Loading...
HomeMy WebLinkAbout3461DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -131 BOX 28 03461 1 9 r y X T 0.1 03461 blao� ' pumAu COVNnr mwAr lam of B>mu DhAda, d lmt.isest.a.td BW S ard. N.Y. low WON"Filee ran" SM MATS OF colnUAN Z Pas>tat Fort MAi DINKNU sYSlfl[ PWUR ' L « G" /Lt, Re)kr) 5(.., L) Tip( *M . ak Whip Two zip' 1-n-¢3 "fta tho /QE 9 D EN r)*I -- ,�., l • `i 4 ,'i'�. F® sn" air Depth valta>re Naalbw d Deicer Dedp Plow G P D U0 P ®Netl0otlee Is Dege�red Who PDl b oeapMted 8epeew Sewewp SPeh. M on ow at l Z >Q 'r1.,.. S"a Tua and 6100 GF s-F i9 i eworw 'rx ewe wcS To bsy b Gr NIYi n7 4/t .J Adive, 1.1 N fro J �✓e1%. W&W Se"tr r a,. Slip* Pte, Adiese an pa..p Sw* DAW by "A,AW � Ad&m . I /.h/1Gr►�Ca:,.i Olisar Regieaarb /'- 6 - /i , 0, 13, j'/ ct- 1 repremnt':that 1 ash wholly and completely responsible for the design and location of the proposed system(:); 1) that these rat• sew • di ssl s stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a rpu ns o County Department Of Health. and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be M,bnlNted to the DOOM NMI . and a written guarantee will be furnished the owner, his successors, heirs or assigns by the bulkier, that said builder will pace In good Operatbg condition any part of ski swage disposal system during the period of two (2) yes Immediately lb following tdate Of the Now ante of the approval of the Certificate of Construction ar Compliance of the original system a any repairs thereto; 2) that the drilled well described atioee WIN W located a$ shown on the approved pan and that aid well will be Installed In accordance with the standards, rules and ree— Ores of the Putnam County O ertme t of "aft". Date &11clict r � Signed P.E. P A. — � L Agar•._;,VSr E7yda��zd v' c r r k•Me No APPROVED FOR CONSTRUCTION: This approval expires two youselPyn the e i less con etion of the building hes been undertaken and is revocable for CAUSN OF lo_ ay be smerWerl or modified when eonsid ►y by the mission► of Health. Any charge or alt•►atio of construction raOUMes a new O mil A proved for disposal of domestic age, and/or t• water supply only. Rev. 10/88 DO By Title P� ?V. 1LQ PUBMUCOWWWARTMWOFELAM view= dandm mmw Be" Sa•bae. Catnd, K.T. Ilm N X18 O Pwtdde Pa,dt puma 0 .a .skv s�a.Ida, lea.. Ld1.iCjZ �I s:1a.f IS( eaa 1 '73. 1 3 rt � Tax Map— � Nsch o..ar /sppdtN... L,�NCh.� D�y� 1.OFMEN�T Ce>.,1a►c,R=aw.L_❑ Doddae ❑ Date d Pmwlm Appovd l(a�D AdieM ZQ71 L� [ Tr( S`T, Tow, LITTLE FEK - -( NJ 1'7 (o X43 Data SuhdiviGinn Annrnv4ad `1 /S /Pgl"rj[1?n� Vee >.,., 1—A . ~ills Type 2esip>e AT Id L 1A Ave, .S4�1 Act2es sftava Depth vahtr Ns>•hae d ••�• Dells Plow G P D ��. PCBD Ne0tle, IS R04dmd Wise, PM Is anpiwd squab Saremp S7eww a omdd d � �'� �-o- Saptic Tank -d 5o C� L : F. ,b,�a IePTl01y TILENGNEC� Te be ea,aO,etad by LI1" K 1-10" VIA, ♦aa.r l.. � ell t1JO W f�i WaMr Sw* Flee Addees on Pdv -- s** DeOad b, y wKr�`� -a►� ��..., use KNo�i t1 otise 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(q; 1) that the separate sewage dispoal system above described will be constructed as Mown on the approved amendment there to and in accordance with the standards, rules a rpu ns o im county Department of HMRh, area that on completion thereof a "Certificate, of Construction Compliance" satisfactory to the Comminkmer of HMithwill be submitted t0 the OeWrt NMI . and a written guarantee will be furnished the owner, his successors, heirs or aaigne by the bulkier. that raid builder will Mesa. in good opersti l condition any past Of aid -- ,- a disposal system during the period of two (2) yews Immediately following the date of the law W49 Of the approval Of the Cartifkate of Construction Compliance of the original system Or any repairs thereto; 2) that the willed well described above Will be loute0 as a, - On the approved pan and that saki well will be Installed In accordance with the standards. rules and ree—Um of the Putnam County Dapartaant Of I smi 0. Date ; % 2 2 %9. six e� Dt I l sw a BtJ3& .i t ). i O.E. _ R.A. _ Adore- k 01 { cone & ` ' Z la Lg j License No- APPROVED FOR CONSTRUCTION: This approval expires two revocable for cause or eY be amended Or modified when eonM reollkes a now/pern; it ��pprOwed for 4NOMI of domedk s bates .y d unless construction of the building has been undertaken and is mmiw1oner of Health. Any change or alteration of construction rats water supply only. n d / w TabsG/ •° � °U"?�a!1 IMa!9�T1 Ir?Egm.+,d47i'�fl'r.;`r! mF rar..�i ir.. U %•Mi.na a1 Bhu.trvMim•mis.l Kau r en CS. M.FWA73 OF (M.I! 'R'7 i + S IM }: t F"eay. Al 1 y i �:;wlits!CTley ". 9`�i�ibR!i7 FviQ �y�':4 �(Hti U�hS'thBSA! 11S- 1�F'•W:M i.. kWx 'u � xA.,{ ! at I Irm \A ,.W I'ikN.i I �u.,� tin ti.� -_ � � f 1 r'list� .'t '_I � sr• � V PS 1 roprasarrt that 1. am .wholly and complotoly responsiblo for the cosign and location of tho proposad, syitam(s); 1) that the mpa►ate_sm disposml system above dcmcribod pill be constructed as shown on the approved amen there to and in accordance Grith.the,staridords, rules a R rco tuns o nom County ®eportmcl It of. "mot.. and that on cof?mpbtion'ihoroof o�^Cartificoto of Construction Cornpikirko" satisfactory to tho Commissioner of Hoalthtvill Ma scabdnmcd 'to' two 'Do�►ernant, areal a - arrititih ,gilarantoo, dull bo 4uvhisha .oho owarlp,. Pris:mrccoas ?s, w0174 0► asst' s by tho bui0dcp, that sold bundw will pbeo in {l¢od op zatinp condition any port' of �iid" �rogo dispor9l system during the pprlod of tl.o (81 yenis Imooc3diotoiy fokro iing thedato 00 tho im. SIM of tpo apwca61 � of telo Cortificato of. Construction Complioneo of � Oho original systdin or any ropods thc;reto; 2) that tho drilled wall dosw� obovo w,100 be tocata it as Mcr-wa on Oho epos vv plan and ,tlot goid tvoll.arill'bo Installed in accordance with the ocedar % 'rubs and rdeu�at ones of tho Putnam County O=rtwcowt of Nwitfh. 8'080 Z' Qj. /... Sbnod P.E. Addveislu- -- C1 kr� to !f Icenso idol APPROVED FOR COiVSTOtuCT10R1: This approval anpiios.taio, years, from the date: issued unless construction of the building .has boon undortotcon and is vovoeabb for eauso or may bo onmondod or modified arhon eonsidc�od nexssspry by the Commissioner of Health. Any eharego or alteration of Construction v4o]uf de=17' t.