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HomeMy WebLinkAbout3186DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 72. -1 -37.51 03186 lk �A � � ��T .` �` '. I f �' ' - - ' ` ' ' . t ' ' - I' r I . rmr r mi �I 03186 A SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 Q ADDITION APPLICATION RESIDENTIAL ONLY t STREET 32 Horton Hollow Rd. TOWN Putnam Vly TAX MAP # 72.-l-37.5,1 NAME Virginia Joy PHONE 914 -760 -6628 PCHD# MAILING ADDRESS A7 unrtnn Hnl l ow Road Putnam Valley, NY -10579 DESCRIPTION OF ADDITION_ part, a1 Fin; GhPrl R G m nr and iinfinished storage NUMBER OF EXISTING BEDROOMS' 11 _PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) * *Any addition which is considered a bedroom requires formal approval of plans.(Construction permit): prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (84S) 278 - 6130. 1. Certified check or money order for $100.00. :2. Sketches of existing floor plan (drawn to- sca.le.. all, living. area includiny.hasement, to be.. . :.- .. - s i;;VVii aYr�l neJ anu use or eacti'room "specined). See Secnon "s:c of tSullettn HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non- professional sketches are acceptable and preferred. (See Section 3:d of Bulletin HA -1) 4. Copy of survey showing all well and. septic locations. on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. Copy of Certificate of.Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling: OFFICE USE COMMENTS s. 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 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 =1580 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ROBERT :MOPURUS. PE Director ofEnvironmental Health . June 6, 2011 Virginia Joy 32 Horton Hollow Road Putnam Valley, NY 10579 Dear Ms. Joy: DEPARTMENT OF HEALTH 1 Geneva Road, .Brewster, New York 10509 Office (845) 808 -1390 Fax (845) 278 -7921 or (845) 808 -1937 Re: Addition- A- 070 -11 No Increase in Number of Bedrooms 32 Horton Hollow Road (T) Putnam Valley, T.M. 72.4-37.51 PAUL ELDRIDGE County Executive I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated June 6, 2011. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at four without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads 9rd faucets Pte. 4. This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. 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 other 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 (845) 808 -1390, ext. 43261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:cw cc: BI, (T) Putnam Valley 0 SHERL,ITA AMLER, MD, MS, FAAP Commissioner. of Health Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 Town Legal Bedroom Count & Proposed Addition Status Re: Toy . (Owner's Name) Tax Map #. 72e'-1-37.51 Address: 32 - Horton Hot low Road Town: Putnam Valley Year Built:. g n n_5 According to records maintained by the Town, the above noted dwelling, is . xx in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: .3 ( septic 4 bedrooms) This information has been obtained from: Certificate of .Occupancy: 2005-46' Other: The plans for the proposed addition are considered: New Construction xx Addition to existing house only Teardown and /or re -build allowed under Town'Regulations 4/6/11 Building Inspect„-r.... Date 6. 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 Nursing Home Care. Fax (845) 278 -6085 WIC (845) 278 -667$ Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 f CERTIFICATE OF OCCUPANCY Certificate No: 200546 Permit No: 2004 -338 Tax Map No: 72. -1 -37.51 Location: 32 Horton Hollow Rd ' Parcel Owner: Joy Virginia 32 Horton Hollow Rd Putnam Valley NY 10579 Date of Issue: 3/7/2005 This certificate covers the construction of: ONE FAMILY RESIDENCE WITH TWO CAR GARAGE; THREE BEDROOMS 4 BATHROOMS; REAR DECK (14'X 57'); FRONT STOOP (12'X 5'); FIREPLACE; UNFINISHED BASEMENT. The applicant having heretofore filed an application for a building permit pursuant to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the TOWN OyF�PUTNAM VALLEY, `' . f� :�i r �1 t'i r�nt».4��• +na ±� n:n 7 + v '� d'i1c7V'u`: : i} N. _ . na. ei� e 3 - - .,_„f�.., n,. 'i ;::.tacrs. c 5- c.SonaU Pt.;L1011 . ascertained that improvement of the proposed structure is in compliance with the requirements of the laws as aforementioned; that the said work and materials meet every requirement of the laws as aforementioned; and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions of law. Now, therefore, the Certificate of Occupancy is hereby issued under the seal of the TOWN OF PUTNAM. VALLEY. TOWN OF PUTNAM VALLEY BY c4r-4-clow Code Enforcement Officer AM COUNTY'DEPARTMENT OF HEALTH N- 10F.ENV RONMENT- A.L HEAL' F CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT PCHD CONSTRUCTION PERMIT # PV- 6-4 - O? Located at 3Z. ROIRTOM 1(;: =Wv4 ROAD Town or Village Cry ?v 1 "O"m VA "�`C- "t' Owner /Applicant Name _V P'C7 Aar a ra -:5-0 \� Tax Map "17— , Block i Lot S-1 - S t Formerly �,k I A Subdivision Lov S Subd. Lot # I Mailing Address 'PC) , ` oy 613 a �a � as ca, �td� � �� V� �i„� YO--k, Zip 1 a's 1 � Date Construction Permit Issued by PCHD `I i 10, .4 Separate Sewerage System built by Sd A%.& L AL*o % C corm a-) Address t a S 1 `t Consisting of Ia`2-3 ® Gallon Septic Tank and 5-1 5 L of ZA ' V/koL A "e- sovv'i'1oaA Other Requirements: Z v" �� 't o � -Z,o t., . S �2," f.x 4- (1 4- Water Sup "I : Public Supply From Address or: Private Supply Drilled by 1S - Y i> Ae-r6, S ion G'a ,Address Cke-ms, (05,z- Number of Bedrooms _At Has garbage grinder been installed? 6- 0 O 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 P tnam un ep ent of Health. Date: 2 Z3 � Certified by ' P.E. � R.A. Design Professional) Address _940E.Y 1, Q4'n Jill P.C. �A 5Pf= -auc1. Oy. Ie) License # ()62 605 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 revocation, modification or change is necessary. Whlw'copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 a a BRUCE.R.FOLEY - - * - - - LORETTA MOLINARI_R.N.;- M. &;N..� _ __ - _ •.:.�: �� .� -'�- - Associate �t�ubiic Heiith Direcfor" _ :_ a - �� °ruGic "iYeuiiriLneei6r" .��. y0 Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845} 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 E911 ADDRESS VERIFICATION FORM OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: John Landi & Virginia M. 72.4-37.59 Horton Hollow Road TOWN OF PUTNAM VALLEY AUTHORIZED TOWN OFFICIAL: (Signature) DATE: November 29, 2004 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. (E911 verfrm) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT NOTE: Exact location of well with distances to at least two permadenf lafidindrks to be provided a separate eet/plan. Well Driller's Name, /0V S/,/ -9 Address: /f/, Signature: //) Z Date: White copy: Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 Fy–�W.-* - n-V7 I q 111 a'g' re.- ­14 11(�]JlVlapV, i a xUrici 7. 77. 