HomeMy WebLinkAbout2664DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
61. -1 -9
BOX 23
02664
.
'
r
L
T` •
.
1; �
ON
T
'
An
L
Z
02664
PUTNAM COUNTY DEPARTMENT OF HEALTH
___.----SI —
_. N._OF ENVIRQNMENTAL:.HEALTH SEItVIC
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # 5(-0 35 w 0-Z
Located at 5C) CHAP' AIJ Z%01V3
Owner /Applicant Name
6i —Ac., i IP-RZ&tA
Town or Village (T) P'54— v \�
Tax Map & t. Block Lot 'i
Formerly NV p A. 05k4 Subdivision Name
Mailing Address
R PA%x-01ax Aveuup
PV�ILLP M. W)Y344
Subd. Lot # 1
Cj-� s9zi luu
Date Construction Permit Issued by PCHD 0�0 I i 15 1 OCP
Separate Sewerage System built by � + &40:5
Zip 105iCa
c 6 a. lc .l' 12 w� i w ;37 eD
Address CTM5' JSq )06
Consisting of 6.,t, ! i Gallon Septic Tank and 335 &F e63QML--)4J -1JTCZ&JL1C-5
J-C' 'd � z
t' Lit cur—
Other Requirements:!
Water Supply:
Public Supply From
Address
1054-1 RL-x3-4F-5z
or: Private Supply Drilled by A2!��A-Q bUELL Address CaneL, I-" Job"?—
w....B ling ,_. Haserosibfi . ofid l oben.conpleted
Number of Bedrooms 3
Has garbage grinder been installed?
710
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 utnam ty Department of Health.
Date: l Z i'� Certified by P.E. R.A.
�D i n ProVio al
Address Z -`/ `" SC-4ul PC- SYW,1�5`-� I 5it3 License # 0�-OZ5c-"5
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.
Vte;co,p,y Title: - HD File; Yellow copy - Buil ing Inspector; Pink copy - Owner;
Date: .2 0 710S
Orange copy - Design Professional
Form CC -97
PUTnM COUNTY DEPARTMENT OF TH
DIVISION OF ENVIRONMENTAL ]HIEALTH'SERVffCES
WELL COMPLETION REPORT
.. .e➢J .Los.��� : -.
�tYeet�ildress =:L. _.._ _ . �. . �. ..,.,-
-
'�tllag�: -- � s-°�
dJ
-
Map (��ro Block 0 Lot(s) �(
Well Owner:
Name: Address: /
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 �e Open hole in bedrock Other
Casing Details
Total length ft.
Length below grade ft.
Diameter 44� in.
Weight per foot lb /ft.
Materials: Steel _ Plastic _ Other
Joints: _ Welded _ Threaded _ Other
Seal: Cement grout _ Bentonite Other
Drive shoe: _�C Yes No
Liner _ Yes XNo
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 .(4L
Yield j:57- gpm
Depth Data
Measure from land surface- static (specify ft)
O&A &62 /
During yield test(ft) Depth of completed well in feet
-7-0— �M�5
Well Formation
Diameter(in) gDe. ption
Well Log
If more detailed
information
descriptions or
sieve analyses
are available, 11--_...
please attach.
Depth Fro rn Surface
Water
Bearing
ft.
ft.
Land Surface
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type Xj,4 Capacity -1 -011me
Depth 5A Model
Voltage B?
Tank Typ // Volume
Date Well C mpl ed
Putnam County Certification o Vf
ate of eport
Well Dri ler (s- nature)
MOTE: Exact location of well with distances to at least two permanent tan arks to be provided o' separ�% s e flan.
rA, Well Driller's Name Address: '
Signature: Date:
White copy: HD File; Y ello w copy Building Inspector; Pink copy c� oPY - = �le11driller
Form WC -97
COG
BRUCE R. FOLEY- LORETTA MOLINARI R.N. M.S.N.
'A,'*99"6—c'r'at6* - P'u-- b I i C H -6- ail i I �:O i f et for
A61'" Health -nrect6r"-;::-----
Director of Patient Services
DEPARTMENT OF HEALTH
I Geneva Road
Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 278-6082 Fax (845) 278 - 6648
E911 ADDRESS VERIFICATION FORM
OWNERS NAME: Eric Perrella
TAX MAP NUMBER: 61.4-9
E911 ADDRESS: 50 Chapman Road
TOWN: (T) Putnam Valley
AUTHORIZED TOWN OFFICIAL: k -7 Ze�U1'
gnatu-re)
DATE:
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 verfnn)
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OE-ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
Eric Perrelia
Owner or Purchaser of Building
02�(_ Z
Building Constructed by
50 Chapman Road
Location- Street
Residential
Building Type
61. 1 9
Tax Map Block Lot
(T) Putnam Valley
TownNillage
Philip M. Hosay
Subdivision Name
Subdivision Lot #
I
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: Month 12 Day 13 Year 06 Signature:
. %
Title: ?(es�deilf"
General Contractor (Owner) - Signature
�jh
Corporation Name (if corporation)
Address: 3Z PAUCOI "Ls� A-VEJJL�p—
State /J�
Zip 1�C�
Polhemus Construction Co. Inc.
Corporation Name (if corporation)
Address: 12 Manitou Station Road
State Garrison, NY Zip 10524
Form GS -97
. V �
x -
, YML ENVIRONMENTAL SERVICES
321 Kear Street
.�` -.� ,1 vnoyw.c-;aco=o'==�= Y'=o[ .. � ts , N. ' ~ ;
"'AWT 24512800
Albert H. Padovani, Director |
LAB #: 1.602681 CLIENT #: 59356 NON STAT PROC PAGE: 1
PERRELLA, ERIC DATE/TIME TAKEN: 05/05/06 01:00
32 PAULDING AVE ' DATE/TIME FEC'D: 05/05/06 02:30
COLD SPRING, NY 10516 REPORT DATE: 65/12/06
PHONE: (917)-612-6796
SAMPLING SITE: 50 CHAPMAN ROAD
' : GARRISON
CQL'D�BY: ERJC PERRELLA
NOTES...: PRESSURE TANK
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DATE FLAG PROCEDURE
�
, - � SAMPLE TYPE..: POTABLE
� ` PRESERVATIVES: NONE
` - 'TEMPERATURE..: '4C
4C '
COLIFORM METH: MF
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
RESULT NORMAL - RANGE METHOD
PUTNAM CNTY
PROFILE
05/05/06
MF T. COLIFORM
ABSENT
/100 ML°~
ABSENT
1008
05/09/06
LEAD (IMS)
2.6
pph(-�/�),/
0-15 ppb
9003
05/11/06
NITRATE NITROG
1.83
MG/L^'
0 - 10
9052
05/05/06
NITRITE NITROG
<0.01
MG/L^�
N/A
9162
05/11/06
a6IRON (Fe)
0.370
MG/LT
0-0.3 mg/1
9002
05/11/06
MANGANESE (Mn)
0.054
MG/L°'
0-0.3 mg/1
9002
0502/06
SODIUM (Na)
3.79
MG/L~/
N/A
9002
0005/06
pH
7.2
UNITS,/
6.5-8.5
9043
05/12y06
HARDNESS,TOTAL
100
MG/L^'
N/A''
05/12A06
ALKALINITY (AS
86.0'MG/L°,
N/A
9001
95/12/Q6-
nTURBIDITy (�TUR-
`3.2NT
������
.0-5
COMMENTS:
BACT THESE RESULTS INDICATE THAT THE
WAT
WAS
NOT) OF A
SATISFACTORY SANITARY QUALITY ACCORDINE��f�7HE
NEW
YORK STATE
AND EPA FEDERAL DRINKING WATER.STANDARDS,
FOR THE`2ARAMETERS
TESTED, AT
THE TIME OF COLLECTION.
|
Pb/Cu LEAD limits for p
EPA Lead & Copper
than 10% of their
than 15 ppb and a
treatment must be
potential.
ablic schools are set at 15 ppb.
Rule for Public Systems requires that no more
distribution points have LEAD value of more
COPPER value of 1.3 mg/L, else water
undertaken to reduce the waters corrosive
Fe/Mn If both iron and manganese are present, their total value
combined shall not exceed 0.5 mg/L.
Na No limits for Sodium are proscribed. Suggested guidelines state
that for people on a sodium restricted diet,the water should
contain no more than 20 mg/L of Sodium. For those on a
moderately restricted diet, a maximum of 270 mg/L of Sodium
m
'��
�
�
�
` YML ENVIRONMENTAL SERVI['E]3
321 Kear Street
!/cnr '
(914) 245-2000
Albert H. Paclovani, Director
LAB #: 1.602681 CLIENT #: 59356 NON GTAT PROC PAGE: 2
PERRELLA, ERIC DATE/TIME TAKEN: 05/05/06 01:00
32 PAULDING AVE DATE/TIME REC'D: 05/05/06 02:30
COLD SPRING, NY 10516 REPORT DATE: 05/12/06
PHONE: (917)-612-6796
SAMPLING SITE: 50 CHAPMAN ROAD
: GARRISON
COL'D BY: ERIC PERRELLA
NOTES"..: PRESSURE TANK
DATE FLAG PROCEDURE
is suggested.
SAMPLE TYPE..: POTABLE
PRESERVATIVES: NONE
TEMPERATURE..: < 4C
COLIFORM METH: MF
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
RESULT NORMAL - RANGE METHOD
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.
_VERY ]H
—~--- 70-140 MG/L. --- -----'-
HARD WATER: 140-300 MG/L (I grain/gallon = 17.2 MG/L)
SUBMITTED BY:
Director
EL.AP# 10323
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
- - - • .(914) 245 -2800 -
Albert H. Padova'T, Direc6or -
LAB #: 1.800548 CLIENT #: 60586 NON STAT PROC PAGE: 1 of .1
PERRELLA, ERIC DATE /TIME TAKEN: 02/04/08 04:00
PO BOX 43 DATE /TIME REC'D: 02/04/08 04:55
SO CHAPMAN RD REPORT DATE: 02/11/08
GARRISON, NY 10524 PHONE: (917)- 612 -6796
SAMPLING SITE: 50 CHAPMAN RD, GARRISON, NY SAMPLE TYPE..: POTABLE:
: KITCHEN TAP PRESERVATIVES: NONE
COLD BY: ERIC PERRELLA TEMPERATURE..:
NOTES...: COLIFORM METH: N/A
DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD
02/11/08 IRON (Fe) <0.060 MG /L 0 =0.3 mg /l
COMMENTS:
FAX 212 527 1819
P
COMMENTS:
Fe /Mn If both iron and manganese are present, their total value
combined shall not exceed 0.5 mg /L.
SM 18 -20 3111B
SUBMITTED BY:- %__ , \
Albert' H . P
Director
ani, M.T.(ASCP
ELAP# 10323
Surveying & Engineering, P.C.
3063 Route 9, Cold Spring, New York 10516
TO:
Paravati
Putnam County Department of Health I
Date:
13 Feb 2008
File No.
81 -146
W. O. #
17725
RE:
Certificate of Construction Compliance
US MAIL
Perrella
Chapman Road
Philip M. Hosay
Tax Map 61.4-9
Permitaitle/PO #
Subd. Lot No. 1
Il Geneva ][toad
Sent via:
Brewster, NY 10509
US MAIL
UPS -NIGHT
�
MESSENGER
F-1
UPS -2 DAY
El
PICK -UP
El
UPS -3 DAY
El
FAX
El
UPS -GRND
2
We are sending:
UPS -COD
El
copies date
❑1 10 -Jan-08
® 13- Dec -06
F 09 -Jan-08
❑3 13- Dec -06
F-31 22- May -06
description of document
lApplication Fee - $300.00
Certificate of Construction Compliance for Sewer Treatment System
E911 Address Verification Form
Guarantee of Subsurface Sewage Treatment System
Well Completion Report
1 12 -Ma -06 Well Water Test Results, two
a2gges
❑1 111 - Feb -08 Well Water Test Results
® 13- Dec -06 ISSTS "As- Built"
REMARKS:
Copies to: ]File
Yours truly:
Jason R. Snyder
Tell: (845) 265 -9217 ext 13
Fax: (845) 265.4428
Email: jsnyder @badey- watson.com
40 40-05 503665 622647 34592
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Street J;ocatio i 1
Town L>Gf
TM # q
.. Owner
Permit # SW— 3
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. 100' from water course / wetlands ...... ...............................
H. Sewage System
a. Septic tank size - 1,000 .. ..1, 250 ......... other ................
b. 'S eptic" tank installed level ................ ...............................
c. 10' minimum from foundation ......................................
Distribution Box
1. All outlets at same elevation -water tested .................
2. Protected below frost .................. ...............................
3... Minimum 2 ft.Original soil between box & trenches
e. Junction Box - properly set .......... ...............................
6. renc es
1. Length required 3 ar Length installed
5
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 surface ..................
7. Room allowed for expansion, 100 % .........................
8. Size of gravel 3/4 - 11/2' diameter clean ....................
9. Depth of gravel in trench 12" minimum ....... :...........
- u0 ca cu ......:..................
-3* visuaVaudio ........:........:.. .............................��
4. Pump e-aas y accessible, manhole to grade .................
5. First box baffled .................. ...............................
6. C cle witnessed by H D.estimated flow/cycle ...........
III.tHouse: adding a.
aPlouse located er approved plans ..................... .....
b. Number of bedrooms ...... ............................... ......
�:--
Welllocated- as1perapproved plans .......:......
b. Distance from STS area measured /�p .. 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 & dinto exist watercourse
g. Footing drains discharge away from STS area ...............
h. Surface water protection adequate .... ...............................
i. Erosion control provided ................. ...............................
Rev. 8102
MIA 4
Date: 10 d(421
:d by:
C/
J
FIX
iJ
WN
mm
FAFA
MUM
► 1
W, ejA- OR 0 R
i
RZAM
C/
J
FIX
iJ
SHERLUTA AMLER, MD, MS, EAAP
Commissioner. of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
October 4, 2006
John Delano, PE
Badey & Watson
3063 Route 9
Cold Spring, NY 10516
Dear Mr. Delano:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re:
ROBERT J. B ®N ®I
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Field Inspection — Hosay
Chapman Road
(T) Philipstown, TM # 61.4-9
The above referenced separate sewage treatment system can be backfilled. The following
comments must be corrected in the field.
