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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.15 -1 -15.1 BOX 34 rr �. ' 'ti ���h ,. PUTNAM COUNTY DEPARTMENT OF HEALTH _HI VIS I GN-_ Q FA14T ► RV_10ES, . CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR S MENT SYSTEM PCHD CONSTRUCTION PERMIT # ?V- S1 - 6 d Located at S / h'/ l L L - -"R c6 -r villag N'M n Owner /Applicant Name39 cRo-roJ ,09A Ro qo coR2A Tax Map 84 IS- Block 1 Lot /S . I Formerly Subdivisiop Name N EL.f ou 1 Ci' wi.r E,r r q ?-tom./• Subd. Lot # Mailing Address 91 MILL ST-REEE` - Pu 7- JAr -, VA L L" t Y. Zip 1QS? i Date Construction Permit Issued by PCHD 141 Separate Sewerage System built by I? cRo-ro.,J DAth AoAt> .T Address 0S's1AJ+xJ GA ni.y. /aSC-L Consisting of 12 G /O! (Gallon Septic Tank and So 4 L. F, P�'t2 ea R i4 TE o PVC `I I Pcr �1�1 Z"('/ Calm (!C L -'j 6,4JCtJ Other Requirements: Water Sunnly: Public Supply From Address . 4 P� i ��1►'�. R UCa.i u� or: Private Supply Drilled by 1?F XCM i � SotJ4- I /JC, . Address T�2r. J Lrl2y, N,4. /w;—of B eo�idn ; ntro been �o.rp:to ? _�oturg -9:! J G ��,�:R _Y Number of Bedrooms )=o v 11 Has garbage gn stalled? ' '1 N W yoR I certify that the system(s), as listed, serving the ove e s w n dte essentially as shown on the as- built plans (copies of which are attached), ' accor the C Co traction Permit and approved plans and the standards, rules and regal ons o . e P ' artm z ; f Health. Date: Z,b o / Certified by -1 P.E. x� n.h. 1/ ,,� `sic s p i n o 11 ✓� ` 11 ✓ E icense # 0,6 L Address �, f> Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatio modinatio e is necessary. By: Title: G Date: 6 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 ' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Welf�ocation-` .ar�•4coerr� ?s.ea.�.�sr.'ae: -: treel: Address: Lot #1 Mills .St., South Fork Subd. Town/Village: Putnam Valley c. Tax:`Grid:# 4 Mapg1t.19 Block I Lot(s)i!rJ_j Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 2- secondary Drilling Equipment Well Type X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby X Rotary Cable percussion X Compressed air percussion Other (specify) Screened Open end casing X Open hole in bedrock Other Casing Details Total length 62 ft. Length below grade 61 ft. Diameter 6 in. Weight per foot 19 lb/ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded X Threaded _ Other Seal: X Cement grout ` Bentonite Other Drive shoe: X Yes No _ Liner Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 540' Depth of completed well in feet 625'. Well Log If more detailed information descriptions or are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 40 Drillin in over urden cl ay and boulders 40 Hit rock at 40' 62_: - Driilan x-i --rock set -eas3.n ` ; routed ' 62 625 Dril i in rock iaranite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump. Type sub Capacity 5 gym Depth 560' Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 V lume 6 1. Date Well Completed 7/5/01 Putnam County Certification No. 002 Date of Report 7/26/01 Well Drill 1 NOTE: Exact location of well with (it sta gs to aTt pgro permanent IanamarKS to ne provt on a separate sneevpian. A / // Well Driller's Name P. F. Signature: Perry L. B� White copy: HD File; Y041 Address: 4 Pubwn Ave., Bream -ter;, NY I(FM Date: 7/26/01 copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 N� :N—QR* `RNAW+y AIBGR �TOR�'' ^O�° LABS 39 MILL PLAIN ROAD - DANBURY, CT 06811 CT Cert: PH -0404 Q _ N 203) 748 -7903 - PAX (203) 748 -0652 NY Cert: 11471 www.NORTHEAST LABORATORIES.COM CHEMISTRY: LABORATORY REPORT REPORT TO: <O.005 pg/L.as N•. .. P.F. BEAL & SONS DATE SAMPLE COLLECTED: 7/18/2001 4 PUTNAM AVENUE TIME COLLECTED: 2:30 P.M. BREWSTER, N.Y. 10569 COLLECTED BY: KEVIN B. • Iron DATE RECEIVED @ LAB: 7/18/2001 • Manganese TESTED BY: LAB #11471 LAB ID. # PFB -78 REPORT DATE: 7/23/2001 SAMPLE SITE: V.S. CONSTRUC TON CORP., LOT #1, SOUTH FORK SUBD., MILLS RD:, PUTNAM VALLEY, N.Y. SAMPLE POINT: HOSE BIB SOURCE: WELL TREATMENT: NONE MAXIMUM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (MCL) OR STANDARD BACTERIAL: • Total Coliform (Bacteria) 0 per 100 ml SM 9222B 0 per 100 ml PHYSICALS: • Color (Apparent) 0 - EPA_ 110.2 15 • Odor. ND - - 3 Units • pH 6.62 - EPA 150.1 No designated limits • Turbidity 0.10 NTUs EPA 180.1 5 NTUs CHEMISTRY: - ,:.._ ... _ ...• .,Nit_rk-Nikozen :- �.... <O.005 pg/L.as N•. .. • Alkalinity 6.0 mg/L • Hardness 20.0 mg/L • Iron <0.03 mg/L • Manganese <0.01 mg/L •. Sedium • Lead 1.7 mg/L <0.001 mg/L -ERA 354.1 .: - . . r : .:. L � `SM4SOOD �.