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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51. -1 -54 BOX 21 I I ro f owns& ol �� lair 16 - ', C. �r L I �l 02493 0 UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION..OF ENVIRONMENTAL. - HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD C�ONN,STRUCTION PERMIT # PV —/ 3 - O `/ Located at PoAnm i eo 24 X T. Town or Village 4 �y .� 'Vc C c Y � Owner /Applicant Name xlL *w. 4.1 i e-r Q!of. rax Map `rl Block Lot s' y Formerly Subdivision Name _%d#q0 / ,Vfi .06 sT o,✓ 7VE &Wr Subd. Lot # / Mailing Address 01 ll ATk- sh(041- " Zip Date Construction Permit Issued by PCHD bahr Separate Sewerage System built by 0 AinClivn Cjw- T Address Got T[,4,o -g 94vu 4 Consisting of .SO Gallon Septic Tank and ySU L. F /96So2loTi o..� 7X c vc-11 L /', p Ur9C O/c &wR Chc,_n d.F_,t Other Requirements: f' (1. 0 6, k 6449 -f' d */12 i£ k Water Supply: Public Supply From Address or: Private Supply Drilled by M&1-9•v Ayysow -T.. c Address �i, �.,•g C/� / /�y :BuildingTy"pe : Has.erosion control. been completed? Number of Bedrooms q Has garbage grinder been installed? /V 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: Certified by P.E. R.A. Address 66 47 SS 0C, < G�� /- (Design Profession License # Q,1 r,Swf a93 �,...,� / ad � Sw �c Zo 3 , So r• E.C,$ �y os g"9 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: Date: 02 / 7 o 7 e copy - HD File; Yellow copy - Buil mg Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OFD ENVIRONMENTAL HEALTH SERVICES GUA TEE! OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block: Lot 1444 l o,PW,- Building Constructed by Town/Village Location.- .Street Subdivision. Name S 7DO �W^5'J Building;Type Subdivision'Lot # '. I represent that I am wholly and completely responsible for the location, .workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed;as shown on the approved plan or approved . amendment thereto, and in accordance with'the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate '!for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, :except where the failure to operate properly; is caused by the willful or negligent act of the occupant of the building utilizing the 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: ' Mo h Day 013 Year 0100 7 General 6ontractor (Ow er.) - Signature Corporation Name (if corporation) Address: State 8� ,7 �' Zip Corporation Name (if corporation) Address: c Out. State zip 1 as 7 Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION _OF. ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT t�1�^W`��eIIP� e��if■ t�'# A'dh'�� 1 ,SA.�'1..^ m "a w"ViN�n :Alu Laum�.3A. �Y.11 Well Location Street Address: j / Y O 401-e Town/Village: V `t (rt Tax Map # / Ste, G MapS /1 Block Lot(s)' . P Well Owner: Name: Address: C� 44 c r1 ti00 `�t, � p a�n O- e—avl fre' AL414 402 [V Use of Well: 1- Primary 2- Secondary _residential _Public Supply Air cond /heat pump _Irrigation Business Farm Test/monitoring —Other(specify) Industrial Institutional Standby Drilling Equipment rotary _Cable percussion Compressed air percussion Other(specify) Well Type Screened !,n a end casing _ Open hole in bedrock Other Casing Details Total Length 2.3 - f t Length below gra At ft. Diameter �n. Weight per foot IS lb /ft Materials: Steel Plastic Other' Joints: Welded L.-Threaded Other Seal: t�ment grout Bentonite Other Drive shoe: Yes _ No Liner: _Yes "o Screen Details Diameter in Slot Size Length ft Dept to Screen ft Developed? First _Yes _No Hours Second Well Yield Test _Bailed _Pumped ompressed Air Hours �%f Yield ( gpm Depth Date Measure from and su ace -scat c (spec .36 During yield test Depth of completed well In ft. �00. 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 If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type li "rcr r- Capacity C Depth Modell Voltaae HP #10 Tank Type QA- �d Volume /o f :w"S .wll 8GN k r DatetWell�jCornpleted" WT i!. "x"Y R V ..v�S t "F .,SE 5 1. SAM: k�ff i'�' ��s. .dv .e +.gym., *. �,: i WeII,Driller , ;). D,"pWx, �1 f4 j.y2fi k^}}'{i33` P u x ..., <.. .i +_,..... r .. kR: hS Y ._ .f� �r.k�r PC;CertiflcaI�te# Ot' 7 NYState #rl.ad6% a ,"F+k:3lY` # RR P) 'yxk Y" 1 r •! : ! :..II i1K Rk •x -' yl 1 'y' -!' IC.:. i'x+ KI y,nr £....0 Ka"("N�F?Y4 �, .. -_ ,..�. , .., ..... ,, x•x� �� [ `� P 11 'f 1 Date"�ofARepo{tl,,�w g� r. YMYI MR" „ fN'Y� % '��.I IN�, r. 1'��Y r l� N t 2, 1'a i g.. ::. "� �.x #, U,$ 1 C 0 , ... �.•. �3� Well :*•_ , kN"P. '. y rx' �: Wy..i'.K' 'YK'".,D ?fi +alk', aR .K 4 �f - �.v AIM, N �R .y:. Jll�ii ".,"NtG.N.,_ x,. j{. 1�'£'x .'!��A�T�._ v3.. �hP 'i?» 3 .r 'S>CA,'Jl k "N?...6Y'' y u`f„�` i` !+^` �3'i, 3- � /` j � x} R ell Drtller� (sig`° cure) ye _ y �{� "•.�1,Jy'� 1�t Yr � � wM, lii l�Y���'T'lA �•'1�.0 ... ... �� ... 'n , nsta er �.. ..Me> Y Pu Ill Name 8►Address W > y �� it w.,u'mptlnstaller 'd`K 5 �.:.M =.�F aat .:..:�4"'S �; ...�'� :;�R.R x�J� x. ..:.,., � t,.:,..,.r �. 5:.: "�:.�' 1: s�.e �x...' .AE'.., ..5�,' .� `:. aS,x 1°y'�:� �,�i> 3xa•,.v `S +y S C4.� i� •r' Y S k y "} ,k 4 `kk k'r : �� �: �e.i,x� d ,'� v Cf'vd �i 5F 'K c.''�.•� T i''!i.+ �4� l� 4'E F. �b �y"`�k,•u', �1Y.1� �Y\ �' �,'�.�R ,3� } � ?: 5 . !S^.sk'�r t "�`«a".T»,."4":.�SR. ¢ ' ux »,>.d. ..�;cs sv.,.xm •.. 1.. >.n.a:� ."a E&'K�>�w's� S:cax.i�'iOa'M�k* ��r`::.�4„�w,.s".,..,R .an k k''S .. signature) .is. �° ��i',.: }�l£��"oa... R t�'�:,., M44y�S.MTi�y:T1 �,.. �,7�^ ^�� �. ,���, ,.:. 'T�yfi. . .. ,. �.. �.^�n�' ��•r..M!1(�'w �'Im �.v.. N. .�� � .y, Y`p��AK'q .�lw.C' ik� a ex. ���C '1:�Sa NOTE: Exact 1- cation of well with dis ances to at least two permanent landmarks to be p ovided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health OWNER'S NAME: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 E911 ADDRESS VERIFICATION FORM v TAX MAP NUMBER:- E911 ADDRESS: TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) DATE: ROBERT J. BONDI County Executive 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. E911 addressverification 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 TOOe IRLSS ON YH /Y11 TT :00 MU LO /L0180 "Of Var zoo if 1'L:O'L y14y4 /4J Jµ NYt15 r-PA2L 01 BY THIS CERTIFICATE OF COMPUANCE THE NEW YORK ELECTRICAL INSPECTION SERVICES 54 Noah Central Ave, Elmsford, NY 90523 CERTIFIES THAT Upon the application of.- Upon promises owned by: Pinto Electric - Mark Pinto AlOn Ortnor - 109 Menlo %ltionum 199 North Shore Road Rye, NY 10S93 Putnam Valley, NY 10579 LOtated at: 199 North Shore Road, Putnam Valley, NY 10M Application Number: 10064657 Corfficate Number: 10064657 Section: Block: Lot: 6OC: Ice Permit Number: A visual inspectlbn of the tNtlt:triGal syst m at this premise described as a Residential occupancy, wherein the premises Olactrk0l syStelm eonsistlng of STOCtriaal devices and wiring, descfibed below, locabed Inlon the premises at: 199: North Shone Road, Putnam Valley. MY 10579 Basement;Oulside. was inspected in accarrianip voth the MYS and UPPA 70-00 and tho detail or the inatalla i.r.o, as 9st forth below, was founded to be In compllance therewlth on the 02 Day of August 2007. Name f3st�e Qea:nt�ety 12at�g......,, . Ciec�uit ::.Z. pe AK S401C pmep smtion MOW up tp I hp � R Officer. Nick Morabl0o Thic oprlNtaalo may not hd altored M any w" and In wandritod only by the p mence of ralsod Seal at the bcatlon lnpioelad. This eoAH1006+ is vslib for weov pre4ormod tarlam dolt of inapegfdn only. wrtratoro 18 Fri d". August 03, 2007 -- - PrR+o 1 of 1 T - d 6EGL266�,T6 alesaT04M d dST =2T LO LO Znd YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 - - _. - 2800... '...�. �..- .. .� .r, -.. ': - Y.:m^�: r.:r.�w- �.v =.'•r: r ... .. ._ .. :..e .n •.. .� f:,Y' -": �:�i ^..2.S.w Albert H. Padovani, Director LAB #: 1.705853 CLIENT #: 60453 NON STAT PROC PAGE: 1 of 2 ORTNER,,ALAN DATE /TIME TAKEN: 10/22/07 12:15 568-.WESTBROOK DR DATE /TIME RECD: 10/22/07 01:15 CORTLANDT MANOR, NY 10567 REPORT DATE: 10/30/07 PHONE: (914)- 774 -5923 SAMPLING SITE: 199 N. SHORE RD PUTNAM VALLEY, NY COLD BY: ALAN ORTNER NOTES...: HOSE BIB ---- ~~~ ---------- ���������������������� DATE FLAG PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: <20 >40C COLIFORM METH: MF RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 10/2.2/07. MF T. COLIFORM ABSENT /100 ML ABSENT. SM 18 -20 9222B 10/24/07. LEAD. (IMS) <1 ppb:, .` 0-15--:p-Pb SM 18 -19 3113B 10/22,/07 _NI NITRAT'E NITROG 0::,53.-MG /L 0 - 10 . ' SM18- 204500NO3• 10/24%07 - NITRITE;;NITROG..,:. <0:01 MG /L ': 1.0 "MG /L SM18- 204500NO2 10/26/07 IRON (Fe)' <0.060 MG /L 0 -0.3 mg /l SM 18 -20 3111B 10/26/07,: MANGANESE (Mn)..; <0.010 -`MG /L 0 -0.3 mg /l SM 18 -20 3111B 10/26/07. SODIUM (Na). 4.15 MG /L N /A' . SM 18 -20 3111B 10/22/07 pH.. 5.7 UNITS 6.5 -8.5 SM18 -20 4500HB 10/29/07 HARDNESS,TOTAL 22.0 MG /L N/A SM 18 -20 2340C 10/29/07 ALKALINITY (AS 14.0 MG /L N/A SM 18 -20 2320B 10/29/07 TURBIDITY (TUR . <1 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: MFTC THESE RESULTS INDICATE THAT THE WATER (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 100 of their than 15 ppb and a treatment.must be potential. ablic 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 m cobined shall not.exceed:0.5.mg /L Na No limits for Sodium,-_,a.re 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 ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ._(914) 245 -2800 LAB #: 1.705853 CLIENT #: 60453 NON STAT PROC PAGE: 2 of 2 ORTNER, ALAN DATE /TIME TAKEN: 10/22/07 12:15 568 WESTBROOK DR DATE /TIME RECD: 10/22/07 01:15 CORTLANDT MANOR, NY 10567 REPORT DATE: 10/30/07 PHONE: (914)- 774 -5923 SAMPLING SITE: 199 N. SHORE RD PUTNAM VALLEY, NY COLD BY: ALAN ORTNER NOTES...: HOSE BIB SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: <20 >40C 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 LITER.:.._::_..:: _ HARD' WATER'l — YTO- 3-004.MG/L'._`.-- .'_-..- -(1- grain /gal di = -17:2 SUBMITTED BY: 3JU�4 Albert H. gadovani, M.T.(ASC ) Director ELAP# 10323 SHERLITA AMLER, MD, MS, FAAF Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joseph J. Buschynski, PE Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Buschynski: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Re: Construction Compliance — Ortner 199 North Shore Road (T) Putnam TM# 51 -1 -54 ROBERT .I. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health December 17, 2007 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. The well needs to be included as part of the as -built dimensions. Please locate the well from two fixed points. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to r -c n0e_t JSP /kly Very truly yours, ur C 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 13113130 ASSOCIATES LLP 293 ROUTE 100 - SUITE 203 SOMERS, NY 10589 (914) 277 -8210 FAX WE ARE SENDING YOU ❑ Shop drawing ❑ Copy of letter dCE44C Q @IF 4 ° ° tHMOCT 11�°� L DATE 7 DATE ATTENTION ..