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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.07 -2 -1 BOX 35 ' rir r- 04591 I :; I / / Y$ PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services. Carmel; N.Y. 10512 Engineer: to Provide Peimlt IY B 3� on CERTIFICATE OF COMPLIANCEJCj�___ Permit N�- "' CONSTRIICPION PERMPY'FOR'SEWAGE DISPOSAL SYSTIEbI g4V 11 Located at '.,yam � To wn or Village 1 Subdivision Name I �-1 abd. Lot N Ta: _Map Block Lot Renewal' ❑ Rovlsion ❑ , Owner /Applicant Name /ri 4✓ i !' r^ Date of Previous A p val Mailing Address / / 3e, Townes �/M /' 67 C- Building Typernf��4G! C✓`' Lot Area Number of Bedrooms 3 Design Flow G/P /D Separate Sewerage System to consist of ` ©p U Gallon Septic Tank To be constructed by t'P U = Fill Section Only " Depth ' Volume _ PCHD Notification Is Requited en F11119 completed Address Water Supply: Pdbllc Supply From' • Address or:-Private. Supply Drilled by , A5 --- Address Other Requirements = 6' `y' represent that I am wholly and completely responsible for the design and location cf he above described will be constructed as shown on the approved amendment there to and in a County - department of Health, and that on completion thereof a "Certificate of Constri be submitted to the Department, and .a written guarantee will be furnished the owner, Place in good operating' condition any part of said sewage .disposal system during th once of the approval of the Certificate of Construction Compliance of the original s will be located as shown on the approved plan and'that said well will be Install1g_14,accorf County Department of Health. Data �i / %' /`lA % Signed APPROVED FOR ONSTRUCTION:�is approval expires one year revocable for cau or may ndetl or modified when consideretl n requires a now it for disposal of domestic sanitary Date /V/ By e ,issued iKtPilo�yfi uilding has been undertaken and is n that the separate sewage disposal system ;die wuu t n s, rules an regu a Pons o e u dam B•ngp I ! ►/it ry to the Commissioner of Health will �s by the builder, that said builder will two (2) y.l§Pme tely following the date of the issu- iny r s the Cs!r+ e2 It t the drilled well described above d regu aT o -nof the Putnam s %I r. e P.E. _ R.A. .• - - - L Lf S59s e ,issued iKtPilo�yfi uilding has been undertaken and is Sy the C change or alteration of c0 ttrUCtion antl /or pr t ' _. Title PUTNAM COUNTY DEPARTMENT OF HEAL DIVISION OF ENVIRONMENTAL HEALTH SEE ...'�.- �.- .. -..T: ..y ^<... .Z, ",+s ::*.v.�o%Jn. : .- x.. -. _ .. .. •r� _.. ..,,.,... •�� ^..; �ii.�l _. �..a .. �r ��:..:�req�: pin CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # a — / Z O -- 04- Located at W O O lD Town or Village } u'ri,1.4 yn VA LLE y Owner /Applicant Name &3 ZOL06 F_ CTaxMap65--J Block Z Lot _ Formerly Mailing Address --/0 9" / / Date Construction Permit Issued by PCHD Separate Sewerage System built by Subdivision Name Subd. Lot # Address Zip / Consisting of 1:5� O O Gallon Septic Tank and S Z '�_ o1 2. �"� �� o 1 fzr t4 =S Other Requirements: I6 00 GOL Po m p T"jq w< Water Suonly: Public Supply From Address or: ✓ Private Supply Drilled by �X/Zm 4 0 15-L`— Address Building Type:_ 12 r . Has erosion control been completed? Number of Bedrooms 074 Has garbage grinder been installed? Mo 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 plans and the standards, rules and regulationsef the Date: Certified by Address &Y- gsO . iv, County Department of Health. P.E. L/' R.A. License # 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 revocati n, modificatio or change is necessary. By: G Title: Date: White copy - HD Fi ; Ye o copy - Building Inspector; Pink copy - ;Orange copy - Design Professional Form CC -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health �LORETTA MOLINARI, RN,AMSN Associate Commissioner of Health ROBERT J. E®NDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 E911 ADDRESS VERI[F'1CATION FORM TAX MAP N UIMER: 85.7-2-1 E911 ADDRESS: . 89 WOOD STREET TOWN: Putnam Valley JP J AUTHORIZED TOWN OF'�'1O1(L: � �( '{ . 'c' � t'�t. �� �':7�' fQ���, (Signature) r The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above forma is completed, i.e., a legal E911' address is assigned by an authorized) town official. This form is. to be submitted with the application for a Certificate of Construction Compliance. E911 addressverification Envirommental Health (845) 278 -6130 Fax (845) 27$ -7921 Nursing Services (845) 278 -6558 WIC (845) 278-6678 Fax (845) 278 -6085 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Town/Village Location - Street Subdivision Name Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. �--� Dated: Month Day a 3 Year 019 Signature: ) - Signature corporation) —1 Address: 100 `�c.1�C State 1 4' 2 .�' %� Zip ,,,0- C,-- Title: Ce V Corporation Name (if corporation) Address: State Zip Form GS -97 P -. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 LAB #: 1.805682 CLIENT #: 61152 STAT PROC PAGE: 1 of 2 BARTOLOMEO, FRANK DATE /TIME TAKEN: 11/19/08 12:30 DATE /TIME RECD: 11/19/08 03:15 REPORT DATE: 11/22/08 PHONE: (845)- 519 -6124 SAMPLING SITE: 89 WOOD STREET, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : HOSE PRESERVATIVES: NONE COLD BY: FRANK BARTOLOMEO - TEMPERATURE::t <`4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE_ 11/20/08 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222E 11/21/08 LEAD (IMS) <1 ppb 0 -15 ppb SM 18 -19 3113B 11/21/08 NITRATE NITROG <0.2 MG /L 0 - 10 SM18- 20450ONO3 11/21/08 NITRITE NITROG _ <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 11/21/08 IRON (Fe) <0.06 MG /L 0 -0.3 mg /1 SM 18 -20 3111B 11/21/08 MANGANESE (Mn) <0.01 MG /L 0 -0.3 mg /l SM 18 -20 3111B 11/21/08 SODIUM (Na) 4.83 MG /L N/A SM 18 -20 3111B 11/21/08 pH 6.2 UNITS 6.5 -8.5 SM18 -20 4500HB 11/21/08 HARDNESS,TOTAL 34.0 MG /L N/A SM 18 -20 2340C 11/21/08 ALKALINITY (AS 22.0 MG /L N/A SM 18 -20 2320B 11/21/08 TURBIDITY (TUR <1 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: MFTC THESE RESULTS INDICATE THAT THE _- WATE (WAS) AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI'IO'` "`THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD limits for p, EPA Lead & Copper than log of their than 15 ppb and a treatment must be potential. ablic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg /L, else water undertaken to reduce the waters corrosive Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. 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 a YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 �...; , = -..� Albert H. Padovani- ' D re i�bY LAB #: 1.805682 CLIENT #: 61152 BARTOLOMEO, FRANK 0 STAT PROC PAGE: 2 of 2 DATE /TIME TAKEN: 11/19/08 12:30 DATE /TIME REC'D: 11/19/08 03:15 REPORT DATE: 11/22/08 PHONE: (845) -519 -6124 SAMPLING SITE: 89 WOOD STREET, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE HOSE _ PRESERVATIVES: NONE COLD BY: FRANK BARTOLOMEO _ TEMPERAT E..: < NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD is suggested. 