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HomeMy WebLinkAbout2711DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -2 -24.1 BOX 23 � � , ♦ r' I ' `1■ s' , 'I It 1 6 IL 16 so 02711 Town or Village n ection Located at Sou T.y u��KUW�:�oAO ��.K•t1r �`N du Pff ;URACiC IGaNO S Block bWuE. DttlE ;,ner • Q.`fJ - _ Lot �Z =. Z �.,.; Job Separate Sewerage `System built .by, L�A 1t2oL'0 `.YoaS - Ad'd.ress cvtn St►�Il�yu , NY 1 A r ?. Consisting of OQQ Gel: Septic Tank Lo lineal Feet -`:X FOOT `- width trench Other requirements a = to '44A VC L' F I CI Water Sup PIY Public Supply, From ` Private 'SuPPIY; Drilled BY OL Addres9 } 4(fTVA QA :LL CaY r Building' `Type STY f n u No oll Bedrooms ' 3- 'Date Permit •Issued N Has trosion Control Been Completed? iEs. - is - i certify that the systems) as,listed serving the abo_ve•peemises were constructed essentially as :'shown on the plans of the completed, work (copies of which are attached),,.*: and. `_ •accordance with. the_standards, ruies end regulations plans filed: avid the permit'1sSu tl by the Putnam County„ Department of Health. Date �! Certified by + P.E._ r � l ` Address = pA 0'tl D'icense iVO: Q Z Cv rv� =Any person occupying premises served by =the above systems) shall,'promptly take is' uch action as may be necessary to secure the correction of •any unsanitary g y id'as soon as. a;public sanitary sewer becomes conditions resulting ,from such usage Approval of the separate ewers a -s sfein'shall become null'and'Vo available and the approval -of the ;private watersupply'shali become null anJ void when a.'public water suppl omes available. Such approvals are subject ^.to modification or,change when,., in the judgment of tI er of Health; such.,reyocati _., modifi tion or change „is necessary. • Date Title V fS .” -ti 4 t " s � ✓ t •. _ _ �.. -, ,,, �, ?#ist � �"'' a?.., i'si -re •� , r -r..• ,s.1 " ": _', ,. PEEKSKILL MEDICAL LABORATORY. 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 Peekskill, New York 10566 PE 7 -8777 # 43272 DATE COLLECTED RESULTS OF EXAM IN ATION OF WATER 11/16%75 OWNS DATE RECEIVED Oliver Bodine Rte 9 D Garrison 11/18/75 CITY, VILLAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED Phillipse Brook Rd.., Garrison 11/20/75 SAMPLING POINT Well BACTERIA PER ML. (Agar plate count at 35 C). COLIFORM GROUP (Most probable No. /100m1.) less than 2.2 RD S, OTAL - ppm DETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm, .15, -- in e I., O, 0= di ' ng B n o n s z; r uc d- b Y S e c "t 2*. oil �p��rI L Location otree.t Blocr. B 11 d il 'n Lot G U A u.;,-RA:,TTY OF A L L res:'�onsible, fo_ , "I, location T.ro- r n s, disposal S c ri n s 4-- c A s bn=n 0 n t, U.— a n i 1.. o n Q j7: n 7 C; 7p a t o f 0 e D aI P u t n an Col—r Depart e f S �o r Z-1 of SYS4- t e ni 'co OD era �.- e ;as causes b I I fu o r n e '-7-- ac, o -f -e o c c uD - n -t o1 t buil di_ r:7 S77stem. day of 19 0 r ES P L S 3— OF FIN,' 7 , I COIT-'�FLSTIOI-T ��ITLL B' TSS D. �i- L Zj Z, - T':' 7D To 7,TT. -7 ul. =J T R S-P U S 1 7 1 E OF D.-T�Z; C. Division of --,lnviror2-;-en-al Ifeal+ S=-"V'CeS, C,Dunty DiDepart-meni,- of, Of gield asoe Posted of different depths during drill;ng, list below $EEY iCAUCINS PER MINUTE, .... , I. t i I , 1 , tit COMP Ut DATE OF FILPonT wELL OnILLFn f lonaturo Q—' `%Lt: �. � � c• « � �'� r •...� �' � '�1`7j�'� }1 ;��., � i:x. L L T: 3 Rk•t.�..' .1 ,,... :I ., k�..�'a �. ,.. .. ;�.Iti ",�: r7iiRl;dt.wM;_ ...�.., ! : §.:.n.. .,.. ..�? .. ...}s: ., .. w ,b e�'.a•. �F..et}..., t,..,..._ ..,._ ....L.. ... ... ,HOURS O. CAILED ❑ PUMPED ® COMPRESSED AIR ,{i.Y,M. XL(L,,CONii'LCTIOiN At-PORT PUt-NAfti COU -TTY DOARTI'.4ENT OF 11EAi_T11 j1f) Ditlig;on of Environf114nta) ticim, ;.nrvtceg . (BOUNTY OFFICE LIUILDING. • CAIWEL, NEW YORK TWI% report is to be completed by ml) driller and sul••,i;ttt•d .o County Health De(variment to ^ether with laboratory repo ►o of 'rr3Tf Of J3corf a3 T, 1, Si�t��:.ry .:,,.,: i', �) y.liys a,.; tart' 6a"eriJi glldiity uClOre CCttitiCi)42 Of Construction COnTplianCC is issued. i " �iEPORT P.91JST BE SUC :!.9t1'iED t'IITHIiI 30 DAYS OF WE'LL CONTLETIO14 , Dgfeet of land NA --- ADDRESS p ®vsW96 In e surface: [LOCATION (o. 6 Streot) (Town) (Lot f:umLei) LENGTH OPEN AQUIFER (toot) • . ) SCREED, ,, ESS ® ❑ ESTAEIISHMENT 0 ❑TEST PROPOSED: DOAImm FAR1A WELL i USE Oi :.' Diameter of well including GRAVEL SIZE (inches): FROM (toot) .