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Home My WebLink About4333DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -44 BOX 33 04333 , T IN ' r IN Ilk 04333 ka- SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 27, 2009 Lisa Zegarelli 4 Sleepy Brook Lane Putnam Valley, NY 10579 Dear Ms. Zegarelli: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 169 -09 Increase from 4 to 5 Bedrooms with Existing 5 Bedroom Septic System 4 Sleepy Brook Lane (T) Putnam Valley, T.M. # 84.4-44 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 October 27, 2009. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at five without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. [Ylurrtbin 1" 6ir- mustbe 'p'at-d- w -1h �u�r saving•devic; s; i:e:; nedv l vr- flii'sh': toilets, restrictors for shower heads and faucets etc. 4. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals 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 (845) 278 -6130, ext. 43261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:kly cc: BI, (T) Putnam Valley Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 l 2 SHERLITA AMLER, MD, MS, FAAP Commissioner, of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of-4;�uironmental Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAIL ONLY STREET L `D ke- Cog IL tc A. TOWN u = VA e- TAX MAp # ?q. ° q NAME PHONE `a A 5 - 7 �1� - 3 a F5 PCHD# — � - I%IK A MAILING ADDPtSS u.el DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS'_ �J_PROPOSEID # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) * *Any addition which i's considered a bedroom requires formal approval of plans.(Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. �1. Certified check or money order for $100.00. -2, .. ketches. of existing -floor plan. (drawn to scale, all living area including basement, to.he 1slic wri and di Tensioned and'tise of'each rooiii- specified):' (See Sectidri 3:c of Bulletin'- HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional, sketches are acceptable and preferred. (See Section 3.d of Bulletin � HA -1) 14. Copy of survey showing all well and. septic locations. on the subject property to `the best of your knowledge. Include date of installation known. Contact this office with any ,. questions. ✓5. .Copy of Certificate of. Occupancy from the Town or Certification from the Building . Department with legal bedroom count of dwelling: OFFICE USE . COMMENTS 5. Environmental. Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 . Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225=1580 - ALITA AMLER, M% MS, FAAP Commissioner. of Health - ..: :.i;ri'�i��OLINAIt.'I;$tN;�YSi� •�'.:� °��'° '_ '-_ ' Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT Director of Environmental' Health DEPARTMENT OF.HEALTH. 1 Geneva Road. Brewster, New York 10509 Town Legal Bedroom Count & Proposed Addition Status Re: "SKT (Owner's Name) Tax Map #. 84.-1-44 According to records maintained by the Town, the above noted dwelling, J,s . xx. in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: house (4) Sepj_C system (5 ) This information has been obtained from: ... -.... .e.w. .�. .0 z ..nce:a:p!.' .. .. -... .e ..-s w. _.._.. .—. ..� :: ..vim w . -..... .v .... -... .. ...,n � n • as `. mc:s�p�.. .M.i - .r -... ... .. -�... - ..�. .��, -,..: `.... .-. Certificate of .Occupancy: CO # 19 9 8 - 81 Other: The plans for the proposed addition are considered: New Construction xx Addition to existing house only Teardown and /or re -build allowed under Town'Regulations .10/19/09 u_ildng Insp -ctor Date 6. ' Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing.Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care. Fax (845) 278 76085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225-1580 MEMORY TRANSMISSION REPORT FILE NUMBER DATE TO DOCUMENT PAGES START TIME END TIME SENT PAGES STATUS FILE NUMBER 912 912 OCT-23 10:52AM 82784865 001 OCT-23 10:52AM OCT-23 10:53AM 001 OK T 1 Mic QCT-2.1-_2ULA0:5,3AM TEL NUMBER" NAME ENVIRONMENTAL HEALTH SUCCESSFUL TX NOT ICE d I c,. P_ u Z_ -E rP. A_R X-=�T C -r (rmirc-lt oriall I, P C O24 # P-mait"21 S.uh>ci; "-;Sion er ,N-mr=e of CLfa-milabke, ee C•r_he- 1xifor-matiort: Spft-_ial LzIs=uctions: vZ_!vmm;ttc! b_: Dace: P_ -son TLtt==i-ing File %- 7_7,- ZZ N_r —_E!TvZZ1-Z— 77 CZ= C. N-7 -17 T-p utc: -tc. r-cl-= ate. .,. V PUT COUNTY DEPARTMENT OF HEALTH i • DIV_ ISIO_ ' _ F ENVIRONMENTAL HEALTH SERVICES - .:.;r•e... : e• ;t;. nrr . ... .. ,'r r1 ^• .v ..w+ �, •nn � ..."i - - ..- +..r,. - r :n.%nlyr= ,r`°�,, ,. v,l•.•'..- ..+ �. ,f.r �.., CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT .# ?I -1-7 -oI5 Located at Q5LE 5-'-PY " 5OZ04 LAi,4 ir. Town or V Owner /Applicant Name',( D Tax Map Formerly Mailing Address :�:!70 .51-4 5 ; Date Construction Permit Issued by PCHD 1 1" " RkTWW V)N, � Block I Lot 4A V Subdivision Name Fit L-L e5TA ;M-5 WE51 Subd. Lot # to Zip Separate Sewerage System built by" 5r4e'-*_ W51UUL Address ' R f MA V %r_4 Consisting of 11I OW Gallon Septic Tank and ' 1034 L F - U W I Oh `t_9Z� SPACF-0 o7- C-0 I o G Other Requirements: ..Fi�i:i�t•:y:0u . I�y•J�N Water °Supply:..; Public Supply From Address Private Supply Drilled by Nd 2MDbt`i 1� Address P1TIUAM VA't or: JY �:B.uildinTye_. -P-C'71 Has erosion control been completed ?.r -, K�o' >.... .G, . n �.,. .T, :c::a:J. ,.- .... ... < ....:.. ....r ....- �.. .��• -.x-.� •..- . .-.. a .... -,.. .d<x. - p , o c a->a:::.r.. ... a .. .....•.. ..y Number of Bedrooms Has garbage grinder been installed? 10 0 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 C ty Department of Health. Date: 170 1 a_7 Certified by A P.E. R.A. (Design Professional) Address �N ,� .q (J License # ro2 Any person. occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. 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 revocation, modifie-a o or-ch_9gv,.is necessary ....--- ----'" ._--- --C_._. �Y:-- --- � -- - - -- . ' � �. Jam• � Byrom -''' Title:' Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desi Professional -97 Form CC Ll 700% EXPANSION AREA V2 Y stWood t0ec/ * ory Story r , owe//', 9 IT S80. 0 Wey SLEEPY. elf, ql� 4=1J.00, C3 cz, 1m Q I.-D-ROP, SO 1500 CAL. PRECAST CONC, SEPTIC TANK II ry 5 112 ke 0 oo rl h 15 0'%537 fi A F fin A tine ital , Fs !L jai iT ee em n Will N. a lv corners ma J, ose Hill Park Town Pa�kl' Cem USIVIC .9 23 i nam Ile VALLEY • -TNAM COL ms I Moheg Lake 6 0" M21 Gr 10 UlngI gm 4 --t'N Sunn4lbr? gm, in II 1`0 'Will m Ii 4Seneca 7'd Travis ,Ih PpRk - 6 WWA .... ............. Se _41 wseb a K; I M ,�4 Corners South Highl nd 5 112 ke 0 oo rl h 15 0'%537 fi A F fin A tine ital , Fs !L jai iT ee em n Will N. a lv corners ma J, ose Hill Park Town Pa�kl' Cem USIVIC .9 23 i nam Ile VALLEY • -TNAM COL ms I Moheg Lake 6 0" M21 Gr UlngI gm 4 --t'N gm, in II 1`0 'Will m Ii 4Seneca 7'd ,Ih PpRk - 6 WWA .... ............. Se _41 wseb a K; I M ,�4 YOU N, V-14EADEPi- ;7,&, M I LY .! • METAL Mv,. FALS 10 A& pm... J4LAATjA A4 Pr-A.