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Home My WebLink About4646DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. mascanyourdocs.com 631- 589 -8100 85.13 -1 -34 BOX 35 Lei me .. 6 Akl r- -6 i - 9 I 9. Lei me •. „.. - ....,.cT<y�e". =rsa. � , ... "7'r..A�-__'+_'�.'.�.. u • f °, `. `+ ' PUTNAM COUNTY DEPARTMENT OF•HEALTH R 386 Divislon of Environmental Health Services, Carmel, NY.10512 rl EnglneerMnat Provide P: 8% D Pe mlt # A�� b CER. CATS OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL,SYSTBM. ».. , _. 'Ff ,�vaS. °�� . _ - _ : i--•- � •�`` /`"i � .�. ...-� ,;�,'.. - � -�-a+r .. ." .c.-4.4 ' ;.. � W a : 'rU'Wn O[ Vlffage j Located at iUL'! ' /' �%/ GYl iLa�'G Tai Map Block �- Owner /applicant Name Formerly Subdivision Name O� Subdv. Lot # Melling ng Address ' l " Z(p %s �'� Date Permit Issued ? I p S"% 1"�Jj4v 27 Separate Sewerage System built by. /7 %G/iez.V lJ� / ��/ Address LL Conslsting of Z r0 Gallon Septic Tank and `¢ 06 A Water Supply: Pabil Supply From ^ Address _ /�d rrJyQ/l !Tnd►rl. Address y. or: Private Supply DrWed by .�✓ OTs'r�✓ �� ". %� ✓•� � Building Type �'°j � Has Erosion Control, Been Completed? Number of Bedrooms" Has.Garbage Grinder Be' a Installed? e'_ -Other, Requirements I certify that the system(s) as listed serving the above premises were "constructed ess tYa tioidlf e �. plkns of the completed work ( copies of-which-are attached), and in accordance with the etandards,,rulec and regulations, "ac c th ad Ilan, and the permit issued by the Putnam County Department Of Heal'h.'' Date certified by P.E R.A. Address Anyperson occupying premises-served by the above system(s) shall prorr condltions_ resulting from such usage. Abproval of the separate sewer availebl,'e a6d,Ahe. approval of the - private water supply shall Decome n I sublect.to mo lflcat nn hangs when In the Judgment of,the.Cddh 2l;Date •�:,� � By v License o. ly take such let G " \ � re the correction of any unsanitary I system $hall be . „ as a puW%. unitary sewer becomes id. void, hen a pu rhis available. Such approvals are ow�er ` Meal a Ifleatlon or change Is necessary. 9 Tltloj5 M= T-rMT T rnmmT VMTnM PVPhPT DEPARTMENT OF HEALTH -Divis,�on Of Environmental Services , PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only STREET ADDRESS: W'GRIO NUMBEL 9 3 F,-� ffzff NA ADDRESS: PBIVATE ❑ PUBLIC WELL LOCATION WELL OWNER USE OF WELL 1- priImprimary 2 - secondary 0-RESIDENTIAL 0 PUBLIC SUPPLY ❑ AIR/C ' ONO./HEAT PUMP 0 ABANDONED 0 BUSINESS ❑ FARM OJEST/OBSERVATION 0 OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL 0. STAND-BY 0 AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE _!!�_0 gal. REASON FOR DRILLING ,'NEW SUPPLY 0 PROVIDE ADDITIONAL ONAL SUPPLY O'TEST/OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVELft. DATE MEASURED DRILLING EQUIPMENT rROTARY ❑ COMPRESSED AIR PERCUSSION Q DUG.• ID -WELL POINT 0 CABLE PERCUSSION 0 OTHER (specify): WELL TYPE. ❑ SCREENED ❑ OPEN END CASING. JR,OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft MATERIALS: -C STEEL 0 PLASTIC 0 OTHER LENGTH .BELOW GRADE 1 & ft JOINTS: - ❑ WELDED C(THREADED 0 OTHER in. , SEAL: 0 CEMENT GROUT 0 BtNTONITE THER -DIAMETER WEIGHT PER FOOT Ir– Ib./ft. ' I -DRIVE SHOE.,KYES ONO LINER: 0 YES KNO I DETAILS SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? - FIRST ❑ YES 0 NO GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE. DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH — It. I WELL YIELD TEST If detailed pumping HOD: 0 PUMPED i tests were done is in- COMPRESSED AIR formation attached? 