L in liakf ll must beremhued priaxao.baekfjling_syst: r- g
i.,1/2. As per note 3 in the pump pit detail on the approved plans, tt�-ccroscel�ts"�
and alarms should be located inside the building.
If you have any further questions, please contact me at (845) 278 -6130 ext. 2155.
JD:kly
Sincerel
f� 12.1) 3/0 f
oseph Digit
Environmental Engineering Aide
Environmental Health (845) 278-6130, Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
SEP-26-2006 16:53 BADEY & WATSON, PC
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
ATTENTION JOSEPH I-] GENE Joe Digit
P.01/01
REQ AL -INSPEMON F(r. Fill
DM� 9126/2006
ix
PCHD Cons- Miction Pen-nit # SW-35-02
(1) (V)-
Local. Chaipman.Road town
AnPhili
Owner/AppficaitNaTm Eric Perrella IM. 61' -- 1 Lot
Fw NIA
—P O.Sy- — �Y-
Subdivision Lot
Is Vsftn fill completed? Yes N/A
Yes Date-
Is system corisauctedasperplos? Yes:.
Is well drilled? Dwe: 912012006
Is well located as per plans? Yes
Am.erc)gon=*ol measures 'm' place? ' Yes -
I certify d= the.Tystern(s), a~ fisted, at the above pr "sw has been ooa*wted aril I have inspected
mxi vwfied their L-cumletumun w=dmw with the mied POID Cmstn=on Permit and
mpwved plaw and the SorAwis, Ruks anA R 4te Putnam Cbw* Dq=tnwt of
Health
LIEft 9/2W2006 C etfifted RA'.
DFAip P
Add m Badey & Watson,'P.C.'300 Route.%.Cold Spring, NY Li .# 062605
Garinmir, Mr. R!v"e would like an open work irapeotion atyour earliest convenience:
Please be advised a pump test Is also needed.
FonnFIR-99
TOTAL P.01
TM Klamp •P1 ITKIOM (-n1 IKITY nr:P0r)TMPWT npr P I
PUTNAM COUNTY DEPARTMENT OF- "HEALTH
:. YY DIVISION OF! ENVIRONMENTAL .HEATLH.SERVIC.E,S.:,Q
FIELD ACTIVITY REPORT
ki1T1RFC.C: .lilY�Pn�+�� lza� Diu PsrvwA)
Street Town State /zip
PERSON CHARGE
(1
R TNTRR VTF[�TFT�:
t�
�l
le
PUMP TEST
0. DOSE TEST
iwumED GALLONS /7/ / uA IL / POS15
1/1 75�
0
3"
I
1A A -
�/r9 TRT
Signature and
RFP(1RT RFC`FT�IFI'� RY° - .
I acknowledge receipt of this report: SIGNATURE;
32/96 Title:
r-1
0. DOSE TEST
iwumED GALLONS /7/ / uA IL / POS15
1/1 75�
0
3"
I
1A A -
�/r9 TRT
Signature and
RFP(1RT RFC`FT�IFI'� RY° - .
I acknowledge receipt of this report: SIGNATURE;
32/96 Title:
SEP -27 -2006 10:46 BADEY & WATSON, PC
P. 01/02
PUTNAM COUNTY DEPARTMENT OF HEALTH
- IbIVYSiON:OF:ENVIRONMAN!CA t -4 —) T$ 7S : - ,......:.
ATTENTION j_J JOSEPH ❑ GENE
0 i�
X Joe Digit
Far: Fill
Trencbes
Located: _— - - - -' Chapman Road — __....._.._ (n (V (T) Philipstown
_ Eric Perreila _ IM 61 Hb* 1 Ld 9
NIA.. Philip M. Hosay
Subdividm Lot # _ 1
1s fiU convkk& Yes
Tk wdem o9 Yes
IS system omon as per pleas? _
1s well chilled? Yes
Is well WNW as per plans?
Are erosion control mmures in place?
Yes
Yes
Yes
Dula -- .. WA
IWMe; 9/26/2006
Dlim 9!2012006
I cer* that the WAem(s� as lined, at the above "ukm has beau oot>struc W and I bane inspected
a W verified *miw c ompl,ehim in woovda= with tho imx d F4aD C lan Pamait axed
gvmvcdpbms and the SWndanls, Rules ands ofthe Puffin C.otmaLy Dot of
Heft
_ 9/2612006 testified f ! J r 13B RA
Dermal
Badey & Watspn, P.C. 3083 Route 9, Cold Sp ft, NY lic. # 062505
Cain Mr. Digit, we would like an open Work inapeabon at your earliest convenience.
Please be advbed a pump test is also needed.
71"91_ ail" t
CCD_'77_OftflC LICK. TCI •- 0/ICZ_070_7001
1.10MC • DI ITh10M f -nI RJTV r)CD00TM1=K1T r1P . P 1
SEP -27 -2006 10 :4; BADEY & WATSON, Pr
vu vi 4J rwrry .,apt uuLuEy 6QZLX7 "
P.02/02
1'-bly YIS11 Ul r-46b
TOTAL P.02
cCD_D7_71aG1t. I.ICl1 ilG • .'G TO • 021CZ_770_7G04 M.IOMC • DI ITKUM r ni RJTY nt:PI3PTMPKIT np, P P
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVIC
w t✓€ +1STR�JCTI�N PERMIT OR SEWAGE T"XTWNT SYSTEM "'
PERMIT # 6L-0 -35 -- °2
Located at C-t+A ij fLO&()
Subdivision name P> 4 UP As Subd. Lot #
Date Subdivision Approved IZ o&° 18�
Owner /Applicant Name M(--
Town or Village (T) P-)r —iMAAA \/* -E`1
Tax Map &1-, Block I Lot 9
Renewal Revision
Date of Previous Approval -1 14 104
Mailing Address Mq 6)l60JJ Aq k_, 3R-00() Mq Zip 1001
Amount of Fee Enclosed �'---
Building Type I- MOB- 4- t Lot Area 4 AC No. of Bedrooms 3 Design Flow GPD 61L
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of )) COO gallon septic tank and
o1'-' -1 9-:�4L44&s SPA CZO C9 FT, :W CZQ '1D EQ-.
Other Requirements:
335 L -
i, C300 60tL gulp 17/W%4- .,J i o J I WAX- *..✓1a^A S
To be constructed by ?CU +MuS C - WST1ZJ6: 10&-( Address C'AMI W 0 ASq /06ZA
Water Supply: Public Supply From
Address
;Private: Supply Drilled by MORyh/A( *I1 ML# .i , - 1/.1=C Address D!J` •' 1 �l /KA Y �/'�
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the
Department, and a written guarantee will be furnished thb 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. X R.A. Date 03 3
Address CLtD �MkK-w, ljq /vSiLf License # OG'Z5Z6
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new pe t. Approved for discharge of domestic sanitary sewage only.
By: �I/ Title: Date: 6115-106
it copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
06/09/2006 .... 15:52 - 9145262130 TOWN OF PV
PAGE 01
-roWN
BUILDING DEPARTMENT
YOURS NumsaL
PERELIA - 50 CHAPMAN RD. TM "1.-1-9.
Dulw.19NT X` FOR OPLEAr-gCOMMEENT OPLEASE'RRIPLY PLEASE RECYCLE
NOTES/cobwRNTS!
ATTACHM IS THE WAND WJWT WAMU WINEWAL) FOR THE
AWVE PARCFJ. AS PER REQUEST OF THE PROPERTY OWNER I WUL 13E
FORWARDING A COPY TO]. PARAVAIT. (HMTH DEPT)
THANKS
DOREEN-
CC: PARAVAn - 845 - 4 76- 1
261 09C. LK. MD.
PV, NY 10379
045-526-2377/?AX 045-6265006
JUN-9-2006 FRI 1.5: E1; TF-1-:949-279-7921. NAHF-:PI-JTNAM cni-INTY r)FPARTMF-NT nF P. 1.
0
06/09/2006 15:52 9145262130 TOW OF PV
PAGE 02
., .:: -r. ' �;:, ,......�..�..,,•'.Z.:4;:.', -.,. ...: ,.. .e, a ....... ,..e... _ ..r ....., -.. ..- .,.:.,:.:r;:i
TOWN OF PUTNAM VALLEY
PERMT,WAMR
CHAPTER 144: Frubwater Wsdnft, VYagr+eoa m and Waterbodies
Ordinance of the Two of Pima✓ Valley, New York.
The Towel Wetlands Inspector, as Approval Authority, has determined that the proposed
action is an Unlisted Action under SEQRA, and will not have a significant environmental
unpact. Tbwefore, a P MIT WAIVER is granad subject to the conditions noted
below.
DATE PERMIT ISSUED: 5/24/06 DATE PERMIT EXPIRES: 5/24/07
APPLICANT SPONSER: Eric and Geraldine Perrella
32 Paulding Avon ue'
Cold Spring, NY 1-0516
PROPERTY LOCATION: 50 Chapman Road DATE OF INSPECTION: 5124/06
TAX MAP 0: 61 -01 -09
PROPOSED ACTON:
WAIVER RATIONALE:
Renewal of WT- 46~eewdvelion of a single family home.
Inspection revealed that conditions found in the original
w6 land peahiit waiver land been..maint. ingd .::�,_:
MATERIALS REVIEWED:
Application Materials, Tile #: WT -20 dated S /8/06 (and prior waiver WT46)
CONDITIONS OF PERMIT:
1. All conditions of the original permit waiver (WT -46 dated 4/26 /04) remain in
effect.
2. Any changes from the prior permit waiver will require submission and granting of
a new wetland permit or permit waiver.
3. Wetland Inspector is to inspect property prior to issuance of a certificate of
occupancy to verify that all permit waiver conditions have been satisfied. wetland
at any time.
1
T, 1K1- Q_PPMr. DDT 1 WD TDB . Pac�_a7A -7Q ?1 NAME: PI ITNAM rn INTY DEPARTMENT OF P. 2
06/09/2006 15:52 9145262130 TOWN OF PV
4. IV Town Phnzdag BOW, Wedwh LIVOCW, aMV0T the Building IMPOCtor,
shall have dw rat to inspect the pm jct fim Ww to tisane.
5. T'1a peralit Shall be prominently displayed at dic project site during the
undertaking of the activities authorized by dw Pernik.
PAGE 03
6. This p ffn t waiver is specific to the pwfing of a wetland permit only. Applicant
is responsible fog securing any other requbW pomaib and approvals from the
Town as may be necessary.
7. A copy of the Wetlands Permit Waiver to be goached to the approved Building
P is poW by this aWication.
MosconpNwce with the conditions above will invalidate this Permit Waiver, and may
result in a Notice of Violation and/or Stop Work r.'Aimy questions regarding this
Permit Waiver should be directed to the Town Wetbods inspector (914)- 962 -7733, or the
office of the Town BuiWing inspector (945) -526-2377.
Bate Permit Waiver Prepared: May 24, 2006
_ --
- _
- - -'fo Wetlands inspectorr
Cc! Applicant
Puilding Inspector
Planning Hoard
Environmental Commission
2
TI 11.1- Q- PrArAr- APT 1 S • 1aZ TPI - PdS- P7P -7QP1 NAME: PI ITNAM rni INTY n1=P0PTMFNT nF P.
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health..
LORET.TA MOLINARI, RN, MSN
Associate Commissioner of Health
Jason Synder
Badey & Watson
3063 Route 9
Cold Spring, NY 10516
Dear Mr.. Synder:
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
ROBERT J. BONDI
_County Executive .
ROBERT MORRIS, PE
Director of Environmental Health
May 3, 2006
Re: Proposed Trench Permit — Perrella
Chapman Road, (T) Putnam Valley
TM# 61 -1 -9
This office has received and reviewed the most recentset of plans for the above - mentioned
project. We would like to offer the following comments for your review and consideration.
1
The Wetlands Permit from the Town of Putnam Valley has expired. Please provide a
.�capy. of_a.valiiLWetland Permi.i or.alettcthtai7e: ark fpr.the �?Ve�l.and..P.erm.it:has' �..:::.. _ -...
been satisfied.
This office will continue its review upon consideration of the above - mentioned comments.
Please feel free to contact me at est. 2157 if any questions arise.
JSP/kly
Very truly yours,
" Joseph S. Paravati, Jr.
Assistant Public Health Engineer
Environmental Health (845) 278 -6130 Fax(845)278-7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648
APR-04-2!'1 BADEY & WATSON, P1.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION ...OF. ENV.IR.O.NM.E E
.NTAL HEALTH SRVICES
ATTE ?JJ0N F1 JOSEPH F GENE
REOIJT-..S 'I'FOR FINAL -INSPECTION
Date 4/412006
PCHD Construction Permit #
SW-36.02
X Mike Luke
For: Fill
Trenches
Located. Chapman Road (T) (V) (T) Philipstown
Owner/Apphoatit Name: -..Eric Perreffia TM Block I Lot 9
Formerl,y. ...... Subdivision Name: Philp M. Hosay
Subdivision Lot #
Is syswnit f-iiii,.-arapleted? Yes Date: 31/29/20.06 .... .......
Is system complete? WA Date: W/A
Is -onstructed as per plans? WA
Is No Date:
Is WO per plans? WA
Are measures in place? No
lcerti' the system(s), as listed, at the above premises has been constructed and I have inspected
and vp theii, completion in accordance with the issued PCHD Construction Permit and
and the Standards, Rules and Regulations of the Putnam County Department of
Healiii
Da . 4/4/2006 Certifi PE X RA-
zf Design Professional
Addres,;, - -S-adey & - W . atson, P.C. 3063 Route 9, Cold Spring, NY
Lic. # 062505
Comjj-Dz� ;% Dear Mr. Luke, We would like fill pad inspection at your earliest Convenience.
r'. -
Form 'I"? R.- 911
-.. 1, 7, , TM • 0ACZ-070-70'Z11
P.01/01
TnTAI.. P. Al
K10HP - P1 ITHCiM mi INTY nFPARTMFNT OF P. 1
... ___.._EADEV.8z.WATSON-.-:::.
