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HomeMy WebLinkAbout2218DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.05 -1 -9 BOX 19 r 02218 of LI N. 02218 i 'AR1'Affirl' OF ®:ALTS � _ as Gemei. N Y IOSI? be Pbdvlde Pwttrlt 1 C841II+ICATB OF Q011lPIAAHiCB 68,D000SAL sYUM j • PV.. 6748 F 1 represent that 1 arn4holly.and completily,retponsittle for the design andlocatioq ofd the proposed ."em,(s) ' 1), that the repitrate'sew disposal s stem above dascriped will be eonitructed is snown'on the approved amendment there to and in accordance with the standards; rules a regu ns o County Depart~'i . of* Health, and that on completion thw*of:a "Certificate of Construction Compliancs" satisfactory to the Comrniasloner of Mwlthwill be submitted to tea O"artnent end a written guarantee will." furnii 4d the owner, his 'tuccaasois,'helrs or asigns.uy the builder, that said builder will place in .good opwatteg tgndltioh 'any pert of old fawage disposal system during the period of two (2) yens ImmedNNiy followinj.6we� c of the ksu- once of the approval: of thp.:,Cirti /kate of 'Construction Compliance iMl. system or any repeirs thereto; 2) that the drilled well d'esat0ed apow wHl M located as sAOwn'on tl» approved Play antl tl►at,sald well.willbe.l staltad in' a cor nee ;�th standards, ruNt in0 r.yu ons of tea PutMm County Department of Health. Date 8/29/97 Signed P.E. X R.A. Address 232 Main St.. nel sohmi 1.1 P N -v- 1n51 6 License No 43736 APPROVED FOR CONSTRUCTION6.Tnia approval eiaphas two years from the date issuaQ unless construction of the building has been undertaken and is nvotabN for cause or maybe ansiiWad or,modNied when considered nec"sa y y-lh rCo q Issione/ of Health. Any change or alteration of construction requires a no par Approved for disposal of donestk se sanitary wage ly only. R2V. Title 10/88 ---q DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 " --­APPLICATION TO'CONSTRUCT A WATER WELL PCHD PERMIT # PV -67 -86 %I+ LOCATION Street Address Town/Village/City.- Oakridge Drive Putnam Valley Tax Grid Number 41.5 -1 -9 WELL OWNER 19. He Jacobson bailing Address 94 Market St Poughkeepsie, NY 12601 gPrivate 0 Public USE OF WELL 1 - primary 2 - secondary R RESIDENTIAL 0 BUSINESS 00 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP ® ABANDONED O FARM O TEST /OBSERVATION 0 OTHER (specify D INSTITUTIONAL O STAND -BY fa AMOUNT OF USE YIELD SOUGHT over gpm /# PEOPLE SERVED _ /EST. ® REPLACE EXISTING SUPPLY O TEST/ OBSERVATION M NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL OF DAILY USAGE 400 Bffi1 ®:ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL 'TYPE DRILLED ® DRIVEN ®DUG ® GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF YELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Roaring Brook Lot No. 503 VATER WELL CONTRACTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO EMS OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY -_ .4..D,ISTANCE...TQ .PROP.ERTY.. FRQM.- NEAREST- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET Aj�.. (date) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant any and all water or waste products from such well property and in such a manner as not to degrade or Date of Issue: z 19 7 Date of Expiration shall take appropriate action to assure that drilling operations be contained on this otherwise contaminate surface or groundwater. Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller ■.. _.. < PUTNAM COUNTY DEPARTMENT. OF HEALTH — DIVISION OF ENVIRONMENTAL HEALTH SERVICES ........ ..Date- . August 19,.- 1997 Re • Property of Herbert-Jacobson- Located at. Oakridge Drive (T) Putnam Valley `•%q'.otion 41.4 Block 1 Lot 9 Subdivision of Roaring Brook Map. 5' Subdv. Lot # 503 Filed Map # Date Gentlemen: This letter is to authorize Frederick A. Zenz a duly licensed professional engineer X 'or register.ed.architect (,Indicate --„ to apply -for a Construction Permit for a separate sewage..system,.to serve the above noted property in accordance with the standards; rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign'all necessary papers on my.behalf in connection with this matter and to supervise the construction of said ,�. system or systems. in...aonformity .with >the.. provisions . of Article: 145.. or 147, Education Law, the Public Health Law,.and the.Putnam County:Sani- tary Code. Very truly kours, Signed Countersi d: Owner f .Prope ty gne i 94 Market Str P.E. , R.A. , # 42736 Address 212 Main Street Address Nelsonville, NY 10516 2G 5 -�n32 Telephone Poughkeepsie, NY 12601 Town (914) 454 -1171 .Telephone Raw W'od +t ..6 NAR115/sU11114I_ (a Ow"/ Mum ,,, `�`+ ►� a t k W"bW ad seporate Seca qp Sysim oa anew Ge 10 To bo oomded by ' b Tax —J S er- 7.1R? �e�v�ero To O `" nr`�nRPA IM Area_ • Cr P® Secdom 0* DeW p How G P D 6 `� PCHD NeM .G?Bl q Sell& TPallf 1I12llg2. lmnnn t Depths Vahme Wgmbmd When FM In empleted 0. Q. ''W a- Wldar $yt rdac Stt* Pie® Ali 031 ✓ Sato y maw by � �,¢. i '4w"A 1 represent that I am wholly and completely responsible for the design and location of tho proposed systom(s)s 1) that the separate saw di ss1 s stem above described will be constructed at shown on the, approved amendment there to and in accordance with tho standards, rules a regulations o ne County Dopartmmt of Health, and that on completion thereof a "Certifkate of Construction Complianca" satisfactory to the Commissioner of Healthwlll be submitted to the Department, and a written guarantee will be furnished thg ow er, his succesaws, heirs or assigns by the builds, that Yid builder will place In good operating condition any part of said sewage disposal syste during t o parked of 1.. (2) yeas Immediately following the date of the Neu- ance of the approval of the Certkfkato of Construction Compliance of t e originals stem any rogal tl�oroto; 2) that the drilled well described above WIN be bcatod as sl — n on the approved plan and that said well will be Instal d G] Ith t Ia ids, rubs and roguUTUns oof the Putnam County Daps RMRQ oP Health. Dato K• t-0 I9 j Stanod. P.E. _ R.A. —. Addroas 292 MA.& /3 ,k ", illy /iJ_y_ /v-SY LkonY No '"373,( , saPPltONl:O FOR CON3Y011JCYION, This approval ottpMe6 two v s Pro the data isau moss construction of the building Ms been underWhom and Is revocable for cause or m y be omondod or modified whop consldor 4mry Dy the o iafionor of hlaanA. Any change o alteration of f;OMtrtictbn v• PcOuiroo o soar p6vmit. �Dprare8 for disposal of domostk Ynit ewes¢, or►d /or star. supply only. fR� Dato / 1 my to —---------- ------- 1, - - - - - - - - - - - - - ---- /* au 1 AL A JL m 41.04 At. CAL.j FE LAKE PARK < 25 1.01 IF EX CIL 26 AL 7- 251, 4 y. 35 3 1.0 It CAL IMSERIED AREA so I," AC CAL DESERVED AREA 32 3 32 34 ROi10 �el roan Ian AMata ■ as 1rl4aln �el roan Ian AMata I lT 41 4 .2 41 �L 38 39 J, 21 -0 Bmr jAar la 4 1 30.17 32.19 PRELIM MARY p TOWN OF PUTNAM VALLEY s PUTNAM CCUKY. NEW YORK V I Z1111A 41.06 41.09 4 1.10 19 I I" I A q COUNTY DEPARTMENT HEALTH 1 DWISIIInN OF I:' E'Ii:M.N7A1. HEALTH I'; I;, CERTIFICATE OF CONSTRUCTION COMP L IANC TREATMENT SYSTEM PCIEl1IID CONSTRUCTION PERMIT# P-61 -� Located at 31 0Ah 9v0F_ rmwg_ Town or Tillage PV'WR•M V4LW -4 Owner /Applicant Name ScA CaAv-,A Tax. Map 41 -5 Formerly Subdivision Flame 9oAf1%W ('- R Rvv k Subd. Lot # so3 Fm 3 a� Mailing Address Yo NAV pu. , Pd, I OSY) Zip nSyJ Date Construction Permit Issued by PCHD Iv 11 bs Sepsirste Sewerage &steam built by 14 e k Lpr C b �21TI1.,xmto w Address 2-V t 13L&o,,3 Jku v w R.A_ MiY Pf}C�a9,�_ Consisting of Gallon Septic Tank and 310 ?y � u-4k als- t„ Other Requirements: 2 }0 C_,- R -�o _i3 av . Water San®®gd: Public Supply From Address ®�a Private Supply Drilled by 1o11) Aturte, tkid 6- Address P4 S , CAr.'t a 0- Building Type Has erosion control been completed? Number of Bedrooms 3 Has garbage grinder been installed? Po 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 regulation a Putnam County Department of Health. �J Date: ' ,S q Certified by P.E. ---' R.A. Address 2qi M,-�'�A, , 1- sO*,: qk 1 oS ( License # '3731 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: 6 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design rofessional Form CC -97 , PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location _ Street Address: TownNillage; IICt�°l Tax Grid # -- Map:. Block ::,..,....,Lot(s) .3 I Well Owner: Name: Address: S y 1e� 40 ' -�Jl & e o OS Use of Well: 1- primary 2- secondary [ Residential Public Supply Air cond/heat pump Irrig tion 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 eft. Length below grade 30 ft. Diameter in. Weight per foot lb /ft. Materials: _L Steel —Plastic _ Other Joints: _ Welded _� Threaded _ Other Seal: _( Cement grout _ Bentonite _ Other Drive'shoe: _K Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First So 560 _ Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield S gpm Depth Data Measure m land surface-static (specify ft) l� IY $ Dunn yield- test(ft) /, .� [�JhawoGJw S Depth of completed well in feet �jC)S Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land surface 91,0 $' o G- h- ?' If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type S Capacityi at., Depth Sod ` Model'70SIOC- Oulc(s Voltage Al-%O HP [ Tank Type Volume ! Date Well Completed Putnam County Certification No. 003 Date of Report 3' !�7 7q Well Driller (s'gnature) NOTE: Exact location of well with distances to at least two permanent landmarks to be provid n a separate sheevplan. 2S-3n[Q�o p Well Driller's Name -r-2 Q w(� . 1-�tc Address: S- I� a� 5;?- Wj Signature: Date: - I '/ 105 White copy: - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Ii FF��� SAN GUARANTEE ®F SUBS URFACE SEWAGE TREATMENT EATMENT S Il SIT. EM br Owner or Purchaser of Building Tax Map Block Lot VX" P Va&�u_q Building Constructed by TownNillage Location - Streeter_ Subdivision ame i f0A� Lb4 hl"A � Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system...__. . The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of h J ilding utilizing the system. Dated: Month 1' _ Day l Year Signatur . T, . i Title: General Contractor (Owner) - Signature Corporation Name if corporation) H' KLA1 �YRUtTION 6N ` �. Address: t �nll Sep' ice Excavati ®n •Site Work o Trucking " Septic Systems Spec la Sewer Hook -Up Y ®p Soil_6 dill. Gravel Shcktop Demolition. p P State zip 246 Buckshollow Road -`�, Maho` ac, New York 10541 d. (9fl062 5738 (9114)x:628- 5066'.: Snow PI win E NORTHEAST LABORATORY OF DANBURY CT Cert: PH -0404 39 MILL PLAIN ROAD - DANBURY, CT 06811 NY Cert: 11471 - ..,.., l�Q). .7.4R:7,993:r.FAI.l03).748,0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: BOYD ARTESIAN WELL COMPANY Rt. 52 CARMEL, N.Y. 10512 SAMPLE-SITE:- SAMPLING POINT: SOURCE: TREATMENT: TEST PERFORMED BACTERIAL:4 /8/99 Total Coliform (Bacteria) PHYSICALS: Color Odor pH Turbidity DATE SAMPLE COLLECTED: 3/23/99 & 4/8/99 TIME COLLECTED: 2:00 P.M. & 10:30 A.M. COLLECTED BY: H. BOYD & S. BOYD DATE RECEIVED @ LAB: 3/23/99 & 4/8/99 TESTED BY: LAB #11471 & 11301 REPORT DATE: 4/13/99 CARLSEN, OAK RIDGE, PUTNAM VALLEY, N.Y. TANK IN BASEMENT WELL. NONE RESULT: MAXUVIUM CONTAMINANT LEVEL 0 per 100 ml 0 per 100 ml 0 2- ORGANIC 7.52 1.4 NTUs CHEMISTRY: no designated limits Nitrite N <0.005 11301 - Nitrate N 0.30 Alkalinity 56.0 Hardness 122.0 __...... ,Iron- .. W0.263 -- Manganese 0.013 ml = milliliter * *Notification Level Sodium 8.2 Lead 0.002 mg/L = milligrams per Liter ** *Action Level no designated limit 5 NTUs mg[L as N 1 mg/L as N mg/L as N 10 mg/L as N mg/L no designated limits mg/L no designated limits zng/L - - -- 030 -mg/L mg/L .0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] mg/L 20 mg/L ** mg/L 0.015 * ** ND = none detected NTU =Units RESULTS BASED ON SAMPLES SUBMITTED:3 /23/99 & 4/8/99 SAMPLE, AS TESTED�ABOVE: � or FE POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) i Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 9 OUTSIDE CT: 800 - 654 -1230 RL . 1 ; �1s l b CT b oTD @nn n 91 ere 1 ,0 4cv ISO DAR Wi4LL COMPANY' ®R9PA DATE SAMPLE COLLECTED: 3/23199 LJ� I COLLECTFP: 2;;00 P.M. i CAR.kEirl 10512 i COLLECTED Y: H. la ®XD I t DATE RECEIVED @ LAB: 3% 3/99 j I T=IID BT:I A13911471 9 11301 !� REPORT DAVIE:3n9/99 SAMPL A 51A AK RMG ]E, P UT14AM AV E3£: K.Y. e I T' AP M W DKWII N T MU 1 i tC® ANT- LEVEL ! ,l ; (lraiia)I TTY S ' I per 100 Ml 0 por 100 ail li )i 1Nl?GA NEGATIVE ' j Colori 0: j I a i Odorl I -OR ANC i 1 pH! 7.52` 1 I no desi cd liatl4 j Tirbidity l : 1.4 NTLIs 5 NTIJs N1 a ite N ( <0.0()o , mg/L as N 1 mg/L, as N N. 0:301 mg/L, as N 10 m0/L. as A"iniity 36.0: mglL no desipmed.limits 122.0 j mg/L no deesipatad )imi4s ion j 0:2i�3.. ; L....; . 0,0`13. 0.30 mg/L . _ _..mom. ... _. _ :0.30 I mA [Note: Combined Unit for Xrod plus Muganese = 0.50 are,] 1 1 . 8.2 1 ! b • 1 A AwA MA rr F i Q4/14/99 04:54 FAX �1U1 r P.I i . .•�. .. _ .n c .. -..._ .. .� .. •ra • - . t a. .--•�. _ .Y, , -, -. •... ...y..C. .�.. .5. ..,zr ._.. - n..,v :-+_ t .C' AIRFIELD Til- l NG. L BORTORY AN INDSPENDINT ACCRECIPTED NVLAP INSPEC -TION AND ENGINE -KRINO LABORATORY MATERIALS TFSTINU. AMALYSIS. CONSIr[.TIN0, RESEARCH, SUDS0IL 1NVCSTICIATION •652 GUNIiROOK IkOAD -- STAMrORD, CONNI C-rIc o -r oO906 (203) 323 -3148 FAX (203) 323 -3140 CLtrNT : _ , ., nA't 4 —2 -119 V PROJECT: 8 LAP. 11) No. 14 13 A#11 9 C -1. TILE TOLI.INO TEST REQUEST(S) WERE PFRFIJr l-D'AS DIRLCIED: SEMIC MATERIAL ASTM C . 116 / SIRVR ANAI..VSIIS �� A17 M 0 - 422 / PAR I ICAL g1717 ANAI,YMS ASTM ASTM U • 4119 / 1.1., M., PI AS"1 D - 1337 / MOD11•IEf) PH()C1'()R ASTM D - 50114 / MIRMEADILITY (11 C) 0M if! R: MATFRIALSOURCE: MAT !►r�'� �UBsS• pU�ST�.0 -SPIT I. TYPE; ('RAVEL MATERIAL SP190"CATION r1 A.M1I1R1 I1F,NS11'Y: PCF 011'IMVM MOISTI1R1:1 'K State of Conn. D),r l Ammmenda .i A' .l 1. 