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HomeMy WebLinkAbout3535DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -10 BOX 28 03535 PUTNAM COUNTY DEPARTMENT OF HEALTH �Y VJ --TF SERVICES-" _ERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P V'- Z Z' O Located at W3 Q R Yi9 kr 1P0/Q0 P LI-tq O Town or Village PU T/J (A m VA L LT_ Owner /Applicant Name --Jo T C AID 09, AJ 0 Tax Map —7 + Block —I Lot Formerly Mailing Address 149 61-0 CHURCH R Subdivision Name Subd. Lot # Zip Date Construction Permit Issued by PCHD I `7 0 _ `P v. 130 k 43 6 Separate Sewerage System built by RA LPN' P 19D WN} o Address Po l -NAM 1 R LLZ) "/11 Consisting of 12 60 Gallon Septic Tank and 410 L F- — 4K 9cie•roRtITE0 PVC - I 2 j' GRAVE l 'TPF-IJC/ -/ l,-J 36" M I N OF Z?,9/VKR jt J Other Requirements: Pump s YS T 6M y Water Supply: Public Supply From Address ti- RJ TN A r-i 1R 8 A-0 or: Private Supply Drilled by Pf. 6AC €�' Sow S Address ;gP WSJ _ of y ! 05-71 Building Type SIIZLe 'F/It4l ji L y Has erosion coritrofbeen completed? Number of Bedrooms ::]rRRE0 Has garbage grinder been installed? I certify that the system(s), as listed, serving the abov in es ons built plans (copies of which are attached in acc an wi th 'sue plans and the standards, rules and regulatio Pup unty ent c Date: / Z 7 -C) Certified by Address 2 •36k/J WA L,SN '13LV Y ially as shown on the as- ion Permit and approved P.E. R- # o6 ZG, 9 0 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 revocation, modification or change is necessary. At�• - '/ ° Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT We cation— Sireet'A ress: 1103 Bryant Pond Road Town/Village: -Tax Putnam Valley Grid # M. Map % Block % Lot(s) / D Well Owner: Name: Address: June & Ralph Adorno, 103 Bryant Pond Road,Putnam Valley, NY 10579 Use of Well: I- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: _ Welded X Threaded— Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length (ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours 6 Yield 162 gpm Depth Data Measure from land surface- static (specify ft) 40' During yield test(ft) 440' Depth of completed well in feet 705' Well Log If more detailed information descriptions or are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 4 Drilling in overburden clay and boulders Hit rock at 4' .• 2 Dr il:li,ng� c;l:, 32 705 Drilling in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 10gpm Depth 660' Model 10GS30412 Voltage 230 HP 3 Tank Type WX350 (2) Volume 119 gallons Date Well Completed 8/26/04 Putnam County Certification No. 006 Date of Report 10/25/04 W er (si re Phi iD J. Beal 1!J(.D"1<'lE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. . 5 Well Driller's Name F.4" Beal `'& Sons Inc . Address: 4 Putnam .Ave.. Brewster. NY 10509 Signature: 42 Date: 10/25/04 P li J.Beal White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 --ach Public Health Director Iz GREG - -, M0L-- &A�.i; t:'•`te;' i:v:1�1i. '- ;.; I Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1. Geneva Road Brewster, New York 10509 Environmental Health (914)279-6130 Fax (9.14) 278-7921 Nursing Services (914)278-6558 WIC (914)278- 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 E911 ADDRESS VERIFICATION FORM . OWNERS NAME: S 11. F. Ri)®rc'�jo TAX MAP NUMBER: -14 LK �- d -t- : I O E911 ADDRESS: /0 3 &Ie474^ PO MP 126 s� TOWN: Pttr V 19-m LIOU, 1 Il-/ , IDS q j1h, �( AUTHORIZED TOWN OFFICIAL: I� I ' (Signature) g DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFRM) YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ._ _.,.,�, .. .. ., .. .� _ ,,,, Q'�/�.. r '��'- ...."rte_- .�:$��i....• :_..__..:..... ., ., .... Albert H. Padovani, Director LAD v #_ 87.400529 CLIENT #: 58133 NON STAT PROC PAGE: 1 ADORNO, RALPH DATE /TIME TAKEN: 12/27/04 09:00 248 OLD CHURCH RD DATE /TIME REC'D: 12/28/04 12:50 PUTNAM VALLEY, NY 10579 REPORT DATE: 01/10/05 PHONE: (845)- 526 -3005 SAMPLING SITE: 103 BRYANT POND RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COLD BY: RALPH AD.ORNO TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF -- ---------------------- - - - - -- --------------------------------- - - - - -- DATE FLAG PROCEDURE. PUTNAM CNTY PROFILE 12/28/04 MF T. COLIFORM 12/28/04 LEAD (IMS) 12/28/04 NITRATE NITROG 12/28/04 NITRITE NITROG 12/28/04 IRON (Fe) 12/28/04 MANGANESE (Mn) 12/28/04 SODIUM (Na) 12/28/04 pH 12/28/04 HARDNESS,TOTAL 12/28/04 ALKALINITY (AS 12/28/04 TURBIDITY (TUR COMMENTS: FAX TO 845 - 526 -3449 RESULT NORMAL - RANGE METHOD ABSENT /100 ML ABSENT 1008 <1 ppb 0 -15 ppb 9101 0.41 MG /L 0 - 10 9139 <0.01 MG /L N/A 9146 <0.060 MG /L 0 -0.3 mg /l 2037 <0.010 MG /L 0 -0.3 mg /l 2037 6.01 MG /L N/A 7.4 UNITS 6.5 -8.5 9043 106 MG /L N/A 82.0 MG /L N/A <1 NTU 0 -5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS) (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. iblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg /L, else water undertaken to reduce the waters corrosive Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (.9141. 24.5 28.0 0 Albert H. Padovani, Director LAB #: 87.400529 CLIENT #:"58133 NON STAT PROC PAGE: 2 ADORNO, RALPH DATE /TIME TAKEN: 12/27/04 09:00 248 OLD CHURCH RD DATE /TIME RECD: 12/28/04 12 :50 PUTNAM VALLEY, NY 10579 ,REPORT DATE: 01/10/05. PHONE: (845) -526 -3005 SAMPLING SITE: 103 BRYANT POND RD, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE ,COL'D BY: RALPH ADORNO TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF. DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM .C_OCE_NTRAT ON1..- .BQTH EXPRE SB tS^_CAIaC U";:.C,ak2 () �1IATE .,...I?�1.._I�JG/Z�.:::..THE .... ........_ HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM.PER LITER HARD WATER: 140 -300 MG /L (1 grain /gallon = 17.2 MG /L) 1 SUBMITTED BY: �'J,v Albert H" M.T.(ASCP) Director ELAP# 10323 PUTNA.M COUNTY Y DEPAR 1l MENT OF HEALTH LTH DIVISION. OF ENVIRONMENTAL HEALTH SERVICIES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM °-1-UjjLr pqo6 2N a Owner or Purchaser of Building Building Constructed by >RV19/-JJ_ otD POOL) Location - §treet Building Type '7 l / Tax Map Block Lot 1nv*TNrgyti VAL L E1/ TownNillage Subdivision Name Subdivision Lot r I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system se5-ing 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 Heaith, 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 t%vo 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 b�,- the willful or negligent act of the occupant of the building utilizing the The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to 'whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month��✓� Day Z Year 2c)o r General Contractor (Owner) - Signature Corporation Name (if corporation) Address: —,F- 0 - *03 k- 4--3 6 StateU j_ rlia m A LSE &) Zip I o S 7 .9 Signature :K uo Title: 4A_1� Corporation Name (it corporation) Address: State Zip Fcrni GS -0' RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200,.2 Johr Walsh •Blvd., Peekskill, N6W.York 10566 _ w Tel. (04)796-3664 i Fax: (914j736 =369 February 2, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: June F. Adomo SSTS Construction Compliance PCDH Permit #PV -22 -03 103 Bryant Pond Road Town of Putnam Valley Dear Mr. Paravati: Please find enclosed as per your request, three sets of the As -Built Plans revised based on our February 1st phone conversation. .Ralph.Adomo will persormlly�pi k-up he SSTS construction- compliance.for.: ,he above referenced project'was the PCbH has issued fnal approval ±~ Respectfully submitted, "'� ZKenneth M. Murphy Design Engineer SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health February 2, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear Mr. Murphy: ROBERT J. BONDI County Executive Re: Construction Compliance — Adorno 103 Bryant Pond Road, (T) Putnam Valley TM# 74 -1 -10 This office _ has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. The end of the trenches need to be located from two fixed points. If something other than the house is used, the points must be permanent and survey located. c.