&U0, 45TA, I PIN TS T R LA- t 711) 0: T%v I& W0.61.LL4 3.2n10 NCA(7[�p Q.ol OF 13 b FAST ii; 1/, L I V) U Gj 4040 ir ;o qq q(o 16 Ilk 1, L q-10-1114 W q jot.,, T-. I Fo willrTT-w ARM ml L-► J Tr' (7, Y (-LOA) I U-c-,. POOr-ti 3'V 1h STAIfI, u p lZ.Rl-*)LPY C TP,7� 30 e -1 A W -1 '43, fuO51 r7y "1% irt. 3WWMCXl-S %,, fiA L', ti 14 ZA(, STUD P057 44 4-1.12. uoxorlssAm -f'mA:11,CAv F/LLcr PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS 14 C-51 91 ALL SUBSEQUENT REVISION ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCOOH FOR APPROVAL 5. Z,e SnMTURE & TITLE ILA rx)m ix OVCP�HE-A�,P 3 r; F H a-A f-3 E P, 3 ;?,A 1 -1 r7r 4 EA -7' 3 It a-, H4 -0" S.O.- y ! 2.2842. TIA .0 EDRO.or _ C1 ?3 P,OOM L4 -;4 vAu 1N r q� C S F�LL�S 71 I I ' ew. � a i � •a t W r- )F I Ills tr .i -r.z • o ' ud I fill -1 �l <. 4 i w vvv t7 CF il�ta. x 4,, _ ... I-AP H IGW WALL 2 AL�E55 OPtq .TYP y'. s f ,'a ud I fill -1 �l <. T OF HEALTH HOUSE PLANS APPROVED FOR 81 DROOPA COUNT ONLY !� BEDROOMS .,9-14 ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED ,,TO��THE ,PCDOH FOR APPROVAL SI NA,TURE F. t� DATE FEMME ;n rr � x t �c�+:'� -Y e�Tt''�7:�n1•iS � � � � r�; 43�'e,�� -'�� -y 5,�� t f � n •;� � � r ENTIA i LimmooiL ON- tA OTENTI 4 i w vvv t7 CF il�ta. x 4,, _ ... I-AP H IGW WALL 2 AL�E55 OPtq .TYP zx'1 -'.)�T•lJ.05 (G`06 T OF HEALTH HOUSE PLANS APPROVED FOR 81 DROOPA COUNT ONLY !� BEDROOMS .,9-14 ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED ,,TO��THE ,PCDOH FOR APPROVAL SI NA,TURE F. t� DATE FEMME ;n rr � x t �c�+:'� -Y e�Tt''�7:�n1•iS � � � � r�; 43�'e,�� -'�� -y 5,�� t f � n •;� � � r ENTIA i LimmooiL ON- tA OTENTI WHO i w vvv t7 CF il�ta. x 4,, 2 ' s f ,'a I L4 L4 0 ;,•K 40,•0 TU5 DRQQM �o t6 x, i,,7- 14T51iq4 It A4L 7 r-AWSL- 0 7 215 LIZ. 2. 28q 7- M if al .0 I MITE- f ep. ;ZIB"47- A L QZ7 OI 4 41im iG'a6 :JUd7ULATI.OL) IOC 3.'; ;,•K 40,•0 TU5 DRQQM �o t6 BEDROOM-3 '6 A4L 7 r-AWSL- 0 F--]P-OTENTIAL N MITE- f ep. ;ZIB"47- A L QZ7 OI 4 41im iG'a6 :JUd7ULATI.OL) IOC 3.'; ;,•K 40,•0 TU5 0 w o D R 00 K-7- -or mu F-PO-T-EWT-iAL RMROOM- L4&-,Y r CL 14 MITE- f ep. ;ZIB"47- A L QZ7 OI 4 41im iG'a6 :JUd7ULATI.OL) IOC 3.'; ;,•K 40,•0 TU5 MITE- f ep. ;ZIB"47- A L QZ7 OI 4 41im iG'a6 :JUd7ULATI.OL) IOC 3.'; .m V/ PUTNAM COUNTY DEPARTMENT OF HEALTH D4'•.I �. ��..., .w;.,._.Ip, O N .. . .. zO.,• .F .. ENVIRONMENTAL de � +: H E- .A.:3e ^Ia.-- : a'^1�H:7. --.r_- S RaVs.. IC . � ::v. . -a CERTIFICATE OF CONSTRUCTION COMPLIANCE PCHD CONSTRUCTION PERMIT # 'N " 114-5 Located at VRILV4 Lh4I- Town or Owner /Applicant Name ®CX/RFTax Map Formerly Mailing Address � �70 SEWAGE TREATMENT SYSTEM Block I Lot 44 Subdivision Name i t-K LL F-> VQi Subd. Lot # t0 Date Construction Permit Issued by PCHD i :° 'qk � Zip Separate Sewerage System built by '5'TeVg�- k.k>iM-L Address Rkr1-J ;SM Vft'L:q'kr/ Consisting of +r--,0(2 . Gallon Septic Tank and C:;�O L 2d It Vii i QC-- MCP•.- PTI&I + Other Requirements: Water Supply: Public Supply From Address or: Private Supply Drilled by N624y? ARV 1 P Address 94PJMA V _B�zilding_Type : °'�i'Iv I°Ias .ero•i«n cvntr °�,l 1?een coni;�letcd _ _ ... . Number of Bedrooms V15 Has garbage grinder been installed? Sri 0 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 C.Wty Department of Health. Date: 7, l C17 Certified by Address P.E. )G R.A. License # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. 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 revocation, modifi ion orel� g. is necessary. B Title: J� �!i ` Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desi I ,Prof sional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT tqui :,Exact location ot weft wi aistances to at least two permanent ignamams to Well Drillees Name o Signature: Addr, Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 ,71 k- f' ddfen: g� / �A IMap Block o / Lot(s) L/y 5: Well Owner: Ir Name:.f Ss: Use of Well: 1- primary 2-sepondwry Resi8ential 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 eft. I Length below grade 7s, . _';4� - Diameter P1 in. Weight per foot —14 lb/ft. Materials: Steel Plastic _Other Joints: Welded Threaded Other -------------- Seal: -> Cement grout Bentonite Other Drive shoe: %>e 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 2-1 Yield gpm Depth Data Measure from land surface-static (specify ft) 3c During yield test(ft) Depth of completed w I ell in feet Well Log If more detailed information descriptions. or 1%ieve�analyses are available, please attach.. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 7 06 I V" If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump Type 5AYi-L. • Capacity Depths Models' -C— ).3 Voltage d_3 D L/ HI) Tank Type Are Volume Date Well toinpletW� _ %in G County Certification No. Date of Report Well Driller (signature) tqui :,Exact location ot weft wi aistances to at least two permanent ignamams to Well Drillees Name o Signature: Addr, Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 ,71 MAY- 28 -1 6-98 08 :58 FROM BADEY & WATSON, P.C. TO 12125814334 P.02 r, 't ]PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION .-OF-ENVIRONMENT-AL HEALT- H- -S-ERV- CES- - - -- GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM IV4 / c ,✓ r L - Lq1 kd Owner or Purchaser of Building_ Ur00 klzGll s O AP T- Cin v� Building Constructed by V 01/ 'fax Map Block l✓ot TownNillage �oot�,i fiS L- /4 Location - Street Subdivision Name 4lr ALT /0 Building Type Subdivision Lot #� Z represent that 1 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 ofHealth, 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. enders gn�d.:.further r- agrees, to, accept .as...cgne us v�e.. the. " T�irector of The ?utnaai County Departmen-t ofHealti as to�whecitehtoer r m_or i nnaott othn e , effaue r e l?ublic�Health ,T_. of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated- Month r S Day Year General Contractor (Owne - Signature Corporatiod�4ame (if corporation) -�- Address: 3 3 c t✓ Y S•' s 7— Address: ,36 State Zip • /00 3,(� State Zip -Lo 0 Form, GS -97 TOTAL P.02 ;� YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ` Albert H. Padovani, Director | LAB #: 32"805017 CLIENT #: 9139 NON STAT PROC PAGE 1 BROOKFALLS DEV CORP DATE/TIME TAKEN: 06/08/98 04:00P 330 W 45TH ST. DATE/TIME REC'D: 06/08/98 04:30P QW'YORK, NY 10036 REPORT DAT': 06/09/98 PHONE: (212)-265-8189 - ' SAMPLING SITE: .LOT #10 SLEEPYBRQOK LN" SAMPLE TYPE"~: POTABLE PRESERVATIVES: NON' COL'D BY: DAVID SCHWARTZ TEMPERATURE..; < 4C NOTES""": KITCHEN TAP COLTFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~_ ~~~~-~~~~~~~=~~~~=~~~�~~~~°~=~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD ` 06/08/98 IRON (IMS) <8.060 MG/L ` 06/08/98 MANGANESE (Mn) <0.010 MG/L 0-0.3 mg/l 2037 COMMENTS: Fe/Mn If both iron and manganeseare present, their total value combined shall not exceed 0.5 mg/L. -~ SUBMITTED BY: ' Alb t H. Padovanir M,T.