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HomeMy WebLinkAbout3579DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.06 -1 -21 BOX 28 03579 L 03579 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, .Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 April 2, 2004 Perillo 1 Park Drive Putnam Valley, NY 10579 Re: Addition - Perillo, Park Dr. No Increases in Number of Bedrooms (T) Putnam Valley, TM #74.6 -1 -21 Dear Mr. Perillo: ROBERT J. BONDI County Executive 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 this Department dated April 1, 2004. The addition is approved with the "following conditions: 1. The total number of bedrooms must remain at four 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, 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. Sincerely, Michael Luke Public Health Sanitarian ML:Im cc:BI (T) Putnam Valley J�-' BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 L43 /0 Y LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services 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 Far (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET k 'RQVZ 'blz (Q T-- TOWN- RKtjP, LU- TX MAPi# NAVM Vte-I _LO PHONE'9g5- `5Z-(o-t" -7 PCHDA j- MAILING ADDRESS t �ftf -!� 1��i ,� V,A��I N`l 10� -75 DESCRIPTION OF ADDITION L 0 0 - 2CC)44 kvo W AIA -t f AuLTrD CC-tU Q L-5 n NUMBER OF EXISTING BEDROOMS L�_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 submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money or- ei foi $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 9) *Non - professional sketches are acceptable. J4. 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. �. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFF7CE USE Comments Feb98 ' . BFhouse;uidelines f F BRUCE R. FOLEY Public Health Director DEPARTMENT. OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 3/18/04 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: 1 Parknri Sze Residence Tax Map 74.6-1-21- Town of Putnam Valley Gentlemen: According to records maintained by the Town, the above noted dwelling IS Xy. IS NOT in compliance with Town code and the total number of bedrooms on record is 4 This information has been obtained from: CERTIFICATE OF OCCUPANCY: YY ASSESSORS RECORD: OTHER Health Dept. Approval Building Inspe r BFhouseguidelines M R> l..l �r�, 11 - - A The attached floorplans and renderings describe the proposed single room addition. The intended use of this addition is as a first floor Living room/Su n room with vaulted ceilings and a center fireplace. The approximate size of the addition is 27.5'x 18.5'. This would expand the first floor by 479 Sq. Ft. The addition would also result in a widening of the Master Bedroom by 6 feet thus adding an additional 63 Sq Ft to the second floor. This area would serve as a balcony directly above the existing basement stairs and would overlook the new living area. An additional 36 sq -ft would also be added to the existing second floor storage space. No additior unaffected. SECOND FLOOR PROPOSED FLOORPLAN WIADDITION MARC & JANIS PERILLO I PARK DRIVE PUTNAM VALLEY, NY 10579 opo TAX MAP # 74.6-1.21 OF gRQ JpP Rail V STORAGE 4-10 SA 11'-V Rail MASTER BEDROOM -y 0 r 0� 0 Z-2* di V/N �l Z BRIDGE 7- -2" 5 -10' Rail OF fo BEDROOM #1 01 OEM- Fi .1 OFFICE 4- BEDROOM #2 I MUD —I N i i g t. a � i i i i i LIVING ROOM 0 STOVE GARAGE FIRST FLOOR PROPOSED FLOORPLAN W /ADDITION MARC & JANIS PERILLO 1 PARK DRIVE PUTNAM VALLEY, NY 10579 TAX MAP # 74.6 -1.21 � a 4 l r• � g 1 e � rL �i t 9 n DINING ROOM . �a KITCHEN 2 STORY FOYER FAMILY ROOM -- --- --- - 23'-0' v iUS: P4 `3r r, a ! \ 0 iv a i 27'. 16-T , 15 -3• SECOND FLOOR EXISTING FLOORPLAN MARC & JANIS PERILLO 1 PARK DRIVE. PUTNAM VALLEY, NY 10579 TAX MAP # 74.6 -1.21 toto to N bo FIRST FLOOR EXISTING FLOORPLAN MARC & JANIS PERILLO 1 PARK DRIVE PUTNAM VALLEY, NY 10579 TAX MAP # 74:6 -1.21 25-0" 4 8� t- 6--ol - -6'-6^- 9L I A K {- _: "� ��. �. +n ,,.�.. - ..a �it'T' - .. - �Y - � 4 _ / I ft �. .. K _ _ vl_ '. /.f.' ;T t _ ._ — ' +P. .:. _. ., r °- . q �� r; �_ -� {e j( s��a �y����r ?' _ � � 1 �� Y o-� � F -ay �, _x .. K {- _: "� ��. �. z SAO . 1 - i�s�•.•t�vla�t To 'PAfu' i -cr,Ja W v� 1/ /y Gj GTbA%C �NSTa�� , 1'L 5bG a! rnd�aa -� Ivo�� ,) TTci'rt~��."P��.�4 Tdar'S4�ovJ�l . c�� �•cao�,o �. ya�z lG THE THE RULES AND 1? GI j- %.I :!:..., ,.. V 0I:PARTDfI:N V OF I IEn rut"aw UOULIT. Lejlar LWenL ul nbal" Division of Environmental Health Servicee /t-S 4 (/, approved as noted for conformance with %PPlicable Rules and Regulations of the 'utnam County Has th Department.. I (• o h/ a SltMUM 6 Ti s r ` FoQ L`cv\o -Cv4ca Fj�Y —'fce ST.d "17a¢K -.