�-2' The well location box has X and Z as coordinates, but the labels on the house corners are X and Y. ... ... .... tk is fer fre -T r the potable. � p no_c� . house water. The existing dirt driveway needs to be abandoned. Provide a note stating such. The perc rate in the expansion area was 8 — 10 min/inch. Only 300 LF of fields has been provided, not the 333 LF required. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. JSP:cj Sincerely, oseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 c� RONIN ENGINEERING P.E. P.C. The Lindy Building,, Suite. 200, 2 John Walsh Blvd., Peekskill, New York W566. Te% (k4` j73ti- 3664 -• Fax`.- (91'4173fr3633':. _ .w. _, ... xr::..,::,'. .....; -, . ... ._.... .January 27, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 Re: SSTS Construction Compliance Certification June F. Adomo . Bryant Pond Road Town of Putnam Valley Dear Mr. Paravati: Enclosed find the information necessary to allow review and approval of the above referenced SSTS construction compliance permit application. Based on the inspections made before, during and after the SSTS installation, it is certified that the system, including those items which were not visible at the time of the open work inspection, were installed in accordance with the applicable PCDH codes and gs-shown-on the- enclosed'-plan: -- Upon review of this information, if you have any questions or ne . " df#iZ k information, do not hesitate contacting me at the above numb "Pig` Re i y b d, cc: June F. Adomo Timothy L. Cro `II f`:a Professional Eng N 62g$0 LETTER OF TRANSMITTAL CRONIN ENGINEERING P.E., P.C. January 21, 2005 The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914 -736 -3664 Fax 914 -736 -3693 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 DBE: JUNE AND RALPH ADORNO PCDDH PERM #PV 22-03 Doi BRYANT POND ROAD 'OWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY 1.) Three guaranties of SSTS 2.) Copy of survey showing f®undation location 3.) E911 address verification form 4.) $300 certified check for application fee. 5.) Well Completion Report .6.) Water Analysis The information enclosed is submitted for review only the As -Built Plans and Compliance Application will be submitted after the pump test. Should you have any questions or require additional information regarding this matter, please contact me at the above phone number. Thank you for your time and assistance in this matte. Respectfully submitted, K enneth M. Murphy Design Engineer P v .,,;,7,;- - v 3 PUTNAM COUNTY DEPARTMENT OF HEALTH -DIVISION- NVIR M NE SERVICES FIELD ACTIVITY REPORT b Street Town State Zip PERS ON IN CHARGE. nR TMTVRVTPUrPT)-. PIJW TEST DOSE TEST it -t-3 IF EL START of v I EL. STOP REQUIRED GALLON'S 4f� �-11 504AIZ, - 2e— TW-qP'F.rTOR! TEJ! Signature an - d Title RT7PQRj'RiR.rFrv-F-n Ry.• I acknowledge receipt of this report: SIGNATURE: 02196 Title: a, it -t-3 IF EL START of v I EL. STOP REQUIRED GALLON'S 4f� �-11 504AIZ, - 2e— TW-qP'F.rTOR! TEJ! Signature an - d Title RT7PQRj'RiR.rFrv-F-n Ry.• I acknowledge receipt of this report: SIGNATURE: 02196 Title: °. _`�- .:iiituCir�-Fi: � �;4`•OL�"Y , ::a-; Public Health Director DEPARTMENT 1 Geneva Brewster, New OF HEALTH Road York 10509 -L RET? A : �Be�(Q ANARL_1,�..I�? Associate Public Health Director Director of Patient Services REOUEST FOR FIELD TESIN� A'T'TENTION: � ❑ GENE REED All information below must be fully completed prior to any scheduling. DATE: 81 • IQ •oS ENGINEER OR FIRM: CROM t13 e1�1 %17lN4 'ijlf PHONE : Q lam• %34, 3E(z,-4 REASON: DEEPS: ❑ PERCS: ❑ PUMP TEST ROAD /STREET: 13911Aa�r -PONS R®,'NQ TOWN: FurNAM VAJ TA.Y NLXP #: 74r- -� SUBDIVISION: LOT: OWNER: A U Q /9O1—N1fl NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES N� - - -Proposed-S$TSLL�vitl:ii-,the drairra exbasinRof «'est Branch'or Bovds Corner Rese:�-o ts. Cl /0' Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ /,0' Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ 0' Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered yes to any of the questions. NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY DATE: TIME: COM-MENTS: (FIELDTEST) "t 6 V V J i:� i • i T t'.. i • � ,', �.. , , n i v . � . • �. . . v v r .. _ . � . ._ _ _ _ _ _ _ ._ _ _ . FROM , FAX NC, :845628805:9 Jan, 13 2005 22.3SPM P4 N =F.-V01 YORK 130ARD OF FIRE UNDERWRITERS BUREAU OF LLECTRICITY 40 FULTON GTREET - NEW YORK NY 10038 Upon the application of 11<1110ELL 6 SONS -INC, 22 BROOKPALS RD. MAHOPAC. NY 10641, OQATiFI SS THAT U}vDn rlreWift Iwrim by d61Ne AOQRN0 103 BRYAR f PQND ROAD PUTNAM VALLEY, NY 1067- Locatrld at 103 I3RYMT PANG ROAD PUTNMi VALI.6Y, NY 10670 AMIC860,1 Iduloibsrt 20397711 CertlfkaW Number- 20Jd'►-•a Sadtltltt' 14 Nock: 10 Lot, 1 BulldigPerrr.lt: Fa Y.: N1106 aooa.+g7 taeacrlbed as a oc:cupency, w1wrein t "e prernixa a cetr!Czi syatc +m +!tl nt; et simplcal devices and wiring, described below, Iocaatog inGm the pramreN wt: i3siomt Pint Floor+ Saoorid door, Aocnrd Ousgr., Auteide, P000*, A visual Inspeftn of the premim electrical g1tam, limited to electrical devices and wiring tC the erbon-' d etri(AN heroin, Waco conducted In oceurdanee with the rCqulroment$ of tho appllcabrd code and.'r ;�;�rt�arcl promulgated by the State of New York, Department of State Code Eniorcement and Ad-r.'.6.�tre' a !+e oWharity hiving Itmadlctlon, and found to be In compliance therewith on the 120, bay of zbw fad' Ettr aactn8 circultt IM w4catletstatta OVIIIA a00t1 SQ FT. PUTNAM CONTROL *12-01 81MC, ?VW, A" ALARM WYA2ftj'Y VATiafl't Alma sad 21Ser100l�qutpment @eneor 7 0 110 &Wke AppMw a sad Aaemorles Chiba+ Dryer 1 0 4.5 Kw Exhaust You $ 0 110 F•H P. AltCoad ciuraor $ 0 36000 ant Dbh aaidw 1 0 1.5 10V O(Boe t 4Mft M;?%AtM Ci 1 C 6.5 KW Fin act 3 C Or1 Kyrra Waage Wb knortpeudc y 0 PuiV Motor 1 0 1 H.P. Bell Traatrt't = 1 0 �etf Mourn Continued oa Neat Page I of 3 ThISOartlfleete may not be aft-PC In am+way and is velidgind urly oy the preeerCe n1 a relsod &oil lit titia ;ore; on ireh -arpr, . .4-2005 02:15 AN RALPH ADORNO ASSOCIATES f- . M a FROM FAX NC. :94562SFAS3 Jam, 13 2005 02,40PM �5 NEW YOORIMAR 130"PARD OF FIRE UNDERWRITERS BUREAU OF RLIECTRICIlrY 40 FULTON STFORT - NEW YORK, NV MW UW the hration of .I.KROELL & SONS INC. 22 &ROCKOALE RD, MAHOPAC, NY 10841, CriRTIFIES THAT Upon pramizes mwnqd 1* JUNE ADORNO 103 BRYART POND 40AC; PUTNAM VALLEY, NY I (),t7 1.800ed st 143 BRYMT POND MAD PVT NAM VA46EY, NY I0670 A044aft NMPW.- secilov: YA 91*0k! 10 1_rit7 I Building ftIffilt: 2CI06-67 9j.W. VY 1 00 DescribW pee occupamr-y, whefel n the p,vrnizeo elect.wal synte.r elor.trlrml devices and wirIM c1sw1bod balow, located, NO the prommas at; I 5158IM011i Firpt Flor, bond F109T, -Amchcd Gam t, outaldc' ftut(sye, A viavil Immction of jja piemkw ejectirical tyalan limited to elutrice, eleviteg and oviling to the em 1•1"* detailed hmin, was canduoted In accordance with lice requirvi-MMA DI the wipfi::able :ode icilit f! :'-tarrierti pramulvited by the State o! Now York, Department of State Code Entot-nameteit and AvrInistration v ot-ie. nuther"y 4604 juiriodiciian, and found to be in com.pi lance tnere*0 on the Uthc)ly Ifinuan.'Vi" coanood as Next Pose 2 of 3 1-blecadfictitsmay notba abisdiiany way and i9w1jd8fW array by the mcwneet, a r;iised twto, vc.xq., gram 2 200 40 —100, %714" and Devilm out 0 rkwe 79 0 1 V) lSOCAt!(!! 