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HomeMy WebLinkAbout3569DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -55 BOX 28 ■ i . 1 I I. 4 Jo L C - _ ,- - 03569 PUTNAM COUNTY DEPARTMENT OF HEALTH R 3 +86 Division of Environmental Health Services. Carmel. N.Y. 10512 Engineer to Provide Permit q % l on CERTIFICATE OF COMPLIANCE s/ e q (t�s -, NSTRUCTION %PPE�RRMMIT FOR SEWAGE DISPOSAL SYSTEM - . J Lorslted at.— 'Town or Vjjlag� /t Subdivision Name "— cubd. Lot q Tar Map ` Block Lot p / ���, ®� 4-0j-0 Renewal_ ❑ Revision ❑ Owner /Appllcaat Name , CA / Date of Previous Approval Melling Address /! tom' Towne Ac- Zip ./ey 5n� J Building Type­ /'? Cj� . Lot Area % i 36 4' 0C' Number of Bedrooms :7 „++ Design Flow G /P /D &/, e a Separate Sewerage System to consist of `P— ed9Gallon Septic Tank and 4ec' To be constructed by Address Fill Section Only " Depth Volume PCHD Notification Is Required When FBi Is completed 4r „ h” Water Supply; Public Supply From Address or:�Private Supply Drilled by sadness °� �aaana•s�e Other Requirements Y represen t a I am wholly and completely responsible for the design and loc (Jells paot�s�d7 am( s); 1) that the separate sewage disposal system ' above described will be constructed as shown on the approved amendment the t^O aa%� Sla tg h he standards, rules en regulations o e Putnam County Department of Health, and that on completion thereof a "Certifi a oy °Aol:structionlian ” satisfactory to the Commissioner of, Health will be submitted to the Department, and a written guarantee will be furni gd t$ 6wne succ 4s, h irs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disDOSaI sy ilia rng e r tl ofWbt2 years Immediately following the date of the issu- I once of the approval of the Certificate of Construction Compliance of them ina anK -ropair thereto; 2) that the drilled well described above i wfll'be located as shown on the approved plan and that said well will be inst 1 n acc ith t a4stalold s, rules anti regu aTkions of the Putnam County Oepar ment of Health, 1 Date igned P.E._{ R.A. •' %�y� Address 72- � � � �'" �j " •° License No � APPROVED FOR CONSTRUCTION: This approval expires one year from the �+ struction o the building has been undertaken a-<** revocable for cause or may be amended or modified when considered necessary by t ayppNS#ioner of Health. Any change or alteration of cons* • ,,. requires 6-27-96 s new permit. Approved for disposal of domestic nitary Sewa e, a /or rivals .water supply only, Date By Title PUTNAM COUNTY DEPARTMENT OF HEALTH ENGINEER MUST Division of Environments/ Health" Serriitaet, _Cerme<�. N., V . 1t512 . -P E RM IT RTIFICATE OF RUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM / ����% j Town or Villagee :ated at el � Tax Map D° `;", Block H8►' a'�� � - -7 ' G O�� /Formerly Tax Map Lot t7 °Y• _S Suixi. I.ot q orate Sewerage System built by t`l �� �� Address '4' �T Consisting of p`r U Oal. Septic Tank and cal Other requirements or Supply: Public Supply From Private Supply Drilled By Address�� ding Type No, of Bedrooms Date Permit Issued Erosion Control Been Completed? Has garbage grinder been installed ?