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631- 589 -8100
73.05 -2 -13
BOX 27
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVIS_IO_N OF ENVIRONMENTAL HEALTI-I. SERVICES__
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APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWATER TREATMENT SYSTEM
1. Name and address of applicant: Benjamin Olson
Cedar Drive
Putnam Valley, New York 10579
2. Name of project: S.S.T.S. for B. Olson
4. Design Professional: G. A. Bass
6. Type of Project:
X Private/Residential
Apartments
Office Building
3. Location TN: T. Putnam Valley
5. Address: 27 Cedar Drive
Food Service
Institutional
Realty Subidvision
Putnam Valley, N.Y. 10579
Commercial
Mobile Home Park
Other (specify)
7. Is this project subject to State Environmental Quality Review (SEQR)?
Type Status (check one) .............................................. :....... Type I
Type II X
8. Is a Draft Environmental Impact Statement (DEIS) required? .........................
9. Has DEIS been completed and found acceptable by Lead Agency? ...............
Exempt
Unlisted X
No
11. If this project is.an area under the control of local planning, zoning, or other
officials, ordinances? ....................................................... ............................... Yes
12. If so, have plans been submitted to such authorities? ........ ............................... I No
13. Has preliminary approval been granted by such authorities? No Date granted:
14. Type of Sewage Treatment System Discharge ................. surface water X groundwater
15. If surface water discharge, what is the stream class designation? ..............:.....
16. Waters index number (surface) ........... ...............................
17. Is project located near a public water supply system? ....... ............................... None known
18. If yes, name of water supply
Distance to water supply
19. Is project site near a public sewage collection or treatment system? ................ None known
20. Name of sewage system
21. Date test holes observed
Distance to sewage system
22. Name of Health Inspector
Form PC -97
P
810
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24. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... No
25. Has SPDES Application been submitted to local DEC office? .........................
26. Is any portion of this project located within a designated Town or State wetland? N0
27. Wetlands ID Number ........................................................... ...............................
28. Is Wetlands Permit required? .............................................. ............................... No
Has application been made to Town of Local DEC office? ...............................
29. Does project require a DEC Stream Disturbance Permit? No
30. 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 (To all appearances)
31. Is project located within 1,000 feet of existing or abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or any
other potential known source of contamination'? None known
DESCRIBE:
32. Is there a local master plan on file with the Town or Village? .........................
33. Are community water and/or sewer facilities planned to be developed within
1_c "'s�vars D.n or
_p +1. to or,��ect site ?__ - .._ r
34. Are any sewage treatment areas in excess of 15% slope? . ...............................
Yes
No
r,
35. Tax Map ID Number .......................... ............................... Map 73.05 Block 2 Lot 13
36. Approved plans are to be returned to ..... Applicant X Design Professional
If the application is signed by a person other than the applicant shown in Item 1 .,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 arepunishable as
a Class A misdemeanor pursuant to Section 210.45 of the Penal Law.
SIGNATURES & OFFICIAL TITLES:
Mailing Address: ................................... P. 0. Box 3622
Poughkeepsie, N.Y. 12603
14- 161(2!87) —Text 12
PROJECT I.D. NUMBER 617.21 SEOR
Appendix C
_ State Environmental Quality Review
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For UNLISTED ACTIONS Only
PART 1— PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APPLICANT /SPONSOR
2. PROJECT NAME
Benjamin Olson
SSTS for Benjamin Olson
3. PROJECT LOCATION:
Municipality Town of Putnam Valley County Putnam
4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map)
27 Cedar. Drive, Putnam Valley, New York;
Approximately 0.2 mile northwest of intersection of Cedar Drive and
County Route 20 (Oscawana Lake Road) '
5. IS PROPOSED ACTION:
rr�Y�
1:1 New E3 Expansion u Modificationlalteration
6. DESCRIBE PROJECT BRIEFLY:
It i.s proposed to replace the existing single- family residence on the property with
a new single - family residence.
7. AMOUNT OF LAND AFFECTED:
Initially ---ILA acres Ultimately 0.6 acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
❑ Yes ®No If No, describe briefly
Variance will be required to allow the existing residence to remain while the
new residence is being constructed. '
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
® Residential ❑ Industrial ® Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other
Describe:
- � -- -.... Prednminantl• v ,si.nCle- fami.l,.- ,res,_c•+en�P� arv�_,(:nnyanienC _$t41^°.(CQllnty ROUt�. O1. ._._... _ -
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR.ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE OR LOCAL)?
