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72. -1 -37.1
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03182
T
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03182
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL. HEALTH SERVICES-
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR
TMENT SYSTEM
PCHD CONSTRUCTION PERMIT #
Located at 64 N0P -_ O� Town or Villg
Owner /Applicant Name
WrLLIAVA
3CZQ&i,04ACxeTax Map -fZ
Block
Lot
Formerly
Subdivision Name
co, '\DAQCfft_
3n-
Mailing Address
Subd. Lot # 1
i Z Nom' A.tEduE_ , pE*AL.- ,icy
Date Construction Permit Issued by PCHD `mil Z`' (�Z_
Separate Sewerage System built by
Consisting of I�
AIL CA`35&5F_
Zip ) OCt 5
Address 0,-7 �.AAW\ �A-LL -( 0 " -t
Gallon Septic Tank and
50t L_ir 0c Z-,4" ) 0 -0 -1C
Other Requirements:
Water Supply: Public Supply From
Address
or: 7C Private Supply Drilled by Address R5 %9Aryl /,W LF_q Ali-` /0`x-5
- BWLldi.ng.Type .. �Z�SiOr�u' _ uau.Prosion control been- completed? 1!_0S
Number of Bedrooms Has garbage grinder been installed?
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the PutnaR County Department of Health.
Date: 05 101 Certified by ILI", +L' P.E. X R.A.
Address ` t'`�.�r '`! , P" (- ,-° ' � f �= � /c �� License # O(OZ50t
Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary
to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage
treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval
of the private water supply shall become null and void when a public water supply becomes available. Such
approvals are subject to modification or change when, in the judgment of the Public Health Director, such
revocatio , modification or change is necessary.
By: R� Title: / i/;'% &14111.e-et' Date: di e .3
Wh copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
NOT Efact location of well with distances to at least two permanot landmarks to be provided on a separate sheet/plan.
Well Driller's Name A�- Address: /1� ig;
Signature ::::)a Date:
White r.nnv- 14DFile- YelInwconv - Building Insnector- Pinkconv - Owner- Orange cony -Well driller
Form WC-9'1
12k;
-A-
a age- UX'Cri iU
Map 7Z�Block Lot(s)31(1
Well Owner:
N94ne: Address: U
1-7
Use of Well:
1-primary
2-secondary
X ResidenfiAl Public Supply Air cond/hiat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
Rotary _ Cable percussion Compressed air percussion _ Other (specify)
Well Type
Screened Open end casing Open hole in bedrock Other
Casing Details
Total length a) ft.
Length below grade /I / �- ft.
Diameter in.
Weight per foot lb/ft.
Materials: -/,- Steel Plastic Other
Joints: Welded _X, Threaded Other
Seal: � Cement grout Bentonite , Other
Drive shoe: )< Yes No
ILiner : Yes X, No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes No
Hours
Second
Well Yield Test
Bailed _Pumped —.X-Compressed Air
Hours-:bV-1
Yield K gpm
Depth Data
Measure from land surface-static (specify ft)
During yield test(ft)
---------------------
Depth of completed well in feet
Well Log
If more detailed
information
descriptions or
sieve-ar-alyses
Depth From Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
q
6
(j
are available,
please attach.
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump/Storage Tank Information
Pump Type :3 Ae. Capacity 5-
Depth _�oo' Model .090-lVeN—A
Voltage 2lo HP
Tank Type A" Volu me
Date Well Completed
13 b
Putnam County Certification No.
Report
Well Driller (signature)
NOT Efact location of well with distances to at least two permanot landmarks to be provided on a separate sheet/plan.
Well Driller's Name A�- Address: /1� ig;
Signature ::::)a Date:
White r.nnv- 14DFile- YelInwconv - Building Insnector- Pinkconv - Owner- Orange cony -Well driller
Form WC-9'1
12k;
,CLAM Cr
a a
BRUCE R. FOLEY * * LORETTA MOLINARI R.N., M.S.N.
Nealt�-llirP_,Ctnr�__
.J..A-.�fi'.0 E 5.•
Director o���atierif �ervlces '-.
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
E911 ADDRESS VERIFICATION FORM
5 1511'I ' ' 1
E911 ADDRESS:
W l LL (Am 3Qs -A 0A C- P -
* ?2 v -- 1- 3 -+. k
(�4 NoQ'1oi1 cDL'Lc�'j iz �'
AUTHORIZED TOWN OFFICIAL:
DATE:
(Signature)
The Putnam County Department of Health will not issue a Certificate of Construction Compliance
unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town
official. This form is to be submitted with the application for a Certificate of Construction
Compliance.
(E911verfrm)
JUN -09 -2003. 11:54. BKEY & WATSON, PG
UTNAM - COUNTY DEPARTMENT. 0E HEALTH
DIVISION.-OF DIVISION.-OF ENVIRONMENTAL HEALTH SERVICES
SEWAGE TkEATNI ;NT grS` M7
W!Hiam Brundage
72.
37.1
.._._
Owner or Purehaser-of Building --
Tax Map
Block
Lot
ctilding Constmcted by
64 Horton hollow I_�_ oad.
Location- Street ~
Putnam- Valley
Tov fitVAlage
vstdiister Holding Co. Parcel III
Subdivision. Name
Resident- 1
-Building Type Subdivision Lot #
I_represent. that I: am wholly -and completely responsible. for the location, worinanship, material,
construction antf dr- ainage 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
-arry part of said system -constructed 'by.-me-which failg —to -operate `for a period of two years
immediately following the date of.. approval. of - the_ "Centificate 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 ft 'willful oriiegligeni act of the occupant of the building utilizing the
system.
