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HomeMy WebLinkAbout2565DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -2 -4 BOX 22 go him, ga J �" 1, ire 7 . I .g, ' 1 OF 101 ILI Wu I 02565 4 3 r.LORETTA MOLINARL- - - Public Health Director ROBERT J. BONDI County Executive 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) 278 - 6014 Fax (845) 278 - 6648 D. Stella 45 Niccopee Rd. Putnam Valley, NY 10579 November 20, 2003 Re: Addition- Stella, 45 Wiccopee Rd. No Increases in Number of Bedrooms (T)Putnam Valley, TM #52 -2 -4, I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated November 20, 2003. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this department. 2. The area of:the existing sewage disposal system, and its expansion area, :must. be maintained: . 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. WH:Im cc:BI Very truly yours, William Hedges Senior Public Health Sanitarian BRUCE R. FOLEY __ ._ Public He6Pth Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA -MOLI:3fiRI- RN.; M—S:N: Associate Public Health Director Director of Patient Services Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 = 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) l ` STREET y W TO R X MAP# NAME, Sie �f Q, PHON��,�o�� —�j� PCHD #I MAILING ADDRESS DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map 4) *Non- professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhouseguidelines 2 - 2 -� LIVING AREA 449 y,-1 f. 2 �v pUTNAM CdUNTY DEPAnTMENT OF 17-ALTS HQUSE PL A1,1', APr ROVED OR BEDROOM, CGt; T GP ��ihvlJ: tJ �- - AID .. i�r.uz e &Title BRUCE R. FOLEY LORETTA MOLINARI.R.N., M.S.N. . Public Health Director.. iO�� _ °` ^ Associkte '�iibli'c Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: 0'; Residence Tax Town According to records maintained by the Town, the above noted dwelling I IS 'IS NOT' - - -_ in compliance with Town code and the total number of bedrooms on record is 3 This information has been obtained from: / CER7 IFICATE OF OCCUPANCY: �✓ ASSESSORS RECORD: OTHER BFhouse I L7 LJ L3 I \ wetland 21 L6 ' I I i utility pole 0 - •a 11l"', c'? """ all PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMENTAL HEALTH SERVICES, CERTIFICATE OF CONSTRUCTION COMPLIANCE F REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # p� — 14' I`o Located at _4-5 W 1cc096Cf kfv Town or Village i LTHMA WrWX Owner /Applicant Name H) "W -re Formerly Mailing Address Tax Map K' Block 2- Lot 4 Subdivision Name Subd. Lot # Date Construction Permit Issued by PCHD 101M©o Zip D G 4 p Separate Sewerage System built by - � . � d bu'(V o� Address i P('" Pot k Consisting of . � 0 0 t Gallon Septic Tank and ) 0 D L_ V- Ab� TWIbR Other Requirements: Pump Water Sup dy: Public Supply From or: _ Private Supply Drilled by M i ll_f0 N ...:_...Building Hype Address Address t,�_ .. _ _ Has erosion control completed ?�.._.. Number of Bedrooms 4) Has garbage grinder been installed? ho 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 Coulity epartment of Health. Date: 61 110"'L Certified by A&A�l P.E. X R.A. �,D,, gn Prof, 1) G Address �� W , +— � k DSO I License # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment -of the Public Health Director, such revoca ' n, modification or change is necessary. y By: �1 i/Jv° Title: ' ate: 2' White copy - HD Fi4 Yel(J copy - Building Inspector; Pink copy - Owner Orange copy - Design Professional Form CC -97 PUTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES is WELL COMPLETION REPORT Well Locatioin ;Street Address: 0%C40 TownNillage. `" At, Tax Grid Map 5�- Block �- Lot(s) Well Owner: Name: Address: tJA V 5 `ac-e l IZ1L1-4M d (4 Voi;t NV.&ale Nj j�E;oj Use. of Well: I'= primary 2- secondary Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) . Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well-Type Screened Open end casing Open hole in bedrock Other Casing Details Total length --.21—ft. Length below grade _LQft. Diameter _7 in. Weight per foot lb /ft. Materials: 7KSteel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: Cement grout Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours _6 Yield _ gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If.inore detailed .information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface & dj -/-Go (a ii E, If:yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type 5- Capacity 5 Depth CQQG Model -7 8 N i�-A 12- Voltage ,23G HP / Tank Type 44-3o2- Volume 9(- Date.W/1C mpleted v� Putnam County Certification No. 06 Date of Re ort r' D I Well Driller (signature) ,,NOTE: EXact location of well with distances to at least two permanegt lanamarxs to De proviaea on a separ sneevpian. 1 "Well Driller's Name R1111kA Address: M IX Zff, ct :5d4i A/.• t , Signature: Date: f White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 -(-914):�245�28A��` Albert H. Padovani, Director LAB #: 32.108530 CLIENT #: 11705 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NON STAT F9U]C PAGE 1 MIRABILIO, JOHN DATE/TIME TAKEN: 12/07/01 10:00 1 RICHMOND RD. DATE/TIME REC'D: 12/07/01 12:45 POUGHKEEPSIE, NY 12603 REPORT DATE: 12/14/01 PHONE: (914)-471-5199 SAMPLING SITE: 45 WICCOPPI RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE ' : KITCHEN TAP ' ,. � PRESERVATIVES: NONE COL/D BY: JOHN MIRABILIO TEMPERATURE..: < 4C NOTES...: ` ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~=~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLlFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 12/07/01 MF To COLIFORM ABSENT /100 ML ABSENT 1008 12/07/01 LEAD (IMS) <1 ppb 0-15 ppb 9101 12/07/01 NITRATE NITROG 0.53 MG/L 0 - 10 9139 12/07/01 NITRITE NITROG <0"01 MG/L N/A 9146 12/07/01 IRON (Fe) <0.060 MG/L 0-0.3 Mg/1 2037 12/07/01 MANGANESE (Mn) 0.022 MG/L 0-0.3 mg/l 2037 12/07/01 SODIUM (Na) 11.5 MG/L N/A 12/07/01 pH 5.9 UNITS 6.5-8.5 9043 12107101 HARDNESS,TOTAL 24.0 MG/L N/A 12/07/O1 ALKALINITY (AS 26.0 MG/L N/A ' 12/07/01 TURBIDITY (TUR <1 NTU 0-5 NTU COMMENTS:- BACT THESE RESULTS INDICATE THAT THE WATERJQ? jS AS NOT) Of A SATISFACTORY SANITARY QUALITY ACCORDI NEW YORK STATE ' AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more ` than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water ^� treatment must be undertaken to reduce the waters corrosive ` potential. ' Fe/Mn If both iron and manganese are presentv their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted dist,the water sho.ld 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 ^--~ I ff14> 245028O0' ,` ` ` ''. '' — '-' Albert H. Padovani, Director LAD #4 32.108530 CLIENT Q 11705 NON STAT PROC PAGE 2 MIRABILIO, JOHN DATE/TIME TAKEN: 12/07/01 10:00 1 RICHMOND RD. DATE/TIME REC'D: 12/07/01 12:45 POUGHKEEPGIE, NY 12603 REPORT DATE: 12/14/01 PHONE: (914)-471-5199 SAMPLING SITE: 45 WICCOPPI RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COL/D BY: JOHN MIRABILIO TEMPERATURE..: < 4C NOTES... COLIFORM METH: MF DATE FLAB 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 O 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 3 /L ��-- ~-MODERATE Yc�AAR-^`ATER:�7O-14' . /L---Wl1G/L =iMlLLISRAMPI����-TER' HARD WATER: 140-300 MG/L (1 grain/gallon 17.2 MG/L) .�» /. ' - � ' ` SUBMITTED BY: A^"=.~~.. .auu.a..^, n.,.IS~r/ ' Director ELAP* 1032-3 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL - HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM M X4,V-5 P 6Z- P e S H� Owner or Purchaser of Building d ,A-� i 6J)LPr_P5 61-1 2 Tax Map Block Lot `)VH N�A � L Building Constructed by Town/Village _46 \N Location - Street Subdivision Name . Building 'Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed. as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system,..except where the failure to operate-properly is caused by the. willful or negligent act of the occupant of the. building utilizing -the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the•failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Mo J 'bay Year 2100 Genera ontractor (Owner) - Signature J,Pj, 60iL0 u -5 Corporation Name (if corporation) Address: _ I �0 ?t 0i — J �� a� State Zip Signature: 4 1111401�� Title: P�7 J, jj L� Corporation Name (if corporation) Address: State Zip�Z�O� Form GS -97 Jan 16 02 09:55a Planning Board (914) 526 -3307 P.1 BRUCE R. FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. Assoctwe Public lfealth Director Director of Patient Services DEPARTMENT OF HEALTH - 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 218.6130 Fax (914) 178 - 7921 Nursing Services (914)279-6558 WIC (914)278-6673 F"(914) 278-6085 Early intervention (914) 278 - 6014 Preschool (9I4) 279 -6082 Fax (914) 278 - 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OF (Signature) DATE: :7 ! C- 1116 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 farm is to be submitted tivith the application for a Certificate of Construction Compliance. (£911 VERFW g 03° 05 5 6 52!)-A` `DIMENSION- CHART (iN 1:'E�r). N_ A B 1 75.00 31 . 00 2 - 7co .00' 35!5 00 � 3 -17.00 40.00 4 78.00 +5.00/ 6 f 37. 50� 4S o0. 7 ib. 00 D2.00 8 24 D3.00 SD. 00 94. 50 � 10 25.00' 20-00' It 28.00' 9: od NOTES THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. I / THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH AND THE NEW YORK , i STATE DEPARTMENT OF HEALTH. SURVEY INFORMATION FROM `5AVf!�Y MAP PREPARED BY RAYMOND J. KIHLMlKt�) L.L.S') PG. pATE�- '. Ft;P. 1 2000 BRUCE `R. "FOL'ET" ' Public Health Director January 22, 2002 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA 'M' OLINAR1- R.N.,' M— . -S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Proposed SSTS - Compliance Deschesne, 45 Wiccopee Road (T) Putnam Valley, TM# 52. -2 -4 Dear Mr. Nichols: Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. As built *plans must include the dimensions necessary to locate the septic tank and pump chamber covers. Use the adjacent comers of the residence for these dimensions. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely, 4e awn Rogan Public Health Technician SR:cj MENEM HaM W, Nichols Jr., P.E. h4orm hit, 30 106 2m ma 3 OWN", NY 10so4 TeWpbom (W) 2794003 :M. F" (945) 3*4$67 To: Attention: 5e—ai-I JL-cill Date: Job No.: 6 1 Project TS L C- C-6 Y) �, Gentlemen: WccncIo3c(5)'COpjC'3of. 0 B/W Prints 0 Revm&cibles Q Reports 0 Specifications 0 Memorandum 0 CopX of letter DmHption: Sent Via: Our Messenger C- Blueprinter 0 First Clan &W u Your me&=er C], Hand Ddvm - Copy to 0 Tracings 0 Revision/Date No. C)g 0 Special Delivery We. ' Alt kr—q- I , — — Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 - giz Telephone (845) 2794003 Fax (845) 279 -4567 January 16, 2002 Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, New York 10509 Re: Individual SSTS Compliance - Deschesne A5 Wiccopee Road Town of Putnam Valley T.M. # 52. -2 -4 Dear Robert: Enclosed are the following: 1. Five (5) prints of Drawing SS -1, "As -Built SSTS," dated 1%16/02. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 1/16/01. 3. Three copies of "Guarantee of Subsurface Sewage Disposal System," dated 106/02. '4. Laboratory Report, dated 12/14/01. 5 5. Application Fee in the amount of $200.00 payable to Putnam County Health Department. 6. "E -911 Address Verification Form," dated 1/16/02. 