Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
3919
DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.20 -1 -29 BOX 30 03919 J .r L Bill T 1 T . L MIA - 03919 j i T a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL .HEAL.TH.SERVICES.: CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 7,d -- _ Locatedt Town or Village T r7%VI ►;,� " Owner /Applicant Name %J ,� Gam- Tax Map J�3- 2- Block / Lot Formerly —" (dart, �.� / Subdivision Name Subd. Lot # x Mailing Address Ili C�11 'Alf Zip /e-�i-1 Date Construction Permit Issued by PCHD 711 e Separate Sewerage System built by 0 nI J-;:7 e -'�- Address -!5 c x"e' Consisting of Gallon Septic Tank and Other Requirements: / f d? U lg 6�-a ref Water Supply: Public Supply From or: ✓ Private Supply Drilled by /K A4�ow' Address Address - - -: jBu'Wi1g ._ . . . eas. erosion.control beti -.n complet.�d? .... , .:- :..-e 3 Number of Bedrooms Has garbage grinder been installed? Al® I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam Co p t of Health. Date: !,/i% o / Certified by P.E. A-**- R.A. r r ��`�� ( Design Profession Address /-� i �^ i # � Xabc �°� Any pers occ py g premises served by th ve system(s) sha such action as may be necessary to secure the correction of any unsanitary conditions resulting from suc sage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatio modi cati n r c is necessary. By: Title Date: 7 A e c White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT W(M_Lucd�lir' " e di= Ss: " c •nN_illage :� Tax Grid # Map, 9,Block Lot(s7` Well Owner: Na Address: Use of Well: 1- primary 2- secondary �_ Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length �y ft. Length below grade Aft. Diameter �� in. Weight per foot i G lb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded >-_1 Threaded _ Other Seal: ;!!L' Cement grout — Bentonite Other Drive shoe: >l Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield .,� gpm Depth Data Measure from land surface - static (specify ft) During yield test(ft) Depth of completed well in feet r Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface oo " If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth fiRr/ " Model fl,) Voltage 2-30 HP 3 III� ffn Tank Type ALY3a v Volume —f_7 Date Well Completed Putnam County Certification No. Date of Report Well Driller (signature) ey" WTY Exact location of well with distances to at least two permanent laptimarks to be provided on a separate sh�eetlplan. Well Driller's Name J, Address: %S Signature: Date: J y o i /dJ 7g White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -9? YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800. Albert H. Padovafii,, Director LAB #: 32.104761 CLIENT #: 13451 NON STAT PROC PAGE 1 NNNNNNNNN ---------- -------- NNNNNNNNNN NNNNN --------- NNNNNNNN -------------------- TICE, ALBERT & JENNIFE DATE /TIME: TAKEN: 07/08/01 03u45P 116 OLD BAY ST. DATE/TIME REC'D.* 07/09/01 I1a-20A PEEKSKILLs NY 10566 REPORT DATE: 07/13/01 PHONE: (914)--739---1747 SAMPLING SITE: 74 PEEKSKILL 1401-LOW RD. SAMPLE TYPE — - POTABLE : PUTNAM VALLEY, NY PRESERVATIVES: NONE COLD BY: ALBERT TICE TEMPERATURE..- < 4C NOTES...: KIT TAP COLIFORM METH: MF ------------ ~--~ ------- DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 07/09/01 MF T. COLIFORM ABSENT /100 ML. ABSENT J.008 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATEF( (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED,, AT THE TIME OF COLLECTION. SUB11ITTED BY: Albert ,H,'."Padovahi, M.T.(ASCP) Dire or ELAP# 10323 . * YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ' _ . Albert H. Padovani, Director LAB #: 32~103890 ~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~~ CLIENT #: 13451 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NON STAT PROC PAGE 1 TICE, ALBERT & JENNIFE DATE/TIME TAKEN: 06/05/01 05:30P 116 OLD BAY ST. DATE/TIME REC'D: 06/07/01 12:10P PEEKSKILL, NY 10566 REPORT DATE: 06/28/01 PHONE: (914)-739-1747 SAMPLING SITE: 74 PEEKSKILL HOLLOW RD. SAMPLE TYPE..: POTABLE : PUTNAM VALLEY, NY PRESERVATIVES: NONE COL'D BY: ALBERT TICE TEMPERATURE..: < 4C NOTES...: KIT TAP ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 06/07/01 MF T. COLIFORM PRESNT /100 ML ABSENT 1008 06/07y01 LEAD (IMS) 2.5 ppb 0-15 ppb 9101 06/07/01 NITRATE NITROG <0.2 MG/L 0 - 10 9139 06/07/01 NITRITE NITROG <0.01 MG/L N/A 9146 06/07/01 IRON (Fe) 0.250 MG/L 0-0.3 mg/l 2037 06/07/01 MANGANESE (Mn) 0.024 MG/L 0-0.3 mg/l 2037 06/07/01 SODIUM (Na) 15.8 MG/L N/A 06/07/01 pH 7.1 UNITS 6.5-8.5 9043 06/07/01 HARDNESS,TOTAL 70.0 MG/L N/A 06/07/01 ALKALINITY (AS 70.0 MG/L N/A 06/07/01 TURBIDITY (TUR 2.8_NTU_ NTU.' _ .-.0-5. BACT THESE RESULTS-INDI-C-AI'E.THAT,TH�:,WATER '—' AND EPA � WATE STANDARDS, FOR THE ' ` TESTED, AT ^- TIME-QF/COLLECTION. ''— - --r�r Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 ma/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,theo water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium . $ YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights° N.Y. 10598 -�,_� � .` ^ '' (914) 245-2800 Albert H. Padovani, Director LAD #: 32.103890 CLIENT #: 13451. NON STAT PROC PAGE 2 TICE, ALBERT & JENNIFE DATE/TIME TAKEN: 06/05/01 05:30P 116 OLD BAY ST. DATE/TIME REC'D: 06/07/01 12:10P PEEKSKILL, NY 10566 REPORT DATE: 06/28/01 PHONE: (914)-739-1747 SAMPLING SITE: 74 PEEKSKILL HOLLOW RD. SAMPLE TYPE..: POTABLE : PUTNAM VALLEY, NY PRESERVATIVES: NONE COL'D BY: ALBERT TICE TEMPERATURE..: < 4C NOTES...: KIT TAP COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO B.S. Hd TOTAL HARDNESS IS DEFINED-AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L �M TE[=Yj | D,-WAIEE�:_�7CL�1�0-}�G�L_ -_- �MG~/[.�=-J��LLIG��AM��`�R'' .` | ''-�-'�'� HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Director ELAP# 10323 f r PUTNAM COUNT'" DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEI2VICE5 GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM li Building Constructed by 411"10 W, Location - Street Building Type Town/Village Subdivision Name Subdivision Lot#€ I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department oi- Realth, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition, any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director 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: Month �,� Day _1,3 Year � -- , General Contractor (Owner Signature 6orporation Name (if corporation) Address: �G State f� Zip Signature: r7 / Title: Corporation Name (if corporation) Address: State Zip Form GS -97 Owner or Purchaser of Building Tax Map Block Lot li Building Constructed by 411"10 W, Location - Street Building Type Town/Village Subdivision Name Subdivision Lot#€ I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department oi- Realth, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition, any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director 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: Month �,� Day _1,3 Year � -- , General Contractor (Owner Signature 6orporation Name (if corporation) Address: �G State f� Zip Signature: r7 / Title: Corporation Name (if corporation) Address: State Zip Form GS -97 a LRMA MOL11,4ARI R.N., M-SW BRUC E P.. O wme T ibk' . ..... �.,: Dil•e•to• of Paiiew Services Gc1le4'a RA)"Id Eavicutwicu(a I I I vaft I (.914 ) 278 - 6 130 Viu< (914) : 78 - 7921 Nin-sing Services (914)'-178 -oxiS WIC (914.) 