•� TO (toes) L ❑ SUPPLY ®INOUSTRIdI AIR ® CONDITIONING ®Spe ify) PACKED: gravel pack (Inches): '' COMPRESSED ❑ ®A R PERCUSSION ❑ PERCUSSION ❑ I4W6 SWACL fAU1PMENT ROTARY ((Specify) 6AS11e(3 ,,_... - LENGTH (feet) OIAMETER(inches) WEIGHT PER FOOT - -_ - _ ._. n 4YDl A/1[A nWIil nif1 �PIJ�OE F< n► ,7,7tf �'�n Vre A Nt,` C� t.Tm7- �iVn Of gield asoe Posted of different depths during drill;ng, list below $EEY iCAUCINS PER MINUTE, .... , I. t i I , 1 , tit COMP Ut DATE OF FILPonT wELL OnILLFn f lonaturo Q—' `%Lt: �. � � c• « � �'� r •...� �' � '�1`7j�'� }1 ;��., � i:x. L L T: 3 Rk•t.�..' .1 ,,... :I ., k�..�'a �. ,.. .. ;�.Iti ",�: r7iiRl;dt.wM;_ ...�.., ! : §.:.n.. .,.. ..�? .. ...}s: ., .. w ,b e�'.a•. �F..et}..., t,..,..._ ..,._ ....L.. ... ... ,HOURS O. CAILED ❑ PUMPED ® COMPRESSED AIR ,{i.Y,M. TILLV (U.P.M.1 1TESU {'t . . " rr MjA3U4E FROM LAND SURFACE— STATIC(SPeoity !TAING YIELD TEST fivep , Dgfeet of land In e surface: LENGTH OPEN AQUIFER (toot) • . ) SCREED, ,, .i) R DIFFATL$ . SOT SI E QIAMETER (IneQ e8) - OF. GRAVEL Diameter of well including GRAVEL SIZE (inches): FROM (toot) .•� TO (toes) � PACKED: gravel pack (Inches): N aROAi I4W6 SWACL FORMATION bESCRIPTIOtd Sketch exact toca on of well wtfh oist]ncoi, to at tees$ $i:eT tY :: ►660 , two permenent lanamerks. ,7,7tf r. , Of gield asoe Posted of different depths during drill;ng, list below $EEY iCAUCINS PER MINUTE, .... , I. t i I , 1 , tit COMP Ut DATE OF FILPonT wELL OnILLFn f lonaturo Q—' `%Lt: �. � � c• « � �'� r •...� �' � '�1`7j�'� }1 ;��., � i:x. L L T: 3 Rk•t.�..' .1 ,,... :I ., k�..�'a �. ,.. .. ;�.Iti ",�: r7iiRl;dt.wM;_ ...�.., ! : §.:.n.. .,.. ..�? .. ...}s: ., .. w ,b e�'.a•. �F..et}..., t,..,..._ ..,._ ....L.. ... ... PUTNAM COUNTY = .DEPARTMENT HEALTH r Division of 'Enwronmenial Health SerI A 4ces Carmel N Y 10512 ' ' CONSTRUCTION. PERMIT FOR SEWAGE DISPOSAL SYSTEM vF r LjT�J /A ? r ,�`/ I.LF( ��,Town ory illage �o�ated at Y oUTFI N[ <[1 C•AIJ'D �t7/lri Sact�an _ 2 3 �,, t, �,. loc Subtlivision _3 Lot ,,- r +Job Owner �{:(�jUa R +4 oiAj 11 -I-AQ r /� Address 5 /lJ Building Type /� S TY F2` 'M C Lot Area _,d'1 4'9a' . /1C.r Ditl-rliq E 1' s �r Number of Bedrooms 3 Total. Habitable Space= 2q�D Square Feet 5eparate.5ewerage .System. to consist of T - ..Gal Septic Tank �• 8 "• I�neal - feet4X 3 F'�•. width trench Ltd l.'M c� 5 To be constructed byD Gat• Pa CSi? (�,�{� Address �� �t, Water`;Supply: Public �Suppiy From [a r` s 7 - -2 a� uc, Iz t: Y X. Private Supply' to'be drilled by [ n Ad ress 1 L rii�•C Other Requirements Cj'U.I;TA �E, �Lf'l. [,►!lL'�. ( E .Ui:�'OL.,d 20 iG( IA. 6M7F6ET' ' I represent that I am wholly and completely responsible for the design and location of ahe proposedz system(s):;.1) that;the separate sewage .disposal `system '• etiove "described will be constructed;as shown on the approved amendment there to and•.'in. accordance witlY.the standards, "rules -an regu a ions -o e ' Putnam County ,Department, of Health,' and that on completion.thereof a .Certificate.`. bf'Construction Compliance satisfactory to 'the Commissioner of 'Healthwill lbe. ;submitted to the Department,' and. a, written'guarantee• will be furnished,ahe, owner h�s'success6rs,;.herrs or'assigns`by'.tlie builder, that said builder will . place in, good operating 'condition'.any part of said': sewage_:ilisposal system.