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1� \� .. DM "�l[ i 4AiM Y rCs OD I�ibI'Y l HDeSilTAh t Si�>IEN1o_F ��
1O
leGns N:Y 2 z'
N Paan hie
ao CBN1fFiCA18 OF CO
Paslt ' .
ao Fos sw�� D�ros. sst®►� P V . 3 0= 8 3
ate Subdivision' Approved hj A Fee Enclosed., -1 Amrijlnt
Residential IM Armis 1 .4 acre4`
- - NO& vakaofi
4 80 0 PC® Notl Notion 4 Room ed Wben M d o. pleiea
Kober et Biiooa DeaiSe Flotr G P D
Slopersfs Severew SpfN to Comm at 1 mule Septic Tenk:.:.d 400. T. F— 2 d° ate s Q r p t i o h t r p n c4 h
unknown
Ti be aro�etod �� .. Address. ,
Water Srlp�:. PdWk Smip* Fro Address
Dt19ad bY. 446se existing
'
oibw
I represent that 1 am wholly,antl eompNtely rifpooaibN for.the•desgn 014 location *of tM proposed fystom(ui 1) that the SOP'S rat. »wa • dif otN t item
above described will be constructed as shown' on,the approved amendment inert to and- In accorGnte with,tho itandard; rules an rsgu a ono c e a
County Departniant of MMlfh; and thaton comomioq,thereof `a "CiAlf6to, of Construlalon Com61146cei. wi tisfactory to.the Commissioner of Naalthwlll
be submRteO.to tM,Oepartni rot, and, a written guarani N will_ba Iumished the owner, his sucgtao►s, heirs assigns the Outk/er, that NIO bY1War will
Olece in 'pod 061sratiisg condition ,any part -4r, OW sewage disposal system. du►ing'the period' of. two (2) years InlnwdNtely following thedate of the loam-
-efKe of �the;appraral .,if the � :Certlflcito-,6f•, Conrtructidri_:Compliance of � the original - system CiW � repairs theiaiot 2) that the drilled wail data*" above
will be located ea mm io on the-approved plan and that aid.wei6a isl be lnitslleA n a cordan wi t seta rot, rules and Fey. aT oils of the Putnam
County Departnold o/ Health
Date A u g . .17,r .1994
Signed P.E. _ & R.A. _
Address BA'DEY & .WATSONl , r.ve in & En ineerin2,j.JA ,C. 62505
oOu�,]� a r11►n�QQ
APPROVED FOR CONSTRUCTION: Th s ipp, viii • lies two�yw ,f i fl un co ruction of the buiktlny ,lies been undertaken and is
revocable for cause or may, e. amended.oi rr Munn' when'consider qry by the. Commissioner.of Health. Any change Or alteration of construction
"Quires a per it.. Approved* for disposal of dori."i unit sewage; arid/ Ivate water supply only.
Rev.
pate 8 , Title
10/88 'Ti— y 6
IE
I - .. . 1 ... - ...F ..
P T mAW-- tURTfl'Y DEPARTNUENT OF HEALTH �
Dlviabia of Fiav asita Redilb SwvOca s, Caramel, N.Y. 10512
Emgbeees Dual FroA& P V- 3 0- 8 3
F.C.H.D. Paz* 0
opus Hollow Road
FOR
Town Of - Putnam -Va lacy
Town or V _ - 7
Tar map 61. ? tot
Avram Natnanson N/A
G=or/Acipp8cWt Name Formerly subdivision N me
Addrew 226 Westshore Drive Zlp 10579 Subdv. Lot #
Fee Enclosed Amount 200 Date Permit Issued 9/l/94
Sepimb Sewerage System b®lit by Mark Meyers �j Putnam Valley
1,250 4 LF O A sorption Trenc
- -- Gallon Septic Tank and
WaBaar Supplys Pubic supply From Addeew
ors X Prlvastte Supply Drilled by Existing Addrew
318111121118 Ty" Residential Lot Size 1.4 AC Has Erosion
Plumber of Bad momst 4 i$DS Garbage Gunder Be= Hmstmlled?
®der Requirements
I certify that the system(s) as listed serving the.above premises were constructed essentially as shown an the plane of the completed work ( copies
of which are attached), and in accordance with the standards, rules and regulat on in ac rd a wi the filed plan, and the permit issued by the
Putnam County Department Of Health.
Data 4/11/96 Certified by P.-E. X RA.-'
Bade & Watson C Rt9 Cold Spring 62505
dlddress License NO.
Any parson occupying prOMINS served by the above systems) shall promp tek0 such action as may bo necessary to tsacuro tho correction of any unanitery
conditions rosulting from such usage. Approval of the separate sew ga stem grail o null and void as Goon es a pubs.'. sanitary sawar becomes
MA and th approval 04 the private ara4or suDPly $hall become. ntX 1 old whew a Ik vratp supply becomes available. Such 69WOVOIC WO
aubloct 4o Mo'd Icatio r change when, in the ludgmont of
the C i of Poe avocation, modification or change Is XZ"—*
TM
3/89
AS - BUILT
RELOCATION - DIMENSIONS
A -1
30.0
Se tic Tank
B -1
19.9
A -2
37.0
B -2
15.5
A -3
45.0
Drop Box
B-3
23.0
A -4
72.3
End Lateral
B -4
34.0
A -5
92.6
B -5
58.0
A -6
71.8
Drop Box
I -6
52.5
A -7
62.3
End Lateral
B -7
61"3
A -e
38.3
B -8
51.0
F
Putmm County Department of Health
Biv1810111 of Environmental Health Servioes
i7
$br ownTbrmarms We
�sIle 6�332�F 8esdatiqns of the
F+� 3L�F .t0. ReRa..tnemt.'
