Loading...
HomeMy WebLinkAbout3193DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 72. -1 -48 BOX 26 03193 L' ti CL "�`l . :1 .' '. .,i,,� r r 03193 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL O AL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAG TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 01 — - O Located at _7 �2 , `� nokl ;�) &gaAA Town or ,Jva,v, Owner /Applicant Name r amAL. (_ . C� �� P1. k,4m j,�ss� Tax Ma 1 Block Lot A L� � per'— � �_ Formerly ,,r(/a Subdivision Name -//A n Subd. Lot # WA Mailing Address t MOW - _ ' L Zip S `l T Date Construction Permit Issued by PCHD �' d Separate Sewerage System built by Cam,, ,Null GN rlS -aU( Address CAN'041A �64V R6. w..e -., i k a... �� _k.1:�!,.._�;�.:. - .0 VM11Vl11J VrJ 41V„- Ta1.S11 G4CGll�_ ''. R `^�� p���� _ �..._yY �. �..••- •-•••• Smcan Id C Other Requirements: 1 z; Cb GA, Lone e -rr Awoi tk i ejAm R L A a6j.c !ti eA1 ,f ,9r1 gryJ- Water Suuply: Public Supply From Address or: C Private Supply Drilled by Address Building Type �F ii n6tJTI/d Has erosion control been completed? s Number of Bedrooms Has garbage grinder been installed? A/—Q y 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 Putnam. County Department of Health. Date: -o Certified by % ' P.E. R.A. (Design Professional) Address S WZV VC - . L,o S ,vt, N l i License # 64 Z 5;ti 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 r ocabion, modificati or B Y• • Title: Date: White copy - HD e; Y to copy - Building Inspector; Pink copy - copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: 7 2✓z /Villa e Tax Grid # Map 72, Block Lot(s) q8 Well Owner: N17 Address: J 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 �5 ft- Length below grade % X lft. Diameter `(min. Weight per foot /� lb /ft. Materials: " Steel _ Plastic _ Other Joints: _ Welded Threaded Other Seal: XC Cement grout _ Bentonite Other Drive shoe: Yes _ No Liner _ Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second k�6�elfiYietd-'Teg�= _-ailed -" ---Pahl &- Coin fay dsir l� p_ Housr "s Yield %`i - nT==-'' gp Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet 3,06 . Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface; ' r '' If If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Types ' ,c.%l.�_ Capacity )0- Depth ,,;UZ) ` Mod.... 1*9S 9 Voltage '>fc} IV G' Tank Type &2KSo)-�Volume / Y0 Date Well Completed Q a- 0 Putnam County Certification No. Date of Report well Driller (signature) r t - "y r. :.t✓xact location of well witn distances to at least two permanent landmarks to be provided on a separate sheevplan. ` •. -- 1Ne11 Dt il_l�x,s_h— Tnme�_Y� z F Signature: j )� %` �-,� --- Date: /J. Z) � r=r White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 BRUCE R. FOLEY * * LORETTA MOLINARI R.N., M.S.N. Public Health Director �c�k, Yo��` Associate Public Health Director Director of Patient Services 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 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN:_.........__ Ron & Celine Karabinos 72. -1-48 AUTHORIZED TOWN Of (Signature) DATE: 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) YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAD #: 32.108575 CLIENT Or 2173 NON STAT PROC PAGL-, NORMAN ANDERSON INC. DATE/TIME TAKEN: 12/10/01 12:30 152 BARGER ST DATE/TIME REC'D: 12/10/01 01:00 PUTNAM VALLEY, NY 10579 REPORT'DATE: 12/14/01 PHONE: (914)-528-1491 SAMPLING SITE: ClMARRON RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : 8UTH FAUCET, COL'D BY: SARAH ANDERSON NOTES...: KARABINOS ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE PUTNAM CNTY 12/10/01 — 12/10/01 12/10/01 12/10/01 12/10/01 12/10/01 12/10/O1 ' 12/10/01 12/10/01 12/10/01 PROFILE MF T. COLIFORM _ _['E8l}AIN-.\_ -- - '-^-^N*I'TRATE` 14lTRJG-- NITRITE NITROG IRON (Fe) MANGANESE (Mn) SODIUM (Na) PH HARDNESS, TOTAL ALKALINITY (AS TURBIDITY (TUR PRESERVATIVESL NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT ABSENT /100 ML ' - . �(1 -'`/L ' 0.53 ^ <0.Ol MG /L 0.060 MG/L <0.010 MG /L 6.31 MG /L 7.0 UNITS 110 MG /L 70.0 MG /L 1.3 NTU NORMAL - RANGE METHOD ABSENT' 1008 N/A 9146 0-0.3 mg/1 2037 0-0.3 mg/l 2037 N/A 5 9043 N/A N/A 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI�f����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 ppb 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. 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 J�7I1 .mo~/i.o�:Srdi�mc',-�'����'��,� / YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 _ Albert H. Padovani, Director LAB #z 32.10075 CLIENT #4 2173 NON STAT PROC PAGE 2 NORMAN ANDERSON INC. DATE/TIME TAKEN: 12/10/01 12:30 152 BARGER ST DATE/TIME REC'D: 12/10/01 01:00 PUTNAM VALLEY, NY 10579 REPORT DATE: 12/14/01 PHONE: (914)-528-1491 SAMPLING SITE: CIMARRON RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : OUTH FAUCET ' COL'D BY: SARAH ANDERSON NOTES...: KARABINOS ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE is suggested. ' PRESERVATIVES:_NONE TEMPERATURE..: < 4C COLlFORM METH: MF RESULT NORMAL - RANGE PH ' H 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. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CAR8ONATE9 IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF M8/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 *iFV:R TE'' HARD WATER: 140-300 MG/L (l grain/gallon = 17.2 MG/L) SUBMITTED BY: Director METHOD ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALT H SERVICES a !_ ' T ?1QPA 1MlF. .1 r c�F� . . , Ron & Celine Karabinos Owner or Purchaser of Building Building Constructed by 722 Sprout Brook Road Location- Street Residential Building Type 72. 