`durmg the period: of two'(2) years immediately,•followJng the date of the Issu- ance of''the- approval of.''the .Certificate of :Construction ,Compliance `of the.originaPsystem or.any, repairs thereto ij :t iat the drilled .well described above, will,be located as shown on,the approved plan and that said well; will be installed in ac rdance with the'stantlar rules'. d :regula, i�'ons of, thee. Putnam. County Department .6U.' of Heal h 3 " =7 E:. Date Signed P R;A Y f Address n License No. APPROVED FOR CONSTRUCTION; Shis, approval expires one yea tom t e 'date, issued unless .construction of the',6uildirig has been undertaken, and .is ►evocable for cause or. may be amended or,modified`When corisidere neces y,.by the ,Commissioner . of - Health. `Any change ' or- alfe'ai16n ;of construction �requires.a new, permit. Approved. for dispospal�ofdomestic' sanitary =sewageand /or prwate water`supplyOonly.. }date. _, . - ..,y.a -Y Pu - �•t,^^T �r.+4^r{ x,t`x. - -4 - "i' ti ,k a:"' �g 1�,�i ``^�a'u'c ",,�a sy-s;r+n �. +e.,' "'Iy: YS . ^•^. °' �. ...r'"?. .. 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DNISION OF ENVIRONMENTAL HEALTH SERVICES Gentlemen: Date 3. l 1 7 (73 C 't Re: Property of I- k u ,= -Q 1A, b d p ;o E . 1a , Located at 'Soo-rg Section Z3 Block 5 Lot 2. 2.m 1 This letter is to authorize SAMC S�d AN oEas(yj a duly licensed professional engineer or registered architect (Indica� to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the Putnam County Depar�ier�t vi nedltil, and to sign all necu:38ary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or tary Code. OF NCMY I. ANt Counters 24 P.E., %-�, #, Addres dA-1 Woc l< P-oa0 (seal) Q2A- 301 Telephone _and__ t l:;e_.Putnc.rb:-X blinty �`Ss:r�._:::,. Very truly yours, Q Signed —� Owner of Property csU.rrvv�ut Addresks -_ o 1— , I `ale ep one PUTNAM COUNTY D£PARTMEPvT OF *HEALTHY ' DESIGN DATA SHEET - SEPARATE. SEWAGE DISPOSAL SYSTEM FILE NO. Owner I V C 1100$�E , � Address- �/U�YR-7LC StrzC- T /V16AJTVAC.0 fAil . Located at (Street) uTU uii.LALA jo &0' See. .5 Lot � •� � (Indicate nearest cross street) 1(3, s t reetM ►tee � 0 u s t4 o i i c ry R . AJ C 44 L .Municipality PvTcJ� VA" c �`� Watershed . CAA3.a A V.S �- QC -:eJC SOIL PERCOLATION TEST DATA REQUIRED:TO.BE SUBMITTED WITH APPLICATION Hole Number. CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water Level No'. Time' From Ground Surface in Inches Soil Rate Start Stop Min. Start Stop Drop in Min/in.drop ;;Inches Inches Inches l g: 2� 3 2 3 9: 07 4: 34 .Q i 3 4 2 12 3 Co 3. d 3 7 0 za . �; 4-7 17 4 •5 1 2 . 3 -- 4 5 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are ob- tained at each percolation. test hole..A.11 data to -be submitted 'for review. 2) Depth measurements to be made from top of hole: - I . 78" 8 Orr INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED 00 C INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY -aj MC5 A,0 OL- s404 Date 3 617 3 DESIGN ov£IL Soil Rate Used cl Min/1" Drop: S.D. Usable Area Provided 5000 tj�- No.. of Bedrooms 3 Septic ' Tank Capacity 9OP Gals. Type M CA9•T Absorption Area Provided 'By L $Q L. F.x24rr 36" A width trench. Other gAttc 15 71n Ar. -rdtir_ Tn 710t%tjiAr?. AT (..CAS? 7' A8 -00m 4.ulT AflIx (?ll N A Soil Rate. Approved Sq. Ft. /Gal. Checked. by_ Date PUTNAM COUNTY DEPARTMENT OF HEALTH (� 1 L'rU �'� G,� LL DIVISION OF ENVIRONMENTAL HEALTH SERVICESi FINAL SITE INSPECTION Date: Inspected by: .�.�.y _ .._:'�. �...•f .%- "1'`. lr "��i �SVi� 1'i /�..� _C Loor, .. Town PLMIA ALL-0 Permit # - /JS— o -3 TM #- (a i 0 2 a- , / Subdivision Lot # NIA 1. Sewage System Area a. STS area located as per approved plans .......... .. ................ b,. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth C. Natural soil not stripped .......................................... I....... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank size 1,000 .....1, 250 .........other ................ b. ' Septic'tank iris t evel ................ ............................... c. 10' minimum from foundation .......... ............................... 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 .......... ............................... 