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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -5 BOX 21 02445 w. M 'UTNAM COUNTY DEPARTMENT OF HEALTH' ISION OF ENVIRONMENTAL HEALTH SERVIC CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYS PCHD CONSTRUCTION PERMIT # N 18- 07 Located at IT,) - 4bLL a13 4� Town or Village C'> ?,,Y-; tJAM \(ALLF.`( Owner /Applicant Name AQF-kt 5EAM AV-2 Tax Map 51 Formerly k JA Subdivision Name Block Lot Subd. Lot # 3 Mailing Address loo 6%5 8,4'Y7l 5-1 -, )IIal-') i 1�� Zip )C)Dza Date Construction Permit Issued by PCHD oz- Separate Sewerage System built by % �� (:� �i� „ ��� Address ZJ� O^`�TE , Ji 1 Consisting of l 5r"o Gallon Septic Tank and qM CF C i= Z4" L,,-A W. AZ> ?-)Cod `f1� �tCiia S SRAC -F-5 k- 6( : a � =�-►,f i�� Other Requirements:_ _) ,D Ohl`�i�.%'� ,t�y �1l.a9-t. "2A 10 Water Sul►ply: Public Supply From Address or: Private Supply Drilled by s Address Building Type �29'-64C)54 1— Has erosion control been completed? Number of Bedrooms Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations o th Pril ounty Department of Health. Date: 1 `�`I Certified by P.E. i� R.A. p Pr essivl Address es ` „',li - �� °C-° t it ;+, y OW License # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. By: Title: /�'P�� Date: l '�I D 4 Whi a 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 COMPLETION REPORT Well Location Street Address: 155 Bell Hollow Road Town/Village: Putnam Valley Tax Grid # Map t' Block Lots) Well Owner: iRaxston Name: Address: Developers, Inc., 17 White Lotus Rd,Brewster, NY 10509 Use of Well: I- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby IDrilling ]Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well 'Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length __32_ft. Length below grade eft. Diameter. 6_in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes _No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield 'Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 8 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) Depth of completed well in feet 2601 325' Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface )urden clay and hm1ders Hit rock at 6' 6 32 Drillina in rocki set casim, arouted 32 325 Drillin in rock gKanite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 7cipm Depth 280, Model 2g 12 Voltage 230 1 Tank TypeWX302 0 1. Date Well Completed 10/15/03 Putnam County Cert ification No. 006 Date of Report 8/12/04 Well Dri r e L al NOTE: Exact location of well with distances Well Drille Signature: permanent landmarks to be provtd n a separate sneevplan. Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 COG a 'a BRUCE R. FOLEY * * LORETTA MOLINARI R.N., M.S.N. Public Health Director yc�`k, YDQ,�` Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OFFIC DATE: Karen & Sean Aiken 51. -1 -5 155 Bell Hollow Road (Signature) The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911verfrm) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Karen & Sean Aiken Owner or Purchaser of Building Building Constructed by 155 Befl IHfoRllow Road Location- Street ResidenH0 Building Type 51 1 5 Tax Map Block Lot (T) Putnam Valley Town/Village Klondike 11 Subdivision Name 3 Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: N*th 08 Day 118 Year 04 Signat Contractor (Owner) - Signature v Corporation Name (if corporation) Address: State 1'/ � Zip Title: Zo Le Corporation Name (if corporation) Address: /! u�lilas Gov-c-s ;?W �'�'� State AIJI-.1 Zip /o 9 Form GS -97 JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: 845 - 279 -2460 Client: Roxsten Develop. Zip: 10509 " ' Fax: 845 - 279 -6613 Collector's Information: Name: Kevin Address of site: Aiken City: State: N.Y. Zip: Telephone: Sample's Information: Sample for Alkalinity collected 9/3/04 Site: Tank Date Collected: 8/20/04 Date Received: 8/21/04 Preservative: N/A Time Collected: 3:15pm Time Received: 11:00am Temperature: <4C Filter: Not Present Lab No.: J048740/J049216 Date Analyzed Test Name Result MCL Method 8/21/2004 12:00 Total Coliform Absent Absent SMWW 9222B 8/21/2004 Chlorine Free Residual <0.1 mg /L ' N/A SMWW 4500CIG 8/21/2004 Color ND 15 Units SMWW 2120 B 8/21/2004 Odor ND 3 TONs SMWW 2150 B 8/23/04 Iron <0.050 mg /L 0.3 mg /L SMWW 31118 8/23/04 Manganese <0.050 mg /L 0.3 mg /L SMWW 31118 8/23/04 Sodium 6.77 mg /L N/A SMWW 3111 B 8/23/04 Chloride 11 mg /L 250 mg /L SMWW 4500 Cl C 8/23/04 Hardness 76 mg /L N/A SMWW 2340 C 8/23/04 Nitrate 1.43 mg/L' .. 10 mg /L SMWW 4500 NO3E 8/23/04 10:00 Nitrite <0.1 mg /L 1.0 mg /L SMWW 4500 NO3E 8/21/04 pH 6.89 S.U. 6.5 -8.5 S.U. SMWW 4500 H B 8/23/04 Sulfate 31.4 mg /L 250 mg /L SMWW 4500 SO4F 8/21/04 Turbidity 0.31 NTU 5 NTUs SMWW 2130 B 8/23/04 Lead <1.0 ug /L 15 ug /L SMWW 3113 B 9/7/04 Alkalinity 46 mg /L N/A SMWW 2320 B At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable S.U.= Standard Unit MCL- Max. Contaminant Level ug /L- micrograms per Liter Signature: Michael Lapman President mg /L- milligrams per Liter ND- None Detected NTU- Nephelometric Turbidity Unit TON- Threshold Odor Number i Reviewed b« Sharon Houlahan, Director State #: PH -0218 ELAP #: 11715 Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmentat.com BADE Y & WATSON LETTER ®f TRANSMffTTAL Surveying &(Engineering, P cC: 3063 Route 9, Cold Spring, New York 10516 Date: 09 Sep 2004 File No. 80- 153.03 W. O. # 16272 RE: Certificate of Construction Compliance Aiken TO: Bell Hollow Road Joseph S. Paravati, Jr. Klondike - H Subd. Lot No. 3 Assistant ]Public Health Engineer Tax Map 51. 4-5 ]Putnam County Department of Health PermiUTitle/PO # PV -18.02 1 Geneva Road Sent via: Brewster', NY 10509 US MAIL 11 UPS -NIGHT El MESSENGER R UPS -2 DAY 11 PICK -UP ❑ UPS -3 DAY El FAX ❑ UPS -GRND ❑ We are sending: UPS -COD ❑ copies date description of document © 25- Aug -04 FAppli cation Fee - $300.00 © 118-Aug-04 lCertificate of Construction Compliance for Sewer Treatment System F-11 23- Aug -04 E911 Address Verification Form 3 118-Aug-04 = lGuarantee of Subsurface Sewage Treatment System ❑ ❑1 120-Aug-04 Well Water Test Results ❑3 112- Aug -04 Well Completion Report ® 118-Aug-04 SSTS "As- Built" r❑ REMARKS: For your review. Copies to: File Yours truly: John P. Delano, PE Tel: (845) 265 -9217 ext 12 Fax: (845) 265 -4428 Email: jdelano @barley- watson.com 40 40.05 513563 629526 25039 PUTNAM COUNTY DEPARTMENT OF HEALTH' DIVISION OT ENVIRONMENTAL HEATLII SERVICES FIELD ACTIVITY REPORT A©�1�� lJ�tcf Street Town State Zip PERSON IN CHARGE. ^ ()R TNTFR VMVrP.T): r y i !�. PUMP TEST [j DOSE TEST 6 ( I I ,e.— ye REQUIEtED GALLONS q- a(( `b : EL. START _ EL. STOP rr�ePFrTnR• TFT Signature and Title REPORT ..11Fr FTypn $Y• I acknowledge receipt of this report: SIGNATURE: 02/96 Title; it m I I I �r� 6 ( I I ,e.