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HomeMy WebLinkAbout2275DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -2 -61 BOX 20 rs .. a him '1 F lk ' I� r .T .� ti. 02275 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health T LORETTA MOLINARI, RN, MSN Y.. -...�> Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 October 14, 2009 Michael Beyer, PE Beyer & Associates 273 Starr Ridge Rd Brewster, NY 10509 Dear Mr. Beyer: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed SSTS Repair for Burkhardt at Holly Street (T) Putnam Valley, TM #41.6 -61 &62 This Department has received and reviewed the submitted trench plans for the above referenced project and the following comments are offered for your consideration. The location of the percolation tests in the ROB fill -pad are to be. identified on: the .plan. . t/2. The submitted percolation test data indicates a percolation rate of 10min/inch although �' the fill certification note on the plan specifies a rate of 3 min/inch. 1/3. The absorption trench detail is to be revised to show the trench bottom and perforated pipe being installed level for a dosed system. 4. The submitted plan does -not provide for _100% of absorption system reserve laterals:,:;;�:.:;� Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:lm Respectfully, Michael J. Director of Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 � _ �, -�: '= 'd.— aa;_.a —= to - =. �c —= m � -cn �i =�z: 77 77T , " ' `273 Starr Ridge Road TeL (845) 278 -6212 Brewster, .NY 10509 Fax. (845) 278 -0403 May 28, 2009 Mr. Gene Reed Putnam _County Department of Health 4 Geneva Road Brewster, New York 10509 Re Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot 61 & 62 Dear Mr. Reed, Enclosed please find a copy of the following items for your review and approval for the enclosedPermit application: • Construction Permit for Sewage Treatment System • Plan and Profile - Separate Sewage Treatment System - Trench Layout last revised 9128109 (4 copies) Design Data Sheets for Fill Pad Percolation Tests. I trust the above materials are adequate for your approval and complete the submission for the above project, However ifyou have any questions concerning this project, .please do not hesitate to. call me. Very truly yours, Michael Beyer, P Project Manag Owner PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA:SIIEET - SUBSURFACE SEWAGE_ TREATMENT SYSTEM Mark Burkhardt Address 16 Holly Street, Putnam Valley Located at (Street) Lake Shore Road Tax Map 41.6 Block 2 Lot 61 & 62 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre- soaking 9/17/09 Date of Percolation Test 9/18/09 Hole No Run No. Time Start — Stop Elapse Time (lvlin•) Depth to Water From Ground Surface (inches) Start Stop Water Level Dropp, in Inches Percolation Rate Min/Inch P -1 1 9:54 -10:00 6 23" 29" 6" 1 2 10:01 -10:04 3 23 26 3" 1 3 10:06 -10:09 3 23 26" 3" 1 4 5 P -2 1 9:55 —10:25 30 23" 20" 3" 10 2 10:25 - 10:55 30 23" 20 ".... 3 10 3 10:56 -11:26 30 23" 20" 3" 10 4 5 1 2 3 4 5 NOTES: 1. Tests to be reheated at same death until anmroximateiv eaual nercolation rates are obtained at each percolation test ( i.e. 5 1 min for 1 -30 min/inch, 5 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. sole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. _ HOLE NO. HOLE NO._ G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5, 4.0' ..;� 4.5' - - 5.0' 5.5' 'a 6.0' ,aA 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Beyer and Associates Address: 273 Starr Ridge Road Signature_ Design Professional's Seal i� r 0 • ,; �� i '6y • D Owner PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF- ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET -SUBSURFACE SEWAGE TREATMENT-SYSTEM Mark Burkhardt Address 16 Holly Street, Putnam Valley Located at (Street) Lake Shore Road Tax Map 41.6 Block 2 Lot 61 & 62 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking 9/17/09 Date of. Percolation Test 9/18/09 Hole No. Run No. Time Start - Stop Elapse Time (Min•). Depth to Water From Ground Surface (inches) Start Stop Water Level Dropp in Inches Percolation Rate Min/Inch P -1 1 9:54 -10:00 6 23" 29" 6" 1 2 10:01 -10:04 3 23" 26" 3" 1 3 10:06 -10:09 3 23" 26" 3" 1 4 5 P -2 1 9:55 - 10:25 30 23" 20 ", 3" 10 2 10:25 - 10:55. 30 ..... . 23" 20" 3" 10 3 10:56 -11:26 30 23" 20" 3" 10 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. ( i.e. <_ 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch ) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' -9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. HOLE NO._ 3 .:C r Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Beyer and Associates Address: 273 Starr Ridge Road Brewster N.Y. 10509 Signature: Design Professional's Seal k SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINk=RI tN MSN Associate Commissioner of Health Micheal Beyer, PE Beyer & Associates 273 Starr Ridge Road , Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 Re: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health September 25, 2009 Holly Street (T) Putnam Valley, TM # 41.6 -2 -61 & 62 An inspection of the fill pad at the above referenced project has been completed. The following comments need to be addressed. Trench permit and plans must be submitted to this Department for final approval of construction prior to the installation of the separate sewage treatment system. Please note that field measurements by this Department in no way suggest the exact size, depth and location of the fill pad. It is the responsibility of the Design Professionatto_ensure. the constructicmat the above referenced project is in compliance with the approved plans. . If you have any further questions, please contact me at 845- 278 -6130, ext. 43261. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 SHERLITA AMLER,. MD, MS, FAAP ulv�,yt ROBERT J. BOND -I Commissioner of Health _ County Executive- ..z. LORETTA MOLINARI, RN, MSN ROBERT MORRIS., PE Associate Commissioner of Health Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York. 10509, June 11, 20.09. Beyer & Associates 273 Starr Ridge Rd Brewster, NY 10509 Re: Field Inspection Holly Street (T). Putnam Valley, TM # 41.6 -2 -61 & 62 Dear Mr. Beyer: The following comments need. to be addressed. 1. The quality of the ROB fill appears marginal. This Department is requesting the results - of a sieve analysis prepared. by an independent lab. 2. A 3/1 side slope needs to be maintained on all sides. If you have. any further questions, please - contact me at'(845) 278 -6130, ext. 2261. Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide GDR:kly Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION b JOSEPH GENE REQUEST FOR FINAL INSPECTION for; till l� All information must be fully completed prior to any Trenches inspections being made_ . PCI4D 'Construction Permit Located: -- Owner /Applicant ame: "AML 8UaVQ4,Aab"r _ -- TM W. Lg Block 2 Lo— t _.2 Formerly- Subdivision Name: R- CAR)AJG &Zc_,Qx t, /! Subdivision Lot Is system fill completed? �" _ lute: _ To Is system complete? 6 Date: Is system constructed as per ans . Is. well drilled? Date: d a k 9 Is well located as pot plans? Are erosion control measures in place? +� I certify that the system(s), as listed; at the above premises has been constructed and I have inspected and vexified their completion in accordance with the issued PCHD Construction Permit and _...__approved. plan -and the Standards;-Rules-and- Reg.ula�tions of -thy Putnarin -Cdtinty Department of Health. Date. / L% Certified by: PE i� RA sign Profess' al . Address; __.2 7 _ 5TJV/Z .Zf IX 17P ,efXAA76 I Lic. # 0 t S^% Comments: Form FIR -99 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Ru -,o 3 --v P Well°�cation - Street Address: - 1 ro Town/Villa"' -� %- [%tll,, Tax Grid # Map Block Lot(s) Well Owner: Use of Well: 1- primary 2- secondary Name: Address: e t M4b6/( larA hqr�� �� 14V //) -S lk�,i,a V&,Ite /v�7 Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment fRotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details. Total length a id' ft. Length below grade X& ft. Diameter _in. Weight per foot h -lb /ft. Materials: 'Steel _ Plastic _ Other Joints: _ Welded &-- Threaded _ Other Seal: _ Cement grout _ Bentonite Other Drive shoe: Yes &---No Liner _ Yes --No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test Bailed _ Pumped °� Compressed Air Hours Yield / O gpm Depth Data Measure from land surface - static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. If yield was tested at different depths during drilling, list: Date Welt Completed x-11Y�Z) 7 Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface c) (, p - -- -- - - _. -1 Feet Gallons Per Minute Pump /Storage Tank Information ` r Pump Type sy , 4Capacity Ss—, .., o Depth IA8D Model S Sa�Sr'� "%3'• Voltage a? d HP //Z- \5 Tank Typetvk aS b Volume Putnam County Certification No. Date of Report / Well Driller ( signI X 0 1 —69 I,/ "1` v 9 % 1401h: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller'ss Name Vevki q h k � h Signature: ,3 Address: /15-k A CL It r VW4 Date: x,4,1 'gh1 09 White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy- Well driller Form WC -97 The Putnam County Department of Health will not issue a Certificate of construction Compliance unless the above form is completed, i.e., a, legal E911 address is assigned by an authorized town official. This form is to be. submitted with the application for a Certificatc of Construction Compliance. (E911 �erfrm) PUTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT 5bi -o3-o ? Well'lLoeatHOn" Stree ddress: Jr Town/Villa /o -� ®ao �a�' Map Block Lot(s) Well Owner: Name: I Address: p M411 /3 U r /( 4 4 V- Oi 0 _f 4 M' 1/ S r �,t 4 4 0, Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details Total length _I IX- ft. Length below grade 3,® ft. Diameter L_in. Weight per foot 1,''lb /ft. Materials: "Steel _ Plastic _ Other Joints: _ Welded ✓ Threaded _ Other Seal: _ Cement grout _ Bentonite Other Drive shoe: Yes t--No Liner _ Yes `No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Yield Test _ Bailed _ Pumped ✓ Compressed Air Hours Yield / O gpm Depth Data Measure from land surface- static (specify ft) 3 ® During yield test(ft) Depth of completed well in feet ® ®� 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 V (, 10 306 G If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type 4 ,Capacity t- Depth 'a ISD Model J S a.S" /3 Voltage *?a O HP /-L- Tank Type tykd3'& Volume LJ�4'1' Date Well Completed Putnam County Certification No. Date of Report Well Driller (signa ) iNv i h: rxact location of well with distances to at least two permanent landmarks to be provided on a separate sheettplan. Well Driller's Name �OV_M&6 AAIewts64 Signature: Address: /15X Aotrctfst., �Lc v Date: White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 u PUTNAM COUNTY DEPARTMENT OF HEALTH -.,.- - " -.r:. - :; I N..OF= ENVIRONMENTAL�HEAETH .:.SERVICES. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # �;(Q) 2 Located at Town or ViRfiK - cr--W n Owner /Applicant Name C...'Kj IIA &D a Tax Map Block _ ° Lot !6% �6 Formerly Mailing Address Subdivision Name . .,y,(z IL, a- Subd. Lot # 2-5-7 , 2-60 Date Construction Permit Issued by PCHD Separate Sewerage System built by ,���J\ &,1AV-l-T1IA Address ,L�t, °r , N Consisting of Z `� Gallon Septic Tank and nI I J Other Requirements: Water Supply: Public Supply From Address or: Private Supply Drilled by 1'rt�,p p ,,�� �.i ivl Address T?Lalwy', Building Type ; ` =ft142 Has erosion control been completed? � Number of Bedrooms Has garbage grinder been installed?� I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: L Address P.E. R.A. �7y,-9 7 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. i Title: Date: copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 110V -14 -2003 08:44 FROM:H7MF 14835305 -18 T U :18452c'b436 P.1/1 ii s• •r p �1} ➢ �_,:.I �'t. � x ;,I •�`. 1, Y -,�i 1. ! ��. ` � � n,r � � � �`�: 1 �' y n t I,..i N GUARANTEE FEE OF SUBSURFACE SEWAGE TREATMENT S` YSTEM 1 I �mr Owner or Purchaser of Building Purchaser of Building Building Constructed by Location'. Stmet T map dock` Lot Tbwn/Village Subdivision Name � .& /a Building Type Subdivision Lot it I represent that i ant wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treaunent system serving the above- described property, and that is has been constructed as shown on the approved plant or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Vcpartrnent 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 61 lowing 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 opemte properly is caused by the wilI& or negligent act of the occ up Tit 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 whbther or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system, Dated: month iysy L5 _ Year _&,Q2 Signature: Title: Cerncral Contractor (Owner) -- Signature Corp;Wation Name (if coyporitron) AddressVZ5 / ZiP,� 6�iYA•A4ladiRl Corporation Name (if corporation) Addres5;l�fi' L` >�Cr�' `�.1.✓z i State t'i�J � a ..ziv,62 � � 7L,a�'l t' ��g.�ei / ' �' ! S / e'S'jd : lSsbIc �` c:T�C � old '��rC�° �ji �. 7�.� Farm GSA7 . 273 Starr Ridge Road Tel. (845) 278 -6212 Brewster; NY 10509. Fax.: (845) 278 =0403. December 7, 2009 Mr. Gene Reed Senior Public. Health Engineer Putnam County Department. of Health . 4 Geneva Road :. Brewster, New York 10509 . Re Marc. Burkhardt S Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot 61 & 62 Dear Mr: Reed; Enclosed please find the following itemsfor the above project: • Certificate of Construction Compliance application form • E -911 verification Form • Three.'(3) Copies of Guarantee of Subsurface Sewage Treatment System. • Well Completion Report • Water Analysis Report • Letter ofAuthorization is on file.: • Four (4) sets of As -built plans dated 61 %08 prepared by Beyer & Associates. • Application fee '.in amount of $300. 1 trust the above materials are adequate for your approval and complete the submission for the above project, . However, if you have any questions concerning this project, please do not hesitate to call ,me. . Very truly yours, Michael B4 r, P.E. . Project Manager - - — .... .:..- �...:.v.Y:..:��X1. 1lR COUNT' Dl:PAR-T-ME�IT-OF.ALTH ...:. t DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Marc Burkhardt Located at 16 Holly Street, Putnam Valley New York TN. T/, Putnam Valley. Tax Map # .41.6 Block 2 Lot . 61 & 62. Subdivision of . Roaring Brook Lake Subdivision Lot #260 & 259. Filed Map # 308 -E Date filed.. 7/18/46 . Gentlemen: This letter is to authorize Beyer & Associates Consulting Engineers. a duly licensed Professional Engineer . X 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 treatment 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. MICHAEL F. BEYER, P.E. #074597 Marc Burkhardt Mailing Address 273 Starr Ridge Road Mailing Address 16 Holly Street/ Bre®vster Putnam Valley State: New York Zip: 10509 State: New York Zip: 10579 Telephone: (845) 278 -6212 Telephone: cj 8 ? Form LA -97 a YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 .,�..._�., _ >.,..-- �,..r_ ,.�,,..a. -ro ¢...::...�..x�.: ,,.r..::, a. -• (91 �!-,,;� : 2 4 5,� =2- 8-0.9�,�..�_ .,...,�� -_.., b..,�, =.,.r� e.,.�.r,.,:r . -, -.�. , x.a_:. �,....�. _me .�.... -A �4, Albert H. Padovani, Director LAB #: 1.903753 CLIENT #: 2500 NON STAT PROC PAGE: 2 of 2 ANDERSON WELL DRILLING DATE /TIME TAKEN: 09/03/09 09:20 152.BARGER ST DATE /TIME RECD: 09/03/09 09:50 ATTN: NORMAN, SARAH REPORT DATE: 09/18/09 PUTNAM VALLEY, NY 10579 PHONE: (845)- 528 -1491 SAMPLING SITE: 5 HOLLY ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE KITCHEN.TAP PRESERVATIVES: NONE COL' -D BY: BEV CRONIN TEMPERATURE... < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD moderately restricted diet, a maximum of 270 mg /L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. _:....:SOFT:. WATER::: 0:- 7.0 MG /L VERY HARD...WATFR , ABOVE .3 0.0 MG L.. , MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER HARD WATER: 140 -300 MG /L (1 grain /gallon = 17.2 MG /L) THE ABOVE TEST PROCEDURES MEET ALL REQUIREMENTS OF NELAC, AND-RELATE ONLY TO THESE SAMPLES RECEIVED BY THE LAB SUBMITTED BY: (AW.,o ---p Alber H. Pa ovani, .T.(ASCP) Director FLAP# 10323 4 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 .,.= 48 -28�-0 Albert H. Padovani, Director LA$, t� jl/M903 ENTN #: 2500NNNNNN NNNNNNMNNONNSTAT�PROCNNNNPAGE: 1NofN2NN ANDERSON WELL DRILLING DATE /TIME TAKEN: 09/03/09 09:20 152 BARGER ST DATE /TIME RECD: 09/03/09 09:50 ATTN: NORMAN,.SARAH REPORT DATE: 09/18/09 PUTNAM VALLEY, NY 10579 PHONE: (845)- 528 -1491 SAMPLING SITE: 5 HOLLY ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE COLD -BY:. BEV CRONIN TEP�IPER TLT E:- < 4C _..._. NOTES...:'', COLIFORM METH: MF --------------------------------- - - - - -- ---------- ---- ------- ------------ - - - - -- DATE FLAG PROCEDURE RESULT PUTNAM CNTY PROFILE 09/03/09 MF T. COLIFORM ABSENT /100 ML 09/11/09 LEAD (IMS) <1 ppb 09/11/09 NITRATE NITROG 0.34 MG /L 09/04/09 NITRITE NITROG <0.01.MG /L 09/14/09 IRON (Fe) <0.060 MG /L 09/15/09 MANGANESE (Mn) 0.042 MG /L 09/15/09 SODIUM (Na) 90.5 MG /L 09/03/09 pH 6.4 UNITS 09/14/09 HARDNESS,TOTAL 232 MG /L 09/14/09 ALKALINITY (AS 72.0 MG /L 09/14/09 TURBIDITY (TUR <1 NTU NORMAL - RANGE ABSENT 0 -15 ppb 0 - 10 1.0 MG /L 0 -0.3 mg /l 0 -0.3 mg /l N /P, 6.5 -8.5 N/A N/A 0 -5 NTU waff l SM 18 -20 922213 SM 18 -19 3113B SM18- 20450ONO3 SM18- 20450ONO2 SM 18 -20 3111B SM 18 -20 3111B SM 18 -20 3111B SM18 -20 4500HB SM 18 -20 2340C SM 18 -20 2320B SM 18 (213'OB) COMMENTS: MFTC a Coliform = This result indicates that the water 44�ew (was not) of a satisfactory sanitary quality according to York State and EPA federal drinking water standard for this parameter. This comment applies to the Total Colif.orm test only. Pb /Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 100 of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg /L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet.the water should contain no more than 20 mg /L of Sodium. For those on a Dec.14 09 11:58a BUILDING DEPT 8455268806 p,2 I' U'.I'NAM. COUNTY -- NO'-1.'ICE Ole '1.'AX MAP CIJANC. -E, 1'()'C �p�,G t.1131az � YAGE, '.t'()WN L' ts�: h'V11f a1m pletcd Date Parcels Added Cards (_rd►1�71)ICI:CCi 13V Date d I�A1 v- Platted I-ironi: BY. v.. Date I)i ,vitl Map Updated 13) C ,� 1)ate Split ler —6 Cop)' to Asscssor 13v M T,ot Ch.11ILT :- Fast: C"oord North Gourd _._..._.__. . ............__.._........... - -- ....__.... _........_.__ ......._.....__...._.- ..___...- -...- - ._....__._.: _...... .......... t� Pry � x _..._._....._.,......_..... ..........__...........__...._. _.__ ...... ........__._.... -- ... - -- '_.�. — ;''`:� - _...-- ..._.__...._ .... ,_,...,...__..,._ c _ . ..__...._._.._...._....__........._- _- .- ..._...... ........... ...... ._ _...._...._....._... ...._.— .- ...._...__._.__.... __..- ..._T` - - .._..___ ._......_..___.._____._...._—...-.._ ..............._......-.._.._........._..._...__.....__....-......-_.-......._..... ......_.._.......__.,..__.:... ... ..._.._ -_____ .._.- ..__...___......._ n -y 444777 7 .._.__......__.........--__ .............._..._...._.__.......___•........_.- ..- _.___.- ._ ......... ____.. -.. _...._...__- _._-_- ____...._.__....._._ ......_. _.__.. , Dec 14 09 11:59a BUILDING DEPT 8455268806 p.3 7( t; �a 76 Putnam Valley 11.06 -2 -61 +62 =61 SHERLITA AMLER, MD, MS, FAAP Com inissione of Health.;._ -_; :: _. - LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 10, 2009 Michael Beyer, PE Beyer & Associates 273 Starr Ridge Rd Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County.- Executive ROBERT MORRIS, PE Director of Environmental Health Re: Construction Compliance - Burkhardt :5 Holly Street, (T) Putnam Valley, TM # 41.6 -2 -61 & 62 This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your review and consideration. ■ Please provide documentation that the two separal`e fay' loits h-avt beerr combmed*into-'Oho - -` -- - =- tax lot. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. JSP/kly V trePior s,� `t-�C•liLe�c,�. -tom' ,/� t t Joseph S. avati, Jr., PE Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 SHERLITA AMLER, MD, MS, FAAP Commissioner. of 'Health.. _ r LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 8, 2009 Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 ROBERT J. BOND( - = Coy ty_Executive- -. ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Burkhardt Holly Street (T) Putnam Valley, TM # 41.6 -2 -61 & 62 A re- inspection at the above referenced lot has been completed. There are no further comments to be addressed at this time in referenced to this Department open work inspections. If you have any further questions, please contact me at (845) 278 -6130, ext. 43261: GDR:kly Sincerely, / -6-&4 Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 ,a,,,:.:.v.;:x�zs;.sn �z.:. n�:> v. •arn >uu.�,e..srs�,zacw.�..wx.:+ was, �r... m.., vicewssw. sn, c.. �,: �.+.» vw. �n�. s> �. wv-.. r,>.:, �, TSa�. z.. �.- �,,:a...,*.0 =...:n...,.�:..�.T -- .®„..._... ..,.....,...,..— .....�.�._..... PUTNAM COUNTY DEPARTMENT `OF HEALTH DNISION OF EN'VIRONM[ENTA:L .HEALTH SERVICES FINAL 'SITE WSPECTION Date: &//>,/ Street Location Alva y Town V -Permit,* 6p, / —oy -08 TM # 41/1 G - a- - 64 4 a Subdivision Lot 4 ,_g/ 2 Go 1. 