1 Block l Lot(SI Well Owner: Nam '77 ddress: d&A. P a.f & /f\ ` -7 A -�3 0 )65 1)ai)j V Use of Well: 1-primary 2-secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary _ Cable percussion X Compressed air percussion _ Other (specify) Well Type Screened Open end casing __,X Open hole in bedrock Other Casing Details Total length )/ ft. Length below grade ­90 ft. Diameter _j in. Weight per foot lb/ft. Materials: A Steel Plastic Other Joints: -=-- Welded _X Threaded Other Seal: __.X Cement grout Bentonite Other Drive shoe: -)L Yes No Liner _ Yeses No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First — — Yes No Hours Second Well Yield Test Bailed Pumped k Compressed Air Hours Yield --q- gpm Depth Data Measure from land su;race -stafic (specify ft) D'uring yield test(ft) '7PA/ Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses ­- ZJ-a-vailabfie, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface ra If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump Type&"l #j' Ctpacity L10 A Sul," Depth 140Qf& Model I G& S2.0 q a Voltage HP ol Tank Type AM Avl Volume 1?0 C16d !3 IM Date Well ompleyd Putnam County Certification No. Date of epont Well rille (signature) NOTE: Exact location of well with distances to at least two permadenf lafidindrks to be provided a separate eet/plan. Well Driller's Name, /0V S/,/ -9 Address: /f/, Signature: //) Z Date: White copy: Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC-97 DEC -06 -2004 09:14 HADEY & WATSON, PC PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM P. 06/08 John Landi & Virginia NL Joy _ 72. 01 37.51 eer ®w or Purchaser of Building T Tax Map Block r. Lot John Landi (T) Patn= Valley Building Constructed by .�� _ Town/Village� -V- Morton Hollow Road .. SubdiivWon Lot s weer Hoidin&_ Location- Street Subdivision Name Residential 1 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. .,.... _. � �_ _.._.__.___...._ _._ - n�e� -_��n �: fi.r�l:- .r....aa - -- -o p ,�� �t riez�%p � jte •m:3�t:�:n -.: -_ k�.Pu. �� :.�e;t + 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 utilizin the system. / _ _ o Dated: Mo h 11 ay 29 Year 04 7 ��y ral Contractor ( er) - Signature Join Landi (Owner) Corporation Name (if corporation) Address: P.O. Box 633 Pa imm ValRey State ,^ New York Zip._ 10579 Signature: V Titl • Owner John Landi Corporation Name (if corporation) Address: P.O. Bm 6331 Putnam Valley State _ New York Zip 10579 Form GS -97 � YML ENU�R IAL SERVICES u�� near �,treet ,^ yprktown Heights N�Y �_�'�����`�/��������;��������������:�`����z������� Albert H. Padovani, Director LAB #: 1.500734 CLIENT #: 58200 NON STAT PROC PAGE�- I JOY, VIRGINIA- DATE/TIME TAKEN: 02/10/05 07:5O PO BOX 633 ' DATE/TIME REVD: 02/10/05 08:01-3 PUTNAM VALLEY, NY 10579 REPORT DATE: 02/17/05 : PHONE: (914)-760-6628 SAMPLING SITE: 32 HORTON HOLLOW RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COL'D BY: JOHN LANDI TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 02/10/05 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 02/10/05 LEAD (INS) <1 ppb 0-15 ppb 9003 02/10/05 NITRATE N%TROG <0.2 NO /L O - 10 9052 02/10/05 NITRITE NITROG <0.01 MG/L N/A 9162 02/10/05 IRON (Fe) <0.060 MG/L 0-0.3 mg/1 9002 02/10/05 ' MANGANESE (Mn) <0.010 MG/L 0-0"3 mg/L 9002 02/10/05 SODIUM (Na) 3.24 MG/L N/A 9002 02/10/05 pH 7.4 UNITS 6.5-8.5 9043 02/10/05 HARDNESS,TOTAL 86.0 MG/L N/A - 02/10/05 ALKALINITY (AS 70.0 MG/L N/A 9001 02110105.,_ .`TUR8IDITy~(TUR `. _<1_NTU _ _--_ 0-5NTU ' COMMENTS: FAX TO BADEY & WATSON, ATTN: NEIL @ 265-4428 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIN���J=THE NEW YORK STATE -- AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper ' than 10% of their —than 15 p0b and a treatmeNt must be potential. iblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value -combined shall not exceed 0.5 mg/L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Mel gh Albert H. Padovani, Director LAB #: 1.500734 CLIENT #: 58200 NON STAT PROC PAGE: 2 JOY, VIRGINIA DATE/TIME TAKEN: 02/10/05 07:50 PO BOX 633 � � ' DATE/TIME REC^D: 02/10105 08:08 PUTNAM VALLEY, NY 10579 REPORT DATE: 02/17/O5 ' PHONE: (914)-760-6628 SAMPLING SITE: 32 HORTON HOLLOW RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COL'D BY: JOHN LANDI TEMPERATURE..: < 4C ' NOTES...: COLIFORM METH: MF 'DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Na' No limits for Sodium are proscribed.:Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND _ FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. DN�SS� NED~6\S�TH[�SUM . - . . ' '_ - - ` '-~-` - RANGE FM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. ' SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER ' HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: WLO - Albert n. raowvanip n./.`r,oCr/ Director B-AP# 10323 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health Lr.~ LORETTA MOLINARI, RN, MSN Associate Commissioner of Health March 3, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Neil A. Seidl Badey & Watson Engineering 3063 Route 9 Cold Spring, New York 10516 Dear Mr. Seidl: ROBERT J. BONDI County Executive V/ Re: Construction Compliance — Joy /Landi 32 Horton Hollow Road, (T) Putnam Valley TM# 72. -1 -37.51 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. 1. The Well Completion Report has not been completed. (Pump /storage tank information section). 2. There appears to be errors in the yield testing section of the report. This office will continue its review upon consideration of the above mentioned comments. Please tP,F. i- St'P�'.. t�� -(• Jn; rat. mC . .._._._. =... .. _. � .:. _... ., __. .. aX f . . .1.. 1 . .G� ' 7 ::fY JSP:cj Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer 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 MAR -3 -2005 21:41 FROM:BOYD ARTESIAN WELL C 845 2258420 TO:927B7921 I C EYI�m 1054 Rte. 52 Carmel, fr X 10512 (845) 225 -3196 r Fax (845) 225 -8420 fill f) RR FROM, COMMENTS, P:1/2 PAGE L OF � 177is transmission is intended oniy for the uee of the individual or endry ro w!?•ch P by addrE,esed and may contain information rhar is prrviieged, conrideniial, and exempt from disclosure urder applicable 14w, ,'the i eaderof this message is not rho intended recipient, you arc hereby aotiJied rhar any dissemination, distribution, or copying of this cammwnicadpn is strictly prohibited, If ymt have received this communication In error, please return the original to;the sender by trail TCt . Qa�_a7l� -74 ?1 HAMF : PI ITNAM rrq INTY DFPARTMFNT OF P. 1 i zo U I' A:�i 0 pq T' �k -TrN 11 February 23, 2005 Re: 32 Horton Hollow Road Tax Map # 72.-1 -37.51 Town of Putnam Valley To Whom It May Concern: I John Landi did install one 2 Horsepower, 10 gallon per minute, 80 gallon Amtrol Diaphragm storage tank model # WX302 PRO in the above captioned residence. GC>utA 5 - Co 91 Re pec Owner BADEY & WATSON LETTER ®f TRANSMITTAL -.0 nee..f- 3063 Route 9, Cold Spring, New York 10516 Date: 23 Feb 2005 File No. 98-105 W. 0. # 16824 RE: Certificate of Construction Compliance Joy TO: 32 Horton Hollow Road Mr. Joseph S. Paravati, Jr. Subdivision Lot 5 Westcheste Subd. Lot No. 1 Putnam County Department of Health Tax Map . 72.