(ASCP) Dire�ctor ` ` � o �� u � �� -.".'.� -. AN LAP# 10323 VMS 111101M YML ENVIRONMENTAL SERVICES 321 Kear Street Ybrktown.Heights, N.Y. 16598 -'^ (9 4 , - ' ''"�' ' '- ��-` 91100- W" Pado��A�';-li1rector - - ` LAB 04004385 CLIENT #: 5698 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FOOTHILLS HOME BUILDER 330 WEST 45TH ST NEW YORK NY 10036 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~�~~ DATE/TIME TAKEN: 05/20/98 12:30P DATE/TIME REC'Dk 05/20/9802:30P REPORT DATE: 05/29/98 PHONE: (212)-265-8189 SAMPLING SITE: LOT #10 SLEEPY BROOK LN. SAMPLE TYPE..: POTABLE : PUTNAM VALLEY,.N.Y. . . PRESERVATIVES: NONE COL'D BY: DAVID SCHWARTZ TEMPERATURE..: < 4C NOTES...: KITCHEN TAP ' . COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE ` 05/20/98 MF T. COLIFORM ABSENT /100 ML ABSENT 100B 05/20/98 LEAD {IMS) 7.2 ppb 0-1Q ppb ` 12345 05/20/98 NITRATE NITROG 2.08 MG/L ` - - 10 9139 � _ 05/20/98 NITRITE NITROG 0.010 MG/L N/A . 9146 �/20/98 IRON (Fe) 04529 MG/L 0-0.3 mg/l 2037 05/20/98 -MANGANESE (Mn) 0.052 MG/L 0"0.3 mg/l 2037- 05/20/98 SOD3UM (Na) 49.1 MG/L N/A 05/20/98 pH 8;1 UNITS 6.5-8.5 9043 05/20/98 HARDNESS,TOTAL 142 MG/L N/A 05/2098 . ALKALINITY (AS 116 MG/L N/A 05/20/98 TURBIDLTY (TUR 4.5 NTU 0_5 NTU . BACT THESE RESULTS INDICATE THAT "THE WATE NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR-THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. _ 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 h ave a LEAD va l ue 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 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain-?o more than 20 mg/L of Sodium. For those on a ` moderately restricted diet, a maximum`of'270 mg/L of Sodium is suggested. ^ '' 'r `��`� , ^ ' YML ENVIRONMENTAL SERVICES . 321 Kear Street Yorktown Heights, N.Y. 10598 ' | Albert H. raoovanz, Director � LAB-#: 32.804385 CLIENT #: 5698 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NON STAT PROC PAGE , 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FOOTHILLS HOME BUILDEM ` DATE/TIME TAKEN: 05/20/98 12:30P 330 WEST 45TH ST DATE/TIME REC'D: 05120198 02:30P NEW YORK, NY 10036 REPORT'DATE: 05/29/98 ` ` PHONE: (212)-265-8189 SAMPLING SITE: LOT #10 SLEEPY BROOK LN. � SAMPLE TYPE..: POTABLE � PUTNAM VALLEY, N.Y. PRESERVATIVES: NONE COL'D BY: DAVID SCHWARTZ ' 'TEMPERATURE..: < 4C NOTES...: XITCHEN TAP ~~~~~~~~~-~~~~~~~~~~~~~~~~~~~�~~~~~~~~~ COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~=~~~~~~~~~�~~~~=~~ DATE 'FLAG PROCEDURE � ' RESULT NORMAL - RANGE METHOD -o < cp �* | / SUBMITTED BY: Al H. F\adovani; M.T.(ASCP) Dir7tor . . ELAP# 10323 15*46 FAX 0144 U. LIJC.Aft COMPANY. FAX js:cg&i� lG IIvCI -UDI�i 1G THIS COVER PAaF- Tmi a YA rW i$ A PROBLEM- I RESIDENTLAL commERcL4L 35. (914) 454 4010.. Ub/ll/lVVU 1b:27 2125814334 00/,09/911 15:60 PAX 91 sr DIRECTlopis: -1-77-n _TN P— ul I pimp PAGE 03 CITY EMPLOYIWENT OF pik"I Municipel 3mov 0 wpjutg VVA uVasto 0 ......... 7 PUMO R.M., AV CANCEL THIS TRAP45ACTION AT ------ int LOAM Uf' 0141b lKAMb, Im.-AL'"ACRUE0 NOTICE OF CAMCFL- iw I !OC6 _UZ; Sam Imcp w Epm. 1p" 0 wo d IT REM. Tom. AV CANCEL THIS TRAP45ACTION AT ------ int LOAM Uf' 0141b lKAMb, Im.-AL'"ACRUE0 NOTICE OF CAMCFL- iw I REM. oral. Fire OVA loutolds AV CANCEL THIS TRAP45ACTION AT ------ int LOAM Uf' 0141b lKAMb, Im.-AL'"ACRUE0 NOTICE OF CAMCFL- iw I L IN VD/11/it"d lb:Yl '.Vfl 2125814334 4- FROM: BE Number of pages includi.ig NSA �JF Lsm ravmO vAtt ouef 0 cmn n chom Mine an _ry P4511C WRY Fam cysvtapw THE TIEPAS OF THIS AGRErapawo ON moym 30DES nF Two-, �U=GM VAM COMM ml I TWO mia w TOTAL CHANG 8 CFO on=. Gb sm pft CAM = mo . em a jo C=3 caftmwis Lop toRa . 11;aw c MQQ. r Wz Xa Wit= Rm!u Fq ra x4m DIM M-_4 am,, Tcu 03 em err; v., 77. V6d T ;WAY CANCEL THIS TRANSACTOOM AT M* TO WIDWIGHT OF THE TWORD @u Fr Em THE DATE OM THIS TRAWS • A,". M AWACHED MOTICIE OF CANCEL- C�Two 'aW OPLANATION OF THIS RIOVr LAMA 4 .4 06/11/1998 16:38 2125814334 PAGE 01 no."09/94 15:66 FAX 9144 L!VARAF r cjw 9u �r ---------------- DIPECT10FIS: 1W ... c 7T�7 RiVeAS UL MN S9 6 'PLACE OF EMPLOYME47 Lsm ravmO vAtt ouef 0 cmn n chom Mine an _ry P4511C WRY Fam cysvtapw THE TIEPAS OF THIS AGRErapawo ON moym 30DES nF Two-, �U=GM VAM COMM ml I TWO mia w TOTAL CHANG 8 CFO on=. Gb sm pft CAM = mo . em a jo C=3 caftmwis Lop toRa . 11;aw c MQQ. r Wz Xa Wit= Rm!u Fq ra x4m DIM M-_4 am,, Tcu 03 em err; v., 77. V6d T ;WAY CANCEL THIS TRANSACTOOM AT M* TO WIDWIGHT OF THE TWORD @u Fr Em THE DATE OM THIS TRAWS • A,". M AWACHED MOTICIE OF CANCEL- C�Two 'aW OPLANATION OF THIS RIOVr LAMA 4 .4 L!VARAF r cjw 9u �r ---------------- RiVeAS UL MN S9 6 'PLACE OF EMPLOYME47 oct%owts- 9 tawft Ist-'ate Water UWW-3.UA— 0& re MuNciag S*oy 0' t9 t Cate 9.. AFFM IM MY Lsm ravmO vAtt ouef 0 cmn n chom Mine an _ry P4511C WRY Fam cysvtapw THE TIEPAS OF THIS AGRErapawo ON moym 30DES nF Two-, �U=GM VAM COMM ml I TWO mia w TOTAL CHANG 8 CFO on=. Gb sm pft CAM = mo . em a jo C=3 caftmwis Lop toRa . 11;aw c MQQ. r Wz Xa Wit= Rm!u Fq ra x4m DIM M-_4 am,, Tcu 03 em err; v., 77. V6d T ;WAY CANCEL THIS TRANSACTOOM AT M* TO WIDWIGHT OF THE TWORD @u Fr Em THE DATE OM THIS TRAWS • A,". M AWACHED MOTICIE OF CANCEL- C�Two 'aW OPLANATION OF THIS RIOVr LAMA 4 .4 -ff DZPAnMZKr0FHHaTH',",' rUnVAMC0UR ,.., woolo, dowhMnadd Beim SM960M CMWL N.Y. 10.512 to Providepstttki eiCERTHiCATE OF COMPUANCZ N now iroR szwA= 9wosAL smw P Town of Pbthdfir- Vc .6t1ley ,� Brook Falls & Sledoy Brook Lane TMM W. VMW' -8 4-�� .7' P 0 _X lot Omm/Appeptio Naliall, Brookfalls Development Corp. Date of Pireviom App m"d 512 9 9:6 Nw&g Ad&. 330 West 45th St., Apt-. Lobby E Tor. New York . ZIP .10036 Datp, Subdivision Approved 6/20/90 #2477A Pee Enclosed Amnfint- Rdsidential 1,360 Ac. seldbe Ty" W Am. . socdo" . 