has SPDES Application been submitted to local DEC Office? a .............. 27. Is any portion of this project located within a designated Town or State wetland ?.... ................... ......... .......0....................... 28. Wetland ID Number ........................ ............................... 29. Is Wetland Permit required? Has application 'been made to Town or Local DEC,Office? ....:...o......... 30. Does project require a DEC Stream Disturbance Permit? ................... �6 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ......... YES or NO N0 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? .....:........YES or NO ND DESCRIBE: 33. Is there a,local master plan or file with the Town or Village? ........... 34. Are community water, sewer facilities planned to be developed within 15 years? NO - 5'e:`- Rre_;any_ sewage =d•fl - 1`"-areas 1n °excess of -1b� slope ?: ,..,e b „ ,a, .�_�..,..,.ro: 36. Tax Map ID Number ............................. ......................... 'i3•a$ °0 °� 37. Approved Plans are to be returned to: Applicant Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the Penal Caw. SIGNATURES & OFFICIAL TITLES: MAILING ADDRESS: PURW4 ODG�lIY DE PARcT,Tur OF HEAL d DIVISICN OF ENVIM L HEALTH SERVICES ' � DFSIGN DATA ' SEi MT- SUBSU'FACE SEWAGE DISPOSAL SYSTEM FILE ^N0. , Owner 1A t,- G41, PIN E Address �. � L 05T k-T"�( ems. roc•, � t"tTLJ� F t N..� . ij (0 3 Located at (Street) Ni2G N �4 j1 -L `9C S> ' so-iTH sec. 13. tb Block Lot' (indicate nearest cross'street) Munici li Pyti`llyi`''( WQ �-1:Y _ Watershed i SOIL PERCO=ON TFST DATA REQUIRED.TO BE SUBMITPED WITH APPLICATIONS Date of Pr Soaking Date of Percolation Test HOLE NUCER C= ZDS PERCOLATION' PERCOLATION. Run Elapse Depth to Water From Water-Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start'- Stop Drop In Min /In Drop Inches - Inches Inches 1 2 4 ! IS 7A K� it K01� 'T N C. F 1 LE t> °M: 4F Z4 3 3 --3 r- t I-F-D. 9 4 'S 1 .. 2 - -- NOTES: 1. Tests to be repeate6 at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. rev.; 9/85 N IEST PIT DATA RD-QU= TO ZE SUEMITTD (ITH APPLICATION- DESC1UPTION OF SOILS ENCOUNTERED IN TEST HOLES t.` DEPTH HOLE NO. r, HOLE . NO. HOLE N0. G.L. 1 ° Lxno.M oo t•1 20 , 3° r 4° 6° - 7° 8° 7/ 7 9° 10° 11° 12° 13° 14° _:I3tCATE L-S<�'�r &T �6VEiIC CC7N ISJUNTIIZID Iii �/� - INDICATE LEVEL TO WHICH, WATER LEVEL. RISES AF`T'ER BEING ENmuwrmED DEEP HOLE OBSERVATIONS MADE BY :. CC'e=V-i EU U&j P, C, DATE: I I I 7 DESIGN Soil Rate Used iS Min/111 Drop: S.D. Usable Area Provided No. of. Bedrooms Septic Tank Capacity M50 gals. Type �, c Absorption Area Provided By 50 O L.F. x 24" width trench Other Name 1�Sir�. ENG�P► 1Cit�C, A . >Ewiti,fc, Signature -? Address Wx--4'i SEAL THIS SPACE FOR USE BY HEALTH DEPAR'IIME92 ONLY: Soil Rate Approved sq.ft/gal. Checked by Date I - ! f PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES IA Date Re: Property of L-INC-A-P- DSVr-LoPt-4934T - 6X:1-i 114C. Located at 131 Kr,,R 411 L- L. P-10AP SCwJ TIR - e c t i o n--3. L9 Block- Lot FUrWAAVAx.