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. Hd TOTAL HARDNESS IS DEFINED 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 /gall'ori' = 17;2 _MG. /L) THE ABOVE TES'PR CEDURES MEET ALL REQUIREMENTS OF NELAC, AND RELATE LY TO THESE SAMPLES RECEIVED BY THE LAB r�yY, SUBMITTED BY: ` J Albert•_,!H . dovani , M. T. (ASCP ) Director ELAP# 10323 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD-OF.RRE UNDERWRMERS BUREAU _ ®F ELECTRICITY RICITY�. 40 FULTON STREET — NEW YORK, NY 10038. r, CERTIFIES THAT Upon the application of . ALL STATE ELEC. /BARTOLOMEO P.O. BOX 11 MAHOPAC, NY 10541, Located at 89 WOOD ST MAHOPAC.. NY 10541 upon premises owned by FRANK BARTOLOMEO 89 WOOD ST MAHOPAC, NY 10541 Application Number: 3027719 Certificate Number: 3027719 Section: Block: Lot: Building Permit: 368 -07 BDC: W106 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in /on the premises at: Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and /or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 11th Day of April, 2007. Name. OTY Rate Racine Circuit Type App!innc:.s- 9..nd:..A.ccessories Pump Motor 1 0 20A F.H.P. Wiring and (Devices Disconnect 1 0 60A General Purpose seal 1 of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETII A MOLtNA'IU) R1V;`MSPQ_._..... *%.* Associate Commissioner of Health June 13, 2007 Mr. Frank Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT X BONDI County &ecutive ROBERT MORRIS, PE Director of Environmental Health Re: Permit R- 120 -04 89 Wood Street (T) Putnam Valley, TM # 85.7 -2 -1 This Department is in receipt of your letter dated June 7, 2007 relative to the status of the above. referenced project. A construction inspection was conducted by this Department on the portions of the sewage system installed to date. It appears the only items remaining for inspection by this Department is a bedroom count of the house, which could not be performed since the house has not yet been constructed, and verification of the pump chamber dosing and alarms. Upon satisfactory completion of the.above,:your design professional:may, submit .a gopst>Wcti Ai -compliarice-applicatiiu"ht peritiit 16 —this Department for approval. Should you have any questions concerning this matter, please feel free to contact this office. Respectfully, Michael J. Director of MJB:kly cc: R. Fredriksen Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278-6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 ._ ..._ _. __._EarJ - btecvention/P_reschool (845) 2.78_601.4_.- FaxISA5.) 278 -6648 _ „ SH ERLDTA A13 LER, ND, NS, U'filA Commissioner of Health (LORE II ll A MO L INARI, Ifs, MSN Associate Commissioner of Health Mr. Frank ]Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. ]Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBlERT.D. BONDI County Executive _ ROBERT MORRIS, PE Director of Environmental Health June 27, 2007 Re: Permit R- 120 -04 89 Wood Street M ]Putnam Valley, T.M. 85.7 -2 -1 This Department is in receipt of your letter dated June 20, 2007 regarding the above referenced project. A, new permit was issued by this Department on January 17, 2007 which also acknowledged the change of professional engineer for this project. Therefore, the current permit is valid for two (2) years and expires on January 17, 2009. If the construction compliance is not issued prior to the January 17, 2009 date then the permit must be renewed by your design professional. -Should you have an uestions concerning tliis matter, please feel free to contact this office. MJB /ens Respectfully, AaA Michael J. Director or Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 wIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA ANILER, MD, NIS, FAAP Commissioner of Health Associate Commissioner of Health 0 Roy Fredriksen, P.E. P.O. Box 950 Mahopac, NY 10541 Dear Mr. Fredriksen: ROBERT J. BONDI County Executive Rte.,•- ::�.....:,UBRT Nf :i. ORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 November 18, 2008 Re: Construction Compliance for Bartolomeo at 89 Wood Street (T) Putnam Valley, TM # 85.7 -2 -1 This Department has completed the inspections of the septic system and house for the above referenced project and the following comments are offered for your consideration. 1. A complete construction compliance application is to be submitted. 2. The surveyed as -built house location is to be shown on the as -built plan. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:kly Y, Michael J. Director of Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH[ DIVISION OF ENVIRONMENTAL HEALTH[ SERVICES FINAL SITE INSPECTION Date: Inspected_ by: Street Location.. .i Town K n L Permit # J TM # Subdivision Lot # 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c.. Natural soil not stripped ................. .. ............................... d. Stone, brush, etc., greater than 15' from STS area.:........ e. 100' from water course / wetlands ...... ............................... H. Sewage System r a. Septic tank size 1,000 ...:.....1,250.. �er. s. v D.. b. ' Septic'tank installed level .... ......................... c. 10' minimum from foundation ............. :............................ d. Distribution Box 1. All outlets at same elevation -water tested ...............: . 2. Protected below frost .................. ............................... 3... Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set .......... ............................... 6. renncc eyes — 1. Length required Length installed 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 - 11/2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ....... :...... ..... 10. Pipe ends -ca ed..,................ . ........................:..... .-a -_ P�X1mp.a1MD0'sedp vsterns 1. Size of pump chamber ................ ? .. L Q. /h.5e f 2. Overflow tank ............................. ............................... 3. Alarm, visual/audio ........:.......... .. ...... ....................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle..:........ IQ[I House/Building a. House located per approved . plans ..... ..... : ............... b. Number of bedrooms..... }.. ' . ............. IV. Welly /�1�:_,� Well located as per approved plans.......:.. ss . - :....... b. Distance from STS area measured—., ft........... c. Casing. 18" above grade ................ ............. ................... d. Surface drainage around well . acceptable ....................... V. OveraU Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfll material contains stones <4" diameter ............... e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall -protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate.... .... : .......................... i. Erosion control pprovided ................. ............................... Rev. ?2r/002 vi 4 S1 f t MAP mm RU" S1 f t PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OY, ENVIRONMENTAL.IIEATLH SERVICES. "I'IEI;D ACTI 1'pt'T NAME: �Qr�—D1�7o'►1P_D Street Town State Zip PERSON IN CHARGE OR TNTFRV1F.UMn-- !Z21,Z i r Thte- 1411'7,1,0 rj�J_PUW TEST E] DOSE TEST - REQUIRED GALLONS a,6'0 7,T1 Aj w Signature and Title RFPCIRT RFCFTVF.T) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. r< I 0 REQUIRED GALLONS a,6'0 7,T1 Aj w Signature and Title RFPCIRT RFCFTVF.T) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. 