— ye REQUIEtED GALLONS q- a(( `b : EL. START _ EL. STOP rr�ePFrTnR• TFT Signature and Title REPORT ..11Fr FTypn $Y• I acknowledge receipt of this report: SIGNATURE: 02/96 Title; LORETTA MOLINARI Public Health Director June 4, 2004 Neal Seidl DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 27S - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Badey & Watson Engineering 3063 Route 9 Cold Spring, New York 10516 Dear Mr. Seidl: Re: Field Inspection — Aiken Bell hollow Road, (T) Putnam Valley TM# 51. -1 -5 & 6 ROBERT J. BONDI County Executive A site inspection was made for the above referenced project on June 2, 2004. The following comments must be :corr,ec d in the field. Six feet of trench needs to be added. Ad� Vw� cU Please provide manufacturer cutsheets for septic tank and pump tank. S}, I (v� i �,h �/ Ditch on the far side of the trenches needs to be filled in (between system and expansion). SJ 4 -. What is the purpose of the clay pile by the SSTS area? t�l Weep hole needs to be provided in pump line inside the chamber. Force main trench should be backfilled according to the force main trench detail. Vtg/ r,7! Pump test needs to be witnessed by a representative of this Department. Please provide proof that tax lots 5 & 6 have been combined. 0lL20 Gor j If ou ha e any further questions, please contact me at (845) 278 -6130 ext. 2157. Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj .. -_ — �Q . DH,,Cr & WHIbUN, FJU P.01iO3 BRUCE R. F01,FY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Read Brewster, New York 10509 LORETTA MOLINARI R.N., &LS,N, Associate Public Health Director Director of PatientServices REQUEST FOR .FIELD TESTING ATTENTION: Pi JOSEP14 PARAVATI GENE REED All information below must be t� completed prior to any scheduling. DATE: __ 8/18/2004 SADEY & WATSON, ENGINEER OR FIRM ' Surveying & Engineering, P.C. PHONE # (845) 265 -9217 REASON: 1C9a > Z23cc.. DEEPS: .❑ PERC'S: �71 PUMP TEST; ® prr;,�iz. ROAD /STREET: 155 Bell Hollow Road ' ALA"'' 19" TOWN: Putnam Valley TAX. MAP #: SUBDIVISION: _ Klondike 11 _ LOT #: 3 OWNER: Karen. & Sean ~Aiken NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES NO ❑ ❑ Proposed SSI'S within the drainage basin of West Bianch or Boyds Cornier Reservoirs. u ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. Cl ❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ n Proposed SSTS design flow greater than 1000 gallons/day or SPDES Permit required. 11 ❑ Proposed SSTS for a Commercial Proje' '..l.. It is the responsibility of the design professional to pr;vide the above information prior to soil testing. This Department will-determine the NYCDEP project status ,(Joint or Delegated) based on the response_. If you answered yes to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for 0.6id testing with the Design Professional and NYCDEP. If a project has been determined to. be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the-soil testing, it will be the sole responsibility of the design professional to.schedule.re -w- itnessing of the soil testing with NYCDEP. DATE: (FIE.D'rEs'r) FOR MINTY USE ONLY TIME: AUG -18 -2004 WED 12:51 TEL: 245-276-7921 1111P°iE:PUTNAM COUNTY DEPARTMENT OF P. 1 AUG -18 -2004 13:10 . BADEY & WATSON, PC BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF RRE UNDERWMTER BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK,' NY 1 0038 CERTIFIES THAT Upon the application of upon premises owned by PRECISION ELEC. SEAN•AIKEN BOX 1112 .155 BELL HOLLOW ROAD CARMEL, N,Y. 10512,'. PUTNAM VALLEY, TN +, NY 10579 Located at 155 BELL. HOLLOW ROAD PUTNAM VALLEY, TN +', NY 10579 Application Number: 1203260 Section: Block: Lot: Certificate Number: 1203260 Building Permit! 374 -04 sOC: W106 P.03 /03 Described as ,a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located inlon the premises at: IRasement, ('list 1"'loor, Second Floor, A=cbed Garage, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and /or standard promulgated by the State of New York, Department of State. Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 10ti, Day of August, 2004, Name M- date Radne Circuit ERs Receptacle 1 0 1.10 Laundry Receptacle 1 0 110 Appliance Scrvic.e 1 k'1►frse 3�' Secvice•Ra�ir�g a0c> rh.mpereS Service Disconnect: 11 200 CB Meters: 1 seal 2 of 2 1'liis certificate May riot be altered in any way.and is validated only by the presence of a raised seal at the location indicated. AUG -18 -2004 WED 12:52 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 3 AUG -18- 2004 13:10 BADEY & WATSON, PC BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK • BOARD -OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of:; upon premises owned by PRECIS IOK'ELEC. SEAN AIKEN BOX 1112'. .155 HELL HOLLOW ROAD CARMEL, N.Y, 1Q51 z, PUTNAM VALLEY, TN +, NY 10570 Located at 15$ BELL I4OLLOW ROAD PUTNAM VALLEY, TN +, NY .10579 Application Number: 1203260 Certificate Number: 1203260 Section: Block: P. 02/03 Lot: - Building Permit: 374 -04 BDC: W106 Described as a Residential . occupancy, wherein the premises electrical system consisting of electrical devices and wiring; described below, located inlon. the premises at: L�ase�nenr, 'First Floor, Second Floor, Attached Garage, Outside, . A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and /or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the' loth Day of August, 2004. Name 0ry Katc Rating .� Tyne Appliances qad Accessories ixt,lre 59 b Hydro Mussage Tub, Residential 1 0 57 0 110 Range 1 0 8 KW Ova-) 1 0 6.5 KW Cooking Deck 1 0 6 K'~'tr Dish Washer 1 0 1.5 KW Wafer I ,*eater 1 0 1.5 IOW Pump/Motor 1 0 110 F.P1.P, Furnace 1 0 Oil !sir Conditioner 3 0 42000 BTU Panels 1 tun 42 �Virin; and Devices 011th-'t 228 0 ixt,lre 59 b 110 Incandescent .Receptacle 57 0 110 Gencral Pmpose Receptacle 23 0 110 GFCI gFa/ Switch 94 0 Ito General Putpos. Continued on Next Page i of This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated AUG -18 -2004 WED 12:51 TEL_:845 -278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 MAY -26 -2004 08:27 BADEY & WATSON, PC PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION JOSEPH GIEN E REQUEST FOR FINAL -IN PEC'}~ ION For: Fill Date: 6 /25/20..,..__ Trenches P.01/01 PCHD Construction Permit. # PV-18 -02,� Located: Bell Hollow Road, -- '(T)(V) (T) Putmm valley.,....._._ Owner /Applicant Name: Seen & Kaaen Alkero TM 51 Block 01---..Lot 5&6. Formerly: Subdivision Name; Klondike 00 Subdivision Lot # Is system fill completed? WA , _._ Date; Is system complete? ... -__ No Date: 2n52W4 Is system constructed as per plans? �enepa0ly Is well drilled? YES _ Date: _ 2125/20M._ Ge Is well located as per plans ?atamlly Are erosion control measures in place?. fifes 1 certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date: 5126J2004____ Certified by: PE RA Design Professional Address: ®adey & Watson, P.C. 3053 Route 9, .Cold SprIng, MY Lic. # 003505 Comments: ;,%'re .