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HomeMy WebLinkAbout3455DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1 -24 BOX 27 ON mom �=19 % Masi 11 ,7� To I To r '- F F i � - T so �T L i . . T�' �" IL ' ' L ' ,, ILL I� I '�' I ol ■ 03455 LORETTA MOLINARI R N., M.S.N. Acting Public Health Director Director .of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental' Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845)278 - 6014 Fax (845) 278 - 6648 March 24, 2003 Geno & Geri Richichi 12 Biiar Ridge Lane Putnam Valley, NY 10579 ROBERT J. BONDI County Executive Re: Accessory Apartment, Richichi, 12 Briar Ridge Ln. Three Year Approval i (T)Putnam Valley, TM #73.18 -1 -24 Dear, Mr. & Mrs. Richichi: I have received jand reviewed the plans for the proposed accessory apartment at the above - mentioned residence. The proposal for the apartment has been approved as per plans bearing the approval stamp from this Department dated March 21, 2003, The apartment is approved for three years iA4th the following conditions: - 1. The total number of bedrooms in the apartment must remain at one without prior approval by this department. 2. The total number -of bedrooms in the main house must remain at fiu—without prior approval by this department. 3. The areaof the existing sewage disposal system, and its expansion area, must be maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. iVery truly yours, illiam Hedges WH:lm Senior Public Health Sanitarian cc: BI (T) Carmel i ( `c{ ,' m. ace -✓xtt a s �. a v �,,, a z e p,2O;�as� ^� 1 MPP-20-2003 09:56 BRUCE .1t.• YOLEY Public Health, -Director F COUNTY DEPART 845-278-792i TO: 95280722 P:2/3 iii LORMA MOLINARI )LN., M.S.N. YQ Associdis -Public Health Dhvctor Dowdor or Patient Sr^wcs DEPAR'i'MEkrT OF T_T0ATnrMY 1 Geneva Road Brewster, . Niw York 10509 EnviroamentAl Health (945) 279 - 6130, Fox (114S) 278.7921 XurA1ngS@rv4cu(945)Z7l1-6S59 WIC(845)279-6678 Fkx(845)219-6095, Early Intervention (845) 278.6014 TAX (845) 27S.66µ9. •Preschool (945)22i-$012 Wax (PA4 229 - 6113 Date Renewal Cl YCs NO STkEJET, JOWN PU'rvAM _T'XMAP# 6_elvo N r_14 MAZqr, ADDRESS t9L, MAMG,ADI . )REss OF APARTMENT S AM U MgR OF BEDROOMS IN MAIN HOUSE 4, NUMBER OF BEDROOMS IN APAItTMZNTJ-- Please submit this form and the requirements on page two to the Pan= County Health Dept., 4 Geneva Rd., Brtwstcr, NY 10509, Phone 278-6130. Approval is effective for a three year period. The applicant must reapply at the -end of each • Pe#Qd to rcncw the legal status of the apartment. Signature of Applicant Approy'ed Date to "000, B Title Comments Nov, 2006 ACCESAff Mar 20 03 02:53p BUILDING DEPT 9145268806 P.2 CJ V'.(X .LJ Cif Ql) L4, LAJ I.L.] ( I l �Yl� Li _-- . -.-. to Ln to ,a to to 0) V- to I Ln MAR-22-2003 SAT 14:36 TEL:845-278-7921 000, '000111-0�0 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 i It I NO (N. ko CV, Ln MAR-22-2003 SAT 14:36 TEL:845-278-7921 000, '000111-0�0 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 i It I FLOOR PLAN -6;' 3� 46,46� �,w 43i;' `277::26 -25 � '-24. 23 40*,�n'3W,' 37 36 -34�,., 21 26, -',1 12 11. AO! 6�:-55' .-,3- 2, 0 Az. �4, 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 +1 +2 26 26 1 25 25 2 24 — 24 23 — 23 4 22 — Pocket 22 -5 21 — Room Dim. Room Dim. Door 21' ,ny 6 20 — 3 17 x 15 14 x 14 —20 19 — -- ------- 19 X. bo 1;9 18 — V" ........... ........... 18 CF) Pocket 17 17 — W D Man WIC Door 16 16 — Room Room is — — 15 C-) 0 Dim. Dim. Ws '4 14 — 6 x 8 4x6 C,) 14 ..nK 1 13 3 • 12 . 12 . . . . . . . 16 10 10 17 9— — 9. A 8 hall — 8 ... loset+ 19 7 closet c — 7 20 6— 6 21 5 — Room Dim. Room Dim. 5 2z 4— 9 x 9 8X9 Room Dim —4 L r . 12.5 x 15 2p 2 2 CD 0 CUT CUT CUT. t CUT. outside -1, C . 33" wide by 54" 39" wide by 59" 36" wide by 54 10' wide to ceiling (87') entrance -2 Doorway foye . r -3 -4' -M of Ernlironm.�MF�,; ---- clothes rack 4 Pr window or glass door Ith Depau-trno; appliance or -utility- —XI counter top or shelving cabinetry IA7 WON OMNI �i� ��ti i[ 19911 WIN no, n NJ I Is till so Lis -111 E ii on FORM 11ollommiIN .�� � III I'� � � ,-9, � u.i� Flolis ii �I - �� � ■! II���! �l��! i� ?iII;IIN!�i�������!111111111111 �l II � IIIIIIIIIIII��! ������ !!QIIIII��!!i���!!��!i!�II ISHED GRADE VARIES PORCH 6 PORCH POSTS � - TE B1' BUILDER FRONT ELEVATION ' � c CGI ,•'G h,. e' SS I- 2848 HAMILTCCjj��I I P-&f2 BOX 683. W/2722 GARA C LryERPDOL, PA r7o�s ELEVATIONS:: (7r7) 444 -3395 WON OMNI �i� ��ti i[ 19911 WIN no, n NJ I Is till so Lis -111 E ii on FORM 11ollommiIN .�� � III I'� � � ,-9, � u.i� Flolis ii �I - �� � ■! II���! �l��! i� ?iII;IIN!�i�������!111111111111 �l II � IIIIIIIIIIII��! ������ !!QIIIII��!!i���!!��!i!�II ISHED GRADE VARIES PORCH 6 PORCH POSTS � - TE B1' BUILDER FRONT ELEVATION ' � c CGI ,•'G h,. e' s I- 2848 HAMILTCCjj��I I P-&f2 BOX 683. W/2722 GARA C LryERPDOL, PA r7o�s ELEVATIONS:: (7r7) 444 -3395 muvw Bn CWXAU 3, WE, �I.; u,¢E, FAX (7r7) 444 -7577 - HJC 10/16/}998 118•=11-1 :%.EXCELHOYES. COY p IS1] IaEVISIDML + ' ! mu b ON98117D t I' a. 3• Y J F -- -'- 2.' OL. TRUSSCS Dn rausscz a z.• Dc. 41• -5• 3- 7- ''1.0•. n• -+ t /2• l3' -1 1/2' SN- 10223/QN- 981170/Nl' WE 22'-0- 1 12' SP 48•-0• . 10'-0' 12' -0' 6'-7' 3' -7' 6•_2• 14•-3 112' 10' -10 112' • 12' -4• e' 0' z,• -8• •• 2 -2• 3 -8' 2 -z' 6 • � 7.�8'I � - ��_ -��- I I 40' -1 3 4• e'7'Z`x O 22-+ 3/ +• 6 3/4• 135.0' �" ❑B Iii I\ STAIRS DN -SITE ; • T7-7YT BY BUILDER 1 1 o a a ONIi 1•-6' SECT' N µp PWS L BEL LOCATION 0 0 0 2. C3262 2. 2x6 L1J�GL IYP_�' .6 N NOR 8 3 /B- 2a6 • V N 1121 GYP +,_7, b -7. I 76.2 X42 2.42 vAL X 2. N I II 7' -7' 12' 8' I BX B>6 DW so X 2442 12•_0• ` e I • I AsN I Dar 39'-6 1 /2' 3� 6•-4 7/8•� zGIRDER A" iLR SPA¢ ,�� 4 } a - - --- ,LAtMORYT - --��-- -- -14-- 0, - - --- I -, ED SIN EXIT WALL CENTERED i '. Y7' SOFfIT I m raq MIG Ir u ABOVE , {• RAM CARS 7/4• O ^ _ ;D iu gk a UTILITY - p. 693. so rr 3' -6' „ 136 LIGHT REPD B]DST. B30ST. a fU l�etl c I I :.7e WENT REPD © NOOK ''�4 DINiNG ROOM - 9 .DI LIGHT PROV• 6820 SO fT 19' 7' I SB.DD SO Fi i I I 11.6 LIGHT REPD L _ _ _ IYE. to REO'D 2..8 VCNT PROV'0 - .4 SKP2 STUDS '1N k N i A nl LIfNT/V[NT PaOV 6.7] VCHt R[PO ;�1 ?I E4 . UNIT I 1 2222 LIGHT PRO V'0 WENT REWD IJJJ 29L9 LIGNI PROV'0 LOL 1 Y93B WE PROV•D ' !R. pLY I I'p IL42 VENT pRDV•D 9' -3' I � CLG GARAGE 2• rUT VENT 4 -2.. SPF42 STuDS '. 6 27• surrIT I 1 1 ACC 1 101-6• 10'-5 7/8' EACH WIT DEP24 IT ` 1? _ ADPL LOLLY _ R0 J - - CA ".24 . RCPD _ DD]OtD UC2m.Y4 12 IT ".24 •0 4•_0• / / / / / / / / / / / // / / /T /T 7 T ❑ , P{-- -� N a UCS24 2 I X24 1 242 a/] N ' ////////////���//////777 E - - -- tK324 -� - -__ N 3' -0• 1 3•-6• 4• -H IR • -1 1/2 8'-3' +' -0' + -0' 3 I/Y MIN. DI.. STEEL COLUMN ./ • O MARTIN FIREPLACE m Q n W �$a 1/2'.6'.12' STEEL PLATE BOLTED TO TO, R. RI/23... 