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HomeMy WebLinkAbout2785DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62. -1 -59 BOX 23 ' r y .r 9 I 1 r J � T ` 'L mg - L 0 ' T 02785 PUTNAM COUNTY DEPARTMENT OF HEALTH ell) ?!N . ENTAL.HE- LTH CERTIFICATE. OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # V - I -0-3 Located at Town or Village Owner /Applicant Name .9. �fjoNY� SS'f1' Tax Map Block Lot Formerly Ir Subdivision Name A Subd. Lot # AArhl gtl& Mailing Address i �1chtw4w'4 Z14-lcc 4A-p Zip Date Construction Permit Issued by PCHD Separate Sewerage System built by AddressS�"oscn- Consisting of Gv Gallon Septic Tank and ��y L "�' 44so�Z7 t/n i 0,1 Other Requirements: Water Supply: Public Supply From Address or:__ Private Supply Drilled by MMA1VJ&0,tue1AJ Address &-Z , /"' n'4- " Ilas efusiorrtoiiirol -nc;en completed': Number of Bedrooms Has garbage grinder been installed? AID I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations the Putn unty Department of Health. r Date: /Z o &00 Certified by P.E. -4 R.A. (Design Professional) Address 0� 96X /d*!K7 c I e14 r74 License # 6747;U Any person occupying premises served by the above system(s) shall promptly take such action as maybe 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. B 6 G Title: -'vhl a copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Date: % /-)L6 107 Orange copy - Design Professional Form CC -97 DIVISION- ENVIRONMENTAL �` �:� HEALTH GUARANTEE ®E SUBSURFACE SEWAGE TREATMENT SYSTEM /IIt D�T� ��oi✓�s�J wner o Purchaser of wilding ^ 61 W6t Building Constructed by : q-T JsG�w)v e Location - Street Building Type �! Tax Map Block Lot Town/Village 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 undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Departrr t of Health as to whether or not the failure of the system to operate was caused by the willful or negligent ac "t of the oecupant of the building utilizing the system. ., Dated: Month Day /0 Year Zoo G General Contractor Owner) - Signature Corporation Noie (if corporation) Address: ,,f�if 4 State 1 1f11<_f 64/�� /� Zip Signature: Title: 0 t04- Corporat' Name (if corporation) Address: State Zip Form GS -97 s° BRUCE R. FOLEY a Public Health Director �LORETTA- MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Vii., 4 J Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 60,85 Early Intervention /Preschool (845) 278.6014 Fax (845) 278 - 6648fig 1;' iDEC 27 2036 E911 ADDRESS VERIFICATION FORM����� OWNERS NAME: .5`FNao'q f 4v,vCs5e9 TAX MAP NUMBER: 4Z - -- `� E911 • ADDRESS: TOWN: AUTHORIZED TOWN OFFICIAL: DATE: (Z&� 44 (Si ature) u.. - X} The Putnam County Department of Health will not issue a Certificate of construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificatc of Construction Compliance. (E911 verfrm) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES t�ilellcPermit#'a .. " �%.:.i WELL COMPLETION REPORT Well Location Street Address: Town/Village: Tax Map # GPS, 113 J � Map 14' Block I Lot(s)Sf Well Owner: Name: _, Address: Use of Well: _,Residential _Public Supply Air cond /heat pump _Irrigation I - Primary Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment \e otary _Cable percussion _Compressed air percussion Other(specify) Well Type _Screened /Dpen end casing _ Open hole in bedrock _Other Casing Details Total Length tO ft Length below grade3ls'ft. Diameter G in. Weight per foot —lb/ft Materials: "teel Plastic Other Joints: Welded ✓Threaded Other Seal: Cement grout Bentonite Other Drive shoe: Yes _L-i6 Liner: _Yes "o Screen Details Diameter (in Slot Size Length (ft Dept to Screen ft Deve ed? First _Yes _No Hours Second Well Yield Test _Bailed _Pumped _ Compressed Air Hours -7%— Yield r% C7 gpm Depth Date Measure from land surface- static spec ft) / .4Y3a During yield test (ft) Soo Dept o complet;d well in ft. 3a� Well Log If more detailed Irlforrllatlo9 ._ _ :_.. sieve analyses are available, please attach. De th From Surface Water Bearing Well Diameter (in) Formation Description ft. ft. Land Su ac6 ..... ., ..._.. _ _ ii.V 0 t, . krC _ ✓ _ _ - a .......... .._.._. If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depths Model 6 f Hlq�s Voltage a36 HP /T Tank Type WA l U ,�. Volume 10 of eport z NOTE: Exact Location of well with distances to at least bko permanent landmarks to be provided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 YML ENVIRONMENTAL. SERVICES e �, sSt^ 2'I. °Kear. Street Yorktown.•`Heights; N.Y.. 10598. (914) 245 -2800 hli7er t- ' Padovatl LAS. ; #.: l.: 606.0'80.. CL I ENT # • 2.17 3 'NON- STAT PROC. PAGE; 1 - -. - - - - - - - - - - - - - - - - - - - - -�- -- - - - - - - - - - - - - - - -------------- NORMAN ANDERSON INC.. DATE /TIME TAKEN.: 10/02/06 12:00 152 BARGER ST KATE /TIME RECD: 10/02/06 02c00 PUTNAM VALLEY, NY 10579 REPORT DATE: 01/19/07 . PHONE:., :(914) - 528 -1491, SAMPLING SITE: 3.4.8 OSCAWANA LAItEiROAD < <` SAMPLE 'TYPE.. POTABLE PUTNAM VALLEY PRESERVATIVES::•NONE. . COL':D.. BY : BEVERLY'. TEMPERATURE...: < .4C NOTES..:: BASEMENT.OUTFALL ! COLIFORM METH:.MF DATE FLAG PROCEDURE. . °r .RESULT'. NORMAL RANGE METHOD PUTNAM CNTY PROFILE. LL--. 10/02/06. MF T.. COLIFORM ABSENT. /1'00 ML; ABSENT ..1008' 10/03/06•.. LEAD. (IMS). <1`.Ppb .:::::..; .. :• .0 =1'S .ppb. 9003 10/05/06 NITRATE' -N1TR• G .:'-- •1 A- 6.:MG /L =:,. <; ...:.:......:.0 = .10. 9052:. 10/0.4/06. NITRITE N -IT 0G <0;.01 MG /L N /A. 9162 16/04/06 IRON -(Fe.) ,' <0.060..MG /L:.­­- : :.'.•. 0 -0.3 mg /'1 9002 10/09/.06. MANGANESE ( ) .. <0. 0:10 :MG /L ` ',` 0 =0.3 mg /1• 9002 10/.05/06, SODIUM (Na) 4.88 MG /L: N/A 9002 10/02/06., pH . 7.5 UNITS:-;.''•:' 6.5- 8..,5;:. ,•9043 1.0/03/06 HARDNESS, L 124' ;MG /L. N/A 10/03/06 ALKP,LINITY ` (S 108 MG /L:':::. ' . N/A 10/'03/0.6' TURBIDITY. (TUR: ��..NTLf.;::.:.;:;::;;:. 0.- .5'NTU COMMENTS: BACT THESE RESULTS INDICATE :T I THE WATER : (WAS) ,• (WAS NOT) OF A. ..SATISFACTORY SANITARY ,QU�TY A000RDI• THE NEW YORK STATE - AND EPA FEDERATE DRINKING•: WP,TER . STANDARDS, FOR: THE-'. PARAMETERS_ TESTED, AT THE TIME- OF. COL( ECTION.' ­,• ' . Pb /Cu: LEAD li.mi.ts for public schools; ar-6- ..set at-;, ppb.. EPA ••Lead. &•• Copper:.Rule- for Pubiic: Systems. -, : qu re.s::tha t no; more". than 10� of their. •disttibultion oints Have a LEAD• value- of...more P . than. 15. •ppb :.and. A COPPER value of .1;'--3 mg /L, else. water . treatment must be underta. yen •to reduce• the waters.. corrosive potential. Fe /Mn If both iron- and 'manganese: are: pr'esent`s ::: their- total .value combined.shall not exceed 0 Na No.. •1imi.ts : for Sodium are p ;oscribed... Suggested .guide.l:ines :state. . that for. people . on. a sodiu n. restricted diet., •the• :water should contain no more than 20 'mg. /L: o .-Sodium. ...For those. on -a moderately restricted. :diet, a• mximum.-of. ;.•230 .mg /L of Sodium YMLENVlRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y, 10598 . .Albert H. Padovani, Director . LAB #: 1,606080 CLIENT #: 203 NON STAT pROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NORMAN ANDERSON INC. DATE/TIME TAKEW 10/02/06' 1000' 152 BARGER ST DATE/TIME REC'D: ]O/02/0602:00 � PUTNAM VALLEY, NY 10579 REPORT DATE: ` 10/09/06�' ' PHONE: (9.14)_52071491. i� SAMPLING SITE: 348 OSCAWANA LAKE ROAD SAMPLE�TYPE..: POTABLE : PUTNAM VALLEY PRESERVATIVESu. NONE 1000 BO' BEVERLY � 4OTES ... : BASEMENT OUTFALL COLIFORM METH: MP | � ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD ' PUTNAM CNTY PROFILE ` 10/02/06 MF T. [OLIFORM ABSENT /100 ML ABSENT 1008 10/03/06 LEAD (INS) '1 ppb 0-15 ppb 9003 10/05/06 NITRATE NITROG 1.86 MG /L 0 - 10 9052 10/04/06 NITRITE NITROG <0.01 MG /1- N/A 9162 10/04/06 IRON (Fe) <0.060 MG/L 0-0.3 mg/l . 9002 tV/09/06 MANGANESE \Mn/ {0.010 MGyL 0-0.3 mgyl 9002 10/05/06 .SODIUM (Na) 4.88 MG/L N/A 9002 J.0/02y06 pH 7,5 UNITS 6.5-8.5 9843 10/03/06 HARDNESSvTOTAL 124 MG/L N/A 10/03/06 ALKALINITY (AS 108 MG /L. N/A , 900j.' 10/03/06 TURBIDITY (TUR _ <1 Q-5- MIT-- COMMENTS: ^ACT THESE RESULTS INDICATE THAT THE WATE WA SATISFACTORY SANITARY QUALITY ACC DI�@ -HE NEW, YORK STATE AND EPA FEDERAL DRINKING WATER ST` DARDS, FOR THE`- 'A ,METERS ' . TESTEDv AT THE TIME OF COLLECTION. - ' ~�^ 'b/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1,3 mg/L, else water undertaken to'reduce the waters corbsive ' e/Mn If both iron and manganese are present, their total value _ combined shall not exceed 0.5 mg/L, . . a No limits for Sodium are proscribed. Suggested guidelines hate that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those ona moderately restricted diet, a maximum of 270 mg/L of Sodium ' . I �| � `l| , ^ ' ' ` + o1.6O6080 CLIENT #: 2173 ORMAN ANDERSON INC. 52 BARGER ST UTNAM VALLEY.., NY 10579 ' .'. . ��� IN� SITF: 1348 OSCAWANA LAKE ROAD ' ` ` pUTNAM VALLEY ' OL. ' D BY: BEVERLY OTES...: BASEMENT OUTFALL ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ��` F/�w� '^'A'^~ ' `' —' - '""CE^"^"- -' YMLENVIRf")NN R(/1[��S'��``��`� 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-28O0 Albert H. Padovani, Director NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ .DATE/T{ME TAKEN: 10/02/06 12:00 DATE/TIME REC`D� 10/02/06 02:00 REPORT DATE: J.0/09/06 PHONE: (914)-528-1491 SAMPLE TYPE..: pOTABL£ PRESERVATIVES: NONE TEMPERATURE..: < 4C COL1FORM METHt.MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD is suggested. A pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH lS ONE OF THE IMPORTANT AND FREQUENTLY U8EDTESTS IN WATER CHEMISTRY., � WATER WITH A LOW pH MIGHT BE CORROSIVE TOMETAL PlPES AND ' FIXTURES. THE NORMAL.RANGE OF pH IS 6.5.1*0 8.5. TOTALHARDNES[� IS DBFINED AS THE SUM OF THE CALCIUM & MAGNESlUM CONCENTRATION, BOTH EXPRES SED AS CALClUM CARBONATE, IN MG/L, THE . ^ � '- NDREDS�[F'!�G/L.,�/EPEWD��'[}� SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD TER: ABOVE 3O0 11C.) /L MODERATELY HARD WATER: 70-140 MG/L MG /L IGRAM PER LI TER ' HARD 140-300 MG/L (1 grain/g�ll-`��'�x�7.2 MG/L) ' 1 ` �' \ ' ' � ` � ` � � U8MITTED BY: AlberV H. Padovani , M.T. (ASCP) Director ELAP# 10323 SHERLITA AMLER, MD, MS, FAAP Commissioner.of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Stephen J..Ferreira 123 Washington Ridge Road New Milford, CT 06776 Dear Mr. Ferriera: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 January 18, 2007 Re: Construction Compliance — Paonessa 548 Oscawana Lake Road (T) Putnam Valley, TM# 62.4-39 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. k! Please provide the original water analysis. 