7. "Well Completion Report," dated 5/8/01. If there are any questions concerning the enclosed, please call. Very truly yours, y Harry W. Nich is Jr., P.E. FBVN:JM:jmm 01- 085.00 PUTNAM COUNTY ]DEPARTMENT OF HEALTH DI SIGN OF IENWRONM ENTAL HEALTH SERVICES __._..,. C S!T I1CTION PERMIT F" .._,,.. R EATM EN T SYSTEM ; PERMIT # /o o, o Located at GC .fl G (2-o Town or Village Subdivision name Subd. Lot # - Tax Map as~ Block Z Lot Date Subdivision Approved Renewal Revision Owner /Applicant Name '!1A J P ce- b e,S cWSo e- Date of Previous Approval Mailing Address Zip 6 Amount of Fee Enclosed Building Type Lot Area <- • No. of Bedrooms -3 Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL. IS COMPLETED Separate Sewerage System to consist of % ,,tea gallon septic tank and %tea 041. RL%np9 � 3� r-T a+ 2 �.0 i t�cL -eiUl,ev . Other Requirements: 2 r-"r P -0B 6I It ('505 - A To be constructed by Address Water Supply: Public Supply From Address _ or: Private .Supply Drilled by 'JB P: - 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 s, sy tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address (VO %5-7c ' P.E. ✓ R.A. Date % 0 v !l License # S-(ftbS' 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 cons' ered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new it. pr r di arge of domestic sanitary sewag only. By -" Title: 1410L Date: 1011(0100 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Prof ssio al Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL a,- -PC'HD Permit # Q X22- fa Well Location: Stre t Address: Town/Villa e Tax Grid # a' � � e e .0 -q Map 5Z Block Z Lot(s) Well Owner: Name: l Address: . "Des es 1, 0(f-ac Use of Well: esidential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought _ 5_ gpm # People Served Est. of Daily Usage _gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling c/New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling; �3 Well Type rilled Driven Gravel Other Is well site subject to flooding. Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. Water Well Contractor: 1'$0 Address: Is Public Water Supply available to site? ................................... ............................... Yes No Name of Public Water Supply: •--- TownNillage Distance to property from nearest water main: _ Proposed well location & sources of contamination to be provided on separate sheet/plan. Date:, 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 'lleUified utnam County. Date of Issue L!U f joc) I Permit Issui� g Official: Date of Expiration Title: t Permit is Non- Transferrabl White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date f' i C4 ;--� Re: Property of li-- Located at W t G-CZ7 per- P-0.. (T) 2 Section Block Z Lot 4 Subdivision of Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorizer ��-- o(�+r{��i`� 0 a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said " - syst'em'or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned,: P.E., R.A., #�Sr PC) J6a x 9S-0 Addre,sss% Telephone Very truly yours, Signed 'rwngr /of Property Address Town -2.03-- 3 27 Telephone PUTHAWCOUNff DH:.Ih A iI OFUMTH ,n ,;� �I� ` Dhli� e[ idrwie�hl'Hs Saevka: Case1.'N.Y 1lSl?' '�� loo FwaWi Fa*alt ani CERIDP CATR OF OO CS CO I t! ®11� FOt ;EWADNF084L .. Fae� • „_ ,. , , t�, SY818M ✓Icco?�E 7�oA 77 TN . ZZE' Subivh in Mount) Iwo T” Map_ L_Rioek Ownw /A, ri.., 1`!t A_y K .I c E_ DF5 C H t S N -❑ ❑ � I Date it Ftevloo Apprdvli reyrty rH %T. � -r—A M Fo KIP C T. O c qo Town tip Date Subdivision Approved Fee Enclosed Amniint Udo' 00 Htttttber ef'lll e06N ? Dew Flo .r G P D: GOO S"Weft se-mee spte. to o.omm at 2 U . Gob. SOP'* Teek anfl 3 OQ L, F To ble oe.5b ided by COSTl9 1`E ,1? E 1 �i Ud eee rc F eS4* ca�- W.ar S % Saet ✓ �--� Deed by �' , L t S01-4 �dd<eaa P ,� D (-0 1 represent that 1 am wholly and _compNtely ntponsibla for the CISI and location of the j above described will be constructed as shown on thaaP�roved'ahiendnent there to and in an County Deparinient of hlaaRh, ' aria that on corilpNtion thereof a -'Certificate of constr. be "witted to the Department, and a written - guarantee will be furnished the owner, piece in good operatiilip condition i6y pert of . fald aawage disposab` system during the a" of the • appre iii of _ the C I ate of Construction Corrlpllence of the lyinal sy Will be located aushown on the approved pion ind that said well will be Instal n a rdo County Dipertment`of.Meilth Date ...� - Signed e r APPROVED FOR CONSTRUCTION: This appreval;ex0ires two years , the date it revocable for cause or ma be amended or modified vvheri consider I OY tie requires anew »rmit.y�.oie0 for, disposal of domestic sand r and /or Rev. r, �'/, / G1 G % / 1a�8° Wte fT r" � BY Fm seetlon Oety. � Vobiioe . PCHD NedSatim li Ramtmd When FM b mmimbd O 24 �,. GRID rEL TxEN c H o A'1A6vLL AVc Ncw 9OCHELL£ I EL✓YE N. Yp' actoV, ind Ommisfbnw pf MMRhwill lOns,liy he b ikler, that said Builder will media, y f0 irie the date of the How 2) that i1e idea. veal described above uNs an use, ns of the Putnam ' tv P.E. R.A. Ing has been undertaken and is tqe or alteration of construction Titer 04 DEPARTMENT GF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 ...APPLICATION- TO "CONSTRUCT A WATER' WELL, PCHD PERMIT #fl 'A(` WELL LOCATION Street Address Town/Village/City Tax Grid Numb r cCo K6jqp po-n4om VgZtc -2-4- WELL OWNER Name Mailing Address rivate A 0 Ff ICC PCSC c SNP 19 SElUEN -r ST. ST F0K D C7- 6 9657 O Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ® PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED ® BUSINESS O FARM O TEST /OBSERVATION 0 OTHER (specify ® INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT _gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE 500 gal O REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION GIADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Wwrc ppLy F®Fi WELL TYPE ENDRILLED DRIVEN ®DUG ®GRAVEL 0OTHER IS WELL SITE SUBJECT TO FLOODING? YES I" NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Namur, '19Fi u- e '�o N Address : F0, Go X UE ygcw�Tc g IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V-11" NO NAME OF PUBLIC WATER SUPPLY: TOWN /V Ntw yORk . DISTA34CE..TO.::PROPERTY .FROM- NEAREST WATER MAIN.: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE 10ON SEPARATE SHEET (O :PS t MV) (date) (signa pN 6.2980 f PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of.the New York State Sanitary Code, and provided that within thirt;• (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or of w e conta to surface or groundwater. Date of Issue: 196 Date of Expiration__�a/_r 19 / Q Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller x' ^ ' �� ������'��� ��l������-�- ����r �J ' �pPLI . ION FOR APPROVAL OF PLANS FOR A.NASTEWATBR DISPOSAL SYSTEM .