500211 Rae"ck 15 0 Ito GM11 1 0 Ito Lbuodry 2 0 110 Nib; Fs n 110 &"hm 90r*e Di3coblu4t. 2 200 sm= Nows. coanood as Next Pose 2 of 3 1-blecadfictitsmay notba abisdiiany way and i9w1jd8fW array by the mcwneet, a r;iised twto, vc.xq., ,P' t4 -2005 02:16 API RALPH ABORNO ASSOCIATES FROM : FA8 MC. : 84562SS053 18455263449 Jan. 13 2005 02=40PM �6 , YY1419 CIERTIFIQATE OF GOMPLIANOE THE NVOIN V YORK BOARD CAP FIRE (UNDERWRITERS 13UREAU 010 MLI:CTRIGITY 40 FULTON STREET - NEW YORK, W 10038 CRNTIFIL9i THAT Upon the application of upon prermson ownec by JXROELL ft, SONS,INC, JUNE ADORNO 22 BRQMA E M. 103 PIRYART Pmp RoAu MANOPAC, Nv 10541, PUTNAMNALt EY, NY 10575 LWOW at 103 BRYANT PONV ROAD PUTNAM VALLEY, NY 106711 A 1110tlan RIWAW' =49779 CerMicaf:n NW"brc; 203e7rt 6eoticn: 74 81MX.. 10 :ot: t Building Permit: 2004 -67 ADC: Yvt06 Deserlw t4 a . oC.MIUy, wherein the p►umitue electrical .ynEam -i nvsuny cr eleotrI" devices am wring, described below, loeeted Won the premi.e5 axt! 90M OM. First Floor, Second 1'1=, AIMC W Qaaroac, Outside, P001/904, A vleuei Inepstttlen of this premises electrical system. IlMited to alectrical devices and whine to 1�*e extw'r -jetai so herein, wo cafticted m accordance with the requirements of the epplle,rblc coda aAcio - Annriarc pramulpted by the 81814 of Neo York, Depertmei r•t of state Code Warcement.ard Admin,strooz.1 1 of a +`het, out.4cHty htttving jurtedletion, and found tote in compliance therewith 3n the 12thos'/ nl Janu4ty, ?,�,R hum Aar kaA gun Tm (8witandtlg PoolY n, It wofkast oovem wm0Iance it the data of ie•greetl0n only t MUM o,' oe etuat en.:•vnmrw :t is C*'Vab •: h' I:.,, r ilvt{tienr exf rAaNa r�tial ntttts b0' a gtuti fled partw, seit 3 of 3 ThIS ceftlrc a rrvy not be attend In any way and m wtidaind enty by the prtttenCe of a %vre sea at the :rc*inn -nov 100. P.04 I i CRO.N.IN ENGINURING PA, P.C. THE LINDY BUILDING, SUITE 200 2 JOHN WALSH BOULEVARD, PEEKSKILL NY 10566 (PH) 914736 -3664 (FX) 914736.3693 Ta Joe Paravat! Putnam County Department of Health 1 Geneva Road Brewster, IVY 10509 Fmm Weeth Staudohar Rec Adomo, TTLV Corp. at Oscawana ke Road, TTLV Corp. at Eastern Road, Town of Putnam Valley axe sent overnight mail Dale January 19, 2005March 15, 2004 Adomo: Enclosed is the request for pump test and the fire underwriters certificate. The request for final inspection will be faxed to you in the morning when Ken is back from vacation. TTLV Corp. Oscawana Lake Road: Enclosed is the request for field testing and a copy of the topographic map. The wetlands were flagged by the Town Wetland Inspector and survey located. ; fu if COP. l=atter Road:'- oad: Enclosed is the request for field testing. I believe Kenny submitted the site plan previously. As discussed, we are meeting on Friday January 21 at 10:30 am. Kindly review the information and please call should you have any questions. Thanks. pcdh--paravati adomo-011805.doc 0 Page 1 of 2 PUTNAM COUNTY DEPARTMENT OF HEALTH „DIVISION OF ENVIRONMENTAL HEALTH SERVICES.. � CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # P V— 2 2 — 0-3 Located at Oe yn N T f6 N i) Ro r4 o Subdivision name Date Subdivision Approved Subd. Lot # Town or Village l U -roA rli VA t l-,A�r' j Tax Map -74 Block Lot Renewal Revision Owner /Applicant Name `J u 1-1E 9 D o 0 A.3 6 Date of Previous Approval Mailing Address 0 4 8 O L b C 14 U R C H RD- f o 4-�� `P� ?' Uri t- Amount of Fee Enclosed p jog-79 Building Type S jN GLLS rilm, IYLot Area 13, Z No. of Bedrooms 3 Design Flow GPD (2 0 O Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 125 gallon septic tank and 1—F OF � �� '?62r0Q11T6_0 �VC 1� 24/' 6,R/iV�L `i-SOO TdAjCH //J _%N of �i�AJJ<2unl Other Requirements: fy ril_ P S -rc " (Scc PL/�� To be constructed by ("j a 13C 2Yrt l N�rC�� Address ..Water Supply: .. _ Public Supply From... : _ _ _ .. _ . .. _ ._. . _ __. Address _ r or: Private Supply Drilled by ?.F 964L So N S T Address T l o via r'h Rolm IFVeNS -re 2, Q 10-15 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 re pW f the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction , - '�li►'e actory to the Public Health Director will be submitted to the Department, and a written guarante ,.. fshe e o er, his successors, heirs or assigns by the builder, that said builder will place i oo�operatin 'co ion an vart 6� of ewage treatment system during the period of two (2) years immediately follo ing the date of 'e i s�ancig's pp r6 1 o the Certificate of Construction Compliance of the original system or Signed: Address 2 `Sd NN khl tX,, X R.A Date i I' z `('" `7 i L L, WZ / 0,5 License # (,) 6 2-9 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 't. Approved for discharge of domestic sanitary sewage only. By: Title: 14-A4,4F Date: ,01/ opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL' SITE INSPECTION l Date: Jl �6�oN -FLLLcw4) Inspected by TSP Street Location rT 9v4 r - Town _ 'P v,�_� %w► :I t� i ('e � : Permit # PV -.2,;2 - 0 3 TM # 7y - - a Subdivision Lot # iv i4 1. Sewage System Area a. STS area-Iodated 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 ..... .. .................. R.' Sewage System a. $eptic..tank size - 1,000 .......•.1,250 ... ....,.other ................ b. " S.eptic tank installed level c. 10' minimum from foundation .... ...... ....... :............. ...:. :... d. Distribution Box 1. All outlets at same elevation -water tested.....:.:...: :.:.. 2. Protected below frost .............:::.. ....................... ....... 3. .. Minimum 2 ft.Original soil between box trenc es e. Junction Box - properly set ................... „ . . 6. renc es .� < "" �•�� 1. Length required " ��j 0 0 Length installed J _ U 2. Distance to watercourse measured Ft........ TWA 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'/2" diameter clean ............... .....: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends cyped,..::.. .... .. _ . g; FL is _ e.. �ystczns- _. - a 1. Size of pump chamber.......... Pr'..`��?�^. :........ 2. Overflow tarik ............................. ............................... .3. Alarm, visual / audio ..... ............:.................. 4. Pump easily accessible, manhole to grade ................. 5. First box baffled.....: .................... ........................ ........ 6. Cycle witnessed by H.D.estimated flow /cycle....:...... M. House/Buildirig A. House located per approved plans ........................:.. b. Number of bedrooms ........................... ...:................. . IV Well . Well located as per approved plans . ......:........................ b. Distance from STS area measured J -1000- ft........... c. Casing. 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Workmanshin . 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� f 'e f. Curtain drain outfall protected & dir.to exist wat co s g.. Tooting drains discharge away from STS area ................ h. Surface water protection adequate........: ........................... i. Erosion control provided ................. ............................... Rev, 102 JvM SITE INSPECTION FOR FILL PAD i(o Oq Date: Fill pad located per the approved Fill Pad Length Fill Pad Width Fill Pad Depth Run-of-Bank Fill Quality 12 0 Slope from Top to Toe 0 0 Impervious Layer Installed Oq Erosion Control Installed y S Inspected by P(I POL OIL feL Required Length,_ Required Width Required Depth ppummtj 70'bekyl, 51-Ks :5-(v 40 ,,.i 12.,06 rewy.La qd bd6re 3 3` "'v, ez� s �� (4K. `tiaore �� y p� �f 5, �� Sieve Test Results (if applicable) AJ ( ,VM-A L'J CA T Reserved for Field Sketch if Applicable 'ea ce tb 'ro r, w PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES = :SV88VA +ACE 9kWAGE TREATM&T-SYSTEM 1° o 12'0 X x'36 Owner -3�,j C O y i2 tJ G Address Pv raw r -1 VA L LIFY : NY 10 7 9 Located at (Street) Q /-�,AJT To tSm V06 o Tax Map `74 Block ^� Lot (indicate nearest cross street) Municipality ( _r) P -rjjA ►'h Vjj LLC-_X Drainage Basin_ FK-rKI L r OLC ow ORv0k SOIL PERCOLATION TEST DATA Date of Pre - soaking fQy V 1 Zd O Date of Percolation Test ALOV 8� Za a z Bole No. Run No. Time Start - Stop Ela se Time (pllin.) De th to Water From Ground Surface (Inches) Start Stop Water Level Dro In Inc es Percolation Rate Min/Inch PE, 1 Sl Jo q 2 161 fro q 3 3 l0 4 25 + 46 I S 5 ,PIC 1 i+ q 1 1z 3 4 2 22s I s- 5 1 2 3 4 5 NOTES: 1 Tests to be repeated at same depth until approximately equal percolation rates are obtained at each Percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2.' Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA BDEKRIiPTION OF SOILS- EIYC ®II�T�'lE ] $➢., 7['IE,�' '_]�IO1r j�j�11 a _ ... _ r _ DEPTH HOLE NO. HOLE NO. HOLE NO. A. G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0;.c; 5.5' 6.0' 6.5' 7.0' ZZ 7.5'�: 8.0' 8.5' 9.5' 10.0' 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 Na ee: ' TJ MIS - L • C t2oNi Al ,� NEW Y . Address: '� �Zsl�►J�941 i'( Lv�P��' o �. �k� C, r Si Design Professional's Seal 629$0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION .,OV ENV [RONMENTAL HEALTH SERVICES. . ...., .,.,r,._..,,, a . 'S•,.. • t;. .. �� : .. =.y e: - 9 . � ...... .. ... .. .. ..a. aa,— .,.- > .;c :W� a rn.. ...ir.. •.' r..:.n�:. .- r � r . . ,., , '.!- CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # 9 V o�o� ° 3 Located at tgWr Pbt-3 D RbA-D Town or Village ?u iNWri VALLEY Subdivision name Subd. Lot # Tax Map Z1 Block I Lot 10 Date Subdivision Approved 13o Owner /Applicant Name vi•1 t p p d R iJo Renewal Revision Date of Previous Approval Mailing Address 2 0 L_0 c u2C.H Ror+r� j''- y- VOA- 436 'j i rPAn 'VA i.�e Zip 10 S � 9 Amount of Fee Enclosed Building Type SAN CLLI rAmlW Lot Area 13, 2 No. of Bedrooms 2 Design Flow GPD 6'00 Fill Section Only )('_ Depth 36" Volume - 7 9 5 Gv ,y,D. PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1000 gallon septic tank and Other Requirements: To be constructed by Address Water 1 :.. ._...._._._._Publ�cupply.F..rom or: �) Private Supply Drilled by (Tb T?CT DET�^YZrir�l�� 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 regulatio the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Co i@iicd'Eat#§ ory to the Public Health Director will be submitted to the Department, and a written guarantee wi ; .e e , his successors, heirs or assigns by the builder, that said builder will place in good erating co ,dit� 'airy paft o.. � age treatment system during the period of two (2) years �. . , immediately followite of the ' su of va tii. Certificate of Construction Compliance of the original system i t any relygirs t4 reto. �.-- ��, -A 3 Signed: L '' _ R-) Date Address 2 Z61oJ WA Ls L License # 6 62oi e 4 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction. of jthe 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 pej7nit. Approved for discharge of domestic sanitary sewage only. copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 10/15/2003 13:18 9147363693 CRONIN ENGINEERING 1 PAGE 01 I, 4rl', 2. JOHN WALSH BOULIEVARD THE LINDY BLDG; SUffTF, 200 PEEKSKILL, NY 10566 TO: Therem Neme& FROM: Km COWANY: DATE: P.C.H.D. 0(,705614,2003 FAX NVIABER: TOTAL NO. OF VA 0 INCLUDING COVER: PHONE MhOER: SGNPFR'$ REPER+CF, NUMBEIL- Bryant Po* Road YOUR RVPPMt4Cq NUMBER: June F. Adomo P.CI)H. jenr6t 13URGENT 13 FOR RFVIP,'QV 13 PLEASE commrNT 13 Town of Pumain VaDcy - sslrs clon$u=tion PC=dt Bryant Pond Road, Lot #10 NIMAGE I COMMM !7- Kenneth M. I REPLY E3 PLEASE RECYCLE TEL. (914)736-3664 0 FAX (9p4)736-3693. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ APPLICATI ®N TO_Gf N --RUC .A. 'YFR,WELL- .c . ' Y • r � - n — 4.' - please print or type PCHD Permit # Q c7- —az Well Location: Street Address: Town/Village Tax Grid # i�tzWr ' oI.1D `j2P uT;jAr11 Ltt Map %11 Block I Lot(s) 10 Well Owner: N e: Address: Jui-jc l4poRNo ' 1'F0. I?0 3 6 u i.119 /-}t -ce V W 105 Use of Well: 1 Residential Public Supply Air /Cond/Heat Pump Irri ation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served 3 Est. of Daily Usage G b 6 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling _ New Supply (new dwelling) Deepen Existing Well Detailed Reason Su i- 'FwR Ra ,p r o 'Rk'S Ion N cE for Drilling Well Type _� Drilled Driven Gravel Other Is well site 'subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ..................... ........... Yes No k Name of subdivision N 0 Lot No. NIA Water Well Contractor: (-to LOS` 0i T C_R M 1 N6oJ Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village t4 Distance to property from nearest water main: Proposed well location & sources of contaminatAte vided on separate sheet/plan. hi 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 Permit Issuing Official- w Date of Expiration Title: Permit is Non- Transferfable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLIST.ED,ACTIONS .Onlx _. Part 1 - PROJECT INFORMATION (To be completed by Applicant or Proiect sponsor) SEAR 1. APPLICANT /SPONSOR: 2. PROJECT NAME: June Adomo SS TS, Bryant Pond Road 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) West side of Bryant Pond Road and Barger street intersection 5. PROPOSED ACTION IS: H■New ❑Expansion ❑Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: construction of subsurface sewage treatment system and a water service connection for the construction of a single family house 7. AMOUNT OF LAND AFFECTED: Initially 13.2 acres Ultimately 13.2 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? .Eyes ❑No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential ❑Industrial ❑Commercial ❑Agricultural ❑Park /Forest/Open space ❑Other Describe: Surrounding lands are zoned single family residential 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? MYes ❑No If yes, list agency(s) name and permit/approvals Town of Putnam Valley- Building Permit, Putnam Co. Health dept- SSTS & Well Permits 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Dyes QNo if yes, list agency(s) name and permitlapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑Yes KNo I CERTIFY THAT THE,INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/S�p��onnssoor na e: Cronin En ineenn P.E. P.C. /Kenneth Mu h date: 07 -30 -63 Signature -�i �� r If the action is in a Coastal Area, and you are a state agency, complete a Coastal Assessment Form before proceeding with this assessment OVER 1 PART II- ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? if yes, coordinate the review process use the FULL EAF ❑Yes 10wo B. WILL ACTION RE IVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative eclarat!*onL ay be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: Answers maybe handwritten, if legible. C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: / C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: / v'o C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other nat . resources? Explain briefly: 0-7 C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: vn C6. Longterm, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: i C7. Other impacts (including c�an , e� s in use of either quantity or type of energy)? . Ex lain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? ❑Yes Pge—lf -Yes, explain briefly: E. IS THERE, 0 ,R IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? 0YesCQV_oj1Yes, explain briefly: Part III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) _ _.. __:r..:....