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HomeMy WebLinkAbout3748DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.19 -2 -12.1 BOX 29 03748 m 19 l y97 ' , xLq. Ll .' , �� ' - kir L 03748 vl PUTNAM COUNTY DEPARTMENT OF b.IVlSI_0N OF ENVIRONMENTAL. H_EALTH,SERVICES.. ' 1I Welr Permit # WELL COMPLETION REPORT Well Location Street Address: Town /Village: Tax Map.# GPS m: Sr` -7 L& 19 -0 -,a,i �c3� S a f'C Map Block Lot(s) Well Owner: Name: Address: Well Type Screened -Open end-casing _ Open hole in bedrock _Other Casing Details NI Wd'9401 "�% LIX _ v /0 s Use of Well: LZResidential _Public Supply Air cond /he t pump _Irrigation 1- Primary Business Farm Test/monitoring _ Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment IRotary - Cable percussion Compressed air percussion Other(specify) . Well Type Screened -Open end-casing _ Open hole in bedrock _Other Casing Details Total Length ';kLLft. Length below grade ft. Diameter � in. Weight per foot IS lb/ft Materials: Steel Plastic Other Joints: Welded L-Tt readed Other Seal: Cement; grout _Bentonite _Other Drive shoe: Yes No Liner: Yes _LW ' Screen Details Diameter (in), Slot Size Length (ft) Dept to Screen (ft) Developed? First., _Yes No Hours Second Well Yield Test _Bailed _Pumped _ Compressed Air Hours lYield Depth Date Measure from land surface - static (specify ft) 3a During yield test (ft) Depth of completed well in ft. � }-v Well Log If more detailed InforM �on- descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter (in) Formation Description ft. ft.. Land Surface •�{1T. p i-'& r If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage. Tank Information Pump Type &-_ 1 s 4- Capacity �S Depth 0 Model /oAo Voltage a341 HP 3J If Tank Type Volume qeL l Date WeII Completed . Well Drliler PG Gertlflcate # ,� o q o NY State # �;, ma- l`nstaller, P(,. Certificate# !:: _ , . NY State # Date of;Rep rt �V NOTE:. Exact Location of well with distances to at least two permanent landmarks to be pr- ided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3106 N PUTNAM COUNTY DEPARTMENT OF HEALTH S 'ON IRO CERTIFICATE OF CONSTRUCTION COMIPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # PV 13 -08 Located at 1301 Wood Street Owner /Applicant Name Michael M a r i n o Formerly N/A Town or Village Putnam Valley Tax Map 74.19 Block_ Lot 12.11 Subdivision Name Marino Subd. Lot # 1 Mailing Address P.O. Box 105, Yorktown Heights, NY Zip 10598 Date Construction Permit Issued by PCHD 5/19/2008 P.O. Box 105 Separate Sewerage System built by Michael Marino Address Yorktown heights, NY 10598 Consisting of 1250 Gallon Septic Tank and 1250 gallon pump chamber and pump 0.5 ft. of ROB fill and 800 if of leaching trenches Other Requirements: Water Supply: Public Supply From Address. or: x Private Supply Drilled by Number of Bedrooms 4 152 Barger St. Norman Anderson Address Putnam Valley, NY S 1057 "Has erosion eointfabeeii completea?' ` " Lei Has garbage grinder been installed? N o I certify that the system(s), as listed, serving the above pren^s were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance 44 a issued PC Construction Permit and approved plans and the standards, rules and regul on of the Putn unty Dep6r t of Health. Date: 12/5/08 Certified by A IaLZZ P.E. R.A._ (Design Prof sional) Address 2 Muscoot Rd. No., Ma p c; NY 0541 Li nse# 11056 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. copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH v _.. _DIVISION OF ENVIRONMENTAL HEALTH SERVICES_ . WELL COMPLETION REPORT Well Location Street Address: Town/Village: Tax Map # GPS 7 � r9 —a — /a.i / <. /cj% c)fi / vL, Map Block Lot(s) Well Owner: Name: Address: /31 w�o� �— /o s N71 d &A Use of Well: Residential _Public Supply Air cond /he t pu p _Irrigation 1- Primary Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment Rotary _C:able percussion Compressed air percussion Other(specify) Well Type _Screened ('_Open end casing _ Open hole in bedrock _Other Total Length al I ft. Materials: Steel Plastic Other Casing Details J Length below grade ft. Joints: Welded L-T- ireaded Other Diameter �° jn. Seal: ement grout Bentonite Other Drive shoe: Yes o Liner: _Yes o ' Weight per foot S Ib /ft Diameter in - Slot Size Length ft Dept to Screen ft Develo ed? Screen Details First I _Yes _No Hours Second Well Yield Test _Bailed _Pumped _ Compressed Air Hours Yield /D gpm Depth Date easure rom an sus ace - static specs ft) During "y'leld test (ft) Depth of complet;d well in ft. 3a 3 �4D Well Log Depth From Surface Well Diameter ft. ft. If more detailed Water Bearing in Formation Description information - Land surface3� .; descnptions or a.3oa G i cs sieve analyses are available, please attach. If yield was tested Feet Gallons Per Minute Pump /Storage Tank Information Pump ape 1, Capacity i at different depths during drilling Depth 00 Model/0.50-�–�� list: Z3v HP lVoltage Tank Type W X Volume jet l Date Well eornpletedt Welt Driller PC Certif(cate�# o �, V Q � NY :State # � ; xR Datesof Rep ;it x Ali— [e� 3'A£ .§'t .J' '? ,',t^°: a : ,NYState Well Dn114' Name 8� dress a R�� £ i k 1 _> A IAI Duller (st ature) ; k � a•.`� ' i PumI stafler�Narre' &Addrtiess;'t r i� k £ }� Rj'_ �'d R.:. ' 9 ,. 