�wc TM— .(o3 -4— 1 X9 89 Coo�U+-- f a—AV PT z - _ - - -- g 4 . o.. 1 -o,, lol 57• -l0' �'o' 1 - Z-S lo' — P...wv �1; ZZ' -o• THE THE RULES AND 1? GI j- %.I :!:..., ,.. V 0I:PARTDfI:N V OF I IEn rut"aw UOULIT. Lejlar LWenL ul nbal" Division of Environmental Health Servicee /t-S 4 (/, approved as noted for conformance with %PPlicable Rules and Regulations of the 'utnam County Has th Department.. I (• o h/ a SltMUM 6 Ti s r ` FoQ L`cv\o -Cv4ca Fj�Y —'fce ST.d "17a¢K -.�wc TM— .(o3 -4— 1 X9 89 PUTNAM COUNTY DEPARTMENT OF HEALTH Rev. 3186 _ 4 Dlyislon of.Environmeritel Health Services; Carmel, N.Y. 10512 t� Engineer Mast Provlde i V . 9 P.C.H.D: Permit #. , CATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE'DISPOSAL SYSTEM 1 I�` 14 k Town or Vlllage ' Located st To, Map 3 Block__4— 'Lot Owner /applicant Name ' - LLy'l7i d1 'Z"{t7tJC Formerly Subdivision. Name Subdv. Lot N Mailing Address -� �'� V— 14ar ZIP- Date Permit Issued - . U'l A l' Separate,Sewerage System built by Address i 'PreZ��IG ,hid .1 NA,n V SICc�, + of ' Z Consisting Gallon Septic Tank and i ►� t` �F C°i Ll [ t rat Water Supply: Public, Supply From Address oil Private Supply Drilled by n, A►.1D�crA11a' i Address ► SZ,. � �(r� �.fi �yi`. pia l.l�ti Bulldhi' Has Erosion Control -Been Completed? H , Number of Bedrooms Has Garbage Grbide Been IpetaUedY Otber.Regairemerits I certify that the system(s) as listed serving the above pm iises were constructed essentially as shown on 'the pla a f he completed work ( copies of which are attached), and in' accordance with the standards, rules and regulation in accords ce with a fiis n, nd the permit issued by the Putnam County /jDe rtment f Health. Date ` -1 [ Certified by, P.E.—RA' Address l_I en"' Nor Any person occupying premises served by .the above system(s) shall promptly take such 'actlon as may be necessary to to ra the correction of any unsanitary conditions resulting from, such usage. Approval of the separate sewerage system shall become null and void as won as a pubs;: sanitary sewer becomes available and the approval of the private water supply shall become null end void when ;& public water su ply becomes available. Such approvals are subject, to modif tion or change when, -in the Judgment of the C mmissi r of H, ealth, such revocot n, modification or change Is necessary. L./ Date / 2 / '74 By Title PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROIFPAL HEALTH SERVICES Own6r or Purchaser of Building %___- m - Street Section Block Lot Subdivision Name icipality V Subdivision Lot # Building Type GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL 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 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 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 19_b Signature i� Title General Contractor (Owner) - Signature Corpor ti on Name (if Corp.) / Address rev. 9/85 mk 7 Corporation Name U Corp.) Address me:. 3;itplLi, Type:. k,- o'ne) able . n pqtable SfiP EF,F he r' do= Lc:i 2.03, 3. 0;,c 4',C 2 GE 9 E GE 12 WATER, 1,19-T THE, ti �tG I ;:WATER: INORGANIC METALS' m MICRO <: Acidity E G GENERAL -AC -21. t I Aik A 1 it i tv T, Chloride . d. D etergian MBA'S, 777 7�:: �,-77, .1_6 .Hardness:; i! 'i.' - Total Nitrogen, Ammonia E l Nitrogen :tr&t Phosphate, ki. C14 _Total Sul fatt!:- ­7 S u I ft d La" .7 Fecal CoiSi�i S. U-1 it b Fecal S t r ett METALS m copppr 7 7 7 Iron Total A 4 77777' m a. ngan e " aal".cdl fo ... . ..... kp-rc.ury Sodium -KEY.' FOA..!Tzgxild Z%i-n c C F U..: 0 our. P*D MISCELLANEOUS ..,LT Less ,,T,12.4. 6T p T N T C:i:." Too XU*6, :Co'lor uniitq.) � :,ii� t, I Ot 0 on: uep Odor (T. NR Non react Turbiditi N T U') REMARKS/C0 E •THESE RESULTS I ND ICATE T HAT TH E WATER SAMPLE SATISFACTORY SAN I TAR Y ..QUA LITY ACCORDING TO "T ' ' STANbOMS, F6R THE PAR AMETERS.TEST ,- tHEpE'.RESULTS,t NDI CATE * .THAT THE,WATER. . SATISFACTORY -. :4CHEMICAL QUALITY,STANDARIS ov"T :. , THE CQPEPj FOR THR,PARWTERSTESTED, _ 7 I Ix/ A:lber*t-. H M'T AtJ C P Di'l—, v n k, 6 `c t o r, me:. 3;itplLi, Type:. k,- o'ne) able . n pqtable SfiP EF,F he r' do= Lc:i 2.03, 3. 