Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2128
DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 19.-2-17 BOX 19 02128 IL' J L� �i �� i'�lT ` 7L L, I Ills IPA or ter, ML 1 - ■ , 02128 PUTNAM COUNTY DEPARTMENT OF DIVISION OF ENVIRONMENTAL HEALTH SJU CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREA' PCHD CONSTRUCTION PERMIT # P V - 10 - 0� Located at 1 g 2-1 �4Y-!$ P-00-1E 1? 0 1 Owner /Applicant Name TOM Formerly F V4 11_141 Town or Village KSIAM \JA'L .Z� Tax Map i �' Block r� Lot Subdivision Name Subd. Lot # Mailing Address J-0 A-"EN 14J yl�5 G A 94& 1/70,k) Zip I off? j Date Construction Permit Issued by PCHD 11,/00 1Oij i Separate Sewerage System built by Address G►v 1• Consisting of (1 Q IZ� Gallon Septic Tank and -Menu c,14 Other Requirements: Water Supply: Public Supply From. Address or: Private Supply Drilled by 1`4WA H AW4. 0j Address 151- 04601-6r, p ` Building Type... 51 DG.1 -1 G� Has erosion control been completed ?_:... Number of Bedrooms Has garbage grinder been installed? N 0 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 regulatignskf the Putnam County Depa}Qnent pf Hgalth. Date: Addre P.E. )4 R.A. I 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 revocation, modification or change is necessary. By: Title: � Date: 0 copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 :- � �h 8 l .� i A I. I r r CERTIFICATE OF CONSTRUCTION COMPLL&NCE FOR SEWAGE TREA PCHD CONSTRUCTION PERMIT# P\1-,P-0'1P Located at 19 2-1 ky'!5 P_00_11� n? 0 I Town or Village Owner /Applicant Name TOM M Formerly Tax Map 1 I' Block I- Subdivision Name Subd. Lot # Lot I Mailing Address J�ro /A-"F_p 0A-1 yg5 G A 94t I /70p) Zip Y o�u Date Construction Permit Issued by PCHD 12 f o(p 10' j Sejgarate SeweraeSystem built by ��}1I,UP� ���- u1s, � Address � � _�� U qwwl I Consisting of 0 Q ® Gallon Septic Tank and C-A Other Requirements: Water Supph: Public Supply From. Address ®r: Private Supply Drilled by k�WAH ANW 0 Address 16f- 0460-x, P' '` NT 10'a 11 P- �g1D�G . ..._ �:.BuaidingT_ypw �,... .. _ _ ... ;_t Has erosion :rontrQJ`,been.complqted? . ... 5. _. ....._ .. Number of Bedrooms 1� Has garbage grinder been installed? NO 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 fif the Putnam County Depa#nentff Health. Date: Certified by Address P.E. '�- R.A. ©- 0q Licei�e # 62 (1 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 revocation, modification or change is necessary. B s�� Title: r- Date: o Y copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Well P3ermrt# WELL COMPLETION REPORT H... Well Location Street Address: ko,j A.,,Cfe Sul Town/Village: Tax Map # Map l / Block Lot( '� p Well Owner: Name: Address: Use of Well: 1- Primary 2- Secondary esidential _Public Supply Air cond /heat pump _Ir igation 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 _ Open hole in bedrock _Other Casing Details Total Length ft. Length below gradegU ft. Diameter min. Weight per foot l_K_lblft Materials: Steel Plastic Other Joints: Welded Threaded Other ; Seal: Cement grout Bentonite Other Drive shoe: Yes V6o Liner: _Yes < No ° ! Screen Details Diameter in Slot Size Length ft Dept to Screen ft Develo ed? First _Yes No Hours Second Well Yield Test _Bailed _Pumped _ Compressed Air 7 Hours %-f Yield -t'7 gpm! Depth Date Measure from land surface - static (specify ft During yield test ft Depth of compete we n; . c. Well Log If more detailed information descriptionsor sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter in Formation Description', ft. ft. Land Surface / O .,:� _..... - - _.._...__.. _. . _. .. - ....._.. < If yield was tested at different depths during drilling list: Feet Gallons Per Minute PumqjStorage Tank Informati Pump T pe b Capacity Depth Model �&o Voltage HP Tank Type fl( Volume Date Well Completed „_- Well Driller PC Certificate # o NY State # Y b 1 D 7t9 PumpInstaller:,PC- Certificate #�.pZ° _� (' NY State #_, Date`,of Report' WeIG� rrller Pu Installer Nam 8, Address N 4 !. }S Pump Installer,(signature)}, !; n; h ! 'Y . Pik , a, L!:5' kj NOTE: Exact Location of well with distances to at least two permanent landrrWrks to be provided -on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller j Form WC -97 Rev. 3/06 M 110v 14 Ub U3:33P BUI.;- -PIING DEPT 91452G880G p.1 NOV -14 -2096 02:32 PM H� �Y W NICHOLS 914 279,E ) 67 P.02 . ...,.. - �ubllr XtivaJak &LroP1oP • • aatpe4ar� d's�lk ditpl�k Ovaerer.•: � . • @fnttra► of PlrRsnc �errkr� ':' . ' ;. OEPAR'iMNT OF HEALTH i Osnovs Road Browster, Now York 19909 biwozoatet Nodik toi4)31t•6ilo w R14) all- 7921 . `: Nrriloa &nfcu t9i6 }al0•i3lt .Wle (9hJ8t6�66t6 ,fw(9aQ se?i•6o93 - E,ry'Titervta8oe'(9ta)8ff.(,mN 9re�a400l{DISI1Pt•�8d1 Pestold)s7a -•�I -. r.SS ME ! ,A,Tj!Qf i FORM -0WRERS NAM: o�fr� �tLi,tPS VTH A.M A. ' TOWN., y AUTS0 =EtrTOWN OFMCI"- Lsy DATE: — Thf Putiar" County Department of Healtb wilt not issue a +Certita'rete W. coustrueflon Compliance unless the above form is completed; 1,e,; a legal`E91 t. address b assigasd by sa &� thvriud town official. 'Phis form d� to ke subrei?ted _ . r►itb the apphation for a Cerditatea of Corutmctto ®.0 -PUTNAM COUNTY DEPARTMENT ur HEALTH DIVISION OF. ENVIRONMENTAL HEALTH SERVICES =z., GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 2- /7 Owner or Purchaser of Buildrn . Tax Map Block Loth Building Constructed by t Location - Street Building Type. Town/Village Subdivision Name Subdivision Lot # I represent that I am wholly" and completely responsible for the location, workmanship, material, constnrt;tiorT and drainage of the sewage - reatment.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 'parr-of said 'l�stem 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,..exeept 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 ithe system. Dated: Mont Nod Day Year %QtP Signature: Title: B Wry J...�C" General Contractor (Owner) - �igry rely pl- tvuvR (Y14o fns Corporation Name (if corporation) Address: 23 jkjje,+n &,vg__ State rte_ Zip Corporation Name (if corporation) Address: O-b NPMtD %LN5,G1 "SOS State 1" J Zir Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (7 14) ' �� � Alber 1H. Pa z , 'irec tor LAB #: 9.700048 CLIENT #: 59932 NON STAT PROC PAGE: 1 | ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ / PHILLIPS, THOMAS 23 ARDEN DRIVE GARRISON, NY 10524 SAMPLING SITE: 1921 RTE 301, CARMEL, NY : KITCHEN'TAP COL'D BY: TOM NOTES.,.: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE PUTNAM CNTY PROFILE 01/13/07 MF T. COLIFORM 01/16/07 LEAD (IMS) 01/18/07 NITRATE NITROG 01/17/07 NITRITE NITROG 01/17/07 IRON (Fe) 01/19/07 MANGANESE (Mn) 01/15/07 SODIUM (Na) 01/15/07 pH 01/19/07 HARDNESS,TOTAL 01/19/07 ALKALINITY (AS 01/18/07 TURBIDITY (TUR COMMENTS: FAX TO 845-737-4844 DATE/TIME TAKEN: 01/13/07 10:00 DATE/TIME REC'D: 01/13/07 10:40 REPORT DATE: 01/22/07 PHONE: (914)-548-4434 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT ABSENT /100 ML <1 ppb 0.45 MG/L <0.01 MG/L <0.060 MG/L 0.014 MG/L 4.69MG/L 6.6 UNITS 86.0 MG/L 72.0 MG/L <1 NTU NORMAL - RANGE METHOD / ABSENT 1008 0-15 ppb 9003 0 - 10 9052 N/A 9162 0-0.3 mg/l 9002 0-0.3 mg/l 9002 N/A 9002 6.5-8.5 9043 N/A N/A 9001 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDINE�����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 thei� 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 reddce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (9 14) � - LAB #: 9. 8 n1CLIENT #: 59932 ~~~~~~~~~'~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PHILLIPSv THOMAS 23 ARDEN DRIVE GARRISON, NY 10524 SAMPLING SITE: 1921 RTE 301, CARMEL, NY : KITCHEN TAP COL'D BY: TOM NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ / DATE/TIME TAKEN: 01/13/07 10:00 DATE/TIME REC'D: 01/13/07,10:40 REPORT DATE: 01/22/07 PHONE: (914)-548-4434 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~�~~~~~~~ RESULT NORMAL - RANGE METHOD 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. 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 ASCALCIUM-CARBONATEv.IN MG/L. THE ~ /MGE FROM-0 HUNDRE- O'-M L- DEPENDS-ON-E '' ``-- AY 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: Director / ELAP# 10323 Harry V/. Nichols Jr., P.E. Pattcmon Parr, Suitt 106 2050 Route 22' Brcwstcr, NY 10509 Tcicphonc (&45) 279 -4003 Date: - -'-d .7 To: Job No.: ✓1 G!/`� Project 9 rc v s u` 104 "IU r L 7- d Attention: /i/1 2- f 7 . Gentlemen: We enclose (�� copies of: B/V/ Prints Reproducibles Reports 1/ . .Tracifigs Specificatior>_s Memorandum Copy of letter. Description: Revision/Date No. ll _ Sent Via: Our Messenger Bluepri4ter First Giass Ma.if . Special Delivery. Your Messenger Hand Delivery Copy to Very N.1y, you rs _ - - arrv':Ii SHERLITA AMLER, MD, MS, FAAP _ _. _. ,-- _Conzr�zi•rrinner.of f�cctdth::�.�.. ,..,... •.:..- - LORETTA MOLINARI, RN, MSN Associate Commissioner of Health i ROBERT J. BONDI .. - -- :Coufity '-Executive - i I i DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 FACSIMILE TRANSMITTAL To: ULI "?j / c �� �s Fax: off- 7 `( - V V GlV ��:i 401+6' 1 1'1 � Ci From: �O� n �r. Date: cS Re: fiv -c,c ( Cdr: �Gr ft� yf Paaes v'L b CC: ...................................................................................... ............................... i ❑ Urgent �r Review ❑ Please Comment ❑ Please Reply i CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that.any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845- 278 -6130) and destroy all documents associated with this facsimile. I Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 I OME Harry VJ, Nichols Jr., P.E. ' Paacrson Park Sukc J06 2050 Routc 22' Brmstcr, NY 10509 Tcicphonc (845) 279 -4003 (245)-279 -4567 Date: To: - Job No.: Project Attention: AV, p�rr/�v�t vcv?� Gentlemen: We enclose ( copies of_ t3/W Prints i/". Reproducibles Reports .Tracings Specifications Memorandum Copy of letter. Description: Revisionll?ate No. r C;,�� DllJw.i lr L �v . f O� J "'l K 4-S � �,JU i Ili' s � L , � l��✓' .-�2�' 1 � —!J � C'/'�t /lUC �'�. Sent Via: Our Messenger i/ - Bluepririter First CCiass-Majf - Special Delivery. . 'Your Messenger Hand Delivery . Copy to Very tVjY Yours Ha W*. icho r., P-:E. _ . SHERL[TA ANILER, MD, NIS, FAAP Commissioner of Health .;:a.. =.�•- L•OR.ETT.A 1V10LI1�1�41�19 ..RN��+^,�(= � -,,.:. - ::- ,:�.:-_: °:;,_ Associate Commissioner of Health Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 ROBERT J. BOND[ County Executive i - ROBER'i`MORR[S, PE" Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 i I i February 13, 2007 Re: Construction Compliance - Philips 1921 Route 301 (T) Putnam Valley, TM# 19. -2 -17 i Dear Mr. Nichols: 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 review and consideration I. °i he ,dell `completion- report -is not 2. The as -built plans note a 4 bedroom residence. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 21.57 if any questions arise. JSP/kly Very truly yours, Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 January 23, 2007 Michael J. Budzinski, P.E. Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 2794003 Fax: (845).279-4507 Email: 6nengmee�61.6om RE: Individual SSTS Compliance — Phillips 1921 N.Y.S. Route 301 Putnam Valley, NY T. M. # 19. -2 -17 Dear Mr. Budzinski: Enclosed are the following: J 1. Five (5) prints of Drawing S -1, "As Built SSTS ", dated 01/23/07. 112. "Certificate of Construction Compliance for Sewage Treatment System ", dated 11/17/06. J3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment System ",-dated 11/17/06. 4.. Laboratory Report, dated 01/22/07. /5. "Well Completion Report", dated 10/31/06. /6. Application Fee in the amount of $300.0 payable to Putnam County Health Dept. ;/7. "E -911 Address Verification Form ", dated 11/14/06. If there are any questions concerning the enclosed, please call. Very truly yours, Harry W. N)ehols Jr., P.E. HWN:gav , 04- 103.00 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health L.ORETTA•MOLINARI, RN, MSN ,.. _ ... ♦vc. �.. T.. ww..{a.....: �- •".:�ru e..c u' ;sc cam. Yic�..- •. r+.a.9+. ..i r.rc n Associate Commissioner of Health November 9, 2006 i ROBERT J. BONDI County Executive -Pd RRIS .I ve. rrv..I....K.