'kfl '. £+ M `' � A f#2 'k Pumpinstalter s gnature), y Jp .: `:� �4"^ L. f V. _9 S ,yy�..' X"M A Y .z z �/.1' C)fkl Vf S x ,y NOR NOTE: Exact Location of well with distances to at least two permanent landmarks to be prOided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 SHERLITA AMLEF, MD, MS, FAAP Commissioner ofHeqlth LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 E911 ADDRESS VERIFICATION FORM OWNER'S NAME: — MAgTNO TAX MAP NUMBER: 74.19-2-12.1 E911 ADDRESS: 131 Wood Street ROBERT J. BONDI Coqnty.4ecykye TOWN: P14nnm Val I P3X AUTHORIZED TOWN OFFICIAL: (Signature) 7 The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is. to be submitted with the application for a Certificate of Construction Compliance. E911 addressverification Environmental Health (845) 278-6130 Fax (845) 278-7921 Nursing Services (845) 278-6558 WIC (845) 278-6678 Fax (845) 278-6085 Early Intervention/Preschool (845) 278-6014 Fax (845) 278-6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION_.OF .ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM MICHAEL MARINO Owner or Purchaser of Building MICHAEL MARINO Building Constructed by SKYVIEW LANE Location - Street RESIDENCE 74.19 1 12.1 Tax Map Block Lot PUTNAM VALLEY Town/Village MARINO Subdivision Name 1 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 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 12 _ Day 1 Year 2008 General Contractor (Owner) - Signature Corporation Name (if corporation) Address: 6 SKYVIEW LANE PUTNAM 'VALLEY State NEW YORK Zip 10579 Signatu Title: OWNER /CONTRACTOR Corporation Name (if corporation) Address: 6 SKYVIEW LANE PUTNAM VALLEY State NEW YORK Zip 10579 Form GS -97 AT, DI V 1'1SIO OF EN ,V �I V ME1, TA L ` EAL_rl .A-C_ERVI si ES,.:..i'. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM MICHAEL MARINO 74.19 1 12.1 Owner or Purchaser of Building Tax Map Block Lot MICHAEL MARINO PUTNAM VALLEY Building Constructed by TownNillage SKYVIEW LANE MARINO Location - Street Subdivision Name RESIDENCE 1 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 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 12 Day 1 Year 2008 . General Contractor (Owner) - Signature Signatu '00 ��� Title: OWNER /CONTRACTOR Corporation Name (if corporation) Corporation Name (if corporation) Address: 6 SKYVIEW LANE Address: 6 SKYVIEW LANE PUTNAM VALLEY PUTNAM VALLEY State NEW YORK Zip 10579 State NEW YORK Zip 10579 Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 - Albert -H-. Padcvani, Director LAB N# NN1 .805567NNN CLIENT � # :�60653������ MNNN��ryNONNSTAT�PROC����PAGE: 1�of-2NN MARINO, MICHAEL PO BOX .105 YORKTOWN HGTS, NY 10598 DATE /TIME TAKEN: 11/13/08 10:00 DATE /TIME RECD: 11/13/0811:30 REPORT DATE: 11/26/08 PHONE: (914)- 760 -3618 SAMPLING SITE: 131 WOOD STREET, MAHOPAC, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COLD BY: MICHAEL MARINO TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 11/13/08 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B 11/17/08 LEAD (IMS) <1 ppb 0 -15 ppb SM 18 -19 3113B 11/19/08 - NITRATE NXTROG 4.45 MG /L 0 - 10 SM18- 20450ONO3 11/14/08 NITRITE NXTROG <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 11/17/08 IRON (Fe) <0.060 MG /L 0 -0.3 mg /l SM 18 -20 3111B 11/18/08 MANGANESE (Mn) <0.010 MG /L 0 -0.3 mg /l SM 18 -20 3111B 11/21/08 SODIUM (Na) 7.82 MG /L N/A SM 18 -20 3111B 11/13/08 pH, 7.1 UNITS 6.5 -8.5 SM18 -20 4500HB 11/17/08 HARDNESS,'.COTAL 150 MG /L N/A SM 18 -20 2340C 11/17/08 ALKALINIT`.0 (AS 112 MG /L N/A SM 18 -20 2320B 11/14/08 TURBIDITY (TUR <1 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: FAX TO 845- 528 -2035 COMMENTS: MFTC THESE RESULTS INDICATE THAT THE WATE (WAS (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TI14E OF COLLECTION. Pb /Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg /L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914 ) 245 - 2800 Albert H. Padovan'i , Direc"tor" LAB #: 1.805567 CLIENT #: 60653. NON STAT PROC PAGE: 2 of 2 MARINO, MICHAEL DATE /TIME TAKEN: 11/13/08 10:00 PO BOX 105, DATE /TIME RECD: 11/13/08 11:30 YORKTOWN HGTS, NY 10598 REPORT DATE: 11/26/08 PHONE: (914)- 760 -3618 SAMPLING SITE: 131 WOOD STREET, MAHOPAC, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COLD BY: MICHAEL MARINO TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF ------------------------ - - - - -- ---------------- ~ ------- _- ------- - -- - -- DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION,_ BOTH EXPRESSED..AS CALCIUM CARBONATE, IN MG /L. THE -- -FROM- --(�- 03 HUNDRE!5,9- SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER HARD WATER: 140 -300 MG /L (1 grain /gallon = 17.2 MG /L) THE ABOVE TEST PR EDURES MEET ALL REQUIREMENTS OF NELAC, AND RELATE ON T THESE SAMPLES RECEIVED BY THE LAB SUBMITTED BY: Z��o / le�' Alber5,X. adovani, M.T.(ASCP) Director ELAP# 10323 PUTNAM COUNTY. DEPARTMENT -OF TMALTH DIVISION OF ENVIRONMENTAL, HEALTH SERVICES • FINAL SITE INSPECTION ° :Date:, Inspected by�6r­7Z�0 - ,..t�ect 01 r f� ►o �:.. r :...:�� - _ -... .. .. ., Town kkERM wTAZ&w ✓ .4z ._Permit # PV 13 0g TM -W 74,4 — _/Z % Subdivision Lot # 3. 'Sewage Svstem 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 th3.n -15' from STS :area.......:.: -e: 100'._froni:water course/ wetlands ......... ............................... IL :Sewage Svstem a. Septictank:'size 1,000 .....1......... . ...... other.......... — b. S epticiahk installed' level........ . ....................�::... c. 10' :..minimum' from foundahon... ........ ............................... d. Distribution Boz 1. All' outlets at.same eleval: ion- watertested :.........Q 2. Protected :below frost ...... ................. .I.......................... 3 Mnimum 2 ft:Origmal soil between box & trenches e. June. ction Box properly set ......... :.............................. 6. krenc es 1. 'Lengh:required oo _Length installed `K 0cf) 2. Distance .towatercoursemeasured4 »c5 Ft.......... '3. Installed according to plan.:.. ......................................... .4. Slope of trench -acceptabl:e 1/16 -1/32" " !foot...:......... 5. 10 ft. from-propertyline - 20 6. Depth of trench <30.inches from surface ...............::. 7. Room allowed for -exparLsion, .100 % ......... :............... 8. Size of gravel 3/4 - 11/2' diameter clean ...................: 9.. Depth of gravel in-trench, 12" minimum ................... 1.0.. :Pipe ends: capppped......._ ............ .... .I .......... I .............. _. . g. Pump or, )ose&Systems 1. 'Size of pump : chamber ...... ............................... 2. Overflow' tank ..................... ............................... . . 3 Alarm, visual/audio ........................................ > 4. Pump easily:accessible, manhole to grade.......... 5. First box baffled .......................... ............................... 6. '.C� y..cle witnessed by H.D.estimated flow /cycle........... IM Housau'Udidg a. :douse located dr er .approved plans ... ............................... b.. Number of: beooms .................... .....1�61y. �m IV. .W611 �t ✓e4ci- aie,AfZ -e�s�' Well located.as per approved plans.,..�ao..�. if5t). ra�s w /p-�r�, b. 'Distance from STS area measured l a el `ft ........... c. Casing-18" . above. grade ................ ............. ................... d. Surface.drainage around well acceptable ....................... V. Overall Workmanship . a.. Boxes properly grouted ............... b, All ; pipes partially backfilled ............ ............................... c. All,pipes flush with: inside cfbox ........................ :......... d. BackEll 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.avvay from STS area ................ h. Surface water protection adequate ........ :.......................... i. Erosion control provided ........:........ ............................... Rev. 12/02 CO1VIlV MNTS 09/29/ 2008 10: 49 ATTENTION 8456282807 JOEL GREENBERG PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION.OF ENVIRONMENTAL HEALTH SERVICES 0 JOSEPH REQUEST FOR FINAL INSPECTION All inf=n.atioa must be fully completed prior to any inspections being made. PCHD Construction Permit # PV -13 -08 k1 GENE For: Fill Trenches x x PAGE 02 Located: Wood. Street (T) (V) Putnam valley Owner /A.pplicaut ..Name. Michael Marino _ TM 74,19- $lock ^ 2 Lot Vii. Formerly. _ - Subdivision Name: Marino Subdivision Lot # 1 Is system fill completed? N/A _ Date: Is system complete? Yes Date: 29 Sept. 2008 Is system constructed as per plans? yes Is well drilled? Yes bate_ 01 July 2008 Is well located as per plans? Yes Are erosion control measures in place? Yes I certzl"y that the system(s), as listed, at the above premises has been constructed and I b.ave.inspected and verified their completion in accordance with the is ed PCHD Constructioni Permit and � �v approved plans_and_the Standards, Rules and Regulation a the to County Department of -. Health... _ _- -_ .... z Hate: 29 Sept.. o o s Certified PE RA Ae$n Professional Address: 2 Muscoot Road North, Mahopgc, Ny l0_ 541 - Lie, # j ].OS6 Comments: Form FIR -99 ShERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joel Greenberg, R.A. 2 Muscoot North Mahopac, NY 10541 Dear Mr. Greenberg: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health September 30, 2008 Re: Field Inspection - Marino Wood Street (T) Putnam Valley, TM # 74.19 -2 -12.1 The above referenced separate sewage treatment system can be backfilled. The following comments need to be addressed. -17"X pump'tegt needs t6 be w>triessed l)y tfii 7Dep"a`rtment once' ffie e eclnca '>nspectlori hd§ been completed and notification of such has been submitted to this Department. 2. The septic tank a:nd pump tank corners need to be exposed for measurement. 3. A bonus room has been constructed above the garage that was not approved by this Department. This extra room brings the potential bedroom count to five. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845)•278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing; Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 . Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Street PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF EN- I'IRONMIENTALA3EAT,141 SERVAL :S FIELD ACTIVITY REPORT Town State Zip PERSON IN CHARGE OR TNTFRVTFW .T): ThtP: Za /l& t� PUMP TEST DOSE TEST REQUIRED GALLONS 73 /, 6 © d V7 I Ll cer�a,rt, O V 41 EL. START I,n 0 t7� A EL. STOP -' O1 TNgPFC'TnR: TFT + Signature and Title REPORT RFCFTVF.T) By: I acknowledge receipt of this report: SIGNATURE: 02/96 SHERLITA AMLER, MD, MS, FAA? Commissioner of Health _. LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joel Greenberg, R.A. 2 Muscoot North Mahopac, NY 10541 Dear Mr. Greenberg: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health October 20, 2008 Re: Field Inspection — Marino Wood Street (T) Putnam Valley, TM # 74.19 -2 -12.1 The above referenced separate sewage treatment system can be backfilled. There are no further comments to be addressed at this time in reference to the open work inspection. If you -have-any"further° questions ;- ptease-ooYrtwA-me at- (8445) 278 =0130 ext. 2Zi3` . _�_. _ _.,.._... ,�..