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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 74. -1 -16 BOX 28 I =21 all I, w • '�I �, f '1koi �j 'T� �, , ,f r I is Ell 03541 i .q ' CONSTRUCTION PERMIT FOR Locat Subdivision_ oSX- ��/ %�9 Building Type PUTNAM COUNTY DEPARTMENT OF HEALTH Permit « / Division of Environmental Health Services, Carmel, N. Y. 10512 ,/ 1 SEWAGE DISPOSAL SYSTEM ✓ �,�'�? r ���' Town or villa ge _ '41, yr14.,. -..' .. - •- _ - n�:"'.IVIaB= _ �.r.- '"P3_*�1c -. •. �i,: �.i oe'^. ,.'�:..��.:.:T•.�r+o•.; ✓....... 4 Rwd G+ Renewal `e Revision ❑ Date Of Previous Approval `-•� e_ C I `, Lot Area rr t /� itc ' Fill Section Only 13 Number of Bedrooms -3 Design H. D. Design Flow G /P /D Notification Required Separate Sewerage System to consist of (! f� GJ Gal. Septic Tank and j �i r W. To be constructed by. Address Water Supply: Public Supply From Private Supply to be drilled by .:' a . Wl Y b �rY Address Other Requirements I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with thp�s;g ords, rulga, Q (� y 4, orbs I UF7,tnlm County Department of Health, and that on completion thereof a "Certificate of Construction ComDl+jail %O.�sat}sny t6 A 1C'6iilril lf hwill be submitted to the Department, and a written guarantee will be furnished the owner, his succe, 'is-,�Aeirso� assign i'bvAt.@.buildilydhatisifl�r will place in good operating condition any part of said sewage disposal system during the period o tiy3o(21gye,titrnmed tfjlY following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or. nY r�p,.� It3 th�retq ,t Mat hs drilled well described above will be located as shown on the approved plan and that said well will be installed in accordance ih (tt¢.;Ztandards, ru(B ;mend segu a ons, of the Putnam County Department of Health. yy It" V Date g,/ Z,-31,7 J Signed n P.E. h' R.A. Address 417 Cjonse No. L r' 4. APPROVED FOR CONSTRUCTION: is approval expires one year from the date issued u eM d tt action �of;�t�btjtQing has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Com I g� o,4pealth,o,JiRy ,ge or alteration of construction requires a new permit. Approved for disposal of dome to age, andlol j ter o. b Date _ By Title Rev. 9 -81 PUTNAM COUNTY DEPARTMENT. OF HEALTH U - 3 � —�'/ Division of Environmental Health Services,. Casrmel, _, ._..Y... f0 .5.12..._ - CONSTRUCTION, -PERM1T —FQR' SE WA_ GCDISPOSAL SYSTEM Putnam- --Boswell down ► Village Located at c 'Boswell Road Tax Map 372800 Block 62.10 -4 Subdivision ' U ✓CLL �%"�/�T j �s Lot ��°jr � �j�t +,�1 JObq�� �y Owner McArthur. Robert +Z. A TnAnin / Address - d °tf'1J.Y��}t l ditfli. of r J Lot P�►�l.- ?_ ?fD% `ate . t!!A ��• 1'+ Building Type .•r Area Number of Bedrooms Design Flow Total Ha itable Space 1 �1� p p Square Feet Separate Sewerage System to consist of Gal. Septic Tank and 1r t � CT I�j14 W47& To be constructed by Address Water Supply: Public Supply From 4— Private Supply to be drilled by Address Peg �la Other Requirements r_ I represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system i above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam County Department of Health, and that on completion thereof a "Certificate -of Construction Compliance" satisfactory to the Commissioner of Healthwill 1 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 disposal system during the period of two (2) years Immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the orVh al system or a re irs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said weirwill be Installed i accordance wi he standards, r les and regu aT{ions of the Putnam f County Department of Health. IS Date-9-A4. y 1 (•� ` Signed P.E. R.A. Address License No. APPROVED FOR, CONSTRUCTION: This approval expires one year from the date issued unles construction of the building has been undertaken and is .revocable for cause or may be amended or modified when considered *necessary by the Comm i or of Health. Any thane or alteration 'of construction e uires a new �. • -• -• - - j q permit. Ap roved for disposal of domestic y wa a end rive stet su By _..,f� -.