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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEW NT SYSTEM
PCHD CONSTRUCTION PERMIT # iii/ -- a— R q �-
1 gRcA•� `[z IVq E L.-kNr
Located at V or Village 7,�- i-nArn VAuU
Owner /Applicant Name 37 eRcrc*i v^,,kg-p ccpti,.
Formerly
Tax Map '73, /p, Block 1 Lot '2 a—
Subdivision Name 41 AcA y7, 3
Subd. Lot # Iq
Mailing Address 3.7 Cg' 'ro� �,�t�n 2 Cds�. N , R �/ Zip lose
Date Construction Permit Issued by PCHD 10-:2.3- qR
Separate Sewerage S sem built by 37 cj?n-reyQ .VAM gD cc z?fp Address SAftt, \ I;-
Consistingof 1 a.s0: Gallon Septic Tank and Ut 4' LF o;r 2' W kr n - Mr.Kc4 0
Other Requirements:
Water Supply: Public Supply From Address
f' F, t3 4 pvTr/.4.�+ �'✓�j
or: Private Supply Drilled by Address GUNWaRmw trams 7Ye.
Building T ��s }D
YPe._ �S c .Has erosion control been ee ed? _
�s
Number of Bedrooms' `'T �� -si�,� Has garbage grinder been installed? N
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved
plans and the standards, rules and regulations of the Putnam County Department of Health.
Date: Z-_ 3 -9 9 1 Certified by
Address .za
P.E. X NA
# (d/ g3/
L, rye 5 Rr 22, 3`c?� w5 X2,11/ Y r c�Soq
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
revoca #on, modification or change is necessary.
r
By: Title: �`�P'!� Date: Z'27- �rf'
i
White copy = HD File; YtffevZ copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -91
a R PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
NQ.DTZ: Exact location of well with distances to at least two permanent landrnarKS to be prUwa on a separatersneevpian.
4 Putnam Avenue
Well Driller's Name P S s, Inc. Address: Brewster. 105097 0509
Signature:
Zo& Date: 1/5/99
PerM L. al
White copy: HD File; Fellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
A; d =ess:TI oodl �stat s
Kramers Pond Roa
Tovati/Vil age..
Putnam Valley
Map? Ie Block Lot(s)
Well Owner:
Name: Address:
V.S. Corporation, 37 Croton Dam Road, Ossining, NY 10562
Use of Well:
Il- unary
2- secondary
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 4a_ft.
Length below grade 42 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 _jL
Yield 5 gpm
Depth Data
Measure from land surface- static (specify ft)
30'
During yield test(ft)
540'
Depth of completed well in feet
605'
Well Log
If more detailed
information
descriptions or
sieve analyses .
:,.
ire •avhilable,�`'�
1please attach.
Depth Fro
Surface
Water
Well
Diameter(in)
Formation
![Description
ft.
ft.
Land Surface
10
in over
urden cla and boulders
10
lDrililin
at 10'
,... _,.. 10 .
:. -43 ._
. -.in rock
- set casin • outed =
_
�43
..`
605
_
in rock
_
- .
ranite
I f yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type sub Capacity 5upm
Depth 560' Model 5GS10412
Voltage 230 HP 1
Tank TypeWX302 Volume 86 _gal.
Date Well Complete
10/30/98
Putnam County Certification No.
002
Date of Report
1/5/99
We r r re
Pe a
NQ.DTZ: Exact location of well with distances to at least two permanent landrnarKS to be prUwa on a separatersneevpian.
4 Putnam Avenue
Well Driller's Name P S s, Inc. Address: Brewster. 105097 0509
Signature:
Zo& Date: 1/5/99
PerM L. al
White copy: HD File; Fellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
i I
NORTHEAST LABORATORY. OF DANBURY
CT Cert: PH -0404
�+•
r1-
39= 11RII,L$I.E iAT �2�A;D.
- �D,ANSij Nl'- Cert:• 114-74,'. >>
=: -�"'
(203) 748 - 7903~- FAX (203) 748 -0652
LABORATORY REPORT -- WATER SUPPLY TESTING
REPORT TO:
P.F. BEAL& SONS i
DATE SAMPLE COLLECTED: 12 /2/98 & 2/3/99
4'PUTNAM AVENUE
TIME COLLECTED: 4:15 P.M. & 3:30 P.M.
BREWSTER, N.Y. 10509
COLLECTED BY: W. MAYES
DATE RECEIVED @ LAB: 12/3/98 & 2/4/99
TESTED BY: LAB #11471 & 11301
REPORT DATE. 2/9/99
SAMPLE SITE: V.S. CONSTRUCTION, LOT #19, WOODLAND EST., PUTNAM VALLEY, N.Y.
SAMPLING POINT: HOSE BIB
SOURCE: WELL
TREATMENT: NONE
TEST PERFORMED RESULT:
MAXIMUM CONTAMINANT LEVEL
BACTERIAL:
Total Coliform (Bacteria) 0
per 100 ml 0 per 100 ml
PHYSICALS:
pH 6.40
no designated limit
Turbidity 0.53
NTUs 5 NTUs
CHEMISTRY:
Nitrite N <0.005
mg/L as N 1 mg/L as N
11301 -Nitrate N .99
mg/L as N 10 mg/L as N
Alkalinity 56.0
mg/L no designated limits
Hardness 70.0
mg/L no designated limits
Iron 0.047
mg/L 0.30 mg/L
A r Manganese:. <0.0.1.. _
._ mgt — OJff ng/I
[Note: Combined Limit for Iron plus
Manganese = 0.50 mg/L]
Sodium 10.6
mg/L 20 mg/L **
Lead 0.001
mg/L 0.015 * **
ml = milliliter mg/L = milligrams per Liter
ND = none detected NTU =Units
* *Notification Level ** *Action Level
RESULTS BASED ON SAMPLES SUBMITTED: 12/3/98 & 2/4/99
SAMPLE, AS TESTED ABOVE: �X OTABLE or OT POTABLE
(PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER)
Laboratory Director
-NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230
PU'g NAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
37 GRoToN 154-Iw 'ROap Coi2p, 73,00 1 2S
Owner or Purchaser of Building Tax Map Block Lot
374Ro-rrON IP4M ROAV COZV `t>vrIVNM VA.LL&_Y
Building Constructed by Town/Village
SRIAZR106ELANF_ r•-o I&*I_L VVAYNET7R1v�� LINEAR T
Location - Street Subdivision Name
R6S /�ENT�AI- ( q
Building Type Subdivision Lot #
I represent that I am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is has been constructed as shown on the approved plan or. approved amendment thereto, and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition
any part of said system constructed by me which fails to operate for a period of two years
immediately following the date of approval of the "Certificate of Construction Compliance" for the
sewage treatment system, or any repairs made by me to such system, except where the failure to
operate properly is caused by the willful or negligent act of the occupant of the building utilizing the
system. :. _ ... .
