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631- 589 -8100
84. -1 -35
BOX 33
04324
e
BRUCE . R. FOLEY Y �✓ T�
Mr. Coppa
1 Sleepy Brook Lane
Putnam Valley NY 10579
Dear Mr. Coppa:
LORETTA MOLINARI R.N., M.S.N..,
~• ^Associates ^Public Health'
Director of Patient Services
DEPARTMENT OF HEALTH
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) 218 - 6014 Fax (914) 278 - 6648
WIC (914) 278 - 6678 Fax (914) 278 - 6085
April 30, 1999
Re: Addition- Coppa- Sleepy Brook Lane
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 84 -1 -35
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 30, 1999. The addition is approved with the following
conditions.
1. The total number of bedrooms must remain at our 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.
Very truly yours,
Michael Luke
ML:kg Public Health Technician
cc: BI
4
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278 - 6130 Fair- :(914) 278. - 7921
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET S��c �� 3a��K- LOTOWN
NAME 6, 56 -fie& C�p:o .4 PHONE g;v s)S eiz7
BRUCE R. FOLEY _I
TX MAP # V : I-'3 S
MAILING ADDRESS s,� 7 A Cyo
DESCRIPTION OF ADDITION
-FjCj ,s�, 2*00-- C-'�V C- 9eA-f4qJ�--
NUMBER OF EXISTING BEDROOMS -F"- PROPOSED # OF BEDROOMSZ
(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.
..z_..__._ .
Please submit this corm and the following toutnam �`oun yeaTt'FIT
ept.,Geneva R ,
Brewster, NY 10509, Phone 278 -6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
* Non - professional sketches are acceptable
i 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
4. Copy of survey showing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property line.
Contact this office with any questions.
5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OFFICE USE
Comments
Feb 98
DEPARTMENT OF HEALTH
Division Of Environm*ental Health- Services
4 Geneva!' Road, Brewster, New York 10509
(914) 278-6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re: COCP4
Residence
Tax Map 3
Town VA w-, VJk
Gentlemen:
BRUCE R.-FOLEY, R.S.
Acting. Public ,Health Director
According to records maintained by the Town, the above noted dwelling
IS
IS NOT
in compliance with To"m code and the total number of bedrooms on record
is FoutR-
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER -,- V —z:W - \,e 5
Building InspecYor
.. ..........
4
PUTNAM COUNTY DEPARTMENT OF HEALTH .
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INITIAL INDIVUDAL ADDITION/REPAIR FORM
SECTION A: GENERAL INFORMATION
Name of Project tZ i � 0 )(V)
Year of Construction Size of Parcel.
TM#
SECTION B. TOPOGRAPHY (Please check all appropriate boxes)
1. lk-ll ❑ 13-Steep Slope 0-Gentle Slope '[]Flat
2. ❑[Xvidence of wetland ❑Clow area subject to flooding 313odies of water
❑Drainage ditches Mock outcrop
3
I Property lines evident?
4. Water courses exist st on, '11 or adjacent to parcel:
5. Existing. individual wells within 200ft of the existing SSTS?
YES NO
71 5-',
SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS)
1. Physical character of existing SSTS area.
A. ❑Level '(73Gentle S16'pe OSt-eep slope
B. . ❑Well drained Moderately well drained
❑Somewhat poorly drained ❑oorly drained
C. Area available for SSTS. (Primary & Reserve)
❑Extremely limited ❑Somewhat limited MXZdeaquate — ft x— ft
V �WZ
:aw:ya`M, .... � +s- '�.ea- ... .. , . >. _ '.c'x:.":,�'. .;.:c«'_ .._• irc �qi,.� � _; y, �xa_,p...... •4-:4R :'tb .L+~ -a'+. -.. - s.:: � _,,.: "�; '. w �. =.i :.`c o 4!s..a'•..
D. INSPECTION Date / /J))�`] P
Ins ector _
L�i'o evidence of failure []Evidence of failure DEvidence of seasonal failure
---- - - - - -- -----------------------------------------------------------------------------
�__.. (Indicate North)
HOUSE
----- -- °- ---- °- --- - ---- -- -----------------------°----------------------------------------
(1) Indicate location of SSTS
A. Size and type of septic tank gallons
0Metal OConcrete CIPlastic
B.. Type of absorption area
1. Fields ft. 2. Pits 3. Gallies ft.
2 indicate "seibacks; front'street back ard'and`side and dimensions
Ol Y Y
(3) Show location of well
(4) Show location of driveway
(5) Note physical features (steep slopes, rock outcrops, streams /wetlands)
SECTION E. EXISTING WATER SUPPLY
IIPWS MShared well Individual well
DDrilled 13Dug'
r bove ground
COMMENTS :
REPAIRS ONLY: Status:
As Built Inspection Required: As Built Submitted:
As Built Inspection Done: Inspector:
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`q PUTNA11r'- II'. - . DEPABTNIENT OF HEALTH
\ 1 Dhtdon d Eo"` MMtd HeLNti Servlo* Giiud9 N.Y 10512
Must Provide,_ �..