-l-37.51 Permitrritle/M # 5312-1468617 1 Geneva Road Brewster, NY 10509 Sent via: F_ US MAIL El UPS-NIGHT El MESSENGER ❑ UPS-2 DAY El PICK-UP El UPS-3 DAY F-1 FAX El UPS-GRND V We are sending: UPS-COD copies date description of document 71 123-Feb-05 [EertiFicate of Construction Compliance for Sewer Treatment System 71 129-Nov-04 E911 Address Verification Form F-31 129-Nov-04 IGuarantee of Subsurface Sewage Treatment System F�l 117-Feb-05 Well Water Test Results (2 Sheets) F-1] 11 9-Nov-04 —7 Well Completion Report F�l 123-Feb-05 I Letter From Storage Tank Installer F 41 123-Feb-05 —7 ISSTS "As-Built" F-1 I M 1 REMARKS: Dear Mr. Paravati, please find the above documentation for your review. If you have any questions please feel free to contact me. Copies to: File Yours truly: Neal A. Seidl Jr. Engineer Tel: (845) 265-9217 ext 25 Fax: (845) 265-4428 Email: nseidl@badey-watson.com Virgin M. Joy John Landi 40 40-05 498572 624187 26217 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL. SITE INSPECTION ' 9./3 Date: i1 1 -1 ley Inspected y.._, ocation, .54eet L Permit # &- 0 _ TM# Subdivision Lot # S- /_ I Sewaze System Area 6z�- 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 ........................................ I ......... d. Stone, brush etc., greater than 15' from STS area....:.:... 6. 100' from water course/wetlands ..... * ................................ R.' Sewitze System *'a. Septic tank size - 1,000....'.._.1,250.........other ................ 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. Nfinimurn 2 ft.Original soil between box & trenches e. Junction Box properly set ......................................... 6. T-r-en-Me—s 7'i 1. Length required Length installed 2. Distance to watercourse measured Ft. 4.1.4` ` 3. Installed according to plan .............. ......... 4. Slope of trench acceptable 1/16 - 1/3211/foot ............. 5. 10 ft. from property he - 20 ft, foundations.......... 6. Depth of trench <30 inches from surf1ke .................. 7. Room allowed for expansion, 100% ...................... ' S. Size of gravel 3/4 V/ 2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ....... i ........... 1.0- Pi'w-erlds -cap d -ktfrn6-of-Dos'e& &Vsteins 1. Size of pump chamber,.-...... ... . .. . ....... 2. Overflow tank ...... ....... .3. Alarm, visu o:.,:.,: 4. Pum '�yy A�a�cesisible.' 'm'* 'a'*n'h'* manhole g­r*a­d­e- 5. f �box baffled ................................................ ...... Cycle r e ycle witness* d by H.D.estirnated flow/cycle ........... a. House located per approved plans .............................. '..b. Number of bedrooms ........................................... IV:' Well Well located as per approved plans ...................... I ........... b. Distance from STS area measured ft.. ....... c. Casing -18" above grade ................................................ d. Surface drainage around well acceptable ....................... V Overall Workmanship a. Boxes properly grouted .................................................. b. All pipes -partially backfilled .............................. ... .......... c. All pipes flush with inside of box .................................. d. Backfill material contains stones <4" diameter ............... e. Curtain drain & standpipes installed according to P1 f. Curtain drain outfall protected & dir.to exist watercl g.. Footing drains discharge away from STS area ............... h. Surface water protection adequate ........ .......................... i. Erosion control provided ..................... ........................... Rev. 12/02 10�1 I■ rim C. 10�1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION X JOSEPH ❑ GENE REQUEST FOR FINAL -INSPECTION Date: 11/10/2004 PCHD Construction Permit # PV -7 -02 For: Fill Trenches Located: Horton Hollow Road (T)'(V) (T) Putnam Valley Owner/Applicant Name: Virginia Joy TM 72 Block I Lot 37.51 Formerly: N/A Is system fill completed? N/A Is system complete? Yes Is system constructed as per plans? Is well drilled?' No Is well located as per plans? Are erosion control measures in place? N/A Subdivision Name: ... Subdivision Lot 5 Westchester Holding... Subdivision Lot # 1 Yes Vae Date: N/A Date: 11/8/2004 Date: 11/8/2004 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: —'— f00i2-d64-'­ -Ferti 71 PE X RA— Design Professional Address: Badey & Watson, P.C. 3063 Route 9, Cold Spring, NY 'Lic. # 062505 Comments: Form FIR-99 a PU7�WAM COUNTY DEPARTMENT .OF HEALTH ry: _AS OF ENVIRONMENTAL HEALTH SERVICES � .y .� ... '. -. Q. ..w:�'S ....�4^': .4tr.= •cc..czT n 4-.. ..r tdc... ?•An:.4.�i .'. r CERTWICA'TE OF CONSTRUCTIONtOMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHP CONSTRUCTION PERMIT # ° 01 .0 Located. at U AGATOM u W ROA0 Town or.Village. ��� -r &i K 6 Owner7Applicant Name y`e o-e r�o a �, a Tax Map Q Z:- , Block Lot Formerly Subdivision Name ®» � sua wwre�wn� d., ®c Subd.. Lot # .. Mailing, Address 6 a 13.E � 3., %t o tv, Vasa �1 rte: taJ Yo - Zip Zi �a"� Date Construction Permit issued by PCHD `"l 2r1 64 Seaarate Sew System built by o a� - �.ws�0 Address .?Isay ± . to. 1 9S, Consisting of 'Gallon Septic Tank and'`. 8. "4 b��.�geos ea Other Requirements., Z ` � � C� A .1� . � � �. ' U itih Water Suaimly: Publi Suppiyrn Address. U. or .: Pnvate-Suppiy. Drilled by..:�+:p.,.r�'c9�4 .a,,Address�c�.::.ad5,'o 5ff / u?1'dasg '- nypeet� r as erc�on cor�+rol beencomplet_ed��I�f �] _ IT— Number 'of Bedrooms Has garbage grinder been installed? + �► . t L cerfifythat the system(s); as listed; serving;the, above premises. were constructed essentially.as s o nzt he.: built plans; (copies of which are attached),. in accordance with the.issued;PCHD Constru tlon.Perni and approved.. .plans and the standards;. rules and regulations a e o De ment of Health: Date. Certified by • P.E. � R.A. V. esiO Professional) Address B &DEY. 1 �t'��� 'P.C. a-® PRJat1 &i-Y.. 1dtf 6 License 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 resultuig from: such usage. Approval of the separate sewage treatment, system shall becoine'null and void as soon as a publ c saiutary.sewer becomes available and the approval of the private water supply :shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in 'the judgment of the Public Health Director, such revocation, modification or change is necessary. By ;sr ` .� (� Title: _ Date: l C7 Wh copy - HD File; Yellow copy - Building Inspector; Pink copy Owner; Orange copy - Design Professional Form CC -97 UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES a CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM 1. AMa PERMIT it N- -� - OZ Located at CiOZivKc kXwL.') VDX6 ... *4 i5i W Lei IS Subdivision nama VMt ?5W Subd. Lot # Date Subdivision Approved ca �'D$ Owner /Applicant Name Mailing Address C�D G33 , �:U. + \/ q Amount of Fee Enclosed it �(DDac`' Building Type �1't- Lea, Town or Village Tax Map Block Lot 3Y5 Renewal Revision A Date of Previous Approval 12- 1 i 2 10.5 PE4,) Zip 105' 0( Lot Area 1Z-2ALNo. of Bedrooms Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of ,2-50 gallon septic tank and �' 5 t IF Other Requirements: Z-0" 022 ate Or- 5A*4rJ - Czn'AQ& - -l^IUL To be constructed by (8AQ� I-�� ° 15095 Address -)J/ 10,50 Water Supply: Public Supply From Address °r �vaie-su piy- Lrnid'u by -N: I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. iI,- R.A. Date I-' Address WO/L -W5t, PC-• cmo 6P74)&--A, ►-H l0Gi(.a License # CCZ505 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Approved for discharge of domestic sanitary sewage only. By: Title: %-Pl+ Date: 7 C, 0 Whi copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT T O F HEALTH DWISBON OF ENVIRONMENTAL HEALTH SERVICES �. . Q....,..,T QPA:_rA7C��ll '�'•�1 q lu,?'';.4:W_,�' Q?