The undersigned 'further: agrees to accept as conclusive the determination oath ubl' ealth
Director of e P tnam ounty Department of Health as to whether or n. the,fail� r A o ,e ystem
to operate ryas ause y the willfiil or negligent act of the occupant o theIbuiig ttilizing the
P a
r,
syste y�
p ' y
Dat f 'd: A`n Day Year Signature:
A
i
Title: Mc s c> a_ T-
G otr for ( caner) - Signature
Corporation Name (if corporation)
Address:_ _3 7 c 2o-rn , yon, r1 rZ o.&- o
State DSSLNtwG, N Zip (oSCZ
Corporation Name (if corporation)
Address:
State
Zip
Form GS -97
Town
TM tr
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Date: 4
gc Owner - --
Permit #. 7�J —7 — C' 1
�S Subdivision Lot # j Q
1. Sei�age System Area
a. STS area located as per approved plans.. ....................::.
b. Fill section -date of placement
3:1 barrier Lgth. Width Avg.Dpth
c. Natural soil not stripped ................. ...............................
d. Stone, brush, etc., greater than 15' from STS area........
e. 100' from water course/ wetlands .... ...............................
II. Sewage System
a. Septic tank size - 1,000 ........1,25 ....other .............
b. Septic tank installed level ............. ...............................
c. 10' minimum from foundation ....... ...............................
d. Distribtuion Box
1. All outlets at same elevation -water tested ..............
2. Protected below frost ............... ...............................
3'. Minimum 2. ft.Original soil between box & trench
Junction Box g propq'erly set.........�j. .......... ...............................
en thh re uired Length installed --tom
2. Distance to watercourse measured Ft.....
3; Installed according to plan ............ :....................
4: Slope of trench acceptable 1/16 -1/32" /foot..........
5: 10 ft. from property line - 20 ft.- foundations.......
6 i Depth of trench <30 inches from surface...............
7. Room allowed for expansion, 100 % ......................
8: Size of gravel 3/4 -1 %z" diameter clean .................
9. Depth of gravel in trench 12" minimum .................
10. Pipe ends capped......,.:. ,..�:.:,:::::.,.,
- -�- g . . ri Pu or'Dostd`gvsteins
Size of pump chamber ............. ...............................
2. Overflow tank .......................... ...............................
3. Alarm, visual / audio ................. ...............................
4. Pump easily accessible, manhole to grade .............
5.- First box baffled ...................... ...............................
6. Cycle witnessed by H.D.estimated flow /cycle.......
III. House/Building
a.
6use located roved laps ..............................
li per pp P
b
Number of bedrooms ................... ...............................
IV. Well '
a. Well located as per approved plans ............................
b.
Distance from STS area measured ft ........
c.
Casing 18" above grade ............... ...............................
d.
Surface drainage around well acceptable ....................
V. Overall Workmanship
a.
Boxes properly grouted ................ ...............................
b.
All pipes partially backfilled ........ ...............................
c.
All pipes flush with inside of box ...............................
d.
Backfill material contains stones <4" diameter..........
e.
Curtain drain &j standpipes installed according to pla
f.
Curtain drain outfall protected & dir.to exist waterco
g.
Footing drains discharge away from STS area...........
h.
Surface water protection adequate ..............................
i.
Erosion control provided ............................................
Rev.
1/97
orm -
AO%
ENG1NEER1NG,'SURVEY11VG
LANDSCAPEARCHIrE=RE, P.C. LETTER OF TRANSMITTAL
(914)27849S
R ut
Brewster, New York 10509 (914) 278-6392
7 DeLavergne Avenue (914) 297-1742
Wappingers Falls, New York 12590
TO: Fr C. H, P,
Date: 'Z -
NO.
I Job No. L3 f 147.3 I
Attn: AP.A-t-,
:5-rte-r36(_1,J6
Re:
sTS
eO," re4,f f0C4E5_
WE ARE SENDING YOU Attached ❑ Under separate cover via the following items:
❑ Shop Drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order ❑
COPIES DATE
NO.
DESCRIPTION
C C— 7
!r--
wc-T7
.... . .. . . . . ... . . . ...... . ............... ........................... ...............................
....... . . . . . . . . ....... . ........................ . . . ............. .............. ............................................................
......... -- ----- - -._.. ..---._....._-_--.-•----- .-- ._.......................... ......... ........................................
__ ...... . ......... .. .... ............ ...................... . . . . . ................ ....................................... .. . . ........................................
THESE ARE TRANSMITTED as checked below:
[]?�provedassurnitted_.. ❑ Resubmit-
Fqr.9pproval b
For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
REMARKS:
COPY TO:
Lot98.dot
F ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
77
P]UTRAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
-7-y
Located
bN' P I M A° 'fD A 'FR A�I EST SY
Subdivision name Z&64k 3 Subd. Lot #
Date Subdivision Approved _ gjCj (FjtED)
Town or Village DOWN VALLE Y
Tax Map 73,18 Block _I Lot s
Renewal Revision
Owner /Applicant Name' 37 dorod PAM At. NRI. Date of Previous Approval
Mailing Address 371 CRO &V DAPI Rn osayiNo- Zip /o•S 2
Amount of Fee Enclosed
Building Type Lot AreatW11 f`No. of Bedrooms Design Flow GPD
Fill Section Only Depth Volume
PCIiD NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED
Seuarate Seweraize System to consist of gallon septic tank and
Other Requirements:
To be constructed by 37 C�DfDN %iA/li R6�0 CO.eP Address 37 C�o�W MM RV, 65, 1�1/�VG ; BY 1456
Water Suooly: Public Supply From Address
PrivateSupplyDrilled =.by��j�! oW Address UIf�1�41J. /1
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewiL treatment 's s}�tem described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the
Department,'and a written, guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said
builder will place in good 'operating condition any part of said sewage treatment system during the period of two (2) years
immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original
system or any repairs thereto.
