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HomeMy WebLinkAbout3453DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1 -22 BOX 27 ru J . ■, f � I T IL JL gq L Le 03453 tShERCITA AMLER, MD, MS, FAAP ` Commissioner of Health LORETTAMOLINXRI, RN, MSN Associate Commissioner. of Health DEPARTMENT OF HEALfH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health a RESIDENTIAL ONLY STREET g Z?f1 IMP, i c�G� 44, TOWN /"t4 %AlAl" V ZZXYTAX MAP# 7j, /9- NAME 6'oA�.4XC'j A_10'e4 vo PHONE ,?VS_ -101.9 IJOO PCHD# MAILING ADDRESS: DESCRIPTION OF _ ADDITION NUMBER OF EXISTING BEDROOMS .3 ' PROPOSED # OF BEDROOMS 3 (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) * *Any addition which is considered a bedroom requires -formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster,-NY- .10509, Phone: (845) 278-6130., ~- 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 3. !!Non- wo sets of proposed floor plan (drawn to scale —, with name,'street and tax map #) professional sketches are acceptable . '4. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. ✓ Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS, Environmental Health (845) 278 -6130 Fax (845) 278 -7921' Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845.)278 -6014 Fax(845)278 -6648 SIIERLITA AMLER, MD, MS, FAAP Commissioner of Health -.. =... LORETTA MOLINARI, RN, NISN Associate Commissioner of Health. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New fork 10509 Town Legal Bedroom Count ROBERT J. R®NDI . 0 1' Executive .. - Re: MORENO (Owner's Name) Tax Map #: 7318-1-22 Address: 4 Briar Ri d,.gp- Lane Town: PlifDam Valley Year Built: According to records maintained by the Town, the above noted dwelling, is I xx in compliance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: C0 #1998':180 (attached) Other: Building Department Records 2/6/08 v Assist . Building Inspector , John W. Allen. Date Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 218 -6014 Fax (845) 278 -6648 ' CERTIFICATE OF COMPLIANCEHOCCUPANCY CERTIFICATE NO.: 98-180 PERMIT NO.: 98- 299 . I - :..>.... 1'M#: _ 73 _i;�1 • :I.2�- � #. - .. _ 1,.. .- . ....;� ��� � �?A�'�::..�a:i ?,� 1998. LOCATIIV: 4 BRIAR RIDGE LANE ISSUED TO: ,'CORTLANDT RACKET CLUB, INC. This certificate covers the construction of: New Ong = family Residence W /rage & Rear Deck 1 Family Year Round Three Bedroom The applicant having heretofore filed an application for a building permit pursuant. to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by personal. inspection ascertained that the applicant has subsequently proceeded with the erection or improvement of the proposed structure in compliance with the requirements of the laws as aforementioned; that the said work. and materials met every requirement of the laws as aforementioned; and that the premises have now been fully completed and are ready for occupancy pursuant to the .provisions of law. Now, therefore, this certificate of compliance /occupancy is hereby issued under the seal of they Town of Putnam Valley. �"" DIVISION OF ENVIRONMENTAL HEALTH IFICA'I'E' ' iffdA I RUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # FV- 5- '14" BR.rAR RtoCvE 4-4�C_ Located at ! Y f7�LM ,�� .� WAY"),� PR �. Vic c �_ � OwnerfApplicant Name evt--r c,g(✓nr� (44 ccvE (cu6fax Map -73.16 Formerly Subdivision Name Block L( ..)c'qtz_ 3 Subd. Lot # 1,5-- Lot ZZ Mailing Address 37 G,-z, ro-PJ re-PA C, , 055t'-✓(rJ67 N y Zip -T— Date. Construction Permit Issued by PCHD /° s'g Separate Sewerage System built by 37 VA-M vZoqfl cOv-4 Address 5 A,, e Consisting of 15-061 Gallon Septic Tank and 1'7S LF 2._'W 1W _rffe:�_OCH Other Requirements: Water Sutonly: Public Supply From Address or: Private Supply Drilled by ad5 Address y3R.e-055-un 1%)!J Building Type D cn*' At— Has erosion control been completed ? - N° Number'of Bedrooms 3 l a ltopm O E31 Has garbage grinder been installed? 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: Address P.E. X--- ��� jd�ry€• zi i32�.r u sr'�'rt_� r✓y �o s-" � 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 revocat'on, modification or change is necessary. By: Title: Date: White copy - HD H14; Yelio .§opy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY D-EPAR 17MENY-ur nr,AL rn DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT e�f]L;geat�o� °... Sireet'tdlressa <.; ���r�A: Kratners Pond Road W d Estates TownNill'age:;� Putnam Valle LIV a 73,In Block I Lots p Well Owner: Name: Address: V.S. Corporation, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond /heat pump Irrigation 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 21 ft. Length below grade 20 ft. Diameter 6 in. Weight per foot 19 lb /ft: Materials: 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 X Yield _5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 540' Depth of completed well in feet 600' Well Log If more detailed information descriptions or sieve. analysesM_ -; De th.From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 3 Drillini in overburden clay and boulders 3 Hit roc at 3' .Dri111 .::ir�� x'oc . set_cass:zi grouted areavailable, �. � please attach. 