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HomeMy WebLinkAbout4789DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.32 -1 -3 & 91.32 -1 -4 BOX 36 loom No No III 1 . i ,, ' III ' I�`, No ■ yy .111 � ` A No I 'Tr I r No I 1 No I of i ' :u!] u I a I y �S l . DMtlsls •[.n.l�.s1�1 ROOM gale & C4•b X T. low � O��Qf1A�[Ki, UNION 6Eer oel.adA��■a.t R.1.. Petfaik . �vT.a✓!f �'I i Z L E _ JTU Data of Pavbsu Appwd Town 14, A04 C2 - -n .++.E TRW f m� ,,et Am 13, 9 flol �' Sftdm ab DP& _9" vbuaa Nmbw •[ Miwso - Dedgm Plow G P D — PC® NOU&Ed R IS Required wbn Pe IS e•ogi•ad M..r s...o@ sYom to am" •[,/O 0 O OWIM gOP& lank MW ToIb•:ea1ag, ded b isLr /9 �G'QT At dmn �L.� % A / �"y wow Ad&vn an �j SIP* Blow by 4664 L —Addloss otba �....�. 1 r•pns•nt'.that 1 am wholly and completely responsible for the design and location of the proposed system(pi 1) that the se crate sewa • di I s slam aeeve described will be constructed as ,hewn on the approved amendment there to and in accordance with the standards. rules an regu a ores o • County Doom MI of ""Ith, and that on completion.thereof a "Cenificat• of Construction Compliance" Satisfactory to the Commissioner of Health Will as Sand"" to the Oep•rtm•i 1. and a written guarantee will be furnished the owns, his IUCatsserp. heirs or assigns by the builder. that Said !wilder will POW Sa good .egur I eo"*iofl, any on Of Said awspe disposal system during the period of two (2) yes knmedistNy following the date of the now errs of the appe•el of the Certificate of Construction Compliance of the original system or any regolrs thereto= 2) that the drilled well dewed a6ow wO be NeatM as shown on the apprevd pan and that said "I will be Installed flat with the standarft curs and 1`411RUMI --Of the hith•m Cwfley Cegurt Of h. � g� Cato S F.E. _ R.A. Adre _,/O C®� S '� d No APPROVED FOR CONSTRUCTION, This approval expires two yens from t date issued unless construction of the 0 ikling Acs been undertaken and is feaepble for cause or may be amended Of modified when considered necessary by the Commissioner of Health. Any change or alteration of construction twwbVs a new permit. Approved for disposal of domestic anitery awape, and /or prwste water supply only. 10/88 By Title JOHN KARELL Jr., P.E., M.S. Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Vincent Ettari, P. E. 1065 Spillway Road Shrub' Oak, BAY 10588 Dear Hr. Ettaris January 30, 1992 Be: Proposed Construction Permit Deena Schneider Elan Road, (T) PV 091.32 -1 -3B & 4 Review of plans dated September 23, 1991 and other material relative to a construction permit for the above captioned property has been completed by the Department. Based upon such review, and pursuant to the provisions of Article III of the Putnan County Sanitary Code, you are hereby advised that the proposed method providing water supply and sewage disposal are considered inadequate as set forth below, therefore, approval of these plans cannot be granted. -I.- The- Tax. Asap. number,. 91.312 -1 -3B 8 4 ..are nod described . .n the latest. tact . se . bmoke It - appesibi Wet` subdivision � 00rov l- mould` b6� requifed' by - bath this Department and the Town of Putnam Valley. Please subeit a letter from the Building Inspector stating that the lot described above is a building lot. 2. The well permit is not signed. 