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HomeMy WebLinkAbout2715DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61. -2 -28 BOX 23 �x ' �■ . lo-irmi IN A� r ` LO'.I L �, . F 02715 ...v♦ ��. .V�.i ^-.. � �. .ao-:aw!.- +..�-.�:.- ..�- .rn..a svar� ••t-t:..tl....z��•t.��.-- .16�ve PETER C. ALEXANDERSON . County Executive Ms. Pamela.Kasa 2 Charles Street Apt. 5F New York, NY 10014 Dear Ms. Kasa: �� � i. Nve .n_. :.. +_:►� •— �arsws�� •l•'. .y.—. .sb •.R:•�•em.a6nv�.N M�..:�.M– Y..ew•l DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 June 6, 1989 Re: Addition - Kasa Philipse Brook Road (T) PV - TM #23 -5 -1.11 ENID L. CARRUTH. M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director I have received and reviewed the plans for the proposed addition on the above mentioned residence. The plans indicate that the addition will be 27' x 16' master bedroom. The "As Built" plans for the sewage disposal system indicates a three bedroom design. A total of three bedrooms will exist after the addition is complete. A review of the survey indicates that sufficient area exists to expand or repair the sewage disposal system, should it become necessary in the future. Therefore, the plans for the above mentioned addition are approved with the following conditions: TQ..r��>nher.. of..:bedrooms not to exceed three wi thou ,__.�... -D arfcrieni - —A -p- `rovai: If you have any questions concerning this matter, please contact me at your convenience. LCW: j r Very truly yours,. Lawrence C. Werper Assistant Public Health Engineer sa�4• tf}', ;., , r v. r+1:• v it e` kM err z rip Ott`• x o' y, ! F .# ✓ t k ,°• Et_S� Ri_ rfOi-v�� � ''., . � �✓..�:ti •- .r - r .�. - r .�f` 1 .ti � •., .* �w }w." ' � f � l ,+ ly ' 1 r� _.,ir t��/ � r.� d Q +,� t�, .!• �d ,•? ,, t � , � t�R• yh� x f '�+> ' .} �,. a• ` �1 1 i� r! 's r p r lY*i + � ^i' fi 1r J` Y , t. 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Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM r ? 1 Town or Village 1b0� / 3 Located ' at Block Owner Lot Job Separate Sewerage System built by Address+ ' of 14® 0. i * i Consisting Gal, Septic Tank_' lineal Feat X width trench a -: Other, requirements Water Supply: P blic Supply From ut�'•. r� ``/ ;; ivate Supply Drifted By Address��i �(•1i f jj'�{LG,E,s� �y,�r. t Building Type E�1��"_._` ,��r No, of Bedrooms Date Permit Issued D( rR- Has Erosion Control Been Completed? yy '� noVESa�o y 1 certify that the system(s) as listed serving the above pre w ' e i as shown on the plans of a comptetetl work (copies of which are t $ '.'':, i•, attached), and in accordance with the standards, rules • ns; the permit issue by th utnam County Department of Health, �jT ��� �� R ;Date V 119p�p/.•2 P.E. A.' { c ta P 2-7 X-0 i Address License No., 02 � 11 ny person occupying premises served by the above em i. a s action as may be necessary to secure the correction of any unsanitary nditions resulting from such usage. Approval of {ta sewera am all become null and void as soon as a public sanitary sewer becomes ' i. ailabie and the approval of the private water sus• ;•: ; :, ;:', : ;^ `.:':.:_ pply u9�C+�- hen a public water supply becomes available. Such approvals are blect to modification or change when, in the judgme tiI* is b of- Health, such reXps3tkic6 modification or change is necessary. e Y c• to �. By Title f :j. J t y;l 1- , t• d.• •1 . .; a .'. .. •. ... ,. .. ., .., .• , _ .. .♦ ...'.s .r 't E. : • 4: v, t: i. J,iCJ ,• i - tt - PUTNAM COUNTY DEPARTMENT OF HEALTH { Dil%is�on of Environmental Health Services Carme% N Y 10512 1 I.CI w c r� -r.��, STF n S;S rt CI ..!� t % r•e 7 C, lea r• i �_. r - .r'.'� .+rf .s II'�'�':.. i��, n � _�: ��^�:- ��...C,Z_ �,., r.: I.�Tte�• - o ' ' "� " Town or ,Village -�- . $� It',al� SON L� • „: Located at - Gv ..� Bloc ' n k Owner' Lots b �c�4 �onDST� s, Lc Separate Sewerage System built ,by - Address �� Cons�stmg of Gal; Septic Tank �'*�' Lineal Feet X� width trench' I Other requiiemenfs <- ' Water Supply Public'SupplY, From Private: SuPP1Y..DrUled BY Address L. Building TYPe >� SID A� /A4` No of Bedrooms Date Permit Issued Has I' on Control Been Completed? ' a c : pfE$S /p� i certrfy that the systems) as lated serving the above pie w e i as, shown on the plans of a completed work (copies of which are 4..., .. q . attached) and in accordance with the standards;, rules ns ip the permit issue by th , Putnam ,County Department of Health ,, bate �dl E� M P.E. R A Address a' 4 M '�/ License No { Any person occupying premises served by ,the above em �i t a s action as may be necessary to secure the correction of any unsanitary ' - ,conditions resulting from such ;usage (Approval „of f@te'�sewera em all become null and,void as soon as .a public sanitary 'sewer becorn ` :. availab a and: the approval of .the: private,w; r.. supply: u9 hen a public` water supply becomes available. Such approvals are ;ub)ect'to modification or change when; = n the_)udgme„ tF� is ,of Health; such °.rev modification "or change is necessary '' S ...Date 4- .. BY Title - PEEKSKILL MEDICAL LABORATORY 1879 Crompond Rd. Barclay Plaza Bldg. A, Apt. 1 �7 _Y;c- - 1-roik 1(�.S.�j ,. .. :�' .7 nn J Vlr GAP1m In M I IV IM {Ji VIA 1 r—K OWNER W��Wm�im CED BACT8RIA PER L. (Agar plate count at 35 C). COjppIF--ORMGROUP (Most probable N6. /100ml.) HARDNESS, TOTAL -ppm DETERGENT - ppm NITRATES (as N) -ppm 1RON, TOTAL - ppm FLOURIDE (F) - mg. /1. These results indicate that the water was of a satisfactory sanitary quality when the sample was collected. A. H. PADOVANI, M. T. (ASCP) io i ..,... a -.:. Tr At4 / oWA Owner ot, Fu:i?chaser of Bui ding IiTUnicipality Buildi g Constructed by 24/1-/PSG ,aPOa,e_ Location - Street Building Type Block Lot GUARANTY OF SEPARATE SEWAGE-SYSTEM I represent that I am wholly and completely responsible for the' location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 guaranty to the owner, his succes- sors, 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 initial use of the sewage disposal system, or.any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further `'agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- _ u!; alit.na?t failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this _ day of J14;J 1 c 77 Signature'/ s Title,�'�1 (If corporation, give name and address) CA�e_ COOS THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of.Health G } v t$ §PVTrtA M, cour TnVi�onmi T L.. Y Subdrvision .-r ! ; :owner a c � Crt 'A l TM, A!/V `',r, `- Building; Type. A�s 'Ek���' .L'ot Area ? r Number: of` }Bedrooms f a " ° 1. -SeOaraWSewerage System to consist of r 7777= 77-77. E To be constructed e f Water-, Supply Public "Supply From r r m' Private Supply.to be drilled by k Other Requirements n x r I represent that.Lam wholly and completely responsiblef above tle3crtibed will be constructed as shown on the'ap County pepartment of ' Heaith, 'and thaton comple be submitted to the Department -,, and a written ;g t1l plPC!- m` good operating condition any part of ° sa ance of the approval of the Certificate of Const, C� 4 ;will be located asshawn'on the approved plan and t sa wel _County Department of;H_e]yalth "tom at • Address t n !ryi FAPPROVfiD FOR- CONSTRUCTION This a rogal expir PP 'revocable "for cause or may be arriended`o[ mods gad when con's requires a n jermi t `Approved f r disposal of domestic Y Ij 4DEPARTMENT'�OF`�HEALT =H l Health Services, aCarme %N Y 10512 4. STEM: b'V/?� u :;sl�1 GL _ Town or,-'V e Lot Job Address d • / n j� n�� _/, �' Total Habitable Space ,Square =Feet �l Gal ptic Tank � � � � � lineal f :width trench ' i Se eet G ui • aJ � �� A/ r Address , ^� a �A•�J�.r� % S O a/ i of the proposed 3ystem(s) "1) that the separate sewage, disposal system` ' e nd m accordance with the standards rules an regu a. ions o e u nam I en i,, onstruc #ion Compliance ;satisfactory to the Commissioner of Healfhwill 1, 3 , ner hrs, successors heirsror assigns by'thtbwider =that saiii builder will y the period of two (2) years imrriediately: following the date. of ?the`�ssu- ti e o system or any repairs thereto 2j that ifie drilled.,welV_ e`scribed; above' rdandei, with +the: st ards •r,ules and 'r u a ions of` the: Putnam; !}} Y � RA �� License No 7 date "issued uhless str coon of the building.- has been undertaken and' his ry by'�the Commies n of Health Any, change or alteration of nstruct�on . 5:L rc r wage rrvat ... �.�, _�_ ...:�.._........_ .....:,� �::,:.._ �..,w ::.�.:: w�DFP,����4�r�:. -�k� .r�..�.�:T�F ..,....._....s� .....:.,:� _...t,_.�,.�.. �.._�, .. ��.�.�. _. ;.