'd JO 1N3WidUd3G A1NF10--i WUND d: 3kdl 4 T26.L_e12_St78: _R_ i 9002-,L2-i'_-)0 4 ]DIVISION OF ElEAIL:TH SERVICES ATTENTION SEPH I U GENE REQUEST FOR FINAL INSPECTION Fon. !,'III All information must be fully completed prior to an, "Trenches inspections being made. PCHD Cons"ction Permit Located: - -- Owner /App cant Name: CA A 1,1 il— L��> Blocl Formerly: w Sabdivl*sl'on Name: Subdivision Lot # Is system fill"completed? Date: Is system complete? Date: Is system constructed as per plans? Is well drilled? Date: Is well located as per plans? Are erosion control measures in place! I certify that the system(s), as listed. at the above premises nas been constructed ai)d 1 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 Counry Department of- Health. 7 Date: U De4gn Professional Address: C. 12Aj YZ 61 5V Comments: Form FIR-99 I To 3I -1 -11 r-1 w,1 1 -3 C, 0 Z - _L -.:I L-1 04/23/2007 13:08 518 - 477 -5233 BREWER ENGR PAGE 01 :... ..:. ..P.U''i�iA,�n COiN'1'.31 I''T14IATT OF. ��TH . . DIVISION OF ENVIRONMENTAL HEALTH 9tXVIC19S ATTENTION 'JOSEPH 0 GENE REQUEST E091INAL INS EC-MN For: Fill All information must be fully completed prior to any Trenches v''� inspections being matte. PCHD Construction Permit # _ i" - G4 Located: J-Z 9 WOOD 44- M (V) � U `` f l e-f Owner /Applicant Name: Grp k nrs ij T �� Block Lot--4- Formerly: Subdivision Name: Subdivision Lot # Is system fill completed? Is system complete? ' Is system constructed as per plans? — ,T5 Is well drilled? r cr + rI — Is well located as per plans. Are erosion control measures in place? Date: Date: Date: I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Departthent of Health. Date: 1.0 Certified by: / 1 PE a.r/ ::: De gn Professional Address: 5d A µ_0 1211 C. Lic. # Form FIR -99 ,401,,,j P'1_'M ;L lV x d=7�lp!� Yl z� /.' 2r- 04/23/2007 13:08 518 - 477 -5233 BREWER ENGR _ BY THIS CERTIFICATE OF: COMPLIANCE �'u `SHE WRITERS BUREAU OF ELECTRICITY 'o 40 FULTON STREET — NEW YORK, NY 10038. 5 CERTIFIES *AT Upon the application of ALL STATE ELEC. /BARTOLOMEO P.O. BOX 11 MAHOPAC, NY 10541, Located at 89 WOOD ST MAHOPAC, NY 10541 Applicintiion NumbeQ; 3027719 upon premises owned by FRANK BARTOLOMEO 88 WOOD ST MAHOPAC, NY 10541 Certificate Number: 3027719 Section: Block: Lot: Building Permit: 368.07 BDC: W106 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in /ori the premises at: Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 11th Day of April, 2007. Ir Appliances and Accessories Pwnp Motor 1 0 20A F.H.P. Wiring and Devices S Disconnect 1 0 60A General Purpose C 1 of 1 seal ^ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location inoicated. d , 3 SHERLIMIL AMLER, MD, MS, FAAP Commissioner of Health V—C1 A M&tNARI, RN, M Associate Commissioner of Health November 2, 2006 Joseph Barbagallo, PE 102 Warren Street Somers, NY 10589 Dear Mr. Baragallo: DEPARTMENT OF HEALTH 1. Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ' ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection 89 Wood Street, (T) Putnam Valley TM # 85.7 -2 -1 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. There are several pipes that must be cut flush within the junction boxes before bacirfilling. - 2. There appears to be a single seventh trench not on the plan; please clarify. If you have any further questions, please contact me at (845) 278 -6130 ext. 2155. JD:kly Sincqligit e Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool(845)278 -6014 Fax(845)278 -6648 M .. SENDING CONFIRMATION .o=, :a. ..',..,.Sy•' R• �i.�c °.pap' :s- --°'., :•cYG 3 c- '.4.. ..a.. ..� •„ :oti'. - z.R•'Yi:.� -Y s= :cif+' .���C>� I F DATE NOV -6 --2006 MON 10:57 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 - 7921. PHONE 96286520 PAGES :L j 1 START TIME NOV- -06 10:56 ELAPSED TIME 00'22" MODE ECN RESULTS OK FTRST PAGE OF RECENT DOCUMENT TRANSMITTED... 1n1ER1.iTA AMLER. MD, MS, FAAP ('nmmtcriomm of Health •.(SRMITA MOLINARI. RN, MSN !scwriarr r_nmmeHaw' ofliMtrh %occmbcr 2. 2006 loscph Hnrlmpallo, PF 1Y Warren Street . Comer.,,, NY 105eq .. - • DEPARTMENT OE- HEALTH 1 Geneva Rood. 11—Ow, Nr11 YMk 111500 ROBERT.1. BONDI C—iv F mhr R(IBERT MORRIS. PE Direom N'lirvhnnmrnMl Hedth y _ i .- .. _. , . ... ... .-so- .. - .. .r�.. • Ti r. Fir IA Inspection 89 Wood Street. 1 r) Putnam Valky TM a 35 -7 I Ocai Mr Baragallo: The above relercuced separate sewage treatment :v%tem can be hackfillee' The (olln -4w -- imitcnts must Lc corrected in the field. i . 'lucre are several pipes that joum Ire ca: hush w•dhi!, the iunetion boxes before backfilling There appears to be a single seventh trench nol •'•n the Dian. planer :In;fy I i ; r•u linvc vN Lirnctr goeslioo<, na: At 154`) N -Malt cia.: 15S. InIC(Clj' • �}m✓tph Digil I'nvin2nmeU(al Fngm:,c,mg Aid: IJa:h Envimoreeetal Rrenh 19.151278.0 Tt fna1A0)278 -7n21 Water 9appiv Sattien (915) 225.518h 14r 18(51:25 -5910 NuntlnA SeMme(M5)2786556 Fe. i8A.ry 27A -o(nn WIC d.1h % %A -G,qA NvndaA W., (.— F-140) 17RAM5 F dv im,wmannlPrm�hm11M5)2';0 ,n;� rmi �R451 '- �tl601A SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ■ LjACI;` ItTtC MOL:IItI'A;1tIV; Associate Commissioner of Health June 13, 2007 Mr. Frank Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: ROBERT J. BONDI County Executive 11�b'iE;>r i2 i''IGII�RRT�; P�`• Director of Environmental Health Permit R- 120 -04 89 Wood Street (T) Putnam Valley, TM # 85.7 -2 -1 This Department is in receipt of your letter dated June 7, 2007 relative to the status of the above referenced project. A construction inspection was conducted by this Department on the portions of the sewage system installed to date. It appears the only items remaining for inspection by this Department is a bedroom count of the house., which could not be performed since the house has not yet been constructed, and verification of the pump chamber dosing and alarms. Upon .satisfactory completion-of the-above; -•your designrprafessional may submit a construction_ - - :. -- �- -•Y compliarice application permit to this Department for approval. Should you have any questions concerning this matter, please feel free to contact this office. Respectfully, Michael J. Director of MJB:kIy cc: R. Fredriksen Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERILITA AMLER, MD, MS, D'AAP Commissioner of Health - 1LORE'I I'A MOLINARI, RN, MSN Associate Commissioner of Health Mr. Frank Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT .I. H®NDI County Executive ROBERT MORRIS, PE Director of Environmental Health June 27, 2007 Re: Permit R- 120 -04 89 Wood Street (T) Putnam Valley, T.M. 85.7 -2 -1 This Department is in receipt of your letter dated June 20, 2007 regarding the above referenced project. A new permit was issued by this Department on January 17, 2007 which also acknowledged the change of