2/ Relocation dimensions A3 and B3 are reversed. 31 The relocation dimensions for the beginning of the trenches have not been provided. A/ The relocation.A;mensions Ex the well n!peds to be provided. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 2157 if any questions arise. , JSP/kly Enc. Very truly yours, tF✓ �: `lit- '''ri�"�i' osephS. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early InterventioniPreschool(845)278 -6014 Fax(845)278 -6648 FAJP EgLffiln€arInu NOVVIGON January 2, 2007 Stephen J. Ferreira, P.E. .... r .... � �... _ ,� _ . _ .._....... New Milford, Connecticut 06776 Joe Paravati Putnam County Health Department Devision of Environmental Services 4 Geneva Road Brewster, New York 10509 Re: SSDS Construction Permit ��vvESJ�J Sect: & Z Blk: ( Lot: PV-19 -03 Dear Mr. Paravati: Please find the attached as -built plan and associated paperwork for the Certificate of Construction Compliance.. Please feel free to contact me if there are any further questions or information required. Since ly Yours, Stephen J. Ferreira M4 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI,.RN, MSN Associate Commissioner of Health Stephen Ferriera, PE 123 Washington Ridge Road New Milford, Ct. 06776 Dear Mr. Ferriera: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 January 23, 2006 ROBERT J. BONDI County Executive Re: Field Inspection — Paonessa 548 Oscawana Lake Road, (T) Putnam Valley TM# 62.11 -1 -39 A site inspection was made for the above referenced project on January 20, 2006.. The following comments must be corrected in the field. wn It appears that the cast iron pipe has a 450 bend. Please verify whether the two long vertical pieces of cast iron pipe are to be used as cleanouts. The garage was supposed to be level with the first floor and the area underneath unexcavated. The garage is now level with the basement, but it appears that the space above is going to be all open. If this is not the case, revised floor plans must be submitted for review. The.footine drainhoof leader discharge.has not been comp?et_ed. ?� , Pieme rnotiP -this 11epnent . upon comp'ietion:. _ There appear to be two 45° bends on the effluent line, which requires cleanouts. The system can be backfilled. S If you have any further questions, please contact me at (845) 278 -6130 ext. 2157. Sincerely, JSP:cj C./ .� Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 MEMORY TRANSMISSION REPORT TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 385 DATE JAN -10 12:04PM TO 919147341029 DOCUMENT PAGES 001 START TIME JAN -10 12:04PM END TIME JAN -10 12:05PM SENT PAGES 001 STATUS OK FILE NUMBER 385 * SUCCESSFUL TX NOT ICE * *� S1FII>aH23.Y'II'A A1VY11..lEEZ. MID, IVQS, Y1C J. HONIDd Commissioner ofH¢alth -0c � County £xecuttve lLO1ZE-S'71'A 1VIl ®Y..Y1�1A1RI, YLN, NYSN y.E $ Assoc[are Commissioner ofH¢alth pEPAFWrMaNT OF 6 e^L. -rH 1 Geneva iLoad, Brewster, Wew'Yoric 10509 Stephen Ferviera, PE 123 Wash rgt..n.R.idpe Road ..._ ... ._. - January 23, 2006 Kd. ' - `rie:d in5pccr'--., -- as c - =cc -- -- . -_... - 77. ... - 548 Oscawana Lake Road, (T) Putnam Valley Tl%4fO 62.11 -1 -39 Dear Mr_ Ferriera: A site inspection was made fbr the above referenced project on ]anuary 20_ 2006_ The following comments must be corrected in the field- 1. it appears that the cast iron pipe has a 45° bend. Please verify whethor the two long vertical pieces of cast iron pipe are to be used as cleanouts_ 2. The garage was supposed to be level with the first floor and the area underneath uncxcavated. The garage is now level with the basement, but it appears that the space above is going to be all open. If this is not the case, revised floor plans must be submitted for review. 3. The footing drain/roof leador discharge has not been completed. Please notify this Department upon completion_ 4. There appear to be two 45° bends on the effluent line, which requires cleanouts_ 5. The system can be baclefilled_ lfyou have any further questions, please contact me at (845) 278 -6130 ext. 21 57. Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj ]Environmental II3eatth (845) 278 -6130 Fax (845) 278 -7921 Water Supply S-0— (845) 225 -5186 Fax (845) 225 -5418 N—Iag Servlees (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Caru Fax (845) 278 -6085 F—ly Interveutlon/Presc600l (845) 276 -6014 Fax (845) 278 -664B PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEPMC FINAL SITE INSPECTION A5' Sr-g k 117 'dos TO Date: 1 1 1.710 Inspected by: 35P 6.-Is7cc Ctreet,Location b5r.�_r Town L2'rr� &V 'W-e Permit # i�"' -e R 3 Subdivision Lot # iu 1. Sewage System Area - a. STS area located as per approved plans .......... :................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ................ ............................... d. Stone, brush, etc., greater than 15' from. STS area.......... e. 100' from water course / wetlands ...... ............................... IL Sewage System a. Septic tank size - 1,000 ...:.....1,250 ......... othed 01) b. ' Septic'tank installed level ...— .......... ....I........................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ...........:..... 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft.Original soil between box & trenches e. Junction Box - 'properly set .....:.... ............................... 6, renc es 1. Length required � Length installed 2. Distance to watercourse measured Ft.... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from sur&ce .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean........... "''' "..: 9. Depth of gravel in trench 12" minimum .......:........... ::.:.10.. Pipe ends capped ............... .. .:: .:::::: :............. . ..��'�ruYp�or-]'ruseri _._. � ... - . 1. Size of pump chamber ...............jj. ............................ 2. Overflow tank ....................... ... . .... ............. 3. Alarm, visual/audio ................ ............... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... I L House/Building a. House located per approved plans .......................:.. ... b. Number of bedrooms ................ ............................... IV: Well Well located as per approved plans .......:................... b. Distance from STS area measured ft........... c. Casing. 18" above grade ................ .............:................. d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted .............. .. .. b. All pipes partially backfilled ...................................... c. All pipes flush with inside of box ... ....:.......................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan; f. Curtain drain outfall protected & dinto exist waterco r g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .................................... i. Erosion control provided ................. ............................... Rev. ?2/02 YE ' O COMMENTS r ' tj 55x5 ,,.%i . dy ,&- fie c:i7irn /i+j' 4 c� VY ✓� aja` w orm .e.j, /0'�' I M ke- IWL FROM :SJFENGINEEPING FAX NO. :860 -350 -2499 APR - 25-2002 03:07 FROM:PU "NAM COUNTY OEpPRT 845-278-7921 Dec. 28 2005 04:03PM P1 717,919147341029 PmArd COUNTY DEPARTbXKT OF RIPALTH - DIM1U1V Of LMU0 !1 NVp*TAL IMALTE SEI.VjC AT7MNTM,q� U. M1 EQ For: Fill All information must be fully -completcd prior to any Teewkes_: ° impectiom being made_ PCED CmnstmwouPermit# t ocatod: dw "&C (1)(V) Opovow4aq VA %, �vnarlAppkcant B3ame ;. .. ;6A 61-. It Bk ` I_ . Lot A4 Formerly; W -� -- Svb&dom Plame: Subdhisicn Lot s Is system fiL coi xpleted? irgt Data / E ^. Is. system comp'lsie? Date: Is system constricted as pcc plans? Is well dr'led? t�$r .. _ Bate.• /90 .YsvQ located zver -pleas? Are erosion control mean m in place? __y4f z that the system(s�, as ]mod; abM P=ises bas bona cen4mated and I barn h' mact ed aad Yee -Red their corWedon in. accordance vAth the issue PcHD Cocs wc°aon 1Pendt and approved plans and the 3taudatds, Rules ®ud Regtaton of th �utnaa County Degat�n os a3_t:. Date; Certified by. f DeaPro sional Form: 99 DEC -28 -2005 WEE, :14:39 1'EL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH :. DIVISION. _OF: N.,V NMENTAL WALTWKERVICE CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # PV-0_3 _- I / Town or Villa e PUTA.,*n Vic l Tax Map, Block Lot 3 Located at e9SC,+W *jy+ ,/41kr- pvtb Subdivision name Subd. Lot # — Date Subdivision Approved Owner /Applicant Name Mailing Address Amount of Fee Enclosed Building Type WOO# Fill Section Only Separate Sewerage System to consist of "Y0 Renewal Revision x Date of Previous Approval Zip of Bedrooms S� Design Flow GPD _IXO Depth Volume gallon septic tank and .5*'',k9t L - Other Requirements: IF ' To be constructed by Address Water SuMly:.__- _.-t P&0FjL ippl;y F:orx► . %3 c:c�s... .._. K or: Private Supply Drilled by. %/j,�, Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: - P.E. Y R.A. . Date & lerk ^ Address /D O • Ojc lQ la Aj1,r, 1/ f1V"0j r0 C, ;7_4* j 76License # 07(o 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 r quires a new per 't. Approved or disc ge of domestic sanitary sewage only. /l,�t/t�ol -� / 01 �0�/ %a� Title: Date. 7 La q '-dopy - HD File; Yellow copy - Building spector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 IIDIIVIIMN (DIL° ENVIRONMENTAL HIEAIL7H SERVICES OONSTR UCUON PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # N -11- 0 _� Located at 1,Akl "o Subdivision name Subd. Lot # Date Subdivision Approved Owner /Applicant Name �36;_N E_ 1) E -T°Tt_--) PA-ctZ_S 5,q Town or Village PV_1Aor&_,_ft Tax Map C Z- Block Lot 3 "1 Renewal Revision Date of Previous Approval 611104: to Mailing Address lb We T11 ST/2/��,.,T SX / Zip Amount of Fee Enclosed �� P *1 T-- Building Type Ouv o 6SA,.4,^- Lot Area ��% fo No. of Bedrooms Design Flow GPD C% Fill Section Only Depth Volume PCHID NOTIFICATION IS REQUIRED WHEN PILL IS COMPLETED Separate Sewerage Sstem to consist of � �o gallon septic tank and Other Requirements: To be constructed by 7-6 P Address WaIg 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 regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: _ �� r P.E. a R.A. Date Y 4 5 2 3 L �I& ��40 License # f9% 6 7 f.3 Address Z � -VAOI '�iy 4 ,0� cr- &617 76 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: F/� `d Title: 14 _4 f Date: �y WhLtez/opy - HD File; Yellow copy - Bu ing Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES please print or type PCHD Permit # F Well Location: Street Address: Town/Village Tax Grid # f iN. J//4 Map Block ( Lot(s)37 Well Owner: Name: Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional. Standby Amount of Use Yield Sought gpm # People Served /v Est. of Daily Usage G'ovu gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling c"'New Supply (new dwelling) Deepen Existing Well Detailed Reason j?