0 BAIL( ❑ OTHER OYES ONO more detailed formation descriptions or sieve analyses WELL LOG ' are available, please attach. DEPTH FROM SURFACE Water pear- ing Well Dia- M ter in'! FORMATION DESCRIPTION CODE. ft. ft WELL DEPTH It. DURATION hr. min. ORAWDOWN It. YIELD gpm. 9PM_ Surf Land ace WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS ❑ COLORED ANALYZED? 0 YES ONO ANALYSIS ATTACHED? 0 YES ONO STORAGE TANK: TYPE Pop CAPACITY GAL. PUMP MATIRN TYPE CAPACITY 26 10 MA DEPTH "0449 ..'T14 MODEL 2- 1--9OLTAGE — HP ;0z .5 WELL OR ILLER NAME 0 12rge W_ 1 A AGOR IG? IRE z N -12e 014749 �. Yorktown Medical Laboratory, Inc. LAB y _ - -� 321 Kear Street Date Taken: ��7'��Time : /U y T Y *orktown( Heights, N. Y.1698 Date R(cY' ydy : p pyT/ggi{ryRme : 7737-v .:.I✓••i.. . �iS. +F.•i.. 1' �. �.71:�..+=. J "�7��..P �.-, �_�..�. _.�..Sw .Y ...Yt+�� '4'.�4•�'�'Vf�' C'w �• ,_� IOVVT._�- ��.�_ Director: Albert H. PadovaniM. T.(ASCP) Collected By: T- , Referred By: Sample Location: i S /e777e75 bd;?;, Phone N / Phone 1/ . Sample Type: L 0GG710/j�'�'+'1 VA( /_eV 1"`7 /d)�7G% _j Repeat Test? _ (check one) LABORATORY REPORT ON THE QUALITY OF-WATER INORGANIC NON- METALS (mg /L) 'Acidity _ Alkalinity, Chloride Detergents, MBAS Hardness, Total Nitrogen, Ammonia Nitrogen, Nitrate Phosphate, Total _ Sulfate _ Sulfide Sulfite METALS (mg /L) MICROBIOLOGICAL (CFU /100mL) GENERAL BACTERIA Standard Plate Count (CFU /1.OmL) MEMBRANE FILTRATION TECHNIQUE Total Coliform Fecal Coliform Fecal Streptococcus MOST PROBABLE NUMBER TECHNIQUE Copper Iron _ Total Coliform Index Lead _ bf a�n•gan a §.'e..... Mercury Sodium KEY FOR TERMINOLOGY Zinc MISCELLANEOUS pH (units) Color (units) Odor (TON) Turbidity (NTU) N/A = Not Applicable LT = Less Than (<) GT = Greater' Than ( >) TNTC= Too Numerous To Count CON = Confluent ( =TNTC) NR = Non - reactive REMARKS /COMMENTS (For Lab Use) _ ✓Potable Non- potable. STP INF STP EFF Other: Sample Status: (check each) Outgoing HNO3 _ HC1 H2SO4 _ NaOH ZnOAc Na2S203 Other: LE k °C _ �GT u °C pH LE 2 pH -GE 9 _ pH GE 12 _ Other: THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS (WASN'T) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO TH W YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) (N /A) MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK STATE DRINKING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. /X/ ��r v� / �' C- �~%?2l 2 /86(Rvsd7 /87)RWE Albert*H. Padovani, M.T. ASCP), Director ti PUTNAM COUNTY DEPARTMENT OF HEALaH I DIVISION _ 9F ENVI�tO�?M AL . H AST FI =0 Rwi: S Owner or Purchaser of Building Building Constructed by Location - Street Municipality ids -"V ewe& Building Type Section Block Lot Subdivision Name Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, 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 -t. °'e�, i eVate-, o C h'tr;�ction "Ccipp1 i ai zr �q:.for. -the s4 4 o -, is sal . yst ' :or .an.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 Director of the Division of Environmental Health Services 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 this day of 19,k� Signature Title General Contractor (Owner) - Signature Corporation Name (if Corp.) Av,-, ev-- Address rev. 9/85 mk Corporation Name (if Corp.) Address APPENDIX C FINAL SITE INSPB TION /" Date < 3 v �` r TION l!'