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HomeMy WebLinkAbout2665DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -10 BOX 23 02665 L ,�- F� i 6 r. kill 1 r � -; . i k 1 ` 4 -1 - : , �� L - , 02665 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL_HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # PA 471 -CA M—v— f Located at 80 P I�A0 Town or Vi \lit.tE -4 AA94 4 scar Owner /Applicant Name_ {�}vv►5 W�CtISi Formerly d Mailing Address Date Construction Permit Issued by PCHD Separate Sewerage System built by Tax Map 61 Block Subdivision Name Subd. Lot # t CO3 10Z.-I Im. I Lot �O Pik Zip jl �lJ L`4� $ Address /Or% Consisting of i) Z`J0 Gallon Septic Tank and ILA LF C)F Z� 'A( 010E A35C: P"TlQ)q ri1 :5 ' ,, Eo (o F-1 Other Requirements: Water Supply: Public Supply From Address or: Private Supply Drilled by �-�L �� Address :. ;Builcii119 yp�: ?!p � d- _ Has erosion control been completed? y .. . Number of Bedrooms a Has garbage grinder been installed? u° I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. e Date: or( Z° 1 07- Certified by P.E. R.A. Address cif ; i,J �' (, (..)3W3 (, ��n�MiNcr, `f 105 C Z5o5 License # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocat n, modification r change is necessary. f' By: Title: Date: t° White copy - HD Fild; Yell w c py - Building Inspector; Pink copy - OW r; OraWcopy - Design Professional U' Form CC -97 V. :; CpG - a a BRUCE R. FOLEY * LORETTA MOLINARI R.N., M.S.N. Public Health Director- <.. ....... , .: ��.� Yo�� Associate Public Health -Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM[ OWNERS NAME: Mark Abrahams & Scott Wechsler TAX MAP NUMBER: 61.-1-10 E911 ADDRESS: V Q TOWN: AUTHORIZED TOWN OF (S ignature) DATE: I ///j The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911VERFRM) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALT H SERVICES OF SUBSURFACE SEWAGE.TREATMENT,SYSTEM. . Scott Wechsler & Mark Abrahams Owner or Purchaser of Building Building Constructed by 80 Chapman Road Location- Street 61 1 10 Tax Map Block Lot Putnam Valley TownNillage n/a Subdivision Name Residential n/a Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construciion 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,determiriation� 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 September Day 20 Year 2002 General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State Zip Signature: Title: Septic Insta er Harold Lyons & Sons Corporation Name (if corporation) Address: 3175 Route 9, Cold Spring State NY Zip 10516 Form GS -97 �� ' YML EN_V___'M__'[AL ___'_C_S _ 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245_2800 LAB #: 32.208734 CLIENT #: 56142 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SNYDER, JASON DATE/TIME TAKEN: 11/17/02 02:20P 3063 ROUTE 9 DATE/TIME REC'D: 11/18/02 09:00A COLD SPRING, NY 10516 REPORT DATE: 11y29/02 PHONE: (917)-612-7835 SAMPLING SITE: 70 CHAPMAN RD. GARRISON : COL'D BY: MARK ABRAHAMS NOTES...: KITCHEN TAP NOT FILTERED °~~~~°~~~~~~~-~~~~~-~~=~~~~~~~~~~~~~~~" DATE FLAG PROCEDURE N.Y SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIF8RM METH: y1F ~~~~=~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL. - RANGE METHOD PUTNAM CNTY PROFILE 11/18/02 MF T. COLIFORM ABSENT /10() ML ABSENT 1008 11y18/02 LEAD (IMS) <1 ppb 0-15 ppb 9101 11/18/02 NITRATE NITROG 4.74 MG/L 0 - 10 9139 11/10/02 NITRITE NITROG 1.82 MG/L. N/A 9146 11/18/02 IRON (Fe) 0.118 MG/L 0-0.3 mg/l 2037 11/18y02 MANGANESE (Mn) 0.064 MG/L 0_0.3 mgyI 2037 11/18/02 SODIUM (Na) 6.{)5 MG/L N/A ' 11/18y02 pH 8.9 UNITS 6.5-8.5 9043 11/18/02 HARDNESS,T8TAL 98.0 MG/L N/A 11y18/02 ALKALINITY (AS 98.0 MG/L. N/A 11/18/02 TURBIDITY (TUR 2.6 NTU 0-5 NTU -- COMMENTS: - � BACT THESE RESULTS INDICATE THAT THE WAT AS NOT) DE-'NEW OF A 'SATISFACTQRY SANITARY QUALITY HCCORD1 ruxn STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS �� ~~ TESTED, AT THE TIME OF COLLECTION. Pb /CU LEAD limits for public schools are set at 15 ppb. r�---- EPA Lead & Copper Rule for Public Systems requires �� that no mo.