- .ter -.,5., n ci a to raiva�'vvcrly 8 IlTD.YIC.IrP,kE� Il 1Cd1Gltl Il �$'Y'J%�(IlS�b.Il �r � :Permit 0 :' - s Division of�Environmental Health Seiv�ces Carmel N Y 105'12 y , �r s� 5 -.. ,; ..�. �" •rs ...:?t•^•..t.'r���'\'•.� 4-!, CORlS�F3UCT80N {PERR+gBY FOR SEWAGE DBSPOSQiB. SYSTER U e" W Town ;or illage 7, —� Block r Subdivi510.�Lw'' /� °"' "`G••' cSUbdLot �N M 'Renewal`% < ❑ vviion ;'wi a '! ? 4„,Y�.7 s e x`k t ,iBUiltlih 'T 9 ype r Lot Area � Fill Section Only ❑ l6 rv-.:� f , '°`e Y " 1. x k E !`t r q. ... F�' .,� '• f ,! ,� NUmber Of�Bed fOOmS � ,ti �'+�Deaign F1ow�G /P /Dy • -`' -� �6 � t P C H �D 'NOti Pication Required �^� �F - 'Separate Sewerage .System to consist of t �s�°�sf� �'' Gal 'Septic Tank Nand ��" �Grr� T'% GASH 'A PTO' be�constructetl by n- �' • s i k i t S 2w ^ •b a t t ,, +ik ] Water Supply r ublie —7. PrivetsSupply v'f7a 3 qq�' pn�n aav 3 v` r t �n Y }l Y ''�7 }t!L K's"eayr�Cy : h ry,G •'C -.T }..; ?i .,(i;3x h,u S �t Address,'' e K'A +y L 5 ���aC+' -i -CJ x� _6r!/ G�✓frs ?S J ?„` G'�r IhrK /' 1 �� ] -i.1 Other Requirements roS,?.' �t' c'r . `.4a P " } i (represent that I'am wholly,antl completely?resgon ;able for the design;andploeation of th® proposed sYStem(s) 1)'that the separate ewage:dtspdsaal system above described Cwill'be cons'tiucted as`sliown on the approved amendment there to end in` accordance with the standards rulei'an regu a- ionsro e" u nam rzCOunty Department q4,7cH eaytthx and'that on compleUOn thereof a Certificate '.of Construction Complianc nistactory.to the Coinmifsior►er of Health.w�ll .' ,10 be :submitted to ;the 1Q0IA tment, and a wcitten'guarontee <will' be fucnished� the owner, his wccessorA ears or_as i,insS by:' he bu�lde►, that said builder will > � " - n_'is. ..-�.. e - .,• .., -r_. , :# V,1 >+r, ve....,y,av: .;•h;..�na.. n ,r;• ._: v -...., - ,4 .- :aseYw „r6Dq ...._ - '^, _ y ...•. , [ ,- place in ggod <operating condition tang part of said sewage disposal system, during; the period.o tom ) y Timm f tely?iollowing.ahedate of the.'fuu -' Dance of .the approval of�the C'art +ficate of Construction Cortipl�ance;of the original system o► tfny`i "s,�ps th r s;�2)!t a the;tlrilled,well Gesuibed abode .T: - .r.. ° x .r. -- -.:5., , so�Y1a n . � will be located as ill"i n on�the approved plan and that said well will be installed in accordance yuifh tie • and?.PV ru s 5 , regu a�Fp ;of the , •,Putnam e, County Department of Health g ��h ; Q a , o " z y tis�q ,n , �?” },,� G `5 -. t�� �k aQ't^', p �,c �t„L w •*r'�' @� c i y .w41rt'' ss .5x w, .1'`'v �`.: -�G� i�� t �.d•: �, 2. - t,¢5I "ImIN ' -c, Date t Signed ?,z � r`� �' 45 w. r .. a � rv* z. a�,�4 ,+✓ r' � - ^.,r'y'a '�'� � * �/s � � " �'r 3 t y �. .: ,ax � ? , , ,? Addre } ss =r 6 yj Gc�nse `No APPROVED: FOR CONSTRUCTION his approval expires orie yearir'om e'detea�ssued yunl f�$�n'st;uction of.!theobtg ha ,.been undertaken; and is', revocable forcause or ma be amend or modrfied whenaconsidered necessar xti the Commiss '' "oo H 1 An!%rre or alteration 'of con$truct.bn c� v requires a new +permit 7Approved for disposal of doitiestic> y ageq�and /or private Via. tr °o h�oa': I +y: .,.r, � .. � ,.y $....� �.K n. «w, �&;;4':, :,uy} , t. �"r�i,'v' s r��., ,�, mx. } 5 •fin. F. �. - a. y -c , a� V 9 91 X1 > -�f .k- . ar .0 r' .� w 4aor a . f rf� c �� „N d ia}' �. ,ti � }' .�, ..� °F• �..