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Home My WebLink About1519DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34.-4 -12.2 BOX 14 01519 L Ir AN.r' hi 01519 \X � PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE F AT NT SYSTEM PCHD CONSTRUCTION PERMIT # Located at 19- V MNC� "VP-56V �-Ahta Owner /Applicant Name Formerly Mailing Address Ppm- 25 14�s✓l Town or Village Tax Map Subdivision Name Subd. Lot # Date Construction Permit Issued by PCHD -11 lit ii Separate Sewerage System built by Consisting of Gallon Septic Tank and Other Requirements: Water Sunnly: Block _- Lot IT-1- 64442-FRI. -1 SuaPi 115JOH rL Address Public Supply From Address or: Private Supply Drilled by Mil -rom iAy' &TT Building Type Zip Address 101'b �LT / o FAfo-;)DA. NY Has erosion control been completed? yE"? Number of Bedrooms 4 Has garbage grinder been installed? No I certify tlat the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plant (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans andthe standards, rules and regulations of the Putnam County epartment of Health. Date: 61 14� �A Certified by 0 P.E. R.A. (Desi rofessional) V r Address 1-0 MlieL'TOWK PWD 14Y i Qy 09 License # r2 G114 Any persan occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure�he 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 pvate water supply shall become null and void when a public water supply becomes available. Such approval are subject to modification or change when, in the judgment of the Public Health Director, such revocati mo ificati r change is necessary. By: - .- -- Title: - - - -- . - . - Date: .�, Al - - White cqy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: ,� hum rq► r 11 e Town/Village: Tax Grid # Map '%14, Block Lot(s) It-1— Well Owner: Name: Address: iJse of Well: 1- primary 2- secondary Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing tl Open hole in bedrock Other Casing Details Total length ft. Length below grade ,ej0 ft. Diameter Tin. Weight per foot _/I lb /ft. Materials: Steel Plastic _ Other Joints: Welded V Threaded _ Other Seal: _ Cement grout _ Bentonite Other Drive shoe: V Yes No Liner: Yes 4 No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air " " 'IHours Yield gpm Depth Data Measure from land surface - static (specify ft) c; % —Pbet' During yield test(ft) L3 q L' Depth of completed well in feet c�0S fk, t Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 3 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Volume Date Well Com leted Putnam County Certification No. 007 Date of Report 11,3AY Well Driller (signature) NOTE: /Exact location of well with distances to at least two permanent4andiharks to be provided on a separg a sheet/plan Well Driller's Name ! / / 2 _. - Signature: Address: CS ow. /V , Date: C White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML E��J SERVICES �� near�z/�ree,�� Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 93.903633 CLIENT #: 10542 STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SHKRELI, PAUL 12 TOMMY THURBER LANE BREWSTER, NY 10509 DATE/TIME TAKEN: 06/22/99 11:45 DATE/TIME REC'D: 06/22/99 12:30P REPORT DATE: 06/24/99 PHONE: (914)-228-5499 SAMPLING SITE: 12 TOMMY THURBER LANE SAMPLE TYPE..: POTABLE : BREWSTER, NY 10509 PRESERVATIVES: NONE COL'D BY: PAUL SHKRELI TEMPERATURE..: < 4C NOTES...: KIT TAP COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 06/22/99 LEAD <1 ppb 0-15ppb 12345 ---COMMENTS: Pb /Cu LEAD limits for EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive SUBMITTED BY: uiremctor-- ELAP# 10323 BRUCE R. FOLEY Public Health Director 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 (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 Harry Nichols Laurent Associates Millbrook Office Centre Route 22 & Milltown Road Brewster NY 10509 Re: Proposed Compliance: Shkreli 12 Tommy Thurber Lane, Lot #2 (T) Patterson Dear Mr. Nichols: June 16, 1999 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: Water analysis results for lead exceeds State standards. It is advised that the system is flushed and the water retested. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. robert ly your Morr is, P.E. Senior Public Health Engineer RM:tn sstsproposed MYMIM9MdM MfMiM111A2MdAAiMlMtM MiM" MFM➢ Rat' 1AxMSMa11A5MCRR1M2M7MEMeM IM:MIMSM�MIMIMZMUMtRAeM M:'M: M', AA -A -A A^." 1 � � y pj a (Vy/116YH:ilLlV1ii11yiHV &v VZHll9il N7Yy? HYfi/ N3yyF�/ �'/.:: �/ y9�( �fY17[ titit�l V7�tit�HEV1?fiVYY1' Eti/ Vryydyy! yVE�l Vl W9�/ 1i% Vl11VL! 1 1ti1S�(y3yy!VViiI� ;YN!H11tNtililN \'V_Y�W VY:YV- .v11`�VS JPUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM PA$4— 'g514Y —P—F_L_e Owner or Purchaser of Building M JfTplr'I��j Building Constructed by 11, To A>AY T M p— i, i, .Na Location - Street W",51 PaHc , 4)4. 12,E Tax Map Block Lot TownNillage PAJI_ 6 �-1 5Ub0i,4l021bH Subdivision Name RA Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month MAY Day 1-6 Year General Contractor (Owner) - Signature Corporation Name (if corporation) Address: il- °RHMi _- "POeaL LArHa State � �`' �' NY Zip l os-o yt Signatur Title: Corporation Name (if corporation) Address: 11 -1_040( TWA- ' State �Q -��ST- f Zip Form GS -97 June 1, 1999 Mr. Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Compliance 12 Tommy Thurber Lane Shkreli Subdivision - Lot #2 Town of Patterson Dear Mr. Morris Enclosed are the following: 1. Five (5) prints of Drawing S -2, "As -Built Plan," dated 6 -1 -99. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 5- 24 -99. 3. "Guarantee of Subsurface Sewage Disposal System," dated 5- 25 -99. 4. Well Completion Report, dated 1 -2 -98. 5. Laboratory Report, dated 5- 18 -99. 6. Application Fee in the amount of $200.00 payable to Putnam County Health Department. We would appreciate your review, approval and issuance of the Compliance at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. t} Harry W. Nich Is, Jr., P.E. HWN:JM:his 95077 -2 / LAURENT ENGINEERING ASSOCIATES, \ Nfillttown Ro d.C. Brewker, New York 10509 HARRY W. MCHOLS JR , P.E. (914)278 -6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS June 1, 1999 Mr. Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Compliance 12 Tommy Thurber Lane Shkreli Subdivision - Lot #2 Town of Patterson Dear Mr. Morris Enclosed are the following: 1. Five (5) prints of Drawing S -2, "As -Built Plan," dated 6 -1 -99. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 5- 24 -99. 3. "Guarantee of Subsurface Sewage Disposal System," dated 5- 25 -99. 4. Well Completion Report, dated 1 -2 -98. 5. Laboratory Report, dated 5- 18 -99. 