1 48 Tax Map Block Lot Putnam. Valley Town/Village N/A Subdivision Name N/A 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. Thhd-i ridersigried`tlirtrier agrees to accept as conclusive the-deterriiinatioii ot- tfie7hub`lic Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day Year o .2- General Contractor er) - Signature Canopus Construction Co. Corporation Name (if corporation) Address: Canopus Hollow, Putnam Valley Signature: Title: .v Corporation Name (if corporation) Address: State NY Zip 1 State Zip Form GS-97. . - ro.b•.2,. - �. .. ..•e .....a.s -..n. • �jt:�N��..r.•+_.�,. -r. w_•- -TC� e.b ^::-_e.a��. � --,_ .:z'• -�.w.. s... _ w The New York Board of Fire Undenwritins Bureau of Electricity is in the process of is -wing a ceiiificate cif compliance for the electrical installation as provided for in the .illiv(icatiun fur inspection At �1 �` S. ►goo New York Board of Fire Underwriters Surcau of Electricity Inspection activity pursuant to Application -bZC.. :Ii; ie iti( �tilci' °d ceciifci "t "aie' "d[ compliance setting forth the detail of the ele >drica )a }stem is being repared. /19 Inspector hate - W,;1 1M) .1441 I.h,lhl) r �I T 5lhate : of Nsw York Town ,of. Putnam Valley. Buildin Dept N° 994'7 g . .............., 20.P /.. Re veId fro ....qL ............. 1 .... 7/ 077 .�.s....... a.. ....l. O ................... .. .. ................ . Alkl Town of Putnam Valley I 1011- i11` lki �L1CIV 11' PERMIT NO.: 2001 -196 BATE: May 30, 2001 TM-#: 72.4-48 ORIGINAL NO.: LOCATION: 722,, SPROUT BROOK ROAD ISSUED TO: KARABINOS RONALD L & CELINE M An application having been properly filed for new construction, addition(s), alteration(s), repairs as per the attached specifications and plans, I hereby grant such application upon the following terms and conditions: All work must be done in accordance with the plans and specifications annexed to the application and shall be located precisely as indicated on the plans) and /or survey All work shall be in accordance with the Uniform Building and Fire Code of the State of New York and ail pertaining County or Town regulations All electrical and plumbing work must be done by contractors duly licensed by the County of Putnam. Where applicable, Home Improvement Contractors' license_ _ will be recsu,.rP .... .._ .�- _..� =.. �..- - ..�..�.. -�--r ...-- .....•.ow ... . ".- .._ -.... ... _...._ ._ ._._moo. -..a .....- .�.-. _.. This permit is issued for the following: New One - family Residence COMMENT: ONE FAMILY RES.W /FRONT PORCH, REAR DECK (18X12), .2 -CAR GARAGE, 5 BEDROOMS, UNFINISHED BASEMENT, FIREPLACE NOTE: THIS PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE TOWN OF PUTNAM VALLEY, NY ' By: CODE ENFORCEMENT OFFICER 265 -Osc N++ke . Road Put slley,�New York 10578 (8141126 -3333 TOWN OF PUTNAM VALLEY NEW YORK MILTON A. EAGENS, Highway Superintendent DRIVEWAY OPENING PERMIT APPLICATION NO. of i',TO D ` U NAME "'R b1n &, Q �.-. a �R � i A 0.S Present PUB X Address TOWN .��t'(:rtAAV%I% VA � LeL4 : STATE ivtZIP 105 1 �. D. .8Y 37 9 _... TELEPHONE NO. T 4 " s a s'�3�� Pursuant to Local Law No. 44979, Local Law No. 8 -1972, and if applicable Sec. 56- 7 (Subdivisions), and Local Law No. 1 -1980 (Forestry), I hereby make application for: On Town Road 'r g f r�ov� T.M.# 2 A _ Applicant I '-sign' ignature Application/Permit fee $50.00 (payable to Town of Putnam Valley) Copy of survey showing driveway location on plot must be provided. .(Copy of law governing Driveway Openings is available in Highway Dept. office upon-request.) : ............................................ ..............e.e..........mass DRIVEWAY OPENING PERMIT PERMIT NO. 90DO ~- ( . Driveway must be graded level with road to edge of right -of -way and must be graded as not to allow water to run off into right -of -way. Monuments must be placed on front corners of property. Property and driveway must be staked prior to final approval. REMARKS: DATE: ///,,?/ X& DATES � �. ................... FINAL C.O. APPROVAL DATE: Highway Superintendent _APPROVAL OF DRIVEWAY CHAN :............... PUTNAM COUNTY. DEPARTMENT OF HEALTH DIVISION OF ENVIRONhIEN TAL HEALTH SERVICES FINAL SITE Itii'SPECTION O Date: l� . � Inspecte y I Street Loca .......__,- o«ii _IT Permits DN - 5 - t TM-r Subdivision Lot 1. Seivage Svsteih Area YES i NO COZ i E1VTS 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 ...... ......... ....................... II. Setikge System � � a. t • size -1,000 ......... 1,250 ......... Other .... b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distributiop Box I' 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 ........... ............................... f ren'I� c e�i s - o��.Zesgth required _ ��Length installed. 2. Distance -to watercourse easured Ft.......... 3. Installed according to plan ......... . ................................ A. Slope of trench acceptable 1116 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft: foundations.......... m . .6. Depth of trench <30 inches from surface ..:............... 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1' /z" diameter clean .................... v V� 9. Depth of gravel in trench 12" minimum .................. g. PUmD or Dosed Systems D 1. Size ol pump chamber ............... ............................... ©� 2. Overflow tank...... .... ............................... .;.�. 3. Alarm, visual /audio.. ✓ .............................. .... 4. Pump easily accessible manhole to ad.� P Y � � � First-box-baffled ::::� :.::::::................. _ .................. .. 