�....- T ._.... Sincerely, GDR:kly Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type MH Well Location S Street Address: Town/Village: Tax Map # Wood Street Putnam Valley 74.19 2 12.1 Map Block Lot(s) Well Owner: N Name: Address: 6 Skyview Lane Phone #: Michael Marino Putnam Valley, N.Y. 10579 9361860 - Use of Well: x x Residential _Public Supply Air /cond /heat pump _Irrigation 1- Primary B Business Farm Testimonitoring —Other(specify) 2- Secondary I Industrial Institutional Standby Amount of Use Y Yield Sought 5 gpm # People Served_ Est. of Daily usage inn gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling x x New Supply (new dwelling) Deepen Existing Well Detailed Reason N Nekz D for Drilling Well Type x x Drilled Driven Gravel Other Is well site subject to flooding? ....................................................... ............................... Yes — No x Is well located in a realty subdivision? ........................................... ............................... Yes x No Name of subdivision Michael Marino Lot No. 1 Water Well Contractor: Norman Anderson Address:Barger St. , Putnam Valley, Is Public Water Supply available on site? ....................................... ............................... Yes No x 1057 Name of Public Water Supply: N/A Town/Village Distance to property from nearest water main: N/A Proposed well location & sources of contamination to be provided on separatesheet/plan. es 6/27/2407.. l. t �a�t gQ A na ure: 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. ........ .............. . 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 Commissioner of Health. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. ., Date of Issue Permit Issuing Offi al:"" Date of Expiration o Title: SS�� Permit is Non White copy - HD file-,Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Rev. 3/06 PUTNAM COUNTY DEPARTMENT OF HEAL , :.-,-- - DIVISION OF ENVIRONMENTAL HEALTH SER IC _�`, i ... - e:�;. o .... ._.. ,..._............, pc.. �- .:..K _�.'.j',..i . :. ....... .+Mta.r -.s'„K :wi+l mfr �- � �• ..: � ,. :.'ry .: �: :.. _., .... ... w.. ,..e � s+ . w.'.r �.. .:.. .... CONSTRUCTIO/N� PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # — �11_( J� Located at wood Street Town or Village Putnam Valley Subdivision name Marino Date Subdivision Approved Subd. Lot # 1 Tax Map74.19 Block 2 Lot r.W 12 May 7, 2007 Renewal No Revision No Owner /Applicant Name Michael M a r i n o Mailing Address Date of Previous Approval N/A 6 Skyview Lane, Putnam Valley, New York Amount of Fee Enclosed $500. 00 Zip 10579 Building Type Residential Lot Area 1.3 No. of Bedrooms 4 Design Flow GPD 8 0 0 Acres Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 12 5 0 gallon septic tank and 800 1 f lT 1�06�> CfecF=/p(3 F/ of leaching trenches, � � Other Requirements: None yy Michael Marino NewkYorkw10579 Putnam Valley, To be constructed by Address Water Supply Public Supply From Address _ - :or.. _ .. - x.. :1 iv tE SupY�1'y D ;ll;.d by d�.o r ma n. Aar ca o r� -:..._ _ ..... ,A idress B.a g e N .:S *:rte �.t. : Putnam Valley, NY 10579 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 s sy tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. x Date 6/26/2007 scoot/ Road North, (Mat opac, N.Y. 10541 License # 11056 APPR &U6 FORtONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires anew rmit. Approved f discharge of domestic sanitary sewage only. .P� Title: Date: copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 TWO MUSCOOT ROAD NORTH MAHOPAC, NY 10541 P 845 - 628 -6613 F Rd51,7R -7Rl17 a -mail• inal'n raanha rn/nl�rrh_vicinnc rnm I 9, ' -/v' c L(, . , r May,14, 2008 Joseph S. Paravati, Jr. Assistant Public Health Engineer 1 Geneva Road Brewster, IVY 10509 ` Re: Proposed SSTS — Marino Wood Street :. Putnam Valley, TM # 94.19 -2 -12.1 .'. Dear Mr. Paravati, . The following is in response to your letter dated May 13, 2008: r The wells have been modified on the plan. The silt fence has been revised.. _ aNdte'# 3 hasbeen revised'. The profile has been revised. y l: �✓.�,': The dual alternating pump will be used. 6. The dimensions of the pump chamber have been provided. T. All required elevations are required. The pump tank has been shown. 9. The calculations have been revised to achieve over 800 gallons. The pump calculation table has been modified. The equivalent length has been adjusted. The pump curve has been clarified. 1 A north arrow has been present on all the drawings of the site. The / north arrow is located next to each drawing's title block. Two sets of floor plans have been included. :.; If you have a questions, please do not hesitate to contact me. "uly Ve your � n , AIA SHERLITA AMLER, MD, MS, FAAP ,,,.. �.�p, jsjioner. of Health;, - ,_ , ,- LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joel Greenberg, R.A. 2 Muscoot No. RFD 2 Mahopac, NY 10541 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County_:Execuzive;. -` ROBERT MORRIS, PE Director of Environmental Health May 13, 2008 Re: Proposed SSTS — Marino Wood Street (T) Putnam Valley, TM # 74.19 -2 -12.1 Dear Mr. Greenberg: This office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comments for your review and consideration. 