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HomeMy WebLinkAbout4347DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -58 BOX 33 04347 ? go r 61 ' -� 'I 1 �a ' T or rr Ma {i� : ' 04347 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health l ;ORETTA MOU NAiR1vRN, •i:'; b .. a •.• .,r ::..__. .- Associate Commissioner of Health Richard & Carol Rosario 19 Sassinoro Drive Putnam Valley, NY 10579 Dear Mr. & Mrs. Rosario: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 January 16, 2007 Re: Addition- A- 348 -06 ROBERT I BONDI County Executive `WOOMil' 1 ORRIS, PE Director of Environmental Health No Increase in Number of Bedrooms 19 Sassinoro Drive (T) Putnam Valley, T.M. # 84.4-58 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 January 16, 2007. 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..Y new J93Y flush w - -toilets;- restrictors`for-shower head8'dn7faucets 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. 2261. Sincerely, X0 ID, Gene D. Reed Senior Engineering Aide GDR:kly cc: Building Inspector, (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 InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health I TA MOLg1VAI8I, RN, MSN _ Associate Commissioner of Health ROBERT I BONDI County Executive DEPARTMENT ' OF HEALTH a 1 Geneva Road, Brewster, New York 10509 d d ADDITION APPLICATION RESIDENTIAL ONLY STREET J q Sa_SSi nano DR. TOW1 111 kfTAXMAPM NAMER AZ + U o I RoSarid PRONE 9g55A9- 03 PCHD# A 0 -06 MAILING ADDRESS 1 ,SSi nor-o DR. - - %lYl .m VdIeg DESCRIPTION OF ADDITION ��� ���C��IJ�7'1�`� V1 �`�G �✓ NUMEBER OF VUSTING BEDROOMS PR ®POSED # OF BEDROOMS_ (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, - Brewstex, NY` 10509, Phone: '(845) 278 =6130: y= 1. Certiffed chedk or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, afl hying area including basement) 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 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. 5. 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 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count BO19kii#:�:�.: County Executive Re: ROSARIO (Owner's Name) Tax Map #: R 4,-1-58 Address: 19 Sassinoro Dr. Town: p,1f nnm Va l Pv Year Built: 2 0 01 According to records maintained by the Town, the above noted dwelling, is XX in compliance with Town Code. is not in compliance with Town Code. _ . ......... vmThe, Legal Bedroom Count is: 4 This information has been obtained from: Certificate of Occupancy: Bee attached er: 12 As s is t Building Inspector Date Environmental Health (845) 278 -6130 Fax (845) 278 -7921 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 t se Y iii F1':\ BI.:N 1P1 �]ER'1'II+'IC�T� ivy.: 2x01 -13 ]PIEl[T Iii ®.: 20aa- 426 Tom: 94. =1 -58 (Lot. #14). DATE: JANUARY 30, 2001 LOCATION. 19 SA3SIl�1 ®llt ®'fl�1�I� ISSUED TO: 37 CROTON DAM ROAD CORP. This certificate covers the construction of: One Family W /Garage, Deck & Fireplace. 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 eve y es u r_oment..of n =s � :. a .af0rbMbntioned; ..., _ 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. TUWW Q} RP P T NAM VALLEY, N.Y.' BY: CODE MWORCIMMM OFFICER UCTION CORP. /ROSARIO 3z' -e' SN- 2z -. 112 B-6• 1•' -10' 12-3 112' 14-1 MS' - 0 3 /4' ,w n•*L sr•rz 1 1112' t •' O O .'u! a ID — O t _ __-- _______ _____ 29' -7 1/2• tuz N• K M 3W pr . 14­6' I rsA a. � ■ >r si VKC �. z..z 1 I t°+ � ' anlrlcrwC z•F t5. 9 1 /a' I f 12•_0• f t •C■� 1 wm waits flt[nK[ M f KITCHEN) O r.sa-.v Ic.erA � 1 laz�a NOOK aio-D � ■z. ' ¢.. ' tzA FAMILY ROOM LIwT MID • DINING ROOM �C. r0 •W VC I 2r■!t m n 1 in i .ID Vr. RDV t ]a• - 1Cp a'-0' nb IL Wla RrO IfA LIRn a0'D . - RCD'D � •■. [" I. .tV a■cr .ttv � xAa LIrHr vtavc 1., U.» vc.T ra0vD W., n.n vcHr repro ?� 1 19' -10' r.t m 1 ---' -- ----- - - - - )'1 cKa •D% . DL LOLL, - -z.. svrvz �_ [a. arD 16 - H. rN A. Iw - ,t r StrrLr f01 yr r.rc •.• cr.. ODi L11 , m.. tto-o M 1Lt CVK ;n DtM IRAs• I I cD�tl - s[[ wrc •a 23'-3 I .Ta Leal, Sa2 4 IN2 • •• 2•a a-7 /1% ' 9 -10 1 12' 8-1 2• w 17az'w- .rille _ ___•o _ ' 6-9 7/8' 15 yr i,rC • :• cn' 6 - I I I •W4 CLO 3[[ KrtC •a SIH• L•tD1.G -0' s B* D' -s DM © l.. Wea(R •tOK vOI L Der ; M I _ _ .cow n ti 1 -z... 1 -z.D $'a Ua Lfw! aDT r SVn, rpl Sla v[Hl ttC0 b.. fLR NK ,b �t■ r��'f 5 [LO / ILIiLn WILICt I �b RAli[' / -p DDD LIwT MV•■11'-2 1/8' '% _ (- S[[ IOTC .) © ��' r I 6 ttP •trRl[•■LC CDa3 ]D' -N' wwpe•a HLr • L L . - ^,v_[\ •per Lair t.a \ a• '-5 5/8' , LIVING n -11 1 /4' nxll•19' r ID ar0 Llwr a- 1 I 6 3 flra BATH a3 Ta •■pVC .as v[Mr avD I 1 ON -SITE STEEL HEADER FRYER zc)a LIDM rROVt I actor MI. ESIGNED, PROVIDED & INSTALLED 7'-11 7/B Iz -3 ■A,3[ nuts �.• ON -SITE BY BUILDER ' 1 I T /16 135x 1 k' 'r RIM re•2 •Ra oaM"iT� :u u [ *tar l• I Ca I I I 1 _ 2- LAYERS 5/8' TYPE 'X' �' cry GYP ON GARAGE CLG [UNIT -A-) scc W'r to _ cap �� E wwv /e, . /m,M1• elnl its [ pl!,'IT ■. 1 1 ^ SEE NOTE aB •DR al, [a, ,I'NS imvC 9 _ al II_____ __ __ - ____________ -___- _ 3210 STCa IC•II w-SIIC ■T aW Z T - tte1,C1CR r0 ■b t -1 1/r.11 IIA' ML [I I S`IAlil m.l 17 6 /1' ID' -0 3/1' GARAGE Ca. ttCD f'•er ti STUDY •' 1' -8' J B' -9' 1 7•_6' to unv srr irvC T• - a.I m ea" - Ir LIwT a _ 9' -4 1/2' 1 I5' -6 1/2' 1 8 IY c*r w ac rws .a• a -SITC n tlnlxe vcHi ao-D zz.+a L)wT•D X0,_3' II )•_6• [LIIy G•rY vIL2 •MIt1 Mi: I � to {t1 25' -1 3/4' TIES. 2.6 EXT WALLS a 16' OCl2.• HARR VALLS 9-0' Cu; HT. 2.10 SPra2 rLOOR JOISTS a 16' O.C../ JOIST MANGERS MV WINDOWS CLG GIRDER OVER KIT- NOOK /TOYER TO BE• 2 -1 1 12'.N 1 LAYER 5/e' TYPE 'X' GYP. BOTH SIDES (ONE SIDE -MARK. WALL) OVER 2.a STUDS (W.P. SHEATHING GYP. {XT. WALL) a 16' OZ. ATTACH . /6d CEMENT COATED NAILS a 7' Dr. (a VP3605) I LAYER 5/8' TYPE 'X' GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS e 16' OC- ATTACH'. /6d CEMENT COATED NAILS (1 -7/8' LONG . /1 /4' DIA. MEAD) a 7. OZ. C■U356) S. 2.8.SPra2 CEILING JOISTS OVER GARAGE. BASE LAYER 5/8' TYPE 'X• GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH ./i 1 /a' TYPE 'S' DV SCREWS AT 24' Mc rACE LATER 5/8' TTPE •X• GYP APPLIED AT RIGHT ANGIEi TO CLG JOISTS. ATTACH ./ 1 7/8' TYPE 'S' DW SCREWS A} 12' OZ' SET BACK SCREVS V AT END JOINTS AND STAGGER JOINTS 2' -0' EACH LAYER. 7/16' OSB:OVER JOISTS PERPEN.. /8d MAILS (RC2601) 9. CEILING DRYWALL WILL BE OMITTED rM ALL ON -SITE PLUMBING CONNECTIONS 'ID RAISE ALL DOORS 3 /4' - tr•TH INTERIOR L EXTERIOR cCXCEPT UTILITY ROOD al. &!_ •DENOTES CENTRAL VAC OUTLET 12. BLDR INSTALLED HEATING SYSTEM TE COVER'A 99,000 BTU LOSS 13. M1,L R -19 FLOOR INSULATION REQUIRED PER N.YSELC. la. SITE LOCATION PUTNAM VALLEY, NTH PUTNAM CO(PITT) 30 PSI, SHOW LOAD R.R�2 Bar Bas 34 58 SPECIAL TWO STORY W120 x11 GARAGE 8127x7 BUMPOUT KC4w LJVCRPOOL PA f7a�s IST STORY (717) 441 -3395 mv. n. U[CQD n. 0.1G ft•LG {'AX (717) 444-7577 aVlsloa. 111/06 20M 1 /4'•1' -D' 1 THE D6mE OUT wrr.Cl•CELHO1fCs.Com Wss w IaraAL ral. XlsD.zz AL .0 Tf eg+, 1 •ib the beat my ledge, belief end ' profea. —1 3 t, 1. this Pa¢ory Maf¢factured BMW (PMB) Plan has been approved frrm a ayatem set of no PlanIrtlreviooaly app[Ovad by OW, Application tb. 96-013, Mnnlifattla:er's !y%OC97, BXPiration mte 07 -03-99, vhich hm irot been modified in any marvler. 2. the e—W poRSyl of the PM plan has h be_ prepared m lr9 Part 5 of Nev York .State Ele.W c x Rion-- t-ctian Code (E—gy 0.4) and fa in fu11 I r Pliance With the bwsgy Code'.'( PUTNAM COUNTY DEPARTMENT Or HEALT14 HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS 4 _ " 6 T.M. ed• -bt'- ALL SUBSEQUENT REVISIOWALTERATIONS j0 THESE HOUSi PLANS MUST BE SUBMITTED TO THE PCDN -FOR APPROVAL 44i / SIGNATURE & TITLE F4+ s DAT pf Ct> �t 1 rlS L ) '1 !I. 9 4i 's.' s tb 1. �1 'i 'ib the beat of my knowledge, belief and Profeesiorol judgment, 1. Chia Factory Manufactured ease (PMB) plan hen been approved from a system set of pm Plane previously -PP—*d . . _ by DW, Application No. 96-013, Manufaotiser'a No.0497, 6Ypiratim Date 07 -(L 9", which hae not been modified in any uunner- energy Portion of the FM Plan has been prepared using Part 5 of New York State 0ucgy conaerwetion — traction Cade (C,etgy Cade) and ie in full j cmplienee with the Crergy Code %{ . PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY !� BEDROOMS —�'v8 — ©6 ` 8'/, - l - 56 ALL SWSEWENT REVISIORUALTERATIONS TO THESE HOUSE PLANS MUST BE SURAITTED TO THE PCDOH FOR APPROVAL SIGNATURE a TITLE DATE 20 s�4210 1 q S� Ss�Ho �o `fir, PUfI« Wr Ve 1(e�, N,Y. 1c,5—;7,7 lq 8assinoro D', �,rtr aM 41N nq 1a5�"9 C$Qs)'SA8- 9603 9 L d 0 v —v N C6 I gad hcule �i p a a m - SSIA { 3 is 1i �t yF� m = 00-\�q* PUTNAM COUNTY DEPARTMEN('OF'HEALTH HOUSE PLANS APPROVED FOR BEDROOM) COUNT ONLY BEDROOMS f4— 348`; el 6— ALL SUBSEQUENT REVISIDN;ALTERATIONS TO THESE HOUSL PLANS MUST BE SUBMITTED TO THE PCLOH FOR APPROVA!y IG ATU�� ATo% 6{ i� � elec�ric�i;': �S-• U�'i 1.��'y 1s. a�! 