__ a... advers •exec€ i ec 95k-ab --' ee =N,I LthPr<t !s suLsta tia!; i3,ge ,rrtpo ant'ttr ots vis€ sig �i�t Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the anvirnnmantal rharartarictirc of tha r..FA ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. /eck this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this. determination: � Q N b � 1 GCrAV-16 , ]r Print or T pe Name of Responsible Officer in Lead Agency esponsible Officer in Leff Agency of Lead Agency /0%5L-3 . - Title of Responsible Officer Signature of Preparer (If different from responsible officer) 117° —T = - -I F —_ it II II II 11 MB CS262 Q 71: Y Z In W1I -1 D CLG ~r C 1- 2668 .n I N GARAGE 122'.301 osEC � 1 CLE AR 17 IT 3•-l0 1J /L P- - - - _ 3 -2■+ sar.z EACH UNIT a:. RAISE 3/4' 135. O 21 DATA PLATE. S,1 AT[ ' O L PfS LABEL''L'•OC'N � ' v�r' N �111�1f1�1f '- CLG PC RIH.TCR 10 BC .o DC ' 1242 VAL mi., 2542 2742 1 3 -1 1/2'•11 1 / +• ML. C• N 12-1 112, . N 2442 1 SRI PP [m 1 10 -� 1/2• 2• fUl VENT 1 P[D_ SINK ti y �' ` 27 SOrrll 3.r I . V-5 7/8- ° - i 1W -3' I _ BATH r3 :D 7B r I I NOOK RA SC 3/ +' " q KITCHEN 1 m I In HEATILAT IR fIR[PLACE I "I o {'.. MODEL •M 1:36 • ru I , N 1 1 RD 39 54'8• :4D' S , / I O I . /19'.SB•ti 6• HEARTH � >rn .BS 1/2•R.O.. 1 I 15' -10DH TiC FAMILY ROOK'., iu / HALL v L — — — J rSPr•a y' 2'-6� EACH UNIT SO�fll ADD•L LOLL 2 -2.4 SPr.2 07 8 -8, BOX /BLOCKING. RAISE 3/+• + 26 -2• f27_SOrrI - ADD'L LOILLT (ON -SITE FA-0 HH 27" SOrrIT7% (PC' H UNIT 42 r - - - - -, I COL. RED'D F7= - - r - - - ,P I �/ AWL LOLL T VKD36 I 1 - (r COL. RCC'D UC2424 UC2424 1 1 r N I .96 D 6 .96 11 ICU 1 1 I I 3624: 1 �{-- �0-� �� 3 i C° SLR "� L DRT L- VASH� L -- J I I • 2.6 OMIT 3•-I0 ' SECT. x ul• 1 1 14•• r o -- = i N '9-11 7/ I 11 _ II 11 U11 II II°,� 9• -8 3/8' .. JBOX IN g$MT� - f1 R fUR CC •^. E 6 r g A i B VIR[ RAILING BY BUILDER PER APIILICABLC CODES 3D'- 34.1HANDRAIL HGT --_ DINING ROOM' 1 OPEN TO ABOVE t CLG LINO Au- -_H rRC 2 -1• PVC BASEMENT 10 FOYER ATTIC 13• -0- ' RAISE 7 B Q CLG PCRIMCICR TO BE F_= ___---- - - - - -- o CLO RAITC 7 /B• PUTNAM COUNTY T , 1�I Z L-�.� �. J I I L -K HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDROOMS N/ /A4, y �! _ �✓ t ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE '\I PLANS MUST BE' SUBMITTED TO THE PCDOH FOR APPROVAL GNATURE &TITLE DATE 6 - S141R TB 1 /�• w.X R 9' MIN TR[AD) ' TREAD DIM. aI1 a rRENCH CLO till I O (��oM BEN 12•-1 1/2' . O C7 Illy J) 1O CL DRi i a0' -0' y JBOX FOR ON- 13'-a' :9'-4'FLR TRUSS IN PLR 7' -4' SITE SPOTLIGHT 5 PLR PERIMETER TO BE AN 2'x9 1 /4'M.L. 40 EU GLD O -0' 1�+-2' PuT v r o•_6' i 7'-3' I - — — — — — — — — — — — — — — — — b•• I d ill a C N mLL 2 - 3 2x N I m_ b BtiTH sll 'z• -0• MIRROR r N S,. RAISE 3/4• I T B 5TH /4 cl O . al I RA SC 7/4• • 10 A3. in . . o BEDROOM r2 a > ©L1N ° �i WALK -IN -0. CLOSET — ;I 2x3 N n - O H 1 L1N N > N I -L`-J CT B VIRE 1' D HALL 15' -1 1/2' II n ''J a, 10' -0' CLO j - T7�lTJ - © ✓ j /� 7' -9' OMIT 3'-10' SECT zD CLG tvnLL GTP 1 / OMIT VAL SECT I ti'• _ /CL /G L VA /LL /GYP N 4' -6' u 8' -3' , / 3 -0 �L 12-2 $iwlR Cdn I ! `2D A - C CL❑ I W <B 1 /�• w Rte"' 1 4 9' MlN 7RCw07 !' r) 1 w { UP a IN ATTIC I• LANDING ;> a•_1• LJ _L _ _ L � - e RAIL G By BU.LDca 1 1 BEDROOM al ,. A t` L P_rP PPLIC BLE . CODES Z 30' 4' HANDRAIL MGT I `` © OPEN TO BELOv a, t ij b — \ BEDROOM u3 IF 11 o „1 } IV 2 -1• PvC P¢ t BASEMENT TO BALCONY a ATTIC p. ------------ - - - - -- -- 13'-1 1/2' 1.: 13' -0' r 12' -1 1/2' -; MDR a 85 1/4- APP . — — — — HDR TC BE 3 -1 O O - -- PLR PERIMETER TO BE 3-1 0 °.S I HDR P 84• Arr CU " vvDH28CHPRCro1LlCD `lid O RL 3• 1/2',71 -6 1 /B- 13' ,. i.. - 1 1 ' is 61' -0' J 40' -0' JIV 16' -6 112' 2- 6' _ 6-0' 2• -6' 12• -5 112' +` I - - - - - - - - - - A _ _ :D -0' 6-0-MAX) N i�-- - - -- --711� �\ 1 N r 2 2'-IU 112- 1 11 2 2.8 SILL PLATE - - — - - - - - - - -- - -- - - - - - - - - - - J J - - - - -- - - - - - - - - - - -�. T - - - � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1/2' DIA. .1B- A ANCHOR BOLT$ ? ° INTfRGRAL PILASTERS OR CDUAL REOUI I (ANCHOR STRAPS REOUIRED FOR RI) O O.C. WHEN BACK(ILL EXCEEDS A' -0' HEIGHT 2 A'.J2' ACCESS (SEE CODE AUTHORITY FOR LUCA EOUIREMENTS) _ _ I I R - REOuIRED ' I I 1 15-10' 1 ADD LOLLY COLUMN HOLD DIMENSION I I I S S H 2' -10' Id;DD LOLLY COLUMN A ADD LOLLY COLUMN I ' ' I I T TLD DIMENSION H HOLD DIMENSION - I ; ; 5' 3' -0' 6' -5' 6' -5' -- - - - - -- - - + +----- F —o ---� --- - - --�-- e- -i- - -t - --1 ---- i---- I I- f-- e- -- 1--- --F --e -- t - - - - -I I I I ► I I I I I 1• 4 4- I I 7 7`• I 1 1 I I i - I i NAY NAVE i0 BE AvvROWE B• A PROFESSIONAL ENGINEER OR A REGISTERED ARCHITECT. I I I 2 2) ALL CONSTRUCTIOM AND MATERIALS BCLOV TK BOTTOM OF SHE FLOOR JOISTS IS INC I 1 G G R RESPONSIBILITY OF CXCCL HOMES' BUILDER. FOUNDATION WALL, FOOTER, LOLLY COLUMNS L PADS ARE ALL TO BE DETCRMINED ON -SITE IN ACCORDANCE WITH LOCH. CADCS L CONDITIONS I I I 3 3) REINFORCED HASDNRY WIT REOUIRED AT CENTCR BEARHL LOCATIONS I 4) LOLLY COLUMNS ARE TO BE SPA-CCD ACCORDING TO SPAN SCHEDULE BASED ON TYPE OF NQ1SC. �- L LOCAL SNOW LOAD L WIDTH OF IN". ADM COLUMNS MAT BE RECD L ARE NOTED ON FLOOR PLAN LOLLY COLUMN SPACING IS BASED ON 1/2•.6 -.12' STEEL PLATE BETVCEN COLUMN L CENIER BEAM I I I I S S) FOUNDATION IS TO BC CDNSTRIY- -TCD IN ACCORDANCE . /ALL APPLICABLE CODES. 63 FOUNDATION SIZCS REFLECT WOOD TO WOOD DIMENSIONS OF MODULAR UNITS, ALLOWING I i i Y YN S SHEAINING AND SIDING TO OVERHANG INE FOUNDATION IF STYROFOAM IS USED I I I I I I F FOUNDATION MAY SE INCREASED IN LENGTH AND WIDTH TO ACCD ODATC. ' 7 7) FLOOR PCRIMC TER BANDS TO BE ATIACHCD TO SILL PLATE . /16e MAILS AT 16. OC. I I I B B) INSTALLATION OF WASHER. DRYER AND /OR WATER NEATER IN BASEMENT PER STATE AND I LOCAL CODES IS THE RESPONSIBILITY OF EXCEL NOES' BUILDER. 24'.32; ACCESS 9 9) SMOKE CCICC7ORS IN BASEMENT SMALL BE INE RESPONSIBILITY Of THE BUILDCR TO - — — — — — — — — — — — - I I R REDUIRCD P PROVIDC AND INSTALL. (COIL WIRE IN BSMT BY EXCEL HONES. INC) I N 1 1 1 10) CRAWL SPACE FOUNDATION RCDUIRCS A MINIMUM 1B'.2N' ACCESS OPENING. INSECT t RODENT PROO OR F -- - - - - - - - - - � r, I L{...________ ____ ____ _ __.... 13' j. k N t: i, 14• -0' 1 i 1 I ` I I' I, 1N I' i• I. -------------- - - - - -- T I 12' -6' •`i o� I I I I LID I I 1 f� o � 1 •1 1 N R®NIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 • °° , � mel• .lgln�7aE 3661. e.g�z: X91 ^l "3f>3�g3 .... P.. September 29, 2003 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster NY 10509 Re: June Adomo . Bryant Pond Road Town of Putnam Valley Dear Mr. Paravati: Please find enclosed the revised information based on your comment letter dated September 19, 2003. Please review the project at your earliest convenience and if there are any questions do not hesitate contacting me at the above number. Respectfully submi ed, Kenneth M. Murphy Design Engineer Ic ,•� ' LORETTA' • ILit0UtNART-R.N:, i'./f.S.N: ' Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 September 19, 2003 Ken Murphy Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Re: Proposed SSTS — Adomo Bryant Pond Road, (T) Putnam Valley TM# 74 -1 -10 Dear Mr. Murphy: ROBERT J. BONDI County Executive This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. 1. Water levels need to be indicated on the design data sheets. ` Silt fence should en.lose.the entire fill -yd for the primary system. mss ' "'° 'There appears'to be an inconsistency in contour labeling. The fill plan and trench plan are showing different elevations in the expansion area. A minimum of 3' -6" cover is required over the force main. Pump calculations for head and friction loss needs. to be provided. Pump curve provided on plans needs to show head/friction loss curve to conform selection. ,,'7. One -day storage above the high level alarm has not been provided. 