278 - tib78 Fas (9) 4) 278 - 6085 E;Irly 1111cryunliul) -om:! Preschuo) (9H)278-6082 Fim (914) 278 - 6648 .1 Z E D TOWN 22 jX -4 Jc -2f 2% uscaw-am-1-ak NY1057gr puNn-Valiey, 'J i �'4hC11, L(1, COUR(y 1) (, J.) , ltllk-lf I-IC111 ill ( issue �1 CertI ficate of i, u c (V011 .'0 111. y11 Uk It CX: 1.11d css i h ab )N C- I'vi v m '15 -,x itg:,A L, ') U CO by an �t (i tho rizcd (own of(icial. J'his form is to be SUbmitted lk(., application 1,01. a Certific';lte of ("..'olis I I'll c tj oil Comphl.111ce, PUTNAM COUNTY DCPAltTMU, NT O 141CALTH DIVISION OF EN VIRONAIENTAL HE ALTU SERVICES m7e ATTENTION ^ A DAM nQN_ All itifoi-mation mwa be fully completed prior to ally inspections beitig made. 0 GENE P'or Fill ✓ Trenches PC FID Construction fiiiry iii 607, 11 OWilt. r/Appli Ciint Name: 1wja, / - - TM !!L- _2 Bloc.), 'Lot SUbdivisimi Loo -9 Is s.ysteua fill completed? is System Complete? Is systeni constructed as per plans? Is well drilled'? Date: is Wli located its pet- plans') Aj ! erasion controf measures in Face.�LAI I certify that the system(s), as listed, at the above prwilses has been coast IXted and I have inspected and verified their completion in accordance with the issued PCHD Constl-ucti.on, P - errait iuid Regulations -cif tll& Putnam Co.way-Departin ent.. of --Up -ul.jbt,st�tidards. R.Ules mw Cealfied by: Dt37V lgil Professtuna Addre,,s: ------ Form FIR.-99 r - -nn I I lnCn r% M 14rWjr #1 Tr ,.T -IT Tnr -� Il.n inn Vlll.II I,r.rAKtA1k;NTOFHEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE IiMECTION. Date: - v - - �nspecte y: Street Location f cC 5�6 t, Lo J Owner r G Town - Permit ._ z _q -_ TM 9 S ' . z� -1 .72 Subdivision Lot 4 1. Sewage Svsteih Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. SeAQe vste a. eptic t • s m ize 10 ...1,250 ......... other ................ b. Septic tank insta ed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Pistribution Box. . All outlets at same elevation -water tested ................. 2. Protected below frost ..:............... ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set .......................................... f. Trenches Len required 3 hLength installed U 2. Distance to watercourse measured Ft ......... t4(Q 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft: foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1 %Z" diameter clean ................:... .9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ....................... : .......... :.................... - . g Pump or Dosed S ste, s :. i s -size of pump MIS er ................ 2. Overflow tank ........................... ............................... 3. Alarm, visual / audio .................... .........:..................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ....................... .................:: ....... :. . * -- 6. Cycle witnessed by .. H.D.estimated flow /cycle....... III. ouse/Buildin a. House located per approved plans ............................... bNumber of bedrooms ................... ............................... IV. Well a. tell located as per approved plans ............ - 4. ............. b. Distance from STS area measured 00 ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ............................... d. Backfill material contains stones <4" diameter .............. e. 'Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercoun g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... n -.. !mn •07/26/01 • THU 1.5:35 FAX 914 739 1747 All Drains Rooter Srvc IM 002 PUTNAM COUNTY DEPAR"UNT OF HEALTH• DIVISION OF ENVIRONMENTAL HEALTH SERVICES dt Location 5 ? it ; Tax Grid # Map Block Lots) •'� Address, ii' = f � •, ,: • •,� � [. y ' �� Win- devaer. dN] Use of well: i -pr Mal R` eOdential Public Supply Air cancUheat pump Irrigatt:on Business Farm „•, TestfmonitorinS Other(gmify) Industrial l�i"or al Standby Drilling Equipment Rotary Cable percussion Compr+e=W air pereusgion Other (amity) Well Type Screened � end casing � : Open hole in bedrock Other . �iag Details Total length - r.-; eft. Length below grade N'7 ,S ft. Diamebar l "� in. WW& per f6at • • 1 h4i Materials:. Steel Plastic _ Other ,loitits: Welded �' --'I7rreaded Other Seal: - Cemv1 BeaWnite DrIve idec. Y \, No Screen Details Diameter (m) Slot Sine T. Mgth(fq Depth-to Screen (ft) Devek+ped? First Y -_No Hotgs Second W8p Yield Test Bailed Puts* . -Ge CO-MOM"I M! Hotu� ?�. �tieid "�". SRm Deptk Date ) VMo(cmWiaed wdl in feet Won % . if mom detailed information sieve anal are available, please attach• De tb '#gym 9erflu� Water p We" i Fortrratio» ne e, tom. ft :ti 1AW SOMACt r' If yield was tested at.difflerent depths du[ying tfrillittg, list:. eat Nliaat6 Pump/5torage ark Ithrmation Pump Ty" zAk,;1-t ity fro am . Modcf.s 1P VVoltap . x �:� JHP Tank Type Volume 41 1-' -a- W411011 85! Nom- .+I AWGi �•• P Yl °/ J ;.''ICE '�s .'�7► 1 • -.!� t Si .4223 Daw. i White, copy: HD File; Yellow copy- Building Inspector.. PiA CM - Owner; Orange copy- Wall- driller Farm WC -97 07/26/01 THU 15:35 FAX 914 739 1747 All Drains Rooter Srvc x001 Cut ctl�-ef X ptct- IL4 U-p D hOAI-� `%*� /tLo �ccrau L�Cvk . 901 i BRUCE R. FOLEY Public Health Director-- LORET"TA MOLINARI R.N., M.S.N. Associate, -Public- -- ith'= DttectFir 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 Preschool (845) 278 -6082 Fax (845) 278 - 6648 MEMO To: MR. WILLIAM J. CARLIN, JR. From: MR. BRUCE R. FOLEY Subject: REFUND TO MR. JOSEPH ARDINALE (copy of money order enclosed) Date: September 11, 2000 We received a duplicate payment fbV a pemit Therefore, please send a refund of $300.00 to Mr. Joseph Cardinale Peekskill Hollow Road Box 269 Putnam Valley, New York 10579 Please send us a copy for our records. Thank you. BF•.EFP ENC. CC: A- Stiebeling q11 I /tfj �- t r 3 a: d Dat 19- '° ` Received of - o. m - ' The Sum Of ` r } Dollars $ - —t-- - -- For._ �• `: , / ... � �r,��.