Loading...
HomeMy WebLinkAbout3618DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.10 -1 -46 BOX 28 03618 ,. IL L 03618 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL, HEALTH S.ER ICES; CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # JO Located at//) /- , y r / �&- own Villag ne"!!Z /4 l ek f Owner /Applicant Name %/4.1 e % i Tax Map %�f. / Block / Lot Formerly Subdivision Name 0414 I,-=42— Subd. Lot # 0 Mailing Address r' 4 iif'f'�,S'/��i� T 77 L6 ofX,77 l le—o ff ��!y Zip ld�P- 6t Date Construction Permit Issued by PCHD Separate Sewerage System built by Address Consisting of IT-6 6 Gallon Septic Tank and Je- Other Requirements: Water Sup&: Public Supply From A Address _ Private Supply Drilled by —k 'r50 Address S -- Building Has.erospQn_GOntrol._been coxrapleted? Number of Bedrooms , Has garbage grinder been installed? /SAD I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of thoutnam County j)epartment of Health. 'Date: Certified by P.E. R.A. esip Profgs nal) ?tAddress �r �� �,' c�/` 16 /�2�1� 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. By: Title: 44 Date: White copy - HD File; Ye opy - Building Inspector; Pink cop Owne range copy - Design Professional Form CC -97 �1\ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT 'elg Ladttoeaa ., .: = Street Address: wn/Villa ���]T ""Grid# ` = Mapl %/ Block Lot(s) Well Owner: Tame: Address: Ilse of Well: 1-primary 2- secondary - Reside ial Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling ]Equipment _ Rotary Cable percussion Compressed air percussion Other (specify) Well ')type , � Screened Open end casing X Open hole in bedrock _ Other „k Casing Details ;ti -; ,Total length ft. Length below grade -ft. Diameter in: ' Weight per foot lb /ft. Materials: Steel _ Plastic Other Joints: — Welded 2�_ Threaded — Other Seal: ?z- Cement grout — Bentonite Drive shoe: Yes _ No _Other Liner:_ Yes �No Screen Details, ' Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed — Pumped Compressed Air Hours Yield gpm Depth Data, Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet 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 ( " j400 I � - If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity -I- Depth 3 SO Model S'P F Voltage �p HP TankTyIWK3v'Y Volume Date Well Completed Putnam County Certification No. Date of Report Well Driller (signature) Nup: rKact Location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. 1 Well Driller's Name Address: /fpm dj . Signature: Date: .d White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML ENVIRONMENTAL.. SERVICES ' 321 Kear Street Yorkto-wn Heightsi, N.Y. 1O59 ' | | Albert H Padovani Director | ^ , | LAB #: 32.108939 CLIENT #: 55026 NON STAT pROC ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~... ... ... ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ QUARTERHORSE DEV,INC 232 BECKMAN/POUGHQUAG RD POUGHQUAG,, NY 12570 DATE/TIME TAKEN: 12/26/01 10:40A DATE/TIME REC'D: 12/26/01 11:10A REPORT DATE: 01/O3/02 PHONE: (845>-724-097l SAMPLING SIIE NAM VALLEY, NY SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE COL 'D BY:�MICHAEL SPACCARELL[ TEMPERA|URE..: < 4C NOTES. . .�~� ' - COLlFORM METH: MF ~~~~~~~~ ~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE �71. 'Hb PROLIEUUKIE RESULT NORMAL - RANGE METHOD PUT ^ -^ PROFILE ' 12 6Y01 �MF T. COLIFORM ABSENT /100 ML ABSENT 1 008 12726/01 LEAD (IMS) <1 ppb 0-�5 ppb 910� 12/26/01 NITRATE NlTROG 1.02 ME) /1.- 0 - 10 9139 12/26/0|. NITRITE NITROG <0.01 MG /L N/A 9146 12/26/01 IRON (Fe) <0.06O MG /1... O-0.3 mg /l 2037 12/26/O1 MANGANESE (Mn) 0.O43 MG/L 0-O.3 mg /l 2037 12/26/01 SODIUM (Na) 13.4 MG /I N/A 12/26/01 pH 6.5 UNITS 6.5-8.5 9043 12/26/01 HARDNESS, TOTAL 126 MG/L N/A 12/26/01 ALKALINITY (AS 78.O M I'D /L N/A 12/26/01 TURBIDITY (TUR 2.2 NTU �7�.,-�� COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS � TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p B�A Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic 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. Na No limits for Sodium are proscribed. Suggestedguidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/1- of Sodium. For those on a moderately restricted diet: a maximum of 27O mg/L of Sodium is suggested. � YML ENVIRONMENTAL SERVICES 321 Kear Street | Albert H. Padovani, Director | LAB #: 32.108939 CLIENT ON 55026 NON STAT PROC PAGE 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ QUARTERHORSE DEV,lNC 232 8ECKMAN/POUGHQUAG RD POUGHQUAG,, NY 12570 SAMPLING SITE: 17 PARK DR,PUTNAM VALLEY, _ KIT TAP COL'D BY: MICHAEL SPACCARELLI NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 12/26/01 10:40A DATE/TIME REC'D: 12/26/01 11:10A REPORT DATE: 01103102 PHONE: (845)-724-0971 NY SAMPLE TYPE..: POTA8LE PRESERVATIVE& NONE TEMPERATURE..: < 4C COLlFORM METH: Ml:-' ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD pH pH SCALE-IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE Or`* THIMPQRTANT AND FREOUENTLY USED TESTS IN WATER CHEMISTRY. WATER I ',-WI-�FH I-i LOW pH MIGHT 01 CORROSIVE TO METAL PIPES AND FIXTUREA" THE NORMAL RANGE OF pH IS 6.5 TO B.S. Hd TOTAQHARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CON ON, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE 1ARdh S 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: 70-14O MG/L MG/L = MILLIGRAMPER LITER SUBMITTED BY: Albert M. .. I aFPa d Zarvia rn �!,, M _.T . ( 4AS C P Director ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM kon, f if le z Owner or Purchaser of Building Tax Map Block Lot Building Con ructed by 104r15 !