8. A datum reference needs to be provided. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, oseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ESIGN'I)ATA'SliEIE;T SUBSURFACE SEWAGE TREATMENT SYSTEM Owner JVrj4. P- 0og/jo Address Located at (Street) 13n yT I 20g rr> Tax Map % Block / Lot / 0._ (indicate nearest cross street) Municipality (T) 'Pu•r,JA Ac.t..c;V Drainage Basin p6 KXKlt_L HoLLow Eloo.K" SOIL PERCOLATION TEST DATA Date of Pre - soaking —5`1i t_y % ZoU 3 Date of Percolation Test 3 Hole No. Run No. Time Start - Stop Elapse Time tPMin.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches j Percolado-: , Rat, Min/Ind' ` 2 II 01 1110, 9 3 4 23 5 2 of 0°1 J 3 5 1 2 3 4 5 NOTES: .l. 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 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES IjEP Ii� q . _ 1 fbLE N .._ .:.. -i HOLE �I O: 1� � : ��iC��,EjI�fO � D...�. G.L. ►C- �jo . I ,i0- I 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 2 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' " 8.5' 9.0' 10.0' (L,oG(L e- Indicate level at which groundwater is encountered . Indicate level at which mottling is observed i.rpA,G Indicate level to which water level rises after being encountered , :5, o ` Deep hole observations made by: Dateo6.3y -63 lGe frN sNWOMW JoL!:: P,4RI�v+7-7 Design Professional Name C. Cad Address: Signature Design Professional's Seal 1 S 0980 'OROFESSko�LP' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES . '. � , ... Vie.. ..�..• :� : ...:.. � �: ,;;-�: •� : ��.;.'+�e -a �•�:; -'..,::: ;'�•.. �� .:•.:.':�k,...: ;:. �� .; :;_i.:.r ' :. .. .6: . ... � :_ ... �._ ^•. y.:. :.:..' �... mr!a: n. .. ''z 6)..�: DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM P O. rah Z/ Owner Jurjt PoopNo - Address 'Pu pq/lni V/ tLCY. NV 10, Located at (Street) T3Ry�N ,— ,�� Ro6o .Tax Map %1f Block / Lot (indicate nearest cross street) Municipality (7-) 'PuTr-A /ILL V Drainage Basin RctKfKILL HoLc.eW SOIL PERCOLATION TEST DATA Date of Pre' soaking 5u `Y %,, U 3 Date of Percolation Test u 3 Hole No. R Run No. S Time E Ela se Time S De th to Water W Water Percol: ti, - 1 2 2 I II�S I 10 _ 2` z 232 � �2 0 I I I 4 1 123 101 I I 3U I I I _) ` 3 3 4 1 2 3 4 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, <_ 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth, measurements to be made from top of hole. Fore, DD -97 VEST PTT DATA . DESCRIPTION OF SOILS ENCOUNTERED IN VEST HOLES DEPTH v HOLE NO, y > ° ' � y v HOLE N0. p 5 � HOLE NO. DG G.L. '.SAML' As No. t 504M AK PO. I s,Anaa A4 No• I . 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 2 (tOGK rzo&- r- fto�l � Indicate level at which groundwater is encountered , jowc o J�5eaul�-o Indicate level at which mottling is observed J�roivc' Indicate level to which water level rises after being encountered ,j Deep hole observations made by: e-lz,.Nrn, &�- N4. / Lq—,- oN Dateo6.3o •o3 14GlM 4*7t-t DOW Jar P412AVAn Design Professional Name: c SZc, N r r-i a Address: 2 -Ta . K ld !�1 %� 1..5� %�L tJ-o ��rK1KIC 1J 10S-66- Signature: Design Professional's Seal �f W L' `S' G2980 FQ "WESSO PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - = E-SIGN DATA:SHE;ET -SUBSURF ACE -SEN -VALE TRE- AT�NIENT'SYSTEIVi Owner J Nes { pog 14 n Address RJ-r-,Jrorti VA LLLPV Ni/ 10 57 9 Located at (Street) 911yia N 7- R c-tn 12,o ALA Tax Map 94( Block I Lot 10 (indicate nearest cross street) Municipality P TNr4r's, i« y Drainage Basin ?CEKX 1Lc_ &L(_a W Fl%on SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Elapse Time ki Iin.) De th to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation ! Rate Min/Inch 1 I I i 2 4 �12 3 4 5 1 2 3 4 5 NOTES: 1 _'' TPetc to hP rPnaatarl at cams rlPntit until annrntrimataly Pnual narrnletinn retoc era nnteinoii et aar}t percolation test hole. (i-.e. s 1 min for 1 -30 min/inch, < 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 L TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES EXP,�►S►oN gft�a FBI �-5 DEPTH ;NQ _h,.77 : HGL;E G.L. 64,K,6.:' A5 o. ► na— o. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' R 8 r� IL .. r S 45 5.0' 5.5' 6.0' r. 6.5' n 7.0' -a 7.5' :� i 8.0' 8.5' 9.0' 10.0' Indicate level at which groundwater is encountered nroN� 085���G� Indicate level at which mottling is observed Indicate level to which water level rises after being encountered ,jilt Deep hole observations made by: G�oNrN�,yG, f PGDN Date .30 »03 Design Professional Name: -TIM en" X L • Cko N`► N . Address: 2 So09V P11Ls" fK/ Signature: 6s-, Design Professional's Seal � V PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,APPLICATION FOR APPROVAL OF PLANS FOR ..__........:�.....��.....- .... 1. Name and address of applicant: e D o (2 N o 'P. v.. oolr 436 . oS 2. Name of project: V&IC«4 9XT'S CON,f -ray cTp/3. Location TN: t i IPX-ra W N 4. Design Professional: Cnopw ktJ6'yNee_r1Z ►6 5. Address: 2 'SoNN W AL rk )FtUjo 6. Drainage Basin: FkCKSK ILL Ha cc.o W 1?RddK F C K.t'K t L L NV 10 C -CC 7. Tune of Proiect: Private/Residential Food Service Commercial Apartments Institutional Mobile .Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status ("check one) ....................... ............................... Type I Exempt Type II Unlisted Y 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... Na 10. Has DEIS been completed and found acceptable by LeadAgency? ............... N Jil 11. Name of Lead Agency ps 12. Is this project in an area under the control of local planning, zoning, or other. If TM 13. If so, have plans been submitted to such authorities? ...:.... ...........a...............:... 14. Has preliminary approval been granted by such authorities? Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water groundwater 16. If surface water discharge, what is the stream class designation? .................... JAI tl 17. Waters index number (surface) ...... ......................... :..................................... ..... N /� 18.. Is project located near a public water supply system? N a 19. If yes, name .of water, supply N A Distance to water supply 20. Is project. site near a public sewage collection or treatment system? ................ N o 21. Name of sewage system Distance to sewage system tJ PI 22. Date test holes observed 6 3.d 200 3 23.. Name of Health Inspector 24. Project-design flow (gallons -per day) 06 6. 25. Is State - Pollutant Discharge Elimination System ( SPDES) Permit required ?... 1-40 26. Has SPDES Application been submitted to local DEC office? ......................... tv Form PC -97 2. 27. Is any portion of this project located within a designated Town or State wetland? N 0 28. Wetlands ID Number. '_� ;r:�;..:<::r;...:..... „��s►'3' ::.,._ r. 29. Is Wetlands Permit required? ................... :.......................................................... 410 Has application been made to Town or Local DEC office? ............................... iJ 30. Does project require a DEC Stream Disturbance Permit? .. ............................... (� a 31. Is or -was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal,' r landfilling; sludge application or industrial activity? ..:,:,.......: >:...;..:.::.:. Yes/No a 32. Is project located within 1,000 feet :of existing or abandoned landfill, - hazardous waste site, salt stockpile, landfill, sludge disposal site or any other ote* ntially known source of contamination? Yes/No i� d DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ....................... ... &_S 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... W6 35. Are any sewage treatment areas in excess of 15 % slope? . ........:.................:..:. 