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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -1 -12 BOX 23 I No oil, f .$ir L ' �4 02666 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health L�RFT��►.:1VInLI1YA:B4 Associate Commissioner of Health Justin Kacur 1 Winterberry Road Beacon, New York 12508 Dear Mr. Kacur: ROBERT I BONDI County Executive _ . _..._ .. _....� - .., � � lt0$ F ,R.T.�QR�IS,,.P.ld_,._..•...... _..:.,_:.�:....•�I y r -� Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 November 2, 2006 Re: Proposed Addition Approved, A- 285 -06 85 Horton Hollow Road (T) Putnam Valley, TM# 61.4-12 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. • The addition for the above referenced property is approved for five (5) bedrooms total based on the five bedroom septic system that was installed per PCHD Permit # PV- 1.1 -03. If you have any other questions, please contact me at your convenience at 845- 278 -6130, ext. I 2.261.... _. :.. _...... ..:' _ ......_ _._c:. __......:' :. :... Sincerely, Gene D. Reed Sr. Environmental Engineering Aide GDR:cj cc: Mr. & Mrs. Horbelt Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MID, MS, FAAP Commissioner of Health LORETTA MOLINARI, RSV, MSN Associate Commissioner of Health e °2s e r .r. . DEPARTMENT OF HEALTH 1 Geneva Road Brewster New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY AD RESs 05- 0/0 7R6 7)#I P- . YAeW DESCRIPTION OF ,, P 4%, _ ) 'qIP�4� / AIDIDITION Z 79h9 'fiA"/A ®F n. PGAedw e92 Y c ZT0g5 CELL'. 545' ` ?_"1 d' NUMBER OF VUSTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATLON.FROM BUILDING INSPECTOR) "Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of.the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Iealth Dept., 1. Geneva Rd, Brewster, NY 10509; Phone: (845) 278 - 61.30:° 1. Certified) check or money order for $100.00 , 2. Sketches of existing floor plan drawn to scale, all living area including basement) 3. Two sets of proposed floor plan (drawn to scale — with name, street and tax map #) *Nonce- rofessional sketches are accen® table 4. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet o the rron rty line. Contact this office with any questions. ` 5. Copy of Certificate of Occupancy from Town or Certification from Building OFFICE USE COMMENTS M Environmental Health (845) 278 -6130 Fax(845)278-7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 e SHERLITA AMLER, MD, MS, FAAP :; �;..;,.-„,.-:. r-,--, a; C. nnamissioner • >ofFf�aEt#4.x >._�.. -w. °_ LORETTA MOLINARI; RN, MSN Associate Commissioner ojHealth DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count Re: HORBELT (Owner's Name) Tax Map #: 61. -1 -12 Address: 85 Horton Hollow Road Town: Putnam Valley Year Built: 2004 According to records maintained by the Town, the above noted dwelling, is xx in compliance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: 4 This information has been obtained from: Certificate of Occupancy: xx attached xx Other: WR County Executive Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHER1LITA AMLER, MD, MS, FAAP Commissioner of Health LORE- A- 'MOLINA-RRH;itN;•MSN'�- :.......1..:_:. Associate Commissioner of Health Justin Kacur 1 Winterberry Rd. Beacon, New York 12508 Dear Mr. Kacur: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 October 18, 2006 Re ROBERT J. B ®NDO County Executive -ROBERT MORRIS, !sE Director of Environmental Health Addition — Application Incomplete Horbelt, 85 Horton Hollow Road (T) Putnam Valley, TM# 61.4-12 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Your plans have been returned to you for the following reasons. This Department requires two types of plans-for submissions as noted below: X Existing floor plans showing existing conditions only. The plans must reflect all floors in the house, including the basement, with all rooms noting their dimensions and use. The plans must also be noted as existing showing owner's name, address and tax map number... _ ' Proposed flbor'plaris. ' Me- plans must show all proposed changes as a finished product. These plans should also reflect all floors in the home including basement, with all rooms noting their dimensions and use. The plans must be noted as proposed, showing owner's name, address and tax map number. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:cj Sincerely, Gene D. Reed Senior Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 Justin R Kacur, A.I.A __._..._.._........... _ Beacon, NY 12508 845 797 5313 ikacurarchitect(a,optonline.net Re: Horbelt Residence 85 Horton Hollow Rd Putnam Valley, NY 10579 September 28, 2006 To Whom It May Concern: Enclosed you will find documentation and the required application for bedroom count review on the above - mentioned project. The existing residence has been approved as a 4 bedroom, while the septic system was oversized and constructed to handle 5 bedrooms. We are seeking approval for the fifth bedroom as we prepare to finish the existing framed "bonus room" over the 3 bay garage. Please call if you have any questions, comments or concerns. I look forward to hearing from you: Thank you. Best Regards, Justin R Kacur, A.I.A. Formerly Subdivision Name.. Subd. Loci #, Mailing Address V L 1 09 N a Pis N a L L o lnl Ral o" , () ;i'N A r'►-► Y6- t OV W Zip LOS _29 Date Construction Permit Issued by PCHD �L2r7 CAhJWU s HDLIOW IZD Separate Sewerage Systean built byNo6tTorJ �,LL 90 V L7 .0(Address �uTNt9r+� 1�t1�c L'V, Qy 05 7 Consisting of Ift jsao Gallon Sep'rc Tank and -556 L. - PLJZr0T4q Tt a 19VC e pe l / 24 GIZA VEL -M C/J C M Other Requirements: 2 01' u N 01" RAnl Water iii Public Supply From Address � 10 i i�O �YT-C 31( Dr.. iPrivafe Supply Drilled by AL�t �"r P�, '(^ SaJ4rAddress -1 ECPSO� AJ Z�� 3 3uild g Type- .911061 L' "12rS- -Has erosion conirol been completed? yes �. lumber of Bedrooms i V Has garbage grinder Jp_ certify that the system(s), as listed, serving the above pre ' es 're c tev , se tially as shown on the as- iuilt plans (copies of which are attached), in actor wi is Cons ion Permit and approved fir, y Mans and the standards, rules and regulations utnam o ty% nt of th. a )ate: "1 G —0 CCertified by r' '' PR- RZk. (Design ProfessionaNIVE, �Adress 2 0 N W �} L �N 13� U _ C-K � e# Z o) ny person occupying premises served by the above system(s) shall promptly take such action as may be necessary i secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage eatment system* shall become null and void as soon as a public sanitary sewer becomes available and the approval the private water supply shall become null and.,void when a public water supply becomes available. Such )provals are subject to modification or change when; . in the judgment of the Public Health Director, such vocation, modification or change is necessary. ✓' Title: Date: . hite copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 m rl •.rte, N Q C'�.aa"v � � ,. g / � ` Y N � r � 1 t � ••13 5i i k c� o $m b� Ni If Air v k}S' ,�98 i�ii� :� \� s 1 \ A 0 � P^ na 414� 10 i i S• EI �9�a j�' \ V Rif :� � iii1, }�) :�r�s' ��a�.l -�yy• t.i� r�'�,�' ;,fy�,i � �I'�i� r! a IM 11 fki {i `�'•i;in:.,:�4•.w!+� Rk p h CERTIFICATE OF OCCUPANCY DATE >4k2 7/2-006,; - ... - . PERMIT NO: 2004 -531 TAX MAP # : 00/61. -1 -12 LOCATION: 85 HORTON HOLLOW ROAD ISSUED TO : HORTON HOLLOW ROAD REALTY 17 DANBY PL YONKERS, NY 10710 This certificate covers the construction of: ONE FAMILY RESIDENCE WITH THREE CAR GARAGE; 4 BEDROOMS; LAUNDRY ROOM; FAMILY ROOM; STUDY; LIVING ROOM; DINING ROOM; KITCHEN; 2 -1/2 BATHS; UNFIN. BONUS ROOM; UNFIN. BASEMENT;NO DECK.. The applicant having heretofore filed an application fora building permit pursuant to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by personal :inspection ascertained that improyement of the.-.proposed-structure'.... - is in compliance with the requirements of the laws as aforementioned; that the said work and materials meet every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions of law. Now, therefore, the Certificate of 'Occupancy is hereby issued under the seal of the Town of Putnam Valley. TOWN OF PUTNAM VALLEY, NY By Code Enforcement Piker OIL-- T, V<- la Y) p IcL h tos4-, DATE: 16 October 2006 REVISIONS: BEAtr 028 fttt.. OF E -1 FILENAME T 0 0 0--Q 0 0 oAp-L > 0 <t 0 0 F- -C C/) z %r- F I , L C) 00 0 U DATE: 16 October 2006 REVISIONS: BEAtr 028 fttt.. OF E -1 FILENAME PUTNAM COUNTY DEPARTMENT OF HEALTH " "DI"ION OF'ENVIRONMENTAL- HEALTH -SERVICE CERTIFICATE OF CONSTRUCTION COMPLIANCE PCHD CONSTRUCTION PERMIT # F J" I t' 03 FOR SEWAGE TREATMENT SY Located at eb � aRTaN H a L Lu in9 R v r4p Town or Village Cu i N A ► VA L L IC ry Owner /Applicant Name 4OPT ON &Lh - W TON41� AMap 6 I Block 1 Lot _ _ Formerly Subdivision Name Subd. Lot # Mailing Address 22 -1 C19 n3 0 P J -S 14 0 LL c W 'RoitJ ru -roA yh VA L L try y Zip j O a� 9 Date Construction Permit Issued by PCHD DEC EMCieR A2, 2003' i` 22� C�i�Oi�U.r �1ocLow i� Separate Sewerage System built by #0JZTor1 UOLLOWT%#10 `QgAQ W(Address PU i NArh VALL LV 1JY 1Qs�� Consisting of tW j�60 Gallon Septic Tank and 556 L, r `f Pc_1ZF0TZA trb 19VC C Pe - I tj 24 GIZA Va .-M C/J C H . Other Requirements: 2 0 F Q u i-I O F AQ K Water Supply: Public Supply From Address 1018 P-0rO .71 or: Private Supply Drilled by ALVC 21- 41A•TV SaaSAddress FATC`RSON', t1 y ) 2�_G Building Type 51N6C rni LV - Has erosion control been completed? . _VCS - _ Number of Bedrooms 15', V (E Has garbage grinder been installed? 