�
t1
—� Signa:. 4e,
5
1 �,F
F 3 1 1250 Gal Precast
Conc. Septic Tank
2 1 4.. C.I.P.
G { A
d
House Under e -
Construction
i
,e
i
I }�
O
well -
CANOPUS HOLLOW ROAD
"AS- BU /LT " OF S. s D.S.
' PREPARED FAQ
AVRAM NATHANSON
' .4/7UA7E /N 7NE 4
TOWN OF PUTNAM VALLEY".
PUTNAM COUNTY ;+ PRINTED
NEW YORK
SCALE n=.30 ft. APRIL // , 1996 ?!
22MS
rAb b /o cK /Jfy /Aol //m sewage 6'o"o/ S."tom °
aros cons /iac %O os hx*o/ed, C //✓s R/an d'W /ha/ ;' BADEY 8 WATSON
/M Sys /em ras ivpeC/eC by m before ros r •SURVEYING 8 ENGINEERING, P.C.
1717 W6l] nU'�C e'
�t
r•
�4
;i
fi
4 IDS oel -, TTATT
DEPARTMENT OF HEALTH
U&W., W1:LL l.Vr1rLL11V1V L�,rVM1
Division Of Environmental~ Health Services'
PUTNAM COUNTY DEPARTMENT OF HEALTH
Office Use Only
WELL LOCATION
STREET AOU 5: N� I TAX GRID NUMBER
�� -�-
WELL OWNER
N E. ADDRESS:
1 ?1Z 7
P8IVATE
O PUBLIC
USE OF WELL
1- primary
2 - secondary
R� RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABAN ONED
O BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT � gpm. /N0. PEOPLE SERVED '� % EST. OF DAILY USAGE`S � rD gal.
REASON FOR
DRILLING
[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY
EgNNEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH °� ft.
STATIC WATER LEVEL __ 'ft.
DATE MEASURED L' df_
DRILLING
EQUIPMENT
OROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG
O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
O SCREENED ❑ OPEN END CASING ,9 OPEN HOLE IN BEDROCK O OTHER
CASING
DETAILS
TOTAL LENGTH fL
MATERIALS: STEEL ❑ PLASTIC O OTHER
LENGTH BELOW GRADE ft.
JOINTS: ❑ WELDED }THREADED O OTHER
DIAMETER in.
SEAL: EMENT GROUT O BENTONITIE TH' ER
WEIGHT
PER FOOT -L,� lb./ft.
I DRIVE SHOE YES ONO j
LIN ER: 0YES 0
SCREEN
DETAILS ::
DIAMETER (in)
SLOT SIZE
LENGTH (It)
DEPTH TO SCREEN (It)
DEVELOPED?
FIRST
-
0 YES ONO
'Howls.
S�Cbgcr
GRAVEL PACK
❑ YES
❑ NO
GRAVEL
SIZE:
DIAMETER
OF PACK IrL
TOP
DEPTH ft.
BOTTOM
DEPTH IL
WELL YIELD TEST ' It detailed pumping
METHOD: O PUMPED i tests were done is in-
41COMPRESSED AIR ,'. ormation attached?
O BAILED ❑ OTHER 0 YES O NO
1P1ELL LOG
It more detailed formation descriptions or sieve analyses
are available. please attach.
DEPTH FROM
SURFACE
water
sear-
Ing
Well
Ilia-
lmeter
FORMATION DESCRIPTION
coat
It
It
WELL DEPTH
It.
DURATION
hr. min.
DRAWOOWN
It.
YIELD
gpm.
Land
WATER CLEAR TEMP.
QUALITY O CLOUDY HARDNESS
O COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? O YES O NO
STORAGE TANK: TYPE
CAPACITY GAIL.
PUMP INFORMATION
TYPE
MAKER
MODEL
CAPACITY
DEPTH
VOLTAGE HP
WELL DRILLER NAME � VAC CAT
ADDRESS Jy" SIGNATURE
mw
YMI FNV7RONMFNTAL SFRVICES
32-1 Kear Stree-t
Yorktown Heights, N.Y. 109,98
(914)2,45-28Q0 � ~.
Alber� H.-P�d���������rpcfor'----�`' '
'
'
,
I
|.AR #: 32.414700 C|J A
FNT #: 6�40 ' NON �T�\pNUi �ht ]
~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~~
NATHANSON, ' RAM DATF/TIME TAKEN: 06/03/' 12:45
226 N. SHORE DR - DATE/TIME REC~D: 06/03/96 13:15
PUTNAM VALLEY, NY 10579 REPORT DATF: 06/05y96
PHONE: (914)-528-417()
SAMP1 7NG STTE: 272 CANOPi|S HOLLOW RD SAMPLE TYPF..: POTABLE
.TNAM VALLEY W||L[X{T|ET PRESERVAt 7VFS: N.ONE
COL'U BY: AVRAM NATHANSON ..: { 4C �
NOTFS".. COL7FORM METH: MF /
~~~~~~~~~~~~~~=.~~~~~~~~~~~~~~~~~~~~~~~ ~~�~~"~~~~~~~~~~~~~~~~~~~~~~~~"~~~~~~~~
/
' DATF FLAG PROCEIli|RF RFSUi- T NORMAL - RANGF
-
'
06/03/96 MF T. COLIFORM ABSENT /100 ML ABSENT
COMMENTS:
BACT THESF RES1.11-TS INDTOATE THAT THE WATF AS NOT) 8F.A
SATISFACTORY SANITARY AUA[ITY ACCORDING-.�THE NEW YORK STATE
AND EPA FF ERA| DRINK ING WATFR STANDARDS, FOR THE PARAMFTFRS
TESTED, A THF- TIME OF COLLECTION.