® Yes ❑ No If yes, list agency(s) and permlVapprovals
Town of Putnam Valley Building Department
11. . DOES ANY ASPECT 'OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
a s li No If yes, list agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION?
❑ Yes ❑ No N/A
I .CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Benjamin Olson 3/Lb'/ u 1:
Applicant1sponsor name: Date:
Signature:
If the action is in the Coastal Area, and you are a state agency, complete' the
Coastal, Assessment Form before proceeding with this assessment
OVER
.1
PART H— ENVIRONMENTAL ASSESSMENT (To be completed by Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF.
❑ Yes ❑ No
A TJMJ REl FIvF f tStjlrL�`ryATcr1. RFJ� -' A$ CRnVMF9_FAR f NL!'RTEP ¢(;T�GRS IN-AMY-C" AR? Ft? �^ -jtNn "2 {�e�atl�a_Q4�1ar31�nn'..
4.+cr.- etr -..c ..t.- - :- u�= -•.,.> -i .�ii..:s.:..- _Ac:...
may be superseded by another Involved agency.
❑ Yes ❑ No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be.handwritten, If legible) .
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal,
potent'al 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:
I
_
s
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered. species? Explain, briefly:
C4. A community's exi�ng plans or goals as officially adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly.
C5. GrpAth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. .
:� CJ
a2�
6C.1►p'eg terms ort term, cumulative, or other effects not identified in CI -05? Explain bristly.:
N
tx -
C Qt ler iMocts (includi changes in use of either quantity or type of energy)? Explain,briefly,
LJ N
O
U —I "� I HtHt, liA %`I Mt}tt LItCELT `fU "dt:, Gl7NTHOVeASF McLAi -ED YO `rtiTENliAE ADVERSE ENVIRONiVItNTAL IMPALUi S•!
❑ Yes No If Yes, explain briefly
r yp '
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 occuFr(ng; (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.
❑ 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.
Ch ck 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:
Print or Type Name ot Resporfsib in-Lead Agency
nature of-Responsible 0 icer in Lead Agency
0)
gency
TIM of Responsible Officer
Signature of Preparer (If different rom responsible officer)
PUTNAM COUNTY DEPARTMENT OF HEALTH
SI!C�N- O�E�ENVIRONMENT�. H_ A T
. FA_L �H SERVICES
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CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PERMIT # q Q
Located at 27 Cedar Drive, Putnam Valley Town or Village _ Town Putnam Val l ey
Subdivision name Camp Lookout
Subd. Lot #118 -121 Tax Map 73-05
Date Subdivision Approved Fi led January 30, 1930 Renewal
Owner /Applicant Name Benjamin Olson
Mailing Address 27 Cedar Drive, Putnam Val1
Amount of Fee Enclosed
Building Type
Residence
N. Y.
Block 2 Lot 13
Revision
Date of Previous Approval
Lot Area 0.8 AC No. of Bedrooms 4
Zip 10579
Design Flow GPD 800
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of
1250
concrete pit with -force main: and SSTS in fill
Other Requirements:
To be constructed by
- gallon septic tank and pump in
Address
_1 7�i tc;..r, '�..._......, .... Public Supply From..—
or: Private Supply Drilled by existing well Address
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewagg 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: Geoffrey A. Bass
iidl k4lo
p.E. X R.A. Date 3/22/02
Address P. 0. Box 3622, Poughkee ie, N.Y. 12603 License # 051630
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. rave or d' arge of domestic sanitary sewage only.
By: �� ` Title: 7� i��% Date: d
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design rofe Z.1
Form CP -97
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P.O. BOX 3622
POUGHKEEPSIE, NEW YORK 12603
(845) 462 -0600 FAX (845) 462 -7325
November 12, 2004
Mr. William Hedges
Senior Public Health Sanitarian
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
RE: Sewage Disposal System Replacement for Benjamin Olson, 27 Cedar Drive,
Town of Putnam Valley (Tax Map Lot 73.05 -2 -13)
Dear Mr. Hedges:
With reference to our joint site visit on 11/9/2004, the components of the system and their
locations, as well as the operation of the pump, were found to be in general conformance
with the design as shown on Sheets 1 of 2 and 2 of 2 of the approved plans, entitled
"Subsurface Sewage Treatment System for Benjamin Olson ", as prepared by this office,
originally dated 3/22/02 and as revised 4/8/02.