1Jd 36. Tax Map ID Number .......................... ............................... Map Block_ Lot ] O 37. Approved plans are to be returned to ..... Applicant _e Design Professional anew OST to'oe iodated wit�iii fheNYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of .impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 1.,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. -- w I hereby aff rm, under penalty of perjury, 'perjury, that inform atr pro 8� � �lti�,f l� Is u to the best of nay knowledge and belief. False ad h din is e a Class A misdemeanor pursuant to Section 2 o the P na lGa 1 SIGNAT7URES & OIFFICL4L TITLES.- ma-n4 v cRN444\11 Mailing Address: .................................... 'L rSo 1't W A L CM PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES C.. t V.1�w.t, n. .... `1 ..4r ,s. w'k.V �' �.a.� v .�1.».�. •.f •o. .. wc. �I.f .. �t v e � .. �_ ..a..� •� I� —. ,.�. w.yp, �".w' a� • i .. .}f v. LETTER OF AUTHORIZATION RE: Property of '7-u1,1t 9 D ofLN y Located at RR V A W T►' ?o 4J a 1?oA Q T/V' ,,,- Tr►Ar1 Lte-V Tax Map # -71-f Block l Lot 10 Subdivision of Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize C. Ci2o N 1 N 12v- a duly licensed Professional Engineer_ t to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provis!PJ15 of Article 145 and/or 147 of the Education Law, the Public Health 1W, Qo�dc:: Countersigned: P.E.,1mi., # _ 6,2980 Mailing Address. S v 2 SvyN V JALXH T. LUP Very truly ours, t W Signed: ZA C� (0 of Property) State EEKSKiLL �J V, Zip %0 S6r Telephone: (914 ) 79C— :? 6'SY Mailing Address: ?0- I?ok 43C 24 3 oco cHyrzcm RdAo State' TNra� VALLCV,_1Ay ip 10S °1 ff Telephone: Form LA -97 rRONIN ENGINEERING P.E. P.C. FILE indy Building,suite 200,.2 John Walsh Blvd Peekskill, New York 10566 1`4)73ir3664edx�(�4rj%(r3S July 30, 2003 Mr. Peter Faranda 61 Bryant Pond Road Putnam Valley, NY. 10579-2406 RE: June Adorno Bryant Pond Road Putnam Valley, NY Tax Map #74 Bk #1 Lot #10 Dear Mr. Faranda: Sent Certified Return Receipt 7001 1940 0004 7185 4366 Tax Map #74 Bk #1 Lot #11 Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. f you have any questions, concerns or information which may bear on the He Departments review of this application, you may call the Health Department at (845) 278 -6130 or myself at (914) 736 -3664. Very truly yours, Kenneth M. Murphy Project Engineer Enc. m ,PUT i VAtLEt'r`> �t'f 105i9 Ln Postage $ ,31/ v+ ra Certified Fee �. 3b,30 r%- Return Receipt Fee /, . (Endorsement Required) 0 Q Restricted Delivery Fee p (Endorsement Required) iJ T ostmarl G CZert; 0 Total Postage &Fees $ _ S Er Sent To Mr. Peter Faranda r 61 Bryant Pond Road Street, Apt. 0 or Po sox No. No.; Putnam Valley, NY 10579 -2406 � Clty, State, Z(P+ 4 - - - - - -- ..... VERNON F TRANSMITTAL CRONIN ENGINEERING P.E., P.C. August 1, 200: The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914- 736 -3664 Fax 914 - 736 -3693 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 RE: WELL & SSTS CONSTRUCTION APPLICATIONS JUNE ADORNO BRYANT POND ROAD TOWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY WE ARE SENDING YOU attached 1.) Copy of subsurface sewage treatment system plan 2.) Three copies of fill placement permit plan 3.) Three SSTS construction: permit_applacatPOn 4.) Letter of authorization 5.) Application for approval of plans 6.) Soil data sheet 7.) Short environmental assessment form 8.) 2 sets of house plans 9.) Updated survey 10.) Property owners notified 11.) $300 for application fee V/ 12.) Application to construct a water well The information is provided based on our June 30, 2003 joint site inspection and ensuing discussions: Please review at your earliest convenience. Thank you for your assistance in this matter. Respectfully submi ted, ,-"Kenneth y Design Engineer :fir. -EF RONIN ENGINEERING P E P.C. -Tel. (914)736-3664 F ax (914)736 3693 �~ November 24, 2004 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services 1 Geneva Road. Brewster, N.Y. 10509 Re: SSTS Trench Permit PCDH Permit #PV -22 -03 June F. Adorno Bryant Pond Road Town of Philipstown Dear Mr. Paravati 1.) Two copies of SSTS trench plan 2.) Construction permit application 3.) Soil data sheet Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. Thank you for your assistance in this matter. Respectfully submitted, Kenneth M. Murphy Design Engineer LORETTA MOLINARI Public Health Director . 7. ROBERT J. BONDI County Executive DEPARTMENT OF HEALTfI 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 24, 2004 Keith Staudohar Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear Mr. Staudohar: Re: Field Inspection - Adorno Bryant Pond Road, (T) Putnam Valley TM# 74 -1 -10 A site inspection was made for the above referenced project on November 23, 2004. The following comments must be corrected in the field. 1 �• Fill pad for expansion area was not constructed according to the approved plan. The pad.' - ('91", dimensions were approximately 58 long by 60 wide. The approved plan dimensions were. 87 long by 40 wide. However, it appears that the required trench length of 333 LF can be met with slight modifications to the constructed pad. Please show new layout on the trench plan and notify this Department when the pad is completed. If you have any further questions, please contact me at (845) 278 -6130 ext. 2157. Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 ]Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 17, 2004 Keith Staudohar Cronin Engineering The Lindy building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Z'�� Re: Field Inspection — Adorno Bryant Pond Road, (T) Putnam Valley TM# 74 -1 -10 Dear Mr. Staudohar: r11 3 A site inspection was made for the above referenced project on November 16, 2004. comments must be corrected in the field. The following Two trees in the clay barrier need to beT removed. �� More clay is needed around the low end of the system (house side). ti 5'e.�e ' (: 33 Expansion area fill needs to be placed and inspected before a trench permit can be ��vcN nhN�rs� issued. �W 4f you have any further questions, please contact me at (845) 278 -6130 ext. 2157. Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP:cj. 11/08/2004 15:-56 9147363693 CRONIN ENGINEERING 1 PAGE 01 PUTNAM COUNTY DEPARTMENT 0', DM91ON'01F ENVUtON-NIENTAL HEAL' ATTENTION A4MM' GENE REQUEST FOR FINAL INSEECTIO For: All informition must be fully completed prior to any inspections being made. PCHD Construction-Permit # Lo'cati& Chvaer/Applicaai Name: '-S6--31E' —Abbaij0" Formerly: Subdivision Name Subdivision Lot # Is system"fill completed? S (fa Dab Is system complete ?' N b Date Is sy► constructed as per plus? Is well drillidl..... %Vts Dati Is well located as per pla;is? Are; erosion,control measures in place? I cetti£y that ;00ve premises has beer, and, .verified . their completion in' accordance )with.tfi.e issued approved" : pliis and the Standards, Rules and Regulations of t� —4.007. 1 L EN Date: Certified by..,. Design PTO Address flip 1!I�A L St,(; L(/, E.C. K4K1 L L -77777 io �HEALTH 'R SERVICES Fill 4v) A M VA t- 4, k-)f 74? 