� /�✓� Location -. Street _c Building Tvype e ow illage, 1 •� , Subdivision Name 16 Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the :... system.. The undersigned further agrees to accept as conclusive the determination 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. Date Mont Day Year General Contractor (Owner) - Signature 0 yyt((I V A ,,v, uv�. Corporation Name (if corporation) Address:o23o2 Be( KA40 PbJ' A Qom/ 1e✓ State wQ ON / Zip Signature: Title: Corporation Name (if corporation) . Address.b9-2 ,- 8.,t4 ,PUtS 4 4e lC State Zip Form GS -97 DANIEL J. DONAH UE9 E.E. CONSULTING ENGINEERS 120 Brecke*iddge.Road Mahopac, N.Y. 10541 845.628 -7576 February 12, 2001 Putnam County Department of Health Geneva Road Brewster, N.Y. 10509 Att: S. Rogan RE: As Built SSTS W Park Drive Putnam Valley Dear Mr. Rogan: Enclosed please find: 1. Certification of Construction Compliance 2. Well Log and Bacti Results 3. Guarantee and two copies 4. Three copies of the asbuiit p an 5. Filing fee of $200.00 6. E911 Verification Letter Your prompt attention would be appreciated Sincerel , Dani J. Donahue, P.E. Site o Sanitary ° Environmental BRUCE R. FOLEY Public 'Health Director L.ORET TA MOLINAIT RN, M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914).278 -.6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 . WIC (914) 278 —6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6p82 Fax (914) 278 - 6648 OWNERS NAME: = I y L� N id i�— l AL V TAX MAP NUMBER: �y E911 ADDRESS: ' TOWN:.. AUTHORIZED TOWN OFFICIAL: • ' (Signature) 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. (E91 l VERFRM) qty •i F,'fv �'� i. IDNVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # i V M -D% Located at 11 d ; v e- , Em- Subdivision name �'h O X-7- Subd. Lot # 1� Date Subdivision Approved J J Owner /Applicant Name kid? /s Town or Village p�r�i9�'� Tax Map') 177 / Block j_ Lot Renewal Revision Date of Previous Approval Mailing Address Q S- ).Z ��� S^ �`� e i : �L'�4' 0 4• �'�G ��j?' %�/ //ice Zip Amount of Fee Enclosed ' a Building Type i v7 Lot Are , j ' 4'7-No. of Bedrooms .r Design Flow GPDJ,6 Oh) Fill Section Only Depth Volume PCIIID NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of /'�� 0 gallon septic tank and Other Requirements: C/�', To be constructed by �/ �%3 Address Water Supply: Public Supply From Address ®�: _� Private Supply Drilled by %- Address i I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment System described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion ' thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. i Signed: P.E. 0< R.A. Date Address 0�-6 % 12 / C License # --yL APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of thi sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended r' modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan require a new permit. Approved for discharge of domestic sanitary sewage only. B _ . Title: i Date: 1 y: White copy - HD File; Yell opy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -9 i I r . PUMAM COUNTY AI~.PA1tTWff OF M"TH IMSION OF ENMOIMNTAL WAtTH 3ERVIC88 e J. -y • : y�� 1. -.Mf • Fcm ccovuctw Petit iv For: 7rfthdw r.—..r 0, OwOOr /AFplieastt Name; •'� 'iM��� Blocic_�,�,_Lo� FosYner�y Su6divisioo Ns►n ��!; ; '' Sumviuon Lot o- Is ayon fm ComplotOd? Date Is sym m complete? Date �.� is �►stma eod as per plans? is weU drilled? Date Is vvU located as per plaas? Ara crWft control mUaares in place? I cw* dot the system(s). u W4 at the above prey has beep c4mtmW end I have Iospe W aid vvAcd dWr compledon io sccoubw x with dw issued PCHD ConsUvotim Permit and gpowd plains ad the $amdards. Rvies and Roplado,as of the Pdm m County Dept of Health. . Dae:� d �-~ Certified by. P� Deaidn Professional Addnu '�0 Lie. #r,'r ^_....,- 7,/An -,A�ov d,9 65jen kflo CST_ t2QC _ - -- -- -- FOR ADAM 17 0MG Flom FM -" JAN-4 -2002 FRI 13:22 TEL:845 -278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 P11 TNAM COUNTY DEPARTMENT ENT OIF HEALTH DMSION OF ENVIORONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER-WELL PrCH Well Location: I Street Address: Town/Village Tax Grid # .t � *, !JV 11-� Map%°',, /Block Lot(s) WeH Owner: Tpne: Address: If r off Well: U Residential Public Supply Air /Cond/Heat Pump Irrigation ary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought _.S gpm eii Est. of Daily Usage�al. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling `New Supply (new dwelling) Deepen Existing Well Detailed Reason � -, • l � �r� for IIDritlIling Well Type c 5Z- Drilled Driven Gravel Other Is well site subject to flooding? Yes No Is well located in a realty subdivision? ...................................... ............................... Yes Name of subdivision 6t !A U" of � Lot No. Water Well Contractor: / / Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: M!l/ Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to b rovided arate sheet/plan. Date:,.. Applicant Signature: -- ... 