The.undersigned: fbirtheT. aarf.cs -to accept.as.conclasive tha determination of- the. Public.HeaIth .
rector of the-Putnam:aunty epartrirent or
Di 1teat4h gas =tom whetner or not tare failufd of ine'systerii', J
to .operate was--caused:—by the -wilftu or-neghgent .act ofthe occupant of the building utilizing the
system.
Dated: Month VS ; _Day -07 -year __�3
General Contracter(Owner) - Sign
- Corporation Name -(if - corporation)
Address:
. State
Signature..
Title: 'c installer _
Cassese General Contracting, Inc.
- Corporation .Name -(i €corporation)
Address: 9 SunsetHift- RdPutnam Valley
. I Zip. . State
.. Zip 10579
Form GS -97
TOTAL P.04
-""
*'
� �21 Ke�r Street
' Yorkte�r �eights M Y 1O598
� (914) 245-2800
|` Albert H. Padovani, Director
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LAB #: 87.800169 CLIENT #: 56592 NON STAT PROC PAGE 1
BRUNDAGE, WILLIAM
32 WATERVIEW ESTATES
FEB<SKILL, NY 10566
DATE/TIME TA](EN: 06/C,2/03 08:4(:
DATE/TIME REC'Dx O6/02/�3 10:l5
REPQRT DATE : 06/10/O3
(�l4}-786-2632
SAMPLING SITE: 64 HQRTON HOLLOW RD, PUTNAM VALLEY, NY SAMPLE TY��. : PUTA8��_:_
� OUTSME SPIGOT P�ESERVATIyG���NONE
WI -,
wu/ES". ~x CULlFURM M'ETH: MF
ATE FLAG3 PROCEDURE
PUTNAM CNTY PROFILE
06/02/03
06/02/03
06/02/03
A6/02/03
06/0�i/03
O6/02/05
06/0p/03
06/02/O3
06/02/O3
06/O2/03
-MF T. COLIFORM
-LEAD <IMS)
-NITRATE N%TROG
-NlTRITE NITROG
-IRON (Fe)
-MANGANESE (Mn)
-SODIUM (Na)
-pH
-�.H�R��ES�,T[}T�D�
'ALKALINITY (AS
-TURBIDITY (TUR
ABGENT /100 ML
<1 ppb
0.44 MG /L
<0.O1 MG/L
0.077 MG /L
0.041 H 0/L
26.1 MG/L
6.9 UNI TS
74.0 MG /L.
<1 NTU
COMMENTS:
'THESE RESULTS INDICATE THAT THE WATE
SATISFACTORY SANITARY QUALITY ACCORDI��-
AyVD`r�^ `FE'RAL DRINKING WATER STANDARDS
TESTED, AT THE TI�E OF COLLEC7-ION.
Pb /Cu LEAD limits for p
EPA Lead & Copper
than 10% of their
than 15 ppb and a
treatment must be
1Dotential^
�ORMAL - RANGE MET�8�
ABSENT
1008
0-15 ppb
91O1
91359
N/A
9146
0-0.3 mg /l
2037
0-0.3 mg/i
2037
N/A
6.5-8.5
�O43
N/A
NOT) OF A
NEW YORK STATE
FOR -THE - F.ARIAHETERS
mb1ic schools arx» set at 15 ppb. ^
Rule for Public Systems requires that no more
distribution points have a LEA)", value of more
COPPER value of 1.3 men/L, else water
undertaken to reduce the waters corrosive
Fe/Mn If both iron and manganese are present, their total value
combined shall not exceed 0.5 mg/L.
Na No limits for Sodium are proscribed" Suggested guidelines state
that for peop1e on a sodium restricted dietrthe water shouid
contain no more than 20 mg/L of Sodium. For those on a
moderately restricted diet, a maximum of 270 mo/L of Sodium
�
`
YilL ENVIRONMENTAL �:',6RV`` S
321 Kear Street
Ycrktown Heights* N.Y. i0598
(914) 245-28o0
Albert H. Padovani, Director
8RUNDA6E, WILLIAM DATE/TINE TAKEN: 06/02/03 08�4C
32 WATERVIEW ESTATES DATE/TIME REC'D: 06/02/03
PEEKSKILL, NY 10566 REPORT 06/10/03
PHONE: (-7,14)-736-2632
SAMPLING SlTE: 64 HORTON HOLLOW RD, PUTNAM VALLEY, NY SAMPLE TYPE-- POTABLE
OUTSIDE SPIGOT PRE��ER���IV��: N�NE
COL..-ID-4. WILLIf��� �-
NOTES.".: CQLlFORM METH: MF
DATE FLAG PROCEDURE I -I,- i -*-:, S, u I...' I * NORIIAL -- FZANGE IIIETHOD
is suggested.
� pH pH SCALE IN WATER RANGES FROM 1-14. OF pH IS OF
THE IMPORTANT AND FREQUENTLY USED TF7STS IN WATER CHEMISTRY.
WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PlPES AND
�
� FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5.