'Sewage System Area NO CONVNTS a. STS area'located.as per. approved : pans ..........:........ IYE b.. Fill :section - date of placement 3 :1 barrier Lgth. Width- Avg.Dpth c. Natural:soil not. stripped .. ......................... ........ ...... d. Stone, :brush, etc.; greater.than 15' °:from�'STS area........•.. e. 1:00' from water course / wetlands ...... ............................... IL Sewaie: Svstem a. Septic tank size - .1,000 ...:.. ,250 :other ................ b. Septic ank:installed level ......... ......... c. l o' ;minimum 'from. foundation.. ......:...... . d. Distribution 'Box Tm 7csAeo/ 1. All outlets at same elevation -water tested:. 2. Protected b elow 1rost ................. ............................... . 3. , :N himum2, ft. Original soil between box & trenches. e. Junction Box properly set ............ :........................... .. 6. ITenclies 1. Length. required 4yo3 ; .Length installed 3s 2. Distance .to watercourse measured -v / o o Ft.......... 3. Installed .according to plan ....... ............................... 4: Slope of trench acceptable 1116 =1/32" /foot ............. 5. 10 ft. from roe Iine - 20 ft:- foundations.......... P .P rty. 6. Depth of trench <30 inches from surface .................. 7. Room.allowed for expansion, 100 %..........I........: 8:. Size. of gavel 3/4 - 1'/2' diameter clean ...................: L4.- -Depth -of- �gxauel. in:trench 12" minimum. - 10..Pipe ends capped.:...:.. .. ................:............ g. Pump: or Dosed Systems ,, 1..: Size .of pump :chamber ............ :.... `�...: x.......9.:. o✓s�.fe to �c ems 2. 'Overflow tank ...........:......... 3. Alazm, visual/audio .......... .....:...:..::........:....:....... 4.: Puinp easily:accessible, manhole to grade ................. 5. First box baffled .................................................... .....:.. 6. Cycle witnessed by H.D,estimated flow /cycle........... III. House/Bduding a. house located er approved plans....:..... .... � :...... b.. Number of I rooms ........................... ...... I.................... IV. Well Weir located.as per approved plans . ............................... b. Distance from STS area measured .I' fop � 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....... :.... I ..................... . d.. Backfill material contains stones <4" diameter ......:....:.. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall -protected & dir.to exist watercourse g. Footing drains discharge away from STS area ................ h. Surface water protection adequate .............................. i. Erosion control provided .....:.......................................... Rev. 12/02 Form ST aw n ,SITE INSPECTION FOR FILL PAD � Date: 2 Inspected by; Fill pad located per the approved. plan i' ears Qh'. Fill Pad Length `ao/ Required Length Fill. Pad Width, f / ! Required Width If 6 Fill Pad Depth .5 Required:Depth Run-of-Bank-Fill Quality 'lee Slope from Top to Toe j Impervious Layer Installed j �S Crosion'Control,Installed Sieve Test Results (if applicable). ✓� !. , r: _....._...Additional - Comments- Reserved for Field Sketch if ApQlicable . � Vi .PUTNAM COUNTY DEPARTMENT OF.HEALTH DIVISION OF ENVIRONMENTAL If-EATLII SERVICES FIELD ACTIVITY REPORT JAME- �DI)RFSS� dL4 % 'S I i��rit�<1A1 i%$LL 46 Street Town State Zip 'ERSON IN -CHARGE .� l � ')R TNTERVIFVF) C , Date. PUMP TEST DOSE TEST REQUIRED GALLONS % STOP J N N I•.( I () H! 1 l �� . ft LZ7 i"�;� TFT Signature and Title FPQRT RF(`FTVFT) RV. acknowledge receipt of this report: SIGNATURE: V96 Title: �7' STOP J N N I•.( I () H! 1 l �� . ft LZ7 i"�;� TFT Signature and Title FPQRT RF(`FTVFT) RV. acknowledge receipt of this report: SIGNATURE: V96 Title: SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health November 20, 2009 Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BOND[ County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Burkhardt Holly Street (T) Putnam Valley, TM # 41.6 -2 -61 & 62 The above referenced separate sewage treatment system can be backfilled. The following comment needs to be addressed. • A pump test needs -to be'witnessed-by this - -Department- once= theelectr-ieal- -inspection- has_.. -. - ::.�.� -- been completed and verification of such has been submitted to this Department. If you have any further questions, please contact me at (845) 278 -6130, ext. 43261. GDR:kly Sincerely, '49�. q-�>' 1AZa Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 ATTENTION PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL REALTH SERVICES 11 ADAM All information must be fully completed prior to any inspections being made. GENE For: pill Trenches PCHD Construction Permit # +A) 3 Located: �It 0 Owner /Applicant N e: M2'4 -iL 013 cJ�-1C A j TM 1.� Bloch 'Z- Lot ( 2 Formerly: Subdivision Name: ►2 9- t W d- Subdivision Lot # a 13 2 Cp G Is system fill completed? Is system complete? -�e Is system constructed as per plans9 Is well drilled? VIP S Is well located as per plans? -' Are erosion control measures in place? _ Date: Date: /ice! q/0-4) Date: fie o I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion, in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of PIealih. Date: 0 by: ` PE RA esign Profe onal Address: 2.7 Zit %1- tom- i. f 6new's Lic, # 7 < Comments: Fonn FIR -99 ATTENTION PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVMONMENTAL HEALTH SERVICES 13 ADAM All information must be fully completed prior to any inspections being made. PCHD Construction Permit qGENE For: Fill Trenches, Located, SaAm �s ."y — (T)'M � �A/A Pvi jfA-t&,e Ow►er/Applicant Name: MAV_V_ _(bL)Z1/QA6]M I K "2 -TN4-;V/,, (, Block I- Lot I I - Formerly: Subdivision Name: L2A>pQ_kw 6- ffigpok( -2-0- Np Subdivision Lot # 22Tl;, 2_&C Is system fill completed? Is system complete? Is system constructed as per plans Is well drilled? Is well located as per plans? Are erosion control measures in place? Date: Date: Date: I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and -approved plans_ and the -Standards, Rules and Regulations of the Putnam County Department of Health. RA Date- Certified by/::; esign ProfeuKonal Address: _272_--� VZK2G� � 6newst_16 Lic, Comments: Form FIR-99 VO Cl) 1,40V -23 -2009 09:53 FROM-HOME 5148353058 T0:18gee?804M- P.t'2 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK ELECTRICAL INSPECTION SERVICES 150 White Plains Road, Suite 104, Tarrytown, NY 10691 CERTIFIES THAT Upon the application of: Ail - Ph *$* Electric of NY Inc - V. Paggolfs 3603 Lee Rd,. #303 Jeferson Valley, NY 10535 LoCated at: 5 Holly SL, Putnam Valley, NY 10579 Application Number: 10078134 Section: &1.s Block! 2 Lot: 81 Upon premises owned lay: Marc Burkhardt - 16 Holly St. Putnam Valley, NY - C�rtifict fe Number: 10078134 13DC: 106 Permit Number: 3 98-09 A visual inspection of the electrical system at this premise described as at Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, desorlbed below, located inlon the premises at: 5 Holly St., Putnam Valley, NY 10579 Basement, Outside. was Inspee ted In accordance with the NY$ and NFPA 70-99 and the detail of the installation, as set faith below, was founded to be In compliance therewith on the 17 Clay of September 3009. Name Date Quantity Rating Circuit Type Swk* Z A/C P -RCS F+ixttrroc 6 lncendascent R -106 mict I r_ ' $crvioo diaonmuot I Mmipan: single-Sitiµle phue I P -RES Sarvfce 0-299 P -XES il(vurlly PlAd f 200 A'r11' 40 sing'a Phww ftocrtacto 1 pi+Ct SinoKa Defector visWalty ItaPCatid(Noc Tgwd by NYLLS SOW J Fitt Alatm P -RFS Septic Pump lie Septic Alarm this cortifkate may not be altored In any way and Is vallaatad only by the pmunce of a rallied east at tha 1waam Indicated. Thle cortificato Is valld for work preformed baforn date of Inspection only, jeande 4 ruesda , Novembar 17, 20C9 Pogo t 0 *2 NOV• -23 -L"0 09:53 FROM:IUP1E 0 5 c TO,1845279O4W P,''c2 1493�I'� offer. Nick Morablto This cartifloeta may not be altered In any way and Is validated only by the proaanao of a roleod seal of the location Indicated. This aertlflcats is valid for vmrk preformed before data of Ingpection only. ieannie 4 T❑agwy, November 19 2009 Fag 7 If 2 IIOU -23 -2009 06:38 FFROM:HOME 9148353058 TO:18452276436 P.1/2 BY THIS CERTIFICATE OF COMPLIANCE THE 150 White Plains Road, Suite 104, Tarrytown, NY 10591 CERTIFIES THAT Upon the application of: All - Phase Electric of NY Inc - V. Faggella 3663 Lee Ind., #363 Jeferson Valley, NY 10535 Located at: 5 Holly St., Putnam Valley, NY 10579 Application Number. 10078134 Section: 41.6 Block:2 Lot: 61 Upon premises owned by: Marc Burkhardt - 16 Holly St. Putnam Valley, NY Certificate Number: 16078134 I BDC: 106 Permit Number: 396.09 A visual Inspoction of the electrical system at this promise described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located Inton the premises at: 5 Holly St., Putnam Valley, NY 10579 Basement, Outside. was inspected in accordance with the NYS and NFPA 70.99 and the detail of the installation, as set forth below, was founded to be in compliance therewith on the 17 Day of September 2009, Name Date Quaetity Rating Circuit Type SN iUh z AiC P -RES Fixtures 6 Incandosccnr P -RES Boiler 1 Scrvica discannoct - 1 - Meterpan: single - Single phaao I M -RES Service I N299 ? -RES Air Handler I 120l240V Panel 1 200 AMP 40 Single Phuse Rccoptaclo I CpCI Smoke Detector t Visually Inspected/Noi Tested by NYCIS Smoke! Fire Alurm P -RSS Scpdc Pump & Scptic Alann This certiticato may not ba altered In any way and 1s valldated only by the prosonco of a rallied tool at the location Indicated. This cortEflcato Is valid for work orofonnod boforo date of Inspection only. jeennie 4 Tucsduy, November 17, 2009 Pagc 102 NOU -23 -2009 06:39 FROM:HOME 9148353058 TO:184522 76436 P.2'2 This certificate may not ba altered in any way and Is validated only 4y the presence of a raised seal at the location Indloatea. This certificate is valid for work preformed before date of Inspection only. Jeannie 4 Tucsdw Novcnibcr 17, 2009 Page 2 oF2 )EPARTMENT OF HEALTH MENTAL HEALTH SERVICES FOR SEWAGE TREATMENT SYSTEM Located at a `v 5;k (-.0 Town or ViHngkP 7Ahgj V4_) I d Subdivision nameRo1Wl�G L Sub Lot # Tax Map Block 2. Lot 61 Z Date Subdivision Approved 7// 6 Renewal Revision Owner /Applicant Name HAti BUQ W_ HhA&L= Date of Previous Approval Mailing Address Amount of Fee Enclosed c., T Zip J65-7 Building Type Lot Area No. of Bedrooms .3 DesignFlowGPD6. Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of j gallon septic tank and / 23'U Other Requirements: To be constructed by Water Supply: Public Supply From Address Address - - --,or:- Private-Supply Drilled by �� — (,I�L� y Address— I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. O R.A. Date Address 7,73 S �s2 atl�e. /2)-) ,, a-Le" t'--e License # 41 s'� 7 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered nec ssary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Approved for 'scharge of domestic sanitary s age only. By: Title: Date: LO White copy - HD File; ello c y - B ilding Inspector; Pink co r; Orange copy - Design Professional Form CP -97 PITTNAM COUNTY DEPARTMENT OF HEALTH IVISION OF ENVIRONMENTAL, HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # PV Ott --0 Su) —o-:,:? — OR— Located at A���� Town orTi -A)inJ",yn N! l Subdivision name 0(beICt ke94j Lot # c cUro Tax Map Block -9— Lot 4.1 Date Subdivision Approved 7 d Renewal Revision Owner /Applicant Name Hack- Date of Previous Approval L- 6 /6 Mailing Address 1(� �Ag S e gxy-e 7 , 6 j a � /m V V- e ! Zip 14T 7% Amount of Fee Enclosed �' �j(�= Building Type g yp � .L��� oV-Arv-t' : Lot Area /j,/// No. of Bedrooms 3 Design Flow GPD 640 Fill Section Only _ Depth Volume_ PCIID NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of Other Requirements: To be constructed by 250 gallon septic tank and Address Water Supply: Public Supply From Address or: Private Supply Trilled by 'Addres's _ I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. Y" R.A. Date ///40/37 Address °mss' /9 ->) �- l�i� / 6 Y C; C— License # 07V-S-7 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered nece pary by the Public Health Directory revision or alteration of the approved plan requires i a new pen/it. Approved fo charge of domestic sanitary sews only. 01, By: �/ L��� Title: Date: White copy - HD File, Yelloico - Building Inspector; Pink copy - Own; O e copy - Design Professional I; Form CP -97 � w `�' PUTNAM COUNTY DEPARTMENT OF HEALT DIVISION OF ENVIRONMENTAL HEALTH SERVICE CONSTRUCTION PERMIT FOR SEWAGETREATMENT SYSTEM PERMIT # Located at Town orb ash, lw°&4D rmp, Subdivision name Subd. Lot # Tax Map Block Lot ^' Date Subdivision Approved e a Renewal Revision Owner /Applicant Name ,�Ase g., Date of Previous Approval Mailing Address 7 u r-hL088q VA.Le V Zip (?� (SKj :Amount of Fee Enclosed Building Type Goh� Lot Area No. of Bedrooms Design Flow GPD Fill Section Only . — Depth, :Y Volume Z30 &6 PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of "12-50 : gallon septic tank and Other Requirements: To be constructed by Water Supply: Public Supply From Address Address or:" � Private-Supply Drilled by _�/ �' OAddress I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the seQarate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. Date License # 07d1f9 7 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. B _ �c Title: C- Date: E a Y White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - APPI;ICA'I'IOhI_'pO.COI` . — .RUCK -� WATER WELD, -; please orint or type PCHD Permit # Well Location: ddress: To Tax Grid # �: 8,� Ma, ,V/,,. t Block Lot(s) *Name: Well Owner: Address: -- -• I Al e Use of Well: Residential Public Supply Air /Cond/Heat Pump Irri gation 1-primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served_ Est. of Daily Usage 6CV gal. Reason for Replace Existing Supply Test/Observation Additional Supply DriMng New Supply (new dwelling) Deepen Existing Well Detailed Reaso® for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ....... ............ ............................ ............................... Yes No � ....... � ............................. ............................... Yes No Is well located in a rea�Zcwx-s bdivision. _ Name of subdivision � L ot No. �_ Water Well Contractor: _ -rA c:.z�eqs,&I>q ddress: Is Public Water Supply available to site? ...... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: ,..— Proposed well location & sources of contamination to be provided o eparate sheet/plan. Date: 1/ Applicant 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 by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue _ lr Permit Issuing Official: Date of Expiration 6 Title: 49 Permit is Non- Transfelrrab e White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 273 Starr Ridge Road. Tel.. (845) 278 -6212 Brewster, NY 10509. Fax. (845) 278 -0403 February 15, :2008 Mr. JosephParavati, Jr. . Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10.509 Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot 61 & 62 Dear Mr. Paravati, The enf lbsed submission has been revised as per your letter dated 2113108: ,r We have enclosed a waiver request form for the toe of slope to ledge rock. ,(�,rn✓� -� The name of the subdivision has been added to the construction permit. A Junction box and outlet have been added to the pump chamber detail. 7F We shall provide a common scale on all future profiles. Enclosed please find the following items for your review and approval • Plan and Profile- SSTS Trench Layout Plan last revised 2115108 (2 copies) • Specific Waiver Application dated 2115108 I trust the above materials are. adequate for your approval and complete the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call me @ 278 -6212. Very truly yours, s Mich Beyer Project Manager Enclosures I SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Attn: Michael Beyer, PE Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROIBERT MORRIS, PE Director of Environmental Health February 13, 2008 Re: Proposed SSTS —Burkhardt Holly Street, (T) Putnam Valley TM # 4.60 -2 -61 & 62 This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your review and consideration. 1. The following doesn't meet current code: ® toe of slope less than 5' from ledge rock Based on the above, the application is denied. It is the right of the applicant to request a waiver from the current code. Please find enclosed the latest version of the waiver form to 2. The name of the subdivision and the lot # is to be provided on the construction permit. 3. The pump chamber needs to be provided with an all weather junction box with an outlet and screwed cover at or above grade to allow for a plug in connection. 4. The profile vertical scale should be a more common scale than 6.67', i.e., 5 scale, 10 scale, etc. Please provide in the future. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 2157 if any questions arise. JSP /kly Enc. Very truly yours, Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 N�;W YORK STATE SPECIFIC WAIVER APPLICATION DEPARTMENT OF HEALTH Request for Approval of Noncompliance with Bureau of Water Supply Protection the Standards of 1ONYCRR Appendix 75 -A Wastewater Treatment Standards — Individual Household Systems Name of Applicant Last First Address Street Cityrrowa state Zap Contact Information phone: FAX: email: Site Location street: I City/Town I County Zip The following information is being submitted in support of my application for a specific waiver from compliance with one or more standards of IOATCRR Appendix 75-A, "Wastewater Treatment Standards Individual Household Systems': 1. The wastewater treatment system cannot meet the following standards of 1ONYCRR Appendix 75 -A: • Separation distances cannot be achieved (75- A.4(b), Table 2, Separation Requirements) • Excessive Slope (75- A.4(1), Soil and Site Appraisal) ❑ Design is not addressed in Appendix 75 -A ❑ Technology is not addressed in Appendix 75 -A ❑ Other: Explain: 2. The following design is proposed to mitigate noncompliance with Appendix 75 -A (brief description): 3. Supporting information provided: ❑ Detailed Site Plan ❑ Detailed Design ❑ Soil and Site Evaluation ❑ Neighboring conditions of concern (e.g., wells, waterbodies, wetlands, etc.) ❑ Other: Explain: I, (applicant) (type or print) acknowledge that this waiver request is necessary because it is not practical,for an onsite wastewater-treatment system to meet the referenced standards of 1ONYCRR, Appendix 75 -A on this property. Signature Date I, (engineer) (type or print) acknowledge that this waiver request is necessary because it is not practical for an onsite wastewater treatment system to meet the referenced standards of 1ONYCRR Appendix 75 -A on this property. In my professional opinion, the proposed design described in this application will provide a degree of protection equivalent to the onsite wastewater treatment standard(s) that will not be met for this property and will not create an increased risk to public health or the environment. Signature PE License # 7'For Health Department use Based upon the information provided in this application to waive the referenced standards of Appendix 75 -A and in accordance with IONYCRR §§ 75.3 and 75.6 (b), the waiver requested is hereby: ❑ Approved as proposed. ❑ Approved, with following conditions: ❑ Not acted on, because additional information is required: ❑ Denied, because: Note. This waiver may be revoked should any conditions considered before approving this waiver change after approval. Health Department Representative Signature Date OAS 2 SAM 273.Starr Ridge Road Tel.. (845) 278 -6212 Brewster, NY 10509. Fax. (845) 278 -0403 February 5, 2008 Mr. Joseph Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road .Brewster, New York 10509 Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY . Tax Man # 41.60 Block 2 Lot 61 & 62 Dear Mr. Paravati, Enclosed.please find a copy of the following revised items as per your letter dated 1129108: 1. A new updated letter of authorization. has been included in this submission: 2. The most recent construction notes have been added to the plans. 3. A separation distance of ]Oft has been maintained from the toe of fill to the driveway. We will be unable to provide a separation distance of 5' from toe of fill to ledge rock. We *designed the system where as all trenches are minimum of 10' from the ledge rock. Due to .the. topographic elevations of the site, we will need to -provide fill over certain areas of ledge rock to provide -the best possible system. We would request a waiver of this criteria due to the nature of the site and the previous approval granted 216107. 4. The well service, connection has been shown on the plans. 5. The.vertical profile has been revised accordingly. 6 A 90 deg bend has been shown on the d -box detail. :7_ .The primary system has been designed. with, equal distribution:.:. 8. The latest pump notes have been provided on plan ssts -2, next to the pump pit detail. 