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HomeMy WebLinkAbout3555DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -30 BOX 28 03555 �� MMAN COUNTY DEFAMWIENr OF HEALTH O\ Dlvblma of elor ensemW Health Seevkes, COUML N.Y. 165n zRabowtoplievililleposlinaltill as C EWMCATE OF Fes!' FOR SEWAGE DL4FOSAL SYSi111! P, ", 0 1,30:5 Laalled at Lage11�1ad own air valege Sebdlybl.a Hams r l� e t ell AE- 'Tea�e•°� a..u, lit Ice .. - N ... _ , w .,.: n... , _ .. T� aVYl, K:.� xemawal� oweladsppRaist ra M J ;M C. IA Ret�elaa �� ��.�b�( BJ�i 4 mat Frevbua Appaoval . Knobs Adtteea r�-�� Pl�ini tip10M92 -2135 y Date ,Subdivision Approved Fee Enclosed mnim nwmbg Thle� lJQ. P.Vf'T, al Let Area 3 Fm setxloa O°b Depth Velose Needles: d 9edsonaa Deep Flow G P D Q� AA P RD NNMf6ntlom k Regahed Wben Fig b completed St> mnb %wamp syotaml te emmdd d jow C.Dma sep* Teoh ,w 6001-F A - %^ir ki % ! i g To be aewhiseted by Address; Water Selp *- Plbe Sw* Fir,om Millen an �FWfI . Sob, Deed by �'L�.l ✓r Addnm Otter R"m1 eeeeats 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sawage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a regu ns o nam County Department of HMgh, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Hesith will be submitted to the Department, and a written guarantee will be furnished the owner, his successors. hairs w assigns by the builder, that said builder will Place in flood operating condition any part of said lawn" disposal system during the period of two (2) yea► Immadiatoly following thedste of the Imu- anCe of the approval of the Certificate of Construction Compliance of,t origiMl system O► any repairs t 02) the he drilled well desgibad above wNl a beefed as shoavn on tM approved glen antl that said well will be 1n 11 in accordance with sta d ru rpu aT%ni of the Putnam County Dapartma/nttof Heealth. Date 6 —30 / 7 Sign MO No 4` Addra d '�'4�; Jp APPROVED FOR CONSTRUCTfON.. This approval expires two years from the date ed unless construction of the building has been undertaken and is fevocsbe for cause or may be amended or modified when co�ednecesury by the Commissioner of Health. Any change or alteration of construction neulres a new rmit. Approved for disposal of dourest e, and /or private water supply only. 3V. )�88 D.ea % ey Title 1���� all 3o . PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 I CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM' - -- °—° Town Village Building Type Section Block Lot �J Job 7EON 05!9;W (,� �,!2 �l Address 8 /��. "- /�pr�"�,y I- Lot Area (JJe i /� I eJ56'A�A Number of Bedrooms — Total Habitable Space J�sa -- . Square Feet T •I. Separate Sewerage System .J� flfl to consist of Gal. Septic Tank —lineal feet X Al [. = width trench To be constructed by f egfli . A Address Add yylt� v`vs i� .i Water Supply: Pub— lic Supply From A j Private Supply to be drilled by A n I Address A.J ! Other Requirements 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations of Putnam j County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill ! 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 disposal system during the period of two (2) years immediately following thedate of the Issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto -, 2)`that the drilled well described above will be located as shown on the approved plan and that said well will be installed in accordance with the standards, rules and regu a� o�fi —ns of the Putnam County Depart ent of Health. {j Date TZ Z /- Signed . Q P. E. R.A, a Address 1W-{1 4 ,q m , ` " /v License No, '05 1,51 1 APPROVED FOR CONSTRUCTION: This approval expires one year from the date i ed s co struction of the building has been undertaken and is revocable for .cause or may be amended or modified when considered net scary by the mmier of Health. Any change .or alteration of construction a' requires a new permit. Approved for disposal of domestics n; a wage, ,t supply only. C > Date By cJ"—v Title r J t I ✓. . PUTNAM COUNTY DEPARTMENT OF HEALTH DIISIQN OF ENVII2nNMENTAL.HEALTH SERVICES_..__, CERTIFICATE OF CONSTRUCTION COMPLIANCE �AAGE TREATMENT SYSTEM H1 � PCHD CONSTRUCTION PERMIT # P�� g " �� � 14 "`,�� Located at 505W F-LL P-OA Tom or Vi la NAJ-1 VAL1-Y Owner /Applicant Name � ' e>1A1-2MAW Formerly Map " oc d o � livision Name B®6i,46W_ a5i-ArF6 Subd. Lot # Mailing Address 6 1+fF ^THEE i-ANJE PQ7kA 1 Date Construction Permit Issued by PCHD Separate Sewerage System built by Consisting of 100 Other Requirements: Water Suonly: 43. V A."- F-Y N,i. Zip 10r5-11 Address Gallon Septic Tank and c2W L r- A AS nej6 Public Supply From or: X Private Supply Drilled by Bzzildidg_ ype...k '�I �E�- 1r��1- Number of Bedrooms Address N I certify that the system(s), as listed, serving the above premises were constructed essentially as"ShoWh on the as- built plans (copies of which are attached), in accordance with the is ued PCHD Construction Permit and approved plans and the standards, rules and regulatignp of the Putnam Couffy If papment of Health. Date: ahv I ov Certified by (D s'gn Professional) V Address � Mlw-m )4 R 6UirE lh $ N, 1060q License # P.E. X R.A. JG 12A 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 ar, subject to modification or change when, in the judgment of the Public Health Director, such revocatio mo i ation or change is necessary. I By: Title�� ld�- ! / %,.�1J� Date: Z7 White c y - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 co M Address r-. Has.Prosion.eontirol been ompleted? Has garbage grinder been installed? - 0 N I certify that the system(s), as listed, serving the above premises were constructed essentially as"ShoWh on the as- built plans (copies of which are attached), in accordance with the is ued PCHD Construction Permit and approved plans and the standards, rules and regulatignp of the Putnam Couffy If papment of Health. Date: ahv I ov Certified by (D s'gn Professional) V Address � Mlw-m )4 R 6UirE lh $ N, 1060q License # P.E. X R.A. JG 12A 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 ar, subject to modification or change when, in the judgment of the Public Health Director, such revocatio mo i ation or change is necessary. I By: Title�� ld�- ! / %,.�1J� Date: Z7 White c y - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ._ .�:.s:'• _.,- .�5— ;.:....._ .. - <: i .t s` .. 'mss_ _- ..�_... ..M .., �a•e. i� .- r:e.a >__ -- .6'.ss::.'.c :' -.a.. � ie�: mss- .. Q. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM /" /A,e/e .Dive �l eXA��Al �SS�,�� G,X 9 17 Owner or Purchaser of Building. Tax Map Block Lot (iVf_s,rcgE!sme NeoutAiz TlaMes loNSRIuC e), Cu 6 P, -?vnVIq M VALlt Building Constructed by TownfVillage swtL L �oa Location - Street Subdivision Name 4s Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system,. except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the Isystem. 