�v .t n u•Lac�.�. R.r.wl.. yfi, •i. •.� A.✓. <. r'�.r,r.t .,.r Director of Environmental Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 i Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Re: Field Inspection - Philips 1921 Route 301 (T) Putnam Valley, TM # 19 -2 -17 Dear Mr. Nichols: A re- inspection at the above referenced site has been completed. There are no further comments to be addressed at this time in reference to the field inspection. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. I ..Slncerel }�, .�., ... .... e... , _ .. .._ -.. >., -. _ .....- Gene D. Reed Sr. Environmental Health Engineering Aide GDR:kly Environmental Health (845) 278 -6130 Fax(845)278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool(845)278 -6014 Fax(845)278 -6648 SHERLUTA AMLER, MD, MS, FAAP Commissioner of Health L0RET 'A M0L1N.AR.6;. ,RN, MSN- ss'ociate`Co'rii 'm'' issioner of health October 26, 2006 Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 R®HERT I BONDI County Executive - Director of Environmental Health Re: Field Inspection 1921 Route 301, (T) Putnam Valley TM # 19 -2 -17 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. Please call for an appointment when you need the bedroom count done. c at: 2355_ If ou h ave an y__further questions, p_ease:dontact me,at.(845)'278 -6130 JD:kly Sincerely, oseph Digit Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH A /< 'T 0 0� 0,�I�� � �' �' U DIVISION OF ENVIRONMENTAL HEALTH SERVICES �S FINAL SITE INSPECTION U Date: • � ZSIo ��l n Insi)ected by: Street Location ��= Owner TM # '7 Subdivision Lot # 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ................: d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course/ wetlapets ...... ............................... E1. Sewage System a. Septic tank size - 1,000 ......... 1, 250 ......... other ................ b. Septic'tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set .......... ......::::....................r . 6. 'trenches -4- 1. Length required -- V7 Length installed a3 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum .......:........... 10. Pipe ends capped ........................ ............................... g. Pumn or Dosed Systems .- . _... pump chamber ................................................ 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. house located per approved plans ............. :......... b. Number of bedrooms ................... Ocuh. .. ,v'b�l 1aK5 IV. Well Well located as per approved plans ............... r................ b. Distance from STS area measured /00' - ft........... c. Casing- 18" above grade ............................. :................. d. Surface drainage around well acceptable ....................... V. Overall Worlananship . 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. 12/02 rr, OCT-24-2006 02:02 F-,r1 HARRY W HICHOLS 914 279 4567 P.01 C t- 10:3 DMSION OF ENVIRONMENTAL HEALTH SZRV7CFs MIMSZMR EINAL rNSkkC1jQN For: Fill Date. Trenches PCHD Construction Permit # Located: -3 cr I (T) Owner /Applicant Name; 2a!46 r k k tj I og 7, TM-12 Block 2— Formerly. Subdivision Name- Is sy-stem, All completed? I's system complete? Is system constructed as'per plans? Is well drilled? Is well located as per plans? Are erosion control measures in place? Subdivision Lot 0 Date: 'Date- Date: —O! . I cenify that the system(s), as listed, at the above pTenxises his been constructed and I have inspected and verified their completion in 'accordanco with the issued PCHD Construction Permit and approved plans and the StiMards, Rules and Regulations of the Putnam County Department of Health. Dw,e-. Certified by- PE _4,::�IA essional w-9- 4_ .Prof Address: _4'zLQM L-ic. # COMMMts: FOR: 0 ADAM 0 GENF, (NA11,17.) Form PM-99 OCT-21-2006, TIDE j..:i,-;:i 'P::L .!,1A111-_:RtJTNAM COUNTY DEPARTMENT OF P. 1 UTNAM COUNTY DEPARTMENT OF IIEALTI IVISION OF ENVIRONMENTAL HEALTH SERVI CONSTRUI T-ION PE..RMIT E-OR..SE-WA GE,,TREATMENT -SYSTEN PERMIT # �-J �. � Located at &S Uq—c 3 d l Subdivision name Subd. Lot # Date Subdivision Approved Owner /Applicant Name // 0 M h W16: Mailing Address Amount of Fee Enclosed 602 or Village �iiJ1 1AM Tax Map / `1 Block - Lot 1 Renewal Revision Date of Previous Approval Building TypeSioUU' I-i r ii.V Lot Area3.5A(,, No. of Bedrooms 3 Design Flow GPD, I Zip (OS Z Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED . -:.1 Separate Sewerage System to consist of J p vU gallon septic tank and 666 L i- of-- i2G Other Requirements: To be constructed by J Lip Address Water Supply: Public Supply From Address or: ° Private.-Supply_.Drilled.by 1� .. Address, _. ,_ ...4 .....� . 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 sv 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. R.A. Date D T O l O Address ��S"c� ZZ 2co-5 > Ad, c 5 " License # .56 12- 41 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment s stem has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when- onsi ered necessary by the Public Health Director. Any revision or alteration of the approved plan requires ` --a_new permit: p ove ' f scharge of domestic sanitary sewage only. �// Title: Date: M16 Ar- <1 ''le; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 P U'l NAM COUNTY DEPARTMENT ENT OIF HEALTH IlDffVIffSICN OF ENW RONMEN 1l'AIL HEALTH SIEIfRW CIES APPLICATION TO CONSTRUCT. A WATER WELL ..,.... -:. , :..._.,:....,., :. , P• p - p :_ :.,zx...�.A..: �,.. .,._ :. ,x ;_� PCHD'Perinit'#.'- Well Location: Street Address: Town/Village Tax Grid # US Ro u re: 3c)( POTPIA K \/19d1E Map I q Block 2 Lot(s) 1 '7 Well Owner: Name-, PNILI.IPS Address: B,3 B ROr N DRkVt' &(4RO.150tJ P -Y. Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation I -pn imairyy Business Farm Test/Monitoring Other (specify) 2- seconndairy Industrial Institutional Standby Amount of Use Yield Sought -.3 - gpm # People Served _3-5 Est. of Daily Usage Loo gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No _ Name of subdivision WA Lot No. Water Well Contractor: Address: Is Public Water Supply available to site? .................................. ............................... Yes . No Name of Public Water Supply: Town/Village rA Distance to property from nearest water main: M /A Proposed well location & sources of contaminatio be provided on separate she t/plan. Date:_.0.7 -o.1: ,®.5 Applicant Signature: — - u 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. AIFP ROVED IFOIIR 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. revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well filler certified by Putnam County. Date of Issue A6 G0 r Permit Issum Date of Expiration Title: Permit is Non- Trannsfferrab e White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 `ine Clty£ November 7, 2005 _ Robert Morris, P.E. Department of Putnam County Department of Health Environmental 1 Geneva Road Protection Brewster, New York 10509 Re: Phillips Residence —SSTS Route 301 (T) Putnam Valley I g. PCDOH Permit # PV -20 -03 4 Boyds Corner Reservoir Drainage Basin r y DEP Log # 2005 -BC- 0740 -SS.1 Emily Lloyd Commissioner Dear Mr. Morris: ' Te! (718) 595-6565: Fax'(718> ss5 -as57: The New York City Department of Environmental Protection (DEP) has !; determined that the above - referenced application received by the DEP on November 3, 2005, is complete. The DEP has no objection to the approval of the Bur eauofwatersuppry . Avenue Columbus above- referenced regulated activity. This determination is based on the review of ' "465 ' � '� • ; �. submitted documents including the plan titled "Proposed SSTS, Phillips -105W 1s Residence, TM # 19 -2 -17, Route 301, Town of Putnam Valley, Putnam County, i New York," prepared by Harry Nichols, P.E., dated 11/01/05, last revised Michael A.` Prindpe,,0h D 10/12/0$. Deputy Commissioner �.:.. T el Please have the applicant contact David Alderisio at (914) 742 -2010 at least two Fax (s1a) dal- osae.: days prior to start of construction of the SSTS so that the DEP may inspect and �nonitor.the installation. 4n due due to the presence of the Delaware-... Joseph Maggio, P !: Aqueduct adjacent to the property, any blasting, pile driving, well drilling, or use Deputy. ire or of heavy equipment/machinery requires the applicant to contact Tim Lawler, P.E., Englneering,Drvision EoH DEP- Operations Section at (914) 232 -8556 regarding this issue. Tel x(914) 773 -4470 Fax :(9I 4) 7734W. ' `. Sincerely, Danny Shedlo, P.E. Civil Engineer. II Project Review ' xc: Roger Sokol, P.E., NYSDOH ' T. Lawler, P.E., DEP Katonah Office y °RKCITYDEPgR�M_ T. Phillips,Property Owner, 23 Arden Dr., Garrison, N.Y., 10524 `ri W H. Nichols, P.E., Project Engineer QO'YAIEMAL PR °� - •ww w.nyc.gov /,d.P ... 1 '(_718) DEP-HELP October 19, 2005 Putnam County Health Department 1 Geneva Road Brewster, New York 10509 ATT: Robert Morris, P.E. RE: Proposed SSTS - Phillips N.Y.S. Rte. 301 - Putnam Valley, NY T.M. # 19. -2 -17 Dear Mr. Morris: Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 279 -4003 -.Fax: (845) 279 -4567 -- - Email: }hnengineer@aol.wm - . .,_ - •'_ ..... . In response to your September 19, 2005 review letter, we note the following: __.1. &2..Proposed__NYS. DEC.Wetlands OL -58 has.been revised on the plan. -and- the accuracy certified to by' e`NY5 DEC biologist, Mr. Douglas Gaugler. Reflecting the above, we are enclosing five (5) prints of Drawing SS -1 "Proposed SSTS ", rev. 10/12/05. Also enclosed is a certified copy signed by Douglas Gaugler, Biologist, NYS DEC. Kindly continue with your review and issuance of the Construction Permit. Very truly yours, Harry W. Ni ols Jr., P.E. HWN:gav 04- 103.00 cc: Mr. D. Alderisio w /enc. Mr. T. Phillips w /enc. SHERLITA AMLER, MD, MS, FAAP ,.._ ., .:.: ..�:�Camrnissioner.o�Health.,.. .,�...... •.,- �..... LORETTA MOLINARI, RN, MSN Associate Commissioner of Health -Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Dear Mr: Nichols: ROBERT J. BONDI _. ,........ _ z:nt)_'. xecytiv Co i DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 September 19, 2005 Re: Proposed SSTS: Phillips NYS Route 301 (T) Putnam Valley, TM # 19 -2 -17 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: 1. With reference to the recently amended DEC Freshwater Wetlands Maps for Putnam, the local wetlands that appears on the site plan is DEC wetlands OL -58 and must be revised on the site plan. 2. The DEC wetlands (OL -58) on the site plan must indicate the source of identification and certification by a Licensed Land Surveyor as to the accuracy of the wetlands location. . _... _.. -�Upon- receipt -of a subniYssion; revised to reflect the above comments, this-application will be considered further. RM:kly Ve 71Y yours, K &---/ Robert Morris, P.E. Senior Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 Department of Robert Morris, P.E. Envirdrimental Putnam County Department of Health P I rotection I Geneva Road Brewster, New York 10509 Re: Philips Residence — SSTS Route 301 (T) Putnam Valley DOH Permit # PV-20-03 Boyds Comer Reservoir Drainage Basin DEP Log # 2005-BC-0740-SS. I Ernlly Lloyd Cornrhissioner Tel, (718) 595 -6565 Dear Mr. Morris: Fax (718) 595-3557 Bureau of Water Supply 465 Columbus Avenue Valhalla, Now York 10595-1336 Michael A. Principe, Ph.D. Deputy Commissioner Tel (914) 742-2001 Fax (914) 741-0348 Joseph Maggio, P.E. Deputy Director Engineering Division EOH Tel (914) 773-4470 Fax (914) 773-0343 The New York City Department of Environmental Protection has determined that the above-referenced project received by the DEP on 9/07/05, is incomplete. The following information is required before the DEP may commence its review: • With reference to the recently amended DEC Freshwater Wetlands Maps for Putnam, the local wetlands that appears on the site plan is DEC wetlands OL-58 and must be revised on the site plan. • The DEC wetlands (OL-58) on the site plan must indicate the source of identification and certification by a Licensed Land Surveyor as to Aheeaccuracy of the wetlands location-. If you have any questions regarding this matter, please contact me at (914) 742-2010. Sincerely, David Alderisio Project Manager Project Review Roger Sokol, P.E. NYS, DEC Environmental Permits Office Ken Markussen, NYS, DEC Fax:914- 773 -0343 Aug 11 2005 11:23 P.02 August 10, 2005 _ :l:'�� "'°"'�► Robert Morris, P.1 .b;.... Putnam County D, EnvironMental ' 1 Geneva Road ;. R�otEtitio Brewster, New Yc Re: Phillips Re,, Route 3011 Boyds Corr DEP Log # (; Dear Mr. Morris: Comtnlsebne�, > te(�J$ The New York Cif a,ct718)595 7. ; that the above -refs The following infc Aaery • The wetlan 166_ .