= than 10% of their distribution points have a LEAD value of mok�p than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must he undertaken to reduce the waters corrosive potential. CD 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 is suggested. YML ENVIRONMENTAL SERVICES ' 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 LAB #: 32.208734 CLIENT #: 56142 NON STAT PROC PAGE 2 ~~~~~~~~~~~~~~~~~~~~W~m~~~~~~~~~_~~~~~~ ~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~M~~~ SNYDER, JASON DATE/TIME TAKEN: 11/17/{)2 02:20P 3063 ROUTE 9 DATE/TIME REC'D: 11/18/02 09:00A COLD SPRING, NY 10516 REPORT DATE: 11/29/02 PHONE: (910-612-7835 SAMPLING SITE: 70 CHAPMAN RD. GARRISON N.Y SAMPLE TYPE..: POTABLE : PRESERVATIVES: NONE COL'D BY: MARK ABRAHAMS _ TEMPERATURE..: { 4C NOTES...: KITCHEN TAP NOT FILTERED COLIFORM METH: MF DATE FLAG PROCEDURE 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. TOTAL HARDNESS IS DEF%NED 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 T8 WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon � 17.2 MG/L) ' | ^ ` | SUBMITTED BY: ^ ELAP# 103R3 n =� c� �� _~ pip ^� rz -~ o-" `^, ELAP# 103R3 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 {914 ) 0[} � ./�\�*���^H� �����a�� D'������r- ' ' / LAB #: 32.208735 CLIENT #: 56142 NON STAT PR8C PAGE 1 SNYDER, JASON DATE/TIME TAKEN: 11/17/82 01:45P 3063 ROUTE 9 DATE/TIME REC'D: 11/18/02 04:00P COLD SPRING, NY 10516 REPORT DATE: 11/27/02 PHONE: (917)-612-7835 SAMPLING SITE: 70 CHAPMAN RD. GARRISON x COL'D BY: MARK ABRAHAMS NOTES...: KITCHEN TAP FILTERED DATE FLAB PROCEDURE N.Y SAMPLE TYPE..: POTABLE PRGSERVATIVES:'NONE TEMPERATURE..: < 4C COLIF8RM METH: MF RESULT NORMAL - RANGE METHOD ' PLTNAM CNTy PROFILE 11/18/02 -MF T. COLIFORM ABSENT /100 ML ABSENT 1008 11/18/02 'LEAD (IMS) <1 ppb 0-15 ppb 9101 11/18/62 —NITRATE NlTROG 4.67 MG/L 0 - 10 9139 11/18/02 ~NITRITE NITROG 1.58 MG/L N/A 9146 11 /18/02 -IRON (Fe) <0.060 MG/L 0-0.3 mg/l 2037 11/18/02 `MANGANESE (Mn) 0.110 MG/L 0-0.3 mg/l 2037 ' 11/18/02, --SODIUM (Na) 5.35 MG/L N/A 11/18/02 -pH 7.0 UNITS 6.5-8.5 9043 11/18/02 -HARDNESS,TOTAL 118 MG/L N/A 11/18/02 -ALKALINITY (AS 100 MG/L N/# 11/18/02 -'TURBIDITY (TUR <1 NTU 0-5 NTU ---'--'COMMENT83: BACT THESE RESULTS INDICATE THAT THE WATO( WAS WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDITHE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS | TESTE09 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. iblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed" Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 . q ' 280 -' �' `^1�iS���^^H�-`r�dov�an' ;~h7's�-f6�-^' LAB #: 32.2p8735 CLIENT #: 56142 NON STAT PROC PAGE 2 --------------------- ------- m ------ --- mm— ------ m ------ SNYDER, JASON DATE/TIME TAKEN: 11/17/02 01:45P 3063 ROUTE 9 DATE/TIME REC`D: 11/18/02 04:00P COLD SPRING, NY 10516 REPORT DATE: 11/27/02 PHONE: (917)-612-7835 SAMPLING SITE: 70 CHAPMAN RD. GARRISON N.Y SAMPLE TYPE..: POTABLE : PRESERVATIVES; NONE ' COL'D BY: MARK ABRAHAMS ^.: < 4C NOTES...: KITCHEN TAP FILTERED COLIFORM METH: MF --- ~M ------------ ~--m ------ -------�����������������. DATE FLAB PROCEDURE RESULT NORMAL - RANGE METHOD PH pH SCALIN WATER RANGES FROM 1-24. 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 EXPRESSEDASCALCIUMCARBONATE, IN�MG7[. THE HARDNESS MAY RANGE FROM O TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER .=.HARD.WATER�-'-140-r300 MG (1yrain/gallon v 1742-MG/L.) ' SUBMITTED BY: Albert H. Padovani, M.T.(ASCP) Director v- ELAP# 10323 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N��Y. 10598_ ��_________ `\914) 245-2800 '� ` - ' two Albert H. Padovani, Director LAB #: 32.209451 CLIENT #: 56195 NON STAT PROC PAGE 1 ABRAHAMS, MARK DATE/TIME TAKEN: 12/15/02 04:00P 180 WEST END AVE., #21C- DATE/TIME REC'D: 12/16/02 10:O0 NEW YORK, NY 10023 REPORT DATE: 12/16y02 PHONE: (917)-612-7835 SAMPLING SITE: 70 CHAPMAN RD SAMPLE TYPE..: POTABLE : KIT TAP PRESERVATIVES: NONE COL'D BY: MARK ABRAHAMS TEMPERATURE..: NOTES...: COLIFORM METH: N/A DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 12/18/D2 `� ` -NITRITE NITROG 0.011 MG/L SUBMITTED BY: Albert F[�Padovani Director / � M.T.(ASCP) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well I,ocatton:.� .:: f Street- Address : "'"'Own OA QVILW C0) Village: � ' �LT A-M Qo' LU—:`l :Tax Grid'# Map 61. Block 1 Lot(s) 10 Well Owner: Name- Address: .X. 2_1 c, )L30 wKA j,.,(O Avoiu ' lam �U17 k mg looz-�) Use of Well: 1- primary 2- secondary Residential Publac upply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion ompressed air percussion Other (specify) Well Type Screened Open eno casing pen h in bedrock Other Casing Details Total length f Length below grade Diameter in. Weight per foot "lb/ft. Materials: Steel Pla tic Other Joints: Welded , hreaded Other Seal: ement gr t — Bentonite Other Drive shoe: s No Liner: Yes o Screen Details D' ter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours econd Well Yield Test _Bailed _Pumped ompressed Air Hours 'Yield 6 gpm Depth Data Measure from land surface- static (specify ft) U During yield ttest(ftft t Q �V Depth of completed well in fey ti Well Log If more detailed information descriptions or sieve analyses are avail'h e, please attach. Depth From Surface Water