- fpsN i 04 dcOmost nary , r supply only. • TiQb My _ SHERLITA AMLE M_D, MS,. FAAP commissioner o �' LORETTA MOLINARI, RN, MSN Associate Commissioner of Health November 3, 2005 Carmen Vail 6 Briar Hill Drive Putnam Valley, NY 10579 Dear Ms. Vail: ROBERT J. BONDI J �wei eiti •fin .,=- f',^,`� 'mar. a�.a.ia v;-•` 1 .DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: Addition — Approval — Vail No Increase in Number of Bedrooms 6 Briar Hill Drive (T) Putnam Valley, T.M. 73.18 -1 -31 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 .dated November 2, 2005. 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 _. 3. All plumbing fixtures must be updated with water saving devices (i.e. new low 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. Very truly yours, Michael Luke Public Health Sanitarian ML: cw cc: Building Inspector, Town of Putnam Valley 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) 278 -6014 Fax (845) 278 -6648 SIIERLITA AMLER, MD, NIS, FAAP Gust*rrnl.�.•;ioner�I_aer�llth.. - -- . _ _ - �.,' ,K;�r:•,.r— ,rpc..,st�. -_ .. :r .�,�r -' _:yam_ �, t....n_ ...- �_ -,'.� <, LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI - .County Rreruttye. - DEPARTMENT OF. HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION r ' r D _.,OLD RESIDENTIAL ONLY STREET iC�U� C.Y" l ( Dle- TOWN 14211116 U� � 'TAX 1VIAP# '7 NAME ( �I;17 c`'/I�� U V PHONE 1116 1 law, - ra DESCRIPTION OF ; ADDITION — L _e .,/l.er) 9-)✓i NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (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 -sub�,rit�y?zA fcllnw�°�_t ®. -P s tai�nt;Tea� Dec�t:�Geneva�R� . 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, aU Hving area including basement) 3. Two sets of proposed floor plan (drawn to scale — with name, street and tax map #) *Non- 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 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845).278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 'a SHERLITA AMLER, MD, MS, I'AAP _ Commissioner of Health . �tt:¢ rt:• i:' a.-'-. nacef 'i:.�i�"�lti+T.�._.- .'". =:+a,t �•�- v'+.�tr�.�ia :+ LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. B©NDI County Executive e'^`-: aav? n. s�. s� „:.r`":7:.�►.'r,;�:i.>.i►�y�.i ',.:.,.:.:i• :a:*r- -��w:v ..:�'�< DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 PUTNAM COUNTY DEPT. OF HEALTH. 1 GENEVA ROAD BREWSTER, NY 10509 To Whom It May Concern: According to r cords - - r IS NOT Re: A �- Residence r TAX MAP# TOWN VAU” maintained by the Town, the above noted dwelling, ., ...t.1- ii�vl .1120i1!PL-i nyl .Crrl-. _•�.. �P. -.iw �+ IN COMPLIANCE WITH TOWN CODE (1i lh t s�►ed- ���� Mir ' 'J� LEGAL BEDROOM COUNT IS This information has been obtained from: CERTIFICATE OF OCCUPANCY: OTHER Building Inspector Date CERTIFICATE OF OCCUPANCY lm Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 SHERLITA AMLER, MID, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH f Geneva Road, Brewster, New York 10509 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, NY 10509 To Whom It May Concern: Re: . VA i L Residence ROBERT J. BONDI County Executive TAX 1VIAP #: SOWN + R I According to records maintained by the Town, the above noted dwelling, .._. -. .. _.... ��.._ _� "d1AT'f1ATAMFI SL \ O.i V'l�ld mJdGS.I ♦ z`. •Y• ~ 4 IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS This information has been obtained from: CERTIFICATE OF OCCUPANCY: OTHER: 1c5 Building Inspector �'b Date CERTIFICATE OF OCCUPANCY Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 lm 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 Oct 24 05 09:53b Commissioner of Health BUILDING DEPT LORETTA MOLINARI, RN, MSN Associate Commissioner of Health 9145268806 DEPARTMENT OF HEALTH I Genev.a,Road, Brewster, New York 10509 PUTNAM COUNTY DEPT. OF HEALTH I GENEVA ROAD BREWSTER, NY 10509 ,Re: Residence County Executive TAX MAP# -13.18 — ( —31 p.2 TOWN +na on VA I To Whom It May Concern: According to' records maintained by the Town, the above noted dwelling, 114r- T- C 7 COD -16- A, I %Cb 'IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS This information has been obtained from: CERTIFICATE OF OCCUPANCY: OTHER: 7 Building Inspector Date CERTIFICATE OF OCCUPANCY Im Water SliPPY SOCAOR (845)' 225-5196 Fax (845) 225 -5418 Environmental Health .(845)278-6130 Fax(845)218-793t Nursing Services (845) 278-6558 WIC(945)27"78 Fax(845)278-6085 Early Interventloafteschool (845) 278-6014 Fax (845) 278-6648 nrT-P4-PMM -Mn w 1'1 M: '—T-P-71---P-4-'c';-;:)7P 74 ;:) I mama: Pi itmam rnj IKITY n1=P0PTM;=K1T np- P P Oct 24 05 09:53a BUILDING DEPT 9145268806 P.1 26+5 OSCAW4NA LAKF. ROAD . ._ ....0 . -.•„ .e K.�..Ai��'. rs1.L.. i . iv i "iJJ'!3`'_ '_'cdr, .., r � ...c...,,,:'. w �,tr... ..�... _.•.. r,., •:tom. __ � � t .. .>,. - :,cY". 4, .... ..._.......... .... .. .......... .. ............... :...._.t :..::F ::::.:_..+. -...., ....... ur:: o ::.r_,j.:,c:p:n'.....,.v' -a..t. �uL• ri9ui'..., .a x_y:ao..._..:. - - ....... .,:. ....... ......... ... .. .................: ............ ....:.. . se..._... .....:::�.............,_....... ,.._...c:x.,.- ::_,:: s. _... ra3uu....., ,: ..la. _ -3:L ?' - `- c:.i:. ^.i ......_......., _....... :. . � ....:. .... ... ..:....:.:.. ._. ..... ., .... .... ..:... .. .. :.c ._:�......_....._..,... ..:r -... 1 uS 9 ,, it„':e: { >i,.ia.. o =':p {, ,.... _:.. .. ,:: _.:......_.:._. .._._.._ a_�n .... ._.... .a.ms_., �e._._., ek.c +_^"u71i6ss..;, _�ti�i � ?jil•.y «r� oG;. 'r•u �iE:' .. .... ._...,:_ ......_.l..r_,..._.. , . �. , _. ....... .. ..... ...... _.. _... ,.:. , =rsn.. _..... :.:... . _,.v..n„ _s:•:: �: r::.r:.= 'I•., ^':: �?!;'iis• ci . _ �.�r, �l,Y s_3F.. i4i( r'f .t..,r_.::..! . ......,.._:,.:. �:�,_. ... ul,.,:F.,,..«.:i.,:.,.. •. �: c.... �. .... _._ d °i t,P_' °...:- :.,:u.t7 , r..........'u..u. ,. d-:2a. T'r'tn.0..,v , :.. acs n le ftwstni" To: JOSEPH PARAVATI Fax:. 845 278 7921 From: JUDY TRAVIS Date: 101242005 Re: CARMEN VAIL TM #73.18 -1 -31 Pages. 