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CER1fl+'ICATE OF CONSTRUCTION COMPLUNCE FOIE SEWAGE"DISPOSAL SYSTEM 11 t 118111' i�a 11 e y Y
Town or V
Br.00kfalls Rd 4. Sleepy Brook Lane Ta:Map 84, O tot 35
B rook fa11s Dev._ CRS Niles Schwartz oothi•11 Est. West
Owner /applicant Name o y �Sabdlv181on Nomo
Malift Ad�330 West 45th St. NY, NY tip 10036 Subdv. Lot # 1
Fee Enclosed Amount $200 Date Permit 'Issued 10/6/93
Separate Sewerage Syotem bunt by S.J. Lore Ad&ws 133 S. Broadway . Red Hook NY
of 44 L F o f Absorption Trench
e n c h Conting on epc ana
Waif Supplyl Public Supply From Address
or: X Private Supply Drilled by 'N_. Anderson Addm.Shrub Oak NY
BuildhWType
Residential Lot Size 1.1.87 Ac
.Has Erosion C�ntrnl Beep Completed'?.
Number of Bedrooms 4- Has-Garbage Grinder Been Installed?
Other Requirements
I certify that the systems) as listed serving the above premises were constructed essentially as shown on the plane of the completed work ( copies
of which are attached), and in accordance with the standards, rules and regulations, in 49�"7V wit h the filed plan, and the permit issued by the
Putnam County Department Of 8e'alth.
1/9/96
Oats Cartifled by � P.E.—l— R.A.
Address Badev & Watson Pt; Rte 9 Cold Spring Dj&nsa N,, 62505
Any person occupying premises served by the above system(s) shall .promptly take such action as may be necessary. to sewn the correction of any unsanitary
eondltk►es resutgn9 from such usage. Approval of the spparatte Bawd em IMII brooms null and void as soon as a pubt;: sanitary rawer becomes
.available and the apps al of the. 'private water supply shall become null id when a publ water supply becomes avallable. Such approvals are
subject to moll katb or Mange when, in the Judgment of the Co /off Heslth, revocation, modification or change Is ry.
3/89 oat. / z ki By Title \` �%
. P k4\, 46 Ifr�l
Wr.LL UVVIL LJL"Illvav �-..�a .. - -�
DEPARTMENT OF HEALTH
ulimp-ONP
Division Of Environmental Healgh Services PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
A
WELL LOCATIO
RE55: I TAX GRIO NUMBER: _
WELL OWNER
AME: s
C
Q PUBI E
USE ,OF WELL
1 - primary
2 - secondary
0RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED
❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTffER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT gpm. /NO. PEOPLE SERVED 7-EST. OF DAILY USAGES gal.
REASON FOR
DRILLING
. ®.REPLACE EXISTING SUPPLY ®TEST /OBSERVATION ®ADDITIONAL SUPPLY
iEW SUPPLY (NEW DWELLING) DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH �G ° ft.
STATIC WATER LEVEL -– O'ft.
I DATE MEASURED
DRILLING
EQUIPMENT
dff ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT O CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING 1;� OPEN HOLE IN BEDROCK ❑ OTHER
CASING
DETAILS
TOTAL LENGTH — 1569 tL
MATERIALS: $cSTEEL O PLASTIC O OTHER
LENGTH BELOW GRADE 138 ft.
JOINTS: ❑ WELDED ARTHREADED O OTHER
DIAMETER ` in.
SEAL: WEMENT GROUT ❑ BENTONITE OOTHER
WEIGHT PER FOOT Ib. /it.
I DRIVE SHOE: 0 YES ❑ NO
I LINER: 0 YES -'NO
SCREEN
_DETAILS___.
DIAMETER (in)
SLOT SIZE
LENGTH (It)
DEPTH TO SCREEN (ft)
DEVELOPED?
_FIRST
_
❑ YES . ONO.. ..
MOUftS -
SECOIrO.:.
_ ..... ..,
,:
...
GRAVEL PACK
O YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK in. I
TOP
DEPTH ft.
BOTTOM
DEPTH N.
WELL YIELD TEST If detailed pumping
METHOD: O PUMPED ; tests Were done is in-
COMPRESSED AIR , ! ormation attached?
O BAILED O OTHER ; ❑ YES O NO
'WELL LOG it more detailed formation descriptions or sieve analyses
are available. please attach.
DEPTH FROM
SURFACE
I Water
Bear.
ing
Well,
Dla-
meter
FORMATION DESCRIPTION
coat
it.
IL
WELL DEPTH
ft.
DURATION
hr. min.
DRAWOOWN
ft.
YIELD
gpm.
Surface
I
06
e-
o
Y
®
WATER CLEAR TEMP.