0;,c 4',C 2 GE 9 E GE 12 WATER, 1,19-T THE, ti �tG I ;:WATER: 111 • 301. y �c WELL UUrirLh"11UN L'>nruml DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only STREET AOURESS: nWR7VlLLACd1CIIY TAZ GRID NUMBER: b�� �� � �-� �• QUELL LOCATION WELL OWNER NAME: ADDRESS:. TS7,1' B IVATE UBLIC USE OF WELL 1 - primary 2 - secondary 9 RE IDENTIAL ❑ UBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS O FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) O INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0: PEOPLE SERVED —" —/ EST. OF DAILY USAGE gal. REASON FOR DRILLING O NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY O TEST /OBSERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH °2 �° d ft. STATIC WATER LEVEL `�° ft. DATE MEASURED ° DRILLING EQUIPMENT ®-ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END.CASING. ® OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH °2 ft. MATERIALS: STEEL ❑ PLASTIC ❑ OTHER LENGTH .BELOW GRADE 01 ft. JOINTS: ❑ WELDED �21THREADED O OTHER DIAMETER " in. SEAL: ❑ CEMENT GROUT ❑ SENTONITE QDTHER WEIGHT PER FOOT lb./ft. I DRIVE SHOE)E�1tES O NO I LINER: O YES ZNO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (f t) DEVELOPED? FIRST ❑ YES ONO . HOURS SECOND GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH • ft. BOTTOM DEPTH It. WELL YIELD TEST ; It detailed pumping METHOD: O PUMPED. tests were done is in- OMPRESSED AIR , formation attached? O BAILED ❑ OTHER ;DYES ONO IELL LOG ff more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- ieg Well Dia- Meter FORMATION DESCRIPTION coot tt. ft. WELL DEPTH it. DURATION hr, min. DRAWDOWN ft. YIELD 9Cm. rface Surf Su r /0 ' WATER ❑ CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ❑ NO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE _ CAPACITY GAL. PUMP INFORMATION TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE HP WELL DRILLER NAME tf— oa E ADORE 4�1 v "�j� li . SfGTJI�TURE oi l e / � � ;AC��� J a PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M:.Simmons, M.D. `. Deputy:Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAND ° G o �l Orig. Routine ct� U,z �v �3~ Orig. Complain Orig. Request ADDRESS T / No. Street Town 21 No. Canpliance _ _ Complaint Canp MAILING. ADDRESS Final P.O. Box Post Office Zip Code Group Illness _ Construction :TELEPHONE i...' Reinspection PERSON 1N CHARGE Field, Sampling Only oR INTERVIEWED _ Field Conference Name and Title Other DATE :,. TYPE FACILITY TIME ARRIVED // : 3 y TIME LEFT % ! : cf 7 Explain FINDINGS:n C46 L E >J' a 2 r �JiZ / ! U l7V✓'t"J / �a�7 INSPECTOR. Signature and Ti PERSON IN CHARGE OR INTERVIEWED: L.acknowledge this Field Activity Report. -6/86: AIVIA7,�— wtizF.R0 19 TITLE: TELEPHONE: PUTNAM COUNTY DEPART OF HEALTH — DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS (Nac f Owner) REVIEW SHEET — CONSTRUCTION PERMIT DATE REVI WED: -23-8 Q, C` n BY: Mreet Location) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Grav-ity-F-low Fill Profile & Dimensions.- Volume r J Box;Trench /Gallery; Pump pit details eptic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two --Foot Contours Existing & Proposed (DrivewL aa'& Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown; gravity flow,suffo size If Pumped Pit & D Box Shawn & Detailed House - Noe 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 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundati 100' to Well; 00' in D.L.0 , 150' pits 100' to Stream, Wa ercourse, 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 ORAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same Cyr tjp ,G7o.o.i. To <I j 1 /O13 f ,1 %art f • r r• / 0250�j11V `. 1Co0'�.ILS t—T� Trz�L�C>,•.rs1'� �r1� �G��� ., t2 Sc7(a Ai McSotizz -c a ' ScPTC. TA.aK oi`z Putnam County Department of Healta Division of Environmental Health Service. /-)� ae 7J,, L 7— Approved as noted for conformance with s.pplicable Rules and Regulations of the Putnam County Health Department. Slgnatuae 6 Tit 35_-0 - 5l-C. 15' •oF Ew P MICM,9C YO Su Fes' . doe i I G 91' 3co' o� a Putnam County Department of Healta Division of Environmental Health Service. /-)� ae 7J,, L 7— Approved as noted for conformance with s.pplicable Rules and Regulations of the Putnam County Health Department. Slgnatuae 6 Tit 35_-0 - 5l-C. 15' •oF Ew P MICM,9C YO Su Fes' . doe i I G 91' 3co' o� V J (�` Insp�•t_,,.,' by � STZiF.r.T LC MON des ,/J 11'e6o-rc �i` r �fXiiz �1 UYN R —; : � a GU�/C" _ PERMIT n �V ~ 7/- � TM Q OR SJBDMSION LOT ff % z_ II IV. V. vi. 1 YES NO Q� SnrMGE DISPOSAL AREA a_ SDS area located as per armroved plans b_ Fill section - Date of plac-e-rient 2.1 barrier. LOTH WIDTH AVG_DPTH c. Natural soil not s "iced d. Stone, brush, etc_, greater than 15' from SDS are_. I. I e. 100 ft_ fran water course /wetlands.. IX Saar-zx, DISPOSAL SYSTH ,a. Septic tank size - ,0 1,250 I I b. Septic tank insta-l-led level c. 10' mini.T= from fcuncat? on d_ No 90° bends, cleanout within 10 ft_ of 45° be-rid Ix I I e. DISTRIBUTION BOX - . 