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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.06 -1 -24 BOX 24 rJ6 iL ir :Al. 02825 PUTNAM COUNTY DEPARTMENT OF HEALTH ® a DIVISION_ OF ENVIRONMENTAL HEALTH SERVI Ili 0 CERTIFICATE OF CONSTRUCTIONC.OMPUTANCE FOR SEWAGE TREATMENT SYSTEM 3� PCHD CONSTRUCTION PERMIT # r1��oZ -o7- Located at 91 �K P191gr 129-W6 t)W.41i Town uFW#Pa1ft1- PyT /J" k/ Owner /Applicant Name PtL.C► Tax Map Z. 4 Block o) Lot Formerly Subdivision Name Subd. Lot # Mailing Address Date Construction Permit Issued by PCHD O? -12• l3 Zip Separate Sewerage System built by s LIi(i Address 15A V 3161 WAP` , ti S Ny Consisting of (t5_0 Gallon Septic Tank and 375- LF of 4"-Ogmfy ?t=1D P Yla /./J Other Requirements: 17_6D CiA-(,LoN PyMP G"MPAIL, yi % Water Supply: _N JA Public Supply From Address 1tJ RE_ Private Supply Drilled by 0Rt4(1jKL Li'kt$T)iuk Address le�+.�,.a.� 12 Has-erosion control been comr. i •. .. - Number of Bedrooms �� Has garbage grinder been inst O OF NE YO I certify that the system(s), as listed, serving the above premises wer co s ucted q, ,sent* lq shown on the as- built plans (copies of which are attached), in accordan a iss e riuctib P� it and approved plans and the standards, rules and regulations of t Pu t'of Health. X .` Date: 0 • Certified by N I??� R.A. (Design Professional) Address � A�1-l� (,Q A . G�ii2-[''LA,whT- MgIVO�tL 1.1�__ r 01' Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to odification or change when, in the judgment of the Public Health Director, such revocatiqn, modification change is necessary. By: Title: Date: 6 White copy - HD V /;Yelloc p y - Building Inspector; Pink copy /-Wner; Uge copy - Design Professional Form CC -97 ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E. _ .Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 E911 ADDRESS VERIFICATION FORM OWNERS NAME: PALEY _ TAX MAP NUMBER: 62.6-1-24 E911 ADDRESS: 31 HEMLOCK POINT DRIVE NORTH MARYELLEN ODELL County Executive TOWN: PUTNAM VALLEY AUTHORIZED TOWN OFFICIAL: ( ignature) _DATE: 4.2.1.44 The Putman 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. (E91 l ver&m) 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM &del 61, L 01 ?i Owner o Purchaser of Building Tax Map Block Lot &AA6 at. R eL e_ pr "mPstq . LNG row - V� Building Constructed by Town/ 3l 01 M.L"A'= Pot" KLV6 NoX0 Location - Street Subdivision Name ISINW41�_' 15�:M t w Building Type 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 system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day N Year 1-0& Signature: A��Z� C1 Title: General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State Zip �S L G L Corporation Name (if corporation) Address: /�_jr— �- gZriMh 62WA %1S State JV-/ Zip /" tit, 0-t z5 6 Form GS -97 yy r-y�-�AA���77 �/ e/ry � I7-I�V7 _E -�p�-.+p� t r DIVISION OF EIN R,,ONMENTA. , me Building Constructed by 3 l tee Lot" Location - Street. Subdivision Name Building Type Subdivision Lot I represent that I am wholly and completely responsible for the. location, workmanship, material, construction and drainage of the, sewage treatment systenm seninZthe 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 ofthe.Putnam- County Department of Health, and- - hereby guarantee to the owner, his successors, heirs ... r assi°ns. 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 system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month _ Day I T Year General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State Zip Si-anature: Corporation Name (if- corporation) Address:/3M K kA4jP P1YY(s State Zip Form GS -97 (,c� L 3, Owner o hurchaser of Building Tdk -Map Block Lot gVtAe, G&,4 OffiWpf L.®M.PANq INC QJI'NAM V/11i1.1�1 Building Constructed by 3l i..o Poluf b►2�v Motto Location - Street Building Type Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material. construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved,plari or approved amendment thereto; and in . accordance. with.the.standards,.rules and regulations of ifie. `Putnam- County Department of- Health, and hereby guarantee to the owner, his successors, heirs or assfgns, 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 system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day 14 , Year- 2-01 . Signature: &Ih� 5__, u� T Title: Caaol2b % General Contractor v ner) - Signature Corporation Name (if corporation) Address: State Zip rF� C_ Corporation Name (if corporation) Address* iz .3x U9ARprw -P)JS State Zip Form GS -97 BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: y Upon premises owned by: Doyle Electric Inc. Alan & Gail Paley 170 Church Hill Road 31 Hemlock Point Drive North Carmel, NY 10512 Putnam Valley, NY 10597 Located at: 31 Hemlock Point Drive North Putnam Valley, NY 10597 Certificate Number: 2013 -5774 Electrical Permit Number: 1844-12 Section:;62.6 Block:1 Lot: 25 BDC:808 Building' Permit Number: �1 A visual inspection of the electrical system`atahis'premise described as a= Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring; described below, located in /on the premises at: 31Hemlock Point Drive North Putnam Valley,�NY 0597 The Outside Septic System was,mspected in accordance with the NYS and NFPA z 170 7 42 008 and the detail of the installation, as set forthbelow, was found to be in compliance there with on the 19ei day of December, 2013.E fi f - .._. _ _. _ _ 5 .. _.. � .- •' _.fl. -.e:. •- � _ .a .:; s,..r�. -. -`-. ._.. __.9 ...,... .. _.` .,_ _rte .. ._ .. _-�.. - Septic System ONLY ex h .s` Pump 01 ' # 20 amp 240 volt Central Alarm Panel 01 W' y110molt Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. This certificate is valid for work performed before date of inspection only. Is r ANALYTICAL REPORT Job Number: 420 - 77058 -1 Job Description: Eco -Tec, LLC For: Ecotec, LLC 25 Corporate Park Dr. Suite C Hopewell Junction, NY 12533 Attention: Ms. Wendy Przetakiewicz Joyce M Esposito Senior Customer Service Representative jsposito@envirotestlaboratories.com 05/02/2014 NYSDOH ELAP does not certify for all parameters. EnviroTest Laboratories does hold certification for all analytes where certification is offered by ELAP unless otherwise specified. Pursuant to NELAP, this report may not be reproduced, except in full, without written approval of the laboratory. EnviroTest Laboratories Inc. certifies that the analytical results contained herein apply only to the samples tested as received by our laboratory. All questions regarding this report should be directed to the EnviroTest Customer Service Representative. EnviroTest Laboratories, Inc. Certifications and Approvals: NYSDOH 10142, NJDEP NY015, CTDOPH PH -0554 Envirotest Laboratories, Inc. 315 Fullerton Avenue, Newburgh, NY 12550 Tel (845) 562 -0890 Fax (845) 562 -0841 www.envirotestlaboratories.com Page 1 of 11 r Ron o to rar:d9a 05 02 2014 ra Job Narrative 420- J77058 -1 No additional comments. Receipt All samples were received in good condition within temperature requirements. Metals No analytical or quality issues were noted. General Chemistry Method SM 4500 H+ B: The holding time for pH is 15 minutes, the samples were received outside of the holding time. No other analytical or quality issues were noted Page 2 of 11 05/02/2014 METHOD SUMMARY -..... .�.:: - . • rn ,.� - - .. • �:.. __ ;.:..., ,_ ._�.. _._z..� : _ ....,:._ . ,_. s ,.... � ...: 9 . `, � . •.:� .�.• y :, <,..3 ° 'J b um N b er: - 77058 -1 420 ...., _ _ ..: -..� . .Client: tcotec, LLC , . _.. _._ ... ,. � -,a r::..,�..w_�t- ._- ::...� .:..� .. ..• .. o Description Lab Location Method Preparation Method Matrix: Water ICP Metals by 200.7 EnvTest EPA 200.7 Rev 4.4 200 Series Drinking Water Prep Determination Step EnvTest EPA 200 ICPMS Metals by 200.8 EnvTest EPA 200.8 200 Series Drinking Water Prep Determination Step EnvTest EPA 200 Anions by Ion Chromatography EnvTest MCAWW 300.0 Turbidity EnvTest SM20 SM 2130B Alkalinity, Titration Method EnvTest SM18 SM 2320B Hardness by Calculation EnvTest SM20 SM 2340B Hardness Prep EnvTest ETL -STD HARD—Prep pH EnvTest SM19 SM 4500 H+ B Nitrite by Colormetric EnvTest SM20 SM 4500B Lab References: EnvTest = EnviroTest Method References: EPA = US Environmental Protection Agency ETL -STD = EnviroTest Laboratories Standard Operating Procedure. MCAWW = "Methods For Chemical Analysis Of Water And Wastes ", EPA - 60014 -79 -020, March 1983 And Subsequent Revisions. SM 18 = "Standard Methods For The Examination Of Water And Wastewater", 18th Edition, 1992. SM19 = "Standard Methods For The Examination Of Water And Wastewater", 19Th Edition; .1 095. "_: e SM20 = "Standard Methods For The Examination Of Water And Wastewater", 20th Edition." EnviroTest Laboratories, Inc. Page 3 of 11 05/02/2014 4 Client: Ecotec, LLC I Job Number: 420-77058-1 Method Analyst Analyst ID EPA 200.7 Rev 4.4 McPhillips, Julie im EPA 200.8 Pistole, Maria MP SM20 SM 2340B McPhillips, Julie im MCAVVW 300.0 Pistole, Maria MID SM20 SM 2130B Travis, Lyndsey LT SM18 SM 2320B Goldstein, Amy AG SM19 SM 4500 H+ B Travis, Lyndsey LT SM20 SM 4500B Pistole, Maria MP EnviroTest Laboratories, Inc. Page 4 of 11 05/02/2014 _ SAlL!! LE -! !'-Yr!!aRY_. Client: Ecotec, LLC Job Number: 420 - 77058 -1 Date/Time Date/Time Lab Sample ID Client Sample ID Client Matrix Sampled Received 420 - 77058 -1 Paley Water 04/24/2014 1000 04/24/2014 1055 EnviroTest Laboratories, Inc. Page 5 of 11 05/02/2014 Ms. Wendy Przetakiewicz Ecotec, LLC 25 Corporate Park Dr. Suite C Hopewell Junction, NY 12533 Client Sample ID: Paley Lab Sample ID: 420- 77058 -1 Analyte Method: 300.0 Nitrate as N Job Number: 420 - 77058 -1 Date Sampled: 04/24/2014 1000 Date Received: 04/24/2014 1055 Client Matrix: Water Result/Qualifier Unit MDL RL Date Analyzed: 04/25/2014 1306 0.300 mg /L 0.0100 0.250 Dilution 1.0 Page 6 of 11 05/02/2014 Ms. Wendy Przetakiewicz Ecotec, LLC 25 Corporate Park Dr. Suite C Hopewell Junction, NY 12533 Client Sample ID: Paley Lab Sample ID: 420 - 77058 -1 Analyte Result/Qualifier Method: 200.7 Rev 4.4 RL Prep Method: 200 Date Analyzed: Iron <60.0 Sodium 12300 Method: 200.8 ug/L 60.0 Prep Method: 200 1.0 Pb 2.77 Manganese 0.223 Method: SM 2340B Total Hardness (as CaCO3) 304 Total Hardness (in Grains /Gallon) 17.8 Method: SM 2130B 1.0 Turbidity 0.790 Method: SM 2320B 04/30/2014 1451 Alkalinity 132 Method: SM 4500 H+ B 1.0 pH 7.03 Temp @ pH Measurement 20.1 Method: SM 4500B Nitrite as N <0.0100 Job Number: 420 - 77058 -1 Date Sampled: 04/24/2014 1000 Date Received: 04/24/2014 1055 Client Matrix: Water Unit RL RL Dilution Date Analyzed: 04/30/2014 1451 Date Prepared: 04/25/2014 1504 ug/L 60.0 60.0 1.0 ug /L 200 200 1.0 Date Analyzed: 04/29/2014 1314 Date Prepared: 04/25/2014 1504 ug /L 1.00 1.00 1.0 mg /L 0.00100 0.00100 1.0 Date Analyzed: 04/30/2014 1451 mg/L 3.30 3.30 1.0 Grains 1.00 1.00 1.0 Date Analyzed: 04/24/2014 1452 NTU 0.100 0.100 1.0 Date Analyzed: 04/29/2014 0930 mg /L 5.00. 5,00 .. _ 4:0 . < Date Analyzed: 04/25/2014 1425 SU 0.200 0.200 1.0 Degrees C 5.00 5.00 1.0 Date Analyzed: 04/24/2014 1350 mg /L 0.0100 0.0100 1.0 Page 7 of 11 05/02/2014 UAYA REVURTING QUALIFIERS Client: Ecotec, LLC Lab Section Qualifier Description General Chemistry EnviroTest Laboratories, Inc. Job Number: 420 - 77058 -1 H Sample was prepped or analyzed beyond the specified holding time Page 8 of 11 05/02/2014 Definitions and Glossary v Abbreviation %R DL, RA, RE EPA MDL ND QC RL RPD These commonly used abbreviations may or may not be present in this report. Percent Recovery Indicates a Dilution, Reanalysis or Reextraction. United States Environmental Protection Agency Method Detection Limit - an estimate of the minimum amount of a substance that an analytical process can reliably detect. A MDL is analyte- and matrix - specific and may be laboratory-dependent. Not detected at the reporting limit (or MDL if shown). Quality Control Reporting Limit - the minimum quantitation levels, concentrations, or quantities of a target variable (e.g., target analyte) that can be reported with a specified degree of confidence. Relative Percent Difference - a measure of the relative difference between two points. EnviroTest Laboratories, Inc. Page 9 of 11 05/02/2014 Enviro Test • ca 315 Fullerton Avenue ( Laboratories, nc. C:kA1N OF CUSTODY TEL(a4gh.N2-0890 9 TEL (845) 562 -0890 FAX (845) 562 -0841 CUSTOMER Ecotec, LLC REPORT TYPE � C A O!+ Ecotec, LLC . _q TURNAROUND 1 CO �- _ I ..` ' / . ��� 11)5� AWB � REPORT # (Lab Use Only) ADDRESS, 25 'Corporate Park Drive; Suite C STANDARD ❑;ISRA ❑ NORMAL LO IS D�BY Q (Duo CITY/ STATE/ Junction, } ZIP Hopewell Junction N1 )2533 [- NJ +REG COMMENTS ❑ QUICK NYSOOH 1014 ::NJDEP NY015 CTOOPH PH-0554: EPA NY00049 NOTE_SAMPLETEMPERATURE UPON RECE1P.T MUST BE 4C •I- 2C. FACT ' O E NY ASP ❑ A � . B SAMPLE TEMP `C' %�?�$ William Povali 897 -8205 ❑ VER.BAL , . RO Ec - . LOCATION 31 Hemlock Point Dr. N., Putnam Valley, NY OTHER "� AMPLE REC'D ON ICE ' Y N ,❑ ❑ R 8 W..U. Allen: & Gail PALEY I H!cHECK ❑Y . ❑ N .. MATRIkDW =DRINKING WATER•Z=s61L O= 01L,WW =WASTE WATER CHLORINE RESIDUAL ,,❑ Y :❑ N SL= SLUDGEGW =GROUNDWATER 4) ( v. o: NY'PUBLIG :WATER SUPPLIES C J N C Z W N .� ou i v a _ p SOURCEID ' H VV LRP TYPE SAMPLING 0- E 0. E a EDERAL ID ANALYSIS REQUESTED f I.D. Sampe# DATE TIME F qbq Ci ` GW PALEY 1 1 L. Fe, Mn, Pb, Na & Hardness Raw GW PALEY Nitrates/ Nitrites & Turbidity (raw) ,v GW PALEY 1 1 pH &Alkalinity (ra W) V I + I 3. F i i S. 1. SAMPLES SUBMITTED FOR ANALYSIS WILL BE SUBJECTED TO THE ENVIROTEST TERMS. AND CONDITIONS 'OF,SALE (SHORT ORM) UNLESS ALTERNATETERMS ARE AGREED IN WRITING. I 1 UIS ED BY C I� � C A O!+ Ecotec, LLC . _q i��� 1 CO �- _ I ..` ' / . ��� 11)5� AWB � COMPANY DATE �IMy. R IVED COMPANY DA TIM VV Ecotec, LLC . :2) L- U LO IS D�BY CO RECE CO ANY DA TIME COMMENTS NYSOOH 1014 ::NJDEP NY015 CTOOPH PH-0554: EPA NY00049 1 Client: Ecotec, LLC Login Number: 77058 LOGIN SAMPLE. RECEIPT. CHECK I -I Job Number: 420- 77058 -1 Question T /F /NA Comment Samples were collected by ETL employee as per SOP -SAM -1 NA The cooler's custody seal, if present, is intact. NA The cooler or samples do not appear to have been compromised or tampered with. True Samples were received on ice. True Cooler Temperature is recorded. True 10.8 C Cooler Temp. is within method specified range.(0 -6 C PW, 0 -8 C NPW, or BAC <10 False C If false, was sample received on ice within 6 hours of collection. True Based on above criteria cooler temperature is acceptable. False COC is present. True COC is filled out in ink and legible. True COC is filled out with all pertinent information. True There are no discrepancies between the sample IDs on the containers and the True COC. Samples are received within Holding Time. False pH Sample containers have legible labels. True Containers are not broken or leaking. True Sample collection date /times are provided. True Appropriate sample containers are used. True Sample bottles are completely filled. True There is suikieni vol. for ail retwested analyses, incl. any i ?gopstetd MSMSDs True VOA sample vials do not have headspace or bubble is <6mm (1/4') in diameter. NA If necessary, staff have been informed of any short hold time or quick TAT needs True Multiphasic samples are not present. True Samples do not require splitting or compositing. True EnviroTest Laboratories, Inc. page 11 of 11 05/02/2014 lu Ir Em Vi MeM., orwn- -. s•- ...... ....,'.. '- ,. -..�. ....,. `�- "..:n t...1 r.�.•tT. �r.JJ- Y'✓-.hsY S.. .�i. ...... -.c. r. ._._. -. ... .. �. ... ANALYTICAL REPORT Job Number: 420 - 76645 -1 Job Description: Eco -Tec, LLC For: Ecotec, LLC 25 Corporate Park Dr. Suite C Hopewell Junction, NY 12533 Attention: Ms. Wendy Przetakiewicz Joyce M Esposito Senior Customer Service Representative jesposito @envirotestlaboratories.com NYSDOH ELAP does not certify for all parameters. EnviroTest Laboratories does hold certification for all analytes where certification is offered by ELAP unless otherwise specified. Pursuant to NELAP, this report may not be reproduced, except in full, without written approval of the laboratory. EnviroTest Laboratories Inc. certifies that the analytical results contained herein apply only to the samples tested as received by our laboratory. All questions regarding this report should be directed to the EnviroTest Customer Service Representative. EnviroTest Laboratories, Inc. Certifications and Approvals: NYSDOH 10142, NJDEP NY015, CTDOPH PH -0554 Envirotest Laboratories, Inc. 315 Fullerton Avenue, Newburgh, NY 12550 Tel (845) 562 -0890 Fax (845) 562 -0841 www.envirotestlaboratories.com Page 1 of 9 Ojt ACC 40�aP 4 5N 04 11 2014 R 0 METHOD SUMMARY Clierit: Ecoiec,�LLC::_ ..., ._ ., ._.,, _ ...... .. , . � "- .. _ � •.. Job Number. 420 - /6645 -1 Description Lab Location Method Preparation Method Matrix: Water Total Coliform and Escherichia coli by Colilert> EnvTest SMVWV SM 9223 Presence /Absence Lab References: EnvTest = EnviroTest Method References: SMWW = "Standard Methods for the Examination of Water and Wastewater EnviroTest Laboratories, Inc. Page 2 of 9 04/11/2014 a ..-.:< .,, ..�.._.., - .. � . .,,. _..:� ......,.. , _, �d��`� ri��v / i�(V�►�.r'sT�' ^�L'iv�ili�N►�'rr....,..., _ .._. Client: Ecotec, LLC Job Number: 420 - 76645 -1 Method Analyst Analyst ID SMWW SM 9223 Travis, Lyndsey LT EnvlroTest Laboratories, Inc. Page 3 of 9 04/11/2014 SAMPLE SUMMARY Client: Ecotec, LLC Job Number: 420 - 76645 -1 Date/Time Date/Time Lab Sample ID Client Sample ID Client Matrix Sampled Received 420 - 76645 -1 31 Hemlock Point Dr.North Drinking Water 04/10/2014 0950 04/10/2014 1050 Putnam Valley Basement Tap EnviroTest Laboratories, Inc. Page 4 of 9 04/11/2014 TI . :..o. n-. ..... .:T♦..�..p.. <.)r�.: .V a, ..v, ;. ... ..... ... ._ .. �. r..♦ q.:e. r_. .. ...cr..na 1 v ..a r ) %t s.1 .•..a -.. x. Ms. Wendy Przetakiewicz Job Number: 420 - 76645 -1 Ecotec, LLC 25 Corporate Park Dr. Suite C Hopewell Junction, NY 12533 Client Sample ID: 31 Hemlock Point Dr.North Putnam Valley Date Sampled: 04/10/2014 0950 Lab Sample ID: 420 - 76645 -1 Date Received: 04/10/2014 1050 Client Matrix: Drinking Water Percent Solids: Analyte Result/Qualifier Unit NONE Dilution Method: SM 9223 Date Analyzed: 04/10/2014 1720 Coliform, Total Absent CFU /100mL 1.0 Escherichia coli Absent CFU /100mL 1.0 Page 5 of 9 04/11/2014 Lab Section Qualifier Description Page 6 of 9 04/11/2014 Definitions and Glossary Abbreviation These commonly used abbreviations may or may not be present in this report. %R Percent Recovery DL, RA, RE Indicates a Dilution, Reanalysis or Reextraction. EPA United States Environmental Protection Agency MDL Method Detection Limit - an estimate of the minimum amount of a substance that an analytical process can reliably detect. A MDL is analyte- and matrix - specific and may be laboratory- dependent. ND Not detected at the reporting limit (or MDL if shown). QC Quality Control RL Reporting Limit - the minimum quantitation levels, concentrations, or quantities of a target variable (e.g., target analyte) that can be reported with a specified degree of confidence. RPD Relative Percent Difference - a measure of the relative difference between two points EnviroTest Laboratories, Inc. Page 7 of 9 04/11/2014 Envirolest Laboratories Inc. c� i CHAIN OF CUSTODY CUSTOMER NAJVE '+ +(K ADDRF,S.S CITY, STATE ZIIIj NAME OF.CONTACT PHONE NO. 1� �ILi 4?L/ PROJECT LOCATION �j -t oC PROJECT NUME ;ER I PO NO. llzrnt sP,"L NOTES SAMPLE TEMPERATURE UPON RECEIPT MUST BE 4° t 2 °C. SAMPLING a m ETL DATE TGy1E a¢ MATRIX &., ,c►iT i n REPORT TYPE STANDARD ❑ ISRA ❑ NJ REG ❑ NYASP A ❑ B ❑ CLP❑ OTHER TURNAROUND ❑ NORMAL 11: QUICK ❑. gVERBAL N % matrix OW = DRINKING WATER S = $OIL O = OIL WW = WASTE WATER SL = SLUDGE ?GW = GROUND WATER 315 Fullerton Avenue Newburgh, NY 12550 TEL (845) 562-0890 FAX (845) 5624Mf, REPORT # (Lab Use Only) SAMPLE TEMP. i C SAMPLE RECD ON ICE ❑ N ph CHECK ❑ Y Q N CHLORINE (RESIDUAL) ❑ Y 6'N REVIEWED BY: NY PUBLIC WATER SUPPLIES SOURCE ID — — ELAP TYPE — — — FEDERAL ID_ - -__ — ANALYSIS REQUESTED SAMPLES SUB,!ITTED FOR ANALYSIS WILL BE SUBJECT TO THE ETL TERMS AND CONDITIONS OF SALE UNLESS ALTERNATE TERMS ARE AGREED IN WRITING. RELINQUISHED.BY COMPANY DATE TIME RECEIVED BY COMPANY DATE TIME SAMPLED r K.� .� t , MPANY .COMPANY S t,l ..�- • L Ir t , DATE TIME RECEIVED B•i , COMPANY DATE TIME RELINQUISHEDsBY ;;.- j COMPANY ��,r.•.�..�L.�K.� DATE TIME �{ / { " � � �l � a , U RECEIV am - :- ..�- . � y, ;� COMPANY � 7 (._ DA YE /C TIME OS!% 4 ;a W 00 I' i --S D SAMPLES SUB,!ITTED FOR ANALYSIS WILL BE SUBJECT TO THE ETL TERMS AND CONDITIONS OF SALE UNLESS ALTERNATE TERMS ARE AGREED IN WRITING. RELINQUISHED.BY COMPANY DATE TIME RECEIVED BY COMPANY DATE TIME SAMPLED r K.� .� t , MPANY .COMPANY S t,l ..�- • L Ir t , DATE TIME RECEIVED B•i , COMPANY DATE TIME RELINQUISHEDsBY ;;.- j COMPANY ��,r.•.�..�L.�K.� DATE TIME �{ / { " � � �l � a , U RECEIV am - :- ..�- . � y, ;� COMPANY � 7 (._ DA YE /C TIME OS!% COMMENTS NYSDOH 10142 NJDEP NY015 CTDOPH PH -0554 EPA NY00049 f e ' - - LOGIN SAMPLE RECEIPT CHECK LIST .. Client: Ecotec, LLC Login Number: 76645 Job Number: 420 - 76645 -1 Question T /FINA Comment Samples were collected by ETL employee as per SOP -SAM -1 NA The cooler's custody seal, if present, is intact. NA The cooler or samples do not appear to have been compromised or tampered with. True Samples were received on ice. True Cooler Temperature is recorded. True 12.1 C Cooler Temp. is within method specified range.(0 -6 C PW, 0 -8 C NPW, or BAC <10 False C If false, was sample received on ice within 6 hours of collection. True Based on above criteria cooler temperature is acceptable. True COC is present. True COC is filled out in ink and legible. True COC is filled out with all pertinent information. True There are no discrepancies between the sample IDs on the containers and the True COC. Samples are received within Holding Time True Sample containers have legible labels. True Containers are not broken or leaking. True Sample collection date /times are provided. True Appropriate sample containers are used. True Sample bottles are completely filled. True ., T�3'° : °. S.fficl °n.':ol. tcr c y '.O ^.