9. The floors plans submitted with the latest application will replace the approved plans. The basement will remain. unfinished single large area. The attached garage will not have access from the main house to the attic. Enclosed please find the following items for your review and approval: • Plan and Profile- Fill Placement Only -SSTS system last revised 215108 (4 copies) Plan and Profile- SSTS Trench Layout Plan last revised 215108 (2 copies) o Letter of Authoriztion I trust the above materials are adequate for your approval and complete the submission for the above project, However if you have any questions.concerning this project, please do not hesitate to call me @ 278 -6212. Very truly yours, chael Beyer Project Manager Enclosures SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ,,.._ LORETTA Associate Commissioner of Health January 29, 2008 Michael Beyer, PE Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Re: Proposed SSTS Burkhardt Holly Street, (T) Putnam Valley TM # 41.6 -2 -61 & 62 ROBERT J. BOND[ County Exec tive ROBERT MORRIS, PE Director of Environmental Health Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: !1. Due to the joining of lots, a new letter of authorization needs -to -be submitted to the .- _- Department with :original signatures. r Please add the most recent construction notes (enclosed). ��3 A separation distance of ten feet needs to be maintained from the toe of fill to the driveway and five feet from the toe of fill to ledge rock. /4. The well service connection needs to be shown on the plan. It appears the profile is not shown at 1" = 10' vertical as noted. 6.. Please provide a downward facing 90° elbow in the distribution box detail. �7: The primary system needs to be equal distribution. 8 Please provide the latest pump notes from Bulletin ST -19. 1 �'9. There are approved floor plans already on file with this Department. Are the floor plans submitted with the latest application replacing the approved plans? J '� The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278-6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 r tests were not'witnessed by a representative of the New York City Department of Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Respectfully, Gene D. Reed GDR:kIy Senior Environmental Health Engineering Aide s a' • r APPENDIX C CONSTRUCTION NOTES FOR SUBSURFACE SEWAGE TREATMENT SYSTEMS & WELL WATER SUPPLIES SERVING SINGLE - FAMILY RESIDENCES The following notes shall be provided on all plans for individual SSTS and well water supplies. Basic Required Notes 1. All trees within 10 feet of the proposed subsurface sewage treatment system (SSTS) shall be removed. 2. SSTS to be inspected by the Licensed Design Professional and the Putnam County Health Department after construction and prior to backfill. 3. The SSTS area shall be staked and roped off so that no trucks, machinery, building materials, nor excavated earth shall be allowed in the SSTS area. 4. All erosion control measures shall be installed prior to the start of any construction and must be maintained until construction is complete and stabilization has occurred. 5. Construction of SSTS to be in accordance with these plans, any revisions thereto, and the rules and regulations of the permit issuing governmental agency. 6. The well is to be a drilled well, constructed. in - accordance with New York State Health _ Department Bulletin, eritiltled `Rural Wdi6r' 'Supply ", pump- estdd' fora minimum of6 hours•and---- -- -° -� have a minimum safe yield of 5 gpm. Yields less than 5 gpm will be immediately reported to the Putnam County Department of Health. 7. The SSTS design shown hereon does not provide for installation of a garbage grinder. Such installation requires additional design and the approval of the Putnam County Department of Health. 8. Putnam County Health Department approval is based on the location of the SSTS, well, building, setbacks, and driveways as shown on the approved drawing. Modifications are to have prior Putnam County Health Department approval. Unauthorized modifications made to this drawing after the date of Putnam County Health Department approval voids said approval. 9. All stonewalls in and within -10 feet of the SSTS area shall be removed to their entire depth and the resulting void replaced with similar on site soil. 10. Cut or fill is not permitted in the SSTS area, except if so specified on this plan. 11. After backfilling the system, the SSTS area shall be covered with a minimum of 6 inches of top soil, seeded, and mulched. 4te'+ t 12. Occupancy of this structure will not be permitted until the Construction Compliance Application has been received and approved by the Putnam County Health Department and forwarded to the Building Inspector of the respective municipality as part of the Certificate of Occupancy application. 13. This plan is approved for sewage treatment and /or water supply only, and all other required permits and /or approvals are the responsibility of the permittee. 14. The Putnam County Health Department approval expires two (2) years from the date on the approval stamp and is required to be renewed on or before the expiration date. The approval is revocable for cause or may be amended or modified when considered necessary by the Department. 15. A copy of the house plans submitted to the building inspector of the local municipality, when filing for a building permit, must be submitted to the Putnam County Health Department to verify the bedroom count. 16. The house, well and SSTS shall be survey located and staked by a NYS Licensed Land Surveyor prior to construction. 17. For all SSTS's which are subject to Joint Review and approval with NYCDEP the Design Professional is to notify PCHD and NYCDEP at least 24 hours prior to the commencement of the SSTS construction. Rev. Feb 2007 12 "`" " ' °'"m•: l3esign criteria on,plans -to -include number of bedrooms, soil percolation rate and deep test hole soil information, and sizes of n. Construction notes pursuant to Appendix C. o. Space for Putnam County Health Department Approval stamp (minimum 3" x 5 ") preferably at the lower right hand portion of the. design plan. p. Location map (minimum scale of 1" = 2,000')4 q. Erosion control measures for house, well and SSTS. r. When a pump pit is proposed due to insufficient elevation for gravity flow or for dosing purposes, the pump pit design /detail shall include, as a minimum, the following: • Make and model of pump to be used and operational characteristics. • One -day's storage past the high -level alarm within the pump chamber. • Check Valve. • Gate Valve • Unions • Operating and alarm levels for pump. • Means for pump removal for maintenance. • All weather junction box with an outlet and screwed cover at or above grade at the pump chamber to allow for a plug in connection for the pump(s). • Pump curve should be supplied with the engineering report. The pump operating range should be indicated on the pump curve. • Pump dose volume 10 be equal --to= 7S-0/o-af -th - voluit ce ayailable in the SSTS pipe network. • Minimum Velocity of 2 ft per second to be provided in force main . • Baffled distribution box to be utilized for SSTS. • Trench detail for force main, specify pipe type and rating, bedding and cover. • Note stating, "All electrical work and material for pump installation shall comply with the National Electrical Code. " • Note stating, "An electrical Underwriter's Certificate for the pump i U j chamber must be provided to the Department prior to the Department 7 �. conducting a f nal inspection on the pump chamber. " ® • Note Stating, "The pump control panel and alarms shall be located inside the house." s. Delineation of United States Department of Agriculture Soil Conservation Service soil type boundaries. t. Retaining walls greater than 4 feet in height for an SSTS design shall be designed and certified by a NYS Licensed Professional Engineer. SHERLITA AMLER, MD, MS, FAAP LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 24, 2007 Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Attn: Michael Beyer Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BOND! County Executive ROBERT MORRIS, ft Director of Environmental Health RE: Application to Construct a Subsurface Sewage Treatment System At 16 Holly St. (T) Putnam Valley, TM # 41.6 -2 -61 & 62 The Putnam County Department of Health (Department) has determined that the. above referenced application, received by the Department on November 21, 2007 is incomplete. Please be advised that the following information is required before the Department may commence its review. ® A letter from the county indicating the two tax parcels have been legally combined into one. --The review-of- your application- will commence once . the Department -receives the requested information and determines that the application is complete. The Department will notify you = - within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the'New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2261. GDR:kly Very truly yours, Gene D. Reed Senior Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278;6648 273 Starr Ridge Road Brewster, NY 10509 . Mr. Joseph Paravati,: Jr.. Hand Delivered Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot .61 & 62 Dear Mr. Paravati; Our client recently entered into an agreement to purchase the lot adjacent to Lot 61. We are hereby submitting a revised SSTS layout for the combined properties.. The SSTS. layout; now provides' for 100010 expansion as well. as meeting all regulation setbacks.' Enclosed please find a copy of the following items for your review and approval for the renewal of the Permit. • Construction Permit for Sewage Treatment System(original) • Application to Construct to Water Well.(original) Application for approval of Plans for Wastewater Treatment System (original) • Plan and Profile -Fill Placement Only Separate Sewage Treatment System (4 copies) Plan and Profile -SSTS Trench Layout Plan (2 copies) . 1 Qhnrt FA F form t I rnnv Updated Survey by Baxter Surveying dated 10 -I1- 2007 (1 copy) HousePlans.(4 copies) Pump System Calculations dated 11119107 (2 copies) Fee = Postal Money Order in the amount of $500 • Copy of Previous Permit SW 27 -02 renewed 12120104 Declaration of Pending Sale (4 copies) Materials on File • Design Data Sheets • Letter of Authorization I trust the above materials are adequate for your approval and complete the submission for the' above project, However if you have any questions concerning this project, please do not hesitate to call me @ 278 -6212. Very truly yours, Michael Beyer Project Manager 273 Starr Ridge Road Tel. (845)•278 -6212 Brewster, NY 10509 Fax. (845) 278 -0403. January 11, 2007 Mr. Joseph Paravati, Jr. Hand Delivered Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York, 10509 Re.: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax MaD # 41.60 Block 2 Lot .61 Dear Mr. Paravati, Our client would like to renew the SSTS Construction Permit due to expire on December 20, 2006. Enclosed please find a copy of the following items for your review and approval for the renewal of the Permit. 9 Construction Permit for Sewage Treatment System Application to Construct to Water Well. • Plan and Profile- Separate Sewage Treatment System (4 copies) Fee — Postal Money Order in the amount of $500 e Copy of Previous Permit SW 27 -02 renewed 12120104 I _trust the above materials are adequate for. your approval and complete the submission for the above project, } - °- ° Jlowever if you nave any questions concerning -this proles , please do. not Hesitate to.calt nw @ .278 - 6217.. ..._ . _._.... ; Very truly your Michael Beyer Project Manager Enclosures 78 Secor Road, Tel.. (845) 621-4756... Bryant Pond Plata, Suite 5 Fax. (845) 628 = 1905 . Mahopac, New York 10541 COPIES ATE NO DESCRIPTION 1 APPLICATION TO CONSTRUCT A WATER WELL k. THESE ARE.TRANSMITTED AS CHECKED BELOW: OR APPROVAL FOR REVIEW AND COMMEM' OR YOUR WE EM-n*NW REQUESTED REMARKS: DEAR JOE, ENCLOSED PLESE FIND AN APPLICATION TO CONSTRUCT A WATER WELL DATED DECEMBER.16, 2004 REGARDING HOLLY STREET, PUTNAM VALLEY, NY IF YOU HAVE ANY QUESTIONS, PLEASE CALL ME,: COPY TO • SIGNED : MICHART, R _ AEXER _ p _ E _ if enclosures are not as noted, kindly notify us at once. 1� � 78 Secor Road, Tel. (845) 621 -4756 Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 Mr. Joseph Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509. September 27, 2004 Hand Delivered Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot 61 Dear Mr. Paravati, Our client would like to renew the SSTS Construction Permit due to expire on September 25, 2004. Enclosed please find a copy of the following items for your review and approval for the renewal of the Permit: • Construction Permit for Sewage Treatment System • Plan and Profile- Separate Sewage Treatment System (4 copies) • Fee — Postal Money Order in the amount of $400 • Copy of Previous Permit SW 27 -02 - 1 -trust the dbove "rridtMdls "dre' ade uate or ou`r d r "oval' and cof'i " lete" the submission Jot "the. above ` ro'ett; ` 4 u f y PP P f� P J However if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756. V truly urs, Chris Caralyus Project Manager Enclosures .......... - 78 Secor Road, Tel. (845) 621 -4756 Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 Mr. Joseph Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509. September 27, 2004 Hand Delivered Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 Lot 61 Dear Mr. Paravati, Our client would like to renew the SSTS Construction Permit due to expire on September 25, 2004. Enclosed please find a copy of the following items for your review and approval for the renewal of the Permit: • Construction Permit for Sewage Treatment System • Plan and Profile- Separate Sewage Treatment System (4 copies) • Fee — Postal Money Order in the amount of $400 • Copy of Previous Permit SW 27 -02 - 1 -trust the dbove "rridtMdls "dre' ade uate or ou`r d r "oval' and cof'i " lete" the submission Jot "the. above ` ro'ett; ` 4 u f y PP P f� P J However if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756. V truly urs, Chris Caralyus Project Manager Enclosures Beyer and Associates Consulting Engineers 78 Secor Road,. Tel. (845) 621 -4756 .. _ _ .. _ _ . _ . -- - . - - a ..._ F, - 1905. Bryant Pond Plaza, Suite 5 aac. (845) 628' - Mahopac, New York 10541 Mr. Shawn Rogan Public Health Technician Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Burkhardt Residence Holly Street, Putnam Valley Tax Map 41. 6, Block 2, Lot 61 Dear Mr. Rogan: September 16, 2002 Please find the enclosed updated plans for the above reference property. We have added the test pit locations as per yourfax dated. September 3, 2002. Additionally, we field measured the test hole depth and included the descriptions on the Plans. The following items have been enclosed for your review: - Three (3) copies of the updated Plans If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. S/ aerel�, t' Chris Caralyus Project Manager F and Associates Consulting Engineers Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 August 30, 2002 Mr. Shawn Rogan Public Health Technician Putnam County Department of Health :,?n 4 Geneva Road _ D Brewster, New York 10509 3 Re: Burkhardt Residence Holly Street, Putnam Valley Tax Map 41.6, Block 2, Lot 61 Dear Mr. Rogan: Please, f nd the enclosed updatedplans for the above reference property. We have made the changes to plans as per your comments dated April 2, 2002: 1. The fill over the entire trench area is 3.5ft minimum. 2. The side slopes on the fill pad have been changed to a maximum of 2:1 slope. 3. The drywell has been moved 50 feet from the well. 4. The system has been altered to avoid the rock ledge areas shown on the plan. The proposed trenches are a minimum of 10 feet from the ledge. 5. The `possible rock ledge " symbol has been removed due to the boulders in this area being removed. Please be aware that we are requesting a waiver of the 10 foot separation distance from the toe of the fillpad to the property line along the back of the fill pad, and a waiver from the 100% expansion area requirement, to 50% expansion, which was the regulation which was in effect at the time the Realty subdivision was approved and filed in July of 1946 The following items have been enclosed for your review: - Three (3) copies of the updated Plans If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. cere , Chris Caralyus Project Manager BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 May 7, 2002 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Chris Caralyus Beyer and Associates 73 Secor Road, Bryant Pond Plaza Mahopac, NY 10541 Re: Dear Mr. Caralyus: Proposed SSTS - Burkhardt Residence Holly Street, (T) Putnam Valley TM# 41.6 -2 -61 The waiver committee entertained your waiver request for the above referenced lot on May 7, 2002. The waivers requested were: 1) Less than 10 foot separation from the toe of fill to the property line; 2) 50 % expansion; and 3) 2 on 1 side slopes. The- committee - agreed that the area noted as "possible ledge" needed to be either proved out or avoided prior to fiirther consideration fora waiver. Contact Shawn Rogan at (845) 278 -6130 ext. 2159 to schedule witnessing deep test holes if needed to confirm the presence of ledge rock in the SSTS area. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely, �--,.-. Shawn Rogan Public Health Technician SR:cj Beyer and Associates ConsultingEngineers 78 Secor Road, Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 Mr. Shawn Rogan Public Health Technician Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Burkhardt Residence Holly Street, Putnam Valley Tax Map 41.6, Block 2, Lot 61 Dear Mr. Rogan: April 4, 2002 END Please find the enclosed updated plans for the above reference property. We have made the changes to plans as pert your comments dated Apri12, 2002: 1. The fill over the entire trench area is 3.5ft minimum. 2. The side slopes on the fill pad have been changed to a maximum of 2:1 slope. 3. The 'drywell.has been moved 50 feet from the well. 4. The system has been altered to avoid the rock ledge areas shown on the plan. minimum of 10 feet from the ledge. Please be aware that we areirequesgl!g -i waiver-of the 10foot separ The following items have been enclosed for your review: - Three (3) copies of the updated Plans The proposed trenches are a If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. Sinc e , Chris Caralyus Project Manager BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 R April 3, 2002 Chris Caralyus Beyer & Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Dear Mr. Caralyus: Proposed SSTS - Burkhardt, Holly Street (T) Putnam Valley, TM# 41.6 -2 -61 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. 3 Meet of ROB fill has not been provided over the entire SSTS area. - - • 2: - _ . Sides slopes.. are. nat .3:1.,.revise_a.ccordingly:.. Be gure.that.the-.fill profile -arid fill detail reflect the proposed side slope. 3. The proposed dry well must be located a minimum 50 feet from the proposed well. 4. The original survey notes large areas of ledge rock in the primary SSTS area. Please confirm and revise plans accordingly. If you would like to arrange to meet on site with a machine to verify the ledge as shown on the survey, contact me at ext. 2159. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely Shawn Rogan Public Health Technician SR:cj BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 March 19, 2002 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Chris Caralyus Beyer and Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re Dear Mr. Caralyus: Proposed SSTS - Burk`hardt, Holly Street (T) Putnam Valley, TM# 41.6 -2 -6 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. The project as proposed does not meet current codes and must be denied based.upon insufficient separation distance from the toe of the fill pad to the property line. You may request a waiver of this requirement by completing the enclosed specific waiver (Gen -152) form and returning it to my attention. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely, Shawn Rogan Public Health Technician SR:cj encl. Beyer and Associates Consulting Engineers 7$Seco''rRoad;_..,.. >_r..,.,.. _.- - .._e. Tel' (845)'621 =4756 Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 March 11, 2002 Mr. Shawn Rogan Public Health Technician Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Burkhardt Residence Holly Street, Putnam Valley Tax Map 41.6 Block 2 Lot 61 . Dear Mr. Rogan: Please find the enclosed updatedplans for the above reference property. We have made the changes to plans as per your comments dated March 6, 2002: 1. The latest pump notes have been added to the plans. 2. The expansion trenches have been shown on the trench plan prof le. 3. The grading has been changed to even the area between the fill pad and the house. The following items have been enclosed for your review: Three (3) copies of the updated Plans If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. Sin,c ly, Chris Caralyus Project Manager BRUCE R FOLEY Public Health Director March 6, 2002 DEPARTMENT OF HEALTH 1 Geneva Road . Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Chris Caralyus Beyer and Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Dear Mr. Caralyus: Proposed SSTS - Burkhardt, Holly Street (T) Putnam Valley, TM# 41.6 -2 -61 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: �he updated pump otes have not been full added to- the trench plan. Reference is made P Y P - - - -to thememo-(copy attached) dated August -10, 2001. Tease revise trench plan accordingly. Show the expansion trenches in the SSTS profile on the trench plan. 3. Grading can occur to the foundation provided that 20 feet separation is maintained from the foundation to the end of the trench. This may help your grading between the house and SSTS area. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely, Shawn Rogan Public Health Technician SR:cj encl. J' l' i Beyer and Associates Consulting Engineers 78 SecorRoad;•,..,;. - -,:._ Tel (845)-621_ 4756 -_ :... _ Bryant Pond Plaza, Suite 5 Fax. (845) 628 -1905 Mahopac, New York 10541 February 21, 2002 Mr. Shawn Rogan Public Health Technician Putnam County Department of Health 4 Geneva Road . Brewster, New York 10509 Re: Burkhardt Residence . Holly Street, Putnam Valley Tax Map 41.6 Block 2 Lot 61 Dear Mr. Morris: Please find the enclosed updated plans for the above reference property. We have made the changes to plans as per your comments dated February 12, 2002: 1: "Enclosed please find the certified mail receipts. 2:'A note stating that no 100 year floodplain is located within 200 feet of the property line has been added to the plans. 3.,-Lea and footing drains have been added to the plans. 4,--A -note stating that no wetlands or watercourses are located within 200 feet of the property line has been added to the plans. — 5:-` - Ae'erosion control has been extended to include the house construction. d -- --The fill certification note has been added to the Trench Plan. 7.—The well has been dimensioned to 2 property lines. _.- _.....•. The pump notes have been added to the Trench Plan. 9: -The 1250 gallon overflow tank has been provided to handle 2 days of sewage flow in the event of an extended pgwer outage or pump failure. new Construction Permit for Fill Section Only is included IL There will be no acquisition of property as shown. As such we are requesting a waiver 6f the 10 foot separation,distance from- the toe of the fill pad to the property line along the back of the pad..,, - The following items have been enclosed for your review: - Three (3) copies of the updated Plans - Updated Construction Permit for Fill Placement Only - Copy of Filed Subdivision Map 308E Copies of the certified mail receipts for the new well will be forwarded upon their return to this office. If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. Sincerely, 17 Chris Caralyus Project Manager +6s .4 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 February 12, 2002 , Michael Beyers, P.E. Beyer & Associates 78 Secor Road Bryant Pond Plaza Mahopac, NY 10541 Re: Proposed SSTS: Burkhardt Holly Street (T) Putnam Valley, TM# 41.6 -2 -61 Dear Mr. Beyers: Review -of plans -and- other supporting- documents -subniitteud at- this' time' relative -to' "the above - regarded project has been completed. Comments are offered as follows: lY Neighbor Notification is required for this project. Provide the 100 year flood plain boundary or add a note stating that none exists within 200 feet of the property line. Show the location of footing and leader drains. Provide the location of all watercourses and wetlands or add a note stating none exist within 200 feet of the property line. Provide erosion control for the house and well. Fill certification note required on trench plans. Provide the dimensions from the proposed well to two property lines. 8. Provide the updated pump notes on the trench plans. (Bulletin St -19, page 12). �?l Provide the dimensions of the pump chamber. It would appear that one 1,250 gallon " pump chamber would provide sufficient volume for a 213 gallon dose and 600 gallon storage above the alarm. Please explain why a 1,250 gallon overflow tank is proposed. 10. Kindly submit a new construction permit for placement of fill only. Complete the center box relevant to "Fill Section Only ". Letter: Michael Beyer, P.E. = February- 1-2,,2002 _ -2- 1 A survey showing the new property lines and verification that the transaction is complete will be required prior to the issuance of a fill permit. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Shawn Rogan Public Health Technician SR:tn Beyer and Associates Consulting Engineers 78 SecorRoad, `Tel: (845)I621 =47k - Bryant Pond Plaza, Suite 5 Fax (845) 628 -1905 Mahopac, New York 10541 November 29, 2001 Mr. Robert Morris, P.E. Senior Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Burkhardt Holly Street, Putnam Valley Tax Map 41.6 Block 2 Lot 61 Dear Mr. Morris: Our client, Mr.. and Mrs Burkhardt, propose.to construct a three bedroom home on the above referenced property. The system will be a fill pad serviced by a pump. Please find the following information for the SSTS plan to service the above referenced property. The following items have been enclosed for your review: • Construction Permit Application • Short Form EAF m Design Data Sheets ® Application for Approval of Plansfor a Wastewater Treatment System ® Application to Construct a Water Well ® Letter ofAuthorization ® Three (3) copies of the proposed SSTS Plan for Fill Placement Only ® Three (3) copies of the proposed SSTS Trench Plan ® Pump system calculations and information ® Two (2) copies of the proposed house plans e $300 Application fee If you have any questions or require further information please give me a call. Thank you very much for your continued efforts. Sincerely, Chris Caralyus Project Manager PUTNAM COUNTY DEPARTMENT OF HEALTH ;�'}IVISION OF ENVIRON. MENTAL: HEALTH CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # 5W22-02- Located at 140M j f iZee_l 5com -0 N4h p Subdivision name FtMrz1N6 69rore lie Subd. Lot # 2&0 Date Subdivision Approved Owner /Applicant Name MARC 6,11-shAO M Town or Village pyINPA VA LL-64 Tax Map 4. 1.1,0 Block Z Lot & l _ Renewal V1 Revision Date of Previous Approvals 02 Mailing Address I& KoLt 6'-1kei %&v IW41A VAUW Na(91 Zip D5;7 Amount of Fee Enclosed ,4100. 00 Building Type WpcO EIZANe Lot Area pis No. of Bedrooms -3 Design Flow GPD �-- Fill Section Only X Depth 15" Volume: 730 C,H. ROB PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of �_ St� gallon septic tank and Other Requirements: To be constructed by Address Water Supply. __ Public Supply From - -Address - - or: Private Supply Drilled by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. Date ik Lo4— License # 0 >4 , 47 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new ermit. Approve r discharge of domestic sanitary se ge only. By: r r Title: Date: Zvi -2 White copy - HD Fi ; Yell w copy - Building Inspector; Pink copy - Own- Orad4 copy - Design Professional Fnrm (`A -o7 ....SL) -ate -ate NEW YORK STATE DEPARTMENT.O.F. _HEALTH_ _. _ „SPC�fLC1lVa.l,!!er- Bureau of Community Sanitation and.Food Protection from Requirements of-Part-75 and Appendix 75- A,10NYCRR for individual Household Sewage Treatment Systems Name of Applicant Address Site'Location lle.k S/1 Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)): separation distance cannot be achieved. Excessive. slope. EJ High groundwater. Inadequate depth to bedrock or impermeable layer. Soil unsuitable. Other(explain) ... : ......... ........................................................................................................... 2. Proposed design or conditions of waiver: ......................................... .L.. s........ ............/ ........ ` `....... ! ?.. -5� ..................................... ` ..... ...................................... .............�p�, ............ .......... ............................................................... ..............................` .. ...:... ... ...... ......... ...... 3. The proposed design may have the following limitations (check appropriate box(es)): Increased risk of well or spring contamination. Increased risk of surface water contamination., Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. Other(explain) .................................... ............................... .................................... ............................... Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver maybe revoked by the ' uing official for a change in conditions for which this waiver was granted. ................................................................... ............................... REPRESENTATIVE OF C MMISSIONER OF HEALTH ORIGINAL - Local Health Agency Z, COPY - Applicant/Design Professional BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH. 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAVIER NAME:leL(K /11�f`�C ADDRESS: SITE LOCATION: DATE: l S -/ - "A,1,- �� STAFF PRESENT: ($ruck F., X b M.,?(Mike 13—'Adam S.• GeneR., Shawls R., Bi1hH. DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD OR ENVIRONMENTAL CONTAMINATION PROBLEM? + - - -+ V YES NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? ES ;. NO DISCUSSION REQUEST APPROVAL OR DENIED �^ APPROVED REASON FOR DENIAL DIRECTO OF PUBLIC HEALTH DENIED DATE: (SPECWAIVER) Kje---,' lows �.SR1�G'IOI�T PERK' F ®lE&WA1� TIlAI .. .�: PERMIT #, -0 D— Located at 61-6 I Town or Village SE& vO 444P- Subdivision name ��, >�rr,- M,,,vt &Ac Subd. Lot # Tax Map L// 6 Block :;i Lot Date Subdivision Approved 7 J a0z/ Yf &L Owner /Applicant Name A,112�ea• _ Renewal Revision Date of Previous Approval Mailing Address ll� /�i_ �v rz VA, LC•,4" 17 -IK Zip 49T79, Amount of Fee Enclosed l�c� t� rJ �iiFn?C Building Type Lot Area a,S No. of Bedrooms "5 Design Flow GPD f rx) Fill Section Only _�(_ Depth 30 �15 � Volume `7 3J 6; 1 A1913 PCHD NOTIFICATION IS REQUIRED WHEN PILL IS COMPLETED Separate Sewerage System to consist of gallon septic tank and Other Requirements: To be constructed by Address Water Supply: Public Supply From Address or: Private..- Supply Drilled by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewaU treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address P.E. R.A. License # Date W1 07Da Z APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when—considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe t. A or discharge of domestic sanitary sewage only. By: Title: D / Date: White copy - HD File; Yell copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH ' DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type — r.PGI3D Permit Will tocifioin '" " Street Address: Town/Village Tax Grid # 04-c !J GG = Mapy � Block — Lot(s) Well Owner: Name: .f Sv1,,„ Address: cu- 7'"' 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_ gpm # People Served '5/ Est. of Daily Usage pa gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling Xl New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type >,Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes >y No Name of subdivision S ,ow-o MP - jZ)4&&6- 611 ok LA& r Lot No. 'a-C- o Water Well Contractor: Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: 7 00 0 FT. Proposed well location & sources of contamination to be rovided on separate sheet/plan. Date: Z z v,Z Applicant 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 by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a w well driller certified by Putnam County. 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". ;OOZ Ulsi- NOI'IYA3'I3 000,111,iMI(7)( YSZlig 2?3iI3'I�C� -1 ZOIJ :'�3II3I.LLO�I-�i0�0I3)Ib96i 32I•dC, 7� mgvs IIIkraaa v s.,q-YZa saa xo YIYa(--)C —) _...t�a.a� Iu�I3ao3anlMO.� sauY�i3MC -')cam SIA'I `ru Sass TVA02iddY-X3C aassa -UTM 3S O.L S32i3dC�C� ' S'' � Q3A2i3Sg0 S3'IOH 1S3I d33QC�C� a.a32I - WivAouay d3a(- -- _ I a3_Ly9 M aaQ 01 X, IaC�C -7 • 43J auna321)una.\7Y12 C� HId3Q Q32H11a32i'I'II,� ?C-i 31y3i 32i3d�C� Q3 IED TYAOIiday . OZ01s Iunsc7(% x,omAIQSns ih hl RU ISaftb 133XT-TtVAC -)M SI.3S 0.' u - smria 3Sf10Ht --- )C%i S1'3S 332iH1-Sk IdC�C� aya rdolasmv) AOLuriosa'a 3iy2?0d2103C--C--) (SQa)133HS y1ya.KolS3a(--) hOLLN MOH.Lny 30 213ii3'I C� 213II.3'I SMd210 ,lIIt'II3d'IZ3.& -) ):0IIy3TIddY .LIIA"d3aM. S ZUU 30 1; A 1 .tp :31Y� `sv `,ao )» :AE GT,il MI • �� :t\I011YDO I 1332LLS Y° IiT4 M, ,.... 0 O 3TVy 2nd O , ........ _.. laams M3IAall . _ - _ _ ... _ _._ - SI43ISAS I).3I�Iy3IiI 30yA13S 3JY32il1SSIIS � A'Iddl1S 213IYMZYfIQ1,1IQ.\Z HIIy3H IyL�3IC \02II11).13 30 AOISIAIQ H1'IY3H 30 I \3I112?yd3a A1Mo0 IqY)1I[ld PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Property of LETTER OF AUTHORIZATION Located at TN 41zLZt,� Tax Map # Block a. Lot Subdivision of . 'fc wo /n/j/' of 1619j,4/l1 �,G Subdivision Lot # (gip _ Filed Map # :3 - C Date Filed ZZ f$r Gentlemen: This letter is to authorize ,-- ,frof_ i,-3 r a duly licensed Professional Engineer ,,Ne� 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 treatment and/or water supply systems in conformity with the. provisions of Article 145.and/or .147 of the .Education Law; the-P,ublic. Health.- - - La�v, and the Putnam County Sanitary Code. Very truly ours, Y Countersigned: Signed: P.E., R.A., # (Owner ` operry) Mailing Address 419 Mailing Address: af A State Zip / Telephone: Ls'---6 OV- V State QLA Zip Telephone:e'>> Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH OF ENVI tO MIF,,NTALHEAILTH;-SERVICES. �----,.tl.-.-,,.-.7- DESIGN DATA SHEET — SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Burkhardt Address 16 Hollv St.. Putnam Vallev. NY 10579 Located at (Street) Holly Street Tax Map 41.6 Block 2 Lot 61 (mdicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Date of Pre - soaking 10/11/01 SOIL PERCOLATION TEST DATA Date of Percolation Test 10/12/01 Hole No. Run No. Time Start — Stop Elaps�q Time (Mm.) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop =e's Percolation Rate Min/Inch P-4 1 12:45-1:15 30 23 26.5 3.5 8.5 2 1:16-1:46 30 .23 26 3 10 3 1:48-2:18 30 23 26 3 10 4 5 P-5. 1 12:38-1:08 30 22.5 25-.5 3 10 2 1:09-1:39 30 22.5 25 2.5 12 3 1:39-2:09 30 22.5 25 2.5 12 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e.:5; I min for 1-30 min/inch,5 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 4 HOLE NO. 5 HOLE NO. 6 G.L. TRACE TOPSOIL TRACE TOPSOIL TRACE TOPSOIL 0.5' BROWN SANDY LOAM BROWN SANDY LOAM BROWN SANDY LOAM 1.0' 1.5' 2.0' 2.5' 3.0' 3.5 ROCK,® 3'-6" 4.0' 4.5' ROCK,@ 4' -6" 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered None Indicate level at which mottling is observed N/A ROCK,® 4' -6" Indicate level to which water level rises after being encountered N/A Deep hole observations made by: Adam Stiebling PCDOH Rob Roselli BA Date 10116101 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite 5 Signatu Design Professional's Seal r S PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN -DATA. SHEET •SUBSUREAC-E SE- 'VAGE-;T- R-EATMENT- SYSTEM.. Owner Burkhardt Address 16 Holly St., Putnam Valley, NY 10579 Located at (Street) Holly Street Tax Map 41.6 Block 2 Lot 61 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Date of Pre - soaking 10/11/01 SOIL PERCOLATION TEST DATA Date of Percolation Test 10/12/01 Hole No. Run No. Time Start — Stop Elapse Time (Min•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 10:33 -11:03 30 20 22.5 2.5 12 2 11:07 -11:37 30 20 22.0 2 15 3 10:55 -11:25 30 20 21.5 1.5 20 4 11:25 -11:55 30 20 21.5 1.5 20 5 P -2 1 11:33 -11:58 25 21 24.5 3.5 7 _:..._.�._ 2: - 11:58- 1228. _ 30 . 21- - — -.._:� .: _s. -. : 3 - _:.: 10 ...�, 3 12:28 -1:58 30 - 21 24 3 10 4 5 P -3 1 10:58 -11:28 30 23 24.75 1.75 17 2 11:29 -11:59 30 23 24.5 1.5 20 3 12:04 -12:34 30 23 24.5 1.5 20 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. ( i.e. 5 1 min for 1 -30 min/inch, <_ 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 q_' a :,DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO.. 1 TRACE TOPSOIL BROWN SANDY LOAM ROCK,Qa 3' -6" HOLE NO. 2 TRACE TOPSOIL BROWN SANDY LOAM HOLE NO. 3 TRACE TOPSOIL BROWN SANDY LOAM ROCK,@ 4' -0" Indicate level at which groundwater is encountered None Indicate level at which mottling is observed N/A ROCK,@ 4' -0" Indicate level to which water level rises after being encountered N/A Deep hole observations made by: Adam Stiebling PCDOH Rob Roselli BA Date 10116101 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite S Signatu Design Professional's Seal 4 '(( 1 f PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL.. _ _ ..._.... _ _.......... _ r.,... _ ,..., . �.._ _. =.,,.n ..� _... _. -.., . •please print =or type: ,. ... K .. .,...� "PCHD PeT'C171t #`. Well Location: Street Address: Town/Village Tax Grid # No[CY 5r2«T U-ImA VAui Map 41, Block 2 Lot(s)&/ Well Owner: Name: ddress: M P,RlebiA2D� I RptJ Ll 6TQtt-7— u7 iU, , 1057 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 __r_ gpm # People Served _ Est. of Daily Usage oo al. Reason for eplace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason k6,J W*ZCP- SuPPC "rZ Xfza&snAL tAk-a( ub 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 Srcr�n K4P - RbhQ -WG 690k tAk* Lot No. Water Well Contractor: _ lb 1) Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: 7 j r-7- i Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: 12, 14 Applicant 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 by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller cer�a'fled by Putnam County. 1 /� Date of Issue 1 &- ZO -D Permit Date of Expiration &- 20 —c)(,p Title: _ Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; CVange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES { t.,:, .a :.:_- ,......,_..... r.,......_._..-A PLi.EATION•FOR APPROyA . OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: M. 1%k: 1,7w -_ i,z;�- &ILL_4 lkn 2. Name of project: 13y1- ,amp).7.. &aF," 3. Location TN: 4. Design Professional: & kCk. e � f,SO(, 5. Address: _S 1 17F S 6. Drainage Basin: %iy✓)Sury ,lives. 7. Type of Project: Private/Residential Food Service Commercial T� Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt w Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required?-; .� ....................... /V0 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency 1.2.. _IsJh.1s,prQject.in an area under th_ a control of local-planning, zoning; or other . officials; o`rd'inances? ........... ' .... ............................... . ............................... . y6T 13. If so, have plans been submitted to such authorities? ........ ............................... /VO 14. Has preliminary approval been granted by such authorities? Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water ,_N groundwater 16. If surface water discharge, what is the stream class designation? .................... 17. Waters index number (surface) ............................................ ............................... 18. Is project located near a public water supply system? ....... ............................... /VO 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ 21. Name of sewage system Distance to sewage system 22. Date test holes observed /o l& to 23. Name of Health Inspector ca/t14,2 •- 24. Project design flow (gallons per day) ... ............................... 25. Is State Pollutant Discharge Elimination , Syystem ( SPDES) Permit required ?... /V0 26. Has SPDES Application been submitted to local DEC office? ......................... V­ PC'-0'7 2 27. Is any portion of this project located within a designated Town or State wetland? . /v 0_ 28. Wetlands ID Number....... 29. Is Wetlands Permit required? .............. ................... .............................................. Has application been made to Town or Local DEC office? .............................:. 30. Does project require a DEC Stream Disturbance Permit? .. ............................... _ w J 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 4/12 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 41a . DESCRIBE: 33. Is there a local master plan on file with the Town .or Village? 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? .......... :....................................... ............. J 35. Are any sewage treatment areas in excess of 15% slope? 36. Tax Map ID Number p .......................... ............................... Ma Block Lot 37. _Approved plans are to be.returned to ..... Applicant _ Design Professional :.- NOTE:.A11_apphcatioiis for re�,w., :andapprovaI of a riew SST-S to- be,locate&within -the -T1YC 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 ofa project, such as stormwaterplans or the creation of impervious surfaces,.and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,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 my knowledge and belief. False statements. made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SI(;NVATURES & OFTICIAL TITLES: Mailing Address: ................................... { 11.164 (9195) —Te :t 12 PROJECT I.D. NUMBER. $17.20 SEAR State Environmental Ouallty Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor 1. APPLICANT /SPONSOR n 2. PROJECT NAME 2. PROJECT LOCATION: n n� Municipality (/T L Ltd County •. PRECISE LOCATION (Street address and load Intersections. prominent landmarks, etc., or provide Tap) .,tN 1"CrL QC&no;4) fi //'v c t Y j-r (, e t' ,J7V0 l A/LC S /-/010'e Irv41 =' S. IS P. APPOSED ACTION. �J New ❑ Espanslon 0 Modlllcallon/alleratlon 6. DESCRIBE PROJECT BRIEFLY: C,JNv)TrLA�17v/✓ (� F A /1/ w .3 4tlgl,,,4, /du, /j- c� 7: AMOUNT OF LAND AFFECTED: Initially J� 7 acres Ultimately acres S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTF. ^IONS7 ® Tea ❑ No It No, describe briefly. 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? . (i�fesntiiit, - `: O'tn0uitrlN :` " O'Commerclat . _ .O Agriculture . Parfil/ForeaUOppn. space.