1 0* Dep& —VobmKober o Bedrooms DesigFlow G P D 00 PCHD Nodlen I don - Is Reiluked'Wben FM III completed sepwaft uWamp Sydm to can" d — 1 0 0,,G B. Septic T"k gad 6 10 of 24". w d a h_qnrpHnn trPnch Tobe,j, I ctedby to be determined Ad&vu Water suppir paft SW* p0m, A&hew on X _—F d,.b Sp* NEW by t o b e . ---Ad&ua I represent1hat I am wholly-and completely responsible for the dasion4nd-location, of. the proposed system(s).,I) that the separate sew a900di!wlV*rn above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and rag lallons nom U U, County DepMnmt of Health. and that on . completion thereof a --c�ificate of 6ristruction compliance" satisfactory to this Commissioner of Hufthwill be submitted to the Department, and a written guarantee. will be furnished the owner,'his successors, heirs or assigns by the bulkier, that said bulkier will piece -in good opoistift condition any port of said saws" disposal syitim during the period of two (2) years Immediately following thedate of the.lau- once of the approval of the Certificate of Construction Compliance I of the original system 'ny repairs thereto; 2) that the drilled well described above t will be located as sliawn on the approved plan and that,seld well will be MOST I accor, co/7i r his standards, rules and rogu%TMns of the Putnam County Delartmen of Healith.' Date Oct 10, . 1996 Signed— A I cildress—Badey & Wat, APPROVED FOR CONSTRUCTION: This approval 6XPW.46 two Y"FS 4 revocable for use or may Ili or modified when considered nee "Mulf" disposal of domestic sanitary Rev.. 'P_V Dot By 10/188 P.E. __X_ R.A. to Issued n s construction of the building has been undertaken and Is the CO'Oner Of NMlt h. y change or alteration of construction I /o► pry or supply only. Title —A& DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 _ (914) 278 -6130 16LICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # PV -17 -93 WELL LOCATION Street Address arQok FAIls 9 Town/Village/City Tax Grid Number SIPapy Snook ZMAG Putnam Valley 94-1-44 s WELL OWNER Name Mailing Ad ress ( riva e Brookfalls Dev° Corp. 330 West 45th St., Apt. Lobby USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL ® BUSINESS ® INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP ® ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify []INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT 6 gpm /# PEOPLE SERVED 8 /EST. OF DAILY USAGE 800 Eat ® REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13. ADDITIONAL SUPPLY ® NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL ls_ de REASON FOR DRILLING DETAILED REASON FOR DRILLING . ° WELL TYPE X DRILLED DRIVEN ®DUG ®GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF TELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Foothill Estates West Filed Map No. 2477A, Date 6/20/90 Lot No. 10 MATER WELL CONTRACTOR: Name To Be Determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __X_NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY DISAYLcE= TO- PT:'vPERT1' FRGi ` +%A LOCATION SKETCH & SOURCES OF CONTAMINATION [DON SEPARATE SHEET Oct. 10, 1996 (date) PROVIDED (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 any and'all water or waste products from such well property and in such manner as not to degrade o / c Date of Issue: G'� �'' 19 Date of Expiration d v shall take appropriate action to assure that dril g operations be contained on this r oth rw a cX e 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 BADEY & WATSON Surveying and Engineering, P. C Route 9 (914) 265-9217 - 739-3577 628-1800 FAX (914) 265-4428 Mr. Robert Morris, P.E. Putnam County Department of Health 4 Geneva Road Brewster, NY 10509 Copies Date No. Description LETTER OF TRANSMITTAL Date: October 11, 1996 Re: BROOKFALLS DEVELOPMENT CORP> Revised SSDS Sleepy Brook Lane Putnam Valley PCDH Permit # PV -17 -93 Sent By: ❑ US Mail ❑ UPS ❑ UPS Overnight 1 10/10/96 Construction Permit for Sewage Disposal System 1 10/10/96 Application to Construct a Water Well 4 10/10/96 1 of I SSDS Plan ❑ Fed Ex 0 Messenger ❑ Pick-Up Remarks: Applications and drawing revised from four to 5 BEDROOMS pursuant to request of Mr. Schwartz subsequent to your reviewing floor plans with him. 01 :C I'M I 1100 96 Signed: J&4,P. Delano, P.E. SOAUS H-LIVIH AN3 Copy to: File ?i.l n o j i,i v �,j i n d 0 __3 A I ^3J T APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYS'T'EMS R_FV#EW SHEET for-CONSTRUCTION ]PERM/ II z - STREET LOCATION -.. . - NAME OF OWNER BY B. HEDGES R.MORRISL THER DATE —J—/ TAX MAP # - DOCUMENTS. Y = PERMIT APPLICATION = PC- I . = WELL PERMIT PWS LETTER = ENGINEERS AUTHORIZATION = DESIGN DATA SHEET(DDS) M CORPORATE RESOLUTION = PLANS THREE SETS = HOUSE PLANS - TWO SETS = VARIANCE REQUEST SUBDIVISION = LEGAL SUBDIVISION = SUBDIVISION APPROVAL CHECKED = PERC RATE = FILL REQUIRED DEPTH = CURTAIN DRAIN REQUIRED =STANDPIPES GENERAL = EX- APPROVAL SSDS ADJ. LOTS Y = EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE = IF PUMPED PIT & D BOX SHOWN & DETAILED ® HOUSE - NO. OF BEDROOMS = WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM _= PROPERTY METES & BOUNDS = HOUSE SETBACK NECESSARY (TIGHT LOT) = HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE = NO BENDS; MAX. BENDS 45° W /CLEANOUT, FILL SYSTEMS = CLAYBARRIER = 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE = FILL SPECS = FILL NOTES = FILL CERTIFICATION NOTE C= DEPTH GAUGES = FILL PROFILE & DIMENSIONS ® VOLUME = FILL IN EXPANSION AREA C� WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH = DATA ON DDS PLANS & PERMIT SAME = LF TRENCH PROVIDED =60 FT MAX = PRE- 1969 - NEIGHBOR NOTIFTFICATION = PARALLEL TO CONTOURS -LEn. TtR- BI/ZBA __ _ .1;o10o% EXPQNS.ION.PROVIDED_ .... - ..... _, . '= 100 YR. FLOOD ELI✓VATi5t�1:. w - _ 4 • �- - -- - .�. ,:..� a..a,�,::;;Y;;�n.,- ..., _ . %__..� - ., ... _ ._. , _.. -. ..._ .. _. _._....�. - .. SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS FIELDS = SEWAGE SYSTEM PLAN - (NORTH ARROW) = 10' TO P.L., DRIVEWAY, LARGE TREE,..S..,I DJ OF FILL CIS SSDS HYDRAULIC PROFILE = GRAVITY FLOW = 20' TO FOUNDATION•WALLS W 15' WELL TO P.L = CONSTRUCTION NOTES (GRINDER NOTE) = 100 TO WELL, 200' IN D.L.O.D., 150' PITS = DESIGN DATA: PERC AND DEEP RESULTS = 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) ED TWO -FOOT CONTOURS EXISTING & PROPOSED = 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER = DRIVEWAY & SLOPES CUT = 10' TO WATERLINE (PITS -20') = FOOTING /GUTTER/CURTAIN DRAINS = 50' INTERMITTENT DRAINAGE COURSE = EROSION CONTROL; HOUSE,WELL, SSDS = 200 FT. RESERVOIR, ETC.= 150 FT. GALLEY SYSTEMS = EROSION CONTROL NOTE = 15' MIN TO C.D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' <1% = PERC & DEEP HOLES LOCATED = 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. = REPRESENTATIVE OF PRIMARY AND EXPANSION SEPTIC TAJVK L� LOCATION MAP =10' FROM FOUNDATION; 50' TO WELL COMMENTS: -7 777.7 m .77 T '�`\ °'DM IOa�i�a�al6nY� 'Sae�ka�a.