1 C� NE PA Ar I certify that the system(s), as listed, serving the above pr sere co to essentially as shown on the as- built plans (copies of which are attached), in acco,,rdar�c� ,die CHH o truction Permit and approved plans and the standards, rules and regulations the' Pu Co e o' Health. Date: —0 CCertified by P.E. ,�r 'BSA. (Design Prof Address 'n N W 1q L4'N 13440 L.L, .,>L �nse # Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. By Title: / Date: 02 D( White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 IPUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL - COMPLETION REPORT: Well Locationfl Street Address: %�� D 0 �!0 Town/Village: P a e Tax Grid # Map �j Block Lot(s) Well Owner: Name: p� Address: Use of Well: I- primary 2-secondary D Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length YO ft. Length below grade _3,9_ft. Diameter 7 in. Weight per foot JIlb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: Yes No Liner _ Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Vest _ Bailed Pumped X Compressed Air Hours __6 Yield _ gpm Depth Data Measure m land surface- static (specify ft) A During yield test(ft) � � Depth of completed well in feet 7 Well ]Log If more detailed information descriptions or sieve analyses are available; please attach. Depth Fro Surface Water Bearing Well Diameter(in) Formation Description ft.. ft. Land Surface * CD&ICS If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type r± Capacity Depth 600 Model 7 &M r Voltage j9M HP _ Tank Type �dw l Volume 50 &A04 Date We I ompl a / -7 ®Y Putnam County Certification No. 007 Date of po Well Driller (signature ) rqu,iril':: mxact location oI well wim Qlstances to at leaSt LWU permanent ItUlu[IlYUxJ w uu pluviucu un a DvTa"V auv'"IF . AA Well DrilleesName -f .soh, Address: 6j; 31 G 50l .0 Signature: k, Date: � U Ore White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 BRUCE R FOLEY Public Health Director ' LORE'rTA ' MOLrNARI RN., M.S.N. 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 Fa (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 '. Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: �,r it�n o i l o w R��rcl K Q�I� sa TAX MAP NUMBER: Je C +i 0 13 l0 � l � � Q� � (, Lo-f 1 Z E911 ADDRESS: $ j H o �r -f-o r\ 0 0{ I L) w TOWN: PL) thcx -m YP,-(ieLk , NY AUTHORIZED TOWN OFFICIAL: (Signature) DATE: <J / o/o � The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town'official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFRM) PUTNAM COUNTY DEPARTMENT OF HEALTH DI[VISDON ..OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM HOLLOW VOAQ VC- L : 1NC,- G1 i 12 Owner or Purchaser of Building Tax Map Block Lot L� afZ`r0%J OLL W �oAD f2>,f INC. fU12JAN u Building Constructed by TownNillage �S oRTohl �j oLLOW ROA i Location - Street Sit36LC �AMIL / a:Siokftick :� Building Type Subdivision Name Subdivision Lot I represent that I am wholly and completely responsible for.the location, workmanship, material, construction and drainage of the sewage treatment system sen-ins 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 prosy rly-is- caustd.by the yviliful- or.negligent act of the occupant of the_b- .ildinq- util- izina. thy. system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Date q#tht(2 Day 2.3ppYear 260,6 Signa Title Contracto /(Owner) - Signature PC),ZT6t., ot.LoW PGAD A //'Ac, tOLL61,3 ?IEq /JC. Corporation Name (if corporation) Corporation Name (if corporation) Address: 1-2-7 GqN OPus �1()JL6W R4iq Address: ZZ_? c4t-30 uS' �'�isLCam p State v ANA iM LLB 0� Zip �j o 5 ? i Form GS -97 A YML ENVIRONMENTAL SERVICES 321 Kear Street ' - Yorktown Hejghts, N.Y. 10598 - . ' ` *^�14')'^245-2EK)0-~ ' -��^-^��������-����~.�,�~~.'-�` `~_�__~`_ Albert H. Padovani, Director LAB #: 1.601133 CLIENT #: 59193 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ HORTON HOLLOW RD REALT 85 HORTON HOLLOW ROAD PUTNAM VALLEY, NY 10579 SAMPLING SITE: 85 HORTON HOLLOW ROAD : COL'D BY: STEVE AUTH _ NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAB PROCEDURE DATE/TIME TAKEN: 02/21/06 01:00 DATE/TIME REC'D: 02/21/06 04:45 REPORT DATE: 02/28/06 PHONE: (914)-490-7596 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE PUTNAM CNTY PROFILE 02/21/06 MF T. COLIFORM ABSENT /100 ML 02/27/06 LEAD (IMS) <1 ppb 02/23/06 NITRATE NITROG <0.2 MG/L 02/22/06 NITRITE NITROG <0.01 MG/L 02/28/06 IRON (Fe) 0.132 MP/L 02128/06 MANGANESE (Mn) <0,010 MG/L 02/28/06 SODIUM (Na) 4.05 MG/L 02/21/06 pH 7.3 UNITS 02/28/06 HARDNESS,TOTAL 76.0 MG/L 02/28/06 ALKALINITY (AS 80.0 MG/L | 02/28/06 TURBIDITY (TUR 1.8 NTU COMMENTS: PICK UP ABSENT O-15 ppb 0 - 10 N/A 0-0.3 mg/l 0-0.O mg 11 N/A 6.5-8.5 N/A N/A 0-5 NTU '-- _~--'-_-_ COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p/ EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. �blic 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. METHOD 1008 9003 9052 9162 9002 9002 9002 9043 9001 YML ENVIRONMENTAL SERVICES 321 Kear Street 10598 Albert - Albert H. Padovani, Director LAB #: 1.601133 CLIENT #: 59193 � NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ HORTON HOLLOW' RD REALT 85 HORTON HOLLOW ROAD PUTNAM VALLEY, NY 10579 SAMPLING SITE: 85 HORTON HOLLOW ROAD : COWD BY: STEVE AUTH NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAB PROCEDURE DATE/TIME TAKEN: 02/21/06 0500 DATE/TIME REC'D: 02/21/06 04:45 REPORT DATE: 02/28/06 PHONE: (914)-490-7596 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~=~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD 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. pH pH SCALE IN WATER RANGES FROM 1-144 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. INED AS1HEt OE'THEMAGNESIUM _ _�_ CONCENTRATION, BOTH EXPRESSED AS CALCIUM-CARBONATE, -IN MG/L. THE � '' � � . � HARDNESS MAY RANGE FROM 0 T8 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: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: 7 DireAr ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION i ,� Date: tcrecel�u // Inspected by: Street`Locatio G"fic(�;� _...,,Owner r .. Q (�G.- f2P-^� ezx v Town ,"( 2P Permit 4L- '3 TM # Subdivision Lot # T 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth 1-2 c. Natural soil not stripped .......................... d. Stone, brush, etc., greater than 15 from STS area.......... e. 100' from water course / wetlands ...... ............................... 11 Sewage System a. Septic tank size - 1,000 .......... �. . 1 2 5 0 ......... other... ..... . b. ' Septic tank installed level ........... ............................... c. 10' minimum from foun dation ......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set .....:......... V—). -'08 ............ 6. T rent es 1. Length required. Length installed 2. Distance to watercourse measured Ft. :Pi .✓ 3. Installed according to plan ................. 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. .7. Room allowed for expansion, 100 %............I............ 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ....... :........... �10:" Pipe.ezads. capped...• _....,,..,.,.. ......:..................... g. Pump or Dosed Svstems 1. Size of pump chamber ...........................�°� 0 ..�`� 2. Overflow tan k ........................... ........................J.1�2�_ 3. Alarm, visual/audio.... ...4a�nhole ....... �,,�.... to -0 4. Pump easily accessible, to grade/....., . �� 5. First box baffled ............... ..................... ........... Au. 551 6. Cycle witnessed by H.D.estimated flow /cycl ... E L House/Building a. house located per approved plans ... ....................:.......... b. Number of bedrooms ....................... ............................... IV. Well Well located as per approved plans. ...... : ........................ b. Distance from STS area measured Aoc - ft........... c. Casing. 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Worlananship . a. Boxes properly grouted ................................ I................. b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box... ........ .. ...................... d. Backf ll material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to play . I f. Curtain drain outfall protected & dir.to exist waterc s g. Footing drains discharge away from STS area ............. ... h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ................. ............................... Rev. 12/02 ' RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566., • _. s� tel: (914)736 - 3664- Fax. "(914)736 -3693 - - - March 22, 2006 Joseph S. Paravati, Jr. Assistant Public Health Engineer . Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: Horton Hollow Road Realty, Inc. SSTS Construction Compliance PCDH Permit #PV -11 -03 85 Horton Hollow Road Town of Putnam Valley Dear Mr. Paravati: Please find enclosed as per your request, three sets of the As -Built Plans revised based on our March 21"t phone conversation. - - - -If you--have-any-questions or require additional information please contact me at the above number, Thank you for your time and consideration in this matter. Respectfully submitted, Kenneth M. Murph Project Engineer SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA'MOLINARI, RN, MSN Associate Commissioner of Health -- ..... _,.... _.. ROBERT J. BONDI .I County Fxecutiye • _. . ..c..s� rF�'. .- � ra.R1 .. y..t...a.y .. .. ••V •v.. r.. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Ken Murphy . Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, NY 10566 ROBERT MORRIS, PE Director of Environmental Health March 21, 2006 Re: Construction Compliance — Horton Hollow Road Realty Corp. 85 Horton Hollow Road, (T) Putnam Valley TM # 61 -1 -12 Dear Mr. Murphy: This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. .-:_,....1:- T-iie-s=eyed-fiouse location with respect•to -the• property iines-has-notbeen,provicaed: The. survey provided should be the final survey and should show all dimension lines from the house to the property lines. The dimension lines should also be shown on the as -built plans. 