1' tt ! S /t F. '.T t/ .1, T S `• :_.. - :�'seplf'c s�1n�,Iro� - - • .. . - ......,. .. ,,. , . �.,: - ����- - •, • .� f , . • ... f -(RANGE) SIEVE .$IZC _M.Q_NT PAS? IIx1n% s' 100.01 100.OZ 150.0 25 -60'Yo ' /." 77.22 74.02 78-51 15.45% 110 55.51 52. Ix 49.11 S -23 g: 940 20.61• 21.81 20.41+ 0.11195 91110 6.'7x 5.5= 3.51: 0 -s a /r 12M 4.0% 3.3x 2.22 9AMPLB wAS CO�.LFCrFn nNU r)1- I.n'r:rtr=n'rl) Irrr: r.nnc Inn 1(In} c►tJ 4 -1 -98 —_- - nY; Tql C 1ZWT %1t>' {!n1+�u at►dudid will�inll tt ► Ilalr FPA w►rd'w A¢ 1 A) dmid.wl, MmA uxdhwh •• d•Inilhl ai 1h• d +is i -lilu T•rm� �.e. ptifrenxd d ana a enerodlle 1611ortb� 10; Fehildd TeA4I shrigwy - NV I AP cr-k ir ion %l i; i Mh l rh ('1' Ilr c r'11 c111I: III gmill l .h MV1 -'%P c•,+ 0 111114v 1'.r�fu;• 11,11%, S111)IIIi1U41 r, FRirlield Teslillg laboratory, .x PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTIt SERVICES FINAL SITE INSPECTION Town TM r — —1 1. Sewage Svc tem Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Loth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc.., greater than 15' from STS area.......... e. 100' from water course/ wetlands ...... ..................... ........... II. Sewage System a. Septic tank si e - 1,000 ....... 1, 250 ......... other ................ b. Septic tank ins e1 ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribtuion Box 1. All out ets at same elevation - grater tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box - properly set . .. ................ ............................... �Zength required installed 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............. ................... 1/16 - 1/32" /foot ............. 5. 0 ft. from property line - Of foundations.......... 6. es from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 -1' /z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10., Pipe ends capped .................... .. .........................:.:::. Date: 3 77 Inspected by: 0111",- wner n'2 i� 51;q Permit # Subdivision Lot # - $ 5,p� —E. g. Pump or Dosed Systems 1. Size ot 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 ....................... .. .............................. `J IV. Well a. "Well located as per approved plans . ............................... b. Distance from STS area measured ft ........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev. 1197 S . e _ c�✓t/t�- IoutO; 7�� �i2. y IL C 1�s/,i C> F` iEn4c t-(� tom` C5( (Cog> Kf n c 1 t2 5 'r� �•: .� IZ !�%'��____�I...�. 1 121iNCG H -- °-- 1 MKT /.��OL! C�_-•- __._� ---- � � - -� Gt�� ._._... PUTNAM COUNTY DEPARTMENT GIF HEALTH DIVISION OF ENWRONMENTAL HEALTH S' W, PERMIT # g%) 61- U Located at Subdivision name Rt! Vnl, �91 5 Subd. Date Subdivision Approved 192A'I<`MlENT S Y9T M _ Town or Village V.), '� �tk►'.c� # 5Q3 Tax Map it 1 ..15 Block . 1 Lot q Renewal Revision Poe c �p Owner /Applicant Name D%iLuv - C&A,,e n Date of Previous Approval /01? hil Mailing Address 40 F 9- 0- kw�,. n0�t - Zip I n SLt 1 Amount of Fee Enclosed 4 1 SO Building Type Lot Area ,614 No. of Bedrooms 3 Design Flow GPD 6" Fill Section Only Depth Volume PCH D NOTIFICATION IS REQUIRED WHEN (FILL IS COMPLETED Separate grage System to consist of `ow gallon septic tank and �- b� Zy W. -tu 0&s Other Regtirements: 2bo c To be consvucted by 16 1� Address Water Su 1 : Public Supply From Address vateSupply Drilled by Address.- .....;..... I represent tat I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sevae treatment system described above will be constructed as shown on the approved amendment thereto and in accordance rith the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a " (ertificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Departmeritand a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said i, builder wiIIjace in good operating condition any part of said sewage treatment system during the period of two (2) years immediateliFollowing the date of the issuance of the approval of the Certificate of Construction Compliance of the original j system or ay repairs thereto. Signed: P.E. �� R.A. Date �� $ Address -Al- KV-G A,% N4 1 Q�Sxt —License #. 93734 APPIRm%rD FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage tr -4rent system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified -Wn considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires 'a new p Approve or discharge of domestic sanitary sew ge only. 3y: Title: Date: Vhite cow% HD Fi e; Y llo opy - Building Inspector; Pink cop Owner, ange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .APPLICATION TO CONSTRUCT A WATER WELL t' � . = :eleuse Drint or tvm PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # (1/} tNo6f QR - I rMrniA VAUFY Map µj- 5 Block 1 Lot(s) `1 Well Owner: Name: Address: p' Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought A,xk S gpm # People Served Est. of Daily Usage *0 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling ,,-�ew 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 �t �Qvt Lot No. �3 Water Well Contractor: bz Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: N 10- Town/Village Distance to property from nearest water main: N' Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: $ �, � A pp licant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article, 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the'well has been completed and inspected by4he PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. �► Date of Issue T 1q'V Date of Expiration Permit is Non- Transferra le Permit Title: White copy - HD file; Yellow copy Building Inspector; Pink copy - 6 Orange copy - Well driller Form WP -97 f PIJTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR P - 46 _.. _ . A .... _,.�.. W�4STEWATLIt �'RF��T1VdE dT SYSTEM.. 1. Name and address of applicant:�,�„� 4e FQe_ 2. Name of project: S ���;� y �, 3. Location TN: V 4. Design Professional: 5. Address: 2A-L 6. Drainage Basin: 7. Type of Project: -"'-Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one)...................................................... Type I Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... 6) 10. Has DEIS been co. m p leted and found acceptable by Lead Agency? ............... N' 11. Name of Lead Agency 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? � ........ ............................... 14., Has preliminary approval been granted by such authorities? Date granted: 6- C4 15. Type of Sewage Treatment System Discharge................. surface water 'groundwater 16. If surface water discharge, what is the stream class designation? .................... N 17. Waters index number (surface) .......................................... ............................... P)1-:' 18. Is project located near .a public water supply system? ....... ............................... No 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? .............. �o 21. Name of sewage system I Distance to sewage system 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ..........................:...... ............................... CIO U 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... V�0 26. Has SPDES Application been submitted to local DEC office? ......................... N Form PC -97 9 2 27. Is any portion of this project located within a designated Town or State wetland? r--00 J 28. Wetlands ID Number .........:................................................. ............................... 29-- Js Wetlands�:P.ermit. required? ............................ :......... .......:::....::...........:.., ..r 0 Has application been made to Town or Local DEC; office? ............................... (�D 30. Does project require a DEC Stream Disturbance Permit? .. ............................... No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................. Yes/No �U 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/No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .................. ... 5 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? . ............................... �o 36. Tax Map ID Number ............................. ............................ Map `t1 S Block i Lot 37. Approved plans. are to be returned to ..... Applicant 'Design Professional NOTE: All applications "for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the: Department; and need not-be sent in duplicate to, the 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 other aspects of a project, such as stormwater,plans or the creation of w 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. j 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, under penalty of perjury, that information provided on this form is true to the best of nay knowledge and belief. False statements wade herein are punishable as a Class A misdemeanor pursuant to Section 2 of the Penal Law.. SIGNAT'IURES & OFFICL4L TITTLES. Mailing Address: -ZI7- .................... �_.1t4i._i....._ j PROJECT I,D. NUM13tR 617.21 SEQR i • r ' Appendix C . State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PA�R�'.;I:. PRQJ�EOT ^lhIfORMATION"(Ta be complotedby"AopllCA orTProJecl sponso ) 1. APPLICANT /SPONSOR C'.cAga� 2. PROJECT NAME br -- /N ` c"A""" 3. PROJECT LOCATION: Municipality Pte. U County 4. PRECISE LOCATION (Street address and road intorsoctlons, prominent landmarks, etc., or provide map) S. IS PROPOS D ACTION: I� Ghlrow 0 Expenslon ❑ ModiflCallon/ailoralion 6. DESCRIBE PROJECT BRIEFLY: W � i 5 �*�- , •r � ��t �� rte,: � GMc•�_ 7. AMOUNT OF LAND AFFECTED: , Initially 0_614 acres Ultimately [9 1 y acres 8. WILL PR POSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes 0 No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Realdontlal ❑ Industrial 0 Commercial 0 Aodcullure 1:1 Park/Forest /Open space 0 Other Describe: 10. DOES ACTION INVOLVE A PEnmIT APPnOVAL, OR FUNDING, NOW OFl ULTIMATEL.Y.FnOM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL.- - -- -,...� __......_. ....... ._.._ SrtAft OR .. CAL)? Yos C No II yes. list aooncy(s) and pormitlapprovals it. DOES ANY ASPECT OF THE ACT. "►t HAVE A CURRENTLY VALID PERMIT on APPROVAL? es 0 N" 11 yus, !Isl ar ency name and pormiUapproval 12. AS A.AESULT OF PROPOSED ACTION• WILL EXISTING PERMIT /APPROVAL nEOUIRE MODIFICATION? 91yos ONO I•CEnTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appllcantlsponsor name: _, Z<:�2 16r uLt'iC,. IceS�r Date: Slonaturo: 1� It the action 'is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Forth before procooding with this assessment OVER 1 ;s K PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN G NYCRR, PART 617.12? It yes, coordinate the review process and use Iho FULL EAF. ❑ Yes . ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN G NYCRR, PART 617,67 If No, 6 negative declaration may be superseded by another,involyoA - riYes l.J No _ ....,...�..... . C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, it legible) C1. Existing air quality, surface or groundwater quality or quantity, nolso levels, existing traffic patterns; solid waste production or disposal, potential for erosion, drainago or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural rosourcos; or community or neighborhood character? Explain briefly: CJ. Vegetation or fauna, lists, shellfish or wlldlllo spocfos, signllicanl habitats, or threatened or ondangorod species? Explain briefly: C4. A communlly's existing plans or goats as officially adopted, or a change In use or Intensity of use of land or other natural rosourcos? Explain briefly. C5. Growth, subsequent development, or related activities likely to be Induced by tho proposod action? Explain briefly. :.i CG, Long,lorm, short form, cumulative, or other ollocls not Idonllllod In C1•C5? Explain brlolly. ; C7, Other impacts (Including changes In use of oilher quantity or typo of energy)? Explain briolly, D:-IS THERE, OR IS THERE LIKELY TO DE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?.........._. ❑ Yes ❑ No II Yes, explain briefly PART 111 — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Idonllllod above, determine whether It Is substantial, large, important of othorwiso significant. Each effect should be assessed In connection with Its (a) sotting (I.o. urban or rural), (b) probability of occurHng; (c) duration; (d) irreversibility; (e) geographic.scopo; and (1) magnitude. It necossary, add attachments or reference supporting materials. Ensure dial explanations contain sufficient detail to show that all relevant adverse Impacts have boon Identified and adequately addrossed. ❑ Chock this box if you have identified one or more potentially largo 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 Imps is AND provide on attachments as necessary, the roasons supporting this determination: Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Name of Lead Agency ,. Date 2 Title of Responsible Officer Signature of Piepatef (if different from responsible of icer) ,FUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ......v.. - .,.._... >.. _�._. -LE TER OF AUT- HOR*ZATION,:.. _ ...,..�. ..