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Home My WebLink About4405DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.11 -1 -6 BOX 33 I ru I VA ' L ■ ' L re T MN IRON a Li IN ME NN NN ,. JA 04405 DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10309 (914) 278 -6130 BRUCE R. FOLEY. R.S Acting Public Health Dire -;;;, PROPOSED ADDITION APPLICATION, /_ (RESIDENTIAL ONLY)i S,TPEET: oP�S ,Jy�•�"1�TOvl_' /Oc/ loo�� TX PAP PFON_S1Sf'O!1 %' PCHO PEFLMIT'��7/ MAILING ADDRESS � �! / `�'��%l /�/i�a��P /�c✓, /t��%� l/��1� Description of .Addition /�� `5 h �� ®�� -�4/ ��^ ''n• Number of existing bedrooms Proposed number of bedroom& -= from Certificate 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 PUTM;Ii COUNTY HEALTH DEPARTMENT, 4 GENEVA ROAD, BRE-WSTER, NY 10509, Phone 278 -6130 with the following information. -' erti" ieo Check for $100. . 2. Sketch of existing floor plan (all living area including basement, if any) Non- professional drawing is acceptable. 3. Sketch of proposed floor plan. Non professional drawing is acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. 5. Copy of Certificate of Occupancy from Town or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments and /or diti LPL ! `� , s t--' G cam• -�.' -;�r 9G� 7' application August 1995 July 1996 (Revised) 1A1SVL,qTIOA( A:7-lq 10013LE ?je4 TOP PLATE x/4 STOA - 16'OC. — 1AISOLA T/W R -1 (IfErR400( MAUS k-14 S(nLE pUrE 48 RIMER .suL4T,ON R -19 wzrr "I TtC, SUB - FLOOR IVITH "PL-900" 6Ld-C 2x8 JOIST 16-O.C. —I_Z-CNr,S114 PLATE 4' WAICAI-uE sma it b0l -il kuTaiam County Department of Heath AVISI �f EnvironmenW Health 5er7loet ipproved as noted for conformance with ipplicable Rules and Regulations of the ..'utnam Co G t. ty—H - h Do artmen.—,. ---------- ODTL !/(,e ar 210" C4A1;rMf 11CR 4Z30VC 1 ---------------- - . .ia - --- * I ZE ; t - !: l7 n Z C4/T /CAL D�/AIENSIOM FRAMER MANTA /N I I •i�^ I ' t. 'f ETE SLAB ?' Ay r� .1 a Q; I A �. Ni - I /` I r, I £'_`siL -:.. S Div aQ ,5� ,' ' i _CLd,SE7 l NiEO. C.O._, , 7«..y -fit /q � � .. t• I i � j CR /T /CAL I � l � 3 FRAMER Q/4 Gtr i P MA/�(/TA/N J G /�� /° �ratliam Uounw lSepartmen� uY xi+dltta / I iv eioh��,,1';•nvironmental alter ervlce� (/ 1 �y ! I ;; •r,v_ s no L•ed '.for. conformance vi:t �3 %1il.i.G� /� -,,. i ^. ^.ple Pules a>hd Regulations oY the , am' GountY ` nt. I n ^L /cliff r_ ___- _- __- ___-- ____- ___ - -_ iuro ?-_ Ti ian _.. __.__. __ . _._ .__. /GJ�/,,/ ____.________ -_gin __ - -_ _ I to °. !r °-:c. �i. �'r - _- ______._ ___ .__.___ __._ �� i ,t 2�8:�>? =2" __ � Z_8�: =2�� Z- '8' "x3 =/O MULL /D�tl s ro 4R.WEq J YfA/T STACK ° � T 2 1MEI♦^ R�oer+, �- ` w. - - -- LEFT �. Ci ONL �i�D, cn�I I WAND p a0 I� .TU/3 �., �� i _ ' �/ , I I I lD -D ' ' � I � I � /0= D" R. � .. � 52 S' -/l'" =/' KO. ' ' 16F = l " _. _ ....- - -- , Q! > >I ; I 1 i p �: c I ^� i; I CR /TIUL �i I i P +S i;L)lA/ENS /GWS, l I DINING ," I KITCHERI C m �' /: !!c�yy ��; �9 '� BEDROOM 1 �I t, g ' _ NI - N� r r 1 /�NI r ! - --1' pis,' d`ry ' r -- i �- I W� CMT FLU£ / cn,c i� a�ce�o� - -� �Z CLolcdT r sMoK� DST -4. I \� II I � �� DLi1VN LiP �� W '� �I • i act o.� . c� . c �j a �. /O' D 4 a k to ='tf LIVING I FOYER I I BEDROOM 3 BEDROOM 2 o x I 5 •• `�' I 2.2 ".,. io "�Ntnoect N to _/f" Lf:�a I I _ i f _ —�'— 3 =0 -x µG- MULLION l'.�; n -- -- - - - -3� X3- /D - - - - -- 340 X3' /D - - -__- - - mil+ - - -_ -J I !�« I'a7TL /NE OF ,PDIDF � � i "° i OYERIMA1G 49011E I i I .j ,f g 7 o ALA LS N �G t �3b . gyp` P � 0 �� ;.La !`�22b `r�3o -''Z r2 �•7�1 0 \1, N 8 y10 R,./ E vn a j5I&I OIL ^ - ONE FAMILY � 1y ., 75' y � ODO GAL. 711E -G45 � CO #4 SE�71c -A µK •ry � j Lo i 111 4 "c.i• -- , i J i y. +Z b AG III 1 1 l ��- 3IS.9I' - N. 4(— ov'�v i 170.Oo.' AL -JA`( --n"f6 C-0. ING• P. / /� �j e \\/AG 6 0.15 A L .. LAYou T rp �E p Cou::g D'ra_t�en$ ai Eel Eealth SI 0 1 �f 4� Q 0 l• Q Q ,1 LU i O t� icee -Ii 11 Y, ..s :..,r it '41 i. �.i .:I _ 'ry BRUCE R. FOLEY Public,; Health. .Dfrector- _ - LORETTA MOLINARI R.N., M.S.N. Associate -Public Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 218 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 July 19, 2000 Tia & Scott Levinson 269_Peekskill Hollow Rd. Putnam Valley NY . Re: Addition- Levinson- 269 Peekskill Hollow Rd. No Increases in Number of Bedrooms (T) P. V. Tax # 