21 600 Drill _ If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5ul�m Depth 560' Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 Volume 86 al . Date Well Completed 10/22/88 Putnam County Certification No. 002 Date of Report 10/30 / 98 Well D ' ley'(s�a rq) L.�)�eal ::A :;:ed NOTE: Exact location otwell with distances to at le t�vo permanent landmarxs to be provtdyect on a separate sneevptan. Well Drillei'sName P.F. Bad & l c. Address:4 Putnam Ave, Erpyster, QTY 1050 Signature: ; C'' Date: 10/30/98 erry a ; White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 SHERU TA AtV LER, MD, ISIS, FAAP Commissioner of Health Associate Commissioner of Health March 3, 2008 Edward Moreno 4 Briar Ridge Lane Putnam Valley, NY 10579 Dear Mr. Moreno: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT .D. BONDI County Executive ROBERTVORRIS� PE' Director of Environmental Health Re: Addition Approval — Moreno No Increase in Number of Bedrooms 4 Briar Ridge Lane (T) Putnam Valley, TM # 73.18 -1 -22 I have received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department date March 3, 2008. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. �._._.: _.:?..•... �` l._pt:, r ng tur s. dust he:'tipda ed with water "savhIg devices, Le.,-i ewyll6w :flush toilets, restrictors for shower heads and faucets, etc. 4. The approval is for the proposed changes only. This approval does not validate any construction shown as existing.that has not obtained proper approvals. Any other permits or variances required are the responsibility of the applicant* and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Respectfully, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:kly cc: BI, (T) Putnam Valley Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 J el C�. [joor %[R� A�i( 1-4 Ile al Va aualym 'No- fit IVAO)IJV Uoj L7 cT 'L'Sf)' ,.f.� O'T' (13'tjTj'Vqr3' aff aMOR asa.-'U o T'V SIVVIIJ SNO w, 31 AHU JNa�j()aSffjjS _IV. tj sIvoc)aaaa--- 'ATKOT' kfC"J-r aO1 (MUOUddV sNVlj asnom 00 oo4 , 4z) cf, C�. [joor %[R� A�i( 1-4 al Va aualym 'No- fit IVAO)IJV Uoj L7 cT 'L'Sf)' ,.f.� O'T' (13'tjTj'Vqr3' aff aMOR asa.-'U o T'V SIVVIIJ SNO w, 31 AHU JNa�j()aSffjjS _IV. tj sIvoc)aaaa--- 'ATKOT' kfC"J-r aO1 (MUOUddV sNVlj asnom 00 oo4 , 4z) al Va aualym 'No- fit al Va aualym 'No- IVAO)IJV Uoj L7 cT 'L'Sf)' ,.f.� O'T' (13'tjTj'Vqr3' aff aMOR asa.-'U o T'V SIVVIIJ SNO w, 31 AHU JNa�j()aSffjjS _IV. sIvoc)aaaa--- 'ATKOT' kfC"J-r aO1 (MUOUddV sNVlj asnom 00 , x ,12 - PUTNAM COUNTY DEPAIITAU;NT OF IIEAI'1H yIi• } x HOUSE PLANS APPROV; D FOR sEDR0OP,1 C' 0 UNT ONLY, E _ BEnrloonts i� 4 -oS j7Lt t1• 73 4f 4-9j2- IPV ALL SUBSEQUF ?NT REVISION/+LT.L'RATEONS.T.9 T_'ESE HOUSE' PLANS AIUST BE SUBMI.1'ED TO )a I'COO11 ["OR APPBOVAL__ CNATURE & TiTLE, -- ATE V.S. CONSTRUCTION CORP. /LO -15 6P -! 1/2• 42-0' ll/ SP I - TF1 Il' -3 5 /B' 2rla 9 24V a X aw ZIF r� a�7 CAS' DINING ROOM KITCHEN IL[ I'M MZxwAtIT[ Mn "IT ZiUa2 0 [w m, �.Na1aG QL tl•C Id -PER APPLICAgF COOTS LIVING ROOM Er m-34' IMxOVA0. KT O - I I FOYER I I pFTM O wXC- ❑1 II CLO II in NOTES' i. 2.1 EXTERIOR WALLS P 16' O.C. 2. 2.4 MARRIAGE WALLS 2 16' O.C. 3. 9-0' CLG HT. 4. ROOF SYSTEM TO HE 16' O.C. 5. ANDERSEN TILT WINDOWS - 6. SITE LOCATION: PUTNAM VALLEY. NY; PUTNAM COUNTY; 30 PSF SNOW LOAD NODK - BATH a3 O � LIN t. HALL 1 I - PAN I 11 I 1 VAiw II aRi 1 3 3 0 8 I ' Ie 1-I.CC O 1LCa Ve'.��al i ;f.ie•.a• ncNeiw " FAFQLT ROOM O A 0 1D.. LJ X MANUFACTURER RRa2. B . 4 32" op) i - Ir 7 ' 1•- /8• _ - -- - -n c" E rnG -i Y, r n R m50T I -1 VCda•aNO R. - O - L An . _ t ti y 0 Q i li r 2842 CONTINENTAL 6_ f> C E L 1ST STORY aavw m• ucrxca m. arc• scAtD •. . OOIAAR STRUCTURES SLS 06/11/1998 T, .mRPDOL PA vws �ySi:K: r T ,2'i Ltu MD Al .1 . MiffO TR FAX (717) 444 -1577 R7rz 9d"i>4S9' WT-214 ca PDO0343 F/:•^,TORY 8,ji:Li -ORTiON r,- i. _ 1 1;. •fb One best of mY,knb+led9e, belief - - - - - - — - profeasiaul judgement, this Fact rY Msnl.Sactorad Hans fPMN) plan has been aMF..-ed fran a ayetem t of FM pl previooslY pp—ed by WS, AWl cation No. 96413, Manufacturer a No.0497: Expiration Date 07 -03-99, ,mid, n"` _ SN- /PD- 80343 /NY not bean aodifiedin ally oanner- 2. the energY PoKioi of the FM Plan has been_ prepared- itsiig- Part_5 et_NN -York State Eknet9Y ro^- ation - s"tr"`E1M is in full ` ». -.. Code (Energy cooe) end coePl ience with the EneM COda•- _ 1•- /8• _ - -- - -n c" E rnG -i Y, r n R m50T I -1 VCda•aNO R. - O - L An . _ t ti y 0 Q i li r 2842 CONTINENTAL 6_ f> C E L 1ST STORY aavw m• ucrxca m. arc• scAtD •. . OOIAAR STRUCTURES SLS 06/11/1998 T, .mRPDOL PA vws �ySi:K: r T ,2'i Ltu MD Al .1 . MiffO TR FAX (717) 444 -1577 R7rz 9d"i>4S9' WT-214 ca PDO0343 F/:•^,TORY 8,ji:Li -ORTiON r,- i. _ 1 L 1.T n PUTNAM COUNTY Di- PARTi♦;2SNT OF HEAT IH RTOUSE PLANS APPROVi-D Y013 EDR QOM COUNT ONLY : l a 'tr ✓ BEDROOMS ;4 40 73.18-1 -a.-P•- ALL SUBSEQUENT REVZSiO `(.? ?. "TZaC) TiUNS TO T�-ESIR HOUSE PLANS MUST LJ ^ /BE S/UIQ1,1'1C,t/ingJ':U iE i'CISJU. FOR APPROVAL t ly 3 Al"08 _ ! •.AY CNATURE & TITLE DAT :` V.S. CONSTRUCTIOM CORP. /LOT#P -15 1t(. j h L scnrrc e2-0' I.