- - . . - ®Dine_►, _, ,_ _ _ _ CN'�I�E $ ��/'il ✓N'iiL'G+r�r i f s`ir�L �E R iC %' 14,�? f 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY. FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. -STATE OR LOCAQ? ;:.1 1I Vas 0 No If yes, list agency() and Pem ivappro als _ 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? ❑ Yes Q'No It yet. 1161 agency name end pertnithpproral 12. AS A RESULT.OF PROPOSED ACTION WILL EXISTING PE.RmrriAPPROVAL REQUIRE mdair CATIONT 0 Yes ®No I CERTIFY THAT THE INFORMATION PROVIDED A11OVE IS TRUE TO THE $EST OF MY KNOWLE:4E APpllcsnVsponedr names, r C� �//% S Z) i �( Dale: �7 Slgnslun: If the action Is In the Coastal Altar and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER f III- .EN.VIR,ONMENTAL ASSESSMENT (To be completed by Agency) 'DOES AC710h EEC ANV TYPE I THRESHOLD IN 6.NtCRR. PART 617 e-I II yes, Coordinate the review process, anC use the Full, EAF ..r Yes E WILL ACTIt?N ECE'IVE 000401NATED.REVIFw pal AOv!q FOR UNLISTED. ACTIONS IN 6 NYCAP, PART 617.6" It No 8 nepel,v�e eecla(ano- Mar of superse e? anplher'rnv0lreC apinCj(r `. " sr. u }n r.. Yea 0 C COULD ACTION RESU:T IN ANY ADVERSE EFFECTS ASSOClwo WITH THE FOLLOWING W -were May be h8n0a'rrtter. If I11`9101e Cl Ex,slm; ar quality surface or 9100nowaifr quality or quantity, notse )&Vela existing Ira1flC patterns, sobs ureste pr00JC1 0r O. 01sposi p0ient,a' for erosior• drainage or Iloodtnp'prob arns'''Explatn briefly C2 Aesthetic, agrICUIIWar arCnaQ010prcJ1, historic, IF other "alutol or Cultural resources, or eontmuntty Or neighborhood Character') E zplair. briefly 0 C2 Vepet8r,or or fauns. lisp., shellfish or wildlife species. significant hoortals, or threatened or endangered species? Explem briefly CA i• romrnuntly's exrsl,n; plans or goals as ontctalty 000pte0, or o change in use or intensity of use of land Or other natural resources) Expleln briefly CS Growth, suoseouenl development. o.l related activities likely 10 tq Induced by the proposed action) Explain briefly. , Ale CE Lon,, lens, snort terry. Cumulative or other effects not Identilro0 in CI-CS? Explain briefly. C7 Othe ^lnlbs is. (Inc 'vein; changes in use of either quantity or type of energy)) Explain briefly: D WILL THE PROJEC HAVE AN IMPACT ON THE .ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA) G.Yes o E'• IS THERE; OR•1 T RE. LIK,.ELY.,T,- QBE,_CONTROVERSY RELATED TO POTENTIAL. ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes Z440 11 Yes. explain briefly ... _...._ "...._ .. .._.__....._ __ .._. — , . '_. PART 111 — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect ldenofled above, oeterriiine whether If is substantial, large, Important or otherwise significant. Each effect should be assessed i!j Conn e' lion with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) peOgraphic scope; and (f) magnitude.-if necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse. Impact$ hove been Identified and adequately addressed. If Question D of Pan 11 was checked yes, the determinition and significance must evaluate the potential Impact of. the proposed action on the environmental characteristics of the CEA. .i ❑ Check this box If you have Identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box It you have determined, based on the Information and analysis above and any a.upporting documentation, that the proposed action WILL NOT result In any significant adverse, environmental impacts ANC provide on attachments as.rtecessary, the ressons.supporting this determination: Orae of ee AS r lint or ype ewe m RriPonilble 01fiCtil M lee AtIenC4 fait or esponsi a wilioce, 31. _ tsnetu►e o es sr W-OViCel M Wild Agenty IlItshature, of Ieperet III different from respon$ * O rter) '-�-12 PUMP SYSTEM CALCULATIONS Prepared for Burkhardt Holly Street, Putnam Valley November 29, 2001 PREPARED BY: BEYER AND ASSOCIATES CONSULTING ENGINEERS 78 SECOR ROAD,, SUITE 5 NL HOP_A NY 10541 PHONE: 845 =621 _=4756. FAX, 84'5- 628 - 1905, 4` iV1ICHAEL'-,BEYER NY PE =_LIC: 074597 Pump System Curve Holly Street, Putnam Valley Minor Losses: FM Dia = 2 in. ft. qty. Minor HL FM Area= 0.022 sf 90 Bend: . 2.8 2 5.6 Hazen C= 150 45 Bend: 1.5 2 3 FM Length= 110 ft. check valve 14.4 1 14.4 Minor Losses= 24.12 ft. gate valve 1.12 1 1.12 Total FM Length= 134.12 ft. Total= 24.12 Static Hd.= 8.0 ft. Flow (gpm) Vel. Loss /ft. FM Length Friction Hd. Static Hd. TDH fps ft. ft. ft. ft. 30 3.07 0.02 134.12 2.45 18.0 10.45 40 4.09 0.03 134.12 4.17 8.0 12.17 50 5.11 0.05 134.12 6.29 8.0 14.29 60 6.13 0.07 134.12 8.82 8.0 16.82 70 7.15 0.09 134.12 11.73 8.0 19.73 80 8.17 0.11 134.12 15.02 8.0 23.02 90 9.20 0.14 134.12 18.67 8.0 26.67 100 10.22 0.17 134.12 22.69 8.0 30.69 DESIGN OF PUMP SYSTEM' Copyright (c) 1991 by MathSoft, Inc. Burkhardt- Putnam Valley, NY. This document calculates a pump chamber and system curve. Enter the problem conditions: 1. Pump Chamber:...: _. . t �.�:<.. = ........�. r... Pump Chamber Area A := 26.25•ft 2 Length of Fields Len := 432-ft Invert Elevation IE := 492.1-ft Pump Height Pumpht := 1.5-ft 2. Flow Rates Number of Bedrooms Bed := 3 Flow Rate per Bedroom Flow := 200 Peaking Factor Pf := 2.5 Hours of Operation Time := 16 Scroll to page 4 The Cycle Volume is (gallons): Distance between on /off floats: The Invert In Elevation is: The High Level Alarm Elevation is: The pump on Elevation is: The pump off Elevation is: The overflow invert is: Cyvol = 212.7•ft3 D1 = 1.1 -ft Inv = 492.1 -ft Alarm = 491.9-ft Pumpon = 491.8-ft Pumpoff = 490.7•ft Overflow = 492-ft The daily pumping rate is (gallons): FlowRate = 600 The peak flow rate is (gallons): PeakRate = 1.5.103 The required pumping rate is (gpm): PumpRate = 1.6 _r. Lq GOULDS PUMPS Submersible Sewage Pump 3886 pY'ia YP' e! Prosurance available for residential applications. APPLICATIONS against component damage Specifically designed for the on accidental reverse rotation. following uses: n Fasteners: 300 series - Homes stainless steel. • Sewage systems w Capable of running dry - Dewatering /Effluent without damage to • Water transfer components. with bare leads. ® Designed for continuous SPECIFICATIONS operation, when fully Pump: submerged. • Solids handling capabilities: MOTORS 2" maximum. against contaminants • Discharge size: 2" NPT. ■ Fully submerged in high • Capacities: up to 185 GPM. grade turbine oil for lubrica- • Total heads: up to 38 feet tion and efficient heat TDH. transfer. All ratings are within • Temperature: the working limits of the 104 °F (40 °C) continuous motor. 140 °F (60 °C) intermittent. s Class B insulation. • See order numbers on Single phase (60 Hz): reverse side for specific HP, -All single phase models voltage, phase and RPM's_ __ . . feature capacitor.start. available.— .. � e, - motors for maximum FEATURES ■ Impeller: Cast iron, semi - open, dynamically balanced, non -clog with pump out vanes for mechanical seal protection. Optional Silicon bronze impeller available. ■ Casing: Cast iron volute type for maximum efficiency. Designed for easy installation on A10 -20 slide rail. ■ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces for superior abrasive resistance, stainless steel metal parts, BUNA -N elastomers. o Shaft: Corrosion - resistant stainless steel. Threaded design. Locknut on three phase models to guard METERS FEET 15 50 1 10 0 w x U a Z 0 J 5 0 30'\ wso5s ; i 20 —_ - -- WS038 I 10 01 0 starting torque. ■ Power Cable: Severe duty • Built -in overload with rated, oil and water resistant. automatic reset. Epoxy seal on motor end •'/ and 1/2 HP —16/3 SJTOW provides secondary moisture with 115V or 230V three barrier in case of outer jacket prong plug. damage and to prevent oil • 3/ and 1 HP —14/3 STOW wicking. 20 foot standard with bare leads. with optional lengths Three phase (60 Hz): available. *Overload protection must be ® Motor Cover 0 -ring: provided in starter unit. Assures positive sealing •'/ -1 HP —14/4 STOW with against contaminants bare leads. and oil leakage. ■ Bearings: Upper and lower e Consult factory for informa- heavy duty ball bearing tion on 575Y models. construction. to Designed for Continuous AGENCY LISTINGS Operation: Pump ratings are Tested to UL 778 and within the motor CSA 22.2108 Standards manufacturer's recommended �cp ® By Canadian Standards working limits, can be us File# R38 Flte9LR38540 operated continuously without damage wh -en . fully : -- ;Goulds Purttps is iso soot Registered.:.: _ submerged. I i i I MODEL 3886 .. ...._.�.__ .i ...1 - ..__ -..... - - 2" SOLIDS f RPM 1725 I I I tOGPM Fr I. I 20. 40 60 80 100 120 140 160 180 200 GPM 0 5 10 15 20 25 30 35 40 45 m3/h CAPACITY Goulds Pumps 02000 Goulds Pumps ITT Industries Effective February, 2000 83886 p 7 5 8 8 COMPONENTS DIMENSIONS, Item No. tion Descri p 1 Multi -vane non -clog cast Max Amps. iron impeller 2 Electrocoat paint outside WS03118 WS0318B and inside 3 Silicon carbide vs. silicon 9.8 carbide mechanical seal 4 Stainless steel shaft 5 High grade turbine oil 6 Al I ball bearing heavy 4.9, duty design 7 Epoxy sealed cable 8 0 -ring seal MODELS (All dimensions are in inches Do not use for construction purposes.) 1 8' /a' 121 14— — /1T�TI/1l.1 l4— 61/4 Order . No. HP Phase Volts Max Amps. RPM Wt' (lbs.) Heaters WS03118 WS0318B '/J - :1 115 9.8 1750 63 N/A 208__.......5.5 _... WS0312B 230 • 4.9, WS0511B WS0518B Y: 115 14.5 65 208 8.0 WS05126 230 7.3 WS05386 3 200 3.8 K34 WS05328 230 3.3 K32 WS0534B 460 1.7 K23 WS07188 % 1 208 11.0 85 N/A WS0712B 230 9.4 WS07388 WS07328 3 200 4.1 K34 230 3.6 K33 WS0734B 460 1.8 K23 WS1018B 1 1 208 14.0 N/A WS10126 230 12.3 WS1038B 3 200 6.2 K42 WS1032B 230 1 5.8 K41 WS10348 460 1 2.9 K29 ' \ KICK- PERFORMANCE RATINGS (gallons per minute) 5 Order No. WS03B WS05B WS07B WS10B HP o. '/a '/a 3/ 1 RPM s 1750 1750 1750 1750 .5 — 150 — — = 3 10 82 122 150 — 15 33 90 123 155 20 — 50 90 126 25 — 7 97 95 30 — — 5 61 35 — — — 20 SEWAGE EJECTOR SYSTEM Simplex ejector system Unassembled Package Order No. SWS0511B offers ease of ordering and Includes: installation. A single ordering • Basin and Cover: A7 -1830P number specifies a complete • Check Valve: A9 -2P system designed for most ; • Pump: Y2 HP,115Volt — WS0511 B residential and commercial • Float Switch: A2 -5 (115 V), A2 -6 (230 V) sump and sewage pump For 230 Volt application Use Order No. applications. SWS0512B. PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. 11d Goulds Pumps <& ITT Industries MOIR GOULDS PlJK SIMPLEX CONTROL PANEL OPTIONS ALARM CIRCUITS ALARM DEVICES (can be added to simplex or duplex controllers) (Requires option 3300) 1. High -level alarm. circuit (Provides alarm circuit in -..,. db ®10 Ft.) NEMA 1 6400 simplex panel. Choose alarm device to complete 2. Elapsed time meter. (Mounted inside cabinet indicates NEMA 3R/4/4X/12 6420 the system. 3300 db ®10 Ft. NEMA 311/4/4X/12 6450 2. Guaranteed pump submergence circuit with low level alarm. 4. Intrinsically safe controls. One required for each float. d light . Lexan NEMA 1/3R/4/4X/1 6480 Overrides manual and automatic operation of pumps) 3320 alarm panel (includes: 4' bell silencer switch, A. NEMA 1' 3. Extra set of alarm contacts. B. NEMA 3/3R/4 cator light; rated NEMA 3 /3R) 4naled 6. Lightning arrestor (Used for signal of remote alarm device.) Single phase larm requiring separate power 115 V power Three phase A. Powered (wet contacts 3330- upply (Signaled by dry contacts in main panel. mounted internally, choose according to power supply (phase). B. Non - powered dry contacts • 3340 equires 3340.) 6500 4. Seal failure circuit with indicator light. (Monitors 15 amp includes 1.5 KVA transformer larm to be powered by main panel. - moisture sensor on dual seal pumps.) Signaled by powered contacts in main panel. A. Circuit bui lt in A3 panel 3350 Requires 3330.) 6510 B. Circuit in separate NEMA 3/3R enclosure - Remote alarm light in separate NEMAt enclosure (Used Jn conjunction with existing panel.). A4.3 requires 115 V supply) 6515 5. Low voltage, phase loss and reversal circuit. (Three phase only, stops. % NOTE: When ordering alarm devices, please note desired voltage and 208 -230 V operation —.pumps and closes non - powered . 3360 mounting location; top, side, front, etc. ' contacts.) 460 V operation 3370 POWER EQUIPMENT -- . Consult factory for options pot listed. ADDITIONAL`ACCESSORIES -1 Order. No.1 -..,. 1. Condensation heater -115 V 3710 2. Elapsed time meter. (Mounted inside cabinet indicates 1 pump run time.) 3740 3. Cycle counter. (Mounted inside Cabinet indicates number of pump Starts.) 3750 4. Intrinsically safe controls. One required for each float. 3760 5. Test push buttons. (Overrides float switches to simulate operation of level controls.) A. NEMA 1' 3770 B. NEMA 3/3R/4 3780 . 6. Lightning arrestor Single phase 3781 Three phase 3782 7. Convenience outlet (f 15 V GFI) with circuit breaker protection, . mounted internally, choose according to power supply (phase). Single phase panels 3783 Three phase panels 15 amp includes 1.5 KVA transformer 3785. Goulds Pumps ITT Industries n-GOULDS PUMA A3 -2012 MAGNETIC CONTACTOR SINGLE PHASE A3 -5034 MAGNETIC STARTER ` Provides automatic o.r-manual pump operation for single phase systems. Volts Model No. I Horsepower Volts A3-2012 I ''A =2 115/200/230 A3 -3012 3 — Includes capacitors and overloads 200/230 A3 -5012 5 — Includes capacitors and overloads 1 230 A3 -3512 3 & 5 —Without capacitors and overloads 230 -Single phase, 60 Hz. • NEMA 1 steel enclosure standard. • Includes: contactor, hand -off auto switch, run light, and terminal block for wiring connections. • May be "u-sed on V3 through 5 HP pump. • Separate:level control switch(es) required. ;rles Electrical Control Panels Simplex A3 Series Control Systems THREE PHASE Provides automatic or manual pump operations, and three leg motor protection for three phase systems. Model No - HP Volts A3 -5034 %z-5 (or 3 HP at 200 V) 208/230/460/575 A3 -7534 7'/ 208/230/460/575 A3 -5038` 5 200(208) To be used for 200 (208 V) 5 HP power supplies. - Three phase, 60 Hz. NEMA 1 steel,enclosure standard. Includes: contactor, hand - off -auto switch, run light, transformer for 115 V pilot circuit, and. terminal block for wiring connections. - Overload protection required. Ambient compensated quick trip type.heaters (3 required)-must be ordered separately. *Separate level control switches required. SIMPLEX CONTROL PANEL OPTIONS (List panel model number, then any of the following-options order numbers.) CAN BE Alf D'TO A60VL BASIC CONTROLLERS TO MEET SPECIFIC JOB REQUIREMENTS `* Custom built panels can be provided per customer specifications. Forward specifications to your Goulds Pumps distributor for quotation. ENCLOSURES Rating construction Order NEMA 3R Steel, Hinged Door 311Simple. NEMA 4 Steel, Hin ed Door jNo. 312a NEMA 4X Fiber lass, Hin ed Door 313NEMA 12 Steel, Hinged Door 3.14 NOTE: Enclosures listed above are dead -front type, all switches and indicator lights would be mounted inside of panel on permanent mounting bracket. 0 2000 Goulds Pumos ENCLOSURE OPTIONS Goulds Pumps ITTIndustries Order No. 1. Through door mounted H.- O- A.switch and run light. (Provides access without opening enclosure, sbrldard'on ' NEMA 1 panels.) A. NEMA 3/3R 3200 . B. NEMA 4 210 C. NEMA 12 [�3220 2. Inner door (hinged) on dead -front panel. (Provides access to switches without hazard of entering actual panel.) 3240 3. Locking hasp, (Adder for NEMA 1 panels, hasp is standard on all others.) 3250 Goulds Pumps ITTIndustries GOUL ®5 PUN, PL_1L. Switch6s . A2 -7 Features ® Bare leads for direct connection to a panel. ® Mechanicail activated A2 -8 PUMP UP DESIGN Features ® Bare leads for direct connection to a panel. ® Mechanically activated tilt switch with heavy duty non - mercury contacts, not sensitive to rotation. m Normally closed design for pump up operation. z Adjustable start/stop level from 5.5" to 36 ". w Entire unit is UL and CSA listed. Specifications ® Unit rating:l0 amps at 120 or 240 Vac. 15 foot SJO neoprene cord 13 amps . maximum. w Two required for simplex t m y .tilt switch with heavy duty Specifications . sys em (one pu p). ® Three required for duplex non- mercury contacts, not ® Rated for up to 3/ HP, system (two pumps). .sensitive to rotation. 115 V or up to 2 HP, 230 V. ;m Differential infinitely m Normally open design for . m Rated for 85 starting amps, adjustable for a wide range of pump down. operation. 115.V,15 running amps applications. ® Adjustable start/stop level . maximum. 85 starting amps, m Bare leads suitable for pilot from 5.5" to 36 ". 230 V,15 running amps circuit control up to 230V. �: -a Ent! re:pnit is;U.L d.CSA ..... frnaxinaur�. - - _ __ �._.__ � �. _�_ =o �._ �.: -� _ .:_..._. , fisted. - ®15 foot flexible 14 gauge, Specifications 2 conductor (UL) SJOW -A, m Rated for up to Y4 HP, -115 V SJOW (CSA) water resistant, or up to 2 HP, 230 V. neoprene cord. P'04 ® Rated for 85 starting amps, w Epoxy sea switch and .115 V,15 running amps cord, conductors. maximum. 85 starting amps, m Not sensitive to turbulence. Can be in liquid to 230 V,15 running amps ® used up A2 -2 , maximum.. 140 °F (60 °C). A2.2 ®15 foot flexible 14 gauge, 2 conductor (UL) SJOW-A, 2.3 Features SAW (CSA) water resistant, Features ® Pressure activated switch. neoprene-cord. - ® Mercury switch ® Liquid level differential ® Plastic PVC housing can be permanently sealed in permanently set at 6 ". used in liquids up to polyurethane resin. Requires 12" submergence. 140 °F (60 °0). w Adjustable weight position. ®15 foot cord with bare . u Epoxy sealed switch and ® Normally open design leads for direct connection, cord conductors. mercury fluid contacts. to a magnetic contactor or a ® Not sensitive to turbulence. is Can be used in liquid up to starter as a pilot switch. 140 °F (60 0C). is Ideal when limited space is available. A2WT m Adjustable PVC cable weight. 0""'A2-3M A2-3M Features ®Mechanically activated tilt switch with heavy-duty :.non-mercury contacts. ..m Adjustable weight position. w Normally open design. ::w Can be used in liquid up to 140 °F (60 °C). Specifications -® Unit ratirfg' 51rflps at1 -i0'' or 230 Vac..15 foot SJOW -A (UL), SJOW (CSA) water resistant, (CPE) neoprene. ® Differential infinitely adjustable. ®Bare leads suitable for pilot circuit control up to 230 V. A2-20F n Bare leads for direct connection of pump in junction box. ® Mechanically activated tilt switch with heavy duty non - mercury contacts, not sensitive to rotation. w Rated for 120 starting amps and 20 running amps. ® Can be used in liquid up to 140 °F (60 °C). Goulds Pumps ITT Inrli ictriP.S CHECK VALVES PLASTIC CHECK VALVES • Ideal for horizontal Pipe Size Order No. installation.- 1i' As 12P • Compression seal connec- I 9 P 2 tion for easy installation. 3' A 2" AMP —" • Swing design flapper prevents clogging. • Available for pipe size 1 Y4 °, 1 Y', 2', 3'. CAST IRON CHECK VALVES • Ideal for.horizontal installation. • Heavy duty cast iron construction. -Swing 'design flapper prevents clogging. • Available -in 2" !and 3" NPT threaded connections. Pipe Size Order No. 2' NPT A9 -21 3'.NPT A9 -31 PIPE CONNECTORS SHORT RADIUS ELBOW • Cast iron construction. • 125 lb. ANSI rated flange at pump end. • 3' NPT or 4" NPT threaded connection for discharge pipe. Flange Order Used Size Number With 3' Al -5 388803 4' A1-6 3888D4 I T 5.38 i 1I3.09 3.75 "I BALL CHECK VALVES -*.ideal for.vertical mounting. • Heavy duty cast iron.or plastic construction. Natural rubber ball. • Clean -out port and plug, • Available in I A ", I W, 2" and 3" NPT threaded connections. • Also available in 4' flanged, (125 #). Pipe Size Order No. 1'/' NPT A9.128 J. f' NPT A9 -156 2' NPT A9 -28 3' NPT A9.38 4' Flanged . A9 -48CF 4' Flanged A9 -4SCT F 6.75 LLI 4.50 4' -8 NPT 3' —BNPT I I A � �--- 1.5 Dia. 9.00 Dla. ---� 05 A1.6 Plastic Pipe Size Order No. 1Y4 A9.12BPT 1'/' A9 -158PT 2' A9 -2BPT Goulds Pumps Cl�, ITT Industries - - - - -- --------------- - - = - -- - - - -- 9a - -- rLli m • J '1 6�7 -05 40 'E - --�' - --�- �, -• : / ' .. T_ ..rte r .r '� / 14" OAKI • I - I I MN 497.1x "^ I a9 — - __ P 1l I �c P-4 /' Vitc .... 494-1- _, ..- _ . _ 4 EDGE. OF x493.9 3 _ — — T-2 PTIC `TANK I Q I — 4 - ASE OF FILL PAD T -5 L- - 4g0 P- _--- "OUNpATION D IN TO DRYWELI o / ;TY LINE �' <• � S LJI � a,�a�e -� � Nek; T)q SITS PLAN 1. =20' K �� a� D"� �� ��yG s.,��- __ C3 �� O.O -. I❑ _iO: _ rte,. Ord PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDROOMS ALL SUBSEQUENT REVISIONIALTERATIONS TO THESE HOUSE PLANS MYS"% BE SUBMITTED TO THE PCDOH FOR APPROVAL IY2 SIGNATUE & TITLE ( "" 1DAtrE— 1 Lj �` t);) PUTNAM COUNTY DEPARTMENT OF HEALTH - -. -D SION OP E. RoNi NTA.L BEALn smviCES. - INITIAL MIM /COMMERCIAL SITE INSPECTION FORM SECTION A. ,GENERAL INFORMATION Narime of Project _ .% r e, County �. jrr r Site Location -r C wt� �jt ID%Z* Building construction begun 1S! CO Extent Is property within NYC Watershed ? ................. Yes -f;�J'No SECTION B. TOPOGRAPHY (Please check all appropriate zes) 1. 0 Hilly-_T-1 Rolling_,Q .Steep.slope._ ' [_ _ _dentle slope --EJ Flat 2. Evidence of wetlands . Low area subject to flooding a Bodies of water E] Drainage-ditche Rock outcrops 3. Property lines or comers evident .......:...:...:....::. .............................:. D Yes o -4.: Do watercourses exist on or adjouz the property. ...........:........:....... Yes o 5. Will these affect the design of the sewage system facilities ?...........:. _- g--_es. Yes o -. 