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HomeMy WebLinkAbout4346DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -57 BOX 33 04346 P�6 APO 04346 a� PUTNAM COUNTY DEPARTMENT OF HEALTH gyJ ES CERTIFICATE OF CONSTRUCTION COMPLIANCE FO ATMENT SYSTEM PC HD CONSTRUCTION PERMIT # V " L( 4 " " v " ti Located at S q SS r4 a 110- .R I Val Town or � i�UT/JA r'''1 VA LL 6:'r Owner /A giant Name,37 CROTOt.) D,OM )20 9 Cc , Tax Map 8i4 Block I Lot S--7 Formerly Subdivision Name V' i � ig r''1 c'ffA re- Subd. Lot # 1 3 Mailing Address 21 5AS.SIA105z a P2 i.ve— & TN A" VA L Le yi /k%t Y Zip Date Construction Permit Issued by PCHD /"r' 1/irt,� mc,R 21� 2v O O 37 CR6TbJ OAA R6A0 Separate Sewerage System built by 37 CGR6Tor+,0y9M ?o Address D-s- l-�JW C ^V- /a.S'Z Consisting of 25Q Gallon Septic Tank and 2 2 L . r y j Zq- y Gi MYL -)7ZE/J C4,/ /,J /2' or- 9�7"J KIZ U J Other Requirements: Water Supply: Public Supply From Address �Z. 07"Pr', nvdF. or: Io,� Private Supply Drilled by 2-f ` O9L /tJC. Address TCWS°rrrL -J, Y. /osn S _II`WL, i €ig-T -j1�'C i�tif:`.i- °�i l_ '.Has:erosion'conti6l been-complete `?, . _.:_� Number of Bedrooms r y -I- Has gar a t . er been installed? of �� ,O ,X I certify that the system(s), as listed, serving 1 a rpreei nstructed essentially as shown on the as- built plans (copies of which are attached), in cwll e.iss d • CHD Construction Permit and approved plans and the standards, rules and regulatio of Punty artment of Health. • ru• ..k w Date: 3 -01 Certified by c,, U P.E. %C R.A. dmxn e�t$n Address 2 TOJ J ad-y P��K -rKf -�s: �0,/XS" License # O6 Z aj S J 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 modi cation or change when, in the judgment of the Public Health Director, such revocatio , modiIti L necessary. By: ._._... Title: Date: f 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 HEALTH SERVICES 2' SA SS lrld Re ®R WELL COMPLETION REPORT Well Locatnoin Street Address:` Lot #13 Town/Village: Putnam Valley Tax Grid # g4 > -1 -57 Map Block Lot(s) Well Owner: Name: Address: S Construction Corp., 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 12-secondary X Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) 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 75 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 140' Depth of completed well in feet 205' Well Log If more detailed information descriptions or are available, please attach. Depth ]From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 8 Drillinc in over urden clay and boulders 8 Hit roc at 8' - -_. 32 = Drillin -�in rock -set casin rQUbed 32 205 Dri-l-linc in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity l�gln Depth 160' Model lOGS07412 Voltage 230 HP 3/4 Tank Type WX302 Volume 86 qa1 a Date Well Completed 8/29/00 Putnam County Certification No. 002 Date of Report 3/27/01 Well ill u NUT E: Exact location of well with distances Well Driller's Name Signature: Perry least two permanent landmarks to be proSc "a on a sepatate sneevplan. Address: 4 Patnarn Ave., Brewster, NY 10509 Date: 3/27/01 White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 : -a , f NE NORTHEAST LABORATORY OF DAN 33 MILL PI:AIN 1ZOAD - DANBURY, °Cf'. - da f - LASS (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT REPORT TO: CT Cert: PH -0404 NY Cert: 11471 P.F. BEAL & SONS DATE SAMPLE COLLECTED: 1/24/2001 4 PUTNAM AVENUE TIME COLLECTED: 10:00 AM. BREWSTER, N.Y. 10509 COLLECTED BY: KEVIN B. DATE RECEIVED @ LAB: 1/24/2001 TESTED BY: LAB #11471 LAB LD.# PFB -015 REPORT DATE: 1/30/2001 SAMPLE SITE: V.S. CONSTRUCTION CO., LOT #13, PUTNAM CHASE SUBD., PUTNAM VALLEY, N.Y. SAMPLE POINT: TOP OF WELL SOURCE: WELL TREATMENT: NONE MAXIMUM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (M[CL) OR STANDARD BACTERIAL: • Total Coliform (Bacteria) 0 per 100 ml SM 9222B 0 per 100 ml PHYSICALS: • Color (Apparent) 0 - EPA 110.2 15 • Odor ND - - 3 Units • pH 6.80 - EPA 150.1 No designated limits • Turbidity 0.40 NTUs EPA 180.1 5 NTUs CHEMISTRY: • Nitrite. Nitrogen <0.005 mg/L as N EPA 354.1 1.0 mg/L • Nitrate Nitrogen 0.24 mg/L as N SM 4500D 10 mg/L Alkalinity- _ 8.0.. _ ,mg/L_ SM•2320B; _ .. No defined limits 4,_' '*l ... . _. - ..... n . , . _ T . - -28.0 • 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 = 0.50mg/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/I--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: —1 OTABLE or OT POTABLE RESULTS BASED ON SAMPLES SUBMITTED: 1/24 /2001 Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 P T NAM COUNTY DEPARTMENT OF HEALTH IE GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot 37 l:eaao D>,4 P IZ0AD feel -, 7ut,vAM 1 %LLC Building Constructed by ow illage 2') S�)Ss w d 2 a D2 t LA:� uT A)AM Ot4AS& Location - Street - Subdivision Name Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful.or nealiaent,act.of the occupant of the. buildin utilizinzg the.,-..-.. . -= system: _ ._ ... ,, ..