6. Application Fee in the amount of $200.00 payable to Putnam County Health Department. We would appreciate your review, approval and issuance of the Compliance at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. t} Harry W. Nich Is, Jr., P.E. HWN:JM:his 95077 -2 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 , ' ` ' (9�4) 24��-2B ' [' '� , ` - Albert H. Padovani, Director LAB #: 93.903204 CLIENT #: 10542 NON STAT PROC PAGE 1 ----------- W --------------------------- ---------------- = ---------------------- SHKRELI, PAUL 12 TOMMY THURBER LANE BREWSTER, NY 10509 SAMPLING SITE: 12 TOMMY THURBER LANE : BREWSTER, NY COL'D BY: PAUL SHKRELI NOTES...: KIT TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE PUTNAM CNTY 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 05/05/99 PROFILE MF T. COLIFORM LEAD (IMS) NITRATE NITROG NITRITE NITROG IRON (Fe) MANGANESE (Mn) SODIUM (Na) pH HARDNESS,TOTAL ALKALINITY (AS TURBIDITY (TUR DATE/TIME TAKEN: 05/05/99 07:00 DATE/TIME REC'D: 05/05/99 09:40 REPORT DATE: 05/18/99 PHONE: (914)-2&S-5499 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE.": < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD ABSENT /100 ML ABSENT 1008 20.7 ppb 0-15 ppb 9101 <0.2 MG/L 0 - 10 9139 <0.01 MG/L N/A 9146 <0.060 MG/L 0-0.3 mg/l 2037 0.058 MG/L 0-0.3 mg/l 2037 16.6 MG/L N/A 6.0 UNITS 6.5-8.5 9043 48.0 MG/L N/A 28.0 MG/L N/A <1 NTU 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE ASNOT) OF A SATISFACTORY SANITARY QUALITY ACCORD HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. iblic schools are sot at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Hei h N.Y, 10598 - `.~ ' ~ . ` '� � ~~� (914) l�450280(> Albert H. Padovani, Director LAB #: 93.903204 CLIENT Q 10542 NON STAT PROC PAGE 2 SHKRELI, PAUL DATE/TIME TAKEN: 05/05/99 07:00 12 TOMMY THURBER LANE DATE/TIME REC`D: 05/05/99 09:40 BREWSTER, NY 10509 REPORT DATE: 05/18/99 PHONE: (914)-228-5499 SAMPLING SITE: 12 TOMMY THURBER LANE SAMPLE TYPE..: POTABLE : BREWSTER, NY PRESERVATIVES: NONE COL'D BY: PAUL SHKRELI TEMPERATURE..: < 4C NOTES...: KIT TAP COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. .WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY-HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER-LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Albert H. Fadovani, M.T.4ASCP) Director ELAP# 10323 I repndanCahst 1, am wholly and Compataly responsible forthe design and location of the proposal System(s); 1) that the Separate sew disposal system be subfnitted to pb>a in via, of once of the ap0i will be located as County Owartw//i Cate .GF VJ an M COI1ftrYCteO af,shown ori4M aoprowU_amendfllsnt thorn to ,Ohd, in accordance, with the 'standards, IY10f a regulations O ant of MosRN and that on completion tho►eof a '!Carti /icits'_o /'Constructlow Co' mplknce" 6ftisfsctory to the Commissioner of MwKhwill live Depeitittint, ,and a .written' guarantee' Seill tie furnished the owner, his successors, hairs or assigns by the builder, that .tab bulkier will lerating COndttbn, ony part of tier eaw+tgs- dkposN 4yetim during' the period of two ) yews bnmedistely following thetate of the Issu- imil oP via ;CertHkiti of" Cot4ruetioii'Conlplante, of; Ohs original s sti n or any "r" Ns hereto; 2) that the Milled well described above iod'pan.b^d that said well whits• 1 AddfOtsl t ii� �[X!R ' /7P ApP OVEO FOR CONST5tUCT10N.Tnis 80*4) 0.l expirestwa fiioeable for cause or may be amended or modified when consi .requNOa a Britt: . Approved.. for disposil of domestic 's Rev. 10/88 Sete�lr7�'. gd m in .acco 'n w8h t .. sta rd ru and fee —W.Un of the Putnam P.E. A.A. License No Ate issued unless constr lion of the building !vest bash uhdergken and is by.,tn mmissionef of MNith. Any change or *Iteration of construction and / evert. :water . supply only. Title WM PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE IN'SM -TION Street Location Tottin TNir� -I- — 1 .2 Date:`; Inspected by: <Z71 Owner Permit 4 - v Subdivision Lot',, 1. Sewage 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 IS' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sew•aQe Svstem a. Septiciafik size - 1,000 ...... ..1. ...... other ................ b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. gistribtuion Bow 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junctions Box. -.properly set ....................... ............................... 1. LengtFi required 5-o o Length installed 5'oy 2. Distance to watercourse measured-4-ac) o Ft.......... J. Installed accordinan ......... ............................... ' 4. Slopzy�fjt ch acce�taloe /16 1/32" /foot ............. fft�< --==ff� S. 10 0 operty line - 20 ft.- foundations.......... 6. Depth of trench <30 inc es'froTO&.-. s}agb ...:.............. 7. Roo ow for 'on, L .................. 8. Size a} 2 ' diameter clean .................... 9. Dep o - gravel in trench 12" minimum................... 10. Pipe ends capped ........................ ............................... g. Pump or Dosed Systems I. Size ot pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. S. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Buildw _ a ouse" ocated per m approved plans bh�umber of bedroos............ . ... �F ..� a. Well located as per approved plans . ............................... b. Distance from STS area measured 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 waterco g. Footing drains discharge away from STS area ..............' h. Surface water protection adequate ... ............................... YES NO COMMENTS f-4a CFAJNr4f ilt s C�eo r d � O b�`-l�ween s+1G q+iq� >G X K 1� r�. fl-tl- 5V •3 .. CpG� S heet of r ; _ PUTNA;M- COUNTY DEPARTMENT'OF HEALTH , - DIVISION OF`ENVIRONI!'XF,I�TTAL IiEATLiI" SERViCES FIELD. ACTIVITY REPORT NAME: :59- %iCRL.) TPIr/k�Y� A "nnRF.�a 7�J'�INtY :" �1U�25`12 LAND P4TTE�F50N Street : Town" ` State Zip PERSON IN CHARGE nR TNTFRVlF T). _ Name and Title TYPE OF "FACII;ITY : u l^ e,P FINDINGS �� n��ec��vh`' � �w`� /�y��e:'' nlas{ -.� t -�'h,a I)t/1V ��- h:0c k4 UaD 2 `je no �'yZh��ec7f-i`oYI (/�o�5e - -'�o te.vlkl " 3 ~ �rc2h!t �"�.,� .�'� t11� ,�,�ci:� '� � "'�2 � � ; r�e+� �-o a.°✓� � v�: ��z 1%� - - � ��i '�? �t ' i �e`�i�1_ i! ,�j � � %r�Ct = a` �Oe'i�! ��' tx � r�etr V'� '��/E� -�- �`�'i►,� -5' . 4 r v, b zzw Signature -and Title - RFPnRT R1?f`F.TVRD RY.' - I acknowledge receipt of-this report SIGNATURE: 02/96 Title.-_ Rev J 'Sg GITY'DEPA4T THE CITY OF NEW YORK DEPARTMENT OF ENVIRONMENTAL PROTECTION Wks! JOEL A. MIELE, SR., P.E. Commissioner ENTAL PQOTE�`�� WILLIAM N. STASIUK, P.E.,Ph.D. Deputy Commissioner PHONE (914) 742 -2001 Bureau of Water Supply, FAX (914) 742 -2027 Quality and Protection June 5, 1997 Mr. Harry W. Nichols, Jr., P.E. Laurent Engineering Associates, P.C. Millbrooke Office Centre Route 22 & Milltown Road Brewster, New York 10509 Re: Log # 7042 Proposed Individual SSTS Paul Shkreli, Tommy Thurber Lane Patterson, Putnam County Diverting Dear Mr. Nichols: The New York City Department of Environmental Protection (Department) has determined that the above referenced application, received by the Department on May 27, 1997, is incomplete. Please be advised that the following information is required before the Department may commence its review: • Please provide the location of all subsurface sewage treatment systems and wells 200 feet from the property line. • A detail of the pump chamber is shown on the plan, please provide the location on the plan and other information such as, model number and applicable pump curve. If the pump chamber is not part of the proposed system then please cross out the detail. • Provide a detail of the proposed curtain drain on the plan. • Provide a detail of the proposed cleanout along the effluent line from the septic tank to the baffle box. • Please provide four sets of plans to this office. 