•�,:� DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner 6uT %-LY1 T°°IV4,Vn% Address � ©.9 ee: 6,9 Z!, �J°; /P; w le�t/_)/, Located at (Street Nnd1cate f � `/yg o0i< U4v �e . 'Z3 Block Lot nearest cross s ree Muni cipality �Q c J4L41/ Watershed (1_11"4wolov s' SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse p o a er Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in -Min. /in drop Inches Inches Inches 2 3:2 3 -¢7 1- 5 1 2 /V 7-515 !�� �Drelc�G? ���•. 3 4 5 Notes: 1) Te'�ts to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. 26 2 5 1 2 /V 7-515 !�� �Drelc�G? ���•. 3 4 5 Notes: 1) Te'�ts to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. 11 Q .-.-,TEST PIT DATA REQUIRED TO BE SUBMITTED_-WITH APPLICATION' D2PTH HOLE 'NO. - HOLE NO. HOLE NO. Airzz z4t, , G.L. 7'36-oz4- 611 14 f'-"r ag W.0 ToqAce, 6;, 12 PA/ ✓ V -0 ct Y 18" 8 2411 3 0 it 3611 4211 48i.1 5411 .-6011 66" 7211 (811 84 It LE 1(.A-G1RKUKD'-'.;ATE-.R :-&.-'E1,T1G0X0q INDICATE LEVEL TO WINCH WAT R LEVEL RISES AFTER BEING ENCOUNTERED .'...TESTS MADE BY FA Date ZZ- 7-3 11 DESIGN Soil Rate Used I S blwl"Drop: Usable Area Provided S-, Jw-z No. of Bedrooms Septic *T 1q'6 C,4- Gals Type A Absorption Area Provided By 'Z width. trench 'Zt 41 Other STMLEY .000 LAND ER Address' IJAUAWAI 9 Al Y inui%\ V THIS SPACE FOR USE BY HEALTH DEPARTIENT C Soil Rate Approved Sq. Ft/Gal. Checked by Date WELL COMPLETI @N REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well drillgr-.and submitted to.CQunty..Nealth D rtr�*tsrr ot�el w_i l+s<b atory4iept3ctafn.;i. : :. <, s�am'p i iridicating,water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER LOCATION �(No. & Street) (Town) r (Lot Number) OF WELL aEZ�oY� i¢ /O BUSINESS 4 ❑ ❑FARM ❑ PROPOSED DOMESTIC ESTABLISHMENT ISHMENT TEST WELL USE OF WELL ❑ ❑ ❑ ❑ OTHER SUPPLY INDUSTRIAL CONDITIONING DRILLING [I COMPRESSED CABLE ❑ OT EQUIPMENT ROTARY AIR PERCUSSION PERCUSSION 1 CASINO LENGTH (feet) DIAMETER (inches) IWE r u_HT PER FOOT © [1 O ❑NO CASING DETAILS OtA 1 THREADED WELDED YES YES NO YIELD ❑BAILED HOURS 1:1 Z G.P.M. YIELD (G.P.M.) TEST PUMPED COMPRESSED AIR f- 3 .3 WATER MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL in feet below Land surface: MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches). IF GRAVEL Diameter of well including GRAVEL SIZE (Inches) FROM (feet) TO (feet) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACEI FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET "I/0f If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE .i DATE WEL COMPLET D DATE OF REPORT JWEY_�DRILLER g ature U l A r1.1.RU) 4 dJ� Yj)ET) , by: PO INITIAL SIRE I.',SPECIIOId tYrFS _ No Comments Property lines or corners found. Can estimate house location . '0 0, a r a a e. W kLL ill .drivevay need, cut.:. o a . . 0 0 0. Must trees be removed -note these Is deep hole representative of entire SDS area Additional deep holes needed.. 0 0 0 0 a _ __ -- Sufficient SDS ar °a.available considering driveway cut, house. iocat on; separation o distances., etc . a o. 0 a o 0 0 a DEEP Mmi DATA 6 o Depth Water elevation: Rock elevation: Soils description: Date: FINAL SITE DISPECTION Tnsn, bv:j_)jr, . Mouse located where shown on. approved pl�;n S.M. �Il �,'F;c?(= t.7i"1lJ r� an1J1ro;jP�, e o .• o � o e a o 0 0 Width of� trench average Slope of the line and trench acceptable Room allowed for expansion trenches Over 5G, ft from swamp, ea•tprcourse _..z- unnecessarily graded o e a 0 0 0 0 o. 10 Fto maintained from propelin.- and 20 ft. from house 4 o e . 0 a 0 0 0 a Separation of trench from house, well etc. follows plan a oo o a`Q 0 a Number of bedrooms checks o o a e 0 a 0 a Stones, brush, stumps, rubble, etc o greater than 15 ft. from nearest trench o a e e 15 Ft., of peripheral soil horizontally from trench o o 0 0 0 0- e o o o - .o o e. e o o a o e, Junction boxes prope_-ly set Could surface run off from drivevray, roads, ground surface, .etc.. channel near SDS ai Y�..a 0 0 0 o o o 0 0 0 0 0 0 0 Does lot drainage amear O.K.- in area of SDS ! . °PJI'ir�i :vyv T `bF tIEAI�ifiM:_:.......�.._._ :�.•..r .. ... a., .�, DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 4, ! f 71 Re: Property of Z?i / T /14 /� 0 A Located at /lf G i `S? 44 a ,�b�:N p,,� i �1,�� �rarn l�lL•G;6'!.• - See -m en I '� Block Lot Gentlemen: This letter is to authorize ` STANLEY J. LANDER a duly licensed professional engineer v"'f or registered architect. (Indicale)- 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 DQpaitiueilt Gf ncd.itil, and to sign all riece56ary 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 Lb:w - -the tary Code. Co ersigned: (�/J P.E., R. STANLEY I LAN DER (Seal) dd ress 267 Very truly- ..,yt)Vrs, SignedL'/JU, l - -L/[ /,ti", L/ tj�njr or vroperty l Address elepnone 'i n D 7 1 C 1 - C 2045 � J, . =.. A 1 D I. I I r � I I I I � I I I V I 1 I I I I � I I I I I I I I I I-- -- Q Mnv ewr� i J M1.- � IJ � . $b II•.J i J T O T M \ 1. 1 O YO� R j ❑a . ❑❑ ❑❑ g 1I II 1lrII1IlrI1l1IlI1lrI11Il1ln111Ilt11Il11lr111l11r11ll11111lr111l1Ilr111lr1Ill111Ilr111l1Ilr11l11Ilr1l111 1Ilrtl111Ilr1ll11Ilr1ll 1r1Ifl11lI lr1 111llr1Iil11r1Il11l l I lr1 111r1I1l1r1Il111I lr1 111 PU i N;?k` CuU'dTi - :''T 1EPT OF HEALTH ll I OUSE PLANS APPROVED FOR cDROO1 COUNT ON LY l I111111I1111r111 l 3 — ! 0 Zoning Plan -Ground Floor BEDROOMS 1 7(0 — / 0 _ z _ and TOTAL ENCLOSED SOFT: 3.737 ALL. SI IBSEOUENT REVISIONALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCOOH FOR APPROVAL SIGNATURE &'TIILE E r 5 4 0 Case Development Inc 37 edlenasrh— d. WIN z BrOW iL MY, 11201 •: sn.s�.aal ftwli MORR A ® w ya•IgpppmYnyb�YiS Im���NN�,OmmRel a�rnlmn The Mai Reaidelne fa/ W-Iff Ratl OuAvt awraf I057B Ground la Floor A-oa��a- t W!P. I1mul!ii iI 4ra,11 �1 , ae b600 "Q 11 O O U V ti 6 Ri N _ a: 1. 0 U g � _ � 1�7 O 00 d O U �'•. m \ w ~ O w Uj U 6 O cc a O n cc 2_ w I J m w = Iw CL � cn c . O I < a a� !V �• � GA8@ t CC.esesd Dne elo menI.Inc f 8­14, NY. 11201 .. r t rr an.m.am • z I t ' 1 ! R A ' �rart «lam C Hqg DA9 CamtvC MECH. ROOM QQQ® e�w� °Eewa h \ 'S B SYmOr Lwwr: 1.It ® GD BASEMENT r Qbnstruction Plan - Cellar Dn�mna;wwnu�no SCALE: 1B' =1'-V TCTAL ENCLOSED SQUARE FOOTAGE: 2960 aoa TOTAL GARAGE SQUARE FOOTAGE: 968 s NUTS: PPo7:10E ALL STRUCTURE, BLOCKING, AND FIREPROOFING, SMOKE RA CARBON D VISUAL LACCR AND MATERIALS REQUIRED TO ACCEPT ALL FINISHES, SD CM �E� ,\ I ALL -PUMBING WORK, HVAC VENTING, INSTALLATION OF ALL COMPLIANCE WITH LL07 /04 \` MF1w ANICAL AND KITCHEN EQUIPMENT, ELECTRICAL FIXTURES ourswe v�vmseew EfC.. NVTL.S: D.oa rh- Aa000000c COH:ULT KITCHEN EQUIPMENT CONTRACTORS REQUIRMENTS, �• SPECIFICATIONS FOR INSTALLATION AND COORDINATION. NOTES: w°ro�eumm PROWDE SMOKE DETECTORS AS PER SEC. 27 -979 M. BUIEGINC CODE GARAGE z The Mandne@ Reskle -e AND 3E CARBON MONOXIDE DETECTORS AS PER LL AND ! , IO7SttpNadBaad ANE•BU9DING CODE REFERENCE STANDARDS 17 -13 AND )V( (Tzn'son,NnYMc10379 n -LA PU T NAPAi COON -pl, D "?.`.,Th9EN7 OF HEAL CeOar HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY Plan � 13EDR00ia1S 7�f,-Oe-all - 2 -z8 � ALL SUBSEOUENT REVISION ALTERATIONS TO THESE HOUSE P(A9!5 MUST BE SUBP "iTTED TO THE PCDOH FOR APPROVAL 3-001.00 ADDITION APPLICATION RESIDENTIAL ONLY STREET 16-7 60. JJ1&i t4tJU 12oAD TOWN F�tAIAM\J&A,E`TI TAX MAP # 61' 02120 NAME ►V � MANCf1J�'1,L1 PHONE q1'1 . X40 -7407 PCHD# MAILING ADDRESS 10-1 dW H16l IA0 POA-D, L5PIRf14 Sb N N-+ 10.52-+ DESCRIPTION OF ADDITION �6 U VWAfaeD HMO -M 06 R-6REQ tiJr-w 6Ll TV C3� Cr�N NUMBER OF EXISTING BEDROOMS _PROPOSED # OF BEDROOMS 3 (FROM CERT. OF OCCUPANCY OR CERTIFICATION 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 Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. 1. Certified check or money order for $100.00. i :- .2:. Sketches of existing floor plan - (drawn to.sr ale,: allaivang ;area.including,basement, to be shown and dimensioned and use of each room specified): (See Section 3:c oilulretiri HA -1) 3.. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE COMMENTS s. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health MrDl�l[tIS; Director of Environmental Health Cronin Engineering Keith Staudohar 39 Arlo Lane Cortlandt Manor, NY 10567- Dear Mr.Staudohar: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Office (845) 808 -1390 Fax (845) 278 -7921 or (845) 808 -1937 January 12, 2011 Re: Addition —A-176-10 No Increase in Number of Bedrooms 107 south Highland Road (T) Putnam Valley, T.M- # 61. -2 -28 PAUL ELDRIDGE County Executive Ate`= I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The. proposal for the addition has been approved as per plans bearing the approval -stamp from this Department dated January 11, 2011. The addition is approved with the following conditions: 1. The .total number of bedrooms must remain at 3 without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets restrictors for s_ho_wer 4. - This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. The approval is for the proposed changes only. This approval does not'Validate any construction shown as existing that has not obtained proper approvals 6. This approval is for bedroom count only. 