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HomeMy WebLinkAbout4415DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.11 -1 -20 BOX 33 LL i -r i . , .6r� ' 04415 PUT NAM COUNTY DEPARTMENT OF HEALTH V L1T OF_E1 T F1N'' , --HEALTH. SERVICES -a= •%ca i <: `.,- r -s - -• . - .. .�� .�,+• yt. <.,.,¢— •'.v o.:...� , ._r - — - .., ,-... ..g .,6:�+�!•.d .� ve ,•a..`•: CERTIFICATE OF CONSTRUCTION COMPLIANC E TREATMENT SYSTEM J PCHD CONSTRUCTION PERMIT #. p !✓ 2 Sr'— s ,3 Located 'G /�� /�, /� /�` ° / /UL r/ / /od,�Town or'�tlillage li 'ow c� �' Owner /Applicant Name 71o,W& .3 _le Tax Map �``� �% Block Lot 20 Formerly SGrr» Subdivision Name ye Subd. Lot # % Mailing Address =d ��� � ��� /�i�/ � %`u� %g'y e �r � � �% /� Zip /Osgz Date Construction Permit Issued by PCHD Separate Sewerage System built by o W "�;' Y/ Address Sa rye' Consisting of 12 Gallon Septic Tank and i�4 - Other Requirements: Water Sup*: Public Supply From Address or: %4 Private Supply Drilled by /ef 4W e / e_" eel Address /67- fy e/ H�►s erosion ._ - /��� =%. r��'"� ' ::. • control• been coriipletcd? Number of Bedrooms Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved pans and the standards, rules and regulations of the Putnam County Department of Health. Date: Certified by o� Address 9 72— veto Zc1_4 Any perpt occupying premises served by the a to secure the correction of any unsanitary condi treatment system shall become null and void as of the private water supply shall become null and -public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocat ,modification or change is necessary. By; Title: n ,er Date: 7 n Wt i copy - HD File; Yellow copy - Bui ding Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 P.E. 1/' R.A. License # 21 Y F9-r" aptly take such action as may be necessary i usage. Approval of the separate sewage sewer becomes available and the approval PUTNAM COUNTY (DEPARTMENT OF HEALTH (DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT.____ _,_ ... Wel ' ocationn _ z taf ...+tea Street Address: � - T n/Villag • - J Tax Grid # Mapp./ /Block j Lot(s) 2.o Well Owner: Na e: Address: Ilse of Well: I- primary 2-secondary Residential Public Supply Air cond/heat pump igat' n Business Farm - Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing (Details Total length - ft. Length below`grade "d Diameter W/"' in. Weight per foot alb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded )e Threaded _ Other Seal: :x Cement grout _ Bentonite . Other Drive shoe: 'x Yes _ No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test Bailed Pumped X Compressed Air Hours? Yield o 26 gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve. analyses.. .. _ are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 0 6 �` ___30o Q �� If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type34,,kti Capacity 5', Depth Model 53'c'7 `� y Voltage y30 HP Tank Type AM+rvl Volume Gay t-1D0 a' Date Well Co pleted Putnam County Certification No. Date of Report Well Driller 'gnature) Fy INN I E% 1 act location of well with atstances to at least two permanenyt lan(ligarxs to be proviceu on a separate sheevplan. Well Driller's Name ��lg�L�c -�-- , /��,,���—',�,� c� Address:` >1 Si g nature: � Date: 'Q1-1j6!3 er White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 Public Health Director Ofreccor of Patient Services I I DETA.RCTME'NT OF IfEAL'TH I U)Cme-va 1\O-al Bre-wswr, Ntwi V*w-k 1.009 Em-hunmoital lleulth t,914)219-61-30 Pax k9 14) 215 - 7021 Nursing Svi-vievs (91:1)-176--bJJ5 i ill C (9 14) 278 • U6, 8 •lix (9 14) 278 - 6OSS Early Pi - 0011 N-esdivul (914)7.I8U82 Pax(914)27a-6648 0"%'v;NVRS NAMY, 1,13iflaut Cotlaty 1.--)UjJIXhIWtIt Of I-fCc-II(It Will 110t iSSUe a CLCtfflUte Of IN ;-ISIsjfIII)'U(-I(j 1) 'y an authorized I-ol-vi.) oll"I'J.-i'll, •bis form is to besubmitted wll)il th(.� application for tI Cel-tific;1tv of C'mis•rat.-boll ("0121ph"Ince, ! i "! I '. iiN I 1,,tm) f , PUTNAM -COUT14TY DEPARTMENT OF HEALTH ,71 DIVISION OF ENN71RONMLNTAI' HEALTH SERVICES CI.. A fUATEE OF SU BSUP. F.ACE SE `N`A E TREATMENT SYSTEM ,tnicted by "few i .. -4� 7 ?-A- J?tv ['ax -map Block Lot e Toro ri/village Sul- livisionName 7. Subdivision Lot # am ,wholly -1.WJ i.'c-r the location, worlananship, material, c(,xi, drainage ofthi.: ,,ravage tj-,atrnej t s,,rving the above-dWribed property, and tlu;t t t+ . rl constructed a,.-> ;:wmn on u; c. ippi,-)v t:.d p idil .,., ZtPpr0Vtd amendment thereto, and in a V.-ilh ti-je standards, gas and r: -I.L.1ation.-; oftti(: 13u,,nwo CountyDepartmentofHealt%, and to the ovaier,I-A.'s successulS, heirs or assigns, to place in good operating condition arc. �,uid- system constrll-,.ted b�- r,-,e which fai`.s. to operate for a period of two years =c liovping tl; e date o-Capprovalof the "Certificate of Construction Compliance" for the Se w, lit system, or an! repairs raL,,dt by me to such system, except where the failure to lsLaused i�v, thy: � Allfal or negligent act of the occupant of the building utilizing the Tlic u1,,,:,,.,r,.,J med further agrees co accept a: conclusive the dete,, ruination of the Public Health o whether or not the failure ofthe system D i the Pi4=m County Departmento f Health as :o to u s ed 1) N, the i -il I fu I or n,- ,i zent act o f the occupant of the building utilizing the Da ',vlondi Day- Year IGZ- Signature: ,,)I.Vraccor (ONN.-ner) - Signature .1-1K)II iMane (if k:orporatiorl) Corporation Nime (if corporation) Address: A 6 "PALW- jP Form OS-97 YML E��IR ��L �c� ^��/ �u.yjRVICES Yorktown ~ . ' Albert H. P dovani, Director LAB #: 32,207614 CLIENT #: 56032 ~~~~~~~~~~~~~~~~~~~~~ THOMAS DEPOLE CONTRACT 268 PEB<SKILL HOLLOW RD. PUTNAM VALLEY, NY 10579 SAMPLINGSITE: 266 PEEKSKILL HOLLOW RD. : COL'D BY: THOMAS DEPOLE NOTES...: HOSE OFF WELL TANK/IMS KIT TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ' DATE FLAG PROCEDURE PUTNAM CNTY PROFILE 10/15/02 MF T. COLIFORM 10/15/02 LEAD (IMS) 10/15/02 NITRATE NITROG 10/15/02 NITRITE NITROG 10/15/02 IRON (Fe) - 0/0109 - NER (46) 10/15/02 SODIUM (Na) 10/15/02 pH 10/15/02 HARDNESSJOTAL 10/15/02 ALKALINITY (AS �R PITY '(�� - COMMENTS: FAX TO 845-528-5126 NON STAT PROC ~~~~~~~~~~~~~~~~ DAT'/TIME TAKEN: DATE/TIME REC'D: REPORT DATEn PHONE: (914)-403 PAGE 1 ~~~~~°~~~~~~~~~ 16114/0b 66:30A 10/1002 04:50P 10/2002 -4358 � ' SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE ' TEMPERATURE..: < 4C COLlFORM METH: MP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT`' NORMAL RANGE METHOD l) 100 ML ABSENT 1008 0-15 ppb 9101 0.91 MG/! 0 - 10 9139 <0.01 MG/L N/A 9146 <0.060 MG/1. 07023 mg/1 2037 <O.010 MG/L 0-O.3 mg /I AN 10"2 UNITS N/A 7.1 UNITS 6.5-8.5 9043 268 MG /L N/A. 256 MG /L N/A .-. '� ' -ABSE��T-1 00/ML " � -�' '-`ABSENT-`-~ COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATER (WAS) F A SATISFACTORY SANITARY QUALITY ACCORDING TO T RK NATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Ph/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. .