�r�a0:•!1T 1�61t. �. �� ':i m TZ TOW Lane St Sleeper k66-kI. In 44 Q nnul 330 Deft il Pkiew .,:West 45th 'S Lobby E New York, NY, ' 10036 j?al a Subdivision 'Annroyed 6/20/90 t#2477A Fee Enclosed 0.; amp ;.,r en"' nn I . n a U �360 6 Fb* G P nm Tank amid- nf 24" �_ wi Af*��iH.On A. I s * T trpnr rtc) D e, Ptei d 'mined • t o , b 6 determines;;; 'Aflian K ,on Ddbd bF 1, epvm* cthifUjRn wholly an0 compMtely rewnable fa iM de"n Oki'loCat] 6d * Wjj j�06jtjjjCted�jg "�J,?n,thQ fl?pf"Lm��""Aj_.jj4jj 4"Aws�! - , i to*: peop"m _ V"I , q bod M",.bhv, vsrt+ ok siw.,!IaWao -dwbsiv Of co"!IvO.""!r-7r nee of the he Mp d,pba alto that Laid wall W Dice s -';3VNdLA) fA Addraa 'MEUY lt �10 t Th!S, approval oiipirft W6 year tM m re" foj . Cijoij@.�ji, I► fr r y 4d"Md *t":4D6n' ivicemkii'a na Oeroft. -Approvedlor diviollie of domaii . it i i in acCOfd 46m-Wli 6,lfie ki4Aiiliii, ilulik and"llu's' h. Ens Zo �Xnm;, vwnam t C`I.in of, Hoe fthwill iwmr 6i a.Uwm ' , WiiO.MiCmid , W'mir will I the pei6i of w"f6looi�Ijiedt* tialum. -d t) tlNt teAilliedwell ies6raw, above ee Kee ft lade ti rules r1illim 11,I of "AhilOiAnial" a X�L N , 62505- icem . lc*nn N Inved'u . n , fewconstruction oi ' "the buiidlft'f��i bmi U-nd'SiUk'On and is 14 C ribi . *'0! A41ih.".'Any C#Wnge or alteration , , of construction or supply 1, UP Tit IE r- DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 .. .-.. •r•m l8r PL1�C'bTdVLtl 10�CVLtl�TitV 4y1 �L'IJ VYCII L/Ry�W�LL•.: -� ¢ -� .mow ,,• i'.• �.s• v PCHD PERMIT # M LL LOCATION Street Address Town Village City Tax Grid Number Brook Falls & SleeRy Brook Lane Putnam Valle 84 -1 -44 Subdo 1 WELL OWNER Name Mailing Address Ea Private David M. Schwartz, 330 West 45th St., P t Lob E, NY, NY ® Publ,ic USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL ® PUBLIC SUPPLY ® AIR /COND /HEAT PUMP ® ABANDONED ® BUSINESS ® FARM 0 TEST /OBSERVATION ® OTHER (specify, ® INDUSTRIAL O INSTITUTIONAL ® STAND -BY OUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED_S_/EST. OF DAILY USAGE 500 Bat 13 REPLACE EXISTING SUPPLY ® TEST /OBSERVATION ADDITIONAL SUPPLY Z]NEW SUPPLY NEW DWELLING1 13 DEEPEN E ISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING VkDC ?o g SLOPS rO<' tJeVJ fZk.,'S10E*J (ALL TYPE ®DRILLED ®DRIVEN 0 in, GRA VEL UOTHER 15 WELL SITE SUBJECT TO FLOODING? YES _ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes, Foo i states W6st Filed Map No. 2477A, Date 6/20/90 Lot No. .WER WELL CONTRACTOR: Name To be determined Address: IS PUBLIC MATER SUPPLY AVAILABLE TO SITE: YES X NO NNE OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY _ LOCA TI ON SCETC H & SOURCES E S OF CONTAMINATION IO N PROVIDED ON SEPARATE SHEET (date) t (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 drillin operations be contained on this property and in such a manner as not to degrade or oth ise Mn am a surface or groundwater. _ate of Issue: 19 13 Date of Expiration 19_ Pe Mil Issuing Official Permit is Non- Transferr ble White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller L rOOD[QtYD>Dr OFMACI>; r \Dirk_, 4 sW sae�ka� Qaa1: w.Y. 18312 termob Paul, vj an L'ER1CYB OF COMMANCO COl1F1RU � WWAM DEPOSAL SMM I Ptl –'; 3 – T/O Putnam Valley ...4. ... w. - r �..'� -. � �:��..�a';✓ . -�.. e.t�: v ri :.Y �:�P,rfl�'. v'. a+ o_ �..- '!•..'��."l w... �. T T� ?s West ww- W 1 ~TU Nbp 84 Mock 1 --Lt _ RO WW L_o OwaadAppSma�tMatAa Niles Schwartz Date of Prevlosta Apptoovd mats Ames 330 West dgth �+ -er $O -1A i+�.� E---- Tmm New York, NY �, 10036 Date Subdivision Aworoved Fee Enclosed ❑ Amn=,nt- s.i1•s Tjp Residential W Am 1.187 Ac. PE Same. o* LJ D.P* Tam Metal low Of Hai- 4 Desku Plow G P D 800 PC® NodDeadoes Is Revn`ed Willa PM Is catplated gspwi1a saw spsials to amM dl, 250 na. sV& Trier , 440 LF of 24" wide abhorpt i nd trench T ,w a by to be determined Ad&m Water SI"►t raffl: Sarah Pka is Al &vn .�, X Ie.H..A. Sup* Dtaeaf by to be determin O& Sewage pump & pit with audio - visual alarm. in dwelling 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the a�►ate wawa a dif ofal s stem above described will be constructed as shown on this approved amendment there to and in accordance with the standards, rules erne rpu a ores o e a m County Department Of H WNh. and that on completion . thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Nealthwill be submitted to the Department, and a written guarantee will be furnished tM owner, his successors. heirs or assigns by the buildar, that said builder will geaee in good Operating condition any part of said eawage disposal system during the period of two (2) seers Immediately following thedate Of the Ismaa- Ofts Of the approval of the Certificate of Construction Compiler u of the original system Of any repairs thereto; 2) that the drilled well described above Will be located ere aelarra on the approved plan and that seb well will fie Instal . inn �ordangr�a}tia )the ysndar s. rubs and rpYTai onT s of the Putnam County DMINtoo t w Health. � L r .� / (p era June 8. 1 signi0 l - P.E.X_ N.A.- Address License No -WM APPNOVEO FOR CONSTRUCTION: This apprewal expires two years fr t date Issued can structlon of the building has been undertaken and Is revocable ter cause,or mat a amended or modified when considered by the Commt of Health. Any change or alteratgn of construction ra0uirss a ne„r mit.. for disposal of domestic sanitary and/or privet t y only. Zev. . l/! `G O/88 Oate BY Title APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS r REVIEW SHEET for CONSTRUCTION PERMIT " 1VAME OF'OJR BY DATE TAX MAP # ,/'DOCUMENTS. DISCHARGE (OK) LL�--�, 7L-L APPLICATION CII ERC & DEEP HOLES LOCATED 4 Y RESENTATTVE OF PRIMARY AND EXPANSION ERMIT; PWS LETTER EXP. AREA: SHOWN: GRAVITY FLOW SUFF. SIZE AUTHORIZATION ff U. DESIGN DATA SHEET(DDS) DEEP HOLE LOG °CONSISTENT PERC RESULTS (3) PERC HOLE DEPTH CORPORATE RESOLUTION PLANS THREE SETS u DOUSE PLANS - TWO SETS 'VARIANCE REQUEST GENERAL .' LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED m PERC RATE m FILL REQUIRED m CURTAIN DRAIN REQUIRED MSTANDPIPES m EX- APPROVAL SSDS ADJ. LOTS m WETLAND (TOWN/DEC PERMIT R & D) DATA ON DDS PLANS & PERMIT SAME m PRE- 1969 -NEIGHBOR NOTIFIFICATION Lm LETTER BMA ' 1: .90. YR:.r FLCaOD'�JX — 1TON . - - -- SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE ® GRAVITY FLOW D/ J BOX m TRENCH/GALLEY m P- PTT DETAILS /S�EPTIC TANK - SIZE, DETAIL WELL DETAIL„ SERVICE LINE IF OVER CONSTRUCTION NOTES (GRINDER RATE) &SIGN DATA: PERC AND DEEP RESULTS TWO -FOOT CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES CUT FOOTING /GUTTER/CURTAIN DRAINS COMMENTS: J.PUMPED PIT & D BOX SHOWN & DETAILED MOUSE - NO. OF BEDROOMS WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SE R - U4 "/FT. 4"0; TYPE PIPE NO BEND ;MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS ORIZONTAL: SLOPE 3:1 TO GRADE . FftFY(H P ECS GAUGES ROFILE & DIMENSIONS m ME TRENCH TRENCH PROVIDED -0 FT MAX ARALLEL TO CONTOURS t100% EXPANSION PROVIDED ,T013.L., DRIVEWAY, LARGE TREES; TOP OF FILL - TO FOUNDATION WALLS ) TO WELL, 200' IN D.L.O.D., 150' PITS I TO STREAM WATERCOURSE LAKE (INC.EXPAN) UEJ >50' TO CATCH BASIN, 35' STORMMIDRAIN, PIPED WATER k0' TO WATER LINE (PITS -20') 1 50' INTERMITTENT DRAINAGE COURSE 200 FT. RESERVOIR, ETC.CL] 150 FT. GALLEY SYSTEMS SEPTIC TANKS I , FOUNDATION; 50' TO WELL WELLS 15' WELL TO P.L- #' PU.TNA M COUNTY DEPARTMENT OF HEALTH APPLICATION FOR APPROVAL OR PLANS FOR A WASTEWATER DISPOSAL SYSTEM c �y ..