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HomeMy WebLinkAbout3471DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1-41 BOX 28 03471 i a P[TIrNAM CODNTY DiWAY� OF 111 ACTH Divlala� dEavbe�meatd HaaN6 Scrubs. C mseL N.Y.14M > to Prw ft Pasty g dis C fflUf OF COMPiJANCE Cp PMW FOR SEWAGE DWOSAL SYS= Fame / �� 2 Taws or v0qe Sobdd. � k .� i`. - -c.. - - a., �;.: xi.,. v :::...•:.,�.a'y._._,;':?...�.. ,r z . :•i �." n .. 1 •C4+- Rfinewnl,k0—Rrv1doo ❑ OwwedAyYcs>< Nswe OElIE2LtiP1VUEN`C _ G - 3 ftt Date d Previous Approval - -- udiog Addl, lei �- 1 � / Town L-inC 4 ma zip T7 CDC d T_..., e..1,A4 -4-4-n Annrnvcrl 1` ` (�) L-��) _Fee Encl.osedig Amnfmt lAW Type t 5 t G� e t /�- _ Lot Area "S C- J - Fm Section Only D,. �S Vdlnme Nltsbee d Bedroom 3 Doer Flow G P D PCHD Nodlestion In Bigobdd When FN Is eospl ted Separate Sewesse Slates to comild of t g U Ga81s Septic Took and To be alostrocted by la it1 �N� �� tJ Adlhea. 1 i11 K pa o cti N Wets Sapptr: PiBe SW* From Address of ,Q fthate s ppb Deed by k) kl\4l6� Address ofber - 1 represent .that 1 am wholly and completely responsible for the design and location of the proposed system(%); 1) that the separate %ewag� disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standard; rules au n% o ream County Department of Mealth, and that on completion thereof a °•Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Departnnanl, and a written guarantee will be furnished the owner, his sucoasaon. heirs or assigns by the bulkier, that said builder will Dyne in }rood operatkg condition any part of said sewage disposal system during the period of two (2) yeas Immediately following thedate of the Isew ance of the appoval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above well be located as - -'n on the approved plan and that laid well will be Installed in accordance with the standard% rules and repuTOTOns of the Putnam County Departins of NNlth. P.E. R.A. Date q- 3L-I Signed - %t 1 3 Address ��� ��1'c } C Llcerae No APPROVED FOR CONSTRUCTION: This approval expires two years from the d issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by, the Commissioner of Health. Any change or alteration of construction requires a now permit. Approved for disposal of domestic sanitary sewage, and /or private wale► Supply only. Rev. 10/88 wa By Title PUINAU COUM°Y D$PAfrll M OF 1;E"M _ d.� DIvYw d[l�vbwat�el HA�If Seedoeo. Car" N.Y. low � �i�G� OF COIIQIJANCB LaaMd at 201-1 �.� �•� �Lx'f M p�`�f ` �/A I:E .. K ., ar VRb v s�ea.bda. No c.t..t Let I TM MeP `I 3 ,1'b !>t� 1 ■�, 4 ` co t1�4c p"m"' I:°d.ia° ❑ Date of Previous Approval 1 / 16 I of Z I mftg A drum 2a -1 ?�:LtY S* • Town F EtL12-`(, Na 1't (o4 3 Date Subdivision ARDroved `I 951 Fee Enclosed ❑ Amnnnt 4i+rs Tyr �'` C1�t'�l,C,.l- Lot Area l , °1 PL .t ff1PCHDN0d&@1IJ=1@ReQdNdWh@oFMkc@mpbI Sectier Dab Deph 3, S Vok � Soo °2•o e Number d ��■ 3 Design Flow G P D b O y ad SWsbw SOwga4p Syatts w amidst of loop tie-- Sep* Tw* said To ba,c 'by %%-AVJ- -A0WIy Add.,,°ss__ uN4CIJ0 W IJ Walar Sapper: Piddle SIB Fran Address an 1�1 stings@ Sop* DOW by use � \Vb1..l t�j Add .a. V h1tL1�1t�1LitV Odw 500 cy o- tt�r�e Ll- a)L ,�►2 1 Mwesent'.that 1 am wholly and Completely responsible for the design and location of the proposed system(s); 1) that these rate sew di YI system above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a rpu ns o� %ii County -Department of Health, and that on completion thereof a "Certificate of Construction ComplNnp" Otisfadory to the Commielensr of Health will to submitted to the Department. and a written guarantee will be furnished the owner, his sw:eofeora. hen Of assigns by the builder. that old builder will Dyed N 9004 .Operating a+ldRlon any Dart of Sid sewage disposal system during the period of two (2) yens immediately following the "to Of the anew area of the approval Of the Certificate of Constructions Compliance of the oiginal system' or any repairs thereto; 2) that the drilled well descri0ed above Will be 16rA*d as sfhdrsm On the aPProved plan and that said wolf will be Installed In accordance w lM standards. rules and rpu a ne of the Putnam County oepartnNnt Of �Me K Date �j 1 j%%j 1',f Signed P.E. R.A. Adar.+r �u�t g�2i a i P. (c, �`�.3' License No APPROVED FOR CONSTRUCTION: This approval expires two years from the data i ed unless construction of the building files been undertaken and Is revocable for cause or may be amended or modifNd wen considered necessary by the Commissioner of NaaRh• Any change or alteration of construction requires anew permit. Approved for disposal of domestic sanitary e, a r e -water supply only.' �y in / . ()eta `f� i By '- s �'"�'- -� 7.lt Lf2f2 '- -'- -"-"7 '�T�— yy� --- - -_ Title � ' ..'��+./ v t ♦�^ .M •up ....��•1 r.[..g: O.R.- '�..C3r�.'+i{`n n•Cr�.0 4• ►!.- s. ^.�[- a..�...� ..... a: .f... �'�...: ��r.:�.�ir. -.r ..�. ..q,;�.:n...{sfy. s•.PVC .. �..1'i�•.C'iti •.. .. h� �++�•r / PunUt[oovNr) MAld OWIDIPMU TB ,1.. w fSBI= OF POD' lt0)! =WA= DIWOBAL BlsflBa[ t.•Md�t� ALA 1 --A gcAC7 Two or va". �. , BtiMaltlw xr.. VIIJC�.!�� . � tic / Tills if" j 13 �� � 1 ..� .0 user/Anhond Hasse. LIN� O�•/r'G1- oPr�EN� Go• NG Dab d PievMw Affroval *WftAiliere -_2�1 L1 T. Ll++L-6 �('teY N.a zip aM .Op Date Subdivision Q,po� Dyed � �P�1 �I-� Fee Enclosed ® nm� „nr �A�..��+roy >~■� 4!e ��i l �� lot Ave. .1 `� L�`G } FBI &Rd= Oiab Depth .ULVehim Is - Pitfi•r d lrie•r . ' DMip Raw, G P D s ftMd'd Wb•. M la eeatyleW Si""&WNW *ON= is ei.it d t o0o Q” Nv a TO& M" Ti IM:eMMMW i.by t.,1 K41)t=)hJ1- J Aalihea• uo Kr- Up WSW Sop* Fain Aalaieea an �Pdynb.Sa* DMW b L.it..) KNOWJhL -Ad&w 1 represencthat 1 am wholly aria completely responsible for the design and, location of the proposed system(s); 1) that tM a crate awe • dis Dal • stom above described will be constructed as shown on the approved amendment there to and in accordance with the standards, runs an ►pu ons o • OouMy D•pa ~t Of M•althr and that on completion. thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be fuelnttted to the Oapartlilaet. and a written guarantee will be furnished the owner. his suecea0n. Mks or assigns by the builder. that old buildw will ~ M good ep•ratblg oonditbn, any part of Sim "wage disposal system during the period of two (2) yews Immediately following the date of the Issu- anle of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto+ 2) that the drilled wait described above WO N IOCat•d ea shaven on the apprews peen and that aid well will be Installed in accordence with the standards6 rules and ree–US o sT—of the Putnam County D•pa sTM of IIeeRIs. Do" Z— Signed P.E. � RA.. Address License No APPROVED FOR CONSTRUCTION: This a expires yea►t'tro M to Onlesr eoriru�t�n of the building has been undertaken and is revocable for cause or may be amMided or modified when con ry 'by the C mmissionW of Health. Any change of alteration of construction V. reeukea a p er�}mit Approved for disposal of don►estk a ego, and /or to water supply only. AA (• i ��P�UTN�AT M COUNTY DEPARTMENT OF HHEALTH :r%- *' -•Y:. =t .; �,� : RG p ��• r. - L '�' �'i :i7' 3Y�%7�] 3 ��° 11 Y 7� a eszT':. ae . CERTIFICATE OF CONSTRUCTION COMPLIANCE PCHD CONSTRUCTION PERMIT # fV- I I -1 -Z- Located at C Kyty-ow Town r V -Ova= /Applicant Name37 CAff& l Mw gt% CAf-P; Tax Map ? ;1 Formerly. Subdivision Subd. Lot # TREATMENT SYSTEM Block ( Lot *1 18 Mailing Address 37 Coeo'T P,*1 lXD S5(<✓t.; ' lvq Zip /o`5r.Z. Date Construction Permit Issued by PCHD Separate Sewerage System built by *57 CA'rA� OW 904) i?3!Address SAC Consisting of 1000 Gallon Septic Tank and 5-00 l-F 'Z' w i tf k654qi tr,J ZKE.