� -.� .._ IS,y9 .. : THANKYOUI - -- ❑ Cas 7 �' ❑Check M,p, Credit Card - -- .. ... . tY By r P: �µ - - T '�6�•'J '•1 Ja?-- '_.yrL�""cT�:, +hwil�" t"%`.' + ,`t:., �Y f :v / a1^i `� n-J. 4s. f_r -'• + ./ t 1� —�� - 4 H^7� t . t ,!! � .Yy' fY�.✓T ,'.'CL .. - - w_1s C �tt�.,^„ J v " t� ` ' ONEY ORDER ® � 931549074 Wl BV tntt{,mtgr, P;wwAt SyyfY� InG. Enoiftvw. Comb Fast notswo N-,nk n, QLYtVL•1. NA. 04AVA I l•Q 23•txiA2A o s NOT VALID OVEn $1,00uo To the order of NON NEGOTIABLE - 4 • ° s s I e ° � F t• JIdQIAS$t� jtt .Li � t �'.i r••• r cp CUSTOMER COPY E•d RQQ /eQ7LTCt e . V IO 6 ° PUT COUNTY DEPARTMENT OF HEALTH 7. DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR ATMENT SYSTEM PERMIT # /-Ir Z 7 %AOC / / -o 0 Located at �r,�f3fjli� %i /w /4 "S/ x;a, j Town or Village p��lt,� Subdivision name 1Y Subd. Lot # Date Subdivision Approved % f ........................ . Owner /Applicant Name: Mailing Address Amount of Fee Enclosed 36"0, Tax Map X-5.2 Block J Lot 2 Renewal ✓r Revision itlG,y' v ry iJ 4-r^ Date of Previous Approval Its 7 i_// N'•J/, Zip Building Type Lot Area /dq-4 No. of Bedrooms -3 Design Flow GPD 00 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of /d-& y gallon septic tank and o o � Other Requirements: / f jle �ra �'�% �� /� yv c • y . To be constructed by Water Supply: d sY,v rr/` Address _-5 a e- Public Supply From Address �.., r. . fi ate S,�pply ;?r311ed by ._ : � � 'S Addres. J/ ,'�( Q %fie ,/�G�rlo i"� Gt hJ ��c 'Ay'A� �� g�.�� 1f'r��ir�� L �r� /1! I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. pf NElti Signed: 6 NNC /S R.A. Date 3v /� v Address 2 ,—> �r �-� G�� License # Z y irk APPROVED OR CONSTRUCTION: �,x ' o years from the date issued unless construction of the sewage treatment system has been completed an r 5tg,� ,PCHD and is revocable for cause or may be amended or modified when considered necessary by a Public ctor. Any revision or alteration of the approved plan requires a new pere%it. Ap oved d' ch a domestic sanitary sewa a only. By Title: Date: _7fiB/C�n White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP PUT'NAM COUNTY DEPARTMENT ENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL :; ... Ilemr, rintortype - .. ._ ,_.. - PC�HD- Permit #-.r .1. Well Location: Street To/wnNillage Tax Grid # "Address: / MapJ,� .;? Block % Lot(s) Well Owner: Name: Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought __45' gpm #People Served _ Est. of Daily Usage Ldo gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling "ew Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yeses_ No Name of subdivision /V r-)J Lot No. 2- Water Well Contractor: : ry/u T�d�r� �� Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village -- Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date Applicant Signature:,... 'aA PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED _FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified b Pu am County. Date of Issue 1711JU0, Permit Iss ing Official: Date of Expiration 0?_ Title: Permit is Non-Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 JOSEPH F. SULLIVAN, P.E. . 7. YORKTOWN HEIGHTS, N.Y. 10598 191 4) 962-4248 IA/ Ax4ell -e'- 47 4P V., 16C C11a 67 "Ple /000; ov NEW fli BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Pvl?li, t5lrzaftk , rJire . >ar. Q� -_ .:. Associate . Public, Health Director ..,. ..:�..�O ...._. ,,.z.. Director 'of `Patient 'cervices DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 June 13, 2000 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 copy Frank Sullivan, PE 2972 Ferncrest Drive Yorktown Heights, New York 10598 Re: Tice, Peekskill Hollow Road TM# 83.2 -1 -29, Town of Putnam Valley Dear Mr. Sullivan: This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your consideration. Prior to approval of construction Permits to construct a SSTS and Well on the above referenced project , all "unsuitable" buried material(s) in the SSTS area to be removed and re- packed with ROB fill to grade. Removal to be under the supervision or a NYS Licensed Engineer and certification of completion of°materials _ removed to be, submitted in writing to this, office.- - Please also notify this office at a minimum of 72 hours prior to start of removal process. This office will conduct a site inspection during site remediation. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj p,r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _...._ ° APPLICATION FOR APPROVAL OF PLANS FOR y w ~ A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant:` 2. Name of project: 3. Location TN:�,yy� 4. Design Professional 5. Address: 6. —Tygee of Pr ' t: P""" Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building .� Realty Subidvision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? /Ifs' Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? ......................... /V:� 9. Has DEIS been completed and found acceptable by Lead Agency? ............... -- 10. Name of Lead Agency __.. i1.. _.If.this project.is'an area under the - ,control of local plane.ing,::zoi!i,:or- ether officials, ordinances? .................. 12. If so, have plans been submitted to such authorities? ........ ............................... 7 ) 13. Has preliminary approval been granted by such authorities ? / f Date granted: 14. Type of Sewage Treatment System Discharge ................. surface water /groundwater 15. If surface water discharge, what is the stream class designation? .................... 16. Waters index number (surface) ........................................... ............................... 17. Is project located near a public water supply system ?^ ....... ............................... 18. If yes, name of water supply Distance to water supply' ' 19. Is project site near a public sewage collection or treatment system? ................ A119 20. Name of sewage system —"' Distance to sewage system 21. Date test holes observed 22. Name of Health Inspector �ww % f��� Form PC -97 2 23. Project design flow (gallons per day) .. .......................... �2a,� ...............•......... 'oi ;xtai�t Discharge Elirr�inatioh' System .(SPDES).Pertnit.required ?: 25. Has SPDES Application been submitted to local DEC office? 26. Is any portion of this project located within a designated Town or State wetland? ��a 27. Wetlands ID Number .......................................................... ............................... 28. Is Wetlands Permit required? .............................. _ ........ .. ............................... A1.0 Has application been made to Town of Local DEC office? ............................... 