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 CountyJ Date of Issue I Permit Issuing cial: Date of Expiratio o Title: Permit is Nonn- Tra®sffe r ble White copy - IUD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .......::.. APPLICATION FOR APpP�Ry�OVAL OAF' PSLANyS FOR ER iiR-E- ATI , 1 S 1rSTL' 1W 1. Name and address of applicant: rz..:) J— IAiex dpilp- 7— 2. Name of project: 1rAxE�-e-, ��J"?F) 3.. Location TN: 4. Design Professional:)eYi &c 5. Address: 14-e ��'���'` A r04o XV 6. Drainage Basin: 1& yfe oL le ���� /`1��1t� � 7. Type of Project: X 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 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... /Y & 10. Has DEIS been completed and found acceptable by Lead Agency? ............... IVI f 11. Name of Lead Agency 12. Is this project in an area under the control of local planning, zoning; or other ffiocials, ordinances? .................................. .. ....:.. _ .:. 13. If so, have plans been submitted to such authorities? ........:......: /Yet 14. Has preliminary approval been granted by such authorities? Date grhnted:tIJY. 15. Type of Sewage Treatment System Discharge ................. surface water Y groundwater 16. If surface water discharge, what is the stream class designation? ....................... /V//f 17. Waters index number (surface) .......................................... ..... .I......................... 18. Is project located near a public water supply system? ....... ..................... ..........: d6 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ 21. Name of sewage system Distance to sewage system 22. Date test holes observed 23. Name of Health Inspector /1, ro 24. Project esign flow (gallons per'day) ................................. ............................... 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... A16, 26. Has SPDES Application been submitted to local DEC office? ......................... A Form PC -97 Z 1."'. i 27. Is any portion of this project located within a designated Town or State wetland? v 28. Wetlands ID Number ......................................................... ............................... t /_ 29. Is Wetlands Permit required? ...................... ........ .........,......._............. ,! .f;? Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... Alf) 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Ye 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 potentially known source of contamination? ............................... YeQ DESCRIBE: 33. Is there a local master plan on file with the Town or Village? 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... NO 35. Are any sewage treatment areas in excess of 15% slope? . ............................... 36. Tax Map ID Number .......................... .......:........................ leap %e / Block / Lot 37. Approved, plans are to be returned to ..... Applicant tI Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approvai 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 l .,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. d hereby affirm, under penalty of perjury, that information provided on this forth is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 21 5 of the Penal Law SIGNATI RES & OFFdCL4L TITLES. ��� Yfa fNrailing dress ..' ............................ 3A8'S-,HiT13H AN3 PROJECT I D NUMBER 617.21 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only anPT,!­R-ROJECM _'-NFORMAT'rjt•,j7i�o 'Ce,campi*Ctaoi by 1. APPLICANT /SPONSOR 2 PROJECT NAME ke N I I? er o� -oc-'f 3 PROJECT LOC,1TION MuniCIP3111•,• County 4. PRECISE LOCA i ION (SIrcel addre s and road intersections, prominent landmarks. etc , or provide map) SEQR 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 5 IS PROPOSED ACTION. Gd,fif'ew C] Expansion 0 Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: C0A,)r-'1-j? (de 'r/O A­; e),Ar 7"Ac X TO S Fit a r- of Si 041, e- 1`'-4 7. AMOUNT OF LAND AFFECTED, Initially 06 r acres Ultimately acres 8. WILL' *PROPOSED ACTION CC)MPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? (xYes lJ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? M,Ksid.n(W Of ndstoal 0 Commercial 0 Agriculture 'ParkJFores [/Open space 0 Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY !FEDERAL. STATF OR I Or41 I) L-yes 11 No If yes, list agency(s) and permit/approvals /101 /N Jr/010 If r-00"t 11. DOES ANY ASPECT OF THE ACT, -N HAVE A CURRENTLY VALID PERMIT OR APPROVAL? El Yes No If yes, list agency name and permitlapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? 0 Yes 4j'N_o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE "Dwvl Ioc Do, A-10# ^ A,"-- 00 /Ir. 4000"t;r 19// Applicant /sponsor name, Date: 000�� 11611110", 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 t- .f%i u— Li..IrlUi.i,',C ,, ,,. ,.,'.c ., .. . .. .. . A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN G NYCRR, PART 617 IV It ve-3. rgordm.u•i :'.• • :r:::: ess ann use the FULL EAF. El Yes lG.i.+co B WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIOrtS IN G NYCRR. Pr•RT •St % 5" If No, a negative declaration may be superseded by another involved agency is -.1 Yes t �}n C L000 -L ACHUN r4ESCiCT IN 9r4y , \UVENSE EF! CC Fi AssOC iAfcG ?Vv9T i THE'ri Cl Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic ea:t !rns, solid waste production or disposal. potential for erosion, drainage or flooding proolems? Explain briefly: C2 Aesthetic, agricultural. archaeoiog-.:a: n ;!qri-, or other natural or cultural resources. or Commur.;:r or .•:r•;nborhood character? Explain brvmily /l ,c C3. Vegetation or fauna, fish, shellfish •.jr vdJ,rfe spec es. significant habitats, or threatened or endangered species? Explain briefly: d &AJ6 C4. A community's existing plans or goals as of!rcrauy adopted, or a change in use or intensity of use of land or other natural resources?.Explain briefly 0. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes ED-Wo If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of 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. ❑ 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: Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency 2 AgPnCy Title of Responsible Officer Signature of Preparer (it different from responsible off rcPrl C5. Growth, subsequent development• or related activities likely to be induced by the proposed action? Explain briefly. Cam`` 01, / G&16 . rt r 8 ry CG. Long term, short term, cumulative, or other effects not identified in CI-05? Explain briefly. /V f "Y cnt;•.c� C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. NQ /V. 0. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes ED-Wo If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of 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. ❑ 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: Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency 2 AgPnCy Title of Responsible Officer Signature of Preparer (it different from responsible off rcPrl PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 1,61,1 A F 1W Address .2'? r-2 lab s"7- %iP.-9�.� Located at (Street) ?Af A- 1#,? ! v e- Tax Map %' / Block % -Lot (indicate nearest cross street) Municipality Watershed . 13.he G Foie t'--) 6a'W SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test /.I- T 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 1 ,W 9"y 3 o JD a! /q ! `/Y a 2 v8 .2 IS 30 3 C� "e02 'eg go ao 01 / 3d 4 Y� J �� �o �-0 v� �v 5 '70 a 6 0--/ / 30 3 !y a yy 3v 9© 3 u 4 y f 3 '-f 36 d 26 5 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, 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 ®F SOILS ENCOUNTERED I TES HOLES J O _ 6DE1' "I'�-T .. _,.. ; 1 i1LE ISO. - _ H )L1 `Nib:. , _. �.. . • WLE NO.. G.L. 0.5' ; 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9:0' 9.5' 10.0' Indicate level at which groundwater is encountered /�/G�✓ Indicate level at which mottling is observedU�/ /� Indicate level to which water level rises after being encountered Deep hole observations made by:? dlN, -- Date Design Professional Name: &mll r J D�o � ��- Address: �� ��P�l•�'.v i�J� �J Po�Y'si °v <�. DOS FD\ Signature: l�J J Ia3 it 0.isl�, a &��'� ' y, Design Professional's Steal qTF OF' N " 4 n PU NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF HEALTH SERVICES PFsicw. DATA. :SI F T :SuEISUFACE S&%AGE_ DISPOSAL, SYSTFxi .: r .. c. ... _.,. -•.. `, -. .. .. .. � _. .. � �-..•. -. c - , r> ., n •. - .eoi_ •. _tea= .r,. -•. ... ., .. , OF v DO' Owner kop p-,4 Ole l G TD Address Located , at ( Street) �R 4P C '-R S F 9 Sec. Block Lot (indicate nearest cross street). Municipality P 14T;49167 y4GG/%Y Watershed Date of ' Pre- Soaking 2Z�-;-9/ Date of Percolation Test 2 2 9' HOLE NUMBER CLOCK TIl4E PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 44 3 /J, ib 30 J� 4 L /` 5/ /Fd'� 30 L/ 3 3/'� 4/ 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until apprcocimately equal soil rates are.obtained.at each percolation test hole. All data to'be submitted for review• _ 2. Depth measurements to be made from top of hole. rev. 9/85 G.L. 1' 2' 3' 4' 5' 6' 7' 8' 9' TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF-SOILS ENCOUNTERED IN TEST HOLES W ,° n 10' zz i 12' o� 13' 21b .. ......... ... .. o INDICATE LEVEL AT WHICH GROUNDWATER IS NO N INDICATE LEVEL TO WHICH WATER, LEVEL RISES AFTER BEING ENCOUNTERED'_ IA DEEP HOLE OBSERVATIONS MADE BY: D a N / f_. C DATE: DESIGN Soil Rate Used f-6 Min/1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity gals. Type Absorption Area Provided By d U L.F. x 24" width trench Other /). 6 /17- �i ��f CG/t! k%"Y /)/l r /,v " 0, .� !� �% 40_,cVq". . Name N / L _ • 1� d 1V <f' # vCd' Signature U to Address _40 SEAL J rn `)y� �0. 4848" THIS SPACE FOR USE BY HEALTH DEPART ONLY: Soil Rate Approved. sq.ft /gal, Checked by Date PUTNAM LINTY DEPARTMENT OF HEALTH Li1:V.i9ioN Or' ` NVIRUNM ;N'tAL HEALTH SERVICES Date us+ 1�� i998 Re: Property of goSe. DUie -Fo c1.,,4 Lte4n Located at park -br;ve, (T) %Ju-� Section ?Y. /® Block / Lot y4 Subdivision of `rAem-go`, Subdv. Lot # /C) Filed Map # 2(oy0 Date 2 6 9S Gentlemen: This letter is to authorize '-bp,,,.jcj T, _bQ QCLAuP= P. E. a duly licensed.professional engineer A15, 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 connectiori_witYi this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigned: P.E., R.A., #����� Address for" Telephone Very truly yours, Signed &X'" Owner of Property lON , Cats+- a c,r 'br,y e Address VQ,Ihalla N� ?Yank /0595 Town 9ly-'76 9- Z4oN Teleph neE, Prz . +Vz 6"er; a '752_ t-OI/CSPur tl INAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'J DESIGN DAT.A.S-HEET SIBSIJRFACE_SE�VA�:FL:Tp 01N-ner rzul i Address Located at (Street) k PC, V_ . 