�u'u u T _ ::Z a ... = -. please print or type PCHD Permit # — Well Location: Street Address: TownNillage Tax Grid # � i j4 E i°1.�J QQ� (J) �TX"N \JALLiEgMap TZ. Block k Lots) 37,51 Well Owner: Name: Address: I�Ik -�Z)`{ 0 (53 � iM VAL.L,i , Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought S gpm # People Served (A Est. of Daily Usage dal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling J New Supply (new dwelling) Deepen Existing Well Detailed Reason 'o gg04 f 0E A L'sj.� jg&Z (za5N 9 C_:F_., for Drilling Well '}Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes )C No Name of subdivision 1AC40iAXz..- Lot No. i Water Well Contractor: OOP -VIA" MoEesw Address: O ighM \1A 1--F -j, 94 105_M Is Public Water Supply available to site? .................................. ............................... Yes No }C Name of Public Water.Supply: 9 %A TownNillage R Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. qfp t- EVA PERMIT TO CONSTRUCT A WA'T'ER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate.surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue A)-7 O y Permit Iss ing Official: Date of Expiration 9 O; Title: Permit is Non- Transferirabk_ White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT ..:�.£:: �.,!` �� - ^?e: ... _ar, c:i �. _ ��: � :%•: r'. i[.a v. latA lJll�l If �N6diw Mapg, Bock aoW Lots l"�Sf Well Owner: Nam : �� �Addre3 Pafnam V0110i ,V � / 657 Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat 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 l ft. Length below grade ft. Diameter _lin. Weight per foot _I_Llb /ft. Materials: ASteel _ Plastic _ Other Joints: _ Welded _K Threaded _ Other Seal: Cement grout _ Bentonite Other Drive shoe: __)� Yes No Liner: Yeses No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield gpm Depth Data Measure from land s rface- static (specify ft) During yield test(ft) /� _rol Depth of completed well in feet 15 Well Log If more detailed information descriptions or sieve analyses please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface `jam' r2 A 1, _ ... _ /'� �'• / _; �`f If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type . , S ypacity �;at Depth 5i� `Model tl$&S LO 1 Voltage 1222 HP oZ Tank Type44nol Volume �0 <<� 1 WX3" AM (3� 3J 611' Date Well Clo mple d l� lq U Putnam County Certification No. Date of eport "�M Well rille (signature) I NOTE: Exict location of well with distances to at least two permanent laridmdrks to be providedAfn a separate 4heet/plan. Well Driller's Nam a - Address: (� / y Signature: Date: 44 White copy: Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 ,t BADEY & WATSON LETTER ®f TRANSMITTAL 3063 Route 9, Cold Spring, New York 10516 Date: 20 Jul 2004 TO: Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road File No. 98 -105 W. O. # 16606 RE: Permit Renewal/NAME CHANGE Joy Horton Hollow Road " ...Subdivision Lot 5 Westchester Subd. Lot No. 1 Tax Map 72.4-37.51 Permit/Title/PO # PV -7 -02 Sent via: Brewster, NY 10509 US MAIL UPS -NIGHT El MESSENGER UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY El FAX ❑ UPS -GRND W We are sending: UPS -COD E] copies date description of document 01 20- Jul -04 __j jApplication Fee - $400.00 Ol 19- Jul -04 = lConstruction Permit for Sewage Treatment System Ol F ILetter of Authorization Ol 11 9- Jul -04 —7 jApplication to Construct a Water Well 02 28- Apr -04 Ll Floor Plans five 5 pages ® 19- Jul -04 Se arate Sewage Treatment System Sheet 1 of 1 U j� U REMARKS: your review. The subdivision info has been updated, the house footprint has been revised, the name has been changed, and the permit is being Copies to: File Yours truly: Jason R. Snyder, Assistant Engineer Tel: (845) 265 -9217 ext 13 Fax: (845) 265 -4428 Email: jsnyder @badey - watson.com 40 40.05 498572 624187 24686 JUL -16 -2004 14:56 BADEY & WATSON, PC P.02i02 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,.n - .;i --..r. :.._w....... ::. .. a:'... -s.. r ya %•�c.'. �i!.vl.;?1 .t- T' RE: Property of Virginia Joy Located at Horton Hollow /toad T/V Putnam Valley Tax Map # 72 Block 1 Lot 37.51 Subdivision of "...Subdivision Lot 5 Westchester Holding..." Subdivision Lot # 1 Filed Map # 2824B Date Filed 7/8/2004 Gentlemen: This letter is to authorize John P. Delano, P.E. a duly licensed Professional Engineer J 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, Countersigned. , Signed: P.E. RW # 062505 (OwwofRu�x Mailing Address Badey & Watson, P.C. 3063 Route 9 Cold Spring State New. York Zip 10516 Telephone: 845 -265 -9217 Mailing Address: PO Box 633 Putnam Valley She Now York Zip Telephone: 845- 736 -3651 10579 Form LA -97 TOTAL P.02 DIVISgON OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM i,7 r"-r MI `t PERT # Q I Located at Town or Villa e 1 s' Lam` Ca., , i,JC. Subdivision name �C t1 _ ► Subd. Lot #, Tax Map Block 1 Lot 3� Date Subdivision Approved aq II Renewal }� _ Revision Owner /Applicant Name vJjt��- ate of Previous Approval of z`a �Z Mailing Address � '�� � N Akoe �i �-/ Zip V b�� Amount of Fee Enclosed 15 -�OCL "' Building Type Lot Area WNo. of Bedrooms A— Design Flow GPD C7LX-.) Pill Section Only Depth Volume PCH D NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED Sepyarate Sewerage System to consist of�j � I I'M �. gallon septic tank and - Other Requirements: Z — C7`` 2+J� ' a--1 t- To be constructed by MQcy-p L16tiQS y '50s,-r6 Address COL-P I01XQ Water Su]pj2ly: Public Supply From Address _ ._� : _ - -. -- _- Frivaie�iippiy ilriilec� by: lC�rYi.i "FCr C, _ _ Acldress� = ice' `q%75 I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the curate 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 ii 15" c7 3 License # (DW-1500 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. B?eC0pVy �� Title: Ap� Date: e2 / v 7) W - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES P:PLI - T-10N Tn C-0N T—R JCT A WA. �TFR W_F ,I.F,. _ . - - - _ 'please print or type . - ..� ....... _ > �PCHD Permit # �� . Well Location: Street Address: Town/Village Tax Grid # ARWW r- Pj \JA.ZV' Map 7Z Block Lot(s) Well Owner: Name: c• -) Address: /D56>1 Use of Well: 1 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 7 gpm # People Served 6 Est. of Daily Usage dal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason F: po � - ,rte fc for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes_ No Name of subdivision Q i*7`,T-e _ 1fCL0 jtk< Ko. a.(C�.. C a �-a Lot No. Water Well Contractor: 1PANJ U22�=j, We . Address: Q wD6l \L ALL", . 4't o5 *9 Is Public Water Supply available to site? .................................. ............................... Yes No G� _ Name of Public Water Supply: 144 Town/Village Distance to property from nearest water main: -.- tA,: Proposed well location & sources of contamination to be provided on separate sheet/plan. �: �l. %�i °; _Il i_3�3�1..."._.).. .An�►1�f`.arp �yjiui'1�711TP.: ,�'11'���/%1. <:!: _,R,ll:_�i`.�t /_ !'t _ ... V 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. In Date of Issue c C T— Permit Iss ' g Or ial: cLI , , Date of Expiration �. Title: 5%s ;-` ��lr Permit is Non White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 �.