__�..'.••' AYerme . WEvella, rim:. York: shown on t The soil tyl • Provide a c !�!+:; . Label prop : • It appears t lief X914) 142-2W1 ' Show all zc • out record il��iW:o;' ? : ; • additional I performed. The above lot. f Lands Di be offered. If you have any q Sincerely, David Alderisio l r,. Project Manager Project Review r- IDWA .77 , .�,._ �.; xc: Roger Sokol of Health 10509 ,nce -SSTs Putnam Valley, TM # 19 -2 -17 Reservoir Drainage Basin 05-HC- 0740 -SS.1 Depamaent of Environmental Protection (DEP) has determined eneed project received by the DEP on 8/04/05, is incomplere. mation is required before the DEP may commence its review: s that were located on the prbpperty roust be survey located and B revised site plan.. boundaries must be shown on the revised site plan. tail showing a stabilized construction entrance detail. sed driveway as sucks. at the area for the septic system has been cleared and regraded. graded contour lines. of previous test holes (1 i/07/03) indicated ledge depths of �. 1y* fee►_ .It-appears thrit fin -has been-brought yin- taprovrde _ __.. •. r.... _ ....... _ ..._ ,pth. This area must now have new soil percolation tests - eferenced plats has been referred to our office of Watershed i yr ion for continent. ' Following their review, further comment may i i u stions regarding this matter, please contact me at (914) 742 -2010. I P.E., NYSDOH AUG -11 -2005 THU 11:07 TEL:845- 278 -7921 I II NAME:PUTNAM COUNTY DEPARTMENT OF P. 21 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LO M*A MOUK.A , RN, MSN Associate Commissioner of Health Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 RE: Phillips Route 301, (T) Putnam Valley TM # 19 -2 717 Reservoir Basin ROBERT I BONDI County Executive July 26, 2005 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on July 6, 2005 is complete. The Department will notify you by August 16, 2005 of its determination.. ❑ The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. 0 Joint review with the NYCDEP will commence pursuant to the guidelines set - forth in the Watershed Agreement::. _......_..- :. .:_._- If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed approved, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2166. V ly yo obert Morris, PE Water Supply Section (845) 1 4 5- 1 �'e�i15i�� �i���a�� n�lneer RM:ky Environmental Health (845) 278 -6130 Fax (845) 278 -7927 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 1 . 4 LORETtIk"MOLINARI RN, M.S.N. Public Health Director DEPARTMENT OF HEALTH 1. Geneva Road: Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 FACSIMILE TRANSMITTAL ROBERT J. BONDI County Executive' To: 77 3 - 0 From: Toe - Pamvmh jr-- -APKE. Date: q � Re: 77-t I Pages: CC: ..................................................................................................................... i ❑ Urgent* DLXor Review ❑ Please Comment Please Reply . eat;;,% rl- /7 ;tl I Odhiga S A—no4--, c.-,4c, lie 7-A"'-5 -Z"'j 6- CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only, for the use of the individual or entity named above. If the reader of Jz)e this message is not the intended recipient you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone' (845-278-6130) and destroy all documents associated with this facsimile. o BRUCE R FOLEY Public_ He 04-163 LORETTA MOLMARI R.N., M.S.N. :..... , . ociare _(rll'�c :.eait6�•airecto�_•�,.f ' Director oj.Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 REQUEST FQR FIELD TESTING ATTENTION: ❑ ADAM STIEBELIi�G ❑ GENE REED �,IG � ,- to v41+1 All information below must 7_,2�vrtcompleted prior to any scheduling. DATE: ENGINEER OR FIR.IVI: REASON: DEEPS: PERCS:X PUNIP TEST: ❑ ROAD /STREET: _ IV TOWN: _ TAX MAP #: SUBDIVISION: LOT #: OWNER: 7n AL � 5 YE NO Proposed SSTS-within the drainage basin of `Vest Branch or B.oyds Corner. Reservoirs. o _ _- : _- Proposed SSTS within 500 feet of a reservoir, reseryolrstern or..conrrol Iahe. • --� .-..•. v ...w .. P ... Proposed SSTS within 200 feet of a tivatercourse or a DEC wetland. 0 Proposed SSTS design flow greater than 1000 gallons /day-or SPDES Permit required. 0 Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered yu to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR C067Y USE ONLY DATE: TIME: CO> I ME,NT$: (F[ELDTEST) ? .. A LORMA MOLANARI P-M. M..S.N RODPAT J. BONDT F—U. DEPAXI'M991' OF HEALTH I Oenva Road, Brewster, Now York 10509 Umith (845)278.500 Fu(US)278.7921 NarAug Swd,u (845)278.6558 %IC (845)278.6671 Fu (04S) 216.601S A.Hy '445)VS-6014 F.(M5)271-6d48' FACSEAME TRANsm-rrv.,U, T,; Qtlfu`)' QeA` Vax; 773-0'3'Sr* From: JR-K- POATLVAIJJ_ ._ APItE. Date:... -�03,�o,r Re: P'I - I ......................... ................... ................ ....... ❑ Urgent DLXor Roview "I -!j: Comment De-alow Reply rhS (-A. 4 4"— 6e 24- 2 s 44e. F Gtu r ahe,-44 !61-e; c- . iY Ail— A—. -4. .. :--u L C M-'e - CONMIENMAIM STATOUNT! TP-- irdor=ttou contained in this ftdcaN awy cooln CONMHN= and Legally p d tcb=mdaa-i—dm o* for the use of the ir&ddtW or entity umacd abovo. N the m4cr of this mmup Is = tho Wmadod miplaik y(m an hareby nod&d U my dimuslon d4ftwim or copying of this tobwpT Is strictly ymidbimd. If 7ou have rwdved = td=W in e=, picasc bzi=&* no* us by t46pbond (843-2785130) and dusM all documeam associated with ft hcciadle, 4 INMIDW MaOaH dO HoVd ISdja )10 : SiUSSd WOH : Wow ,ZT,TO : awil (Iasdvlia 99:OT T£ —XVW : awu ju%Ls Z/z : j saovcT GSC0ELLVT6T6 : !aNOHd TZ6L-8LZ-9f178 : lial HMV aO MaWIUVdaa xiNnoD WV N1f1d : aWN MOT HfIl GOOZ—T£ —XVW : NOUVWUN03 ONIGMS PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DFAT A'SHEET S V _B:! SWURfAit E'S E'W A G E TREATMENT SYSTEM Owner 10M PAILLips Address Je-i, give_ CY -I ry is" ah Located at (Street) 0. IZO tj 7C 3- c) I Tax Map (I Block 2. Lot 1 (indicate nearest cross street) Municipality PwrAth^ VALLEY Watershed. C fl c>76 0 SOIL PERCOLATION TEST DATA Date of Pre-soaking i o o3 Date of Percolation Test to,22-0:5 Form DD-97 .1. q. 20-175 1.25 i 24 25 Y2� 2 11123-11:63 30 19.6-20-75 1.2's zi 3 i V00 -12'. 3(> 3d I9.5 -20.75 I,Z!5 ZI 4 5 �,q 1-7 60 26 2 GO 17 — IF 6.0 - -.. .3 4 5 2, 3 4 5' NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be! submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLIES DEPTH HOLE.NO. HOLE.N®. 2-3 - - 5 G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' HOLE NO. 6 -7 -E -9 2 7.5' ! 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered PfeLL 0 6,,M 7 9 A 7' -c�" Indicate level at which mottling is observed Flo de Indicate level to which water level rises after being encountered Q''-0" 6VO Rog) Deep hole observations made by: j4,VN,, 15f - Date Design Professional Name: ligo W McApIs Tr. j E L. Address: 2.o,!�y at- Z Z Signature Ryesigun nrullubaigunaza a o v u ti rti ; ��,' ✓P r. w No 68124 T PIT PROFILES �� � "S . ? ��°� � %`-. c �� �� � ✓�' �c�= �. �' � ?-•� -� Hole # Lot '# Hole #_ Lot # Hole # Lot # epth to water l p _ __- -_ • 6 .D pth to water %� wa � ,� _ _ e to ter - - ��._. Depth to mottling Depth to mottling iv: Depth to mottling .- Depth to rock/imp. t t � Depth to rock /imp. .� r •-Depth to rock/imp. t l G.L. G.L. 0.5 1.0 2.0 3.0 4.0 - - 0.5 0.5 1.0 2.0. 3.0 4.0 4.0 5.0 5.0 7.0 10.0 10.0 .10.0 Hole # Lot # Hole # Lot # Hole # . Lot # ' Depth to water _ . Depth to. _.�.. D_w e th to watet _ T Depth to mottling Depth to mottling Depth to mottling' - _ Depth to rock/imp. G.L. Depth to rock/inip. Depth to rock/imp, G.L. -._... _ 0.5 0.5 - _ ... -.1:0 -- 1.0. _..... 10 . 2.0 2.0 2,0. 3.o. 3.0 3.0 4.0 4.0 4.0 5.0 5.0 6.0 6:0 7.0 7.0 8.0 9.0 10.0. 8.0 9.0 10.0 5:0 6.0 7.0 8.0 9.0 10.0 TEST PIT PROFILES Hole # Lot # iu Depth to water A � 14 Dep to Mott ing Depth to rock/imp.M/A Hole # Lot # Depth to lvaerT A, k" Depth to mottling A 14K Pe pth. to rock/imp G.L. G.L.. 0.5 1.0 Mul 1.0 2 k 3.0. 3.0 4.0 °i�4,0 Hole. # 'Lot # Depth to water /u7m-_ Depth to mottling Depth to rock/imp. G.L. Ak, 1.0 2.0 10 4.0 5.0 .5.0 5.0' 6.0 6 6.0- (7)0 8.0 8.0. 8.0 10.0* 10.0 Hole # Lot # Depth to water C..._ - �. .- .- _31- EveA-f6foal: Depth to rock/: G.L. 0.5 .0. -2 . 0 I 3.0 " = Wv -/ . 4.0 Hole 9 Lot # Depth to water tc) Depth -to mottling" . Depth to roddimp. Hole # Lot # Depth to water Depth to mottling Depth to rock/imp. 6J G.L. 1.0 1.0 2.0- 2.0 5.0 4.0 4.0 5.0 5.,0 5.0 6.*0 6.0 .ef 'AO .o 7.0 - -- 7.0 8.0 8.0 9.0 9.0 .9.0 10.0 10.0 ME 14 -16.4 (9195) —Text 12 I PROJECT I.D. NUMBER 617.20 ! SEQR Appendix C -- 'State "Environmental Quality F eview SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME i�RoPoSL-'u 7' I�.i.i PS S�`is 3. PROJECT LOCATION: Municipality PUTWAPA V444–EV County PL) °'7JRf`'l 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) 5. IS PROPOSED ACTION: ew ❑ Expansion ❑ Modificatlon /alteratIon 6. DE CRIBE PROJECT BRIEFLY: SiOGLL PAHIL. IQ2S1 LXWC r 0(LW L-JA J LiEL L 4 SST5 NRElA . i 7. AMOUNT OF LAND AFFECTED: Initially c %U acres Ultimately ��S acres B. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR -OTHER EXISTING LAND USE RESTRICTIONS? Yes ❑ No If No, describe briefly I 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other I • 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? XYes ❑ No If yes, list agency(s) and permit /approvals t3ulLD1(4G l)EPnRI P' vw—r 1 43U I L U1IVQ 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes No . If yes, list agency name and permit/approval. 12. AS A RESULT OF ROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes No. I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor ame: ' • Date: 0 7' 0 1 "'O I Signature: V v • If the action is in the Coastal Area, and you are a. state agency, complete the . Coastal Assessment Form before proceeding with. this assessment OVER 1 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate* the review process and use the FULL EAF. ❑ Yes .. _❑ No.. B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART. 617.6? If No,.a negative declaration may be superseded by another involved agency. ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly. C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in C1-05? Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? ❑ Yes_ . ❑ No__ — E.- IS- THERE;'OR'IS- MERE'LIKEL'Y TO- BE, CONTROVERSY RELATED TO POT ENTfAg -ADVERSE 'ENV(RON9ENTACIMPACTS ?' ❑ Yes ❑ No If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurrin.g;. (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Resporg er Signature of Responsible Officer in Lead Agency Signature of Preparer(It different from,fesponsible officer) Date 7 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR 7I'RATMIEI�dB' -SXSTM ...,.�,.... 1. Name and address of applicant: 7am -aq I (,t -(PS C' (h 92ISory to 2 I 2. Name of project: Pao Pos iF D . ss7rS 3. Locatioov: 17,TMA." 4. Design Professional: n�N a/ A/cNvI T-., rP.(�, 5. Address: _0- cb RT' Zz_ 6. Drainage Basin: CJ1oT0&) .15 tixar= u1 ivtaci 7. Tvne of Proiect: Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building, Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQk)? . Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted -,x 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... ,� d 10. Has DEIS been -completed and found acceptable by Lead*Agency? ............... . 11. Name of Lead Agency, A 12. Is this project in. an area under the control of local planning, zoning, or other. officials, ordinances? . ............................ .............` ........� . 13. If so, have plans been submitted-to such authorities? ... :............... : tiP 14. Has preliminary approval been granted by such authorities? W0 Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water oundwater g Y g 16. If surface water discharge; what is the stream class designation? .................... u 17. Waters index number (surface) : ...................................................................... ....