�V�i�i SL . OWNER l� /TL 4<,44-12: by r,r • - _ • y- K ' % iS qM # OR. SUBDIVISION U)T # i 21 Z, ' -� SEWAGE DISPOSAL AREA -- -- - --'� a. SDS area located as per a roved lans —i - II. b. Fill section - Date of placement 2:1 barrier. LGTH Wim AVG.DPTH c. Natural soil not stri d. Stone, brush, etc., greater than 15' from SDS area. e. 100 ft. from water course /wetlands . SEWAGE DISPOSAL SYSTEM a. Septic tank size - 1,000 1,250 �. b. Septic tank installed level IX c. 10' minimum frm foundation -- d. e. No 90° bends, cleanout within 10 ft. of 450 bend DISTRIBUTION BOX 1. All outlets at same elevation - water tested 2. Protected below frost` -_- - _- - -.. f. g. h. 3. Minimum 2 ft. original soil between box and trenches JUNCTION BOX - properly set TRENCHES 1. Length required - Length installed 2. Distance to watercourse measured'. ft. 3. Installed according to plan 4. Distance center to center 5. Slope of trench acceptable 1/16 - 1/32 " /foot. 6. 10 feet from property line - 20 feet - foundations 7. Depth of trench < 30 inches frm surface 8. Roan allowed for expansion, 50% 9. Size of gravel 3/4 - 1j" diameter 10. Depth of gravel in trench 12" mink= 11. Pipe ends capped PUMP. OR DOSE SYSTEMS, 1. 2. Overflow tank 3. Alarm, visual /audio 4. PLunp easily accessible manhole to grade -. - jf M 5. First box baffled 6. Cycle witnessed by Health Department estimated flora per Sycle IV. HOUSE a. House located per approved plans. b. Number of bedrocros _ `? • v V. VI. WELL a. Well located as per approved plans b. Distance from SDS area measured ft. c. Casing 18" above grade. d. Surface drainage around well acceptable. OVERALL WORKMA.SHIP a. Boxes properly routed b. All pipes partially backfilled rou v c > T o s D ILL, C. All pipes.flush with inside of box i- d. Backfill material contains stones < 4" in diameter e. f. g. Curtain drain installed according to plan Curtain drain outfall protected & dir.to exist.watercours Footing drains discharge away fran SDS area a1S h. Surface water protection adequate- A. :M i. Errosi.on control provided on slopes greater than 15%. 71 M PUTNAM COUNTY DEPARTMENT OF HEAiTH 8 0 nmentolMH �6 Cos. j ear to proilde PqiiWt.#, 31 11 ,Y30512,, CO Is, wo Of r 1, vj ON PEE' WT- FORS GE DISPOSAL iiSikbf - - OW Town or Y 46-'. n'. .%T Z;l Subdiii e Snbd. Lot # T Map 7 Renewal� 0 slon MI ie:�; AS Owner/Applicant Nellie_ Date of Pre as' Upro A Mall1iii; Address Town p Rallding 045 7 �/J Lot Areas F7#ili Section Only Type �TCIEID Notil&tlo6 Is lte4nlried Wlin7FM is, completed Nun�ikiek. dt li�s Deslin Flow G/P/n n . -Se de Tank 54'a S, sl Separate sewerage to con at of an, p lo,W'6onstracted by I ." .11. - . �-*-',',' - A'ddress: 7 Address Rum c, 4, MV11111- qq�61� Drilled qk by 9*0r Regalrements Aq I ttiat�l am wholly ei;ly-.resp (s) ;,r.Lj,that xne- separate, sewage disposal � ,� system -P dam a6ovi d xr, e constructed 'ii,shown-on in cv M, tandirds,kiiis and regulations of lh*' Department of Hiat6, iamli.that on completion the Commissioner - of H�iuith will County Depaf 'Piet ion:-!: thereof a.,!