1/4• VIA �h1 j ON A 24'x2.•.12' CONCRETC r00TER P :ATH p ,- jai PROVIDED AND INSTALLED BY BUILDER tTYP) 19'x18'.6• HEARTH j 4,N '. Y. INSTALL ^ • Q u RAELMG vi :g O FAMILY ROOM OAIST . 236.74 20 rT W WALL FOR :1 _ m mA" 19.47 VENT REPD NEWEL POST �• $' -11' o iU He O 1 42 LIGHT PROV•D - 66 n.2 LIGN vROV•D CLO N LIVING ROOM o > 213.96 SO FT 17.12 LINT REPD 8.16 WENT REPD T. - FOYER 2222 LIGHT PRDV•n r m \ d 11.42 VENT PROV'0 iu • I7z• Gip 20'-11 7/8' D, 32'-3 112• N N n 1+' -8' LANDING -i9 15'_2• 16•_3' 2.6 2.6 O O 2i q��6 L•7 13'-6 k- /+0• 15•- 67/0• II O �- O 42 -67 /10, 3 -- I + 8 3/4' {I 0•_+ 7/10' -0' B 4r -0• 1{ 1 F 12' -2' •" I -2' +_ 1 �, Ij"5 -�• 4j -4--0 3�-6 -? 2i a -� L31­2 1/2• Ik l' -ID NOTES- 1. 2x6. EXTERIOR VAL'lS 8 16. O.C. WE 19' -II 1/4' " 2. 2.4 MARRIAGE WALLS 8 16. O.C. PLUne " 3. 9' -0' CLG HT. CB` =0' CLG MGT GARAGE) 4. 2x10 FLOOR PER METERS UNITS 'E' L 'F' 5. 7D VINDOVS - DOUBLE HUNG 6. BUILDER .IS RESPONSIBLE FOR CONTINUATION OF FIRE SEPARATION FROM GARAGE SLIT -SIDE OF ROOF SHEATHING 284$ HAMILTON 1 UNDER 7. CEILING DRYVALL WILL BE OMITTED FOR ALL ON -SITE PLUMBING CONNECTIONS 7 •'i ' R.R. #Z BOX 689 w/2722 GARAGE 8. RAISE ALL INTERIOR L EXTERIOR DOORS 3/4• CIST,FLOOR) EXCEPT UTILITY ROOM •' INEPPOOL. PA 17046 1ST STORY 9.' CLG GIRDER OVER $R TO BE:2 -1 1 /2•x11 1/4•x18' -D' M.L. / 2 -1 1/2'x11 1/4•x20: -8' M.L. 10. CLG BEAM OVER GARAGE TO BE:2 -1 1/2'x16'.22' -0' M.L. (717) 444 -3396 DRAWN BY, p ErgERED Rn yro SC 11. BUILDER IS RESPONSIBLE FOR PROVIDING'A PROPERLY ' FAX (717) 441 -7577 iE, t• -0• 10/28/1998 SIZED HEATING SYSTEM _ RE,,SIVIS..XR29 a -v -9L Arr Dux ND TO COVER A 87,000 BTU LOSS 12. SITE LOCATION: PUINAM VALLEY, NY; PUTNAM COUNTY, 30 PSF SNOW LOAD },.• 1' FROM THE IBI$iDE Ol1T IIFTN.£XC£LROHES.COH 11 /z./9e 1616 XL8358 o > T. 1 -------------------------------- 1 I i 1 i 1 1 1 1 i 1 1 I 1 1 1 I 1 ' 1 1 . 1 1 i 1 1 1 1 1 . i i 1 I I 1 i 1 1 1 -------------------------- - - - - -- i SN- 10223/ON- 981170/NT NOTES. L 2x6 EXTERIOR WALLS @ 16' O.C. 2. 2x1 MARRIAGE WALLS 8 16' O.C. 3. B• -0' CLG HT. 4. ROOF SYSTEM TO BE 24' O.C.CLT276-7M)CLT27- 7M)CGARAGE) 5. 7D WINDOWS - DOUBLE HUNG 6. PLR GIRDER UNDER BRII TO BE�2 -1 1/2•x9 1/4'x22' -0' M.L. / 2 -1 1/2'x9 1/4'x18-0' M.L. 7. CLG BEAM OVER BRIII /MALL TO BE :2 -1 1/2'x74'x31' -0' M.L. R.R 12 BOX 663 LIVERPOOL, PA 17045 (717) 444 -3395 FAX (717) 444 -7577 WWV.EXC£LROIr£S.COY 2848 HAMILTONiil 2ND STORY ; CHECKED NY. WiU .' �XLS359 10/28/19ITT 11 -9 •1T /.0 lck i' r H. . a i TNAM COUNTY DEPARTMENT OF HEALTH SIGN. OF' ENVIRONMENT L HEALT H SEIaYICES CER ICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD C TRUCTION PERMIT # -PV-- S - -7 S 5Z r fig; 43 �4�q L `ate � Located at o nn ! l for Village ?t)rA/A ,.M VQ-L.L1=V' Owner /Applicant Name V9 C0N5tRvcTtoL CoWaxMap 73, g Block ( Lot �Lf Formerly Subdivision Name Li to c-AR 3 Subd. Lot # 17 Mailing Address ? CRoToK r,>A rrt 2V C>651 Nov a N 4� Zip I- : Date Construction Permit Issued by PCHD Separate Sewerage S, :sy tem built by 4, coNSfiRucT-iatg co;p-,r' Address Sly Consisting of 12 StZ Gallon Septic Tank and 14 qq LF a-F' 2 ` ogr T_RZNC_ t S Other Requirements: Water Supply: Public Supply From Address or: Private Supply Drilled by Address _- is;•'�1 Has erosion control been `< I ippev vl Number of Bedrooms 121!591 Cr A) Has garbage grinder been installed? No 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,'l rules and regulations of the Putnam County Department of Health. Date: l ��-°1q Certified by Address ZN,;ire P.E. )< W. # �/T i tcrgS RT-22, �RGW std �l Y . /0S6ct 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 ti n, modification or change is necessary. ` By: Date:-W Title: White copy - HD File; copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 i DMSION DE ENVIRONMENTAL Y IRONMENT AL HJS.:/AILTH SERVICES _ _=w 7' -:•_W .^b["c •i'TrF�. �. �r:.• ...�. ., GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM V,5. CUNSTRucrt0 N '-OR , Owner or Purchaser of Building 37e-rZ roN pAm Ro.a.9 GoRt? Building Constructed by GRIAIZ RID &S cZV �VZ> -&-e Ly VA%CNE ©Mwa) Location - Street 73. it? l 24 Tax Map Block Lot _PvTNA,M V.-.LL 6Y Town/Village Subdivision Name �Z�SI�FNrI AL 17 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 system. ... ..;,:. �:.:::. The undersigned, furthe agrees to accept as conclusive the determina,gon , f tH Publif ealth Director of e ttna C unty Department of Health as to whether or `tlt th'' fail " e of tli`e stem to operat0 ras use; b the willful or negligent act of the occupant the�buil }ng ut l mg the Day Year Signature: 0 Title: ( Owner) - Signature \/,S' LONS i R ti CTiot) GoZe Corporation Name (if corporation) Corporation Name (if corporation) S/o 3-? C RoTO N vA-t -L 2oA-t> c Dap. Address: 3-7 c g_o rrn N pa, r, jZ,,a n Address: State os s, N, ry gT y Zip I o S z State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION _ Date: Owner- —cktCW,1­ Town ! y Permit # Subdivision Lot # 1. Seivaee System Area a. STS area located as per approved plans ....................... b. Fill section - ',date of placement ? 3:1 barrier I 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. Sew age System' a.beptic tank size -1,000 ........1,25 .,.......other........... b. Septic tank installed level ........... ............................... c. 10' minimum,�from foundation ..... ............................... d. DistribtuionlBox . All out ets at same elevation -water tested............. 2. Protected !,below frost ............. ............................... 3. Minimum 2.ft.Original soil between box & rencl Junction Bos - properly set ........... ............................... . lLength required Length installed 2. Distance to wal rc6ulselmeasured Ft..... 3. Installed according to plan ..... ................. ............... 4. Slope of trench acceptable 1/16 - .1/32 "Hoot ........ 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 %" diameter clean ............... 9. Depth of gravel in trench 12" minimum ............... :4:0 .. Pike end a�p�ed:: -_ ._ ::- ::.:::...:> >..4:� g: Puin D or Dosed Svstems ize of pump chamber ........... ............................... 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..... III. House/Buildin 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 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 pl f. Curtain drain outfall protected & dir.to exist waterc g. Footing drains discharge away from STS area......... h. rfac'e water protection adequate ............................ i. Er osiion control provided ........... ............................... Rev. 1/97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM �f S ConrSTZuc"i"�� N ca2�, 73.1f3 ( 24 Owner or Purchaser of Building Tax Map Block Lot 37ei?OTON PA MRo^.p.eoR� 7PoT- litA.M V,. LLCY Building Constructed by TownNillage 3R1A1gRj0&Sn Rt7 ��o1Zerlfi{@,Ly 14/aYNE Or4tvrQ LINC'ATZ 1T.0 Location - Street Subdivision Name TZ 7F id r i A L 17 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 system. The undersigned further agrees to accept as conclusive the determin do o ;the is Health of th Putn County Department of Health as to whether or. t e ailur: th T e system to op ate a `caus the willful or negligent act of the occupant" o:, the bldin utilizing the syste its p ° D e' '+ u Day 5 Year Signature: QQ Title: Pt 157 s i DE NT- Gene nt for (Owner) - Signature Corporation Name (if corporation) 37 GR -O-FON v,4-r"-%Zo &0 ed2P Address: :3.7 c g_o r-o N VA NA j�nA. y State OSg i N ,� q� Y Zip 10 Sz� z Corporation Name (if corporation) Address: w: State Zip Form GS -97 i i v pw r : ENGINEERING, SURVEYING LANOSCAPEARCH/TECTURE, P.G. LETTER OF TRANSMITTAL (914):27.8 ..i ;}r •''6. .. ..n,.. .. ;w -var •r. ;, - a.H::a ps:.^V s^.r 4 ^•t^.A.V asp -w .. .r•.:- •arw�'n¢t un:r..•, ^.mow. +. •-.ia :�yisi eLi�rocs�v -rii Brewster, New York 10509 -6392 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: p, G H , p, 1 j I Date: t _ $- 9`( ` NO. Job No. Q t tA7.15 17 Attn: AP kw, STS r'rs E�i •�Ei Re: j 1,jc,6r '�> Lo — l % 5 sT5 co.rr pc.�,¢Nce� 3 _ (0 _. WE ARE SENDING YOU Attached ❑ Under separate cover via i ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ the following items: ❑ Samples ❑ Specifications COPIES DATE ` NO. DESCRIPTION '`7 _- ,0- Approved as submitted ❑ Resubmit ^ copies for approval 3 _ (0 _. _......_......�......... l Z - � � - � �l --- _ c✓.4_ -rte res-T Cc�s v �'i� - Z— 9 $ •. 4aGg7 l.��'Z� �� GdK1 /�i7 l_C�ti� corrected prints ❑ For review and comment ❑ _..... ___ ..�._...__.._.._.. __ __ _......._ .................... ....................... .................. .._..._.._..__.... _ _._..... _..__......_.._..._.._._._..... __ _ ._..........._..................... ............................... THESE ARE TRANSMITTED as checked below: ® For approval . _- ,0- 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 ❑ I REMARKS: ............... ........... _ ..... ......... _ ............................... ......... ...... _ .......................................... ........... .......................................... .... ........................................................................................................... . ........... ............................... l ^; 1� NORTHEAST LABORATORY ®iF 1DA1W UPY "CTiCert::- PH_ -04Q4_ �W�Il v NY Cert: 11471 (203) 748 -7903 - FAR (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS DATE SAMPLE COLLECTED: 11 /23/98 & 12/1/98 & 12/3/98 4 PUTNAM AVENUE TIME COLLECTED: 9:00 & 8:30 A.M. & 9:30 A.M. BREWSTER, N.Y. 10509 COLLECTED BY: W. MAYERS DATE RECEIVED @ LAB: 11/23/98 & 12/1/98 & 12/3/98 TESTED BY: LAB# 11471 & 11301 REPORT DATE: 12/8/98 SAMPLE SITE: V.S. CONSTRUCTION, LOT #17, WOODLAND EST., PUTNAM VALLEY, N.Y. SAMPLING POINT: ROSE BIB SOURCE: WELL TREATMENT: NONE .TEST PERFORMED RESULT:. MAXIMUM CONTAMINANT LEVEL BACTERIAL: 12/1 -Total Coliform (Bacteria) 0 per 100 ml 0 per 100 ml PItYSICALS: pH 7.65 no designated limit Turbidity 1.9 NTUs 5 NTUs CHEMISTRY: Chlorine Residual 0.5 mg/L - -- Nitrite N <0.01 mg/L as N 1 mg/L as N 11301 - Nitrate N 1.6 mg/L as N 10 mg/L as N Alkalinity 108.0 mg/L no designated limits Hardness 1.20.0. .m ;no designated l inits Manganese 0.029 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 4.3 mg/L 20 mg/L ** Lead <0.005 mg/L 0.015*** m1= milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ** *Action Level RESULTS BASED ON SAMPLES SUBMITTED: 11/23/98 & 12/1/98 & 12/3/98 (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director oNORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037° (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800- 654 -1230 i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES j WELL COMPLETION REPORT W- ell <L ©eatzo� i - =: _: t��d �Cddr85� " waodiand '�Est�tebWf7/ViTi age: NOTE: Exact location of well with distances to at least two permanent landmarks to be prov d on a separate �heet/plan. 4 Putnam Avenue Well Drillees Name Address: Brewster, NY 10509 Signature: Date: 12/2/98 White copy: HD FVe-, Yellow copy -Building Inspector; Pink copy - Owner; Orange copy- Well driller i Form WC -97 r Kramers Pond Road �- Putnam Valley Tax Map73,16 Block ( Lot(s) Vzo Well Owner: Name: V. S. Corporation, Address: 37 Croton Dam Road, Ossinin , NY 10562 Use of Well: 1zrimiarD 2- secondary _ 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, i Screened Open end casing X Open hole in bedrock Other Casing Details Total length 33 ft. Length below grade 32 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 — Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface-static (specify ft) 40' During yield test(ft) 540, Depth of completed well in feet 605, Well Log If more detailed ' information descriptions; or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ' ft. ft. Land Surface 15 Drilling in over urden clay and boulders 15 Hit rock at 15' .!_15- 33 ' Drillin i:n rocky spa :,asin .. c1route d - - -- 33 605 Drilling in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 55_ m Depth 560, Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 Volume 86 Date Well Completed 11/7/98 Putnam County Certification No. 002 Date of Report 12/2/98 Well D ' (si NOTE: Exact location of well with distances to at least two permanent landmarks to be prov d on a separate �heet/plan. 4 Putnam Avenue Well Drillees Name Address: Brewster, NY 10509 Signature: Date: 12/2/98 White copy: HD FVe-, Yellow copy -Building Inspector; Pink copy - Owner; Orange copy- Well driller i Form WC -97 r I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,�.+c: -_, r �zs • r?a'.- t'Sv_" K„,... s<";. ' _•r°«�.';c c -::i =: '- :� • �a• �, i..: a,:.:,:•.'..ser�:.vruo.:e'�;:�: "----'�y,,:,:; CONST'tUCTI01�1 PERIVI�TS��VAG�E TREATMENT'SYSTEM PERMIT # 6 Located at(AP./�1A& LIANe -ED IVO�'1f�iE' 41&!544M,� Subdivision' name L /a/12 Subd. Lot # 7— Date Subdivision Approved q- 5-- 8 9 C FiL�O� Town or Village %�ili(�/�/t'1 Zi414-r y Tax Map 73/ Block --L_ Lot Renewal Revision Owner /Applicant Name: V S - 0-0t6fietK floN CD/1Q Date of Previous Approval - Mailing Address 3� C�6�o n�%�Alh - 0531 i N & /V. Y. zip.- S� 2 Amount of Fee Enclosed r Building Type �k51 % /j�L Lot Areat3- 310(plio . of Bedrooms Design Flow GPD_(%) i Fill Section Only Depth Volume PCHiD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 12LO gallon septic tank and i 7 Other Requirements: To be constructed by 7 C, mr pA14 X0, cam'. Address S � Water Supoly: Public Supply From Address d-= ®�: -_�=I Pry+ i- �i�>kl�d•.kiy....