Signed:
P.E. "c"— ReA Date l4 6 9
jjC#1)' rCfV6 PC. License # 6
2
i�8M, ►`"qffbe, N r. iC)s—oq
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 hecessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new 1wrinit Approved for discharge of domestic sanitary sewage only.
By: Title: 44"t, Date: 23 /9
White copy HD ile; Ye 1 copy - Building Inspector; Pink copy - ner; Yange copy - Design Professional
Form CP -97
-, DEPARTMENT OF HEALTH
Division of Environmental Health Services
I 4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 .
APPLLCA IORT Q C!QNST,RUC.T _.A, WATT R, 9LLc
PCHD PF.RMTT 9
WELL LOCATION
Street Address
Town/Village/City
V L-L- EY
Tax Grid Number
Z57
WELL OWNER
Name Mailing
`11�jP
Address
L,
Wrivate
O Public
USE OF WELL
primary
2 - secondary
WRESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED
0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify
0 INDUSTRIAL b INSTITUTIONAL 0 STAND -BY
AMOUNT OF USE
YIELD SOUGHT
`j gpm /#
PEOPLE SERVED /EST.
OF DAILY USAGE (25(�Sal
REASON FOR
DRILLING
0 REPLACE EXISTING
NEW SUPPLY NEW
SUPPLY
DWELLING
® TEST /OBSERVATION
® DEEPEN EXISTING WELL
12. ADDITIONAL SUPPLY
DETAILED
REASON FOR
DRILLING
WELL TYPE
DRILLED
®DRIVEN
"DUG
®GRAVEL
0OTHER
IS WELL SITE.SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:Lj6CLa fit
Lot No. `Q(
WATER WELL CONTRACTOR: Name 0�)y.�%j63A)NI Address :I- )tAQ�OVJN�
IS PUBLIC DATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY �4
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH SOURCES OF CONTAMINATION PROVIDED
VON SEPARATE SHEET
(date) ature)
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of 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 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 attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a ma ner as not to degrade or otherwise contamin ce or groundwater
Date of Issue: 19
Date of Expiration 19 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
tv
llRi+lA�[ COUl11Y D�AlI�Mi OFIKMTH
< W DIrY� •[ �1�•ua�� Aed16 Sadees. �7usa1. N Y 1�SU ° � a Fwi!Id• Fa1�M:'1 ;' .
,JI • 1'• C�lII�1G18OF C0
SWAM pow"AL SYST®1[
w c::N�mr4LLF
L�e•ai••a �'� in1�' ! Y7ZCtJ�" ar..,vi0fi�
,�: ...� sue,„ _ � �- • -.�,. r... �, _
'rf .R 'Aw!•��MYr� �Ytr
a
�R G-ytzc�Pir�e,- f � ., 2'NG
Qao oit N DOwa/Alkt� aRQ ' ❑.
Dite of Fte0oai Appiov l
leis +/C/ Li (J!<%7� , ✓%TZ%r Town Gtrr! EL --7Z, /i.� 1 i 17G
Date Subdivision Approved Fee .Enclos',AO— A,tin„ It -�" 300.�X7
e++rs i c=o rtRt Lot Area {' y, o! Fm s•a:oa>b
valoane
Naiiiar e[ Beiie•atr_ Flow G P D PC®1 Ni11Do tloa to �ep�eed Wlfad'FN b,oaopNled
i ,
SaPaetla if—W, •eap Sroace a'oaiiat i[ cu9w s�pue Tu_ k ••••t l y q dF Z` wfoe / [3So nTl ?•J CK� j
yy/SifJrr;:J
. Te b. oa�ettee/id ,Wlhe,r C.L yJKn7oc..+'
Wi/ar slow. Addieu
aih g1. Stt old N/S �^� �a�a.e rA ✓.�, v
-yI o
1 f, � c l
, Oftiar �k•bNb ''a ,
1 representanat 1 am.'wholly anA Completely -rafpontiph for tM deiiyn and kication or tM proPoad stist•m(s), l) that the separate_sawage dift"I system
above dascrip•d,wiltt» CbnitruCttld.aa shown on tM app►o,fed amendniarit there to-and,in accordance with tM•standards, rules awn rpu ions. of
County Oapartment? Of FIMRI►, grid that on eolnpletbri,thereof a - 6rilfkita of; Construction Compliance" saiiifactoryi to'tM Commissioner M HMKhwlll
be supmittidj to tM', O•partniant, an0•a writt n`guaranta• will M;fumis id tha:own•r )Ws 'fuccia",heirs_or assigns by the bull' thatsaid builder will
Otac• in ,good oPdratMlg condition any ":.pMt'of :wW iaiwig• dispoial, syst�in duri„ p tM period of two (2) yiar's"Unrnadiataly•folfiwirlg thedite Of tta Ipw
,Dow of ,the,,i0'"' al of the 'C•rtOkata of Construction 'Compliance oP. the original, system'or• any repairs thwatos 2) that the drilled well:disal0ad above
wo be bcaNd ai oioat<n on tni apprmhd;PNn erne that aid well will 1: histallod , in': aecordo ith the„ standard s. rules and reg—Migns of- . the Putnam
county op "ftmfint ren?
Data 2 ' 1ZS ; sign J P.E. I� RA.
APPROVED FOR CONSTRUCTION. This appoval •xPires two Yea► tM a issued unless C
revoable.for m"'oc mey be ifvi d or modified khan considered n -' ry by the Un
Now a germ
Approved or dl Sol of domestic anitir o, and /o►
Rev..
10/88 Wta By
"z✓.fl^7Z qqN License No
instruction of tM building Jos been undertaken and is
of Health: Any change or alteration of construction
.supply only.