84.11 -1 -6 Dear Mr. & Mrs. Levinson: I have received and reviewed the plans for the proposed addition of the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the'approval stamp form this Department dated July 19, 2000 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at Three without prior approval by . this department. ._....., .. The area.of the existing sewage,, disposal system, and its expansion area, must-be n maintained: 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly yours, William Hedges WH:kg Senior Public Health Sanitarian cc:BI 1 DEPARTMENT -OF HEALTH Division of Environmental Health Services - _ 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fa~ (9I4) 278 -1921 BRUCE -R nT Public Health Director PROPOSED ADDITIO \r 'APPLICATIONS (RESIDENTIAL Q`&Y) STREET LL. kWTOWIX .1% TX LAP .. 2- -17• �- . I(- ( —(9 NAME PHONE- W-732.3 PCHD A � r ®� MAILENG ADDRESS PlCeo*LL. 44o4 eQ ii) 1-6 A' AA �Lkrpf . DESCRIPTION OF ADDITION ao11(r,�ret o<- FoRzA To f -Au ' a _ A979 ®f16r. To. A&�f ASJT NUMBER OF EXISTING BEDROOMS PROPOSED. OF BEDROOMSa (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING NSPECTOR) *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 th% following to Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10309, Phone 278 -6130. fl. Certified check or money order for $100.00 Sketches of existing floor plan (drawn to scale, all living area including basement) /Non- professional sketches are acceptable V3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map 9) # Non- professional sketches are acceptable ✓4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. j Contact this office with any questions. J 5. Copy of Cert. of. Occupancy from Town or Certification from Building Dept. with legal bedroom.count:of dwelling...; OFF'IC'E USE:,"-.'. Comments Feb 98 JJ �. PUTNAM COUNTY DEPART ENT OF HEALTH �\ \C Division of Environmental Health Services, Carmel, N. Y. YO U Permit # CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM hA LC E0 Town or— MOtage —f Located at k5�k +`t° c + •0°� Tax t4ap e r�• Hlock - Owner • L A • /`�� /Q�Forrmme/rfly✓ < Tax Map Lot # i Subd. lot q Separate Sewerage _ System built by Ai "S; Fd6— A &O •-s I�7� Address F&'J-1-��G�pKI LL d iLL , 16 Consisting of /a Gal. Septic Tank and Af� L� �r rt ��+� P�_d_/s OAA r! �`r Other requirements Water Supply: Public Supply From _. Private Supply Drilled By Addrenssst Building Type 6) Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. Date `•' `' Certified by P.E. R.A. Address L tense No.' 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 sewerage system shall become null and void as soon as a public unitary "war becomes available and the approval of the private water supply shall become null and void whop a public water supply becomes available. ' Such approvals are subject to modification or change when, in the Judgment of the Co Issioner of Health, such revocation, modification or change Is necessary. Date Title 12C Rev. 9 -81 Ilia, z18 . - ;, r.{ Off• IaJ, - y 8 . ativ - ` � i g.5 3i .yl(p O a LF W do Yj l� OFFie LVy vit (�.v�LL LoT #a. a5;P-,u,L -r .Z 1 f 3 4 0 I..-+Z AG i a> �Y l'' +�1 P.✓ 5 B�eR'MS IOOO GcL- /� 2 fRECayr A Taw��. J 2i 6 348 I J - - - — � 33.91' n+.4G °• oo'ty - _ � � �`y J��LENCE G., _. I.. /70.00 fry S it o p JOEL "LAWRENCE ORE N.BERG- LoT'�3.• lao- HousE ARCHITECT -TOWN PLANNER . AL -JAY GQTTG6E GO• ci- MWa%0%F NORTH RFDVZ /Bou X88. tt �UILL_� McAopece, Now York -10641 � P °- onoS��pPr .. DF N6� EW AGE-- •- SJf5.�o5A l.. '- LAY0UT - (818)- 828 8818 nam Count Department of Health 1 '3v oa. Division of Env ronmental Health Services pEEKraKILL.NOLL�u_ R17, PUTNAM V4LLB r m.y. 10j" �� OS DGT+c. :.21v �C4N�: 1984: Jo�:.77_= IS4 -- I ?.4 APProd as ro ed for colformarce with applicable Eules and Regulations of the Count/ ealth Department. ;, -ture Title] =� T ^� _ 9 . a T3 -�i iy .. is rI � ,h .2 1 ---------.--------------------------- u SP2 a i3 t?i I s 227. S 59° 34' 57a E S 61 ° 52 50 E 7 39, 241.95' N 09° 02' 00" E 1 D R I N 60° 31' — S 59° o 39' 15" E I : > E 15.00', I Q6OAi EX. PORCH TO 5E ENCLOSED IS I WEL� S 1 FI L N 149 22'0(Y!,',* S EX. E 57.06'. DRAINA I 7.. 