Surveying & _ Engineering, P. C.
3063 Route 9, Cold Spring, New York 10516
TO:
Joseph S. Paravati, Jr.
Assistant Public Health Engineer
Putnam County Department of Health
LETTER of__TRANSMITTAL......
Date:
30 Mar 2006
File No.
81 -146
W. O. #
17725
RE:
SSTS Trench Permit
UPS -NIGHT
Perrella
Chapman Road
Philip M. Hosay
Tax Map 61.4-9
Permit/Title/P0 #
Subd. Lot No. 1
1 Geneva. Road
Sent via:
Brewster, NY 10509
US MAIL
❑
UPS -NIGHT
❑
MESSENGER
❑
UPS -2 DAY
❑
PICK -UP
❑
UPS -3 DAY
❑
FAX
❑
UPS -GRND
R
We are sending:
UPS -COD
❑
copies date description of document
® 30- Mar -06 7 lConstruction Permit for Sewage Treatment System
❑
1 29- Mar -06 IDesijzn Data Sheet
® 30- Mar -06 ISubsurface Sewage Treatment System SD15102 R05
REMARKS:
Copies to: File
Yours truly:
Jason R. Snyder, Assistant Engineer
Tel: (845) 265 -9217 ext 13
Fax: (845) 265 -4428
Email: jsnyder @badey- watson.com
40 40-05 503665 622647 29367
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Owner
Eric Perrefla
Address 1119 Edison Avenue, Bronx, NY 10416
a
Located at (Street) Chapman Road —Tax Map 61.
(indicate nearest cross street)
Municipality (T) Putnam Valley Drainage Basin
SOIL PERCOLATION TEST DATA
Date of Pre-soaking
03/28/06
Block 1 Lot
Hudson River
Date of Percolation Test 03/29/06
Hole No.
Run No.
Time
Start Stop
Elapse Time
(Min.)
Depth to Water
From Ground
Surface (Inches)
Start - Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
H
1
2:52 3:22
30
21 - 24
3
10
H
2
3:23 3:53
30
21 - 24
3
10
H
3
3:54 4:24
30
21 - 24
3
10
4
2:53 3:00
7
21 24
3
2
8&_...:_._.
.2- .._. -..__
-3-
......
3
3:09 15:17
8
21 24
3
3
4
5
2
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. < I min for 1-30 mWinch, <.2 min for 31-60 mWinch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
Form DD-97
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
T)EVVI ffotnc�- 'HOLE NO:'
G.L.
0.5'
1.01
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.01
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
.9.01
, 5i ... ...
9.
10.01
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered
Deep hole observations made by: Date
Design Professional Name: John P. Delano, P.E.
Address: Baidey & Watson fh0Y4'r'0t
)�U ngineering, P.C.
& S 10516
IP AA
3063P! .0(&-!LC6
a qr 90
Signature:
*62 4,
"ROFE.
'R 0 F
I I ro6ss'lonsfl's SeaR
Form DD-97 (Pg. 2 of 2)
'9.P-r 30 04 01:42p Planning Board
1914) 526 -3307 p.l
91 -l4G
TOWN OF PUTNAM VALLEY
CHAPTER 144: Freshwater Wetlands, Watercourses and Waterbodies Ordinance of
the Town of Putnam Valley, New York
The Town Wetlands Inspector, as Approval Authority, has determined that the proposed action is
an Unlisted Action under SEQRA, and will not have a significant environmental impact.
Therefore, a PERMIT WAIVER is granted subject to the conditions noted below.
DATE PERMIT ISSUED:
DATE PERMIT EXPIRES:
APPLICANT /SPONSOR:
Eric Perrella
1119 Edison Avenue
Bronx, New York 10461
-PROPERTY LOCATION:
April 26, 2004
April 26, 2005
Chapman.Road
TAX MAP #: 61 -01 -9 SIZE OF PARCEL: 4.014 acres ZONING: CD
PROPOSED ACTION: '--- Single- family residence, septic- system;- driveway, well within
buffer to pond ......
MATERIALS REVIEWED:
1. Application Materials, file # WT -08.
2. Site Plan as prepared by Badey & Watson, P.C., dated 04 -13 -04
CONDITIONS OF PERMIT:
1. All construction shall follow Site Plan as prepared by Badey & Watson, P.C,, dated 04 -13-
04.
2. Erosion controls to be placed as per Site Plan and inspected prior to commencement of
construction.
3. This application requires Site Plan approval from the Planning Board.
Page t oft
`°. `OP-r 30 04 01:42p P1annine Board
1814) 526 -3307 p.2
4. The Building Inspector shall be notified once erosion control measures are in place and at
least 48 hours prior to the initiation of any site work.
5. When Erosion controls are required, they must be maintained properly throughout the
construction process and remain in place until final site inspections for compliance with
conditions of permit have been completed. _
6, The Planning Board, Wetlands Inspector, and/or Building Inspector, shall have the right to
inspect the project from time to time.
7. The permit shall be prominently displayed at the project site during the undertaking of the
activities authorized by the permit.
8. An additional escrow account in the amount of S 300 must be established with the Town
before this Permit Waiver can be considered validated. These additional escrow funds will
be appropriated as required for construction monitoring purposes. Any portion of the
account not used during the project monitoring period shall be returned to the applicant
upon satisfactory completion of the project. (this requirement waived, if additional
deposit done at time of application)
Noncompliance with the conditions above will invalidate this Permit Waiver, and may result in a
Notice of Violation and /or a Stop Work Order, Any questions regarding this Permit Waiver
should be directed to the Town Wetlands Inspector (914) 494 -5544, or the office of the Building
Inspector (914) 526- 23.77.
Date Permit Waiver Prepared:
cc: Applicant
Building.Inspector
Planning Board
Pap 2 af2
Apri126, 2004
Stephen W. Coleman
Town Wetlands Inspector
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Date:
_ Inspected by:
"Street Location Gl _. -: - - Owner
Town P L.Z l ��J -fv �,, Permit #
TM # 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. 100' from water course / wetlands ...... ...............................
IL Sewage System
a. Septic tank size
000..:.....1, 250 .......... other ...............
b. ' Septic'tank install el ........ ...:. .................... ..
c. 10' minimum from foundation .......... ...............................
d. Distribution Box
1. All outlets at same elevation -water tested .................
2. Protected below frost ................. ...............................
3 knimum 2 ft. Original soil between box & trenches
e. Junction Box - properly set .......... ...............................
6, rent es
1. Length required Length installed
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 surface ..................
7. Room allowed for expansion, 100 % .........................
8. Size of gravel 3/4 - 11/2' diameter clean ...................:
9. Depth of gravel in trench 12" minimum ...................
- 10 P- pe -ends- cappad.::.- ::.- ...::.-
-- g Puma or Dosed Systems
1. Size of pump chamber ................ ......................'....:...
2. Overflow tank .......................... ...............................
3. Alarm, visual/audio .................... ...............................
4. Pump easily accessible, manhole to grade .................
5. First box baffied ........................ ...............................
6. C��yycle witnessed by H.D.estimated flow /cycle...........
M. House/Building
a. house located per approved plans .. .....................:.........
b. Number of bedrooms ..................... ...............................
IV. Well
Well located as per approved plans . ......:........................
b. Distance from STS area measured . . 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 & dinto exist watercour
g. Footing drains discharge away from STS area ...............
h. Surface water protection adequate ........ :.........................
i. Erosion control provided ............... ...............................
Rev. ?2/02
SITE I SFE..+ ON FOR FILL PAD
Date: ,_1 /2
Inspected by:
Fill pad located per the- approved plan
V
Fill Pad Length J Required Length
Fill Pad Width . Required Width
J-
C'
Fill Pad Depth 3 Required Depth
Run -of -Bank Fill Quality
Slope from Top to Toe
0 f'6,la,
l
Impervious Layer Installed.
0 Ky
Erosion Control Installed
Sieve Test Results (if applicable)
Additional. Comments:
Reserved for Field Sketch if Applicable
12/05/2005 11:50 FAY 2125271819
PARETO
la 001/003
r-ro
12
2
DEC-4-2005 SUN 23:51 TEI-:845-278-7921
vi
lei
I
NAME:PUTNAM COUNTY DEPARTMENT OF P. 1
N
W
l-
O
Z
W
E
H
Q
W
W
O
}
H
Z
O
U
Cl
Z
H
D
E
W '
Z
Q
Z
P
smr,- -
W. SmBib, Apohidea
66-3U RhilmeLer
'Ll NY
i
i
' l
co
O
O
co
C>
I O
- 'i
AL.z FL.
40
T.�Plc Smith, Architect
66 uviagai6' SL, Rhinebeck, NY
re)
LL
0
z
w
r-
F-
W
cl
CL
LLI
Z
:3
0
V
cl
Z
F-
Z)
IL
w
E:
Cl
Z
11/14/2005 22:53 8452652615
HOULIHAN LAWRENCE PAGE 01
.4. .
FAX C10"v. EXPR SHEET
,50 OW6777
COMPANY-,
FAX:
PHONE-
3
1A
FAX:;
PHONE:
,Fis-
TOTAL NUMBER OF PAGES INCLUDING THIS COVER SHEET:
r For Y6u Reply lease
Urgent I y
Review, JASAP Comment
CONWEN71-S:
4t
oi-
Let
'Ale,
3
NOV- 14 -200r- 4- TEL ' 945-279-792.1 NAME:PUTNAM COUNTY DEPARTMENT OF P. I
11/14/2005 2'4:53 6452652615
HOULIHAN LAWRENCE
PAGE 02
NOV-14-2005 r U=q :417 ?"EL: 7921
Vit-MAL Aim FL
00 llllf�-
NAME:PUTNAM 03UNTY DEPARTMENT OF P. 2
11/14/2005 22':5:--- .8452652615
HOULIHAN.LAWRENCE.:. PAGE 03
NOV-14-2005 A': TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 3
Warren a1C]L en TeIl1C ple S]I1C uhq AIA
LETTER OF TRANSMITTAL
To: 20 o
,j S�
&-rA A114 Co. -2' r, of fJA -c92 Re:
icu -0 Job No. d �0
We are sending to you attached under separate cover via L/�Cz! Jc
the following:
Qty. Date No. Description
These are transmitted as indicated:
For Approval Approved Revise and Resubmit
✓For Your Jse Approved As'Noted- Returned
As Requested For Corrections For Review and Comment
Other: Ioi;;2 ew6c ,�,� 0.v T you,71J'
Remarks: ,a-F-l/(�iF� � �,1' / 4 0 , C l� 61 (/-1 C10 C�T'or./
OA- too T71e4 ^fT
Copy To: By: -
65 LivingsEon Sfreef Rhinebeck, New York I2572 `vLsmia @u1s6er.nef (845)876-5707-
� PUTNACOUNTY DEPARTMENT OIE HEALTH
DH,% iSION OIL IENVHRONMENTAL HEALTH SERVICES
CONSTRUCTION PERMIT FOR SEWAGE TREATMIEN VS,
P EST #
Located at Ll pnn -I Town or Village
Subdivision name Q�1U0 A l-�0'5AJ Subd. Lot #
Date Subdivision Approved 121 W 1pq
Owner /Applicant Name C-91C- 9e0-ELLA
Tax Map C� t Block Lot
Renewal A Revision _�
Date of Previous Approval 101 3 1 o z
Mailing Address It ll a0N-,)w &Jur 3zw� 1 by
Amount of Fee Enclosed 0 40D- 6"
Building Type ?-�5 10Dts bt- Lot Area � V. No. of Bedrooms 3
Zip )0 64
Design Flow GPD
Fill Section Only Depth Volume q50
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Sepairate Seweira System to consist of
I,OCD
gallon septic tank and
Other Requirements:
J1000
WMP ':�MM1G 1..q- '�TV,(Lz
05E)
To be constructed by
04FOLO L4045 °
-S94S Address COf-0
`- M1•f T. �1� 1Ci71(D
Watez SnMPlve Public Supply From A dress
®1r.* . _ y Private Supply DrifW'by - - -► i .T r Address WT�
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatments stem 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.
i7
Signed: P.E. R.A. Date
Address ��o � (�. L< COLZ syidc -41 kt `1 ICy,3tC4 License # MZ505
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new ermit. Approve for discharge of domestic sanitary se ag`e only.
h \,
By: Title:
White copy - HD Fi e; Y tj copy - Building Inspector; Pink copy - l y4ner; Orange copy - Design Professional
V Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A_WATER WELL .
"•`'orease`OAAf 5f type: ... , :.: -.�� o...._ PCHD Permit'#
Well Location:
Street Address: own/Village� Tax Grid #
CMQ '�`� LA w V -"I Cak C1
- Map Block Lot(s)
Well Owner:
Name:
plc.
Address:
1 1 1, &015c-.(A,., ( 3�, &(q ) al&
Use of Well:
Residential Public Supply Air /Cond/Heat Pump Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought _5 gpm # People Served S Est. of Daily Usage �o gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
-IL New Supply (new dwelling) Deepen Existing Well
Detailed Reason
9 104 i o t ,k \-4-1) Vgkj
for Drilling
Well Type
Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ...................................... ............................... Yes x No
Name of subdivision NALA P AA. . 1-tD -ZX q Lot No. 1
Water Well Contractor: 066 V1ib.1 A DiF06p4 ilE_ Address: Mli^ Aj: D5:1
Is Public Water Supply available to site? .................................: ............................... Yes No
Name of Public Water Supply: J44- Town/Village LAX
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan.
Date: 05 1 L-1-e Q4. Applicant-Signature: _
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a w ter well driller certified by Putnam
County.