1. Two wells are shown on the plan. 2. The silt fence is unclear on the plan. 3. Note # 3 of the fill notes should be 0.5' of fill, not 3'. 4. The dosing chamber in the profile is not labeled and the outlet is in the wrong location. 5. Dual alternating ;pumps are not required but can remain if so desired. 6. The dimensions for the section view of the pump chamber need to be provided. 7. All required elevations (dose on/off, alarm, storage, etc.) should be provided in the pump chamber section. 8. The pump chamber is to be shown in the profile. 9. There doesn't appear to be enough room for one day's storage above the high level alarm (800 gallons). The storage amount noted on the plans is incorrect (443 gallons). 10. There needs to be a gate valve, check valve and union for the pump chamber. These should be added to the fittings specified in the pump calculations table. 11. The total equivalent length of pipe appears to be incorrect. 12. The pump curve is hard to read and needs to be clarified. 13. There still appears to be no north arrow provided. 14. Please provide a minimum of two new sets of floor plans with the revised first floor. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at est. 2157 if any questions arise. Very truly yours, Joseph S. Paravati, Jr. Assistant Public Health Engineer JSP/kly Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 TWO MUSCOOT ROAD NORTH MAHOPAC, NY 10541 P 845-628-6613 F 845-628-2807 TRANSMITTAL LETTER No-. Of Copies TO: Joseph S. Paravati, Jr. DATE: May 8, 2008 Description FROM: Joseph Fassacesia PROJECT: Marino 4 k SUBJECT: SSTS Construction Permit err WE TRANSMIT: ❑ Attached ❑ Under separate cover VIA: ❑ Mail ❑ E-mail ❑ Courier ❑ Other FOR: ❑ Approval/Action ❑ Information ❑ Use as requested ell", ❑ Comment ❑ Distribution ❑ Other THE FOLLOWING: ❑ Drawings ❑ Specifications ❑ Submittals ❑ Other No-. Of Copies Date -prawing Description -Mdj_7--20U­8"'-7­ FAf'FI*&R'P1i'n REMARKS: Enclosed please find attic floor plan with revisions as discussed. BY: JIF/sem COPIES TO: n/a - .. � ..IMC- .�... .rc•! "... a..c�h::. ea i3'�.�."w'W¢�... ... .t..i':ti ,.. _ .i" .... A z " .e. e.rK. " . �' ._�+.P` .. `T �.•- Y .. . -- �.O Ga: � .. . .�.a•. _ • :. M'.. •.Y' - TWO MUSCOOT ROAD NORTH MAHOPAC, NY 10541 P 845 - 628 -6613 F 845 - 628 -2807 May 6, 2008 Joseph S. Paravati, Jr. Assistant Public Health Engineer 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS — Marino Wood Street Putnam Valley, TM # 74.19 -2 -12.1 Dear Mr. Paravati, Please note the following with regard to your letter of April 29, 2008. -1 All neighboring wells and septic systems are now shown. 2. The pipe from the dosing siphon to the distribution box is SDR -35. 1 �K The bends in the SDR -35 pipe do not exceed 22 degrees. 4. The well is dimensioned to two property lines. T he 1iJatE:F SefliCE CGnr 1cCilCin is- shown'- I The silt fence and detail of same is shown. Fill contours are shown in the plan view and profile. v r: n �W-3 8. Fill notes; are shown. __ -- - "-`` $ s ... .� „FN�I T_he�d crag- chamber- is`shown in profile. zt, 'T a pu hmp chamber details and calculations are shown. l ✓ The dosing siphon is now detailed. The absorption trenches are laid level. . J��✓ Survey information and datum reference are indicated. 14' orth arrow is shown. he roof leader drain and discharge location are shown. f The USDA soil types are indicated. As per the attached cross section the garage is at the basement level. Therefore, the unfinished attic space is at the first floor level. .''.;', ^ If you have y questio or oncerns please do not hesitate to contact me. e truly u , ODD \ �Y)J / 7 I / � � .�° 5'.'L`'•• . r', Ct ",j 5 "c . SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health April 29, 2008 Joel Greenberg, R.A. 2 Muscoot No. RFD 2 Mahopac, NY 10541 Dear Mr. Greenberg: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI .County. &ccutive- w- ROBERT MORRIS, PE Director of Environmental Health Re: Proposed SSTS - Marino Wood Street (T) Putnam Valley, TM# 74.19 -2 -12.1 This office has received and reviewed the most recent set of plans for the above = mentioned project. We would like to offer the following comments for your review and consideration. 1. All existing wells and SSTS's within 200' of the proposed SSTS and well are to be shown. 2. The pipe from the dosing siphon to the distribution box is to be SDR -35. 3. If the bends in the SDR -35 pipe shown are 45 °, cleanouts are to be provided. As a reminder, 22° bends do not require cleanouts. 4. The well needs to be dimensioned from two property lines. 5. The water service connection is to be shown. 6. Silt fence is to be provided. Please also provide a detail. 7. Based on the approved subdivision, a minimum of 6" of fill is required.. Please provide the fill contours in the plan view and show the fill in the profile. 8. Please provide the fill notes pursuant to Bulletin ST -19, Appendix C. 9. The dosing chamber is to be shown in the profile. 10. Since.a pump is required for the expansion area, a separate pump chamber is to be provided and installed for future use. Please provide a detail and all calculations for the future pump design. 