3. The proposed well is located 21 feet from the SDS to.the north. A minimum separation distance of 100' is required. 4. The proposed well is 59 feet from the proposed sewage disposal system. (40 feet toe of slope). A separation distance of 100° to toe of slope is required. 5. The proposed leaching area does not allow for any further expansion. Expansion area equal to 100% of the proposed primary leaching area is required. 6.. The proposed leaching area is shown 4' from the proposed residence. A minimum of 200 is required. 7. The proposed well is shown 10° off the property line. A minimum of 15' is required. } 8. The proposed residence is shorn 6' off the side property line. Zoning may require a greater setback and therefore eliminate some of the limited area available for,seva9e disposal._ -. .-:T".. � y:.::, •: -:..:'�ls-� ^ Plar�- •c�Bibir3d•-b3`sd�- �if11= ��tioa�=diily ©i� "1'0� Mrequ= i�r3ng�a - dept�� �f• 2:i< <�cSx*•aiore.� � �� :+•��. ;:- 10. Pere test must be run at A minimum depth of 30 inch. If you have any questions, please call me at Ext. 304. Very truly your , ohn Karel , Jr..,' P. Public Health Director JK /jp APPENDIX L PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISIO OF -EN`JIR(jUMUAL • HEP.LrM °StRVIC E DATE: • RE: Property of /I/ ,C7 -Located at (T) �c� , 11,411'e V Section Block_ Lot Subdivision of G/� �G� - S�EiLL S'�Cj Subdv. Lot # /-2 Filed Map # Date Gentlemen: This letter is to authorize X/ I dAcw dam, e 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 Cmimissioner of the Putnam County Department of Health, and.to sign all necessary papers on my behalf in connection with this matter and to supervise the construction -of. said. sys.tem,_or._systems.. -in Qonformi.ty with ...the . provisions of Article.145 or 147, Education Law, the Public Health Law, and the Putnam County Sanitary Code. Countersigned: PeE,, R,Aa, # O�o #4.rP Address Telephone Very truly yours, Signed: Owner of Property -2) Address /E 4I- F*J1r' /GL /03"3 j Town Telephone 19 PC -1 1 PUTNAM C OUNTY D E PAR'�ME.NT O F H EAL TH ' _ •: °': „� - �Ft�G'Al'i ©I�''F'0tPPFiOVAt' bF' Pti`AIVS' r''`1 Name and Address of Applicant: 9 2. Name of Project: 4. Project. Engineer: Location T /V /C: 5. Address: License Number: D o S Phone: Type of Project: __C Private /Residential Food Service Commercial 'Apartments Institutional Mobile -Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (Check One) Type I. Exempt_ Type II. Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required ?. ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ......... ... 4 10. Name of Lead Agency .11, .Is_this.project..in:an area .under. -.the control. of -local, planning., _ zoning, or, other o'Ff i ci als-, 'ordinances? ..":`. :`::.::'::: :::.:...'.:.:::.:.:. 12. If so, have plans -been submitted to such authorities? ......... ..........� 13. Has preliminary approval been granted by such authorities? Date Gr ,o rs M Za ! /06;v p /giF7E�' T-MIMIMM 14. Type of Sewage Disposal System Discharge...... Surface Water ✓ Ground Waters 15. If surface water discharge, what is the stream class designation ?......... 16. Waters index number (surface) ............................................ ✓_,,�,� 17..Is project located near a'public water supply system? 