` r - : PUTNAM COUNTY;1 DEPARTMENT OF HEALTH ?eat _a te .. r s ~ D ` isi n_ of: Environmental Health =Services, %erMel, N -'Y. 10512 . i C.ONST,RUCTiON R'-SEWAde DISPOSAL SVSTEM h �� : < ,.Olutt^ Or 118gc Located at TaK -Map block Lot ? �i l °3ubd Lot 1t sr Renewal RetYtsion [� "l Sutidivisfon ��: ,'ty' 'fN' fry .,i'.s}lt i• `1.. -:IG '. ) 'J %2�y' _r•..,�`¢ .,u }:.+Y.`r'” ;�F ,�?.- r:r,,.JJ_x ii>r Date- Of.•Pravioua proval 1,�1 z ,Owner /Address AF ti� s Fi1 Section`Odl ❑ Build�hy. Type Lot Area k Y Number -of Bedioofrts P,.' C' H. D Nofication �Rkequired - - . - - - Sepsiate,Sewerage'System to cohsist of,+ Gal, Septic Tank" an Address T,o be constructed ; b - - '* ` Wet$r- Supply' _• —;, - 11b�IC SIUF1p(Y'FrOf1 a P_.rfyate Supply to be drilled byt � e Address - Othe7 Requirements r ' `^ .. y 1 h r� r 1.'reprgsent the! (;am whoNy; and completely •responsible for the- design and location of the proposed system(s), 1)° that `the separate sewage disposal system fi =atioire.desC "ribednwil) be constructed as stiowm:on tho.approved§ a Mend ment there: "to and` in'accordance with th yt rules an regu, s ons o e u Ina County ``Departifient of Health, and that.on completion the�e5! a'•Certificate: of Construction ,Compliit(sfa�tq "rto the Commissioner of Health will - be submitted to[:the Depsttment,-.and a',wr;tten guaranteo :will be ------ -shed tie owner, his succe S,groB; ns y,the builder, that said builder will place in good operating ' tond(tion -any part of 'said sewage ,disposal: system during the, per,,fod of; ' ,p re�W0.1 meoiiate,N' following the date of the issu- ance..`of .ihe approval of ,the' l:ertificate, of. ConStructzon :COmpliance of the orig(nal system or a re s�theieto;,2�j, of th6,_drilled mell described above will lie ",located as shown on:,S,he' approved plan_and filet salctoell' will be.Instatled 'in a2cordsnce wit th tandard , _ ?ides Ad, ;Vf4u a� tions of SAe Putnam' .� County Department of Health U s Date . Signed i` r�� �s P E R.A. h ,ilt ,: Address j* Licen a No ' APPROVED FOR. CONSTRUCTION: Trhis approval expires- year from•t�ie date, issued unless urea it f :4he`bliiidfq has been undertaken and is revocable for cause or may ;be bmended' or modified' when considered necessary by the: Comrnisj)ooerdagf =. '� th o Anysciiaq(je or• alteration of construction requ Was -a new permd Approved -for disposal of domestia`silmtstyaewage, and�or' pnvatewater w�S¢I otka _ , ,W-. a Wa �? `Title ,� Rev 9 81 1 T J � All "IV II I_�_, __...,.........,.. ..,.._.......,.....:.��,. F �.. .. ��q V..,.�.- �.:.:, `= ��wr5�- +icr�!e- t^"— r1- ±..:.? —s. « ,�..rs. r .,.�_:.o �.. �- ..a.. _ _,,; _� - .,.......... r� � , pal �!� 1 iiRUCE. R:, F�tz�Y Public Health Director '...' .. — ..�,p���q.•,�M�I,I�1AFiI.. R.N., .M;$:N.' _ Associate 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 October 9, 2091. Greg Morra _ 10 Boswell Rd. Putnam Valley, NY 10579 - - - -- Re: Addition Morra- Boswell Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax #74.4-1.6. Dear Mr. Mona: 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 form this Department dated October 5, 2001 The addition is approved with the following conditions: 1. The total number of bedrooms must remain au h= without prior approval by this department. _.. " 2 Tfie`area ofafie existing sewage disposahs`ystein;-aridaits "expansion area; must be #. maintained. 3. 