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I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONM— FNTA:L- HEATsTH. CE.RVI!r'FS- CERTIFICATE OF CONSTRUCTION COMPLIANCE F REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # , 3_ Located at Z-44 (:�or Village Owner /Applicant Name C-n,,� Tax Map "l Block �_ Lot =� Formerly �o �.-- ��,,.. i a,, L,,�. L1, • Subdivision Name L ,,,�� � -M Subd. Lot # C;� Mailing Address 3n Zip taS&.Z Date Construction Permit Issued by PCHD Separate Sewerage System built by 'j - p�,.,�,� Address c�;,,.,�,,,e, , ti Consisting of Gallon Septic Tank and Z , W ,,4 e _ t.(z�cq "-V-- -==.._,,.a -. � Other Requirements: Water Supply: Public Supply From. Address or: Private Supply Drilled by ?.I=. Address gm,;,, sEk, h� Number of Bedrooms Has garbage grinder been installed? Wc> 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 regulations of the Putnam County Department of Health. Date: -1- t _ "M Certified by Address vac P.E. y, - m'"ticense`# 4%�►e-1--st Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatio , modifi ation or chan a is necessary. By: Title: t Date: t s" White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy -Design Professional Form CC -97 s , PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERWCES WELL COMPLETION REPORT ",jc,4 -"& z c.�T .-G7 d a cnkaum r� - - - S ' eei Church Street rlcress: JViica l age: Putnam Valley - tfax-'Urid # Map 7 3 Block 1 Lot(s) WellO®vner: Name: Address: V.S. Co oration, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling ]Equipment X Rotary Cable percussion x_ Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length _eft. Length below grade 31 ft. Diameter 6 in. Weight per foot 191b/ft. Materials: X Steel Plastic _ Other Joints: Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Lin er: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed. First _ Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 6 gpm Depth Data Measure from land surface - static (specify ft) 5' During yield test(ft) 180' Depth of completed well in feet 245' Well Log If more detailed information descriptions or 6Sieve Y o a 1�: �s C . are available, please attach. De th From Surface Water Bearing Well Diameter(in) Formation Description fft. fft. Land Surface 15 Drilling in overburden clay and boulders 15 Hit rock at 15' ..� _ :3l ir._ -j n _i 'rT Yf,f'nY� 32 245 Drillinq in rock ciranite If yield was tested at different depths during drilling, list; Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 qpm Depth 200' Model 5GS05412 Voltage 230 HP 2 Tank TypeWX302 Volume 86 Date Well Completed 6/2/99 Putnam County Certification No. 002 Date of Report 6/9/99 Well Y Le Nu>< : l;xact locanon or well wrtn arstances to at i1eaSt two permanent lanamarxs to be prov ea on a separate sttemplan. 4 Putnam Avenue Well Driller's Name & 'So , Inc. Address: Brewster, NY 10509 Signature: Date: 6/9/99 P=ile;Yellow Beal White copy: copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 NORTHEAST LABORATORY OF DANBURY CT Cert: PH-9404 (203) 748-7903 - FAX (203) 748-.0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS 4 PUTNAM AVENUE BREWSTEP, N.Y. 10509 DATE SAMPLE COLLECTED: 6/10/99 TIME COLLECTED: 8:30 A.M. I COLLECTED BY: MTB JR. DATE RECEIVED @ LAB: 6/10/99 TESTED BY: LAB# 11471 REPORT DATE: 6/21/99 4V' SAMPLE SITE: V.S. CONSTRUCTION; 1,3 117#27101'" - 47-A1 ItHURCH RD., PUTNAM VALLEY, N.Y. SAMPLING POINT: HOSE BIB SOURCE,: WELL -NEB.' TREATMENT: NONE TEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL BACTERIAL: Total Coliform. (Bacteria) PHYSICALS: Color Odor pH Turbidity CHEMISTRY: 0 per 100 ml 0 per 100 ml 0 ND 7.31 no designated limit 0.40 NTUs 5 NTUs Nitrite N <0.005 mg/L as N 1 mg/L as N Nitrate N 0.62 mg/L as N 10 mg/L as N Alkalinity 214.0'. rng/L no designated limits Nardnesq. mg/L 0.30 0 mg/L Manganese <0.01 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 5.3 mg/L 20 mg/L** Lead <0.001 mg/L 0.015"** ml = milliliter mg/L = milligrams per Liter ND = none detected NTU=Units **Notification Level ***Action Level RESULTS BASED ON SAMPLES SUBMITTED:6/10/99 SAMPLE, AS TESTED ABOVE: MOTABLE or NOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828-9787 - FAX (860)829-1050 TOLL FREE WITHIN CT: 800-826-0105 e OUTSIDE CT: 800-654-1230. PUTNA M COUNTY DEPARTMENT OF HEALTH. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 7 CfRctc_�vt 73 i 163 Owner or Purchaser of Building Tax Map Block Lot 37 :fVcn ©v-.L -D i;?,P P07-W, -NA VAL4�El/ Building Constructed by Jf&3Willage CNURC d RCz> Location - Street RFS:� �tir�ia`. Building Type Subdivision Name 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,utilizi-ng the. The undersigned further agrees to accept as conclusive the determi�ation of e P li Health Director of the Putnam County Department of Health as to whether or not th fait re th system to operate was caused by the willful or negligent act of the occupant of the,buiding tilizing the system. Dated: Month -7 Day ( Year `k `� General Contractor (Owner) - Signature 3 7 <_"'R 0 r'c.��i V'N'PA Corporation Name (if corporation) Address: 3-7 -0*A-N -t7,C.,4,r> Signature: Title: oL:'.; FS. Corporation blame (if corporation) Address: State ©s s i N i u& 4&1 r. Zip ins C Z State Zip Form GS -97 N S T E ENGINEERING, SURVEYING& LA NDSCAPEARCHITECTURE, PC. LETTER OF TRANSMITTAL (2' 4 �1 'y 22 r *I a n 7 -'A Brewster, New York 10509 (914) 278-6392 7 DeLavergne Avenue (914) 297-1742 Wappingers Falls, New York 12590 TO: Date: 7-1 Job No. Attn: Re: -xt WE ARE SENDING-YOU .Attached ❑ Under separate cover via the following items: ❑ Shop Drawings gL Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change Order ❑ COPIES DATE NO. DESCRIPTION --------------------- .....__.........._...»...._......_.._....._.......__ ................ . .............. . ....... .......... ..................................... .... . ... . ........ . ................................... .......................... I .... - - --------- --- .................... ........... ........ . ...................... . ........................ . ....... .... . . .......................................... ....................................................................... ............................ THESE ARE TRANSMITTED as checked below: g -For approval...,_ mz — .. -[I- Approved as submitted.....