� er6m.wevej rrtify that the system(s) as listed serving the above premises were constructed essenti sl SWhe plans of the completed work ( copies rhich are attached) , and in accordance with the standards, rules and regulations, in, an e t aled plan, and the permit issued by the ;am County Department Of Health. Ceryfled by ' P. E. R.A. Address _ License No person occupying premises served by the.6ove system(s) shall promptly take su ch ac m be nefe ry °t ure the correction of any unsanitary ttions resulting from such usage. Approval of the separate sewerage system shall b #n a! as a public sanitary sewer becomes able and the approval of the private water supply shall become n void when a li pp y mss available. Such approvals are pct to modification or change when, In the judgment of the ommis Oner of HeaIt ilcation or change If necessary. B �'V• Title t?�7 a, e i J !' IA r ,• ro I". {r �i Yr1y ilhi ,}�v" � ��' �1 1 r r C tr ",}�' At y, +•�"�3�'�' � � A -li % I 4 ( �•Q �• F•�rRr 1 1 rf4 s ��,` gyf I Irrr y . 1 j8yg,, I ly�jl�y'1 . r� Ire: fl° A�)t � i 4t✓ C5 t ,. It I fii � � 14 y I f t � M r r .f M�.frY, L ,y ti' r'�y p * y 1'tfi r , a ; x d t �7f11p� t �" {�y� p� h 11 t +� l+ { 1fi h u�� gnT�4�r fii4 J•7'C'•�}S7�N t t .4V,i+'tir ii r J(' C 5 x_.,.� A iri i,d�i1 7 1r jj r yf ly: ly I i^,rl t 7 4 r- �?,•t PUTNAM COUNTY if DEPART& r t , Division of Environments /, ;Hae /ih• <; n CERTIFICATE OF O TRUCCT�ION COMPLIANCE POR'SEWAGE +DISI Located at .yrd G� . tG�' �• I ,,. n C ownereit!.tt "�" ��f+i'rl,�Ci 61/° G7 / Formerl y, Separate Sewerage System built, by ' W Ir �`Consitting of .d/ro Gal Septic Tank and w Other •requirements. Water 5uDPlys Publie Supply From Private SupP1Y Drilled BY w�" SA :. Address Buildin g T YPe t.: w No of Bedroa Has .Erosion Control Been Completed?'' `si , r:* i � , }� + °• Has garbage 2 certify. that theisystem(s) as- .listed serving the above i t t•" 1 ' -' ' Of which are attached), and in accordance with the standardsrulesere ongulations, Putnam County'Department Of Health. /? %" t_ A, ,t Date Cert letl by_`•_ „ Address l... 4.. Any person occupying premises;Served by. the above systems) shall promptly take such ac conditions d' ;: ng _from wch;,usage..: Approval, of ,the ,separate }sewerage systemssch ac aval6ct and': approval of'the private water supply shall become ni4ll�an� void avhen`` sub)eet to modifiatl0n' or change, when, In ,the, Judgment of the�C'ommiss ones of Heal Date :. Rev. .6%85 .. �.,'- 1 • i . - . ,'r.' 1 ... !. .. .b. r,,,.',,..;.,.•6.:•. ' NT'OF'�!HEAiTH�'I��,'�'ENGINEER MUST? Carmel, N PROVIDE 11' 10512,'" 'pERMI•T #. �',4'!��1= ,tea / i )SAL SYSTEMa►rYJ x Town or Villag c Tax Map Jt�+1 Block II �� t; ti Address f7 j/. k . 1 1 9' k , I ' t3tl . trl Iv! li 111 ---- ----. Date Permit,/ Iswed._ ✓ ,r1, r j t, binder been installed? , entially;as abar.. t �T na of the' completed work.( co lea an enc. t d permit issued )) the �, R1A "' il4 W Icenss ju! �5i��`It �.��9 ,•correction qt any.. th ''Publfc nnitary,sewsrbecomes� 'vailable, `:'Such:' app rovais, ere n or change Is necessary, ; �Ji1.11 I aq Titlsl�" r' I rl_\ 5 ,e.� 11. �`ti� v�.41.nIMa.�L� 1:�. Y.f..• .� I, . .t _ \e.....:.11.'i:t.... �.... DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 . PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY) BRUCE R. FOLEY Public Health Director STREET `�� �Gr aj -S TOWN TX MAP # NAME // ;° -G ONE 'cy PCHD # � MAILING ADDRESS_ - - - -- K � '_/ -a /- x ,14 c DESCRIPTION OF ADDITION - -NUNBER OF EISTdNG BEDR ®GMS :. PROPOSED # ®F 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 submit this form and the following to Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10509, Phone 278 -6130. 