- _. . RE: Property of 4_�f CT`s 4 O) (�t-NIE <fP R. L's FiJ Located at C17 t-e T/V PtA -rpAm VAtt6r Tax Map # I s' Block / Lot Subdivision of IFT►i M A p 6r' f 2o%1(2) N�_ R Ro 0 p L, 1« Subdivision Lot # X03 Filed Map # Date Filed 7 I Gentlemen: This letter is to authorize F., 4 - Zf h'Z k a duly licensed Professional Engineer /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 with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law and the Putnam County Sanitary Code Countersigned: P.E., E-k., # r13 736 Very truly yours, Signed: (Owner of Property) Mailing Address Mailing Address: Rellijelue /Jeff �{ a�oDa� _ ''YI l/L lb5y! State P1 Zip (05-1 1 State Zip Telephone: ZK -103-L Telephone: Form LA -97 Fred A. Zenz, P.E. 292 Main Street Nelsonville NY 10516 Dear Mr. Zenz: r. mp rn DEPARTMENT OF BEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York .10509 Tel. (914) 278-6130 F " (914) 2z,,78 - 79 1 eptember 1 �, 1998 Re: Carlsen Residence, Septic TM# 41.5 -1 -9 (T) Putnam Valley BRUCE R. FOLEY Public Health Director. This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your consideration. Plan: lease show minimum 10' from driveway and property line to area of SSTS. As a reminder restrictive distance starts at toe -of -slope in a fill section. Please verify slope in area of proposed system. Maximum allowable slope in area.:q .sy,*m is 15 %. Pease label length of trench on plan. - Please label 100% expansion area. lease provide quantity of required amount of fill. Please call out (label) silt fence. . Plan to show proposed grades. Profile: 1. Profile to i ude: xisting and proposed grades. Representation of 100% expansion. et Please specify size and dimensions of septic tank. (i.e. 1000 gallon tank) Please edit absorption trench to read minimum 4' to water. Letter to: Fred Zenz - September 17, 1998 -2- ..n... - ..-•..al... -.r:: .- .u......e. Z,,�Wnction box detail to have note stating trench starts 2 feet from box, 2' separation to be solid pipe. Fill section detail required. otes, Notes to be pursuant to Putnam County Health Department Polices and Procedures Bulletin ST -19, App. C. . Fill notes are also required, elimination of note #1 (fill) when less than 2 feet of fill is proposed is acceptable. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, ���,,, �• Adam B. Stiebeling ASB:tn Assistant Public Health Engineer 11TU iT'1 =� 2 FBI y March 2 , 1998. r... .w. ., .,.�.. ._ .... < ... 'a 7 TIME 9:52:49 AM r cr . ..... .......... TO Adam Stiebiing COMPANY Putnam County Health Dept. ' I'll•1r -C.IT 1770 1G•`•J O1LL l'..M�ILL. .�CnLt �J v._w �� .vim -- • t O {��{ ,..r,. -- .-� .... , .. ,.. e.... -v :..,... ,: -: - � n...- :.- ....0 ... .R���'�{�4. , .rs.. s� �_i ..r _ . ........�.w.•'<a�::a ., n r.. - t,.::i.• �i�::�:.,1 .. ••e1r, ~••� No.r sl�l stir. • rf » 1 AREA: .614 acres I R!: rumic I-a6a Ina) for ~~ '304 • pie ' 1" •rr tlr wy GA220 wr _ - • Iw..lr. nr .. r.•.w u.rl, r1r • .� 3,j --, 'w o �n•�y s•N .Kf rc+er 4.1 wf w �� •r. r. i yr f C�� .pY/` all oV% � K4� ei flcOltA � /aleA surrteea r�� . er�tnco .tit1t 400 09 Mg NIP 5C >IAEIOER .ps 1 H..•1 Iv., u:e. PERCOt,ATOM TEST' troOiCuN sett �.'• Itinla . REQUIREMENTS: 1000 aelien tw k 'Gal otsieN f�ow: 333 �,r %, •tar ee+a alum tnoen boo •�, o+ttlao; '- -bml;en twtn dour APFUCATI(N RAIL: COO 1•o t.j. R.O.B. Iim ua "-I .Mtn � .;. vral.n r�. 2 I .r� c., ;,I,pr..tort sit 3v 9663/so/so MIGI 151M AR @Gel :a1qI&FxAd@3 Im MU=Z= aaeu ------------------------------------------------------------------------------ :mf opec-M& (9?IGD Mm Well SDMY! %tgoft 30,?T IELO-960 qmw amm mumm 1E Immmm 39AM: wuzo zQ7R ------------------------------ ------ km v m ova: ouww ",rv" vFU 0 44 .1 0 -------------------------- ------------------------------------ e ------- -% -- -- :oae ------- -% -- -- G ------------------ -------------- IL, U19" pQpaqq8Tft . SRowmoemom :Fmn Wang as zog --------------------------------- ----------------------------------- my3mmid WIM0 , agm . a tkol QW01 "FT�NT 7T-7 gam 'Nom is wj Ma M918 THIM `TVnMW mmw:TOCIPS MIS ----------- ------ ft ------------------------ :IZTTS 4cpz UTM u:eftm@ 000,9e :;9b@ pwn. ZOE gm : andbo o(V : DQ2" %Cz GeV. _*Zuolad ---------------------------------- vpq 9 :dam 02"PTze ------------ ------------------------- NS W@ :01 vew'VAM 62A LLMJ to-d CAS _j Id: 14b '+uxcl rtc�,� CVJ —/43 -1041 P-04 DEPART41 T OF SEILTH j • Division of Uviromental Health Serview 4 Geneva Road, Brouster, tUN York ICS09 * (916) 278 -6130 "FLICATXGN TO CCOSTRt1C1' A WITBR Nat - - PCBD P$BMIT ! Pv -6T-6b ry NEi.L 1,OCAlIow - -Street reas ", ;.Tow Gic�, _ . Tae_ s- Oftifte Win putmw rilloy° 41:3 1-9 1Q1.L OMlBR 8. 00-obm 9i•••ASat at • - 10, wi 12601 wrsbhew Or WILL 81 PMT 1 8 �sll�url4l. p Oil C �Y 0 � i�1�1��'�� 11 O= capoaifY mLICATi m TO CON! TR CT A WATER WELL Wnem e,ear *-w a Ow -67-M 16f7.L LOC11TiON raet ess OW=fts Ot'tve o" Yil age ty Tas - - - -- - s fttaw VaI dl.s -1-0 V= O"Ut e. aboaboOn 9Ai1911ckat St 12 ie, AY 12601 Oiuelseo m or MM10 1 - Frumy 2- astoodary 9usim1f m o iuslass O INDDSTRIAL amatit smut O ?Ali[ U IASTITIFTiO�IA L QAIE/Ctwl1 Ater Pow tim mom 0 TUT /0262SvATIOt OOlm (steatfy 9TA04T Q MOM Or DSE ' Tim smalima i-gpdi MUM SRR ab ty /UT. " MILT DEAL'E *a�sl 'i6PI11CL` awriIC SDPlLY ?E$i/O sE"ATtcw 11ADwI?IOiIAL SUPPLY 2116 MIM R hits Rm" FOR MW IM name TM MDR1110 '. E]nalvtK [3m OGUV t Is wm SIT$ smu= to lLOOpm? YLS "A 10 _ 11 M IE xQww Wit EM "WHISIOw. of s6SDIVIS . . � _ Lot so._ YA1 V� VRL C00lDACl'.dE: Aaps��itid -- �._lY1d=saa: IE 11I8LiC Vm SUMT AQ rum 'ro Strl: Tis X so �Ad or MLIC unu mny: rr N/A F TOUT /YIL/CITY OISTA= TO Pip M= nN MANST WAT21 MAIN. W,% LOrATION 0=0 d SOUMS OF ICWCOUNATIaU PRMDLV /T _ .._. .... �� SEPAIATt SUET trey slggature Paull To CONSTRUC7 A VATel ML We pareit to construct oat water well as sec forth above is granted under the provtafoa■ of Su% wt 5-2 of pert S of the few York State Sanitary Code. and provided that within chitty (10) 6472 of th0 costpletios of water well eowstruetion, the applieant, shall: 1. Peep tba van until the Water is clear. 2. Disinfect the veld in aeeordaaes vith the resuireaonts'of the Putnam Conoey nealth Uepateasnt attached to tble Persia. 3. subait a %tell Completion Report on a tote provided by the Purnae•.County trealth Dep&'ctwent. Dyeing all well drilling opatattoas. the appltcant shall take appro94atn action to assure that any sad all water or va9ts producta fry suit- well drilling opera! ea■ be concatnod on VMS Party and in such 6 "Mee as Dot, ko degrade or otherwise tea twinatc� surface or groundwater. Date of Issue: Data of [xpitatiaa _ l_ _447 pssmi� to ng OEM ial Pareic Is Son- Transforrabla White copy: me File Pink Copy: Owner 3189 yellow espy: Slds. Insp. orange copy: wall arillor U&O..L 10. Ub MCHL I t D vaoti 11 r i \ LARD. rAmh LINE Me S �._., o 30.17 ` PREL I M I NARY ••,'�' 23 Shp SCA 0 41.06 '� DEVELOPER! LOT MBA J DEED D Di "'°" 'D"D' SGLED DIYO"IOR IDOI SI TOWN OF PUTNAM VALLEY ai \ 41.09 41.10 - s S PUTNAM COUNTY, NEW PORK DATE OF AERIAL PNOI Pam MAW NT $ 140 IF Av p N r� 25. \ , 8 , g I ► ` \ . Ja \ 1.01 ACS' CAL 26 AL ` 6 .4 e A- / 27 ,y 1 1.98 AC. CAL. RESERVED AREA ti Q 35 41 j N 950 LEGEND ' LINE Me S �._., 30.17 30.18 PREL I M I NARY ••,'�' SCA 41.06 '� DEVELOPER! LOT MBA J DEED D Di "'°" 'D"D' SGLED DIYO"IOR IDOI SI TOWN OF PUTNAM VALLEY 41.09 41.10 F ' � �•• t t °. :' : '__ Dkwuhe z>, 9IStIAL CEIITROID S PUTNAM COUNTY, NEW PORK DATE OF AERIAL PNOI Pam MAW NT $ 7- T ,PWIXAMCK Ar;iii 6rY DEFAMINMU 00 BLUM "' 'i - i0l," also, ir 1=�?ZRAIF PDI� WWAM DISPOW SIMIM; 7 VU0. 3 x 17 OMM/AppNOW Rollie Date . , 7 Z10. A Fee' Rii c 1 nk P d 0 W Am FM Section s * awwwa.. . - `�� Dap*_vdbi,9 p Ntfaratr 41 nedmwmL.�- NWVM-G P D, 000 CHDN*d&ndoimbRGQWM4WbwFMhgp 0 -53 A- -3 8IML_ SWOU "Womp sydm to 10 Ad *SSW S60*: F� " on o C� NZ-0.,45- V d w it j jjh'an� ti "c9m"taly Fesponsib- !.-or 14.4,ios I L I. of "the propissd, iyst•miU, nl'ila,t:,& o je►st• few sp above tfascriboo will be Constructed as "n on the approved afflendmiint th i to' and in accordance with the standards. VU1011 and regulalionsof "t a --tekif to ind�that On Completion thereof a of coAsirticti-im corr%'�IiincW' satisfactory to IM Commissioner of Healthwill ;puntY Dolis", Of tioa!tti it be submitted to. tho'Deportmen. turni ff, his successors. hairs Or is�s by the bulljor, that' Yid bulkier will and 8:wr ittan* 9, wi,rant", wp, shed "AMM 't in good -40wat c6ikiltion, port.,pf "id,liwalli dislioiffil'sySto' ur!F10:,l • *10d Of'tIwO (2) years Imimnedistely'followins tliedato fit the lnu- of" any r"M du4 "C saw of •tlii, iil�ii Of,,,., An'tim= of construction Comoisnii, of t 4: O!iehmll� stem" of 2) that the drilled well "so ANN WIN 'b• 4j4aqmdntKo jl�o" pi . ap and t I hat said ,w*11 will be lnstsll� ncsit h t a s. rules and requSTOns of 4�?U, , ­ jjj@ hZ" I , . — .. ­­.. .1 I , , . I . . . I . .I. . 1. ply Dope .0( it . �: , !, . .- . , . I . 61.;" P.E.— RA. Signed Date ' AT 1 n516 —License No 937 3,1 Address , k . I I . I been undertaken and is APPROVED FOR CONSTRUCTION: This 860OVSi a#Pires two y 6 fro the do t• -ijiu construction of the,:buildingbas on as alth. Anj'ihinge or alteration of construction revocable f or modified when r 0 -the" Issio .61,044 Or cam" or be a to Y SIONW n u as a bv"'f6r dispoial Of 46MO ater supoily, onp Rev. Title it 10/88 gate MI ,A I a Badfil Sm . CGEML R.U. now w OE o WA wa= P�:�� t3 s ��i- G'7� r�t�tbi,�ic. ��. 67_5gS' ,patc Subdivision Abnroved Fee Enclosed ® Amrn,nr Pmbm C2 3960=3 `� Ma G 7 D Gat? t Is Mmedra wbamPm m mmpkftd alp FsaI--PA>aot w by � � t � ►en lt� Ada 0 reprosont that I, am wholly and Cofflibtoly reSpanaiblo for tho design and location, of the p►opOWd ayatOm(a); 1) thot tho separate I�ewage _ditpotal ayatam DboW d= Wad will be conatrUCtsd as Snoarn on tho.approved amendment there to and in accordenco t7ith the Standard% rules a r�u na o n m (County ®Opsrtneant Of 00¢abh. and that on e000plotbw,thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Has thmlll lie cWpmated to tho ®apartmom. OIW a written puarawteO will tie furnished th6 ownw. his sueeoas we. hobs or assigns by the bulklm. that said builder will QMCO 661 ."Wating Condition any part Of mid tmua" dlapml cyst Ob perwd of taro (a) yC*£ma Imfoadieeoly folt¢alne thodets of the Isew amw 00 the approval ®t. tho Certifiaato of Construction Compliance, the original or entf rapaba Omrato; 2) thot the drilled wall doferill id abowo @A Coietcd ®a on flea amprO¢a39 pion and that f31d arell will loo i a11Cd in a afOtOe at a, ru00a and Pq ss o4 fpm C)utnont CdMRQb ®cvartat=d t0O90th. A0ross ZqZ 6 .� , Sr),nv�l C , b.J t-icsnse No A 6 APMdVC<O ROW CONSTOUCTIONt This aww#Ol sxpirea a from tho dato issued unkxia construction of the buildine has bean undertaken and IS mawbEo for Cauca or may be arn� rn or osificd whon necessary COmfnlwk Kw of f-0Glltii. Any chanao or Olteyation of construction gimuirea a now� mX Apfarstwad for 401mmml of do Or aewillp / priwato taatm cupply only. 0 88 /Q L. oy `✓ Titkl �D `q / � !'QWIAr[ DovIRT DDlAlr1�'f!' OF �AL'r8 ONUfr ei�aaittrpbtaf 6aaitl Saniaaa. CioneL KIT lilt • BosbwR OfPCOSQUARIM p>i1SrlOClfOt11 FOSS' FR =*A4u mwo"L harm[ _ . a-_ �... 4 .. .. .. .._...._ Ask • .4...- e_...._.. �.- ..:.... 9. ,_.._ �._--•_ .- +-- ,•,�,. >v..e,..- '---• ^v��, «•,ate ir.w..�. A� $n,d• Tam Wr J Ct m� i.t-- �--OL� 0,,,,dw/�io�tliw C�aatA �Zbene.�e.'l�ro ....w.+_al PV -ci- Z.,Y„ p Dab of Reek.. A,twd cd 6 Date Subdivision Approved Fee Enclosed ❑ Amat,nr •++ps TIr j'u,:� � rut Aces ' aGtel. M sftdm otrb LJ Dew vetspm [Itih� or isa--e 3 Dadp Flew G r D CO 0o r®NMbotlw k s.odfpd Wbn FS k ce=~ Swarieft &MMOV S;dtlla tb soak" 1 too Tn4 --+ 333' �•� „ t.«f t To be 'by Addison. WRAW S"W. Pd ft Stay RM Addrsua .�, y per, b� Zoo c ��(Loss-, �tM z-1 c 0dM 1 represent that 1 am wholly and Completely responsible for the design and location of the proposed systern(y; 1) that the separate save dl sal em above daspibed will be constructed as shown on the approved anandment there to and in accordance with the standards. rues a rpu m o ream Cowley Department of ""111% and that on completion thereof a "Certificate of Construct)" Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Departineitt. and a written guarantee wib be furnished the owner. his successors, heirs or asliens by the bulkier. that said builder will place in pod Operating condlt)n any part of said swap disposal syst hi period of two (2) yews Ion me4'Nely following the ate Of the her. ante of the approval of the Certificate of Construction Compliance the original at or a repays thereto; t) that the drilled well ~41ted 46oe+ will be lo.MW as shaken on the approved plan all that said well will be fled in wlth d s. rules a"d repu ns of ten PutMm County Depertnunt W l/a IL j// Date a,',� ��/ S7��te� P.E. _> R.A. Aeare� ZIAZ - .