6. Cycle witnessed by H.D.estimated w /cycle........... III. HouseBuildin -a. house located per approved plans..... ..., .. .................. b. Number of bedrooms ................. : ........ ?.. ...........:.. . W. Well a: Vell located as per approved plans . ............................... b. Distance from STS area measured ft ........... ,c ine IT! above,.gra de :........... ....... ................... . o nx u. ,4n ._- v 1 MV- 414111-5- 4LV -ilV1 1 . "V ,- .. V. v ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box .......................... I........ d. Backfill material contains stones <4" diameter .............. e. 'Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dirto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ...........................:... 0 �c s D' �� � �� ��Ft �►tv � S Y %: i� o OCT -17 -2001 16:12 BADEY & WATSON, PC P.01/01 PUTNAM COUNTY DEPARTMENT OF HEALTH DI VLSION OF ENVIRONMENTAL HEALTH SERVICES RRnC ST FOR FIN,ALMMTION for: Fill Trenches ,...:.. . PCHD Constriction Permit #_ P V `5-0 I - Located (T) (V) �'L 1%t4c Y Owner/Applicant TM 7'Z- • Block k Lot +v Formerly Subdivision Name ►-� /` Subdivision Lot # 0 -jA Is system fill completed? OAL. Date Is system compleis? 'a+P Tx+uw-, 4 F, Is system commeted as per pleas? 4� Lam • ls'well drilled? 00 Date o I lv lD I Is well located as per plans? J /Al- Are erosion control measures in place? Yes I certify that the systems), as listed, at the above premises has been constructed and I have ingxcted and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Swda 4, Rules and Regulations of the P== Comq Department of Health, Date: 10 / i 4l %p l Certified by: -"•*P• -�C--r-0W 0, E, PE x RA Design Professional Address WAh m PA), b.G - Lic. # P& --ZV4 Comments: GAS i zf Ra3 P, T` f-� &tA 1 A) i,A K)ar- T FOR: XADAM 0 GENE ........r . -. ��� • . .�� w r . • • Try n nC ^1'7!5 �(n^ 4 ]Foray FIR-99 . TOTAL P.01 AIl1MC. 01 ITAIf1M (^f'II II.ITV nCDODTMCNT n1 P 1 NOV-21 -2001 16 =22 BADEY & WATSON, PC P.01i01 t :ry PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVTRONMENTAL HEALTH SERVICES RFO EST FOR FINAL DIRECTION For: Fill Date: l2o\/_ z 1T avo 1 Trenches PCHD Construction Permit # �� — 5" l R""t P A N k X Located: t;feyv ; 'BOOK PO4 (T) (V) P0-ttJAj*k 181 -i&4 _ Owner /Applicant Name: �� � 6 - KAMAMN 2s TM -7z- • Block \ Lot q e Formerly: Subdivision Nance: ri Ar Subdivision Lot # tj A Is system fill completed? 0 A. Is system complete? YEr S Is system constructed as per plans ?'-� -Y Is well drilled? YFs Is well located as per plans? Are erosion control measures in place? ` e:. Jute: tj A Date: ��Zf1D1 Date: --.0 t /Z.t /O 1 I Certify that the system(s), as listed, at the above prenr ses 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: 1 i % z l %p ( Certified by: ` -VH a -�c M '-am 0, �,�. PE,Y_ ItA . - Design Professional Address: 12A45ef � 0 Anwo, f>,G. Comments: 40k:C 1 ' 290,0 P, PC TO sL-P i rr- T-A N p- rs 4:0 Pc /+G.6 v '�Fo Nl dF t n&) -� c7 .1� r siy�c E �rDaa ?< S G.O wti#k -!r + + o F O IA P EQ O M Int (s -zk-C �J �t p a,� }3 . �'y*n�' 0�p r M R Pe7Aw --P- o kx-Nio 1�tSVAL S FOR )(,kD k i �a ❑ GENE ❑ oil Zile Fo F -99 TOTAL P.01 - - - - - - • -- • — . �� .., �� -ran _ �ooa AIOMG a PI ITNAM rn INTY npPARTMF-NT OF P. 1 EADEY & WATSON LETTER of TRANSMITTAL _ r a � . ; -. •.� � � � �- =-a, �.� =•aye � _� >''- -- - i 3063 Route 9, Cold Spring, New York 10516 Date: 25 Jan 2002 (845) 265 -9217 (914) 628 -1800 (914) 739 -3577 File No. 98 -105 (845) 225 -3312 FAX (845) 265 -4428 W. O. # 14148 RE: Karabinos TO: Sprout Brook Road/Cimarron Road Sean Rogan N/A Subd. Lot No. Tax Map 72. -148 Putnam County Department of Health Permit # 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS -NIGHT d❑ MESSENGER ❑ UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN ❑ UPS -COD ❑ We are sending: copies date description of document Ol 15- Jan-02 --j A lication Fee ❑1 29- Nov -01= ICertificate of Construction Compliance for Sewer Treatment System 1 25- Oct -01 JE911 Address Verification Form ❑ 1 03 -Jan-02 IGuarantee of Subsurface Sewage Treatment System ❑1 20- Nov -01 NY B and f Fore Imderwroters Bureau of Electricity 14- Dec -01 lWell Water Test Results i13 T� . -02 _ ._ .i. EyVel? orn leripn Refow. - Fl 24 -Jan-02 Letter from Ron Karabinos with attachments 03 29- Nov -01 ISSTS "As- Built" J REMARKS: Signed: John P. Delano, P.E. Copies to: File 6528 SENDING CONFIRMATION DATE : NOV-26-2001 MON 11:03 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845-278-7921 PHONE 92654428 PAGES 1/1 START TIME NOV-26 11:02 ELAPSED TIME : 00'31" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... I 'd JU A"O'Ll- Way) ( -wig w F a V ADO elammmi"ral ry,liw -,-4w-L --,u-w XL v VOTE 10`3 uopmm:) cma WIM "I TP& ompmm 91 smw m- p2pom PAK 61 4pm%*m ug umua R t% n, cd WW Wag wa SWIM' S JUW= IYUMMOMOZ &0 NOMMU Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Associate Public Health Director Director of Patient Services 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 ' Date: / 8 162 g- To: ,J/-li✓ 272 a S?7zOC"l / 6701 From: Gene D. Reed Putnam County Department of Health Fax #. G s - `7` 2, No. Pages % (Including cover sheet) ..._ _.._.._ --• - - ---^ `Y iii' j.iii ^•iii't'iii,T;itt ➢v-u• .s ..�.., w,, ........ ... _._...- i'�ay i'E5�0'i'�a`�i "' ..�_ .. .....'_ ,,,,._ .. .A �,_..._.._.._..,.:_.