49`0124- _ _ —�F m 1 .45' y 460 0010 0" W I »a a l,p ' ristine Bmda Architect All dlrnan.I— to be verified by the cantrastor befaro Cautructlon begins And the - rdit=t notlfled of R y dlecn,panolee. It io a Wolatlm of the NmYort State Edu tim ✓ g Q 891anr6trset L— for arty person• unless acting undar the dirsctlon of a Ikeneed a.hitac , to alter 6 Har%a*, NY 10530 thls drawing In eriy way. All dese, designs, arrargemeMe and plane IMkated p OF NE`N 5 911/683.3867 ropreoAntad by thle drawing am pored by and tine ealushro pmparoy of Ch,"- Orude 911 /6 8 53590(- Amhitect, and wen, Gmatad, evolved and davabpsd for use on, aM In conr -t7on with, 2E ' { this proJeat. Nona of such idea-, deel8ne, arrargamalrte aM pWns ehatl ba used by, copied, reproduced p dlecloead to any parson, firm or corporation for a wrPDBO PU i t>; whatsoever without the written pmmle -bn of Chrbtina Bmda Mchitecctl ® ChristNa H. 13roda 't r :ry ' �J '1. N ;e i' f EX. PORCH TO 5E ENCLOSED EX. POOL z 1000 GAL. 7T�-Wr—.- SEPTIC SEE EX. SEPTIC PLAN FO :DETAILS. [pristine Broda Architrd A8 dimenebne to be vmiW by the contactor before c ' —'ticn b4M atd the . cbtect not fled of a ry 4 ar °PaaU° °. K b a vblatbn of LM NwYwk State EducaGm 89 J.- 5trert 914/683- 86 1OS30 ►'6�1�JV -iµYi' 9u/6833867 914/68&359D fax Lae for ary In W V. A eW order the 44ectbnaf.IloaaL. WAI.. to otter rq dra W m a o wy. m deaa d e y .d th.. m *.ne pff m Oi W o thla dr wlrg aro owned by .d thetaWeha of �O6o�bY pq++q QvbfB�e dada Atcbr ct, and ware created. aaHW and devcbped for oee aq and b ammectbn with dm, project. Narra of such tdeaq de•b••. artangunente aro pirate efem w card q, COPWA reprod d mA6doacd to im pm"m% fbm m —pa-am for arse P"POOe wh.teae„m w thw Uw w MW parmbelon .f t].fetare dada Arddtect. O aafswe K dodo Moroi AM FOF NE s r` pkIVEWAY EX I S'T SEPT FIELL Proposed plan for Levinson Residence 269 Peekskill Hollow U. Putnam Valley, NY 10579 SITE PLAN DETAILS Scale: 1" = 20'-0" 6/15/00 I' i` r� 1: .1a�. t• , } >;� P2 ,1. t :, j,. _ .wr'0 W11G 1- V l 1 t.�l y DU llg.+ .- �.a.�v�w.►Y,r •- .r�.Y; C uilllpa lty AL'JAY Es INO, building' onstructed by. erection, e5 e_1 CSC, 4oLzQLd Locati6n - Street. Bock U_W M )A L'I 15,V N. , d _ 0. Building Type. Lot GUARANTY OF SEPARATE SEWAGE- SYSTEM I'rep'resent that I am wholly and completely responsible for the location, workmanship, material, construction and drain-age of the sewage disposal system serving the above described property, and that it has been constructed as'' shown on the approved plan or- approved amendment thereto, and in accordance with the standards', rule's and regulations of the. Putnam .County Department.of Health, and hereby guaranty to the owner', his *succes - sors, 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 initial use of the sewage' disposal system, or any repairs :Wade by me to. such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system.. The. undersigned further `agrees to accept as. conclusive the de- termination of the'Director of the Division of Environmental Health Ser- vices of the Putnam County Department of Health as to whether or not the failu-r.e -o-f :the. sy,ste�m. to.:.eperate was caused by. the .willful or negligent act of the occupant of the uilding utilizing the system. Dated this 22 day of 198-- Signature Title V ' / , /0507._,4- 7._, 4- If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPS _,ETION WILL BE* ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division,of Environmental Health Services, Putnam County Department of Health WELL COMPLETION REPOR, T PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY- OFFICE. BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. ` T MUSTSE- SUBMU�,TTEP- WiTH'I'IY-16.-DkYS:Cir-WELe��- L I ON OWNER NAME ADDRESS LOCATION OF WELL (N Street) (Town) (Lot Number) 5,4 PROPOSED USE OF WELL DOMESTIC PUBLIC SUPPLY BUSINESS ❑ ESTABLISHMENT 11 INDUSTRIAL ❑ FARM TEST WELL'6' AIR E] CONDITIONING El (OTHER specify) DRILLING EQUIPMENT ROTARY COMPRESSED ❑ AIR PERCUSSION CABLE OTHER ❑ PERCUSSION. ❑ (specify) CASING DETAILS LENGTH (feet) DIAMET"finches) 4 it. IWEIGHT PER FOOT THREADED D WELDED SHOE Ran ':SJ E. ❑ NO IG YES 9NUTED? NO YIELD TEST BAILED PUMPED 'COMPRESSED AIR HOURS G.P.M. YIELD (G.P:,Afj. WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [feet) Depth of Completed Well in foot below Land surface: -SCREEN MAKE LENGTH OPEN To AQUIFER 0;8t; �DETAILS. SLOT SIZE DIAMETER (inches). IF GRAVEL PACKED:. Diameter of well including gravel pack (inches): GRAVEL SIZE (Inches) (toot) TO (toot) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location at well with distances, to at least two. permanent landmarks. FEET to FEET If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE ELCOMPL ED DATE OF REPORT L IWE ILLER 7 t , Nat s4ccl Yorktown Hei hts, N.Y.'10598 `❑� 9-2_1 KEAR ST., YORKTOWN HEIGHTS, N.Y. 10598 ;24S•320] i XLZ01 BUTTONWOOD AVE., PEEKSKILL. N.Y,10568 .)V47)) 145,3203 ❑ 495 MAIN ST., MT. KISCO. N.Y. 110549 666•3335 1 • "� �., -£3•.I 4E.