6...,.-Do watershed regulations apply in this development ?... :.::.:.......... YNo — 7 Will extensive grading be necessary?::::..,:.., .:....:.. ..:............:E...::..- .. - = -- Yes- No 8. Will extensive fill be necessary for SSTS? ......... ............................... Yes . No -- .. -- - 9. Do filled areas exist within the SSTS area ? ................ F-1 Yes D No If yes, what is the condition of the fill? - - - -- - SECTION C. SOIL OBSERV TIONS - 10.'- Appearance of soil: and_ Gravel oam lay - Hardpan IViixture " - - 11. Observed from: E] Borings Q Bank c t ackhoey�e ations 12. Soil borings /excavations observed by on to 13. Depth to groundwater 'K r e c on A ( - - - - 14. Depth to mottling on `� S Ir ,) o f4 15. Are test holes representative of primary & reserve areas ...... ....t .......................... E] Yes Ej No �►� Y 16. Soil percolation tests made by ��(k Sx _ _ on 17. Soil percolation tests witnessed by f— on SECTION D (on back) 9- 4 0 4 { 2 SECTION D. DRAINAGE 6fe-s 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? Q No 19. Will groundwater or surface drainage require special consideration? ......:.............. Yes . o 20. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... ❑ Yes o SECTION E. REMARKS 21. If a common water supply is proposed, has an inspection been made of the existing or proposed source and facilities? ................................ ............................... Yes o Inspection data - -- - . _ 22. Do adjacent . wells and/or sewage systems exist?. ..:................ ...._..................... _, es No 23. Additional comments _ [4 kt- '.Cl 5 i =V_ %Z _ - 24. Site observer /inspector and title - -- 25. Dates) of observation(s)inspection(s) lCF IC, TEST PIT PROFILES Hole # Lot # _Hole # -= Lot # _ -Hole # Depth to water Depth to water Depth to water - -- -- - Depth to mottling Depth to mottling Depth to mottling Depth to rock/imp. _: :- - ' ` = ]Depth to-wck/imp: Depth to rock/imp. G.L. G.L. G.L....._. . --0.5 -.. - 0.5 0.5 3.0 :3.0 - - 3.0 4.0 4.0 - . - . 4.0 . . 5.0 5.0 5.0 6.0 6.0 6.0. 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 __ i r,,,3 i PI I' PROFILES Hole # ' Lot # Depth to water Hole # Z Lot # Depth to water .Hole # Lot # Depth to water Depth to mottl ?.� i Depth to ng ' Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. 0.5 _ 0.5 0.5 1.0 %12 1.0 1.0 c .0 2.0 2.0 3.0 3.0 3.0 �4.0 - - 3�- tr 4.0 5.0 5.0 ..� 6.0 6.0 hal 7.0 7.0 8.0 8.0 .O 10.0 Hole # Lot # M 10.0 Hole # Lot # 4.0 5.0 6.0 7.0 8.0 10.0 Hole # G Lot Depth to water Depth to water Depth to water Depth to mottling Depth to mottle ` _g; �� .- -- ��- epth -to= mottling.._._ .. y Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 �" <<- (o t r -t-b _ 0.5 -- 1.0 1.0 0 2.0 t�� �� 2.0' 3.0 \� S5 �. 1, 3.0 4.0 3 - 4 4.0 of �� 5.0 5.0 6.0 6.0 0 7.0 7.0 8.0 8.0 9.0 9.0 10.0 10.0 0.5 1.0 14 0 2.0 3.0 4.0 5.0 �� 6.0 0' 1 7.0 8.0 M 10.0 TEST PIT PROFILES a. Hole # Lot # Hole # Lot.# Hole # Lot r Depth to grater Depth to water Depth to water Depth to. mottling .. Depth to mottling.. De th to.mottlincr Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 0.5 0.5 . 1.0 1.0 1.0 2.0 2.0 2.0 3.0 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 Hole # Lot # Hole # Lot # Hole # Lot # Depth to water Depth to water Depth to water Depth to-mott ling ....: Depth to mottling'-­ - - _ .- _....._. Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 0.5 0.5 1.0 1.0 1.0 2.0 2.0 2.0 3.0 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5.0 6.0 .. 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 -10.0 V U JV 111JW1UVUJV 1111 \I IVJ WVI \111U •JWVII YVVL VLI... �VV' IJi VV'VY VJII YVVV IrY C3-NJ BRUCE R FOLEY � LORETTA MOLMARI, RN., M.S.N, Public Health Director 04 Associate Public Mealth Director Director of Patfcnt Services Nx 0Pv 11 1 1 Geneva Road Brewster, New York 10509 ATTENTION: XADAk kIEBELING •GENE REED All information below must be IdiX completed prior to any scheduling. DATE: ENGINEER OR lr'MM: , .- d- - G. PHONE M (0 REASON: DEEPS: )l PERCS: ;W PUMP TEST: A ROAD /STREET: x4 / S TONVN: TAX MP #: SUBMISIOM ^ L 0 T M Z � Q OWNER.- 1.i�an�.- 1�;rr�cl � ._..,.• P SQ1L TESTING. YES NO t C3 . - rya. ,Proposed SSTS within the drainage basin of'West )Branch or Boyds Comer Reservoirs. Proposed SSTS within SOO feet of a reservoir, reservoir stem or control lake. Proposed SSTS within 200 feet of a watercourse or a DEC wetland. Proposed SSTS design flow greater than 1000_ gallons/day or SPDES Permit required. JProposed'SSTS for a Commerical Project .. ". _ . Iris the responsibility of the design professional to provide the above information prior to soil testing. This Department wi!1 dctermine the IVti CDE'P project status (Joint or Delegated) based on fat response. If you answeredke_s to fine of Che qucstions, NYCIDEP must witness-the soil testing. This Department will coordinate a mutually suitable time for field testing with the 1PMOR, the Design Professional and NVCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates. N GCDEP, is requ ed to ,_ ,to � ss the soil testing, it•wM be the sole responsibility of thee d pro onal to schedule rg- witnessing of the•sail testing with NYCDEP. FOR COMM ME ONLY `®r PAM MIE; 31, IM Tif- lMMA ESTj . V 391d 906t8Z9 M Xd3 S310I0OSSM3J138: Q I Off: TO TO, ZT /60 TW oN 3'113 SENDING CONFIRMATION DATE : SEP -24 -2001 MON 15:25 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE : 96281905 PAGES : 1/1 START TIME : SEP -24 15:24 ELAPSED TIME : 00'29" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMJTTED•.. FILE No.191 09,12 'Ot 01 :20 MMYSMMIATES FM(:8458261808 PAZ 4 • fiS3L0'i�U - -ILL, yy dB�lL�19t!��WaOQ�Wt3� xa+�laPnp�01N�P '$P°FNola d- Ha a9+aa IL-.a ImW►nov egl malt► 44 P*" sl d=1G1 * rosin! ao:►am om I I I U'mo P- ataoMe -m agl- p—q pnolw +a og —q nqpajud six dfimtN Paa Tww"VIA rqy •0nCa . 0 °4t - Pat!R mall5+PQ m ;Wfi mjvp la*id d=AW ml -p—p m- p —wntoa =IRL loppoaeow +Wdoop>mmjqaeaaeagavpmdroPvq-la d12pvagio4.rm ad- aw9.11 I-r-d p4mm -0 s.4 Un pmadaa if o ' pa, pbaaijowadS70dS+ avP/ �IN00Dla !91�1ae�.aaB�+PBJ83P��+d d o ' �qef+o i+ II�4�eP¢ a8+ a4�e+ HWMlomwRaBtmr •,PAPmW!°BTISSP�mda+d +Q o . ' 011 Sit ���ddV1J�1IVi r1UttOZ . +A9>QLi4ia1N0>r . o zsataptu A $ ;Saw jA06ViLK ' of rp 81<IOHd IW411ro ul W)m 7x177) —rya ? aglepagwA nol .taudpwtftp X4a9 vow rapqumom+mUV /7���G 098$3NS.9ff '.�798iA1S1iYOY�( 9.'Oi,WSLiV . Mot tvak —H =---a ping mama g HIT43H. SO .LNEEKL2iVd3Q iwl.sp A"W N A-90 RI mM NO WVIM QY 1wa10 g7mX RAY nwam,r . 't!8'p4 •14'S'lgV►070pt VLLID(O'i x ARM '8 =Ta f b .:._�.::.> •..�..: :.> >,a.. .'. ._ >. r. -.� . ._i..�a _ 14,08._TF1:B4, -2R- 79214. �.Wil'£ePLI7WY'I OF P.,_.4. COUI!IiV.OFPPIZII'fNf .,. '18 2L�d1•_NEP. ..� .. w O p J LL 1 1/r ` - :f urn pin set formerly .¢yna e `" .. 49 496 1 6 1'7 . 14' 77 °06'40 E �j ..' °sph °I 1 16 •� 500 i 4, - � � r ♦ conr�ete manurY�en[.. , / i' � r 1 •.« r3Q i-'_ ■ 1< i a e 'F ♦ ♦ .f. • V 9# a ,.'V�v ' ..;.• / //' ^ j 498 �\ �■ 00u, r • k ♦ 14' Oak Cif i ♦ ff,,,,�' t .� • • Ir" -� .j- -- 4.48— __ -�Si. F� : ♦ .O`+ � - �' r O,, 14ros9 cut found' • - •i•s.••• ♦e♦r \ ♦•••••t • �. '� i 4�i to cr+ ledge OJ' E i ( :i' 49a. ••■■ •n•. C! / t • ad °, •,rte ro) , _!♦� ® --- 491 � O •., Q LOT .= 60 ..' 494.,:. Er �Y• Q� .i'. TP EXPOSED ROCK LEDGE ♦••9 ®. / �` • �oep free _ _ : • � / •''� Y, h�' '' �• . ♦ . ♦ e .490 fff ►►►^^^�����wwwiii *�- � .�' • � 492 OS- .'pe .. , , ,_ .� ' bbl' . - O 49 •♦e■••s■• ■••♦ R �ab �,�' Qj gyp,. 1�- TP .Pole •• • . � iron pin set stake set C. I V _ f —960.23' vw pin set S .77 °56'00 TY q,• J 90 n . V -cut set on rock . .below surface - P . LOT 1259 ell r VA. .BOUNDARY & TOPOGRAPH /C only to: SURVEY OF PROPERTY PREPARED FOR Elevations. given hereon refer to an assumed IV 1r,% i vertical datum. v certification appearing hereon ct to eoyeinents, lights of wav coven on UZA NNE. BURKHA, �d e and belief, this survey was This property subject S m m .standards for land survgys acid restrictions of record and. to any state of facts that an PROPERTY S/TUA TE IN _ s f t;f/b may disclose. a 6. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address Located at (Street) �� S Tax Map Y/ Block °? Lot (-o / (indic nearest cross tre t.) Municipality Ian.` _ Watershed SOIL PERCOLATION TEST DATA Form DD -97 S TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES . ..__......_ �.., �. HOLE NO. DEPTH HOL�O. .HOLE NO. _... _�..�_._... G.L. 0.5' 1.0' _ 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' . 5.0' 5.5' J2 ns;� �z 6.0' 6.5' lor (01 j tr L9 7.0' ` Ia inn 7.5' 8.0' 8.5' ?% l 9.0' - 9.5' 10.0' Indicate level at which. groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: Address: Signature: Design Professional's Seal U C� --!( Ad- � F' ♦ �{.�'h. _� h,r Tw', �ti'j;. �ii s�'+Y` ♦ -f ON � `£ Signatt and Tif1e is' FP fit IT RFCFTVF RY• I acknowledge receipt: of this report SIGNATURE; 4 _a �.. MR 1 Tit 1e I Nil IRV its opt `:f3.8�s - r a � F' ♦ �{.�'h. _� h,r Tw', �ti'j;. �ii s�'+Y` ♦ J tom,., l "Yost; MEN `£ Signatt and Tif1e is' FP fit IT RFCFTVF RY• I acknowledge receipt: of this report SIGNATURE; 4 _a �.. 02,1960- Tit 1e I t PUMP SYSTEM CALCULATIONS FOR BURKHARDT RESIDENCE HOLLY STREET PUTNAM VALLEY, NEW YORK TOWN OF PUTNAM VALLEY PUTNAM COUNTY November 19, 2007 . _:r. a ... .. � .. _.. ��.. _........ �, w. .... ._.. .. F.:.. -..._ _ ...i_ ... +..-- vim....... -... ._..a... • .. -.. PREPARED BY: BEYER AND ASSOCIATES CONSULTIlNG EN-GINEERS 273 STS.,, � GOAD [tEWS� ER1�IW�YO X10509 Beyer & Associates Consulting Engineers 273 Starr Ridge Road Brewster, New York 10509 ._.... -:o -.. .....anr -.::s �. _._...._,. -.., ...�.,tz,:�:+.ra..- .,«_.. �..m..�•.ar.,.�.<� -se. .:- ,Tx.c. <.. .. .. _ ._ ;.e.: ;.s..,..�.x+... _.� :� _ .. _ BURKHARDT RESIDENCE HOLLY STREET, PUTNAM VALLEY, NEW YORK Pump System Curve & Calculation November 19, 2007 Use Goulds Submersible Sewage Pump Model 3886 1.0 hp single phase 230 volt 1750 RPM with 2" solid handling capabilities. Minor Losses: FM Dia = 2 in. ft. qty. Minor HL FM Area= 0.022 sf 90 Bend: 4.3 3 12.9 Hazen C= 150 45 Bend: 2 0 0 FM Length= 60 ft. check valve 11 1 11 Minor Losses= 25 ft. gate valve 1 1 1 Total FM Length = 85 ft. Total= 24.9 Static Hd.= 16.25 ft. Flow (gpm) Vel. Loss /ft. FM Length Friction Hd. Static Hd. TDH fps ft. ft. ft. ft. 10 1.02 0.00 85 0 16.3 16 20 2.04 0.01 85 1 16.3 17 30 3.07 0.02 85 2 16.3 18 40 4.09 0.03 85 3 16.3 19 __:, -•.. ^ .....50 :.: - .5:11 _ . 0.05 85 4 -1-6.3. .:... =,: -20... 16.3 20 60 6.13 0.07 85 6 16.3 22 70 7.15 0.09 85 7 16.3 24 80 8.17 0.11 85 10 16.3 26 90 9.20 0.14 85 12 16.3 28 100 10.22 0.17 85 14 16.3 31 Use Goulds Submersible Sewage Pump Model 3886 1.0 hp single phase 230 volt 1750 RPM with 2" solid handling capabilities. M60ULD.S PUMP$ ;ubm'' ersi .fie Brae Pump Im 3 '80:L OU WON Prosurance available for residential applications. APPLICATIONS . component.damage on, starting torque.. . , ® Power Cable: Severe duty Specifcally designed for the accidental reverse rotation. e Built- inoverload with rated, oil and water resistant. following uses: " ®Fasteners:_ 300 series . automatic reset: Epoxy eal on motor end • Homes stainless steel: • :'/ and' /z HP —16/3 S1TOW provides secondary moisture Sewage systems ®,Capable of:running dry with 115U or 230V three: barrier in case of outer jacket • Dewatering/Effluent without damage to prong plug damage and to prevent oil ' Water transfer components. ® % and 1 HP 14/3 STOW wicking Standard cord. is20'. ® Designed for continuous with-bare I cl& ea Optional lengths are i able. ava la SPECIFICATIONS operation, when fully sub- Three ree phase (60 Hz): ® ® Motor Cover 0 r ng: Assures ositive:sealin p g merged Overload protection must be Pump; provided instaiter.unit. ag aifistcoritaminants Solids handling capabilities: . , /2 -1 HP -.14/4 STOW with and oil leakage. . 2.. maximum. MOTORS bare leads. Dischargesize:.2" NPT- m Fully-submerged in high ®_ Bearings: Upper and lower AGENCY LISTINGS Capacities up to 185 GPM.. grade turbine oil for lubrication heavy duty ball bearing Total heads: u to 38 feet p and efficient heat transfer- All - construction: Tested to UL n8 and ; TDH. . ratrn s are within the workin g g ® Designed for Continuous g cip ® CSA22.21.08 Standards By Canadian Standards _ . Temperature: limits of the motor. Operation: Pump ratings are U Association 104 °F.(40°C) continuous 10 Cl insulation. within the motor manufacturers .S Hie #ut3ssa9 140 °F (60°C) intermittent: .B Single phase (60 Hz): recommended working limits,. Goulds Pumps is ISO 9001_ Registered. See: order numbers on All single ph.ase.models. can be:operated continuously - reverse side for specific HP, - feature capacitor start without damage when fully voltage, phase and RPM's. motors for maximum submerged.. available. FEATURES. METERS FEET . 15 MODEL 3886 IR Impeller:.Cast iron, semi- 211. SOLIDS open, dynamically balanced, non -clog with pump out vanes 40 .. i.... 1ocPM RPM 1725 for mechanical seal protection. wslpa 5 .Optional, Silicon bronze 10 q # r impeller available.. 30 `wso�s 0 Casing: Cast iron volute type for'maximum efficiency. wsoss ; RLAzO r. Designed for easy installation _ on A1:0 -20 slide: rail. c s ws ® Mechanical Seal: SILICON CARBIDE VS: SILICON 10 ... _.. ; . CARBIDE sealing faces for superior abrasive resistance,, stainless steel metal parts, o o BUNA -N elastomers. 0 20 go . 5f 60 8o 100 120 140 160 180 200 GPM 0 Shaft: Corrosion - resistant 0 5' 35 40 45 m3/FI 10 15 '20 25 30 stainless steel. Threaded �"P "�'TM design, Locknut on three phase Goulds Pumps models to guard against © 2002 Goulds Pumps Effective October, 2002 ITT Industries www.goulds.com B3886 [qG0LlLDS. PUMPS ROTATION 614 81/4" KICK-BACK S —UV U� MODELS. PERFORMANCE RATINGS (gallons per minute) Order No. HP Phase Volts Max Amps. RPM Wt. WS031 1B 'A 1 115 10.7 1750 6.3 WS0318B WS0312B 200 6.8 230 4.9 WS0511B ; 115 14.5 65 . WS0518B 200 8.0 WS051�20 X230; 'l o MOM 3 200 3.8 WS0532B 230 3.3 WS0534B r 460 1.7 WS0718B % 1 200 11.0 85 W50712B 230 9.4 WS0738B 3 200. 4.1 WS0732B 230 3.6 WS0734B 460 1.8 WS1018B 1 1 200. 14.0 WS1012B 230 12.3 WS1038B 3 200 6.2 WS1032B 230 5.8 WS1034B 460 2.9 WS0537B 1/2 3 575 1.4 65. WS0737B % 1.5 85 WS1037B 1 2.4 I Order No.' WS03B WS05B WS07B WS10B HP-lo: 1/3 1�2 % 1 RPM 11,- 1150 1750 1750 1750 10 ► 80 . _.:.. 122 145 _ 15 36 90 116 152 a o 20 - 50 86 123 . 25 _ _ 48 95 30 – – – 58 35 - – – 20 SEWAGE EJECTOR SYSTEM Unassembled Package Order Numbers and Components = Use these simple order numbers to purchase all the components necessary for a complete residential system. All packages include: • Basin With.Cover: A7 -1830P • Check Valve: A9 -2P Float Switch: 115 V = A2E21, 230 V = A2E22 • Pump— see below Package Order No. / Pump Model / Voltage . SWS0511 B WS0511 B (115 V) SWS0512B WS0512B (230 V) Goulds Pumps and the ITT Engineered Blocks Symbol are registered trademarks and tradenames of ITT Industries. PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Goulds Pumps & ITT Industries Cen #r PrM Provides automatic or manual: pump. operation for single phase systems. Overload protection must be:provided by the pump Model No, Horsepower Amps. :Volts. •2:5 -10' All A30918 1,15/208/230 A3- 35120 3 & 5 20 -36 208/230 Q�JG3�� pG7LagC�.. Provides:automatic.or manual p ump operation, and.three leg motor protection for three phase systems. select panel by . maximum amp draw and voltage: Model, No: Amp.Range. Volts A32510 •2:5 -10' All A30918 9 -18 All. A31327 13 -27 All ' O Use these panels only with pumps that have built -in capacitors and overloads. Rating Construction Order No. Simplex NEMA 3R Single phase, 60 Hi: r1 Three phase,. 60 Hi. • NEMA 1 steel enclosure standard. • NEMA 1 steel enclosure standard. Includes: contactor, hand -off auto. Nberglass, Hinged Door • NEMA rated starter with: ry switch, run light, and terminal block` NEMA 12 Solid state adjustable overload. ' for wiring connections. 1/3 _ A= `':` a Class 10 over current protection • May be used on through 5. HP pumps �' with manual reset. Separate level control switch(es) SINGLE PHASE Built-in automatic phase loss ' required. MAGNETIC protection: CONTACTOR Hand / Off / Auto switch. • Run light. THREE PHASE • 115V transformer for pilot circuit: • Terminal block. MAGNETIC STARTER . Enclosure Options — if options.are required please panel as A37 _ _ _SPL followed by the desired options listed in numeric order on your purchase order. If more than a few options are needed. please complete and fax us. a. Panel Quote Request Form along with the engineer's (end user's) written specifications. It is usually less expensive to quote custom. panels than to add several options to a standard panel. �wQdo��a�� �aQao��a� op�ooa� NOTE: Enclosures listed above are dead -front type, all switches and indicator lights would be mounted inside of panel on.permanent mounting bracket. CentriPro and the TIT Engineered Blocks symbol are registered trademarks and tradenames•of = Industries. © 2003 CentriPro Effective July, 2003 BCPA3 -RO Rating Construction Order No. Simplex NEMA 3R Steel Hinged Door 3110 °° NEMA14 Steel, Hin ed Door 3120 Enclosures. NEMA 4X Nberglass, Hinged Door 3130 . NEMA 12 Steel, Hinged Door. 3140 NOTE: Enclosures listed above are dead -front type, all switches and indicator lights would be mounted inside of panel on.permanent mounting bracket. CentriPro and the TIT Engineered Blocks symbol are registered trademarks and tradenames•of = Industries. © 2003 CentriPro Effective July, 2003 BCPA3 -RO CentriPro ITT Industries Order No. 1. Through door mounted H -0 -A switch and run light. (Provides access without opening enclosure; standard on . NEMA 1 panels.) A. NEMA 3/311 3200 B. NEMA 4 3210 C. NEMA 12 3220 2. Inner door (hinged) on dead -front panel. (Provides access to switches without hazard of entering actual panel.) 3240 3. Locking hasp. (Adder for NEMA 1 panels, hasp is standard on all others.) 3250 CentriPro ITT Industries C Pro" Can be added to simplex or duplex controllers. Requires option 3300. IIy'� 3 N i is i 1 ti 1 pOu�J.CG3 G0)�O�i1li� OrderNo: 1. High -level alarm circuit: (Provides alarm circuit in NEMA 1 _ simplex panel. Choose alarm device to complete NEMA 3R/4 *112. the system.) 3.300 2: Guaranteed um submergence circuit with low evel alarm 3620 .' (Ovemdes'manual and autorrratic operation 'Dumps) 3320:, 3. Extra set of alarm contacts. 6480 (Used for signal of remote alarm device.) 3781 A. Powered (wet contacts) 3330 B. Non - powered (dry contacts) .3340.. 4. Seal failure circuit.with indicator light (Monitors Three phase panels 15 amp includes 1.5 KVA transformer moisture sensor on dual seal pumps.) 6500 A. Circuit built in A3 panel r 3350 B. Circuit in separate NEMA 3/311 enclosure (Used in conjunction with existing panel.) A4 -3 5. Low voltage, phase loss and reversal (requires 115 V supply) circuit. (Three phase only, stops pumps and closes non - powered 208 -230 V operation 3360 460 V operation 3370 contacts.) 6. 1 GA and 2GA seal fail and high temp. control and status circuit. 3805 pOu�J.CG3 G0)�O�i1li� " Consult factory for options not listed. PRINTED IN U.S.A. Order No. Main and control circuit breakers (Standard,simplex panels do not contain breakers.) NEMA 1 _ Single: phase, 1.15/230 V. NEMA 3R/4 *112. Three phase, 208/230 V 3610 Three.phase, 460/575 V 3620 " Consult factory for options not listed. PRINTED IN U.S.A. NOTE: When ordering alarm devices, please note desired voltage and mounting location. top,"side, front, etc: :Order No. 4" bell (90 db @ 10 Ft.) NEMA 1 _ 6400 NEMA 3R/4 *112. 6420 3750 Hom (,101;db'.@ 10 Ft) : NEMA 3R/4 /4X/.1•Y 6450,: , Flashing red light Lexan NEMX1/3R/4/4X%12 6480 8: Remote alarm panel (includes: 4" bell silencer switch, . 3781 and indicator light,' rated NEMA 3/311) 7. Convenience outlet (115 V GFI) with circuit breaker protection, mounted internally, choose according to power supply (phase). , A. Alarm requiring separate power 115 V power. . Single phase panels supply (Signaled by dry contacts in main panel. Three phase panels 15 amp includes 1.5 KVA transformer Requires 3340.) 6500 B. Alarm to be powered by main panel. (Signaled by powered contacts in main panel. Requires 3330.) 6510 Remote alarm light in separate NEMA1 enclosure (requires 115 V supply) 6515 NOTE: When ordering alarm devices, please note desired voltage and mounting location. top,"side, front, etc: CentriPro ITT I n U U Strl eS SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Order No. 1. Condensation heater =wl 15 V - 3710 2. `Elap'sed time ii eter.1Mounted inside cabinet indicates pump run time.) 3740 . 3: Cycle counter. (Mounted inside cabinet indicates number of pump starts.) 3750 4: Intrinsically safe controls. (One required for each float.) 3760 5. Test pushbuttons, (Overrides float switches to simulate operation of level controls.) A: NEMA 1 3770 . B. NEMA 3/39/4 3780 6: Lightning arrestor Single phase Three.phase 3781 .3782 7. Convenience outlet (115 V GFI) with circuit breaker protection, mounted internally, choose according to power supply (phase). , Single phase panels 3783 Three phase panels 15 amp includes 1.5 KVA transformer 3785 CentriPro ITT I n U U Strl eS SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. e - -. ..t �. •. Y y �ta.