1E, j 18. If yes, name of water supply �� !E.�S.tiL L Distance to water supply .SU 19. Is project site near a public sewage collection or disposal system ?..... _ 20. Name of sewage system Distance to sewage system AI/IX 21. Date observed:, . 23. Name of Health Inspector: 24. Project design flow (gallons per day). .................................. . 0 0 2. :_.., ���I��S 'tat1�- 14it °-�i��cMa�r�, fl�'ini-r�a�or�aS}%stei� "� °��5 •Pe��� i�a-t�cltia�.,.:. _n.�,. 26. Has SPDES Application been submitted to local DEC Office? ............... 27. Is•any portion of this project located within a designated Town or State wetland ? .................. ............ ............. 28. Wetland ID. Number > ......................... ............................... A11 29. Is Wetland Permit required? ... ...... Has application been made to Town or Local DEC Office? .................. 30. Does project require a DEC Stream Disturbance Permit? A10 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application'or industrial.activity? YES or NO U 32. Is project located within 1,000 feet of existence of abandoned landfill, . hazardous waste site, salt ,stockpile, .landfill, sludge disposal site or any other potential known source of contamination? ..............YES 'or NO DESCRIBE: 33. Is there local master plan or file with the Town or Village? �S 34. Are community water, sewer facilities planned to be developed within 15 years? ,re-:: SS 35:-Are any sewage disposal areas in'excess of 15%'slope? '........ J� 36. Tax Map ID Number ........................................................ %% —;:LZ ' / ;32 31. Approved Plans.are to be returned to:................... Applicant ✓ Engineer If the appl,ication is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 290.45 of the Penal Land. SIGNATURES &,OFFICIAL TITLES: MAILING ADDRESS: �!1 ��� 5� /�� A V, PUlmm COUNTY DEPARTMENT .OF HEALTH DIVISION OF HEALTH SERVICES -DESIGt1-tAtA ° E`%-' (iH i7F t'E =`` TP E:,,DISPOG— ;MS`S T-5t:-�- +Ls'ne. .•q`r " -►7al / ►J :L'S 1`i+6'd ,S:•,C"s:FC'1`I�i'i ``'`^ '��'•5�r •; �'.,a.n w+:r --. Owner.E�!✓� . �G'/JiVEiPP Address _,4,4E ,037 - Located at (street) 7- Sec, .9/:.. (indicate.nearest cj; s street) Municipaiity v e Watershed SOIL PERCOLATION SST DATA REQUIRED. 4n SE'SUBMITTED WITH APPLICATIONS Date of Pre'- Soaking .?- Date of Percolation Test HOLE NC�iBIIt Q,OCIC TIME - PERCOLATION . PERCOLATION Run. Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate *2 Start -Stop Min. Start Stop Drop In Min /In Drop 00 If 23 Inches Inches Inches :�� �e? •:/ ff bird / 02� 1� all. �7 .5 03 e�2 *2 /,�: D �' /��' �� '� J ig✓ / �r 4 3 �r ;; d 7 3 00 If 23 �. Q :�� �e? •:/ ff bird / 02� 1� all. �7 NOTES: 1. 2. Tests to be repeated at same depth until. approximately equal soil rates a.re• obtained at each percolation test hole. All data to'be submitted for review. Depth measurements.to be made fran top of hole. i r ? TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH ^r=w �i:s�4,.•- HOLE NO HOLE NO.. v2 HOLE -NO a ; .=a- ...:�,;w -.. cr•. .qw, :.�.' �:� �'.. ��•.i�?yeq,%e <wvu-.eA r, sv: -• .