'this approval does not include the accessory apartment which is under separate permit, of which must be renewed every three years. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. ' If you have any questions, please'contact me at (845) 808 -1390, ext. 43261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:cw cc: BI, (T) Putnam Valley Sheriita Amler, NW, MS, FAAP Commissioner of Health Robert Morris, PE iili`L�::C•7'Oj i.Iri'cr°v;:':;ic'i »�^! ^.IF3'' Robert J. Bondi County Executive n u ..1.- -. •.....r.•T..�.�n.M .!....�. r..._as'AU ./.>. .. ... •11', �- �.. x•11 •. am: Department of wealth 1 Geneva Road, Brewster, NY 10509 Office (845) 868 -1390 Fax (845) 808 -1937 December 17, 2010 Cronin Engineering, P.E., P.C. 39 Arlo Lane Cortlandt Manor, NY 10567 Attention: Keith Staudohar Re: Addition — A- 176 -10 107 South Highland Road (T) Putnam Valley, TM # 61. -2 -28 Dear Mr. Staudohar: The Engineering Review Comity has reviewed the house plans for the proposed addition/replacement to the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The proposal is over 50% square feet expansion from the original dwelling. 2. The first floor room titled office is considered a potential bedroom. 3. The legal bedroom count for the dwelling is 3. The potential bedroom count of your ,.proposed addaior: 4. The addition of potential bedroom and being over 50% o square feet expansion of the - original square footage requires this Department's approval of a revised septic system plan from a professional engineer. Please revise the proposed floor plan to reflect no more than 3 potential bedrooms and less than 50% square feet expansion, or have a professional engineer or registered architect design a sub- surface sewage treatment system meeting present code requirements. Sincerely, Gene D. Reed Sr. Environmental Engineering Aide GDR:cw a Dear Mr. Staudohar As with all addition applications, this Department also requires the submission of one set of floor plans showing existing conditions only. The plans must show all floors including the basement- All rooms must be shown and noted as to the use. Therefore the RPS sheet submitted in place of, is insufficient. Please note that the plans can be in the form of simple hand sketches drawn to scale. As with the Mancinelli Submission. Due to the fact that the existing septic system does not meet current codes (i.e.: designed with a 50% expansion area), The proposed dwelling is not granted the same design criteria's as current code allows. Therefore a proposed office can be considered a potential bedroom. In an effort to address your concerns in this matter. I will present vour proposal at the next Health Department engineering meeting for a final determination. Sincerely Gene D. Reed From: Keith Staudohar [ mailto :keith @croninengineering.net] Sent: Tuesday, December 14, 2010 3:48 PM To: Gene Reel Subject: bedroom counts Gene, v. airs. iaWicati%jr.--T, era -air& no house plans on file in the building department. The house is approx 34'x 36', 1 1/2 stories and three bedrooms. Kindly review and let me know. Thanks. Also, regarding Mancinelli, the office can be considered an office and not a potential bedroom with the additional 50% expansion?? Keith Stdudohar Cronin Engineering, P.E., P.C. 39 Ado Lane, Cortlandt Manor, NY 10567 P: (914)736-3664 F: (914)736-3664 JJ I I 1 - A L rt 1 a i t I ► 1 II 1 1 1 1 Iflolr.. , Jt 1J11'st 9 J'& JJ1,111J .t 1% 1' JIJ t3PslJIJ 11 �j � ..1itJ a 49 .11 1�.1J!tr Jl ; �..,!l?4. 'X75 s`+'i :6... , is ?;'.' :i t• °: �� c "S'l�:�`,'` { J; :11/1' U }3!I!JI,U :ic',c; `f 5`; +: :..........:: FUe Edit View Toolbar Wndow Help Interior Cond ( _ _ _ _o,{ Fin Over Garr No. Kitchens: {1 Consir Grade: (A Expellent ,�,] Fin Attic: Kitchen Qual: (_ .] - 37230'3.. Putnam Valley Active R /S:1 School: Garr-rson Union':,. - mancinalG, Mark W 107 South Highland Rd Roll Year• 12011• Curr Yr Land Size: 12.22 acres 9 Family Res Land' W. 342, 6u Total AV: 747,000 .t J Parcel 61. -2 -28 Li Notes U History - Li Assessment C i Spec Dist(s) ( -'j Description LA Ownw(s) L:1 Images Li Gis Site 0) Res Lj Land(s) & @-gl L _j Imprvrnl(s) L_i Valuation Li S aleO9130/10 - i_J -Site (1) Res Li S) L'i Bldg LJ Imprvmt(s Li Valuation i J SaleOB/21 /09 L.i - Site'(1) Res Lj L.and(s) u Bldg Li Imprvmg6 C:Ij Valuation i.1 S alel 0/1 MG - Lj -Site (1) Res Lit Lands) D Bldg - .0 imprvmgs, J Valwion - Li Sde10i05/05 - (:_r •Site (1) Res J Land(s) u Bldg i =) Imprvmt(s) i-'j Valuation - LA Sale02/08 /02 - LJ -Site (1) Res U Land(s) i_.r Bldg i.a Impcvmt(s) LJ Valuation - LA Sale10/30/98 - L-1 •Site (1) Res i_I Land(s) iJ Bldg Lj Imprvmt(s) ,.J Valuation -�J Sale03 /01M Site No: 1 _ _ Bldg Style: (06 Contemporary o] Central Air: _ -.... __...._..- ........ _j 1 st story: �i'278 , 3 } No. of Stories: (2.0 _ Bsmt Type �2 Cr�wB _e_j 2nd Story:_ i r Ext Wall Mat: 01 •*Wood _ - __._p] Bsmt Gar Cap :F Add Story: A cBurRs'1985 Overall Cond- {4 Good °j. 1-12 Story, {__.,_._. 'Elf Yr Built: I Exterior Cond: �_ Pl 314 Story: F Yr Remodeled:( !•• __ Interior Cond ( _ _ _ _o,{ Fin Over Garr No. Kitchens: {1 Consir Grade: (A Expellent ,�,] Fin Attic: Kitchen Qual: (_ .] Grade Adjust• Fin Basmt: { Na Baths: �3 No. Hall Baths I : Pct Good { _.._._ Unfin 1 /2: { -- Bath Qua_ k _ {_ , , �,� :N:G Funct Obs: - - Unfin 3/4: room .1% _ Unfin Rm: ii-01 ftoomS: {0 Unfin Over No. Fireplacesl ­ Gar: '- Heat Type: {3 Hot wtr /stm o) Fuel Type: RCM RCNLD: 1,332,934 SFLA: 14:i56 1,053,019. Fin Rec ..j] Run HPS440 Edits: NO 1z",J)" 4 sD o - /7.1/02 9 10 J 2, (i / Prints the screen _ [' 7, p y :..K•<(�4.- ..t.+tiG•ai�tl,:.: +,,. le. .t��,. .A.la.•p.41i'S., •t.:r,•:, cc:;`,r.c�Tit.' �'�j }F^ - y� y,_�• r� ,r.. .1;F�'P7' 1r�F'. MEMORY TRANSMISSION REPORT TIME DEC -10-2010 04:48PM NAME ENVIRONMENTAL HEALTH FILE NUMBER DATE TO DOCUMENT PAGES START TIME END TIME SENT PAGES STATUS FILE NUMBER 696 696 DEC-10 04:4TPM 82784865 001 DEC-10 04:47PM DEC-10 04:49PM 001 OK *** SUCCESSFUL TX NOT ICE *** 17-11t-s- (C'-irc:l!: one) T- o c,-- -X-1 0.-L\' ;v V f -7 Gomms -c al ci cil R-eat t CZ' S-Ll b Ci IS 10 33 Otiz ar of 0---iui=zxj Owner- �lf a-vail b le; row=: built: Spe=liai :Lr-st=-actions: P-tvzei-ed by: Dace: Person Fps: ni�ine File C, r,=, S USE C, ZT LC-. r-e=o!-d-= File View Toolbar Help 4N 05 LOA;' 1 372800 Putnam Valley Active RISA School: Garrison Union ......,..� .•.. _ .,. . ,.; _ __ •:....-::_ r -c; :: , f f ie ..ota , 747,000 �^ Inancrrielu. f♦iiari: w _ � ' , -:' ' �rd�','';�' 32;i� :..., ..... 107 South Highland Rd Land Size: 12.22 acres T IAV• Owner Totat 2 A Site Total: 1 Total• 1 Name: Mark W Mancinelli Sale Data Sale Price Owner Bldstyle: OB Contemporar Prpcls: NbadCd Sewer: Water: Utilities: AddlAddr: 450,000 Mancinelli. M Sfla: 4258 1 Family Re 28140 Private Private Electric Street: 141 South Mountain Pass 10 Thye, John Fr Baths: 3 112 Baths: I Beds: 3 EffYrblt: 0 Cond: Good 1779 119 PO Box: 0 Thye, John Fry Exemption -C Total' 0 Term Own City: Garrison, NY Zip: 10524 - Arno�rnt Year Pct F04 Barn -1.0 ge 0 0 1220.001985 Taxable Value Miscellaneous Land Total: 3 8.00 32.00 .001985 County: 747,000 Book: 1862 Typec FF: Depth: Acres: Sqft: Muni: 747,000 Page: 465 RP4 Porch -encl: Primary 0 0 5.00 0 School: 747,000 Mortg: Residual 0 0 6.61 0 .00 .00 Bank: Wetland 0 0 0.61 0 Schl after Star: 747.000 Acct No: Sale Totd: 7 A Building Total• 1 Book Page Sale Data Sale Price Owner Bldstyle: OB Contemporar Ext WalL 01 1862 465 09/30/10 450,000 Mancinelli. M Sfla: 4258 Yr Built: 1985 1837 329 OW21109 10 Thye, John Fr Baths: 3 112 Baths: I Beds: 3 EffYrblt: 0 Cond: Good 1779 119 10/1G106 0 Thye, John Fry Exemption -C Total' 0 Term Own Improvement Type Name T 4 Diml Dim2 SQFT Yr Built Code Arno�rnt Year Pct F04 Barn -1.0 ge 0 0 1220.001985 F87 Barn -pole 8.00 32.00 .001985 LS7 Pool- st /vny 0 0 640.00 2000 RP4 Porch -encl: 0 0 100.001985 Special District Total: 1 Value / Code Units Pct Type Move Tax FD014 Fire district .00 .00 .00 i i Dpubfe dick to open a wVxkm ¢0� {,f ttfit `''�.,�..� f;;�j�A4:•.r:��:�- "�41;.,. � YS�! rr��Y' ,4(_1- ;'_�,`all3il�.._ �'� �'�..� r.s•t ... 11.._. v...., �. -- .�.....:�L�i•.I :la» __ _ - +a.