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HomeMy WebLinkAbout4342DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -53 BOX 33 04342 i. JA r R'm m 04342 F- - . W r := LORETTA' 1v10LINARI Public Health Director - ROBERT J. BONDI - County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 . Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Richard Davenport 37 Sassinoro Rd. Putnam Valley, NY 10579 Dear Mr. Davenport: December 22, 2003 Re: Addition- Davenport, 37 Sassinoro Rd. No Increases in Number of Bedrooms (T)Putnam Valley, TM #84 -1 -53 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 December 22, 2003 The addition is approved with the following conditions: 1.. The total number of bedrooms must remain at four without prior approval by this ` .department 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly your William Hedges WH:lm Senior Public Health Sanitarian cc:BI BRUCE_ R. FOLEY �•` ` � Public...Ne'ctltff "DitecCor = ''''.., '.,.,. ,�.,..,`�.• . "�. `•z�,,. _. _ . _ - ��- rI;ORETTA- -;•�i10LINARI� R:N•.;' IV1.S"N: ^�°'.'F Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845)'278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 I ADDITION APPLICATION (RESIDENTIAL ONLYM STREET 37 TOWN TX MAP# ?7 /c�'tPHONE �''j� PCHD #� �I -d3 MAILING ADDRESS DESCRIPTION OF ADDITIONi'� \ 'UUYIBER OF EXISTING BEDROOMS_PROPOSED # OF BEDROOMS y (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. Pleaie submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments AL Feb98 BFhouseguidelines BRUCE R. FOLEY LORETTA MOLINARI -R.N_, M.S.N.. Public Health Director 51ssiScrate Public +rleal�h`'7jirector • -;_ =,,., k• __ _'4= �U Director of Patient Services DEPARTNIENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 . Re: Residence Tax Map 1 3 Town 1 Gentlemen: According to r ords maintained by the Town, the above noted dwelling IS - JS NOT �_...•_ . , ,.,....., , , _ _ -' = .... _ . in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORSS RECORD: OTHER 1 L�4 BFhouseguidelines Building Inspector 0 0 c.. - �• ..�... °" -"" lor DEPAR'TKENT OF HEALTH ..:r, '1i �g SCALE:.4 �� APPROVED BY: COTJ;.61`T- .._,,� ,• DATE:' 71f -f DRAWN BY =•" REVISED E DRvM " y��i �t y n, l" i ,l 2',3.0 DRAWING NSJ _ it ELEASED FOR PRODUCTION:- -12522 1'- 1/4'59' -4 314' 58'-4' 21' 33' -0' TYP 1'-a• •fi vz- cow. sra1P N z N N - �' S IP . STE CLI it II II Y . S IP . STE il 1 II II II ' I �.I II II II 11 II II II II II II II a _ '�- - I 1 11 II II II II II II II II II II II II II II II II II II 0 - _ _ F - � j • II II II 11 „II II II II II X11 II 11 11 - I' _ 311 II 11 II u u n n _ _ zu n n n i 11 II II II Il II II II II II 11 II n i u -ll -J` - iL • 1/2• COW. STRIP - I C11T -I 1111 -SIZE L40-5 I 12' 15' -I 3' -9' 7 b �,13' -9' TYPI'_41 I. 2 -2x12 SPFa2 PERIMETER JOISTS 2. 2x6 SPFR2 CEILING JOISTS 3. 2 -2.12 SPFp2 CENTER BEAMS EACH UNIT (EXCEPT AS NOTED) 4. 2.3 SPF12 LEDGER HELD TO TOP OF EXTERIOR 6 CENTER BEAMS 5, CROSS HATCHED AREA INDICATES OMISSION OF CEILING DRYWALL Ce4 R.R. /2 BOX 683 CEILING FRAMING DETAIL L /VERPOO4 PA 17045 ' (717) 444 -3395 oawvR Bn rj�g p —D By- w Ob/23/2001 SE I%4' =,' -I Z FAX (717) 4.4 -7577 Bltt r4r • FROM THE IH910E OUf M!'M.£XCELNOYES.COY � /�� zz •1 XL10931 f., .i ;I 1i i; to yq I g!; *.1 fl h� �r s •I lT' is R;1 a� F' ,: I �✓ 4 PUTNAM COUNTY DEPARTMENT OF HEALTH + �2 a.1�'aW -1. �.I'.'