� ,;M Form FIR 799 TOTAL P.01 MAY -26 -2004 WED oe :10 TEL :845- 278 -7921 NAME :PUTNAM COUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # F V-15 °-OZ 4 'll� H 9 F Located at 1%e l4 AP Town or Village �l'i`�(A6�►4 i% t. Subdivision name i4N9i Ke- Subd. Lot # S Date Subdivision Approved J-USEE- 15, 'iC1S j Owner /Applicant Name w k 5 A<1 Mailing Address 4W r Tax Map 5i Block I_ Lot 5 Renewal Revision X Date of Previous Approval 05-07--07- Amount of Fee Enclosed A 1 %dCO Building Type 0e-k ml Lot AreaJ�we 10. of Bedrooms 4_ Design Flow GPD Zip 10102 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of I, Z' gallon septic tank and 41t �ttD�c,fizr"T ic�tJ `cif SP►t.p (v�`��C -. Other Requirements: i,Z ...� ' � �3 IC To be constructed by KAfW 1. 01v 6 �.5'N5 , INC . Water Sunnly: Public Supply From Address 3 it 5 !Zr, q COLD ,\J&, j Address or: X' Private Supply Drilled by NtPld11Ai� � +ice ,� , I a'� C . Address f-NLt`iN%m \A"W. I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s, sY tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof. a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed Address R.A. Date O Zej 1,0 Z License # 06ZSO� 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 p rmit. Approved for discharge of domestic sanitary sews a only. By: j Title: Date: White copy - HD F le; ell copy - Building Inspector; Pink copy - er; range copy - Design Professional Form CP -97 BA❑EZY & WATSON ILIETT ER ®T TRANSMffTTAL Surveying & Engineering, P. C. 3063 Route 9, Cold Spring, New York 10516 Date: 09 Oct 2002 File No. 80- 153.03 W.O.# 15329 RE: Permit Renewal Aiken TO: Bell Hollow Road Theresa Nemeth Klondike - H Subd. Lot No. 3 + ]Putnam bounty Department of Health Tax Map 51.4-5 & 6 1 Geneva Road PenmtiTitle1PO # PV -18 -02 ]Brewster, NY 10509 Sent via: US MAIL 9 UPS -NIGHT El MESSENGER El UPS -2 DAY El PICK -UP 11 UPS -3 DAY El FAX El UPS -GRND El We are sending: UPS -COD copies date description of document F-11 25- Sep -02= IConstructionPennit for Sewage Treatment System El I F1 I ❑ I ❑ I —� ❑ El 71 1 El I REMARKS: Revised permit application pursuant to our conversation yesterday afternoon. Thank you. Copies to: ]File Yours truly: ,john P. Delano, PE Tel: (845) 265 -9217 ext ]Fax: (845) 265 -4428 Email: jdelano @badey 12 - watson.com BADEY & WATSON Surveying & Engineering, P.C. 3063 Route 9, Cold Spring, New York 10516 I I�L7� Mr. Joseph S. Paravati, Jr. Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 We are sending: copies date description of document 0 0 0 El El LETTER of TRANSMITTAL Date: 07 Oct 2002 File No. 80- 153.03 W. O. # 15329 RE: Proposed SSTS - REVISION Aiken Bell Hollow Road Klondike - II Subd. Lot No. 3 + Tax Map 51.4-5 & 6 Permit/TitletPO # PV -18 -02 25- Sep -02 Iseparate Sewage Treatment System Sheet 1 of 1 125-Sep-02 IPump data & info 26- Jul -02 IFloor Plans - sets 03- Oct -02 [Application Fee - $150.00 money order REMARKS: Sent via: US MAEL MESSENGER PICK -UP FAX plan has been revised to reflect owner proposed house in preferred location; pump selection revised accordingly. Copies to: File Yours truly: 11 UPS -NIGHT 1:1 El UPS -2 DAY F� El UPS -3 DAY El UPS -GRND UPS -COD John P. Delano, PE Tel: (845) 265 -9217 ext 12 Fax: (845) 265 -4428 Email: jdelano @badey - watson.com 40 40-05 513563 629526 13643 _/S?'/} )\ /�� BE *~ � _'_ -_ rvtp v ` « r �� __u����-��----------'-�^~---------'-----' .... __ ' `'`^ __-__--_-__�-�-�--__---_-__-_- ______� -4 _� ---------------' | | Li s S. 9 APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools Hospitals industry • Effluent systems SPECIFICATIONS Pump: . Solids handling capabilities: 3/; maximum. • Discharge size: T NPT. • Capacities:'up to .128 GPM: • Total heads:'up to, 123 feet TDH. • Mechanical seal: silicon oarbide- rotary seat/silicon carbide- stationary seat; 300 . . series stainless steel metal parts, BUNA -N elastomers. • Temperature: 104 °F (40 °C) continuous 140 °F (600C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage .to components. Motor: Single phase: 1/3 HP, 115 or 230 V 60 Hz, 1750 RPM; % HP, 115 V, 60 Hz, 3500 RPM; '/2 HP -1'/2 HP, 230 V, 60 Hz, =3500 RPM. Built-in overload with automatic reset. Class B insulation. ®1994 Goulds Pumps, Inc. �_. G° :s Su :,. e' rs able Effluent. Pump 38-85 CANADIAN STANDARD ASSOCIATION SP • Three phase: 1/2 HP - 1'/2 H P 200/230/460 V, 60 Hz, 3500 RPM. Class B insulation, overload protection must be . provided in starter unit. • Shaft: threaded, 400 series stainless steel. • Bearings: ball bearings upper and lower... Power cord: 20 foot standard length (optional lengths available). Single phase: 1/3 and 1/2 HP —16/3 SJTO with three prong .plug. % -1' /z HP —14/3 STO with bare leads Three phase:.' /z -1Y2 HP —14/4 STO with bare leads. On CSA listed models — 20 foot length SJTW and STW are standard. METERS FEET r 9 25r f 0 20 o � C 10 5 ` 1 0 FEATURES Impeller: Cast iron, semi= open,, non =clog with pump - out vanes for mechanical seal protection. Balanced for smooth. operation. Silicon bronze impeller available as an.option. Casing: Cast iron volute type for maximum efficiency. 2"N PT discharge adaptable ' 'for slide rail systems. . Mechanical Seal: Silicon carbide vs. silicon carbide sealing faces. Stainless steel metal parts, BUNA -N elastomers. Shaft: Corrosion - resistant stainless. steel: Threaded design. Locknui'on three phase models to:gukd against.companent :damage on accidental reverse rotation. Motor: Fully submerged in high -grade turbine'oii for lubrication and efficient heat transfer. beslgried for. Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, . can be;operated continuously withopt-damage. . Bearings :.Upper and.. lower heavy drlty.batl bearing construction. . 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. 0 -ring: Assures positive . sealing.against contaminants and 'oil leakage. �■■■■■■■■■■■■■■■■■■■■ • ■Q\■■■■■N■■■ ■ ■■■ ■236S■■■■■■■ ■ ■■ lio�ll� ■�� ■li ■■■ ■ ■ ■ ■ ■ ■ ■■ ■ ■ ■ ►: \ ■■ ■■■■■■■■ u 1u .1u 1 0. I �I 30 40 50 60 70 80 90 100 110 ' 120 130GPM W 10 CAPACITY 30 m31h Effective May, 1994 ' B3885 PARTS Item No. Description 1 Impeller 2 Casing_ 3 Mechanical seal 4 Shaft 5 Motor - 6 Bearings - upper and lower 7 Power cable ' 8 0 -ring WE0312L Ya 230 4.7 ' 1750 WE0311M 115 9.4 WE0312M 230 1 4.7 WE0511H 115 13.0 WE0538H 200 .3.9 -WE0532H 230 3. 3.4 WE0534H '/x 460 1.7 WE0511HH 115 1 13.0 WE0512HH - •230. 6:5 ' WE0538HH 200 3.8' ' WE0532HH 230 3 3.3 WED534HH 460 1.65 WE0712H 230 1 10,0 WE0738H 200 6.2 WE0732H 208 -230 3 5.4 WE0734H. :460 _ WE0311M 2.7 WE1012H ..230.. 1_ 12.5 WE1038H 1. 