Loading...
HomeMy WebLinkAbout3127DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 63. -4 -15 BOX 25 03127 .. N: ,. 17-Mir J O 1 ��.. J 1 1 , . is I al 03127 Owner /applicant Name Mang Address r� PUTNAM COUNTT DEPAMI NT OF HEALTH Dlvlaton of EavhoamenW Health Set' . sea, Crsmel, NX.10512 Mast P.C.H.D. Permit III trl J 3- Town or Village " T. Map Block ! _Lot Z Subdlviplou Name Canis" Subdv..Lot # -2— Fee Enclosed 2L Amount ®O ® Date Permit Issued Separate Sewerage System built by 0 0— Address ACCIm C.49&—S Consisting of — Gallon Septic Tr nli and 220 k-k Wow Supply: Public Supply From Address on f Private Supply Drilled by L __ Address V A TiI✓AW Ail. ;5AW94- CTG'7O_ •, Barg Type Ze i,�e�tl �a.a� Lot Size Has Erosion Cnntrnl Rppn Cmmpl ptpti9 Number of Bedrooms r, Has Garbage Grinder Been Installed? 06 Other I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work I copies of which are attached), and in accordance with the standards, rules and r lati ns, i accordance vi filedilplan, and the permit issued by the Putnam County / par ntt Of Health. Dab ��r �T Certified by Kl:.60000"R.A,. Address ' LlpnU No. Any parson occupying prarnisei served by the above system(:) shall promptly take Such action as may be neceisery to sawn the correction of any unsanitary conditions resulting from such usage. Approval of the separate system shall become null and void as soon as a pubs;: Unitary •Isle/ becomes available and the approval of the private water supply shall become 1 void when a u lic water Supply beeomee ovallabhk Such approvals we wbJatt to(`mo�d�H,katb or change when. In the Judgment of the 1 o of Ma eh revocation. modlfiutbn Or Change U n.ry. ,9 Date Z ey Title -i�i— '--- --------- ~—~~~~ DEPARTMENT OF HEALTH 1v sidri"'O PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATION 12 Richards Drive, Putnam Valley WELL OWNER NAME: ADDRESS: LPL Custom Builders, 11 Sun Hill Rd, Katonah, NY 1053610PUBLIC 0 PBIVATE USE -OF WELL 1 - primary IN RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR/COND.1HEAT PUMP 0 ABANDONED ' 0 BUSINESS 0 FARM 0 TEST/OBSERVATION 0 OTHER (specify) AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED _/ EST. OF DAILY USAGE — gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY []TEST/OBSERVATION []ADDITIONAL SUPPLY [ONEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA 2251 WELL DEPTH ft. 51 STATIC WATER LEVEL ft.1 5/13/94 DATE MEASURED DRILLING EQUIPMENT Iff ROTARY IM COMPRESSED AIR PERCUSSION 0 DUG 0 WELL POINT 0 CABLE PERCUSSION 0 OTHER (specify): WELL TYPE 0 SCREENED 0 OPEN END CASING M OPEN HOLE IN BEDROCK 0 OTHER CASING LENGTH BELOW GRADE 39 ft. JOINTS: OWELDED C9THREADED OOTHER WEIGHT PER FOOT 9– Ib./ft. I DRIVESHOE. 129 YES 0 NO LINER: 0 YES :M NO SCREEN DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? FIRST 0 YES ONO GRAVEL PACK 0 YES 0 NO GRAVEL SIZE: DIAMETER OF PACK In. TOP DEPTH ft. BOTTOM DEPTH — It. I WELL YIELD TEST If detailed pumping METHOD: 0 PUMPED tests were done is in- 10 COMPRESSED AIR formation attached? it more detailed formation descriptions or sieve analyses VELL LOG are available. please attach. DEPTH FROM susFACE "I" Well WELL DEPTH DURATION DRAWOOWN YIELD Land surlace 1qtor i 11 i aa in overburden clay & boulftrs 225, 6 180 35 10 40 Drilliag in rock, set casing, grout?d 40 225 Drillliag in rock granite WATS 0 CLEAR TEMP. QUALITY 0 CLOUDY HARDNESS 0 COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? 0 YES ONO STORAGE TANK: TYPE Well Xtrol WX250 CAPACITY 44 gallons GAI�. PUMP INFORMATION TYPE submersible CAPACITY 7gpm MAKER Gould — DEM 160' MODEL 7GS 5412 VOLTAGEL3_0 HP 2 WELLORILLERNAME P.F. Beal & Sons, In DATE ADDRESS 4 Putnam Ave. SlGt�JATZUR/E 7 /94 Brewster, NY 09 3/89 FA PUTNAM COUMN DEPARTMENT OF HEALTH DIVISION OF. ENVIRONMENTAL HEALTH SERVICES _ s�rr yrr •C' -•rMa ..v.ila. •�c...rba �T 'r+s .Nr- ��i „-•YY .-v-.-.L4'�'s .vr. r..p tv-- r.�al�r.�rr �`�•G"•.w�.v •rd.f •Vwha. arty -•4 •.r.4 ��•yr('�'r lr +nf-.1 ti13Aa��� -a �vu.