- t6's138� LAD # a ,E k DATE TAKEN: - - t.. DATE RECEIVED: tans mr p DATE REPORTED: vt-,77 S+or�e c��Je._ SAMPLE SOURCE: Tot, sks it U � ►USt�ly ' y REFERRED BY1 COLLECTED BY: t + LABORATORY REPORT TY ....:.... ........ ............................... ❑ALUMINUM O ACIDI , •,: ih ,s, ' t . t. O.ALKALiNtTY ❑ANTIMONY .:..... ............................... r . *,r ..,.....;.... VACTERIA.TOTAL/m . ................. .. ❑ ARSENIC ........... ............................... ❑ BARIUM ..... ... .... .....00 . 5 DAY ................................................. . r} } `O BROMIDE .................... .............................. O BERYLLIUM .. ................................ j. .N.. ❑CARBON DIOXIDE, FREE ❑BISMUTH ...................................... •.. ..•..•......•.•......•..••..... PS. •N i..i..0 4yF ,O C14LORIDE . ... ..... ............................... , • ❑BORON ................................................. 0 CHLORINE ............ ....... .. ....,..« .. O CADMIUM O COO .......................................................... .. ... .:........•::.....r i 0 CALCIUM .. .. ........................... O COLOR .......................................... .❑ CHROMIUM (tot.) . ............................... .... ... „" �`O CYANIDE : '' ................... ............................... ❑ CHROMIU.M (hexwilmt) ............................. t:.:.t .... •.�: w,,.:.t ;rt.:.. ......... .....O DETERGENT, ANIONIC ................. .•............... ❑ COBALT .... . ..........................: . :5.;N ; :i::a:.f.'• . ..:;.`.:,;'�a.:y. : ,.s . :T•wtr�; -;kY; : •.. OFLUORIDE ............ t ...... ............................... O COPPER ..... ..... .............. ............................❑GOLD .... ...... O HARDNESS ....... ..... ........................... O MPN COLIFORM COUNT/ 100 ml ._ ❑ IRON �II?T • '.L.<. ... ............. ' ..... ,..................... COLIfORM COUNT/ 100 ml .......... ❑ LEAD' ............... ..........................•.... . f r I' • r• .. ;;• ❑ CONFIRMATORY TEST , ...... O LITHIUM .... Q•WITROGEN;A.MMONIA ..:: :::..::::....:...�.::....:�::.' G= i1fiAGiVES1UM, ..... ; O .... ..................•.� ...�.• NITROGEN, KJELOAHL ••••••• .... .... 0 MANGANESE ........ ..............................�..•. .� ..... :�. ❑ MERCURY ; O NITROGEN, NITRATE .................................. . • .�...N...w.:..N.. . ..• P 4 t a........'r 0 NITROGEN, ORGANIC ................... ........... ❑ NICKEL ................................. ............... ..:.... .O ODOR ................................................... ❑. PALLADIUM .......... ................... ; .............................................. ............................. :..•..: i.: O OIL dGREASE ............ ....................... ....... O , .:.;,.!:: 'y.:' ;., :..- POTASSIUM .................... ❑ PH .......................................................... O RHODIUM ............... ......................................... a.. ....... . .. OPHENOL ....................... ............................... ❑ SELENIUM ...................................... .,. ..... ... O PHOSPHATE lortho) ....... ............................... 0 SILICON ....... .. . .. . . . : n c •O PHOSPHATE Ieondenstd) ........................... :.. •••••••••••• .... ❑SILVER ............................................ ............ �s:.':.[ 0 PHOSPHATE (soul) ....... .....:..:...................... .......... ....:.:..,....... ;. O SODIUM + i'f ;.' +•. .. ............................. ........ . OSOLID$, SETTLEABLE, mt /L .......................... .❑ TIN ............................................ ............:.....::. :......... OSOLIDS, SUSPENDED ................................... ..... O 2114C ........................... t O SOLIDS, DISSOLVED �•�•�•�� OSOLIDS, TOTAL ..... ............................... OO ... J'............::.............:.........::........ .................::............ O SOLIDS. VOLATILE ........... R .•• ARKS• • ..(l.�TJ1.�:K.US��JJ�.. :7b..�'f GU�%LI •�OI� 777 O SPECIFIC CONDUCTANCE ...................... :... Y..�✓,::i JG�r..[.•.•� ..O.I�.La...�s�c... :0 3ULfATE :...............:......f. ..,.................. ❑ [117:GJ�:!If�C?�! i1.4✓..i1�T /.Q'...., O-SULF16i .................... ............................... ... 0.4 . � :. . ....: .... f.r.f.. Ti� ....... ............................... O SULFITE ...... .. O . ❑ SURFACTANTS ❑ TURBIDIT`: ..........:.... . . ❑ ..... .............................. ......................... .. ................................................. ........................................ . _..•......... THESE RESULTS INDICATE THAT'T11E WATER WAS A�SATISFACTORY SANITARY QUALITY,WHEN THE -SAMPLE 14AS COLLECTED. THESE RESULTS INDICATE THAT THE WATER DID MEET THE SATIS ACTO ' CHEMICAL QUALITY' NEW YORK STATE ADMINISTRATIVE RULES & RE C DR N SATE A ARDS (P T FOR THE PARAMETERS TESTED. _ ALBERT N. PADOVANI 1•f,T (ASCP), DIRECTOR. I ?• Jun -30 -00 07.48A 9144289834 P.01 Ana w. tr<e .. ..o . .;. nv. •e R' .._.....' C: .. ..c ¢- . _ _ _ ._ _ .._ .. •- .J"�w:;:7' �. i^+'a!iR ••� ^(ir _ .M.. �.1a t.. T.N ♦. �0 •,�.s. .. �., r -. v- . .. . a' BRUCE R. FOLEY. R.S. Acting Public .Wealth Dvector DEPARTMENT OF HEALTH Division .OE Environmental Health Services 4 GenevZ .koad; Brewster, New York 10509 1914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster. NY 10509 Re: ez Residence Tax Map Gentlemen: According to records mai-atained by the To%,.A the above noted levelling IS IS NOT in compliance %rith Tomm code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: -�' A-3 4Z> Cr OTHER I " :1 RuildinP lrtcner°tnr 7 7.7 T-.4 rn\. .0 ' Y si.on.:6. nytron " me) I?CbNSTRUCTION, POMIT--i-FOR SEWAGE DISPOSAL' ils o" "A 0 ubc "n e TMENT OF HEALTH Permit .a RV < 20 =8.3 K'.- 0512 Y Putnam '. Valley -,down. oF4.Village. Tax - e ne wa ,n e eAUcT.Se s Peekskill rl Q 1.iL U .Rd, Put - Valley. NY_° Date';Qf Previous Approval 6/5/ 1 Approved , for � disposal of A t :7'- :'46;;t`,;��I-�' E g jilding .Type F section Only ke' ijffiber D 3 on' oiiite,+SeW6ragersyitem -1-.-4n 3z -L sslftks-"-11� Tank` eep -- e ki S f b6'i constructed: �1. , I b u nam a e y. p y %AdAress, ° Nb `Supply ater ` Public Supply From 7 -Private Supply to be drilled, by Vt Addre [her 106g am s ?4A V , p - 1, -.1 1, ;f ", '- 'de' � d "- t- 18 i rit tifi f I' - A-nd pi 6, �., : or the sii�Wand"Wc - f se, t.., a, rn-y�,hol y corn le el respons!p 9, -Altipn,,,,� , J�p j_,p!op the Jewage.,A I soosal. sy stem opera !ng ;condition ,.,an any �pari :ol, said ',sewage lCis MI. ,good ance.1 of the approval of the �':Certificate - of ccihstruetloh,�gcom I 'PI _will be. located is''Sh8iiiin on the app iowed 4ian -and ioaJ7* id'wel , I County, -,;.-DaWK - 8' -1 co 7= U, pgcoo Address n A�C "APPROVED F OR 'C'ON' STRUCTIOW This 'approval expues. one, P�6 se ..oi: 1niiy .1equires- a.-ne�iv permit C Approved , for � disposal of A t 3. Date: E g ke' ti i61iF1d1n`a'c6'o`idihca With .ndar,9 �,"u lat ions -of- the"ll'u' Fnam,7 of,, Compliance l satisfactory to the do mimissioner,of Health will btAder;:that safdbullcliroklll"`,�'�- during- the period Y )UMS Immediately f6ilowl I ng the date of tihal , I uu- ovi -Inal s y repairs the that the drill6di'viell described above I;A-W standards les and,-!0g-u5qp-n$- the utnam,'' accordance of P a PR.A.7,-X License 14 ... . . .. date construction. , I itiuii�ing' has been uhderUken..And is oft Commissi An _c ange a or 15.11: ation of •construct Ion li , �i t IV o- n1, - �� "� ��x a p�7 a'� 1 d�' � �4 {��r R ^,�•`� � � � ,��' '�k".,,�"�'� '� `� �w � +� �., , w�� 1� , .,.,. � � n _ t sl, ,� � � � � ,.,, �r L PIY' AM -00NI T DEPAR�'AREfgi' OF fi�E�I.:Y'Ii 1�- ry � � °� r �, �. Division of.; Environmental Plealth ,Services, Carmel �I1I V 105,12 r CONSYR,UC.T,BON PERMITFOR; S�IAIAGE<DISPOSAL „SYSTEM�;':�Y ti.C,b; . �,_; �.� 9 »d fi kt S`Tt �t.r'G 3.v R�'irwr` +titC tC �� `�'Y.4 �...