- .o-_�:�l�l(i� �-;'.. _ _ ........_..._.:._.:: �A�dc��s •:=- �,',ii�A�1�- ::.:.:�.:::'_.. �..:� 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, sti 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: P.E. _ - Date o 16176 p Addres G QI U2 U� I f/ U/�' License # 6 i 13 jggT KT ,2,2 &K wSfi:t - NY- fa5a9 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 petnit. Approved for discharge of domestic sanitary sewlige only. � C i By: �� Title: a Date: /4 Z White copy - HD File to copy - Building Inspector; Pink copy - O er; O ge copy - Design Professional Form CP -97 ' t F t a If (-I C Q rya Lo r / / e PUTNAM COUNTY DEPARTMENT OF HEALTH UAVASAUN UE ENVIRONMENTAL HEAL? rMl.r W4G✓:.'•OV.3 '.rc'af 6�'®� PE�r.R.ii: M.. I.� T FAO�`•�R •� FS/•� E WIO MAt G E �J �T•P..WR�E'•'..CAT iM1 PIERMff Y 4 Located at . k,4 VA Subdivision name L•/�Cur 3 Subd. Lot # Date Subdivision Approved `� e Owner /Applicant Name Mailing Address 37Ct-alah AA Amount of Fee Enclosed Building Type P1 c Other Retirements: or Village )r,1 dam Vy eV Tax bap 7 Block �_ Lot Renewal �', Revision�"`� Date of Previous Approval 7 • Zip Lot Area 3 i IVq. of Bedrooms '5� Design Flow GPD Section Only to consist of To be constructed by 37 Cr, V+ atea° Sean ®eve Public Supply From _ I represent that I am Depth -S" Vo9ume C'11.= )UIRED WHEN FILL IS COMPL1E allon septic tank and I IV �cR� 16L y and completely responsible for the design and gp described ill be constructed as shy accordance with the stand ar ,rules and r te% on f the Putnam Coye thereof a "Certificate of Con ction Co ce" atis factory to Departmend a written auara a will is he owner, his Aerating ondition an of said sewag treat ate of the i ance of the approval of the ertific builder will place god o immediately following system or any repairs thereto. Signed: APPROVED ]FOR sewage treatment sy modified when con a new neknit. An rJIME M-11,1111111111 Iglition of the proposed system(s) and that the 4n on the approved amendment thereto and in Department of Health, and that on completion blic Health Director will be submitted to the ssors, heirs or assigns by the builder, that said nent system during the period of two (2) years ate of Construction Compliance of the original 3NS I ®N: This pr al expires two years from the date issued unless construction of the in to d ins cted by the PCHD and is revocable for cause or may be amended or n s e PubfiFHealth Director. Any revision or alteration of the approved plan requires discharge of domestic sanitary sew a only. `— 1 e: Yel w c py - Building Inspector; Pink copy - er; Orange copy - Design Professional Form CP -97 • PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. APPLICATION TO CONSTRUCT A WATER WELL . c;.:; •.. ' -.. _.P .. •r.; r -. 6.i- ✓cr+r> - •jtle8sepi�n er -ry ; ' 'y. �t- ...._. ..-,. - -,- - .. ,. � Z.c <.�.'...�r: i. T� '��-; ig .y.-. .c ..rte'... _ .... .. t;. .p�,. ``� �PCHD`Permif #� '�✓- J- Well Location: Street Address: own/Village Tax Grid # 73, IY - 1 -.2y i "A rn Va, Ile Map Block Lot(s) Well Owner: Name: — Address: 1. aS�%ai.Jj kfY' 16 62 Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1 -prima Business Farm Test/Monitoring Other (specify) 2- secondary i Industrial Institutional Standby Amount of Use Yield Sought ,S` gpm # People Served Est. of Daily Usage _31�_gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling ' JL New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type_ Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes_ No -, Name of subdivision 1 -/hCyr Lot No. Water Well Contractor: Url /thown Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water; Supply: MAL Town/Village -� - Distance to property from nearest water main: Proposed 'well location & sources of contamination to be provided on separate sheet/plan. Dater Applicant Signature:. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and 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 or their designated representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and 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. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well 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 permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue r Permit Issuing O cial: Date of Expiration Title: Permit is Non -Trans errable White copy HD file; Yellow copy - Building Inspector; Pink copy - Owner; "Orange copy - Well driller Form WP -97 Owner; Located at (Street) Municipality _ Date of Pre- soaking MCOUNTY DEPARTMENT OF HEALTH, f OFx EN'�IRONMENTAL HEALTH SERVICES 7F�r Y LET - SUBSUR— FACE-SE- WAGE-TR-EATMENT "SYST IVI� Q& criz..y'�') Address . -�5 7 Of zpr6d Mw tzo*D, o�tr•�► ,✓C� � ,N , ,,✓•�;, c.=. ✓�� Tax Map -- 3,6Block Lot Z� adicate; nearest cross street) .,., I% Drainage Basin ✓ SOIL- PERCOLATION TEST DATA Date of Percolation Test /✓�-- Hole N' . 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 /Inch 1 2 3 I 4 5 1 I 3 4 � y I 5 i l i ! 2 3 ' 4 � ' 5 'NOTES: 1. 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. i i Form DD -97 i I G.L. 0.5' 1.01 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.01 5.5' 6.0' 6.5' 7.0' 7.5' 8.01 8.51 9.9 9.5 10.0' K A 'T'ES'T' PIT DAT. DE$C1Ri�TION OV'SOILS.-ENCOUNTERED, IN TEST HOLES HOLE HOLE NO. HOLE NO. VIN Indicate level at which groundwater is encountered /vim Indicate level at which mottling is observed 11/&7V6 Indicate level to which water level rises after being encountered A/ Deep hole observations made by: OHV pq. Date OL94LS I Design Professional Name: Jeffrey j. contelmo, P.E. OF NEW yL, Address: insite arjbieezing, arveying & Landscape Arcutecbme, PA- .,.I :, —(,, - zv- - 1548'5 ----Rofite 22 T "'.41- 1. Brewster, New York 10509 j 7 Signature: 6 V3 2 A .'Op Design Professional's Seal Indicate level at which groundwater is encountered /vim Indicate level at which mottling is observed 11/&7V6 Indicate level to which water level rises after being encountered A/ Deep hole observations made by: OHV pq. Date OL94LS I Design Professional Name: Jeffrey j. contelmo, P.E. OF NEW yL, Address: insite arjbieezing, arveying & Landscape Arcutecbme, PA- .,.I :, —(,, - zv- - 1548'5 ----Rofite 22 T "'.41- 1. Brewster, New York 10509 j 7 Signature: 6 V3 2 A .'Op Design Professional's Seal ,. / AJCA-,Z- 5 C---T t l j �PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ... . -. _ .. .....i .r T.�• -s _. Ti'- Y.'...� - .