-6 Y Subdivision of Subdv. Lot # Filed Map Date -T- 5--.95. Gentlemen: This letter is to authorize insite Engineering & Surveying, P,(-, P duly licensed professional engineer -- x q<rxx)'A&�c§)&Wxq&xx xcx.I�Axtx%SZ; ( Indicate to apply y 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 --J-7 system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: Jeffrey J. Contelmo <:s P.E. , Fxxkx, # 61931 Insite,Engineering & Surveying, P.C. Address Route 22, Brewster, NY 10509 278-4990 Telephone Very truly yours, Signed 031 LIsrarw ---r. Address LPL rE:KP, 1-7 0 4- 3 Town &)l f Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION'OF.ENVIRONMENTAL HEALTH SERVICES W tw- IM Date D A is Re: Property of LINCAR MVr--LOPMV-,Nt CD. IW, Located at .131PZA HILL (T)-Mtj66 \JALLEY Section 12?.Ib Block I Lot Subdivision of LINCAF- 1IL 5UM6bW Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize IN51jr-ENGINEEF4W-1 &b jt5IBN PC• a duly licensed professional engineer o r registered architect c (Indi 7' ate e— 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 provisions of Article 145 or.. 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly your Signed C . ountersigned<3 P. E. , -RIM C IWN* EW3IWr=PXW6 A14D =260 'EC .Address CA% -MPJ-, N N. 10512 Telephone il t ENT W, IW- - 01IM-0 - Address LIME EEM -d • tIP43 Town Telephone having offices 'at FEWY NJ 11CA43 Whose officers are:- President: Donald Nuck-61 281 'Li.b6ifty, Street Little Ferry, NJ 07643 (Name and Address) Vice .-D (Name and Address) (Name and Address) Treasurer: (Name and Address) and that I am and will be individually responsible for any and all acts of the corporation with resipect, to the approval requested and all sub7�lnt acts Fj ating thereto. _4_7 I tvorn to before me this :_J day of Gt rj 19-2- Nota:7 Public.. ARLENE FALISTINI NOTARY PUBLIC OF NEW JERSEY My Comssion tkpires June 24, 199 E., S, a Title: Corporate Seal , I I 0 INSITE-0 SURVEym, P. C. 91:4 .27.8 -_4990 S" . Brewster, New York 1050� "Fax :"914 278392- 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: F (f- 0 I3) LETTER OF TRANS TTAL DATE / JOS NO: ff 1 1¢7. '3oz AMNnON 1"OR f\ r 5 RE: 5 S D S Re-7J y e� �/ FO O ��/ Il �—�r � — —Z ❑ WE ARE SENDING YOU 45- Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy. of Letter ❑ Change order ❑ THESE ARE TRANSMITTED as checked below: p-For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE 19— REMARKS: ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: lj If enclosures are not as noted, kindly notNy us at once Insite Engineering & Design, P.C. 1849, Rt. 6 Carmel, NY 10512 ---Phone: (9.14) 225-6200., F4)x:- (914).Z25-6438 TO Gov v4T,( V4 SALT o >F�T. > WE ARE SENDING YOU �(Attached ❑ Under separate cover via- 0 Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ LZUTER OF DATE JOB NO. NO. L0T 2 5-S-D-S f1c Sc:) r--" the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION f1c Sc:) r--" 'PC=-eA--A%T Apf L-1c4-r ic> TE V— (Z:)r- AL I TNC r_17-Ax to t'.1 'SZF F I _C>4\J I T Co r— F;=) tcAJ IF= 0 4e r_5k--4 I P 31.2 1 3 WELL 4;'�r—t-IIT 15; /T5 .11 S/. ©a eo. =/-- L -5, 5'- 7TH-rS-E as checked xFor approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested, ❑ Returned for corrections ❑ Return -corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY to SIGNED It enclosures are not as noted, kindly notify FE, Ilk FLU T 44, , FRI �nieSCARSDU4LE 11 Second Floor 27'8" X 48's 2656 Sq. Ft i 1l � I BEDROOM4 BEDROOM3 Ll o W-0• X 91- t" t 1d-0*X IV-cr 2JI'8- MASTFR BEDROOM B�EQROO�g I-r-2 12 , le- a" 16 -4Y2 X 13 -0 J- 48' First Floor 1001 r --i 0 ! 