Bearing Well Diameteron) Formation Description ft. ft. Land Surface No 00 L° _: - :,: ,; -.. _..:.._::_ • .... If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 0 a Pump Type Capacity Depth �d� Model p?Dy� Voltage l^ HP Tank TypewLwo Volume Date p1l C mpleted Putnam County Certification No. Date of Report Well filler gnat NOTE: Exact location of well with distances to at least two permanent andmarks to be provi d n a separate sheet //plan. Well Driller's N e K GS(Ij� ', 7/ Address: Signature: Date: '�j h o Z. White copy: HIYFile; Yellow copy- Building Inspector; Pink copy - Owner; Orange copy- Well driller Form WC -97 Su" eying. &- Engineering, AC. 3063 Route 9, Cold Spring, New York 10516 TO: Joseph Paravati ]Putnam County Department of Health 1 Geneva ]Road ]Brewster, NY 10509 We are sending: copies date description of document 0 29- Nov -03 Well Water Test Results not filtered El ❑ I ❑ 1 —71 REMARKS: Copies to: ]File I . ,( LETTER of TRANSMITTAL Date: 02 Jan 2003 File No. 93 -115 W.O.# 15461 RE: Well Analysis ❑ Wechsler Chapman Road N/A Tax Map 61.4-10 Permit/Title/PO # Sent via: US MAIL MESSENGER PICK -UP FAX Y ours truly: Subd. Lot No. N/A PH -17 -01 ❑ UPS -NIGHT ❑ ❑ UPS -2 DAY ❑ ❑ UPS -3 DAY ❑ ❑ UPS -GRND R UPS -COD 0 Jason R. Snyder, Junior ]Engineer Tel: (845) 265 -9217 ext 13 ]Fax: (845) 265 -4428 ]Email: jsnyder @badey- wafson.com 40 40 -05 503694 623367 20511 BADEY & WATSON LETTER of TRANSMITTAL Surveying & Engineering, . P. C - - 3063 Route 9, Cold Spring, New York 10516 Date: 16 Dec 2002 File No. 93 -118 W. 0. # 15461 RE: Certificate of Construction Compliance Wechsler TO: Chapman Road Joseph Paravati N/A Subd. Lot No. N/A Putnam County Department of Health Tax Map 61-1-10 1 Geneva Road Permit(ride/PO # PH -17 -01 Brewster, NY 10509 Sent via: US MAIL UPS -NIGHT MESSENGER UPS -2 DAY PICK -UP UPS -3 DAY FAX UPS -GRND We are sending: UPS -COD copies date description of document 13- Nov -02 JApplication Fee - $200.00 FT 120-Sep-02 lCertificate of Construction Compliance for Sewer Treatment System F-31 120-Sep-02 lQuarantee of Subsurface Sewage Treatment System 1 27- Nov -02 Well Water Test Results ❑ 1 11 6- Dec -02 Well Water Test Results ❑ l 12- 14ov -02 lWell Completion Report O 4 ISSTS "As- Built" ❑ ❑ 14- Nov -02 E911 Address Verification Form El REMARKS: Copies to: File Yours truly: Jason R. Snyder, Junior Engineer Tel: (845) 265 -9217 ext 13 Fax: (845) 265 -4428 Email: jsnyder @badey - watson.com 40 40.05 503694 623367 20386 a� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRmNM ENTAL HEALTH[ SERVICES FINAL SITE INSPECTION Inspec . Street Lucatlbri "� _ Owner =- Town Permit # R14 -1 Z TM # &(- ( — Z o Subdivision Lot # 1. Sewage System Area a. STS area located as per approved plans ... .. ....................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil.not stripped.., .................. ............................. d. Stone, brush, etc., greater than 15' from STS area.......... e.. 1 00' from water course / wetlands ..... ............................... H. Shwa e System a. Septic tank —size - 1,000 ......... 1,250 ..:. ..... other ................ b. Septic tank installed level ................ .....:......................... c. 10' minimum from foundation .......... ............................. ... d. IDi tribtuion Box outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil-between box & trenches Junction lE$ox roperly set, ................... .......in........:............. engtFi required Ole Length installedG 2. Distance to watercourse measured Ft.......... 3. Installed according to plan..,.... .......... v�L 4. ,Slope of trench acceptable 1/16 -1/32" /foot ............. 5._ 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 1 %Z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe -ends capped ::,­.:.:::...::... : ,.::.. ..........,:.............. PUm or Dosed Sys tems 1. Size ot pump c am er .......:..... 2. Overflow tank ............... .................:....... :...... . 3. Alarm, visual/audio. .................. .........................:..... '4. Pump easily accessible, m ole to grade.. ............... 5. First box baffled .......... ..: ........ .:................................... 6. Cycle witnessed by H.D.estimated flow /cycle........... Ili. ouse/Buildinne a. House located per approved pl .................................. b. Number of bedrooms ....... ........:...... ............................... IV.ae 1. 4ell located as per approved plans . ............................... b. Distance from STS area measured )4064 ft ........... L. Casing 18" above grade .........:........ ............................... 