professional engineer for this project. Therefore, the current permit is valid for two (2) years and expires on January 17, 2009. If the construction compliance is not issued prior to the January 17, 2009 date then the permit must be renewed by your design professional. Should'yourhave any questions concerning this matter, please feel free to contact this office. MJB /ens Respectfully, C Michael J. Director or Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 °.. .1 �j, 1,a /�, •�•� �i: «:'. ...'b' 1 %.r'�cY•' �,�1V 11Ye�`a` v tf.. wwe' —5�4V - V ^ 4V�1r{s -(V '�- "y sii �.. a' , ,'�•- °t^ c , F..: 1736 Grinnell Terrace 407 - 682 -3270 Fax Winter Park, FL 32789 April 27, 2007 Mr. Michael Budzinski cc. Mr. Roy Fredriksen, PE Director of Engineering Putnam County Department of Health 2 Geneva Place Brewster, NY 10509 RE: 89 Wood Street, Putnam Valley, NY Permit number R- 120 -04 Issued 1 -17 -07 Dear Mr. Budzinski, I am requesting your help in the resolution of a matter at the above property. I am the builder and owner of record. In. 2005 -I ma.s. issued a. permit. to- replace the SSDS.;at-that.location. �.ln -2005, I -had hi SSDS installed "and - obtained a "cover' inspection. At that time, I discovered that the original engineer, Joseph Barbagallo, was no longer practicing that type of engineering service; and I then hired Roy Fredriksen to redraft the plan and submit for final approval. During that time, I obtained an Underwrites Certificate for the pump wiring. Since the permit was issued, I have demolished the existing home in contemplation of construction of a new home. The installed SSDS and well remain on the lot for re -use. 1 American Manufacturing Company -- Alarms Page 1 of 2 AimER0CAlid MAINUF'A rURBN(II COM6'ANY9 OWCa Home About Order Info Products Drip Systems Controls Contact Data Center - , a fANK RM Alam v a+ 3 T ? , fi' Am" prl��hlig 1�6i, -;x TAt A:, 1n LMTE6'I ,OUICK AND EASY LATION ITEM DESCRIPTION Al- B0001P Al -A ALARM W/ FLOAT A4- B0510P A4 -AFL W/ 10' FLOAT TAI TA1 TANK ALARM W/ FLOAT A1A TA1 -A ALARM W/ FLOAT (AUTO-RESET) TA L TA1 LOW LEVEL TANK ALARM TA3 TA3 OUTDOOR TANK ALARM W/ FLOAT STANDARD ALARM The Tank Alarm "TAi" rovides a versatile means of indicating an alarm ndition in a water or wastewater syste The unit has an amber "Power On" light to ind' ate it is in service and the unit will sense a high vel condition (or a low level condition just cha in the floats). The Alarm condition pro 'des ed light and sound. the sound may be turne until the alarm condition is corrected. The unit is I voltage and U/L Listed. The "Bracket/ ver" is a mounting bracket and cover only. All wiring a components are housed in the front insert module. "FLOAT I UDED" MODEL Al -A NEMA1, INDOOR AUTO RESET The Auto Reset Ala A" & -AF is a desirable option for many i tallations. In a event of a pump failure, wa er will continue t rise in the tank and sound the arm. The buzzer ca be silenced by pushing the sil nce switch. Once the \rair condition has been Corr cted and the alarm floed down, the b zer will automatically rmake the system fully operational again. Th person will not be able to forget to reaudible portion of the alarm. http:// www. americanonsite .com/american/catalog/alanns.html 4/27/2007 J •..t t _l. ..,:. y'. _. t... �. •�! "1C: '. ti.•NO 1!>!��'�a. n.. •0.'�fa .�. nnr • • .., tl .:•f.� ,.�•ynN •4•.. .4f,. • Pi'••V ii.'. �� (3) Drop Manholes. (i) Drop manholes are used on sloping sites to reduce the velocity of flow to . lower distribution lines. This system may be used with gravity distribution. (ii) Baffles at the inlet end of the manhole and approximately four inches from the inlet are required in drop manholes. (iii) The inverts of all outlets in each manhole shall be at the same level. (b) Pressure distribution and dosing. (1) These methods permit the rapid distribution of effluent throughout the absorption system followed by a rest period during which no effluent enters the system. The maximum length of absorption lines used in conjunction with these methods shall be 100 feet. (i) Pressure distribution utilizes a sewage effluent pump to move the effluent through the pipe network and into the soil. The volume discharged in each cycle will exceed the volume available in the pipe network and will be discharged from the pipe under pressure. (ii) Dosing involves the use of a pump or siphon to move the effluent into the pipe network. Discharge from the pipe is by gravity. The volume of effluent in each dose should be 75% to 85% of the volume available in the pipe network. (21 Dosing or pressure distribution is recommended.for all systems.as it promot.e.. s. beter trmbf wastewatd'arid•syserTongevifY. " (3) In absorption fields, single dosing units are required when the total trench length exceeds 500 feet. Alternate dosing units are required when the length exceeds 1,000 feet. (4) The use of manually operated siphons or pumps is not acceptable. (5) Pipe used in pressure distribution shall have a minimum diameter of 1.5 inches and a maximum diameter of three inches. Pipe for siphon dosing is sized to conform with the volume of the dose and can range from three to six inches in diameter based upon the volume of each dose. The ends of all pipes shall be capped. be used. 16 (6) Only pumps designated by the manufacturer for use as sewage effluent pumps shall i(7) Pump _chambers shall be equipped with an alarm to indicate malfunetion. Siphon. , I . - - ,� , *UNOFFICUL COPY prepared for electronic posting and distribution. Hard copy reprints of the official version of Appendix 75-A may be 'obtained by contacting the New York State Department of Health, Center for Environmental Health, Bureau of Water Supply Protection, Flanigan Square, 547 River Street, Troy, NY 12180-2216 or your local health department office. Pursuant to the authority vested in the Commissioner of Health by Section 201(1)(1) of the Public Health Law, Appendix 75-A of Part 75 of the Administrative Rules and Regulations contained in Chapter H of Tide 10 (Health) of the Official Compilation of Codes, Rules and Regulations of the State of New York, is REPEALED in its entirety and replaced by a new Appendix 75-A, to read as follows: APPENDIX 75-A WASTEWATER TREATMENT STANDARDS - INDWIDUAL HOUSEHOLD SYSTEMS [Statutory Authority: Public Health Law, 201(1)(1)] SECTION 75 -A.1 Introduction 75-A.2 Regulation by other agencies 75-A.3 75-A.4 75-A.5 75-A.6 75-A.7 75-A.8 75-A.9 75-A.10 75-A.11 Sewage flows Soil and site appraisal House or building sewer Septic tanks Distribution devices Subsurface treatment Alternative systems Other systems New product/system design interim approval 1 06/07/2007 12:46 4076823270 BARTOLOMEO PAGE 01/01 Frank Bartolomeo 407 -625 -0743 Cell 1736 Grinnell Terrace 407 -682 -3270 Fax Winter Park, FL 32789 June 7, 2007 Mr. Michael Budzinski cc: Mr. Roy. Fredriksen, PE Director of Engineering Putnam County Department of Health 2 Geneva Place Brewster, NY 10509 RE: 89 Wood Street, Putnam Valley, NY Permit number R- 120-04 Issued 1 -17-07 gear. Mr. Budzinski, Thank you for your call yesterday. I am anxious, as I am sure you are as well, to put this behind us, Kindly forward a letter to me from your office, stating the current # +qs of the above..listed project, and any.further requirements. . needed to comply fully.I as far this letter so thet Imay be fully aware � of the future requirements to comply, and to ensure that what was already done is acknowledged by your department. I appreciate your prompt attention to this matter. I look forward to your response. Please feel free to contact me if you have any further questions. Thank you for your courtesy, Sincerely, Frank Bartolomeo I 12111111 •��,1 1 t19i Bill il)II:i' .