���al� �LT�/:dKiA. 1NAC-0 "�'.in , - .� n.. _. - u. �; �:e __. -.<... :.,. a (.*... .. _. r._... -�.. o.. ... ..e....,...o.,.w .. �, ,. '. ._. .. .....-- ._.r- ii. »;. �,�. ..-x r.._...w- .:n >r, ..... .. ..,....�..,,. c. ,. a.�. •.. err �. 1�I Town Letial Bedroom Count & Proposed Addition Status Re: AAAfIL &W- 41J9-L1 (Owner's Name) Tax Map # 621 • 02. - 46 Address: 10-7 -5001f 416RtA0 "AP Town: 'pcJfM VP�I.I -GPI Year Built: 9 8 According to records maintained by the Town, the above noted dwelling, is in compliance with Town Code. /V G S' Is not in compliance with Town Code. u`i The Legal Bedroom Count is: I This haforination has been obt -;ned prom: . Certificate of Occupancy: Other: The plans for the proposed addition are considered: New Construction Addition to existing house only Teardown and/or re -build allowed under Town Regulations mg Inspector 1 /1,0 i 0 Dat 6. PUTNAM COUNTY DEPARTMENT OF HEALT DIVISION OF ENVIRONMENTAL SERVICES 16 b G _.._ . - - CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at 10'? $ D. �ft 4ytAkib fLQ , Town or-V� POTIJA.M Vffi t,c 4 Owner /Applicant Name Ju A064WO..l.1 Tax Map &I Block 02- Lot -2-6 Formerly Subdivision Name Subd. Lot # Mailing Address Date Construction Permit Issued by PCHD 10• Lt, 13 Separate Sewerage System built by Address Zip Consisting of ' `JVD Gallon Septic Tank and 3 $D U New �' D f Z-4" 4nAyk"L P Cam- X P ile-UU,M&4 t t D° e KP11k-W5 l o N At(Z* Other Requirements: Water Supply: '—Public Supply From Address or: V Private Supply Drilled by L'kJb , Address � .t' ° t r. ��_ . _ .. . .... __.... _ :571M _mpolm c_.o. p . Bu -lding Typ - =H serason control. beep. - C-en -p jje: - cou�L4- j:L '� _ Number of Bedrooms S Has garbage grinder been I certify that the system(s), as listed, serving the above premises were built plans (copies of which are attached), in accordance with the issue plans and the standards, rules and regulations of the Putnam Coin Date: It. 1 3 Certified by Mo c.. N (Design Profession \� Address 5ff AV-L.z- L.r tiC P..OR.- ANDT 4APodL M•1 1 05U7 rialI a, own on the as- ki P rm t and approved J R.A. 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. 4it�,c,� Title: �'Ph Date: copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTM1ENT OF HEALTH DIWSION OF ENVIRONMENTAL HEALTH H SERVICES .. ...;w.�...rr.'•:r.••CCispr -r.-o ..t-- .....- ..q:. -. .;....� n. .. t -.. - ... r•t ..«.�. -. :s" ri - y,- -n�iy W. � - - GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM MAfiez Owner or Purchaser of Building Building Constructed by lo-7 !�22JW- t'lC KAAJP 90AD Location - Street -51i AL6 Building Type 61 M '8 Tax Map Block Lot f 7�" ��►1.d -ezl Tow 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 serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good. operating condition any part of said system constructed by. me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused. by the willful or negligent act of the occupant of the. building utilizing the The undersi ed further agrees to accept as conclusive the determination ofA Public Health Director o e Putnam County Department of Health as to whether or not the ail a of the system to opera s caused by the willful or negligent act of the occupant of bui ing utilizing the system. 0 Day L—Year l®1 (Owner) - Signature Corporation Name (if corporation) Address: 1®-7 :5a. j,G�kEr� PAD Signature: 9 Title: 0 W h!e"R " Corporation Name (if corporation) Address: <AM � State AWN Zip 01 State Zip Form GS -97 SMITH LABORATORY ....FNV!R NTAL +1 �CEtViC- QFtlllf» $ fZT � HYDE PARK, NEW YORK 12538 (845)229 -6538 CERTIFICATE OF 'ANALYSIS Citent: Aqua -tang International Kurt Reiner 214 Van Wagner Rd. Poughkeepsie NY 12603 PO`# Client Pr*ct Name: Mancinetli,107 S• Highland Rd., Garrison, NY Sample Type: Water Order comment: Order 10: 117406 Sample Number: Sample Location: Sample comment: DatefTime sample collected: 0ateMme sample received: DataMme sample analyzed: 208828 Raw C 9 eg C. 12!2013 17:30 Collected 8y Kurt Reiner 15.30 Received by: Amy Jo 121412013 17:00 Tech: SS Parameter Test Result* Units Test Method Total Collform Absent CFU /100mL Collsure E, cols Absent CFU /i00mL Collsure *Exptanabon of Test Results: Total Coliform test result of "ABSEtM or "< 1" (Lass than One) Indicates that the water sample DOES MEET EPA drinking water standards. Total Coldonn test result of "PRESENT', or a test result expressed as any number other than "e 1" indicates that the water sample DOES NOT MEET EPA drtrtkirtg water standards. Bacteriological test results are e*ressed as Colony Fanning Units (CFU) per 100 milliliters of sample volume. Results Comment Reviewed by: ab M agar, FLAP lab ID 010824 06- Dec•13 alnith Laboratory is approved as an Enveronmental T99MW Labamfo/y rn carprarm wee with the National romin rtmental laboratory Accreditation Conference (NELAQ Standards. This test repart pertains only to the whom items analyzed on this sample as received by the laboratory lrlfarmation supplied by dye client is arsuered to he correct The total number of pW In this report is I (one), ALLEN BEALS, M.D., J.D. Commissioner of Health Director of Environmental Health November 25, 2013 DEPARTMENT OF.` HEAL I Geneva Road,. Brewster, New Fork 10509 Phone:# (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering Keith Staudohar 3 9 Arlo Lane Cortlandt Manor, NY 10567 Dear Mr. Staudohar: MARYELLEN OAELY. Coway Executive Re: Construction Compliance — Mancinelli 107 South Highland Road (T) Putnam Valley, T.M. 61 -2 -28 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. All trench ends are to be provided in the as -built chart. 2. A satisfactory water sample for bacteria is to be provided. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 43157 of any questions arise. Very truly yours, Gosepph S. Paravati, Jr., P.E. Assistant Public Health Engineer JSP:cw PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IIEATLH SERVICES ..- _..:...... „•...:�: .,....:,•. ..... ;?�. r.. •� •'�L�I I�'i l 1'.'RC:�'�'K 1: -, . ,_ ...� .... .. ..... n....�„ .... „ .. _ .... .. L NA MR: //Ulo.v�L.n Street Town State Zip PERSON IN CHARGE OR INTFRVTFWFD- L&44 1'0- L4A , DatP• PUMP TEST DOSE TEST REQUIRED GALLONS i I b 75. Signature and Title REPORT RF-rFTVF.T) RY: I acknowledge receipt of this report: SIGNATURE; 02/96 Title: Rev. m II O O O REQUIRED GALLONS i I b 75. Signature and Title REPORT RF-rFTVF.T) RY: I acknowledge receipt of this report: SIGNATURE; 02/96 Title: Rev. �I V A1V19 V 1V1 %,WL)1 b b nVJVJKJ% DL11YJ VjX4 .L U.0 II7 d%J .1= D" ION LION OF ENVIRONMENTAL BMALTH SERVICES FATAL SM INSPEC17ON Street Location a So, Z/, g G,/ -ti_L , TM Date: Inspected by: Owner Mavt ci vt�l /1 a . Z mit Subdivision Lot Ya Sewatse System Area a. STS area located as per approved plans ..........:................ b.. Fill section.® date of placement 3:1 bmier Lgth. width Avg.Dpth • c. llattiral soil not stripped....... ............. ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course w atla�nds ...... ....:.......................... II. S .a • s►Ltem 1000 ...:. a. epttc;tank size• , 1, 250 ......... other ................. b. 'Septic link installed level ................ .........:..................... C. 1 ®' mm from fo iktion .......................... ... ............. d. A otrtlets at same elevation - eater .tested ................. 2•. d below frost ................. ............................... 3. 2 ft, Original soil between box & trenches e. J B 9z properly set ....... ..............................: 6. 1. -Uq th required 3'90 Length installed 3<17C, 2. Distance to watercourse measured 4-1 ors Ft.......... 3 Installed according to plan. ..... ... ... .... ...... .................. 4. Slope of trench acceptable 1/16 - 1./32 " /boat ............. 5. 10 & from .properly line - 20 ft. m fo tions.......... 6. Depth of trench <30. inches from smAce .................. 7. , RDom allowed for expansion, 10.0% ......... :............... S. Size of gravel .3/4 71W diameter dean. ................... 9. Depth of gravel in•trench 12" .....:.... ..... 10. Pipe_ ends.ca�p ........................................................... . _ 1. of pump dwriber ....................... I ............... I. ........ 2. ow tank............................................................ . 3. • vIsuaVauudio ...:................ ............................... 4. Pomp .easy- accessible, manhole to grade ................. . 5. First box bad ........................... ....... ......................... 