1. Surface drainage around well acceptable ....................... V. Dyth,11 Workmanship i. MIT&xes properly grouted ................... ............................... . All pipes partially backfilled ........... ................:.............. i. All pipes flush with inside of box ................... 0.............. I. Backfill material contains stones <4" diameter .............. s. Curtain drain & standpipes installed according to plan.. Curtain drain outfall protected & dir.to exist watercourse F. Footing drains discharge away from STS area ............... i Surface water protection adequate ... ............................... i Erosion control provided.. ................ o ............................. l.;v. 1/97 Date:.. Li 1h- SEP -25 -2002 09:47 BADEY & WATSON, PC PUTNAM COUNTY DEPARTMENT OF HEALTH P-01/01 "DIV'ISION OF'ENVIRONMENTAL 'HEAI;TH SERVICES REST FOR FINAL INSPECTION For: Fill Date: 9 /252002 Trenches �...__ PCHD Construction Permit # _ PH -17701 Located: Chapman Road (T)(V) _ Putnam Valley Owner /Applicant Namc: Mark Abrahams & Scott Wechsler TM — 61_ Block 01 Lot 10 Formerly: M . WA Subdivision Name: N/A Subdivision Lot # WA _ Is system fill completed? _ Yes _ Date: 7/19/2002 Is system complete? _., ._ Yes _ Date: 9M002 Is system constructed as per plans? Yes Is well drilled? . _ Yes Date: 7/19/2002 Is well located as per plans? Generally Are erosion control measures in place? .. Yes I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regidations of the Putnam County Department of Health. Date: 9/20002 Certified by;. John P. Delano P.E. PI .X,_: R A ._ y Design'iGfessional Address: Badey & Watson, P.C. 3063 Route 9, Cold Spring, NY Comments: FOR: ❑ ADAM GENE El (NAME) SEP -25 -2002 WED 09:41 TEL:845- 278 -7921 Lic. # 062505 Form FIR -99 NAME: PUTNAM cn INTY n;:PAf7TMPWT nr7 e , MVISION 0IF IENWRONMENTAL HEALTH SERWCES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PEST # O Located at I. —WRIN Subdivision name ii 1A Subd. Lot # 14A Date Subdivision Approved PIA Owner/Applicant Name . t„w,zL�SL PP /ice � �'► Mailing Address Amount of Fee Enclosed u N Town or Village Tax Map 6— Block 01 Lot 10 Renewal Revision Date of Previous Approval 1 Z p3 j (-fl zip loo ? -3 Building Type L-Ktip2�,f i IAJ_ Lot Area Zj1 dt No. of Bedrooms d Design Flow GPD 800 MR1 Section Only Depth VoRume PCHD NOTIFICATION IS REQUIRED WHEN ]FILL IS COMPLETED Separate Seweragg System to consist of i, z�J� gallon septic tank and �cx 4-F oi- Z41 o, t,J , oa /A 20,T1 cif Sr'1cE o .,fir 6 F-1 0 ,c. Other Requirements: i 04 ZQ1 t=-)! �ALRmF _/ To be constructed by M&DI-0 Lull 7 Som1J Address C a cl `� 1.(C�{� tJ `i )1 16 Water Suwfly: Public Supply From Address �.�.;> . --- _ .- Privvate�Suply D'rillec by�1�t��at 12v Address'2�215t7� 1•!�( JCZ I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address Date c13 # �GZS /8516 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 it. Approved r discharge of domestic sanitary sew a only. r f By: Title: Date: q-7"1-02 White copy - HD File Yello opy - Building Inspector; Pink copy - Owner ran opy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES •... -...t . - DESIGN -DA► -A SHEET" SMS MACE SEWAGE TREXn4E1V1r SYSI - I® Owner Abrahams & Wechsler Address 180 West End Avenue, Apt. 21C, NY, NY 10023 Located at (Street) . Chapman Road Tax Map 61 Block 1 Lot . 10 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA Date of Pre - soaking 07/22/62 Date of Percolation Test 07/23/02 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 G 1 2:35 2:44. 9 19 — 22 3 3 2 2:45 — 2:55 10 19 — 22 3 3 3 2:56 3:06 10 19 - 22 3 3 4 — — 5 — — H 1 12:30 — 12:51 21 19 — 22 3 7 -. — 12s53. - 1:14 :. .......21... : 19 — 22 . 7 3 1:16 1:37 21 19 22 3 7 4 — — 5 1 — — 2 — — 3 4 - - 5 - - NOTES: 1. Nests to- be,repeated at same depth until approximately equal percolation rates are obtained at each col tz ation -test hole. (i.e. < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be miffed for review. 2. :measurements to be made from top of h e.� Form -97 2 VEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEP I'Ii . =..: -. LiOL i�0: _ _ _::.. Ii?LE NO: _ .:. iIOLE-NO. G.L. 0.5' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' C'':.c 4.5 c" 2: x > M- 5.5'gf?� (Y) 6.0' o ;X . 