-jcK S Other Requirements: • S ��'�� Fl w Water Suunly: Public Supply From Address ME, � Private Supply Drilled by P F 13Y�L � 5�� �.5 0 � NG-. Address S+�e.�s�t� •✓'J I�'% -Bull 'Type "�-•��' Number of Bedrooms 2✓ 1364ft 9. Ral &d Has garbage grinder been installed? 6U0 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: Certified by P. E. X R. 7 9r. -- Address /Nf i?r fit/ r.J.�+ ._v „� `, License # 1 �-5 1 f g.6'.5 t�L' � t V,5-4=7 - Any person occupying premised served by the above s §stem(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 revoc ion, modificat' or change is necessary. lk4 . % _ P By: �,(` --' Title: Date: White copy - HD ,ile; Y copy - Building Inspector; Pink copy - ner; Orange copy - Design Professional Form CC -97 S A �UTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT e9l�oe�ti ®n �OF ���R �T�YDO���T T�u'ij— ..53�f� �•C".:��:s6�I."�weAY' Street address: Church St. Woodland Estates :]I Tit�lnl�.i ..• Town/Village: Putnam Valle _. _r_�— — �_� —_ Tax Grid # �� IMap'73.1F Block p Lot(s) .� Well Owner: Name: Address: V.S. Co ration, 37 Croton Dam Road,'Ossinin NY 10562 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 IlDrilling Equipnnent 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 eft. 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 su . ace - static specify ft) 30' During yield test(ft) 400' Depth of completed well in feet 465' Well (Log If more detailed information descriptions or Ve AiiflSy�P� .. _ are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 2 Drillinq in ove burden clay and bmlders 2 Hit rock at 2' L'.y . ­32 32 465 Drillin in roc If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub_ Capacity Depth 420' Model 5GS05412 Voltage 230 HIP i Tank Type XW302 Volume 86 Date Will Comp eted 4 /2 /gg Putnam County Certification No. 002 Date of Report 6/10/98 W I ller (se) e N i n';: t;xact location of well wtm distances to at least two permanent landmarks to be p9wcled on a stparate stteettplan. Well Driller's NgW, P Beal ans, Inc. Address: 4 Putnam Ave. , Brewster_ NY 10509 Signature: Date: 6/10/98 co al; Vrt White copy: HID File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 - c,<:;'.i�s: s. ,.- ,a.Sa:% :w"QU 3- w <w'",�e..'7si�'r %,�`,+� �..�..:i� ...�-0 ^� ^• norg '..�%n r.a �i»:i:':u v -t ���e "i,�;��'.r:� :�'<ar.�:.� iw- r`s�':m:sv:� :7f- ice' : C:. �..�.; - • rri.:+e : rt nlanics Analysis Data Sheet Form I IN Client Name: P.F. BEAL & SONS Project Name: STANDARD ETL Sample Number: 188064 -01 Client I.D. V.S. CONST. LOT 18 GMURCH ST PUTMAK VALLEY Date Collected: 11- JUN -98 Matrix: 1 DrinkH2O Date Received: 11- JUN -98 Comments: Analysis Result Units Method Analyzed Turbfdlty: .:..:.. : 0 85. ::.. pH 8.2 Remarks: 1 7 Ti1::... 8 4500 -HB 11- JUN -98 l 315 Fullerton Avenue Newburgh, NY 12550 16� AF Tel: (914) 582 -0890 e.... NYSDOH 10142 NJDEP 78015 CTDOHS PH -0554 EPA NY049 PA 68378 M -NY049 Fax: (914) 582.0841 U -e ,. r:.. er.. r— �.. w...,+ �• c�c.. ..-- ._..�,..- .o..i.- •�_.«s..... e.,.a..- . ...- +wea�.:;�.�.,..s a,..� ...- «�.... <_..,n.. ..v. � ...so..:.� __ ...- . _ _ r r--a .._ __ _ ., _ __ _ _ _ _. _ _.. ._. n -+•vin .- w— . ^io.,., �,� , �t ...e _ Severn Trent Envirote -st The following data qualifiers are used to assist in the interpretation of analytical results. Unless otherwise indicated, sample passes applicable drinking water standards. (1) Parameter fails applicable drinking water standards (2) Exceeds lead SWDA action level of 15ug /1. (3) Exceeds copper SWDA action level of 1.3mg/l or 1300ug/l. (4) The results indicate the water to be corrosive. (5) The recommended sodium. level for a moderate diet is 270mg /l. (6) The recommended sodium level for a restricted diet is 20mg /l. (7) Hardness 0- 99mg /l soft 100- 200mg /l moderately hard 200- over very hard a part of Committed To Your Success Severn Trent Plc NORTHEAST LABORATORY OF DANBVRY �i,� .;�,,..�� ,,, :' >p'? r :�= �•��••ir,:;; -�,: ,. .�',,•', � ;;:�F'z. E�•:,� -,�� .e. _5_�,;.-•� _�.. -,.��- ., ,�-•« t•..;� ('�.,7(.,�,Prr );'H`(14Q14.. J�s�; =-' 39 -3 MILL PLAIN Roan - DANBURY, CT 06811 NY Cert: 11471 )203) 748 -7903 - FAX )203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: P.F. BEAL & SONS 4 PUTNAM AVENUE BREWSTER, N.Y. 10509 DATE SAMPLE COLLECTED: 7 /10/98 TIME COLLECTED: 11:30 A.M. COLLECTED BY: M. BEAL DATE RECEIVED@ LAB: 7 /10/98 TESTED BY: LAB# 11471 REPORT DATE: 7 /10/98 SAMPLE SITE: V.S. CONST. CORP., LOT #18, WOODLAND EST., PUTNAM VALLEY, N.Y. SAMPLING POINT: HOSE BIB AT TANK SOURCE: WELL TREATMENT: NONE TEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL CHEMISTRY: Iron <0.03 mg/L 0.30 mg/L Manganese <0.01 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] _ . ml = milliliter .,., tng/L, = milligrams per Liter ND ° none detected NTU =Units I * *Notification Level ** *Action Level l - " G _ - ••� _� _ , .:; ,., RESULTS BASED ON SAMPLES SUBMITTED: 7/10/98 (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director � ra; Cz- Cn °N *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800- 826 -0105 •OUTSIDE CT: 800- 654 -1230 P UT �* -��•: �,�,.��i� -f �;.::., .,s;;» :f � •.vii GUAR COUNTY DEPARTMENT OF HEALTH E ENVIRONMENTAL HEALTH SERVICES CIe.r<..,.ssa.A.�....:..t«...� E OF SUBSURFACE SEWAGE TREATMENT SYSTEM lub, Iric- Owner or purchaser of I luilding c/o 37 Croton Dam Road Corp. Building Constructed by Location - Street Ags t PoiV Building `type I represent that I am w construction and drainal that is has been construe accordance with the stain hereby guarantee to the any part of said systei immediately following t sewage treatment syste operate properly is cause system. �- _.._... The undersigned further Director of the Putnam ( to ooerate etas camas d b e General Corporation Name (if cc c/o 37 Croton Dam Address: 37 C'rnton State ossini 73t 10 1 4 Tax Map Block Lot L% Town/Village G t,JcA 2 3 Subdivision Name Subdivision Lot # illy and completely responsible for the location, workmanship, material, of the sewage treatment system serving the above- described propt:rty, and d as shown on the approved plan or approved amendment therett'), and in trds, rules and regulations of the Putnam County Department of He and vier, his successors, heirs or assigns, to place in good operating c)ndition constructed by me which fails to operate for a period of m o years date of approval of the "Certificate of Construction Compliance' for the or any repairs made by me to such system, except where the f iilure to by the willful or negligent act of the occupant of the building utilizing the agrees to accept as conclusive the determinatio 0 aunty Department of. Health as to whether ci of e i the willful or negligent act of the occupan�t.