`;.I 1 1 1. (�)1 i1i Al. 11)i� i�it1)� t1)1 i �"� ii'�t1)���i `� 1 •�i lli: •�1. 1 11 �i:l'2`► it 1.� CONSTRUCTION ,1C 8'JR1V111111 -. :. . �.. 1 "t�. �. ,� .... .�., ya "C'�.. ..:. s.y. ... Q •:.. ,. ...'. u..�.� �:ro -. .. t�.rn .. •�.. •. ]FOR SEWAGE TREATMENT SYSTEM ]ERIN # R — I o?o -- c> 4- Located at vq Ldo cr> �^ ' Subdivision name lJ tl �Z%" , Subd. Lot # Date Subdivision Approved .24 61 Owner /Applicant Name I -P— t4) ,r4 120 (-0 121 e Town or Tillage TT LIA Ye Tax Map Block cQ Lot Renewal V1 Revision Date of Previous Approval Mailing Address T ti:C /4Y Zip OS-21' Amount of Fee Enclosed Building Type I -S Lot Area L IVo. of Bedrooms Design Flow GPD 41Q G, Fall Section Only Depth Volume FCH D NOTIFICATION IS REQUIRED WHEN FIILL IS COWLETIEIID Selparate Sewem9e ystemm to consist of cU gallon septic tank and ! L )C) Other Requirements: To be constructed by L3 Address Watem SupubLI Public Supply From Address — '. rivate-bupply -Vr ed by . . = -= 1 di .,ess I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewilge 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 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: Address R.A. Date 12 f 3 License # APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. By t _ �� Title: Date: ite opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pro essional F CP -97 PUTNAM COUNTY DEPARTMENT OF HEAL'T'H r. DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE: Property of LETTER OF AUTHORIZATION V1 i,:� Located at v`% 00 v 0 D T/V ��'j �.� {} /lei_ Tax Map # �g Block 2 _ Lot r Subdivision of Subdivision Lot # I Filed Map # Date Filed Gentlemen: This letter is to authorize a duly licensed Professional Engineer ✓ 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 provAsiolhs:of Article.1.45 an%/orJ47.,9f the. Education LaWJhe Public. Health," Law, and the Putnam County Sariitaryt Code. r , Very truly yours, Countersigned: Signed: er P.E., R.A., # �5 D 5-0 ,5- (.Owner of Property) Mailing Address P0 act 26-0 Mailing Address: Pd t?a)< / 09 tff(107, C State Zip IOS'4- j Telephone: _ 5/ State _Zip /QS-41 Telephone: i - q6l— 62.E -61 Y3 Form. LA -97 DIVISION V ISION OF ENVIRONMENTAL HEALTH SERVICES ICES '• -a. 'tG'. as .�. .r�.._ .., ' Tl CPNSTRUCUON PERMIT FORSEWAGE Tki ATMENT �4 1M :PERMIT # - (020 - C) q Located at 89 Wood Street Town or Village - Putnam Valle Subdivision name Wirtxz . Subd. Lot # 1 Date Subdivision Approved 4 -24 -87 Owner /Applicant Name Frank Bartolomeo Tax Map 85 e 7, Block 2 Lot 1 Renewal. Revision Date of Previous Approval N/A Mailing Address P.O. Box 11, Mahopac 10541 Zip Amount of Fee Enclosed Building Type R=S Lot Area 1 ace No. of Bedrooms 5 Design Flow GPI) 10 0 0 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1500 gallon septic tank and . 5 0 0 ' 24" wide trenches @ 6' on center Other Requirements: 1500 gallon Pump tank and pump To be constructed by TBD Address watet- Sun-i Public Supply From Address ®�: - ifri�a ' Siipply� -D it ea Ly ; x 'c� nc _ � . Ad:" ,.. I represent that I am wholly and completely responsible for thdAlesign:and location of the proposed system(s) and _ that .the separate sewage treatments sy tern 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. 61Wj O .mil P.E.. R.A. Date 10'x' License # APPROVED Fit CONSTRUCTION: This approval expires two years from the date issued unless construction of the, sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perm it. Approved for disc rge of domestic, sanitary sewage. only. o7 Title: Date: Wh to py - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 SIIERI.ITA AML,ER, MD, MS, FAAP .__� �- -' -. Co���;;�issioner�ofii2cYlYY •s, ;. - ... 1LORETTA MOL.INARI, RN, MSN Associate Commissioner of Health ROBERT J. R ®NIDI - - Lounty Exeeu ?ive ' ` .. -•- - DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 OFFICIAL REQUEST FOR STOP-WORK ORDER October 3, 2005 Iry Sevelowitz, Building Inspector Putnam Valley Town Hall 265 Oscawana Lake Road Putnam Valley, New York 10579 Re: Stop -Work Order Request: Bartolomeo, 89 Wood Street (T) Putnam Valley, TM# 85.07 -2 -1 Dear Mr. Sevelowitz: The following has come to the attention of this Department: I . The proposed SSTS is within 200 feet of a proposed well downhill of the proposed SSTS. The proposed well location was approved on a flied subdivision map (Triglia Construction Filed Map #2492, filed on December 5, 2003). - s ' It is respectfully requested that a Stop -Work Order be issued until these items have been satisfactorily resolved. Thank you in advance for your cooperation in this matter. Should you have any question or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2157. Sincerely, � 2 Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj cc: Frank Bartolomeo, Owner Joseph Barbagallo, PE, Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENIAL HEALTH SERVICES INDIVIDUAL WATER. SUPPLY'& SUBSURFACE SEWAGE DISPOSAL SYSTEMS (Name VVVof` Cgqer) REVIEW SHEET - CONSTRUCTION PERMIT _ 5� ..o -BY: -(Street Location) DOCUMENTS_ Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent.Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench/Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two-Foot Contours Existing & Proposed Driveway & Slopes Cut Footing/Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff. size H.Plumped Pit. & D Box.-.Shcwn,..& .-Detailed., 'House - No. of Bedrocm§ Wells & SSDS's w/in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1/411/ft. 4"0; Type pipe No Bends; Max. Bends 450 w/cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 101 to P.L., Driveway, Large Trees 201 to Foundation Walls 1001 to Well; 200' in D.L.O.D, 1501 pits 1001 to Stream, Watercourse, Lake Unc. expan) 151 to Drains-Curtain,Stom,Leader,Footing 251 to Catch Basin 101 to Water Line (pits-201) Septic Tanks 101 fran Foundation 501 to Well 151 Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex-approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of % ,i^ Y, f� " Located at Section /A52 Block � Lot Subdivision of Subdve Lot # Filed Map # Date Gentlemen: This letter is to authorize a duly licensed professional engineer 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 connection with this system or systems 1A 147, Education Law, tary Code. Countersi. e P - E - , .,R!A.41 Address matter and to supervise the construction of said conformity with thW;&ovi.sions of Article -145 or the Public Health Law, and`the..,utnam County Sani- O Z.