- } (D (D 0- 12• -7 1/ 8 - -0' 12• -3' ! !L,• i 2 ?.6 i WOCL X000 VALX -I{•1 I \ 1 w ATE o CLOSET 1 V I \\ I BATH $2 fO O BATH tll BEDROOM $2 � O,, a 2.6 LrGCJ a ATE 1•f IRaw a z.a LIN ' I v>D O I tt0 I I P" HALL CLO e1y L_� J CLO t%Y t wotW r� 1, BEDROOM RI IN I r 7 - t, AILIW S) MLaCR P.E.YR..AI CODES i A' ->IA' NANDRNIL WI N - - BEDROOM tl3 OMEN To i,. w out I 12-2' I 13• -3. x i z.� . " SN- /PD- 80343/NY f} �tL ------------------- tF� I I I 1 - I r I . 1 Iri g I O I iD I iD I - I i J• I . 1 � 1 m 2842 CONTINENTAL 6 2ND STORY Rtl 1 PD803e3 , the peat of ay knowledge, belief and professional Judgement, 1. this Factoreey Manufactured Home (MR) has bn pprwed from a- tom set of ENB plans previously approved. M 005, Application No. 96-013, Manufacturer's No.0497, Expiration Date 07 -03-99, which has not been modified in any manner. 2. the energy Portim of the ENO plan has peen prepared using Part 5 of New York State Ertergl• eenaervatfm mnstmm'm Code (E—VY Code) and is in full compliance with the metgy Code ti 1 , A0P1:evr,E !.11t ED T{I .;1V: CRY BOIL( PORTION . scE ! � __- - - -_ 1S ° Now a et• Arr N II CI20 -eN R.O. a) J /s'.aA' NOTES 1. 2.6 EXTERIOR VALLS'S 16. O.C. " ED MwCI alt. a) ve•.Ar 2. 2Re MARRIAGE VALLS a 16' O.C. 3. 8•-o' CLG HT. e. ROOF SYSTEM TO BE O.C. ,'16* 5. ANDERSEN TILT WINDOWS x i z.� . " SN- /PD- 80343/NY f} �tL ------------------- tF� I I I 1 - I r I . 1 Iri g I O I iD I iD I - I i J• I . 1 � 1 m 2842 CONTINENTAL 6 2ND STORY Rtl 1 PD803e3 , the peat of ay knowledge, belief and professional Judgement, 1. this Factoreey Manufactured Home (MR) has bn pprwed from a- tom set of ENB plans previously approved. M 005, Application No. 96-013, Manufacturer's No.0497, Expiration Date 07 -03-99, which has not been modified in any manner. 2. the energy Portim of the ENO plan has peen prepared using Part 5 of New York State Ertergl• eenaervatfm mnstmm'm Code (E—VY Code) and is in full compliance with the metgy Code ti 1 , A0P1:evr,E !.11t ED T{I .;1V: CRY BOIL( PORTION bLTS BOLTS • 7-,7 U. (STAi RASH TOP - - !v $„ TFICNC POURED '-q* 2'-10' Y OONICRETE FOIJTpATgN — WALL TYPICAL • - — b - - POUR® CONCRFTE ING FOOT - - _TYPICAL— -� — iA t GC TO OOORDNATE LOCATION OF I- _ PROVIDE DROP FOUNDATION b STAR W/ MODULAR MAN.FACTlRER I - . _.. _ _I _ _ - -- - WALL AT GARAGE DOOR - L -I - ;' - - - - -- -- -_ _ _ -- FOR- ADOITION&- STRUCTURAL -UFO OPEtarG- OOOFOfdATE W/ ', I I MODULAR MANUF I 15' -6' —AEFLALLY I �. COLUMN' I' 1 I OLD DIMENSION iB' -9�'• °� 10' 5 -7 ' 5.1 5' -3j'c . 5- -3j- 5' -3j• 6-3j- • ' 10'i 5' -7 -r 10 1 o i BEAM mph 1 -1 F -1 'r -I F 1 I I L L— J L— J L— J — J L— L J L— J L— J c; 4' STEEL. PPE COLUMN ON 3•-0' I I UIEXCAVATED - x 3.O' x T-O• DEEP POUIRED I 4• POURED CONCRETE SLAB WITH 44' POUIRED CONCRETE SLAB WTM 8 ?'A CITE FOOTING - TYPICAL I I 66-W14xWU4 WWF OVER 4' CRUSHED 6B-WL4XW14 WWr OVER 4' CRUSHED I STONE/GRAVEL BED AM ML VAPOR I I STOPE/(iiAVH BED AID 4 ML VAPOR ; Ii BA1� BAKVSR �� I I io PROVIDE DROP FOUJTOATION I b I WALL AT GARAGE DOOR i PROVIDE FIRE RATING AS �!S OPENING COORDINATE W/ I I BY NYS CODE AT T I I MODULAR MAN4FACTlF& PROOUwo CONDITION .: i I i •� I I I _ ` - TYPICAL .. SECTION ts'-o' ta-o• � ' 1e•-o• j 20"1 62' 1 c9. n =. i G7 to V.S. CONSTRUCT ON CORP./LOT4P-15 DINING ROOM 4- _7 SO 0. heat-., jpd92!!int, - app—�^fricn -y-t- tbf,�fpl"jpre,i�=IY al�W N6. 96-013, by Man DOS�' SN— /PD-80343/NY 641-1 4 22'-0r 2. th6 York el P4M - 11" 11 15-4 3/8• NOOK BATH ■3 KITCHEN IN b. L 6 C.■.- C. LIN 0 HALL 6 TCC KICK TD MIC, F -i El S, I C.. '1� PAN c ao 3• 0• 3• 0• L I- - 1 1. r RAILING N —1-1c ms —34- -- �T LIVING ROOM FAMILY ROOM E II FOYER < CLO 91-9 112- 07- NOTES• 2842 CONTINENTAL 6 1. 2.6 EXTERIOR WALLSI� 16- Or. 1ST STORY 2 2-4 MARRIAGE WALLS @ 16' D.C. 3: 9-0- CLr HT. CA- 4 R SYSTEM TO BE IS* D.C. 1/4-1-0' OF SLS Noc6m,qqq lC`L" 5: ANDERSEN TILT VI BOWS UCTURES 6 S 6q SITE LOCATION-. PUT NAM VALLEY, NY; PUTNAM COUNTY; 30 PSG SNOW LOAD .■2. BOX 681 L ft APP cl --.7. -l.A;f-,.0 V A. alm Ff.CTORY Biji'Ll -0?,TION MTV* xa J FT %�sc-•.• "+fir "y,ys r.'.ss'1„� -�'+' - n,•`°��4 -- belief and �St of my km � to 11wa1_i -ag n ,.Fld9l, _ __- _ -_ -- -- -- - -- -- -- -_ _ — - t ♦ _ ?. Y. �•d.,7+ v+, /`r? 1. Chi. Feotory MappY�enu ,, ioied FIaM VFTW) wy_ =as been ed fran a s -m °r`t'3 - - _ _ et of FTIB Pee... O i_lr approved u�rr" q• DOS,. Applscati No. 96.013. V.S. CONSTRUCTION CDRP. /LOT#P —IS t / ' �irn n!e SN— /PD- 80343 /NY i f-d, oY ro �n a ttnc Imnner. of the FMB Pl— has Oj Q ------ a beenePrerdrt�''� PaR 5 of 'Nev York 0 O �,, :- _ 4 _ SGtl[!- Pnar9Y-emu!_vaCion_o;ms[NeCim_ - _ i9's°' �5}C'"'± -_ _ _ _ -. __ _. StAt _0 r9v Cole} at i! in Eull r_D• 72•_T 1/ B._D, ornpliAroe iw n,a e,er9r caa '• ... , .: .. 12'-3" - � • 0.AatM O _ - -- - -- _ _ ___- _______ 'a VALK -IN' CLOSET BATH 02 �! O BATH 11 _ 1 . BCDRDDM 02 Lr6CJ > 5' 1 . 1 •� O LIN I ac I 1 I liM 1 HALL CLO 1 Rr. DoT ' L a0 J ;I 5. 1 �•. N I CLO I t pe BEDROOM al I O I • - =lc n Mnt¢a 1 PER .RE'CO¢5. ..,� I Gl 71tl•_— 1NMRR•VL K, - S RBCDROOM 43 1 I. - y I _ __ ____ ______________________J l <• -10' 12' -2' I 13•_3• . t NIIe ! 9l- Af V . • A. T7 16' -0" 10._0• 16.-D• car ,-@1D, a0. o ve•v.