� -::• .....�.;�r'r..e+: :,•: • ° =T � .�n�:'i ... „. ..,� 'r . '_ .. ...'may:' „;.��-.: ...:y:. ..T r.,e,n'ir... -.T �. .A`:r' . .:4'.�•. , �e�•,:r,: Name and Address of Appl icant: David M. Schwartz 330 West 45th St.,. Apt. Lobby E Newyork, NY 10036 2. Name -of Project: David Schwart 3. Location TMXK: Putnam Valley 4: Project Engineer: John_ P. Delano 5. Address: BADEY & WATSON, Surveying & Engineering, P.C. U.S. Route 9, Cold Spring, NY License Number: 62505 Phone: (914) 265 -9217 6. Type of Project: X Private /Residential Food.Service Commercial Apartments Institutional Mobile Home Park Office.Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? TYpe.Status (Check One) Type I.. Exempt Type II. X Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? No .--,)Has DEIS been completed and found acceptable by Lead Agency? ........... N/A 1 Name of Lead Agency N/A 11. Is this project in an area under the control of local planning, zoning, Yes or other officials, ordinances? .. ....... .. 12. If so, have plans been submitted to such authorities? No 13.. Has preliminary approval been granted by such authorities? N/A Date Granted p/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 located near a, public water supply. system? .................. No 18. 'If yes, name 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 systemNJA _ )ate observed: 23. Name of, Health Inspector: Michael J. Budzinski '- project design flow (gallons per day) ...... ............................... 600 2. 25 Is State - Pol.- 1.utant Dische.- rge,Elamination-�System (SPDES) f?err it_�$aEi �red? :1Vo +1 Z.- c.:Y.�`• ..o.v:- coo— ;,— v-""""'�' j _x.: Has SPDES Application been submitted to local DEC Office? N/A 27. Is any portion of this project located within -a designated Town or State No wetland ?... ..... .......... 28. Wetland ID Number . .......... ..................... N/A 29. Is Wetland, Permit required? ..... No Has application.,been. made .tb "Town or Local DEC Office? ...... 30. Does project require a DEC Stream Disturbance Permit? No 31. 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 NO 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 known source of contamination? .........:.....YES or NO No DESCRIBE: Is there a local master plan or file with the Town or Village? Yes 34. Are community water, sewer facilities planned to be developed within 15 years? NO 35.. A.re.any.sewage d:i_spgsal. areas in_ excess of 15.ro sl.oPe? 0 36. Tax Map ID Number ............................ .. ........................84 -2 -44 37. Approved Plans are to be returned to: ................ Applicant X Engineer 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 be7 ief. False statements made herein are punishable as a Glass A Misdemeanor pursuant to Section 210.45 of the Penal Law. A SIGNATURES & OFFICIAL TITLES: Engineer for appli BADkY & WATSON, Surveying & Engineering, P.C. MAILING ADDRESS: U.S. Route 9, Cold Spring, NY 10516 PUTNAM COUNTY.DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE DISPOSAL SYSTEM FILE NO. ., 0 mp, -' . Pavi 4N. Sdhw6ttz > =.�, , °. - �,� D ', R988,330: Wi '45th Sf: -Apt -LOUT .E;-NY 'NY`.'10036 LOCATED AT ( STREET) Brook Falls Rd & Sleepy .Brook Ln SEC . 84 BLOCK . 1 LOT 44 (indicate nearest cross street), Subd. Lot # W . r.. MUNICIPALITY WATERSHED Peekskill Hollow Brook SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS DATE OF PRE = SOAKING 12/13/87 DATE OF PERCOLATION TEST 12/14/87 HOLE 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• A 2:16 - 2:46 30 28 1/2 31 21/2 12 2 • 2:48 - 3:18 30 28 30 1/4 2 1/4 /4 13 3• 3:19 - 3:54 35 27 3/4 30 1/4 2 1/2 14 4. 5. 1• B 2:21 — 2:51 30 28 1/4 30 3/4 2 1/2 12' 22 :326_ -_- .33 - __...: _ _ .. 28 -30 3 /4� _ _ _. 2' 3;L4.. 1.2, s 3• 3s2R — e5� 30 2A 30 112 2 1/2 12 4. 5o - 1. 2. 3. 4. 5. NOTES: 1. Tests to'be' repeated at same depth until approximately equal soil rates are obtained.at e'ach:.percolation test hole. All data to be submitted for review. 2: Depth measurements to be made from top of hole. rev. 9 /85•" TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES I G. L. Topsoil to 8" Topsoil to 8 silt loam silt loam 21 to 61 0" to 51 211 3 41 It if 51 6' sandy loam sandy loam 71 to 81 0" to .71 0" 91 it 10, water @ 81 0" 12, 13, 14. INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED 89 oil INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED 8° - -0" DEEP HOLE OBSERVATIONS MADE BY:BADEY & WATSON,P.Q. DANE Surveying & Engineering, P.C. DESIGN Soil Rate Used 11-15 Min/1" Dropo. S.D. Usable Area Provided 5000 SF No. of Bedrooms 3 Septic Tank Capacity 1000 Absorption Area Provided By 76 L.F. x.24" width trench Other Name gals. Type Concrete gnature � Address Route 9 SEAL Cold Spring, N.Y.. 10516 0 0 Soil Rate Approved sq.ft/gal. Checked by - Da 101"" OF PJEW 1i;01, r Oz FO PijTNAN[ C01I14TY DEPARTMENT OF HEA�r�i" PM51QN QF,E ENV �QNMENTAY, HEALTH E_RVICE . 'Y V'TX M...A •'y`.a n,..::lK..f.•. ^.r.00 �....... '.: 'N !r etc -rY ^ fti'. �.[. �T•�!!`nC�1�• A iin 1w �'a.�.iM ^.'r .;+.• .e;. N, ... ... . RE: Property of: NILES SCHWARTZ Ldbated ate Brook Falls Rd. &.Sleepy.Hrook "%,Ane T /O- Putnam Va I' Y Sectixon' 84 B1, ek ] 1,dt 44 Subdi:vsipri .Q.f; :Foothill Estates West Subd. Lot No. .10'.. Filed MA P No. 2417A Date 6 -20 -90 Gehtlement. This letter is 'to authorize John P.Delano, !P .'E , a duly licensed Profoss.ion.al ,Engineer., 'to. 'apply' for a Construction Pei^mit for a Sewage Disposal System and /or a Private Water'Supply, to.serve the above. noted property in.accprdance 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 Art o - 415adi- • 14 It,' ,' ub ` t �,dw;�_-'tlSe::IrubT:ic. Putnam.County.Sanitary.Code. Very truly yours, BAD _WATSON. Surveying.& Eng Being, P.C. r by• John P.' Delano, P.E. NYS Lic. No. 62505 U. S Route 9 'Cold Spring. ,. N. Y. 10516 ( 914 ). 265-9.217,* Signed Owner of Property 330 Wgst_:45th Street_ Apt. obbv E New York, NY 10016. Address. 