` 8 5r'VCNTFA— 677 If so, have plans been submitted to such authorities? ..,......^^,^^^^^^ _ 2. Name of Project: 13. 3. Location '^.'-� Date Granted:________ r)w'I�/��/���` �u/T6-2Y� | 4. P 'ect Engineer: -~ N�ter � round Waters �__u Surface � u _� 5. �d�resa' ' ' ` 9 7YO HN. kVq L '� H '25 o 0. - 09 r-lJD designation?-,...'.. � '(surface) rc6 ' License Number: Waters index number ~.......^.^^^`'^^'^'^^`^^^''^'^^^'`^^^^�^'^ � Phone: �� � �� ` 6, Tyce of .'',,,,..~'^.^'^'^ 'Private/Residential Food Service . Commercial ----- �er�me`� p � s institutional � ----- Mobile Home Park ' Offi�� Bu�l�in8 ____ Realty Subdivision . Other (specify)' 7. Is this project subject � to State Env nronmenzu l Quality Review (SEQR)7 Tvoe Status (Check One.) Typo I.. Exempt Date o1serve,2: 23' �a.me of He-Elth Inspsotor� � 24. Type II. Unlisted 8. Is a Draft Env` 'nmentaT Impact Statement (DEIS) required? ......,'..... No 9' F,-=s been completed and found acceptable by Lead Agency? ........,�. 10. Name of Lead Agency T.J./A , 11. Is this p 'ect in an area under the control of local planning, zoning, 12. If so, have plans been submitted to such authorities? ..,......^^,^^^^^^ 13. Has preliminary approval been granted by such au%horities Date Granted:________ ^�- 14. Se*age Disposal System Discharge .,..., __ Type c-:,' Sewage N�ter � round Waters �__u Surface � u _� 15. If surface water diocharqe, what 1a the. stream class designation?-,...'.. � '(surface) NLA) 16. Waters index number ~.......^.^^^`'^^'^'^^`^^^''^'^^^'`^^^^�^'^ 17. ' Is prcfa,ct located near a Public water supply system? .'',,,,..~'^.^'^'^ � ' Distance to water supply 18. If yes, name of water�supply l- i ' i' ll -i �� �o � s«s���- Zs prc^��t s �e near a pu�l c sewage �o y�. on or s s� ..'..' Distance to sewe9-e aY.-Ste� ZO. Na-ma-o� 21' Date o1serve,2: 23' �a.me of He-Elth Inspsotor� � 24. Project design flow (9 1 E]lons per day) '.'....,'`^'''''`''^'^'^''^^^'''''''' GOO 2. 25. .Is.`Sftate Pollutant Discharge Elimination System (SPOES) Permit required? W6 ' - - • .. � -. - ..> - •_ys... -. _ r :e ... ... ..�.vr .S_ ...... _a r. -. ... _..-r +.�- aR'v • . rte= - r..>.. 26. Has SPDES Application been submitted to local DEC Office? .... 27. Is any portion of this project located within a designated Town or State wetland? .................................. ............................... TJ o 2S. Wetland ID Number .................. ............................... .. La 29. Is Wetland Permit required? .............. No Has Application been-made to Town or Local DEC Office? .................. =30. Does project require a DEC Stream Disturbance Permit? ...................... 1J0 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal; land.filling, sludge application or industrial activity? ........ YES or NO U :32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO 110 DESCRIBE: Is there a local master plan or file with the Town or Village? ........... F .32. Are community water, sewer facilities planned to be developed within 15 years? _ -3- ;_.Ahs .. any ,sewage..dl.sadsal::areas::.in- excess_ of 1, .35. Tax Map ID Number ...... .......... ..... ............................... 37. Approved Plans are to be returned to ................ Applicant ✓ Engineer the application is signed by a parson other than the applicant shown in Item 1, the .application must be accompanied by a Letter cf.Authorization. Failure to comply with this ,)rovision may be grounds for the rejection of any submission. I hereby affirm, under Pena 1 ty of perjury, tha form is true to the best of my knowledge and herein are punishable as a C1a s A Hisdeme n r the Pena 7 Law. /� A 7 I -. T! INC ADDRESS: I M (3-7 T1IE L1f4 2 X H /V � L )F NEW y� a R vided on this �y Fa to , nts made ua%t 7 210.45 of r w W X00 K14-L t4V 10 g CRONIN ENGINEERING PE PC The Lindy Building, Suite 200 2 JOHN WALSH BOULEVARD PEEKSKILL, NY 10566 (914) 736 -3664 FAX (914) 736 -3693 TO Robert Morris Assistant Public Health Engineer Putnam County Dept. of Health Dept. of Environmental Services #4 Geneva Road Brewster, N.Y. 10509 \fE ARE SENDING YOU Attached 1.1 :l l l;i. t /)I I I. \4111 DATE -- 15 _ JOB NO. ATTENTION ROBERT-MORRIS REi MAURICE DESCHESNE WICCOPEE.'::ROAD SSDS' PUTNAM VALLEY PLOT PLAN & SEPARATE SEWAGE DISPOSAL SYSTEM •2 COPIES DATE NO. DESCRIPTION 3 PLOT PLAN & SEPARATE SEWAGE DISPOSAL SYSTEM •2 HOUSE PLAN 1 CONSTRUCTION PERMIT APPLICATION 1 APPLICATION FOR APPROVAL OF PLANS 1 LETTER OF AUTHORIZATION 1 DESIGN DATA SHEET 1 WELL PERMIT APPLICATION 1 CHECK FOR APPLICATION FEE THESE ARE TRANSMITTED For approval A- 5 0 5 � �r-�. � �ic. ���� h"e �. -� �'G�2 �' bone ✓1�yr1 .��r ; SIGNEDI �(/� APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES JNDIVIDUAL. WAFER. SUPPLY_.& SUBSURFACE: SEWAGE .AISPOSAL SYSTEMS REVIEW SHEET for CONSTRUCTIONrj RMIT STREET LOCATION ! gl2a NAME OF OWNER /. BY B. HEDGES R.MORRIS OTHER DATE TAX MAP # - - Y DOCUMENTS. PERMIT APPLICATION PC -1 �VELL PERMIT M PWS LETTER �• NGINEERS AUTHORIZATION ® ESIGN DATA SHEET(DDS) CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS m VARIANCE REQUEST t SUBDIVISION GAL SUBDIVISION DIVISION APP VAL-CHECKED C RATEL REQUIRED DEPTH RTAIN DRAIN REQUIRED m STANDPIPES Y , MXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE F PUMPED PIT & D BOX SHOWN & DETAILED OUSE - NO. OF BEDROOMS WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM . PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE M NO/BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS CLAYBARRIER 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE FILL SPECS m FILL NOTES FILL CERTIFICATION NOTE DEPTH GAUGES FILL PROFILE & DIMENSIONS VOLUME GENERAL FILL IN EXPANSION AREA E - VAL SSDS ADJ. LOTS,ai' TOWN/DEC PERMIT REQ ?) MOVIDED D DS PLANS & PERMIT SAME THE 6 0 FT MAX -19 ]EIGHBOR NOTIFIFICATION LEL TO CONTOURS :. _ _._..... ..: :...