�.;__ For your review - ttachcd as requested As discussed Please call Notes/Messages 41,sue �// / ;lam 7-0 In the event of transmission /reception difficulties, please contact this office: at (845) 278 -6130 ext. 2261. SENDING CONFIRMATION DATE : JAN -21 -2000 FRI 21:44 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE : 92654428 PAGES : 1�1 START TIME : JAN -21 21:43 ELAPSED TIME : 00'21" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... a a BRUCE R FOLEY LORSITA MOLINARt RN, MB.N, Psatk N.dla VWWW A—k" P.Nk Asda1 Auvaa OD-W d Pl#hw 6lnr/w DEPARTMENT OF HEALTH I Geneva Road BmwsW, Now York 105D9 • LlwasasXslallies(942)Z71.6136 re(942)276.7221 N.nln1 ew.k. (54S)271.USI WIC (941)276 -6676 P- (115)276.6WS r■rry utnesdW (865)779.6011 rreldsal MS)mEea Na1M>)rn.6M6' . FAX COVER 99EE7' .' '. .'. Date: To: JOA,.l 7;Lr4.0. a cr f<A9ZC61AV2t Sp�puT' Emgnt 2ze- No. Pages (Including cover sheet) From., idag Q. RW Putnam County Department or Health _. For your Information Please respond For your review — A)ttachrkq requested As discussed Pkue can .J� Notes/messapm r /.F 772 %2E50LV6 OPr'.v GoN.s�wiYS . In the event of transmissionfreception difficulties, please contact this ofRee at (84S) 2784130 ext. 2261. PUTNAM COUNTY DEPARTMENT DE HEALTH �..:.I-0 .n. • S .iE�V®�IT� IT �a -..�.. .. +�...r.ia�iaa. •. ,m- .�,iiY- s:Z;.�G�.�•.-- .a. -... .e r- .:.- ..r.. --. -....- CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at Q, NR U T 13 uo y- (Z--O lUo Town or Village PU i t l 1401 y4uFq Subdivision name y I Subd. Lot # iV JA Tax Map .Z Block ( Lot 4 �7 —7 Date Subdivision Approved Renewal Revision Owner /Applicant Name (Lo k) Date of Previous Approval Z C i Mailing Address y Zip to1�,-711 Amount of Fee Enclosed i SSDI 00 Building Type tit NCI Lot Area &q-7K No. of Bedrooms 5 Design Flow GPD . O O Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of (, 5 -00 gallon septic tank and 600. L(= -24- 11 Other Requirements: J G CA PU 6 P PIT, f ', 4010 1 U l SU It 6LW46 S W To be constructed by WW1,-, I._4 GNUS SW <, Address % a 5P� -106 , f A _. --------- � Pubic Supply Yrom . _ Address or: Private Supply Drilled by KID S Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatments em 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 ' R License # 0 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 w en considered necessary by a Public Health Director. Any revision or alteration of the approved plan requires a new pe i Ap ved KX i ch e f omestic sanitary sews only. By: Title: Date: 2 > White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pr essio al Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION-, A WATER WELL. -_ _ _ please print or type- Well Location: Street Address: Town/Village Tax Grid # 1 QECO t) Pl) l i�f�A L�f \' 7'MaP 7-2 Block Lot(s) Well Owner_: Name: C-0 PQ 4. Ca LA svE Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought > gpm # People Served "1 Est. of Daily Usage • Q al. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason R V 1 'i> - 0ab- (31.1 R _ LL PO L 1vi`-iAJ ESi J F IV CG 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 N Lot No. N Water Well Contractor: E P 1 C 440 P--.)� S Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water, main: l (�l I LE Proposed well location & sources of contamination to be provided on separate sheet/plan. '� : _ .� 5 . 'nt�:t;anl1iart> iui °c:.,_' �'(d- ;,`_ `_ &"' "� 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 alters ' n of the approved plan requires a new permit. Well to be constructed by a water well er c rti ed y u am County. Date of Issue 7,/Z IS Permit Issuing fficial: ati Date of Expiron ?-It ® Title: 1 Permit is Non- Transferra le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 �y ' o X�� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF aENVIRONMENT AL . E E VICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # ` V — Located at Spm-r 8?—z i4- U own or Village P�[TQA I y Subdivision name P• Subd. Lot # Tax Map -72 Block Lot Date Subdivision Approved Owner /Applicant Name ROW � Cjw me ftmwos Renewal Revision Date of Previous Approval Mailing Address 'LOD %EL L1j1QL .CW Q Q PLI) TOA M VAULL LN Zip 10 5 9 Amount of Fee Enclosed I a`C! ' 0() Building Type LIE& WILT I �L. Lot Area ,10- 71KNo. of Bedrooms _4 Design Flow GPDaQ[) Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1, 250 gallon septic tank and 4 CSC; -Z4,1 Other Requirements: 12 5 b &A L POMP PIT, A0'b!q& 1 SUAL UPWS I ti A ASt✓ MENT To be constructed by RWL-'D LIONS I SONS Address P-19 C7 Lb SPM)61-. �jl Water Su. VW ,. Public. Si. pply_FrAZn__�- - . Address , ~ or: Private Supply Drilled by iC,I���N,..yd ^R �S� Address SbiU 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 R.A. Date 1 License # 0 (01 S7t) S7- 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 cons• ered necess by the Public Health Director. Any revision or alteration of the approved plan requires a new pe Appr ed r •sc a of domestic sanitary sewa only. By Title: Date: O White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professi nal Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION. TO CONSTRUCT_A WATER WELL uiease print or tune PCHD Permit Well Location: Street Address: Town/Village Tax Grid # 4 Map 2. Block Lots) Well Owner: Name: IZGt. i C.EU MG Address: 1�,4� N �J U 5 I 2iJp kt )W 2` .. A'1 0 1t 7 Use of Well: Y� 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 __(p Est. of Daily Usage b0 L gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason �3 1 ' 6 T 1-8- — W R P_ VRO fps i bE e 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 Lot No. 1V Water Well Contractor: Tz,-4(JG. C'w Address: 0 Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: IJ 1 A Town/Village Distance to property from nearest water main: -2 ! M t L Proposed well location & sources of contamination to be provided on separate sheet/plan. 'Date..