Date of Issue ® Permit LI4Tng O ici `
Date of Expiration 0051 Title:
Permit is Non- Transferr ble
White copy - HD file; Yellow copy - Building Inspector; Pink copy = Owner; Orange copy - Well driller
Form WP -97
NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Community Sanitation and Food Protection
IS'W-- 35 -0--j-,
Specific Waiver
from Requirements of Part 75 and Appendix 75 -A, 10NYCRR
for Individual Household Sewage Treatment Systems
I --- - - - - -- - ----------------- - - - - -- --- - - - - -
Last Name First M.I.
Name of Applicant Hosay Philip M
L_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _I
No. Street Clty/Town State Zip
_ Address-- --- _ _ 100 _ _ _ _ Bleecker St., Apt. 6A _ - - - _ New York NY 10012
----------------------------------------------------------- - - -----
- - - - - - -I
No. Street Ci4gown State Zip
_ Site Location ____________________ _____ ___�hapmanitoad__-- - - -_ -- Putnam Valley
r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I
1. Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)):
Separation distance cannot be achieved.
LEI' Excessive slope.
I -
L _I High groundwater.
Inadequate depth to bedrock or Impermeable layer.
Soil unsuitable.
LW Other (explain) - Limited usable area for S.S.T.S. and adjacent existing slopes preclude design of peripheral
fill slopes at 1 on 3 (while still providing 100% expansion area).
I----------------------------------------------------------------------- --- - - - - -- ,
- Fill in excess of 31/2'.
-------------------------------------------------------------------------------------------
2. Proposed design or conditions of waiver:
1. Reduce separation distance from toe of till to property line from 10 ft to zero.
-------------------------------------------------------- - -----------------------
2. _Regrade system area to 15% using sand & gravel R.O.l$ fill.
-------------------------------------------------------------B
------------------ 3. _Grade peripheral fill slopes to 1' max vert. / 2' min horiz.
4. Due to uneven existing contours, some areas of ROB fill will _exceed_ 3 U'.
2
=- ----------=----------- - - - - - - - - - - - - - - - - -- - - - - - _ '___ = _=-== -' - - -- - - - - - - - - - -- - -- - - - - - -
3. The proposed design may have the following limitations (check appropriate box(es)):
I I
Increased risk of well or spring contamination.
Increased risk of surface water contamination.
Expected design life of the system will be diminished.
Operation of sewage system is subject to mechanical problems.
'
L -' Other (explain)
_I I
I I
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f
I I
Additional information attached
I I
'---------------------------------------------------------------------------------------- - - - -'.
Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with
New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver
may be revoked by the issuing official for a change in conditions for which this waiver was granted.
- - -- - - - -- ---------------------------
REPRES TATIVE OF COMMISSIONER OF HEALTH
- -�-� =� --------------------- - - - - --
DATE
ORIGINAL - Local Health Agency
COPY - Applicant/Design Professional
DOH -1326 (7/92) (GEN -152)
BRUCE
Public 'Health'Director
C) -
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
I - Geneva Road
Brewste•, New York, 10509-
Environmental Health (845) 278 - 6130 * Fax (845) 278 - 7921
Nursing Services (845) 219 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 27.8 - 6014 Preschool (845) 228 - 6108 Fax (945) 278 - 6648
PUTNAM COUNTY DEPARTMENT OF HEALTH
. SPECIFIC WAVIER
NAME:
ADDRESS:
SITE LOCATION:
DATE:
STAFF PRESENT:
Phil P L-IV5-!�:V
�JY,-A,9 toei:Z
� —:F '114
6tis-�–m,:z (;zm P6 4WA v prope,119 1;net#;,1,--n1-
SPECIFIC WAVIER.
REQUEST: 514( . dL" Are-OL 40 I�Vr, US-)h4 54i4de-qr"ej 40.6. j;' jf
e-
6rg4le..- r"pA e-p-f lore-s +b ve.,4, h;,, k:-riz
Ove 4 oeieveo zx1',j7'nq aAloars, some Aee,,sce t.;dex&-td
DOES. THE 'PROPOSED. VAPJANCE. REQUEST POSE A HEALTH. HAZARD OR
ENVIRONMENTAL CONTAMINATION PROBLEM?
YES NO
WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP?
'YES NO
DISCUSSION.
Au'd �?
AAULb �el
REQUEST APPROVAL OR DENIED
APPRO
MASON FO—R-RENIAL
DIRECTOR OF PUBLIC HEALTH'
(SPECWAIVER)
F11410-Wil
DATd- `K/J
-L
BADEY & WATSON
LETTER of TRANSMITTAL
' Surveying _ & Engineering, P. C:
3063 Route 9, Cold Spring, New York 10516
Date: 15 Jun 2004
File No. 81 -146
W. O.# 16505
RE: Proposed SSTS - REVISED
Perrella
TO:
Chapman Road
Joseph S. Paravati, Jr.
Philip M. Hosay Subd. Lot No. 1
Assistant Public Health Engineer
Tax Map 61.4-9
Putnam County Department of Health
Pennit/TidelPO #
fl Geneva Road
Sent via:
]Brewster, NY 10509
US MAIL UPS -NIGHT
MESSENGER El UPS -2 DAY
El
PICK -UP El UPS -3 DAY
F
FAX El UPS -GRND
W1
We are sending:
UPS -COD
El
copies date description of document
® 15- Jun -04 Se arate Sewage Treatment System Fill Plan Sheet 1 of 2
'F 11 15- Jun -04 Se arate Sewage Treatment System Sheet 2 of 2
REMARKS:
Please find attached revised plans pursuant to your comments dated 6/1/04.
Copies to: ]File
Yours truly:
Jason R. Snyder, Assistant Engineer
Tel: (845) 265 -9217 ext 13
Fax: (845) 265 -4428
Email: jsnyder @badey- watson.com
40 40.05 503665 622647 24419
LORETTA MOLINARI
Public Health Director
June 1, 2004
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (845) 278 -.7921
Nursing .Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention/Preschool (845) 278 - 6014 Fax (845 - -1278 - 6648
Jason Snyder
Badey & Watson Engineering
3063 Route 9
Cold Spring, New York 10516
Re: Proposed SSTS Revisions — Perrella
Champan Road, (T) Putnam Valley
Tax Map # 61.4-9
Dear Mr. Snyder:
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. Show future location of distribution box and future path of force main.
2. _Profile the expansion area. showing ptunp;� trenclies,etc: - _.. _....__ _ ._ ...... _.... ......._ . ...
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
Very truly yours,
Joseph S. Paravati, Jr.
Assistant Public Health Engineer
C C
i Pli
;
;.j
•
i ^
� J
.
-'
........... _...____.....-.-._.. ......
._.._.___.---_-.__,__....._ ...._._...---- _..___.__.___ - -_-
.......... -
iv � �� is L-- ,,� "� � i! � T`f-f- � " �• 1= c.' {�: �; i �\
OULDS PUMPS--
APPLICATIONS
Specifically designed for the
following uses:
• Homes
• Farms
• Trailer courts
• Motels
• Schools
• Hospitals
•Industry
• Effluent systems
SPECIFICATIONS
Pump
• Solids handling capabilities:
3/1' maximum.
• Discharge size: 2" NPT.
• Capacities: up to -140 GPM.
• Total heads: up to 128 feet
TDH.
-_ ,Temperature:_ ^
1040F'(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 -dog 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.
® 2001 Goulds Pumps
Effective November, 2001
83885
p 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.
Submersible
Effluent Pump
38.85
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.
•'h and'/ HP -16/3 SJTOW
with 115, 208 and 230 Volt
three prong plug.
• 3/i -2 HP —14/3 STOW with
bare leads.
Three phase:
• Overload protection must
be provided in starter unit.
•'h -2 HP —14/4 STOW with
bare leads.
■ 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.
■ 0 -ring: Assures positive
sealing against contaminants
and oil leakage.
AGENCY LISTINGS
■ Designed for Continuous
Operation: Pump ratings are Testedtoucn8and
within the motor manuf'acturer's A � ® CSA 22.2108 sbndards
recommended working limits, By Canadian standards
■ Class B insulation, can be operated continuously c us A
File 8yry
xv�thoUX daM. -age °w
. hen full :..... ... _....__......__ submerged. Guks'wm p s .. o 9
ooil ".
sieed "
METERS FEET
40
35
30
25
20
0
15
0
10
0 10 20 30 40 60 70 80 g0 1o0 110 120 130 140 150 160 GPM
0 5 10 15 20 25 30 35 m31hr
CAPACITY
Goulds Pumps
ITT Industries
www.goulds.com
r:z���
.
a�sssssssssssssssssssss
. r : .
'�isssssssI
IN....e_
-�smoll
_,�s.s.1sss.
®sssssa;
csQS�ssssss
,.L----
N�ssssssssssssssssssssssssssss�
801%,
is�
.'s
=c��C:ZSSSS�ssssssssssssss
60
���
iW3�t:;:�``il�i���iiiiii►..
..,,,r■
�
sus
s
ss
is?isiiCi
{asss�iii
�-
k�
='�sssJ•
►��
tr"n
G612
.104i■'iii;'�ii�I
.'�i�ii
�s"'�i'
isllih
ii'N
awl
'
Q.��!
rplggob
;
.quo
rimm'+.itii��i
`'isss�elamlil�i610.441111112110
Mimi.
iii
;sssssCS
=
=��1:5ssson
0 10 20 30 40 60 70 80 g0 1o0 110 120 130 140 150 160 GPM
0 5 10 15 20 25 30 35 m31hr
CAPACITY
Goulds Pumps
ITT Industries
www.goulds.com
FONjGOULDS Ply PS
ENTS
Item -Nn • Aesc+iptisn. - - -- - - - _ 7
MODELS
Order No.
I HP
I Volts
Phase
Max. Amp.
RPM
Solids
Wt abs.)
WE0311 L
�'A
115
1
9.8
1750
-
56
WE0318L
200
6.8
WE0312L
230
4.9
WE0311M
115
98
WE0318M
200
6.8
WE0312M
230
4.9
WE0511H
115
14.5
_.
•..
3500
60
WE0518H
200
8.1
WE0512H
230
7.3
WE0538H
200
3
4.1
WE0532H
230
3.3
WE0534H
460
1.7.
WE0511HH
115
1
14.5
WE0518HH
200
8.1
WE0512HH
230
7.3
WE0538HH
200
3
4.1
WE0532HH
230.
3.6
WE0534HH
460
1.8
WE071W
90
200
1
11.0•
� -•-
70
WE0712H
230
10.0
WEO738H -
200
- ....
.3
6.2
. WE07321-1
7230
.:-.5,4
WE07341-1
460
2.7
WE1018H
• 1
200
1
14.0
WE1012H
230
12.5
WE1038H
200
3
8.1
WE1032H
230
7.0
WE1034H
460
3.5
WE1518H
1 '
200
1
17.5
80
WE1512H
230
15.7
WE1538H
200
3
10.6
WE1532H
230
9.2
WE1534H
460
4.6
WE1518HH
200
1
17.5
WE1512HH
230
15.7
WE1538HH
200
3
10.6
WE1532HH
230
9.2
WE1534HH
460
4.6
WE2012H
2
230
1
18.0
83
WE2038H
200
3
12.0
WE2032H
230
11.6
WE2034H
460
5.8
WE0537H
�
1/2
575
3
1.4
60
WE0537HH
1.5
WE0737H
%
2.2
70
WE1037H
1
2.8
WE1537H
WE1537HH
1
1 h
3,7
80
3,7
WE2037H
2
4.7
83
Order
No.
I WE03L
WE03M
WE05H
WE079
WEIOH
WEISH
WE05HH
WEISHH
WE20H
HP
'h
: 'h
'h
%
1
1'h
'h
1'h
2
nPM
1750
1750
3500
3500
3500
3500
3500
3500
3500
5
86
-
-
-
-
-
-
-
-
10
70
63
78
-
-
-
58
-
-
15
52
50
70
90 .
-
53
-
-
•20
27
35
60
83 .
98
123
49 -
90
136
25
-
-
48
76
94
117
45
87
133
x735
30
-
-
-
-
35
20
67
57
88
82
110
103
40
35
83
80
130
126
40.
-
-
-
.45
74
95
30
77
121
d
45
-
-
-
35
64
86
25
74
116
v
50
-
-
-
25
53
77
-
70
110
s
55
60
-
-
-
-
-
-
-
-
40'
30
67
56
-
-
66
63
103
96
F
65
-
-
-
-
20
45
-
58
89
70
-
-
-
-
-
33
-
55
81
75
-
-
-
-
-
25
-
51
74
80
-
-
-
-
-
-
-
47
66
90
- 1
-
-
-
-
-
-
37
49
100
- 1
-
-
-
-
-
-
28
30
DIMENSIONS
(All dimensions are in inches. Do not use for construction purposes.)
KICK -BACK
Goulds Pumps and the ITT Engineered Blocks Symbol are
registered trademarks and tradenames of ITT Industries.
PRINTED IN U.S.A. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
Goulds Pumps
<& ITT Industries
a f Friction
8
Loss
_
.u...:C3. :.v- w.. c,...
PL:A91ric PIPE: •
FRICTION LOSS PER 100 FT.
GPM
GPH
2"
2%11
3"
4"
6"
8"
10"
Ft.
Lbs.
Ft.
Lbs.
Ft.
Lbs.
Ft.
Lbs.
Ft.
Lbs.
Ft.
Lbs.
Ft,
lbs.
6
360
.10
.044
8
480
.17
.073
10
600
:25
.108
.11
.046
15
900
.52
.224
.22
.094
20
1,200
.86
.375
.36
.158
.13
.056
25
1,500
1.29
.561
.54'
.234
.19
.083
30
1,800
1.81
.786
.75
.327
.26
.114
35
2,100
2.42
1.05
1.00
.436
.35
1 .151
.09
.041
40
2,400
3.11
1.35
1.28
.556
.44
1 .191
.12
.052
45
2,700
3.84
1.67
1.54
.668
.55
.239
.15
:064
50
3,000
4.67
2.03
1.93
.839
.66
.288
.17
.076
60
3,600
6.60
2.87
2.71
1.18
.93
.406
.25
.107
70
4,200
8.83
3.84
166.