+n Leo & Christina Ferrari Owner or Purchaser of Building Building Constructed by 1Z 'RI C & hi &#• e' Location - Street e? 706 Nll I” Municipality Building Type 35 14 Ma. Section ock Lot —J)OGr 4jeeaJ G*_*fs Subdivision Name .L Subdivision Lot # GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as 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 "C.ert -if icrate--of _ Constr_uct•ior. • Compl-iance" . far . the. sewage disposal systen . 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 Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day of/ 1)5)-19 `� Signature Title general 7 ii6tol/(Owner) - Signature Corporation Nam (' Corp.) i �� //� , - �,�� r Address rev. 9%85 mk �'/ Im \"if. _.....�v.`stnr c�mT n *r ncInnnrn Office Use Only - Divisinr et ices NR�DEPARTMENT]FHEALTA PUT STREET AOURESS: ___ffW_N1VlLkACT / City TAX GRIO NUMBER: WELL LOCATION 12 Richards TR, Putnam Valley NAME: A00RESS P81VATE WELL OWNER LPL Custom ,rs, 11 Sun Hill Rd, Katonah, NY 10536 Q PUBLIC USE OF WELL Iff RESIDENTIAL PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED 1 - primary O BUSINESS If-ARM O TEST /OBSERVATION O OTHER (specify) 2 - secondary ❑ INDUSTRIAL MINSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. 1N0. PEOPLE SERVED /, EST. OF DAILY USAGE gal. REASON FOR ❑REPLACE EX`SUPPLY ®TEST /OBSERVATION []ADDITIONAL SUPPLY DRILLING []]NEW SUPPLY SELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL —IL ft. DATE MEASURED 5/13/94 DRILLING ROTARY TMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT O WELL POINT MBLE PERCUSSION ❑ OTHER (specify): WELL TYPE 1 O SCREENED IEN END CASING ® OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENS �TH 40 - ft_ MATERIALS: G STEEL ❑ PLASTIC ❑ OTHER CASING LENGTH BELOW Ell 39 ft. JOINTS: O WELDED G THREADED ❑ OTHER DIAMETER I, in. SEAL: G CEMENT GROUT O BENTONITE ❑OTHER DETAILS WEIGHT P`-- FOOT 1 A lb./ft. DRIVE SHOE: G YES ONO I LINER: OYES IC NO 0(Atd£� 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (it) DEVELOPED? ; DETAILS FIRST _ - � "fES= 12 No . . SECOND i HOURS GRAVEL PACK O YES GRAVEL DIAMETER TOP BOTTOM O NO SIZE: OF PACK _i in. DEPTH ft. DEPTH N. WELL YIELD TEST ' If detailed �a/ 'WELL LOU if more detailed formation descriptions or sieve analyses are available, please attach. I METHOD: O PUMPED t tests we- DEPTH FROM i wafer well 7 COMPRESSED AIR ; !Ormatioit* SURFACE. Sear- 012- FORMATION DESCRIPTION CODE ing O BAILED O OTHER ❑ YES Meter tt. It. WELL DE PTH DURATION DRAV10OWN S unrtacc 10 Dr lli icr in overburden clay & bould rs It.. hr. min. It.:: 10 i ro k at 10' 225' 6 180' 10 40 Dr"lli g in rock, set casing, grout d 40 225 Dri 111 ag in rock granite WATER O CLEAR TEMP QUALITY ❑ CLOUDY HARDNESS L OY STORAGE TANK: TYPE Well Xtrol WX250 O COLORED ANALYZED? ANALYSISArI'ACHED? OYES O i PufKF INFORMATION CAPACITY 44 gallons GAL:" TYPE submersible CAPACITY wEt is oRiLLER NAME P. F. B e a l & S o n s, In DATE T MAKER Gould DEPTH ` Aoo9Ess 4 Putnam Ave. SIGNATURE MODEL VOLTAGE _„ - 7GS05412 230.;.1 Brewster, NY 10509 BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. (914) 855 -1930 -- WATER ANALYSIS REPORT - SAMPLE NO. 8498 SOURCE: LPL Builders 12 Richards Drive Putnam Valley; N.Y. COLLECTED: 8/2/94 BY: P.F. Bea 1 & Sons BACTERIOLOGICAL EXAMINAMON Coliform Count, MF Method TEST WELL 0 per 100 ml. 8/4/94 This arsult indicates the source of the sample was of satisfactoy sanitary quality when the sample was collected. y �e .rf __.._ �ranti.�a•.a•..�'Jti .rig. .r.o.••�YV..wn. aen!u�: �v�yn`. ^�- t•-�L " "= i >WY�,au�: -•. ve.a�n. �yW��pye��y �pv��y�ey, .���o��y perry( n•: ''y¢,1 �q�ty�����yr ••• MU•/ 1��.�1.t:.4v.�.�W.�- :K'��a_v -,f �.-'. u.��c�r'...•.a .•• _ __. IL09 U{� V V � Y lL9 L:F •IL�Y II�Y��/Y ➢Y Lti�t•.�e•r w T•••�. �-.sr -r ..�.f n _ Box 224 - BREWSTER, W.Y. (914) 855 -1930 SAMPLE NO. 8498 TEST WELL SOURCE: LPL Builders 12 Richards Drive Putnam Valley, N.Y. COLLECTED: 8/2/94 BY: P.F. Beal & Sons BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 8/4/94 This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. 