-- RE: '0Z r a y or " 74e e_ fir ❑ Attached ❑ Under separate cover via the following items: s • Prints ❑ Plans ❑ Samples ❑ Specifications • Change order ❑ COPIES DATE NO. DESCRIPTION - �r .� �� rte, s • lire., THESE ARE TRANSMITTED as checked below: For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As.requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ [:f FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS 'COPY TO SIGNED: H enclosures are not as noted, kindly notify u at once. SHERLHTA AMILER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARO, RN, i64SN Associate Commissioner of Health a, Bibbo Associates Attn: Ray Hamel Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Hamel: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 August 14, 2007 ROBERT J. BON ®H County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Ortner North Shore Rd. Ext. (T) Putnam Valley, TM #51 -1 -54 The results of today's pump test on the above mentioned property were satisfactory. The bedroom count was performed and the well inspection was done. There are no further concern : t :this- ime If you have any further questions, please contact me at (845) 278 -6130 ext. 2155. Sincerely, . JD:lm Joseph Digit Environmental Engineering. Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845)225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 08/07/07 TUE 04:32 TEL 914 277 8210 BRUCE R. FOLEY Public Health Director BIBBO ASSOCIATES LLP 44-+ PCHD 2001 • LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPART -WNT OF HEALTH 1 Geneva Road • ' Brewster, New York '10509 REQUEST FOR GELD TESTING. Al':CENTION: VIOSEPR PARAVATI ❑ GENE REED All information below must be fully completed prior to any scheduling, DATE: % ENGINEERORFIERM: 91913d, 19fasind'-. PHONE#: REASON: DEEPS: o - PERCS: ❑ P.UYT TEST: o—" ROAD /STREET: 4J' oyTu 5�►e2.c s-b� . f_Y,-g &3-, ,o a — TOWN: P v-%aAoA % -6V-V TAX MAP #: SUBDIVISION: i ozAbpt:!t r'�s�- at j -rNE 1-j9Kr LOT#: OWNER: va, w NYCDEP CMERI . FOR iYOM REVIEW AND 'WITNESSING OF SOIL TESTING . - -• YES TACO E3 ❑ CMS ❑ * r✓ D Proposed SSTS within the drainage basin of West Branch orBoyds Corner reservoirs. Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. Proposed SSTS within 200 feet of a watercourse or a DEC wetland. Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. Proposed SSTS for a Commercial Froject. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered yes to any of -the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field 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 NYCDFP 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. COUNTY USE ONLY TM- PUTNAM COUNTY DEPARTMENT OF HEALTH .� _ _, .- PI'VISION ®I ENVIRONMENTAL IiEA.T-LhI YIELD ACTIVI'T'Y REPORT AT A A A'T-' � a inRFS4: 1#0XTW ��L� �D xT. �l ir!/0i% VXLF(� -Ai ' .Street Town State Zip PERSON IN CHARGE 1 ) 4 0 7 I1O PUMP TEST DOSE TEST REQUIRED GALLONS 3 RFPQRT REC'ETVFn RY° , I acknowledge receipt of this report: SIGNATURE: 02/96 Title: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION 7 Z Date: ' �d/ %� _,.SSlar -� �� Inspected by Streot,g.ation ...... Town 91TWAtA V U- Permit # >V- 13 O TM # Sf — / Subdivision Lot. # 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. 1 00' from water course /wetlands............ 11 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. Junction Bog - properly set .......... ............................... 6.. Trenches 91 1. Length required .�_ Length installed 7 �!� 2. Distance to watercourse measured Ft...:...... 3. Installed according to plan ........................................ 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surfa.ce .................. 7. Room allowed for expansion, 100°/x ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum .......:........... 10. Pipe ends ca fed .:...................... .::..::.: ;.................. g. um'p br ose" Systems iZ 1. Size of pump chamber.........: 0.. �sto�.• ....................... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........... .............:.................. 4. Pump easily accessible, manhole to grade................. 5. First box baffled .......................... 6.............................. 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building . a., house locatedper approved plans ....................:......... b. Number of bedrooms ......... ............................... IV. Well Well located as per approved plans....... :...... b. Distance from STS area measured '1 ZO ft ........... c. Casing. 18" above grade .............................. : ................. d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate.... ....:.. ........................ i. Erosion control rovided ................. ............................... Rev. 12/02 �M es me M= WAN IWOM , WA= MAW ... 08/07/07 TUE 04:33 TEL 914 277 8210 BIBBO ASSOCIATES LLP PCED Z002 -ruDo [SL88 ON Xd /%Ll TT;00 MU LO /L0 190 Ial;i lys1, zutf r Ix: 5x '91gtlq 14=4 myr-Ao r'PA2L as Ap pEcation MItembeiro IWGMS7 Lot upon poa6ses owned by". Aga DMer - In menh share R"d P umam V0008y, MV, 9 asn calf m=2Z Number: I OWA657 mu¢a� Diem � �_ st n¢' �e - 9�vilclo f afL s ifPumpSDUUFI Mme uP V I nP y . . I Tmir. ccnVocao wivo tow bo ®ftmd Air Ohl? t=� mvsg to % mli M* Asp em wdoaRco om MMI Qt 0�0 DOW00" k0aftw wd. lml;, e®e9 OV& fs tulldf for waft Pmftesod MA" tuft aP 9s66- fal�ibt34�AB Y 1$ BRUCE" R.:1 OLSY.. Public Health Director ,associate Public Health Director Director of Patient Services DEPARTNffi'NT OF BEALTH 1 Geneva Road - .,:,Brewster, New York '10509 REQUEST FOR FIELD TESTING , ATTENTION: WIOSEPH PARAVATI ❑ GENE REED All information below must be fn!!y completed prior to any scheduling. DATE: -*-90-0-7 ENGINEER OR FIRM: 9, S Sa PHONE #: REASON: DEEPS: o • PERCS: ❑ PUMP TEST: a---- ROAD /STREET: Mee-ni SoceLe Sh t`xr �sraa TOWN: R rmAaA U ra,►.iz.V TAX MAP #: 45;71 - I " S�_�_ SUEDIVTSION: - ^d9D r,;sc, r =•r o" -rli g t-A K E LOT#: 1 OWNER: aL.At.i 4�-� .cam NVCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING r• YES NO ❑.: e'er - Pro osed SSTSwithinthedr-ainage basin of West Brinch or Boyds Corner Reservoirs. - ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ e Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ e'' Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. o a/ Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (,point or Delegated) based on the response. If you answered y_&-v to any ofthe questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field 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 NVCDEP is (required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR CorJM vSE orn y DATE: ME: r ro lrlAl(� (FIELDTEST) TOOK QHDd <-EF all Sa,LvIoossv OHSIS OTZB LLZ tT6 ZRZ CS :OZ MRS LO /6Z /LO SHEIl LRTA AMLER, MD, MS, FAAP Commissioner of Health Il 61ki t k RN, MSN Associate Commissioner of Health July 27, 2007 Joseph Buschynski, PE Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Buschynski: ROBERT J. BON®Il County Executive _.. -,r.. �-.... ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: Field Inspection — Ortner North Shore Rd. Extension (T) Putnam Valley, TM # 51 -1 -54 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected —in the field. 1. Please leave distribution box open for pump test. 2. Pump test, bedroom count and well inspection must still be performed. If you have any further questions, please contact me at (845) 278 -6130 ext. 2155. JU.kly Sincere , fti; Joseph Digit Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845)278 -6014 Fax(845)278 -6648 .. r DIVISION OF ENVIRONMNTAL HEALTH SERVICES' ATTENTION JOSEPH Q GENE REOI ST FOR FINAL INSPECTION For: Fill Ail information must be folly completed prior to any Trenches inspections being made. PC14D Construction Permit # '\1- 1 -o J Located: O a knk t%Hm- %*sa- f, a c `o'a (T) (V) Owner/Applicant Name: 66,a TM 5 Block ► Lot , Formerly: — _ - Subdivision Name: T2Aaiu4 atW, av,,F- Subdivision Lot # 1 Is system U. completed? Yr- 5 Date: Is system complete? �f- s _ Date: J- V- -e l- Is system constructed as per plans? `rte Is well drilled? S Date: -4-46,67X- Is well located as per plans? li�. S Are. erosion coutrol measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam 'County Department of Health. Date: /� PE X RA T esign professional Address: 9 93 flewXg. / .y, r� �a�_1_1�,, 9 Lic. # C�.S'"✓"g.2 9- Comments: 0,.�F s-riot15 VQ-> ed Form FIR -99 TOO in Wlr7d FEE d1l SUVInDom OSHIS OTZB LLZ M 'I9.L L0:4:b IIA,T. LO /A71L(1 , rt' ti D UTNAM COUNTY DEPARTMENT OIL' HEAL CONSTRUCTION PJI:JYOlYJLJlT Y' ®R NR Y Y A �.Y T19 17 A r� VVQ it �VA1 PERIYUT # PV - l� -a Located at & &MA OO -Z92� /?W1 Trmmlln Subdivision name fir_� Subd. Lot # Date Subdivision Approved z T M Owner /Applicant Name ®r -X�fce Town or Village bla Tax Map J—/ Block / Lot X-f- Renewal Revision Date of Previous Approval Mailing Address /S A� al t� cSd - e-1z9z AZZ Zip la.-5 W, 7 9 Amount of Fee Enclosed ee Building Type 12aa r&& Lot Area4 -,0. 9 No. of Bedrooms Design Flow GPD z96767 ]Fill Section Only Depth volume P CH D NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED it Seg grate Sewerage _System to consist of 1,2,f"® gallon septic tank and 4ft 46rAr" -o, Other Requirements: _ To be constructed by Z; g,12 , If Wzjg LSunbld: Public Supply From Address o1r: Private Supply Drilled by %,,�,,�, Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment ay stern tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. Date Address d�� /(¢��y'�S:. �L/�'�/aatp te- License # A, X 4 7eam A / /.r `"/97 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 pemlit. Approved for discharge of domestic sanitary sewage only. By: Title: Date: t opy - HD File; Yellow copy - Bu i ng Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health I ORETTA MOLINARI, RN, MSN Associate Commissioner of Health Bob Howe Bibbo Associates Mill. Pond Offices 293 Route 100, Suite 203 Somers, New York. 1.0589 Dear Mr. Howe: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 December 14, 2005 ROBERT J. BONDI County Executive Re: Approved SSTS — Ortner North Shore Road, (T) Putnam Valley TM# 51 -1 -54 The application for. the above referenced project has been approved by this Department. This application was received by this Departure t on October 27, 2004 and the review, comments, and subsequent review of resubmissions has been on- going. Since the application was received and reviewed prior to the change in bedroom count criteria (3/9105), the floor plans were reviewed based on the prior bedroom count criteria; resulting in a bedroom count of four. If the new criteria were applied, this house would be considered a six . - - �dreen,- ;si ar,c : Please be ad�fised t at if the >xpstairs. unfnis)led- attie'spact is finished, an addition application must be sent to this Department and the finished space would be considered 2 additional bedrooms, requiring an increase in the septic system. If there are any questions, please do,nothesitate to contact the writer at ext. 2157. cerely, V e'o l� Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj cc: Building Inspector, (T) PV Alan and Janet Ortner Environmental Health (845)27&6130 Fax (845) 278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (843) 278 -6026 WIC (845) 278 -6678 Nursing Home.Care Fax (845) 278 -6085 Early Intervention/Presebool (845) 278 -6014 Fax (845) 278 -6648 14 -16 -4 (11/95) —Text 12 PROJECT I.D. NUMBER 617.20 SEAR - - AQQet1dlX• -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) 1. APPLICANT /SPONSOR dIG o9 2. PROJECT NAME -TNT- 3. PROJECT LOCATION:: e D Municipality / ,06u1i o� iU�%%�f � County �(J 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) AF 1AqZ5Pd6Z-10N Al—' ,floAf *- J��/-157 goo /y�,/ 5. IS PROPOSED ACTION: RNew ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: DRIWO W01-1, A -A /0 S� 7. AMOUNT OF LAND AFFECTED: Initially /'!