11. The dosing siphon detail needs to be completed. Please show the actual dosing device bt ing used and provide the dose amount. 12. Please note the trenches are to be laid level in the absorption trench detail. Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 13. Please provide all survey information and a datum reference. A - :-Please,providea.nortbar-Tow, 15. The roof leader drain and discharge location is to be provided. 16. The USDA Soil types are to be provided. 17. Why is there unfinished attic space shown on the first floor? This office will continue, its review upon consideration of the above-mentioned comments. Please feel free to contact me at est. 2157 if any questions arise. JSP/kly Very truly yours, Joseph S.(P2a9ravati, Jr. Assistant Public Health Engineer MEMORY TRANSMISSION REPORT TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 504 DATE APR -29 03:23PM TO 96282807 DOCUMENT PAGES 002 START TIME APR -29 03:23PM END TIME APR -29 03:24PM SENT PAGES 002 STATUS OK FILE NUMBER 504 * ** SUCCESSFUL TX NOT ICE ** SHERLI'['A AMLGW- M3?. MS. FAAZP ^ ^4 ROBERT J. BONII)[ Corn»afrrioner ofHeolrh # '+[' COT—*, Fxa —fl— LORE"I"['A MOI..INARI. RN. MSN f`e` ROBERT MORR[S.'pE Associate CO— isslonar of Haolrh Olrecror of Bnvirortmersrol Hev /rh C)EPoekM—r E=—M—F OF HEALTH 1 Geneva Road. arewstar. New York 1 0504 April 29, 2008 Trjel..!_4!z•e �.. ;.:.... 2 Muscoot No_ RFD 2 - Mahopac, NY 10541 Rc= Proposed SSTS - Marino . Wood Street m putnaan Valley. TM# 74.19 -2 -12.1 Dear Mr_ Greenberg: This office has received and reviewed the most recent set of plans for the above - mentioned project_ We would like to offer the following comments for your review and consideration. 1. All existing wells and SSTS's within 200' of the proposed SSTS and well are to be shown_ 2. The pipe from the dosing siphon to the distribution box is to be SDR -35. 3. If the bends in the SDP-35 pipe shown are 45e, cicanouts are to be provided. As a reminder, 22e bends da not require cleanouts_ 4. "rhe well needs to be dimensioned from two to property lines_ 5_ The water service connection is to be shown. 6. Silt fence is to be provided_ please also provide a detail. 7. I3ased on the approved subdivisiorj, a rni*+ir um of 6" of fill is require - , Please provide the fill contours in the plan view and show the fill in the profile. 8. please provide the fill notes pursuant to Bulletin ST -19, Appendix C. 9. The dosing chamber is to be shown in the profile_ 10_ Since a pump is required for the expansion area. a separate pump chamber is to be provided and installed for future use_ Please provide a detail and all calculations for the future pump design- 1 1. The dosing siphon detail needs to be completed. Please show the actual dosing device bt_ing used and provide the dose amount. 12. Please note the trenches are to be laid level in the absorption trench detail_ Envlron menesl Heala6 (845) 278 -6120 Fn,c (845) 278 -7921 Water Supply seetian (845) 225 -5186 Pax(845)2-25-5418 Nursing Services (845) 278 -65S8 Fax (845) 278 -6026 WIC (845) 278 -6678 r4-lag Home Care Fax (845) 278 -6085 6.ar)y tnta...oneion /Praseolooi (845) 278 -6014 Fax (845) 278 -6648 �v -t3_ PUTNA.k COUNTY DEPARTMENT OF HEALTH �F E1`IViRONMENTAT�.�'ALTH.: - -.. ; .�..: • ,..- .. _, �- r. _,- _. ,.: • . . I1�iDIYIDUAL WATER SUPPLY &SUBSURFACE SEFVAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NANM OF OWIIER: IjA TLIAIG STREET LOCATION- 400f, REVIEWED.BY: RNi, 51 S]:�DATE: 3&/0q TAX MAN: (CONFIRMED) Y N DOCUMENTS Z`. (REQUIRED DETAILS ON PLANS CONT'D) C .. PERMIT APPLICATION U$a WER FT.�4'' 0!..; Ti pE_PIPE. CAST IRON ' ) PERM OR FWS LETTER (_, 0 $END 'BE1VD5 4:5,' W /CZEANOUT _)WELL IT ,PC =97 .4. (i LLETTER OF AUTHORIZATION UCORPORATE RESOLUTION ,SHORT E 4F PLANS -THREE SETS USE PLANS - TWO SETS I _)UVARIANCE REQUEST SUBDIVISION LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED Zyc:�PERC RATE �L')LL-�L REQUIRED, 19. 5' DEPT73 ' CURTAIN DRAIN REQUIRED GENERAL LOCATED .IN NYC WATERSHED LANS SUBMITTED TO DEP --)(-w'ELEGATED TO PCHD P APPROVAL; IF REQ'D _) DE )DEEP TEST HOLES OBSERVED ErERCS TO BE WITNESSED EX4P.PROVA-L SSDS ADJ, LOTS �L�WETLNDS (TOWNIDEC PERMP.0 REQ'D ?) --)L_pATA ON DDS- PLANS *&- PER_SAIvLE_- )�1969 NEIGHBOR NOMITTIFICATI.ON TTF,R, BIIZBA �k00 YR; FLOOD ELEVATION WTI' 200'' ___ L( 0SQII, TESTING LOTS?10 YEARS OLD .VTTY FLOW ' FILL SYSTEMS 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 ,QGRADE (!)(FILL SPECS / FILL NOTES 1 -5 L--)L-)FILL PROFILE & DIMENSIONS L-)L--)FILL IN XXRANSION -AREA -- FILL GREATER THAN Z FEET LL CLAY BARRIER A� UiU)FML•CERTIFICA TE / - LLDEPTH S ON PLAN FOR RO.B., tJNCLkSSIFIED & M2ERVIOiJS SEPARATION DISTANCE FROM'TOE OF SLOPE TRENCH' (� LF TRENCH PROVIDED 13 QO _60FT MAX. PARALLEL .TO CONTOURS ( • 1100% EXPANSION PROVIDED BO ( 0 ,D9TAmEUDUST FREE CRUSE ED'STONE OR WASHED GRAVEL ( )GEOTEXTME COVER ; SEPARATION DISTANCES ON PLAN : FR.OM'SSTS (,, )10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FII.,L . 