6.5'a 7.0' 7.5' 8.0' 8.5' 9.0' 9.5, 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Name: John P. Delano; P.E. Address: ]Barley & Watson, P.C. 3063 Route 9, Cold Spring, NY 10516 Signature: oa Design Professional's Seal M C ��'�� N, • BRUCE .. R FOLE-Y 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 (945)278-6014 Fax (845) 278 - 6648 August 1, 2002 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 John Delano; PE Badey & Watson 3063 Route 9 Cold Spring, New York 10516 Re: Wechsler Chapman Road, (T) Putnam Valley TM# 61.4-10 Dear Mr. Delano: An inspection of the fill pads at the above referenced project has been completed. Trench plans must be submitted to this Department for final approval. Please note that field measurements by this Department in no way suggests the exact size, depth and location of the fill pad. - ----If you have -any further questions, please coiitact me at (845)- 278 -6130 ext 2Z61.-' GDR:cj fill pad Sincerely, 011, C - M-11 Gene D. Reed Environmental Health Engineering Aide 6 6- .1 SENDING CONFIRMATION -Z DATE : AUG-5-2002 MON 08:58 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845-278-7921 PHONE : 92654428 PAGES : START TIME : AUG-05 08:57 ELAPSED TIME : 00'21" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. BRUCE R. FOLEY LORETTA MOLB4AR1 FLN, M.S.N. P.01 H64b Dk-w A—w P.Nk Hw1h DbMQ 0' DEPARTMENT OF HEALTH I Geneva Road Brewster, Now York 10509 CrMmme-hl Reld1h (54S)273-61I6 9U(945)279.7921 WIC (141)271-6671 bx(PAS)27 .&*J Cady Lduven6m (145)M.6014 7wQ"278-664 August 1, 2002 F.1(843)221-6113 John Deland, FE Baday & Watson 3063 Route 9 Cold Spring New-Yolk 10516 Re: Wccbslcr Chapman Road, (T) Putnam Valley Tw 61.4-10 Dear Mr. Delano: An inspection of the fill pads at the above referenced project has been completed. Trench plaw must be submitted to this Dcpmuxm for final approval. Please note that field measurements by this Department in no way suggests the am oim depth and location oftha fiil pad. Ifyou have any further questions, please contact me at (845)-278-*6130 ext. 2261. Gene D. Reed Emironmental Health Engineering Aide GDR:cj 90 pad JUL -22 -2002 09:33 BADEY & WATSON, PC ]PUTNAM COUNTY ]DEPARTMENT OF HEALTH REQUEST FOR FINAL - INSPECTION For: Fill X Date: 7/2212002 Trenches WA PCHD Construction Permit # PH -17.01 Located: C d (T) (V) Pa nam Valley Owner /Applicant Name: Abghems Wechsler TM 59 -Block I Lot 10 Formerly: Subdivision Name: N/A Is system fill completed? Vea Is system complete? NO Is system constructed as per plans? WA Is well drilled? Ve$ Is well located as per plans? Qenerally Are erosion control measures in place? Yes Subdivision Lot # K/A Date: 7/1 DOM Date: MIR Date: 7/1912M2 I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. - mate: '��� Certified by: Johan P. Delano, P.E. PE X RA-- P. 01/01 Design Pr6fessional.. - Address: Badey & Wamon, P.C. 3M Route 9, Cold Spring, NY Lic. 0 52505 Comments: _ FOR: ® ADAM GENE ❑ (NAME) Form FIR -99 JUL -22 -2002 MON 09:28 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 BADEY & WATSON LETTER of TRANSMITTAL Suryeying.& Dig!'geering, P.0 3663 Route §', C_.o.­1d Spring, New York 10516 Date: 21 Aug 2002 File No. 93-118 W. O. # 15149 RE: Proposed SSTS - Second Permit Wechsler TO: Chapman Road Shawn Rogan N/A Subd. Lot No. NIA Putnam County Department of Health Tax Map 61.4-10 1 Geneva Road PermitrritIdPO # PH-17-01 Brewster, NY 10509 Sent via: US MAIL ❑ UPS-NIGHT ❑ MESSENGER ❑ UPS-2 DAY 1-1 PICK-UP ❑ UPS-3 DAY ❑ FAX ❑ UPS-GRND 9 We are sending: UPS-COD 11 copies date description of document F-11 121-Aug-02 � lConstruction Permit for Sewage Treatment System F-11 123-Jul-02 —1 IDesign Data Sheet 74 19 -Au -02 771 ISeparate Sewage Treatment System Sheet I of I E-1 I El 1 El I I REMARKS: Copies to: File Yours truly: John P. Delano, PE Tel: (845) 265-9217 ext 12 Fax: (845) 265-4428 Email: jdelano@badey-watson.com 40 40-05 503694 623367 13294 o PUTNAM COUNTY DEPARTMENT OF HEALTH IDWHSRON OF ENVIRONMENTAL H EAILTIHi BERVHCEg . r�a..K....rw.Y':•nt.: cam. r:.M'Y.:.+R_'..i!;: �. aca:.Tt. u••.n :...V .�.~••p•M Located at C "A -PMAt1 (Zoe Town or Tillage FtT -J Acid VA Subdivision name Subd. Lot # Date Subdivision Approved Tax Map G— Block ( Lot 10 Renewal Revision Owner /Applicant Name 19Joc"i-e� Date of Previous Approval Mailing Address ISO Ar t -PGU�: APT-. IC, Wl-� Zip I C*4-3 Amount of Fee Enclosed • a t� Building Type RE�541>0i .Lot Area 2-q r- No. of Bedrooms _,k_ Design Flow GPD eCO ]HIR Section O ®fly Depth 3 -6° VoReme PCHD NOTIFICATION IS RE UIIREIID WHEN ]FIILL IS COWLETEBD Selpairate Seweurae System to consist of q Z1bo gallon septic tank Other Requirements: To be constructed by "fit l-� Ls-61 15 !t SO&J -5 Address '�115 (2-T--, ,Cep sp(aw Water �anl� Public Supply From Address _ _ :..._ ��:.. _� -�.... Pr�vat$ Su�i�l� •Drr(led =b� - �- +�L�G-���i � 1��2� =::+. _ _.. V.+.. _Address- -�= .