200 '!3 8.1 W 32H ' 208 -230 3 7.0 WE1634H 460 - 3,5 WE1512H 230 1 15.0 WE1538H '200 57 10.6 WE1532H 208 7230 3 9.2 WE1534H 1, 460 ' 4.6 W1512HH, 230 .1 15.0 WE1538HH 200 10.6 WE1532HH 208 -230 3 .9.2 WE1534HH 460 4.6 5l- �liiiiiiiiiiii 'i►iiiiiiiiii■ ppoiiiiiiiiii ' N=l•iiiiiiiiiiiiiiii' WE051111 WED511HR Order : W10511H WEO 12H WE1012H WE1512H WED512HH WE1612HH 1 Ne. �� WE0311L WE0311M WE0532H WE0132H WE1032H WE1532H WE0532RH WE1632RH WE0312L WE0312M WE0534H WE0134H WE103411 . WE163AH WE0534HH WE1534HH HP '/ '!3 '/2 1 1'/2 '/2 1'1/2 RPM 1750 1750 3500 3500 3500 3500 3500 3500 5 - - - - - - 60 10 80 65 . . - - - 56 84 15 60 57 .69 . 90. 104 128 53 82 „iiii\iiiiiiiiiiiiiii ii■ ■\iiiiiiiiiiiiii ii■ iomiiiiiiiiiiiii, °'iiiiiiCiii iiiiiii►14ii iiiiiiiiii !\iiiiiiiii\\iiiimiiii :' ioiiiiiiimiiiiiiiiii 111,!J.!w::iiiiiiiiiiiiiiii '' ■Iikhiltliiiiiiiiiiommmiiii iiiii`iiiiiiieiiiisi ' iiiiii►iiiiiimiiiiii iiiiiii►i■iiimmiiii■ " iiiiiiii►`tiiiiiwiiiii iiiiiiiii\iiiiir•iiii ...i.ii.ii.o=i.o..iii iiiiiiiiii\. ii ■Miii 'iiiiiiiiiii\iiiimiii mmmmmmmmiiiiiiiiiiim Goulds pubmersible PEROORMANCE.RATiNOS (gallons per minute) DIMENSIONS (All dimensions are 106ches. Do not use for construction purposes.) D' 'h,'h, % and 1 HP =15' except for model WE071.2H and WE1012H= 18';1'I HP =18' NPT. L KICK -BACK L_ VV --► EFFLUENT EJECTOR SYSTEM a Effluent 9jectorsystem KIN Package Includes: offers ease of- ordering Submersible Effluent Pump WE0311L, and installation. A single 12L or WED31 1 M. 12M, WED511 HH, 12HH ordering number specifies Mercury level Control Switch 0 10 20 30 40 50 80 70 80 80 100 GPM A2- 5(115V) A2- 6(230V) a complete system designed Basin A7- 1801S, Basin Cover A8 -1822 0 10 20 m3lh for. most residential and CheckVanreA9 -2P cnPACrrr commercial sump and. Order No.: SWE0311L, SWE03121, effluent pump applications. SWE0911M, SWEE0512H WATER TECHNOLOGIES GROUP SWE0511HH, SWE0512HH. WE051111 WED511HR Order : W10511H WEO 12H WE1012H WE1512H WED512HH WE1612HH 1 Ne. WE0538H WE013811 WE10388 WE1538H WE0530HN WE163SHH WE0311L WE0311M WE0532H WE0132H WE1032H WE1532H WE0532RH WE1632RH WE0312L WE0312M WE0534H WE0134H WE103411 . WE163AH WE0534HH WE1534HH HP '/ '!3 '/2 1 1'/2 '/2 1'1/2 RPM 1750 1750 3500 3500 3500 3500 3500 3500 5 - - - - - - 60 10 80 65 . . - - - 56 84 15 60 57 .69 . 90. 104 128 53 82 DIMENSIONS (All dimensions are 106ches. Do not use for construction purposes.) D' 'h,'h, % and 1 HP =15' except for model WE071.2H and WE1012H= 18';1'I HP =18' NPT. L KICK -BACK L_ VV --► EFFLUENT EJECTOR SYSTEM a Effluent 9jectorsystem KIN Package Includes: offers ease of- ordering Submersible Effluent Pump WE0311L, and installation. A single 12L or WED31 1 M. 12M, WED511 HH, 12HH ordering number specifies Mercury level Control Switch 0 10 20 30 40 50 80 70 80 80 100 GPM A2- 5(115V) A2- 6(230V) a complete system designed Basin A7- 1801S, Basin Cover A8 -1822 0 10 20 m3lh for. most residential and CheckVanreA9 -2P cnPACrrr commercial sump and. Order No.: SWE0311L, SWE03121, effluent pump applications. SWE0911M, SWEE0512H WATER TECHNOLOGIES GROUP SWE0511HH, SWE0512HH. Fraction PLASTIC PIPE: FFIICTION LOSS PER 100 FT. GPM GPH 2" 21/h" 3" 4" 6" 8 ". 10" Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Us. Ft. •Lbs. 6 360 .10 ..044 8 480 .17 .073 10 600 :25 .108 .11 .046 15 900 .52.. .224 .22 .094 20 1,200 .86 .375 .36 .158 .13 .056 .25 1,500 1.29 .561. .54' .234 .19 .083 30 1,800 1.81 .786 .75 .327 .26 .114 35 2,100. 2.42 1.05 1.00 .436 .35 .151 .09 .041 40 2,400 3.11 1.35 1.28 .556 .44 .191 .12 .052 45 2,700 3.84 1.67 1.54 .668 .55 .239 .15 064 50 3,000 4.67 2.03 .1.93 .839 .66 .288 :17 .076 60 3,600 . 6.60 2.87 2.71 1.18 .93 .406 .25 .107. .70 4,200. 8.83 3.84 3.66:. 1.59 '1.24 .540 .33 143 80 4,800. 11.43.1..4.97.' 4.67 1 2.03, 1.58. .687 Al 180 90. 5,400 14,26 6.20 5.82 2.53. 1.98 861 .52...' .224 :. 100 6,000 7.11 3.09 2.42 1.05 ..63- ,272 .08- :.036 125 71560 10.83 4.71. 3:80, 1.65 .95 .415. :13 :.055 150 9,000 5.15 2.24 1.33 ! .580 .18 .077 . 175 10,500 6.90 3.00 :1.78 • ;...N- .23 .1C2 .200 12,000 1 8.90 3,87 2.27 .985 .30 , .130 250 15,000 i r 3.36. 1.46 r '.45 .195 1 .12 .051 300 18,000 j i , 4.85 2.11.: 63 i ..275 17 .072 350 •21,000 ; 1 ; 6.53 - 2.84 .84 .367 .22 I .095 a 400 1 24,000 1 j 1.08 .471 1 .28 .121 500 ; 30400 j 1 ! 1.66 i 720 I .42 .182 14 .059 550 33,000 i '•, 1.98 861 50 219 16 .071 600 36,000 r I I ]2.:35: 11.02 .59 .258 .19. 1 .083 700 42,000 19 343 26 (.112 800 48,000 i 1 1.02 .443 .33 .143 900 54 ' 000 , I ! ; i. 1.27 .554 41 ; .179 950 .57,000 .46 .198 1000 � 60,000 .50 ' .218 r a• 2 Loss E��IVALEi�T HUMBER OF FEET STRAIGHT PIPE FG.,.. R DIFFERENT FITTINGS Size of fittings, Inches 172 314„ 1" 1174„ 1174 2" 217:" 3" 4" 5" 6" 1 8 10" 900 Ell 1.5 2.0 2.7 3.5 4.3 5.5 6.5 8.0 10.0 14.0 15 20 25 . 450 Ell 0.8 1.0 1.3 1.7 2.0 2.5 3.0 3.8 5.0 6.3 7.1 9.4 12 LongSweep Ell 1.0 .1.4 1.7 2.3 2.7 3.5 4.2 5.2 7.0 9.0 11.0 14.0 CloseReturn Bend 3.6 5.0 6.0 8.3 10.0 13.0 15.0 18.0 ' 24.0 31.0 ° 37.0 39.0 Tee - Straight Run 1 2. 2 3 3 4 5 Tee -Side Inlet or Outlet 3.3 4.5 5.7 7.6 9.0 12.0 14.0 17.0 22.0 27.0 31.0 40.0 GlobeValve Open 17.0 22.0 27.0. 36.0 43.0 55.0 67.0. 82.0 110.0. 140.0. 160.0 220.0 AngleValve Open 8.4 12.0 . 15.0. 18.0 22.01 28.0 33:0 42.0 58.0 70:0. 83.0 110.0 Gate Valve -Fully Open 0.4 0.5 0.6 0.8 1.0 1..2; 1.4 1.7 2.3 2.9 3.5 4.5 '. CheckValve (Swing) 4. 5- 7 9 11 13 16 20 . 26 33 39 52 65 CheckValve (Spring) 4 6 8 12 14 19 23 32 7 43 58 Exeimple: .: -(A) 100 ft. of 2" plastic pipe with one (1) 900 elbow and one (1) swing check valve. 90° elbow - Equivalent to . 5.5 ft. of straight pipe Swing Check - Equivalent to 13.0 ft. of straight -pipe 100 ft. of pipe -- Equivalent to 100.0 ft. of straight pipe 118.5 ft. = Total equivalent pipe Figure friction loss for 1185 ft. of pipe. (8) Assume flow to be 80 GPM through 2" plastic pipe. . 1. Friction loss table shows 11..43 ft. loss per 100.ft. of pipe. 2. In step (A) above we have determined total feet of pipe to be 118.5 ft. 3. Convert 118.5 ft. to percentage. 118.5 =100 = 1.185. 4. Multiply 11.43 x 1.185 13.54455 or 13.5 ft. = Total friction loss in this system. 8 1 M PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # ✓- Id'- c? Located at �- L-W 6 Town or Village Vi•1Tl w VAri,.i Subdivision name "NVIKIE� JE Subd. Lot # :� Date Subdivision Approved JtWe t5 1,11101 Owner /Applicant Name Ai Mailing Address Amount of Fee Enclosed a00 Tax Map '51 Block I Lot 1— Renewal Revision Date of Previous Approval Building Type ` d lM.. Lot Area No. of Bedrooms Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of °L J gallon. septic tank and 4W LF� 11 ?A" W I DO- aF I0Q TTZ-F-OC S- S' AT- (6 0-C-, Other Requirements: To be constructed by r Al%10 - -OSt, AL-44A , - Address 3 d `1 `5 (ZT-- CA LC)LD SMM6LL_ Water Supply: Public Supply From Address or:. Private Supply Drilled by NCi`M*j 4+ 00 10C , Address PuIT�,hAM �pAtiA 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 04124 0 t License # zyg2 s- 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 p rmit. Approved f r discharge of domestic sanitary se age only. 2 By: r Title: Date: White copy - HD F' e; Y o copy - Building Inspector; Pink copy - O er; Or a copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH >TDIVIKON OF El`1WT8®N1ViT1EN TAIL HEALTH H S ElE8WC ES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # V_ ) Well Location: Street Address: Town/Village Tax Grid # ' 5GLL HOLLOW 0. RVWNA V Map 5p Block I Lot(s) 5 Well Owner: Name: k Address: AIV, 61N 400 T- e4i�5�. PJ 02,6 Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2-secondary Industrial Institutional Standby Amount of Use Yield Sought 9i gpm # People Served Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling _)c/ New Supply (new dwelling) Deepen Existing Well Detailed Reason '\J f -De E�c`r��� ��� `�� -t�'Q� �tX'� 1� �V1� (zf'Si i» Cs 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: NOF—IM-AIQ AWDE_-V_S0ZJ Address: fkx`fio-J►�A edM,_L�t Is Public Water Supply available to site? ............. ................ ............................... Yes No Name of Public Water Supply: �J/ A Town/Village W/A Distance to property from nearest water main: '� i D-N t LE_ Proposed well location & sources of contamination to be provided on se arate sheet/plan. Date: ® 12,4 0Z 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. A 14 Date of Issue 6-"-z'Zg 2- Permit Date of Expiration --Z Title: _ Permit is Non-Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WP -97 PUTNAM' COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, GR, AS, &ATE: I (�'I' TAX MAP #: (CONFIRMED) Y N DOCUMENTS Cj _)PERMIT APPLICATION L.!!�)_)WELL PERMIT OR PWS LETTER CU _)PC -97 _)LETTER OF AUTHORIZATION _)DESIGN DATA SHEET (DDS) UCUCORPORATE RESOLUTION (.Z)_)SHORT EAF i (( _jPLANS -THREE SETS (__)HOUSE PLANS - TWO SETS Cj _) _)VARIANCE REQUEST SUBDIVISION ((__)LEGAL SUBDIVISION (:/)_)SUBDIVISION APPROVAL CHECKED C�_)PERC RATE /— 7E- _)C_,:�FHLL REQUIRED DEPTH _)(_CURTAIN DRAIN REQUIRED GENERAL _) 4-)DE OCATED IN NYC W (__) LANS SUB D TO DEP _) ED TO PCHD EP APPROVAL, IF REQ'D EEP TEST HOLES OBSERVED ✓jC__)PERCS TO BE WITNESSED (_J _-EJC- APPROVAL SSDS ADJ, LOTS (Cj _)WETLANDS (TOWN/DEC PERMIT REQ'D ?) ((-_)DATA ON DDS PLANS & PERMIT SAME (� .i PRE 1969 NEIGHBOR NOTIFICATION C_)C�aTTER BI/ZBA C_JS,eJ100 YR. FLOOD ELEVATION W/I 200' _)C : I<m TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS (e5 )SEWAGE SYSTEM PLAN - (NORTH ARROW). /f(__JSSDS HYDRAULIC PROFILE ( �C JGRAVITY FLOW CONSTRUCTION NOTES 1 -15 _)DESIGN DATA: PERC & DEEP RESULTS ((�, (_j2' CONTOURS EXISTING & PROPOSED C )DRIVEWAY & SLOPES, CUT (=��FOOTING /GUTTER/CURTAIN DRAINS USDA SOIL TYPE BOUNDARIES _)TITLE BLOCK; OWNERS NAME ADDRESS TM #, PE/RA; NAME, ADDRESS, PHONE# (e�(___)DATE OF DRAWING/REVISION (��DATUM REFERENCE LOCATION OF WATERCOURSES, PONDS � ►_) LAKES,WETLANDS WITHIN 200' OF P.L. t: PROPOSED FINISH FLOOR AND / BASEMENT ELEVATIONS (y/ _)WELLS & SSDS'S W/IN 200' OF SSTS �C__)PROPERTY METES & BOUNDS EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (REVSHEET)09 /01 /00 Y N (REQUIRED DETAILS ON PLANS CONT'D) HOUSE SEWER -' /." FT. 4 "0'; TYPE PIPE CAST IRON _) _)NO BENDS; MAX BENDS 45' W /CLEANOUT RENEWALS _) )SIT 0 CHANGE) FILL SYSTEMS C__)U10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE (_-J(UFILL SPECS/ S 1 -5 ((^}FILL PR UVIENSIONS CU) )FIL EXPANSI AREA FILL GREATER THAN 2 FEET C -__)(_ __) CLAY B _) _)FILL CER CATION NOTE _) _)DEPTH AUG _) _)VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS _) _)SEPARATION DISTANCE FROM TOE OF SLOPE T C C� _)LF TRENCH PROVIDED -�U 60FT MAX. _) _)PARALLEL TO CONTOUR C,, ' 100% EXPANSION PROVIDED L�DETAEUDUST FREE CRUSHED STONE OR WASHED GRAVEL GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM'SSTS 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL 020'T0 FOUNDATION WALLS 0100'TO WELL, 200' IN DLOD,150' TO PITS 5 100'TO STREAM, WATERCOURSE, LAKE (inc. expan). 0' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER (10'T0 WATER LINE (pits - 20') _)50' INTERMITTENT DRAINAGE COURSE U0200'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS CnT __)10' MIN TO LEDGE OUTCROP // SEPTIC TANK C 10' FROM FOUNDATION; 50' TO WELL WELL (_)DIMXNSIONS TO PROPERTY LINES (LOCATION OF SERVICE CONNECTION (7,�MIN 15' TO PROPERTY LINE SL_ OPE (—)SLOPE IN SSTS AREA 4 At A(520 %) C_)L,jIFEGRADED TO 15 %, IF REQUIRED / DOSE/PUMP SYSTEMS (_) PUMP NOTES DOSE 75% OF PIPE VOLUME/DOSE ETAIL FOR FORCE MAIN, (PIPE T AND D -BOX SHOWN & DETAILE 1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN UUS: NDPEP , ' BOTH SIDES, DETA (_)(_)15' CDS >5 %, 20' -4 %, 25' -3% C___)C_)20' ISCHARGE /100' with _) _)10' to NON - PERFORATED PIPE VOLUME NOTED YPE, ETC.) D IL ,35'46/6, 100%-<l% 182 cons day discharge Pump VC-5 16)v PLASTI(- FOA, MAIW L' �-CV C! GEC VALVE- 'I, GATE Vi4LvE 354, 4 Id LUV 0 5UlaillEg-5MLE EFrLVEVVT Pvvt.\f M005-1- \AbtC>7�4 vvi-ro, lit C.) 1, 3 ------------ q 5UlaillEg-5MLE EFrLVEVVT Pvvt.\f M005-1- \AbtC>7�4 vvi-ro, I t. APPLICATIONS Specifically designed for the following uses: • Homes Farms . • Trailer courts • Motels Schools Hospitals Industry • Effluent systems SPECIFICATIONS Pump: • Solids .handling capabilities: %Q maximum. • Discharge size: 2" NPT. • Capacities: up to 128.GPM. • Total'heads up to 123 feet TDH. • Mechanioai seal: silicon carbide - rotary seat/silicon carbide- stationary, seat, 300 . series-stainless steel metal parts, BUNA- N-elastomers, • Temperature; 1041(40 °C) continuous 140 °F (60 °C)' intermittent. • Fasteners: 300 series, stainless -steel. • Capable of running dry without damage to components. Motor: • .Single phase: 'Is HP, 115 or 230 V 60 Hz, 1750 RPM; '/2 HP, 115 V, 60 Hz, 3500 RPM;'' /2 HP —11/2 HR, ' 230 V, 60 Hz, 3500 RPM. Built -in overload with automatic reset. Class BInsulation. 4% 100A • Three phase:'' /2 HP — 1'/2 HP 200/230/460 V, 60 Hz, 3500 RPM. Class B insulation, overload. protection must be provided in starter unit. • Shaft: threaded, 400 series stainless steel. • Bearings: ball bearings upper and lower. Power cord: 20 foot standard length (optional lengths available). Single phase: % and' /2 HP. =16%3 SJ70 with three prong plug. % -1'/2 HP -14/3 STO with bare leads. Three phase:' /2 -11/2 HP -14/4 STO with bare leads. On CSA listed models - 20 foot length SJTW and STW are standard. Mmmmmmm . 0Sak'SENNNI 70 20 . ° so 5 -L- � gg 15 ' 50 Q 40 J OR 10 3o E Goulds Oft mersibl fiflue.nt Pump.. 3885 CANADIAN STANDARD ASSOCIATION S P FEATURES Impeller: Cast iron, semi;.. open, non -clog with pump - out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as an option. Casing: Cast iron volute type -for maximum efficiency. 