Title
�
I
1� ropi oil 6 It
0wr1t'th6tTbn1 'IM V and _c6i6plot,�Oy.'-roS� a OMd - OySto 0);' 1% 2 Jp0rBtQ 23,vOilb iimial gst
for h, do., on(
III 1) 115 Vol a III s . e11VXwq'VY 11 1
C uctio'kCornoliorica" entisfactorr to thqCproomilsionw.of HoalthWill
. his ►owe Or oss*ns'bY t6o'buillOW. tlieCOM 61JHdC7 Will
M. yown Ignonagiatoly io(i6iaj iftb t4a dato of tho i=p
pmeo. 6w sy
�=,
of 1= 461 tho Cortif J"f"�"li r It C 0 Pup of
any OM0170 t9=0110; 2) that 1310 CrIlICS Well *OWN= 000VO
WHO bo tocatod as WOW teto� _68oftro two Will it
r oog� r th tho_�g role. rulos 0 fttnarn
�ii Dhdo nil rCauFaMons of -tho
In
ep.(E. A A.
■
iconso NO
R3Rjn&)G22 M U122 4:�
APPROVED FO OMST 'C Yhia approval 01t0!ras taro .19pre P In
to issubd unlas, construction of tho Building .has b=n undortaken and is
JFM
Rev.
rmt L airos a no OV I a - 9, for. , g ljipo 1, OV . at iomodk sanitary we i a
r porp2
no-
'10/88
Dato�
TRIO
IN x! Qwa
rwlr WIMUMA -
1� ropi oil 6 It
0wr1t'th6tTbn1 'IM V and _c6i6plot,�Oy.'-roS� a OMd - OySto 0);' 1% 2 Jp0rBtQ 23,vOilb iimial gst
for h, do., on(
onant, '09 ;n noroof VNCOA if Wmt&
County DMrt 01�� I % arom
i
610 M*rmm Ow Dcwrtinciit .'a' 6- fit'! t %:im8i0'fuml4oiii
C uctio'kCornoliorica" entisfactorr to thqCproomilsionw.of HoalthWill
. his ►owe Or oss*ns'bY t6o'buillOW. tlieCOM 61JHdC7 Will
M. yown Ignonagiatoly io(i6iaj iftb t4a dato of tho i=p
pmeo. 6w sy
�=,
of 1= 461 tho Cortif J"f"�"li r It C 0 Pup of
any OM0170 t9=0110; 2) that 1310 CrIlICS Well *OWN= 000VO
WHO bo tocatod as WOW teto� _68oftro two Will it
r oog� r th tho_�g role. rulos 0 fttnarn
�ii Dhdo nil rCauFaMons of -tho
to
Del Slone
ep.(E. A A.
. . . . . .
dd
iconso NO
R3Rjn&)G22 M U122 4:�
APPROVED FO OMST 'C Yhia approval 01t0!ras taro .19pre P In
to issubd unlas, construction of tho Building .has b=n undortaken and is
iovoelblo for COU2`0 ay ao"CA`*CSL Or modified urhon considovo.d. o 0"If-y". b_y"tML..COnoMi"jOn0j of. Health. Any chango or oitcration of construction
1
Rev.
rmt L airos a no OV I a - 9, for. , g ljipo 1, OV . at iomodk sanitary we i a
r porp2
no-
'10/88
Dato�
TRIO
I
R C'1
PUTNAM ; COUNTY .DEPARTMENT
APPR0VA�L �•QR�- PLANS;-FOR;, :4fASTEWATER ; O
1. Name and Address of Applicant: LiacAg D�vEc.oP.•�E..�T
7-61 4 aexry. Sr.
OF HEALTH
ISPOSAL,�SYS,T EMS i
Larrc.E F�,crz y , N,S. / 7 6 ys
2. Name of 'Project: ,SSDS fit G��c DevEioraro�r �.T mc. 3. Location VV /C: PuM*K VAUXY
4. Project Engineer: ZN.Pre EN&N,rVCf a J�xv�� c, c,5. Address: 1Zo&*rr ZZ
License ;Number: (o /13 f Phone:
6. Type of Project:
X PPrivate /Residential Food Service Commercial .
Apartments Institutional Mobile Home Park
Office Building Realty Subdivision Other (specify)
7. .Is this project subject to State Environmental Quality Review (SEQR)?
Type Status (Check One) Type I.. Exempt
Type II. Unlisted.
8.1s a Draft Environmenta1.Impact Statement (DEIS) required? ...:......... NO
9. Has DEIS been.compl'eted and found acceptable by Lead Agency? A
10. Name of Lead Agency NSA
..11— Is. th.is,,prolect: -.in an.area under the con trol .of.:.1ocal plann- i_ng_, .zoning, �D6 pei°T
or other officials,.. ord' inance" s'?'_*: ............
.. ...:........�...:.:.:.::.: :F�t Bcy6.P�,er+r-
12. If so, have plans been submitted to such authorities? .................. No
13. Has preliminary. approval been granted by such authorities? 11A Date Granted: �" A
14. Type of Sewage Disposal System Discharge...... . Surface Water —L —Ground Waters
15. If surface water discharge, what is the stream class designation ?........ NIA
16,. Waters index number N /A
( surface) � ............ ....:....:.:...................
IT. Is project located near a public water supply system? %10
18. If yes, name of water supply N 1A ly Distance to water supp N�A
1C''Is project site near a public sewage. collection or disposal system'..... No
20'. Name of sewage system N /A Distance,to sewage system N�A
F-
21. Date observed: ' U2 23. Name of Health Inspector: NNKa °'QA)
E3
24. Project design flow J gallons per day) ..... C
.............................
2.
25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. NO
26o Has SPD1WApplicai:ioh 6i6itn '"tubmttted�to'local°DfEsOf�Fic - >o ae Q e =V-
27. Is any portion of this project located within a designated Town or State -
wetland ? ...o...... dyC7
m o 0 o e o 0 0 0 0 0 0 o a o 0 o a e o 0 0 o a o a o 0 0 o e o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28. Wetland ID Number eooa00000000a000......0 o o o o o o e o e o e o o e o o o o o 000 o 0 o o o 000 o 0
29. Is Wetland Permit required? .o...o,.......o Ai/o
Has application been made to Town or.Local DEC Office? .................. N A
30. Does project require a DEC Stream Disturbance Permit? .... oo...00.....e.. NO
31. Is or was project site used for agricultural activity involving application
of pesticides to orchards or other crops, solid or hazardous Waste disposal,
landfilling, sludge application or industrial activity? .00..... YES or NO N-0
32. Is project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or
any other potential known source of contamination? ..............YES or NO /did
DESCRIBE:
33. Is there a local master plan or file with the Town or Village? ......000... y
34. Are community water, sewer facilities planned. to be developed within 15 years? NP
35, Are any sewage disposal areas in excess of 15% slope? .......?6�a(eFfAD
36.1 Tax Map ID Number vl........000000........ ...e oo °o°o............
37. Approved Plans are to be returned to: Applicant Engineer
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. Failure to comply with this
provision may be grounds for the rejection of.any submission.