-pprwi"te;, isfaoiior� to lier _�er will be submitted �t6�: the Department, the bulid6i '1�6A said :iiiull A I n 'goo operating ' ' ' Flu ly At 1 0 'i , IG 1)41�41 , , - - ' ' ' _t* Cor P'Jilo nj e issu- ance j�i'rt of, said sewage pisp sak sy" .9- d e ie ollowing theda 0 �of the dj'rtificlij,6q I ' 0040 t *the ance of -the approval.1 ion . 1 're her, 't drliiiid Welldiii�rjbed-:above will be located-as shown pn.thq approved plan and that saidwel I will -instilled i C ne a s les and* oni 5f the ouiriarn County qDe rt tIof.Health 7t if Date_:� a P.E. R..A. A _v. 6y d a he M-1 0 --'— 'V 12 F A 7 ddViss ib License N 0 APPROVED ISI FOR COSTRUCT!qN!,'This _approval "pires�'one yeak•fioqi tl�ej a oLiov c 'n cton 07 the b ilding.has been undertaken and is '#Y,�ll�arnended o revoi:ab!e for cause or may nqdifi0,when.consid#r@d'n e r Ith. L Any change or, altera 60, of-constrkctlon re4uWes a new permit. Approved for'- disi6ialq of domestic sin ifa'� y a P only: —7 Date Title DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 - pAP,P:F IGAT3C`N 2 CON.T:HTi.CT'_.:;A-:_YI&TFI2. I - - _ P Ut CHD PERMIT #!'. WELL LOCATION treet Addr ss Town /Village /City. Tax Grid Number /e• /- i -' 3 T ;.e_ i4 "Per �J �,i► l�rr / : /a a – 2 - 1 WELL OWNER NaiCe Address / rivate c f C_ "9_50"14,' V did ° r ire° P!' ❑ Public USE OF WELL 0 - primary 2 - secondary 931RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS ❑ FARM ❑ TEST /OBSERVATION 0 OTHER (specify ❑ INDUSTRIAL CIINSTITUTIONAL ❑ STAND -BY 0 AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED L4 /EST. OF DAILY USAGE ?0Q gal REASON FOR DRILLING EW SUPPLY ❑ REPLACE EXISTING ❑PROVIDE ADDITIONAL SUPPLY ❑TEST /OBSERVATION SUPPLY ® DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ®DUG 13GRAVEL El OTHER IS WELL SITE SUBJECT TO FLOODING? YES P-' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name / �r+�al ; /�/��F sG�7 Address: '6' Vr IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: .., TOWN /VIL /CITY DISTANCE - -TO:. PROPERTY .FROM.._ NEAREST WATER- - MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION N SEPARATE SHEET (date) f (_ atur PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issuer ,'e�' -19_s� � Date of Expiration• 19 p ermit ssui ffici Permit is Non - Transferrable �T� s APPENDIX B DIVISION OF ENVIRONMENTAL HEALTH SERVICES PUTNAM COUNT DEPARTMENT DEPAMENT OF HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET (Name of Owner) (S CQMMFNTS YES IF trench required - c&-O 60 ft. max. Parellel to contours. .ON PERMIT BY: Location) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc Hole Depth S/S SUBDIVISION Perc (3) Fill cd House Plans - Two sets Well permit; PWS letter Variance Request GENERAL Legal Subdivision Subdivision Approval Checked 1]x-approval SSDS Adj. Lots Checked Wetland (Town /DEC Pen-nit R & D) Data On DDS Plans & Permit Same RBQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) 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: perc and deep results Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shcwn;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w/in 200 ft. of Proposed System Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1/411/ft. 4"0; Type pipe No Bends; Max. Bends 45* w/cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 101 to P.L.1, Driveway, Large Trees,Top of fi' 20' to Foundation Walls 100' to Well; 2001 in D.L.O.D, 1501 pits 100' to Stream, Watercourse, lake (inc. expa 151 to Drains-Curtain, Leader, Footing 35'to catch basin,stormdrain,piped watercour. 