='. Cd 8'2! fSsincl. nny ro— !ed MSSID S T—e , _ VOA sample vials do not have headspace or bubble is <6mm (1/4 ") in diameter. NA If necessary, staff have been informed of any short hold time or quick TAT needs True Multiphasic samples are not present. True Samples do not require splitting or compositing. True EnviroTest Laboratories, Inc. page 9 of 9 04/11/2014 ALLEN BEALS, M.D., J.D. Commissioner of Health �.. ,..:., >. � ,. , ..1K1�1S�1(Y ' '1V��la� r. �`.� !vll'H ..,,....�:.::u, -_ -..• . Director ofEnvironmental Health January 21, 2014 DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering Tim Cronin, P.E. 39 Arlo Lane Cortlandt Manor, NY 10567 Dear Mr. Cronin: MARYELLEN ODELL County Executive Re: Field Inspection — Paley 31 Hemlock Point Drive N. (T) Putnam Valley, TM 62.6 -1 -24 A re- inspection at the above referenced property has been completed. There are no further comments to be addressed at this time in reference to this Department's open work inspection. If you have any further questions, please contact me at (845) 808 -1390 ext. 43163. GDR:cml 3 Gene D. Reed Principal Environmental Health Engineering Aide PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH -SERVICES 7 FINAL SITE INSPECTION Date: 1- _�3 - .TK tic ` Inspected by: ""'Y Street Location 3- I�� &1,4& v. e �?� . s , Owner flown- 1 'Permit -# TM # —6.2-, G _ _ rr Subdivision Lot # _- 1: Sewaae System Area a. STS area located as per approved plans .......... :................ b. Fill section -n- date of placement 3:1 bam. er 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 Sewase System a: Septic tank size.- 1,000 ...:. .. 25 ...:....other ................ b. ' Septic tank installed level ................................................. c. 10' minimum from foundslion ..................... ............. d. Distribution Box 1. A.0 outlets at same elevation- water.tested .................. 2. Protected below frost .................. ............................... 3. Mmimum 2 ft.Original soil between box & trenches e. Junction Bog properly set ............ ............. :.............. 6. re c es 1. Length required 3 7 Z Length installed 3 2 17 2. Distance to watercourse measured -E- loo Ft.......... 3. Installed according to plan ....:................. ................ 4. Slope of trench acceptable 1/16 -1132 "/foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. T ; Room allowed for expansion, 10.0 %.........4 ............... 8. Size of gravel 3/4 - 11V diameter clean .................... 9. Depth of gravel in trench 12" minimum......:,........... _.. _ .� -.� ..... :....f..d,� , �......_......_..._... ... q.. _ :e d...t ..,..-7 rm of _ pump chamber.... .............. ............:................. 2. Overflow taiik... * .................... .............. .................. . 3. Alarm, visual/audio ..................................................... 4. Pump easily accessible, manhole to grade........ :........ 5. First box bated...:......... :.:. ....................I.. : :...... 6. Cycle witnessed by H.D.estimated flow/cycle ..... 7...`:� D1 House7Bmldirie b lofep ppplans . N berobdr oapproved s TV. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured -74-10 o • ft ........... c. Casing. 18" above grade ..............:_F7 ... 4 d. Surface drainage around well . acceptable .....:................. V. ' Overall Worlomaashin a. Boxes properly grouted ....................... 0......................... 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 watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ....... ............................ i. Erosion control provided ................. ............................... Rev. 12/02 ALLEN BEALS, M.D., J.D. Commissioner of Health J Director of Environmental Health September 18, 2013 AL4RYELLEN ODELL County Fxecutive � ..'..: J..,. x�uG"• -•.b'tl.:. lay. .1 _i/•.:M. �.^.+sf ar .� , -R. ��.'t_... -. ♦ Tom•.► . _ n DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering Tim Cronin, P.E. 39 Arlo Lane Cortlandt Manor, NY 10567 Re: Field Inspection — Paley 31 Hemlock Point Drive N. (T) Putnam Valley, TM 62.6 -1 -24 Dear Mr. Cronin: The above referenced separate sewage treatment system (trenches only) can be backfilled. All other components of the septic plan need to be inspected upon completion. If you have any further questions, please contact me at (845) 808 -1390 ext. 43163. -�. � ,:._�....�....�. -._ .. _ `.�.�_ >.. __�:.:.._ _�_w,..°���. �:� _:r ��.:. ,Sii7erciy _ .: __— ._,__..�..,"...� ..�__-v -.: - -- _- - -•,:: ____w..s _.�.�.:.. _.._.. Gene D. Reed Sr. Environmental Health Engineering Aide GDR:cw '13- 09- 12...10:56 FROM- T-300 P0001/0001 F -688 OI>ipar 13'E�' -eaxr a 1 ` m -D DIVISION OF ENVIRONIYIENTAL HEALTH SERVICES ATTENTION L1 ADAM XGENE REQUEST FOR KNAI, INSPFCTION . For: Fill All information must be fully completed prior to any Trenches inspections being made. d� PCHD Construction Permit # Fy --O-7--0-7 Located: 31 HIM A95- &Acrr pgl Jngi (T)X Zy7.&Am' v Q- Owner /Applicant Name: � eti -- TM 2. Block I Lot Formerly: &9niYA tj __ Subdivision Nam e: - — Subdivision Lot # Is system fill completed? X14- bate: der 1 Is system complete? -J�IkU5?- 966 LM= Date: g2! 11 / 13 Is system constructed as per plans? Q 5 Is well drilled? Date: L � Is well located as per plans? Are erosion control measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of _ - Health. 'Date: 4 ' 12-. ` 1 Certified by: 1W1 PE RA ^ Design rofessional Address: Sa 0 L A&—e Lie.# 46 LO80 -_ Comments- •�1WR •• PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES j`30 . CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at Zq Liemi.� Poi Nf pakvLe tjognt own o Village F(jT),jAm \-JAU." Subdivision name — Subd. Lot # Date Subdivision Approved Tax Map 2. Block O I Lot ZS Renewal ✓ Revision ✓ Owner /Applicant Name _& 1. 6A1 t_ MA Date of Previous Approval Mailing Address gT- A-PT- I.SG NOW J100 WV 1002-& Zip Amount of Fee Enclosed ir2 b2 Building Type SIKbir f*-uL V Lot Area - Fill Section Only No. of Bedrooms 6- Design Flow GPD -7-SD Depth Volume Separate Sewerage System to consist of ^ I ZSa gallon septic tank and 21Z Lei. ®f � f tilt er We 2-dt-„ k., J ME 4aot Other Requirements: 6A-L - &yn�P C0A:n5 f3aL To be constructed by A Address Water Supply: Public Supply From Address _ on ~ jC wPrivate Supply Drillediy ' "�. X��{LZaY.,- 1.� Add're'ss _ 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 Comy, e� iii Cory to the Public Health Director will be submitted to the Department, and a written guarantee will his successors, heirs or assigns by the builder, that said builder will place in good operating co fwe �a part of'sa' se ge treatment system during the period of two (2) years immediately followi t f the i uant���of tke appVva`l� Certificate of Construction Compliance of the original system or any re irs 7,aeo eto. 4r_ :..: Signed: ° P 111 `4' R.A. Date o-3-13 I3 _ Address Sq A-fLLv LqN� W .- ti+ laS67 License # O�Zgdo 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 4ecessary by the Public Health Director. Any revision or alteration of the approved plan requires a new p it. Approved r discharge of domestic sanitary sew ag ply. 2 By; Title: Date: - Ir White copy - HD F' ; Yel w c y - Building Inspector; Pink copy - Own Ory�fig copy - Design Professional V Form CP -97 May 6, 2013 .,..v' .. - .i.r. <..•«rr ov-..tr•- u.......«rv. -a . ^«m;., m...: �- .- .,.�._m. ..= Town of Putnam Valley Planning Board 265 Oscawana Lake Road Putnam Valley, New York 10579 (845)526 -3740 Fax (845)521 -3307 wwvputnamvaffey.com PALEY,ALAN NEGATIVE DECLARATION OF SIGNIFICANCE AMENDED SITE DEVELOPMENT PLAN APPROVAL AMENDED MAJOR GRADING PERMIT AMENDED WETLAND PERMIT AMENDED GROUND AND SURFACE WATER PROTECTION PERMIT 29 -31 HEMLOCK POINT DRIVE NORTH TM: 62.6 -1 -24 AND 25 FILE: 2013 -0110 WHEREAS, the subject property is located on Hemlock Point Drive North and currently consists of ±0.85 acres of land; and WHEREAS, Alan Paley ( "the applicant ") proposed to demolish two existing dwellings, merge two`_ parcels -and eonsiruci a -5 ;;b turoo�n res, encr, •urivewy `Sept -C Sy�tCii�; - stormwater improvements and other site amenities; and WHEREAS, on March 12, 2012, the Planning Board issued a Negative Declaration of Significance and granted Site Development Plan Approval, a Major Grading Permit, a Wetland Permit, and a Ground and Surface Water Protection District Permit, all subject to conditions; and WHEREAS, the applicant satisfied the conditions of approval, the Planning Board Chairman signed the Site Development Plans and construction soon after commenced; to date, the two dwellings have been demolished and the applicant is in the process of constructing the residence; and WHEREAS, the instant application was reviewed simultaneously with a separate lot line realignment application, involving Mr. Paley's parcel (among others), which was approved by the Planning Board on May 6, 2013, subject to conditions (see Planning Board File #2012 - 0109); and Page 1 of 8 :. _ UEREAS. as _ a- result of the. proposed lot . line realig_ nment,_ the_Paley parcel will be increased from 10.851 acres to (5.170 acres; and ` WHEREAS, the land to be acquired by Mr. Paley includes a partially installed driveway and foundation, which were constructed following approval by the Planning Board in September of 2004, but were never completed by the former owner; and WHEREAS, Mr. Paley's original application, approved by the Planning Board on March 12, 2012, proposed a peat biofilter septic system located immediately west of the proposed residence and ±100 feet from Lake Oscawana; and WHEREAS, the applicant is now proposing to abandon the originally proposed peat biofilter septic system and, instead, locate a conventional septic system on the portion of his property to be acquired as a result of the Lost River Associates, LLC, et al. Lot Line Realignment Application, and WHEREAS, in addition to relocating/reconfiguring the septic system, improvements proposed on the additional lands to be acquired by the applicants' include the removal of portions of the existing foundation, the construction of a boat storage shed/garage, the re- grading and surfacing of the access driveway, and the relocation of a portion of Hemlock Point Drive North; and WHEREAS, the applicant's proposed relocation of a portion of Hemlock Point Drive North has been approved, in writing, by Marion and Claude Loewenstein, owners of 33 Hemlock Point Drive North and co -users of the affected portion of Hemlock Point Drive North; and tiie partial t'oe- ion, of Hemlock Point Drive A,o. and the re-, grading/surfacing the driveway providing access to the boat storage shed/garage are _ W partially located within the Town of Putnam Valley jurisdictional wetland buffer and, therefore, an amended Wetland Permit is required; and WHEREAS, the proposed action, including portions of the project that were previously approved and remain unaffected by the proposed amendment, result in ±0.99 acres of land disturbance and the applicant has developed an Erosion and Sediment Control Plan; and WHEREAS, the Planning Board granted Sketch Plan Approval on April 8, 2013; and WHEREAS, the application was referred to the Advisory Board on Architectural and Community Appearance (ABACA); and WHEREAS, the subject property is located within the Town's Ground and Surface Water Protection Overlay District and an Amended Ground and Surface Water Protection District Permit is required; and Page 2 of 8 WHEREAS, the-Planning Board finds that. except IKh Z.rejqqt. pertinent or n.4 s. a:y for the proposed development, the elements of the proposed Amended Site Development Plan required by Town Code Section 165 -92B have been provided and/or addressed; and WHEREAS, in considering and acting upon the proposed Amended Site Development -Plan, the Planning Board has taken into consideration the Town of Putnam Valley Comprehensive Plan, adopted by the Town Board on December 12, 2007, as well as the health, safety and welfare of the public and of the immediate neighborhood; and WHEREAS, the conditions hereinafter prescribed will, to the maximum extent possible, encourage the most appropriate use of the subject property, taking into account the elements and considerations specified in Section 165 -92C of the Town Code; and WHEREAS, the proposed Amended Site Development Plan, subject to the modification and conditions specified herein, provides the elements required by Section 165 -16A of the Town Code and fulfills the purpose and intent of said Section; and WHEREAS, the Amended Grading Plan submitted by the applicant, subject to the conditions and modification specified herein, meets the design criteria and regulations specified in Town Code Section 155 -10, as applicable to this project; and WHEREAS, in reviewing the Amended Wetland Permit Application, the Planning Board has considered the effect of the proposed activity with reference to the criteria and considerations specified in Section 144 -7C(1) of the Town Code; and WHEREAS, in connection with the Amended Wetland Permit Application, the Planning Board finds that the criteria specified in Town Code Section 144- 7C(2)(a) through (e) been eAtic ±ia_� it, flta the Town VA ad-Ins ocior.hGs_reviewcd,said criteria aT1C1 �lii5 .._ . determined that there are no significant negative wetland impacts associated with the proposed improvements; and WHEREAS, the proposed action has been determined to be an Unlisted Action under the State Environmental Quality Review Act (SEQRA) and a coordinated review was not conducted; and WHEREAS, the applicant has submitted Parts 1, 2 and 3 of the Full Environmental Assessment Form (EAF), last revised on March 20, 2013; and WHEREAS, the Planning Board has compared the proposed action with the Criteria for Determining Significance in 6 NYCRR 617.7 (c) and determined that the proposed action will not have a significant adverse impact on the environment; and WHEREAS, the Planning Board has considered all reasonably related long -term, short - term, direct, indirect, and cumulative environmental effects associated with the proposed action including other simultaneous or subsequent actions. Page 3 of 8 N0W THEREFORE BE TI' RESOLVED -THAT, -_the, Planning_ Board hereby issues the attached Negative Declaration of -Sign* iflicance; and BE IT FURTHER RESOLVED THAT, the public hearing on the Amended Site Development Plan, Amended Major Grading Permit, and Amended Wetland Permit is hereby closed; and BE IT FURTHER RESOLVED THAT, the Planning Board hereby approves the following drawings, which shall constitute the Amended Site Development Plans, prepared by Cronin Engineering, P.E., P.C. and dated (last revised) April 19, 2013, subject to the below conditions: • "Cover Sheet" (C -0.1) • "Existing Conditions" (EX -1.1) • "Layout Plan" (L -2.1) • "Utility & Grading Plan" (UG -3.1) • "(SWPPP) Erosion & Sediment Control Plan" (ESC -4.1) • "Wetland Mitigation Plan" (WM -5.1) • "Tree Protection & Removal Plan & Landscaping Plan" (TPR -6.1) • "Construction Details" (CD -7.1) BE IT FURTHER RESOLVED THAT, the Amended Site Development Plans are valid for a period of 18 months after the Amended Site Development Plans have been signed by the Chairman and may be extended once, within said 18 month period and at the written request of the applicant, by the Planning Board for a period not to exceed six months; and ,,._ .._ ��._..-..:... ••' =�ri 11.••l�U1ZTJ�R �Eal%�.iV1rL Tiltil,'ll'lai'iallliill� iiucuu ri�rcv�-i$�il��•ai► r�iTi�i�ueG � � .: _ _ ... � -�.r.. Major Grading Permit, subject to the signing of the Amended Site Development Plans by the Chairman; and BE IT FURTHER RESOLVED THAT, the Amended Major Grading Permit shall . expire six months after the signing of the Amended Site Development Plans by the Chairman; however, such permit may be extended in accordance with Chapter 155 of the Town Code; and BE IT FURTHER RESOLVED THAT, the Planning Board hereby issues an Amended Wetland Permit subject to the signing of the Amended Site Development Plans by the Chairman. The Amended Wetland Permit shall be valid for a maximum period of three years from the signing of the Amended Site Development Plans; and BE IT FURTHER RESOLVED THAT, in accordance with Chapter 144, the Planning Board, Wetland Inspector and Code Enforcement Officer shall have the right to inspect the project from time to time; and Page 4 of 8 BE..TT FTJ.RT-ff:F,R -RESOLVED ...T- HAT:._.tla^ _,�xraend_ed_. _Wetland.. Permit- shall automatically expire upon completion of work; however, such permit may be extended in - accordance with Chapter 144 of the Town Code; and BE IT FURTHER RESOLVED THAT, the Planning Board hereby issues an Amended Ground and Surface Water Protection District Permit, subject to the signing of the Amended Site Development Plans by the Chairman; and BE IT FURTHER RESOLVED THAT, Conditions #1 through #9 must be completed within six months of the date of this Resolution. Should the below- listed conditions not be completed within the allotted time frame, this Resolution shall become null and void unless an extension is requested by the applicant (in writing) within said 6 -month period and granted by the Planning Board. Conditions to be Satisfied Prior to the Signing of the Amended Site Development Plans: 1. The applicant shall supplement his /her escrow account to pay for any outstanding review fees. The Planning Board Clerk shall confirm that all consultant fees have been paid in full. 2. The applicants already established construction monitoring escrow account shall be supplemented to bring its total back to the originally approved amount ($2,500). 3. The applicants already established wetland permit inspection escrow account shall be supplemented to bring its total back to the originally approved amount —X$45.0 _ 4. The proposed septic system shall be approved by the Putnam County Department of Health (PCDH); plans /permits approved by the PCDH shall be submitted to the Planning Board (four copies). 5. The Amended Site Development Plans shall not be signed by the Planning Board Chairman until such time as the Lost River Associates, LLC Lot Line Adjustment Plat, approved by the Planning Board on May 6, 2013, has been signed by the Planning Board Chairman. 6. The applicant shall satisfy any outstanding written comments provided by the Town Engineer, Town Planner and Town Wetland Inspector. 7. Final reports from the Town Engineer, Town Planner and Town Wetland Inspector addressing resolution compliance shall be submitted to the Planning Board. Page 5 of 8 8. Four copies of the architectural floor plans and elevations associated with the b g-fted - -aiid 5s u1ke4 by uic -De' s gri° ATChiiecf, -sliali be submitted. 9. The Amended Site Development Plans shall be revised to conform to the above conditions. Eight original copies of the revised Amended Site Development Plans, signed and sealed by a NYS Professional Engineer and the owner of the property, shall be submitted for the Chairman's signature. . Conditions of the Amended Wetland Permit: 10. The applicant agrees to allow periodic inspections by the Town and the Town's Consultants. 11, All plants as shown on the approved plans must be installed between April I" and October 15`h and prior to the issuance of a Certificate of Occupancy. 12. Plant substitutions shall not be made without the prior written approval of the Town Wetland Inspector Additional Requirements to be Satisfied Subsequent to the Signing of the Amended Site Development Plans: 13. The applicant shall continue to comply with the conditions outlined in the Planning Board's March 12, 2012 Resolution. 14. During the Building Permit review process for the boat storage shed/garage, the .. Code Enforcement.-Officer shall consider any outstanding comments.submlted 15. Prior to the issuance of the Building Permit for the boat storage shed/garage, the Building Permit Application and submitted drawings shall be supplied by the Building Department to the Town Engineer and Town Planner. Prior to the issuance of a Building Permit, the Town Engineer and Town Planner shall countersign the construction drawings submitted to the Building Department. 16. Prior to the commencement of any work, beyond that which has been previously approved, a site inspection shall be conducted with the applicant, contractor, Building Department, and Town staff. 17. Prior to framing the boat storage shed/garage, an as -built survey of the foundations, compliant with the approved Amended Site Development Plans and including elevations, shall be submitted to the Building Department. The survey shall be prepared by a NYS Licensed Land Surveyor and to the satisfaction of the Town Engineer and Code Enforcement Officer. Page 6 of 8 Prior to t_ he issuance ,of a_ any Certificate of Occupancy, ,a final site mspectioi� _ . shall be conducted' with the applicant "con - rac'tor,�)3uilding Department, and Town staff. 19. Prior to the issuance of any Certificate of Occupancy, an as -built survey demonstrating compliance with the approved Amended Site Development Plans shall be submitted to the Code Enforcement Officer. 20. Prior to the issuance of any Certificate of Occupancy, the applicant shall submit a letter or report from the NYS Licensed Professional Engineer stating that all stormwater improvements have been installed as per the approved Amended Site Development Plans and are functioning properly. 21. Prior to the issuance of a any Certificate of Occupancy, the Town Wetland Inspector shall provide written certification to the Building Inspector that all mitigation plantings have been installed in accordance with the approved plans. 22. A Certificate of Occupancy shall not issue for any structure until reports prepared by the Town Engineer and Town Wetland Inspector have been supplied to the Building Department stating that the site has been developed in accordance with the approved Amended Site Development Plans. 