Z hereby affirm, under penalty of perjury, that information provided on this
form is true to the best of my knowledge and belief. f=alse statements made
herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of
the Penal Law.
SIGNATURES & OFFICIAL TITLES
MAILING ADDRESS:
�c 7� ZZ y Iz-��S Tom' /U 7• / oSo g
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New .York 10509
(91_4) 278 6130
,_...ia. -..r vi -d'rc� -mow.. aw'�e`•'.._« z> v.r ,n...:....:+i«. b:.:: �. . �zY"•.K. '.. +:iir
APPLICATION TO CONSTRUCT A WATER WELL
j PCHD PERMIT
WELL LOCATION
Street Address Town Village City Tax Grid Number
A)1f Y A) 6_ 1 U6_ i Fi — I — 7-5—
WELL OWNER.
Name Mailing Address
�inJCrfii� bEYiZr�t4m��✓i"tr.Tr�G '26/ Llg4tn ST
02zvate
y blic
USE OF WELL
- primary
- secondary
&RESIDENTIAL O PUBLIC SUPPLY
0 BUSINESS O FARM
0 INDUSTRIAL 0 INSTITUTIONAL
O AIR /COND /HEAT PUMP O ABANDONED
O TEST /OBSERVATION O OTHER (specify
O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT gpm /41 PEOPLE
i
SERVED /EST. OF DAILY USAGE 0 Sal
REASON FOR
DRILLING
0 REPLACE EXISTING SUPPLY O TEST /OBSERVATION 12-ADDITIONAL SUPPLY
ANEW SUPPLY NEW DWELLING) 13 DEEPEN EXISTING WELL
DETAILED,
REASON FOR
DRILLING
WELL TYPE
AODRILLED
DRIVEN
0DUG
GRAVEL -
0
OTHER
IS WELL SITE SUBJECT,TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lrn1GRk'
Lot No. / q
WATER WELL. CONTRACTOR,: Name Address: GC.i✓,��r✓c.i
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ NO
NAME OF PUBLIC WATER�SUPPLY: i✓ �� TOWN /VIL /CITY ti
~DISTAN~CE TO �PROPERTX rFROM NEAREST 'WATE1R .MAIN : �/ ,4
;LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
Z ZS ARATE SHEET
(d te) ig ature
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of 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 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 attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all 'water or waste products from such well drilling operations be contained on this
property and in suW manner as not to degrade or othe w se conta pate surface or groundwater.
Date of Issue: Z 9�.
Date of Expiration Z.t 19 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Ingp. Orange copy: Well Driller
PUIMM COUNTY DEPARniENT OF HFALTH
DIVISION OF MrBMMM�L HEALTH SERVICES 1-1,0CAr-ff LO( 19
DESIGN DATA SHED-SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner yecrr r Co - Address L./-,,7t, i-
-76 q3
Located at Street) 4" 4, Uc Sec. 7-3 • t8 dock C Lot
(indicate nearest cross street)
Municipality Pt) 7-Aj&M VAI -C.EY Watershed
;*4) 1 mv go'comp-mv (O"m Y Kim I-y-ywg Li 5�0,, I'm !"n
V V11
Date of Pre- Soaking IV.LA Date of Percolation Test
iv A
(
HOLE
MEM 'CUM TIME PERCOLATION
PERCOLATION
,Run Elapse Depth to Water Fran
Water Level
NO. Time Ground Surface
In Inches
Soil Rate
Start-Stop Min. Start stop
Drop In
Min/In Drop
Inches Inches
Inches
2 0 Iq Po,-1610 R67CZoLA7-7o-.n) )27&-t-6- CRr- r"VIIIA)
3 - , 77VK C?'J re-c, M 771C roc- &-):) ��14P 0 ZtI3 3
4
2
3
4
5
NOTES: Tests to be repeated at same depth until approximately equal soil rates
are obtained at each percolation test hole. All data to* be submitted
.for review.
2. Depth measurements to be made from top of hole.
i
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOIIS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO.- HOLE No. Z HOLE NO.
�'� ty'. f•� u`., x..+ .R' ` e :;C' i:.vl4:.pi�V . ;y; ., Gr7 F.. [ J `.Y. ` rn
001- „ :.Z -+r•6 ,as.. s... _ t F ...r z' . r . . A:
G.L.
ir/ (GrtT Zt bH T.
1, ($iZacJn� j3tZ�ncJ:v
LO Ate►') C� r4"n'l
2'
j I
3'
4'
5'
x t,
6' Jr 7-V KOGfl� I t t rt I r l 1 J
7'
8'
9'
10'
11'
12'
13'
14'
. _:" • -. -- iIVDIC' A` I` Ei�VEL� 'AT``WEiiC�i`GROi7JN2`ER" IS °•ENOOUI3TIItED °. - jt�C��•%:��:.'-- .:s;�:,:�Y::: .,. -. °�,::::>
INDICATE LEVEL To WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED /L) C2 ^�
DEEP HOLE OBSERVATIONS MADE BY: E Cox") 6U v!S DATE: /67
i
DESIGN
Soil Rate Used 60 Min/1 " Drop: S.D. Usable Area Provided GOGO
No. of Bedrooms / Septic Tank Capacity / Z 5C gals. Type OOiJC
Absorption Ar Provided By _2!L L.F. x 24" width trench
Other Z F IE D NEW y
..s. r
SEffCCY
Name sn►sirr u Signature `
Address %Zav Z� SEAL S -, V -, - ",' k? P
JIZE "7iJs
yie% aft
SOS L`� �p .JIM
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
Soil Rate Approved sq.ft /gal. Checked by Date
7.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
._...:.
.:DE916N - � °, ;ES ?V E: T A. MFJI'T7C S3 STE I ::-
n,9 iLO� OfSi✓�•Adress Owner 3Cw A�r 1P, G t) ✓ < <, y y
feJA7C IZ O C
Located at (Street); w,r.r Tax Mat) . '7,�6 Block ! . Lot Z
(indicate nearest cross street)'
Municipality A,47v�m `A- Drainage Basin �f�osm✓ ���X —=- -`
SOIL PERCOLATION TEST DATA
J
Date of Pre - soaking ,V I,4-- Date of Percolation Test
Hole No.