2° NPT discharge adaptable for slide rail systems: Mechanical Seal: Silicon. carbide'vs.'silicon carbide sealing faces. Stainless steel metal parts, BUNA -N elastamers. Shaft: Corrosion- resistant stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accide'ntal'reverse rotation. Fr CAPACITY Motor: Fully submerged in high- grade turbine oil for lubrication and efficient heat transfer. Designed for Continuous. Operation: Pump ratings are' within the motor manufacturer's recommended working iimits,, can be operated continuously without - damage. Bearings:.Upper and lower hearty duty.batl'bearing construction. Power'Cabie: Severe.dury: rated, oiland water resistant. Epoxy seal on motor end• provides secondary moisture . barrier in case of.outer jacket damage and to prevent'oll wicking. ' 0 -ring: Assures positive sealing again st.contaminants and oil leakage. S RIES1885 SIZE: W SOLIDS RPM: VARIOUS 80 '90 100 110 120• - 130GPM m 31 lilj file• I-- I i( I' I. i; Item. No. Description 1 Impeller 2 Casing 3 Mechanical seal 4 Shaft 5 Motor 6 Bearings - upper and lower 7 Power cable 8 0 -ring WE0311 L 36' 115 60 9.4 98 WE0312L 48 77 � 230 4.7 1750 56 WE0311 M 92 115 '.45 75 9.4 WE0312M . 67 230 1 -09 1 4.7 35 . WE0511 H 115 5.8 13.0 .102 WE0512H 40 230 6.5 47•' _ WE0538H 94 200 AC 3.9 WE0532H . 23Q nc CA 3 3.4 WE0534H • 460 Y2 1.7 ' 60 WE0511HH 115 13.0 OEVI 512HH 230 ' 1 6.5 WED538HH 200 3.8 WE0532HH 230 3 '3.3 WED534HH 460 1.65 WE0712H 23.0 10.0. WE0738H Y 200 .1. 62 WE10732H 208 -230 3 WE0734H 460 .5.4 3500 2.7 WE1012H 230. 1. .12.5 70 WE1038H 1. 200 8.1 WE1032H 208-230 3 7.0 WE1034H 460 3.5 WE1512H 230 1 15.0 WE1538H 200 10.6 WE1532H 208 =230 3 9.2 WE1534H 1 1 460 . 4.6 80 WE1512HH 230 1 15.0 WE1538HH 200 10.6 WE1532HH 208 -230 3 9.2 WE1534HH 460 4.6 . METERS FEET ' 120 MODEL: 3885 35 1' ^ SIZE: W SOLIDS 30 1 25 � 20-- 15 10 5 L■ ■ Pr 9 k .a� .'' " r:' s9 • Order WE0512H WE0712H WE1012H WE1512H WED512HH WE1512HH N0. WE0530H W8138H WE1038H WE1638H WED538HH WE1638HH WE0311L WE0311M WE0532H WE0732H WE1032H WE1532H WED532HR WE1532HH WE0312L WE0312M WE0534H WE0734H WE1034H WE1534H WED534HH WE1534HH HP % . % '/z . 3/ 1 1 Y2 %2 1'/2 RPM 1750 1750 3500 ' 3500 3500 3500 3500 3500 5 - - - - - - .60 10 80 65 - - - 56 84 20 36' 45 60 83 . 98 122 48 77 ` 25 25 . 50 76 92 116 '.45 75 ' 30 .. '38. ' . 67 85 1 -09 40 72 35 . 26 5.8 78 .102 35 .70 40 15 47•' 70. 94 30 6 AC nC an OC nc CA 52 55 17 . 42 - 3 21 46 DIMENSIONS (All dimensions are in inches. Do not use for construction purposes.) D' 'K q,.% and 1 HP =15' except for model WE0712H and WE1012H =18';1 %HP =18' ' ` KICK -BACK to EFFLUENT EJECTOR SYSTEM o Effluent ejector system Package Includes: offers ease of ordering. Submersible Effluent Pump WE0311L. o and installation. A single 12L or WE0311M;12M, WE0511HH,12HH A 0 Mercu ordering number specifies ry Level Control. Switch o • a0 20 30 40 50 60 70 .80 so •100 QPM. A2.5 (115 , V-B (23011) a complete system designed ( o:10 ' ^^ Friction Loss. -, PLASTIC PIPE: , FIAICTION LOSS PER 100 FT: 2" 21 /2n 3" 4" V 8" 10n. GPI GPH Ft, lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Ltis. Ft. Lbs. Ft. Lbs. 6 360 .10 .044 8 480 .17 .073 10 600 :25 .108 .11 .046 15 900 .52 .224 :22 .094 20 1,200 .86 .375 .36 158 .13 ..056 ' 25 1,500 1.29 .561 .54' .234 .19 .083 30 1,800 1.81 .786 .75 .327 .26 .114 35 2,100 2.42 1.05 1.00 .436 .35 .151 .09 .041.- 40 2,400 3.11 1.35 1.28 .556 .44 .191. .12 .052 45 2,700 3.84 1.67 - 1.54 .668. .55 .239 .15 1 .064 50 3,000 4.67 2.03 1.93 .839 .66 .288 .17 .076 60. 3,600 6.60 2.87 2.71 1.18 .93 .406 .25 .107 70 4,200 8.83 .3.84 I.K. 1.59' 1:24 .540 :33 � .143 80 4,800 11.43 4.97. 4.67 2.03 1.58 .687 .41 :180 90 5,400 14,26 .6.20 5.82 2.53 1.98 .861 .52 .224 100 6,000 7.11 3.09 2.42 1.05 .63 .272 .08 .036. 125 ' 7,500 10.83 4.71 .3.80 1.65 .95 .415 .13 .055 150 9,000 5.15 2.24 1133 .580 .18 .077 175 10,500 6.90. 3.00 1.78 774 :23 A2 200 12,000 { 8.90 3.87 2.27 ! .985 .30 .130 250 15,000 i i 3.36 ! 1.46 ; .45 .195 .12 .051 300 18,000 i I 4.85 2.11 .63 i .275. 17 .072 350 21.,000 6.53 2.84 .84 .367 ' .22 1 .095 400 24,000 { i j i . ' 11.08 .411 ! 28 121 } 500 30,000 y ;. 1:66 i .720 1 .42 .182 .14- 059 550 .33,000 j I 1 1.98 861 50 219 .16 .071. 600 • ! 36,000 r' i I 1 ! 2.35 1 1.02 i .59 .258 .19 I .083 700 4000 i j { I i 79 143 .26 .112 80.0 1 48,000 .1.02 443 .33 ,143 900 ; 950 1nnn I 54,000 i ! ! 1.27 I .554 57,000 {,. _ i i . cn nnn .41 .179 . .46 .198 - n [UNAy. Sizeof Fittings, Inches 1/2" 3 /411 1° 11/4° 11/1 2" 21 /2 3n 411 5" 611 811 1017 900 Ell 1.5 2.0 2.7 3.5 4.3 5.5 6.5 8.0 10.0 14.0 15 20 25 450 Ell 0.8 1.0 1.3 1.7 `2.0. 2.5 3.0 3.8 5:0 6.3 7.1 9.4 12 LongSweep Ell 1.0 1.4 1.7 2.3 2.7 3:5 4.2 52 7,0 9.0 11.0 14.0,. CloseReturn Bend 3.6 5.0 6.0 8.3 10.0 13.0 15.0 18.0 24.0 31.0 37.0 39.0 Tee - Straight Run , 1 2 2 3 3 4 5 Tee -Side Inlet or Outlet 3.3 4.5 5.7. 7.6 9.0 12.0 14.0 17.0 1 22.0 27.0 31.0 . 40.0 GlobeVaive Open 17.0 22.0 27.0 36.0 43.0. 55.0 67.0 82.0 110.0 140.0. 160.0 220.0 AngleVaive Open 8.4 12.0. 15.0 18.0 22.0 28.0 33.0 42.0 58.0 70.0 83.0 110.0 Gate, Valve -Fully Open 0.4 0.5 0.6 0.8 1:0 1.2 1.4 . 1.7 2.3. 2.9 3.5 4.5 CheckValve (Swing) 4 5 7 9 . 11 13 16. 20 26 33 39 52. 65 CheckValve (Spring) 4 6 8 1 12 1, 14 19 23 32 43 58 Euample: (A) 100 ft. of 2" plastic pipe with one (1) 900 elbow. and one (1) swing check valve. 900 elbow - Equivalent to 5.5 ft. of straight pipe Swing Check - Equivalent to 13.0 ft. of straight-pipe 100 ft. of pipe - Equivalent to 100.0 ft. of straight pipe 118.5 ft. Total equivalent. pipe Figure friction loss for 118.5 ft. of pipe. (B) Assume flow to be 80 GPM through 2" plastic pipe. 1. Friction loss table shows 11.43 ft. loss per 100 ft. of pipe. 2. In step (A) above we have determined total feet of pipe to be 118.5 ft. 3. Convert 118.5 ft. to percentage; 118.5 = 100 =.1.185. 4. Multiply 11.43 x 1.185 13.54455 or 13.5 ft. = Total friction loss in this system. BADEY & WATSON LETTER of TRANSMITTAL Surveying & Engineering, P.C. 3063 Route 9, Cold Spring, New York 10516 Date: 24 Apr 2002 (845) 265 -9217 (914) 628 -1800 (914) 739 -3577 File No. 80- 153.03 (845) 225 -3312 FAX (845) 265 -4428 W. 0. # 14787 RE: Proposed SSTS Aiken TO: Bell Hollow Road Shawn Rogan Klondike - II . Subd. Lot No. 3 + Putnam County Department of Health Tax Map 51.4-5 Permit # 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS -NIGHT ❑ MESSENGER ❑ UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN UPS -COD ❑ We are sending: copies date description of document F11 14- Apr -02 I lConstruction Permit for Sewage Treatment System �l Letter of Authorization ❑1 1 ___7 lApplication for Approval of Plans for a Wastewater Treatment System 1 24- Apr -02 = IShort Environmental Assessment Form ❑ F-1] 124-Nov-99= IDesign Data Sheet ® 24- Apr -02 = ISeparate Sewage Treatment System Sheet 1 of 1 ❑1 22- Mar -02 Pump data & info ❑2 24- Apr -O::1 IFloor Plans ❑1 124-Apr-02 —77 jApplication to Construct a Water Well [—I] I 10- Apr -02 jApplication Fee - $300.00 money order REMARKS: Signed: John P. Delano, P.E. Copies to: File 69)6 Z0'd X101 4J A IN P11VA CA—J U I 1 b 1.01L.A 1'Y104, 1 IV 11.41 V 1 vl lbLad A.L.i A.