__._ ... : D .1'00% EX�PANSIONPROVIDED _ ._ _..__.....:.. _ ..._ 3 I%Z]BA 100 YR. F OD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN �REQUIRED DETAILS ON PLANS EWAGE SYSTEM PLAN - (NORTH ARROW) S HYDRAULIC PROFILE m GRAVITY FLOW Elff CONSTRUCTION NOTES (GRINDER NOTE) =YrESIGN DATA: PERC AND DEEP RESULTS O -FOOT CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES CUT ��i�R/CURTAIN DRAINS m OSION CON L; HOUSE,WELL, SSDS 4i EROSIC1 C6NTROL NOTE fff'PRREPRESENTALTIVE ERC & DEEP HOLES LOCATED OF PRIMARY AND EXPANSION rn&,e, 1 4 i % -,2.o r 10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL 20' TO FOUNDATION WALLS DJ 15' WELL TO P.I 100 TO WELL, 200' IN D.L.O.D., 150' PITS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (PITS -201 50' INTERMITTENT DRAINAGE COURSE 200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS 15' MIN TO C.D. S= >5 %,201- 4 %,251- 3 %,301- 2 %,35' -1 %,100' <l % '20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. 10' FROM FOUNDATION; 50' TO WELL MARVIN O'DELL Bldg. Inspector :..TOWN HALL,.. __ .... PUTNAM VALLEY, N.Y. (914) 526 2377 JOHN MAHONEY BETTE STOCKING ER Deputy Zoning Inspector TOWN O F p U T N A V VALLEY Bldg. Dept. Clerk BUILDING, ZONING, AND SANITARY DEPARTMENT December 3, 1996 Putnam.Counry Dept. of Health 4 Geneva Road Brewster, N.Y. 10509 Att: Robert Morris Re: Deschesne 45 Wiccopee Road TM #52. -2 -4 Dear Mr. Morris: In response.to your "letter of November 25, 1996, I have reviewed the proposed improvements shown for the above no "ted property Said -- _construction as_shown "by Cron in- .Engineering,P-- E.�.P.C.. _. s'ite•plan 'dated - January 14, 1996, indicates improvements to be outside the one hundred (100') foot wetland control area. Erosion control measures should be taken prior to any construction to protect adjacent wetlands. x•- Very y yours, O yq MARVIN 0 DELL Building & Zoning Inspector MO'D:es PUTNAM COUNTY WATII� U STRA--TEG- Y COMVIl79'EE To: Water Quality Strategy Committee Members Front: Lauri Taylor, Co -Chair Subject: Meeting Notice Date December 2, 1996 The next meeting of the Putnam County Water Quality Strategy Committee is scheduled for Tuesday, December 10th at 9:30 am at the :Division of Planning Office, Patterson, NY. Agenda 1. Watershed Management Plan 2. Display Material 3. Storm Drain. Stenciling , - -- 4..... a.nternship. /Water .Models in - School 5. Open Discussion 6. Next Meeting PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL.HEALTH.SERVICES Date Re: Property of N%Lor lc.�_ �..G- Located at CGOP E Ko ) (T) uTr4190.7 V/g1.LEy Section Block Lot Subdivision of Subdv. Lot # Filed Map , Date Gentlemen: This letter is to . authorize -IIN 6TH Y a duly licensed.professional engineer ✓ or re* (.Indicate to apply for a Construction Permit for a separate serve the above noted property in accordance with or regulations as promulagated by the Commissione: 7IU sewage system, to the; standards, rules r of the.Putnam County Department of Health, and to sign all necessary papers on my behalf-in. connection with this matter and to supervise the construction of said system or.systems in co.nformity.with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. —� Very ours Y trul Y yours,. r% Sixned // Countersigned 5 P.E , R.A. , #THE VN L I N.D tfi , V U Address 3_0 N N 1' 9"L 5 H [7 u LEU� ri K) L L ty Y 1 y -,5-66 914- - -7:3 6. -- , G-G 4- Telephone of Property ess Town 12_ -7 C� Telephone TO: All EMC Members ENVIRONMENTAL MANAGEMENT COUNCIL RR 9 -Fair Street Carmel, New York 10512 (914) -878 -3480 FROM: Lauri Taylor, Putnam County Division of Planning COPY TO: Robert Bondi, County Executive William Bell, Chairman of County Legislature Bruce Foley, Public Health Marjorie Keith, Cooperative Extension Gordon Maxwell,. Recycling Coordinator DATE: December 2, 1996 Roy 10< QR' The next meeting of the Putnam County Environmental Management Council will be . -held ,.on _Thursday; ._D&6 her: _12,� 1996. at : 30= pm= at:. the Putnam-- -County Transit - Facility on Fair Street in Patterson. If you can not attend, please notify the Planning Department or arrange to have a representative in attendance. The tentative agenda for the meeting is as follows: 1. Update on the Great Swamp, Dan Siemann TNC Great Swamp Program Director 2. Minutes of the November 14th meeting 3. Chairmanship Decision for 1997 4. List of Members for 1997 5. 1997 Program 6. Open Discussion P.F. BEAL & SONS, INC. 4 PUTNAM AVENUE ARTESIAN WELLS BREWSTER, NEW YORK 10509 WATER SYSTEMS a&d/�eli %�y% SUBMERSIBLE PUMPS TEL. 279 -2460 - 2461 FAX 279 -6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE October 18, 1996 Cronin Engineering, P.E., P.C. Attn: Kenneth M. Murphy The Lindy Building Su i ite 200 2 John Walsh Boulevard Peekskill, New York 10566 Dear Mr. Murphy: WATER TANKS COMMERCIAL WATER SYSTEMS - •HYDROFRACTURING-' = WATER CONDITIONING EQUIPMENT After receiving the plot plan which you sent to me concerning the property of Maurice Deschesne on Wiccopee Road, Putnam Valley, NY, I met with Mr. Deschesne to look at the proposed drilling site. I also looked at the bridge that we would have to cross which is located on his property and he gave me specifications as to the construction of the bridge. Having received this information, I feel comfortable saying that our drilling rig will be able to cross the existing bridge and once the existing roadway is cleared and the proposed site work completed by the location of the house, I feel that there will be adequate access for our drilling rig to drill the well. I would anticipate a.well depth of- approximately 3 -&0� and -- ----- _._......