- .,.... . _ . . � The unde igned further agrees to accept as conclusive the detrant n t on the bl' Health Direc or he P m County Department of Health as to wheth n t the lure a system to oprate ca ed y the willful or negligent act of the occu o t e b ldin ilizing the PI Dav {d Year Z ° 6 ( Si Title: ) - Signature 37 j'2orv� IMAM �OAi) (�o�i'. 3-t e► .L.,j j>A Corporation Name (if corporation) Corporation Name (if corporation) Address: 37 a -c,o -DAw Ail State �1I. y. Zip 10562 Address: 51 CIty,,j PAq ROAD. 055f -v "Iv6 State 'Al y Zip /'056 L . Form GS -97 Public Health Director ORETTA k4 '. i -L— OLrUAkr- k Associate Public Health Director Director of Patient Services DEPARTNENT OF HEALTH I 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) 279-6082 Fa(914)279.6&8 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: Deq> - ,. AUTHORIZED TOWN OFFICIAL: . (Signature) DATE: 01 0 X *A The Putnain County Departinent of Health will not issue a Certificate of Construction Compliance unless the above form is complet i.e., a1eg ­61 E911 _ address is assigned by an authorized town official. This form is . to be siibinlifted with the application for a Certificate of Construction Compliance. (E911 VERFM ­v, Z9 CRONIN ENGINEERING P.E., P.C. The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914-736-3664 Fax 914-736-3693 Adam B. Stiebeling, Assistant Public Health Engineer Putnam County Department of Health I Geneva Road, Brewster, N.Y. 10509 RE: 37 CROTON DAM ROAD CORP. "PUTNAM CASE SUBDIVISION" SASSINORA DRIVE, LOT 13 P.C.D.H. PERMIT #PV-44-00 ac�r�a o� o��a April 3,2001 THESE ARE TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMNENT X PLEASE REPLY WE ARE SENDING YOU attached 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 7.) Well completion report 8.) Laboratory report 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 . . �C • . ',f .. .. _ ^ � ' �S :e.,•� m... .-�. .. i , .. f�_ � �� • _ _ i,.�n c Jd. � + G.. � .+`'.. . � • �C p,.�:a�w. W , r .. .- Ic \� 0 ohM 06 t � � ,m .Ipj� •grg C1 � _. �27•`�8, .mss r�' 1� N qi 'o 00, `9'9t �o Osa`� 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: :Ste�t�Loc 'o i- - '� ; , '', _. V • . "4 veer P2 Town Permit # �{ - TM # _ 8 — — -5� Subdivision Lot # t 1. Sewage Svsteth Area 'ICES a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth l� 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. Septic tank size -1,000 ... .1,250 .......other ................ b. Septic tank installed level ............... c. 10' minimum from foundation .......... ............................... d. st ti n Box 1. A l outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft-Original soil between b9T trenches e. Junction Box - properly set .............:... . j� ............... f. re'f chnies 1. Length requ r6'd�,� Lengt� installed 2. Distance to %watercourse measured k Ft..../.1.... 3. Installed according to plan. ........ .........9............ I/ .... 4. Slorof,&nch acceptable 1/16�f 1 /32�' /foot.y:......... 5. 10 ft. from property line - 20 ft -_fo dat , ns..... . / < ' .... 6. Depth of trench 30 inches from s ................ .• 7. Room allowed for expansion �00 % ......................... 8. Size of gravel 3 /4 °r -1' /z" dian er clean .................... 9. Depth Hof gravel in trench_12 ".minim :. - .._ �10. --PiDe ends capped:: : :...:..::: :::::::.:... .......i. g. FUMD orEliosea =stems 1. Size of pump c ,,amber ....................... ................ 2.Overfl ..................................... ....... 3. Alarm, visual / audio ............................. . ... :..... .... .. 4. Pump easily accessible, manhole to gr e ................ 5. First box baffled .............................. ..... ....... .............. 6. Cycle witnesse y ated flow /cycle..........„ III. ouse/Buil( fN p e d p a. House per amv .......................... b. Number of bedroo................. ................................. ... . IV. Weil a. Vell located as per approved plans ............................ b. Distance from STS area measured ' ........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable .............. I........ V. Overall Workmanship. a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ........................... ..... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... COMMENTS K�,- I ),,-. L, & U 03/27/2001 16:40 9147363693 CRONIN-ENGINEERING 1 PAGE 03 ..PUTNAM C0UM:DEPAR-TMENT_,OF BYALT9 DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION ADAM GENE REQuEsT FOR xisAwNsplacnoN For: Fill All information must be fully completed prior to any Trenches inWt4ons being made. PCHD Construction Permit #PV- 4 4, o Located: -C,4SS1A61L6 01Z1V_4r FUvJA'% VALL6Le Owner /Applicant Name: '37 qR676_0 04^ ROAD 966 TM _ Block Lot For Subdivision Name: 1*j1,,j #a r, CHAFormerly: LK Subdivision Lot # Is system fill completed? Date: Is system complete? . Ye----r - Is system constructed as per plans? Is well drilled? V6J Is. well located as per plans? )LeLl- Are erosion control measures in place? Date: A 1Z W 11, -Lm. i Date: 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 Putnam County Department of Health. • - j WP) Al C Date: &A&M 17 Certified by- t3 I r&/ C1j PE Lj:f ✓'RA es*n Professional � Add=: PCCKX0<0jLL tJ.Y, Lic. Comments: 00 F'06 FIR 99 PUTNAM C(DUN7Y DEPARTMENT OF HEALTH t^i < _ F' O w tr.... -.p � � � N1.0 re .