23. All components of the Amended Site Development Plans shall be installed/implemented prior to the issuance of a Certificate of Occupancy. Under certain circumstances where public health and safety are not otherwise jeopardized and where unforeseen circumstances and/or unavoidable conditions warrant, the posting of monetary security, in the form of cash or irrevocable —Letter-of of such public - works -- contracts) -as:.-- _ would be required to fulfill'said conditions (as computed or approved by Town f _� staff), may be approved subject to the written approval of the Town Attorney and only in compliance with the Planning Board's January 25, 2010 Resolution pertaining to the acceptance of monetary security. The posting of a monetary security shall be limited to final grading, final site stabilization and/or driveway paving, unless otherwise approved by the Planning Board as provided under said Resolution. 24. Prior to the issuance of any Certificate of Occupancy, the Building Department shall confirm with the Planning Board Clerk that all consultant fees have been paid in full. Motion: Joseph Raetzer Second: Tom Carano Page 7 of 8 :. .. ea..- .. _Nay... Abstention � .. st on, sent._... -. -- - - 1Vhchael Raimondi, Jr. r Tom Carano X Annette Lindbergh X Joseph Raetzer X Adam Babbitt X Rory Gribbon BY: ichael Raimondi, Jr. The Planning Board Clerk hereby confirms that conditions 1-9, identified above, have been satisfied. Confirmed BY: Date: Filed at the Office of the Town Clerk, Putnam Valley, New York, On the Date of: ECEIVE MAYA 7 2013. TOWN CLERK TOWN OF PUTNAM VALLEY Page 8 of 8 vt7tf'x'.iEe .� NEGATIVE DECLARATION Notice of Determination of Non - Significance Date: May 6, 2013 This notice is issued pursuant to Part 617 of the implementing regulations pertaining to Article 8 (State Environmental Quality Review Act) of the Environmental Conservation Law. The Town of Putnam Valley Planning Board has determined that the proposed action described below will not have a significant environmental impact and a Draft Environmental Impact Statement will not be prepared. Name of Action: Amended Approvals for Alan Paley SEQRA Status: ❑ Type 1 ■ Unlisted Conditioned Negative Declaration: o Yes a No Coordinated Review: o Yes w No Description of Action: on March 12, 2012, the Planning Board issued a number of approvals allowing for the construction of a 5-bedroom residence, driveway, septic system, stormwater improvements and other site amenities. The applicant has acquired additional lands and is now proposing to relocate his septic system further away from Lake Oscawana. In addition -to relocating/reconfiguring the septic system, additional improvements proposed on the applicant's recently acquired lands include the removal of portions of an existing foundation, the construction of a boat storage shed/garage, the re- grading and surfacing of an access driveway, and the relocation of a portion of Hemlock Point Drive North. Location: 29 -31 Hemlock Point Drive North, Putnam Valley, Putnam County, New York Reasons Supporting This Determination: The Planning Board has compared the proposed action with the Criteria for Determining Significance in 6 NYCRR 617.7 (c). Specifically: Page 1 of 3 1...:..:The proposed action will not result in a substantial adverse change in the existing air quality, ground or surface water gbilfty -or quai�fity; traffic or "noise "levels;' a " '` substantial increase in solid waste production. The proposed action involves amendments to an approved Site Development Plan. The septic system will be located further away from Lake Oscawana and a previously approved residence /partially completed foundation will be replaced with a much smaller boat storage shed/garage. The proposed amendments are relatively minor in nature, will result in a net environmental benefit when compared to the previously approved condition and will not result in an adverse environmental impact. 2. The proposed action will not result in the removal or destruction of large quantities of vegetation or fauna; substantial interference with the movement of any resident or migratory fish or wildlife species; impact a significant habitat area; result in substantial adverse impacts on a threatened or endangered species of animal or plant, or the habitat of such species; and will not result in other significant adverse impacts to natural resources. See Response to Finding #1 The proposed action will not result in the impairment of the environmental characteristics of a Critical Environmental Area as designated pursuant to 6 NYCRR Part 617.14(g). See Response to Finding #1 _1 . •The ru oseu : action will not result in. a. material cu_ rMi ct . with_ _ th_ e� TovW s . officially approved or adopted plans or goals. _t See Response to Finding #1 5. The proposed action will not result in the impairment of the character or quality of important historical, archaeological, architectural, aesthetic resources, or the existing character of the community or neighborhood. See Response to Finding #1 6. The proposed action will not result in a major change in the use of either the quantity or type of energy. See Response to Finding #1 7. The proposed action will not create a hazard to human health. See Response to Finding #1 Page 2 of 3 8__._. _.. The ronosed actionwi.11.not.Greate a.subst in the use, or intensity of use, of land including agricultural, open space or recreatioriahr`esources, ^or in'its capacity to support existing uses. 9. The proposed action will not encourage or attract a large number of people to a place or place for more than a few days, compared to the number of people who would come to such place absent the action. 10. The proposed action will not create a material demand for other actions that would result in one of the above consequences. 11. The proposed action will not result in changes in two or more elements of the environment, no one of which has a significant impact on the environment, but when considered together result in a substantial adverse impact on the environment. 12. When analyzed with two or more related actions, the proposed action will not have a significant impact on the environment and when considered cumulatively, will not meet one or more of the criteria under 6 NYCRR 617.7(c). 13. The Planning Board has considered reasonably related long -term, short-term, direct, indirect and cumulative impacts, including other simultaneous or subsequent actions. This notice is being filed with: Putnam Valley Planning Board _.. - Put,ai„ VaUe. Town. --a i�._� .._:._.......,, � .. - -- 265 Oscawana Lake Road - - - --_ _ ____.�, .... _ -. -. - . -•.. -• -_- • -, �, _.._.__.. __.�_� �. w_....- ..__ Putnam Valley, NY 10579 Page 3 of 3 Michael Budziriski From: Keith Staudohar <keith@croninengineering.net> Sent: Tuesday, jury 0!d', 2013 9-.36 AM To: Michael Budzinski Subject: Fw: Receipt for filing of deeds Attachments: 1139_001.pdf; Deed - Paley Consolidation.doc Mike, See below and attached. The lot line adjustment added land to TMD 62.6 -1 -24. The filed document for the consolidation deed is #1501638 on the receipt. I am revising the SSTS plan and would like to stop by in the am to get the permit. Is 9:00 am ok, or Thursday or Friday at 9:00 am with all of the necessary goods? Keith - - - -- Original Message - - - -- From: "Paley, Alan H." <ahpaley @debevoise.com> To: "'Keith Staudohar "' <keith @croninengineering.net> Sent: Monday, July 08, 2013 3:58 PM Subject: Receipt for filing of deeds Keith, Attached is a copy of the consolidation deed we filed, consolidating into a single parcei the previously combined lots -29 and 31 Hemlock Point Drive North, which the Town has combined into the tax ID for 29 Hemlock Point Drive (62.6 -1 -24) together with the property transferred to us by Lost River Associates, LLC and by Hochster, less the property we transferred to Hochster. As instructed by the Town tax assessor, I have retained the tax ID for 29 Hemlock Point Drive. The Town initially assigned the address 29 Hemlock Point Drive North to the combined lots but has agreed to change it back to 31, though the tax ID will remain the same. Also attached is a copy of the receipt from the Putnam_ County Clerk's office with respect to the filing of all the deeds fore`. 1 the receipt for the consolidat , =� h l _ Alan ' c. t 1 - a Dennis J Sant, Putnam County Clerk OFFICIAL RECEIPT 40 Gleneida Ave., Carmel, NY 10512 RECEIPT -12424 ENTERED BY: CSKIJIMINO DATE - 07/05/2013 DRAWER: 01 TIME- 10:37:22 USER: CSKIJIMINO Issued to: ALAN H PALEY I!-.EAST 86TH. - STREET NEW YORK NY 10028 ----------------- _--------------- - - - - -- ---------------- - - - - -- -•----------------------- NUM NUM MORTGAGE AMT/ DOCUMENT NUMBER DESCRIPTION ITEMS ADD CONSIDERATION AMOUNT 1501361 DEED COM OR VACANT _ - --- -_ _ _ 5 --- - - - - -- 45.00 Book 1926 Page 48 GRANTOR LOST RIVER ASSOCIATES LLC TP -584 1 5.00 CULTURAL EDUCATION 15..00 RP -5217 COMMERCIAL 250.00 RECORD MANAGEMENT 5.00 TRANSFER TAX .00 PROCESSING FEE 1 1:00 1501362 DEED COM OR VACANT Book 1926 Page 53 GRANTOR TP -584 CULTURAL EDUCATION RP -5217 COMMERCIAL RECORD MANAGEMENT TRANSFER TAX 1501363 DEED COM OR VACANT Book 1926 Page 58 GRANTOR TP -584 CULTURAL EDUCATION RP -5217 COMMERCIAL RECORD MANAGEMENT TRANSFER TAX TOTAL FOR DOCUMENT 5 LOST RIVER ASSOCIATES LLC 1 TOTAL FOR DOCUMENT LOST RIVER ASSOCIATES LLC 1 TOTAL FOR DOCUMENT 1501364 DEED 4 Book 1926: -Pa; 63 -. GRANTOR PALEY ALAN H TP -584 1 CULTURAL EDUCATION RECORD MANAGEMENT RP -5217 RESID /AGRIC TRANSFER TAX TOTAL FOR DOCUMENT 1501365 DEED 4 Book 1926 Page 67 GRANTOR HOCHSTER GERTY M CONTINUED ON NEXT PAGE 321.00 45.00 5.00 15.00 250.00 5.00 .00 320.00 45.00 5-00 15.00 250:.00 5.00 .00 320.00 40.00 5.00 15.00 5.00 125.00 .00 190.00 40.00 Dennis J Sant, Putnam County Clerk OFFICIAL RECEIPT 40 Gleneida Ave-, Carmel, NY 10512 RECEIPT-12424 ENTERED BY: CSKIJIMINO DATE-07/05/2013 DRAWER: 01 TIME- 10:37:22 USER: CSKIJIMINO Issued to: ALAN H PALEY APT 1 C NEW YORK NY 10028 - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - -- - NUM NUM MORTGAGE AMT/ DOCUMENT NUMBER DESCRIPTION ITEMS ADD CONSIDERATION. AMOUNT TP-584 5.:00 CULTURAL EDUCATION 15 .:00 RECORD MANAGEMENT 5_00 RP-5217 RESID/AGRIC 125.�-00 TRANSFER TAX I .. . .00 ------------- TOTAL FOR DOCUMENT 190400 1501366 DEED 5 45..00 Book 1926 Page 71 GRANTOR TP-584 CULTURAL EDUCATION RECORD MANAGEMENT RP-5217 RESID/AGRIC TRANSFER TAX 1501367 DEED Book 1926 Page 76 GRANTOR TP-584 CULTURAL EDUCATION RECORD MANAGEMENT RP-5217 RESID/AGRIC .TRANSFER TAX SCHEIDER CYNTHIA I TOTAL FOR DOCUMENT 4 BELLEZZA THOMAS J TOTAL FOR DOCUMENT 1501368 DEED 5 Book 1926 Page 80 GRANTOR PALEY ALAN H TP-584 1 CULTURAL EDUCATION RP'-5211 k9!jID/jkGAfd TRANSFER TAX 1501369 DEED 5 Book 1926 Page 85 GRANTOR PALEY ALAN H TP-584 CULTURAL EDUCATION RECORD MANAGEMENT CONTINUED ON NEXT PAGE 5.00 15,-_00 5::00 125 .:00 .:00 195.00 40.00 5.:.00 15 :.00 5.00 125::00 _00 190.00 45.00 5.00 15.00 125.00- .00 195.00 45.00 5.00 15.00 5.00 ' Q Dennis J Sant, Putnam County Clerk OFFICIAL RECEIPT 40 Gleneida Ave., Carmel, NY 10512 RECEIPT -12424 ENTERED BY: CSKIJIMINO DATE- 07/05/2013 DRAWER: 01 TIME- 10:37:22 USER: CSKIJIMINO Issued to: ALAN H PALEY rn ^T - 8 TH 3TRFET =- _ _ : -.. -.. APT 1 C NEW YORK NY 10028 NUM NUM MORTGAGE AMT/ DOCUMENT NUMBER DESCRIPTION ITEMS ADD CONSIDERATION AMOUNT RP -5217 RESID /AGRIC 125.00 TRANSFER TAX .00 TOTAL FOR DOCUMENT. 195.00- 1501370 DEED 5 45.00 Book 1926 Page 90 GRANTOR HOCHSTER GERTY M TP -584 1 5.00 CULTURAL EDUCATION 15.00 RECORD MANAGEMENT 5.00 RP -5217 RESID /AGRIC 125.00 TRANSFER TAX 00 TOTAL FOR DOCUMENT 195.00 1501371 DEED COM OR VACANT 8 60.00 Book 1926 Page.95 GRANTOR LOST RIVER ASSOCIATES LLC TP -584 1 5.00 CULTURAL EDUCATION 15.00 RP -5217 COMMERCIAL 250.00 RECORD MANAGEMENT 5.00 TRANSFER TAX .00 TOTAL FOR DOCUMENT 335.00 -21646 TOTAL FOR ALL DOCUMENTS .00 CHECK: 1345 2,646.00 TOTAL COLLECTED = - -- __ -_- 2,646.00 Thank You - Dennis J Sant CONSOLIDATION DEED THIS INDENTURE, made the day of July, 2013 BETWEEN Alan H. Paley and Gail Paley, as tenants in common 11 East 86th Street, Apt. 15C New York, New York 10028 party of the first part, and Alan H. Paley and Gail Paley, as tenants in common 11 East 86th Street, Apt. 15C New York, New York 10028 party of the second part, WITNESSETH, that the party of the first part, in consideration of TEN AND 00 /100 ($10.00) dollars paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the SEE SCHEDULE A ATTACHED HERETO The purpose of this deed is to combine and merge those parcels owned by the parties of the first and second part, and previously submitted for recording. TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever, except as aforesaid. -AND the party of fhe first part, in'compliarice with,Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: Alan H. Paley Gail Paley Standard N.Y.B.T.U. Form 8002 - Bargain and Sale Deed, with Covenant against Grantor's Acts — Uniform Acknowledgment TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE State of New York, County of New York ss: State of New York, County of ss: On the day of July in the year 2013 before me, the undersigned, personally appeared Alan H. Paley and Gail Paley personally known to me or proved to me on the basis of satisfactory evidence to be the individuals) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his/her /their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. On the day of in the year before me, the undersigned, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his/her/their capacity(ies), and that by his/her /their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. (signature and office of individual taking acknowledgment) (signature and office of individual taking acknowledgment) TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State (or District of Columbia, Territory, or Foreign Country) of ss: On the day of in the year before me, the undersigned, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she /they executed the same in his/her /their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in the in (insert the City or other political subdivision) (and insert the State or Country or other place the acknowledgment was taken) BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS Alan H. Paley and Gail Paley, as tenants in common to Alan H. Paley and Gail Paley, as tenants in common SECTION 62.6 BLOCK 1 LOT 24 COUNTY OR TOWN Putnam County RETURN BY MAIL TO: Alan H. Paley Debevoise & Plimpton LLC 919 Third Avenue New York, New York 10022 y N, Alan H. Paley and Gail Paley, as tenants in common to Alan H. Paley and Gail Paley, as tenants in common Consolidation Deed ti .. .. Schedule A ALL that certain parcel of land situate in the Town of Putnam Valley, County of Putnam and State of New York that is those lands that were heretofore conveyed to Alan H. Paley and Gail Paley by that certain deed recorded in the Putnam County Clerk's Liber 1903 of deeds at page 426, TOGETHER with those other lands conveyed to Alan H. Paley and Gail Paley from Lost River Associates, LLC by a deed recorded concurrently herewith, TOGETHER with those lands conveyed to Alan H. Paley and Gail Paley from Gerty M. Hochster by a deed recorded concurrently herewith, LESS those lands conveyed to Gerty M. Hochster from Alan H. Paley and Gail Paley by a deed recorded concurrently herewith, that when taken together is bounded and described as follows: BEGINNING at a point in the easterly shore line of Oscawana Lake at the comer common to the lands formerly of Brieant and now or formerly of Lowenstein on the northeast, the lands formerly of Levine and now or formerly of Paley on the southeast and the lands now or formerly of Paley on the southwest. THENCE from the said point of beginning, partially along said lands now or formerly of Lowenstein and partially along the lands now or formerly of Lost River Associates, LLC S 66 049'10" E 182.77 feet, S 15 004'00" W 101.92 feet, S 84 032'20" E 48.23 feet, S 56 049'40" E 90.64 feet and S 06 018'00" W 265.40 feet to a point on the northerly side of a private road known as Lost River Road. Thence continuing along said lands of Lost River Associates, LLC and along the northerly side of Lost River Road N 81 000'00" W 35.00 feet on a tangent curve to the left, the central angle of which is 45 °40'00 ", the radius of which is 85.00 feet for 67.75 feet S 53 °20'00" W 32.00 feet on a tangent curve to the left, the central angle of which is 19 °20'00 ", the radius of which is 150.00 feet for 50.61 feet S 34 000'00" W 76.00 feet on a tangent curve to the right, the central angle of which is 78 °20'00 ", the radius of which is 125.00 feet for 170.90 feet and N 67 040'00" W 37.44 feet to a point on the easterly side of a private road known as Hemlock Point Drive North. Thence continuing along said lands of Lost River Associates, LLC and along the easterly side of Hemlock Point Drive N 00 040'00" E 167.09 feet to a point. Thence continuing along said lands of Lost River Associates, LLC and crossing Hemlock Point Drive North N 89 040'00" W 20.25 feet to a point and the lands formerly of Lost River Associates, LLC and now or formerly of Bellezza. Thence along said lands Schedule A — Page I of 2 X N 46 058'06" W 149.64 feet to the southeasterly terminus of the divison line between the lands of Bellezza on the southwest and the lands formerly of Hochster and now or formerly of Fleisher on the northeast. Thence along said lands of Fleisher N 57 025'40" E 85.74 feet to a point and the lands formerly of Paley and now or formerly of Hochster. Thence along said lands of Hochster N 59 021'30" E 66.44 feet and N 55 029'50" E 66.44 feet to a point. Thence continuing along the lands now or formerly of said Hochster N 25 039'40" W 177.92 feet, N 29 016'00" W 55.80 feet and N 31 010'20" W 5.59 feet to a point in the easterly shore line of Oscawana Lake. Thence along the easterly shore line of Oscawana Lake N 67 022'00" E 11.73 feet, N 10 003'50" E 28.94 feet, N 17 058'30" E 33.80 feet, N 06 034'20" E 16.77 feet, N 74 029'30" E 31.36 feet, S 17 004'50" E 56.56 feet, S 43 024'50" E 23.09 feet, S 78 025'20" E 53.40 feet, N 84 019'00" E 23.51 feet, and N 58 02140" E 23.19 feet to the point or place of beginning, containing 5.170 acres, more or less. Description prepared by BADEY & WATSON Surveying & Engineering, P. C. U.S. Route 9 Cold Spring, New York 10516 (845)265- 9217(V) (845)265 - 44280 File No. 00 -150 W.O. No. 21291 Doc. No. PA20MY13BD.Iwp Created: May 17, 2013 Revised: May 23, 2013 Printed: May 24, 2013 Figure No(s.) 134 Author: SRM Schedule A — Page 2 of 2 ALLEN BEAL39 M D., J.D. VA MARYELLEN oftLL Commissioner of HealfB * ,� County Executive ROBERT MORRIS, P.E. Director of Environn oW Health DEPART MEN1' OP HEALTH 1 Geneva Road, Brewsta, New York 10509 Telephone: (845) 808 - 1390; Fax: (845) 278 -7921 February 25, 2013 Cronin Engineering Keith Staudohar 39 Arlo Lane Cortlandt Manor, NY 10567 Re: Proposed SSTS for Paley (PV- 02 -07) (T) Putnam Valley, TM 62.60 -1 -24 & 25 Dear Mr. Staudohar: This Department has received and reviewed the submitted application and plans for the above referenced project and the following comments are offered for your consideration. ► 1. Please .submit a narrative summary which describes the proposed application and all approvals. A6. _ The 13erc lation1 t st results are in excess of 10 VPars o -14 and are to be r- -ddhe. �C%3. Please be advised that the two existing tax parcels for this application must be combined III_ into a single lot. . 4' The previously issued permit (PV- 06 -01) for Beltran was approved as a "fill permit" since 3.5 feet of ROB fill was required in the SSTS area. The soil information for deep test hole #6 is not included on the plan. The SSTS design information on Sheet 1 of the plans indicates a design flow of 400 gpd which appears to be incorrect. .,)k- 7. Proposed erosion control measures for the SSTS construction are not shown on the plan. SSTS Note #1 on Sheet 1 of the plans references a percolation rate of 11 to 15 minutes /per inch and a 4 bedroom. residence which appear to be incorrect. Fill Note #3 on Sheet 1 of the plans specifies a fill depth of 24 inches which is incorrect since the original design required 3.5 feet of fill. 0. The proposed grading for the primary and reserve SSTS fill pad side slopes is shown,in excess of 3H:1 V. �. . Finished spot grade elevations are to be provided in each corner of the primary SSTS fill ad. he absorption trench detail is to be revised to specify the perforated pipe being installed level for a dosed system. 3 The distribution box detail is to be revised to specify a rninimum of? feet .)f solid piYc t;�zt ufdi� `rit x "priur'to the start of the perforated pipe. any. 4. The primary system area is to be revised to comply with Section 2.B.1 of Bulletin ST -19 {�\ which specifies the following: 1" « for fill systems greater than 2 feet, the toe of the fill pad is to be keyed into existing soil and maintain a minimum horizontal separation distance of 5 feet to ledge." Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. Resp ctfully, Michael J. Bu' ns k E. Director of nine MJB:cw is ago Alba, Lane NGINTERINC• P.L. P.C. C'r rtiaFy h� in r,triY � ssr Professionai Erigin efing..4 Consul 4 T: 914) 7345 - ,3664! F.(9'14) 736.3(593 March 14, 2013 Michael J. Budzinski, P.E. ; Director of Engineering . Putnam County Health Department . = 1 Geneva Road Brewster,- New York ,1050.9. Re: Alan 8 Gail Paley SSTS Corrstntction Permit 29 H.emlockPoi'nt.Drive North ftbom Valley, New York.1009 Section: 62. 0, Block: 1, -Lot 24.8, 26 Dear Mr. Budzinski, We 'are in receipt,of: your memorandum dated February 25; 2013, ark as subsequently discussed, the,plans have been revised aocoirdingly. ` This includes the,Department's.abandonment of.the previously approved septic'expansion area`in. Permit #PV-06 -01 -and the -: r+etesting of the original primary septic area and the testing of two separate. areas .for expansion system potential Items 2 through 12 in the memorandum have either been, revised on the plans or are no longer applicable to the - revised plan. Rem 1 of the memorandum; a narrative summary of the project, follows: This, project Involves the rO7developmjent of :two_former tax lots (lots 62 60.01 24 &:25) that h2ve..been mel+ged .into orp .: -..... - -.... - .