5t. et 1.. �s �i s� e� `•i +S is Si i'. ti. i Now, 86ss'.,moro Del, CPS) ----------- 10 'IrpSt,boat-8 "AmAer Q i IS�IrIs�Un��` �� ..A,; fv� h Em I (I . 1 UJ4 �Oovn �4 s PUT NAM COUNTY DEPARTMF,,N I' OF HEALTH [VISION OF ENVIRONMENTAL" HEALTH SERVICES cC l�tS' RIUCTI.ON PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # r V -c� J Located at Sassinoro Drive /Framers Pond Road Subdivision name Putnam Chase Subd. Lot # / Date Subdivision Approved Oi- Z S- _0 o Town o ?c- XAH4gb Putnam Valley S.5- Tax Map 84 Block 1 Lot Sub Lot 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 $300.00 Building`Type Residential Lot Area No. of Bedrooms 4 Design Flow GPD 800 Fill Section Only Depth Volume PCHD NO'T'IFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1250 gallon septic tank and L.F F. of 4" PVC Perf:. pipe in 24" Gravel trench. Other Requirements a N f. /,;J . OF iZ am 0,F 2334.41/(. To be constructed by 37 Croton Dam Road Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Water Sup ly: Public Supply From Address Be - -� or: .??rivate Supply Drilled. by `f � _..:_ �� Sons ;f .Inc : `Address 4 Pd hain Ave. - - C Brewster, ' 1 9 i I represent that I am wholly and completely responsible for the design alocation of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Con . ti �""Ncll " satisfactory to the Public Health Director will be submitted to the Department, and a written #d r e�Wed the owner, his successors, heirs or assigns by the builder, that said builder will place in good/ immediately followin system or any re I'm t N Signed: Address 2 John Wal s elf th ce he �G•� of said sewage treatment system during the period of two (2) years proval of the Certificate of Construction Compliance of the original P.E. X R.A. Date 7- Z 7- v y 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 necessary by the Public.Ijealth Director. Any revision or alteration of the approved plan requires a new perMit. Ap ove8 o discharge ofdo''esticsanitary sew ge only. By: CLL Title: Date: c3ilel ov White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design P ofe sional Form CP -97 ()v. !-4 180 LF D SDR J8 PVC t (IX UN SLOPE) 7 ' . : 7aV a ,TA,,5*(ryp Ixl 24' MIN OF RUN ) AREA) NO CU. W. TS) a& t I 30 Jo 60 //� 'A TE SEWAGE TREA MEN 7- S YS TEA4 I BASED ON A 4-MR0.0M RESIDENCE AND 11 rO 15 MIN PER I m m WCP SM AND IS 70 CONUS7 OF A 1250 a4LLOV CONCRETE UAW 500 /L r . OF 4 *0 PERFORA 7W P W PIPE IN 24' CRAWL SCALE I "=JO' 4 6A 36 996 if. AND 14 AAWAOUM a' R41,V OF BANK ?A 7E SMOE SMEW BY-4 OUP" & MCOV DAM ROAD CORP. J7 CROMV DAM ROAD CORP. MOM DAY ROAD 37 090700V DAM ROAD 'Q At Y 10562 OSVNING, N. Y 10562 WA MR SD M MEL BY PEWSKILL HOLLOW BROOK AL & SONS. INC AN A KNUE B?, N.Y. 10509 . - - -- I - . . . -.1 6 Pp I . 4 Ao so 5 A6.4 65. 16 1.4 61 Sy g5T .02 05 N 'k i • Lk A Z�-�N 1 mss ;b t Y� r:4 r !Dt 'VO > 3 Y i r r i V, THE S57S AREA SMALL BE CO RED iW 7H A MINIMUM OF 6 AND MUCG7•IED. '£ W i± NOT BE PERMITTED UN77L THE CON57RUC7701V COMPLIANCE -- - - - - - -- SD AND APPROVED BY THE P.C.D.H. AND FORWARD Ro 7T•I£ BU/LD/NG MUNICYPALITY AS PART CF THE CERTIFICATE OF OCCUPANCY APPLICATION. — - �--- -- L'WAG'E TREA TMENT AND WA TER SUPPL• Y OWL Y, AND ALL OTHER REQUIRED R£A SON ' DA r£ TH£ R£SPOWSYSIL1TY OF THE PERMIT ZEE. S _ 11bU (2 YEARS - - fR0Af, 7HF.DA:W, -- _JHF. APPROVAL STAMP- AND -. jS'. - - °�'W BEFOIRE` 71.1E FXP /RA770N` -bAV. -)7 e APPROVAL /S RE ,XABLE FAR 4 MODIRED HHEN CANSTDERED N£CEWARY BY THE DEPARrVENT. ; - -2Y MAP : SUBM/TTED TO THE BUILDING INSPECTOR OF THE LOCAL MUNICIPALITY, WHEN MUST BE SUBMITTED TO 7HE PU7T/AM COUNTY HEAL 774 DEPAR77VENT TO SEC: 9-' n: - 0T 58 OWNG THE FILL MA 7ERIAL 70 SFrILE NA 7i/RALL -Y FAR A PERIOD OF A T T LEAST (1) fRE£Z£- 7HAW CYCI-E" OR FILL STA81LIZA 770N MA Y BE C77ON IN APPROXIMA7EL Y 5 IW4 LIF7S TO THE APPROXIMATE IDERL PING SCVL. t NNG PLACEmENr OF FILL ARE TO BE CIOWDUCTED DURING #ZE SOIL SMEARING AND EXCESS /VF SO/L CCM/PAC77ON. THE SEWAGE 7REA7YDvr SYSTEM AREA IS 2 fE£T -WHICH 'OS. FILL SHALL BE RUN OF BANK 6RAVEL SU(TABLE FOR SEWAGE R 07HER UNSUI TABLE MA 7ERIAL AND SHALL HA V£ AN INPLACE AL . TO OR FAS7FR 7HAN THE NA MURAL UNDERL )'ING SOIL W PERIOD. THE DESIGN PROFESSIONAL SHALL PERFORM E'STS IN THE FILL AFTER STABILIZA770V IS ACHIEVED. P77ON SHOULD CONTAIN NO MORE 7HAN 5Z AND PR£FFRABL Y NO FINE'S ARE CLA Y AND SIL T PAR77CLES THA T PASS 200 SIEVE. c- THE FILL MA 7ERIAL SHOULD PASS 100 SIEVE. DENSE CLAY TYPE SOJL WITH LITTLE OR NO SEWAGE ABSORP77ON REQUIRED 24" RUN OF BANK FILL LARGE BOULDERS W17NIN ED. ;} d T. OF HEALTH a.nw 1 uUUVrr W fart' N16 V: i1N11- jiv-1aiou of EnviroUWntal Health BOMOF .yproved as noted for oontoraaaos With ,pplioable bass and ROSUU M o2 tM eu Coun De i�:irswta T1.t1� ~tie. A@ 1 :JRA wry: KS JA I£ • 7- 25 -2006 itiG. c .f: S: ISS'�-_�'r'�.06vC 0006 72 W F- 0 L W 0 Z } Q J Z a w a� W � Q w 3 Q J Q W 0 0 Q Z a W U) W J J �- �- z 0 J a mm Lim Li:: w Q O Z o U oQ 0 Q � Z D Z 0 a IL I W G Q Y S-1/2 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA 1k1 ®LINARI, RN, MSN Associate Commissioner of Health Richard & Carol Rosario 19 Sassinoro Drive Putnam Valley, NY 10579 Dear Mr. & Mrs. Rosario: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New. York 10509 ROBERT J. B ®N ®I County Executive ROBERT MORRIS, PE Director of Environmental Health January 11, 2007 Re: Addition -A- 348 -06 19 Sassinoro Drive (T). Putnam Valley, TM #84 -1 -55 . I have received and reviewed the plans for the proposed addition at the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The two proposed rooms in the basement titled storage rooms are considered potential bedrooms by this Department's guidelines. 2. The legal, bedroom count for the dwelling is four. The potential bedroom count of your proposed addition is six. 3. The addition of a potential bedroom requires this Department's approval of a revised septic system plan from a professional engineer. eage`riMi the proposed plan to "reflect rio mor 'than fou"r'pofe tialWRrooms, or' have` a " professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements. If you have any questions, please contact me at your convenience. Very truly yours, Gene D. Reed Senior Engineering Aide GR:mcb cc: Building Inspector, (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 o Qss,r)&-o rAZ UT, y ho �16 Lq--q Q 0 S Eire. rooms -7 �C3 All, VI. slovqp- \J fi U Room F—TAO-KD llyl P, o L Tl L'i . i-L I --A0 I 14 VA I-lt4 OAU-Issn� ION 29:-7 1 i 1W: IKRKC 1 rdal SCraweW H a ,D WY.0 .• ,. 1 ./IY.SY,1• hCAelx o 1 FAMILY ROOM `I zvse° •m � I +ss�. Kxi e°CCmo h i �i - ------------ ------ - -- hNt� .1 Lir. 11 I — L] 0x AC— •7 © • ­11— - •en Law - e.6 19• -11 1/1' u[ hoi[ .17 ii ON -SITE STEEL HEADER 6 ESIONED, PROVIDED & INSTALLED 11 ON -SITE BY BUILDER - II 11 P II m n I I ^ 2- LAYERS 5/B' TYPE 'X' azr , T 1 I 12 GYP ON GARAGE CLG (UNIT 'A') HT[ xal[ A I I N SEE N13TE NB Ron 11 __- -_ - - -- ADPL LML, STCII. QM C e, ttOt GARAGE A GE H� Ott L•,Ce 5/B- l,K 'i rtt ]fir w -s n nn V Me wiw: uz - Mnzs yr wwL «r- s r K la xoic 31' -8' 1 -- 12'-3 1/2' 31' -B 1 /�• niisri.cTti L•�r,[x 21' -1 nj - wD •k, era - IT - b h � CLO e9 ZD - KDCZhAI ©- VCx rR AINVC T BATH 93 COYER ; ' % % %L___ 7' -11 7/B' 12' -3' a•IS[ stt 135.0' • ih�tllTI" NW [ill valLS[CM TKD ' .Me LIKS „7 /B' /pwL eu, Ca �� ` ezx+ is •Tit[ iD[ V T— _ A0 Ciil S A.DwE 9 SLID KenCtCa i/ 6D L-+ WY,N 1 /.' ML • SIHttt 5,1,', STUDY "•1 -_8, rz.0 m rr %se Ln4n Kan 9' -4 112' aq9 VCNt Kn'0 zzx Awl .sorb ; I' 2L 0 -7 TIES, 2x6 EXT WALLS P 16' OZ./2-1 MARR WALLS 9•-D' CLG HT. 2x10 SPFS2 FLOOR JOISTS P 16' OC- eG JOIST MANGERS MW WINDOWS CLG GIRDER OVER KIT -NJOK /r DYER TO BE: 2-1 1121x11 I /1' x13•-1' KL 1 LAYER 5/B' TYPE '%' GYP. BOTH SIDES (ONE SIDE-HARR VALL) OVER 2.4 STUDS (WP. SIEATHDL GYP. -EXT. WALL) P 16. OC, ATTACH • /6d CEMENT COATED MAILS P 7' OZ. (ef/P3605) I LAYER 5/B' TYPE 'X• GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS P 16. OZ_ ATTACH . /6d CEMENT COATED HAILS (1 -7/8' LONG ./1/1' DIA. MEAD) a 7• OC. maw 16• -1 1/2' 1�_ C t IS' B 1 /1' 1 r I 16 —1 F la.z. w DINING ROOM twit u 11 e.as vcx, KRD xn uwT zaw•n ] VCMI IYOwT C S R, rrt M rLa Ott Lau Ca4 KCD� I� VY AFr -- ziG I -YW 1 . , -z.a LIVING RDOM zvnn m rr LLA LIWi KVn er VCxI KD'D zax LIGxT vmwD 1261 VCMT PetNO 12052/QN- 1� 7/1• re� G 7-6' 15-6 1/2' 111-6. O O L3•-4 1/r 25-( 3/4' RIAm 8.2 SPFA2 CEILING JOISTS OVER GARAGE. BASE LAYER 5 /8' TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/1 1/1' TYPE 'S• DV SCREWS AT 21' OZ. FACE LAYER 5 /8' (TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/ 1 7 /8' TYPE 'S• DV SCREW .AT 12' 11C. SET BACK SCREWS Y AT END JOINTS AND STAGGER JOINTS 2• -0- EACH LATER. 7/16• 'OSB OVER JOISTS PERPEN.. /ed NAILS (RC2601) 6'-3 1/2' 9.