10'. to Water Line (pits-201) 501 intermittent drainage course Septic TE�E 101 fran Foundation; 501 to well 15' Well to PL - - wo- i ( P �- -L i-y, I + A T 13 PUTNAM COUNTY DEPARTMENT OF HEALTH Z7 U.Z Date �/Z 7`�� /-N 0- /Z Re: Property of A Located at /3�rTe, -�� Subdivision of Subdv. Lot # Gentlemen: Section,,,-' Block Lot Filed Map # Date This letter is to authorize -7�---$e'-0'1 � V 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 coiutection.;,i-ri.-t'IT- thi-a-m - " '.:, 1. :. - -. - - -s "V-i-'s'e'*XIx:e-.c,-'o ' +';" -o33-bly, s a. id- W-t ". - I.ip 6 i . - I . rstrud i system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very tr ly yours, l /U Signed Countersigned: d' Owner of Property Address 7 4.6 �72 10S Address Town Telephone Telephone DESIGN DATA SHEET-SUBSUFACE SEWAGE DISPOSAL*SYSTIN FILE NO. /;7 Owner, 17-cll�a :.Address Located at (Street) 13c Sec.,/,--'2- Block Lot (indiarife nearest cross street) Municipality /'0 � 01,,7 Watershed Date of Pre-Soaking Date of Percolation Test _>_ HOLE NUMBER CI= TDE PERCOLATION PERCOLATION Ran 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 7 ;17 21 3 Js lS' 4 5 V 4 5 2 3 4 0 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 submittiBd for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 e r TEST PIT DATA REQUIRER TO BE OF SOILS APPLICATION DEPTH HOLE.NO. HOLE NO. HOLE NO. -•¢ • n = •r,��c. - °. ��:..`.r.. .'"�'.# '.'..� • u.�.." c • .,.Ca tr.. �' !y,.rl •- �. e. , ...�,. �, a':..,;,,�.�. ... -. �v ;ri': '.%w • e•.�. ." c� Z._; • �� "'':.. �� :` •.' :. 1° 4° 5' 6° 7' 8' 9' 10° 11° 12° 13° 14' _. •- - �INI31l AT-le`LMM, `tll� W IIC"it ` vtcw' �' IS tt' INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER jBEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE DESIGN Soil Rate Used _ Min /1" Drop: S.D. Usable Area Provided Noe of Bedrooms Septic Tank Capacity � gals. Type 11-6,560/Y Absorption Area Provided By ,-/� L.F. x 24'° width trench Other Name Address 41 USE BY HEALTH DEPARMNT ONLY: of -1. Signature �� 0 ONNIQs ° "° f s` °yG v QP' � p..• y J 3 f1.9 - pih�. Soil Rate Approved sgeft /gal. Checked by Date 3 Public Health Director -Y, - i--LORZ1 -iW TVIOLINARI k.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 WIC (845)278-6678 Fax(845)278-6085 Early Intervention (845)278-6014 Fax(845)278-6648 Preschool (845)228-5912 Fax(845)228-6113 July 8, 2002 Charles Babish 44 Barger St. Putnam Valley, NY Re: Accessory Apartment- Babish Three Year Approval- 44 Barger St. Town.: Putnam Valley Tax # 85:13 -1 -34 Dear Mr. Babish: I have received and reviewed the plans for the proposed accessory apartment at the above - mentioned residence. The proposal for the apartment has been approved as per plans bearing the approval stamp form this Department dated Jul 8., 2002 The apartment is approved for three years with the following conditions: 1. The total number of bedrooms in the apartment must remain at One without prior approval by this department. 2. The total number of bedrooms in the main house must remain at Three without prior approval by, this depw.ment:.. 