� -T� _ ♦. :tf .r . r... � .. .. ^.: . ". e. -p . .... �� . J. - ro.n+ �c. .t ra.xY� ^r� 0-.3 °. +:KV•t -r .c�:,y a. r� o LETTER OF AUTHORIZATION RE: Property of Located at &V v !1 Tax Map # T-3, Block �_ Lot Subdivision of UryCA-rC Subdivision Lot # 17 Filed Map # �0433A- Date Filed — Gentlemen: This letter is to authorize Incite Enghieering, Surveying & Landscape Architecture, P.C. (Jeffrey J. Contelmo, P.E'. a duly Licensed Professional Engineer �_ or�amdxVebdxaaxxxxxto 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 d/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the uc lion , the Public Health .Law .and -the Pufiiam County Sanitary Code. Countersigned P.E.,•, # 6 i i Mailing Address Incite ax neerinq, st,rveyim & Landscape Architecture, P.C. Roue 22 State New York Zip 10509 Telephone: (91.4) 278 -4990 Very truly Signed: of Mailing Address: '37 COOrVn) . A*al 9-D State Zip Telephone: q e 4-- 7 3 1 ''7 3C. Z Form LA -97 "PUTNA M COUNTY DEPARTMENT OF HEALTH[ DIVISION OF ENVIRONMENTAL HEALTH SERVICES ... A. Tw <••wa«»1%•'i'g:ra�R'%w��niKys+: ' >'r +c,:. !'V.i'.''ri''-i�-% AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: n.) K S w r-S D 1 V L s t t? ty I, UA-t- represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: C"—Pe_ 37 ccr7zW Wpm xg, c 91W,, rz&ca, v,5r cwaJ t Nc Having offices at: 7 7r.,,4 o�5401^16 , N I 0,--f, Whose Officers Are: President - Name: v.k' 5A-"j 0c -c- Address: , 57 Gr2o ro-•J PA,- -t t2_� A-t>, o 5-5 t vt 1vC' , Vice President - Name: Address: Secretary -Name: .. • -z �. ax U[t... .... n. i P n i .W-'r.:r. a.as. [r p Treasurer -Name: Address: and that I am and will be individually responsible for any and a)l It , the �+ oration with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this d c, (month) No ary Pub t LAWRENCE KALKSTEIN Notary Public, State of New York No. 01'-4752767 Qualified in Westchester Count Term Expires February 28 Form CA -97 Signed: Title: DION Date `.:Sutidivisiorn Nltaille.�[ Haiti ° ' Syibift W M aa�iloe/al>1 WlttalrlP Poll i Mows described, will bn:condr I rprapnt tMt I am wholly,a Oli:wbinm�d�to tM Opart NKa � tIOOA olowratiiN ea " "of tM;;apparal``of alw WIN be loeftie as thonrn ob: to CeuiltY rt o/ MMtI ale APPROVED. FOR "CONSTRL revocable for 4M, a: may. b "Quires a per t. • Ap Rev.. 10/88 Data /7 A7 aS"C•�,. ..=W. s sa�rn staAarol4 runes a .►pu ns o t�tsfactoiy.to the Coniminlonir'of MMlthwlll• it ' iii: OW0 by the builiar thit .frill b4iWb► will y.lia < <imnMdf�tbly fo110wiq tMati+,Of tM hau- tharKO 2) tlht tM afiilNd wI1,ANo►10�d a6ova ieaia% rukis'. :1411 Putnam ' of tDa ; Putnam P E 'RA. �J S 7Nft Lieailsa N . ton, bildin4 has bNn undartatken and if alts. Any cna or 'aatwatton of construction only M^L Title I L s r�C IiI. LOr 17 DEPARTMENT OF HEALTH Division of Environmental - Health Services 4 Geneva Road,. Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION Street Address 1J Ya E pirivir o Village City Tax Grid Number -73. g - t - WELL OWNER Name Mailing Address �1 Lig�,r/ Sr' private (�103G,4K 1 EGOPYr+e Go sic. L., e 7645 O Public USE OF WELL ®- primary 2 - secondary O=SIDENTIAL ® PUBLIC SUPPLY Q AIR /COND /HEAT PUMP ® ABANDONED ® BUSINESS ® FARM O TEST /OBSERVATION Q OTHER (specify ® INDUSTRIAL M INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED. /EST. ® REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION CAKM SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL OF DAILY USAGE 300 gag 13 ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING E�LL TYPE ONMIJED ®DRIVEN ®DUG ®GRAVED ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES A< NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No.. /Z WATER WELL CONTRACTOR: Name Address:-44 fJ,;10'0 % ) IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES �NO NAME OF PUBLIC WATER SUPPLY: AJ A TOWN /VIL /CITY A-.)74- % A- tFIST itC 6"klkOPERTY "FROM "NEAREST "WATERyMAIN: LOCATION SRET H & SOURCES OF CONTAMINATION PROVIDED f� ON SEPARATE SHEET i (date si natu 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 a manner as not to degrade or oth se contaminate surface or groundwater. Date of Issue: 3 ;3 19'7( Date of Expiration 3 IL 19 14L Permit Issuing Official Permit is Non - Transferrable White copy:-HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller y .• Al" •'err "• 'i.� Ir IS _ l4\ \�A •���`��' NN pope 1 „11 ONIES, INC. Pt TNAM COUNTY DE HOUSE PLANS5 APPROVET HMO( N1 COUNT ONLY; .0 27'8" X 48' e 2656 Sq. Ft. 27'8' 48' First Floor 100 010 0: KITCHEN BREAKFAST FAMILY ROOM 12'-0 °x 19-0" I3' -0, 20'-O*x IV-e FOR .DINING ROOM LIVING ROOM up 27'8" u-e Title 48' STANDARD SCARSDALE 11YEATURES 4-Spacious Bedrooms o. Framingham Pediment on Front Door * 2%z Baths o Fireplace Options Available * Open Two-Story Entry Foyer o "Boxed-out" and "Angle Bay" Options ® Formal Dining Room Available * Formal Living Room o Consult an Authorized Westchester Builder * Spacious Country Kitchen with Breakfast for a Complete List of Options Room and Pantry 0 Artists renderings and Floor Plan Dimensions are appro)dmate. n1 specifications must be Written in the * "'Cottage - Style" 3056 Lower Level Windows contract. No oral conditions. with Architraves on Front WESTCHESTERHODULAR KOMES, 114C. Q: P0. Boy, 900 o Dover Plains, NY 12522 1914183? -940'0 . I800► I I APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY .& ,SUBSURFACE SEWAGE DISJ? 9 L,-SYSTEMS..- . . _....._s�.� �• �; tCt tom,,.. - EW SHEET' foi 'CO1VS 1~RtJ'C 'IDW -�?ln - .a.. .: _ . . STREET LOCATION /� ti� NAME OF OWNER ()dlt l BY B. HEDGES; R.MORRI /THER DATE �J-qCTAX MAP # DOCUMENTS. Y Frl PERMIT APPLICATION m PC -1 m WELL PERMIT PWS LETTER m ENGINEERS AUTHORIZATION EE DESIGN DATA SHEET(DDS) El CORPORATE RESOLUTION PLANS THREE SETS m HOUSE PLANS - TWO SETS m VARIANCE REQUEST SUBDIVISION m LEGAL SUBDIVISION OD SUBDIVISION APPROVAL-CHECKED PERC RATE m FILL REQUIRED DEPTH CURTAIN DRAIN REQUIRED m STANDPIPES YN ED EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE III IF PUMPED PIT & D BOX SHOWN & DETAILED EE HOUSE - NO. OF BEDROOMS M WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM m PROPERTY METES & BOUNDS m HOUSE SETBACK NECESSARY (TIGHT LOT) m HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE m NO BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS m CLAYBARRIER m 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE m FILL SPECS m FILL NOTES - m FILL CERTIFICATION NOTE m DEPTH GAUGES m FILL PROFILE & DIMENSIONS m VOLUME GENERAL m FILL IN EXPANSION AREA m EX- APPROVAL SSDS ADJ. LOTS m WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH DATA ON DDS PLANS & PERMIT SAME m LF TRENCH PROVIDED m 60 FT MAX PRE -1969 - NEIGHBOR NOTIFIFICATION m PARALLEL TO CONTOURS -- I:EFER $UZBA -= 10G°/a'EXPANSION'PROVIDED 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECI F IED ON PLAN REQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) m SSDS HYDRAULIC PROFILE m GRAVITY FLOW m CONSTRUCTION NOTES (GRINDER NOTE) m DESIGN DATA: PERC AND DEEP RESULTS m TWO -FOOT CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES CUT FOOTING /GUTTER/CURTAIN DRAINS m EROSION CONTROL; HOUSE,WELL, SSDS EROSION CONTROL NOTE PERC & DEEP HOLES LOCATED REPRESENTATIVE OF'PPJMARY AND EXPANSION I FIELDS m 10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL m 20' TO FOUNDATION WALLS EJ 15' WELL TO P.I m 100 TO WELL, 200' IN D.L.O.D., 150' PITS m 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) m 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER m 10' TO WATER LINE (PITS -20') m 50' INTERMITTENT DRAINAGE COURSE m 200 FT. RESERVOIR, ETCH 150 FT. GALLEY SYSTEMS m 15'MINTO C.D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' <1% m 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. SEPTIC TANK m 10' FROM FOUNDATION; 50' TO WELL COMMENTS: -.