- J]. Rqsqbrni!, [I For your use El Approved as noted Submit ❑ As requested ❑ Returned for corrections ❑ Return ❑ For review and comment ❑ REMARKS: i ........................................................... ...................................................................................................................................................................................................................... COPY TO: SIGNED: IF ENCLOSURES ARE NOTAS NOTED, KINDLY NOTIFY US AT ONCE Lot98.dot 99piesfor.apprjo.v copies for distribution corrected prints A Torn T&I r N1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMEl\TAL HEALTH SERVICES FINAL SITE I\SPECTION Owner t U e Permit r ?19 — Subdivision Lot r e__ 1. SewaQre System Area a. STS area located as per approved plans....... .. ..........:........ b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course/ wetlands ...... ............................... II. Sewage System aseptic t's e - 1,000 ....... 1,250 ......... other ................ b. Septic tank in el ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribtuion Box outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box - properly set... y ength required '� Length installedO 2. Distance to waterc arse measured Ft.......... 3. Installed according to plan ......... .......... ...................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .........:........ 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1 %Z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... _... _....___.:. ,: :....- 10..,Pi_� . .......................... w.. _.._d... - - - -a - Pump or Dosed Svstems Size ot pump c am e ........ ............................... 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 /cy-cle........... III. HouseBuildin a. house located per approved plans ... ...................... .......... b. Number of bedrooms .......................... ................I....... IV. Well a. Well located as per approved plans .............. b. Distance from STS area measured (0_ ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i Erosion control provided ................. ............................... Rev. 1197 - "— PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES y -,-, � .._- ..,;:= :..�.•.r..,�. >:� _ -_, --- ., .:_. ._ .:� a .._ >,,,,. _ :... ._. :,:< � - ;�;��- G...rr:.:..;�.1'w .:— ... , . ..,� CONSTRUCTION PERMIT FOR S GE TREATMENT SYSTEM PERMIT # V -(o --'( 2— Located at G V A-6 A-6V A-id 9 r Village PV ✓ "f- A1 VAz- .4jF,/ Subdivision name 4,r"c- X �!- Subd. Lot # Tax Map -7349 Block I Lot Date Subdivision Approved 01 2-q - L� OvAwlApplicant Name 3 7' GA6?7-e9,V DA P% C-eAP, Mailing Address 3 1- c Amount of Fee Enclosed r 3 ®dJ, 0 O Renewal X Revision Date of Previous Approval A "144, 03 114 M Zip /2 Building Type R- 6SVD,-0SuT .r/.�i! Lot Area -13.—)-*o. of Bedrooms _- Desi n Flow GPD 4 o�&O 13epae� p6tz Fill Section Only Depth Volume Separate Sewerage System to consist of /g e9 ©0 gallon septic tank and t Other Requirements: To be constructed by 3 �1 c A-P oev py ca go, Water Sup IV: Public Supply From Address 3:7- G ,KvTvA.i ,Qfi-M A040, . ps 2.t..Tiv /-/IV Address or "_ rnvate Supply Drilled by If 'r, "6E/l4- 4 5 e; 3 - , 'rn=' C - A&id e s - q-- ,PAfVWA i}vr 13r i yc I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s sY tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. Date �^ ^,c�Ss V--1- cF^T1/ G— o g GAVC V;rx -'fG^ 4— L.R�vO 5C.4vC Address License # 6 1 1 3 1 /4q6' Ac9ce7 -CXa- $AEw97-EA )40 V rc95c9 °L 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. Ap oved for discharge of domestic sanitary sews a only. By: Title: .14. fL Date: '- White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pr fessional Form CP -97 I P TI NAM COUNTY DEPARTMENT OF IFIIIEAIL'II"IHI i / IlDRVISION DIE ENVIRONMENTAL HEALTH SIEII VRCIES APPLICATION TO CONSTRUCT A WATER WELL ,� ?�::�- ::�,�-,�c �.-:.:,...:.��,�-:�::,: �°�'-�iea`se pn`ht or type":=- <,4, -,,,,� ate=- ..ti..��., ... .� :,'.w.�..,- �►��-= 'Il�'Y�ilt �''�1L WeIR Location: Street Address: o illage Tax Grid # 0.110 A, e-H .47,,V fP d0C--rA --',4 &I V ~C/ Map 73 „ Block Lot(s) L WeII Owner: Name: 3-7- C ^O r,'4�0 Address: 3-7- c Aerel, -, vot r4 Aa fo DA-m e9reF. P, v�S� r�1 evG� A,-� I ep 5-6 2- U e off We1h U Residential Public Supply Air /Cond/Heat Pump Irrigation - >rfl>nmarry Business Farm Test/Monitoring Other (specify) - secondiarry Industrial Institutional Standby Amount of Use Yield Sought _� gpm # People Served __q Est. of Daily Usage '3 ® gal. ]Reason for Replace Existing Supply Test/Observation Additional Supply IIDrrillU ng X New Supply (new dwelling) Deepen Existing Well IIDettaelled ]Reason for IIDrifling Weill Type _( Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes P No Name of subdivision (T"C4 Lot No. Water Well Contractor: 0, AA4Z, %-sv u s Address: It 0107AIAI-% AWa C-57"F� Is Public Water Supply available to site? .................................. ............................... Yes _ No k Name of Public Water Supply: ��/} Town/Village Distance to property from nearest water main: ," ,,. R/ wi'A Proposed well location & sources of contamination to be provided n separate sheet/plan. DeaM t.e _ : g�r .. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED ' FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue li✓ q q I Permit Iss 'ng O cial: . Date of Expiratio 14 11110 1 Title: I c. Perrum it is Non-Transfeilrable White copy - HID file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 t-tb-2.5-1999 10:09 INSITE ENGINEERING 914 278 6392 P-08 PUTNMI COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER APPLICATION FOR ,PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARIN NT To: Public Health Dire D- ' or , 1htfiernatterof app lica on for: 5;ST5 V& 37 C,"*--J 0A-"-,1UAt COW. represent that I am an officer or employee of the corporation and am authorized to act for: Nain of Corporation: —,-37 COr� !VA-P" /ZOA-I> Havitlg offices at: 3 � cezora-J Pf w -Irp 1i 05(/vt,46 ,cry z as"& 7— � Whose Officers Are• Q 01 1 -J President- Name: -A " tA Address: 9 o - -i-o /\ i —iDA mi r3d Vice President - Name: Address: Secretary -Name: Address: t .,-Name:: Address: and that 1. am and will be i to the'�#pproval requested idually responsible for any -, all subsequent acts relating Sworn to before me this ' Y�) day of ! MWLA (month) Notary PublW AMY L. KLEIN NOTARY PUBLIC, STATE OP NEW -YORK QUALIFIED IN PUTNAM COUNTY NO. OlKL5065476 MY COMMISSION EXPIRES 9-3 -` ZO Ferns CA-97 Corporate Sea[ ion with 1 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH - IINDIVIDUAL WATER SUPPLY & SUBSURFACE SELVAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PF.RNUT ' ;_ , ,,, : - •..... •: STREET iOCATION 101 2vt 1 V`�/ )- NAME & c tom- AM EOF• �VNER 1 REVIE3YR BY RINI, GR, 62mB, BH / DATE 31,11111? TAX NIAP # 4j". *Klrk_i ;GAL SUBDIVISION IBDIVISION APPRO AL CHECKED ;RC RATE LL //REQUIRED DEPTH �RZM DRAIN QUIRED 'ANDPIPES GENERAL )CATED IN NYC WATERSHED ANS SUBMITTED TO DEP iGATED TO PCHD ;P APPROVAL, IF REQ'D ;F&P TEST HOLES OBSERVED RCS TO BE WITNESSED :OSION CONTROL:HOUSE,WELL, SSDS , T APPLICATTON. tDDOCUMENTS ERMIT XPWS LETTER R OF AUTHORIZATION DATA SHEET (DDS) RATE RESOLUTION EA F PLAN - THREE SETS USE PLANS - TWO SETS ARKNCE REQUEST FEE I Y ;PRESENTATIVE OF PRIMARY & EXPANSION CATION MAP i AREA; SHOWN; GRAVITY , SUFF.SIZE PUMPED, PIT & D BOX SH & ETAILED )USE - NO.OF BEDROOMS ELLS & SSDS'S W/IN 200' OF OSED SYS. .OPERTY METES & BOUNDS ���0 / )USE SETBACK NECESSARY (TIGHT LOT) )USE SEWER - 1/4" FT. 4 "0; TYPE PIPE ) BENDS; MAX.BENDS 45° W /CLEANOUT Q L t= - I M #,PE/RA; NAME,ADDRESS,PHONE# �JE OF DRAWING/REVISION kTUM REFERENCE )CATION OF WATERCOURSES, PONDS � kKES AND WETLANDS WITHIN 200 FEET LOPOSED FINISH FLOOR AND BASEMENT EL. 4j". *Klrk_i ;GAL SUBDIVISION IBDIVISION APPRO AL CHECKED ;RC RATE LL //REQUIRED DEPTH �RZM DRAIN QUIRED 'ANDPIPES GENERAL )CATED IN NYC WATERSHED ANS SUBMITTED TO DEP iGATED TO PCHD ;P APPROVAL, IF REQ'D ;F&P TEST HOLES OBSERVED RCS TO BE WITNESSED :OSION CONTROL:HOUSE,WELL, SSDS , RC & DEEP HOLES LOCATED ;PRESENTATIVE OF PRIMARY & EXPANSION CATION MAP i AREA; SHOWN; GRAVITY , SUFF.SIZE PUMPED, PIT & D BOX SH & ETAILED )USE - NO.OF BEDROOMS ELLS & SSDS'S W/IN 200' OF OSED SYS. .OPERTY METES & BOUNDS ���0 / )USE SETBACK NECESSARY (TIGHT LOT) )USE SEWER - 1/4" FT. 4 "0; TYPE PIPE ) BENDS; MAX.BENDS 45° W /CLEANOUT Q L t= - I ,AY BARRIER � J,,, ,,••� - FT. HORIZON ;SLOPE 3:1 TO GRADE PEGS FILL NOTES _L C ATION NOTE iP GAUGES _L PROFILE & DIMENSI FILL IN EXPANSION AREA TRENCH NCH PROVIDED 60 FT MAX. LLEL TO CONTOURS �aj % EXPANSION PROVIDED 100 D SEPARATION DISTANCES SPECIFIED ON PLAN - FROM SSTS A ON DDS PLANS & PERMIT SAME 1 ' TO P.L., DRIVEWAY, LARGE.TREES, ;FOP OF -FILL w1969 NEIGHBOR NOTIFICATION • _!?'T F!ILz1:I�. " -. iv :'..' /ILiJ 1S rvLLL IvYL ri[ 1'6k'13UL'dA _ O' TO WELL. 200' IN DLOD,_ 50LR=S OR. FLOOD ELEVATION THER REQ'D PERMIT(S) REOUIRED DETAILS ON PLANS iI,GE SYSTEM PLAN - (NORTH ARROW) , S HYDRAULIC PROFILE CAVITY FLOW "�% )NSTRUCTION NOTES i ESIGN DATA: PERC & DEEP RESULTS CONTOURS EXISTING & PROPOSED RJVEWAY & SLOPES, CUT 16TING /GUTTER/CURTAIN DRAINS )IL TYPE BOUNDARIES TLE BLOCK; OWNERS NAME,ADDRESS E M #,PE/RA; NAME,ADDRESS,PHONE# �JE OF DRAWING/REVISION kTUM REFERENCE )CATION OF WATERCOURSES, PONDS kKES AND WETLANDS WITHIN 200 FEET LOPOSED FINISH FLOOR AND BASEMENT EL. TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER TO WATER LINE (pits -20') INTERMITTENT DRAINAGE COURSE 1'/500' RESERVOIR, ETC. _150' GALLEY SYSTEMS 15'MIN to CDS= >5 %,l0'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' - <I% P'MIN to CD discharge /I00'with 182 cons day discharge SEPTIC TANK 10' FROM FOUNDATION; 50' TO WELL WELL DIMENSIONS TO PROPERTY LINE LOCATION OF SERVICE CONNECTION p(4 v,_ i i 1 -' /NS/ T E ENGI FERI:IG. 'UR11EYAA1C t? _ LANUS APEARCH/TECTUkE PC. April 1, 1999 Mr. Adam Stiebeling Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 RE: Lincar 2 Lot 5 Tax Map No. 73 -1 -53 Dear Mr. Stiebeling: The enclosed construction drawings have been revised per your March 15, 1999, memo. Responses to your comments are as follows: • A copy of the Town of Putnam Valley Wetland Permit Waiver for the subject lot is enclosed. • Note #27 has been removed from the drawing. A Putnam County Health Department waiver is requested for the 100 -foot restrictive setback to water to be measured from the absorption trench, and not from the toe of the fill pad. Should you have any questions, please feel free to contact our office. Very truly yours, INSITE_ENGINEERING, SURVEYING & LANDSCAPE ARICH!TECTiURE; P.C. - JJC /jms Enclosures Insite File No. 92135.305 Gds 1485 Route 22, Brewster, New York 10509 (914) 278 -4990 Fax: (914) 278 -6392 ❑ 7 DeLavergne Avenue, Wappingers Falls, New York. 12.fi90 (914).297 -1742 www.insite- eng.com <F y S yyii f � k RE: Property of Located at (5 " "' 914 278 6392 P.03 OF ENVIRONMNTAL HEALTH SERV 14 LETTER OF AUMORIZATION 646d Tax Map � "?'� Block Lot �3 Subdivision of .1 Subdivision Lot # 15� Piled Map # Z A Date Filed Geptlemen: Ibis letter is to author a daily licensed Pwfev wastewater treatment; with the stands, rule County Health Dept matter and to st' ervis M �nformity with the Laey, and the Putnam � )nal Engineer cz . xxxxxto apply for th4 regc dlor water supply pernnic(s) to serve the above -noted property in adcord; or regulations as promulgated by the Public Health Director of 16 Put lent, and to sign all necessary papers on any behalf onnection with the construction of said wastewater treatise and/ r ti ter suppl' sysi rovisions of Article 145 and/or 147 a th tio' ! La , the Pub4c laic )unty Sanitary Code. Very trial • , � p; - Mailing Address: 57 CAIIV . Stag Zip IOW9 State , Zip /® WZ Teleg hone: m4) mE±990 Telephone: "? �'� • °i �� ¢Orm LA P. is lth . ^ M- T4 N, 17 ♦ R'Y T .5,i�t� , "I� ��:N ii . PERMIT WAIVER CHAPTER 144: Freshwater Wetlands, Watercourses and Waterbodies Ordinance of the Town of Putnam Valley, New York. The Town Wetlands Inspector, as Approval Authority, has determined that the proposed action will not have a significant environmental impact. Therefore, a PERMIT WAIVER is granted subject to the conditions noted below. DATE PERMIT ISSUED: March 17, 1999 DATE PERMIT EXPIRES: March 17, 2000 APPLICANT /SPONSOR: 37 Croton Dam Road Corp 3 7 Croton Dam Road Ossining, New York 10562 PROPERTY LOCATION: TAX MAP #: 73.- 18 -1 -53 PROPOSED ACTION: Insite Engineering, Surveying & Landscape Architecture, P.C. (agent) 1485 Route 22 Brewster, NY 10509 Attn: John M. Watson 2 Lincar >g=& - Lot:## S, .Church.RQa.d -... :.... : �_.. SIZE OF PARCEL: 3.025 acre ZONING: R -2 Construction of Single Family Residence, Driveway, SSDS, and Well within wetlands buffer MATERIALS REVIEWED: 1. Application Materials, file # WT -287, dated 2 -8 -99, referred 2- 18 -99. 