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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -90.3 BOX 26 , .. !6 E i 03275 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT 'ivll lC,i�catpdi _ _ Sireet'kdalres>;: _ .'. _ _ _._. Tyler Road, Lot #3 TowrilVillage: Putnam Valley �. Tax Grid # Map 75 Block ( ' Lot(s)70.9 Well Owner: Name: Address: Dr. Ben Miraglia, 46 Cedar Pond Lane, Cortlandt Manor, NY 10567 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X 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 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic _ Other Joints: Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 640' Depth of completed well in feet 705' 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 3 Drilling in over urden clay and boulders 3 Hit rock at 3' =..3 3� : I'xil lin ..in ..rc?�lfi -�� t::ca6i _. ,,�vdt el 32 - 705 Drilling in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5__gpm Depth 660' Model 5GS1 2 Voltage 230 HP V-5 Tank Typek'X302 Vo l . Date Well Completed 9/21/01 Putnam County Certification No. 002 Date of Report 6/3/02 Well i r (s' NOTE: Exact location of well with distances to at leas two permanent landmarks to be prov n a separate(sneevpian. Well Driller's Name P. F. ons Inc. Address: 4 Putrw Ave., Brewster, NY 10509 Signature: Date: 6/3/02 Perry L. al White copy: HD File; Y ow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Dv PUTNAM COUNTY DEPARTMENT OF HEALTH 1 IN 1 !0. {/ 1 11� "`�y 9 •4e i t . •� 3 '� N e . CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # PV -7 -01 (J •- -O 1 1 U/ Located at' Tyler Court Town or Village Putnam Ley Owner /Applicant Name Benedict Miraglia Tax Map 73 Block 1 Lot 90.3 Formerly Subdivision Name Donald &Richard Brown Subd. Lot # 3 Mailing Address 46 Cedar Pond Lane, CortlandtManor, New York Zip 10567 Date Construction Permit Issued by PCHD 2-6-01 Separate Sewerage System built by Lemcar Address Mahopac, NY Consisting of 1250 Gallon Septic Tank and 450 if Absorption Trench, baffled D -Box, J -Box cleano.ut Other Requirements: Water Sunnfid: Public Supply From. one X Private Supply Drilled by P. F. Beale & Sons Address 4 Putnam Avenue Address Brewster, NY 10509 I?es a d xz e ..� ': Has: erosion controLbean. codi I — W, Number of Bedrooms 4 Has garbage grinder been installed? No 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 the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the P ty Department of Health. Date: 6Z12/02 Certified by P:E. x R.A. Address 113 Smith Avenue, MOunt Kisco A 1 NY 10549 License # 611.2 2 6 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 revoAa* , modif icatio r change is necessary. r By: K . Title: Date: White copy - HD Fi ; Yel opy - Building Inspector; Pink copy weer; Orange copy - Design Professional Form CC -97 )BRUCE R- ..COLEY Public ifeaith "birector *- 9 LORETTA MOLINARI - R.N:,...KS_l .:r.......:. `�� "- .� -..` �- .4ssociata 'Public �edgth - Director •- _ ,. , � �- ... , Director of Patient Services DEPARTMENT OF HEALTH - 1 Geneva Road Brewster, New York 10509 Environmental Health (914).218 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 218 —6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OF (Signature) DATE: 3. 2-7 -1-v le r Pa . 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 GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Ben Miraglia 73 1 90.3' Owner or Purchaser of Building Tax Map Block Lot Lemcat Putnam Valley Building Constructed by _ TownNillage g7 Tyler Court Donald & Richard Brown Location - Street Subdivision Name Residence 3 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 .. .r.,.,.... -.. •rs c. .. .a s.. > .r+ .._. .. - ... . .. .:6 _' a —. - ..-... _.. --.: w- .....+ yti -.� . -aK. ...s -m .p.n . -.m-aa .. ..w .. a �s .a.. A- a.w .-... ....r .J The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month 0 6 Day 10 Year 0 2 General Contrac (Owner) - Signature Signature: Title: Corporation Name (if corporation) Corporation Name (if corporation) Address: 46 'Cedar Pond Lane,Cortlandt ManorAddress: State New York Zip 10567 State Zip Form GS -97 z m JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory Y .�• - . _. .. .. .. .. .n .. .. _ .. ..- . �. .. - n .. .'...K+ .• «. .. f v x..� �. • .� _.. ... _ �s.s� C . - :a s. Y. .. ..iFK. r ..n Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: 845 - 279 -2460 Sample's Information: Client: Ben Miraglia Zip: 10509 Fax: 845 - 279 -6613 Collector's Information: Name: Chris Beal Address of site: Lot #3 Tyler Rd City: Putnam Valley State: NY Zip: Telephone: Site: Date Collected: 8/28/02 Date Received: 8/29!02 Preservative: N/A Time Collected: 14:00 Time- Received: 10:30 Temperature: <4C Lab No.: J023226 Date Analyzed Test Name Result MCL Method 8/29/2002 15:00 Total Coliform Absent Absent SMWW 9222B 8/29/2002 Chlorine Free Residual <0.1 mg /L N/A SMWW 4500CIG 8/30/02 Color ND 15 Units SMWW 2120 B 8/30/02 Odor ND 3 TONs SMWW 2150 B 8/30/02 Iron <0.03 mg /L 0.3 mg /L SMWW 3111B 8/30/02 Manganese <0.01 mg /L 0.3 mg /L SMWW 3111B 8/30/02 Sodium 17.5 mg /L N/A SMWW 3111B 8/30/02 Chloride 47 mg /L 250 mg /L SMWW 4500 Cl C 8/30/02 Hardness 36 mg /L N/A SMWW 2340 C 8/30/02 :.: ,_ Nitrate.... -...._ ..... :.::: :.. �_....:_._ -1.43 mg /L 10.mg /L -`_ _ .- SMWW- 4500.NO3E 8/30/02 12:00 Nitrite <0.1 mg /L 1.0 mg /L SMWW 4500 NO3En 8/29/02 pH 6.65 S.U. 6.5 -8.5 S.U. SMWW 4500 H B 8/30/02 Sulfate 13.9 mg /L 250 mg /L SMWW 4500 SO4F 8/30/02 Turbidity 0.83 NTU 5 NTUs SMWW 2130 B 8/30/02 Lead <1.0 ug /L 15 ug /L SMWW 3113 B At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg /L- milligrams per Liter ND. None Detected S.U.= Standard Unit NTU- Nephelometric Turbidity Unit MCL- Max. Contaminant Level TON- Threshold Odor Number ug /L- micrograms per Liter Signature. State #: PH -0218 Michael Lapman ELAP #: 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmental.com �., 1 � Y' s zr n�•: t• iv a y i +^l.KZ,4 'h tz,is "..1� Fkkr 7 , l , :; p ,E L y�y� n�$js/ r,i 'S�'¢ y# yrfikaw yF y . iGS ?3{aa vpX G7+ tiv�l� � r h a4; JMS SERV ENVIRONMENTAL ` � J,, :.•t56A UMMER STREET ,�. : S�A�V1F(1RL1 C�.�I.N.Ei TICIIT nFgc�4yx NFLAC CT and lVY State Cer►pdaEnvknnmenMl,Coharet2�,z Mailing Information \ ; Collectors Information 'Name: PF Beal BfSons ' Ben Mlagla rf� t ame Chns Beal Address: 4 Puthim' . ve Address of site Lot #3 Tyler Rd 5 .r sir City: Brewster City Putnam Valley ., 4 State: NY Zip: 10509 ; `4 k ` State NY,. Zip y� Telephone: 845479 -2460 Fax:845- 279 -6613 Telephone Sample's information Site: Date Collected 8/28/02 Date Received Preservative: NIA Time Collected '14 QO Tir>ie Received ::10:30 Temperature: <4C Lab Nos J023226 Date Analyzed Test Name Result MCL Method 8/29/200215:00 `Total Coliform Absent Absent SMWW 92226 8/29/2002 Chlorine Free Residual. <0.1 mg/L N/A SMWW 4500CIG 8/30/02 Color ND 15 Units SMWW 2120 B •: 8/30/02 Odor ND 3 TONS SMWW 2150 B 8/30/02. Iron <0.03 mg/L 0.3 mg/L SMWW 31116 8/30/02 Manganese <0.01 mg/L 0.3 mgA- SMWW 3111B 8/30102 Sodium 17.5 mgA- WA SMWW 3111B 8/30/02 Chloride 47 mg/L 250 mg/L SMWW 4500 Cl C `. 8/30/02. v ..'... _ v,l !a Jness ...... 36 r 2 ... ,. A :.: _ __, .....- MM 2340. 8/30/02 Nitrate 1.43 mg/L 10 mg/L J T SMWW 4500 NO3E 8130/02 12:00 Nitrite 50.1 mg/L 1.0 mg/L SMWW 4500 NO3E 8129/02 pH 6.65 S.U. 6.5 -8.5 S.U. SMWW 4500 H B 8/30/02 Sulfate 13.9 mg/L 250 mg/L SMWW 4500 SO4F. 8/30102 Turbidity 0.83 NTU 5 NTUs SMWW 2130 B 8130/02 Lead <1.0 ug/L 15 ug/L SMWW 3113 B At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg/L- milligrams per Liter ND- None Detected S.U.= Standard Unit NTU- Nephelometric Turbidity Unit MCL- Max. Contaminant Level TON- Threshold Odor Number ug/L- micrograms per Liter Signature: State #: PH -0218 Michael Lapman ELAP #:11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fox 203 961 9919 imsenvironmental.com }139/08/.02 FRI 12 29 FA% B, z f k s Fri Ott Vii' tii ar: Tt 1MS ENVIRONMENTAL SERVICES INC } J i- 1500 SUMMER 5TREET V, , STAMFORD. CONNECTICUT o6gas -N6tAC -CT dad MY.- !``ale Certlfle:i Envlror I Ldbaratory , Mailing Information: Corrector's Information. } Name: PF Beale Sons Client: Ben Muaglra Name' Chrts8eel + '_� x "F t ��assts . 