As shown on the attached as-built drawing, and as specified on the drawings, the disposal
system is comprised of a concrete septic tank; concrete pump chamber and pump; and a
_ -. til.e fie._ld in_ ill att-he wes ±.end -of the- prop?rty.
If you have any questions or require any additional information, please give me a call.
cc: Benjamin Olson
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Putnam County Department of Heald)~
Division of Environmental Health ServIdD
Approved its noted for conformance with
applicable Rules and Regulations of the
Putnam County Health Department.
Signature VTitle
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SEf':TIC SYSTEM AS -BUILT
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Division of Environmental Health ServIdD
Approved its noted for conformance with
applicable Rules and Regulations of the
Putnam County Health Department.
Signature VTitle
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,,edges Date: 3/29/2002 Time: 5:23:10 PM Page 3 of 3
0 1
CLOSET
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IF III
DEIE D R 0 0 M ' ' II BEDRv%j
8'5 x 10'6 CLOSET' 10 I 99 x 10'6
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BEDROOM CCifill-41T ONLY;
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BASS ENGINEERING
P.O. BOX 3622
POUGHKEEPSIE, NEW YORK 12603
(845) 462 -0600 FAX (845) 462 -7325
September 5, 2001
Mr. William Hedges
Sr. Public Health Sanitarian
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
RE: Replacement Septic System at Benjamin Olson Residence, Cedar Drive, Town of Putnam Valley
(Tax Map Section 73.05, Block 2, Lot 13) '
Dear Mr. Hedges:
In accordance with your request, please find attached, as depicted on a copy of a portion of the referenced
tax map, approximate well locations for all adjoining properties, in addition to the location of the existing
well and proposed septic system for the lot in question. The lots for which well locations are shown are
73.05 -2 -5, -6, -7, -8, -10, -11, -13, and —14, with the well locations having been shown on the sketch as W5i
W6, etc: to represent the individual wells for Lot 5, Lot 6, etc., respectively. Please note, however, that these
locations are qualified as follows: (1) the wells indicated for Lots 11, 13, and 14 have been located as part of
a survey, but the owners or occupants of Lots 11 and 14 have not confirmed that the well locations are
correct for_ those respective parcels; (2) the balance of the wells shown were not located by actual survey but
were spotted on the tax map by this office during a house -by -house canvassing of occupants; (3) the well
shown for Lot 7, was not visible but was represented by the occupant of the associated dwelling as being
beneath the surface of the ground'at the indicated location; (4) Lot 5 is apparently served by a well located
_..... Ji :L... ' j'; whi h-aa[ 3[: d ilP-W. �ni and ��i) L1`. 9 i� �c_T:� tL� be_vaCail�,-ti'1. +.ask. d• q�l +. - ..
.. - _ ..
As had been stated in the earlier submission, the location and size (300 lineal feet of absorption trench) of
this replacement septic system is based solely on available space and topography; pending your approval of
the concept layout for the planned 4 bedroom residence, the plan is to then run percolation tests and log test
pits, as required, to complete the design.
Please advise. as to the next step in the approval process; if you have any questions or require additional
information, please give me a call.
Vas»
i'
Geo ass, E.