• Q 2642 CONTINENTAL 6 r is NOTES: nrER ewes an v vs•..r ,EXCE LMtl� 2ND STORY 1. 2.6 EXTERIOR VALLS B 16' O.C. t• 2. 2a4 MARRIAGE VnLLS 2 16' O.C. vM n• cxrxEp n. wto u.u• `�• 3. B• -0• CLG HT. n� SLS 06/11/1998 1 /z•=1' -0• <. ROOr SYSTEM TO BE 16' O.C. MANUFACTURED MODULAR STRUCTURES A"�_;I;yti !.117' ED 7t1 - 5. ANDERSEN TILT VINDOVS RR.R2 IIOI 681 LIVCRPIIDL ►A I7WS 1p zz�e C! arEe Pa > -zlne Ktl PD80343 s / t 'i ,i tl �T. i 'b i tit .� •`�, r, a 7 4LL F.,.,,,. 7[S NOTED O.4T"1 LOT 15 1 i 3. 'OTAL Li.NGM; OF t'ELD5 REOWREE. 375 LF. •f IOTA" :.ENC.1F1 Or ?F..ES ° ?vi•GEJ 3 ?5 L. r. AREA .596 A•.."RES =. ! 4. PROPER IY L/NF, HOUSE I. OCA TiON, AND WELL I 4 �'` rvELLLNG •.{{ FROM F.�ELOWORK Pi ?FCRMF,D Dl' :NSITE ENJ/Ni 1 1 ti� I.AN85C.41':: ARCI!'IFC ?_ COMPLE•TFD _ � 1111 � r#��� `Va^5' II • . t: { i % i i ,{+ s .r. 3-• w'r: + to „��v` "''++��yy e :�t4r � �✓ F Y•cy F � rr i-[ - ,, 1 y,i" Ste- t - • ' r 6 ��` �`,`�"� � � ��` ' � ;S_�vll T A•!,FA.SL'4F /st;: /T� Deparcuout vt P a;, Zffvirowwnta2 Health 3 \.�•!{ s�uti r t 14' 42' -� --- SFPrrC Jis as wtod for OOmforo m -DROP ROX syplioable *nlss aad 8esalaU ms c r= ; i -- 7 - - t0af CDOa4 Hl6ltII Depa>' o vd tir V. 42' E7' :iR7l' ROC 00. 5 M r I 47' 74' DROP ROX bL -. 81' DROP BOX -- - — -- /� Y -8&. -- - DROP BOX - - -- - - - .3. 75' -- EIVD OF- TRENCH - - - m - -- - A e4o" I 82' END OF TRENCH ENGINEERING, SURV rs!/ LANDSCAPE ARCH ITECT 1 el 45° 87' END OF TRENCH 92 END OF TRENCtI !'ROjf C !: - - - - _ - - - - - 8-7'-- _ SSTS FOR END of TRENCH COR TLAND T RACQUET CLUB N 4517000' W uy t t F� ` -- 88 - - -92_- END OF TRENCH. ur cAR 3 , tlaa;lnN. , PUTNAM Tau -{ C� vEn' 24.00' i eb 91' 99' I ENO Ot TRENCH DR iNlNi,: i 9' 95' ElJD I!I AS - -BUIL T 7 . ,9' - - _ OF TRENCH DRA WING — - - -- -- - - - — O Err - - -' - -- - 91 7. _315 YROJ 14 VROJ£C1 NO. MANAGER in . on DRAWN -.._ i 'AM COUNTY DEPARTMENT OF HEALTH N ® - E11I,VIRO.N A.L HEALTH-SERV10E. OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CO T UCTION PERMIT # BRa Located at ! Fea-1 M t W : DRS a � Town r Village 1°�� Va-u!1 Owner /Applicant Name'. ��Tc�„�n� G u�fax Map -73,' S Block I Lot z2 Formerly Subdivision Name i- t''��� 3 Subd. Lot # 1 5— Mailing Address 37 ; G ?or l /3414'1 rev&i> , 055016) IVY Zip IGS�Z Date Construction Permit Issued by PCHD Separate Sewerage System built by 37 C-Orv?J pAYA geft 600,, Address 5 Consisting of 1 SDl> Gallon Septic Tank and ?j �S GF 7., wtp& yz -�o�ffe� Other Requirements: Water Suouly: Public Supply From Address or: X Private Supply Drilled by t:5��L- 5 5 Address T3 60-41 z. N y ..aaldr T e._,; �:�1 t -A2i Has a *osiori control been completed? N, Number of Bedrooms 31I. 00, levvm 0X31 Has garbage grinder been installed? tv 0 I certify that the systems) 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: Certified by P.E. X R.A. Address hni i 5v C, License # 6101-31 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 revocat'on, modification or change is necessary. By: ° Title: Date: —//—/?1-76 White copy - HD Fil ; Ye opy - Building Inspector; Pink copy - wner; Orange copy - Design Professional Form CC -97 ' I V PUTN M COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM C oR-ri- N DT Qo cq aJg4- CL,,s, J"rc. . 73, is 1 2 2 Owner or Purchaser of Building Tax Map Block Lot 3% Gito7i oN DANI RCoA tD Cc'Ta-P. Building Constructed by Town/Village -BR1A@R ut69Ej_s.NQ ( For SLY WAYNE7 VRAVC) Location - Street LINC,O,R M: Subdivision Name R.E S 1'i)F NT 1 1\L r.s 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 approved amendment thereto, and in PP p or Pp 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 system �...._ o�. The. undersigned further agrees to accept as conclusive the determinatioh of the Pfibli. Health Director of t e P nam County Department of Health as to whether or of the f ilure i a system to o er to as ed b the willful or negligent act of the occu anf the b.`ildin �utilizin the P Y P 4 g g n •' system o Dated: f Mo th' /p Day 5 Year l $' Signature: u III gaff gana Title: 1RFS DC7Nt Ge' erajC traco (Owner) - Signature CORTI- AND -r eLUB, Tntc. Corporation Name (if corporation) Corporation Name (if corporation) �/0 3 7 CLZo'G� t7A- M lZ b A-® Cott_? Address: 3? Cttp-ic�N �... -1 tzaa.p State_ hSS( N1gQ NY Zip to SG Z Address: State Zip Form GS -97 til PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Weln;oeatlfbfV-�"7� Str6dAddi,&S`S:'-1 Kramers Pond Road Woodland Estates owti/Vill e. Putnam Valley T Urfd'-#4 I Map-73,,IPBloc*k I Lot(s) Well Owner: Nime: Address: V.S. Corporation, 37 Croton Dam Road ,-Ossininqr NY 10562 Use Use of Well: 1- primary Residential Public Supply Air cond/heat pump jrrigation Business Business Farm Test/monitoring Other(specify) Industrial institutional Standby Drilling Eqkiipment, 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 21 ft. LeWh below grade 20 ft. Diameter 6 in. T Weight per foot 19 lb/ft. Materials: X Steel Plastic Other Joints: Welded X Threaded Other Sel: X a _ Cement grout Bentonite Other Drive shoe: x Yes, _No ILiner: 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 � Yield 5 gpm Depth Data Measure from land surface-static (specify ft) .30, During yield test(ft) 540 Depth of completed well in feet 600, Well Log If more deti ! iled information descriptions or sien. yseS. are available please attach. Depth From Surface Water B . earing Well Diameter(in) Formation Description ft. ft. Land Surface 3 Drilling in ove burden clay and boulders 3 Hit roc]: at 31 ­3 21• = ­,Dri-iiinq in-,, r i- .set'_ casincf.