�of b the Ptablic Health lur t the system ldi gtili:;ing the Day 2 4 thyear 1998 Signature: a ;) -Signature Club, Iric, Qration oad Corp am Road dip 10562 Title: President Corporation Name (if corporatio:­i) Address: State Zip,_ Foim GS -97 TOTAL P•02 PUIJTNA M •V 1C' rOJl� U ♦ N iTl\ RY D� EP'A1.� Rr T A M � •E. N�T .. � OF HEALTH `R wr ifVlrlVN' E` CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P��' (f -�ZZ Located at G Kyrr� Town r Village KvTN.tu'l► A owner /Applicant Name-37 CAKM thw 9P, C,00.¢; Tax Map 73,19 Block Lot 4'1 Formerly Subdivision Name Mailing Address 37 Date Construction Permit Issued by PCHD Subd. Lot # 18 Separate Sewerage System built by e &AdM� Pbq ftre Address SttV i// Zip /oSr.Z Consisting of Gallon Septic Tank and 500 L.F 2 y< A-65041-2r,l 7�.-JGK� Other Requirements: -&-s' O� �S� Fl f✓t,- Water Suppb: Public Supply From Address 4 f tMa4L. , or: X_ Private Supply Drilled by .5, t N6-. Address BKews T� g Building Type /rD�sJ77KZ Has erosion control been completed~? Number of Bedrooms �; gM %4n i9e5i6dHas garbage grinder been installed? M 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: Certified by Address l vsI .X /? Po" Any person occup to secure the com treatment system of the private wa; ' approvals are sul.; revocation, modif: White copy - HD Fi i For- a :~ Cl -Cash Check r ., LTH DEPT ` 017 8 4 7 '8 -6130 n6 +o _�� ' , �. 1c! Fl, a ! Y 0- ;J NAM COUNTY DEPARTMENT OF HEALTH DIWSION-.O.F-ENVIRoNMENTAL.UAL7H-SERVICES- ZZ n:r.Y'vr� CONSTRUCT PERM R SEWAGE TREATMENT SYSTEM PERivltllll N v Located at C U CI P. or Village &vrr ✓RLr y Subdivision name 4 C ?2 subd. Lot # _ ax Map 7316 Block I_ Lot _ Date Subdivision Approved q qf� /1Q- Renewal _ Revision Owner /Applicant Name' 0QoTON PAPI Roi4D CBRh? Date of Previous Approval Mow, I Mailing Address W C,00foy Q -/A kaa oZWIyg &&14161K Zip Amount of Fee Enclosed i✓��1 Building Type ES /Ot�ITT1A1- Lot Area No. of Bedrooms 3 Design Flow GPD &0 FBI Section Only Depth � Volume Seumte Sewer�ae System to consist of Ago gallon septic tank and r0Q 1-F a' wipF .a �BsoR �N �,�AKHFS Other Requirements: , To be constructed by Address Ui AUWA/ Water Supply.. Public Supply From Address _ - __- t': - z"- '........ _.,�. o..�._. ,.... ®g._ Pnvate Supply Drilled by Address 1 r I I represent that I am Wholly and completely responsible for the design and location of the proposed system(s) and that the arate.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 park 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. `- , . . AddressX� IT - -syAy ING A LANt?S hfe &cjQ2&&e PC. License # aq3) -zz fSfz&wST&iz lv toSo7 APPROVIEID FOR C0NS?3t.TC 101: 'I'�is a�proval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Approved for ischarge of domestic sanitary sewage, only. By: �.2�i' Title: r �' L. Date: t) White copy - HD File; ello co - Building Inspector; Pink copy - ner; D ge copy - Design Professional \ - Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH W ►� ,jQ,FJ ENV�R, MENTAL HEALTH SERVICES _ f - .�z�':t:�:': •_ .a.r - ::Y v.�.Se's.:�.�.isi�.•* :7• «,fir .��'•�",�i:- ':.�.:�'- ..�'.�'. .n..:._.,:: -@ °' "'— - / aa+�••.t=_ , iT,.. rxTi 7^��!%"iw*^ii`iir`a�:Sa= s•t'$ CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMI Located at 66c)PZ41 AQA Q Town or Village Pvr, l�n 1/�+'r- �-45`i' Subdivision name LIAlcA2 S Subd. Lot # Tax Neap 73. /9 Block Lot Date Subdivision Approved T ��9 Lic,gn Renewal _ Revision Owner /Applicant Name 3-7CRp7b,, I A4en yAQ <g&A Date of Previous Approval Mailing Address 37 j5Ag � ,OAM &AD Zip /056,2 Amount of Fee Enclosed 300,00 Building Type riAL Lot Area No. of Bedrooms 3 Design Flow GPD 60th Fill Section Only Depth , S Volume % C• PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage Syltem to consist of Moo gallon septic tank and Other Requirements: To be constructed by i /I�;� t�u�✓ Address GknO :...._.teic Sttnu . - Public Supply Fbor Address Private Supply Drilled by _ Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed :. Address P.E. R.A. Date L2088 G - License # lqov-t#,� R' 'rd<- NY 1.0S0 APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it A roved for di harge of domestic sanitary sewage only. By: Title: sr.��' �} Date: 2j to e White copy - HD File; Yellow copy - Btu ding Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 e VTNAM COUNTY DEPARTMENT OF HEALTH DnqSRON OF lENWI18ONM ENTAIL HEALTH SiEIf W CES <.. - ? f $, SON T �G�21`s?�,'I' LfJOC A- WA'1r'IER WELL t,. z PCHD Pe'r - u . 'please print or type - -. _. ,. — . - - rmlt # ...���� WeR Location: Street Address: Town/Village Tax Grid # ckbfzz �l � Pur�g,� 11AL 9Lf Map 73,10 Block Lot(s) WeH Cwimeir: Name: 37 UaZv bAm AMO 401t, Address: 37 eAa7cv✓ 44&1 R.,/J . OSSWI44-1 A-Y /DSK�Z- U Residential Public Supply, Air /Cond/Heat Pump Irrigation - ms� Business Farm Test/Monitoring Other (specify) 2-secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served 4 Est. of Daily Usage ,2O gal. Reason ffo>r Replace Existing Supply Test/Observation Additional Supply DrflUng New Supply (new dwelling) Deepen Existing Well Detained Reason ffoir HDnUing . WeU Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes_ No Name of subdivision 4./,u CcmL 71 Lot No. AR Water Well Contractor: +✓ '."4r t r✓ Address: !/ wi✓ Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: %y Proposed well location & sources of contamination to be provided on separate sheet/plan. v PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION.- This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue 101 q 5 Permit Issuing Official: . Date of Expiration ® Title: Pe>r>m>iit is Ikon- Tirensff irrra e White copy - HD file; Yellow copy - Building Inspector;— Pink copy - Owner; Orange copy - Well driller Form WP -97 //� �N S T �/ E .. ,t '�..r� . / .•rt��.r , e ..r v:'i `a=r• t Gti v'.. at Z� JI.. ,i: �: Lr�G:7:�Y; .r�+ F�� %.�L7;... - "iY. /1�:i= •7 �: lcV_.iX, .. _ .. ._ .. _. _LA NDSCAAFAfidPl C. July 29, 1998 Mr. Adam Stiebeling Assistant Public Health Engineer Putnam County Health Department 4 Geneva Road Brewster, New York 10509 RE: Lincar 3 Lot #18 Church Road Tax Map #73.18 -1 -41 Town of Putnam Valley Dear Mr. Stiebeling: This letter is to respond to comments in your department's letter dated July 10, 1998, and subsequent discussions with Michael Budzinski, P.E. Due to your department's concern with the quality of the R.O.B. fill on the above - mentioned project, our office visited the site to perform two additional percolation tests in the fill pad. Stabilized percolation rates of 5 min. /in. and 8 min.An. were obtained (data sheets attached). An additional visual observation concluded that the full 3' /z -foot depth of R.O.B. fill was clearly brought to the site, and was typical quality R.O.B. gravel. In conclusion, we believe the R.O.B. fill is clearly better than the underlying soil and has a faster percolation rate than the underlying soil. The previously achieved 30 min.An. perc rate was obviously an isolated pocket.in the fill pad and not representative of the entire fill pad. Should you have any questions or comments regarding this information, please feel free to contact _. ......, -: }Very truly yours, l INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. By: Jeff ontel o, P.E. r ineer JJC /JMwfjms Insite File No. 91147.318 07N98as.doc 1485 Route 22, Brewster, New York 10509 (914) 278 -4990 Fax. (914) 278 -6392 ❑ 7 D ®Lavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -1742 www.insite-eng.com DEPARTMENT OF HEATH .Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 July 10, 1998 John Watson Insite Engineering & Survey Route 22 Brewster NY 10509 Re: Limcar III, Church Road, Lot# 18 TM# 73.18 -1 -41, Lot 918 (T) Putnam Valley Dear Mr. Watson: BRUCE R. FOLEY Public Health Director This office has received and reviewed the most recent set of construction plans for the above mentioned project, on July 8, 1998; we would like to offer the following comments for your consideration. Review of percolation test data.of (April 30, 1998) in fill placed on the above referenced lot show results in the design range equal to that of original recorded perc results in existing in situ soil, (21 -30) minutes per inch. n1 mu Qfe'Withih the 2Y-30 minutes per inch design range, with hole 91 at primary, 15 minutes per inch and hole 92, expansion at 30 minutes per inch. Original record of percolation rate "Design" is at 22 minutes per inch. Putnam County Health Department current polices and procedures require stabilized fill percolation rate to be equal to or less than the soil percolation rate upon which the design is based. Caution should be noted in the adequacy of fill material being placed in area of SSTS, to be in compliance with current Putnam County Health Department Standards on fill material. Please feel free to contact us if any questions arise. ASB:tn cc: Robert Morris, P.E. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ENGINEERING, SURVEYING & LANDSCAPEARCH.ITECT(IRE, : . LETTER OF TRANSMITTAL �.. s ".li'.5�:�: .,.0 •Z . -. .=P.C'• i.��:; ...- ai.�.._�+- �v w.�- .i'....R.•c'�0 ._Ri�G,.a„'1 >S +i�.. *. Route 22 (914) 278-499(Y' ^ • - Brewster, New York 10509 (914) 278 -6392 7 Del-avergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter Date: Job No. R 1 9 7 '5 ( 8 Attn: Re: [�ttached ❑ Under separate cover via 01-prints ❑ Plans ❑ Change Order ❑ COPIES i NO. DESCRIPTION �°crr►srRvcrc OD �i'1 pti51 DA�A- 5(4F-Cr 3� 8 cP -�� the following items: ❑ Samples ❑ .Specifications THESE ARE TRANSMITTED as checked below: _ . '�7 1- cr•appiovz' Gnpro Ngrl:1 Si ;il)i ltieO_. ,.. I1 RESUDiTIIl y R`1 ?lei ?:r•aL�pfCV21 - ^- . ❑ 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: SIGNED: v IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE Lot98.dot 0 PUT NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -- AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: 37 Crnfnn nam RnAa ror'p I, Val Santucci represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: 37 Croton Dam Road roxrp Having offices at: 37 Croton Dam Road', "7r;0­_Si ni ncr _ My 1056.2 Whose Officers Are: President - Name: Val Santucci Address: 37 Croton Dam Road, Ossining,. NY 10562 Vice President - Name: Address: Secretary -Name: Michel a Sariticci Address: - ~37 Croton Dam Road, Ossining, NY - -10 -562 Treasurer - Name: Address: and that I am and will be individually responsible for any and 411 cts f th ora with respect to the approval requested and all subsequent acts relating th4r�t I'lic"IP Title: . Sworn to before me this 1 3 ttday of January (month) 9 8 (year�j Notary blic MeryAnn, Diamond otary Public, State of New York Qualified in Rockland County Corporate Seal lNo. 487-1934 34 Commission Expires Form CA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH L:r1 �i- �a. T T Ea .Rir r.�. a' ey..a..... J sf..�:...,.Ey.'... v- n!r..+, as'N. a'.- y.•. n +.:iY:r.w<+- '.- +...:. : ��y:�.i. LETTER OF AUTHORIZATION RE: Property of St Theresa's Subdivision (�J-,Linear III) Located at 4CRVACE AOAn TN PM/pn IIALLZY Tax Map # _7 3,1 g Block Lot �. _ Subdivision of I-Jn/Co L Subdivision Lot # I Filed Map # 24'33, Date Filed Gentlemen: - This letter is to authorize Insite Engineering & Surveying, P.C. (Jeffrey J.Contelmo, P.E. ) a duly licensed Professional Engineer — 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 y` ...' F „1 :j A �....� ..it'7` rotiC�,� acxi hP Qac.1'i' visions.. c) .,.e ., ,'u,,� -or -I.. Law, and the Putnam County Sanitary Code. T T t Very to CountersigneS61 Signed: P.E., R.A., # A - E Mailing Address Insite Engineering' & Mailing Address: 37 rre)4i6n•„n81m,-Road Surveying, P.C. Ossining, NY 10562 Route 22 Brewster State New York Zip Telephone: ( 914) 278 -4990 10509 State New York Telephone: 914-739-7362 Zip Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS i'. - ;:rii��'.: _ t(r�. 66 ... T♦ ��S "�i� i STREET LOCATION NAME OF OWNER REVIEWED BY �Wiqjak- c 7T, 4, P, 6L DATE 2 ��ERMIT DOCUMENTS APPLICATION WELL PERMIT _ PWS LETTER UTTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) C`0 TE RESOLUTION SHORT E , 1 PLANS - THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST 1-1 J SUBDIVISION SUBDIVISION 'ISION APPROVAL CHECKED PERC RATE C FILL REQUIRED - DEPTH C TAIN DRAIN REQUIRED STANDPIPES GENERAL 1,06ATED IN NYC WATERSHED P NS SUBMITTED TO DEP r EGATED TO PCHD EP APPROVAL, IF REQ'D DEFPTEST.HOLES OBSER :'ED;. =, ARCS WITNESSED, IF REQ'D APPROVAL SSDS ADJ. LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) I TA ON DDS PLANS & PERMIT SAME 1969 NEIGHBOR NOTIFICATION L ER BI/ZBA I YR. FLOOD ELEVATION Ji3'fHER REQ'D PERMITS) REOUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE_ GRAVITY FLOW CONSTRUCTION NOTES DESIGN DATA: PERC & DEEP RESULTS T CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT FOOTING /GUTTER/CURTAIN DRAINS � 9 1� jt� 'bat , , TAX MAP # -7 3• I g PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION f6CATION MAP Pf ' AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE DUMPED, PIT & D BOX SHOWN & DETAILED t,�O FUSE - NO.OF BEDROOMS WS & SSDS'S W/IN 200' OF PROPOSED SYS. P, PERTY METES & BOUNDS PUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1/4" FT, 4 "0; TYPE PIPE BENDS; MAX.BENDS 45" W /CLEANOUT FILL SYSTEMS 2LAY BARRIER P- FT. HORIZONTAL;SLOPE 3:1 TO GRADE / FILL SPECS FILL NOTES` FILL CERTIFICATION NOTEa DEPTH GUAGES /ILL PROFIL DIMENSION VOLUME FILL IN EXPANSION AREA TRENCH r� LF TREN ^I I P. ^.,VID n � (bO FTTvi X ®;P PARALLEL TO CONTOURS 100% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN - FROM SSTS 1' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL :rO' TO FOUNDATION WALLS _15'WELL TO PL 100' TO WELL, 200' IN DLOD, 150' PITS }00' TO STREAM WATERCOURSE LAKE (inc. expan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATERLINE (pits -20') 50' NTERMITTENT DRAINAGE COURSE 200'/500' RESERVOIR, ETC. _150' GALLEY SYSTEMS 15'min to CDS= >5 %;10'- 4 0/o,25'- 3 1/o,30'- 2 %,35'- 1%,100' - <I% 20'min to CD discharge /I00'with 182 cons day discharge SEPTIC TANK 10' FROM FOUNDATION; 50' TO WELL FORM ST -2 .. _1 1 INSITE-0 SURVEYIN(ENGINEERING & - P.C. Route 22 914 278 -4990 Brewster, New York 10509 Fax: 914; 278 -6392 .