„ -1 - ,F 4 kvW TA4 /S/:Z &,W f ft s2� for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No No Is well located in a realty subdivision? ...................................... ............................... Yes Name of subdivision Lot No. Water Well Contractor: 7- 6-0 Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. 4 .. ... . �,.. LaIC:: !.� _._.._ _`AI�VCZhlI J1�11Q�W.V �` - _ .�,: ... _r,_... -... ...... _._. ... .__.c. .. .. -. _...,..... -. ..,E PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County.. Y Permit Issuing Official- Date of Issue g Date of Expiration c7 o&2 Title: s Permit is Non - Transfer able White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 P.UTNAM COUNTY DEPARTMENT OF HEALTH LETTER OF AUTHORIZATION RE: Property of le ;-o air 5 - Located at (9 5 c+.,-, /+w i A1,+6 T/V -rm t Tax Map # (O 2 Block Lot Subdivision of Subdivision Lot # �- Gentlemen: This letter is to authorize <' e� Filed Map # Date Filed a duly licensed Professional Engineer _Z_ or Registered Architect to apply for the required - wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance " with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and /or water supply systems in - -- conforrnit w =itb the rovisions.of.Article 145 and/or-147-of the- Education..Law, the- Public - Health. Law, and the Putnam County Sanitary Code. , Countersigned: P.E., R.A., # _/ Mailing Address og fyrIAWINy Md State G Zip O0 7 74; Very truly yours, Signe Z n A I � 41— (Owner of Property) Mailing Address:, /Z _s;lr" State P, Zip 1bS' yt-f Telephone: �60 S Telephone: ?lq Form LA -97 �blk PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # P11 I q-t r ``r Located at 65CAiv � LAkK or illage PU i NAM I�ALCC� -/ Subdivision name Subd. Lot # Tax Map Block �_ Lot 3 Date Subdivision Approved N/A Renewal Revision Owner /Applicant Name [3e1je&= e&W A Date of Previous Approval 1/1/ /63 Mailing Address 16 kmrm 5T :eeT– ijuai pie. mg, Zip Io5 Amount of Fee Enclosed 20D'00 Building Type D KZAh P Lot Area ! 7 No. of Bedrooms 5 Design Flow GPD two Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of I S C)o ` gallon septic tank and 564 L; d &-3 50RPr1 0tJ r iZ,&%J1CMe 5 [2F r bi (D -0 PR IMW(A AIV-Q (005t t ed • h)0 �REQ Other Requirements: To be constructed by %j) Address Water Supply: Public Supply From Address — or: Private Supply Drilled by % (' " " ' ` " ddress I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the _separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. 9 Signed: / P.E. / ✓ R. A. Date U" Address % F) Se.CoR RLkD mHoAc iva ID64 f License # g?!J5 92 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Approved for discharge of domestic sanitary sewage only. By: G. �Z�cr/d Title: / �' Date: e D Wh to opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 78 Secor Road, Tel. (845) 621 -4756. Bryant Pond Plaza, Suite 5 Fax.(845)628 -1905 Mahopac, New York 10541 July 27, 2004 Mr. Joe Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa — Oscawanna lake Rd Tax Map 62.13 Block 1 Lot 39 Putnam Valley, Putnam County Dear Mr. Paravati, In response to your letter dated July 22, 2004, the following items have been addressed: 1. The Construction permit was signed and is enclosed. 2. The letters RO.B has been added to the fill note on the plan and profile. 3. A steel sleeve has been shown in the expansion area profile 4. The CIP has been changed to PVC pipe consistently. 5. Fill the distribution box detail has been altered. 6 A new revision date has been added. - e Silt fence detail wq, alac updated I trust the above materials are adequate for your approval and complete the submission for the above project, However, if you have any questions concerning this project, please do not hesitate to call me @ 621 4756. Very ruly y, urs, Chris Caralyus Project Manager LORETTA MOLINARI Public Health Director July 22, 2004 � ro.t.... «: ham•. w..... ..• .. �. R.. '. • �• ... r • .•e•.@: Y.• i�+R1`i tY••• 1 4 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 -.6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 ROBERT • J. BONDI County Executive Chris Caralyus - Beyer Associates . 78 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Proposed SSTS Revision — Paonessa Oscawana Lake Road, Town of Putnam Valley TM# 62.13 -1 -39 Dear Mr. Caralyus: 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 construction permit was not provided. 2. The fill for the grading note needs to include "R.O.B." in the plan view and both profiles. ; ti �e i ..�.. xY,a c; '� �inti fn_r tlia F;jT;i.(�.T1:pf �11P, n.inP�llTi es �h "_L•�:'::'.. '.., e sk driveway. 4. Both profiles are showing cast iron pipe from the septic tank to the distribution box. The plan view shows PVC pipe. Please clarify. 5. The distribution box detail is showing six inch diameter outlets, not four inch. 6. Every time a revision is made, the revision box needs to be filled in and dated. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj �•. y % JGLUf t�UL4Ll, l ^ �•. _ - Bryant Pond Plaza, Suite 5 Fax. (845)628 -1905 Mahopac, New York 10541 June 24, 2004 Mr. Joe Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa — Oscawanna lake Rd. Tax Map 62.13 Block 1 Lot 39 Putnam Valley, Putnam County Dear Mr. Paravati, In response to your letter dated March 30, 2004, the following items have been addressed: 1114-80L& -O The Construction permit was signed and is enclosed. 02 A note "Fill for grading purposes "has been shown, and the profile has been updated The fill note has been updated to reflect the 1 foot of fill 4! The deep testing information has been updated. Fill for grading has been added to the expansion area. IThe expansion area has been moved and rotated slightly. 7� The expansion area trenches are now shown the required 10 feet away from the property. line. Sc�c, an- detail has be En uDte._ The Septic plan box has been updated and the subdivision information appears to be incorrect thus it was emoved. is information has been updated. . A Profile for the expansion has been added to the plans. I trust the above materials are adequate for your approval and complete the submission for the above project, However, if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 Very trruly,yburs, Chris Caralyus Project Manager 40 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 March 30, 2004 Chris Caralyus Beyer & Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541. Re: Dear Mr. Caralyus: ROBERT J. BONDI County Executive Proposed SSTS Revision — Paonessa Oscawana Lake Road, (T) Putnam Valley TM# 62.4-39 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_ .__ w I_ft? rr�rsr�r .;tinn.rai'_Tllr- `'J��:2 t Sg::eC� aIiE3 tla ^cad v�` u G'�iililC 2. Fill is being proposed over the primary area. It appears the fill is for grading. If so, please specify and note that ROB fill for grading is being proposed. Also, fill (proposed grading) needs to be shown in the profile. 3. Fill note #2 is specifying a depth of 0.5 feet. It appears that at least one (1) foot of fill is being proposed. 4. The deep hole depths and descriptions provided on the revised plans. do not match the field testing witnessed by this Department on December 16, 2002. Please clarify. 5. It appears that fill for grading may be needed in the expansion area. 6. It is recommended that the expansion area be rotated to fit between the two 850 -foot contours with the middle being over the spot grade of 851.9' feet. However, fill for grading would still appear to be needed. 7. The last expansion trench is less than 10 feet from the property line.. 8. Septic tank detail needs to show minimum/maximum cover dimension. 9: Septic plan title box is showing that the lot is part of a subdivision. If so, all subdivision information on the application forms needs to be filled in (not N /A). 10. Based on deep hole descriptions and depth provided, one foot of fill is required in the expansion area. However, the depth and descriptions appear to have some errors. See note A. , i 1 e�lai�'iu3i"�ue'a`.: This office will continue its review upon consideration of the above - mentioned comments. Please feel free to,contact me at ext. 2157 if any questions arise. Very truly yours, (,s"eph S. Paravati, Jr. Assistant Public Health Engineer JSP: cj -.. - -. ........... ... ..._. _ .� _. �._. F.. re+. n. .w- w:.ew+e...w.•w•rix•r•�:iszs. •_ a..:. LORETTA MOLINARI R.N.; M.S.N. Public Health Director DEPARTMENT OF HEALTH 1. Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 FACSIMILE TRANSMITTAL ROBERT J. BON,DI County Executive To: �'a`� � 44 Fax: To From: �o � 7 A Date: Re: %�oc��ss�. j2 ,r ' AuoPages: CC: ❑ Urgent . ❑ For Review ❑ Please Comment ❑ Please Reply CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDFNTIAL and legally protected information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845 - 278 -6130) and destroy all documents associated with this facsimile. T"M., .4f" " <izT*""!, .. .. ... . ... 10 k TEST PTT PROFILES .01f� Hole# 'Lotff: Dole w Lot # Hallei -to water -D- 4a- atet Depth Olt gx D th ottling Al De to ni 5A Depth to mottling Deptktp mot" J*Pa. Depth to rodk/ifiip.- Depth--to roc Afby Depth to rock/imp. k/imp.- ----------- G.L.. G.L. y �27, 17A-V T-7 0 .5 0.5 1.0 I a 1.0 2.0 2.0 2.0 3.0 3.0 13 6 0*01 <b 4.'0 W 5.0 -------- hou 5.0 v 6.0 6.0 ------------- 7.0 7.0 x•7.0 8.0 .8.0 8.0 .0 .9.0 9.0 .10.0 10.0. 10.*0 x Hole Lot Hole 4 Lot # Hole # Lot # T;. ��e�Depth to water Aj Depth to 'Mottling A)IX Depth to mottling A0A Depth to mottlin g_ Depth to roc k/imp. Depth to rocklimp. Depth to rocklimp• I. G.L. 1-0,74 0 G.L. G.L. 0.5 0.5 0.5 1.0, 2.0 2 n 3.0 4'.0 % S �. 5.0 6.0 -9.0 10.0 3.0 4.0 5.0 8.0 Lo -36 sic 2.0 3.0 S� 4..0 5.0. 6.0. 7. 8.0 9.0 9.0 10.0 10.0 �' " _­�p�T-�1_14w,*u,,.', L� 2 SECTION D.: DRAINAGE iaieria* alter. the natural dr amag di M 'this or adjacent areas? a Yes No q.