4 Putna m Ave Cl 7 - f tY. . iYt3 t �5 s4 .6t '43 :• . y Tyler Rd City: Brewster City: Putnam VaAey w a State: NY Zip• 10509. State. NY F Abe , a Zip.. r Telephone• 846- 279 -2460 Fax: 845- 278.6613 Telephone t°' Sample's tafa mation: Site: Date Collected: 8128/02 Date Received. $!25/02 Preservative: N/A Time Collected ::14:00 Time_Recpived - :10 30 Temperature: <4C Lab Na.: J023226 Date Analyzed Test Name Result MCL i Method 8129/200215:00 Total'Colilbrm Absent Absent SMWW 92226 8/2S/2002 . Chlorine Fme'Residual <0.1 mg/L WA SMWW 4600CIG 8/30/02 Color NO 15 Units SMWw 2120 B 8/30/02 Odor NO 3 TONs 1 SMWW 2150 B 8130/02 Iron <0.03 mg/L 0.3 mgA- SMWW 31118 8/30/02 Manganese <0.01 mg/L 0.3 mglL SMWW 3111B 8/30/02 " Sodium 17.5 mg/L N/A SMWW 31118 8/30/02 Chloride 47 mg/!, 250 mg/L SMWW 4500 Cl C 8130/02 Hardness 36 mg/L N/A SMWw "2340 C 8/30/02 Nitrate 1.43 mg/L 10 mg/L SMWW 4600 NO3E Jtirite ..;- -.. _.: ., .. <0:1 mg/L .._1 O rfto'':. :- $x:4500 .03E -- .- :.- .... . _... - 5wi02 _...pK.. 6.65 S:U: 6.5$.5 S.U. SMWW 4500 H 8 13/30102 Sulfate 13.9 mg/L 250 mg1L SMWW 4500 SOV 8130/02 Turbidity 0.83 NTU 5 NTUs SMWw 2130 S 8/30/02 Lead <1.0 ug/L 15 ug/L SMww 3113 B At the time of analysis the sample was acceptable for total conform NIA = Not Applicable rng/L- milligrams per Liter ND- None Detected S.U.■ Standard Unit NTU- Nephelometric Turbidity Unit MCI.- Max. Contaminant Level TON- Threshold Odor Number uglL- micrograms per Liter Signature: �'r'¢'"'� State;tE: PH -0218 Michael Lopman ELAP M 11715 President Tel 203 9619911 Toll Free 1 866 557 5097 Fax 203 961 9919 jmsenv1roninen;al.COm Date Analyzed Test Name 8/29/2002 15:00 Tdtal Coliform 8/29/2002 Chlorine Free Residual 8/30/02 Color 8/30/02 Odor 8/30/02 Iron 8/30/02 Manganese 8/30/02 Sodium 8/30/02 Chloride 8/30/02 - -- Hardness - :8/30/02 Nitrate ... . _ 8/30/0212:00 Nitrite 8/29/02 pH 8/30/02 Sulfate 8/30/02 Turbidity 8/30/02 Lead MCL Absent Absent <0.1 mg/L N/A ND 15 Units ND 3 TONs <0.03 mg/L: 0.3 mg /L <0.01 mg /L 0.3 mg /L 17.5 mg/L N/A 47 mg/L 250 mg /L 1.43 mg/L 10 mg /L <0.1 mg /L 1.0 mg /L 6.65 S.U. 6.5 -8.5 S.U. 13.9 mgA- 250 mg /L 0.83 NTU 5 NTUs <1.0 ug /L 15 ug/L At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable S.U.= Standard Unit MCL- Max. Contaminant Level ug/L- micrograms per Liter SMWW 9222B SMWW 4500CIG SMWW 2120 B SMWW 2150 B .SMWW 3111B SMWW 3111B SMWW 3111B SMWW 4500 CI C :.SMWW-234O C . SMWW 4500 NO3E SMWW 4500 NO3E SMWW 4500 H B SMWW 4500 SO4F SMWW 2130 B SMWW 3113 B mg /L- milligrams per Liter ND- None Detected NTU- Nephelometric Turbidity Unit TORS- Threshold Odor Number s Signature: "t- State #: PH -0218 Michael Lapman ELAP #: 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fox 203 961 9919 imsenvironmental.com KEANE COPPELMAN ENGINEERS, P.C. 113 Smith Avenue MOUNT KISCO, NEW YORK 10549 To ?T1JAM �oVN ?`I �E4A+i�t'ME,NT ®F t"[ EAI.TN WE ARE SENDING YOU Attached ❑ Under separate cover via _ ❑ Shop drawings /Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ [LIEVVIM @1P DATE �Q 2: ?- -0z JOB NO. XMENTION N R-06 AN RE: Q TN M A x h(kK CCUKITI wevi 09y, the following items: ❑ Samples ❑ Specifications . COPIES DATE NO. DESCRIPTION 4 9561-S AS GOIL-T FIAN THESE ARET,RA� JSM!TTED. ,s ch P*ckP.d_b0 w.,,. For approval ❑ Approved as submitted ❑ Resubmit copies for approval • For your use ❑ Approved as noted ❑ Submit copies for distribution • As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS _ COPY TO SIGNED: l° if enclosures are not as noted, kindly notify us at once. KEANE COPPELMAN ENGINEERS, P.C. CIVIL & ENVIRONMENTAL CONSULTANTS 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 (914) 241-2235 September 26, 2002 Shawn Rogan, Public Health Technician Putnam County Department of Health I Geneva-Road Brewster, New York 10509 Re: Proposed SSTS Compliance - Miraglia Tyler Court, (T) Putnam Valley TM# 73.-1-90.3 Dear TW Rogan: We are resubmitting As Built Plans for the above referenced project for your review. The following items have been addressed as per your.review memo dated August 21, 2002: 1. A complete water sample analysis is provided. 2. The metes and bounds description is now legible. A note indicating the source of surveyyhas-beenprovided- on the plan. 4. The dimensions necessary to locate the ends of the trenches have been provided. Should you have any questions regarding the above, please don't hesitate to contact me. BRUCE R. R. FOLEY? Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 August 21, 2002 Peter Gregory Keane Coppleman Engineers 113 Smith Avenue Mount Kisco, New York 10549 Re: Dear Mr. Gregory: Proposed SSTS - Miraglia, Tyler Court (T) Putnam Valley, TM# 73. -1 -90.3 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. Water sample analysis is incomplete (see attachment). 2. Metes and bounds description of property is not legible. _ .Prv,4de.;the �soidcexi .: the -s irvey;'�� %`note-on the'pla:r ..r .,.:..- �. _ � ...:_ .... ... � ......,. 4. Y Provide the measurements necessary to locate the ends of the trenches. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Sincerely, Shawn Rogan Public Health Technician SR:cj encl. pH No designated Limit Hardness No designated limit Alkalinity No designated limit NOTES: (1) Maximum contaminant level. _ ()2 Water containing more than 20 m . of sodium should not beused.._-- - =. = -- ' - g ......... ..... . ........ - - for drinking by'people on severely restricted sodium diets .._Water__..- ___- _- ___..._ . containirig more than 210 r go of sodium should not be'used by '1 people on moderately restricted sodium diets: (3) NTU means Nephelometric Turbidity Units. (4) mg/1 means. milligram per liter. (5) ug/l means microgram per liter. • h b. A Well Completion Report signed by the well driller, including the results of .at least a 6-hour pump test (See Appendix K). A minimum well yield of 5 gpm is required. For yields less than 5 gpm see Appendix F for procedures on performing a 24 -hour well pumping test. The ! results of the 24 -hour pump test are to be submitted to the Department for - • review ' az d a determination will be made regarding utilization of the well for supplying potable water to the dwelling. If the new well is found acceptable, r ;e \:w .: Y`, ?.Y;.YA•1.\ -.,. µ. W vA`p•��.¢ -'.• . ,,f y�;S': ;'A:? Sw-ti {':�`.y . i^`9.Y'h; {n, ,M�•, , ;C�R�. \\.-,�W. •'c�•'Q: �'?�.','i:Y..- nJ::t..A 2S.A'`• `+.�• .tk.;.•:•.].•v,::w:T ^w- :•.' V.:Y \ u w,•<J�ha� \M'\. :\ �\ .�Z4- ,, }.ar r:,•• -xa'\ ;�xa;.;.• }...•ti,F"n°,•'•n :a,Y �7:,�t:'"'t•.;�C'�• ,k ,'�?" �•i.; . ,4`�'3Y`&,c�,+.�,.. �`.t . R :. , a. �H:: �aw�: �;^ �.,>.;-: �4�: rr;,,,., 3'>.>,: �4YS3; r: �?% �; isx<,, �3,;:;<;{:<, �>:;<;; ��:, �;, o-.:, cft:: �.•. Yx•.•> rvr; :�rfia,�:.•.- :•����•a..::::.x.�. r.• - :; _ CON• TANT MCL (1)(4)(5) iform bacteria Any positive result is unsatisfactory Lead 0.015 mg/l (15 ug/1) Nitrates 10 mg/l as N Nitrites 1 mgn as N - Iron 0.3 mg/l Manganese 0.3 mg/l Iron plus manganese 0.5 mg/l pH No designated Limit Hardness No designated limit Alkalinity No designated limit NOTES: (1) Maximum contaminant level. _ ()2 Water containing more than 20 m . of sodium should not beused.._-- - =. = -- ' - g ......... ..... . ........ - - for drinking by'people on severely restricted sodium diets .._Water__..- ___- _- ___..._ . containirig more than 210 r go of sodium should not be'used by '1 people on moderately restricted sodium diets: (3) NTU means Nephelometric Turbidity Units. (4) mg/1 means. milligram per liter. (5) ug/l means microgram per liter. • h b. A Well Completion Report signed by the well driller, including the results of .at least a 6-hour pump test (See Appendix K). A minimum well yield of 5 gpm is required. For yields less than 5 gpm see Appendix F for procedures on performing a 24 -hour well pumping test. The ! results of the 24 -hour pump test are to be submitted to the Department for - • review ' az d a determination will be made regarding utilization of the well for supplying potable water to the dwelling. If the new well is found acceptable, KEANE COPPELMAN ENGINEERS, P.C. 113 Smith Avenue MOUNT KISCO, NEW YORK 10549 -91Qw241.-2235 TO Putnam County Health Department 1 Geneva Road Brewster, New York WE ARE SENDING YOU Attached ❑ Under separate cover via > ❑ Shop drawings allr�ints ❑ Plans ❑ Copy of letter ❑ Change order ❑ [LIEVITIEN @1P DATE 6/12/02 JOB NO. .fg-rENT40N - - Mr. ii;�bert Morris RE: Benedict-Miriglia Tyler Court Putnam Valley As Built InnnAld & Richard Brown R.S. Lot 3] the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION 4 AS Built Plan 1 Certificate of Compliance Guaranty Form Well Log Bacterial Analysis THESE ARE TRANS 71�p as checked ..belo ._ 3efor approval ❑ Approved as submitted ❑ Resubmit -copies for approval ❑ For your use ❑ Approved as noted ❑ Submit - copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return -corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: If enclosures are not as noted, kindly notify us at KEANE COPPELMAN ENGINEERS, P.C. 113 Smith Avenue MOUNT KISCO, NEW YORK 10549 MO-24-1-42W TO Putnam County Health•Department 1 Geneva Road Route 312 Brewster, NY 10509 [LIEVVIEE @1P4 ° o MMOVU&I DATE . 