� �• StMV�I t 1.1 - License No ia13� APPROVED FOR CONSTRUCTION: This approwl expires s from the ate issued unless construction of the building has been undertaken and is fMOCa010 for cause Of may be ananded or modified when cars "ecessary Commissioner of health. Any change or alteration of Construction reeuires a new ermlt. Approved for diwoul, of N swap • / private water supply only. w �t )/88 Date L my I i✓ F'L7/h Title /r /U County be subr place .. it ance . of will tie I County Date APP,ROVEO *OR CONSTRUCTION This`approi revocable for .Cause Or may be amended Ormoditir requires a new permit. Approved for disposal c Date—! _ ie'design and`bcation of the proposed sys(em(s); 1) that the separate sewage disposal system . a amendment fhere to and in accordance with thetandards, rules and, regulations of. the Putnam eof a of Construction Compiiance "satisfactory to the Commissionerrof Healthwill will be- furnished the owner; his ;successors, heirsor assigns by the builder, that mid builder will tlispoSal system the perwa `of'two (2) years Immediately following the date of. the issu- �mpl,iance. of th -,or inal system or`.any repairs thereto; 2) that the drilled, well described above 16will be install i accor nc with a standards. rules and "iegu a�f. the Putnam Signed P.E.. R.A. — �� License No --0731 meyear from the date issued unless construction of the building has been undertaken and is sidered. necessary_ by. the Commissioner of Health. Any change or alteration. of construction ,sanitary sewage; and /or privy a .water supply only. �_ Title 0- : — T. — -1-1 UAL/ r —oi--1 2r M I 'I 14. AMD Fi- SOLTS r -1 PLAN VIEW WELL will $#01 - ab out Pluess Cm. 4f ~ CMI- Mo..M.M 12• Cover Jvnction Some* to be set oA P. a 12 deep bed of pea gravel which muSt eilend 10 0 thift;Murn jP • of 3 6" belo- grade. Putnam County Department of Health • Division of Environmental Health Service-- -i A Approved as noted for confcrmance with .SEPTIC TANK applicable Ruler. and F.egulations of the JUN.CTION BOX LOCATION "OUND SURFACE Signature & Tit n D7 9TAK4 "El" ABSORPTION TRENCH • F, MAM001,11 COVER Irt Ah 1404#01.1 COVER -j e CA41 004 J­ AIIPMLTIC UAL 1% r wanT OF iuLgT r Anove • • ON Kwt eomecwy F4 MEAT OF OUTLET . outlet CAUL9 90 JD110T LIOUID LEVEL Dun wT —► CAULKID JOINT lateral outtel(tistsh) ELEVATIOf4 f SAMAXY T111 ir - Til Sea se"'t" 116400TAXY Tit 'o,ft's BAFFLU MAY 69 USED 9W"D OF SANITARY at 4r MIN - &r MAX L10649 OPT" r &NMMVM WALL TMCCKNKSS FOR POURED 11 PLACE -7 C1111711 PLAY SECTION • VIEW UAL/ r —oi--1 2r M I 'I 14. AMD Fi- SOLTS r -1 PLAN VIEW WELL will $#01 - ab out Pluess Cm. 4f ~ CMI- Mo..M.M 12• Cover Jvnction Some* to be set oA P. a 12 deep bed of pea gravel which muSt eilend 10 0 thift;Murn jP • of 3 6" belo- grade. Putnam County Department of Health • Division of Environmental Health Service-- -i A Approved as noted for confcrmance with applicable Ruler. and F.egulations of the Putnam County Health Department. Signature & Tit n D7 ABSORPTION TRENCH ISO* or ops d) t L VIEW AREA* .614 titres SYSTEM PROFILE DA I `40N OK LPK� ! -7 Ro 0, r' -0 Co 516 940' 3p E tk 504 ezi N/F GAZZO vacant land B17' 3: 0, - -, HMO a ' " .AREA: .614 otms f N i N a. i 823' 504 821 N/F GAllO 84 ( vacant land) 817, It 0 615, v' 1 N •I 8:0' _ z ~� DATA :ST: to water _ to imperviou3 to water to impervious _ to water to impervious 805 Cos. fNldf.\ PROPOSED `. 3 SEDR06M RESIDENCE N/F ..._FUNK.._. ..__..._ ..._._ 1 (vacant land) ROB fill impervious fill A N � ei _ 1ot► oho - -- L ' to 145' to e=istmQ SSOS 9C 0' / %20 795' _ �Z,30 0 PK _..._�__...: _....._ �.._..__.._._.:.:..._.___.. _�_.:�..... ;.:y..._. . N/F SCHNEIDER ( vacant land ) PERCOLATION TEST: stabilized rate e"'o n-Winl DESIGN FLOW: Soo gals. /day APPLICATION RATE' r 0.9 -gpd/sq. ft.� REQUIRE 1000 333 s 200 21 MENTS; _ gallon septic tank . 2' wide absorption trench junction boxes _ c.y. R.O.B. fill (I.5' deep) c.y. impervious fill r�•a..�n c+. x>i.. ....r.- �.a-�::.r —e:e.- ':w- ...a.. u.� . r: xr^:.........._ �- �qM�(1/ �' �'^ �1.lyggy.���ya1p'�1,..�ryu� -p-�y RIp19 ,�y�raryp�.{����y��yry ++���yy 1��u/��/��Ny��q- -��aa_ .. 1,a1�I,1 �- i..ss..... Jlalll.J ii VJrR O Y ELE 811 ®1 Yl1:J M V Y I R9AT Jrli' PUT NAM COUNTY DEPARTMENT OF HEALTH Division of Ennvnronnmen:nl Health SeMces 7acility: c `{"y Town: Time: � ' �%s Date: Z `�. 'Il'elep�lnonne # r'Z ©3 - %`f 3 - to 4f Caller's Name: DISCUSSION: 04' 20 -7z 22Z W Signed: Date: 3 z7 9g Rev. 6/97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL 14EALTH SERVICES Date ,,, i��ex6 Re: Property.,of H . `�AcocSSoQ Located at' t,R- (T):P J Section Block / Lot %. Subdivision of NAPS R6P -(ZAQ6 L4KC Subdv. Lot, #. so3 filed Map # Date Gentlemen: This .letter is to authorize a duly licensed professional engineer for registered architect (Indicat,e to apply-for a*Construct.on Permit fora separate sewage system, to serve•the above noted property in accordance with the standards 'rules or -regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter, and...•to supervispi the construction of said s stem or systems in conformity with'th;e r _ y y y p provisions of Article 145 or 147, Education Law, the Public - Health Law, and'the Putnam County Sani- terry Code. Very truly. ours, Signed 1 weer f Pro rty . Countersigned:, P.E. ,�$.�A , h 43V7U Address Telephone �m4xge f Address To Telephone M PUTNAM COUNTY DEPARTMENT Or HEALTH y D CVISION OIL LNVI120NM`LNTAL "11,;ALTH SERVICES Date_ 10 Re:.* Property of L 04-3rr cm.")CN1iDEf1-yb Located at oAkR-iO&-rz R1\tr (T) PvciJl�w� \)P,-LLEy - Section A Block \. Lot., "I Subdivision of AP 5- ;,. R6Att.Iaj6- . '('>P tAC . •.Ua k� 5ubdv; Lot` X03 riled Map Date Gentlemen:. This letter is to authorize a duly licensed professional engineer o registered architect (Indi6ato to apply for a Construction Permit for a separate sewage system, t. 0 serve the above noted property in accordance with the. standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of I1dalt1i, and to sign all no•cossary papors on my bohalf in 4gjnQc'tion-wi.th-.tki. s., matter....and- -to s.upe vis §e . -the _c_oi1stxuct on. -of said _ system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and -the Putnam County Sani- tary Code. i Countersigned: Address 2Gs -►032. Telephone Very'truly yours, Signed Owrier of roper y Address Town O . Telephon ' PUI'NAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SE%GE DISPOSAL SYSTEMS 1 11 Maw (Name of Owner) REVIEW SHEET - CONSTRUCTION PERMIT _ _. ,.. T DATE REVIEWID : "­A0 0 t✓ ' BY: (Street Location) CONTENTS YESJ NO t P r� ,�+ .::�rBt_ d., new /1ti %� . da..�4.Y„+• 9 ��{,,.. f ,� { it ' 4'i L!•6.: � i1,t.t [.�'t�� -!/ /` „�.- Ala- t.�`• "��, ,.��. -e.� �ifi' � %ai�:.s� �. �'� A/ f� a-II� f DOCUMEM Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PW5 - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage,System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic'Tank - Size, Detail Well Detail, Service Line if over Construction Notes DesigniData Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown;_gravity, flow, suff :- _size If Pumped Pit & D Box Shown & Detailed House -. No. of Bedroans Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields' 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains -Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' fran Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same w • t w ' PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS FINAL SITE INSPECTION INSP.BY: ' ` FZET,Dr INSPECTION- REPORT . . _.._.... O ..r _. . I DATE: 6!UW_v'(- V �i - �. r + L� i INSP. BY: .5 (Name of Owner) (Street Location) House SSDS located per approved plan ............. INITIAL SITE INSPECTION YES I ,NO COMMENTS Wetlands on /or proximate to property ......... °,.,, Length of trench measured Property lines or corners found ................... Can estimate house location. , Will driveway need cut ............................ Must trees be removed -note these ................ Deep holes representative of entire SDS area...... Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area Additional deep holes needed......... ... .... Sufficient SDS area available considering driveway cut, house location, separation distances, etc... Adjacent wells / septics ...,....... — ....... oo _ _ i unnecessarly graded .......... ...... ....., „ I'/ LO ft. maintained from property line and / 20 ft. from house .............................. , D.H. - Deep Hole G.W.- Groundwater D. H. 1 Lot D. H. 2 Lot D. H. 3 Lot Depth to G.W. Depth to G.W. Depth to G. W. Depth to rock Depth to rock Depth to rock 0 ft, 3 ft, 6 ft. 9 ft, 12. ,ft Soil 4t 'X, i 0 ft 3 ft. 6 ft. 9 ft, 1.2 Jt; Soil Descri Soil Descr 0 ft. 3 ft. 6 ft. _ 9 ft. / ­12 DATE: FINAL SITE INSPECTION INSP.BY: YES NO CarMENTS House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded .......... ...... ....., „ LO ft. maintained from property line and 20 ft. from house .............................. distance well to SSDS (ft.) ...................... Vumber of bedrooms checks ........................ atones, brush, stumps, rubble, etc., greater than 15 ft. from nearest trench ................ L5 ft. of peripheral soil horizontally from trench ...................... ........... 3oxes properly set.... .... ......o ............. 'ould surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... L_ )oes lot drainage appear OK in area of SDS....,,, FINAL GRADNG OF SITE ACCEPTABLE .................. • • 09 r•: "I ►� 0 v •►y �: �• may. .,:°.,.. DESiGA] DATA - SHM, -- SUBSUFACE'- S EKTAGF,DISPC)SAL_SYSM -.. ; _- F E> ::• _.> Owner R•ao D; Address. "170 ' Qr" %5 Located at (Street) O `t•�! Dc'- i , �( Sec q Block l Lot (indicate nearest cross street) Municipality Watershed N-�� . SOIL PERCOLATION TEST DATA RDQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking C 15 6 Date of Percolation Test 6 ► s q _ HOLE KMER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface j -. ..In Inches Soil Rate Start-Stop. Min. Start Stop Drop In Min/In Drop Inches Inches Inches 2 _ 1 .3 2� 2y .. it 3 - - 4 . -z j 2l 3 5.' 1 2 1 J NOrTFS: - :,.'ti1.. Zees s. a repeated at tame-"depth until apprcx mately equal soil rates are'obt{aib�d',at each' cola�tion.test,:ho�le. All data. fi�o'.be submitted per.. " • fof xe�w. 2: asurecments to be made from top of hole. rev. 9/85 G. La 19 29 . 39 49 59 6' 72 89 99 10° 119 . • 129 139 INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED _. �m *e INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEED' HOLE OBSERVATIONS MADE BY: DATE. 6 .)V S C DESIGN 2 Soil Rate Used Usable Area Provided•. • _SALE_.. . _. --No. of Bedrooms '­ ..Septic Tank Capacity ... ...1 30 0)a .... gals Type w4 . Absorption Area. Provided. By.:. x..24P0 . width trench...._ Other 2dc .C. • � FffJ2t � V'K�.• _._...w._.:_S1gil3tLlie IF- Address SEAL 777 ..r.:iZ-V,, THIS SPACE FOR USE BY ' TFi "DEPARTNT `ONLY c Soil Rate raved +� r •, : a :.►s:: _,. �; :;a 0 -. .. G't���: _ Jul.,►. :.,..._:.. C::_`..` 'hs��.?,'v_.s.a:•it.J"- .!_ts::9 ..ic.7r.. °; PUTNAM COUNTY DEPARTMENT OF HEALTH -- ,:.._,�_ ,_,_..•, DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Located at ��� c���e viii (T) Q�l�a Section °_Bloc 1 Lot l�} Subdivision of Mu � _ c� $1101 WjLc Subdv. Lot 503 Filed Map # 3VO& 2 Date--71) Gentlemen: This letter. is to authorize /�. ZJ(%Z a duly licensed professional engineer `---� or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commi'ssioner.of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connect-ibxi with-'this� ma;tt'er and- to supervise the -cons•truc- tion- ••of.. said.... system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Si g ned JA , .0, Nl 1. A "- Owner of Property Countersigned: )Z P . E . , R . A . , # Addr s zA _ fix. .Y. Address -own 26 5 l of Telephone ', �c fig t 620 . Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS ... .. F?.�'•LD,::,I�ISPECTION.: INSP. BY (Name of Owner) (Street Locat' ) INITIAL SITE INSPECTION CPIs 12 YES NO CAS Wetlands on /or proximate to property.............. Property lines or corners found ................... Can estimate house location ....................... / Will driveway need cut ............................. 0 Must trees be remved - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed..... ........ .... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells /septics........................ Access to prg sed well location for drilling..... D.H. - Deep Hole 22 G.W.- Groundwater D. H. 1 Lot J D.H. 2 Lot 2- D.H. 3 Lot l Depth to G. W. "— Depth to G. W. Depth to G. W. -� Depth to rock Depth to rock . Depth to rock Soil Descri tion Soil Descri tion Soil Descri tion 0 ft. t. 0 ft. 3 ft. 6 ft. 6 f. 6 ft. 9 ft. 9 ft.— 9 ft. DATE: FINAL SITE INSPECTION INSP.BY: YES NO COATS House SSDS located per approved plan.— ......... Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Roan allowed for expansion trenches .............. Over 100 ft. fran watercourse .................... Natural soil not stripped or SDS area unnecessarly graded... o ......... .. ......... 10 ft. maintained fran property line and 20 ft. from house... ......................... Distance well to SSDS (ft.) ...................... Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally from trench.... o ............................... Boxes properly set......... ................... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... —� FINAL GRADNG OF SITE ACCEPTABLE.. ..... .. A DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -'6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT' /✓ - /_ WELL LOCATION Street Address Town/Village/City Tax Grid Number 0AW,D&F, P WS PWTNA�\ VNULC�Y *t -s- I- I WELL OWNER Name Mailing Address : 'ACO g 5'00 q'i $A (7,KcT iZc °l 'jti*MCGEPS11E, 8Trivate O Public USE OF WELL 1 - primary 2- secondary G- 6SIDENTIAL 0 PUBLIC SUPPLY 0 BUSINESS O FARM 0 INDUSTRIAL O INSTITUTIONAL Q AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY O ABANDONED 0 OTHER (specify O AMOUNT OF USE YIELD SOUGHT 0-c,\.S gpm /# PEOPLE SERVED f /EST. OF DAILY USAGE ev al 0 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION 12 ADDITIONAL SUPPLY E1' EW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE C215JR-ILLED 13DRIVEN DUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REAITY SUBDIVISION, NAME OF SUBDIVISION: vo(ko -1WCr p &OV- Lot No. S03 WATER WELL CONTRACTOR: Name k-t \o,- Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES 1./ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEARE -ST.. WATER' �MAI -N s LOCATION SKETCH & OURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (date) PERMIT TO CONSTRUCT A WATER WELL i� This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt3, (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well dril g operations be contained on this property and in such a ItaF er as not to degrade or of er a conta . atne,�surface or groundwater. Date of Issue: 19 �0 Date of Expiration 19 Pe it Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow ,copy: Bldg. Insp. Orange copy: Well Driller J 'I I 9 DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER,.CARMEL, N.Y. 10512 (914) 225 -0310 o....., .,. _r. _,. APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # PV -67-26 ALL LOCATION Street Address Town Vill ge City Tax � cu 00 -i-e- Grid Number W.ro_ ® 1 WELL OWNER Name D;�e DA Mailing 0.vox 1345 Address a k. "A' oil rivate OPublic USE OF WELL 1 - primary 2 - secondary RESIDENTIAL BUSINESS 0 INDUSTRIAL ® PUBLIC SUPPLY ® AIR /COND /HEAT PUMP ® FARM O TEST /OBSERVATION U INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify AMOUNT OF USE YIELD SOUGHT gpm /(E ® REPLACE EXISTING SUPPLY G&W SUPPLY NEW DWELLING PEOPLE SERVED _ /EST. OF DAILY USAGE t-O _gal ® TEST /OBSERVATION ®:ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR "DRILLING F- WELL TYPE 1315RILLED DRIVEN MDUG L"A GRAVEL. OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LO TED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: MAP S 1'�itl►Ub- 13i4ok /AGE Lot No. 4h3 STATER WELL CONTRACTOR: Name -6 L.,o- Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES � NO WM E OF PUBLIC MATER SUPPLY: Q.9 TOWN /VIL /CITY - �g�TANCE T'0 PItOPERT'Y'FROM BTEAREST-t4ATER. MAID1':- ' LOCATION SKETCH 5 RCES OY CONTAMINATION PROVIDED A ON SEPARATE SHEET 30 � (da a (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above.is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty. (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or othqx contaminate surface or groundwater. Date of Issue • ' / 19A Amy Date of Expiration 'U 1 Permit ���Isssuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller UtNAK I MUN I yr nC/AL. I n _ • Division Of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y..10512 (914) 225=3641 .. ,..:. > _.