./D•� �NT:� ✓` ^`1'� �AWWY THJER.VE '• °•:mo i .tom+ NMENTIAL- J A L CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR TMENT SYSTEM PCHD CONSTRUCTION PERMIT # FV - 30 Located at 39 SASSI tila RO ORrVC . Town or Village tPu''i NY-1 rti 1�i4 Lc.G r Owner /Applicant Name 39 CYZoTvtJ VArti 1Q000 cc,11P Tax Map V`f Block I Lot --5--i Formerly Subdivision Name f :U' T'NA ►'',1 e� f OX6 Subd. Lot # Mailing Address -19 PR i L1 100— ,uA ry 1% L ( C_ Y �J.Y'- Zip 16 S -7 i Date Construction Permit Issued by PCHD I) t1 G . 300 '2000 _? oz a voii DA r-1 R0 Separate Sewerage System built by 37 Ct2oToiJ _i�, i2csrVo eoy2P• Address a-rf i� 0-J 6', N. Y. I o SCE. Consisting of 1 S Gallon Septic Tank and (30 L . w : – +�' Pg-)Z t=. Pi! C. Pte' Ihl 24„ nZ (4VeL Other Requirements: Water Supply: Public Supply From. or: t/ Private Supply Drilled by 1? F Address 4 POT -A.) A n-i la Vc tN c . Address 1312 W-r-rc ft . 'J . Y'. 1 o-oa C� . _ t,BUMin4 Typ ' P-Te - rey-, , T is be&f c ;m�leted? Number of Bedrooms Has garbage grind9fFc.salled? ►mac; I certify that the system(s), as listed, serving the above e. des ukmYpens� le essentially as shown on the as- built plans (copies of which are attached), ' ac ordan the 'eydCHD C ' struction Permit and approved plans and the standards, rules and regul ion of the P to peartm f Health. Date: Certified by Address 2 `Y o 1l1J I J(4LSN jTZ'VD �2 P.E. t< R.A. # 067,O )W 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 revocatiof,\tnod icati n change is necessary. By: Title: Date: LS O White copy - HD. File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL 1El[IEALTIH[ SERVICES WELL COMPLETION REPORT, 1VQDTIE: Exact location oI well wim alstances to at ieaM <wu PouuaucuL }auumaina w Va t„v..yyW.. . —F—­ ­­-r. •- Well Driller's Name Pa F. Address: 4 Putmu Ave., Brewster, NY 10509 Signature: Date: 9/19/01 Faxy Le Bed]. ` White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Street Address: Kramers Pond Rd Put —Chase Subd. , Lot #9 Town/Village: Putnam Valley Tax Grid # 84. -1 -53 Map Block Lot(s) Well Location Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1-primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock _ Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded X Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes -No Liner:_ Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 540' Depth of completed well in feet 605' Well Log If more detailed information descriptions or sieve ariul*s — "—" are available, please attach. Depth From Surface Water Bearing Well Diameter(in) ]Formation Description. ft. ft. Land Surface 17 Drilling in over Burden clay and boulders 17 Hit rock at 17' " ' 17 32--- Drilling -irn ° rock -set, casing ` routed 32 605 Drillincf in rock aranite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity gpm Depth 560' Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 Volume al. Date Well Completed 9/1/00 Putnam County Certification No. 002 Date of Report 9/19/01 W' P • , 1VQDTIE: Exact location oI well wim alstances to at ieaM <wu PouuaucuL }auumaina w Va t„v..yyW.. . —F—­ ­­-r. •- Well Driller's Name Pa F. Address: 4 Putmu Ave., Brewster, NY 10509 Signature: Date: 9/19/01 Faxy Le Bed]. ` White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 LNORTHEAST LABORATORY of DANBURY �o \N ACCO, o X39 .Mu.z;,PLx xaa : AjrsxrRY . ;.f�.,:. e�xt .:044 �:} a. m �_.. J. 203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 t www.NORTHEAST LABORATORIES.com Q LABORATORY REPORT REPORT TO: P.F. BEAL & SONS DATE SAMPLE COLLECTED: 9/19/2001 4 PUTNAM AVENUE TRAE COLLECTED: 10:30 A.M. BREWSTER, N.Y. 10509 COLLECTED BY: KEVIN B. DATE RECEIVED @ LAB: 9/19/2001 