• MIA 18. Is project located near a public water supply system? ....... ...................:........... �y 19. If yes, name .of water. supply PA Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................. � v 21. Name of sewage system NA Distance to sewage system 22. Date test holes observed A 2 Z • 0 3 23.. Name of Health Inspector 24. Project design flow (gallons per day) ................................. ............................... po 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... N U 26. Has SPDES Application been submitted to local DEC office? ......................... N L Form PC -97 2 -27. Is any portion of this project located within a designated Town or State wetland? Rio 28. Wetlands ID Number ........................................ ...................................... 6 ........... 29.- -1s, Wetlan6 Permit require . ............................................................................. Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit! .................................... 31. Is or -was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfillingi sludge application or industrial activity? ............................ Yes 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site 'or any other potentially known source of contamination? ............................... Yes DESCRIBE: 33. Is there a local master plan on file 'With the Town or Village? ............. ............. es 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................................................ 35. Are any sewage treatment areas in excess of 15%, slope.? ............................... 36. Tax Map ID Number ................................................ ! ........... Map _j_lBlock__2_Lot (-7 37. Approved plans are to be returned to ...... Applicant Design'Prdfessional NOTE:.All applications fo' r,review. and approval of a new_SSTS -to be located within theN..YC Water' '-'shalt- V6�d.iitt6tlie-D&Vaf&iirit"bhd'ne7edilofi�6,s,-e,n,t-i,n,-d"u,pl-i*c-a*'t"e,-t,o-t,he- Y DEP, although the project may'require DEP approval of the SSTS prior to final approval. by the Department. Projects within the watershed may also require DEP review and approval of otheraspects of project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate . forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person -other than the applicant shown in Item L,ft application I I must be accompanied by a Letter of Authorization (Form LA-97). Failure to comply -with this provision may be grounds for the rejection of any submission. .Thereby affirm, under penalty ofperjury., that information provided on this form -is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Seq!qn 210.45 of the Penal La )v. A SIGNATURES& (OFFICIAL TITLES.- 01 Mailing Address: .................................... ZO 50 IZO Atigust•10,- 2(105•: .. ( �.. 21%Wrrl�, Robert Morris, P.E. L Putnam Count De artment of HealthW Department of y P ..Environmental 1 Geneva Road n Protection Brewster, New York 10509 Re: Phillips Residence —SSTS Route 301 (T) Putnam Valley, TM # 19 -2 -17 Boyds Corner Reservoir Drainage Basin DEP Log # 2005 -BC- 0740 -SS.1 ?Emily Lloyd Dear Mr. Morris: Commissioner; Tel. (718) 5 95-3333 The New York City Department of Environmental Protection (DEP) has determined Fax (718) 595 -3557 that the above - referenced project received by the DEP on 8/04/05, is incomplete. The following information is required before the DEP may commence its review: :Bureau of Water Supply 465 Columbus Avenue . • The wetlands that were located on the property must be survey located and ,vaIMM, New York 10695 -1336 . shown on the revised site plan. • The soil type boundaries must be shown on the revised site plan. • • Provide a detail showing a stabilized construction entrance detail. . MichaelA Principe; Ph p: .: Label'proposed driveway ag such. Deputy commissioner , It appears that the area for the septic system has been cleared and regraded. Tel (914) 742 -2001 Fax (914) 741 -0348 Show all regraded contour lines. • , Our records of previous test holes (11/07/03) indicated_ ledge depths.of.: approximately 4 feet. It appears that fill has been brought in to provide' Joseph Maggio, P.E. additional depth. This area must now have new soil percolation tests Deputy Director Engineering Division'EOH performed. • The above - referenced plan has been referred to our office of Watershed Fax (914) 773 - 0373 Fax (914} 773-0343.. , ..., Lands Division for comment. Following their review, further comment may g � y be offered. . dORi If you have any questions regarding this matter, please contact me at (914) 742 -2010. Sincerely, David Alderisio Project Manager Project Review f DEPee . Elm ENTAL PB�t�' , .'(718) DEP'-'HELP xc: Roger Sokol, P.E., NYSDOH i� July 1, 2005 Putnam County Health Department 1 Geneva Road Brewster, New York 10509 ATf: Robert Morris, P.E. Re: Individual SSTS N.Y.S. Rte. 301 Putnam Valley, NY T.M. # 19. -2 -17 Dear Mr. Morris: Enclosed are the following: Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster; NY 10509,: Tel: (845) 2794003 Fax: (845) 2794567 Email: hnengineer@aol.com 1. Five (5) prints of SS -1, "Proposed SSTS ", dated 07/01/05. 2. "Short EAF ", dated 07/01/05. 3. "Application for Approval of Plans for a Wastewater Disposal System ". .4. "Construction Permit for - Sewage: Disposal System% dated 07/01/05, 5. "Application to Construct -a Water Well ", dated 07/01/05. 6. "Design Data Sheet ". 7. "Letter of Authorization ". 8. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 9. Review Fee in the amount of $400.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry W. hols Jr., P.E. HWN:gav 04- 103.00 cc: Mr. T. Phillips w /enc. mfrona riului Firs i I VWA G1;�. BEDROOMS TO Tll,' PCDOI-I I OINI)qG r,0614 BEDROOM z I z' - -N,x I0'- o' THESE 140TTSF OR AT'P' OVAL DATA- K ITIC H E.q 14AS 7ER 8 EORO OM LIVING ROOM, 14 X 13'- C,' 14, - C, UP �ecor� rl��Ur , • . I. c 1 �% aE�ROOU 2 14 '- 1' X i61- G' �i — 1. IL' - .5,X 101 -G/ i r PUT NAM C OF JHEALTH HOUSE PLANS APPI 0-R Ev Y.00M" COUNT ONLY, BEUnitO %,a.z, J ALt QTM r, rr , I \iJ •lt��l.' E JUG: ^!,,'I'T -T��i'.� ,•,�Z ;•:; ..., r� A"JPROVA 11' First F;cor . 1 � Fi OK K 4-L�� ' l ' 14AS7ER BEDROOK LIVlHG ROOK. G'XIS. -G' v i . r • 1 r i PUTNAM COUNTY .DEPARTMENT OF HEALTH DNISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Located at W .1l S P- O u TL S a l . TCv Pv p I w� VA I �e k Tax Map # Subdivision of Subdivision Lot # 1` Gentlemen: 19 Block Z Lot 17 Filed Map # — - Date Filed This letter is to authorize �/'q,2r2 l/ W, N t c & h S a duly licensed Professional Engineer K _ or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity wi W �' s of Article 145. and/or, .147.. of .the- Education Law, the Public Health ..._...._...... Law; and th Ct- nitary Code.' Very truly P.E.,-I;t # Mailing Address 2a5o (27+ 2--2- . State �C-yj oel(_ Zip I r)sva Telephone: S ` S--Z79 -qoo� Mailing Address: a3 A.aUt N DR,Uu- GA rd', So^ State P L y,/ `lo K. Zip 105 `4 Telephone: q1+- '13C - 8113 Form LA -97 _ IN \ N.N COED / ����� 1\��..a........\� .. \.. \ a:\:•.... ._. _..._... ... •;old. • }11 „00,90 o9 LS INV 142.0'x\ r$ Mm \ PROF M ELLING / / FF LE�45.0' r _ \ i >r I INV OUT;141.3'� r tAl / 14 6 / D1 0. INV IN 140.5' � � � •� / 20' 7 0 \ gd 0. 60' 3 3 O�fG� �g�O %% /� g /D"_ F�P� FOOT G DF N o 1206 40' ZONING 0 i /•� i ;�;, oar l / U. I00 oi r GATE I R C 10. I 0' \co / / I a60 ZI m � 1 ,._... BRUCE R. TOLEK.. �... -.: Public Health... Director -- DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 04 - 103 LOitETT A... MOLINAR ?.•R_N.;_M.S,I•!�,",._. y . -. Associate Public Health Director Director of .Patient Services ATTENTIO\: ❑ ADAM STIEBELI G ❑ GENE REED Tro Z I `,rot V k-h All information below must be fly completed prior to — any ys scheduling. DATE: ENGINEER OR FIRM: rr4l �4I% �Gf UY� PHONE #: REASON: - DEEPS: PERCS: PUMP TEST: ❑ ROAD /STREET: Al )(S- f1�c, 3 6 1 TOWN: vw►� I%I���► TAX MAP #: _ jC, —2 ' 17 �7 SUBDIVISION: J j LOT #: OWNER: o (! N`Y DEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YV NO - ` Proposed SSTS -within the drainage basin of `Vest Branch or. Bpyds Corner Resei birs'�' `-0 - Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ Proposed SSTS design flow greater than 1000 gallons /day-or SPDES Permit required. 0 Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered= to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. DATE: CO INfFi TS: (FIELDTEST) FOR COUPTY USE ONLY TIME: ay6' lif 11 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ---`D98t6Wz A]tET�'SU!iSt!16XCt'SMk6t'TREA:'YMkft SYSTEM Owner ��,�Zm— &.✓ Address Located at (Street).�U "'- 12,VjC .7 0 Tax Map Block Lot (indic to nearest cross street) Municipality AL)Vh" OLIaq Watershed SOIL PERCOLATION TEST DATA aodb :) 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 .. ....... ......... V g1V Urf Dr ... t . ...... es.: 3b 0-75 > 11"o 30 J5 02 4 5 2 3 10 'db - 11,26 !3 4- 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 :........ DEPTH- Ik. G.L. TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES ..:HOLE-NO- HOLE NO:._.:::.,�� f,— &'75 0.5' /,0,060; w� 1.0' Svjv; rock �(�- 5 4�11n2 1.5' 2.0 3.0 4.0' fLt�� ai . c� w►wf-��� h ��t 4.5' - 5.0' c "a vwl s , re 5.5' 6.0' y 16 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed k) Indicate level to which water level rises after being encountered Deep hole observations made by: ��l� // Date Design Professional Name: Address: Signature: Design Professional's Seal a 12!15/2003 00:39 FAX 1914T39460.1 MARSHA KRESSIN 11/26/2893 14:59 9144243560 NaVIF' Z002 I -.... —,.. � a.......�.... i7R i flk' lRg. ,4 • .. - , . t. smwm WE �K AlYM MATTHEW A. NC)VIELLO- P.E X.S. M0ftSW019AL ENGiNBEWNG dt LAND SURVEMG r x�aa Carmel; NY 10512 (845) Fax (845) 225 -2934 Novemtber26, 2003 Fanned to (914) 739 -4601 Marabs I). K=4 fiaq• 832 Soutb SvW Peekslailt, NY 10566 Re: NEWM.AN PROPMTY ROM 301 FILED MAP 169, LOT 1048•A rT Tow QP PuTNAM VALLEY Tyear Ms. K>«: As VOU I mow aye have beets wottcing oa trying ID oM m putasm County Boarrd, of Ii mM DMwftmW approval of a well and wpm system 1'or the above captioned pmpetty for tunes of this year. To date we have completed tW folW%itAg. I. pmpetty m"ey 2. Topogtaphxal. surv8y 3. Pamol tilon tast4 4. r0mvation of deep hole tests S. Pralmsed weR MW septic pb:zs togbtlu with ant AIMY 8PPficatiOW for a fom- 6. Revised well and septic,ptans fvt,a tbree be*wm house ....... , _...... _ 7_ ..Re percoleiion of site wikh Patqwu co Amu Depurnncm 8. Emaveim of edditidffi1 deep feat b"Dks 9. Meeting at s,* with N,Y.CG bepeatuzeot of P.nvironmet W Pratoction The site contains 3.458 *Am of t and Abbough the site sounds tare a nice large sane 6rrr a ly boase, at this point it is f umdepisble that them are many 'she- spec38c' pbysiwd obstacles that together p v4y reduce the usable land when trying to obtaux any Health Apprcoval fvrthis stto: DEC -15 -2003 MON 12:45 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 r AUG -09 -2004 11:38 PUTNAM COUNTY 845 228 0231 P.01/01 Sc'$Yl {)'utnam Ca r Clerk CLE 1 K � un ' Public Informaiion Officer. 1�fiU „liu d F'1, I+ AU_Hcation fog° Public Aa to Records J To' keeOrds Access 0fricer Name of Agency Address I HEREBY, APPLY TO INSPEiCT THE FOLLOW NO ECgFk A . 4A - t PIL 1 wlli hand deliver myself Please submit to th ®'specified depa ent for Me APPROVED DENIED Record of which it Agency Is Local custbdlan cdnln be'found. Record is not maintained by this Agency, .. ; Signature Title Date , NQTIcE:, YOU HAVE A RIGHT'YO APPEAL A DENIALO.F THIS APPLICATION TO THE PUTNAM COUNTY EXECUTIVE.- Name Business Addywo . ` • , WHO MUST FULLY EXPLAIN HIS REASONS FOR SUCH DENIAL. IN-WRITING SEVEN DAYS OF R9"IPT OF �N, APPEAL. I HEREBY APPEAL; i31gne4ure Dare s r AUG -09 -2004 11:38 PUTNAM COUNTY 845 228 0231 P.01i01 Dennis J. Sant t•Odity' Public Information Officer. 