6. Trenches l/ 1. Length required /0 Length installed /00 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % .................... -- 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum .......:........... . g. 11P0u: riFip i} Q ends capped... ......... .... ................... or Dosed SVstems 1. Size of pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ....... ............................................. 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. house located per approved plans' ... ....................:.......... b. Number of bedrooms ....................... ............................... IV. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured ft........... c. Casing 18" above grade ................ .............:................. d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... A Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ................. ............................... Rev. f2/02 ,/) 6 / -/--/ a `1/ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEMV A M PERMIT # 1911J' — Located at c9 %So,V;rH /H vz /�D l Subdivision name fI Subd. Lot # �✓ /9 Date Subdivision Approved Town'or Village ��vi •✓/� �i �� ���� Tax Map 61• Block -2 Lot Renewal _� Revision Owner /Applicant Name AZh'RY 10 447 Date of Previous Approval 7' �• Mailing Address6i.ffo;��/ 111gH1,iWb AoA b f /bow Zip Amount of Fee Enclosed Building Type/ f��Ei✓ri9 Fill Section Only No. of Bedrooms / Design Flow GPD '), DO Depth Volume Separate Sewerage System to consist of gm gallon septic tank and /d0 0/- oz. -/'/ GJ z- ,0 104 �• e-xrz e) l r -T 0 -C Other Requirements: To be constructed by</.S,FoZi ,L, • ..5 o A/..V Address d ®% Water Supply: Public Supply From Address - Pfivate guppiy " I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. %� R.A. Date .3 % Address &q Wig -rSp C. /17 1 gs /b WX License # 061jrPT. 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 anew permit. A�rr �e of .sewage only. lam' By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design ofe onal Form CP -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health 'r LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 13, 2006 Badey & Watson 3063 Route 9 Cold Spring, NY 10516 To Whom It May Concern: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection - Ganswindt 69 South Highland Rd. (T) Putnam Valley, TM # 61.-2-24.1 The above referenced separate sewage treatment system can be backfilled. ­stlom, -p eace -'cc-tactnne a+­,8451- 278 30 cxt. 5-5.­- _i­1 .11 .. L i� , .../ ,.,¢E I V L Z� _L L11' Jli�,r. q, Jf yoll—have-any .;JD:kly Sincer Joseph Digit Environmental Engineering Aide Environmental Health (845) 278-6130 Fax (845) 278-7921 Water Supply Section (845) 225-5186 Fax (845) 225-5418 Nursing Services (845) 278-6558 Fax (845) 278-6026 WIC (845) 278-6678 Nursing Home Care Fax (845) 278-6085 Early Intervention /Preschool(845)278 -6014 Fax (845) 278-6648 DEC-13-2006 08:.7-9 & PUTNAM COUNTY DEPARTA&ST OF HEALTH DIVISION -0F,XNVIR0NMENTA..-k,: HEALTH SERVICES ATTENTION . Fli JOSEPH GLNE, X Jo, e Digit P.01/01 REQUESTFORMAL-USSPECTION JKr. FM Dft: 12/1312006 Trmclw PCHD C a k Pennit # Located- 6! .R.I. auth Hidiiiand k0ad, Garrison CKmjWAppjjcantNatr= Mary & Thomas 0answincit Black 2 Lot 24.1 .... ...... . . .. ..... Runedy- NIA N/A Ts *,mm fiff emVietar XIA Is *,,Oem YES. Is system constructed as pa pIxis? ------ - YES Ts well ddfted? Existing. ... Exist_ ....... Is well looted as per plans? Phk • Are erosion control measmz mplaa.,' ..YES Dak-, N/A DOW,- 12/1312006 DBL- we I ceWfy that the systiam(s), as -at. *w, aWw p&wnj9w hw,.b= oorjstiuc�d and I have inspected and verified their corq4t ion wdi K.