2 Cc: 0 0 • 0 0 0 0 0 • 0'.dJ �Oeat ❑ F67 Review ❑ Pin" Convo d ❑(fie Reply ❑ Please Recycle RE1/ISED'BEDROOM COUNT LETTER FOR CARMEN VAIL.. THE ORIGINIAL LETTER WAS DONE IN ERROR, PLEASE CALL ME IF YOU HAVE ANY QUESTIONS. e o G e U C C G G n MnN 9a.:4P TPl:R4S- a7A -79 ?1 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 0 p 'jdLt-jL t -, Zone District . R-2 i u vv isi u r r u i iNHivi V tALLL Y PERMIT RECORD Application is hereby made for Bldg. T C I ion 6 Briar Hill Road Location of Premises—Street or Road Permit Work to start j z-V - TM#73.18-1-31 SEC.� BLOCK--- LOT FRONTAGE Depth Rear ACRES (other description) I or number of square feet 739-7362 SUBDIVISION N . AME Lincar III /Woodland Estates TEL. OWNER V.S. Construction Corp. ADDRESS 37 Croton Dam Road Ossining,N.Y. ling CERTIFICATE OF OCCUPANCY ONE FAMILY W/REAR DECK Certificate of. Occupancy No .......9g ..... .... ;Applicatio n ... No ... 98-53 ............... ........ Location of Premises ... 6 Briar Hill Road - W13.18-1-31 ...................................................................................................................................... V.5,.' Construction .9 Rrp - .. Of rtdn 'am Rd.-O ssin in g , N.Y. N ... . ........ I ..................... I ..........! ........•......... heretofore filed ......... having an application for a building permit� pursuant to the Zoning Ordinance, Sanitary Code and the -Laws in effect in the Town of Putnam Valley, Putnam County, New York, 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 struc. ture in, compliance with the requirements of the laws as aforementioned and -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 read for occupancy pursuant to the provWo therefore, this certificate of occupancy � P cy ns of law, Now, hereby issued under the seal of the Town of Putnam Valley this ...... A.5..... day of ............ !u. Y .................. Not Valid unless signed in ink by a duly authorized agent TOWN OF P *VALLEY, Of 04 under the ad of the Town of Putnam Valley. By .............................. I ............... ................... 10 0,0,e 1114,5 -,r- Plumbing Pemit J6 Well Permit TOTAL 0 tc d10u) Ck jov,., I cq ZBA Approval. PCBOH- Approval i Planning M � NAM v1 �T 'r n G i IL P-0 ��, �. �.. i.os'0i'tf����'��s`° -tom AY'r9Z.$&k a' +• '3•�; E T- ^ CERTIFICATE OF CONSTRUCTION COMPLIANCE IF S'; ATMENT SYSTEM >PCHD CODS RUCTIION PIER` IT # f V -11,-`0 � F . B try da0� L aeat'X" KW— 1PQVN own r Villag �a< i e�r'1 v�r Owner /Applicant Name -37 C!l -arl 10, 6W, Tax Map -73, Block _� Lot -SI Formerly Subdivision Name Subd. Lot # Mailing Address 37 C - &-4Z-.� Owl TZA , 0551111 64 6y r a5 67- Zip Date Construction Permit Issued by PCHD / V-7-4-9 7 sf Address 37 r / P*m let>, � �► Se�arat�e Sewerage System built by � . S• Cam, Consisting of 15W Gallon Septic Tank and SO O epe yu-y Jc H es, Other Requirements: li �. �� �� GC/ watgK SnnnpIlv: Public Supply From Address r 4 F� 1 rj,&. � e, qtr Private Supply Drilled by ] ► F - 5 5� , P�'�r Address na!?, � -�,✓!I o V! ®' — 9TuTding 'Type . - ... ,�..+e v 9 t r ci: _..has erus o i-ciintrc rbt bVtiTjJ xd.' Number of Bedrooms 4'$P,V101 19 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: -7 — Cc-' *1 '�' Certified by Address Mff P.E. )( R-A,,. # 619.1 Any person occupying premises served by the above sysieem(s) L, 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 revocati dificatio r change is necessary. By: Title: Date: 1 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT ,V�ll\.fw.-e+..wr `' �,: w•►..,, -S 'i axT.vfi]�3:: ". -.n .w+.'4i._.. _.T.s r. ��l'bcc �udisrs�. - nL: 'tiv. h -1i4.. a..xoi,.c�. -a .. .r,.^i�•C >.... .. • - `I owi,ti �liag�: 1'�clX'llTla # - �f Map 73,16 Block 9 Lot(s) Well Owner: Name: Address: V.S. Corporation, 37 Croton Dam Road, Ossining, NY 10562 U f ell: 1- primary 2- secondary X Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) 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 42 ft. Length below grade 41 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic _ Other Joints: _TWelded X Threaded _ Other Seal: X Cement grout _ Bentonite —Other Drive shoe: X Yes No Liner Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed . X Pumped X Compressed Air Hours __6_ Yield 15 gpm Depth Data Measure from land su 30' ce- static (specify During yield test(ft) 380' Depth of completed well in feet 505' Well Log If more detailed information descriptions or ,sie-c analses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 15 Dr' illi 15 Hit roc at 15' 42--T 505 DrilliM in . � If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5gm Depth 400' Model 5GS07412 Voltage 230 HP 3/4 Tank TypelpX Volu 86 Date Well Completed 4/4/98 Putnam County Certification No. 002 Date of Report 6/10/98 W II le atu o T. 'B a nu i m txact iocanon or wets wttn aistances to at ieast two permanent lanamarxs to be provtaea on a separate sheet/plan. Well Driller's Nam -P. al /S :S, Inc Address: 4 Putnam Avp _ - Rraweter _ riy 10509 Signature: Date: 6/10/98 Mal !k beal, Jr. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Inorganics Analysis Data Sheet Form I - IN ' .Client Name: P.F. SM &SONS Proje(x Name: -STANDARD Ell. Sample Number: 188176-01 Client I.D.: V,5- CDNST WT I WOWLANO EST. PUTNM VALLEY Date Collected: 15-JUN-98 I Orl n16120 Date Received. 15-JUN-98 AoalysI5 8050 Units Method .. ........ .. ....... . ....... a 'None 24 . ... ........ 1170 . Nitrate tN) 0.30 30U 't6difii Wit.. ........ 200,7 Total har6ess",'", pH 45 - ..... .... Remarks: 0^ 4 Analyzed 23- 15-JUN-98 01-JUL-98 16-JUN-98 01-JUL-96 ..-dii .Fit � ' m 31S rVOWIGM AVO" mowbwjp, w 12550 �....... $.... •... Tel. %14) oft WY5001410142 WDEP?W15 CT004C V%44M Emwvw9-- -P6045 Psw (ai4) SO-MI L'Ilt'v iRQ*i 4114?4 Tfen I F -1-ire to ci The follo*ing data %ualified are used to assist in the interpretation of acalytical Unless otherwise indicateit sample passes applicable drinking water standards. (1) Parameter fails applicable drinking water standaids (2) Exceeds lead SWDA action level of 15uVA. (3) Exceeds copper SWDA action level of 1.3mg/l or 1.300ug/l. (4) The results indicate the water to be contusive. (5) The recommended sodium * :Ievel for a moderate diet is 270mg/j. (6) The recommended sodium level for a restricted diet is 20mg/l. (7) Hard-ncss 0-99ttig/I soft 100-200mg/l moderatcly hard 200- over very bard b 'Pon of Committed To Your Success seven Trent p IQ) DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster,- New York 10505 Tel. (914) 278-6130 Fax (914) 278-7921 FAX COVER SHEET Date: "-7/ To: J tw j4TSC>t4 From: Adam B. Stiebeling Asst. Public Health Engineer Fax #: - 2-78-63U.