< .. -•• :M:. _ ._,. .{ psPpL2�'P TION� TO_ CON T tUGT A W;AsTE.P KELL 'ELL LOCATION STRELI A00RESS. ©�I1r� 1OWNIVILLAGE101y W GRID NUMBER. ., �- WELL OWNER NAh .. C� 0 p�� ADDRESS: 'PSIVATE ❑ PueuC USE -OF WELL 1 - primary 2 -secondary. CIESIDENTIAL O BUSINESS ❑ INDUSTRIAL, O• PUBLIC SUPPLY 0 _FARM O INSTITUTIONAL ❑ AIR /COND. /HEAT PUMP O ABANDONED ❑ TEST /OBSERVATION ❑ OTHER (specify) ❑ 'STAND -BY ❑ VIOUNT OF USE YIELD SOUGHT gpm. /NO. PEOPLE SERVED Z / EST. OF DAILY USAGE gal. REASON FOR DRILLING ONEW SUPPLY' ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DRILLED ' ' 0 DRIVEN Q DUG E] . GRAVEL Q OTHER WELL TYPE ES WELL' SITE .SUBJECT TO , FLOODING? _ YES NO EF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF- SUBDIVISION: LOT NO.: ?ATER WELL CONTRACTOR:` Name Le- &44AAh4 Address: :S PUBLIC WATER. SUPPLY -AVAILABLE TO SITE:. YES NO FAME OF PUBLIC-WATER SUPPLY: TOW`N /V /C / I ►ISTANCE TO PROPERTY FROM NEAREST WATER.-MAIN :cwt -OCATIOIJ SKETCH & SOURCES OF"CONTAC1INKT10 lS ( a e) i (signa . PERMIT TO CONSTRUCT A WATER WELL This permit to'construct� one water well asset forth above is granted under the provisions of Subpart!5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the�iwell in accordance-with the requirements of the,Putnam County Health Department attached to this permit.. 3. 'Submit a Well Completion Report on a.form provided by the Putnam County Health Department. Date of Issue: 19/, -=� Permit Issuing ff cial Permit is Non - Transferrable 4. PUTNAM COUNTY DEPARTMENT OF HEALTH i DIVISION OF ENVIRONMENTAL HEALTH INDIVIDtAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS - - _ nAk REVIEW SHEET FOR CONSTRUCTION ?E -W YIT' - STREETLOCATION kOct lz Vtr' NAME OF OWNER CR�"��Si�u°�( 'Q J REVIEWED BY J��G!� DATE 9/iSIPA TAX NIAP # S- Y NZ DOCUMENTS Y N APPLICATION WELL PERMIT _ PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) TE RESOLUTION 'TORT EAF '-AN IS - THREE SETS OUSE PLANS - TWO SETS ARIANCE REQUEST SUBDIVISION LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE FILL REQUIRED . DEPTH CURTAIN DRAIN REQUIRED STA`DPIPES GENERAL LOCATED N NYC WATERSHED PLANS SUBMITTED TO DEP DELEGATED TO PCHD -. HDEP APPROVAL, IF REQ'D PERCS DEEP TESfiHOLES f1$$E.RVED . WITNESSED, IF REQ'D EX- APPROVAL SSDS ADJ. LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) DATA ON DDS PLANS & PERMIT SAME PRE 1969 NEIGHBOR NOTIFICATION LETTER BUZBA 100 YR. FLOOD ELEVATION OTHER REQ'D PERMITS) REQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE_ GRAVITY FLOW CONSTRUCTION NOTES DESIGN DATA: PERC & DEEP RESULTS T CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT FOOTNG /GUTTER/CURTAN DRAINS COMMENTS: EROSION CONTROL:HOUSE,WELL, SSDS & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION LOCATION MAP EXP. AREA; SHOWN; GRAVITY FLOW, SUFF -SIZE IF PUMPED, PIT & D BOX SHOWN & DETAILED HOUSE - NO.OF BEDROOMS WELLS & SSDS'S W/IN 200' OF PROPOSED SYS. PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1/4" FT. 4 "0; TYPE PIPE NO BENDS; NiAX.BENDS 45° W /CLEANOVT FILL SYSTEMS CLAY BARRIER 10- FT. HORIZONTAL; SLOPE 3:1 TO GRADE FILL SPECS FILL NOTES FILL CERTIFICATION NOTE DEPTH GUAGES FILL PROFILE & DIMENSIONS VOLUME FILL N EXPANSION AREA TRE1yS .. _... _ ._..... _; .. _ .:. LF TRENCH PROVIDED —60 FT--MAX. PARALLEL TO CONTOURS 100% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS 15'WELL TO PL 100' TO WELL, 200' N DLOD, 150' PITS 100' TO STREAM WATERCOURSE LAKE (inc. expan) 50' TO CATCH BASIN, 35' STORMDRAN, PIPED WATER 10' TO WATER LINE (pits -20') 50' INTERMITTENT DRAINAGE COURSE 200' /500' RESERVOIR, ETC. _150' GALLEY SYSTEMS 15'min to CDS= >5 1/o,10'- 4 0/o,25'- 3 %,30'- 2 0/o,35' -1 0/o,100' - <I% 20'min to CD discharge /100'with 182 cons day discharge SEPTIC TANK 10' FROM FOUNDATION; 50' TO WELL FORM ST-2 T _. Public Health Director r April 9, 1999 ...- .:.rLORF.M4 Il`iAI.: RA1;,_ M,S.N Associate Public Health Director Director of Patient Services DEPARTMENT OF . HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 -6130 Fax (914) 278 7921 Nnl Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Fred Zenz, PE 292 Main Street Nelsonville, New York 10516 Re: Carlson TM# 9 -1 -14, Lot 503 Town of Putnam Valley Dear Mr. Zenz: I was requested by Hekla construction to conduct a "fill' placement inspection on the above referenced project. This letter is inform you that the fill material placed in the proposed expansion area, as shown on both approved plan and "Preliminary As- built" is not of ROB quality, as specified on the approved plan. --' t have re nested from the ro ert "owner-to-conduct- sieve analysis testing of material-to veld soil gradation. I request you, as design engineer, to assist your client to obtain a sieve analysis from a NYS Certified soil sample lab. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj •o ^ D Public Health Director MEMO .. ,, ... :._;.LnR�TT,t1�w.M�i�I3�,ARL. RN., .�YLS.N•, Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10.509 Environmental Health (914) 278 - 6130 Fax (914) 278-7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 To: Fred Zenz From: Adam B. Stiebeling, APHE Re: Carlson Septic - PCHD # PV -67 -86 Date: April 8, 1999 As per my filed visits as listed below, I offer the following comments: Field Visits: April 2, 1999 with Mr. Fred Zenz, PE April 8, 1999 with Hekla Construction Visit - ADril 2. 1999 * Received copy of "Preliminary As- built" A. * Inspected deep test holes ..._......_...._...REsults - Fodr. feet .(4'±) of miscellanPoiis:f111_used.over: iriginal( existing): grade.. . Fill contains "rock" 12" f and smaller. B. Erosion control measures not in place. C. Relocation of drive had begun, but not completed. D. Proper separation distances from drive to start of trenches not met. E. Proper separation distance from trench to tip of fill not met. Visit - April 8. 1999 Inspected placement of fill as required for SSTS as shown on "Preliminary As- built" plans, (no date) prepared by Fred Zenz. * Quantity of fill is inadequate for "proposed ", expansion area as shown on "Preliminary Plan". * Quality of fill not ROB as required and specified on SSTS plan approved by PCHD 10/7/98, ;Permit # PV- 67 -86. * Depth of fill greater than 1.5 feet. a --- Merri-o-= Zenz/Carlson Page 2 April 9, 1999 Phone Conversation - April 8 1999 at approximately 3.30 pm with Mr. Scott Carlson. * Explained above field visit and requested sieve analysis of "fill" to compare to PCHD construction note spec's. * Stated ROB must be placed as shown on approved plan. * Miscellaneous fill can be used as borders and transitioned back into existing grade. Attempted to contact engineer, Mr. Fred Zenz via phone, no success. Copies of approved plan attached. ABS:cj cc: Scott Carlson File final grade to be eat; existing grade due tc removal of surface bo 824' < 15% grade which cover proposed., •, ti . � , _ _• ..,. ' - _• -' T' .8eptte Tart ►� .1, Y'4 'cost iron J B20' grade @ 1/4" per ft. ��••• 819' R.O.B. GRAVEL F JUn on Boxes _� set note c 100:. EXPAM1r-7I0I SYSTEM PROFILE I11- IOf Al;el HORIZONTAL a VERTICAL .wn 12� corer lio. so... 10 De eel an dnf D.d of Pao groeet mad .clend to a minitn- wadi QpRK (v.acanl . K 00 BR :ption trenches start PR \N� 517 !o>a boxy f irst 2 r to RO )lid pipe NIF 845' 516 • B40'.. �° E 21' N ' 4E, flcldl AREA: .614 oCfes cas,m,rnon nor B30' ~ PROPOSED �� 1, qrW .:9 UWA 10 K r4lt N wca tf:61 I �' qM Yln/ Ties at s uul, a 3 BEDROOM N ' N "•- " • "' i1 502 ,•, I. FWI 0,41M 10 At 10 IS l"I'mo 1IRK.P' " . -,i. ,•a RESIDENCEro,cc,3tp,1tcl. t++atduah.a0v lvr'w" .; boll � - ��.-,. ..., ........ .. . .. .�...... �' . • - "B2s: ..._ .... � ^ ' N/ F FUN ' ••- — •• — u•1.0 14010,3 a nuu CLOT. AI o Dul ler. IKI PULL It ptkW w er uWM I ua _._•• 20 (vacant land) wnnawcl Pucl. At rrnW,w u Ccoca w nrNrca w" - KLlle' ocrtt,00 IN INC AM ft 3 ' 504 821' , R.O.B IIII U.S. WMI.WI d.NIMIWI ti r edn nxtoanIa tc.rlu i Sit. BI9' 10:.1 ^�+- -��,,, r 0 'sq. It. N/F GAZZO a l3' deep t , lwtlnC OCT," f (vacant land) BI)' o _ /oez eta elan i BIS' !fee 1 10 LATERALS @ 34' ro tvttlnp BOS' �•r.� ►ul ` 143' to ext.tlny SSOS SILT FENCE (typ) t2 °p0 PLAN BASED ON ; BY H. I. BRIGHAM, `tom FC r uirU II ala VOL Gy Ut;kb V 6tllyll 1. VL nb, /ivision of Environme tal Health St ipproved as otedor aoniormanoe t iil 3 plioable Rules and Regulations 01 (, P t= County alth Department. qRn W N/F CHNEIDER ~tvn4FtL7^ft re T .l'b `Dwfi (vacant land) nF -q It;N nATA 1 L final grade to be equal to existing grade due to required removal of surface boulders .. which hept'i -e'• -area /J B19 R.O.E. GRAVEL. FL; Set nose ob:,. f •ems : ^ - •C .. , ... P ... _�_.. Z 100% EXNAI! °1 0 _ l E' 1 maul Pond 892, �r P. o v m w it jr Opac - e LOCATION MAP 111.= 20001 O +,•,,, ,,,,� ,,,. 1 1. ALL TREES 111THLN 10 FEET OF THE PROPOSED SUBSURFACE SEWAGE TREATMENT Sl'S -. UI (SS1S) SI IALL UL' R1:\IOVED. ' S SSl'S 70 UC INSPECTED UI'THE LICENS ED DESIGN PROFESSIONAL. AND THE PUTNAMI COUNTY HEALTH DEPARTMENT AFTER ODNSTRUCnON-MD PRIOR TO BACKFILL •' • O. THE SSTS AREA SHALL BE STAKED AND ROPED OFF SO TLtT NO TRUCKS, I • M'ACHINCRY. BUILDING MATERIALS. NOR EXCAVATED LARTH SIULL BE ALLOWED __ I IN THE SSTS AREA. ,���•.�e .. °::: ( (. ALL EROSION CONTROL MEASUUS SHALL OL INSTALLED PRIOR TO S1 ART 01 ANl' CONSTRUCTION. • 3 3. CONSTRUCTION OF SSTS TO BE IN ACCORDANCE WT'H THESE PLANS. A. \Y • i REVISIONS THERETO. AND THE RULES AND REGULATIONS OF THE PERMIT ISSUING i(CTioN R GOVERN%LENTAL AGENCY CONS .TABRION N01CS FOR FABRICAICO SILT FENCE 6. TILT WELL IS TO DE A DRILLED WELL. CONSTRUCTED IN ACCORDANCE WITH NEW - YORK STATE HEALTH DEPARTMENT BULLETIN. EYTITLED -RURAL WATER SUPPLY. L rIIT. r:A(rU¢4 to 6C witMD stw. ml a/L.:C,otn POSTS: STL(L U1..A•I• 1.1. PUMPTESTED FOR AMIINUNUM OF6 HOURS AND HAVE AMUI•IMUMH SAFE YIELD OF rIN -IPI TIES OR Pout. I,,( w I• w .Ow GPML YIELDS LESS THAN ,S GPM WII1 BE IMMEDIATELY REPORTED TO THE PUTNMI _ COUNTY ^EPAATMtN7 of HE.'LLT . ..I. YILICA RO1M Tf M to M /iiltrto S[CtKIT TO Olt. .]U FENCE: .o'(. riAL I. tit SA. rE.CC MI. TIES PACED MAT 81• 17 101 u0 .10 MCIIN. i• W..w1 at.l.t 7, THE SSTS DESIGN SHOWN HEREON DOES NOT PROVIDE FOR THE INSTALLATION OF A GARBAGE GRADER SUCH INSTALLATION REQUIRES ADDITIONAL DESIGN AND THE 'UNK I. -u-7•0 UCTINS Or rum LLOIN Aa!oi. TIN P.(. FILICR CLOTH: r ov A APPROVAL OF THE PUTNMI COUNTY DFPARTA'F'4TnFHEkLTH. Tnt1 twLL of D'�w 1111. I.NEI AAC 1¢Dto. •WI ,• • ,• ^• Inds I. PUTNAM COLTTYHEALTH DEPARTMENT APPROVAL IS BASEDONTHE LOCATIONOF„ . MIAL -ICE DWI M PUVDA•CO As "COED A•o .ATUTAL PAEFABAICA7 Mo'AD, TG SSTS, WELL, BUILDING, SETBACKS, MD DRIVEWAYS AS SHOWN ON THE wwLO rNDI •ale[S• ar(yo. tp 1Nt TIu Ft.Et L.11RD'E,e[ a orRO1[o APPROVED DRAWING. MODIFICATIONS MADE TO THIS DRAWING AFTER THE DATE • • • twµ. OF PURNAM COUNTY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL -• 9. CUT OR FILL IS NOT PERMITTED THE SSTS ARE.` EXCEPT P SO SPECIFIED ON THIS Y.S. CV-1" DP AUICWTWt PAAOW 3•W0. PLAN. 161L CNSU IIXW UA'ICI S I I. T r E N C E 10. AFTER BACKFMLD40 THE SYST K THE SM AREA SHALL BE COVERED WTIH A PPAwSC .C. Taw M ENUIRIM OF 6INC'HES OF TOP SOIL, SEEDED, AND MULCHED. it OCCUPANCY OF T US STRUCTURE WILL NOT BE PERMITTED UNTIL THE 10 LATERALS @ 34' PLAN BASED ON SURVEY BY H. I. BRIGHAM, L.S. [LLLnam UOUIII:y UGilbl LItt7A1l ' Vl IIbs1LII ,Sion of Enviropme tal Health Servioet �GppT7L � tfiliL •oved al'lnoted -for conformanoe with .ioable iiules and Regulations of the Lam County 49alth Department. CONSTRUCTION COMPLIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNA%I COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BUILDING INSPECTOR OF THE RESPECTIVE MUNICIPALITY AS PART OF THE �I CERTIFICATE OF OCCUPANCY APPLICATION. I N PLANTS APPROVED WATER SUPPLY IL AND ALL OTHER REQUIRED PERM]TS ANDOOR APPROVA LS ARE THE RES PONSIBILIT Y OF THE PERMITTEE 13. THE PUTNAM COUNTY HEALTH DEPARTMENT APPROVAL EXPUES TWO (7) YEARS FROM TEE DATE ON THE APPROVAL STAMP AND IS REQUIRED TO BE RENEWED ON OR BEFORE THE EXPIRATION DATE. TIE APPROVAL IS REVOCABLE FOR CAUSE OR MAY BE AMENDED OR MODIFIED WHEN NECESSARY OF THUS DEPARTMENT. Eft TI £9M+ TPROXLtDCTC'DERST'T'OF iT�- tltiBt5it3RB EDt1NDPJtL1'tl/OYDR 17. SITE MODIFICATION ACnVMES INVOLVING PLACEMENT OF FILL ARE TO DE CONDUCTED CURING RELATIVELY DRY PERIODS TO MINIMIZE SOIL SMEARING AND ., EXCESSIVE SOIL COMPACTION. 