� Very truly yours, P. F. PLB j mm al & Sons, PUTNAI<I COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date:. / O! St�eetl✓oC1 :.._: :4wd., - Owner r, 5 G I U S Town Permit # v - Z 2 TM # Z -- - Subdivision Lot SeNvage Systetb Area YES NO COMME TS a. STS area located as per approved plans ........................... v g a b. Fill section - date of placement 1 barrier Lgth. Width Avg.Dpth i>u� � tural soil not stripped ................... ............................... one, brush, etc., greater than 15' from STS area.......... 0' from / A water course wetlands ...... ............................... Qe Svstem a. eptic tank size -1,000 ......... 1,250 ........... other ................ b. eptic tank installed level ................ ............................... c. 0' minimum from foundation .......... ............................... [Distributiop d. Box 1. All outlets at same elevation -water tested ................. 2. Protected below. frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Bo -properly set ........... ............................... �--- - --°- -- f. Trenches Length required -�> oc } Length installed ° o Co 6w11110 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... © U u c.o 4. Slope of trench acceptable 1/16 -1/32" /foot :..:......... 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1%" diameter clean .................... ( �° 9. Depth of gravel in trench .12" minimum ................... :. y 10 Pipe-ends capped......................................................... RumR or Dosed Stems Size chamber « V • �� ot pump ................ ............................... o.c 2. Overflow tank ............................. ............................... 3. Alarm, visual /audio .................................................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ........................................ : .. ° �v► -�� ................. 6. Cycle witnessed by H.D.estimated flow /cycle........... ouse/Buildin a. House located per approved plans .. ............................... b. Number of bedrooms ....................... ............................... . . Well a. Well located as per approved plans ................ .......... ''� b. Distance from STS area measured ej-1-........... c. .Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship. , a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... 'a- 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 & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided .................. ..:............................ �DIVZSION OF II�1VI�20NNPAL HEALTH SERVICESz �oi3 i 5 4 ' + DF.SiGN DATA SHEEP- SU13St7FACE 'S�. DISPOSAL SYSTEM •R�Y fry,^ .: ... - : .. - - it - .. Oamer`t�'IU1, v ..pt ss t� € - zldress= yEr;�-rW-r-rx�.r� - _ �� c �. o tr�C ` Loca street Sec. Block Lotted - (indicate nearest cross street) Municipality. . i •p U -r N r? rPP 09 L L Watershed fi•-ff. r SEW 14L SOIL PERCOLATION TEST DATA RDQUIRED TO BE SUBMITTED WITH APPLICATIONS of .Pre-Soaking _ _ Date g; � � % _ .q�•.• Date of Percolation Test. ' 1 � - -7 � SS • • �. .. HOLE ' . NUMBER CLACK TIME PERCOLATION PERCOLATION • Run . Elapse Depth to Water From Water Level - No. Time Ground Surface In Inches Soil Rate Start Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 1 19¢5 9s_7 12 29-`� �oi3 i 5 31 ;q 032 6 4 P.3 P"L 1 � •So � 0 z _ 2.A. °3 I 4 5 NOrIES: 1. .'Tests to be repeated at same depth until approximately equal soil, rates are obtained at each percolation test hole.. All data to be submitted for review. �. 2. Depth measurements to be made fran top-of hole. , rev. 9/85 • 3 . 3 -. 4 5 NOrIES: 1. .'Tests to be repeated at same depth until approximately equal soil, rates are obtained at each percolation test hole.. All data to be submitted for review. �. 2. Depth measurements to be made fran top-of hole. , rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION- DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE N0. V.1 HOLE NO. HOLE N.O. 2' .�/q /v D 6.rf SAS o K/ 3' r Ki co c K ICk;A C. 0 F 0 C_ K 4' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED ' 'N cI N C F1N C 0 v N 'rEt� E-D INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED Y nIIxJ DEEP HOLE OBSERVATIONS MADE BY: 'Ti Nv'THY Z; C: ON I W ` ' ±r DATE: DESIGN - Soil Rate Used —% Min/1" Drop: S.D. Usable Area Provided 5 QW No. of Be3rocros Septic Tank Capacity It gals. Type /YiA.Co NA ti Absorption Area Provided By 3D0 L.F. x 24" width trench EVyo; l_. c& Other h10 f4 �y. Name —f t IvIoyJTN y L . C -Kd N I' N --ttr— Signature lE" L 1 N D-,/ F U 1 L iP 1'�1 G . Sv ►-t c� c� . .. Address SEAL 2 �O HIv L S;h/. �oUZE li'�'iJI . �GJ�Q 629ii0✓� ,r ter ' THIS SPACE FOR USE BY HEALTH: DEPARTMENT ONLY:. �' Soil Rate Approved sq. f t/gal. 'Checked by Date r4 •f @` +�?� ... ' -� . �: :rte ''v L` . , Y'1 Public Health .Director, ..10REVA"MOLINARI R.N., M.S.N. - Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 August 3, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Deschesne, Wiccopee Road Town of Putnam Valley TM# 52 -2 -4 Dear Mr. Nichols: S] This office has conducted a final site inspection of the above referenced project on Wednesday, August 1, 2001 as requested. I offer the following for your review and consideration. System "as- built" location is to be shown and proven out on the as -built plan. Location (100' separation) from wetlands to be shown on as -built plan. Septic tank and pump chamber covered with dirt at the time of inspection. Putnam - County. Health. department unable•to ins' ect/measure k* t.k. tank or-the purnp chamber Distribution box to contain baffle. D -box installed to be removed. System greater than 90% backfilled/covered. SSTS to be uncovered for inspection. 