29. Does project require a DEC Stream Disturbance Permit? .. ............................... A/d 30. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ........ ........... Yes/No A41 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ... ............................... Yes/No Ale I�+10s_ 32. Is there a local master plan on file with the Town. or Village? ......................... _ /I/ej 33. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? .................. Age _- v 35. Tax Map ID Number .......................... ............................... Map >'�z Block / Lot 0,57 36. Approved plans are to be returned to ..... Applicant 4,-' Design Professional If the application is signed by a person other than the applicant shown in Item I.,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATU ES & OFFICIAL TITLES: Mailing Address: ................................... PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Ownerz,.:�e,e� 27eze- 7;7. Address //0/ elj. '-%ry Located at (Street)' 14, 4/' iv -. AV Tax Map gam. z Block Lot -2 (indicate nearest cross street) Municipality e- V Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test .......... ... ...... a Frnm Grhun&...." k 2 3 A/ \V I I 1A;5L5L IQ E)e rej)ealea at Same UOPEn UnEll dppF0X1MdLt;1y ZqUdi POrWIULIVII FULUS are U0Ld1nUU UL UdUf percolation test hole. (i.e. :5 1 min for 1-30 min/inch, 15 2 min for 31-60 min/inch) All data to be submitted dr review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES r r �., _,_. HOLE NO .. _ . . DE1�TH 'f-IOL,E`NO. HOLE NO'. G.L. 0.5' 1.0' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' .6.5. ' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: g :5 alib t-10 Date. we- Design Professional Name: `'- 1 l ; ✓'R Address: Z i 7 2- c.^ Y1 Signature: Design Professional's Seal nI PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER bf AUTHORIZATION" RE: Property of /Z��_,, /U Located at /` /y ��j f/ A//), 0__*' J�'c -a T/V A - e L Tax-Map # f _ -3. Z- Block Lot 2 � Subdivision of �`� -0-e -'' " e-11 Subdivision Lot # Gentlemen: Filed Map # This letter is to authorize 0,4 eyl;�F Date Filed //�� - a duly licensed Professional Engineer j.-'or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and /or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. Very truly yours, Countersigned: �F Signed: P.E.,., #� (Owner of Property) Mailing Addr W� r .fr��� Mailing Address: /X� ZOOS Ak State ' Zip Telephone:%' v `' State Zip Telephone: / z? Form LA -97 14 -164 (2/B7) —Texr 12 PROJECT I.D. NUMBER SEOR a Appendix C _.. State Environmental Quality Review 5�I AT ENVIi�6'Ii14 NTAL' 7A SESSMENT FORS " For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NA�IIE . 3. PROJECT LOCATION: 1 Municipality Lyi�f ��;�/ e' County / 4. PRECISE LOCATION (Street address and road s, prominent landmarks, etc., or provide map) �innttersect S. IS PROPOSED ACTION: ❑ New ❑ Expansion Modiflcatlonlaltsrstion 6. DESCRIBE PROJECT BRIEFLY: j 7, AMOUNT OF LAND AFFECTED: , initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZO NO OR OTHER EXISTING LAND USE RESTRICTIONS? Ayes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential [3 Industrial ❑ Commercial ❑ Agriculture ❑ ParklForesUOpen space ❑ Other es ribs: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? Ayes ❑ No If yes, list agency(s) and permiVapprovnis 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? Ayes ❑ No It yea, list agency name and permittapproval / � / J J 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? Yea ❑ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TOO THE BEST OF MY KNOWLEDGE Applicantlaponsor name: 7L/ / Signature: If the action is in the Coastal Area, and you are s state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 9 .._._ -- \ DNWIa d ft kdr@Wd acrd& s«.ka.. CMWL N.Y. 14512 anabsessi lo ti e.vta s reams. m CR!'1nWATS DF 00 MNS1tIIC110I�, FS1Qr MR tl WAM 010110 L F:BIEII[ .. hI�' 7 —At' 1/", p VE _ Sgiigltiee.. Pipe —G. f L�� -stud ut / a- rear 11dIP g 3 ' 2' tip Lr. -zf-- ,\ :!' Adr loop" Dated Apptovd T� �i7A Yl /a i 7? Date Subdivision utroved , Fee Enclosed 8' Amnii4- i'S Gf1Gl� AG r e DW1101116 W Ana FM S«tla. od, Ydtl1110s Nt>•bae of sefbawe 3 Design Flow G P D y v PCHD Nod0ce" Y Reguibed Wbea FMU aMPMtsd Sep eft -4 wig e SpdM is a di t ON GWhM Sande Tent smad Var. TO be aa..4.a. -by dlbeiw WAW SRipitr Piing Sup* ho. 4 ; Adbm ;: ✓iii 5"* Defied by an ate other R.oahesw ate ' I represent that 1 am wholly and completely responwo for the design and location of the Proposed syst.nits); 11 that the separate sewage dispoml t stem above described will be constructed as shown on the approved amendment there to and in accordanp wi f rds, rules a regu ens OT nom County Department of HNRh, and that on completion thereof a "Certificate of Construction Co f c ry to the Commissioner Of HeeRhwill be submItted to the Department, and a written guarantee will be furnished the owner, his scat i by the builder, that said builder will place in good operating condition any part of said seawall disposal system .during the per' tely following tMdate Of the im . anon Of the approval of the Certificate of Construction Compliance of the original system Ms thaw It the drilled wall described above will be located as shown on the approved plan and that mid well will be Instilled atCOrdinq a ti reeu ns of the Putnam County Department Of Health. p 1,! (Hsi 6/� 7 Signed P.E. R.A. AAdress `Z/.Z %/7 Cir r: rc� i l.lcenfa APPROVEO FOR CONSTRUCTION: This approval expires two years from the date issued un :- r wilding has been undertaken and is revocable for cause or may be amended or modified whelk consider ed necessary by the Comm.: change or alteration of construction nquhes a now mit. Approved for disposal Of do" k: sanitary aow/ ,.j lv water w Rev .. _ �- �- c...+— Date �f /r mY� Title 1U�88 t PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: s /4 2. Name of project: - 77> 4. Design Professional: �R�t Ka-'y 3. Location TN: "PaApll 5. Address: 6. Tvne_ of Project: i-**�'Private/Residential Food Service Apartments Institutional Office Building Realty Subidvision Commercial Mobile Home Park Other (specify) _ 7. Is this project subject to State Environmental Quality Review (SEQR)? 1W Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? 9. Has DEIS been completed and found acceptable by Lead Agency? ................ �- 10.. Name of Lead Agency :.- 11. If this project is an area under the control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... 12. If so, have plans been submitted to such authorities? ........ ............................... vee 13. Has preliminary approval been granted by such authorities ? Oej- Date granted: 14. Type of Sewage Treatment System Discharge ................. surface water A,-groundwater 15. If surface water discharge, what is the stream class designation? .................... 16. Waters index number (surface) ........................................... ............................... 17. Is project located near a public water supply system? ....... ............................... Ala 18. If yes, name of water supply Distance to water supply /% IJ5.4 19. Is project site near a public sewage colle tion or treatment system? ................ 20. Name of sewage system Y4 A Distance to sewage system ^; /6 21. Date test holes observed � 22. Name of Health Inspector Form PC -97 2 23. -... ............... Project design flow (gallons per ;.da Y) _yo 24. _ Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... Ale 25. Has SPDES Application been submitted to local DEC office? ......................... --` 26. Is any portion of this project located within a designated Town or State wetland? A""Cl 27. Wetlands ID Number ........................................................... ............................... 28. Is Wetlands Permit required? Has application been made to Town of Local DEC office? ............................... -- 29. Does project require a DEC Stream Disturbance Permit? .. ............................... /�c? 30. Is of was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial active Yes/No !16 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ... ............................... Yes/No AIV DESCRIBE: 32. Is there a local master plan on file with the Town or Village? ............... ........... A-110 33. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? ........................... ......... ... A✓d 34. Are any sewage treatment areas in excess of 15% slope? ...........:� 35. Tax Map ID Number .......................... ............................... Map 0.2- Block_Z_ Lot ;-2 1' 36. Approved plans are to be returned to ..... Applicant k,"" Design Professional If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES. C Mailing Address:.... ............................... //4X'�'101 id•1Fr4 (087) —Text 12 PROJECT I.D. NUMBER 617.21 SEOR W Appendix C State Environmental Ouslity Review :.: SHORE :ENS!lRONNtEPEYALASSESSR�EN � :FORMA, _<....._,,. ,...;..�, .. For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR j 2. PROJECT NAME. 3. PROJECT LO ATION: �I Ile- �n'l7d Municipality ,e , County 4. PRECISE LOCATION (Street ad dress and road Interifections, prominent landmarks, etc., or provide map) 11VIlG' I'✓ XZ�e.-e l 5. IS PROPOSED ACTION: New ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: > r /revs' /�. l`i ,1 /,e/ /f Cl u�i 7. AMOUNT OF LAND AFFECTED: Initially ! acres Ultimately acres 8. WILL PROPOSED A15TION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? MYes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space C3 Other Dribe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? �/� �/ 5695 ❑ No If yes, list agency(s) and permitiapprovals �/ ���d le 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ !j Yes No If yes, list agency name and permldapproval w —V' Y^' C ;or s� 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE � � � � Date: 3 i &jgg Applicant/sponsor .name: 2` Signature: L4 If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 ". PART II— ENVIRONMENTAL ASSESSMENT (ro be completed by Agency) W' DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. tJ Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another Involved agency. ❑Yes.. No :.. _• - . C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or Intensity of use of land or other natural resources? Explain CS. Growth, subsequent development, or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not Identified in C1-05? Explain briefly. C7. Other Impacts (including changes In use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO.BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? Yos 0 No' If Yes, explain briefly: PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether It Is substantial, large, Important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. ❑ Check this box It you have identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this bok *if you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: Print or Type Name, of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Name of Lead Agency Date fA Title of Responsible Officer Signature of Preparer (If different from responsible officer)- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES r'o- �.. ,:;, X .;.;: .zr..,.. •-.'v. »..... _ .._ �_ t.a.,..... > n , w...., F.-...- ::;:�. --. 4'. LETTER OF AUTHORIZATION .RE: Property of 161)° h a le Located at �` %l� /�� /�`���/✓s��Qc Tax Map # Subdivision of Subdivision Lot # Gentlemen: ,5.5.2 Block Filed Map # l Lot ;?119 Date Filed This letter is to authorize a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and.tht Putnam- County'Saa-iitary Code.. r� Very truly yours, Countersigned:' P.E., R.A., # Owner of / roperry) Z Mailing Address j',t�� /� Mailing Address: �. A Z ip State 2'�State /� k Zip X55-79 Telephone: ,7� // Telephone: I i Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONNfENTAL HEALTH �� G ENDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATINIENT SYSTEM � REVIEWS ET FOR CONSTRUCTION PERMIT STREET LOCATION " \.CIE OF OtiY \�R - �' « RM, GR, S NIB, BH DATE TAX NIAP 9 �' D0CUAIENTS Y N ERbfITAPPLICATION ER SIOV CONTROL:HOUSE,Wfi ' J C -1 WELL PERMIT _ ,PWS LETTER E OF PRIMARY EXPANSION RATE RESOLUTION EAF - THREE SETS PLANS - TWO SETS NCE REQUEST ,r SUBDIVISION AL CHECKED DUI DEPTH 4 DRAM REQUIRED GENER4L ATED I, i NYC WATERSHED YS SUBMITTED TO DEP EGATED TO PCHD APPROVAL, IF REQ'D P TEST HOLES OBSERVED I/`S TO BE WITNESSED !