-,---.qrouti g 21 600 Drillin- in ro grani Eta If yield was tested at different depths hs during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump Type sub Capacity 5=m Depth 560-! Model -59S10412 Voltage 230 IP —1 Tank Type WX302 Volume 86 1. Date Well Compete l— 10/22 88 Putnam County Certification NO. 002 Date of Report 10/30/98 1 Well D I s* a ;ZW n4t)it: txact location of well with distances to . at lea/sIro permanent landmarks to be provide on a separate sheet/plan. . Well Driller's'Name P.F. c. Address: 4 Putnam Ayp 'Rrewstpr, Iry 10509 Signature: Date: 10/30/98 j iklerry L -Iffe-al White copy: HD File; Yell copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 i r . / . ENGINEERING, SURVEYING & LANDSCAPEARCHITECTURE, P.C. LETTER OF TRANSMITTAL Route 22. (914)'2784990 - Brewster, New York 10509 (914) 278 -6392 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: t,0-'e- H, �- Date: I I -' r-,7 g Job No. 19 l 14-7 • 31 :�- Attn: MoA n-1 5Tr E csEZe AC Re: LAAe*jz- WE ARE SENDING YOU FAttached ❑ Under separate cover via the following items: ❑ Shop Drawings [9--Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change Order ❑ COPIES I DATE ` NO. DESCRIPTION dc:' - 3o-i8 ��-1 - c�v�c -r v�Aw..✓ ll - S —`� ®� �'% cr�s`nZ✓ r�l� cep. p ac.o-s�� Io -io • iQi Z�a97 moo. vo FED THE-Rr�ARE TRANSMITTED as checked below: For,approval :❑-Approved as submitted ❑.Resubmit ❑ For your use ❑ Approved as noted ❑ Submit ❑ As requested ❑ Returned for corrections ❑: Return ❑ For review and comment ❑ REMARKS: COPY TO: - copies.for approval copies for distribution corrected prints SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE LotM.dot r� NORTHEAST LABORATORY OF DANBURY CT Cer!.. P11- Q494 D-ANB-UkV�1- CT` --069.Y1 1V1' Cert: 11471 (203) 748-7903 - FAX (203) 748-0652 LABORATORY REPORT --. WATER SUPPLY TESTING REPORT. TO: P.F. BEAL & SONS 4 PUTNAM AVENUE BREWSTER, N.Y. 16.509 SAMPLE SITE: SAMPLING POINT: SOURCE:' TREATMENT: TEST PERFORMED', BACTERIAL: Total;Colifbrrn (Bacteria) PHYSICALS: DATE SAMPLE COLLECTED: 10/20/98 TIME COLLECTED: P.M. COLLECTED BY: M. BEAL DATE RECEIVED @ LAB: 10/20/98 TESTED BY: LAB# 11471 & 11301 REPORT DATE: 10/26/98 VS CONST., LOT #15, PUTNAM VALLEY, N.Y. TANK WELL-NEW NONE RESULT: MAXfi%1UM CONTAMINANT LEVEL 0 per 100 ml 0 per 100 ml pH 7.23 no designated limit Turbidity 2.0 NTUs 5 NTUs Odor 2-HYDROCARBONS, -- CHEMISTRY: Nitrite N 0.02 mg/L as N I mg/L as N 11301- Nitrate N 3.4 mg/L as N 10 mg/L as N Alkalinity 110.0 mg/L no designated limits Hardness mg/L no designated limits. Manganese 0.017 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 4.7 mg/L 20 mg/L** Lead 0.005 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: 10/20/98 SAMPLE;� AS TESTED ABOVE: ❑ OTABLE or DOT POTABLE AP . (PER NEW YORK STATE DEPT; OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) 01 Laboratory Director q •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 ^b 's :.. �-.<. -rr:, i1c`ia�. .. .:._a. .. .- .. ..- :••�3 � if'f 1'r.'�zra *� Date: To: 70t4j t0�s5,-M 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 Fax #: 27 8� °%'�'`lZ No. ?ages (Including cover sheet) From: Adam ]B.. Stiebeling A st. Public Health Engineer For your information Please respond For your review Attached as requested As discussed Please call Notes/Messages L A,4, ILL- T- r 5 i In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 157. BRUCE R. FOLEY Public Health Director. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION. I / - anspecti owner ' !2 Town Permit # S' TM # `�3 , t'� — 2 Z Subdivision Lot # 1. Sewage Svstem Area a. STS area located as per approved plans ........................... b.. Fill section - date of placement 3:1 barrier Lgth. 120 Width_lgqLAvg.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 si e - 1,000 ......1, 250 ......... other ................ b. Septic tank insta eve ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribtuion Box . All out ets 'at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box - properly set ...................... ............................... ength required `�� Length installed 376, 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 P roP e rtY line,- 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 106 % ......................... 8. Size of gravel 3/4 -1 %2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... _ I.Q. Pipe ends-cauped_ . ...................................... .. -„ � + .••••-'iT" -�Yi viY`Gi'.: r•�icn'i�C�re +nisi e.•• � •. _.. ... .�. ..« �,. i. size or pump cnamoer ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual % audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled.......