TESTED BY: LAB# 11471 LAB I.D. # PFB -98 REPORT DATE: 9/21/2001. SAMPLE SITE: V.S. QONSTRUCTION, PUTNAM CHASE SUB., LOT #9, PUTNAM VALLEY, N.Y. SAMPLE POINT: HOSE BIB SOURCE: WELL TREATMENT: NONE MAXIMUM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (MCL) OR STANDARD BACTERIAL: • Total Coliform (Bacteria) ABSENT per 100 nil' SM 9223 ABSENT PHYSICALS: • Color (Apparent) 0 - EPA 110.2 15 • Odor ND - - 3 Units • pH 6.91 - EPA 150.1 No designated limits • Turbidity 0.24 NTUs EPA 180.1 5 NTUs CHEMISTRY: o Nitrite Nitrogen <0.005 mg/L as N EPA 354.1 1.0 mg/L Nitrate Nitrogen:....: ".. ; .... T.3.6_ a _mg/L as.N . y_..�. $F135 3'�a^ _,. - ... 1:On / • Alkalinity 12.0 mg/L SM 2320B No defined limits • Hardness 30.0 mg/L EPA 130.2 No defined limits • Iron <0.03 mg/L EPA 236.1 0.30 mg/L • Manganese <0.01 mg/L EPA 243.1 0.50 mg/L Combined limit for Iron plus Manganese = 0.50 mg/L • Sodium <1.0 mg/L EPA 273.1 20.0 mg/L ** • Lead <0.001 mg/L EPA 239.2 0.015 mg/L * *' ml= milliliter mg/L--milligrams per Liter ND =none detected MCL= Maximum Contaminant Level TNTC =Too Numerous To Count * *Notification Level ** *Action Level COMMENTS: -All holding times (were) met. SAMPLE, AS TESTED ABOVE: XO OTABLE or F06T POTABLE (PER STATE OF NEW YORK DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) RESULTS BASED ON SAMPLES SUBMITTED: 9/19/2001 - -- .,� -- - --�^"'- 6 Laboratory Director -NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 09/25/2001 11:45 ' 9147363693 CRONIN ENGINEERING 1 PAGE 02 n9^ �:2$ ^!` >i9t �F7�i"•� l""Y::�'"DLU1Y'" - -T9 .� "1�.�1, :..�. i r II NORM BT kUQRAT0*T air 2UMSMIK MAo, *0 Mm&'P1T ROAD a D&MWW, CT CTCmft VM4W ' 2031749 -7"9 ww�t,;204Jr 2 BY Cat 1%411 �g imam T .j r 1(��06Lia✓„ ' ' e.%. ` LAB: *I*Mg � LOO 1471 ' �falf�0� {j L. LOT 09e Knbku WAM, Ay. ' Amwt 1w l oo ml sm m AWWri I • ® �ei 11@2 � 15 1 - 3 Unrts 1 r 6.91 4 19-A 2 l id® duos® 1tiT 6.24 US EPA la 1 316TJi { 136 m51;, e N 9PA3343 lip MWL su m drgi w Baits! AD MA WA 13 BTs AAbad Isliti. 4.011 M91 SPA 2341 0,30 AOL � a 02 �g/Y VA3411 9.5014WL t �' itY�it/b!� pM1Y Mop►�sa Odd fq� e1.0 mgl¢ EPAx9 1 10,0 c2.001 mg& w1k $3 ;b.o1! s#r ©.a 1. r vaErsmi pa Lft Y-nag g 9ecaoLSd t�� wn a L ��se ltiue+ To C U&MAM2 w OUT HICTUMW r. ° °aAs�4n Low ; 1JK �EPZ'.l6'11Ab %� �tYiC {' m�elr�e►no757'1' eoey.n.s ®� • � cv�orr• Odtkt 1 4 � o 0 v I i I +� DOM. { STAIN I'�LJn`Lr�• a . ' j f• Z0 �� r n.) J's131H.17 01W389 �5 ?LEEL4Y� 90 . T4 Toez rf W 15a r I.f.:1: 1�1. -.:�� 1(��06Lia✓„ ' ' e.%. ` LAB: *I*Mg � LOO 1471 ' �falf�0� {j L. LOT 09e Knbku WAM, Ay. ' Amwt 1w l oo ml sm m AWWri I • ® �ei 11@2 � 15 1 - 3 Unrts 1 r 6.91 4 19-A 2 l id® duos® 1tiT 6.24 US EPA la 1 316TJi { 136 m51;, e N 9PA3343 lip MWL su m drgi w Baits! AD MA WA 13 BTs AAbad Isliti. 4.011 M91 SPA 2341 0,30 AOL � a 02 �g/Y VA3411 9.5014WL t �' itY�it/b!� pM1Y Mop►�sa Odd fq� e1.0 mgl¢ EPAx9 1 10,0 c2.001 mg& w1k $3 ;b.o1! s#r ©.a 1. r vaErsmi pa Lft Y-nag g 9ecaoLSd t�� wn a L ��se ltiue+ To C U&MAM2 w OUT HICTUMW r. ° °aAs�4n Low ; 1JK �EPZ'.l6'11Ab %� �tYiC {' m�elr�e►no757'1' eoey.n.s ®� • � cv�orr• Odtkt 1 4 � o 0 v I i I +� DOM. { STAIN I'�LJn`Lr�• a . ' j f• Z0 �� r n.) J's131H.17 01W389 �5 ?LEEL4Y� 90 . T4 Toez rf W 15a 13UWAcU Uy. Location Street . Building Type "X DEPARTMENT- OF HEALTH ENVIRONMENTAL - HEALTH SERVICE_ S 2 90SURFACE SEWAGE TREATMENT SYSTEM Tax Map Block g Lot Fa-WAM _11ALLEY < �oillage , t'al-A)A M O H A-se- Subdivision Name Subdivision Lot # I represent that I aftimhollY 'd completely responsible an for the location, workmanship, material construction and drainage of the sewage treatment sy* tem serving the above - described' property,and s 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 of Health, and 1. 