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Home My WebLink About2413DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 50. -1 -11 BOX 21 1"m ' r T T� . I� ' ..T 1 . 02413 Jjiblic Health Director OLNARI R.N., L;c'ia_te'MI P_ubUc H"'e"o'l-A—Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (04) 278 - 6014 Preschool (914) 278-6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: AC4� L TAX " NUMBER: 5EC 50 07 390 VAJY -7&dA) E911 ADDRESS: TOWN: lvN 1 o579 AUTHORIZED TOWN OFFICIAL (Signkure) DATE: E The Putnam County Department, of Health will not' issue a Certificate of Construction Compliance unless the above form is C'ompleted,.i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the applicationfor a Certificate of Construction Compliance.. (E911 VERFRK PUTNAM COUNTY DEPARTMENT OF HEALTH bM"S ON DF ENVIRONMENTAL HEALTH SERVICES.._ GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM m c glt, , MM!yrwr 3,, `l ✓ Owner or Purchaser of Building W KJ 6RA Building Constructed by Location — street Building Type <ec 6"0 l 11 Tax Map Block Lot TownNillage Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. .- .. _ _ The undersigned further agrees to accept as conclusive the determination of the Public Health Director of - the Putnam-County department o-j'- i'calth- as to whether - -or not -the -failure of -the ;system to•operate� :vas.._ .: caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day-2-3--Year Signature: Title: General Contractor (Owner) — Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: oww 41� Address: State AIM Zip 1?.Lu State Zip Form GS -97 't 273 Starr'Ridge Road Tel.. (845) 278 -6212 1. Brewster, NY 10509 Fax. (845) 278 -0403 November Z 2006, Mr.. Joseph S. Paravati, Jr.. Assistant Public Health Engineer Putnam County Department of Health . 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence = Dennytown Road, Putnam Valley Tax Map 50 -'1-11 Town of Putnam Valley, Putnam County; N.Y. i Dear Mr. Paravati,' Enclosed please find the following items for the above project: • Four (4) sets of As -built plans dated 10 13 106.revised 11%2 /06 prepared by Beyer& Associates The above plans were revise to show the correct distance for AS and B7 I trust the above materials are adequate for your.approval and complete the submission for the above project, However, if you havelany questions concerning this project, please do not hesitate to call me. Very truly yours, Michael Beyer, P.E. Project Manager YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 Albert H. Padovani, Director {� LAB #: 1.606081 CLIENT #: 2173 NON STAT PROC PAGE: 1 NORMAN ANDERSON INC. 152 BARGER ST PUTNAM VALLEY, NY 10579 DATE /TIME TAKEN: 10/02/06 01:20 DATE /TIME RECD: 10/02/06 02:00 REPORT DATE: 10/18/06. PHONE: (914)- 528 -1491 SAMPLING SITE: 390 DENNYTOWN ROAD,PUTNAM VALLEY,NY SAMPLE TYPE..: POTABLE : M. BARTHOLOMEW PRESERVATIVES: NONE COL'D BY: BEVERLY TEMPERATURE..: < 4C NOTES...: OUTSIDE SPIGOT COLIFORM METH: MF DATE FLAG PROCEDURE PUTNAM CNTY PROFILE 10/02/06 MF T. COLIFORM 10/03/06 LEAD (IMS) 10/05/06. NITRATE NITROG 10/04/06 NITRITE NITROG 10/04/06 IRON (Fe) 10/09/06 MANGANESE (Mn) 10/05/06 SODIUM (Na) 10/02/06 pH 10/03/06 HARDNESS,TOTAL 10/03/06 ALKALINITY (AS 10/03/06 TURBIDITY (TUR RESULT NORMAL - RANGE METHOD ABSENT /100 ML ABSENT 1008 <1 ppb 0 -15 ppb 9003 0.73 MG /L 0 - 10 9052 <0.01 MG /L N/A 9162 <0.060 MG /L 0 -0.3 mg /l 9002 <0.010 MG /L 0 -0.3 mg /1 9002 2.24 MG /L N/A 9002 7.1 UNITS 6.5 -8.5 9043 120 MG /L N/A 74.0 MG /L N/A 9001 <1 NTU 0 -5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS),(WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE.TIME OF COLLECTION. Pb /Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg /L, else water undertaken to reduce the waters corrosive Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium YML ENVIRONMENTALISERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ...._. .....� - _ --- -,. � , , •:� ... ..,,.: -; (91;4),,. 24,5- 28DQ•- _- :�_:.......:;.. •- ,. � . .. ., ...•�, .... _._... Albert H. Padovani; Director LAB #: 1.606081 CLIENT #: 2173 1 NON STAT PROC PAGE: 2 NORMAN ANDERSON INC',. 152 BARGER ST PUTNAM VALLEY, NY 10,579 DATE /TIME TAKEN: 10/02/06 01:20 DATE /TIME RECD: 10/02/06 02:00 REPORT DATE: 10/18/06 PHONE: (914)- 528 -1491 SAMPLING SITE: 390 DENNYTOWN ROAD,PUTNAM VALLEY,NY SAMPLE TYPE..: POTABLE M. BARTHOLOMEW PRESERVATIVES: NONE COLD BY: BEVERLY TEMPERATURE..: < 4C NOTES...: OUTSIDE SPIGOT COLIFORM METH: MF DATE FLAG'PROCEDURE RESULT NORMAL - RANGE METHOD 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 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY' -HARD--; WATER-: •7.0 -140 MG /L MG /L = MILLIGRAM PER WATER: 140, -300 MG /L (1 grain /gallon = 17.2 MG/L) SUBMITTED BY: Albert ITY, Padovani , M. T Director ELAP# 10323 ll� - °~ � 32l Kear Street _ -. (914) 245-2800 Albert H. Padovani, Director ` LAB#:. 1.606O81 CLIENT #: 21.73 ` � -NORMAN ANDERSON INC. ' ` �' +' :152 BARGER ST F`UTNAM VALLEY, NY 10579 '. ' ` NON STAT PROC PAGE: 1. ~~~~~~~~~~~~~~~~~~~~~~~~~~°~~-~~~~~~~~~ DATE/TIME TAKEN: 10102106 01;20 DATE/TIME REC'D: 10/02/06 02�00 REPORT DATE: J.0/09/06 PHONE: (9140-528-1491 ^, SANPLING SITE: 390 NENr-,iYTOWN -__ ROAD, PUT NAM VALLEY SAMPLE TYPE..: POTABLE � -- S M. ^BART � ^;COL�D`BY�`BEVERLY � WOTES,,":� []UT�JDE SPI6OT � �DATE FLAG PROCEDURE PUTNAM CNTY pROFILE ' RESULT `,10/02 MF T. COLIFORM ABSBNT /100 ML 10/03/06 LEAD (INS) <1 ppb 10�05/O6 NITRATE NITRO� 0.73 MG /L ^ {0/04/06 NITRITE NITROG <010l MG /L 10/04/06 IRON (Fe) <0.060 MG /L 10/09/06 MANGANESE (Mn) <0.0{O MG /L 10/05/06 SODIUM (Na) 2.24 MG /L 10/02/06 pH 7.1 UNITS 10/03/06' HARDNE5S,TOTAL 120 MG /L 10/03/06 ALKALINITY (AS 74.0 ["IN /L .'' 10/03/06 TURLIIDITY (TUR <1 NTU PRESERVATIVES:- NONE TEMPERATURE, 4C COLlFORM METH� 'MF� ~~~~~~~~~~~~~~~~~~ NORMAL - RANGE ABSENT 0-15 ppb 0 N/A 0-0.3 mg/l 0-0.3 mg/l N/A 6,5-8.5 N/A N/A !` COMMENTS: I3ACT THESE RESULTS INDICATE THAT THE OT) OF A � ''� .' SATISFACTORY SANITARY QUALITY ACCORDl HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. - ' PI? /Cu LEAD limits for public schools are set at 15 ppb. ,sPA Lead & Copper Rule for Public Systems requires that no more ` than 107. 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 Fe/Iln If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. �a No limits for Sodium are proscribed. Suggested guidelines state that for people 'on .a sodium restricted diet,the water should ` contain no more than 20 mg/L. of Sodium. For those on a moderately restricted diet., a maximum of 270 mg/L. of Sodium IIIIETHOD 1008 9003 9052 9162 q0(./2 9002 9002 9043 900l O I YP' L . ir: V I RONMENTAl.; l:ik =.hV:( :CIS 3 r�w•„�.�r _ n....r,,, ,}:. - *, - -'; :Jc?::��.Eac'il "�:'i�:l "F�C?t: Yorl;t•own Efniyl'it <,,, ,N.1'. 1c7`:96 ( 914) 245- -0000 Albert H. 1-adovani;, Director ,. LOB # -. ,. 1.. 604001 , CLIENT NT 0 ;: 2173 NN NnINNNh /MMNN M.NN IN IV IVNh/NNMNNn/NNn/NNAINAI NMNN NON GTAT• F'Rf*)C; PAGE: 2 /,INNryINNIVNNAINryI ryrNMn/NNryIN IVMIV A• I.. A.NMryr h/Ml:r h/n /IV .. • NO OMAN ANDERSON I Nf' : DATE/TIME TAKE Ng ° 10 /02 /06 0020 20 ' 152 BARGER ST- c: o DATE; /1° I I II ' RI= C ' D : 10/OR/06 000o . PUT•NAM VOLLEY, NY .10579 REPORT DATE: 10/09/06 PHONE.-, (914)--528-1491 . SAMPLING S I T'E : S90 NENNYTOWN ROAD, PUTNAid VALLEY SAMPLE •T•YPE:.. n POTABLE M . � +F1RTHL VEOUS P iE� �.: ERVAT I Vi •S t NONE C01_.' D ICY BE:VE:RL.Y ' , 7 : TE_MPE:RATURE., .I u < 4C; NOTES.,.: OUTSIDE SPIGOT (:OLI1=ORM METH: MI= 4N V / NN INII /IV IV /,l NN/V r V�V ,f/ MN/V/ hf VIV I4I1 /hIry ♦I4NIV IV IV /4 /rf N/4IV /4 /4N/V /•I I•f hI „f DATE FLAY PROCEDURE RESULT NORMAL,. - RANGE METHOD is S.iUI•JgIsted ':;PH �, ' ' : pH SCALE IN W(-�Tf: Fi .I ANCf: S FROM 1-14. hIL=:(dMilJfiE:l�ll l�l i" C31= Eil�l IS i:INE:. (71=- f I• m I MPUR I AN L AND r nmuuF N (L ( ummu f Mn I S IM WA I MM (. MMM 1 cti I k (., WATER WITH A I_CIW PH MIGHT BE CORROS I VEI TO METAL. PIPES AND FIXTURES. THE: NORMAL RANSE: OF PH IS 6 .. 5 TO S. S. ZHd TOTAL_ . HARONk;.SP I S DEFINED AS THE SUM OF THE CALCIUM & MAGNES I I.IM CONCE:NTRAT'.ION, BOTH EXPRESSED AS C:AL.C,T.l.1M CARBONATE, IN MOK., THE: HARDNESS MAY RANGE FROM 0 T•(7 NUNDRE S OF MG /I..., DL::qE:NDI:i• (all, -;T'H ' •.: _ _SOURCE .'AND',- TREi=i7'MENT TO DHICH ' Ti••1E 'WATER HAS BEEN- CiUBJ'Ca:'TEn . SOFT WATER: 0n7O MOIL VERY HARD WATER: ABOVE 300 M011 MODERATELY HARP WATER „ 70-140 MOIL MOIL = MILLIGRAM PER LITER HARD WATER: 140•• -300 MG /L- (1 grAin /gai.l.on 17.2 MG /I-.) SUBMITTED BY: Albert: Direct; FA Padovan i , Iii. T. (ASCP ) EL..AP* L 03'2 3 SHERL,ITA AML.ER, MD, RCS, 1FAAP Commissioner of Health L,ORETTA MOL,INARI, RN, MSN1 Associate Commissioner of Health Michael Beyer, PE Beyer & Associates 273 Starr Ridge Road 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 October 31, 2006 Re: Construction Compliance — Bartholomew 390 Dennytown Road (T) Putnam Valley, TM# 50.4-11 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. o : The relocation dimensions for A5 and B7 appear to be incorrect. 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 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 '273 Starr' Ridge Road _. -_ ....- Tel. (845) 278 -6212 Brewster, NY 10509 Fax. (845) 278 -0403 October 19, 2006 Mr. Rob Morris, P.E... . Senior Public Health,Engineer Putnam County Department.of Health 4 Geneva Road Brewster; New Y6410509 Re: Bartholomew Residence — Dennytown Road, Putnam Valley Tax Map 50 -1 -11 Town of Putnam Valley, Putnam County, N.Y. Dear Mr. Morris, Enclosed please find, the following items for the above project: • Water Analysis Report - Original 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. Very truly yours, Manager A, r. 273 Starr Ridge Road Tel. (845) 278 -6212 Brewster, NY 10509 Fax. (845) 278 -0403 October 17, 2006 Mr. Rob Morris, P.E. Senior Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence — Dennytown Road, Putnam Valley Tax Map 50 -1 -I1 Town of Putnam Valley, Putnam County, 'N.Y. Dear Mr. Morris, . Enclosed please find the following items for the above project: o Certificate of Construction Compliance application form o E -911 verification Form o Three (3) Copies of Guarantee of Subsurface Sewage Treatment System. o. Well Completion Report o Water Analysis Report (Anderson did not forward the original, I have requested an original from YML and it will be forward once received.) o Four (4) sets of As -built plans dated 1013106 prepared by Beyer & Associates. °..:: App lication fee. -in amount of $300 : -_ ...... 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. Very truly yours, Michael Bey E. Project Manager S ITA Commissioner of Health, LORETTA MOLINAM, RN, MSN Associate Commissioner of Health DEPARTMENT OF 'HEALTH I Geneva Road, Brewster,,New Yo* 10509 REQUEST FOR FIELD'TESTING County Execsiiiw All information below must be fully completed prior to any scheduling. DATE: 04C)6 ENGMEPUN6kRM: 6�iF1t 41 A55Ck__, Z I t- PHONE#: PERSON TO CONTACT: A(R*GL_ 131 1 WCONSTRUCTION P REPAIR PROGR,*Nl 10 ADDITION PROGRAM REASON: ,,PEEPS: 0 PERCS: L] 1-1 P TEST; ROAD /STREET`: TOWN: T,,4,X MAP SUBDTVTSJON: LOT #: OWNER•. 111 iI NYCDEP QkItERIA FOR JOINT REVIEW-AND WITNESSING OF SOIL TESTING YES NO Pr6foSed SSTS Within the-drainage Wsinlof'Wegt Biknthor)Koyd�Qhi-W6r Croton Falls Reservoirs. iX Proposed SSTS within 500 feet. 6f a reservoir, reservoir stem or control lake. Proposed SSTS within 200 feet of a watercourse or a DEC wetland. Proposed SSTS des1ga flow greater than 1000 gallons/day or SPDES Permit required. Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to sot) testing. The Departmeni *ill determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered.Les to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for fle'ld testing.i ith the Design Friofessional and NYDCEP,) If a project has been determiued t9. be Delegated based ion the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re-witnessing of the soil testing with NYCDEP. OyNn", VSF ONLY TIME: IM,, - 6___ kP0. FOR PIEL,.,, mn,u b:i OCT- 2006, "!Q-- EnvircummWIlReAft (845) 2 1 3Q Fax (845) 278,7921 Water Supply Section (845) 225 -1196 Fix(845)22$-S418 ArsingServices (945)278-655? Fax (843)27Pio25 WIC(945)278-6678 Numbig Home Care i'tix 278-6085 Early Fax(845)278-6648 C-OUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF - HEALTH DIVISION OF! ENVIRONMENTAL J1 E_ATLH.SERVICES - FIELD ACTIVITY REPORT MATVM. vf4-b4e-x Al . .Street Town State Zip PERSON IN CHARGE OR TN1-E.1ZViRVTT)-. 67- PUMP TEST DOSE TEST I LSD G� -y iv' �, "AbP REQMED GALLONS / �/ `T " 'Lg /0 10,00 .t-3 �- uvaOR.'i 1 4 Z7? 9;20 Zi�r I acknowledge receipt of this report: SIGNATURE: 02/96 Title: f mo 1�' 0 om DOSE TEST I LSD G� -y iv' �, "AbP REQMED GALLONS / �/ `T " 'Lg /0 10,00 .t-3 �- uvaOR.'i 1 4 Z7? 9;20 Zi�r I acknowledge receipt of this report: SIGNATURE: 02/96 Title: i, i ® UTNAM COUNTY DEPARTMENT OF HEA IYISIO OF•E-N- 1RONMENT- — =HEALTH S CERTIFICATE OF CONSTRUCTIO COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at 3 l o D1° ,w ouiy ,2-&A p Town or V46ge u; �IM 14L4,0_ !�e Owner /Applicant Name's iumru 91%1 loa.g:yi Tax Map ® Block / Lot Formerly Subdivision Name Subd. Lot # Mailing Address 9 Oy61 AIQ -PL&CE 1J 9.0. awt Zip 0 Date Construction Permit Issued by PCHD E? Z Los, Separate Sewerage System built by iJ&j �a/1,+ ®tae, Awmf Address M Zr2,9A j%rein,�,( Consisting of Gallon Septic Tank and 3YO ' Af A2 h",9 �irad. y Other Requirements: '"Pqyj to c Water Supply: Public Supply From Address or: Private Supply Drilled by Address Axwwwb," A N�e Building Type aS erosion corifroTeeri completed? " Number of Bedrooms °3 Has garbage grinder been installed? A/0 I certify that the system(s),;as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: ® ®•I 'Certified by P.E. T R.A. IV If (Design Profes oval) Address &sLw2 License # 07yS J 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. B- Title: [-tom Date: Y Wh copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION-OF ENVIRONMENTAL HEALTH SERVICES WELL UUMPLEI IUN KhPURI Well Location Street Address: X10 > v�v�, �% Town/Village: �. V`i.l le- 61 Tax Map # Map 5 V Block 1 Lot(s) Well Owner: Name: / Address: �i / r� f i. r Ci'l k p l �Cl r ! �'Lo'yh e (A J 010 46/!h td Qa, Q AA 4'1" Use of Well: I - Primary 2- Secondary esidential _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 ft. Length below gradeLbft. Diameter � in. I Weight per foot _lb/ft Materials: Steel Plastic Other Joints: Welded ✓'Threaded Other Seal: Cement grout Bentonite Other Drive shoe: YeskZNo Liner: _Yes No Screen Details Formation Description Diameter in Slot Size Length (ft) Dept to Screen ft Develo ped? First I I Yes No n .,. s sv: #v 1/ /r4rr ,... m .�. NOTE: Exact Location of well with distances to at least two per anent landmarks to be prod ded on a separate White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 Second lHours Well Yield Test _Bailed _Pumped _j-Compressed Air Hours –7 4- Yield ! b gpm Depth Date measure from land surface-static (specuty k 3 Dur —In g y We test Depth of completed well in ft. 3 0� Well Log If more detailed inforniation - descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter in Formation Description ft. ft. Land S�Wacv If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type-& S /.. Capacity sf Depth kW Model Voltage ,) 3y HP I/;)- Tank Tvpe W. X 3 a �, Volume 4 n .,. s sv: #v 1/ /r4rr ,... m .�. NOTE: Exact Location of well with distances to at least two per anent landmarks to be prod ded on a separate White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: Inspected by: Street Location TM # . ,. 1. Sewage System Area a. STS area located as per approved plans .......... .. ..............:. b. Fill section - date of!placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................... ............................... d. Stone, brush, etc., greater than 15' from STS area.........: e. 100' from water course / wetlands ..... .............................:. II. Sewage System a. Septic tank size - 1,000 .... ..... 1, 250 .........other ................ b. ' Septic tank installed level .............................................. c. 10' minimum from foundation .......... ............................... d. Distribution Bog 1. All outlets at same elevation -water tested .................. 2. Protected below frost .................. .............................:. 3. Minimum 2 ft.Original soil between box & trenches e. Trenches nct - properly set ......... ..................... e. Junction Bog ro .......... 2 1. Length required. Length installed J o 2. Distance to watercourse measured Ft../&0�1 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. '10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for, expansion, 100 % ...................... 8. Size of gravel 3/4 11/2" diameter clean ...................: 9. Depth of gravel in; trench 12" minimum .......:........... 0. Pi P a ends ca ed ........................ ............................... v......g s stems w T. Size of pump chamber ................ ............................... 2. Overflow tank 3. Alarm uaVaudio ......:........... ............................... 4. Pump sible, manhole to grade ................. ' 5. First box baffled .......................................................... 6. Cycle witnessed by H.D.estimated flow /cycle........... M. House/Buildirig; a. House located er approved plans ................ . b. Number of be rooms .. ............................... �� ................ IV. Well Well located as per approved ';,plans .......:........... ...... b. Distance from STS area measured ' % ft ........... c. Casing-18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship! a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfll material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall;protected & dinto exist watercourse, g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ...................................... i. Erosion control provided ................. ............................... Rev. p2/02 Permit # Subdivision Lot # —OZ N n/ 1 •1.1 mom A r IMAM N Om N/= � = Mm� WIAM POPE A A j EWA r /1EA N n/ y - ... 50.1 ERLL I Il A Al'4'Ab+E:R 16'tlDf tzMz &i r--AA • . "— 1w Commissioner of Health IL,ORIETTA\ MOLINARU, RN, i'Ji[SN Associate Commissioner cif Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING ROBERT J. - OOM.� - Covaty ExeMiw All information below must be fRily comOkted prior to aney scheduling. DATE:— 011a. ENGINEERUNG FIRM: e_>HF,2 PHONE #: IPERSON TO CCDNTACT: MSC "/NEW CONSTRUCTION .0 REPS PROGRAM, C]..AIIDWTIION PROGRAM REASON: DEEPS: ❑. PERCS: 0 PV M? TEST: ROAD/STREET: (AWOPO ^AO LWVIJ )a?Ayx V, rp wv-) 12OLD TOWN: k�i mn► Awn �� TAX MAP i#: '5_0 SUBDIVISION;— —IJIL LOT #: N'YCDE? CRITERIA FOR JOLT REVIEW AND WITNESSING G Ole SO)lb, TESL` N_G YES NO cJ ]Proposed SSTS within the drainage basin of West Branch or Boyds Corner & Croton Falls Reservoirs.. =i ry, Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet of a watercourse or a, DEC wetland. u Proposed SSTS design flow greater than 1000 gallons /day or S)P DES Permit required. D Froposed SSTS fora Commercial Fropect. it is the responsibility of the desigu.professional to provide the above information prior to soil testing. The Department will determine the NYCDEP projecti staters (Joint or Delegated) based on the response. If you answered yes to any of the questions; NYC'DEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professional and DWDCEP. If a project has been determined to be Delegated based on the above, response and then subsequent information indicates'YCDEP is required to witness the soil tests, it will be the'sole responsibility of the desigm professional to schedule re- witnessing of the soil testing with NYCDEP. IDATE:_ - IC'ONNEISTS: NEO. FOR FIELD TIM;TzU!, �.• FOR COUNTY USE ONLY TTW: OCT -4 -2006 I,IEI U_G; Envir®amentil Health (845)278-6A30 Fax(845)278-7921 Water Supply Sect( ®n (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845).278 558 Fax (E43) 278-6026 W X (845) 278 -6678 Nursing Home Cn a Fax (845) 378.6085 6'arty 6.aoaewmw?law/�wacnennl fAd51 77Rlef)Id Aaa t$@.51 27R.FuiBR <<�` TEL:845 -278 =7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. ! I OCT 03, 20(_+6 OJ A9 j M.iChag- Bar�hclomow 9146362796 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD ' OF ' FIRE UNDERWRITERS BUREAU OF.. ELEICTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT F,� • r?-k, of uL,G' !yY,'r? 15c'S c-wrle.cl I)y 'rOMl ELECTRICAL CONTR, CORP WCHAEL 5ARTHOLOMAN 107 MILLER HIL.i. WOODS 350 DENNYTtiWN RD. ARML'! , NY 10512 PUTNAM VALLEY, NY 105, Page 2 kQI Seed is CVRiflcate 'nay rot Gie dl,tet-Fo -n zny way am,4 15 va, ca p.ij i IiY MP 1,05"M T E e r r r.rw7W7l�� OCT -4 -2006 WELD LJ8: Cf FEL:845- 278 -7921 TAME:PI_ITNAM COUNTY DEPARTMENT OF P. 2 u � QXatt31 at 3,jO DENNYTOWN RD. (JUTNAM VALLEY NY 10579 Application Number' `'43404 Cent +Kate Dumber: 21034'154 W406 D85VIbed as ;e atc�; l�uti,f.' OOfL4(IOC square ft. �,or: y !,r u: a ii ;ne t:�r.,,n •tom e ert.riU1I cmr) sting ur eleGt�r,,di davN:a� sr,c v:. �. 6: mbed locatpu ,n _''f':e Raseni:c�; ,n, fiiot:� • :.tcu�td. Fleur, n�dChCti tJ�ragc. i �?::rsi�ie•, At..... . A vl ual inspeo h,:i, ?I` Ct,e' . - -or ses >riN['ti'ICIi 5yotel'o Kr;,tr!.I ' J d'E'. thG,;i ;;rv,. t•'; alt!1 :'Jltla� ?:: ;I;� (Rft"'." .Q herein. w r, „ u'.aK r atccrdance w;tn f.`'.: . �QUfrer i :.i,, tnE, a;:a;l:; �I,!e e a;.;lrr >I st�tnclard promuiRateo '!, °ar _;,ire ut 1 61 Yrjrx, �e:'att:�al,c i Pf .� �' p F'r:`,.7r, t� to v,.)d a : +r! �; , ,. :;n.nt a .d i,..rn.•.,5�rdltt: ), ilr irl ,r r 3ut''orlt, »v. ['rt a ?iii 'ot. no to oc. r,; .n the '7tb '-))y 0 September, '035. SLfj km;. _i�i6ifit6; r rsl�t t � t40 1'i�(ut'e 101 0 (,t4311d+3sCCnt Switeh 9. u n t;ructal (w,;;ose Itc, cpittc;lr, I (.t t5 A L)tyc Rccupsacie 1. l3 ..0 A aar•dr} Row ptada .. ,i • tj .. Appliance MOIvr Control +..enre, ! 0 51..Y'1!� Saeciul Switch 1 0 1k'1 L1 Mokor Cuntrol Service ! Yht�isc i W `er.,� „ K:,t,�» :'•,jt, .an:prics ; Service •L 50 t:!? �tct+� •� kQI Seed is CVRiflcate 'nay rot Gie dl,tet-Fo -n zny way am,4 15 va, ca p.ij i IiY MP 1,05"M T E e r r r.rw7W7l�� OCT -4 -2006 WELD LJ8: Cf FEL:845- 278 -7921 TAME:PI_ITNAM COUNTY DEPARTMENT OF P. 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVMONMENTAL REALTIR SERVICES 119 ATTIU,MiON P A5A# 0 GENE ST EQRFINAL INSEEL= For; FBI — All idonnation must be fully completed prior to any Trenches inspections being made, PCHD Construction Permit # _P _V - 2z. 0 Located: Owner/Applicai m(F-i-J TM SO Block Lot Subdivision Name- Subdivision Lot # Is system fill completed? Is system complete? Is system constructed as per plans? . YD'S' Is well drilled? _-_mod d Is well located as per plans? s� ,Zve �wt <,;T A%4 Are erosion control measures in place?,. VC=S_ Date: Date.- Date.- I cerffy that the system(s),, as fisted, 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. Date. Certified .by: ,AL._ PE RA Address: 'Z ?"o Z Lic, # Forte FIR-99 C vv( c1l 7& 0 44-S ;?4 IV47w- -OUNTY DEPARTMENT OF P. 01JCq--2)5-L`D00f_, FP! TEL " 84.5 - 278 -7921 NAME: PLITNAN C ,I ! PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION 0-Aii2136 GENE, . R` EQUE.ST FOR FI_NAII, IIYSPECT41N : For; All information .must' be fully completed prior to any inspections being made. fill Trenches PCHD Construction ftran t #. .Located: S'At• Q iPu.s t1PLw, , "' 1 Owner /Applicant Name.j �C� r3 AR i kfOLur' TM S' Block _, / Lot Formerly: , _ _ Subdivisiod Name: Subdivision Lot "# _ Is system fill completed? �fi _ Date: Is system complete? 