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. WH:kg cc:BI Very truly. yours, William Hedges Senior Public Health Sanitarian i BRUCE R. FOLEY Public Health Director LORETTA MOLINARI_ R.N., M.S.N: - Associate • Public Health- Director Director of Patient Services DEPARTMENT OF - HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)279-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845)278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET 10 Q TOWN 4W4 -*;vj TX MA P# NHS �d -S� -77 33 NAME G PHONE q 5 - ,? �15 -0 3 (,� %dQ CHD# MAILING ADDRESS 10 DESCRIPTION OF ADDITION e- IV L \ 'LtiIBER 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. Plege subtiiit.this,form and.the- follotiving to Putnam County -j4ealtti Dept., 4 GenevaRoad, Brewster;•NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non - professional sketches are acceptable. 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 location, 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 Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments ..Feb98........ _ .. BFhouseguidelines a) It BRUCE R. FOLEY ' . 1�1- LORETTA MOLWARI R.N., M.S.N. Public Health Director '�C� W-—v'4- Associate Public Health Pirector, DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 110509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278-6082 Fax (845) 278 - 6648 Putnam'County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map Town Gentlemen: According to records maintained by the Town, the above noted dwelling 0 IS IS NOT in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: �Mffl Building Inspector BFhouseguidelines Co 6 f Oo mw � r •,I nt 0 0 i0 m 0 n ••t9as It 1 ti vro p fj LP00 �a n�( n Nr�x �pUrn DF�x �(A1�0 �►a�to� rj ,OyG,tn � �rn�am �a� � M n n a �a r n 0 r J 0 m � L117?a C' [L X►S i n3L u1.1��2 •f. a _Q f` t' x. A 1 G�IK a •A CorJC. -rA,JK �r a`, II I ' � 4 r N N c e-�- ---------------- .---- - -�1 -- 4-L�Gs 7w 7 MRS � A 4t CERTEFUCATE OF;OCCUPANCY Scree ned Porch -d ------ *, Certificate of Occupa. nc.. y C .N. o...'91' M M. App.li c-: itioh ..No . ..... .9..0...0 . ............ .. Location of Premises .B . ...- . ..T m#.62-10-.4 .......................... .............:'...............J ... .. ........ ... of.10 Boswell Road - Putnam ........ hiretofore•filed"an- application .for .a. building.permit pursuant to the Zoning Ordinance, Sanitary Code effect -in-.th6-.To*n of .Putnam Valley, Putnam County, New York, having paid the reqitifred fee`-'ihefefor�'and ithe undersigned having by personal inspection ascertained that. 'therapplicant- has. subsequently` proceeded, with the erection or improvement of • the proposed struc- . tM.. -work.;., u `in.',compl1ance'- with :the requirements of the laws as aforementioned and that the. said i have and. materials- met..'every, requirement of ..the laws as aforementioned and that the, premises now been.. fully completed, and 'are,, read for ."occupancy pursuant • t6"the provisions of law, 'Now; therefore,: this 'certificate.. of. ,occupancy' is :.hereby issued under the q6al of the Town of Putnam Valley-this .... ....... day of ...... Ma...........rch .............. .. ....... 19N Not valid unless signed in ink iy'a duly authorized agent TOWN UTHAN LLEY? kNEW YORit of and under the seal "of the .Town of Putnam Valley. By..... .7 CERTIFICATE OF OCCUPANCY Certificate of Occupancy No ..... PA7:§P7 ........ Application No.. 0:772N- (1F&mily w/De-ck) Boswell Rd. TM 62-10-4 Locationof Premises ........ ***** ............................................................................................................................. Nicholas Dator ................ of �Putnam Valley . . ................ having .... .................. .................................... . ............................. ..... 'her,e"t*o"f"o**r*e*i"*f*il**e"d".