2. Construction Drawing for Lincar Estates, Lot 5, as prepared by Insite Engineering, dated 3- 26 -92, last revised 2- 19 -99. DATE OF SITE INSPECTION: March 05, 1999 CONDITIONS OF PERMIT: 1. All work to be performed in accordance with the above referenced plans. Page 1 of 2 f¢icucAates5pw _ ... _ .. ? :r�'ultiri a.iii u �i 11 i1L Glinu viS S i2�l UtS 111P a(;e "pl—i0 to the LRiftati(ili oI construction/grading work. Erosion controls to be inspected by Building Inspector prior to commencement of construction activities. All erosion controls must be maintained properly throughout the construction process, and remain in place, until final site inspections for compliance with conditions of permit have been completed. 3. The silt fence shown on the plans for the driveway and house should consist of one long fence that runs the entire distance from the southern property line past the location of the proposed well site. Both ends of the silt fence should be turned at right angles and run for 10 -15 feet towards the western property line. 4. All disturbed areas within the 100 ft. wetlands buffer. to be graded, seeded, and mulched immediately with hay, hay to remain until seed successfully established. 5. The Building Inspector shall be notified once erosion control measures are in place and at least 48 hours prior to the initiation of any site work. 6. The Planning Board, Wetlands Inspector, and/or Building Inspector, shall have the right to inspect the project from time to time. 7. The permit shall be prominently displayed at the project site during the undertaking of the activities authorized by the permit. 8. An additional escrow account in the amount of $ 300 must be established with the Town before this Permit Waiver can be considered validated. These additional escrow funds will be appropriated as required for construction monitoring purposes. Any portion of the account not used during the project monitoring period shall be returned -to the applicant - 'Lip0ir,at sfac iuryoc)inpietion• of 'the project. NoncompliaAce with the conditions above will invalidate this Permit Waiver, and may result in a Notice of Violation and /or a Stop Work Order. Any questions regarding this Permit Waiver should be directed to the Town Wetlands Inspector (914) 762 -7288, or the office of the Building Inspector (914) 526 -23 77. Date Permit Waiver Prepared: cc: Applicant/Agent / Building Inspector Planning Board Environmental Commission March 17, 1999 Stephen W. Coleman Town Wetlands Inspector Page 2 of 2 rummest m5pw BRUCE R. FOLEY r. mss_ March 15, 1999 LORETTA MOLINARI R.N., M.S.N. Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 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 John Watson Insite Engineering Route 22 Brewster, New York 10509\ Re: Linear II, Lot #5, TM# 73 -1 -53 Town of Putnam Valley Dear Mr. Watson: This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for.your consideration. 1. Prior to final approval please provide this office proof of wetlands permit obtained from the Town of Putnam Valley as discussed. 2. Provide in writing a- request. for waiver of restrictive distan* -ce _to.00n (wate - W t; - - - ' -SST ; o'odgm at trie start of trenches not toe of sfope or f ll T - - 3. Please review note #27 on plans. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj h •• • 21 V41 1114 4 1 W owe) • •' • t• •' ' 1 NARPIUM M9•. _ r DESIGND�,TP� SHEET- SUBSUFACE S9AAG_E, DISPOSAL Owner /N�'.f1/1.. QL.�iL i ✓� J% co. AZ Ad&ess Z8 C 1&OM 3, S7, L/jn.,g rel-,Aj�, /V /70-3 Located at (Street) e -quR.4,41 RCAO Sec. 23, Block Lot S.3 (indicate nearest cross street) Municipality A�I111411-7 t,.A L4-e Watershed Date of Pre- Soaking Date.of Percolation Test HOLE NUMBER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Frain . Water Level No. Time Ground Surface' In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 1 2 3 4 14 O sleAl ✓�� �Ioyl/ /�/,liLT 5. ® P aD ,� 1� zS 2 3 4 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 subnitted 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 G.L. 11 Ile Z-014011 21 CLA Me, Y 31 IO.Amn W&/ SAOV6 41 51 61 1 -- 71 81 91 10, 12' 13' M /10 INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED *VIA INDICATE IEqIM To WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATION I S MADE BY: IY7. DATE: /,o DESIGN ppilgate used � Min /1" Drop: S.D. Usable Area Provided _5 e/oo No. cif Bedrocms 3 Septic Tank Capacity l000 gals. Type — — 0 �— — UJ n --,.[ C,,j L) Psorption Area Provided By u ic Per L.F. x 24" width trench Name zoy:g1n-,-r gnyxmet r A<%gnature THIS SPACE FOR USE BY HEALTH DEPAKIMMX ONLY Soil Rate Approved sq.ft/gal. Checked by Date I INSITE ENGINEERING AND .DFS1.GN,�PX., 1849, ROUTE 6 CARMEL, NEW YORK 10512 (914) 225-6200 Pump Pit Design for SSDS for Lincar Development Co., Inc. Lot 5 of the Lincar 2 Subdivision Design Flow = 600 gallons per day Use peak hourly flow 10 times average daily flow Qpeak gpm (24)(60) Static Head 23 feet C = 150 A211 L 200 feet GPM = 23 gpm Equivalent L (Bend & Valve Losses) 50 feet Total L = ± 250 feet HI = 10.44(Tota1 L GPM = 2.8 f eet C' Total Dynamic Head (23 feet + 2.8 feet) = 25.8 feet Use Gould Pump model # 3885 1/3 HP :series WE0311M (or, approved equal) This pump will pump 23 GPM with a total dynamic head of 25.8 feet. May 19, 1992 APPLICATIONS Specifically designed for the following uses: o Homes o Farms e Trailer Courts o Motels o Schools o Hosptitals o industry o Effluent Systems SPECIFICATIONS Pump: G Solids Handling Capabilities: 3/4" Maximum o Discharge size: 2" NPT e Capacities: Up to 114 GPM ® Total Heads: Up to 123 Feet TDH © Mechanical Seal: Carbon -Rotary Seat/Ceramic- Stationary Seat 300 Series Stainless Steel Metal Parts BUNA -N Elastomers m Temperature: 160 °F (71 °C) Maximum q Fasteners: 3.00 Series Stainless Steel o Capable of Running Dry Without Damage to Components C�oul ") J3•a"'- '.. r'3}":. .�:c- .i.�:vYe -.� C.� 'CC' S 1;:y r4� ?. •r.. 1��. •a.a.ri_. .r. V °. ETL LISTED SUBMERSIBLE PUMP CLASS I AND II DIV. 2 AND G1086131480 CLASS III DIV. 1 AND 2 ETL TESTING LABORATORIES, INC. CORTL ND. NEW YORK. 13045 Motor: • Single Phase:' /3 HP, 115 or FEATURES 230V 60 Hz, 1750 RPM Impeller: Cast iron, semi -open, '/2 HP, 115V, 60 Hz, 3500 RPM non-clog with um out vanes for '/z HP thru 1'/2 HP, 230V, 60 Hz, mechanical seal protection. Balanced 3500 RPM Built -in overload with automatic for smooth operation. Bronze impeller available as. an option. reset Casing: Cast iron volute type for Class B insulation R maximum efficiency. 2 NPT • Three Phase:' /2 HP thru 1'/2 HP discharge adaptable for slide rail 208/230V, 460V, 60 Hz, systems. 