9IZ 9(of This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. �3 2,0 01 ABS:,cj Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer „_.. . a,NOV. =i91 -2001 08:10 PM HARRY W H I CHOLS — 914 27 9 4567 P.01 BRUCE R FOLEY Publie Hrafth- Director DIEPARTNIENT OF HEALTH 1 Geneva Road Brewster, Now York 10509 LOREITA MOLINARI X.N., M.S.N. Ausckts Publie Nsaltb Director Dlrsotor gj.Mkow selvecr ATTENTION: WADAM STIEDELING c: GENE REED All information below must be jolly completed prior to any scheduling. DATE: —� ENGIiYEER OR FIRM: rr GU /U 1 •7 4 JW r, — . PRONE #; � ` oa REASON; ' DEEPS: o PERCS: a PUMP TEST: ROADISTREET: ._._'a J _ — T0IVL ! �1G�'h!d� V'& II � TAX MAPII: �” v SUBDIVISION: �°° LOT #: OWNER: NI ot:u� t Ge: 1 J-G5 el, �S H F.1 1•'ES NO _ _ ❑ _ o _ - :__ _Proposed SSTS - within the drainage-basin or west Branch or-1 oyd Uriter-Reservoirs: + ❑ i M ❑ 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. ❑ 0 Proposed SSTS design flow greater than 1000 gallons /day -or SPDES Permit required. ❑ O Proposed SSTS for a Commerical Project. It is tk'e 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 ya to any of the questions, NYCDEP trust witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional. and NYCDEf. If a project has been determined to be Delegated based oh the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NY(DEP. roa co*ry usE ony e DATE., Td1tE: �. o oo (MLI)TEST) 4 d a, BRUCE R.. FOLEY Pub((e DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 0 LORETTA MOLINARI R.N.,._M.S.N,. A sociate' Piiblic Xeah Director Director of Patient Services Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 R'IC (8.15) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278.6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 a a To: Design Professionals Submitting Plans to Putnam County Health Department From: Bruce Foley, Public Health Directo Date: August 10, 2001 Subject: Revisions to Putnam County Health ,parment Bulletins ST -19 and CS -31 As a result of a recent meeting held with the Putnam County Electrical Board, the following items were agreed upon with respect to the design and construction of wastewater pump chsunbers: 1. An all weather junction box with an outlet and screwed cover will be provided at or above grade at the pump chamber to allow for a plug -in connection for the pump(s). - - 2:- Prior_to.eondllcting afinatinspecAion on ihe.dump.ch tuber an- electzic.alUnderwriter'� -� Certificate for the pump chamber must be provided:to the Putnam County Health Department. The Putnam County Health Department will not schedule a final inspection of the pump chamber until an electrical Underwriter's Certificate is provided. 3. The Putnam County Health Department will only inspect the pump.pit construction, pump dose and alarm operation. 4. The note "All pump power and control wiring shall be made directly to the control panel without any outside splices," is to be deleted from Bulletin ST -19, Section 4.A.7.r and . from Bulletin CS -31, Section 4.C.15.h. 5. The following note from Bulletin ST -19, Section 4.A.7.r and Bulletin CS -31, Section 4.C.15.h has been revised and shall now read as, "The pump control panel and alarms shall be located inside the house or building." The following revised sheets from the above referenced Putnam County Health Department Bulletins are included for inclusion into your existing Bulletin documents: - Page 12 - Bulletin ST -19 - Page 13 - Bulletin CS -31 Should you have any questions concerning the above, please contact this office. Cc: William Picarella, Electrical Board SENDING CONFIRMATION DATE : NOV -15 -2001 THU 10:44 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE : 92794567 PAGES : 2/2 START TIME : NOV -15 10:42 ELAPSED TIME : 01'26" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... • • 0'�-0 � � 5 •� 4ssta eau ep -WWI ewq QQ ; nmt 0 oZ 11 atra av�eaaA+yiwra IMAM IN-110- 0pTMIMI -GPWJ AdUlPaPSMJa 13HIV-11- Na oql °q L-31 "M Qo oql llWq1lA M P V90 h ARWAN alvolpul uafruuaful m0nhargW af»p PUF 010141M *A*" Up va p01e9 aq al peopapp ovog arq us fud it JI •d>ta�AJa o�•INal�ia�a uIllood.op V003d aip tata lt*mo pp9 +oJ mM ofgagpu LQaamm ■ aJ M"oo Itw pwawsdaa a.0 **m QN a* mmIAL pm d9fDAN Voopumb mp p in 43 W PUMON aot JJ vrvadai oyf uo poo!q CM&M b noo aapgr WJOid aMAN mp mp+r»p MA a®wurdo0 Ml ftpm lat as japd vollowan &.W so "&a as dm aaio I g1tuo4w.y, g it ...- • -- :._��....:..._. -.,... -. ._ .. ._. -. .... .. ..,�%odlpF�J'6161Bperw6ia .._o.._o..__.._ _ ,. '• upb- apagd 980491@ J0poMd pOOJ u p AmA m9 dpop 6189 pmdo a o a paIRIAL= a9AGM011aoapnaJ010 %Q"0R"LUBpo0dad a a lompgoolJO=gl*L*4t'tpua U010 We B0 RW 6168 P019daj a p '1qo tnos AMINO 9194 Ad, V- tRWMJa mall 4tp«9 Spud+d a o ON 83A s119NAt0 t0y07 �.�� WOISJA1f18f18 1rw y —� 418Yp17R/l `+J �-« !VA101 T p�.v � •,J�afl.lS�aroa um mu u a :2=34 o :Wm • �NO6Y31! ;fJDJOItd ' gV1IJdQ0V37N1'JN3 Off - -2m '><vlP"W by as AGO po Rftgr fm 0a mao "0104 arp.nuepg er am Sao a OJD'1u= WMA :NOIiN7uy ME= Irlml Rod nmion 88801 3WA -m 1-8 pmlJ rAIL"D 1 H11M 40 iri$wiVdga NfV X00 aOKQ IVOY B!Y 0aFaval' +aft00'V/W rr8 W 'N 8 IJIYJO'm vLunm * — AMU Y 9afmv 19'1 A9t• -ALL rib _••• -+•_- 9'f0NpftN N, ANOWH ... 0e 01:90 1001- 10 -M1ON JUL -25 -2001 11:09 AM HARRY W NICHOLS 914 279 4567 P: "02 . _. .' p1J'XNAI�i COUNi'YDEFARi'R+YEN`�"Oh 1I,'Y'� • ' . - - - DINSION OF.ENMONMENTAL HEA TH SERVICES ATTENTION .ADAM .0 GENE gEQIMilIM IFINU 2122 rInty For: 'Fill All information must be fully completed prior to any Trenches ,�/ inspections beiq made. PCHD Construction Permit # )0 P'_ 2.;L 9G �( Located: Ownex /Applicamt Name: TM 5-? Block W, _ Lot Formerly! Subdivision Naas *: — Subdivision Lot # Is systeni fill completed? Date: Is system complete? Date: 3 -- Is systern constructed as per pleas? X." Is well dulled? Ye�x Date: _ :Z-2.3 -0 Is well located as per plans? �Y�s Are erosion control measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and 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. Cert ified by: Deign Professional Address: S1t Lic. it SCt t ? Comments: Form FM -99 above descnbetl will be constructetl as shown on the approved amendment there to and m accortlance wdh th @stantlartls "rules an regu a ions o e u nam • 'County - Department of Flealth anp that onticomplet�on thereof a Cert1t�eate" of..Construct�ori Compliance :satisfactory