-- 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 ell ill c ifi by Putnam County. Date of Issue 12 3 o Permit Issuing fficial: Date of Expiration L Z ® Title: Permit is Non-Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 BADEY & WATSON LETTER of TIaANSMITTAL 3063 Route 9, Cold Spring, New York 10516 Date: 09 Feb 2001 (845) 265 -9217 (845) 628 -1800 (914) 739 -3577 File No. 98 -105 FAX (845) 265 -4428 W. O. # 13907 RE: Revised SSTS Karabinos TO: Sprout Borok Road /Cimarron Road Adam Stiebeling N/A Subd. Lot No. N/A Putnam County Department of Health Tax Map 72. -1 -48 Permit # PV -5 -01 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS -NIGHT MESSENGER ❑ UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN ❑ UPS -COD ❑ We are sending copies date description of document F-11 08- Feb -01 lConstruction Permit for Sewage Treatment System 5 04 -Jan-01 ISeparate Sewage Treatment System Sheet 1 of 1 ❑ ❑1 08- Feb -01 jPump data & info ❑2 08- Feb -01 IFloor Plans ❑1 08- Feb -01 lApplication to Construct a Water Well ❑1 08- Feb -01 7--] jApplication Fee $150.00 Certified Check ❑ REMARKS: Signed: John P. Delano, P.E. Copies to: File 4681 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPUCATION FOR APPROVAL,OF PLANS FOR. -. A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Ron & Celine Karabinos 200 Bell Hollow Road Putnam Valley, NY 10579 2. Name of project: Karabinos .3. LocationT/V: Putnam Valley 4. Design Professional: John P. Delano, P.E. 5. Address: Badey & Watson, P.C. 6. Drainage Basin, Sprout. Brook Rt.9 Cold Spring, NY 10516 7. T)N 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 X 9. Is a Draft Environmental Impact Statement (DEIS) required? _ _ _ _ _ _ _ _ _ _ _ _ _ 7- No 10. Has DEIS been co leted and found table b Lead A en N/A mP �ceP Y g c3'? ---- - - - - -- 11. Name of Lead. Agency P.C.D.H. 12. Is this project in an area under the control of local planning, zoning, or other 'Yes._.....: - .: 13. If so, have plans been submitted to such authorities? _ _ _ _ --------- I _ _ _ _ _ _ _ _ _ _ _ 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? ___---------------- ____ :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 A. Stiebeling 22. Date test holes'-observed 11 /i2 /00 23. Name of Health Inspector. P,C.D.H. 24. Project design flow (gallons per day) _ ----- _ 800 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 27. Is any portion of this project located within a designated Town or State wetland? Yes 28. Wetlands ID Number N/A 23. is WCdaelds t`amit requii Cd'. - - - - - - - - _ - ----------------=---------- - - - - -- Yes Has application been made to Town or Local DEC office? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ No 30. Does project require a DEGStrearn Disturbance Permit? _ _ _ _ _ _ _ _ ----------- No 3 L Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes/No No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ No 35. A r e a n y s e w a g e t r e a t m e n t a r e a s in excess of 15% slope? -------------- - - - - - No 36. Tax Map ID Number ---------------------------- _ Map 72 Block 1 Lot 48 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 lei= :�z,�:t1 i�1P i�rY1r'1iKTSiFiT. 51 _7P_P!�_1111t;���', �11i•tj? lal»i)�iCa e :! the - DER alihcvu l he pry, e tYiM -y regJ.:irq DIEP r approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious,surfaces; and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l.,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45, of the Penal Law. SIGNATURES & OFFICIAL TITLES:, Mailing Address: ------------------------ Badey & Watson, P.C. 3063 Route 9. Cold Spring, NY 10516 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 200 Bell Hollow Road Owner Ron & Celine Karabinos Address Putnam Valley, NY 10579 Located at (Street) Sprout Brook Rd./Cimarron Rd._ Tax Map 72 Block of Lot 48 (indicate nearest cross street) Municipality Putnam Valley Drainage Basin Sprout Brook SOIL PERCOLATION TEST DATA Date of Pre-soaking 11/16/00 Date of Percolation Test 11/17/00 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 1:34 1:37 3 19 22 3 1 2 1:38 1:42 4 19 22 3 1 3 1:43 1:49 6 19 22 3 2 4 1:49 1:56 7 19 22 3 2 5 1:57 2:04 7 19 22 3 2 B 1 10:56 10:58 2 19 22 3 1 2- 00- -7 .02 19 3 11:03 11:06 3 19 22 3 4 11:08 11:11 3 19 22 3 5 1 2 3 4 5 NOTES: 1. Tesfs'f6b6 ie*W at same depth until approximately equal percolation rates are obtained at each percolation test'bole. (i.e. < I min f or 1-30 min/inch, < 2 min for 31-60 min/inch) All data to be , submitted f6t review. I *th measurements to be made from top of hole. Form DD-97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES _DEPTH- HOLE NO 2 _ .HOLE G.L. Topsoil 0.5' Sandy Loam w/ Stone 1.5' I 2.0' I 2.5' I 3.0' I 3.5' I 4.0' I 4.5' I 5.0' I 5.5' 6 0' I Topsoil Sandy Loam w/ Stone I I 6.5' I I 7.0' 7.5' I I 8.0' y 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered not encountered 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: G. Avalear, Badey & Watson, P.C. Date 11/21/00 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: _' Design Professional's Seal oT NEW Y� OAS - p. Opp Ilk 14- 16- 41t11951 -- Text 12 ^p PRO.ECT I.D. NUMBER 617.20 SEQR Appendix C _ State Environmental Quality Review . .�� �. ir+s:=- `._�i;:...i� L•' .� -..+ ::o�a �•bini+a^r+ °,V 4,.'Y .11.,,,,ee..��t y,-� .y: _ ....._ 1'.'. -r '"' ,� e, 'S ^_ .`• -"`c�. --.b �:��. -tea ..m. • -.�• ... . For UNLISTED ACTIONS Only PART I.— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1 . APPLICANT /SPONSOR 2. PRO.ECT NAME Ron & Celine Karabinos Karabinos 3. PRO,ECT LOCATION: Municipallty T/o Putnam Valley County Putnam 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Sprout Brook Road (see map provided) 5. IS PROPOSED ACTION: ® New ❑ Expansion ❑ Modification/ alteration 6. DESCRIBEFFCLE['T EIRIEFLY: Single Family Residence, SSTS and Well 7. AMOUNT OF LAND AFFECTED: .Initial) <5 acres Ultimately <5 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING. ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ®Yes El No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PRO.ECT? ® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park / Forest/ Open space ❑ Other Describe: Single Family Homes on 2+ acre lots C' FUN ii 'NO i -V A-r i-� ;a IV n7 0V k!R1 /`Cy�rv(4R�q? R.:i.N �. NOW- A.^ E':Y.. M r: NG3fi �! H_.4_� STATE OR LOCAL)? ®Yes ❑ No If yes, list agency(s) and permit/ approvals Town of Putnam Valley: driveway, building & wetland 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. ASA RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes ®No I CERTIFY THAT THE INFORMATION PROVIDED. ABOVEIS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/ sponsor name: John P.'Delano P.E. Engineer for Applicant Date: 01/04/00 "r Signature: ° 'tJ 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 Aaencv) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR PART 617.4? If yes, coordinate the review process and use the FULL EAR ❑ Yes ❑ No = 2: :�,s::1C'tG�, tvcr•. :, �c..ri��r17�:: i-:c•Lv�. ,'s Friv`:i... -.. FGicGNLfsT J ,::Tiv. +� E,4 - ?.1ki`a`I , .,,. i, ,-a negative aE.ioraiio�o ' may be superseded by another involved agency. . ❑ Yes ❑ No C. COULD ACTION RESULT IN ANYADVERSE EFFECTS ASSOCIAT® 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: C2. Aesthetic agricultural, archaeological historic, or other natural or cultural, resources: or community or neighborhood character? Explain briefly: C3. Vegetation,or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not identified in C1 -05 ?Explain briefly. C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. D. WILL THE PRO ECT 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? -- L�Yes- ❑No. If Yes, explain briefly PART III DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSrR=CNS 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 CEk ❑ 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 FAF 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 Rint or Type Nam of Responsible Officer in Lead Agency Title of Responsible Officer . Signature of Responsible Officer in Lead Agency Signature of Reparer (If different from responsible officer) Date 2 • PUTNAM C( JNTY DEPARTMENT P F HEALTH DIVISION OF UVIRONMENTAL HEALTH SERVICES _ _JJ .. .,._._ -.c• +. w _- ....ca �., :- .- ..- r� -.t'.. .q�.....w .... - r. .,.. -T-'hi o ,., -..._ .v`i• -. - .. - . ,- .:. -�., _a.u.. a. ... _.... ar.. ..,..o � �- •^C•, ...+ ... c., .n -. -. s r .. - _ RE: Property of Ron Karabinos Located at Sprout Brook Road T/V Putnam Valley Tax Map # Subdivision of 72 Block N/A Subdivision Lot # - Filed Map # - Date Filed Gentlemen: This letter is to authorize John P. Delano, P.E. Lot 48 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. Very �truly yours,:. Countersigned- 0 Signed:', PE 062505 (Owner of Property) Mailing Address Badey & Watson, P.C. 3063 Route 9, Cold Spring State New York Zip 10516 Telephone: (845) 265 -9217 Mailing Address: Ron Karabinos 200 Bell Hollow Road, Putnam Valley State New York' Zip 10579 Telephone: 845 - 528 -9390 Form LA -97 BADEY • WATSON LETTER of TRANSMITTAL V/ k-E:ngineering, _Surveying ou e pWg�,e -Mik­ dr6 Date: 05 Jan 2001 (845) 265-9217 (845) 628-1800 (914) 739-3577 File No. 98-105 FAX (845) 265-4428 W. 0. # 13741 RE: Proposed SSTS Karabinos TO: Sprout Borok Road/Cimarron Road Adam Stiebeling N/A - Subd. Lot No. N/A Putnam County Department of Health Tax Map 72,148 Permit # 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS-NIGHT RJ MESSENGER ❑ UPS-2 DAY ❑ PICK-UP ❑ UPS-3 DAY ❑ FAX ❑ UPS-GROUN ❑ UPS-COD ❑ We are sending copies date description of document FI] 04 -Jan -01 [Construction Permit for Sewage Treatment System F-1] 04 -Jan -01 ILetter of Authorization F__1] 104 -Jan -01 A [pplication for Approval of Plans for a Wastewater Treatment System F11 04 -Jan -01 IShort Environmental Assessment Form r__1] 121-N6v-00 1 IDesign Data Sheet 75 04 -Jan -01 I Separate Sewage Treatment System Sheet I of I [H-_Jan-Q_j__.=...FPuimD data & info .. .... .... . . . . . . . . . . . . . . f72 _-_F04'-Ya_ri_-R_-__TFF�1oor PIZ 71 04 -Jan -01 � jApplication to Construct a Water Well 71 104-Jan-01 1 jApplication Fee 7 1 REMARKS: Signed: John P. Delano, P.E. Copies to: File a xv . ............ SS-Ts (2-) 90 EG�NS. ---------- �vz H -F. LL AL YrE U! ... .... ...... .. ..... 'b I ST ... ....... . .. ... ...... MODEL Wo38 CANADIAN STAND PANTS Item No. Description 1 • - Impeller • _ -, 2' - • Casing - 3 Mechanical seal 4 Shaft 5 Motor 6 Bearings- upper and lower 7 Power cable 8 0 -ring 7 5 8 1 2 MODELS Order No. HP Volts Phase Max. Amp. RPM Solids M. flbs.t (.Aoulds Subme s l _ Eff & a 11 6 11 4 3 3885 IMANCE RATINGS (gallons per minus WE0511H WE0311L 1 115 9 9.4 : :'g� WEOSI2H WE0712H WE1012jtM'� WE0538H WE0738H WE103WE0312L 3 230 4 4.7 1750 5 56 t ti 2 v t• WE0311L WE0311M WE0532H WE0732H WE1032WE0311M 1 3 2 115 9 9,4 e ea' WE0312L WE0312M WE0534H WE0734H WE1034N WE0312M 2 230 4 1 4..# W WE0511 H 115 1 . F 1750 1750 3500 3500 3500 WE0512H 2 230 6 6.5 WE0538H 2 200 3 3.9 80 65 WE0532H 2 230 3 3 3 3.4 4 4 160 57 69 90 104. r ~e WE0534H 4 460 1 1.7 < < r 36 • 45 60 83 98 WE0511 HH ' '/z 1 115 1 13.0 6 60 y y... 50 76 92 WE0512HH 2 230 1 1 6 6.5 3 38 WE0538HH 2 200 3 3.8 " "' z 26 58 78 WE0532HH 2 230 3 3 3 3.3 ; ;r %:.: as .I 15 47 70. WE0534HH 4 460 1 1.65 ' ' ` ., 36 62 WE0712H 2 230 1 1 1 10.0 x xr'. 