'i re— Tax Mi ap � 'dock Lot :4 indicate nearest cross street) Municipality Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking f &12 -c-0,14? Date of Percolation Test q g Hole No. Run No. Time Start - Stop Ela se Time �iliin.) Depth to Water From Ground Surface (Inches) Start ' Stop Water . Level Drop In Inches Percolation Rate INlin/Inch �0 2 '-� z. z� 2 i 7,0 4 z: � ~ 3' -� ® Z- o 30 5 20 L 1 1 _ 3o 3 z: i9 2 iltq 30 00 Z 30 4 =�i 3:� 30 -2Q 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth untie approximately equal percolation rates are ootamea aL eacn 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 DANIEL J. DONAHUE, P.E. ._ _ .._..CONSULTING ENGINEERS 120 Breckenridge Road Mahopac, N.Y. 10541 914-628.7576 November 10, 1998 Putnam County Department of Health Geneva Road Brewster N.Y. 10509 Att: Mr. Adam Steibling RE: SSTS Permit & Well Permit Property of Fanelli TM# 74.1 -1 -46 Theresa Estates Subdivision Putnam Valley Dear Mr. Steibling: Reference is made to our conversation regarding the possibility of redesigning the proposed septic system for the abovecaptioned lot without the requirement of 3.5 ft. of ROB fill. A review of the subdivision map and the design data sheet for the subdivision_ indicates that percolation tests were performed in tests holes 30 inches deep and 40 inches deep. The deep percolation exhibited a rate of 40 min _per in with no rock or groundwater noted. Based upon this information, the septic could be designed on the 40 min rate and no fill would be req!!ired. Our discussion further included the department's considering one of.the..rooms ..another.bedroom which was not part of this application.. Needless to say, the cost for the fill is. quite expensive and since it could be eliminated and still meet the PCHD requirements, we respectfully request that you consider this request. Please advise as soon_ as possible in order that I may continue with this application. Sinc y Daniel'J. Donahue, P.E. Site • Sanitary • Environmental DANIEL RNs DONAiYUL' 9 olio 120 Breckenridge Road Mahopac, N.Y. 10541 914 - 628 -7576 October 3, 1998 Putnam County Department of Health Geneva Road Brewster, N.Y. 10509 Att. Adam Stiebliq Re: SSTS Lot #10 Theresa Estates Property of Fanelli Park Drive Putnam Valley Dear liar. Stiebling: Enclosed please find: 1. Application for a constriction permit a `'t ` /o "/ 2. Form PC -1 3. Short EAF 4. Letter of Authorization 5. Filing Fee $300.00 v. Four'copies of fill section plans for the ssts 6bTwo copies of the trench plan T Two copies of the house plans 8. Design Data Sheet Comments: The subdivision requires the installation of 3.5 It of ROB fill over the ssts area. This will result in a significant cost to the owner. While the owner is anxious to obtain a permit in order that he may start construction this year, he is aware of the excessive costs of the fill. During construction of the house, I would appreciate the opportunity to conduct further percolation tests. The originial soil test showed percolation in the deeper soils which should obiviate the need for the fill. I would appreciate the opportunity to discuss the above with you. Sinc , Daniel J. Donahue, P.E. Site o Sanitary , Environmental W PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT STREET LO' CATION '� �Q .v IL NAME OF OWNER lV rii.l� I REVIEWED BY RNI, GR, AS NIB, BH Z?� TAX 1`IAP I! �4• / / —'� 6 Y DOCUMENTS Y PERMIT APPLICATION. ROSION,CONTROL:HOUSE,WELL, SSDS PC -1 ERC & DEEP HOLES LOCATED LL PERMIT_ PWS LETTER PRESENTATIVE OF PRIMARY & EXPANSION LETTER OF AUTHORIZATION OCATION MAP 12 1 D GN DATA SHEET (DDS) EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE i2 CORPORATE RESOLUTION IF PUMPED, PIT & D BOX SHOWN & PnLED SHORT EAT OUSE - NO.OF BEDROOMS , REE SETS WELLS & SSDS'S W/IN 200' OF PRO SYS. ANS - TWO SE ROPERTY METES & BOUNDS AARIANCE Q xv (I USE SETBACK NECESSARY (TIGHT LOT) E-E _ HOUSE SEWER - 1/4 FT. 4"0; TYPE PIPE SUBDIVISION l� o NO BENDS; MAX.BENDS 45° W /CLEANO G d^F�►9"`�� �� EGAL SUBDIVISION FILL SYSTEMS JBDIVISION APPROVAL CHECKED AY BARRIER - FRC RATE s4 ©. 10- HORIZONTAL;SL 3:1 TO GRADE PTH FILL SP _ FILL NOTES T kEQUIRED ® FILL CERTI ON NOTE ®� DEPTH G ES GENERAL JFILL' FILE & DIMEN 0 &to PCATED IN NYC WATERSHED V UME f ANS SUBMITTED TO DEP F LL IN EXPANSION AREA FLEGATED TO PCHD TRENCH EP APPROVAL, IF REQ'D LF TRENCH PROVIDED 0�0 60 FT MAX. CEP TEST HOLES OBSERVED %�� ( PARALLEL TO CONTOURS ERCS TO BE WITNESSED 100% EXPANSION PROVIDED }APPROVAL SSDS A . LOTS SEPARATION DISTANCES SPECIFIED /ETLANDS (TOWN C PERMIT REQ'D ?) ON PLAN -FROM SSTS T ON DDS S 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL jE 1969 NEfGHBOR NOTIFICATION 70 'FO F01- NDATION WALLS �' ALL : J PL OTTER BI/ZBA 100' TO WELL, 200' IN DLOD, 150' PITS WB R. FLOOD ELEVATION 100' TO STREAM WATERCOURSE LAKE (inc. expan) iTHER REQ'D PERMIT(S) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER ,REOUIRED DETAILS ON PLANS 10' TO WATER LINE (pits -20') SWAGE SYSTEM PLAN - (NORTH ARROW) 50' INTERMITTENT DRAINAGE COURSE SDS HYD IC PROFILE r d X200'/500' RESERVOIR, ETC._] 50' GALLEY SYSTEMS 'RAVITY FfiaW j"Jv1j• ;TRW ON, NOTES MN to CDS= >5 %,10'- 4 0/o,25'- 3 0/o,30'- 2 0/o,35' -I %,100' - <1% ON ATA: PERC & DEEP TS 2 'MIN to CD discharge /I00'with 182 cons day discharge PAURS EXISTING & PR ED SEPTIC TANK Y & SLOPES, C I ' FROM FOUNDATION; 50' TO WELL f7NG /G ER/CUR RAINS WELL TYPE UNDA DIMENSIONS TO PROPERTY LINE S BL WNI AME,ADDRESS LOCATION OF SERVICE CONNECTION kOCATION OF�WATERCOURSES, PONDS LAKES AND WETLANDS WITHIN 200 FEET PROPOSED FINISH FLOOR AND BASEMENT EL, COMMENTS: DANIEL. J. DONAHUE, P.E. February -22. 1999 CONSULTING EN�a EERS 120 Breckenridge Road Putnam- County Health Department Mahopac, N.Y. 10541 Geneva Road 914 -628 -7576 Brewster, N.Y. 10509 Att: Adam Steibling RE: Fanelli SSTS Park Drive Putnam Valley Dear Mr. Steibling.