- 73�z _. - Telephone r.' ; Ver y - ,truly ours. -f Signed Owner Xf Property Address ell 3- Town Telephone _ Frank..Rara!mp, ;Fsq,-. FB Realty Holding, LTD. PO Box 11 Mahopac NY 10541 845 628 3800 September 18, 2008 Putnam County, Dept. of Health 1 Geneva Road Brewster, NY 10509 By hand delivery Re: 89 Wood St. Permit # R- 120 -04 Dear Mr. Budzinski; Please find the attached house plans to be built at 89 Wood Street. Please stamp these plans for bedroom count at your earliest possible convenience. Please find other correspondences for your convenience as Please do nct hesitate to call if there are any questions or concerns. Yours truly, F SHERLITA Ali11LER, MD, MS, FAAP Commissioner o Health LORE'H i'A MOLIiNARI, RN, MSN Associate Commissioner oJHealth Mr. Frank Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 R®HERT J. H ®N ®I County. Executive ROBERT MORRIS, PE Director ojEnvironmental Health June 27, 2007 Re.- Permit R- 120 -04 89 Wood Street (T) Putnam Valley, T.M. 85.7 -2 -1 This Department is in receipt of your letter dated June 20, 2007 regarding the above referenced project. A new permit was issued by this Department on January 17, 2007 which also acknowledged the change of professional engineer for this project. Therefore, the current permit is valid for two (2) years and expires on January 17, 2009. If the construction compliance is not issued prior to the January 17, 2009 date then the permit must be renewed by your design professional. Should *You have any questions concerning this matter, please feel free to contact this office. MJB /ens Respectfully, k-'UA Michael J. Director or Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP romni kh P. 9!?er orHealth - LORETTA MOLINARI, RN, MSN Associate Commissioner of Health June 13, 2007 Mr. Frank Bartolomeo 1736 Grinnell Terrace Winter Park, FL 32789 Dear Mr. Bartolomeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive - ROBERT MORRIS, PE Director of Environmental Health Re: Permit R- 120 -04 89 Wood Street (T) Putnam Valley, TM # 85.7 -2 -1 This Department is in receipt of your letter dated June 7, 2007 relative to the status of the above referenced project. A construction inspection was conducted by this Department on the portions of the sewage system installed to date. It appears the only items remaining for inspection by this Department is a bedroom count of the house, which could not be performed since the house has not yet been constnict_ed, and verification of the pump chamber dosing and alarms. Upon satisfactory 66mpleii(5Tof't e above; your design professional inay'submit a construction::::.::.:. compliance application permit to this Department for approval. Should you have any questions concerning this matter, please feel free to contact this office. Respectfully, Michael J. Director of MJB:kly cc: R. Fredriksen Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278.6648 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PR O O I 1 yUl OFFICIAL USE ONLY i�2-d e SITE LOCATION 89 Wood Street, Putnam Valley TM# 85.7 -2 -1 OWNER'S NAME Frank Bartolomeo PHONE ( 845) 628- 3800 MAILING ADDRESS P.O. Box 11, Maho ac, NY 10541 PERSON INTERVIEWED PCHD Complaint # Name & Relationship i.e., owner, tenant, etc. DATE 5/7/04 TYPE FACILITY PROPOSED INSTALLER ADDRESS PHONE REGISTRATION# 0 0 (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system .Different location may require submittal of proposal from licensed professional engineer or registered architect. Remove existing house, Abuild new house and new SSDS /J / I, as owner, o epos d agent of�owner agree'to the conditions stated on this form.' TITLE C2b.N`�i DATE ! 7 C' 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a Owner's name b. Site Street Name, Town and Tax Map number. C. Location of installed components tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep e. Installers' name and number. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML DATE e r Public Health Director Herman Walter Schull 89 Wood St. Mahopac NY 10541 DEPARTMENT 1 Geneva Brewster, New OF HEALTH Road York 10509 LORET A : II .L._R 1-1 Associate Public Health Director Director of Patient Services 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 April 2, 1999 Re: Addition- Schull - Wood Street No Increases in Number of Bedrooms (T) Putnam Valley Tax # 85.7-2 - Dear Mr. Schull: I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp form this Department dated April 1, 1999 The addition is approved with the following conditions. 1. The total number of bedrooms must remain at - without prior approval by 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam ValLe -y If you have any questions, please contact me at your convenience. Very truly yours, William Hedges WH:kg Senior Public Health Sanitarian cc: BI n e PUTNAM COUNTY DEPARTMENT OF HEALTH t DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project 11 / �-��' �` S L (T)(V) ev TM #. Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. ❑Hilly ❑Rolling ❑Steep Slope ❑Gentle Slope ❑Flat 2. ❑Evidence of wetland ❑Low area subject to flooding ❑Bodies of water ❑Drainage ditches Mock outcrop YES NO 3. Property lines evident? 4:. ztt ?r:' atirses exist ®n;_or.adljacer ±.to parcel: L .... :....,❑ 5. Existing individual wells within 200ft of the existing SSTS? ❑ ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level ❑Gentle Slope ❑Steep slope B. ❑Well drained ❑Moderately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS. (Primary & Reserve) ❑Extremely limited ❑Somewhat limited ❑Adequate ft x ft 4 ERUCE R. FOLEY, F.0 Acti „g Public Haalth pirz,. D'EPART� -: T 0. HEALTH 01' Enviro:.:-..:n:al Health Services Ce. Roa- 6,e,,;;er \ati'. York 10509 (9 T IC.'; r'.z;. T1C?: ONLY) h� M ►vi S '_ _T S'E!y T i ' VA L >_ Y T X „a 1B 5-- 7—,2 -- r_. r1.AN Vy.Ai.'1" ER: SGT P 91$ SZ1. It 17 pf 4po PE,RXIT / w aa4 ST 0.0-14 o.R caG DzScripii&i Of '-.d;titi:�7i T-e.bv i (� E'vtla�YC� -Q w BSI �cL�ejVV1 ,-bE- of existing :ro =used number of badror-�-.)s �- IrG:.. Corti 14 ccic Oi G up O' G rtifiCatiOi C: -t E�`Idir.= �.iy a- :iition Y;.nich co'iS...zreC F- be_ z:tS rSyUlrEs formal approval of plc1s (Con _:NCtiOn PEre.it a Prc-_ssicnal Engineer or Registered architect accorda:nca- r; i th c;'a i e se , i or, ,S c,` the Putnam County Sanitary Code. rlecSE submit this Tc a the i,oIIce; - to PUT i�:''i ��i•!TY } `n!�Iii -,� r��� [�h(_�•� -, •- �- G.. ; =� ?t;.F��;J,:F;:r >. -? 1 =?;��, ; ::_ 2� -,f0 viito tna following information. i . Certified Cnecr; fo- Yl.&D.00. S':etcn of existinz fl c,: - plan (all i'ving area including basement, if 2.ny) Non- professional is acceptatle 3. SkEtch of proposet flog- plan. t � 11 .Non professional drEwin� is accepta',iE 41 / 4. Copy of survey sr,,:-?;ing -?;=ll septic location, to the best of your -krtc-rrledge. Include date of installation if kncrrm. Include all r ;ells and septic systems within 200 feet of property line. Any questions please contact this office. 