465 Columbus Avenue, Valhalla, New York 10595 -1336 Harry W. Nichols, P.E. Page 2 of 2 A E.- Shkre If SSTS __ , ._m..:.. _ - _ _- June 6, -1997 ___:..: Please forward this information to me at the following address: 465 Columbus Avenue Valhalla, New York 10595 The review of your application will not commence until the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow the Department procedures is sufficient grounds to deny approval, pursuant to Section 18- 23(b)(3). Should you have any questions or care to discuss this matter, please contact me at (914) 742 -2068. Thank you. Sincerely, annine M. McColgan Staff Engineer Engineering Design and Review xc: Putnam County Department of Health 465 Columbus Avenue, Valhalla, New York 10595 -1336 P. LaM WiJIMEZ DEPA'_RMl;arL Oz- DEAL DIVISICN OF- FM%LUd -S&RVIC ES .... .. .... ------ SES,MGE• DISPOSAL 'SYSTEH' FILE t3� Crem er Address So 1 )!!1 N Ibcated at (Street) S, -C Lot (.indicate nearest cross street)' nlnicipaLity Watershed, _4P-0-ri9 N COm PaRCmA=CN-..= aAzA- PBW=To BE-sLPax_r= WIL APPLIC=WS 1-te Of Pre-soaking r ''' Date of Pe-Co lation Test Na,T _PR CLCCK TDrE p _-:� PT-_pCx&-lmq Deapth to. Pater . Vr o m Wa_.ter Level: • 1110. Ti I,=, ..Ground Surface. ln-,Yn(fhes -Soil Rate7. Staft-q_�010 Min Start Droo In Min/In D-roo :Inches Inches Inches L A2 9 ' 71 2 ''00 2 :7 S O 3 r-9 -7 2 .3 -�T- 11,4-2, '35a 4 5 2 .3 ca e7—al SOL! r, uzl-,_ ZIT c, C2 to' ba r t I LOc • ... ... � _ .`n�u�. ��S . ,. �� .N�'� • �� I % . :rte %j �•� �. • I• SSa�.7Ci . v • . v Vp,��;W � ''1�l I� • Cdr O••?.l „O. "�I ��O _T-pu@� . LPPTM „�Z x °3'`i • _ OQ�C Xg Paprnoxa .�ax� irot�dxosq� ' �Z •sre�i .. .. �� YOxieO �u-er or�dag. swx�xY� �o -off . . POPznoxa "2aav aZq--,sl3 'Q'S :doxQ ,r` LMl pa,SII 'Eq-e-a TTOS N- IsaQ . VS./-: ./- N CS F N O` Q XQ! 3Q"c i•i Sroiam'3 sso rs-103 c�Q Caasl rjl= JUTS - 3"d sasTd 'mn U&LTM HJg!M GL-mm =ZCk`a c��_uN sx HJxFi� BFI 'I3t�3Z 'Jxar�z - - ,VT JET tZT 1TL s6 9 1-1 Ijd r : 19 G 1-Ays sa4mq L7,S L NI CLH t�T ZC alza 5120- 3C? ,�-i1.^:,;7Drf ` -7 YLIT � i l f ilC, � oi �� 7'�]i 1 r Z?wi`T PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re:. Property of PAVI _ SAI $ra— Located a t V W KAY_ Tt�-t� R P� t tZ l,% t�l �.• (T) PA'T-(1T0� Section 3t Block 9' Lot �Z Subdivision of Subdv. Lot ; - Filed Map # Date Gezitlemen : This letter is to authorize_ �U -Agg-( W. NI 0401- �F,, a duly licensed professional engineer K -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 Article 145 or 14.7, Education Law, the Public Health Law, and the Putnacu County Sani- tary Code_ Countersigned m �9� !PLO Telephone i ;ry truly yo , _geed / Owner of roperty . OG G4es:f6p PRN!�j y-- — Address -(0 MKEQ Town Telephone AA10VRIO"I", FOWAMAAkOkAf"MAJOW". F^AMAfAAIAAiAAMqlAAf Tf. Val iI II .......... LAURENT, ENGINEERING ASSOCIATES, P.C- . MILLBRd0KE oFFICE CENTRE Roiite.22.8',MilRawn'Road .