2. Please provide the locations for the'beginning of the trenches. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. JSP:kly Very truly yours, Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 CRONIN ENGINEERING P.IE., P.C. March 16, 2006 The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 91t-736-3664 Fax 914- 736 -3693 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health I Geneva Road Brewster, N.Y. 10509 RE: HOOT ®N HOLLOW ROAD REALTY, INC. fl CDH FERMI #FV -Il1-03 85 HORT ®N HOLLOW ROAD TOWN OF FNTNAM VALLEY THESE ARE TRANS1ITU D as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY , WEAn SEN DING YOIU attached. " -... 1.) Three copies of as -built subsurface sewage treatment system plan 2.) Three certificate of the construction compliance. 3.) Three guaranties of SSTS 4.) Copy of survey showing foundation location 5.) E911 address verification form 6.) $300 certified check for application fee. 7.) Well completion report 8.) Water analysis The information enclosed is for your review. Thank you for your time and assistance in this matter. Respectfully submitted, enHneth ICI. ' Design Engineer LL Z. 40 DA, 110- .ftvg uz .j ...... ..... .ftvg uz .j PUTNAM COUNTY DEPARTMENT OFREALTH DIVISION Or! ENVIRONMENTAL H.EATLTI SERVICES ,..... FEEL D, ACTIVITY REPORT Street PERSON IN CHARGE. 412 Town .'&PUMP TEST 0 DOSE TEST H PpnTirarn r.ATTnvq IF 80. 3 1701 -.el 4,1 EL START EL. STOP TN.qP'F.rTn1Z! TPTt Signature and Title R ppng I iz Tzr-F.Tvp-n 1Rv,• I acknowledge receipt of this report: SIGNATURE: 02/96 Title: y ra '(D IF 80. 3 1701 -.el 4,1 EL START EL. STOP TN.qP'F.rTn1Z! TPTt Signature and Title R ppng I iz Tzr-F.Tvp-n 1Rv,• I acknowledge receipt of this report: SIGNATURE: 02/96 Title: SHERLITA AMLER, MD, MS, FAAP Commissioner of Health Associate Commissioner of Health Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear Mr. Murphy: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 February 8, 2006 ROBERT J. B®NDI County Executive Re: Field Inspection — Horton Hollow Realty Inc. 85 Horton Hollow Road, (T) Putnam Valley TM# 61 -1 -12 A site inspection was made for the above referenced project on February 7, 2006. The following comments must be corrected in the field. 1. 2. 3. A manhole cover needs to be provided for the pump chamber. A baffle needs to be provided for the distribution box. The pump test witnessed on the above date resulted in a dose of 9 ", which is 2.5" too high. Please have the dose level adjusted and call to schedule another pump test. IIf you have any further questions, please contact me at (845) 278 -6130 ext. 2157. JSP:cj Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (843) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 01/30/20K`! CRONIN ENGINEERING 1 FUTkNAM COUNTY DEPARTMUNT OF I DIVISION OF EINVMONMENTAL HEALTI ❑ ATTU "I".10K ❑ Aa*Rt GENE for-. All information must be fully completed prior to any inspectip,as Wag made, PCHD C�ppstruction Permit Irl?V Located: J./021 1W ;W0 1. LOW IL &,.4 o (T.) Owner/k�" phta.at Name: 7#644" Pgaiv Tim j Subdivision Name: k Subdivision Lot 'Tr Is system-`!l completed? Date: Is system. ��6nipleW Date'. Is system,:;onstnicted as per plans? Is weJ dril,IeV Date'. Is well h*.%.-'at-f d) gas per PL-nel Are 01 rnea,.,;,a-6 in place? FALTH SERVICES PAGE 01 ill reuche )(?)Imm lvjq t ev I— Block - __ - 1 1 Lot JZ ' certi.,,.-Vlithillt �!*bc- wstem(s), as listed, at the above' premises has been constructed and I havi inspected - t and vi-ik , t'ki,r completion in qccorewr-e with the issued K HD Coostruction erwit and appnoveiA piL wand the Standards, Rules and R m-lations of the Putum County Dedapment of Health. Date: Certified by: (AJ fj PE RA Lro . -rj Design Profe i5ional Address-. k K"6 4' commC1115. ............... Form FIR-W.", W a. '77,1 J C11111 I I JAN-30-200C) &I 1FL:845-278179Pi. NAME:PUTNAM COUNTY DEPARTMENT OF P. I N m i W t� '•y l�)!iR �rfD�yB'6 4Br d'iPi' o�[14d� °Ii/V8'B�i`1'!9 �• .. .. -- .- _ p— �- rMr+-04C -�. ° a " -v `6 `Aaf vna VIZ HMO L.� !':! pyl liir�L i !e'rfrtrrc �allk�la]1B� �4) A`b()YYvatinli v r .�I.tP1,`atit $D., xgricq$y ;, 3 Z i:. ail 4,1e l�ld @Q ' °61 a• ye °P ¢ f 'f — r '� o. iDt @��1•D16t :1 G'n 'l+ it ,a f �+ , [Y i� ,. _ 1.1 -'e �br'�•!1 �'i6rtlrt�4'id °t. .illt: .l 6'a'.':I �;i'.9�i• 4l: w von). ,ot t[ir .,��,foq+. -.� �ra•o;.11.,; . i +f9t•1�i.:,tc -t• :.+'air1; fc�r�k4 i�ie• a;a °[ai. !s: ita• RAF- Z R41 1 .l a . W %x.'•'16 ";;4liF S ♦ t. . 1 a t 11.10 4 ...1 H i m LO m - - UD i� V f, ii ii i LL N ° CO � 1 to CD 01/17/2006 ilcl: il,4 9147136'_3693 CRONIN ENGINEERING I PAGE 01 PUTNAM, COUNTY DEPARTMENT OF I ONWIENTAL HEALTE DIVISION OF ENVIk ATTENTION 0 GENE 9EQ1 TEST FOR FINAL fNSPEcnQN- For- All information must be fully completed prior to any inspections being made. PCHD Co s"ction Permit T Located: 4? kORT ON . 0 Le-4 V4. fzCA Q (T) Owner/Applicant Name: %L"W QVA'- U 103C- Tl%,,l 'Sublviswa Name-. Formerly, Subdivision Lot -# Is system. fill completed? Date. Is system complete? Date: Is system consmicted as per plans? Is well drilled) Date' Is well located as per plans? Are erosion coutprot measures in place? I certify that the s'vstem(s), as listed, at the above premises has been,c( and verified their completion :in accordance ,.Oth the issued PC approved plain awd the Standai&, Rules arcl Re-_Wations of the I Health.- Date-.11-70"J t 7x4 Certified b'- c-16A) i PJ LW 6 y, Desia-m Profess Address; CtF"Cw 4)< t i1.1 C6- C EALTH SERVICES Trenches-A" Block IjotlL Lstructed and I have5lospected U) Construction Permit and ituam County Department of U tFe� PE RA onal Lic. W Conurierits . . .... er 'Vefu Iq PTO- -TH LX I_j>VefL_( LA"r A-F U Ri �nz Form F[R-9� .� 1j yL e JAN-17-�.006 TUE j.,_:':11'7 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 S " CONSTRUCTION CTION PIERM IT FOR SEWAGE TREATMENT SYSTEM PIERMIT # ?V-11-03 Located at Jib (R'T0/J �oLLoW R o(D Subdivision name Subd. Lot # Date Subdivision Approved Owner /Applicant Name 9QR r?)J,1 UDLIAW R AQ 'QkQ LT t 033 Mailing Address '0 0 CAN o p u S dOLLOW kQ aL) Town or Village �PU —IM jq 0 V,4 L L9t Tax Map G 1 Block _ I Lot j 2 Renewal �, Revision Date of Previous Approval q 200 3 E Zip Amount of Fee Enclosed Building Type Si A6 L6 rel lug Lot Area 6. G Ac No. of Bedrooms 5 Design Flow GPD MIR Section Only Depth `r . VoRume 5 3, J5 :: -O>40 PCHI<D NOTIFICATION IS REQUIRED W}fEI1EN FILL IS COMPLETVI) i Separate Sewerage ystem to consist of ts' d 6 gallon septic tank and �J�� �- � F P6,g FoyP r pro Pyu Pipe iN 24-"' GROVEL - -Re/ �Cd Other Requirements: py M p T-CM To be constructed byPOR`r0Q N6LLOW R06D ��A�Tt/ Address 22-7 611jOpuS F/bLLO W 'POii-D WateLSu29Ila: Public Supply From 0.T Private Supply Drilled by 0t.3,t d:' a ij / � C . Address f I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewaae_treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations nam County Department of Health, and that on completion thereof a "Certificate of Construction Compli dad& , the Public Health Director will be submitted to the Department, and a written guarantee will be Ofrtl?ls the 6 hi §., uccessors, heirs or assigns by the builder, that said builder will place in good operating conditi �p'drt of §aid sew E . eatment system during the period of two (2) years immediately fo mg date of the issuan( a a#awa)7Nof the ere. icate of Construction Compliance of the original system or atuf re airs t reto. Signed: J. E ' f4m Date Z,g _a Address L 'S-0 /J WO 1-514 L Ob �W ✓`0 /%"P 1J License # 06 ZM 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 pert it. Approveed for d' charge of domestic sanitary sewage only. G" Title: Date: I i / �topy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 I . 11/22/2005 14:0 l*' 91.•7363693 "J t-40V-22-200`: 't'jl--' q 0i7l-'-" TEL:845-278--1921 4.:. CRONIN ENGINEERING'i I o 4 A 4 PAGE 01 • 1p _4 1 -100 NAME:PUTNOM COUNTY DEt'HKIMLNI OF P. 1 RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 .°r.Tel. (914)736-3664* Fax. (914)736 -3693. - . .. . - . - November 8, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: SSTS Construction Permit Renewal Tax Map #61 -1 -12 PCDH Permit #PV -11 -03 85 Horton Hollow Road Town of Putnam Valley Dear Mr. aravatc Please find enclosed three sets of the revised SSTS permit plans. The plans were revised in response to your comment letter dated November 2, 2005. 0 Please review the.proiect at your earliest convenience and if there are any questions do not - hesitate contacting rde�at the above number. _ . , Respectfully submitted, 1- Kenneth M. Murphy Design Engineer SHERLITA AMLER, MD, MS, FAAP Commissioner of Health...... - LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF. HEALTH 1 Geneva Road, Brewster, New York 10509 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear Mr. Murphy: November 2, 2005 ROBERT J. BONDI County Executive Re: Proposed SSTS Renewal Horton Hollow Road Realty Inc. (T) Putnam Valley, TM# 61.4-12 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. The house is downhill and in direct line to the proposed SSTS. The required separation distance between the house and the SSTS should be 50 feet. � Revised floor plans need to be submitted for review. . Proposed spot grade elevations are off by 100 feet. 4.. ,..If.thQre.is_no well within20.0 feet of the proposed SSTS on tax lot # .13, please - ` provide a note stating such. ,k 5. The note stating that the proposed SSTS and proposed well needs to be staked by a licensed land surveyor prior to construction has not been provided. See comment # 10 from letter dated August 5, 2005. 