*z*qi, application for a building permit pursuant to the Zoning Ordinance, Sanitary A- U Code aii&- " An av "b A - effect in the Town of Putnam Valley, Putnam County, Ne ect paid th&f quirSal' A it -efor and 'the undersigned having by personal inspection ascertained that the •apolicajlt has subsequently proceeded with the trection or improvement of the proposed struc- ture,ih compUbLnee with-th6 requirements of the laws as aforementioned and that the said work inet ,ev6h,-Yequirement of the laws as aforementioned and that the premises have --provisions of law, Now,. now- beeX'fUl1y,;.cj6p!A r- occupancy .R-2nif 46 .. read-j_fo, narsuant -to the�_ therkore;` this certificAd'of: occupancy is hereby issued under' the seal of e Tdwh"o I dtnam Valley., his 22 - .4 4 .... October. ................. Miy of ......................................... 19.H. 'A - ile - Not "� %nlen ir ink by a duly authorized agent of and 'under the 'seal of - the To w'n of Putnam Valley. TOWN OF PUTNAM VALM, KEW YORK By..........................................................................I T ERTIFIC TE: OF OCc PANCY '7: -W6' Sheds - R ecreatfon' 61 Pm Certificate' of 0 ccupy _8V -388" 30.anc. .... ...... n No... ..... . B Location-:-of Pr mis-e-.. oswdll:-�Road-.- Vf 74- -1.; 16- e es, . ............. . ............................ .......................................... ............................................... . Nich6l' 11. R ...................... ........ ................. 10 we oad' "Putnam: Valley, N Y.': - ............ ....................... .Ito ........... ! ........................... heretofore. filed application f6r a,buildihg - permit'. pursuant .;':-thi 7,onji2g Ordinance -.:.Sanitary-.', napp ca o 0V �na,.0 e-an& the,--.Laws.*, in. effect. in the:Town&-.-9f Putnam Valley, Putnam New York,,, ;haulm by personai inspection ascertained � at:,"' •e" quir that: e . a subsequently -., pike ded4ith the•: erection or: improvement- of - the proposed struc. ' ", *sand materiali laws - as aforementioned and that the said - work. .,me ^ ever, e* laws as aforementioned and that the premises have -,-,.,.now,4be� for occupancy - pursuant to the provisions of law, Now;: iheiefo'rd'p-':this.!:certWcate:..O-f-'Oc'cupancy is hereby issued under the seal of the Town of Putnam Vallea' e* .::.::....... :.:.day. 10M 0C tober y. Y*.,".,.O:.�� I of, . ........................................I Not valid u�nlesa`signed in'- ink It:y.. 'a-id;iii`lya'uthorized agent TOWN 0 of and under the seal .* of the: Town of Putnam Valley. F A" VA By . .... ... .... 5W . ..... �`t- i e i AP" i t 107 . . . 12" KX tv) W IQ 11 i* t 40 u �I I 1-7110, 1 L--, J ^U 7 0 1 �_ 1-- �P IS �., U Owner or Purchaser of Building Section Building Constructed by 6,5 GcJ e // /n .. Location - Street Muni cip /ality / Building Type Block Lot Z5 e// Fs-1aT1's Subdivision Name Subdv. Lot # GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his success- ors., heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept .as conclusive- the,.O_etermin- . � n-of n of Envirozrmental -He-alth._Service.s... - a - a tB - of the Putnam County Department of Health as to whether or not the fail- ure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of Qe 19 $ Signature Title Corporation Name if corp. Address lv��Wl THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health YORKaI"O MEDICAL LABORATORY INC. P.O. box 99 321 I<ear Street LOCATIONS: ❑ 321 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 245.3203 e Yorktown Heights, N.Y. 10578 11 261 BUTTONWOOD AVE., PEEKSKILL, N.Y. 10566 737.8777 ` 245 -3203 : ' - _. ~- �4 95 MAIN.ST., MT KISCO, N.Y. 10549, 666.3335. _ I ❑ STONELEIGH AVE. (NEAR HOSPITACI. CARMEL, N. Y,'10512 278.93^ LAB # 142 . DATE TAKEN: 08 :45 �— 10/8484, —� DATE RECEIVED: °' .m. 10— Q -18H Karen Dator DATE REPORTED: Tap - Boswell Rd. C/0 Ferrara SAMPLES RCE: Valley, N.Y. 12 -A Heritage Hills Somers, N.Y..10589 REFERRED BY: - L .699-1234 J COLLECTED BY: Karen Dator LABORATORY REPORT mg /L ❑ ACIDITY ............................ ............................... ❑ ALUMINUM ................................ ............................... ❑ ALKALINITY ........................ ............................... ❑ ANTIMONY ................................ ............................... BACTERIA, TOTAL /rtoL ........... i� .............................. ❑ ARSENIC ..........................::........ ............................... ❑ SOD, 5 DAY ............................ ............................... ❑ BARIUM ....................................... ............................... ❑ BROMIDE ............................ ............................... ❑ BERYLLIUM ................................ ............................... ❑ CARBON DIOXIDE, FREE ........ ............................... ❑ BISMUTH .............................. .. ............................... ❑ CHLORIDE ............................ ............................... ❑ BORON .. .................................. ............................... ❑ CHLORINE ...............:............ ............................... ❑ CADMIUM .................................... ............................... ❑ COD ..................................... ............................... ❑ CALCIUM ................................ . ................................. : ❑ COLOR ................................ ............................... ❑ CHROMIUM (tot.) ............................ ............................... ❑ CYANIDE ............................ ............................... ❑ CHROMIUM (hexavalent) .................... ............................... ❑ DETERGENT, ANIONIC ............ ............................... ❑ COBALT .......................... ...... ............................... ❑ FLUOR101: ............................ ............................... ❑ COPPER ...................................... .............................. ❑ HARDNESS ............................ ............................... ❑ GOLD .............................. ............................... ❑ MPN COLIFORM COUNT/ 100 ml ....... .................... XMFT COLIFORM COUNT/ 100 ml ,. .... ................ ❑ IRON ..................................'..... ............................... ❑ LEAD . ............................... .... ............................... ❑ CONFIRMATORY TEST ............ ............................... ❑ LITHIUM .................................... ............................... :....._... = -,: ❑ NITROGEN,'AMMON ►A:. ; is :.'.`.::..::.::::aic..:::c.::. ... 0 MAGNESI,VM:. .........:r...::.;..,:.w; . s ........ ....................... ❑ NITROGEN, KJELDAHL ............ ............................... ❑- MANGANESE.............................. ............................... , ❑ NITROGEN, NITRATE ............ ............................... ❑ MERCURY .................................... ............................... ❑ NITROGEN, ORGANIC ............ ............................... ❑.NICKEL ........................................ ............................... ❑ ODOR ................................ ............................... ❑ PALLADIUM ................................ ............................... OOIL & GREASE ................... . ............................... O POTASSIUM ................................ ............................... ❑ PH .................................... ......................:........ O RHODIUM .................................... ............................... ❑ PHENOL .....................:•.......... ............................... ❑ SELENIUM .................................... ............................... ❑ PHOSPHATE (ortho) ................ ............................... ❑ SILICON .................................... ............................... ❑ PHOSPHATE (condensed) ............ ............................... O SILVER ........................................ ............................... ❑ PHOSPHATE (total) ................ ............................... ❑ SODIUM ........................................ ............................... ❑ SOLIDS, SETTLEABLE, ml /L .... ............................... ❑ TIN ............................................ ............................... ❑ SOLIDS, SUSPENDED ............. ............................... ❑ ZINC ........................................:... ............................... ❑ SOLIDS. DISSOLVED .............. ....................... :..... ❑... ............................................ .................................... ❑ SOLIDS, TOTAL ..................... ............................... ❑ .........................................:.......... ........................... /... .❑ SOLIDS. VOLATILE ................. ............................... ❑ REMARKS:..................................... ............................... ❑ SPECIFIC CONDUCTANCE ......... ............................... ❑ .................................................... ............................... OSULFATE ............................. ............................... ❑ .................................................... ............................... ❑ SULFIDE ............................. ............................... ❑ ................................................... ...................:........... ❑ SULFITE ............................. ............................... ❑ .................................................. :................................. ❑ SURFACTANTS - •.. ❑ ❑ TURBIDITY ......................... ............................... O .................................................... ............................... THESE RESULTS INDICATE THAT TIIF WATER WAS Y65oF A SATISFACTORY SANITARY QUALITY WIIE11 THE SAMPLE WAS COLLECTED.' THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATISFACTORY CHEMICAL QUALITY 01" DR RYPRhAMETERDMTNEST ATIVE RULES & gREGULATIONS, DRINKING WATER STANDARDS (PART 72). _ ALBERT H PA OVANI M T. (AS .P1 DTR TOR !' � 1t •X ,-Q /� ,\ ) � �C tali-(% �� ; �1 •T • l.l..r'JI0IPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of �f; a( :of; rer fnpl�, djp�jrjguve#erbis:p# factory bacterial quality- before,cegificate of. oonstcuctionmcompliance ,is- issued: REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME ADDRESS LOCATION OF".WELL r� I � (No. & Street) (Town) (Lot Number) PROPOSED USE OF WELL BUSINESS ©DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ AIR OTHER SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING (Specify) DRILLING EQUIPMENT COMPRESSED CABLE © ROTARY ❑ AIR PERCUSSION El PERCUSSION OTHER ❑ (Specify) CASING DETAILS LENGTH (feet) v DIAMETER (inches) G r r WEIGHT PER FOOT /Z ' THREADED El WELDED X YES ❑ NO X CASING YES NO YIELD TEST HOURS G.P.M. El BAILED El PUMPED ,® COMPRESSED AIR 2-L YIELD (G.P.M.) 6 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [feet) Depth of Completed Well l in feet below land surface: SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (inches) IF GRAVEL PACKED: Diameter of well including gravel pack (inches): GRAVEL SIZE (Inches) FROM (feet) TO (lest) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL (�OM,PLLEEYED Q Y DATE OF REPORT WELL GRILLER g. ature �j�9 T7 ,f_ � i 1,D4)2) 1.4-1- 4 eve- IF Ll IV iUA)CT,D,,) 13ax ri ID " Z ? '. �t: 1� " -,� I ; � - - : kk. .0. ,Y AIIL'AAOLA::!� z4 7-6w- 2- e9a -,-tb tsma'R Ot Vhe 44 -LLr-- � no s Approved as . -i County / L LD — ZZ AWZ�S AS dr-1,4 4,i 00 A3 -Cb7Y J C ff 0 Ll IV iUA)CT,D,,) 13ax ri ID " Z ? '. �t: 1� " -,� I ; � - - : kk. .0. ,Y AIIL'AAOLA::!