�� R''^'.t •��a =S' ��n.4 1 'C J• 4 N �YYar^'+Va.,i +.L L }nested "at i • X ° ' z -..,ax;. Map /$look Lot AA (� . ,r: r• s k �Ubdivifi�Onp� `�J L y • Subd %Iot q Renewal Rev/i/sion❑ e�Addr�ee y- �w° �• / - d �"� Date Of�Previous Approval `°” " _ 'J Y , �p �� ,a c: • ^ ,shi »."� i > a ;,;.Buildmg3Type��iHfGl • Lot Acea d ction Only= t- ► F111 Se ❑ = v a P C rH D Notification. Number'of,Bedrooms _ Design Rlow Required .} '�: 4 •& i' €` .o- KY ,k R ..1 Separafe; Sewerage System to consist of 6 �% :Gal Septic Tank and 1 n 9. 1. 'IT be constr y 3 • 3 � "' .c� UCted b � ' � � � � r Add18S5 r e K —tom Wate► SuPDIy Public SuDPIy Fromi l c . n Prwate `S�uDP1Y to De` dulled byr � {6� ' AYti -+ �,., i f ir.�. +' + ► c H 3 .l t 'r r { s it t .in a "5 a t Y OtherRequirements 7t`1 "' .` °.s . fir-` t .j w.c ,r ,n , �; . a a,..:� . iM1 � t ., ., .,. n ,... •.� ti..,, r,� k �` i;'sJ +Y I!rGepresent kthatyl.am� wholly andscomplete dr e ign� and sota,, ij o m., s e? w . ts .. . . a fi :d $ ` a a . , t s te...:a � j lyxresponslbie for the i u " '.above described will be constructed'as shown on theyapproved' amendment thereto antl in accordance witl%the stan8ards, rules an regu a, ona o e n y :County .,Departmenti of , Meatth ac�dtthatwontomplef�on the eoi a Certrfwate of Construction°,Compliance tAi_ _Isfactoryao the Comm sloner of Healthwill `t..�,n R;n A.'vw:• 3- ...,c T...rv...,'4.`4. ., 1 T`n � +. c", ,`. z F "M-" k ...:..r r. :Y;c.>+• .. -.x.r M._ " rwt►mitted t- the . Department and ib written rgudrsntee ,will be furnished` the owner yhis wccessors, "• heirs or ;assigns by the builde►,ahat sakl.tiufldor will ! :place �n..good operating, °_condition any part of said sewage disposal system during`'.the5period of two:(2) yeses ImmeGiately followtrg ;thedste of ttie;fsw- :ante iof }fhe approval of the CertNicate_,of Construction Compliance of the originahsystem'oi any repays theeto, 2)c4hat therdrillad`wvoll desC►ibed .aboyo will 6e io'eated as shownron` the aDp►oved plan andahat said well will 6e installed< in, accordance with the standards, rulos endreyu a ona„ of the; f?iithem 1 `< county QeD rtme,t t Health° y h ri K tnY y tf ti y k t a -A r .l t tS "'Pn s`.`'Y'. -a� -• ,��s K c t A1/ r r e i r a " ' ¢' �rE�+ Date '� � � � T r . � _� 5 igned�` ° ,d- x' OR- Address ieense No r" APPROVED FOR.CONSTR. UCTION This-a'" roval�ex jres ones ea from the ,date isued ". unless 'construction of1the•tiuiidiri ''lies been- 'undeit ken.'and'•is k z 5M, c _,_ . c. » 97 - ,revocable "for caude'or may be amended or modified when cons�deregynecesseryaDy� the »,HCommissi 04, Health , Any �chsnge ors alterotrion o nstructlon '•� requires a new permit Appro ed for disposal of domesti rotary age, and/ pr wpply only + i v Title , j Rev 9 81 8h n ^f PUTNAM COUNTY DEPARTMENT OF HEALTH !� Division of Environmental Health Services, Carmel, N. Y. 10512 �� PhP CONSTRUCTION' PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valley town or -Village R'.'T. I I - ..a a.. Subdivision Ll1- Owner Al —Jay Cottacjes Co- , Tnc. Building Type 1 f ami 1 y rPai d _ncet -ot Area 1,423 AQ. Number of Bedrooms _4 Design Flow 800 GPD Separate Sewerage System to consist of 1200 Gal. Septic Tank To be constructed by Paul Kastuk Water Supply: Public Supply From Tax-.Map 72 -4 -17 Block, v. :r� - " - i. '��,�r^-o:," ._ "rc .v . ;. .6:- ...'col► .:�.' �,:, -...':.:6:•,:y�.r",n� Lot `� Job 1 Address P -Pk .qki 1 1 Hnl 1 nw. Rnarl Putnam Valley, New -York 10579 Total Habitable Space 1500 Square Feet and4-precast concrete leachin ** Address, Peekski l 1 Hol 1 nw Road Putnam Valley, New York 10579 * Private Supply to be drilled by Norman AndPrsnn Address Barer S _rP t, P tt-.nam Vnl 1p-V, Npw Vnrk 10579 Other Requirements ** 8 s WI diameter 8 1 O 1r deep I represent that I am wholly and completely. responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder.will place in good operating condition any part of said sewage disposal system during the period of two (2) years immediately following the date of the Issu- ance .of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be installed in accordance with We standards, rules and regulations of the Putnam County Department of Health'. Date May 2 2, 1979 Signed P.E. R.A. AddressRR #8 Muscoot North ho a N.Y. O License No. 1 10516 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and Is revocable for cause or may be amended or modified