20' TO FOUNDATION WALLS . {100' TO WELL, 200' INDLOD,150' T0, PITS. . - r,- 100' TO STP.F:Ai4'd`lAT%RCOURSE, LABm -(inc. eivai1j, _ ),L_)501 TO CATCH BASIN, 35'. STORMDRAW, PIPED WATER 10' TO WATER LINE (pits ( Y l50'• INTERMITTENT DRAINAGE COUME, (✓X )200'i500' RESERVOIR, ETC. 150' GALLEY SYSTEMS 10' MW TO LEDGE OUTCROP SEPTIC TANK UlO�'FROM FOUNIDATION; 50' TO WELL ONSTRtCTION NOTES 1;S( 7 ESIGN DATA: PERC & •DEEP RESULTS CONTOURS EXISTING & PRO ?OSF,D RIV'EWAY &- SLUES, TM#, PEIRA; NAME, ADDRESS, PHONE# WDATE• OF DRAWINGIREVISION ✓li )LO. WIGF TTTRCOURSE3, PONDS LAKES,wETLANDS WITSIN 200' OF P.L. ✓��PROPOSED FINISH FLOOR AND ELEVATION—" y - SION. C QL k QFZ ROL•1SE5S!E �- - SST 5= ,1<;ROSION CON'I ROL 1!tOT]{ - ~` ANTS: 'SLOPE IN SSTS AREA (520 %) DED TO 15 %. IFMOUIitED (UUDETAIL FORFORCE'.MAIN, (PIPE TYPE, ETC.) LLUPrr AND D-BOX SHOWN & DETAILED ULj1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN ULST�PIPES, T BOTH SIDE (�LJ15' MIN to CDS= %, 25' -3 %, 35' -1 %, 100 % -t<% (x(_)20' DISCHARGE/100' with 182 cons day discharge to NON - PERFORATED PIPE SHERLITA AMLER, MD, MS, FAAP .Commissioner of Health.. LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joel Greenberg, R.A. 2 Muscoot No. RFD 2 Mahopac, NY 10541 DEPARTMENT OF HEALTH Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County. Executive•_ , ROBERT MORRIS, PE Director of Environmental Health March 18, 2008 RE: Proposed Subdivision — Marino (T) Putnam Valley, TM # 74.19 -2 -12.1, Lot # 1 Reservoir Basin - Amawalk Dear Mr. Greenberg: The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on March 6, 2008 is complete. The Department will notify you by May 1, 2008 of its determination. I] The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ❑ Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the .,project, th.e office with which you filed the application originally, and. a statement that: a decision is sought -iii accordance'witfi "sect-ion- 1�8=23 (d) "(65 6Ythe NYC -llepf. of Eiivironment`al" Protection' Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2157. JSP:kly ry truly yours. A Joseph S. Paravati, Jr. Assistant Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Public Health - D_ irector LORETTA . MOLINARI. R.N., M.S.N. - Associate Public" Healt`{i' -Direclor - Director of Patient Services DEPARTMENT. OF HEALTH 1 Geneva Road r 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 -6082 Fax (914) 278 - 6648 TO: DEPARTMENT OF ENGINEERING AND DESIGN REVIEW ■ • IPTa"M DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM f TOWN: C SE--P K :PV � DATE SUB'I9 APPROVs4L,: -- NOTICE OF COMPLETE APPLICATION DATE: 1-55c 03/13/2008 15:05 8456282807 . JOEL GREENBERG PAGE 01 TWO MUSCOOT ROAD NORTH MAki'PPAC, NY 10541 P 845 - 6286813 F 845.62 8-2807 e -mail: joel,greenberg@arch- visions.com DATE: -3- "2- 0 O e TO: ATTENTION: ` FAX NUMBER: .7 -? q FROM: ~ COMMENTS: TOTAL NUMBER OF SHEETS INCLUDING THIS COVER SHEET IF YOU DON'T DECEIVE ALL PAGES OF TRANSMISSION, PLEASE CALL US AS SOON AS POSSIBLE. SHERLITA AMLER, MD, MS, FA.AP Commissioner of Health LORETTA-,':OL NAR'e, RN , ii-ISN :' - Associate Commissioner of Health March 12, 2008 Joel Greenberg, R.A. 2 Muscoot No. RFD 2 Mahopac, NY 10541 Dear Mr. Greenberg: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 RE: Application to Construct a Subsurface Sewage Treatment System at Wood Street (T) Putnam Valley, TM # 74.19 -2 -12.1 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on March 6, 2008 is incomplete. Please be advised that the following information is required before the Department may commence its review. 0 Design data forms have not been submitted with your application. The review of your application will commence once the Department receives the ' requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application_ Please be- advised that failure to submit information touheDepart-ment of 'to'fbllcw_ procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2261. GDR:kly Sincerely, Gene D. Reed Senior Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION -OF ENVIRONMENTAL.HEALTH, SERVICES RE: Property of Located at LETTER OF AUTHORIZATION MICHAEL MARINO WOOD STREET TNPUTNAM VALLEY Tax Map # 74.19 Subdivision of Subdivision Lot # Gentlemen: MICHAEL MARINO 1 Filed Map # Block 2 Lot 00P 12,1 Date Filed /A A X Z -,tQ07 This letter is to authorize JOEL GREENBERG a duly licensed Professional Engineer or Registered Architect x to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the p o r' rricle 147 of the. Education. Law, the.Public. Heal_th_. 14.5 and/or. Law, and the Putnq.* C 'a` ' Code. _ .... _ ._ ... _ . ._.......: �..:.. JVJ MWO !7r ,MAHOPAC State NY Zip 10541 Telephone: 845 628 -6613 Very truly yours, Signed: 4A� (Owner of Property) Mailing Address: 6 SKYVIEW LANE PUTNAM VALLEY State NEW YORK Zip 10579 Telephone: 914 760 -3618 Form LA -97 03/13/2008 15:05 8456282807 JOEL GREENBERG PAGE 02 .. o• i, ....., .... a ..,.,.....; - - • : <..y vo +rt ^'.r •:; .�ua: �- . , ,., o 'w.. - ... , ,'.q :,�. :. .< srn .o a,° PUTNAM COUTNY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DAT /k SHEET- SUBSURFACE SEWAGE TREATMENT SYSTEM LOT #1 Owner:: MIKE MARINO Address: SKYVIEW LANE Located at (Street) SKYVIEW AND WOOD Tax Map 74.19 Block 2 Lot 12 (indicate nearest �:ross street) Municipality PUTNAM VALLEY Watershed: AMAWALK Sail Percolation Test Data Date of Pre- Soaking: 12/12/02 Date of Percolation Test: 12/13/02 Hole No, Run No. Time a Start Stop Elapse Time (Min,) Depth to water from Ground surface(inches) Start Stop I Water level drop in inches Percolation rate Min / Inch 1 1 10:53 1'1:23 30 23 24.75 1,75 011.75 =17 2 11:28 11:68 30 23 24 1 3011=30 3 11:59 12:29 30 23 24 1 3011=30 4 5 2 1 10:46 11:16 30 22 22.75 0,75 01,75 =40 2 1111 12,21 60 22 23.5 1.5 6011,5 =40 3 ., 6:28......1.27. 