6. witnessed by I.D. estimated flow /cycle........... C a. Houma . approved plans :.. ............................... b. Number df be ooms ...................................................... W; orated as per approved plans .......:................ .... b, Distance from STS area measured — ft........... .c. Casing. 19" above grade ............. ............... ............... d. Surface drainage around we l acceptable ....................... Y. Q►er° Il �, bio a. Boxes proPerlY BrOutAd .................................................. b. All P P with "inside of box ... ............................... c. All pipes iitish . d. 13ackfill 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 ............... b_ Surface water protection adequate ..... _: ................... I....... . d i. Erosion control provied ................. ............................... Rev. &2 I ose, FU'1'NAA'l UUUNTY 1MrAH'1'ML+NT OF HEALTU DIVISION OF ENMONIYIENTAL HEALTH SERVICES FINAL SITE INSPEC ITON Date: Inspected by: Street Location Owner TM # Subdivision Lot # 1. -Sewase System Area a. STS area located as per approved plans .......... :................ b.. Fill section date of placement 3:1 barrier Lgth. 'Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS ar-ea.......... e. 100' from water course/ wet, lands ...... ............................... IL Sewa e S stem a. 3eptic tank size. -1,000 .......... 1, 250 ......... other ................ b. ' Septic'taak installed level ................................................ c. lot mininmnn-from foundation ............................... ............. d. Distribution Box 1. Alt outlets at same elevation- water.tested ................. 2-. Protected below frost .................. ............................... 3. •. h iaimum. 2 ft. Original soil between box & trenches e. Junction Bo properly set .......... ............................... 6. Trencho 1. Length required Length installed 2. Distance to watercourse measured Ft.......... 3. Installed according to p1an ....:... ............................... 4. Slope of trench acceptable 1/16 - 1/32 "/foot ............. 5. 10 ft. from .property he - 20 ft.! foundations.......... 6. Depth of trench <30 inches from surface ................... 7. { Room allowed for expansion, 10.0% .........:............... 8. Size of gravel 3/4 - 11h' diameter clean ...................... .................. 9. Depth of gravel intrench 12" minimum......:,...:....... 10. Pipe eads.ca.p ........................... ....... . Pfitem 1 Size of pump chamber ................ ............................... .2. Ove& w taalc ........................ ..............:................ . 3. .. ............................... 4. Pump easy accessible, manhole to grade ................. 5. First bona baked... .................. ............................... . .... . 6, Cyycle witnessed by H.D.estimate.d' flow /cycle........... In no u9elBnildinia a. House located�per approved plans :.. ............................... b. Number of bed - rooms ....................................................... IV. wen. WeTlocated as per approved plans. .... .. .:...................:.... b. 'Distance from STS area measured ft ........... C. Casing, 18" above grade ................ ............. ................. d. Surface drainage around well Acceptable .....:...:............. V. ' Overall Wo - kman_shio' a. jgoxes properly grouted .:................. ............................... b. All pipes patially backfilled .......................................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area........ ........ h. Surface water protection adequate...... '........:... .......,.... i. Erosion control provided ........ ............................... ...... Rev. 12/02 ALLEN BEALS9 ALD.9 JJD• Commissioner ofHealth Director of Environmental Health November 19, 2013 DEP W OF IMALTH 1 Geneva Road, Brewster, New Fork 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering Tim Cronin, P.E. 39 Arlo Lane Cortlandt Manor, NY 10567 Re: Field Inspection — Mancinelli 107 South Highland Road (T) Putnam Valley, TM 65. -2 -28 Dear Mr. Cronin: County Executive The above referenced separate sewage treatment system can be backfilled. There are no open comments to be addressed at this time in reference to this Department's open work inspection. If you have any further questions, please contact me at (845) 808 -1390 ext. 43261. S - erel Gene D. Reed Principal Environmental Engineering Aide GDR:cml 61 '13 -11 -04 12:40 FBOM- T-6 0 J rWJWWII vavaval r— r u r r ..z_..,..- ...... „. ... _. .. ...:�_�.. . -a,�• �t... '; : DSr£_Q.�.!._ytldSh'`r ll F'ADTH_� - DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION 11 ADAM RFQT T, ST FOR FINAL _TN PE. TION All information must be fully completed prior to any inspections being made... PCHD Construction Permit # GENE For: Fill Trenches Located: 10- 190, (T) U wf Owner /Applicant Name: MAAi4I Y4 4.1 TM Block , o l Lost Le Formerly: Subdivision Name: �-'-- Subdivision Lot # -- Is system full completed? Date: 10 2A13 Is system complete? t_... Date: Is system constructed as per plans? Is well drilled? u O bate: Is well located as per plans? ��. - Are erosion control measures in place? --- 96 .. tVEW I certify that the system(s), as listed, at the above premises has been cq,r ru d c fl and verified their completion in accordance with thfe is d � - astru approved plans and the Standards, Rules and Re i�ions f t. e o T� Date: 11— _ — I. Certified by: Design Prof 11 s2980 pt'ofiE55%(:; A.ddress:.'�' EtM1�h+ . l.�INa�i` /w4101� LiC. Atli. 1� ,_._ � �► � .� . 1,. 3 - t 00 Form FIR -99 and t of za ALLEN BEALS, M.D., J.D. Commissioner of Health ��vlli:)A Y � l�'1�YY= ►�7� ±i�.r.y 1�IPir� -.:.: -;... Y.... _ _ Director of Environmental Health September 25, 2013 MARYELLEN ODELL County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering James W. Teed 39 Arlo Lane Cortlandt Manor, NY 10567 Re: Proposed SSTS - Mancinelli 107 South Highland Road (T) Putnam Valley, TM 61 -2 -28 Dear Mr. Teed: 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. The proposed fill doesn't appear to be returning to natural grade. ...._ ._.: , ....:.�� : -'F'ue e a �� ..b : a': u u�i teru s de ofth� pro osed ccT� mew: -:s �ria w:l � used to retain the SSTS fill? If so, a detail showing the fill and wall is to be provided and top and bottom wall elevations are to be shown. 3. It is highly recommended that the amount of fill be reduced to the minimum amount possible to correct the contour irregularity. 4. It appears that a portion of the proposed 204' contour is in cut. 5. It doesn't appear a clay barrier is being proposed. The fill section detail is to show a clay barrier and it should be shown in all profiles where applicable. 6. The dose volume in the pump chamber calculations doesn't match the dose volume in the pump chamber detail. 7. The pump on and pump off labels in the pump chamber detail are reversed. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. Very truly yours, .i t ' J' oseph S. Paravati, Jr., P.E. Assistant Public Health Engineer JSP:cw ALLEN BEALS, M.D., J.D. Commissioner of calth ROBERT MORRI%P.E. Director of Environmentd Health May 13, 2013 y DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York - 10509 Telephone: (845) 808 -1390, Fax: (845) 278 -7921 Cronin Engineering James W. Teed 39 Arlo Lane Cortlandt Manor, NY 10567 Dear Mr. Teed: MARYELLEN ODPi LL CountyExecutive Re: Proposed SSTS (Addition). — Mancinelli 107 South Highland Road (T) Putnam Valley, TM 61 -2 -28 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. I. The proposed fill is to extend 10' past all trench ends before returning to grade at 1:3 slope. 2. It appears the proposed fill is not returning to natural grade on the southern side of the proposed system. 3: Pleaseprovide ih&name ofthe'Town'on'dfepian. _ _. , ._.. __.. ;_.._.._ ._ ...... -- • ___...._.__. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. Sincerely, oseph S. Paravati, Jr., P.E. Assistant Public Health Engineer JSP:cw t L°9.KILE BL' tfLS OLD W.D. Commissioner of Iieft ROBERT MORRA P.E. DEPARTMENT OF HEALTH 1 Creneva Road, Brewster, New York 105 ®9 Telephone: (845) 808 =1390; Fax: (845) 278 -`Y921 March 4, 2013 Cronin Engineering James W. Teed 39 Arlo Lane Cortlandt Manor, NY 10567 Re: Proposed SSTS (Addition) — Mancinelli Increase in Bedroom Count 107 South Highland Road (T) Putnam Valley, TM 61 -2 -28 Dear Mr. Teed: CoimtyExca" 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. The proposed SSTS design flow can be reduced to 600 gallons per day (150 gallons per bedroom) pursuant to the latest revision to Bulletin ST -19. 