� -':.w-r�- v-v�o. _. .. �; �r�'+ ��cioS: ot�+ �►^. �4 +u'ean�e.iv:..aiue:.,y...s>..� Bill Brickelmeyer Insite Engineering 1849 Route 6 Carmel, W 10512 Dear Mr. Brickelmeyer: DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 - May 2, 1994 Re: Proposed SSDS: Lincar Dev. Corp Wayne Drive Subdivision Lot #17 (T) Putnam Valley ffia Public Health Director Review of plans and other supporting documents submitted at this time relative to the above- captioned project has been completed. Comments.are offered as follows: "The construction of this sewage disposal system may be subject to local wetl.ands regulations. You should contact local wetlands officials in this regard." The SSDS is proposed outside the approved area as shown on the subdivision plat "Lin-car I I i._...�..... ...rc.. �_ .__ -ac. �.o.,.�_...�..,�..,. _...s :'vS- •°- v +..r�. ... .. �. �...... _.. .p....i•.y... �.. ... m.:. .a.._.- e....+.,.- '.e.4r... -... ..o.._ . ,... .. -.-. c... -.._ _. Please revise plan or arrange a mutually suitable time to witness deep test holes. Upon Receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve truly yours, Robert Morris .Public Health Engineer RM/ j p APPENDIX 3 " PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS EVISHEET.f_or CONSTRU�'IIQN- PERMIT w NAME OF WNER STREET LOCA77ON - - •a.x=.'' .. - BY DATE S TAX MJG� -3 � 19- DOCUMENTS. Y, N ? r ISCHARGE (OK) ml PERMIT APPLICATION. E & DEEP HOLES LOCATED PC -1- WELL PERMTT;w PWS' LETTER ENGINEERS' AUTHORIZATION DESIGN DATA SHEET(DDS) DEEP HOLE LOG CONSISTENT PERC RESULTS (3) PERC HOLE, CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST GENERAL J -LEGAL SUB DIVISION SUBDIVISION APPRO AL CHECKED PERC RATE _q i .fr /,J CURTAIN DRAIN REQUIRED MSTANDPIPES X- APPROVAL SSDS ADJ. LOTS (TOWN/DEC PERMIT R & D) DATA ON DDS PLANS &, PERMIT SAME PRE. 1969 - NEIGHBOR NOTIFIFICATION L ER BJIZBA . R :Q 1 ::FLOOD � LE V ATI O N UIIiED DETAILS O�Gi'�P'L.AI�TS""'"' "' °"""" ` • -• SEVAGE SYSTEM PLAN - (NORTH ARROW) SSD3 HYDRAULIC PROFILE CD GRAVITY FLOW D/ JB OX EFI TRENCH/GALLEY =1 P- PIT DETAILS SEPTIC TANK - SIZE, DETAIL WEIL DETAIL, SERVICE LINE IF OVER COIiSTRUCTION NOTES (GRINDER RATE) DESGN DATA: PERC AND DEEP RESULTS TM-FOOT CONTOURS EXISTING & PROPOSED DRNEWAY & SLOPES CUT FOCI'ING /GUTTER/CURTAIN DRAINS COMMINTS: SENTATIVE OF PRIMARY AND EXPANSION XP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE IF PUMPED PIT & D BOX SHOWN & DETAILED HOUSE - NO. OF BEDROOMS WELLS & SSDS'S W/IN 200 FT. OF PROPOSED SYSTEM PROPERTY METES &,BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE NO BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS 14CLAYBARPJER 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE FILL SPECS DEPTH GAUGES FILL PROFILE & DIMENSIONS ED VOLUME TRENCH LF TRENCH PROVIDED 60 FT MAX PARALLEL TO CONTOURS 100% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN F21100 S FREES; TOP. OF FILL ..- .0' TO FOUNDATION WALLS 00 TO WELL, 200' IN D.L.O.D., 150' PITS TO STREAM WATERCOURSE LAKE (INC.EXPAN) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (PITS -20') 50' INTERMITTENT, DRAINAGE COURSE 200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS SEPTIC TANKS 13J10'FROM FOUNDATION; 50' TO WELL WELLS Efli5'WELL TO P.L. I i ,--X* di .. PUIM COUNTY DEPARIMENT OF HEALTH DIVISION OF EWIRCNMMM HEALTH SERVICES DESIGN DATA SHEET-SUBSUFACE SEAM DISPOSAL SYSTEM Owner 69-,_-vuc_ A&Iress, z-17mc N.-,T. 1 -76,g3 Located at (Street) � ,VC c Sec. 73 . (6 Block lot -Z (indiaife nearest cross sa;J—) Municipality P07-A)&M VALf-EK Watershed Date of Pre-Soaking IV ZA Date of Percolation Test -1U HOLE NUMBER Cl= TIME PERCOLATION PEROOLATION Run Elapse Depth to Water Fran Water level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start stop Drop In Min/In Drop Inches Inches Inches 2 4 to 3 7-8Ku7J F)OCM 771r /-,-7,4P 0 Z�Y33�, .4 5 6A 3 4 5 2 3 5 kxm: 1. Tests to be repeateff 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. 6A 3 4 5 2 3 5 kxm: 1. Tests to be repeateff 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. i G. r.v � rc 1.y1. ccr T � •7 CAA7'rJ 2' 3' 4' iu�K .lit_I�c 5' � vc, is �{ r 6' 7, 8' 9' , 10' 11' � 12' L0,41-1-7 111Z IQs IIl E7 iCc Roc k e� '57' L o/??n 111 =- I(,(— M E I�1 13' -- . 14' • •, -• . -';.. ,.Y /�. +.a: <m. s- s'-�. KS .CK�:� ���_, ., ' .. yv. ,.. a. a•.... ...... rr -.... � -� --,. ___q^ r. ... _ Y .c'1'l _., _ .• INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED INDICATE LEVEL, TO WHICH WATER LEVEL RISES AFTER BEING ENMUNTERED ✓VO�%� DEEP HOLE OBSERVATIONS MADE BY: C-Vx^) ELJ V S DATE: I g DESIGN Soil Rate Used ` /0 Min /1" Drop: S.D. Usable Area Provided ,5 .0 -Sir No. of Bedrooms Septic Tank Capacity /Z,75-0 gals. Type COAC , Absorption Area Provided By W��� L.F. x 24" width trench Other virze -t�>f r. e SE rf irc 3. Ga,JTE LM C eta it i Name' snisirr: E;-C- /.JF_6xfnx Svrvcyl-xa PC, Signature I �, Address r`ev7� ZZ SEAL.`, ,a t U n , `` . /o5-Z-)9 6p 17 -4 .J57;re- W."1 ���'>. - ". Ei931✓°fcC�� /� THIS SPACE FOR USE BY HEALTH DEPT ONLY: Soil;Rate Approved sq.ft /gal. Checked by Date DESCRIPTION OF SOILS ENCXMT i RED IN TEST HOLES I HOLE No. 1�'Z HOLE NO. D - s• -+^.a -Js- -. r ,. ....,t. .•t _... ..� �:.. ✓-r. .. _+ .«. �' _ . - .:r+�,..T.= .- '....o »., r .. - ..... ....�.n.«:..r:.ia u.., . 1 . +S G.L. i �l ro HT L/G HT G(6N 1c S,�r��aF✓ 0rz 040,.) ,t3Ri00n7 CAA7'rJ 2' 3' 4' iu�K .lit_I�c 5' � vc, is �{ r 6' 7, 8' 9' , 10' 11' � 12' L0,41-1-7 111Z IQs IIl E7 iCc Roc k e� '57' L o/??n 111 =- I(,(— M E I�1 13' -- . 14' • •, -• . -';.. ,.Y /�. +.a: <m. s- s'-�. KS .CK�:� ���_, ., ' .. yv. ,.. a. a•.... ...... rr -.... � -� --,. ___q^ r. ... _ Y .c'1'l _., _ .• INDICATE LEVEL AT WHICH GROUNDWATER IS ENOOUNTERED INDICATE LEVEL, TO WHICH WATER LEVEL RISES AFTER BEING ENMUNTERED ✓VO�%� DEEP HOLE OBSERVATIONS MADE BY: C-Vx^) ELJ V S DATE: I g DESIGN Soil Rate Used ` /0 Min /1" Drop: S.D. Usable Area Provided ,5 .0 -Sir No. of Bedrooms Septic Tank Capacity /Z,75-0 gals. Type COAC , Absorption Area Provided By W��� L.F. x 24" width trench Other virze -t�>f r. e SE rf irc 3. Ga,JTE LM C eta it i Name' snisirr: E;-C- /.JF_6xfnx Svrvcyl-xa PC, Signature I �, Address r`ev7� ZZ SEAL.