08/15,02 JOB NO. ATrENTION• --" ` "'!"' Mr. Robert Morris RE: Benwdict Miriglia Tyler Court Putnam Valley SSTS As Built Donald & Richard Brown R.S. Lot 3 WE ARE SENDING YOUl Attached ❑ Under separate cover via the following items: ❑ Shop drawings [N Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order N Check & Form COPIES DATE NO. DESCRIPTION 911 Address Verification Application Fee THeS ARE TRAM Mff('Eb' b -.as -C K e� liked d ebw For approval ❑ Approved as submitted ❑ Resubmit -copies for approval ❑ For your use ❑ Approved as noted ❑ Submit - copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return -corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: H enclosures are not as noted, kindly notify us at m S JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: Sample's Information: Client: Ben Miraglia Zip: 10509 Fax: Collector's Information: Name: Bob Address of site: lot 3 Tyler Rd City: Putnam Valley State: NY Zip: Telephone: Site: kitchen tap Date Collected: 4/18/02 Date Received: 4/19/02 Preservative: N/A Time Collected: 16:10 Time Received: 12:00 Temperature: <4C Lab No.: J021477 Date Analyzed Test Name Result MCL Method 4/19/02 15:00 Total Coliform 4/19/02 Chlorine Free Residual Absent Absent SMWW 9222B <0.1 mg /L N/A SMWW 4500CIG At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable MCL- Max. Contaminant Level Signature: Michael Lapman President mg /L- milligrams per Liter State #: PH -0218 ELAP #: 11715 Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 imsenvironmental.com I %_u nx Ai,in DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE WSPECTION Street To%}m IM "7 -s o. Subdivision Lot 1. Seivage Svsteih Area Y a. STS area located as per approved plans ........................... b..* Fill sl-ction-- 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 ................ ..................... SeiN%ee System a. SePtic tank size -1,000 .... .....other............ b. Septic tank- installed level (� .......................... -c.- 10' minimum from foundation'.... .................................... Box A . All .out lets.'at same elevation-water tested ................. 2. Protected below- frost ................................................. 3. Minimum 2 ft.Original soil between box & trenches ___e. Junction-Box- -w properly set .............................................. f. Trenches 1. Len iriquiied ,S`© Length installed, Ft., 2.. Dis;tance '-to watercourse measured ......... 3. Installed according to plan ............................................ .4W Slope of trench acceptable 1116 -1/32 "/foot ............. 5.:10 ft.: fr6m:property line -.20 ft. foundations..:....... .6. Depth of trench <30 inches from surface ..:.. ............. 7 i Room. allowed for expansion,. 100% ............................ 8._Sizd_6fgta:,M314_1`/"' diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends tapped ....................................................... 'Ump or Dosed'S Tzeo pumps amber....... ....... ............................... 2. Overflow tank ............................................................. 3. Alarm, visual/audio ................................................. 4. Pump easily accessible, manhole to grade ................. - 5. First lox -b affed;; . ... . .. .. . w ................ ...... .6. Cycle witnessed by H.D.estimated flow/cycle ........... M. Houseffluildlng,, 2. J_iouse located per approved plans .................... ! ................... b. Number of bedrooms .................. * .................................... IV. W611 a. Well located as per approved plans ............. b. Distance from STS area measured * 00 ft........... c. , Casing 18" above grade .................................................. d. Surface drainage around well acceptable ....................... Y. Overall Workmanship a. Boxes properly grouted .............................................. b. All pipes partially backfilled .......... ............................... c. All p1p6s flush with inside of box ................................... d. Backfill material contains stones <4" diameter .............. e. *Curtain drain & standpipes installed according to plan.. f.. Curtain drain outfall protected & dir.to exist watercourse 9. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................................................. n_ etn� Date: Inspecte - --------------- - 0(�4 -11 -01 10:19P PUTNAM COUNTY DEPARTMENT OF REALTH DI"SION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION /ADAM All information must be fully completed prior to any inspections being made. ❑ GENE For: Fill vdA►dC6W-2--01 Trenches P.02 PCHD Construction Permit # V - -7-- 0 1 Located: 'CYLeg GouR om _Po-mktA gAL.Ly Owner /Applicant Name: 09N Ml'RAA1.•1 A. TM "13 Block I —Lot 90 Formerly: Subdivision Name: Rox(&O 4- tZV-M 1V -13 W N Subdivision Lot # LA 3 Is system fill completed? Y 5 _ Date: 1 0110101 Is system complete? Date: 10110161 Is system constructed as per plans? 5 Is well drilled? _ Date: bo 1 Is well, located as per plans? Yrrs Are erosion control measures in place? Y_ I certify that the "em(s), as fisted, 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 Sndards, Rules and Regulations of the Putnam County Department of Health. _ . . e .. t 2 0 ' Certified b. _pE- /� Date. y. Des' Pro io Address: l 1 5 �'11'T►1 Ay MT K� 5G 4 . �1.`[: i° 1 Comments: Form FIR -99 # 67/ Z716 nrT- 1P -?AA1 FRT 10:77 TFL:R45- 278 -7921 NAME:PUTNAM COUNTY DFPARTMFNT ❑F P. P Vy Oci. -1 1 - 01 10:19P KEANE GOPPELMAN ENGINEERS9 P.C. CIVIL & ENVIRONMENTAL CONSULTANTS 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 FAX TRANSMITTAL COVER PAGE OUR FAX NO. (914)-241 -6787 DATE-. 1611-2,161 TO: A 04 M -..�-ri 9 t Lj /JCx FAX NO: 4 4 5 2-76 79 2.1 - SUBJECT: RI5- GLVF_ST foV, E%4AI, lNSt? &-T1ClN �3� N► b iR �L ► �► NUMBER OF PAGES: Z_ (INCLUDING THIS PACE *'PLEASE CALL IF YOU EEO NOT RECEIVE ALL PAGES * * ** P.01 (914) 241 -2235 J. . ,��i PUTNAM- "COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES U T 1 -0, N PE MIT FOR SEWAGE TREATMENT SYSTEM 0 PERMIT # 7 Located at Tyler Court Town or Village Putnam Valley Donald & �> ._... Subdivision nameRJohar.d Brzox.: Subd. Lot # 3 Tax Map 73 Block 1 Lot-- "9= Date Subdivision Approved File Map 2778 Renewal Revision Owner /Applicant Name Benedict Miraglia Date of Previous Approval Mailing Address 46 Cedar Pond Lane, Cortlandt Manor, NY Zip 10567 Amount of Fee Enclosed $300.00 Building Type Residence Lot Area 2,4AC No. of Bedrooms 4 Design Flow GPD 800 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1250 box w /baf,fle, 450LF absorption tre Other Requirements: S Q" i F I C_ t" gallon septic tank and Distribution ch 24" wide.. 7' -0" 0. A�vt To be constructed by United Septic SvstPms Address 311 Railroad Ave. ,Bedford. Hills, Water Sup"I Public Supply From Address NY 10507 Prate Su.....1....11 :; .'?.'F'�:- `Bead. & Son. 4. .Putnam. Ave. pp y _ _.,d o f Addres r:eiing icr r NI,Y 10 5 0 9 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 ofe; isnce o�feyf1 of the Certificate of Construction Compliance of the original system or an y rs thereto. , re Y w ,. Signed: P.E. X R.A. Address Krzan,- r r ) n r 4 h ' 1 m;;r/' :nrrrs . 1 1 3 Smith Ave - . License # Date 12/22/00 Mount Kisco; 10549 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 p i . Approved for discharge of domestic sanitary sewage onl . j. By: TitleARJA l (C- 1 t► /Date: !1 _ White copy - HD ; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 �HRUC: Public a NAME: ADDRESS: SITE LOCATION: DATE: STAFF PRESENT- -'-LO tET'TA ' Oi INA 1 R:N.; . ivl:S.Iv:' ° ""•° 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 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 PUTNAM COUNTY DEPARTMENT OF HEALTH n SPECIFIC WAVIER S J �-oZ C IF I" 1 t A c- Di- , l k- /� ( Cfop �OtZZZrF� y lr�t*�ow " Y ( '0S-71? Z/ G/10 SPECIFIC WAVIER REQUEST: y S (0 V�a ,4o Irr tf Ll If DOES THE PROPOSED VARIANCE REQUEST POSE A HEALTH HAZARD -OR ENVIRONMENTAL CONTAMINATION PROBLEM? YES NO WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP? YES NO DISCUSSION REQUEST APPRO OR DE.NTED , REAS�Or DENIAL DlIkEICTOR OF PUBLIC HEALTH I S� - °2"°( NEW YORK STATE DEPARTMENT OF HEALTH , . Specific Waiver Bureau of Community Sanitation and Food Protection from Requirements of Part 75 and Appendix 75- A, 10NYCRR for Individual Household Sewage Treatment Systems Name of Applicant "Miraglia Benedict Nu. street City/Town State zip Address 46 Cedar Pond Lane, Cortlandt Manor, NY, 10567 Site Location k Tyler Court Putnam Valley, NY 10579 1. Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)): S paration distance cannot be achieved. 7 '._..cessive slope. High groundwater. Inadequate depth to bedrock or impermeable layer. Soil unsuitable. Other(explain) ............. ....................................... ..............................� ...�. .. - -... ........ . ... : �Lo �% i' iu ................... ............................... ............................. ? ... 1................................ ............................... .........................:mot... ........................................................................................:................................................................................_......................................................._.._................... ..............................: 2. Proposed design or conditions.of waiver: ...................... .......... ...........: .............................................. t..� ......... !�."'tr. A!�. .. ..........- .....1b�......... ....................-...... ...... ............................... ...... ...................... . ............................... .. 3. The proposed design may have the following limitations (check appropriate box(es)): J Increased risk of well or spring contamination. Increased risk of surface water contamination. C] Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. Other(explain) ..._ -.... ..................................................... ....................................................... ' ' ' ` .................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver maybe revoked by th ' uing official for a change in conditions for which this waiver was granted. i' ... ....f .......................... ........................................... ............................... RE RESENTATIVE OF MMISSIONER OF HEALTH ORIGINAL - Local Health Agency ................................................... ............................... COPY - ApplicanUDesign Professional DATE ..... DOH -1326 (7/92) (GEN -152) b- `PYii ib�S:�•' Department of Environmental Protection 465 Columbus Avenue Valhalla, New York 10595 -1336 Joel A. Miele Sr., RE. Commissioner Bureau of Water Supply,,. Quality & Protection William N. Stasluk, P.E., Ph.D. Deputy Commissioner Tel (914) 742 -2001 Fax(914)742 -2027 bry DFP.IR�j�F�� ®✓�I Eli ,, MEMORANDUM Distribution FROM: Edwin Polese, P.E. Chief, Engineering Section . RE: Installation of Subsurface Septic System Absorption Fields DATE: June 19, 2000 Since September 18, 1998, the New York City Department of Environmental Protection (the Department) has followed the New York State Department of Health interpretation of Appendix 75 -A regarding slope modification for septic system installations. This particular interpretation allowed the modification of the natural ground slope of between fifteen and twenty percent down to fifteen percent by the use of fill in order to permit the installation of a septic system absorption field. Effective immediately this practice will no longer be permitted by the Department and all septic.system absorption fields must be installed on'natUral 'slopes of fifteen percent or less. Lots which are in filed subdivisions shall comply with this memo to the extent possible. All other, design criteria outlined in Appendix 75 -A must be met Distrubution: R. Tramontano /J.. Covey, NYSDOH B:, Foley, PCHD D. Palen; UCHD M. Sakala, WCHD M. Principe/T. Hook J. Maggio/T. Simroe /M. Lloyd D. Rider /B. Drake T. West r' PVTNAM COUNTY DEPARTMENT OF HEALTH Sc-� - Z- — of DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ ��T-ao-N TO ?A4 please print or type P H P rD mit # Y" fV� Well Location: Street Address: Town/Village Tax Grid # Tvler Court Putnam Valley 73 1 s 9.6' ' Map Block Lot(sy" - Well Owner: Name: Address: 46 Cedar_ Pond Lane,_ Benedict Mirag.l.ia Co.rtlandt Manor, NY 10567 Use of Well: X 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 ___a_ gpm # People Served 4 Est. of Daily Usage 8 0 0 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling x New Supply (new dwelling) Deepen Existing Well Retailed Reason New Residential Dwelline7 bei-ng constructed for Chilling Well 'Type X Drilled Driven Gravel Other Is well site subject to flooding? ......................................:.......... ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes X No _ Name of subdivision Donald & Richard Brown Subdivision Lot No. 3 Water Well Contractor: P - F. Beal & Son Address:4 Putnam Ave . , Brewste3. , NY10 Is Public Water Supply available to site? .................................. ............................... Yes No_ X Name of Public Water Supply: - Town/Village - Distance to property from nearest water main: - Proposed well location & sources of contamination to be provided on separate sheet/plan. D4te: Applica>utSignature: _ ?c; 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 w well driller certified by Putnam County. Date of Issue 0 Permit Issuing Official: Date of Expiration S Title: 0,1� g , C 11�A� ����• Permit is loon- Transferra le` White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 509 le t 14.16.4 (2187)—Text 12 PROJECT I.D. NUMBER 617.21 SEAR ' q,, Appendix C State Environmental Qua 11 ty ev ley ,, "� H��iiNVIRONI�IINAL ASSSMENTWFORM For UNLISTED ACTIONS Only' PART I— PROJECT INFORMATION (To be completed by Appllcant:.or Project sponsor] 1. APPLICANT /SPONSOR 2. PROJECT NAME.. Benedict Miraalia Mi rag lia Residence' 3. PROJECT LOCATION: Putnam Valley Putnam 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) The property is located on the Western side of-Tyler-Court 300 Ft. West of Tyler Road. 5. IS PROPOSED ACTION: 0 New - ❑ Expansion ❑ Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: The project involves the construction of residence, 12' wide - driveway, :subsurface and well. a signle family sewage.disposal system 7. AMOUNT OF LAND AFFECTED: Initially 1 AC +�— acres Ultimately 1 AC 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 D Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space Other Describe: '-Pr d er ;:y:. - -ats 16 catsd _tai;th.i:i?=tiro. re. isdentiai,:.v ng:�` istricts �- R- 2 & R- 3. - 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ® Yes ❑ No If yes, list agency(s) and permit/approvals Putnam County Health Dept. Construction Permit for Sewage Treatment System & well. Town of Putnam - Valley Building Permit. 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 39Yes ❑ No If yes, list agency name and permif/approval Putnam County Health Dept. Realty Subdivision. 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑ Yes FC1 No . j' . I CERTIFY THAT THE �INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: /� 1 i r"a � a- ',Ben Mi racrlia Date: a e o-° Signature: J 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 Ll PART 11— ENVIRONMENTAL ASSESSMENT (To be completed by agency) n � A. DOES ACTION EXCE ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes B. WILL ACTION fiECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaratlon may be superseded b another Involved agency. ❑ Yes ::: t3Uir D�a1%TiJi� RESULT tN ANY ADVERSE Ei'�eCTS A5SC1CiArEO'wITH THE POLL` OWING. "(AFSswers'may'tie iiandw�llten, 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: f 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.intenslty 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. L\ 0" C7. Other Impacts (including changes In use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR Is TH LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? cl Yes PART 111 — 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 (i) 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. ❑ Check this box if you have Identified one or more potentially large or significant adverse impacts which MAY cur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. . ��Ccumentatlon, heck this box if you have determined, based on the information and analysis above and any supporting that the proposed action WILL NOT result In any significant adverse environmental Impacts AND pr a on attachments as necessary, the reasons supporting this determination: name or Leaa nggncy b L-4 or Ty ame of Responsible Officer in Lead Agency I Title of Res O i r Signature of Respotjible Officer in Lead Agency Signature of Preparer (11 dillereWt rom responsi e o Z 10,5'1 P U TNAM COUNTY DEPARTMENT OF :HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR .. , - .:,... A WASTEWATER.T-.REATMEL�TT_ -.