- Will groundwater or surface drainage require special consideiation? .................. a- Yes . No 20. Will'guUies,.ditches, etc., b . e filled and watercourses be relocated ?. .. ....................... DYes 571NO SECTION E. REMARKS 21 22 23. If a common water supply is proposedi has an inspection'been ade of the existing or proposed source and facilities? .................. ............ *.: ......... . F7Yes D No: Inspection data Do adjacent weilsandLor sewage systems exist? ............................ * ........................... I 0-Yes a No Additional comments observer/inspector and title I 'rvatio*n(s 'ti on(s) m )inspec :.ZA e FHole # Lot # � J_Lo I k Depth to Water Depth to water Depth to mottling tJJA Depth to mottling Depth to rocWimp. 0101- ._Dept to- rock_ lmu. G.L. G.L. 1. -Hole# Lot# j &,T.. Depth to water Depth to mottling G.L. - �'v .0.5 0.5 6tt2 1.0 rxe - /* ) 1.0 2.0 b/T-1 aLA, 2.0• — 2.0- _J 4.0 '4.0 4.D 5.0 5.0 - 5.0 6.0 .6.0 6.0 0, 7.0- 8.0 8 8.0- 9.0, 9.0 .0 10.0 10.0, 10.0. SENDING CONFIRMATION DATE JUN -14 -2004 MON 1152 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE a 96281905 PAGES s 4/4 START TIME s JUN -14 1150 ELAPSED TIME s 01143" MODE : ECM RESULTS o OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... . om+ �ana+mwv�(���nm�vwcoeireczsve) . 000gdolot dq dgpoo k4vlp=mq amid l=m vl Moovm m Pmp- oa9q no+L3! ImuRud 4pvp R ddmola tPn m.4niRd90 m laapngptnp bo19u9991p &I WP P;Pcu kWl;q 9O 006 hmdp9L WPmP oM too P 98ntum I >o � �n =rp 4nm+� P=wwworwllo m oa u) 4M P ' t P�w�d 4tdM P- 1VI12J8��IOO atvtuvo dm om9 S F1gL V! 900lv1�'o avA�W� vqi :,t.K2JA=VZS AlrlVId.NX=90J k1dogV —ld ❑ I132=03anold G mo!Awajoi C =E]f1 ❑ .................. ............................... • � r+.r�.y-n rJ :a8odi3 og �I p h/ y :'tea 3wdy' • :woia -Toz Tiny —a amm w3 • 0"9-ut(S/9)"d V109. 9Lt(S") P°9t*ydlvppa�viW LS!t9 5909- 1.(Ivo-d IL99. 211(m) 3m tSS9'A1t (5►9)vxN+t9 tcryan 196L. 9Lt (599) ttd 0[l9 • t1t (ht) WI•vN Invw w+l•va 60501 3tmA - N'nm;Awu 'Ptot(ao -D 1 RLIly i ao .r n mulvda(i 1=91 Imo1S N'S'K "N'tI rdvmo)N V1184CS LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1. Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 ROBERT J. BONDI County Executive FACSIMILE TRANSMITTAL To: Pay• From: i- �U� -ll. -� f T� Date: 5 tidy Re: i" G, 01W SSG- Pages: CC: 0 Urgent For Review ❑ Please Comment ❑ Please Reply CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845- 278 - 6130) and destroy all documents associated with this facsimile. 6, 1 002 -rs Medium Pjaw SL S&�O. SAP",": .30 , vet A6�f 0.3 MW 30 - LON". O�2 4-A6jW.,4r Wes. g�f a3. AD 'ilNti I M, .a. LORBT[A MOLINARI R.N.. M.S.N. ROBBRT I. BONDI Na6Go HaohB D4aaer Graq 6kon,11rr DEPARTMENT OF HEALTH 1 Geneva Road, Brewetcr, New York 10509 Bovltoamaotal Health (845)278.6130 F7x(845)278.7921 Nurdna Bervlecs (845)278.6558 WIC (845)278.6678 Fe.(645)218.6087 Sally IotarventtaNFrescbool (847) 278.6014 Fu(345)2 11 - 6648 ' FRCS ILE TRAIT SNUTTAL toss. � •v5 To: .G.,S B�: From: J�9 Pjxw N * ' .Y VC Date: Stye °Y PlAo^e Re: sSa Pages: CC: ..................... ............. ............................. ....................................................... C3 Urgent ,,eC20rReview 0 Please Comment 0 Please Reply COItpD3UMALITY STATE V8)ENT: '(Le intotmmion eoeteined tathis 1so"a orgy o0>ffdn COth'IDEN'[['IAI. ' and legally ptoMCW 43lbtmdltm int=dcd only tae the sue of the i0dividud 01 cgdW tuttoed etww. It the Hader ' . this message is not the Wcr ded redpiwt You as bmvby -tided than aW &sseusiou, diattBadlaR or cup*g of this ' tdtcepy is strictly prohibited. U you have voodved this tdewpy in stmt, pleew 11 ediddy notify its by telepbo- . (84 5.27& 6130} and &AuW ail dee=cr s associated with this facsimile. . • • •GSZJ.TWSNVHI sRMmOOG J,NSOHN dO Sf)Vd sSUI3 xo ssznsSx WOH SGOW ttZ0,T0 : aKIS GSSdK'IS LV:80 6T -AKW : SWIS MIS £/£ : SSOKd S06T8Z96 : SNOHd TZ6L- 8LZ -SV8 'ISZ HS'IEiSH aO JRM1 Vc1aU XTd1IAJ 00 WVNLfld aKVN 8f7:80 GHM i'00Z- 6T -AKW • SZKG NOIZVER00 ONIMIIS PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES -DESIGN DATA SHEET-- SUBSURFACE SEWAGE:TREATMENT: S ST 119_;:..; Owner Benedetto Paonessa Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson'River Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13/02 Hole No. Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (inches) Start Stop Water Level ;Di p ;.Inches Percolation Rate MinUch P -1 1 1:47 -2:17 30 20" - 23" 3" 10 2 2:19-2:49 30. 2051- 23" 3" 10 3 2:50 - 3:20 30 20" - 23" 3" 10 P -2 1 .1:50 - 2:20 30 20))-239) 3" 10 2 .. .2:22 -2 :52 30- - 20. - 21 " 2:53 - 3:23 30 2091- 23" 3" 10 PRIMARY AREA 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, 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 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO. G. L. 0 —12" Top Soil 0 — 6" Top Soil 0 — 6" Top Soil 0.5' 1.0' Med Brown Loam 6" — 32" Redish Loam Sandy 6" — 36" Med Brown Sandy Loam 2.0' 2.5' 3.0' 3.5' 4.0' Gray Sandy Loam Gray Sandy Loam Gray Sandy Loam w /Cmvel 4.5' 5.0' 5.5' 6.0, 6.5' 7.0, T -0" depth 7.5' 8.0' TV depth 8,0„ depth 8.5' 9.0' ` ILI 10.0' Indicate level at which groundwater is encountered NIA }indicate level at which mottling is observed AZA Indicate level to which water level rises after being encountered 7' Deep hole observations made by: CC_ BA. Date 12116102 Design Professional panne: Beyer and Associates Address: 78 Secor Road, Bryant fond Plaza, Suite 5 Mahopac, N Y 10541 Signature: Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIROMENTAL HEALTH SERVICES hOPIJ DFSI(}1!T DA'I' SKEET -- SU BSURFACE SEN GE.TREAT -MENT SYSoTEM..... -..., :....._ . Benedetto Paonessa Address 16 North, St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map. .b2 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Basin Date of Pre - soaking SOIL PERCOLATION TEST DATA Date of Percolation Test 12/13/02 Hole No. Run No. Time Start — Stop' Ela se Time Min.) Depth to Water From Ground Surface (inches) Start Stop. Water Level Drop in Inches Percolation Rate Min/Inch P_ 1 1 2:06 — 2:36 30 23)9-25,55 2" 15 2 2:38 — 3:08 30 23" — 25" 2" 15 3 3:10 — 3:40 30 23" — 25" 2" 15 P_2 1 2:08 — 2:38 30 24" — 26" 2" 15 3:10 __ : _ 30.- . _. 24'?.-- -_ 267.:.... 2" .....15 w_... 3 3:11— 3:41 30 24" — 26" 2" 15 EXPANSION AREA 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, 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. TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. - 1 HOLE NO. 2 HOLE NO. _ G.L. 0 —12" Top Soil 0 — 6" Top Soil 0 — 6" Top Soil 0.5' �- 1.0' Redish Brown Sandy Loam 6" — 36" Redish Loam Sandy 6" — 36" Redish Brown Sandy Loam 1.5' 2.0' 2.5' 3.0' 4.0 Gray Sandy Loam w /Gravel 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' CM @ 'T -0" •6'6" depth TO" depth 7.5' - 8.0' 7'6" depth 8.5' 9.5' 10.0' Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel Indicate level at which groundwater is encountered 79 Indicate level at which mottling is observed --NIA Indicate level to which water level rises after being encountered i' Deep hok observations made by: CC_ PA. Date 12116102 Design Professional Name: Beyer and Associates Address: i8 ,decor Road, Bryant Pond Plaza, Suite .5 Mahopaco N.Y. 10541 Signature: Design Professional's Seal 78 Secor Road, Tel. (845) 621,47.56 Bryant FBnd Yiaza, Suite 5 y _ - Fax. (845) 628 1905 r Mahopac, New York 10541 March 1, 2004 Mr. Joe Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa Residence Oscawana Lake Road, Putnam Valley NY Tax Mav 62 Block 1 Lot 39 Dear Mr. Morris, Our client, please find the revision to the previously approved SSTS, PCDOHpermit # PV- 19 -03. We are hereby applyingfor a revised construction permit for. an individual SSTS. Enclosed please find a copy of thefollowing items for your review and approval: • Construction Permit for Sewage Treatment System • Design Data Sheet (primary and expansion data sheets) • Plan and Profile- Separate Sewage Treatment System (4 copies) • Fee — Certified Check in the amount of $200 I trust the above materials are adequate for your approval and complete the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 ttru lyz,�u�c Chris Caralyus ° Project Manager 11)"09SION OF ENVIRONMENTAL., HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM 0 PF,RmT <' # f 1% 1 Located at 0 530NL08N A L 42e Town or Village Subdivision name % Subd. Lot # Tax Map %� Block Lot' _ Date Subdivision Approved A) Z& Renewal Revision Owner /Applicant Name Date of Previous Approval Mailing Address L l'u'rk'- u A J, I Zip � 5j Amouri of Fee Enclosed 3aq, v0 Buildng Type J :P AVkf- Lot Area 11 No. of Bedrooms -5 Design Flow GPD lQtQ MII Section Only Depth Voflume 1POIIID NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED _, -�ce_ Sewerage S stem to consist of % 500 gallon septic tank and 1� 60i-11)- (CIj - aeft) c 1 -r � � j iJiJ) -el Other lequirements: To be a)nstructed by % rl Address ��>t�urne�flv° Public Supply From Address 22°e Private Supply Drilled by T_!� Address I reprent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separgsewage tr eat ments sY tem described above will be constructed as shown on the approved amendment thereto and in accoa-6ce with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereia "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Depwent, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said lbm lid,ovill place in good operating condition any part of said sewage treatment system during the period of two (2) years izrmeitely following the date of the issuance of the approval of the Certificate of Construction Compliance of the original s3ikt --9r any repairs thereto. R.A. License # Date )45103, 04-51) AF DVEID FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the se -.treatment system has been completed and inspected b at e d, HMI 611 sl1vocable for cause or may be amended or d when considered necessary by the Public Health )fi b ny revision of alteration of the approved plan requires a� a rmit. Approved for discharge of domestic sanitary C. tt;,.y1ro, Tithe: q t'�;i `i Date: %A0`1:-topy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL iEt o?rype .s _ C Permit Well Location: Street Address: Town/Village Tax Grid # C>( -b%-) ` k- _ 2-i i7K -'4t A \;J&qd Map 6,2_..Block l Lot(s) B Well Owner: Name: Address: /-!lf' ^.•F Lj' - ` � � � ] ( � 1. '•, �� , 1. J ri�.