- 4-- acres Ultimately �� ¢ acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? AYes If No, No describe briefly yam❑ ,U SN/ xA -9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑ Industrial ❑ Commercial ❑ Agriculture XPark/Forest /Open space ❑ Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? .A Yes ❑ No If yes, list agency(s) and permit /approvals �tJTA1o� V"� 11. DOES ANY ASPECT OF THE ACTION HAVE 'A CURRENTLY VALID PERMIT OR APPROVAL? KYes ❑ No If yes,, list agency name and permit /approval Z12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes No 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /sponsor name- 4 Date: Signature: If the action is in the Coastal Area, and you are a state agency,. complete the Coastal Assessment Form before proceeding with this assessment OVER 1 yr 14? PAPT II— t?NVIRONMPNTAL ASSESSMENT (To be completed by Agencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCHR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. :�.�.� -•❑ Yes .. - - - - - - ~ - - B. WILL AOTIQN REdEIVE COORDINATED REVIEW AS PROVIDEb FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If 'No, a negative declaration may be superseded by another involved, agency. ❑ Yes 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's, solid waste production: 'or disposal, potential for erosion, drainage or flooding problems? Explain briefly: e- C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. - C5. Growth, subsequent development, or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in CI-05? Explain briefly. �lJf vN.. C7. Other Impacts (Including changes in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF'A CEA? Yes _ o E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes 12�No If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its .(a) setting (i.e. urban or rural);. (b) 'probability of oociurring;• (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. - Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: � � 1 G�.c'L�vc�. -f l � •l ✓ arne Lead Agency Title of Responsible Officer :'SignatuW of Responsible Officer in Icead Agency Signature of Preparer (If different from responsible officer) Z, -3 Date i! SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MO.LI.NARI, RN,. MSN Associate Commissioner of Health June 6, 2005 Bibbo Associates Mr. Bob Howe Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Howe: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: Proposed SSTS — Ortner North Shore Road, (T) Putnam Valley, T.M. #51 -1 -54 ROBERT J. BONDI County Executive , 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) Relocation of the driveway is acceptable to this Department. It now appears that all comments relevant to the septic.system have been addressed. The only outstanding comments are as follows: a. Top and bottom wall elevations need to be provided for the wall behind the b. The well can be moved out of the wetland buffer provided all separation distances to the proposed and existing septic systems on the adjacent lots are maintained. c. A 10 foot minimum label should be shown between the force main and the . water line. Once the above comments have been addressed, this Department is prepared to issue a permit for the SSTS and well once a valid town wetlands permit is. provided. 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:cw Very truly yours, 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 EM B o O A°- ` S MAT S 9 L.L.P. Joseph J. Buschynski, P.E. Consulting Engineers - Planners Timothy S. Allen, P.E _ - - ,- .... r ^....s.1+al.cO. n:. A •.r.�r. �: ;�+.:v �.:r...,, ` r . .. .. .. .. . .. � .r .Y C. Y� .a..rtd .s A f . .. .... ...�.. . ♦ .. _. October 27, 2005 Putnam County Department of Health 1 Geneva Road Brewster N.Y. 10509 Att: Joseph F. Paravati, Jr., Assistant Public Health Engineer Re: Alan Ortner SSTS Application North Shore Road, (T) Putnam Valley TM# 51 A -54 Dear Mr. Paravati: John P. McNamara, P.E. Robert A.B. Howe, B.S. Phys. Enclosed are 4 sets of the revised plans for the above referenced matter. I have also included, for reference, copies of the Mitigation Plan that was required for the Wetland Permit. In response to your letter dated June 6, 2005, we note the following: 1:.: VJe enclose_a.460yof .the Wetland '-P- edMt.Which- -w�s ap far -oved- by -the P- an mg= Board of Putnam Valley on October 24, 2. Top and bottom elevations for the proposed retaining wall at the rear of the building are now provided. 3. The well has been relocated and meets the required separation distances from all existing and proposed sewage disposal areas. 4. Required 10' separation between the force main and well line is now posted on the plans. A note has been posted on the plan indicating that "there is no existing or proposed sewage disposal system on lot 5 within 200' of the proposed well on- site." Since our last correspondence, a few additional modifications to the plans have been made at the request of the Planning Board, including: 1. Minor adjustments to the proposed house location to increase separation between it and the 100' wetland buffer. PLANNING / SITE DESIGN / ENVIRONMENTAL 293 Route 100, Suite 203, Somers, NY 10589 - (914) 277 -5805 - (914) 277 -8210 (FAX) - bibbo @optopnline.net 2. Addition of Stormwater Treatment — "rain gardens" — and additional mitigative measures. It was also agreed that the expansion area of the proposed sewage disposal system would not be seeded to lawn. Instead, it was required by the town that this area be seeded with a conservation seed mixture. The primary system will be seeded to lawn / meadow. Refer to the Mitigation Plan attached. 3. Extension of the clay barrier around the sewage disposal area between it and the existing local wetland. This was added at the request of the Town Wetland Inspector. 4. Enhancements along the boundary of the 100' Lake Protection Area (walls and planting). 5. A pathway and a floating dock have been added to the plans. All other aspects of the plan remain the same as previously submitted. We trust that the plans are acceptable and that you will issue a Permit for the construction of the Sewage Treatment System and proposed Well. Thank you for ,all your assistance with this matter. Sincerely, Bob Howe, Sr. Designer Cc: Alan Ortner, Wencl. PLANNING /SITE DESIGN /ENVIRONMENTAL 589 Route 22, P.O. Box 403, Croton Falls, NY 10519 - (914) 277 -5805 - (914) 277 -8210 (FAX) - BIBBO. LLP @VERIZON. NET 9001A LLTT9 ON XH / %,L] Lip : LO IIH,Z 40 /LZ /0T State Environmental Quality Review NEGATIVE DECLARATION Notice of Determination of Non-Significance Date: October 24, 2005 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Conservation Law. The , Town of Putnam Valley. Planning Board has determined that the proposed action described below will not have a significant environmental impact and a Draft Environmental Impact Statement will not be prepared. Name of Action: Proposed Single-Family Residence for Alan Ortner SEQRA Status: Type 1 X Unlisted Conditioned Negative Declaration: _ Yes X No Description of Action: The Putnam Valley Planning Board is currently reviewing an application to permit a single-family residence on 4.03 ( + / -) _.. __._... .__.__._..._..lres- 6f'-lai -fd -f kited- 'on ~Norttli ghb�- -R6ad-m. the=Cbnservation~(M- 1 —onmg District. In addition 'to Site Development Plan Approval, the applicant requires a Wetlands Permit from the Planning Board for buffer disturbance related to the installation of the sanitary sewage treatment system, stormwater management facilities, retaining walls, and a proposed bock dock on Oscawana Labe. Location: North Shore Road, Town of Putnam Valley, Putnam County, N.Y. Reasons Supporting This Determination: The Planning Board has compared the proposed action with the Criteria for Determining Significance in 6 NYCRR 617.7 (c), specifically: 1. The proposed action will not result in a substantial adverse change in the existing air quality, ground or surface water quality or quantity, traffic or noise levels; a substantial increase in solid waste production; or a substantial increase in the potential for erosion, flooding, leaching or drainage problems. Page 1 of 3 S-d LOEE -929 (1016) pueog 2uiuueld e100:80 so La 400 9002 [LTT9 ON XK /XSl LV :LO alll 50 /LZ /OT 2. The proposed action will not result in the removal or destruction of large quantities of vegetation or fauna; substantial interference with the movement of any resident or migratory fish or wildlife species; impact a significant habitat area, result in substantial adverse impacts on a threatened or endangered species of animal or plant, or the habitat of such species; and will not result in other significant adverse impacts to natural resources. 3. The proposed action will not result in the impairment of the environmental characteristics of a Critical Environmental Area as designated pursuant to 6 NYCRR Part 617.14(g). 4. The proposed action will not result in a material conflict with the Town's officially approved or adopted plans or goals. 5. The proposed action will not result in the impairment of the character or quality of important historical, archaeological, architectural, aesthetic resources, or the existing character of the community or neighborhood. 6. The proposed action will not result in a major change in the use of either . the quantity or type of energy. 