- SM 2320B No defined limits EPA 130.2 No defined limits EPA 236.1 0.30 mg/L EPA 243.1 0.50 mg/L Combined limit for Iron plus Manganese = 0.50 mg/L EPA 273.1 20.0 m�; EPA 239.2 0.015 mg/L * ** ml= milliliter mg /L= milligrams per Liter ND =none detected MCL=Maximum Contaminant, Level TNTC =Too Numerous To Count * *Notification Level ** *Action Level COMMENTS: -All holding times (were) met. SAMPLE, AS TESTED ABOVE: MOTABLE or .00T POTABLE RESULTS BASED ON SAMPLES SUBMITTED: 7/18/2001 Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 x r , ]PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 37 RdAn cofZ1° Owner or Purchaser of Building Tax 'Niap Block Lot Building Constructed by Towne S' MILL S T-RiE 6-T-- �EC,Jos.r f C 1.�tiJ JTj� s.J hJeJQ- Location - Street Subdivision Name .S Iti1 CL� /- -/a/'ti (<- � �C. l � �J� ^i✓ Cdr , Building Type Subdivision Lot I represent that I am wholly and completely responsible for the 'location. workmanship, material, construction and drainage of the sewage treatment system serving the above- described property, and that is has been constructed as shown on the approved plan or approved amendment thereto. and in accordance with the standards. rules and regulations of the Putnam County Department of Health, and herebv guarantee to the owner. his successors, heirs or assigns, to oiace in good operating condition, any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any- repairs made by me to such system. except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the The undersigned further agrees to accept as conclusive the determi ation of t �e (v, is Health Director o the Putnam County Department of Health as to whether or of t ' fa' ure he system to op rate as aused by -the willful or negligent act of the occupan of t bu din 'zing the spte i /� �� n. I Day 2q Year 2 (Owner) - Signature ��6Td aor, f?aAe C..d Re- Corporation Name (if corporation) Address: 37 CRQT -vim Li'4/y j�dA%a State 6 .r ri,,-J 1 a G 4,K Zip J 0.06 -L Title: N 27 c.fZ n Tom taAN lZAiob Ce Corporation Name (if corporation) Address: 3' 7 cRq -O'J /Z10 State O.- CrIN9sW C N•'4 Zip !OS'� Form GS -97 '4 Public Health Director Associate Public Health Director . Director of Patient Services DEPARTMENT OF HEALTH I * Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 279 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 279-6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM 9TCR'5-r0Aj AqM Ro Iq 0 co 1Z e, OWI�ERS NAME: TAX MAP NUMBER: 545c-, SOrX L 0 T E941 ADDRESS: M I L L 4M2EET- TOWN: Pj Art% VALLEY AUTHORIZED TOWN OFFICIAL: (Signature) DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 T" address is assigned by an authorized town official. This form is to be submitted with the application- for a Certificate of Construction Compliance. = I LET912 W I n ENNL,°JlS CRONIN ENGINEERING P.E., P.C. July 26, 2001 The Lindy Budding; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914-736-3664 Fax 914-736-3693 Adam B. Stiebeling, Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road, Brewster, N.Y. 10509 RE: 37 CROTON DAM ROAD CORP. "NELSON / LEWIS ESTATES WEST SUBDIVISION" MILL STREET, LOT I P.C.D.H. PERMIT #PV-52-00 THESE ARE, TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMN ENT X PLEASE REPLY WE ARE SENDING YOU attached 4su ffwe3� wage 2.) Three certificate of the construction compliance. :3.) Three guaranties of SSTS 4.) Copy of survey showing foundation location 5.) E911 address verification form 6.) $200 certified check for application fee. Should you have any questions or require additional information regarding this matter, please contact me at the above phone number. Thank you for your time and assistance in this matte. Respectfully submitted, jen'n'eth M.1Vlurphy Project Designer LETTER OF TRANSMITTAL X-� CRONIN ENGINEERING P.E.9 P.C. Auoust2,2001 The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914-736-3664 Fax 914-736-3693 Adam Stieb6ling Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road, Brewster, NY 10509 RE: 37 Croton Dam Road Corp. Nelson I Lewis Estates West Subdivision Mill Street, Lot I P.C.D.H. Permit #PV-62-00 THESE ARE TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT PLEASE REPLY We are sending you water afidlytrit'f6f-16-t-17 Should you have any questions or require additional information regarding this matter, please contact myself or Ken Murphy at the above phone number. Thank you for your time and assistance in this matter. 0 k-1 U S3 f v .E I 0 J Respectfully submitted, Ronald Wegner Cronin Engineering, P.E., P.C. ..