Run No.
Time
Start - Stop
Ela se Time
min.)
De th to Water
From Ground
Surface (Inches)
Start Stop
Water
Level
Drop n
Inches
Percol on
e
nch
1
2
3
4
5
1
.. , ....� v
r W2\1 .. -
s P . ,..qr w-r _
. �4.
.- ti�.,....r_.,�.- ..ss,. �'w .,n.. .
...� ♦�. _. .....
�O.- ..•- !_.mow.•, • ..
3
4
y
5 I
l
.
2 ;I
3
4
5
1VV11,J: 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
0)
G.L.
0.5'
1.01
1.51
2.01
2.51
61931
3.01
3.5
4.0
ev /ev 52;,C7
4.5
5.0'
5.5'
6.01
6.5'
7.01
7.5'
8.01
8.5'
.......... .. ..
910F.:.
..... .....
9.5'
4
10.0
C-1
ZZ
n-<
Indicate level at which groundwater is encountered
10045 Co
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered
Deep hole observations made by: J a ffAi Date
I
Design Professional Name: Jeffrey J. contelmo P. E.
Address: __incite p?q �uq, sanling & Lxosape Architecture, P
1-.-4e5'--R.oi1te 22
Brewster, New York 10509
Signature:
Design Professional's Seal
OF NEPv
T.
61931
THE
HOUSE,PILA
BEDROOM C
RSDALE If
Floor
27'8" X 48' • 2656 Sq. Ft.
48'
First Floor
11001
3!0
-3: FAS
KITCHEN BREAKFAST FAMILY ROOM
0- 20' -0 "a 13' -0'
i2,-o,x 13-0, "
.5, X IS-0,
27'80
27'8'
LIVING ROOM
Is% 9" X 13' -0'
Signatki-re
STANDARD SCARSDALE If
FEATURES
• 4- Spacious Bedrooms •
Framingham Pediment on Front Door
• '2Y Baths •Fireplace
2,
COUNTY DEPARTMEN
E.AIT
"Boxed-out" and "Angle Bay" Options
Formal Dining Room
APPROVED FOR
q,81
r- --
0
0
11-IT 0.*bfN'I'NG ROOM
• SpacioUs'Country l(itchen with Breakfast
for a Complete List of Options
Room and Pantry •
Artist's renderings and Floor Mn Dimensions are
• "Cottag�-St
yle" 3056 Lower Level Windows
27'80
27'8'
LIVING ROOM
Is% 9" X 13' -0'
FESTCHESTER MODULAR K OMES, IN
P.O. Box 900 •:Dover Plains, NY 12522
Signatki-re
STANDARD SCARSDALE If
FEATURES
• 4- Spacious Bedrooms •
Framingham Pediment on Front Door
• '2Y Baths •Fireplace
2,
Options Available
• 'Open Two-Story Entry Foyer •
"Boxed-out" and "Angle Bay" Options
Formal Dining Room
Available
• Formaltiving Room •
Consult an Authorized Westchester Builder
• SpacioUs'Country l(itchen with Breakfast
for a Complete List of Options
Room and Pantry •
Artist's renderings and Floor Mn Dimensions are
• "Cottag�-St
yle" 3056 Lower Level Windows
approximate. All specifications must be Written in the
contract. No oral conditions.
with Architraves on Front
FESTCHESTER MODULAR K OMES, IN
P.O. Box 900 •:Dover Plains, NY 12522
A
I'M
;'M
so;
MC,
4ODULAR KOMES, ING.
T7
ES HESTEP
Re:
L-1 21I-..
PUT, -.AM COUNTY DEPARTHEW OF HEA-' H
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Da
Property of L-iAk�AR �C-'-
Located at w•4 r-> r,-t ✓�
W Pur�JA -i VAU -ems Section W... le Block �( Lot Z�
Subdivision of
I q
Subdv. Lot 1 Filed Map # Z-'i-33A Date -k 5
Gentlemen:
This letter is, to authorize ;1:;0-5J'TC
a duly licensed professional engineer or registered architect
(Indicate
to apply for, a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
I cj
-uy;;stem' .or,- sy;St.en:s: - -in- Gorrfo.rmity:: -with . -t•he :- provi-sior�s -v;f- k- -t�icl-e
-1 . _... - -. _ -.
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersign
,
Address
I
.6Z co
Telephone
Very truly your,
Signed
Nner OY erty
- { r�-
Ltae
5 77�t� -T
Address
cirz� fe-rl,�.y,
tiT 1-76 y3
Town
�> Z01- yyC,
- 'Y 7C
Telephone
?','�-4AK COUNTY DEPARTMENT OF REALTH
Division of Environmental Realth Services
AFFIDAVIT CORPORATE OWNER APPLICATION
SUBMITTED TO
PUTN&H COUNTY HEALTH DEPARTMENT
TO: . Commissioner of Health
In the matter of application for-
L /,u cA
Peva-Opmew7-
gg c? r0.AL-1> N Ltc 1<,Ft-
represent that I are an officer or employee of the corporation and am authorized
to act for
1DCVeZ_a1-'1'70;10_1
(Name of Corporation)
having offices at
L_i.m6g-
Whose officers are:
90/0AC_C:, Cj13e7ZT,51_ L-,r7-Lr_ FiE_r:�'ZV 17,6y,3
President. /
04ame and Address)
Vice-President:
(Naue and Address)
Secretary:
Name;
-and,A -dr- s
Treasurer:
(Name and Address)
and that I am and will be individually responsible f
corporation with respect to the approval requested a
thereto.
Svqrn to before me this day
of 19
Public
ARLENE FAUSTINI
NOTARY PUBLIC OF NEbV JERSEY
'My e'o'mmjssfon Expires June 24. 1996
F -E-.
o
Title:
Corporate Seal
_0
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date CA
Re: Property of I" cc-v-- ll Qve-la,n vv,(--vi -4- CO. �
Located at.