7. The proposed action will not create a hazard to human health. _ 8. The proposed action. will not create a substantial clange`in _the use, or intensity of use, of land including agricultural, open space or recreational resources, or in its capacity to support existing uses. 9. The proposed action will not encourage or attract a large number of people to a place or place for more than a few days, compared to the number of people who would come to such place absent the action. lO.The proposed action will not create a material demand for other actions that would result in one of the above consequences. 11. The proposed action will not result in changes in two or more elements of the environment, no one of which has a significant impact on the environment, but when considered together result in a substantial adverse impact on the environment. 12. When analyzed with two or more related actions, the proposed action will not have a significant impact on the environment and when considered Page 2 of 3 9 •d LOEE -92S (b16) pjeog 2uiuueld eb0 =80 So LZ 400 L001M UTT9 ON XH /X,L] Lb : LO 11HZ SO /LZ /OT cumulatively, will not meet one or more of the criteria under 6 NYCRR 617.7(c) 13. The Planning Board has considered reasonably related long-term, short - term, direct, indirect and cumulative impacts, including other simultaneous or subsequent actions. For further information contact: Laura Lussier, Planning Board Clerk 265 Oscawana Lake Road Putnam valley, New York 10579 This notice is being filed with: Putnam Valley Planning Board 265 Oscawana Lake Road Putnam valley, New York 10579 Page 3 of 3 G'd GOEE-9ZS f�T6l pueog 2utuuejd eS0 =60 SO GZ X00 LORETTA 'MOLINARI R.N.; M.S.N. - Public HeallA Director DEPARTMENT OF HEALTH 1: Geneva Road; Brewster, New York 10509. Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 27.8 - 6014 Fax (845) 278 - 6648 ' FACSIMILE TRANSMITTAL Tr PB To: Mr. lo-t'iK 7��: lord 6"" Fax: 54- , )(3o From: J—oe. 19c r",r i Sr. APRE• Date: .6.. / 6 L-5 spy OF , �,-.�/ �,, sue. Re.. Pages: c9 CC: ❑ Urgent For Review ❑ Please Comment ❑ Please Reply ROBERT J. BONDI County Executive CONFIDENTIALITY STATEMNT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only. for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845 - 278 -6130) and destroy all documents associated with this facsimile. ■ SENDING CONFIRMATION DATE JUN -6 -2005 MON 1317 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 95262130 PAGES : 2/2 START TIME : JUN -06 13:16 ELAPSED TIME : 01'03" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED RT TT" T*2vPo= qm -"'DP M �P Pnn (OET "LL-00 " ao�d A4 to •SJPaTioiOTP�{ av¢otd 5naa m sdoz(oa r!RT Parccxu anvq noL n •nPagd0000Paie l ARP Sa �1�� 10 'n8pnglpsTP'a01115F ry An TOM Pop= gq.V R oie not Imldvai p2pm m zW ion fT a vmc OR . ..Ta zi 21p 'aea9a wrou ATino so 1>w1PW mnp m aft so: ,Gua 1*•'Pnaln{omm gm pm wsd kdm Poe ']FLLNgaWN03IIlelaoo Arm aFUIPMORD;jAumac:.von —a -. mij. i. VSfRCa .1,ViB:t.LT'1V11.N7fCQ440J i raVag.1e4-1i� I-B:n D or. mlta i 9d �T' 'T' .L:LTI�SNt 1 griLmSav3 I YtD9'1TLZ (fOB)'sd tld3•BLZ (fPP) I��q•r+�d/uopao.uoiol RTmB flog OLT (,,I) °d WO • ALZ OO DIM Ni f9 • P/.7. (fTf) a�Nia9 7vioap T164 • BLZ (5►Y) nd eCTO • RL2I51'R) ��T�+11 Ptnowon,hua . 605oi *aI. maH'lalshyq 'prc>T enona� KVIVaH Jo Lid$11.1. ?IE�d�Q a)g I VEAT .om.rp HrIDOH �I79M )rt„OB 'i itlf ?Hflii "N-d I-dym -10YV V]:ino-I . , r • • .— . .. •• ••. e . . •• •• _.. • >ll • .• 6tlRRLf1'A AMLBR, MD, M9, FMP CammirsionoofNcrdrh LOR=TA MOI.INAW, RN, M5N Assxtare Commustoner olllenlrh June 6, 2005 Hibbo Associates Mr. fiob Nowt Mill Pond Offices 293 Route 100, Suite ^.03 Somers, NY 10589 ROBERT J. BONDI # Cwuary &—a w DEPARTMENT OF HEALTH I Geneva ltoad, Drowswr, New York 10509 "posed SSTS —Onner .onh tihnaa kond, I , Pumain Valley, T;M. 451 -1.54 Dent W. Howe: Ibis office has received and rcvi, :•,r, :,. .o „s1 .came set orplano for the above mentioned prujuct. We would lilac w of ii; We following comments tar your review and consideration. l) Relocation of dic driveway c: ;n.n:pu,yl.: 1., this Department. It now appears that till comments relevaut to the sepl iC .p arw hiwo lain uddressed. The only outstandinr, comments are as ibllow: : a. Top and bottom wall [ci :d;.,ae: need to be provided for the wall behind the house (deck eider . b. The well call be uun•e,t,au it ,tic wrtland buffet provided all separation distances to the propo:wd ;';r.! c. i,iing,eptic systems oli tho adjacent lots are maintained. c. A 10 foot uriuirruur, label :d:, •, 67 I,;: shown hetween the force main and the wiled line. Once the abovr. commi::u; 6:r: i ,. •..,, .,�•!ressuJ, this Department is prepoled to issue a permit for the SS'I'S anti wr:G . •,n . alid tu,•::; wetlands permit is provided. 771Is otticc will continue tm rvne„ .q,ou , :in : :nrirt :niuu of Ore above moati0ned ' . comments. Please 1icl rice. i,. ton;a•.I ,r :;it sr. 2151 if any questions arise. '_':iusrpl, r,. rsrtrah, Jr. A.':,kwTi: Public fle;d:h Engineer JSP:cw ' w.ar suypt7 s«w,,,i4» � :vna wa rust resell • - .. Ea.4uawmarl Redte 1945):79.000 r. (845) 379.7931 _.... _........... _.....�...._ ...,. - ., .. .. Nul- hq;5etvn:r4(945)3796559. WIC(US)1 ?8.6678. Paa(945)379.609S........ ...r.. , <. :_.. _ .7 . _.v—. ....... r n7 rntervaanm,mru,mm4(8s5) 278.6014 F=(NS)378.6649 "'QSbLIWSN'd2i1, Ili1qSWn0W JMDH*d ,dO Hf)Vd IRE[d HO : SlIMSH)i Wz)s : saOW "SZ,00 : wis assdvas Lt?:ZT 90 -Nnf : HKII ILUVIS T/T : S30Vd 0TZ8LLZVT6T6 : sNOHd TZ6L- 8LZ -SV8 Zss HIrNSH dO 1N9K1UVdsa XJW100 WVNSnd ZMN 9t,:ZT NOW SOOZ -9 -Nnr HJVa NOUVWUN00 ONIMS rLRAB OO AtJtJW/ll1TES, L.L.P. Consulting Engineers - Planners May 13, 2005 Putnam County Department of Health 1 Geneva Road Brewster N.Y. 10509 Aft: Joseph Paravati, Jr., Assistant Public Health Engineer Re: Alan Ortner SSTS Application North Shore Road, (T) Putnam Valley TM# 51 -1 -54 Dear Mr. Paravati: Joseph J. Buschynski, P.E. Timothy S. Allen, P.E Sabri Barisser, P.E. John P. McNamara, P.E. Robert A.B. Howe, B.S. Phys. Enclosed are 4 sets of the revised plans for the above referenced matter. At the recent Putnam Valley Planning Board Meeting, we were asked to prepare:.a plan shoyving the house reversed, with the driveway approaching the house along-the °wetsterly property line and above the proposed sewage disposal area. As a result of this, we note the following: The- trench layouthas'been reconfigured -somewhat-in order 16 provide room•forthe;'- -T ,alp driveway without impacting the sewage disposal area. Please note that the driveway roe ° will be in cut for a portion of the run above the sewage disposal system. We have LLto V/1' I been advised by the Town that the driveway can be shifted even closer to the property line, if need be. Grading, however, cannot spill onto the adjacent lot and therefore, some retaining walls will be necessary. 2. Since the trenches will be within 50' of the proposed dwelling and at a higher elevation, we are providing the "impervious berm" — clay barrier trench as previously proposed. The next Planning Board Meeting will be early in June. If this plan - -with modifications, if required .7 are in approvable form, let me know. We would appreciate a letter indicating the status of approval to the Chairman of the Putnam Valley Planning Board, Mr. John Zarcone. PLANNING / SITE DESIGN / ENVIRONMENTAL 293 Route 100, Suite 203, Somers, NY 10589 - (914) 277 -5805 - (914) 277 -8210 (FAX) - bibbo @optopniine.net Thank you -for all your assistance with this matter. Sincerely, Bob Howe, Sr. Designer Cc: Alan Ortner, Wend PLANNING / SITE DESIGN / ENVIRONMENTAL 589 Route 22, P.O. Box 403, Croton Falls, NY 10519 - (914) 277 -5805 - (914) 277 -8210 (FAX) - BIBBO.LLP @VERIZON.NET 04 /11 /05 MON 12:22 TEL 914 277 8210 BI AS_ C S LLP ��-� PCHD �Jppl X113130 AS T S9 L.LP 293 Route 100 - Suite 203 Somers, NY 1058 (914) 277 -5805 (9.14) 277-8210 SAX,; . bibbo @optonline.net FAX COVER SHEET PLEASE DELIVER TO: NAME COMPANY FAX NUMIAF -k FROM; SUBJECT-. r-7W DATE; �"! /, as' s � � ;� . % °v ® ins a� ieov c�i1 R. vet �lf,5� .. we. Wi U— Aim 7v v 0,*- 1�✓��v� ,�/� �.�- • � � XCVrLn, * .. eg- ` i S/tlg- 1-h F /4- x-01-U. AS REQUESTED, � FOR YOUR APPROVAL FOR REVIEW AND COMMENT NUMBER OF PAGES BEING TRANSMITTED (INCLUIDI1 THIS PAGg) -- Hard copy being sent ?_ AO No � Regular {Mail Overnight If you do not receive all pages in legible condition, please call (914) 277 -5905, APR- 11- 2005.,MON 12:30 TEL:e45- 278 -7921 "JgME:PUTNAM COUNTY DEPARTMENT OF P. 1 04/11/5 HON 1222 TEL 914 821 ��� / IBBO ASSOCIATES LLP �-�� PCH�D fr v .002 gt� LLu . --a- PROVIDE I Iv.. o DEPTI•I CLEAN* - / „ / / / ,�' / / �`L 7 2 ROB SAND 6 GRAVEL FILL! � MAX. SLOPE OF PROPOVE S.S.0A = 15% 570 DRAINAGE- � � ! � � I � EXIST CUT-OJT;: / 0 1 TO BE 8 OUTLETS - ; r . Q \ DISC', BOX .. : .r- % ' �,, . `� 5 \ 1,..� ^►�, STONE RM / s \ WA1 rx LOT ,2 ml ro :.... 1. .I C P / PROF. I' GALLO P /C: opc. 5� P L J 1�'1� 0 dam' 0 583.0 X ti AMC 64x_ 56 mom. --545 5 I2 /c CONC / $ Q + PU STONE PI'AINING a N . 5' MAX) 4 W/ TWACE B �+ ROOF 540 6 APR -11 -2005 MON 12:31 *TEL: 845.1-278-%..7192.1.1. �-AME:PUTNAM.000NTY DEPARTMENT OF P. 2 NJ a Hers - Planners March 10, 2005 Putnam County Health Department 1 Geneva Road Brewster, NY 10509 ATTN: Joseph Paravati, Jr., Assistant Public Health Engineer RE: Alan Ortner - SSTS Application North Shore Road, (T) Putnam Valley TM #51 -1 -54 Dear Mr. Paravati: Joseph J. Buschynski, P.E. Timothy S. Allen, P.E. Sabri Barisser, P.E. John P. McNamara, P.E. Robert A. B. Howe, B.S., Phys. Enclosed are. 4 sets of the revised plans for the above referenced matter. We note the following in response to your letter of March 3, 2005: 1. As requested, the encroachment of the northern lobe of the sewage disposal expansion area has been shifted off the land with slopes >15 %. Two (2) of the expansion trenches are now shown at the southeasterly end of the expansion area. 2. As a result of discussions with the Town of Putnam Valley Wetland Inspector, we - - - - �- have.shifted�the building_ further away from the SSDA,- thereby eliminating the need for the clay barrier trench. The detail has been removed from the drawings and a notation that the building shall be 50' min. from all trench ends. 3. Once these plans are acceptable to your department, we would appreciate a letter from you that will repeat your requirement that a valid Town Wetland permit for the proposed activities be obtained prior to issuance of an SSDS permit. Thank you for all your assistance with this matter. Very truly yours, Robert A.B. Howe Senior Designer RABH /bs cc: J. Bates, w /encls. A. Ortner, w /encls. Planning o Site Design o Environmental Mill Pond Offices • 293 Route 100, Suite 203 - Somers, NY 10589 Phone: 914 - 277 -5805 - Fax: 914- 277 -8210 • E -Mail: bibbo@optonline.net SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA`MOLINARY,l�i;`1V�SN" Associate Commissioner of Health March 3, 2005 Robert Howe Bibbo Associates Mill Pond Offices 293 Route 1,00, Suite 203 Somers, New York 10589 z Dear Mr. Howe: ROBERT 1 BONDI County Executive r. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 105b9 J Re: Proposed SSTS — Ortner North Shore Road, (T) Putnam Valley TM# 51 -1 -54 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. ��hb�1• s G The separate section of expansion area is proposed on slopes greater than 15 %. It appears the area can be shifted to the southeast, alleviating the excessive slope. Please verify. The separation between the house and the SSTS is approximately 45 to 50 feet. If the - house:can_be moved slightly. to. the southeast, the 50 foot separation xiiay..be.obtained,....:: and the clay barrier would not be necessary. A copy of a valid wetlands permit is required before the permit can be issued. Once all comments are addressed, the letter you have requested will be written and sent to your office. 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 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 SHERLITA AMLER, MID, MS, FAAP Commissioner of Health Associate Commissioner of Health March 3, 2005 Robert Howe Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, New York 10589 Dear Mr. Howe: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 J ROBERT I BON ®I County Executive Re: Proposed SSTS — Ortner North Shore Road, (T) Putnam Valley TM# 51 -1 -54 This office has received and reviewed the, most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. 1. The separate section of expansion area is proposed on slopes greater than 15 %. It appears the area can be shifted to the southeast, alleviating the excessive slope. Please verify. 2. The separation between the house and the SSTS is approximately 45 to 50 feet. If the house can be- moved - slightly to the southeast, the 50 foot separation may be obtained,__ _. and the clay barrier would not be necessary. 3. A copy of a valid wetlands permit is required before the permit can be issued. Once all comments are addressed, the letter you have requested will be written and sent to your office. 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 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 T0012 [LTT9 ON XH /X11 Lip : LO MU SO /LZ /OT JOAN M. ZARCONE Chairman MICHAEL J. RAIMONDI Vice Chairman THE CHAZEN COMPANIES Town Planner INSITE ENGINEERING Town Engineer October 24, 2005 `1'0WN OF PUTNAM VALLEY PLANNING BOARD 265 Oscawana Lake Road Putnam Valley, NY 10579 -2004 (845)526 -3740; Fax: (845)526 73307 E -mail nlannine(u�nuhian »ullev.com ORTNER, ALAN SITE DEVELOPMENT PLAN APPROVAL WETLANDS PERMIT NEGATIVE DECLARATION OF SIGNIFICANCE NORTH SHORE ROAD TM: 51 --1-54 FILE: 51./305/963 THOMAS PATTERSON Secretary RICHARD TULLY EUGENE T. VETTER, JR. JOSEPH C.BECERRA (Adhoc) LAURA L. LUSSIER Clerk WHEREAS, the applicant is proposing a single-family, four bedroom fesidence on 4.03 ( + /-) acres of land located on North Shore Road in the Conservation (CD) Zoning District; and WHEREAS, in accordance with §165-16 of the Zoning Code, a Site Development Plan is required; and WHEREAS, in accordance with Chapter 144 of the Town Code, a wetlands permit is required for approximately 14,380 sq. ft. of buffer disturbance associated with the installation of a sanitary sewage treatment system, proposed stormwater management facilities,:pr.oposed retaining.walls, propo ed a ..nrg stone pathway to lake, and boat dock; and WHEREAS, the site contains a 100-foot rear yard lakefront setback .and 100-foot watercourse buffer from Lake Oscawana, as regulated under Chapter 144 of the Town Code; and WHEREAS, the applicant has submitted a wetland mitigation and planting plan prepared by Tim Miller associates, Inc., last revised August 27, 2005; and WHEREAS, the Site Development Plan and Environmental Assessment Form (EAF) has been submitted and approved by the Putnam County Department of Planning on August 10, 2005 under §239-m of the General Municipal Law; and WHEREAS, the Putnam County Department of Health has indicated in a letter dated June 6, 2005 that a permit for the sanitary sewage treatment system and well would be provided upon receipt of a wetlands permit from the Town of Putnam Valley; and WHEREAS, the Putnam Valley Highway Superintendent has reviewed the plans and has indicated that the proposed access onto North Shore Road is acceptable; and Page 1 of 4 I'd LOSE -9ZS (bT6l pueog 2utuueld ee0 =80 SO LZ 400 Z00[8 [ LTT9 ON Y?I / %Z] L% : LO MU 50 /LZ/OT M REAS', "the Planning Board has determined that no security is required under §165-16C(3) of the Zoning Code; and WHEREAS, the public hearing for the Site Development Plan and Wetlands Permit was closed on August 8, 2005; and WHEREAS, the Planning Board received consent from the applicant to extend the 62-day decision period to October 24, 2005; and WHEREAS, the proposed action has been determined to be an Unlisted Action, pursuant to the New York State Environmental Quality Review Act (SEQRA) 6 NYCRR Part 617.4; and WHEREAS, the applicant has submitted Parts 1 and 2 of the Full EAF, last revised July 22, 2005 and no potentially large impacts have been identified; and WHEREAS, the Planning Board has compared the proposed action with the Criteria for Determining Significance in 6 NYCRR 617.7 (c) and determined that the proposed action will not have a significant adverse impact on the environment; and WHEREAS, the Planning Board has considered all reasonably related long-term, short -term, direct, indirect, and cumulative environmental effects associated with the proposed action including other simultaneous or subsequent actions. NOW THEREFORE DE IT RESOLVED THAT, on motion by Richard Tully, seconded by Eugene T. Yetter, Jr. and carried, the attached Negative Declaration of Significance is hereby issued; and IRTHER: 'R:.1 SOL'�D- THA'a; - on inoti-on byy- Riciiard t'ially," seconded. by Eugene Yetter, Jr. and carried, the Putnam Valley Planning Board hereby approves the Site Development Plan prepared by Bibbo Associates, LLP, last revised August 27, 2005, subject to the below listed conditions; and BE IT FURTHER RESOLVED THAT, the Site Development Plan is valid for a period of 18 months after said Plan has been signed by the Chairman, Vice Chairman, or Secretary and may be extended once, at the request of the applicant, by the Planning Board for a period not to exceed six months; and BE IT FURTHER RESOLVED THAT, on motion by Richard Tully, seconded by Eugene T. Yetter, Jr. and carried, the Wetlands Permit is approved subject to the signing of the Site Development Plan and shall be valid for a maximum period of three years from the signing of the Site Development Plan. All work associated with the Wetland Permit shall be conducted in strict compliance with the Site Development Plan and shall be completed within six months following the initiation of construction; and Page 2 of 4 2'd LOEE -925 [7161 PueOS 2utuueld et.0:80 50 L2 400 600 Q( ILTT9 ON XH /%Ll Lip : LO MU 50 /LVOT BE IT FURTHER-. TtESPINED-.-TI-gAT, -= accordanee ,kith vha pter - 1.44; the- Planning Board, ' y' +'�letlands Inspector and/or Code Enforcement Officer shall have the right to inspect the project from time to time; and BE IT FURTHER RESOLVED THAT, the Wetlands Permit shall automatically expire upon completion of work; and BE IT FURTHER RESOLVED THAT, the below listed conditions must be completed within 6 months of the date of this resolution. Should the below listed conditions not be completed within the allotted time frame, this resolution shall become null and void unless an extension is requested from the Planning Board within said 6 month period and granted. I. Submission of all applicable fees and escrow. 2. Site Inspection Escrow in the amount $1,000 shall be submitted to the Planning Board, 3. The applicant shall address any outstanding comments provided by the Town Planner, Town Engineer, or Town Wetlands Inspector. 4. Part 2 of the Full EAF should be revised to indicate that the proposed project will likely generate public controversy. 5. The revised EAF shall be signed by the Planning Board Chairman, Vice Chairman or Secretary. 6. At least two business days prior to the commencement of the work, the applicant shall apply to the Code Enforcement Officer for a permit to commence work, pursuant to Chapter 155, Soil Erosion and Sedimentation Control; of the Code of the Town of Putnam Valley. 7. This wetlands permit shall be prominently displayed at the project site during construction. 8. Prior to the issuance of a Certificate of Occupancy, the Building Department shall confirm the Planning si rire of Boil ii =germs applicable a ems; ®nstiuction-meeting s 1 bg h ld' Wi`tt — -: -: "-.1 the applicant, contractor, Building Department, Highway Department, Wetlands Inspector, and Town Engineer. 10.In an effort to ensure compliance with the approved Plan, monthly site visits shall be conducted with the applicant, contractor, Building Department, Highway Department, Wetlands Inspector, and Town Engineer and a final site inspection shall be conducted prior to the issuance of a Certificate of Occupancy. 11.An as-built survey demonstrating compliance with the approved Plan shall be submitted to the Planning Board, Town Engineer, Town Planner, and Code Enforcement Officer prior to the issuance of a Certificate of Occupancy. 12. The applicant shall submit draft deeds identifying compliance with Chapter 144 of the Town Code, prepared to the satisfaction of the Town Attorney. 13.Eight original copies of the Site Development Plan, signed by a Licensed Professional Engineer and the owner of the property, shall be submitted for the Chairman's, Vice Chairman's, or Secretary's signature. Prior to signature, a final report from the Town Engineer, Town Planner, and Town Wetlands Consultant addressing resolution conformance shall be submitted to the Planning Board. Page 3 of 4 e -d LOce -sas I�T6l pueog 2uiuueTd ej,0 =80 SO La -400 600 C1 (LTT9 ON XH/11] Lt:Lo fIHI 20/LZ/OT 14. Any other conditions that. may_be required by the.Town of-Putnam.Valley -Plannin, D-6 aif mie'nt', '-Righway-be partment, and any other department of the Town of Putnam Valley. I John M. Zarcone, Jr., Chairman Michael J. Raimondi, Jr., Vice Chairman Thomas Patterson, Secretary Yea Nay Abstention Absent X X X X .x X Page 4 of 4 j" - CI LOEE-92S (P T6) PJeDH 2uiuueld e-IF0 :80 so LF, -400 SSOCIATES, L.L.P. Joseph). Buschynski, P.E. �.f `.' Timothy S. Allen, P.E. ;t engineers - Planners _ Sabri Barisser,.P..E: ��,� � •_ ... ,.. .. � -. .. • _..n .a.... . ' a ... __.... .. -.... .-. n...a r.� .,. .. Ya. s. ).t.: .