- x/02/2001, 10:30 9147363693 CRONIN ENGINEERING 1 PAGE 01 Fax Trans""'8sit0n Q R* En dgmrLML P.E.. PPc Suite 240, The LiWy Bulling 2 John Wals,h Boulevard PeeL*K NY 14566 Tel; (914) 736 -3664, Fax: (914) 736 -3693 ro: Adam Stiebe ft fax: (8 45) 278-7921 Putnam County Department of Health p1 : (845) 278 — 6130 � obi iw ■ r 6 i �.��i.i ir�a�r From Ron Weper Date: August 2, 2001 Re: 37 Croton Dom Road Corp. Nelson Lewis Estates West Subdivision Mal Street, Lot l P.C.D.N. permit #PV -52-00 Rt -hz� -£md u soPy_ cal' ems: r„eJ coMPWi Q r rt: a l.water. ve Contact me if I can be of any fiutiw as*tance. Sincerely, Ron Weger - - -- -• -1141 ,1n•04 Tgri:R45 - ?75 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 013/02/2001. 10:30 9147363693 08/01/2001 21:01 9147397156 o7;36 /01 TIT. Itc47 FAX CRONIN ENGINEERING 1 PAGE 02 PREMIER AYHL.ETIC CU PAGE 04 > =z,. okOFENVMON',�iF.NT.0 ALTHSERVICIES WELL COI1vI.ETION Mmol T weu Loc�on a Owner; street ;, of imuwilsege: Tax Grid ►r �'ltle *tt., fib Faric �amd. Ptzvnm ttniiW 12ap Black Lots) \abC Address: VS Co U&CUCUmn, 37 C rot= Dm Road, deauning. NY 10562 ae et1 Well! : I -p imary ado Residaeliai _,,,, Public Supply Air coad&W pump In-i tint] �t>ainess Farm TeWmoniwrin8 0&eKsparify) tednstziel Institutional gtaodby ralk ggv%maslt x !!Mry Cebla percussion X compmmed sir pereU*2 06W (59004) Well $cmaod Open end casing 7C Open hole in bedrock O*ar Cee W Aes& Stress DO%& Tow wo 62 ft, Length below gWt tit. D meter 6 in, Weight per foot 19 Ib /R. Diameter (in) MaarrW#; x steel Plastic 00m Joints: =-- Welded 7C 'I'�ra _aded — Othtr sue: x CgEm d t 8mtonia� btmr mafta Drive shoe. X. Yes No jUmter. Yec X No Slot Sit t Leno(ti) Depth to Sereen ($) LDvvelopWl Flnt Y�No m ovm ,,�,, second Wet Yield;4st Bailed X Pumper! X Comprosed Aix �� Hoar: 6 Yield 5 gpm Dttiytb ftm l (-1Pcoi , ) 30' n8 ride aep(, 590' or elmw=d well Ir. . 6251 Weft � If =we detailed infotntatioa de>; dixionsor s i ve "Alyses lerr9a ettacMi - _ _ nepth From Surface aee 'Water Rearing I Well momcurval irorntatio�a 10,0E i dom IL Ltma Swine 9`J_ Dri _a1w in mpeximan Clay 40 4t_rLock at 961 - 40 - 52 brill I II rQ� !!!I -gisim r 4- mut'a _� ' - - If yield was leaNd at di#%reat depols during drilling, list: pact allay s Fee Miultte Pump/Stersp Tank Informatiloa T }ve nab , C"Ay 5 qgn Depth 560' Modal x,^]0412 v.23-0� mkTypo Via, Vol am J6 gal. e p 7/',l' /01 aMat aunty uuAcat'gn , 002 o 7 /2S /pl rz- M1 I C. L'X= IOQdUM QI WOR 1xM 10 o p=onuu 1WXEMKkK* w w IMUT16 U vu o AMr- + am4 -YAL.. Well Nller's Name P. F. Address: 4 Signature: - Pam L. DW White Copy; k1l) File', Y Copy - Building Inspector; Piek copy - Owner; Or mge copy - Well driller Form WC47 n1 v- _0_0raa4 Tut I 1 m. a1 TPI : A4S- P7A -7gP1 NAME: PI ITNAM mi NJTY n;=PARTMFNT nP7 P P .08/02/2001, 10:30 9147363693 ; '3314 Ta 9 7 15 E 03/01/2001 , 1:61 07-128-e0l M 15:47 FAX CRONIN ENGINEERING I 'PAGE. 03 PREMU.-K XTHLETI" CL..; FADE 0.-,, NQKTHLUT LABORATORY olp D-axiturr so M& PLAN Itaw - paw*v, CT 0" 12 cvr cam. m.&o4 031 114&7903 • FM 128M MA"r—e I Am lok- rV WAM N—M fflmr L&MUTOMM Cow LA80H=XT &r&VAT pywv -&SONS DAM SAUPU ==TM V2001 4 PLY11ILLS1 AV&qUl& ZM. ccu"-ru` A C Wor (Apmmd) 105o.., coli2cim) 1•. umlw mcinm (p 7/14=1 ZWKIRT b&rx. dli %it A c C.),v V.8 WNSTRUCTON COO,. -'#I, SoVtu WRX 4-trBy),. V In HOSU my, M jS NJA cn�_IF 71 m*bdllJRw xqAPmWpmbzpaT,4w ND5wooift--traled ***AndCV3 JLWPI .,An badiag umn-J& As mag-kWa., MOTABLE DOT PMAKA MuLTs BASED ON $&mrLss ORWiniv. wisami L*Cmm LAMPATMY, 179 =, STVEET, OMER. CT 06037s. (860)M-5787 • FAX (bfg)9-105 I VLL FR M, W1 T MW CT: M- 226.0170{ UT i ME CM 80 113 1) allr--p-=ArAl TWII lrA- Pl TM !R4c-%-P7P-7qPl NAME: PI mi INTY nFPARTMENT OF P. 3 per I" ty!t Sr IMIP, 100 MA A C Wor (Apmmd) EPA, V 10 1 IS L-14 ISO I TuzbWky 0.16 ll"(•k MA 180.1 Mtrkc N&CIpm 9FA 9.54.-. 1.0 w.q/L -WId 4 =L- 5"V • 14th 2 'V' EPA 139,2 6cfined Bfrjw • Irtm 4.ol W/T- VA 2351 1130 MWI, a h1m eaese <0,01 rql. IMAM.) 17 VIA, EPA 2'13. l"d <oml uq!�. UA 239-� m*bdllJRw xqAPmWpmbzpaT,4w ND5wooift--traled ***AndCV3 JLWPI .,An badiag umn-J& As mag-kWa., MOTABLE DOT PMAKA MuLTs BASED ON $&mrLss ORWiniv. wisami L*Cmm LAMPATMY, 179 =, STVEET, OMER. CT 06037s. (860)M-5787 • FAX (bfg)9-105 I VLL FR M, W1 T MW CT: M- 226.0170{ UT i ME CM 80 113 1) allr--p-=ArAl TWII lrA- Pl TM !R4c-%-P7P-7qPl NAME: PI mi INTY nFPARTMENT OF P. 3 • ru i ivAA1 COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE I\i'SPECTION. _._ - - - - - -- -- - - - - - -- - - -- ate: .._... C\ Street Lom on �4 J-r- 84 1 S - t - SS- 1. Sewage Svsteth Area a. STS area located as per approved plans .......... :................ b. Fill section- date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped.... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. SeAge System a. Septic * tank size -1,000 ....... ,2- .....other ................ b. Septic tank installed level ................ ..................... ........... c. 10' minimum from foundation.. .......................... d. Distribution Box. - All louttlets at same elev 'on -water tested ................. 2. Protected below fro .................. ......... ....................... 3. Minimum 2 f1.0 ' final soil between box &trenches e. Junction Box - p perly set ........... ............................... 0�vner 3 7 r rr�ro.� • ,. ,-rye S2 Subdivision Lot # I Il- -S,101 COMMENTS f. re�nT� c— s I. Length req red ' > -VO Length installed 2. Distance watercourse easured Ft.. .. 3. Installe accor pl ....... ............................... 4. Slop tre accep ab 1/16 1/ 2" /foot ............. 5. 10 ft o property a 20 - f undations.......... 6. Dep o trench <30 ch s m ace ................ 7. Roo lowed for an ' ,100 ....................... 8. Siz f .3/ -1 V2" diameter clean ................... 9. De t f grav in trench 12" minimum ............. ... 10. Pi a en s apped.. P11 r' o*ed S to .� ..- ....�:.z� �: r o pump c er ............... s ...................... 2. 0 rflow tank ............. ....... ............................... 3. Al , visual / audio .. ...... .... ............ .:................... 4. P easily access' m ole to grade ............... 5. First ox baffled ............. ...........................:... .:... -- .. 6. Cycle 'tnessed by H.D.estimated flow /cyc e_ .... ..... . III. ouseBuildin - a. house located approved plans .................. b. Number of bedroo .. IV. Well a. Nell located as per approved plans..:----- .......... ✓ b. Distance from STS area measure ft ........... .000 c. Casing 18" above grade .................. ............................... r 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 ... ............................... c 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. .............. I Surface water protection adequate ... ............................... • i. Erosion control provided ................. ............................... 07/20/2001 10:40 9147363693 CRONIN ENGINEERING 1- PAGE 01 DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION ADAWI ® GENE REQUES ?FOR EW& IUSP=QN For: Fill All information must be My completed prior to any Trenches � inspections being made; PCHD Construction Permit # P V- 51-- d O Located. J& r LL - 9Tla -d6 T (97-- vs } (T) M QA 1 ILL-w Owner /Applicant Name: 37 CR4 ate+ Aqw 20 do c6xf TM 84, /SBlock _-L— Lot �S Formerly:_ Subdivision Name 'VELSaalf- coild'(- eygre./ rr Subdivision Lot � e Is system fill completed? � Date: Is system complete? YA S Date: Is system constructed as per plans? Y6-r Is well drilled? YIS Date: i 0 d Is well located as per plans? ME Are erosion control measures in place? I cerdy that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date :.. 54 _. d0, Zo ®.t . CertiSed by .. - Design Professioaial Address: PLPEK rKI LL , A- � YetL L® 47 CC I.ic. 06Z w la o Form M-99 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ... " ..:.: =iC`.'ONMiJCTION'P PERMIT # Located at G� Village _(TA)A rA VA4L&-1X Subdivision name A£csoN 11-cwi &rArhubd. Lot # / Tax Map ft I Block / Lot 15.1 W11 r Date Subdivision Approved 08 05 % 91 Renewal Revision Owner /Applicant Name 31 CeZ-TW DIEM �fl . C-pVt . Date of Previous Approval )VIA . Mailing Address 31 e?-csmnl J>AM yss- , -) n,15 r , A) - y. f D 56 Z- Zip 1056Z Amount of Fee Enclosed 30Z) Building Type l s: D6A)T►A t.._ Lot Area 2,1-9 Z No. of Bedrooms Design Flow GPD 80� AC. Fill Section Only Depth Volume PCHD NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 12 5C7. gallon septic tank and Jy9/) 4. F. Other Requirements: To be constructed by m .Address <` C ?�l 4,m � Orb %�wi� .��� Water Supply: Public Supply From Address �- " `Priyate_,StjF'P .>d "lgd�l -b -y-R-F �B #1::�'!