1. All outlets at same elevation - w-te_r testes - L �' I +UV/17 ;) --- 2. Protected belcw frest I I X,I -_ 3. Minim =- 2 ft. or_c—zzl soil betwee -ri box and trenches Iv f. JUNCTION BOX - properly set - q. TREN= 1. Length required - / CP a I,-ngth ins-tal-1 ed Ad& I I 2. Distance to wate_r=Ursa neasued . D.. I I I 3. Lr s -celled acrdinq to Dlan _ _ I I X1 � I C 4. Distance celt°T to ce- Tter /s 04, .TAid-'26 I i I 5. Sloce of t__dch acceptable 1/ - I /32 " /foot_' I X I I , 6. 10 feet free Drcze--ty line A 7. Depth of trance < 30 Limes from s-=face I 8. Roam allcwed for e_Y- -m -cion, 50% I 1 9. Size of gravel 3/4 - li" diameter 15Z I' 10. Depth of gravel in trench 12" minim= I � L . - Pipe ens capped I � h. PRMP OR DOSE SYST�.S ( 1. Size of pug &.a-ub-r I I 2. Overflow tank I (. 3. Alain, vi sum /audio I I *( 4 P= easily accessible manhole to grade 5. First box baffle l' I 6. Cycle witnessed by H =ea th Den_ artment -- estimated flow per Cycle HOUSE a. rouse to -ted peer approved plans. b. Nminer of be::roars Pax, I a. Well located as per approved plans � I b. Distance from SDS area measured 6o t- ft_ I I c. Casing 18" above tirade. d. Surface drainage around well acceptable. I 1 OVERAII, WOM- mS"nIP a_ cxes prcperl Qrcut -z S ✓9 J aJ01; �► p rUp b. All Pines partially backfilled c. All iDes; flue's with inside of box, d. xr-kfill material contains stones < 4" in cianeter e. Curtain drain installed according to plan I f. Cirtain drain out_a l protected & dir.to eY ;st.wate_rccurs� I I g. Footinq drains EscLarce awav from SDS area I h. Surface water prot_c`.ion adecuate 5� i. Errosion cant=o prcvided on slopes greater than 15 %. I I 1 4AAA -leV Cc.olu AGP-,�c -1 '.*d `1T j'4 C a wart PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES r J j7 FIELD INSPECTION REPORT &J4�3/K- . A �, - 11vve ( Name ,bf Owner) (Stroet Location) INITIAL kTE INSPECTION YES NO Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... Willdriveway 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 DescriAti 0 ft. 3 ft. e"n L 6 ft. � 9 ft. 12 ft. D.H. 2 Lot Depth to G. W. Depth to rock boil uescr Oft.F- 3 ft. 6 ft.. 9 ft. 12 ft. DATE: U INSP. BY: ca4a Nm 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. Soli DATE: FINAL SITE INSPECTION INSP.BY: YES NO CQMMENTS 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. fran watercourse .................... Natural soil not stripped or SDS area unnecessarly graded........... ..... ........ 10 ft. maintained from property line and 20 ft. from house.... ........................ Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set... ............ Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE.. PUTNAM COUNTY DEPARTT -= OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SLVMGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT &,\.Q (Name of er) (Street t cation) INITIAL SIrPE INSPECTION 2 Q is YES I NO Wetlands on /or proximate to property.............. PC Property lines or corners found.. .................. Can estimate house location ....................... Will driveway need cut .......... .................... v 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 D.H. 2 Lot Depth to G. W. Depth to rock DATE: - INSP. BY: •� WTI ko i� �; D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G. W. Depth to rock Soil Descri tion Soil Descri tion 0 ft. 0 ft. 0 ft. 3 ft. 3 ft. �A - n 3 ft. 6 ft. 6 ft. 6 ft. 9 ft.� �. 9 ft.,-. 9 ft. 12 ft. 12 ft. 12 ft. Soli Descri DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded ........... ....... ........ 10 ft. maintained from property line and 20 ft. from house... ........................ Distance well to SSDS (ft.) ...................... Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally from trench ..... ............................... Boxesproperly set... .... ................... Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE.......... .. Rev. 3/86 � 3 CONSTRUCTION PERMIT Located at. Subdivision Name PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y. 10512 Engineer to Provide Permit # on CERTIFIC F OMPLL4,NCE SEWAGE DISPOSAL Lot N Owner /Applicant Name Lye4 i a °s Meiling Address 6. -.) N • STr4Tr- 1 PoacL Permit q i i1 IC L-3 Town or. VNag Tax Map `� -Block Lot _ Renewal_ 0 Revision ld' Date of Previous Approval Towufirl t ' IR 99&r- V 9 rylp cx�� [� Building Type I Is "S "147 r3 / Lot Area . f�. x(0:1 --/ 4 FW Section Only Depth Volume Number of Bedrooms Design Flow G/P /D 8001��f��' -�� 0p4/) PCBs Notification is Required When FIB Is completed Separate Sewerage System to consist of Gagou Septic Tank and !