when consi )Ned necessary by the Comrpi§sioner of Health. Any change or alteration of construction requires a new permit. Approved for disposal of domestic Anijarylewage -eFtci(or pfiv4fe/ -uMnnly only. Date �� By "'�"�r�� - -_ s� d- Title PU Div'isic c NSTR�UC 1 PER NH9T FOR S�IINA F'P,eek's ) :ir1, ":Fo 11:i�ni ;Subdivision AT 46V Cottagesf'� " Alf 4 Cot. -ales Owner = Number of Bedrooms 4 Design `Floi beparate'Sewerage System to consist of � au1 �Kastuk `To be iAiAructid by Water supply Public Supply F -ron * Private. Supply 'to` t ' Address, Other Requ�:ements '' * -�8' ::O" d i a 'AP •rev re i - r I ai;shbm4hron the approved plan andE tment of Health ,st -.15 1.97:7_ .x Address BOX A �. y �7��Kr'i��../ � �y:�'' f y�2 �O V N ll ll 4 -EP-A r nvironmental Health Se ,POSAL - SYSTEM lrilled byx'. Ng rman AI =St reet,�' Putnam '1 tt MF pA` T1ryIy4 `S i Carmel IV. Y.. :.10512 � - . �f�<dtnarn . Val'l ev 7 Tow or Village `Taz Map * '/ 2 4° 1 t`gBfock ► Lot 14° roe 77 134 Address Peeksk) 1 1 '`HO 1 1ow r Road ` Putnam �`Ua 1,:1 ey, uN , Y 10 :579 _ Totah�Hab� table Space >'1 500 Square 'Feet and' 4 :;;precast cop _e xl each) ng Aiidress'Pe'eksk01 `.Hol,aow --Road Puanam: Valaey,LL :` °N��YT 10579 j r,son ly Rtt4C s pr w ;ys (,d ) tf;k crate sewage disposal system ! acco an Owit r� regu a tons o e u ninam ruM c o` ns b �h i sioner os builder, .that sad "builpli adessors lethr :vnll pe f tw etl� el ollowing,ahe date of the .issu i ste repair to 2) e`drilled` well described above ,F h� ,gtandar s mil 4a regulations of 'the Putnam F oti P.E. R.A.* °-1053;:6. 11056 _ Lice a o. , ed unless -con ruction of the;bwldin 's been undertaken and it- ommission of `Health Any - change "or alteration of; construction' rvate A PUTNAM COUNPY mPARTMENT OF BEALTH DIVISION, OI+ ENVIRONMETITAL KEALTII SERVICES - _ _ COUN -�V OFT'!PF, I311[LnU101i :•CARP.F!1.; �N- °!' -- :1-07jI =2-� DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM. FILE NO. OwnerAl-Jay Cottages Co. ,Inc. Address Peekskill Hollow Rd. Putnam VaIIey,..N.Y. TM 72-4-17 Located at (Street Peekskill Hollow Inc. Block Lot —4 �Indicate nearest cross street) Municipality Town of Putnam Valley Watershed Hudson" SOIL PERCOLATION TEST DATA REQUIRED-TO BE SUBMITTED WITH ' APPLICATIONS . 5 Notes: 1) Tests to be repeated at same depth•u.ntil a. r.oximately equal' soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth moasurements to be made from top of hole. Role Number CLOCK TIME X- ERCOIATION PERCOLATION Hun No.'. Mapse Time Start -Stop Min. DeptFi. to�Tlater lwater From Ground Surface Start Stop Inches Inches Levei in Inches Drop in Inches Soil Rate Min. /in drop 1 1 8:10 - 8 :28 .18 36 39 3 1813 =6 2 8:29 - 8:47 18 36 3.9 3 18/3 =6 '... 3 8:48 --9-:06 18 36 39 3 18/3 =6 2 1 8:_l5. - ,.8:33 18 36 39 . 3 18/3 =6 ... 2 .8 :3 4. -., a: 52_:. 18 39 3 18/3 =6 3.,8:53 --9:11 18 36 39 3 18/3 =6 4 1 . . 5 Notes: 1) Tests to be repeated at same depth•u.ntil a. r.oximately equal' soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth moasurements to be made from top of hole. 1211' 1811 24" 30" 3611 42'1 48" 5411 60" 66 7211 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED-. INDICATE LE',TEL TO WITCH WATER LEVEL RISES AFTER BEIN TESTS I4ADE BY Joel. Greenberg DESIGN Soil Rate.Used_ 6-7 Min/1 "Drop:; S.D. Usable No., of Bedrooms 4 Septic Tank Capacity 1200 Absorption Area Provided By L.F. x2411 None 1w I 1. .120," C ENCOUNTERED - N/A Date August 8, .1977 Area Provided 5000 s.f. Gals. Type tc c r e t e width . E G ' -0" diameter. x $' -0" deep recast concrete 1 Joel Greenberq S igna -ure _ Address Box 417 Katonah,.New York THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by - �- T n TEST PIT DATA l�iI�QIIIRED 7'O 1iL +' SIJ1�f 1;T`.I'J ill -TH APPLICATION DESCRIP7'TOI4 OF SOILS IN TEST 1101�3 r DE, D HOLE. NO. 1 HOLE N0. 2 HOLE N0. 3 ~ :t- x^ c�ii ".*- .sc.• a -rtJ _ } C:cx rt i ': a alt.. , df7.n V :c- r.YO t -5•i .,: u e. na r;4n : wQ*: 'a -cl ,r. e L •� Topsoil Topsoil Topsoil Sand � Stones Sand � Stones San d � Stones 1211' 1811 24" 30" 3611 42'1 48" 5411 60" 66 7211 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED-. INDICATE LE',TEL TO WITCH WATER LEVEL RISES AFTER BEIN TESTS I4ADE BY Joel. Greenberg DESIGN Soil Rate.Used_ 6-7 Min/1 "Drop:; S.D. Usable No., of Bedrooms 4 Septic Tank Capacity 1200 Absorption Area Provided By L.F. x2411 None 1w I 1. .120," C ENCOUNTERED - N/A Date August 8, .1977 Area Provided 5000 s.f. Gals. Type tc c r e t e width . E G ' -0" diameter. x $' -0" deep recast concrete 1 Joel Greenberq S igna -ure _ Address Box 417 Katonah,.New York THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by - �- T n CQITNT:.DEPARTI! d.' �0 A'.