•C'•c.. .r1a. .. a ...a ... John P. McNamara, P.E. Robert A. B. Howe, B.S.. Phys. February 9, 2005 Putnam County Health Department 1 Geneva Road Brewster, NY 10509 ATTN: Joseph Paravati, Jr., Assistant Public Health Engineer RE: Ortner — SSTS Application North Shore Road — (T) Putnam Valley TM #51 -1 -54 Dear Mr. Paravati: Enclosed are 4 -sets of the revised plans for the above referenced matter. We note the following in response to your letter of January 7, 2005: 1. The proposed SSTA has been shifted back into its originally approved location. As a result, the grade though the system averages less than 15% and, therefore, it.is Our understanding that,, of. depa tri eat require ' ' is will be - __ __._. _._._.. _...- ...... -- required. 2. A minimum of 1' of ROB fill is indicated over the SSTA. Although there is an area within the central portion of the system that will require slightly more than 2' of fill, the average depth of fill works out to be less than 2'. Under these circumstances no separate "fill plan" should be required. 3. See response to #2 above. 4. As has been approved by your department in the past, we are now requiring a clay barrier trench to be installed between the foundation and the SSTA to inhibit flows from the SSTA to the footing drains. It does appear, however, that if the fields are installed as shown, the 50' separation distance is, in fact, obtained and the clay trench may be superfluous since the average fill is less than 2'. Please advise. 5. The large rock will be removed from the SSTA as now indicated on the plans. Planning . Site Design . Environmental Mill Pond Offices 293 Route 100. Suite 203 • Somers, NY 10589 Phone: 914- 277 -5805 Fax: 914- 277 -8210 - E -Mail: bibbo@optonline.net 0 i 8. The required dosage has been corrected in the dosing notes to 222 gallons. 9. We attach a copy of the dosing /pump sizing calculations and pump specifications for your review and approval. 10. Details of the force main trench and distribution box are now provided. 11. As requested, fill shall extend 10' beyond all trench ends, per the detail provided. 12. As noted above, there will be no "fill pad" as such and therefore no dimensions are required. 13. Although the SSTA on lot #2 Trading Post will be less than 100; from the SSTA on the Ortner lot, it will be greater than 200' from the proposed well. There are no off -site wells existing or proposed within 200' of the proposed SSTA. A note to that effect has been placed on the plans. 14. A note clarifying the flood plain issue is provided on the plans. 15.A downward pointing screened vent is now provided on the pump chamber. 16. The access to the pump chamber is provided with a locking manhole frame and grate at grade. 17. As we discussed on the phone, the architect has eliminated the internal door to the sunroom:and_repl ce f itwith..a`6' wide ..drehed =epee �± :::_Enelds are 2-b ie oaf the-, first floor plan. Since we will need to obtain a wetland permit from the Town of Putnam Valley, we request a letter from your department, once your requirements are satisfied, indicating your "intention to issue an SSTS permit based on the drawing dated so and so ", once you have received a copy of the wetland permit from the Town. As we discussed, this should enable us to file for a building permit with the Town and get the wetland permit process going. Thank W6 for all your assistance with this matter. Very truly yours, X /r G' Bob Howe Senior Designer BH /bs Enclosures cc: Alan Ortner, w /encls. Jim Bates, w /encls. ASSOCIATES, LLP 66 P.O. Box 409 Designer: NT Crot'o'n Falls, New York Checked: Date: 2/4/2005 DOSING CALULATION PER WCHD CODE: 0.5 GAL/ L.F.ABSORPTION TRENCH 0.5 gal./if 444 If. OF ABSORPTION TRENCH DOSE REQUIRED(gal.) = 222 PUMP CALCULATION 2" PVC FORCEMAIN where Q=V x A V(FPS)= 3 A(FT 2)= 0.0218 Q(CFS)= 0.0654 Q(GPM)= 29.36 USE Q= 30 GPM LENGTH OF FORCE MAIN (ft.)= 160 ADDITIONAL EQUIVALENT LENGTH DUE TO FITTING LOSSES (ft.)= 24 L(ft.)= 184.0 FRICTION LOSS -FL= 1.81 HF= L x FL/1 00 H(ft.)= 19.5 TDH (ft.)= H+HF = 22.83 USE GOULDS MODEL #WE05HH 112 HP SEE ATTACHED SHEET FOR PUMP CURVE GOU LDS APPLICATIONS PUMPS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump • Solids handling capabilities: 3/a' maximum. ' • Discharge size: 2" NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. • Temperature: -T 04 °F(40 °C) continuous 140 °F (60 °C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM'S available. 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. ■ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA -N elastomers. m 2001 Goulds Pumps Effective November, 2001 B3885 ■ Shaft: Corrosion - resistant , stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. ■ Fasteners: 300 series stainless steel. ■ Capable of running dry without damage to components. ■ Designed for continuous operation when fully submerged. MOTORS ■ Fully submerged in high - grade turbine oil for lubrication and efficient heat transfer. ■ Class B insulation. AETERS FEET 40 13C 12C 35 11c 30 10C 9 90 = 25 8C 20 70 0 6C 15 5C 0 4C 10 30 5 2C 10 0 Submersible'. Effluent Pump 3885 PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. Single phase: • Built -in overload with automatic reset. • All single phase models feature capacitor start motors for maximum starting torque. •'/3 and' /2 HP -16/3 S1TOW with 115, 208 and 230 Volt three prong plug. • 3/4 -2 HP —14/3 STOW with bare leads. Three phase: • Overload protection must be provided in starter unit. •'/2 -2 HP —14/4 STOW with bare leads. ■ Designed for Continuous Operation: Pump ratings are within the motor manufacturers recommended working limits, can be operated continuously without dam'ag`e .�hhe' n fully submerged. ■ Bearings: Upper and lower heavy duty ball 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. Standard cord is 20'. Optional lengths are available. m 0 -ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS C�p Te sted and CSA 22.2 .2 t 0 08 St St andards By Canadian standards Association " US File A1138549 Goulds Pumps is ISO 9001 Registered. 00 10 20 30 40 50 60 70 80 90 100 110 '120 130 140 150 160 GPM 0 5 10" 15 20 25 30 35 m3 /hr CAPACITY -r ). H = ZZ ,83 www.goulds.com Goulds Pumps ITT Industries mill • NINE ®S® in I 11111N111111 p \ In /1111011 MINI MCA NINE , gp I 00 10 20 30 40 50 60 70 80 90 100 110 '120 130 140 150 160 GPM 0 5 10" 15 20 25 30 35 m3 /hr CAPACITY -r ). H = ZZ ,83 www.goulds.com Goulds Pumps ITT Industries LURE ITA MOLINARI _" Public Health Director DEPARTMENT OF HEALTH pt SAY 1 Geneva Road, Brewster, New York 10509 ,5 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 0� � B D Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 1 Early Intervention/Preschool (845) 278 - 6014. Fax (845) 278 - 6648 ©,r January 7, 2005 Joe Buschynski, P.E. Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Re: Dear Mr. Buschynski: Proposed SSTS — Ortner North Shore Road, (T) Putnam Valley TM# 51 -1 -54 County Executive This office has received and reviewed the most recent set of plans for the above - mentioned project. uutd-frkzl 6t"frlh�ollowing comments for your review-an"onsi io"n. ,.eT �w4lG S�eAS -•. aff E'er,. ., s� vs .o's ` -,` Sii. f v c-• The proposed SSTS area has been shifted to ately 15- feet from lwmd &"`'k the approved area on the filed subdivision map. This shift places the SSTS over slopes greater than 15 %. Therefore, the current application is denied. Jba+w n'r► ✓� A uniform 1 foot of fill is required over the entire SSTS area. nT-r 4;3-*' If.the fill for depth and grading is greater than 2 feet of fill, a 2 sheet septic plan is J ' ; The proposed SSTS area -is higher in elevation than the proposed house. The SSTS and house need to be separated by a minimum of 50 feet. (This includes toe of slope if the fill is greater than 2 feet.) The trenches are less than 10 feet form the large rock and the toe of fill is being graded into the rock. The rock should be removed as was the requirement of the / subdivision plat. �f Equal distribution is required for a pump system. L7-1" The required inches of dose based on the interior pump chamber dimensions provided should be 7 inches. The dose of 445 gallons shown in the notes section of the detail is incorrect. 'I Please provide all pump calculations (head loss from static and friction, etc.) and provide manufacturers pump curve and performance charts and rating showing how pump was selected. Please provide a force main detail and a distribution box detail. Fill needs to extend 10 feet horizontally past all trench ends. Fill pad dimensions need to be provided. (if 2 sheets are required). X. Please show all existing or proposed SSTS's and wells within 200 feet of the proposed SSTS and well or provide a note stating none exist. -P4. Please show any 100 year flood plain within 200 feet of the proposed SSTS or provide a note stating none exists. ump,ch beri sliould;be equ }pp'�d,With.46; w& d7&ding screened �+ent riser. The pump chamber should be provided with a riser to grade and a locking manhole cover. The sunroom is a potential bedroom. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 2I57 if any questions arise. JSP/km Very truly yours, 644JO-4 le Joseph S. Paravati, Jr. Assistant Public Health Engineer 13 r�� J f S73 V, _ - < LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive 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 January 7, 2005 Joe Buschynski, P.E. Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Buschynski: Re: Proposed SSTS — Ortner North Shore Road, (T) Putnam Valley TM# 51 -1 -54 This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your review and consideration. 1. The proposed SSTS area has been shifted to the west approximately 15 -20 feet from the approved area on the filed subdivision map. This shift places the SSTS over slopes greater than 15 %. Therefore, the current application is denied. 2. A uniform 1 foot of fill is required over the entire SSTS area. K.: .. If the fill _for depth and grading is greater -than 2 feet offill,,a_2 sheet.septic,plan is_ required. 4. The proposed SSTS area is higher in elevation than the proposed house. The SSTS and house need to be separated by a minimum of 50 feet. (This includes toe of slope if the fill is greater than 2 feet.) 5. The trenches are less than 10 feet form the large rock and the toe of fill is being graded into the rock. The rock should be removed as was the requirement of the subdivision plat. 6. Equal distribution is required for a pump system. 7. The required inches of dose based on the interior pump chamber dimensions provided should be 7 inches. 8. The dose of 445 gallons shown in the notes section of the detail is incorrect. 9. Please provide all pump calculations (head loss from static and friction, etc.) and provide manufacturers pump curve and performance charts and rating showing how pump was selected. 10. Please provide a force main detail and a distribution box detail. 11. Fill needs to extend 10 feet horizontally past all trench ends. 12. Fill pad dimensions need to be provided. (if 2 sheets are required). 