�5��; ::.:: r �._ I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: &it-will (4 P.E. X' R.A. Date 11001 Address PC SM4 C6 icense # 061'505,- 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 App r ed fo sc ge of domestic sanitary sewa a only. By: Title: Date: f o White copy - HD File; Yellow copy - Building Inspector; Pink cop - Owner; Orange copy - Design Professional Form CP -97 BRUCE R. FOLEY Public. Neolth Director LORETTA MOLINARI RN., M.S.N. l - Y u4� "Associate Public Health 1irector Director of .Patten! Services DEPARTMENT OF HEALTH 1 Geneva Road ; Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 -7921 Nursing Services (914)278-6558 Fax (914) 278 - 6085 Early Intervention (914)278-6014 Fax (914) 278 - 6648 1YIC (9141279-6678 Fax (914) 278-6095 COVER SHEET PROJEC , (0«ners Name): ST T: ,MUNICIPALITY: `SC`s TAX MAP. NUMBER: DESIGN PROFESSIONAL: DATE: REVISION REQUESTED ADDITIONAL INFORMATION OTHER Ouls S jz__ N� ( '1 SS 64-\ Ste. Cpl\ P�o�.rz q y �b0q . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES :.. .... .:..:. ..:.... .-: LETTER OF.AUT,I�4RIZATION:.:.:. .- :,.:... .... RE: Property of Mark Abrahams & Scott Wechsler Located at Chapman Road T/V &x Map # 61 _ Block 1 Lot 10 Subdivision of Subdivision Lot # _Filed Map # Date Filed Gentlemen: This letter is to authorize John P. Delano 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. trulyyours;.... _._ ._.. __ � ......._ .... ... _.. � .:....._ .:..., .._ d_)4Z41C)_ Countersigned:. Signed: .j _ _�_. P.E.; ig # 062505 (own ofPrope )` Mailing Address Badey & Watson, P.C. _ Mailing Address: 180 West End Avenue, Apt 21C 3063 Route 9, Cold Spring New York State NY Zip 10516 _ State Zip Telephone: 845 - 265 -9217 Telephone: 212- 337 -6237 Form LA -97 1416.4 (11/95) — Text 12 PROJECT I.D. NUMBER 617.20 SEAR Appendix C State Environmental Quality Review SHORT. ENVIRONMENTAL ASSESSMENT. FORM._ u For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1 . APPLICANT /SPONSOR 2. PROJECT NAME Dark Abrahams & Scott Wechsler Abrahams & Wechsler 3. PROJECT LOCATION: Municipality Putnam Valley County Putnam 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) (see map provided) 5. IS PROPOSED ACTION: ® New ❑ Expansion ❑ Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: Single family house, septic system & well 7. AMOUNT OF LAND AFFECTED: Initially < 5 acres Ultimately < 5 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ® Yes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/ForesUOpen space ❑ Other Describe: single family houses on 2+ acre lots 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL..,.. -- ".:STATE OR LOCAL)? plYes ❑ No If yes, list agency(s) and permit/approvals Putnam Valley - building permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ®Yes ❑ No If yes, list agency name and permit/approval Putnam Valley - driveway permit 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. DelaAg, P.P. Engineer for applicant Date: 11/16/01 Signature: 4✓ If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT. SYSTEM 1. Name and address of applicant: Mark Abrahams & Scott Wechsler 180 West End Avenue, Apt. 21C New York, NY 10023 2. Name of project: Abrahams & Wechsler .3. LocationT /V: Putnam Valley 4. Design Professional: 6. Drainage Basin: John P. Delano, P.E. 5. Address: Badey & Watson, P.C. Hudson River Rt. 9, Cold Spring, NY 10516 7. Tvve of Proiect: X Private/Residential Apartments Office Building Food Service Institutional Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (check one) ------------------------------------------------------ - - - - -- Type I . Type II 9 Is a Draft Environmental Impact Statement (DEIS) required? ___ __________ __ Exempt Unlisted X 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 officials, ordinances? - ------------- = -------------------------------=-------------------- - - - - -- .- - - - -.- Yes 13. If so, have plans been submitted to such authorities? ________________ ___ _____ __ ___ ___ ______ ___ __ _ _ __ No 14. Has preliminary approval been granted by such authorities? NSA Date granted: N/A 15. Type of Sewage Treatment System Discharge ------------- - -- - -- surface water _K groundwater 16, If surface water discharge, what is the stream class designation? ............. .. .......... N/A 17. Waters index number (surface) --- -------- -- -------------- - - - - -- N/A 18. Is project located near a public water supply system? ----------------- ----- -- --------- -- ------ - - -- No 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? .......... ....... .. No 21. Name of sewage system N/A I Distance to sewage system N/A 22. Date test holes observed 11/21/00 & 23. Name of Health Inspector 08/20/01 A. Stiebeling 24. Project design flow (gallons per day) ------------- --- -------- --------- - - - - -- --------------------------- - - - - -- 