`
;;URM}TTFD
-
Albert H. Padovani, yi.T.(ASCP)
Director.`
. • Y
PUTNAM COUWY DEPARTMENT OF HEALTH
_ - -.- IIIVISIOiy OF ENVTRONM' TAL HEALTH SERVICES _
_.... �� �; . •_: T ._. a f f'Wd a:. -. tii. — ... _. s-�,. .i a a•.i.l .t'W d.' �:. .a t — ✓ a •
Avram Nathanson
Owner or Purchaser of Building
Same
Building Constructed by
Canopus Hollow Road
Location - Street
61 -08 1 7
Section Block Lot
N/A
Subdivision Name
Town of Putnam Valley N/A
Municipality Subdivision Lot #
Residential.
Building Type
GUARANi'EE OF SUBSURFACE SEWAGE DISPOSAL 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 shoran 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
operata far._a__pez ad. of- two. years inrnediately following the date of approval of the
Ce! tif cate--o Cui75tractioil Compliance'- far�the sewage •disposal y ter,.:or:any..�• w �.
repairs made by me to such system, except where the failure to operate properly is
caused by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services of the Putnam County
Department of Health as to whether or not the failure of the system to operate was
caused by the willful or negligent act of the occupant of the building utilizing
the system.
Dated this day of v-,19-z Signature
Title
GehEal Coritracfor (Owner) - Signature
Avram Nathanson
Corporation Name (if Corp.)
225' West Shore Drive
Address
Putnam Valley ,7Y 10579
rev. 9/85
mk
Septic Installec
Marl; Meyers
Corporation Name (if Corp.)
Putnam Val. .ley NY
Addres
APPENDIX C F I NAL SITE I NISSPECT I Old DATE: - [.
Inspected by:
STREET LOCATION r t/J OVER
PERMIT i$ TM 0 OR SUBDIVISION LOT
1. SEWAGE DISPOSAL AREA
a. SDS area located as per approved
b. Fill section - date of placement
2:1 barrier LGTH
C.
Natura i sou noL sLi
d.
Stone,brush,etc.,gr
e.
100 ft. from water
I1 SEWAGE DISPOSAL SYSTEM
a.
Septic tank size -
b.
Septic tank install,
c.
10' minimum from fog
d.
DISTRIBUTION BOX
Boxes properly g
1. All outlets at s+
All pipes partia
2. Protected below
All pipes flush
3. Minimum 2 ft. or
YES NO OOMMENTS
Tans
WIDTH AVG.DPTH
from SDS area
ds
e. : i i uN bvR - proper i y ser-
f. TRENCHES
1: Length required - go-7) Le
2. Distance to watercourse measured
3. Installed according to plan__
4. Slope of trench acceptable 1/16 - 1/
5. 10 feet from property line - 20 feet
6. Depth of trench < 30 inches from sur
7. Room allowed for expansion, 100%
8. Size of gravel 3/4 - W' diameter cl
9. Depth of gravel in trench 12" minimu
10. Pipe ends capped
S . - PUMP OR DOSE SYSTEMS
1. Size of pump chamber.
2. Overflow tank
3. Alarm, visual /audio
4. Pump easily accessible manhole to gr
5. First box baffled
6. Cycle witnessed by Health Department
1 1 1 . HOUSE
a.
House located Pe
b.
Number of bedroo
IV. WELL
a.
Well located as
b.
Distance from SD
c.
Casing 18" above
d.
Surface drainage
V. OVERALL WORKMANSH 1 P
a.
Boxes properly g
b.
All pipes partia
c.
All pipes flush
d.
Backfill materia
e.
Curtain drain in
f.'
Curtain drain ou,
g.
Footing drains d
h.
Surface water Pr
i.
Erosion control
i
s�
an
IUMMM CC,Ut -ZfY r)FT%1Z- J_XW,P 01 1111AL,T11
DNCSIOt� C)1,I dV:L1 1LI�[7�L` ,Ill.AT,'[EI salyiCES;
'DESIGN CATA Sl-1iMM- SUBSUFAC::E, S.Bq LE DIS1?OSAL SYSfU t1 FiLE iJJ.
C_..:A•v- r.ar�� N•athan�a�Y_: ?kI�}rc ``22.6 s,t' Shore- `'Dr:i' Put'hdin valley
Located at (Street) Canoous_.Hollow Road_ __ Se; . 61 .08 I31 1 J.ok 7
Undi.ca to new e_s L Cross J LrEiLL _
r1,11rrici lit }' Town of Putnam Vall - ey WaLershed Hudson River
- - -- SOIL. PERCOLAdaCN '.MS11' [. *TM PIQUIML•'D 11t7 B1: SU)?R= WI'. 1 11PPLICNI.'MNS
Lkzt.e of Pre- Soaking Aug . 5,1994 LEzLe oi: Pei:c�olation Test Aug . 5 � 1994 .
HOLE
NC)z iT3F R =-K TIML_r
_
P3a tC_QLA ION
PMCOrATI0N
Run ):lapse
Dop( :h to
Wa un:. irc:rrr
Water Level .
--
No. '.t'UiY?