�CEILING DRYWALL VILL BE OMITTED FOR ALL DN -SITE PLUMBING CONNECTIONS TISE ALL DOORS 3/1' - _ ?aYH INTERIOR.A EXTERIOR (EXCEPT UTILITY ROOIU I1.G - DENOTES CENTRAL VAC OUTLET 12. BLDR INSTALLED HEATING SYSTEM TO COVER A 99,000 BTU LOSS 13. MIN. R -19 FLOOR INSULATION RE(jIREI PER NY.SC.CC. 14J SITE LOCATIOK FULHAM VALLEY, NY) PUTNAM COUNTTi 3D PSF SNOW LOAD 8 SPECIAL TWO STORY RR. (2 BOX 689 7 '-/230Q511 GARAGE &12 x7 BUMPOUi SJV£R PA 1ST STORY (7177) ) 4 111 -]9995 5 uv.vx en X_[_D e,. D•m zcwc. }1 rAX (717) 114 -7577 e(wU1pa.Sµ 10/06/2000 1 /1•�I' -d FROM TIE ENSM OUT WmEXCELHOLES.COY w XLID622 >i r� • '1b the best of my kn>rlI edge, belief and , professional judges -t;. - I 1. this Factory Manof'�ctwred Bonne (FMB) plan has Deco appr�bi•M frun a system bat of LI® plaza prewioosly approved by DOS, Application,No. 96-013, Manufacturer's N0.0497, Expiration Date 073 -99, which !as irot bean nmdified,in any a—er. 2. the energy Portico of the FKH Plan has been prepAred Suing: Pert 5 of New York State Energy co-e —tion mn troction Code (Ex:rgy Code }.aid is in full c-Pli— with the'Exrgy Code'- (.. . ;? IS' M1)• • r:....... z JJ {' ry . . 2c�c�ria �• �' G -. s:. 3? . h'• S`f KITCHEN zD]NOOK zD sD rl u u• u. 'ez. .13 1 LI(.1 KD'D w wrx, eco•D z>)e LIfM+ vew-D H.A Kxl Raw•p T Tf) 1 xev x DDV ca. ac- b h � CLO e9 ZD - KDCZhAI ©- VCx rR AINVC T BATH 93 COYER ; ' % % %L___ 7' -11 7/B' 12' -3' a•IS[ stt 135.0' • ih�tllTI" NW [ill valLS[CM TKD ' .Me LIKS „7 /B' /pwL eu, Ca �� ` ezx+ is •Tit[ iD[ V T— _ A0 Ciil S A.DwE 9 SLID KenCtCa i/ 6D L-+ WY,N 1 /.' ML • SIHttt 5,1,', STUDY "•1 -_8, rz.0 m rr %se Ln4n Kan 9' -4 112' aq9 VCNt Kn'0 zzx Awl .sorb ; I' 2L 0 -7 TIES, 2x6 EXT WALLS P 16' OZ./2-1 MARR WALLS 9•-D' CLG HT. 2x10 SPFS2 FLOOR JOISTS P 16' OC- eG JOIST MANGERS MW WINDOWS CLG GIRDER OVER KIT -NJOK /r DYER TO BE: 2-1 1121x11 I /1' x13•-1' KL 1 LAYER 5/B' TYPE '%' GYP. BOTH SIDES (ONE SIDE-HARR VALL) OVER 2.4 STUDS (WP. SIEATHDL GYP. -EXT. WALL) P 16. OC, ATTACH • /6d CEMENT COATED MAILS P 7' OZ. (ef/P3605) I LAYER 5/B' TYPE 'X• GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS P 16. OZ_ ATTACH . /6d CEMENT COATED HAILS (1 -7/8' LONG ./1/1' DIA. MEAD) a 7• OC. maw 16• -1 1/2' 1�_ C t IS' B 1 /1' 1 r I 16 —1 F la.z. w DINING ROOM twit u 11 e.as vcx, KRD xn uwT zaw•n ] VCMI IYOwT C S R, rrt M rLa Ott Lau Ca4 KCD� I� VY AFr -- ziG I -YW 1 . , -z.a LIVING RDOM zvnn m rr LLA LIWi KVn er VCxI KD'D zax LIGxT vmwD 1261 VCMT PetNO 12052/QN- 1� 7/1• re� G 7-6' 15-6 1/2' 111-6. O O L3•-4 1/r 25-( 3/4' RIAm 8.2 SPFA2 CEILING JOISTS OVER GARAGE. BASE LAYER 5 /8' TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/1 1/1' TYPE 'S• DV SCREWS AT 21' OZ. FACE LAYER 5 /8' (TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/ 1 7 /8' TYPE 'S• DV SCREW .AT 12' 11C. SET BACK SCREWS Y AT END JOINTS AND STAGGER JOINTS 2• -0- EACH LATER. 7/16• 'OSB OVER JOISTS PERPEN.. /ed NAILS (RC2601) 6'-3 1/2' 9.�CEILING DRYWALL VILL BE OMITTED FOR ALL DN -SITE PLUMBING CONNECTIONS TISE ALL DOORS 3/1' - _ ?aYH INTERIOR.A EXTERIOR (EXCEPT UTILITY ROOIU I1.G - DENOTES CENTRAL VAC OUTLET 12. BLDR INSTALLED HEATING SYSTEM TO COVER A 99,000 BTU LOSS 13. MIN. R -19 FLOOR INSULATION RE(jIREI PER NY.SC.CC. 14J SITE LOCATIOK FULHAM VALLEY, NY) PUTNAM COUNTTi 3D PSF SNOW LOAD 8 SPECIAL TWO STORY RR. (2 BOX 689 7 '-/230Q511 GARAGE &12 x7 BUMPOUi SJV£R PA 1ST STORY (7177) ) 4 111 -]9995 5 uv.vx en X_[_D e,. D•m zcwc. }1 rAX (717) 114 -7577 e(wU1pa.Sµ 10/06/2000 1 /1•�I' -d FROM TIE ENSM OUT WmEXCELHOLES.COY w XLID622 >i r� • '1b the best of my kn>rlI edge, belief and , professional judges -t;. - I 1. this Factory Manof'�ctwred Bonne (FMB) plan has Deco appr�bi•M frun a system bat of LI® plaza prewioosly approved by DOS, Application,No. 96-013, Manufacturer's N0.0497, Expiration Date 073 -99, which !as irot bean nmdified,in any a—er. 2. the energy Portico of the FKH Plan has been prepAred Suing: Pert 5 of New York State Energy co-e —tion mn troction Code (Ex:rgy Code }.aid is in full c-Pli— with the'Exrgy Code'- (.. . ;? IS' M1)• • r:....... z JJ {' ry . . 2c�c�ria �• �' G -. s:. 3? . h'• S`f TIES, 2x6 EXT WALLS P 16' OZ./2-1 MARR WALLS 9•-D' CLG HT. 2x10 SPFS2 FLOOR JOISTS P 16' OC- eG JOIST MANGERS MW WINDOWS CLG GIRDER OVER KIT -NJOK /r DYER TO BE: 2-1 1121x11 I /1' x13•-1' KL 1 LAYER 5/B' TYPE '%' GYP. BOTH SIDES (ONE SIDE-HARR VALL) OVER 2.4 STUDS (WP. SIEATHDL GYP. -EXT. WALL) P 16. OC, ATTACH • /6d CEMENT COATED MAILS P 7' OZ. (ef/P3605) I LAYER 5/B' TYPE 'X• GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS P 16. OZ_ ATTACH . /6d CEMENT COATED HAILS (1 -7/8' LONG ./1/1' DIA. MEAD) a 7• OC. maw 16• -1 1/2' 1�_ C t IS' B 1 /1' 1 r I 16 —1 F la.z. w DINING ROOM twit u 11 e.as vcx, KRD xn uwT zaw•n ] VCMI IYOwT C S R, rrt M rLa Ott Lau Ca4 KCD� I� VY AFr -- ziG I -YW 1 . , -z.a LIVING RDOM zvnn m rr LLA LIWi KVn er VCxI KD'D zax LIGxT vmwD 1261 VCMT PetNO 12052/QN- 1� 7/1• re� G 7-6' 15-6 1/2' 111-6. O O L3•-4 1/r 25-( 3/4' RIAm 8.2 SPFA2 CEILING JOISTS OVER GARAGE. BASE LAYER 5 /8' TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/1 1/1' TYPE 'S• DV SCREWS AT 21' OZ. FACE LAYER 5 /8' (TYPE 'X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH •/ 1 7 /8' TYPE 'S• DV SCREW .AT 12' 11C. SET BACK SCREWS Y AT END JOINTS AND STAGGER JOINTS 2• -0- EACH LATER. 7/16• 'OSB OVER JOISTS PERPEN.. /ed NAILS (RC2601) 6'-3 1/2' 9.�CEILING DRYWALL VILL BE OMITTED FOR ALL DN -SITE PLUMBING CONNECTIONS TISE ALL DOORS 3/1' - _ ?aYH INTERIOR.A EXTERIOR (EXCEPT UTILITY ROOIU I1.G - DENOTES CENTRAL VAC OUTLET 12. BLDR INSTALLED HEATING SYSTEM TO COVER A 99,000 BTU LOSS 13. MIN. R -19 FLOOR INSULATION RE(jIREI PER NY.SC.CC. 14J SITE LOCATIOK FULHAM VALLEY, NY) PUTNAM COUNTTi 3D PSF SNOW LOAD 8 SPECIAL TWO STORY RR. (2 BOX 689 7 '-/230Q511 GARAGE &12 x7 BUMPOUi SJV£R PA 1ST STORY (7177) ) 4 111 -]9995 5 uv.vx en X_[_D e,. D•m zcwc. }1 rAX (717) 114 -7577 e(wU1pa.Sµ 10/06/2000 1 /1•�I' -d FROM TIE ENSM OUT WmEXCELHOLES.COY w XLID622 >i r� • '1b the best of my kn>rlI edge, belief and , professional judges -t;. - I 1. this Factory Manof'�ctwred Bonne (FMB) plan has Deco appr�bi•M frun a system bat of LI® plaza prewioosly approved by DOS, Application,No. 96-013, Manufacturer's N0.0497, Expiration Date 073 -99, which !as irot bean nmdified,in any a—er. 2. the energy Portico of the FKH Plan has been prepAred Suing: Pert 5 of New York State Energy co-e —tion mn troction Code (Ex:rgy Code }.aid is in full c-Pli— with the'Exrgy Code'- (.. . ;? IS' M1)• • r:....... z JJ {' ry . . 2c�c�ria �• �' G -. s:. 3? . h'• S`f .q WALLS B 16' OC %2.4 MARK WALLS E HT. 12 FLOOR JOISTS�.P 16. O.C../ JOIST HANGERS _ IWS '.TEN TO BE 24' O.C.( -UNIT E- ROOF SYSTEM TO BE 16. O.CU(LT32- 7M)(LR27 -12M) ER TINDER HALL TO BE: 2 -1 1/2'.9 1/4'.17-4• Ml. I OVER HALL TDk BC1 2-1 1/2- .14'.I8'-0' ML. ER UNDER VI.C.:ITO BE: 6- 240.11'-11' SYPe2 IOC SYSTEM IS DESIGNED FOR CEILING DEAD LOAD ONLY IECHANICAL EOUIPMENT SHALL BC INSTALLED IN THE CEILING 'db the but of vy knw'edge, belief and professional judgement, 1. tt1la Factory Manufactured Nome (F71B) Plan has been approved fray a eyste set of FMB Plana pt —i—ly approved by DOS, Appliratim No. 96 -013, Manufacturer's No.0497, EYpiretim Date 07 -0 3-99, which has inet been codified in any —er. 2. the energy portion of the FMB plan has been prepared using Part 5 of N— York State Energy care _ti— _tructim O.S. 'Energy Code) and ie in full j omPli— with the Energy Code -. - ( .. .. .. .. .... 4.. ice. :... A. C14) u v� r n • 'r i �o I I I it li I I ( � I I � �I I ICV FF--44 I 31 �I I f I f0 T1iCK POURED CONCRETE ---� n 36 I :.roLlnpATgN WALL - TYPICAL V WINDOW (LOCATE N FIELD) — — — -- r, 20• x 10• DEEP CONTINUOUS POURED CONCRETE FOOTING - TYPICAL BASEMENT 4' POURED CONCRETE SLAB WRH I 66-WL4xW'L4 WWF OVER 4' CRUSHED STOLE /GRAVEL BED AND 7' -5• 50'-7' 4 ML VAPOR BARRIER 23'-6' ADD LALLY COLUM ADD LALLY COLUMN • HOLD DFAENSION HOLD 33 -10' DQv1EN3ION iii ADD LALLY COL UM ,) 5' -4' 5' -4• 5'- HOLD DMENSION 5' -2' 5' -2' 4' -6• • 65`s� 4_2x12 �— WID X 39 W /2X8 — — 1CONT OL w J OC STA L L J L — — L_ — x lo• a• STEEL PIPE COLUMN ON . 3' -0' x 3' -0' x r-0• DEEP @ • , POURED CONCRETE FOOTING 1; - TYPICAL UNLESS OTHERWSE NOTED ° L I IOC TO COORDINATE LOCATION OF — — — — — STAR W/ MODULAR MANUFACTURER LOCATE INTERIOR FOR ADORIONAL STRUCTURAL WO FOLNDATgN WALLS AS I REOURED BY MODULAR MANFACTLiiER SO 0 W12X40 W/ 2X8 NAILER — _ — L _ I POCKEr —t r II �- UNEXCAVATED —4• ; POI WITH 4• PO I TYPICAL 66- Wl4xWt4 VIER V CRUSHED I ! I SECTION STONE/GRA AND 4 N L VAPOR BARRIER I I —4.t— — —� t tl.. I 36 }•X 36t WINDOW VACATE N f 1 19' -8• n o, a D) r' i '=1 I L'I I --1 i ^rfl. i tl I BEAM POCKET Al' (TYPICAL) I I t�: I `I: I I 4' DEEP BRICK SHELF - TYPICAL AT FRONT OF BULDM V2' DW O I 0 A . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - .:.:�,- .. - 'w "u }'.�Q;;cq, v,¢: -_ "x.:ic"•'.'y. "'j�y,:��% , n'•;:_a:... - ._...rbw ::;;r..