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 7 Year, i Signature: l� Title: General Contra6tdr (Owner) - Signature /11/�SrCH�SrF� /1ifo�v�,ylz � %a��s G�S�ed�T7ory �,er� � ��< Corporation Name (if corporation) orporation Name (if corporation) Address: 111Z) Aure, ZZ State PX77c-,esolv. � ��ll Address: obi /Gl� z-�Z State �,� Zip 1,2---,63 Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well -Coca an ,_: <, :, Swreet Address° Boswell Road - Tovvn/`Jillage - Putnam Valley Tax Grid ;# Map Block Lot(s) Well Owner: Name: Address: Westchester Modulars, Box 2910, Route 22, Patterson,-.NY-12563 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment x Rotary Cable percussion _2_ Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock _ Other Casing Details Total length 268 ft. Length below grade 267 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 X? gpm Depth Data Measure from land su ace- stauic specify ft) 30' During yield test(ft) 240' Depth of completed well in feet 325' Well Log If more detailed information descriptions or sieve analyses.. are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 165 Drilling in over urden clay and boulders 165 Hit rock at 16511 -165.; : • . = 268• Dr'- - 268 � �� -'� -� -.• If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5crom Depth 260' Model 5GS05412 Voltage 230 HP Tank Type WX302 Volume 86 Date Well Completed 6/4/98 Putnam County Certification No. 002 Date of Report 7/23/98 Well Dr' a (si I.., l M: FxttL;L rvcauurr vi Wert wrtn urstances to at least two permanent lanamarxs to De prov7a on a separate sneevptan. Well Drillees Name • F. Beal & ons, Inc. Signature: Perry . Beal Address: 4 Putnam Ave. , Brewster, NY 10509 Date: 7/23/98 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Inorganics Analysis Data Sheet i-or " Client Name: P.F. BEAL & SONS Project Name: STANDARD ETL Sample Number: 188312 -01 Client I.D.: WEST MODULAR WESTCHESTER BOSWELL RD PUTNAM Date Collected: 17- JUN -98 Matrix: 1 DrinkH2O Date Received: 17- JUN -98 Comments: Analysis Result Units Method Analyzed .... ........................ ............................... `213U .. 18. JUN 9 _........ y .............:.......:.:....................:::................................................................................................................................... ............................... pH 7.7 4500 -HB 18- JUN -98 Remarks: 1 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562 -0890 s... r,. a• E.. I,. i.. I NYSDOH 10142 NJDEP 73015 CTDOHS PH -0554 EPA NY049 PA 66378 M -NY049 Fax: (914) 562.0841 NYSDOH10142 NJDEP73015 CTDOHSPH -0554 EPANY049 PA 68.378 M•NY049 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562 -0890 Fax: (914) 562-0841 �Env.iroteIt 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 MXEI .F.F. Bits m NORTHEAST LA130RATORY oF DANBURY 34-3 XMt, FLMX RQlW , DANMY, CT 06811 (203)745-7903 - PAX MM) 748-0652 LABORATORY REPORT WATER SUPPLY TESTING :SONS. INC. DATE SAMPLE COLLECTED. 721/98 AVRME TIME COLLECTED: 9:00 A.M. COLLECTED AY: CMUS DATE RECEINED, @ L4B: 7/21/98 R . DI .KALT14 DEPT. TESTED BY:)LAB#FH6404 REPORT DATE. - 7/22/98 It.' BumeH Rd. XutfiAm Valley, NY MUM kitchen Sink WELL NONE-NIEW MVL-lm Od ll,' l CT Cert: MOM NY Ce M. 11471 Ma (lost e-'ONTAKINANT UM Tron : <0.03 . 0.30 m&IL, ii; W-Liter ND=nonedetscud MCL=MaximiumConta6fn=tLevel established. 'Lovels noted we United States Public 3IW4 Sorvics (USP11) recorameadations. lills CIVW: r6mp&A with au State of Connecticut re&tory guldeloes. 1� TESTED ABOVE*. OTABLE I B iSEDI ON SAWLES SUIBNOTTFD;7/21/98 RE" Laboratory Director *NOVfMAST LABORATORY, )29 MILL STREET, BERLIN, CT 06037• (860)828-9787 - FAX (860)819-1050 TOLD FM WITHIN CT: S00 -826-0105 a OUTSIDE CT: 800.654-1230 -rOTAL P.01 FRLIM INC. ,Y: 10509 DATE SAAB LE COLLECMD- 7x1/92 TMO C0112=01 9.00 A.M. COLLECTEDBY;Cms -Are orrpTucp an t Ana 71lr) /09 WMALTH DEPT. TESTED W: LAWH04" -7/22 swma, qogwa ad. poftem VsHey, NY CT C90; PH-04" ;.9ft&-WRH9mhs per Ljtw Mft one detected UCL—MaxiErAwa Contaminant Level 4,40 3 of bomx&cticmt MCL ei %bU*O& Uvels aMd om IU*md SUM Pubk1c Heilth Service (USPH) revommeAfthobs. e® 4i& with am Sate or Coonaftut Ngwary ga W42M AS TESTED ABOVE: OTABLE 8 Ts BA 34D ON' SA US suamr"ED:7/21/90 jAORMEANST LABCP� MRX. 129 MILL $TAM, SMN, CT 06037- (360)828T787 - FAX (i60)829-1050 "%I T "IM VMKN CT; 900.226-0105 - OMIDE CT- SW654-1230 T ITAL F. ®1 L COMIY RM andlar REMARM Distribution System. Analytical Results Sampling Location Date of Sample Type .Total Colifonn E..coll Free Cf- Raw Turbidity Sample (1, 2.3)' PoSM" Positive Residual aWl, NTU ._.,_ r..v. Yee —No —yes —No . _ YN _ No —Yes _No Yes No Yee Yee No Yee No Yes ^ No _ _ Yee _ No • �•_,, �� Y" NO YO No Yes _ No . _ Yes No Yee No _Y" No Yes No Yee _ No • Y_ Yes No Y- ,,.,, No Yee No Yee _10 Y,* .� Nn _._. Yes NO Yea _ft Yee No ". No yes No Yee No Yee me Yee .� NO .� Yin No —Yes _No _, YN _No - Y" No Ya NO °i : RvAlne sample 2 e Repeat Sample 3 = Hftwb samo COMIY RM andlar REMARM A BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH.- Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 . Far (914) 278-7921 Date: 7 RO To: �1%�Y \y tCH-OsCr FAX COVER SHEET Fax #: No. Pages (Including cover sheet) From: Adam B. Stiebeling Asst. Public Health Engineer . For . 3 your information Please respond Attached as requested As dlscusscu n `° \ otes[Messages �fA�[ Please, call 4 - f eST- + ar Y NTAME hsSo4c'- VIES - '-'a rc. ��� S�a► S In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 157. MINE! PUTNAM COUNTY DEPARTMENT OF HEALTH • DIVISION OF ENVIRONMENTAL HEALTH SERVICES /* FINAL SITE INSPECTION trlt� Date: �e Inspeqtpd by: Wr. Sir&_tLarat Town Permit -k TM # Subdivision Lot 1. Sewage System Area a. STS area located as per approved plans ............................ b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth .c. Natural soil not stripped .................................................. d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water courss.4wetionds ..................................... II. Sewage Sy0stem .71 I a. Septic tank si 1,00 ......... 1,250 ......... other ................ b. Septic t s q;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.0riginal soil between box & trenches e. Junction B.ok.'- properly set ............. ............................ f Trenches TUe-n-g-th required Length installed 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 V2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10.. g. Pumn or Dosed Systems I . Si-ne—of pump chamber ............................................... 2. Overflow tank ................ ............................................ 3. Alarm, visual/audio ................................................... 4. Pump easily accessible, manhole to grade .................. 5. First box baffled .......................................................... 6. Cycle witnessed by H.D.estimated flow/cycle ........... 111. House/BuildLing a. House located Per approved plans .................................. b. Number of bedrooms ...................................................... IV. Well Nell located as per approved plans...... .............. . b. Distance from STS area measured .......... 