16. THE REQUIRED DEPTH OF FILL WTTHIN THE SEWAGE TREATMENT SYSTEM AREA is I•S FEETWHICHAPPROXIMAT12STO %0 CUUICYARDS.FBISIHALLUERUN OF BA11%GRAVEL SUITABLE FOR SEWAGE ABSORPTION, BE FREE OF FINES OR OTHER UNSUITABLE MATERIAL AND SHALL I LAVE AN IN-PLACE PERCOLATION RATE AT LEAST EQUAL TO OR FASTER THAT THE NATURAL UNDERLYING SOIL AFTER THE REQUU&ZD STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHALL PERFORM A MINIMUM OF TWO (I) PERCOLATION TESTS IN THE FILL AFTIA STABILIZATION IS ACHIEVED. 17. FILL SUITABLE FOR SEWAGE ABSORPTION SHOULD CONTAIN NO MORE THAN PERCENT AND PREFERABLY NO MORSTAT Z PERCENT FINES BY WEIGHT. FINES ARE MY AND SILT PARTICLES THAT PASS A 1100 SIEVE NO MORE THAN 10 POUCENT BY WEIGHT OF TIE FBI. MATERIAL SHOULD PASS A 1100 SIEVE. IL. THE IMPERVRHIS PI.T, SILULL BE A DRYC 07.11' T'PC S(8I. %1111 LTITL,' nR No S. ':IIiL,ANLHB7•I W \GYACI'fY. SEPTIC DESIGN 10 LATERALS @ 34' PLAN BASED ON SURVEY BY H. I. BRIGHAM, L.S. [LLLnam UOUIII:y UGilbl LItt7A1l ' Vl IIbs1LII ,Sion of Enviropme tal Health Servioet �GppT7L � tfiliL •oved al'lnoted -for conformanoe with .ioable iiules and Regulations of the Lam County 49alth Department. CONSTRUCTION COMPLIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNA%I COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BUILDING INSPECTOR OF THE RESPECTIVE MUNICIPALITY AS PART OF THE �I CERTIFICATE OF OCCUPANCY APPLICATION. I N PLANTS APPROVED WATER SUPPLY IL AND ALL OTHER REQUIRED PERM]TS ANDOOR APPROVA LS ARE THE RES PONSIBILIT Y OF THE PERMITTEE 13. THE PUTNAM COUNTY HEALTH DEPARTMENT APPROVAL EXPUES TWO (7) YEARS FROM TEE DATE ON THE APPROVAL STAMP AND IS REQUIRED TO BE RENEWED ON OR BEFORE THE EXPIRATION DATE. TIE APPROVAL IS REVOCABLE FOR CAUSE OR MAY BE AMENDED OR MODIFIED WHEN NECESSARY OF THUS DEPARTMENT. Eft TI £9M+ TPROXLtDCTC'DERST'T'OF iT�- tltiBt5it3RB EDt1NDPJtL1'tl/OYDR 17. SITE MODIFICATION ACnVMES INVOLVING PLACEMENT OF FILL ARE TO DE CONDUCTED CURING RELATIVELY DRY PERIODS TO MINIMIZE SOIL SMEARING AND ., EXCESSIVE SOIL COMPACTION. 16. THE REQUIRED DEPTH OF FILL WTTHIN THE SEWAGE TREATMENT SYSTEM AREA is I•S FEETWHICHAPPROXIMAT12STO %0 CUUICYARDS.FBISIHALLUERUN OF BA11%GRAVEL SUITABLE FOR SEWAGE ABSORPTION, BE FREE OF FINES OR OTHER UNSUITABLE MATERIAL AND SHALL I LAVE AN IN-PLACE PERCOLATION RATE AT LEAST EQUAL TO OR FASTER THAT THE NATURAL UNDERLYING SOIL AFTER THE REQUU&ZD STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHALL PERFORM A MINIMUM OF TWO (I) PERCOLATION TESTS IN THE FILL AFTIA STABILIZATION IS ACHIEVED. 17. FILL SUITABLE FOR SEWAGE ABSORPTION SHOULD CONTAIN NO MORE THAN PERCENT AND PREFERABLY NO MORSTAT Z PERCENT FINES BY WEIGHT. FINES ARE MY AND SILT PARTICLES THAT PASS A 1100 SIEVE NO MORE THAN 10 POUCENT BY WEIGHT OF TIE FBI. MATERIAL SHOULD PASS A 1100 SIEVE. IL. THE IMPERVRHIS PI.T, SILULL BE A DRYC 07.11' T'PC S(8I. %1111 LTITL,' nR No S. ':IIiL,ANLHB7•I W \GYACI'fY. SEPTIC DESIGN .........:BRUCE .R.-FOLE:Y Public Health Director ..,_.... LC'EtEU. .A. :.MOLIN�. _,RN.,.- ,M.S.N::.a. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278- 6085 ' Early Intervention (014)278-6014 Fax(914)278-6648 WIC (914)278-6678 Fax (914) 278-6085 April 9, 1999 , Fred Zenz, PE 292 Main Street Nelsonville, New York 10516 Re: Carlson TM;# 921 -14, Lot 503 Town of Putnam Valley Dear Mr. Zenz: I was requested by Hekla construction to conduct a "fill" placement inspection on the above referenced project. This letter is inform you that the'fill material placed in the proposed expansion area, as shown on both approved plan and "Preliminary As- built ", is not of ROB quality, as specified on the approved plan. I have re "uested 'from the -ro erf owner "to conductt q p p y sieve analysis testing ofmaterial' fo ve`rify soil gradation. I request you, as design engineer, to assist your client to obtain a sieve analysis from a NYS Certified soil sample lab. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, CQ" �• . Adam B. Stiebeling Assistant Public Health Engineer ABS:cj Public Health Director �IT I f _U\ (,l :� _:_• . �:.._�1ORET`f�1. >:,�40LI�dtiR� �L:N:; :.M•:S.N =�;.: . Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914)278-6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 To: Fred Zenz � nQ From: Adam B. Stiebeling, APHE Re: Carlson Septic - PCHD # PV -67 -86 L% Date: April 8, 1999 As per my filed visits as listed below, I offer the following comments: Field Visits: April 2, 1999 with Mr. Fred Zenz, PE April 8, 1999 with Hekla Construction Visit - April 2. 1999 * Received copy of "Preliminary As- built" A. * Inspected deep test holes Resul-ts:-. four-feet -(4:)-ofrimscellaneousfill- used -over original-(existing)-grade: Fill contains "rock" 12" ± and smaller. B. Erosion control measures not in place. C. Relocation of drive had begun, but not completed. ' D. Proper separation distances from drive to start of trenches not met. E. Proper separation distance from trench to tip of fill not met. Visit - April 8. 1999 Inspected placement of fill as required for SSTS as shown on "Preliminary As- built" plans, (no date) prepared by Fred Zenz. * Quantity of fill is inadequate for `'proposed" expansion area as shown on "Preliminary Plan". * Quality of fill not ROB as required and specified on SSTS plan approved by PCHD 10/7/9$, Permit # PV- 67 -86. * Depth of fill greater than 1.5 feet. ytl . -. .. -- - - -- ..Memo = ,Zenzl,CarlsorL•:� :v- - - - . � . . ... - -... . -. .. :i. ^..onV •- a=n.r. v-• ! "..:v.<,sn,.. .'r.. ..' - -... t:..6 v. ....._.. ..�- ...... .:'.4[nv sw a. .[... .o.n. vi+r ..... ar. .i a. ^. >.i.r v...4 .. ..n . .. •'r.•N Page 2 April 9, 1999 Phone Conversation - April 8. 1999 at approximately 3:30 pm with Mr. Scott Carlson. * Explained above field visit and requested sieve analysis of "fill" to compare to PCHD construction note spec's. Stated ROB must be placed as shown on approved plan. 'k Miscellaneous fill can be used as borders and transitioned back into existing grade. Attempted to contact engineer, Mr. Fred Zenz via phone, no success. Copies of approved plan' attached. ABS:cj cc: Scott Carlson File I LTON — t2" cover 1 wnntrenn) 4' casl Iron Sealtd Pipe @ I /4" per If )otate Am- I.e. a"-- to be set m ' dnf bed of Pee groeel mod utend to a wal.- 6' We- grede. =trenches AREA: .614 acres 035' final grade to be eqt: existing grade duo tc ` Isz removal of surface bo 9r °de hich cover w �. .• .. .... .. _ . ... .. .EroposQd ..._........�- �.�822'•, a .��.�... .. ._. .- ._y....:e.. .....•.. -- ....... -. _ .�. . A- fin" 'e. �(......� 820' 1� \\ Prede Jv` oa •aasee SYSTEM PROFILE 1 "= 10' HORIZONTAL 8 VERTICAL la 0`S�R1c� ^di PRK `vacs ^L.OK G eR0 f RO PR�N 517 N� 516 6N5 tzo.oli edo'.`L'�Z��a N ` 830' __.. .,- •v..... .....- ......., _.yam_..... .. •........v .r -».. ...... .. .._ .. .� _..._ -. .... •_....._.. ^.-.,N .., �Raaff� 825' golfer — drata.� :23' 20 504 1 N/F GAZZO al9' (vocanl land) 917' 3 j 913' 0 t � •1 .•)e0 610' `y ` � �LI Z G•9h_ R,(.4 � F0 `3 U c) t03 fa PROPOSED 3 BEDR004 RESIDENCE n area 819' R.O.E. GRAVEL F scc note c 100. EXPAkltl Af.EC f MISTRJCTICN 1, A 1. vary) e• N -IN i:e( TI [t q Q st F1. 502.. _ ", . .a. r(uuatlN•7p e('la•tii 3ti:o iFeu•c.. /(+'(c e(TN 110 Vecw I'", !O It IY N/F FUNK ]• wn I•] Ketlaa v /Ilt(A met. r ,,. (vacant land) wci ec svuunn a (I( (.(a¢, ...a1Nt(nulC( e•..LL t( ILY YM(] of KeC(] 3 •�•t] .w sKeet' ae.L•,'! iw I-( $ILI y� R.0.6 fill V.S. ­14A a, n 0 'sq. f). IdtL (o4av111, tU.IC( I S I Q LS' deep aart I nC rn aoeN SOS' aef! to oslellna SSOS SILT FENCE Ry`p) 800'. � �•.� ea+�ir�r ' i 793' �y GE / 4An N/F CHNEIDER ( rdcpnf land ) 10 LATERALS a 34' PLAN BASED 01 BY H. I. BRIGHA' 471I1CIIUL11 V01.1411;y Lt:jlt/.rwU04t1. V1 f Itvision of Enviroame tal Health � - 'n aLLCi ipproved as oted for n C aonformanoe i plicable Holes and Regulations ,�Itnam ' County alth Depart /m�e!n`t. nt°^0.'f?L?'P final grade to be equal to existing grade due to required removal of surface boulders which. -cover proposed septic area )' B19' R.O.E. GFAVE�. FI_L set 11016 r_CC Z 100'X EXPANtI �1 o `r P fl'�`IL i m K ' O 9 r o� �.. ..... r (3 1 .1 �.; ✓ it ^�� r � man —iT PIT . S � ::,., ,- �_ %. LOCATION MAP I °.= 20001 y T}iAET AND i}IE RULES AND REGULAnOf'S OF THE PFR.LIIT ISSUING tf cTaw .. 0. GOVk7tN =NTAL AGENCY. C011SIRtICr10M WCS FDA FaPA1C17C0 $ILI fC+C( 4 THE WEU. LT TO DE A DRD1YD%VELL, CONSTRUCTED IN ACCORDANCE WITH FEW • YORK STATE HEALTH DEPARTMENT DULLE(LV. ENTITLED *RURAL WATER SUPPLY% I. -"!:1[ FWA is K r"IC.CD Soxw It 1:'1 .GSIS Postt slim glImA•1• .1•u' PUMP TESTED FOR A AIMPNM OP I HOURS A. \D HAVE A MINIMUM SAFE YIELD 0P3 .Id -1-1 114 a 9101•11. 1+F[ a I• RRUiD•a0 GPML YIELDS LESS THAN S GPM µ916E IMMEDIATELY REPORTED TO THE PUTNAM . .. '. COUNTY DEMATNtiT OF HEALTH. 9. /m1G tied 70.9[ 10 M 1011Wm 1[aF4MT la .era rt4 .1 'liq , .O+f+..i M. ;l, IR {..' _ /riot stet Stu tr0[up [ru+ s. ti uv .ro uo state +. 9T w..t�l a+t:nt � 7. THE SSTS DESIGN SNOWNIaREON DOES NOT PROVD)E FORbE C�STALL-A4ffO.'% OF n - UN K GARDAGE OXNMER'L sucH Los rALLAnoN REOULRM ADOMONAL DESIGN ANO nDi s. ?`W` S IS alt tr 101.11:1 I WS t•oR etil. flLi(R cLOI D r.1.1 a APPROVALOFTIMPUTNAMCOV TY DEPARTM_4TOF IM4t.TN. 1wA ewu 9[ e.ua.vm a ua l +ae1 .Ra Farm. .Iti•R ... .. IA0) t..a•.: :. :.1, tv., t. PUITAN CV!.1TY HEALTH DEPARTMENT APPROVAL IS DAIED ON THE LOCATIONOF. 4, I,4ML U µLL M PtlVeA.[3 u NCOCO 00 uTW.L PAErABAICAIEO L'n11: Iz7,L THESSTS. W-4_1 BVG.DNO. SETBACKS, AND DRSVEW'AYS AS SHOWN ON THE Pw +fO -0 •9mt[t• DtK1V t. I c 110 Foci APPROVE?ruw NO. MODIFICATIONS MADE TO THIS DRAWING AFTER THE DATE • ,• tCi1i. OF PUTNAM COL'YCY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL 9. M OR FILR is NOT PEUIrrrED THE SSTS APIA. EXCEPT P SO SPECIFIED ON TUS V. t. LV,AI.rMi W OAI[1A11Nt tl W,'.Iq t•VDL PLAN. 160 CWtWIIJ0t UA,Ht I S 11, T FENCE 10. AFTER BACKFILLLNO THE SYSTEM, THE SSTS AREA SHALL BE COVERED WITH A ' Slumt. KV . 1W - MLNUCUM OF 6INCHES OF TOP SOU, SEEDED, AND MULCI LED. • S' oCNPANCY OF nus STRUCTURE WILL. NOT DE PERMITTED UNTIL. THE CONSTRUCTION COMPLIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNAM COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BUO.DINO INSPECTOR OF THE RESPECTTVE MUMCPAUTY AS PART OF THE 10 LATERALS Q 34• ' \J� CFATFICATE OF OCCUPANCY APPUCATION. �K " TITS ALL PL�N OT ER REVCDFORSE1,03AN RAPPR ANO✓SA ETEREPPL \'ONLY. AND ALL OTHER REQUIIIED PERMITS AND/OR APPROVALS ARE THE RESPONSIBILITY Or TUC PERMTTEE. 11. 71M PV NA.M COUNTY IMALTI I DEPARTSENT APPROVAL EXPIRES TA'O(7) YEARS 740 FROM THE DATE 0471 1E APPROVAL STAMr AND 13 REQUUMD TO OE RENEWED ON ORUFlORETHEEXPIIATIONDATE TILE APPROVAL IS REVOCABLY FOR CAUSE OR MAY DE ANff.NDED OR MODIFIED WILE : NECESSARY OP TUS DEPARTMtCAT. P�ZTT'T'OF i}lC- VHDKiUR91OV4OeKM4O" = ' 13. SfTEMtODtnCAnONACnvR1ESL4VOLVINOPLACEMIFNTOFMLARETOBE CONDUCTED CURING RELATIVELY DRY PERIODS TO KNI%DZE SOIL SMEARING AND PLAN BASED ON SURVEY EXCESSIVE $02. COMPACTION. BY H. I. BRIGHAM, L.S. 14. T 10 REQUIRED OEM Of FRI WITHIN THE SEWAGE TREATMENT SYSTEM AREA IS ' /.S FERT WSDCH APPROXIMATL'S TO IlO CUUIC YARDS. FOIL SHALL BE KUM ' ` OF BANS: DRIVEL SUITABLE FOR SEWAGE AMILMON. 80 TREE OF FINES OR OTIFA UNSUITABLE MATERIAL AND SIULL HAVE AN W -PLACE PERCOLATION KATE CULESIl1B COUSSLy UO.Pti umlotll, VL nbc"T:SI AT LEAST EQUALTO OR FASTER THAT THE NATURAL UNDERLYD:O SOIL AFTER THE REQUIRED STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHAW. .Sion of Environme tal Health Servi OH► PCRFORM A MINLMIUM Of TWO (2) PERCOLATION TESTS IN71IE FILL Mn-A GG STAD0.LZATION IS ACHIEVED. JiGp 17. FBI. SUITABLY FOR SEWAGE AD SORPTION SHOULD CONTAIN NO MORE TANS •Oved as' Oted lfor conformanoe with PERCENTAhDPREFFAADLYNOMOREntATIPERCEn FWESBYWEIGIR. FINES .ioable Holes and Regulations of the %IM CLAY A7•D SILT PARTICLES THAT PASS A nod SIEVE NOMORET1AN10 PERCENT BY WEIGHT OPTIC FILL MATERIAL SHOULD PASS A 9100 SIEVE. I= County 4a1th Departmmeennt. It. THP. PPERVInuSFR.LSI L1LL 6e A O1TSF. CLAY TYPO SOU. 1ATn1 LrM.F /tlt NO , . LL, i� �G) % �� +. • :R,a :.ula:;•Iw:•cereclrv. SEPTIC DESIGN • Pf •t.[C11K Mfg 1 ;�n•4 ,wR . .. ALL TREES ',IN IO FEET OF THE PROPOSED SUBSURFACE SEWAGE TREATMUT • SYSTGILSST1)SIIALL1ILR KF.MOVD. SSiT TO UE l> :SPECRiD U1' TIM UCENSLD DL'S104 PROFESSIONAL. AND THE PU TNA \I COLN N HEALTH DEPARTMENT AF[TA CONSTRUCTION-AND PRIOR TO BACKFILL • 7 7. TI SSTS AR?.151W.L BE ST AM AND ROPED OFF 30 TILAT NO TRUCKS, __ r r ••••••^ ••+ +•w MACHINERY. DU^--DL40 MATERIALS, NOR EXCA VATED LARTH SI WI BE ALLOWED 1 L Ln TIE SS:S .�'�•.ii. ::. 4 4. ALL EROS;ONCON`'AOLMEASURES SHALL DL INSTALLED PR10KTO STAKT01'ANY • —L• S CONSTRUCTION. ' tf cTaw .. 0. GOVk7tN =NTAL AGENCY. C011SIRtICr10M WCS FDA FaPA1C17C0 $ILI fC+C( 4 THE WEU. LT TO DE A DRD1YD%VELL, CONSTRUCTED IN ACCORDANCE WITH FEW • YORK STATE HEALTH DEPARTMENT DULLE(LV. ENTITLED *RURAL WATER SUPPLY% I. -"!:1[ FWA is K r"IC.CD Soxw It 1:'1 .GSIS Postt slim glImA•1• .1•u' PUMP TESTED FOR A AIMPNM OP I HOURS A. \D HAVE A MINIMUM SAFE YIELD 0P3 .Id -1-1 114 a 9101•11. 1+F[ a I• RRUiD•a0 GPML YIELDS LESS THAN S GPM µ916E IMMEDIATELY REPORTED TO THE PUTNAM . .. '. COUNTY DEMATNtiT OF HEALTH. 9. /m1G tied 70.9[ 10 M 1011Wm 1[aF4MT la .era rt4 .1 'liq , .O+f+..i M. ;l, IR {..' _ /riot stet Stu tr0[up [ru+ s. ti uv .ro uo state +. 9T w..t�l a+t:nt � 7. THE SSTS DESIGN SNOWNIaREON DOES NOT PROVD)E FORbE C�STALL-A4ffO.'% OF n - UN K GARDAGE OXNMER'L sucH Los rALLAnoN REOULRM ADOMONAL DESIGN ANO nDi s. ?