3500 RPM Mechanical Seal: Ceramic vs Class B Insulation, overload cb seling faces. Stainless steel -ction mustbe'faro'vldo::lI ��_ i1let I"pafts,- SUNA-YJ'el istomners. starter unit Shaft: Corrosion - resistant ® Shaft: Threaded, 400 series stainless steel. Threaded design. stainless steel. Locknut on three phase models to ® Bearings: Ball bearings upper, guard against component damage and lower on accidental reverse rotation. ® Power Cord: 15 foot standard Motor: Fully submerged in high - length (optional lengths grade turbine oil for lubrication and available) efficient heat transfer. Single Phase: % and' /2 HP -16/3 Designed for Continuous SJTO with three prong plug. Operation: Pump ratings are /4 thru 1 /2H P- 14/3, STO with within the motor manufacturer's bare leads recommended working imits, can Three Phase: 1/2 thru 1'/2 HP -14/4 be operated continuously without STO with bare leads damage. On CSA listed models — 20' Bearings: Upper and Lower heavy length SJTW and STW are duty ball bearing construction. standard. Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor -end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. O -Ring: Assures positive sealing against contaminants and oil leakage. Ff'n. .:_ D-o�Plnhl.' 10C' FEATURES 1. Impeller 2. Casing 3:. Mechanical 7-- eai 4. Shaft 5. Motor 6. Bearings - Upper & Lower 7. Power cable 8.O -Ring 1 MODELS 3 Goulds pug `' M 1 3885 PERFORMANCE RATINGS (Gallons Per Minute) ' HP WE0511 H Phase Max.Amp. RPM Solids WE0511 KH Series 65 . WE0512H WE0712H WE1012H WE1512H WE0512HH WE1512HH No. WE0311L WE0311M WE0532H 'WE0732H WE1032H WE1532H WE0532HH WE1532HH 9.4 WE0312L WE0312M WE0534H 'WE0734H WE1034H WE1534H WE0534HH WE1534HH ... :• HP '/3 1/3 ' '/2 % 1 1'/z '/2 1'/2 RPM 1750 1750 3500 3500 3500 3500 3500 3500 5 100 70 80 90 106 - 60 - Series HP .Volts Phase Max.Amp. RPM Solids Wt. 10 80 65 . 76 87 102 112 56 84 WE0311 L 80 115 208/230 9 9.4 (All dimensions in inches) 15 60 57 72 84 100 108 53 82. WE0312L ,/e 230 4.7 1750 20 36 45 65 79 95 105 48 77 WE0311 M 115 1 9.4 56 .25 25 59 74 91 100 45 75 WE0312M 230 4.7 3 30 50 .67 85 96 .40 72 WE0511 H 115 13.0 35 40 61 79 92 35 70 WE0512H 230 • - . 6.5. d `40 26 52 72 86 30 67 I WE0532H 208/230 3 3.4 : 45 10 43 64 80 25 64 WE0534H ,/2 460 1.7 60 50 30 54 73 18 .60 WE0511HH 115 ,1 13.0 130 55 17 42 65 12 58 WE0512HH , 230 6.5 � 0 60 6 30 54 '3 54 1NIE0532HH - . 20131/230 ... _ .33 Q _ ...._ WE0534HH 460 1.65 a/� 70 .. _ _ _ _ _ 5 26 47 WE0712H 23.0 :.'1 10.0 ,75 14 43 WE0732H Y4 208/2.30 ,3 5.4 3500 ;.80 4 40 WE0734H 460 2.7 .. 70 : ' „90 33 WE1012H 230. 1 12.5: 100 24 WE1032H 1 20030 3 7.0 ` . ::110 15 WE1034H 460 3.5 120 5 WE1512H 2 230 -.-1 1 15.0 ' WE1532H 2 208/230 3 9 9.2 WE1534H , 460 4 4.6 ' 'DIMENSIONS WE1512HH 2 , 4 15.0 , 80 WE1532HH 2 208/230 9 9.2 . ( (All dimensions in inches) WE153HH 4 460 3 4.6 ( °EFFLUENT EJECTOR SYSTEM � 12'h '.Package Includes: Effluent ejector system Submersible Effluent Pump, .,offers ease of ordering WE0311L, 12L or WE0311M, . and installation. A single .. ' 12M, WE0511HH, 12HH -- Mercury Level Control Switch ordering number specifies. A2 -5 (115V), A2.6 (230V) a complete system Basin A7 -1801S designed for most resi- Basin Cover A8 -1822 dential and commercial Check Valve A9 -2P sump and effluent pump Order No.: SWE0311 L, applications. SWE0312L, SWE0311M, SWE0312M, SWE0511HH, SWE0512HH. . L-KICK -BACK I: 2" NPT I \1 31A D "'/3,'/2, % and 1 HP =15" except for model WE0712H & WE1012H = 18 ";. 1' /z HP = 18° Available Certifications: $p Canadian Standards Association © Testing Laboratories . L-KICK -BACK I: 2" NPT I \1 31A D "'/3,'/2, % and 1 HP =15" except for model WE0712H & WE1012H = 18 ";. 1' /z HP = 18° Available Certifications: $p Canadian Standards Association © Testing Laboratories 1, i � •. ' `1 Curves K i METERS FEET .. _. _ ....�.�� ,. _.�. -. _.._. -.,... .. .. l UPTCQC CCCT 35 1 30 D I20 J F- 15 10 5 MODEL 3885 SIZE 3/4' Solids 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L I 0 10 20 30 m'/h CAPACITY . G®ULDS PUMPS, INC. SRECA FALLS NEW YOM 13148 m■■■■■■■■■■■■■■■■■ MODEL :: SIZE3/4" Solids MENNEN �1 1 • ■ 1 ■ ■ .1 1 r ■ 1 • ■ GI ; 1 • 1 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L 1 1 0 10 20 30 m'/h CAPACITY 90 25 80 70 z 20 J 60 50 15 40 10 30 20 5 10 0 0 l UPTCQC CCCT 35 1 30 D I20 J F- 15 10 5 MODEL 3885 SIZE 3/4' Solids 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L I 0 10 20 30 m'/h CAPACITY . G®ULDS PUMPS, INC. SRECA FALLS NEW YOM 13148 m■■■■■■■■■■■■■■■■■ MODEL :: SIZE3/4" Solids MENNEN �1 1 • ■ 1 ■ ■ .1 1 r ■ 1 • ■ GI ; 1 • 1 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L 1 1 0 10 20 30 m'/h CAPACITY PC -1 PUTNAM COUNTY D E PARTMENT O F H EAL TH �:. -;:`� : �».=; � �•:::.,�:;�„� �, �T��?�;..:F�Q- .�PF.-Il�'�i -�C+. ,;,�lA,;��t.`i�°-� -;�;.° TT '� one@:. ��•.T _. ; � : - � . 1. Name and Address of Applicant: LIt F_ DEVE 0-pM%t C01 IIJC. UaMtY .Sire LIME FAY, WJ.' I ?4243 2. Name of Project: e5M_FC? UKCAP- M- M- 0I 3. Location T /V /C: R.t \,ALLFY C,�•t G• 4. Project Engineer: IMIIE NAP --ANC AND CL5W,5. Address: Ff. 69 p,G C ZME., N'Y. I0f►2 License Number: �pIg31 . Phone:gA425tPZC0 6. Type of Project: _ Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental 'Quality Review (SEAR)? Type Status (Check One) Type I.: Exempt Type II. Unlisted _X 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... WA _ 10. Name of Lead Agency 14;-Js- this R1-eject in- an area_ -�� dar_.the,control...of_.l:ora:l: planning.,.. zoning •.. � __ .;. r-.. or other officials;"ord�nances-' ..... 12. If so, have plans been submitted to such authorities? .................. iD 13. Has preliminary approval been granted by such authorities? WIA Date Granted:l3/p 14. Type of Sewage Disposal System Discharge...... Surface Water _Ground Waters 15. If surface water discharge, what is the stream class designation ?.......: N 16. Waters index number (surface) .......................................... WA 17. Is project located near a public water supply system? .................. NO 18. If yes, name of water supply VVA Distance to water supply- M 19. Is project site near a public sewage collection or disposal system ?..... l� 20. Name-of sewage system Distance to sewage system_ 21. Date observed: L)N _~4 23. Name of Health Inspector: 1Jt4YA CMJ4 24. Project design flow (gallons per day) ...................................... 2. ..`,Y_ L'� o �1 �.�..�La�.��' �� �I riOtl i l.T'u`I .�iiri"it ►S " ' f lili i'i ii*�C�. i vi i "'.T�v v`c`::'��'CT..