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... ahoouse located per approved plans ... ..............:......:......... b. Number of bed' rooms ....................... ............................... IV: Well ; i a. Well located as per approved plans . ............................... b. Distance from STS area measured ft....:....... c. Casing 18" above grade .... :............................................ d. Surface drainage 'around well acceptable ....................... V. Overall Workmanship a. Boxes Y ro erl routed .................... ............................... g P P , b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backf ll material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev. 1/97, i � I Date: 1 —S- orm 0 A- UUNA I COUNTY DEPARTMENT OF HEALTH SHOD OF ENVIRONMENTAL HEALTH H S ERWCES R.. _ •�'•.ir Y�: �.. � ....�- :�•!q's."rsii>:rrec..�Gfa ..xrr. -. �'0'ro'rs"i. ..::d _. - '''.- .. . •� _.._ .. _�. ..: .. _ ��.. vx•. �- 1i' s'W: .:.i.:.r. „^'t'T's;wor.:as ts.•- .��f•-.. -.� aiPA•rn 4s�.•..:�Fr: r..cc• cCONS7RU CTffON F ERIC ff7 ]FOR SEWAGE TREATMENT SYSTEM T Located at WAU E 0010, (G ;)Or Village AT Vi tl.& Y Subdivision name , LI AI CAA X= Subd. Lot # 1 �' Tax Map 73,18 Block _ I Lot '22_ Date Subdivision Approved _Tl,6-J 89 EMQ Renewal AA Revision — - Owner /Applicant Name C OR•1'LAkgpj kfiCQV ,0j- Clvb Date of Previous Approval 8 -:Z- 96 Mailing Address 37 Cko -My O A- 110,4 0�, ossa w e A f Zip 10.5-6a Amount of Fee Enclosed WA Building Type RESIMAt Lot Area qat o- of Bedrooms I Design Flow GPD ®t) IKU. Section Only. Depth VoRomme PCHD NOTII1FIICATIION IS REQUIRED WHEN IFIILL IS COMPLETED selpa►rate sewomee System to consist of /000 gallon septic tank and 3 "7S� ITE NCNRS Other Requirements: g00 c. y-. 1 Moe- � o tP FI U QAY MAIM To be constructed by 37 U0roAI PAtj RA CORD Address _SAMF- Water Stnrm®lvo Public Supply From Address ir I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the swam 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. R.A. Date 7-23-98 OSCAPE AR yUKSAMLicense # 6/731 I BS Rr�'J� gflE�sr�Q, Ny: 10Soq APPROVED FOR CONSTRTUCTHON: 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 pe it. Approved fq discharge of domestic sanitary sewage only. By: 11 14 jFi Title: 6 Date: White copy - HD Ye ow py - Building Inspector; Pink copy wne O ange copy - Design Professional Form CP -97 i I .- INS-1 T E ENGINEERING, SURVEYING & f LANDSCAPE ARCHITECTURE P.C. LETTER OF TRANSMITTAL •i - c.A�'.r 'RQule-22 rl.t 1r. :r kr t •.nyv- (914)27,84990" �{ -,w' �:.'�•w .. . ,iiy:.... -ter• � irn ..:i ai�..u. i.. Brewster, New York 105,09 (914) 278 -6392 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO:G Date: a 2g, 4S Job No. 4 r ( q7, 31:�— Attn: A0II'" '51-r(CF Z-.JC7 Re: Cis r•_ EJ� �'T �. WE ARE SENDING YOU [Attached ❑ Under separate cover via ❑ Shop Drawings ❑ Copy of Letter Prints . ❑ Change Order the following items: ❑ Plans ❑ Samples ❑ Specifications THESE ARE TRANSMITTED as checked below: For approval °= °° [1 -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, ❑ REMARKS: COPY TO: SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE I Lot98.dot PUTNAM; COUNTY DEPARTMENT OF HEALTH Fr" FA p DIVISION OF ENVIRONMENTAL HEALTH SERVICES i %� �DSIN�n`A'TUBSURFAC�STWAGE T'RATMENTT SYaTE=° Owner f �- �4 A -GAvc Address C W wt-1 91) 05f( �('J6 �✓y Located at (Street) r b✓.461 ,46 p24 vim. Tax Map -13 J6 Block ') Lot 1z (indicate nearest cross street) Municipality crryy M y Drainage Basin kdoso� TLi� � SOIL PERCOLATION TEST DATA Date of Pre- soaking ° Z4 .18 Date of Percolation Test `'� p 257158 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 Percolation . Rate Min/Inch V3', 2 6'41 z-S 3 3 3 a g�o7 -5 =1� 2234 zs 3 4 5 3 4 5 l l 2 3 4 n V l tb.; 1,. i ests 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* 1- Depth measurements to be made from top of hole. r Form DD -97 TE5� Jl DL 11 A b, Ey{ �,} ✓f.n 4 DESCRIP,TI01 Q SOII:S ENCOiJNTERE :Ili .TESL' HOLES ' ,rr tiq:. a ., . a e. '." � , mac:; :.crwr u;� -t" r.��' u...a�, : q „� ..: ..� �ir� y� o •:vin . .':.r ;:. �E�'' �,r�: �,., � r !��_z+�+:.:.: ^ PTH HOLE N0. HOLE N0. HOLE NO. G.L. 05 I v . 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 10.0' 2 — %....M Cp _= Ca,j : Indicate leve at which groundwater is encountered Indicate 1 el at which mottling is observed Indic level to which water level rises after being encountered D p hole observations made by: Design Professional Name: Jeffrey J. Contelmo, P. E. Address: 7nsite Wiring, sirveying & Iarx7scape Arrhitecbme, P 15495 -jkoate 22 Brewster, New York 10509 Signature: h Design Professional's Seal Date OF NEW S. COVFxLN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES t -1. .. •},d.q_ .n ., \�.•�i%`w <. trY�N.t/�"� ^- -._ _.n,..n.a .... �.i.,, ti1m�'y..5 \�.� r�3 r<J�.....+en .r ....q .. +fir fkC.`..•r„S.:.i ���/]'f� Y`:. a.�r.' Y ..