1� Yo- Application for Public Access to Records Records Access Officer Name of Agency Address I HEREBY -APPLY TO INSPECT THE POLLOWINGRECOFkO: _�c_k_oAn: aj I wlli hand deliver myself © Please submit to the, specified department for ire =1 N j FOR AGENCY USE ONLY APPROVED sl I ° y DENIED ' Record of which this Agency Is Legal Custodlan cannot be'found. Record is not maintained by this Agency: Signature Title Oats NOTICE:, YOU HAVE A RIGHT'YO APPEAL A DENIAL OF THIS APPLICATION TO THE PUTMAM COUNTY IJ{ECUTIVE.' Name Business Address WHO MIDST FULLY EXPLAIN HIS REASONS FOR SUCH DENIAL IN WRITINQ SEVEN DAYS OF RF.CWPT OF AN APPEAL. I HEREBY APPEAt,; Signature AUG -9 -2004 MON 11:26 'TEL:845- 278 -7981 Date NAME:PITNAM COUNTY DEPARTMENT OF P. 1� DESIGN DATA.SHEET SEPARATE SEWERAGE SYST>M -- XL E -... u . -..�_ N0. . -. .> -..._ OwnexIOI v+ L'bli d h r)i/ NPwj'1�flddress Located at (Street �l(71.i�'(' 301. Sec. % / Block Lot (Indicate nearest cross st:) Municipality 10144h e? M V� /I Watershed Cpvio n SOIL PERCOLATION•TEST DATA REQDIRED TO BE SUBMITTED WITH APPLICATION Presoak' Date: Run Date: JG e%, Z^ pfi� q . Iiole # i CLOCK T ME 'PERCOLATION IIole ; Run Number ! No. ! Start ! Stop 1 l � X1161 /l�3/ 2 3 �v DZ i /2/ 32 i 5 2-6 .12,'.0 _!�. -- ..�f. =;.3/. . .i i. � i i � i • 7q 17)1 i4 i5 i .••: i i i i i i i Z, ' 2 i /l l "1 i i2, ' /� i 3 b -I-/ ; i i i 3 12; �l , 3 z� ,. 3 i i i •, i 4 • � i i i i i i i ;5 Notes: Perc t-es t done by: 1) . Tests to be• repeated at same = 'depth until approximately equal soil rates are obtained-at 'each percalata:on test hale. • All data to be submitted for 'xeview. 2) Depth measurements to be made. from top of hole, DO NOT REPORT INCREINENTS 47F LESS TrLAN ONE INCH. i-Depth to Water : Water ' Soil from Ground 'Surfaced Level ; Rate I Elapse i Time ' Drop ; ; Start ; Stop ... ; Min /In In Min. ';.Inches- Inches Inches Drop 30 2y� i 17 i 5 2-6 .12,'.0 _!�. -- ..�f. =;.3/. . .i i. � i i � i • 7q 17)1 i4 i5 i .••: i i i i i i i Z, ' 2 i /l l "1 i i2, ' /� i 3 b -I-/ ; i i i 3 12; �l , 3 z� ,. 3 i i i •, i 4 • � i i i i i i i ;5 Notes: Perc t-es t done by: 1) . Tests to be• repeated at same = 'depth until approximately equal soil rates are obtained-at 'each percalata:on test hale. • All data to be submitted for 'xeview. 2) Depth measurements to be made. from top of hole, DO NOT REPORT INCREINENTS 47F LESS TrLAN ONE INCH. a -: DEPTH air .....w�.wr....— ,...... ,• G-: L 6" 12" 18" 24" 30" 36 "• 42" TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF'SOILS'ENCOUNTERED IN TEST HOLES HOLE N0. � HOLE NO. 2' HOLE N0. 3 HOLE N0. CPA Vt. v bGM J0,1Vn loom S�0 r7 py.%q1- 48" 1Y - v 601, 66" 72" 78'... 84" WAS GROUNDWATER ENCOUNTERED �•U - . _...._ — _.. . ° "IN'DICATE- LEVEL'AT WHICH GROUND•;WATER..IS~ENCOUNTERED INDICATE LEVEL FOR WHICH WATER'L VEL RISES AFTER BEING ENCOUNTERED AAA DEEPTESTS MADE BY M y ) A, /VO)- f3U DATE OF DEEP TESTS DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided__�64�03 No. of Bedrooms / Septic Tank Capacity �2�0Gals. Masonry ,A Metal Absorption Area Prov. by V?( L.F.Y24" Z7 width trench. Other �ZSt l.f 14.16-4 (2187) —Text 12 PROJECT I.D. NUMBER 617.21 SEOR Appendix C State Enj nmental� lity.j „SNORT "ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only. PART I— PROJECT INFORMATION (fo be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME Francois & Jennifer Newman House 3. PROJECT LOCATION: Municipality Putnam Valley County Putnam, County 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) N.Y.S:•Route 301 b 5. IS PROPOSED ACTION: 43liew ❑ Expansion ❑ Mcdification /alteration 6. DESCRIB= PROJECT BRIEFLY: Construct a one family house. 7. AMOUNT OF NO AFFECTED: Y.4 3.4 Initivy acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes Xf No If No, describe briefly Use variance was granted in 2003 by Town .Z..B.A. 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? C1 Residentia! CJ Industrial ❑ Commercial ❑ Agriculture Park/ForesUOpen space ❑Other Describe: _ ... - -- 1C. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR LOCAL)}}? �� C3 Yes `C.JNo If yes, list agency(s) and permillapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? ❑Yes. JUNo If yes, list agency name and permillapproval - 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes [❑ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor narmn Francois Newman Date: Signature: rr. . It the action is in the Coastal Area, and you are a state agency, complete:the Coastal Assessment Form before proceeding.with this assessment OVER 1 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. , ❑ Yes A3 No S. WILL ACTION RECEIVE COORDINATED REVS RS PRaVIDED FOR UNL ?STED- ACTIONS iN @dYCRR 'PAf{r °61?:6? If No, a negative declaration inaybtl'sUptsrsEdiid by another Involved agency. 04s ❑ No C. COULD ACTION. RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) Ct. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly No C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: No C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: • ,y No Ca. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly No C5. Growth, subsequent development, or related activities likely to be induced*by the proposed action? Explain briefly. No C6. Long term, short term, cumulative, or other effects not identified In CI-05? Explain briefly. No C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. No D: IS TRERE OR IS fHERE'LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes &o If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether It Is substantial, large, important or otherwise significant. . Each effect should be assessed in connection with its. (a) setting (i.e. urban or.rural);.(b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (Q magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. ❑ Check this box If you have identified one or more potentially large or'significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a'positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency. Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of reparer (it different from responsible officer) Date 1) W E S T C H E S T E R M 0 D: U L A R H 0 M E S alb , `911 - i :I� 1 = E9j—�-1. !s-.li i I ! _ +�, . I_^�IL�.id � iiinu° {iii ii.num . I w� —' t I •� i _iJ ° w in:iii = _i l_. ����1_� "�'�1+�.�i .mss _ ..� 7 i.:...i �.e..:.n... - , Y.�.®c ' i��s�a � _ a.i L. .�ti✓', _—._. �.�u�uuw .n 1.,.. - __ rn � sxn•. .. _ .. - ..aa.. T -q: �! '�� .v M1w���ra� Th e Bye Tb 27t8n x 0' o 2166 Sq. Ft. W E S T C H E S T E R M O D U L A R H Oa;-M E S 26'x 40 ' 1➢ a '� 1 66--o- Optional Master Bath 401-09 0 3 Spacious Bedrooms 0 2 1/2 Baths 0 Luxurious Master Suite Features; Dressing Table, 60" vanity, 60" Shower, and Walk -in Closet 0 Boxed -out Living Room with Reversed Gable 0 Spacious Country Kitchen Features Island with Real Butcher Block Top • "Cottage - Style" 3056 Front - Windows • Fireplace Options Available rd • Consult an Authorized Westchester Builder for a '' 40!# Andt�'® Complete List of Options Tdt -Was Windows • Artist's renderings and Floor Plan Dimensions are apprommate. All specifications must be Written in the Contract. No oral conditions. \I \I 30 Reagan Mill Rd. 0 Wingdale, New York 1259A (800) 832 -3888 0 (914) 832-9400.:' www.westchester- modular.com 6/97 ... r .. 3 _ j ,Standa� '°. g- d ���d�eeentwood. ;z Tai h 0 3 Spacious Bedrooms 0 2 1/2 Baths 0 Luxurious Master Suite Features; Dressing Table, 60" vanity, 60" Shower, and Walk -in Closet 0 Boxed -out Living Room with Reversed Gable 0 Spacious Country Kitchen Features Island with Real Butcher Block Top • "Cottage - Style" 3056 Front - Windows • Fireplace Options Available rd • Consult an Authorized Westchester Builder for a '' 40!# Andt�'® Complete List of Options Tdt -Was Windows • Artist's renderings and Floor Plan Dimensions are apprommate. All specifications must be Written in the Contract. No oral conditions. \I \I 30 Reagan Mill Rd. 0 Wingdale, New York 1259A (800) 832 -3888 0 (914) 832-9400.:' www.westchester- modular.com 6/97 Hole 4 CLOCK TIME— "` PERCOLATION , !Depth to Water ! Water iSoil ; i from Ground Surface! Level ;Rate lIole ;Run Elapse ; ; ; Time ; Start ;Stop ... Drop , In i i ;Min /In Number ! No_ Start ! Stop ! Min. Inches' Inches i Inches I Drop__ .'Zq i b 101 _ 30 13�t 17,1 i 5 s jZ OZ /Z; 32 3 �... 2f i ,� ! i 'l�i ( i l2id' 3'n i 3 ? /7 i4 • i i5 � ,. i i i i ; i i 3 2, i 2 3 !.3 i .12;3 i , .'Zq i ZS3�� 13�t 17,1 i 5 ,2 i ,� ! i 'l�i ( i l2id' 3'n i i y i 27 3 t2.1/ �2; fl 3 i Z7 .3 I.o i i i i i i i 4 S i i i i i i i Notes: - Perc test done by: U ►T/CJ'��i 1) Tests-to-be repeated a't same'depth' until approximately equal soil rates are obtained-at each percolation test hole'. All data to be submitted for 'review. 2) ',Depth measurements to be made.from top of hole. DO NOT REPORT rINCRMHENTS OF LESS TiDN ONS INCH, TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION 4� DESCRIPTION OF'SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE N0. i HOLE NO. 2' HOLE NO. ✓ HOLE NO._ 6" �Dn M Jo,1 iM oc, w► son ry . ko 121 1$" 24" 30" 36"; 42" 46" 5411 60" 66" 721.. 78" 84" WAS GROUNDWATER ENCOUNTERED.--/V D .. _ ..... �._.. ®... TNDiC�TE.I;EVrI;'A2�W�iIitT GR�'CJND'iiNA'i�'R IS ENCOUNTERED �` -/� °_ _�,• INDICATE LEVEL FOR WWHICH WATER'LEVEL RISES AFTER BEING ENCOUNTERED /' /A DEEPTESTS MADE BY M).4, NoL/y //V DATE OF DEEP TESTS DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided 7 G3 No. of Bedrooms / Septic Tank Capacity `2S0Gals. Masonry Metal Absorption Area Pro by /bI�L.F.�c24" �� width trench. Other S"l ✓4'�` -' BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Public Health Director Associate Public Heath Director Directorr. 'of Patient 'Services DEPARTMENT OF HEAL'T'H 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278.6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6538 WIC (845) 278 - 6678' Fax (845) 278 6085 . Early Intervention (845) 278 - 6014 Preschool (845)218 -6082 Fax (845) 278 - 6648 Date: 11,E , To: MA ��a vj Nail itv l (o Fag. #: �a 5 - a 13 y No. Pages (Including cover sheet) . From: Putnam County Department of Health For your information Please respond _ . .... _.--.� .;....- ..L. c .. .. --.... c z - �=.� Fo.r your review w a Attached as requested `" As discussed Please call Notes/Messages C.-l- h s F, . tI" ?_ s u. Dec s 1A S n vhf iiA e, ' vf_n iii rte? �r�s.�3 ��► l �02l �� 3 In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext.- at 15 7 BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Public Health Director oelate Public Health _D.irector . Ass . -- .- _K,,,�.._�...,a.' - - .•....,... .,._...�... >,�, --: :.:�... •�.-, Lirector. 0 f ' rvces 7.. DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 -.6130 Fax (845) 278 - 7921 Nursing Services (845) 278 -'6538 WIC (845) 278 - 6678' Fax (S45) 278 - 6085 . Early Intervention (845) 278 - 6014 Preschool (845)•278 -6082 Fax (845) 278 - 6648 Date: To: a-An't, From: a ePh -S5. PC -f*V0A Tr. t A PN . ]Putnam County Department of ]health Fax. #: ' / 7 /y -:773 - c, -3 � e No. 1Pages � - (Including cover sheet) . zFo>r your information Tease respond For your review Attached as requested �1i s discussed Please call[ Notes/Messages • (n,��U� ethl' '_k &� nn J'%zti, (/� i'le c, , �C f 5 vsf &.1,ve (�`D.•✓! �G� LGt!"iY� ! C�r;•�� =f /,O //t . ' � �'la� 1i :7 � �C¢c:. i •t` /i.°�l L��.'L°id i � .�.t7 ,"C��: �c?G� t't'(Gl. T �.wCtGt . , � • Ll. (5 y � or"! � 7 � �s/ G ✓�1.�.'f > 5 �l O ; •i� `� o K iGY��. . ��P�.:p i2.c C� $�.. 5 D/'qr2 tip k4Win !7/V "i lt/1D.`i/ /�^ � E� ! /LP. nvrcS �6� s�inI I"/- i:CL/ig kc Le,.5 . In the event of transmission /eeception difficulties, please contact this office at (845) 278-6130 ext.- 9157 11 i. 10/15/2003 08:42 9144243560 NOVIELLO PAGE 01 BRUCE IL FOLLY Public medirh .alms. -W LORETTA MQLINA PJ RN., M,s.N. Auorratx Pvbllo Sealrh Dowaar ,Db vdor of padew services DEPARTMENT OF HEALTH I Genova livid —Brom -tex, New York 'SpSU9 REC1i�:gT EM TE87�iN ATTENTION; XX%J0SEP0PARAVVf1 Q GEN1 REiD All information below must be _&_I& completed prior to any scheduling. DKM: 10/14/03 Matthew A. Noviello, P.E. (845 222 - 9144 *cell ENGMER OR PMM: , qa tE o; 8 4 5 2 2 5 -4 004 MASON: DEEPS: ❑ - I'EIiCS:= PV1 r TEST; c ROAD/STk2EXT: N.Y.S. Rt . 