��J;�a =� - ^"a -Ls'S J' Zi-" 26, Has SPDES Application been submitted to local DEC Office? ............... W A 27. Is any portion of this project located within a designated Town or State wetland? .................................. ............................... No 28. wetland ID Number....... . ._ ..... .......e .................. 14/A 29. Is Wetland Permit required? ............ ...........o ................... ss Has application been made to Town or Local DEC Office? .................. 30. Does project require a DEC Stream Disturbance Permit? ................... NO 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 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 ?. ........... i— YES or NO Nb DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... YES 34. Are community water, sewer facilities planned to be developed within 15 years? W) 35. Are any sewage aisposa l "areas i "ri' excess of 15 % - -! 1iype ..e o.e.o.o -.: ............... � 36. Tax Map ID Number .......................................................... ( 37. Approved Plans are to be returned to: Applicant _X_ Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this Provision may be grounds for the rejection of any submission. � r~ r hereby affirm, under penalty of per, `b�rvrm s true to the best of my hnow7ei bere�Pn are punishable as a Class A i ilre 09pa 1 Law. STGNJkTURESA OFFICIAL TITLES: C�_ —, that information provided on this and beZ False statements made ean_ suant to-,section 210.45 of NAILING ADDRESS: 2b► L1 1"( 5i', LIME MWY, P-� j 1 '7&43 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL.HEALTH SERVICES .ate S /6&_ Re: Property of DEVELO MEI-l4 W. INC.. Located at MiWA ?p-% I R1`t1 M \/"Y Pv7l✓Arr1 . (T) Section - Block Lot 53 Subdivision of L NCAL 2 45LtW LION Sub dv. Lot # Filed Map # 2,285MA Date 9 29 ') Gentlemen: This letter is to authorize tN5i1 tiN�INEINC ANpr� R 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 matter and to supervise the construction of said �� "�� system or systems - iri•corii "ormi'ty "witri "tne pr�isoris 'oz�'��'ii:ie'"`i4 -5- �r " " " "' ' "'- "" 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very t Signed Countersigned: P.E. , R=A. , # derpRey a. O*teI.MD) �E 1N61a _I10- Nezwj AND iCaN Address TAR Rk. Co CA�t'1EL► ��( ►CF,�12 Telephone UM E PF W. N 1 11(v4�2) Town -2-01 4-40 -X700 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT .1 TO: Commissioner of Health In the matter of application for: WNW Q&yEWPrAWi COAW�, represent that I am an officer or employee of the corporation and am authorized to act for of Corporat having offices at rj??j Uafgjy f}, 0 Whose officers are: President: LOILIALZ (Name and Address) Vice—?resident: (Name and Address) Secre ta-ry: (Name and Address) Treasurer: (Name and Address) and that I am and will be individually responsible for any and all of corporation with respect to the approval requested and all subse!� !!�e acts 11� � thereto. Sworn to before me this C, day Signed: of 19 Votary Public. ARI 'E FALISTINI A T- F U Cor� r ?YP 13LIC OF NEw JERSEY on ExPIMS JunG, 2 F 'S-' Title Corporate Beal ing -ENGINEERING I JD`R�J & DESIGN, P. C. N S IT 76 &ewswr Avenue, Carmel, New York 10512 • W W, LETTER OF TRANSMITTAL DATE DATE ATTENTION RE: 7 T i 4, ES F- AA F- X 13 k1 � �1 01, -- r G�s 9 kt �k! kc L tq w: Lot 5 or- bwcm 9- 45U epi 14 Puma 0 Resubmit WE ARE SENDING YOU IVAttached 0 Under separate cover via • Shop drawings • Copy 61 letter 0 Prints 0 Change order Plans . 0 Samples O the following items: 0 Specifications COPIES DATE NO DESCRIPTION 7 T i 4, ES F- AA F- X 13 k1 � �1 01, -- r G�s 9 kt �k! kc L tq w: 1�(For approval Puma 0 Resubmit copies for approval W-1 COOtW011p DFAWING Z, copies for distribution 0 As requested VW5t FLAIAS 1 5 q-2— IE#Eg OF AUIWIZAIION RIND AV-PIDAVIT 071?f. 0WNER5)bP APPLE CAMON t-Of APPRNAL or A M51WER DPPZ*kL ! YfEM 5 cr?- 4e-7 CHWJ(- 114 lit AM MA 'O LA a00-20 DE516 4 PA 5V�t 0 For review and comment 0 0 FOR BIDS DUE REMARKS COPY TO: 19 - 0 PRINTS RETURNED AFTER LOAN TO US SIGNED fV,n.P V1 7- Cd-f& C- 5 r 1"RA..Ldr. .4-11 7 T i 4, ES F- AA F- X 13 k1 � �1 01, -- r G�s 9 kt �k! kc L tq w: 1�(For approval 0 Approved as submitted 0 Resubmit copies for approval 0 For your use 0 Approved as noted 0 Submit — copies for distribution 0 As requested 0 Returned for corrections 0 Return — corrected prints 0 For review and comment 0 0 FOR BIDS DUE REMARKS COPY TO: 19 - 0 PRINTS RETURNED AFTER LOAN TO US SIGNED N S /T E ENGINEERING, SURVEYING& LANDSCAPEARCHITECTURE, A a L SMITT F! %z: T. k 4P - -TAP :F� SAR 7 1485 Route 22 (914) 278-4990 Brewster, . New York 10509 (914) 278-6392 7 Del-avergne Avenue (914) 297-1742 Wappingers Falls, New York 12590 TO: 'd, /-/, A 1p WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter Date: 3 — 9 Job No. Attn: Re: ey 7- eAttached E]'Under separate cover via ❑ Prints ❑ Plans ❑ Samples ❑ Change Order 11 the following Items: ❑ Specifications ,THFSE, ARE TRANSMITTED as-checked.below:-.--.-,,.......-.....- Approved as submitted ❑ Resubmit ❑ For your use ❑ Approved as noted ❑ Submit ❑ As requested ❑ Returned for corrections ❑ Return ❑ For review and comment ❑ REMARKS: COPY TO: Lot98.dot copies for approval copies for distribution corrected prints SIGNED: M %( ��1m..___...._._._..._........_...._._._.... .._......__.__._..�._....�._.., IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE k10 7, s 7, T-TT' 77— J��m *o Mo P 7 Daft of Pmvkml Awaval x0ft Addrems St',:' t,�tri..F -t6N.a /, 1'1`643 MM Data Subdivision Apgroved Ck Tee E c i0s e& 1 am n- ;,,,t` I > Vab� Dei*m Flow G P D-- %mlowad Beilkewm- S@Pmnw S@ansoW Sy§k= gs'b=K" d_.L000 Gam Sq* TO& md ROD G. WINIIII! CIMPA Fdwlk SVIP*:TIo* Adhems %-A V4 KJN, l.�1 N Addrome NA V-1421e-i N I I lly and .-C ion o_lha OoPOSICI SYStiM(S); A)-that theilisMatCOM -j� dispose le for I s stem above ilsicriiied w!ll;br c6O#!uOed as mown "TQ"t there :'to 8MOnJ46rdaAcewith the standarg% PI f6v be INWIMIM" - to 1111C pepartn". and a W!ilten ywrailtN tw'WjWfuifiiih" the owner. &.assigns by the bulkier, 64t fald,buMdir Will P" in 9".piserst part, of -aid I 'w-deo'duril year inv'"""n' any. SIWOW� S". slinomaii sly -following the dati thel"u- Once of,the Ap" Partif 0 Construction rd"ion system*or SAY repairsthweto;2) I that this drillad Will describW -1661 ii ulas and ragui=rs—of the Putnam wo be located approms" plansoo that ,saidwell will be Instal*& .In 46mo4rica,� with the :standards, r County ot r Date P.E.