6. The 100 -year and 500 -year flood elevations should be shown on the 30 -scale SSTS plan. 7. The junction box detail should be removed. r `��his office will continue its review upon consideration of the above mentioned comments. Please 'a feel free to contact me at ext. 2157 if any questions arise. otn JSP:cj Sincerely, oseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health, (845) 278 -6130 Fax(845)279-7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC(845)278-6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention(Preschool(845)278 -6014 Fax(845)278 -6648 SHERLITA AMLER, MD, NIS, FAAP Commissioner of Health .,LORETTA.MOLI.NARI, RN, MSN Associate Commissioner of Health August 5, 2005 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 5 Dear ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 L// . Re: Proposed SSTS Revision Horton Hollow Road Realty Inc. (T) Putnam Valley, TM# 61. -1 -12 This office has received and reviewed the most recent set of plans for the above mentioned project.; We would like to offer the following comments for your review and consideration. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. ? (to JSP:cj °µ Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 ,(t J ��Y/ A new well permit is required. ' Y The wetland permit from the Town of Putnam Valley has expired. Please provide a valid wetlands permit. 3." The house is downhill and in direct line to the proposed SSTS. The required separation distance between the house and the SSTS should be 50 feet. The house footprint shown on the plan does not match the approved floor plans from the first �Qa 9r 61-1 approval. The expansion area is short by 1 foot. Please show -the actual expansion area layout, like -the primary system. 511✓. o� ` C7., It is unclear as to whether a uniform l feet of f ll is being provided over .the entire SSTS area. Proposed spot grades may be necessary. There appears to be an error in one of the well to property line dimensions on sheet 2 of 2. S pmt y'� Is there a well within 200 feet of the proposed SSTS on tax lot # 13? ,; i 0. .,Please provide a note stating that the proposed SSTS and proposed well location need to be PJor r staked by a licensed land surveyor prior.to construction. This includes the beginning and end of the expansion area trenches and the house location. Any changes from the approved plan to, will require a revision submitted to this Department for review. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. ? (to JSP:cj °µ Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 Nov 02 05 12:01p BUILDING DEPT 9145268806 P.1 'TOWN OF PUTN AM VALLEY, B u rt A" R' T M E N `T-'--'� . ..... ❑ Uk(;E'.N'(' X FOR REVIEW OPLEASF COMMENT' ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES /COMMENTS: ATTACHED PLEASE FIND WETLAND WAIVER RENEWAL DATED 10/28/05 RECEIVED FR(-.)M S. COLEMAN. . k .IF V4MIING FURUIER IS NEEDED REGARDING THIS WAIVER, PLEASE CALI..TWS OFFICE. THANKS:-- DORET',N 265 OSC. I.K. RD. PV, NY 10579 845-526-2377/S26-8806 JAN-12-2000 WEI-: TEL:845-278-7921 NRME:PUTNAM COUNTY DEPARTMENT OF P. 1 FACSIMILE TRANSMITTAL SHEET TO: PROM: JOE PARAVATIJR DOREENPIACENTE COMPANY. DATE: PCHD 11/2/2M5 PAX NIJMBE?,: TOTAL NO. OF PAGES INCLUDING COVER 845-278-7921 2 SENDER'S REFERENCE NUMBER TM #61.4-12 RE: YOUR REFERENCE NUMBER WMIAND WAIVER RENEWAL 85 HORTON HOUQW ROAD ❑ Uk(;E'.N'(' X FOR REVIEW OPLEASF COMMENT' ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES /COMMENTS: ATTACHED PLEASE FIND WETLAND WAIVER RENEWAL DATED 10/28/05 RECEIVED FR(-.)M S. COLEMAN. . k .IF V4MIING FURUIER IS NEEDED REGARDING THIS WAIVER, PLEASE CALI..TWS OFFICE. THANKS:-- DORET',N 265 OSC. I.K. RD. PV, NY 10579 845-526-2377/S26-8806 JAN-12-2000 WEI-: TEL:845-278-7921 NRME:PUTNAM COUNTY DEPARTMENT OF P. 1 Nov 02 05 12 :01p BUILDING DEPT 9145268806 X0,2 CHAFM 14W: Fmhwaftr Wei Wow=wm wd Wawboew ardhmee of w Tam of ftban Val y, l Yw. Tlt Town Wdlands Motor, as Approval Auftrky, hu ddemdwd that ft prowsed action is an UWW@d Action u®du SEQRA, and wA tort leave a agwficaut coviaomraenwl kMa ct. a PMUffF WAMR is 4o tl a awfitsm aa➢id lehw. 3ATR PERM ISSUED: Octobw 28, 2005 DATE Fff1W DES:: Octobgr 28, APPMAW/SPONSOIL- Horton Hollow Rwd may, Inc. CJe Steve A & ? 227 Canoes Hollow Road, Pattom Valley, NY 10579 1F - LOCATION: libriton Hollow Road TAX MAP k- 61.4112 OF PARCH: 6.0 acs WNW: R -3 A�°ffi Ai : Smewsl eF r Woftob Pmk waiver 48W 07 MAMUM - espir+md 67 1. Applkstion MatoWs, fk # WT49 -05. COND MOM OF FERKM 07 - - 05 -05. All condk ions of prior pa=il Waiver shy � apply and are required as part of permit waiver. RescamrNsam with the ems above vA nrAddde dos renek Waiver, and may mwit in a NOUN d Vim s/or 4 Stop Work 0#dw Amy queftmseguift tlnk Pew Wawa slmuklIx directed to the Tbv m-Vctlwds b4octor (914T494-5544, or the offu offt Daft Luect ®r (914) 526 -2377. Date ®f Site Inspection: DMW23,2M Date Permit Waiver fteparedL Oclober 29, 2003 cc: ApplicM liaifdirg i�c�r • Row l3 . C , .n U 774 W. : �d JAN -12 -2000 WEB 14.-PL--- TEL:845 -278 -7921 - r . 21 Stephen W. Cokmm Town Watlands ImXWor OOZE _l 3f?I75k! 1 dH Wc19E c 01 ZOOZ 16 100 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 _ ..,.. 36. 3691 . October 19, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: SSTS Construction Permit Renewal Tax Map #61 -1 -12 Formerly PCDH Permit #PV -11 -03 85 Horton Hollow Road Town of Putnam Valley Dear Mr. Paravati: Please find enclosed three sets of the revised SSTS permit plans and a $200 certified check. The enclosed is for your review of the above referenced application. The plans were revised in response to your comment letter dated October 12, 2005. Please review the project at your earliest convenience and if there are any questions do not hesitate contacting me at the above number. ;'!ja Respectfully submitted, Kenneth M. Murphy Design Engineer 11/01/2005 17:15 9147363693 CRONIN ENGINEERING_1 PAGE 01 i .h,. PUTNAM COUNTY 1111 PARTIN1ENT OF E R DIVISION OF EINVIROM IENTAL REAJL'1 SER CES ATTENTION >C GENE wtsr /c ,fvr� FEQ »S FCR..MAL IN PE 'ION For: # FW �-� All information must be fully completed prior to any inspections being made. PCHD Construction Permit # ?V-11A — CO Located: 13 h k da-jj�jd J4 4 L¢.cs W _ _. (T; Owner /Applicant Name: H,,aR a+ WaL L4w J?aa n &&IJ aek Tli Formerly, 6„1�d �R �'r►9_ �- Subdivision Name- ' Subdivision Lot n M Trenches (V) v Block .L Lot " t Z Is system fill completed? PIP — Date :I i Is system complete? VIE -C Date: Na 1' S- Is system constructed a per plans? _ 0 Is well drilled? -S Date: i 1 Is well. located as er plans? � Are erosion control measures in place? ' I i I certify that the system( 's), as listed, at the above premises has been onstructed and I harje inspected and verified their completion. in accordance with the issued CID Construction Permit and approved plans and the Standards Rules and Regulations of th Putnam County De0a4rxlent.9f..... . .....:__... _s Health. _. .. ..._ _ : - . �.:... _......._:.... _•:....�_ : _.. :. - - - - ...... __ .... .. __- • . ..._.y ....- ...... ._ c �... i ..I.. Date: &)091Gd'4%,1'L Certified by:C1240 d CAJ e I "'i e PE�� RA Desip Prof ssioaal Address: Z _LXH CCU_K11{ _Lr.„ T Lic. n Comments: Form FL's -99 JAN -I1 -2000 FU 1E:• `EL:3345 -273 -7921 NAME:PIJTNAM COUNTY DEPARTMENT nF SHERLITA AMLER, MD, MS, FAAP Commissioner. of Health.._. •.: -- LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 12, 2005 Cronin Engineering Ken Murphy The Lindy Building, Ste 200 2 John Walsh Blvd Peekskill, NY 10566 Dear Mr. Murphy: DEPARTMENT OF HEALTH 1 Geneva Road; Brewster; New York 10509 Re: Proposed SSTS Revision - Horton - Hollow Road Realty Inc (T) Putnam Valley, T.M. 61. -1 -12 ROBERT J. BONDI County Executive Please be advised that the above application currently under review by this Department has now expired. A renewal is now required. Please have the owner submit another $200.00 certified check or money order made out to the Putnam county Department of Health. All comments from the previous letter dater August 5, 2005 are still valid and need to be addressed. Please. also., check. with the Town concerning the status of the wetlands permit. The current permit this Department has on f11e liar ezp'— RU.Either.a valid permit has to be issued and a copy provided to us or a letter from the Town stating the work has been completed in accordance with the wetland permit. If you have any further questions, please do not hesitate to contact us. JSP:cw Sincerely, 66seph S. Paravati Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ' 'L'ORETTA MOLINARI; N,1V1SN Associate Commissioner of Health August 5, 2005 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT 1 BONDI County Executive Re: Proposed SSTS Revision Horton Hollow Road Realty Inc. (T) Putnam Valley, TM# 61.4-12 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. 1. A new well permit is required. 2. The wetland permit from the Town of Putnam Valley has expired. Please provide a valid wetlands permit. 3. The house is downhill and in direct line to the proposed SSTS. The required separation distance between the house and the SSTS should be 50 feet. 4. The house footprint shown on the plan does not match the approved floor plans from the first approval. 5. The expansion area is short by 1 foot. Please show the actual-expansion area: llayout, -like the primary system: _... __ ... :....... _ h ..... . 7. It is unclear as to whether a uniform 1 feet of fill is being provided over the entire SSTS area. Proposed spot grades may be necessary. 8. There appears to be an error in one of the well to property line dimensions on sheet 2 of 2. 9. Is there a well within 200 feet of the proposed SSTS on tax lot # 13? 10. Please provide a note stating that the proposed SSTS and proposed well location need to be staked by a licensed land surveyor prior to construction. This includes the beginning and end of the expansion area trenches and the house location. Any changes from the approved plan will require a revision submitted to this Department for review. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. t& "'44' ��'"` �P Sincerely, L0 1a t'`, -,,• "' �„rr�s oseph S. Paravati, Jr. G vii 1110 Assistant Public Health Engineer JSP:cj � �11_ ow Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 ®I 0 a 6/24/2003 16:18 9147363693 CRONIN ENGINEERING 1 PAGE 01 post-Ii" Fax Note 7671 Fog"861 - 24 ; of P. J CoMeM TOWN Ok' PUTNAM LLEY CHAPTER 144: Fmhwater Wetlands, Watercourses the Town of Putnam Valley, New Yo The Town Wetlands Inspector, as Approval Authority, has de an Unlisted Action under SEQRA, and will not have a sigaific Therefore, a FERAW WAIVER is granted subject to the co DAT19 PERMIT ISSUED-. March 31, 2W3 DATE PERhM EXPIRES: March 3 1, 2004 APPLICANT/SPONSOR. Nine Acre Estate, Ltd. Phffip W. Cassese, President 9 Sunset M Road Putnam Valley, NY 10579 WaterWits Ordinance of wined that the proposed action is eaviromnental impact, i0as noted below. - / ) 1? 0 �&- PROPERTY LOCATION: Hortoa Hollow Road//C opus Hollow Road TAX MAP #-. 61-1-12 SIZE OF?ARCEL- 8.765 acres ZONTNG: R-3 ]PROPOSED AMON! Construction of driveway for iingle family residence within wetland area 1. Application Materials, Me # WT-2003. COIF IDMONS OF PERMIT! 1. Driveway to be constructed as per Site Development I Ian as prepared by Cronin Engineering, P.C., dated 12-11-02. 2. Erosion controls consisting of a Of fence required on, th sides of the driveway.. Erosion controls should extend beyond the area to be disturbo .. 3. The Building Inspector shall be notified once erosion (ontrol measures are in place and at least 49 hours prior to the initiation of any site work hgft I gf-.. JUN-24-2003 TUE 14:56 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 06/24/2003 16:18 9147363693 CRONIN ENGINEERING 1 PAGE 02 Jun 23 03 10:10a f P.s 4. When k.rasion controls are required, they must be main wined properly throughout the construction process and remain in place until final site nspertions for compliance with conditions of permit have been completed. 5. The Plinnietg Board, Wetlands Tnspector, andlor Buildi ig inspector, shall have the right to inspect the project from time to time. 6. The pennit shall be prominently displayed at the prqjec site daring the under<aldng of the activities authoriEed by the permit. 7. An additional grow account in the amount of $ 300 ust bt established with the Town before this ]permit Waiver can be considered cilidated. These additional escrow funds will -be appropriated as required for construction momitonn puMoses. ,P� portion of the account not used during the project monitoring period hall be returned to the applicant upon satis&ctor'y completion of the project. (this req rement waived, if additional deposit done at time of application) NooeompHwoce vvith the conditions above will invalidate this Pernaft Waiver, and may result in a Notice of Violatkon and /or a Stop Woirk der. Any quest ns regarding this Permit Waiver should be directed to the Town Wetlands Inspector (914) 762 7288, or tba office of th® Building Inspector (914) 526 -2377. Date Permit Waiver Prepared` March 31, 2003 cc: Applicant .. _ -Building Inspector..... planning )Board Environmental Commission ?W-2&2 JUN -24 -2003 TUE 14:57 TEL:845- 278 -7921 Stephen W. Coleman Town Wetlands Inspector NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 06/24/2003 16:18 9147363693 CRONIN ENGINEERING 1 PAGE 03 Jun 23 C3 10 :10e L2/09/2002 11:51 9145264729 PV HLt>t41AV PAGE al nn�swtt FJ1flLSytctin - 20SO..WAWARA LAKP-AOAO rysw,e,ryM�i p.17t4AM VALLEY.14MYORK I*= 'eke *4 Wpkrig { TOWN OF PUTNAM VALLEY HIGHWAY pt: ARD EW DIZi AX t]ERNING PE A>PPI,YCATION NQ�:.T NA i r # OA CA P T1�P FAMant to Loch L& No. A-1979. Lacst lAw No. 8-1011, and 7 (84dirisi9as), and Lori Low Not. 1-1900 ('Fore3tryk, I htreb, for. �j.� ..•. 67�.,..�a�a On Town , / h t tc'F ° 0-1 T.T J / Date L � Q 1.- applicable Stu. -56- make appUo ioa �-►pplwant S1 aturt AlaPUCItian /Permit fee 5100.00(payable to Town of PntnamVa ty) %14� ev "'NOTE- Copy of survey shoeing driveway tocrtiwo on plot i riu:% lac proMidrd, Monuments must be plAmd on frost earners of pr4 perty showing Driveway tocatico- Oat Drivs►ray road to edge of right -af• y and must be graded not to at1oW► ttrto tue ofCinto right -of- -way. PINAUS: ONLY ONE•I)RIV£WAY OpFNING PER PAI kCEL ES PERMiTT>EU AS PER TOWN Po LACY A ra.r O* aaaa♦ r .aa...- M ..... •... ..•.........a.. �..•.�,. ���..�. a*a.•...•.. FINJ1l, C.Q. APPROVAL Final appro.d refuse bt; obtained before drivcwa7 is DATE: H JUN -24 -2003 TUE 14:57 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 3 C RONIN ENGINEERING P.E. P.C. - „The Lind Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 .,' Y g - Tel:- (014)736- 3664 0 Rapt: (�114)7�fr3633::.:�::.._= : =- . '::ro_ :,::.. _ . .. ... -....r = .<... r •_ . April 26, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 Re: SSTS Construction Permit Revision Currently PCDH Permit #PV 11 -03 Horton Hollow Road Town of Putnam Valley Dear Mr. Paravati: Enclosed is the following information necessary to process the revision for an SSTS to be constructed on the above referenced lot. '1.) Three copies of the revised subsurface sewage treatment system plan 2.) Four permit applications 3.) Affidavit — corporate owner application 4.) Letter of authorization -- 5:) Updated survey showing lot line adjustment 6.) $200 revision fee The SSTS plan has been changed to show the grading and elevations of the house to allow the permit to be revised for a pump system. Since the permit was issued by your department, a new owner Horton Hollow Road Realty, Inc. has purchased the lot from former owner Nine Acre Estate,. LTD. It is our request that the originally submitted soil data sheet and other necessary data are incorporated into this revision and further a new construction permit is issued for a pump system under the new owner. Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. Thank you for your assistance in this matter. Respec lly submitted, A neth M. Murp y Project Engineer PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Located at HoR1 -01J HOLLOW Rot-lb TN&1rtJArh a Tax Map # G I Block. Lot 2 Subdivision of Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize '-Ti M aTh L< CQon1 I /J a duly licensed Professional Engineer er�d A=hkmt 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 Sarlitar�'�'bd�`"��° :.::......_ .. _. _._.._.., . - �'� �:�.�� "�. truly yo �.:j.. _ Countersigne P.E.,1., # �. bSF.O 62980 P�.. Mailing Address SU 1TL 'Z.00 2 S0410 W A Z s J4 Z?Z-Vr>- State'&1erKILL 8 Zip Jj ()SC Telephone: l �l i +) -7 3 G - 36 6 4( of Property Mailing Address: �, O C /� 36go s aLc.cinJ V000 State U7NR 119LwAyZip 105 1) i Telephone: Form LA -97 "IFMDAVT - CORPORATE OWNER APPLHCATION FOR PERMIT APPLICATION SUBNUTTED TO PUTNAM COUNTY HEALTH DEPARTIVENT To: Public Health Director represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Having offices at. President - Name: Address: ea) f L v V Mice President - Marne: Address: Secretary -Name: Address: I........ TPeaSUrer -Name: ._. ... ____ .....__........ � -_ - _.. . = ..w..:.: - : .: .:.:.... ... ...... .....:.. ._. ,. _. _:..___. ._...._.._. � -- - - Address: and that 1 am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating theret TIMOTHY L. CRONIN Z Notary Public, State of New York _ No. 4923313 side Qualified in Westchester County Title: -� COMM, fission Expires March 14, Zo of. r to befo this day of l o ) u (year) Notary Pu tic Corporate Beall Form CA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # PV- I I - 03 Located at NoR 1-a-" HOLLOW Rooe4y Town or Village PU TWArh V19 LLCK Subdivision name Subd. Lot # Tax Map ro I Block I Lot 12- Date Subdivision Approved N - ' { Renewal Revision Owner /Applicant Name N r N iC A c ae C S TA T tF, L Tb Date of Previous Approval Mailing Address cl S0$JX 6T HILL Rorie `Po TwI rN VA l 4-Q , N.Y. Zip l oSi,-3 Amount of Fee Enclosed 4:30 O Building Type SIQ&e fAMILV Lot Area 8.96 S No. of Bedrooms S Design Flow GPD 1 0130 Fill Section Only Depth 12„ Volume ± 3 S '? PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1600 gallon septic tank and 9-E6 L , r `PURFORA •TC0 fvc 'PI'P6 1N GRAy L —MCM cI-1 Other Requirements: To be constructed by C A SS ES E G404,041 L Co N 7, Address c1 S u NsL -r H I LL RD, Pu T UA Zc �l hi y Water Supply: Public Supply From Address Private'Suppl-y Drilled by Pr 19 L 0 A yt - Rl�,-lnsT -eR, Nj% /6 6-0`� 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 sy,,gtem 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 Compliw= -- satiafactory to the Public Health Director will be submitted to the Department, and a written guarantee will,be�fiilrni e tR6',p er, his successors, heirs or assigns by the builder, that said builder will place in good operating condiaFly'pa`rt` ids age treatment system during the period of two (2) years Immediately following the date of the issu ce of thpa . rod" Certificate of Construction Compliance of the original system or any repair► thereto. ; . },; !, Signed: P:Ic Date "7 —1 U `G .3 i Address 2 �Yo Hsi VJA C SM 13L � � � � � � / 0,56"C License # 06 2 "I � 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 for discharge of domestic sanitary sewage only. By: Title: )q7�� Date: -�,q o Whi opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUS NAM cCOUIY'll'ZY DEPARTMENT OF HEALTH DEWSRON OF IENWRONM ENTAL HEALTH S ERWECES APPLICATION TO CONSTRUCT A WATER WELL _ ,z please piinf oitype` - PCHD Permit # - : Well Location: Street Addrress:. Town/Village Tax Grid # HORTON f-ioZL6W P-0 ?vT iAr4 V4LLeV Map G l Block I Lot(s)12- Well Owner: Name: Address: q S UN S, 7— /-/ 1 C C RO/9 D i.11 N( 11 C Q C E4 --rig u-r" A rn Jq L L.L �J / O S i Use of Well: _� Residential Public Supply Air/Cond/Heaf Pump Irrigation I -p irimmary Business Farm Test/Monitoring Other (specify) 2-secondary Industrial Institutional Standby Amount of Use Yield Sought S gpm # People Served G Est. of Daily Usage _L 2o o gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling X New Supply (new dwelling) Deepen Existing Well Detailed Reason \/\% Tr✓ _!;QppLV F RES 106-, C C for Drilling Well Type Drilled Driven gravel Other Is well site subject to flooding? ................................................. ............................... Yes No —)<' Is well located in a realty subdivision ?