•Qy. ' V . •:11 t. f 4, C^ • CONSTRUCTION PERMIT 1F® ATMlENT SYSTEM PERMIT # V" 0 6 0 �c� V ' Located at Sassinoro Drive4sbmoaomw TownWVX1qft Putnam Valley Subdivision name Putnam Chase Subd. Lot # 13 Tax Map 84 Block 1 Lot '. Date Subdivision Approved t) y - .2 5 -6-6 Owner /Applicant Name 37 Croton Dam Road Corp. Mailing Address Amount of Fee Enclosed 37 Croton Dam Road. Ossini 300.00 Building Type Residential Renewal Revision Date of Previous Approval NY Lot Area �6, 30 No. of Bedrooms 4 ii C' Fill Section Only Depth Separate Sewerage to consist of 1250 N/A Zip 10562 Design Flow GPD 800 VoRume MA gallon septic tank and �4 �4�1 L . F . of 4" PVC Perf, pipe in 24" jzravel trench. Other Requirements: /,P'/ /t-fpv, . . RAW( of /?"/V. To be constructed by 37 Croton Dam Road Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Watg SflIl1l91y. Public Supply From _ Address ' o1r: 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 described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regtdatiqq of the Putnam County Department of Health, and that on completion thereof a "Certificate of Constructip ,Pdfn �l �iic�e9 isfactory to the Public Health Director will be submitted to the Department, and a written guar an ' 3v. e lfu�ii the., wrier, his successors, heirs or assigns by the builder, that said builder will place in good operatkig itionn v past fiaid sewage treatment system during the period of two (2) years immediately following the date 'issu ppr c�f�h �� , e a va of the Certificate of Construction Compliance of the original system or rep, irs thereto. Signed: ` ` �, ,. ,�� , j'P.E. ( R.A. Date Address 2 John Walsh Blvd. ee)QS3f4Z 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 necessary by th blic Health Director. Any revision or alteration of the approved plan requires a new permi . Approv for 's ar of o estic sanitary sewag only. By: Title: Date: It 120)oc) White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pro essio al Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .. e APPLICATION TO CONSTRUCT, AWATER.WELL ' 4' ple "a"se piint or type • -a. 'VIM Pirmif r Well Location: Street Address: TownNWW Tax Grid # Sassinoro Drive/ Ma Block Lot (s) LOT 13 Putnam Valle P 84 1 �) 57 Name: Address: Well Owner: 37 Croton Dam Rd Corp. 37 Croton Dam Road, Ossining, NY 10562 Use of Well: X_ Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought _L_ gpm # People Served 4 Est. of Daily Usage SM gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling x New Supply (new dwelling) Deepen Existing Well Detailed Reason Water supply for new residence. for Drilling Well Type X Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No x Is well located in a realty subdivision? ...................................... ............................... Yes X No Name of subdivision Putnam Chase Lot No. 13 Water Well Contractor: P.F. Beal & Sons, Inc . � Address-,`- 'yu�a�� Brewster, NY 10509 Is Public Water Supply available to site? ° ; �f;�..!::.4sc�; No X F Name of Public Water Supply: N /AT Distance to property from nearest water main: Proposed well location & sources of contaminatio o be rovi ed se eet/pl . Lu f Date: -.. '' Z °L-?... Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration. of the approved plan requir a new permit. Well to be constructed by a water well nlearrtffled y Putnam County. Date of Issue C Permit Issuin fficial: Date of Expiration 11 1 1 Title: Permit is Non- Transferr ble White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY ' ' • i OF HEALTH , S , / V fi,/ i A A[ HEALTH S t RV4 S S LETTER ER ®F AUT11 OR112ATRON RE: Property of 37 Croton Dam Road Corp. Located at Sassinoro Drive /Kramers Pond Road T/ Putnam valley Tax Map # 84 Block 1 Lot Subdivision of "Putnam Chase Subdivision" Subdivision Lot # 4,5 Fi1ed Map # _28a z. Date Filed o-1-2:5­00 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 Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise th(0 § n of said wastewater treaP t d/or water supply systems -irt_conformity.with th , . ons-b ic� ,145.and/or 147.of -th lucal n --w;..the Public Health-- Law, acid utn _ f Count igned: `, ,• x,2.;80 P.E., # 06298 `" - YJF ES\13 Mailing Address 2 John Walsh Blvd. #200 State NY Peekskill Zip 10566 Telephone: (914) 736 -3664 Very 0 Signed: , Pres. Mailing Address: 37 Croton Dam Road Corp 37 Croton Dam Road, Ossining State NY Telephone: (914) 739 -7362 Zip_:. 10562 Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR ..r... .....