(PPROVAL SSDS AD]. LOTS !'LANDS (TOWN/DEC PERMIT REQ'D ?) "A ON DDS PLANS & PERMIT SAME T69 NEIGHBOR NOTIFICATION TER MgrL ' YR. FLOOD ELEVATION iER REQ'D PERIMIT(S) AGE SYSTEM PLAN - (NORTH ARROW) i HYDRAULIC PROFILE ,VITY FLOW 'STRUCTION NOTES IGN DATA: PERC & DEEP RESULTS )YI OURS EXISTNG & PROPOSED VEWAY & SLOPES, CUT DRAINS IL TYPE BOUNDARIES LTIT BLOCK; OWNERS NAME,ADDRESS F PE/RA; NAME,ADDRESS,PHONE"" OFDRAWING/REVISION M REFERENCE LOCATIOV OF WATERCOURSES, PONDS S AND WETLANDS WITHIN 200 FEET PROPOSED FNISH FLOOR AND BASEMENT EL. COMMENTS- �A E AREA; SHOWN; GRAVITV , SUFF.SIZE (> MI PED, PIT & D BOX S ETAILED HOUSE - NO.OF BEDROOM 'WELLS & SSDS'S W/N 200' SED SYS. .PROPERTY METES & BOUNDS ki'OUSE SETBACK NECESSARY (TIGHT LOT) .HOUSE SEWER - 1/4" FT. 4 "0; TYPE PIPE INO BENDS; MAX.BENDS 45' W /CLEANOUT FILL SYSTEMS CLAY BARRIER 10- FT. HORIZONTAL;SLOP TO GRADE SPECS FILL NOTES L CE$TIFICi<I ION NOTE , rnvr,i.L a tvJtviv� OLUME�� }LL N EXPANSION AREA REICH LF TRENCH PROVIDED 60 FT MAX- PARALLEL TO CONTOURS 100% EXPANSION PROVIDED ON PLAN- FROM SSTS )' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL K.0 FQUNDATIOIR WALLS : 15'WELLTOPL ?9• TO WELL, 200' IN DLOD,159 PITS 00' TO STREAM WATERCOURSE LAKE ('mc. expan) ;(TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER VINO WATER LINE (pits-20) TERMITTENT DRAINAGE COURSE P7500' RESERVOIR, ETC. x150' GALLEY SYSTEMS 15'MN to CDS = >5 %,10'4%,25'- 3 %,30'- 2 %,35' -1 %,100' - <1% 20'MIN to CD discharge /100'with 182 cons day discharge SEPTIC TANK 10' FROM FO LL WELL d =-A-AM q 4j° voc V4 / t0/ CVVV V7. 40 API -? -Olj SAT h,b(tle Health Drrwtw �i4�v�v[v+s JUbLFH 5ULL1VAN PAGE 01 F.l�f F ti � ITT EIS'," �hLTif FAX U. 191421 "3i92i ?, ! os 1;A. � .. RErra Wtepvi►tu Arsoalssr Ptrbtlo MOrk Dbstrcr Df eror f/ Pao" Sarum DEPARTMENT OF HEALTH I Geneva Road Brewster, Now York 10509 REQUEST EUR FIELD TESTI ArfEN''l'TO1: STIESELING G GENE DEED AN Idorawtion below must be JI& completed prior to any scheduling. BATF.�v � ENGINEER OR FIRM: ��. k,& Y_ PHONE 0: REASON; pDEEPS: A PERCS: T PUMP TEST: o ROAWSTRh8T: G 4 ef., ; // —/w� /a tl ej a 0� TOWN! TAX MAP#. 2 9 SUNDIYISION- /� inh � LOTM: 1� OWNER: _%Z���� ✓ % GG l �s �.r, 4 %fy �.1y49/l /� a IdJ�I C; YES NO ❑ der Proposed SSTS within the drainne basin d West Brtutch or Boyds Corase Reservoirs. o Proposed SSTS within 000 feet of a reservoir, re:mroir stem or control lake. O Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ Proposed SM design flow greater than 1000 gailesWday or SPDES Permit required. C) Proposed SSTS for a Commerical Project. J _ _ Iiis tlts�ss�cunsibaiit�r 9f:ti►e e. r - - . desigr±. pr_ ofotsional t ..�r�� :d�.t4�+tbovsinfoantstion prior to.eailteltir►gi: _ - - _� This Department wig detertahm the NYCDEP project status (Joint or Delegated) based on response. If you answered xes to any of the questions, NYCDEP must witness the soil tasting. This Department will coordinate a mutually suitable time for Held teoft with the PCDON, the Design Professional and NYCDEP. If a project bits been determined to be Delegated based on ttte above rasp, 1 and theft subsequent information indicates NYCDEP is required to 'witness the soli testing, it will be t1►e sole respondbHity of the design professional to schedule mwitnessing of the soil testing with NYCDEP. �- FOR COUNn use ONLY ® { �esmr:otYi� _ Q cfua.orr�r� *AAA BRUCE Pu'b7ic "'Ffealt, Director .... LpRE T -, QI A`?AR1-R i�dn- S r r.- ... . Associate Public Health Director Director of Patient Services DEPARTMENT OF HEAD 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 . October 13, 1999 Mr. Frank Sullivan, PE 2972 Ferncrest Drive Yorktown Heights, New York 10598 Re: Cardinale, Peekskill Hollow Road TM# 83.2 -1 -29, Town of Putnam Valley Dear Mr. Sullivan: This office has received and reviewed the most recent set of plans for the above mentioned project We would like to offer the following comments for your consideration. Prior to further review, this office must witness additional field work. "Current" field Prior must represent the area of primary and expansion. Please contact this office to schedule an appointment to witness deeps. 2. Provide a location map of the property on the plan. Cla'fy-Afabel:topo contouts.. 4. Provide dimensions to locate the well from property lines. Provide a note at the effluent side of the septic tank stating: "No bends in line greater than 45) ' with a clean out." ,.I Provide a design data sheet (DD -97) of record field work from the subdivision, as well as new field work. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj s FUTN M COUNTY DEFAR220M OF HEALTH x ?� . h/pr ` DFMe� of �dYegetesW HeeHh SerYloea. Camel: N.H.1SS12 fb Paovide Pesdt 1 `- _ w CER11F1CATE OF OOMPLANNCE NSTlIICliON PEIMR FOR SEWAfiS DiSiOSAL SY81ffi11, tee= i Mjeoetl��L Sold. ~Lot r Ter Mep '� �' Malk /Appflcat Names �+�5 lair l/�'�iGJJ'J d /L' Revhisn ❑ —�3/ Date Of Approval Ma0gAd8w e DS J' /.lT/J� / Tewn f�' - /7!i . * / 0_ %y Date Subdivision ADDroved _ Fee Enclosed a Amn,,nt O ✓ s%s o�L�l� -J' % C're- Tjpe Lot Aires Fm See-don Only L peps Va Nubee of Bedrisss Design Flow G P D y PCHD NoM atioe b Requhed When FM V oompkbd . Sepasafs SewanEe Spdss to oeaalst d %oro Gen— Sepa Task and a Gy 4 ;Llfif , To be oae boded by AAdren Water Sq4* PWft Soffly Fe000 Address Fflvate Ss Ds®ed by — an Add-Other Regu eeleets 1 represent that 1 am wholly and completely responsible for the design and location of the proposed systeen(s); 1) that the separate sewig• difpetal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a rpu �onf O narn County Department of Health, and that on completion thereof a "Certificate of Construction C 'satisfactory to the Commissloner of MMlthwill be submItted to the Department. and a written'ouarantee will be furnished the owner his,'' r assigns. Cy the bulkier. that said bulkier will piece in. flood operatinp. condition ' tiny part of said eawagi Aiipoiaf system during the lire 'lately following thedate of the issu- anp of the approval of the Certificate of Construction Compliance of the original sy, ; 2),tfiat the drilled well described above will be located of shown on,tlie'approved plan and that,said well will be Installed accor th6.' ref, ales and regu ores of, the Putnam County Department of Nultn. Date d 1 Signed NOW T P.E. t RA. - .Lieem• Addre� Zrr�L'Td ,-y� � Nom 5+ APPROVED FOR .CONSTRUCTION: This - approval expires two years from the date M9 re=j o building .has been undertaken and is revocable for cause or may be amended or mollified when considered necestary by the Co ny change or alteration of construction noufres •• n`ew mit. Approved, for diissppoosal of domestic sanitary sew p 9 ivat Rev. 1088 Mr 7�I -% BY Title DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road; Brewster, New York 10509 (914) 278 -6130 v.. "'-"'APPLICATION"' -` It3" �COYJSTRUCT "A "ITI:R.WEL'Y�,p._:;. ,..,a:... , PCHD PERMIT 0 WELL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name M ili g Address ,[ ��T icivate ❑ Public USE OF WELL 1 - primary 2 - secondary ,RESIDENTIAL ® BUSINESS ® INDUSTRIAL ❑ PUBLIC SUPPLY ❑ FARM b INSTITUTIONAL ❑ AIR /COND /HEAT PUMP p TEST /OBSERVATION ❑ STAND -BY O ABANDONED ❑ OTHER (specify, AMOUNT OF USE YIELD SOUGHT e6r gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE 44ve gal ❑ REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION GIADDITIONAL SUPPLY ANEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE OPRILLED ® DRIVEN ®DUG ® GRAVEL. O OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION; %90 -,-�y2 ty Lot No. �. WATER WELL CONTRACTOR: Name /ice Aw e-,�'$ dry Address: ✓�rloo» ����_ IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES )'° NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE, T. O'_ .P.ROQI?RTY..:F- RO:l- STFARE:S�: WA -T_ER ,IKATIY - LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED N SEPARATE SHEET '(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 thirt -y (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminat or groundwater. Date of Issue: Y 19_� Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller .a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .. ... i r- -,.: _ .., r i. a _ .. •. . - ..