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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
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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� •� .�
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it :•. .y �.:i
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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
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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