�i"�' 2 Wappingers Falls, Ne! w rk 12 91 "Kx '".� TO: ! �✓ l IIO LETTER OF TRANSMITTAL DATE Jo AWWtM N CJ~- CKJ RE: Lr.vcA2 4a5Mtb5 1-67' /J6 / /59% F104 3 -7 /Jn as 49x-a.° ❑For your use ❑ Approved. as noted ❑ Submit copies for distribution 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 ..... ..... ...................... :........ ........... ...................... .................. ....... ............................... ...................................................................................... ............................... ............................... .......... .................. .....�_? -p .................._.........__................... F! _.._.. .. ....... _ ... ..... ........__.... _.............................. 1: _.................................:.............. ... .8......... .......... ........ ...1 ..... T....................................................................... .............................. ......................:........ 3 r ..._ ........ __........._ .. f �F'! v� °-_ Q.!, ►' ___�._.__.. ___... _.__._ .._ _.._ _._....... ............................. .................._.. c..:........... ....0 ..... _ ... u�► r,a,y ,�lti _ __. _...._.._.__.._ _ . _ ..._ .....__ ........ _...... l31...� THESE ARE TRANSMITTED as checked below: �<For approval E] 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 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY TO: OR &u, , �I JAM SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE r/ DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 TT (914) 278 -6130 ^ /,•C�i� 1..^� Bpi s�y..r "iil• � i �/ t:U`la J l��i:rf i°'71j ::..'@.:%. Yl>r _:+::i'.i Y'- .a�«ari.,:_, y,��a:..1 "'se�l n5?:i. PCHD PERMIT . WELL LOCATION Street Address CHV P4- P Town/Village/City �. Tax Grid Number 01 --- -- 41 .WELL OWNER Name W Mailing Address c.. ?_6f L.I L 704-- Wrivate ,D Public USE OF WELL ..l _ primary secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ® ABANDONED 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify O INSTITUTIONAL 0 STAND -BY AMOUNT OF USE YIELD SOUGHT gpm /# ® REPLACE EXISTING SUPPLY EW SUPPLY NEW DWELLING PEOPLE SERVED /EST. ® TEST/ OBSERVATION ® DEEPEN EXISTING WELL OF DAILY USAGEaI EX ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ®DRIVEN ODUG ®GRAVEL. OOTHER IS WELL SITE SUBJECT TO FLOODING? YES __NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:1✓f�� Lot No. 1,45 WATER WELL CONTRACTOR: Name( Address:_ IS PUBLIC MATER SUPPLY AVAILABLE TO SITE: YES ___X_NO NAME OF PUBLIC WATER SUPPLY: 9L TOWN /VIL /CITY --,1 _ .. MTANCA TO PIPPERTY.. FROMf. PIEAREST WA:TER_. MAIN : �- ✓:.. — LO TI0 SKETCH & SOURCES OF CONTAMINATION PROVIDED 0% 30 q N SEPARATE SHEET (date) ( gnat r ) 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 thirt3• (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 manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: Date of Expiration Permit is Non - Transferrable 3/89 19 19 Permit Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller 1 .. .w v: �S•r..JI•. C:.IY`_a: ..[ r � r,i �' li � w.. v �'. -..t.r �e �rti'.aiw•w.:': .`ia_v.iJ�.:.sc. f, • 1849, ROUTE 6 CARMEL, NEW YORK 10512 (914) 225 -6200 May 19, 1992 Pump Pit Design for SSDS for Lincar Development Co., Inc. Lot 18 of the. Lincar 3 Subdivision Design Flow 600 gallons per day Use peak hourly flow 10 times average daily flow Qpeak = (600)(10) 4.2 gpm (24)(60) Static Head ± 17 feet C = 150 d = 211 L = + 190 feet GPM = 22 gpm Equivalent L (Bend & Valve Losses) _ ± 50 feet Total L = ± 240 feet Hl _ - f.e _....... __._.- ,10.44 /Tnta�, C =P�h .5 t _ _ 7 z ..,., .. .. _ ... , .. c,.; .. . `.i� Ste; ; ..,. � � .. _. , ., .. � .a. — .. .., r---. w.,. , ...� _ a.=. •v . ..... . �,..,__ ... . Total Dynamic Head (17 feet + 2.5 feet) = 19.5 feet Use Gould Pump model # 38714/10 HP (or approved equal) This pump will pump 22 GPM with a total dynamic head of 19.5 feet . ,i , F � 6 ,MODEL FEATURES SPECIFICATIONS MOTOR Impeller: Thermoplastic Semi- Pump: o Single Phase: 0.4HP,115 or 230 Vortex design with pump out vanes for o Solids handling capability: Volt, 60Hz, 1550 RPM, built in over mechanical seal protection. 3/4" Maximum load with automatic reset. Casing and Base: Rugged o Capacities: Up to 55 GPM o Power Cord: 10 foot standard thermoplastic design provides superior o Total Heads: Up to 24 feet length, 16/3 SJTO with Nema 5 -15P strength and corrosion resistance. o Discharge Size:1 ' /z" NPT 3 prong grounding plug. Optional Motor Cover: Thermoplastic cover ° Mechanical Seal: Carbon -Rotary 20',length, 16/3 SJTW with Nema with integral handle and float switch Head/Ceramic- Stationary Seat, 545P 3 prong grounding plug. attachment points. Buna N Elastomers. Fully submerged in high -grade Temperature: 140 °F (600C). turbine oil for lubrication and efficient Power Cable: Severe -duty rated Maximum. heat transfer. aad_water.r . resistant. p- FasteDers.�.3Q0,Series,Stainless ..___...�..�a .. No gaskets to replace during Capable of running dry without Available for automatic and maintenance. damage to components. manual operation. Automatic Stainless steel fasteners. models include Mercury Float Switch assembled and preset at the factory. . APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump Water transfer • Dewatering r..,". c.,.- -.- t,,. Et'eytive December. 1 ?'-. ti 10 8 9 ------------- 4 3 i 2 PARTS 1. Impeller 2. Rugged thermoplastic base 3. Rugged thermoplastic pump 5 casing 4. Mechanical seal 5. Ball bearings -6.' O-Rings cord-- 8. Oil filled motor 9. Cast iron motor housing/stator 21 assembly 10. Thermoplastic motor cover PERFORMANCE RATINGS GU 's I L 1 ca, I) 6 Ix,7 d MODEL ;3B7 DIMENSIONS (AJ1 dimensions In Inches. Do not use for cons"ion purposes.) MODELS fft I k , V 1 1/2 INPT 3 3/a ., Series HP Gallons Total Head Per (FT of Water) Minute 5 53 10 46 15 36 20 .21 24 1) GU 's I L 1 ca, I) 6 Ix,7 d MODEL ;3B7 DIMENSIONS (AJ1 dimensions In Inches. Do not use for cons"ion purposes.) MODELS fft I k , V 1 1/2 INPT 3 3/a ., Series HP Volts Phase Max. RPM Solids Amps Handling Power Cord Length Wis. (IDs.) EP0411 115 12 10, 20 EP0412 230 6 10, EP0411A 4/10 115 1 12 1550 1/4, 10, 21 EP041 1 F 115 12 20' 20 EP0412F 230 6 •20' 20 EP041 1 AC 115 '12 20' 21 �7- ^,t C!.., r ",7 - , "n.n., SPECIFICATIONS APE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U S.P. METERS FEET MODEL: 3871 SIZE: 3/4" SOLIDS 0. 