(aY,.Kul - �#_k► the :hts origin.�.il j 'vxiv'aii �y hv� i �vMG �B—Z„ li's�ic u �r•ii �2-COnnrucuor'u Er aiiiyilr ramify:resiale foe =on� 'ire �ooinbrriea lots, which is currently under construction. The new house received .an addition permit, PCDH R- 111 -11 / A- 064 -11 from the`PCDH for construction; of the five - bedroom residence. The septic system was approved With the use of 5 peat-bio filters- in a large fill pad, adjacent to the house and near the 100 =foot boundary to Lake Oscawana. Since-that time, the entity'in which the Applicant controls 'has-obtained the adjacent parcel of land, tax lot 62 -01 -25, formerly the Beltran lot. The Applicant is presently before the'Town of Putnam,Valley Planning Board fora Lot Line Realignment where approximately 4.2 acres of the former Beltran lot Will be added to the existing merged lotto increase its size to 5.17 acres. As part of this addition of land, the Appli cant wishes'to relocate the approved septic from -'near the. house and lake to the former PCDH approved septic location (Permit #PV- 06-01) on the former Beftran' portion that is being added to.the Applicant's lot. The, net effect will be one house on 5 -plus acres 'w kh a septic system on a portion of the. former Beltran lot that is being added. to the Applicants lot. It is understood that the PCDH cannot issue a permit until such.time that the lots are formally merged. At this time, we respectfully request a letter indicating that approval will be granted by the PCDH. upon the merging of the lots. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _.. DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SI'STEIVI' Owner Address 20i WALQL4 I1ollA' t7goA t\1O1 lot t Located at (Street) 'AMID 4 Tax Map &L Block p 1 Lot 2k (indicate nearest cross street) Municipality ��(i 9Jl'J !AM \IALLEj Watershed 44XV QN R-t%40.! SOIL PERCOLATION TEST DATA Date of Pre - soaking 02S.- 13 .. L- „ bate of Percolation Test 01 - [,+-13 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 5 -N I 3 2 3 g- g -'T 4 5 vp► 1 X43-- g `�� t 1— t� t 3 too 4 5 3P 1 21- 2 4 5 NOTES: A. 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, <_ 2 min for 31 -60 min/inch). All data to be submitted for review. 2.' Depth measurements to be made from top of hole. Form DD -97 Pg. 1 oft ZT_ _ TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES :`DEPTH _._ HOLE NO. HOES NO. G.L. 0.5' A 1.01 Lai 1.5' 2.0' 2.5' 3.0' 3.5' Pei <& 0 6 4.0' - 4.5' rWaL 5.0' 5.5' 6.0' .0 6.5' r 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' _ - - .v..e+....... ...._- n. . -.. ... _..._.,.- -_.... p.._._.,.. J.. �.-......_._ �....-...-........... _.........+a.......�....____._c .. ....».. ..v -.rem. .:�. - � � .:- �... - -.... .....- r�®� -... _v ... n... ...w_.a� Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encounter d Deep hole observations made by: C90wjfjc?a t� P H ,Date ®3 ®7• l Design Professional Name: m&Igp-d i_.G?.&AjlA) tgr, Address: �eal L. CRO�'y ' w 62960 ��'OROFESSIO�A� TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES TT .:1<3Q1 —01.. .:�.h. _.. G.L. 5o t L 0.5' WL 1( 14.1 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' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encounter d Deep hole observations made by: Date p •Cr7. t .v Design Professional Name: L• CR/+a tf� 39 A14-& LA&)g sb't Signature: Design Professional =s Seal ��i a� FQ pROFESSO) -v 1 1. 2. 4. 6. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LI A T >I 01N - JF liR ATPR:0V —Or Pl A WASTEWATER TREATMENT SYSTEM Name and address of applicant: Alan & Gail Paley 29 Hemlock Point Drive North Putnam Valley, New York 10579 Name of Project: Paley Design Professional: Timothy L. Cronin N Drainage Basin: Hudson River 7. Type of Project: ✓ Private/Residential Apartments Office Building 8. 9. 10. 11. 3. Location: TN: Putnam Valley 5. Address29 Hemlock Point Drive N. Food Service Institutional Realty Subdivision Putnam Valley, NY 10579 Commercial Mobile Home Park Other (specify) _ Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/No Yes Type Status (check one) ...................................... ............................... Type I Exempt Type II Unlisted ✓ Is a Draft Environmental Impact Statement (DEIS) required ? .................... Yes/No No Has DEIS been completed and found acceptable by Lead Agency ?....... Name of Lead Agency Town of Putnam Valley Planning Board ... Yes/No N/A 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ............................................................. ............................... Yes/No Yes 0 ;Jl�alan� t9:nst7bfLttcd_t(aAC11G 14. Has preliminary approval been granted by such authorities? pending ate granted: N/A 15. Type of sewage treatment system discharge ........................ surface water ✓ groundwater 16. If surface water discharge, what is the stream class designation? .......................... N/A 17. Waters index number (surface) ... N /'4 18. Is project located near a public water supply system? . ............................... Yes/No No.. 19. If yes, name of water supply Not Applicable Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? .......... Yes/No No 21. Name of sewage system Not Applicable Distance to sewage system N/A 22. Date test holes observed see permit #PV -06 'A1 Name of Health Ins o see permit #PV -06 -01 24. Project design flow (gallons per day) ....................... ............................ t BPD ... 25. Is State Pollutant Discharge Elimination system ( SPDES) Permit re s o 0 26. Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A Rev. 11/02 \ Form PC -97 Pg. 1 of 2 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No No 28. Wetlands ID number ...................... .................. i ........... N/A 29. Is Wetlands Permit required? ..................................................................... Yes/No No Has application been made to Town or Local DEC ........................... Yes/No N/A 30. Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ................................................................... Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? .................................................................. Yes/No No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .........................Yes/No Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ........................................................... Yes/No No 35. Are . any sewage treatment areas in excess of 15% slope? .............................. Yes/No No 36. Tax Map ID Number ............................................. Map 62.60 Block I Lot 24 & 25 37. Approved plans are to be returned to ................ Applicant . * Design Professional ; 41 1 - 1. ! '. . i... - '-"- * Lib- 466--- eviev/-ard:arpr f STM Iva '10' tetsh�d-shall' -QVal Ql a. be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization (Form LA-97). Failure to comply wl"is provision may be grounds for the rejection of any submission. 14EW I hereby affirm, under penalty of perjury, that in, my knowledge and belief. False statements made pursuant to Section 210.45 of the Penal Law.,//, SIGNATURES& OFFICIAL TITLES 4L Tim6thy L. Cronin III, Mailing Address: ........................... Cronin Engineering 39 Arlo Lane. Cortlandt I. Cp,-QA,' g on this fang Arue to the best of 7 IQ: W Form PC-97 oll •� � � � � �' Y ►.-�' � ~1 Cam✓ V I O �Cn cs �:777� • : � �" :CRONJN 39 Arlo Lane : ; ; ENGINEERING P.E., P.C.' Cortlandt MahorNY 10567 P,rofesslonal Englneering &Consulilng T:(914) ?36-3664 F:(914) 736-3693 January 29,2013. Mt.'Joseph S. Faravati, P.E. ..Publld Health En g ineer PtAharfi. County Health Department I Geneva Road 'Brewster, Ne'w.York 10509 Re. AIM & Get/ FWeY. :SSTS Cowsftcffdn Permh 29, Hemlock Point Ddve Nodh Putnam Valley, New Yi:)* 10579 Sectiorc 62. 60, BI,6ck- 1, Lpp 24:$•25 -.-Dear Mr. Para,vkti, Please find, enclosed the following regarding -an application for a Subsurface Sewage Treatment Construction Permit Renewal/Revisiph it the above referenced lot: 1. one. (1) Money Order in the amount of $500 made payable to.the'Putnam County Health. Department as par t of the review fee.. 2. One (1),Lettqr of Authorization 3. One (1) Application, for Approval of Plans of a Wastewater Treatment System (PCDH One (1) N'YS SEAR Short Environmental Assessment. Form (Part 1. Only) 5— �,our (4),Applications for'6nstruction Permit for Sewage Treatment..System. (PCD.H. Form CP-97):at the above referenced locitio". 6. Four (4) Subsurface Sewage Treatment System Construction Permit Plans fortheAbove referenced lot., Should you have any:questions or require additional information, Please do not hesitate in contacting me at the number above. Respectfully .Sutpitt6d, ....... W. Teed, Jr. Engineer -. cc: Owner- Alan 8 Gal Paley File- Paravati-PCDH-Paley-29 Hemlock Point Drive Nath,-SSTS- SubmRaWT-21)l 30129.doe i -10L _r EL _T_ ri/ 39 Arlo Lane ENGINEERING P.E., P.C. Cortlandt Manor, NY 10567 °rgf�ssigna! Fncineer ng &,C6n;�;'U; _ _ .T� .G, EL-3664 F.(9''4)'3ii- 3ii93' LETTER OF AUTHORIZATION DATE: January 10, 2013 TO: Town of Putnam Valley 265 Oscawana Lake Road Putnam Valley, NY 10579 RE: Lands of Alan and Gail Paley TMD 62.06- 01 -24, 25 29 Hemlock Point Road North Town of Putnam Valley, NY This letter shall authorize Cronin Engineering PE PC, a duly licensed professional engineering firm in the State of New York to represent me, produce all necessary Site Development Plans, reports and . other pertinent documents . and to sign M! necessary papers on my behalf in connection with file above noted property. This letter shall also authorize the Town of Putnam Valley Wetland Inspector, if necessary, to enter upon the above noted property for the express purpose of delineating or verifying on -site wetlands as prescribed per Section 144 of the Code of the Town of Putnam Valley. Signed: Aten and Gail Pally, owner 29 Hemlock Point Road North Putnam Valley, NY 10579 Date 1 ;% PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPL CATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Alan & Gail Paley 29 Hemlock Point Drive North Putnam Valley, New York 10579 2. Name of Project: Paley 3. Location: TN: Putnam Valley 4. Design Professional: Timothy L. Cronin N 5. Address ?9 Hemlock Point Drive N. 6. Drainage Basin: Hudson River Putnam Valley, NY 10579 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) ? .............. Yes/No Yes Type Status (check one) ...................................... ............................... Type I Exempt Type H Unlisted ✓ 9. Is a Draft Environmental Impact Statement (DEIS) required ? .................... Yes/No No 10. Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes/No N/A 11. Name of Lead Agency Town of Putnam Valley Planning Board 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ............................................................. ............................... Yes/No Yes i.'S.:. . -. ....rr ... ,.� ._ t . J. . :',[ ry .. r .L` !.frs .... .._ '_... .. ....... .5 .. 11dVG �J1a1lJ UG�Yl Jl1UYI11LLCl1�LU Jt1la't1ULIlUY1L1eJ: ... ` .:............................ es/ VU� 14. Has preliminary approval been granted by such authorities? pendin -%ate granted: N/A 15. Type of sewage treatment system discharge ........................ surface water ✓ groundwater 16. If surface water discharge, what is the stream class designation? .......................... N/A 17. Waters index number (surface) ............................................. ............................... N/A 18. Is project located near a public water supply system? . ............................... Yes/No No 19. If yes, name of water supply Not Applicable Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? .......... Yes/No No 21. Name of sewage system Not Applicable Distance to sewage system N/A 22. Date test holes observed see permit #PV -06 'A1 Name of Health Inspector see permit #PV -06 -01 24. Project design flow (gallons per day) T PD 25. Is State Pollutant Discharge Elimination system ( SPDES) Permit required? ... Yes/No No 26. Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A Rev. 11/02 Form PC -97 Pg. 1 of 2 m 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No No 28. i et ant's . number' ...............:.....:.:::............::............... ............................... 29. Is Wetlands Permit required? .......................... ............................... Yes/No No Has application been made to Town or Local DEC ........................... Yes/No NIA 30. Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? .......................................... .........................Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ................................... ............................... Yes/No No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .........................Yes/No Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? .... ............................... ............:......Yes/No No 35. Are any sewage treatment areas in excess of 15% slope? .............................. Yes/No No 36. Tax Map ID Number .......... Map 62.60 Block 1 Lot 24 & 25 37. Approved plans are to be returned to Applicant Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such-as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply W9 provision maybe grounds for the rejection of any submission. NEW roR i CHO k I hereby affirm, under penalty of perjury, that inform ro �d on this is ue to the best of m knowledge and belief. False statements made e' ,e �ish C�' A isdemeanor Y g f i �p pursuant to Section 210.45 of the Penal Law. if,; ,Y,_`, w 4, SIGNATURES & OFFICIAL TITLES:J``° c Tinib"thy L. Cronin III Mailing Address: ........................... Cronin Engineering 39 Arlo Lane. Cortlandt Man 67 Form PC -97 ...q 617.20 Appendix C State Environmental Quality Review For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by Applicant or Proiect Sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME Alan & Gail Paley Construction of Single Family Residence 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 29 Hemlock Point Drive North 5. PROPOSED ACTION IS: New E] Expansion 0 Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: Amended Site Plan for the construction of single family residence (under construction) and the relocation of a previously approved sewage treatment system to a new location, also previously approved by the PCDH. 7. AMOUNT OF LAND AFFECTED: 5.170 5.170 Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ZResidential M Industrial Commercial Agriculture Park/Forest/Open Space Other Describe: Surrounding lands are zoned Single Family Residential 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? aYes No If Yes, list agency(s) name and permittapprovals: Town of Putnam Valley - Amended Site Development Plan, Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ZYes M No If Yes, list agency(s) name and permittapprovals: Town of Putnam Valley - Building Permit, Site Development Plan Approval PCDH - Sewage Treatment System Permit 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? Z✓ Yes 1:1 No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsorname: Cronl i P. P.C. /James W. Teed, Jr Date: 01 -28 -13 Signature: If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. Yes ❑ No n ^TIG'J F Fr ^C•1R oA"c; vF�,. Fir; `i'S 'R= \ CC ✓_ » •, ,y.., 1 r DIl�- � • , ; ': ,`-:: '�,.2 :, „fE .^.,Tl:^.id:i ri. 6 I.i= :KR, i -.;'2 lwu; a nega't'ive' declaration may be superseded by another involved agency. Yes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? Yes 11 No If Yes, explain briefly: E. ! THERE, OR IS THERE LIKEL Y.TO BE, CONTROVERSY REZATED TO POTtNTiaL f D�trZ.r� tNY,I�RI3MFNTAi, 11tPACT:�;•, ._,.._ _ _ � Yes LJ No if Yes, explain briefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. ❑ Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination 01 -28 -13 Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature o Preparer (if different from responsible officer) \\ �F-LJIZAN� I' v # k fro ff� 70 00 ho 6 out OP ,f Ap 7 7 00 0 .00 6-655142"40" 4-84(74 ,/l/ Lj -20 V7--, 18'-0" 51 78. -0 oe� C+ancrete 41�SepfiC, ran* \v�\� • ,, ! i 1 t P3 t i t �i li + .0 `, ►® , / I ID6' t, 1'``, 1��I��II�I��Ii�I��I�CYI ®�I ®�II ®j9 •'ENO wrni •� �r �• .ti � `' ; � � ���, ,X582.93`' ®i��1001�.1 ■DIY■ \\ a ,1 ,` ` ` zod of M F ``� ``I��IY I�YIy YIY YY,YYIYYIq IY�IY�jYYIY�`N 14 I lipIwgI, ®�. re® j Ai j� t t O ^i or1 \\ `� ,``tl \ `, O` \•® ■IYYI ■ ■1Y�I - -- `` `` ``` `` %,ClIPA ION '`,• -,,,: , '; ` `, P \� ®\-*1■ 11, ly - - r� ';,�e ;mod \� { - >: ri'� 4�YIYY3riYIYYIS®I�101 ®YlY ®li► .. .A :_, ` ^I- STONEIMASONRX ` I AREA OFi1MTIGATl0N` WALL TO,REMAIN'�� =5,570 SQUARE`FgET it -��-�-�:••�•;- ::;:�:• `,,, `, ®� r` - ,, , , `` ` _ �� a ✓ ^` •` ®'i 1 G CONCRETE FOUNDATION " :::fir: �: ��: � • ` ` i ! °'`, ' ,, ', 1`, ``, ' �``` `,, `` ```, o �c 1 ; •�' 0 ' ', ` ``, ` io I REMO AND AREA TO BE SEEDEC ` PROVIDE TH A NATIVE/NA, v� al 1 ``` - - - - -- RSEED MID� .r Ilk 1Y : \`` i i ®e ` •' j ` 11 ` ,i _ d % +Y twin I4f# 1. S o u — - -- APPI GRA IZI PIPE BETWEEN `III I" • `�x �` ,, `\`,`` `` ```�`\ , ` `, S DBOX 8 TRENCH ` —R_ ��t' _ PRODE 378 `fi0 � — ``• S , ` � •Y � % I � 0, � -- 4'B PERFORATED � _ , / � ``` `� __ \ X `, � t � ■ ___, PB'ELt24' GRAVEL 7 Pi .la `` `�, `• �`. ' _ ►_ �� ®T� TRENCHES -- �`_v� • i �; d PRIMA - -.°7 _ RY Ss39 Dl '? - . ' 9.6 �, ? <O 558.9 ,o _ Z. _ 631 `., ■ ,\ (I. ', 557.5 •4 1 ' 56 8 1 Ea(pANSI p x,.. Np,�� �'• �1 � N AREA— ` ..,► ■•r ■. •.:,,•,.: ,;,. -f..'• • *;, �R� '� / ) :: t •..•. .,•.•.•� QED TEST PIT PROFILES Hole # _� Lot # Hole #. Lot # Hole # Lot # Depth to water '-' Depth to water -'" Depth. to Y7epth'to mottling w - s. ^_ . +Depth to mottling Depth to mottling Depth to rock/imp. � 1�2 l Depth to rock/imp. �p � Depth to rock/imp. //Z- G.L. G.L. G.L. 0.5 0.5 e` 0.5 ©�L 1.0 ��'� 1.0 1.0 2.0 7iU i1 2.0 �.7� 2.0 3.0 3.0� 3.0'1 4.0 `�'Z 4.0 4.0 5.0 6 �F� 5.0 c �rlo 5,0 y< 6. 6.0 j 6.0 7.0 7.0 7.0...` .7 Ile 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 Hole # Lot # Hole # .�.. - Lot # Hole # Lot # Depth to water °' Depth to water Depth.to:water Depth to mottling Depth to mottling Depth to mottling Depth Depth Depth S/Z to rock/imp. to rock/imp. to rock/imp. G.L. G.L. G.L. D� �s 0.5 0.5 0.5 1.0 .� 1.0 51���` ` ` 1.0 4P-�,� - 2.0 2.0 2.0 /tY 3.0 3.0 3.0 4.0 5AWIS 4.0 4.0 5.0'% 5 5.0 5.0 6.0' 6.0 UV 6.0- U i9 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 .- 4UCE~R FOLEY Public Health • Dthwar DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI RN., M.S.N. Associate Public- Health Dtnetar Dlnctor of Po(tew Servkes Environiaentsl Health (846) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845)278.6558 WIC(845)278-6678 Fax(845)278.6085 Early Intervention' (845) 278 - 6014 Preschod (845) 278.6082 Fax(345)278-6W. ADDITION APPLICATIONfiSIDENTIAI.ONLYI S1 OEM a P01" STREET 09-%,-AE- .l 991 TOWN \JAL.L:F--'q.' -TX MAP# NAME - `� PHONE 4k4,( E-Z PCHD# 1/4 MAIIrIl�G ADDRESS �. °^-ti -c ` 0114 1053 6 DESCRIPTION: OF ADDITION_ j C S ► �s (,sue 1.,� ( SZa 5hlc NUNA3ER OF EMSTING BEDROOMS PROPOSED # OF BEDROOMS GJ (FROM CERT. OF OCCUPANCY OR �' ' r • ' CER771CATION FROM BUILDING INSPECTOR) r *Any addition which is considered a bedroom requires formal approval' pprovallilaris (Construcctio>z Permit) preparedby a Professional Engineer or Reestene l kkhi...ct in ��=Ordanw w&h �'0L-' bl 's~4ti . � .: _ - - - ... - as�r.>u•'c•;:�`y �y Code: - - 6 . .� :. r � - - Please submit this-form and the following to Putnam County Heath Dept.- 4 tleneva Road, Brewster, NY ' 10509, Phone 278 -6130. *'l. Certified check or money order for $ 100.00.. 2. Sketches of misting floor plan (drawn to scale, all living area including basement) *Noll -professional sketches are acceptable. 3. Two sets of proposed floor plan (drawnto scale, with name, street, and tax map #) *Non -professional sketches are acceptable. i 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. -'Coact this office with any questions. 5. Copy of Ceit. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwem;g. OF�10E USE Comtnmts 1 Peb98 t BFhou� guidelines RUCE R FOLEY LORMA MOLWARI R.N.o M.S.N. _ _ _ .... .:. �. -14. !til"_ osatk Asry r : _.. . 'wl * : PS A!_ . Dd+ator le pdtfW serykw DEPARTNIM. OF ALTH 1 Geneva koad - - Brewster, New York 10509 Mavironmm4i 8n1W (945)278-6130 Fax (845) 278 - 7921 Nnedns s"ca (9 45)178 - 6566• WIC (645)173 - 667E Fu (845)178 - 6083 TAr1y InterMiGn (845) 278 - 6014 Praebool (845)176.6062 • Fax(M)21i .6648 Putnam County Dept. of Health' 4 Genova Road Brewster, NY 10509 Re: Residence Tax Map Town ?,'T Gentlem4n: . Accol4iing t records• maintained by the Town, the above noted dwelling ' in compliance with Town code and the total numbor of bedrooms on record is ` • . Thus infomaation has been obtained from: CERTMCATB OF OCCUPANCY: ASSESSORS RECORD:. OTIR Building Inspector BFhouseguidelines ufGM Dblaw Arsodate PxbIk Xadth Dbfttor Dbidw o' Pad W &rvlaw DEPARTMENT OF HEALTH 1 C um& Road - • Bmwstw, -Now York 10109 Environmental Health (445)278-6130 Fax (845) 278 - 7921 NWilus Servker (843)272-051. ;WIC (845)278.&78 Fax (845) 278 - 60&s Early Intervegl[on (945)'272 - 6014 Prerdool (845) 278.6082. Fax (845) 2% 6648 Putnam County Dept. of Health' . 4 Genova Road Brewster, NY 10509 IL Residence Tax Map Town Gentlemen: Accoi'din to records maiinta ned by the Town, the*above noted dwelling ' IS NOT . in compliance with Town code and the total number of bedrooms on record is ' . This information has been obtained from: CERTIKCATE OF OCCUPANCY: ASSESSORS RECORD: . Building Inspector BFhoumguidelines e �b I BADEY & WATSON ' i:Y. ^s•, �. Ju, 4.�i.'