'S Date: . Is system constructed as per plaits? _YES. Is well drilled? — _n �� d Date: -- Is well located as per plans? syzura.2 S"TAitc� Are erosion control measures in place? UGS I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in. accordaace with the issued PCHD Constrvction Permit and approved plans and the "Standards,' Rules and'Regulations of the Putnam County Department of . Health. ; .:..... Date: 7 a CP ! Certified' b PE RA Y. esige Prq essional A.ddress:. Z 7 L a yst' 42 t' kt We 9-E� Wrz V t Lic.. # O�yS `� 7 Comments: (rl� _""' S ySt�n� �(.� r1 �T�2.� C�•P � lid t Y H!- � psi 12 �6 u � � cir- -► ca r, s r c7 � ,� i i � rM� r_1 �` Form FIR -99 JUL-8-200E. H i,�, TEL:845- 278 -7921 Arvo hl*iw-- NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health L®RETTA M_0_LINARI, :RN,,.MSN_' _ .: Associate Commissioner of Health July 12, 2006 Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 To Whom It May Concern: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 R ®BERT .D. B ®N ®I County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — PV -28 -03 Dennytown Road, TM # 50. -1 -11 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1: -Silt fence needs to be repaired. - final- site-inspection-upon completion of-well; septic tank; and -pMnp tesf. If you have any further questions, please contact me at (845) 278 -6130 ext. 2155. JD:kly S, ly, oseph Digit Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH ® OF °ENVIRONMENTAL HEALTH SERVICE °12UC�M0NT]EIMIT:.Wiff G` TREA MEN S°3�STElVI T.� s PERMIT # C7�� Located at c oS l.i [3 t,.l �APtn n�(' c,,s� l Town or Vi lie pu -rtj &,q VAWe-y Subdivision name Subd. Lot # Tax Map '50 Block Lot Date Subdivision Approved Renewal Revision X Owner /Applicant Name 01 0{Pg L R AaT 14A L rn E4-j Date of Previous Approval 4 Z-7/0 Mailing Address q C3V e'l ai n Yip 9�-AcF_ dy e2 �-Coitso t.2. 01 1 C Y01 Zip Amount of Fee Enclosed ©C Building Type _4 c � • i+o Lot Area 4.37 No. of Bedrooms 3 Design Flow GPD (•CC Section Only Depth i Volume Separate Sewerage System to consist of 12,50 gallon septic tank and 3"75 Ltd -oF- Other Requirements: 'Pgmn CAy.,w er c.,,& 1,75- To be constructed by j ,(�i� Address Water Supply: Public Supply From Address .... - Pr'vate.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 RI f S Ios License # %q5'9 % 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. Approved for ' 'charge of domestic sanitary sewage only. By: 1S.J• Title: / Date: S o WhCDV- HD File; Yellow; copy - Buil mg Inspector; Pink copy Owner; Orange copy - Design Professional Form CP -97 PU NAM COUNTY DEPARTMENT OIF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLIICATION TO CONSTRUCT A WATER WELL — p11.W'pdnt`6e type Well Location: Street Address: TownNillage Tax Grid # '' CAR,, l ,w �Pnw ' ,� 7 . V, ,e Map 5D Block / Lot(s) Wen Owner: Name: Address: IeW L C30camAt 7 Pi rr—a N 1Zac& LLe PV /0a J Use of Well: _ Residential Public Supply Air /Cond/Heat Pump Irrigation I -pri marry Business Farm Test/Monitoring Other (specify) 2-secondary Industrial Institutional Standby Amount of Use Yield Sought .. 5 gpm # People Served 3 Est. of Daily Usage g�j gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason � y!% 2� inn r �� .�.✓o+�'r' 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 Lot No. Water Well Contractor: TaD Address: Is Public Water Supply available to site? .................................. ............................... Yes No X Name of Public Water Supply: TownNillage Distance to property from nearest water main: '> ®LO'= I Proposed well location & sources of contamination to be provided on separate sheet/plan. Date:.: 11T) 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 hov /0'1- Permit IV9k, Offici . Date of Expiration Title: pit is Non- Trannsffe abl .opy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 •y.urwse+.na aN'. i,•- aYw..•a a.I�.ws ice- r.c�M.r:•:v �. -..i"a n'.w -:.s• •� : n ._ r �t....� Brewster, NY 10509 Fax. (845) 278 -0403 August 15, 2005 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N Y Tax Map 50 Block 1 Lot 11 Dear Mr. Paravati, Enclosed please find `the additional information requested as per your phone call on August 15, 2005: • Construction Permit for Sewage Treatment System, • Application to Construct a Water Well .. Revision !Fee — Bank Check in the amount of $200 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. Very truly yours, cchael Beyer Project Manager SO_'� -y - 273 Starr Ridge Road Tel. (845) 278 -6212 Brewster, NY 10509 Fax. (845) 278 -0403 August 11, 2005 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N.Y. Tax Map 50 Block 1 Lot 11 Dear Mr. Paravati, The enclosed approved Individual SSTS plans for the above project have been revised to reflect comments from your letter dated August 8, 2005: 1. A clay barrier has been shown on the plan and a detail added to the plan. 2. The temporary. diversion swale ahs been labeled and note #10 added to the plan. Enclosed please find a copy of the following items for your review and approval: o Plan and Profile- Separate Sewage Treatment System (4 copies) 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. Very truly you Michael Beyer Project Manager i SHERLITA AMLER, MD, MS, FAAP Commissioner of Health Associate Commissioner of Health August 8, 2005 , Mike Beyer, PE Beyer & Associates 273 Starr Ridge Road Brewster, New York 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT 1 BONDI County Executive Re: Proposed SSTS Revision — Bartholomew Dennytown Road, (T) Putnam Valley TM# 50 -1 -11 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 Cow. ©� 2 The separation distance between the proposed house and the proposed SSTS needs to be a minimum of 50 feet due to the house being downhill and in direct line of drainage to the SSTS. Since the permit 'was already issued and it appears the separation cannot be met without encroaching into the wetland buffer, please provide a 2' wide clay barrier along the appropriate house side to a depth equal to the footing drain level'. Please also provide a-detail. The proposed swale is less than 50 feet from,the proposed SSTS. As mentioned in our phone conversation on August 8, 2005, the swale is temporary and is to be removed when construction is complete. Please .note this on the plan. Also, be advised that the compliance will not be issued until the swale: is removed. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. JSP:cj Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 =6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 273 Starr Ridge Road Tel. (845) 278 -6212 Brewster, NY 10509 Fax. (845) 278 -0403 June 29, 2005 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N.Y. Tax Map 50 Block 1 Lot 11 Dear Mr. Paravati, The enclosed approved Individual SSTS plans for the above project have been revised to reflect comments from the Putnam Valley Planning Board during Site Plan Review. The following items have been revised as per this review: 1. The plan has been revised to reflect a new house configuration, as well as the driveway, pool and patio. 2. The well has been relocated due to the location of the SSTS of the property to the northeast. (The SSTS was originally located towards the rear of the house and property.) 3. The proposed grading at the south side of the expansion area has been adjusted. (contour 648 has been revised) 4. The septic tank and pump chamber location has been adjusted due to the new grades. 5. The house elevation has been adjusted due to the new grades. -.En to ed.pleasefind a_con_ ..e .thp ollgwin items or vourxeview and o rcival:.- . y f o f f Pp o . Plan and Profile- Separate Sewage Treatment System (4 copies) 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. Very truly Mi)clael Beyer G Project Manager i JUN 23,2005 07:55 Michael Bartholomew 9146362796 O» C: uf' r�':..+•+.-...' i.;' �tY' Y. vcJC::. ek .�.<avt?'•.'1zs.'�I:'nl.:ir�!vi ai'�W tiler �ilw +.e' i'i •��•' ..•0 �Y_CY i $7j(_ �^ LA N=APE ARCM Town of Puham Valley Planning Board Town Hall, 265 Oscawana Lake Road Putnam Valiey, ,New York 10579 Via Fax: 845 -526 -3307 (Planning Board Office) . 845 -5201 4992 (Planning Board Chsairainn) RF: Development Approval Plan BarMolonlew Residence Dennytown Road Tax Map No, 50 -1 -11 F. C .lung 16, 2005 Duar Chairman Zarcone and Members of the Board: Our office has received and reviewed the following documents submitted for the above referonced project as prepared by Boyer and Associates:. • "Site Development Plan and Drivoway Profile ", Sheet S -1, revised May 30, 2005. "Tree Plan ", Sheet S-1, revised May 30, 2005. • "Plan and: Profile Subsurface Sewage Treatmont System ", Sheet SSTS -1, revised September 2004. Based on our review, we offer the following comments, which may warrant discussion with the applicant andlor,aclion by the Board. 1. The, (applicants design professional has indicated that a revised approval Is pending with the Putnam County Health Department (PCHD) for the relocation of the well. The proposed grading, house, and driveway location should be consistent both on the PCHD approved plans and the Development Approval Plans. 2. As discussed at a meeting with the applicant's design professional on June 0, 2005 a detailed construction sequence should be provided to guide the contractor with the Implomontation of the earthwork and erosion control necessary for the project in order to .. he!p prevent sediment lard discharge off-of -the steep. slopas late tt.6 sdjacent broor: - 3. As' indicated by the applicant's design professional the applicant is researching retaining wall,options. As previously mentioned the Limit of Disturbance sooms tight and based on the design of the retaining wall the limits of Disturbance might need to be modified. Once the final retaining wall design Is chosen and the detail has been submitted we can further advise the Board on the appropriateness of the Limit of Disturbance. Should you have any questions or comments, ploase feel free to contact our office. Very truly yours, INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. William J. kri&e imaier, III, P.E. Senior Project Engineer, Associate WJBlrndmlamh cc: Applicant Iry Sevelowltz, Building Inspector, Via Fax: 845 - 526.8£30(3 Jan Johannessen, Town Piannor, Viva Fax: 845-454 -4026 Steve Coleman, Wetland Inspector, Via Fax: 914- 762 -6260 r:rr- ra„ 09in7 Ifn 3 Garrott Place, Carmel, Now York 10512 (845) 225 -9690 Fax(845)225-9T17 061605pvpb.doc www.insile-ong.com Page 1 ReridKINMEM 273 Starr Ridge Road Tel. (845) 278-6212. Brewster, NY 10509 Fax. (845) 278-0403 February 15, 2005 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Roadl Dennytown, Putnam Valley N.Y. Tax MaD 50 Block 1 Lot 11 Dear Mr. Paravati, Enclosed please find the final house plans for the above referenced lot. We are herby requesting a review for bedroom count for conformance to PCDOHSSTS Permit 28-03. I trust the above materials are adequate for your approval and complete the submission for the above project, However i . fyou have any questions concerning this project, please do not hesitate to call me @ 278-6212., :} ja ray. k� . s. '. t o i,,, z '. �. t r' ;,,ya 's y.& ro. x�;.$aw.cY ?tij& . Y u- �z ! ,° .. l{ i,� h, ��7 ;. f t�� ...z r1 c4` �i„ .x j d..•tit `� F 4 , i' Q' �f� 1,," " �},A sr ,1 1, r_I+1 TM �, to i;„ .. ,% s h `w a t Y =: S -, t ea PUT�N`AM COITNTY DEPARTMENT "OF HEALTH 11. t z, IDMSION40F ENVIltON1VIENTAL' HEALTH tSERVICES Z. • .