25 52 r WE0738H 2 200 6 6.2 17 42 WE0732H 2 208 - 230 3 3 5 5.4 : :-;ice: ; 8 32. 35 30 v 25 'c � zo 0 L': s `mommmmmmmmmm 1 1 ' M000000001111111111000 •1 1 41■MMMMMt INIEM \MMMMMMMMMMMMMMMM mmmm,mmmmmmmmmmmmmmm ..:::::G::::CCI::C::: mmmmmmmumm mmmmmmmm\■ ■smmsmmmon 'mm■mmmmmm'���������� "mmmm■mmmm .monom■mmmm���������■ noilrimommmmmmm mmmmmmm mI7•t■mmo■mmmmmmummmmmm mmmmmmommmmmmommmmmm ■mmmmmm►mlt mmmummmmmm mmmmmmmmommmmmwmmmmm mmmmmmmmmommmmmammmm .......Iti mmoo.00056.. mmmmmmmmmmmwmmmmmmmmi 0 10 20 CAPACITY WATER TECHNOLOGIES GROUP �12'/2 :•.` .::. I r- ROTATION D' KICK -BACK ;{ A. ,LUENT EJECTOR SYSTEM xFr 1t "lector system Packagl a of ordering Subme -, " Won. A single 12L or j! umber specifies Merc66jir system designed. A2 (# �. g Basil n` sidentlal and Check' _bump and Ord, appifcations._ S.- 1^ S w, I nction EQUIVALENT NUMBER OF FEET STRAIGHT PIPE FOR DIFFERENT FITTINGS Size of Fittings, Inches Yz" 3 /a" 1" 11/4 11/2 2" 21/:" 3" 4" 5" 6" 8" 10" 900 Eli 1.5 2.0 2.7 3.5 4.3 5.5 6.5 8.0 10.0 14.0 15 20 25 450 Ell 0.8 1.0 1.3 1.7 2.0 2.5 3.0 - 3.8 5:0 6.3 7.1 9.4 12 Long Sweep Ell 1.0 1.4 1.7 2.3 2.7 3.5 4.2 5.2 7.0 9.0 11.0 14.0 Close Return Bend 3.6 5.0 6.0 8.3 10.0 13.0 15.0 18.0 24.0 31.0 37.0 39.0 Tee - Straight Run 1. 2 2 3 3 4 5 Tee Side Inlet or Outlet 3.3 4.5 5.7 7.6 9.0 12.0 14.0 17.0 22.0 27.0 31.0 40.0 Globe Valve Open 17.0 22.0 27.0 36.0 43.0 55.0 67.0 82.0 110.0 140.0 160.0 220.0 Angle Valve Open 8.4 12.0 15.0 18.0 22.0 28.0 33.0 42.0 58.0 70.0 83.0 110.0 Gate Valve -Fully Open 0.4 0.5 0.6 0.8 1.0 1.2 1.4 1.7 2.3 2.9 3.5 4.5 Check Valve (Swing) 4. 5 7 9 11 13 16 20 '26 33 39 52 65 Check Valve (Spring) 4 6 8 12 14 19 23 32 43 58 Example: (A) 100 ft. of 2" plastic pipe with one (1) 90° elbow and one (1) swing check valve. _ 90° e!bov. Equivaler.t_to 5.5 ft: of straighf.piF Swing Check - Equivalent fo 13.0 ft. of straight pipe 100 ft. of pipe - Equivalent to 100.0 ft. of straight pipe 118.5 ft. = Total equivalent pipe Figure friction loss for 118.5 ft. of pipe. (B) Assume flow to be 80 GPM through 2" plastic pipe. 1. Friction loss table shows 11.43 ft. loss per 100 ft. of pipe. 2. In step (A) above we have determined total feet of pipe to be 118.5 ft. 3. Convert 118.5 ft. to percentage. 118.5 =100 = 1:185. 4. Multiply 11.43 x 1.185 13.54455 or 13.5 ft. = Total friction loss in this system. U Friction � vp -x. .... ... r� y�......n.... l A .... r.. t ....'4` n .< • . �. M- sa.'_"'+.•1 <.. xi r- .o-.,K ,. , �. ar- c c.r�iv- .. +.. _...M ._� _. �.. - "i.�.�. -r.;. <- PLASTIC PIPE: FRICTION LOSS PER 100 FT. GPM GPH . %N y2° 3/4n 1° 11/4° 11/2ff Ft. Lbs. R. Lbs. Ft. Lbs. Ft. Lbs. R. Lbs. Ft. Lbs. 1 60 4.25 1.85 1.38 .60 .356 .155 .11 .048 2 120 15.13 6.58 4.83 2.10 1.21 .526 .38 .164 .10 .044. 3 180 31:97 13.9 9.96 4.33 2.51 1.09 .77 .336 .21 .090 .10 .043 4 .240 54.97 23.9 17.07 7.42 4.21 1.83 1.30 .565 .35 .150 .16 .071 5 300 84.41 36.7 25.76 11.2 6.33 2.75 1.92 .835 .51 .223 .24 .104 6 360 36:34 15.8 8.83 3.84 2.69 1.17 .71 .309 .33 .145 8 480 63.71 27.7 15.18 6.60 4.58 1.99 1.19 .518 .55 .241 10 600 97.52 42.4 25.98 11.27 6.88 2.99 1.78 .774 .81 .361 15 900 49.68 21.6 14.63 6.36 3.75 1.63 1.74 .755 20 1,200 86.94 37.8 25.07 10.9 6.39 2.78 2.94 1.28 25 1,500 38.41 16.7 9.71 4.22 .4.44 1.93 . 30 1,800 13.62 5.92 6.26 2.72 35 2,100 18.17 7.90 8.37 3.64 40 2,400 23.55 10.24 10.70 4.65 45 2,700 -,_ . 9:44 _� _ a. 12, 80 13.46. _.. _ 5 95 . 16.45 1 7.15 60 3,600 23.48-1-10.21 Ts. (i� 9QOFLhQwS 5,5 . . ............ 'bi ST A — -------- -- ... . ...... r v Goulds Submersible _ Eff No, I. -Pu 6 3871 APPLICATIONS Motor: FEATUGS ■ Stainless steel fe�teners Specifically designed for the ' Single phase: 0.4 HP" j ■ Bearin s: U `Yi �' ZN following uses: or 230 V, 60 Hz, 1550 ftn`errtjlermoplastic heavy du 9 pair and lower Effluent systems RPM, built in overload with dp�n`resign with pump vY duty ball t�tyarlY[g y t ' br mechanical seal construction, • Homes automatic reset. r •Farms •Power cord: '10fo •Heavy duty sump standard length,1� - ease: Rugged AGENCY LISTIN • Water transfer with three prong; esign provides Canadian and SP Canadianstapd� • Dewatering plug: Optional 2fl; zj ,, ' q au to length, 16/3 Si :` t ,'' � knce. b t , SPECJICATIONS three prong groura `Cast iron : • Filly submer ed'' ar 9 ransfer,�,"y Pum grade turbine oil bil dy d F t 'y • So i %s handling capability: lubrication And a fihermoplastic ' f heat transfer. a 1/4".-in' aximum.�n !handle and •Cap _g1ties: up to 55 GPM. ent points. • Tofgl,; .earls: up to 24 feet. Available for auto P • DI rs' r 11/2" manual o Severe duty � �� ge size: NPT. Peration�� � I,,. • Mehanical seal: carbon- models include M a'r resistant. ro Float Switch asse`. s positive rCeramic- stationary, p ��,r BV kN elastomers. preset at the facto 1S to replace • Tei�ature: 1 ^�q7'�� °C. co►ttinuous' -,. - _..�,. _�.� _,. �' ^ r�''� - � _ _ -- - -r:. _....�.