QUALITY •O CLOUDY HARDNESS
O COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES O NO
STORAGE TANK: TYPE
CAPACITY G
WELL DRS NAME OA
ADORES SIGNATURE
7
PUMP INFORMATION
TYPE CAPACITY
MAKER DEPTH
MODEL VOLTAGE HP
.510!%
YM| ENVIRONMENTAL S�RVI(::ES
^ ^� 321 Kear
Street
�
^ Yorktown Heights, N.!/. 10598
(914) 24572800
81hn,+ W p=A".,="i W ..'+..
-
[..AB #: 32�.411926' C!'IENT #: 569 NON STAT PRDC
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~r~~~~
.
FOOTHILLS HOMFBUILDFR DATE/TIME TAKEN: 81/12/ ' 12:15
' 830 WEST 45THST ' ` ' DATF/TIME-REC'U: 01/12/96-0:15
NEW YORK, NY 10036 � � REPORT. DATE:, 01/16/96
PHONE: (210-265-8189
SAMPi`INGSITF: SLEEPY BROOK |ANE V SAMP!'E TYPE;.: POTARLE
PUTNAM V'.LEY BATHROOM TAP PRESERVAT7VES: NONE'
CO\,."D BY� DAVID SCHWARTZ '
� � TEMPERATURE...: { 4C
NOTES : `
^^^ ' ` CO[.IPORM METH: MF
.DATE FLAG PROCEDURE RESULT NORMAL — RANGE '
` . .
.
_01/12/96 T. COi.IFORM ABSENT /100.M[ ` ABSENT `
COMMENTS:
'BACT THESERESU-TS INDICATE THAT THF WATER (WAS'NOT) OF A
����
SATJSFACTORY SANITARY QUALITY ACCORDIN" .0 THE NFW YORK STATE
AND FPA FEDERA(' DRINKINO WATER STANDARDS, FOR THE PARAMETFRS
,TESTED, AT THE TJMEOF COLLECTION. ' `
' .
'
-
`
SUBMITTFD BY: ............... _----------------
Albert A. Padovmni, M.T.(ASCP)
Director
`
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'
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�
`
E|'AP# 10323 ' �
T);N 4 MID!`
Omer or Pathmox ot
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Toun. Of-fttria-m
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othi'Ll. Satat(bg
,-I represent tr;�t 14=11y WAd COMPIO-Lely. responsible tor the
and drAihage, of the zewa
td tha
sorviliq th above pxvTektY, -t it. has Leen
the* Approvea pl.a.,� ox afi4.Prlll A,�*endment. thhereto� and in 4cc rdla, W. I.
jy4sl 4,
standar(U 0 xul of the • ?)Aham Coanty Deqartn�nt clt
qu,2xW1tee:tO* the 011W
On-StriActed by 'Ito '-whiob, �000
qptra tiA�j - x Ilk'
U
f 5
-the Sdl
by cWS-Pt wheria th't. ftilwe to Opax,-4-,fte • prbp_&Vqs
ant -of the
1-.Y -the act ot t�he -Cocvp
wul, Systl
Thd und Ullfu l thlo
to av
I . le
th� , V110V of - tb: tmc4w
t
not
-act, o�, the m='Pary'U"�_1 "the b
r)aUd tbis 1.• - &ay Q.,5. JO, (• sismture
a,�ftexal cortxmcl
awporaft
$��Ozs wo, 100S,6
maw
4c
APPENDIX C FINAL SITE INSPECTION DATE:
Inspected by:
STREET LOCAT I ON 1_001L -
OWNER
Pti;A-I T•, i'--' TM # OR SLJBD I V I S IOW LOT #
I. SEWAGE DISPOSAL AREA
a. SDS area located as per approved
b. Fill section -date of placement
C.
d.
e.
YE S_1 NO I. COMMENTS
Natural soil not stripped 74'
Stone .brush .etc. .Areater than 15' from SDS area
100 ft. from water course wetlands
a. Septic tanK size - 1,uuu
b. Septic tank installed level
c. 10' minimum from foundation
d. DISTRIBUTION BOX
1. All outlets at same elevation
2. Protected below frost
3. Minimum 2 ft. original soil b;t-,
e. ' JUNCTION BOX - properly set
f. TRENCHES
1. Length required YqY Len(
2. Distance to watercourse measured
3. Installed according to plan -
4. Slope of trench acceptable 1/16 - 1/3
5. 10 feet frcm property line - 20 feet -
6. Depth of trench < 30 inches fran surfz
7. Roan allowed for expansion, 100%
8. Size of gravel 3/4 - 11" diameter clee
9. Depth of gravel in trench 12" minimum
10. Pipe ends capped
PIMP OR -DOSE .SYSTEMS
-1. Size -of
2. Overflow tank
3. Alarm, visual/audio
4. Pump easily accessible manhole grac
5. First box' baffled
6. Cycle witnessed by'Health Department
estimated flow per cycle
III. HOUSE
a. ' House located per approved plans
b. Number of bedrooms
IV.- WELL
a. Well located as per approved plans
.b. Distance from SDS area measured
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"
e. Curtain drain installed: according to Pi
f. Curtain drain o'utfall protected & dir t
!9. Footing-drains discharge away frcm SDS
h. ' Surface water Protection adequate
i. Erosion control nrovidpd
F�_
■
=1=
WARMONG:
ALTERATION OF THIS DOCUMENT, IN
ANY WAY, BY ANY PERSON, NOT UNDER
THE DIRECTION OF A LICENSED
PROFESSIONAL ENGINEER OR LAND
SURVEYOR, AS APPROPRIATE, IS A
VIOLATION OF THE EDUCATIO- i I uW nF
THE STATE OF NEW YOtm _
SSDS AS -BUILT DIMENSIONS
A B C DESCRIPTION
1 42.9 34.1 SEPTIC TANK
2 48.3 38.5 SEPTIC TANK
3 57.5 42.2 ELBOW
4 1n5.n SG 4 R9 5 nRnP ROY
r•
7.Lt
r li
1 ikz 1,
+r
9
i�•
Y. !
ti.
0
PO �;
�0
4,
w.
.Putnam County Department, of Health
Division of Enviromaental Health Servioes
Approved as noted for conformar,.ce with
BPP2VAd le Rules and Regulations of the
-- wage
AS -BU /L f- OF SSOS
PREPARED FOR
L OT NO.1 OF FODATHILL ES TA TES 'WEST fE
TOWN OF PUTNAY VALLEY
PUTNAM COUNTY
NEW YORK - A
a�1111 u„ SCALE lin. = 50 ft. October 12, 1995
• ,s
ail
is
r.
kv� �
Older fo phis'. Ffxtilt
ICAM OF CO MA
1itQt.7fOli !F! F�lsEWA� DfSlO�L slfsi®II
Town,�of Putnam � a ,ey •,,'
rook.. Falhs :Rd. &' Sleetw Brook 'Eerie .
;.�,� E9otlill Es _tes
84,
1 1
. Reoetl._O' Rerlaro p
Ni
Oi��AMap•tN les Schwartz
.: ,' ' , � D,t�e of Pe•vlor Appeovd _ ,'
,� ,.. 3.10 W6''At _'45th- St And- t.ohh E Town N w york.� Nii 10036.
sion AOnrov6 /2 Q0.00
Da v e 9#4,
zyp Residential tot A e 1:187 Ac. m seams o� vas
4 800 FCHD NotlOauoe'r rev whee rm r a:pM.d
FD
Nt�Yar e[ Baia�•ellr � F)otr G _
1f250 `444 LF of 24 ".wide absorption.trench`.
S.N.r' Sw.eK. s�al�ta /i;a>tnit ai[ Scift Teak
To M oa..4.eWb� To he determined Addebn
c AMmom
Wiper Std: Ftiia Stlp Flr>•
X . va..e s•wb� DtbA lie determi neda..
1 ►epre4nt ;that 1 am ;wholly and eompNtely ntponsibN'fa tM Axtign and.kiutlon of,-iM propuaed sYitem(sji 1) that .thai. tkpawb swaa .ditpOaaI system
above dapiOed will a axlrastruated as shown on tAi approved amerwment;the►i to and -in accordance with tM standardOules a • ►pu ns,o ,
Couety Ostpartmant .of IIMRp, and that on compNHa► thaeOf a Certifkab of Coristructbn..COmplianp' �tig story to the Commissioner of Mwlthwill
Or nabni" t? tM Oepxrtiv M,' and a. writ en .guarantee will.. be :furnishaid the ownN his icessors heirs aii, assigns by the builder. that se4 builder will
Mace M boos opaatMrg cOawpion any pat of takl aawage di•➢Otal syRam durUq fhe period of two,.(:) yWs kMlNdiately, following the date Of the iMa-
.IIrIN of thi approval Of tha CatNk;ate Of GonR►uctbn'COmplNna of �.tM aginatsystem
or a .. pairs thereto; 2) that the drilled well described aboaw
wIN'be` toes �ted es MaMrh on tM`app►owd'pMn andahat fmkf'wdl will M instillW a rdan i t ales Mt, ruNs, and. ipuiai ois �Of the Vutnam
CouMY -.Oe_ WrtarMt of Muhl
oats 9 28 -93 Signed
i►aiass °BADEY. & WWONi . PC outs;: 9 f Cold Sprlrig i NY Liceaue. Ho 62505
A�pPROVEO ROR CONSTRUCTION: Thi1 approvatl expires two years hafiin the date issued unleS construction of the building has been undertaken and is
rigocabto foi�aa Oi may ee imended':or, moafifiad wMn.considaW y tM Commissioner of Hamltrj Any change or alte►atbn o/ structbn
iaatuires a ilavr it A x "' f disposal of domestk sanitai sew�da clef ata.w supply only.