1.59
1.24
.540
.33
.143
80
4,800
11.43
4.97
4.67
2.03
1.58
.687
.41
.180
90
5,400
14.26
6.20
5.82
2.53
1.98
1 .861
.52
.224
100
6,000
7.11
3.09., .
2.42...:
05
...63_
.272
08
.036
-7,500'
_. --
10.83
4.71
3.80
1.65
.95
.415
.13
.055
150
9,000
5.15
2.24
1.33
.580
.18
.077
.
175
10,500
6.90
3.00
1.78 774
.23
.1C2
200
12,000
8.90
3.87 2.27 ! .985
.30
.130
250
15,000
i
,
3.36 ; 1.46
.45
.195
.12
.051
300
18,000
I
I
,
4.85 2.11 ! .63 1 .275 '
.17
.072
350
21,000 I
I
6.53 2.84 - .84 .367 ' .22 I
.095
400 I 24,000 j i I
j 1.08 , .471 .28 ,
.121
j
500 30,000 ( ! j
1.66 ` 720 I 42
..182
.14
550 33,000
C 1.98 1 .861 .50
.219
,16 .071
600 36,000 i i 1 i 1
E.31 1 1.02 i .59
.258
.19 ! .083
700 j 42,000 j ; ! .79
.343
.26 .112
800 ; 48,000 i 1.02 I .443 f
.33 .143
yUU 54,000 ! i 1.27 .554 1 .41 .179
� x--
950 j 57,000 i j _ i i .46 j .198
1000 60,000 .50 `I 218 2
f action
IFF
EQUIVALENT NUMBER OF FEET STRAIGHT PIPE FOR DIFFERENT FITTINGS
Size of Fittings, Inches
W
3/4"
1"
1 V4"
W
2"
2W
3-
4"
5"
611
a"
10"
900 Ell
1.5
2.0
2.7
3.5
4.3
5.5
6.5
8.0
10.0
14.0
15
20
25
450 Ell
0.8
1.0
1.3
1.7
2.0
2.5
3.0
3.8
5.0
6.3
7.1
9.4
12
Long Sweep Ell
1.0
1.4
1.7
2.3
2.7
3.5
4.2
5.2
7.0
9.0
11.0
14.0
Close Return Bend
3.6
5.0
1 6.0
8.3
10.0
13.0
15.0
18.0
24.0
31.0
37.0
39.0
Tee - Straight Run
1
2
2
3
3
4
5
Tee -Side inlet or Outlet
3.3
4.5
5.7
7.6
9.0
12.0
14.0
17.0
22.0
27.0
31.0
40.0
GlobeValve Open
17.0
22.0
27.0
36.0
43.0
55.0
67.0
82.0
110.0
140.0
160.0
220.0
Angle Valve Open
8.4
12.0
15.0
18.0
22.0
28.0
33.0
42.0
58.0
70.0 1
83.0
110.0
Gate Valve -Fully Open
0.4
0.5
0.6
0.8
1.0
1.2
1.4
1.7
2.3
2.9
3.5
4.5
Check Valve (Swing)
4
5
7
9
11
13
16
20
26
33
39
52
65
Check Valve (Spring)
4
6
8
12
14
19
23
32
43
58
Example:
(A) 100 ft. of 2" plastic pipe with one (1) 900 elbow
and one (1) swing check valve.
90° -elbow - Equivalent -to 5 5,ft; of.straight.pipe-
Swing -Check - EgLiNdI hf f6 13.0 ft. of straight pipe
100 ft. of pipe - Equivalent to 100.0 ft. of straight pipe
118.5 ft. = Total
equivalent
pipe
Figure friction loss for 118.5 ft. of pipe.
(B) Assume flow to be 80 GPM through 2" plastic
pipe.
1. Friction loss table shows 11.43 ft. loss per 100 ft. of
pipe.
2. In step (A) above we have determined total feet of
pipe to be 118.5 ft.
3. Convert 118.5 ft. to percentage. 118.5 _ 100 = 1.185.
4. Multiply 11.43
x 1.185
13.54455 or 13.5 ft. = Total friction loss in
this system.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
.�.-.. ....._. .- .. -.A �.�. _. .... _.. .- ......... :... �...v... r.. s. t. T. Ka lb �..i` .. •...al iM.K ♦.
RE: Property of
Eric Perrella
Located at Chapman Road
T/V Putnam Valley Tax Map #
Subdivision of
61.0
Block 1 Lot — 9
Subdivision Lot # Filed Map # 2058A Date Filed
Gentlemen:
12/6/1989
This letter is to authorize John P. Delano, P.E.
a duly licensed Professional Engineer or Registered Architect — to apply for the required
wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and to supervise the construction of said wastewater treatment and/or water supply systems
in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health
Law, and the Putnam County Sanitary Code.
Very truly
Countersigned: Signed: 7_�4;
P.E., lZf, # 062505 (Owner of Property)
Mailing Address Badey &Watson, P.C. Mailing Address: 1119 Edison Avenue
3063 Route 9 Cold Spring
State New York
Zip
10516
Bronx
State New York Zip 10461
Telephone: 845- 265 -9217 Telephone: 917- 612 -6796 (C)
Form LA -97
®N
B,,pp1�7y��EYgp� &��{yWAQT�ySy
LETTER ®f TRANSMITTAL
pp. ] (�
S 84Y1 �Ly6 /bTw _ �U6. QJ86gine�ill_b�b�y'
v
-3063 Route -9; � Cold Spring, �NewrYork 10516
Date: 06 May 2004
File No. 81 -146
W.O. # 16505 '
RE: Proposed SSTS - RENEWAL (revised)
Perrella
TO:
Chapman Road
Joseph S. lParavati, Jr.
Philip M. Hosay Subd. Lot No.
1
Assistant Public Health Engineer
Tax Map 61:1.9
Putnam County Department of Health
Pernritll ide/PO #
1 Geneva Road
Sent via:
18rewster, NY 10509
US MAIL El UPS -NIGHT
El
MESSENGER El UPS -2 DAY
11
PICK -UP El UPS -3 DAY
El
FAX ❑ UPS -GRND
0
We are sending:
UPS -COD
copies date description of document
l 05- May -04 jApplication Fee - $400.00
O
❑1 106-May-04 iConstruction Permit for Sewage Treatment System
ET Letter of Authorization
❑1 03- May -04 Pum data & info five 5 pages
0 26- Apr -04 xc: Wetland Permit Waiver, two 2 pages
F1 106-May-04 7 JApplication to Construct a Water Well
3 OS -Ma -04;; -.= — - Se Uate-Setva Treatment System Fill Plan Sheet 1 of 2-
❑1 106-May-04 7 ISeparat& Sewage Treatment System Sheet 2 of 2
REMARKS:
For your review. Floor plans shall to be submitted by client.
Copies to: ]File
Yours truly:
Jason R. Snyder, Assistant Engineer
Tel: (845) 265 -9217 ext 13
]Fax: (845) 265 -4428
Email: jsnyder @badey - watson.com
40 40-05 503665 622647 24097
U
LORETTA MOLINARI R.N., M.S.N.
Public Health 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) 278 - 6014 Fax (845) 278 - 6648 '
FACSIMILE TRANSMITTAL
To- r L Y (�° C.G. Fag: �?. �� 02 �v l
From: Geer Aln'VZ-V Date: `7
Re: ��r! Pages: 3
CC:
❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply
ROBERT J. BON,DI
County Executive
CONFIDENTIALITY STATEMENT: 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.
Public Health Director
Associate Public Health Director
Director of Patient Services
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 i'reschool (845) 278 -6082 Fax (845) 278 -.6648
'boa Local Building Inspectors
Firm, Bruce R. Foley, Public Health Director
Davao 7/27/00
Re.- Summary of June 14,'2000 Meeting
The following is a summary of the points discussed during the meeting held on June
14, 2000 in this Department relative to single family. houses with respect to issuance
of Construction Permits by this Department.
1. It was agreed that prior to the issuance of a building permit, the building
inspectors will require that architectural plans be submitted to the Putnam
a -.:- GountyHealth Department.for bedroom:count,: The�D.epaitment_iAill place•an. -
approval stamp on the plans with the bedroom count specified.
2. The Department has determined.that each single-family dwelling is allowed a
living room, dining room, kitchen, family 'or playroom, and bathrooms. Any
rooms beyond those listed above will be considered a potential bedroom. The
exceptions to rooms which will not be considered a bedroom are:
If room has a minimum six (6) foot wide opening (archway
with no doors).
- If room has a floor area less than 80 square feet.
If room has a horizontal dimension less than 7 feet
.3. If proposed house plans indicate a "bonus room," typically above the garage,
the space will be considered a potential bedroom. If the same space is
identified as "unfinished" storage or attic space, then it will not be considered a
potential bedroom.
1
4. If a bonus room is located in a structure (i.e. garage) not attached to the
dwelling, then it will not be considered a bedroom.. For example, if a "bonus
room" is indicated above a detached garage, which is separated from the
dwelling by a breezeway, the bonus room will not be considered a bedroom.
We believe the meeting; in which the above points were discussed, was informative
for all rparties, in addition to opening the lines of communication between our
respective Departments. I again thank you for taking the time out of your busy
schedules to meet with us.
Should you. have any comments or .questions regarding. the above, please contact
this office.
BRF /MJBrp
cc: EHS Staff
• Page 2
I
SENDING CONFIRMATION
DATE : APR-21-2004 WED 15:12
NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH
TEL 845-278-7921
PHONE
: 92652615
PAGES
: 3/3
START TIME
: APR-21 15:11
ELAPSED TIME
: 00'51"
MODE
: ECM
RESULTS
: OK
FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.
Sm %pyl pnvpom SMAW—P UV Amop VOW <091"11-cog)
so —0q, xg
TnLN
gldwg osnlj c3 1.10e0=03 99"Id 0 o
......................................... ...... ........... ...............................
:sawed —p� :m
A-V
lid., • 2Lt (Swo "d ofig - ILZ tpl=Fl l.lAwAft4A-3
60507 3jjoA,-K'X4i&*3G 'PIOURAOU3DI
RITrM 40 1KM1WJaG
V4 -y 1091W
IQNOH 'f SYHHOH .. 'W81K "PrIff My.luloyl YJJH1[0'7
°, Apr` 20 04 03:30p
Exclusive Affiliate of
SOTHEBY'S•
International Realty
HL COLDSPRING
8452652615
FAX TRANSMISSION
r
DATE:` I
Of.
FAX NUMBER:
FROM:
HOULIHANILAWRENCE INC.
60 Main Street
Cold Spring, New York 10516
-Phone: (845) 265 -5500 FAX: (845) 265 -2615
RE: tt.,c Z-c
r ,y
Number of Pages Including Cover Sheet = �?
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL NUMBER ABOVE
This facsimile communication contains privileged and confidential information intended only
for the use of the individual or entity names above. If the reader of this communication is not
the intended recipient, you are hereby notified 'that any dissemination, distribution or
photocopying of this facsimile communication Is strictly prohibited. If you have received this
facsimile communication in error, please notify us by telephone and return the original
facsimile communication and any copies to us at the address above via United States Postal
Service. Thank you. HOULIHAN /LAWRENCE INC.
60 MAIN STREET. COLD SPRING, NY 10516 (845)265 -5500 FAX (845)265 -2615
APR -20 -2004 TUE 16:22 TEL:845 -278 =7921
p.1
NAME:PUTNAM COUNTY DEPARTMENT OF P. 1
Apr 20 04 03:30p HL COLDSPRIHG
8452652615
i
i
f
i
7
i
i
4
sli
i
V
APR -20 -2004 TUE 16:22 TEL:845 -278 -7921
o0
I I
J " I IL'-- * J 11 " - -
NAME:PUTNAM COUNTY DEPARTMENT OF P. 2
Apr 20 04 03:30p HL COLDSPRIHG 8452652615
APR -20 -2004 TUE 16:23 TEL:845- 278 -7921
P
J
1-11 �N
p.3
IVIOC4 df,
rr ;
is
/ t
r I IIf I f °-
NAME:PUTNAM COUNTY DEPARTMENT OF P.
a 0
Mar 09 04 03030p HL COLDSPRING 8452652615 X0.1
Eselool.ra Affiliate
y oofv .
S4.1t � HEB a�
Intemationd Redty
:A
®ASE- j
0z
TO: JOE 6±44uOTTI
FAX I��,��E�o y -- a79 — -,7 i� I
FROM:
HOULIHAN /LAWRENCE INC.
60 Main Street
Cold Spring, New York 10596
Phone: (645) 265 -5500 FAX: (645) 265 -2695
RE: -=T HO) C 1 #O- QL1 641G #
Fve Yo To e2 vteW, T t Kew WEE b 7`#f�t— /xr45
Le- S C,# L C o1c 7-If EL c z_ c-f.� R
YOq GE 1 A dOeC
N umber of Pages Qncluding Cover Sheet
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL NUMBER ABOVE
This facsimile communication contains privileged and confidentia9 hformation intended only
for the use of the individual or entity_ names above. If the reader of this eommunicago j, not . '
the intended recipient, you are hereby notified that any a9issem6adon, -distr button'; or `
photocopying of. this facsimile communication is strictly prohi"id. Of you have .recelved this
facsimile communication in -error, please notify us by tefephorie and retune .the'or gtnal
facsiriiit® oorinrtwnication grid any copies to us at the >ddrass above via t&nited States Pos"'�at k
,...- ..
Senrice.';Thankycu. HO ... ..... , .. ... ... , "' = - ���.: =' ... Attu w�:, .t � k -:: _ •._,: ::= .
INC: UgIfyAN/I.AWRENCE` -: rx•: • - ':4xw�' :::.'•. . -.. .
COLD SPRING
' 'NY 10516 184S)Z45-5500 _ Bk (84 6 -26ll5
• • .e }lax..