_ ...................................... ............................... Yes No Name of subdivision Lot No. ri !I-V Water Well Contractor: F jCt:t -qL So nil` ItJ C Address: Y Po-r,-JAN AVE- gpkk m_rell 7V�/ Is Public Water Supply available to site? .................................. ............................... Yes No k Name of Public Water Supply: N/A Town/Village N /R7 Distance to property from nearest water main: N In Proposed well location & sources of contamination to vided on separate sheet/plan. Date:. Applicant Signature: _ ... . PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue fl Permit Issulniz Official: Date of Expiration Title: Sys J_'64L 1kdOl 14X7 .6 Permit is Noon- Tmansffeirmablle White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 617.20 SEQR Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For.UNLISTED ACTIONS Only Part 1 - PROJECT INFORMATION (To be Completed by ADDlicant or Proiect sponsor) 1. APPLICANT /SPONSOR: 2. PROJECT NAME: Nine Acre Estates, LTD. SS TS, Horton Hollow Road 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) North comer of Horton Hollow Road and Canopus Hollow Road intersection 5. PROPOSED ACTION IS: ©New ❑Expansion ❑Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: construction of subsurface sewage treatment system and a water service connection for the construction of a single family house 7. AMOUNT OF LAND AFFECTED: Initially 8765 acres Ultimately 8.765 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? QResidential ❑Industrial ❑Commercial ❑Agricultural ❑Park/Forest/Open space ❑Other Describe: Surrounding lands are zoned single family residential 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? (Yes ❑No If yes, list agency(s) name and permit/approvals Town of Putnam Valley— Building Permit, Putnam Co. Health dept— SSTS & Well Permits 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes jNo If yes, list agericy(s) name and permitlapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑Yes MNo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/Sponsor name: Cronin En in erin .E. P.C. /K nn th Murphy date: 05 -19 -03 Signature: i II L`• If the action is in a Coastal Area, and you are a state agency, complete a Coastal.Assessment Form before proceeding with this assessment OVER 1 A. DOES ACTION E EED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process use the FULL EAF ❑Yes o B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration pfay be superseded by another involved, agency. ❑Yes Alb- C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: Answers may be handwritten, if legible. C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing trafficpatterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefl : C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly::. , Cz C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C- "_ � IVFJ C7. Other impacts (including changes in' use of either quantity or type of energy)? Explain briefly: CD D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONME_ NZAL CHARACTERISTICS THAT CAUSED THE DTA .* ENT OF*A CRITICAL ENVIRONMENTAL AREA (CEA)? Wes If Yes, explain briefly: " C,` E. IS THERE, OR IS THERE LIKELY TO BE; CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPA S? ❑Yes If Yes, explain briefly: Part III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency). INSTRUCTtOW. -For each adverse effect identified: above, determine' whether it- is- substantial,: large, =important or othervitise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting, materials. Ensure that explanations contain sufficient detail to show that all relevant adverse.impacts have been identified and adequately'addressed. If question D of Part II was checked yes, the determination of significance must evaluate the* potential impact of the proposed action on the ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. - -eheck this box if you have determined, based on the information and analysis above and any supporting documentation; that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting.this determination: _. Name of Lead Print or T pe Name of Responsible Officer in Lead Agency Sfg6ature of Responsible Officer in L e e% i ANA,date in I 4 4gency Title of Responsible Officer Signature of Preparer (If different from responsible officer) RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 Tel. (914) 736 -3664 • Fax. (914) 736 -3693 September 5, 2003 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: Nine Acre Estate, LTD Horton Hollow Road Town of Putnam Valley Dear Mr. Paravati: .Please find enclosed the revised information based on your comment letter dated September 2, 2003. Please review the project at your earliest convenience and if there are any questions do not hesitate contacting me at the above number. Respectfully submitted, � "r enneth M. Murphy � o r Design Engineer �n y l�1'I LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 September 2, 2003 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Re: Dear Mr. Murphy: ROBERT J. BONDI County Executive Proposed SSTS — Nine Acre Estates, LTD Horton Hollow Road, (T) Putnam Valley TM# 61 -1 -12 This office has received and reviewed.the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. Percolation hole # 2 should have been run again to determine. if the next design bracket should have been used. .; .It appears.more.cleanouts are needed on the effluent line,,- especially. near- the.first junction- - -- �- box-.-Please-clarify-all bends and �ieeessary cieanouts.' k,13 . A rip -rap pad should be provided for the roof leader and footing drain discharge to protect JV,,,.. wetland from erosion. op ., Please provide fill pad dimensions (length and width). It is recommended that t he SSTS area be staked to avoid encroachment into the wetland buffer area. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, oseph S. Paravati, Jr. Assistant Public Health' Engineer JSP:cj PUTNW COUNTY DE�A.RTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT,SXSTEMS..- . - :_ _ REVIEW SHEET-FOR CONSTRUCTION PERMIT NAME OF OWNER: ' �S "'� STREET LOCATION: � lLrsw Alil REVIEWED BY: RM, GR, SRDATE: bo/r , L 3 TAX MAP#: (CONFIRMED) Y ,,N DOCUMENTS PERMIT APPLICATION V )WELL PERMIT OR PWS LETTER t OF AUTHORIZATION 'DATA SHEET (DDS) RATE RESOLUTION EAF PLANS -THREE SETTS U�USE PLANS - TWO SETS U(! VARIANCE REQUEST SUBDIVISION U LEGAL SUBDIVISION ' (_)L__)SUBD'IVISION APPROV /�j� (��PERC RA /v 'C/ (_)(___)VO FOR R.O.B., UNCLASSIFIED & IMPERVIOUS CUU QUIREA DEPTH �CUURRTAIN DRAIN REQUIRED GENERAL U�OCATED.IN NYC WATERSHED (___)p_� S SUBMITTED TO DEP ( (�D LEGATED TO PCHD (___) EP APPROVAL, IF REQ'D (�D EP TEST HOLES OBSERVED () EROS TO BE WITNESSED -APPR , �DATA ON DDS PLANS & PE (� )ERE 1969 NEIGHBOR NOTIFICATION 51e�som YR. FLOOD- ELEVATIONWl 200'' TESTING LOTS >10 YEARS OLD REQUIRED -DETAILS ON PLANS SE LAN SSD G )DESIGN RESULTS 2' CONTOURS EXISTING &PROPOSED DRiVE�VAi�` ER/CURTAIN D USDA SOIL TYPE BOUNDARIES (__)TITLE BLOCK; OWNERS NAME ADDRESS f TM#, PE/RA; NAME, ADDRESS, PHONE# ✓DATE OF DRAWING/REVISION DATUM REFERENCE . - nC__JLOCATION OF WATERCOURSES, PONDS A+ M WETLANDS WITHIN 200' OF P.L. ZL_j=P&ED FINISH FLOOR AND ' BASEMENT ELEVATIONS WELLS & SSDS'S WAN 200' OF SSTS PROPERTY METES & BOUNDS zj(� )EROSION CONTROL FOR.HOUSE, WELL & SSTS, EROSION CONTROL NOTE �nMms: + G ✓f9f YU i� 5111�1(� �1L1V�' �L` j:!/Jt n`�`� y,G d %�t/�c[T /�•� 9c�/O " lvv r."' :VSHEET)09 101/00 Y,-,N (REQUIRED DETAILS ON PLANS CONT'DI (_'• )U USE SEWER - W, FT. 4 "0'; TYPE PIPE.CAST IRON (� 0 BENDS; MAX BENDS 45' W /CL ANOUT -'-� � _RRIZIRWILS ,, ` jam, UUS (NO . GE) /'J FILL SYSTEMS C� 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE (.� FILL PROFILE I, NO Py� ✓�� . fi'lL�i ,,l (FILL IN EXPANSION AREA CLAY BARRIER (__)(___)FILL �CERTIFICA (JLJDEPTH GAU PARATION DISTANCE FROM'TOE OF SLOPE TREN ' LL) TRENCH PROVIDED- ._ 60FI MAX. U � PARALLEL TO CONTOURS � l '•�C `�' � 00% EXPANSION PROVIDED DETA�./DUST FREE CRUSHED�STONE OR WASHED GRAVEL �GEOTEXTILE COVER ' (�SEPARATION DISTANCES ON PLAN : FROM'SSTS 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL. W20' TO FOUNDATION WALLS -,, 100' TO WELL, 200' IN DLOD,150' TR PITS f )100' TO STREAM, WATERCOURSE, LAI{E (inc. ezpan), , (� 50' TO CATCH BASIN, 35' STORMDRAIN, PIP,ED.WATER -�- -•° •- -•° ' - 10 � TO•WATER IC;I�IE'(pits - 20') ' 50'� IN'TERMTT"TENT DRAINAGE COURSE (��200'/500' RESERVOIR, ETC. � 150' GALLEY SYSTEMS U10' MIN TO LI<rDGE OUTCROP / SEPTIC TANK (�U10' FROM FOUNDATION; 50' TO WELL DIlVIENSIONS TO PROPERTY LINES LOCATION OF SERVICE CONNECTION UMIN 15' TO PROPERTY LINE SL ' (PE IN SSTS AREA (S20 %) RADED TO 1S %, IF REQUIRED ' • DOSE S TEMS ' UUPUMP NOTES . (r j(�DOSL 75% OF PIPE OSE VOLUME NOTE ./ (�(___)DETAiL FO CE:MAIN, (PIPE TYPE, ETC.) �l,J �DPAY -BOX SHOWN & DETAII.ED RAGE ABdVE ALARM CURTAIN 1 UUSTANDPIPES, 5' BOTH AIL �f �r�.` (_ }(�,�15' MIN to CDS=>5- , '-4 %, 25' -3 %, 35' -1 %,100 % -<1% . (_,_)(__)20' DLSCHARGE/100' with 182 cons day discharge (-� to NON - PERFORATED PIPE WE S (TOWN/DEC PERMIT REQ'D ?) ' '� WAGE SYSTEM P - (NORTH ARROW) S HYDRAULIC PROFILE RAVITY FLOW DATA: PERC &DEEP PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES N,-J)A-T---A-$U.jET -.