- No. Pages *W -3 (Including cover sheet) For your information Please respqnA,,.,.._..... For your review Attached as requested AS di s C I I s 3 od Please call No tes/1-Wes sages t3 "_ I &I C. 411_ -LE- L-O'-r * 1 C OnA rj�) t.1 PrN C I "h- S 1L ' f. I _C' STO OF In the event of transmission/reception difficulties, please contact this office at (914) 278-6130 ext. 157. 1* - V ^ -lT'^^ )�� �'.�yTYJ �v . ` -�?'+w AuYwrtry��.- ��:.�j.t�+,� .�'Tt' ;'�r�.c+.�. �v.r..._. Ir :.l. �.�1JG�•�+�s 3. If the water supply is from a drilled well: FJ a. Satisfactory results of a water analysis, for the parameters in Table I below, conducted and reported by a NYSDOH approved laboratory under the "Environmental Laboratory Approval Progtam (ELAP)." ?f5-0V'r '' iI A f5 .15 04 g(� NOTES: (1) Maximum contaminant level. (2) Water containing more than 20 mg/1 of sodium should not be used for drinking by people on severely restricted sodium diets. Water containing more than 270 mg/1 of sodium should not be used by people on moderately restricted sodium diets. (3) NTU means Nephelometric Turbidity Units. (4) mg/1 means milligram per liter. (5) ug/1 means microgram per liter. «Wrs :!tD f .ise t ��+n , ao .�i+ �►�.* m y.c'� • - '•°� .' Disc >w�fia•' `••� .e _ `�`"" 1 ate Form I IN !" Client Namc: P.F. BEAL & SONS Pre,lect Name: STANDARD En. Sample Number: 188176 -01 ­Client T.D.: V.S. CDNSY LOT 1 WOODLAND EST. PLMW VALLEY Date Col Iec.ted: 15- JUN -98 91trix: 1 Orlr&H20 Date Received: 15- JUN -98 Comments: Awlysls Rctsdlt Units Method Analyw .. EfCOLY A85EKP _ Lead �1 i ....., ..............: R:�L- '....._., .., ...... N" 2.0 �... 1 , ,fig ": N n _ 25B .... Nitrate (N) G.3 .... off.. .... .:..... ..•.. 9. .......... .,.. .. ............ 3113 , �µ .. ...:. .:...::.. .zoo Sod- •10.8 . ..... ::AA .. •'.:.. ; /r0o:r�' : ° :'::.... i 922.5 ' 01- JUL -9a � •dllh't =9$ Total hardness 118 L 20u i O1 JUL-48 j .... .. . fi PH 7.6 §3Q-k J'�1g, Remarks: � 9 315 Fvltert«+ Avanua Nm+urgh, NY t25se Tot (914) ......-- -,-.....,..., MYSMH 10142 W.IDEP P2015 CTDOHS films Ev4 RY049 P6 d"70 M- t�fY'O 0 F1W (014) 66524W1 /NS/ TE ENGINEERING, SURVEYING & .7. 4 LANDSCAPE ARCHITECTURE, P.C. LETTER OF TRANSMITTAL route 2t2, . `914) Brewster, New York 10509 (914) 278 -6392 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 T0: Date: 7- �.�i'8 Job No. � r fq7, 3c,r Attn: OA-v^ - -z- Re: WE ARE SENDING YOU ttached ❑ Under separate cover via ❑ Shop Drawings 13/prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ the following items: ❑ Samples ❑ .Specifications THES E TRANSMITTED as checked below: - ror approval Approved as .• �bmittcd ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ REMARKS: COPY TO: Lot98.dot - copies f^r npproval ❑ Submit ❑ Return SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE copies for distribution corrected prints < < C. , 7Ti 3. The Design Professional shall provide a note,on the submitted plans indicating present site conditions with respect to the well and SSTS area are comparable to those at the time of the original approval (i.e., site conditions have not been altered). B. Construction Permits being renewed by a Design Professional other than the one who obtained the original permit (original or new owner). SUBMIT: 1. Letter of Authorization 2. Construction Permit Application 3. New plans signed and sealed by the new Design Professional 4. -Soil Data Sheet (if applicable) 5. Same as Section 5.0 A. 3. C. A complete new application for a Construction Permit, including plans signed and sealed by a Design Professional, will be required as follows: 1. Where the Department determines that the SSTS design, as approved, is no longer adequate due to altered site conditions or revised standards. 2. If the number of bedrooms proposed is increased. _ ON, COMPLI.A�CE F.n CERTIFICATE OF CO�SIIUCTT Before a Certificate of Occupancy for a dwelling is issued by the local Building Inspector, a Certificate of Construction Compliance for the SSTS must first be issued by the Department. The Department must be notified before the system is backfilled in order that an inspection of the completed system can be made. Open work inspections may be omitted only at the discretion of the Director or his designated representative. In order for the Department to issue a Certificate of Construction Compliance, the following must be submitted: (Note: All submitted Department application forms shall contain original sign res (no photo copies)). Certificate of Construction Compliance. (See Appendix K) j Oa m C6 -97 '.2/ Three (3) copies of a two (2) year guarantee, signed by the installer, and/or general contractor, or the owner. (See Appendix K) �02V4 C- S " 9 3. If the water supply is from .a drilled well: PA a. Satisfactory results of a water analysis, for the parameters in Table I below, n1aucled and reported by NYSDOH approved laboratory under the "Environmental Laboratory Approval Program (ELAP)." v51� CONTAMINANT MCL (1)(4)(5) Coliform bacteria Any positive result is unsatisfactory Lead 0.015 mg/1 (15 ug/1) Nitrates 10 mg/1 as N Nitrites. 1 mg/l as N Iron 0.3 mg/1 Manganese 0.3 mg/1 Iron plus manganese Sodium N Hardness No designated limit Alkalinity No designated limit Turbidity 5 NTU (3) NOTES: (1) Maximum contaminant level. (2) Water containing more than 20 mg/1 of sodium should not be used for drinking by people on severely restricted sodium diets. Water containing more than 270 mg/1 of sodium should not be used by people on moderately restricted sodium diets. (3) NTU means Nephelometric Turbidity Units. (4) mg/1 means milligram per liter. (5) ug/1 means microgram per liter. t � b. A Well Completion Report signed by the well driller, including the results of at least a 6 -hour pump test (See Appendix K). �G _ 1-Oam A minimum well. yield of 5 gpm is required. For yields less than 5 gpm see Appendix F for procedures on performing a 24 -hour well pumping test. The results of the 24 -hour pump test are to be submitted to the Department for review and a determination will be made regarding utilization of the well for supplying potable water to the dwelling. If the new well is found acceptable, then the procedures for determining the minimum potable water storage requirements, located in Appendix G, are to be utilized. 