- .... . ' Fe/Mn If both iron and manganese are present, their total value combined shall not exceed0.5 mg/L. YML ENVIRONMENTAL SERVICES 321 Kear Street LW598������' (914) 245-2800 U Albert H. Padovani Director | n ,~ / LAB #: 32.207614 CLIENT #: 56032 NON STAT PROC PAGE 2 THOMAS DEPOLE CONTRACT DATE/TIME TAKEN: 10/14/02 06:30A 268 PEEKSKILL HOLLOW RD.: DATE/TIME REC'D: 10/15/02 04:50P PUTNAM VALLEYr NY 10579 REPORT DATE: 10/22/02 PHONE: (914)-403-4358 SAMPLING SITE: 266 PEEKSKILL HOLLOW RD. SAMPLE TYPE..: POTABLE : PRESERVATIVES: NONE COL'D BY: THOMAS DEPOLE TEMPERATURE..: < 4C NOTES...: HOSE OFF WELL TANK/IMS KIT TAP COLIFORM METH% MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE 'FLAG PROCEDURE - RESULT NORMAL - RANGE METHOD Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium i s sugg ested ^ pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED'TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. [~---'- � . . __ _~��—, _� -_.- - TOTALHARDNESS IS D�. ^NED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L =MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Director ELAPO 10323 YML ENVIRONMENTAL SERVICES 321 Kear Street ;.x. 014) 245-2BOo Albert H. Padovani„ Director LAB #F „ 32.301999 CLIENT #a 56399 NON STAf f'ROC'• FIAGE I DEPOL.E , THOMAS DATE /TIME: TAKEN g 03/18/03 06:30 268 PEEKSK I LL HOLLOW RD LATE /TINE REC ' D 4 03 / 1 O 10 3 0015 1='UTNAM VALLEY, NY 10579 RE POI T DAT& 03/21/023 �19i /l --/ --- '—"c' PHONE; (845)-528-7649 SAMPLING S I TE g 266 f'EEF':SK I Lt_. HOLLOW RD, PUTNAM VALLEY SAMPLE TYPE:... , POTABLE: BATHROOM SINK PRESERVAT I VES N NONE COLD ICY: THOMAS DEPOLE" TEMPERATURE..: - ::: NOTES... 4 COL I FORM METH c Ml=- DATE. FLAG PROCEDURE RESULT NORMAL ._ RANGE: METHOD 03/18/03 MF" T. C OL I FORM (ABSENT /100 0 11L AE: IGE:I11T 100a COMMENTS FAX TO 845-528-5126 COMMENTS,. BACT THESE RESULTS INDICATE:: THAT THE WATE k (WAS) ; ( WAS NOT) O A SATISFACTORY SANITARY QUALITY ACCORD] 1Vf:� HE: NE:W ''((7FtK { TAT'[:: AND EPA F EDE RAL DRINKING WATE=R STANDARDS , F°OR THE PARAMETE RS TESTED,- -AT TF-IE- 1 -IME: -OF COLLECT10N - - -. _— ........ .._:. ,_ a .. .._.__..... .._.... .. ...... .. ..._. .__. .... _ —...�> .,•s .....r.- .. , SUDM I TTED LAY H. Padovani„ M.T. (ASCP) r E LA1 ='* 1 032 3 -acns,i3-6 oP 460 L.,F. I. , 71 77 :e4 hl '-P 64 216 2 25 Wh 7 7 P/O OFT to LOO:AQ M m 1.00 At At 12 I A0. CAL. 1.00 At 9 '?04q . 17 Ar 1.00 AC 1.01 Ar 6 14 1.42 At o 1.01 K 24 11.14 At CAL. a DEMPT KING OAViO CEMETERY 5 1 19 BEVERI 1.41 At 1.06 AC 4 1.31 At 20 % [.It At d ° 1.19 At T.51 26 5.97 At PEEKSKILL IA yA 1. 16 At 3.0; At 216 25 Wh 23 1.9; At 24 ° ! T.51 26 5.97 At IA yA 3.0; At &CO At 2 . 34.i 1 02 At Ar. P K15 1.3 Ph 84.15-1-4 P/O 84.15-1-5 FOR ASSESSMENT PURPOSES OM.Y 1MVISIONS • SPECIAL DISTRICT INFORMATION NOT TO BE USED FOR CONVEYANCES m"_.__9IIM191­W313TA — LIN LIM g51YN am CNIKM DI/MI p MI'm 0, um il;IM "Ati FIRE 4. mftw ilff;iam DIMIU Tm �w An tax JAMES N. SEWALL COMPANY liiUI% LIM 147 CENTEII.STREET; 01 .mwom LINT gaw Ll oft 11010 slimm' LIM mi key LINK pm? w Imm. wm 216 r...._ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES BT _N RF Well Location Street Address: PT nNi�flag-v Tax Grid # Map Block Lot(s) Well Owner: N e: 'Address: Use of Well: 1-primary 2- secondary Residential, Public Supply Air cond/heat pump __CkrigatVn i ecify) Business Farm Test/monitoring Offie'. (sp Industrial Institutional Standby Drilling Equipment Rotary Cable,'percussion Compressed air percussion Other (specify) Well Type Screened =,''Open end casing Open . hole'in bedrock Other Casing Details gth Total len —ft. Length Diameter.,. jn.. Weight p er fo ot ± L _lb/ft. . Matetials:_2L Steel , r`::' Plastic Other Joints: Welded Threaded Othe'r,:;.'. Seal:/-,-,, Cementgrout:.:--.­.' entonite .,.,Other-."' Drive shoe: x Yes :." -..No'-. jLiher:- i ;x-No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First — Ye s —7 No Hours_ Second Well Yield Test Bailed 'Pumped Z Compressed Air. Hours � F Yield Z0 gpm Depth Data Measure from land surface-static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve an,alyse's, are available, pleas e attach. Depth From Surface- Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 30' If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump.Type3,,t, Capacity Dep t4 M1661 th: Voltage ;190 HP Tank Type volume Date Well Co pleted Putnam County Certification No. Date of Report tjure) lWell Driller nature) F)q �T iNuli:L.% hpct location of well witti clistancesJo at least two"permanet lanaMarKS to De proviaea on. a'separate sneevpian. Q Wel I Driller's Name 0 Address:/ j Signature:' Date: /OA White . copy: HD File; Yellow copy Buflding Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 NORMAN ANDERSON INC 152 BARGERST. to.. Total $4,621.45 -C 5/4/2002 3400-416 Total $4,621.45 NO. TERMS PROJECT QUANTITY KDESCRIPTION RATE, AMOUNT �100 @ $8. per foot 8.00 2;400.00 42 6" Steel Casing '8.00 336.00 subtotal 2,736.00 20 .GPM 5/3/02 PUMP 5/21/02 10S07 -12 1 OGPM3/4BP3W GRLTNDFOS .763.00 763.00 3/4BP 3W230V CB 76.00 76.00 BlOX Martinson Pitless Adapter �._',.`-: 39.24 .:39.24 TA48 PVC Torque ArTestor-Clamps 10.15 10.15 280 160# FLEX PIPE /FT : 0.6 187.60 00 '(50 X2) FLEX OFF-, 0;67 6 7,60Q 290 10/3 Submergable wire 1.675 31'e75 50 WIRE 10-3 OFF 1.075 ­53.75 TapZ-, clamps, splice kits, etc. 40.00 40.00 .2 Stainless steel male insert 12.3013 ..24.60 6 wire protectors 2.06 12.36 6 LABOR 60.00 300.00 subtotal 1,885.45 Total $4,621.45 _4MBING HEATING SHOWROOMS. . ,,c S SUPPLY of k il. LL, INC. * * ORIGINAL INVOICE _u5 OLD ROUTE 9 FISHKILL, NY 12524 (845) 896 -6291. Invoice #: S1645725.001 , �' ..... .0 =Orders Dat ,Ne�7'7i . Shi Date- Invoiced 03 /15/01, -'Y• N &S H.V.A.C., Inc. M1 ShowrogmalQS.Corp -- o ..:. Re .:$. P.: :" _ " N8S`SUPF�LY N &S SUPPLY r N &S SUPPLY N &S SUPPLY Terms: 2 0 10TH NET 3 0 DAYS BREWSTER CATSKILL KINGSTON HUDSON Page . 1 ^fi Bill To: THOMAS DEPOLE CONTRCT. INC 268 PEEKSKILL HOLLOW RD. PUTNAM VALLEY NY 10579 Ship To. THOMAS DEPOLE CONTRCT. INC 268 PEEKSKILL HOLLOW RD. PUTNAM •VALLEY, NY 10579 Vit�y"lI 1.�. '�.�(tf•F '.'., a. . r ,t ;ti. ��i ^: 4u,. S'L�� x+, A \ ,...., u -r•;. :: f'..,...: •t ',} r.: S•Fr � f. },,Yv x7 k. ,+. Y i f ., % ,k a. x'r-' .vrY t •n � td�y �n i ty. � 1... nil r§ +ir.�,�,r> >fy'� ,ti y n • ,.5 �' •1 *, t i, }1•t1 T ` :1�Y '�.:�••. tr'. k a;l .t 5 �,�h,Ai , �' ..... .0 =Orders Dat ,Ne�7'7i . Shi Date- _. s -trs. � [ s Ek' .• ,� r�rx�l: l.: S h �;-Ul,a��tr, .; �, `c ..n� dB ,v ;.. Y t P.: :" _ i ;! 44 P._ .. . ,Ordere , �.. ..r;.. ,r x%15/01 ` -M r037 lea `�u `._.. _ ^fi ,• - THOM DEPOLE a n;. �:.� 'Kprs. { % tt 4rt t' �' 'tit; T�1 : k. R '�1•)r {�',k 1 . ] Mr .x�p i b!'�i«i„Mt i •✓r "s.. %:in,,ri,RF ,AS`Q �,M1 �F t 114x•" 1 'F : ht 1. a,,,1!. 'riF..v. .:tS.., .a. .lk ,.�.. ,. .«k. •���..ara s . ,.q° ,`'� - .�!.,^Yu.. ¢.�5 k t si;:�sZ t?., 4:. ..t: -i. 4.:{'.�5+�'^2iaii:a�� i•>:t� .:u :'?rlv...!i4,w+akts'.'k?' r .. ' h, v. `tr �, tt r3.:'f�b Ord ' t S2 r' : a. Sh- t Q {,... .. .tri`�•'�gw,fs �''F ��' r iii x.. 4 t .... rya t� �i„S�hs -�V�`= l�r. r Fl ,, ` a ^P.ro'duet :De "sc'r ' Lion ' 4 ' x P.? tr * •2 .ritiv :s�:F.�r Net' .l"�, f:�ry +i �kjMi?�;.