$.UjBSU"-A-C-E-SF-'vVAGE.,-TREAT,�MEN-T-SYSTEM--,-.-.ri:.;..�,,Y."-,- S UNSCT- HILL 1?6191 L-T--D Address FJTo1J1qfv1 VAUC-)�, MV /o,�;-?j OwnerNWE 14cr?C 8STt4VF1, ------- r— Located at (Street) { JORToiJ HO/LL6W Vogqjo Tax Mat) 6 1 Block I Lot 12- (indicate nearest cross street) Municipality r 6wi-3 OF For,40 Drainage Basin "?CCKX,<1 t L. k1a 4 e-o w 4RoQK SOIL PERCOLATION TEST DATA Date of Pre - soaking PPRIC bq, 2063 Date of Percolation Test ( '7 PR I L I S- 'Zo O's 4-- Hole No. Run No. Time Start - Stop Elage Time i in.) Dipth to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Mimqnch II0 IF? Zg 19 2 //q IZ,0'7 29 3 /Z t 0 12,`10 20 io 4 12 *3 /10 So ID 5 'Z 2 3 1221 12s0 4 10 5 2 3 4 5 NOTES: I Tests to be repeated at same depth until approximately equal percolation rates ate obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, s 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 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' 0' 7.5' 8.0' 8.5�.:.. . 9.0' 9.5' 10.0' NINA Wz 6 iTkfE: L'rD . 2 TEST PIT DATA DESCRIPTION. OF. SOILS ENC- OUN- T- EREDI- N'TEST"H'DI;E'S HOLE NO. D _ �y �l HOLE NO. Ti HOLE.NO.9 3 otL TD p 50 PL —01T lL T,4 <,4mAj Lo A^, Stc,T4 546JW tmAfj- p 1� n aw Indicate level at which groundwater is encountered i- 6 Indicate level at which mottling is observed N 0 !"i'!o TTY I Indicate level to which water level rises after being encountered 6'- 6 Deep hole observations made by: Y,'ir J6�iwvV J. M4WAI t wy �r ^o/e ,\ Design Professional Name: L. Wo14iN J= Address: WAt-r 44619 Ks W(- C- , NY i0 Signature: Design Professional's Seal /f ;y Ay LAJ Cn ' 4 . rte7 Indicate level at which groundwater is encountered i- 6 Indicate level at which mottling is observed N 0 !"i'!o TTY I Indicate level to which water level rises after being encountered 6'- 6 Deep hole observations made by: Y,'ir J6�iwvV J. M4WAI t wy �r ^o/e ,\ Design Professional Name: L. Wo14iN J= Address: WAt-r 44619 Ks W(- C- , NY i0 Signature: Design Professional's Seal /f ;y Ay LAJ vJ, 62980 � cep N,'oFE'35%0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _�J)ESPGN-DATA SHEET - SUBSURFACE -CE--SEAVAGE: TR1EATM-EN-T`SYST-t`N1-' 9 SuNsc-r HILC 1?619D Owner _ijl/Jg _14Cf'?C ES-r/4,TiF, L-7--D Address 'PUTI-JAM VAUC-)�_tqy Located at (Street) 14OR T6,1J 140 /_ L -b W 120 q_o Tax Map 6 l Block Lot 12- (indicate nearest cross street) Municipality 16vit-3 OF FortJO Drainaae Basin Tc-eKX.0 L L kl"e-ow 'ZRO�K SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Elage Time a.) Dipth toWater. rom Ground Surface (Inches) Start Stop Water Level Drop D In Inc%es Percolation Rate Min/Inch 2 3 4 5 2' 3 4 5 2 3 4 5 NOTES- F. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, :5 2.min for 1-60 min/inch) All data to be submitted.f6r review. 2. ; Depth measurements to be made from top of hole. Form DD-97 20 TEST PIT DATA DESCR1PT1.0FQF$QjL§.-K-NjC -Q1 -T-E-R,-El):JN-.-,T-E-Sl:HOLES:... UN DEPTH HOLE NO. D HOLE NO. HOLE NO. A� G.L. oI L 0.5 1.01 1.5' ANW LoAm 2.0 2.51 3.0" b 3.5 4.01 C 4.5 :..j 5.0' 5.51 6.0''R WAMM 6.5 K- - �01 8411 C-IM 7.5' IND 8.0' 9.0 9.5' 10.0 Indicate level at which groundwater is encountered Indicate level at which mottling is observed t o 0'16 -r T z- i ^J C Indicate level to which water level rises after being encountered Co Deep hole observations made by: K. S-n9()06HqR1,To,5- Y"Y VA-T-1 Date t N Design Professional Name:-Ti—ma -r1j),, L. CRMW A. Address: 2 -,YO WM WiqL-f "YeV-P Signature: Design Professional's Seal LAJ V, 62980 OFESSO M'I'NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM.,_ . w .y. r _, _, y - : ,•,,t. 1. Name and address of applicant: h1JJJ6. r=1 cR E 0X-rA -T C ., L'T Q - q SuN4'4E T HI L C JZ 6AJ 2. Name of project: SS7"S-NoiAUA Ho1.CoW W3. Location TN: f'v-rNAn. 1/�Icc.E�y 4. Design Professional:CRotJO Ent C mJ L Rin!G 5. Address: S 'SoNtJ W AU11 'rcvD 6. Drainage Basin:r?Eeksk 1 c c Ho s c o w 7: Type of Project: Private/Residential Food Service. Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review -(SEQR)? Type Status (check one).......... .............................................. Type I Exempt Type II Unlisted A-- 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... o 10. Has DEIS been completed and found acceptable by Lead'Agency? ......:........ 11. Name of Lead Agency 12. Is this project in. an area under the control of local planning, zoning,' or other. officials, ordinances? .......... ............................... ............... ... ..._.,...�- 13" so; Have pl ............... ans been submitted-to such authorities? ...:................ l� 0 :... 14. Has preliminary approval been granted by such authorities? Date granted: A3 A 15. Type. of Sewage Treatment System Discharge ................. surface water groundwater 16. If surface water discharge; what is the stream class designation? .................... 17. Waters index number (surface) .. 'J JA 18. Is pr6ject.located near a public water supply system? ........................... 0 o 19. If yes, name .of water supply N LA Distance to water supply Ni9 20. -Is project site near a public sewage collection or treatment system? .........:...... ri d 21. Name of sewage system Distance. to sewage system N JI4 22. Date test holes observed MAf� I I,,- 2oo 3 23.. Name of Health InspectorToiF 09ftii yn r 24. Project design flow (gallons per day) ............................:::.. ............................... 1606.- 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... t-J y 26. Has SPDES Application been submitted to local DEC office? ......................... Form PC-'97 2 -27. Is any portion of this project located within a designated Town or State wetland? Aft €X 28. Wetlands ID Number ........................................................... ............................... 29: FIs Wetlands Permit required? ............................................... .(' . Has application been made to Town or Local DEC office? 30. Does project require a DEC Stream Disturbance Permit? .. ............................... . 00 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 W o 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 t J6 DESCRIBE: 33. Is there a local master plan on file with the Town or Village.? ......................... ye 'r 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................. ............. ::.... :.........._ 35. Are any sewage treatment areas in excess of 15 % slope? ... ....:......... ............... , A) 36. Tax Map ID Number .......................... ............................... Map _k 1 Block__ Lot ( 2 37. Approved plans are to be returned to ..... Applicant Design Professional NOTE: :All applications for review and approval of a new SSTS: to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other.aspects ofa 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. d hereby affirm, sander penalty of perju y, that information provided on this fopara is true to the best of my knowledge and belief.. False statesmen ade herein are punishable as a Class A grmisdemeanor pur-suaamt to Section 21® o the Penal Law. SIGNATURES - ES.- C,o j 3!i ^� ',i.r Mailing Adgss.... ............... L CRu rd 12 'moo wN MI LSH 7/_V4 1PECKSkiLL WV J6�9'C 4` t, r 05/12/2003 12:47 9147363693 CRONIN ENGINEERING 1 PAGE PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In theArnatter of application for: k); dc AC -e- l 5 / d I, rvu P u55C� '_. represent that I am an officer or employee of the corporation and am authorized to act four: Name of Corporation: /U; 0 e Acleyl Having offices at: Cl S uJs C 7- k4 I L L 12d A D l Fu TN AAA VA U VV, �� /0 S %� T� President - Name: ��JJhi lLI(1 L `i% Address: `7 Llt a Vice President -Name: Address: Secretary - Name: Address: Treasurer = Name: Address: and that I am and will be individually responsible for any and all a is of the corporation with respect to the approval requested and all subsequent acts relating theret Signed: Title: before me this - day of ,r(mQnth) (year) JOHN M. 7ARCONE, JFoirporate Seal ~~ Notary Public, State of New York No.027A5035857_- Form CA -97 oualified in Putnam Courdy�L commission Expires Nov. 14, �' 05/12/2003 12:47 9147363693 CRONIN ENGINEERING 1 PAGE 01 PUTNAM COUNTY DEPARTMENT OF HEALTH RE: Property of N I Psi A C R L E S'iA iC d L10 . Located at d. a o LL o o T/V %jTNrq wi LA L ( e yTaLx Map# Subdivision of M Block I Lot I Z Subdivision Lot # Filed Asap # Date Filed Gentlemen: ,This lettor_is_to.authorize ...'ri r4 -o_- .