301 TOWN; Putnam Valley TALI "#., 19-2-17 SCJHDxYrSXON: LOTtt: 014'N'1`R: Francois & Jennifer Newman EXDRP t•:, MRHIA FOR,iC3i?QT'l7EYT.F�R AND W-W, i A .9 RC, (F 9 91h LM- TTNt*:: _ ...... - Xz rt )Proposed SSTS within thodruinage busin of Wmt Araneb orpoyds Corder Tteorvolrs. a A Proposed SSTS "kin 500 feat of a reservoir, ruocvoir stem or control lake. p o Proposed SSTS within 200 feet of a wratereaurae or a DI;C wetland. 0 o Proposed SSTS design flow greater than 1000 g4oas /day or SPDES Permit required• a a Proposed SSTS for a Commercial Project, It is the responsibility of the doslgn proteasional to provide the above information prior to soil testing. This Department will determine the NYCDEP project statues (loiat or Dtlagated) based on the rrapanse. If you answered y-r_s to any of the questions, NYCDEP moat witotess the $oil testa. This Department will coordinate a tnittualiy suitable time for Yield testing with tbd Design Professional and AiYCD P. If % project has been determined to be Delogntsd based an the ubovt: response god tbeA subsequent Information indicates NYCDEP k required to witness the soil teats, it will be: the sole responsibility of the design professional to schedule re- wituft' sing of the soil testing with N'YCDI;r. /o `tea FOA coven use ONLY �a rh �'rcEsv K anxE: C� /mot cmm:_ zu;-1 �s cnnc . tFtELMF -ewe v ~NAME DEPARTMENT OF P. 1 OCT- 15-2003 WED 08 :41 TEL:845- 278- 7921�� :PUTNAMCOUNTY IE T LII LINT BOUM 7ic i- A-1 le 31 e.82 AC. CAL. 9) 1,4 15 X..24 AC. S) 24.42 AC. CAL. AL 1245.8 -514.70 lit 0 iL JIL 4L AL 4L AL F LLJ '1.61 AC, 12 19001 AC. —2 cr_ AL —3 it —4 5 Oro z4 A C.. 6 13.78 CAL, . 1.93 AC . A17 -8 / 1. /9 (s) 2.79 AC CAL. P/O 30-2-27 a LEGEND QIPUTED AREAS ............... WETLANDS LINE AND SYMBOL t owimucus OWNERSHIP 30 DIEVELOPERS LOT NUINVIER Do o -4 PUTNAM COUNTY, NEW YORK DATE OF AERIAL PHOTMRAPHY.—.' �%OW FLO.W. DEED DIMENSION IMD) SCALED DIMENSION 100(5) ',SPEOIAL DISTRICT LINE —I— CALCUi-ATED AREA 2.34 AC. CAL I. _�j6flolll DISTRICT LINE i —SCH-- VISUAL CENTROIO A OF PARCEL BOUNDARY "rhRT PARCEL N"ER 72 a M III PR LIMINARY SCAALE P- TOWN OF PUTNAM VALLEY P462N 29 30 Do o -4 PUTNAM COUNTY, NEW YORK DATE OF AERIAL PHOTMRAPHY.—.' NY STATE PLANE .Q B 292s0m W'11- N swono M III PR LIMINARY SCAALE P- TOWN OF PUTNAM VALLEY P462N 29 30 Do o -4 PUTNAM COUNTY, NEW YORK DATE OF AERIAL PHOTMRAPHY.—.' NY STATE PLANE .Q 7 ' 1 i 9 .t I s, I 3B.A9 �• w 1. AL 19 0. y• ti I A J 45.49 AC. CAL. 119706 AL 9 J ca �. o' AL WI - --L -- P/0 30 -2 —I - - - - -- P/0 30-2-3 — -- - - - - -- 960000 L------ - - - - -- ! - a ; . i FOR ASSESSMENT PURPOSES ONLY REVISIONS i SPECIAL DISTRICT INFORMATION SCWM -SCH- PUTNAM VALLEY CENTRAL SCHOOL DISTRICT --- 3728OZ STATE LINE .D!SPIIIFO NOT TO-BE USED FOR CONVEYANCES CARMEL CENTRAL SCHOOL DISTRICT - -- 372002 CagrtY LINE "IEPARED BY - - ' TOWN LIRE - JAMES W. SEWALL COMPANY ' ` FIRE •F- PUTNAM VALLEY FIRE PROTECTION DISTRICT TILLAGE LI1Z - 8LOqT LIMIT — — 147 rFNTER STREET. OLD TOWN, MAINE i PROPM LINE o ORIGINAL LOT LINE • OU /i 0 /GU(].33IISA�I) . �SI.I`I3I1T�eG� 3aIa auvkiojuci-1:011 od m ,OIC�n 3lON'IO*ilNOO NOISoua ,slSS '� QZ3M `3SllOH ZiO d'IO�i L1100�I.0IS0�i3C��i 02.1UROSIP SUP Sn03 Z8I 1441A,001/3OXYHOSla QO 03 1�II'd ,OZi�n $�nOS S3�L3I�11 XI.2i3dOZid�)n oI 0'al ,Sinn sm d0 100Z NUM S,SQSs't S I'13Mnn •• ' ' ' • 'II�'l3Q S3QISHlOg,S S3dIdQ.titYLSni� _ MUUMUU no S1�;01J:YA3'I3l!�3LV3SYS " I4�YiY 3dOfiY 3JYTi0IS XYQ ICBM amy aobuHsiNia Q3SOd0?Idni -J Q3'IIYl3Q V Xog-Q (Iqy ijac � IT(Tao ,OOZ=JlIA SaNYZl3M'S3xY7 - .DOHS ('0l3 3dXl 3did) javi t 3o)iO3Ii03 ZIYI.3aM. sQAOd'sasuaOD'aglYM 30 ),mlinO imn Q3,Lfl;d 3IQn'IOA 3•S6a/3I4n'IOA 3ald 30 %SL 3SOQC —)C- 3DN32i333�i NIIIlYQC�n NOISIA31i/OMMYEa 30 SIYQC--)n S310�I dT�(ldC -)n #3110Hd `ssamQY `3wy 1YTi/3d'K9J. Si Q3?II b a jai ` / 10l Q3QY2 bau( M SS32iaQY 3L1IYN S1i3NMO 1Jio 0'IS 371I1(�C� ' ( %OZS��'Y3IIY SLSS A�I3d07Snn' SaMYaNnOg 3dJlS. ZIOS YQSIInn _ .. ' SNIYiiQ�Y .L2illohi3Z.LI1J /JAU.L00.3i�i� . • • �dO:ZS ' •. ' . . ZnD •`•S3d0'IS � AYKi3AI3iQ(�n . -- .. - . 31.TI'iAl2i3d0)id O.L,S11.'II'l'ni� Q3SfldOZIa �8 J1�IIZSIX3 S2in0�oo ,ZC�C� - . NoMR.Ux-OD 3oIAZi3S 30 !ROII.Yoolic Sl'Iam a33Q v ou wYZYa mmsaa(7n _ -- -- _ - - - -• SMZXIZi3 ow-oi sms..am. iQ7) ) 3A� moU A LIAYxo(--)m 'I'I3M O L,OS �1\OIlYQ.\1103 Ii0�I3 Ainn 3'II3ouaolrinraaAH SQSsC7M 3S• (MoriY.H7.,ao)4)-2dY'Ia walsAs 30YAt3s( —)C--) • • aouDinonaQ3 o3.2m#,,ol( ST1?3ls1tS 1I3'ITs'9 ,OSI 'D�3 `iHO�i�i3S32i3OOSI OOE{�n ° -. ; -,, �_ •a'Ifl S2TY31s bI <SiO'I, -DM.S3 LrIIOSC7 -) �_ :. '_ .. ;.,.•' - 351if10� 3JY1�'dZiQ 11.3I�II1�i3i:�TI �OSC�C -� ,OOZ UAL i:OIlYn3'I3 Qn0'I3 2IX 00' C—) COZ- nld) M,.j)i3lYA1 Ol,OIC�C� Y8Z/IgZi3313'IC�C� ?i3lYM Q3dfd :�Y�1QIIZOIS ,S£'1,IISYgHOlYO O i ,OSC�i7 NOIlY3UIlOK- ?IO$HOI31d 696I 32idC -)C� • (n�dza -am) 3XIY'I'anmooUllyA lly-aldis 01 .0 -)C�• 3�'dYS SIL.��i3d.?8'S11�+'Id�SQ{I i�'U•�.L`'Qi- -)(� . SIId Dl OSI ` QO' IQ' 1vTI ,00Z''I'I3,ii•OI.•,OOIC iZQ�a3g'• itl�tZi3d- �.3Q/i17�013:5(IZZ'dTY3�LC�(� - STIVIA R Z's a. \f103 O.L ,OZF 7)i) s.ZOI `r.QY sass iYn02iddY-xa( 113I3 30 aol'S37ai abiry I' kYASvma "I.4 01,01( . - Q3SS3NllIM 3g 01 d3dC�n ' 402{3 - \ ' I \0 Sao ti !�0 i Yd S Q3ATI3Sg0. Sa MH .LS�I d33QC�n 'MOD 3ZII.X3 L030nC- •Q,b32�3I''IYn02iddY d3QC�( -) IaAY2i0 •a3IiSYM 2i0 3.\OIS a3HSn` b 332i31S -,IVI. Yi3QnC� QHOd O.l Q31Y03a3ci( .... :. - -. -_ ..._... _..... Q3QIA0?Id :�OIS \YdX %.t O L' Q3S LII�fil1S S \YTdn suftomL o:) OZ'I3'I'i� -'YaF Q3HS2i3 LYM 01iid 1�I Q3 L�+JO'IC�C� 'XYI•ml I209 Q30IAO d l HONITU 3'IC -C--) HoRml aamriba'd NIY2iQ 1�YI2InoC�C� 3do'IS 30 301I�0 -i3 Hld3Q Q3ulrlba i'I'Ii3nF-) SI101AUUNII -7 (IMUSSYTIOM''S'0 d 2i0d .1,lY'Id \0 ZO AC-�(--) _ 3ZY2i xuaC7M. S39f1YO I Id3QC�n Q3;io3HO TYnOIiddY i�0ISI1►IQansc • 3lONNolly3mi2i30'i'II3nn x oisw aans 'IY93'IC7M . .. • � • 2i3I2I2iY S ?�'� -IO C�C� `�' Lois a ns . r ls3nb3zt 3011t7ZiYnC�C� Y32IY moos 'YaX3 .'.Z S13s OMZ - smrid 3SnOH)C--) . S\OIS \3XIQ F 31I301da I'II3nC� Sl3S 332iH1•S \Y'IdC�C� :-i S3IOU I II3 /SJ3dS I'II3C�n 3QY2iJ OZ I £ Sums HO. .ad.L ISYd !'I�'.L \OMoH .01( � 3Y312i0Hsc a kOIj nllosa i 3lyZIOd oo� Sid 1S.�S Till 2�� (SQQ) I33HS Y.I,YQ KlmsaQC7m (30.\lYH.0 0.'0 310\ 311SC—)C- )C--) saYNK3. 32{ •:LnO \Y3'10 /A1 °St SQ\'dg xyp �Sa \3g 0 \C�C� 2i3 Llali SM UO .LiN. aid 7113; U F7 ]\0'al .LSYJ 3aia 3d it ,0„ t- ' I 3 , %-2I3m3S 3 silo HC7(7-) a. \OO '. r. 1`OI L day III' (� • +'�,... '•. �l • S\ \0 S"1 �1 Q a32liA 3 \ :t S :�3I4f1o0Q ((131%r@- 1\OJ): =dXllXYl :3I.YQ?IS 'SY "dlD `M :.kgQ34131 U _ 1\OIiYJO"I 332i LS:...... :'daM1 10 3O 31.qd11 .'.. . MlZli3d .K.olMn2ilS \OJ 2i03133HS MaLklld SIV3ISAS L \3Ikilya 130Y.U3S 30Y33nS3nS T Aliclans ld3lYA1'IYlIaLki(1:11I - Hl'IY3H7IYl\3IQ\03L•LN3.iO KOISWQ HllY3H 10 1 \3Iwayaaa A.L \1100! I11t1..Lnd VA—rwA wide rse Cal W-0 OC. 2IM3 --JUL 2 8 PH 1: 4 9 dersen *Available for upgrade in the Affordable Series JEFFERSON Jefferson 1st Floor 27658 1,572 Sq. Ft. CLO BATH g2 BEDROOM #4 CLOP rEAUNDRY CLO LIN WALK-IN CLOSET BEDROOM #1 I6'-7"xI2'-II" "We're Building Our Reputation With Your Home." BATH #1 r HALL . nk.1 _/ CLO OPEN TO BELOW BALCONY Jefferson 2nd Floor 27658 1,572 Sq. Ft. Floorplans and room sizes are approximate. *Upgrade to Andersen high performance windows for a minimal investment. (See your builder for details.) B IF— BEDROOM 03 11-11"X BEDROOM #2 1I'-II"xI2'-II" I EXCEL: C MOPULARS. BY McGLASSON INC. #3 ROUTE 6 CORNERS OF RTS 6 & 52 CARMEL, NEW YORK 10512 �)))) (914) 225-7988 1 BREAKFAST NOOK C KITCHEN SUN ROOM 13' -Y x9' -8" 1 7' 3- LEE] PAN B BATH ATHO 0 #3 #3 LIVING ROOM JABOVE 14'-4"X28'-8r FAMILY ROOM DINING ROOM To OPEN TO [ FOYER Jefferson 1st Floor 27658 1,572 Sq. Ft. CLO BATH g2 BEDROOM #4 CLOP rEAUNDRY CLO LIN WALK-IN CLOSET BEDROOM #1 I6'-7"xI2'-II" "We're Building Our Reputation With Your Home." BATH #1 r HALL . nk.1 _/ CLO OPEN TO BELOW BALCONY Jefferson 2nd Floor 27658 1,572 Sq. Ft. Floorplans and room sizes are approximate. *Upgrade to Andersen high performance windows for a minimal investment. (See your builder for details.) B IF— BEDROOM 03 11-11"X BEDROOM #2 1I'-II"xI2'-II" I EXCEL: C MOPULARS. BY McGLASSON INC. #3 ROUTE 6 CORNERS OF RTS 6 & 52 CARMEL, NEW YORK 10512 �)))) (914) 225-7988 1 q F77,71 AWAM "Welre Build n g ur Reputation With Your Home." MANUFACTURED Photographs may show exterior elevations and options which are not part of the ANUF I MODULAR STRUCTURES 1 NOTE.- Upgrade to Andersen Windows. (See your builder) Series Specifications. J� 4" N, r a OWNER OF RECORDS OF: SURVEYS, SITE PLANS, SUBDIVISIONS, &O.FI:A. ., .. `... JOHN C. HOFFMANN, L.S. TOPOGRAPHY, HOUSE PLANS MATTHEW A. NOVIELLO, P.E.,L.S. PROFESSIONAL ENGINEERING & LAND SURVEYING 77 Hughson Road Carmel, NY 10512 (845) 225 -4004 Fax(845)225 -2934 July 19, 2003 wf . Mr. Michael Budzinski, P.E. PUTNAM COUNTY DEPARTMENT OF HEALTH Geneva Road Brewster, NY 10509 Re: FRANCOIS & JENNIFER NEWMAN PROPOSED DWELLING WELL & SEPTIC SYSTEM APPROVAL N.Y.S. ROUTE 301 TAX MAP 19.— 2 —17 TOWN OF PUTNAM VALLEY Dear Mike: _.:. :.:.. Enclosed please -find an application for Heath Department approval of a well and septic system for a proposed one family dwelling on vacant land. If anything else is required please contact me. Your prompt attention will be appreciated. Sincerely, ye &j LS AW- I wA 4 e: .'roc .. �,�wr,a♦I - ✓c.n «x : - ._ s. �_ ., _ .<J ='. ENGINEERING REPORT PROPOSED WELL & SUB- SURFACE SEWAGE DISPOSAL SYSTEM AT NEWMAN PROPERTY N.Y.S. ROUTE 301 TAX MAP 19.— 2 —17 TOWN OF PUTNAM VALLEY JULY 199 2003 0 By: MATTHEW A. N®VIELL®, P.E.L.S. 77 Hughson Road Carmel, NY 10512 (845) 225 -4004 IBACKGROUND: This project is located on the south side of New York State Route 301 in-the Town of Putnam Valley, just west of the former County of Putnam Highways & Facilities Department `Putnam Valley Stockpile' The property appears to have been vacant forever. The City of New York Delaware Aqueduct passes under the property and the City has a shaft near the south property line of the subject property. The remains of blasted ledge rock is strewn about the subject property. This most likely is from when said aqueduct was built. II SITE INVESTIGATION: The existing conditions were investigated by excavating four deep holes around the site. The deep holes varied from 4 to 7 feet deep before ledge rock was encountered. No sub- surface ground water was found. Three percolation test holes were also made. The soil was stoney loam III SYSTEM DESIGN: We are proposing to construct a single family dwelling with an independent well and septic system HYDRAULIC LOADING - This system will be sized based on theoretical loading. Four bedrooms without metered water equates to 600 gallons per day. (from Appendix E) SEPTICa'hANK= .....- _... _. . _ . - ..-_..._ ......_ _ . _.. _ . _ , - . _� . :.._.�... _ .:. :. .....:__....:....... 600 gallons per day * 1.5 = 900 gallon tank minimum Use a 1250 gallon concrete tank with dual baffles ABSORBTION FIELDS - For percolation rates of 16 — 20 minutes per inch, the allowed application rate is 0.7 gallons per square foot. For 600 gallons per day use: 600 gpd / 0.7 g.p.d. /sf / 2 sf/lf trench = 428 l.f. 24" wide trench Use 4801124" wide trench. Since the property is sloped a 12" deep 24" wide swale should be constructed to keep the surface runoff away from the septic system area. WATER SUPPLY: Although the New York City Delaware Aqueduct runs under the subject property it is not likely that the City would allow an individual tap. Since the property contains 3.4 acres of land and all of the surrounding properties are vacant, it is most likely that a water well could be successfully constructed. PUTNAM COUNTY DEPARTMENT OF HEALTH - _.. DIVISION _OF..ENVIRONMENTAL.HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: FRANCOIS & JENNIFER NEWMAN 2. Name of project: 1 family house 4. Design Professional: M.A. Noviello 6. Type of Project: xx Private/Residential Apartments Office Building 3. Location TN: Putnam Valley 5. Address: 77 Hughson Road, Carmel, 10512 Food Service Institutional Realty Subidvision Commercial Mobile Home Park Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Type II 8. Is a Draft Environmental Impact Statement (DEIS) required? ......................... Exempt Unlisted No 9. Has DEIS been completed and found acceptable by Lead Agency? ............... N/A 1G.