- _ _ Brewster, New York 1 " �(914j278- 8108 - (FP,�•�7�2� CONSULTING SITE ENGINEERS Date: W&WAIRM MaWNIMM-A&L'I MV l� ICI A �g►�� STC - -� �i '147 501 Attention: Gentlemen: We enclose (+) copies of: 0 B/W Prints ❑ Reproducibles Job No.: Project: ❑ Reports ❑ Tracings ❑ Specifications ❑ Memorandum ❑ Copy of Letter Description: SS -� 'PRO PoSeo SsCI)s" L�-rtrt2 mot: LJT rZ iz -r i o r� '' R e . -7 M Revision /Date No. Q-5: V 7 -4) `6) re�Isi01�S Pet OUI'L CO►.l�I 5,4-tlo� iN) >_[- PI . OP APPfZovAL 7-141S w �r - 1-ANtZ-5 Sent Via: ❑ Our Messenger ❑ Blueprinter 9 ❑ First Class Mail ❑ Special Delivery ❑ Your Messenger *and Delivery ❑ Copy to: Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRON1,ENTAL'HEALTH SERVICES Date Re: Property of VAL)j_ SIqKIRSIL_) ..'L-ocAted at (T). .,Section ---Block 1,0, Subdivision', of SH gar-- Subd v. Lo t # Filed Map{` Date Gentlemen: This letter is to authot7_z,6_ E�A-99_-1 W, S1614eLG A - a duly licensed -professional engineer X, .•or registered architect U-ndicate.) to apply for a Construction Permit for a separate sewage -system, to serve the above noted property in accordance -Kith the standards, rules or reg-ulat:Lons as promulagated by the Commissioner of, the Putnam County Department of Health,. and to sign all necessary papers on my behalf connection -w-ith this matter and to supervise the construction of saic I system or - systems in conformity the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code_ C 0 U-1 I t C. rs -': - "—n C." ,krery truly yo z S i ggn e d o -' Owner of Property L L 0 P_.Q a K� OV-rl 'A'd.drcss 0 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 -- - (914.,1.278 _5130_ " APPLICATION TO "CONrTRLTCT -A -- WA R WELL- "= n - PCHD PERMIT # WELL LOCATION Street Address U Town/Village/City Tax Grid Number -2 JZ WELL OWNER Name Mailing i ( Address " ) `( Wrivate O Public USE OF WELL - primary '12' - secondary 13 RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL OPUBLIC SUPPLY QAIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY ❑ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT _gpm /# 0 REPLACE EXISTING SUPPLY SINEW SUPPLY NEW DWELLING PEOPLE SERVED,j -,� /EST. OF DAILY USAGES - D al O TEST/ OBSERVATION CI ADDITIONAL SUPPLY 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ODUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES _ <, NO WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 6N4 Lot No. WATER WELL CONTRACTOR: Name -rv?>-o Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ENO NAME OF PUBLIC WATER SUPPLY: w AS, TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N �� 1. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVI OAN SEPARATE SHEET (date) "Wignatur 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 drill' operations be contained on this property and in such a manner as not to degrade or othe wi contA;�; ' rface or groundwater. Date of Issue: 19�_ A&C, Date of E xpiration 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 APPENDIX 3 PUTNAM-- COUNTY -DEPARTMENT : OF HEALTH — DIVISION ;OF ENVIRONMENTAL - HEALTH SERVICES_ _ INDIVIDUAL WATER ,SUPPLY_. & - SUB, SURFACE. SEWAGE DISPOSAL SYSTEMS..,-. _ - ' `REVIEW`SHEET for CONSTRUCTION PERMIT STREET LOCATION rOM P` q V'041594 4-6" NAME OF OWNER BY B. HEDGES R.MORRIS , ETHER DATE tjt_jd/ ' •_TAX MAP # - - Y DOCUMENTS. PERMIT APPLICATION PC`-1 WELL PERMIT M PWS LETTER 5NGINEERS AUTHORIZATION 6ESIGN DATA SHEET(DDS) CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST, SUBDIVISION M LEGAL SUBDIVISION M SUBDIVISION APPROVAL CHECKED M PERC RATE ED FILL REQUIRED DEPTH M CURTAIN DRAIN REQUIRED mSTANDPIPES Y EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED PIT & D BOX SHOWN & DETAILED HOUSE-7-NO. OF BEDROOMS LS & SS S'S WAN 200 FT. OF PROPOSED SYSTEM P ER ETES & BOUNDS m HOUSE SETBACK NECESSARY (TIGHT LOT) FT-1 HOUSE SEWER - 1 /47FT. 4 "0; TYPE PIPE f ENDS; MAX. BENDS 45° W /CLEANOUT FILL SYSTEMS YBARRIER T HORIZONTAL: SLOPE 3:1 TO GRADE SPECS m FILL NOTES CERTIFICATION NOTE H GAUGES PROFILE & DIMENSIONS UME GENERAL L IN EXPANSION AREA m EX- APPROVAL SSDS ADJ. LOTS CLl WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH m DATA ON DDS PLANS & PERMIT SAME F TRENCR PROVIDED • m 60 FT MAX m PRE -1969 - NEIGHBOR NOTIFIFICATION ARALLEL TO CONTOURS _ ....