= „#.tt. Gba •-•' ^iy��...ar ....., G.L. D�'Sd /L 6mC,1 ;,- �p,(Gli<vae, DSo %I- �a26ffs✓ /� 2' 3' 49 59 6' 8° .10° 12' 13' 14'. INDICATE LEVEL AT WHICH IGROUNDWATER.IS ENCOUNTERED /()6. -t/�F INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEER HOLE OBSERVATIONS MADE.BY: DATE: f w�ra�ss�� Soil Rate Used <,:2 S Min/1” Drop:, S.D. Usable Area Provided o No. of. Bedrooms Septic Tank Capacity gals. Type e�ov Absorption Area Provided By JP6 L.F. x 24" width trench Other THIS SPACE FOR USE BY HEALTH- DEPARTMMqr ONLY: Soil Rate Approved . sgoft /galo Checked .by Date _... DEPARTMENT OF HEALTH Division of Environmental Health Services 10 COUNTY CENTER - CARMEL, N.Y.. 10512 (914).225 -3641 _ t _ •Yd w ':�4. A?PhIC -ATI ?N - TO � EONST�R C�I'� �. �TA'FEI2 F9_nL;'- -:.:.. ; - PCHD PERMIT # WELL LOCATION Street Address Town Village City Tax Grid Number WELL OWNER ame ENf7 M61 11n �7 Address Wrivate k O Public USE OF WELL 1 - primary 2 —secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL �/El�litYdG 0 PU SUPPLY. ' Q AIR /1COND /HEAT P O ABANDONED O FAtM Q TEST %OBSERVATION Q OTHER (specify O'INSTITUTIONAL 0 STAND -BY O AMOUNT OF USE YIELD SOUGHT " gpm /4� PEOPLE SERVED_IEST.,'OF DAILY USAGE Q O. gal REASON FOR .DRILLING. 12MEW SUPPLY ,REPLACE EXISTING SUPPLY Q PROVIDE ADDITIONAL SUPPLY 0 TEST /OBSERVATION 0 DEEPEN EXISTING WELL DETAILED REASON FO DRILL; E.,- �' /1/ NJ CA L . Ole Cta/ Ou J& WELLTYPE OR ILLED DRIVEN DUG OGRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES, NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: L . S/«GL �/• Lot No. J.2. -/19 WATER WELL CONTRACTOR: Name ,BEi9L Address : STf;P IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: 1.1/ YES NO S u 7vw e? 01114 y NAME OF PUBLIC WATER SUPPLY: �/�, �E��S/�1LL TOWN /VIL /CITY IMSTANCE°.'.T'O' ' FROM °NEAREST-�WATER-MA -1N. :- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION )!ION SEPARATE SHEET (date) (signature)' PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within 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 Issue: 19 Date of Expiration: 19 Permit is Non - Transferrable 2/87 Permit Issuing Official White copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller BY PENN LYON HOMES INC. MODULAR$ BY DEGION INQ P.O. Box 783 Mohopac, N.v. 10541 (914) 628-2626 I.. BA 102 HATH'I HALL KIICHEN I LIVING RM FOYER DINING BATH'2 • �j' KITCHEN CHARLESTON 27'X48' Ste* 6 T 'BATH'2 BATH'2 X 0 KITCHEN DINING Jc:�A -; BED RM' I BED RM* I LIVING 'RM DINING HALL HALL 07 0 .(DBUH i. LIVING RM BED RM'2 FOYER FOYER BED RM'3 BED RM'?. BED RM3 MK n' KITCHEN ➢ Ilk. RALEIGH 27'x48' HARTFORD 27 x52' PENN LYON HOMES- INC. PENN LYON HOMES OF NEW ENGLAND Old Trail Road, Selinsgrov"6 P&.1 7010.. RFD #2, Box 92C, Tilton N.H. 03276 Telephone (717) 743-011"1 I Telephone (603) 286-4141 I I BATH'2 • �j' KITCHEN DINING 10BAT 11 1 BED RM 01 ..1 HALL LIVING Rm BED RM13 BED RM'2 LANSING 24'X44' Ste* 6 T 'BATH'2 BATH'2 X 0 KITCHEN DINING Jc:�A -; BED RM' I BED RM* I LIVING 'RM DINING HALL HALL 07 0 .(DBUH i. LIVING RM BED RM'2 FOYER FOYER BED RM'3 BED RM'?. BED RM3 MK n' KITCHEN ➢ Ilk. RALEIGH 27'x48' HARTFORD 27 x52' PENN LYON HOMES- INC. PENN LYON HOMES OF NEW ENGLAND Old Trail Road, Selinsgrov"6 P&.1 7010.. RFD #2, Box 92C, Tilton N.H. 03276 Telephone (717) 743-011"1 I Telephone (603) 286-4141 I I L t 390 J ---.—SLOPE FOR; ' CLAV HARRIFR'WN THIS AREA 394 EDGE I]F KILL 96 - I. TOE OF Ctoy E.BAAKMFNT 7402 —\­ 404 40: o l_\ )4 10 i 4,2 • W a 414 w 4 1 16 143 4 17 2 t ll- AN 30",