- S+'� " "?9in'• 3t � rc".�'3�`�X �� �lw� L-a yY fist- ti` `. f v:.:r^ Sa v`^� Y�t�§.�'j y.i $...�"v� i-�� t:ii � J• 4vt�s f� � �� x_�� {y-'` c Ft- �S'�'{ �rh�.s� c ; jy�_� J*x. ir} ¢�lns�,c� �Lrs k E luerlt and " em , e r tr r _:fie ti� a TM t v r z r ■ Centre Pro AZ Cast Iron / Plastic .Check Valves VG�2V�S '' ' U2 O 111 2G`Ur-P, SGK d/A11 `J. 2; Ideal for horizontal Installation. ° .Ideal for horizontal installation. ® Compression seal connection for easy Installation. O Heavy duty cast iron con struction.w, ®Swing design Swing design flapper prevents flapper prevents £T r k. clogging. x� clogging. „, Available.in 2" and 3" NPT Available for pipe threaded :connections. size 11/4", 11/2' 2" y . � ° 75 P51 leakage rating. 311. 125 PSI burst rating. f 200 PSI burst rating Pi a Size . Order No. 1' /a" A9 -12P 1' %21' A9 =150 .2 A9 -2P <<: 3" A9 -3P Pi ' e Size Order No 2" NPT A9 -2C 3" NPT A9 73C M o Irin�l inr vnrtirnl rnmintinn Heavy duty.cast.iron or plastic construction. _1 Natural rubber ball. Clean -out port and plug. Available in 1 /a , 11/2", 2 and 3 NPT threaded connections. Also'av , ilabl. , in 4" flanged (125 #). Plastic Models NO Size Order No. 1'A" NPT 49- 126PT. 1'/2" NPT A9 -15W 2" NPT A9 =213PT © 2003 CentriPro BCPCv1 -ko Cast Iron Models Pipe Size Order No. 1 1/4' NPT . A9 -12B 11/2". NPT .., :: A9 -1513 2 "'NPT A9 -213 3" NPT A9 -36 , 4" Flanged A9 -413CF Flanged A9 -4B9 ITT Industries Centri ProM 'A2D31 (A2 -9F) Same as above except: • 20 foot cord with 115 V piggy back plug. A2D23W.(A2 3M); Same as above except: z e ISfootcord With bare leads. • Includes snap "'AM Weight. A2.D33W (A2-3M20) Same as above except: • 20 foot cord with bare leads. • Includes snap in AM cable weight. A2D12 Same as above except: 10 foot cord with 230 V piggy back plug. A2D13 Same as above except: 10 foot cord with bare leads. A2D32 iame as above except: 20 foot cord with. 230 V piggy back plug. AA2D33 Same as above except: • 20 foot cord with bare leads. D 2003 CentriPro 3CPFS -RO UL and CSA listed. A2E22 (A2 -6) Same as above except: -1.5 foot 230 V piggy.back plug, A2E23 (A2 -7) Same as above except: 15 foot cord with bare leads. A2E31 Same as above except: • 20 foot cord with 115 V piggy back plug. A2E32 Same ,as above except: • 20 foot cord with 230 V piggy back plug. A2-E33 Same as above except: • 20 foot cord with bare leads. CentriPro ITT Industries PRECAST SEPTIC TANKS ST -1250 SINGLE COMPARTMENT TANK 10, 0" wnery ��- s/ 0 "---� op�7yor -tcw4vtos klnie 51off SPECIFICATIONS Concrete Minimum Strength — 4,000 psi at 28 days Reinforcement - 6"x6" x10/10, WW Mesh, #4 Rebor Air Entrainment — 57 - Construction Joint — Butyl rubber -base cement Pipe Connection — Polyloc seal (patented) only) �,pJ MI�C7 V 7' AA 0 _ 10, 0„ I PRECAST SEPTIC TANKS ` ST 125E L� 1250 GALLONS Top View 4" Dina Outlet T; Side View SPECIFICATIONS Concrete Minimum Strength — 4,000 psi at 28 days Reinforcement — - 6 "x6 "x' -Ogo. WWF, #3 Rebar Air Entrainment — 5% Construction Joint —. Butyl rubber —base cement Pipe Connection — Polyloc seal (patented) H2O loadina on request i 1 3A gm lZide R6-cT Brewster, NY 10509 Fax. _ (845) 278 -0403 January 4, 2008 Mr. Joseph Paravati, Jr. Assistant. Public Health Engineer Putnam County. Department of Health 4 Geneva Road Brewster, New York 10.509 . Re: Marc Burkhardt 16 Holly Street, Putnam Valley, NY Tax Map # 41.60 Block 2 :Lot .61 & 62 Dear Mr. Paravati; Enclosed please, find a copy of the following items for your review and approval as per your letter. dated 12124107: o . .Copy of Deed to show Marc Burkhardt owns both parcels indicated on SSTS drawings. 1 trust the. above materials are adequate for your approval and. complete' the submission for the. above project, However if you have any questions concerning this project, please do not hesitate to call me @ 278 -6212. Enclosures — SWPm&W Sae Dow..;OC.%r '1rCMUMMOr'n Aar,-- rndtvldud mCMpandon {Siaale S4aen CONSULT YCURILffiYYER SEFOR[? etaNINO THIS INSrRUA ".SYT THS INST- AweNT SHOULD Be USEO BY IAtWERS.ONLY. I TWS 1"EN+U1tE, made the god day ofJanaary, in the I 2008 BETWEEN VINCENT GUILIANO as Trustee of Ike TRUST F80 IM'WE P, GUILiANO LIM VWCENT J. OUILIANO, residing at 203 manchester Raod, River Sdge, Na. Jersey lis 661, i parry of the first part, and MARC!BURK}IARIYf, tesldhz Holly Street, Putnam Valley, Ncw York 20579, parry of the seared part, WITNESSXTM Chet Oho party of the first part, In consideration of j Thirty Three Thousand (533,000.00) dollars paid by the party of die second part, does hereby groat and roloase unto the party of G:e second part, the heirs or successors and easisns ofthe party of the second port forever, ALI, neat certl plot piece or parcel of fond, with the bttil ings and improvements thereon orcctrd, situate, lykig and being In thud at Roarer$ Brook Lake, in the down of Pumas Valley, County of Putnam and State of New York, and desmlbed as follows, to wit: Lit No, 259 asidesignated and dellneated on the map onlNed, "Map 12' of Roaring Brook Lake, Town of Putnam Valley, Putnam County; Now •Yoek," and Mod in thti Putnam Count j Clork's Office on the 8th day of Juty,1946• m. ap No. 308E and 306F. I TOGSTEZR with the right to use Roaring Brook lake for boating, bathing and fishinj in common with others, I i Said promises being known as and by the street address of Like Sh.oro Road East. Ptamem Valley, New York. TOGETHER with. all t.*t, titfs and interest, if'any, of the parry of the first part An and to any streets and roads abuninglhe eb6e described premLsos to the Conte: lines th eof, TOGETHER with the sppun maces and all the estate and right of the party of the lint part in and to said premises TD HAV B AND, TO HOLD the premises heroin granted unto the party of the s Ind part, the h6re or successor and assi;ns tno party of rho second part forever.. AN"D the party of the flirt pair coV=Mts that the pary of the fhst part has not. done or.suffered anything whereby the said premises have b4rs'•aa'=betodihF �df$ er, excapt as aforesaid. : _. ; ..:.... .• . AND the patty 61lhti stsjaei �aAtr�jy an w "i{jt Section l3 0° t'ta Lin Law, covenants that the party of the first part will receive the coa;it ,fanwtis eon d-#hA Lnd x711 Old the right to receive such corsideradoa as a trust tired to be applied firs! for the yurpdi"fPiym�'titToost of the lteprovement sad will apply the same first to the payment of the oast of the imptavaaent'before using aarny pa;t.of the•totai of the 346e for any other purpose. The word "pW' shall be construed w if it read " kip" whanever the sore of ibis Wenturs so requires. IN WITNOM WHSREOP, the p6r y ofthe first part bas duiy executed this dead the day and year that above written. VINW TT OLAL1ANO; TRUSTEE t'd 5Z59lM5tK3 86P3 p41 —0 e of 80 bo Uer V ACKNOW CSMLNT TAKEN IN NCW YORX STATE State at W -Y Vc rk, County ofNew York, ss: On the 2n4 day of January in ft year 2008, before me, the urodersiored, pe i onslly appeared Vincent Gul Liam i personally known to me at peeved to me on the basis of xtlniscwry cr not to be do indivldual(s) whose name(,) is Cain) subscribed to tbi witltin iratrument and acknowledged to ma that heAhedury cxoc�tted the same in tdslhethheircapacityocsj and prat by nlsrAevthe' a) on the Insutrmen, the Individual(s), or the Perron a dralf of Whlclhdd In viduai(a) acted, executed the :nstrumrnt. RO Ln 8. PCtir. 11�%!i Puq'.i _. Btet®_ol Naas lobrbt TAKEN IN KZ%V YOItK STATE I State of Now Vork, Cotxtry of SEE On the IICay of in tit° year before M the undersigned, a Notary Public In and for said State, personally appoartd . the suLsoribing wi I S to the forty. "ng insttvntatt, with whom r atrt personally a'Tipinud, who, being by ate duly swam, did depose sad say that ho4tMlrey resides) in Ina ear. (nd diretarr any moat A mbw if my. ftmor. that fivshcieley to be the indivittual. described in and who executed tiro fore3oicg (nrrument; that said subscribing witneu was present and saw said CKCCoo the sem ; and thatsatd witness atthe same time subscribed niwtted0uir na c {s) es switnos thereto Title No. gain and Sale Deed With Covenants LIST 7130.1'=V Nr8 P. GUIL"O U^V VINCENT.I. GUMIANO TO MARC DUP"ARDT 013TTRIIBUUTT @D /SYY YOUR rrTLI tXPRa TS That JuLOc(al Title Insurance Agency LLC 80o,T6�- Tf7LE(W51 FAX:809•FAXA399 t'd SZSBL795t8 ACKNOWLEDGEME,'VT TAXZN IN NEW YORK STATE State of New Yori< County of , as; On the , day of in tie year before mc, the undersigned, personally appoaeed personally known tome or proved'b mean the :asis of eatisfectory eridutcc to be the Indtvidual(s) whose name(s) is (are) aubecribed to the wlth(t instrument and acknowledged to me that ha'sho'duy exeeutod,the sime in hiyberhheir capacltygos), and that by hWhar/dhetr signature(s) on the it strumem, the individual(Q� or the parson upon behalf ofwhieh the indtvidual(s) acted, executed the instrument. ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK STATE *State, of .. County of , ss: '(Or (nun District of Columba, Territory. Possession or Foreign County) On the (by of id the year , befoit ma the undersigned panowly appewed Personstly known to moor proved tome on the basis orsatisfactory ovidonoo to be the individual(s) whose names) is (are) subscribed to the wddn instrument and acknowledged to me thm hdshcl toy executed the same in hWAerhhoir cepaeity(les), that by hislher/thcir slgnmure(s) on the instrument, the itdividual(s) or the person upon baSalf of which the indivldud(s) acted, executed the instumcnt, and that such individual make such apposrance before the undersigncd in the _ (add the city or political subdivision and the s:m or country or other piece the acknowledgement was taken). SECTIOR 41A 31.0=; 2 LOT: 62 COUNrYOR TOWN: PUTNAM RETUM BY MAIL TO: RQNALi7 S. PtML, k=iQ. toe POHL LAW OROUP LLC $00 FIFTH AVENUE NEW Yom NEW YORK 10110 e6p3 0(1 JaAO e0001, 80 110 Uer VINCENT j. G.UILIANO, ESQ 205 Manchester River Edge, NJ 0.7661 (201) 262 -8324 : DECLARATION OF PENDING SALE I, Vincent J. Guiliano ;. being the: sole Executor for the Estate of my father, Vincent John Guiliano; and.the sole Trustee of the Testaments ry . Trust created :under his,-Will, do hereby make the following statement regarding the sale of a. piece of vacant land in Putman. Valley, New-York; which was.solely owned by my father at the time of hi s death.. Said vacant :land. being an approxihiately..6 acre tract fronting Lake Shore Road. in Roaring Brook Lake, which: is designated as Swis.: 372800, SBL 41:6 -2 -62 for tax and assessment purposes: Please be advised that I have reached an.agreement with my nephew; Marc Burkhardt, to sell the above vacant land to him, so that said property.can be combined with an. adjacent tract, which . he currently owns. _ The intended purpose of combining. these two properties will be to build a Single'family home as my nephew's primary residence on the combined property. This sale is contingent on Mr. Burkhardt being able to obtain. all necessary.permits and meeting all zoning requirements for him to, build a primary residence. on the combined property. i Vincent J.. iano Executor &Trustee Date: VINCENT J. GUILIANO; ESQ 1 1. PUTNAk COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE,TgF�,TMEN T SYSTEMS -- - REVIEW SHERT FOR CONSTRUCTION PERMIT NAME OF OWNER: jZg r :7' STREET LOCATION- f%(i _ y S t� /� P ✓ -- REVIEWED BY: RK G si� SRDATE: Y `O TAX MAP# :(Co NFIRMED) 7�� �v -` .Z –G� �•� Y /N DOCUMENTS Y11;q (REQUIRED DETAILS 01N PLANS CONT'Q �L(�PERMIT APPLICATION L ! HOUSE SEWER - YT FT. 4 10'; TYPE PIPE.CAST IRON UWELL PERMIT OR PWS LETTER UUNO BENDS; MAX BENDS 45' W /CLEANOVT (CPC =97 RENEWALS ETE &kUF- AT3THORIZAI`%ON� SITE NOTE (NO CEANGE) #Je- ,r /m-I DESIGN DATA SHEET (DDS) FILL SYSTEMS CORPORATE RESOLUTION U ,U)10' HORIZONTAL; PAST TRENCEI SLOPES 3:1 TO GRADE SHORT EAF / . FILL SPECS/ FILL, NOTES 1 -5 (+PLANS -THREE SETS �( 7k. TILL PROFILE & DIMENSIONS (HOUSE PLANS - TWO SETS U FILI•T • IN EXPANSION AREA VARIANCE REQUEST FILL GREATER THANI FEET SUBDIVISION CZ,Ay BA RR BARRIER . LEGAL SUBDIVISION fJFILL'CERTIF'ICATION NOTE UU DIVISION AP RQVAL CHECKED /�—� DEPTH GAUGES U CRATE LJUVOL. ON PLAN FOR RO.B., tJNCLA.SSIFIED & IMPERVIOUS -2(_) REQUIRED DEPTH U, SEPARATIONDISTANCEFROM 'TOEOFSLOPE •- 7� � 7riue Ul �'JL TAINI}RAINREQUM.ED�/�� TRENCH GENERAL (fY—JLF TRENCH PROVIDED 1/;6 9- 60FT MAX OCATED .I N NYC WATERSHED U R PA a r,r,EL fi0 CONTOURS y� Q P S SUBMITTED TO DEP 100% EXPANSION PROVIDED /,,-3 -7 . LEGATED TO PCHD L�DETAdLIDUST FREE CRUSHED'STONE OR WASHED GRAVEL. DEP APPROVAL; IF REQ'D GEOTEXTILL COVER EEP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN - FROM'SSTS ��LRCS TO BE WITNESSED ' 10 TO P.L. DRIVEWAY,*LARGE TREES, TOP OF FILL . -�- APPROVAL SSDS ADJ, LOTS Z0' TO FOMgDATION WALLS �WETLANDS (TOWNIDEC PERMIT REQ'D ?) 100' TO WELL, 200' IN DLOD,150' T0, PITS' D TA ON DDS- PLANS & PERMIT SAME • 100' TO STREAM, WATERCOURSE, LAKE, (inc. ezpaa.), 6�RE 1969 NEI;GH.SOR NOTICICATI'ON ?ie,44O V-5- ' 50' TO CATCH BASIN, 35'.STO•RAfIDRA.II�I, PIPED WATER -ao G• L �U SI/ZBA - 10'T 0 WATER LINE (pits - 20') f ' oo YR PLOOD ELEVATION W1I 200' �, - _� �' S0 DRAINAGE COU.RSE� �USOIL TESTING LOTS>10 YEARS OLD ( N 1200'1500' RESERVOIR, ETC. 150' GALLEY SYSTEMS / REOUIRED -DETAILS ON 10' MIN TO LEDGE OUTCROP , S AGE MTEM PLAN-(NORTH ARROW) SEPTIC TANK �(� S HYDRAULIC PROFILE (x(_,)10' FROM FOUNDATION; 50' TO WELL U GRAVITY FLOW qdR. 16• me �QI +�� }� WELL CONSTRUCTION NOTES 1 -1�"" e.w•Kga (,/ UD,NSIONS TO PROPERTY LINES 4� DESIGN DATA: PERC & DEEP RESULTS ( jC--) LOCATION OF SERVICE CONNECTION CONTOURS EXISTING & PROPOSED L✓) MIN 15' TO'PROPERTY LINE DRIVEWAY &SLOPES, CUT / 'SLOPE LeFOOTING/GUTTERICURTAI NDRAINS / USDA SOIL TYPE BOUNDARIES U OPE IN SSTS AREA _ jA(520 %) TITLE BLOCK; OWNERS NAME ADDRESS U(-- UREGRA.DED TO 15 %, IF REQUIRED DOSKTUMP SYSTEMS TM#, PEMA.; NAME, ADDRESS, PHONE# % • . PUlYlP NOTES . DATE OF DRAWING/REVISION j DOSE 75% OF PIPE VOLUMEIDOSE VOLUMENOTED 1 DATUM REFERENCE . ETA.IL FOR FORCE•.MAI N, (PIPE TYPE, ETC.) U�LO.CATION OF WATERCOURSES, PONDS PTT AN]j D -BOX SHOWN & DETAILED LAICES,WETLANDS WITHIN 200' OF P-L. � U PROPOSED FINISH FLOOR AND DAY STORAGE ABOVE ALARM / CURTAIN DRAIN �L=S NT ELEVATIONS STANDPIPES, 5' BOTH SIDES, DETAIL SSDS'S WIM 200' OF SSTS 15' MIN to CDS =?5 %, 20'-4%,151-3%,35'4"/., 100%-<l% , PROPERTY METES & BOUNDS 0' MIN to CD DISCHARGE/1D0' with 182 cons day discharge EROSION CONTROL FOR-HOUSE, WELL & • 4&10'MW to NON - PERFORATED PIPE SSTS, EROSION CONTROL NOTE PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMENTAL BEALTH.SERVICES LETTER OF AUTHORIZATION RE: Property of. Marc Burkhardt Located at 16 Holly Street, Putnam Valley New York TN T/ Putnam Valley Tax Map # 41.6 Block 2 Lot 61 & 62 Subdivision of Roaring Brook Lake Subdivision Lot #260 & 259 Filed Map # 308 -E Date filed 7/18/46 Gentlemen: This letter is to authorize Meyer & Associates Consulting Engineers. a duly licensed Professional Engineer X 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 treatment 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., R.A., MICHAEL F. BEYER, P.E. #074597 Mailing Address 273 Starr Ridge Road Brewster State: New York Zip: 10509 Telephone: (845) 278 -6212 Very truly yours, . Signed: (Owner of Property) Marc Burkhardt Mailing Address 16 Holly Street' Putnam Valley State: New York Zip: 10579 Telephone: g i Y 8 7 �- 172-3 Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL...... PCHD� Permit ......... . ,.please print.or- type; -. - _ Well Location: Street Address: TownNifftV Tax Grid # f�� " � Ze'�" ' "'- b'fiy� MaP 1, (0. Block J Lot(s)�%.� Well Owner: Name. Address: C= -��t J car 1v Pi 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 5 gpm # People Served Est. of Daily Usage 600 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling > New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No_ 3f Is well located in a realty subdivision? ...................................... ............................... Yes f< No Name of subdivision RbW-i c ,$ ;aot>>C r Z SOY N'P Lot No. AV . 2,51 Water Well Contractor: � �D— 1/ yc#t vas -es3 c t,,9- Address: Is Public Water Supply available to site? .................................. ............................... Yes No X Name of Public Water Supply: Town/Village Distance to property from nearest water main: '71& A�- Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: %/ c -" Applicant 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 by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified b Putnam County. Date of Issue T Permit Iss ng O ial: Date of Expiration - "` Title: Permit is Non- Tradsferrable \ White copy - HD file; Yellow copy - Building Inspector; Pink copy - er; Orange copy - Well driller Form WP -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LURETTA,MOLINARI,.RN,- MSN�...: n Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAIVER ROBERT I BONDI County Executive NIORMS,'ft_ t-.-- . Director of Environmental Health NAME: i1 V1 Gt�c r ��%�tcrz�7L ADDRESS: _ l /14 7 Y SITE LOCATION: 14V 11.1 DATE: STAFF PRESENT: ., Michael Budzinski, P.E., C,erte Joe Paravati & Larry Werper SPECIFIC WAIVER REQUEST: �p e. �,� S �� ,16� 11 DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD OR ENVIRONMENTAL CONTAMINATION PROBLEM? YES ❑ NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? _ YES DISCUSSION REQUEST APPROVAL OR DENIED REASON FOR DENIAL NO ❑ APPROVED DENIED ❑ DIRECTOR OF ENVIRONMENTAL HEALTH COMMISSIONER OF HEALTH DATE DATE Environmental Health (845) 278 -6130 Fax(845)278-7921 (SPECWAIVER) Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 *tj to J 14-0 - i .r.� -. ls- cdnom� .�i" NEW YORK STATE SPECIFIC WAIVER APPLICATION DEPARTMENT OF HEALTH Request for Approval of Noncompliance with Bureau of Water Supply Protection the Standards of 1ONYCRR Appendix 75-A Wastewater Treatment Standards - Individual Household Systems Name of Applicant Lam U ( 4 Kb 1 First i�t (Z C-MI A ddress sweet O LL I %Z E E'r Cityrrown PU'T K) A L L C ` Fstee z+r. /05 7 Contact Information - Phone: Or "57 2--0 ✓ &v FAX: 1,%0/J6 email: /tii�h%r Site Location street. OLL ST12F City/Iown��?TNA �ALLE county PUTIVA111 lip /d 7 The following information is being submitted in support of my application for a specific waiver from compliance with one or more : _standards of l..ONYCRR,Appendix..75:A, "Wastewater Treatment Standards- Individual Household Systems'. 1. The wastewater treatment system cannot meet the following standards of IONYCRR Appendix 75 -A: ;K. _Separation distances cannot be achieved (75- A.4(b), Table 2, Separation Requirements) ❑ Excessive Slope (75- A.4(1), Soil and Site Appraisal) ❑ Design is not addressed in Appendix 75 -A ❑ Technology is not addressed in Appendix 75-A ❑ Other: Explain: DuE TO S I T E COt05.1(2 INTS . SEPA►767" 7)STHiyfr !3F S� � D� 7z 6: of SiyP�� To LCpGE jZocy CArJiioT Br- ACH1EWEZ5. 2. The following design is proposed to mitigate noncompliance with Appendix 75 -A (brief description): PR imAiLy SYST -e/" ANJ> F�C�A io•v 5) s-y 6/00 z ,4A-e Gvoa,-Fti W 771t 179?PI /f A61 E SFP19RAn0--�- D,tsTAi.JC s 3. Supporting information provided: p( Detailed Site Plan ❑ Detailed Design ❑ Soil and Site Evaluation ❑ Neighboring conditions of concern (e.g., wells, waterbodies, wetlands, etc.) ❑ Other: Explain: 1 PN A l E J> 1511-1-Ft 55 T S rraO VT A W D D mss) G w r4 S L,/F&4-:- o Z-Z— S' ITEM -v,,jS j134 / NiS • je I, (applicant) /r/ ��G�fi (type or print) acknowledge that this waiver request is necessary because it .�f�. --- is not�prac4ical for an ohdte wastewat € r- treatment- system io -meet- tlie.rdereuced standards.of_10NY:CRR,.Appendii:75 -A on.. ;::.' this property. !�� Signature Date I, (engineer) C o 15L J5-/Z— (type or print) acknowledge that this waiver request is necessary because it is not practical for fin onsite wastewater treatment system to meet the referenced standards of IONYCRR Appendix 75-A on this property. In my professional opinion, the proposed design described in this application will provide a degree of protection equivalent to the onsite wastewater treatment standard(s) that will not be et for this property and will not create an increased risk to public health or the environment. Q NO. 7 Sign-a)rdFe PE License # wFor Health Department use omy F Based upon the information provided in this application to waive the referenced standards of Appendix 75-A and in accordance with IONYCRR §§ 75.3 and 75.6 (b), the waiver requested is hereby: ❑ Approved as proposed. ❑ Approved, with following conditions: ❑ Not acted on, because additional information is required: ❑ Denied, because: Note. This waiver may be revoked should any A4 tqwele- Health Department Representative Sig considered be a approving this waiver change after approval. Date SHERLITA AMLER, MD, MS, FAAP Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health April 16, 2008 Mark Burkhardt 16 Holly Street Putnam Valley, NY 10579 Dear Mr. Burkhardt: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York. 10509 ROBERT J. BONDI County Executive ROBERT' MORRIS; PE':-,.