-MbonstuctimPermit and approved plaris and the Suffid's6si, f4uk s. and Rq0,Wy of die. ftnan Cou* Dqpart<n�t of HeMi 'tif 12JI�T iWi' - - -i " Dal-- jed BE X RA Badey & Watson; P;G A061fouie Q.,(.'oW:3w4nq,.NY Lj-, # 062505 Curanwk Mr. Digit, the tr "'ip On. . d an rea*f*' Forni FM-99 TnTAI P L711 DEPARTMENT OF P. 1 Paa � 1�i 1 � � "+y� � 1 44 OF gR J '' i i Y + i( Q/s i + DEPARTMENT i i i '�, ! CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at (,Q SouTH H 16,11LA.uh &A1? Town or Village PU T►JAm V ALLY Subdivision name lj JA Subd. Lot # __�j Tax Map 6 1, Block 7_ Lot Date Subdivision Approved 6! Renewal Revision Owner /Applicant Name p�q FY TT WmA6 CQA hj5LJ W Q Date of Previous Approval Mailing Address 6cl Soon I-1 i(%0j.Awt% Rotes ��� Zip /052& Amount of Fee Enclosed I Inp , no Building Type Qgsipga TjM_ &YA9 6 Area Z.gBb No. of Bedrooms g_ Design Flow GPD 2 c) Fill Section Only Depth Volume PCH D NOTIFICATIONI IS RE UIREID WHEN FILL IS COMPLETED Separate Sewerage System to consist of I , npp gallon septic tank and I oo i., F o F 2., " W ODE ,A050 ALF110 J `fR-E_WCJ4 ;5 SPACE i 6 FT- Q. C. Other Requirements: To be constructed by -14APt)LI) L Yo N6 e Scqjs Address pT. Cf COLD SPL P& 10Y I oSi 6 Wateir Supply. Public _Supply From _ Address or: y_ Private Supply Drilled by ( DfX %5T ttj&) Address — I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in.good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. R.A. Date C2q Q3 License # 06Z51p57 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 anew permit. Approve-" r-d' _ a4ge of domestic sanitary sewage only. By: Title: S_<:` ----' Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desig rofessional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE: Property of LETTER OF AUTHORIZATION Thomas and Mary Ganswindt Located at 69 South Highland Road T/V Putnam Valley Tax Map # Subdivision of Subdivision Lot # Gentlemen: This letter is to authorize 61 Block 2 n/a n/a Filed Map # n/a Date Filed John P. Delano, P.E. Lot 24.1 n/a a duly licensed Professional Engineer or Registered Architect _ to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. Countersigned: P.E.,1Z+ U 062505 Mailing Address Badey & Watson, P.C. State 3063 Route 9 Cold Spring New York Zip 10516 Telephone: 845 - 265 -9217 Very truly yours, Signed: (Owner of Property) Mailing Address: 69 South Highland Road State Telephone: Garrison New York Zip 10524 845 - 424 -4775 Form LA -97 BADEY & WATSON LETTER of TRANSMITTAL r ..- �a7r:• F %��',�ii'G� %r�,.rr: �a(.� �sTfr�'��'� �PYl'i:'y r� `..o-���s'+,"_.,wsv . . 9w...... :. ra. .:�.n.. ,. .n. - _.... -_ _r.....r, s ..m Il� .o �'�,..: -. _[z -. ma:...R�7aw'o -.. 3063 Route 9, Cold Spring, New York 10516 Date: 15 Apr 2003 File No. 74 -122 W. 0. # 14475 RE: Proposed SSTS Ganswindt TO: 69 South Highland Road William Hedges N/A Subd. Lot No. N/A Putnam County Department of Health Tax Map 61.-2-24.1 1 Geneva Road Permit/Title/P0 # ]Brewster, NY 10509 Sent via: US MAIL El UPS -NIGHT 0 MESSENGER UPS -2 DAY PICK -UP UPS -3 DAY FAX 11 UPS -GRND El We are sending: UPS -COD copies date description of document 0 14 -A r -03 Construction Permit for Sewage Treatment System 0 Letter of Authorization 0 I lApplication for Approval of Plans for a Wastewater Treatment System 0 15 -A r -03 I Short Environmental Assessment Form 1 ❑ Desi n Data Sheet ® 14 -A r -03 ISeparate Sewage Treatment System Sheet 1 of 1 - 1- F1.t1:.mSLeet -1�2 ❑2 115-Apr-03 Floor Plans Sheet 2 of 2 1 12- Apr -03 — ❑ jApplication Fee REMARKS: Copies to: ]File Yours truly: John P. Delano, PE Tel: (845) 265 -9217 ext 12 ]Fax: (845) 265 -4428 ]Email: jdelano @barley- watson.com 40 40-05 509813 623889 21215 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES rA PRON'AL Vr -PIA-I li���r 011':.:;'.'.:. :•.: :'.;: _ ..d A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Mary &.Thomas Ganswindt 2. Name of project: . 4. Design Professional: '69 South Highland Road Garrison, NY 10524 Ganswindt 3. Location: TN: Putnam Valley John P. Delano, P.E. 5. Address: Badey & Watson, P.C. 6. Drainage Basin: Hudson River 3063 Rt.9 Cold Spring, NY 10516 7. Type of Project: v� 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) ? ------------ Yes/No Yes Type Status (check one)_ _ _ _ _ _ _ _ _ _ _ _ _ Type I _ ---------------- .