��� 1t✓ At d 014 e To be constructed by Address Water SaPPIr Public Supply Fro m r Address or: _Private Suppl Drilled by Address Other Requirements 1 represent that 1 am wholly an 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 the standards, rules and regulations of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 1. place in good operating condition any part of said sewage disposal system, during the period of two (2) years Immediately following the data of the issu- ance of the approval of the Certificate of Construction Compliance of:the original syste or any r pairs thereto that the drilled well described above will be located as shown on the approved plan and that said well will Da' installed i cc with 't a stand a ule and u let iTf^ons oof the Putnam County Department of Health. Date o� Z. Signed P.E. q� R.A.. Address N' Icense No �n T�" APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construe ion of the uilding has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a new ermit. A/p /proved for disposal of domestic sanitary sewag�n�pr' wat�u� op Date_����- Tit (/ f Re 3186 v� PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel, N.Y. 10512 Engln. eer to Provide Permit q CERTIFICATE OF COMPLLANCE on b' CONSTRI MORI pER10IiT FOR SEWAGE, DISPOSAL SYSTEM Permit N ,1 fi,� Oalle,V Located at ear ®e i ST. r1D j� 0" _ ' 1" I /�. nam Town or Village Subdivision Flame i1 ra{ 14111 ar I Subd. Lot # ._ Tax Map Block Lot�— Fa �a ofle Renewal_O Revision 0 Owner /Applicant Flame r4 ffO Date of Previous Ap val Me111ng Address t 1 V . .�7 T�- � � n a + �C.L` r� Town 1��18 i� i i V1 A r18i� Zip Building Type , `�5 t. 3e n,_ Lot Area O Bd� f'+ Fill . Section Only Depth —Volume Plumber of Bedrooms 3 Design Flow G /P /D PCHD Notification Is Required When FM Is completed Separate Sewerage System to coriaiat. of — Ga11on.Septic Tank ats i To be constructed by Address Water Supply; Public Supply From Address r or:. Frivato Supply Drilled by Adiroas - _ . Other Requirements 1 l i— represent that 1 am wholly an completely esponsible for the design and location' of the proposed..system(s); 1) that the separate sewage disposal system above described will be constructed_as shown onthe approved amendment there to and in accordance with the standards, rules and regulations of e Putnam County Department of.. Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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- ante of the approval of the Certificate of Construction Compliance of 'the original system or any repairs thereto; Pt the drilled well described above will be located as shown on the approved plan and that. said well will be.Installed in a cordance with the Vandards, r6les And regu aT ons oof the ' Putnam County Dep rtmen of Health. Date - Sig P.E.= R.AQ. Address License No �+ APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessill"ry by the Commissioner of Health. Any change or alteration of construction requires a new rmit. Approved for disposal of domestic sanitary sewage, a for rivate water supply onty. Title Date�,�i /��� PETER C. ALEXANDERSON County Executive December 22, 1988 DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Thomas Daly, P.E. P.O. Box 243 Shenorock, New York 10587 Re: SSDS Final - Ragone Barger Street & Park Drive (T) Putnam Valley TM #63 -4 -1 �K ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Dear Mr. Be13t%%4&; A final inspection of the above captioned sewage disposal system was conducted by Mr. Werper of my staff on December 15, 1988. The following observations were made: 1. Unequal distribution of flows to galley absorption areas. This must be corrected by piping. 2. Ten feet of galley less than 20 feet away from foundation. This must be plugged for now and removes or relocated later. When the above corrections are made, please submitt normal compliance materials for approval. If you have any questions, please contact Mr. Werper at Ext. 317. V tr ly yours, J ar ., Director, Environmental Health Services. JK:pt cc:JK File EC ti PETER C. ALEXANDERSON County Executive December 22, 1988 Thomas Daly, P.E. P.O. Box 243 Shenorock, New York Dear Mr. Belluscio; DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 10587 Re: SSDS Final - Ragone Barger Street & Park Drive (T) Putnam Valley TM#63 -4 -1 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director A final inspection of the above captioned sewage disposal system was conducted by Mr. Werper of my staff on December 15, 1988. The following observations were made: 1. Unequal distribution of flows to galley absorption areas. This must be corrected by piping. 