`:.SO�JS vc ;r Address,' I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system'described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Constryp"tiet *6 orp �liance" satisfactory to the Public Health Director will be submitted to the of, N4 E Department, and a written g Cl it fished the owner, his successors, heirs or assigns by the builder, that said builder will place in good . �� 3 g ho&diti-9.n a-n part of said sewage treatment system during the period of two (2) years immediately following th ,' da �a the js4ppce- gf,ffie.pproval of the Certificate of Construction Compliance of the original an or system qs-th ret y y r Signed: ` P.E. 1" R.A. Date 1/17,W Address ZJvk ox AW x) �y� -96 License # 6161 ZC 0 APPROVED FOR CONSTRUCTiOI°This approval expires two years from the date issued unless construction of the sewage treatment system has been coMpleted and inspected by the PCHD and is revocable for cause or may be amended or modified en considered eces y e Public Health Director. Any revision or alteration of the approved pl requires a new p A ove r is e o domestic sanitary se age only. By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink c y - Owner; Orange copy - Design Pro essio al Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A .WA7['ER WELL .. >. pl ..ease . . prin1J t or ty �'! pe .:.'r _.. < � , m.T- ....... - .ryy�- •y..;.r..: y..M -.� - - .�: � ~! _ .. CH17 �ermlt # V �: J Well Location: Street Address: TownNillage Tax Grid # /V141- Ste. ( )f /UAL -1 I1ALLB 1VIap /f-Block / Lot(s) 15.1 Well Owner: Name: Address: / 31aMWOPAIJ R0, C�Rt� -- PMMO A P A). f O Use of Well: V Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought 5 gpm # People Served Est. of Daily Usage �DW gal. Reason for., Replace Existing Supply Test/Observation . Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason Q 5 L- 1)f1W J?C_51_QCA1CC_ for Drilling Well 'Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes V No Name of subdivision We4SW ILLe fit/ /S 1N t�-j T Lot No. . Water Well Contractor: _ ? F. BEAL S �=nS e Address: �/- i�" IEA)A;u Ave. /0 Is Public Water Supply available to site? .................................. ............................... Yes No V/ Name of Public Water Supply: N Town/Village N� Distance to property from nearest water main: A/ Proposed well location & sources of contamination t e ovided on separate sheet/plan. Tate: / .z COQ-, - Applicant- &gnature 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 '11 =ifib tnam County. Date of Issue ?i I O -D Permit Issuii g Official: ilf— L Date of Expiration I JZJi3Jp0 Title: Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 10509 � s t PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES i;. ° :-; ...; ::. .- . c'I'IJICA'I`ION E I PR L� : _' _.:, s _._. . ..., ;ry .. . .: AD'TLAW FDR, - A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: -31 COMDR T).AM �AD /14 2. Name of project: 53-ce37 Z' yy i z iLIPPL 3. Location T�/ 1: -s-ad,4,-m_ y4z_L&v 4. Design Professional: T%mo-rf+�,j it 5. Address: vVda Ct (3tvd_ 6. Drainage Basin: R e A S ✓, i L HoLe _o yy 13 o ✓, 63 @ X-C A ► L__,, O.Y. M5 9G 7. Type of Project: ✓ Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to :State Environmental Quality Review (SEQR)? Type Status (check one) ....................... .I.............................. Type I Exempt Type II Unlisted ✓ 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... Alo . 10. Has DEIS been completed and found acceptable by Lead Agency? ............... AA .11. Name of Lead Agency _ 1: Is; this project tn;an area under the control of local .planning .anin. fir. other _:,:. - - Is'- ........ ............................... �s 13. If so, have plans been submitted to such authorities? ........ ........................:...... ry 14. Has preliminary approval been granted by such authorities? Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water groundwater 16. If surface water discharge, what is the stream class designation? ..................:. X�A - 17. Waters index number (surface) ........................................... ............................... N% 18. Is project located near a public water supply system? ....... ............................... AID 19. If yes, name of water supply 1V1,4 Distance to water supply u�/+ 20. Is project site near a public sewage collection or treatment system? ..........:..... a10 . 21. Name of sewage system A11A Distance to sewage system /yI,4 22. Date test holes observed 23. Name of Health Inspector ,¢p�q;g 24. Project design flow (gallons per day) .........:....................... ........................:...... 8c0 GA C . /DA y 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... /vy . 26. Has SPDES Application been submitted to local DEC office? ......................... Ado . Form PC -97 0 /AA �s 2 27. Is any portion of this project located within a designated Town or State wetland? itJo , 28 - :�]Uetl_ands.II1 Number. - ;•1+T-S:: "n .,. .. nd I .._ber ..r ... �:�;...^.::e':,.•�+bl ...�..�a� '- r..