- As per your request enclosed please find three construction plans for a septic system which will serve a five bedroom house along with house plans which reflect the same. Your prompt attention would be appreciated. Thank You. Sin . y, aniel J. Donahue, P.E. Site o Sanitary o Environmental 2752 .lrarksp Street. Yorktown Heights, NY 10598 February 17, 1999 Mr. Bruce R. Foley, Public Health Director Putnam County Health Department One Geneva Road Brewster, NY 10509 Re: Fanelli Residence, Park Drive TM# 74.1 -1 -46, (T) PV Dear Mr. Foley: As d�6\ Enclosed please find a set of house plans for a five (5) bedroom residence, as we previously discussed: Mr. Donahue will submit a five (5) bedroom septic design under separate cover. Thanking you in advance for your immediate attention to this matter. Sincerely, cc: Mr. Mike Budzinski, Director of Engineering (without enclosure) Mr. Dan Donahue Professional En ' eer with enc osure �1VE.Adarn Stiebeling, Asst. Public Health Engineer (without enck O- o Yorktown Heights, NY 10598 February 17, 1999 Mr. Bruce R. Foley, Public Health Director Putnam County Health Department One Geneva Road Brewster, NY 10509 Re: Fanelli Residence, Park Drive TM# 74.1 -1 -46, (T) PV Dear Mr. Foley: Enclosed please find a set of house plans for a five (5) bedroom residence, as we previously discussed. Mr. Donahue will submit a five (5) bedroom septic design under separate cover. Thanking you in advance for your immediate attention to this matter. Sincerely, .._..._ ._._ . "Ken Fanelli. cc: Mr. Mike Budzinski, Director of Engineering (without enclosure) Mr. Dan Donahue, Professional Engineer (with enclosure) IVAm d Sbtu Asst. Public Health Engineer (without enclosure) l_ BRUCE R FOLEY _ _ . f Publtc ifealtti ` birector February 5, 1999 LORETTA VOLINAPIRN.,:MS.I� ;..:.. Associate 'Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 -.6678 Fax (914) 278 - 6085 Mr. Dan Donahue 120 Breckenridge Road Mahopac, New York 10541 Re: Fanelli Residence 16 Paul Drive " TM# 74.1 -1 -46, (T) PV Dear Mr. Donahue: As discussed, I have reviewed the attached set of house plans submitted for review with Bruce Foley, Public Health Director and Mike Budzinski, Director of Engineering. The bedroom count for the above stated residence from plans as submitted, has been determined by this office to be six (6) bedrooms. .- W . _._ _ .. r...... Subsequent discussions between your client and Mr. Foley, Public Health Director, has concluded that a design based on a five bedroom residence would be acceptable. Please have Mr. Fanelli submit revised five (5) bedroom house plans. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Q� Adam B. Stiebeling Asst. Public Health Engineer ABS:cj cc: Mr. Ken Fanelli B. Foley M. Budzinski Z SL BRUCE R. - .FOL?~ A'. _ - Public Health Director January 27, 1999 991a� .LORETTA MOLINAM :R.N.,.M::S.N:.. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 Re: Fanelli, 16 Park Drive TM# 74.1 -1 -46, (T) PV Dear Mr. Donahue: This office has received and reviewed the revised set of plans for the above mentioned project. We would like to offer the following comments for your consideration. 1) As discussed and noted on memo of 10/22/98, the set of house plans submitted indicate this is a six (6) bedroom house. Please resubmit plans based on a design for a six (6) bedroom house. yl npo_ amn�m.r+nt'a --n lan efs'stem�calli Cl.�tri���:tl�.n b") x- - "J-BrJ_v_" (t p', - -- � -- P•leµ:., rte...,, .., ..,.,, p. } ..g - . . -Ir,• 3) Please provide a detail of proposed cleanout. 4) Dose Chamber cannot be "retrofitted" into pump chamber for use as expansion system. Please provide a pump chamber as required, based on bedroom count / design flow. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Adam B. Stiebeling Asst. Public Health Engineer ABS:cj ' PUTNAM COUNTY DEPARTMENT OF HEALTH. Date To: From: Subject: ?,,10,(":,rf- A.Zo -n f 5 ?,A-' C S� COT � lC�i � l +!�i2rfs� C 5� S t-i "Lo AT7-w-(+%kz Cop-., o, I.SC �'G►V `� �� Co Y car of C� 9 10 ?,A*+A L )s t t?, 4 y l,o-r �(/ 1►► r f Q I` mil. c r t Aco c,LO.>2{� �(.c.cfi ST I _l` . .? �rf s f (�-� 5� �i v�u, s C �✓� �f C,�� -, Qc9► � � �e.Q ©� b .� �-� s ►� �� � S� -a.�. <-m� S �� Z own � S — � (�� s , ra tss trr rs y.P tr-r IS-r r-Y t 1 4 t § § 5 t l DECK O 0 up tI Q w r F arm OI �'g M .0 E I DINING ROOM 1 1 BAR-ARM Y•. \\ i b § n - • t MIJD ROOM R: 1 NO n. -f Ir -If r-r Ka ( I .fAr T.O. HGMIIS OEM Mu w 7 BGB«0 wNl. R mm wu1.5 ! SfrP �1 ORNO N OMSOE YS \ BEWY10 NHL #� nv-wm it O USrED R RECREATION ROOM FM U.L. Mum 4 ti 3—CAR 6 RAGE rwc o Boor • k 6 K4 � f ^� tr0 74 t- I F 6rtiy Y ROOM 6 II k y ' r.Y _mow «r « —� II w19B Ep II \ �WowwL Icco BED ROOM -5— x (i��`o�n rr (w� uv�+wBC iY°� o1 zaR e-C oB 0 .wa \ v- v.e• -P awnc Dorn a•- v.n• -v ckwc ooaB r -a.r -a oywx 000B O O R vAv ( ?� stuns ` t k tP BOUYD WN BrABV+O vv.a columa , ur � BIS[IIS n T Y -tr If -f K -f 7.1P 7 -f r.f r -f YX 7 -t Yd A IYr tlT :tr4�i my LD • �tr+lysc^ pig i yzii��Q?t� IR9$ • ����r9,1 t�9y;:� � �� � FIRST FLOOR FLAN SECOND FLOOR PLAN sc=. I1• - V-0, HOUSE PLANS APPPOITED rOR BEU;WOON COUNT ONLY; ?;Title Date Ir -r - r -r Is -r u.r r -u• 3 ------------------ - - - - -- - - - - - -- ---------------------- HEO RM -2 Ild T771M , Y � wo co p. WO \ M yy \ rp J f L Ir -f -^- i ' iS soo ' t. HED RM -3 sly% FOYER MASTER D.R. �, b / I I1 I I • \ I Nm / `� � /�. re w• -r u -r t -r r -r r•r r -r r -r >d ._ > -r 11 -f Ud / SECOND FLOOR PLAN M„r 1/r - r-f t , • I h I DECK t i um BAR AREA tl MUD RGCM ld 1 Mfd ' Ip wr -- r 1 MN MIEo 1 -AUS 6 COU, tl1 G J E ORECREATION ROOM 1 / b tl 3 —GAR GARAGE IA l' 1 GUEST BED ROOM (t2t�dl�MU�'EfiP°�i' (:2t2o�dl�fE,"iP�i" (}�i2 %��ml�"i OED 8000-4 \ 9•- r.0' -r COULE DOOM S' -V.r-0 DAPAGE DOOR 9•r.!' -7AP GE I DEN \. �. 