`, ,a t U n , `` . /o5-Z-)9 6p 17 -4 .J57;re- W."1 ���'>. - ". Ei931✓°fcC�� /� THIS SPACE FOR USE BY HEALTH DEPT ONLY: Soil;Rate Approved sq.ft /gal. Checked by Date i PUTNAM ' COUNTY DEPARTMENT O F HEALTH APPLICATIONPFOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM ' 1. Name and Address of Applicant:. L Iac�R •'DcvEc.oP•- �E..�T 4,v, sivc . 7-6r 43m7y sr. Larrc E ��,yz y , N.S: /7 6 YS 2. Name of ';Project: SSDS fat .G.4Az Dzyftot'�►o - �, K� 3. Location T/V /C: fo M414 VA!' 4. Project ;Engineer: 'Zvprc .fvav y ,wF_ c,5. Address: Koh U. License Number: 611 3 f .Phone: 6. Type of Pro ect:'� :. X_ 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 (SEAR)? Type Status (Check'One) Type I.. Exempt Type.II. Unlisted X 8. Is a Draft Environmental Impact Statement.(DEIS) required? NO ! 9. Has DEIS been completed and found acceptable by Lead Agency? ........... i aLA 10. Name, of Lead Agency; NIA - =1- - 4- s- t#i-s t- in.'an area under.. the,,control= of: local.planning;" zoning, . _ ; or other officials,, ordinances? ... ...... .............................rot at.".P6�[i+ri_ 12 . If so have plans been submitted to such authorities? No 13. Has preliminary approval been granted by such authorities? NSA Date Granted: �" A i 14. Type of Sewage Disposal System Discharge...... Surface Water X 'Ground Waters 16. If surface water discharge, what is the stream class designation ?........ NIA .16. Waters index number!_( surface) ........... ... ............................ Is project located near a public water supply system? ..... .............. A/0 16. If yes, name of wat er. supply NIA � �� Di'stance to water supply N�A X19. Is project site nea'r'a public sewage collection or. disposal system ?..... No 20. Name of sewage system N �A Distance to sewage system .N�A 21. Date observed: UNK1000A) 23. Name of Health Inspector: 4PN4° 4A) 1 24;. Project design flowl( gallons per day).. .............................. i ,i 20 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required?... NO 26. Has SPDES Application been submitted to local~ DEC Office? ..... eoeeooao.. '00,v/ A 27. Is any portion of this project located within a designated Town or State wetland ? .................... O . o 0 0 0 o e o o. o. o e m o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o e. o o 28. Wetland ID Number .....................e........e A o 0 0 0 0. o 0 0 0 o a o 0 0 0 0 0 0 0 o e e o 29. Is Wetland Permit required? e.. ..e ...... ................oe............e NO Has application been made to Town or Local DEC Office? s.a.e.s >o......... IUTA 30. Does project require a DEC Stream Disturbance Permit? ................... No 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 NO 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 DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ...e.. e.... YE-5 34. Are community water, sewer facilities planned to be developed within 15 years? M9 35,E Are any sewagq.,.disposal,.argas in excess of 15% slope? ........!".�t.��:�!? :. 36. Tax Map ID Number e ...................................................... 31. 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 fora 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 Law. SIGNATURES & OFFICIALTITLES: HAILING ADDRESS:' I1VSI'� I SURVEYING P. C x849, R" 6 (914) 225,6200 Carmel, New York 10312 Faac (914) 225-6438 �j "DeL'aue►bme Auentte . , o Wappingers Falls, New York 12S90 (.914) 297.1742 TO For" A,'n C.mVit77y b. —Pr op 9"(-T71- "L'71 WE ARE SENDING YOU iAttached ❑ Under separate cover via_ O Shop drawings ❑ Prints ❑ Plans p Copy of letter ❑ Change order ❑ ELFITTEQ OF IrMkRZO TUAL DATE JO B NO. gl3l7 _ RE: 1 JJ D� Li .11L s�aal vfston7 -- i— PCAD Fo R M PG- ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION -- i— PCAD Fo R M PG- PERen( _ 74P ?u t: qTt ot-4 14FAMAVIT- or- 6V CePWATC 40,00 rsK►P 1 --- D6s/6,j D wr 4 Su T 14J eau Pte► &,- r->Pu cAvv a --- 300 le-�Er- PAxr of 1300, 00 alqj n DAE Tt NSvtTc) as cfiecker THESE V- FeC.-awrova1 ❑ Approved as submitted ❑ Resubmit copies for approval p; For your use' L Approved as noted El 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 us at ce PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .. ...+r ✓: :. +n f':. .'8...±r:�l�Y1. .e; a... PL .� - -_ ._� .o.. - •. ....nw4a. Y4: f'-h' .A - �.. _ -� ._._ c D a't e� Re: Property of (jC.,, Located at 6J* Y JU (T) PU*rnJArV1 VAUx-Y, Section 73.16 Block Lot `l Subdivision of- -�"��2 5c���id�SrG� Subdvo Lot # 17 Filed Map # Date `j S) Gentlemen: 0 This letter is to authorize �051?r a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or re-gulations 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 :��..e.. cyst =eri . _'®y.--is"+`e s -in - e,oiff rmity �a4 li a o�ra� a sA -m r $cle . 1 ^•dy. -... � ; .'.p.- 1$7, Education Law, the Public health Law, and the Putnam County Sani- tary Code. Very truly yours Signed Countersigned: iC o ll.' y 0 9 Eil' '5-CjZ)eft6Y V5- Address `11`1- ZZS- 6 -ZcG Telephone 2 DLy�t.o /�ic-�vi GP.JS'1�G. dress 4:r7-C f�-�zzy1 ti'j 1-761/3 Town Zv I - q`10 - `17C, o Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH i Division of Environmental Health Services AFFIDAVIT - CORPORATE OWNER APPLICATION Q FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of, application for: =/-j G . �nJ G¢ � _50 BDT 7) L / �J C A TC -Pr' 6P.111 represent that 11 am an officer or employee of the corporation and am authorized to act', for ' (Name of Corporation) having' of f ices at ZS < <-� z3e-r-Ty S 1. Ll rr'�c- Frey ; A� 5 3 Whose officers are: ,, 9 c • I L)v��c.a / )4rokcc�.� ZS I CJI3EiLTr/ 5� Csrruc- FETZiZ/ )/0T 76,13 Pres_d. nt• (;dame and Address) Vice - 'resident: (Name and Address)' Secretary: (Name, and Address)' _ : _ - _ _ ... >.• Treasure: (Name and Address) and that I am and will be individually responsible for any and al��ts of t corporation with respect to the approval requested and all subse'�t acts• acing thereto. Scorn to before' this / / day . Signed: of �� pq Title: Ab Not ublic i ,ARLNE FAUSTINi �1pTAR� PUB, es Jug 24,1996 MY COmmISS10 P Corporate 'Seal I I EAIG/MEER /MG, SURVEYI/VG & LA/VDSCAPE.AACHITECTURE,'•P.C.... , - s.;4•rJ1 , - -r October 20, 1998 Mr. Adam Stiebeling Assistant Public Health Engineer Putnam County Health Department Four Geneva Road Brewster, New York 10509 RE: Lincar 3 Lot #17 Briar Ridge Lane (formerly Wayne Drive) Tax Map #73.18 -1 -24 Town of Putnam Valley Dear Mr. Stiebeling: Enclosed please find revised Construction Drawings and appropriate documents for an SSTS Revision. Please note that the SSTS was redesigned with no fill due to recent deep test holes. 