---- Exempt Type II _ Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? Yes/No ----------------- No 10. Has DEIS been completed and found acceptable by Lead Agency? Yes/No No 11. Name of Lead Agency Putnam County Department of Health 12. Is this project in an area under the control of local planning, zoning, or other, _ ...., r.... _ ° uifi�tals; orurnances . �Yes%N o --------------------------------------------------- Yes Yes/No 13. If so, have plans been submitted to such authorities? ------------------------ No 14. Has preliminary approval been granted by such authorities? No Date granted: N/A g Y g _ 15. Type of Sewage Treatment System Discharge ------------------ _ surface water �[ groundwater 16. If surface water discharge, what is the stream.class designation? N/A ---------------------- 17. Waters index number (surface) --------------------------------------------------- N/A 18. Is project located near a public water supply system? Yes/No ----- - - - - -- ----- No - - - - -- 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near,a public sewage collection or treatment system? Yes/No No 21. Name of sewage system NSA Distance to sewage system N/A 22. Date test holes observed 10/12/2001 23. Name of Health Inspector 24. Project design flow (gallons per day) 200 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required? No _ _ _ _Yes/No 26. Has SPDES Application been submitted to local DEC office? Yes/No No Form PC -97 Page 1 of 2 27. Is any portion of this project located within a designated Town or State wetland ?_ - - - Yes/No 28. Wetlands ID Number 29. Is Wetlands .Permit reouired? _ Has application been made to Town or Local DEC office? No N/A Yes/No i. _ . No. Yes/No N/A 30. Does project require a DEC Stream Disturbance Permit? - - - - - - - - - - - - - - - - - - Yes/No No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal,landfilling, sludge application or industrial activit Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? Yes/No No ---------------------- - - - - -- DESCRIBE: 33. Is there a local master plan on file with the Town or Village? --------------------- Yes/No Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ----- -------------------------------- Yes/No ' No 35. Are any. sewage treatment areas in excess of 15% slope? Yes/No No 36. Tax Map ID Number ----------- Map 61. Block . 2 Lot 24.1 37. Approved plans are, to be returned to ------------------ _ Applicant Design Professional T T i.: _A,l' applicatio n s f?roryr� 1�UU x'1111- .�1i5pi��S�;:�:.n a Y1P,w SSTS.to Die - located within t�i1PzNYC Wat ?TCt1Fd Ch--" 1. be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects. of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 1., the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge `and belief. False statements wade herein are punishable as a Class A misdemeanor pursuant to. Section 210.45 of the Penal Law. SIGNATIr RES & OFFICIAL TITLES. ?4� Mailing Address: ;`.Badey Vii. Watson,, Surveying & Engineering, P.C. 3063 Route 9, Cold Spring, lY 10516 Form PC -97 Page 2 of 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -...�. _:.. ,- a.r '•��.....� 'L1JI.;1�:;1V - ���� �� ,�:T :. -���1•�7iv`%2�'l;i� � c.'v�H►�� 1i�ittle:�-Yi��v �� ���.�iVI`...: ;�. _. �.. �v.� ....� Owner Mary & Thomas Ganswindt Address 69 South Highland Road, Garrison, NY 10524 Located at (Street) 69 South Highland Road Tax Map 61. Block 2 Lot 24.1 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Date of Pre - soaking SOIL PERCOLATION TEST DATA 10/16/01 Date of Percolation Test 10/17/01 Hole No. Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (Inches) Start - Stop Water Level Drop In Inches Percolation Rate Min/Inch A 1 1:06 1:18 12 19 — 22 3 4 A 2 1:19 — 1:32 13 19 — 22 3 4 A 3 1:33 1:49 16 19 — 22 3 5 A 4 1:50 2:06 16 19 22 3 5 A 5 2:07 — 2:23 16 19 — 22 3 5 1 — — 2 3 — — 4 — — 5 — — 1 — - 2 — — 3 — — 4 5 — — NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. I Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED III. TEST HOLES T1 T Tl TT,�T .. 