� Hd TOTAL HARDNESS IS Dl-7FINED AS THE SUM OF THE CALCIUM & MAGNESIUM
CDNCENTRA EXPRESSED AS �A|CIW�{�AF�8ONATEr�[k�MG/L T��-
-'- -��` ' ~ ^� '
^- --- -- ��������� �Av �AN�E �RGM 6 T[) HUNDHEDS
SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN, SUBJ�CTED.
�
SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 30O 116/L
`
� MODERATELY HARD WATER: 70-140 MG/L MG/L = MI1.-.LIGKAM PER LITER.
� HARD WATER: 140-300 MG/L (1 grain/gallon = �7.2 MG/L)
SUBMITTED BY:
ELAP� l/)323
BADEY & WATSON
LETTER of TRANSMITTAL
3063 Route 9, Cold Spring, New York 10516
Date: 29 Jul 2003
File No. 98-105
W. 0. # 15587
RE: Certificate of Construction Compliance
Brundage
TO:
Horton Hoftow Road
Joseph S. Paravati, Jr.
Westchester Holding Co. Parcel 11 Subd. Lot No. I
Tax Map 72-1-37.1
Assistant Public Health Engineer
PemiitffiddM # PV-8-02
Putnam County Department of Health
I Geneva Road
Sent via:
Brewster, NY 10509
US MAIL UPS-NIGHT
MESSENGER El UPS-2 DAY
El
PICK-UP El UPS-3 DAY
El
FAX El UPS-GRND
W
We are sending:
UPS-COD
copies date description of document
F11 129-Jul-03 __1 ILetter w/ storage tank info
F-1 I
7-
El 1 -71 F_
F-1 1 77—
F-1 1 71
7 1 711
F-1 I I F_
REMARKS:
Copies to: File
Yours truly:
Jason R. Snyder, Jr. Engine er
Tel: (845) 265-9217 ext 13
Fax: (845) 265-4428
Email: jsnyder@badey-watson.com
40 40-05 500113 626157 21956
Re: William Brundage
. (T) Putnam Valley, TM# 72. -1 -37.1
Dear Joe:
Pursuant to our conversation, the storage tank is an 86 gal. Amtrol WX -302 Pro.
If you have any other questions or comments concerning this Certificate of Construction
Compliance, please do not hesitate to call.
Yours truly,
BADEY & WATSON,
by,
Jason R. Snyder
Jr. Engineer
JRS /jrs
Cc: File:U\98- 105B \WB29JL3.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
BAi DEY A WATSON
Surveying sand E7ginee.ring PC
O O
-
SINCE] 1973 3063 Route 9, Cold Spring, New York 10516
(845) 265 -9217 Glennon J. Watson, LS.
(845) 225 -3312 John P. Delano, P.E.
FaL- (845) 265 -4428
nesicN
(914) 628 -1800 Peter Meisler, LS.
(914) 739 -3577 Stephen R. Miller, LS.
(877) 3.141593 Jennifer W. Reap, L.S.
July 29, 200.3
George A. Badey, L.S., Senior Consultant
Mary Rice, R.L.A., Consultant
Julius I. Cesare, P.E., Consultant
Joseph S. Paravati, Jr.
Assistant Public Health Engineer
Putnam County Department of Health
1 Geneva Road
Brewster, NY 10509
Re: William Brundage
. (T) Putnam Valley, TM# 72. -1 -37.1
Dear Joe:
Pursuant to our conversation, the storage tank is an 86 gal. Amtrol WX -302 Pro.
If you have any other questions or comments concerning this Certificate of Construction
Compliance, please do not hesitate to call.
Yours truly,
BADEY & WATSON,
by,
Jason R. Snyder
Jr. Engineer
JRS /jrs
Cc: File:U\98- 105B \WB29JL3.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
BADEY & WATSON
LETTER of TRANSMITTAL
-/ p -� O � .- ."P'nf -.. .. �N:�- vn....+. -'.6 �.1�. a..P. �.-.....�•o ,v .aw-.a a.vr
ram.•
3063 Route 9, Cold Spring, New York 10516
Date: 09 Jul 2003
File No. 98 -105
W. O. # 15587
RE: Certificate of Construction Compliance
Brundage
TO:
Horton Hollow Road
Joseph S. Paravati, Jr.
Westchester Holding Co. Parcel H Subd. Lot No. 1
Assistant Public Health Engineer
Tax Map 72-1 -37.1
Putnam County Department of Health
PermiuTitle/P0 # PV -8 -02
1 Geneva Road
Sent via:
Brewster, NY 10509
US MAIL 11 UPS -NIGHT
El
MESSENGER El UPS -2 DAY
El
PICK -UP UPS -3 DAY
FAX UPS -GRND
We are sending:
UPS -COD
copies date description of document
U 1— 7 jApplication Fee - $200.00
107-May-03 Certificate of Construction Compliance
for Sewer Treatment System
71 112-May-03 JE91 1 Address Verification Form
3] 107-May-03 IGuarantee of Subsurface Sewa a Treatment System
0 02- Jun -03 Well Water Test Results two 2
pages
1 120-May-03 Well Completion Report
❑
dy -J✓ �I 1003:S "Ao•'iitiiai .•• . ++ .••. • .