— RA. r dai!em A 'A, APPROVED FOR C)os:rw"i*'1i6Ni4bIj.ipprpvsl' expwes. tw-o' , yses ho dateunless itrucI t Io I n of the buIMIng has been undertaken and is rftliciblifoutiusi or "yfie a ini-A or. -,6i.64.comnissioner of Health, Any change of arieration of construction "Quires a V* permit. Approviii for•cllipbsai,of i0inallic Unitavy.. low"". SIMI/o► ivate water supply only. Rev. '7— BY 10/88 Ode, MbI6 qQi,thQ,dWjn'aBd local" -60 tho pro"sed - avi sh li. tiiii �di I sytion rewoft -iaixw , - abovi Oviolbid wdi be condruitaiii's" own on two with the Standard% rules am resumsons or .!trA . Puffeem. qty -biisr�,:of wMak 'i"i jAi a I.Vort I to the c �icatq- condructio, tke buidir. 66" iod biwer wm dia.,win b4 "furn!",.!" pr?mr,' lilt U.Mis"O.M, or issipi bv -a �Fr -1.111MIM- swoiWJ�* "SMV, OW lef, "I -;w"" I Wvt, d-W4 two pdriod. ii"two (tyripers of,the'lime- 4"Wo e& tw appevst 0_ ,i wt#olqv tiiiiiiici , .c "Ob trAmos ii toist the cirvied writ awormis As" r-16-9, C414 ciiiiiii, -MPG tii6i; gild' ui4t -met% �tli6:ili rules s4di"_v5fWr*_0f Ilia AitaiM Z7 1 57" Rev. Ov t 7 RA. .unl&G\I/LMu d- ion ag* the buildb*. Ass been unclertaken a" IS "MR! I!q "Nolk Any chow or afterstion of construction at ar IV oNy. TMD APIA 0 1° DTFMAM CODN'fY DEPARMW OF EWALTH ey 1 ! DbrWM deadmMovedd Hadh Sp dcm Cumel. N.Y. 10612 Hear to PMvlde Feamlt am CEMTWWATE OF CONMANNCE ICONSllDCl10N PtSbQI FOR SEWAGE DL4POSAL SYSTEM Peed 1'= ( ` Z at Gi�ti�l`C' �["�� oy%a Town or N 1►�C GS ''v,: -:s p lati_ °Tax Map j/ .._......: x _..._1. z:`ot /ApptleMt Naes•L/I(�Cd �P_ .1�v�-crJi vtr" 4� _ ,4�VG eaw"'t —�j ItevWa° o - — Date d Pmvk `Approval v� (o L3 19+ Mabt Adili M 1--� ys Town L &%T L FFR;er AD 176,943 Date Subdivision Agp roved- �Z�' ` s (E: -S-T>� Fee Enclosed ❑ Amn„nt BdWk2 1iP gEi iD 'I�R`% i.. Lot Area a 0 Fm Seaton Obb LJ 1>aipa valame Number of Bedrooms Desiv Flow G P D PCHD NodBudlan Is EequhW Wbea Fm to completed Separate SewenSe Sydm to d Cqd1= Sep& Tank ao� L� / � � / RLl- To be oMdeaated by Add<aw Q Water StdppIy: PtttaHc SstppIy Fran Addmp an _, PAvate Sop* DAW by D l dress U � Otber Regdeemea�s 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system($); 1) that the separate sewage dl sal f stem above described will be constructed of shown on the approved amendment there to and in accordance with the standards. rules a rag o ov e nern County Department of MMlth, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Mwtthwill 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 pod operating condition any part of sera sewage disposal system during the per iod of two (2) years Immediately following the date of the issu• once of the ca approval of the Certificate of Construction Compliance of this original system or any f"Mrs; thereto: 2) that the drilled well deSafted above will be located as shown an the approvid plan and that mid well will be installed in accordance with the standard•, rules and regu aTions of the Putnam . County Department of tth ; Date � ci �, Signed P.E. ��/] L R.A. - Add,, license No (111 q11 1OPROVED FOR CONSTRUCTION:{fifipjro�kpaa� East fiolln'�the W VO-h Ted unless tonstrucion of the building .has been undertaken and is revocable for cause or may be amerwed or modified when considered necessary by the Commissioner of MNlth. Any change or alteration of construction nguires a now permit. Approved for disposal of domestic sanitary sewage, and /or private water supply only. Rev. 10/88 Date By Title DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 AYP'LTCArION 1•l7 C ONS`PR&UT A 'WATER -WELL` PCHD PERMIT #P'V - (o-9Z WELL LOCATION Street Address C H0P4 N uIND Town/Village/City Tax Grid Number R"r w&H V,&L'LF- Y 3. -I -52 WELL OWNER Name Mailing Address L mum-. _ rivate LtoJCAe �M i' c- �,iQ.1C_. f LM9�CTYSZ. . O Public USE OF WELL primary 2 - secondary RESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY O AIR /COND /HEAT PUMP ® ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify, O INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED 4- /EST. OF DAILY USAG al D REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13. ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING) ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE RILLED DRIVEN ODUG GRAVEL O OTHER IS WELL SITE SUBJECT JO FLOODING? YES NO WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:j>J)�,) Lot No. WATER WELL CONTRACTOR: Name(, 941 -)w 9 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES >( NO NAME OF PUBLIC WATER SUPPLY: LA TOWN /VIL /CITY I:. 11IaiAFGE.._ O F ROPo R`r° FRnM WEARES T WATER. MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ZN SEPARATE SHEET to- -8 -9(o (date) (s gnatur ) 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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: Date of Expiration Permit is Non - Transferrable 3/89 19 19 Permit Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller PU.NAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services AFFIDAVIT CORPORATE OWNER APPLICATION FOR PEIHIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: i -NoNf- i OF�'«� crJ •�1 . i , Aon.AL/� w yGk E C_ represent that I am an officer or employee of the corporation and am authorized to act for UWCA9 DE1IN,0Ifi ENi CG INC. (Name of Corporation) having offices at` UBt( ill -r/SO Whose officers are: President: rvA4x /Vl/Gka --4- (Name and Address) Vice - ?resident: (Name and Address �i'Id12�`STl(1" tiflu'T'c�.i j� Treasurer (Name and Address) and that I am and will be individually responsible for any and all A4 of th corporation with respect to the approval requested and all subse a acts ting thereto. Swora to before me this day Signed: of `�Vl_p 19 i rotas., Public , .ARLENE FAUSTINI �mRY PUBLIC OF NEW . iERSEY ��►77 Co ruS31 Title Corporate Seal PUI,,AM COUNTY DEPARTMENT OF HEk..rH DIVISION OF ENVIRONMENTAL HEALTH SERVICES t-_ ,Lt'•��. 1 -... ..�.�r:_.. :w8•... -a s. �. al -PtRr�'- v.r..C�'..'4.� --�n ns -. _. _ -4vr �•�.t it r �-�H _ :: Sf^i _: �Yi/•Gis -A..� Y4�: .- w�:Mt•'�Nw'.