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 & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .................................. i. Erosion control provided ................................................ Rev. 6/97 un � ---COMMENTS E IBMW, A' = N I 11,01ME Ian I WN I `R3 IMBRUE I E. MR.. I a", lm= low I C R- = W W-A r MW` -MM Form ST-3 CA& 'M - CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHDD CONSTRUCTION PERMIT # PV" 6 - T7 Located at 950'5W 1�il-L. MAD Owner /Applicant Name C1�14'`rA `5JA"'5MAN Formerly Town or Village PON AM VA L -FV Tax Map Block I Lot Subdivision Name Subd. Lot # 4'-3 Mailing Address 13 4 1FATH EP- 1-h W F- P\ri Ht,�>1 V A )AZY N %Y. Zip 10611 Date Construction Permit Issued by PCHD 016wi Separate Sewerage System built by Address Consisting of 100 Gallon Septic Tank and E�00 L F P bS Ff6LP5 Other Requirements: Wattt SUnnla: PUMP ;V16 -rEM Public Supply From or: X Private Supply Drilled by Address Address ..B�iilding.Type...R � F�-kf" dam... u: erosiar; control heeii completed ?.. Number of Bedrooms Has garbage grinder been installed? ND 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 is ued PCHD Construction Permit and approved plans and the standards, rules and regulati, n of the Putnam Co y p ment of Health. Date: (0/0) a Certified by P.E. R.A. Address � MIL4/Mw� 4 R SuTE 15 (D s gn NY, 10 601 License # 5612A 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. LON Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 Mr. William Hedges - Putnam County Health Department. - 4 Geneva Road Brewster, NY 16509 - RE:. - Individual SSDS Compliance - Sussman i Boswell Estates Lot 43. Boswell Road (T) Putnam Valley Dear'Mr. Hedges: Enclose are the following: Fo (4) prints of Drawing S -1, "As -Built Plan ", dated 6/30/98. " ertificate of Construction, Compliance for Sew #ge Disposal System ", dated 6/30/98. - "Guarantee of Subsurface Sewage Disposal System ", dated 6/30/98. 1 ' 4. ell Completion Report,, dated 6/30/98. - Laboratory Report, dated 6/25/98. 6. Application Fee in-the amount of $200.00 payable to Putnam'County Health Department. , f If there are any questions concerning the enclosed, please call. , Very truly yours, - LAURENT ENGINEERING ASSOCIATES, P.C.. - _V Harry W. Nichols, Jr., P.E. HWN:JM:bd , 96068 • i LAURENT ENGINEERING jASSOCIATES, P.C. ... MILLBROOKE OFFICE CENTRE \Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 . HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS July 2, 1998 Mr. William Hedges - Putnam County Health Department. - 4 Geneva Road Brewster, NY 16509 - RE:. - Individual SSDS Compliance - Sussman i Boswell Estates Lot 43. Boswell Road (T) Putnam Valley Dear'Mr. Hedges: Enclose are the following: Fo (4) prints of Drawing S -1, "As -Built Plan ", dated 6/30/98. " ertificate of Construction, Compliance for Sew #ge Disposal System ", dated 6/30/98. - "Guarantee of Subsurface Sewage Disposal System ", dated 6/30/98. 1 ' 4. ell Completion Report,, dated 6/30/98. - Laboratory Report, dated 6/25/98. 6. Application Fee in-the amount of $200.00 payable to Putnam'County Health Department. , f If there are any questions concerning the enclosed, please call. , Very truly yours, - LAURENT ENGINEERING ASSOCIATES, P.C.. - _V Harry W. Nichols, Jr., P.E. HWN:JM:bd , 96068 • i a V, PUTNAM� COUNTY DEPARTMENT OE HEALTH CERTIFICATE OF CON1STRUCTIONI COMPLIANCE PCHD CONSTRUCTION PERMIT # PV- A -1-7 Located at f505W kZ-L . . P-OAD Owner /Applicant Name � '°� -e>yA/7r' AN Formerly Mailing Address 8 4FATHEP— i-kNF- Date Construction Permit Issued by PCHD Separate Sewerage System built by l".1fen WAGE TREATMENT SYSTEM Map Block o Name 506WjFW— a;,r;J Ar1E6 Subd. Lot # 43 P�rj »Ph VAS' N,Y, Address Consisting of low Gallon Septic Tank and r- A 81 Fib Other Requirements: NMP 5V6i E► Zip Wkter Sunnly: Public Supply From Address `co or: Private Supply Drilled by Address Has' errsion control been Number of Bedrooms Has garbage grinder been installed. ry I certify that the system(s), as listed, serving the above premises were constructed essentially as' showi on the as- built plans (copies of which are attached), in accordance with the is ued PCHD Construction Permit and approved plans and the standards, rules and regulatignp of the Putnam Cou y I?Vparlment of Health. Date: C. h0 i 9 do Certified by Address 'kV MILUMW► 4 R 5uM6lei P.E. X R.A. na I Opg,, V License 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. Title: Date: White copy. - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 t Clieoi- LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Rate 22 R Mi,Itown Road .. ... C..v- 1.1:.1 •-'-,.,, -..•: r.... -. .: •.r e. .. , — \ Brewster, New York 109&' \\ (914)278 -6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS Y - July 2, 1998 Mr..William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE:: Individual SSDS Compliance - Sussman , Boswell Estates Lot 43 Boswell Road (T) Putnam Valley + Dear Mr. Hedges: Enclosed are the following: 1. Four (4) prints of Drawing S -1, "As -Built Plan ", dated 6/30/98. 2. "Certificate of Construction Compliance for Sewage Disposal System ", dated 6/30/98. - 3. "Guarantee of Subsurface Sewage Disposal System ", dated 6/30/98. 4.' Well Completion Report, dated 6/30/98. 5. Laboratory Report, dated 6/25/98. 6. Application Fee in-the amount of $200.00 payable to Putnam'County Health Department.' If there are any questions concerning the enclosed, please call. , Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. - Harry W. Nichols, Jr., P.E. HWN:JM:bd , 96068 .-AA.AI.Y:T:.I:.C.AI. .....R;E. R.O.R T. ....... F ::8EAUA BREWSTER N Y -40509:' : xx 315 Fullerton Avenue Newburgh, NY 12550 AW iff � Tel: (914) 562-0890 NYSDOH 10142 NJDEP 73016 CTDOHS PH-0554 EPA NY049 PA 68-378 M-NY049 Fax: (914) 562-0841 Client Name: ETL Sample Number: Client I.D.: Date Collected: Date Received: Comments: Inorganics Analysis Data Sheet P.F. BEAL & SONS Project Name: STANDARD 188312 -01 WEST MODULAR WESTCHESTER BOSWELL RD PUTNAM 17- JUN -98 Matrix: 1 DrinkH2O 17- JUN -98 Analysis Result Units Method . Analyzed Remarks: 1 Nitrate (N) 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562 -0890 1-- 11.1. �(1, -- NYSDOH 10142 NJDEP 73015 CTDOHS PH -0554 EPA NY049 PA 68 -378 M -NY049 Fax: (9 14) S62-0841 0.2 U MG /L 300 18 JUN 98 O.. U14' :. MG /L :. :.:. >450..0:. NO2 . B...:..:19 JUN 98, Sodium 5.4 MG /L 200.7 19 JUN 98 Total form ABSENT; ..... ...... /100:; MLS :. ... .. ; :: :92.23... 17 JUN .98> ..C.6: ..> Total Hardness 52.4 MG /L 200.7 19- JUN -98 TurbldltY ` 9 1 ::: Tf1 :::...: 2500 JUN: 98 .:. pH 7.7 B l8 4 0 -HB 18- JUN -98 Remarks: 1 Nitrate (N) 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562 -0890 1-- 11.1. �(1, -- NYSDOH 10142 NJDEP 73015 CTDOHS PH -0554 EPA NY049 PA 68 -378 M -NY049 Fax: (9 14) S62-0841 -S37vern Trent. The following data qualifiers are used to assist in the interpretation of analytical results. Unless ®therwbe indicated, sample passes applicable drinking water standards. (1) Parameter fails applicable_ drinking water standards (2) Exceeds lead SWDA action level of 15ug/l. (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 ANALYTICAL REPORT ..................................... ............................... ........................................... ............................ .............. ........................................... .......................................... ........................................ Report Date ............................... ............................... ............................... ............................... ............................... 25 JUN 98 >; Pro ect ' STANDARD;,.., ?;: a:db Number 1883.12 Sc�RIDIP;(d� {iphPrfc�' ,,1R�j,9 nt �.. 188312 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562.0890 s.., • NYSDOH 10142 NJDEP 73015 CMOHS PH -0554 EPA NY049 PA 68-378 M -NY049 Fax: (914) 562.0841 Inorganics Analysis Data Sheet___. Fgrm , Client Name: P.F. BEAL & SONS ETL Sample Number: 188312.01 Client I.D.: WEST MODULAR WESTCHESTER BOSWELL RD PUTNAM Date Collected: 17- JUN -98 Date Received: 17- JUN -98 Comments: Analysis Result Units Project Name: STANDARD Matrix: 1 DrinkH2O Method Analyzed 1 Lead Mang <; . 1.0 U I: 2 -: ... ;` UG /L GfL 3113 : 200 .. 22- JUN -98 19..JUK 48: Nitrate (N) 0.2 U MG /L 1. 300 18- JUN -98 Nltriite. (N'7.:. 0:;014 : MGlL 4500 =NO2 Sodium 5.4 MG /L 200.7 19- JUN -98 Total':CDI tform ABSENI ..: .. ;: f100 MLS 9223. :: 1T.:JUN 9$s Total Hardness 52.4 MG /L 200.7 19- JUN -98 Turb;dltY 41 ... TU 2130 gs IB.JUN.98. pH 7.7 4500 -FIB 18- JUN -98 Remarks: 315 Fullerton Avenue Newburgh, NY 12550 Tel: (914) 562 -0890 s.... •..��,. •,.. NYSDOH 10142 NJDEP 73016 CTDOHS PH -0554 EPA NY049 PA 68378 M -NY049 Fax: (914) 562.0841 Severn Trent Envirote$1 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 SVWDA action level of 15ug/1. (3) Exceeds copper SVVDA 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 Committed To Your Success a part of Severn Trent Plc Of Euvi COUNTY BEPAB27�NT FEMALTH N.Y 1 1 %)tv�aa � F�le'h�c�salal.HealtL Smrvlcmd. t .armol. N.Y. I0512 Fnghw�w to Favvii10 Permit 0 on CERTIFICATE OF COMT11ANCE Q COPISIEDt TIOPi PEBI�I FUR SEWAGE DISPOSAL SYSYER4'' ID - 88 T. Putnam ValleV Lccatm� AOlatre d Town or Wffihae Boswell Estates •sm.1.Dto 43 Tax es 62 Block 9 Lot 17 HetrevrteL_ O Revision ❑ 'sr a . Otrmer/ApplicaatAnme ,eGlasson Realty nc. Date of Previous Approval leg Addn= P.O. BOx Town Carmel, ?1Y 10512 gig. Tyl- Modular Lot Area 8.358 Acres Fin Section Only RIO Depth Volume Nmnbar of Bedrooms Three Design Flow G P D 600 PCHD Notification to Regtilred When FM to completed Soparwe Sewerage Sytttam to coaalat of 10" 0 G.Bpd Septic Tltnk and 500' x 24" w, x 18" Deep laterals To be comtrueted by ' Addrm- Wat- Sapplr: Pubuc supply From - M Addrow or• x Private Supply Drffled by ? Addreag Other ltsiouiriamentaCurtain Draini 110' ar 5' Deep + TaiiniDe x 90'_t (Intl. 6" CH? Under Road) 1 represent trial 1 am wholly and completely. rosoon sib to tor. the cosign and location of trio proposed system( 9); 1) that the separate %&wage disposal system above Oescribed will be constructed as shown on the approvrd amendment there to and in accordance with the standards, rules and regulations O o u nam County Department of Hearth. and that on completion thoroof a •'Cortificato of Construction Compliance" salistactory to the Commissioner of Hbuithwlll Do suOmlttod to the Department, and a written guarantee will be furnished the owner. his Successors, hairs or assigns by the builder, that said builder will olaco in good operating condition any part of said sewage disposal system during Use period of two (2) years immediately following the date of the issu• once of the approval of the Certificate of Construction- Compliance of the original system or any ropairs thereto; 2) that the drilled wait described above aill be low-at" as shoran on the approved plan and that said wall will be Installed in accon)anco with the standards, rules and ra,/ula r— oT ns of the Putnam County Dopartmonl Of Health. - J Date 25 Hanuary 1988 signed r ' • � _ P.E._X R.A. — Address RDQ-Fair St., Carla 1, NY . 10512 license No 29206 APPROVED FOR CONSTRUCTION: This approval expires two yoari from the dato - issued unless construction of the building has boon undertaken and is revocable for cause or may be amonoed or modified when considarod necessary yy 'the C:cmmissioner of Health. Any change or alteration Of construction roduiros a now permit. Approved for disposal of domestic sanitary sewage, and /or private lwxtor s�ppty only. l l i Data �(I C r I �' Y T ` J :.C.r %Cc.c: ` : :: r _ 4/ `t.� BY -title r m %;q �vlGc -L, LAP '+'�C9�ii �'..L.�1.1 „j.r`� ITV`/• y� Nb� u... .0_ .. ..... a. -. _. �. . -� ...... Gx1 ralz�DC —�, �, fin, \►�ila��,. 3✓c- D��o�� -- .... - - - - -- 0 ro`c/L? �— �_Iloao �dl • Pecs �� ot 3 r ®�Z app....__ .__ .......... _. _....-- - ..... ................ ....__ _ .. d ;\ .............. 444? c-- .�...._. ....... . ..... I ` off? I j;JIVJ :1 . '� ' %';c• ,:' G IJ DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION" TO ;OIVSTRUCT'A'"WATER WELL PCHD PERMIT 0 b'q WELL LOCATION Street Address Boswell Road Town/village/City Tax Grid Number T. Putnam Valley 62-9 -17 WELL OWNER Name McGlasson Realty, Mailing Address Inc. P.O. Box 610 Carmel NY 10512 ®Private O Public USE OF WELL 1 - primary 2 - secondary ®.RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 FARM 0 TEST /OBSERVATION O INSTITUTIONAL 0 STAND -BY ® ABANDONED 0 OTHER (specify AMOUNT OF USE YIELD SOUGHT . Five gpm /# PEOPLE SERVED Six /EST. OF DAILY USAGE 400 gal REASON FOR DRILLING ®NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY 0 REPLACE EXISTING SUPPLY 0 DEEPEN EXISTING WELL ®TEST /OBSERVATION DETAILED REASON FOR DRILLING Residential Supply WELL TYPE UX DRILLED DRIVEN []DUG ®G-RAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED.IN A REALTY SUBDIVISION,'NAME OF SUBDIVISION: Boswell Estates Lot No. 43 WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NQ NAME OF PUBLIC MATER SUPPLY: TOWN /VIL /CITY - 1)15`TANa- TG "PROYEiffY FROM NEAREST:'' WATER `MATn�:" Over one mi le�� g LOCATION SKETCH.& SOURCES OF CONTAMINATION ®ON REAR OF THIS APPLICATION 26 January 1988 (date) PROVIDED(see Dwg. No. 1, Job #S.O. 2453 By Jonh H. ®ON SEPARATE SHE Prentiss, P.E. (signature) 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 s.hall: 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 pro ided by the Putnam County Health Department. Date of Issue: 3 19_ Date of Expiration: 19 ermit Issuing f cia Permit is Non - Transferrable White copy: H.D. File 2/87 Yellow copy: Pink Copy: Orange copy: Bw ldj.ng Inspector Owner Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH DIV! S1ON OF ENVIRO�TMTENTAL •HEALTH ��.�• `•!