Rev. --.�� -`w ' ..
bate By Title
3,0/88
OOUNTY DEPAHi'NM OF HEALTH
Bedlh Sie�Oe�m. b a�a7, N.H.1®Bl8 w TZ OF 00
N PSUM FOR WWAGMB — ,
Town of Putnam , a .
Brooi t'ills' Ad.' & S1eepY `Brook' 'Can'e aWn
foothill Estate s 1 sde�m 1 Tim map 84 1 W 35 Muk
/i H. Niles Schwartz
Dab off Previlow AM"*vJ
A 330 West 45th St., Apt. Lobby E Town New York, NY ztp 10036
Date Subdivision Approved 6/20/90 #2477A Fee Enclosed El Amn„nt $300.00
Residential Lt Aga 1.187 Ac. . ff�o*
LJ Die$ vow
Bltx*W d! 4 . Dedp Flow G P D 800 . HledfisRde® to tlesgWm4 Wbm FM to cosepisted
S to 411 i, 250 Twk mad 444 GF of 24" wide absorption trench.
To b*,c=wftwftd by To be determined Ad&vw
en X , sup* Di: W j j be determined)
O&W
1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(.); 1) that the separate sew&" disposal system
above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a reli ions o nam
County Oepartment ol, Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill
be submlttod to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said buckler will
place in good operating condition any port of said towage dispowl system during the period of two (2) years Immediately following thedato of the teal-
once of the approval of the Certificate of Construction Compliance of the original system or a y"Wirs thereto; 2) that the drilled wall described above
will be located as shoovn on the approved plan and that said well will be Installed M a ordonc� it two sty rdb rules and repo a-T4ions of the Putnam
County Department of Hoolth.
Data 9- -28 -93 signed I /� /. P. E. RA. _
Address BADEY & WATS014i PC oute 9, Cold Spring, NY. License No
62505
APPROVED FOR CONSTRUCTION: This approval expires two years 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 necessary by the Commissioner of Health. Any change or alteration of construction I.
requhos a now permit. AgW �r disposal of domestic sanityryrsew�ge,..and /di yrivato aratf »supply only, __..
ev. /�
i r— �n ' _
/.
O/88 Date l—� ! By Title
99 =8 NY 17Z MY 5661
SOMS
';I Ad
Q:.A130��;J
9
DEPARTMENT OF HEALTH
Division of:Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278- 6130_..
..- .....: :;.,eF`..i.,' �l'1T 1 ON �T� _ t! 1. 1 Li W H ...•....-- .r.:r:.._i aim �.. .Y - . :w .:- .i:1,.0.rA;.:lewi.Ir
PCHD PERMIT 0
WELL LOCATION
Street Address Town/Village/City
Brook Falls & Sleepy B.rook Ln., Putnam
Tax Grid Number
Valle 84- 1--35, Subd. #l,
WELL OWNER
Name Mailing Address
Niles Schwartz, 330 West 45th St., Apt.
73Private
Lobby E., NV Ptfbgic
USE OF WELL
1 - primary
2 - secondary
® RESIDENTIAL
0 BUSINESS
1)INDUSTRIAL
❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED
O FARM ❑ TEST /OBSERVATION O OTHER (specify]
0 INSTITUTIONAL °U STAND-BY Q
AMOUNT OF USE
,YIELD SOUGHT 5 '; gpm %FkPFOPLE SERVED fi
/EST. OF DAILY USAGE 600 gal
REASON FOR
DRILLINGl
❑ REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION Q ADDITIONAL SUPPLY
NEW ;SUPPLY NEW DWELLING O DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
To suppXy
proposed residence.
WELL TYPE
:DRILLED
DRIVEN
0DUG
GRAVEL
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes, Foothill Estate5
.West, Filed Map No. 2477A, Date 6/20/90 Lot No. 1
TER WELL,CONTRACTOR: Name To be determined Address:
PUBLIC WATER SUPPLY AVAILABLE TO SITE:
YES X NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY
.::•.DISTANCE T0•,PROPERTY- .FROM-- NEAREST- . WATER 'MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
,N SEPARATE SHEET
C
Sen 28, 1993 L/
1, r
(date) (signature) •� Ci -:�'
j
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;- (30) days of the completion of water well construction, the applicant shall:
1.
2.
3.
Pump the well until the water is clear.
Disinfect the well in accordance with the
Department attached to this permit.
requirements of the Putnam County Health
Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant
any and all water or waste products from such well
property and in such a manner as not to degrade o
' ,te of Issue • '` ' -- �'' � �` 19
`u
Date of Expiration 19 <,
shall take appropriate action to assure that
drilling operations be contained on this
r otherwise contaminate surface or groundwater.
Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
M
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
d ;..: -,:�; PAP- P�, �E` ATIOAT= �E�-- •C- ONS�iRF3CT =AIt�6�EEL�.. _- ._- .��„r�:.:_.�: PCHD PERMIT Xt-
WELL LOCATION
Street Address
Brook Falls &
Town/Village/City
Sleepy Brook Lne, Putnam
Tax Grid Number
Valle 84 -1 -35, Subde #1
WELL OWNER
Name Mailing Address
Niles Schwartz 330 West 45th St. Apt.
Wrivate
Lobby E., N14POlic
USE OF WELL
1 - primary
2 - secondary
® RESIDENTIAL
® BUSINESS
0 INDUSTRIAL
® PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED
0 FARM p TEST /OBSERVATION O OTHER (specify
O INSTITUTIONAL 0 STAND -BY
AMOUNT OF USE
YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 600 gal
® REPLACE EXISTING SUPPLY 0 TEST /OBSERVATION CIADDITIONAL SUPPLY
M NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL
To supply ro Osed residence.
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
"
WELL TYPE
DRILLED
®DRIVEN
®DUG
®GRAVEL
®OTHER
IS WELL SITE SUBJECT TO FLOODING? YES X NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes, Foothill Estates
West, Filed Map No. 2477A, Date 6/20/90 Lot No. 1
DATER WELL CONTRACTOR: Name To be determined Address:
.3 PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY
DISTANCE.. TO .PROPERTY .FRO.M. NEARES,T.,.WATER MAIN: .
LOCATION SKETCH &'.SOURCES OF CONTAMINATION PROVIDED
N SEPARATE SHEET-
date) U (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.
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 Mm. er as not to degrade or otherwise contaminate surface or groundwat
,,_J'te of Issue: 19_C
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
BADEY & WATSON
s Surveying and Engineering, P.C.
Route 9
COLD SPRING, N.Y..10516.
4914) 26.5_- 9a2117._.__7.39.3Q5_7�7 ' 628-1000..-
.�. ''M- !�=- F�-r''•Yti vr� �M ��i:�J- 4`f2�4 •• .a..e. �- .7.... t:.C' «.i' . -n =sa .:.M
TO Putnam County Department of Health
4 Geneva Road
Brewster, NY 10509
LEETTEQ W ITRUM UL
DATE JOB NO.
Se t. 28 - 199:3 -- .86- 192..0.1.
MT'lr nto� .. -r,.- .- ..n....,,,.1,,,.:�.s -.. +peen «..r. ,_. • ,. ,--,^. �=-� .,
Mr. Robert Morris
RE:
Permit Lot #1
Brook Falls Rd '& Sleepy'Brook Ln
Town of Putnam Valley
WE ARE SENDING YOU ❑ Attached ❑ Under separate. cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES ,
DATE
NO.
DESCRIPTION
1
9 -28 -93
Construction Permit Application_
1
Application Form PC -1
1
Design Data Sheet
1
9 -28 -93
Well permit Application
4
5 -19 -93
Separate Sewage Disposal Plan
2
House Plans
1
Letter of Authorization
1
Check for.fee of $300.00
THESE ARE TRANSMITTED as checked below:
ER For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
> ❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FOR BIDS DUE. 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO
40% Pre-Consumer Content • 10% Post - Consumer Content SIGNED: Kurt S c h o l l m e y e r
PROM U240 ®mc. WA Vm m4ii. if enclosures are not as noted, kindly notify us at once.
PC -1
PUTNAM C OUNTY DEPARTMENT O F HEALTH
APPLICATION FOR APPROVAL. OF PLANS. ,FOR. A.WASTEWATER „DISPOSAL SYSTEM _ .� ;,_ ,
1. Name and.Address of Applicant: _ Niles Schwartz
330 West 45th Street, Apt. Lobby E.
,. New York, N.Y. 10036
2. Name of,,-Project: Schwartz 3. Location T/f Putnam Valley
.4. Project,,Engineer: John P. Delano 5. Address• .BADEY & WATSON,. r
Surveying'& Engineering, P.C.
U..S. Route .9, -;Cold Spring, NY
License Number: 62505 Phone: (914) 265 -9217
6. Type'of Project:.:
X Pri..vate /Resi.dential Food Service Commercial
.Apartments Institutional Mobile Home Park
Office Building Realty Subdivision ' Other (specify)
7. I.s this project subject to State Environmental Quality Review (SEQR) ?.
Tyoe Status.(Check One) Type I.. Exempt
Type II. X Unlisted
.8, Is a Draft Environmental Impact Statement (DEIS) required? .......:..... No
t` Has DEIS.__been completed and found acceptable by Lead-Agency? N/A
10. Name ,of Lead Agency N/A
11. Is this project in an area under the control of local planning, zoning,
or'.otheE officials, - ordinances ?_., • •.•.�.• . ....:, :.. .. ,.. Yes
12. If so, .have plans been.submitted to such authorities? ................ ... No
1.3. Has preliminary approval been granted by such authorities? N/A Date Granted: N/A
14. Type of Sewage Disposal System Discharge....... Surface Water. X Ground Waters
15. If surface water discharge, what 'is the stream class designation ?........ N/A
16. Waters index number (surface) .. ..................... N /A.
17.• Is project l.ocated,near a public water .supply system? .................. No
18. If yes, nave of water supply N/A Distance to water supply N/A
19. Is project site near.a "public sewage collection or disposal system ?..... No
?0. Name of sewage system N/A Distance to sewage system N/A
'Date observed: 23. _Name of Health Inspector: Michael J. Budzinski, PE
'4. Project design flow (gallons per day) ..................................... WO`._.