�e�.w'e J�v Date— `' f�`_. Re: Property of �-INCZ�j I'rE ELbPiE3-�j W. WC. Located at ('WUA PQ 1 % "M YAU FL Y PvTI✓RI,e) (T) VAC�_ffy Section Block Lot 53 Subdivision of L WCAY. 2 `5-IWN60H Subdvo Lot # Fj Filed Map # ,5& A Date Q� Gentlemen: This letter is to authorize 445 01 _ El WEEgNG Aa4p U�,A% R- 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 matter and to supervise.the construction of said system or systems in conformity with the provisions of Ar 1 145 or w 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours Signed Countersigned: PeEa, tea, o1erFFE�f a• COVA UMO) Pb - IW-2ATE Wn►Nemw -1 AND Address % ?YAC , C�I''1 Ei� %)Y ►�i 2 Telephone of zVroyffty MV E N1 (NC. ess U fii-(,E Etffl VA J B1 Cow Town �o I 4-440 - 4700 Telephone DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 P. PPL -ICATT N PCHD PERMIT # WELL LOCATION Street Address C%-AQ0c, -A Town/Village/City Tax Grid Number Y2 r-u -13 . � - 53 WELL OWNER Name Mailing Address "-VtLE GFPrivate 1 WCAP- �/�I.DR- E CO 1NL, lbk 1_.1SEZ -t-( S'A, r-SW � 41 NJ0Public USE OF WELL primary 2- secondary 0 RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION. O OTHER (specify d INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE b °a gal E3 REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 13. ADDITIONAL SUPPLY W SUPPLY NEW DWELLING1 D DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ODRIVEN []DUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES k NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: t- tvQC&VZ Z 5Ua4>IVo&IONJ Lot No. S WATER WELL CONTRACTOR: Name L1r4I4t-4pWtJ Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: N /R TOWN /VIL /CITY DISTANCE. TO PROPERTY FROM NEAREST WATER MAIN:. V,NV4-,3Ei LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ISON SEPARATE SHEET 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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19__ Date of Expir ion 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller • d e I. ` PUT qM COUNTY DEPARTMENT OF HEj't o rH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date $ /6 %K� Re: Property of (m• INC . Located at p�YNS�� (T) . VA�CLY"� Section Block Lot 53 Subdivision of LIW(:,Ar; 2 45L1WlVr nPJ Subdvo Lot # Fj Filed Map # �';� Date % � j _ - 1 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 matter and to supervise the construction of said - e Y's *tem or' systems"" n_ cont`ormity wi- th "tne provis ofis- of, Arti -di 5 -of- 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code Very truly yours Signed Countersigned: P.E. , R=A-9 # �� J� �Nf�I.N�G�PE• 1051-, � C'�►N .lt ANn Q�iC . Address �t��► �Y s�i2 Telephone of ro ty &Z-2-At.�� . loc. dress UME (r�??Y. Wd O b+o ) Town ao / 44o - 47oo Telephone PO LIAM COUNTY DEPARTMENT OF REALTH�' l Division of Environmental Realth Services AFFIDAVIT - CORPORATE OWNER APPLICATION = FOR PERv IT , -- ...._._ -- _ APPLICATION S'JBKITTED -TU PUTNA21 COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: • j�1NC/� DEVEIOF}��1� Cl� •tNG , I, A on�AL/� N yGk E L represent that I am an officer or employee of the corporation and am authorized to act for LIN ;`lame of Corporation having offices at %�j UE,Ltg}Y i► i�ose officers are: President: ,66r,1AZ,0 (Name and Address) Vice - President: (Name and Address) Treasurer: (Name and Address) and 'that I am and will be individually responsible corporation with respect to the approval requested thereto. Svorn to before me this (-- day ofO Notary Public ARLENE FAUSTINI NO'T'ARY PUBLIC OF h_ ;.; ,_?c� �1 Comnuss�on Exp:ro - Y Signer Title Corporate Seal DEPARTMENT OF HEALTH Division of Environmental Health Services D ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 r,n.: APPLICATION TO CONSTRUCT A WATER WELL Pun FF.RiwTT WELL LOCATION Street Address CRUIZC ft) Town/Village/City Tax 'VALLEY -73.--)--53 Grid Number WELL OWNER Name Mailing LI C r- 1 Address b pPrivate j O Public 6 SE OF WELL 1 - primary 2 - secondary O RESIDENTIAL ® PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP ® BUSINESS 0 FARM 0 TEST/OBSERVATION ® INDUSTRIAL U INSTITUTIONAL 0 STAND -BY ® ABANDONED ® OTHER (specify AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE &W Itffi1 REASON FOR DRILLING 0 REPLACE EXISTING SUPPLY IffNEW SUPPLY NEW DWELLING 0 TEST /OBSERVATION G ADDITIONAL 0 DEEPEN EXISTING WELL SUPPLY DETAILED REASON FOR DRILLING WELL TYPE DRILLED ®DRIVEN [3DUG GRAVEL. 0OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:_ L 114C/W Z 5IPAV151C44 Lot No. c, WATER WELL CONTRACTOR: Name Address: IS PUBLIC MATER SUPPLY AVAILABLE TO SITE: YES No 0. NAME OF PUBLIC WATER SUPPLY:. N/% TOWN /VIL /CITY .. TC_ A:S�? .'IcJ- °�!�?L�RTY— FP.C?i�' =•'�E< =.REST �'A:[!N^ ►�.,r *r.. _ `�t?Y��IVIJ��t'�N.. --- __.a_...�. -._. _..�,......._.__..,...._. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED WON SEPARATE SHEET (date) IN q(si'fn'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. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drillin perations be contained on this property and in such a manner as not to degrade or othe .s contaminata surface or groundwater. Date of Issue: 19 2, Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller Cr N C: F L,;! Cr — v�cC_, q_ , Crr�crc �esoluL_Cn Three sacs S/S - _ -L�g per. P = C FO1a r.-oth C3 Use plan Two, se s `�..�Z ME, 012 Sc On DDS P! an s G= over ra U _ & r.-�C -G? =5 c_-la. ew_.___ _ _v I.- prcoc ; = :s- No c=�Rk rrCN--� DDS =�iGS 5? `='i--) CN PLI -IN r''il�csLo p.L., r+a T_e ,r'_ Sf 20' to z ouna—a -ica ►;_? ? s 100, to Fa1? ; 200' is D.L•.O.D, 150' 100' to laka (:.... Lam` ��l -Y�- - ���! _�•.._ JJ LJ L• , G I to n_ =r Li-1e c� ic�Tar_ks -11 oV-lc_ `ion; 5J' to we- 10. 15' we! I to PL a I 1 �I ) I I� i I I- PC 1 I Ir pre-1969 I I' 1 N.i�=lbor IlOL= LIC2ilOil I I L" i ,ch _ =oL ided ea Z :: Co { I I I I 4- 10 fill r,Gts= { r•F,4 sec- { - I 100 vr. =1 oar= e av- I �I 200 t. r=_senm__, etc. U ` { I II { 1 Crr�crc �esoluL_Cn Three sacs S/S - _ -L�g per. P = C FO1a r.-oth C3 Use plan Two, se s `�..�Z ME, 012 Sc On DDS P! an s G= over ra U _ & r.-�C -G? =5 c_-la. ew_.___ _ _v I.- prcoc ; = :s- No c=�Rk rrCN--� DDS =�iGS 5? `='i--) CN PLI -IN r''il�csLo p.L., r+a T_e ,r'_ Sf 20' to z ouna—a -ica ►;_? ? s 100, to Fa1? ; 200' is D.L•.O.D, 150' 100' to laka (:.... Lam` ��l -Y�- - ���! _�•.._ JJ LJ L• , G I to n_ =r Li-1e c� ic�Tar_ks -11 oV-lc_ `ion; 5J' to we- 10. 15' we! I to PL a PUTNAM COUNtY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 0 I'ErjC-.4-x %- &--,-r < I Re: Property of_j—jV1co,y, Located at 0 o-cj (T) PCJV)CLVTj Vc.-Ije� Section -"73 Block Lot Subdivision of Vx ce�- a, r) Subdv. Lot # Filed Map Date Gentlemen: This letter is to authorize—Insite Engin eering & . Surveying, PI(I- a duly -licensed professional engineer -- x (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 prom ulagated by the Commissioner 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-sai-d_—, 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 t Signed Countersigned- Jeffrey J. Conte P. E. , RQ*x # 619 Insite,Engineering & Surveying, P.C. Address Route 22, Brewster, NY 10509 278-4990 Telephone Address Town do 1- 11-0- Telephone 6 0 C)