MAR -9 -2004 TUE 16:24 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1
N
Q
U7
CD
N
V)
(D
N
V)
V
W
L
a_
N
A
J
O
U
J
2
Q
O
m
m
O
O
W
O
L
N
a �
I
i
;s.
6
.p
is
'e
4-
• s'
S
f
Notes} t
1. Al base data 6y othcrs. No representation ncr 1
implied as to acaraq of same.
2. Laya4 of ca r4pbA design is for illustratft p
to rewew and condtUms, of approval to be establb
3. this, drawing t, bawd on data from the 10/ 2
Watsai; Sheet 1 of 2.
m
m
CD
N
N
CD
N
L
co
Ct.
O
m
m
0
0
w
0
L
ro
;r
k
r
Y
;a
Y
1%
.0
i7
i�
�r
i4
3z .
Notes:
I. All base data by others. No represerrtatw ror wa
tmphed as to acar-aN of same.
2. i
' i.
"of conceptual deskr i, for dlustrattve pwp
to regrew and C&OItW5 of approval to 6, estabdishe,
S" All:envrr-orvrrental constrabtts subject to local. state
junsdictton must be reviewed by approprkte a,
m
ti
LL
O
F-
z
W
CL
0
}
H
z
O
U
E
Q
z
H
LL
CW
L
Q
r,
N
Q1
N
N
I
U)
I �
J
q-
N
W
cc
v
m
m
N
m
rZ
Nov 12 03 04:31p
EXClufive Affiliate of
SOTHEBY'S
Intemational Realty
DATE:
TO:
Of.
FAX NUMBER:
FROM:
HL COLDSPRING
8452652615
FAX TRANSMISSION
/ a ./ '
1.)/. _. 03
v
i°C(�11if E M C o U Il= AEA> T1f ZJ27—
V ',i;z lag 7 7?al'
p.1
ek(C
HOULIHANILAWRENCE INC.
60 Main Street
Cold Spring, New York 1051.6
Phone: (845) 265 -5500 FAX: (845) 266-2615.-...__
M
0
Number of Pages Including Cover Sheet = C
IF YOU DO NOT RECEIVE ALL PAGES, PLEASE CALL NUMBER ABOVE
This facsimile communication contains privileged and confidential information intended only
for the use of the individual or entity names above. If the reader of this communication is not
the intended recipient, you are hereby notified that any dissemination, distribution or
photocopying of this facsimile communication is strictly prohibited. If you have received this
facsimile communication in error, please notify us by telephone and return the original
facsimile communication and any copies to us at the address above via United States Postal
Service. Thank you. HOULIHANAAWRENCE INC.
60 MAIN STREET, COLD SPRING, NY 10516 (845)265 -5500 FAX (845)265 -2615
NOV -12 -2003 WED 17:29 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1
Nov 12 03 04:32p HL COLDSPRIMG 8452652615 p•2
Oct 14 03 03:4010 Planning Board 1914) 52BL3307
P-2
fy STEPHEN W. COLE . -IAN Environmental Planning t3 Site analysis
ENViRONMENTAL CONSUL ','1G, LLC Wetland Mitigation & Restoration Plans
Wetland Delineation Et Assessment
Natural Resource Management
Pond B Lake Management
Wildlife & Plant Surveys
Breeding Bird Surveys
Landscape Design
MENI®
To: Putnam Valiey Pla: iing Board
From: Stephen W. Colem t Town Wetlands Inspector
Date: October 10.2003
Re: 1Perrella, Chapina Road, Tax Map No. 61 -1 -9, 4.01 acres — Wetlamd Review
Cc: Applicant
I received a z to Alteration Permit f i Aication for the above referenced property for construction of a new
residence, sego -ic, driveway, well on i2prnan Road, which is in a Conservation District. The proposed plans as
presented hav-.: the entire house wid the 100 -foot wetland buffer to an existing pond. Based upon review of
the plans and:. site visit on 10 -03 -0: 1 offer the following comments:
1. This appl iration will regairc Pla ing Board review and approval.
2. The existitg site has a lot of led, • rock throughout-the property, which limits the available sites for
placeme:n, . of the septic and the I use.
3. According; to Chapter 144, of thr town Code, an applicant should identify avoidance of wetland impacts as
the preli;r-,:d plan. It is my reco nendation that the alrplicant review with h :s architect ane engineer
alternative locations that place ti house either outside of the 100 -foot wetland buffer or as far away as
- .. feasible. Specif=lly I wouldyli' :aq sec :a fe y °alts= mate. lay o�ts.and znalysis of possibl4 )i C,Coeatiens_.:
- - and associt ted environmental irr :.cm
a. Site plan with house .aside of 100 foot wetland buffer
b. . S.te plan with major , of house outside of 100 -foot wetland buffer with a mitigation plan fo.
coripensating for tht .,tcroachnient within the buffer
C. Site plan as propose( :: itli further information provided on impacts and mitigation measures
4. The Site Plan submitted does not st the narne of the person who prepared the plan. The plan needs to be
gnepared b}. a licensed architect c ,-nginecr. This information should be provided and their stamp shown.
5. The pond h )undmy is well define . and it is *tot necessary to have the boundary re- flagged and stnveyed.
6. The above ; nalysis of site plans s A quantify the arneunt of wetland buffet disturbancc for each
alternative.
7, Derails shot ld be provided on fn. grades and how drainage will be handled on the property.
This complete, my review at this time ['lease let me :craw if you have any questions or require additionai
information.
3 ASPEN CCi..RT, OSSINiNG, NY 105t .. 914 - 494- 55441FAX 914 -762 -5260 eSteve.Coleman$ (Pverizon.net
NOV -12 -2003 WED 17:29 TEL:845- 278 -7921' NAME:PUTNAM COUNTY DEPARTMENT OF P. 2
BRUCE-, Rr --F0hEYt: i :-1r:,_
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
November 21, 2002
John Delano, PE
Badey & Watson Engineering
3063 Route 9
Cold Spring, New York 10516
01
Dear Mr. Delano:
J
Waiver Determination - Hosay
Chapman Road, (T) Putnam Valley
TM# 61.0 -1 -9 .
The Putnam County Health Department reviewed the waiver request for the above regarded
project on November 15, 2002. The following determination hasbeen made:
® The Waiver request was approved.
The.Waiver:request was conditionallygpproyed._HoweYer, the.�revision(s) noted,,belo.w..:
DWRSIGN OF ENVNRONMENTAL HEALTH SERVICES
CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PIEIBI�UT# W Located at C)A � MAM \7.OAO
Subdivision name 41AP Ma [W-tS bd. Lot # Tax Map Block Lot
Date Subdivision Approved % 2 O(D Renewal Revision
Owner /Applicant Name 1 U P /AU unk A A L_ 5k' —hate of Previous Approval
Mailing Address
Amount of Yee Unclosed
Building Type Lot Area , ( No. of Bedrooms 3 Design Flow GPD C;00
Fill Section Only _� Depth VoRume
PCH D NOTIFICATION IS ICE UIREID WHEN FILL IS COMPLETED
Sejarzte SeweraFle ftstem to consist of
gallon septic tank and
Other Requirements:
To be constructed by ���� ��(D.(`� C� Address C 1� . y
WateLSant 2Ry: Public Supply From Address A 16
. .. or: Private - Supply Drilled by �C �� ,�.1�� �3 � 1-�� - Address
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
senarat„� a sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the
Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said
builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
Signed:
Address
—Date l ®c 3 ' o---
# C)GZ�3C6
APPROVED ]FOIE CONSTRUCTION: This approval expires two years froPthe date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHL) {iWVevh(%th9% ?Qause or may be amended or
modified whe nsidered necessary by the Public Health Director. Any revision or- alteratiQQ of the approved plan requires
a new permit. pr ed for discharge of domestic sanitary sewage on A J ; • +` :'i' ltl
By: i,, Title: 01 = . , r ' ,a , Date: 24 0 L-
White copy - HD File; Yellow"bbpy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
q
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A WATER WELL
,,. .- ......: ,..,_ please pririf or'type
Well Location:
Street Address: Town/Village Tax Grid #
A'? A \ (D _ V )_LE Map �ji� Block Lots)
Well Owner:
Name:
Address:
N►L1 P A A
1)CX3 Z,�ECVEQ!2�,, AP i (,A 0-9q, 10DZ
Use of Well:
1G 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 __tt_ gpm # People Served Est. of Daily Usage gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
�a � k— i f�.,� '' ('` ( Lam/ - IC7 EQ gE610EK G.
for Drilling
Well Type
Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ...................................... ............................... Yes__ No
Name of subdivision 'k N 3 P M. Lot No.
Water Well Contractor: N(, 2\N ( AJQ J'(Q)4,. IW Address: mil, ir4v'v1 VALL `i ki� )0`54-9
,
Is Public Water Supply available to site? .................................. ............................... Yes No )C
Name of Public Water Supply: N /.A- Town/Village
Distance to property from nearest water main: 7 1 M,-
Proposed well. location & sources of contamination to be provided on separate sheet/plan.
Date: t 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. An revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water w)fftiller certified by Putnam
County. /L - 1.4 1
Date of Issue 0 L' Permit I60i* Qjfi*l .
an
Date of Expiration Title:
Permit is Non - Transferrable 4 S i i i. ; " `H A Q
N!rd
White copy - HD file; Yellow copy - Building Inspector; ink cope Orange copy - Well driller
Form WP -97
PART II - IMPACT ASSESSMENT (To be completed by Lead Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR; PART 617.4?
0 Yes CWN o•
• ,;•:B.: WU:L- A.CT-ION:RECEtyrc COORDINOATF- MEVIE. WAS ,RROVIDED; FOR UI&. kV,E.D:AE.T40NS lt3 6 .NYM.-i;PART,,6<1.7.6 ?,,It.No;ra negative-. ,*••. — �-* '-�•
declaration may be s erseded by another involved agency.
0 Yeslo
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible)
C1. Existing air quality, surface or groundwater'quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
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:
/v Ifl�✓
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:
4vtr�
C5.
Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly:
C6.
Long term, short term, cumulative, or other effects not identified' in C1-05? Explain briefly:
A.Aw'c-
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 CRITICAL
ENVIRONMENTAL AREA CEA ? If yes, explain briefly:
Yes N o
E. IS THERE, OR I THERE LIKELY TO BE, CONTROVERSY. RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:
Yes No
PART 111 - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. -Each
effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b): probability of occurring; f c) duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that. explanations contain
sufficient detail to show that all relevant adverse -impacts have been identified and adequately addressed.. If.question d of part Ii was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
F-1 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
F1
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this
determination.
Name of Lead Agency it., — Q.O Date
Print or Type Name f Responsible Officer in Lead Agency i -111 l itle of Responsible Officer
A10_0kl' i3 vi vv1inj
0
,1':
Sign ture sp sible' Officer in Lead Agency Signature of Preparer (If different from responsible officer)
617.20 SEOR
PROJECT ID NUMBER APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
(To be dornletedbAplicant•r Project - S-PAB 4 -PROJECT INFORMATION" o ponsor)
1.APPLICANT /SPONSOR 2. PROJECT NAME
Philip M. arc Cynthia lK. Hosay Philip Hosa
3. PROJECT LOCATION:
Municipality Putnam Valley County ]Putnam
4. PRECISE LOCATION: Street Address and Road Intersections, Prominent landmarks etc -or provide map
Chapman Road (see map provided)
5. IS PROPOSED ACTION ® New ❑ Expansion ❑ Modification /.alteration
6. DESCRIBE PROJECT BRIEFLY:
Separate sewage treatment facility to service new single family dwelling with new private water supply.
7. AMOUNT OF LAND AFFECTED:
Initially < 2 . acres Ultimately < 2 acres _
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS?
Yes ❑ No If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply)
® Residential ❑ Industrial ❑ Commercial ❑Agriculture ❑Park /Forest /Open Space Other (describe)
Residential housing on 2+ acre lots.
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, State or Local)
® ,Yes ❑ No If yes, list agency name and permit /approval:
Putnam Valley - Driveway &Building. Permits
11. DOES ANY ASPECT OF THE ACTION, HAVE A CURRENTLY'VALID PERMIT OR APPROVAL?
❑Yes ® No If yes, list agency name and permit / approval:
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
❑ Yes ® No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO.THE BEST OF MY KNOWLEDGE
Applicant / Sponsor Name John P. Delano, P.P. Date: 09/27/02 .
Signature _
*4& �L��!�• . Design hr ®$seal ®nal $ ®P a IiCa09$
�. pp
If the action is a Coastal Area, and you are a state agency,
complete the Coastal Assessment Form be$ore.proceeding with this assessment
si
ti
DRESSING,.
o AREA BATH
KITCHEN
BEDROOM #1 FF DINING ROOM
Li
HALL
I L i
00
------ ------
0
j-_j
CLOSET CLOSET CLOSET CLOSET 1-- _7-i 0--
0'-2 1/2
A
=l C=)
yi
,
C-11
• a
cla
BEDROOM #2 BEDROOM #3
LIVING ROOM
FOYER
<
6'- 1/
1i
N
14'-1
PUTNAM COUNTY DEPARTMENT OF WEALTH
HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY,
BEDROOMS
9w - 350j-
ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE-':
OWNER/APPLICANT
PLAN' ST SUB-AlITTED TO THE PCD011 FOR APPROVAL'
FIRST FLOOR PLAN
PHILIP M. & CYNTHIA K. HOSAY
qi
z-(
100 BLEECKER ST., APT. 6A
NEW YORK, NY 10012
SCALE: 1/4" = V-0"
'DATE
'TURF. rlT,?
COPYRIGHT 2002 BY BADEY & WATSON. SURWYWb & DATE: 09/27/02
ENGIZERNG. P.C.
a
NOTE: A COPY OF THE HOUSE PLANS SUBMITTED TO
LOCATION
BADZY & WATSON. mwwxv & Avftwrft pe THE BUILDING' INSPECTOR, WHEN FILING FOR A BUILDING
CHAPMAN ROAD
PERMIT, MUST BE SUBMITTED TO THE PUTNAM COUNTY
PHILIP M. HOSAY, LOT NO. 1
3DO3 RoUte 9 (845) 285-OW
Cold Spring, Nww Tork 10516 (845) 225-3312 HEALTH DEPARTMENT TO VERIFY THE BEDROOM COUNT.