``w 29. Is Wetlands Permit required? .......................... ................ ............................... N0 Has application been made to Town or Local DEC office? ............................... A/4 . 30. Does project require a DEC Stream Disturbance Permit? .. ..............................: Afo 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No N D . 32. Is project located within 1;000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No AID . DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... A10 35. Are any sewage treatment areas in excess of 15% slope? . ............................... A/D _ Map Map 81/ /rBlock / Lot /5. 36. � Tax Ma ID Number ............:............. ............................... 37. Approved plans are to be returned to ..... Applicant V" Design Professional NOT 'E -Wp#1i ns= �r4ei6&=a approval 6fanCv`S�T� �r a ocat��€ -�-�� YO"%� dial be.sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approyal_of the. S -STS prior to final approval by the Department: Projects within the watershed may also require DEP• review.and,approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces And the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. , 'r If the application is signed by a person other than the applicant shown in Item ,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure l .ailure to comply with this provision may be grounds for the rejection of any submission.; � Y.0 I hereby affirm, under penalty of perjury, that to the best of my knowledge and belief. false, a Class A misdemeanor pursuant to Secton SIGNATURES & OFFICIAL TITLES. _ Omen! ' mad lter n afl-e.\ u � Tg' 4$ of he is true able as Mailing Address: ....................... .. CV-0,0 I") s C4A) VIA LF ii 5-Lo PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH S_ ERVICES • ... a -�. .. .F.�iw� ai o•'. , :�ry ... �-..e . cr .. .�`. ^. ey..1 :� u ,..i•:-,' �. ..eb :'cd =. -.; 9'.`a s+ +`2i •' . n- . µGo e',. ..'+ -. .. rn er __•il p.,; i. c . LETTER OF AUTHORIZATION RE: Property of 31 e(?_uoA,) yAm i?oA o Co e_- P,. Located at %+' /i`LL. 0otAa y PoAy> z.3. 1 Zffi, A;t VALLE y Tax Map # Block / Lot 15. / Subdivision of "�/E c so,�/ Z L FWV 5 E9TA7-,5S WE-5-Fl" Subdivision Lot # 2 Gentlemen: Filed Map #5// Date Filed 0 8 —0s —5 / This letter is to authorize &�n7Ny 4. a duly licensed Professional Engineer or 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 m be alf in connection with this matter and to supervisex tion of said wastewater tr, at nt d/or water supply systems _ pin- conf�r�ni Yr' h tkaY y °c1e.145,andlor 14 a _e uc 17f o,% ^�MjLav�, the Puhlic: Healtt'�- Law, arrd'the :P,utn, m Minty Sank, Clyde. n 'Y/ / Very t Co tersigned: �' - Tso Signejwner e �7 o P. E., , # 2 r perry) Mailing Address 2 Qo +w • VII A L-.3 t4 YB vp. Mailing Address: -3'1 e�0&3 PAM `Pt'A r-). 5c, irF .2aD , e &' /,s r� r L L State N - \/, Zip )0.5G6 State AI. Y. Zip 10.562 Telephone: Cc (q) i36 3661 Telephone: (- / '139 - -136L Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH J SJ(�rI:B()F � . V RC► E AL.. EALTH-.SE�RVICES;._ -. a AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBNIITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: C o A)_-;, t P_-u c-r toA3 OF 55TS kioj> �V�-re'r_ su r>p 1--y I, \SAL 5AN-ru Ccl represent that I am an officer or employee of the. corporation and am authorized to act for: Name of Corporation: _:3`f e�__O_-oN )'�-)A,4 !OA D Corte? . Having offices at: 31 ' eez -fooQ JDA; � .. C�s�p�..vG . A). y /0562 Whose Officers Are: President - Name: VA � 5AN - r-ucci . Address: AS A30 <« ) Vice President -Name: 5A A6 A 5 ��� s ;� �.J7 Address: (.5AM.9 -Ai A136 it ,C) Secretary -Name: 5A (O-rL+ cc i Address: 4,s , -As o U F) Treasurer - Name: '�:)A yur< AAA Address: and that I am and will be individually responsible for any ale �l t o th jorporation with respect to the approval requested and all subsequent acts relating t et . � \ Sworn t before me this Z© day of v (year) AU ate of New York Not fry Plabligied 6n Westchester County Cot- nasission Expires March 94, 2vuL Corporate Seal Form CA -97 I RNA njM. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner _3i C 1✓o'ros'd 1)Am RbA 1� doe i� _ Address 23 Y _DAM ?-. 