2. Ten feet of galley less than 20.feet away from foundation. This must be plugged for now and.removes or relocated later. When the above corrections are made, please submitt normal compliance materials for approval. If ou have any questions, please contact Mr. Ve y tr ly yours, J ar Director, Environmental Health Services JK:pt cc:JK File EC Werper at Ext. 317. PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services T. Michael Daley, P. E. P.O. Box 243 Shenrock, New York 10587 RE: Proposed SSDS Ragone Barger Street and Park Drive Putnam Valley, N.Y. Tax Map # 63 -4 -1 Dear Mr. Daley: JOHN SIMMONS, M.D. Deputy Commissioner 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: 1. Show gutter and leader drains. 2. Add note that all electrical work in pump pit should be to NEC codes. 3. Submit a revised design data sheet reflecting the change to 160 LF trigalleys. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ver4Ane4ittner truly yours, Asst. Public Health Engineer AB: pt cc:JK AB File 110 OLD ROUTE SIX CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 t 60n4UZtln y Enyines2 0 0 Putnam County Dept. of Health 110 Old Route Six Center Carmel, New York 10512 Atto Anne Bittner Ref. Proposed SSDS Ragone Barger Street and Park Drive Putnam Valley, N.Y. TAX MAP # 63 -4 -1 Dear Anne, (914) 628 -0507 BOX 243 SHENOROCK, NEW YORK 10587 January 27, 1987 Pursuant to your letter, I am enclosing (3) copies of the revised plans and a revised design data sheet reflecting a 1250 gallon tank and 160 LF trigalleyso I am also enclosinga "check print" with the revisions highlighted in yellow. If you have any questions, or require additional information, please do not hesitate to contact me. Very Truly Yours, To Michael Daly, P,E TMDpbh PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, .CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner L�e71la. K AC90 ,) b Address IE 'Fn) nn7 beiABC uF-r- rAA4oa. Located at (Streeter - P �� (o Block 4- Lot 1 indicate nea -street) Muni cipality�� V ,_ = c Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME �{,' PERCOLATION PERCOLATION Run Eiapse p o a er water Level - No. Time From Ground Surface in Inches Soil Rate "'Start -Stop Min. Start Stop Drop in Min. /in drop - Inches Inches Inches 2 jJ Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. l-7 3 a- 1 9 19 l7 6 13 l o o- zA 210 f 7 5 5- z-O 1, -7 7,0 7 z 1 0 .- 19 5o IS S 3 2 ?_ ? 3 Z 4 0- 2( Z( j0 33 3 '7 z 5 0_ - Z� -3 3 3 3 7 2 jJ Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN:TEST HOLES DEPTH ' HOLE NO. i HOLE 140. Z HOLE NO. J G.L. 6" I 12" rTIS 18" 2411 r \i 3011 42'1 , 48" 54" 6 11 72" �� ✓� 7811 84" ' INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED K�o INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY -T'- �is� -�c Date DESIGN -Soil Rate. Used �� 8 -10 Min/1 "Drop: S.D. Usable Area Provided -/-C 4,Qpp (j No. of Bedrooms 4 Septic Tank Capacity t2-60 Gals. p �P Absorption Area Pro ded By L.F. x24" b" X0,ft I r.DP411 e, ''`�- - --� ,.,nv �� in l:t-A -1 1_]1.:1 \�I�,�a� �y n. , r'/ -. •'� /i Name '� M; u� rti �A ti_ —�.� bignatiure_- r Address SEAL` THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: ., Soil Rate Approved Sq. Ft /Cal. Checked by Late PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner (f, Address 5 �, . �1- jr]lT,� f- 'M a�p Located at ( Street )�(� ._, Bl ock Lot nd! ate neare�/ cross s ree Muni cipalityTLkDam li�le U Watershed SOIL PERCOLATION TEST DATA .REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole - Nu_mber CLOCK TIME PERCOLATION7K -* , PERCOLATION Elapse No. Time Start -Stop Min. o Water From Ground Surface in Inches Soil Rate Start Stop Drop in Min. /in drop Inches Inches Inches 1 l d �zo ;� ( 1 30 - 19 19 17 ao �3d .33 3 7 4o v av 2 1 50 '7 n2 o �0.7 4 xz 30 33 3 �.3 ffte4 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. a 4o -fit 30 33 3 7 50 - _'2J aI �3d .33 3 7 1 2 3 4 ffte4 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. llE51G1V Soil Rate Used $'-) a Min/1 "Drop: S.D. Usable Area Provided ti '/OyO No. of Bedrooms 3 Septic Tank Capacity DC)n Gals pe a 1r Absorption Area Prodded By L. F. x24� o trench. 1,1,1 1. � . ;-1 ,., i-► . /1., /l , ._ � _ _ _ �.__ .. �.� ; ;.� fa r���� %� .. Vii,' � .9� ,,. I I - M0 - THIS SPACE FOR USE BY HEALTH DEPART?MT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by z A �c S510� Date TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. J HOLE NO.