B S EN ERING
cc: Hudson Valley Construction Management
From: Home User To: Bill Hedges
Date: 3/2912002 Time: 5:25:44 PM
Page 2 of 4
• 03/29/2002 15:38
19147345231
PAGE 01
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P.O. BOX 3622
POUGHKEEPSIE, NEW YORK 12603
(914)462 -0600 FAX (914)462 -7325
April 8, 2002
Mr. William Hedges
Senior Public Health Sanitarian
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
RE: Sewage Disposal- System Replacement for Benjamin Olson, 27 Cedar Drive, Town of
Putnam Valley (Tax Map Lot 73.05 -2 -13)
Dear Mr. Hedges:
With reference to my previous submission, dated 3/25/02, for the proposed replacement
subsurface sewage treatment system (SSTS) for Mr. Olson, please find enclosed four (4)
sets of design drawings, consisting of (a) Sheet 1 of 2, entitled "Subsurface Sewage
Treatment System for Benjamin Olson ", dated 3/22/02 and revised 4/08/02; and (b) Sheet
2 of 2, entitled "Detail Sheet for Benjamin Olson ", dated 3/21/02. Please note that, as per
your request, Sheet 1 of 2 has been revised to show a future expansion area for the SSTS,
together with a future well location, should it be necessary to use the future SSTS
...ea..F +....m. .4 m3'+eD:. . .. .... _ + &d ..... v. -nl- .�C.� ^ i ._em�.,es.�- r.�s.-- .n.►e.w'a... ..I.�wr+...a.a w...�r .Y L-r �r ... w�. ..... b�y�.ss�- ds - .�- .•e.- •�w� - " -�-
Thank you, and please call me if you have any questions.
�I
Enclosure
cc: Mr. Benjamin Olson
Hudson Valley Construction Management
C�L°e-X'J
• - PIRANHA S16 12W, S16/2
*1g 0�2 0,•i Q� „• nata..��q section. Piranha �., SFries Pace
- = 8 - ,S„
Model HP Phase RPM Freq. Std. Disch. Impeller
Piranha S16/2W 1 2.1 1 3450 60 Hz 1%inch 136mm
Consult an authorized ABS representative when selecting Piranha pumps for low head applications!
Liters per Second
subject to change without notice
A Company in the Cando Group
ESSpecifications
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A Company in the Cando Group
ESSpecifications
From: Home User To: Bill Hedges Date: 3/29/2002 Time: 5:25:44 PM Page 4 of 4
03V29/2002 15:38 19147345231
BRUCE R. FOLEY
Public Health Director
PAGE 03
DEPARTMENT OF BEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director
Director of Patient Services
Lnvironmental health (843)278-6130 Far (845) 278.7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (945)278 -0014 preschool (84$)278 -60$2 Fax(941)279 -6648
PROPOSED ADDM —O 1 APPLICATION MSiDEINTIAL ONLY)
STREET dad" Or TOWS;' fa . a J/ . TX MAP# "73, 5� - �-'i 3
NAIVE /.3e-A PHONE, h7'i S -,J-0W PC-HD4t-r-
IAILENIG ADDRESS Cc, r
DESCRIPTION OF ADDITION
NUNMER OF EXISTING BEDROOMS .3 PROPOSED f, OF BEDROOMS
(FROM CERT. OF OCCUPANCY OR
CERTIRCATION FROM BUILDING INSPECTOR)
'Any addition which is considered a bedroom requires formal approval of plans (Construction permit)
prenare3 by.a.RrQfesigil Engineer or Registered Architect in accordance with applicable sections ofthe
^.._ _ -
Putillaw-c6imLy aauirxt y Cc5at:. • ... . ..... . � - -• -- ---- - �, ..... � . _.
Please submit this farm and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY
10509, Phone 278 -6130.
1, Certified check or money order for $100,00.
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
sNon- professional sketcbes are acceptable.
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax imp 6)
*Nor.- professional sketches are acceptable.
4. Copy of survey showing well and septic location, to the best of your lmowledge. Include date of
installation if known. Label all wells and septic systems within 200 feet of the property lane.
Contact this office with any questaous.
5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom
count of dwelling.
OFFICE USE
Comments
Feb98
BFhouseguidelines
From Home User To: Bill Hedges Date: 3/29/2002 Time: 5:25:44 PM Page 3 of 4
03129/2002 15:38 19147345231 PAGE 02
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44'10
S'11 15'11 1211 101 WALL SUPPORTS 2ND LEVEL
N N
BATH
5'5 x 4'8
BOILERNNOW LIVING °
9'7 x 10'1
R
in
LIVING N
KITCHEN 127 x 18'1 N
12'x 21'6 I i
CLOSET
UTILITY B
9'x 16'6 I
.. - -.
it �,
L
-9'6 12.6 LIVII40 AREA 1211
728 sq ft
44'10
EXISTING STRUCTURE
9'11
t %
44'10
8111 2'10 1011 819 4'2 0.