13. Please show all existing or proposed SSTS's and wells within 200 feet of the proposed SSTS and well or provide a note stating none exist. 14. Please show any 100 year flood plain within 200 feet of the proposed SSTS or provide a note stating none exists. bequiplzd: v�itJi.: dw .ward:£�cing:sereene�et?s�x 16. The pump chamber should be provided with a riser to grade and a locking manhole cover. 17. The sunroom is a potential bedroom. 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/km Very truly yours, Joseph S. Paravati, Jr. Assistant Public Health Engineer PUTNArir COUNTY DEPARTM EDIT OF HEALTH D"rON OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEIKS -: __....... . _..... '. - ... _ __..:_..._. .._.REVEEW- SII.T�?�•C�TI�UCTIO� . •..,.. � .-- _.w_.- ,.w...z- .�.�r..._ -..�- . — ..,_,._., -T.� y NAME OF OWNER: l9r STREET LOCATION: REVIEWED.BY: RM/ G JSP SRDATE• i �° i9c, TAX MAP#. CONFi UaD 7 fVV Y pGCU.N NTS PERMIT APPLICATION WELL kEIuar OR PWS LETTER ETTER OF AUTHORIZATION ESIGN DATA SHEET (DDS) ORPORATE RESOLUTION HORT RAF. LAPIS- TB[REE SETS DUSWLANS - TWO SETS ARIANCE REQUEST- 1._ Cat TftT{T 9T J LEGAL SUBDIVISION SUBD'TVISION APPROVAL CHECD �` PERC ItATE �`Gy t TZ UU REQUMED 1-3 U. DEPTH U TADi DRAIN REQUIRED ' GENE ' C_) OCATED.lNNYC, WATT RSMD (J LAPIS SUBBM -rED TO DEP (2L�LEGATED TO PCHD (___,)� EP APPROVAL, IF REQ'D uJU EP TEST HOLES OBSERVED dF,w � TO BE WWITTNESSED VAL SSDS ADJ, LOTS APIDS (TOWN /DEC PERMIT REQ'D ?) ON DDS- PLANS & PERMIT SAME (__)(. PRE 1969 NErG'HBOR NOTIFICATION LETTER.BMA (� OIL-TESTING LOTS>10 YE OLD REQUIRED •DETAILS ON PLANS (,`7� SEWAGE SYSTEM PLAN- (NORTH A]RRO* UU EMRAULIC PROI+'ILE GRAVM FLOW ONSTRtTCTIOPt NOTES I -15 ESIGN DATA: IPERC &DEEP RESULTS 2' E= MG EMG & PROPOSED DRIVEWAY & SLOPES, CUT Y N (REOU_EM DETAILS ON PLANS CONT'D? ( (� OUSE SEWER, - y» FT. 41101; TYPE PIPE.CAST IRON (� r/ NO BENDS; MAX BENDS 45' W /CLEANOUT Pt =ALS UUS0 GE) FILL, SYSTEMS 11C rev ( 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE Ff—tL SPECS/ FILL NOTES 1 -5 (,.,(__)FILL PROFILE & DIMENSIONS , )(__,)FILL IN EiPAPISIOPI Am F= GRiTBR TH4N3 '(JU CLAY BARR= UUFnwCERTIFICATION NOTE , UUDVM GAUGES (_UC-JVOL. ON PLAN FOR R.O.B., VNCLASSIFIED & IMPERVIOUS UL_)SEPARATION DISTANCE FROM•TOE OF SLOPE TRENCH' ��( L' TRENCH PROVIDED 601IT MAX &1� �v�( 0ARALLEL TO CONTOURS 100% EXPANSIONPROVIDED C, J DETAILMUST FREE CRUSHED'STONE OR WASHED GRAVEL (�GEOTE 111 COVER OW" A A A N.Tf1A1 wT~ 1 L //1Pf. AAT 11T. A AT . R ATA tx-oo ro A cave 555 ��lJto� I _J100' TO WELL, 200' INDLOD,'150' TQ PITS -}100' TO Ste, WATERCOURSE, LAXX(iaa ezpmct). __)50' TO CATCH BASIN, 35'.STORA'1 UK PIPED WATER X10' TO-we wp, Lzm -(pt6 -22iD'') .:•- �30'• INTERMITTENT DRAINAGE COUME . • J.200' 500' RZSER�•GIJR,- ET-C._ 150' dALLEY SYSTEMS ✓ a TO LI DGE .0tf TCROP r. v-rrrI RrA�rar WL-J-10' FRON FOUNDATION; 50' TO WEXX ' DIIVIEPTSIONS O EItTY I;II 'IIOIY OP' SERVICI� CO,ia1PtECTION (.,MIN fly' TO'PROPERTY LINE • FOO,TENG/GUTTERICURTAINDRAINS / USDA SOIL TYPE BOUNDARIES .UUTXTLE BLOCK; OWNERS NAME ADDRESS UL REGRADED TO TM, PE/RA; NAME, ADDRESS, PHO DOSE/PUMP SYSTEM ATE OF DRAWINGaMNISION (� PUMP NOTES . �ATUM RE%+'ERLNCE . 06E °110 ®F-Y"� LU%l�" N' LOCATION OF WATERCOURSES, PONDS - E AILf FOR FORGiEL ' PE TYPE, E �� G �•�76t�6 � —"�•. ,� � r AAND � iD C -aBLAX3SWETLANDS VyTrH N 200' OF P.L. L JROPPODFNm FOOR AND 'BA.g��i��AT0S �tev O , X �' SI3F® I ®e 6gWID� l 1�I , ET28y6g N ,r - �}te ` f 1 ROPERT�' METES &BOUNDS f i UU MAN 4o CD ®, g0'- 4 %,S' - ° / ®, 100 %�1% EROSIOPi CONTROL FOI�:I3f0USE, WE%.L & �� --)ZOt CD DIISCIHA7[tGE/100'h 182 Boas day discharge . SETS, �OS %OPt COI�ITI�O%. PIOTE (---) ' � �o NOPI�i�E%�'OI�TEID P%PE YSHEET)09/OIAO PUTNAM COUNTY DEPARTMENT 'OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH .SEVG:.,,,., RE: Property of LETTER OF AUTHORIZATION (,43 t T *Ju oeq- )6Z. Located at lynel f _IV ti°L yOViet Ohle; Tax Map # 57 VC M) C: Xis l ✓�i� r✓ Block. Lot RS l Subdivision of lj�?AQ 11✓G Pm' r- d (v -rhe 44XE- Subdivision Lot # Filed Map # 7 Date Filed / - 7- 98 Gentlemen: This letter is to authorize /� zyac s.. , LL/V a duly licensed Professional Engineer _X_ or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article-_145�_and/or 147. of thelEducation l •.aw;Ahe- Public Health=' L'aw, and the Putnam County Sanitary Code. Very truly yours, Countersigned: Signed: P.E., R.A., # Mailing Address 19 ora et- Z z Ro 4 03 State . ' & 2 Zip Telephone: Mailing Address: JS MMDatr 5WGM f26b State 1-3EW Telephone: y SQO Form LA -97 PUTNA.M cCOUI4TY DEPARTMENY OF HEALTH RE: Property of LETTER OF AUTHORIZATION (At3 t TET ofq- ^)rj- � i Located at lvnel w �H6)f oL VCA �)CE . !yr,yPA Tax Map Block �_ L,ot �S � Subdivision of l / ?AQ / A1 & P® Sr 01V 'rhe 1.4.A<Z� Subdivision Lot # Filed Map Date Filed / - 7— '?�q Gentlemen: This letter is to authorize 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-arid/or i47 of the Education Law, the Public. Health Law, and the Putnam County Sanitary Code. yours, Very truly Countersigned-- Signed: c - �-Z-�' 1C , Mailing Address j IV I X -z State &� Zip Telephone: -I- - a i 7--6 —tO aj- Mailing Address: 1S AJO�AWIA SlsW- State t-3ew Telephone: q P �� Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION,QTENFV R0?�TMEN'I.At AtA,L TH SERVICES , :.... LETTER OF AUTHORIZATION RE: Property of AtAt3 CTMET oe:F^)rj� ( CoaTMcx- VEAbu-.' Located at IV 2RI- l W1_91e4 ���� L �i�t ✓S`i�j✓, ('V Ful yo Tax Map # 6-1 Block �_ Lot RS Subdivision of (/ ?AQ 11V& Pm Sr ON -her ;44Ae Subdivision Lot # 1 Filed Map # Date Filed 1- %- qB Gentlemen: This letter is to authorize, a duly licensed Professional Engineer X or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this ,. _..... _ ..::., matter and to supervise the construction of said;wastewater treatment and /or water,supply-systerff— in_conformi.ty_with she pro= Aslons of-Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. Very truly yours, . y Countersigned: Signed: P.E., R.A., # O.S^'cs"�i �`� (o.ar) llo,�c�'JrA� UZi+�DE�' Mailing Address .t!V Z Z. Mailing Address: 15 M64DO r SCJ=r f4b 'Pa ' Z' fox � O3 � 1.P�1ZJT ��fl . State !, Zip L,S" State %3EW Yom Zip /Ose.? Telephone: o2 7 Telephone: 7 y S�O PUTNAM COUNTY DEPARTMENT OF HEALTH ' DIVISION OF ENVIRONMENTAL HEALTH SERVICES AsiGN DATA SUUT = SUBSUAFACE SEWAGE TAEATIVMENT`SYSTEM ` Owner 01ZI -V61Z Adaress /r;1yea/0,,7,_1W0 a/, L'o�1 •,a�'/Ya��r, �y Located at ( Street) J'hor eRgI Z- 7- Tax Map S1 'Block', / Lot (indicate nearest cross street) Municipality A,TX, 4 7 (>4a,,C5", Drainage Basin -SOIL PERCOLATION TEST DATA Date of Pre - soaking _ y 9 Date of Percolation Test.., 9 0 Hole No. Run No.- Time Start - Stop Ela se Time Min.) De th to Water rom Ground Surface (Inches) Start Stop Water, Level Dropp.Iu Iuclies Percolation Rate Min/Inch .J 3 Z - Zk 3 3 Zoe- /tzs- z Z 3 b, G s 23 2 1 L 1/ r !Z/ z �3 ..� -. 3 .. 6167 3 2/'3- 121s 2 Z3 -Z� 3 6. 4 l Z/.r - /z, /T 13 Z3 . s 'Z_S - z 6- 3 .o 7-3 2 lip i -. GIs' S' Z3 - 2,b 3 z, C 3 /10 - l Z67 Z3: - Z Z. � .. .4 s 1 NOTES: /l. Tests to be repeated at same depth unfit approximately equal - percolation rates-are uUM11cu M cu%iI ; ti' percolation test hole: (i.e. s 1 min for 1 -30 min /inch, s 2 min for 31 -60 min /inch) All data to be •. submitted for review. Depth measurements to be made from top of hole.' ` Form DD -97 2 ' TEST PIT DATA Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: }� , 1, �60���,_ Date Design Professional Name: ti6sa L o r s';, Address: Signature: n ' au 0 ysFO �O 05592 .o Design Pa-ogessional's Seal I 90pas '° DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES _ DEPTH HOLE NO. HOLE NO. HOLE NO. C 0.5' TOi°So /� Oa.A-.%. 1.0' I V1 6— 15 _ G©aQi ��r Su- s35D /G 25 3.0' moo 40 7'. erslr 4.0' , 43' 5.0' 5.5' K 001C 773.` N 8'0' . .. .V Q.,o� n. .�.A.w .c m ._.. +C• •- .......m. .......... r.. .....,r .w w, m _. .. m... ... • -• , 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: }� , 1, �60���,_ Date Design Professional Name: ti6sa L o r s';, Address: Signature: n ' au 0 ysFO �O 05592 .o Design Pa-ogessional's Seal I 90pas '° PtrtNAM ooUwY DEPAii'm;T oF' kmLTH DIVISION OF ENVIRM+iF ML HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE ND. owner �C.isst�ll�j . �.•.• (�'1!'iJ Address ro, yU]c 6�. t7UwP4 0 kt V.Y- Located at (Street) Na SRVR* A'r Block tot Jr7 (indicate nearest, cross street) " ,{,*{ Q3.,4 t Municipality ?(ATV A,*A V �w � �'�"� Watershed . SOIL PERCOLATION TEST DATA RW= TO BE SUBMITTID WITH APPLICATIONS Date of. Pre- Soaking �'� -�"' °�� - Date of Percolation Test HOLE MICM CLACK TIME PERCOLATION', PERCOLATION Run Elapse. Depth to Water. From Water Level - '�� �1 No. 3 Time Ground Surface In Inches Soil Rate 9.3 Start -Stop Min. Start. Stop Drop In Min /In Drop, Inches Inches Inches a tire_ Z�9 i 2.� �3 3 0 ,3 3 Z3 ('6a 4 110 V3 I 2 3 4 5 ... NOTES: 1. Tests to be repeated are obtained at each for review. 2. Depth measurements to rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to be. sukmitted :. be We from top of hole. 30 " 2 ZS' - '�� �1 �- .3 � 3 4 .3�L qz° 9.3 5 1 2 3 4 5 ... NOTES: 1. Tests to be repeated are obtained at each for review. 2. Depth measurements to rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to be. sukmitted :. be We from top of hole. `;r PIT DATA Ki7 'ED TO M' SUBMITTED Wl'11 APPLICA7- ON . r DESCR .PTION ~SOILS MCXXO M IN TEST HOLE: DEPTH HOLE NO. HOLE N0. HOLE NO. GoLo no) 14VD CPIA 3 sl d>i" .. �� D IAN N r / M 5 !�'� 'ems 14 o 4' 36 -MOD iv Ili, ter Sigm JESi c�, SM .Wu, 11' 112'. 13' 140 Mel P �/0 . INDICATE .LEVEL..:AT• _WHICU,.GROUNDWATER IS MCOUNTEREQ INDICATE LEVEL TO WHICH WATER IBM RISES AFTER BEING ENOOUNTERED DEEP HOLE OBSERVATIONS MADE BY: Soil Rate Used ® Min /1" Drop: S.D. Usable Area Provided -4- No. of Bedrooms Septic Tank Capacity gals, Type Absorption Area Provided By L.P. x 24" width trench Other p' e N d CLVA k) 'PI LA, OV97, SP a ED'S °Nat F�' Name Blbbo Associa Signature 4( rr "Ung EnVneers-Marmers _ Address Rte. 22 & Hardscrabble Rd. SEAL + Fromm Falls, N.Y. 105 a dF�s`ry �o. 42.1 R THE S THIS SPACE FUR USE BY HEALTH DEPARZYd.ENT ONLY: Soil Rate Approved sq.ft /gala Checked by Date i . SA boas 6Lrtv �✓ ;., C L a: , w 11' 112'. 13' 140 Mel P �/0 . INDICATE .LEVEL..:AT• _WHICU,.GROUNDWATER IS MCOUNTEREQ INDICATE LEVEL TO WHICH WATER IBM RISES AFTER BEING ENOOUNTERED DEEP HOLE OBSERVATIONS MADE BY: Soil Rate Used ® Min /1" Drop: S.D. Usable Area Provided -4- No. of Bedrooms Septic Tank Capacity gals, Type Absorption Area Provided By L.P. x 24" width trench Other p' e N d CLVA k) 'PI LA, OV97, SP a ED'S °Nat F�' Name Blbbo Associa Signature 4( rr "Ung EnVneers-Marmers _ Address Rte. 22 & Hardscrabble Rd. SEAL + Fromm Falls, N.Y. 105 a dF�s`ry �o. 42.1 R THE S THIS SPACE FUR USE BY HEALTH DEPARZYd.ENT ONLY: Soil Rate Approved sq.ft /gala Checked by Date i . 2. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR ~ A WASTEWATER TREATMENT SYSTEM Name and address of applicant: f`o A4 AVoa<, iV o 7 Name of project: 3. Location TN: 1V71Vf-M V111-46Y 4. Design Professional: ,[ l,& o &CceLtM 105 6. Drainage Basin: L- tX" 054t+WA. -Al �9' Address: J"89 12411 W S2- 7. Type of Project: _Private/Residential Food Service Apartments Institutional . Office Building Realty Subdivision 71071" O Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (check one) ........................ .......:.......:............... Type I Type II k 9. Is a Draft Environmental Impact Statement (DEIS) required? ........................ 10. 11. Exempt Unlisted &L0 Has DEIS been completed and found acceptable by Lead Agency? ............... 19414 Name of Lead Agency A)IA Is-this project`in-an area 'under'the contral-of lucai Planning; zoning, or other--.. - - - .officials, ordinances? .............. Y 13. If so, have plans been submitted to such authorities? ............. IVA 14. Has preliminary approval been granted by such authorities? Date granted: N �4 15. Type of Sewage Treatment System Discharge ................. surface water groundwater 16. If surface water discharge, what is the stream class designation? .................... /V 17. Waters index number ( surface).. .............:.......................:.... ............................... ....... ............................... o 18. Is project located near a public water supply system? /� 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? .......:........ No 21. Name of sewage system Distance to sewage system 22. Date test holes observed 23... Name of Health Inspector 24. Project design flow (gallons per day) ..,:.:...¢ :�:!�,.?� ?-ems �'Pp.,l Bf.L....... 84� 25. Is State Pollutant Discharge Elimination System (SPDES).Permit required ?... No 26. Has SPDES Application been submitted to local DEC office? ......................... A11,4 2 27. Is any portion of this project located within a designated Tom or State wetland? �S _.2$ ands ID Number. ::...::.. ...:. :............. :........ :.. ........................................... I� it- 29. Is Wetlands Permit required? ................... ............................... LoG L ........... )!1, Has application been made to 0yor Local DEC office? ........ /!1! /°�G6-50 30. Does project require a DEC Stream Disturbance Permit? .: ............................... Nd 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 - Ald 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any �� other potentially known source of contamination.? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .. .............. ........... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... A1(9 35. Are any sewage treatment areas in excess of'15% slope? . ................................ ��✓ 36. Tax Map ID Number .......................... ....................... ......... Map �/ Block ! Lot 2,6 37. Approved plans are to be returned to ..... Applicant...._,. ,..Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS.prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of 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 I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury; that information provided on this form is Prue to the best of nay knowledge and belief. False statements made herein are punishable as Mass A' m4demeanor pursuant to Section 210.45 of the Penal Law. S A.TIi �& ®FFIC'IAL TITLES. Mailing Address: ................................... AZ BIBBO ASSOCIATES. LLP TO: JOSEPH PARAVATI DATE: 11 -3-04 PUTNAM COUNTY DEPT. OF HEALTH RE: ORTNER PCDH # PV -13 -04 1 GENEVA ROAD LOT 1 "TRADING POST ON THE LAKE" BREWSTER, NY 10509 NORTH SHORE ROAD, PUTNAM VALLEY (T) WE ARE SENDING YOU ( X ) ATTACHED ( ) UNDER SEPARATE COVER THE FOLLOWING ITEM$.VIA. # COPIES DESCRIPTION 2 SETS OF HOUSE PLANS (REVERSED) THESE ARE TRANSMITTED AS CHECKED BELOW: ( X ) FOR YOUR APPROVAL (.) AS REQUESTED ( X) FOR YOUR USE ( ) FOR REVIEW AND COMMENT REMARKS: THESE PLANS WERE INADVERTENTLY LEFT OUT OF THE APPLICATION PACKAGE THAT WAS SUBMITTED TO THE DEPARTMENT: LAST WEEK. SIGNED: COPY T0: FILE ae 589 ROUTE 22 — P.O. BOX 403 CROTON FALLS, NY 10519 (914) 277 -5805 — (914) 277 -8210 FAX — BIBBO.LLP@ VERIZON. NET IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE AT (914) 277 -5805 I TO: PUTNAM COUNTY DEPARTMENT OF HEALTH DATE: 10 -21-04 ATTN: ROD MORRIS RE: ALAN ORTNER -- SSTS PERMIT APPLICATION 1 GENEVA ROAD LOT #1 TRADING POST ON THE LAKE BREWSTER, NY 10509 CP -97 CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM WE ARE SENDING YOU ( XX) ATTACHED ( ) UNDER SEPARATE COVER THE FOLLOWING ITEMS VIA OVERNIGHT MAIL. # COPIES DESCRIPTION 1 PC -97 APPLICATION FOR APPROVAL OF PLANS 1 EAF - SHORT FORM 1 CP -97 CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM 1 WP -97 PERMIT TO CONSTRUCT A WATER WELL 1 DD -97 DESIGN DATA SHEET 1 LA -97 LETTER OF AUTHORIZATION 1 DESIGN DATA SHEET FOR LOT #1 TRADI OST ON THE LAKE (FROM 1992) 1 CERTIFIED BANK CHECK FOR $400 4 COPIES OF SITE PLAN THESE ARE TRANSMITTED AS CHECKED BELOW:, Fa�R Y ®UR APPR®VAL _..,.......__ ( ) (^ )� `AS REQUESTEDu ( ) FOR YOUR USE ( ) FOR REVIEW AND COMMENT REMARKS: The testing indicated on DD -97 was conducted on 9 -10 -04 with Joseph Paravati in attendance. SIGNED: T ° COPY TO: File, Alan Ortner 589 ROUTE 22 - P.O. BOX 403 CROTON FALLS, NY 10519 (914) 277 -5805 - (914) 277 -8210 FAX - BIBBO.LLP@ VERIZON. NET IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE AT (914) 277 -5805 "ENI ,. L710N 17 PM 4. 55 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH. SERVICES WELL COMPLETION REPORT WeII,Permit� #I a ' I � ' I I !. i:w•: II I .. 15 Well Location Street Address: Town /Village: LA ! lP Tax Map # Maps � Block ' Lot (p) Well Owner: Name: /� �( Address: 444 �faa c fr.t 300 E- Mao' &t ff�c7t�1` x':'14 ko� Use of Well: 1- Primary 2- Secondary _(residential _Public Supply Air cond /heat pump _Irrigation Business Farm Test/monitoring —Other(specify) Industrial Institutional Standby Drilling Equipment ✓Notary _Cable percussion Compressed air percussion Other(specify) Well Type Screened c�< pen end casing _ Open hole in bedrock Other Casing Details Total Length a..3 ft Length below gradAll ft. Diameter �° ii n. Weight per foot 'S_Ib/ft Materials: teel Plastic Other Joints: Welded L--Threaded Other Seal: Dement grout Bentonite Other Drive shoe: Yes _L�-No Liner: _Yes "o Screen Details Diameter (in) Slot Size Length ft Dept to Screen ft Developed? First _Yes No Hours Second Well Yield Test _Bailed _Pumped ompressed Air Hours `?f- Yield ( gpm Depth Date Measure from land su ace - static (specify ft) During y e test (ft) Depth of complet;d well In ft. 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. If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump T peSu I .tc- - Capacity Q Depth Modell Voltage �3O HP Tank Type QA Volume /0 Date Well Completed r :�Ik...� '..., .. Well Driller PC Certlficate# 60`5 L� % NY State # �o a;6 /, ! PumpI,nstaller PC Certificate. # 0 /a "�?,+ NY State # %; r, Date'of Repo�tl +�;�� fJd %Ell�`;. <<' Yi�t y �, � Well riller'Name &Address 5 4 Y t ?5 1 WeII Drtller (si/� ture :777!7 7777 ., .. ) I (1 t gi Pu p:Installer�Name &Address , * it4 F, 6 rr �C ..J.. ... I L ' .:.. Iffy' ��C ump Installer signature)h We L I >, ryHilia N�I N. I�,fy, '.47th_ ..: Ln"u!►no�.h a, ..r.. ;;i NOTE: Exact 1-6cation of well with distances to at least two permanent landmarks to be pFovided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller D Form WC -97 Rev. 3/06 CLAY BARRIER TRENCH I — -,-- e._ P.MMhft%0RTNERAV,XSa9LT, 12n2r2W9'54.49 AK NbWT. 1:1 CONSTRUCTED AS INDICATED ( COVERED OVER. THE SYSTEM � WITH ALL STANDARDS RULES i COUNTY DEPARTMENT OF HEA DEPARTMENT OF HEALTH. . . ....... I k C 3, OFFSET DIMENSIONS # ITEM w "w 1 ST4N 37.5' 15, 2 ST-OUT 28' 15! 3 PC 21' 19.51 4 DB 108' . 113.5'. DATE: 5 JB 105, 111, DATE: 6 is 105! ALAN & JANET ORTNER. NORTH SHORE ROAD TOWN OF PtM" VALLEY, PUTNAM COUNTY,NY EREHENEWEPHiffil BIBBO ASSOCIATES.) UP ow% C%f IvIrr, --- 103.5' 7 JB Iw BY 101, 8 JB 107.5' 100.5, 9 JB 110' Iw 10 J13 113.5' .101, 11 TE. 421 w .12 TE 38' 61' .13 TE 34' 56, .14 TE 33' 50, 15 TE 32' 461 16 TE 32.5! 4-1' PUMP & AUDIO / VISUAL ALARM TEST: DATE: 8-1407 DRAW: 8.76" DOSE: 231' QAL AUDIO / VISUAL ALARM: OK CONTACT INFO: ALAN ORTNER 215 BUSINESS PARK DRIVE ARMONK NY. 10504 00WHORM AUM"UM AW ADVOMM TV IM DI O 6 A VIOLATM OF OF IW NEW MW SrAlr m�uran�ow urn swam UP uwun AFROME MW NOTES: 1.)-THERE-ARE-NO KNOWN -EXISTING OR PROPOSED WELLS WITHIN 100' OR'200' DOWNGRADIANT OF THE PROPOSED STS UNLESS SHOWN ON THIS PLAN. THERE ARE NO KNOWN EXISTING OR PROPOSED STS' WITHIN 100' OR 200' UPGRADIANT OF THE PROPOSED WELL UNLESS SHOWN Ot THIS PLAN. - 2.) THERE ARE NO RESERVOIRS, RESERVOIR STEMS, WITHIN 500' OF PROPOSED STS UNLESS SHOWN ON PLAN. 3.) THERE ARE NO NYSDEC WETLANDS NOR•SURFACE WATERCOURSES WITHIN 200' OF PROPOSED STS UNLESS SHOWN ON PLAN. HOUSE. LOCATION AND PROPERTY BOUNDARIES FROM SURVEY PREPARED BY: BUNNEY ASSOCIATES: LAND SURVEYORS. SHEET.. 2 BLOCK 5 C LOT: 1-6 RS #2 FIELD REQUIRED- 444 FT.. 2* IN. WIDE TRENCH FIELD INSTALLED: 450-FT 24 -IN. WIDE TRENCH SYSTEM INSTALLED BY: DAMFINO CONST. -CORTLAND MANOR, NY' 0 co ZIN, 0: DATE: DESCRIPTION BY/C DATE: DESCRIPTION, B) A. 0 bg 0. A ._ _F ESSI AS-BUILT SEWAGE DISPOSAL SYSTEM' DATE: 12-11-07 SCALE. I"= W ALAN & JANET ORTNER. NORTH SHORE ROAD TOWN OF PtM" VALLEY, PUTNAM COUNTY,NY EREHENEWEPHiffil BIBBO ASSOCIATES.) UP ow% C%f IvIrr, --- FILE. AS-BUILT DSGN CHIC JB BY NT SHT NO. 1 10 FI PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A, WATER WELL please print or type — PCHD Perinit. #� ry4� v Well Location: Street Address: Town/Village Tax Grid # 3'¢ N ®eiN �ho !? l?vI/VO/ WWI � Map Block Lots) Well Owner: Name: Address: *Av- 6W-771F — I,SMGhDO w SWELc;-TU CoA;r1*&0 14hAloA Use of Well: J4 Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought 15r gpm # People Served Est. of Daily Usage 3, r gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason 1* 02 & AO f 63- G w Sv L for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...... .... ....... Yes_iZ_ No Name of subdivision TRA1)/NG pm Z1 WA/ 7H e L Lot No. Water Well Contractor: VJ"94VV V N (7,'5D Address: Is Public Water Supply available to site? .................................. ..............:................ Yes No Name of Public Water Supply: N Town/Village Al 4= Distance to property from nearest water main: ;V4— Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: .,O- 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 1 n Permit Issuing Official Date of Expiration la 13- Title: > Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Too y