-. o2 HOLE NO. G.L. Fc)n Rdz.k I CO_ 4 �Cb 611 ,1 A 18" A 11 2411 n. ►� 30" R 361f ►� „ 4211 48" 5411 ► ►� 60" �, u 66" ,, �► 7211 7811 ,, ►, 1% u3at ' emAAn INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED \ TESTS MADE BY r Date llE51G1V Soil Rate Used $'-) a Min/1 "Drop: S.D. Usable Area Provided ti '/OyO No. of Bedrooms 3 Septic Tank Capacity DC)n Gals pe a 1r Absorption Area Prodded By L. F. x24� o trench. 1,1,1 1. � . ;-1 ,., i-► . /1., /l , ._ � _ _ _ �.__ .. �.� ; ;.� fa r���� %� .. Vii,' � .9� ,,. I I - M0 - THIS SPACE FOR USE BY HEALTH DEPART?MT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by z A �c S510� Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner �--'C :�r,tA�l,��x )� Address�7-2.� -� Located at (Street (.3 Block Lot indicate neares .cross street) Municipality uTNAM- y A-►_ i- E;t4 Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME -ke- PERCOLATION 5— -Y- PERCOLATION RM No. Start -Stop Elapse Time Min. Depth to Water From Ground Start Inches Surface Stop. Inches Water Level in Inches Drop in . Inches Soil Rate Min. /in drop 18 1 1 ZO 1 2 v - z0 3 . i 3 . _(7 z 0 c Z -z-o 7 20 2 1 0- .19 -Y so— 2- 2 10 - -7, O z C7 �p _ 3 07) 7 — — 3 -7 Z 4 . Q — CD 2 5— Z Z- 1— 72, 7 -- 4". 10-7 •, -r —X_ C, A-) u�l��c�k-� . Notes: 1) Tests to be repeated at same depth -until approximately rates are obtained at each percolation test hole. All data to b for review. 2) Depth measurements to be made from top of hole. e0 equal soil submitted TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 4 HOLE NO. 'Z HOLE NO. G.L. 6" 1211 19 L? 1$" `( i 24" 30" r r 361 r 42ii , 48" 5411 ' 60,E i r 72„ 78" ' 84 11 INDICATE LEVEL AT WMCH GROUND WATER'IS ENCOUNTERED .INDICATE LEVEL TO WHICH WATE EL RISES AFTER BEING ENCOUNTER TESTS MADE BY _-- J Date (J t�Z� Soil Rate Used > -IU Min/1 "Drop: GN D I S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity 1 o00 Gals. Absorption Area Provided By L.F.x24" V " re z 9 oath o a.me --,- VIA-- - i "" A , ,I Signature " Address SEAL THIS SPACE FOR USE BY HEALTH DEPARTM, T ONLY: Soil Rate Approved Sq. Ft /Cal. Checked by Date pUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES 1W.L 4p (e Owner) COMMENTS LF Bch provided — required _ 60 ft. max. :�� 4 � :�'Yil � � MI ��'l•Y�1:�Y�1:� �+:�a ai.'i a, ^. ►:�N aI REVIEW SHEET - CONSTRUCTION PERMIT DATE REV e L2 BY: (S t Location) YES01 NO DOCUMENTS Permit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) r SUBDIVISION Deep Hole Log . Perc Consistent Perc Results (3) Fill 30" Perc Hole cd Other House Plans - Two sets If PWS - Letter if well/permit Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow :Fill Profile & Dimensions - Volume D or J B=;Trench /Gallery; Pump pit details Septic Tank — Size, Detail Well Detail, Service Line•if over. Construction Notes sign Data o-Foot Contours Existing & Proposed riveway & Slopes Cut Footing /Glitter Curtain Drains Perc & Deep Holes.Located. Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff, size ' If Pumped Pity& D Bax Shown &Detailed House -No. of Bedrooms 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 100' to Stream, Watercourse, Lake Unc. expan) 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse 10' to Water Line (pits -201) 50' intermittent drainacie course S -eP is Tanks 101 roman 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 DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services Mr. Michael T. Daley, P.E. Box 243 Shenorock, New York 10587 Dear Mr. Daley: October 14, 1986 JOHN SIMMONS, M.D. Deputy Commissioner Re: Proposed SSDS Ragone Barger Street & Park Drive (T).Putnam Valley, TM 63 -4 -1 Review of plans and other supporting documents submitted at this time relative to the.above- captioned project has been completed. comment e offered as . follows: 4Application.and design data sheet should.be revised to reflect design based : on.tri - galleys instead of trenches. Upon receipt of a submission, revised'to. reflect the above comments, thin application.will be considered further Very truly yours, Anne M. Bittner AMB;pt Asst. Public Health Engineer ccsJK AB File E,/ TWO. COUNTY, CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Re: Property o a Located at Date /3u �� (T)I -� nAl2 Section Block Lot / Subdivision of G/.