GT "OL1r1Cl
SCL1-.l:1Cl'
In Inches
SOil 11-. Lte
start-stop btin
.Il:r3.[.t
Stop
Drou In
24in /In Drop
Enchas _
Inches
Inches
A. 1 11:19' 11:28 9
_23 _5/8
26 5/8
3
3
A 2 11:29 11:38 9
23.1/2
- -26 1/2
3
3
A 3 !1:.39 11:48 9
23 114
26 1/4
3
3
A 4 11:49 11:58 •9 23-1/2 26 1/2 3 3
5
A 1 .11:46 12 :07 21 231/2
26 1/2 3 7
B 2 12:08 12:29 21 23;7/8 26 7/8 ;3 7••
B 3 12:30 .12:51 21 24 27 3 7
B 4 12:.52:..1:13 21 23 3/4 26 3/4 :3 7 -
5
2
3
4
5
Tes is to bc' repez Led' a L scuiY2 depth until approximately equal • soil rates
are obtained ,at each percolation test hole. X.11 data to' be subhidttocl
for review.
2_ Depth meaasu.rements to be made frcm top of hole.
rev. 9/85
ir..:�i ll�.'• 1. ii�ll i.l tl: ��, �u: �U..' lU :.isu:.,:::�u.�:�t�,'1'1'S::!). Wll'F-1.A:1:'k'1.�.1(_:A'1'01�!
- -- 1) . E-SCRIPTIOWOF sc rls r a urrr z �,.IN :TrsT,; x�za .. .
nrrYru Holm : No tica� 1 z � -- — 2 . lioLt
G L•' Tcsoil.'. =6" T :apsoil
— - -
..-_.- ......r »— ...r: "- �- .- .- ..n -..... ,. ... .i.. y'�' -t, +vx-._a.��..'�+�...- ..--.. ._._�.r. . ->'^l� ._ .. 7 —� �: �-. -• s. .. d.Or. _. -.<`. - M.-._. n..... .- --�,._
sa`rid login sand loam
.,'•. w ravel w
ravel—.
3 ,
6,
( end of hole) _ ( end of hole)
1_i'
.14'
imucATI: LEVl3, 'AT vmicH mai wy,•tA'I'ER I S EtTWJ N'=, :,D not encountered
__.. �--- iNi_ 7:C C1�Z' I7'_. Ti�t7�[.,- �` l�'- 4S? EJ>r � "��1`1';'12-1'ii��;11C;`� ?ISEa 11C� `1 "Ci2 "- I��:�i�1�•�6�tJNTE�D� ..NJp.... ".- _.,... _ „..._. .�..::..___ -,..__
DEE13 HOLC OBSERVA'T'IONS MADE BY: BADEY &, WATSON, P. C . Dpi: Aug. 3, 1994
Soil. Rate Used _ 7 Min /1” Dr-o[):" S.D. Usable Area Provided 5,000 SF
No . of Bedrooms . 4 Septic Tank Capacity 12 5 0 gals. 2ype
conc.
Absorption Area Provided By 400 - L.F. x 24" width trench
Other
Nacnc BADEY & WATSON, P . C . � � -- Signature
-- - --
�. O
Address Route 9 SEAL
Cold Spring NY 10.516: `P 0.062
THIS SPACa1 MR USE BY kM� L M 'DEf ?ARUJJ-rrr O ,Y _ >/i \�
.. O101iai011116a\
Soil hate .Approved scj -f t /yal _ Checked by. Date
' ��- 10579.'-.---
'
. ~
� Namo of Project: � ' 3. Lo(atiqn T/X/ ey
� Projec� Enginaer: &DE _ 5� 4d�r�su� U.S. Route 9
`
'
L�canse Number- 62505 Phone: '
. .
� � o e of . .
X Privete/k8sident,iel Food Sarvice ______ �Omngr01a` '
�partments Institutional Mobile Homa Park
OffiCe Building
9ealty Subdivision Other (sppo�fy`
__--_
' I�z P[0eot subject to State Environmental Quality Review (SEUR)?
Status (Check One) . I. Exempt
Type II. Unlisted
Lead Agency Putnam C
s this project in an area under the control of" local nlainning, zon-ing,
-0 r other of 'a I s, ordinances? '
-°
| �2� If so, nave plans been uubmitt_ed to such authorities? ........ . . .'...... |
1 ;5
Has* ore liminary approvaT been granted by _ �oh authorities Date Granted�
�_�
Type of Sewage Disposal System Dischorge�,�.... Surface Water _jC- 'Ground Waters
If surface water discharge, wh8t is the stream class designation?
|6. Waters index numbar�(aurfaoe) ....''..-''.^..�.'.'.`..........'.`'......
. '
17. Is project located near a pVbllc water supply system? ..................... 0 o'
| /8. If .es.' nome�o� *. r"sup�ly 0�� � �Distance to water. ply
. .
IS | rojent site near a�publ1o`aewege collection or disposal syytem?...,. _0
'0. Name of sewage aysteni'��-'
|
| }ate observed: (ll
. ' N/.
Di� ` '''to sewage'. system*
'
23� Name of 'oa�th`Ino! c nr� ' - obert
. �
' roject design flow (gallons per day)......'.'....................'...'....
` � � -
0 No
System (SPDES) Perri .�,6q,u i,
is ..State Pbll'utant'."Di*sc�,,a'r-g6.-:-.I,-:Imi.r-';8'. I
'
26. qas SPDES Application been su b mitte6d' t o local DEC 0 f, + i c e
Ts any portion-of 'this project locat,ed within a designated L
Wetland? .. .......... ......... No ......... — -----
28. .'wetland ID Number ............. NI/A
................
-_S Wet iand Per -it requ i red?