1 t.�4 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 The undersign d further agrees to accept as conclusive the determ at n f the bl. Health Direct, e Lutnarn County Department of Health as to whether no the ilur f the I system to ope, - t as ed by the willful or negligent act of the occup t )f te ildi utilizing the A . i), g I Ica 9_Day /4f Year.-J':!51� ) -Si _31 (!P_6TC1/j SAM Corporation Name (if corporation) Address: 31 pea-rel", �1" ROA 0 State /V. 'IV zip 10,!5wo V Title- 3y CROTOA) J ,W RCA_D Oopj' Corporation Name (if corporation) Address: 31 CeLYMA) -DAM k0A%)1 w State — Al. 1 1 zip / 1_> - Form GS-97. 'Lot NO. 9 9 41 0 S1602 Lot 1V0. 10 161.3, p- 09 .24 - Ci O SUIT VE r 0IF PROPERTY BEIAV IOT JV0 " 9 located at . " �PU_TjVA ff CHA SE" As shown on a map filed in the Putnam County Clerk's Office, Division of Land Records on July 25, 2000 as may no. 2832 Situate in the FOXY OF PUTYVAff VALLEY COUNTY OF PUTYVAff, /Vr Scale: 1 "= 50 J4 May 26, 1999 Date of Field Survey Nov. 28, 2000 Date of This Vap March 15, 2001 Foundation Location BRUCE R FOLEY Public Health Director LORETTA MOLINARI�ik, M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (9.14) 278.7921 Nursing Services (914) 278 - 6558 WIC (914) 278.6678 - Fax (914) 278.6085 Early Intervention (914)278-6014 Preschool (914) 27&6082 Fox(914)278-6649 I E911 ADDRESS VERIFICATION FORM OWNERS NAME: .3 7 �tzoTO n9 PAM TAX MAP NUMBER: -9 E911 ADDRESS: ��" ='l A O i?O > TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) ` DATE: 9 PIZ- The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERE M) Y- e ,r .r ' :.. , r 5,.: n�.�i . e. � `'' .. � • ;t uH �s�aSv1 �"i._ i �_ ., �.i �rY. 7f"�i. :' r.' -°,. ,."P.';�4,'...— „,:�.'B�✓; -;�`. -. � c� _ .. ,.v. v- -. �- _ -r.Y�i.. .7. -.;�a` ,+'.�i..r.r.-- '°v`+..:i_„ ......._ ... 'a :��=- �z:�r�.. .,. 4C'� ... -..:I CRONIN ENGINEERING IP.E., P.C. The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914- 936 -3664 Fax 914- 936 -3693 Adam B. Stiebeling, Assistant }Public health Engineer Putnam County Department of health 1 Geneva Road, Brewster, N.Y. 10509 RIE: 37 CROTON DAM ROAD CORP. 66PUTNAM CHASE SUBDIVISION” SASSINODA DRIVE, LOT 9 P.C.DD.H. PERMIT #PV 30-0® THESE ARE TRANSMITTED as checked below: September 19, 2001 ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY WE AM SENDING YOU aftched 1.) Three copies of as -built subsurface sewage treatment system plan 2.) Three certificate of the construction compliance. 3.) Three guaranties of SSTS 4.) Copy of survey showing. foundation location 5.) E911 address verification form,, 6.) $200 certified check for application fee. Should you have any questions or require additional information regarding this matter, please contact me at the above phone number. Thank you for your time and assistance in this matte. Respectfully submitted, Kenneth M. Murphy Project Designer PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at Sassinoro Drive/ Town oix%fif&Z Putnam alley Subdivision name Putnam Chase Subd. Lot # .9 Tax Map 84 Block 1 Lot . . Date Subdivision Approved O-7 —ZS coo Renewal Revision Owner /Applicant Name 37 Croton Dam Road Corp. Date of Previous Approval N/A Mailing Address 37 Croton Dam Road, Ossining, NY Zip 10562 Amount of Fee Enclosed $goo -oo Building Type Residential Lot Area 6,gt No. of