800 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 2 27. Is any portion of this project located within a designated Town or State wetland? . No 28. Wetlands ID Number NSA ---------------------------------------------------------------------------------------------- - - - - -- 29.. Is Wetlands..P.ermit.required? .. • .......... Has application been made to Town or Local DEC office? -------------- ---- ----- ---- -- - - - - -- 30. Does project require a DEC Stream Disturbance Permit? -- - - - - -- 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? --- -------- --- --- ----- --- - - - - -- Yes/No NSA No M 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? --------- 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ------------------------------ ----------------------------- ---- - - - --- . Yes No 35. Are any sewage treatment areas in excess of.15% slope? -------- ----- - - -- -- --- --------- - - -- -- No 36. Tax Map ID Number ------------------------------------ 37. Approved plans are to be returned to ..... -._- - - - - -- - - Map _§l Block 1 Lot 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 -fin tA� proval_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. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES:• Badey & Watson, P.C. Mailing Address- -------- ------ 3063 Route 9 Cold Sprang, NY 10816 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE. TREATMENT SYSTEM Owner Abrahams & Wechsler S Address 180 West End Avenue, Apt. 21C, NY, NY 10023 Located at (Street) Chapman Road Tax Map 61 Block 1 Lot to (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA Date of Pre - soaking 08/06/01 Date of Percolation Test 08/07/01 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 Mhvbch A 1 12:16 - 12:26 10 19 - 22 3 3 A 2 12:27 - 12:39 12 19 - 22 3 4 A 3 12:40 - 12:52 12 19 - 22 3 4 A 4 12:54 - 1:06 12 19 - 22 3 4 5 - - B 1 12:22 - 12:26 4 19 - 22 3 1 B 2 12:28 12:34 6 19 - 22 3 2 ,... B 3 12:35 12:42._: ;, : ,19 : - - 22... 3 .. -. 2 - B 4 12:42 12:49 7 19 22 3 2 B 5 12:50 - 12:57 7 19 - 22 3 2 1 - - 2 - - 3 - - 4 - 5 - - NOTES: 1. Tests tb'be repeated at same depth until approximately equal percolation rates are obtained at each percolation tea hole. (i.e. < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be subiriitted. fonreview. 2.: Depth measurements to be made from top of hole. ;;' Form DD-97 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' - 1.0:0' :..,. TEST PIT DATA (DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 5 HOLE NO. 6 Topsoil -- _ -- Topsoil Silty sandy loam Silty sandy loam HOLE NO. 2 Indicate level at which groundwater is encountered not encountered Indicate level at which mottling is observed not observed Indicate level to which water level rises after being encountered N/A Deep hole observations made by: G. Avalear, B &W & A. StiebeGng, PCDH Date 08/20/01 Design Professional Name. John P. Delano, P.E.. Address: Badey & Watson, P.C. 3063 Route 9 Cold Spring, PSI' 10516 Signature: I (Design Professional's Seal tk , try r M U � _ Indicate level at which groundwater is encountered not encountered Indicate level at which mottling is observed not observed Indicate level to which water level rises after being encountered N/A Deep hole observations made by: G. Avalear, B &W & A. StiebeGng, PCDH Date 08/20/01 Design Professional Name. John P. Delano, P.E.. Address: Badey & Watson, P.C. 3063 Route 9 Cold Spring, PSI' 10516 Signature: I (Design Professional's Seal tk , try r M PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ...: DESIGN.;DATA SHEET, - :SUBSURFACE: SEWAGE TREATMENT .'SYSTEM ' Owner Abrahams & Wechsler Address 180 West End Avenue, Apt 21C, NY, NY 10023 Located at (Street) Chapman Road Tax Map 61 Block 1 Lot 10 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA Date of Pre - soaking 11/20/00 Date of Percolation Test 11/21/00 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 2:50 - 2:57 7 19 - 22 3 2 D 2 2:57 - 3:06 9 19 - 22 3 3 D 3 3:06 - 3:17 11 19 - 22 3 4 D 4 3:18 3:29 11 19 - 22 3 4 5 - - 1 - - 2 - - 4 - - 5 - - 1 2 - - 3 4 5 - - NOTES: 1.+ Tests to,be- repeated at same depth until approximately equal percolation rates are obtained at each percolation teMhole. (i.e. < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be submitted `for review. 2. ; Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA IDESCIBIPTffON OF SOILS ENCOUNTERED IN TEST HOLES .....