�_ ' � `�,,. �, ._- 14 X60 °C) intermittent. • Fa t ers: 300 series Std E, s Steel. METERS FEET • Ca of running, 4 c,} Y } et YCC74. t "i, 743 dr°1ibYhout damage to 8 a° w 6 20 2 z 5 15' 4 J Q O 3 10 I- 2 1i 5 l'►2 1 V 0 00 L 0 m 189�,%qulds Pumps, Inc. --► 5 2.5 FT I , I -j- 30 40 c � 8 10 ITY 'v 10 6 9 5 4 3 1 2 ;;are in inches. Do not use for construction purl 11 MAX. x 6' MINIMUM WATER LEVEL WHEN w k? c SUPPLIED WITH FLOAT SWITCH �t:. _ .. _ ,� -. • - _- "_ • _ - - �; :, ;, 9 was ,i ,r, y Goulds • PARTS 1'/ NPT 5 Item No. D Description 1 I Impeller 2 R Rugged thermo °{ base` 3 R Rugged thernioW pump casing 4 M Mechanical seal,': 5 B Ball bearings 6 0 0 -rings 7 P Power cord 8 O Oil filled motor 9 h Cast iron motor 10 T Thermoplastic I drNo. HP Volts Phase Max. RPM .. ±tg dS ?Power Cord Wts. Amps Hip ffir%q Length (lbs.) Ep X11 115 12 10' 20 :. EP0412 230 6 10' !011A a /�u 115 12 '/4" 10' 21 1550. EI?0%3'11 F' 115 1 12 20' 20 EP ' 12F* 230 6 20' 20 >ER411AC` 115 12 20' 21 "A. ";denotes automatic operation. Pump includes float switch. "F' d6h&&5 20 foot power cord. "AG`' denotes. automatic operation, CSA listed with 20 foot power and switch cords. ' CSA lifted units. _.mn or cove.,: rf i PERFORMANCE Total Head Gallons Pdr - (ft. of water) Minute 5 53 10 46 15 36 20 21 24 0 r � PUMPS, INC. TECHNOLOGIES K 13148 F A p T TO CHANGE WITHQUTINPITICE. :4 FALLS NEW YORK 13148 6 Y ' t sY jn 'r PRINTED; "A. ";denotes automatic operation. Pump includes float switch. "F' d6h&&5 20 foot power cord. "AG`' denotes. automatic operation, CSA listed with 20 foot power and switch cords. ' CSA lifted units. _.mn or cove.,: rf i PERFORMANCE Total Head Gallons Pdr - (ft. of water) Minute 5 53 10 46 15 36 20 21 24 0 r � PUMPS, INC. TECHNOLOGIES K 13148 F A p T TO CHANGE WITHQUTINPITICE. :4 FALLS NEW YORK 13148 6 Y ' t sY jn 'r PRINTED; r � PUMPS, INC. TECHNOLOGIES K 13148 F A p T TO CHANGE WITHQUTINPITICE. :4 FALLS NEW YORK 13148 6 Y ' t sY jn 'r PRINTED; 6 Y ' t sY jn 'r PRINTED; Friction Low ELASTIC PIPE: PER 1 I qll , Y2" 3 /i" 1" 1�I4° 1yt" `PM GFH Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. Ft. Lbs. 1 60 4.25 1.85 1.38 .60 .356 .155 .11 .048 2 .120 15.13 6.58 4.83 .2.10 1.21 .526 .38 .164 .10 .044. 3 180 31.97 13.9 9.96 4.33 2.51 1.09 .77 .336 .21 .090 .10 .043 4 ,240 54.97 23.9 17.07 7.42 4.21 1.83 1.30 .565 .35 .150 .16 .071 5 300 84.41 361 25.76 11.2 6.33 2.75 1.92 .835 .51 .223 '.24 .104 6 360 36.34 15.8 8.83 3.84 2.69 1.17 .71 .309 .33 .145 8 480 63.71 27.7 15.18 6.60 4.58 1.99 1.19 .518 .55 .241 10 600 97.52 42.4 25.98 11.27 6.88 2.99 1.78 .774 .83.. .361 15 900 49.68 21.6 14.63 6.36 3.75 1.63 1.74 .755 20 1,200 86.94 37.8 25.07 10.9 6.39 2.78 2.94 1.28 25 1,500 38.41 16.7 9.71 4.22 .4.44 1.93 30 1,800 13.62 5.92 6.26 2.72 35 2,100 18.17 7.90 8.37 3.64 40 2,400 23.55 10.24 10.70 4.65 45 .. _._ - .. 2,700 .... _._ - . _ - - - - - - - :9.:44 •� � 7:8�, : 3 4„ .. � �-�- - - 50 3,000 16.45 7.15 60 3,600 23.48 10.21 Riction Lo __ �..e .< ....•.smz.. .s_ �y,anC_•.d„o...-.z�a..t> __ :: s+.e:•.i.:iw= +.r.�,a>w.� .'5.�•;i '~ is EQUIVALENT NUMBER OF FEET STRAIGHT PIPE FOR DIFFERENT FITTINGS Size of Fittings,. Inches Yz" 3/4" 1" 1Y4" 1'1/2" 2" 2Y2" 3" 4" 5" 6" on 10" 900 Ell 1.5 2.0 2.7 3.5 4.3 5.5 6.5 8.0 10.0 14.0 15 20 25 450 Ell 0.8 1.0 1.3 1.7 2.0 2.5. 3.0 3.8 5.0 6.3 7.1 9.4 12 Long Sweep Ell 1.0 1.4 1.7 2.3 2.7 3.5 4.2 5.2 7.0 9.0 11.0 14.0 Close Return Bend 3.6 5.0 6.0 8.3 10.0 13.0 15.0 18.0 24.0 31.0 37.0 39.0 Tee - Straight Run 1 2 2 3 3 4 5 Tee -Side Inlet or Outlet 3.3 4.5 5.7 7.6 9.0 12.0. 14.0 17.0 22.0 27.0 31.0 40.0 Globe Valve Open 17.0 22.0 27.0 36.0 43.0 55.0 67.0 82.0 110.0 140.0 .160.0 220.0 Angle Valve Open 8.4 12.0 15.0 18.0 22.0 28.0 33.0 42.0 58.0 70.0 83.0 110.0 Gate Valve -Fully Open 0.4 0.5 0.6 0.8 1.0 1.2 1.4 1.7 2.3 2.9 3.5 4.5 Check Valve (Swing) 4 5 7 9 11 13 16 20 '26 33 39 52 65 Check Valve (Spring) 4 6 8 12 14 19 23 32 43 58 Example: (A) 100 ft. of 2" plastic pipe with one (1) 900 elbow and one (1) swing check valve. :30° elbow .Ea0v_alent�t Check -"'Equivalent to 13.0 ft. of straight pipe 100 ft. of pipe - Equivalent to 100.0 ft. of straight pipe 118.5 ft. = Total equivalent pipe Figure friction loss for 118.5 ft. of pipe. (B) Assume flow to be 80 GPM through 2" plastic pipe. 1. Friction loss table shows 11.43 ft. loss per 100 ft. of pipe. 2. In step (A) above we have determined total feet of pipe to be 118.5 ft. 3. Convert 118.5 ft. to percentage. 118.5 =100 = 1:185. 4. Multiply 11.43 x 1.185 13.54455 or 13.5 ft. = Total friction loss in this system. E3 i�q� `\ BADEY & WATSON LETTER of TRANSMITTAL 3063 Route 9, Cold Spring, New York 10516 Date: 20 Apr 2001 (845) 265 -9217 (914) 628 -1800 (914) 739 -3577 File No. 98 -105 (845) 225 -3312 FAX (845) 265 -4428 W. o. # laoaa RE: Revised SSTS Karabinos TO: Sprout Brook Road /Cimarron Road Adam Stiebeling N/A Subd. Lot No. N/A Tax Map 72.4-48 Putnam County Department of Health Permit # PV-5-01 1 Geneva Road Brewster, NY 10509 Sent via: US MAIL ❑ UPS -NIGHT ❑d MESSENGER ❑ UPS -2 DAY ❑ PICK -UP ❑ UPS -3 DAY ❑ FAX ❑ UPS -GROUN ❑ ° UPS -COD ❑ We are sending copies date description of document ❑ 5 20 -A r -01 ISeparate Sewage Treatment System Sheet 1 of 1 ❑ 1 El I 0 ❑ F_ ❑ v sa , OF V14 Revtised pursuant to conversation on ril 20, 2001. 0,014 V a; , = §`:�e,s}� 5,. Signed. John P. Delano; F. ° � � � _ ' SO Copies to: File 4946 E LF ABSORPTION :NCH A.. 1500 GAL. SEPTIC TANK OD N of r- 00 rn x w 0 z _0 S CL c� 0 0 00 I i N r- L0 0 I G rn AS -BUILT RELOCATION- DIMENSIONS 1B 39.2' SEPTIC TANK 1C 42.6' SEPTIC TANK 2B 33.7' SEPTIC TANK 2C 49.7' SEPTIC TANK 3B 31.1' PUMP TANK 3C 55.8' . PUMP TANK 4B 37.1' PUMP .TANK 4C 59.1' PUMP TANK 5A 140.5' DISTRIBUTION BOX 5B 112.1' DISTRIBUTION BOX 6A 139.8' BEGIN LATERAL 6B 111.5' BEGIN LATERAL 7A 136.3' BEGIN LATERAL 7B 107.7' BEGIN LATERAL 8A 133.1' BEGIN LATERAL 8B 104.0' BEGIN LATERAL 9A 130.0' BEGIN LATERAL 9D 100.7' BEGIN LATERAL 10A 127.1' BEGIN LATERAL. 11A 124.5' BEGIN LATERAL 118 53.6' BEGIN LATERAL 12A 53.6' END LATERAL 12B 35.0' END LATERAL 13A 58.8' END LATERAL 13B 41.1' END LATERAL 14A 64.1' END LATERAL 14B 47.2' END LATERAL 15A 69.5' END LATERAL 15B 53.2' END LATERAL 16A 75.1' END LATERAL 16B 59.3' END LATERAL 17A 80.7' END LATERAL 17B 65.4' END LATERAL WA 223.0' WELL WD 225.0' WELL D