Bedrooms 4 Design Flow GPD 800 Ae- Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of of 4" PVC Perf. pipe in Other Requirements: 1250 gallon, septic tank and 1T/Q0 L. F. 24" gravel trench. To be constructed by 37 Croton Dam Road Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Water Supply: Supply From Address or: X Private Supply Drilled by P . F . Beal & Sons, Inc. Address 4 Putnam Ave. Brewster, NY 10509 I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system describ&dihQU will be constructed as shown on the approved amendment thereto and in accordance with the standards, rule ndcr �atY ' the Putnam County Department of Health, and that on completion thereof a "Certificate of Cons tr �` om ' s'a 'sfactory to the Public Health Director will be submitted to the Department, and a written gu to �h�ll be furnishes owner, his successors, heirs or assigns by the builder, that said builder will place in good ope in on ' pa4t f s id sewage treatment system during the period of two (2) years immediately follow' g the dat A a iss ""� �e a v; 1 of the Certificate of Construction Compliance of the original ., a { P Uj P system or any air thereto. :`� w:: o' Signed: 62980 \J P\, P.E. n R.A. Date -2 -11 -00 Address 2 John Walsh Blvd., �1, NY 10566 License.# 062980 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or .modified when considered neoessary_by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it: prove f -r di harge of domestic `sanitary sews _.... By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink cop - Owner; Orange copy - Design Profession Form CP -97 PUT NAM (COUNTY DEPARTMENT OIF HEALTH IIDRVIISNON OIF ENVIRONMENTAL ENTAIL H EAIL'll'H SIERVU CIES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # V-3()- 00 Well Location: Street Address: Tow tM4* Tax Grid # Sassinsro Drive/ _ LOT Putnam Valle Map 84 Block 1 Lot(1)1573 Wen owner: Name: Address: 37 Croton Dam Rd Corp 37 Croton Dam Road, Ossining, NY 105(2 Use of Well: x Residential Public Supply Air /Cond/Heat Pump Irrigatian I -Pri mirty Business Farm Test/Monitoring Other (slecify) 2- seconndairy Industrial Institutional Standby Amount of Use Yield Sought 5 gpm # People Served _�/ Est. of Daily Usage 500 gal, Reason ffoir Replace Existing Supply Test/Observation Additional Supply IID>riBinng __X_ New Supply (new dwelling) Deepen Existing Well Detailed Reason Water supply for new residence. for IIDn-ming Well Type X Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No X Is well located in a realty subdivision? ...................................... ............................... Yeses_ No Name of subdivision '�f -45r Lot No. �q Water Well Contractor: P.F. Beal & Sons, In .4 Putnam Ave, Brewster,NY 10509 Is Public Water Supply available to site? ........... s .`. ..,...C.,o� ...:: ................. Yes No X Name of Public Water Supply: N A Distance to property from nearest water main: Proposed well location & sources of contami ti to &y , ed s6p ate sheet/plan. Date: -7-14— 00 Applicant Signature: \ ��e PERMIT TO CONSTRU ER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED 'FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. l Date of Issue 3v Permit Issui Official: Date of. Expiration Title: c -Permitt is'Nonn -Tn• nn�ff¢>rn•� `le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller F" orm WP -97 PUTNAIII COUNTY-DEPARTINfENT OF HEALTH DIVISION OF ENVIRON1IEN TAL HEALTH SERVICES FINAL SITE RgSPECTION 1 Date: Street Location C----) &S S M 0 rz,D Owner 3 ? � Town Permit # TM 9 (—S2, Subdivision Lot # 1. SeNvaQge Svsteb Area YES a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... / II. SeAge System ,. --� a. eptic t • size -1,000 ....... .,1�......other ................ / b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Dist 'buti n Box L'All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set ........... ............................... f . Trenches Zerigth instIFeJ- 2. Distance to watercourse measured Ft.......... 3. Installed according to, plan ........... .......................... .4. Slope of trench ace table 1 /16 - 32" /foot ............. 5. 10 ft. from property e - 20 ft. undations.......... 6. Depth of trench <30 in es fr o ace .................. 7. Room alto pan 'on, l 0 o ....................... 8. Size of g v /4-1 " d et lean .................. 9. Depth o gr vel in tre h 1 " m um ................. 10. Pipe en pped ......... ......... ... . ..... * ................... g. um or Do e S stems ml�u 2. Overflo tkr� ........ ...... .............�................. ...... 3. Alarm, v sual/audio ................... ..:........ :.......... 4. Pump eas ly accessible, anhole to grad ................ 5. First box fled....... ............... ..............:..... ....... . .... . 6. Cycle witn sed by H.D estimated wlcycle........... M. ouseBui ldin a. ouse ocated pe , pprov plans ............................ b. Number of bedroom . ........... .......... :................ .. . IV. Well a. Well located as per approve lans ............................... b. Distance from STS area asured ' ft ........... c: Casing 18" above grade ........... ............................... ... d. Surface drainage around well acceptable ....................... V. Overall Workmanship. a. Boxes properly grouted ....:.............. ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ..:............................ d. BackfilJ_ material contains stones <4 ". diameter....,,...,.....: drain & staridpipes liistailed according to plan:.' f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... n_.. el -. V/ � COi MENTS 0 1 C I-L () 0 !j -m 09/07/2001 14:26 9147363693 CRONIN ENGINEERING 1 PAGE 01 AMMON JXAJDAM GENE HFUMSIMUMALINSPECIM For: Fill All information must be fully completed prior to any `drenches V" inspections beinp, made. PCHD Construction Fermit # fv— 2 O— 0 0 L6 Located. SPISIAJOAd. _J291Vf__ (T) M - f'V T"IRM L 0,wner/Appli=tN&me:Vcxa,ro.J 4AMTMD CO'Re- TM 84 Block Lot r_? Formerly: Sub"sioaName: CHAM Subdivision Lot Ys system fill completed? U6. Is system complete? of 'Y ~Y Date: 1421-0 1s'system'c6xist�cted.1as'pOr pigns? Is well drilled? )! � EZ Date: Is well located as per plans? Are erosion control menurev in place? I certify that the system(s), as listed; at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Patnam. County Department of Health. Date; _C1 Certified by- CR GA.) J P 6V d1A*6R 641 d' P]E-RA- Design Professio" -L -.roHu t-Ac-rm Mao- Addrm, Comments: I a­ n '511doi (9"NIC, Form FIR-99 SEP-7-2001 FRI 14:18 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL H_ EALTH SERVICES LETTER OF AUTHORIZATION RE: Property of 37 Croton Dam Road Corp. Located at Sassinoro Drive /Kramers Pond Road T/ Putnam Valley Tax Map # 84 Block .1 Lo C 3 Subdivision of "Putnam Chase Subdivision" Subdivision Lot # Filed Map # Z03Z Date Filed Gentlemen: This letter is to authorize Timothy L. Cronin III a duly licensed Professional Engineer X to apply for the required wastewater treatment and/or water supply .permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Departm all necessary papers on my behalf in connection with this matter and to superv' � `n§.. i0 , f said wastewater treatr pe t an17 water supply systems 1 in conformity with e� �%isions o f M 45. and/or .i 47. th cati Lav�!,.the,Public Health - L x the Puti . �-. 