•..» rt r -w, r, ,s, q ti V �`.'s '"" -y*n "'� z v v \s . a 1 .. r . - r �' a. . CONSTRUCTION PERMIT FOR SEWAGErTREATMENT SYSTEM , ,� t<< w i "' r I , r. to �; ' 1 , ;,.y, t ` , � S ;>u,. ?-� i'',' 11S h 3,w-., ` T, j K` u a -, t , f ,.. Located at' F , �� ' ` i ti t �N3 , s Town or Village' v-.1�A �1 ,� 4 g i c 's' Subdivision name Subd Lott # F Tax Map Block _�' Lot-` _ �> t , ..� t I - .x ai l r /F . n; Date. Subi#i Sion Approved x Renewal _ Revision � �, `, , a, t Owner /ApphcautName 1'� i'`1� ` hxf�+ra+''xr� Date=of Previous Approval I Ma uig +Address ;� i ,i,i a i t s t � �.. P � t3 � �� s 6 � � 1 �` � �E � � �� , ' Zip a r ', � Amount of Fee Enclosed > �:�a �. F _ z r 11— s i { '' �'� r ,.b Buildnig Type' 'k :,. � i` -All Lot Area �Y�.; ,�" , No" of Bedr i, . - ) fi Design )Flow GPD� �� M. F i " > �: - ,.,�.: I;. '._ t•'£ w r7 "e. ?.� .?.unv.r .w- ", �. e.a '. h ` Filf$echon Only ` _ Depth ' �' Volume y I IM ` ` i A,PC`HD NOTIFiCATi N.IS°RE TIRED, FILL C - 10I:ETED . a: � I { -j ,, to consist of gallon septic and ,5 ° ;:: I <t k r ' Other Requirements t` =f p'' ` ••e IT " =G;� } =d " >/e 'IMP m r �' To be constructed by ' ', 4� 1 �° Address ` ?' ` e '" ti � k '' ; i k .. 7 r' ddre iaiw� 'a n• Su�o I. 1? PUTNAM COUNTY DEPARTMENT OIL HEALTH COINSTRU CUON PERMIT FOR SEWAGE TREATMENT SYSTEM PEPMT # ry- a.8- 03 R le ao u� Located at CA1JQR) S l40LLGty � Town or Village uMAjA V Atle-q Subdivision name Subd. Lot # Tax Map 60 Block I_ Lot Date Subdivision Approved Renewal Revision Owner /Applicant Name 141 C N) ( 8Ai2 j j,0LpLW_k% Date of Previous Approval Mailing Address b VflZ i kk 0 Pd.d` Q X)-i &.J I& C-R LL e - Inf-,11 Zip — Amount of Fee Enclosed 3po - t Building Type G� jez, D62sg,1 Lot Area No. of Bedrooms _ 3 Design Flow GPD 4300 Fill Section Only Depth Volume IFCHI[D NOTIFICATION IS RE >1 IREIlD WHEN FILL IS COMPLETED Separate Sewerage System to consist of 17 503 gallon septic tank and 32:5 � •%• of ZIT w of- Ab6 p'z r'r oy j'r&N C" Other Requirements: PQ & P C hAAA lie 0 k 1, i S F of FILL %e.G1. To be constructed by Address r Se�psir. Public Supply From or: rivate Supply Drilled by Address � 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 treatments sy tern 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 0 7&_3 License # A]FPROVII';IID FOR CONSTII UCTIION: 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 Apilt. Approved for discharge of domestic sanitary sewage only. B Title: Date: 1D o�7 �11 W 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 _... APPLICATION TO CONSTRUCT A WATER WELL _. .. ,...... o.. _....,, n__, .. �.,.... •..... PC1= ID °Pe'rmif please urint or tvue Well Location: Stteet Ad e s. Town/Village Tax Grid # APCNS IUN Map 50 Block Lot(s) Well Owner: Name: Address: M1CMAtL W-C �c (mat C {e A� 'At IPE Use of Well: esidential 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 __G gpm # People Served Est. of Daily Usage Q�p gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling ew Supply (new dwelling) Deepen Existing Well Detailed Reason Juu,,� k5fopx�fekc �WeGLj�cJf� for Drilling Well Type rilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. 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: Proposed well location & sources of contamination to be provided on separate sheet/plan. - - A, P lic t Si nature: 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 (3 0) 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 8 v Permit Issuing Official: Date of Expiration Title: i�'' Permit is Non-Transferrable' on -Trans errs le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Bryant Pond Plaza, Suite 5 Fax. (845) 628 1905 Mahopac, New York 10541 October 27, 2004 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N.Y. Tax Map 50 Block 12 Lot 11 Dear Mr. Paravati, Asper our telephone conversation today the following comments have been addressed: 1. The proposed pump tank size has been changed to a standard size as per the latest Mid-Hudson concrete products catalog and the volume calculations have been updated upon the plan. Enclosed please find a copy of the following items for your review and approval: 0 Plan and Profile- Separate Sewage Treatment System (4 copies) bust -spyke�, above materials are.adeauate for your approval and complete the submission for the above project,.... i--'*-'-'-'--'-- 'Ca) However ifyou have any questions concerning this project, please do not hesitate tate to ca I me' 'I I Very ly , yours �Urs Chris Caralyus Project Manager 14.16-4 (9195) —Teza 12 PROJECT I.D. NUMBER. 617.20 SEOR _.. —Append x. C _ ...:. .. .. _ :. � . • , .....:. r.�� =... �. a , +.-,t � _ .. ..:. .N _ .....,... a. ,... .. to.. .,. �SUte Enlrlronmerit i I Owlify SHORT ENVIRONMENTAL ASSESSMENT FORM For' UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applkcint.or Project sponsor) 1. APPLICANT /SPONSOR' 'j I r 2! PROJECT NAME MunlclpallCly ATTui"Ak S. PROJECT LO / a e County U U 4. PRECISE LOCATION (Street address and road ntersectlons, ptornlnent landm' srks, ate., or provide map) C�xP�s x� Rp/�D t �? F L 6. IS PRO ACTION. New ❑ ExPonslon �] ModlNcatlOnJalterailon 6. DESCRIBE PROJECT BRIEFLY: e�5772 v C r L r14� v t',�JeCC ate; W f /a)) t L) 10uPrC 65, 5 7: AMOUNT OF LAND AFFECTED: f� •-I InglNly _ �� acre U•Itlmately / acres A. WILL PA SED ACTION COMOLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTF.."IONS? Ye. ONO If No, decrIt* prlallr 9. WMAT I SENT LAND USE IN VICINITY OF PROJECT? Ind' usirlal ❑ Commercial O Aprlcupura ❑ Park/Forest/Open space ❑ Omer 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR Ay? e ❑ No' It yes, TIN agency($) and pennitlapprowls PuTiv,�r� v�cct- y pZ LX t`- tt,�r�� d- Ee-3 ,real Ts 11. DOES ANY ASPE iOE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 0 Yes NO It y*611141 agency name and peftuappmvel 112. AS A RESULT OF P31408 9P ACTION WILL DUSTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑ Yes NO :. . I CERTIFY THAT THE INFORMATION PROVIDED ABOVE 18'TRUE TO THE BEST OF MY KNOW=4E Appueanvaponsor nanw' _ L ('% _ �� /T 7 �Ja C/ P�� S ate I 7 0 slgnsturs: 11 the action Is In the Coastal Area, and you ,are a state agency, complete the Coast) l Assessment Form before proceeding with this assessment OVER li `1 PART II ®ENVIRONMENTAL ASSESSMENT (76 be completed by Agency) a DQES A1.710h EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617 iY 11 yes, 69010,n1310 11110 rem$ew process an4 use Ine FULL EAF NO E WILL ACTION RE kVE CTIANS Itv 6 MYCRR, PART 617.61 It No D ne®abrP OQU61WID• mat be 50it +Se,o�e/0 o! anoint$ InvolveC,Ogencq r- rte, < -,r> go= :3 • -_.._ ye'S C COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING f&—weI$ may be handwrlttet of 199$010 C1 E„laling 0$' quality. outface or groundwater Quality 61 Quantity. noise (Ovals UII101n1g traffic patiorns, 001$4 waste D100aclior 0' 013005a polent$o' ffor Or0s$Or ara$nago or floodlnb problem$,$ Enploln briefly C2 Auslnelic. DBoculturW archaeological. 011010116. St off4f natural or cullur ®I rosourcob, or communriy or n0lghborhopd cnDr9cter9 Esolwil briefly 0 Ve9010110r of fauna. lion. 0hellfi0n or rpddlile 006clos: significant R41411010. or @RrmptenQd of pnflangared Dpecleb? Explain briefly V Ca S. rommunity'b eaI$tins Dian$ or 00016 06 ofllerolly Igoploo, Or p change in moo or Inlonoily of wo Of land or, other natural ro0ourees9 guploln briefly C3 Gro$xth, 0ubsocutnf 0tveloomalil, of rofot0d octrvlbos likely to Do rnddgad by tho proposad Octlon9 Eaplaln bilofly. Ce Long later., snort tern.. cumutalraft at othat OliOct$ not identillea in C1.07 Elzpfoin Woolly. v ; Mdam C7 Who- Impaps.larIcluc$n6 Changan in use of Gotha( quantity or type of onOrgy)? anploin btiofly. D WILL THE PROJECT AVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS.TMAT CAVSED THE ESTABLISHMENT OF A CEA+ No T4E -RE; 0R-IS- N RE-LIKE•L•t� YO••OF,.COKTQpbERkY.kE TED TO POT10AL_A9..VERSE t£RtVIR?NMENTAL IMPACTS? M ® YD$ . o If Yee.. onplaln broofly -_ PART I If— OE'TERMINATiON OF SIGNIFICANCE (To be completed by Agency) IwS*k17CTI0fdS: 1 For each adverse'effecl identified above, determine wrhethor it is Substantial, large, important or otherwise significant. Each effect should be assessed i9 eonneetion With !ta (a) Selling (l.a, urban Or mraf); (b) probability of occurring; (c) duration; (d) Irradersibilily; (e) ®eo®raphie Scope; and (f) magnitude., U necessary, add attachment or reference Supporting materials. Ensure thot CuPianations contain sufficient detail to shoos that all relevant adverse Impacto have boon Identified and adequately addressed, It qu0stion D of Part It was chocked yes, the determination and 8lgnlficanca fnuot evatd ate the potential impact of the proposed action on the ewlllronmentat characteristics of the CEO, ,q Cheek this box If you have Identified on@ . or inom potentially large or significant adverse Impacts which MAY mccur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Chock this box If you have cdetermined, d on the Information and anslysis'above and any aupporting documentation, that the proposed action WILL NOT result In any significant adverse 'environmental Impacts AND,provide on attachments as.necsss®ry he reasons supporting this determination; rm1 pp NName or 'PDAbitill, officer o Leo Aaencv 1gn01are 0 ftbPOnD$ P Office# M LM A"nCv — ea ® eb(iIIrlbr a leer tamium of w"witel III 30110mi Irm "b""bible Dill 91 MIT 78SecorRok ! i Tel ,(845) 621 -4756_ Fax. (845) 628 1905 Mahopac, New York 10541 September 30, 2004 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York' 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N. Y. Tax Mav 50' Block 12 Lot 11 Dear Mr. Paravati, As per your last comment letter dated June 15, 2004, and as per our telephone conversations the following comments have been addressed: 1. Equal Distribution by the addition of a distribution box, and equal trench lengths have been provided. 2. The side slopes have been corrected 3. The minimum and maximum cover note has been shown upon the septic tank detail. 4. The required'one day storage above the high level alarm has been corrected. 5. A note for the proposed clay barrier has been added to the plan. 6 The grading has been corrected. Enclosed please find a copy of the following items for your review and approval: • Plan and Profile- Separate Sewage Treatment System (4 copies) 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 @ 621 -4756 Chris Caralyus Project Manager 4"S o r PUMP SYSTEM CALCULATIONS BARTHO}LMEW RESIDDENC E PUTNAM VALLEY N.Y. i r� 78 SECOR ROAD, SUITE MAHOPAC, NY 10541 ,p s j s Minor Losses: < FM Dia = 2 in. ft qty. Minor HL FM Area= 0.022 sf 90 Bend: 18 1 2.8 Hazen C= 150 45 Bend: 1.5 2 3 FM Length =' 105 ft. check valve 14.4 1 14.4 Minor Losses= 21 ft. gate valve 1.12 1 1.12 Total FM Length =' 126 ft. Total= 21.32 Static Hd. = 10 ft. . Flow (gpm) Vel. Loss /ft. FM Length Friction Hd. Static Hd. TDH fps ft. ft. ft. ft. 30 3.07 0.02 126 2 10.0 12 40 4.09 0.03 126 4 10.0 14 50 5.11 0.05 126 6 10.0 16 60 6.13 0.07 126 8 10.0 18 4 70 7.15 0.09 126 11 10.0 21 80 8.17 0.1.1 126 14 10.0 24 90 9.20 0.14 126 18 10.0 28 100 10.22 0.17 126 21 10.0 31 T� 1 i J J Pump System Curve BARTHOLOMEW SSTS PUMP ,. _ .:. GQNOPUS_HOLLOW RD , FUTNAM V VALLEY N Y.. •., _ .... . .., ,. _..1. .v..._+..x.� .•A ua r r.'_. n r..a.fcn no ..�x�. ttb. .. .t.•.'1I'a1nNtl yr.v DESIGN OF PUMP SYSTEM - Copyright (c) 1991 by MathSoft, Inc. BARTHOLOMEW- CANOPUS HOLLOW RD., TOWN OF PUTNAM VALLEY. _, ._. . -... This document caicuiates a pump chamber and system curve. Enter the problem conditions: 1. Pump Chamber Pump Chamber Sidewall Dimensions S:= 6.11 -ft Length of Fields Len:= 375. ft invert in Elevation Inv := 645.02 -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 ha � Hours of Operation Time: =16 4 .Scroll.to rage 4.... :...... _. ... J t i i ic. %.y�ia vvlul i is w %vouvi .Ji. %.yvv1 = i iy.o i c u Distance between on /off floats: D1= 0.6ft The IhVert In Elevation Is:. Inv = 645ft The High Level Alarm Elevation is: Alarm = 644ft ,.r.ls�s•. a.....