. - _ _ _ - _ - - -
- _
REMARKS:
Copies to: File
Yours truly:
Jason R. Snyder, Jr. Engineer
Tel: (845) 265 -9217 ext 13
Fax: (845) 265 -4428
Email: jsnyder @badey - watson.com
40 40-05 500113 626157 21799
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Date:
Inspected by: _
-'lK;
Town Permit #+
TM # - / - 37, , 1 Subdivision Lot # (Ale-su"6 , s�
1. Sewage System Area
a, STS area located as per approved plans .......... .. ................
b.. Fill section - date of placement
3:1 barrier Lgth. Width . Avg.Dpth
c. Natural soil not stripped ................... ...............................
d. Stone, brush, etc., greater than 15' from STS area..........
e. 100' from water course / wetlands ...... ...............................
IL Sewage System
a. Septic tank size - 1,000 .... ..... 1,250 ......... other ... �.... Dv
b. ' Septic'tank installed level ................ ...............................
c. 10' minimum from foundation .......... ...............................
d. Distribution Box
1. All outlets at same elevation -water tested .................
2. Protected below frost .................. ...............................
3... Minimum 2 ft. Original soil between box & trenches
e. Junction Box - properly set .......... ...............................
6, Irenches
1. Length required (�5b Length installed -F�'o (7
2. Distance to watercourse measured Ft..........
3. Installed according to plan ......... ...............................
4. Slope of trench acceptable 1/16 - 1/32" /foot .............
5. 10 ft. from property line - 20 ft.- foundations..........
6. Depth of trench <30 inches from surface ..................
7. Room allowed for expansion, 100 % .....................1111..
8. Size of gravel 3/4 - 11/2" diameter clean ...................:
9. Depth of gravel in trench 12" minimum .......:...........
-
:1-0' u. -P"in- e e nds camped:
inp or -AoseaS ystems"
- - --
1. Size of pump ch //
2. Overflow ta ........................... ...............................
3. 'Alarm ........:........... ...............................
4. P easily accessible, manhole to grade .................
5 first box baffled .......................... ...............................
6. C�yycle witnessed by H.D.estimated flow /cycle...........
III. House/Building
a. House located per approved plans .........................
b. Number of bedrooms ............ .............................. ........
IV. Well
Well located as per approved plans . ......:........................
b. Distance from STS area measured io ' • ft...........
c. Casing -18" above grade ................ ............. ...................
d. Surface drainage around well . acceptable .......................
V. Overall Workmanship .
a. Boxes properly grouted ................... ...............................
b. All pipes partially backfilled ........... ...............................
c. All pipes flush with inside of box ... ...............................
d. Backfill material contains stones <4" diameter ..............
e. Curtain drain & standpipes installed according to plan..
f. Curtain drain outfall •protected & dinto exist watercour
g. Footing drains discharge away from STS area ...............
h. Surface water protection adequate .... ....:..........................
i. Erosion control provided ...... ............................... `,11.11.....
Rev. 12/02
NO COMMENTS
0
z lv 3
orm
MAY-08-2003 07:48 BADEY & WATSON, PC
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
ATTENTION X JOSEPH ❑ GENE
REQUEST FOR FINAL -INSPECTION
Date: - 5/812003 ___
PCHD Construction Permit #
Located:
iiz_.:#�
Horton Hollow Road
For: Fill
Trenches
(T) (V) Putnam Valley
P.01/01
Owner/Applicant Name:
William Brundage TM
72- Block-1
--Lot 37.1
Formerly: _ n/a
— Subdivision Name:
womhtwer HOWIng
Co. Inc., Parcel III
Subdivision Lot # 1
Is system fill completed? n/a
Is system complete? yes
Is system constructed as per plans? Y"
Is well drilled? yes
Is well located as per plans? generally
- -
Are erosion control measures in place? yes
Date: n/a -,
Date: 5a/0003
Date: 1/14/2003
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.
71
Date: 5/812003 Certified by: John P. Delano
Design Professional
Address: Badey & Watson, P.C. 3M Route 9, Cold Spring, NY Lie. # 062505
Comments:
Form FIR-99
TOTAL P.01
P. 1
PUTNAM COUNTY DEPARTMENT OF HEAL'T'H
DIVISION OF ENVIRONMENTAL HEAL'T'H SERVICES
PERMIT # / — —U ri1-=
Located at ¢#a g �OLt_60 go.
Wf--(TCH65-r&K Iaoi,offic" Co.
Subdivision name we.. }Acs J1 Subd. Lot # 0
Date Subdivision Approved Am. 7-17— 001
Owner /Applicant Name aint m BA04Q916
Town or Village RA TWA 8 LLI.. 6
Tax Map '7? Block 41 Lot 311
Renewal Revision
Date of Previous Approval
Mailing Address )4 AJ S6Lj t1F . ; L& L 6146R� Zip /
Amount of Fee Enclosed J�dD• °o
Building Type A uS ) O&j7 Lot Area 7� No. of Bedrooms Design Flow GPD 000
Fill Section Only Depth Volume
PCIID NOTIFICATION IS REQUIRED WHEN PILL IS COMPLETED
Separate
Sewerage
System to consist of 1 600
gallon septic tank and
&b Lr
?ReJe- 6c - Umr--6
6 6' 0 t'
Other Requirements:
To be constructed by MARar.+o LL -YOVS � %PS
Address l 9-,_ . Cowa J PA1Ai&< td 10516
Water SwDly: Public Supply From Address
�r� Pv�te
Supply,-Drilled by Addressr�R�
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatments sy tem 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 / Z 1
License # OZ So S
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a. new pe it. Approved f discharge of domestic sanitary se age only. / Z
By; Title: y Date:
White copy - HD File; 1�ellc opy - Building Inspector; Pink copy - 60wner; Orange copy - Design Professional
Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION T_ O CONSTRUCT A WATER WELL
u. ..... � .c r -.. ..i ii.°::.c+ �. ,.�... "..�'... .. ......:,`_ - e. .r ..� -..< -' v.a ... ,� .ma. : < —a :!,'Po".��u st=C :A -`�.' . ..1• ri�-a R• %k .� '_jy��.. ,U: _...