- :r :A*AS `EWATEkTREATMENT'SYSTEM 1. Name and address of applicant: 37 Croton Dam Road Corp. 37 Croton Dam Road Ossining, NY 10562 2. Name of project: Putnam Chase - Lot # 13. 3. Location: Putnam .Valley 4. Design Professional: Timothy L. Cronin II1 5. Address: 2 John Walsh Blvd. 6. Drainage Basin: Peekskill Hollow Brook Peekskill, NY 10566 7. Type of Project: X Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park . Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) .................................................... Tvpe I _ Exempt .Ty pe II _ . Unlisted X 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... No 10. Has DEIS been completed and found acceptable by Lead Agency? ............... N/A 11. Name of Lead Agency Town of Putnam Valley Planning Board 12. Is this project in an area under the control of local planning, zoning, or other :.._ .. officials, ordinances? ....: e :.........:........:...:.:.::::..:.:.:.::.:...: .:............ :..:.::.:....:..: ES - ._.. 13. If so,'have plans been submitted to such authorities? YES 14. Has preliminary approval been granted by such authorities? YES Date granted: 08/02/99 15. Type of Sewage Treatment System Discharge ................. surface water x —groundwater 16. If surface water discharge, what is the stream class designation? .................... N/A 17. Waters index number ( surface) ..........:.............. .................... ............ ... N/A 18. Is project located near a public water supply system? ....... ............................... No 19. If yes, name of water supply N/A Distance to water.supply NIA 20. Is project site near a public sewage collection or treatment system ?............ ...... No 21. Name of sewage system N/A Distance to sewage system N/A 22. Date test holes observed 03/29/99 23. Name of Health Inspector Adam Stiebeling . 24. Project design flow. (gallons per day) .. ............................... ............................... 800 GAL /DAY 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... No 26. Has SPDES Application been submitted to local DEC office? ......................... NO Form PC -97 27. Is any portion of this project located within a designated Town or State wetland? NO WetlandsID Number ...... .........:. ................:................... ............................... N /A. 29. Is Wetlands Permit required? NO Has application been made to Town or Local DEC office? ............................... NO 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/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................ Yes/No YES DESCRIBE: Property adjacent to the west was the former Orlando Landfill. 33. Is there a local master plan on file with the Town or Village? ......................... YES 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ?........... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... No 36. Tax Map ID Number ......................................................... Map s4 Block 1 Lot .Aj' 2 37. Approved plans are to be returned to ..... Applicant X Design Professional -� Nti E: All applicatiofts f�Sr "revte grid approval`of a new SSTS -td`be located' "within the NYC Watecsheh sfiatl' be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater.plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. I If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may b Urovyds for the rejection of any submission. t—> ., © ae a rmir, under penalty of perjury, that information provided on this form is true W e st of my knowledge and belief. False emeuts made herein are. punishable as !ilas A misdemeanor pursuant to Sect' m 2 O.45 of the enact Law. Si T & OF'F'ICIAL TITLES.- �.: w cz Mailing Address: .......................... ........ Cronin Engineering, P . E . , P . C . "_' .John Walsh Blvd, Peekskill, NY 10566 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 37 C,9oTalu 1 >-i m i7oR 0 GUil-P Address 3? CgoV AJ 13-IM aD 11 40551Ni AJ6 AJ y. Located at (Street) KgA�je72-S 1t%v0 /zo g Tax Map 8 Block _I Lot T (indicate nearest cross street) Municipality,/-r pX -AiAM V,,+ Lg1J Drainage Basin -)CSC/, NyLl,o 646eg SOIL PERCOLATION TEST DATA Date of ing O -07-9 Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Time (pli lin.) De th to Water rom Ground Surface (Inches) Start . Stop Water Level Drop In Inches Percolation Rate NwInch t� 1 13_ 37 Ztf Zi — ZQ- 3 27 ., 2 37_ 20'7 30 2-1 -2¢ 3 10 3 Zoe _ Z a7 3� 21— 2 J 1 v 4 ` Z3 s 3 %:: zo 2 7 Z" ZaZ 3o Z -14 .3 to 3 4 5 1 2 . 3 4 _ 5 .. N u s a.j: t . Tests to be repeated at same depth until approxunatery equal perco1211011 races are oouuuca M percolation test hole. (i.e. s I min for 1 -30 mintinch, s 2 min for 31-60 min/inch) All data to De submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 . 2 TEST PIT DATA DE CI31iPTION OF SOILS ENCOUNTERED T107-IFi O L-lES DEPTH HOLE NO. HOLE NO. S HOLE NO. G.L. 1T P o L S C 0.5' 1.0' 1.5 M,N ovPt4 1,0 L04-1 _8AZA"a AAW LJA—r 2.0' �� �• . 