0:: --- KITCHEN SREAKF� F FAMILY 509M S� L J 12' -O•x 11-e 0§�Sy 20' -0: 13 -0 C 7;e,ro 27'8* 0, �,-�DINING ROOM LIVING BOOM up STANDARD SCARSDALE 11 FEATURES • 4-Spacious; Bedrooms • Framingham Pediment on Front Door • 2%z Baths • Fireplace Options Available • 'Open Two-Story Entry Foyer • "Boxed-out" and "Angle Bay" Options. Is Formal Dining Room Available • Formal Living Room • Consult an Authorized Westchester Builder • Spacious Country Kitchen with Breakfast for a Complete List of Options Room and Pantry , • Artist's ' renderings and Floor Plan Dimensions are • "Cottage- Style" 3056 Lower Level Windows approxcimate. All spedfications must be written In the Contram No oral condidons. with Architraves on Front ESTCHESTER MODULAR HOMES, INC. P.O. Box 900 Dover Plains, NY 12522 (914) 832-9400 • (800) 832-3888 i . % -APO \\A 5 Cll t!. 1 OMEN Moog IA k (4 LL a k Ix c cc C� (13 ct L I N - -- WELL - --- - - — - -- — - - N/F POWE / _�_.c�s�- �- }..,;.1st :�Y � =... .. a.�'rt -.,• .�.s. 7.._. �a%,u�?�,*;'�e:z .,.:; -/. ..::.a . �<xt.- .. .. ....y.. -c. ....�. ......,.., :W:...,:... ,.teea ...ow:�.. - -- WELL - --- - - — - -- — - NO. A. B REMARKS N ; 89 .62' . DROP , BOX 2 ..90' 64' : DROP BOX � 3 98' 62' DROP BOX � i 1..! ''.."`{ r j\ 4`^ \Y'-f ! i,- .+ > 4: T � Yj y r _ 4;. 100' 65' DROP .BOX �1���. f iL�i yr�t il. ' 'a} i r ,�.,.sw� �'C �a��+t�5,,.r 'l 5 104 `68: DROP BOX ; 6 123 .. 61' DROP BOX 16 ' 7. 129' • 64' 7 DROP BOX ..;,. 8 45' 106 END` OF TRENC;' iA 9 52 103 END, OF ,TRENC,'! .10 59'. 701, END OF TRENC '. 11 66' 99' END OF: TRENC'{;, 98' . END OF TRENC I 79' 98' END 'OF TRENCH , - 14 88 95 END OF TREN'G?` 15 135 ' 25 END. OF. •TRENC END OF TREK, , "r •1.7 ,.13,7 • 36': . END. OF 'TREN. yr . 18 •137' 42, '. END - OF TRENC !z 19.. ` 737' 48' END OF TRENC C 20 16'. 46' .1250 GALLON SEP7 C.. 'TANK l • _ rat`,• ��� . t.a :l �" ti c � � i 1..! ''.."`{ r j\ 4`^ \Y'-f ! i,- .+ > 4: T � Yj y r _ - i• 1. - ttt `r { jk .'�` 'r!' 2� �Y •7 j �A .r � ."•� i ,� 1 t S. J _'MJ . ��' Y'x'•� ]�'il�rN��• t� � �� . \ Y .Vy if-..�t,.> !' -K.0 J t.�•��1 5 ,t ! ti V y7x � i. i v(t' ( au,Yf !i. ,S { ..\ {F. �N _ . .. y: Y F�+ �i t'�''fi (J!� lily\ yt ..ii +.{ r,� ��, n'� ..f?�,t� Y , `'r,;.�, ,s'i C t O .>� t +S �.'�, •F .. 3 `l� 4. H 4 :. 1 i { F ,r f W •�•.° .�,.«ri3•a �7k;�? ,N 'tii�,i -N' i ��%.• ki' .. +?C � t �a'S. � '"- ty. t , ,4 �i�s�`�°..a �1���. f iL�i yr�t il. ' 'a} i r ,�.,.sw� �'C �a��+t�5,,.r 'l '#.01.'7�,�tYtxS'>.� a —mss- �a>.. > m��•_hoY'r�e*,. ,n...� :d.iF .'ru.r�,dr„w.s .,+h.:f>^�Sr _..,d.:,,,:.,�Y,..�...,:�' #t ..- ,tb.Y.v. d�i .. r_..d _. it��i:.x . I ��i. ..vZS .S..'