�•. ,. . ilea ELe AMTROL CM17002 PRECHARGED TANK 86 320.320e' 320.32 GAL..26" X 47" lea lea LONG TANK CROSS KIT 1 -1/4" ::P 40.2756 40:28' lea lea FSG -2 40/60 PRESSURE SWITCH 12:.01.6e'! 12.02 9013FSG2J'24 6ea 6ea WATTS FBVS -3 BALL VALVE 3/4" CXC 4.91846 29:90 FULL PORT Sea Sea 1/2" NIBCO.,`74= CL,'.COP X•HOSE BOILER 3.066e 15.33 DRAIN lea lea 1/4" 0.`* - ;1,00 GAUGE, ;`. •, 2.430e 2 .43 -lea -lea FSG -2 '3:0150 PRES SURE ,;SWITCH 12_._0.1,6.6.. - -. -•.- 1.'x.,..:.0.2;:; . ea 8ea 1" CXM.COPPER MALE ADAPTER ., 1.692e 13.54 (1- 1 /8b�! 4ea 4ea MILL 3/4 "Y °ID FITTING 3.708e 14.83 ,633060 - . vet xz,? •`. , .. ,: BRUSH t� 6300 SERIES ; BOXED., 2ea 2ea SOS SFG 1`2 zl /2 PINT 80LDER` FI.,UX '3.522e 7.04 l0ea l0ea FEET ',1;' °` L`COPPER 'PIPE_ •(20',) 1.6026. 16.02 "&V r�► �y �',�, it .. „� �.. j f %i `[ta t.x i r. t� ,iy F.. 5 ^� rc r .. y'. i ! x t •a` P . .i3:S pt. 4 ASH t r . vtr rra'1 15 Y.: ': I � �.h'iY� F�� a 7� ` � �•1 �1. r j,} r t,. ,1 r' 1 4 t`` r_.F x >} r i i i x yr GX'ti'P.ti j � � I:^Sk l' y ANetAmoun `459:69 ,Y,,1�`r� ',a� "fix,; i •f :n iY itli Q i �, ,: C u ,.{ -e # 3, <A •1i,. % 3, '.� 9 t{ �i >; h1t'iA b,,hF ,� t r Fx °,rl'.�'f l'1 r• ��. ,� cUy% iz� - i`'u> r1 t - r�,�T J(�� v �t`!y„}�+eY.,yMXt.i1�, i;(.•{.h' ... Tf 1 •rH 1!4 ,•171j``wr'+ Y{,,,, fit. I , �F`re J 7z. t; v.. - ..;;i1N 3 ��'. '. ms "?t`ry RF" iYtaRM�P`. K�F�hs �yr 7 Ll� J'�.L.,..� J ... O 00 . . {3 :.}, r1 r3••t` t5'11. t ?'� }}4 33 .33 r''•<',vy� [ C• � '� �a� y i }J �t � 1.}%f ,/• i$Y.�.A`y- J '�.Ryuil �if�si � �'�4G�"1 }�4 y8�'�x•�q?�iZ?l t �l{�Kt�r a. � ,}`'T�t 41,�� #n,i. :�ZY�F•i.*. i i 1 t.i �- '� 4:�1i St .. ;+�fti K ` t{ �rt 1�.4.fa j !!''tx��'.41.tit.: � a+ � 2` .� 4 `� 2FK �' t,..�t� C k �' • K t i '1' 4'�' Y � F : ty�+'� o ^, Rv A 'S '"`} W n ,u`S 1r >t &• , ••�t � .�� 7, �Gt. °F�t2ilN�{ „u� °���f `�� � �� s � ,�nf� ��tTota• -• �' �is,� '. k`i �r we 493.02 ;.`a� 1� �• am, � > t ,� ,3[ fxd'7 fSt' sfp -�,��, �* i, }.f. .°r �y. c9.'S W• .:�..�'U.. ..:3 r.}.i ,.YY'R�1S. 3. -. .4£�4�:..,�u:'r. �._ >+t4 a:i•; �.�t i i�.s�.'' j .��..4 � •+ti+.rih o returns accepted without authorization. We charge 15% for handling on all goods returned. No claims for damages or deficiencies allowed unless made within 2 hours after receipt of goods. Goods furnished that prove defective will be exchanged, but under no circumstances will any allowances or claims be allowed for labor consequential damages. MATERIAL ORDERED SPECIAL NOT RETURNABLE. Please inspect merchandise before scheduling installation.' . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION. Date:. j _ ... 17siec#ed {cy (� " DTs ,wner pp „Otreef Locaion - . . Town Permit # TM # _ Subdivision Lot # 1. Sewage System Area a'. STS area located as per approved k ........... b. Fill section - date of placement ✓" D 3:1 barrier Lgth. Wid ___._ Avg.Dpth c. Natural soil.not stripped... .... , .......................................... d: Stone, brush, etc., greater than 15' from STS area........./ e.. 100' from water course / wetlands ...... II. Shwa e Systeinj a. Septic tank size - 1,000 .........1,250 .... other ............,........�. b. Septic tank installed level ............... .................... ............ c. 10' minimum from foundation .......... ............................... d. istrib uion Bo 1. All out lets at same elevation -water tested ................. 2. Protected below frost .................. ............... ................. 3. Minimum 2 ft.Original soil between box & trenches ,function Boz -,properly set .... ........... ....:...... ..................... . 1. Length required�� Length in to -ed 2. Distance to watercourse measured %` Ft.......... 3. Installed according to plan .:....... ............................... 4. ,Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 . ft.- foundations.......... 6. Depth of trench <30 inches from surface........... ........ 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 1' /z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... A0: Pipe ends-:apped : :......:::.:.:..:.. . :.:....,:............::....... Pump or Dosed Systems 1. g� Size o pump chamber ......... Z 2. Overflow tank............ :...........: A .............. 3. Alarm, visual/ audio ... ................ ............................... 4. Pump easily accessilil manhole to grade ................. 5. First box baffl ... ......:........... ............................... 6. Cycle witness d by H.D.e ated flow /cycle........... M. House/Building a. ouse ocated per approved plans..; ............................... b. Number of bedrooms ...................... ............................... IV. Well a. Well.located as per approved plans . ............................... b. Distance from STS area measured 4 / 0 0 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. 1/97 /$ 09/23/2002 09:46 9149624248 JOSEPH SULLIVAN PAGE 01 ._. 4. b ..��'�': G'� T Y r . � � • 1.. .. .? � . ..f . : . a S.. � • t. :'�`�.;�.�r :!' .�f �•. ... ,. ♦ M� - .1 � . r.. .. _'f . J .. . �► PUT NAM COUNTY DEPARTAIW OF =ALM DWUIOK OF ZNVMONhUWAL NZALTIt MUCV= ATTEN'T'ION D Gm For: Fill AII inform Pion must be compieted prior to any - Tip impactions bairn made PCHD Comucdon Permit # .f� Loc": ati/ e OftulApplicant Name: (Ti �:�� irOSmerly: •� S13bdiviti0n LOt � . Is system $li Completed? Date: Is system complete? Date: Is system conttnuted as per ? Is well drM*d? V pate: Is w*U located as per plans? An erosion Control mupures is ? I certify tb* the sy rmm(s), es Isud, at the above premises hu beep cmauded and I k" *acted and verMed tbair completion lm aCCankm with the UKW lCE1L1 CCONg ioa tgmk ued approved plans ad the StuWarda, RWa and R%Waim of the Pttbosee . Depattmm of ........._, Certified by: nun: �� = z /m Addvs: _ - i/ Z 7, Vii. -�,� �ry� r • I.iG. ,g? Comments: Form M -99 CCD -a 2_aflfila Mnki 1 1 , mA Tai a RaS— P7P -7gPl NAME: PI ITNAM rn.INTY DEPARTMENT OF P. 1 a , Form M -99 CCD -a 2_aflfila Mnki 1 1 , mA Tai a RaS— P7P -7gPl NAME: PI ITNAM rn.INTY DEPARTMENT OF P. 1 X&I PUTNAM COUNTY DEPARTMENT OF HEALTH �\ DlVffSffGN OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWACI A MIENT SYSTEM PERMIT # Pk 2:7 Located at �a G /� r �'/ /moo / ® ®a c� Town or Village ��d �i'�. f i Subdivision name �m r�� �/ QC. Subd. Lot # Tax Map Block ® Lot 1-0 Date Subdivision Approved / f J— Renewal e' Revision Owner /Applicant Name 7� v w d g /�,v h Date of Previous Approval /99` Mailing Address J /f% Amount of Fee Enclosed :30 d /rte 40Qd K Al V Zip / ®S Building Type i� _ Lot Area I ® No. of Bedrooms -4 Design Flow GPD fvd ]Fill Section Only Depth Volume PC HD NOT}I1FIICATIION IS REQUIRED WHEN ]FILL IS COMPLETED Separate Sewerage System to consist of /Zje gallon septic tank -and yfS`'p J..4 Other Requirements: "Ole ,--v g0d �.o To be constructed by e Py'07 ems' Address r<e w e- Wat¢r SunDfla: Public Supply From Address _ -... ; ®a• �'`' Fiivat� Supply i3riil�d-by ► ��~ ��^ �� ._ Addres 1 t I represent that.I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s sy tem 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 Construction Compliance" satisfactory to the Public Health Director will 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 treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. �' 1 W1R4 r A& Signed: / 7,y Address License �i APP][t ®V]EII9 � 8g5 approval pires two years from the date issued unless construction of the sewage treatment sys eted and -insp cted by the PCHD and is revocable for cause or may be amended or modified when consider y the Public Health Director. Any revision or alteration of the approved plan requires a new pe Appr ed r isc rge of domestic sanitary sews a only. By: _ Title: d1L Date: I 011z- White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 P PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL ° pl'eise'pflnt obi [ype' r '- - PCHD Permit # Well Location: Street Address: Town/V, iillage ��� y Tax Grid # ��i�u / /�✓ /T��`e�a! %�� l �thjQ o''J / Map f¢ //Block / Lot(s) Well Owner: Name: Address:, n Use of Well: Resi enti Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served _,d Est. of Daily Usage GO gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type 1/ Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes di' No Name of subdivision l +,rte t%if_ Lot No._ Water Well Contractor: Alz2ad vo Address: _moo %,�- - "Pie, �/' �• Is Public Water Supply available to site? ............... Yes —Noe Name of Public Water Supply: Town/Village Distance to property from nearest water main: z:g.Af Proposed well location & sources of contamination to be provided on separate sheet/plan. Date:. Applicant Signature:._....�, ol PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the ,water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller cent ie by Putnam County. Date of Issue o !z 47 Permit Issui Official: � Date of Expiration O 1 © Title: Permit is Non- Transferrabl White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 f 8 � r 0 ~BRUCE R FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services " . . . DEPARTMENT OF HEALTH 1 Geneva . Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 ' Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 October 9; 2OO 1 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 a Frank Sullivan 2972 Ferncrest Drive Yorktown Heights, New York 10598 Re: DePole, Peekskill Hollow Road (T) Putnam Valley; TM #- 84.1- 1 -1 -20 Dear Mr. Sullivan: This office has received and reviewed the most recent -set of plans for the above mentioned project. We _would like to offer the following comments for your review and consideration. Plan: 1:. Revise note "No SSTS within 200 feet " to read "There are no SSTS within_ 200 feet, unless shown." 2. Dimension well from the property lines. 3._ : Provide access way, to drill/serv; ce yell.. v 4. - Provide letter of feasibility to drill /service well from a Putnam County.registered well driller. 5. Show additional deep test holes (and perc's) witnessed on 9/28/99. 6. Show required erosion control measures. x . ---- ____.------ 7:------- Re- draw -and verify- .topo! -!! — Topo -is- illegible.___ .------- _------ _--------- - - - - -- 8. Revise the title block to read: "Proposed sewage treatment system" and add revision date. Details: 1. Dimension septic tank. 2. Provide "size" of septic tank. 3. Please remove all "non- required" details. — Curtain drain — Distribution box — Stand pipe — Force main — Pump pit — Pump chamber — Dose — Alarm calculations This office will continue its review upon consideration of the above mentioned comments. Please feel free. to contact me at ext. 2157 if any questions arise. Very truly yours, Adam B. Stiebeling Assistant 'Public Health Engineer ABS:cj enc. i r r a _. c IFU7I NAM COUNTY IIDIEPAR7I'MIEN7 OF HEALTH l`IDIIVISRO N OF ENVIRONMENTAL ENTAIL IHIIEALT HI SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREAT ENT SYSTEM. PERMIT # Located at A&101- /6 J Town or Village /-&,�'Aaw Za / —�± °� Subdivision nameLp-e- i"�-.> Subbd. Lot # Date Subdivision Approved %,o Y- d Owner /Applicant Name re md.$ /,,-Aaord Mailing Address e Amount of Fee Enclosed 1?67ti Tax Map AW Block / Lot 2-67 Renewal 40� Revision Date of Previous Approval lP V yr � y Zip /�r�'7 Building Type j�e c _ Lot Area / -hga No. of Bedrooms 44, Design Flow GPD GO (Fill Section Only Depth Volume IPCH D NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separzte Sewerage System to consist of i; gallon septic tank and Other Requirements: To be constructed by d w,9 mot- Address Water s—up lv: _ Public Supply From _ Address o1r: P", Private Supply Drilled by e-I-y0119 Addresso0l,,e�- � %�e I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatmentsystem 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 Construction Compliance" satisfactory to the Public Health Director will 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 treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A�Ovoltiw Address �, Lic APPROVED FOR CONSTRUCTION: This approval expires two years from the u es� c truction of the sewage treatment system has been completed and inspected by the PCHD and is revoc u be amended or modified when considered necessary by the Public Health Director. Any revision or alte ed plan requires a new perXiit. ARproveclfor dis,ch*ge of domestic sanitary seNyage only. j P By: Title: V lidHt— Date: L Y White copy - HD File; Yellow copy - uilding Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL �1 Please print or rype�_ ' PCHD Permit #` f(6W- / Well Location: Street Address: TownNilla e� Tax Grid # r /".4W / V ! � ,� 1�% MaPOVI Block % Lot(s)-?& Well Owner: Name: Address: Al Use of Well: YResidenTial Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought _d_ gpm # People Served Est. of Daily Usage gew gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type ✓' Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision ,/71 Ile,- �� Lot No. -7 Water Well Contractor: An, j4w Agi, _4 a,J Address: 1-96 e4ew- V- "A- K IV 7- Is Public Water Supply available to site? .................................. ............................... Yes No Ae Name of Public Water Supply: Town/Village ✓- Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. , Applicant, Signature:., -- - PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue Z q9 Permit Issui Official: Date of Expiration Title: L 1+k- Permit is Non - Transfer abl White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OE HEALTH 101L V lail0l Or Z11 V JI OI IVILIl TAiu nnAL,A n aE V IcEs APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Blame and address of applicant: r®le- 2. Name of project: .4. Design Professional: 3. Location TN: 5. Address: 6. a of Project: Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty ,Subidvision Other (specify) 7. Is,this project subject to State Environmental Quality Review (SEAR)? A161 T. YP Ty pe P e I Exempt t Type II Unlisted.. _ .. g. Is a Draft Environmental Impact Statement (DEIS.):required? ..........Av { 9. Has DEIS been completed and found acceptable by Lead Agency? ................ 11. If this project is an area under the control of local planning, zoning, or other ofdcials, ordinances? ............................... ................................................. ........ . d*� 12 If'so, have plans been submitted to such authorities? �f 13. Has preliminary approval been granted by such authorities' Date granted: 14. Type of Sewage Treatment System Discharge ................. surface water groundwater. 15.' If surface water discharge, what is the stream class designation? .................... 16. Waters index number (surface) .............. ....:........... ............................................ 17. liproject located near a public water supply system? ................ 18. If yes, name of water supply Distance to water supply /yileo 191. Js project site near a public sewage, collection or treatment system? ................ �o 20. Blame. of sewage system Distance to sewage system% /6 21 )Pate,. test, holes observed;.. 2:2. Name,of Health Inspector ., . Form PC -97 23. - Project design flow (gallons per day) .............. ,................................................... -24: Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... o ' 25. Has SPDES Application been submitted to local DEC dff ce? 26. Is,any portion of this project located within'a-designated Town or State wetland? All' . 27: Wetlands:ID Number ...................................... .. 28. Is" Wetlands Permit required? .. . ... ......................................... � PP . Hasa application been made to Town of Local DEC off ce? ...................:........... 29. Does project require a DEC Stream Disturbance Permit? ... ............................... A140 30. Is or was project site used for agricultural activity "involving application of pesticides to orchards or other crops, solid: or.1azardous waste disposal, landflling, sludge application or industrial activity? ............................ Yes/No 31. Is'prcject.located within 1;000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other otential known source of contamination. Yes/No �� p. ............................... 'DESCRIBE: . ...:... .. 32'.. there a local master plan on file with the'Town.or Village? ......................... p'a 33,: Are community water and/or sewer facilities planned to be developed within 15 years.in or adjacent to project site? ........ ............................... 34. Are any sewage treatment areas in excess of 15 %..slope? . ............................... 35. Tax Map -ID Number .......................... ........ M Block.. � _L Lot 3,6. Approved plans are to be returned to ..... Applicant ✓Design Professional-%• 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. I� ereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a'Class.A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: Mailing Address: PUTNAM COUNTY DEPARTMENT OF HEALTH _ -DIVISION OF ENVIRONMENTAL_HEALTH SERVICE DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address Z2,Y fc-& 1'{-5 K; l P61 1,o w Located at (Street)"-" " . Gj�fA ��s -i/; ax Map gy I1 Block % . " Lot 20 (indicate nearest cross street) Municipality 1/�r /% f Watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking ��� Date of Percolation Test �) 1 3 4 5 2 3 4 5 1 2 3 4 )TES:, ' Tests.toI r, ` � pereolati� 1 `'= submittel 2:.: Depth, m » f� 74 %f t �uriace:;(1:ii cheS) Start!Sfop<> ..3 /U. G repeated at same depth until approximately equal percolation rates.are obtained at ea( 1 test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be for review. isurements to be made from top of hole. Form DD -97 2a J- _�5 ..3 /U. G repeated at same depth until approximately equal percolation rates.are obtained at ea( 1 test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be for review. isurements to be made from top of hole. Form DD -97 TEST PIT DATA 2 DESCRIPTffON OF SOILS ENCOUNTERED IN TEST HOLIES DEPTH HOLE NO._ HOLE NO. HOLE NO. G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 9.5' 10,0', Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date' 9 Design Professional Name: J 69- ,,51-11) i V7 P JE- Address: 2-- q 7 Z Fear rj Crams r Signature: Design ]Professional's Seal ✓� 29" PUTNAM • 0 DEPARTMERr OF DIVISION OF 1. 0' ' E Y• L HEALTH SERVICES rDRSIGN­DATA SHEET -SUBSL ACE SEWAGE DISPOSAI. �SYS Lji F=' DA.~ Address %14 11leerl Ad, Located at (Street) /' ���'� %7iJf U �.i'ja� S_ec. lf�. J i Block J Lot zV (indicate nearest cross street) [Municipality �14 ka)y A Watershed SOIL PM2CO MON TEST DATA RBDUii2ED TO BE SUBMI= WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test 3 % >3, d HOLE NUMBER CLOCg TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 2 3 4 5 3% J Sz .4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated* are obtained at each for review. 2. Depth measurements to rev. 9/85 at same depth until appradmately equal soil rates percolation test hole. All data to'be submittod be made from top of hole. DEPTH G.L. 1' 2' 3' 4' 5' 6° 7° 8° 9° 10 °, 11° 12° 13' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION HOLE NO. % HOLE NQ. �— jef r, IN TEST HOLES HOLE NO. .a , a. . INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED °- DEEP HOLE OBSERVATIONS MADE BY: �j�� /%x''4'/7 DATE: AAA > DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided "5110 0 No. of Bedrooms Septic Tank Capacity % gals. Type Wa._S. Absorption Area Provided By L.F. x 24" width trench Other . "woAf 6 >re & r✓ d Name Signature 4y�SE OF Address /G��% t��/ /� SEAL FRAkC18 ` THIS SPACE FOR USE BY HEALTH DEPARTMENT' ONLY: Soil Rate Approved sq.ft /gal. Checked by Date 14.1`1 267) —Text 12 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review S,HO RT. ENVIRONMENTA LASSES SINEyT F�1RIlA For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEGR 1. APPLICANT /SPONSOR 2. PROJECT NAME. ors 3. PROJECT LOCATION: / tl �U/7��/yJ � Municipality County 4. PRECISE LOCATION (Street address and road Inters lone, prominent landmarks, ate., or provide map) 5. IS PROPOSED ACTION: ew ❑ Expansion ❑ Modificationialteration 6. DESCRIBE PROJECT BRIEFLY: /VIP �'Y � � /� �l'i..s /�� �YGG ��/ /f � ✓1�6 r/� G!/ G// 7. AMOUNT OF LAND AF ECTED: % Initially acres Ultimately acre B. WILLJPROPOSECrACTION COMPLY WITH EXISTING ZONINIS OR OTHER EXISTING LAND USE RESTRICTIONS? as ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑ Industrial ❑ Commercial ❑ Agriculture C3 Park/Foresuopan apace ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ❑ No If yes, list agency(0) and permlVapprovals 19Yes 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 0Yes ❑ No If yes, list agency name and permlVappmvat ,`'s.p'/%i� ✓• 12. AS A RESULT ROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑,Yes ZNo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE G �G /� Applicantisponsor . name: Dab: l Signature: If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 FART It" ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A: DOES ACTION EXCEED ANY TYPE I THRESHOLD IN a NYCRR, PART 617.12? If yos, coordinate the rovlew process and use the FULL EM. ❑ Yes ❑ No S. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617A? If No, a negative declaration may be superseded by another Involved agency. ❑ Ybs ❑ No - 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 apecies, significant habitats, or threatened or ondangerod spoclos? Explain briefly: C6. 