.T."fL�'LvJ�L: Rif. 3063 Route 9, Cold SorinQ New York 10516 TO: Michael J. Budzinski, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 Sent via: ❑ US MAIL ❑ PICK -UP We are sending : LETTER of TRANSMITTAL File No. 00 -150 W. O. # 17390 ❑ MESSENGER ❑ FEDEX ❑ FAX ❑ UPS -COD copies date description of document F-11 I Addition Application ❑1 18- Sep -08 I 113edroom Count (TM #62.6 -1 -24) ❑ 1 18- Sep-08 Bedroom Count (TM #62.6 -1 -25) REMARKS: Copies to: File RE: Addition Application Paley 31 Hemlock Point Drive North Lot No. on Subdivision Tax Map 62.6 -1 -25 PermiUTitle/PO # ❑ UPS -2 DAY ❑ ❑ UPS -3 DAY ❑� Tracking Numher: — Yours truly: UPS -NIGHT lAl�► ,, 217 Jason R. Snyder Tel: (845) 265 -9217 ext 13 Fax: (845) 265 -4428 Email: jsnyder@badey- watson.com 40 40-05 509660 634106 36029 577 1 i J6 J6 co SITE 19171 Q) LOV!All- 21 25 MAPLE ISLAND /x h �,/ `` ` J( RALPH G. MASTROMONACO,.P.E., P.C. Consulting Engineers 13, Dove Court, Croton -on- Hudson New York 0520 (914) 271 -4762 (91'4) 271 -2820 Fax Mr. William Hedges Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Paley Property Hemlock Point Road North Putnam Valley, NY Dear Bill: Please find enclosed the following materials: March 3, 2005 1. Two (2) copies of drawing entitled Site Plan Prepared For Alan H. & Gail Paley Located at Hemlock Point Drive North, Town of Putnam Valley, NY, dated January 13, 2005 2. Two (2) copies of the floor plans of the two (2) existing houses 3. One (1) copy of the septic evaluation report 4. Two (2) copies of the Town of Putnam Valley assessment records confirming the existing bedroom count We are requesting your continued review of the referenced materials. �{ Please call me if you have any questions Y, Mastromonaco RGM /jl Enclosures Dec-02-04 09:51A Ralph 914 271 4762 P.01 IN 57 - � =7 *,. RALPH G. MASTROMONACO, P.E., P,C. CorwJWg Engineers 13 Dove Court, Cmton-< ► K4m, Now Yo* 10520• - (914) 271 4762 TO: Fxc Phone (8-4-!S) 2 7 6 -7 <3 12!Lu / z-(-z (914) 2714762 (914) 2712820 of urgent []For ),ow review []Re*AMP. Co t p Qn��e Ir c ---- ------- -- if diere is a problem mofA d jax, please call as at (9J 4) 2714762 DEC-2-2004 THU 10:49 TEL: a.'!L -278-7r?--,, Dec -02 -04 09:53A Ralph G. Mastrumoriaco PE 914 271 4762 P_04 • 1r. N :� D n NN N l Gi\ ,.L `rs \ h \ < It Al. \. �3.i kb i , °' 1• N• ✓ J d'\ .:• n �0 J��. P !^- "NIP * IL lb •554.0 VP --------------- - - -'°b 552.0.. - q o� / �` - 550:0•- __ - - - -: ` ti � � \ w \ Cn ` ° IL \ a 46 �p 544.0 Dec -02 -04 09:54A Ralph G _ Mastr•omonaco 'NE '.914 271 4762 P.06 S. b •i Otl � �.. I, I n . 1 Tl TIM 7'T — -- — �;' !•'. =Y! 't'..: - . —..u" .'•iii ... �- u:r� � .... -� 6?.�•+�. rl sha r+.- a.A� :w.•a. •e..s. •a'x.., tY '�J .•V`rM�ti.c%:• ':.�: it? . •ay. � M•. T_ i r� , ..w.. � , s �. rh 1. r +r ��tl:•:'v.w . +a9� •:1'•�.J - -- .-. .--- "7n �nr 4 Lh1MC • 01 ITKInM 1-ni IKITV ni=DIODTMCAIT nP P A Dec -02 -04 09:54A Ralph G. Mori stl, v'a ciiiac_o PE 914 271 4762 P.05 `V z O npr- P -POR4 TWI I in-q7 TCI • ❑dCZ_770 -77061 ------ ..� `r �� ► ,y .F •� S r , tit", -"'r'I ►I r r �r M ! J 1�j`�ti sf 4.� \\ f r Y r \ pcld r cl \7 V r fig• l.rte \ �1 I '• ref , //� �V N` y e� Qr •� :i \ r' \� . \ / Slot \\4� .L�. J� \` , 7' , _ -.+r ' I ;' i r'.S" `�\ ti� �•.. l F �H'e / /;ry9 \\ � p\\ N... ar ..• ~ ' r ! r l�! J' ! ,. Concrete Walk N .� Q .. foi {. (r ; !, \ Fie P/v I 0C) Shed , opruce ' ! I r / ( t� 1B �itChf ,' I i AW o , y -T lr J 24' �8'Sp�uce ; i t 1 , ' I' I i //' i j✓ '41. "Ook I fJ? yff!'% l�lllr r" { 'i fr7 ! L %i70 e�s F- r ti0� z W 55J.i 1? Q W CE !� W al oj , w p I I ii m J +, f r' J, r.l!1r•J J ?l I• Ir } -.$'t y m CU r V 0 v �9 �l O a I N � n H n , N LJ a p .gtrGn a t2 c x55 *� E :` ! •, _` Ret. If6 ro e 6 : o O �� w i 0ul •�Ok � l q.. .t 'C •t ru 0 f60 CE IL ° Af Im z Q .� 20 0` ;4 to O �e � Z t e f tops I to i std t F Q F. F Stott' IV!, `6, Y v it' a .eY� # er ab 8 ,•t �., ',�- _ �y� ru 8 ��.. emu+ Fr ' - M.• --- 1 U� r•.F"' 8 M k { f ArQ4K n r•^ ��j �o { s� S{88 .y �^ i - •""` �'" a B� w v is ` p Cl) � tel •� fi C f S H Ak!a`� . A it Oj i • CLI i W RALPH G. MASTROMONACO, P.E., P.C. Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (914) 271 -4762 (914) 271 -2820 Fax Paley Residence Septic Evaluation #29 and 31 Hemlock Point Road North Putnam Valley, NY March 2, 2005 The two existing residences are serviced by sewage disposal systems and drilled wells. The residence at #29 consists of a 500 - gallon metal tank and one 8' diameter seepage pit, installation date unknown. The residence at #31 consists of a four (4)- bedroom house. The septic system consists of a 600 - gallon metal septic tank and two 6' diameter seepage pits. This system was installed in 1981. Both systems appear to be functioning properly with no signs of surface failure. Additional available area has been investigated for possible expansion. Deep test holes were dug in this area. This area has the potential to provide an area for 200 LF of absorption trench or 4 -6' diameter seepage pits. RALPH G. MASTROMONACO, P.E., P.C. Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (914)271 -4762 (914) 271 -2820 Fax e', Mr. Robert Morris, P.E. Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Paley Property Hemlock Point Drive North Putnam Valley, NY TM #62.6 -1 -24 & 25 Dear Robert: Please find enclosed the following materials: 1. Completed bedroom count form for Lots 24 and 25 2. Completed Application To Abandon A Water Well dated March 29, 2005 3. Completed Construction Permit Application dat April 4, 2005 4. Check #300642565 in the amount of $300.0 ayable to the PCDH We would like to discuss this project with you at your earliest convenience. ncerely, Iph G. Mastromonaco RGM /jl Enclosures April 4, 2005 0 sE --�Lsnafi Lot f 4 I �- -,I- vocn-'70C J'A.TL-1 91173 70 SINT I n111M-1 SHERVITA AMLER, MD, MS, FAAP Commissioner of Health ....� ._ . >....:��- i'it��°TA N7 CS:i3vt�'IK�;- I•Z�v,'i�S�7�. =e ...,.., .- .;�::,u:,:�:.:: Associate Commissioner of Health ROBERT J. BONDI County Executive ;o..., -. .• -.- �. e�,=•. v. - wa- . s+•^. ��. sr. ts.» r••.. ��•- s..+ u ....-- :.�.a....t.arc:- ..rcn:oa. ROBERT MORRIS, PE Director of Environmental Health September 24, 2008 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Mr. Alan Paley 9 Huguenot Drive Larchmont, NY 10538 Re: Addition — Approval — A- 185 -08, Paley No Increase in Number of Bedrooms 31 Hemlock Point Drive North (T) Putnam Valley, T.M. # 67.6 -1 -25 Dear Mr. Paley: This Department has received and reviewed the plans for the proposed addition application at the above referenced site. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department dated September 24, 2008. The proposed project involves two adjoining lots, owned by Alan & Gail Paley, at 31 Hemlock Point Drive North, containing two (2) existing dwellings. The two houses have a combined total of seven (7) bedrooms. This project would combine the two lots, demolish the existing houses, abandon the existing septic systems and one of the existing wells, and create a single five (5) bedroom residence. The newly constructed house and garage will be serviced by a new subsurface sewage treatment system, designed with an aerobic treatment unit, and an existing well. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at five 5 without prior approval by this 2. The new subsurface sewage treatment system (SSTS) must be constructed and this Department shall inspect the system prior to backfill. The new SSTS is to be constructed and completed prior to issuance of a certificate of occupancy. 3. The new SSTS is to be inspected by the licensed design professional and the Putnam County Health Department after construction and prior to backfill. 4. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper, approvals. Any permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Respectfully, Michael J. Director of MJB:kly U a: J. Delano, PE Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 BI (T) PV 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 (/4 1 13ADEY & WATSON 3063 Route 9, Cold Spring, New York 10516 Fax: (845) 265 -4428 www.badey- watson.com info @badey- watson.com April 18, 20� 1 Michael J. Budzinski, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 Re: -Addition Permit— Paley (A- 185 -08) 31 Hemlock Point Drive North (T) Putnam Valley, TM #67.6 -1 -25 Dear Mr. Budzinski: Surveying & Engineering P.C. (845) 265 -9217 Glennon J. Watson, L.S. (845) 225 -3312 John P. Delano, P.E. (845) 831 -0100 Peter Meisler, L.S. (845) 562 -0060 Stephen R Miller, L.S. (914) 628 -1800 Jennifer W. Reap, L.S. (914) 739 -3577 (877) 3.141593 George A. Badey, L.S., Senior Consultant Mary Rice, R.L.A., Consultant Robert S. Miglin, Jr., L.S. This correspondence is directed to your attention with regard to the captioned project, and the proposed revisi ^ns ther to._ The ToW., -of Valley_,has.renuired_the owner_t�: - - .- - -- - ` -` d M'—_6i traie a 100' %Reserve Replacement area on fhe- siie.- uCtto the larger) y- absorption area associated with the previously approved geo- textile sand filter system, a replacement area is not feasible. Utilizing a peat fiber bio- filter system, we are able to design a wastewater treatment system with a smaller "footprint ", and provide an alternate area for 100% replacement of the proposed system. When designed with a 30 minute /inch percolation rate, the Geotextile Sand FilterTM by the Eljen Corporation has an application rate of 0.86 GPD /SF, while the Puraflo® Peat Fibre Biofilter by Bord na Mona Environmental Products has an application rate of 1.11 GPD /SF. As well as providing a reserve replacement area, the revised system will reduce the proposed volume of fill, and eliminate the need for a 61 /z' -high retaining wall along the west property line in order to retain the absorption area. The peat filters will also require a more conventional pretreatment in the form of a 1,250- gallon septic tank and 1,250- gallon pump tank. These were sized, as they typically would be, for a five- bedroom, single- family residence. Owners of the records and files of Joseph S. Agnoli o Barger & Hustis, Surveyors o Burgess & Behr o Roy Burgess o Vincent A. Burruano o Hudson Valley Engineering Company, Inc. G. Radcliff Hustis, Surveyor o Peter R. Hustis, Surveyor o James W Irish, Jr. o J. Wilbur Irish o Douglas A. Merritt o E.B. Moebus Reynolds & Chase o General Jacob Schofield o Sidney Schofield, C.E. o Taconic Surveying & Engineering, P.C. o D. Walcutt April 18, 2011 Micheal J. Budzinski, P.E. Page 2 of 2 A total of five (5) peat units are proposed; one .(1) for- each bedroom, as recommended by_. t ie'iff nutactu`rei 7-TI he hsoiption pad was designed using -the 750 GPD hydraufic — ~ r. capacity of the units (150 GPD /unit) and the application rate of 1.11 GPD /SF. An absorption pad with the dimension of 16'x43' has been proposed to provide 688 SF (675 SF minimum) of absorption area. The units will receive a 62.5- gallon dose (12.5 gallons /unit) 12 times per day. Again, this project will involve the demolition of two existing single- family residences, having a total of seven (7) bedrooms. A new five (5) bedroom single- family residence will be constructed, and will utilize the new wastewater treatment system and the existing well. The 100% Reserve Replacement Area delineated on the plan shall not be installed or otherwise prepared at this time. However, any fill placed on site, which is associated with the demolition of the existing dwelling (No. 29), shall be run -of -bank sand and gravel material meeting the specifications on the plan. We trust that the design elements described herein, and specified on the plan, meet the requirements of the Putnam County Department of Health for issuance of the subject addition permit. Kindly review the proposed plan, and we will follow -up with the application and supporting documentation. Please call this office if you have any questions or required additional information. Thank you in advance for your attention to this matter. Yours truly, BADEY & WATSON, Surveying and Eng veering, P. C. by, John P. Delano, P.E. NYS License No. 062505 JPD /jrs enclosures cc: File:U\00- 150B\AP18AP11BP.doc BADEY & WATSON Surveying & Engineering PC. BADEY & WATSON LETTER of TRANSMITTAL Surveying & Engineering A Date:- 18 Apr 2011 - - _ : _ - � �` Su69 ltdute y. kola 5niini;, New Yor% 1AS 16 File No.� 00 -150 M v w TO: Mr. Michael J. Budzinski PE Putnam County Department of Health 1 Geneva Road , NY 10509 W. 0. # 20482 RE: Paley 29 & 31 Hemlock Point Drive North Lot No. N/A on Subdivision N/A Tax Map 62.6- 1 -24 &25 PermittTitleIP0 # Sent via: ❑ US MAIL ❑ MESSENGER ❑ FEDEX ❑ UPS -2 DAY ❑ UPS -NIGHT ❑ PICK -UP ❑ FAX ❑ UPS- COD ❑ UPS -3 DAY RJ UPS -GRND Tracking Number: f i' 663162035*5212331 Weare sending: ._..._.._.. ....... .................................... .... ........ ..... ..........._...... copies date description of document 18- Apr -11 ILetter _ ❑ 11 8- Apr -11 Subsurface Sewage Treatment System Sheet 1 of 1 ❑ II ❑ Ej❑ I _... ❑ 1 I REMARKS: Copies to: File Yours truly: John-P. Delano, PE Tel: (845) 265 -9217 ext 12 Fax: (845) 2654428 Email: jdelano @badey - watson.com 40 40 -05 509660 634106 41012 I'II"11C- Kj4 -GCJ11 10 • .JU Ur9LL 1 C WM 1 - l f 1 - 1 -.1 1+ VJ BADEY & WATSON 3063 Route 9, Cold Spring, New York 10516 FAX; (845) 265 -4428 FAX- TRANSMITTAL Total Number of Pages: , File Number: EXC)— Surveying and Engineering P. C. - ot_ (845) 265 -9217 Glennon J. Watson, L.S. (845) 225.3312 Jolm P. Delano, P.E. (914) 628.1800 Peter Mcislr..r, L.S. (914) 739.3577 Stephen R. Miller, L.S. (877) 3.141593 Jennifer W. Reap, L.S. George A. Badey, L.S., Senior (consultant Mary Rice, R.L.A., Consultant Julius I, Cesare, P.E., Consultant Name 1Company Fax # ! TO. '�)JVW -- ( 2�� � '_71 FROM: 'e4j'/ z DATE: a{�� ` 1b1lrSSAGE: 4.5 )J A04 ai-IC'E . , Owners of the records and files ofJoseph S. Agnoli, Burgess & Behr, Ray Burgess, Vincent Burruano, Hudson Valley Engineering Company, Inc., James W. Irish, Jr., J. Wilbur Irish, Douglas A. Merritt, E.B.Mixbus, Reynolds & Chase, Taconic Surveying & Engineering, P.C. and D. Walcutt WARNING: ALTERATION OF THIS DOCUMENT, IN ANY WAY, BY ANY PERSON, HOT UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER OR LAND SURVEYOR, AS APPROPRIATE, IS A VIOEATION OF THE EDUCATION LAW OF THE STATE OF NEW YORK. Putnam County Department of Aeal•ta Division o Environmental Health Services o � �5 A ppr ved as noted for conformance with ayppliZzbls- i:u1cs and Regulations of the P tnam County He th Department... 3i�natcre & T le Datri - PUTNAM COUNTY HEALTH DEPARTMENT APPROVAL STAMP 1 % Iwo 44 • i q r�vI% -I I -Y SERVICE NEW SINGLE --- FAMILY DWELLING WITH EXISTING INDIVIDUAL PRIVATE WATER SUPPLY PREPARED FOR ALAN H. PALEY 9 HUGUENOT DRIVE LARCHMONT, NY 10538 SUBSURFACE SEWAGE TREATMENT SYSTEM SCALE: AS NOTED 5' . Ur PRIN'rcp " it 4 7008 6250� c S10 BADEY & WATSON SURVEYING & ENGINEERING,' P I ENSE NO. 62505 COPYRIGHT 2008 BY BADEY & WATSON. SURVEYING & ENGINEERING. P.C. BADZY & WATSON, 3003 Route 0 arc a Cold Sprieg Neer York 10518 (845) 265 -921" (eat 314—IM Ton —ire (845} 828-180r) -9slz (845) 265 -4428 (Ax) (914) 5r (914) 73B -3S7" SHEET 1 OF 1 FILE NO. MAR -04 -2011 16:30 BADEY & WATSON, PC SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health September 24, 2008 Mr. Alan Paley 9 Huguenot Drive Larchmont, NY 10538 Dear Mr. Paley: DEPARTMENT OF HEALTH. 1 Geneva Road, Brewster, New York, 10509 Re: Addition — Approval — A- 185 -08, Paley No Increase in Number of Bedrooms 31 Hemlock Point Drive North (T� Putnam Valley, T.M. # 6 6 -1 -25 P. 02/03 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Heath This Department has received and reviewed the plans for the proposed addition application at the above referenced site. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department dated September 24, 2008. The proposed project involves two adjoining lots, owned by Alan & Gail Paley, at 31 Hemlock Point Drive North, containing two (2) existing dwellings. The two houses have a combined total of seven (7) bedrooms. This project would combine the two lots, demolish the existing houses, abandon the existing septic systems and one of the existing wells, and create a single five (5) bedroom residence. The newly constructed house and garage will be serviced by a new subsurface sewage treatment system, designed with an aerobic treatment unit, and an existing well. The addition is approved with the following conditions: :..x ht -io ai-;iumber oi�be- (Inuunis must rre1`ria l di ilv_ 0 -62) wit'itvut prior apprc;v al- by. u�is- Department. 2. The new subsurface sewage treatment system (SSTS) must be constructed and this Department shall inspect the system prior to backfiil. The new SSTS is to be constructed and completed prior to issuance of a certificate of occupancy. 3. The new SSTS is to be inspected by the licensed design professional and the Putnam County Health Department after construction and prior to backfill. 4. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals. Any permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Vallev. If you have any questions, please contact me at your convenience. Respectfully, !, A.. Michael J. B Director of l MJB:kly cc: J. Delano, PE Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225.5186 Fax(845)225-5418 BI (T) PV Nursing Services (845) 278.6558 Fax (845) 278 -6026 WIC(845)278-6678 Nursing Horne Care Fax (845) 278.6085 n. . r .. . ._ .. ... .n. .__.. _•,n.w•. win ♦n. � r... .n.w. ��n ri •n i - - -. > > .. C> aw-.� r. � . •.Y .w. _ -. .> a. -u . �: CS w.w r.. � a ...� r x_i... .. _. ENGINEERING REPORT Alan H. Paley Residence Proposed Subsurface Sewage Treatment System Repair 29 & 31 Hemlock Point North Town of Putnam Valley Putnam County PROJECT The proposed project involves two adjoining lots, owned by Alan & Gail Paley, on Oscawana Lake. Each of the lots have existing residences with private wells and septic systems. The two houses have a combined seven (7) bedrooms, each having presumably substandard septic systems by current standards. This project would combine the two lots, demolish the existing houses, abandon the existing septic systems and one of the existing wells, and create a single five (5) bedroom residence. The newly constructed house and garage would be serviced by a new subsurface sewage treatment system, designed with an aerobic treatment unit, and an existing well. DESIGN FLOW Due to environmental constraints and requirements of the Town, the previously approved (PV- 02 -07) subsurface sewage treatment system must be relocated. The new area available for treatment allows for installation of 160 linear feet of geo- textile sand filter. The proposed geo - textile sand filters have an effective leaching area of 6.0.square_ feet _ t t.lin ar tncit. F� r fnr y ?. trJ*�^! 'L'f y� gqu'wxe f;;el- afabsb iuvu aiea uiw' ~ provided. Additional percolation testing conducted at the site indicated a sewage application rate of 0.86 gallons per day per square feet. Applying this rate to the available area yields the 825 gallons per day hydraulic capacity of the system. This design flow exceeds the State standard of 650 gallons per day, for a 5- bedroom residence, by 27 percent. 160 LF * 6.0 S'A, * 0.86 "DIsg = 825.6 GPD August 2, 2008 BADEY & WATSON Fi1eUA00- 150B\AP02SP8R.doc Surveying & Engineering PC. BADEY & WATSON ing 3063 Route 9. Cold SDring. New York 10516 TO: Michael J. Budzins1d, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road lBrewster, NY 10509 Sent via: ❑ US MAIL ❑ PICK-UP We are sending: LETTER of TRANSMITTAL Date:` o5i Sep 26A ! _7 -.7 File No. 60-394 W. O. # 18768 RE Revised Plans ❑ MESSENGER 1:1 FEDEX ❑ FAx ❑ UPS-COD Paley 29 & 31 Hemlock Point Drive North Lot No. on Subdivision Tax Map 62.6-1-24&25 Permit/Title/P0 # ❑ UPS-2 DAY ❑ UPS-NIGHT ❑ UPS-3 DAY V UPS-GRND Tracking Number: copies date description of document ❑ 1] 102-Sep-08 -7 lCover Letter 1] 102-Sep-08 —] jEngineering Report F-11 I Floor Plans, four (4) sheets F-1 I D I S. ...... .. F F-1 1 7 1 REMARKS: Copies to: File Yours truly: Jason R. Snyder Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com Alan Palev 40 40-05 509660 634106 35958 3063 Route 9, Cold Spring, New York 10516 Fax: (845) 265 -4428 www.badey-watson.com info @badey - watson.com September 2, 2008 Michael J. Budzinski, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS Repair — Paley M Putnam Valley, TM #62.6 -1 -24, 25 Dear Mr. Budzinski: Surveying & Engineering PC. a. -M1 w-... -...mow a¢a�J.r. cv...b. ... .a Y.._ .• (845) 265 -9217 Glennon J. Watson, L.S. (845) 225 -3312 John P. Delano, P.E. (914) 628 -1800 Peter Meisler, L.S. (914) 739 -3577 Stephen R. Miller, L.S. (877) 3.141593 Jennifer W. Reap, L.S. George A. Badey, L.S., Senior Consultant Mary Rice, R.L.A., Consultant Robert S. Miglin, Jr., L.S. This office has received and reviewed the comments issued by your department dated August 28, 2008, regarding the above referenced project. Please be advised of the following: - _ 1. , The proposed desi „�`(D_, QiIiiinp.CI in �n�3. 1! » fi,e - .a �; r t ..Q ..-h- L% -In-add1�:Sn;-thss design flow is detailed in the Report. 2. An Engineering Report has been provided which describes the project and provides calculations regarding the design flow. 3. Please find enclosed an additional set of floor plans. We trust that any concerns with regard to the subject application have been addressed. Yours truv BADE VA WATSON Survey' g and Engine P.C. by, / Jas R. Snyder Assistant Engineer jrs cc: FileU: \00- 150B\AP02SP8L.doc Owners of the records and files of Joseph S. Agnoli, Burgess & Behr, Roy Burgess, Vincent Burruano, Hudson Valley Engineering Company, Inc., James W. Irish, Jr., J. Wilbur Irish, Douglas A. Merritt, E.B. Moebus, Reynolds & Chase, Taconic Surveying & Engineering, P.C. and D. Walcutt SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health August 28, 2008 John Delano, PE Badey & Watson 3063 Route 9 Cold Spring, NY 10516 Dear Mr. Delano: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Revised SSTS for Paley at Hemlock Point Drive North (T) Putnam Valley, TM # 62.6 -1 -24 & 25 This Department has received and reviewed the revised plans for the above referenced project and the following comment is offered .