0 s.lr ur_r I?.r FIRST FLOOR PLAN SCAL. lir . 1• -r Ol O'UP f I I 0 KITCHF ,lc DINING ROOM b A R •� 3Sd Is -�' 4T 9C T.O. — — (2) 2.12 DECO c.-MS 11E_ADEN_ _ - 4 up r - -- M 0 DEMWO FALL 2f.tf f' aA eEMUMC rAU w•.ec . fAN U.L USiED PV {t •�� DD - - -- LR tif. wN Ilu[ 10 ROOF Ifd Ed fd FAMILY ROOM � II M R UP 1!R b ^� II OCCO COLUMMS -^ —ml ar. I FOYER (ill2cablwcs i § 3 11 1A O .us o D PEMN Ep S D• -r OR (2) er O-•— tbe-- O 4 BRICN PAM Cp1tR E SR s J If Pm. ION) UP 2 R=RS Ai r "" P.V.C. c0W .s IDA • .1 3 at 'V fRAGONE F-bd MOP N9 a will, it \ \ \ m 1 N erly (fort" rrrFer i now or fo 5' a F tiv 8A O'w ov w poN;? J 1 _ b I. 1A - � \,� ?�� C� /�V �� / Ii. -`I t -� /1 1 ,� �J�\ \ \�� \\ \� • \! / � \ � �I� ri�'6ZeC.N. o Co OWNERS' CON., .. Prior. to sale, the sewage disposal systems and wells orr Lots 7 & 9 shall conform. to Putnom County Health Deportmenl regulolions. ' The undersigned, owners c IM COUNTY DEPARTMENT OF HEALTH hereby state that they on REALTY SUBDIVISION GENERAL NOTES contents and legends, one and conditions of opprovo filing of this mop in the l plans for-individual' 10. The conditions noted on the Putnom County Deportment of Heollh Certi!'cote of Approval „I\ are on integral part of this subdivision approval, and complionce is required. • .,. _. , '' .. .. - tr i.2 dieos delfneo.ed"for oiro.:ui'ueid:>cr,B txrcu.t.oa o'" v;a•io hY_4,; r..a,:red o,l:. " Qwt)S�C•7 '.:c"•: :E .,q_' . the ground and no earth moving or construction equipment is to be allowed in these areas except as required for construction of the system. Owner State Health Deport— 11. No We field to be less than 100 feet from any lake, stream or water course. 13. It is the intention of this plan that wells be o minimum of 100 feat from trench except ions of sewage Sys— when o well is downhill and in direct drainage line with the septic system, in which case dificotions to have . the minimum, distance shall be 200 feet. 14. Flow from all proposed dwellings to the sewage disposal areas to be by ,grovity -. _ utnom. County Health 15. Septic tank capacity must be :increased by 507a . nor disposal fields by 20.Z if garbage , grinders ore proposed. specified on on op- 16. Alt stone wo1 /s within sewage dispogol areas to be removed to their entire. depth, and the resultant void to be replaced with R.O.B. fill. 17. Approval is herewith gronted.for o Moto/ of 10 lots only, name /y Lo(s 1,2,3,4,5,6,7,8,9 & 10 approved by the and these lots only. >rtificote of Approval. �1 g PARK � N . 855) LET S E o AUR MOP ,ne O �L. g59 p5 ' teal; 0 . 5 distonoysPro Fc N c7- 1, SAP MOy SeP °ro�onarnjed o \ :.... h0 o n. filed �OT "in, locations 1' 3 l Mimi' and 602.5 z . c� ternsstiq °lion deePo pe 'nyE .. Pr 4,JIs ant. roPp50dDeportal s m $o .ng. or. P, N °oltn ..._.. _- -- •,._ .�. ......__ _.. - 0< qo E. '1._ N W O. No a$, 0ou line ` • 1 'Za �Q 1 ,,,Oro ,�O • 3 R �O. Pon f / gene LOT T / \ 0. Pole P I,AIJr 1 fj l/ .S / O % 3.499 ' Acres o o� _ 3 ^,3 Ile ,proped 152,429 .Sq. Ft. � � o �oa well ? 5. c 6� _ G I i0 ''120 -.. •v. •\ �� 212.80" 0 5 °qo r:3 726 IR MANSION AREA FOR 2 .r • '� a .. s'o .. .. .. WW 1' $ SANG SSOS lF NELV£D:. • o P � m 1 pole' �•� /? `Q® 5c�0 _ o •� ...1 \0.. 5;`_' on O poi c: 1 OSfO _ cT 1 a. p �. ",Ph �\ QED p22.31 ,a p0„ 5 3g 47 a ye N 49'45.p0" W m11. as or �, � 1 40.00 223.00 —N \ 0�,. NI. as Oar •\ . ,woes _ 00" W N 5 4.9.00 OON,tRO� . wood . 1,: I� $ 40'10 .. ' . . platform ti0 1167, 49 l741p0n W � 1: o ik "pUSE FRAMpQ '� N .60.17 :-., •� - .45,p0., ".yy .bs° SHED r u` ••� , tI o 1R1 lm g o� t � I �t' '.. ,x, e o ? ` " • .< .' y . . .. , , i . I _ 7 I 53 ro .00 Pole o drive LOT 0• W : y $ pP . y � , p' �Ei' � "oi '! .= C FAME 5HE0 oWeu`a 2'.—. d 236.22. 1611 Acres p0 P r 7 ' �ww 94,138 Sq. f t. 48* 45 -2 CF o ).8 9 i e W < of ,Aj czi.*- 1. 1 "�_�::, .. •y :•; _,`1� I Iz / ostve^i a„mer lb :,moo. 1'.c' a Ip ./ // 690 . -.... . '•`:. X20 Op o Z cambers Z 3'NI . TP O .p Chambers�� ti L CQ RAGONE - \�. — lb+a as v� Fitd M\ n9 855 \\ .83' ` conlarlrro Of slaw Ooll, It \\ \ _ — _ ("'• . I i (formerly form ow o r AU n� 0 g. `\ f /':Or�Er_y/7CP j�10 7��.,', a� / \ , 1 `: LOT 9 A RK 655 LOT . LOT 8 _. AURELaS MOP No _. „dare. _.....�_ _ ..__ .- _... ,. ._.a......_..w. • ..: .. ; .��.1 ..- . 5 I__. ... V ._. ,.*.* _ . .. ...._ distonc yS ptcF ... -... !A �/ .. .. .... MO! Sep °t0toft ed by 0 5 K {Ile. ��T ., ni ^� �o onions P 51, 11 3 Witni^ and 602... tens tiq °lion Un R .. SOP as se in"es _ .. per °Sad wall$tin"'t °5 � � o cr pt0alth Dep A O �• o efistt C only He N xjz 3 poll, yo line 1.1 ►-OT Mon' ally I v� z 9i �a 'LOT 10 � N� 2 3.4993 Aces ZZ m one, . mil proposed 152,429 .Sq. Ft. , o' /. s' >0 110 -- •,,. \ z No, ON b f,rr or �Rg, 212.810' 0 �'1ry 726, n O00 og'' . „n Zi EXPANSION AREA FOR Z. r , . A . 0�5� j� Y: v:... •.. .�,: �.. X c aS17N0 :SS05 1r'NEEDC0 •. OG ®1 •rot Pde.' •� �� �b •/! P�® SS. - - I'��'...1�0. � n. iQ- W "O o' l . ph a OP s ..: - . 3 .,Q ea . • 222.3 �o ° ^mod- -- p0,. µt� .. p= .. pp" W 5 3L3-47 N 49'45 , _ «aUOn'ar e,. • 40.00 2P3.00 t rNl. os Per `p N '\ N 55.3g'00 W o�tRO� a•na '40'10.00 " W 0-p0 . Platform i� 5 b5 p 0 67• �� oa I ^^• 1 1 49.04,00 et`PN 'moo •ptic FRAME `RAMS \ N 1 �' .. - :......., • " IN . ,,><,'.•:. ��� .- O BO ank rlousE �HEO. 60• ,.. - •� ` 53.45•p0 pale 16.5' PrOWe�. ''~� 55' u �drN!