2tZ 2�5- t�1� Tble'phone . TOTAL P.O3 BADEY & WATSON Surveying and Engi.neering,. Route 9: COLD SPRING, N.Y. 10516 FAA (914) 265 -4428 TO Putnam County Department of Health Geneva Road, Route 312 Brewster, NY.10509 LJETUFEM.;: (T)OF a. DATE 3..::.:86 L NO. _ ATTENTION Robert Morris RE: David Me Schwartz SSDS Permit Application Brook Falls Road Town of Putnam Valle TM 84 -1 -44 Sub Lot 10 1 > 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 ❑ For your use ❑ Construction Permit Application 1 copies for distribution > ❑ As requested Design Data Sheet 1 ❑ Return corrected prints PCDH Form PC -1 1 Application to construct a water well 1 ❑ FOR BIDS DUE Letter of Authorization 1 ❑ PRINTS RETURNED AFTER LOAN TO US Check # 53 7vlo for Application. fee of $300.00 2 should have any questions. 3 Bedroom house plan sets 4 Please sign and return with the owne r "and Building Proposed SSDS Plan THESE ARE TRANSMITTED as checked below: EX 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 Please call if you should have any questions. The extra SSDS Plan is for our records. Please sign and return with the owne r "and Building Department's copies. COPY Thank you. SIGNED: Kurt Schollmeyer if enclosures are not as noted, kindly notify us at once. BADEY & WATSON Surveying and Engineering, P.C. Route,9 C61d Spring;' NY '10516 (914) 265-9217 739-3577 628-1800 FAX (914) 265-4428 TO: Putnam County Department of Health 4 Geneva Road Brewster NY 10509 We are sending you: Attached Via: U.S. Mail Copiea Date No Description 1 6/8/95 SSDS Permit 1 6/8/94 Well Permit 4 6/8/95 SSDS Plan LETTER OF TRANSMITTAL Date: June 8, 1995 Attention: Mr. Re: Niles Schwartz SSDS Permit revision Sleepy Brook Lane Town of Putnam Valley TM#84-1-35 These are transmitted: For approval Remarks: The plan has been revised to include a sewage pump. Copy to: Signed: Kurt Schollmeyer, P.E. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 AFPI:=IC�±OE, -TT ttRUCfi, k- WATER "WFLi,...,. PCHD PERMIT # PV -33 -93 ILL LOCATION Street Address Town/Village/City Tax Grid Number WELL OWNER Name Niles Schwartz, fling A dress 330 West 45th., Apt. Lobby E., Private 0 Public USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP 0 FARM 0 TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY ® ABANDONED 0 OTHER (specify AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 60_ 0 Sal ® REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION ® ADDITIONAL SUPPLY M NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL To supply ro sed residence REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN ®DUG ®GRAVEL. LjOTHER IS WELL SITE SUBJECT TO FLOODING? YES x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes, Fonthi11 E,state.9 West, Pilr_6 Map ps 7G77A, natP F /90/can Lot No. 1 WATER WELL CONTRACTOR: Name to be determined Address: `J PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO WAKE OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY DISTANCE- TO:- PROPERTY._FROMINE, ARES7':..WAT -ER LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET Jame Ad 1 c?c35 (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 tooff degrade or otherw's contam" to surface or groundwater. e of Issue: 2 19 . G3 �- Date of Expiration Z L 19 .'Permit Issuing Official Permit is Non - Transfer able White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller Lt. RECO CONVERSATION,- RD PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmenal Health Services Facility:_ "-�Voog 21—x--s toT Town: Time: C?! 4 7 Date: 9 8 Telephone �- eallet's 1,q me: DISCUSSION: �rzo"vlz- t-V&-L-S 1 C7 -I 00 rAD IL lao" S Lr*- / S L A-n Signed:_ Date: Rev. 6/97 YML ENVIRONMENTAL SERVICES 321 tear Street Yorktown..-He.ights, :.,N �9 (914) 245-2800 Albert H. Padovanip Director 32.804694 CLIENT #: 5698 NON STAT PROC PAGE 1 NNN --------------------- ------------------- -------- FOOTHILLS HOME BUILDER DATE/TIME TAKEN:.05/29/98 01:40P 'WEST 45TH ST DATE/TIME REC'D: 05/29/98 02s3OP 'YORK, NY. 10036 REPORT DATE: 06/03/98 PHONE: (212)-265-8189 SAMPLING SITE: LOT 10 SAMPLE TYPE...,-POTABLE PRESERVATIVES: NONE .,CDL'ID BY: TEMPERATURE..': < 4C �,��TES...: KITCHEN TAP METH. N/A -------------- DATE FLAB PROCEDURE RESULT NORMAL RANGE METHOD 05/29/98 IRON (IMS) 0.215 MG/L COMMENTS.- ,,,-,O,%Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. T Nr .9 SUBMITTED BY: Albert ILLPadovani, M.T.(ASCP) Director ELAP# 10323 --il--- }4,. " >-- � 17-1-""-".-:�--,-,--,-� � — ;. - -- -- - -i,� � . I Icie 11�77 sw�!g Type Residential It Am 1.360 Ac M.Secdon O*= D,*& _Vdii. Naimbor of Bedimmos- 4 De Flow G P D 800 — PCHD NottDosdon Is Reqohvd,Wbm FM Is cot ndded sopurAm s6ionlip syllsolle o. 6 conew Sp& T. k od 500 LF of 24" wide absorption trench To be one boded b To Be Determined ♦ddms Water SGP*• p PAW Sls * Fnes Addmn arl X PelvaiDe SgPP6 DAW'by To Be Ad&,eas Determined Odw 1"a*11mmalso Cre,present that I am wholly and-compiet ei y responsible for the design' and locatio, . n "of the proposed systerri(s). that the 2parale sewage above described will be constructed as shown Ori the approved amendment there to and in accordance with the standards, r gou rpo � he. County DSP@rtrrOnt Of Hosith, - and that on completion thereof a "Cortif kato of Construction Compliance" satisfactory to the Commissioner of Hoeft will be submitted to the. Departrrient, and a written quarantes w - ill be . furnished the owner. his successors. heirs or assigns by the bulklor.'t bu h r I I . hot said, ilder will pine - in good -Operating condition any part of said sews" disposal system during the period of two (2) years I • once of the approval 'I the Certificate of Construction n Compliance Of the Original cyst or,a . ny-C . a r Saks immediately following the"to of the Imu. - - . 1 0 . thereto; 2) that the drilled well - described above *Iilb4ibcatodisshgWngnthe'approv planandthatuldwellwillbein ;i1h std rds, rules and rog-uTaffo—nsof the Putnam County Department, of Wimith., Date MaV 2 j 1996 Signed, P.E. A— PA. APPROVED FOR CONSTRUCTION: This approval expires two I rivocible for cause or may amended or modified when consid requires a na�N ,#mIt. P owed for disposal of domestic mi Rev. 10/88 in Route 9 Cold Sprinq NY License No 62505 the date. issued unless construction of the building .Ms been undertaken and is ari by the missidner of Health. Any change Or alteration Of construction Is DF at Water supply Only. 5rf;aul� — Title All� PUTNAM COUNTY DEPARTMENT OF HEALTH ' D( Of 7- 1, Ei �— P6 O llIC' EWMCATZ*O -Compw, t2LUTUCTIOF PE "R SEWAC AL SYSTM Peiok 4 3 Bro"OK Fallt & Sl�,bpy Bro&�, Lane. Town of Putnam or Yll tit + 674 Tax Me owmeiriAippeelet Nimes, Bro—okfal Is.Development Corp. Daft of Pn"bo,s Apinovol. 31243 Mmftg Addeein; 330 West 45th St., Apt. Lobby E Town New York 22. 