^e ^Y' CONSTRUCTION PERMIT FOR SEWAGE TREATMENT �� lul PERMIT #; Located at `` // ne J� Own or Village _ 1 VT Vol 6 Subdivision name ncar Subd. Lot # Tax Map %3. /� Block Lot me Date Subdivision Approved : o S Renewal . Revision a -je. Owner /Applicant Name ' Date of Previous Approval Mailing Ad dress Z'Cro l"o n DA-m good 5'S f,01;0 AN Zip Amount of Fee Enclosed Building Type e t Arear�10. of Bedrooms, Design Flow GPD 1,50 Fill Section Only Depth 3,T Volume C -' PCHD NOTIFICATION: IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of ��U(1� gallon septic tank and 37Z 4F, 7renC4 S Other Requirements: �(/� Cj� -� ©%�ier �i� G 044y /Sr�✓'a'61, To be constructed by ^V(:rnfl #i Pa rd IU & CP Address 54 Me i Water Suuoly: Public Supply From `. Address Q :x►Sn ate Supply "Drilled Fiy "'� %R��r`..SoriS 4 '�Acidress "L%•' i� !�° IewSfer �= 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 s sY tem 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: Address P. E.. --:A—. Date /aeh�S /�lc�c� '�icenvrn ce��r se � 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 p it. Approve discharge of domestic sanitary sewage only. r w By �� Title: �- -- Date: White copy - HD FileLYell%w c�ppy - Building Inspector; Pink copy /Owner; OrAnge copy, - Design Professional v 'Form CP -97 n s 4T `; a i:" rr ?f:d o nl +' {:iii'' A I Ti:i y' • Uri.:ax'axn w .�.;a t. - 1..-.. 1 'K.d `� 5 IQ: I' s .-r r: •.., ..k 7 m,n $Kin r Ir iv: I, r l•(1' , I. , IMi: F "erww+�l (•J, ''i:: "('°,�11 .-TZ'I -.. *`�Ti,('1 ^. #h1� 'v'J){� :it?!``,1' hR II- £`Y"'�I+ -P.F �'. rr -;nl'i ,� 1a1C bCL_ � 'sum. End a 7fnit Or@ , +I llama ��r /scene is 1 • -• 1 . • • • • • • • Amniint- M.NX-31Y . `.nytsen Ar ��,. cr n:c :: °t -Taw �a ,.vs�:Su� ayf 1 tl♦ f:.uilbwr 6 I..c lc ene„i _ I + +� ', 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system($); 11 that the separate sewage dispofal f stem . above described will be constructed as shown on the approved amendment there to and in aeeordanco with the standards, rules and ragulatOns o nom County Gopsrtmant W Health. and that on complotion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Hissithwill ba submitted to the Doportment. and a writteA guarantee will be furnished the owner, his succossors, hops or assigns by the builder, that said buil0or will place in flood operating Condition any part of sold sawago disposal system during the period of two (2) years immediately following thodate of tho Isom- on= of the approval of the Certificate of Construction Compliance of the original system or any ropof7s thereto; 2) that the drilled (wall descrv=d above will be toeatod as Mania on the approved plan and that said wolf will be Installed in accordance with the standards, rules and rcgu o1 oit na of the Putnam County Ocgartmont of Health. Data 2L --- —:2 — l i.P. � , � ` � Sinned P.E Vo 1 P.A. — aculwl A4ddressLt/��ltt�aZtiVyasb [� L 22 v - iconso No�•, (Q V 'APPROVED FOR COPISTRUCTlOP1: ThlsZsdprooaTe pp r® taro years from the data issued unless construction of the building .has boon undortakon and Is revoeabld for cause or may Do amended or modified when considered necessary by the Commissioner of Hearth. Any change or alteration of construction xQuires a now permit. Approved for disposal of domestic sanitary sewage, and/or private water supply only. ReV . 10/88 Mato ®y Title i PU7 f.. 'M COUNTY DEPARTHETT OF HE/ .;=: 'i'H _ DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 411319 Re: Property of 'DIFVeLcfn?C�� '� _ (j Located at (T) nl,q „� (r�� Ct�'y. Section Block Lot �V r ZZ Subdivision of i Subdv. Lot if � � Filed Map A Date � S Gentlemen: p This letter is to authorizeNS�TE �NG��✓E =�= S�'Er)�JC ),�,. a duly :licensed professional engineer or registered architect (Indicate to apply'for e,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 i connection with this matter and to supervise the construction of said system , or systecs in conformity ki th the provisions�of Article 145 �or 147, Education.Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours-, ' r Signed A / i0 e o f t Countersigned- p LtC5C r 57-;r -' T P.E , , #' y� Address Z N75 5or: yeyl A, Pte - L i rZC fC�72.�.�/1 /l/ /-7(c y3 Address Towri Zv(- yYG, — Y7G'o Telephone `ll`f - ZZS- �'Zrc) Telephone i i P 1AM COUNTY DEPARTMENT OF HEALTH,` Division of (Environmental Health Services AFFIDAVIT - CORPORATE OYNER. APPLICATION. _... _ _. - . .- - .. ... ., ?`� - - •_ ... ..Tye =. FOR PERMIT APPLICATION SUBMITTED TO PUTNAX COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for; • L ! /0 C.A PcyECo P m E---J 7- Cry -, =-N C . (�IAX — Sv a DI ✓. 6,07- �S gD �orV NL-D NucI<, represent that I a:� an officer or employee of the corporation and am authorized to act for �! �J C/i'1Z ��J EG0e•-? (Name of Corporation) having offices at Z-8 Lr i3�Ty S i,_ Lr 77-GC r 7(� Y 3 Whose officers are: Pres _-?ent• 00aAC_a �arcKCL•� Z8 Cj0e/?