•...c. - -n. it �'•"".....w. �..;..q.. ..:. ia•.�._ . a....a .+�rv.. - ..n -t r..n .. LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278-6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 December 5, 2003 John Delano, PE Badey & Watson Engineering 3063 Route 9 Cold Spring, New York 10516 Dear Mr. Delano: ROBERT J. BONDI County Executive Re: Proposed SSTS Renewal — Westchester Holding Corp. Horton Hollow Road, (T) Putnam Valley Tax Map # 72. -1 -37.5 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. XI .. Please provide a copy of the wetlands permit. n "4' the bends in the effluent line 45 °? If so, cleanouts and cleanout detail need to be provided. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, eTl- oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:ci PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & STTBSUR ,(�'A ,C �- 7T�z� E ���� �.�1�� +:ri c,1.:L+.�Si/m�� _ �:,.,,e,�.;ti, .•N i.......- „ -.•'rx an i-+nse r .� • _. ti >`:� c ”. • ' �i* I`E E 1 1• U7EF (�NST�tTJCZ ION PERMIT NAME OF OWNER: Lz,1 `0_1 STREET LOCATION: REVIEWED.BY: RM, GR, �%� , SRDATE: f TAX MAP#: (CONFIRMED) �Y� Z DOCUMENTS Ci: PERMIT APPLICATION WELL PERMIT OR PWS LETTER (J(-_)PC=97 LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) (CORPORATE RESOLUTION SHORT EAF (_� PLANS -THREE SETS ( OUSE PLANS - TWO SETS (�AR7ANCE REQUEST SUBDIVISION LEGAL SUBDIVISION ' SUBDIVISION APPROVAL C HECK ED J��PERC RATE.� p n•` /nut` l:✓JC • ► L REQUIRED D EPTH (�CUURTAIN DRAIN REQUIRED GENERAL (� LOCATED.IN NYC WATERSHED (��)PLANS SUBMITTED TO DEP ( )DELEGATED TO PCHD (_J EP APPROVAL, IF REQ'D ( DEEP TEST HOLES OBSERVED (_ _J(�ERCS TO BE WITNESSED (-_)L PRE 1969 NEIGHBOR NOTIFICATION (_„�tETTF3?,RllZBA LUUD ILEVATION W1I 200' ((OIL TESTING LOTS >10 YEARS OLD (� REQUIRED DETAILS ON PLANS ). SEWAGE SYSTEM PLAN - (NORTH ARROW) �SSDS HYDRAULIC PROFILE 4�)GRAVTTY FLOW CONSTRUCTION NOTES 1 -15 JJ(��TT DESIGN DATA: PERC & DEEP RESULTS ( ✓� 2' CONTOURS EXISTING & PROPOSED Q�DRrvmwAY & SLOPES, CUT (,�t�FOOTING /GUTTER/CURTAIN DRAINS (�USDA SOIL TYPE BOUNDARIES (�UTITLE BLOCK; OWNERS NAME ADDRESS TM #, PEMA; NAME, ADDRESS, PHONE# (4/ DATE OF DRAWINGaMVISION DATUM REFERENCE (__)LOCATION OF WATERCOURSES, PONDS LAKES WETLANDS WITHIN 200' OF P.L. PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS '�E�WELLS & SSDS'S WAN 200' OF SSTS ��-�PROPERTY METES & BOUNDS - )(__)ERASION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE `-- )MMEIVTS: ---4 t-`' �1e as ?.lM=cw•r %nnim inn (�Y �R -EMED DETAILS ON PLANS CONT'Dl (� OUSE SEWER -'/.'' FT. 4 "0'; TYPE PIPE.CAST IRON (�(�O BENDS; MAX BENDS 45' W /CLEANOUT RENEWALS LLI_USUTE NOTE (NO CHANGE) FILL SYSTEMS 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE (FILL SPECS / FILL NOTES 1 -5 FILL PROFILE & DIMENSIONS FILL IN EXPANSION AREA FILL GREATER T9AN2 FEET CLAY BARRIER ULUFILL CERTIFICATIO?jN_OTE`�- L-)(JDEPTH GAUGES-` UUVOL..ON PiAN FOR R.O.B., UNCLASSIFIED & MERVIOUS (__)(_�—SEPARA.TION DISTANCE FROM'TOE OF SLOPE � )LF TRENCH PROVIDED�N� 60FT MAX /�'�G ✓'Lr�C 5"�d ✓( (� l� PARALLEL TO CONTOURS U 100% EXPANSION PROVIDED (-L—T( EE CRUSHED'STONE OR WASHED GRAVEL 6GEOTEXTILt FR COVER / SEPARATION DISTANCES ON PLAN - FROM -SSTS 3 (�i 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL ()20' TO FOUNDATION WALLS 100' TO WELL, 200' IN DLOD,150' TQ PITS r v 100' TO STREAM, WATERCOURSE, LAKE-(inc - ezpaa), __)50' -T0 GAT-C'H- 7!A_5,1: 5' SYtZc21i�:�•Ra ? F Er: W =EB 10` 1 ti vV9.TER LINE (pits - 20') ' U50'• INTERMITTENT DRAINAGE COURSE (� )200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS v10' MIN TO LEDGE OUTCROP SEPTIC TANK (✓U10' FROM FOUNDATION; 50' TO WELL WELL CL�- ' IMENSIONS TO PROPERTY LINES (t/ LOCATION OF SERVICE CONNECTION MIN 15' TO PROPERTY LINE SLOPE �(_ jS PE IN SSTS AREA i0 %) (_)(� GRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS UUPUMP NOTES . ( )C_JDOSE 75% OF PIPE VOL OSE VOLUME NOTED ((__)DETAIL FOR FOR , (PIPE TYPE, ETC.) (_- __)(„)PIT AND BOX SHOWN & DETAILED STORAGE ABOVE ALARM ..-- -- -` CURTAIN DRAIN f UUSTANDPIPES, 5' BOTH SID AIL , v (x(_,__)15' MIN to CDS�>5, %� -4 %, 25' -3 %, 35' -lb /o, 100 % - <1% C_) __)20' MPLU -CD DISCHARGE/100' with 182 cons day discharge L—(_ NO"MIN to NON - PERFORATED PIPE NOV-18-2003 17:28 BADEY & WATSON, PC P.02/03 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FOR PERMIT APPLICATION SUBM1TTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: arste !Lw e trMtMelml fac*ty. E _M_ 1, Beirde Rath represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Wesfthwier Holdigg Co., loco Having offices at: 33 Chester Court, Corflwdt Nftmoir, MY IOS67 Whose Officers Are: President - Name: Berude Raab, President Address: 33 Chester Coa•t, Corflandl Manor, NY 10567 Vice President - Name: Address: Secretary -Name. Address: Treasurer - Name: and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating, thereto. Tide: President iqqy-, �worn to before me this day of tZ (monffi) '-';Z6 (year) Notary Public WV -18 -2003 17 :28 BADEY & WATSON, PC P.03/03 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES r7 -Ji ETTERACM- 98 , i .! .'►.,s.. pav_,:�. ;�� .... -u fe �.' � ..-s. RE: Property of Westchester Holding Co., Inc, do Bernie Rath Located at Horton Hollow Road & Cimmaron Road T/V (T) Putnam Valley TAX Map # 72 Block 1 Lot 37.5 Subdivision of Westchester Holding Co., Inc. Parcell III Subdivision Lot # s Filed Map # 2824A Date Filed 08 /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 andlor water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public H ealth Director of the Putnam County H ealth 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 m conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public H ealth Law, and the Putnam County Sanitary Code. truly yours,_ - - - - - -. _.. - - Count y. ed: Sinsi P.E.;o# PE 062MS (Owner of Pmperty) Mailing Address Badey & Watson, P.C. 3063 Route 9, Cold Spring State New York Zip 10516 Telephone: (US) 265 -9217 Mailing Address: 33 Chester Court Cordandt Manor StateL New York Zip 10567 Telephone: (914) 739 -3198 Form LA -97 TOTAL P.03 BADEY & WATSON LETTER of TRANSMITTAL—- C 3063 Route 9, Cold Spring, New York 10516 Date: 24 Nov 2003 File No. 98-105 W. O.# 15705 RE: Permit Renewal TO: Horton Hollow Raod & Cimarron Road Joseph S. Paravati, Jr. Westchester Holding Co., Inc. Par Subd. Lot No. 5 Assistant Public Health Engineer Tax Map 72.4-37.5 ? Putnam County Department of Health Pernutfride/P0 # I Geneva Road Sent via: Brewster, NY 10509 US MAIL El UPS-NIGHT 11 MESSENGER El UPS-2 DAY PICK-UP 0 UPS-3 DAY E] FAX El UPS-GRND 0 We are sending: UPS-COD El copies date description of document FT 120-Nov-03 I FApplication Fee - $300.00 71 118-Nov-03 I [Construction Permit for Sewage Treatment System F-11 119-Nov-03 Affidavit - Corporate Owner Application F-11 1 771 Letter of Authorization F-11 11 8-Nov-03 lApplication to Construct a Water Well F-41 118-Nov-03 71 ISeparate Sewage Treatment System Sheet I of I ❑ I El I F-1 I REMARKS: For your review. 