- -,-.o �<, -• - _ .- - __ � v .,( v.T .,.. r c.aa . .-_ .. >. eb:.- 2r.. -x+f cn , i Dated /� Re: Property of 64e/ g 4p& Located at (T) Section Block _Z Lot Subdivision of C�41 e- Subdv. Lot ## 2 ,Filed Map # Date Gentlemen: - This letter is to authorize O �'��p�7.• Lo�/ /�1°"'U' --ter a duly licensed professional engineer ✓ or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules. or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of- Article 145 or 147,'Education Law, the Public Hebilth Law, and the Putnam County Sani- tary Code. ka Counters gned:., P.E.,�A., # Address ®/ 17 / Telephone •i f Vei�y, truly yours, S i n,7 9 f Address i- Telephone r, PUTNAM COUNTY HEAL TH DEPARTMENT REALTY SUBDIVISION GENERAL NOTES I. THE PUTNAM COUNTY DEPARTMENT OF HEAL TH REQUIRES THE SUBMISSION OF PLANS FOR INDIVIDUAL SYSTEMS PRIOR TO THE ISSUANCE OF BUILDING PERMITS. 2. ALL WELLS TO HAVE A MINIMUM SAFE YIELD OF 5 GALLONS PER MINUTE. 3. ALL INDIVIDUAL WATER SUPPLIES SHALL BE DRILLED WELLS 4. ALL WELLS TO BE DRILLED WELLS CONSTRUCTED IN ACCORDANCE WITH NEW YORK STA TE HEAL TH DEPARTMENT BULLETIN, ENTITLED "RURAL WA TER SUPPL Y" 5. THE PUTNAM .COUNTY DEPARTMENT OF HEALTH APPROVAL IS BASED ON LOCATIONS OF SEWAGE SYSTEiWS, WELLS, HOUSE AND DRIVEWAY LOCATIONS BEING MAINTAINED AS SHOWN. ALL MODIFICATIONS TO HAVE PRIOR PUTNAM COUNTY DEPARTMENT OF HEAL-'TH APPROVAL. 6. UNA U THORIZED MODIFICA TIONS . MADE TO THIS DRA WING AFTER THE DA TE OF PUTNAM COUNTY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL. 7. NOT CUT OR FILL IS PERMITTED IN THE SEWAGE DISPOSAL AREA, EXCEPT IF SO SPECIFIED ON AN APPROVED. PLAN. B. NO CUT IS PERMI T Tc' D WITHIN /0 FEET OF A SEWAGE DISPOSAL AREA. 9. PURCHASERS OF LOTS TO E FURNISHED WITH A TRUE COPY OF THIS PLAN AS APPROVED BY THE PUTNAM COUNTY DEPARTMENT OF HEAL TH TOGETHER WITH A TRUE COPY OF THE CERTIFICA TE OF APPROVAL. 4- S /0- THE COMOI TIONS NOTED ON THE PUTNAM COUNTY DEPARTMENT OF HEALTH CERTIFICATE OF APPROVAL ARE AN INTEGRAL r'ART OF THIS SUBDIVISION APPROVAL AND COMPLIANCE IS'REOUIRED. ll. THE AREAS DELINA TED FOR DISPOSAL FIELDS AND EXPANSION AREA TO BE PHYSICALL Y MARKED ON THE GROUND AND NO EARTH MOVING OR CONSTRUCT /ON EQUIPMENT IS TO BE ALLOWED ;IN THESE AREAS EXCEPT AS REQUIRED FOR LOT No AREA GENERAL DEEP HOLE % SLOPE PERC. GROUND WATER /MPER- LENGTH OF TILE FILL CURTAIN DRAIN ACRES DESCRIPTION SSDS RATE DEPTH TO WOOS FIELD AREA MIN /IN LAYER EP TH TO LINEAL FEET DP TH VOL DEPTH LGTH 3BRS ADD BR FT CY / 1.7096 3 3 NONE NONE l00 NQj VE NO E 2 /.0000 SANDY LOOM 4 3 NONE NONE 300 /00 NO VE NO IE r, PUTNAM COUNTY HEAL TH DEPARTMENT REALTY SUBDIVISION GENERAL NOTES I. THE PUTNAM COUNTY DEPARTMENT OF HEAL TH REQUIRES THE SUBMISSION OF PLANS FOR INDIVIDUAL SYSTEMS PRIOR TO THE ISSUANCE OF BUILDING PERMITS. 2. ALL WELLS TO HAVE A MINIMUM SAFE YIELD OF 5 GALLONS PER MINUTE. 3. ALL INDIVIDUAL WATER SUPPLIES SHALL BE DRILLED WELLS 4. ALL WELLS TO BE DRILLED WELLS CONSTRUCTED IN ACCORDANCE WITH NEW YORK STA TE HEAL TH DEPARTMENT BULLETIN, ENTITLED "RURAL WA TER SUPPL Y" 5. THE PUTNAM .COUNTY DEPARTMENT OF HEALTH APPROVAL IS BASED ON LOCATIONS OF SEWAGE SYSTEiWS, WELLS, HOUSE AND DRIVEWAY LOCATIONS BEING MAINTAINED AS SHOWN. ALL MODIFICATIONS TO HAVE PRIOR PUTNAM COUNTY DEPARTMENT OF HEAL-'TH APPROVAL. 6. UNA U THORIZED MODIFICA TIONS . MADE TO THIS DRA WING AFTER THE DA TE OF PUTNAM COUNTY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL. 7. NOT CUT OR FILL IS PERMITTED IN THE SEWAGE DISPOSAL AREA, EXCEPT IF SO SPECIFIED ON AN APPROVED. PLAN. B. NO CUT IS PERMI T Tc' D WITHIN /0 FEET OF A SEWAGE DISPOSAL AREA. 9. PURCHASERS OF LOTS TO E FURNISHED WITH A TRUE COPY OF THIS PLAN AS APPROVED BY THE PUTNAM COUNTY DEPARTMENT OF HEAL TH TOGETHER WITH A TRUE COPY OF THE CERTIFICA TE OF APPROVAL. 4- S /0- THE COMOI TIONS NOTED ON THE PUTNAM COUNTY DEPARTMENT OF HEALTH CERTIFICATE OF APPROVAL ARE AN INTEGRAL r'ART OF THIS SUBDIVISION APPROVAL AND COMPLIANCE IS'REOUIRED. ll. THE AREAS DELINA TED FOR DISPOSAL FIELDS AND EXPANSION AREA TO BE PHYSICALL Y MARKED ON THE GROUND AND NO EARTH MOVING OR CONSTRUCT /ON EQUIPMENT IS TO BE ALLOWED ;IN THESE AREAS EXCEPT AS REQUIRED FOR t v. PEEKSKIL f._ <O S 86' 15' 00" W 57.38' BROOK -y S 73' 27' 00' W 108.35' S BT• q0. CD BROOK 00- Sg LOT I 1.7096 AC — LO AREA= = 74,471 SF REA= 1. 43,560 F 140 /rome W O � I o � � 2I N I coot U) DH A PH 35' MI.o O O PROPO n PH P N 50005 SSOS 0 DH I co 1 ct W 10' 10 EXISTI SSOS MIN MIN � M greenhouse a' 150 deck I 200 TO N EX. h %SDS :05.6 9NE STORY FRAME 31.0' DWELLING PROPOSED DWELLING 30, h FIF 154 106.2' L'i / 100'_ TC w O � p well p p 0 - B' Alps p`'� well 160 4 . 1NV 155.7 O QPpe r0 O_ Lu ai L= 165.4 L= 15 .0 /'.... _ R= '3246.00' _ _,f 232.b7 t po8� 170 . -Q polar 13, 00' E -� polo p a v e men f_ povem nl °I .. N 7183.13' - � - --- -- - _ u3 ROAD WIDENNG -� V - TO THE PUTNA cenrerllne __. �^ DEPT. AREA= 0. 200': TC EXIST. SSDS PEEKSKIL L HOLLOW ROA O MINOR SUBDIVISION PREPARED FOR JOHN P. & CAROL McDONNEL L SITUATE IN TOWN OF PUTNAM VALLEY. PUTNAM CO., N.Y. SCALE: 1' =50' DATE: NOV. 24, 1987 DEC. 8, 1987 REVISED DEC. 17, 1987 REVISED ''SANTUCCI CONSTRUCTION /TICE SN- 12286/QN- 201'0004%NY PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, ^BEDROOMS j RIDGE vENT I LTERAnONS TO THESE HOUSI§ PYANS BQ T B ' SU fTED TO THE PCDOH FOR PPRO It f ' le SIGNATME & T1Tatx4 12� J %�J�c•,l `/'rte /]�.�✓t. � 'l �( IDGE VENT ` 'lIZ ?(�c� WIN'. I oil Kno WON son MAN looll mots WE ■��' ' ■iii' � � ;r � I �i�� ��i� - iii � � � � ; � i � �■� � � is i i J FINISHED GRADE VARIES FRONT ELEVATION LIVERPOOL. PA (7045 (717) 444-3395 By. JDATE�jje FROM THE INSIDE OUr WIM.EXCELHOMES.COM REVIU�. C�S P.R �— 0. k-l—al cis. 1-15 I CONSTRUCTION /TICE I— aw vd ouf --, M?