11111(1-14- . rtlfied 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 Feb 98 DEPARTMENT OF HEALTH Division i Of Environmental Health Services 4 Geneva ' Road, Brewster, -New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 BRUCE R. FOLEY, R.S. Acting Public;:Health Director Re: Residence Tax Map _ • _ _ =. _._.. _.._.. _ __...... _ . ­Town.. _.. . Gentlemen: According to records maintained by the To =, the above noted dwelling 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: OTHER— -f"�!T .. .. .. ..._. ...,: L'.:1+:. .: �. ..t':.. - ..._y.. lr . .. ..._. ....... .. .. _.. • ... _.. ... —M.. In Building Inspector Debbie Nacik Paul Engongoro 246 Wood Street Mahopac NY 10541 BRUCE R. FOLEY Public Health Director DEPARTMENT OF BEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 October 28, 1998 Re: Addition - Naick/Engongoro, 246 Wood Street Increase in Number of Bedrooms (T) Putnam Valley, TM# 74 -1 -55 Dear Naick/Engongoro: 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 latest revision date of October 28, 1998 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restructures 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. Very truly your William Hedges Sr. Public Health Sanitarian WH:tn PUTNAM COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD JNSPBCTIO (Name 00 (Street Locat INITIAL SI INSPECTION 2_ (�) r � N Wetlands on/or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Will driveway need cut ............................. Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed..... .. .......... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/ septics ............................ D.H. 1 Lot Depth to G.W. Depth to rock - _..w0�it: 3 ft. 6 ft. 9 ft. 12 ft. LLB Cam. D.H. 2 Lot Depth to G. W. Depth to rock .... Soil. 0 ft. r- 3 ft. I L 0/� 6 ft. 9 ft. 12 ft. MO 0� ME DATE: S • 20-1 -6 L. INSP. BY: D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G. W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: IYES1 NO I ('TATS FINAL SITE INSPECTION INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over 100 ft. fron watercourse .................... Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained fron property line and 20 ft. from house .............................. Distance well to SSDS (ft.) ...................... `umber of bedrooms checks ........................ '.ones, brush, stumps, rubble, etc., greater `han 15 ft. from nearest trench ................ eft. of peripheral soil horizontally pan trench ..... ............................... Properly .set.,, , 0.. ............ ...... surface runoff from driveway, roads, pd. surface, etc., channel near SDS area.... )t drainage appear OK in area of SDS....... t WNG OF SITE AIXCEPTABLE .................. PUTNAM COUNTY DEPART OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEM M WANT • DWI, --03 REVIEW S - CONSTRUCTION PERMIT DATE REVIEWED: 7 OK Variance Request ,-REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank -. Sa zA -p DAB =1 -Well Detail, Service Line if over Construction Notes /Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown; gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits i 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' fran Foundation 50' to Well 15' Well to PL GENERAL Legal. Subdivision Subdivision Approval Checked /Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same BY: (Street Location) YES I NO DOCUMENTS Permit Application r Corporate Resolution Plans - Three sets }- V Engineers Authorization Design Data Sheet (DDS) ✓ Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets _-=- If PWS - Letter OK Variance Request ,-REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank -. Sa zA -p DAB =1 -Well Detail, Service Line if over Construction Notes /Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown; gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits i 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' fran Foundation 50' to Well 15' Well to PL GENERAL Legal. Subdivision Subdivision Approval Checked /Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same rye r \ PUTNAM COUNTY DEPARTMENT OF HEALTH �. DIVISION OF ENVIRONMENTAL HEALTH SERVICES A.? v �Y C -A, Re: Property of_ Date Q/7 f o, /—W Located at (T) Section d< 2— Block Lot' Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize. a duly licensed professional engineer or registered architect (Indicate.)_ to apply µfor a ConstruGtioxi_ P.ermit... for =: -a se,paw.a-t-e--•sewage-7sy's.. em, " 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 with the provisions.of Article'145:or 147, Education Law, [[the Public Health.Law, and the.-Putnam County Sani= !i® tary Code. L c; r AY ( l�r � Very truly,'yo6r�', EPT. OF HEAL�.H Signed' �,E1016 % 0 er of operty Counter r,Pt c� . Voo, i P.E., Address Address ..ear Town P Telephone January 21, 2007 246 Wood St. Mahopac, N Y 10541 RE: TM# 74 -1 -55 To Whom It May Concern: We the owner of the above mentioned property are writing to confirm some information about our property that the county would have knowledge of which we are somewhat confused about. When we bought our home in February of 1999 we bought what was advertised and sold as a 4 bedroom contemporary high ranch home. Since that time we have been paying tax for a 4 bedroom home. Recently we were given information by the assessor's office (on 11 -8 -06) via the telephone that we do have a 4 bedroom home. But since that time I believe the health department has reported that we have a three bedroom home. Can your Department please shed some light on this dilemma and explain how such a mix up could occur, and if this is the case in point how do we go about getting a reimbursement for our over paid taxation. A tax paying citizen should not be in error as to a true and correct description of their property. Our tax map numbers are: 74 -1 -55. fnld tcvdet�rs i0scilbrri ,our:properiy look to hear from your offices soon. Respectfully Yours, 16 �v4L /Lsan & Barbra Black Kemet .. � .,� .... -.. ... ..�.._....._ .., _.,... .. �.4�.. .. fir. .. -+r.. =..J.i _. .. .. ... .. RECUTED MLS #:9810059p SF ACT Area:9 LP­_=, 189.,000 Addr : 2 4 6 WOOD `15 E PO:MAHOPAC Zip Cod 10541 - -------------------------- - - - - -- --�. -�- City/Town:PUTNAM VALLEY Grid:A Map: Village:NONE Sch:MAH Rooms. - 9 - - - - -- sL SgFL. 2n0 YrB1L.1986/ -- Bedrooms: 4 Elem School:AUSTIN ROAD Bath3:3.0 Jr High'School:MAHOPAC Levels;: 2 High School:MAHOPAC ------'---------------------------------- - - - - -- buvi. e'X •t �J �,'i... b Y y kY. >,`�7•' y ••• C' in n`�+.. �.