2.5' 3.5' all u� 4.0' 4.5' 5.0' 5.5' . 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0�• :-. ._ .. _- . .. _........ LW_ ._ . y >._ .. ..�3 :,ems - - s. --� -.. __......._K.> ., ... �' ..�. ..: ,.. 9.5' 10.0' Indicate level at which groundwater is encountered 1 4' Indicate level at which mottling is observed Indicate level to which water level rises after being encountered C Deep hole observations made by: A Date D —q q DesWr ssional Name: Tjm Q114 / — -C r br t 5 \i L. C Kph; Sign •�' 62980 Design Pirofessional9s SeaU c` `'��F E':,�� �" 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM - ...For IINISiE®QA,CTIQN3�Only Part 1 - PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEAR 1. APPLICANTISPONSOR: E�uptnaom:jChase ECT NAME: 37 Croton Dam Road Corp. Subdivision, Lot # /3 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) Kramers Pond Road/ Sassinom Drive 5. PROPOSED ACTION IS:' ®New OExpansion ❑Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: construction of subsurface sewage treatment system and individual we# water supply 7. AMOUNT OF LAND AFFECTED: Initially 6 �9 9 acres Ultimately, acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ®Yes ONo If. No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Wesidential ❑Industrial ❑Commercial ❑Agricultural ❑Park/ForesUOpen space ❑Other Describe: Surrounding lands are zonooingle.famity. residential ..: . -_ • �' , , _„ �. — 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ®Yes ONo If yes; list agency(s) name and permitiapprovals Town of Putnam Valley—' Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ®Yes ❑No If yes, list agency(s) name and permillapproval Subdivision Plat Approval —Putnam Chase Subdivision" 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑Yes Wo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor na e' St udohar date: 0419 -00 Signature: If the action is in a Coastal Area, and you are a state agency, complete a Coastal Assessment Form before proceeding with this assessment OVER 1 A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process use the FULL EAF OYes ONo B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative.declaratio_n maybe superseded by another involved agency. Oyes .. .-y. �. t. .• ❑NO ` •� r. -.. '.H C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: Answers may be handwritten, if legible. C 1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patters, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? ' Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? OYes ONo If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? DYes ONo If Yes, explain briefly: - Part III.- DETERRAINATION.OF SIONIFICANCE,(To,be completed,by- Agency).: -. INSTRUCTIONS:' Fdf each adverse effect identified above, determine wh6ftr it is substantial; large, importarit or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the nvironmentai cnaractenstics Or the LtA. D Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. O Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action VWLL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Title of Responsible Officer Signature.of Preparer (If different from responsible officer) CD Print or T me6SResponsible Officer in Lead Agency =) U) Sig�,r�df Responsible Officer in Lead Agency ate w C=) Title of Responsible Officer Signature.of Preparer (If different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT ''CORPORATE OiWNER kPPUICATION 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 j Val Santucci represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation:. 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) Vice President Name: Same as President Address: Secretary -Name (Same as above) Michelle Santucci Address: (Same as above) 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 to before me this day of month) 2 eA (year) Notary Public KELLY M. LENT Notary No lic, S to of New York Corporate Seal Qualified in Westchester Count Commission Expires June 21, County Form CA -97 1 ac the c oration with respect to., es t 1 b ��'.� /Jw'f 431 l KdK pti. SILL Lr U:_Nv s , Pfau, tj g ?zirS .. 1 ')L • �S ° or �i•:k iS (t iz 1.i( }� j it i:.tY it u • �Cj Co L'.. PLANS PCDOI-1 F011. A " a IGIgTU ZiTI,�Y __ - i, /SAL I vs cONSrRmuon cow./&4jFrA c5 Pv � i, 1� t.: Lao] to Flalla El I f 11111 tual e: a' y1 !j i•. •a Qt 't L: i .1 SNP t i r� t. eGSr a -sin w au R+► ��4 nn a d. A �t • �1. �.i •as >I' MpKII:ION 1 it it la dr Is�;e ao�jaca uRxea. n �ro.s :lEvA 071 ""--Joss (V," µ - >D �y •NIILi III gwcn 1U mw =1 W*Xod I -I —OR 47 nry .w ppj ai "W-t Pox. socr U-77 GAI;LE OW L "I. [W—[I. GM, OEM R a #I Im 09.1 1011002k P. 1017 Jt' mrs 0" W V%LS V W CC It.. mV "LL 1. 04 CLG w 3, W.pf% mfgft!WDc-Aw—,wR% 'aw STS", fN I' 1 91 ,4 'Jaws welt gr— 040 X.• L 0 E) A"Xram. P. 'PO-3 POUNN I 11-50 : ) ?4 � 1. a. i G Ul ti ° I � K1CL I.M t s••I / 0.4 P MI7 � mll i 7 1 w•1N[C. kLItos i.