�..5% %�. ^-'r �f t,.fJ �9 Use of Well: esidential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served _L Est. of Daily Usage IczNd gal. Reason for Re lace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type ''Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No- Name of subdivision X) Lot No. N/A Water Well Contractor: ) .D Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate eet/plan. Date:._? -3 l Appl.icant_Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED.FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue _ �� o3 Permit Issuing Official: / ✓i ce ` (i Date of Expiration I co) s� _ Title: s° 1 cti Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Bryant Pond Plaza, Suite 5 Fax. (845)628 -1905 Mahopac, New York 10541 August 31, 2003 Mr. Joe Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa — Oscawanna lake Rd. Tax Map 62.13 Block I Lot 39 Putnam Valley, Putnam County Dear Mr. Paravati, In response to your letter dated August 25, 2003, the following items have been addressed: 1. The grading has been adjusted to avoid areas of cut. 2. The presoak date has been added to the design data sheet, and three new sheets are enclosed. 3. The new revised floor plans are enclosed for your review, and the words "6ft Min.Archway" have been added at the Breakfast Room Entrance. Y trust the above materials are adequate for your approval and complete the submission for the above project, However, if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 `. f Ve truly )� Urs, Chris Caralyus Project Manager I INEK 1.1.10.4 (2/67)—Toxl 12 PROJECT 1.0. NUMDER _ G17.21 SEAR - Appendix C Sinlo Environmonlnl Ounmy Roviow SHORT-ENVIRONMENTAL ASSESSMENT FORM 1lLT {C;dJ- 0-1Iy. PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PRWCT NAME � J..PROJECT LOCATION: Municipality County 1. PRECISE LOCATION (Street address and road Inlersecllons, prominent landmarks, etc., or provide map) A Pica vt- 44 re- ',C % &OP-TA 0�- I )IJ40" IL � l� � � ��Cf�fJH�► J� Il/3k 5. IS PROPO D ACTION: !. 0 Expansion 0 Modllicatlon/allorolion 6. DESCRIBE PROJECT BRIEFLY: f 7. AMOUNT OF I_ANO/ AFFECTED: d Initially �,2.lv acres Ulllmalely acres 0. WILL ACTION COMPLY WITH EXISTING ZONING On OTHER EXISTING LAND USE RESTRICTIONS7 PROPOSED Bl s ❑ No II No, describe briefly 9: WHAT lVrfESENT LAND USE IN VICINITY OF PROJECT? V'rrrossldonilal 0Industrial 0 Commercial 0 Agriculture 0 Pork /FomstlOpon space • 0 Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, On FUNDING, Now OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCALI? 0 Yes No It yes, list agency(s) end permlllapprovals It. OOE dNY ASPECT OF THE ACTION HAVE A CunRENTLY VALID PERMIT OR APPROVAL? Yos 0 No It yns, list agency name and patmlllappro4al v � st►`j� C d� r> f2 Lt I� 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL nEOUIRE MOOIFICATION7 0 Yes ONO I CERTIFY THAT THE INFOnMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appllconllsponsor name: Ey eA. V- / 1 3` 2 _L t Oalo: h)45 Slgnoluro: It the action Is in (tie Coastal Area, and you are a stale agency, complete the Coastal Assessment Form before proceeding with this assessment OVER - - 1 PART II— ENVIRONNIENTAL ASSESSb1ENT (To be completed b'I r:ijullcy) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.12? If yes, cooidinato the rovluw procoss and use the FULL EAF. . ❑ Yos 9No 0. WILL ACTION RE WE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 It No, a nagallva declaration may bo superseded anolhor Involved agoncy. — - C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers maybe handwillton, Cl. Existing air quality, surlaca or groundwater quality or quantity, nolse levels, exisling Iralllc patterns, solid waste production or disposal, potential for erosion, dralnago or flooding problams? Explain brlolly: A/9?t_4_' C2. Aesthotic, aodcullural, archaeological, historic, or othar natural or cultural rosourcos; or community or nolghborhood charactoR Explain brlolly: CJ. Vagolallon or launa, fish, shelllish or wildlife species; significant Habitats, or threatened or andangamd species? Explain brlelty: 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 bdoi i CS. Growth, subsoquoni dovolopmoni, or rolatod acilvlllos likely to bo Inducod by tho proposod action? Explain brlolly. C6. Long farm, short term, cumulativa, or other effects not Idenlllled In CI-C.57 Explain Wally. C7. Othor Impacts (Including changes In use of ollhor quantity or typo of onorpy)? Explain brlolly •0. S THER£.OR- IS.THERE.LIKELY To,D_E, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? o It Yos; axpta5n brlolly PART 11.1 — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether it Is substantial, large, Important or olherwlse significant. Each effect should be assessed In connectlon with Its (a) salting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (o) geographic scope; and (1) magnitude. II necessary, add attachments or relerence supponing materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have boon Identified and adequately addressed. ❑ Chock this box If you have Identified one or more potentially large or slgnlllcanl adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. Chock 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; Nrmo of Le t nl ur I ix• N nurp Itrtlyyt� 0 do crt lit I itail Aet•ni y .r in Lea A� ignasuto of lisepafe((If different Itom rasponst e office() 4 3 Date 2 IF._. .4 � v i i •� + T. t/ \! V 1 \ i i i+iJi L -Xi\ 1 IVXA.J1 \ 1 V1' AX.0 rm y i 11 DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM "Owner Benedetto Paonessa'` A dress I6 North St. lVlon66s NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Block 1 Lot 39 Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13/02 Hole No. Run No. Time Start - Stop Elapse Time (Min•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 2:06 - 2:36 30 23" - 25" 2" 15 2 2:38 - 3:08 30 231).-2519 2" 15 3 3:10 - 3:40 30 231)-2515 2" 15 4 5 P -2 1 2:08 - 2:38 30 24)1-269) 2" 15 2 2:40 - 3:10 30 24" - 26" 2" 15 :..:...... - .3.:_, 3:?.? ;`_,3�j; .. . - ?n:... _ �A _2, >» 26» 4 5 P -3 1 2 3 4 5 NOTES: 1. Tests to be iemated at same death until annroximately eaual nercolatinn rate, are nhtaine[I at Parh nr+ +,.a+ i, ( i.e. <_ 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 ole. DEPTH 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 1 0 —12" Top Soil Redish Brown Sandy Loam HOLE NO. 2 HOLE NO. 0 — 6" Top Soil 0 — 6" Top Soil 6" — 36" Redish Brown Sandy 6" — 36" Redish Brown Sandy Loam Loam Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel 7.0 Gwt Q 7' -0" .6'6" depth 7'0" depth 7.5' 8.0' 7'6» depth 8.5' 9.0' 9.5' Indicate level at which groundwater is encountered 79 Indicate level at which mottling is observed AZA Indicate level to which water level rises after being encountered 7' Deep hole observations made by: CC—BA, Date 12116102 Design Professional Name: Beyer and Associates Address: 78 Seeor Load, Bryant Pond Plaza, Suite 5 Signatu Design Professional's Seal 074153 1c�j r4 :a s ., i 1 . A u.L 1 ..v L' 1 ruX 11VAL` 11 1 jr nL' L-l►L 1 I1 DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET — SUBSURFACE SEWAGE TREATMENT SYSTEM 1i'3wner ".` "Benedetto Paonessa V Address 16 Norkh St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13/02 Hole No. Run No. Time Start — Stop Elap�se.. Time (lI�•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 2 3 4 5 P -2 1 2 4 5 P -3 1 2 3 4 5 NOTES: 1. Tests to be reheated at same death until annroximately eaual percolation rates are obtained at each percolation test 1 ( i.e. S 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. pole. Form DD -97 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 4 HOLE NO. HOLE NO. G.L. 0 - 6' Tpn Soil 0.5' 1.0 6" — 26" Redish Brown Sandy Loam 1.5' 2.0' 2.5' 3.0' Med. Gray Sandy Loam w /Gravel 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8'0" depth 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered NIA Indicate level at which mottling is observed NZA Indicate level to which water level rises after being encountered NIA Deep hole observations arcade by: CC _ BA, ,Toe Paravatti - pcdoh hate 12117102 Design ]Professional Name: Beyer and Associates � Address: _ 78 Secor Road, Bryant Pond Plaza, Suite 5 Mahopac, N.Y. 10541 signature: Design Professiong's Beal of NEW 1�, �C. 0 All F. 0745 ' - E S �C�-7�'aPti I i V� / v v 1 IV i i L iii ZXA%, A. 1T11:11 11 1 V 1' 11LLV.L 1 n DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM owner Benedetto Paonessa Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13%02 Hole No. Run No. Time Start - Stop Ela se Time in.) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 2:06 - 2:36 30 23" - 25" 2" 15 2 2:38.- 3:08 30 23)).-25)9 2" 15 3 3:10 - 3:40 30 23" - 25" 2" 15 4 5 P -2 1 2:08 - 2:38 30 24" - 26" 2" 15 2 2:40 - 3:10 30 24" - 26" 2" 15 3 . - '3:11 - 2:41- . 3 - - - 24" - 26" - 2,�_ i i5 4 5 P -3 1 2 3 4 5 I T NOTES: 1. Tests to be reheated at same death until anuroximately eaual percolation rates are obtained at each nercolation test 1 ( i.e. 5 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. Form DD -97 ole. -- 1 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' .5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' iAl ii' DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 1 HOLE NO. 2 0 —12" Top Soil 0 — 6" Top Soil 6" — 36" Redish Brown Sandy Redish Brown Sandy Loam Loam HOLE NO. 3 0 — 6" Top Soil 6" — 36" Redish Brown Sandy Loam . Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel Gwt cQ 7' -0" .6'6" depth 7'0" depth 7'6" depth Indicate level at which groundwater is encountered 7' Indicate level at which mottling is observed MA Indicate level to which water level Irises after being encountered 7' Deep hole observations made by: CC—BA, Date 12116102 Design Professional Mamie: Beyer and Associates Address:. 78 Secor Road, Bryant Pond Plaza, Suite 5 Signatu Design Professional's Seal F. CIO 074 0 .. = i. j .. •� �, v l I i i "L 1 tilt 11Vi v it 1 yr n A.L l ti " DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET — SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Benedetto Paonessa Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 1 Lot 39 Date of Percolation Test 12/13/02 Hole No. Run No. Time Start — Stop Elapse �� Time (���•) Depth to Water From Ground Surface (inches) Start Stop Water . Level Drop in Inches Percolation Rate Min/Inch P -1 1 2 3 4 5 P -2 1 2 4 5 P -3 1 2 . 3 4. 