16036 sw�!g Type Residential It Am 1.360 Ac M.Secdon O*= D,*& _Vdii. Naimbor of Bedimmos- 4 De Flow G P D 800 — PCHD NottDosdon Is Reqohvd,Wbm FM Is cot ndded sopurAm s6ionlip syllsolle o. 6 conew Sp& T. k od 500 LF of 24" wide absorption trench To be one boded b To Be Determined ♦ddms Water SGP*• p PAW Sls * Fnes Addmn arl X PelvaiDe SgPP6 DAW'by To Be Ad&,eas Determined Odw 1"a*11mmalso Cre,present that I am wholly and-compiet ei y responsible for the design' and locatio, . n "of the proposed systerri(s). that the 2parale sewage above described will be constructed as shown Ori the approved amendment there to and in accordance with the standards, r gou rpo � he. County DSP@rtrrOnt Of Hosith, - and that on completion thereof a "Cortif kato of Construction Compliance" satisfactory to the Commissioner of Hoeft will be submitted to the. Departrrient, and a written quarantes w - ill be . furnished the owner. his successors. heirs or assigns by the bulklor.'t bu h r I I . hot said, ilder will pine - in good -Operating condition any part of said sews" disposal system during the period of two (2) years I • once of the approval 'I the Certificate of Construction n Compliance Of the Original cyst or,a . ny-C . a r Saks immediately following the"to of the Imu. - - . 1 0 . thereto; 2) that the drilled well - described above *Iilb4ibcatodisshgWngnthe'approv planandthatuldwellwillbein ;i1h std rds, rules and rog-uTaffo—nsof the Putnam County Department, of Wimith., Date MaV 2 j 1996 Signed, P.E. A— PA. APPROVED FOR CONSTRUCTION: This approval expires two I rivocible for cause or may amended or modified when consid requires a na�N ,#mIt. P owed for disposal of domestic mi Rev. 10/88 in Route 9 Cold Sprinq NY License No 62505 the date. issued unless construction of the building .Ms been undertaken and is ari by the missidner of Health. Any change Or alteration Of construction Is DF at Water supply Only. 5rf;aul� — Title All� DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 -.... ; 3. APF 'L7CAT�` ®�' °3�`C�i�iB`T�ttiCm� �iTi�A'i`E��1ELL. _ •=3�'- .::a1 -, :. �. m•'-�:.1:-t_-:.:p.q .,_ PCHD PERMIT #PV -17 -93 TRIFLE LOCATION Street Address Town/Village/City Tax Grid Number Brook Falls & Sleepy Brook Lane, Putnam Valley 84 -1-44, Subde #10 WELL OWNER Name Mailing Address O;Private Brookfalls Devo Corp. 330 West 45th St., Apt Lobby E, NY NY O public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ® PUBLIC SUPPLY. O AIR /COND /HEAT PUMP O ABANDONED ® BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify ® INDUSTRIAL ® INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 600 gal O REPLACE EXISTING SUPPLY O TEST/ OBSERVATION M ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Provide potable water supply for new residence. TRIFLE TYPE ®DRILLED ODRIVEN ®DUG ®GRAVEL OOTHER 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. 10 HATER WELL CONTRACTOR: Name To Be Determined Address: `.LS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __X_NO HARE OF PUBLIC WATER SUPPLY: NSA TOWN /VIL /CITY r; DISTANCE" TO .:.PROPERTY.. FROM .NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED SON SEPARATE SHEET May 21 1996 (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 third, (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 dril g operations be contained on this property and in such a manner as not to de /grade or oth, e cont ate surface or groundwater. e of Issue: y 19 4 Date of Expiration 4 L 19 Permit Issuing Official Permit is Non-Tr ansf rrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller ' r a PUTt A,tf COUNTY DEPARTMENT OF HEALTH Division of Environmental health Services APPEVDIX L AFFIDAVIT — CORPORATE_ OWNGR,APPLICATION _ai i--`. ..�6r':o: cam. -�.. .Tma..�. -. .-j - ✓=.:. `.•�- -. ^_ -;c• -o., -, � .. ...•,.;,. ..... .%�>i " >':w= r`,:.i ^.. FOR PERMIT APPLICATION SUBMITTED TO : PUTNA`t COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: Constructi.oti ( -omit for Sewage Disposal .System & Water Well V. Schwartz ' represent that I am an officer or employee of the corporation and am authorized to act for Pcookfalls Development Corporation (Name of Corporation) having offices at 330 West 45th Street, New York, New York 10036 ; Whose officers are: President: Niles Schwartz, 330 West 45th St., NY, NY 10036 -Name and Address) Vice — President: (Name and Address) Secretary: .(Name and "Addr.eSl)-... _ - _ Treasurer: (Name and Address) and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this 29 day Of Deceinhe r 19-9-5 Notary Public REBECCA W. LINDA NOTARY PUBLIC, State of New York No. 5004353 Qualified in Dutchess County's , Commission Expires November 16, gq 8/84 a Signed: Title: g �,�,,, ,�,..1 :Corporate Seal J?[, l N. COUNTY D1E1)A1Z1MSLrr 01;, HEAL" AP 11 il•! j." 1;: 1 DIVISION OF ENVIRONMENTAL HEALTH SFRVICES propbrit.y o.l._. Brookfalls, DeTeLaMent Corp. :H-61 164 koacl Sleepv Brook Lane Located at (T) Putnam valley Section 84 B.1 o c k Subdivision of foothill Estates.. Werst S 1.11) d v Lot Map Y Date, 6/20/90 —Filed # 2477A Gentl emcii: This Ic-t-tc. is to autliorize John P. Delano, P,F_ ,.a duly licensca professional engineer X or registered architect (Indicate) to apply for a . ,._)nstruction PerMit for a separate sewage' systew'' L:O serve t1joi, above .::o tee property in accordance jqit1,j 61e I-AA i C 5 or regulations a , -3sioner of -�Ile Cou;lLN' ,ul,at4on.s as promul, rated by the Conimi. D e t ju t of I I cal L h -uid to S 1. -,Q n all .necessary Pa -I:j c x- s o 11. 'w. V connection witil this -to .5upervise the con.,itruc.,,,.J-o11. th the provJ.,:ij.ons of 4 c - -.1 confornlit vii or S stem or Y 1;rn 147,: Educ.-.-, Liffli Ilie Public 1-lealth Lzivr, and.t]'C PUtYli-111i I I :tary Code, Countcrsigil C. 4-;, p.r IXXXX, # ?2505 BADEY & WATSON, P.C. Address :US Route 9 Cold Spring NY _ID ..Telephone Very truly yours, Si, i ed 01-nior of 1'r. op: 330 West 45th Address New York, NY 10036 Town (212) 247-3450 j 2 0 10 EXPANSION ON AREA w to V O V .O O DROP BOX (TYP) 1500 GAL. PRECAST CONC. SEPTIC TANK C � , V �0 \ 0 we // 100� E ��PodioiJ 0 ,L=24:54', R= 150.00 L= 65.19' r® AS-BUILT RELOCATION -DIMENSIONS 113 16.3' SEPTIC TANK 1C 29.8' SEPTIC TANK 28 32.7' DROP BOX 2C 55.8' DROP BOX 3A 30.9' DROP BOX 313 58.6' DROP BOX 4A 71.6' END LATERAL Q 85.5' END LATERAL 71.8' END LATERAL 5C 98.6 -.7 - N - E�*-LkTtRAL: O WARNINU: ALTERATION OF THIS DOCUMENT, IN ANY WAY, BY ANY PERSON, NOT UNDER THE DIRECTION. OF A LICFNI'Ni.D PROFESSIONAL ENGINEER OR LAND SURVEYOR, AS APPROPRIATE, IS A ViGLATION OF THE EDUCATION LAW OF THE STATE OF NEW YORK. REVISIONS—.: — -r%r% LOCAT SLEEP' TOWN COUN' T. M. I` STATE SUB[ LOT MAP DATE