� z4 7-6w- 2- e9a -,-tb tsma'R Ot Vhe 44 -LLr-- � no s Approved as . -i County / L LD — ZZ AWZ�S AS dr-1,4 NORMAN ANDERSON INC.'..: {....�, It v DATE •C.»•.�,`.'. .•v>°' .i'. WELL DRILLING AUGUST 23, 1982 R.D. 3 Barger St. Box 244 NUMBER PUTNAM VALLEY, N.Y. 10579 914 LA 8 -8698 MR. Mc ARTHUR - 35 -16 KAMHI DRIVE, YORKTOWN HEIGHTS, N. Y. 10598 BOSWELL ESTATES TERMS - PLEASE DETACH AND RETURN WITH YOUR REMITTANCE i NORMAN ANDERSON INC. PAY LAST AMOUNT 09"'yow IN THIS COLUMN WELL DRILLING i; /I .r ,4 'Y J r .Y i trj NI •� x � � I � !li l.� 11O D'o L.A2 — C otiJC . 7'A,JIC i r �.M � 1• UjL— L //aa L,j STE 0CllDn�k 1 wetw Lil -�d#J[ 1!0PJ SOX Q � I Ft- - , N __ � 4,,9-,, f- � k o �I t # E ti e4art 1 hex ro 7 O�j 13 � . ;T 7?9 TCs 1. V Y PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date (; C` 1 v L' % ALI Re: Property of %lLCfljdfj 1,n1 o , IM&W F Located at C!fA �" „e)I�iG Section Block Lot -Z -2 Gentlemen: This letter is to authorize ` G' s�/ %d•'t 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 nece$sary papers on my behalf in uuiu,eC Iivi, wl Lr1 UU-S mac per a116 to. supervise ine construe cion of saia 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., R.A., Very tru y yours, Signed • Owner of Property •o�50a+b .. v f,.rp.t� Address 6i /�t .i a'e Aa.aaas Telephone Address / Telephone ' im a, OCT 24 1983 PUUTNA, ` .., PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.ENVIRONMENTAL. HEALTH SERVICES Date Re: Property of eo� QT /v(G /I Located atD� Section f0 G Block �� Lot Gentlemen: This letter is to authorize -'OW I T7Y 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 uv1111t:Q L-LUJJ wl Ln Uus ma c i_ev anti to. supervise 'Lhe curistruc t:iuri of said system or systems in conformity with the provisions of Article 14S or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very tru urs Signed er of oper Countersigned: � j Address _P.E , R.A . l a 7e j �ti� U 1, Telephone P;1Z: 1 dres� r/ RZC% {c w &e l�o�I�'IGCLGO�` 11 701 AIJG� p9 Telephone PUTNAM COUNTY DEPARTMENT :OF HEALTH DIVISION OF ENVIRONMENTAL HEAL'T'H SERVICES COUNTY. OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE.NO_. Owner /e4�f'�� %�e�.�ioio, Address 65� (JIM 1301--o AAV &, y l-%5. +j /070 Located at ( Street y G .U, A A19 Se.c . 4�Z Block /0 Lot indicate nearest cross street) Municipality. %/ Oi` Pb,rolly' VAL(_ Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS oe Number CLOCK TIME PERCOLATION PERCOLATION Run No. Start -Stop apse Time Min. Depth. to Water From Ground Start, Inches Surface Stop, Inches a er ve in Inches Drop in Inches Soil Rate Min. /in drop 3 I0 ig" l9,, 5 - -, 1 - 2 4 5 1 , Notes: 4sQ:51 repeated at same depth until approximately equal soil rate ' a lttf'ned at each percolation test hole. . All data to be submitted for review. 2) ,.,,De.pth::meb surements to be made from top of hole. DEPTH" F - - - ;, -- G-,, L: A TEST PIT DATA REQUIRED.TO-BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOtES1 HOLE NO.. HOLE. NO.* HOLE NO. 6-11 1211 2411 Co 14 M 3011 Lo#m 3611 A/ 0'-( 4211 fil ,9 4811 /VP iy (,VAN 5411 .6011 fr 6611, 7211 78 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 9C-12 59 -INDICATE TESTS MADE LEVEL TO WHIC 4 WATER LEVEL RISES AFTER BEING ENCOUNTERED 5, BY t L4.1i r Y Date Area Provided Soil. Rate DESIGN Used _jQ"_PUn/l "Drop: S.D. Usable No.. of. Bedrooms. 3 Septici;.Tank .Ca Xa,& ty, Area Provid By L. h4 0 Absorption Are 36" Gals. Type C0NCA6TL- width trench. he Name S y L • Hvilto W-1 'SDTm�ure J-1 A Address /2.69 AA1K(-(it1 &IC- SEAL THIS.. SPACE FOR .USE BY HEALTH DEPARTMENT-ONLY: Soil Rate Approved. Sq. Ft/Gal. Checked by DaN T -) Ece vx)