-- - NarfkFuf LeadAgency - Putnam . Count_y- - Department.: -o f.: `Heaxth . 11. If this project is an area under the control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... Ye s 12. If so, have plans been submitted to such authorities? Yes only to..obtain variances 13. Has preliminary approval been granted by such authorities? Ye sDate granted: 2003 14. Type of Sewage Treatment System Discharge ................. surface water xx groundwater 15. If surface water discharge, what is the stream class designation? .................... 16. Waters index number (surface) ........................................... ............................... 17. Is project located near a public water supply system? ....... ............................... Yes 18. If yes, name of water supply Delaware Aqueduct Distance to water supply zero 19. Is project site near a public sewage collection or treatment system? ................ No 20. Name of sewage system 21. Date test holes observed Distance to sewage system 22. Name of Health Inspector Form PC -97 2 23. Project ' o�ect design flow_(ga 80.0 . lions. p ... .. ..... ... ... _ .... , er ay ,. <. 24. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... No ti 25. Has SPDES Application been submitted to local DEC office? ......................... 26. Is any portion of this project located within a designated Town or State wetland. No 27. Wetlands ID Number .......................................................... ............................... NJ 28. Is Wetlands Permit required? 00 Has application been made to Town of Local DEC office? . o'' ;_.. 29. Does project require a DEC Stream Disturbance Permit? 30. Is or was project site used for agricultural activity involving application of y pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ... ............................... Yes/No Ye s DESCRIBE: S = =ite a s adjacent to former .Putnam County salt , s orage site _.. -, 32. Is there a local master plan on file with the Town or Village? ......................... N /A 33. Are community water and/or sewer facilities planned to be developed within 15 years in or._adjacent to project site? ...................................................... No _ 34. Are any sewage treatment areas in excess of 15% slope? . ............................... No 35. Tax Map ID Number .......................... ............................... Map 19.. Block 2 Lot 17 36. Approved plans are to be returned to ..... XX Applicant Design Professional If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, irm, under penalty of perjury, that information provided on this forge is true to the best of my knowledge and belief. False statements made herein are punishable as a Class Al misdemeanor pursuant to Section 210.45 of the Penal Law. JAA 1 d4i,L�N B � Mailing Address: ................................... (IeAtfuSow lf" 12/15/2003 00:38 FAX 19147394601 MARSHA KRESSIN la 001 '.t-r. ,.:.u...' -•a �c.iv6z .:� ... ...._.. <..... ar -.r �w+_•..w. -_,. r •.:Y::x.. iii. _r... -..... _t'_P. •.t:'rr.. . ...:.. ... ..:. a.�. -. � -.ail u�. .. _— ... .. ... �-v. an r .-w -wr .. Y'.Y v.....r.. ta...'� Y t.P_ a.vra MARSHA D. KRESSIN ATTORNEY AT LAW 832 SOUTH STREET PEEKSKILL, NEW YORK 10566 (914) 739 -3394 FAX (914) 7394601 TELEC0PIER COVER PAGE, PLEASE DELIVER THE FOLLOWING PAGES TO: DATE: Total Number of Pages Including Cover Sheet FAX sent to Telephone Number ��45 ofp if -ynu -o not receive a!'-- pago-- or -ha ,e please tall.._ (914) 739 -3394. REMARKS: This message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you receive this communication in error, please notify us immediately by telephone (collect) and return the original message to us at the above address via the U.S_ Pnctnj Sarv;,-& DEC -15 -2003 MON 12:45 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 12/13..•'2003 00:39 FAX 19147394601 xtRsEu nESSIN la 003 0 11/26/2ES83 14:59 9144243560 NOVIELLO ME 02 1. '?,'lei Delmar Aquedac4 pia uu&= *e property and *e N X.0 D.V--- P. :' . _ ... edvisad no *4 they will lilt albW MY cmaMtiau ovet or GM tl3t - Tbis disqu+cli6es at lmd 0363 acres £rem use. 2. Tbwe is a large swamp and bvWJ are= czossiag the sbe oovcrim about 1.046 acw& 3. Tlam is an ezis ft N.Y.C. DB.P_ aoos easeme that bisects ft She md Covers about an addi vxW 0Z46 4. Much of ft immalinimg property :is, in excess of &v mvgja mun 1595 slope flowed for septic qstem this ,avers abaci amot 1349 acros. 5. Mad of the teQa hft site of 0.455 satrs is a W seem Appacenly this arm was wed to damp the diet, clay, sand and soon, £roux when time Nlaware Aqueduct wag camtructed in the 1960'x. Them is a mi neslaR tot that Dehw= Aquedud Jug south of the property. It is my belief dW the m ak rW c=vatcd lkem 41ae aineeW was damped on the `flatter' part of tails 4W. 'ate =&mb$ testshave shovm tbat eoase of this'ares is clay and does mot petoolatm Some ofthis area is*64imid X atd lbQ water races aw too 652. Sam of Ws oft is bm that paauW% sWdadoWy at aboitt 30 mkom per ilacb. Tbo mat no* is that m** ®m+ ddid oftb , 0..455 mites is aeceptabk for a septic 7Cb+e result is that only J#js tLari 7QW,s9ua 1� of soil is atvaa�sble wida a 30- tali geteo>at n rate 1Jnder sus:reioit ?nmaM C 9untg� Heaalltl9. Depaeboen4 goide0m tkn ie tot enou- > Wilble lea ;d• available im order 0o deOp a septic xydiem fora §6ur4wdr6dxi house or rhea a t sao- badge homm- Addrtia=lty the septic area, rieod up m 3'h fic6t of t"itl, a clay barn and a curtain dra& I£goiu vatatlld him ime. to Wdemp wick a 1 or 2 hadtiavna bym please advise. DEC -15 -2003 MON 12:45 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 3 a SENDING CONFIRMATION �n .. -. n:a. ... tea. ..nw— t.. .. • tu.ic ..A... ..... DATE : NOV -4 -2003 TUE 17:32 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92252934 PAGES : 2%2 START TIME : NOV -04 1730 ELAPSED TIME : 00'56" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... 78 aa�{o tEgy pgaoa a d Ufa• LSRE� 06i9'tLt (514) �1 t►iTM'l;atP aopd000yno�e�mtttwt jo ttra•a oQt IIj e[ouaaano[J g�-- paodtw otoaU -- tlotxwajm snot aog • II9 Qi � 4�1?�H )o l . cau. a LlonaJ ama}nd 3.. y s:- :mo4j i {1sa4a aeero 2alpop" i V ,,p POF41 'ox 1 0 j,200N r4TW . '61 atft'VR 6MI•b Lt09y[r(Cet) w.vyw stot -u:0g1 ••u�wn t[+R ' C/M;4L([WAd ,tl9)'t[L(CW J[bl tj(9•iLi(MI [W[+�e �tL•N ILK•tL[(S1b>•a att9'UL([t>7 �Ila[! 1.1•a�.7•ra 60$01 4Mx AlObt 49MW8. POOR MOOD t �w+e A -," HLTfa 30 �i3,ZIVflMa ��v vtw u mo�v +m�opr ' xsrt am rnrx�oat va.=cn +wura w m turd .�aTOa ii eonae j LORETTA MOLINARI R.N., M.S.N....:_ DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Environmental health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Matthew Noviello 77 Hughson Road Carmel, NY 10512 Re: Dear Mr. Noviello: ROBERT J. BONDI County Executive August 15, 2003 Application to Construct A Subsurface Sewage Treatment System for Newman Route 301 (T) Putnam Valley TM #19. -2 -17 The Putnam County Department of Health (Department) has determined that the above referenced application received by this Department on July 29, 2003 is incomplete. Please be advised that the following information is required before the Department may commence its review. ogo The above regarded lot is within a New York City Department of Environmental Protection priority watershed, therefore, soil testing must be witnessed by Y)(*C Dept. of Environmental Protecti-on and the Putnam - County Dept. of Health: - ...Contact Mr. -Gene Reed, Putnam County Dept. of Health, to schedule a mutually suitable time. 00o Well permit application has not been submitted. 00o The current Form PC -97 has not been completed (enclosed). All questions are to be answered or noted as N /A. House plans, 2 sets, have not been submitted. Only one house plan was submitted. ®oo Engineers Authorization has not been submitted. The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of the 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 procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Dept. of Health regulations. 5b.ck'k!d'YQq. b4.vP:aMY_I:WstioDs,. please feel-frec to contact me-at (845)-278-6130 ext. 2148. RNVjp Very truly yours, M 'w' Robert Morns, P. E. Senior Public Health Engineer PUTNAM COUNTY DEPARTMENT OF DffVffSE(DN OF ]ENVERONM ENTAL HEALTH S E]i� <<' . - ..��.�. - •mss.- ..,a.::..:.._ ..� -:._ . .. �.� cC®T U CUON PERMIT FOR SEWAGE TREATMENT SYSTEM,? � ` ; PERMIT # 0 (D j Located at N.Y.S. Ro.ute 301 Town or Village Putnam Valley Subdivision name None Subd. Lot # Tax Map 19. Block 2 Lot 17 Date Subdivision Approved Renewal Revision Owner /Applicant Name Francois & Jennifer Newman Date of Previous Approval Mailing Address Zip Amount of Fee Enclosed $ 3 0 0 . Building Type 1 f ami ly Lot Area 3.4 ac No. of Bedrooms 4 Design Flow GPD 8 0 0 Fill Section Only Depth Volume PCHI(D NOTIFICATION IS REQUIRED WHEN PILL IS COMPLETED 1250 conc. Selgarate Sewerage System to consist of 3tR2x *xfrx:RARtx gallon septic tank and tg2R 4 8 0 1. f . 2 4 " trench Other Requirements: swa l e 850 c . y. R.O.B. & 2 5 0 c_ y_ c 1 ay f i l l To be constructed by t . b . d . Address Waiter Supply: Public Supply From Address Private Supply iX I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a 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. ,X h A. yge o, P E.,L.S. Signed: Z LS P.E. . Date 7.4 19.4 0 3 Address 77 Hugrson Rd., Carmel, NY 10512 License # 061145 APPROVED FOR CONSTRUCTffON: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 4 LORETTA MOLINARI _.. ....._..._.. ,. ... Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Matthew A. Noviello, P. E. 77 Hughson Road Carmel, NY 10512 Dear Mr. Noviello: ROBERT J. BONDI County Executive January 26, 2004 RE: Application to Construct a Subsurface Sewage Treatment System at Newman NYS Route 301 (T) Putnam Valley, TM# 19 -2 -17 The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on July 29, 2003 is incomplete. Please be advised that the following information is required before the Department may commence its review. • Well permit application has not been submitted (requested on August 15, 2003). • House plans, 2 sets, have not been submitted (requested on August 15, 2003). • Engineers authorization letter has not been submitted (requested on August 15, 2003). • Current SSTS construction application has not been submitted (revised to 3 bedroom). • Design data sheet, reflecting witnessed soil testing, has not been submitted. • SSTS plans reflecting witnessed soil testing has not been submitted (60 min/inch perc rate). All watercourses, and water bodies on and within 200 feet of the property are to be shown. The review of your application will commence once 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 procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. Letter to:. Matthew A. Noviello,.P.E. - January 26,,2004_ -2- .. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2166. RM:tn r iruly yo s, wi" Robert Morris, P. E. Senior Public Health Engineer BRUCE R. FOLEY Public ffeaith Diruator e..�._...,,...._. .:a 5' 3�t LORETTA 'MOLINAIU R.N., M.S.N. X- tioeiatu Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road •'•Browa-ter, New York '10509 REQ'(JRST FOR. FMLll TESTING A,TTEN'TION; XXMJOSEPR PARAVATt 0 GENE REED All information below must be Lally completed prior to any scheduling. DA'L'E: 10/14/03 Matthew A. Noviello, P. (gj 4 cell ENG'EER0IZFIWAI : � 45 225 - 400 REASON: DEEPS: ❑ - PFRcS:m PLT.MY TEST. G ROADISTREET: N.Y.S. Rt . 