�h.. L .... G92 Q tq 1►Lt- a'duly l,i . ed - ofessional" gineer 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 any behalf in connection with this matter- and to supervise the const t f said wastewater treatment and/or water supply systems in conformity with the prow r v 45 and/or 147 of the Education Law, the Public Health Law, and the Putnam C unit •v 4t Colantersa ,,r{ c� ��•� ��� P.E., R.A., # C/ L�si'� r3 629&Q Mailing Address. L''`'e 'Z-10"N VJAzsif ePe� Ks K< < Statc yu w 6 fL K Zip /O 56'6 Telephone: (CI 14 w: Very truly y A.4,a-- b Signed: (Owner My) Mailiog Address qZU ; Ll State Zip Telephone:2 -f 3) - Situs: , NY APN: APN: 2800 -061 -000 -0001 -013 -000 RectSale Dt: $380,950 Total Value: $17,600 County: PUTNAM, NY Sale Price: Use: Land Value: $17,600 Use: RESIDENTIAL ACREAGE Doc #: Map Pg: 2800 -061 -000 1st Mtg $: Impry Value: $2,715.95 Card #: Map Pg: 2800 -061 -000 1st Mtg $: Lot Area: Prop Tax: $128.50 Munic: PUTNAM VALLEY TOWN State Use: 311 Lot Area: 356,321 Township: Cnty Use: 79 HORTON HOLLOW RD; PUTNAM VALLEY NY 10579 -1801 R004 Zoning: Phone: Owners: STABILE RALPH & RAFFAEL 103 CANOPUS HOLLOW RD; PUTNAM VALLEY NY 10579 -1805 R004 Census: 109.00 Phone: 914/969 -2624 Mail: 60 YONKERS AVE; TUCKAHOE NY 10707 -3910 C019 4) Situs: NY APN: 2800 -061 -000 -0001 -017 -000 Rec/Sale Dt: 05/23/2000 05/18/2000 Total Value: $200,800 County: PUTNAM, NY Sale Price: $110,000 Land Value: $200,800 Use: RESIDENTIAL ACREAGE Doc #: 151141 Impry Value: Card #: Map Pg: 2800 -061 -000 1st Mtg $: Prop Tax: $1,466.04 Munic: PUTNAM VALLEY TOWN State Use: 322 Lot Area: 1,926,659 Township: Cnty Use: Zoning: - -..Ownem F IPdN IRVINE' D ;: w,. _.. _ .._ _... ..... Eensus: _- .. ...109.00. .. d Phone: 212/423 -9883 Mail: 1170 5TH AVE; NEW YORK NY 10029 -6527 C036 1) Situs: 103 CANOPUS HOLLOW RD, PUTNAM VALLEY NY 10579 -1805 R004 APN: 2800 -061 -000 -0001 -011 -000 Rec/Sale Dt: 06/23/1989 06/01/1989 Total Value: $380,950 County: PUTNAM, NY Sale Price: $465,000 Land Value: $100,900 Use: MULTI FAMILY DWELLING Doc #: 1061 -289 Impry Value: $280,050 Caryl #: Map Pg: 2800 -061 -000 1st Mtg $: Prop Tax. $2,715.95 Munic: PUTNAM VALLEY TOWN State Use: 280 Lot Area: 268,765 Township: Cnty Use: Zoning: Owners: Owners: ZARCONE JOHN M JR & EVA G Census: 109.00 79 HORTON HOLLOW RD; PUTNAM VALLEY NY 10579 -1801 R004 Phone: Phone: 845/526 -3040 Mail: 103 CANOPUS HOLLOW RD; PUTNAM VALLEY NY 10579 -1805 R004 1) Situs: 79 HORTON HOLLOW RD, PUTNAM VALLEY NY 10579 -1801 R004 APN: 2800 -072 -000 -0001 -024 -011 Rec/Sale Dt: 10/17/1995 10/17/1995 Total Value: $266,400 County: PUTNAM, NY Sale Price: Land Value: $105,500 Use: SFR Doc #: - 1311 -228 - Impry Value: $160,900 . ap'Pg` 2800 -072 -000 1st Mtg $: " Prop Tax: $1,944.97 Munic: PUTNAM VALLEY TOWN State Use: 210 Lot Area: 261,360 Township: HORTON HOLLOW ESTATES Cnty Use: Zoning: Owners: KURITZKY KENNETH & CHARLOTTE Census: 109.00 Mail: 79 HORTON HOLLOW RD; PUTNAM VALLEY NY 10579 -1801 R004 Phone: 914/526 -3787 * Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. m Print your name and address on the reverse so that we can return the card to you. E3 Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Kenneth & Charlotte Kuritzky 79 Horton Hollow Road Putnam Valley, NY 10579 2. Ar (Tr PS F A. Signature ❑ Agent ❑ Addressee jec N d.y ( ri led ) C. Da" Delivery ar D. Is delivery address different from ite Yes If YES: enter delivery address b ❑ No 3. Se Type Certified Mail ❑ Express Mail • = • . Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑Yes i S . e Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. o Print your name and address on the reverse so-that we can return the card to you. Ei Attach this card to the back of the mailpiece, or on the front if space permits. rticle Addressed to: Ralph & Raffael Stabile 60 Yonkers Avenue Tuckahoe, NY 10707 ❑ Agent - _Q1 � 11', P ❑ Addressee B. Received by (• rioted Name) C. D e f Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type 23,Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes _ -.. 2. Article Number 7002 0460 0002 7610 3660 (transfer from service label) :102595 -p2 -M -0835 PS Form 3811, August 2001 Domestic Return Receipt •102595.02 -M -1540 M V., Postmark Postage Na netum neceipt Fee (Endorsement Required) / .. Here , " ; Postmark J v Here Z to C3 (Endorsement Required) m O Restricted Delivery Fee tD 0 (Endorsement Required) C3 (Endorsement Required) �, .• L ....�.. i 0 Total Postage & Fees $ Ralph & Raffael Stabile z ' –0 60 Yonkers Avenue C3 � orrPO'e x o. ° j < - --r Sent To C 0 Kenneth -& Charlotte- Kuritzky= .._ . to ; =? siieee, aP�: nio:; " "' " or PO Box No. No . 79 Horton Hollow Road Putnam Valley, NY 1057 ._._.-•....x 0 Cliv. State. Z/Pi 4 n ®� 0 • 1 I 4.:f�:Srr e Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. o Print your name and address on the reverse so-that we can return the card to you. Ei Attach this card to the back of the mailpiece, or on the front if space permits. rticle Addressed to: Ralph & Raffael Stabile 60 Yonkers Avenue Tuckahoe, NY 10707 ❑ Agent - _Q1 � 11', P ❑ Addressee B. Received by (• rioted Name) C. D e f Delivery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type 23,Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes _ -.. 2. Article Number 7002 0460 0002 7610 3660 (transfer from service label) PS Form 3811, August 2001 Domestic Return Receipt •102595.02 -M -1540 M C C ...En Postage $ -,o �. n r� y o - `D Certified Fee q Ot p 7t , " ; Postmark J v Here Z to C3 (Endorsement Required) < < CO Restricted Delivery Fee r` tD 0 (Endorsement Required) �. a y Total Postage & Fees �, .• L ....�.. 4 .0 ;-Te—nt To Ralph & Raffael Stabile - - -•- 60 Yonkers Avenue C3 � orrPO'e x o. ° j Tuckahoe, NY 10707 •-- •----- •-- ••••..... 0 r Clty, State, ZIP: 4 171- r ... ER: COMPL&E THIS SECTION1. COMPLETE THIS SECTION ON DELIVERY :omplete items 1, 2, and 3. Also complete A. Si nature tom 4 if Restricted Delivery is desired. g [I Agent 1 Print your name and address on the reverse X e /O� Z, ❑ Addressee so that we can return the card to you. B. Received y (Printed Name) C. Date of Delivery Attach this card to the back of the mailpiece, I `—�S�j` -r .m the front if space permits. ` f< 1. 1;rcle Addressed to: D. Is delivery address different from item 1? Mas If YES, enter delivery address below: ❑ No Irvine D. Flinn \ 1170 Fifth Avenue New York, NY 10029 - 6527 3. S ice Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes i 2. Article Number 7002 0460 0002 7610 3677 (iiansfer from service label) \ r_ /. , .;� •� Form 3811, August 2001 Domestic Return Receipt ; . � -'i.G. jA2595 -02•M -1540 C 7>" _1 Return Receipt Fee J ' / J Here Z ° (Endorsement Required) a O Restricted Delivery Fee ° (Endorsement Required) / C, n ° Total Postage & Fees $ i c0 c1 Sent To _ . __....... ....._.. -___.. _.... .__.,., ... .. y... n ----__ .. - - -• . "mlrvitle_D. Flina.. ...... -.... =. B� Street;Apcnio.; 1170 Fifth or PO Box No. Ave n u e ° -------------- Z---- -- - - - - -- New York, NY 10029 -6527 -------- - - - -•I ° City, State, 1P+ 4 r�- • COMPLETE THIS SECTION ON DELIVERY Complete items 1; 2, and 3. Also complete item 4 if Restricted Delivery is desired. Print-your name and address on the reverse so that we can return the card to you. Attach this card to the back of the mailpiece, ur on the front if space permits. Article Addressed to: Zarcone, John M Jr. & Eva G. 103 Canopus Hollow Rd. Putnam Valley, NY 10579 A. Signature . X ❑ Agent l ❑ Addressee . Received'b v ( Printed Name), C. Data of Delivery D�lkdelive address diffe4t1rom item't? • Yes if YE 97 enter delivery adch s,,below: '• ; 7 No.. . 3. Sprvice Type &Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7 7002 0460 0002 7610 3684 (Transfer from service label) PS Form 3811, August 2001 D Domestic Return Receipt I •102595.02 -M -1540 ,� -(' I 3 c [C3 Postage $ l lI/r✓ 1 1 1 n -n Certified Fee �. �: Return Receipt Fee . 1 !'7 Postmark ° ( C° (Endorsement Requires!) �.o : r . �=> L`_ _ ... . .Oac..1 ibfet•P0918yg� as Y . c • :: F -4 ......... arco ne John M Jr. &Eva G. � pt. No; � � x Al- • 3 Canopus Hollow Rd. t°` ciry,'staie; zfPr s Putnam Valley, NY 10579 ....... r.s , ,r,r i'A�aa$t9`5'�'yrst�+ •awm ® I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: /Tpow�(n,/Village: /7D o /4i` Yu1 ,AJt�1 e Tax Grid # Map (0 Block j Lot(s) Well Owner- Name: Address: Use of Well: 1- primary 2- secondary / Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length ft. Length below grade 39 ft. Diameter in. Weight per foot /Zlb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded Other Seal: ,fit Cement grout , Bentonite Other Drive shoe: _X Yes No Liner:^ Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No' Hours Second Well: ieIIal TOM ` Bailed .- - Pumped = : CompressedAir Hours - Yield gpm Depth Data Measure from land surface- static (specify ft) MA Durin -g yield test(ft) Depth of completed well in feet Well ]Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameteron) Formation Description ft. 4't. Land Surface ( ' S 964A r i fTl •'• CF) co If yield was tested at different depths drilling, list: Feet Gallons Per Minute Pump /Storage Tank Infotoation�- -i a= i c;? n Pump Type ,. Capacity � Deptha0 Model =durin Voltage eLb BP Tank Type, dm i Volume 0 6a %tiN. Date W7-/ mpl / 05 Putnam County Certification No. 007 Date of po Well Driller (signature) nul%: loxact location of weir win atstances to at least two permanent ianamarxs to oe proviueu un a separtv siiccupiaa,. A, ft Well Driller's Name d �; f Signature: Address: .6 :� .�.. . tDrs`= Date: f White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 Tel. (914) 736 -3664 o Fax. (914) 736-3693 July 10, 2003 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: Nine Acre Estate, Ltd. ° PCDH permit #PV -11 -03 Horton Hollow Road Town of Putnam Valley _ - • - . ' - - _ _ Dear Mr. Paravati: The information enclosed has been re- submitted for a 5 bedroom approval. The SSTS permit plan has been revised to show the additional wetland line as located in the field by the town wetland inspector. Please review the project at your earliest convenience. If there are any.questions or if additional information is required please do not hesitate contacting me at the above number. Respectfully submitted, Kenneth M. Murphy Design Engineer u• S� h of I �I I� now or former /; RALPH RAFF,gELE / S \ tox MOP,(' 61-1 - S _ �6 "`- .( '`ti a",dt, }r r 0 iii OF D1S7UR,9AAl D/SIURBANCE y =J -� PROpOSED BEYOND 7)1 /S �°ff ' i { L /NE REOU /RESq� "" ' j r \ P LANN /NC BOARD PER r x,11' 1:. APPROVAL pCDH pE % ��l! YVt���,, s .l + 'WE7Z L /Nfw3? AS LOC D BYEti TO W� % 1HE� WETLAND•• �.,,,",� 3r, VHANCEMENT " r a �t AREA ' `i' hR Fr u� LLAND EN CEA/ENT #1 Fo • :�\ h ^� o AREA h2 . B -� LOCA A. PROPOSED 1 O � �; .� :I STONE o f It W t y s, LIM /IS OFNWTLAN '-` LACC OS nif rdd BETriAEV4NS & BY i y �SOC /A%FS s• ' x >� PW k.,