&.& TIVISTU"'N OF ENVIRONMENTAL HEALTH SERVICES LETTER Of AUTHORIZATION RE: Property of _ ._.., _._ Sears & Karen Aitken Located at.. Bell Hollow Roast '1 /V Putnam Valley Tax Map # - _........ S1 IIlock.- _ _ I-- ....._ Lot 5 & 6 Subdivision of Klondike 11 Subdivision Lot # _.._.__- ....._.__ . ..... Filed Map # 13107. Date Filed �P� 15,1981 Gentlemen: This letter is to authorize.-- ._......_. .➢ohn P. Delano, P.E. - - - - -_ a duly licensed Professional Engineer X or Registered Architect --- to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the :Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this smatter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code, �• Countersigned: _._..__ .062505 _.._._..._._. 1Vlailinb Address Baadey & Watson, P.C. 3063Route 9 Cold ,Spring State New York _— - -Zip — 10516 Telephone: 845- 265 -9217 Mailing Address: _ 400 East 84th Street, Apt. 21A State Telephone: New York New York Zip 10028 -56]11 212- 230 -1518 Form LA -97 1 l ale LEI �,A 1al! b�,8n1 LL9L Q10N xe.� JKSOd TO /To d Sd `NOSIUM I A3QdS 62:ZL Z00Z- 01-8dU a ouoed a 8U0gCj (y.��/�''i • /�' •off •iaaaPOp Qi g�9'1a� Wo�� lid of Mailing Address: _ 400 East 84th Street, Apt. 21A State Telephone: New York New York Zip 10028 -56]11 212- 230 -1518 Form LA -97 1 l ale LEI �,A 1al! b�,8n1 LL9L Q10N xe.� JKSOd TO /To d Sd `NOSIUM I A3QdS 62:ZL Z00Z- 01-8dU DIVISION OF ENVIRONMENTAL HEALTH SERVICES 0ldy`�� vl FINAL SITE INSPECTION n rrt Date: a LU t Inspected b Street Location1�(ow F2�` Owner /� kph p y �s� Town Permit # TM # (, 1 - S �G Subdivision Lot # k a 4-7 1. Sewaze 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 ...... ............................... Sewage Systems a. Septic tank size - 1,000 .......... 1,250 ......... other ... .......... b. 'S eptic'tank installed level ................................................ c. 10' minimum from foundation ....... ............................... d. Distribution Box 1. All outlets at same elevation -water tested .......:......... 2. Protected below frost .................. ............................... 3 Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set...........' .......................... 6. Trenches 1. Length required ' �fOQSLeng h ips alled 2. Distance to watercourse measured PU11 t.......... 3. Installed according to plan.: ....... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property he - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1'A" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends ca ed ....... .......... I....................... g. Puma or Dose ystems 1• r 1. Size of pump chamber........... ..... � ` .. . .......................... 2. Overflow tank .............................. . ........................!?4 3. Alarm, visual / audio ..... ........... .:.. . ... ....... .................... 4. Pump easily accessible, manhole to grade ................. S. 5. First box baffled................. � 6. C�� yycle witnessed by H.D.estimated flow /cycle.........,. C,1 House/Building a. House located per approved plans ........................:... b. Number of bedrooms ............... ............................... . IV. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured du ' - ft........... c. Casing 18" above grade ................ .............:................. d. Surface drainage around well acceptable ........................ V. Overall Workmanship . a. Boxes properly grouted .................. ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box .............................. . ... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan .\ I Curtain drain outfall protected & dinto exist watercour; g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ........ :........................ i. Erosion control provided .................... I.......................... Rev. 12/02 COMMENTS / e., `' a SITE INSPECTION FOR FILL ]PAID Date: Inspected by: Fill pad located per the approved plan Fill Pad Length Required Length Fill Pad Width Required Width Fill Pad Depth Required Depth Run -of -Bank Fill Quality Slope from Top to Toe Impervious Layer Installed Erosion Control Installed Sieve Test Results (if applicable) Additional Comments: Reserved for Field Sketch if Applicable PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART I - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) SEQR 1.APPLICANT /SP6NSOR 2. PROJECT NAME Karen & Sean Aiken Aiken 3. PROJECT LOCATION: Municipality Putnam Valley County Putnam 4. PRECISE LOCATION: Street Address and Road Intersections, Prominent landmarks etc -or provide map 149 Bell Hollow Road 5. IS PROPOSED ACTION ® New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: Construction of a new 4 bedroom residence, septic system & well 7. AMOUNT OF LAND AFFECTED: Initially Q acres Ultimately <2 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ® Yes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) 1-1 Industrial ❑Commercial ❑Agriculture ❑Park /Forest /Open Space. Other (describe) ® Residential single family houses on 2+ acre lots 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ® Yes ❑ No If yes, list agency name and permit I approval: Town of Putnam Valley - building permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ElYes ® No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ❑ Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /Sponsor Name John P. De no .E., Engineer for applicant Date: 4/24/2002 t Signature IIf the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART 11 - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? F] Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be uperseded by another involved agency. Yes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: F— /Vo C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: At D C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: IMo C4. A communitys existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: fio PO C5: Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: –p y .. cn C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: 7- �G� C � C7. Other impacts (including changes in use of either quantity or type of.energy? Explain briefly: F_ D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL- ENVIRONMENT4 AREA CEA ? If es, explain briefly: ❑ Yes . o E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ex lain: E] Yes No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and.adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination. pn Name of Lead Agency Date rint or Type Name of sponsible Offter in Lead Agency Title of Responsible Officer t l I, Als _Oj ' T Signature oyReS_Po4sibI4 Officer in Lead Agency Signature of Preparer (If different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: 2. Name of project: Aiken Karen & Sean Aiken 400 East 84th Street, Apt. 21A New York New York, NY 10028 3. LocationT/V: Putnam Valley. 