- -- .• °�.:� i�:::�: .. ;�. DIVISION OF :ENVIRONMENTAL HEALTH. SERVICES Date August 11, 1977, Re:. Property. of Al -Jay Cottages,Co,, Inc.. Located at Peekskill:.Hollow.Rbad TM 72 -4 -17 ; Section Block Lot` Gentlemen:*�.: This letter is to _aut]iorze :JOEL LAWRENCE,`GREENBERG a, duly lia.e'nsed professional engineer or registered architect . (Indicate) to.apply Ior'a Construction- .Permi.t',for a separate-sewerage, system; to soave this„ above noted property in .accordance with the standards, rules ..or rogulii.tions as pl- OffliligRtc,d: by+ th(3 .,Cununissioner of the .Putriam County- Department, of Health, and to sign all 'necessary papers on my behalf in conn'e•e-t3o the ' coris-truc "t-on -of -said �° =— system or . systems An conformity,.with' the prdvis.ions of Article 145 or :lla.'j,. Ediacata on L+ ,; ";f�he' -'.P ij, c Health Law, and the 'Putnam •County Sanl- • mot• , tart' code.,-.: ff Very truly yquyso Signe \ -I)" " 5��0 .Owner of operty •. <' f` f 1F. v! Peek ski11 Hollow Rond Cota.tlte�rsigned:, a,...l ��,1ij �,t.:e� ` A ress Putnam Val 1 et', New York .10579 P.E., R.A.; 11056 914 -528 -2380 Telephone Box 417 (Seal) AdTress Katonali, New York- 914-2132-5033 Ta opTzo�ne Putnam County Department of Health Division of Environmental Sanitation YjE ........ A'&!* ]jK' nkP0WY"0WNft --AVP ICATTOW FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for /-q- reprepppt that I am an officer or.emploype of the corporation and am authorized p Z to act for 7" (nqm of. "co', .e. �� 9 /Y haying offices at Whose qfffperp gre President n `Name P Address) Vice-President r'e t A 5t?V-"6Z As 9; y 0 lid' �ame and r0dress Secretary Treasurer &1 T - (Name and Address] . x, All Nam' and Td_dfiTesp) and that I am and will be individually of the corporation with respect to the sequent acts relating thereto. $Worn to be ore me this of 1977 71 A� I Fotfa ry Rlbli'c' ANNA N. BURNS NOTARY PUBLIC, STATE OF NEW YORK QUALIFIED IN PUTNAM COUNTY No. 4607700 Commission expires March 30, 19ff responsible for any or all got@ approval requested and all pvlb- Signed Title 7-W cr COUNTY BOARD br— HEALTH • 0 014/225-3641 Putnam county "OSEP111 P con JOHN rfa dqnt` AN L,: ELDIN D.D' S.* -Director 0f.•?iv,6ronmentr,,7- acre DEPARTMENT OF - HEAITH MINE E County Office Building or OP p6t4ep't 'Seaviocq,.; Diree t 411ALDINE "A., nkciytki M.D. LFREDO-j; GA FfO A 'Jr. M. D. Car6ie9, New Ark f. A Ub 'tz CHANG -M-0 10512 LL R:, M -D. -M, U Rif E�LLEk."M.-D,.�— j9'. TOMAS AER G -1 N ... ..... Y qin h) c a h 64ifiF Re: /eats 14 C er 7 Whg eaP 7 z. 1` k` t 6Vi6w of the submitted application to construct sanitary w g e, d Sys . for: `fh'd:--�prop6scd* premises has been,c6ncluded by this de partment - Th&. plans are being returned to you for the following -reasons. REQUIRED INEORT-tkTION MISSING -d applica. Olu. v-' comp tion C v 9 f o #,? t; r X iM il -r completed heet PEA)c -Ij r-. qnta �^z AuthoriE�ition for engineer Layout plans (SUS) 'o se locati T W Plan and profile o f SD S Lccatioi--i of,driv ,qvia - Lc ' aEl�� of well or public water main ij 4r. (e) Contours of property M Location of any water courses, ponds or lakes oii prope.fty . or within 100 feet of property (q) Location of deep test holes and porcolation test holes (h) Location of all wells and sewage disposal systems %.jj. t h:�n 200 feet of property lines AJ SO� Set W House setback A✓ c7r 5 h (j) Footing and leader drain location A-1- 7' 00 10feet to property line (1) 20 feet to foundation walls .100 feet to nearest well t4 uS 7' A V (M) /5-o (n) 15 feet . to curtain drain (o) 10 feet to water line (pits 20 feet) (p) 15 feet to storm drain (q) 10 feet to large trees (r) 10 feet from foundation to septic -tank (s) 15 feet to pipe from leader drain and footing drain . -W Other: -0 -crniny this mal-t, I I a so fool frcc,'tfi I f YOU 11:11 z�it% qoentloiv; conc 7, P. 0 ot thin oft i,�o. Vcry truly