3. The area of the existing sewage disposal system, and its expansion area, must be maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly yours, William Hedges WH:kg Senior Public Health Sanitarian cc: BI BRUCE R. FOLEY Public Hecltr. Director LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-6.130 Fax (845) 278 - 7921 1 ursing Services (845) 278 - 6558 WIC (845) 278.6678 Fax (845) 278 - 6085 Early Intervention (845)279-6014 Preschool (845) 278 -6082. Fax (845) 278 - 6648 Date -o z- 11 9 9101.1 X-00 Renewal ❑ a Yes No /.VO/ � STREET �l , �y 57'- TOWN A //eV TX MAP # " – 5 NAME �%�15 �l Jj�S �I PHONE �^ s ~ N PCHD 4 -0 a MAILING ADDRESS�/%�� e j-3 yt MAILING ADDRESS OF APARTMENT NM-2 ER OF BEDROOMS IN MAIN HOUSE 3 A. Nliplyl ER O BEDROOMS TiV APARTMENT % Please submit this form and the requirements on page two to the Putnam County Health Dept., 4 . Geneva Rd., Brewster, NY 10509, Phone 278 -6130. Approval is effective for a three year period. The applicant must reapply at the end of each period to renew' the legal status of the apartment. Signature of Applicant A�vvroved Date to �5 By Title OFFICE USE Comments m BRUCE R. FOLEY Public Heath Director •r...p.. �'S" ��..�M�- .OH,��b.'. i.. 9.• L:! rv1�I ` \'�. . 4�'(T -lam .�. r CMS .�l� W.- LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278.6130 Fax (845) 278 - 7921 Nursing Services (845)278-6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 . WMA Approval is effective for a three year period. Please submit the following 1. Certified check or money order for $100.00 2. Sketches of floor plans for both main house and apartment (drawn to scale; all living area including basement) * Non- professional sketches are acceptable 3. Coliform Bacteria water sample results from the apartment. drinking water supply. 4. Septic tank pumping receipt plus letter from pumper that tank is in.satisfactory condition. 5. Copy of site plan showing well, septic, and parking area. Include date of installation if known. - babel a11_:w�lls.and septic systems within 200 feet of.the.property line. 6. C opy of Certif cafe or Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. Approval by this department is for the water supply and subsurface sewage treatment system only. The applicant must apply for and receive approval from the individual town to occupy the accessory apartment and must comply with all applicable rules and regulations set forth by the town. Failure to supply adequate quantity and quality of drinking water or a failure of the subsurface sewage treatment system may result in the immediate revocation of the approval by this department. Pg. 2 Nov. 2000 BRUCE R. FOLEY Public RecIA Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF . I Geneva Road - Brewster, New York 10509 Environmental Health (845) 278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278.6558 NVIC (845) 279 .6678 Fax (845) 278 - 6085. Early Intervention (845) 278 - 6014 Preschool (845) 278-6.082 . Fax (845) 278 - 6648 ACCESSORY APARTMENT APPLICATION Date c<-S, Ao L Renewal 1:1 19 Yes No STREET -TOWN1' ;144601 TXMAP# V ' 1-�Pqr- NAIME al" PHONE PCHD MAUNIG ADDRESS MAILLNG ADDRESS OF APARTMENT N-UTIMBER. OF BEDROOMS IN MAIN HOUSE 3 SIN 'MENf 7" XUMBEROFMWROMI A.PAkf"N Please submit this form- and the requirements on page two to the Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10509, Phone 278 - 6130. rev Approval is effective for a three year period: The applicant must reapply at the end of each ar;nel to rpnwtv the legal status of the apartment. .. . .