+ -. .- ,..:3,. ..�..;�:= ::.:- i•_- ;.��_. .�.•-v,�•.V-v��":i�.:.�:e: -. , .- •.x•;::�a:.. _.- ra .CERTIFICATE OF CONSTRUCTION COMPLIANCE SEIYA TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # �� -2t) -- D(D - Located at �5A 5t-,tA)0E0 E Town QPW446W RuToJAM IIA LLF_.Y Owner /Applicant Name 31 �01W _Qw ?m &.i-. Tax Map Block �_ Lot ,,578 . Formerly Mailing Address Subdivision Name _Pu-r,,sAA NA5r_ Subd. Lot # Date Construction Permit Issued by PCHD 8L8-Zoo - - Zip D/ S6z Separate Sewerage S, sy tem built by 3y C�oTO �� 'FoRn (`zeiAddress 3`i (�tpn7A ni, D�s�.� 9� N.Y Consisting of 1,2�D Gallon Septic Tank and S// L ./= 01� y ,� ��'��� PVC 7>1 PC ,/ / .?41 a G Q A VEL TP—e'.V['11. Apt /) .X A Alla/ - Or- - A.+/ WIP—OW - Other Requirements: Water Supply: Public Supply From. Address or:- V"' Private Supply Drilled by ? F. �3EAL- � 5r)nas �l✓,e .Address 4 �wrNAtt A v4 . Building Type. 4 A AU_t _uc wAT. %A L Has erosion control. been completed?. yr-T Number of Bedrooms Has garba.g �. en installed? AID I certify that the system(s), as listed, serving the to ere eer . � of cted essentially as shown on the as- in built plans (copies of which are attached), in a r ce tirt? `', sued. C Construction Permit and approved plans and the standards, rules and regulati s o ,tp Putn . 'Cotunty D ent of Health.. Date: p 09 D/ Certified by P.E. ✓ R=;V-.- p r (Des �FFr Address 2 ,c�nvi Wall � �u�.. .�S �'�E 7 `10566 License # D 6` 9 86 � P FA _ 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 rpodifidation or change when, in the judgment of the Public Health Director, such rev o , m ifi ti or - ange is necessary. r By. Title: Date: 2 O White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 .10 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT fNuiE: txact location ot well with distances toati o permanent landmarks to be provid a s6parate sheet/plan. s 'w 7 Well Driller's Name P. F aj,!12jas leas Address: 4 Rtnarn Ave., Brewster, NY 10509 Signature: Date: 1/25/01 Perry L6__I�eA - White copy: HD File; Ye low copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 q- Pond ' Rd, Put-Chase Subd., Lot 14 N­illdgd�: 1 Putnam Valley Tax 4 iMap 84 Block 1 Lot(s) 58 Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 T<Jse 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 65 ft. Length below grade 64 ft. Diameter 6 in. Weight per foot 19 lb/ft. Materials: X Steel Plastic Other Joints: Welded X Threaded Other Sea]: X 'Cement grout Bentonite Other Driveshoe: _X Yes No ILiner: 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 5 gpm Depth Data Measure from land surface-static (specify ft) 10, During yield test(ft) 4201 Depth of comp _ leted well in feet 4851 Well Log If more detailed information descriptions or 1sieve .analyses ,..-, areavaifabfe_, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 40 Drillind in ove burden clay and boulders 40 Hit rock at 40, 65 Drillinc ­in- rock i;* :set -casipq,­_-_c[r.outed�- 65 r 485 Drilli in roc granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump Type sub Capacity 5cm Depth 440' Model 5GS10412 Voltage 230 HP 1 Tank Type M02/ Volume 8_ 6 gal. Date Well Completed 4/1/99 Putnam County Certification No. 002 Date of Report 1/25/01 Well D le si D fNuiE: txact location ot well with distances toati o permanent landmarks to be provid a s6parate sheet/plan. s 'w 7 Well Driller's Name P. F aj,!12jas leas Address: 4 Rtnarn Ave., Brewster, NY 10509 Signature: Date: 1/25/01 Perry L6__I�eA - White copy: HD File; Ye low copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT 'yell Location..... _.. _ . T.• >eet,Address: - :,;: Kramer`s• orid Rd, Put –Chase Subd. , Lot 14 �',ttwgiage`• Putnam Valle T,aa� rid: Vin:.;:_ -, .. p -:.: =�• Map g4 Block 1 Lots) 58 Well Owner: Name: Address: S 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 65 ft. Length below grade 64 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 � Yield �_ gpm Depth Data Measure from land surface- static (specify ft) 10' During yield test(ft) 420 Depth of completed well in feet 485' Well Log If more detailed information descriptions or sieve analyses are. ava ►la 1`e, °° _ ' please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 40 Drilling in over urden clay and boulders 40 Hit rock at 40' 40 65._.... -Drill in in roc c, ...set. casing,_c1routed. .....__... ­'65 "" 485 - Uri`Y iri in rock gr an If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5cfpm Depth 440' Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 Vol u 8 al . Date Well Completed 4/1/99 Putnam County Certification No. 002 Date of Report 1/24/01 Well D II al NOTE: Exact location of well with distances to at leas o permanent landmarks to be pro vt do a separate sneevplan. Well Driller's Name P. F. &1 , nc. Address: 4 R txriam Ave., >3cewster, NY 10509 Signature: Date: 1/24/01 Perry L. White copy: HD File; Yel copy - Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 "w":w LA38 NORTHEAST LABORATORY OF DANBURY . I3LL_ a' `:ax_ROA67..-�ANbjU tY9• (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 Ev REPORT TO: P.F. BEAL & SONS <0.005 • DATE SAMPLE COLLECTED: 1/18/2001 4 PUTNAM AVENUE <0.20 TIME COLLECTED: 10:30 A.M. BREWSTER, N.Y. 10509 8.0 COLLECTED BY: W. MAYES • Haidneas ':" -.. .. _ ....... T _M:(k_ DATE RECEIVED @ LAB: 1/18/2001 • Iron <0.03 TESTED BY: LAB #11471 • Manganese <0.01 LAB LD.# PFB010 REPORT DATE: 1/18/2001 SAMPLE SITE: V.S. CONST., LOT #14, PUTNAM CHASE SUB., PUTNAM VALLEY, N.Y. SAMPLE POINT: HOSE BIB @ TANK SOURCE: WELL -NEW TREATMENT: NONE MAXIMUM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (MCL) OR STANDARD BACTERIAL: o 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 6:83 - EPA 150.1 No designated limits • Turbidity 0.25 NTUs EPA 180.1 5 NTUs CHEMISTRY: • Nitrite Nitrogen <0.005 • mg/L as N EPA 354.1 • Nitrate Nitrogen <0.20 mg/L as N SM 4500D o Alkalinity 8.0 mg/L SM 2320B • Haidneas ':" -.. .. _ ....... T _M:(k_ -mga—. • Iron <0.03 mg/L EPA 236.1 • Manganese <0.01 mg/L EPA 243.1 • Sodium • Lead <10 mg/L EPA 273.1 <0.001 mg/L EPA 239.2 1.0 mg/L 10 mg/L No defined limits = 0.30 mg/L 0.50 mg/L Combined limit for Iron plus Manganese = 0.50mg(L 20.0 mg/L ** 0.015 mg/L * ** ml. -nil niter mg,'L =inilligrams per Liter ND =none detected MCL= Mrai,-,- um Contaminant Level TNTC =Too Numerous Te Caunt "'Notification Level ** *Action Level COMMENTS: -All holding times (were) met. SAMPLE, AS TESTED ABOVE: ® OTABLE _ or OT POTABLE RESULTS BASED ON SAMPLES SUBMITTED: 1 /18/2001 Laboratory . Director -NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037° (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800 - 654 -1230 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location street Address: Kramers Pond Rd Lot #14, Putnam 02ase Subd- own/Village: Putnam ValleyM Tax Grid Map 9 � Block Wen Owner. Name: Address: D.S. Corporation, 37 Croton Dam Rd, Ossining, NY 10562 Use of Well: 2-secondary x Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify)' Industrial Institutional Standby Tilling Equipment x Rotary _ Cable percussion X. compressed air percussion _other (V=*) Well Type Screened Open X Open hole in bedrock Other CAsing Details Total length 65 & Length below grade 64 & Diameter 6 in. Weight pee 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 ILiner _Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screw (ft) Developed? First Yes No Hours Second WeR Yidd Test Bailed x Pumped Compressed Air Hours 6 Yield 5 9ppm Depth Data 9=—= fim wwsiurdcc-so c (specify ft) 30, During yield test(ft) 2101 Depth of completed well in feet 4851 Well Log If more detailed information descri lions or sieve are available, please attach Depth From Surface Water Bearing Well ntammr(in) Formation Description ft. & Land Surface 40 Dri.11in in ove.,burdm clay and boulders 40. 40 65 Drillizz in roc:, et casing, grouted 65 485 Drill' z q in r te If yield was tested at different depths during drilling, list Feet Gallons Per Minute Pump/Storage Tank Information Pump Type Calmity Depth Model Voltage HP I Tank Type Volume Deco we mom 4/1/99 Putatto County Cadfladw No. 002 -lot Date of Report 4/14/99 ell RUTZ: Exact location of well With distances tD at least Well Drinces'Name P. Ste: ;;0 mn.mum to be pwa" a separate snemian. 4 Putnam Avenue Address: Brewster, NY 10509 Date.