0ej �� Gass �•�i�rJC, -A, r Located at (Street) Tax Map8 g- Block _� Lot 15. / (indicate nearest cross street) _ Municipality -F) I�� T N A r k i1;4 L C Y Drainage Basin _ I� ,J A i � L- �Z Lo W SOIL PERCOLATION TEST DATA Date of Pre - soaking - --• Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Time �i Iin.) De th to Water Vrom Ground Surface (Inches) Start Stop Water Level Drop In Indies Percolation Rate Min/Inch l A P1'1' --VAC 2 3 4 5 2 3 4 5 1 2 3 4 5 MUTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i:e. s 1 min for 1 -30 min/inch, s 2 min for 31- 60.min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA 2 DESCRIPTION OF SOILS, ENCQUNTERED_.W_,TEST,_ DEPTH HOLE NO. )A .11 0-8 Q -T. 0.5' 1.0' I A) 50-tJ D 1.51 W L 2.0' AND Qof�5RL6JN 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.01 75 8.0' 8.5 9.*01 95 M11111 HOLE NO. 13 CtAY 'S4 HOLE NO. fAme AS 1A. . K to VqA-r fk A-/Q AA4ml,&,rf — A10 PVA-rg-e /V0 Ae r 7�=Ilyr, . AID - A10 M 0-rT L 1106 Indicate level at -which groundwater is encountered xf. 1,4 Indicate level at which mottling is observed N14 Indicate level to -which water level rises after being encountered Y� Deep hole observations made by: ((ro A) 1A) jQV6_. Date Design Professional Name: Address: Signature I Design Professional's Seal 1 11 /r A 44� LLI QI* 0-80 'YOFESS\') 14-16 =?) —Taal 1= 61T.Z1 PROJECT I.D. NUMBER SEAR : -- ' State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNUSTED ACTIONS Only i PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsoo 1. APPLICANT /SPONSOR 2. PROJECT NAME 01 w ZoA .su 1Z T. S: PROJECT LOCATION: LO eQt2�, Mun Coq un tegaaly T ti .4. PRECISE LOCATION (Strig addnaa and road Intarnetions. p =W4nt IwWmarka, eta. or provide mao) V�1 ST Sv L7 ca >\4 1 L L 5-r. C��I�T y TD . Z3) — A ppz�_.o x. i 6Do Sc "xv4 SST ouvl A>AMS CO%->M6zs . 11.111 K* AcnoN: l : ❑ Eapanelon ❑ ModlficatlorValtaratlon a. DESCRIBE PROJECT BRIEFLY: C-TIa10 01� SSL4GSl!2-r_AiCE. 56JAIAC€ Ttr, TM9/.JT" YX72ee0 A'�Z� A/ATE7>_ LL& C> W61z_L) 7. AMOUNT OF LAND AFFECTED: Inlllally Z uta Ultimately am— Demo a. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LANO USE RESTRICTIONS? LMYa ❑ No If No, daefl0e W%fty e. M,KATA PRES04T LAND USE IN VICiNrTY OF PROJECT? W Residential Q Indu&UW ❑ CommereW ❑ Agriculture C) PvWFamVOW spas ❑ OUW -u 4�V1 S �AlaF_ -BONE .SD/uGLe, F,1 M.L.y 9 v2�,e'N7,,9L C a 5-r 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE LOCAQ? [9 'Yes ❑ No If yft list aqw yls) and pwm!Vapprorals -� CWJV 6� ��70 A, M VA y 11. ANY ASPECT OF THE ACTIC.J HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? appOEES L�J YM ❑ No M yW Wt Sg&=Y name and OWIT10111aPOWv �L1.�3�tUl5tpN �A�?1V���-- 1I ��LS4� /LEyV�S � -�4T�S I�IIF.._CT �r .S�1L3Y�91/o5rb�% 12. AS A RESULT OF ACTION WILL EXISTING PERMR)APPROVAL REWME MOWICATIW ❑ Yea [ Ns- I CERTIFY TMAT THE INFORMATION PROVIDED ABOVE 4 TRUE TO THE BEST OF MY KNOWLEDGE '1 Aoak.naaooR.or n.fnaG `� RA) (:5)6. l . v! il%U 2 Onto: It 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 PART It— ENVIiRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART $11.127 II yes, coordinate the review prooeae and use the FULL EAF. t J Yes ❑ No I S. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN a NYCAR, PART 617.{? If No, a negatlra dxlaratlon, may be superseded by another involved agency.- -.. = .'❑Lyre � No- � , .. r . -• �: - r, ; _ - - - �- - �- - :. , C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwrtiten, If Wbial C1. Existing air quality, surfwA at grour4watw quality or quantity, noise levels, existing traffic patterns, solid waste production or dloposal, Potential for erosion, drainage or flooding problenla? Explain briefly; C2. Aselhetic, agricultural, archaeological, historic, or other natural of cultural resources; Of Community or nolghborhood character? Explain briefly: Cf. Vegelatlon or fauna, flab, sheilllah or wildlife speclsC significant habitats, or threatened Of endangered species? Explain brefly: Ci. A cornawnity's existing plans at goats as officially adopted. w o change In use w Intensity of use of land or other natural resources? Explain brlafly CS. Growth, subsequent development. or related activities likely to bo Induced by the proposed action? Explain briefly. Ca Long term, short term. cumulative, or other effects not identified In C1431 Explain briefly. C7. Other impacts [Including changes In use of either quantity at typo of energy)? Explain briefly. 