- d (_ ►rlu a ILSCD , L------------------- ------- ---- ------ --- ---- --- - --- --- - --- -- -- --- -- -- --- -- - - -- ---- - - iC.Ib. IUiY vA[6 ~' fi�M i I: yUSEP YY• S!K Y' LI^ ✓ft9c �-E91:[IV- OY M. SIK Dort Z.a T, , Y IL' DI 1 Y /5• p[ plS! .p;C.I f:I�r .Iby C[RM MIRt Nat -S tl -7/Y 5 .I1,.. M. --- v Y 7C I-Aw MI IL'BC GaY ✓J m I t-ca YD' IUC 'I' -♦i, Ea StK Dv[4 l•. M.m P w DC al t J. f" [[KM' COI r_ aLl- Y- D-1c.Y IPr „lr bAflt '—VI [ CP,sRMOl I19I - gVMS- SN^M Isk :!•- t.s AACSI r P. DC V-t-[a Aft" t.' D: l• 13" IY Ilr- 1.1 MY +7 :N - +iYT NS i[CSP/ P UlIIIfYI Y IgOYIR ADI o••yf IWYS A9.lal;Cn ►iY A +iECC I Uil[I. ^1 PYI4aN tYSnlYr L Pr- TMH lbD L[ l - iV j; [: ;1{ I 4� n5 .I 3 r fi r.. V C N [L A r V1 Qi T Cis l� 1� Nom: r� i p a 1 existing —� i water. sernce \ existing well VI VIA, .. `, b - A d N v + . t ,z,/ tree 44A:F. -4 01 _ 24' gro 0 \ \`` \}',1,•4.\ Q o \1f J�I i (ends 0" \ \% WX ii}i'ht� tt� t / J �4 •,i ! ;, 1009 expansh ;.f yII �a r!! '/!'• f l: �� ' :'r' area of 12 of bonkrun e y Q 1 .; !/ oil`! J / .�. ,.: i, _ (shaded area) F `i® ^QQjot� t h� it c roof leaders and ' footing drains (40 1 � I ,,h ",d) 7 7. suBsuRFAcT sTwAG-F mi-A.-miNipstriv (ssTs),ls qplavp ON A SOIL PERCOLA 77ON RATE OF TO V Y11VU TS PER INCH. DROP (SEE SOIL DATA 2. ENGINEER WAS NOnnED PRIOR TO STAR77NG WORK AND PRIOR 7'0..BACKfXLJNG 7RENCHES. J UNAUTHORIZED AL TERA 77ONS OR ADDIRONS TO 7N/S., DRAlWNG /S A.- WOL A 77ON OF SECTION 7209 (2) . OF THE NEW YORK ,STATE -TE EDUCA 77ON LAW 4. 12" RUN OF BANK AND GRA VEL WAS PLACED IN 7REA , 7 um r AREA. PRIOR '.TO CONS77?UC770AI OF SSTS-BANKRUN IS. CLEAN AND FREE Of .ALL ORGANIC MA 7FRIAL.-AND LARGE, R". S. BA NK$UN DOES HA VE A SOIL PERCOLA 770)V I kA rE OF LESS THAN 5 MVNUXS:PER INCH DROP 5 THE PREMISES SHOW HEREON IS .SHORN AS LOT IJ QN. A VAP EV-77.RM- `S&8D1V$'1OY- OF PROPERTY K'NONN. A�§l PU'7'7VA-M'- CHA",SE•, -FILED IN, THE PUNAM COUNTY 'CLERKS OFFICE, 0lklsyON 6F LAND RECORDS ON JUL Y 25, 2000 AS. MAP No. 28.32. 6. HOUSE LOCH -77ON W7H P RESPECT .TO -PROPERTY LINES WAS SURVEYED AND AND PREPARED R DONALD - J DONNELL Y, , C DISTANCES M N0)?lTH ENDS .oF,ss.Ks f1m) -ws. . -` �T E . T,�,Na SOU7H INDS WEST END OF 2ND 7RENCH 46, XFS T END OF 3R0. TRENCH' WEST END OF 4 7H. TRENCH EAST END OF isr DISTANCES TO SOU7H INDS OF SM. EAST END OF isr rnEvcH 45 96 EAST END OF 2ND. TRENCH EAST ovD, OF WD. TRENCH -57' loj EAST END OF 4 TH, wlvcH. 6"- or z 0 c 0 Z 0- , fAA , )-o 0 x z W z 0 0 V RE 510N rA.Y. MAP 4- ;CC170 84 & LOT 57 SUK CHECKS OA TE.- 04-2-2001 ,DWG FILE SIAS-BULL T SHERLITA AMLER, MD, MS, FAAP Commissioner of Health Associate Commissioner of Health Nicholas Sgoupis 27 Sassinoro Drive Putnam Valley, NY 10579 Dear Mr. Sgoupis: ROBERT I BONDI County ,Executive - •° ° '- ~ROBERT MORRIS, PE' • ' �"'" ' Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: Addition — A- 216 -07 No Increase in Number of Bedrooms 27 Sassinoro Drive (T) Putnam Valley, T.M. # 84. -1 -57 October 24, 2007 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 the Department dated October 24, 2007. The addition is approved with the following conditions: 1. 2. 3. a The total number of.bedrooms must remain at four without prior approval by this department. The area of the existing sewage disposal system, and its expansion area, must be maintained. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. This` Department recommends:you .contact- your .local Buildirig'Deparfinerit io= ensure =• '� setbacks and other current codes can be met. 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 permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley . If you have any questions, please contact me at your convenience. Sincerely, 4�1� 0, Gene D. Reed Senior Environmental Engineering Aide LCW:ens 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool(845)278 -6014 Fax(845)278 -6648 J V� SI-IERLITA AMLER, MID, MS, )FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE DirectgL of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION 1[IESIDEIY7[ L4 L n t Aln j a7 .�ASS,e -taro t?� Je_ :. STREET TOWN F. t-A-a . V Jk!y TAX MA.P# K� I S7 NAME 5C ► � '� %� PRONE 94 r Uq -23 3q PCH D# i � r MAILING � `% Sass •ro a J (� ADDRESS P,.�-r y4�a,�y v 0 S'7� DESCRIPTION OF ADDITION F °>e r-4-mT" NUMBER OF E)USTING DEDROOIMIS PROPOSED # OF IBEDROOMS�_ (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) "Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster; NY ;10509,--.,Phone---(845)278-6130..,,. . Certified check or money order for $100.00. Sketches of existing floor plan (drawn to scale, all living area including basement) d3. 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 locations 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. 15. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE °,COMMENTS 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 +j ) ) 'To the beat of my V.Aa ledge, belief and pmfeasimal judgeaaalc, 1. thia Factory ra 4factured Nome (Fm) Plan has been aWFFoved frw a ayaten aat of PM Plans,, previously eppr —d by MS. Application No. 96 -013, ammfactt r•a No.0e97, Bxpiratim Date 07 -03-99, which ha! rot been Aodified in any —er. i i2. the —M Portico of the M plan has been prepared usi'q Part 5 of New York State Cmtgy cone atim conatrmtim Code (Cmryy Code) and is in Toll r ylie -a with the Cmtgy Code•• 1 cxtST /.vf, Bf15iEdt��vT 1, Nicho %its S9ov ® %S 27 `7c�5S irrlorp 3��� ,rM A- $ 411 a• ..t r! GI i' S 7 r�- l': �i dS; ,•Ir .S. CONSTRUCT.fUN CORP. /SGOUPIS Q x p �i pe6B ] 3064 N ] '.IY ]DNZBC VVNRBCN IV 2x6 Nom BC NRDI 1 S NOTES, j 1. 2x6 EXT VALLS 816' O.C. /2x4 MARR WALLS 2. 9' -0' CLG HT. 11 3. 2x10 SPFB2 FLOORAJOISTS Q 16' O.C../ JOIST HANGERS 4. MV WINDOWS 5. RAISE ALL INTERIOR /EXTERIOR DOORS 3/4' / EXCEPT UTILITY (UNIT 'A' L B. ONLY) 6. CEILING DRYWALL ?VILL BE OMITTED FOR ALL ON -SITE PLUMBING CONNECTIONS 7. 1 LAYER 5/8' TYP.{r'C' GYP. APPLIED PERPENDICULAR TO 2x6 CLG. JOISTS, ATTACH w /6d CEMENT COATED NAILS It " /8'L- 0.0915113. SHANK, 1 14'13. HEAD) E 71 O.C. INST BLOCKING B 7' -0' (RL539) 1,6 k 16 .1 I !. • 'I1 V ;9 0 o oil CC) O I O O 10 N I r.BC RII 19-5 11 1/2' l2' -11 1/2' —2 zE �2 12•-7• 2 S•�' 212 W R-7— �. 1 rE--- - - - - ' rLAT WILDIG - I 13l.. i t E0 Lt 4 P]AD DATA PLATC STATE LABEL O 'LNI I VENT wo �T�N 't 3z 16 urK"ATTT �D A AND PIS LABEL LOCATION 'O I I pt I DINING ROOM IB0.5] SO rT ^ KITCHEN u ISL32DSOX NDDEL nxo Z. " Wrx47 1/ r LIGHT RECD - m I ti, rT 1212 LIGHT RECD VENT REO'D 244. LIGHT PAT V'D - e I RAISE CALK 3/4• SAS VENT RECD ]-1 VENT P40V'p i =:,I ISD9 VENT PRw'D " 1 i 5/11` TYPE 'x' GYP. mOM LLOU L!FL 9• m :: D/r TTPE 'x' G.P. I I . REO'D 5'-11 11211 ; I I I I' 34' -ll' I• 'D 4WSPr42 I I ? S -2N SPf42 @)N' C®PCR L 41 I : 1 I EACH WIT ^ DM LD.LT BS T TO AT TIC. 1b .:� DOT. LOLLY CO.. RECD II 2)' SOrrIT c0.. m0'D :� }3/4• II `^/1 1/81 6' -0' 3' -2 uz4z, nP 1•) n6 I I 6 / = 1 I 5' -3 1/2' N P SING ' a ON -SITE STEEL HEADER ]642 II TLT VENT -- - - - - -- DESIGNED, PROVIDED & INSTALLED T- 1 2" -0 3'-9 1/2' 4'-7 i/ 1 j4 �:; -.ON_SITE BY BUILDER -------------- 0------ :11--------- ---- -- !.: STEEL BEAM ON SITE BY BUILDER - 1 'A N q rQ I; PANELIZED WALLS •`µSNw�'CD BSNT STAIRS E❑ ``1Vb © UiTLITI. A BA H B3 PLAT p • -0 7/16' WALL MGT. (WE DETAIL) STRIP f2M <B V4• •� MI V SN AS • RAVI 4'- - 4 I CLG CINC -1 DDT. LOLLY j� I 1 Zg I 1 COL. REO'D 4 .0' - --/ 2x6 N I 4303 SO rT 'r _ - - A IM RAILING IT BUILMR ` ,- 3U LIWT REO'D 1A0 VENT REO'D DAD LIGHT iMiDV•p ;` J LIVING ROOM 3' -11 I /4' PER APPLICARE CODES m' -l4' HANDRAIL NET O CLO ru 0.0p VENT PROV'p ADD •L LIGHT /VENT PROVO 2-3- INSTALL FOYER STUDY y�0 RAILING jV g P V I� V! OPEN ]I4. N TO ABOVE p c vtl ;I I� x p �i pe6B ] 3064 N ] '.IY ]DNZBC VVNRBCN IV 2x6 Nom BC NRDI 1 S NOTES, j 1. 2x6 EXT VALLS 816' O.C. /2x4 MARR WALLS 2. 9' -0' CLG HT. 11 3. 2x10 SPFB2 FLOORAJOISTS Q 16' O.C../ JOIST HANGERS 4. MV WINDOWS 5. RAISE ALL INTERIOR /EXTERIOR DOORS 3/4' / EXCEPT UTILITY (UNIT 'A' L B. ONLY) 6. CEILING DRYWALL ?VILL BE OMITTED FOR ALL ON -SITE PLUMBING CONNECTIONS 7. 1 LAYER 5/8' TYP.{r'C' GYP. APPLIED PERPENDICULAR TO 2x6 CLG. JOISTS, ATTACH w /6d CEMENT COATED NAILS It " /8'L- 0.0915113. SHANK, 1 14'13. HEAD) E 71 O.C. INST BLOCKING B 7' -0' (RL539) 1,6 k 16 .1 I !. • 'I1 V ;9 0 o oil CC) I ADM LRLY Col.- "co'. 20' -0' �R'R.02 BOX 893 316 60 JEFFERSON LVEP.PODL, PA 77045 1ST STORY '(T /7) 444 -3395 DRAWN h• MCKEO BM1 DATE, SCALE• ASA 10/2312000 1/4•=1' -0' fAX {717) 444 -7577 VISIONS, ND PER Pp II -2 -m Ay Dlix NO FROM T11E INCIIIC nR CCA'. F.Yf. F.').NOYr'.c MU ^ ^^^•- 1. ! e' 'b= 1 �X M T /AAj f s- Fl- 616172 NooPos�� G Nicdtotos S�oE.p %s �2-7 Sa S5 /`n Ora Dr, cl*y Lwt Ved (e�.. A2Y, /05 7% 19-5 11 1/2' ' rLAT WILDIG .•Y FAMILY ROOM ST IT E0 Lt 4 P]AD - O 'LNI I VENT wo �T�N 't 3z 16 urK"ATTT �D 'O I I pt I rLt 11.73 VENT PROV•D • % MARTIN IMPLACE NDDEL nxo Z. " Wrx47 1/ r m x /1YxDB'x6' HEARTH � V1 m 1 i 5/11` TYPE 'x' GYP. mOM LLOU T 9• m :: D/r TTPE 'x' G.P. . REO'D N0.0 ALL BEEx IN iL rW W -SI rE CRUNN I I ,_i :. I 1 I 'D µEEL I II II :� II GARAGE • SEE NOTE 47 = 1 s B' TYPE •x, GIP. - a ON -SITE STEEL HEADER II DESIGNED, PROVIDED & INSTALLED /4• -.ON_SITE BY BUILDER -------------- 0------ :11--------- ---- -- !.: STEEL BEAM ON SITE BY BUILDER - 1 'A N PANELIZED WALLS I I I I iP • -0 7/16' WALL MGT. (WE DETAIL) e> y IB'-Il 7/8' I 1 Zg I 1 0x6 2x6 N I ADM LRLY Col.- "co'. 20' -0' �R'R.02 BOX 893 316 60 JEFFERSON LVEP.PODL, PA 77045 1ST STORY '(T /7) 444 -3395 DRAWN h• MCKEO BM1 DATE, SCALE• ASA 10/2312000 1/4•=1' -0' fAX {717) 444 -7577 VISIONS, ND PER Pp II -2 -m Ay Dlix NO FROM T11E INCIIIC nR CCA'. F.Yf. F.').NOYr'.c MU ^ ^^^•- 1. ! e' 'b= 1 �X M T /AAj f s- Fl- 616172 NooPos�� G Nicdtotos S�oE.p %s �2-7 Sa S5 /`n Ora Dr, cl*y Lwt Ved (e�.. A2Y, /05 7% V.S. CONSTRUCTION CORP. /SGOUPIS (13PC) 1 12' -0' '- rLa Teuss u r(e 8'- 600' • : e I Da ROfP 40-0• TWO STORY 7.1, 'SP 7'-0' 15' -6' 9'-4' 4 B• -2• + v n =1 n C) n is VH 2. y . . CLO (ID • 2K 2.6 >0 .DUI / SCS44S 6'-8' G a 6• -0• 6s•.es >/e• as 6' -0' 7' -4' 13' -4' 12•_0• "8' 10' -9'rLR TRUSS IN rLe TC oI1¢a 4 20" -0' 7/12 RAFTS d b„ s= wQ 40TES 7 I I. 2x6 E %T WALLS 2 16' D.C. /2x4 KARR WALLS : t Da R� RArrzes 2. 