< 1. Name and address of applicant: Benedict Miraalia 46 Cedar. Pond Lane Cortlandt Manor, NY 10567 2. Name of project: Miraglia Residence 3. LocationTN: Putnam Valley 4. Design rofessional: Keane nears - Pman gn ,Encri nP�rs _ P _ C. S. Address: 113 Smith Avenue 6. Drainage Basin: Peekskill Hollow /Hudson. . River Watershed e 7. Type of Project: X Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision .Mount Kisco, NY 10549 Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status ( check one ) ........................................................ Type I Type II x 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... 10. Has DEIS been completed and found 11. Name of Lead Agency Agency? ............... Exempt Unlisted No 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? Yes 13. If so, have plans been submitted to such authorities? ........ ............................... No 14. Has preliminary approval been granted by such authorities? Date g&nted: 15. Type of Sewage Treatment System Discharge ................. surface water X groundwater 16. If surface water discharge, what is the stream class designation? .............:...... - 17. Waters index number (surface) ............................................................... :.......... 18. Is project located near a public water supp y system. No 19. If yes, name of water supply Distance to water supply No 20. Is project site near a public sewage collect n or treatment system? ..... ............ No 21. Name of sewage system - Distance to sewage system - 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ................................ ............................... 800 No 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... 26. Has SPDES Application been submitted to local DEC office? ......................... Form PC -97 2 . ,..0 27. Is any portion of this project located within a designated Town or State wetland? No Vettands�IDNumber.:......:....-.; ��.: 29. Is Wetlands Permit required? .................. ......... .....:...... ............ :.................. No Has application been made to Town or Local DEC office? ............................... 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, No landfilling, sludge application or industrial activity? ............................ Yes/No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? Ye s 34. Are community water and/or sewer facilities planned to be developed within No 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 3 Block 1 Lot 3 37. Approved plans are to be returned to ..... Applicant x Design Professional _._ _::pT A: lie« c o r zwv�� apprcjvalofa"hew Waleishe be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater.plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 0 of the Penal Law.. FOR KFANE OPPELMarq SIGNATURES & OFFICIAL TITLES: Kean Cop elman gineers, P "C. Mailing Address: 113 Smith A Mount Kisco, NY 10549 3, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES '. .. ...;d - DESIGN -.DATA-- S1FIE'-'ET SUBSURFACE; SEWAGE- TREATMENT`SYSTEM Owner Benedict Miraglia Located at (Street) Tyler Road Address 46 Cedar Pond Lane, Cortlandt Manor, NY 105b/ Tax Map 7 3 Block 1 Lot 9 0 3 (indicate nearest cross street) R.S -LLo 3 Municipality Putnam Valley Drainage Basin Peekskill Hollow /Hudson River watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Time tiviin.) De th to Water from Ground Surface (Inches) Start Stop Water Level Dropp In Incles Percolation Rate Min/Inch 1 1 2:00 - 12:21. 21 18 21 3 7 2 2:25 -32:47 22-1 18 21 3 7 3 2:50 -1:13 23 18 21 3 8 4 5 2 1 :05 -1:28 23 18 21 3 8 Y � - -- ..��._._.. • 3 0 - .:...: 5 3;��.. 23 ....18 21 � - - -3 8 ... _r_ ..... 3 :58- 2:22 24 18 21 1 8 4 5 1 2 3 4 5 ivUTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA Indicate level at which groundwater is encountered M/A Indicate level at which mottling is observed N/A Indicate level to which water level rises after being encountered N/A Deep hole observations made by: Date Design Professional XT allWo Peter J. Preq ry AddrewKe,Flne Coppelman Engrs,: 113 smith Ave. Mount Kisco, NY 10549 Signature: Design Professional's Seal F 02 KEANE COPPELMAN PR0FE1-'-7,'3,0 relm DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. i HOLE NO. 2 HOLE NO. G.L. Orcfanic organic_ 0.5' 1.01 Red Brown Sandy Loam 1.51 if it if 2.0 to it if 2.5' Grey, Brown Grey, Brown. Gravel Sandy Gravel, & Sandy 3.51 4.0 Loam Loam 4.5 5.01 5.5' 6.01 .6.51 it 7.01 7.51 8.01 8.51 9.51 10.01 Indicate level at which groundwater is encountered M/A Indicate level at which mottling is observed N/A Indicate level to which water level rises after being encountered N/A Deep hole observations made by: Date Design Professional XT allWo Peter J. Preq ry AddrewKe,Flne Coppelman Engrs,: 113 smith Ave. Mount Kisco, NY 10549 Signature: Design Professional's Seal F 02 KEANE COPPELMAN PR0FE1-'-7,'3,0 relm i; :i • � 97 ► A .17 ; 7 �,�.�/ J.4 95 AsaLA �, '; ¢ 3.87 C�L► ��' 135.90 AC. CAL. ..... • • ...— Q .7VIC 62 AC� =1116Z 9 3.08 90.3 240 0• 66 12.53 , t CAL, r v 8 2.00 AC 90.1 7% X89 50 1 i .06aU I 2.62 ' x 1. 76 AC. t- el 61 0 Ac 1� s 9. � AfN •0.4_ AC .o1'_R' :11 %► 4 s I linb AK.."' i Fu I QC6 1,20 Q 1 i3 8 �a� u ii A T. n: 3� PUTNAM COUNTY DEPARTMENT OF HEALTH Located at Tyler Court TN Putnam. Valley Tax Map # 73* Block 1 Lot 9 0.3 Subdivision of Donald Brown & 'Richard Brown Subdivision Lot # 3 Gentlemen: Filed Map # 2778 Date Filed This letter is to authorize Keane Coppelman Engineers, P.C. 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 P fn Comity Sanitary Code: --- ___ .__� .. �Y ._ F o fnz KEANE COPPE -MAN Very truly (/ours y Countersigned: IXI Signed: P.E., R.A., # (Owner of Propertyl Mailing Address 113 smi Mount Kisco, NY 10549 venue State NY Zip 10549 Telephone: ( 914) 24172235 Mailing Address: �6 Gedwv 6''OV%A LG.Hc l or+66h 9' _ IY�GLbIVV , State Zip lo 7 Telephone: 51' Y 7,359 — d 3 a Form LA -97 14 -16.4 (2187)—Text 12 PROJECT I.D. NUMBER B1 %$1 SEOR Appendix C State Environmental Ouaalliitt�y Review w �f:"....►�•n,�. �... ..s.ua.- c•vU��r•r`rT .pct. ^wn M-:. .... �'�� ®�� .i.� t.�V��E��I7�•�VVEV�r�.t^'1^ r sV' For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant:. or Project sponsor) 1. APPLICANT /SPONSOR Benedict Miraalia 2. PROJECT NAME , Mirag.lia Residence; 3. PROJECT LOCATION: Putnam Valley Putnam Municipality coon tY 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) The property is located: on.. the 'Westerr, ' side of:• Tyler , Court 300 Ft. West of Tyler.Road. 5. IS PROPOSED ACTION: New ❑ Expansion ❑ Modificationialteration 6. DESCRIBE PROJECT BRIEFLY: The project .involves: the construction of a signle family residence;' 12: wide driveway, ;subsurface sewage disposal. -system and well. 7. AMOUNT OF LAND AFFECTED: Initially 1 Ac +/— acres Ultimately 1 AC +/— 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: . - Property ',is _I cated within.. two residentj.al :zoning districts_ 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ® Yes ❑ No If. yes, list agency(s) and permillapprovals Putnam County Health Dept..Construction.Permit for Sewage' Treatment System & well`.`Town::o.f Putnam-Valley Building Permit.... It. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY.VALID PERMIT OR APPROVAL? Byes ❑ No , If yes, list agency name and permillapproval Putnam County.Health..Dept. Realty Subdivision. 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REOUIRE MODIFICATION? ❑ Yes ONO I- CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: 1 1 F0. ��0., Benedi,7t W racrlia a p-n - Date: Signature: J 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 4gency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another Involved agency. ❑ Yes ❑ No O. '*(!bULi3 ACnCN7(EtULT'fR'XR -t A&ti?SSc EFFECTS "ASSOCIATED•WitW -'rHE'FOLLOWING: {Answers'maybe handwrltteri tf +leglbl'e)�• _- •r• � Ct. 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 brlefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: ... a .. - 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.intenslty 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. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? . , ,❑Yes.. ._ ��,Nv '.. IfYes,.l3zplaln. brll3fly- ,�...�. -.. ,�.. -. �,<. — � .....� _..., b K .d.._,.. _...._ . _ _ _�_ ate. . �- .