0. IS THeft OR Is THERE LIKELY TO a& CONTROVERAY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? • ®No -. !! Yea,•.eeplcM §rislfti- ''- • ,...... =.,.. PART 11111— DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRtlC77t & For each adverse effect Identified above, determine whether It is substantial, lanes, Important or otherwise, ilgnlf(i t. Each affect should be assessed In connection with Its (a) "Olne p.e. urban or rural; (b) Probability of occurring (c) duration; (d) Ir»ve7slbilttr. (s) geographic scope; and (f) magnitude. If nacese", add attachments or reft to ce supporting material. Ensure that explanations contain suff font detail to show that all relevant Adverse Impacts have base Identified and adequat" 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 andior prepare a positive declaration. ❑ Chack this box If you have - determined, batted on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental Impacts AND provide on attachments ore necessary, the risawns supporting this determiniatkr- Mat Or Type P44nw at Responss6k Officer in Lead A#wKV Svgnatum od 11*10onable Officer in Lead Agency Name or Load AVOCV DtQ a Tide W Respoos4le i3ifica (11 diffemu trorn raNmusW officari Hole Depth to water Depth to water Depth towater Depth to mottling Depth to m.ottling.- 1 Depth to mottling D e th - Ao 7 �Nptetb -roc IbiffiP7 Depth to ro k k/imP . G.L. 0.5 1.0 2.0 0 L3 .).0 4.0 5.0 6.0 ..7.0 8.0 9.0 10.0 Lot # Hole A G.L. 0.5 0 1.0 2.0 3.0 Me, 5.0 6.0 7.0 8.0 9.0 R X11, Hole # -4 Lot 9 7--- G.L. I 11M 1.0 2.0 3.0 4.0 5.0 6.0- 7.0 8.0 9.0 10.0 Hole 4 2 L Lot # 71- 13 0.5 T5 0.5 1.0 2. 0 3.0 4.0 5.0 A ,Ile G-65 ce 5 M. 7.0 8.0 10.0 1.0 Depth to water Depth to water Depth to water Depth to mottling r2 Depth to mottling t4 Depth to mottlinc, Dwh.-o rock/ i mp Dept to rocku-rnp- c MP. G.L. G.L. G.L. 71- 13 0.5 T5 0.5 1.0 2. 0 3.0 4.0 5.0 A ,Ile G-65 ce 5 M. 7.0 8.0 10.0 1.0 2.0 3.0 4.0 5.0 M 7.0 ------ 8.0 9.0 10.0 0.5- 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0- 9.0 10.0 1 f r Q 7 7r•• ..__ � 0 ]r'•�LI.MiwRiv: Itr ...f ® 9 'a. _.. •, O p• ---• -- L 1e f»- IB'i UI r r, -Vi•r 9'-0' laK � � I -v-r- I 7• • Q -3 311• . 1 split as 1'at "mma��pR bi f ! yafYi iµAaKi. awa \f Sit 1-9 lire t crap• pCf\ r Ifl \C,Ea +• pC.0 r �' .satin 4n I Y -N ? -p• ••f Kr tips S fKL y ! 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JO PSr WV LOAF s J. . �• GR, V F r 'fu i7'5& JErFERSEN Il' 1 I.r AA�7 sox sdJ .,2422 GARAGE SRO^ !ST SJURY pnJ at Jl19 WNM I 1w ^ IpX pfq a• -rtn f:F ___. -._ IOaabT.'A a1'•Y-SJ R a MI j f1 am r91.[7CAMOxCYtf1V Il)0.7 '} �/•1— 2 ' 7 r� Z. � 1 s J. . �• GR, V F r 'fu i7'5& JErFERSEN Il' 1 I.r AA�7 sox sdJ .,2422 GARAGE SRO^ !ST SJURY pnJ at Jl19 WNM I 1w ^ IpX pfq a• -rtn f:F ___. -._ IOaabT.'A a1'•Y-SJ R a MI j f1 am r91.[7CAMOxCYtf1V Il)0.7 '} �/•1— 2 ' 7 r� Z. � 1 ob Ill .31 ob Ill Lam-: a i. Oft G G (A G -n X m x C) rn r T- o A tr) ,3 -,3 (A 0 W (A 0) UK, (S) (S) a) "UPO"JUJ'AgA UVL-00. (LOA) jmd tlw gitc-pol (Ads) fVdf# VJ ')#*,N31)7 r" x" a# my i. Oft G G (A G -n X m x C) rn r T- o A tr) ,3 -,3 (A 0 W (A 0) UK, (S) (S) a) - -- - — -P� ---- � �-- _ N2'Ll L4 &ATION. , x one rANX_ �'t5 185 JffiVClJ(W BOX f2 65 ,75._5 �1.arctrOti sox,/.? TO •BO .�xvcnav sox �i °ts ,as ��vCnov aQXi5 � s% e0 +JE R g.TPRE4�ARED - FElf1 =,11!E SON i LEti+l, ESTATES WEST Fzlb?AREp B,r 6AtlEY 41W A 151 W,41RWWIVG ANL1 ENyYNE tlNG'P,C, 'FILED 1N THE PUTNAM s tyfl GL RK S OF77CA+ �A$ MAP Nb 2511 ON AUG 5, Y991 {( 5 ifGZUSr-40CA71ON IN RESPECT lvi ROPER. R7Y 4. Adw AND'P!?EPARED 57�DONALD .� DQNNfLY 1 A „ L -.,r• g t 4 N ST -AD pF �*D, 717EN2k u€ir. oa' 3RD, T>t : : 36' i�fsT }ttP- CF, 4TH, 7RENLYI' 42' _. air =,oT �rF 7REI 74797: . „r f V f c i A 4r Z" k Y 5 4 =. Y' s `A E.4_f7'E'PV�i QF tSl' 1NENCt1 _. 104 ` 1r� .: EAST OX OF 2ND TREistCN 10$ 119 5''" EAST -MR OF.,M:'TRWON tt; EAST END_fJF 47N .TR�iVGEF its 127 . EASj':E'ND O1•'- `5TH'' JRENCt.3, ib. 1:71' ; 13� 5..- -- Z' iL F� t ." D one rANX_ �'t5 185 JffiVClJ(W BOX f2 65 ,75._5 �1.arctrOti sox,/.? TO •BO .�xvcnav sox �i °ts ,as ��vCnov aQXi5 � s% e0 +JE R g.TPRE4�ARED - FElf1 =,11!E SON i LEti+l, ESTATES WEST Fzlb?AREp B,r 6AtlEY 41W A 151 W,41RWWIVG ANL1 ENyYNE tlNG'P,C, 'FILED 1N THE PUTNAM s tyfl GL RK S OF77CA+ �A$ MAP Nb 2511 ON AUG 5, Y991 {( 5 ifGZUSr-40CA71ON IN RESPECT lvi ROPER. R7Y 4. Adw AND'P!?EPARED 57�DONALD .� DQNNfLY 1 A „ L -.,r• g t 4 N ST -AD pF �*D, 717EN2k u€ir. oa' 3RD, T>t : : 36' i�fsT }ttP- CF, 4TH, 7RENLYI' 42' _. air =,oT �rF 7REI 74797: . „r f V f c i A 4r Z" k Y 5 4 =. Y' s `A E.4_f7'E'PV�i QF tSl' 1NENCt1 _. 104 ` 1r� .: EAST OX OF 2ND TREistCN 10$ 119 5''" EAST -MR OF.,M:'TRWON tt; EAST END_fJF 47N .TR�iVGEF its 127 . EASj':E'ND O1•'- `5TH'' JRENCt.3, ib. 1:71' ; 13� 5..- -- Z' iL F� t ." D +JE R g.TPRE4�ARED - FElf1 =,11!E SON i LEti+l, ESTATES WEST Fzlb?AREp B,r 6AtlEY 41W A 151 W,41RWWIVG ANL1 ENyYNE tlNG'P,C, 'FILED 1N THE PUTNAM s tyfl GL RK S OF77CA+ �A$ MAP Nb 2511 ON AUG 5, Y991 {( 5 ifGZUSr-40CA71ON IN RESPECT lvi ROPER. R7Y 4. 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