8'-0' CLG HT. 1 2x10 SPF #2 FLOOR JOISTS E 16' D.C. ./ JOIST HANGERS �a BEDROOM a3 S. FLR GIRDER UNDER BATH 01 TO BE: 2 -1 1/2'x9 1/4'.154• ML " - •'� zo BEDROOM a4 316 60 JEFFERSON 10'-5' I L7YERPD0L, PA T70t5 11931 SO (1 11.96 LIGHT RCCO 591 KNT RECD AND NO MECHANICAL EQUIPMENT SHALL BE INSTALLED IN THE CEILING y` 7T7 444_9995 ( J .421011 1134 LIGHT RECD Sl7 VENT RECD 9. 23/32' TLG AGENCY RATED SUBFLOOR APPLIED PERPENDICULAR TO FLOOR JOISTS ATTACH BATH p2 i 12' ASA 10/23/2000 21- LIGHT PRDV•D fAX (717J III -7577 — 4CNIS1D16[NrS .D PCa rD IT- -00 w 21A4 LICIT PROV•D W VENT PROV•D CLO vTHIS SECII d -SITE 6Y wus. t313 1 �� 0 O ti 8' -I1• F — !RAISE Dmt 3/' (THIS AREA FINISHED ON SITE BY BLDR.) BATH al I I P t"�_ HALL '1/2' l 3I_BAT VALK -IN ('*I ELSE 4,- (tr (zs 1• caPPEa Lugs i 3' -0' 3' -2 1/2' CLOSET. L 3- h4 SPr(2 !UT N1 ______�_ VS136 ]a fir. I, RD jjj A'* WALK-IN INUT -Orr © LANDING (� 3' -7• +(,: E CLOSET ALV[s CLO IN ^IN RAISE 314• } . (THIS AREA FINISHED ON SITE BY BLDR.) 7­1 112, 2' -0' 3' RARIHG el AIII.MR PER APPLICAXE MKS 30' -34• HANDRAIL NOT BEDROOM al 262.49 s0 rT - 210t LIGHT RECD IOSD VCNi REO'D - — zu4 135H, PaDV•D SEE NOTE a9 113aj VCNT PRDV•D BEDROOM 02 13964 SD rf 1f 11.17 LIEN' RCWD 539 VENT RECD OPEN TO XC 21.44 LIGHT PRDV•D 1192 VCNT PRDV•D ' , 12-9 112' I1' -0' 14'-1 112' NOR. 3 -1 11r.1 I— —� _ MDR ! B7 Ir4• Ar( _ _ _ _ __________________ t.6 ___ _______________________________ • 2K 2.6 >0 .DUI / SCS44S 6'-8' G a 6• -0• 6s•.es >/e• as 6' -0' 7' -4' 13' -4' 12•_0• "8' 10' -9'rLR TRUSS IN rLe TC oI1¢a 4 20" -0' 7/12 RAFTS d b„ s= wQ 40TES 7 I I. 2x6 E %T WALLS 2 16' D.C. /2x4 KARR WALLS : t Da R� RArrzes 2. 8'-0' CLG HT. 1 2x10 SPF #2 FLOOR JOISTS E 16' D.C. ./ JOIST HANGERS 4. ROOF SYSTEM TO BE 24' O.C. (16 O.C. GARAGE /FR ROOF) (LT32- 7M)CLR32- 7MV)CLT12 -7P) s. MV WINDOWS S. FLR GIRDER UNDER BATH 01 TO BE: 2 -1 1/2'x9 1/4'.154• ML " - •'� R.R. /2 BOX 689 316 60 JEFFERSON 7. CL BEAM OVER BRLI /HALL /BATH#) TO BE: 2 -1 1/2'.14'x40• -0' M.L. TRUSS ROOF SYSTEM IS DESIGNED FOR CEILING DEAD LOAD ONLY •.: L7YERPD0L, PA T70t5 2ND STORY AND NO MECHANICAL EQUIPMENT SHALL BE INSTALLED IN THE CEILING y` 7T7 444_9995 ( J DRAWN n, [KCxc0 #Y• wiE, 9. 23/32' TLG AGENCY RATED SUBFLOOR APPLIED PERPENDICULAR TO FLOOR JOISTS ATTACH •' 12' ASA 10/23/2000 . /CONSTRUCTION ADHESIVE AND 6d CEMENT COATED NAILS (SAME SPECS) 2 7' OZ. (11539) fAX (717J III -7577 — 4CNIS1D16[NrS .D PCa rD IT- -00 w FROM THE Dew OUT irlmEXC£LHOYES.C"OY s ; d :'e f i;l I to T•l PD934A5 :s. is FXrST /N4 ,2 —`� FLdo-rt Na TrZOP10,s6-�' D G //A N lv,/� S Mcho %L s 6' 1, `5 '2 7 �tSS;noco 7P ,. S77 yi 1, t •fin G'. `q. ) I n= �h( i �1 j( 4 Yi 4'J ( .I 1•. .ti EMM��� SHERLITA AMLE&,MD,,MS, FAAP. Cojiihii§s4YnW6fNealth - U , LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH I Geneva Road,- Brewster, New York 10500 Town Legal Bedroom Count --R0 BERT 4' B N1DI:- County Executive Re: (Owner's Name Tax Map #: 4-. Address: Silm&/IVOKC) -bTZ -11)E- Town: — PU170 AM VAL L EV Year Built: 2c) 0 According o records maintained by the Town, the above noted dwelling, Is in compliance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other: Building Inspector Date Environmental Health (84. 1 5) 278-6130 ;'Fix (845).278-7921 Nursing Services (845) 278=6558 Fax (845)278410,26 WIC(845)278-6678 Nursing Home Care Fax -(845)278-6085 Early Intervention/Preschool (945) 219-6014 Fax (845) 278-6648 J 'a �r„'• °_f2.:. _ +iro- . • a . r r. - > .. - _. 'r v-.'4 "a poi l o ` , - •a.: . i. -.n3.. ... s .r. .i� �� - CERTIFICATE OF COMPLIANCEHOCCUPANCY 1' - - .. CERTIFICATE NO.: 2001 -53 PERMIT NO.: 2000- 479 TM #: 84.4-57 (Lot #13) DATE: April 19, 2001 LOCATION: 27 SASSINORO DRIVE ISSUED TO: 37 CROTON DAM ROAD CORP. This certificate covers the construction of: One Family Residence w/ deck (12' x 141) Garage, fireplace, Four Bedrooms, Unfinished Basement The applicant having heretofore filed an application for a building permit pursuant to the Town Code, Sanitary Code, the Uniform Building.& Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by personal inspection ascertained that the applicant has subsequently proceeded with the erection or improvement of the proposed structure in compliance with the requirements of the laws as aforementioned; that the said work and materials met every requirement of the laws as aforementioned; and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions of law. Now, therefore, this certificate of compliance /occupancy is hereby issued under the seal of the Town of Putnam Valley. TOWN OF PUTNAM VALLEY, N. Y. BY= CODE ENFORCEIENT OFFICER