"\14
(T) section q3..W.-Block. 1 Lot cis
Subdivision of
Subdv. Lot # Filed Map Date
Gentlemen:
This letter is to authorize Insite Engineering & Siaveying, 12,r
-
a duly g&xx-�&RjaAekR'�
,y licensed professional engineer x qxCxFA&-k§xtMx
(Indicate)
to apply for a Construction Permit for a separate sewage system, to
serve the above noted. property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
ifem oy-BYAeihs -Iii C,01&o; i y the provisions of Article
145 or
14 7, "' Educa t ion La w, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
Si ned
Countersigned: y
Jeffrey J. Conte o
P 1E. FW*x, # a61931 -S+,re -e-
Address
Insit'e,8ngineer ing & Surveying, P.C. A/3- I PX43
Address Town
Route 22, Brewster, NY 10509 0 1- 411 j' :
Telephone
278-4990 t - VA a 0
Telephone
PUTNAM COUNTY DEPARTHEW OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Re s Property of 6-►�%c rtiR p t- y� c�P �=�T Cat% -� �C-.
Located at— GJA Kn> F C> Tc
(T) PU'rrJAr,, VAUCy Section 73,ie . Block Lot ZJ
Subdivision of u,j 2 �' SC., r->i brs1o"3
Subdvo Lot Filed Asap � Z -`��3� Date
Gentlemen
This letter is to authorize �NSITF Ca)611atLVrOtAt
a duly licensed professional engineer or registered architect
(Indicate)
to apply for a Construction ]Permit for a separate sewage system, to
serve the above.noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
- - -'- sys:t:em..or -sysyems =: a: _conformity a� ith the :p ovasions of Arta 1 X45_:or:
147, (Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Countersi�gne
D-E9 25�G568 0, j '
5-CIZ�C/zEy •5: Ca,i L mt} r PE.
i051 5 -c'2 vEYt 'VC.
Address
6 cg�,��z. IV ICS -f
Telephone
Very truly you,
Signed
i per ou Y eriLy
Z ��2 /J
Z( L t (3 e r 5
Address
L i TL C ('7 6, t/,S
Town
Zvt - yyC - 4( 70c
Telephone
II
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services
AFFIDAVIT - CORPORATE OWNER APPLICATION
OR, PMIT APPLICATION SUBMITTED TO "
PUTNAM COUNTY HEALTH DEPARTMENT
TO: Commissioner of Health
In tie matter of application for:
D =,,o c- . Ica jc,-R nr Sv1�w. tl- l°I
L / N GA 1r CVEt -o Pr.� e7,7� � -. —
I, dorV, L-D Nctcj<, L
represent that .I am as officer or employee of the corporation and am authorized
to ac: for
(Name of Corporat
CO,, ::=Ac .
having offices at
LirT(-c- Fe�c-(ry, mss. I74�f3
Whose officers are:
Pres Gent• %�pNftca IulmACCL.� Z$ I UT3�7�/ 5-r C.irre,- FE -ZieV AZI 176y3
. (lame and Address)
Vice - °'resident:
(Name and Address)
Secretary:
Name
Treasure::
(Name and Address)
and that I am and will be individually respon
corporation vithirespect to the approval requ,
thereto.
Sworn to before me this day
of 19 9 y
Wotan: Public ,
ARLENE FAUSTINI
NOl'ARY PUBLIC OF NEW JERSEY
My COff M ssion Expires June 24, 1996
Corporate Sea
m
pit
N 45'4X'00" E, 40.00'- 81•57'40" E
R=66.00; L=150,04'
'9RIAl? RIDC,'-- SANE
)3'57'00" W 80.00'-
•
N 86'08'4'0' W V 86'40'06
4.041 ACRES _t
8
- - - -WELL.
9 CERTIFY TTIAT THE SEWAGE TREATMENT SYSTEM
STRUCTED AS INDICATED ON THIS PLAN AND THAT
EM WAS OBSERVED BY INSITE ENGINEERING,.
G -AND LANDSCAPE ARCHITECTURE, P. C. BEFORE IT
:RED OVER. THE SYSTEM WAS CONSTRUCTED IN
ACCORDANCE WITH ALL STANDARD RULES AND
ONS OF THE PUTNAM COUNTY DEPARTMENT
'f/ AND THE NEW YORK STATE DEPARTMENT OF
_/TIES EXISTING, UNLESS. NOTED OTHERWISE.
Y LINE, HOUSE LOCATION, AND iVELL LOCATION TAKEN
LDWORK BY INSITE ENGINEERING, SURVEYING &
PE ARCHITECTURE, P.C., COMPLETED 1128199;
y -NO. DATE
AS .-BUILT MEASUREMENTS ® d
0. A B f REMARKS RI
LANDSCAPE A.
1250 GALLON
,N
67'
140'
END OF TRENCH
1
35
47
SEPTIC TANK
12
A
C
END OF TRENCH
2
61'
126'
GLENN. OUT
3
10-3'
107'
L?ROP Box
4.
103'
.107'
DROP. BOX
6
106'
112'
QROP -. BOX
5
109' -
116'
:1JROP . BOX
7
112'
121'
QR P:BOX
8
115'
126'
DROP--.BOX.
.9
66'-.
139'
;ENDS OF...TRENCH
p
67'
140'
END OF TRENCH
11
71
143'
END OF .TRENCH
12
75'
147'
END OF TRENCH
13
79'-
'151 '
END OF. TRENCH
141.
83'
155'
END OF TRENCH
15
144'
77'
END OF TRENCH
16
143''
84'
.END OF TRENCH
.17
145'
90'
END OF TRENCH
18
147'
95,
END OF TRENCH
.19
150'
101'
END OF TRENCH
20
134'
114' _ -
ENO OF TRENCH .
PROJEC T:
Ss TS FO.
37 CRO TON DAM.f
LINCAR 3 SUBDIVISION, LOT 19, PUN
DRA WING:
AS -BUIL
DRAWN(
PROJECT .91147 319 PRO:.
NO. MAN
DATE 2-2 -99 ORAi
BY
SCALE- .AS NOTED CHEC
BY
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11
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ENGINEERING, SURVEYING &
LANDSCAPE ARCHITECTURES p,�q
October 20, 1998
Mr. Adam Stiebeli'ng
Assistant Public' Health. Engineer
Putnam County Hbalth Department
Four Geneva Road
Brewster, New York 10509
RE: I Linca'r 3 Ld #19
Briar Ridge'L.ane (formerly Wayne Drive)
Tax Map #73.18-1-25
Town of Putnam utnarn Valley
Deat Mr. Stiebeling:
Enclosed please find revised Construction Drawings and appropriate documents for an SSTS
.Revision. Please 'note that the SSTS was redesigned with no fill due to recent deep test holes.