-.. -L_.— - - Signature of Applicant Ac-Approved ate V ;:z;tz to ';TI-111'9� 14'::--)>— By Title OFFICE USE Comments Ul �-V BRUC_7E,t R. FOLEY DEPARTMENT 1 Geneva Brewster, New ��ca cy A vlir rrPrl '9,; 'IvI X Associate Public Health Director Director of Patimi Services OF HEALTH Road York 10509 . Environmental Health (845) 278.6130 Fax(845)278-7921 Nursing Services (845) 278 - 6558 WIC (8 45) 278.6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 •' IWKIMa 1 I Approval is effective for a three year period. Please submit the following : 1. Certified check or money order for 5100.00. 2. Sketches of floor plans for both main house and apartment (drawn to scale, all living area including basement) # Non- professional sketches are acceptable 3. Coliform Bacteria water sample results from the apartment. drinking water supply. 4. Septic tank pumping receipt plus letter from pllrnper that tank is in.satisfactory condition. 5. Copy of site plan showing well, septic, and parking area. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. 6. Copy of Certificate of ftu�aancy from T ,owrl gr Ctrt�owtion: om, Buil i g-Dept: i* i- regal: bed, oolu co welling. Approval by this department is for the water supply and subsurface sewage treatment system only. The applicant must apply for and receive approval from the individual town to occupy the accessory apartment and must comply with all applicable rulestand regulations set forth by the WWII. _ ........ Failure to supply adequate quantity and quality of drinking water or a failure of the subsurface sewage treatment system may result in the immediate revocation of the approval by this department. Pg. 2 Nov. 2000 DRIVER= TIME= 914-737-3700 FAX=914-737-7918 WORK INV= 367342 CORTLANDT TANK AT WIND RIVER ENV. ACCOUNT-- - 29645-tUVU-]�., �pql� ....... LLPIMNE=845-526-3810 TAXW= 7.28 MONTROSE, NY 10548 SITE PRONE=845-526-3810 TAX#-D ❑ PO#= TERms-NET10 ORDER BY= SALES= N DATE-04/18/2002 BILL ADDRESS SERVICE ADDRESS CHARLES BABISH CHARLES BABISH 44 BARGER ST. 44 BARGER ST. PUTNAM VALLEY, NY 10579 PUTNAM VALLEY, NY 10579 SERVICE DESCRIPTIONs/PkTES QUANTITY P PUMP SEPTIC 4 #TJ(S: 0 D10:2 TYPE; COVER: AMOUNT J124 S UB - TOTAL , 3 � TAX e2, IvIrW UvIal lia.L.7 J-HYV.LkZl EOSE FT: GALLONS; CONDITION: !F/! t r kJ( LOCATION: 44' COMMENTS :\,\ - -BILLI:NG INSTRUCT: DIRECTION: INVOICE ITEM CODE DESCRIPTION . 0 'J $10 RETURN CHECK CHARGE STATEMENT AS OF04/17/2002 CUPM74T 0.00 31-60 DAYS 0.00 61-90 DAYS 0.00 90+ DAYS 0.00 TOTAL DUE 0.00 QTY 0 TOTAL AMOUNT DUEi: - AMOUNT PAID: CHECl(# or CASE i 7-zl-Z-- 1/6 6 3 RECEIVED BY: Z no I - - "il G.......... oN °57 PAWLING LAKE PAWLING, NEW YORK 12564 (845) 855 -5181 Charles Babish Maryann Babish 44 Barger Street Putnam Valley, N. Y. 10579 The attached report shows that the results of your water test came back satisfactory. If you have any questions, please do not hesitate to contact us. Thank you for using P.M.I. Home Inspections. Ver tr yours, w R. PARKE R. Parke, P.I. for P M.9. Certified Engineer P.M.I. Home I nspections �1� -� 66292 u - .. . �..._ .