0 per 100 ml. John M. Simmons, M.D. -7:1 :PUTW' , COUNTYz-fFALTff-M;1)ARU1ENr- DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Cmmissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME Orig. Routine Orig. Complain ADDRESS Orig. Request 'No. Street Town TK No. Compliance Complaint Camp MAILING ADDRESS Final ,P.O. Box Post Office Zip Code Group Illness Construction TELEPHONE PERSON IN OR INTERV DATE TIME IqZkr Name and Title TYPE FACILITY TIME LEFT Reinspection Field, Sampling Only Field Conference Other 7 /INGS: el<lt /,- / , 5 13 '1, i � � Explain INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: .. ...K. < .... _ 1R T=ER - L� ®�fR�4� Sox 224 - BREWSTER, N.Y. (914) 279 -4945 SAMPLE NO. 8477 SOURCE: LPL Builders COLLECTED: 7 / 7 / 9 4 BY: P.E. heal & Sans BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method TEST WELL 0 per 100 ml. 7/11/94 This result indicates the source of the sample was I of satisfactory sanitary quality when the sample was collected. • of ii 4� 0 D147-E e// 7h/ A. o �- a „�.y' � •y�.�r 3 ' am County DePgrUeat of Health Putn Services th a Division of Environme ntal Real N a. as noted ormanoe with YOT OOIIY Approved atione of the Ralee and Hem le apDli ealth AeD�alp' (/V/ to 0 Signature Title ' r bo C4 x _ f. Fs,e iViLl PUT'Nr! ��/ir'GLE� ` ° /9 iti "-- • e '"v= = r�) � � � 19I'S IS TO CFIItTIFY THAT THE SEWA# DISPOSAL SY31TA1 fie- = -'T _ z �1 �,�e" .A (� I/fS CONSTRUCTED AS ib70ICATED ON THIS PLAN AND THAT *10 '� '.,:e'_:i SYS? ii W II ^- p= E BY 14 B7_i0RF. IT WAS COVER- ED.-OVER Q 80 -OVER ; ; .'.:i=... 2=.15 CONSTR14ED IN ACCORDA•NCS #!!H ALL TF: iU : A14D V 3 z yg ' ti �� c REG-,;WT1bkS OP THE PUTfin 1701/117 DEPARTiEHT Or' HEALTH. '� 0 V `C . ` • Of' NEW �� DD ' z z- 4 .' ' �FOFE5710Yi1'� ��ilf�a 4 a 1 ll , / 0 -rO i }t. ;. y'. I represent -that 1 am wh011y,Snd completely fesP0n0bl0 for the design and location of the proposed system(s)1 1) that the separate tewa dis owl s stem above Aascribeft will be constructed as snowe on seta approved amandmeAt there to an in accordance with the d% rules an rpu a . ions or e ° a County -Department of . Maalth, and that on compNtion thereof a "Certificate of Construction Compliance" satisfactory/ to the Commissioner of Maelthwill be submitted to the oepertmad, and a written guarantee will' be furnished the bwnw,.his succesms, heirs or assigns by the busker, that old, builder will VIM ill good operating condition any part of said sewage dispool system during .tha period of two (2) yeas Immediately following thedate of the iwu- ahce of the approval of the. Certificate of Construction Compliance. of the original system or any repairs thweto; 2 that the drilled well described allow will be located as sAO/ow/1!n on tha approw plan and that old well will, be lnsta i a non with the ti, ru had rpu ads of the Putnam bounty Depa,C Health. Date � 7,, rh� c � Signed P.E. �A:A. Address — the . . ®�� © License NO APPROVED FOR CONSTRUCTION: This approval expires two years f date Issued un construction of the building has been undertaken and is revocable for cause or me be amaided or modified when Sid ad n ry pry the Com i r of Wealth. Any change of alteration of construction nouhet a new mit.A13 OWOwd for disposal of domeslk unitary erg and /or prWa ter w b only. zev. z� LO/88 Date By Title . °l — . ca C4 T 7 ca r C . c«,C.1 - Dam= c= - ric- L LG= W C- CTG ^ter , T-u- E C C , ' _ `�- % } r- ? , 000 - _- c= T ilti ' C q T __C-,_a WE cantar 11 1 •_�_ irr i J. r c- c--. —..� C,? c� C"4; _� I to _ r, =n Lam - r ^Lc CCs ==- r 0 -car c� -c an ji =�l 1cG =_ = = a _ seS`_ea C_ u 17_;- C_cr•C_ _ I C=C-' ���C 18 c rc : -' i a _ _ 1 Grp =:. �. ---_- .-- I - v C-C:U. _ h^ I n C A I C:_�= _==C° - ' S� _ C__L_ 1C =� C = _CC .c - L -C- r 0 DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 PCHD PERMIT #1L� WELL LOCATION Street Address D rvc� ilge C y Tax Grid Number T71�xjzm__ WELL OWNER ame B' Mailing . Addr ss Z °j'ua A rivate O Public USE WELL - primary - econ ary VCRESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT .1�_ gpm /# 0 REPLACE EXISTING SUPPLY kNEW S PLY NEW DWELLING PEOPLE SERVED /EST. OF DAILY USAGE CfDOgal ❑ TEST /OBSERVATION 13. ADDITIONAL SUPPLY O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR 'DRILLING. O c!jj1.pm J.