2. The proposed SSTS needs to be a minimum of 25' from the top of bank. 3. According to the Department's witnessed deep hole descriptions, D3 is only 6.5' which requires six inches of fill. 4. A proposed sleeve is to be shown for the future expansion area effluent line that is under the driveway. _ '�A ael pTlitii:l'i-GGIic%iu�tlYuu 15 �o'u1: Yr�ivd�° f0' i'`i.%i::-vn�;cai,olv�Ti•i.uea. .; . • ... ._. , __. - ,. - ..,__,. �_..._ . _.._.,. _ 6. A separate profile is to be provided for the expansion area. 7. The pipes for the absorption trench are to be laid level. Please note in the absorption trench detail. j 8. The proposed pump chamber has been mislabeled as a septic tank in the plan view. 9. Why is four feet of fill being proposed? 10. Fill over 2 feet requires a fill only plan and separate trench plan. 11. The updated PCDOH notes per the latest Bulletin ST -19 revision are to be provided. 12. An all weather junction box with a plug in connection for the pump is to be provided at or above grade near the pump chamber location. 13. The fill notes are to be provided. 14. The floor plans provided have five potential bedrooms. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. Very truly yours, JJ ph S. Paravati, Jr., P.E. istant Public Health Engineer JSP:cw . ONIN, 39 Arlo Lane . ® ENGINEERING P E., Pk.: Cortlandt Manor, NY 10567. Professional Engineering & Consulting T :'(914) 736-3664 F: (914) 736 -3693. January. 31, 2013 Mr. Josoh.S. P.aravati, PE.' Public Health Engineer " Putnam County Health Department 1 Geneva Road. Br*ewster,:New.York 10509 Re; . " 'Mancinelli. Property , ; SS TS Construction Permit .107 South Highiand.Road:. Town of Putnam Valley, New York,' Section: 61.00, Block: Z Lot: 28 Dear Mr, Parovati, Please find enclosed the foilowing regarding in, application . for a Subsurface Sewage Treatment .,Construction Permit Renewal /Revision at the above referenced -lot: 1. One (1) Money Order: in theamount of$500"made payable to the Putnam County. Healfti be' artment as part of the review fee. 2. One (1) Letter of Authorization 3. •'One (1) Application: for Ap Ps of a Wastewater Treatment System (PCDH corm PC -97) 4. Une (1), IN S'SEUR'Snort EnVironmentai.Assessment Form. (Flart I`Unly) "" 5. Four (4) Applications for Construction Permit for Sewage Treatment System;(PCDH.Form CP -9.7) at the above. referenced - location. 6. Four (4) Subsurface SewageTreatment System Construction Permit Plans for the "above, referenced lot (Renewal) 7. Four (4) Sets of House Plans for the above referenced location. S. One (1) Set of Design DataSheets.' Should, you_ have''any questions or require additional'information,; please do not hesitate in contacting me at the number above: R .. ubmitted, ames W. Tee ; r. ; Project Engineer cc: Owner- Mark Mancinelli File Peravati PCDH- Mancinelli 107 South Highland RoadSSTS- SubmittaWT- 20130131.dopV j jl� CQO, . ; " " - FEg 0: �. 2013 • QEPART�ENT OF HEALTH t' I/ � mosonfY uot�oJO �. Palo z s • saJlq / i(/awasoe a! , y x s of K -., } P°a 9.ssod - 4 !o ® \ J o 4,oj uO'Joo, w .. J o ° of Jo Puri ° m O X4o"pO ", or C'.y �:�; 'fl \ ,! ;•I Pt,i ° °Z ° 9o!s ao100d,• I 1 II / Shpt° l 1 `��� � � E� `�� 0� 2t `ooh � 1 �ou�'�✓•� Y ��' mLL��x oq oQ �a ' �o , \ j°� m '� 204 �� o \ _ a,��t CN ` I� =ad�q� O0' N I J A `fg < . \ u? } I s o ?€ ` ` �\ �' i t •� ,\� te•.� +•. \y N � J'/ c cps: � -. ..-� i \ i! r � � \� to !•\t e, -� ^ �� .'�' N rf i -- - \ - i• 1-4Z!2 j �• CO p W x. 6g' m 0.0.0. .�.`' .•' .,.• (P . •P ' 'N._' _ w�. cu .c r• x of • �.; f 5 "Q _ o o ! da ooh ` I o�m 9 v l „lion woll N Ii•y ''� "£ ao •N ° Cow C '\ \�Q^� J',` � !i m�i �'za Sri; fL Af :v \� 6 \:: ;/: j, (; -�jy�J cv Si- w o b p. m 3 �/V w¢ F / ` M l \�0 t: 'PUnO cone. IT f L ��`�'�.'��' - o•;�, ms's' ti a f9. t J `� '` a� r •. �'� _ r4 -.... - � - ... ...i1 f.. „ �.! c�y ���'t.+'�t',S �'�'a �'.,...L�S:� - r 4..0 iF '.> .�w-. � � �i ..�.•bb o�Ra+9�, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -CONSTRUCTION PE RMf FOR SEWAGE TREATMENT SYSTEM r PERMIT # Located at I-Q9: '&Vltf H 141Fa uo Nn Town or Village 'PU TrJ ft VJFU,f V Subdivision name HE 1-1 MAN Subd. Lot # 1 Tax Map 6 ( Block 2 Lot 28 Date Subdivision Approved W ARC 41 31 193S Renewal Revision Owner /Applicant Name MARK MA0CINQ4.1 Date of Previous Approval Mailing Address V N. Sup ( -510E AVE; Wlout%fUK N Zip 1195y Amount of Fee Enclosed <9 50 p S(NU"� F"`�� 5 Design Flow GPD 750 Building Type R rk Lot Area IZ� •21 S No. of Bedrooms g Fill Section Only Depth Volume Separate Sewerage System to consist of 1 Jc oO gallon septic tank and 3 $o L-• F p� " m f obaftT Eo P Vc f 1 Prz (4 21 G CIVE4,. *'►2PNGN E 3 Other Requirements: PUfh P 5 y [ 6M To be constructed by T i it �D, Address Water Su Public Supply From Pr:`��t" Tlrii,l ' CnYYIy. �� ��.. .... ..y _ .. 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 Cop •sfactory to the Public Health Director will be submitted to the Department, and a written guarantee e�tiilpt d er, his successors, heirs or assigns by the builder, that said builder will place in good operating , ' ''a r�� ',p ai ewage treatment system during the period of two (2) years immediately following thS, a a the iss e o�al pk _ 1b' a Certificate of Construction Compliance of the original system or any repair �efo. Signed: Address R.A. Date d License # o G Z 9 80 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. . /. Title: I P A-C- Date: / 0 lJq// 3 F�opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Owner—H49K HAWCUALLI —Address 10 � SO- Pi4g(" go, 4ftyt-orb '" Located at (Street) 101 &. fi(jg tAjo (1b. Tax Map 6 9 Block Lot 29 (indicate nearest cross street) Municipa lity Ulm Watershed RU0660i Rtvg�- SOIL PERCOLATION TEST DATA Date of Pre - soaking (V1q17o1'5 _Date of Percolation Test /0/15- /Z. I ole No.H 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 Pioz 2 9 12 3 3 3 1: 31 9 19 3 5 4 9:31 -9-4u 9 is 2,1 3 3 5 1 IDS - 9:1q 9 21 2 Jg 21 3 3 4 .5 2 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. S I min for 1-30 min/inch,:!5 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 Pg. I oft NEW L. C; >o dS ()a-5 62980 ; 610151516151016T.20,01810 T -306 P000110001 F -726 PUTNAM COUNTY - - .Y �'f�7 }l�l �-��-,t�:��T�`3�1-i1'.(Q�•�{ :'!,..�.f ...... ,.— _ _ � .. DMSION OF ENVMONNIENTAL HFALTH SBRVICES OCT 1 5 2013 ATTENTION C1 ADAM RF,QLTEST FOR TNAL INSPECTION All information must be fully completed prior to any inspections being made. PCHD Construction Permit # Ej -OZ l3 GENE For: DEPARTMENT OF HEALTH Fill — L/- Trenches Located: dr? 0. AU M (V) �1*AM VMS Owner /Applicant Flame: L + 'I'M Block: - B � Lot y - Formerly: __ __ Subdivision Dame: Subdivision Lot # Is system fill completed? Date: Is system complete? ' Date: is system constructed as per plans? Is well drilled? , M Date: Is well located as per plans? - Are erosion control measures in place? Ail- • OF NEW I certify that the system(s), as listed, at the above premises has b o ave'inspected and verified their completion in accordance with th is Ca i Permit and approved plans and- the Standards, Rules and Re f of u a artment of Date: o • us ` %I Certified y: Design ip98o �� `�• kUFESS0 Address: Lic. IF `'° 6n 12V cj PU7NAM COUNTY DEPARTMEN7 OF HEALTH DEVISION OF ENWRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PIERMIIT # _IN—or --0 Located at It* -SOUTH R IIaF LOD 9044 Town or Village �U�NIAM VAL&a f V Subdivision name HEITMAN4 Subd. Lot # 1. Tax Map (ol Block 2, Lot z Date Subdivision Approved &Rcd 34 19 85 Renewal Revision Owner /Applicant Name HARK WAIMEELLI Date of Previous Approval Mailing Address t/1. M Svp.Fsi ®E hve , , M ON -rA vK At Zip 119 5 � Amount of Fee Enclosed 495DO Building Type Sta44v- Lot Area$2.716 No. of Bedrooms 5 Design Flow GPD ' 50 Fill Section Only Depth VoRurmne Separate Sewerage System to consist of 1500 gallon septic tank and Wo `° F 6P V j PurV A4TOO jPVC ?