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 498572 624187 22883 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # 1� - -�-- j`lG�� Located at H o yroN _�4 0 U- w �� Town or Village P m,,, M iA L1 ;F-a WUrcwC�-rak 1401,01atr Subdivision name Co. ., lue_.I PAfg-,, -jK Subd. Lot # Tax Map -17- Block Qj Lot 3`j ._.5 Date Subdivision Approved �a t lAi t.B Owner /Applicant Name Renewal Revision Date of Previous Approval Mailing Address 3S GArs ; r& CuM7 , CAMANry MAMDL NJ Zip,, Amount of Fee Enclosed 2100 `�' Building Type RriSl,vx„rAA& Lot Area 32.9 A, No. of Bedrooms Design Flow GPD_,M Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of Z,sp gallon septic tank and 515 L F - or n" Other Requirements: P V IY""t- V-o" M iN- 9-0.8. Gi l.i.- To be constructed by AgaLn Lma -tjs Sax)c Address 1-15 A-nA . GAGA Water Sunaly: Public Supply From Address yr., rivate Supply Dritled'by jtkS0 i hi s; Ad&ess -C ;; ; -n1'9 057,q I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address Wk— Date License # ®d256f� 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 rmit. Approved or discharge of domestic sanitary se age only. r� By: � '--- Title: Date: C White copy - HD File Yell w opy - Building Inspector; Pink copy - O er; 0 an copy - Design Professional Form CP -97 . PUT NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL .:10411 Permit # .. �� _ v�: please print or type - r~ ��% ^Yf � . Well Location: S eet Address: Town/Village Tax Grid # AD, P,, , A , VAuo Map I Z Block 01 Lot(s).37.5 Well Owner: Name: W,n Address: PA I VITA M.). t S3 ClAalra Coi1�; i i CoqLWT MOdV i og 6 5 Use of Well: Residentfal 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 _5 gpm # People Served Est. of Daily Usage 00 al. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling _ New Supply (new dwelling) Deepen Existing Well Detailed Reason PwAC NIML& wAT&& Stmt 71) J&Q A6DO&JC6 for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No D Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision`, 6t- IfAfl-S3.0 9o; ML C -0 !NC..,, &Cep_ 11 Lot No. Water Well Contractor: _ , Address: • Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: WA Town/Village 6&A Distance to property from nearest water main:t/� Proposed well location & sources of contamination to be provided on separate sheet/plan. PELT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED ' FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. /] . Date of Issue 1 _2 '—b 2 Permi Date of Expiration I — Title: Permit is lion- Transfer able White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 a: r PUTNAh1 COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH LN-Dn'IDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS R- /E,V, I-EW S[H:EE'TT R FOR CONSTRUCTION PEP IN' Tr NAB tE OF O��i 1ER:. /�✓�`�J�� / ""�" ITREET LOCATION: y. REVVED BY: RDL GR, AS, &ATE: r�'- TAX NIAP ": (CONFIRMED)_ 99 1" N DOCULNTENTS -Y N (REQUIRED DETAILS ON PLANS CONT'D) UUUPERIIIT APPLICATION ((__)HOUSE SEWER -' /," FT. 4 "0'; TYPE PIPE CAST IRON ELL PER`IIT ORPWS LETTER (:(ENO BENDS; NIAX BENDS 45° W /CLEANOUT UUPC -97 RfagWALS (_ZULETTER OF AUTHORLLATION ()USiTE NOTE (NO CL) J �( )DESIG`' DATA SHEET (DDS) ILL S S EtitS UL-)CORPORATE RESOLUTION (�U10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE VJUSHORT EAF U�UFILL SPECS/ FILL NOTES 1 -5 UUPL.A-NS -THREE SETS (� FILL PROFILE & DIMENSIONS UUHOUSE PLANS - TWO SETS FILL Di EXPANSION AREA (J(_)VARLANCE REQUEST FILL GREATER 7Wj.,N 2 FEET SUBDIVISION U' (� CLAY BARRIER (�(__)LEG_AL SUBDIVISION (___)UFILL CERTIFICATION NOTE ((__)SUBDIVISION APPROVAL CHECEED (__)UDEPTH GAUGES (/U(__)PERC RATE - 0 {� vUVOL. ON PLAN FOR R.O.B., UNCLASSIFIED & BIPERVIOUS (U(__)FML REQUIRED DEPTH UUSEPARATION DISTANCE FROM TOE OF SLOPE U(j CURTALN' DRAT REQUIRED R GENERAL (�( CA TED L`. Iv'YC WAT LF TRENCH PROVIDED � 60FT hLAX. PARALLEL TO CONTOURS ((___)PLAN D TO DEP 0100% EXPANSION PROVIDED. (�( GATED T_ - - -- ( DETAILIDUST FREE CRUSHED STO`tE OR WASHED GRAVEL C ( _JDEP APPROVAL, IF RE COVER CZ __)DEEP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN - FROM SSTS (�(__)PERCS TO BE WITNESSED 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL WUEX- APPROVAL SSDS ADJ, LOTS 20' TO FOUNDATION WALLS t .J(__)WETLANDS (TOWir'/DEC PERhIlT REQ'D ?) 100' TO WELL, 200' I`( DLOD,150' TO PITS (Q(__)DATA ON DDS PLAINS & PERIN= SAME 100' TO STREAh1, WATERCOURSE, LAKE (mc. eipan) Lj(-,�ORE 1969 NEIGHBORNOTIFICATION a0' TO CATCH BASIN, 35' STORbIDRAIN, PIPED WATER U(�LETTERBUZBA f10' TO WAiEF�hTi ta4� 2� f:• . - - _ _C lrtnTj h`iTERiIIITTENTDRAIiAGE COURSE U(USOIL TESTL`iG LOTS >10 YEARS OLD (200'/500' RESERVOIR, ETC. — 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS (�H10' MLY TO LEDGE OUTCROP ( Z(SEWAGE SYSTEM PLAN - (NORTH ARROW) SEPTIC TANK Y)L.JSSDS HYDRAULIC PROFILE U10' FROM FOUNDATION; 50' TO WELL (..,6(JGRAVITY FLOW WELL (,ZLJCONSTRUCTION NOTES 1 -15 UDLNIENSIONSTOPROPERTYLINES -- -- - - --- - -- (�f(__)DESIGN DATA: PERC &DEEP RESULTS L/)ULOCATION OF SERVICE CONNECTION _ _ _j2' CO, 8c PROPOSED _ _._U_ __ vUNM 15' TO PROPERTY LINE ( �IFO DRIVEWAY & SLOPES, CUT SLOPE OTI ING /GUTTER/CURTAIN DRAINS �(�SLOPE li`i SSTS AREA a—y (0I (�( _)USDA SOIL TYPE BOUNDARIES (,L�(___)TITLE FLOCK; OWNERS NAME ADDRESS (_)(QREGRADED TO 15 %, IF REQUIRED TM;, PE/RA; NAME, ADDRESS, PHONE DOSE /PUMP SYSTEMS ( -Z( —JDATE OF DRAWING/REVISION UUPUitiTP NOT (�( _JDATU1N1 REFERENCE LU(UD0SE 75 / F PIP OL /DOSE VOLUME NOTED ( -4(—JLOCATION OF WATERCOURSES, PONDS UUDETAIL FO FO CE , (PIPE TYPE, ETC.) LAKES,WETLANDS WITHIN 200' OF P.L. U-)CUPIT AND D -B SHO & DETAILED (J (PROPOSED FINISH FLOOR AND UU1 DAY STO ALARM C T D Iri BASEh1ENT ELEVATIONS UUANDP S 5' 0TH ES DETAIL (f�(�WELLS & SSDS'S W/IN 200' OF SSTS UU15' hILY to - >5% 0'4%,25'-3%,35'-l%, 100 % -cl% (�(�PROPERTY h1ETE5 &BOUNDS �)U20' h1L'i to C GE/100' with 182 cons day discharge U(�10' NIL`( to ON - PERFORATED PIPE CONIh1ENTS: (REVSHEET) PUTNAM C, 'UNTY DEPARTMENTS )F HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .DESIGN DATA SHEET SUBSURFACE. SEWAGE TREATMENT .SYSTEM 33 Chester Court Owner B. Rath / Westchester Holding Co. Address Cortlandt Manor NY 10567 Located at (Street) Horton Hollow Road Tax Map 72 Block 1 Lot 3 7 (indicate nearest cross street) Lot 5 Municipality, Putnam Valley Drainage Basin Hudson River SOIL PERCOLATION TEST DATA 08/07/00 (A) 08/08/00 (A) Date of Pre - soaking 08/09/00 (C) Date of Percolation Test 08/10/00 (C) 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 12:10 - .12:40 30 19 - 201/2 1 1/2 20 -A 2 12:41 - 1:11 30 19 - 201/2 1 1/2 20 A 3 1:12 - 1:52 30. 19 - 201/2 1 1/2 20 4 - - 5 - _ C 1 12:17 - 12:41 24 19 • - 22 3 8 12:42' .- .