u
CLOSET
CLOSET n�73
LLsi j
Z8 x"
BEDROOM F BEDROOM
8'5 x 10'6 CLOT SE 9,9 x 10'6
78 x Irlo
L ZD
MASTER BDRM STORAGE/NON- LIVING
9'7X18'1
R-77LeCnul----(l -
127 x 166 fV
u
BATH —DN-
T5 x 61
BED-ROOM
--k 60AGt in
8'8 x T8 Li I
9'2 2'10 2N110 LOOR 12'9 1011
LIVING AREA 44'10
726 sq ft
SEPTIC-,,,
LSEPTIC
SEPTIC -)
SEPTIC ->
10,101,
DINING
127 x 161
< SEPTIC
<--SEPTIC
22'10
KITCHEN
22'10 x 17'9
OFFICE
10' 1 1 x 9'4
264
FAMILY LIVING
167 x 187 30'1 x 16'11
uP
Z4X57
1- 7' ---
BENJAMIN J OLSON
27 CEDAR DR.
PUTNAM VALLEY, NY 10579
1ST FLOOR
LIVING AREA
1728 sq ft
9.
7'
BATH
T5 x 8'1
1/8 SCALE
TAX MAP ID: 73.5-2-13
/7
WELL
SEPTIC TANK---'
4
L\ O
MASTER BATH 0BATHD1
]o 9'6 x 9'5 - 6'8x10 '4
0 BEDROOM,
U00 167 x 16'3
MASTER BDRM CLOSET
23'1 x 21'3 . 11 21•zo
HALL
4'9 x 167
CLOSET CLOSET
V4x2B I I /A\ 8 . "
---LAUNDRY
CLOSET LL4'2 x 4'J
T4 x Tl 1F
BEDROOM
2ND FLOOR
LIVING AREA
1728 sq ft
13
i
LIVING/MEDIA
27'10 x 177
STORAGE
18'10 x 8'1
HALL
92 x 4'
BATH//T--7 UTILITY
(.'BAR C9'2 x 6'4,0 9'4 x 7'3
Fl x 8'3
RECREATION u GARAGE
17'2 x 17'1 19,9 x 19'
7., LF
BASEMENT
LIVING AREA
1328 sq ft
s ..� ' -+ar•: +�':..t.s = >� ..'i•T.. .. _ .. - - �.. .: }.. ._ .. -.._ .. iir• / it nj ' D ..'V s'.::_ "'
Putnam Valley, NY 10579
February 12, 2001
Putnam County Health Dept.
4 Geneva Road
.Brewster, NY 10509
To Whom It May Concern:
I'm submitting this Health Application for a new house to be put on the existing property
using existing well & septic fields. (Septic to be Modified or added to if required). The
septic tank will be moved to one of the proposed locations on survey. My plan is to
remove the existing house when the new house is completed. Enclosed are the 5
requirements that are specified the application. If you need to contact me see numbers
listed below.
Thank You,
Ben Olson
(845) 526 -3472 (Home)
(914) 734 -5162 (Work)
E -mail: Ben—Olson@msn.com
` 1/3/2001 :mo rm FROM: Fax TO: 278'7921 PAGE: muormn
�
°°°"
v
"
27 Cedar Dr.
Putnam Valley, NY 10579
To:
Adam Stiebling Or New Construction Associate
Fax number:
278-7921
From:
Benjamin 3OlsN0n ---
Fax number:
045-528'4902
Business phone:
91+73+5162
Home phone:
845-526-3472
Dmte& Time: 1/3/30014:59:10 PM
PmBwm 2
Re: Building New Home
I am building a new house on my current property and demolishing my existing house and was
wondering what else I would need to-do for a approval of the septic system. The old house *currently
and has always had 4 bedrooms. The new house will have the same amount of bedrooms as seen on
r----~'--------^-�~ `-------~---------'--'-------''------'--- �— ----- —
I would like to know what documents I would need tn obtain approval.
if Possible Please E-mail me at matthew—olson@hotmall.com
j
1/3/2001 4:59 PM FROM: Fax TO: 278-7921 PAGE: 002 OF 002
Z�.