_Ty 51-) C,rr-Lr- FE[Z74Zy, /V3" /76Y3 Vice-President: Game and Address) (Name and Address) (;lame and Address) _ n Treasurer: (Name and Address) and that I am and will be individually responsible for any and all acts of the eor ?oration with respect to the approval requested and all subseq ant acts;. . laeing thereto. Sworn to before me this day o f i L�2 19 9� •9otar Public , FAUSTIN,E4SE $ E Y Q�pTAR PLUS �c OF NEW ,Go .nm;ss'on EYp;;es June 2 F S_ Signed: Title: 21 corporate seal a j,i.jcAr& 3 c mr i 5 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: : Property of G' rL ✓�� �'�r�y�°r" CJ- ✓.fT>1 , tiuE Located at a Pry+ %rl" VA-"!!, Tax Map # -7 -3, It, Block 1 Lot Z' Z 'Subdivision of Subdivision Lot # �� Filed Map # Olf- 33 A Date Filed Gentlemen: This letter is to authorize Insiite Engineering, Surveying & Iandscape Architecture, P.C. (Jeffrey J. Contelm, P.E. a duly licensed Professional Engineer x_ orRogi�md�Offig xxxxxto apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in- conformiGy,w ith:-the�rav_is ons.ofArticle.]45 andlor 147 ofthe_Edi�c_atio i.; w_ ;- tfie_:F biic Health;, °y: � Law, and the Putnam County Sanitary Code. ' ty �' A� s; Countersigned: P.E., l •, # � Mailing 'Address Ins'ite Engineering, surveyim & 1 n&cape Architecture, P.C. Poute 22 Now YarAt 10509 State taw York Zip 10509 Telephone: (914) 278 -4990 Very trul4nofP, yoursi`�' Signed: Mailing Address: 3-7 c DA 21> 49 1�55e.,✓L AAq State AJJ Zip Telephone: °t 1 --7 `3e7- _ -7 Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICE AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: G- "y CA S v [3 D c s t o N I, At-- �5A"V vc'1_c represent that I am an officer or employee of the corporation and am authorized, to act for: Name of Corporation: �.5> Csrrz,,�,z C6,��� �R�»{ 37 C&7?'� t?/?M _KF, C41� , Cwr t rvC Having offices at: j7 6-1--o -rz�,-4 D,4 i2e;�a, o��l�yW�; Ne-r- 1 01– t— Whose Officers Are: President - Name: V.,(-t, Address:. '57 Croe rs�J rZ rte, iv . Y , Vice President - Name: Address: Secretary -Name: Addr Treasurer –Name: Address: and that I am and will be individually responsible for any and av tac to the approval requested and all subsequent acts relating thereto. Sworn to before me this / day of 0^? (month) (year) No ary Pub i LAWRENCE KALKSTEIN . Notary Public, State of New York No. 01- 4752767 Qualified in Westchester Coun�tn� Term Expires February 28C�,"�" Form CA -97 Signed; Title: I on with respect PM CCU .� FW �j04 WET COMPLETION REPORT DErARTMENT OF HEALTH 'D;ivision Of Environmental Health Services t' COUNTY ,DR RTMENT.- OF•HEALTH. Office Use Only ,.._ WEer 0lit:SS: wN� W'6RI0 M UKk Pond Rd. , Putnam Valley NY Lot .15 WELL OWNER NAME: ADDRESS: ' ' tincar Dev Corp. ,Vollins ackens , . , P8IVATE MBLIC USE OF WELL 1- primary 2 - secondary, 13 RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /CONO. /HEAT PUMP ❑ ABANDONED p BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL O INSTTTUTIONAL ❑ STAND -BY ❑ MOUNT OF USE 'YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR . DRILLING IN NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA ; WELL DEPTH ' 600' ft STATIC WATER LEVEL ____ice ft. DATE MEASURED 10 :22 88 'DRILLING ,EQUIPMENT I3 ROTARY 9 COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT D CABLE PERCUSSION' ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING. aOPEN HOLE W BEDROCK O OTHER TOTAL LENGTH 21 ft MATERIALS: #STEEL ❑ PLASTIC O OTHER CASING LENGTH.BELOW GRADE 20 tL JOINTS: ❑ WELDED IN THREADED O OTHER , DETAILS DIAMETER ! 6 -in. SEAL: fl CEMENT GROUT ❑ BENTONITE O OTHER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE O YES ❑ NO I LINER: ❑ YES O NO SCREEN otAMEiER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (to DEVELOPED? DETAILS FIRST -HOURS F. SECOND ,• 6RAVEl PACK+ ,'. _G YEs O NO GRAVELY n SIZE DIAMETER TOP OF PACK In. DEPTH tL BOTTOM DEPTH It. WELL YIELD TEST If detailed pumping METH00: O PUMPED ' ; tests Were done is in- �COMPRESSEO AIR c formation_ attached? O BAILED O OTHER' i ❑ YES O NO W�L� t0G if more detailed formation descriptions or sieve analyses. are available, please attach. DEPTH ROM . SURFACE Water Bear- ing welt D,a' Imeter FORILATION DESCRIPTIOM cooe IL IL WELL DEPTH It. DURATION hr. min: DRAWOOWN It. YIELD gpm. Surf u 3 Dri Llilig in overburden clay & bldrs . Hit rock at 3 feet 6,00 6 585 k set casin routed 21 600 Dr ll ng in rock granite. , VATEP O CLEAR TEMP. UAWY O CLOUDY HARDNESS O COLORED ANALY2ED1 OYES ONO ANALYSIS ATTACHED? 0YES ONO STORAGE TANK: TYPE CAPACITY GAL. WELL MU-Ht NAME P.P. Beal & Sons , Inc . °" PO Bbx B 1 ADDRESS 14 88 S7Gi Brewster, NY 10509 UUP, INFORMATION CAPACITY, 0.7CI =R, DEPTH )CEL, VOLTAGE HP Re: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Property of hi vN C.G. V- 2✓9--)C2 wNe✓\ i- C,�D•,, (Located at V✓0.�/_v�2_ I�Y^i t� (T) Q- .i-v�a,m Vct• Section 73, IV (Block• j Lot a• Subdivision of L; L v- � -S d- I- vi'S• 1 O 01 Subdv° Lot # ) S' Filed Map .�} a,93�� Date � $- Gentlemen: This letter is to authorize Insite Engineering & Surveying, P.C. a duly licensed professional engineer x 9cx1�cC'x&�xfix�cx�C (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards., rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connept.ion -w-jth this ma.tt•er and t,o supervise the construction of .sa;d system or systems in conformity with the provisions of Article 145 or 1471 ]Education Law, the Public Health Law, and the Putnam County Sani- tary Code Very t Signed Countersigned: o Jeffrey J. Conte P. E. o MQ*x s �,{ 6193 Insite:Engineering & Surveying, P.C. Address Route 22, Brewster, NY 10509 278 -4990 Telephone AT/ L_.Se��� Address Town Telephone - v3o c