• 1.12' C 3 1:14 - 1:44 30 .19 - 22 3 10 4 - - 5 -. - 1 - - 2 3 - - 4 5 - - NOTES: ° •1 `' { . Vests `toly *rE ' 'percolatronr-: submitted foi 2. Depth i e6su ted at same depth until approximately equal percolation rates are obtained at each hole. (i.e. < 1 min for 1 -30 min/irch, < 2 min for 31 -60 min/inch) All data -to be to be made from top of hole. Form DD -97 Indicate level at which groundwater is encountered 41-011 Indicate level at which mottling is observed #2 41-011 Indicate level to which water level:rises after being encountered 41-011 Deep hole observations made by: J. Delano, P.E.' Badey & Watson, P.C. D . ate 11/06/00 witnessed by A. Stiebeling PCDH Design Professional Name: John P. Delano, P.E. Address: Badey & Watson, P.C. 3063 Routed, Cold Sprinj, NY 10516 Signature: Design Professional's Seal T - - .4 I TEST PIT DATA 2 DESCRIPf 1*O*N OF SOILS ENCOUNTERED IN TEST HOLES DIEPTH—. NU. G.L., Topsoil Topsoil 0.5" Sand & Gravel 1,oatn Sandy Loam 1.01 V V 131 V V .2.01 V Loam w/ Clay 2.'5' y V 3.0. V V 3.5' V V 4ff V H2O V H2O 4.5' V V 5.0' V V 5.5' V V 6.01 V V 6.5 V V U1 7.0' V V 7.5' C-M 8.0' 8.51 9.Of 9-- 10.0' Indicate level at which groundwater is encountered 41-011 Indicate level at which mottling is observed #2 41-011 Indicate level to which water level:rises after being encountered 41-011 Deep hole observations made by: J. Delano, P.E.' Badey & Watson, P.C. D . ate 11/06/00 witnessed by A. Stiebeling PCDH Design Professional Name: John P. Delano, P.E. Address: Badey & Watson, P.C. 3063 Routed, Cold Sprinj, NY 10516 Signature: Design Professional's Seal T - - .4 I 14.164 (115-) — Ted 12 PROJECT I. D. NUMBER 617.20 SEAR Appendix C State Environmental Quality Review r -11OP E`v 111 NSh,, r f tSL For lr�r -GlvI' 'i` i•l�''T�'Ii V ti ' . -.s .:,. .. ._. UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1 . APPLICANT /SPONSOR 2. PROJECT NAME Westchester Holding Co. Inc. Westchester Holding Co. Inc. 3. PROJECT LOCATION: -, Municipality Putnam Valley County Putnam 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 LAN_ D AFFECTED: Initially <2 acres Ultimately <2 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? ® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park /Forest/Open space Other Describe: Single family house on 5+ acre lots. ULTic ATELY FPOF AN, . OTijEtZ GOV�-FNENTA t (F� 10. DOES ACjJO";INV0LVE.A FERWT iPPROVAL.' GR FUNDING CV-1 Or , YA _ 55 OL ®Yes ❑ 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 ® 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 MY KNOWLEDGE Applicant/sponsor name: John P. Delano P.E. Engineer Vapplicant Date: 01/11/02 , a Signature: ./ / V 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 - ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR PART 617.4? If yes, coordinate the review process and use the FULL EAF. ❑ Yes ❑ No ...y i.' i I r+ -� a A;f , fYti 4 r S t • � V ,. 11 „t% .., >y AY- may be superseded by another involved agency. ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers maybe 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: 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 ?gplain -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 CEA? ❑ Yes ❑ No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? . ❑Yes _... ❑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 and significance must evaluate the potential impact of the proposed action on the enGironmental 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: Name of Lead Agency Print or Type Name of Responsible Officer in Lead Agency rile of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL- OF PLANS FOR... =A:VA 1 "EWATEER TREATMENT SYSTEM 1. Name and address of applicant: Westchester Holding, Co. Inc. 33 Chester Court Cordandt Manor, NY 10567 2. Name of project: Westchester Holding Co. Inc. 3. LocationT /V: Putnam Valley 4. Design Professional: John P. Delano, P.E. 5. Address: Badey & Watson Surveying, P.C. 6. Drainage Basin: Hudson River 3063 Rt. 9, Cold Spring, NY 10516 7. Tvne 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 H Unlisted _-K 9. Is a Draft Environmental Impact Statement (DEIS) required? --------------- No 10. Has DEIS been completed and found acceptable by Lead Agency? ------ - - - _ 11. Name of Lead Agency Putnam County Department of Health n/a 12. Is this project in an area under the control of local planning, zoning, or other oc?als,or(in�nees?: - - -�� fi .�. 13. If so, have plans been submitted to such authorities? -------------------- _ _ _ _ No 14. Has preliminary approval been granted by such authorities? No 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? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ No 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 ' ay _______ ________ ___ ___ 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? Yes 28.. Wetlands ID Number --------------------------- --- -------- --- ---- - - - - -- n/a Ly is VVetarias rerni "t required' % -------------------------------------------- � F � - , �...r Yes Has application been made to Town or Local DEC office? _� _ n ?�� a -�------ Yes 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: n/a 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 ? --------------------------------------- 35. Are any sewage treatment areas in excess of 15% slope? -------------------- No 36. Tax Map ID Number -------- ------------------ - - -- -- Map 72 Block of Lot 37.5 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 LEF, 1 +. - Ugk -4, �.t:r�j��� •,�.; -r _ q ; - i`c � 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 maybe grounds for the rejection of any submission. I hereby affirm, under penalty o f perjury, that information provided on this form is true` to the best of my knowledge -and belief. False statements made herein are punishableca',s a Class A nusdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: Badey & Watson, P.C. Mailing Address: -------------------- 3063Itoute9 Cold Spring, l@iY 10516 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - AFFT� lVTT - .COIRPf?R- ATE_OWN_ER APPLICA TION_ FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: I, CONSTRUCTION PERMITS FOR SEPTIC & WELL BERNARD RATH represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Having offices at: Westchester Holding Co. Inc., Parcel III 33 Chester Court, CortlandT, NY 10567 Whose Officers Are: President - Name:zN�v�,�i9T /� Address: '3 '3 Cr/C s re 2 �'�' &-011C7c,'AWQ 7- �i'�ivo� AV Vice President - Name: '41` �C Address: d Secretary -Name: Address: C •r/90 .T - ..6, «. 'AT,. iii iC' "r1' �. A f✓ iQ .i A:;q .. . -.... , • 1 rGA u1�a - ivtCj.iv. .- v�— •; :Y �%•' i...:.r`SE ♦ rY � •. .. - _... .. .. _. -. Address: / 4- L-/3,*, 00 r //v_? 't." '�'/`/� /va3 and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Signed: ` '� Title: s: o 6-A-r Swo o before me this day of o e Notary Public REBECCA W. LINDA NOTARY PUBLIC, State of New York Corporate Seal No. 5004353 p Qualified in Dutchess Count Commission Expires November 16, Form CA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE: Property of Westchester Holding Co., Inc. Located at T/V Putnam Valley Tax Map # Subdivision of Subdivision Lot # Gentlemen: 5 Horton Hollow Load 72 Block 1 Westchester Holding Co., Inc. Parcel III Filed Map # Lot 37.5 e6 /(j401 2824A Date Filed `���'— 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. Countersigned: P.E.,64�,#25c�5 Mailing Address Badey & Watson, P.C. 3063 Route 9, Cold Spring, State N.Y. Zip 10516 Telephone: 845- 265 -9217 Very truly yours, Signed: 21 4_ (Owner of Property) Mailing Address: Westchester Holding Co., Inc. 33 Chester Court, Cortlandt Manor State New York Zip 10567 Telephone: 914 - 827 -7469 Form LA -97 13ADEY & WATSON LETTER of TRANSMITTAL .r_ -_ .�r�.rzU�19�j104�. Fn�iy,��?Or'•31;�.r .. -_'. .: ".. � . .. ......s'.i : ._ -._.. ... ..,.. -. -..`. - _ .i ..... 