Has .?.pplicazlon 0een mane zo !own or LCcai utu UTTICe�
project r;aquire a DEC Stream Disturbance Permit? ....................
i-`tural ac- ivity involrin..-i ;apn 1, r; n
cir ,.ias pcj
re-_-,t S`-5 LlSeCl Lj
'Cles to orch�ards or- other- -rchs, Solid or hazar�.loiu_s d scr, s "a
j ication or �r.J-ustlrial activity? r - IQO_. —_ f3 - .. , � 1 G
d j
c; je. c C I o c a t. e d ''J1 1 000 -ife- e t o f ex i s e r c e of a b a i d w:- ri 1 7 ri
CI U Vi ST e. Site' te sa t s toc,p i I e, a d f i 1 1 Sludge di
Sr sall S 1'*7'_
k S 0 L; o f Co a. m i n. a t 1on9
.... .......
'Yes
'local master plan or- -1—ile with the Town or-
'here a Vi lave? ....
No
. a C 4 e S th 4 n 5
arer', sewer -1
planned to be develope,
.o nuni y w
-e -eas n excess of 15ov. slope? .............. . . . . . . . . . No,
��wage disposal ar
7
Hap D NUmbe r ............................................... ........
7 7 t r n Appi ic-ant
Approved Plans are to be re,u ed. to. Engineer
p
I b-f -by.ac pers-on'* o't, er than "ahe ap :�CalSl: efil I
I 9'T9 n 8 d'. .1 ne,
mu,�t be c1ccompanied 1,\ . f Autho,-." 7 at ion. F- U re w.' 1-11., t ` -s
1i; T 10 ti a Lette'r C). '', . I , th:
.7
sion may be grounds for the rejection o 1'. any.,submission.
I hereby aiff irm, under pena Ity of perjury., that informat ion provided on th. is
f.m. is true2 -to the best of my.knbw7eo�ge and. be7ief. Fa7se statements made
-orm
herein are.pun'ishab7e as a C7ass A M.is.demeanor pursuant to-Section 210.45 of
-the Pena7
G N A T UR E S OFF
ICIAL TITLES: Engineer.for applicant
e,
BAVEY & WATSON, Surveying & Engineering, P.C.
Route'9, Cold Sprin New.York 10516.
PUTNAM CO(JNTY: DEI)ARTMENT OF IILALTII
APPENDIX I,
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Jte : Property of--- Avram Nat hanso -�___�
I_,o c a t e d at Canopus Hollow Road _ _______, _ _._- _•_.____ .___..._.__..
('1') Putnam! Valley -_`S e c t i o n_61..08 _ _Dl a c lc_._._lZ o f
Sizhil i.v .. :i on of N/A
Sub(ay. Lot .' Filed Map I Date
Ger,tlemeii :
This. 1_et; ter is to authorize John P. Delano
a duly .licensed professional engineer X or registered architect___
(Indicate)
to apply for a Construction Permit fora separate sewage system, to
serve the above rioted property in accordance with the standards, ru:ir;.z;
or regulations
as promulagated by
the Commissioner of
the
Putnam CdLulty
Department: of
1lealth, and to
all .necessary p;. pers
on.
my behalf i_n
coau�ec.tiotz ��it:}r this niatte:r and to supervise the constru.ct:i.on of said
sti stern or systems in conf.ormi.ty with the provis-i.on.s of Ar•t.i.clr: 14> -or
147, Education Lail, i:he Public Health Law, and the Putmom County Sair:i -
ta.ry Code.
Very tru.).y yonx-s ,
S i gn e cl Aft 4v,
- - - -- - -- --
X
Utiniex of Property
Countersigned: L r
P . E . ,xftx , ;�`_ S - 226 Me t.-._ _Shore _Drire —_..
Address
BADEY -Putnam A_ . _ a11EYs _NY— X057 -9 --
Address a'owrr.
914- 528 -4170
Route 9 Co - S-r-ing
Tel_rphone
(914) 265 -9217
Telephone
BADEY & WATSON
Surveying and EEnglrseering, P.C.
Route 9
COLD SPRING, N.Y. 10516
(914) 265 -9p2�17 939 - 3.5787 628 -1800
TO Putnam County Department of Health
4 Geneva Road, Route 312
Brewster, NY 10509
DATE JOB NO.
8/18/94 8
ATTENT!ONr::
Mr. Robert Morris
RE:
Permit Revision
AV AM NATHANSON
Canopus Hollow
Putnam Valley
TM 61.08-1-7
IPCDH PV -30 -83
> WE ARE SENDING YOU )C] Attached ❑ Under separate cover via the following items:
• Shop drawings X7 Prints ❑ Plans ❑ Samples ❑ Specifications
• Copy of letter -❑ Change order X] other. as listed
COPIES
DATE
NO.
DESCRIPTION
1
8/17/94
Construction Permit for Sewage Disposal System
1
8/17/94
Letter of Authorization
1
8/5/94
Desi n Data Sheet
1
Form PC —1
4
8/17/94
Pro osed SSDS Plan
1
8/16/94
Mone order — $150.00
THESE -ARE TRANSMITTED as - checked. below:
7 For approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
> E As requested ❑ Returned for correction
❑ For review and comment ❑
❑ FOR BIDS DUE 19
REMARKS
❑ Resubmit copies for approval
❑ Submit copies for distribution
s ❑ Return corrected prints
0 PRINTS RETURNED AFTER LOAN TO US
COPY TO
40% Pro-Consumer Content •to %Post-Consumer content SIGNED: �
J
PRODUCT 240 � in„ Wun. Ym 01471. If enclosures are not as noted, kindly notify us at o S e
Y t 1•�yta J z �.,° M" F L ' {}. R x' s t §�' .L k •a.�, a- „ ,� 3 Z xA (
N
ba F a }r
` .„ i p` � 6' P.UTNAM COUNTY°DEPARTMENT"•30FREALTH'' r
8. ' f �8Rev to Ptovlde Peenilt' q.