5 NOTES: 1. Tests to be revealed at same death until anvroximately eaual nercolation rates are obtained at each nercolation test 1 ( i.e. S 1 min for 1 -30 minhnch, S 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 ole. DEPTH G.L. 0.5' 1.0' 1.5' 2.0.' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 4 HOLE NO. HOLE NO. 0 — 6" Top Soil 6" — 26" Redish Brown Sandy Loam Med. Gray Sandy Loam w /Gravel 8'0" depth Indicate level at which groundwater is encountered N/A Indicate level at which mottling is observed NIA Indicate level to which water level wises after being encountered N/A Deep hole observations made by: CC _ BA, Joe Paravatti - pcdoh Date 12117102 Design ]professional Name: Beyer and Associates NEW o ro Address: 78 Secor Road, Bryant fond Plaza, Suite S A%N1 A-4�P F. CIO . Maho ac . .I: 10541 ; Signaature° 074503 k`�7 RX ")�OFF�n� -- d3S � ? Design ProfessionVs wy a �y V1\ 1 1 LLl riMjLivi n 1 Ur HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Ovmer Benedetto Paonessa 'd Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13/02 Hole No. Run No. Time Start - Stop Elapse Time (Min•) Depth to Water From Ground Surface (inches) Start Stop Water Level Drop in Inches Percolation Rate Min/Inch P -1 1 2:06 -2:36 30 2359-2511 2" 15 2 2:38 - 3:08 30 231).-259) 2" 15 3 3:10 = 3:40 30 23" - 25" 2" 15 4 5 P -2 1 2:08 - 2:38 30 24" - 26" 2" 15 2 2:40 - 3:10 30 2455-261) 2" 15 _ _. .._. ..3 . 3._1,1- 3:4 1-- ; _.._3 -� _-2-61' .__.. 2» 4 5 P -3 1 2 3 4 5 NOTES: 1. Tests to be reheated at same death until annroximately eaual nercolafion rates are obtained at each percolation test l ( 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. Form DD -97 ole. aLV 1 111 J/!i1 TX DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH - _ DOLE NO.. 1 HOLE NO. 2 HOLE NO. G.L. 0 -12" Top Soil 0 — 6" Top Soil 0 — 6" Top Soil 0.5' 6" — 36" Redish Brown Sandy 1.0 Redish Brown Sandy Loam Loam 6" — 36" Redish Brown Sandy Loam 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel Gray Sandy Loam w /Gravel 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' Gwt ® 7'-0" 6'6" depth 7'0" depth 7.5' 8.0' T6" depth 8.5' 9.0' 9.5' ..- 10.0' Indicate level at which groundwater is encountered 7' Indicate level at which mottling is observed 1@r /fg Indicate level to which water level rises after being encountered 7' Deep hole observations made by: CC _ BA, Date 12116102 Design ]Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite S 5ignatu Designs Professional's Seal NEW 0 F. Xr co .k P 0740 `�.R0Sry/ 1 v i V i l\ t�1V1 L v U IN 1 Y DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET — SUBSURFACE SEWAGE TREATMENT SYSTEM "Owner' ' y <. Benedetto Paonessa .r c- Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking 12/12/02 Date of Percolation Test 12/13/02 Hole No. R Run No. S Time E Elansle. Time S Depth to Water W Water Percolation P -1 1 1 2 .3 4 5 P -2 1 1 2 4 5 P -3 1 1 2 3 4 5 NOTES: 1. Tests to be repeated at same death u until aDvroximately e equal percolation rates are obtained at each nercolation test 1 i.e. S 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. .ole. Form DD -97 1��1 Yll'llA'1A DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES A DEPTH HOLE NO. e 4 HOLE NOS HOLE NO. 0.5' 1.0 6" — 26" Redish Brown Sandy Loam 1.5' 2.0' 2.5' 3.0 Med. Gray Sandy Loam w /Gravel 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8'0" depth 8.5' 9.0' 9.5' Indicate level at which groundwater is encountered NIA Indicate level at which mottling is observed AAA Indicate level to which water level rises after being encountered NIA Deep bole observations made by: CC _ PA..7oe Paravatti -pcdoh Date 12117102 Design Professional Name: Beyer and Associates Address: 78 Secor Signature: Pond Plaza, Suite 5 JJ" Design- roffessioWs ial NEW F S- ,p it & vul'4 1 Y JJErAXJiviLENT Ot.' HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES t APPLICATION FOR APPROVAL OF PLANS FOR . A WASTEWATER TREATMENT S..► . - 1. Name and address of applicant: 7-1 _/� 2. Name of project: AuK�eS'56 3. Location TN: 4. Design Professional: 645. =(. 5. Address: 70 y,f(eVz IQ ` 6. Drainage Basin: 7. Type of Project: Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park' . Office Building Realty Subdivision Other (specify) 8. Is this.project subject to State Environmental Quality Review. (SEQR)? Type Status (check one) .............................. ................... :....... Type I Exempt Type II Unlisted .9. Is a Draft Environmental Impact Statement' (DEIS) required? ............ ........... 10. Hag.DEIS been completed and found. acceptable by Lead Agency? ............... l 1. Name of Lead Agency 12.'.. Is this projectin an area under the control of local planning, zoning, or other : %officials, ordinances? ... ..:,..:,... ................................... ............................... ......... _ If so, have plans been submitted to such authorities? ....................................... 14: Has preliminary approval been granted by such authorities? .Date granted: Type g y g surface water Z round� ter 15. T e of Sewage Treatment System Discharge ................. 16. If surface water discharge, what is the stream class designation? ..:.................. (J M7 -; 17. Waters index number (surface) ................ 18. Is project located near a public water supply system? •�' 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ A,)t 21. Name of sewage system Distance to sewage system 22: Date test holes observed ll a 23. Name. of Health Inspector J v.� Hip V 131 24. Project design flow (gallons per day)... ......... ....................... ............................ 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... A)6_ 26. Has SPDES Application'' been submitted to local DEC office? ......................... WA Fa, Q -97 .wva, aja:: 27. Is any portion of this project located within a designated Town or State wetland? 'S 28. Wetlands ID Number :...............................:.......................... .....................:......... 0 2 29,: - Is 1; W e t-11 aads•rDer ;Tii t -requ- reun., .,_ ,__.-. . h �:::� ...... _..,....... Has application been made to Town or, Local DEC office? ............................... �rl 5 30. Does project require a DEC Stream Disturbance Permit. W-) 31. Is or was project. site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No m o 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on file with.the Town or Village? . .................... .... � 34. - Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ?...... .......................... .......... ........... 35. Are any sewage treatment areas in excess of 15% slope? 36: Tax Map ID Number ..................:..:.... ............................... Map L2 Block I .Lot -- 37. Approved plans are to be.returned to..... Applicant Design Professional NOTE: All application$ for review and approval of a new SSTS. to be located within the NYC Watershed shall' - 'be-seni co rne-1uep ranent� and need not be sent iri 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 stormwaterylans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit. those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item L,the application must be.accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be "grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210 ,45 of1he Venal Law. $ICN,4T'URES & OFFICIAL TITLES.- Mailing Address: d 6 z&c &1,yi, i o, 541 Owner PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Benedetto Paonessa Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake, rd. Talc Map 62 Block 1 Lot 39 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Date of Pre - soaking SOIL PERCOLATION TEST DATA Date of Percolation Test 12/13/02 Hole Hole No. Run No. Time Start - Stop Ela se Time Depth to Water From Ground Surface (inches) Start Stop Water Level Drop.in Inches Percolation Rate Min/Inch P -1 1 2:06 -.2:36 30 23" - 25" 2" 15 2 2:38 - 3:08 30 23" - 25" 2" 15 3 3:10 - 3:40 30 23" - 25" 2" 15 4 5 P -2 1 2:08 -2:38 30 24" - 26" 2" 15 2 2:40 - 3:10 30 24" - 26" 24" - 26" 2 "..... 2" 15 . _3 - `3:11 - 3:41 30 15 4 5 P -3 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. ( i.e. 5 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. Form DD -0 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES ✓E� 1% -` ` 1TOLE NO. 1 lYiiLL IVY. G G.L. 0 —12" Top Soil 0 — 6" Top Soil 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' Redish Brown Sandy Loam 6" — 36" Redish Brown Sandy Loam lllJ L r01 0 — 6" Top Soil 6" — 36" Relish Brown Sandy Loam Gray Sandy Loam w /Gravel Gwt @ T -0" T6" depth Gray Sandy Loam w /Gravel .6'6" depth Gray Sandy Loam w /Gravel Indicate level at which groundwater is encountered 7' Indicate level at which mottling is observed NIA TO" depth Indicate level to which water level rises after being encountered 7' Deep hole observations made by: CC _ BA, Date 12116102 Design Professional Name: Beyer and Associates Address: 78 Secor Road, Bryant Pond Plaza, Suite S Signatu Design Professional's Seal - PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES DESIGN DATA SHEET —SUBSURFACE SEWAGE. TREATMENT SYSTEM : Owner Benedetto Paonessa Address 16 North St., Montrose, NY, 10548 Located at (Street) Oscawana Lake rd. Tax Map (Indicate nearest cross street) Municipality Putnam Vallpy Drainage Basin SOIL PERCOLATION TEST DATA 62 Block 1 Lot 39 Date of Pre - soaking Date of Percolation Test 12/13/02 Hole No. Run No. Time Start — Stop Elapse Time (Min•) Depth to Water From Ground Surface (inches) Start Stop Water Level Dropp in Inches Percolation Rate Min/Inch P -1 1 2 3 4 5 P -2 1 4 5 P -3 2 3 4 F_ 5 NOTES: 1. Tests to be reheated at same death until approximately eoual percolation rates are obtained at each nercolation test 0.e.:5 5 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. sole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. - 4 HOLE NO. HOLE NO. G.L. o - 6" Top Soil 0.5' . 1.0 1 6" — 26" Redish Brown Sandy Loam 1.5' 2.0' 2.5' 3.0' Med. Gray Sandy Loam w /Gravel 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8'0" depth 8.5' 9.0' 9.5' Indicate level at which groundwater is encountered NIA Indicate level at which mottling is observed . NZAI Indicate level to which water level rises after being encountered N/A Deep hole observations evade by: CC _ B j, Joe Paravatti - pcdoh Date 12117102 Design Professional Name: Beyer and Associates Address: 78 Secor Signature_ Pond Plaza. Suite 5 Design ]Professional's Seal Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 August 25, 2003 Chris Caralyus Beyer & Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Dear Mr. Caralyus:. ROBERT J. BONDI County Executive Re: Proposed SSTS — Paonessa Oscawana Lake Road, (T) Putnam Valley TM# 62 -1 -39. 