�L� , .r .ri: .n .c. r .,. ..... .... ... .., , Date 19 January 1988 Re: Property of McGlasson Realty Inc. Located at Boswell Road (T) Putnam Valley Section 62 Block .9 Lot 17 Subdivision of Boswell Estates Subdv. Lot # 43 Filed Map ,# Gentlemen: This letter is to authorize John H. Prentiss Date a duly licensed professional engineer x 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 :corr�ection__ith_ minis matte ;:and `L9..sulae,�iS4. 'the __cox�� :ta;:.�cic�� 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. QqLoFESbiuroqi F N. PRF ��` .�o��• �`� Very truly .yo� , Signed : _ .. Property Co t signed: F�J/ . ryo. - 29206 ��� .. : • ,. P.E , R.A. , # fTH TRS� � P. 0. ,. Box 610, Hill & Dale Road `Address Carmel;:NY 10512 Address R09 FAIR ST 914 -878 -6170 Town' ` CAMEL. NEW YORK 10512' 914 -225 -7988 Telephone Telephone r L...' -, DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 _. .M t PL'I' '!6lti "3'0' C0NSTRU0T1 A —WATEk PCHD PERMIT FALL LOCATION Street Address Town Village Cit Vedley Tax Grid Number C2 - WELL OWNER Name rakm subs Ma' ling a PO Address '��V )0av►s 77-- W.V. Private U 2 -934' ®Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ® BUSINESS 0 INDUSTRIAL ® PUBLIC SUPPLY Q AIR /COND /HEAT PUMP ® ABANDONED ® FARM O TEST /OBSERVATION O OTHER (specify U INSTITUTIONAL ❑ STAND -BY AMOUNT OF USE YIELD SOUGHT 200 ® REPLACE EXISTING SUPPLY ANEW SUPPLY NEW DWELLING PEOPLE SERVED V� /EST. ® TEST /OBSERVATION ® DEEPEN EXISTING WELL OF DAILY USAGE OCR &1 13. ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL 'TYPE ®DRILLED DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES __tX NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: / S Lot Mo. 4__3 WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES f NO NAME OF PUBLIC WATER SUPPLY: ,/�° / .J`4` TOWN /VIL /CITY _..DI�TA1dCE.,TO_ F OFERTY FROM NEAREST WATER, MAIN: _ LOCH ION SKETCH & SOURCES OF CONTAMINATION PROVIDED # /2� V VON SEPARATE SHEET Ca 3a .dat ) (s g ature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2.' Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a/ manner as not to degrade or of 'se contaminate surface or groundwater. Date of Issue: �L 199 Date of Expiration G 1996 _ fermit Iss g Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller NEW YORK STATE DEPARTMENT OF HEALTH Specific Waiver Bureau of Community Sanitation and Food Protection from Requirements of Part 75 and Appendix 75 -A, IONYCRR 49r inglvldual Household. Sewage Treatment Systems,. Last Name First M.i. } Name of Applicant No. Street City/Town State Zp Address /°o Vi No. Street City/Town State . Zip i Site Location p5 �� eat l f �-C /i d 11-o p'' 1. Reason why site does not meet 10NYCRR Appendix 75 =A (check appropriate box(es)): Separation distance cannot be achieved. Excessive slope. High groundwater. Inadequate depth to bedrock or impermeable layer. Soil unsuitable. JOther (explain) .......................................................................................................................................................................... ............................... ..........................................................................................................................:...............................................................-.......:.......... .......-- ...................... .................................................................................................................................................................................................................................................... ............................... 2. Proposed design or co ttiions of waiv r: / -9 .0 '( °!G. ..."- 5.........%L. ° ............ . e..........� ..cv.n. s 7r`s -v 1�.'a' J ...... ....... ............................... ........... ............................... '1 ........C-.....�A�.. .. .......�... °...........�........ -a-7 . �.. �� .............................................................................................. ............................... ............................................................................................................................................................................................................ ............................... r .......................................:................................................................................................................................................................................................................... ................................ 3. The proposed design may have the following limitations (check appropriate box(es)): i i J Increased risk of well or spring contamination. Increased risk of surface water contamination. Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. Other(explain) ....................................................................................................................................................................... ............................... ................................................................................................................................................................................................... .......................... . . . .. . . . . .. . . . .. Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver may be revoked by the issuing official for a change in conditions for which this waiver was granted. A*E"NNTAAfiVVCt'0'.... ............................... REP MMISSIONER OF HEALTH ORIGINAL -Local Health Agency ................................................. ............................... COPY - Applicant /Design Professional GATE DOH -1326 (7/92) 1 (GEN -152) J -ua *an .! r Yr. .r ♦O-' f. .•t 0.?..r .. .a ♦a ..n1•.w - _T C b t - ,\ t V •.. •ti{ b.'. �• r.n i..• .-r.. •... _t .v. _., f oly i, i 24 W 18 Z 60 � o o � = 12 - 40 CD cal Appgcation' -'High ;lead EliiueoFfinJ "0ew6terrq " " - - - _ _ Capacities to 55 GPM (3.5 IN Heads to 121 h (39 m) 6 4- 2(j Eleuricol 230V,1a,12FLA, 60Hz; 20OV, 3e, 6.1FLA, 60Hz; 230V, 3e, 5.OFLA, 6011z; 460V, 3e, 2.5FIA, 60Hz; 5154 3o, 2.OFLA, 60Hz Motor (single phase) -1.5HP Split phase w /solid state switch, start capacitor and thermal overload protection, 3450 RPM ; _ (three phase) -1.5HP polyphase, 3450 RPM Recommended Simplex = 24" (609.6mm); Sump Diameter Duplex = 36" (914.4mm nattc Operation _ Manual standard _ Optional_ wide -angle float switch (le only). of 'Construction _— Class 30 cast iron Impeller Thermoplastic semi -open non -clog Discharge Size 2" (50.8mm) S_o_Iids handling 3/4" (19.1 mm) Power card I o (without seal failure probe) - 20',STW -A; le (with seal failure probe) & 3e - 20', STW -A perior =e,:::. Two (2) carbon /ceramic type 21 mechanical seals mounted in tandem "Id filled motor w /automatic reset thermal overload for maximum protection upper & lower ball bearing construction ueneraies high heads for bigger drainffelds Snol failure probe warns of seal leak (optional) Ca,Iacitor start for increased starting torque 0 L 01 1 1 1 I° II 1 (apacity -U.S. G.P.M. 0 20 40 60 i - Liters/Second 0 2 4 Refer to yo.. . c:r,matic;." Dstrieutor, Representative or the factory for othe 80 QW w sue' ,o LAURENT ENGINEERING R� ASSOCIATES, P.C. BR7or, PFFJr �JTRF... Route 22 & Milltown Road Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS July 7, 1997 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Boswell Estates - Lot #43 Mr. Graham Sussman Boswell Road Putnam Valley, N.Y. Dear Bill: Enclosed are the following: 1. Four (4) prints of SS -1 "Proposed SSDS ", dated 6- 30 -97. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 6- 30 -97. 4. "Application to Construct a Water Well ", dated 6- 30 -97. 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 6- 30 -97. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only". 8. Pump data. 9. Money order in the amount of $300.00, review fee. 1 - Page 2 We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Ni Is, Jr., P.E. HWN:RTL -bd 96068 cc: G. Sussman w /enc. 05-15-1997 03:16PM FROM LAURENT....ENGINEERING ASSOC .TO.- 92854489 P.01 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISXON OF ENVIRONMENTAL HEALTH SERvicss Date _zu Re: Property of Gm A. vs f;-M0"VN,- LocAted at (T) Sectio Block (2 Subdivision off' 1?0-5 tj/- P/ 5< 4dk4� 5 Lot J 7 .c;ubd-v;. Lot _413 Piled Map # Date Geittlemen; This letter is to authorize__* -a V11 a duly licensed professional engineer V",-.Qr recistered architect (Ind±oate) to apply for a Construction Permit for a sej:parAte 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 liealthl, RaTnd to sign, all necessary papers on my behalf in system or systems in conformity with tl e provisions of Article 145 or 147, Education Law-, the Public Health Law, and the Putnam County sani- iaf EV, tary Code. N rkLly yp Ur A P U�p Countersigned: L to \ , 1 1) ; uii.' 24 V _ssl F. -A Address /0509 Z 79- � 149 9 d caner of Fr6lperty x je Address Town 110A Y F, I&a 2 -ev X5!6) � 732 - 5 4 �4 TOTAL P.01, SCALE LAURENT ENGINEERING JOB No. -- 96 06 IF ASSOCIATES, P.C. SHEET No. OF MILLBROOKE OFFICE CENTRE CC; ft Pc; T l_ Brewster, New York 10509 CONSULTING SITE ENGINEERS CHECKED BY DATE SCALE ----------- m �p -H —7 . ..... ...... 7—! Z-8 2 7— ----------- m JOB No. SHEET No. 2 OF �7 y COMPUTED BY DATE .u. wl :•... ., a _ - . t. »i0. n. .. rl Ma V • , �Y , J —_ ...,,�.. CHECKED BY DATE SCALE ..:.. _:. _ ���. �T��:M:_�lQ_L.U_�:,��,.= _._.._. .. ._ C•a,?��.o._1�P�.10..N ..TR�NGN.�.S�. .... i :. - :..- °•.------- 1-4 -'Z7,T- C ....... ... _ LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE j Route 22 & Milltown Road Brewster, New York 10569 CONSULTING SITE ENGINEERS JOB No. SHEET No. 2 OF �7 y COMPUTED BY DATE .u. wl :•... ., a _ - . t. »i0. n. .. rl Ma V • , �Y , J —_ ...,,�.. CHECKED BY DATE SCALE ..:.. _:. _ ���. �T��:M:_�lQ_L.U_�:,��,.= _._.._. .. ._ C•a,?��.o._1�P�.10..N ..TR�NGN.�.S�. .... i :. - :..- °•.------- 1-4 -'Z7,T- C ....... ... _ .I 0 .I II " I _�, !.: , " , . . �', . . , , . . 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'. i, . t , A, olik " .�,., , , : I t . . .1 0 ii!, - ,,,, 4;�t.; " -A I " ;.,.,l I . ""t.? 11 � "; I NOT'ARY PUBLIC SlATE OF .,k,.; . ', i -1, � ���­_, . ' COUNW , I .:. , -I- � ,% "'. " .�, %4, � , '. .. � VES1 C14ESI EW �. . CON,IINJISSION FILVD IN V ��­* * � - it, :;" - - " . . . .4 . .� , . j - �' , . . I ' - I ��,, �.'�:t`_ . . , �, e� :.,,, . . " N,6. 60-0142123 t " i, 1 -',o� ,� �,t �.-.:.-""�,. � ", � A �I , , .- ,.; . :: , - , f - , , , �i. , _c . ", - - . ', � " � ., .. �.­.�+., ... � 1 . . : 1, . . ,. , ", � � , '. , k. , I .1 i.; . i � �, , _'. ov") -1. , ; "i " ! . . . 1. ,., .." . . - �,' q ,,,, .,.� . � --, � , . I , - - , 4r; N I �XHIW5 AIAIWIJ jO, 197 4 . �,� , ."ti .., , "', I I . , , , . . . , ' P� : %. . . . 1� .. - - ... . - .�� _ . . :. ': . I . , , , . :� ,, . " , " . - . . I �. ,:" , � . , , , � ,:;, 't� I .. ". : '. , ... . it . n � . : t t� . �t .1 . . . . . , � . , ,A �,z. � . 1. . t . . . I 1, � I � - . ... . 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" t�r . , . �P , , : - : , . , � , , , , I . : . ,k i�L�; �_, ti., , , . , , , I , .. 'I. " , : . . 11 . . . � '. . 1 , � . . : _ �.: '. , � I I . q ', - 14 , �, ,!, . .", " -� . :. � , , .� I o , � ;, .it ." � � t,,� � t , . , ,� � . : " ': , � , I �,-. . I ; 4 . I - � t �:, _. �, i _ I . t.; , . �: . , v " 1, v, , , � ..! , � , , , '. - - ", �!,f � . "': - I I .1 - : - j.: '. , . . � il. � � , , , ., �i, " , , ,; " ". , 1 � 1 ., � �� �: 3 � j!, ,! - , � �­L , I I ` I . I -1 I , - �. 1� � , " . I , , � . I � , . . ': . . I , I � - ��.- , " . "), ", � -'a .1 � 11 I . .. �� � �,i ,� � � "17 .�W,!_, � ,� � 'X 1;1 .: September 18, 1985 Mr. J. Hodgens Health Department County Office Building Two County Center Main Street Carmel, N.Y. Dear Mr. Hodgens: I am concerned about a possible error that is being made in the placement of a planned new septic system on the pro ross the stree his property is listed as Lot #43 on.Putnam County Subdivision Map #1238B, (Section "B", Boswell Estates, situated on Boswell.Road in.the Town of Putnam Valley,_ _ New York)... I_ believe a _Mr. Michael Deem (Deen ?) of �p - _- re p �r f .. . I3: � . -r `En ��y-• �t:.r.:h�.::,�.� - h::� - y.:�::. an lanning to build a new house on it. My concern is related to the fact that this new septic system is being cleared for installation only 80' feet from my down hill well head. (My house is on Lot #36. It is my understanding that Putnam County requires at least 200 feet be maintained between the closest point of a septic system to a down hill well. On County Map #-1238B it states that the houses on the uphill slope must be set back 250 feet from the.road to allow for their septic systems, while maintaining the 200 foot clearance between down hill neighbor's wells. This set back was approved and signed on Map. #1238B.by Robert J. Cossell, Director of Environmental Health Services,'Putnam County, Department of Health in 1973. Your help in correcting this matter that will effect the health, safety and well being of my family, will be g atly appreciated. THOMAS N. MARSCHNER 528 -8615 or 737 -4400 ext. 2409 Thomas.N, Marschner (Boswell Road s _._ Putnam. September 18, 1985 Mr. J. Hodgens Health Department County Office Building Two County Center Main Street Carmel, N.Y. Dear Mr. Hodgens: I am concerned about a possible error that is being made in the placement of a planned new septic system on the pro ross the stree his property is listed as Lot #43 on.Putnam County Subdivision Map #1238B, (Section "B", Boswell Estates, situated on Boswell.Road in.the Town of Putnam Valley,_ _ New York)... I_ believe a _Mr. Michael Deem (Deen ?) of �p - _- re p �r f .. . I3: � . -r `En ��y-• �t:.r.:h�.::,�.