—.:'' -- Director of Environmental Health Re: Approval of Plans for a Subsurface Sewage Treatment System for Permit # PV -04 -08 (T) Putnam Valley TM# 41.6 -2 -61 & 62 This Department has received the engineering plans and application for the proposed subsurface sewage treatment system for the above -noted project. Upon review, it was determined that the submission did not meet the applicable criteria of the NYS Department of Health and the Putnam County Health Department for the design of sewage treatment systems and therefore, a.specific waiver was issued by this Department. This approval of plans is issued under provisions of Article 3 of the Putnam County Sanitary Code,' and 10 NYCRR Part -75, and is issued for plans prepared by Michael Beyer, PE and dated November 16, 2007 with the last revision date of February 15, 2008. This- letter shall serve as record of approval of the project covered by this approval of plans and the appiicant-accepts and - agrees to- abide.,lzy-and:c9nform to the following::. 1. THAT the approval is revocable or subject to modification or change pursuant to Article 3 of the Putnam County Sanitary Code. 2. THAT the facilities shall be fully constructed and completed in compliance with the engineering plans, as approved. =} 3. THAT the approval is valid for two (2) years and expires on April 16, 2010. 4. The issued specific waiver will expire on the same date as the issued Construction Permit. If the proposed subsurface sewage treatments system covered by this approval is not constructed by the expiration date, the Department reserves the right to require a reduction in the bedroom count so that the design is in more compliance with current codes and /or regulations. The Department is forwarding three (3) copies of the approved construction permit and two (2) copies of the approved construction plans to your design professional. Re tfully, t� Robert Morris, PE Director of Environmental Health MJB :I{jy Environmental Health (845) 278 -6130 Fax (845) 278 -7921 cc: M. Beyer, PE Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Mic l B Project Manager Enclosures PUTNAM COUNTY.DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A-WASTFWA'I'ERTR�ATMFNT SYS`PE1VI °•..T- ,:..-r.Y. = 1. Name and address of applicant :, Mark & Suzanne Burkhardt 11. Name of Lead Agency N/A 12. Is this project in an area.under the control of local planning, zoning or other officials, ordinances ?.......... .... ............................... .............................. YES 13. If so, have plans been submitted to such authorities ?........... YES 14. Has preliminary approval been granted by such authorities? NO Date granted: 15. Type of Sewage Treatment System Discharge:...... surface water XXXX groundwater 16. If surface water discharge, what is the stream class designation ? ........................ N/A 17. Waters index number ( surface) ................................ ........... ..................... N/A 18. Is project located near a public water supply system? ...... ............................... NO 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system ? ..................... NO 21. Name of sewage system N/A Distance to sewage system N/A 22. Date test holes observed 10/6/01 & 8/27/02 23. Name of Health Inspector ADAM STEIBLING 24. Project design flow (gallons per day) .......................... ............................... 600 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?........... NO 26. Has SPDES Application been submitted to local DEC office ? ........................... N/A Form PC -97 16 Holly Street PUTNAM VALLEY, NEW YORK 10579 2. Name of project: BURKHARDT RESIDENCE 3. Location TN: TOWN OF, PUTNAM VALLEY, NEW YORK 4. D6Slgn PTOfesslonal: BEYER'& ASSOCIATES : 5. Address: 273 STARR RIDGE RD, BREWSTER, NY :10509 6. Drainage Basin: HUDSON RIVER WATERSHED BASIN 7. Type of Project:. XXXX Private/Residential -Food Service Commercial Apartments Institutional. Mobile Home Park Office Building Realty Subdivision Other (Specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....... ............................... Type I Exempt XXXX Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required ? ............................ NO 10. Has DEIS been completed and found acceptable by lead Agency ? ...................... N/A 11. Name of Lead Agency N/A 12. Is this project in an area.under the control of local planning, zoning or other officials, ordinances ?.......... .... ............................... .............................. YES 13. If so, have plans been submitted to such authorities ?........... YES 14. Has preliminary approval been granted by such authorities? NO Date granted: 15. Type of Sewage Treatment System Discharge:...... surface water XXXX groundwater 16. If surface water discharge, what is the stream class designation ? ........................ N/A 17. Waters index number ( surface) ................................ ........... ..................... N/A 18. Is project located near a public water supply system? ...... ............................... NO 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system ? ..................... NO 21. Name of sewage system N/A Distance to sewage system N/A 22. Date test holes observed 10/6/01 & 8/27/02 23. Name of Health Inspector ADAM STEIBLING 24. Project design flow (gallons per day) .......................... ............................... 600 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?........... NO 26. Has SPDES Application been submitted to local DEC office ? ........................... N/A Form PC -97 27. Is any portion of this project located within a designated Town or State wetland? NO 28. Wetlands ID Number ...................................... ............................... N/A Wetlands" Permit required? ............. ..............: .....:.......... . .Has application been made to Town or Local DEC office ? ......................... .30. Does project require a DEC Stream Disturbance Permit ?......... .... NO 31. Is or. was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, land,filling, sludge application,or,industrial activity? .. Yes/No NO, 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?.... . ............................... DESCRIBE: Yes? No? NO 33. Is there a local master plan on file with the Town or Village? ............................... YES 34. Are community water and/or sewer facilities planned to be developed within 15 years. in or adjacent to project site? ............................ ............................... NO 35. Are any sewage treatment areas in excess of 15% slope? ............ ............. :........... NO. 36. Tax Map ID Number ...................... ............................Map 4 1.6 Block 2 Lot 61 &62 37. Approved plans are to be returned to: ............ Applicant XXXX Design Professional ,Ar13_applkatiQna.fnt .review ,.aAd.a,.nproyal.of.a, new, SS.TS.to belocated..within,the:NYC. aters6edshall.be.sert 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 impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 1, 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 afrm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL & ASSOCIA' Mailing Address: .. ...................... 273 STARR RIDGE ROAD BREWSTER, NEW YORK 10509 (845) 278 -6212 PROJECT ID NUMBER 617.20 SEQR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only �:�:.a.•� ­sRART-- 1", PROJECT INFORMATION - -( To be completed by° Applicant <or'Ptroiedtt�ahs8r�°'""' " "`" '"'�`•�'' °` " - "" - ' `- 1. APPLICANT / SPONSOR 2. PROJECT NAME - - Mark Burkhardt /Beyer & Associates Burkhardt Residence 3.PROJECT LOCATION: Holly Street, Putnam Valley Putnam County Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map Intersection of Holly Street and Lake Shore Drive 5. IS PROPOSED ACTION: ❑✓ New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: New single family residential dwelling with onsite subsurface sewage disposal system and drilled water well. 7. AMOUNT OF LAND AFFECTED: Initially 1.1.11: acres . Ultimately 1.111 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ✓❑Yes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) M✓ Residential ❑ Industrial ❑ Commercial []Agriculture ❑ Park / Forest / Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) R]Yes ❑ No If yes, list agency name and permit / approval: Putnam Valley Develoopment Approval Plan, Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? aYes No If yes, list agency name and permit / approval: Putnam County Department of Health SSTS and Well Permit 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ✓ es No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ge & is Consulting Engineers Date: November 20, 2007 Signature If the action I's -a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PORT.II - IMPACT ASSESSMENT ITn hp cemnlptpd by Lpad Anancvl -- A. YDOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4 ?. If yes; coordinate the review process and use the FULL EAF. No . Yes 1:1 B_WILL ACTION RECEIVE COORDINATED.REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration maybe superseded" by another involved agency. . 0' Yes " E] No C. COULD ACTION RESULT-IN ANY.ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C.1: Existing air quality; surface. or groundwater quality or.quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage, or flooding problems? Explain briefly:: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:. ' C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: 1 C4. A community's existing plans or goals as officially adopted, or a change: in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:. - -- — C6. Long term; short term, cumulative; or other effects not identified in C1 -05? . Explain briefly: C7. Other im acts.(including changes in use•of either quantity or type of. ener ? . Ex lain briefly: " D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If yes, ex lain briefly: . Yes No E. IS- THERE, OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain Yes El No 0 PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f).magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and "adequately. addressed. If question d of part ii was checked ves. the determination of sionificance must evaluate the potential imaact of the orODosed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the. FUL 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 actin WILL NOT result in any, significant adverse environmental impacts AND provide, on .attachments as necessary, the reasons supporting W determination. Name of. Lead Agency Date not or Type Name of esponsi e Officer in Lead ea gency Signature of esponsible Officer in Lead Agency Title of Responsible Officer. Signature'o reparer different from responsible officer) ---------------------------9— } t 1 I I I r T r--------- - - - - -- ----'--=------------------------------ - - - - -� I - -• _ .a I I I I 1 i I I I I I I s I MANUFACTURER INFORMATION i MO08 I I I th I I I F I I I I rOLSG ROUTE 9W P.O. BOX 1 IDB RWTE 9N' PNONE: 845236 -3311 I i I I 4 SHEET # A -2a MARLBORO. NY 12542 FAX:. 845236-)881 a `" r0• c W p O R V F µ n C LLY ST 1 204 PT 22 I I i ronxwnT1�7C" MSEAMOwwelaMM. INC. _AUwcrosRIZMMm ARCKGTC ALV.oRR CONTAWD NtAPDN F PR TECT 1.0 D SRTION 102 Of TBE COP PJGNT ACT. 17 U.5 f.. A9 AuPwm. __. rNUM VALLEY (PUTNUM) NY 10579 I IN-10 1/4' 5' -2' 5'-8 3/4' )5'-83/4' 5-63/4- 2' -6 112' G' -2' 5' -1' 1 W� I I I 1 I I 1 I I I I r - -1 r- - -, r - --1 i.' - -, r -- - -, r - --I . I I I 11 1 PL I I PL PL I PL I PL L J L J L L I I -- -- L -- J L -- J L— J -- J L— J I 1 I I I - 15' -1 1 112" I 1 I f? 5 � I I I I I MANDATOR+' I I I I wPPDRT BY I I 1 I BUILDER 1 e' I I 5CALE 114' -Ty-oIr I I I I I I I I I 4 m FOUNDATION DE51GN AS SHOWN 15 ONLY SUGGESTIVE. ACTUAL 1 LOCAL ACCORDANCE I I CONFOUNDATION ITI5 ANND IN VAT i LOCOALL I I I I I L------------------- - - - - -- ----------------------------- - - - - -- j I I ---------------------------9— } FLOOR PIAN5 AND ELEVATIONS OF ALL CHELSEA MODULAR HOME5ARE COPYRIGHTED. WE WILL ENFORCE ALL COPMGNTS TO PROTECT OUR CON5IDERABLE JNVE5TMENT IN DEVELOPING THE5E MANS AND ELEVATIONS. t 1001,15TRUCTION BY CHEL5EA MODULAR HOME5. INC. r T BUILDER: i J a' FOUtVDATION PLAN MANUFACTURER INFORMATION i MO08 JRKIIARDT 5HERWOOD MODULAR CONCEPT5 th aQ ■■ rOLSG ROUTE 9W P.O. BOX 1 IDB RWTE 9N' PNONE: 845236 -3311 SHEET # A -2a MARLBORO. NY 12542 FAX:. 845236-)881 a `" r0• c W p O R V F µ n C LLY ST 1 204 PT 22 PROJ. ID #: G318 4 ronxwnT1�7C" MSEAMOwwelaMM. INC. _AUwcrosRIZMMm ARCKGTC ALV.oRR CONTAWD NtAPDN F PR TECT 1.0 D SRTION 102 Of TBE COP PJGNT ACT. 17 U.5 f.. A9 AuPwm. __. rNUM VALLEY (PUTNUM) NY 10579 P4 W� DATE: I I /09/OC 7r:_� K ....:.�......_ i t a - f? 5 � 1 1 3, 't .1 1, e' 5CALE 114' -Ty-oIr FLOOR PIAN5 AND ELEVATIONS OF ALL CHELSEA MODULAR HOME5ARE COPYRIGHTED. WE WILL ENFORCE ALL COPMGNTS TO PROTECT OUR CON5IDERABLE JNVE5TMENT IN DEVELOPING THE5E MANS AND ELEVATIONS. KCV I51UN5 1001,15TRUCTION BY CHEL5EA MODULAR HOME5. INC. DJECT NAME: BUILDER: i FOUtVDATION PLAN MANUFACTURER INFORMATION i MO08 JRKIIARDT 5HERWOOD MODULAR CONCEPT5 TWO STORY ■■ rOLSG ROUTE 9W P.O. BOX 1 IDB RWTE 9N' PNONE: 845236 -3311 SHEET # A -2a MARLBORO. NY 12542 FAX:. 845236-)881 3JECT SITE: ADDRE55: DWN. BY: JMP LLY ST 1 204 PT 22 PROJ. ID #: G318 APP. BY: ronxwnT1�7C" MSEAMOwwelaMM. INC. _AUwcrosRIZMMm ARCKGTC ALV.oRR CONTAWD NtAPDN F PR TECT 1.0 D SRTION 102 Of TBE COP PJGNT ACT. 17 U.5 f.. A9 AuPwm. __. rNUM VALLEY (PUTNUM) NY 10579 PAWLING NY 1 2564 SERIAL #: - - -- i DATE: I I /09/OC 7r:_� K ....:.�......_ i t i� N G AN_M I � I I � I I I I ALL F05T5 BY BUILDER I I �I --------- � ------- - - - -�— COVERED PRDM PORCH BY t%IIIDER— �_--- - - - - -- 1 2' -1 1 112' 8' -1 1/4' I I' -8 114- 7' -3' �c CONSTRUCTION BY CHELSEA MODULAR HOME5, INC. d- 0'8' -I 1 1/2 i 13' -2 3/4' p ;> O O O FIRST FLOOR PLAN ._ . _.. _. .. 24210 -. _ .... ..- 6-0 MW TMANSEAL SGD 3046 -2 W3330 �O W2730 �O T7 17) " MANUFAMRERINFOR`ATION AR HOMES. INC. CHELSEA AR 11-AV BURKHARDT _- .._ 16 b �b O �, C B2i tM 5HEET # A -3 I MARLBORO, NY 12542 FAY: 845 -236- 1 PROJECT 51TE: ' 5036 so - O - _ � ► I i O OWN. BY: AD ` v �' COPYWGHT 199TO+aw,MOMLARWMCS.W - -,•r RJGr rseoaeoTne.ROmeclvRUwoP.A HOLLY 5T b I I FAMILY ROOM .tp H PROJ. ID #: G318 APP. BY: 1 1109106 JMP CONAJ ff R 6 MOTE= UWER 515MON 102 OP THE ODPYWGHT ALT. 17 U.5.C. AS WENDED KITCHEN NOOK ` 159 5F N 5ERIAL #: - - -- m CMH WUM�G OOIAMR�9TOWN SN6 wvmE�PRNN ORMAAT NOrCMUSEsuAMMILAR OMB Ir D-3 °finm i 120 SF 113 SF I I A o .PAWLING -. -- Q _ 48 5F i Bea Bea ICI ZXB PLUMBING :4 1q _ z ) LAYER s)e' HRE 4'-0' t Itl WALL b • f: k Ir > r > fi RATED GYP I$I ttL 1j f M � i I w � n 10.7 zG M F I I in I I R. 5 9 or B24 SR a in Gt1A5E — iV 1• (6) 2%3 SPP+< I/� .2430 W3615 EACH MOOULE / \\ 0 9 — — _ _ _ _ _ _ - — _ _ _ - — — —6-0 HDR — — T (@ 2X3 SPP 112 © EACH MODU m 51.1 OLTLINE ' MANDATORY WILpERT (1) LAYER SW FIRE FLOOR ABOOVEOND RATED GYP Q m OPEN _ N TO _ ABOVE �!��Q,1{ >� a co ... K Y - FOYER FAM I LY ROOM DINING ROOM 925E 1835E 145 5F P n N j 5 ® TEMPERED I H 3046 3046 3046 3046 3-0 3' -O 1/2 5' -1 OF Z (Il 4' -3' 6' -d 9' -9' 9' -9' G -d 4' -3' I � I I � I I I I ALL F05T5 BY BUILDER I I �I --------- � ------- - - - -�— COVERED PRDM PORCH BY t%IIIDER— �_--- - - - - -- CW E/ r SCALE THE FLOOR PIAN5 AND ELEVATION5 OF ALL CHEL5EA MODULAR HOMES ARE COPYRIGHTED. WE WILL ENFORCE ALL COFMGHT5 TO PROTECT OUR CON5IDFRABLE INVESTMENT IN DEVELOPING THE5E FIAN5 AND E14VATIONS, KCV 151VN7 �c CONSTRUCTION BY CHELSEA MODULAR HOME5, INC. PROJECT NAME: p ;> O O O FIRST FLOOR PLAN MANUFAMRERINFOR`ATION AR HOMES. INC. CHELSEA AR 11-AV BURKHARDT ` z 16 b �b O �, C 5HEET # A -3 I MARLBORO, NY 12542 FAY: 845 -236- 1 PROJECT 51TE: ' ADDRE55: O OWN. BY: AD ` v �' COPYWGHT 199TO+aw,MOMLARWMCS.W - -,•r RJGr rseoaeoTne.ROmeclvRUwoP.A HOLLY 5T f .tp H PROJ. ID #: G318 APP. BY: 1 1109106 JMP CONAJ ff R 6 MOTE= UWER 515MON 102 OP THE ODPYWGHT ALT. 17 U.5.C. AS WENDED PUTNUM VALLEY (PUTNUM) NY 10579 NY 12564 5ERIAL #: - - -- DATE: 09/ 9/06 CMH WUM�G OOIAMR�9TOWN SN6 wvmE�PRNN ORMAAT NOrCMUSEsuAMMILAR OMB Ir f O A o .PAWLING -. -- I O/ 1 2/06 AD Au rLOOR rua9 SUE IECT TO cT+ANCe M+TnoUr NOT1a. :4 1q z • f: k Ir > r > fi li I 1j M w � n 10.7 R. 5 ] � CW E/ r SCALE THE FLOOR PIAN5 AND ELEVATION5 OF ALL CHEL5EA MODULAR HOMES ARE COPYRIGHTED. WE WILL ENFORCE ALL COFMGHT5 TO PROTECT OUR CON5IDFRABLE INVESTMENT IN DEVELOPING THE5E FIAN5 AND E14VATIONS, KCV 151VN7 CONSTRUCTION BY CHELSEA MODULAR HOME5, INC. PROJECT NAME: BUILDER: FIRST FLOOR PLAN MANUFAMRERINFOR`ATION AR HOMES. INC. CHELSEA AR 11-AV BURKHARDT ` 5HERWOOD MODULAR CONCELfi5 TWO STORY P.O. BOX I 1 DB ROUTE PHONE: 045- 236 -331 I 1 108 ®■ 5HEET # A -3 I MARLBORO, NY 12542 FAY: 845 -236- 1 PROJECT 51TE: ' ADDRE55: OWN. BY: AD ` �' COPYWGHT 199TO+aw,MOMLARWMCS.W - -,•r RJGr rseoaeoTne.ROmeclvRUwoP.A HOLLY 5T f 1204 RT 22 PROJ. ID #: G318 APP. BY: 1 1109106 JMP CONAJ ff R 6 MOTE= UWER 515MON 102 OP THE ODPYWGHT ALT. 17 U.5.C. AS WENDED PUTNUM VALLEY (PUTNUM) NY 10579 NY 12564 5ERIAL #: - - -- DATE: 09/ 9/06 CMH WUM�G OOIAMR�9TOWN SN6 wvmE�PRNN ORMAAT NOrCMUSEsuAMMILAR OMB Ir .PAWLING -. -- I O/ 1 2/06 AD Au rLOOR rua9 SUE IECT TO cT+ANCe M+TnoUr NOT1a. :4 1q ' • f: k Ir li I 1j M I i � � y 0 r xw D; p U 1 n 1 -c, ./ z a , 1- x 5CAL�E LJ 114" = f '-U' G -3 1/4' -. i.31 _._ ._..- -'-. 18' -1 I/4•.. - .,. .. 2' -3 112' PI"5 AND P.E. / R.A. STAMP VALID ONLY FOR MODUUH THE FLOOR PLANS AND ELEVATIONS OF ALL CHELSEA MODULAR HOME5"ARE COPYRIGHTED. WE WILL ENFORCE ALL COPYRIGHTS TO PROTECT OUR CONSIDERABLE INVESTMENT IN DEVELOPING THESE PLANS AND ELEVATIONS. REV151ON5 1 I' -6 I/2' CONSTRUCNON BY CHELSEA MODULAR HOMES, INC. 1 K n. BUILDER: 9'-2- .15'-2' . MANUFACTURER INFORMATION EA MODULAR INC. BURKt1ARDT SIIERWOOD MODULAR CONCEPTS TWO STORY —`•� �1''— PROJECT 51TE: ADDRE55: 1 24210 MARLBORO. NY 12642 PAX. bT5- 2364aB1 41:236 f/ HOLLY 5T i 204 RT 22 PROJ. ID #: 1 G3 8 APP. BY: I 1 /09/06 JMP COPRGH 1997 CH1'L`EA MO UWt HOMG9, INC. -N WGHT9 RZ51! [ THEN ITEGTURAL WORK CONTAINED HEARON 15 FROTECTED UNDER 5=DN 102 OF ME COYYWGHT ACT. 17 U.S.C. A5 AMENO® PUTNUM VALLEY(PUTNUM) NY 10579 PAWLING NY 12564 SERIAL #: -- DATE: 09/29/06 IO/I21O6 AD 12 -0 1 -90, THIS DRAWING SHN1 NOT BE REMODU= IN ANY WAY OR USED FOR CONSTRUCTING ANY CMH BUIIDWG WIIHOU BRSTDBTNNING THE WRNTEN AURIORUATION OF CHM5CA Mb01ANt HOMES. INC. 3046 - i� FAU55UaeaTDO NGeA,HOUrara 3046 I Y BEDROOM 3 I A 1 f 61 .Cf i1 P S, 1 18 5P 1 13-2 ® MB 71 5F ?nii stRT - I I 60'SHOWER b I. G�182104 v VB24 B 0 LINEN - 1-4 2 -G 2 -6 r - -1 122 I ® T 3/ ��/ 5' -12' N —_ I ATnc I ACCE55 F/tA,�e S \ 4.0 2 -6 2X1.021r 0 1/2 (1.) I -I /2'X 16',LVL IN CENNGPACH MOWLF (5) 2XD SPF 112 (2 ) 2X6 5PF N 12 m9 — EACH MODULE EACH MODU I 6. ® I d o! �g I 3' -0 1/2' - RAILING BY BUILDER I - OPEN N ? N — TO BELOW L.... - a _ — r � OUTLINE Of BEDROOM 2 1 } I 14 MASTER BEDROOM 145 5f I 20G 5F .'I 3046 3046 3046 I 3046 3046 I l' -10 112' 11' -7' 2'-9 . 12' -G 1/2' 4' -3' G' -O' -3' .. .: 11112 FTTC11 REVERSE GAME PORLH ROOF BELOW i � � y 0 r xw D; p U 1 n 1 -c, ./ z a , 1- x 5CAL�E LJ 114" = f '-U' CHELSEA MODULAR HOMES, INC. RESERVES THE RIGHT TO MAKE MINOR CHANGES IN DIMEN510N5 A5 REQUIRED BY MODULAR CONSTRUCTION METHODS: ' PI"5 AND P.E. / R.A. STAMP VALID ONLY FOR MODUUH THE FLOOR PLANS AND ELEVATIONS OF ALL CHELSEA MODULAR HOME5"ARE COPYRIGHTED. WE WILL ENFORCE ALL COPYRIGHTS TO PROTECT OUR CONSIDERABLE INVESTMENT IN DEVELOPING THESE PLANS AND ELEVATIONS. REV151ON5 CONSTRUCNON BY CHELSEA MODULAR HOMES, INC. 1 K PROJECT NAME: BUILDER: SECOND FLOOR PLAN MANUFACTURER INFORMATION EA MODULAR INC. BURKt1ARDT SIIERWOOD MODULAR CONCEPTS TWO STORY ROUTE 9S, P.O. BOX I 108 ROUTE 9W PHONE -3311 ■■ P.O. PROJECT 51TE: ADDRE55: 1 SHEET # A-3a DWN. BY: AD MARLBORO. NY 12642 PAX. bT5- 2364aB1 41:236 f/ HOLLY 5T i 204 RT 22 PROJ. ID #: 1 G3 8 APP. BY: I 1 /09/06 JMP COPRGH 1997 CH1'L`EA MO UWt HOMG9, INC. -N WGHT9 RZ51! [ THEN ITEGTURAL WORK CONTAINED HEARON 15 FROTECTED UNDER 5=DN 102 OF ME COYYWGHT ACT. 17 U.S.C. A5 AMENO® PUTNUM VALLEY(PUTNUM) NY 10579 PAWLING NY 12564 SERIAL #: -- DATE: 09/29/06 IO/I21O6 AD 12 -0 1 -90, THIS DRAWING SHN1 NOT BE REMODU= IN ANY WAY OR USED FOR CONSTRUCTING ANY CMH BUIIDWG WIIHOU BRSTDBTNNING THE WRNTEN AURIORUATION OF CHM5CA Mb01ANt HOMES. INC. i� FAU55UaeaTDO NGeA,HOUrara I Y A 1 f i1 P S, aav 'I s a fou 1 ya g°d° D e eta j O 1 gay Y WELL �� •�, Al�< ° 5K5' ac B .4 a lbund w s� tI ae N AREA = 48, 396 SO. FT. i = ( 1.1110 ACRES to= north a i of s' x.90' 7 f . o°naeta mmronant tuvndi tan �,; LOT 260 ( Uber 1604 Page 391) O IMPERVIOUS BARRIER D BOX 35' --------- - --73' -- - -, ------------ - - - - -- _,_ 83, 87' & L 87' - 4' 6 i i 87 12 _ _ 6' 0 7' 87'C3)- - - ® PRIMARY AREA (435 LF) 8793 _ 9' I - -- co'I'c O ---------------- - - - - -- 79' 1,F00 -------------------- o pp % -- EXPANSION -AREA i- --(-429 L r4.y,�3F,o ------- - - - - -- - km ph .scawrea LOT 25911 � ( Gber 1797 Page 51) Q F � 7 AF-3 atots asst pe�� W—t �� 1 2 3 4 5 6 7 8 9 10 11 12 -13 14 WELL SWING TIES TABLE (FT. ) A I B I C I D 29.9 40.6 25.4 45.6 18.2 54.8 52.4 105.2 46.6 92.3 44.2 87.1 42.4 81.9 41.9 76.9 42.9 72.2 133.2 161.1 132.2 157.9 130.2 153.6 128.8 150.1 128.2 147.1 THIS IS TO CERTIFY THAT THE SEWAGE TREATMENT SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARDS RULES AND REGULATIONS OF THE.PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. 48.4 . 1 66.5 OFFICIAL E -911 ADDRESS AS PER TOWN OF pally II<I o 911 COORDINATOR, VERIFIED ON : 12/4/09 TAX MAP 41.6 BLOCK 2 LOT 61 THE OFFICIAL E -911 ADDRESS: 5 HOLLY STREET TOWN OF PUTNAM VALLEY