_3 s ° p rk o 1 "rr" I ME SHED y LOT. O ✓ Ala t _I M.. _ P P ° °�` �' t . ti2 FF.a �:` ''. fires _ -- Jo It 3 i�l i' gip" t' BEY ° s 3 �.. We I �5.3J5t�i� 94, 138 Sq. 'Ft. Q �N. 4L3'45 0' 0 qP� 5 � t • {. ` e 0 0. 1 101 \ ,J I gp REOt)L/ + o .. location, o Ca :no1 ro/ t. as Per wr'er 0 O { °I 4� Z P concrete / 690. 2 �^ "�' o o A 1 z Ph drop /'. ' / �• • 19 . l 0 3 'L'''t> chambers% OWNERS' CI •• Prior to sale, the sewage disposal systems' and wells on Lots 7 & 9' ' shall conform to Putnam County Health Oeparrment regulations. The undersigned, owne, hereby state thot they ,AM COUNTY DEPARTMENT OF HEALTH contents and le REALTY SUBDIVISION GENERAL NOTES t opi and conditions of oppf filing of this mop in t, •f plans forindivlduol 10. The conditions noted on the Pulnom County Department of Health Certificate of Approval are on integral part of this subdivision approval, and compliance is required. J1. The areas delineated for disposal fields and expansion area ore to be physically marked on the ground and no earth moving or construction equipment is to be allowed in these Owner f I: •l /.)LG -+ areas except as required for construction of the system. Owner k State Health Deport- l?.'N6 the field to be less than 100 feet from any take, stream or water course. 13. It is the intention of this plan that wells be a minimum of 100 feet from trench except ' otions of sewage sys- when o well is downhill and in direct drainage fine with the septic system, in which .cose ,odificotions to have. the minimum distance shall be 200 feet. 14. Flow from all proposed, dwellings to the sewage disposal areas to be by gravity. Putnom County Health 15 Septic tank capacity must be; increased by 505.' and disposal fields by 20K if g'orboge grinders are proposed. e specified on on op- - 16. All stone walls within �sewoge disposal areas to be removed to their entire, depth, and .. the resultant void to be replaced with R.O.B. fill. 17. Approval is herewith granted. for a total of 10 lots only, namely Lots 1,2,3,4,5,6,7,8,g dr 10 s approved by the and 'these lots only, , • Certificate of Approval. '. .. LOT 9 A RK 655 LOT . LOT 8 _. AURELaS MOP No _. „dare. _.....�_ _ ..__ .- _... ,. ._.a......_..w. • ..: .. ; .��.1 ..- . 5 I__. ... V ._. ,.*.* _ . .. ...._ distonc yS ptcF ... -... !A �/ .. .. .... MO! Sep °t0toft ed by 0 5 K {Ile. ��T ., ni ^� �o onions P 51, 11 3 Witni^ and 602... tens tiq °lion Un R .. SOP as se in"es _ .. per °Sad wall$tin"'t °5 � � o cr pt0alth Dep A O �• o efistt C only He N xjz 3 poll, yo line 1.1 ►-OT Mon' ally I v� z 9i �a 'LOT 10 � N� 2 3.4993 Aces ZZ m one, . mil proposed 152,429 .Sq. Ft. , o' /. s' >0 110 -- •,,. \ z No, ON b f,rr or �Rg, 212.810' 0 �'1ry 726, n O00 og'' . „n Zi EXPANSION AREA FOR Z. r , . A . 0�5� j� Y: v:... •.. .�,: �.. X c aS17N0 :SS05 1r'NEEDC0 •. OG ®1 •rot Pde.' •� �� �b •/! P�® SS. - - I'��'...1�0. � n. iQ- W "O o' l . ph a OP s ..: - . 3 .,Q ea . • 222.3 �o ° ^mod- -- p0,. µt� .. p= .. pp" W 5 3L3-47 N 49'45 , _ «aUOn'ar e,. • 40.00 2P3.00 t rNl. os Per `p N '\ N 55.3g'00 W o�tRO� a•na '40'10.00 " W 0-p0 . Platform i� 5 b5 p 0 67• �� oa I ^^• 1 1 49.04,00 et`PN 'moo •ptic FRAME `RAMS \ N 1 �' .. - :......., • " IN . ,,><,'.•:. ��� .- O BO ank rlousE �HEO. 60• ,.. - •� ` 53.45•p0 pale 16.5' PrOWe�. ''~� 55' u �drN!_3 s ° p rk o 1 "rr" I ME SHED y LOT. O ✓ Ala t _I M.. _ P P ° °�` �' t . ti2 FF.a �:` ''. fires _ -- Jo It 3 i�l i' gip" t' BEY ° s 3 �.. We I �5.3J5t�i� 94, 138 Sq. 'Ft. Q �N. 4L3'45 0' 0 qP� 5 � t • {. ` e 0 0. 1 101 \ ,J I gp REOt)L/ + o .. location, o Ca :no1 ro/ t. as Per wr'er 0 O { °I 4� Z P concrete / 690. 2 �^ "�' o o A 1 z Ph drop /'. ' / �• • 19 . l 0 3 'L'''t> chambers% PA L HALL R jJRE a OF as M P ` VAP o lrl ( filed May 5' 19 L 0 2' 8 y PK AR so2.5 cc T 7 ,• LOT Z .. � lot on VE b r paval"0"t ya„erau j0-21 W y, i.M. Na4M v ep S too-00, �y \ 2 ?8.29'0_ �„g Row• to vdO m o S 43500" £ a 47.00' S�rNT �� �\ \\ // /i ac. a it �' ► 4 1 EASE YC�,. lysyb3 �, LOT >0 X00' 1. cant. Areo = 3.4993 Acres L++ Q l / 21? 80' loop s�O` ( 152,429 Sq. Ft.) gg g g u' 1 53.9' �- l.iC''� � � � —. p ^I pole . , y un/ta 7 V: v Z F O LOTS (Fy ti0 , 164 0) i V • S crow cut eat $ 494500' E —�I gap k, raa Iran pin sat of n stone rail rest and of wall 4 pose cut set Man ph set 40.00' ' N 4070'00" E 223.00' N 38'47'00' E 22231' g art -- - - -' LOT 8 LOT 7 S� ( F.M. Na 2640 ) ( F.M. Na 2640 certified, os noted and limited below, only to: — KENNETH d & GERAL YN M. FANELLI lu6uam uouazy vepaxTmeus, ui ao<irA rivieion of Environmental Health Servlcer SUR VY Al"TT" ,TATFT, s i J LOT 7 ge erally a vem stone. 2640 F. M• � le . h I 2a9'.... refer to n R W on Pole Ilne { 228 Q— regard 9 trove �arOO o / a. C. unit / O \ Q 19f�* ❑ a o \. on c. °G0� aye / stoop _ d / conc, A S too 80 55.9' l ` 0 �y0 pole G. C. �O o o units 2540 J stone wall ` v <D f \ \ Q \ a \ yf • P P } 9 E t t e i Q ( SSTS TIE - INS (1`'¢ASUR>;D BY TAPE) B LENGTH OF TRENCH UNIT SEPTIC TANK A 19 49 DOSING TANK 614 2494 7 DLST. BOX l 76 DIST. BOX 2 DIST. BOX 3 44 70 END OF TRENC 132 50 1 2 92 95 132 50 50 3 97 135 100 137 50 a 5 104 140 50 50 6 109 143 111 145 50 7 8 116 150 50 50 9 118 151 121 151 50 10 11 52 50 50 86 12 56 87 50 13 14 62 91 50 50 15 72 95 80 100 50 16 17 83 103 50 50 18 86 106 90 111 50 19 96 115 50 20 1 95 94 88 87 22 23 80 80 24 76 74 69 66 25 26 62 60 27 65 52 51 44 28 29 43 37 30 36 32 38 72 31 32 45 79 33 52 82 58 85 34 35 64 90 S 36 70 95 76 98 K 37 83 102 i 39 88 107 96 114 40