on CERTIFICATE &tOMPLLANCE
} CONSTRUCTION P a FOt EWAGE' DISPOSAL SYSTEM i; Yr y'tiFy Permft' ' �D ~C.a
•� _ - `Putnam Val -ley f
lawn Or
Ckj! PPl .s Iio] low Road '
'YIIIfiRO
c
2
Sabdlvlslon Name
z
• Sabd. Lot A a~ � ^' Ta: Map3 3 �� 2 $IOCk 7 k2 Lot 6
a
k ` Avram `and Ka Nathanson Renewal�k❑ 4 ' ROV eiOn p %
Owner /Applicant Name - �% �`` y • ,� u `',1x
vloae )1p
Malang Address R . D Wye S� Shol^e Drive ~ ;Tel'Unam ey44�pt t y , I
Two Story .4 acres y1
Baildmg Type Lot Area t "'f FID Section Only Depth' �Volame
Nttmlier of Bedrooms 12 Design Flow G /P /1) Q T PCHD NotlBcatlon'is Regolred When FW Is completed
'r; 333 J1!�z• rent
Separate Sewerage system to consist of rlan GsUn1nb Uoris and ` 4 ] e Y' ane , _ am, a ey
t To be rnnstacted by -= (�
Water, SaPPI) Pabllc Supply From' QY
1
x rs on e4 ri
or: Private Supply; DrWied�by'hi Address a B w a r
a Y 4 i 4 ar`g Sta ;P.� ,alley
Othe['Regairements
x.~ , 'DOWQS't j.V Uses ��l'lly `C.,1 4 ^+yt \� iJ,2 i'� s 'y tl t, nr 5 •'
represen ha.; am wholly and completely respoh ;able for the tlesxgnand+ +location of the proposed system(s)��j��t� rte; se' peiate` „sewage,;disposal- iyftem
�..,
above °descnbatl will be, `con structetl as shown on the spprovetlamentlrnent there Lo and'�n;accordance with.,tftglt aiLp��=r .regu a ons o e u nam
Couhty Department -.of H 'ea lth - an tl�that on completi'on thereof a Certificates�of ConstructionyCOmpliap aTdf6t <tR�Cortimissioner of Hisalthwill,
be submitted Ito the Department antl a :wntten guarantee will De, furnished the owner his�`wceessa��•� AAA e► that said b'ulider, Ill'
place an ;gootl' operating condition any,,'part of said seMrage 'tlisposgl�� syriem during the` perxOA;ot,�t•v r �!n 1 Swing the of, the ipu-
ance of the approval of the;Certdicate..of ConstrucLon Compliance of. thtrougmal2system oranl r e t rHled Well described above
County; Oe artrhent of Health, a and a ons .of` the ,',Qutham
will tie located as shorvmon the approved plan and that said well will be installetl m a cordance with�t s r
28` 186
e �e • ;, _,
Date uJ ! 5�9ned r • d a•P E ii
ACd.ess w Peek 11 n 'yo. 27846
APPROVED FOR CONSTRUCTION This approval`expues, one year from the date issued unless tca�stru t oQ.7��iD ing ha been undertaken and is
revocable for cause or'may be amendetl:o�:moddxed when eonsxderod neeessary by the`Co mxssxoner if h e obalCeratlon of cohttruetiOn
.. -
'Approved”, .;%
requires a'•new, perrgit_ for,tlisposal oftlomeriic,sanda sewage',antl r p ^i ate afar sue�l �[`� ••
It
UC
Date J. 4— BY • tale
i
IPUTN COUNTY
,1p\ Division of Environmental
.CONSTRUCTION •PERMIT FOR $EWAGE;.DISPOSAL SYS
K .•sous =Hallc:;v R�,� : , j,
Located at ,
.None
,,Subdivision
owns; Mildred, McCoy,
Building Type 2 -StVy- /y Lot Area 1` a�
Number'of Bedrooms T �`
Separate Sewerage System to consist of ?�� G
To tie :constructed by Jerry Nika
5
Water Supply: Public ''Su pply ;From =
s X: Private •Supply, to be` drilled by %= AN<
Address: _ Barger':
O,ther•'Ftequiretnents DOmestlC; USe OI114
I. "represent that I am ,wholly and completely responsible for the design a
,above described -will be 'constructed as. shown on the'approyeo'ipj ndmei
County Department of Health, and that on compl_et=on thereof a Gei
r be' submitted -to the Department „and a written guagap.ge�wil be�zifu
place =n' good ,operating 'condition, any part of said sewage disposal
ance of the approval of ,f he Certificate of Construction Compliance
)iVill "be: located asrshown on the approved, plan and that sa=d well will bbJ
°County ,DepartmentTOf Health �x °� a'
! f June 27"
.D`ate f 1
_. ,;F �1 Northr dge`� �Rc
. Ad 'dress z
A
APPROVED FOR CONSTRUCTION �Thisapproval'expir stone year.j
revocable for cause or ma`y•be. amended• or.modif=ed"when,considered•gni
!requires 'a new o ' . q p ved for disposal of `domestic no a.;
KDate BY
S
DEPARTMENT 'OF HEALTH b "�
6'iiih 5Sekvices, Carmil- N. Y 1,0512
fgEM F
.-Putnam, Valley (T
Town or Village.