� i, t r L .�t+�n��;'��� � Style: CONTEMP, RRANCH Model: Fxter :CT,APRn Color:RROWN evell :ENHALL,LG EIK,DRW /SLIDER,LR W /WOODBURNING STOVE,SKY LGT Living: :S,2BEDROOMS,MASTER BEDROOM WITH BATH,HALLWAY BATH Dining: eve12:BEDR00M,FAMILY ROOM,KITCHENETTE,FULL BATH,WALK IN CLOSE Mst BR: eve13:T,LAUNDRY,2 CAR GARAGE asemt: Attic: eighborhd Assn :N Additional Fees:N Homeowners Assn:N Att /Det:A X X X -------------------------------------------------------------------- --- - - - - -- omplex: Est Tax$: $6,570 Front: ax ID 4:74 -1 -55 Tax Year:97�98 Depth: Shape: oning:RES Assmt: $208,900 Est Acres: 1.31 r` menities:EIK,ALARM SY,FPL,WLKOUT B Iflcludes: RANGE ;REFRIG,DW;WASHER,D9YER,A /C UNTS;W /W :R OPNR,MICROWAV,LITE FXT Excludes:LITE FXT eat : ELEC arkg : 2CAR GAR ater:WELL Fuel:ELEC Wall:SROCK Sewer:SEPTIC CRPT,STRM,ALARM SY,D Elec CO:NYSEG Roof:ASPHALT Garbage:PRIVATE .em: BEAUTIFULLY REMODDELED,LARGE EIK W /BREAKFAST AREA,IMMACULATE HOME FRESHLY PAINTED,UPGRADES GALORE,BEAUTIFULLY LANDSCAPED W /LEVEL GRO UNDS,POSSIBLE MOTHER /DAUGHTER,MUST SEE!!OWNER ANXIOUS REDUCED FOR QUICK SALE. CLOSE TO PARKWAY AND SET BACK FROM RD. VERY PRIVATE!! irections:6N TO LEFT ON SECOR TO RIGHT ON WOOD ST. 2ND HOUSE ON RIGHT. ----;----------------------------------=-=---------------------=------- - - -� -- wner4�ENGONGORO /NOVICK Possession:ASAP Modif /Excl:X03,XO4,XO7 ist Office :HOULAWI3 HOULIHAN /LAWRENCE ROBER (914) 962 -4900 LD:05/18/1998 ist Agent :6211 )GINA ROWED (914) XD: k Email: i CIA Email: D -List Office: ` SMP: :)-List Agent : List Type:1A lb Agent Comp:3 Buyers Agent Comp: 3 Negotiate Thru: LA _---------------------------------------------------------------------------- Data believed accurate /not warranted All Data subject to verification Copyright: 1998 by Westchester - Putnam MLS, Inc 11/15/1998 10 :55 C ��;,4. Irv, r cu r�U' COUNTY OF PUTNAM TOWN OF PU, TNAM VALLEY- * ** PROPERTY DESCRIPTION REPORT * ** THIS REPORT IS FOR YOUR INFORMATION. IT SHOWS IMPORTANT DATA WHICH HAS BEEN COLLECTED FOR YOUR PROPERTY AS OF DECEMBER 1, 2002. THE DATA WILL BE USED FOR ASSESSMENT PURPOSES. PLEASE SIGN AND RETURN THIS REPORT TO THE ASSESSOR'S OFFICE AT THE ADDRESS BELOW. IF THE INFORMATION IS CORRECT, NOTE 'DATA CORRECT'. LIST CORRECTIONS, INCLUDE PHONE NUMBER, RETURN BEFORE DEC. 31, 2002. 372800 74. -1 -55 KEMET HASSAN E & BLACK BARBRA A 246 WOOD STREET MAHOPAC, NY 10541 * ** rROPEkTY DATA * ** PROPERTY ID 372800 74. -1 -55 ... r..... -.... ....... .. .- - -�A :. :.ter ..:...... ..�_... __.. .. .�.�. ..�. PROP.E•RTY•- LQCATI- 6N.:.. 2 4 6 `WOO'6 "S I`REPl .<.':::..:.; -- - PROPERTY DIMENSIONS 1.31 ACRES PLEASE VERIFY SALE INFORMATION IF YOUR PROPERTY HAS SOLD SINCE 01/2000: SALE DATE SALE PRICE SITE NO. 01 TYPE OF ENTRY PROPERTY'TYPE 210 1 FAMILY RES ZONING R2 AVAILABLE UTILITIES ELECTRIC WATER SUPPLY PRIVATE TYPE OF SEWER PRIVATE * ** RESIDENCE DATA * ** BUILDING STYLE RAISED RANCH YEAR BUILT 1975 EXTERIOR WALL WOOD SQ. FT. LIVING AREA 2,460 BASEMENT TYPE FULL NO. BATHROOMS 3.0 TYPE OF HEAT ELECTRIC NO. BEDROOMS 4 TYPE OF FUEL ELECTRIC NO. FIREPLACES 0 CENTRAL AIR NO YOU MAY CALL THE TOWN ASSESSOR'S OFFICE TO ARRANGE AN APPROINTMENT FOR AN INSPECTION /DATA