please pant or type " ' i 1.1C1� i cliiliC � v -
Well Location:
Street Address: T wn/Village Tax Grid #
laic 0,.; -.` Map -1Z Block o1 Lot(s)
Well Owner:
e:
Address:
�N Q
Ami
Use of Well:
Residential Public Supply Air /Cond/Heat Pump _Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial. '.:;, Institutional Standby
Amount of Use
Yield Sought _ gpm # People Served Est. of Daily Usage gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
ovi' 7 0
for Drilling
Well Type
1J, Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No �C _
Is well located in a realtyZTC'Cr"6!;1a vision? ...................................... ............................... YesX No
Name of subdivision 6 Co 1. e Lot No.
Water Well Contractor: CA►wa--i U AS Address:
Is Public Water Supply available to site? ' � ............ .................... ............................... Yes No X
Name of Public Water Supply: Town/Village 1� 1�
Distance to property from nearest water main: LJZA-
Proposed well location & sources of contamination to be provided on separate sheet/plan.
Pate: 12 °!�: ��:�_ Applicant Signat,,:re: P -
._,_.... -F,
A
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam
County. I
Date of Issue r �0 Permit Ins g Official:
Date of Expiration r -7 Title: AJtj
Permit is Non- Trahsferrable /) �'J
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
BADEY & WATSON LETTER of TRANSMITTAL
3063 Route 9, Cold Spring, New York 10516 Date: 18 Dec 2001
(845) 265 -9217 .(914) 628 -1800 (914) 739 -3577 File No. 98 -105
(845) 225 -3312 FAX (845) 265 -4428 W. 0. # 14405
RE:
Brundage
TO: Hoton Hollow Road
Adam Stiebeling Westchester Holding Co. Parcel 11
Subd: Lot No.
Tax Map 72-1 -37.1
Putnam County . Department of Health
Permit #
1 Geneva Road
Brewster, NY 10509 Sent via: US MAIL ❑
UPS -NIGHT W
MESSENGER ❑
UPS -2 DAY ❑
PICK -UP ❑
UPS -3 DAY ❑
FAX ❑
UPS -GROUN ❑
UPS -COD ❑
We are sending
1
copies date description of document
0 2121�1 —77 jApplication Fee
0 . 14= Dec -01 IC6nstruction Permit for Sewage Treatment System _. ___
❑' . Letter of Authorization
F-1] 06- Nov -00 Application for Approval of Plans for a Wastewater Treatment System
❑ 14- Dec -01 !Short Environmental Assessment Form
06- Nov -00 Design Data Sheet _
Oil'
-' - .176 JS Ptsat`af Seaiaa tie "(re�rnejlt- S- '�ierlhF`1 �;s ; —� ...._ -. - -_ :_ : _ _
_ _ - - - <�•
114- Dec -01 7 lApplication to Construct a Water Well
❑ I - -- - - --
REMARKS:
Floor Plans under separate cover. UPS /N -Tube
Signed: John P. Delano, P.E.
Copies to: File
'
6318
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
RE: Property of William Brundage
Located at
Horton Hollow Rd.
T/V Putnam Valley Tax Map # 72 Block 01 Lot 37.1
Subdivision of Westchester Holding Co,, Parcel III
Subdivision Lot # 01 Filed Map # 2824A Date Filed Aug. 02, 01
Gentlemen:
This letter is to authorize John P. Delano, P.E.
a duly licensed Professional Engineer X 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
Law, and the Putnam County Sanitary Code.
Very truly yours,
A, 4
Countersigned:. Signed: 'n.
P.E.,y"; # MSS 057 (Owner of Property)
Mailing Address Badey & Watson, P.C. Mailing Address: 172 Hansen Ave./ Pearl River
3063 Route 9, Cold Spring,
State N.Y. Zip
10516
Telephone: 845- 265 -9217
State
Telephone:
NY Zip 10965
914 - 736 -2632
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
A,PPLICArHON FOR APPROVAL OF PLANS FOR
1. Name and address of applicant: William Brundage
172 Hansen Ave.
Pearl River, NY 10965
2. Name of project: William Brundage 3. LocationTN: Putnam Valley
4. Design Professional: John P. Delano, P.E. 5. Address: Badey & Watson, P.C.
6. Drainage Basin: Hudson River Rt. 9 Cold Spring, NY 10516
7. T)W of Proiect:
X Private/Residential Food Service Commercial
Apartments Institutional Mobile Home Park
Office Building Realty Subdivision Other (specify)
8. Is this project subject to State Environmental Quality Review (SEQR)?
Type Status (check one) -------------------------------- Type Exempt
Type II Unlisted, X
9: Is a Draft Environmental Impact Statement (DEIS) required? --------------- No
10. Has DEIS been completed and found acceptable by I:ead Agency? - _ - - - - - - - - N/A
11. Name of Lead Agency Putnam Valley Department of Health
12. Is this project in an area,under the control of local planning; zoning, or other
..._... ' . �...,.�")f��1CLlJ_l)i (1. ,a:i;G`;� .. _. ., o.....: �.:,, -._ rt _. �.�a., « .:.... -.�F - - .�.w.. �-._ < .. -....t ...-�- _ -� r'3- `•: _, .. _ -.- ..