- 4/14/99 White copy-. HD Ric, Yellow copy - Building Inspector, Pink wff - Owner, OrzzIV W" - Well driller Client Name: I TIN MILLER ASSOC. STL Sample Number: 201459-01 Client I.D.: kELL L-14 Date Collected: 13-APR-99 Date Received: Comments: -14- APR -99 Analysis Result .Federal Io;. qqlJqFt01 by Tirb,"r,g"a,hics 'Anal YVVD;ft� Form I - IN Project Name: 9863 Matrix: 1 DrinkH20 Units . Method Analyzed • k .... .. . f V. Arsenic UG/L 200.7 16-APR-99 our ... .. ... Beryl ium U UG/L 200.7 16-APR-99 ni. 0. Z; Chlorides 18.0 4500-CL-8 16-APR-99 .. ..... .. Color 2.5 PT -CD 2120 -8 15-APR-99 "'AAM M Cyanide, Total 0.01 U NGIL 450OCNE :E= •0.4 Fluoride U MG/L 15-APR-99 q. 41,$ Lead 1.0 UG/L 3 13 20-APU99 -get, An" Nercury 0.2 U UG/L 245.1 19-APR•99 Remarks: 315 Fullerton Avenue NewburgK NY 12550 S7Z_ �J Federald•.Callected an d:. Voi2`tfile °Ur'� Analysis Bata Sheet FoMI VOA 502.2MTBE Client ID: WELL L -14 Date Collected: 13-APR-99 STL Sample Number: 201459 -01 Date Received: 14- APR -99 Client Name: TIM MILLER ASSOC. Date Extracted: Project Name: 9863 Date Analyzed: 17-APR-99 X Solid: NA. Report Date: V-APR -99 Matrix: 1 Drink.42O Column: RTX•502.2 Sample Wt/Vol: 511 Lab File Id: A4754.0 Level: LOW Dilution Factor: 1.00 Detection Conc,. Data Limit CAS NO. Compound ug /l ug /l Qualifier ' . .:::;;):.. , •:.........,tom t.,, 108- 38 -3 110 m.p- Xylene ., .. :.,. :.2.::. 947.. .. :..:...,,: }.:..:..... :;..'.:.,:,.:...:. >:...:.. .2:• �,�,.�.� u 98 -82 8 Is .pr Y. 103 -.65 -1 n -Pro Xlbenzene .� .:. .�,.$ �!l' �@y{��♦�y .. ,., . :,v ..v:,. ., $Y.1 ":•1�♦1:55$; :' }. ::ti:';i' ,.`ti ;{. v'.. • .... .. n ... v. .:. v. $. ... .. ..�.^.,�Y►{F,W.. -.. „,2 .. .. q.,:.};.,... . -..v. :- :},ffl. t, ^.: ":J: '' \::j.`':: }:. :. .. `:'t�� "• }`�:�,' M1. \ \: •.:'w,., '•::� .:.; .rid ��.. 135 -98 -8 t ne : :.: • ..:..::•'::. :.CUs sec -Bulbenie�' 99 -87 =6 4 Isapropylto uene :s:;5 ..,:....... ), ... .: ,.:.... 74.83 -9 Bromomethane :.. .. .... . . . ... . }• ,. . 87473 Hexaadiene - „. :.. }:... 91 -20 -3 Naphthalene ,5 U �'_' <:�'�).`:::`:.; .:',t +:iu• :S•. �::2;:�..!-;,\ .F ..... -.-�. ... i'ii V. : -•.. ., 3','; �••� J:42; }`. �': +:::. ..; •. }; h`\. •l:��ti` ?<:••2,:,'$ .,... ..,,. , . ,. •::1;:; „'ra >;::;,��. Y i 75 -01 -4 Vinyl Chloride .5 x� U 75 -09 -2 75-35-4 1,1 Dichlaroethene :.,.,..... ..., �1t�`4 ,.:,:.., :, •. ::... �..,;..,J.:.:. ,.:.;::.::,. ?:. }; *: <,;'2::5•:.• :k <.2� :�;a,;h:55s >•• 75 -34 -3 1.1- Dich/l�oroethane 156 -59 -2 cis- 1.2•Gichlaroethene� "••"Y 'f Y. .:...; 107 -06 -2 1.2•Dichloroethane 74.95 -3 Dibromomethane "':Cry'.`:..<,:.:..•. 2:,:.., : +:.:,{ ..:.tt���F{,Jt��''{ . 5: ...:,hT3•:: i:'':2 } > \,: :••.. "..i,!•'�T�h:i } {: }''.: ...'S.. ,,•.::� J)t :: •:ji,:i! \2)J ::; U:$::r{ }t`::ti; 56.23 -5 Carbon f'etractil•aride \ 1 A J' ' ^" .: •. ..J 47 i::;• :..}).; }:+i ':yJ :i 2.1:;: „,(,; ,•� \h 78 -87 -5 1.2- dichloro ro ne {W. W-Wi ra., Tri chloroethene ;....• •v } h .5 >t .�r�'w/- ��.��.5v,.�{ ': -... •.::•... n: .. tl.. �`•.� •.., n.,.. . . n: . ... •:,v \:! � `••1 ;, ....!C!.C�'... .:J ,... .,t ••.. I'.- A: ��� ... -.. .. nx.:,. ... •.,•,.nv :•v }'Tt'J{.i ill \:• '1,; '' (ti:'k• y/y ,, v 124 48 -1 iDib!r�o♦m,ociiiar�ietliane Te 106.93.4 1.2.Oibromoethane 5 U 315 Fudestm Avenue Newburgh, NY 12550 Forml MA 502.2KTBE Results are continued from the previous page for 201459-01 CAS MO. Compound w 3- ug/1 ug/1 Qualifier U A. -49�y-8ar� 2-Chl( y9.5 541 73.1 1.3-D1 !ne • 106-46.7 1.4-01 10061-02.6 trans- U 11-43-2 Benzer 144150,-- ls M U -hylb w 3- ug/1 ug/1 Qualifier U 315 Fugenan Avenuo NeMxwgk NY 12550 A. X U !ne U enzene .5 U 43. enzene .5 U hloropro ene .5 U .5 315 Fugenan Avenuo NeMxwgk NY 12550 1 TJl V 1►J1Vl\ lJ1' i'JIT V limIJl I IV1L1� 1 t-1'11 Vj 1 tl= Omit V „ll -IJEJO GUARANTEE OFSUBSURFA'CE SEWAGE TREATMENt SYSTEM 31 QbAQ (0, p'. sec. 8�- Owner or Purchaser of Building Tax Map Block Lot Building Constructed by oL� illage f uTi )AM l yRSF ` 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 negligent act of the occupant of the building utilizing the system. The' under igned further agrees to accept as conclusive the determination o e P i 'c Health Direct r of he Pu red County Department of Health as to whether or not e i ure f system Zapoe to as ca y the willful or negligent act of the occupan oft b it ing i zing the m 1 1 / * Day D 8 Year 2CO J \ Title: V \11 1; Ge eral C PlTxtor ( er) - Signature 37 ' CP-oTO� � � � (�D2t�: 37 �oi-o� �,AM � D 0o��a Corporation Name (if corporation) Corporation Name (if corporation) Address: 31 � O►ncG . Address: O o,4 AM J Q ��j� ���► State /V. % Zip 01 6.Z State Zip /a5'6z Form GS -97 'BRUCE; R ,; - - Public Health Director .. ,�i�:. - ..- ..�;�Ja�a�r'Y'S r1�W�`•K:1T.� ^171..�f:1`a. •-.. .+ Associate Public Health Director Director of Patient Services DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fai (9.14) 278 - 7921 Kursing Services (914) 278 - 6558 WIC (914) 278.6678 - Fa (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278.6082 Fox (914) 278 - 6648 ®Wi�ERS NAIM: 37 M �bA_Q TAX MAP NB MEB: .sec. S�� ��� L- oT;;:��� �� �T 1$4- E911 ADDRESS: TOWN: ya (-L€ Y AUTHORIZED TOWN OF V (Signature) DATE: :2 d0 d w. The Putnam County Department of Health .ill not sue at Ceracate of , Construction (Compliance Mess the above form is compReted9 le. a legal E911 A address is assigned by an auth ®nized town OfficlaL This form is to be submitted with the application f ®r a Cerfificate Of C ®lstmcli®mt cCOrmpHanceo (E911VSRF M) J1 1 f�,• 5: tk e PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION 12, ;? 7 O� Date: / Inspect y: Street Location - � SS Vi iZ .. ,: vOwner�. C:: - ° - =-'Town° .. e.. :..., ... Permit # TM # — i 5 y Subdivision Lot # 14 T 1. Sewage Svstem Area a. STS area located as per approved plans ....................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. §eptic tank size - 1,000 ... .1,25. .other ................ b. Septic tank installed level ............................................... c. 10' minimum from foundation .......... ............................... d. Distribution Bo 1. All outlets, at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.0riginal soil between box & trenches e. Junction Box ..- properly set ........... ............................... f. Trenches engt required -� Length installed 5vo 2. Distance to watercourse measured Ft.......... 3. Installed according Itpabl, lan.....; ........................... 4. Slope of trench acc I -1/32" /foot ............. 5. 10 ft. fromropert ne -�20 .- foundations......:... 6: Depth o otreno <3ch s.from surface .................. 7. Ro llawedl or an�ion,1000 ... 8. Si of gravel /4 -Z" dtUZMinimum r clean .................. 9D pth of grave i in ...... ............. 10. Pi, a ends . cop ....... Pum r -Dosed-S sfems� ' 2. Ove ow ........... .. ...... ...................... .... ...... 3. Alarm, visual /judio ......................... .......... 4. Pump easily a&ssiblet`= / ole� grade ................ 5. First box baffle'l ........ ..� . ...... ............... :.................. 6. Cycle witnesse y H. A ' ated flow /cycle........... III. Iouse/Buildin a. House located per a o ed plans .............. : ............ ....... b..Number of bedroom .... .............................................. . IV. Well a. Well located as per ap roved plans . ............................... b. Distance from STS area measured ' ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area :.............. h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev. 6197 L ljULI I'L PUW.%bI COUNTY DIEPARTMLNT OF HEALTH WMION OY MMONWIENTAL MaTlff SIERWCES FAIWIM P F® fig lll�fSPIC�IOR1 For. FM AJI infonmdon mm be My completed prior to any Trenches mspections being made. PCB Cwmuction Permit # F✓ 2A - DO Located. raj g uz Iaey & LIAUbCK Om&ApplicantName- 0,r-mw Tim 05�-, RIO k Lot —.:5-& - Forardy: Subdivision, Subdivisio ot# Is synem, fill completed? Is System complete? I - Y-ren Date: Is system constr=ed as per plans? ye!!�-) Is well drilled? ye-0 Date: Is well located as per plans? Are erosion control xne=es in place? cm* ft the system(s), as fisted, at the above premises has been constructed and I nave inspected nerd verified their completion in accordance vAth the issued PCHD Construction Permit and Approved Plans and the Standards, Rules &W Remotions of the Mam County Depamnem of Hedth- -001 Address: •2 QLm OIL' d -E J'- J'd - - - It - Lic. # --Q-&Z—qeta , commew; Ogst 5:�rj Pf-c -T0,Be--RIACfA Form FIR-99 DesiA Profissional Address: •2 QLm OIL' d -E J'- J'd - - - It - Lic. # --Q-&Z—qeta , commew; Ogst 5:�rj Pf-c -T0,Be--RIACfA Form FIR-99 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ . Cl ..y- .R -•'' O�V fJCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Cf if --A O - 0 J Located at Sassinoro Drive /Kramers Pond Road Town ol(Migt Putnam Valley Subdivision name Putnam Chase Subd. Lot # IV Tax Map 84 Block 1 Lot Sub Lot Date Subdivision Approved 0- 7 —ZS-0o 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 $300.00. Building Type Residential Lot Area O No. of Bedrooms �_ Design Flow GPD RpD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage S_ ystem to consist of 1250 gallon septic tank and 5de) L. F. of 4" PVC Perf. pipe in 24" gravel trench. Other Requirements: Z.4' ©F Iz og D,=7 !3Awly. To be constructed by 37 