8 25 7 wg 20 5 95 4 ®.g 90 2 5 9 0 0 20 30 40 50 GPm 0 90 10 12 m3/h CAPACITY �.... �G ®UL ®S PUMPS° INC. SBC-CA FALLS NEW VCW 8148 l Effective October, t 98E p •c: c cyper P -'"rnr Inc SDFCIFlClTION.S ARF SUBJECT TO CHANGE IVTHOUT NOTICE PRINTED IR U.F t PUf L'-,M COUNTY DEPARTMENT OF HEA H DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date SZK Re: Property of 1114CAF M \,LDPjE14A C2. IWG. Located at (X-}(,) P17, ,j''j %UEY (T) 1�4,TA-Am ection '73,1F. Block Lot Subdivision of L1NG/ `3UP�P1�%1�1pti1 Subdv. Lot # I�'j Filed Map # 2433-3 Date C1 29 Gentlemen: This letter is to authorize INN-1. EVA 611AEEP1U AND LE5W EL a duly licensed professional engineeror 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 c;oni—ctioii_ rim. M `t? iro mato er, and. to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours,,` Signed Countersigned: P.E. , R=A- , JE�f � �N1�LMb,PE. 16*T -- WONeMNa AND G�iGN . Address CirA - 295, (jp?c o Telephone r r ,poperty,. POEM 00 INC. Address Lk #tx-- BEY, N� 1 tyl - Town :-)0/ 19+0 --f-1700 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 5zgz��j. Re: Property of OWCAr i�EVEL-bt" MEI-4i CO. Located at Cj�{,j {� R.ttNAM YA U, ,EY (T) /°&TNA/n Section. 73, / Block Lot Subdivision of LIPIG/ �IiVriQl�l Subdvo Lot Filed Map # -24.535 Date Q 29 Gentlemen: This letter is to authorize MOW RI_ 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 system or' systems' iri'coritormity 'w"ith the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours Signed Countersigned: PoEo, e, # INaS WO NEEMWIJ AND MSQ4 , W Address VA 6 Telephone Address LIME MAY, W J INA?, Town :-> 6 / 440 - %-700 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services AFF CORPORA` FOR PE14IT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for- ONO)?- PeyEwmwi WAW, represent that I am an officer or employee of the corporation and am authorized to act for Name of Corporation) having offices at %!)I LA?)tF*y fAj !gjaWdU0ar r Whose officers are: President: 0 A,,,4 L/_) /V Ll &k G-C (Name and Address) Vice-?resident: (Name and Address) Secretary: (Name and Address) Treasurer: (Name and Address) and that I am and will be individually responsible for any and all is of corporation with respect to the approval requested and all subs nt t ing thereto. F I-, Sword to before me this day o o f fyLa A V Notar--, Public E QFNOTARY P UBLI -N" EW jER Mi qRMM'ssion Expli-es. une 24, Title: Cnrnnratp Spa J: PUTi.GCM COUNTY DEPARTMENT OF HEA_ aH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: ]Property of 1N E PL\1E1,C� Ew Co. luc Located at b-UWAA P7• V-41EY (T) /° rA-Am koJL-L � Section %1, / Block Lot Subdivision of L�1JIP�1Vl���l Subdv. Lot Filed Map # 243313 Date q rN , Gentlemen: This letter is to authorize W50t- 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 �._ system or systems in conformity iC? ^.• - 'iz"" i 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed Countersigned: P o E 0 9 9 deffm--f d- Address TACA ' Co C40EL I1V '0512 Ctvf� - 2q5e (,OM Yelephone tm (X-) INC. Address LIME Efl?f, W 1 h&45 -Town 0/ 140 - �7op Telephone PoaAM COUNTY DEPARTMENT OF HEALTH ` Division of Environmental Health Services AFFIDAVIT - CORPORATE OWNER APPLICATION V/ii�� �PEf4111 111\` tU17�11111i� PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: I, 6,,111,4 L,6 A.1U&k,Lr7 _ represent that I am an officer or employee of the corporation and am authorized to ac: for LINCAV- DENt-.1.�NJ CG INC. (Name of Corporation) having offices at U��,'�(: Whose officers are: Pres -cent: f _ E ,. (Name and Address Vice - President: (Name and Address) Secretary: . r '( Name and - Address) - Treasurer: (Name and Address) and that I an and will be individually responsible for any and all is of corporation with respect to the approval requested and all subs nt actuating thereto. Scorn to before me this _�_ day Signed: of ]Rotary Public NOTA AR PUBLIC FAUSTIM, M! Commission Ex ,, , �EW JEV' G e June 24. 1gcj,j r 'C Title: Corporate Seal .r. ` DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 _ 914 278-6130 _ APPLICATION TO CONSTRUCT A WATER PCHD PERMIT # Py 114 ? -- WELL LOCATION Street Address C."09C_1.4 races Town/Village/City Tax Grid Number 13 . b - l - 41 WELL OWNER Name Mailing Ltwo -"r- 0e'4EwR -tit CO' jrt Address LortLE r-ee-p_-f, OPrivate Z4b1 Ue*_= _Tj St 1-A3 V1 b43 0Public USE OF WELL .0- primary 2 - secondary &RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS 0 FARM O TEST /OBSERVATION 0 OTHER (specify 0 INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY AMOUNT OF USE YIELD SOUGHT S gpm /# 0 REPLACE EXISTING SUPPLY KNEW SUPPLY NEW DWELLING PEOPLE SERVED 4 /EST. OF DAILY USAGE 600 gal 0 TEST/ OBSERVATION. ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED ®DRIVEN "DUG ®GRAVEL. OOTHER IS WELL SITE SUBJECT TO FLOODING? YES ")< NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: L.VNCL�tZ -3 Lot No. l Q> WATER WELL CONTRACTOR: Name k--XNKNDW t­� Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES VC NO WAX OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER N1Aily LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 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 manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19 Date of Expiration 19 Permit Issuing Offici Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller DEPARTMENT OF HEALTH Division of Environmental Health Services 10 OLD ROUTE SIX'CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 ,--�. r .. r . ��,�,�= - �_ • "` �{'�'�Sr�?R�iC'T �'�:tnl��� -�r;Is PCHD "�:�.....p ERMI T -.-: x..-- ,-, ., • / # '� " WELL LOCATION ' Street. Address CA .,Town/Village/City Tax Grid Number 'FuiUAM MALLPY 7 _ WELL OWNER Name s Mailin g Address � - RYLI Nd 11A5 rivate A3 Public .USE OF WELL �- primary 2 - secondary RESIDENTIAL, 0 BUSINESS O. INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM p TEST /OBSERVATION, D INSTITUTIONAL O STAND -BY O ABANDONED p OTHER (specify Q AMOUNT OF USE YIELD. SOUGHT gpm /# PT:OPLE SERVED /EST. OF DAILY •USAGE (lO Jgal REASON FOR DRILLING 17 REPLACE EXISTING SUPPLY gpNEW SUPPLY NEW DWELLING) 0 TEST /OBSERVATION D.ADDITIONAL SUPPLY 13 DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE SDRILLED aDRIVEN OGRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES - -NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME'OF SUBDIVISION: L INCAR N6V V)6) Lot No. 1Q� WATER WELL CONTRACTOR: Name Address: IS.PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: WA TOWN /VIL /CITY DISTANCE, TO...PROPFjtTY,FRQM. NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED I/A? MON SEPARATE SHEET (date) INJ G949mleture)l 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 suck / a anner as not to degrade or he se contaminate surface.or groundwater. Date of Issue: Gb 19 E Date of Expiration! - 19 ermit Issuing Official Permit is Non- Transfe rable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller 10 �,��V ENGINEERING & DESIGN, P. C. yb Brewsw Awnue, Carmel, Neu, York a o3 j a DATE JOB NO. PTIf Nl to . � '.�a,. L =C 11 @•.Cj�j'r�; •n T: r +awl o: - .� -S•.' - RE: F1 t..L 19AM -� T5 Or- 'LINCAE iYl Cc j lC1(GN t7tAWING /SOPy Flu— 0AAi- 3 conie.S WE ARE SENDING YOU VAttached D Under separate cover via the following items: O Shop drawings O Copy of letter O Prints Plans 0 Samples .0 Specifications O Change order 0 COPIES DATE NO DESCRIPTION . F1 t..L 19AM -� 3/-j-6- 92-.