� WELL TYPE DRILLED ®DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 4201E MA /�frIlIzes Lot No. 17- WATER WELL CONTRACTOR: Name A, rldimwsaW Address: ,f,Q6 A?- ,N,Oof ,/ttc,7 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY - _ —DISTANCE TO. - P.ROP.ERTY..: FROM . NEAREST._+ .T- ER-MAI.N.:._._. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED : ON SEPARATE SHEET P a (date)' (signature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt�� (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit :a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such manner as not to degrade or oth wi e- contam' ate surface or groundwater. Date of Issue: L 19 3 Date of Expiration 19 Permit Issuing Official Permit is Non- Transferr Ale White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller J PUTNAM COUNTY DEPARTMENT OF HEALTH I�46 = 1FIRON?4EN -rAJ; =HMi Date .51 2 3 Re: Property of J,1 C'7 0 Located at ((,/C•� (T) vT 0} I/Ac,(,f4 Section Block ___q Lot Z Subdivision of �D6 (�1/UQ� / ,�6S Subdv. Lot # Gentlemen: -2 Filed Map # '2-2./3 Date 3 —y-17 This letter is to authorize l6- /o9-m 7�1G�2 a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in •- eoh eot- o-if,= Sri -t-h -this mat -t -er =aiid to supervise -=th -e- �cori'struction"of'-s-a- d. system or systems in conformity with the provisions of Article 145 or 147, Educati tary Code Countersignedi Public Health Law, and the Putnam County Sani- P.E. , , r# le . Address Telephone Very truly yours, Signed VW7 of rr P// "Irz� J� - c 3vA) Address Town �6,,2 -��i� Telephone % t / tt• I �1• •01 I� • -.12"14 Y. •' • 1' •' 1� Y 'I �• M�. f—y, .. .. — ..r-•' - �f ` . -w , .t...r...e w_f- ..s+t=> r v.:. • m . .. DfiTGN�DATl� SEAT- SiJ "tTr'piC° Sr1F,GE „DISPOSAL SYSI F1'i� -IAA: Omer � 71- L �1 ill Cr -21<o Address / 2 IP! /,U /�, I-L l�.l� ).fTOAUA14 Ally Located at (Street) P, Sec. __:IV Block _ / Lot z• (indicate nearest cross street) Municipality 7- AIAAvl /Ll��"}/ Watershed • • • �1• �• •' M�. / � Y• • �•� 1• �I • 1 4:11 • • • Date of Pre- Soaking Date of Percolation Test HOLE NUMBER CLACK TIME 20OLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches C! IC2.4-7—e— / ,5- 11f//li r,+j + 3 C;-,U7-1r(-et 4 CP 7 5 2 3 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated: at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 TEST PIT DATA REQUIRED.TO BE SU13MITTED WITH APPLICATION DESCRIPTION OF SOILS INCOUNTERED IN TEST HOLES DEPTH NO HOLE NO. HOLE NO. - .... ;r -.x• _,,.. „ ..n-• ... •rT?� .a• r:v va, ,:.�.rt�%'°s^e%. —s:i^ ^°.°ar. .i.:r..:.✓.AU: s G.L. -� J ( 61I 1° �Y 2' 3' 4' 5' 6' 7' 8' g' 10' 11' 12' 13' 14' LEVEL AT WHICH GROUNDWATER IS �ENCOUNTERED w � . _ • _ ._... _.... ,,..�, _...�..�,,..;....: _ - _.. �„��._:.� .... 4 R/G INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: el - d V4 0,V,4Af DATE: DESIGN Soil Rate Used /S' Min /1" Drop: S. D. Usable Area Provided 70 0 0 % f� No. of Bedrooms Septic Tank Capacity /2-0 O gals. Type Absorption Area Provided By 510 O L.F. x 24 ". width trench Other F _ t Name f4G //I/d9 /GG'7�. Signat L 4 Address Z OA./ c Zs S f ... THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date T C) F :-EI✓�_�T APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM (.., T. •.a F ✓ . .-4. . ...r q rr- - .