VERIFICATION AT 845 - 526 -2517, MON -FRI 8AM -4PM. BE AWARE THAT THERE MAY BE OTHER DATA ITEMS THAT HAVE BEEN COLLECTED FOR YOUR PROPERTY WHICH ARE NOT INCLUDED ON THIS REPORT. IF CORRECTIONS HAVE BEEN MADE (ON THIS FORM), PLEASE SIGN AND DATE BELOW, AND MAIL THIS FORM TO THE FOLLOWING ADDRESS: ASSESSOR'S OFFICE SIGNATURE TOWN OF PUTNAM VALLEY -------------------------------- 265 OSCAWANA LAKE ROAD PHONE # PUTNAM VALLEY, NY 10579 ------------ --------------------- _ _ DAZE 5 Debbie Nacik Paul Engongoro 246 Wood Street Mahopac NY 10541 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road . Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 �7 BRUCE R. FOLEY Public Health Director October 28, 1998 Re: Addition - Naick/Engongoro, 246 Wood Street Increase in Number of Bedrooms (T) Putnam Valley, TM# 74-1-55 Dear Naick/Engongoro: 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 latest revision date of October 28, 1998 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restructures 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:tn I- Very truly your, William Hedges Sr. Public Health Sanitarian WELL LOCATION I WELL COMPLETION REPORT DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Off Use ly TAX GRIO NUMBER NAME: ADDRESS: • WELL OWNER PRIVATE %..®R .>✓ �-�" r r1-�_ O PUBLIC USE OF WELL )& 10E ' AL O PUBLIC SUPPLY O AI COND. /HEA PUMP ❑ ABANDONED 1 - primary O BUSINESS ❑ FARM O TEST/ OBSERVATION ❑ OTHER (specify) 2 - secondary ❑ INDUSTRIAL O INSTITUTIONAL O STAND -BY p MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED —EST. OF DAILY USAGE REASON FOR j8. NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION DRILLING ❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DEPTH DATA . WELL DEPTH 1 ft. STATIC WATER LEVEL .ZU ft. DATE MEASURED .DRILLING J. ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE , ❑ SCREENED . ❑ OPEN END CASING. TOTAL LENGTH CASING LENGTH.BELOW GRADE DETAILS I DIAMETER WEIGHT PER FOOT DIAMETER (in) SCREEN FIRST DETAILS SECOND GRAVEL PACK O YES GRAVEL O NO SIZE: WELL YIELD TEST MET 0: O PUMPED COMPRESSED AIR O BAILEO O OTHER WELL DEPTH DURATION It. hr. min. /-, If detailed pumping tests were done is in- formation attached? ❑ YES ❑ NO DRAWOOWN YIELD tt. gGm- 10 (v0 1 G_ A 9 (;. 1 ')00 r-4-- 1 s' 1 WATER )0 -CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO PU111P INFORBMATION�_ 5_... TYPE -.. CAPACITY MAX✓ DEPTH yU ` MODEL C/j'i �� VOLTAGE2-30 HP OPEN HOLE IN BEDROCK O OTHER I� . . ft. M! ATERIALS: ' ;,STEEL OAASTIC ❑ OTHER I Q ' ft- JOINTS: ❑ WELDED );THREADED' O OTHER in. SEAL: ❑ CEMENT GROUT O BENTONITE ;.OTHER Ib. /ft. DRIVE SHOE_YES ❑ NO LINER: ❑ YES_,M�O SL07 SIZE LENGTH (ft) DEPTH TO SCREEN (I't) DEVELOPED? O YES ONO HOURS DIAMETER TOP I BOTTOM OF PACK in DEPTH ft. I DEPTH It. WELL LOG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM I Water well SURFACE Bear- Dia- FORMATION DESCRIPTION CODE, It. ft. ing meter .and I wrtace STORAGE TANK: TY' CAPACITX,:�. /..� WELL DRILLER NAME ° 7,u✓yy� PUTNAM COUNTY DEPARDMU OF HEALTH - DIVISION OF ENViRONlENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FIELD INSPECTION} REPORT of "er) (Street Location) INITIM SITE INSPECTION YES NO Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Will driveway need cut ............................. Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed..... ....... .... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/septics .. ... ... ... .. ...... D. H. 1 Lot Depth to G.W. Depth to rock Soil Descriptii 0' ft. 3 ft. 6 ft. 9 ft. 12 ft. D. H. 2 Lot Depth to G. W. Depth to rock Soil De 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE: ) INSP. BY: D. H. - Deep Hole G . W . --Groundwater D.H. 3 Lot Depth to G. W. Depth to rock "0 ft. 3 ft. 6 ft. 9 ft. 12 ft. ml. T7PS�'X: jntJl.nn 4 6b 3 r� DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS . House SSDS located per approved plan ............. G-S� ✓ 8�� o� ►-� Length of trench measured �)U Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. I\- Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded.......... .... ........ o4— 10 ft. maintained from property line and 20 ft. fran house.... .........,.(..� /.......... Distance well to SSDS (ft.) ..�jrfy .1 0.. Number of bedrooms checks .. Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench........ ...... 5 15 ft. of peripheral soil horizontally fran trench ..................................... _ Boxes properly set .. .... ......... ...... �.. __. Cow.d : sarf�acQ -- runoff *-Iran dr veway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE.. i PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Camnissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME GON 6 0RE [9 Orig. Routine ! _ Orig. Complain ADDRESS Ldp S'72'l!�7 / % a 3 �- � . �- _ Orig. Request No. Street Town TM No. _ Compliance Complaint Comp MAILING ADDRESS Final P.O. Box Post Office Zip Code Group Illness Construction _,p< Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title _Other.. -.-DATE . . �4' -,��- .i YP. °FACIL _._ .30 TIME ARRIVED TIME LEFT �j Explain FINDINGS: INSPECTOR: ~ t ati Pule ~ igna ire �iYt!m PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: r 4 ' PUTNAM COLWY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchas of uilding i` Building Constructed by L .� .,4 7 Location - Street "5 7a,/�40;!2�4:� Municipality Building Type 4;?- 3 4..4 Section Block Lot Subdivision Name Subdivision Lot # GUARANTEE OF SUBSURFACE SEVRGE DISPOSAL SYSTEM rPpYPCPnt. _th= T . a.^_a w-h -11 t' and - completely- responsible - -f-o -�the--lF�Catior � 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 successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage 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 occupant of the building utilizing the system. The undersigned further agrees to accept-as conclusive the determination of the Director of the Division of Environinental Health Services of ' the Putnam County Department of Health as to whether or not the failure of sy tem to operate was caused by the willful or negligent act of the occupant e ilding utilizing the system. Dated this 7 day of 19 �� Signatur e Title General Contractor (Owner) - Signature Corporation Name (if Corp.) Corporation Name (if Corp.) Address rev. 9/85 mk LAB # Y®ikt®wn Medical Laboratory, Ins : 321 Kear Street Collection Station Used: Yorktown Heights, N. Y. 10595 Carmel — Peekskill Mt. Kisco New City _ (914) 245 -3203 Director: filbert H. Padovani M. T. (ASCP) Date Taken: /S `" % ldl)21 -1 Date Received: If �J AI �J Date Reported: ai_l Collected By: pYJ/F' �►(/�'/V9 S� Referred By: Sample Source: /j✓r �y'> LABORATORY REPORT ON BACTERIOLOGICAL A,UALITY.OF WATER GENERAL BACTERIA Standard Plate Count per 1.0 ml 12-0 (Agar plate @ 35 0C)' ME14BRANE FILTRATION TECHNIQUE 0-IFT ) Total Coliform ner. 100 ml Fecal Coliform ner 100 nl Fecal Streptococcus per 100'ml MOST PROBABLE NUMBER TECIINIAUF (.VP' Total Coliform: MPN Index per 100 ml Fecal Coliform: VPN Index per 100 ml OTHER ANALYSES THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) (WAS NOT) (NOT APPLICABLE' OF A SATISFACTORY SANITARY QUALITY ACCORDING THV NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT TIME OF COLLECTION. - - -_- : dovani9= 'A"T. (ASCP), Director ~RDS = Recommend Disinfect - ing Water Source < = less than TNTC = Too Numerous Too Count PUITM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRCNKERM'HEALTH SERVICES DESIGN'.DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. 4 Owner (N Located at-(Street), Ap!ea Sec... . Block Lot ..(indicate nearest cross street) Municipality 'Cie �7 C am • " Watershed SOIL PERCOLATION TEST DATA RDQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking Date of Percolation Test HOLE NUMBER CLOCK. TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. f. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches Inches 4 5 5 1 R 2 3 Y.. 4. AWL. QE .HEALTH 5 NOTES: 1. Tests to be repeated at same depth until -apprmimately equal soil rates are obtained at each percolation test hole. All data to*be submittod for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED T0. a. SUBMITTED WITH APPLICATION ¢ r DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES P DEPTH HOLE NO. r HOLE NO.. HOLE NO. 3 � 3 4° 5.° 6° 7° W 9° _ 10° 9 11 12° 13° 14° ,T..�IC�:TS :gymir�u_c�3�1'E?rzL�IA?? INDICATE LEVEL TO WAICH WATER LEVEL RISES AFTER BEING EN00UNTERED DEEP HOLE OBSERVATIONS MADE BY: C 4. % 1�eA4 DATE: jI ee DESIGN Soil Rate Used % Min /1" Drop: S.D. Usable Area Provided© No. of Bedrooms .3 Septic Tank Capacity r ��(1 gals. Type a Absorption Area Provided By 'G,' L.F. x 24'° width. trench Other Name , 3,. v-, ue RcIS, ._off °:a ao aa. Address 7 P- Ve• ' .et, e THIS SPA FOR USE BY HEALTH DEPAR ONLY: Soil Rate Approved sgeft /gale Checked by Date i a� S .. 1 ai g t H f St Wa iZ ,Zc we 0 ( a� /''*'_i 7"'' ,ro i f a• i"?�'k•X - Y'fai+$� -st'y •:i' - _F 2 F 8 = o 0 >. 777a-s4- -T-,e 4v,, Y de D** Ir)cI,t :j v C v � a �- k ©w, i a � °� j � � 1"� i i'`1 t-i �%c.5 � •� m �!, S^� �/o- C.,�r"� �ra9 d ,�•a�s► �`�r'°". SC w 1 j Putnam County Department of Health f e oof yf�.c Division of Environmental Health 5ervicen ,f.� SDS /lJ6tL s; 0-�y�a�a —+ Approved as noted conformance with `�lleable Rules and Regulations of the • 4� -`— Putnam County Health Department. – j. 1 j Putnam County Department of Health f e oof yf�.c Division of Environmental Health 5ervicen ,f.� SDS /lJ6tL s; 0-�y�a�a —+ Approved as noted conformance with `�lleable Rules and Regulations of the • 4� -`— Putnam County Health Department. – T op A Kfv f I -ION MT PL t"6 NOTES= SR F;( Nl� JVATIOWNO-TES... I T o� k :F66 VO4T AE:_ nc irr. -,v is 6 . . . . . . . . . . . . . . . ........... f I -ION MT PL t"6 NOTES= SR F;( Nl� JVATIOWNO-TES... I T o� k :F66 VO4T AE:_ nc irr. -,v is 6 ■1 = m I I �= ,• 3- 0* BEDROOM,!l c? 0 A WALL CABS. 0 Qo 10 54 P� K -f- C HE � l 7 3 . . . . . . . .... BE DROOMI; 3'.2 ii