13. If so, have plans been submitted to such authorities? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 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 X 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? - - - - - - - - - - - - - - - - - - - - W o .
19. If yes, name of water supply N/A Distance to water supply N/A
20. Is project site near a public sewage collection or treatment system? - - - - - - - - _ _ No
21. Name of sewage system N/A . Distance to sewage system N/A
22. Date test holes observed 23. Name of Health Inspector
11/06/00 A. Stiebeling
24. Project design flow (gallons per y) _ ___________________ ____________ _ __ loco
25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required? ... No
26. Has SPDES Application been submitted to local DEC office? --------------- N/A
Form PC -97
2
27. Is any portion of this project located within a designated Town or State wetland? IVA_
28. Wetlands ID Number NSA
.. .. >-e -•_ a• .r-.. _.'.c+ •+�. _.. _.:,- �- :- ;0•:..n,.:+n. $...r w..e•- ._i:= F;:�:€m.' .i :��4�� s�o` =o. - n..•.:. >: r.'....._ .r. :.�._.....ti�:, -.
°L. YJ `�13GLa1TU'�J 1rCIY� leC�ll��111
-------------------------------------- No
Has application been made to Town or Local DEC office? ------ _ _ _ -------- NSA
30. Does project require a DEC Stream Disturbance Permit? -------------------- 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: NSA
33. Is there a local master plan on file with the Town or Village? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes
34. Are community water and/or sewer facilities planned to be developed within
15 years in or adjacent to project site ?---------------- - - - --- I
- - - - -- No
35. Are any sewage treatment areas in excess of 15% slope? --------------
36. Tax Map ID Number - -- ------- - --------- ---- -- -- - - -- Map 72 Block of Lot- 37.1
37. Approved plans are to be returned to _ _ _ Applicant X Design Professional
NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall
- � Cci�,I tC'.:.i iV.�,`�� in .'., i�!: l�i1 i'A_dl- _- n!)T�;��',SP, "�CPTif 1Ti_1�1ir�St`,�iP,� l : fid' jF,;,- ��. ��... �ailo�.. r" �j"% ���_( 1�P :`f.l_71�1,1,5'P.ilv.i %il.iFS�`
_ = r i.
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 Orue_,
to the best of my knowledge and belief. False statements made herein are punish We as
a Class A misdemeanor pursuant to Section 210.45 . of the Penal Law. " r-"' =
SIGNATURES & OFFICIAL TITLES: , t
Badey & Watson, P.C.
Mailing Address: ------------- L ------ 3063 Route 9
Cold Spring, NY 10516.
%1r>4(11PA —Ted 12
PROJECT I.D. NUMBER
1 617.20
Appendix C
SEAR
State Environmental Quality Review
.+.:+. ... o�...�.a wM� w....rs , .s, , .cwt r•...o .. .r...�. wrw .r�s .....a.. \ Y- 'ha.; q.r -L C '� sv ... n..., �.....�..�
C�IIVI�E I /('i�� IiJSESgMCN I .�F IJ�CM"`
For UNLISTED ACTIONS Only
PART I —PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1 . APPLICANT /SPONSOR
2. PROJECT NAME
William Brundage
William Brundage
3. PROJECT LOCATION:
Municipality Putnam Valley County ,Putnam County
4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map)
( See Map Provided )
5. IS PROPOSED ACTION:
® New ❑ Expansion ❑ Modification /alteration
6. DESCRIBE PROJECT BRIEFLY:
Construction of new single family residence, septic system & well
7. AMOUNT OF LAND AFFECTED:
Initially. <2 acres Ultimately <2 acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
MYes. ❑No If No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other
Describe:
Single family house on 5+ acre lots.
STATE OR LOCAL)?
MYes ❑ No If yes, list agency(s) and permit/approvals
Putnam Valley - Driveway and Building Permits.
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
❑Yes M No If yes, list agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
El Yes MNo
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant/sponsor name: John P. Delano .E. Engineer Vapplicant Date: 12/14/01
` t
Signature:
oil
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
I'
PART II - ENVIRONMENTAL ASSESSMENT (To be completed by Agency)
A. DOES ACTION EXCD ANY TYPE I THRESHOLD IN 6 NYCRR PART 617.4? If yes; coordinate the review process and use the FULL EAF.
❑ Yes LJ No _
—T ..
Ei:' W7LL '7�i;9furiRe:tiVECOOROINtiiE" F lEW'�, .-- PK– OVTCrti5'FLI –m–u'N iSiEO`�MN6lri`6WVd FtFZ"r3HKi b0/6. ifhio,anegativedecrarati n
may be superseded b other 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 patterns, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
1�
C2. Aesthetic agricultural, archaeological historic, or other natural or cultural, resources: or community or neighborhood character? Explain briefly:
/ / " `CJ
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
A10
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.
A-6
C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. s
D. WILL THE PROJECT HME AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA?
❑ Yes LcffNo f'J
E. ISfTHERE, OR IS THERE L ELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
<p!ai. ^r!gfly..