�..jr...... �11.'G�HL..G:, n Name and Address of Appliczn t:: NaT c Project: S iC �7'/6a.1 , v,2 c?L �.R�cr72kD 3. Location T /V /C: �vrdoF.st lf.cca� Project Engineer: &44ZW, ai 2,t: —/.a72__ 5. Address: _mod' �� � mod. License Number: Phone: Tvice o= Project:'— Private /Residential Food Service­ ­7' - Commercial - Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) • Is th's.project subject to State Environmental Quality Review (SEQR)? Tvoe St?tus . (Check One.) Type I.... Exempt Type II. Unlisted • Is 'a Draft Environmental Impact Statement (DEIS) required? .............. o Fes D= =S. been co:rpleted and found acceptable by Lead Agency? .......... Name OF. Lead> Agency...,;;:.:.:_ Is this project in an area under the control of local planning, zoning, or o h 'Fdfficials, ordinances? ......................................... es' If so, have" plans been submitted to such authorities? .F ................. Fes preliminary approval been granted by such authorities ?„ YX-s Date Granted: Type cf Sewage Disposal System Discharge...... Surface Water round Waters If S•!rf1ce water discharge, what is the stream class designation ?........ Waters index number '(surface) ......... • .. ............................... Is Fr; iect located near a zl ublic water su system? ? P P. Y Y If des, na ie of water supply Distance to water supply 15 Ct, . site near a Dubl seiiage C:.iection oil C'. --Poste «'s�ar ^..... 0 Na.::_ c,2 sewage system Distan-ce tc sewage svtteu1 Dam_ c: served: 23. N°_.71e of FeEl h inspecto". Prci_c: design flow (g-lIons per, day) ...... ............................... oc>do 2. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?:: Has ySPDES Appl i cat ion been suEri �ted to�loc�l- DEC'Cifr`ce ?' :.'.:'.'::.:::"' :`�'" - T Is any portion of this project.located within a designated Town or State wetland? . ............................... ............................... WetlandID Number...... .. .................... .A.......... .........I...... Is Wetland Permit required? .............. ............................... Has application been made to Town or Local DEC Office? .................. Does project require a DEC Stream Disturbance Permit? Is or was project site used for agriculture] activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, land-Filling, sludge application or industrial activity? ........ YES or NO Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO DESCRIBE: ° - Is there a local master plan or file with the Town or Village? ........... s Are community water, sewer facilities planned to be developed within 15 years? _... -Are -any-semage. disposal are-as: i.n Excess of 15A. s.lopt? .. TaxMap ID - Number.......... ....................... ..... ........... S. Approved= Plaris =are to= be `= returned to: Applicant Engineer the - a ;:plic3tion-`is`;signed....by -a: °-person .other than the applicant shown in_Item 1;' the )lication must be accompanied by a Letter or Authorization. ' Failure to cerrply with this )vision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this for„ is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A Hisdemeanor pursuant to Section 210.45 of the Penal Lair. 1 TURFS O=E=C.A_ TITLES: LING ADDRESS. e- q THECORNWALL. 27'8" X 44' •2434 S . q Second Floor uO O� — ..,r:_ .. a.,,;.r. -a — - —. .. r..n n..._ra..r...._....e o- r. ~.�Li r. _. atir�,4�� ♦. .. r�.+:: i BEDROOM 4 13' -6' X 9' -7" I 27'8' H c v I OPEN TO MASTER BEDROOM 1A BELOW BEDROOM 2 BEDROOM 3 12' -0" X 18'-9' 8'•8' X 10'•8 I0' -0, x 13,- 44' First Floor KITCHEN /BKFST 18'-5" X 13'-0" I D W � dagk --rte -- --- FAMILY ROOM 18'-8'X 13' -0' OPTIONAL 10 FIREPLACE OPTIONAL ANGLE BAY ROOM UVING ROOM DINING _ ININGX1$.0. 27'8° 44, -- - - I STANDARD CORNWALL FEATURES • 4- Spacious Bedrooms • Framingham Pediment on Front Door • 2%2 Baths • Fireplace Options Available • Open Two -Story Entry Foyer • "Boxed -out" and "Angle Bay' Options • Formal Dining Room Available • Formal Living Room • Consult an Authorized Westchester Builder • Country Kitchen Features Island with Solid for a Complete List of Options Maple Butcher Block Top and 36" Desk • Artist's renderings and Floor Plan Dimensions are "Cottage-Style" 3056 Lower Level Windows approximate. All specifications must be Written in the Contract. No oral conditions. with Architraves on Front ESTCHESTER MODULAR HOMES, INC. M p M 30 Reagans Mill Road - Wingdale, NY 12594 11 R (914) 832 9400 • (800) 832 -3888 10/92 acv APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INIDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET for ,CONSTRUCTION PERMIT ,,.. ;M NAME OF O R 5 �" Z « STREET LO r TION iLk BY � DOCUMENTS. Y N b�rERMIT APPLICATION PC -1 DATE GIII 13 TAX MAP # 02.