`or your consideration. 1/ 1. Please indicate how the design flow of 825 gallons per day was derived. The previously .... _. -.. ___. -. c :.�y n' k.... n_l...n .i .. .-_n .3 n. ,re,.r of Iii(/.��i� rt.P1, nr+n. r..arid -... -.. ... _... -_.. <- ....;_ - 1.7nJ-iied perril'it- ;vas Uased on, a design Y°lci 4Y -ui ivi:lV b:.aal'vaau t,Va .a..y: - ;/ 2. Please provide a revised engineer's report which describes the project and includes calculations for the SSTS design. Please submit one (1) additional set of building floor plans Should you have any questions concerning this matter, please feel free to contact this office. MJB:kly Respectfully, Michael J. Director of C4 { Environmental Health (845) 278 -6130 Fax (845) 278 -7921. Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 WATSON LETTER of-TRANSMITTAL Sury iytng'-'&-E ngt'n'e'eW'n"g`, P,.'C Date: 27 Aug 2008 3063 Route 9, Cold SvrinR, New York 10516 File No. 60-394 W. 0. # 18768 RE: Floor Plans TO: Paley 29 & 31 Hemlock Point Drive North Michael J. Budzinski, P.E. Lot No. on Subdivision Director of Engineering Tax Map 62.6-1-24&25 Putnam County Department of Health Permit/Tide/PO # 1 Geneva Road Brewster, NY 10509 Sent via: ❑ US MAIL ❑ MESSENGER ❑ FEDEx ❑ UPS-2 DAY ❑ UPS-NIGHT ❑ PICK -UP ❑ FAx ❑ ups-coD ❑ UPS-3 DAY R] UPS-GRND Tracking Number. We are sending copies date description of document ❑ 116-Jul-08 7 Basement Plan F-1] 116-Jul-08 7 [Ground Floor Plan FjI 116-Jul-08 jUpper Floor Plan F-11 121-Jul-08 lGarage Ground and Upper Floor Plans F� F� :F7 F-1 I F-1 I REMARKS: Copies to: File Yours truly: Jason R. Snyder Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com van palsy 40 40-05 509660 634106 35901 BADEY & WATSON LETTER, of TRANSMITTAL Daiz: 3063 Route 9. Cold Spring, New York. 10516 File No. 60-394 TO: Mr. Michael J. Budzinsid, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 Sent via: ❑ US MAIL ❑ PICK-UP We are sending: W. 0. # 18768 ❑ MESSENGER ❑ FEDEX ❑ FAx ❑ UPS-COD RE: Revised Plans Paley 29 & 31 Hemlock Point Drive North Lot No. NIA on Subdivision N/A Tax Map 62.6-1-24&25 Pernut/Title/P0 # ❑ UPS-2 DAY ❑ UPS-NIGHT ❑ UPS-3 DAY k UPS-GRND Tracking Number: J copies F-4] date. 109-Jul-08 description of document lConstruction Permit for Sewage Treatment System F-1] IDesign Data Sheet, two (2) sheets Fil 109-Jul-08 Pump & info, seven (7) sheets F14 109-Jul-08 ISubsurface Sewage Treatment System (Sl)17390� jWft Sheet I of 1 F2 I 16- Jul -08 5- Bedroom Floor Plans, four (4J ❑ 1 17,5- �L-C61 FA_PV"CAANoA4 PfF_ — 42-60." FU — SVL_— F-1 I !L9 -40 9•0 L-11 ITTV Copies to: File Yours truly: Jason R. Snyder Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com Alan Paley 40 40-05 509660 634106 35610 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ... . � �. _ .°'D�SlCT1V ll►A'I`A SHE�'1'� . � 1J�5 UItF�I��: S�VVA��'rl�AT1VlENT�S�STEIVI .. a . _ .' _... . Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 (indicate nearest cross street) Municipality Date of Pre- soaking (T) Putnam Valley Drainage Basin Peeskill Hollow Creek. SOIL PERCOLATION TEST DATA Date of Percolation Test Hole No. un 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 1 - - 2 - - 3 - - 4 - - 5 - - 1 _ - 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 - - 5 - - NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 1 -30 min/%l ch, Ymin for 31- 60 °min/inch) All data to be submitted for review.`' w� 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES 1GL ;iti. y:- 1 GL 43` : HOLE -N& it G.L. Topsoil Topsoil Topsoil 0.5' Brown Sand & Gravel V V 1.0' I Orange -brown Silty Loam Orange -brown Silty Loam 1.5' I I I 2.0' I I v 2.5' I 3.0' 3.5' I V 4.0' V Gray -brown Sand & Gravel 4.5' 5.0' 5.5' V 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' -9.5`_ 10.0' Indicate level at which groundwater is encountered Not encountered Indicate level at which mottling is observed None observed - Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - B &W Date 2/7/2008 hnP D 1 PE Design Professional Name. Jo a ano, . Address: Badey & Watson, Surveying and Engineering, P.C. 3063 ou 9 Co g, NY 10516 a Signature: Design Professional's Seal Form DD-97 (Pg. 2 of 2) r �a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES �DESWIl DA° A'KHRET SUR RYNC SE' Au TR7hA' i' MENrSY3�i' Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 (indicate nearest cross street) Municipality (T) Putnam Valley Drainage Basin Peeskill Hollow Creek Date of Pre - soaking SOIL PERCOLATION TEST DATA Date of Percolation Test Hole No. un 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 1 — — 2 — — 3 - - 4 - - 5 - - 1 - - 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 - - 5 - - NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 1 -30 min7inch < °min.for 3g1 \-6 minhnch) 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 -rs: x''4ET!. :2 :_lam. -•r• ty - w...., • 'L aiY `Y Y a' � laVL iv`v': 'i , 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' -95, 10.0' Indicate level at which groundwater is encountered Not encountered Indicate level at which mottling is observed None observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - B &W Date 2/7/2008 Design Professional Name: John P. Delano, P.E. Address: Badey & Watson, Surveying and Engineering, P.C. 3063 Rout 9 Co1 p ' g, NY 10516 Signature: Design Professional's Seal Form DD -97 (Pg. 2 of 2) P• A✓ S ubmersible Fffluent Pump Design. .�. .. ;.- ... - : , w . r 00 -150 7/9/2008 "Paley" 11/2" Equivalent Friction Loss 2" Equivalent Main feet °r Main feet 40 If of plastic force main 1.0 40.0 11.52 8.49 1.0 40.0 4 90 degree elbows 4.3 17.2 23.95 12.43 5.5 22.0 1 check valve 14.0 14.0 19.0 19.0 1 gate valve 1.0 1.0 1.2 1.2 72.2 82.2 Vertical Head Loss Invert Elevation @ Junction Box = 557.2 Low Water Elevation @ Pump Tank = 550.2 Head Loss = 7 Capacity (gpm) 10 20 30 40 60 70 80 Total Head Loss in 1 1/2" & 2" Plastic Mains Friction Loss Total Dynamic Per 100 Feet Head (ft) 1 1/2" 2" 1 1/2" 2" 0.83 0.25 7.60 7.21 2.94 0.86 9.12 7.71 6.26 1.81 11.52 8.49 10.70 3.11 14.73 9.56 -1-6:45 23.48 6.60 23.95 12.43 -- 8.83 -- 14.26 -- 11.43 -- 16.40 Install one (1) Goulds Pumps submersible effluent pump, Model 3885- WE03M, with 2" pressure rated HDPE flexible sewer main. 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F : ............. ........... ............. ............. ......... ................ ........... .......... .............. ............. .............. ........... ............. .......................... . .............................. ............. ............. ............. ............ .... ........ .............. ........... .................................. .......... .. . ....... .............. ............. ............. ........... .......... .............. ............. ............. .............. ............. ......... ............... ............ ............. ........... ........ ...... .............. ............. ............. .......... . .......................... ............. ............. ............. ............ .. .............. ... ... ... .. ............. . .. . .. ....... ............. . ............. ............. ......... . . . . . . ....... ............ ........ . . . . .. . ........ .... . . .. .. ..... ............. ... ..... ............. .............. . ........... . ............. .............. .. ........... .............. .... . .. ..... ...... . .. . . . ..... . . ........... ... ............ ....... . ........... ............ ........ . .. . .. ... . . ........ . .... .... . . . ............. .............. ............. . ....... ... .... ............. ............. . ............. 130 120 110 100 go Lu 80 70 Z 60 50 0 40 30 20 10 n PERFORMANCE CURVES 0 10 20 30 40 50,5660 70 80 90 100 110 120 130 140 150 160 CkPACITY (gpm) WE03U" WE03M WE05H WE07H, WElOpl, —WE15PI —WE05H 1 —WE015'HH —WE020H 1 1/2" k�j`ain —2" Maim; O-A409 � Z- Goulds Pumps WE Series Model 3885 Submersible Effluent Pump PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. [qGOULDS PUMPS Goulds Pumps is a brand of ITT Corporation. www.goulds.com Engineered for life FEATURES • Impeller: Cast iron, semi -open, non -clog with pump -out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as an option. • Casing: Cast iron volute type for maximum efficiency. 2" NPT discharge. • Mechanical Seal: Silicon Carbide vs. Sili- con Carbide sealing faces. Stainless steel metal parts, BUNA -N elastomers. ■ Shaft: Corrosion - resistant, stainless steel. Thxea d .riot fit► L ocknUt :60 t�l'. .- ��elj;ti?:, guard against component damage on ac- cidental reverse rotation. ■ Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. • Designed for continuous operation when fully submerged. APPLICATIONS Specifically designed for the following uses: • Homes, Farms, Trailer Courts, Motels, Schools, Hospitals, Industry, Effluent Systems SPECIFICATIONS Pump • Solids handling capabilities: 3/4" maximum. • Discharge size: 2" NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. • Temperature: 104 °F (40 °C) continuous, 140 °F (60 °C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM'S available. MOTORS ■ Fully submerged in high -grade turbine oil for lubrica- tion and efficient heat transfer. • Class B insulation on 1/3 —1 Y2 HP models. • Class F insulation on 2 HP models. Single phase (60 Hz): • Capacitor start motors for maximum starting torque. • Built -in overload with automatic reset. GOULDS PUMPS Wastewater • 'A —1 HP models have NEMA three prong grounding plugs. • 1'/2 HP and larger units have bare lead cord ends. Three phase (60 Hz): • Class 10 overload protection must be provided in separately ordered starter unit. • STOW power cords all have bare lead cord ends. • Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously without damage when fully submerged. • Bearings: Upper and lower heavy duty ball bearing construction. • Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. Standard cord is 20'. Optional lengths are available. • 0 -ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS Tested to UL 778 and CSA 22.2108 Standards A• By Canadian Standards Association File #LR38549 • S1TOW or STOW severe duty oil and water resistant c �" us Goulds Pumps is ISO 9001 Registered. _- power cords...... METERS FEET 40 130 120 35 110 30 100 9 90 = 25 80 20 70 c 60 15 50 40 10 30 5 20 10 i0 GPM I I I I I I I I I I I I I I 0 5 10 15 20 25 30 35 m3/hr CAPACITY ' t • mm\■■■■■■■ ■ ■ ■ ■�a�ti� ■■■ ■■■ ■■ =l1Im■ ■ ■■ f�a ■ ■ ■■■ ■ ■ ■■ ■1 ■■■f■f ■'' On ■■ ■ ■■■ ■ ■ ■1 ■■■ ■■■ ■■■■�\`■r■■ ■ ■ ■1 ■I■■ ■B ■j 111Aw1A■l■ ■■a ■■■■ ■■ mill.sn"'�aIe� :li-�■cN=mMI®Mm� In +■illlll�o� ■�iV ■ ■ \� ■ ■��.�� ■� ■ ■■■ l■ ■.■■..ellll. �,�.�..■ �.i■■■■IC.I1.■a■■ I�i■■ �i�iiQi�iiil i�iii�w■�i�il:�ill�i ®■���iiil�i 11 10 20 30 40 50 60 70 :r •• 100 110 120 130 140 150 i0 GPM I I I I I I I I I I I I I I 0 5 10 15 20 25 30 35 m3/hr CAPACITY MODELS GOUL ®S PUMPS Wastewater Order Number HP Phase Volts RPM Impeller Diameter (in.) Maximum Amps Locked Rotor Amps KVA Code Full Load Efficient % Resistance Power Cable Size Weight JhL Start Line -Line WE0311 L 0.33 1 115 1750 5.38 10.7 30.0 M 54 11.9 1.7 16/3 56 WE0318L 208 6.8 19.5 K 51 9.1 4.2 WE0312L 230 4.9 14.1 L 53 14.5 8.0 WE0311M 115 10.7 30.0 M 54 11,9 1.7 WE0318M 208 6.8 19.5 K 51 9.1 4.2 WE0312M 230 4.9 14.1 L 53 14.5 8.0 WE0511H 0.5 115 3450 3.56 14.5 46.0 M 54 7.5 1.0 1413 60 WE0518H 208 8.1 31.0 K 68 9.7 2.4 16/3 60 WE0512H 230 7.3 34.5 M 53 9.6 4.0 WE0538H 3 200 4.9 22.6 R 68 NA 3.8 14/4 60 WE0532H 230 3.3 18.8 R 70 NA 5.8 WE0534H 460 1.7 9.4 R 70 NA 23.2 WE0537H 575 1.4 7.5 R 62 NA 35.3 WE0511HH 1 115 3.88 14.5 46.0 M 54 7.5 1.0 14/3 60 WE0518HH 208 8.1 31.0 K 68 9.7 2.4 16/3 60 WE0512HH 230 7.3 34.5 M 53. 9.6 4.0 WE0538HH 3 200 4.9 22.6 R 68 NA 3.8 14/4 60 WE0532HH 230 3.6 18.8 R 70 NA 5.8 WE0534HH 460 1.8 9.4 R 70 NA 23.2 WE0537HH 575 1.5 7.5 R 62 NA 35.3 WE0718H 0.75 1 208 4.06 11.0 31.0 K 68 9.7 2.4 14/3 70 WE0712H 230 '10.0 27.5 1 65 12.2 2.7 WE0738H 3 200 6.2 20.6 L 64 NA 5.7 14/4 70 WE0732H 230 5.4 15.7 K 68 NA 8.6 WE0734H 460 2.7 7.9 K 68 NA 34.2 .-.- WE1018H 1 1 208 4.44 14.0 59.0 K 68 9.3 1.1 14/3 70 WE1012H 230 12.5 36.2 1 69 10.3 2.1 WE1038H 3 200 8.1 37.6 M 77 NA 2.7 14/4 70 WE1032H 230 7.0 24.1 L 79 NA 4.1 WE1034H 460 3.5 12.1 L 79 NA 16.2 WE1037H 575 2.8 9.9 L 78 NA 26.5 WE1518H 1'S 1 208 4.56 17.5 59.0 K 68 9.3 1.1 14/3 80 WE1512H 230 15.7 50.0 H 68 11.3 1.6 WE1538H 3 200 10.6 40.6 K 79 NA 1.9 14/4 80 WE1532H 230 9.2 31.7 K 78 NA 2.9 WE1534H 460 4.6 15.9 K 78 NA 11.4 WE1537H 575 3.7 13.1 K 75 NA 16.9 WE1518HH 1 208 5.50 17.5 59.0 K 68 9.3 1.1 14/3 80 WE1512HH 230 15.7 50.0 H 68 11.3 1.6 WE1538HH 3 200 10.6 40.6 K 79 NA 1.9 14/4 80 WE1532HH 230 9.2 31.7 K 78 NA 2.9 WE1534HH 460 4.6 15.9 K 78 NA 11.4 WE1537HH 575 3.7 13.1 K 75 NA 16.9 WE2012H 2 1 230 5.38 18.0 49.6 F 78 3.2 1.2 14/3 83 WE2038H 3 200 12.0 42.4 K 78 NA 1.7 14/4 83 WE2032H 230 11.6 42.4 K 78 NA 1.7 WE2034H 460 5.8 11.2 K 78 NA 6.6 WE2037H 575 4.7 16.3 L 78 NA 10.5 3 ITT PERFORMANCE RATINGS (gallons per minute) COMPONENTS Older No. WE03L WE03M WE05H WE07H WE10H WE15H WE05HH WE15HH WE20H 5 HP '/3 i/3 1/2 % 1 1'/2 '/2 1'/2 2 RPM 1750 1750 3500 3500 3500 3500 3500 3500 3500 5 86 — — — — — — — — 10 70 63 78 94 — — 58 95 — 15 52 52 70 90 103 128 53 93 1 138 20 27 35 60 83 98 123 49 90 136 ` .d, 25 5 1 15 48 1 76 1 94 117 45 87 133 3 30 — — 35 67 88 110 40 83 130 — 22 57 82 103 35 80 126 40 — — — 45 74 95 30 77 121 45 — — — 35 64 86 25 74 116 50 — — — 25 53 77 — 1 70 110 55 — — — — 40 67 — 66 103 60 — — — — 30 56 — 63 96 65 — — — — 20 45 — 58 89 70 — — — — — 35 — 55 81 75 — — — — — 25 — 51 74 80 — — — — — — — 47 66 90 — — — — — — — 37 49 100 I — — — — — — — 28 1 30 Wastewater Item No. Description 1 Impeller 2 Casing 3 Mechanical Seal 4 Motor Shaft 5 Motor 6 Ball Beann s 7 Power Cable 8 Casing 0 -Ring 7 5 DIMENSIONS 8 (All dimensions are in inches. Do not use for construction purposes.) ROTATION 53/+ o I 1 ° KICK-BACK 2° NPT [gGOULDS PUMPS Goulds Pumps and the ITT Engineered Blocks Symbol are registered trademarks and tradenames of ITT Corporation. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. B3885 June, 2008 © 2008 ITT Corporation Engineered for life 6 4 3 Surveying & Engineering, P.C. 3063 Route 9. Cold Soring, New York 10516 TO: Michael J. Budzinsid, P.E. Director of Engineering Putnam County Department of Engineering I Geneva Road Brewster, NY 10509 Sent via: ❑ US MAIL ❑ PICK -UP We are sending: VO Date: 25 Aug 2008 File No. 60-394 W. O. # 18768 ❑ MESSENGER ❑ FEDEX ❑ FAX ❑ ups-coD RE: . Revised Floor Plans Paley 29 & 31 Hemlock Point Drive North Lot No. on Subdivision Tax Map 62.6-1-24&25 Permit/TitldPO # ❑ UPS-2 DAY 1:1 UPS-NIGHT 1:1 UPS-3 DAY UPS-GRND Tracking Number: copies date description of document F-2] 118-Aug-08 —] �Upper Floor Plan F1 1 7 F-1 I F-1 I R I F-1 I ........... F-1 I _71 1 F-1 I _71 F1 1 -11 F-1 1 71 REMARKS: Copies to: File Yours truly: Jason R. Snyder Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com Alan Paley 40 40-05 509660 634106 35875 Jul 04 08 06:35a Alan Paley 845- 526 -4778 p,1 Vnesimi[e Cover Page Date August 15, 2008 To Putnam County Department of Health Ann Michael J. Budzinski Fax 845- 278 -7921 Tel 845- 278 -6130 From Alan H. Paley TO (845) 526 -2343 2 pages including cover page Mr. Budzinski, Attached is a drawing of our proposed revision to the second story so that the office can be entered only through the adjacent bedroom. I will call you to discuss it later this morning. Many thanks. Alan Paley Jul 04 08 06:35a Alan Paley 845-526-4778 p.2 RUG-13-2e08 12:10 FROM:MGRRCHPC 2129e99981 P.1 HAL47- r2�0 61, MESON 111111 BEDROOM LX Room/ f-71 CTIOSFF 11�111 L44 FIA, —f-Wefi.7rF00 Of Mehon W,11 BOW CL 206b CL ' ' � 209b r. -- — -- i 7 LX Room/ f-71 CTIOSFF 11�111 L44 FIA, —f-Wefi.7rF00 Of Mehon W,11 BOW SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health July 31, 2008 John Delano, PE Badey & Watson 3063 Route 9 Cold Spring, NY 10516 Dear Mr. Delano: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Revised SSTS for Paley at Hemlock Point Drive North (T) Putnam Valley, TM # 62.6 -1 -24 & 25 This Department has received and reviewed the submitted application and plans for the above referenced project and the following comment is offered for your consideration. 1. As previously agreed upon, this Department indicated the project could proceed with a new five (5) bedroom dwelling to replace the seven (7) bedrooms in the existing two dwellings and a new SSTS designed with an aerobic treatment unit (ATU). Upon review of the submitted house plans, the main house has 5 bedrooms plus an office on the second floor which would be considered a potential bedroom. Consequently, the submitted ':- aD"Iicationwill 4t _bereyieww'ecl.untll,.0.6 -itvyl _. ;fan. r P)ta t�. - floor plan is submitted. Should you have any questions concerning this matter, please feel free to contact this office. MJB:kly Respectfully, Michael J. Director of 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 19AM1,114 3 �. DIVISION OF ENVIRONMENTAL HEALTH SERVICES CO TIt'UCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # r ol — Located at 29 � 31 dim LMJL �Dt ° Dej\jf- B.doa4m Subdivision name Subd. Lot # &A Date Subdivision Approved Uh Town or Village () OJ T IJA-M \/*LLF_ -$ Tax Map (9Z& Block 1 Lot Zit e Z.S Renewal Revision Owner /Applicant Name AL&I 0. PALL -{ Date of Previous Approval Mailing Address 9 Vay-TOE.44 UT Off& iA 2l iJ \4 Zip )0538 Amount of Fee Enclosed ` °C Building Type RS ►Ol t T)A Lot Area ® 9.4L No. of Bedrooms 5 Design Flow GPD K'XX--) Fill Section Only Depth Volume PCHD NOTIFICATION IS RE UIRED WHEN FILL. IS COMPLETED Separate Sewerage System to consist of gallon septic tank and MAN D1C- 6400 t- 1M -12DO A) A UA-X5%C. 5 (�i . V,&+Ti yi 'J`6S a s c Csa AL 1 t�0 A f2A Ll� Other Requirements: .20D L�F Of 7E*11 LE 5WO f ILVEIZ ( o VV%00Z/_ 3643) To be constructed by RARDLO L`ICM5' 1 Address COLI'-� 5P0JkK`9; 9q IC61b Water Suonly: Public Supply From Address or: Ynvate Suppty`i)nlled' "�y ." Address' I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the se 12arate 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: Address R.A. Date 0% k. OT License # C�PZ505 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 ecessary by the Public Health Director. Any revision or alteration of the approved plan requires anew p rmit. Approve or discharge of domestic sanitary se age only. By: ' Title: - Date: ✓°"t White copy - HD F' ; Ye to copy'- Building Inspector; Pink copy w er, Orange copy - Design Professional Form CP -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health _ .LORETTA MOI,INARI ;,.RNi MSN._. -., Associate Commissioner of Health February 20, 2007 John Delano, PE Badey & Watson 3063 Route 9 Cold Spring, NY 1051.6 Dear Mr. Delano: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BOND[ County Executive Director of Environmental Heali ;r 2 Re: Proposed SSTS for Paley at Hemlock Point Drive North (T) Putnam Valley, TM # 62.6 -1 -24 & 25 This Department has received and reviewed the.submitted application and plans for the above referenced project and the following comments are offered for your consideration. 1. As previously agreed upon, this Department indicated the project could proceed with a new five (5) bedroom dwelling to replace the seven (7) bedrooms in the existing two dwellings and a new SSTS designed with an aerobic treatment unit (ATU). Upon review of the submitted house glans, the main house has 5 bedrooms plus a study on the second floor which would he considered a potential bedroom. Furthermore the Second stor of s Y ; the detached garage shows an office, children's play area and bathroom which would h.e.. increas . po +_e.a.rt . alb_.c_. dro_ o n _c..f_ 3 ;;. tv_e h�glier. The .. a applicant should reconsider removing the plumbing (water & sewer) service to the detached garage in addition to revising the second floor plan of the house to remove the study area. L , Due to the presence of shallow bedrock, the SSTS design should incorporate a minimum el of two (2) feet of fill Into the plan. x- 3. Please submit calculations for the sizing of the SSTS components. j I Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. Respectfully, Vr7L -,,.