- Section ',G i 6YOcli .:
Lot 6 ' Job
a Adaress .Canopus Hollow Rd
•rye _+ -, Put_ nam' Valley, .NY 10579
Total Habitable Space 1'60'0 Square Feet
Q J
al 'Septic Tank ��3 _ lineal feet X” width trench
Address ;Lake. Peekskill,. N.T.
ierson Well Drnllers .
street, :Putnam' Valley, NY 10579
ntl location of'tin proposed system,( is a arate sewage disposal system
rt there to and m accorJance with t egu a ions of e Putnam
t=ficate of Construction C omplia mmissioner•of.Healthwill
rn=sned the owner his successors ass. s i er,_th6t said "builder will
_ s'Sw f•: d
Y the ate of the Issu-
system tlur=ng •the period o twa i ng
of {� }fhe ongmal system,or any ;� r t th I well described above
stalled m ;accordance with, fl and r._ r1s f the Putnam
s e
P.E. X
�aPeetksk}i11; _NNIV 17 en ,
02786.
s�VOi
omfthe date issued Sunless construet� has been undertaken and is
cessa'ry by�4tFie�Coni s ner -.of .,,—, a or alteration; of construction
sage'pnva ater supply only
f .
. _ _. �• .Titl
O
MR
P
Ymmm
/ o
PUTNAM COUNTY DEPARTMENT OF HEALTH.
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
'iv cP r.�-�: -.r. HYV'./.'V -a'M�.YY .`d� ►u wa- fM1•�vASC. mnen . •., h."'+i. ttrt'L.r•.. ..�....v+.l: -v T�..u».: tt .n •��...:..'`......
Date 10V @tuber
Re: Property of Avram Nathamson
Located at RD #4 West Shore Drive Putnam Valley, NY
(T) Putnam valley Section 23.2 Block 2 Lot 6
Subdivision of none
.Subdv. Lot # Filed Map # Date
Gentlemen:
This letter is to authorize John S. Romeo P.C.
a duly licensed professional engineer or registered architect_
(Indicate
to apply fora Construction Permit for a. separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary 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*;.
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned'
P.E. , 1:�A*• , #
9'�_ 4. A---
2846
Very truly yours,
Signed alv -VirL
Owner of Property
1 Northridge Road
Address a ®�Qc� ,��a•.R����9., °.
Peekskill, New York m '°
(914 ) 737 -1056 4
Telephone ® �786 a
®00 of NEw Alt °
°000.9 ®OA
RD #4 Webt Shore Drive
Address
Putnam Valley, New Yorl
Town
(914) 526 -3058
Telephone
PUTNAM COUNTY DEPARTMW T OF HEALTH
DVI-SION = OF=- "ENVIRONTAI; HEAT�TH` SEtVICES
Date June '279 1983
i
Re: Property of Mildred McCoy
Located at Canopus Hollow Road Putnam Valley
Section 23 °2 , Block 2 Lot 6
Gentlemen:
This letter is to authorize John S°. Romeo
a duly licensed professional engineer X or registered architect
(Indicate)
to apply fo.r a'Construction Permit fora 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
Department of Health, and to sign all necessary 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
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned:
P °E °, f' go, # 21 846
1 Northridge Road
Ad ress
Peekskill, NY 10566
737 — 1056
Telephone
Very truly yours,
Signed
Owner o roperty
Addre
Telephone
(Seal )0° 0 0000000
,0�pN�1 ENS /ryFF ° ®o
0 p
o �a
°°®
1A
gv
JUN :2 9 1983
PUTNAM COUNTY
DEPT, OF h -EALTH
P'UTNAM COUNTY DEI'AMTEN`' OF HEALTH
DIVISION OF ENViROWMEMTAL JID1 LTH SERVICES
COUNTY. -_OFFICE-. ... 2 1
FILE NO
OwnelAvram. Hatham8 on Address # Weat Shore Dr. _Putnam Valley
Located at (Street anopue Hollow Rctec.'-2 .2. Block 2 Lot 6
Hcdicate neares cross street)
Municipality Putnam.-Valley Watershed Peekskill
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM
o e
Number CLOCK
TIT.
PERCOLATION
PERCOLATION
apse
Dapth to Water
Water Levei
No.
Time
From Ground Surface
in Inches
Soil Rate
Start-Stop.
Min.
Start. Stop
Drop in
Min. /in drop
Inches Inches
Inches.
(i )1. 1002 ig
s4i .9
22.50 25.x;0
.3.00
3.00
Notes :. 1) Tests to be repeated at same depth until approximately equal. soil
rates are obtained at each percolation test hole. A11 data to be submitted
for review.
2) Depth measurements to be made from top of hole.
TEST PIT DATA REQUIMED TO BE SUBMITTM 1-11TH APPLICATION
DESCRIPTIO11 OF`3011Z 1,11CCUNTE 2 ED TPI TEF3T HOLES
OL
DBPTH HOLE NO. MIX NO, a T, _NO.,_
G.L. Topsoil .Topsoil Topsoil
6 511,'? Topsoil. . .61 T-opsoil 5.1! Topsoil
12" R a0 6,B Gravel R., Q. B o Gravel R :O r
o,B o, Gravel
2411
3011
3611
42"
4811.