/Joe /', zy'. guygt i aemr's Other Requirements: Pt! m P Sys ?see To be constructed by Ts D Address wgltez Supply- Public Supply From 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 re Putnam County Department of Health, and that on completion thereof a "Certificate of Construction C i c to the Public Health Director will be submitted to the Department, and a written guarantee ished t e , his successors, heirs or assigns by the builder, that said builder will place in good operating c ' di 'cyan = said e ' ge treatment system during the period of two (2) years immediately followin hg ate of the su ce o appr,�va1 o th elCertificate of Construction Compliance of the original system or an r irs th eto. u+ f'0 Signed: , �z3so .g.F' R.A. Date 9 1 2,®r3 Address License # 66,79$0 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: �� � Date: Whi opy - HD File; Yellow copy - uilding Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 TER. O' A c HORI &,A- �- ON _._.... _. DATE: October 27, 2009 TO: Town of Putnam Valley 265 Oscawana Lake Road Putnam Valley, NY 10579 RE: Lands of Mancinelli TMD 61 -02 -28 107 South Highland Road Town of Putnam Valley, NY This letter is to authorize Cronin Engineering PE PC, a duly licensed professional engineering firm to represent me, produce all necessary Site Development Plans, reports and other pertinent documents and to sign all necessary papers on my behalf in connection with the above noted property. This letter shall also authorize the Town of Putnam Valley Wetland Inspector, if necessary, to _ anti "..IIGo.I, tr �J'1 , nOteq._DrO ;Q� ✓ c:r' p PXpress- purnc,cP nf.riPlineat g.,Of �_eitF'��ia4larde ar,, _ ... _ ._.._..:. prescriber Section 144 of the Cade of the Town of Putnam Valley. Sign Ma;KN12paifielli, owner 107 South Highland Road Garrison, NY 10524 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES A IPPIL W ATYON, FOR �R APPRV!,K .l_ OF P -L s N S -!''^R - A WASTEWATER TREATMENT SYSTEM Name and address of applicant: Mark Mancinelli 907 South Highland Road Putnam Valley, New York 90579 2. Name of Project: Mancinelli 4. Design Professional: Timothy L. Cronin 111 6. Drainage Basin: Hudson River 7. Type of Project: 3. Location: TN: Putnam Valley 5. Address: 907 South Highland Road Putnam Valley, NY 90579 Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) _ 8. Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/No No 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 NIA 11. Name of Lead Agency. Not Applicable 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ..... ..... .6 ........................ ... ........ Yes/No Yes - 13. 'If so, have plans been submitted to such authorities? ................ Yes/No Y* es 14. Has preliminary approval been granted by such authorities? Yes Date granted: N/A 15. , Type of sewage treatment system discharge ........................ surface water ✓ groundwater 16. If surface water discharge, what is the stream class designation? .......................... NIA 17. Waters index number (surface) NIA 18. 19. 20. 21. 22. 24. 25. 26. Is project located near a public water supply system? . ............................... Yes/No No If yes, name of water supply Not Applicable Distance to water supply NIA Is project site near a public sewage collection or treatment system? .......... Yes/No No Name of sewage system Not Applicable Distance to sewage system NIA Date test holes observed 51512092 23. Name of Health Inspector Gene Reed Project design flow (gallons per day) ............................... ..........................7`.�v GPD Is State Pollutant Discharge Elimination system ( SPDES) Permit required? ... Yes/No No Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A Rev. 11/02 Form PC -97 Pg. 1 of 2 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No No 28. Wetlands ID number ... NIA : - - ....... _..... 29. Is Wetlands Permit required? ................................._. ............................... IYes/No N /A': 30 31 32 33. 34. 35. 36. Has application been made to Town or Local DEC ........................... Yes/No N/A Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No No 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 No 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: Is there a local master plan on file with the Town or Village? .........................Yes/No No Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ...............:........... .........................Yes/No No Are any sewage treatment areas in excess of 15% slope? .............................. Yes/No No Tax Map ID Number .............. ............................... Map 61.00 Block 2 Lot 28 37. Approved plans are to be returned to ................ Applicant 'k Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person. other than the applicant shown in Item 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. /CIF NEW v— I hereby affirm, under penalty of perjury, that in my knowledge and belief. False statements made pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES. Mailing Address: ........................... -Tinf6thy L. Cr ino n , \ Cronin Engineering N2 N � 39 Arlo Lane. Cortlandt ' 10567 is true to the best of w A misdemeanor Form PC -97 b- 617.20 Appendix C State Environmental Quality Review SNORT ENVIRONMENTAL ASSESSMENT F RM PART I - PROJECT INFORMATION To be completed by A p licant or Project Sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME Mark Mancinell/ Construction of Single Family Residence 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) 107 South Highland Road, Town of Putnam Valley, Putnam County 5. PROPOSED ACTION IS: IDNew 11 Expansion Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: This project involves the construction of a new residence to replace an existing residence that was damaged by fire.. The entire remains of the damaged house are to be removed and an entirely new structure will be built in essentially the same location.. Construction of SSTS Area for 4 bedroom Residence. Well to remain. 7. AMOUNT OF LAND AFFECTED: 0.74 0.74 Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential 11 Industrial Commercial Agriculture 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 z No If Yes, list agency(s) name and permit /approvals: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes No If Yes, list agency(s) name and permit/approvals: Town of Putnam Valley- Building Permit 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? 11 Yes 0 No I CERTIFY T ORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: onin Engine rin ./James W. Teed, Jr. Date: 3 I 22. 13 Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 6.. PART II - IMPACT ASSESSMENT To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. El Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. 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)? Yes No If Yes, explain briefly: E. IS..THERE..OR.IS THERE LIKELY TO BE, CONTRCVERc— RE..' T-ED T . o^ c T + ^ - ! I �+ + -- T. IA . _ . _. _ _.. O'� �r - _id : - =.:D v •,�oC:�R� IR RM�hTAL Lr�l'A , S � - �U 'T es, " U ivo • "'if res; ezplain'tirieTly: .. -_ —._ 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 materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) IF>ZJTNAM COUNTY DEPARTMENT O F HEALTH DIVISION OF ENVIRONMENTAL IEIIIEAIL'TIHI SERVICES Ave: -.. :�., �.♦ .y ..V .. .� - �t ..�+.. _ _ a. .: f- .r.• ... .�.n.-..s -aM :'.. �_. �._. _.,. ._ D>ES)(GN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEMC Owner ffiA, MANC Uam Address lo-7 fyD. ftffLAPP ►z1) . 5010 Located at (Street) 1 0`I 0. ftyLAyup UAD Tax Map bj Block 07- Lot 20_ (indicate nearest cross street) Municipality �i9t'AlF M 1i' j Watershed s �I Vti�- SOIL PERCOLATION TEST DATA Date of Pre- soaking 17 Date of Percolation Test f, / No ole Run No. Time Start -Stop Elapse Time (Mm.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min /Inch 1 :12p :2,1 Q 2 4 5 .. _ _ 2 3 4 5 1.23 ®9:�q 2 : §I 1� p 3 4 'I9 .... 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. 5 1 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. PUTNAM CWhTI `D -91 Pa. I oft FEB 0 4 2013 OEPARTMF -NT OF HEA!.TH PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ` DESIGN DATA SHEETS SUBSURFACE SEWAGE TREATMENT SYSTEM Owner NVO94 MAN44Nat-4 Address j07 50. ftth.AO AD.60AASam � Located at (Street) o'l 0. WIRA,&& UAo Tax Map bl Block OZ Lot 1� (indicate nearest cross street) Municipality Oil NAM uAL44;,j Watershed j0jm Rlub7 SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test No ole 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 4 1 a.0 $-W Z 19 Zr 3 2 3 , �, . 9:04 4 5 5 1 �: o - ��; 9 �� Z• L J9 5 1 2 3 4 F7-T 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. S 1 min for 1 -30 min/inch, 5 2 min for 31 -60 min/inch). All data to be submitted for review. 