�t .. .. ...`.P- -:C T. : ' ..i.u+na�..ar.'li..ra..a-P•�ua -p •mn.p .Ko Elevos- ^rr -.Y • • .. _ .. 'i.uwr :�he M mpon = 643.5ft Thewr'. pump off Elevation is: Pumpoff = 642.9ft The chamber bottom Elelvation is: Bottom = 641.4ft The daily pumping rate Is (gallons): FlowRate = 600 The peak flow rate Is (gallons): PeakRate =1.5 x 103 The' required pumping rate is (gpm): PumpRate =1.6 4 j a i 4 I • I I f APPLICATIONS Specifically designed for the following uses: • Homes • Sewage systems • Dewatering /Effluent • Water transfer SPECIFICATIONS APPLICATIONS Specifically designed for the following uses: • Homes • Sewage systems • Dewatering /Effluent • Water transfer FEATURES m Impeller: Cast iron, semi - open, dynamically balanced, non -clog with pump out vanes ' for mechanical seal protection. Optional Silicon bronze impeller available. 0 Casing: Cast iron volute type for maximum efficiency. Designed for easy installation on Al 0-20 slide rail. El 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 against component damage on accidental reverse rotation. m Fasteners: 300 series stainless steel. m Capable of running dry without damage to components. m Designed for continuous operation, when fully sub- merged. MOTORS ® Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. All ratings are within the working limits of the motor. ® Class B insulation. Single phase (60 Hz): o All single phase models feature capacitor start motors for maximum METERS FEET 15 r- S1 10 3 LJ c 20 0 5 r 10 0L_ 0 !fix ACM Prosurance available for residential applications. starting torque. o Built -in overload with automatic reset. '/3 and 'A HP -16/3 SJTOW with 115V or 230V three prong plug. o %and 1 HP -14/3 STOW. with bare leads. Three phase (60'Hz): Overload protection must be provided in starter.unit. °'/2 -1 HP -14/4 STOW with bare leads. o Bearings: Upper and lower heavy duty ball bearing , construction. o Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be.operated continuously without damage when fully submerged. Ei Power Cable: Severe duty rated, oil and water resistant. . Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket. damage and to prevent oil wicking. Standard cord is 20':.. Optional lengths are available. ® Motor Cover 0 -ring: Assures positive sealing against contaminants. and oil leakage. ® Consult factory for informa- tion on 575 V models. AGENCY LISTINGS Tested to UL 778 and ® CSA 22.2108 Standards By Canadian Standards C US Assodadon File AR38549 Goulds Pumps Is I50 9001 Registered. ■■■ ■ ■ ■ ■ ■ ■ ■■ • , :: • 11110■■■ ■■0• ■■Vffimi, 0 11� .. iL .. 0 n ■ ■ ■■ Mail ■1�� ■■ ■ ■ ■ ■ ■ ■'�i■ too 0 5 10 15 20 25 30 35 40 45 m3 /h CAPACITY m 2001 Goulds Pumps Effective November, 2001 www.goulds.com f B3886 Goulds Pumps ITT Industries SPECIFICATIONS Pump: o Solids handling capabilities:. 2" maximum. o Discharge size: 2" NPT.: o Capacities: up to 185 GPM. o Total heads: up to 38 feet TDH. o Temperature: 1040E (4010 continuous 140OF (60cQ intermittent. o See order numbers on reverse side for specific HP, voltage, phase and RPM'S avallable. FEATURES m Impeller: Cast iron, semi - open, dynamically balanced, non -clog with pump out vanes ' for mechanical seal protection. Optional Silicon bronze impeller available. 0 Casing: Cast iron volute type for maximum efficiency. Designed for easy installation on Al 0-20 slide rail. El 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 against component damage on accidental reverse rotation. m Fasteners: 300 series stainless steel. m Capable of running dry without damage to components. m Designed for continuous operation, when fully sub- merged. MOTORS ® Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. All ratings are within the working limits of the motor. ® Class B insulation. Single phase (60 Hz): o All single phase models feature capacitor start motors for maximum METERS FEET 15 r- S1 10 3 LJ c 20 0 5 r 10 0L_ 0 !fix ACM Prosurance available for residential applications. starting torque. o Built -in overload with automatic reset. '/3 and 'A HP -16/3 SJTOW with 115V or 230V three prong plug. o %and 1 HP -14/3 STOW. with bare leads. Three phase (60'Hz): Overload protection must be provided in starter.unit. °'/2 -1 HP -14/4 STOW with bare leads. o Bearings: Upper and lower heavy duty ball bearing , construction. o Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be.operated continuously without damage when fully submerged. Ei Power Cable: Severe duty rated, oil and water resistant. . Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket. damage and to prevent oil wicking. Standard cord is 20':.. Optional lengths are available. ® Motor Cover 0 -ring: Assures positive sealing against contaminants. and oil leakage. ® Consult factory for informa- tion on 575 V models. AGENCY LISTINGS Tested to UL 778 and ® CSA 22.2108 Standards By Canadian Standards C US Assodadon File AR38549 Goulds Pumps Is I50 9001 Registered. ■■■ ■ ■ ■ ■ ■ ■ ■■ • , :: • 11110■■■ ■■0• ■■Vffimi, 0 11� .. iL .. 0 n ■ ■ ■■ Mail ■1�� ■■ ■ ■ ■ ■ ■ ■'�i■ too 0 5 10 15 20 25 30 35 40 45 m3 /h CAPACITY m 2001 Goulds Pumps Effective November, 2001 www.goulds.com f B3886 Goulds Pumps ITT Industries B :I J J J J 1177VwIr."2 7 B .3uumermulie Sew' 'age age Pump ._.: 3886 ._ l�� I COMPONENTS DIMENSIONS (pll dimensions are in inches. Do not use for construction purposes.) Item Description No. 1 Multi -vane non -clog calf iron Impeller 2 Electrocoat paint outside and inside 9 Silicon carbide vs. silicon carbide mechanical seal 4 Stainless steel shaft 5 High grade turbine oil 6. All ball bearing heavy duty design 7 Epoxy sealed cable 8 O-dng seal MODELS Order No. HP Phase! volts Max Am s RPM Wt. pbs.) W503119 'A I 115 ' 9.8 1750 63 WS03186 200 6.8 WS03126 230 4.9 WS051.1B: _ ,y: T. 1.15 ,. ..14.5. 65 WS0518B 200 8.0 W505128 230 7.3 WS0538B 3 200 3.8 WS0532B ! .230 3.3 WS05348 .460 1.7 WS0718B % 1 200 1t.0 85 WS0712B 230 9.4 WS0738B 3 200 4.1 WS0732B 230 3.6 WS0734B 460 1.8 WS1018B 1 1 i 2_00 14.0' WS10128 i 230 12.3 WS1038B 3 200 6.2 WS1032B 230 5.8 W 10348 460. 2.9 W50537B 1/2 3 575 1.4 65 WS0737B % 1.5 85 WS1037B 1 2.4 &K-BACK, ICK BACK PERFORMANCE RATINGS (gallons per minute) Order No.. WS63B WS05B WS07B WS108 HP ► '/3 'fr % 1 RPM ► 1750 1750 1750 1750 m 16 _ d 10 ► 80 122 145 — 15 36 -90'- : -... 116,_ 1.52 . 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 . (115V) . SWS0512B WS0512B (230 V) Goulds Pumps and'the ITT Engineered Blocks Symbol are . registered trademarks and tradenames of TIT Industries. PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. i Goulds Pumps ITT Industries THREE PHASE MAGNETIC STARTER Control Panels' iMpex A3 Series Control Systems SINGLE PHASE THREE PHASE Provides automatic or manual pump operation for single Provides automatic or manual pump operations, and three leg phase systems. Overload protection must be provided by the motor protection for three phase systems. Select panel by pump. maximum amp draw and voltage. Model No. Horsepower Amps volts A3 -2012 % -2 up to 20 115/208/230 A3 -35i2 3 & 5 — Without capacitors 20-36 208/230 Fiber lass, Hinged Door and overloads' NEMA 12 Steel, Hinged Door o Single phase, 60 Hz. d o NEMA 1 steel enclosure standard. o Includes: contactor, hand -off auto switch, run light, and terminal block for wiring connections. May be used on' /3 through 5 HP pumps. -Separate level control switch(es) required. I-, Model No. Amp Range volts A32510 2.5 -10 All A30918 9 -18 All- A31327 13 -27 All • Three phase, 60 Hz. • NEMA 1 steel enclosure standard. • NEMA style starter with: • ESP 100 solid state adjustable overload. • Class 10 over current protection with manual reset. • Built -in automatic phase loss protection. • Hand / Off/ Auto switch. • Run light. • 115V transformer for pilot circuit. • Terminal block. Heaters are no longer required. SIMPLEX CONTROL PANEL OPTIONS (List panel- model'num ber, then any of the following options order numbers.) CAN BE ADDED TO ABOVE BASIC CONTROLLERS TO MEET SPECIFIC 10B REQUIREMENTS ** Custom built panels can be provided per customer specifications. Forward specifications to your Goulds Pumps distributor for quotation. ENCLOSURES NOTE: Enclosures listed above are dead -front type, all switches and indicator lights would be mounted inside of panel on permanent mounting bracket. Goulds Pumps and the ITT Engineered Blocks symbol are registered trademarks and tradenames of ITT Industries. ki ENCLOSURE OPTIONS Rating Construction . .. Order No. Simplex Enclosures NEMA 311 Steel, Hinged Door 311.0 NEMA 4 -Steel, Hinged Door 3120 NEMA 4X Fiber lass, 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. Goulds Pumps and the ITT Engineered Blocks symbol are registered trademarks and tradenames of ITT Industries. ki ENCLOSURE OPTIONS © 2001 Goulds Pumps Effective November, 2001 www.goulds.com BSIMPLEX Goulds Pumps �& ITT Industries Order No. 1. Through door mounted H -O -A switch acid run light. (Provides access without opening enclosure, standard on NEMA1 panels.). A. NEMA 3/3R 3200 .3210. B. NEMA 4 3220 C. NEMA 12 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 © 2001 Goulds Pumps Effective November, 2001 www.goulds.com BSIMPLEX Goulds Pumps �& ITT Industries �� i �avvr.r.r i '• v�v�� =9 L SIMPLEX CONTROL PANEL OPTIONS ALARM DEVICES (can be added to simplex or duplex controllers) ALARM CIRCUITS (Requires option 3300) .:POWER EQUIPMENT Order No. 1. High -level alarm circuit. (Provides alarm circuit in NEMA 1 simplex panel. Choose alarm device to complete 3600 the system.) i 3300 2. Guaranteed pump submergence circuit with low level alarm. 3620 (Overrides manual and automatic operation of pumps) 3320 3. Extra set of alarm contacts. 6480 (Used for signal of remote alarm device.) 3782 A. Powered (wet contacts) 3330 B. Non - powered (dry.contacts) 3340 4. Seal failure circuit with indicator light. (Monitors moisture sensor on dual seal pumps.) 6500 A. Circuit built in A3 panel 3350 B. Circuit in separate NEMA 3/311 enclosure. (Used in conjunction with exist ng�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 o eration 3370 contacts.) 6. 1 GA and 2GA seal fail and high temp. control and status circuit. 3805 .:POWER EQUIPMENT g ' Consult factory for options not listed. I J I I Order No. Main and control circuit breakers (Standard simplex panels do not,contain breakers.) NEMA 1 Single phase, 115/230 V 3600 Three phase, 208/230 V 3610 Three phase, 460/575 V 3620 g ' Consult factory for options not listed. I J I I NOTE: When ordering alarm devices, please note desired voltage and -mounting location; top, side, front, etc. ADDITIONAL ACCESSORIES Order No. 46 bell (90 db Qa 10 Ft) NEMA 1 6400 NEMA 3W4 /4X/12 6420 •, 3750 Hom (101 db @I O Ft.) NEMA 3R/414X/12 .6450't"' Flashing red 11 ght Lexan NEMA 1/311/4/4)/12 6480 8.,Remote alarm panel (Includes: ,V bell silencer switch, 3782 and indicator light; rated NEMA 3/3R) A. Alarm requiring separate power 115 V power 3785 supply (Signaled by dry contacts in main panel. 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 NEMAt enclosure ' (requires 115 V supply) 6515 NOTE: When ordering alarm devices, please note desired voltage and -mounting location; top, side, front, etc. ADDITIONAL ACCESSORIES PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Goulds Pumps ITT Industries e Order No. 1. Condensation heater -115 V 3710 2. Elapsed time meter. (Mounted 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 push buttons. (Overrides float switches to .simulate operation of level controls.) A. NEMA 1 B. NEMA3/3R14 3770 - 3780 6. lightning arrestor Single phase Three phase 3781 3782 7. Convenience outlet (11,5 V GFI) with circuit breaker protection, mounted internally, choose according to power supply (phase). Single phase panels Three phase panels 15 amp includes 1.5 KVAtransformer 3783 3785 PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Goulds Pumps ITT Industries e Pape Fittings -� .. ...i(.w...q •..vm.