62-389 Countersign o `NOFESS� °: 06298 Mailing Address 2 John Walsh Blvd. #200 Peekskill State NY Zip 10566 Very truwwoW ,.,i/ 11 11.1'l,l!A!!1UPJPI1 Mailing Address: 37 Croton Dam Road Corp. 37 Croton Dam Road, Ossining State NY Telephone: (914) 736 -3664 Telephone: (914) 739 -7362 Zip 10562 Form LA -97 'rr"UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT -` CORPORATE OWNER APPLICATION^ . FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Construction of SSTS and Water Supply T Val Santucci represent that I am an officer or. employee of the corporation and am authorized to act for: Name ofComoration: 37 Croton. Dam Road Corp. Having offices at: 37 Croton Dam Road, Ossining, NY 10562 Whose Officers Are: President - Name: Val Santucci Address: (Same as above) Same as President Vice President - Name: Address: (Same as above) Secretary -Name: Michelle Santucci Address: .(Same as abov_e). -- _.. _ Treasurer - Name: Same as Secretary Address: (Same as above) and that I am and will be individually responsible for any to the approval requested and all subsequent acts relating Signed: Title: Sworn toy b fore me this ay of (month) J0,10 (year) Notary Public KELLY M. LENT Notary Public, State of New York Corporate Seal No. O1 LE6026834 Qualified in Westchester Count Commission Expires June 21, 2 Form CA -97 t oration with respect O fl'-5 V2 GD l\ i yb LADS APPROVED FOR+ 3 -2mI 9 ,�0`A�OV� v6 P BEDIIOOMS SOUS r lei Q� ALL.SUBSEQUZNT REVISIONIALI S MUST L 'U M1 wee or ORK To vo x� 1 A ZaD I i36T�ii�Y SODOM= "al" D7i31G5 8" SO 17-5 107-6 D'-5 r p1i i . �s. IF ( /�e ✓rises r `Y� l� s t ENT OF HEALTH � s•. • OOM COUNT ONLY, rni r TIONS 1 u GD l\ i yb LADS APPROVED FOR+ 3 -2mI 9 ,�0`A�OV� v6 P BEDIIOOMS SOUS r lei Q� ALL.SUBSEQUZNT REVISIONIALI S MUST L 'U M1 wee or ORK To vo x� 1 A ZaD I i36T�ii�Y SODOM= "al" D7i31G5 8" SO 17-5 107-6 D'-5 r 1.99 OF — 61iiDW1Si:OM Fi 6T �F 3� r pie !l` +I P�9 gt y`; i p1i i . �s. IF ( /�e ✓rises r `Y� l� s t ENT OF HEALTH 1 OOM COUNT ONLY, TIONS 1.99 OF — 61iiDW1Si:OM Fi 6T �F 3� r pie !l` +I P�9 gt y`; i Y t� 9 24' OVG .:l •' Ink ry •Fy ,� 1 1 � �t ..,1.. 1 � • ' A. t , �y JY t wW 1 , O'N y C-6 VZ Ift N Y-2 1 4. 1 t� 9 24' OVG .:l •' Ink ry •Fy ,� 1 1 � �t ..,1.. 1 � • ' �y , O'N y C-6 VZ Ift N Y-2 1 4. ' T -7 ' 9 -7 YZ A — T � 6 VZ t� 9 24' OVG .:l •' Ink ry •Fy ,� 1 1 � �t I i um w S N I'o V:A,.t i ei r vee RO�r 4aEADERS AND rOOW DRAINS (tip) Lot No. 9 fOOX iXPAA 600U.-470 PLRF. PLC /N 24' VAlfl WAADY cqwd) "'cTov L70X .t221.F-4'. SOLID SORM Pvc p1pr t oc� A 1250 GALLON 6OVOirT 5--17C TANK 12L. F. - 4',0 C4 5 r RON PPF 8 EA7S77AC NrU CXUYDVG WATR SERKE 2AI. — — — — — — 1-1 bo PU.TNAM CHASE — LOT #9. sui AS-BUILT SEWAGE TREATMENT. SYSTEM co/vsls SCALE: 1" = 30 F.T. 4'0 PE SEPAR 37 CRi 37 M OSSIN11 GA 70 PR / VA j P.F 81 4 PUT! 00C'IA0L- O I% r I ern, a 3 3 a DISTANCES TO NORTH E"ND OF SSTS c w NORTY END OF 1ST. TRENCH 74.5' 120.5' NORTH-END OF 2ND. TRENCH 73'. 