`W` S IS alt tr 101.11:1 I WS t•oR etil. flLi(R cLOI D r.1.1 a APPROVALOFTIMPUTNAMCOV TY DEPARTM_4TOF IM4t.TN. 1wA ewu 9[ e.ua.vm a ua l +ae1 .Ra Farm. .Iti•R ... .. IA0) t..a•.: :. :.1, tv., t. PUITAN CV!.1TY HEALTH DEPARTMENT APPROVAL IS DAIED ON THE LOCATIONOF. 4, I,4ML U µLL M PtlVeA.[3 u NCOCO 00 uTW.L PAErABAICAIEO L'n11: Iz7,L THESSTS. W-4_1 BVG.DNO. SETBACKS, AND DRSVEW'AYS AS SHOWN ON THE Pw +fO -0 •9mt[t• DtK1V t. I c 110 Foci APPROVE?ruw NO. MODIFICATIONS MADE TO THIS DRAWING AFTER THE DATE • ,• tCi1i. OF PUTNAM COL'YCY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL 9. M OR FILR is NOT PEUIrrrED THE SSTS APIA. EXCEPT P SO SPECIFIED ON TUS V. t. LV,AI.rMi W OAI[1A11Nt tl W,'.Iq t•VDL PLAN. 160 CWtWIIJ0t UA,Ht I S 11, T FENCE 10. AFTER BACKFILLLNO THE SYSTEM, THE SSTS AREA SHALL BE COVERED WITH A ' Slumt. KV . 1W - MLNUCUM OF 6INCHES OF TOP SOU, SEEDED, AND MULCI LED. • S' oCNPANCY OF nus STRUCTURE WILL. NOT DE PERMITTED UNTIL. THE CONSTRUCTION COMPLIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNAM COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BUO.DINO INSPECTOR OF THE RESPECTTVE MUMCPAUTY AS PART OF THE 10 LATERALS Q 34• ' \J� CFATFICATE OF OCCUPANCY APPUCATION. �K " TITS ALL PL�N OT ER REVCDFORSE1,03AN RAPPR ANO✓SA ETEREPPL \'ONLY. AND ALL OTHER REQUIIIED PERMITS AND/OR APPROVALS ARE THE RESPONSIBILITY Or TUC PERMTTEE. 11. 71M PV NA.M COUNTY IMALTI I DEPARTSENT APPROVAL EXPIRES TA'O(7) YEARS 740 FROM THE DATE 0471 1E APPROVAL STAMr AND 13 REQUUMD TO OE RENEWED ON ORUFlORETHEEXPIIATIONDATE TILE APPROVAL IS REVOCABLY FOR CAUSE OR MAY DE ANff.NDED OR MODIFIED WILE : NECESSARY OP TUS DEPARTMtCAT. P�ZTT'T'OF i}lC- VHDKiUR91OV4OeKM4O" = ' 13. SfTEMtODtnCAnONACnvR1ESL4VOLVINOPLACEMIFNTOFMLARETOBE CONDUCTED CURING RELATIVELY DRY PERIODS TO KNI%DZE SOIL SMEARING AND PLAN BASED ON SURVEY EXCESSIVE $02. COMPACTION. BY H. I. BRIGHAM, L.S. 14. T 10 REQUIRED OEM Of FRI WITHIN THE SEWAGE TREATMENT SYSTEM AREA IS ' /.S FERT WSDCH APPROXIMATL'S TO IlO CUUIC YARDS. FOIL SHALL BE KUM ' ` OF BANS: DRIVEL SUITABLE FOR SEWAGE AMILMON. 80 TREE OF FINES OR OTIFA UNSUITABLE MATERIAL AND SIULL HAVE AN W -PLACE PERCOLATION KATE CULESIl1B COUSSLy UO.Pti umlotll, VL nbc"T:SI AT LEAST EQUALTO OR FASTER THAT THE NATURAL UNDERLYD:O SOIL AFTER THE REQUIRED STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHAW. .Sion of Environme tal Health Servi OH► PCRFORM A MINLMIUM Of TWO (2) PERCOLATION TESTS IN71IE FILL Mn-A GG STAD0.LZATION IS ACHIEVED. JiGp 17. FBI. SUITABLY FOR SEWAGE AD SORPTION SHOULD CONTAIN NO MORE TANS •Oved as' Oted lfor conformanoe with PERCENTAhDPREFFAADLYNOMOREntATIPERCEn FWESBYWEIGIR. FINES .ioable Holes and Regulations of the %IM CLAY A7•D SILT PARTICLES THAT PASS A nod SIEVE NOMORET1AN10 PERCENT BY WEIGHT OPTIC FILL MATERIAL SHOULD PASS A 9100 SIEVE. I= County 4a1th Departmmeennt. It. THP. PPERVInuSFR.LSI L1LL 6e A O1TSF. CLAY TYPO SOU. 1ATn1 LrM.F /tlt NO , . LL, i� �G) % �� +. • :R,a :.ula:;•Iw:•cereclrv. SEPTIC DESIGN CONSTRUCTION COMPLIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNAM COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BUO.DINO INSPECTOR OF THE RESPECTTVE MUMCPAUTY AS PART OF THE 10 LATERALS Q 34• ' \J� CFATFICATE OF OCCUPANCY APPUCATION. �K " TITS ALL PL�N OT ER REVCDFORSE1,03AN RAPPR ANO✓SA ETEREPPL \'ONLY. AND ALL OTHER REQUIIIED PERMITS AND/OR APPROVALS ARE THE RESPONSIBILITY Or TUC PERMTTEE. 11. 71M PV NA.M COUNTY IMALTI I DEPARTSENT APPROVAL EXPIRES TA'O(7) YEARS 740 FROM THE DATE 0471 1E APPROVAL STAMr AND 13 REQUUMD TO OE RENEWED ON ORUFlORETHEEXPIIATIONDATE TILE APPROVAL IS REVOCABLY FOR CAUSE OR MAY DE ANff.NDED OR MODIFIED WILE : NECESSARY OP TUS DEPARTMtCAT. P�ZTT'T'OF i}lC- VHDKiUR91OV4OeKM4O" = ' 13. SfTEMtODtnCAnONACnvR1ESL4VOLVINOPLACEMIFNTOFMLARETOBE CONDUCTED CURING RELATIVELY DRY PERIODS TO KNI%DZE SOIL SMEARING AND PLAN BASED ON SURVEY EXCESSIVE $02. COMPACTION. BY H. I. BRIGHAM, L.S. 14. T 10 REQUIRED OEM Of FRI WITHIN THE SEWAGE TREATMENT SYSTEM AREA IS ' /.S FERT WSDCH APPROXIMATL'S TO IlO CUUIC YARDS. FOIL SHALL BE KUM ' ` OF BANS: DRIVEL SUITABLE FOR SEWAGE AMILMON. 80 TREE OF FINES OR OTIFA UNSUITABLE MATERIAL AND SIULL HAVE AN W -PLACE PERCOLATION KATE CULESIl1B COUSSLy UO.Pti umlotll, VL nbc"T:SI AT LEAST EQUALTO OR FASTER THAT THE NATURAL UNDERLYD:O SOIL AFTER THE REQUIRED STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHAW. .Sion of Environme tal Health Servi OH► PCRFORM A MINLMIUM Of TWO (2) PERCOLATION TESTS IN71IE FILL Mn-A GG STAD0.LZATION IS ACHIEVED. JiGp 17. FBI. SUITABLY FOR SEWAGE AD SORPTION SHOULD CONTAIN NO MORE TANS •Oved as' Oted lfor conformanoe with PERCENTAhDPREFFAADLYNOMOREntATIPERCEn FWESBYWEIGIR. FINES .ioable Holes and Regulations of the %IM CLAY A7•D SILT PARTICLES THAT PASS A nod SIEVE NOMORET1AN10 PERCENT BY WEIGHT OPTIC FILL MATERIAL SHOULD PASS A 9100 SIEVE. I= County 4a1th Departmmeennt. It. THP. PPERVInuSFR.LSI L1LL 6e A O1TSF. CLAY TYPO SOU. 1ATn1 LrM.F /tlt NO , . LL, i� �G) % �� +. • :R,a :.ula:;•Iw:•cereclrv. SEPTIC DESIGN Public Health Director Date: P L It t r- LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT ®F HEALTH 1 Geneva Road . Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (FAX COVE Fax (914) ET 6085 Fax #: Z c5 — to Into. Pages �Q (Including cover sheet) Prom: Adam B. Stiebeling Asst. Public Health Engineer ..._ _._ : _.... For your information _ . ... _ . Please resp6nd IFok, your review Attached as requested /discussed Please call Notes/Messages C I LSO In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 157. Public Health Director April 9, 1999 -,.._ iL TT.A ,MOLINARI R.N.,, M.$:N.,;, Associate Public Health Director Director of Patient Services DEPAR'T'MENT OF HEALTH 1 Geneva Road Brewster, New York 10509 . Environmental Health (914) 278-6130 Fax (914) 278-7921 Nursing Services (914) 278 - 6558: Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Fred Zenz, PE 292 Main Street . Nelsonville, New'York 10516 Dear Mr. Zenz: C. Re: Carlson TM# 94 -14, Lot 503 Town of Putnam Valley I was requested by Hekla construction to conduct a "fill" placement inspection on the above referenced project. This letter is inform you that the fill material placed in the proposed expansion area, as shown on both approved plan and "Preliminary As- built" is not of ROB quality, as specified on the approved plan. I have fe -uestedTr rrf the- p"fo' ei-t testing of material to'vefif " soil gradation. I request you, as design engineer, to assist your client to obtain a sieve analysis from a NYS Certified soil sample lab. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. ABS:cj Very truly yours, C4" . Adam B. Stiebeling Assistant Public Health Engineer -BRUCE R . 6L*EY -_ Public Health Director \UP Uv (,k DEPARTMENT OF 1 Geneva Road Brewster, New York -.. LORETA- :N0L1,NAMI PUN.., tY1:sR� Associate Public Health Director Director of Patient Services HEALTH 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 To: Fred Zenz � n� From: Adam B. Stiebeling, APHE Re: Carlson Septic - PCHD # PV -67 -86 (� Date: April 8, 1999 As per my filed visits as listed below, I offer the following comments: Field Visits: April 2, 1999 with Mr. Fred Zenz, PE April 8, 1999. with Hekla Construction Visit - April 2, 1999 * Received copy of "Preliminary As- built" A. * Inspected deep test holes "- - -- 'Restilts- - Four feet-(4' t) of miscellaneous fillused over,original-(existing) grade. Fill contains "rock" 12" f and smaller. B. Erosion control. measures not in place. C. Relocation of drive had begun, but not completed. D. Proper separation distances from drive to start of trenches not met. E. Proper separation distance from trench to tip of fill not met. Visit - April 8, 1999 Inspected placement of fill as required for SSTS as shown on "Preliminary As- built" plans, (no date) prepared by Fred Zenz. * Quantity of fill is inadequate for "proposed" expansion area as shown on "Preliminary Plan ". * Quality of fill not ROB as required and specified on SSTS plan approved by PCHD 10/7/98, Permit # PV- 67 -86. * Depth of fill greater than 1.5 feet. Memo-- Zenz/.Carlson., Page 2 April 9, 1999 Phone Conversation - April 8-1-1999 at apuroximately_ I3 :30 um with Mr. Scott Carlson. * Explained above field visit and requested sieve analysis of "fill" to compare to PCHD construction note spec's. Stated ROB must be placed as shown on approved plan. * Miscellaneous fill can be used as borders and transitioned back into existing grade. Attempted to contact engineer, Mr. Fred Zenz via phone, no success. Copies of approved plan attached. ABS:cj cc: Scott Carlson File s Y rer 1.eye ee.e. � final grade to be eq` existing grade duo tc (� a�',.• • i Qraae of surface bo i ;4 Proposed . ez ' < IS• v8 which cover s;ioM {Jewel wlw-'an) '4" to51 iron Septic Tank � � P— final - Sealad pipe @ 1/4" per 11. 82O' ' loieh •. grade �� 819' l h rcleon Botos �y 4 R.O.E. "AVeL F . ELI tcc note c SYSTEM PROFILE 1 101 loo,; ExFA�,; "' AfiE'C HORIZONTAL 8 VERTICAL 12* co— bee Bose, to be set ' 4s11 bed of pea grace, -' -ad 1.18.4 to a mi.tmsen 6' be,o. grade. oaaa`' iaad1l>,KE ?ARK -ption trenches start 8 .,on. box j first 2 r to ROAR \N 517 ` ,lid pipe N'F 516 9a5', tz ° °° j��'�-� v i 840'.`1'3 ��30 • N 25' `'\ `` , • Y,. ✓•e�.l w,. ,may � aI 835'. 103' to ... .. abs. fields AREA: .614 ocres f v [Ox:TRJCTICN Na' 870' PROPOSED w N S BEDROOM H` s• •]'c`!x rbct t1 u rustw uaral •. N ••..' ': ... •lal e1K T1G a e1Ntt. RE N ,._: _., .. ... _...... ,.... .. ... ._. ... _- .._. -•-- --.. _.... be!1. _-- r - ..... X502 .�_ `.. ,t cola Tl et aau vs,t.tr staann .. _ .. ... .. _ ..... SID ENC E a.asN ' rt•tt'I N ?Its —co bar 8'. ' 825' Butler N/F FUNK ]. nt„•Tq U9IJW V r1Ua 117. a I. t (rocant land) s«n esa, et e.tWra] n at 1+a13 e.e �� Mel�'1(/,u✓.( Wu at ILY Y,v'] e3 •ttcta'. 'I a NN.f] ewe •""I, a,lkw a In( 1111 i 504 ezt 1 s a s N/F GAZZO 3f A.0.8 fill o. t. wn y 819' IOW «•.8s ����. —�/ e.V n4TVtt 0 'sq. H. silt UoJINello, sa,tll I sit. lS' I (vacant land) 817' 3 1 deep naarsc 0" 'vox 0 /osz ago iK -IS'•. BIS' -„ _ elen aroe i CD BID, �C • 1 _ _ ..1 10 LATERALS 0 34' L �C \ 803' 180',0 a41fin, �4 ,'�•`f"_J .,�� yell p ` 145' to etleling SSOS SILT FENCE (lyp) \\ (� ">f L 1 800' "Bg"( ��}^$ -•- .tea- ,:.r -i.= NL 785' ;0 E ` r / v PLAN BASED ON 11.3Z" /� By H. I. BRIGHAN FO CLLLila8 L 1 UOLU1Gy C,pgar,Wo,IIg, VL a 7� (� p,K� revision of Envlronme tal Health ipproved as oted for conformanoe t, i plioable Rules and Regulations c P tnam County alth Department. l N/F CHNEIDER _ (Vacant Tana) 'c OT'4+?ttw T .le T10 r)FCIr_At__ _ne r� r• 0 final grade to be equal to existing grade due to required removal of surface boulders which -cover proposed.Beptic, area 019 1; R.O.E. GRAVEL FI_L ice. tee note Bb::, AkEC � r • rt +fr[Ur.f vrh. 1 0 'uateT � 815 I � � 0 a 0 to ` i 0 I W � r OPe P . LOCATION MAP 1 20001 1,•,,, „•tl ,,„ .. AU TREES WTTHC,N 10 FEET OF TICE PROPOSED SUBSURFACE SEWAGE TREATSICLT _ SYSTEM (SS" I) SICALL BL' RENIOV[D. SS) S TO BE L-31 IL'D BY TILE LICENSED DESIGN PROFESSIONAL AND THE PUTNAM COLN'TY HEALTH DEPARTMENT AFTER C:ONSTKUCTION•M'D PRIOR TO BACKFILL Ir' M ' 3. TI'_^ SSTS AREA SI WI. BE STAKED AM ROPED OFF SOTIIAT NO TRUCKS, ^ „e, ••••••• ••w MACH STAY. DUC.D:NO MATERIALS, NOR EXCAVATED, EARTH SILL. BE ALLOWED LN THE SSTS AREA. "' {'`1t. n ^• A. ALL EROSION CONTROL MEASURES SHALL BE INSTALLED PRIOR TO S1 01 ANY _.1'.n ..... CONSTRUCTION. . -l• I. CONSTRUCTION OF SSTS TO BE LN ACCORDANCE WITH THESE PLANS. A_ \'Y nwV RVASIONS THFAETO, AND THE RULES AND REGULATIONS OF THE PERMIT ISSUING . 0O\t7tT. ?(E.TAL AGENCY. C0147TUCTION IMICS FOn F.FRICAICo SILT FERC( 1. TE? 14FLI. IS TO DE A DI 1 rn WELL CONSTRUCTED IN ACCORDANCE WITH NEW YORK STATE HEALTH DEPARTMENT BULLETIN, ENTIT(ED-RUKAL WATER SUPPLY. ' I. VTWA!: I I LACC 10 K FaSII C2 SC W;MT IC l:r:C eCI II POSTS: {II6 1111A •1' to •V' II TESTED FOR A MINIMUM OF S HOURS AND HAVE A NUNLMUM SAFE YIELD OF S .Jr. r1.0 TIES ON {l./u{. 1109 a V w 402 GPAL YIELDS LESS THAN I GPM WILL BE O.0,1LO ATELY REPORTED TO THE PUTNMI • _ t. �PRlp SOTM Tt K le, K /Ll(wtD {eM6T Tt earl. vlM F(NC[: .T4 .11Y, 1• IR C.. .. c .. 1. . OPIiP ILT}L " .• ILA CC 1IU SI 1.CA1 I,- It 101 . x0.10111 v..A..9•.r o•9.t.1 7. ,a SSTS DESIGNSHOWN HM04DOES NOTPROVWE FOR!rNi INSTALLATION OF GARDAGE GR.'\DPA SUCH INSTALLATION REQUIRES ADDITIONAL DESIGN AND TIE 'UNK s. VC44.0 CCC•Itw d FILICA amO.tI-o1N 1.C. a.n P11610 CLOIK / 110 k v7ROVALOFDL: PUTNAMCOUPTYDF ►ART'_'"FFDFliLALTH. tAn /A•1a 1t 1•rA.rr91 91 u. IIII ..o /gwt1. •1..•1 • . 1 ^A i lr•0..a . ::.t: 9:... 1. PUTNAM COI HEALTH DEPARTI TENT APPROVAL IS BASED 04 THE LOCATION OF- 4. ^.Cnt"C9 JI U KAIGIVC3 as wat0 Ale "11,114 PAVABaICATCO U11: 917.L THEE SSTS. V67" DUWNG. SETBACKS, MD DRIVEWAYS AS SHOWN 04 THE we.tl.vA •tI atrnw 4r ur9 III• /C.CI 4rIAY9ti9 p YM,•+t0 APPROVEDGR;kwNO. MODIFICATIONS MADE ToTIGS DRAWING AFTER THE DATE tov.l OF PllSNAM COMITY HEALTH DEPARTMENT APPROVAL VOIDS SAID APPROVAL 9. M OR FILL IS NOT PE0.4I1'11D TIM SSTS AREA. EXCEPT IF SO SPECIFIED ON THIS V.I. CCPM144 W 0A1C%LT%OI {IYOW X.41 PLAN. dAClwlur.tsorsamt I 510 FENCE 10. AFT EABACKF41LN0 THE SYSTEM THE SSTS AREA SHALLBE COVERED WITH A �10.onL rH •1 )•L'\'%NM OF (INC HM OF TOP SOU. SFFDED, AND MULCHED. 1:. OCCUPANCY Of TI IS STRUCTURE WILL NOT OE PERMITTED UNTIL THE CONSTRUCTION COS?LIANCE APPLICATION HAS BEEN RECEIVED AND APPROVED BY THE PUTNAM COUNTY HEALTH DEPARTMENT AND FORWARDED TO THE BVE.DDIO INS7ECT00. OF THE RESPECTIVE I(UMCIPALITY AS PART OF THE 10 LATERALS Q 34' CERTIFICATE OF OCCUPANCY APPLICATION. [2 AND PLANT ER )PROVED FOR SEWAGE TREATMENT APPROVALS ARE SUPPLY ONLY, AND ALL OTHER REQUIRED PERMITS ANDHOR APPROVALS ARE TFOL RESPONSIBILITY GFTi(EPEFUd.TEL 7406)&b 17. THE PURIM COUNT HEALTH DEPARTf.IENT APPROVAL EXPIRES TWO (7) YEARS W FROM TILE DATE ON TI LE APPROVAL STM9• AND IS REQUIRED TO BE RENT WED ON OR BEFORE THE ESLPUTATION DATE TICE APPROVAL IS REVOCABLE FOR CAUSE OR MAYBE AMENDED 0,2 MODLFtW WHEN NECESSARY OP THIS DEPARTMEN r. .