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 w 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 offecte not Identified in C1-05? Explain briefly. C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? `Q Yas ` ❑:Ro ; If Yes, fIx0Iglr; brlfly, FART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether It Is substantial, large, Important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (f) magnitude. It necessary, add attachments or mference supporting materials. Ensure that explanations'contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed. ❑ 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 WILL NOT result In any significant adverse environmental Impacts ARID 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 ea Agency Date E Title of Responsible Off icer ianature of reparer different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE: Property of LETTER OF AUTHORIZATION Q'la� , ale— Located at 44v4fl a U�!/ /l-o� i T/V�u� ,� Tax Map # �PA /l Block Lot zd Subdivision of Ze n° Subdivision Lot # % Filed Map # Date Filed Gentlemen: This letter is to authorize e3 �-,�fj �k �1j`Y'� d a duly licensed Professional Engineer _1� or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, aad the *Putnam County Sanitary; Code. Countersigne `. P.E.,,&4, # Mailing Adfi r,%�O' WE State Very truly yours, Signed: '?VK (Owner of Property) Mailing Address: 260"-- State Py Zip /oS 7 !� Telephone: `ol > Telephone: TI( V 5W — 2 6 Y 9 I Form LA -97 240,E \ 9\ \ � 00 roc • e o ND EEP ROLE -- S f \ \ ` , \ ^� \ \ \ \..` \ \ . \ \\ 00• RC. HOLE 0�.� �2 \ ^49 IONUMENT O� \ \ .�" C9 \ i •.\ \\ `� ; ``'� `�e % \ \\ ROP. HOUSE /O" \S�' \ \ ``` ` \ `' j' \ • VC. Si �� � F' 162. � \`�\ �, ?� \ a \ \`'�\ \ •y /tic\ � c �\ \ v y l� Fly \� \� 6 °� \\• �f, \ \\ \V� �O \�`'P ` \. '` 7i Is 17 \ \\ \ ' 49'E 9.8 APPENDIX `° PUTNAM COUNTY HEALTH DEPARTMFNf \ \ �49 REALTY SUBDIVISION GENERAL NOTES ' Sri ` \� `\ \ \ \ \ • ` \ '`. County Department of Health requires the submission of plans \ N \ `l S ` ♦\ `\ \\ \ '`. \ al systems prior to the issuance of building permits. c `z• ;S \ \ \` ` \ have a minimum safe yield of S gallons per minute. O� /O /•OS. \ \' ♦ 9 I l \ \ y> \ al crater supplies shall be drilled wells. i, \ o be drilled wells constructed in accordance with Ned York Department bulletin, entitled "Rural Water Supply." G� Zo N16 °pT, \ \\ s° �� R County Department of Health approval is base3 on locations of �F S' X \. /\� ,�O ms, wells, house and driveway locations being maintained as L N. 4S, Zj< modifications to have prior Putnam County Department of Health �� 4/ E \ � ` C-9 �\ \ d modifications made to this drawing after the date of Putnam o N 9/_4 \ \. 9� Gy\ ` h Department approval voids said approval. f 4 \ ♦ \ \c �\ 37 9b• .... \\ • � • ,` I F� fill is permitted in the sewage disposal area, except if so I ! N. l9. �z z3q an approved plan. rnmitted within 10 feet of a sewage disposal area. Sa \a of lots to be furnished with a true copy of this plan as 1•` (0 the Putnam County Department of Health together with a copy of ti -, i ate of Approval. 4, . ons noted on the Putnam County Department of Health Certificate j'. y NS 6SS3'...'' are an integral part of this subdivision approval and \.•O\ s required. °rc t � elineated for disposal fields and expansion area are to be f 'Y -�e•24 f. Zao\ marked on the ground and no earth moving or construction i 1' 3L 96, is to be allowed in these areas except as required for of the system. iti • t t' P, 'D 14. Flow from all proposed dwellings to the sewage disposal areas co gravity. 15. Septic tank capacity must be increased by 506 and disposal fields by 20% it garbage grinders are proposed. 16. Approval is herewith granted for a total of IG lots only, namely lots I THROUGH Irp 1WCLU51VE and these lots only. PUTNAM COU NTY NEW YORK 5CACg V -50' BATE= JULY V. 1566 REVI 5F- 0 : AUO. 4, Vbb(b I,ANTVAOWY DE R05A, THE SURVEYOR WHO MADE. TH15 PREPARED BY MAP DO HF-REbY CERTIFY THAT THE FIELD WORK UPON W141CH IT 15 15A.6V0 WA5 COMPLETED ON FE15.8,i,385 AND 5UNNEY ASI50CIATF-15 LAND SURVEYORS THAT T015 MAP WAS COMPLETED ON JULY Z1,19bro- RURAL ROUTE #Z FIELDS LANE MORT14 SALEM, NEW YORK I 05W 4e N.Y.S. LICAO. 4935Z W , 84*mipi to Pion, r, • ,PU2WAN 4 CRIMPOCATE OF Co OEM" STSTIDA' T owl! "Me x4slu imoi�� 0 Dote o(I pate. Subdivision .-M roved Fee "Etclosed-' I: regasont;;tMt I orn M6011Y and completely rosiiiri 1. ftiiAhe&siqi%and idCitlon, Of the. propop". System(pi .11 ;that the'saiMrate Sewao 'dilposal, system of Date ant. and--a Itton anyf,part imW inva""dil0oul-A Cirtificate-of n aflidthat siicl.wiil will '64 InSI AiMill APPROVED FOR CONSTRUCTION TMs Fi ;",*" for 'c'amsm of >m be. amarwed or modified whan•c rkmite Aoisrigrvo foi iisooul (if iloon'"' Rev. 10/88 By 0 sm acl ction ComplleinW GatisfaCtory1o, thi Commissioner of Health will his succisiors; hells or assigns by'thi. buliddit, that sold WNW Will i- of tw''O" '2" f ­ 114 , the4liete of the luu- ii-or id, I I yews lfnmwiat*iy allow • teii or any faimirs It t the drilled Weil deso a" above Mae h in* do fee—uGM—S& the PUtnern P.E. - R.N. 2, J-) K.nieis iond "io u'i' S'boan undertaken is n and ;FIsslon'St it =,,he, alteration of construction :water supp i ire , - I b4j%6' DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278-6130 " APPLI&PiON - I `b''�ONvTTRUCT" Pi' tAA `R'� [niELL = - i T : • / l� PCHD PERMIT WELL LOCATION Street Addres�j� T,wn Vill ge City Tax Grid Number E i` /% / ��G rv' Tacr d �0 /' �,// - % ` 21 WELL OWNER Name Mailing Address f gPr iv ate -- ����Public USE OF WELL 1 - primary 2 - secondary firRESIDENTIAL ®PUBLIC SUPPLY.- ®AIR /COND /HEAT PUMP 0ABANDONED 0 BUSINESS 0 FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL O INSTITUTIONAL 0 STAND -BY AMOUNT OF USE YIELD SOUGHT- 5- gpm/ # PEOPLE SERVED /EST. OF DAILY USAGE fs J gall ® REPLACE EXISTING SUPPLY 0 TEST /OBSERVATION 13 ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING ® DEEPEN E7,ISTING WELL REASON FOR DRILLING DETAILED REASON.FOR DRILLING WELL TYPE DRILLED ®DRIVEN []DUG ®GRAVEL. OTHER IS WELL SITE SUBJECT TO FLOODING? YES i" N0 IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: c l G - 41 / Lot No. 7 MATER WELL CONTRACTOR: Name /Va ✓�/1 ��r.�r� Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY ._ DIST- : TQ- PROPERTY.' FROM-.,NEAREST:.WATER- , MAIN--r .�1_.. d_..., .:- � . m•: �:= �:' ::. _. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET�,�/� —'( a ) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt7 (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such manner as not to degrade or othe i. a contaminate surface or groundwater. Date of Issue:- C' 19 Date of Expiration ,3 19 `l b Permit Issuing Official ! Z Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller k -1 PUT NAM COUNTY D E PART M E NT OF H EA EY H L�f a': ".%i :c, f „ "t:r:'. w.i_... _.�•.� ,.. �:.. ._ �%•K'`A ... , •�s -F�+OR q �%.G•{C•� cc :'n '....,• Yaa. `. �•'- ,_" •a..e..� fl, J «...:'•: '..'�re.::_,...