/ 'F i ;a i. t. i I t , i F BOX 683 exc JL L! (7!7) 4L44 3395 45 _ FAX (717) 444 -7577 FROM Tiff ONSIDE OVf 6NM.EXC£LHOMES.COM G SN- 12286/ON- 2010004 /NY as REAR ELEVATION i4• =1' -0' [ D XL 10654 i Q g SANTUCCI CONSTRUCTION /TICE 30• -3' It V01r 70'-9 1/4' ll r7 -7- --� -1/+•' P3-0�' -6' Cpe)y 1 I 41 114•.41 . I 11/2' DC 2442 AL 60 >6 1 2442 4 ti•� 22. 2 x Dy v SN- 12286/ON- 2010004 /NY 13' -2 I /�' KW m � w41 O ^ LAHVD4 - � 2•-0• n - © I J BATH $3 r r fart RG 1114 .O H]!Z < N bw lU CVAC I RAILING By VUILRR CHIT rlxTUR oN .6v PER APPLICABLE COOIS 5'-1' - 3a -N• w DRAIL MGT .- <Nr- P \ • 1 STUDY -1 rRM mw I Dixie So rT Iu, 10 127N i0 rT ' UTILITY L � + L+D uGMr Rao otis oa I" LIGHT Rao I 72..2 so rr SIN(. b 7.5 VIEW Rao 1.10 cu 303 VEN1 Rao '! - - FOYER l0 j °� - t2.w LIGHT PWOV•0 ,O 179 LIGHT ROD 11i r 22..o LIGHT PWV'D F1.r 10.10 VCHT PROW, n� 0..9L ENT RcO` D \ I CHCM TO ABOVE N I0.ID VCM7 PROV•D NO+LJ Ig'D• 000 VCMT PROV'I f Z ^O ADD% LIGHT /VCNI PROV•D; L' I oZL, n r` 35.0• In 12•- /2 ^ T;I Ii b 'L 14._5• - 36• -7 IM' (vtfr ' f 0i y4 J Cf233 - -- - - - - - -- - -- ��- - - -_ -- nr n 7 , 3( D•_B I /2'aoett naol 3peu 2� i' -9 ] /4• 1- iI 1� 0'-6 7/+• ----- - - - - -- - - - -- J - -- , c I 1]' -9' 1--' l6. vrs6• Rn 6 PLU10 8'-7" 13' -9' 1 11 2' -� 1 /A• 38'-31 1 3� 1'-J ]/+• 2+'-6' 11 S•_I I/+' 142•_0• 1.2x6 ExT WALLS a 16' O.C. /2x4 NARR WALLS GARAGE ( PLLw2 x1 0"-2 1/4' 51A (PLU10 2.9 -o cLG NT. (""" R.R ez aox 693 276 52 HAMILTON 1 ].2x10 SPF02 LT WI .DOWS a I6. O.C. 4. ANDERSEN GILT WINDOWS <01.24214 82.2842, 07.3046. 04.2852, 011.2836) � LTVERPOOL. PA 17045 1ST STORY 5.CLG GIRDER OVER N00% /pR YO K. 2 -1 1 /2'x11 1/4'x19' -4• N.L. /2- 2x12xI6'-8' SPF82 (717) IIt -3395 MwVN 0n ucuccD fn pAt . uxi 6.CLG GIRDER OVER EN 10 BED 2 -1 I /2'x11 1 /4'x16' -B' N.L. /2 -1 1/2 xtl 1/4'x19' -4' 121. IRE 02/15/2001 li 7.CEIUNG DRYWALL WILL BE OMITTED FOR ALL ON-SITE PLUMBING CONNECTIONS ' PAX (717) 444 -7577 prpx 9.BUILDER IS RESPONSIBLE FOR CONTINUATION Or FIRE SEPARATION _ vlflas. C' FROM GARAGE SLAB TO UNDERSIDE OF ROEIP SHEATING FROM THE RODE OUT MV N.EXCELROMES.COM % _ Dziwm as.+ d 1; i t b o " 1 ow To ATTIC f 'IT' o fu " 1R1a .I Ty M v N NDR 6=06N 7 7 SBEDROOM . MG o § § f vfgrE.P4I. A • D .+2 M FAMILY RCE)1 • r rur v[Nr _ _- 0 DVPS30 O OVnx 1 - 6.72 VENT Rao _ fZ?0 LIIGHfT aaD r 0 4 4. -0• a1 A ALL S SUB`E 1 1;�I0 A ALTERAi�i �il�.h=RESE HOi °z = = O O 3 3w LIGHT .Rxo -'D � �._II• i i�; T BMITTED TO THE PCDOH FOR APPROV O 3 11.43 VENT PRO'" 3 3 -7N SPf.2 3- fPr42 J N . .0 b b U U I EACH NIT E OL L T 1�. 4 3 3 -2.4 SPr.t I I ICOL lRCODr C CBL' Y YO.4frr LR CVAC m n O O C CACH LfRT I IE1x 1 11 3 3-2.. ffr.2 p C4 RiaoL• - - f f T TL�OI A p Sum C .R - -6r 5 5'-91' I/2" 2 2x l ly 2 2n A - Y A'-3' b c cEL RD•D / tVyY7Z� . % 1 - 7N' - . N 3 3042 3 362. 1 2 2142 � �- - Y PAN - //I7 a ' 'O c �oer r 6 r ac vALL cT► w41 O ^ LAHVD4 - � 2•-0• n - © I J BATH $3 r r fart RG 1114 .O H]!Z < N bw lU CVAC I RAILING By VUILRR CHIT rlxTUR oN .6v PER APPLICABLE COOIS 5'-1' - 3a -N• w DRAIL MGT .- <Nr- P \ • 1 STUDY -1 rRM mw I Dixie So rT Iu, 10 127N i0 rT ' UTILITY L � + L+D uGMr Rao otis oa I" LIGHT Rao I 72..2 so rr SIN(. b 7.5 VIEW Rao 1.10 cu 303 VEN1 Rao '! - - FOYER l0 j °� - t2.w LIGHT PWOV•0 ,O 179 LIGHT ROD 11i r 22..o LIGHT PWV'D F1.r 10.10 VCHT PROW, n� 0..9L ENT RcO` D \ I CHCM TO ABOVE N I0.ID VCM7 PROV•D NO+LJ Ig'D• 000 VCMT PROV'I f Z ^O ADD% LIGHT /VCNI PROV•D; L' I oZL, n r` 35.0• In 12•- /2 ^ T;I Ii b 'L 14._5• - 36• -7 IM' (vtfr ' f 0i y4 J Cf233 - -- - - - - - -- - -- ��- - - -_ -- nr n 7 , 3( D•_B I /2'aoett naol 3peu 2� i' -9 ] /4• 1- iI 1� 0'-6 7/+• ----- - - - - -- - - - -- J - -- , c I 1]' -9' 1--' l6. vrs6• Rn 6 PLU10 8'-7" 13' -9' 1 11 2' -� 1 /A• 38'-31 1 3� 1'-J ]/+• 2+'-6' 11 S•_I I/+' 142•_0• 1.2x6 ExT WALLS a 16' O.C. /2x4 NARR WALLS GARAGE ( PLLw2 x1 0"-2 1/4' 51A (PLU10 2.9 -o cLG NT. (""" R.R ez aox 693 276 52 HAMILTON 1 ].2x10 SPF02 LT WI .DOWS a I6. O.C. 4. ANDERSEN GILT WINDOWS <01.24214 82.2842, 07.3046. 04.2852, 011.2836) � LTVERPOOL. PA 17045 1ST STORY 5.CLG GIRDER OVER N00% /pR YO K. 2 -1 1 /2'x11 1/4'x19' -4• N.L. /2- 2x12xI6'-8' SPF82 (717) IIt -3395 MwVN 0n ucuccD fn pAt . uxi 6.CLG GIRDER OVER EN 10 BED 2 -1 I /2'x11 1 /4'x16' -B' N.L. /2 -1 1/2 xtl 1/4'x19' -4' 121. IRE 02/15/2001 li 7.CEIUNG DRYWALL WILL BE OMITTED FOR ALL ON-SITE PLUMBING CONNECTIONS ' PAX (717) 444 -7577 prpx 9.BUILDER IS RESPONSIBLE FOR CONTINUATION Or FIRE SEPARATION _ vlflas. C' FROM GARAGE SLAB TO UNDERSIDE OF ROEIP SHEATING FROM THE RODE OUT MV N.EXCELROMES.COM % _ Dziwm as.+ d 1; i t - � 2•-0• n - © I J BATH $3 r r fart RG 1114 .O H]!Z < N bw lU CVAC I RAILING By VUILRR CHIT rlxTUR oN .6v PER APPLICABLE COOIS 5'-1' - 3a -N• w DRAIL MGT .- <Nr- P \ • 1 STUDY -1 rRM mw I Dixie So rT Iu, 10 127N i0 rT ' UTILITY L � + L+D uGMr Rao otis oa I" LIGHT Rao I 72..2 so rr SIN(. b 7.5 VIEW Rao 1.10 cu 303 VEN1 Rao '! - - FOYER l0 j °� - t2.w LIGHT PWOV•0 ,O 179 LIGHT ROD 11i r 22..o LIGHT PWV'D F1.r 10.10 VCHT PROW, n� 0..9L ENT RcO` D \ I CHCM TO ABOVE N I0.ID VCM7 PROV•D NO+LJ Ig'D• 000 VCMT PROV'I f Z ^O ADD% LIGHT /VCNI PROV•D; L' I oZL, n r` 35.0• In 12•- /2 ^ T;I Ii b 'L 14._5• - 36• -7 IM' (vtfr ' f 0i y4 J Cf233 - -- - - - - - -- - -- ��- - - -_ -- nr n 7 , 3( D•_B I /2'aoett naol 3peu 2� i' -9 ] /4• 1- iI 1� 0'-6 7/+• ----- - - - - -- - - - -- J - -- , c I 1]' -9' 1--' l6. vrs6• Rn 6 PLU10 8'-7" 13' -9' 1 11 2' -� 1 /A• 38'-31 1 3� 1'-J ]/+• 2+'-6' 11 S•_I I/+' 142•_0• 1.2x6 ExT WALLS a 16' O.C. /2x4 NARR WALLS GARAGE ( PLLw2 x1 0"-2 1/4' 51A (PLU10 2.9 -o cLG NT. (""" R.R ez aox 693 276 52 HAMILTON 1 ].2x10 SPF02 LT WI .DOWS a I6. O.C. 4. ANDERSEN GILT WINDOWS <01.24214 82.2842, 07.3046. 04.2852, 011.2836) � LTVERPOOL. PA 17045 1ST STORY 5.CLG GIRDER OVER N00% /pR YO K. 2 -1 1 /2'x11 1/4'x19' -4• N.L. /2- 2x12xI6'-8' SPF82 (717) IIt -3395 MwVN 0n ucuccD fn pAt . uxi 6.CLG GIRDER OVER EN 10 BED 2 -1 I /2'x11 1 /4'x16' -B' N.L. /2 -1 1/2 xtl 1/4'x19' -4' 121. IRE 02/15/2001 li 7.CEIUNG DRYWALL WILL BE OMITTED FOR ALL ON-SITE PLUMBING CONNECTIONS ' PAX (717) 444 -7577 prpx 9.BUILDER IS RESPONSIBLE FOR CONTINUATION Or FIRE SEPARATION _ vlflas. C' FROM GARAGE SLAB TO UNDERSIDE OF ROEIP SHEATING FROM THE RODE OUT MV N.EXCELROMES.COM % _ Dziwm as.+ d 1; i t d 1; i t �., .t ,# t •9i 9 i r_ 3 4f 6 14 7� t q•:,y- 1 � to-' i �' t 3 �: h r¢t ��rG4��% < kY rc +^ ��j/,y..'_'f+c�i= � + � � _ ��1 s7 } Mf r ��'-"' �.�y.���?a."�""'^";�•v�.�'��f �Y+ �+ �. +W�:ai:�.^rr�—= -lr�-- �""�' --"-- 3 d .NEty r a� �1P t nww o9. • 1 } y 189 , 5/Ys , CUr! s►'i T:� a /T3 O GO Iloh; /Gi C fOrv/) :i F •,