3063 Route 9, Cold Spring, New York 10516 Date: 14 Jan 2002 .L . �. (845) 265 -9217 (914) 628 -1800 (914) 739 -3577 File No. 98 -105 (845) 225 -3312 FAX (845) 265 -4428 W 0. # 14380 RE: Rath TO: Horton Hollow Road Adam Stiebeling Westchester Holding Co., Inc. Par Subd. Lot No. Putnam County Department of Health Tax Map Permit # 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS -NIGHT ❑ MESSENGER ❑ UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN ❑d UPS -COD ❑ We are sending copies date description of document �f 7i ;12- Dec -01 A lication Fee F1 ;11 -Jan-02 lConstruction Permit for Sewage Treatment System ❑1 ILetter of Authorization 1 106-Nov-00 A lication for Approval of Plans for a Wastewater Treatment System 1 i 11 -Jan -02 Short Environmental Assessment Form 1 i 12- Dec -01 Affidavit - Corporate Owner Application - -- .- . �6 >1 lov -c) Sheet 1 11 -Jan-02 A lication to Construct a Water Well 21 IFloor Plans E 11 -Jan-02 ISeparate Sewage Treatment System Sheet 1 of 1 C� RENI_?KS: Sfgni: John P. Delano, P.E. Copieto: File { i { 6464 I:Ot _tt4, SECOND FLOOR PLAN SCALE:1 /&' = V4P �L - TAP - l - 37 -si F O 4,t,,z� Is. �� N � I i g C O DS' u 6 urao+'rtuc ;i Oaf PANTRY S � B Pill !i o E� ,� 5 gill gp�n� oel (0 rLS�Oj /bl f $�k LJ•i It CREA7 ROOM ry 6 +w r 12 eiiZv �� O }° Z ? 2b lt1N.- 9° W A BATH a]• -,' m 4 I raj to• -e• ��j a''-o- pp ol h• F I ' - v'.z- s9 P� I DECK i( 9' -+• ,a' -115' 1J�_'i 1_e. s •; tm I or ;I. K :S BREAKFAST ' FAMILY ROOM a._will DEN - t DIN YG ROOM • jg I7 ur. a' ,o' ctm ,m t;l is FIRST FLOOR PLAN' SCALE: 1!8' = 1'-0" P4, tv,t ,>>� i� �t• N � I i g C O DS' u 6 urao+'rtuc ;i Oaf PANTRY S � B Pill !i o E� ,� 5 gill gp�n� oel (0 rLS�Oj /bl f $�k LJ•i It CREA7 ROOM ry 6 +w r 12 eiiZv �� O }° Z ? 2b lt1N.- 9° W A BATH a]• -,' m 4 I raj to• -e• ��j a''-o- pp ol h• F I ' fj 7-1 In 14*-D' 'X-o* II OT- QI ]ERS ONPAIHVSKI, R.A- Arcbitmet Erc-:�' -528-0409 NEW RESIDENCE FOR: Virgina M.Joy Horton Hollow Road mwa Putnam Valley, New York 6 N 23' -0' 5 e 4.A Ulk-FWC .• - 06- O'f' I - - - -- _-0 •p' TOt 105 ;`j MASTER _ _ Lt ' O BATH I TH BEDROOM 2 i- 3 15' -" 5' -9 t' MASTER BEDROOM 7' -5- yy • �-� 203 P OPEN TO BELOW ON ' I^ I'' -zX "p DRESSING ROOM O O 6ISIg �tl$Fi ro 5'. _ '_'o• ''_d5• Y o- '•''K w -0• m) m' -YO• 5K' '+ . 9i' 3a' BATH r 'iS BEDROOM 3 ' 1 0 } AS a U o o Z ' L OPEN TO BELOW �5 Y — _ — —� _ _ �L. f I W ' �• J to c o> A - --- - -_ -- __ — — — - - -- - --Q wo,S PUTNAM COUNTY DEPARTMENT OF HEALTH w o Z = d HOLSE PLANS APPROVED FOR BEDROOM COUNT ONLY x-070-1/ i =•� i I _:� _ BEDROOMS 7,-w o 72.. 37, 6- SLED Aq _ a Al f SUBSEOUENT REVISION /ALTERATIONS TO THESE HOUSE ,�4� ClYj 0`7 I PANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL �V �QN Mlgr `r. B7, e- SI , ATURE & TITIE ATE z SN SECOND FLOOR PLAN •�i SCALE:1 /8" = 1' -O" S= •.J N An SB' -7' 5J'.7• ' I ' ,t DECK A I `• o i7•- - O +os 4 OV 107 i 11 W UP €I •i O ffi' . BB BREAKFAST WCHE PANTRY � ' Q d FAMILY ROOM I toe 0(Z �0 4e S�Oj of A `G ig a•_5- CREAT ROOM �/'L G ,w toe U T z 11,_ U• 7'_p,• _, �' -e. ty 9k� -9j' z QN GEN m N, +O7 oy toe , to LU V5 . z x a 'tot p, -W 7, w' / l� 103 24'-W AR to PA(Fyy7 a�z Ii _ �'• _ E .. - ,:,.z •.. is '-; -O 9 i NO. N4S,s' F f_ a FIRST FLOOR PLAN' i SCALE: ilEr =1'-0" - S i. 7, 0 ' i �.t t Q _ __ ___ ___� _ �t __ _ _ __ ' _____ __ ----- — ----------- - _ __ _ _ _____ ______ __ y,. _ ___ __ ___ __ _ -_-_ - -_ - -_ - - - - - t:. - - - ' t i,.t' UTILm Oyt I i . . j d I I Room a I OR, a - - - - - -- l 1 I 645EMEM _.. .. .,- I Imo' I •q d i 1 IL _ I Cl GE I I I I � I -- ------ - - - - -- I , I 4 , ----�--- --I --- -- ------ --- ru � ✓ - --- -- vp'A - -_ I `l � 1 IL r J I ,t._�.. �.,A �: ��y -: C� � F'•" Sao 1 2 3 4 i i FOUNDATION /BASEMENT FLOOR PLAN 1 SCALE:I1W 1'-0" ,1 !• i �I ,1 N sa gill� o r v o� ui •_ _' Ly z is i 0 nA U'- t3• -�- 1 °� -�- r a._I. Q _ __ ___ ___� _ �t __ _ _ __ ' _____ __ ----- — ----------- - _ __ _ _ _____ ______ __ y,. _ ___ __ ___ __ _ -_-_ - -_ - -_ - - - - - t:. - - - ' t i,.t' UTILm Oyt I i . . j d I I Room a I OR, a - - - - - -- l 1 I 645EMEM _.. .. .,- I Imo' I •q d i 1 IL _ I Cl GE I I I I � I -- ------ - - - - -- I , I 4 , ----�--- --I --- -- ------ --- ru � ✓ - --- -- vp'A - -_ I `l � 1 IL r J I ,t._�.. �.,A �: ��y -: C� � F'•" Sao 1 2 3 4 i i FOUNDATION /BASEMENT FLOOR PLAN 1 SCALE:I1W 1'-0" ,1 !• i �I ,1 N sa gill� o r v o� ui •_ _' Ly z is i 0 R= 101.9, L =B4. JI , Monument Set 2002 RecioK"d 2004 S60J0'00T Pin & Cop Set I Septic Oeonout o Pin dt Cop H & Cop Set - e�i tae v� 00. d0�d We P4 fAed )Nk X±:. isy 1 Monuments Na Fire Easement to be dedicated to — the Town of Putnom Valley for the purpose of Emergency Services. Area — 0.066 &ms Under Ground Ton* /ocvted October 2000 O 3 y yzr " Monuments Reeo 222 G c v S ?Ir N245077 ° o fis �oS :d f AO s r- 1 • i 1 a - i i SURVEY OF PROPERTY i PREPARW FOR J® lV LANDI & t1 /RGINIA M JO Y SITUATE ;fl THE TOWN OF PU VAM VALLEY s PUTNAel+11 COUNTY 1VEW X ARK SCALE 1 inch = 50 feet AUGUST 25, 2004 SEP 22 20 We hereby certify that t&-,'survey shown hereon was completed by us on August 25, , 2004 that this mop was completed on August 25, 2004 and that this survey has been prepared in accordance with, the existing Code of Practice for Land Surveys odootec' by The New York State Association of Professional Land 'urveyors, Inc. Revised September 21, 2004. .Seep note 7 PRINTED I&A TSON SV EW ISERING, P. C. SEP 2 1 2004 o BADEY & WATSON NEW YO ND SURVEYOR SURVEYING & ENGMERING, P.C. °X8167 FILE No. 98 -105 1" = 100, HOLLOW )�POSFZ __1 41. 2 ROOF LEADER DRAIN PROPOSED 6",DIA. . 3' DEEP SEEPAGE'P.IT — True North of x N ... .......... 241.0 241. 39.5 4° LlP OR APPR E VA T �> $ / 1 /4" PER FT. PITC 125 AL RECAS .,CONC. TI TAN PVC *1 FT. "FAIN., PITCi 50 FT. FOR Cl 'LAN x STI 39X t!�EIIAFFLE )o,nNG TO 42 P. - ;PEED LEVELERS'. PROVIDE 575 \F LF ABSORPTION TREIC��( LATERALS OF 57.5 , Jp H05 Jn Ln PVC *1 FT. "FAIN., PITCi 50 FT. FOR Cl 'LAN x STI 39X t!�EIIAFFLE )o,nNG TO 42 P. - ;PEED LEVELERS'. PROVIDE 575 \F LF ABSORPTION TREIC��( LATERALS OF 57.5 , Jp 1 It = 30' ION AND SURVEY INFORMATION IS AS SHOWN 'RTAIN MAP -n-n Kr) "qi ip\/Fy or Ppe)PPPTY Sid .'AS-BUILT RELOCATION- DIMENSIONS 1A 63.6' SEPTIC TANK 13A 86.8' BEGIN LATERAL 1B 40.0' SEPTIC TANK 13B 115.9' BEGIN LATERAL 2A. 66.6' SEPTIC TANK 14A 85.9' BEGIN LATERAL 2B 44.3' SEPTIC TANK I 14B 119.7' BEGIN LATERAL 3A 82.3' DISTRIBUTION BOX 15A 153.0' END LATERAL 3B 83.6' DISTRIBUTION BOX 15B 169.3' END LATERAL 4A 96.5' CLEAN -OUT 16A 150.6' END LATERAL 46 111.6' CLEAN -OUT 16B 169.7' END LATERAL 5A 99.2' BEGIN LATERAL 17A 148.8' END LATERAL 5B 113.9' BEGIN LATERAL 17B 170.6' END LATERAL 6A 97.7' BEGIN LATERAL 18A 147.2' END LATERAL 6B 117.0' BEGIN LATERAL 18B 171.8' END LATERAL 7A 95.0' BEGIN LATERAL 19A 147.3' END LATERAL 76 119.0' BEGIN LATERAL 19B 174.6' END LATERAL 8A 92.7' BEGIN LATERAL 20A 51.0' END LATERAL 86 121.3' BEGIN LATERAL 20B 58.1' END LATERAL 9A " " 90.2' BEGIN LATERAL 2i-A-- 1 A 45.4' END LATERAL 96 123.5' BEGIN LATERAL 21 B 61.1' END LATERAL 10A 94.5' BEGIN LATERAL 22A 40.9' END LATERAL 10B 108.8' BEGIN LATERAL 22B 65.5' END LATERAL 11A 90.6' BEGIN LATERAL 23A 36.7' END LATERAL 11B 109.9' BEGIN LATERAL 23B 70.1' END LATERAL 12A 88.5' BEGIN LATERAL 24A 33.3' END LATERAL 12B 112.8' BEGIN LATERAL 24B 75.2' END LATERAL WC 76.0' WELL WD 78.0' WELL /: j TJJ7 1 TA h