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 and 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
Then`proceed directly to the FULL EAF and/or prepare a positive declaration. •
heck this box if you have determined, based on the information and analysis above and any supporting
documentation,'that the proposed action WILL NOT result in any significant adverse environmental impacts
AND provide on attachments as necessary, the reasons supporting this determination:
` Name of Lead Agency
c r�
T Name of bl cer' Lead Agency Title of Re
�Qvt
)le Officer
ignature of Res nsib 0 cer in Lead Agency Signature of Preparer (If different from responsible office r)
1�-Z, �2
Date
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
���'�'`�AT$�► ►�Yli��.�� ��1i1�%]��t� ��:R�``�7itiii1 �itill`vlril\ 1 ���'.li"1` � �,.,.�d- :.:... ....:...,.;.::.
Owner William Brundage Address 172 Hansen Ave./ Pearl River, NY 10956
Located at (Street) Horton Hollow Road Tax Map 72 Block 1 Lot 37
(indicate nearest cross street) Lot 1
Municipality Putnam valley Drainage Basin Hudson River
SOIL PERCOLATION TEST DATA
Date of Pre - soaking 08/07/00 Date of Percolation Test 08/08/00
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
A
1
4:36 4:42
6
19 — 22
3
2
A
2
4:43 — 4:51
8
19 — 22
3
3
A
3
4:52, — 5:01
9
19 — 22 .
3
3
4
—
—
5
—
—
B
1
4:38 — 4:45
7
19 — 22
3
2
B
3
4:55 5:03
8
19 22
3
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 liole. (i.e. < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch) All data to be
submitted for-review.
'- 2.. Depth measurements to be made from top of hole.
- Form DD -97
TEST PIT DATA- 2
DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES
G.L.
Topsoil
Topsoil
0,5'
Sandy Loam
Sandy Loam w/ Stone
1.0'
V
V
1.5'
V
V
2,0'
Sand w/ Stone
V
2.5'
V
V
3.0'
V
V
3.5
V
V
4.0'
y .
y
4.5'
V
V
5.0'
V
V
5.5'
V
V
6.0'
V
V
6.5'
V
V
7.0'
V
v
7.5'
8.0'
8.5'
9.0'
10.0'
Indicate level at which groundwater is encountered not encountered
DO
Indicate level at which mottling is observed not observed ;
Indicate level to which water level rises after being encountered N/A
Deep hole observations made ,by: J. Delano, P.E., Badey & Watson, P.C. Date 11/66/00
witnessed by A. Stiebeling PCDH
Design Professional Name: John P. Delano, P.E.
Address: Badey & Watson, P.C.
3063 Route 9, Cold Spring, NY 10516
Signature: F'
Design Professional's Seal
ty
0
VOL
PUTNAb1 COUNTY DEPARTMENT OF HEALTH
DMSION OF ENVIRO\INLENTAL HEALTH `
rNI) 'IDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS
REVIEW SHEET FOR CONSTRUCTION PER}15
..51.a . ✓ ,r..
S 4 � �I M!- J. . .a. L +._ _ ...... v... .� •O. M. f^.� /���I I -.• v�. G'• v Y I -1 :...t . a...++.r. i....Y�- c.. .... .. IA- : ....
�¢ ET LOCATION:
REV '7v'ED BY: nL OR, AS, SATE: % TAX MAP-r: (COYEItMED)
Y N DOCUMENTS
�UPERti1II APPLICATION
( (_)WELL PERMIT ORPWS LETTER
(_)UPC -97
(fUULETTER OF AUTHORIZATION
(� )DESIGN DATA SHEET (DDS)
(_-)(Z)CORPOR -kTE RESOLUTION
(IUUSHORT EAF
()(_)PLANS -THREE SETS
(jJUHOUSE PLANS - TWO SETS
U(,,e)VAR40CE REQUEST
5UBDIVI5TON
(i(ULE GXL SUBDIVISION
LUSUBDIVISION APPROVAL CHECKED
UUPERCRATE .-
U4FMLREQUIRED DEPTH
_)_)CURTAIN DRAIN REQUIRED
GENERAL
'Y N (REQUIRED DETAILS ON PLANS CONT'D)
O(__)HOUSE SEWER -'VV FT. 4"0'; TYPE PIPE CAST IRON
(_Q( )NO BE��S; bL4}C BENDS 45° W /CLEANOUT
U LOCATED IN N D
U NS :TED TO DEP
U PCHD - . - -.-
_)DEP APPROV Q'D
(_ZUDEEP TEST HOLES OBSERVED
(lU(UPERCS TO BE WITNESSED
(Q(EX- APPROVAL SSDS ADJ, LOTS
(�f ( _)WETLANrDS (IO)NN/DEC PERNIIT REQ'D ?)" '
_)DATA ON DDS PLANS & PERMIT SAME
( PRE 1969 NEIGHBOR NOTIFICATION
UULETTER BI/ZBA
REt SWALS
UUSITE NOTE (NO,iSILIINGE)
L SYSI
UU10' HORIZON AL- A TRENCH SLOPES 3:1 TO GRADE
UUFILL SPECS/ NO ES 1 -5
UUFILL PROFI NSIONS
UUFILL IN E ANSION AREA
FILL. GREATER 77TAX 2 FEET
UU CLAY A
UUFILL C T CAT N NOTE
UUDEPTH UGES
LUUVOL. 0 P FOR R.O.B., UNCLASSIFIED & IMPERVIOUS
UUSEPA ON DISTANCE FROM TOE OF SLOPE
TRENCH
Ul'ULF TRENCH PROVIDED 60FT MAX.