4. If the water supply is from a public water supply, satisfactory results of a coliform bacteriological analysis of a water sample taken from the service connection, performed by a laboratory approved by the NYS Health Department "Environmental Laboratory Approval Program." 5. Three (3) sets of "as- built" plans, signed and sealed by a Design Professional, licensed and registered to practice in New York State. These plans shall be to scale (minimum 1 inch to 30 feet horizontal) and shall include: uvvzsurveyed house location with respect to property lines. The plan shall make reference, by note, to the source of survey. Metes & bounds description of property lines. s/ Ac al locations of installed SSTS and water supply improvements. The distances necessary to locate the septic tank, distribution boxes, junction boxes, ends of the SSTS and well from two fixed points, preferably the corners o e building. The plan must include a legend, which reads as follows: "This is to certify that the sewage treatment system was constructed as indicated on this plan and that the system was inspected by me,before it was covered over. The system was constructed in accordance with all standard rules and regulations of the Putnam County Department of Health and the New York State Department of Health. 99 ,;:y+o,,.:o o•y< ,'.r •ti,RV: _- �'- _r _ ��:n,. ..-, x.,•4� -�tiG ice:..- .. 19 • The "as- built" plans must also include a title box; • giving the information required on the original design drawings. Minimum size of "as- built" plans //-'s7hould be 11 inches by 17 inches with a minimum scale of 1 inch to 30 feet. /.g.'Space for Putnam County Health Department approval stamp (minimum 3" x 5 ") preferably at the lower right -hand portion of the plan. /./Fee - See Appendixo After the Certificate of Construction Compliance Permit is issued by the Department, a copy of the Certificate of Construction Compliance Permit, Well Completion Report and approved "as- built" plans should be brought to the local Building Inspector for processing the Certificate of Occupancy. The local municipality should be contacted for their particular requirements for a Certificate of Occupancy. �.i.r.,. -w.. -. .....qx.. ye ..— •w..... ..y.w. .. .. .. .. .. ....a............ -. .w .... ....... w.. ..gip_. e.a .. a... - .w .. r —..w.• ... .. r,.. ..�- ........ .. w. w�.-. .. ...n.. •.w...—...- .... —...1 3 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 #fV -1Z -q3 WELL LOCATION Street Address Town/Village/City Tax Grid Number -7 -1 WELL OWNER Name Mailing Address . _ 70W,3 rivate 0 Public USE OF WELL 0. primary 2 - secondary RESIDENTIAL ® PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT �gpm /41 PEOPLE SERVED �- /EST. ® REPLACE EXISTING SUPPLY O TEST /OBSERVATION EW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL. OF DAILY USAGE�ga 12. ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR •DRILLING WELL TYPE RILLED DRIVEN ®DUG ®GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES >C, NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: LA Nr-&j? =- Lot No. WATER WELL CONTRACTOR: Name_`jNk,N2sw N Address:/ V iN V- v,4 crioki IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES / NO WARE OF PUBLIC WATER SUPPLY:. tij k TOWN /VIL /CITY fA wwrwv r.w w.♦TTy+'.n nm ..,Tr.�T 1�.�T a7aSasaioCc lv P1lVi is aCli riwii it Lili�GuI I;ATr. auiaiti. T LOCATION SKET SOURCES OF CONTAMINATION PROVIDE N SEPARATE SHEET (date) �gnaure 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 thirt3• (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�gmanner as not to degrade or otherwise co � urinate surface or groundwater. Date of Issue: Date of Expiration 19. ermit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller e PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date- Re: Property of L-INe-AR Located at j?;JKcA HIL-L- P-PAI? SCV11i (T) FurWAtA VALL-EY Section 73, L6 Block I Lot Subdivision of LNC_A.?- 6U.BP1V1SI6tA Subdv. Lot # Filed Map #' 043310.1 Date Gentlemen: This letter is to authorize Insite Engineering & Surveying, a duly licensed professional engineer -_ x T_ 9cRXKA&i§>tMMxAaR04xtACA _ (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 connection with this matter and to supervise the construction of said system 'or systems in conformity with the provisions of Article 145 -or' 147, Education Law., the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: Jeffrey J. Contelmno P.E., Ex, # 61931 Insite,Engineering & Surveying, P.C. Address Route 22, Brewster, NY 10509 278-4990 Telephone Very t Signed F-01 �ISERC� sr Address 41E 515KRY4 QA. 1-704-3 Town I — -2? / - *-M - 4 100 Telephone DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Jeff Contelmo Insite Engineering Route 22 Brewster, NY 10509 Dear NIr. Contelmo: - BRUCE sYR ;jOLER Acting Public Health Director December 16, 1996 Re: Proposed SSDS: Lincar Lot #1 Church Road (T) Putnam Valley 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 wetlands regulations. You should contact local wetlands officials in this .��..n...- .7.�.. .......�... .�?.i ..cY► ~ :. �_ .t.. �._` •.._ .�� :.r Y ... :+... -. -' ,•"1.' i �... a.` ...'w -':� _ .::: .— Via,. �.•... •rP'... � .. ....y7..a.. �°--�.. - ���, siuizcoi�u�� -itieas°�����c���lic I°�i;����u' a► �i�, ������ory"�iiur�ri'ax�t��u�iau�a otr�ne plan. Furthermore, a note is to be added stating all erosion control measures are to be constructed prior to the start of any construction. 2. Current erosion authorization letter is to be submitted. Upon receipt of a submission, revised to reflect the above, this application will be considered further. Very yours, Robert Morris, P. E. Public Health Engineer RNVjP 'NEER'N G a INSITE-0--MuGRvEvING, p C. Route 22 Fav 14 7'qF+. 