301 TOVS'N: Putnam Valley TAX IyLApp: 19-2-17 SUBDIVISION- LOTO: OWNER: ^ Francois & Jennifer Newman NYCDr,,,P OUTERIA, FOR SOTNT'RFVTF,W,�,ND •WlTNESSTNG oiT so-m nSTINC YES NO - X10 0 _Proposed SSTS within the drainage busin ofWcst Branch orBoyds Coraer7Zeservoirs. U ❑ Proposed SSTS within 500 Peet of a reservoir, reservoir stem or control lake. ❑ n Proposed SSTS within 200 feet of a watercourse or a DEC wotland. ❑ o Proposed SSTS design flow greater thaa 1000 gallons /dayorSPDESPermit required. ❑ 0 Pro posed SSTS for a Commercial project. It is the responsibility of the design professional to provide Tile above information prior to coil testing. This Department will determine the NYCDE*P project status (loint or Delegated) based on the response. If you answered Ls to any of the questions, NYCDEP must witness the soil testy. This Department will coordinate a mutually suitable time for field testing with the'Desiga Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsedueut Information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of 'the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY usz: ora,v DATE. TIME: COMMENTS; (FIKDTEST) ti, ti : d b5= 6ZS226 01 126& a2- Sb8 !2 HdM AINnoo WHN.Lnd : wodu st7 : c T f_e02- b ti -ioo a� ~ LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1, Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 FACSIMILE TRANSMITTAL To: Di'v7e�- 1 t; vi Fax: I- q 1.4 - 7 3g - 6e- ! From: --J4:2 c� P�LVwI� /�Pt +� Date: I 117 I o OU��r�� fie• fn%c%�vu>7� P� ^pP� V A.Pages: 7 CC: -y1'f- 77:3- -0 3 q3 ❑ Urgent For Review ❑ Please Comment ❑ Please Reply J t -17 ROBERT J. BONDI County Executive CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845- 278 -6130} and destroy all documents associated with this facsimile. LORETTA MOLINARI R.N., M.S.N. Public Health Director...... DEPARTMENT 4F HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 -6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 rROBERT J. BONDI County Executive August 15, 2003 Matthew Noviello 77 Hughson Road Carmel, NY 10512 Re: Application to Construct A Subsurface Sewage Treatment System for Newman Route 301 (T) Putnam Valley TM #19. -2 -17 Dear Mr. Noviello: The Putnam County Department of Health (Department) has determined that the above referenced application received by this Department on July 29, 2003 is incomplete. Please be advised that the following information is required before the Department may commence its review. ❖ The above regarded lot is within a New York City Department of Environmental Protection priority watershed, therefore, soil testing must be witnessed by N`YC _ _ . - - Dept. of Environmental Protection and the_ Putnam CountyDept.'ofHealth: 1. Contact MrT Gene Reed,_ Put am County Dept. of Health, to schedule a mutually. " suitable time. ❖ Well permit application has not been submitted. ❖ The current Form PC -97 has not been completed (enclosed).. All questions are to be answered or noted as N /A. ❖ House plans, 2 sets, have not been submitted. Only one house plan was submitted. Engineers Authorization has not been submitted. The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of the 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 procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Dept. of Health regulations. „�h�zld:yu hv� anyquestians, .please feel.iree to contact nrie:�t 2¢8 -5130 eac,: X148 -: - (8 S� RM/JP Very truly yours, Robert Morris, P. E. Senior Public Health Engineer BRUCE R. FOLEY LORETT R A MOLINARI N., M.S.N. Public Health Director LL► O�1 Associate Public Health,_D.ir_ectpr: ervic - ., DEPAR'T'MENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845)278-.6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6538 WIC (845) 278 - 6678' Fax (945) 278 - 6085 . Early Intervention (845) 278 - 6014 Preschool (845)278 -6082 Fax (845) 278 - 6648 Date: n� NOV3 To: � Fax. #: �a5 "0213 No. Pages - (Including cover sheet) . From: Putnam County Department of health For your information Please respond -'_A2f- F`.r your review ' Attached as requested As discussed Please call Notes/Messages • Lo /_e-,. �`d' t� T+ /L e U d-&/ i l In the event of transmission /reception difficulties, please contact this office at (845)-278-6130 ext.- 2157 oo� 4" P INV IN 140.6' !NV 142.0\ P 0, 60, Dl 40' so, 0. /V 2 2 446d 0. 60' 13 .10 014 Y20' 6 FOOT G DF N '360 D 6 Y, 1200 , j 40' ZONING SETBACK It j --7r U. III . J l � � i I -Aco CD GATE' 110 �. / / I I uj R.C.M. INV 1100, oj cv) ZI -loll 1 41 s 'soos IF .20 t4160 . . . . . . . . . . . . . 71 � INV OUT'141.3' InA -+Ag e oo� 4" P INV IN 140.6' !NV 142.0\ P 0, 60, Dl 40' so, 0. /V 2 2 446d 0. 60' 13 .10 014 Y20' 6 FOOT G DF N '360 D 6 Y, 1200 , j 40' ZONING SETBACK It j --7r U. III . J l � � i I -Aco CD GATE' 110 �. / / I I uj R.C.M. INV 1100, oj cv) ZI -loll 1 41 s 'soos IF .20 t4160 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .......... .... i-, ISUBS€ RF. CE*,SE, WAGE'T' Rf� ;ATMENT.-'Si'�'T9k:',.Z,`..... Owner N &UAIVI A10 Address Located at (Street) "411k -70 Tax Map Block Lot (indic to nearest cross street Municipality.,.., VkL6, Watershed SOIL PERCOLATION TEST DATA 5� nntP of aa-lbD l 1 Via: e K5'40-7 2 - tea jj��) �0 3 t0d" r 30 4 5 . .2 P 3 la rah- - l 4 5 2 3. 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 95- TEST PIT-DATA . 2 (DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLIES - DEPTay. w . .:.. HOLE -NO � -� �. nz.�..,.� HOLE NO. G.L. 0 — % S 0 -- & V5 -0.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' l�y� TS 7.5' 8.0' pt 8.5' ,,✓ '� [Wye real 9.01 p,�¢' 10.0' rho � ri�l Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level level to which water level rises after being encountered Deep hole observations made by: Date !o a t a3 Design Professional Name: Address: Signature: Design Professional's Seal I 'i SENDING CONFIRMATION DATE : NOV -17 -2003 MON 11:26 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE } 919147394601 PAGES `� 7/7 START TIME : NOV -17 11:20 ELAPSED TIME : 05'20" MODE \ : ECM RESULTS ': OK r I FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... oaagd91o1 �9 m flgl)0 BW�� Lo ooPnk4ol+m�lwD � *q T �m WR P W;l T (R Tr Ad-In vm Pop- Awn --A PxPooml m=17 -Vm- sm N =P- oql R 00 Pq— Arm m P'IWWWR woo am am A4 kao pv-m um-4p PMMMA krv:?I vo9 '1VI.LW301'0100 m¢fg6o,4m ol!m?s:Ig bi41 m pom91m6 aoP9mlgy¢I oY,I. �SH3f13S:ZS x]TIVIZN�QNOO 1 Aldi o99old O 1.==03 os9old ❑ r601n2g 10$ v =&II ❑ ............. . ..................................................... l................................................. ahao- LI -hr - 90 "�T :33 ' L :9oS9d a� u . wrna�( na of LII :79a(l 3f�ItV .L "nn'r''d v r :wojg 109b'bEL-h /h -1 :xog I.Iro VIA,-(j- :qj, . 9999.la(f19)x" 1109.9L2(f19) Aws 9909-sa(09) -d 9199.9LE(f19) 01M fff9 •BLC (6191 AxH+�S �WeR 126E • BLL (f1U ad OC19.912 (1991 g11pH Mmwxal•wg 60501 i10X AlaX'2*"AlwH V20J UMD 1 HI I'b M LIO .LNSW. idyad -V)- v NwhbJ M "OMa WMI'll9 -d IONOH 'f 111HH011 'N'S'W •'1111 rdvt 0N3 Yd.1H11o1 i OWNER OF RECORDS OF: SURVEYS, SITE PLANS, SU13bngSI0NS; S:O.H.A: JOHN C. HOFFMANN, L.S. TOPOGRAPHY, HOUSE PLANS MAT JL IE W A. NO `C HELL ®9 P.E.L.S. PROFESSIONAL ENGINEERING & LAND SURVEYING 77 Hughson Road Carmel, NY 10512 (845) 225 -4004 Fax (845) 225 -2934 July 19, 2003 Mr. Michael Budzinski, P.E. PUTNAM COUNTY DEPARTMENT OF HEALTH Geneva Road Brewster, NY 10509 Re. FRANCOIS & JENNIFER NEWMAN PROPOSED DWELLING WELL & SEPTIC SYSTEM APPROVAL N.Y.S. ROUTE 301 TAX MAP 19.— 2 —17 TOWN OF PUTNAM VALLEY Dear Mike: Enclosed please find'ari application for Heath Department approval "of a well`and septic _ . system for a proposed one family dwelling on vacant land. If anything else is required please contact me. Your prompt attention will be appreciated. Sincerel , y � ��`iG l r 3 ENGINEERING REPORT PROPOSED WELL & SUB - SURFACE SEWAGE DISPOSAL SYSTEM AT NEWMAN PROPERTY N.Y.S. ROUTE 301 TAX 'MAP 1-9.— 2 —17 TOWN OF PUTNAM VALLEY JULY 199 2003 T*A By: MATTHEW A. NOVIELLO,'R:E.,L.S. 77•Hughson Road:, Cannel, NY10`512 (845) 225 -4004 IBACKGROUND: This project is located on the south side of New York State Route 301 in the Town of Putnam Valley, just west of the former County of Putnam Highways & Facilities Department `Putnam Valley Stockpile' The property appears to have been vacant forever. The City of New York Delaware Aqueduct passes under the property and the City has a shaft near the south property line of the subject property. The remains of blasted ledge rock is strewn about the subject property. This most likely is from when said aqueduct was built. II SITE INVESTIGATION: The existing conditions were investigated by excavating four deep holes around the site. The deep holes varied from 4 to 7 feet deep before ledge rock was encountered. No sub- surface ground water was found. Three percolation test holes were also made. The soil was stoney loam III SYSTEM DESIGN: We are proposing to construct a single family dwelling with an independent well and septic system HYDRAULIC LOADING - This system will be sized based on theoretical loading. Four bedrooms without metered water equates to 600 gallons per day. (from Appendix E) SEPTIC =TANK- 600 gallons per day * 1.5 = 900 gallon tank minimum Use a 1250 gallon concrete tank with dual baffles ABSORBTION FIELDS - For percolation rates of 16 — 20 minutes per inch, the allowed application rate is 0.7 gallons per square foot. For 600 gallons per day use: 600 gpd / 0.7 g.p.d. /sf / 2 sf/lf trench = 4281.f. 24" wide trench Use 4801124" wide trench. Since the property is sloped a 12" deep 24" wide swale should be constructed to keep the surface runoff away from the septic system area. d • WATER SUPPLY: Although the New York City Delaware Aqueduct runs under the subject property it is not likely that the City would allow an individual tap. Since the property contains 3.4 acres of land and all of the surrounding properties are vacant, it is most likely that a water well could be successfully constructed. rU V.1•I'✓ h( "I !tt � HEAD ?r.`.? ' 1' i T PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Feet Well Location Street Address: Town /Village: Tax Map # Ao -fe -3 •, Map /7 Block Lot(s� Well Owner: Name: Address: -rw P49 )41ks A3 A,(- Q, A_ Y*jkk 13 YVI /Z (5,434 Use of Well: esidential _Public Supply Air cond /heat pump _Ir igation Tank Type Volume �. 1- Primary Business Farm Test/monitoring —Other(specify) NY State # `� a`� Date of.Report Yiw 2- Secondary Industrial Institutional Standby NY State Drilling Equipment rotary _Cable percussion Compressed air percussion _Other(specify) Driller`(signa e) Z. Well Type Screened V Open end casing _ Open hole in bedrock Other PuRn� nstallei• Name &Address #lta4 ;Pump Installer (signature) Total Length ft. Materials: _Steel Plastic Other Joints: Welded Threaded Other Casing Details Length below gradeola ft. Seal: Cement grout Bentonite Other Diameter min. Weight per foot / lb/ft Drive shoe: Yes "o Liner: _Yes LZNO Diameter (in) Slot Size Length ft Dept to Screen (ft) Developed? Screen Details First _Yes No Hours Second Well Yield Test Bailed Pumped Compressed Air 17 Hours 7'If" Yield tom gpm Depth Date Well Log If more detailed information descriptions or sieve 'analyses are available, please attach. urface- static ( Depth From Surface ft. ft. Land Surface /0 in- 7.P)h k) During yield test (ft) 00 moo, Well Diameter Water Bearin a ao ' Formation Description JL•✓ cLa!r;�E A-.) If yield was tested Feet Gallons Per Minute Pum Storage Tank Informati at different depths Pump Type %D9440bViS Capacity during drilling list: Depth Model 94 Voltage HP Tank Type Volume �. Date Well Completed Well Driller PC Certificate # 0 1 �� NY State # `� a`� Date of.Report Yiw V Pump LnstallerRC Certificate # e .o NY State Well Biller Name �r Adtlress –r� F Driller`(signa e) Z. PuRn� nstallei• Name &Address #lta4 ;Pump Installer (signature) NOTE: Exact Location of well with distances to at least two permanent landnWrks to be provided�on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 D b t-I .X)-*>T. IVN4f4-L SoLlb fd,� SDP-35 D e_00 'A 1000 GAL ol V • ^i � �O Zy�� / / I 0 o �° �% ! j , _/ / N / DO V VL N IV JdT KI // f. 11 .. . I - .1. 1 ... 4 . - - - DIMENSION CHART. (in feet).. -Number 6 2 74 "10 3. 11 119 4 Ilo Ila 5 101 1,16 6 103 7 100 112 9 9 . 8 111 9 95 109 10 53 108 - 39. 50 4�3 51 13 415 53 14 53 56 15 58 59 16 64 66 17 74 14 118 145 151 1,+5 IGO 22 141 23 132 156 24 137 .155 OF YORK o /� .. z STS-08