UPA.RALLEL TO CONTOURS _
_)0100% EXPANSION PROVIDED.-
(, f,UDETAIIIDUST FREE CRUSHED STONE OR WASHED GRAVEL
(_/)(UGEOTEXTME COVER
SEPARATION DISTANCES ON PLAN - FROM SSTS
C6C_)I0' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL
(.,6U20' TO FOUNDATION WALLS ,
�U100' TO WELL, 200' IN DLOD,150' TO PITS
TO STREAM, WATERCOURSE, LAKE (me. eipan)
�50' TO CATCH BASIN, 35' STORIYIDRAIN, PIPED WATER
r � I HT E: (pits D .
j( 100 YR FLOOD ELEVATION IY B
50. ..TLO.iiv'L3ia�iu`i�EAt25l�L1J" (.!�(_ __)200' /500' RESERVOIR, ETC._ 150' GALLEY SYSTENIS
REQUIRED DETAILS ON PLANS (=::-_�10' MLN TO LEDGE OUTCROP
(jUSEWAGE SYSTEIIPLAN- (NORTH ARROW)
(2jUSSDS HYDRAULIC PROFILE
lQLUGRAVITY FLOW
(__)CONSTRUCTION NOTES 1 -15 ..._
DESIGN DATA: PERC & DEEP RESULTS
(�' CO�iTOURS.EXISTI�NG & PROPOSED
DRIVEWAY & SLOPES, CUT
UUFOOTING /GUTTER/CURTAIN DRAINS
( ( _)USDA SOIL TYPE BOUNDARIES
( ( _)TITLE BLOCK; OWNERS NAME ADDRESS
TMf , PE/RA; NAbIE, ADDRESS, PHONE
(� _)DATE OF DRAWING/REVI.SION
Z( _)DATUM REFERENCE
(Zj(_)LOCATION OF WATERCOURSES, PONDS
LAKES,WETLANDS WITHIN 200' OF P.L.
_)PROPOSED FINISH FLOOR AND
BASEMENT ELEVATIONS
(A()WELLS & SSDS'S WAN 200' OF SSTS
(—/J( )PROPERTY METES & BOUNDS
orpsle -,,, er'l o--
COINIMENTS:
(REVSHEET)
SEPTIC TANK
Q(__)10' FROM FOUNDATION; 50' TO WELL
WELL
U DVv ENSIONS TO PROPERTY LINES -- -- - -- -
(� )�—�LOCATION OF SERVICE CONNECTION
C r JL._.)MIN 15' TO PROPERTY LINE
SLOE
r)SLOPE R(SSTS AREA (520 %)
(U( GRADED TO 15 %, IF REQUIRED
UUPUI'IP NOTES
UC__)DOSE 75% OF V UMEMOSE VOLUME NOTED
LUUDETAIL FOR C , (PIPE TYPE, ETC.)
UUPIT AND D- X S OWN & DETAILED
UU1 DAY SI{ GE OVE ALARM
CURTAIN DRAIN
(_)(__)STANDPIPE ' 0TH SIDES, DETAIL
L�U15' MI's( to 5%,20'4%,25--3%,35--l%, 100%-<I%
_,)20' h1IN CD CHARGE/100' with 182 cons day discharge
(_J(J10' MI`ito NON - PERFORATED PIPE
P
BADEY & WATSON LETTER of TRANSMITTAL
_Surveying & Engineering,. A.C.
J.iy,• _ ...._ * ....� .. .. T. ._ Y • ' •:.v acv._ ..u... :P �ai'? �' -:,,.. � -ia.• : -w so:. �eu- `w•i�.ti. ^. .vr-` v�ira+ q; 4w�' �.-.
3G63 houte y; 'C o'ia spring, °l�ew �oik ll�5i`b Date: 118 Dec 2001
(845) 265 -9217 (914) 628 -1800 (914) 739 -3577 File No. 98 -105
(845) 225 -3312 FAX (845) 265 -4428. W. 0. # 14405
RE:
TO:
1Adam Stiebeling
Putnam County. Department of Health
I Geneva Road
Brewster, NY 10509
We are sending:
Brundage
Hoton Hollow Road
Westchester Holding Co. Parcel 11 Subd. Lot No.
Tax Map 72 -1 -37.1
Permit #
Sent via: US MAIL
U
UPS -NIGHT
C
MESSENGER
❑
UPS -2 DAY
❑
PICK -UP
❑
UPS -3 DAY
❑
FAX
❑
UPS -GROUN
UPS -COD ❑
copies date description of document
' 121 _Sep_01 _ I ;Application Fee
F11 i 14- Dec_01__ 1 Construction Permit for Sewage Treatment_System
= — =--
1 I Letter of Authorization
06= Nov_00 _ I iApplication for Apyroval of Plans for a Wastewater Treatment System
I 14- Dec -01 7 ;Short Environmental Assessment Form
'- J ;0 -00 — esign Data_Sheet — ..— .. - - - -- -- - ..... - - - -- - _ ------------------ .— _-- - - - - -!
I 6! 1( 4= Dec -01 _ S� eparate Sewage Treattent System_$heet 1 of 1
1 14 -Dec O1 , [Application to Construct a Water Well
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