2. Depth measurements to be made from top of hole. Fomi DD -97 Pg. I oft TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES �i:'r 11=i, _ .:. , _.. r'IGL� i�C�3' ... , -`ULl✓ 1V °G "HALE 1VU G.L. lL IOU., 0.5' 1.0' 1.5'nJ 2.0'v�y 2.5' 3.0' 3.5' 4.0' ` 4.5' 5.0' Le 15 5.5' 6.0' 6.5' caw 4gMb 4 -L 7.0' 1,4 9 awi , 7.5' -7 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered ►J ®�1G t��lCD�N"i�"� Indicate level at which mottling is observed X0111 css ®(% GxUL:P Indicate level to which water level rises after being encountered A Deep hole observations made by: 400MIti x* IJ Date 06 ^dS l� Design Professional Name: :DrAgl N Design Professional =s Seal Cj TEST PIT DATA AAM DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES G.L. 0.5' 1.0' 1.5' 2.0' tvq�1 2.5' _ 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' :tfULE -1� U:.: -.z J-�: , _ :..Y��t1UL1✓ 1V U. �...a:,. n LOA-" rr i •� i • u 7.5' _ . S' 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered N©gG Indicate level at which mottling is observed MONO 0f%" L� Indicate level to which water level rises after being encountere d . A Deep hole observations made by: 690 tN A.6 IT PCO 0 Date Design Professional Name: - nmarRy Signature: Design Professional =s Seal r��.�'���.� L. CRO C, TEST PIT DATA -,:7L DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. G.L. !me '49W 0.5 G 1.5' 2.0' 2.5' 3.0' 3.5' D lvgZ 4.0' ISM I AMP CaMU&. 4.5' t S 5.0' 5.5' 6.0' 6.5'�� 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' - - __.... _. _.. .. .. .... .. ..... - - �. ....... O - Indicate level at which groundwater is encountered Noble, QMwja'i9=-'-4> Indicate level at which mottling is observed kJONG el%oxuap Indicate level to which water level rises after being encounter ed `A Deep hole observations made by: (490poi W41kkMAJ& F4pq Date ®,�, Design Professional Name: rAoMV �. Design Professional =s Seal FIr CRC W J t �S 62930 BRUCE R. FOIXY wnEP 1.RTNLE T OF HEALTH I G!n�va Road Brewster, \-,,.v York 10509 LORETT A J(OLI':ARI R.N.• M.S. . ATTE 0N: v:i ADAM STIEBELI\G � 1'Gr��T REED All information below must be fully completed prior to any scheduling. E GINEER OR FIR`I: C: °:ICi�r�)4t _I' I I':li•f,) (jt l �e 9 R.E:1S0 : DI ;EPS:.A" PERCS: C, PC NIP TEST: ROA STREE'C: i �' __..__.. a,'? Y`:: i` �.'`,t�tl�_ _ 9A-T.' 'rows: _ �4, ` P.JAAAI . ��� �.g ;.l.� ... •I•. -1,\ NL1P- � �._ t " %•t - SUBDIVISION: _ —_ —_ -- _ LOTS: � - -- NYC'I)EPCRCFFRIA FOR I [V_I f _[EL N'DWITNiF-.Sjl�'(� t7 :° Proposed S57 -S within the drainage basin of West Branch or M)Vd.s Corner Reservoirs. 1-1 r 'ZI Proposed SSTS within S00 feet of a reservoir, reservoir stem or control lake. C; ° L�''_� Proposed SS'I'S within 200 feet of ' it watercourse or a DEC wetland. Proposed SS'FS design flow ,neater than 1000 uallonidav or SPDES Permit ri:quired. ' j l'L "vUU5e(4 1gT.S-for ,i, It is the responsibility of the desig.,n professional to provide the above information prior to soil testing. This Department will determine the NYCDE:P project status (Joint or Delegated) based on the response. if you answeredy_es to any of the questions. SNCDEP mist witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and If a project has been determined to be Delegated based on the abov:; response and then subsequent information indicates;iti'C'I)lr.P is required to witness-the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing %vith .NYCDEP. DA rE: F0 1% CUL:1,L' l.SF.U.N LI i i f xz� nn V6 C J wem go % INDIAN a F O Pond u High anc , Stat Pa,l J i Ql 1 Dick Castl f + w f1® RD i V~ \off a s iR j �OOK .. 1 'i /,`.Ifs•✓ i! > r�� COO I TL NOR,, . f � i�[it � i gR711URq "Jo al u 'Garrison \.� �� uNrgs w � i A e 1 1. i NEgS l '�e�3 ,i .� ••.�� } ai HUDSON VIEW UMSET /'� 1 \ �Q i J ,I � � � � j} s o . �0 i � "• W � ® �.' t ; Q SU Gn CHAP e N ¢ o STAR ° V IEPW 0524�1.. L 9 -- -/` •` ®/ -' - --' -- try — - W o Az `✓ ' 1 `1.1 �A o�vn H s< g° r R i 41p; ke J >; POWHATfEN LA >INT P l'S i . r I %� CRAH9ERR'! RD V� % Co Re y2 ! � r0 � 1 � KRANERS I PUTNAn4 VAkJLEY x_ H � 1 N, AV Otb Park f �Y .m 10537 POINT .I 1 ¢ G Arr �{7v�`� l f , ¢ �° P °R o I*AWN ` ��� Sheet of PUTNAM COUNTY DE ' PA1iTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEATLH SERVICES ADDRESS.: I Street Town State Zip PERSON IN CHARGE C)R TNTF.RVTF.WPT'). nate., Name and Title TYPE OF FACILITY: FINDINGS: LTJ ........ .. I 5/1 q Signature and Title I acknowledge receipt of this report: SIGNATURE: N 02/96 Title: Rev. 2 3 lid Gov �r11 5�G -(L 5 , t;GjL � l . IV w1G��h�e3 70 iy Id c //:30 � Or 6 i Ito I � J � 1 3,5 , S".L- f D/ 0 Construction Plan - Cellar SCALE: llr— Nr TOTAL ENCLOSED SQUARE FOOTAGE: 2M TOTAL GARAGE SOGABE FOOTAGE: 90 NO7EC MdX ALL SU&CRM - O WIG. AW F03FROOTnO. TABOR Alm MATO S REOLOU TO ACOM ALL TRTO� / ALL RAMM ROME WIC VWK. WMIATM OF NL / NEOWOTAL NO WOU EOIWLOM. DLCTWGL MURES / ETC. NO ES TFOAOF SYOIR DETECTORS AS PEF BIO.WC CODE PRM C MN "OU COUTORS AS MADW COOS {3 i t yGi'hA�1 COUNTY D EVARTMENT OF REACT' sRnSB 9LANS APPROVED FOR BEDROOM COUNT ONE.:. s Pv 3 ALTERAT`Ng TO THESE AUL SE ,LL SUjj!SFQUV.VT RI:Vi61ONI TO '1[IF PCllO(i FOR APPROVAL O1SNA AII` ( IF 5UR[ "Cull it f' i; QA GCS Develop entInc 33 8. SLBW2 BmNQ'.i. NY. 11201 t-- !. ! A Nom-' t tt JI �1 ®iih ®} RrmNRTrx Ceur Plan A- 001.00 T �-rr- ` L T Ry ` SS !T J o , U EVELOV MEN T'. 1 Case Development • • •■ • O O i O O , !f"V,V� n °° / t _. 1 _ _ r_,__,r�� (.n>se : 1■�Of■u � o `.. �� `, 1t / ■■iuiiu■i�i ■i�f�i j����A���■��nj ■ff�fq /1 ➢t■ ■■ ■■ ■ 1 ■■■u■■■1■■■■■■�_f_f_ut11■■■.... ffftf� A ■ /fff ■ ■ ■�■ = ff ■ / ■ ■ ■f ■■G ■ ■ ■ ■I. ■ ■ ■ ■tG ■ ■ ■t ■ ■ ■1 i1 ■q ■ ■ ■■N 11 p■ ■■■fl ■ ■ ■ ■ ■ ■f--- . ■ ■ ■ff ■t f ■ ■ft■ ■ ■ ■��!� - .a/uoo... _ ■.T� ■u■uv 1 a►_e • r-� iru■■ �11r ltY' ■■■■■■t■■■■fo■■■f■f■ufl■■■■■uTi i f■T��' o y \\ �'V� ♦cs. _________- :_z - -:yam ��osa�a ��s `��r;��r o■���■ ��, czrn q/ - %�',j� — — j�,y., `► yam Cl TOTAL EN[LOS ®61vUME FOOTAGE: 3,737 i1 N07 6 ,' N, s. aad PROM ILL SIRUCiE' E, BLOCI®ID. AND FMEPROONNG. LABOR AND INTFAML'REOUIRED TO ACCEPT ALL FINISHES, ANi M VEMBNG, INSTALLATION OF ALL . • . ECMANII AND KIICrIEN EOUNMFNT. ELECTRICAL FIXTURES ETC. Ron. r Safe 100I_� Sw Md Tp Sw abd ' ' •.' j NOTES 1.'y' PROADE SMOME OEY'C2,D0.5 AS PER BUICK CODE PROME CARBON Mi DIEMCTORS AS BWIIP/G CODE �,n it : •, :. •. .. . � "�o. :•.. �,. `'•''•�•���•� �� lI?f r �( I I li I I I I I'r IVVJ ri1ii11rr ��!�ti '�C '•'"�''''' ••'Y: +L �IIIIi'1n 1 I'I'111'11111'n VI'I'111'I'lll'lll'I I'r. a111illl1l1lll i1 Slillt llllllllr 1 1111111111111'? ;:'., :'•';': '•''" . • r 1 VIII IIIIIIIIIIT. ��, III, I, I; 1,111 i11111,I;1i1,1,1�1T� �I, t, 1; 1, 1, i ,l,1,1,111,1,1,1,I,I;I,ii!�11•T dd,I, 111,1, I,, 1,11111111111,1,1,1,1,111, rI,I,1,I,1,I,I,iiI,I, I,I,1,1,1,111;1;1,1,1,11111�1. ;�.. f i- !• ly C111II II III II 1111111 IIIT,�I 111,111 lllllllllilllilllll'PI uVll'I' III' I' IIIIIIIIIII'111'I'lllll'111'I'I I I'I'll1' Ill' Ill' I' IIIIIIIIIIITI 'I'111i1'1'11111111I'll1' / V'IIIl< 1111111' 11111'1'1' 1111111' I 'I'I'lllllll'I'I'lll'lllll'I'i' III 'lli'lll'lll'lllll'lillllllll� rtn-1 I 1N -ul I,I1111; 1;1111111,1,1,1i,1;11it 11111, 111; 111, 11111111 ,1'11111'Ill'I'lll'ill'Ifl i l {11,1;1,1,1,1 I ,T I��I 11111,, 111,1111111111111111111 lil 111 ti1111111111 I1I11 ,1111111111111111111 1111 1111, �I,I,Iit, 11111111111111111 �7� ';!•:: , See, -' —w PYepr. JI TT,. a. AMT.�� 1 •; y �, F ,1i1, 11111,i11, 11111111111, 11111111111, 11111111 ,1111111,1111111,1,1111) 1, 1, 1, 1, 1111111,111111111,1il,l1111111i IIIIIIIIIIIIIIII1111III'1' 111111111111111 '11111111111'lll' X111111 I I1111111IIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIII , • ' Lihl l l l l l l i IIII III III ^f,1,1,1111I,11 i,1,1;ljl,t, 1111111 III111111J� 1,11,,,, 1,1� I I'I 111111 lil I I I I l' I I ila .LI1W.L.LIay�;j j,}.I LI 11.1J 1111 QQ Zoning Plan Ground Floor T" '.'�,. •. 'i �yIiI ,1;111i1,111,yl,lil,liyi,lil,l� II IIIillllllillllll ✓ I�Illlt' I'IIIIIIII111'I'I'I'111i1'111'� TOTAL ENCLOSED $oFr: 3,954 .'. . ,j. y �(Z IIII' III' Ii11i111111i1 '1111111'111'I'I'I'I t'A /I 1I II IIIIIIII.IIIIIIIIII ,1I,1,1,1,1,1,1;1,1,1111I, 111,1,1;1, I,III,I,I,N �111,III,I,lil, 1, 1, 111,!1111, 1, I, I,I,I,lilll,l n �'.'.'��'._�. •.. 1 �!. , .. •��o. CI1111111I,I,I,I1111 ,1,1,1,1,111,111,,11,111;13 1'.'.:•'.' • 1�IIIIII II1111111111� 11x11, 1,11111,111i111i111;11111,i, r 1 { I '(k fti I➢ i AM-IrYe! msma�0aol�w W The Mardi Rniche ce 107 S kRpN.Id pwd G.MmA NeMYpk 179 Ground r Plan A 002.00 0--1 Construction Plan - 2nd Floor SCALE I• = 1'4• TOTAL ENCLOSED SQUARE FOOTAGE. 2198 PROMA ALL SIM)MRE. MOOONG. AND FIREPROOFM LABOR AND WATOMS REOLORED TO ACCEPT ALL F♦IM ALL PLOAM WORK. WAC VEMONG. RMAUATION OF ALL klEaWMAL AND WCHEN COMMENT. ELECTRICAL MURES ETC. NOTES: PROWE SPOKE DETECTORS AS PER BLILDW CODE PROVIDE CARBON MMODE DETECTORS AS MMLOWC CODE -T-- 4 Cb A 11 COUNTY DEPARTMENT Lof 11LAL.1 ti tyrt!SZ VLAN� APPROVED FOII 13FDIIOOM COUNT , 7-)Lf 0-6 1 -d-1 All SUOSEQUENT REvlslOxjALTEnm-l-W Ttl AWST BE SUBMIrITFD T0 -F "c"DOR i-oll AppIl0"V'AZ Case'Development Inc Sll* 2 ;Tr, 77m7 Tr �m.mal i The A#AdwM ROSILWM Second Fbor Plan 4. A-003.00