'TT/ T F._�TA _ �. _ ... _ ..TT(��. TAI/' TT��'T T. AT/� G.L. Tosoil (2 ") 0.5' Silty Loam 1.5' 2.0' y 2.5' Fine Sandy Loam w/ Stone 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' y 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered bone Indicate level at which mottling is observed None Indicate level to which water level rises after being encountered N/A Deep hole observations made by: GAA, Badey & Watson, F.C. Date 10/12/2001 Design Professional Name: John P. Delano, P.E. Address: Badey & Watson, P.C. 3063 Rt.9 Cold Spring, NY 10516 Signature: DesignwProfessionaPs' 'Seal Form DD-97 (P& 2 of 2) PROJECT ID NUMBER 617.20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only RyF,.QJ �1�A�- O I... _- ...... T. r I 1 `' P t`e;- .c_.:� vl• -._ - _ -. ._ ... ...�:J..:...,_.L.v ..��t.y.aT :. o. �.., r�,: am. �� .:��i!�:G3F.�vn�.:Fx«'{'�K�' III+' �' ir'+ si�"% 7v` i3' LF.' F%` nwS'. �... �:.. i.. .-„ v- �,.. mi• s•::'..,.`:. �- �..,. ie:.-.>:. r% .:.....•r..�.o.,�+.- ,,..w::w.. 1.APPLICANT /SPONSOR 2. PROJECT NAME Mary & Thomas Ganswindt Ganswindt 3. PROJECT LOCATION: Municipality Putnam Valley County Putnam 4: PRECISE LOCATION: Street Address and Road Intersections, Prominent landmarks etc -or provide map 69 South Highland Road (see map provided) 5. IS PROPOSED ACTION ® New Expansion Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: New garage /workshop with a seperate SSTS 7. AMOUNT OF LAND AFFECTED: Initially <1 acres Ultimately <1 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes ® No If no, describe briefly: Setback variance 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ® Residential Fl Industrial ❑ Commercial Agriculture F] Park / Forest / Open Space ❑ Other (describe) Single family homes on 2+ acre lots 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) xYes No If yes, list agency name and permit / approval: T/ Putnam Valley - Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ® No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? Yes ® No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name John P. Delano, P.E. Date: 4/15/2003 Signature _ �� / — — Design Professional for applicant �:✓ If the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? Yes No ��: ilJf" ��F�i'. ili3iL` l�' �l'. ��% �l. l�l�i' tL111VA11CUY `PZEVItVN'l;N��'KllVll'igL� ��1K 11f��IJI'f= U- Hliiltl�V� l�t'tiiv�'�t�Fc, F�HR' i' 61 't`t'i` ?'if'�vo;'ariegati�e'�' declaration may be superseded by another involved agency. Yes a No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: 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: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If yes, explain briefly: Yes F� No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain: ❑ Yes 1-1 No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting mat gals: 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 prppag—edWn on the environmental characteristics of the CEA. F-1 Check this box if you have identified one or more potentially large or si nificant averse i s which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. —1 Check this box if you have determined, based on the inf rn and ana I e and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environrry�n Impacts vide, on attachments as necessary, the reasons supporting this determinatlon. Z Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead , Title of Responsible Officer Signature of Responsible Officer in Lead Agency *? Signature of Preparer If different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH SION OF ENVIRONMENTAL HEALTH SERVICE CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # A l 15 - o5 Located at &9 -500V 4AU l M0 Z040 Town or Village (T) `,:��" \1 v Subdivision name 94 Subd. Lot # dA Tax Map tot. Block 2 Lot 24, 1 Date Subdivision Approved Renewal _� Revision Owner /Applicant Name NVIN° JNDA45 6g%VJ-'A-,JW a j Date of Previous Approval _ 03 of O5 Mailing Address 69 5aX�i a 0 %3 I-ZJ:)Ao (LTh!'b2J56JJ, IJ`4 Zip .I05ZLA Amount of Fee Enclosed N 5DO, 00 s &a ,) S8SNo. of Bedrooms 0 _Design Flow GPD Building Type (�At�. �a�+cy�o�L,ot Area Z• gn Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of O ,QOO gallon septic tank and 100"' OF Z4" Other Requirements: 4,ZWM LIM2- F)'ZOM C4ZAL; - 1Z) ' ilc- j1W\C.. (� � To be constructed by 010LO L IWS SW5 Address C.a�� � ► �'`� 1 �5l(� . Water Supply: Public Supply From Address or: ..._ rYivate 'Sippiy i�rilea n� . �: ��a �'� ^; .� . .._...... _ ._ Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will.be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. Date ° oa 10+ Address M '3F-y IVV*MS j I P- LCX-0 )r-610 License # CXOZ5 05 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 permit. Approved for discharge of domestic sanitary sewage only. By: Title: 'y�" Date: Fite- copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF.-ENVIRONMENTAL .HEALTH SERVICES_- _ -- .. �..- 1�r.:^ r..-.,.:.. �_:-:: �s�.. ro..-:"= '�y'Y.r�.vK•�_.tKV.Y.N:��:..st ra..F..l....:.y.,• -�O -Y:'. �.'= YiK..•_�� :• aSf:: I r%:t' it• '�:.1^..:..R...- ��vc�:..C.:,��r K. r >faia•?..RY^Gi'Y�C � <. .. �. �•�•. •f i _ RE: • Property of LETTER OF AUTHORIZATION Thomas and Mary Ganswindt Located at 69 South Highland Road T/V (T) Putnam Valley Tax Map # Subdivision of 61. Block 2 Lot 24.1 n/a Subdivision Lot # n/a Filed Map # n/a Date Filed Gentlemen: n/a This letter is to authorize John P. Delano, P.E. a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wtewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health a���,•znd: the; Putnam. ^ -.s,rty.Saia:t Countersigned: P.E., M # V 062505 Mailing Address Badey & Watson, P.C. 3063 Route 9 Cold Spring State New York Zip 10516 Telephone: 845- 265 -9217 Very truly yours, Signed:,P�ur�i,��,�r� (Owner of Property) Mailing Address: 69 South 11ighlaind Road Garrison State New York Zip 10524 Telephone: (845) 424 -4775 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ��"v..R.:•�.KD'M�M. . e.M'.: tT- aF"1J' =�:�4 _ _ _ _ _- .-^. .1T+N:.. :n-�n.s-+la LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health . . December 13, 2006 Badey & Watson 3063 Route 9 Cold Spring, NY 10516 To Whom It May Concern: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive -v:•F. :. �'.K � w . {�.� °1 :.r.. " ..- q:vC:'v.. ^!tvr. �c•.C�y F!'rr!•^AIrv. ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Ganswindt 69 South Highland Rd. (T) Putnam Valley, TM # 61. -2 -24.1 The above referenced separate sewage treatment system can be backfilled. t '1310-ext.-2-1155 r _....7f:rt�i b.t sYeta >�?y_iii�.h�:i;cgn'iiehsYlea� cd t� me a'(345�'2�'8 -6� . .. _... . SIseph { G' J igit E nvironmental Engineering Aide JD:kly 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 &-.WATSON LETTER.of TRANSMITTAL -BADEY Engtheen—n-g-7F.C.- 3063 Route 9, Cold Spring, New York 10516 Date: 24 Jan 2007 File No. 74-122 W-0-# 17156 RE: SSTS Permit Renewal Ganswindt TO: 69 South lEghland Road Joseph S. Paravati, Jr. NIA Subd. Lot No. Assistant Public Health Engineer Tax Map 61.-2-24.1 Putnam County Department of Health PermitfritIM # I Geneva Road Sent via: r, NY 10509 US MAIL 11 UPS-NIGHT MESSENGER El UPS-2 DAY El PICK-UP El UPS-3 DAY El FAX El UPS-GRND W We are sending: UPS-COD El copies date description of 'document F-11 120-Jan-07 I [X Iiqation Fee - $560.00 F-41 109-Jan-07 —1 lConstruction Permit for Sewage Treatment System ::1 ILetter of Authorization F-11 113-Dec-07 Field Inspection - Ganswindt F41 108-Jan-07 :j ISubsurface Sewage Treatment System (SDI4478R03) F F-1 I F-1 I 0 -11 REMARKS: Copies to: File Yours truly: Jason R. Snyder, Assistant Engineer Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com 40 40-05 509813 623889 31901