�, 1I° 1- WELL PERMIT;W pWS LETTER ENGINEERS AUTHORIZATION DESIGN DATA SHEET(DDS) DEEP HOLE LOG Ll Px PERC RESULTS (3) L-' J PERC HOLE DEPTH EB,ro-RpoRATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST ISCHARGE (OK) ERC & DEEP HOLES LOCATED N V PRESENTATIVE OF PRIMARY AND EXPANSION X73 . AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE PUriiPED PTT &D BOX SHOWN & DETAILED [��HJ OUSE - NO.OF BEDROOMS G WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM PROPERTY METES & BOUNDS LiJ-HouSE SETBACK NECESSARY (TIGHT LOT) . LIJ-HOUSE SEWER - 1/4 "/FT. 4 "0; TYPE PIPE EfINO BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS YBARRIER GENERAL 0 FT HORIZONTAL: SLOPE 3:1 TO GRADE LEGAL SUBDIVISION FILL SPECS SUBDIVISION APPROVAL CHECKED DEPTH GAUGES M PERC RATE 1 FILL PROFILE & DIMENSIONS m FILL REQUIRED � ,VOLUME ' FnATA URTAIN DRAIN REQUIRED mSTANDPIPES TRENCH X- APPROVAL SSDS ADJ. LOTS LF TRENCH PROVIDED a?n ETLAND (TOWN/DEC PERMIT R & D) 0 FT MAX 1 ON DDS PLANS & PERMIT SAME PARALLEL TO CONTOURS 1969 -NEIGHBOR NOTIFIFICATION 100% EXPANSION PROVIDED RBI/ZBA SEPARATION DISTANCES SPECIFIED ON PLAN `, P,- FL-GOD-EL-EVATION- - _.- .- FI�EI:L —S..r � .�� ::, . �_. •- -- � - -- - - _. _ _.� _ REQUIRED DETAILS ON PLANS l�1 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL SEWAGE SYSTEM PLAN - (NORTH ARROW) 952(Y TO FOUNDATION WALLS SSDS HYDRAULIC PROFILE m GRAVITY FLOW 20 100 TO WELL, 200' IN D.L.O.D., 150' PITS D/ J BOX m TRENCH/GALLEY =1 P- PIT DETAILS ® 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) SEPTIC TANK - SIZE, DETAIL ® 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER LL DETAIL, SERVICE LINE IF OVER ®10' TO WATER LINE (PITS -20') CONSTRUCTION NOTES (GRINDER RATE) ® 50' INTERMITTENT DRAINAGE COURSE ffi DESIGN DATA: PERC AND DEEP RESULTS ® 200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS TWO -FOOT CONTOURS EXISTING & PROPOSED .1 SEPTIC TANKS Z' RIVEWAY & SLOPES CUT ®10' FROM FOUNDATION; 50' TO WELL L�LJ FOOTING /GUTTER/CURTAIN DRAINS WELLS X15' WELL TO P.L. COMMEATTS: DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278-6130 June 11, 1993 William Zeiler Concord Road Mahopac, NY 10541 Re: Proposed SSDS: Snetzko Richard Drive (T) Putnam Valley Dear SZ-- JOHN_KARELL, 41..:,*2.F ;M.S... Public Health Director Review of plans and other supporting documents submitted at this time relative to the above-captioned project has been completed. Comments are offered as follows: 1. 100% expansion area is to be shown on plan. 2. Actual SSDS hydraulic profile is to be shown on plan. Invert elevations for the septic tank and.junction boxes are to be noted. 3. Erosion control detail is to be shown on plan (hay bales). Upon Receipt of a submission, revised to reflect the above comments, this —_,application will be considered further. Very_truly yours, Robert Morris Assistant Public Health Engineer RM/jp i 7 0 At YELL t` •GL6Y �B.�S.s �S+ 77. 677.4 G n.8 /ZOO CAL. CDNG. 6Nr8 X20 /N. SLOPE � ✓IFFY /C TANK BJOR% %ON T CNGNC! /FJ F a ✓/'L OPE s� /� )leg r. o s / �• D P / ! V g 6• �1 p �I/rNAM Y.QLL Y, NEJf'• Yot.0 ik �•e PREPARED .BY� 1 ` • 4•�.� PROPOC.. °o yACq�,� ? � %�i[L /AM IE�I/LE.Q - SsDF, � V PRoiESS�oNJII►t EN6��'`ER �.vp 323• -- -' ' ; t Aa erdYOX t► Co,vcn.eo .eo., �A,voP.rct.Y.Y. County Putnam De Dartment of Health •, DisiBlOn of Environmental Health Services of NEW • .3 z' •. ill O .�Pxfc YdR Approved as noted for conformance with l�XPM F' app11 a Rules and Regulations of the Count alth Department p r Slgna$agae &Title D N ✓ 63 W� f o. U b yfED Pe0FFS510M�'�A@ ?Y .. I IIILII..L� CC W I I � I IW wl ' o I I i•� I CASING 2O FT. MIN. LENGTH UNDER ANT ICONDITIONS. ucr F`I I I W '•f. I I USE CLAY PUDDLE CORE Q BETWEEN CASING AND • � DRILL HOLE. SOLID ROCK CASING, /2' MIN GROUT 10' MIN.' IN ROCK SEAL THICKNESS ;5 14 SANITARY SEAL ON WELL CAP 1� }� SCREEN VENT WELDED SLEEVE . 