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. ..✓ w. 4�, .. ewr .mss. +s r .., 'L9u 39-Mfr+.s •w4.`w...u.�P. T '. r��,- y.,yr.v iTr.�C, sa ..�r...Hr.i�...� -.... ... - �� . rip.• r r - Y4••y .�+��W'w.•.�ww4 �.y...q.. -. v.r.....y �t ^.W ^.- 'i�w•.•.4. .�.. .. -M•. Mr By ar 4on te o, P.E Pne r JJC /jms cc: Val Santucci Insite File No. 91147.317 101698_3.doc 1485 Route 22, Brewster, New York 10509 (914) 278,4990 Fax: (914) 278 -6392 ❑ 7 DeLavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -1742 www.insite- eng.com MUM COMaT MrARTMENT OF HEALTH Hida swvkm CUMA N.Y. 16512 afthow to FMVMM Pamn 0 Z51/ 1 Dhmmdenwbvwmmw (ZRTMCATE OF COSPUANCE PEUM FOR UWAM MWOSAL r C I (A RWhj TO!- or, raiw.. Aod at 7 SubdlvWm -Solad. Tax Mop 2 3 Block •'• _0 LAQ414C(L 00V- 6-0.0 IWC. DM, of Pwvlous AkwW MdbgAdillIeoeze3( L_(:Y:grj?TY !!—f->T Two Lf n-f- kewt Nb, zip o (aq 3 Date Subdivision i Approved l-5-22n Fee Enclosed ❑ Amniint BuMillng TYi*1Qe_12(rCz"h42_ Mot FM Section Only Xj Depth _Z!_VdUW NUAW of Bedrooms Dealgop Flow G P D PCEID Nodleadon Is Requhred Wben FM Is compleled sewmw sydm to 6MM of Z5D_G.___ sq* Took .d44 4 To b.6 coolancled,6 QW Water SW*. PA M & S* Flom Address . I ore Mn.ft Sop* DAW by k ---Ad&,= 0111 6 (=-jL_L_ ZE aviv-EV -k- APPeox- 017-ti-or-4 F14-.t .,L I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate Sewage di sal •stem above described will be constructed as shown an the approved amendment there to and in accordance with the standards, rules —& m-Frogulation, o u nom County Daiiertmerit of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Doportf4ent, and a written guarantee will be furnished the owner, his successars, heirs or assigns by the bulkier, that said builder will Place in good operating condition any part of said sewage disposal system during the period of two (2) yews Immediately following the"to of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto-. 2) that the drilled well described above will be located as shown on the approved plan and that mid well will be Installed in accordance with the standards, rules and red-uTaTo-Rof the Putnam County Department of moaittL Dat!53 -7 Signed P.E.>—(' R.A. Address4f, a FI\)(-A &C, k4 License No q APPROVED FOR CONSTRUCTION: Thi1S,­ap(*o.ii CE, wli years from construction of the building has been undertaken and Is revocable for, cause or may be4manded or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a now permit. Approved for disposal of domestic sanitary sewage, and%o► private Water supply only. Rev. 10/88 Oats By Title DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT `5-19 WELL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name De-"V. C.v Mailing Address ILy . L e: /,7& -fa Wrivate rWoell Alit 0 Public USE OF WELL 6> primary 2 - secondary WRESIDENTIAL 0 BUSINESS ® INDUSTRIAL 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP 0 ABANDONED 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify U INSTITUTIONAL 0 STAND -BY El AMOUNT OF USE YIELD SOUGHT 5 gpm /$ PEOPLE SERVED `4 /EST. 0 REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION NEW SUPPLY NEW DWELLING1 ® DEEPEN EXISTING WELL OF DAILY USAGE -5Oc9gal 0 ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ODRILLED ®DRIVEN ®DUG [](;RAVEL 0OTHER IS WELL SITE SUBJECT-TO FLOODING? YES NO IF WELL IS LOCATED IN' A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. rZ WATER WELL CONTRACTOR: Name will "Ow 10 Address: L) QVW8VJ0 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES >< NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE-TO - PROPERTY- FROM-NEAREST-W A'iW?3AIN: LOCATION SKETCH A SOURCES OF CONTAMINATION PROVIDED _ N SEPARATE SHEET (date) PERMIT TO CONSTRUCT A WATER WELL ature 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 a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: Date of Expiration 19 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 •, I PUTNAM COUNTY DEPARTMEW OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES I Date - Re:'; Property of I. -INGAK D>✓y.LO�htEtl'r' G�� It�1C Located at &-)A!jsX DR.1OC (T) T->U • • A A ALL-CY Section -7-3.t& Block I LO t, 1 Subdivision of LIkC-A,?: 11L 6UBDIVIS10A Subdv. Lot # « Filed Map .; 2�j33 P. Date - $1 I Gentlemen: This letter is to authorize Insite Engineering fr Siirve;na_P.0 . a duly licensed professional engineer X (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with th-e 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 systemlor systems in conformity with the provisions of Article 145 or 147, ;Education Law, the Public Health Law, and the Putnam County Sani- � j tary 'Code. Very t Signed Counter, signed Jeffrey J. Conte P.E. ,i )lax, ,#/ 61931 Insite.Engineering•& Surveying, P.-C. Addre=ss Route 22, Brewster, NY 10509 a 278 -4990 Telephone L'tR:1GAz 1;>EVr, L�Opkjv OT Gb,.� lP1G. ZS I LIIIERr1 -.-.T Address Town I ' Telephone 11VU1 V 1 J a 1iJ • YOUZAN OUrr1LZ of OUMULWftL G �?15YYH ZZ U.LOk%"U# .7Z.Y1'ld"!,7 REVIEW S - CONSTRUCTION PERMIT ��.. (Name of Owner) COMMENTS required _ 60.fte max. Parellel to 100% expo _ 10 ft. new 100 200 ft, reservo ft. tr contours , ,etc. DATE e bit te1A9 r-'f-- eyec G% BY: (Street Location) YES I NO DOCU EMS LAM Pernu t Application rporate solution Plans - Thfee sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc. Hole Depth : H-Plans - Two sets s/s (3) W permit; PWS letter — Variance Request GENERAL e Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland /DEC Permit R & D) Data D lans & Permit Same Mumtrvghkuls ON PLANS Sewage System Plan (north arrow) Sewa e ISSS9 H is Pror' - vity Flora ill rD' nsi n� olume - D or. ,Tren , ery; tails Septic Tank - Size, Detail Well Detail, Service Line if over Construction- Notes,- :Sgrinder,•= rate)' Design Data: Perc and deep results ' Two-Foot Contours Existing & Proposed Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area ;shown,gravity flow,suffe size Box Shown & Detailed House - Wo 0 of Bedrooms Wells & SSDS's w /in 200 fte,of Proposed Systems ro rty`11 etes ..& 4 House Setback Necessary (Tight lot) House Sewer - 1 /411/fto 4 110; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D >L.O.D,.150' pits 1001 to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Leader,;Footing 35 1to catch basin,stormdrain,piped watercourse 10' to Water Line (pits -201) 501 intermittent drainage course Septic Tanks 10' from Foundation; 50' to well — —LOT 16 c• i t AS- BUII,j MEASl1REyENTS x - - - - - - 3.345 ACRES f MO. A B REMAIN i 16' 67' 12so:�� sePnp,�T �r 2 39' 52' DROP' " 3 ' 43 -' 56'--- DRQP B(i -' 4 48' 61' DROP7; 5. 53' 66' DRD�.`30, „Y 6 41' 708' 'END,.Of�'E 7 44' 110' :•END O , 8 49' 112' ',END OF �TRBR( 9 48' 106' KENO OF TREFY _ 10 96' 45' END OFjTRE..,. 11 98' 51' END 12 101' 55' END 0. y 73 94' 59' END