�.�.... -... =.�.� 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 alf relevant adverse Impacts have been identified and adequately addressed. ❑ 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: C3. 1 k t Print or Type Name of Responsible Off icer in Lead Agency Title of Responsi e O icer Signature of Responsible Officer in Lead Agency Signature of Preparer (I f different from responsible o icer) Date 2 I 4 tip' �D PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES z . >. _. TItU r. z...T .P RM UR SEWAGE T__. TIO ,E IT F RE�T1�F,,�T PERMIT # Located at Tyler Court Town or Village Putnam Valley Donald & Subdivision name Ri �l3a r S ewn Subd. Lot #. 3 Tax Map 7 3 Block 1 Lot 90&91 Date Subdivision Approved File Man 2778 Renewal Revision Owner /Applicant Name Benedict Miraglia Date of Previous Approval Mailing Address 46 Cedar Pond Lane, Cortlandt Manor, NY Zip 10567 Amount of Fee Enclosed $300.00 Building Type Residence Lot Area 2,4AC No. of Bedrooms 4 Design Flow GPD 800 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1250 . gallon septic tank and Distribution box w /baffle, 450LP absorption trench 24" wide. 7' -0" O.C. Other Requirements: To be constructed by United Septic Svstems Address 311 Railroad Ave. , Bedford Hills, Water Supply: Public Supply From Address NY 10507 x P.F. Beal & Son 4 Putnam Ave., or: Private Supply Drilled by AddreSSRre ,$tor, , NY 10 0.9 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 m part of said sewage treatment system during the period of two (2) years immediately following the date of e-issuance ofep 1 of the Certificate of Construction Compliance of the original it system or any /repe¢rs ther o. -: - f ,f �� t' S ::.•t ...•. t RATION- Signed: Address P.E. X R.A. License # Date 12/22/00 Mount Kisco, N 10549 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. Un Title: Date: White copy - 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 APPLICATION TO CONSTRUCT A WATER WEL�Lp lease_print or typ..- _ - . ^ 3 +� e14J a'It+FiA -e cN �.• R f - r! + ]:Y r, wK . r� M^�s. Well Location: Street Address: Town/Village Tax Grid # Tvler Court Putnam Valley Map 73 Block 1 Lot(s) 0 &91 Well Owner: Name: Address: 46 Cedar Pond Lane, Benedict Miraglia Cortlandt Manor, NY 10567 Use of Well: x 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 __ ci_ gpm # People Served 4 Est. of Daily Usage _3_Q 0 gal. Reason for Replace Existing Supply , Test/Observation Additional Supply Drilling x New Supply (new dwelling) Deepen Existing Well Detailed Reason New Residential Dwelling being constructed for Drilling Well Type x Drilled Driven Gravel Other Is well site subject to flooding? ...:............................................. ............................... Yes No x Is well located in a realty subdivision? ...................................... ............................... Yes x No Name of subdivision Donald & Richard Brown Subdivision Lot No. 3 _ Water Well Contractor: P • F. Beal & Son Address:4 Putnam Ave. , Brewster, NY10 ..................... Yes No _ Is Public Water Supply available to site? ............ ............................... x— Name of Public Water Supply: - Town/Village Distance to property from nearest water main: - Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: 12/21/00 Applicant Signature: a r t .F 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. Date of Issue Date of Expiration Permit is Non - Transferrable Permit Issuing Official: Title: White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 509 s � PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES { APPLICATION FOR APPROVAL OF PLANS FOR �?V�#S7EW�TEI1F1&€S•Ti1� 1. Name and address of applicant: Benedict Miracrlia 46 Cedar Pond Lane Cortlandt Manor, NY 10567 2. Name ofproject: Miraglia Residence 3. Location TN: Putnam valley Keane Copoelman 4. Design Professional: Engineers. P. C_ 5. Address: 6. Drainage Basin: Peekskill Hollow /Hudson River watershed 113 Smith Avenue Mount Kisco, NY 10549 7. Type of Prpiect: 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 I Exempt Type II X Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... No 10. Has DEIS been completed and found acee! by Lead Agency? ............... 11- Name of Lead Agency G 12. Is this project in an area under the control of local planning, zoning, or other officials ordinances? Yes YPs 13. If so, have plans been submitted to such authorities? ........ ............................... No 14. Has preliminary approval been granted by such authorities? Date glinted: 15. Type of Sewage Treatment System Discharge ................. surface water x groundwater 16. If surface water discharge, what is the stream class designation? ............. a...... - 17. Waters index number (surface) ............................................................... a........... 18. Is project located near a public water supp y system. No 19. If yes, name of water supply Distance to water supply No 20. Is project site near a public sewage collects n or treatment system? ..... ............ No 21. Name of sewage system - Distance to sewage system - 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ................................. ............................... 800 No 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... 26. Has SPDES Application been submitted to local DEC office? ......................... Form PC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES "E.,S1 DA.T AAj3j�ET: w.$V SUR1FACE SEWAGE TREATMMTPSY Owner Benedict .Miraglia Located at (Street) Tyler Road Address 46 Cedar Pond Lane, Cortlandt Manor, NY 1056/ Tax.Map 7 3 Block 1 Lot 90&91 (indicate nearest cross street) R.S.. —Loff- 3 Municipality Putnam valley Drainage Basin Peekskill Hollow /Hudson. River Watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Elapse Time kivian.) De th to Water From Ground Surface (Inches) Start, Stop Water Level Drop In Inches Percolation Rate Min/Inch 1 1 2:00 -12:21 21 18 21 3 7 2 2:25 -12:47 29 18 21 3 7 3 2:50 -1:13 23 18 21 3 8 4 5 2 1 :05 -1:28 23 18 21, 3 R 18 '21 3 8. 3 :58- 2:22 24 1R 21 3 8 4 5 1 2 3 4 5 MUTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 minlinch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLErNO. °l ' :<_.: ;HO)y:;I�iO: _ a.� .�-� =�H 'NC3:, G.L. oroanic Organic 0.5' 1.0' Red Brown Sandy Loam 1.5' 2.0' 2.5' Grey, Brown Grey, Brown 3.0' Gravel & Sandy Gravel & Sandy 3.5' 4.0' Loam roam 4.5' „ 5.0' 5.5' if 6.0' it 6.5' to 7.0' 11 7.5' 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered �I /A Indicate level at which mottling is observed N/A Indicate level to which water level rises after being encountered N/A Deep hole observations made by: _ _ _ Date Design Professional Name: peter J. rrec?ory Address- .Keane Coppelman Engrs, 113 Smith Ave. Mount Kisco, NY 10549 Signature: Design Professional's Seal FOR I <E -AN_ CIDPR i_MAN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,..q_. . .r.. . ..�r � -r.....a.. . . +c•�eg. y �.... N - -.11� _ .1 �.. . _. •'.. htr< lam.. ,.. . b /ti- t a... �N Y � /ip■�� 0 1LV N, .. �1. � _ ♦ �' .�.Y; . .4 '..V.f. RE: Property of Benedict Miraglia Located at Tyler Court TN Putnam Valley Tax Map # 73 Block 1 Lot 90 &. 91 Subdivision of Donald Brown & Richard Brown Subdivision Lot # 3 Filed Map # 2778 Date Filed Gentlemen: This letter is to authorize. Keane Coppelman Engineers, P.C. 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 stan dards, 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. KEANE (J07 PELMIAN Very truly yours, t Countersigned: Signed: P.E., R.A., # (Owner of Prope Mailing Address 113 SmitVAvenue Mount Kisco, NY 10549 State NY Zip 10549 Telephone: (914) 241 -2235 Mailing Address: y6 Cedav Pohl LaNe. l.or�'Gth C T !I►l0.KOV' State Zip lo 5-9 7 Telephone: Form LA -97 . n1 �,. 97 • .� £ . a a 2 • t 95 L '+ o`ti.{�• Q • �p 3.87. CAL, ��� •: � �,• 135.9:0 AC. CAL. Opp 3 O� 1. r 93 ���1 • 92 • a• • r-' w29 6 i 2 62 ACO AC. ,6 .J 73..08 £ : 3I9Z � , 80,3 .°+ 2401 IOC' 2. got 12.53'A C. . °fie ,gig 4C .40 AC. x 3• ' `- CAL. 8Q �`� ��.� a oz Act .o cN ,. ry 2.62 A� 1.76 j SKEANE C®PPELMAN ENGINEERS, P.C. .� 113 Smith Avenue MOUNT KISCO, NEW YORK 10549 I 98.) -244 G .a TO Putnam County Health Department 1 Geneva Road Brewster, NY 10509 IMUTEN @[F DATE ^ JOB NO. 