to thefComm�ssloner,of` Healthw�ll t °be submitted to- the °- Depa'rtment and a written guarantee will De furnishred;therowne► li5'S000eSSOrf heics:0► assigns Dy the,bwlder -that saitl builder will place �n'gootlaoperatjngcondrt�on any part'Eot said: sewage gisposal system duitng the pgr�otl of`two (2)`years Imme`tl�ately foltowmg;thetlate of the`issu- ante `of _the approval of he Cert�i�cate of Gonstructiori Compliance 'of to r,ig� al system or any repairs thereto ):that the'drillodwell described above wUl be located as shown gn;the approved plan;and that aid well will be Jnstal ui`: cor ante dh ;the standards rules and ►egu a wns of the- 'Putnam ,County D par meet rof Health r '` { r s,,., ✓ - Date I /5gi6 r Sgne 3 Address License No 30 APP ROVED FOR "CONST.RUCTIONi TMs approval expnes one year from the date issued,uniess construction of ttie•bu lding -,has been undertaken antl'is revocable for 'ca Us@'Or may be anie'ntled or mod�fled when Considered necessary b the Commissioner ;of Health , , Any:. change':or alterafiOn Of Construct ion - requires a new:'permit :Approved for disposal of domestic'sanitary sews a 'ii %or �nvate water'supply only. °N pp�� /� //•-� Date L9`�� 07t'7 ". BY ' QAR��� Tale y PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date +{ 101(, Re: Property of �or�l�, ��4iC_'Vfte. Located at vi (T Section 3 5 Block Z Lot )p Subdivision of Subdv. Lot # Filed Map # Gentlemen: Date This letter is to authorize a duly licensed professional engineer 1 or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in _.,.:c.onrnection with this' matter. and- sup_er-v.is.e-- -the - .construction .of said - system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed �L� a"401t Countersigned: Owner of Property P. E. , R'..A. , # i}3�''j Address 5��btk J- 069105 Address Town NY Telephone Telephone PUTNAM COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS e FIELD INSPECTION REPORT DA'L'E: / - -- W INSP. BY: INITIAL SITE INSPECTION IYES NO COMMENTS Property lines or corners found ................... I I I .Z� Y�ai Can estimate house location ....................... Willdriveway need cut ............................ Must trees be removed - note these... ............. Deep hole representative of entire SDS area... .. Additional deep holes needed ...................... Sufficient SDS area available considering driveway cut, house location, separation distances,etc... Adjacent wells/ septics ............................. w t Access to propgsed well location for drilling..... D.H. 1 Lot D.H. 2 Lot Depth to G.W. Depth to G.W. Depth to rock Soil Descri 0 ft. 6 ft� 9 ft. ... rp, Pr,•. 12 ft. FINAL SITE INSPECTION Depth to rock . Soil Descriptioi 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. DATE-.--- - - INSP.BY: House SSDS located per approved plan ............. Length of trench measured Width of trench average Slope of tile line and trench acceptable......... Room allowed for expansion trenches .............. Over 100 ft. fran swamp, watercourse ............. Natural soil not stripped or SDS area unnecessarly graded ...... ....................... 10 ft. maintained fran property line and 20 ft. fran house .............................. Distance well to SSDS (ft.) ...................... Number of bedroans checks ........................ Stones, brush, stumps, rubble, etc., greater than-15 ft. fran nearest trench .. ............ . 15 ft. of peripheral soil horizontally fran trench.. .... ............................... Boxes properly set ............................... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE ACCEPTABLE .................. rev /9/85 D.H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock Soil Descri tion 0 ft. 3 ft. 9 ft. PUINAK COUWY. DEPARTMENT OF HEALTH e, DIVISION OF ENVIPSIZENM HEALTH SERVICES DESIGN D?,T - SHMr- SUBSUFACE. SEWAGE DISPOSAL, SYSTEM - FILE ��. Address ib Owner i�sal.�, 5�e.►., �,ie_ nn11 '' 11 Located at (Street) �'CofW, ate. 2MO. W44 v� Sec. 35 Block 2- Lot 10 (indicate nearest dross street) ,kC Cos heir Municipality P.oM J Watershed' i t4 SOIL PERCOLATION TEST DATA RBQUIRM TO BE SUBNBTrED WITH APPLICATIONS Date of F7re- Soaking 33 d$ 6 Date of Percolation Test. 3 IM 66 HOLE NUMBER C= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No.: ; , t ...-.Time Ground Surface "Start 'Stop In Inches Soil Rate -Stop` Min. Start"'. Drop In Min/In Drop Inches Inches_ Inches.. 17 3 J 1 t 2 _ I�j.� zy ZI ,.r 3 �b -3 20 1 _z ' 4 �o . Z`t 7-7 5 27. 2 2 2 7 g 20- 2 'Z 4 Z0. 2 .3 b g 5. 1 2 3 ' Nl7i'ES• ;Tests, tc e`repeated'at same depth until - =c4ma tely equal soil rates, �d °.at • each. peroolatioai;:test�ialef�.�. _ ' "c7ata�to`.be "submitted uremants to be made.from top oU hale. DEPTH G.L. 1'. 2' 3' 4' 5' 6' 7' s' 9' lo' 11' 12' 13' 14' -NIF N We v �Qp 1• DII 1 1 ivy N 0I IMITIM y 6: VII • • V • 1 S: et R 1• • • • 1 MO 5 kNWOR 0 w b1. 5- FS V S Yi- 0 : •1 �. HOLE NO. HOLE NO. 2 HOLE NO. R 6A1)K 6cb hgo 2rky- t N cbo4;T OF rf!�t SZ-0AP 1� 1 r•�IY � . Fri iii' iii A.: PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL 'WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS - -. REVIEW .. S . - .CONSTRUCTION PERMIT DATE REVIEWED: 1J1V� �CQ BY: (Name of Owner) (Street tion) DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains, Perc & Deep Holes_ Located Representative of Sewage & Expansion Area �Fx ns on. ,rPa,;.shQ ;.gza .ty:. flow, suff' If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake Unc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Etc- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same 0� 0� 0� B� DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains, Perc & Deep Holes_ Located Representative of Sewage & Expansion Area �Fx ns on. ,rPa,;.shQ ;.gza .ty:. flow, suff' If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake Unc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Etc- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same