� - h::� - y.:�::. an lanning to build a new house on it. My concern is related to the fact that this new septic system is being cleared for installation only 80' feet from my down hill well head. (My house is on Lot #36. It is my understanding that Putnam County requires at least 200 feet be maintained between the closest point of a septic system to a down hill well. On County Map #-1238B it states that the houses on the uphill slope must be set back 250 feet from the.road to allow for their septic systems, while maintaining the 200 foot clearance between down hill neighbor's wells. This set back was approved and signed on Map. #1238B.by Robert J. Cossell, Director of Environmental Health Services,'Putnam County, Department of Health in 1973. Your help in correcting this matter that will effect the health, safety and well being of my family, will be g atly appreciated. THOMAS N. MARSCHNER 528 -8615 or 737 -4400 ext. 2409 Page 2. cc: 1. Mr. O'Dell InVI: Town of Putnam Valley Putnam Valley, R.Y. 10579 2. Mr. Joseph F. Sullivan Consulting Engineering 2972 Ferncrest Drive Yorktown Heights 10598 3. Mr. Michael Deem (Deen) Staten Island, N.Y. 4. York:Cohstruction PART 11— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DQgp.ACTION EXC ED ANY TYPE_ I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes >o e. WILL ACTION P.ECEIVE COORDINATED.REVIEW AS.PRQVIDED:FORUNLISTED ACTIONS IN.&..NtYCRA, PART 617.6? .. If.No. a ne�ativwdecla soon ' ° "rrtay tie Sope�Be'di #G'by anoi7►er9n "volv8iy ageh`cy" []Yes o C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or. disposal, potential for erosion, dralnage or flooding problems? Explain briefly: c C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources;•or community or neighborhood character? Explain briefly: e C3. Vegetation or fauna, fish, shellfish or'wildlife species, significant habitats, or threatened or endangered species? Explain briefly: A­`_'r, '? ,e C4. A community's existing plans or goals as officially adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly. C5. Growth, subsequent development, or related activities likely to be Induced by the proposed action? Explain briefly. S S �� C6. Long term, short term, cumulative, or other effects not identified In C1-05? Explain briefly. C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. () X43}1EFt AS.!S:TFiiL4t_DkEIY.?41 N-, !' INTROVERSY- HELA�fED..TO 9C ?Et %1TIAL- �ADVE?RcS EN,gPO *rlEt4T—AL-:,APA^,TS?• '-:• ❑ Yes APSNo If Yes, explain briefly PART 111— DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it Is substantial, large, Important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that 611 relevant adverse Impacts have been Identified and adequately addressed. ❑ Check this box if you have identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare 'a positive.declaration. ' . Check this box If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental Impacts AND provide on` attachments as necessary, the reasons supporting this determination: fiUO.,,r � o cent✓ ��_`' �' �t�j �.�° �,�s /� name or Leaa Rgencv P A, Print o y e ame o sponsi le O icer in Lea Agency TitTe of Responsiblg•.Q 1 er Si nature of Res t nsi e Officer7n Lead Agency Signature'o Preparer (if ifferent from responsible Date 2 I \ r 4 T4 -16.4 (2/87)— Tez%12 PROJECT D. NUMBER 691.29 Appendix C il oe!aw- SHORT EWRONME TAT ASSESSMENT. ... FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEOR 1. APPLICANT /SPONSOR 2. PROJECT NAME 3. PROJECT LOCATION: Municipality ���o"� vC� � County / 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) 3 1�s 5. IS PROPOSED ACTION: ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: J .CjS'�"f`d» 4 ? oA �j 7. AMOUNT OF LAND FFJECTED: Initially acres Ultimately � acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? &[es ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? residential El Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other >' Describe: _ k ,. 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ' ❑ Yes 0&& If yes, list agency(s) and permitiapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes .. If yes, list agency name and permit /approval ° 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes jP�,No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ant /sponsor e: Date: Signature: , If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before, proceeding with this assessment OVER 1 Ti. A." .0 —?. ter/,,.J_.. L - .. ' .lui — i .: : \� _ W.. .r' T�.._.. i .Iti w _ —Y N,5.^•.,� APPLICATION FOR APPROVAL OF PLANS FOR A AA tEWATER DISPOSAL SYSTEM 'i : Nana and Add ress ".of: App l iI cant L�Y�`y!a° w.�S VY1 Cc (.�J R. 2,. Nam e- of Project:- �STa�e_ S 3_ _ Locatidn .T%Y /.C: faynaw V /X T :...Project Engineer: Address: i`illbiooke'Office Cent: :Brewster,' tIY':' 1Q509 License hurber:�� Phone: (914).278 - 6103,:'. ; 6 .. T ..oa o. Pro.iect Private /Residential Food.Se­r.v,ice .•Coct e'rcial , Apartrents Institutional M6bi1e .Hone:: Park 0f f.ice Building. Real.'ty.Subdivision Othe.r..(spec'ify) f. Is• this.project subject- to State Environmental- Nality Review' (SEAR)? Type Status (Check One). Type -:h.:. ExeMDt Type II. Unl,isted.. >�,_•._ S. Is a Oraft Environmental Impact' ..Statement" (DEIS):required? ..:......, O g Has DEIS ' been completed 'and 1"ound a.cceptabl,e; by :Lead Agency ?• : , ........ . 0. h_ame o-P Lead Agency i^ is' 'this' project i.n an area under'•the control of.-local planning;' zoning, ' or other officials, ordinances? . .............��. '. y z so, have plans been .suLmitted to such.'author.ities ?... -- ' . .. Has preliminary approval beeo 'gran.ted :by .such,-authorities? Date_.Granted:• Type of Sewage Disposal: System'•Discnarge...... Surface Water Ground �;aters I-" surface Hater discharge, what is the. strean class -designation ?.._......_ 'Waters index nunber ( surface) '. . . .:.:...:..:.•.... _ .... _ :.......... .. .._• Is project located nez.r- a public water supply system? ....... If Yes, nairie olr water su' Pp 1 A Distance to water supply /.. } c GJect si'_e n ar. a. p,,,•blis sewage col leci.:ion'or- disposal syF. t ?..... --1`L-0 __..• o � sewage S)'Steil c AI1A D1S -ance ' o sewage syste . /" /..A ser\e:� 2 3 . cF r._alth nspecto, . J­_ cesicn .lcw ( =Mons per day;. P ?.. � G5, Is State Pollutant Discha , .r9 El a i ij J,o Sys e n, j required NO 26. Has SPDES Application been. subimitted-.to' office NIA. 27. Is. any po'rti on of this proJect located, w i th .'I n a des,i,gn*at6d.-:To;wn or, Stat'e wetland?.. .. ............ . ..................... I ........ 28. Wetland ID Numbe.( ................................ ....... 29. -is Wetland Permit requjred? . ..................... . a. Has applicatioo been-made to Town'br -.L oca I— DEC" OTT . .................... NIA 30. Does, projqct, ,,.requj re- a-, DEC StreFn, .,'Disturbance- Permit? ...................... 31. Is or was - project -':site used 'for-.-a' ridultural -a(ttivity-inypiving.�'appli6'�i" a on OT pestIcIde-5- to orchards• of "other -crops] s'ol'id or hata'rdous' waste disposal landftilling, sludge application or industrial activity? YES.b_�'�Aq;b,'-. -�N 6 32. is pr*oject -located within J;000-feett 6-1:7,exT stence,-of abandoned landfill,- hazardous was,te; site,' s*al t -.stockpi I e, "Te'_n­dT-).l 1',. s lud§6'--'d.jsposal­sit6` 6r'.:- any other potential known • source: o f -con t*a­�n­ inat i bn?. or N6 DESCRIBE: 33. Is there a.local master plan .or f i Ch' the TOW n or-.Vi. I I a"ge? ........... 