«— -6 -02 Hi 0,4:51 FM YML FAX:914245317(i FAUE 1 ear `, ;;.. _aT�"y:` .. , . raa.t:is,r ('• H. PAdovan'z ,l L•)irer:tur•` LM #;: y3 ,, 201.124 CLIENT ih: 461 T NION E:i-fAT PROC PAGE i ...NNN.YNAIw•N.YNNN.YMNNwe.v n.N -Ir N.vN V.. MMN.V. NN N•v Nnl IV.rNNAlNNNNwI.y....vn Al r..... nr rvnr nrNnr nl llN141A•NIV IV I,!wlly w•A.M/VN F'Irtl NJTIE: I.INJGPC- CTICJNE- DATE /TIME TAKr—.NY Of+ /R4* /0? llt.t0t) 57 PAWL I NG LAKE DATE /TIME_ I I ---C I ? : 04 /r�.4 /f.)P ' I ?_ t I :9 BOX 57 Rr-- ORT DATE, 04/26/02 I= 'AWL.INI3 - NY 12I 64 PHONE,, SAMPLING SITE -3 44 BAFOE R. STP;EE::T . PUTNAM VAL -LEY. NY SAMPL.E:. T Yki A n P07"A ALE i �,' I T (;HFN TAI=' PRESERVATXVES, NONE COL ` D 14Y:: S. PAFtkC: 'iTE- MPE ? < r tF1YLIF E. .t �r, Iv�TEE ... r_.cJt_ x r t�r;rl MEM.I r: PII:; N NaV IVNNIVM rlN +v.YM.Y IV IV N+. rNM NfV .V NIV .YNNIV Al.4 +M .v /IIV A+nr N.VU+Nn. rnr n.N....vr.NN.�we Nn.AfIV IV I.l1•r. rinlrlN nrKnll./rI AI NJ•+�rl n: DATE F= + -_AQ F- 1RDc.L"I.,VliRE: RESULT NORMAL_ — PUINGE METHOD 04/26/02 I.lc: T. lIJL.IFfJRM ABSE:ITF /100 NL A8SENT Iclo8 QOIIMFNTS F Ax TCl COM1,11FNTS BAC:T THESE: RE:EA1L -TS I IVDIC'.ATC-- THAT THE WATERS (WA'S . (WAS NOT) IMF A SAT It3FACTGRY SANITARY QUALITY ACCORDI M. THE NEW YORK ST AND EPA FEDERAL DRINKING WATER STANDARDS), FOR THE IDAh'AmE•TF.Rs TESTED, AT THE rI!•IE; OF' COLLECTION. ado v, n 'i.., N. T. (ASCP) birector EI_AF'# 10 02Z; Or, O'd U1 -I .r CERTIFICATE OF OCCUPANCY Oi),.-2 Farr.,ily 8 Certificate of Occupancy No .- .I C. ....... Applcation No ...._...... .;j .j .. ...... Location of Premises Ler:--ir STreet — MJ1122-2-13 :..: ... ::%': ................................ ............................ ................ I ........................................ '04 V J_ 1 V ...................... ............. I ...... ............. ........ 1.e Y.j ...... 1.y having heretofore filed an application for a building permit pursuant to the Zoning Ordinance, Sanitary Code and the Laws in effect in the Town of Putnam Valley, Putnam County, New York, having paid the required fee therefor and the undersigned having by personal inspection ascertained that the applicant has subsequently proceeded with the erection or improvement of the proposed struc- ture id ,compliance with the requirements of the laws as aforementioned and that the - said work and materials met every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready for occupancy pursuant -to the provisions of law, Now, therefore, this certificate of occupancy is hereby issued under the seal of the Town of Putnam Valley this day of ............. ju.IY .................. 19 ... Not Valid unless signed in ink by a duly authorized agent TOWN�:V�VTNAH VALL NEW YORK of and under the seal of the Town of Putnam Valley. .... ....... ... .................. ky ......................... L LI -Az= rl Putnam County Pepartment of Haefth ,pprovedasnoted or con" lormancewifl, pplicable, Rules acid Regulations of the utnarh County-Health- Department. 313 ol 1- Lt y A3& Ea F. ffm roved as noted for conforrnRn('iWItI, :dicable Rules and Regulations fit the atnam co aith Department. - 21- IE & Tide 7 I / A4. of JA C K '� CO S. 75 CO .i E EVE �YN C3. q r —y �S. i� _ i h r S •`o in i %rr� \ •�� TORT ^rELE ALL h ` _ V V •3 • W n_ r ;i VON c` L� B . o yes I O .rt-ss �X� YT��+y^�.4}�G`-'�L -St •.:� ; } arm .r �,,..+�r -�b<� 1' �C.Y� -f :�3�4 __ ��n' -•`D _ _ - - - K� ''+rr., t i*`.• .. -.yam • ��,s�. ».., ,S.,,f -;, ' �? '6: �^.- ..{ i G. _ i .Y " z£ e•l. 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