Croton Dam Road 'Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Water Sunuly: Public Supply From Address . .X. Fj .v4t6-S.uppIy Drilled -lay = $� =,� ; .'Ad'dfres� .4...Pu�tfiam 'Ave : - _...., Brewster, N 9 I represent that I am wholly and completely responsible for the 46sign and location of the proposed system(s) and that the separate sewage treatmensystem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Constru ell ce" satisfactory to the Public Health Director will be submitted to the Department, and a written guard`gteLY i d the owner, his successors, heirs or assigns by the builder, that said builder will place in good op Teti iti10% p of said sewage treatment system during the period of two (2) years immediately followin a to e i .o ap oval of the Certificate of Construction Compliance of the original system or any rejdfirs t er W r° jr 41 . ' Signed: 4k �� ' P.E. X R.A. Date Address 2 John Walsh °v�di ,' a2�e - � 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 necessary by the Public Health Director. Any revision or alteration of the approved plan requires anew pe it. Ap ove o dis arge of domestic sanitary sew ge only. By: Title: Date: � � av White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design P ofe sional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES _ ,. .. . -, ..,o- .. .-. .. . -. z, r. � _._ s .eS�': i•.� •'4. .v. _ "� r _.rod .� ... ..�:: .._. ... � ._ ,. r. .. _ _ ' . LETTER OF AUTHORIZATION RE: Property of 37 Croton Dam Road Corp. Located at Sassinoro Drive /Kramers Pond Road T/ Putnam valley Tax Map # 84 Subdivision of "Putnam Chase Subdivision" Block 1 Lot Sub Lot fe74 Subdivision Lot # %% Filed Map # Date Filed 07-ZI -a> 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 Mr accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the F o of said wastewater far�'•fi, "cep.. :n -t_ r ea en oLr water supply systems in conformity with the 45:and/or 147 o _ u aw, the Public Health grd Pu`i nia ... \ it Very tru%ero�Ap;c;r�ry) ` Countersigned• ��;. ��s��' ` Signed: Pres . P.E., # 06298 `y'F� Mailing Address. 2 John Walsh Blvd. #200 Peekskill State NY Zip 10566 Mailing Address: 37 Croton Dam Road Corp. 37 Croton Dam Road, Ossining State NY Zip 10562 Telephone: (914) 736 -3664 Telephone: (914) 739 -7362 Form LA -97 'PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIi;A ' - "CORPORATE 0- 'WNER�A.P�i,tC�TiO"N 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 I, 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: (Same as above) Secretary -Name: Michelle Santucci Address: (Same as above) Treasurer - Name: Same as Secretary n �� Address: . (Same as above) and that I am and will be individually responsible for any to the approval requested and all subsequgnt acts relating Sworn to before me this Notary Pub day of _ (year) KELLY M. LENT Notary Public, State of New York No. 01 LE6026834 Qualified in Westchester Coun Commission Expires June 2i, 2 Form CA -97 Signed Title: Corporate Seal t d cc ,. poration with respect .PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH. SERVICES APPLICATION FORAPPROVAL OF PLANS FOR `—X WASTEWATER 'TI2EATME'NT SYSTEMT � ' P 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 #. / V 3. Location TN: Putnam Valley 4. Design Professional: Timothy L. Cronin III 5. Address: 2 John Walsh Blvd: 6. Drainage Basin: Peekskill Hollow Brook Peekskill, NY 10566 7: Type of Protect: 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) .................................... .. ........ Type I, - Exempt _ Type 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? ...::.:::..: .... ............................... ........... :..:::........ :........... 13. If so, have plans been submitted to such authorities? ...:.:.............. 14. Has preliminary approval been granted by such authorities? YES Date g&ted: YES — YES 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 N/A 20. Is project site near a public sewage collection or treatment system? ................ 'NO 21. Name of sewage system iv /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 �. 2 27. Is any portion of this project located within a designated Town or State wetland? NO - .,c>' .i, .�• ._•. r. ... .... ., . .. b r�r y- .�:.K:: .`.y.: ai. no-- .,y -t. :� � .i• � �..�. -. •, ..�-. ..._ _.. .r .. s•r -. �,.,�.�. ,G 2'9. Wetlands'1D 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? ................................ ............................... NO 35. Are any sewage treatment areas in excess of 15% slope? . ............................... NO 36. Tax Map ID Number ................. .......................................... Map 84 Block 1 Lot ,6f 37. Approved plans are to be returned to ..... Applicant X Design Professional • NOTE: All'appticatioris "fir review and'approval'of a riew'SSTS-to'be"located`�v thin ttioNYC Wadt8hed,thall' " 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 stonnwater.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. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission.. NEW Y - I hereby affirm, under penalty of perjury, that inaforma d ran is trace to the best of my knowledge and belief. False stet n s..m herein a� able_ as a Class A misdemeanor pursuant to Section o ent M-- SIGNATURES & OFFICIAL TITLE'S: 62980 -X" Mailing Address' Cronin Engineering John Walsh Blvd, Peekskill, NY 1.0566 __Z- 4. `A PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES "".DESIGN DATA SHEET - SUBSURFACE SEWAGE. TREATMENT SYSTEM Owner -3� C$oTMJ DM &AO egA-P Address 37 G9, Aj 13'►M OSSImuG) �%. Located at (Street) KgA4 je-7;5 t:bv0 rz.ofro Tax Map Ej Block.- Lot 11t 2-4j (indicate nearest cross street) Municipality(T) B.L, yAM UAz Drainage Basin -kSr.tu: hipacW ct2 K _ I/V t�So�U 21 vain � SOIL PERCOLATION TEST DATA 04 -o- — qq Date of Percolation Test 64 -06 -r9 Hole No. Run No. Start -Stop Elaps in Time De th to Water rom Ground Surface (I S op Water Level lInc3es Percolation 1 EWInch Z� ' °g_ t 2.3 i 2A - V 3 S 18 7-4-27 3 4 5 2 3 13 3 rt'+' - JZ,0 4 Z �,4 �z ,� . 04 -cq-� q r' �zc o� • 5 1 2 3 4' NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 mWinch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 -q4 2 TEST PIT DATA DESCRIPTION OF SOILS -7 ST 9_I DLES . DEPTH HOLE N0. 41 -HOLE NO. 47, HOLE NO. 4'7,A G.L. So a L So tL tb /moo c c._ 0.5' 1.0' 1.5' gAu,4j .S1 (,vim Lo AVM, eZ . a /lr aNa L04," 2.0' 2.5' 3.0 3#1f 3.5' wl G- �rza���� 2 Soh w G m2 4.0' —0 4.5' 5.0' LO 5.5' 6.5' 7.0' 7.5' 8.0 rf" 8.5' 9.5' 10.0' Indicate level at which groundwater is encountered.' Indicate level at which mottling is observed A1 ®a.c o 4SCAUch Indicate level to which water level rises after being encountered �d-a Deep hole observations made by: AE)4nn Igo& 5myOwDate Design Professional Name: Ttm on4V f. • ar WmA) Address: Signature I Design Professional's Seal ,:. Uj 62980 �r``_tV0FESS ►Q�VNi A 37� °58 SPECIAL TWO STORY 4 JL1242 MW E09 M/ 20 x 11 GARAGE & 127 x 7 BUMP OU T V.S. � MRSWOM PIS 17015 ELCVATIONS •~. fit?) .044 -J"s •u.w t • •n FAI (tllf 411.7377 08/281Z� 1 /�••1.�. MY r -rcl•L "es COL 'i �q�p� it i`. *81e91W 9654 j i� ■ . . UUN CORP n 1� I� 1 'll II .a 1, Fb r< i low. vINM PAMILS KIWEM ISI t 211Y ELWR WPCGWS WI-SITE By IMUR i. rRUNi ELEVATION 4� . .,1 e r 9� i ! Lim 11 lot gal now (fi m T i m 1 m m • �.. 37� °58 SPECIAL TWO STORY N) JL1242 MW E09 M/ 20 x 11 GARAGE & 127 x 7 BUMP OU T � MRSWOM PIS 17015 ELCVATIONS •~. fit?) .044 -J"s •u.w t • •n FAI (tllf 411.7377 08/281Z� 1 /�••1.�. MY r -rcl•L "es COL �q�p� *81e91W 9654 Ida 0 { 1 Iw lY, F C� 1 G P ti N 4 6 .i i T]QN CORP. /RO E y i; s. R .. 01 -SRE ov Dl TVPL i MIMES 3L BEE aa®a sar sav � tmnroat �n rDtas YAIC (DV 7) aee -76DD vvt�eACBtaaH¢8.torr 'f &W- x IONS rov�zm N m v i m N m A��� W N e a� I ' i C• 1 .! a i!9 1' a .c. u 1+ /l P , i iRUC1101Y CORP./R0SAS?10 '1A ;sD .j RIGHT GABLE TWO S Me xl mw Tw mw; O!A • /r• [1JIOw[S.fOY rN']2E9 p .a '.rt j l �.r.'� • �iL m F+ j nn cn 3r? "Pt aar ow w /20 UMPOUL AI 11M P») 4a —U#7 PAX (11 f) Nd —rs" v TWO S Me xl mw Tw mw; O!A • /r• [1JIOw[S.fOY rN']2E9 p .a '.rt j l �.r.'� • �iL m F+ j nn cn t 1 V.S. CONSTRUCTION CORP. /ROSARW SN- /PD93209 /WY .r ,f t;1 r. arw 1 :4 i i ! n Hl- -ERE Illud.. t8 a IS ERA Ya41[5 f REAR ELCVATIDN 3 98 SPECIAL TWO STDRY ses w /20 x!1 GARAGE &12'x7 RUMPOUT Ameepolq. rb 1"45 ELEVATI ®NS gwWwr (717) 444 -OW Down an e6r • PAr (lvf) #44 -75" Yaw 08R8mwo Y"r -o' .o 97V.M&lHftrS.COH PU93204 �H r: l �� I n M . .t F V.S. i CORP. •I f� *nc r vmT I -1 1 ii - 1f(�!o!ej� � �CLO rec in K��1� -jA��l t1LUw— Jp.t_. rtl'1 �1tAb UI L`It7 11IJ~ O I o - 1a• -Z I�FV �• rr -11 11r ON -SITE STEEL HEADER 6 DESIGNED, PROVIDED R INSTALLED ON -SITE BY BUILDER I r T GNP C" GutA6E CLG t1AT •A•f . I I SEE rmr AR tM~ 11'- --------------- --- �. _ -- __- ___ _____ ___ ___ __ _ _ _- 1 1 tM'R rb4 tMllrf 1R LM — 1 { 6ARA6E fl 11 1 1 011 .r[A Dt! @we T M311[ T >LRR! Y�11 arKula a-Aw vKa 1 1 Re K wu K1 �11 11 a 11 I 1 Ova ,AIL. la t [t"W r[ 01 11 Aln ACt e ^: .2 12'-1 i/E - -rF- If• -• ry Iw tJ.T� R..f. irax j R Lrgr• .