-s+c_.:r= �3•.w._.� =r.. �.. �. _.,_ .. .. rc�:Y.<+� ^ -.W.�- � -. i.. ��.•u..a�w0� - •- .'s_q. CHECK VALVES PLASTIC CHECK VALVES ° Ideal for horizontal 200 PSI burst rating. installation. Compression seal connec- tion for easy installation. Swing design flapper -prevents clogging. o Available for pipe size 1'/4 ", Pipe Size Order No. 1%, A9 -12P 1%, A9 -15P 2" A9 -1P 3" A9 -3P z Pi a Size ' 11/211, 211, 311, 2" NPT AMC 3 -NPT A9-_3C 2" NPT • ' A9 -2B 3" NPT CAST IRON CHECK VALVES BALL CHECK VALVES A9 -4BCF ° Ideal for horizontal ° Ideal for vertical mounting. installation. . ° Heavy duty cast iron or �I ° Heavy duty cast iron plastic construction. construction. ° Natural rubber ball. ° Swing design flapper ° Clean -out port and plug. prevents clogging. ° Available in 1'/4", 1'/2 ", 2" ° Available in.2" and 3" NPT and 3" NPT threaded connections. threaded connections' ° Also available in 4" flanged (125 #). ° 75 PSI leakage rating. ° 125 PSI burst rating. Cast Iron Models Plastic Models . z Pi a Size ' 'Order No: ' 2" NPT AMC 3 -NPT A9-_3C PIPE CONNECTORS • • 'Pi a Sde. ' ` Order No. 1'/4" NPT A9 -128 1'k" NPT A9 -15B 2" NPT • ' A9 -2B 3" NPT IAMB 4" Flanged A9 -4BCF 4" Flanged A9 -4BCT SHORT RADIUS ELBOW o Cast iron construction: 7 125 lb, ANSI rated flange rt 6.15 at pump end. 3.09 3.81 0 3" NPT or 4" NPT threaded connection for discharge 3.15 pipe. 4' -8 NPT � 3 ° -8 NPT t I I I A A f�-- 1.5 Dia. 9.00 Dia. —� Al -5 Al -6 Goulds Pumps, and the ITT Engineered Blocks Symbol are registered trademarks and tradenames of ITT Industries. www.goulds.com PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Flange Size Order Number Used With 3" Al *5 3888D3/35D(X) 4" A1-6 3888D4/45DM Pipe Size 'Order N "o." 1' /i A9 -12BPT 1 %, A9 -15BPT 2" A9 -2BPT Goulds Pumps - ITT Industries y: L0J %2%auLvZ, ru1V1rM 14 i t I 1 Paned 5witenes i J I _s A2H12 (10VM2WP) Same as above except: ; ii 10 foot cord with 230 V piggy back plug. A2H32 (20VM2WP) . Same as above except: ■ 20 foot cord with 230 V 'piggy back plug. ■ 15 foot cord with 230 V piggy back plug. 'PRESSURE SWITCH VERTICALMASTER @�' DOUBLE FLOAT SWITCH FLOAT A2H11 (10VM1WP) A2C21 (A241) Features Features ■ SJE Vertical Master.flo6t Features ■ SJE Double Float'"' float R Mechanical contacts, with switch. switch. narrow angle float switch. ■ Magnetically activated i Mercury activated contacts, ■ Cast iron switch housing and ■ Includes cast iron cable mechanical contacts, with ! two float switches molded into ■ For use in liquids up to ■ Maximum temperature adjustable float e14' to 61/29 a single control cord. Maximum pump running pumping range).. i ■ Holding relay located in one current: 10 Amps. ■ Non- corrosive PVC housing float operates the pump control panel input. ■ 15 foot SJOOW cord with and float for use in liquids up between the top and bottom piggy back plug. .■ UL and C —UL listed. to 125 °F (52 0C). floats. applications. ■ Maximum pump running ■ Non - corrosive PVC housing M current: 13 Amps. for use in liquids up to 140 °F ■ For direct pump operation or (60°C). control panel input.. ■ Maximum pump running ■ Not sensitive to turbulence. current: 15 Amps. 010 foot S10W cord with � , v For direct pump operation or 115 V piggy back plug. control panel input. ® Includes mounting_ clamps. ■ Not sensitive to turbulence. ■ UL and CSA listed. 015 foot SJOW cord with 115 V piggy back plug. A2H3.1 (20VM1WP) ■ Includes mounting clamps. abowexcept: E.20.foot.cord with 115 V A2C22 (A2 -12) piggy back plug.. , Same as above exce t• i J I _s A2H12 (10VM2WP) Same as above except: ; ii 10 foot cord with 230 V piggy back plug. A2H32 (20VM2WP) . Same as above except: ■ 20 foot cord with 230 V 'piggy back plug. ■ 15 foot cord with 230 V piggy back plug. 'PRESSURE SWITCH POLYURETHANE FOAM A2S21 (A2 -1) FLOAT iFeatures ..�A2K23W' (A2 -3) GP cast iron pressure Features activated switch. ■ Conery 2900 float switch:: R Mechanical contacts, with ■ Reliable mercury contacts,'.. pump turn on at 18" and off narrow angle float switch. at 12 ". ■ Polyurethane foam body. ■ Cast iron switch housing and ■ Includes cast iron cable BUNA -N diaphragm. weight. ■ For use in liquids up to ■ Maximum temperature 104 °F (40.0. 170°F (17 0C). Maximum pump running ■ Maximum pump running current: 13 Amps. current: 10 Amps. 0 For direct pump operation or ■ For control panel input.. control panel input. ■ 15 foot SJOOW cord with 0 15 foot SJT cord with 115 V BARE leads. piggy back plug. .■ UL and C —UL listed. Ideal for limited space applications. A2522 (A2 -4) Same as above except:..... A2S23 (A2 -2) Same as above except: s'Bare leads. PVC CABLE WEIGHT ■ Adjustable snap in design. ■ Works with all float switches shown. Contact your Goulds Pumps Distributor for all your Float Such needs. All SJE switches are available from Goulds. Pumps PumpMaster ®, PumpMaster Plus ®, AmpMaster ®, VerticaIMaster ®, -Double Float'" are registered trademarks and tradenames of SJ Electro Systems, Inc. Goulds Pumps and the ITT Engineered Blocks Symbol are registered trademarks and.tradeurnes of ITT Industries. Www.goulds.com PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. Goulds Pumps ITT Industries q :t LORB9TA MOLINARI Pb&k (ford DO. W DEPARTMENT OF HEALTH l Genova Road, Bmwata, New York 10509 8'n4traaamahl Heabb (x45)278 -6U0 Fu(845)278.7921 Nutalag xsnlso (x45) 379.6559 WIC (945) 278. GM Pax (x47) 27a • 6017 RUtr 11*MVdoWPrMbui ( &45)378 -6014 Fa(945)273.66411 Iune 15,2004 ROBERT L BONDI (brio Canilyua Beyer & Associates . 78 Secor Road Bryant Pond Plaza I / Mahopec, New York 10541 V Be: PlvposedSSTS— Bmtholoaew Dennytown Road. M PLAMM Valley " TM#50: 1 -1t Dear:dr, Camlyus: This office has rooeved and reviowed the moat recent set of plane for the above mentionedprojcM We would like to offer the following comments for your review and conaidure6on. 1. When dosing, equal distribution should be provided 2. Sido slopes still appear to be abown grease than 1:3. 3. Please provide the minhnun tmaximum cover for the septic tank and ptmp chunbec (show in 4. Required onaday storage above the high level alarm bas not been provided. 5. Phase clarify the label for the proposed retaining wall so that it is clear That the clay healer is to be placod on tbe'tranch' side of the wall, 6. Please check side slope regrading. It appears taut some contmae ore being graded to the wall even (hough the contours tic in to existing grade before reaching tit wall. TWs office will continue its review talon consideration of the above -rn ndoned ono. Please fret fiat to contact me at ext. 2157 if any questions arl9e. V holy yours. 04 AZ . /�. aeeph S. Paravati, Sr. Assistant Public health Engineer ISP:o.1 •• JS1�1sN amulooa IMMU ao a0Vd ssIdi3 xo : MINIM Woff : Haow AZ,00 : slams CasdVU 9tF:0T VZ -Nf1f : SNITS JIHVLLS T/T : SaWd S06T8Z96 MOM TZ6L- 8LZ -SV8 rial H -LTVMH aO ZN8NISMMU AIM100 KVNMd : MMN LV:0T f1H1 V00Z- tZ -Nf1r : 'alVa NOUMN03 DKOMS LORETTA MOLINARI j ' Public Health Director June 15, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York- 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 1 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Chris Caralyus Beyer & Associates 78 Secor Road Bryant Pond Plaza Mahopac, New York, 10541 i Dear Mr. Caralyus: ROBERT J. BONDI County Executive V Re: Proposed SSTS — Bartholomew Dennytown Road, (T) Putnam Valley TM# 50. -1 -11 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. When dosing, equal distribution should be provided. �►2' Side slopes still appear to be shown greater than 1:3. w vide the minimum/maximum cover for.. the.septic.tank and .pump chamber (show in - �' Please pro detail).! . _ .... Required ne -day storage above the high level alarm has not been provided. S Please clarify the label for the proposed retaining wall so that it is clear that the clay barrier is to be placed on the `trench' side of the wall. Ja! Please check side slope regrading. It appears that some contours are being graded to the wall even though the contours tie in to existing gra&before reaching the wall. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Fyours, aravati, Jr. Assistant Public Health Engineer JSP:cj i ...L ..�. 8: 78 Secor Road, _.�.. _ _ _ -_ __._._ Pond Plaza, Juite� 3 � Yw:YVS?�,..P _u,.�.0 w....++. +. _- _...r J.a, v n Fax. (845) 628 1905 Mahopac, New York 10541 Mr. Joe Paravati, Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N. Y. r Tax Map 50 Block 12 Lot 11 Dear Mr. Paravati, April 23, 2004 As per your last comment letter dated February 25, 2004, and 'as per our telephone conversations the following comments have been addressed: f. The revision box has been updated. The two foot clay barrier has been shown, in front of the wall, within the retaining wall detail. hGl��'� The side slope has been corrected. g 6, tt° L *� section detail for the retaining wall has been shown on the plan . ws , ✓' -5.' There is only one pt -1 shown on the plan. S�P, ` The overflow tank has been removed and one day storage is provided within the pump chamber. a f't The dose for the current pump chamber has been recalculated. ,,ter ,, &8. / The house plans have been updated to show three bedrooms. The words dust free have been added to the absorption trench detail upon the plan. Enclosed please find_a'copy of the following items for.your review and approval • Plan and Profile- Separate Sewage Treatment System (4 copies) • Pump system calculations for the new pump chamber are enclosed. 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 @ 621 -4756 to4d 4v W�11l ikJ P&AvI'W Very ly urs Chris Caralyus Project Manager 1 a3COY Q�.V� V` 78 Seeor Road, ! _ Tel. (845 621 -47_ . , Bryant Pofi &Piid4,'S�tite,g °• �... � , .... — Fax. (845) 628 ...1905 ~ . Mahopac, New York '10541 I February 13, 2004 Mr. Joe Paravati, Public Health Engineer Putnam County. Department of Health 4 Geneva Road Brewster, New York 10509 Re; Bartholomew Residence Canopus Hollow Road /Dennytown, Putnam Valley N. Y. Tax Map 50 Block 12 Lot 11 Dear Mr. Paravati,! ' As per your comment!letter dated January 9, 2004, the following has been addressed: 1. All proposed Construction is now outside the Wetland and Wetland buffer Area, thus a wetland permit should no longer be required. 2. The existing slope is currently under 15% within the SSTS area. 3. The Datum 'reference has been shown on the plans as assumed or arbitrary. 4. The side slope has been corrected. 5. As per our telephone conversation, the typical fill detail is shown upon the plan. 6 Fill pad dimensions have been shown upon the plan. 1 7. Proposed contours are labeled at the 10 ft contour. 8. The words dust free are shown in the trench detail. 9. Dimensions! have been shown from the well to the property line. _ J0...A. water-service line has beer shown upon the _plan. -W- II. Yum P notes'have been lced upon thP l an. 12. As we discussed, the House that is depicted is f o r a two bedroom house, however the owner is planning to finish the basement in the future, and will be adding a third bedroom. Enclosed please find, a copy of the following items for your review and approval: • Plan and P, rofile- Separate Sewage Treatment System (4 copies) 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 @ 621 -4756 Very yours, j Chris Caralyus Project Manager - L� { „ Public Health Director January 9, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Malth (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 -.6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Chris Caralyus Beyer Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Dear Mr. Caralyus: ROBERT` 1.