� LETTER.BI/ZBA.. - -- t-100% EXPANSION PROVIDED m 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS .FIELDS SEWAGE SYSTEM PLAN - (NORTH ARROW) ® ' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL SDS HYDRAULIC PROFILE m GRAVITY FLOW 0' TO FOUNDATION WALLS � 15' WELL TO P.L CONSTRUCTION NOTES (GRINDER NOTE) 100 TO WELL, 200' IN D.L.O.D., 150' PITS DESIGN DATA: PERC AND DEEP RESULTS 00 TO STREAM WATERCOURSE LAKE (INC.EXPAN) TWO -FOOT CONTOURS EXISTING & PROPOSED V TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER RIVEWAY & SLOPES CUT 10' TO WATER LINE (PITS -20') FOOTING /GUTTER/CURTAIN DRAINS 50' INTERMITTENT DRAINAGE COURSE ROSION CONTROL; HOUSE,WELL, SSDS 200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS ROSION CONTROL NOTE 15' MIN TO C.D. S=> 5%, 20'- 4%,25'- 3 %,30'- 2 %,35' -1 %,100' <l% ERC &DEEP HOLES LOCATED ' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. REPRESENTATIVE OF PRIMARY AND EXPANSION TE21c TANK LOCATION MAP [III FROM FOUNDATION; 50' TO WELL COMMENTS: ' LAURENT ENGINEERING -- - -- ASSOCIATES, P.C.' - • Route 22 &Milltown Road Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS May 20, 1997 Robert Morris, P.E. . Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Paul Shkreli Tommy Thurber Lane Patterson, N.Y. Dear Robert: Enclosed are the following: 1. Four (4) prints of SS -2 "Proposed SSDS ", dated 4- 16 -97. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 4- 16 -97. 4. "Application to Construct a WaterVell ", dated 446-97. . 5. "Design Data Sheet ". 6. - "Letter of Authorization ", dated 4- 16 -97. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ", 8. Money order in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LA NT ENGINEERING ASSOCIATES, P.C. Harry W. Ni Is, Jr., P.E. HWN:TR:bd ; 1/ 95077 -2 APPLICATION FOR APPROYAL..jDF ,PLANS , Fog..A.VASTEWATER DISPOSAL;SYSTE.H 77 Name and Address bf..Applicant:. �7AQI ;7 . .... ......... . .............. ---------------------- 2.. ...Na-me -of Project:' 3.._ Location T/V/C: 5 • Address: Milibr'6o"ke 'Office Cent 4. __-.,Pr6ject� Engineer: -1A4JZ 116 s: 'Brevister, 0509 License N u b e r 5G(24 -.,Phone ,::-(914).-.278-6103 6.. TYPe of ,7 e e si Fo 0 d se; i ce -Cor,nerciaJ P -6bi.le :Home - Pa rk Apa rtr,-,e n ts Ins - t - i ' tutiona I Officelbu"il8ing, ea'1t_Y._'.Subd'i'vi.sion- Other'. (Specify) 7. Is .-'this -project' s'u'bje'ct' to -State. Enviroinm'enital -Qual itY Review (SEQR)? Type Status (Check One) Type I.. Exempt Type 11. UnTiSt ei'.8.' S. 19 a Draf t Envi r'Onmenta-1 Impact-.Sta:temen t :_(DEIS). -required? ........... 3. Has DEIS been completed 'and 'fo-Unid acceptable by Lead Agency?. N /A 7 t� N•ame of :`ec-'�d A-9--e6cy /,6_ Is this project in an area under.. the contro or other officials, ordinances ?. .......... I of-local planning, zoning, .............................. No If so, have plans bee it'ted to such'.'authori ties? .......... .......... Has prel in. inary approval beep'"gran'Led. by '.such authorities ? N,�ADa.te Granted: Type of Se�?a'92e'Disposal. System' Discharge, Surface Hater K Ground haters if surface water discharge, what is the stream class designation ?........ ri'a t e r s index number - (surface): ........... -'s project located near a public water supply syste-m? ............... .1�0 y e s 'm. e C, 'rater supply Distance t o a ter s u.p e C - C):� 0 r- C, S P 0 S a S s J a p L, b i c s e c o L 0-1 sewage s y s t em D i s t a n c= c s age s v s e r-, ---------- 2 I hereby affirm, under penalty of p-_r�ur Y, that information provided on this fon-,7 is true to the 'best -of my 1,now7e8se and. b,- 7 1 f.- Fe 7se 'sta'terAntsmede herein are punishable as a C7 s A Xis, or P sun to Section 210-45 of the Penal Lev. '.-IJURIES OFFTCT L T r', - ITLES - Q 92 W N I I tr-_ PLS ;•illbrooke O'L.'Lice Centre 1NC ADDRESS: I Bre;.,ster, NY 10509 I s-s- t -at ePollutant D-i.s.charge7Eul;in�inat-166-*:Sysedfi-'(SPOES) Perm it requ i red?. 26, Has SPDES Applicati6n bee6,sub,,itted' to1o'cal DEC:Offic'e? ............... 27. is any. portion .•of this-project -lociated.:witlhin--a ---desA§n4t6d*T6Wn, or• State wetland ?.......... ........ .... * ............................. 5 28. Wetland ID Hunnber. ............ ........................... ....... .. .... 29. required?' - 'Is et . . . . . . . . . . . . . . . . . . . . . . . . . .. W land'Peml ►1 . . . Has app�l i cgLt i oo been made to-'Town or Local DEC Offi6e?*_. .......... ..... ZA ,5o -equire a-.DEC Strepm Disturb e Permi. it? Does,:proJect anc ......... 0 21- is or was. - project `s i- e use 'Tor_=aqr- cOlturAl activity involving =application of pesticides to orchards- or other 'crops* solid or hazardous waste disposal land-IN ling, sludge application or industrial activity?. .-;YES:--6r_'N0,.'- 7, 32. is project - l6cat.ed•i•t'hin OT ..-exisi6n6e,,, 7.of-,.abandoned.. landfill, azardous'caste,si e,-salt stockpil'e',,landfi)i,-7sl, u d -disposal'- te 'or hazardous caste. si a n y other potehtial known •source of contamination ?..... - ......YES or 0 DESCRIBE: �3. a local ma�t' a is- er plan o r*'f i I e • w i t. h the Town or Vill 'ge? 19 I 1 ire c o.-nii u'n'i t y water, sewer facilities planned"L o be developed within 15 years?. A Z, S. Are any sewage, disposal areas in excess of 15% 'slope? . • = -'-, ..................... Taz': Hap I D N um be r . ............................. .......................... . Approved Plans; zre' tobe returned to: • .............. Applicant iC Engineel- the applicationlis signed by a person other than the applicant shown in I t- en, I the.- olication must be-accc,-,,paJ L n ed by-a Letter* of Authorization; 'Failure to comply with L th-is :)vision may be grounds.for the rejection:o-F, any -sub.-iiissfon. I hereby affirm, under penalty of p-_r�ur Y, that information provided on this fon-,7 is true to the 'best -of my 1,now7e8se and. b,- 7 1 f.- Fe 7se 'sta'terAntsmede herein are punishable as a C7 s A Xis, or P sun to Section 210-45 of the Penal Lev. '.-IJURIES OFFTCT L T r', - ITLES - Q 92 W N I I tr-_ PLS ;•illbrooke O'L.'Lice Centre 1NC ADDRESS: I Bre;.,ster, NY 10509 THIS IS . CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS -INDICATED- ON THIS PLAN AND THAT THE. SYSTEM WAS INS= :.-PELTED -By ME BEFGRE IT WAS COVERED OVER. OVER. I THE SYSTEM WAS CONSTRUCTED IN ACCOR- - DANCE WITH - ALL- STANDARD RU.LES AND REGULATIONS OF THE- PUTNAM COUNTY •DE- 4 - PARTMENT OF HEALTH AND THE NEW YORK _ STATE DEPARTMENT OF HEALTH. 'I suKvr5:'f INr-OPMATION TAICt-'-N -,FROM Q .M I v S -1 CO;LV C H A RT (in A 5U2vE,f, f3Y TER.KY ��KC�EN;DOR�F GOLL (NS, L.S. - NO DATED OGT 5 - f 096.. . 1 52 27 ". j4 3O2 2 2;17 4 300. 2 7 f . 3.34 30 3 5 304" 2 6b` I8 3.4•�.'� :. . ,.3 1 " 4 3•0 2`05., °: 7 296 " 2 :62 20 352 3 19.,. 8 29,,3" 2 &0 1: 3g !o 9 2 22 ;. 3 G 0. 3 2.5 .`. J: >• 10 28ro" 3° 327 24. 3.3g, -3.0%3 2 -2 2 56 . I3 277, 248, Y 4 'i rl