� DEPTH. HOLE NO_ 3 G.L. Topsoil 0.5' Silty loam 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' 10.0' V Silty sandy loam V 2 HOLE.NO, 6 HOLE N0, Topsoil Silty loam I V Silty sandy loam I V Indicate level at which groundwater is encountered not encountered Indicate level at which mottling is observed not observed Indicate level to which water level rises after being encountered N/A Deep hole observations made by: C. Avalear, B&W & A. Stiebeling, PCIIDH Date 11/21/00 Design Professional Name: John P.Delano, P.E. Address: Padey & Watson, P.C. 3063 Route 9, Cold Spring, Nib 10516 Signature: Design Professional's Seal 4�� r orc� •� .� r it :•. .y �.:i iA. BADEY & WATSON Surveying & Engineering, P.C. 3063 Route, -9; �• Cold„ Spring1.:.New-.York- .:1.0516 (845) 265 -9217 (914) 628 -1800 (914) 739 -3577 (845) 225 -3312 FAX (845) 265 -4428 TO: Adam Stiebeling jPutnam County Department of Health 1 Geneva Road Brewster, NY 10509 We are sending copies date description of document LETTER of TRANSMITTAL '•19 Nov 2001 File No. 93 -118 W. 0. # 14385 RE: Proposed SSTS Abrahams & Wechsler Chapman Road N/A Subd. Lot No. Tax Map 61.4-10 Permit # Sent via: US MAIL ❑ UPS -NIGHT ❑ MESSENGER UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN ❑ UPS -COD ❑ F1 16- Nov -01_1 Construction Permit for Sewage Treatment System O l 7 ILetter of Authorization A pplication for Approval of Plans for a Wastewater Treatment System Ol 11 6- Nov -01 Short Environmental Assessment Form O l 20- Aug -01 __1 IDesign Data Sheet 1 of 2 Ol 12 1- Nov -00 I FD-esign Data Sheet 2 of 2 F3 14- Nov -01 ISeparate Sewage Treatment System Fill Plan Sheet 1 of 2 1 14 -Nov 01 Separate Sewage Treatment System Sheet 2 of t - -- r2 01- Nov -01 IFloor Plans - sets Fl 16- Nov -01 Application to Construct a Water Well F1 30- Oct -01 :__1 JApplication Fee - bank check #0937100891 REMARKS: Signed: John P. Delano, P.E. Copies to: File 6108 IFUTNAM (COUNTY DEPARTMENT HIF HEALTH DIVISION 07 ENVIRONMENTAL HEALTH SERVICES APPLICATION TO (CONSTRUCT A WATER WELL _ .......... _ _ .... PCID Permit #' T please peiiii or type WeRR Location: Street Address: Town/Village Tax Grid # VAt Map (,�,0 Block Q Lot(s) 10 Wellll Ovy>me>re Name: Address: � j �1f l l t% � to � Or-. 2,1C t. c� I dhow '-�v zv_ �J (C)013 Use of WAD: Residential Public Supply Air /Con eat Pump Irrigation I -primary Business Farm Test/Monitoring Other (specify) 2 -secon dgi ry Industrial Institutional Standby Amount of Use Yield Sought � gpm # People Serv' Est. of Daily Usage A�20 gal. Reason for Replace Existing Supply Test/Observation Additional Supply dDri llinng New Supply (new dwelling) Deepen Existing Well DetaiRed Reason ErQv i -F— wkiwz suppo -e r--aSZ- i53u tkyasG for IlDriflinng WeH Type _� Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No >e Is well located in a realty subdivision? ...................................... ............................... Yes No ,-%C Name of subdivision - Lot No. Water Well Contractor: eKZ.aS , Address: Is Public Water Supply available to site? .................................. ............................... Yes No -k Name of Public Water Supply: /A Town/Village _1A Distance to property from nearest water main: 4 t 01 t L*_ Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: d I tto .p.1 Applicant Signature: PEST TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. ]FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well 'llejce�tifi-,4 ut nam County. Date of Issue IZ 0.1 Permit Issui*ng Official: Date of Expiration 1 2, az, o3 Title: Permit is Non-Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 i End wall. t � 1 AS —BUILT RELOCATION —DIMENSIONS 1A 130.3' :i 16 134.0' SEPTIC TANK ;L 122.7.' a 2B .i SEPTIC TANK 9 88.0' a y�: _r DISTRIBUTION BOX 4A kti , 4B 100.9' BEGIN LATERAL � 1 AS —BUILT RELOCATION —DIMENSIONS 1A 130.3' SEPTIC TANK 16 134.0' SEPTIC TANK 2A 122.7.' SEPTIC TANK 2B 125.8' SEPTIC TANK 3A 88.0' DISTRIBUTION BOX 3B 103.5' DISTRIBUTION BOX 4A 86.5' BEGIN LATERAL 4B 100.9' BEGIN LATERAL 5A 83.2' BEGIN LATERAL 56 101.4' BEGIN LATERAL 6A 80.3' BEGIN LATERAL 6B 102.2' BEGIN LATERAL 7A 77.7' BEGIN LATERAL 76 103.4' BEGIN LATERAL 8A 75.6' BEGIN LATERAL 8B 105.0' BEGIN LATERAL WC 73.9' . BEGIN LATERAL h9A 6 106.8' BEGIN LATERAL i t AS —BUILT RELOCATION— DIMENSIONS 10A 72:6' BEGIN LATERAL 10B 109;0' BEGIN LATERAL 11A 49:7' END LATERAL 11B 44.6' END .LATERAL 12A 43.9' END LATERAL 12B 45.7' END LATERAL 13A 38.x' END LATERAL 13B 47.6' END LATERAL 14A 32.7' END LATERAL 14B 50.1' END LATERAL 15A 27.4' END LATERAL 15B 53:2' END LATERAL 16A 22:4' END LATERAL 16B 56.7: END LATERAL 17A 18 END LATERAL 17B 60:7' END LATERAL WC 12.x' WELL WD 3 0.1' WELL End wclls i i i 1 Tive North of 770' LL Nest Longitude .t 816.98' Cos Tonks Elec. Box r 01, ' Box _ v'' Elec. Meter 7s Mme Deck Stone Ref. Wo// in room 00