7 3;, Are c oF,-.m ut n i -L, y water, sewe r, f aci I iti eti .'planned: to be deve'io'ped within 15 years? 3.5. Are any' sewage disposal a -eas ­r. e-vc _o_ F-� : S� p e ? . . .. .. .............. ...................... ...... ....................... Tax-Kap I D IN u r-,, b e r Y Approved, Plans returned to: ......... 'E n 9 i 11:_� 7 %.�App:� i. cint the he application:is signed by -a . person other than the appl i cant shown -in I 'L,e n, 1 the.' .pplication must be-acccimpanied by,•a, Letter'-, of' Authorization Failure to coniply.with this Covision may be Trbunds'-. for- ec� the r ej L ion;ot-any.submission.. I hereby arc—Firm, under penalty of.p-eryury;� that information provided on this is true to the best '*o F lmow ?ed .ge and belief. False std te,-r-ents" 'made .., herein -,-reanor- pursuant to Section ion 2 10 n are pun7shab7e as a Class A Hisd ,5 01 the Penal Law.. ... T UR S zs 0 T C T _n L TTTLcS: elf 'Mil.l brooke 0 f, Jr i e­ Centre t I! C ADDRESS: Brewster, 'Nn, 10509 F ES S 10� VJTNAM CDUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENML, HEALTH SERVICES _ ..._ DESIGN DATA; SHEET- SUBSUFACE SEWAGE. DISPOSAL. SYSTEM_ FILE NO.�� _" :. e, a ••e ��.. ee-- . 'c� � .. . .. ;1� ,� ,... ,. � .,. �:_ .- -..,. �... .... •m._ - ... � -.r-• . <- ....., .,..e J.. . �� c, r — -- Owner 14 e- j g( SDH. / u Address Ba�tde i/ Ipc� Located at (street) Rek s ( &I" gd. Sec-7#o0- Block 9 Lot /iz_ (indicate nearest cross street) �Bos�e/ /mss S'�,�gly Lo�¢p Municipality /OVj4► J1e u Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of . Pre- Soaking �� // �88 Date of Percolation Test HOLE NUMBER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 2 3 /)08 /1fj 36 1.4 1.2 3 ri - /s. l Oric► ;mg I <,ub i yisrop 2( -3o Kin -to htie- rs used Ar_ Ns r� a.. t t .v.. ....o .. .n ...._ � n._ ..�. w.- ...��. .. . � � .._ �• .. � . �')_..r..w ne... . _. ..... ....� ... _ ...... ..r ... n ..�... r ... ................. .. .�. .....�.�. .w�.....�,..a. w .. ,S .. n 5 NO'T'ES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be suhnittBd for review. 2. Depth measurements to be made from top of hole. rev. 9/85 G. L. 1'' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' TEST PIT DATA REQUIRED TO BE SUBMITTED 'WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES . rR �k al 6 L - Ij er® eta 13' 14' INDICATE LEVEL AT WHICH YGROUNDWATER IS ENCOUNTERED �- INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: 0 0 0 88 - DESIGN Soil Rate Used ® Min /1" Drop: S.D. Usable Area Provided 9000 No. of Bedroans T� d'eg? Septic Tank Capacity 0 ® gals. Type Haro g3 Absorption Area Provided By FOO L.F. x 24" width trench Other II0')eVbcpm + 4 "T ifalffitt Ulf. Name Signature M. RD9 FAIRPSTw914 -878 -6110 Address SEAL K1% AUDIZ THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by +s 29a 6 . THE Stet Date _P .' 1Z ' COUN<T`X DEPAR33KE' U OF iiEALTH DIVISION OF ENVIRDt�`,r,�"yTAi,. HEAE,Tri SEtJZS_ - - DESIGN DATA ..SHEET-- SUASUFACE SEWAGE DISPOSAL SYSTEM FILE No. Crr7i1 °i r. C rc Y1uw► cJV s 5 �y1 Address P, 6. 8 8384. W k,�, P(a;hs W.Y. 1 ow? -9394 L xcated at (Street) S ky_— O Sec. �02. Block Lot 7 (indicate nearest cross street) municipality . ZZ „ 23 CIatershed �0.43 ►ty.d 2� 2C /4'' _ t:14 ._.... 1 .A i : 2r$ __....' .. 1 �.., .� _ 22'' SOIL PERCOLATION TEST DATA-REQUIRED TO BE:SUEAITTED WITH 'APPLICATIONS Date of Pre - Soaking repeated at s~rree depth .until .apprcxinately - - Date of - Percolation' Test are obtained HOLE test hole. All dal to t�.subiii.tt<.=: 'NIRNUSER CLOCK TDT, PERCOLATION tItS 1-0 J- rc-;'. LOJ Of hole. PERCOLATION Run :.. _ Elapse Depth to Plater Fran _ SIater. Level - No. �Tirr:a Ground. Surface In Inches Soil Rate Start -Stop Min. -Start ... :'Stop Drop In Min /In Drop Inches 'Inches Inches G 8:53-TO Zo 21.. �4 22 f�.o, 2.9 -i4 - 9027. 1,3 3 20 l4. � 21 /4 9:28 -9:s1 23 Z� j, : 2.t � 1�� .. 23 24 zo /�,.. •. .! ./ � it . I `1 24 l % ; 02 - 27 . ZZ „ 23 �0.43 ►ty.d 2� 2C /4'' _ t:14 ._.... 1 .A i : 2r$ __....' .. 1 �.., .� _ 22'' —31% I �, Z5. 1. Vests to he. repeated at s~rree depth .until .apprcxinately ea�ual _soil rates are obtained at each percolation test hole. All dal to t�.subiii.tt<.=: l % ; 02 - 27 . ZZ „ 23 2 9:30 -9' 53 2:3 ... _ �2- . 23 3 9 34 -6� =J9 2 =� ' 22'' —31% I �, Z5. 1. Vests to he. repeated at s~rree depth .until .apprcxinately ea�ual _soil rates are obtained at each percolation test hole. All dal to t�.subiii.tt<.=: 1. Vests to he. repeated at s~rree depth .until .apprcxinately ea�ual _soil rates are obtained at each percolation test hole. All dal to t�.subiii.tt<.=: it :^ SlllF_l tItS 1-0 J- rc-;'. LOJ Of hole. T=ST PIT DATA REQUIP.) TO BE SUIEMI=1 - wz1H APPLICATION D ESCP.L�ION OF SOILS PENKMWERED IN TEST HOLES DUCji-H EiOLE NJ. • HOLE N0, HOLE rte. .l. ': •�„ .. .... .. _ .. ... .... -... a.. _r- .'.�.�. .'�.. ��n:-- •°mr -.i ^•��,. -.n- +—�r_. .._.. ..- ram >.. -e ..�. ... 2' 12' 141 INDICATE LEVEL AT MHICH C40UNL- D;r4TM IS EACOUNTERED C7 pi A�`f.;• _ . .� y- c;"�ICiaTc;•-�I,��`E:•i.; �:Tv"i�"riTC.'rT "�i,ATc R LEVY RISES/ )ASTER BEING E.'NOJUtJTERED DEZP HOLE 03SERV.4TI0 \'S MADE BX: /� �i llia ��s DATE: DESIGN Soil Rate Used 2% -3d Min /1" Drop: 'S.D. Usable Area Provided No. of B-�drocros � Septic 'Tank Capacity /00(), gals., Types �Incvv Absorptioh Area Provided' By �j ^5�� L. F. x .24" iaidth' trench 0ther �---` W. JV iC 5 Jr* R Em Sign tune daxess;'� �Ce Ce�dG SERI, l 1.... �. �0O No, 561z4 T -_-- .0o THIS SPACE FOR USE BY HEUTH DEPAR NT 9.,X: _ -- — :':. R` tr_ ' :»ro; �:1 - -- - -- - `s T . ft/gal. 1 �2Ci:�3 b,, C., X 0 n C I)RI v I--- 1.5+ FL ELF-V 4-4-0.7,5 EXIT ELEV 457,15 4" � C I P, 900 GAL $.T. 5XPA,t4. I '�� s P L,6, I-J "-.5-T IWF ELEV. 43L• 92 1�5•T EFF ELEV• 4-36.67 F1 E L DS P KO F'j L- E. HOR: I''-2o' V EFT; I'- 10' p./ IioLj5r: NOTE 1• 0551r-M EIA5170 CW SOIL RATE Ofr" 21-!, ivj;t-, FROM 51,1f.iD. MAP 130�-,WEUL F.5-1 -.47 F 2.C,')HToUR5 FROVA e)F-5T AVAIL-AB 7095 V4 ELL �-r-LIRTA,10 DRAIN C3RKDE �1011, LOT -q5 8,3 513 A :L PROPOSED SEWAGE SYSTEM AE''ROVED . . . . . . . . LOT 43 BOSWELL ESTATES PUTNAM VALLEY . . SEPZ OWNER: ROBERT + ROSEMARY THOMPSON 01T TWO ATTITA5H K.T. U PP E K ASSOCIATES CHAPPAQUA, KLY. 9-22-75 SHEET I OF I Ef 9MROXf-41ENTAL. HEAUNISERVICP 1b �v 2v 1 12 0' 118' c�^° IoB'- 22 44'- O (G) Z11 32'-6 (4) o z 0 1 b /7 7 J / `� � � ,ice•; • Q ; •-. MpE Yi � .. J aH %IMP yr�n P.� 1 1 1 \ \ Exlsr. wee I- - :/ -.low .. 1. )60-6 -\ - c �/ • - LA THIS IS ,. CERTIFY THAT THE SEWI�GE DIS SYSTEM -WAS 'GOhi$TRUCTED` AS•_;INQICAj ' THIS PLAN. -AND t4`AT� "�TME'SYSTEM :WAS r " PECTED: BY ME ,BEFORE..- IT WAS t ,COVE -OVER THE SYSTEM WAS .,;CONSTRUCTED IN" ACI - :DANCE .WITHIALL STANDARD - RUL" - f - 1 DIMENSION CHART (in ft. No. A B w 9 12 ICo4'-c° 4 11 8' 1",- On 5 108'G� 14G' -O" 9 11 9'- 0 I Zo' loo 10 109' - d 143'- 0 11 99 '- O" 10Cp'- 0" 12 - 144'-Ou 1910'. O" Mi" 194' - O 169' -0' 14 125' -0' 162' -0 15 IICo'-Oo I-1 j;' -o 16 108. O° 1Co3'- o 142' - o 144'- o" 18 .t02'- d hiCo'- op . 19 hy2' -0' 12"1'- o 20 I {2' O' IIS' o 21 1020" .1o8' -0 ZZ 44'- e A 7