25. Is State Pollutant'Dischirge Elimination System (SPDES) Permit required?.. No
-a -p..- •.e,•�" - '.a .r,. a^+.a v.�u`, ir.�i+ ",:. h." "'_. -�- .^- '..mr, •„ :ei .ys- `��:r �•'�^°' r,. -'.r. es- ...oi..a.:as -• iicY- .�r�s.b _• `.� .�- .r:fi, ^.s �. -
26,. Has SPDES Application• been submitted. to local DEC Offices N/A
-
27. Ls any portion of .this . project located wi hin a designated Town or State. No
wetland ?... ........
28. Wetland ID Number .....,.e.'.. ..::'o. .........e N/A
4
Is, ;Wetland Permit'' requi red? :.. ...... .. . . e NO
`.Has appl cat ion :been made to Town or.Local DEC-Office? e .......
U /A.
30. Does project require a'DEC Stream Disturbance Permit? ..... ,.... No
3i.. Is or.was project site used for agricultural. activity.involving application
of pesticides to orchards or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity ?.......... YES or N.0 No
32. Is.project, located within 1,000 feet of existence of abandoned landfill,
hazardous waste site,..salt stockpile, landfill, sludge disposal site or .
any other potential source of contamination? :.:..........:YES or NO No
DESCRIBE:,
33. Is there a local maste.r.plan or file with.the Town or Village? ......::... Yes
34. Are community water, sewer facilities planned to be developed within 15 years? No
35, Are any sewage disposal areas in excess of 15X_sl,ope?
36. Tax Map ID Number ........ ... ......84 — -35
37. Approved Plans are to be returned to: ................ Applicant. X . Engi.neer
If the application:is signed by 'a person other than the applicant shown in Item 1, the
application must be accompanied by'a Letter of Authorization. Failure to.comply.with this.
provision may be grounds for the rejection of any submission.
I hereby affirm, under penalty, of perjury, that information provided on this
form is true to the best of my knowledge and belief. False statements made
herein are•punishable as a Class .A Misdemeanor pursuant to Section 290.45 of
the Penal Lawn.
SIGNA`fURES &OFFICIAL TITLES: .Engineer. for.:.:appl'icant
BAD W& WATSON, Surveyiri-g & Engineering P.C.
10516
MAILING ADDRESS: U.S. Route 9, C.old. Springs _NoYo
J 0,
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF'ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET- SUBSURFACE SEWAGE DISPOSAL �T EFILE NO.
-0WNER Niles ":''Schwartz �iDDRESS Wegt. a5th St ,—NY, NY 111036 � -V A
LOCATED AT (STREET)Brook Falls Rd & Sleepy Brook Ln SEC . 84 BLOCK__. 1 LOT_._
(indicate nearest.cross street) Subd.. Lot # 1
MUNICIPALITY Town of Putnam Valley WATERSHED Peekskill Hollow Brook
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH'APPLICATIONS
DATE OF PRE - SOARING _1/21/88 DATE OF PERCOLATION TEST 1/21/88
I9iWD
NUMBER CLOCK TIME PERCOLATION PERCOLATION
RUN # START -STOP ELAPSED DEPTH TO WATER FROM WATER LEVEL SOIL RATE
TIME GROUND SURFACE DROP DROP
(MIN) START(in) ..STOP(in) (inches) (min /inch)
1.
2.
3.
4.
5.
A 2:08
- 2:19
11
23
26.
3
4
2:20
- 2:35
15
24
27
3
5
2:37
- 2:52•
15
24
27
3
5
1. B
2:11 - 2:40 29 24 27 3 10
2.
3.
4.
5
VOTES:
1. Tests to be repeated at same depth until approximately equal soil rates are
3btained at each percolation test hole. All data to. be submitted "for review.
Z. Depth measurements to be made from top of hole.
cev. -9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
iEPTH HOLE NO'a �` BOLE NO 8 iiOLY.NO e
G.L. Topsoil 12" Topsoil ;
21 Silt Loam Silt Loam
_ 3
3'
4' Sandy Loam Sandy Loam
5'
Y _ 6
6'
7' Sand
8'
INDICATE-LEVEL AT WHICH GROUNDWAtER . IS ENCOUNTERED Not encountered
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED N/A
DEEP HOLE OBSERVATIONS MADE BYsBADEY & WATSON;PDC. DATE 5/28/87
Surveying & Engineering, P.C.