48 M4 'r, IP TYPE COUPLING r. FROM PUMP AILI TO PUMP WELL CASING \ I BUSHING yi TYPICAL . SECTION OF DRILLED YS'FLL 1 i . r ASPHALTIC . 11}�i\ RING II INLET Il j If Q y� i I BOLTS _ I I O OUTLET CONCRETE SEPTIC TANK I I L� SLABS POURED IN PLACE T__ t_. ARE DESIGNED TO ' SUPPORT A MIN. LOAD OF = e — i ° PLAN ' LOCATION STAKE REMOVABLE MANHOLE, A3 BARS, 6' OL. 20• MIN. OPENING CAST -IRON PIPE, WITH • - ASPHALTIC SEA!_ TIGHT JOINTS ^ 2 INVERT OF INLET ' 1 1 3 "ABOVE INVERT n V41 FT. MIN. SLOPE INLET +' 1 a OF OUTLET. OD LEVEL } CAULKED JOINT BAFFLES MAY BE • USED INS CAD SANITARY TEE OF SANITARY TEES ( U • II _ e. fa CEMENT W PARGING < I .1�1. c ON INSIDE j 4 -0. 5._O. 12. MIN. REMOVABLE MANHOLE, 20" 36" MAX. MIN. OPENING 4.. SOL[b PIPE WITH TIGHT JOINTS, IGRADED 1/B FT. MIN. OUTLET — — CAULKEDl1 — SANITARY T O 6" MIN. WA ft THICKNESS 'J c FOR POUREDI. IN PLACE • CONCRETE i i �• I 3 Q _D- _ ��I PEA GRAVELI OR SECTION CLEAN SAND I � TYPICAL 1200,,,z GAL. CONCRETE SEPTIC TANK SEPTIC DETAILS prepared for OF NE j -- W Y R �P prepared by ✓ y WILLIAM F. ZEILER J Professional Engineer b Land Surveyor Concord Road - Mahopac -New York 10541 (914Y628-4764 fA Plea Im1J�'`r 7 ..tea I I, d I .:0 77 O.A I elo Ir e 3e7"t I- C F l 0-0 7-6r72 1i9 Bf le- 5!7 __N r1 4 V FL F47 1_ c 4 a" Miti. _ 4 1 1/2 P w45;4E. OR CRUS%fc_' '/3 .60' PIH. ON C-! —PROFiLlf GACUMO W A 7E.R. Is- "'l-leocX I UL E 7 cc'eer TR EN C it-J, 'Wig. aarTam cp • GAA01-') 1/a DET-AIL f INSTALL Z' Ot4 C.EAi_:'=11 -TL(&(CTI- NL 6 0) sr SUBSCU.-F_-ic-Z SzW;.G-7- D-1-57P0S-:1- S7*.- Basic Required Notes " trees within 10 feet of the proposed SSDS shall be removed. ': A 2 S to Health SDS be inspected by the design engineer/ architect and the Putnam County He a P', Department alter construction and prior- to backiill. 3 be allowed in the H. trucks, machinery, building materials, nor excavated earth shal.' sewage disposal area. Construction of 5SDS to be in accordance with these plans. any revisions thereto, and -he rules and regulations of the permit issuing governmental agency. j' Minimum well yield of 5 gpm is required. Yields less than 5 9pa will be immediately . V reported to the Putnam County Department of Health. X7.5. The sewage system desion shown hereon does not orovide- for installation of a garbage grinder. Such installation reauires the aooroval of the Putnam County Department of Health:' Notes Required When ROB Fill Pr000sed 1. ROB fill must be s'tabil'ized by allowing the ROB fill to settle naturally for a period of at least 6 months and include at least one freeze -thaw cycle or �_Jll stabil.tic. ma be achieved by mechanical compaction in approximately six inch lifts to the apprcuimat density of the undisturbed underlying granular soil. The results of density tests performed in the undisturbed underlying Boil and in the fill pad ar&� to be submitted t the Putnam County Health Department if mechanical compaction is to be utilized. 2. Elte 'modification activities involving placement of fill are to be conducted during relatively dry periods to minimize soil smearing and excessive soil ',compaction. 3. Run of bank fill shall be suitable for sewage absorption, be free CLfifines or other unsuitable material and shall have an in-place percolation rate at 1_*eaBt equal to that in the natural Boil af�er the required stabilization period. The engineer/architect shall perform final percolation tests in the 1411 alter stabilization. 4. The impervious 1111, clay barrier, shall be a dense clayey so-41 with little or. no sewage absorption capacity. 5. Fill suitable for sewage absorption should contain no more than 5X and preferably no more than 21 fines by veight. Fines are clay and silt particles that pass a 200 sieve and no more than IOX by v6ight, of the fill material should pass a 100 sieve. SEPTIC DETAILS prepared for 0. 