}..!'Zl' ] 3v, i {° /NS/ T i ENGINEERING, SURVEYING & uNOSC,apEARCHirECruRE P.C. LETTER OF TRANSMITTAL Routh 22 .. .. - (914) 278 -4990 - Brewster, New York 10509 (914) 278 -6392 7 Del-avergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: .c l��i (� Date: Job No. q' //¢7,� Attn: AV A%m zr/63ELr� Re: Lt•wc 3 5575 (,✓ V"'j /S WE ARE SENDING YOU EfAttached ❑ Under separate cover via the following items: ❑ Shop Drawings Prints ❑ Plans ❑ Samples ❑ .Specifications ❑ Copy of Letter ❑ Change Order ❑ THESE ARE TRANSMITTED as checked below: . "For approval ; r - ❑ Approved as submitted:- __IA] Resubmit ,popies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: . . ......................................................................................................................................... .......................-- - - - - -- COPY TO: SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE I Lot98.dot ,PIF/ ENGINEERING, SURVEYING NDSLAPEARCHITECTURE, AC T SMIT7AL Route 22 (914)278-4990"---"-'--'- Brewster, New York 10509 -- (914) 278-6392 7 Del-avergne Avenue (914) 297-1742 Wappingers Falls, New York 12590 TO: Fr C, H % VP WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter Date: iL-j I i NO. I Job No. Attn: S-ri e- ns e: L/ Re: CC -%7 09 8 4 Attached ❑ Under separate cover via ❑ Prints - ❑ Plans ❑ Change Order ❑ ❑ Samples the following items- 0 Specifications COPIES DATE i NO. DESCRIPTION CC -%7 09 8 C1.+4A1%1*re5 1-1 I-C) I- 7-cj ::Z"997 F;6C . . ............. ........ ............ ............. ._.__.__-_.___........_..........._ e..........._......_ ............................... . .......................... ............ ........................... ........................................... ............. ......... . ........................ . ..... . ................... ... ... . . .. . ...... . .. . . .... . ............................................................................................................. THESE ARE TRANSMITTED as checked below: a For-ap prov aL Approved as submitted '-�-0,ResDbmit-- `-copies es for' ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: COPY TO: Lot98.dot SIGNED: P e-1 -j IF ENCLOSURES ARE NOT AS NOTED, KINDLYNOTIFY US AT ONCE INSITE ENGINEERING, SURVEYING& LA LANDSCAPE ARCHITEC7VRE, P.C. LETTER OFTRANSMITTAL bie 22 (914) 278-4990 Brewster, New York 10509 (914) 278-6392 7 beLavergne Avenue (914) 297-1742 Wappingers Falls, New York 12590 TOI• C, Date: /Z// /9* Job No. q1 THESE ARE TRANSMITTED as checked below: -0 A -submitted .--,t,E]Restibmit...---- 'copies for-approval T�Sr approval- wroved as ❑ F6 r your use ❑ Approved as noted ❑ Submit copies for distribution, ❑ As requested ❑ Returned for corrections ❑ Retum corrected prints ❑ For review and.comment ❑ REMARKS: I COPY, TO: — /461�05�p /fis, — SIGNED: t. I 1-f A.) IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE Lot98.dot Aftn: Re: THESE ARE TRANSMITTED as checked below: -0 A -submitted .--,t,E]Restibmit...---- 'copies for-approval T�Sr approval- wroved as ❑ F6 r your use ❑ Approved as noted ❑ Submit copies for distribution, ❑ As requested ❑ Returned for corrections ❑ Retum corrected prints ❑ For review and.comment ❑ REMARKS: I COPY, TO: — /461�05�p /fis, — SIGNED: t. I 1-f A.) IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE Lot98.dot