'A ENTION Mr. Robert Morris RE: Benedict Mira lia Tyler Court Putnam Valley SSTS Permit Donald & Richard Brown Subdiv Lot3 WE ARE SENDING YOU EN Attached ❑ Under separate cover via the following items: • Shop drawings ❑ Prints C$ Plans ❑ Samples ❑ Specifications • Copy of letter ❑ Change order Yo Application & Forms COPIES DATE NO. DESCRIPTION 4 Revised SSTS Plan, Profile & Detail 2 Revised House Floor Plans 1 Revised Construction Permit - Sewage Treatment Sys. 1 Revised - For Water Well 1 Revised Design Data Sheet 1 Revised Authorization Form 1 Specific Waiver Form DOH -1326 - GEN -152 THESE:ARE TRANSMLT,TED_as_ checked belosnr -.: ❑ For approval ❑ Approved as submitted ❑ Resubmit • For your use ❑ Approved as noted ❑ Submit _ • As requested ❑ Returned for corrections ❑ Return _ For review and comment ❑ REMARKS COPY TO copies for approval _ copies for distribution corrected prints ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US SIGNED: If enr_inaurPS are not ac nnted kinrih, — KEANE COPPELMAN ENGINEERS, P.C. 113 Smith Avenue MOUNT KISCO, NEW YORK 10549 TO Putnam County Health Dept. 1 Geneva Road Brewster, NY 10509 DATE - wi- .•.�. JOB NO. _ yr iaa•�fi x�..r - s,A ATTENTION Mr- Robert Morris RE: Rpnpaict- Tyler Court Putnam Valley SSTS Permit Donald & Richard Brown Subdiv. Lot WE ARE SENDING YOU CR Attached ❑ Under separate cover via the following items: ❑ Shop drawings }Q Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order Ek Application & Forms & Check COPIES DATE NO. DESCRIPTION 4 SSTS Plan, Profile & Detail 2 House plans 1 Construction permit - Sewage Treatment Sys. 1 - for Water Well - 1 Wastewater Treatment System Application 1 Design nata Sheet 1 Authorization Form 1 Short FAF Form THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints Ek For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: fq I >rotirS PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROi• IN DIVIDUAL WATER SUPPLY & SUBSURF •IyW —W SSE ,T:FOR =Cad: NAME OF OWNE - -. /REVIEYCU7ANTS RM, G AS, RDA' Y IPL�. C__X/ )CORPORj�n RESOLUTION (��)� SHORT EAF (__)PLANS -THREE SETS C (__-)(__)HOUSE PLANS - TWO SETS 7 (VARIANCE REQUEST SUBDIVISION .� , -:::•,:. SUBDIVISION SUBDIVISION AP VAL CHECKED UU RC RATE RLL REQUIRED DEPTH (__)URTAIN DRAIN REQUIRED � GENERAL U(! L CATED IN NYC WATERSHED 5ANS SUBMITTED TO DEP U LEGATED TO PCHD �(ul -/ �DEP APPROVAL, IF REQ'D (__)D EP TEST HOLES OBSERVED 'jj . UF( CS TO BE W ITNESSED APPROVAL SSDS ADJ, LOTS LANDS (TOWN/DEC PERMIT REQ'D ?) ��,D `TA ON DDS PLANS & PERMIT SAME LU�Jx 1969 NEIGHBOR NOTIFICATION (�(�TER BI/ZBA � U�SOIL TESTING LOTS >10 YEARS OLD SEWAGE SYSTEM PLAN-(NORTH ARROW) SSDS HYDRAULIC PROFILE GRAVITY FLOW CONSTRUCTION NOTES 1 -15 DESIGN DATA: PERC & DEEP RESULTS 2' CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT FOOTING /GUTTER/CURTAIN DRAINS USDA SOIL TYPE BOUNDARIES TITTLE BLOCK; OWNERS NAME ADDRESS TJSW, PE/RA; NAME, ADDRESS, PHONE# WE OF DRAWING/REVISION DATUM REFERENCE (LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. (PROPOSED FINISH FLOOR AND !!EASEMENT ELEVATIONS (WELLS & SSDS'S W/IN 200' OF SSTS (PROPERTY METES & BOUNDS :OMMENTS: REVSHEET) AL HEALTH ( a ... SEWAGE TREATMENT SYSTEMS `�!. •i RUC�FiOifv P�c�`" ':.' - � .�,....., ,,., -. J ATION: I it L,r- e- T 7 TAX n: (CONFIRMED( (REQUIRED DETAILS ON PLANS CONT'D) [OUSE SEWER -' /," FT. 4 "0'; TYPE PIPE CAST IRON fO BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS ITE NOTE (NO CHANGE)(, FILL SYSTEMS 0' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE, U FILL SPECS/ FILL NOTES 1 -5 U FILL PROFILE & DIMENSIONS U FILL IN EXPANSION AREA FILL GREATER THAN 2 FEET (_JC_j CLAY BARRIER UUFILL CERTIFICATION NOTE p (_)UDEPTH GAUGES �`� (�UVOL. ON PLAN FOR R.O.B., UNCLASSIF & IMPERVIOUS J(._- EPARATION DISTANCE FROM TOE OF SLOPE . TRENCH NCH PROVIDED 60FT MAX. LEL TO CONTOURS 0 %EXPANSION PROVIDED DETAILIDUST FREE CRUSHED STONE OR WASHED GRAVEL ( EOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS f� 0' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL ,'TO FOUNDATION WALLS 00' TO WELL, 200' IN DLOD, 150' TO PITS 100' TO STREAM, WATERCOURSE, LAKE (inc. espan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER `10' TO WA'TEA.L 1T< , (nits - . ?0'). ( n0' INTERMITTENT DRAINAGE COURSE 00'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (� 0' MIN TO LEDGE OUTCROP SEPTIC TANK 10' FROM FOUNDATION; 50' TO WELL WELL IMENSIONS TO PROPERTY LINES LOCATION OF SERVICE CONNECTION UU,Nl]N 15' TO PROPERTY LINE S O (__)SLOPE IN SSTS AREA (520 %) CZL'JREGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS (�( PUMP NOTES (__) % 75 %° OF PIPE VOLUME/DOSE VOLUME NOTED (__) DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) U--) PIT AND D -BOX SHOWN & DETAILED (� 1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN (j STANDPIPES, 5' BOTH SIDES, DETAIL U 15' MIN to CDS = >5 %, 20'4 %, 25' -3 %, 35' -1 %,100 % -<1% (__) 20' MIN to CD DISCHARGE /100' with 182 cons day discharge (___)( 10' MIN to NON - PERFORATED PIPE P , ;-ir v BRUCE R. FOLEY - ��;_ %:. ..• Public .��KeaithsDiresaor•..r,:� =• _ <<,.....c.,:;: -:r� -_ -_ ....- LORETTA MOLINARI R.N., M.S.N. 'Associate'= Publrc•`Healtk �'�'ireL�ldr ` - - - ��' Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509A 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 January 23, 2001 Mr. Peter Gregory Keane Coppleman Engineering 113 Smith Avenue Mount Kisco, New York 10549 Re: Miraglia, Tyler Court TM# 73 -1 -90.3, Town of Putnam Valley Dear Mr. Gregory: 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 consideration. Do ments - Original documents are enclosed for completion. Application Form WP -97 - Tax Map Number is incorrect. Correct Tax Map Number is 73 -1 -90.3. Application form WP -97 -.Tax Map Number is. 73 -1 -90.3. 4APplication Form DD =97 - Please sign under Design Professional. Application Form LA -97 , - Tax Map Number-is incorrect. Correct Tax Map Number is 73 -1 -90.3. Howf Plans House plans submitted result in a five bedroom (bedroom count determination) by this office. Please reference Department memo dated July 27, 2000. Pl Please verify house plan bedroom count vs. design of SSTS. Four (4) bedroom design vs. five (5) bedroom classification. Five bedroom design requires: - 1500 gallon tank - 556 LF of trench Please provide note on plan and profile stating: "Existing grade within SSTS area to be re- graded back to 15% or less" as shown on plan and profile. 'Provide note on plan stating: "Maintain minimum 10'0" from SSTS trenches to stonewalls. Walls within 10'0" to be removed and voids replaced with ROB fill. Well Detail - Detail to state well head to be a minimum 18" above grade. 1+ A n Paget "1Vliragfla Janu 23, 2001 S. Junction box detail to state: "Trench to begin TO" from box. Two foot separation to be solid pipe." This application will require the issuance of a Department "Specific Waiver" for approval of SSTS on an existing slope of greater than 15 %, re- graded back to 15% or less. This will require formal denial of application by this Department and formal request of waiver by your firm, as stated on enclosed denial letter. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj BRUCE R. FOLEY - .y . �'Ytd17��'IE'Yiit9: DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETfA; _MOLINAIU*XN;, M.S.N. 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 January 23, 2001 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Mr. Peter Gregory Keane Coppleman Engineering 113 Smith Avenue Mount Kisco, New York 10549 Re: Proposed Construction Permit Miraglia, Tyler Court TM# 73 -1 -90.3, (T) Putnam Valley Dear Mr. Gregory: Review of plans dated December 18, 2000 and other materials relative to a construction permit for the above captioned property has been completed by the Department. Based upon such review, and pursuant to the provisions of Article III of the Putnam County Sanitary Code, you are hereby advised that the proposed method providing water supply and sewage disposal are considered inadequate as set forth below. Therefore, approval of these plans cannot be granted. Existinggrade / slope+ si- ar--a -of the --Separate- Sewage - Treatment -System 5 %:.' "' Proposed regrading with ROB back to 15% or less. It is your legal right to request a waiver of the denial based on item(s) noted above. The denial request must be submitted in writing after the receipt of this letter. The request must specifically state the waiver being sought. Please submit a formal waiver request of the above stated comments and complete the enclosed NYSDOH "Specific Waiver" Gen. 152 form, general information section. This project will be discussed at the next specific waiver meeting of this Department. If you have any questions, please call me at ext. 2157. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj enc. Gen. 152 4. If a bonus room is located in a structure (i.e. garage) not attached to the s dwelling, then it will not be considered a bedroom. For example, if a "bonus room" is indicated above a detached garage, which is separated from the dwelling by a breezeway, the bonus room will not be considered a bedroom. We believe the meeting, in which the above points were discussed, was informative for all parties, in addition to opening the lines of communication between our respective Departments. I again thank you for taking the time out of your busy schedules to meet with us. Should you have any comments or questions regarding the above, please contact this office. BRF /MJBrp cc: EHS Staff 0 Page 2 NEW YORK STATE DEPARTMENT OF HEALTH Specific Waiver Bureau of Community Sanitation and Food Protection from Requirements of Part 75 and Appendix 75- A,10NYCRR for Individual Household Sewage Treatment Systems 1. Reason why she does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)): Separation distance cannot be achieved. Excessive slope. High groundwater. Inadequate depth to bedrock or impermeable layer. Soil unsuitable. JOther (explain) .......................................................................................................................................................................... ............................... i ................................................................................................................................................................................................................. ............................... : ...................................................... ............................................. :............................. . ............................................................... _.................... . __..._._.._ ............. :.................................. _ ....................................................................................................... _ ........................................................ _ ........... _-_ ........................................ w 2. Proposed design or.conditions of waiver: ................................................................................................................................................................................................................. ............................... i ......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................................................................................................................................................._.................._......_......................................................_........... ..........._............. -_..._ ; 3. The proposed design may have the following limitations (check appropriate box(es)): J Increased risk of well or spring contamination. Increased risk of surface water contamination. Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. Other (explain) ...............:. Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver may be revoked by the issuing official for a change in conditions for which this waiver was granted. ... A ......................................................................... ............................... REPRESENTATIVE OF COMMISSIONER OF HEALTH ORIGINAL - Local Health Agency .................................................................................. ............................... COPY - Applicant/Design Professional GATE DOH -1326 (7/92) - (GEN .152) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT V al Los-I ' S.ti� et Address: - = - Tyler Road, Lot it3 To��n/Village: ° Putnam Valley Tax Grid'# Map Block Lot(s) Well Owner: Name: Address: Dr. Ben Miraglia, 46 Cedar Pond.Lane, Cortlandt Manor, NY 10567 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X 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 32' ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No ' Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 640' Depth of completed well in feet 705' Well Log If more detailed information descriptions or sieve analyses r. are avai[a5fe, please attach. Depth From Surface Water Bearing FDiameter(in) ell Formation Description ft. ft. Land Surface 3 Drillin o e b 3 Hit roc 3' 3- - -32 DriJ -lin in roc set: casino �- .grouted 32 705 DrillinT in ro aranite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5gx�m Depth 660' Model5GS15412 Voltage 230 HP 1% Tank Type hX302 o al. Date Well Completed 9/21/01 Putnam County Certification No. 002 Date of Report 4/23/02 1ZWal tvurll;: txact location of well wttn aistances to at Well Driller's Name P. F. Signature: Perry L. permanent lanamarxs to ne provlgea on a separate sneeup►an. Date: 4/23ZD2 White copy: HD File; Yell6w copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 )MS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory_: Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: Sample's Information: Site: kitchen tap Preservative: N/A Temperature: <4C Client: Ben Miraglia Zip: 10509 Fax: Collector's Information: Name: Bob Address of site: lot 3 Tyler Rd City: Putnam Valley State: NY Zip: Telephone: Date Collected: 4/18/02 Date Received: 4/19/02 Time Collected: 16:10 Time Received: 12:00 Lab No.: J021477 Date Analyzed Test Name Result MCL Method 4/19/02 15:00 Total Coliform 4/19/02 Chlorine Free Residual Absent Absent SMWW 9222B <0.1 mg /L N/A SMWW 4500CIG At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable MCL- Max. Contaminant Level mg /L- milligrams per Liter signature: State #: PH -0218 Michael Lapman ELAP #: 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmental.com SWING TIES A B BOX � 90 95, 30X 1 1.1915, 90.51 0 Y e y� gs mature Tit r. r Data; t i : a7paa0BO v 1 200.' ,anroc orem a. a.aanr drsaari •THIS)S TO CERTIFY .THAT -THE SEWAGE TREATMENT SYSTEM WAS CONSTRUCTED F 'AS INQICATED ON;.THIS PLAN'AND THAT Tkt SEWAGE WAS INSPECTED BY ME;BEFORE;. IT WAS COVERED OVER. -; THE SYSTEM WAS 60NSjfRUCTED IN ACCORDANCE : WITH ALL. , STANDARD RULES =& REGULATIONS OF.THE'',PUTNAM COUNTY DEPARTMENT-OF HEALTH AND. THE'NEW-YORK STATE DEPARTMENT OF' HEALTH, TOWN OF PUTNAM VALLEY TAX MAP INFO. erg SEC, 73 BLk. *- 1 aOTS 90 & 91' R.S. .IOT 3, .OR ADDITIONS ,TO THIS DRAWING IS Q VIOLATION iE NEW -YORK ;STATE EDUCATION LAW" ' �� ERT►oT L r s 4 AS 8 1LT PLAN SEVSIONS IP F� E MIRAGLI4. RESIDENCE y RTMENTk(X1MM�! T3 c r , t TYLER -COURT b.< PAJTNAM' VALLEY: k La KEANE CCR,PEMAN ENGINEERS, t WESTCHESTOW, COUNTY, N Y._ �.. CON$UL11NO CIVI1 .SANITARY &'ENVIRONM TAL,,EN;GINEERS: _R M F+�N.. t . + E t J .•a r $; i; i t I SURVEY INFORMATION OBTAINEDFROM A SURVEY OF PROPERTY PREPARD.FOR: DONALD & RICHARD. BROWN SURVEY OF PROPERTY PREPARE BY: 6 DONALD J. DONNELLY, L.S. (i ! II t N.Y.S. LIC.'NO. 49000.. !E �ee.�s•. °p ^aB"''O0P�eart 1929 COMMERCE. STREET YORKTOWN HEIGHTS, NEW YORK ={0598 Putnam County DeDartmht of Health 'LOT 14 Divirion of Environmental health Services r �.. m 3 .`� APproveII of . c niarmanoe sitn ble Hulse and Regulations of the ' ouHealth Dep artment. ._ ,��t// Eic Y e y� gs mature Tit r. r Data; t i : a7paa0BO v 1 200.' ,anroc orem a. a.aanr drsaari •THIS)S TO CERTIFY .THAT -THE SEWAGE TREATMENT SYSTEM WAS CONSTRUCTED F 'AS INQICATED ON;.THIS PLAN'AND THAT Tkt SEWAGE WAS INSPECTED BY ME;BEFORE;. IT WAS COVERED OVER. -; THE SYSTEM WAS 60NSjfRUCTED IN ACCORDANCE : WITH ALL. , STANDARD RULES =& REGULATIONS OF.THE'',PUTNAM COUNTY DEPARTMENT-OF HEALTH AND. THE'NEW-YORK STATE DEPARTMENT OF' HEALTH, TOWN OF PUTNAM VALLEY TAX MAP INFO. erg SEC, 73 BLk. *- 1 aOTS 90 & 91' R.S. .IOT 3, .OR ADDITIONS ,TO THIS DRAWING IS Q VIOLATION iE NEW -YORK ;STATE EDUCATION LAW" ' �� ERT►oT L r s 4 AS 8 1LT PLAN SEVSIONS IP F� E MIRAGLI4. RESIDENCE y RTMENTk(X1MM�! T3 c r , t TYLER -COURT b.< PAJTNAM' VALLEY: k La KEANE CCR,PEMAN ENGINEERS, t WESTCHESTOW, COUNTY, N Y._ �.. CON$UL11NO CIVI1 .SANITARY &'ENVIRONM TAL,,EN;GINEERS: _R M F+�N.. t . + E t J .•a r $; i; 0 `r. CONSTRUCTION NOTES \ 1. EXISTING 4 BEDROOM, DWELLING. 2. 1250 GALLON SEPTIC TANK. 3. EXISTING 450 LF ABSORPTION TRENCH 0 \ 6' -0" O.C., W/ ENDCAPS & J —BOX (TYP.) 0 0 � 1 EXISTING WATER SERVICE . *SHOULD STONE WALLS Bt:-REMOVED PERMANENT MONUMENTS SHALL BE I STALLED AS REFENCE TO POINTS A & B t a. f, I EXIST. WELL \NG ON` 0 0 ` C.I.P. WASTE I 1250 GALLON SEPTIC TANI �® 6G UNCTION BOX CLEANOUT " SOLID P.V.C. PIPE a: r PLAN SC 450 LF ABVORBTION; TRENCH W/ JUNCTION BOX (TYP.) r. r C VMA Ktcctnut t.. 3 '• t � k' h -. �n 9 s i i1 t