9 4� 27874990 Fax I 2 - 2 7 CieLavergne Avenue (914) 197-1742 Wappingers Falls, New York 12590 TO: PC- H D LETTER OF TRANSWTTAL DATE� . F3 7_ i JO NO. 1 _ ATTENT104 Ro M 0 R i� IS RE: '55D5 R(��Ewtc WEARS SENDING YOU O-Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change order ❑ HiSE- �ARE 'THANSWfTED 'as 611ecke7­bel6v%�." ._7 *-For approval ❑ Approved as submitted ❑ Resubmit copies for approval 13 For your use ❑ Approved as noted ❑ Submit — copies for distribution 1] As requested ❑ Returned for corrections ❑ Return corrected prints C] For review and comment ❑ 1] FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO- US RF—fARKS: ........................................ .............. .................. ..................................................... .......... 11 ........... ................................................. ............. ..... .. ...... Clov TO SIGNED#_V;iw� ff enclosures am not as noted. kindly noiffy us t once DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A TniTERy VaEY, ` PCHD PERMIT # ALL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name � �pMst�AT cu, ice. filing Address Lbt Lie EE Z:TY Sr, LiyrLE FEZSZ -f t iJ 0 4043 Wrivate ® Public USE OF WELL l - primary 2 - secondary RESIDENTIAL ® BUSINESS ® INDUSTRIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 FARM 0 TEST /OBSERVATION CIINSTITUTIONAL 0 STAND -BY ® ABANDONED 0 OTHER (specify, AMOUNT OF USE YIELD SOUGHT gpm /# 0 REPLACE EXISTING SUPPLY 61 NEW SUPPLY NEW DWELLING PEOPLE SERVED -4 /EST. OF DAILY USAGE Z �10Cgal 0 TEST /OBSERVATION O: ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ®DRIVEN ®DUG ®GRAVED ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF 'WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Liil�� S��Dl�IS10i�b Lot No. WATER WELL CONTRACTOR: Name �Jt 4Ki.6D 4 )'A Address: IS PUBLIC WATER SUPPLY. AVAILABLE TO SITE: YES DC NO MAHE OF PUBLIC WATER SUPPLY: N %. TOWN /VIL /CITY .. _,.. VD' iS' 11"[ eivC�;`'%^ recvrEiti:- °��acici`iv,:�::F�� wn��i:-i`,i'►�::•: - --'Li; ..� __ _..s - ..:.o..:.,.;_ .. .... ........... ,...:. _ ... LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (date) ( gna ure 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 thirt7 (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 other 1 e contamg'.rlate e� surface or groundwater. Date of Issue: 19 /a, 414, V/ Date of Expiration 4 1,3 19� Permit Issuing Official Permit is Non- Transfer able White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller 7/1) L i wzx- � DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 '°ArrL1 UN '1 U+ tri1N' '1 '-A WATER WELL UC 1 p PCHD PERMIT # P11-I2.- l -► WELL LOCATION Street Address Town/Village/City Tax Grid Number $1RGK ",U_ IZD. 500T-H u*rNAM VA '7 3- 11, ° 1 -3 WELL OWNER Name Mailing Address I d2%rivate Z�,V4QIQ U�'YELor'i+� ce'- j^JC, U( Ut3-e 57,' i.MLF reR t NS. )76- f3 0 Public �SE OF WELL l - primary 2- secondary SIDENTIAL t3 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED 0 FARM 0 TEST /OBSERVATION O OTHER (specify O INSTITUTIONAL 0 STAND -BY O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED, /EST. OF DAILY USAGE 3UQ gal 0 REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION D:ADDITIONAL SUPPLY PAW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL _ REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN DUG [:]GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: I- / /V Cri P . '17� Lot No. WATER WELL CONTRACTOR: Name /<A) C�C� /� Address: �% j4 �i✓ IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES >4- NO NAME OF'PUBLIC WATER SUPPLY: A�) /A TOWN /VIL /CITY _ A­� /4 1A :. _ ...� .. _..._.� ..�_ LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED _SON SEPARATE SHEET ( ate) (si natur ) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such manner as not to degrade or otherwis ontaminatens�urface or groundwater. Date of Issue: ,3 19 qj Date of Expiration 6 19 9 ;� Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller LWA9 -L H PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date M193 Re: Property of LIfA?- MVPLOPMENt CO. , 1W, Located at BI?44-1 HILL RD. =-V (T) PLI"i�IAM �/�L ,ii Sect ion `�3. 8 Block I Lo t Subdivision of LINGAR IL 5UWYL5-k: ! Subdve Lot # Filed Map # 24L��& Date` Gentlemen: This letter is to authorize W51M EN(31NEr,-F4NCg &b P S215N PC• 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 regulations as promulagated by the Commissioner of the Putnam County Department of.Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned• P.E., -9 # dEFfFE`! a•' CocJTELMO Fe . 1WD1iS- EN51ti1 lAI6 AND DE%O -FC -- Address W. ' ' ' 1! • r • •0 Telephone Very truly your Signed r �-_ !!nul Lit, Address L1ttLE; FE99 `i IN-d- n(P43 Town 2b1 -44o -4100 Telephone .- 1 .4 .1. TO: PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services a udki 6&n` u'r4 FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT Commissioner of Health In the matter of application for: L114CAe DeVELOPMEtt CO.) INC. b1V I, DONALD Nl.�C1�EL represent that I am an.officer or employee of the corporation and am authorized to act for XVELOPMM CD. Name of Corporation: having offices at 261 Libetil tmit- UIAM PERKY NJ 11CO45 Whose officers are: President: Donald Nuckel 281 Liberty Street Little Ferry, NJ 07643 (Name and Address) Vice-President: (Name and Address) (Name and Address) Treasurer: ' I (Name and Address) and that I am and will be individually responsible corporation with respect to the approval requested thereto. Sworn to before me this 3 - day of 19 Notary Pablic. ARLENE FAUSTINI NOTARY PUBLIC OF NEW JERSG* My Commission Expites June 24,1996 8.11'9-'. Sign Titl Corporate Seal I 0 - I NORTHEAST LABORATORY OF ]DANBURY 4 . _- _.....__._� .. ...,.. .._-.��--..,...;:..�^.......�_• .- --:: - -_. _ �-� NYC 11471 C:t •L•'e•Iw. ''P er t H. ..4 �� -3 MILT. PH,?iIDd' DANBURY, CT 063b b LM (203) 748 -7903 - PAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REIPORT TO: P.F. BEAL & SONS 4 PUTNAM AVENUE BREWSTEF, N.Y. 10509 DATE SAMPLE COLLECTED: 7 /10/98 TIME COLLECTED: 11:00 A.M. COLLECTED BY: M. BEAL DATE RECEIVED @ LAB: 7 /10/98 TESTED BY: LAB# 11471 REPORT .DATE: 7/10/98 SAMPLE SITE: V.S. CONST. CORP., LOT #1, WOODLAND EST., PUTNAM VALLEY, N.Y. SAMPLING POINT: HOSE BIB AT TANK SOURCE: WELL TREATMENT: NONE 'BEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL CHEMISTRY: Iron <0.03 Manganese <0.01 ml = milliliter mg/L = milligrams per Liter "K—il'icatior !'cve! RESULTS PASTED ON SAMPLES SUBP mg/L 0.30 mg/L mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] ND = none detected NTU =Units vHTTED:7 /10/98 (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) 9 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 PUTNAM COUNTY DEPARTMENT OF HEALTH . DMSION F ENVIRONMENTAL HEALTH SERVICES :d;`�:rs.:�� x%.r�%•.:.:.iG .s+.