�i ^'o.rw.�. ►. .. •I APPLICATION ,:FOR �APPROVALGOFPLi ANS A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: / / G��i' z "'t i?o :� Alb a/ j3Ud 2. Name of Project: sj �S� z�i 3. Location T /V /C: ���Yu� 4. Project Engineer: X"t'c_�,� 1 %�' °��°''? 5. Address: �i License Number: Z �% �J l�S Phone:�� y 6. Tvpe f Project: Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (Check One) Type I.. Exempt t/ Type II. Unlisted 8: Is- a -Draft Environmental Impact Statement (DEIS) - required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... 10. Name of Lead Agency I✓o _. 1 -1 -:1s thia::project:ATt an area under the contr.o... -:o oca, ::p .ann,ing,::160'69i. or other officials, ordinances? ........................................ 12. If so, have plans.been submitted to such authorities? .................. 13. Has preliminary approval been granted by such authorities? Date Granted 14. Type of Sewage Disposal System Discharge...... Surface Water t-," Ground Waters 15. If surface water discharge, what is the stream class designation ?........ 16. Waters index number (surface) ........... ....`7......................... 17. Is project located near a public water supply system? 18. If yes, name of water supply Distance to water supply % 19. Is project site near a public sewage collection or disposal system ?..... Ny 20. Name of sewage system — Distance to sewage system ei'k-5- 21. Date test holes observed: 22. Name of Health Inspector: 23. Project design flow (gallons per day) ........ a............................. 11/93 2. 24. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. AIU r �. _ _ .r ; s0✓ • P+' :'..rC< .. .r O'Y -. nt'�.. • h. t.:v� v �Y' •.: a � •. _-i w •phi o s wvo.r.. r. +.. +� ti �O+_ � � � : •.%c. �. �j..: W+..wi�. . •�. I- -css v'.�P •.r � .r . w.�. i .r. • .rra 25. Has SPDES Application been submitted to local DEC Office? ............... `4 26. Is any portion of this project located within a designated Town or State wetland ?. ............................... ............................... 27. Wetland ID Number ....................................................... 28. Is Wetland Permit required? < ............. ............................... Has application been made to Town or Local DEC Office? .................. 29. Does project require a DEC Stream Disturbance Permit? ................... 30. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ........ YES or NO .Au 31. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO A14;1 DESCRIBE: 32. Is there a local master plan or file with the Town or Village ?t 33. Are community water, sewer facilities planned to be.developed within 15 years? 34. Ara ..any._ sewage disposal, areas_ excess of 15% slope ?.. ... 35. Tax Map ID Number .................. ...... .................. 36. Approved Plans are to be returned to: Applicant il Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization'. Failure to comply with this provision may be grounds for the rejection of any submission. % hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable.as a Class A Misdemeanor pursuant to Section 210.45 of the Penal Lae. SIGNATURES & OFFICIAL TITLES: MAILING ADDRESS: �7z PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ j" ..:.;"!..-- �.. ...' .. a .... vs.o., . r .. .,lad -'., .. r. •.. ,a..: ro••, ra =a •.. .. a n`t. • . - «... .. ,.:� .r a .::.� . -.. ....� .. r, ,,,.Q'.;�r Date /��d�% Re: Property of Located at /" ��/�.����� ��p`�ov1/ /'�GIrC✓ (T) I Section ZG.Al Block / Lot 2-O Subdivision of IZ re- Subdv. Lot # % Filed Map # Date Gentlemen: This letter is, to authorize CJ y���' �u �I I ✓�� a duly licensed professional engineer Y or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules. or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connectioxi with. this matter and.. to, s.up,ervise -the constr. uction- :,of.: said system or systems in conformity with the provisions of Article 145 or ;47, Education Law, the Public Health Law, and the Putnam County Sani- iary Code. Countersigned: �4£ 4f AL . I.E., R /A., # dress 'llephone Very truly yours, Signed Owner of Property Address Town r' Telephone Public Health Director Frank Sullivan, P.E. 2972 Ferncrest Drive Yorktown Heights NY Dear Mr. Sullivan: .°.. � � I;01t1✓'Tr'1'A�� 1�IOLIN�RI' �R:N:; �11%I: S:N: �` � _ Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road �D Brewster, New York 10509 �0 Environmental Health (914) 278 - 6130 Fax (914) 278-7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 - September 14, 1999 10598 Re: Depole, Lore Peek Acres, Lot #7 TM# 84.11 -1 -20 (T) Putnam Valley This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your `consideration. 1. Prior to further review this office must witness additional field testing in area of SSTS. Please call to schedule an appointment. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. ABS:tn Very truly yours, Adam B. Stiebeling .Assistant Public Health Engineer Ll C� rr 7 Or 11�9 �V'j'kj S� C� '�>s Lf y ..-fir � .t.�. fc, �'. . 2:�a ci':. . w. -..c- � .'.. .' . as .. ... „ • 2.%s, ol.: ,:. . -. t,] \� a� ? -•• a v n �� V' .� t WELL DRILLING 152 Barger Street Putnam Valley, New York 10579 1- 845 -528- 8698/1- 845 -528 -1491 Fax. 1-845-528-1491 October 15, 2001 PUTNAM COUNTY ENVIROMENTAL HEALTH DEPT 4 GENEVA ROAD, BREWSTER, N.Y. 10509 RE; MAN TAI ING WELL; DEAR SIR; WE FORESEE NO PROBLEM IN BEING ABLE TO TAKE CARE OF THE WELL FOR TOM DEPOLE. THE WELL IS TO BE AT 266 PEEKSKILL HOLLOW ROAD., PUTNAM VALLEY, N.Y, 10579. IT IS LOVE PEEK SUBDIVISION LOT #7. SINCERELY YOURS, RANG �A -1 . 0--- Manufacturers No. M 1168 BI -LEVEL A -1 T -RANCH A -1 T -SPLIT LEVEL A -1 l -RANCH A -1 SPLIT LEVEL A -1 ttvA aV [9Y6 — 1 ' E E mw as - o.c 9L J 1 � al TWO FAMILY A -2 RANCH TWO FAMILY A -2 BI -LEVEL SINGLE STORY /TVO FAMILY A -2 [OFFSET) :___TVO�STORY /TWO. FAN[ LY- A- 2.____.___-._.,9 Ya.> li _.__— _._...__- __- _iVO.fTORY /iVO FAMILY -A-2 OSiSET)._ NOTO EACH SIDE OF A TWO FAMILY A -2 IS A SINGLE FAMILY UN[T mvc as ,wA ap 1%w"mi sm w p, . ry nem, ,nu IS • r@ Gros K.9 Iw9 u 9 . Nmw o® vrA Iw9 _ RAFTERL Y 9 • G xNg1w9• CEILING JIIISTS fS7ORAGEP N U w I— IS 9 K KWL VNOY • K.[91w9 FLOORS (HID(- SLEEPING AREAY _ FLOORS [SLEEPING AREA} U 9 w KT„L v[[wr . KY LDM � WIND LOAD - - -- - r9 tY • b R n Yp9N.lU Y2 UPLIFT, ORAm.bry .r m•bIV ATE _ .- - - . - - -- - -- FIELD INSPECTION NOTES [ rK Iar. aa.trrs mK promar vrlm {,•vt r.n.[ ,rt K to nn9 .nr Y.u[ KiYa. wru[rs IS, dsr=r� Yix.u�a [ rt SK,,g x mac w{-[xr rtA T. rn @ M iipi9:t �W[ i Wf41T, miY R rpw� CONSTRUCTWM TYPE, COITR!!.TTM TYPE- OCCUPANT .m TM f.,nr Nu[A[i COX CONFORMANCE f. THE__PEAI( OF pZRF'Royl IV 1 -11,11 n NA-11 COUNTY DEPARTMENT KERm. oTsi HOU ".' A I:ROVED FOR BEDROOM COUN�1 b §��' -' " 247— US'- HICHWAY -522 N,- HIDDG , �TjDM -(570) ,837= 2333ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUB TTL-0 TO THE PCDOH L FOR APPROVA � .