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. , , .', , ti9 Te ayout:ote propose . specfal� -red = -- -- -- -- "- areas *of cut. �2. A pre -soak date has not been provided on the design data sheet. `3. Floor plans provided contain six (6) bedrooms. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Ve truly yours, SD'- p�wl�t�•� Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj .78.SecorRoad, Bryant Fond Plaza, Suite 5 Fax. (845)628 -1905 Mahopac, New York 10541 August 11, 2003 .............. . Mr. Joe Paravati, Jr. Assistant Public Health Engineer p 12-- a,3 Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa - Oscawanna lake Rd. Tax Map 62.13 Block 1 Lot 39 Putnam Valley, Putnam County Dear Mr. Paravati, In response to your letter dated August 4, 2003, the following items have been addressed: 1. A North Arrow has been provided. 2. Datum reference and Survey source has been added. 3. 0.5 Ft. of fill has been shown and clarified. 4. Fill notes have been provided. 5. Seepage pit has been labeled. 6 Seepage pit has been relocated. -.. __Sn.1 rvne-_.h-m , ,00, a� '. thep "r: 8. 4" CIP has been added to the plans. 9. The primary and expansion laterals have been corrected 10. The 10 Ft. Min. label has been added. 11. The words "Dust Free " has been added to the trench detail. I trust the above materials are adequate for your approval and complete the submission for the above project, However, if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 Very .truly your , Chris Caralyus Project Manager LORETTA MOLINARI_R.N.,- M.S.N::- ; ....... �- " "' °" Aciing Pubrc Healtlir irector Director of Patient Services August 4, 2003 .. .. .. "M $" Kt* "J. BONDI� . . County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Chris Caralyus Beyer & Associates 73 Secor Road, Bryant Pond Plaza Mahopac, New York 10541 Dear Mr. Caralyus: N Re: Proposed SSTS – Pronessa Oscawana Lake Road, (T) Putnam Valley TM# 62 -1 -39 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. JT1 Please provide north arrow. Jd). WA. c4M Please provide dam reference and source of survey. Based on deep hole descriptions, 05 feet fill is required. It appears fih_is be, ink- xarovidedbut ...,_: :: = -•: : , . ".` iri - lanr— opbs &i•cortr r�-a� "pecifying on ih ? i 3i plan how much fill is being provided. 4. Please provide fill notes. -5-.�. Seepage pit for footing and roof leader drains needs to be labeled. Seepage pit is proposed uphill of drains. . �' ( 7 Soil boundaries need to be shown on plan. r / Plan view is showing SDR 35 PVC pipe coming out of the house instead of cast iron. It appears expansion area is starting over the last lateral in the primary area. Please clarify primary and expansion area. 16' A minimum label between driveway and trench ends should be provided. The words `dust free' should be added to the crushed stone /washed gravel label in absorption trench detail. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, Gc- uot;�b�. Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj i PUTNAk COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATiV ENT: SXG-TFNES - .... _ -- - . 1?.E��.TeT',v..Gs.,•y�'�� ;[%- '.�R'c�i�1V5 LYt13t;1'10N PEIt11R1T . - NAME OF OWNER: y S STREET LOCATION: �S �` ` 'j` (1&t-4 JS , 3 & j 3 SDAE: f REVIEWED.BY: RM GR, � N DOCUMENTS Y _.natei?IRED DETAILS ONI.AP1S'CON i �Dl� fat � ` `' {� A L__)PERMIT APPLICATION ELL PERMIT OR PWS LETTER m97 b LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CCORPORATE RESOLUTION SHORT EAF �PLA�TS -THREE SETS g--:o HOUSE PLANS - TWO SETS C c(�/ VARIANCE REQUEST / SUBDIVISION JLEGAL SUBDIVISION ' C U )SUBDIVISION APPRO CKE1D UUPERC RATE C _)SUBDIVISION UIItED DEPTH U TAIN DRAIN REQUIRED / GENIE,RAL UOCATED.1NNYC WATERSHED LANS SUBMITTED TO DEP LEGATED TO FCHD U EP APPROVAL, IF REQ'D (DEEP TEST HOLES OBSERVED C__)(___) .EROS TO BE WITNESSED EX VAL SSDS ADJ LOTS UE SEWER - WI FT. 4 "0'; TYPE PIPE. CAST IR_ O1V-, BENDS; _WDM BE iDSti4V44GLEAi`TOt4 --- --' S 0, L - ? 3 ,U�U10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRAD {U(.�JFILL SPECS/ FILL NOTES 1 -5 6) f <f •�`l (}(__)FILL PROFILE & DIMENSIONS /� �� >1�•� = �� / %f xvwr r r T Y..<J•vf I nTATAnr I s;­ . rij.i, vtccna�lc c r�c� fyy (U(� CLAY BARRIER (_ )L_)FILI.'CERTIFIC NOTE UUDEPTH ES „)(JV . N PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS SEPARATION DISTANCE FROMTOE OF SLOPE _...._.__.__ _TREPICH- ^ --=,�� (� LF TRENCH PROVIDED tZE 60FT MAX �C d- CONTOURS �1L46.0). , EA ROVIDDE :2 ' DE UST USHED'STONE OR WASHED GRAVEL (_JGEOTEX VER Gi �py'Vval.� U(�WETLANDS (TOWNIDEC PERMIT REQ'D ?) ,Cf/ �� 20' TO FOUNDATION WALLS j ATA ON DDS FLANS &PERMIT SAME (L,6C_ )100' TO WELL, 200' IN DLOD,150' TO, PITS (A RE 1969 NEIGHBOR NIOTIFICATION 100' TO STREAM, WATERCOURSE, LAEX (ine. espan). _.. ._ (�ULETTER B EIGH _ i . 50' TO CATCH BASIN; 35' STOF.IIO' RA _- v_ ,t, r �iS' a CWATER Lin (pits -20 ') t;O:YD?..,4�eI9 v1:::VA'b `vlv rVrt�bii'` 1 UUS IL TESTING LOTS>10 YEARS OLD 50 INTERMITTENT DRAINAGE COURSE iLiDEFAII,S ON- PLAI•IS_.. _ �n�Pa1lV3;( .� : x--)200 /500 RESERVOm ETC. 150 GALLEY SYSTEMS ,t (__,)U10' MIN TO LEDGE OUTCROP (� SEWAGE S�ii5TEM PLAN# (NORTH ARROW) rty_? / SEPTIC TANK SDS HYDRAULIC PROFILE ` 10' FROM FOUNDATION; 50' TO WELL GRAVITY FLOW WELL (._„j�CO1VSTRUCTIOPI NOTES 1 -15 (_/ DIMEIVSIOPIS TO PROPERTY LINES MIGN DATA;._PWC & DEEP RESULTS 2' CONTOURS EXISTING & FROFQS v �• LOCATION OF SERVICE CONNECTION i . UUMIN 15 T® PROPERTY LINE .,.� �: _&.sLO�ES,. SLOPE • F D GIGYITTER/CURTAYN DRAIN USLOPE IN SSTs AREA _(_.2o%) JS�DA S B0 4 AIftIES.- -~'' �� � F� .- (___)TITLE BLOCK; OWNERS NAME ADDRESS (--- )REGRADED $O 15 %, IV REQUIRED TM#, PE/RA; NAME, ADDRESS, PHONE# DOSE/PUMP SYSTEMS ATE OFDRAWING/REVISIONt C�C.UPUIp NOTES . (0I� DOSE 7 ° /o J( )DATUI�I Y2EFEREIVCE . UC_� 5 /o OF PIPE OSE VOLUME NOTED (rJL ®CATION OF WATERCOURSES, PONDS C�UDE:Z7 FO CE,.mAIN, (PIPE TYPE, ETC.) / LAI4ES,WETLANDS 200' OF P.L. C.000FTT -BOX SHOWN &DETAILED _ JC— )PROPOSED FINISH FLOOR AND U SRAGE AR ®VE ALARM �BASEMENT ELEVATION S CURTAIN DRAI1�1� w SWELLS & SSDS'S W/Ig1200' OF SETS C_X_JSTA NDPIPES, 5' BOTH SID ����~11PIbQPERTY METES �s �011N1DS UC _)1S' MIN to CD �- ° -4 °10, -15' -. %, 35' -1 %,100 % - <1% r�C,,,,,JEROS$ON CONTROL FOR - HOUSE, WELL & U J20' MIN t �C]�RGE/100' with 182 cons day discharge SSTs, EROSION CONTROL NOTE CU to NON-PERFORATED PIPE DMMENTS: IVSHEET)o910v00 78 Secor Road, _ - ....- . _ ... . Tel.(845).67.1 -4756, _ ..Dryani Fo' nId Pih&, auife _ : Fax. (845) 628 1905 Mahopac, New York 10541 . oe Ail July 3, 2003 Mr. Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Paonessa Residence Oscawana Lake Road, Putnam Valley NY Tax Map 62 Block 1 Lot 39 Dear Mr. Morris, Our client, proposes to construct a single-family residence at the above address to be serviced by an individual subsurface selvage treatment system and a private drilled well. We are hereby applying for a construction permit for an individual SSTS and drilled well. Enclosed please find a copy of the following items for your review and approval: • Construction Permit for Sewage Treatment System • Application for Approval of Plans for a Wastewater Treatment System. • Application to Construct a Water Well • Design Data Sheet • Letter of Authorization Pump system report(if applicable) Short Environmental.Assessment Form- and Profile- Separate Sewage Treatment System (4 copies) • Fee — Certified Check in the amount of $300 • Wetland Activity permit, issued by the Town of Putnam Valley • House Plans (2 Copies) I trust the above materials are adequate for your approval and complete the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call me @ 621 -4756 Very truly your , Chris Caralyus L0 :C Wd 0 I W CO Project Manager 0 y ; 3 �:, '-] 1 DIVISI ®N OF ENVIRONMENTAL HEAL'T'H SERVICES RE: Property of Located at LET T JER101r Ali TH tTtiZf MK' TN Tax Map # ; 2 Block ( Lot 3 Subdivision of 4A Subdivision Lot # - . Filed Map # Aj h Date Filed Gentlemen: This letter is to authorize r'r' a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by .the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with. this matter and to supervise the construction of. said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145.and/or'147 ofthe Education Law, the Public Health . 6 ... .. _rte a^.d the R'u«.0 rr ;,urty San' ta_ry=C;od*e . Countersigned: P.E., R.A., # Mailing Address 70 .fir' i:c-P 00 ILA State Zip Telephone: 6 , 21 °-4-75 ` Nery truly yours, Signed: :I (Owner of Property) Mailing Address: / j0 N %lQ s r State A,1 � Zip /b -- 4 Telephone: 1q) 3Y— l 3 Form LA -97 •b TOWN OF PUTNAM VALLEY CHAPTER 144: Freshwater Wetlands, Watercourses and Waterbodies Ordinance of the Town. of Putnam Valley, New York. The Town Wetlands Inspector, as Approval Authority, has determined that the proposed action is an Unlisted Action under SEQRA, and will not have a significant environmental impact. Therefore, a PERMIT WAIVER is granted subject to the conditions noted below. DATE PERMIT ISSUED: DATE PERMIT EXPIRES: APPLICANT/SPONSOR: Benedetto Paonessa 16 North Street Montrose, NY 10548 PROPERTY LOCATION: April 30, 2003 April 30, 2004 Lot 39 Oscawana Lake Road TAX MAP- #: -62 -1 =39­ .-SIZE. -OF PARCEL: 17.556 ac., ZONING: R-3 - PROPOSED ACTION: Construction of Existing-Access into permanent Ariveway access MATERIALS family c:denee w;*�inet 1:i'er:� _.. _ ......_:.._ ..: _ ..__..._.... MATERIALS REVIEWED: 1 • Application Materials, file # WT -14. CONDITIONS OF PERMIT: 1. Existing access area to be retrofitted with an 18 inch culvert, or a combination of two - three smaller drainage pipes to allow for water flow and to prevent the buildup of stagnant water on both sides of the access area. 2. Side slopes ofendsting access way to be stabilized with a conservation seed mix, and straw mulching. Pap I af2 �o 3. Shoulder area of access way to be planted with a minimum of 15 native.shruabs on both Sid" of driv y> rvuti - t. -dd 3 5450a °gi st -of one or more 6f following - native viburnums, dogwoods, bayberry, wintekberry, mountain laurel, bayberry, clethra, spicebush, highbush blueberry, ' inkbeM holly, or V*qpa sweetspire. Plantings to be inspected by Wetlands Inspector. 