--1-4 MJB:kly Michael J. Budztlnskl, V Director of Er bineering 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 t k l' Jason R. Snyder, Assistant Engineer Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com 40 40-05 5096'sn AIAI� :UT ic Surveying & Engineering, P.C. 3063 Route 9, Cold Spring, New York 10516 Date: 23 May 2007 File No. 00-150 W-0-# 17390 RE: Proposed SSTS Paley TO. 29 & 31 Hemlock Point Drive North Mr. Michael J. Budzinski, P.E. Director of Engineering Putnam County Department of Health Subd. Lot No. Tax Map 62.6.1-24&25 Pennitfritle/PO # 1 Geneva Road Sent via: Brewster, NY 10509 US MAIL ❑ UPS-NIGHT MESSENGER UPS-2 DAY ❑ ❑ We are sending: PICK-UP UPS-3 DAY' FAX 0 UPS-GRND UPS-COD F-1 9 copies date description of document F4� 123-Mlay-07 wage Treatment System (SD17390 RO2) 0 F-1 F-1 I F-1 Jason R. Snyder, Assistant Engineer Tel: (845) 265-9217 ext 13 Fax: (845) 265-4428 Email: jsnyder@badey-watson.com 40 40-05 5096'sn AIAI� 40 40-05 509660 634106 32648 L RALMANWITA Surveying & Engineering, P.C. 3063 Route 9, Cold Spring, New York 10516 Date: 14 May 2007 File No. 00-150 W. O. # 17390 RE: Paley TO: 29 & 31 Hemlock Point Drive North Michael Budzinsid PE N/A Subd. Lot No. N/A Director of Engineering Tax Map 62.6-1-24&25 Putnam County Department of Health Permit(ritle/PO # 1 Geneva Road Sent via: Brewster, NY 10509 US MAIL ❑ UPS-NIGHT ❑ MESSENGER ❑ UPS-2 DAY F-1 PICK-UP ❑ UPS-3 DAY ❑ FAX UPS-GRND R] We are sending: UPS-COD ❑ copies date description of document F-21 110-May-07 I IDWG. No. 3 BASEMENT PLAN 21 110-May-07 —1 IDWG. No. 4 GROUND FLOOR PLAN 72 110-May-07 DWG. No. 5 UPPER FLOOR PLAN 72 110-May-07 IDWG. No. 6 GARAGE GROUND & UPPER FLOOR PLANS F-1 E-1 ❑ F-1 F 7_1 IF ❑ fill ❑ LY REMARKS. Revised floor plans, as provided by architect for owner. Copies to: File Yours truly: John P. Delano, PE Tel: (845) 265-9217 ext 12 Fax: (845) 265-4428 Email: jdelano@badey-watson.com 40 40-05 509660 634106 32648 X3/21/2007 13:44 FAX 212 909 6836 DEBEVOISE & PLIMPTON LLP Date March 21, 2007 . To Putnam County Department of Health Attu Mike Bodzinski Fax 845- 278 -7921 Tel 845- 278 -6130 From Alan H. Paley Tel (212) 909 -6694 Re: Proposed SSTS for Paley at Hemlock Point Drive North (T) Putnam Valley, TM # 62.6 -1 -24 & 25 Dear Mr. Bodzinski, [a 001 Facsimile 3 pages including cover page Attached is the drawings.prepared by my architect showine the powder room in the Prage ,moved "to the en tYy 'Wel from did-wi&W4 ieadiii g to the douse �► i dYcaien ' °� f - on the phone, this entry level is between the garage floor level and the upper floor where the children's play area and my office will be located. Thank you for your consideration. N ' rx For assistance or confirmadon please call 212 909 6407_ This message is intended only for the use of the individual or entity to which it is addressed and may contgn information that is privileged, confidential and exempt from disclosure. If the reader of this message is not the intended recipient or an employee or agent responsible for dclivcting the message to the inrcndcd recipient, you arc bcrcby notified theist, any disscminadoa, discribudon, or copying of this communiattion is strictly proht'tited. If you have received chip commanic 110X7 in error, please notify us immediately by telephone and return the original message to us by mail- Thank you. 22422597vi 03/21/2007 13:44 FAX 212 909 6836 DEBEVOISE & PLIMPTON LLP 002 MAR -20 -2007 09:19 FR0M$MGARCHPC 2129999901 T0:912125RI7694 P.2 GARAGE GROUND FLOOR PLAN 03/21/2007 13:44 FAX 212 909 6836 DEBEVOISE & PLIMPTON LLP W MAR-20- 2007 09:19 FROmMeARCHPC 2129899991 TO. 912125217694 Alt %fi J�j OF FCE 21j 1 If J: L T -RTQRAG'R I *;: ''1 ` �* STORAGE LIFIB ij It'd 7 fill (-,HMDRPI -Vj PLAY AREA I 1 7 1 i Bm PW W %V I L 111 Elul Nli r; [a 003 P.3 GARAGE UPPER FLOOR PLAN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Alan H. Paley App GAIL PAL y Located at 29 & 31 Hemlock Point Drive North T/V (T) Putnam Valley Tax Map # Subdivision of 62.6 Block 1 Lot 24 & 25 n/a Subdivision Lot # n/a Filed Map # n/a Date Filed Gentlemen: n/a This letter is to authorize John P. Delano, P.E. a duly licensed Professional Engineer _v� or Registered Architect _ to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health ..- - sx _ils. ICw pl.itllalit - (11,77tTU.. V Code' __:.._..:....._ _._ . ... ^_'.�. Very truly yours, _ Countersigned: Signed: IV& g g P.E., M # 062505 (Owner of Prope Mailing Address Badey & Watson, P.C. Mailing Address: 9 Huguenot Drive 3063 Route 9 Cold Spring $ " State New York Zip 10516 State Larchmont 0 Zip Telephone: 845- 265 -9217 . Telephone: (914) 834 -2267 10538 Form LA -97 I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPL' ICATYON FOR APPROVAL. OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Alan H. Paley 9 Huguenot Drive 2. Name of project: "Paley" 4. Design Professional: John P. Delano, P.E. 6. Drainage Basin: Hudson River 7. Tvne of Proiect: Larchmont, NY 10538 3. Location: TN: (T) Putnam Valley 5. Address: Badey & Watson, P.C. 3063 Route 9, Cold Spring, NY 10516 v/- Private/Residential _ Food Service --- Commercial _ Apartments _ _ _ Institutional _ Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)----------- Yes/No No Type Status. (check one)-------- -------------- -- --------- - ----- Type I Exempt Type H �/ Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? Yes/No No 10. Has DEIS been completed and found acceptable by Lead Agency? Yes/No n/a 11. Name of Lead Agency Town of Putnam Valley Planning Board -12. Is this project in an area under the control of local plarni.nn, zoning, or. other P J _.. officials, ordinances? Yes/No Yes --------------------------------------------------- 13. If so, have plans been submitted to such authorities? Yes/No No ------------------------ 14. Has preliminary approval been granted by such authorities? n/a Date granted: n/a 15. Type of Sewage Treatment System Discharge surface water �/ groundwater YP a f g Y g ------------ - - - - -- - 16. If surface water discharge, what is the stream class designation? n/a 17. Waters index number (surface) n/a --------------------------------------------------- 18. Is project located near a public water supply system? Yes/No No 19. If yes, name of water supply „/a Distance to water supply n/a 20. Is .project site near a public sewage collection or treatment system? Yes/No I No 21. Name of sewage system n/a Distance to sewage system n/a 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) 1,000 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required? Yes/No No 26. Has SPDES Application been submitted to local DEC office? Yes/No n/a Form PC -97 Page 1 of 2 27. Is any portion of this project located within a designated Town or State wetland?---- Yes/No No 28. Wetlands ID Number n/a Yes/No N3 Has application been made to Town or Local DEC office? Yes/No n/a 30. Does project require a DEC Stream Disturbance Permit? Yes/No . No 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops., solid or hazardous waste disposal,landfilling, sludge application or industrial. activity? ------ _------------------------------ Yes/No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? DESCRIBE: Yes/No No No 33. Is there a local master plan on file with the Town or Village? _ _ ----------------- Yes/No Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? _ _ _ _ _ _ _ _Yes/No. No 35. Are any sewage treatment areas in excess of 15% slope? _ Yes/No No 36. Tax Map ID Number -------------------------------- Map 62.6 Block 1 Lot 24&25 37. Approved plans are to be returned to ------------------ _ - . Applicant ./_ Design Professional 1i0 E: f 11 hppllCaikol IS 1U1' 're VICVv` f,d apPiU• 9a i 6f Q 1l��VM3STS lU �1�G�IvC' lGd VVi hiI 't11e'1����-WatG1J lZll J1ItZ11 be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 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 of the Per"r r"U, SIGNATURES & OFFICIAL TITLES: ,�OOZ Mailing Addrbss: NVr ®�� ]Badey &Watson, Surveying and Engineering, P.C. 3063 Route 9, Cold Spring, NY 10516 Form PC -97 Page 2 of 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 & 25 (indicate nearest cross street) Municipality (T) Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Peekskill Hollow Creek Date of Pre - soaking 1241/06 Date of Percolation Test 12/12/06 Hde No. Run No. Time Start - Stop Elapse Time (Min.) Depth to Water From Ground Surface (Inches) Start - Stop Water Level Drop In Inches Percolation Rate Min/Inch A 1 11:05 11:26 21 22 - 25 3 7 A 2 11:27 - 11:52 25 22 - 25 3 8 A 3 11:53 - 12:18 25 22 - 25 3 8 4 - - 5 - - B 1 11:06 - 11:36 30 22 - 23 1 30 B' 11.37 12.07 3U 22 23" B 3 12:08 12:38 30 22 - 23 1 30 4 - - 5 - - C 1 11:07 11:17 10 22 - 25 3 3 C 2 11:17 - 11:34 17 22 - 25 3 6 C 3 11:36 - 11:53 17 22 - 25 3 6 C 4 11:54 - 12:11 17 22 - 25 3 6 5 - - N CUES: 1. Tests to be repeated at same depth until approximately+�ec}ualpercolaton rates are obtained at each percolation test hole. (i.e. < 1 min for 1- 30,mm/inch, 2 nnm for 31 -50 - 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 Oct 'go. ''` ° -Y . � �.... � Hi�L�I .. - :; ,h « . ; ..: DOLE N6. G.L. Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") 0.5' Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' V 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Date 1215/2006 Design Professional Name: John P. Delano, P.E. Address: Bade y & Watsofi;$"h -2tand.Enaineering, P.C. Signature: Form DD -97 (Pg. 2 of 2) 10516 Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 & 25 (indicate nearest cross street) Municipality (T) Putnam Valley Drainage Basin Peekskill Hollow Creek SOIL PERCOLATION TEST DATA Date of Pre - soaking 12111/06 Date of Percolation Test 12112/06 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 D 1 11:08 — 11:38 30 19 — 20 1 30 D 2 11:38 — 12:08 30 19 — 20 1 30 D 3 12:09 — 12:39 30 19 — 20 1 30 4 — — 5 - - 1 - - 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 - - 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 1 -3_ iri , c'2 '`for 31 =60 min/inch) All data to be submitted for review. a =.. n 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES DEPTH ... - HOLE NO, .. ' 4_._,. :HOLE NO. .5 _. _..._HOLE NO. � ...,6•. G.L. Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") 0.5' Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel 1.0' 1.5' I 2.0' I --Y- 2.5' 3.0' 3.5' I i 4.0' I y 4.5' 5.0' 5.5' y 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0, - 9.5' 10.0' Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Date 12/5/2006 Design Professional Name: _ John P. Delano, P.E. Address: Badey & Watso ii a oaf and4Engmeering, P.C. 3063 Rou old Swtwe; N 10516 Signature: PR Form DD -97 (Pg. 2 of 2) gn Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 & 25 . (indicate nearest cross street) Municipality (T) Putnam Valley Drainage Basin Date of Pre- soaking SOIL PERCOLATION TEST DATA Peekskill Hollow Creek Date of Percolation Test 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 1 — — 2 - - 3 - - 4 - - 5 - - 1 - - 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 5 - - NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 1 730 min/inch IQ' for 3 60 n/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. 7 HOLE NO. 8 HOLE NO. 9 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' Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel I I I I I I v V ---V— Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Date 1215/2006 Design Professional Name: John P. Delano, P.E. Address: Badey & Wats6° 'Sum '/ Z&Ensneenng, P.C. 3063 vut 9. Cold Sri iing:NY 10516 Signature: Form DD -97 (Pg. 2 of 2) Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 & 25 (indicate nearest cross street) Municipality (T) Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Peekskill Hollow Creek Date of Pre - soaking Date of Percolation Test 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 1 — — 2 — — 3 — — 4 — — 5 - - 1 - - 3 - - 4 - - 5 - - 1 — — 2 — — 3 — — 4 — — 5 - - NOTES: 1. Tests to be repeated at same depth until appr percolation test hole. (i.e. < 1 min for 1 -304 submitted for review. 2. Depth measurements to be made from top of )lation rates are obtained at each 31 -6Q mfn/inch) All data to be Form DD -97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 10 HOLE NO. 11 HOLE NO. 12 Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel v =v Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Date Design Professional Name: Address: Badey & Wats Signature: Form DD -97 (Pg. 2 of 2) K,Jobn P. Delano, P.E. A 1 rVq—jjhg Qn Engineering, P.C. cwa, IN-Y 10516 Professional's Seal 12/5/2006 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62'6 Block 1 Lot 24 & 25 (indicate nearest cross street) Municipality Date of Pre - soaking (T) Putnam Valley Drainage Basin SOIL PERCOLATION TEST DATA Peekskill Hollow Creek Date of Percolation Test 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 1 - - 2 - - 3 - - 4 - - 5 - - 1 - - 2 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. < 1 min for 130 min/' ch; <Vmin, for 31;- 600min/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. 13 HOLE NO. 147 HOLE NO. 15 G.L. Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") 05 Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel 1.0' 1.5' 2.0' I 2.5' 3.0' V 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Design Professional Name: Address: Badev & Wats Signature: Form DD -97 (Pg. 2 of 2) John P. Delano, P.E. �g�and >Eneineerine. P.C. 16 Professional's Seal n/a Date 12/5/2006 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL "HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Alan H. Paley Address 9 Huguenot Drive Larchmont, NY 10538 Located at (Street) 29 & 31 Hemlock Point Drive North Tax Map 62.6 Block 1 Lot 24 & zs (indicate nearest cross street) Municipality (T) Putnam valley Drainage Basin SOIL PERCOLATION TEST DATA Peekskill Hollow Creek Date of Pre - soaking Date of Percolation Test 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 1 - - 2 - - 3 - - 4 - - 5 - - 1 - - 3 - - 4 - - 5 - - 1 - - 2 - - 3 - - 4 - - 5 - - NOTES: 1. Tests to be repeated at same depth until approximately percolation test hole. (i.e. < 1 min for 1- 30:minhnch, < submitted for review. _y 2. Depth measurements to be made from top of hole. )lation rates are obtained at each 31 =60 ruin/inch) All data to be Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH MUM. 16 HOLE 90... 17 _ HOLE N0. is G.L. Topsoil (2 ") Topsoil (2 ") Topsoil (2 ") 0.5' Sandy Loam w/ Gravel Sandy Loam w/ Gravel Sandy Loam w/ Gravel 1.0' 1.5' 2.0' I �_ 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' 10.0' Indicate level at which groundwater is encountered Not Encountered Indicate level at which mottling is observed None Observed Indicate level to which water level rises after being encountered n/a Deep hole observations made by: N. Seidl - Badey & Watson, P.C. Date 12/5/2006 Design Professional Name: John P. Delano, P.E. Address: Badey & WatsoS `e' �'+ 'd En eerin P.C. 3063Ito 'te`9. Cold � 10516 Signature: 41 w- x /;;Fl Gav � .. �n W "`'D'esig ffea %pal's Seal Form DD -97 (Pg. 2 of 2) PROJECT ID NUMBER PART I - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEAR 1.APPLICANT /SPONSOR 2. PROJECT NAME Alan H. Paley "Paley" 3. PROJECT LOCATION: Municipality (T) Putnam Valley County Putnam 4. PRECISE LOCATION: Street Address and Road Intersections, Prominent landmarks etc -or provide map 29 & 31 Hemlock Point Drive North, Puntam Valley, NY 10579. 5. IS PROPOSED ACTION ® New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: Separate sewage treatment facility to service new single - family dwelling with individual private water supply. 7. AMOUNT OF LAND AFFECTED: Initially <1 acres Ultimately <1 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ® Yes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ® Residential ❑ Industrial ❑ Commercial Agriculture ❑ Park / Forest / Open Space ❑ Other (describe) Residential housing on 1+ acre lots. 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ® Yes ❑ No If yes, list agency name and permit / approval: Town of Putnam Valley Site Plan Approval, Building and Driveway Permit; PCDH Septic Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? 1:1 Yes ® No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? ❑ Yes ® No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF.;`fiAY KN0INLEDiGE Applicant / Sponsor Name 641oP, Delano, P.E. Date: 1/12/2007 Signature V If the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by (Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? U Yes C No ._ B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No; a negative declaration may be superseded by another Involved agency. El Yes E] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? (If yes, explain briefly: GI Yee: F-71 No u E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ez lain: El Yes F-1 No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action 17 WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination. Name of Lead Agency pol 6 I myr . auuny Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (if different from responsible officer) BADEY &: 3063 Route 9, Cold TO: & WATSON Spring, New York 10516 Mr. Michael J. Budzinsld, P.E. Director of Engineering Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 We are sending: copies Fil Fil Fil 0 0 u 0 0 F] date description of document LETTER of TRANSMITTAL Date: 17 Jan 2007 File No. 00 -150 W. O. # 17390 RE: Proposed SSTS Paley 29 & 31 Hemlock Point Drive North Subd. Lot No. Tax Map 62.6- 1 -24 &25 PermiUTidelPO # Sent via: US MAIL, ❑ UPS -NIGHT ❑ MESSENGER ❑ UPS -2 DAY ❑ PICK -UP El UPS -3 DAY ❑ FAX UPS -GRND❑ UPS -COD El 16 -Jan-07 I FA-Poication Fee - $500.00 12 -Jan-07 lConstruction Permit for Sewage Treatment System better of Authorization A lication for Approval of Plans for a Wastewater Treatment System 12- Jan -07 Short Environmental Assessment Form 05- Dec -06 IDesign Data Sheet six 6 sheets 1127an-07 I ISubsurface Sewage Treatment System (SD17390_R0,1,*) f7 NNI Floor Plans Copio to: File Yours truly: Jason R. Snyder, Assistant Engineer Tel: (845) 265 -9217 ext 13 Fax: (845) 265 -4428 Email: jsnyder @badey - watson.com SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Mr. Alan H. Puley 9 Huguenot Drive Larchmont, New York 10538 Dear Mr. Puley: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 October 18, 2006 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed Addition 29 & 31 Hemlock Point Drive North (T) Putnam Valley This Department has conducted a further review of your application and is willing to approve a design for a five bedroom residence with the following conditions: 1. An aerobic treatment unit (ATU) be included in the design for the new septic system. This needs to include a service contract for the ATU. 2. The new house footprint is not to use up viable septic system area. The new house should :.bed --n ti�°e sasiie location or, in the vicinity of tr.;.existinghouse fc�c;tpiini:s. 3. The existing well is to be abandoned if any proposed SSTS area is within 100 feet of the existing well. Please contact this Department with my questions that may arise. JSP:cj Sincerely, 7Joseph 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 Alan H. Paley 9 Huguenot Drive Larchmont, New York 10538 - September 18, 2006 Mr. Robert Morris Putnam County Department of Health 1 Geneva Road Brewster, New York 10509 Paley Residence 29 and 31 Hemlock Point Drive North Putnam Valley, NY Dear Mr. Morris: As we have discussed on a number of occasions, my wife and I have applied to the Department of Health for a permit to build a new house on Lake Oscawana at 29 and 31 Hemlock Point Drive North, Putnam Valley. Our proposal involves the removal of the two existing houses on our property and the construction of a single new residence. You have informed me that, based on the information we have provided to date, the preliminary position of the Department of Health is that it would be willing to consider making certain accommodations to enable us to obtain a permit to build a four bedroom house. As you know, our original application requested a permit for a seven bedroom house, which would be equivalent to the seven bedrooms that we currently have between the two houses on our property. We understand that our property is such that we cannot meet current Health Department standards for new construction and greatly appreciate the willingness of the Departrnent_to consider certain accommodations to_ - ~- - cr�ru u5 -tti bui�iu anew house: °riowever; having given our lam iy's nee as`a gieafdeal" of thought, we have concluded that, unfortunately, a four bedroom house would be inadequate. Accordingly, I am writing to request that you consider allowing us to build a five bedroom house, which would still reduce the current bedroom count by almost 30% and improve the protection of the lake compared to the current situation. The property at 31 Hemlock Point Drive North has been in our family for over 50 years. It was originally purchased by my wife's father, and after his death my wife and I purchased the house from her mother. As our family grew, to accommodate our needs, we purchased the house adjacent to our property at 29 Hemlock Point Drive North approximately 15 years ago. Three generations of our family regularly spend weekends at Lake Oscawana, enjoying the beauty and benefits of the lake and its surrounding area. This includes my mother -in -law and sister -in -law, my wife and I, and our two daughters and son -in -law. As you can see, on a regular basis, we use five bedrooms. Furthermore, my wife and I expect to make this our retirement home and we fully intend that the property will remain in the family for future generations. 222814070 Both houses are quite old and need to be replaced. The house at 31 Hemlock was built as a hunting cabin in 1913, when there were no building codes or health requirements. Similarly, the house at 29 Hemlock was built over 50 years ago. Not surprisingly, the septic systems of both houses would not comply with current codes and the system for 31 Hemlock is quite close to the lake. Realizing that the current situation has potential negative consequences for the lake environment, part of our construction plan has been to improve the situation to the maximum extent that our property allows. We recognize that we could rebuild both houses on their current footprints with the current bedroom count and continue to use the existing septic systems. However, from both a functional perspective and an environmental perspective, this would be the least desirable outcome. I am confident you can appreciate on a personal level that it would be preferable to have the entire family in one house. More relevant to our application, construction of a single new house would enable us to remove the existing septic systems and construct a modern septic system further away from the lake. As you know from the site plan, we own two small, uniquely- shaped pieces of property that even combined do not allow us to locate a septic system 200 feet from the lake. We have worked with our architect and the septic engineer to develop a plan that, given the constraints of our property, would locate the septic system as far away from the lake as possible. We have even explored purchasing a piece of land adjacent to our .property from a neighbor to further improve the situation. If this additional land would enable us to build the :house that we desire, we would gladly pursue this purchase further. Building this new house is extremely important to us and our family. It represents ..........._.._..