D 111 -4 N'G, U KITCHEN,
27z1 10
2310 r 179
Uri UTY
911 A W
`75 r 81
L lVill-IG; FAMILY
159x17'40 ISE ic Ti
W 1 N G AR E Al
172A
PROPOSED 1ST FLOOR LAYOUT. 03648
I
LIVING AREA
Mb q ft PROPOSED 2ND FLOOR PLAN - C3648
MASTER BATH
99 9110
1 A -1;H
BEDROOM
(oo I v
,
MASTER BDRM
0, x 31
C
BEDROOM
1V? x 14'11
BEDROOM
V4 x i 5'2
7JN all
I
LIVING AREA
Mb q ft PROPOSED 2ND FLOOR PLAN - C3648
BRUCE R. FOLEY
Public Health Director
1 . Geneva Road
Brewster, New York 10509
LORETTA MOLINARI RN., 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 (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648
April 10, 2001
Benjamin Olson
27 Cedar Drive
Putnam Valley, NY Re: Addition - Olson - 27 Cedar Dr.
(T) Putnam Valley Tax # 73.5 -2 -13
Dear Mr. Olson:
I have received and reviewed the plans for the proposed addition to the above mentioned residence.
The plans indicate that the proposed addition will consist of the following:
Replace an existing 3 bedroom with a new 4 bedroom residence
Based on the information submitted, the above mentioned addition cannot be approved for the
following reasons:
1. A professional engineer is required to prepare a site plan when replacement of a structure
is propossed.
'GJGTMI thdd'i�-.tllf n Sf %rnn tiA -r.f' 4c
_ ... _ 1�•6_u1iYb 1S -T. , r.:;.G__,,.u. Uvffia3v' "iu
your proposed addition is Four
3. The addition of a potential bedroom requires this Department's approval of a revised
septic system plan from a professional engineer.
Please revise the proposed floor plan to reflect no more than Three potential bedrooms, or
have a professional engineer or registered architect design a sub - surface sewage treatment
system meeting present code requirements.
If you have any questions, please contact me at your convenience.
Very truly—yours, _
William Hedges
Senior Public Health Sanitarian
WH:kg
BRUCE E._ FO F N. _
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
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET 0� t�,edo Qe^ TOWN /" T�ta �. �B TX MAP# ,`7 3, 5'- '13
NAIME &,j t a rr►� i1 S V S sa r` PHONE �$ �( 5%-:31V P CHD#
MAILING ADDRESS
DESCRIPTION OF ADDITION %Ve,,,d
Itor
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
*Any addition which is considered a bedroom requires formal approval of plans (Construction Permit)
prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the
Putnam County Sanitary Code.
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY
10509, Phone 278 -6130.
1. Certified check or money order for $100.00. .
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
*Non- professional sketches are acceptable.
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
*Non- professional sketches are acceptable.
4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of
installation if known. Label all wells and septic systems within 200 feet of the property line.
Contact this office with any questions.
5. Copy of Cert. Of Occupan cy from Town or Certification from Building Dept. with legal bedroom
count of dwelling.
OFFICE USE
Comments
Feb98
BFhouseguidelines
Jan JU U1 U;j:Ulp BU1LUINU UEVI 814b2888Ub p.l
Y
.4
.. .. 11iaU�`i:l "1'ta3Ftl'T l^S�'.�:l.v_ 5:,. � •ar�.:w qev... .x.a r. +.. .,.,.... sz. ..,... .. .. .- ... ....
P.O. BOX 3622
POUGHKEEPSIE, NEW YORK 12603
(845) 462-0600 FAX (845) 462 -7325
November 12, 2004
Mr. William Hedges
Senior Public Health Sanitarian
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
RE: Sewage Disposal System Replacement for Benjamin Olson, 27 Cedar Drive,
Town of Putnam Valley (Tax Map Lot 73.05 -2 -13)
Dear Mr. Hedges:
With reference to our joint site visit on 11/9/2004, the components of the system and their
locations, as well as the operation of the pump, were found to be in general conformance
with the design as shown on Sheets I of 2 and 2 of 2 of the approved plans, entitled
"Subsurface Sewage Treatment System for Benjamin Olson ", as prepared by this office,
originally dated 3/22/02 and as revised 4/8/02.