4 Block I Lot 18 constructed and I have inspected PCHD Construction Permit and e Putnam County Department of PE—RA- -.Lic. 9 NOV-8-2004 'MON "-1624 TEL:845-L78-7921 NAME:PUTNAM .CO . UNTY DEPARTMENT OF P. 1 PUTNAM* COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY SUBSURFACE 8 wA.GF -TREA! rOlEN i REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: ���° STREET LOCATION: REVIEWED.BY: RM, GR, A, SRDATE: /'3 TAX MAP #: (CONFIItMED) Y N DOCUMENTS Y N ( REOUIREDD DETAII.S ON PLANS CONT'D? PERMIT APPLICATION LVO OUSE SEWER - %" FT. 4 "0'; TYPE PIPE, CAST IRON ll�WELL PERMrr OR PWS LETTER NO BENDS; MAX BENDS 45' W /CLEANOUT ER OF AUTHORIZATION W DATA SHEET (DDS) ORATE RESOLUTION T EAF ( `'1F )PLANS -THREE SETTS (__) L-)RO USE PLANS -TWO SETS (�CE REQUEST SUBDIVISION L_) LEGAL SUBDIVISION UUUSUBDTVISION APPROVAL CHECKED UUPERC RATE (UL}FILL REQUIRED DEPTH UL-)CURTAIN DRAIN REQUIRED GENERAL U LOCATED IN NYC WATERSHED �LANS SUBMITTED TO DEP m LEGATED TO PCHD P APPROVAL, IF REQD EP TEST HOLES OBSERVED (_•��RCS TO BE WITNESSED (•jU APPROVAL SSDS ADJ, LOTS U W F�DEGFERMEr 'D ?) . A ON DDS PLANS & PE " (_}U 1969 NEIGHBOR NOTIFICATION 'A j 9-�IET 00 YR. FLOOD ELEVATION W/I 200' •1lJ (�(!f)SOIL TESTING LOTS>10 YEARS OLD REQUIRED DETAILS ON PLAINS (� )SEWAGE SYSTEM PLA14- (NORTH ARROW) u U DS HYDRAULIC PROFILE GRAVITY FLOW 41 CONSTRUCTION NOTES 1 -15 DESIGN DATA: PERC & DEEP RESULTS CONTOURS EXISTING & PROPOSED (DRIVEWAY & SLOPES, CUT EEFOOTINGIGUTTERICURTAIN DRAINS USDA SOIL TYPE BOUNDARIES ___)TRTLE BLOCK, OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# E OF Dj�YRK/REVISION DATUM REFERENCE , U(_,,)LOCA OF TERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. CDC-)PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS (_ -)WELLS 4 SSDS'S WAN 200' OF SSTS .��$OMTY METES & YOUNDS' ERASIOIN CONTROL FOXHOUSE, WEY,I —SSTS, EROSION CONTRO_ L NOTE 119rlp-i 4-1-4- poly FILL SYSTEMS 0' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE FILL IN EXPANSION AREA r FLLL GREATER THAN2 FEET CLAY BARRIER . . UNCLASSAD & ] (_✓ (SEPARATION DISTANCE FROM'TOE OF- SLOPE- TRENCH• ' ( ✓�(�LF TRENCH PROVIDED S - 60FT MALL. ()PARALLEL 'TO CONTOURS �100% EXPANSION PROVIDED - 3 33 �F ' `" "ti 333 iz'�`r DETAdLIDUST FREE CRUSHED'STONE OR WASHED GRAVEL ((-_)GEOTEXTILE COVER uSEPARATION DISTANCES ON PLAN - FROM -SSTS (___•)10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL ✓��20' TO FOUNDATION WALLS 100' TO WELL, 200' IN DLOD,150' TQ PITS L} ,/�—�100' TO STREAM, WATERCOURSE, LAS (inc. expan), , �• • _�_..i ;6(_)(L-)10' TO WATER LINE (pits - 20') ( E_-_)50'• INTERMITTENT DRAINAGE COURSE (_,LJ200' /500' RESERVOII.3, ETC. 150' GALLEY SYSTEMS C ✓ C-J10' MIN TO LEDGE OUTCROP ll SEPTIC TANK U(—)10' FROM FOUNDATION; 50' TO WELL WELL �' DMNSIONS TO PROPERTY LINES (_% LOCAT'ION OF SERVICE CONNECTION UUMIN 15' TO'PROPERTY LINE SLOPE .� UU��S 'OPE IN SSTS AREA UU�GRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS PUMP NOTES . ( SE 75% OF PIPE VOLUML OSE V UME NOTED ETAIL"F(�RFORCE'.�IAIN, (PII'E TYPE, ETC.) <- •�`.I'� � 1 � � ' it I DAY STORAGE ABOVE 3 6 CUR AIN D UUSTANPPIPES, 5' BOTH MIN to o, 20' -4 %, $5' -3 %, 35' -1 %,1 0 % -<1% ( -U2 ' to CD DISCEL4RGE/100' with 182 cons day discharge S� 0' MIN to NON -PER/ FO�R�A®T�ED PIPE C'I�OG C�vrJf•,��.� y', v-t fi llO/� -N ��-c/ `fi'G►ti� /�[ PUTNAM i COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUC 16N PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # " Located at fib "l�"�'�?.lv% ' r > �l Town or Village Subdivision name Subd. Lot # Tax Map Block d Lot 10 Date Subdivision Approved j! cs Renewal Revision Owner /Applicant Name '";S -v ,-j c: j4 o o t2 /jc) Date of Previous Approval Mailing Address 2134, oL-o (:Nuf2Gkt r.:d &6 'i .o- 1FO t 'roAr's VAec% Zip Amount of Fee Enclosed •` .0 �� 10 ; •Itl Building Type 5) N. (Le'-.: : Lot Area 13 2 No. of Bedrooms Design Flow GPD COO 0 Fill Seetion Onl Depth 6 ` . Volume ±: 7 q 6 C u y .� P. . Separate Sewerage S sY tem to consist of 16.60 gallon' septic. tank and Other Requirements: To be constructed by Address Water Supply: Public Supply From Address � T or:.— Private Supply Drilled by CTaM1 r� tzt? /j0 C> Address._. _R I. represent that I am wholly and completely. responsible for the design and location of the proposed systems) 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;iules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction C .. " satisfactory to the Public Health Director will be submitted to the Department, and a written guarante lb`be n a owner, his- successors, heirs or assigns by the builder, that said builder will place in good PP,,erati Qidn o id. sewage treatment system during the period of two (2) years immediately •followiggtheiate o the�uance p the' Iry of the Certificate of Construction Compliance of the original system or any repairs etreto. I " W Signed:'^. c .E. R ":AEA Date Address '2, �� o tv tJ ��� t. -,18. '� 4: "" - . "�, . I I... (L . ; jJ.� / t�� F; 6` License # 0629 _ � c7 APPROVED FOR CONSTRUCTION: TMTapproval 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 discharge of domestic sanitary sewage only. B ;�,.� r;: t'' ` r.,�c.. x {`;, " , Title: m Date. LI' White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT .: Y: 61'Y N.- Y - -.._ WeliL'oeatdom ._ _ .._._ _ ....... ...�. �. :.- .,._.:' _ -,: y". ... . Street Address: 103 Bryant Pond Road .w.: L.N. - 1'o ; illage: Putnam Valley Tax Grid # Map 7LI Block / Lot(s) / D, Well Owner: Name: Address: June & Ralph Adorno, 103 Bryant Pond Road,Putnam.Valley, NY 10579 Use of Well: I- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling ]Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: ' X Steel Plastic Other Joints: _ Welded X Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: . X Yes No Liner: Yes X No Screen )[Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Vest _ Bailed X Pumped X Compressed Air Hours 6 Yield 162 gpm Depth Data Measure from land surface- static (specify ft) 40' During yield test(ft) 440' Depth of completed well in feet 705' Well Log If more detailed information descriptions or are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 4 Drilling in overburden clay and boulders Hit rock at 4' .i.a nl;i ng' r n_ax'�.�k, sYr,_ ";, i.ng r: �r�utF _..a. r 32 705 Drilling in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 10gpm Depth 660' Model 10GS30412 Voltage 230 HP 3 Tank Type WX350 (2) Volume 119 gallons �,�U; + L' `' }}'` _--- -'"� Date Well Completed 8/26/04 Putnam County Certification No. 006 Date of Report 10/25/04 Wre Phi i J. Beal NUDE: DE: Exact location of well with distances to at least two permanent landmarKs to be provided on a separate sneevpian. Well Driller'sName eal & Sons Inc. Address: 4 Putnam Ave., Brewster, NY 10509 Signature: Date: 10/25/04 PlAliVJ.Beal White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 I each �b :A I• O 0 I / r �5 20.. E N83 °. 1 . S :1 2. Story Stucco ona ., Dwelling v� .i / \l 1 112 Slory Stucco and Stone E 10" }Y \ \ 98' \ N61°oi'20 -W .55._32': N64 °34'00 "W 27.62 ".N63 °06'10 °1Y 46.78' -/ oy Arb' N60 °51'10•'W 26.72' N68 °35'50"W 10.53' - y �! N63 °48.40 "W 147.3.3' i • t' f ' 1 • 1 • i. t C { t / tone l / / f Area 13.2064 Acres �6 Metof ®Weil - .. ° a,-rel. Ped C8 — irons: Rim 770.0 ' I Rip —Rop �\ CY In 768.9 \ \ 1 _ Rip —Rop \ \� /{ln v. 71Z 12 "CMP In 793.6 � 12 "CMP" to Inv. 300.2.J 9 N61 °30'40'•W 126.09' $ $ i /9f 9 TOPOCRAPHICAL SURVEY OF PROPERTY PREPARED /br JUNE F. ADORNO Situate in the TOWN OF PUTNAM VALLEY COUNTY OF PUTNAM, NY Scale: > " =50' April M, 2003 t' C4Nav /Hind Lhhmi U.SF9. (Amai/ Rl/EYORS CERTIFICATION T ®200J nv9r aI um sconsrwr; I.C. Aa 9085 9f31PlED IlOVS oe4r.'A nD NEREDN 5>vsr ll� UYAIIINOR® ALaxArnv Of A0a19M ro nae 945 PREPARED N ACMO]AMT 9RN nE 1410 COOL OF PRACnCC iD9 UND SIMIEYS 1[D eY DL ASSOC (Y PR0FE59DVAt SY41E1' 45 A YOlAnJV C! K Y.S mlJr U9 SECnON Ml ]204 9A)Ilrl SVR1El: nnurxMS SNALL RI91 OILY ro n1f PEPSON um[AfiC?Wdl SI.VUC'KIIES. ! AIT. N0T AIL L£RnnCAllovs ARE VAID !iX IMS Ynv M/OII INS SaiIEY 9A5 FREPARED AND p/ N9 ro f1E nnE m am u9mis Mnrvnrw ANO COPES HERE? CHIY i SW YAP tK LI'MSS 4u9 nE 9Ea 4am sEAE a nE surlEroe MxuE IIEIPEbt 90'IAIIeE APEFARS' IQIEOK . o94N5 DONNELLY LAND SURVEYWG, P.C. D19 mYIERRCE SRiZET ri'owrro9Y 1na1rs Nr ros7e L SC1960 L3, KY.3 LC N0. 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