4. Design Professional: John P. Delano, P.E. 5. Address: Badey & Watson, P.C. 6: Drainage Basin: Hudson River 3063 Rt. 9, Cold Spring, NY 10516 7. Type of Proiect: X Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one )________ _____ _________________ Type Exempt Type H Unlisted -K 9. Is a Draft Environmental Impact Statement (DEIS) required? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ No 10. Has DEIS been completed and found acceptable by Lead Agency? _ _ _ _ _ _ _ _ _ _ n/a 11. Name of Lead Agency Putnam County Department of Health 12. Is this prof ect in an area under the control of local planning, zoning, or other officials, ordinances? --------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- Yes 13. If so, have plans been submitted to such authorities? -------------------- _ _ _ _ No 14. Has preliminary approval been granted by such authorities? n/a Date granted: n/a 15. Type of Sewage Treatment System Discharge _ _ _ _ _ _ _ _ _ _ surface water X groundwater 16. If surface water discharge, what is the stream class designation? _ _ _ _ _ - _ _ _ _ _ _ - n/a 17. Waters index number (surface) --------------- ----------------------------- n/a 18. Is project located near a public water supply system? ----------------------- No 19. If yes, name of water supply n/a Distance to water supply n/a 20. Is project site near a public sewage collection or treatment system? _ _ _ _ _ _ _ _ _ _ No 21. Name of sewage system n/a Distance to sewage system n/a 22. Date test holes observed 23. Name of Health Inspector 11/99 A. Stiebeling 24. Project design flow (gallons per ay) ______ _______________ __________ ___ ___ 800 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required?... No 26. Has SPDES Application been submitted to local DEC office? --------------- n/a Foam PC -97 27. Is any portion of this project located within a designated Town or State wetland? Yes 28. Wetlands ID Number-------------------------------------------- ---- -- n/a 29. Is Wetlands Permit required? ------------------------------------- - - - - -- No Has application been made to Town or Local DEC office? ------------------ n/a 30. Does project require a DEC Stream Disturbance Permit? --------------------- No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ------------------ 11 IC n/a Yes/No . No 33. Is there a local master plan on file with the Town or Village? --------------- 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ?___ ____ ____ __________ 35. Are any sewage treatment areas in excess of 15 %slope? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes No 36. Tax Map ID Number ------- --------- ---------- - - - - -- Map SI Block 1 Lot 5 37. Approved plans are to be returned to _ _ Applicant X Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC W tgrs4o shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project ma u�EP approval of the SSTS prior to final approval by the Department. Projects within the waters �o pp p require DEP review and approval of other aspects of a project, such as stormwater plans or th�creOti�M impervious surfaces, and the project applicant should obtain the appropriate forms for such ac`tivitiea #,d@ 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 applia tiommst be accompanied by a Letter of Authorization (Form LA-97). Failure to comply with this provisi may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A. misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: Badey & Watson, P.C. Mailing Address: --------------------- 3 063 Route 9 Cold Spring, NY 10516 2 . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Karen & Sean Aiken Address 400 East 84th Street, Apt. 21A New York Located at (Street) 149 Bell Hollow Road Tax Map 51 - Block 1 Lot 5 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA Date of Pre - soaking 11/23/99 Date of Percolation Test 11/24/99 Hole No. Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (Inches) Start - Stop Water Level Drop In Inches Percolation Rate Min/Inch C 1 1:30 1:33 3 19 — 22 3' 1 C 2 1:33 — 1:36 3 19 — 22 3 1 C 3 1:36 — '1:42 6 19 — . 22 3 2 C .4 1:42 1:48 6 1 19 22 3 2 C 5 1:48 — 1:54 6 . 19 — 22 3 2 D 1 2:10 2:15 5 19 -. 22 3 2 D 2 2:15 2:20 5 19 — 22 3 2 D 3 2:20 2:25 5 19 22 3 2 D 4 2:25 2:30 5 19 22 3 2 D 5 2:30 . — .2:35 5 19 — 22 3 2 1 — — 2 3 — — 4 F571 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole..(i.e. < 1 min for 1 -30 min/inch, < 2 min for 31.60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 4 G.L. Topsoil 0.5' V 1.0 ]Fine sandy loam 1,5' with gravel, 2,0' cobbles, stones. & 2.5' occ. boulder 3.0' I 3.5' I 4.0' 4:5' C/7 5.0' I 5.5' I 6.0' I 6.5' I 7.0' V 7.5'' 8.0' 8.5' 9.0' 9.5' 10.0' HOLE N0. 5 Topsoil V Fine sandy loam with gravel, cobbles, stones & occ. boulder V HOLE NO. 6 Topsoil V ]Fine sandy loam with gravel, cobbles, stones & occ. boulder i rn , I � rr Cn. C/7 Indicate level at which groundwater is encountered not encountered Indicate level at which mottling is observed not observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: ,1.1Delano,ll &W,S &E PC; A.Stiebeling,PC DH Date 11/99 Design Professional Name: John P. Delano, P.E. Address: ]Badey & Watson, P.C. 10 1. 3063 Route 9; Cold Spring, NY 10516 � Signature: Design Professional's Seal I .e. �IR '4ko, 2" PLASTIC FORCE MAIN NAIL SET IN TREE 20" HEMLOCK `I e Well m Rio' Flog Stone Ent. 3 Story Frame Dwelling No, 155 1250 GAL. CONC. PI 4" PVC - 1500 GAL. PRECAST CONC. SEPTIC TANK Wood Deck CIP 13 Etec.Sox ,E /ea Meter 0 1 Story C%ge (Under Construction) 1 ■ t i 1 I i REVISIO in I DATE DESCRIPTTO 08/18/04 ORIGINAL DRAWING BADI SURVEYING :n :V PUTNAM COUNTY DEPARTMENT OF! DIVISION Of ENVIRONMENTAj HEAL' CD /r � -14 APPROV Ns NDTED FOR CONFORI APPLICABLE RULES AND REOULATI( 2 Story Garage (Under Construction) AS -BUILT RELOCATION- DIMENSIONS to 23.5' SEPTIC TANK 1B 29.3' SEPTIC TANK 2A 24.0' SEPTIC TANK 2B 36.0' SEPTIC TANK 3A 1 26.3' PUMP TANK 38 41.7' PUMP TANK 4A 29.7' PUMP TANK 4B 46.0' PUMP TANK 5E 44.7' DISTRIBUTION BOX 5F 76.6' DISTRIBUTION BOX 6E 46.0' BEGIN LATERAL 6F 74.0' BEGIN LATERAL 7E 47.3' BEGIN LATERAL 7F 66.9' BEGIN LATERAL BE 51.0' BEGIN LATERAL 8F 61.9' BEGIN LATERAL 9E 55.3' BEGIN LATERAL 9F 55.1' BEGIN LATERAL 10E 60.0' BEGIN LATERAL 1OF 49.6' BEGIN LATERAL 11E 50.3' j END LATERAL 11F 68.1' END LATERAL 12E 55.0' END LATERAL 12F 63.7' END LATERAL 13E 61.0' END LATERAL 13F 59.7' 1 END LATERAL 14E 65.5' END LATERAL 14F 56.1' END LATERAL 15E 71.2' END LATERAL 15F 53.0' END LATERAL WC 72.4' WELL WD 43.2' WELL ALTERATION OF THIS DOCUMENT, IN ANY WAY, BY ANY PERSON, NOT UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER OR LAND SURVEYOR, AS APPROPRIATE, IS A VIOLATION OF THE EDUCATION LAW OF THE STATE OF NEW YORK 3 Story Frame Dwelling No. 155 NAIL SET IN TREE 15' BLACK BIRCH E