DESIGN
Soil Rate Used 10 Min /1" Drop: S.D. Usable Area Provided 5,300
No. of Bedrooms 4 Septic Tank Capacity 1250 - gals. Type Concrete
Absorption Area Provided By ' AA4 L a F e x 24" width - trench
Other
ture
Address Route 9 SEAL
����4144i 66 D
N� OS Pdc b� `'�I•�i
Cold ..Spring,' RT..Y. .10516- \`�P ,� Q 9�
O
0
0
Soil Rate Approved sgeft /gala Checked by
p
9�FEMMA ..
P CUN�'X EP RT1'ENT_OF HEA,rrfl"'
PIVISIO IRQNMENTA_L HEALTH $,E WILES
-r •C fit" :tom, `.iF i - •J 'Y*'`�. %•� _,y... ,P� •' :.i: Uate2 .�)Y, -,i •.w i�, .;,� .."b �+•ey %.::'ir.: •• �.� -
Sept q28, -1993
RE:. Property oft NLLES..SCHWARTZ
Loc►aticd : at • Bro&l,. I'nlls did: 8� . Sloepy Brook Lane
T /p:Putnam Valley 8ectaon 64.. Block. 1. Lot 35.
`Subdivision M Foothill Estates,West
Subd. Lot No. 1 .Filed Maki X10.: 2477A Ante 6- 20 -90
Gentlemen.t
This: letter is to author',ze john P . Delano; P. E . , a duly licensed
Prof4ssional Engineer, to apply for a Construction Term3.t . for a .,
Sewage Disposal.System and/or a Private Water. Supply,:to serve the
above noted,property`in. adcordancb with the standards, rules, or
regulations as promglagated by the Commissioner of the Putnam: County
Department of Health.. and to sign all necessary papers on my behalf
in,conne.cti,on with f.his mattar and to supervise the construction
of said system .or systems in conformity :with the provisions of
oHduoation:. Lair., fi�z'puka3i :- Hea1?:iy= :Law -, .`it .
Putnam County Sanitary Code.
Very ,truly yours,
BADEY & WATSON, Signed L
Surveying &.Engineeing, P.C. ..Owner of Propertyw
pp 3 Q, est -4 5 t Street
1: bbv E
b John P. Delano; P.E. New dark, NY 10036
NYS.LiC. No 62505. Address
U.S. Route . 9
Cold Spring,-N.Y. . 10516 Telephone
('914) 265 -9217
TOTAL P.03
O ` b
a
X 9Z61
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C2 b
sssiX 3„ LS sow / Ogg ti
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LV S
q p6
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-o
js
NDosopdpt 3yyH'09 �� °9y.hr �V -
i/ a o
o / do 'i3M
IV
000
OPUn)
WAS
.
P A �•
113M 3'13M °3`'Od• ad� �.� ,i
'`tj
1: a
c
err
O
Area = 1.187 Acres
SSDS AS—BUILT DIMENSIONS
A
B
C
DESCRIPTION
1
42.9
34.1
SEPTIC TANK
2
48.3
38.5
SEPTIC TANK
3
57.5
42.2
ELBOW
4
105.0
59.4
82.5
DROP BOX
5
20.9
40.9
DROP BOX
6
73.7
81.7
END LATERAL
7
95.0
111.1
END LATERAL
Std
ww; P-1 Q.
C-)
Putnam County Department of.i' Health
Division of Environmental health Services
Approved as noted for 01-jform�,nce
Pi with
-le.Ruies and Regulatlofie of the
coun Health DepartmT
tore to Title ate YA
Y.
AS-AR111- 7" OF SWS
PREPARED f'CW
LOTNO.1 OFf-00THILL ESTA TES ,..,WEST
qRIA Ir IN ME
TOWN OF PU7NAY VALLEY
PUTNAM COUNTY
NEW YORK
SCALE fin.= 50 ft. October 12, 1995
this is to certify that the sewage disposal system
was constructed as indicated on this plan and that
the system was inspected by us before it was covered
ovM_ the system was constructed i7 occardbnce with
olf standarda 'rules, and riegulations of the Putnam
County Department of Health and the New York State
Deportment of Health Revsed • December 19 1995
Notes
f
1. 17ie premises hereon is Lot 1 05 shown on that certain map entitled
BADE Y & WATSON
BADEY & WATSON, s.—I&, PC
Subdivision Plot ..• Foothill Ftotes West ... ', which was 19ed in the
Putnam County Oc,*s 0frice on June 20, 1990 as Map No 2477A.
SURPEWNG • ENMVEERINQ P. C.
U.S. RK& 9 (914) 255-9 W
Z/001
by
Cold Spriv& New York 10518 025-1800
NEW YCRK(�17A 7F MENSED PROFESSIONAL ENGNEER
739-357?
(914) 265-4420 (►4
VOSIVSF Na. 62505
W.O. NO. 10709
rAf. 84.-I-35
F�ZFN6. 86-1-92.01
t
Ft