�'`- �:'F.. Ag3 i'c�ina`�3:t- o:ii.�-•t+;�.. _ -. -^ vSt:::" s°-. s= r..:. v.:- �+: cm :rim.`s- r.:sG�vc.':.•,;.�.;.. spa=:: t:.: 1£, �i „'i�':'�e.'��'n.�yy�,.oc:v..: GUARANTgE Op' SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of V, 5, C47L' co` Building Constructed by Location - Street. Building Type I represent that I am v construction and draina that is has been constru accordance with the star hereby guarantee to the any part of said syste immediately following sewage treatment systc operate properly is caul system. on Corp. 73, 18( Tax Map Block Lot I�vTN�+t VA L4. Tow illage G1 NC+ht Subdivision Name I Subdivision Lot # illy and completely responsible for the location, workmanship, r.iaterial, of the sewage treatment system serving the above - described property, and !d as shown on the approved plan or approved amendment thereto , and in irds, rules and regulations of the Putnam County Department of Health, and vier, his successors, heirs or assigns, to place in good operating ci)ndition constructed by me which fails to operate for a period of t,,O years date of approval of the "Certificate of Construction Compliance`,' for the or any repairs made by me to such system, except where the f<<ilure to by the willful or negligent act of the occupant of the building utili;?.ing the r �” ITh` undersigned further agrees to ~accept -�as "conc� lusive the — determination of the Public Health Director OfAhe A�us m C unty Department of Health as to whether or not the failure of the system to ve4te as d by e the willful or negligent act of the occupant of the building utili sing the 6 1 Day 1_9 'Year, 98 __ff T_ ) - Signature V.S. Construdtion Co Corporation Name (if co or, Address: ` Address: Zip .105-62 . State Zip: Form GS -97 w 1�1+ f -ir j - M:= I I- �= -i' �+' Imilte Engineeioing & Design, P.C. 1849, Rt. 6 Carmel, NY 10512 .6 TO t. ARE SENDING YOU Attached ❑ Under separate cover via— C1 Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ LGETTIE12 OF "TRUSETTU ALA - DATE ^ JOB NO. 4-1 k .,k-rTS_1T 0TA_ RE: ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION LETTER <01F 3 A I P I F j1>4--J I T C x:;- 31 -22-A3 x9L5 3 C— 1•4 F—C, F0 9— 1�3 0 0. c) 0 tll"A7 i©0.06 < THESE ARE TRANSMITTED as checked below: XFor approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return —corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 190 PRINTS RETURNED AFTER LOAN TO US REMAIKS 10PI TO SIGNED- ... #..,ores are not as noted, kindly notify us at on t4 ;, b a rap THE3 CA 1`15" DA L E I 1 27'8' X 48' 2656 Sq. Ft Second Floor �.s ��^: �•� �.�xRananzwtit- aa- frr•:Ha_:.: _• �: x.., ,:,,• � , t�;:. -- Bey aee�cv-.�acssnt9aaasrw rs:rr av�+,n BEDROOM 4 x 9,-7, BEDROOMS 111-W A I i 27'8° 00 l J 1 I I 1 I KITCHEN i i BREAKFAST FAMILY ROOM 12'-0 "x IS-0' I 9-5"x 13' -0° 20' -0'x IS -0' 1 I I I 1 I I 1 PUTNAM COUNTY DEPARTMENT OF HEA16TH r 27"8" �v R ON Y; - 13�° x 13 "- 0' 48' �. .e. IB-g x M 0 STANDARD SCARSDALE. 11 FEATURES • 4- Spacious Bedrooms a Framingham Pediment on Front Door • 2/2 Baths o Fireplace Options Available • Open Two -Story Entry Foyer o "Boxed -out" and "Angle Bad" 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 ® MsYs renderirgs and Floor Plan Efte dons are • "Cottage- Style" 3056 Lower Level Windows aC.00ntma No oral o�onditiorm m tome with Architraves on Front .. WESTCHESTER ODUILARMOMES, INC. P.O. Box 900 o Dover Plains, NY 12522 (914) 832 -9400 a (800) 832 -3888 i / APPENDIX 3 ,UTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS _ REVIEW SHEET for CONSTRUCT PERMIT ;ME OF OWNER c �yl t.�% :� -1, .r Y / " DATE TAX MAP # DOCUMENTS. YX MT APPLICATION 1 LL PERMIT; PWS LETTER AUTHORIZATION DESIGN DATA SHEET(DDS) DEEP HOLE LOG CONSISTENT PERC RESULTS (3) PERC HOLE DEPTH CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS U' VARIANCE REQUEST GENERAL -LEGAL SUBDMSION SUBDMSION APPIAL CHECKED PERC RATE LL REQUIRED_ ✓ CURTAIN DRAIN REQUIRED EOSTANDPIPES AL SSDS ADJ. LOTS LAND (TOWN/DEC PERMIT R & D) k ON DDS PLANS & PERMIT SAME 1969 - NEIGHBOR NOTffTFICATION L�iTER BI/ZBA �! -LLj1 SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE L= GRAVITY FLOW D/ J BOX m TRENCH/GALLEY m P- PIT DETAILS SEPTIC TANK - SIZE, DETAIL WELL DETAIL, SERVICE LINE IF OVER CONSTRUCTION NOTES (GRINDER RATE) WWO-FOOIT ESIGN DATA: PERC AND DEEP RESULTS CONTOURS EXISTING & PROPOSED MDRIVEWAY & SLOPES CUT F/fj FOOTING /GUTTER/CURTAIN DRAINS COMMENTS: It DISCHARGE (OK) W-PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY AND EXPANSION' EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED PIT & D BOX SHOWN & DETAILED [RHOUSE - NO. OF BEDROOMS WELLS & SSDS'S WAN 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 ;LAYBARRIER 0 FT HORIZONTAL: SLOPE 3:1 TO GRADE ZLL SPECS 1EPTH GAUGES TLL PROFILE & DIMENSIONS TRENCH � \ TRENCH PROVIDED f6O FT M AX RALLEL TO CONTOURS 0% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN LLJ 10' TO P.L., DRIVEWAY, LARGE`7REE5 'iuP "tit "r "IiL - m 20' TO FOUNDATION WALLS 100 TO WELL, 200' IN D.L.O.D., 150' PITS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) &2010 TO CATCH BASIN, 35' STORMDRALN, PIPED WATER TO WATERLINE (PITS -20') INTERMITTENT DRAINAGE COURSE FT. RESERVOIR, ETC.M 150 FT. GALLEY SYSTEMS SEPTIC TANKS M 10' FROM FOUNDATION; 50' TO WELL WELLS m 15' WELL TO P.L PURUVA CC(U1W.( DEPARR4aU OF UALTH DIVISION OF EWIRCtZM I'AL HEALTH SEWICES- DESIGN CATA. SH=-SUBSUFACE S5qAGE DISPOSAL`SYSTE-m Fnz. W. Owner' Liw-AV- MJELr,,rr1—tz-V111 C:0-,1 Address - u*TTLF-: v-pr Jij Located at (Street) _N2CW HII-L F-6)4.D S buT*t-A Sec 15,� 12 Block Lot (indicate - .nearest cross street) municipality Urv-44-M VA som, PERcoumm TEST DATA Pzwipm To BE smaTTED wrrH Appucmm Date of Pre - Soaking Date of Percolation* 'Test 1J /AA HOLE NL74BM CL= TIME PERCOLATION PERCOLATION Run No. Elapse Time Start-Stop Mini. Depth-to Water Fran Water. Level. Ground Surface In Inches Start stop Drop In Inches Inches Inches Soil Rate Min/In Drop 2 JPE�-L-AXIDVi �TF C-,) F 15 3 �crl MAT- Le -At6X 3 4 5 2 2 3 4 5 NO1TS: 1. Tests to be repeated at same depth until approximately equal soil rates are bbtained.at each percolation test hole. All data to'be subutitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA P-SQUMM 20 HE SM- HITTED WITH PPSITIMCU DESCRIPTION OF SOILS MCOMERED IN TEST HOLES Tr.