Should you have any questions or comments regarding this information, please feel free to contact
our off ic'6.'
Very truly yours,
INSITE z,,ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C.
o, P.E. By
r ntel 0, PE�
41Pri' al h ee
JjCfjms
cc: Val Santucci
Insite File No. 91147.319
1485 Route 22 . , Brewster, New York lo5og (914)278-4990 - (914) 278-6392
1 Fax
❑ 7 DeLavergne Aitenue, Wappingers Falls, Now York 12590 (914) 297-1742
www.insite-eng.com
V ",--
... .., rpi BRUCE R FOLEY,
-
RS
l£cting P -,Director
for
-ub is Health
4, W WI, Joi
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 December 16, 1996
Jeff Contelmo
Insite Engineering
Route 22
Brewster, NY 10509
Re: Proposed SSDS:
Linear #9
Waynbe Drive
(T) Putnam Valley
Dear Mr. Contelmo:
Review of plans and other supporting documents submitted at this time relative to the above -
captioned project has been completed. Comments are offered as follows:
"The construction of this sewage disposal system may be subject to local wetlands regulations.
You should contact local wetlands officials in this regard."
1. Current engineers authorization letter is to be submitted.
2. Erosion control measures for the house and :well is to be shown on the plan along with.a.
---note -note sta ' all erosion control measures are to:be installed' '6r:to the'start of an -
P� Y.
construction.
3. Details for all erosion control measures are to be shown on the plan.
Upon receipt of a submission, revised to reflect the above, this application will be considered
further .
V truly yours
Robert Morris, P. E.
Public Health Engineer
mip
T li r ] �% ENGINEERING &
/ 11 V• 1 1 SURVEYING, P. C.
1849, Rome 6. ! (qZ4) 225-62oo
Cainwl''New York 10312 Fax (914) 225.6438
7 DeLaueigne :Avenue
J6 :, - stgera fialb; iJew 1'�vlm =r jgir =- —= (4 a"9s°5741_.. ,.. ;:
TO f2"jAj) M ova -y bCPr OF &5-9 -e-V1 .
> WE ARE SENDING YOU O- Atikched ❑ Under separate cover via_
D Shop drawings ❑ Prints ❑ Plans
Copy of letter ❑ Change order ❑
L [ETTEQ (01F "MMOOMD "TU RL
DATE
JOB NO.
ATTENTION
Ssps
LIn)CAP, j7•1- ScJQDIVISICr
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PC-'H b 09-0-1 PC -
the following items:
❑ Samples ❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
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PC-'H b 09-0-1 PC -
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TH E ARE. TRANSMITTED as ,checked „below:
o LFor 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 ❑
0' FOR BIDS D'IUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO
SIGNED:
If enclosures are not as noted, kindly notify us a once.
1
APPENDIX 3
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEW -AGE DISPOSAL SYSTEMS
REVIEW SHEET for CONSTRUCTION PE
.N. c�W`R yr STREE CA OT1 �., G
B Y DATE TAX MAP #
DOCUMENTS.
Y
[�Q PERMIT APPLICATION
® PC -1
LL PERMIT;CD PWS LETTER
ENGINEERS AUTHORIZATION
ESIGN DATA SHEET(DDS)
EEP HOLE LOG
CONSISTENT PERC RESULTS (3)
PERC HOLE DEPTH
CORPORATE RESOLUTION
PLANS THREE SETS
ED HOUSE PLANS - TWO SETS
CD VARIANCE REQUEST
GENERAL
GAL SUBDIVISION
UBDIVISION APPROVAL CHECKED
PERC RATE — W
CD FILL REQUIRED 2
m CURTAIN DRAIN REQUIRED mSTANDPIPES
ED EX- APPROVAL SSDS ADJ. LOTS
WETLAND (TOWN/DEC PERMIT R & D)
m DATA ON DDS PLANS & PERMIT SAME
m PRE 1969 - NEIGHBOR NOTIFIFICATION
m LETTER BVZBA
m 100 YR. FLOOD ELEVATION
SCHARGE (OK)
;RQ & DEEP HOLES LOCATED
:PRESENTATIVE OF PRIMARY AND EXPANSION
Y. AREA; SHOWN; GRAVITY FLOW, SU.FF.SIZE
PUMPED PIT & D BOX SHOWN & DETAILED
)USE - NO. OF BEDROOMS
ELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM
'PROPERTY METES & BOUNDS
HOUSE SETBACK NECESSARY (TIGHT LOT)
V10OUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE
BENDS; MAX. BENDS 45 W /CLEANOUT
FILL SYSTEMS
CLAYBARRIER
FT HORIZONTAL: SLOPE 3:1 TO GRADE
FILL SPECS
EPTH GAUGES
FILL PROFILE & DIMENSIONS
.VOLUME
TRENCH
TRENCH PROVIDED
60 FT MAX
PARALLEL TO CONTOURS
100% EXPANSION PROVIDED
S
-R UIRED DETAILS SON. :PI;64A1S _ 1s: T0:1? T ;DRIVEWAY,. LfiRGE:TRES,:?'O SEWAGE SYSTEM PLAN - (NORTH ARROW) ' TO FOUNDATION WALLS
DS HYDRAULIC PROFILE m GRAVITY FLOW 100 TO WELL, 200' IN D.L.O.D., 150' PITS
/ J BOX m TRENCH/GALLEY m P- PTT DETAILS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN)
EPTIC TANK - SIZE, DETAIL 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
WELL DETAIL, SERVICE LINE IF OVER 10' TO WATER LINE (PITS -20')
r•CONSTRUCTION NOTES (GRINDER RATE) 50' INTERMITTENT DRAINAGE COURSE
DESIGN DATA: PERC AND DEEP RESULTS C 200 FT. RESERVOIR, ETC.m 150 FT. GALLEY SYSTEMS
TWO -FOOT CONTOURS EXISTING & PROPOSED �L-, SEPTIC TANKS
DRIVEWAY & SLOPES CUT 13— 10' FROM FOUNDATION; 50' TO WELL
FOOTING /GUTTER/CURTAIN DRAINS WELLS
15' WELL TO P.L.
COMMENTS -