5411
6011
66"
Off
INDICATE LEMEL AT V`HICH GROUND WATER IS ENCOUNTERED None
.J IC 7..71 7, ►
if
ov I
.Soil Rate Used 0-5 Mini "Drop: S.D. Usable Area Pr' 1 ded
No. of Bedrooms 4 Septic Tank Capacity 1200 Gals. pe
..Absorption Area Provided BY__322_L-F.x2411 x 3611
I" LIM
R
I , Name jQn-n i, Komeo manature,
Address A . Northrtidge Road
SEAL
Pbekskill,q New York
5000 SF
Masonry
rench.
e
0
THIS SPACE FOR USE BY BEALTH DEPARTP4ENT ONLY.- 00G0` a p.0-
0006000
Soil Rate Approved Sq. Ft/Cal. Ch,66kcd by Date-
171,,, 1
V
14
OF. HEALTH
4
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
...... _ COUNTY OFFICE.:BUILI?INC
DESIGN DATA SHEET;- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner Mildred McCoy Address Canopus Hollow,Ad Putnam Valley, NY
Located at (Street 4dicate anopus Hollow Rte. 23.2 Block 2 Lot 6
nearest cross street)
Municipality Putnam Valley (T) Watershed Peekskill
SOIL PERCOLATION TEST DATA REQUIRED T.O BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
apse Dept o. a er Water Levei
No. Time From .Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop,
Inches Inches Inches.
(1) 1
10 :32
10:41
g
22.50
25.50
3.00.
.3.00
2
10 :43
10 :53
10
22.50
25050
3.00
3..33
3 10 :55 11 :05 10 22.50 25.50 3.00 3.33
m
r.
.5
(2) 1 10 :37 10 :47 10 20.25 23.25 3.00 3.33
2 1�s50 113 Q2 ,_ ._._12 ........._ 200 25 . z3.5. o0 4-.00...::....:....._ _....�:
3 11 :06 11:18 12 20,25 23.25 3.60 4.00
5
1
2
4-
5
Notes: 1) Tuts to be repeated at same depth until approximatelWrUIVED
rates are obtained a,t each percolation test hole. All data to for review.
2) Depth measurements to be made from top of hole.
JUN 2 9 1983
PUTNAM COUNTY
DEPT OF HEALTH
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH. _ HOLE _ NO. .1 _ _.MOLE. NO.. _ . _:LE n ?J. .. 3.
G.L. Topsoil _ Topsoil Topsoil
6" 51 TopsdLl 6" Topsoil 5" Topsoil
12" P.O.B. GRavel ROO.B. Gravi R.O.B. Gravel
18"
24" i
ku
i
3011
INDICATE- LEVEL AT WHICIi.,GROUND WATER IS ENCOUNTERED None
INDICATE -LEVEL TO WHICH "WATER LEVEL RISES AFTER BEING ENCOUNTERED -
- _ _ ,.TESTS. MADE BY :, Date Jane .18 9 1983
John - . omP� __...._
DESIGN
Soil Rate Used 0-5 Mir/1 "Drop: S.D. Usable Area Provided 5000 SE .�
No. of Bedrooms 4 Septic Tank Capacity 1200 Gals.. Type Masonry
Absorption Area Provided By 333 L.F.x24" x by' _thok:�ench.
Name John S ^. Romen Signature
O
Address` 1 Northridge Road SEAL o
Peekskill, NY 105 0
:o
THIS
SPACE FOR USE
BY HEALTH DEPARTIENT
ONLY:
Soil
Rate Approved
Sq. Ft /Cal.
Checked by_
0
4 p
x' o
c
.0
0040000000-
Date
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS
FIELD INSPECTION
.. _ ,.,.. � , . ... .,.....__. _... .. ......,. �- .::.:. .,..:; .. :� - DATE`:.:..:... _.: c,`. .- �•�-�:.� ..... �...
INSP. BY:
(Name of Owner) _(Street`Location
INITIAL SITE INSPECTION S U YES NO COKV0 rS
Wetlands on /or proximate to property..
Property lines or corners found... .............., d�ti1
Can estimate house location....... ..............
Will driveway need cut ............................ 0
Must trees be removed - note these ................
Deep holes representative of entire SDS area......
Additional deep holes needed..... .... ...... Mb
Sufficient SDS area available considering driveway
cut, house location, separation distances,etc... ✓
Adjacent wells/ septics ............................ ✓
D.H. 1 Lot
Depth to G.W.
Depth to rock
Soil DescriDti(
0 ft.
3 ft.
6 ft.
9 ft.
D.H. 2 Lot
Depth to G.W.
Depth to rock
Soil Description
0 ft.
3 ft.
6 ft.
9 ft.
12 _ ft. _ .. _... _. _ _ _...12 ft. _
D.H. - Deep Hole
G.W.- Groundwater
D.H. 3 Lot
Depth to G.W.
Depth to rock
0 ft.
3 ft.
6 ft.
9 ft.
12 ft
Soil Descri.
DATE:
FINAL SITE INSPECTION INSP.BY:
YES
NO
COMMENTS
House SSDS located per approved plan .............
Length of trench measured
Width of trench average
Slope of tile line and trench acceptable.........
Room allowed for expansion trenches ..............
Over 100 ft. from watercourse ....................
Natural soil not stripped or SDS area
unnecessarly graded.......... .... ........
1,0 ft. maintained from property line and
20 ft. fran house... ........................
Distance well to SSDS (ft.) ......................
Number of bedroans checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. fran nearest trench ..........
15 ft. of peripheral soil horizontally
from trench ..... ...............................
Boxes properly set......... ...................
Could surface runoff from driveway, roads,
ground surface, etc., channel near SDS area....
( __
Does lot drainage appear OK in area of SDS.......
�-T
FINAL GRADNG OF SITE ACCEPTABLE.. ... ....
QROQOg`c
,� OF
FEE
0
\ � -� -vim
Do 0
IPS
00,
"Zoo. -0,. !L
SO
OJ �dJ
Q�o
PLAN
o O
4 F
a,
0
QSO''
F
aS
PLAN
o O
4 F
a,
0