• SIGNATURE &TITLE ; D TE TO THE BEST MY KNOWLEDGE, BELIEF AND ALL SUBMITTALS [LmLESS OTHERWISE NOTED) SHALL BE BASED ON PART -5 OF THE PROFESSIONAL JUDGEMENT, THIS PLAN IS NEW YORK ENERGY CODE. PART -6 MAY BE USED WITH IN CALCULATIONS. IDENTICAL TO THE ORIGINAL, ON FILE WITH D.D.S. DONE FOR EACH HOME AND GIVEN TO THE LOCAL CODE OFFICIAL - AND HAS NOT BEEN MODIFIED IN ANY MAHIN- V. SHOW LOADING PER INDIVIDUAL SIBMIFIIL SHALL-BE LOCATED ON FLOGR FLAN - t ' - LILNLKHL NUILN - MODELS .nrt[t �_.V .Yt =c,;.--, @C ..[ K [[o[<n O YQ 3-- Y� [K wwm`ri{�v,wl i m�.r v Kwcm'[ mu'w °•+[ u.u„olns ,>s v ncK .[ - ra¢i[ ew �aaa[ u.pc [[.n roc .a.a[ w aua, . @.n Y.a @ nu r.+uc., •wprn. ' i.oct r YAa_ K iiasYV[t . sao-m,ia.ccr pG . nAbL M0a is . •mcAa mOrKiQ R 7R9:A'. ec YT[Y ma [,,G .r,rKiuK9 °,• we . [< Cat[ soar [tvn ,oC Rl3D @ . rul [.K�oa iu„s.r,a, KP . Wi {iAa Spa .,._.. rT Ww,•4 ,9„9•iP v N P•. S,­ L C uO ITS Kll � maftlLiO m�[[i[ rtnfLf Tp[tY4 M "—,I [Uipi� [ur o,- rr, w •n [u` ua• rtuY+a a �a I'm, mr v neKt c •v+on ,0,4 YES W 9�K�O0� rtw K wr[IS raQ 6 YN[ to W,G U O -I. Y ,OC S9 w tD[n PM W V K 1 1,w b K n O s U b t K •w [rK•. OryY i KnaxtWa L . .'� r1 ro x m aWnq -r -I- Q <b �a nYI Vr04, i Yr l R ,�M t Y[,� M i.O. iMa A[Wu � O. I . I ST. . " M .R. � CC L Tq ­.Si R1:9 G9Q . w.Yt Y.5 ITS /ILL M[GCC fpsYT[M , iara. mnYi. n[z*. YY[ Yr,trrm[ roc ecT. Yr. r.as[ rta [K mI qt =111— + w c.� mtz sirsuc an[ n ... v K ana ,mu[ Kts .n ,o[n, ' RC IITtlnx[9 u[t p i,9s YrAYY,a rY( I(SA x[.rt[ p Kaip.Q viq ,[i,09 IT' ap Y tC[xA19 tID, tpi W{ Kw fAb YIrM K IOAY,OIT T ipR p .GSP.6 YI,Y Kiv[L,1CU a Im {p �[ @ [,xl(A. WK rr.Q a, rY1 4i[Tat U ,au=[i tm alxm ti IT t m t Y ' . Y t m z , . u . o • . Q . m K . @ n . Y [ [ % . R [ L � a a 6 . I T - m. ,rs[ .vs YxPVr ,msxr+rv[ •b,rm. @ Gann, p .,....ca ���� i,� v� pY,.n S I T tw P Y pYAr U W K. Krm U [, a C{o i {i0 a nti MCX/r [Cib[of, 1 - t CAPE A -1 CAPE ./ SHED DORNER -A -1 YYa an im agoY oho a - 9pi IT � man COVER SHEET - U= pryT 0/3 /S7 cM6 /zB /ai r e ,I • � d ,/y I - - -- I, j .�T tj4 � }I I 9J s F� T ti. I D DEPCILE CONTRACTING/SPEC ON- 940' 1 /NY- . 82e FOYER ED [H) 23-80 LIGHT PROV'a} ---.-----10.40-VENT-PROV;lf--'*- c Yl 2' CONDUIT R 'T. cu m 1p 12 -U -1 -NIP" M04 -2" r 3 spr .2 Y L LIMITED TO 33'-5-j 41, 10' F. UILT PORTION JUL 3 2001 T. NOTES LBUP DER iS R-S-ONSIBLE FOR. PR,-ViDiNG A PROPERLY 6 HOUSE TO PE ERECTED AT 7 . S!ZZ_7� SYSTEM, 10 COVER A 84,0',0 BTU LOSS 7 PLj_--NAM VALLEY; NY- PJTNAY. CO-NITY TWE P"A- 0/' je4e TWO STnRY IS _P HEAT ' _-'SS WAS CALCULATED W/ R-19 INSULATION OR HEATED 3SMT 8 35 LB. SN�_.w ZONE. 9 STORY FLOOR PL*AN 3x - DE-ND'ES ADDITI13NAL: COLUMN' IN BASEMENT 1st 4 CLG �_!RDZR OVER GREAT ROOM TO BE 6-1 1/2'.9 1/4' ML ig hroAfEs, INC. w'wm c DWF' J�t6-25-01 I A9901 7P"S6 33-10 1/2' Ul L STATE M;IPP ATE, A rS LABEL LABEL LOCATION 48'-0' HDR 3-2.6 (D (D spr 42 CV2 2.6 Foul I '7 6'L 2• FUT *VT 2 F U ' VT - I- VENT RA ENT 3' RADON VENT �U �U .'S, 11. kl-:I. 12'-3" L iII L • 'OM 3- -RA DINING ROOM 3' DRAIN L L I 2 0 - f 2-3/4' SUPP. :114 SUPP FROM FROM 2�d STORY STORY E;-; PUTNAM CO ll- )EPARTMENT Pr HEA 'H �U T 152.58 SO. F T. 12-21 ;LIGHT REOT 'E�' , KITCHEN n A f1OU&,%VlS PPI( 'D 'D HOR BEDROOM COUNT OR BEDROOM ONLY, 0 MARTIN FIREPLACE MODEL 4 SC42 RAI 44 4 S' I D ,E 6.10 VENT REO'D 23.78 LIGHT PROV' D ALL BASE CABS_) T BE SSI 1 V/A 20'.66' HEARTH .14.70 VENT PROV'D I BEDROOTI Ell 0 59 ALL SUBSEQUENT Ill. SIO] 10 IATIONS TO THESE ItALTU I LTU Housr- S MUST BE SUE N I r TO FOR To THE P APPROVAL GREAT ROOM V 10'-5112' ' 4 TEP114 0 S 4DET rRR B24 824 B36 SIGNATURE &TITLE Lj_U — — — — — — — — — — — — — — — — — — — — — — — — — , 'I I — E3 - - - - --- V3615 %124_30 VZ4 3o W3630 OMIT 2'-B' SECT 6. CLG I VALL GYP - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3­0 112' 4­10' 1 '.Ai wo 432.00 SO. FT. LANDING . N BATH #3 34.56 LIGHT REOT .. .... 17.28- VENT - REOT 59.50 LIGHT PROWD RAILING 26-00 VENT PROV'D ONJITE Y_ ED OT" DEN �u �U a t> OPEN TO z SECOND STORY CLO 157:50 SO. FT. - - - - - - - - - �U 12.60 630 LIGHT RE D VENT 82e FOYER ED [H) 23-80 LIGHT PROV'a} ---.-----10.40-VENT-PROV;lf--'*- c Yl 2' CONDUIT R 'T. cu m 1p 12 -U -1 -NIP" M04 -2" r 3 spr .2 Y L LIMITED TO 33'-5-j 41, 10' F. UILT PORTION JUL 3 2001 T. NOTES LBUP DER iS R-S-ONSIBLE FOR. PR,-ViDiNG A PROPERLY 6 HOUSE TO PE ERECTED AT 7 . S!ZZ_7� SYSTEM, 10 COVER A 84,0',0 BTU LOSS 7 PLj_--NAM VALLEY; NY- PJTNAY. CO-NITY TWE P"A- 0/' je4e TWO STnRY IS _P HEAT ' _-'SS WAS CALCULATED W/ R-19 INSULATION OR HEATED 3SMT 8 35 LB. SN�_.w ZONE. 9 STORY FLOOR PL*AN 3x - DE-ND'ES ADDITI13NAL: COLUMN' IN BASEMENT 1st 4 CLG �_!RDZR OVER GREAT ROOM TO BE 6-1 1/2'.9 1/4' ML ig hroAfEs, INC. w'wm c DWF' J�t6-25-01 I A9901 Nk --.----------------------- BEDROOM kl N . -336.42. SO. FT. - 26.91 LIGHT' REO'D D a 13.46 VENT REO'D m 33.30 LIGHT PROW➢ `W J ^1 1830 VENT PROV'D .. I 1 '1 RAILING OPEN TO ONSITE FIRST STORY By OTHERS EN FROM 2• VT 1st STORY LIGHT �' CO ;'•- �p' c KPH MAS DEPOLIE QN- 9401 /NY CONTRACTING /SPEC 18.30 ROV'D 18.30 VENT PROV'D now A. 3'-9' 10' -9' 17-11• 26'-6' BALCONY 34' -6' 43' -6' 48' -0' iv 6'- .6 -1/2' 6' -9" 8' -2' ° w 7' -I1' 15'-11 112' • ).. .�,05 L OD 1670 �xI ' VENT FROM 1st TOR Y I I 16' -0' 14-3 112' \ _ 15- 11 .11-2' 'Q �z V/ D AP.ipN 3' D@l VENT v AI WALK -IN WALK -IN - NT W, ..I 0 Q 24' -0' A p' A .12,_0" CLOSET CLOSET NBOAR., S OUND ATH r I 33' -5' 41' -10' FA a UILY PORTION z { �! > JUL - 3 2001 BATH #I' NDTES I dr+ i CLG BEAv 7VERIIREDROOM �; T�] BE 2 -1 1/ ?•X18' ML 5 6. . ,1 / � 1E 848 T 2 CLu 3EAM E�V_F2iHALL TO 3- 2 -; 1/2•x19• ML 7' 2 �} d ��P�,X ' 2nd STORY FLOOR PLAN PUTNAM COUNTY DEPARTMENT OF HE 3 TLR GIRDER GNDFR BEDROOM :? TO 3E. 6 -1 1/2'x9 1/4' Mi- 8. \v ij{' O 4 � ., es if o /vE , f/Y C.. e., scuc c..cx BEDROOM a2 N ' ;I DWP 1.1, 6 -25 ze 9401 ^� ` HOUSE PLANS AtgMQ _ , BE DROOM COUNT b I: :f '1 coo 16.76 LIGHT REO'D Q, ly T• 6 Y r I •I 1❑ B 4,q in - O ' VENT ROV'D LI 2-4' 112-[1-- -11-3 -1/2' - -- - -- - = - -ALL S SEQUENT REVLSIONIALTF.RATIONS TO TH HOT SE I N - -T - -1 .. E OH PL S. MUS B .TED TO THE PCD FOR RO AL ;' -- o — N _ t•------------ P DOWN ' I ❑ — c LIN.- © ST - —_— 1 12'.50 112' RO -- - X26 ------------------ - - - - -- P -- - - -��� �� HALO— - - -_: SIGNA URE &TIT z-- o ' - ' m - -- OMIT 2' -8• SECT - - CLG L WALL GYP OMIT 2•-8' SECT CLG L WALL GYP Q o ' u v Nk --.----------------------- BEDROOM kl N . -336.42. SO. FT. - 26.91 LIGHT' REO'D D a 13.46 VENT REO'D m 33.30 LIGHT PROW➢ `W J ^1 1830 VENT PROV'D .. I '1 RAILING OPEN TO ONSITE FIRST STORY By OTHERS ? ;;9 ° ?o wm •i az SX CLO n Q a ajyz Wmz ; - _ S ijy BEDROOM a3 w >« J <Kr N W m S z CONDUIT 195.20 SO. FT. 15.62 LIGHT REO'D - - --781--VENT REO'D- '1 EN FROM 2• VT 1st STORY LIGHT �' CO ;'•- �p' c KPH o� 18.30 ROV'D 18.30 VENT PROV'D now BALCONY iv w &zz . .�,05 ol �xI I I 16' -0' 14-3 112' 15- 11 .11-2' 'Q �z won: ..I 0 Q 24' -0' A p' A .. ._. . LImmo TO I 33' -5' 41' -10' FA a UILY PORTION �! JUL - 3 2001 NDTES I dr+ i CLG BEAv 7VERIIREDROOM �; T�] BE 2 -1 1/ ?•X18' ML 5 6. . ,1 / TNfP6A,rOf 848 T 2 CLu 3EAM E�V_F2iHALL TO 3- 2 -; 1/2•x19• ML 7' d ��P�,X PfRFfCT /ON 2nd STORY FLOOR PLAN 3 TLR GIRDER GNDFR BEDROOM :? TO 3E. 6 -1 1/2'x9 1/4' Mi- 8. [P A,fp _!! [-'� /� //+ 4 � ., 9 if o /vE , f/Y C.. e., scuc c..cx DIRE M ' DWP 1.1, 6 -25 9401 I: :f '1 it N ly T• 6 Y r