• CO-1 Cc j lC1(GN t7tAWING /SOPy Flu— 0AAi- 3 conie.S l ett or- AU1"6? -I M0N A�AD AFf-IDAVIt • cWNE,R3}p1P —. -- )kPPU CNM14 VW- AFMAL 01F A 1r SMMIEP I >P> L 5�`�5tEjj 1 S s Z '914 CflWK- IN tNE AMCWt O •.,, acozo - -- De5ic,4 PAPA 5ftj�t t s a A Ic toN t) gL-* et- A WR WaLL a, THESE ARE TRANSMITTED as checked below: For approval O Approved as submitted O For your use 0 Approved as noted O As requested 0 Returned for corrections O For review and comment O O FOR SIDS DUE REMARKS 0 Resubmit copies for approval O Submit copies for distribution 0 Return corrected prints 99 O PRINTS RETURNED AFTER LOAN TO US COPY TO: S�Gti'ED � e N "� __ ENGINEERING & S 1 / L.0 SURVEYING, P.C. Route 22 (914) 278 -4990 Brewster, New York .10509 Fax: (914) 278 -6392 7 DeLavergne Avenue _ (914) 297 -1742 "4.sagil ' . r��x;... .�..r^i''1��.:•�''.�rn�'.ir*A•� ..Q•w"'t{'i� c:: �.:.i ti i ♦ -..sue ;._:,�..u`. ::i TO: LETTER OF TRANSMITTAL DATE r� JOB NO. q �I Z%, jU Z cl t 47' 318 ATTENT N -. �. ry�. i. vwS:.!* v. � .'M1= �i•`,.r..- `,.+pl'.;.snrn -. r:.w�r��`I�i ..s'a'ri -•c,. . .� RE: ❑ Approved as submitted LOT— Resubmit copies for approval ❑ For your use. WE ARE SENDING YOU Attached ❑ Under separate cover via the following Items: ❑ Shop Drawings JM� Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change Order ❑ THESE ARE TRANSMITTED as checked below: ,�Eor 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 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: COPY TO: lJ� SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE ` PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTR SERVICES FINAL SITE INSPECTION Date: -7 13 .rte T p , i'�' '� n f.1 f. r__•� .�i:ocati :•. _1 �_:.. ,"�'...`i +Afa•:- :..ten_... _ r �.�} r�bY f.. r'l ".;Y^.1..l.K q' IM�V. w••�ev, ae.r t'-A1F Street Lli.��11.3"v'�rs'Cl•U�'`. ,� C. +'•' n C wv rz( V1 i g 4 Owner � t V4C'd)1_ ►mot t Town Permit # TM #. (, T I Subdivision Lot # is 1. Sewage System Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 4 3:1 barrier Lgth. k'O Width R8 Avg.Dpth 3.,,5 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, 250 ......... other ................ b. Septic tank installed level ................ ............................... c. 10' .minimum from foundation ........... ............................... d. Distribtuion Box . All outlet at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box - properly set.. .................... ............................... I - �ngtFi required � Length installed M 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. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1%" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... g. Pump or Dosed System ize o pump mp cha 66e s r ................ ............................... 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/Buildin a. House located per approved plans ... ............................... b. Number of bedrooms ....................... ............................... IV. Well a7-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 & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto .exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev.. 1/97 onn PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION P_FRINIIT STREET LOCATION My 2�tf -� - R . I.mr'I 8 NAME OF OWNER aC2m �� N�/ F4W� X61 REVIEWED BY NO A-vv\. . S�i✓� Lt t-k DATE ?-16 q TAX MAP I- V DOCUMENTS ERMIT APPLICATION WELL PERMIT _ PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION d SHORT EAF) u� PLANS - THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST J T l FEE SUBDIVISIONS 1 �i vivo LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE Y"" REQUIRED '3 EPTH CURTAIN DRAIN V.FNERA:i STAMP S / , R / TED IN NYp WAT S SUBMITltD TO D E ATED TO CHD APPROVAL, INUOD RVED ,f,EP TEST HOLES v:), D, It - APPROVAL SSDS A.D.J. LO ETLANDS (TOWN/DEC PERMIT DATA ON DDS PLANS & PERMIT PRE 1969 NEIGHBOR NOTIFICAT. LETTER BI/ZBA 100 YR. FLOOD ELEVATION OTHER REQ'D PERMIT(S) / SYSTEM PLAN - (NORTH ARROW) )RAULIC PROFILE_ GRAVITY FLOW RESULTS DRIVEWAY & SLOPES, CUT FOOTING /GUTTER/CURTAIN DRAINS COMMENTS- Y N CONTROL:HOUSE,WELL, PZRC &DEEP REPRESE TATIVE OF PRIMARY & EXP LOCATION MAP EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF. PUMPED,.P,IT�& D BOX SHOWN &-DETAILED HOUSE - NO.OF BEDROOMS WELLS & SSDS'S W/IN 200' OF PROPOSED SYS. PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1/4" FT. 4 "0; TYPE PIPE NO BENDS; MAX.BENDS 45° W /CLEANOUT i' FILL SYSTEMS CLAY BARRIER NOTES s & DIMENSIO i (00 O G y C EXPANSION 3. S THE OR PROVIDED 60 FT MAX. A : L E L Tv O l T it,jR33 . 400% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN - FROM SSTS 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS _15'WELL TO PL 100' TO WELL, 200' IN DLOD, 150' PITS 100' TO STREAM WATERCOURSE LAKE (inc. expan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (pits -20') 50' INTERMITTENT DRAINAGE COURSE 2 ETC. _150' GALLEY SYSTEMS 15'min to CDS= >5 0/o,10'- 4 %,25'- 3 0/o,30'- 2%,35' - 1%,100' - <I% 20'min to CD discharge /100'with 182 cons day discharge SEPTIC TANK m 10' FROM FOUNDATION_ 50' TO WELL FORM ST -2 VI COUNTY DEPARTMENT OF HEALTH DIVISION; OF ENVIRONMENTAL HEALTH SERVICES 'DrE15T : T:1_� 5 +^ri =� T+� '�T- . �TT7ucTT?�F r_• :Cr, c�.7r� .°r N m3- �: R'� �'= =? :' ' '1�: ;:-_ _ Owner e- I&Tbrl P97n /LecW Address 37C�oro�✓✓bAz* -rte ,I1/r7 Located at (Street) `g*yj-p Tax Map 7�'<<� Block Lot `f'I (indicate nearest cross street) Municipality Avo-e/^m I/ Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking -7 S Date of Percolation Test 77 Z-3 Bole No. Run No. Time Start - Stop E14 6Y Time n.) De th to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch Z7SZ 2 t of Z4'z 7,- 71Z 3 �-- 3 1: n y (5 2 Z7 3 -S- 4 5 `7- C7C 12 - - -- - , l Z Z:_ 3 3Z - I: SL -Z* 4 5 s 1 2 3 4 7►Tl1TTl�_ 1 5 : i. iests 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) Alb data to be submitted for review. t ' 2. Depth measurements to be, made from top of hole. Form DD -97 V1f TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST MOLES DEPTH HOLE NO HOLE N0�nF 0. = .�- .yi a�-��- '=.a- ii�-S'e+z. F:- _uait:.r'�sOy4s- : -ss.�, sve•::?�.n: s--�'= ra.�:a:r:�ri:�i.'F3'FFyr.� .; ;:r�.n�•;;t:- .a- �:.�ue v'. �m -.ate .. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' ....� --..< _...-- ._ `-•.• -. - -:: -- _ s....r — sm .ice_ �A' - ..:� -• --- ~10.0'' � ' _ _ �, . , _,./ �_ �....... _ Indicate eve oundwat Indicate level at which mottling is Indicate level to whic , e observations made by: is encountered es after being Design Professional Name: Jeffrey J. Contelmo, P.E. Address:Insite Engineeri.ng & Surveying, P.C. Route 22 Brewster, New York 10509 Signature: _ Design Professional's Seal PC -1 PUTNAM COUNTY DEPARTMENT OF HEALTH - A•.•PP..-�-LI. •-�•Cw„ A, 4T . �O- N : 4 �1F:•=•O. oR : APPROVAL-OF. PPRO VAL .+io• O>�FY ' :. :PLi:A� N+ S zv .r.FO R z • � rKASTEWATER DISPOSAL SYSTEM °._ � r�f�.°.�s`r sa+... -,I •" t. �..' .. ... ... .. •�•.... t.• `,�..- .r,::.,. ,�"r' "'�•t,:' - „_ i,.. ;'`q..r_.`j.... err• r+—•+.•, �y;+ ^�:o:.::e�:.:.,'.'