4P e72- '7 prepared by Profess icr-1 -nC;=ee_- & Tan,: canczr� Rcp 2t a -.0 4ol its t• 4 V FL F47 1_ c 4 a" Miti. _ 4 1 1/2 P w45;4E. OR CRUS%fc_' '/3 .60' PIH. ON C-! —PROFiLlf GACUMO W A 7E.R. Is- "'l-leocX I UL E 7 cc'eer TR EN C it-J, 'Wig. aarTam cp • GAA01-') 1/a DET-AIL f INSTALL Z' Ot4 C.EAi_:'=11 -TL(&(CTI- NL 6 0) sr SUBSCU.-F_-ic-Z SzW;.G-7- D-1-57P0S-:1- S7*.- Basic Required Notes " trees within 10 feet of the proposed SSDS shall be removed. ': A 2 S to Health SDS be inspected by the design engineer/ architect and the Putnam County He a P', Department alter construction and prior- to backiill. 3 be allowed in the H. trucks, machinery, building materials, nor excavated earth shal.' sewage disposal area. Construction of 5SDS to be in accordance with these plans. any revisions thereto, and -he rules and regulations of the permit issuing governmental agency. j' Minimum well yield of 5 gpm is required. Yields less than 5 9pa will be immediately . V reported to the Putnam County Department of Health. X7.5. The sewage system desion shown hereon does not orovide- for installation of a garbage grinder. Such installation reauires the aooroval of the Putnam County Department of Health:' Notes Required When ROB Fill Pr000sed 1. ROB fill must be s'tabil'ized by allowing the ROB fill to settle naturally for a period of at least 6 months and include at least one freeze -thaw cycle or �_Jll stabil.tic. ma be achieved by mechanical compaction in approximately six inch lifts to the apprcuimat density of the undisturbed underlying granular soil. The results of density tests performed in the undisturbed underlying Boil and in the fill pad ar&� to be submitted t the Putnam County Health Department if mechanical compaction is to be utilized. 2. Elte 'modification activities involving placement of fill are to be conducted during relatively dry periods to minimize soil smearing and excessive soil ',compaction. 3. Run of bank fill shall be suitable for sewage absorption, be free CLfifines or other unsuitable material and shall have an in-place percolation rate at 1_*eaBt equal to that in the natural Boil af�er the required stabilization period. The engineer/architect shall perform final percolation tests in the 1411 alter stabilization. 4. The impervious 1111, clay barrier, shall be a dense clayey so-41 with little or. no sewage absorption capacity. 5. Fill suitable for sewage absorption should contain no more than 5X and preferably no more than 21 fines by veight. Fines are clay and silt particles that pass a 200 sieve and no more than IOX by v6ight, of the fill material should pass a 100 sieve. SEPTIC DETAILS prepared for 0. 4P e72- '7 prepared by Profess icr-1 -nC;=ee_- & Tan,: canczr� Rcp 2t a -.0 4ol a Ir 1� ;o - I Straw Bale Dike Details I -,.. FLOW •+�- TE�Z: �1••VE RTICAL FACE J • ,I BEDDING DETAIL - -. STANDARD i SYN30LI • - I DRAINAGE AREA NO MORE THAN IA x.PER 100 FEET OF STRAW BALE DIKE FOR SLOPES LESS THAN 25% . ANGLE FIRST STAKE OWT ARO PREVK)USLYLAID BALE sr FLOW I. -� EfOUNO BALES PLACED ON CONTOUR - �r ') 2 RE-BARS,STEEL PIOKETS,OR 2:2 "STAKES � 11/2 TO 2* IN GROUND, DRIVE STAKES FLUSH i WITH BALES. - i ANCHORING DETAIL I MiSTRUMN SPECIFICATIMS ' 1. 9415 SMN-L BE PLACED AT TIE TOE OF A SLOPE OR ON THE CONTTOLIR AND IN A ROW WITH EMS T113H LY ABATING THE AWACFNT BALES. ;2. EACH 116 STALL BE D®EIDED IN THE SOIL A MINI" OF (4) m6cs; AND PLACED SO THE BINDINGS ARE K)RIZCNTAL. .3. EALES PALL BE SE "ELY AWJiDRED IN PLACE BY EITHER TWO STAMS OR RE-BARS DRIVEN , pR il - TH ICUG t THE BALE. Hf FIRST STAN IN EACH PALE SHALL BE CRIVEH TOrNRD THE PREVIOUSLY LAID BALE AT AN ANGLE TO FORCE THE BALES TOGETHER. STAKES STALL PE r!',pN�62 '-O/Z CRIVEN:FUISH WITH THE BALE. INSPECTION STALL BE FRECLENT AND REPAIR REPLACEMENT SHALL BE MADE PRCMFnY AS i.•4. NEE¢EDJ iGs T�'7Z T crT��D OF NEW • �. 94US OWL BE RETIOVED VkfN THEY HAVE SERVED THEIR USEFULNESS SO AS NOT TO BLOCK 'A r0. � qP CR IYPEIDE STORM FLOW OR DRAINAGE. pM F. -�7y LEA /GG.. -• - I Z N C 8 0 4 O � /C L/% 1 W°� ¢F.••.,MO. Oil :H � I y°iy ESSIOK a Ir 1� ;o -