� l R, LAwt O. fMr O-W -% 3w vt at. rur 1zi_2 . x y tR,a r 1NA. ' A rA X1TCNEX L rr. rea 91 E C•ir Oc k__1 q y H Irk, caxT f.C1. „Mtl K 17 A1rt I.a([ .9.11 tb. AEtrr It! MN WrAQ, t Talc leer iQpi q -m t /z• • � P -1 t ,r y ura.a [ —� --•- C10 1 IMAIMI M w6c 1 ...1a .; d �Or[L ea ,.r. Mfl►1P.a• .TfIUn � 1 rAIIILY Imw ' AL et ±' r a' [[yy[[ �I 1 ts[A ra &Va.[ 1 ItITN �) 1 --------------------- •I f� *nc r vmT I -1 1 ii - 1f(�!o!ej� � �CLO rec in K��1� -jA��l t1LUw— Jp.t_. rtl'1 �1tAb UI L`It7 11IJ~ O I o - 1a• -Z I�FV �• rr -11 11r ON -SITE STEEL HEADER 6 DESIGNED, PROVIDED R INSTALLED ON -SITE BY BUILDER I r T GNP C" GutA6E CLG t1AT •A•f . I I SEE rmr AR tM~ 11'- --------------- --- �. _ -- __- ___ _____ ___ ___ __ _ _ _- 1 1 tM'R rb4 tMllrf 1R LM — 1 { 6ARA6E fl 11 1 1 011 .r[A Dt! @we T M311[ T >LRR! Y�11 arKula a-Aw vKa 1 1 Re K wu K1 �11 11 a 11 I 1 Ova ,AIL. la t [t"W r[ 01 11 Aln ACt e ^: .2 12'-1 i/E - -rF- If• -• ry Iw tJ.T� R..f. irax j R Lrgr• .� l R, LAwt O. fMr O-W -% 3w vt at. rur 1zi_2 . x y tR,a r 1NA. ' A rA X1TCNEX L rr. rea 91 E C•ir Oc k__1 q y H Irk, caxT f.C1. „Mtl K 17 A1rt I.a([ .9.11 tb. AEtrr It! MN WrAQ, t Talc leer iQpi q -m t /z• • � P -1 t ,r y ura.a [ —� --•- r SWDI wq I 2u' -L' 1 sQEI- �tt6 EXT VALLS a 16' OL12.1 MARK WALLS CL6 Ar. r iAJ WSJMDOWS L00I1 JOISTS a )6' at. Si GRDER OV(tI a1•NROGI'OTER 10 RE' t-t Ire.[t Vf•.Ir-e' ML. 7 IMEW 5A. 1[K _r SW- 101" SMS COME SIDE -MN1R VALLI OVEI? 2.4 STUDS CVp yIMEAT1RIG GYP.-[tT. WALL) a 36• aC. ATTACH ./60 CEMENT C(jAtED MAILS e Y CL cM36 w 7: 1 LAYER 3. ' TTPE "2' GYP. APPLIED VERT)MLY OM ONE SUE OVtR 2.4 SUDS 26. M. ATTACH ­60 CEMENT COATED MAILS 4 -7/9' lO16 .Af4' DIAL 1QA1D a 7• aC. trtgS6) C10 i�� IMAIMI M w6c .; d .�-v ar•.or ,ttrCwai IGl AL ±' r MIAP roc [[yy[[ ts[A ra &Va.[ ItITN �) TOYESI: ' -a 7/16• 1 A' i 11 ' 6 .3 lrl. W n J f71w 11 11 r SWDI wq I 2u' -L' 1 sQEI- �tt6 EXT VALLS a 16' OL12.1 MARK WALLS CL6 Ar. r iAJ WSJMDOWS L00I1 JOISTS a )6' at. Si GRDER OV(tI a1•NROGI'OTER 10 RE' t-t Ire.[t Vf•.Ir-e' ML. 7 IMEW 5A. 1[K _r SW- 101" SMS COME SIDE -MN1R VALLI OVEI? 2.4 STUDS CVp yIMEAT1RIG GYP.-[tT. WALL) a 36• aC. ATTACH ./60 CEMENT C(jAtED MAILS e Y CL cM36 w 7: 1 LAYER 3. ' TTPE "2' GYP. APPLIED VERT)MLY OM ONE SUE OVtR 2.4 SUDS 26. M. ATTACH ­60 CEMENT COATED MAILS 4 -7/9' lO16 .Af4' DIAL 1QA1D a 7• aC. trtgS6) cauMG Rom UvMG mm rte.R,c m 1 r-6 719' ® a m SKR2 CCILVA JUISTS DVCR GARAGE. BASE LATER 5/r TVVE 'Y GYP APpLICD ,v RIGNt AWAE1'TD CL6 JOISTS. ATIMM M IAA' TYPE 'r DV !GREYS AT RI' CC ME LATER 91r TWE .'1g' GIP APPLIED AT RWIT AI(LES TE CLG ARMS. ATTACH r/ 1 ) /Y• TIRE V 1At SCREVS AI Be- LC SET MIT 90MVS V AT am JOPITS me ITAWAR AIMIS r1' EACH LAYER 1116' 051 Ovm -arm PERM woo MAILS aRC260 ) 1. CCILING'DITTWALL WILL )E ORITTE1 rM ILL WSITE FLUODT6 CONWCOM IR R41M 061L DODRS ]N' - IbTN URCRKW I EXTERIOR IEVCVn UTILITY ROOD IT. SETE 113CAT101M PUTI[AM VALLEY, //b PUTNAM COJMTT, 30 PI/ 9AOW LOAD Rot" wx6w 3C 58 SPECIAL TVQ STORY %_McAml UPSAPOOL PA 170Ib w120 xIl GARAGE 8127x7 BUHPOUY !ST STORY fs »1 r.e— w AxY trT/7f Ht -tA» SA" OR /t6/RD00 Ui•rr-P Rmoq an IRw / iA'I'{ mAfISIVU to..e� .... ►VM09 1 _ n E La. V (AJ �t�Dr SN- cauMG Rom UvMG mm rte.R,c m 1 r-6 719' ® a m SKR2 CCILVA JUISTS DVCR GARAGE. BASE LATER 5/r TVVE 'Y GYP APpLICD ,v RIGNt AWAE1'TD CL6 JOISTS. ATIMM M IAA' TYPE 'r DV !GREYS AT RI' CC ME LATER 91r TWE .'1g' GIP APPLIED AT RWIT AI(LES TE CLG ARMS. ATTACH r/ 1 ) /Y• TIRE V 1At SCREVS AI Be- LC SET MIT 90MVS V AT am JOPITS me ITAWAR AIMIS r1' EACH LAYER 1116' 051 Ovm -arm PERM woo MAILS aRC260 ) 1. CCILING'DITTWALL WILL )E ORITTE1 rM ILL WSITE FLUODT6 CONWCOM IR R41M 061L DODRS ]N' - IbTN URCRKW I EXTERIOR IEVCVn UTILITY ROOD IT. SETE 113CAT101M PUTI[AM VALLEY, //b PUTNAM COJMTT, 30 PI/ 9AOW LOAD Rot" wx6w 3C 58 SPECIAL TVQ STORY %_McAml UPSAPOOL PA 170Ib w120 xIl GARAGE 8127x7 BUHPOUY !ST STORY fs »1 r.e— w AxY trT/7f Ht -tA» SA" OR /t6/RD00 Ui•rr-P Rmoq an IRw / iA'I'{ mAfISIVU to..e� .... ►VM09 1 _ n E La. V (AJ �t�Dr 40 jsj d a ryr Y! V.S. CONSIRUCT113N CORK/RUSARIO l SN- /PD93209/NY 0 0 ID 'r QVLVG XC CLO mamp, —11a UNIT m tun BEDROOM 03 GEDROOK 04 1• b, VWTI III MOW oftcow CLO voi W-7. 4'_61 .6 37-V 3 LI'D 1"2- aw L�Dp Dl Tr_1r r -1 r-aIN-1 ;T 3 L/ woo Vast -0 Stir A 14'-7 1f2' F1 IIU III 4r-r- 11 %i J-7 1.P. 'r-w 36 3 r1l an 43 144 a. CLO - IILL_ L==1v Pago 1 2 0-•ult -3- lit 1:1 CULVER OwIt .A61 Id Tim 0 On— DEDROW of Tui W.T. me DEMOOK 02 lanx to .0o s4w emov op t v f L N 7 ca r-w 9 VIM, m oly! AM Z. err f.6 N arp—mm 9 In momwim TO tc. �_l 11r.. 4 I® I Of I'M, ag------------------- stli tow. FQV" LOW 22- Imm olmkg Tom Do 0 CLOUT pp 16 Sr-7- ITT Tip 1.2x6 E30 WALLS Q W BCJZ.O "ARR WALLS ?. 9­w CLS "T. 3 Zm3o 1"V? ITILOOR Q W 131C. 3C58 SPECIAL TWO STORY -GISTS 4. RW vu4naws 'RA-02 BOX wis W/20 x11 GARAGE &12''x7 RUMPOUT 5 ROOT MICR TO GE 24' Ot i iw8pi00S. At 97046 ZND STORY f. rLQ GIRDER UNKQ HALL. 18 DE' 21-t lf?'Ti 3/4'.13-4• CIL. 444-SM ai ST. 7. CLO BEAR OVER HALL TO BE: 2 -1 If2'xI6•x18'-V ML. B. FLR GIRDER UNDER VIC 10 BE; STPoe fAJr (7$?j 9. *TRUSS R2W SYSTEM IS O[SMK1D FOR Cr9LbIiIi, IXAS LOAD ONLY FRM BE lam WT womacirlow'r s.cay I AND NO MUNi COUi SHALL OE LNSTALLCQ to THE CEIL114 wg_" N Ii I I a 0 6 • l „9 I 1 i •i 1 4 'r IONSTRUCTION COMADSARIO SN- ---- ---------- -------- --- ' ------------------------r----'-- 1 • _ Ir -- -- ------ ---------^ — - -- - -_ ur T[a sr Sl,w [au .otsaald li'aitoi e - --- 1 1 MKM1 SUMS I[\Pt11[P I71 l IIIIM IIa11RC atttr .•M !. K10�1 - ;. Ir 1 1 I 1 tn[ atft4m/. to «tyi ItaAtlana 1 1 1 I 1 1 1 j• , 1 1 ' SVM tbi. at11. 1 i 1 �� t 1t�osa ae taL. 1tLO 9 /NY 1 1 41-7 11-2' t• -P1 L I 1 a --- - - -- -- -� - - 1 - - - - ; r- L I r- -11 I I 1 I f [ 1 1 1 1 i 1 50 r L 1 L_ 1 1 1 1 • ¢> 1 1 1 1 1 i I 1 t l 1 1 t 1 I / 1 11 1 i 1 •- � 1 j u—. mss L- _-- -- - I ju If =1 3� 58 SPECIAL 1 STORY RR.a M as W120 x11 GARACC 812'x7 BWOUT La AMOL PA Ma a F OMI)A T I(iN PL A(J Oft) 444-3m a IV (9HJ #" -767? SOW ffwwrAw V r•t•-1 axartaaxws'am _ tvr+m rTI f'693aY19 •i ' 1 1 ( Y 1 1 I i 1 1 1 1 1 1 1 1 7 : l0.tT I . --- --------- --- -- ----- -- -- - -1 [ t i 1 t - 's1i:XtAYACAYR TE 1 'J' 1 I i �...._ . _ . _.. — . — . � ------- -------- ---- ------ a 1 1 1 1 1 t 1 T 'Iw11=%t[II KNOW ART A< /w et+nty [I<t 1[n1a 14wMTi1a��1 /rsu TIIT •TUt< iD L /1111I/R1 JM 1AIf1i01i tAAl41 w Itl11t� t tAtAl[L1. �iT[I/wt}T r+a1 N ItKf /1itWtpt I 1 1 1 1 , im 1K�1r�11=°lat MliMf lT (6 p�?�tl 1{ . VIX Ili 1 R �►M(■ am 1 1 1 I L - - - - -- -- --- -----J 1 ARDO mli IRII [i1Kt l i�Mw6 Y4 Ttawli ms � MWwgcllaiie[�ei[rcv.rllt I we rM msS 1 1 1 1 r_ _ _______ ___ ___ yyAAT d of Siam K t�v(o t AX w 1 tw qOe R.w 71 Ylwlw°w1 n is t( g[ I A� -AMM wttdRtiT Icum i stRP IP° �nfallai 1 1 or °M tblit TOy 1K 10�6lTOl iT mom" wn60Alcams 11a1°r1�1 1IR [Rl7 td. I(trtl 1 1 ( - - wT [R IIw[ 0 Y t4f� p am I[t'C10W[• y� I�4[tII IMwT01 '°t ------ --------- -- --- -- -- -- -1 I I 7b Rt &UX ma Q q Ayr SO, [[y�� SEA „ -------- --- -- ---- ------ 1A� lR{Ki. t `I[rttiT XitQ iO�lg11w M w[ sm 10 tltatrrt 011t[ [Pldnwl f A 11WIU1 t[ra[M i([ip wcol VMtL4 b YKW 'atttr - --- -� ant vtwf >Ra tPtfiMttl °°o lAtpQ n[a1 .MW Y1T117<tI1tI11Dt D SO w t741 tp[t rMf! ff. Pp[ K td I-------- - - - �[ y[iTViR p [in" =1 3� 58 SPECIAL 1 STORY RR.a M as W120 x11 GARACC 812'x7 BWOUT La AMOL PA Ma a F OMI)A T I(iN PL A(J Oft) 444-3m a IV (9HJ #" -767? SOW ffwwrAw V r•t•-1 axartaaxws'am _ tvr+m rTI f'693aY19 •i ' 1 BRUCE' R.: FOLE,Y Public Health Director January 22, 2001 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA mbLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 Timothy Cronin, PE The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, NY 10566 Re: Application of Certificate of Construction Compliance: Putty m Chase, Sassinoro Drive Lots # 2,5 and I�W Town of Putnam Valley Dear Mr. Cronin: LIDO @0 o This office has determined that the above referenced Certificate of Construction Compliance applications, received by the Department on January 10, 2001 are incomplete. Please be advised that the following information is required before the Department may commence its review. Lot #2 1 Form WC -9.7 -Well Completion Report (original attached)..... _. a: - Pump %ai- &rage' tarsi: information needs to be cmpletted`` b. Tax map number is required. Lot #5 1. Form WC -97 well completion report required. 2. H2O quality analysis required. Lot # 14 1. . Pump /storage tank information required. Please submit completed copy. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours., Adam B. Stiebeling Assistant Public Health Engineer ABS:cj 617.20 SEAR Appendix C State Environmental Quality Review . SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS.�OnIy: -- Part 1 - PROJECT INFORMATION (To be completed by Applicant -or Project sponsor) 1. APPLICANT /SPONSOR: E�uptnaomjChase ECT NAME: 37 Croton Dam Road Corp. Subdivision, Lot # 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) Wamers Pond Road/ Sassinoro Drive 5. PROPOSED ACTION IS: ®New ❑Expansion ❑Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: construction of subsurface sewage treatment system and individual well water supply 7. AMOUNT OF LAND AFFECTED: Initially d acres Ultimately, acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? @Yes ❑No,.. If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Wesidential ❑Industrial ' ❑Commercial ❑Agricultural ❑Park/Forest/Open space ❑Other Describe: Surrounding lands are zoned single family residential 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ,@Yes ❑No If yes, fist agency(s) name and permit/approvals 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 permit/approval Subdivision Plat Approval — `Putnam Chase Subdivision° 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑Yes @No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor name: C ak m fin P.E. P. taudoh r date: 04 -19-00 Signature: N the action is in a Coastal Area, and you are a state agency, complete a Coastal Assessment Fonn 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 ❑Yes ❑No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative.declaration_may.be superseded by another involved. agency.. T.. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: Answers may be handwritten, if legible. C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain 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)? ❑Yes ONo If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes ❑No If Yes, explain briefly. —_.-Part III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)___ �, ° �Ii�: tDCS40NS:: Foi eaciradverse effect eeFrt da�iove; ,deterrninewhethes�t i6• 4istantial, large; import ant�or.othennr ;e sigatfri grit :: 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 ❑ 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. ❑ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action VALL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Name of Lead Agency °date Title of Responsible Officer Signature of Preparer (if different from responsible officer) � PACE , TIM MILLER ASSOCIATES 15 MAIN STREET . COLD SPRINGS NY 10516 ATTN: ACCOUNTS PAYABLE INVOICE DATE: 04/27/99 ORDER DATE: 04/14/99 CUSTOMER NO: 00- MILLER PROJECT /P.O.# 9863 KRAMERS POND ROAD REPORT # 0201459 TERMS Net 30 days.. Retum Top Poftion of invoice with Remittance 502.2 MTBE 2.000 seven Trent t.abomtoriea 360.00 315 Fularwa AVOW Newburgh NT 12550 2.,000 Tel: (914) 562.0890 460.00 Fax: (914) 562-0841 _ Committed To Your Sat ress 2.000 TIM MILLER ASSOCIATES 15 MAIN STREET . COLD SPRINGS NY 10516 ATTN: ACCOUNTS PAYABLE INVOICE DATE: 04/27/99 ORDER DATE: 04/14/99 CUSTOMER NO: 00- MILLER PROJECT /P.O.# 9863 KRAMERS POND ROAD REPORT # 0201459 TERMS Net 30 days.. Retum Top Poftion of invoice with Remittance INVOICE TOTAL: 11100.00 PLEASE REMIT PAYMENT TO. SEVERN TRENT LABORATORIES -NY P.O. BOX 7777 -W3535 PHILADELPHIA, PA 19175%%W 915Fuftb nAveMN - 6 Nowkvgh, NY 12550 Tet (914) 5W-0wo C mmittad To roses Sacem Fw,; (914) 5612 11941 502.2 MTBE 2.000 180.00 360.00 GROUP I & I1 INORGANICS 2.,000 230.00 460.00 Ag 2.000 15.00 30.00 Fe 2.000 15.00 30.00 pyl 2.000 15.00 30..00 Na 2. 0.00 15.00 30.00 Zn 2.000 15.00 30.00 COLOR 2.000. 5.00 10.00 ODOR 2.000 5.00 10.00 Ph 2.000 15.00 30.00 Cu 2.000 15.00 30.00 TURB 2-000 :_0 0..., NO3 T _ 2.000 1.0 .00 20-00 INVOICE TOTAL: 11100.00 PLEASE REMIT PAYMENT TO. SEVERN TRENT LABORATORIES -NY P.O. BOX 7777 -W3535 PHILADELPHIA, PA 19175%%W 915Fuftb nAveMN - 6 Nowkvgh, NY 12550 Tet (914) 5W-0wo C mmittad To roses Sacem Fw,; (914) 5612 11941 PUTNAM COUNTY DEPARTMENT OF EMAT TIE IlDIVISION OF ENVIRONMEENTAL ENIALTIN SERVICES WELL'COWIETION REPORT, WOO LOca ioz Street Address:.. Kxmoers pond Rd Town/Village: Tax Grid # cluing Egtalp�aremt Lot #14, Putnam Chase Subd. Putnam Valley Map Block Lots) 14 Wen men Name: Address: Screened V.S. Corporation, 37 Croton Dam Rd, Ossining, NY 10562 Use of WeR.- fl -p ' 2 -send X Residential Business Industrial Public Supply Air cond/beat pump Irrigation Farm 'Test/monitoring Other(specify) institutional Standby cluing Egtalp�aremt Rotary Cable percussion % . Compressed air percussion Other (specify) Well T Screened Open end casing X Open hole in bedrock _ Other Cuing 11Details Total length Length below grade Diameter Weight per foot 65 & 64 & 6 in. 19 lb /fL 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 Sereem IDetaila in r Diameter (in) ISlotSize Length(ft) Depth to Screen (ft) Developed? First I I I I I Yes No jWelt Vied Test 1_ Bailed X Pumped _ Compressed Air � Hours __E I Yield 5 gpm d WD--& 1kt81 IMMM a0m. I=; =,bc, spaafy ft) IDuring yield uaglt) IDepth of completed well in feet it yield was tested at dif%rmnt depths during drilling, list: Feet 50 'ell Log more detailed brMation scrip ima . or" me analyses d availabfl@, use attach. Depth From Surface ft. & LaAd Surface 40 Drill' _40� 40 65 65 485 Drill' it yield was tested at dif%rmnt depths during drilling, list: Feet White copy: HD File; 'Yellow copy - Building Inspector; Pink copy - Owner, Orange copy - Weil driller 210' 485' Water Bearing WeE Dfameber(lra) Formation (Description Drill' in burden clay and boulders An Drill' in r , set cask g, Eouted Drill' in r qpplte Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity. Depth Model Voltage BP Tank Type Vo11;e White copy: HD File; 'Yellow copy - Building Inspector; Pink copy - Owner, Orange copy - Weil driller b� "`Fiedei al cf 'f- �tfoll Lict Inorganics Analysis Data Sheet Form I • IN Client Rome: TIN MILLER ASSOC. Project Name: 9863 STL Sample Number: 201459-01 Client I.D.: WELL L -14 Date Collected: 13-APR-99 Matrix: 1 Dri nkH2O Date Received: 14•APR-99 Comments: Analysis - Result Units Method Analyzed Silver SW Sulfate Total Coliform 11T« Remarks: SW. bE 15 -APR- ti(* '300 IWAlulm. iti -APR-99 • p 2150 9 9 300 NW-99 • M • SENT 9223 14-APR- 9 .0 U UG/L 200.7 16-APR-99 316 Fullermn Avenue Newburgh, NY 12550 Arsenic Beryl.1 i um 460 UG/L Chlorides 18.0 MG/L low or 2.5 PT- CO " , ­i Cyanide, Total 0.0 U MG/L de. OXV MG/L a.0 Lead 1.0 RAW Silver SW Sulfate Total Coliform 11T« Remarks: SW. bE 15 -APR- ti(* '300 IWAlulm. iti -APR-99 • p 2150 9 9 300 NW-99 • M • SENT 9223 14-APR- 9 .0 U UG/L 200.7 16-APR-99 316 Fullermn Avenue Newburgh, NY 12550 71" Federal Id: Collected BY: Volatile Organics Analysis Data Sheet Forml VGA 502.29ME Client ID: WELL L-14 Date Collected: 13-APR-99 STL Sample Number: 201459-01 Date Received: 14-APR-99 Client Name: TIN MILLER ASSOC. Date Extracted: Project Name: 9863 Date Analyzed: 17-APR-99 X Solid: NA Report Date: 27-APR-99 Matrix: 1 DrinkH20 Column: RTX-502.2 Sample Wt/Vol : 5ml Lab File Id: A4754. D Level: LOW Dilution Factor: 1.00 Detection Conc. Data Limit CAS NO. Compound ug/l ug/l Qualifier .... ........ ...... .. -5 108-38-3/10 m.p-Xylene .5 U . ......... 98-..82-8 . 5 Peqgnq-.. .5 U n • 103-65-1 n-..Pro pyl.benzep�. .5. U. . .. ........ ..... . ...... ......... TO 135 -98 -8 B... uA I b e nze n e .5 U 99 ft' ik ilftbm ft "I ene .5 _V 4-Il Myv _6 . u 74-83-9 9'ro"mimethane .5 V U 87-68-3 loro'bikadiene .5 U 91-20.1 Naphthalene .5 U • 75-01-4 Vi nyl - Chl ori de .5 U Methylene Chloride .5 ....... I VON �.� 75-35-4 -Dichloroethene .5 U 19-34-3 T c­fil' o r o e t h a n e 5 , U 156-59-2 ci s - 1. 2 - Gi chloroethene .5 U K -2 .5 0 A 00 74.95-3 Dibromomethane .5 U Carbon or'ide .5 5 .23-5 78-87-5 1.2-Dichloropropape .5 U 79-01-6 Trichloroethene .5 W U Di browc oromethane .V. ....... . . ........ .. U—M 04 106-93.4 1.2-Dibromethane .5 315 Fullerton Avenue Newburgh, NY 12550 Forml VGA 502.2KME Results are continued from the previous page for 201459-01 CAS NO. Compound ug/l ug/l Qualifier 315 FuileFton Avenue NewbuMh, NY 12650 . I ---- --- ---- 630-20-6 1.1.1.2-IT.- etrach lo roet hane .5 U . '- .... ...... PA.1 .0 =79-34.5 1,1.2. -Tet ch 6roethane .5 108-90-7 Chlorobenzene .5 U owl § 95-49-8 2*-Zfif6F6ioluene 6 U i,.3-di6loi�6benzene 1 73-1 .5 U MR 1.4-Dichlorobenzene .5 ISO, C4 10061-02.6 trans- 1. 3 -Di chl oropropene .5 IOR ' .:E n 3,; it 71-43-2 Benzene .5 U -41-4- 315 FuileFton Avenue NewbuMh, NY 12650 . I ---- --- ---- S7,> �� y v .�o. .�ry8a8s�, �..�• so kk s8 S' yb: °g IN „.,z �,� -e,-,'- ,- - ,,-, , , . .1 ,i�, �j---,5- .- �r y - -, 1 , , .�, 11 I, �,- �. � ,., - i i - I - . � .,� ” lf,� I- I , .. - 't .- � ��-:j*. v,,,,--,-`,,, � � -, - - I , . - ,�,,t, - , `, .,�, , - . - ,, - .;� - . .. . ,. - ,� . - - � , I . I I " W- I . . -, " . 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