PUTNAM VALLEY
T.M. NO. 61-1-9
(877) 914 -1699 Toll -Fm To--Fm
pmq (914)
(m) 255--442Sjft4 (924) =1=61
%E NO.
81-146
si
ti
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
.'4. .� �. r. ..,.. A- WASTEWATF.R•TRFA W1EN- ' SYSTEM ... • • ,.... _ .. u ✓. _.,�.:. , •r,.
1. Name and address of applicant: Philip M. & Cynthia K -Hosay
100 Bleecker Street Apt. 6A
New York,.NY 10012
2. Name of project: Philip Hosay 3..LocationT %V: Putnam Valley,
4. Design Professional:, John P. Delano, P.E. 'S. Address: : •Badey & Watson, P.C.
6. Drainage Basin: Hudson River 3063 Route 9 Cold Spring, NY 10516
7. Type of Proiect:
X Private/Residential
Apartments
Office Building
8. Is this project subject to Sta
Type Status'(check one)_
Food Service Commercial
Institutional —Mobile Home Park
Realty Subdivision Other (specify)
to Environmental Quality Review (SEQR)? .
- - -` --------------=--- - - - - -- Type.I .. Exempt.
Type II Unlisted
9. Is a Draft Environmental Impact Statement (DEIS) required? _ _ _ _ _ _ _ _ _ _ ----- No
10.- Has DEIS been completed and found acceptable by Lead Agency?'--
N/A .. .
11. Name of.Lead Agency Putnam County Department of Health
12. -Is :this.project in an area under the control of local .planning, zoning, or other
officials5 :ordinances?.,_ _ _ _ _ _ _ _ _ _ _
_ .. - -- . - - -- - - - -- - -- Yes.
13. • If so, have plans been submitted to such authorities? ------------------ _ _ _ _ _ _ No
14. Has preliminary` approval been granted by such authorities? ' No Date granted: N/A .
15. Type of Sewage Treatment System Discharge--.-----_--_ surface water X groundwater
16. If surface `water discharge, what is the stream class. designation? -------------`- 'N /A
17. Waters index number (surface) --------------------- ____________ N/A
18..Is project located near a'public water supply system ?.
19. If yes; name of water supply NSA
----- -------------- - - - -.. No
Distance to water supply N/A
20. Is project site near a public sewage collection or treatment system? _ _ _'_ _ _ _ _ _
No
21. Name of sewage system N/A Distance to sewage system N/A
22. Date test holes observed 23. Name of Health Inspector
07/26/02 Gene Reed
24. Project design flow allons era _ _ _ ------ .,600
25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... No.
26. Has SPDES Application been submitted to local DEC office? --------------- _ N/A
Form PC -97
27. Is any portion of this project located within a designated Town or State wetland? No
28. Wetlands ID Number NSA
29. Is Wetlands Permit required? --- _ - - - - -- ___________ __ __ ___ No
Has application been made to Town or Local DEC office? ----------- _ --------
30. Does project require a .DEC Stream Disturbance Permit? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .
N/A
No
31. Is or was project site used for agricultural activity involving application of
pesticides to orchards or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ----- _ _ _ _ _ _ _ _ _ Yes/N6 No
32. Is project located within 1,000 feet of existing or abandoned landfill,
hazardous waste site; salt` stockpile, landfill, sludge disposal site or any
other potentially known source of contamination? ----------------- Yes/No No .
DESCRIBE:
33. Is there a local master plan on file with the Town or Village? _ _ _ _ ------ _ _ _ _ _ Yes
34. Are community water and/or sewer facilities planned to. be developed within
15 years in or adjacent to,
project sit e?_________ _________________.____________ --- No
35. Are any sewage treatment areas -in excess of 15% slope? --------- _ _ _ _ _ _ - _ Yes
36. Tax Map ID Number -------- - - - - -- - - - - -- '-- - - - -__ Map 6�: Block Il_ Lot -
37. Approved plans are to be returned to': _ _ Applicant .. X Design- Professional
NOTE: All applications for review and approval of a new SSTS to be located within the NYC 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 l .,the application must
be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision
may be grounds for the rejection of any submission.
hereby affirm, under penalty of perjury, that information provided on this form is true
to the best of my knowledge and belief. False statements made herein are punishable as
a (Class A misdemeanor pursuant to Section 210.45 of the Renal Law.
SIGNATURES & OFFICIAL TITLES: eWe PI
alley & Watson, ]'.C.
Mailing Address: - - - - - - - - - - - - - - - - - 3063 Rouuti 9
CoRd SpAng, NY, 10516
. PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
<DATA>SHE]ET ; -SUBS 2 CE_19
Owner Philip M. Hosay Address 100 Bleecker St., Apt. 6A, New York, NY 10012
Located at (Street) Chapman Road Tax Map 61. Block 1 Lot 9
(indicate nearest cross street)
Municipality Putnam valley Drainage Basin Hudson River
SOIL PERCOLATION TEST DATA .
Date of Pre - soaking o7i17 /02 Date of Percolation Test 07/18/02
Hole No.
Run No..
Time
Start - Stop .
Elapse Time
(Min.)
Depth to Water
From Ground
Surface (Inches)
Start - Stop
Water
'Level
Drop In
Inches
Percolation
Rate
Min/Inch
D
1
1:42 — 2:11
29
19.: .- 22
3
10
D
2
2:15 — 2:44
29'
19 — . 22
3
10
D
3
2:46 — 3:15
29
19 — 22
3
10
4
5
—
—
E .
1
1:43 — 1:56
13
19 - 22
3
4
E
2_ ._..:
- 1:57. •..- ..2.11.,..:....
- -14. ,.
19.,__ 22•
3
5
E
3
2:13 2:27
14.
19 — 22
3
5
4
-
—.
5
—
—
G
1
12:50 ' - 1:17
27
19 — 22
3
9
G
2
1:19 — 1..47'
28
19 — 22
3 .'
9
G
3
1:48 — 2:16
28
19 — 22
3
9
5
to
w
NOTES:.'1. t `Tests "ta lid= rgeatet
Ypercolatioi i s 01
cy sulrintted for`revie,
2. E160'-'ffieasuir'em.en
• : �; _... yr. _�''
at same depth until approximately equal percolation rates are obtained at each
. (i.e. < 1 min for 1 -30 min/iiich, < 2 min for 31 -60 mionch) ' All data to be
to be made from top of hole.
Form DD -97
TEST PIT DATA 2
(DESCRIPTION OF SOILS ENCOIJNTEREID IN TEST HOLES
DEPTH . _...
IOL'> NO::':... 6:. ; _ .
; ..' 07L ISO.... -
hflLh NO-..- .-
G.L.
4" Topsoil
Trace Topsoil
Trace 'Topsoil
0.5'
Reddish Brown Fine
Reddish Brown Fine
Reddish ]Brown Fine
1.0'
Silly Sandy Loam
Silty Sandy ]Loam
Silty Sandy Loam
1.5'
2 0'
V
V
2.5'
3.0'
3.5'
4.0. 1
4.5'
5.0'
5.5'
6.0'
6.5'
7.01
7.5'
8.0'
8.5'
9.0'
10.0'
Tan Fine Sand & Gravel Tan Fine Sand & Gravel
W/ Cobble w/ Cobble
V, _V
V
Indicate level at which groundwater is encountered .' Not_Enebuntered
Indicate level at which mottling is observed None Observed
Indicate level to which water level rises after being encountered N/A
Deep hole observations made by: dRS, Badey & Watson, P.C.; Gene Reed, PCD H Date 07/26/02
Design Professional Name: John P. (Delano, P.E.
Address: Badey & Watson, P.C.
3063 Route. 9, Cold Spring, NY 10516
Signature:
(Design Professional's Seal
C';�saysi,
X
w,
,• ... 4
1
c�
®
t''i
�7
Indicate level at which groundwater is encountered .' Not_Enebuntered
Indicate level at which mottling is observed None Observed
Indicate level to which water level rises after being encountered N/A
Deep hole observations made by: dRS, Badey & Watson, P.C.; Gene Reed, PCD H Date 07/26/02
Design Professional Name: John P. (Delano, P.E.
Address: Badey & Watson, P.C.
3063 Route. 9, Cold Spring, NY 10516
Signature:
(Design Professional's Seal
C';�saysi,
X
w,
,• ... 4
1
PUTNAM CC,NTY DEPARTMENT' (' HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES.
I.EMR -OFA ' (i ATION
RE: Property of Philip M. & Cynthia K. Hosay
Located at Chapman Road
T/V Putnam Valley Tax Map #
61
Block 1 . Lot 9
Subdivision of Philip M. Hosay
Subdivision Lot # 1 Filed Map # 2058A Date'Filed : . 12/06/89
Gentlemen:
This letter is. to authorize John P. Delano, P.E.
a duly licensed Professional Engineer X. or Registered Architect ..to apply for the required
wastewater treatment and/or water supply permit(s) to. serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection'with this
matter and to supervise the construction of said wastewater treatment and/or water. supply systems
in conformity with the provisions of Article 145 and/or 147 of the Education Law, .the Public Health
Law, . and. the Putnam County Sanitary. Code....
Countersigned: % d
# 062505
Mailing Address Badey & Watson, P.C.
3063Route 9 Cold Spring
State New York Zip
.10516
Telephone: 845- 265 -9217
Very to
Signed:
Mailing Address:. 100 Bleecker Street Apt. 6A
State NY Zip
Telephone: 212- 777 -8158
New York
10012
14 /` N3
Form LA -97
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO. HOLE N
DEPTH
HOLE NO.
G.L. 411 Topsoil Trace Topsoil Trace Tops . oil
05 Reddish Brown Fine Reddish Brown Fine Reddish Brown Fine
1.01 Silty Sandy Lo . am Silty Sandy Loam Silty Sand . y Loam
1.5
V
2.0' I V
2.5 Tan Fine Sand & Gravel Tan Fine Sand & Gravel
3.01 I w/ Cobble w/ Cobble
151 V I y
4.01 V
4.51
5.0'
5.5
6.0
6.51
7.0
.7.5
8.01.
8.51
9.5
10.01
Indicate, level at which . groundwater is encountered Not Encountered
Indicate level at which mottling is observed None Observed
Indicate level . to which water level rises after being encountered -N/A
Deep hole observations made by: JRS, Badey & Watson, P.C.; Gene Reed, PCDH Date 07/26402
Design Professional Name: John P. Delano, P.E.
Address: Badey & Watson, P.C.
3063 Roube . 9, Cold Spring, NY 10516
Signature:
Design Professional's Seal
' `PEST PI',. WT-A REQUIRED TO BE SUFMITTED H ,' APPLICATION
�' - -- DESL,' ` PTION OF SOILS ETCOUN'171M Ii4' ` I,_.ST HOLES
DEPTH• HOLE NO. 1 HOLE N0. 2 HOLE NO 3,
,`: w. aa.ra:•.. +. a. •:•F.:'w ry' _•'- S..•`1:1♦ .-vr' .. .a ...: ... .... ..T•_.0 •!r' -r.:M F'R t.'., - -. .. .. ... .r M. ... —v . r...a ti.• . .r . .• .•�..• t },..u0 .t r, Y. m wtac%"n:. i11:u
G. L. 0' -6" Topsoil r _ 01 -6 Topsoil 0' -6" Topsoil
Silt Loam Clay Loam Clay Loam ~.
1 w /pockets of sand _
2'
3'
4 Clay Loam Clay Loam
rock @ 4' -2" rock @ 3' -7" rock @ 3' -9"
5' water @ 2' -9' water @ 2' -9"
6'
7'
8'
9'
10'
11'
12'
13' -
14'
.INDICATE .L EVEI, AT WHICH GROUNDWATER IS ENCOUNTERED 2'
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING'ENCOUNTERED N/A
DEEP HOLE OBSERVATIONS MADE BY: J..Swim of BADEY & WATSON DATE: 12/31/87
.C.
DESIGN - - --
Soil Rate Used 20 Min /1 ". Drop: S. D. Usable` Area Provided 7,.000 S.F.'
No. of Bedrooms 4 Septic Tank Capacity 1250 gals. Type concrete
AbsorptioniArea Provided By 571 L.F. x 24" width trench
Other Dosing syste m or alternate system required; 2' -5" R.O.B. fill requii
Name BADEY & WATSON,
surveying & Engineering, P.C.
Ad&essRoute 9
dold Spring, NY 10516
.(914) 265 -9217
THIS SPACE FOR USE BY HEALTH DEPARIMENT ONLY:
Signatureiy
SEAL
i l,
Soil Rate Approved sq.ft /gal. Checked by
TEST PIT . -.'. A REQUIRED TO BE SUBMITTED WIT: _= `: APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO.. 4 H . HOLE NO 5 0
_ LE NO. - 6 _
G.L., 0' -6t1 topsoil 01 -611 Topsoil 01 -611 Topsoil
Silt Loam Silt Loam Silt Loam
2°
31
49 Silt LQa'm - Silt Loam Silt Loam
550 Rock @ 4' -011 Rock @ 31 -611 Rock @ 31 -6 91
71
- 8'-
9°
101
11°
121
131
14°
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED Not e n co u ri t e r ed
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED --
DEEP HOLE OBSERVATIONS MADE BY: J. Swim / BADEY & WATSON,' DATES 9 -29 =88
Surveying & Engineering PeC,
DESIGN
Soil Rate Used Min /1°° Drops S.D. Usable Area Provided
No. of Bedroa s Septic Tank Capacity gals. Type
Absorption Area Provided" By L.F. x 24 width trench
Other
... .. erg;: •,
BADEY & WATSON/ Surveying.& ?