� re L Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize a duly licensed professional engineer v 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. Countened: P.E. ,. , # Address Telephone - �f`**Very truly yours, S Own r of Property Address Town Telephone PUTNAM COUNTY DEPARU4ENr OF HEALTH - DIVISION OF ENVIR0NMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS (/Z -,-(-( F/ (Nam" of Owner) REVIEW SHEET - CONSTRUCTION PERMIT D ATE BY: (Street Location) REVIEWED: DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter 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 - Size, Detail 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 Shawn & 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 101. to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 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 s® w� MM REVIEWED: DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter 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 - Size, Detail 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 Shawn & 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 101. to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 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 r ran DAVID D. BRUEN rJl'4 + �+ JOHN SIMMONS. M.D. County Executive �►l, �Q� Deputy Commissioner �V F w r� Y DEPARTMENT--; OF HEAL H �; , y _ {� t��,..�a -� �. R T r ` _Diyision'..Of Envlrorimental. Health August 25, 1986 Mr. Michael T. Daly, P.E. Box 243 Shenorock, NY 10587 Re: Ragone.SDS Constr. Permit Applic. Barger St.. & Park Dr., PV, TM '63 -4 -1'' Dear Mr. Daly: Review of revised plans for the above referenced project has been completed. Items 2 and 3 of my June 24, 1986 letter have not been addressed; specifically: 1': It has not been demonstrated that no sewage disposal system lies within 100 feet east nor 200 feet southwest of proposed well. If none exist, so note. \,/2. Distribution box detail is lacking. Depth of frost penetration in Putnam County is four feet. Unequal lenghts of tri- galleys are being fed equal volumes of sewage. Additionally, ;,4�. Sewage disposal system is less than 20 feet from foundation. 5• Depth of-cover bver tri- gallery is not specified. 6:.' .;Dosage_ -volume .should :..be.: noted.. -to be•. based,: on.:an:',equivalent pipe capacity as trenches are no longer proposed. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, s S. Hod g ens Assistant Public Health Engineer JSH:amm cc:. File L. Ragone TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 ��onau�tin� �nyuaEE2 T. MICHAEL DALY, RE, 0 (914) 628 -0507 BOX 243 SHENOROCK, NEW YORK 10587 /{ t Sept. 29, 1986 Putnam Co. Dept. of Health Two County Center Carmel, N.Y. 10512 Ref: Ragone SDS.Constr. Permit Applic. Barger St. & Park Dr., P.V., TM 63 -4 -1 Gentlemen, Enclosed please find revised plans for the above mentioned project. The changes requested in.your letter of Aug. 25, 1986 have been made. I have enclosed a copy of the drawing marked "FOR REFERENCE ONLY" with the changes highlighted in yellow for your convenience. If you have any questiones or require additional information, please do not hesitate to contact me. Very trul yo rs, r T. Michael Daly, DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #__ WELL LOCATION Street Address Town Village Cit Tax �3a Grid Number I3 --4 -1 WELL OWNER Name n Address L Ci a Ra qorc, 5 a PC eilarrAP �§dPrivate o (O Public USE OF WELL 1 - primary 2 = secondary RESIDENTIAL O PUBLIC SUPPLY ❑ BUSINESS O FARM ❑ INDUSTRIAL ❑ INSTITUTIONAL O AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY ❑ ABANDONED ❑ OTHER (specify ❑ AMOUNT OF USE YIELD SOUGHT `)ij 11 Jgpm /4� PEOPLE �' —, SERVED $ /EST. OF DAILY USAGEgal REASON FOR DRILLING MEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL ❑TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE rZIKILLED ' ❑DRIVEN aDUG OGRAVEL E] OTHER IS WELL SITE SUBJECT TO FLOODING? YES 4--'NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 4R1. Lot No. WATER WELL CONTRACTOR: Name T'. t3,1� . Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: _ YES [/ NO NAME OF PUBLIC WATER SUPPLY: DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: TOWN /VIL /CITY LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED OON REAR OF THIS APPLICATION f]ON SHE (date) signature) 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. Date of Issue: j�e-,00� 19 Date of Expiration: 3 19 6% ermit Issuing ffici Permit is Non - Transferrable M. 5 7,- Igc) -1-0 (94- 1000 UAL IAOO�IZY M, I &JP A . mp cAlo (AMC Of wfve IF na•p P90,.p ~ Pei DO-IV \00 oo A ZOO Ol/ E5 2.00 As 4-ovez 10., .04, OPe W4 5 7,- Igc) -1-0 (94- 1000 UAL IAOO�IZY M, I &JP A . mp cAlo (AMC Of wfve IF na•p P90,.p ~ Pei DO-IV \00 oo A ZOO Ol/ E5 2.00 As 4-ovez 10., .04, OPe