___.__.._. _..a ivug lcuitliy itTowr"y aliu riiariy'fGnd Oiu lat'i.uc, ivtuEiiiBilt y�ari and uiE. . enjoyment of Lake Oscawana for future generations of our family. That being said, we realize that improving the septic situation is an integral part of helping to preserve Lake Oscawana for years to come. Though we wish it were otherwise, we cannot meet current codes for construction of a new house. But we are willing to work with the Department of Health to devise a plan that improves the protection of the lake and satisfies the Departments concerns, yet at the same time will be functional for our family. We think building a single new house that reduces the bedroom count almost 30% and relocating the existing septic system further from the lake would be a reasonable and good result for both the lake community and our family. For all these reasons, we would gratefully appreciate it if you would reconsider our application and allow us to construct a five bedroom home. I will give you a call in 2 222814070 .s` two weeks to discuss this further. Should you wish to call me to discuss this, you may reach me at my office at 212 - 909 -6694. Many thanks in advance for your consideration. cc: Dr. Sherlita Amler Commissioner of Health 222814070 N Alan H. Paley 9 Huguenot Drive - 10538 Marc . mont, New York September 18, 2006 Mr. Robert Morris Putnam County Department of Health 1 Geneva Road Brewster, New York 10509 Paley Residence 29 and 31 Hemlock Point Drive North Putnam Valley, NY Dear Mr. Morris: As we have discussed on a number of occasions, my wife and I have applied to the Department of Health for a permit to build a new house on Lake Oscawana at 29 and - 31 Hemlock Point Drive North, Putnam Valley. Our proposal involves the removal of the two existing houses on our property and the construction of a single new residence. You have informed me that, based on the information we have provided to date, the preliminary position of the Department of Health is that it would be willing to consider making certain accommodations to enable us to obtain a permit to build a four bedroom house. As you know, our original application requested a permit for a seven bedroom house, which would be equivalent to the seven bedrooms that we currently have between the two houses on our property. We understand that our property is such that we. cannot meet current Health Department standards for new construction and greatly ,._ a reciate the -wi ingness o ftne �ep�rt erat:lc .cry s�., r.:_�:ert;� r accomrr�ndatinw -.tcy - permit us to build a new house. However, having given our family's needs a great deal of thought, we have concluded that, unfortunately, a four bedroom house would be inadequate. Accordingly, I am writing to request that you consider allowing us to build a five bedroom house, which would still reduce the current bedroom count by almost 30% and improve the protection of the lake compared to the current situation. The property at 31 Hemlock Point Drive North has been in our family for over 50 years. It was originally purchased by my wife's father, and after his death my wife and I purchased the house from her mother. As our family grew, to accommodate our needs, we purchased the house adjacent to our property at 29 Hemlock Point Drive North - approximately 15 years ago. Three generations of our family regularly spend weekends at Lake Oscawana, enjoying the beauty and benefits of the lake and its surrounding area. This includes my mother -in -law and sister -in -law, my wife and I, and our two daughters and son -in -law. As you can see, on a regular basis, we use five bedrooms. Furthermore, my wife and I expect to make this our retirement home and we fully intend that the property will remain in the family for future generations. 222814070 .1' Both houses are quite old and need to be replaced. The house at 31 Hemlock was built as a hunting cabin in 1913, when there were no building codes or health requirements. Similarly, the house at 29 Hemlock was built over 50 years ago. Not surprisingly, the septic systems of both houses would not comply with current codes and the system for 31 Hemlock is quite close to the lake. Realizing that the current situation has potential negative consequences for the lake environment, part of our construction plan has been to improve the situation to the maximum extent that our property allows. We recognize that we could rebuild both houses on their current footprints with the current bedroom count and continue to use the existing septic systems. However, from both a functional perspective and an environmental perspective, this would be the least desirable outcome. I am confident you can appreciate on a personal level that it would be preferable to have the entire family in one house. More relevant to our application, construction of a single new house would enable us to remove the existing septic systems and construct a modem septic system further away from the lake. As you know from the site plan, we own two small, uniquely- shaped pieces of property that even combined do not allow us to locate a septic system 200 feet from the lake. We have worked with our architect and the septic engineer to develop a plan that, given the constraints of our property, would locate the septic system as far away from the lake as possible. We have even explored purchasing apiece of land adjacent to our property from a neighbor to further improve the situation. If this additional land would enable us to build the house that we desire, we would gladly pursue this purchase further. Building. this new house is extremely important to us,and. our family. It: represents _ ' - _a long'iamlyhstory and many iond memories; our future retirement years an d the enjoyment of Lake Oscawana for future generations of our family. That being said, we realize that improving the septic situation is an integral part of helping to preserve Lake Oscawana for years to come. Though we wish it were otherwise, we cannot meet current codes for construction of a new house. But we are willing to work with the Department of Health to devise a plan that improves the protection of the lake and satisfies the Departments concerns, yet at the same time will be functional for our family. We think building a single new house that reduces the bedroom count almost 30% and relocating the existing septic system further from the lake would be a reasonable and good result for both the lake community and our family. For all these reasons, we would gratefully appreciate it if you would reconsider our application and allow us to construct a five bedroom home. I will give you a call in 222814070 2 il two weeks to discuss this further. Should you wish to call me to discuss this, you may reach me at my office at 212-909-6694. Many thanks in advance for your consideration. cc: Dr. Sherlita Amler Commissioner of Health F] 222814070 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health Associate Commissioner of Health May 16, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Ralph Mastromonaco Consulting Engineers Mike Doebbler 13 Dove Court Croton -on- Hudson, NY 10520 Dear Mr. Doebbler: ROBERT 1 BONDI County Executive Re: Proposed Addition — Paley 29 Hemlock Point Drive North (T) Putnam Valley, T.M. 462.06 -1 -24 This Department has recently reviewed the above referenced application and we offer the following comments: ,.. 1. When propesillg4 cons ±tact -a brand rl! �w -residence which involves an increase -in.. the footprint and a change of use (replacing a 3 bedroom house and a 4 bedroom house on two lots with a 7 bedroom house with a detached garage on one combined lot), it is the decision of this Department that a new septic system that meets current code is required. 2. If the existing houses are replaced on the same footprint and the bedroom count remains the same for each house, than the existing SSTS's may continue to be used, provided the systems are not failing. Please be advised that this still requires an addition application be filed with this Department. If you have any further questions, please do not hesitate to contact us. JSP:cw eossin e rely yourseph S. Paravati, Jr. Assistant Public Health Engineer Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool(845)278 -6014 Fax(945)278 -6648 Apr -21 -05 02:52P Ralph G. Mastrromonac_u PE 914.271 4762 P.01 l_' iff 1 VY S- YvIffir"TAL SHEE 1 RNN G. MASIROMONACO, P.E., P.C. Date 4 D5 Corsuft Engineers 1.3 oove Court, Gabe -on Lrism. New York 10520 (9141 271 4762 TO: FROM I" I Dog-��Levl Fax Phone g4 " Z3 B - —79?— 1 )lone (914) 2714762 Fax Phone (914) 2712920 RTMAFM: p Urgent �Por yow review aReply .lMP QPkase Commeict PAL of F)P-Ive Nc,>FA- VALLE'f E M Loc� � P � �u Tt� AM' orteS .c F F.E= _vlaustr1f FOF- WAF -0 ED MATERIALS . W 1u.. D 1scus5 W I Yoo A E r?- Nj o JPA-r5 50AP -0 M -T�A► i> , -(o 0 j If there is a problem with tkis fax please cull us at (914) 171 4762 APR -21 -2105 TiU 14:'47 1- EL!845 -278 -7921 rIAME:PUTNAM COUNTY DEPARTMENT OF P. 1 Apr -21 -05 02:52P Ralph G. Mastvomonacq PE 914 271 4762 P.02 RALPH G. MASTROMONACO, P.E., P,C. Consumng Englneers - - (914) 271 -4762 (914) 271 -2820 Fox -+ - Mr. Robert Morris, P.E, Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Paley Property Hemlock Point Drive North Putnam Valley, NY TM #62.6 -1 -24 & 25 DOr'Robert: Please find enclosed the following materials: t. Completed bedroom count form for Lots 24 and 25 2. Completed Application To Abandon A Water Well dated March 29, 2005 3. Completed Construction Permit Application dated April 4, 2005 4. Check #300642565 in the amount of $300.00 payable to the PCDH We „would like to Oisciuss this project with you at your earliest =r;venience. ncerely, G. Mastromonaco RGM/il Enclosures April 4, 2005 APR -21 -2005 THiI 14:419 TEL:845- 278 -7921 t•IAME:PUTNAM COUNTY DEPARTMENT nF P. a Apr -21 -05 02:52P Ralph G. Mastromonaco PE. 914 271 4762 ., ... _._.._SsiF.tc;;f"TA �►�3.'ii:i�l:; Y�i��tr.a, , .-7►�- Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 PU?NAM COUNTY DEPT. OP HEALTH 1 GENEVA ROAD BREWSTER, N.Y. 10549 County Executive RE: i�lt =L Li Residence TAX MAP## TOWN 0 TN AM W I- t_ To Whom It May Concern: r; According to records maintained by the Town, the above noted dwelling: IS IS N O "I' IN CO PLIANCE'WITH town code and the total number of bedrooms is This information has been obtained from: CERTIFICATE OF OCCUPANCY P.03 ASSESSOR'S RECORD OTHER ' "b S ^� l4 vv,�� ` ^ a C� C� APP. -21 -2005 THII 14:48 w -y ( i BULL DING INSPECTOR Environmental Health (845) 278 -6130 Fax(845)278-7921 Nursing Services (845) 278 -6558 WIC(845)278-6679 fax(845)279-6085 Early Intervention/Preschool(845)278 -6014 Fax (845) 278 -6648 TFI : R4S- ?7R -79P1 tJAMF: PI ITNAM rni INTY nFPAPTMFNT nF P. d'l.W.ai��J'J.La� �1�iR: -.S 2S.�- [lu'�YL .et i -� '. N 4.42J !•:,U 'ry �Y.: '. .._ J.C,Ig'c➢'"d »a::nii,^`^r Mead. -.S tv xxewY n' - t .F'a?'-,� OF v^h3�' �' (.^''' �` r� -s-,• �-� .c,� s. '�- f'�c`s -'Aay . /.� +'a45 2 ... %`- 'ti'.g, °� ..� - �'p °r'� ` t �SY?. f _ .. _ _ y�EE YiL gg� i1.- i.- 7G�`'?� ���lJ ✓ l_ n [' tom. � J .'f-)fe F`�r t`�.5.^"�Y's� > yT d�2. y a on. tb-.n P �� k J ��,yfi�'1`",j'54 4�n t�� ,,z+y ,(!�. �iN�Yr,F i�. ff +� �°a r Y! g�4 y^ti Ti 1`•'` -�J °[{��',,'�+^ b"• ✓'� '7f�c ✓,6.Gilv�s. e�c, ,! r.4'%•f.,r.f�.. ,M4�xS�eti3lLSG'sc. �. .-T., ,. ? „�d. } „ /�. �<..��.0 it•Su'Ji {�.e.t r .. >"'�"�,•'A: t�.z. tt 1 ���� -..`' �.cafp I l •h.. S[4;�'S"R�`�A'.2 arAeb6e�+f69:rLCrnM �v,-���2t-.KD'd#C.i"�'.y{�'W .m"Tx/[SCMf_sTiY4N£7jj{Y .i YCl � _ � I ' r 1 • f� I , - ;I ,t�; � •f 1 P•ts � r � i • l” I. A � 1. l . /a Mw i�. F77 �lr..y .�•-a�....:r� � f -. r�- `t't --� � ?wy^'.- �C.• �.'."'y-..'Y^�+w- S"^�v!"'['�'LG ' _[��r_�i �.� __ _� _. - -<s -t,�- 'ri.tcM ♦!y�'� �.n. ��y,. •y��}ywl.[�I {��. -n w:G, -v ..i•' '_`F f, I r _ac - 3.. t.^ u, ' 2w "L• . —L All ¢ ,tom. 9� Jf ._e:;, �'-- .tr.TI +�r,+ l Apr -21 -05 02:56P Ralph G. Mastromonaco PE Commissioner ojHeallh LORETTA MOLINARI, RN, MSN Associate Commissioner of Health 914 271 4762 P.05 .... . , ..., . lII� - fir'- lza??. —'•- . County Execu live DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 RE: 4 L G `1 Residence TAX MAP# 2 , �O - - 2� TOWK eVrU f-pn V,ALX To Whom It May Concern: According to records maintained by the Town; the above noted dwelling: IS .- _ ..... JS-NOT IN COMPLIANCE- WITH town code and the total. number of bedrooms is This information has been obtained from: CERTIFICATE OF OCCUPANCY ASSESSOR'S RECORD OTHER Sk � C_ s V, AQ BUIWING .• Environmental Health (845) 278.6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC(845)278-6678 Fax(845)278-6085 Early Iat erventiou /Preschool(845)278- 60I4;Fax (845)`275 -6648 APP -P9 -PLAFF TI-II 1 '1 4 --l-,7 TFI -9�4S- P7R -7Q ?1 KUMD - DI ITKIOM rni IKITV r1C1D00TMCFJT na" D CZ W7 "I iyKj-� W if, WARA .. . . . ...... . oil 771 dFF J: F,� i; Ed m it �f �i, 't, 4, f —�I, Apr -21 -05 03:01P Ralph G. Mastromonac:o'PE 914 271 4762 P.07 :.... _ ,- > .. PERSONAL L HOLD OCCUI IEN- UP i0 THE L G' IT TC VI' V; - "IUC. V A'CRbL'tAK HOW DOCUMENT UP TO THE LIGHT 70 VIEW TRUE WATERMARK QNFY - " X300642565 CnP 48.61Ni'aYp�jr 036 $0.00 ONE P I C io-ee ra 023 -03 Ck:. `Ser, # 30.0642565 DATE 0 4 / 0 4 / O 5 3 0 0 0 0 PAY * ** *THREE., HUNDRED ' DOLLARS * * ** TO ORDER P 0 ..41.rn C i;J t`:�c� 1� 4.� .. I� eC. l� 4 OF h.:.: .. l/ NOT GOOD FOR MORE THAN $1,000.00. ✓; ' MP MEMO PURCHASER`S sl 3 TU Issued by Integrated Inc.. Eny e.wocd, CnIorado To Citibank. N.A., Buffalo; NY - ADDRESS 7.90. 54211° P:0220008681: .2800'30064.2565511° • J 4 APR -PI -PPIRS TI-111 14:58 TEL: 845-278 -7921 t•IAMF: F1 ITNAM rnl IFJTY nI=PAPTMFNT nF P_ 7 Apr - 21 -05 03:02P Ralph G. Mastromonacc ). PE 914 271 4762 P.08 PUTNAM COUNTY DEPARTMENT OF HEALTH NIV CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at Am y. Poit�"a• F o Town or Village PuT4AM �/Qj.1,.Cf Subdivision;.name . Subd.. Lot # _ Tax Map(PZ.62 Block Lot_ Date Subdivision Approved : Renewal Revision Owner /ApplicAiit Name `t-t ,4 'PA LEY _ _ • 'Date of Previous Approval Mailing Address, L:.: N uaUeiJoT �21VE .LAnc. ,4 0h1T . Zip 105 38 Amount of Fee Enclosed 3C;0 EX. Building Type' ' AMIL r V_G—S. Lot Area .85„�vo. of Bedrooms Design Flow GPD Fill Section Only Depth Volume FI PCHD NOTICATION IS N FILL IS COMPLETED $eDar lg$ w+agc�ft tg em to consist of 6.Ac:, gallon.septic tankiand Other Requirements: _ To be constructed by Address tes r Sunnly ;_ Public Supply F'ro - - Address _ .. to a - _ Pnvafe Supply Drilled by _ _, - -- Aa &ess I represent that I am wholly and completely responsible for the design and location'of the proposed system(s) and that the scnarate'sewage`j&a ant sygm described above .will .be constructed as shown on the approved amendment thereto and in accordance: with tthe standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Cotnplidnce" satisfactory t6 the Public Health Director will be submitted to the --1 Department, and a written yarrptee ie, furnished the owner, his successors, heirs or assigns by the builder, that said builder .will place in goodt`iftatg:eoitditii ,any.,part of said sewage treatment, system during the period of two (2) years immediately following tlje dab of the issuance of the approval of the Certificate of Construction Compliance of the original system or:an Signed R E y R.A. Date 4I 4-joS q Address # 5Q- l APPROVED FOR CONSTRUCTON _ This�approval expires .two years from the date issued unless construction of the sewage: treatment system. has beets corn kted.and.inspected by. the PCHD. and is revocable for cause or may be amended or modified;:}yhen considered necessary by the Public Health. Director.., Any,revision or alteration of the approved plan requires a new Wmit. ; Approved for discharge of domestic sanitary sewage only.:.. By: Title: - -- Date: White copy- HD ,i:ile; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 APR -21 -2005 . TH' U 14:54 TEL : 845 -278 - 7921 NAME • PI ITNAM r ni INTV nPP00TMCA1T. nE- 0 0 SHERLITA AMLER, MD, MS, FAAP -,i-42 LORETTA MOLINARI, RN, MSN Associate Commissioner qfHealth DEPARTMENT OF HEALTH I Geneva Road, Brewster. New York 10509 Ralph Mastromonaco,'P.E.,P.0 13 Dove Court Croton on Hudson, NY 10520 ROBERT 1. BONDI March 18, 2005 Re: Proposed Addition Paley, Hemlock Road North (T)Putnam Valley, TM#62.6-1-25 Dear Mastromonaco: Review of plans and other supportingdociunents submitted at this time relative to the above - regarded project has been completed. Coniments are offered as follows: L "-,,The bedroom count form, Certification of Occupancy, has not been completed and signed by the Town of Putnam '�,ailey Building Department. (Enclosed) 2. ".Minimum distance from a seepage pli to the foundation is 20 feet 3. A well abandonment permit must be submitted to abandon well labeled "C'. 4. Please submit a completed 5. No fee has been submitted. Upon receipt of a submission, revised to reflec.1 die above comments, this application will be considered further. yS ;ely, L Robed Momis, P.E. Senior Public Health Engineer: Environmental Health (845).'':: , !.;.I. � Fa; (845)278-7921 Nursing Services (845) 2.78-655 Wl(--:", ";5 -66778 Fax(845)278-6085 Ert--lylnterventioq,'Prescho�; r. Sw:" F"jx(945)27M648 PROTECT NAME: 31 HEMLOCK POINT ROAD NORTH SK #• 01 SKETCH TITLE: PLAN EXISTING CONDITION - EXISTING HOUSE PLAN '9-CAL� Bedroom atbroom Bedroom #1 #4 Master edroo Bedroom Screen #2 ##3 Living Porch Room Kitchen GROUND FLOOR MICHAEL GOLDMAN Architect, P.C. 43 WEST 24th STREET, EIGHTH FLOOR NEW YORK CITY, NY 10010 Ielepbenv 212.989.9980 fox: 212.989.9981 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CANS 1 ItUCTI ®N PERIV�IT F ®It SEWAGE TREATMEI�f SYSTEM PERMIT # Located at O 1 Hamm,- y- Poi4r Dp IVE tA opq-�— Town or Village EZ AM VALLam_ Subdivision name Date Subdivision Approved Subd. Lot # Tax Map Block I Lot Renewal Revision Owner /Applicant Name AIA- L PALE-1 Date of Previous Approval Mailing Address HUG ue lJ CST D a I yE LA RG0 M o i-)i° Amount of Fee Enclosed Z-> cc:) Building Type 1 F-A M I Li 121 :5 Lot Area -85&-No ESC. of Bedrooms _7_ Design Flow GPD. Zip pl 538 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED F--V %ST I V, C Separate Sewerage System to consist of Z - 5006 AL, . gallon septic tank=d E)t. e-o&;C Eq � :5��iJ A/,P F ITS Other Requirements: T To be constructed by �( Water Supply: Public Supply From Address Address Mt! PPivaie- D--ni l'..'d by- 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 Qt�e a furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in goodre�liejatfa&con�ditio y part of said sewage treatment system during the period of two (2) years immediately following r of. the approval of the Certificate of Construction Compliance of the original system or an p rs tfieretQ Signed: Address P.E. ;K R.A. Date 4 4- o5 License # 54.4913 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. 0 Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 i �• Commissioner of Health �LORETTX MOLINARI, RN,�MSN ^ x Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 1050.9 County Executive ' PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, N.Y. 10509 RE:. T-�'O L L Residence TAX MAP# (fl 2 2 TOWN_ _ _ &t Q ..A vn V AL.J- E-( To Whom It May Concern: According to records maintained by the Town, the above noted dwelling: IS �/ IS NOT IN COMIPLIANCE WITH town code and the total number of bedrooms is This information has been obtained from: CERTIFICATE OF OCCUPANCY ASSESSOR'S RECORD' o Si OTHER -� V� d .�, BUILDING , 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 F•' Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 1050.9 "County Executive PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, N.Y. 10509 RE: Residence TAX MAP# G2- TOWN __f U I ti Avv V�LL- To Whom It May Concern: According to records maintained by the Town, the above noted dwelling: IS IS NOT IN CO ,MPLIANCE WITH town code and the total number of bedrooms is f This information has been obtained from: CERTIFICATE OF OCCUPANCY ASSESSOR'S RECORD OTHER Y "� S �rv� A-0 G.ske b v� re t,`�►/Y -Q WX SSA �`J BUILDING INSPECTOR 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 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES C. pnr.. �.wwt'!.. -� +:V'. •1.+ � v u Kr W': .t�3r. r. .. . :.R +�_- .. ... ..s .,�... u'W:� - -x1� . .� — .0 �.��i:[T la.wa � .btu:__. r_ -_. APPLICATION TO ABANDON A WATER WELL please print or type PCHD PERMIT # Well Location: . Address: Tax Grid # pTownNillage Z9 HE MLc�K I c W-r .I - PUT4WALLF--rMaP620lock I Lot(s) 2 Well Owner: Name: AW FA' LEY Address: 9 H urm DoT DR. LARD y r= o Well Type: Drilled Driven l< Dug Gravel Other ']Depth Data: Well Depthft [Static Water Level J!5t�_ ft Date Measured Use of.Well: 'Residential Public Supply Air /Cond/Heat Pump Abandoned 1- primary Business Farm Test/Observation Other (specify) 2- secondary Industrial Institutional Standby Water Well Contractor: Name: A11ddress: 41DEPso� DP-I LLI N(�,- �)AP-6-1rP- ST- PUT4M VALLEY Reason For Abandonment: wl, �11 IVOr �E�N� USED. Description of Work To Be Performed: I EX IST"ItJC� W P E- �I LLEi�A' 0 BURL IEDA-E,S � 1Lt-TO Pc- DH PZULESAND RE:l -" 0LA-rj 05. \VELL'(f AS 0c)rJ PL.A►� . Date: - 2'1105 Applicant Signature: PERMIT This permit, to abandon one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and/or Part 75 of 10 NYCRR and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. . Date of Issue Permit Issuing Official Title White copy: HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WA -97 F[AIL -IF 1 J1 NISM 560 him . . . . . . . . . . 1811 Jt M.Ibedrvoy it GROUND FLOOR PLAN 6 -4 Flick i I Mudmom -W mw-m cz cz CL UP cz. W, Gnat Room Lj V—;\ l Xrrh E Dn. Wlorkbencb milh Sink gr Below UPPER FLOOR PLA l'V edruom I Bath Bed omi Bath Bedmo L CL CL i CC Shdr H,11 - -1 W/D Linen Dn. 1 I Bedrt gm Bedro�m Open to Grraj Room Beam L Open Deck I I i I Rod Belam 1 Barbecue Chimney Valk I I I I I I I I I I I I I I I I l I I l I IL- I L---I LI =4-1 ---I Dn. t' I ' I I l..r y Area I 3t I 2' j. t ti is t' ji. .j