Name Engineering, P. C_ Signature
Address Route 9 Ste, a M
Cold Spring, -NY 10516. . '
THIS SPACE FOR USE BY HEALTH DEPAR!MM ONLY. .s
,...: Soil Rate Approved sgoft /gal. Checked by Date
TEST PITT : 3. REQUIRED TO _BE SUBMIT ED WIT:'`.,; PPLICATION
DP.SCE: - TION OF, .SOILS 'ENCOUNTERED IN . fig ,` `HOLES .
DEPTH HC 1 NO. 7 HOLE NO. HOLE NO.
°Oss;6,...�•.,'Popsoa..l.ti.. .. ... _..._ ,....� ..,.... _. ,.,...., .........
Silt Loam
2' 1'
3 Silt Loam
4'
5'
6'
71
8':
9'
101•
11'
121
13'
.14'... .
..._.._,
I�VpICAT .: AT :'b4HICH .GROUNZ7WATER .1S. FNOOUNTERED :Not.. e n c o u n t er a d:. -" .
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING'ENCOUNTERED' --
DEEP HOLE OBSERVATIONS MADE BY:J Swim /BADE & yWATSON, DATE': 9- 29. -88
Surveying & Engineering, P.C.
DESIGN
Soil Rate Used. Min /1" Drop: S.D. Usable.Area Provided'
No. of Bedroans Septic Tank Capacity gals. Type
Absorption Area Provided By L.F. x 24" width trench
Other
BADEY & WATSON, Surveying &
Name Engineering, P. C. Signature
Y'
Address Route 9 SEAL a►� C� 4
Cold o d Spring, NY 10516
•o Al.
THIS SPACE FOR USE BY HEALTH DEPARZMENT ONLY:
Soil Rate Approved sq.ft/gal. Checked by Date
P
DEPTH--
G.L.
0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
TEST JCIA DATA 2
IDESCRIPTI ®N OF SOILS ENCOUNTERED IN TEST HOLES
HOLE, NOv • - u.M.b.n_ ....., .. _,�. _... .
15� -Naw FIME tiZW61-� 6QCL16j Fate
St iz-H Spoa—/ LCAM Smog Jar
Indicate level at which groundwater is encountered 43�Ce�i.2C�
Indicate level at which mottling is observed )'Come-
Indicate level to which water level rises after being encountered IA
Deep hole observations made by: (E (J��� 5�2 r�.,"" per, Date U� Z6
Design Professional Name: John P. Delano, P.E.
Address: Badey & Watson, P.C.
3063 Route 9, Cold Spring, NY 10516
Signature: °
Design Professional's Seal
e
FE --
PUTNAM COUNTY DEPARTMENT OF HEALTH ` L
5 �
DIVISION OF ENVIRONMENTAL HEALTH
INDIVIDUAL WATER. SUEPI Y- &,,T.JIISURFACE SEWAGE TREATMENT SYSTENO
REVIEW SHEET FOR CONSTRUCTION PERMIT �/L J v� 0
NAME OF OWNER: STRE, T LOCATION:
P 1
REVIEWED BY: RK GR, Jam; SRDATE: � I S '19 TAX MAP#: (CONFaMED)
Y/ DOCUMENTS Y N ( REOUIRED DETAILS ON PLANS CONT'D)
Cw PERMIT APPLICATION (HOUSE SEWER -'/." FT. 4 "0'; TYPE PIPE CAST IRON
SWELL P OR PWS LETTER ! NO BENDS B
PERMIT (�(� ,MAX ENDS 45 W /CLEANOUT
(PC -97 RENEWALS
LETTER OF AUTHORIZATION 0 CHANGE)
UUDESIGN DATA SHEET (DDS) % / FILL SYSTEMS
rJ / /�}' (/�il 10' HORIZONTAL; PAST TRENCH SLOPES 3 :1 TO GRADE
�HORT EAF /(�( FILL SPECS / FILL NOTES 1 -5
PLANS -THREE SETS (V FILL PROFILE & DIMENSIONS
HOUSE PLANS - TWO SETS FILL IN EXPANSION AREA
La:ffLJVARLA,NCE REQUEST Ii✓�'-v �pPy (�
SUBDIVISION
(� �(F Pk FILL GREATER THAN 2 FEET
• ,v.4.1� . �
a, f ysk� '�'I CLAY BARRIER
(LEGAL SUBDIVISION �r7' FILL CERTIFICATION NOTE ?6' N1e • fate � n sl�a') °7 a
(� SUBDIVISION APPROVAL CHECKE y' , 9��V�'� DEPTH GAUGES ��' ��� ap��✓rd(
PERC RATE ^7�' N' ' c )VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS
(FILL RE - " DEPTH
�1�� Q�E SEPARATION DISTANCE FROM TOE OF.SLOPE
(�L_JCURTAIN DRAIN REQUIRED � 1a � / .� TRENCH
GENERAL SHED v/4- �LF TRENCH PROVIDED 3 3� 60FT MAX.
UULOCATED IN NY ' ARALLEL TO CONTOURS (PLANS S �'D TO DEP 100% EXPANSION PROVIDED
( u DEL TO PCHD DETAIUDUST FREE CRUSHED'STONE OR WASHED GRAVEL
(�} PROVAL, IF REQ'D (JGEOTEXTELE COVER
D EP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN - FROM'SSTS
U(�ERCS TO BE WITNESSED (! �j 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL
(�(-JEX- APPROVAL SSDS ADJ, LOTS U — ,
(� WETLANDS ' OWN/DEC PERMIT REQ'D? ?0 TO FOUNDATION WALLS
(T ) 100' TO WELL, 200' IN DLOD,150' TQ PITS
(�(�DATA ON DDS PLANS & PERMIT SAME 100' TO STREAM, WATERCOURSE, LAKE (Inc, expsn),
50' TO ?CATCHBASIN,.3S %S•TORMRA.11�1, PIPED - WATER _ __......-
-.
^:, t- �_.__.' _ .._._ _.• ..�.... ( )10' TO WATER LINE (pits - 20')
(-„ J 0 YR. FLOOD ELE ATION W/I 200' �7jj, )50' INTERMITTENT DRAINAGE COURSE
(��OII, TESTING LOTS >10 YEARS OLD U�—_,)200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS
(_REQUIRED DETAILS ON PLANS : (=JC—)10' MIN TO LEDGE OUTCROP
SEWAGE SYSTEM PLAN - (NORTH ARROW). / SEPTIC TANK
SSDS HYDRAULIC PROFILE (r)(�10' FROM FOUNDATION; 50' TO WELL
)GRAVITY FLOW WELL
(� CONSTRUCTION NOTES 1 -15 UDIlVIENSIONS TO PROPERTY LINES
DESIGN DATA: PERC & DEEP RESULTS (/ )LOCATION OF SERVICE CONNECTION
2' CONTOURS EXISTING & PROPOSED �U 15' TO PROPERTY LINE
DRIVEWAY & SLOPES, CUT SL PE
FOOTING /GUTTERICURTAIN DRAINS
(� USDA SOIL TYPE BOUNDARIES UEREGRADED SLOPE SSTS AREA (S20 %)
(TITLE BLOCK OWNERS NAME ADDRESS ✓ TO 15 %, IF REQUIRED �✓h� �p'�
(TM#, PE/RA; NAME , ADDRESS, PHONE#
DATE OF DRAWING/REVISION
DATUM REFERENCE
LOCATION OF WATERCOURSES, PONDS
LAKES,WETLANDS WITHIPI 200' OF P.L.
(__)PROPOSED FINISH FLOOR AND
BASEMENT ELEVATIONS
( WELLS & SSDS'S WAN 200' OF SSTS
ROPERTY METES & BOUNDS
- (, EROSION CONTROL FOR HOUSE, WELL &
SSTS, EROSION CONTROL NOTE
10MM MS: ��c v ' �"-Z/ /,
C-jUPUMP NOTES - - - ^- - -' - ^ -- -- ,�
(_ jUDOSE 75% OF PIP OLUME/DOSE VOLUME NO'1l // !
�
U(__)DETAIL FOR CKMAIN, (PIPE TYPE, ETC.)
(-_JUPIT AND D X SHOWN & DETAILED
C_JUl DAY RAGE ABOVE ALARM
CURTAIN D!' O `�
(___)(__)STANDPIPES, 5' BOTH SIDES AIL
(x(_)15' MIN to CDS�5 %, 20' °,15' -3 %, 35'-1 %,100 % - <1%
(�U20' MIN to CD DIS GE /100' with 182 cons day discharge
U(_)10' MIN to N - ERFORATED PIPE
C:Jr�h•N diva, :., L.,ss ��,�rl, ,
3-
BADEY & WATSON
LETTER of TRANSMITTAL
Surveying &-Engineering, P:C-;'-
3063 Route 9, Cold Spring, New York 10516
Date: 28 Oct 2002
File No. 81-146
W. 0. # 15366
RE: Proposed SSTS
Hosay
TO:
Chapman Road
Joseph S. Paravati
Philip M. Hosay Subd. Lot No.
1
Tax Map 61.- 1-9
Putnam County Department of Health
PennitfritlefPO #
I Geneva Road
Brewster, NY 10509
Sent via:
US MAEL UPS-NIGHT
MESSENGER UPS-2 DAY
PICK-UP UPS-3 DAY
❑
FAX ❑ UPS-GRND
We are sending:
UPS-COD
copies date description of document
F-11 Five 5 Pa a Design Data Sheet
F_4� 128-Oct-02 JSeparate Sewage Treatment System Fill Plan Sheet I of 2
F-1 128-Oct-02 I FSeparate_Sewage Treatment System Sheet 2 of 2
E� 1
El I
El
F-1
❑ I
0 1 -71
09
REMARKS:
Deep hole revisions pursuant to comments of 10/16/02.
Copies to: File
Yours truly:
Jason R. Snyder
Tel: (845) 265-9217 ext 13
Fax: (845) 265-4428
Email: jsnyder@badey-watson.com
40 40-05 503665 622647 13759
PUT' ' .M COUNTY DEPARTMENT OF I ALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
We11,L.oction : <._
S.treetpAddress:.. _..G �: r : r: �r =;
�Q
Tovvn>�iil lades =:.:.. ,: r.ax:,.0iid�#
Y
- .. .., < . ,,.4 .- . _,-
Map &1_ Block Lot(s) C(
Well Owner:
Name: Address: .
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 X Compressed air percussion Other (specify)
Well Type
Screened Open end casing _ZC Open hole in bedrock Other
Casing Details
Total length ;?/_ ft.
Length below grade _�O ft.
Diameter al in.
Weight per foot 16 /ft.
Materials: Steel _ Plastic _ Other
Joints: _ Welded >0 Threaded _ Other
Seal: X Cement grout _ Bentonite Other
Drive shoe: -_X, Yes No
Liner: Yes XNo
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes No
Hours
Second
Well Yield Test
_ Bailed _ Pumped Compressed Air
Hours , '
Yield gpm
Depth Data
Measure from land surface- static (specify 8)
During yield test(ft)
_�0_ ,0
Depth of completed well in feet
X05
Well Log
If more detailed
information
descriptions or
sieve analyses
are a9df1able; ....__•-
please attach.
Depth From
Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
C:
_ -- _
_.. ..
_ - .._.....
a......
_.
. Jr
ea
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type Capacity -' Q9VJ/(/(
Depth Model
Voltage 221� HP""`
Tank TypeU//49 Volume _4��
Date Well gompyed
Putnam County Certification No.
003
Date of eport
Well Dri ler (s' nature)
NOTE: Exact location of well with distances to at least two permaneift land arks to be provided onA separxle s 1an.
Well Driller's Name Address:
Signature:
White copy: HD File; Yellow copy - Building Inspector; Pink copy -
Form WC -97
well
I
jpmv-i�
%%a:,
Coe-
0)
1.000 GAL PUMP TANK
9
TOTAL OF 335 LF OF ABSORP11ON
TRENCHES HAVE BEEN INSTALLP
Tj
eC
1
�AS= BUILT
RELOCATION- DIMENSIONS
1A
14.1'
SEPTIC TANK
1B
18.5'
SEPTIC TANK
2A
14.4'
SEPTIC TANK
2B
24.1'
SEPTIC TANK
3A
17.5'
PUMP TANK
3B
30.0'
PUMP TANK
4A
21.5'
PUMP TANK
4B
35.0'
PUMP TANK
5A
39.0'
END LATERAL
5B
30.4'
END LATERAL
6A
32.9'
END LATERAL
66'
26.4'
END LATERAL
7A
27.3'
END LATERAL
7B
24.0'
END LATERAL
8A
22.7'
END LATERAL
8B
23.6'
END LATERAL
5A
J 21.6'
END LATERAL
9B
26.7'
END LATERAL
10A
22.5'
END LATERAL
10B
30.8'
END LATERAL.
11A
56.6'
DISTRIBUTION BOX
11B
49.6'
DISTRIBUTION BOX
12A.
55.7'
DROP BOX
12B
49.2'
DROP BOX
13A
54.6'
DROP BOX
136
49.9'
DROP BOX
•r
-AS- BUILT-_._
RELOCATION - DIMENSIONS
14A
52.3'
DROP BOX
14B
49.2'
DROP BOX
15A
'51.6'
DROP BOX
15B
50.3'
DROP BOX
16A
52.9'
DROP BOX
16B
53.3'
DROP BOX
17A
54.9'
DROP BOX
176
56.9'
DROP BOX
18A
57.1'
DROP BOX
186
60.4'
DROP BOX
19A
74.0'
END LATERAL
19B
68.4'
END LATERAL
20A
75.6'
END LATERAL
20B
71.3'
END LATERAL
21A
77.8'
END LATERAL
21 B
74.7'
END LATERAL
22A
80.5'
END LATERAL M
22B
78.5'
END LATERAL
23A
84.5'
END LATERAL
23B
83.6'
END LATERAL
24A
88.9'
END LATERAL
24B
89.0'
END LATERAL
25A
94.0'
END LATERAL
25B
95.0'
END LATERAL
WC
98.0'
WELL
WD 1
104.9'
WELL
�.