— 01461 County Executive Re: Proposed SSTS — Bartholomew Dennytown Road, (T) Putnam Valley TM# 50. -1 -11 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like t ffer the following comments for your review and consideration. It appears that a. wetlands permit is required. If so, the permit must be obtained before approval by this Department. The existing slope appears to be under 15 %. However, please clarify existing topography so an exact . determination can be made. -.., _ Please pioVide ��- It appears some ;of the side slope regarding is greater than 1:3 slope. ----- 5 Fill design has not been completed in the SSTS profile. It should be completed according to �v �i �� - "' the fill detail. �ill pad dimensions should be provided. roposed contours should. be labeled. The words "dust free" should be added to the crushed stone /washed gravel label in the absorption trench detail. Please provide dimension from the well to the property lines. c'Please provide water line and location of service connection. t,H. Please provide pump notes. 12. Floor plans submitted are for two bedrooms. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Ver truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj LORETTA� MOLINARI Public Health Director January 9, 2004 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster,1New 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 InterventioNPreschool (845) 278 - 6014 Fax (845) 278 - 6648 Chris Caralyus Beyer Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 ROBERT J. BONDI County Executive Re: Proposed SSTS - Bartholomew Dennytown Road, (T) Putnam Valley TM# 50.4-11 Dear Mr. Caralyus: 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. It appears that a wetlands permit is required. If so, the permit must be obtained before approval by this Department. 2. The existing slope appears to -be under_ -54 --H veu r,:.please clarify existing topography sb - - - •- -' -&I e9act -determination can be made. 3. Please provide a datum reference. 4. It'appears: some ;of the side slope regarding is greater than 1:3 slope. 5. Fill design has not been completed in the SSTS profile. It should be completed according to the fill detail. 6. Fill pad !dimensions should be provided. 7. Proposed contours should be labeled. 8. The words `:`dust free" should be'added to the crushed stone /washed gravel label in the absorption, trench detail. 9. Please provide dimension from the well to the property lines. 10. Please provide water line and location of service connection. 11. Please provide pump notes. 12. Floor plans submitted are for two bedrooms. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Ve truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj PUTNAM COUNTY DEPARTME NT OF HEALTH �G DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TRF e "E??.I-SY5'I'.; .... ....... __ - -- ... _�fLEVIEW SHEET rOR CONSTAUCTIONPERMIT :NAME OF OWNER: (t, ,%e4Ar) STREET LOCATION: w IZ.e�A REVIEWED,BY: RM, GR, SRDATE: I U TAX MAP #: (CONF1RIv1EDI ' l -- N DOCUMENTS Y (REQUIRED DETAILS ON PLANS CONT'D� PERMIT APPLICATION (HOUSE SEWER - 4?1 FT. 4 "0'; TYPE PIPE. CAST IRON JWELL PERMIT OR PWS LETTER (�( NO BENDS; MAX BENDS 45' W /CLEANOUT PC=97 RENEW rye �� ) --jLETTER OF AUTHORIZATION (J US CHANGE) Ulm ESIGN DATA SHEET (DDS) C(•- ORPORATE RESOLUTION (JSHORT EAF C SETS IISE PLANS - TWO SETS (__)ARIANCE REQUEST SUBDIVISION ULC-jfEGAL SUBDIVISION UUSUBD"ION APPRO l) (!)(�PERC RA (JL _) S QUIRED DEPTH CURTAIN DRAJEN REQUIRED GENERAL LOCATED.INNYC WATERSHED ('p L j PLANS SUBMITTED TO DEP ELEGATED TO PCHID (_}(l )DEP APPROVAL, IF REQ'D (� TEST HOLES OBSERVED ( )(S TO BE WITNESSED q,j(. )WETLANDS (TOWNIDEC PERMTTIIM'Q ATA ON DifS'�i�ET`: V-1 K 1969 NEIGHBOR NOTIFICATION U TT.E suZB4. - . _ - _ 0 Y FLJ'Oi� Ei; VX-10N iV1I 200' (�( SOIL TESTING LOTS>10 YEARS OLD REQUIRED DETAILS ON PLANS (_ ( SEWAGE SYSTEM FLAX (NORTH ARROW) (=:jC_MD S HYDRAULIC PROFILE ( )(,k-" )GRAVITY PLOW ��CONSTRUCTION NOTES 1 -15 (DESIGN DATA: PERC & DEEP RESULTS � j 2' CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT (FOOTING/GUTTF,PJCURTAIN DRAINS (USDA SOIL TYPE BOUNDARIES TITLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# D + F DR G/REVISION ATUM REFERENC A URSES,PONDS LAXES,WETLANDS WITHIN 200' OF P.L. �UPROPOSED FINISH FLOOR AND BASEN(ENT ELEVATIONS WELLS & SSDS'S W/IN 200' OF SSTS f)�PROPERTY METES & BOUNDS (EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE IMMENTS: : _...- "TriyEtPond Plaza, Suite" " T Mahopac, New York 10541 _ , ..._. _..�.�. Fax. (845) 628 1905 November 7, 2003 Mr. Joe Paravati,I Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Bartholomew Residence Canopus Hollow Road/Dennytown, Putnam Valley N. Y. Tax Map 50 Block 12 Lot 11 Dear Mr. Paravati, Our client, proposes to construct a single-family residence at the above address to be serviced by an individual subsurface sewage treatment system and a private drilled well. We are hereby applying for a construction permit for an individual SSTS and drilled well. Enclosed please find a copy of the following items for your review and approval: • Construction Permit for Sewage Treatment System • Application for Approval of Plans for a Wastewater Treatment System. • Application to Construct a Water Well • Design Data Sheet • Letter of Authorization • Pump system report(f applicable) Sh ort - °- • • En' vz_ronmentdl,Ascessment -Form ... - ` ` " -- • -- •. Plan and, Profile- Separate Sewage Treatment System (4 copies) • Fee - Certified Check in the amount of $300 • House Plans (2 Copies) 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 @ 621 -4756 Very 4tris Caralyus Project Manager PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISI ®N OF ENVIRONMENTAL HEALTH SERVICES A��n �1 \ 9:—: 1 -r v♦ , .v—_. ._ .�+. +.. .. .. .a..4 .:.e.�..� RUZg RE: Property of /5AIZjj_kzLoReLJ Located at TN LO&A �AUe�Tax Map # Block I Lot Subdivision of jj I { Subdivision Lot # _ Filed Map # Date Filed Gentlemen: This letter is to authorize 7 Cc 6 a duly licensed Professional Engineer* or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with. this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145. and/or 147 ofthe Education Law, the. Public Health.... r zNv —an u, 11,,.E , - Sanitary Code:- .. _ ..... .... . - d the at p111 1.1)11 1L.y :Very truly yours, Countersigned• L� Signed: C�1 P.E., R.A., # 07-gg —�F (Owner o operty) Mailing Address 7Y S -e'u,2 `W D SZ Mailing Address: q ww iAh?u 1 LaZ? State N7/ Zip /OS_y Telephone: 2 ( H? �� nc►�r�rt -e �y;� �� g State t� Zip Telephone: 91 Z Form LA -97 r A v i114 tLWiii t.vv1\ 1 1 "L' 1 t-11X11Vi111\ 1 %JV i1L L-1LII1 DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Mia ael' Bartliolmew 9 Overman Place, New Rochelle, n.y 10801 Located at (Street) Canopus Hollow I)eNp y jowl.+ ii Tax Map. 50 Block 1 Lot 11 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 4/22/03 Date of Percolation Test 4/24/03 Hole No. Run No. Time Start.- Stop Ela se Time gin.) Depth to Water From Ground Surface (inches) Start ' Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 2:03 - 2:33 30 221)-2511 3" 10 2 2:34 - 3:04 30 22" - 25" 2.5" 12 3 3:06 .- 3:36 30 22" - 25" 2.5" 12 4 5 P -2 1 2:05,_2635 .30 20" - 23" 3" 10 2 2:367 3:06 .30 2071-231) 3" 10 4 5 P -3 1 2:08 - 2:38 30 23" 26" 3" 10 2 2:40 = 3:10 30 23))-26" 2% 11 3 3:1.1 3:41' 30 23" - 26" 23/4" 11 5 ivu i rs i. i ests to ne repeatea at.same aepttn until approximately equal percolation rates are obtained at each percolation test hole. ( i.e. 5 1 min for 1 =30 min/inch, S 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. I HOLE NO. 2 HOLE N G.L. 0-12" Top Soil 0-12" Top Soil 0.55 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0 4.5' 5.0 12"-32" Brown Sandy Loam 36"-65" It. Brown Sand & Gravel Rock@ 65" 12"-36" Brown Sandy Loam 36"-76" It. Brown Sand & Gravel Indicate level at which groundwater is encountered NIA Indicate level at which mottling is observed NIA Indicate level to which water level rises after being encountered Deep hole observations made by: CC—B&A, Joe P;arovatd-PfD0H Date. 9,26103 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite 5 MahgRac, N.Y. 10541 Signature Design Professional's Seal NEW F z "'A 0740 1%FES v1 I Jl i "J.J1 Z&JCV 11T1L 1\ 1 kill 11L' t&L 111 DIVISION ]OF ENVIRONMENTAL HEALTH SERVICES 'APPLICATION FOR APPROVAL OF PLANS FOR r A WASTEWATER TREATMENT SYSTEM . 1. Name and address,of applicant: • M [(&(L• PJA:i G &_Okeij aQC_r *iA�J PLk 2. Name of project:' ,c�9�21 �DL C f1P S 3. Location T/�I: L--pJ& J&ee_ 4. Design Professional: �He,(L 4- AS Sg C . 5. Address: C At.4o5 RuUco-�Z1�K-(Uw /c'y). 6. Drainage Basin: P up 5cyu Nu /3Ft5 / Al �u�� Uh�c� 1 g —�-. 7. TvDe of Pr 'ect: rivate/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 Type II Unlisted . 9. Is a Draft Environmental Impact Statement (DEIS) required ?............ ... .............. 62 D 10. Has DEIS been completed and found: acceptable by Lead Agency? ............... 11. Name• of Lead Agency N.J 12:: Is this projectin an area,under the control of local planning, zoning, or other ..,:officials, ordinances...............:....................... :.............. :.................................... -e 5 13: If so, have plans been submitted to. such authorities . �h5 14: Has preliminary approval been granted by such authorities? Date granted: 15•. Type of Sewage g Treatment System Discharge .....:.....:..... surface water groundwater 16.' If surface water discharge, what is the stream class designation? .. .............. ...... XJ /i1 17. Waters index number (surface) .................................... .................. ......................... IU/A 18. Is project located near a public water supply system ?' .... ...........I..........:......... xJ(7 19. If yes, name of watersupply 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 23. Name.of Health Inspector - -,Toe.P4�9UA.i 1 24. Project design flow gallons per day)..'.:': .% b d 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... M 26. Has SPDES Application'been submitted to local DEC office? N For►C. -97 I, i i . 2 27. Is any portion of this project located within a designated Town or State wetland? 28. Wetlands ID Number ............................................`.............. .....................:......... 29. Is Wetlands Permit required? . ........., ...:............::s:..:...: Has application been made to Town or. Local DEC office? ............................... )Up 30. Does project require a DEC Stream Disturbance Permit? .. ............................... Pp 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 A)o 32. Is project located within 1,000 feet of existing or abandoned landf 11, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on file wifh. 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? ....................................... :........................ lU0 35. Are any sewage treatment areas in excess of 15% slope? . ............................... qe-!5 36. Tax Map ID Number ..................:....... ............................... Map__12L Block_j_.Lot /l 37. Approved plans are to be-returned to ..... Applicant ✓Design Professional NOTE: All applications.for review and approval of a new SSTS to be located within the NYC Watershed shall be sent toAe- Iepakent, and need *�+ be seat in duplicate to the DEP, altizo��gii 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 stormwaterylans 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 pe'rj*ury, that information provided on this form is true to the best of my knowledge and belief. false statements made herein are punishable as a C'las's A 'misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES ®FFICL4L TITLES. COZ 26 A L , S v i T Mailing Add'' ress:..................................... &AA r / y �' a co 3RJCE R. FOLEY M Nei- f ialth '�rarrx 00 N CO 00 M M ` CD C> . Z �., ATPWrfON. M v M M 0 0 CV co z _z 0 ,1 f 4* M.S.N. ,&ne dare Pw c Kew, Dirwra- LUiaeror e,O' Pc::eM Seater: DEPARTMENT OF HEALTH - 1 Geneva Rani Brsus -,e., New York IDSOS- RIF,Q T„ JF j}T FOR F EL TEES i`INC� D GENIE, Ri M AD infarr:retioa b else r must be fay completed prior to any ache dsdmg. Ell G[?�SEH DR ;Elttli: �-� �IQ �' �f �LtC"1 ��-4•„ RE AS ON. , ROADfiTREEf: rWW_ 6 r 1,45 PHOA•E �: x — DIEM. PBR S: 7 Pll.W ZEST: !3 TOWN: rtJ_T4J>4pA- VP4_��S 6b-- t —(( SUeDiy7SYOl+I: N% LOW: ii'YtSQBP CR1TERiA FOR TOIWf R'EYIE'4Q AYO WfTh�CCtl1Tr �E'SOIL T]3Si[P,'f, YES NOJI o � rolswcd SM sritbk the drainage basin of Rest Branch or B;oyds Corner Reaervnirar o/ :e Proposed SSTS ssithia SOD feet of a reervoir, reservoirsim or caacrot lake. c o P:,cp used SSTS wittmi I00 feet of a watercoine or a -DEC wetland. Proposed SETS design ill w Futer Tian 1000 gallonsidap jar SPMEES Permit regmred. ` Yroposed SSIS for a Commerical Psojact. It•is the regom1b.ity of the design prefeasionattip provide Oe abaveinformation-prior to soiltestieg: This Department will dd:nnme the NY.CDFP project shun (Jaisd or DeseptedC, based on the response. Kyou amstFered= to any of the quesliaW, MYCDEP rant Ritness the mg teselgg, This Deparanent gill toordiaat: a nutuafly stnteble f-me Fer field testing with the PC73013, the Design Professional hud NYCDZP. Ifs project has been determined to be Delegated bsaed_wi the -above respowe wAL thim_oulorequCM1 - - - inferrnaticn irc_di:atei NYCZMP- is- requiredto witaess=lhe soil Destine, Jt will be the sole spansi5iiip - - _afthe aeaign ptoiessioaal -tio sthedute re- witneSSing oftbe sail testing with WI CDEP. i� SOR OQLfi1i MONLY turs: ° - o t] �L Z W E I— W a W } 0 V H tl I F1 m� r` N N i In J F- _03-. 1� tri 0 E M 0 N i tD i Z D ti BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Public Health Director �� W�_W Associate Public Health Director . w Director. of Patient Services DEPARTWIENT 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 (945) 278 - 6085 . Early Intervention (845) 278 - 6014 Preschool (843)•278 -6082 Fax (845) 278 - 6648 Date: / Z� To: Cl/i'Y`l CBs , y Fax. #: No. Pages (Including cover sheet) . From: :70Seph' -5, Qar7�V,0TA Tr, t AP14E Putnam County Department of Health your information ]Please respond For your review Attached as requested As discussed Please call Notes/Messages Xn the event of transmission/eeception difficulties, please contact this otce at (845)'278-6130 ext.- 2 15 7 PUTNAM� COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES- _. _.:. AINITIAL MIVMUAVCOMMERCIAr S �.ILSP��IbI��FORV. f SECTION A. GENERAL INFORMATION n� (� 9 Name of Praj ect dA'� �TZK �i h � - a l_ � 0 �%(T)(V).. County Site Location , f Building construction beg Extent Is roP e ttY within NYC Watershed ? ................. a Yes �No P SECTION.& TOPOGRAPHY (Please heck all appropriate boxes) 1. Billy a 'Rolling -,Steep slope EZf Gentle slope Flat. 2. F7. Evidence. of wetlands F7. Low area subject to flooding Bodies of water Drainage ditches, F--J Rock outcrops I... Property lines or. corners. evident ............................ . ............. :..:..:......... ..Yes :: No 4. Do water courses exist on or adjoin the property? :............. Yes N . 5. Will these affect the design of the sewage system facilities ?............ Yes No 6. Do watershed regulations apply in this development ? ....................... Yes o 7 Will extensive grading,be necessary? ...................................... ' .. ...... .... F--J Yes_ E•'' No 8. Will extensive fill be necessary . for SSTS? ......... ......... ....................:.. a Yes Q ..No 9. Do filled areas exist within the SSTS area ? ................... ...... a Yes LZ"`N0 If yes, what is the condition of the fill? SECTION.C. SOIL OBSERVATIONS . 1-0. Appearance of soil: `, Sand r' i Gravel Loam 0 Clay ' Hardpan 0 Mixture 11. Observed from: F 1 Borings a Bank cut a Backhoe excavations 12. Soil borings /excavations observed by ,) Sf� . %� �� i (49 on % v? 31d 13. Depth to groundwater / on 14. Depth to mottling on 15. Are test . holes representative of primary & reserve areas..., ... .............................. E�es F --1 No 16. Soil percolation tests made by . on 17. Soil percolation tests witnessed by on SECTION D (on back) Form ST -1 2 SECTION D. DRAINAGES 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? a Yes Fv7 No 19. Will groundwater or surface drainage require special consideration? ......... .............. Yes � � o 0 ; 20. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... Q Yes No SECTION E. REMARKS' 21. If a common water supply is proposed; has an inspection been made of the existing or proposed source and facilities? ................................ ............................... 0 Yes [ No Inspection data 22. Do adjacent wells-and/or sewage systems' exist? ..................... ............................... a Yes �No 23. Additional comments 24. Site observer /inspector.and title,pi 25. Date(s)-of observation(s)inspection(s) 0. TEST PIT PROFILES f Hole # ` # ..Hole # o t # Depth to water 1�11 t Depth to water „it ti Depth to water f Depth to mottlin g De th to mottlin g X Depth to mo_t_tl.i.n �� Depth to rock%imp. Depth to rock%imp. l✓ .g_� Depth to rock/imp. ✓� . G.L. `I Mof ' G.L. � G.L. �� %,� 5 � . 0.5 ti M-e .5 Q I .. 0.5 /o, 1.0 ti 1.0 silt' L - yi) ffs 1.0 L!J - q'% . 4,k-i iN. 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 �.0 8.0 8.0 9.0 9.0 9.01 10.0 10.0 10.0 .9s fss MI, !72.01 ' ,5.r,4,V P 1 . 17 YO St" won of O to I p to, .9s fss MI, !72.01 ' ,5.r,4,V P 1 . 17 YO St" won of O 2 T SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? Yes No 19. Will groundwater or surface drainage require special consideiation? ........... "Flyes- �Io 20. Will gullies, ditches, etc., be filled and watercourses - be relocated? ......................... F--] Yes No SECTION E. REMARKS'__ 21. -If a: common water siipplyls proposedi has an inspection been made of the existing or proposed source and facilities? .................................................. ......... Yes No Inspection data 22. Do adjacent wells and/or sewage systems'exist? .................................................... "Yes Q No 23. Additional comments e. c. 24. Site observer/inspectorand title 25. Date(s)-ofjobservation(s)in! 'TEST PTT PROFILES Hole # L-Lot # Hole # 'Lot # ..Hole# V3 Lbt # Depth to water Depth to water 'h+ /X Depth to water W* ' __Depth to mottling Depth to mottling Depth to mottling Depth to rocklimp. Depth to rock(imp. Depth to rock/imp. .G.L. G.L. Q-11d T01?5cd G.L. 41* 5,2 5.1 0.5 .% .0.5 were --:'S 01 ' 0.5 q,) 1.0 1.0* .1.0 QJ 2.0.!5Q 2.0 2.0 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 1.0 8.0 8.0 8.0 .9.0 9.0 9.0 10.0 10.0 10.0 < lo 03 e. c. ,d 'PUT�INAM COUNTY DEPARTMENT OF HEALTH .DIVISION OF ENVIRONME1 TAL HEALTH SERVICES. C INITIAL INDIVIDUAL/COMMERCIAL SITE INSPECTION FORM SECTION A. GENERAL INFORMATION 6,. ,rr.&� // Name of Projectt/'�h�'o L /(T)(V) P(i 61 L% County Site Location �p ✓ [n�/� Building construction begun Extent Is property within NYC Watershed? ................. Yes ©/ o SECTION.B. TOPOGRAPHY (Please fleck all appropriate boxes) 1. Hilly 0 Rolling Steep slope Gentle slope O Flat 2. Q.Evideace.of wetlands a Low area subject to flooding Q Bodies of water Drainage ditches O Rock outcrops 1. Property lines or comers. evident.. :...................: ............... . .6es IiDNo 4. Do water courses exist on or adjoin the property? : ...... :..................... Yes 0' N " 5. Will these affect the design of the sewage system facilities ?............ Yes IVo � o 6. Do watershed regulations apply in this development ? ..................:.... 0 Yes �No 7 Will extensive grading be necessary? ................: .:.. .......:.......:...:....:.. a Yes. No 8. Will extensive fill be necessary . for SSTS? ......... ........... .......:. ............. Yes dNo 9. Do filled areas -exist within the SSTS area! ....................................... Yes No If yes, what is the condition of the fill? SECTION C. SOIL OBSERVATIONS 10. Appearance of soil: Sand Gravel Loam a Clay -0 Hardpan = Mixture 11. Observed from:: a Borings Q Bank cut 0 Backhoe excavations 12. Soil borings / exlvations observed by c f i on /U ,5 -/O�z 13. Depth to groundwater �j A- on ,1 14. Depth to mottlirig on 15. Are test, holes representative of primary & reserve areas ...... ............................... es 0 No 16. Soil percolation tests made by ; on 17. Soil percolatiori`tests witnessed by on SECTION D (on back) Form ST -1 7. s V k t .9 f Y 10/1512002 08:48 9147363693 CRONIN ENGINEERING 1 PAGE 01 P L BRUCE -R * , 1k LORET-rA MOLWARI RN, M-5-N. FOLEY $ Pub noue POU HAMM pbeaa• Qc Xea O lN frretar .I �° O l7irsaar of Poarm Sass= - - _ - DEPARTMENT OF HEALTH 1 Gateva -Road - - - - - -- Brewster, New .Yorti 10509- - grniTFST FOR HE )< D TES ATTEr -MON: 0�A0AMJ-;M5fiWG a GENE REED All information blow must be full completed pprior to any scheduling. DATE: K•i�l MO( P A ENGINEER OR FIRM CRoNtN sN�tNk�Rtn►G PHOiYE0 REASON: DEEPS:,)(' PERCS: c PUMP TEST: C RO.AD/STREFr: TAE ),JNXTO a q o t T096 -i: ?-? tyAr% VFI LLey TA INLAP..: -6-0. — I — 1 SUBDIVISION: LOTH: li Ow!r�R:QEL2(i•RLfNlr Deyf:to ?MEUT ceR? a N- cDEPY'RrrERI_A FOR Jouvr REVl£WA-'%M=NE.SS1rr -0F SOLI IESTLNS - ITS NO O tst Proposed SSTS within the drainage basin of West Branch of Bolds Corner Reservoirs o _/ Proposed SSTS within 500 feet of s reservoir, reservoir stem or control lake. o ES Proposed SSTS within 200 feet of a watercourse or a DEC wetland O oY Proposed SSTS design flow greater than 1000 gallonuday or SPDES Permit required- C3 gr" Proposed SSTS for a Commerical Project It is the responsibility of the desiggprofessianal to provide the above information prior to soil testing. This Department will let- ermine the NYCDEP project status (Joint or Delegated) based an the. response. If you answered y-q to any of the questions. NYCDEP mast witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequenO information indicates 14YCDEP is required to witness the soil testing, it will be the sole responn'bility, of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COU \TY M ONLY DATE, TMIL. MT_ C_Y.VA7 nC fAD•Zd m .pa�_77p_7pP1 kknms- Mrrkjom ( u.RV r%rj� nc P 1 i- i• J 3. i� 4. E' t PLW uw 1 120D spnc TW P. F-. of AV, Abw or ^M-dw/ P. BpYmdt m sm;z ---------- I .. -, - 1.4 _.- -. . - .- -1 W.tbw n.9 *tww Lmw (W Ana = 4.37'26 'Acres mm' - Swwned MW M40 SURVEY PLAN SCALE: 1"= 60• rn mrm•&•r M4 • mww•frr swwlsrF I e 38---------- - - - - -- ------------- f(56� - Ro f 5ticl -- ------------- cher ----------- E-�NSION AREA - 69 ------------------------------- 58 15 - --------------------------- 00 --- s ------------ PUMP TANK 1250 GAL SEPTIC TANK ICH SSTS AS-BUILT PLAN SURVEYOR PUTNAM COUNTY AL E-911 ADDRESS INFORMATION DEPARTMENT OF HEALTH i SWING TIES TABLE (FT. ) A B �C... D _... C 18 17 18 19 20 21... 22 i 1 ;44.0 46.0 20.0 28 2 40.0 61.0 3 107.0 93.0,F'% 4 46.0 42.0 .5 122.0 104.0 6 46.0 38.0 7 124.0 104.0 8 47.0 33.5 9 123.0 104.0 10 40.0 31.0 11 125.0 103.0 12 52.0 28.0 13 .. 89.0 65.0 14 22.0 15 36.0 37.0 _... C 18 17 18 19 20 21... 22 23 24 25 ' 26 27 28 29 30 31 32.-. 33. 34 35 36 37 38 39