� ; x012 NO. 1 HOLE NO. HOLE NO. G.L. 1° 2° _ 39 45 . S,4,ND 5° 6° 7° 80 9' 10° 11° 12° 13° 14° TT Trl lr f_GC11 S�V'TNJ/'%�•.L t:pJ .?,F Korai -,2 m INDICATE LEVEL TO WHICH WATER LEVEL RISES AF M BEING ENMUNTERED N /A DEEP HOLE OBSERVATIONS MADE BY: bLDi•:l►N $ cwt -AGE D'IU5, P C. Dom: 14 l 7 - - DESIGN C7U� �.� Soil Rate Used IS Min/1 �� Drop: S.D. Usable Area Provided 6 Noe of Bedroans Zf Septic Tank Capacity �Zr gals Type Absorption Area Provided By a L.F. x 24" width trench 8 Ap Other i 1�!.0. g. i- Name . 1NSiT E RC. Signature r 0 Address 1c?)4l SEAL o Fa. M1 THIS SPACE. FOR USE BY HEALTH DEPARTMENT ONLY: �'U'�FSSiVi�F�' Soil Rate Approved sgeft/gal. Checked by Date P- -1 UNCAQ 791 -1 oi- PUTNAM. COUNTY DEPARTMENT OF HEALTH �. U��T':.- a:•>. •Sa^......�.jp1.-,`n,.�'•FsY.a• c.. 'J�.��i :.'i: "=.-I..- ••!_Chi.ea^..�.,. APPLICATION FOR APPROVAL OF PLANS F6R A 1iASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant:.. LINCAR DEVE1OPMENf' CA•110C• 2Pb1 LifAf , . i.,li'fil,�• CRY � N'�• ��� - . , 2. Name of Project: 95D5 FOR. UWAR• M\1EQPMEJ 3. Location T /V /C: R.1tt M VALLEY CO. , IhIC 4. Project. Engineer: IN�ItE ENCaiNEERai•C-� AND DESIGPIr1�5. Address: M9 i�+• o WMEL K•Y, 10512 License Number: 619131 Phone: °114-225 -&2W 6. Type of Proiect: Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty,Subdivision Other .(specify). 7. Is this project subject to State Environmental Quality Review (SEQR) ?. Type Status (Check One) ,Type I.. Exempt Type II. Unlisted 8: Is a Draft Environmental Impact Statement (DEIS) required? ... :........... tab 9. Has DEIS been completed and found acceptable by Lead Agency? ........... NIA 10. Name of Lead Agency IWA ` ..1 ... -.IO{ s,i..^y` Z:.......� . `•i�,•�1$' .'X135"'�7fu'G�L`itl "cli7'Fi�' d"ruYlUt°r t'�i �i.�tlLivi' "ui'"''iuin"i" id1Fi��iy; ° °� i�' ?i��', �- �aA or other officials, .ordinances? ........................ ....... .. Bi- �4• -�'llt 12'. If so, have: plans been submitted. to such authorities? hlb 13. Has preliminary approval been granted by such authorities ?_y Date Granted:. NI,T 14. Type of Sewage Disposal System Discharge...... Surface Water __X _Ground Waters 15. If surface water discharge, what is.the stream class designation ?........ 16. Waters index number, (surface) .::.. :.:::...:...:............ .. ........ 17. Is. project.._ located near a .public _water_ supply system? . . _ . 18: If yes, name of water. supply . NIA ' _ ° `.Distance to water supply N A .:. . 19. Is project site near a public sewage..collection.:or disposal'. system ?..... ND 20. Name of sewage system 1p► Distance to sewage system RIA 21. Date observed: UNWDYN'N '23. Name of Health Inspector: UNIT -14 24. Project design flow' (gallons per day) .... ............................... . CPD 2. —,.5.,. Js State Pol.1utant_ .i.scharge- Elimination; System mit required ?_ . (�0 - a.. ,... •:-y ._ 'c.•.`= ,. �:•�s..... :u- ,.r...... _''v- yi= .a.r- +.` «� - ; :i.: •`3 ._- .. r. r v..,.,,. �:�. -.. . . �• c- �, .�-•:c�.:':r�,;�;.c::- u= ..•'.:i .... ._iY -�.w :. :� 26. Has SPDES Application been submitted to ilooal: "bEd' OffiGe71 I ....... o . > ... , N 27. Is any portion of this project located within a designated Town or State wetland? ........................................ .°°...................... NO 28. Wetland ID Plumber ......................................................... . 29. Is Wetland Permit required? .. ..................... ND Has-application been made to Town or Local DEC Office? ...... NIA 30. Does project require a DEC Stream Disturbance Permit? ................... N 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 ND DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... YE25 34. Are community water, sewer facilities planned to be developed within 15 years? NO -35' ��,-s. an .� es, ► , y I r • s iii 2 > <�esa.: uf': 9 ` :.a'cpe? _ R ._ _ _ 36. Tax Map ID Number ...°.......° ............. .............e................. 13.18 °0'38 37. Approved Plans are to be returned to: Applicant Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and be 1 ief. Fa ]se statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the Pena 1 Law. SIGNATURES& OFFICIAL TITLES MAILING ADDRESS: 18A1 14-& CAt''JEL tb�St2_ .g • �i 1 `E S - •�Wt7 i� 315 j HILL SOUTH) p., •p�ILL ROAD. B R I A R (FORMERLY AIRS . Ao t y f 1r S ` 3 .._ x•11. � � ' (F it r• t `" s1 F£ tocA noAl TOiNNi fJF PUTNA7t� IALtEY . ' ; r .y 31n+v a an- xCn a s' r P01, 1 WWI Y NEy° Y{3Rif 73'18 -1-31 P 1 7?Irs is ro GERTiFx 1NArfrP+E SEWAGE mEA7nfA+r srslEla a{ a 18 t 3� 1SOi3 ALlON' s£PlY - TANK 3 '•a �, iMAYrDJS`BII7 0N ;BOX uj co, i y937 e 144 I 4 1.34 ..134 1� EMD pF �TI1'ENCN 5 , 40 h;38 � ., £NQ OF TRENCH" 6 41 58 ` £ML1 OF TRCN fi f t `" s1 F£ tocA noAl TOiNNi fJF PUTNA7t� IALtEY . ' ; r .y 31n+v a an- xCn a s' r P01, 1 WWI Y NEy° Y{3Rif 73'18 -1-31 P 1 7?Irs is ro GERTiFx 1NArfrP+E SEWAGE mEA7nfA+r srslEla a{ _. {974) 278 4990 i VGIIV,15 MIG SURVEYING & (9r) 2V8 639 6- 4 r /', CANDSCAPEARCf%ITECT(IRE PG: w`ww_fnsf[e eng.com `•PROJECT SS TS `FOR 37`CROTON_ DAM ROAD CORP. ySP��o r7��Fn� ' � CINCAR':i SlJBDlNSJON .LOT 1 �� 't , �� . .�il[irt9��1G'• 1 't. r flRRWINGFOp .6793.E e: ssrcn'+� "PRWE&'l PR0/£CT;; ' ORAWING'NO SHEfT< 91147 301 uANAGER '. W J B 'DATE �` ' 6/19%98 ByAWA7 T G M D 1 ', 1 ! 7 In 3 '•a �, uj co, .i W ;,n ,cam _ ,,, P � i +• I } f f s r s N _. {974) 278 4990 i VGIIV,15 MIG SURVEYING & (9r) 2V8 639 6- 4 r /', CANDSCAPEARCf%ITECT(IRE PG: w`ww_fnsf[e eng.com `•PROJECT SS TS `FOR 37`CROTON_ DAM ROAD CORP. ySP��o r7��Fn� ' � CINCAR':i SlJBDlNSJON .LOT 1 �� 't , �� . .�il[irt9��1G'• 1 't. r flRRWINGFOp .6793.E e: ssrcn'+� "PRWE&'l PR0/£CT;; ' ORAWING'NO SHEfT< 91147 301 uANAGER '. W J B 'DATE �` ' 6/19%98 ByAWA7 T G M D 1 ', 1