As shown on the attached as -built drawing, and as specified on the drawings, the disposal
system is comprised of a concrete septic tank; concrete pump chamber and pump; and a
tile field in fill at the west•end of the property.
If you have any questions or require any additional information, please give me a call.
Very lY &J
of NC-1
oO -AEY4 0
*
Geo ey A �k
BASS ENG
c�
cc: Benjamin Olson 0 1630
9�FESsic,
jt
D
.b
Mr. William Hedges
E
November 12, 2004
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
.+ - a "ra, m r., o::c,... r„si «. � �r.+;. .. K!nc. -, .. .o,,. c. n.. ._.. •_.. . -.. .. .. -. .. 'b':. � _ r.. +.a ..; -.cr: . � a;. aL:. . ,,. .� .... ..
LETTER OF AUTHORIZATION
RE: Property of Benjamin Olson
Located at 27 Cedar Drive, Putnam Valley
TNT. Putnam Val ley Tax Map # 73.05
Subdivision of Camp Lookout
Subdivision Lot # 118 -121
Gentlemen:
Block 2 Lot 13
Filed Map # 121 -A Date Filed Jan. 30, 1930
This letter is to authorize Geoffrey A. Bass
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 tretment and/or water supply systems in
.confor*r l3" =�ttl+ tl?e provisions of r.tiule• 14!5 a_^d/er 147_. of the Education Law, the Public Health
Law, and the Putnam County Sanitary Code. �W
untersigned:
P,E R.A., # C5 P ?0
Geoffrey A. Bass
Mailing Address P. 0. Box 3622
State New York
Poughkeepsie
Zip 12603
Very truly yours,
Signed:
5 d
(Owner of Property)
Benjamin Olson
Mailing Address:
State New York
27 Cedar Drive
Putnam Valley
Telephone: (845) 462 -0600 Telephone: .(845) 526 -5472
Zip 10579
Form LA -97
{f.
a
...m'o �.:,'.:.... . ;itFa � -� .. �" s" .�:¢.. /. .... ..y-w,.w p� -' =dN' a x'ly:M— ��jo�`}j jt��� '<`d;... .;4- .=�e =.�_. _ _ =_�_� ..- 'r.:+- e:c�:.- =""r: �..n is a•:��.._
P.O. BOX 3622
POUGHKEEPSIE, NEW YORK 12603
(914)462 -0600 FAX (914)462 -7325
March 25, 2002
Mr. William Hedges
Senior Public Health Sanitarian
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
RE: Sewage Disposal System Replacement for Benjamin Olson, 27 Cedar Drive, ,Town of
Putnam Valley (Tax Map Lot 73.05 -2 -13)
Dear Mr. Hedges:
Enclosed please find for your review the following documents, which are being submitted
in support of the application of Benjamin Olson to construct a replacement subsurface
sewage disposal system (SSTS) on the parcel at the above referenced location.
o Four (4) sets of design drawings, consisting of (a) Sheet 1 of 2, entitled "Subsurface
Sewage Treatment System for Benjamin Olson ", dated 3/22/02; and (b) Sheet 2 of 2,
entitled "Detail Sheet for Benjamin Olson ", dated 3/21/02.
_... o _ Construction. Permit Applicati.o??
o Application for Approval of l;la`ris for `A Wastewater `f'reatmerity "stem o_.:.�, _.__w� _.��
• Design Data Sheet
• Copy of survey, entitled "Survey of Property for Hudson Valley Construction
Management ", prepared by John A. McGloin, L. S., and dated 6/19/01.
• Copy of performance curve for pump proposed for SSTS
NoXhe ' osed for the application fee as 'it is understood that th fee has already
e n paid by t plicant. However, the Letter of Authorization for Design ro e a
brt Environmental Assessment Form will be forwarded under separate cover by the
applicant, Mr. Olson, and two (2) sets of house plans will be sent by the architect, EGL
Architecture, P.C.
(continued)
Mr. William Hedges 2 March 25, 2002
k., a, -..n. �'p �..: a -�- , , i�.�, :' r.- ..- _ n?" :;*=x �-„r.r :�,::�e�i:a ..:tS�ir"�5!�z.`. `ar T- _ ..._....�. � ;--... ..•._.. ..