126' NORTH'ENO'OF 3RD. 7RENQH 71.5' 13f' NORTH END OF 47H. TRENCH 70.5' 137' WORTH END OF 57H 7RENCH 70' 142' NORTH END OF 67H. TRENCH 71' 148' .. DISTANCES TO SOU7N END OF SSTS A E SOUTH END OF 1ST. TRENCH 101.5' 105' SOUTH END OF 2ND. TRENCH .108' 99.5' SOUTH END OF .3R0. TRENCH 114' 94'. SOUTH END OF 4TH. TRENCH 120' 88' SOUTH END OF 57H TRENCH 126' 82' SOUTH END OF 67H. TRENCH 132' 77' BOX DISTANCES C D j.wcwN sox ja 126' 0 „vNcno,v 124.5' 0 xwnav box 83 123.5' 0 .INC rtoN Box 84 123' 0 - fWLT10N&bI'3'.f225'_' 6 -• • WCnov Box 0 123' 0 SSTS DISTANCES A B SEPnC TANK 16' 38' ciEAN our 58' 62' Xf1 LOCH AON X I Y W I Owl 0q • N U.z .Q N ¢ z v U L1.± > ({�• C9 o Z z J zQ y J > Y J y W a W zd Z Z O _ z N m W D W >O {v Z m Zz W r W z z o z ON jj 14L +U-... •;fir yL.C,�. \\ THIS IS 7'0 CER77FY THAT THE SEWAGE DISPOSAL SYSTFiW WAS CONSTRUCTED AS MICA TED ON TNIS PLAN AND 7HAT THE SYSTEM WAS INSPECTED BY ME BEFORE /T WAS COGER£D .OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE W hY ALL STANDARD RULES. AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STA'7F DEPARTI4ENT OF HEALTH. ICE SEWAGE 7REA 7MENT SYS7 ? E) l 1LLBh6VO EVE -S6P7* 7A;VK,'AND '500LF. - °VC PIPE IN 24' DRAWL TRENCH. ?OAD CORP. 37 CROTON DAM ROAD CORP. POAD 37 CROTON DAM ROAD X62 OSSINING, N. Y. 10562 MVP CLS" . PUi7N�,��J-_�.CG? :- a 4 = ' u1,44- Guuuiy uapn+•.meu. u1 abc11:1. 'iviaion of Environmental Health g�y� "roved as noted for conformance vith +881icable Sales and tioae of o c�� I: REASON - REU/SiON AX NAP jE SECTKav 84 BLO LOT- M SUBIC �RA� Ga£Ch:E 2A 7E., 09 -11 -2001 DK-C F /L£: S /AS -BUIL r. 000507 W 0- 0 w J l V) D O g U U} Q z t� D a 09/25/2001 15:21 9147363693 CRONIN ENGINEERING 1 PAGE 01 1 TeRONIN ENGINEERING P E. P.C. he Lindy Building, Suite 200, 2 john Walsh Blvd., peekskill, New York 10566 l. (914)7963664 • Fax. (914)736-9693 SEPTEMBER 25, 2001 ADAM B. STIEBELING PUBLIC HEALTH ENGINEER PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL SERVICES 4 GENEVA ROAD BREWSTER, N.Y. 10509 RE, SSTS CONSTRUCTION COMPLIANCE 37 CROTON DAM ROAD CORP. P. C.D. N. PERMIT #PV -30-00 37 SASSINORO DRIVE TOWN OF PUTNAM VALLEY DEAR MR. STIEBELING: THIS LETTER IS TO INFORM YOU THAT MANDY SANTUCCI WILL PERSONALLY BE PICKING UP THE CONSTRUCTION COPLIANCE WHEN THE PUTNAM COUNTY HEALTH DEPARTMENT HAS ISSUED FINAL APPROVAL FOR THE ABOVE REFERENCED PROJECT. PLEASE CONTACT ME AT THE ABOVE NUMBER WHEN FINAL APPROVAL HAS BEEN ISSUED SO I CAN INFORM MR. SANTUCCI. IF YOU REQUIRE ADDITIONAL INFORMATION OR HAVE QUESTIONS PLEASE DO NOT HESITATE TO CALL ME. SEP -25 -2001 TUE 15:04 TEL:845- 278 -7921 RESPECTFULLY SUBMITTED, e4 Kenneth M. Murphy Project Uesipeer NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 09/25/2001 15:21 9147363693 CRONIN ENGINEERING 1 PAGE 01 -:- Q�NIt+i.>LPi�I�EE�NG .>P:�..:F.C, - .;���a. �_�;. ��_:>,� "��.��:_�.�-= :.3.: =ate: =, ".. .. -� , :.. f• �--.._ .�,.�,�.�;.;�r�= �;�- �' °�:'.��;; he Lindy Building, Suite . 2 john WkIsh B>wd, Qeekskill,'New York I05fi6r Tel. (914)796.V664 • Fax. (914)73&303 SEPTEMBER 25, 2001 ADAM B. STIESELING PUBLIC HEALTH ENGINEER PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL SERVICES 4 GENEVA ROAD BREWSTER, N.Y. 10509 RE. SSTS CONSTRUCTION COMPLIANCE 37 CROTON D•4M ROAD CORP. P. C.D.H. PERMIT #PV- -3x00 37 SASS/NORO DRIVE TOWN OF PUTNAM VALLEY DEAR MR. STIEBELING: - THIS LETTER IS TO INFORM YOU THAT MANDY SANTUCCI WILL PERSONALLY BE PICKING UP THE CONSTRUCTION COPLIANCE WHEN THE PUTNAM COUNTY HEALTH DEPARTMENT HAS ISSUED FINAL APPROVAL FOR THE ABOVE REFERENCED PROJECT. PLEASE CONTACT ME AT THE ABOVE NUMBER WHEN ` FINAL ^APPROVAL HAS BEENtISSUED SO I CAN�� INFORM MR. SANTUCCI. IF YOU REQUIRE ADDITIONAL INFORMATION OR HAVE QUESTIONS PLEASE DO NOT HESITATE TO CALL ME. RESPECTFULLY SUBMITTED, K=eth M. Murphy Project Designer