4. Erosion controls consisting of a row of staked heybales and silt fence required on both sides of the driveway access. Erosion controls should be turned upslope on each side to prevent sediment from entering the buffer and wetlands areas. 5. _ The Building Inspector shall be notified once erosion control measures are in place and at least 48 hours prior to the initiWon of any site work. 6. When Erosion controls are requwed, they must be maintained properly throughout the construction process and remain in place until final site inspections for compliance with conditions of permit have been completed. 7. The Planning Board, Wetlands Inspector, and/or Building or, shall have the right to inspect the project from time to time. 8. The permit shall be prominently displayed at the project site du the undertaking of the activities authorized by the permit. 9. An additional escrow account in the amount of S 300 must be established with the Town before this Kermit Waiver can be considered validated. 'These additional escrow funds will be appropriated as required for construction monitoring purposes. Any portion of the account not used during the project monitoring period shall be returned to the applicant upon satisfhatory completion of the projecty..(Ws requirement waived, if edditional d,�q ryrye�♦♦ ... ...._- . /y11tl• - one aftLT K� Oq ww4%wr> . b Noncompliance with the conditions above will invalidate this Permig Waiver, and may result in e Notice of Violation and/or a Stop Work Order. Any questions regarding this Permit Waiver should be directed to the gown Wetlands Inspector (9 14) 762 -"88, or the office-of the Building Inspector (914) 526 -23 77. Date Permit Waiver Prepared: April 30, 2003 Q,L dw, (0• Stephen W. Coleman Town Wetlands Inspector cc: Applicant . Building Inspector Planning Board EnArontsmental Commission { 'PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMEN'T�AL HEALTH SERVICES - .111ilT A.L'fNY iVIDUAL %COMMERCIAL SITE INSPECTION FORM SECTION A. GENERAL INFORMATION Name of Project 47"6- 5'1141 - (T)(V) County Site Location Building construction begun Is property within NYC Watershed ? ................. Extent 0 Yes �No SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. 0 Hilly Rolling teep slope �Geritle slope F� Flat 2. Evidence of wetlands 0 Low area subject to flooding Bodies of water Drainage ditches Rock outcrops 3. Property lines or comers evident ... ............................... 0 'des O-No 4. Do water courses exist on or adjoin the property? ............................. 0 Yes No 5. Will these affect the design of the sewage system facilities ?............. F7.Yes No 6. Do watershed regulations apply. in this development? g P ? ....................... 0 YesNo 7 Will extensive grading be necessary?...... ............ ............................... Yes ® No 8.. Will extensive fill be necessary for SSTS ?............. _... ' ` {es_. _Nn� i70 filled areas exist within-the SSTS area?........ . .. ............................. Yes No If yes, what is the condition of the fill? SECTION C. SOIL OBSERVATIONS 10. Appearance of soil;n-Sand Q Gravel a Loam F-I Clay 0 Hardpan Mixture 11. Observed from: Borings Bank cut lwkhoe excavations 12. Soil borings /excavations observed by on 13. Depth to groundwater on 14. Depth to mottling N on 15. Are test holes representative of primary & reserve areas ...... ............................... —Yes No 16. Soil percolation tests made by ,r�?`�'�' on 17. Soil percolation tests witnessed by on SECTION D (on back) Form ST -1 I 2 SECT QXP.�,D I RAA N AGFW 18. Will proposed grading material . ly alter the natural drainage in this or adjacent areas? Yes No . 19. Will groundwater or surface drainage require special consideration? ............... Y ........ es. No 20. Will gullies, ditches, etc., be filled and watercourses . be relocated? ......................... F7Yes FZ71 No L SECTION E. REMARKS 21. If a common water supply is proposed, has an inspection been made of the existing or proposed source and facilities? ..................... A," ........................ Ye's No Inspection data 22. Do adjacent wells and/or sewage systems exist? ................... I .................................. Yes No 23. Additional comments 24.-. Site observer/inspector and title 25. - :.Date(sJ-.of observation(s)inspection(s) TEST,- PIT PROFILES Hole 4' Hole # 'Lot # Depth to water Depth to water Depth to mottling Depth to mottling D`el�ffi ' 6: Depth to rio,zk/imp. ov W, • G.L. 16 16Svw'l G.L. 62� 0.5 CV"' .0.5 1.0 1.0 A 2.0 *- 2.0 V J 3.Or All 3.0 J 4.0 'il 4.0 M 5.0 6.0 6.0 8.0 .8 9.0, 9.0 10.0 10.0 Hole # Lot 4 Depth to water Depth to mottliniz Depth to racOimp ///I� G.L. 75, < 0.5 1.0 A 2.0 3.0 40 5.0 6.0 7.0 10.0 4 TEST PIT PROFILES Hole # Lot- # 9187*� Hole# Lot # Hole # Lot # Depth to water Af br Depth to water AJ14- A wat-L-r- Depth to mottling Depth to mottling. AIM Depth to mottling Depth to rock/imp. Depth to rock/imp. AJ17Y Depth to rockJimp.V G.L. G.L. 7,xv 6'o G.L. 0.5 .0.5 0.5 1-0 Q-4b' M"it'-Afi ma'V11-0. 2.0 (-> L. 2.0 girl, .0 6.0 7.0 8.0 .0 10.0 Hole # Lot # 44 Depth to water 7 0, -,Depth to mottling Depth to rock/imp. G.L. OS 3.0 4.0- 3 b 5.0 LJ 6.0 7.0 8.0 9.0 10.0. i-o 2.0 3.0 4.0 67'1 'sLo, ' d4 5.0- -let 600 7.0 8.0 9.0 10.0 Hole # Lot# AW 3 Hole# Lot # Depth to watei Depth to mottling Depth to mottling Depth to rock/imp. Depth, to rock/imp. G.L. r-1 .L. G.L. 0.5 1.0 2.0 2.0 3.0 4.0 q u L 5.0 "')el -1 v 3.0 4.0 0.5 1.0 -36 2.9- 3.0 5/ 4.0 5.0 -5.0 6.0 6.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 f - ------ - --- lin LJ2 OA� ltt;? AA 6,11 �y I rg )TA I FILE No .306 08/09 '02 1143 ID DYER &ASSOCIATES ,s =�..y. .- w.�•,u.-cn•.e. -rv: :.•no-:c,]k. ..,. .:".. _--c ♦ t...�.. i <.t.L - ] - BRUCE R. FOLLY Public. Health Director MWOMMIM -,Q I,- . FAX:8456281905 PAGE 1 I.ORETTA MOLINARI. R.N., A'i.S.N, Associate Public Health Director Director of Patient Services DEPARTMENT, OF BEALTH I Geneva Road Brewster, New t'+ York 10509 S! FQR TE ES -TING ATTENTION: ❑ ADAM STI>a13E ING o'GENE I REED All information below must be I& completed prior to any scheduling. MTE: ENGINEER OR FIRM: I . � P Z, c - h 5 5601 1A i e3 Pxon #: REASON: / DEEPS: a PERCS: cr PUMP TEST: 0 ROADIS1s REET: ©SC.A W AAA �A -e RD TOWN: PU��M t1/�CCC� TAxMfAP #: -- SUBDIVISION: f, LA LOT#: O'WNER: 8ek:a�q NYCDEP CRITERIA FOR JOINT RE' E AND) I SHNG OE SOIL IFSTINr YES NO „, _.._ .<.....' .. -... - : _ ..:.: W_._ :�:'-.. e - � "'•� lvra�csod Su':S•ir : uiiilrhr- drainage basin ofV9'es4 Bunch or Boyds Corner 1'�eservoirs. -� -. ~+ _—. r -... . O Proposed SSTS within 500 feet of a reservoir, reservoir stem or control. lake. roposed SSTS within 200 feet of a watercourse or a DEC wetland. C3 �/--Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. © proposed SSTS for a Commerical Project. kis the responsibility of the design professional to provide the above information-prior to soil testing. This Department will determine the NYCDEP project statas (Joint or Delegated) based on the response. If you nnsvrered = to any of the questions, I+YCL'EP mast witness the soil tcs6ig. This Department will coordinate a mutually suitablo time for Field testing yvifn the PCDOR, the design Professional and NYCDEP. Tf a project has been determined to be Delegated based on the above response and then subsequent: information indicates NYCDEP 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 with NYCDEP. Q1 r- q -PRSP ART r ikn�cicigo y i M/o YSp i av 0 1013'o AM 41-4:3 TM • CldC_O 70.. �n^ie - - - 9'(1'If AC. 3 e X0,00 32 1o123s / �" 4.76 AC. / Q s ., °•° g 11.06 AC. M9.1 Q s3.2 1 828 1819,18 59.23 AC. .e�._.1 e. - ca.•.ae.,m:..•.. -.,r. rorr ;,."..C.:GI.r•c.., . -�� -. ,,? 000... �'..�•„. sn ron:r'. �= °e'e..,..e: .rn ..r..w..,- .n -.ar_r >'w :, . ,',:, ...ti.- ..'I -, '.,�. .. - . 33.1 'e 1 24.02 AC. CAL. 3.14 AC. ti \ 1852.83 v 1 /1P0fi 8 NI 186.91 ]15.49 .. �A I • W 4 34 2.At6 AC��' ' • 1001.89 1 e 1 ao. 17.64 AC. CL. 6 L. I 1 260.43 07 300.00 369.24 35 I 36 a 17.50 AC. 2.21 AC. �' S1S.51 8 194.5 e^ `�6J p0 • y'. Y o� m e 2n' 38 . 3.30 AC. AL e / I 1' 17.71 AC. CAL. • .� � 2ET.0o 1 569.42 143.01 1.81 . , * . j ` rev 1 i .Y A �0 47 42 I I • 34.03 AC. 17.3eac. 45 62.5 18.41 AC. em v LSeA; 45100 330.0o AL 43 1350t51 ROAD �e naa - a \4� li W ' =m 2p0 23 e ssps� a 4.01 AC. -4 03 zo SKY 29.2 Flo. 61 AC. ti 30 r �p ,a2.04 AC • ;� AC. ,. � 29.3 2.64AC. ' 8 3.17AC. ° I 9 0. • IJ� '�► P6 °o I I 10.19 AC. •� 29.1 X. 2y: 22� 1 >v� ?see >, 49 �r `e 2.07A�4>> 201 . oe�AC I • / / P1E/j T a 6.4.a AC. CAL. 11 , m 21 2 �is9j28 ww ..: .0 26 e . 2.29 AC tip; 8.0 AC. CAL 4.21 AC. ^ !1':06. AC. i.86 Ac. h ... '.. 4J Id 8 2940. s, i 27 11112 / 31 54 r 9.92 AC. /� / 5.95 AC. CA 14.80 AC. 9.99 AC. CAI. •�� b 'Iyt �i�' ` ^``8 6y'r,' 1r `• a� 53/91p i /20 16 50 52 7.06 AC. JSoI i ' e `.7.35 AC. °' • �'$ 48.52 AC. 18 7.11 AC. Qr, 12.54 AC. ' 40.31 AC. sia/J r, ° 1 pp0 C. ��•• AREA IN •DISPUTE ei� �' /ACSe � `• ~ �� IS $ �Rtr51 �e psi 5.46 AC.� \ X2.53 ACS � ed.'s ,� •�� CAl• � e`ti °�� 1j4v 71.90 tie1� �� ,w' 14 V o� 4. 12 2:67 AC. �o� ,y wee 34.16 . 31� 28.86 AC. lip ,d -- - -- - - -P /0 73 -1 -95 ---- - - - - -- do LEGEND 5a 5 52 ° PRELIMINARY S ASE ............. wETLAROS LINE AMD 9181BaL c.._� !-.. °- OEr WERE LOT Kam t am OIAEri910N Ioa01 SCALED OIMMIN 100(51 TOWN OF PUTNAM VALLEY?° 6 63 72 73 74 - -- F - - CALCIA.ATEO AM 271 8C. CAL VIML CEOIO •. mR PARCEL ROARER T2 $ PUTNAM COUNTY, NEW YORK OATS 'AERIAL PIIOT031AP1e.,, -`10•BT' RT STALE Me COOADIN ,Ott j/ kpZ#d q Ak,649- AW4. IClo 5 3v Orou 9,ndj - fuel 6-4 -9— & -30 m eJ,,,vT 0--*% 3 —Xq 00" OCATIONS ;..A 8 �P �\ 3 64' 80 \ \ \ `•. `• 4 70' 87' \ �� 5 76' 92' _ \ \ a� , I, 6 82 98' �' (\� �j�APS "(-Ty 15 16 ' 19' 16 19' 7 116' 114' 8 120' 120' 9 < 126' 125' \� 10 128' 130' 11 132' 134' 12* 135' 138' . 13 130' 136 2 14 66'. 76' 15 66.5' 78' ' 16 71' 841 ' 17 76' 89' _ 18 87" ' 101' 19 92' 107' 20 70' 80' .. . _ . _ _.. �....._ __..... 21. . __ — - � 85:5'_:: .: _ -- - �'� -�; �''• _'_ ..•-...: ._. _;.`.:_. _...._._. 75' _ 22 79' 91' 23 841 97' 24 89' 102.5' WAS CONSTRUCTED AS 25 95' 108' 3PECTED BY ME BEFORE 26 99' IN ACCORDANCE WITH ALL - UNTY DEPARTMENT OF HEALTH LED" AS -BUILT PLAN GRAPHIC SCALE so 0 15 10 60 120 _ ft. 1 inch = 30