�':S•...r },n� 1. Name and Address of Applicant: _ LINC/lk= LVELOPMC►•It Ca. INC. 2. Name of Project: !95M_ UNCAR- tY�lCIEIJt 3. Location T /V /C: RI11�1lIli.EY 4. Project Engineer: I01'1k AND Lf5leH,5. Address: j 9 PG C P-ME , NY ic2 License Number: 100151 Phone AA- 225te2CO 6. Type of Project: Private /Resident Apartments Office Building 7. Is this project subject Type Status (Check One) ial Food Service Commercial Institutional Mobile Home Park Realty Subdivision Other (specify) to State Environmental Quality Review (SEAR)? Type I.. Exempt Type II. Unlisted X 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... 10. Name of Lead Agency 1�%A 11. Is this project in an area under the control of local planning, zoning, QQ �� �c;•r- '- stheK•ef a�.. Als; y. CIr4. ,ninee1'��'_oe...,= .aT.:.a�, 12'. If so, have plans been submitted to such authorities? ................... WD 13. Has preliminary approval been granted by such authorities? NICE Date Granted: WA 14. Type of Sewage Disposal System Discharge...... Surface Water _Ground Waters 15. If surface water discharge, what is the stream class designation ?........ RIA 16. Waters index number (surface) ................ ............. ......... NA 17. Is project located near a public water supply system? .................. 18. If yes, name of water supply WA Distance to water supply ,_ 19. Is project site near a public sewage collection or disposal system ?..... _ �D 20. Name-of sewage system Distance to sewage system_ 21. Date observed: UNKNOWN 23. Name of Health Inspector: _ (JNYAiOWN 24. Project design flow (gallons per day) ..... k . ............................... Caob 2° Poll�.�tant Discharge Elimination. System ( SPDES) Permit required?.. NO .., ... ..,,. .. _ -. 26. Has SPDES Application been submitted to local DEC Office? ° ° ° ° ° ° ° ° ° °. ° °.. _�jfj�_ 27° Is any portion of this project located within a designated Town or State wetland? ................................................................. ND 28. Wetland ID Number °°°°°°°.°°°°°°. e ° ° °. ° °....... ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° °. °o.... K/A 1-9. Is Wetland Permit required? ° °.. ° °. ° ° ° ° ° °° °e o °°°°.°°°°°°° ° ° ° ° °. °. ° ° °..... ko Has application been made to Town or Local DEC Office? ° ° ° ° ° ° ° ° ° ° ° ° ° ° °. °° 30. Does project require a DEC Stream Disturbance Permit? ° ° ° ° ° ° ° ° ° ° ° °.. ° ° ° °. KID 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ° ° °..... YES or NO NO 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 No DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ° ° °.... ° ° °° Y 34. Are community water, sewer facilities planned to be developed within 15 years? b sewage .d soo >a-1­ _draws -_in• excess- o�:f- 115%. slope?­.,;; .: . _ ..._._. _ ._ .......__ .._ .. ......_..... °yp.., AND _ 36. Tax Map ID Number ° ° ° ° ° ° ° °.. ° ° °. ° ° ° ° ° ° °. ° ° ° ° ° °. °° ° ° ° °. °° . °. ° °. °...'..° 73. /g 37. Approved Plans are to be returned to: ................ Applicant _X_ Engineer vs If 1-hip apRication is signed by a person other than the applicant shown in Item 1, the natipq must be accompanied by a Letter of Authorization. Failure to'comply with this �ai`sion may be grounds for the rejection of any submission. w';_,. 'C -) r ' hereby affirm, under penalty of pegdnd hat information provided on this tr i.:_.. --irorh is true to the Hest of my knoal belie se stet nts made Ahern are punishable as a Class A o su t to Spc on 210.45 of �thigpena 1 Law. / _ A SIGNATURES & OFFICIAL TITLES: 4AILING ADDRESS: ribs U t� C LIME MWY, V,�j N&A3 4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES f� � Y' �/l„t::A :� 2+ ^�. t _.:S � r�f.v ( ?VJ:J�'i VJ:'1 4 ;♦ - ^JO Y`►lf'ti .J:(y�J' -•.�Y. Owner. 37CUa g DAM R6�Q COkA Address 37 CRarg Dr�l�1 gQAQ, 6 IN�,1/, ; JI /.y los6o2 .Located at (Street) 0#Ug 1?9A,9 Tax Map 73.ff Block 1 Lot (indicate nearest cross street) Municipality &Wg. VJ _ Drainage Basin !�(/D.SdN le/lifR Date of Pre - soaking SOIL PERCOLATION TEST DATA Date of Percolation Test ivvr�;a:fr t. y Tests to be repeated at same depth until approximately equal percolation rates are obtained at each f percolation tesf,hole. (i.e. ,:g 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) Alt data to be sub'mittedfor review. ' -2' , De A nh 'easuremenfs'to be' made from top of hole. -97 Form DD D?'th to Water Water From Ground Level Percolation Time Elapse Time Surface (Inches) Drop In Rate Hole No. Run No. Start - Stop kmin.) Start Stop Inches Min/Inch 1 s^ 30 2z,!- d? ,( �� s 2 6' iL l f 3 .4 5 1 Si 7 -6 -' 20 a2" - a3" P 6 4 5 1 .2 4 ivvr�;a:fr t. y Tests to be repeated at same depth until approximately equal percolation rates are obtained at each f percolation tesf,hole. (i.e. ,:g 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) Alt data to be sub'mittedfor review. ' -2' , De A nh 'easuremenfs'to be' made from top of hole. -97 Form DD G.L. 0.5' 1.01 1.5' 2.0' 2.5' 3.0' 3.5 4.01 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.51 8.0' 8.5.'. 9.01 10.01 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Ewa— any ■ Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional game: Jeffrey J. Contelmo, P.E. Address:Irisite Engineering & Surveying, P.C. Brewst N-P 9% 'Signature: -1 liv 'Design Professional's Seal ' PViNAM CORM DEPARTMENT OF HEALTH DIVISION OF HEALTH SERVICES DESIGN DATA SHEET— SUBSUFACE S5gAGE DISPOSAL SYSTEM FILE .a � .. ..•...- :. .:- ..- � . - T-.:o- '. •:,�,.:.•..w..�,: +`•r+s. n'i.j �.gnt�:.:Sd. .r. .i uhav't. s4 ..�_..rPe.• •�9. a- „7.. ..- .. .. - W ...._ m as a.-s .. - . •.... �. •--�,C- � • , ::F >. ,•,a.., her oft t_'zcoOMDq cry. Address ?.R/ u &mty s1 47'17re- fCL4 f' AIJ Located at (Street) <�#!/.2c# 2DAZ Sec. 7.'. /P Block / Lot (indicate nearest cross street) Municipality Watershed Date of Pre- Soaking Date of Percolation Test HOLE NadAm.. CLOCK TIME PERCQIAT ON 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 1 2 3 4 Aj 882kcoo2•Arrml - -2 1 •I v < a. . ye +r> a s .. . p:'•.v.... c . .�w...w...r�� 1. a •� • r _ 3 • 4 5 1 ,. 2 . 3 4 5 s NOTES:, .1. Tests-t& be repeated at same depth.until approximately equal soil rates are - obtained ..at each percolation test hole. 'All data to•be sutmitted for:: review. 2. Depth masuremnts to be made fran top of hole. TEST PIT DATA REQUIRED TO BE SUEMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES :. DEPTH HOLE NO ....... _, fiiY..t =: -_ �.�• 31- G. L. 1' 2' 3' 4' 5' 6' 7' 81 9' 10' 11' 12' 13' ./10 cat <:P- s �►...,._... �.. ]-;!e ... ....,. . _ - _ - .J: - . -.,._d �n.,e....s_.�...,Y.......... tea. -_a-�. a- re�r%�.:'._'e. ...;. .. .. .._.. -.:.�. .. ..._......�. .�.., INDICATE LEVEL AT WHICH GROUND ATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: PGA/, `3L Z4- DATE: // J - — DESIGN – Soil Rate Used Z 2, Min /1" Drops S.D. Usable Area Provided 0<90 Sf' No. of Bedrooms 3 Septic Tank Capacity /peo gals. Type erca' (Qnseghtion Area Provided By Soy L.F. x 24" width trench 1 �btYler 3.5 X13 LI LL - :> C? _ UJ __j CV �-vs l4/& /-O&S/ v Signature w CL- yldrss f �y �PLs { SEAL L Uj cr, ivy'' THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Rate Approved sq.ft/gal. Checked. by ^ Date -