•Y�FB. •EO!' 'f O1ftCKtL7TSTCtittRTPICORZIOlTC -0171 TSIF 4 M.YNDISiUR9ED•HHDeKtTtNGI 11. SITE MODIFICATION Acnvrnes INVOLVING PLACEMENT OF FILL ARE TO DE CONDUCTED CURD:0 RELATIVELY DRY PERIODS TO MINUOU SOIL SAffARB.D AND PLAN BASED ON SURVEY EXCESSIVE $03.COMPAcnoN. BY H, I. BRIGHAM• L.S. 14. TIRERC•QUIRFD DEPTH OF FILL WRHUN THE SEWAGE TREATMENT SYSTEM AREA IS /.S FEET WHDCHAPPROXIFIATLLS TO 2)o CUDICYARDS. FOLSIALLUBRUN • OF 13ANK GRAVEL SUITABLE FDA SEWAGE ADSORPTION. BE FREE OF MW OR CITILER UNSUITADLE MATERIAL AND SHALL HAVE AN D.•PLAC C PERCOLATION RATE t LLLLIltlll (iO4IlT:y UGyIt.1'LWgA11. 1JL nb1aL 11D AT LEAST EQUAL TO OR FASTER THAT TILE NATURAL UNDERLYING SOIL AFTER THE REQUIRED STABILIZATION PERIOD. THE DESIGN PROFESSIONAL SHAM .Bion of Envirorme tal Health Servloet PCRFOMJ A MINIMUM OF TWO (2) PERCOLATION TESTS IN THE FILL AFTIiA (� STABILIZATION is ACIDEVFD. J iGQT(L tLIl(� 17. FU SUITABLE FOR SEWAGE ADSORPTION SHOULD CONTAIN NO MORE THAN 'Oved as noted 'for conformanoe With PERCENT AND PRE"AAOLY NO MORE TItAT I PERCENT FINES BY'A IGIR. FINES Soable Rules and Regulations OY 9119 ,RLCLAY AND S7.T PARTICLES THAT PASS A 1700 SMYE NO MORE THAN 10 PELC04T DY WEIGHT OF TI M FILL. MATERIAL SHOULD PASS A 1I00 SIEVE. Lem County F alth Department. )I. SNP 1XVII IS Flu, S1 ALL BE A OITSF. CLAY TYPE SIN;. Wm1 Ln71.I'r111 NO /��r _ / 1. ':WiL.Ui::Ii l'i10:. CAPACITY. SEPTIC DESIGN . CAo-v .vkf Re.' (T) Dear 19 a. `� - �k,� Ok AtINT 5 f -:) r1c.. vv r Ott. 7 it !> 4)t-ve This officeyill continue its re%iew upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. .ABS:tn forml-r Oil e OV f"6;<r . ad Very truly yours, Adam B. Stiebeling, Asst. Public Health Engineer \ 5�. 11 -,"- -,-,A s _ .---- F1L�(StSt -,�� ..- _.�- <a'$"''._..___':_._ - - -- -lam -V � - ��v`�"t'! •-r;;' °(1 ------ - ------- ... ..... . .. IT... ........ .0 .. . . 99 7­ J/ gqg &J I .100, Or -- C,� -�-,° -AAA Ole. 0-1 1 I-, 1,S AA Qt Ca o ia fk�, Ina. 7 5> 45 i.- -LIM v A a Mt L C K\l v ?CMD A-, -43 . .. ...... .... . .. -Tb ..................... C- -_ -- - --- -- _ ------ - - ---- - -_ _._.__ . .. . ....... -1 0 BRUCE - R FOLEY> Public Health Director April 1, 1999 LORETTA . MOLINARI RN.,. M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 �n_ WIC (914) 278 - 6678 Fax (914) 278 - 6085 ° Mr. Fred Zenz, PE 292 Main Street Nelsonville, New York 1516 Re: Carlson, Oakridge Drive TM# 9 -1 -14, Lot #503 Town of Putnam Valley Dear Mr. Zenz: As per our field meeting last Tuesday, March 23, 1999, I am writing regarding the following comments, as discussed. *Also., please reference my comment letter of March 22, 1999. 1. Fred Zenz, PE to prepare plan showing: a. Additional fields (reserve) required. _ b. Proper separation distances from drive and top of slope. Plan to be submitted to PCHD prior to additional field inspections and issuance of Certificate of Compliance. 2. Contractor; Hekla Construction to contact PCHD to arrange a field inspection to verify: a. Depth of fill over the proposed expansion area. b. Type of fill used in expansion area. C. Deep test holes to a depth of 7+ feet are required. d. Cleanliness of inside of septic tank baffles. e. Completion of erosion control measures. f. Relocation of drive to gain minimum separation of 10 feet from the drive to the proposed "reserve" trenches. g. Proper separation distances (setbacks) from top of fill and tree(s) to trenches, primary and reserve. Zenz - Carlson April 1, 1.999' Please contact this office to schedule a field inspectio In. A Certificate of Construction Compliance can not and will not be issued until such time as above stated comments are completed. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj L­� ,'-h . -BRUCE R.: `FOLEY ": - - .:,...._ . Public Health Director April 1, 1999 fi-P6 /,--? LORETT7i• •MOLINARi Associate Public Health Director Director of Patient Services DEPARTMENT OF BEA,TH 1 Geneva Road Brewster, New York 10509 `ap Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Mr. Fred Zenz, PE 292 Main Street Nelsonville, New York 1516 Re: Carlson, Oakridge Drive TM# 9 -1 -14, Lot #503 Town of Putnam Valley Dear Mr. Zenz: As per our field meeting last Tuesday, March 23, 1999, I am writing regarding the following comments, as discussed. *Also, please reference my comment letter of March 22, 1999. 1. Fred Zenz, PE to prepare plan showing: a. Additiorial`fiel'ds (reserve) required. b. Proper separation distances from drive and top of slope. Plan to be submitted to PCHD prior to additional field inspections and issuance of Certificate of Compliance. ' 2. Contractor; Hekla Construction to contact PCHD to arrange a field inspection to verify: a. Depth of fill over the proposed expansion area. b. Type of fill used in expansion area. C. Deep test holes to a depth of 7+ feet are required. d. Cleanliness of inside of septic tank baffles. e. Completion of erosion control measures. f. Relocation of drive to gain minimum separation of 10 feet from the drive to the proposed "reserve" trenches. g. Proper separation distances (setbacks) from top of fill and tree(s) to trenches, primary and reserve. - Zenz - Carlson April 1, 1999 Please contact this office to schedule a field inspection. A Certificate of Construction Compliance can not and will not be issued until such time as above stated comments are completed. ABS:cj Very truly yours, CO Adam B: Stiebeling Assistant Public Health Engineer BRUCE Public Health Director April 1, 1999 :...: LORETTk MOLINARI- R.N -.,-,,M.S:N. Associate Public Health Director Director of Patient Services DEPARTINEN T OF BEA,TTT 1 Geneva Road Brewster, New. York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 CO, Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Mr. Fred Zenz, PE 292 Main Street Nelsonville, New York 1516 Re: Carlson, Oakridge Drive TM# 9 -1 -14, Lot #503 Town of Putnam Valley Dear Mr. Zenz: As per our field meeting last Tuesday, March 23, 1999, I am writing regarding the following comments, as discussed. *Also, please reference my comment letter of March 22, 1999. 1. Fred Zenz, PE to prepare plan showing: a. ` Additional fields (reserve) required: ` b. Proper separation distances from drive and top of slope. Plan to be submitted to PCHD prior to additional field inspections and issuance of Certificate of Compliance. 2. Contractor; Hekla Construction to contact PCHD to arrange a field inspection to verify: a. Depth of fill over the proposed expansion area. b. Type of fill used in expansion area. C. Deep test holes to a depth of 7+ feet are required. d. Cleanliness of inside of septic tank baffles. e. Completion of erosion control measures. f. Relocation of drive to gain minimum separation of 10 feet from the drive to the proposed "reserve" trenches. g. Proper separation distances (setbacks) from top of fill and tree(s) to trenches, primary and reserve. Page. 2 Zenz - Carlson April 1, 1999 Please contact this office, to schedule a field inspection. A Certificate of C . onstruction Compliance can not and will not be issued until such time as above stated comments are completed. ABS:cj Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer. �:.. «:., ,.....:. BRUCE Public Health Director April 1, 1999 LO. RETTA ..�MOLINARI.R.N..,..;VI.$N._ Associate Public Health Director Director of Patient Services DEPARTMENT OF BEAT H 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Mr. Fred Zenz, PE 292 Main Street Nelsonville, New York 1516 Re: Carlson, Oakridge Drive TM# 9 -1 -14, Lot #503 Town of Putnam Valley Dear Mr. Zenz: As per our field meeting last Tuesday, March 23, 1999, I am writing regarding the following comments, as discussed. *Also, please reference my comment letter of March 22, 1999. 1. Fred Zenz, PE to prepare plan showing: a.. 'Additional fields-(reserve) required. b. Proper separation distances from drive and top of slope. Plan to be submitted to PCHD prior to additional field inspections and issuance of Certificate of Compliance. 2. Contractor; Hekla Construction to contact PCHD to arrange a field inspection to verify: a. Depth of fill over the proposed expansion area. b. Type of fill used in expansion area. . C. Deep test holes to a depth of 7+ feet are required. d. Cleanliness of inside of septic tank baffles. e. Completion of erosion control measures. f. Relocation of drive to gain minimum separation of 10 feet from the drive to the proposed "reserve" trenches. g. Proper separation distances (setbacks) from top of fill and tree(s) to trenches, primary and reserve. J �� •�tl Zenz - Carlson April 1, 1999 Please contact this office to schedule a field inspection. A Certificate of Construction Compliance can not and will not be issued until such time as above stated comments are completed. ABS:cj Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ----------- Ss cc �- (No __ ✓ 1. A s`4�D �� ��S— 'D_�..� i . ` `e ALL �fz 6 Vri�a i� ► plaft-A l " cr- Co v � lNl LL. -o_rrc, �T� kk15 �►tcy+'ttL►�-c �T�LG�e Ltt< �� _ BRUCE R. FOLEY. Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services E 204 191 I have completed a "final" site inspection of the septic, well and house on the above referenced lot on March 18, 1999. The following items require your attention and that of the owner /contractor. System (SSTS) is not constructed according to plan. ` 1. Depth of fill is greater than shown on plan. 2. Material used as fill is not as required on plan. _-� I Separation distance from the drive to the end of trenches is not 10' as required. d§Pparation distance is not 15' from property line to end of trenches, as shown on plan. LSe*Virst two (2) feet of trench is not solid pipe, as specified on plan. (�>rosion control measures have not been provided for. 7. The use of "rock" fill is not permitted under area of SSTS. — ¢' (✓+ dequate area for 100% expansion is not provided. J .9. oncrete spillage/baffles in septic tank need to be.cleaned. Please contact this office to conduct an additional site inspection. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. / 7, ABS:cj Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer DEPARTN ENT OF REAL TH 1 Geneva Road Brewster, New York 10509 Environmental health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 March 22, 1999 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Mr. Fred Zenz, PE 292 Main Street Nelsonville, New York 10516 Re: Carlson, Oakridge Drive TM# 94-14, Lot #503 (T) Putnam Valley Dear Mr. Zenz: E 204 191 I have completed a "final" site inspection of the septic, well and house on the above referenced lot on March 18, 1999. The following items require your attention and that of the owner /contractor. System (SSTS) is not constructed according to plan. ` 1. Depth of fill is greater than shown on plan. 2. Material used as fill is not as required on plan. _-� I Separation distance from the drive to the end of trenches is not 10' as required. d§Pparation distance is not 15' from property line to end of trenches, as shown on plan. LSe*Virst two (2) feet of trench is not solid pipe, as specified on plan. (�>rosion control measures have not been provided for. 7. The use of "rock" fill is not permitted under area of SSTS. — ¢' (✓+ dequate area for 100% expansion is not provided. J .9. oncrete spillage/baffles in septic tank need to be.cleaned. Please contact this office to conduct an additional site inspection. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. / 7, ABS:cj Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer � f ` . t <.t U tll ; 0 I � � t a E 3 ; � a � 0 F e a tl m 3 i CD rF Al N ' r ,.n N m a U U 0 QI 0 I L E 3. a 0 F a v 3 h In 7 I H 0� I I 7 Q J t UVINGARCA m mgft P TTNAM COUNTY DEPARTMENT OF HEALTH WOUSE PUYS APPROVED FOR BEDROOM COUNT ONLYa IBB ROOMS Signature & Title r- - -- - jDa$e T M -A ji UVWM AREA PUTNAM COUNTY DEPARTMENT OF "MALTH ROUSE PLANS APPROVED FOR BEDROOM COUNT ONLYD -.ZBEDROOMS Signature & Thule Date ��s e:.`,�CZ� �'�r���� R4 A t, Y4'k W t 3 �\ l � D• IRA" � � ��t�l�"�L .a -C• �' y�- Ei��," �.'• �'�'s`a -' 4"1>�i�,... � v-H,�'� t, �'��" ?�Z,� i'��.� �•s� "�'�i? -SS^- '��'Cr',� Rum ':r� -.�`�x�,. 4c a• '�CX La r { �`"�-or".r� . �f•,r: -„..i x � s��!a` �Ti . �,. � ;'N^. ��,` L�/C1.r$,t' 3�2 � '„�'} � � 0 "�..� F �NF r/S�F .� �''' ;s�+"�'aem:i°r�• R-u ,.��� �.O�. A+?rYtz:F. �R � /p Y=- �sG '�-A; Xr E zor 330 �: s '� ^. -}' a �. - t s:. ;, ��"`J�r'r � : , r •:` 'rt�t 1 i� ' . , • , /ZO -OO , 74 ES 3iT' G `�+'`''lOmry4,� .y dr3f�n•`}ir ..ti'' E k, - � - l �...... . _._ .__..._ . `. a e. .., ...... _. .... 3EPAi?ATION ' DISTANCE • i t 3 � e e s e' a �o u " 2 tt5 31.f 37-13 ys zl 30 1s 41 4' 7.13 30 to 3 qos Yf SI V7 st sss 60 6 3 C I � - 12 / mar a 13 \ ` ` f \ � � 19 -''- , lovi • Is AS -BUILT SEI prepare CARLSEN R] OAI�RIDGE DRIVE rusiam coon TOWN OF PUTNAM VALL 4vie1 on "i o ��►Psro mental aenith s6mae, PUTNAM VALLEY, N.Y. p` sDProv@d ae noted for ooffioreanoe with �1 aD$iloeble 8ulee end BeguLtione Of tb Putney �01mtY Hail Dey�9IILa �a;•., � .,,f.: s -ti f - ..I� �ifi4' "S8 i u� ^ / .G•R+" J f... vt r ... '.hsti.`G3wzxtk1 >< . .� .. _ - - -Fa �.'`�r --• �{ h` -''�� v'.+�'�iRRatUle a! T1 *1�► � � -,.-.: � - - • SEPARATION` DISTANCES.: -IN-. ,-FEET- 3 4 3 6 7 6 9 10 1f 12 13 14 15 16 17 is ff3 45 i3 SQ 35* 41 49 63 68 6*7 77- 79 35.s -Wj yf V 41 s z os Go AIJ ki AS BUILT- .SEPTIC PLAN prepared for ENC, E-- 0` i'G-- -E-i"DRIVE ' *SCALE: TQ".0FPUTNAMVALLEY 4/16/ 99 to -urviow p V EY N.Y �TM: 41.5-1 -9 lia...... .... M3084--- 0T:S03'',t Y NP IMMIR.".1 U. KA �-lwv m