The replacement system is required so that Mr. Olson will be able to remove the existing
dwelling on his property and construct a new four - bedroom residence. The new system
will include a 1250 gallon concrete septic tank; a pump and concrete pump chamber; and
500 lineal feet distribution lines, which will be constructed in fill due to the depth at which
rock was measured in test pits excavated on the site. No room is available for an expansion
area for the disposal field, but the system has been situated_ui a portion_of theproperty that
neighborhood wells, including., a mamtined. 7--..,
It is also proposed that Mr. Olson be permitted to occupy the existing residence on the
property while the new residence is being constructed This would be contingent upon a
temporary connection to the new SSTS and would mandate that the new SSTS be built
during the first phase of construction.
Please call me if you have any questions.
A 1 !
Enclosures
Hudson Valley Construction Management
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner Benjamin Olson Address 27 Cedar Drive, Putnam Valley
Located at (Street) Mountainview Road Tax Map73oo5 Block 2 Lot 13
(indicate nearest cross street)
Municipality Town of Putnam Valley Watershed Hudson River
SOIL PERCOLATION TEST DATA
Date of Pre-soaking Date of Percolation Test 114214n
.P
Depth to Water
Water*
Tro
ev
tt on
Time
El Tim
L
Aa
8urfm ce (finches):
o ti n
: : R " e:
de
unN
..
Start ,.:Stop - : :
2.50 -2.51
i o
Inches
M, inanC h
A
1
2:42-2:53
11
18 19
1
11
2
2:54-3:06
12
1
12
3
3-09-3:21
12
1
12
4
5
.P
2
2.50 -2.51
7
7
3 2:58-3:06 8 it 8
4 3:08-3:16 8 8
5
2
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. s I 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
J
WELL ■ I:
PAFCFL 'SHOWN 'HEREON KNOWN AS
® =Proposed Septic Tank
ora'120 ANO'PARrS of tors lie, `N? -.- Existing Junction Box
AND 121 WHICH ARE SHOWN ON MAP
NO I?i 4, FlLEO AT CARAIfL,N.Y. ON '
l JA;d J0, i -930. 1
SURVEY OF PROPERTY F,C)R
�Bn!N. N ' .,�� $..oN.. .
T0- - I.
:r. ILL SAVINGS BANK SITUATE IN
r 4I'rY TITLE -B GUAR. co.
J L- �JRY CAsRPENT'ER & CO. TOWN (7 "F Pl fTNAN1 'VII 1'FV I.
LOT /JO
tor 1j1 .
LOf iJ2 [Or 133
N
N 6 -O4 00.' E.
{
m
. .. 90.73
<4Neighbors Septic
PART
"LOT/2 /' LOT '/20 :. A T' ! I. PA
'LOT lie I
I
! I M_,WELL
is
4
n
S 6' 04 E. I
r iv
}.
I 96 .24
y
F el i I i oo t l Oo " 40
O
l I J.30'
I DROP` I \
EXISTING
F. GARAGE.
OwG lU
�
a
PROPOSkD iI I� I v
i!
t :
I I .,
..STRUCT RE» i., 3
k
.
, w44
EXisUn Q
`_
�
�.•
±WELL: °o
` SEPTIC TAN
I j
!
o
.• I ...: i,l:. I i ;l EXISTING
HOUSE
.
I:
No rH ENO
!
84.5'6,'- :Td
iF 50 H/ UlU CURVE 2
. I I S •
."
I /O.O TO.LCT
AT M1 UN7AlN VIEW KO.
. 533
53 117
I''
5 O-O.E
t
WELL ■ I:
PAFCFL 'SHOWN 'HEREON KNOWN AS
® =Proposed Septic Tank
ora'120 ANO'PARrS of tors lie, `N? -.- Existing Junction Box
AND 121 WHICH ARE SHOWN ON MAP
NO I?i 4, FlLEO AT CARAIfL,N.Y. ON '
l JA;d J0, i -930. 1
SURVEY OF PROPERTY F,C)R
�Bn!N. N ' .,�� $..oN.. .
T0- - I.
:r. ILL SAVINGS BANK SITUATE IN
r 4I'rY TITLE -B GUAR. co.
J L- �JRY CAsRPENT'ER & CO. TOWN (7 "F Pl fTNAN1 'VII 1'FV I.