5, Copy of Certificate of Occupancy frc::, To?.,n or Certification froi7 Building Department of lecr-1 bedroom count of dwelling. OFFICE' USE Comments and/or conditions ' r Ly:I tii 1 I iy1 application august 1995 July 1996 (Revised) 's 9ilura:I1, FOLLY":•ft$ if -�:: � / �Gtitta .l'dti11G•111t�1tb•'Ullr�nal QUAI(rMINT, Or HEALT1•1 tg•. Division Of Cuvitc,nmcnl:tl t•Irr,•tfth, Services .. • 4 Ccliev i 1:aad, (ircwstcr, Ncw Yc r' 02 . isugy nept. ol'c�e�lial �: • � � cncva� �o;id 10509: Rc- Tug Ma{} owil �; F` 'ate < :. 1i1 G4Pt t:1� aQ rcCnrdS t:)ailtl�iit;ctl by 11w "t own, the' above nolcd dwe @titi Gs'�. •' - - . ..� . .y.. .... .�.�. .. w_. ..14_.0. `. .. .. ... . �„T Q}. . .rw tit.. —.�, �,�, w• 1 ,`� �A * • =< - iE1 cot }.�a i lncc w:ll�'1'�w►ti code mid the tata{ numbcr orbedroonis on record 44 L ,3:'.'. ' �;��j:�-1l�r��;?illiil�tU11 �1ii5 �CCt1 0U1i1}Ilt:d'ji�0I11: � `1 . " CA E OF OCCUPANCY XORD- �,� • � ... .,4TI�� Std s,_.�,, °�<t�nu ��'' •• •. ' ' BlllitiUls LAW (73/23/1999 14:43 9145261137 SCFLLL ZIMMERS PAGE 01 it UJ /.IU/1999 16:13 9145261137 SCHULL ZIMMERS PAGE 01 a -e BRUCE R: FOLEY. R S n9 p�. a ti u nl. n c c Health C•�e:;,• DEPARTMENT OF HEALTH Division Of Environmental Health Services 4. Genera Road, Brewster, New York 10509 (914) 278 -6130 7 6 ray i i rti:C6iinty IIept. of Health ISt0t. -M 10$09 .�: 1w. R q � �� eside nce � Al "'"'u►,.ie. g ,'3f.-A:!:r `7es Tax Map t!!�• Town 4M Ac rd tg =to records maintained by the TO'NNM, the above noted dwtlliii�' ' g� th' M. i re'with Town code and the total number of bedrooms:an tecofd ¢' :- T.,Wj'd.biTnaEion has been obtained from: '< aFt`I:ATE OF OCCUPANCY:. �, --� t W 110.51' EXPAN510M AREA 04 A 03 . ;� �_ oo•BE �. --�� -- ---- -- �. Uti 0 � � i [ii OD v u� O O M.. o-!s7, c). 0,-5 114, 00' EXPA"510N AREA ar- At ®i rn _p N `J a �1 r5s r �-0 3�f Z � .1� �,•. , ,. u, Iti It � \�1 �, ,� o. o *r - �. ,, ,:..: ::: r oa oa% 30 .3'c Y17 /).�' -- •p-- -- 6�/&�rV,d�cs .�O .- C1�t/� ®,7 �'h��l o..t o.30.�.�0' a`"'d' Ol / '•►1 . Cb `J a �1 r5s r �-0 3�f Z � .1� �,•. , ,. u, Iti It � \�1 �, ,� o. o *r - �. ,, ,:..: ::: r oa oa% 30 .3'c Y17 /).�' -- •p-- -- 6�/&�rV,d�cs .�O .- C1�t/� ®,7 �'h��l o..t o.30.�.�0' a`"'d' Ol / '•►1 . i 'gib xt T-CD - Y' „baD Tro Ex PST ►,v c rt# ! t~gAfvS %[u1�` OEPHRTMEN T OF HEALTHp HQU�E PLANS APPROVED FOR � N g %� $EoROo is € - z X AZT' ------- =1r i �, Z-it 1PNE� _ LOCATION'' _ I - roG ;A/Y GECLC LEVEL - -- EL. Na 0 C: • a { t: A -7 7- hl F-LAJI 41 Co CI NOP -Tiq ST MST. Sr. 2 d Di5r. 'aOX Box EL13ou� 1 ,, �6 q�W �vb t nervy ,J rtz • Wood Street v Boa 112, Shrub 0fik9 T Y 10588 528 -56799 or 5262709 lZ 000 1. C.O A/C 'R 'gt `T'zltvk o. TA UPC: 1, 000 S8 ,• Lv, DE? y„ TO 1 nrv®-rLT D t STS t'c E5.. L. 1 A 43 I sT Di.ST. 13Dv `; ��' �' 24'!D,, a IM SCP-T-1L (PROFI;;RTY OF 46N¢7' Wt,T2) �`8t9Zz -� (cr7ti— __ ---'� 9; TO SC AL v III j �vb t nervy ,J rtz • Wood Street v Boa 112, Shrub 0fik9 T Y 10588 528 -56799 or 5262709 lZ 000 1. C.O A/C 'R 'gt `T'zltvk o. TA UPC: 1, 000 S8 ,• Lv, DE? y„ TO 1 nrv®-rLT D t STS t'c E5.. L. 1 A 43 I sT Di.ST. 13Dv `; ��' �' 24'!D,, a IM SCP-T-1L (PROFI;;RTY OF 46N¢7' Wt,T2) �`8t9Zz -� (cr7ti— __ ---'� 9; TO SC AL v Q.. P ttJ ll 1 V AM COUNTY V ll 1Y IlD1EPAILBTMENT 07 HEALTH DWESRON OY ENVIRONMENTAL HEALTH AILTIHI S E+ RVRCIES A PIPLIICATIIO TO CONSTRUCT A WATER WELL � Q �-,• DfeeSe print or type _. P( rill Penni[ WeH Location: Street Address: Town/Village Tax Grid # 3 `� .. v✓exs� i M -A H r7T'A e Map9 ', %Block Z_ Lot(s) -1-. Well Owner: Name: Address: Use of Welk ar Residential Public Supply Air /Cond/Heat Pump Irrigation I- primalry Business Farm Test/Monitoring Other (specify) 2- secondanry Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served Est. of Daily Usage __gal. Reason for Ar Replace Existing Supply Test/Observation Additional Supply Dr flung New Supply (new dwelling) Deepen Existing Well IIDetailled Reason for HDrMing vv� F, -�i'tn � ►J��� � �-� � - WeIR Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No x Is well located in a realty subdivision? ...................................... ............................... Yes No x Name of subdivision Lot No. Water Well Contractor: tAv-f o4—,AA Address: Is Public Water Supply available to site? .......... Yes No �+ 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. Date: �/� /-`��. Appl:ica-it Signature: ]? ERMIIT 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 Permit Issuing Offic' . Date of Expiration Title: Permit is Non -Trans elr1rablle White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 E-116 N/F WILL EX 1S i 4 .: ,� �. � W. c •.za.vf.B X03 11 �-- � ` `� , I f7- W '•.� -Tf 9.45- } -�� NIF. Mc PADDY•. 2 A�O LOT �3, � 2G - 5.�. �•�\ V' ✓ELL � � �� a �o�, APEA =2,823 .5�: 1 j r ��� �i• S N WELL °EWEIL 115' DEEP 390.Q0' �t1� Ta EXtST'G. 5505 t `irk z: 45, ?<o °� e. F i hi O ..', 1.00 N/F RANK ►o; =_�' 061 �� • Cb� 3 7. o,Z o� - _ Cb 30 - -xz,5- co Ne8 °/ 9 r✓ - - + , irate` June 14,1998 From: Herman Walter Schull, 89 Wood Street, Mahopac, NY, 10541 Re: Neighbor Notification, Department of I lealth Review of Proposed Well NAME: flerman Walter Sclitill ADDRESS: 89 Wood St., Putnam Valley TOWN: Putnam Valley TAX MAP: 85.7 BLOCK: 2 LOT: 1. S 1 �y Y �Ct�L7 Dear 01 y -4 b "5 Vvi Please be advised that an application for a Construction Permit relative to the construction of a well, proposed for the above captioned property has been made to the Putnam-County Department of I lealth. Attached please find a copy of the latest site plan. The proposed work will deepen the existing well, If you have any questions, Concerns or information which may bear on the Health Department's review of this application, you may call Mr. hedges or Mr. Morris oi'the Health Department at 278 -6130. Very Truly Yours::.: Ilerman Walter Schull Rille T4, From: Herman Walter Scholl, 89 Wood Street, Mahopac, NY, 10541 Re: Neighbor Notification, Department of Health Review of Proposed Well' NAME: Herman Walter Schull ADDRESS: 89 Wood St., Putnam Valley TOWN: Putnam Valley TAX MAP: 85.7 BLOCK: 2 LOT: 1. To: + N zy IA,f E Dear +N1 Y, P Please be advised that an application for a Construction Permit relative to the construction of a well, proposed for the above captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. The proposed work will deepen the existing well. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. hedges or Mr. Morris of the Ilealth Department at 278 -6130. Very Truly Yours: I Lerman Walter Schull Hare: .Elide 14,1998 From: Herman Walter Schull, 89 Wood Street, Mahopac, NY, 10541 Re: Neighbor Notification, Department of Health Review of Proposed Well NAME: Herman Walter Schull ADDRESS: 89 Wood St., Putnam Valley TOWN: Putnam Valley TAX MAP: 85.7 BLOCK.- 2 LOT: 1. Dear Y�r : 4 1 Please be advised that an application for a Construction Permit relative to the construction of a well, proposed for the above captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. The proposed work will deepen the existing well. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. hedges or Mr. Morris of the Health Department at 278 -6130. Very Truly Yours: Merman Walter Schull _ .. ....,. . ^q.•l1 .�,'�q.i ..rt :! .CC.gii. G'V:. "f'Ll�li. �\ 5,f� {' /U +. r•�� v r " . From: Ilerman Walter Schull, 89 Woad Street, Mahopac, NY, 10541 Re: Neighbor Notification, Department of Health Review of Proposed Well NAME: Herman Walter Schull ADDRESS: 89 Wood St., Putnam Valley TOWN: Putnam Valley TAX MAP: 85.7 B[,OCK: 2 LOT: t. wl k41oCA -c. N i i � S � / Dear 0-1 v, 4 M w -3 C -A -�; Cpl o t'..,. -04 Please be advised that an application for a Construction Permit relative to the construction of a well, proposed for the above captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. The proposed work will deepen the existing well. If YOU have any questions, concerns or information which may bear on'the Ifealth Department's review of this application, you may call Mr. hedges or Mr. Morris of the Health Department at 278 -6130, Very Truly Yours:,�.v��i`- I lerman. Walter Schull PUT NAM COUNTY DEPARTMENT ®IF HEALTH DE VIIMON OIF IENVITRONM EIVTAL IHIIEAIL'll'H SIEIRVRCIES _ :_.... CONSI'Rl�i�:��'>��DN �`1L�m ll'll' t�` 1[8 I A I '�']C�IE��1'1�I11 1�1T SYg'll"'JEM - �- PERMI[T # - 20 s o q Located at 89 Wood Street Subdivision name Wirtxz Subd. Lot # 1 Date Subdivision Approved 4-24-87 Owner /Applicant Name Frank Bartolomeo Town or Village Putnam Valley Tax Map 8 5.7 Block 2 Lot 1 Renewal Revision Date of Previous Approval N/A Mailing Address P.O. Box 1 1 , Mahopac 10 541 Zip Amount of Fee Enclosed Building Type Res o Lot Area 1 ac _ No. of Bedrooms 5 Design Flow GPD 1000 Fill Section Only Depth Volume Separate Sewerage System to consist of 1500 gallon septic tank and 5 0 0 ' 24" wide trenches @ 6' on center Other Requirements: 1500 gallon Pump tank and pump To be constructed by TBD Address WatE SUPPIlY: Public Supply From Address or: Pnvate S 1pDiv i?iilled 1 >y . 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 Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a wr ttg irk Tantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place jli- 6 tl.opg 41 "'ECOndition any part of said sewage treatment system during the period of two (2) years immediately followjri` dale ' �.suance of the approval of the Certificate of Construction Compliance of the original Y l � ' system or Signed: Address 1 G 0 P.E. X R.A. Date 0 CR7 License #%�� rj AIEDlEnIlBOV]EI<D lF fi'IOl`T: This approval expires two years from the date issued unless construction of the ' sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for disc ge of domestic sanitary sewage only. By: xa-,Z-0� Title: Date: -711,Wlas` Wh to py - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 ... .. ; ;� -;,rY. a 1. a ... . ...a .'ro: i : ; "a." _ :7 •o =w': ..:. ?'i '.� ,- •cnet LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1. Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Ndrsing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 27$ - 6014 Fax (845) 278 - 6648 ' FACSIMILE T- ANSMITTAL To: ��� �, / ,,wd Fax- From: foe. Par",r i- Jr-., ANE- Date: Ix CC; ��7 ✓� Sry ❑ Urgent - ❑ For Review ❑ Please Comment ❑ Please Reply ROBERT J. BON.DI County Executive CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only, for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845 -278 -6130) and destroy all documents associated with this facsimile. SIERLI B p Ail✓ALER, aialD< 16, p.ai.,�''.� c. ; Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 12, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Putnam Valley Town Hall Iry Sevelowitz, Building Inspector 265 Oscawana Lake Road 'Putnam Valley, NY 10579 Re: Stop -Work Order — Bartolomeo 89 Wood Street (T) Putnam Valley, T.M. 85.07 -2 -1 Dear Mr. Sevelowitz: County Executive Due to further information that has come to the attention of this Department, the Stop -Work order on the above referenced project can be lifted. The approved SSTS area on repair permit R- 120 -04 was originally approved on the Wirtz Subdivision Plat. The plat was approved on April 24, 1987. Therefore, the owner has the right to construct an SSTS in that area. Well location on the adjacent subdivision (Triglia, Lot #4))- will have to be. relocated. It is the opinion +h is` e ,alrtn3Prit;:tllat'ai. am ended subdiviS'6h`' 3ap'sh`uuiii•Ce 111001: `° - -- - Please contact this Department if any questions arise. JSP:cw Sincerely, oseph S. Paravati Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARRn41W OF HEALTH DIVISION''OF' `HEALTH SERVICES. DESIGN DATA SHEET- SUBSUFAC'.E SEWAGE DISPOSAL SYSTEM FILE NO— Owner. G �,? / y %�� %/^ Address C ^ f "�� Za l Located at (Street) rJ �% /�' z'�'�' -/ Sec./;?61 Block Lot -00' (indicate nearest cross street) Municipality J o 4;70 G� C '%/ '�� Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking. `�/�I Date of Percolation Test 5 / 11 HOLE NUMBER CI= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min /In Drop - Inches Inches Inches 4" 5 ..«' !-- Grp^• _w7 .. ... r 'A� - Y .+�.. ,.li•• � 1 •l• _ i. 1C1 "'f ...+�• 4 2 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at'.each percolation test hole. All,data to' be submitted for review. 2. Depth measurements to be made from top of hole. / rev. 9/85 `'� TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES D HOLE. NO. HOLE NO. HOLE NO. � .. -. _ . f' -wr ... cY-. .� r • 1 .• �.L�.r.. t " -, W ^� 'a�,+J •- re .. '' . �� G.L. H - r.na ..0.- • -n - ...i+- c .. ..... . .n. .. .., ... .. ! 2' 3' 4' 5' 6' 7' 8' 9° 10' 11' 129 13' 149 - -INDICATE LEVEE 'AT WRICf GRWN17irifATER_,YS INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEFY MOLE OBSERVATIONS MADE BY: ~ 1 i -)')'1 DATE: .3 fl DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided✓ C� Noe Df Bedrooms Septic Tank Capacity gals. TypeA14SQov` V Absaption Area Provided By 3c�t9 L.F. x 24" width trench OthEr i' 14, k - /✓%� ! i � /�� �� 0 ✓/ Nang c" /P i �/ s Si na g - � J / ��� �� 7 Sao -XHIrSYACE FOR USE BY HEALTH DEPARMMFIU ONLY: ' . y.p:9 A�A Soi Rate Approved sgeft/galo Checked by Date EXPAN510M AFF-.A A iW .N. ti �I goo r- dX � r t" / X A k JVl (j) --i Ul O 114, 00' S5 o5 EXPAW51ON AREA , r A' •I A41 0 C) Lu m 6. ily Fj PC A41 0 44 Lu m 6. ily Fj •N Ss 0 71fs 0 Lu m 6. PC Lu PC (040-40 44 t'l 47 pi ni rn z 0 ill fr- / � 1 ' LO cATlom 2 ' L2JI HAT T? SF,J 114E DI`• TrFiS' iS Tb GoNGEK T A uo ON Tw S'RJ,'=ry S u�I� '?Et fE� MY1 L rPosl l' %`'TEt W�:FS I s.T^-'1 WAS C I+ps tpVF �o 6 All 11'r R,1E� grata 2aA+I c>r. r{ ITh I}tRLTh oR'PT` RNA r ZA yo-t, w, DESIGN PLANNING 4 44 266 SHEAR HILL RD. • MAHOPAC OWNER FpANIL 8 T�'� I1l0 .moo rorRr.. �, o .°ole•'I - 7- rencHeS . MAFFO Ac, is ia4 PROJECT: RiR"►IT IJo R420 . 89 >eJ000 ST �t�TH An'1. V4 Ile , ►• PLC e Coy_ ^ty.DeT, Division.,,,. t1 ^tnent of Hnitf, . rnviro"Mental Realth sezw:cej: SHEET TITLE* I LT ApDroved'as not OF appli ^e', r4 noted for confformanc m1t —� �- es and Re ;slatiors of the. Put au Cociay'H'e h Departont. S1gnat—a tle Dat REVISIONS: DATE: fo /8 C