80 '. 22 .._... 23.5 .., .1,5. -. . -.,.. 0/1,5 =40 ... . .. , 4 5 1 2 3 4 5 Notes: 1, Tests to be repeated at same depth until approximately equal percolation raises are obtaines at each pecolation test hole, (i.e. <_ min for 1.30 min / inch, < 2 ruin for 31.60 min / inch). All data to be submitted for review. 2. Depth measurements to be made from top of hole. 03/13/2008 15:05 8456282807 JOEL GREENBERG PAGE 03 Depth G.L. 2.0' 2.5' 3.01 3.5; 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 9.0' 10.0' .r ......... ... Test Pit Data Description of Soils Encountered in Test Holes Indicate level at which groundwater is encountered: NON15 Indicate level at which mottling is observed: NONE Indicate level at which water level rises after being encountered: N/A Deep holes observation made by, JOE PARAVATI Date: _12/1312002 Design Professional Name: Address: TWO MUSCOOT Signature: 03/13/2008 15:05 8456282807 JOEL GREENBERG PAGE 04 PUTNAM C:OUTNY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET- SUBSURFACE SEWAGE TREATMENT SYSTEM LOT #1 Owner:: MIKE MARINO Address: SKYVIEW LANE Located at (Street) SKYVIEW AND W300 Tax Map 74.19 Block 2 Lot 12 . (indicate nearest; Cross street) Municipality PUTNAM VALLEY Watershed; AMAWALK Date of Pre - Soaking: 25 JUN 2007 Soil Percolation Test Data Date of percolation Test: 26 JUN 2007 Hole No. Run No. Time Start Stup Elapse Time (Min.) Depth to water from Ground surface(inches) Start Stop Water level drop in inches Percolation rate Min / Inch 1 1 9:16 9:26 12 241/2 27112 3 12/3 =4 2 9:29 9:47 18 241/2 271/2 3 1813 =6 3 9,48 10 :07 19 241/2 27112 3 19/3 =6.33 4 5 1 z 3 4 5 1 2 3 4 5 Notes: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtaines at each pecolation test hole, (I.e.= min for 1.30 min / inch, 2 min for 31.60 min 1 inch). All data to be submitted for review. 2. Depth measurements to be made from top of hole. 03/13/2008 15:05 8456282807 . JOEL GREENBERG PAGE 05 .. _ • .::• •�. Y._ -:.. �. ..• � .. .r -. �••9 <e...••_•,s� vYF ... ♦f•. 'L):'R�.v:- ^_:.�:�.v. w - .• .. <._ •. ...• • J.w _. �. w • i �.... Y•O .� • �.•� -•••F �. ♦f... �) w - Test Pit data Description of Soils Encountered in Test Holes Depth G.L. 0.5' 1.0' 1.5' 2:0' 15' 3.0' 3.5; 4.0' 4.5' 5.01 5.5' 6.0' 6.5' 7.0' 7.5' 9.0' 9.5' 9.0' 9.5' _10.0' Indicate level at which groundwater is encountered: NONE Indicate level at which mottling is observed: NON Indicate level at which water level rises after being encountered: NIA Deep holes observation made by: JOE PARAVATI Date: 26 JUN 2007 Design Professional Name: JOEL GREENBERG AIA NC Address: TWO MUSCOOT ROAD NORTH Signature: Design Prcfessional's �R�Qq �� °•'rasa �- NEWN PUTNAM* COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - APPLICATION FOR. A_PPROYAL_.OF PLANS. A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Michael Marino 6 Skyviewe Lane Putnam Valley, New York 10579 2. Name ofproject: Marano 3. Location TN: Putnam Valley 4. Design Professional: Joel Greenberg 5. Address: 2 Muscoot Road North 6. Drainage Basin: 7: Tyne of Project: X Private/Residential Apartments Office Building Mahopac, New York 10541 Food Service Commercial Institutional Mobile Home Park Realty Subdiyision. Other (specify) 8. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (check one) ....................... ............................... Type I Type II 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... 10. Has DEIS been completed and found acceptable by Lead Agency? .............. 11. Name of Lead Agency Exempt Unlisted -V No N/A N/A 12. Is this project in an area. under the control of local planning, zoning, or other official�s.ordirances`� - .. Y e s 13. If so, have plans been submitted to such authorities? Yes f'nal 14. Has Vadw lwy approval been granted by such authorities? Y e spate granted: .5/7/07 15. Type of Sewage Treatment System Discharge ................. surface water x groundwater 16. If surface water discharge, what is the stream class designation? .................... N/A 17. Waters index number (surface) N/A 18. Is project located near a public water supply system? ....... ............................... No 19. If yes, name of water supply N/A Distance to water supply 20. Is project site near a public sewage collection or treatment system? ............:... No 21. Name of sewage systern N/A Distance to sewage system 22. Date test holes observed T I R / H & 23. Name of Health Inspector Joe P a r a v a t i 24. Project design flow (gallons per day) ............................................................... :. 800 GPD 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... No 26. Has SPDES Application been submitted to local DEC office? ......................... N/A Form PC -97 0 ,nn 617.20 Appendix C Stated hvironh, entai :Quality_ Review _..yam - •.. . - ". -: ._ •.•. -. SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by Annlicant or Proiect Sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME Michael Marino Marino 3. PROJECT LOCATION: Municipality Putnam Valley County Putnam 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Wood Street & Skyview Lane 5. PROPOSED ACTION IS: New [:] Expansion Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: New Home New SSDS & Well 7. AMOUNT OF LAND AFFECTED: Initially 1.3 acres Ultimately 1.3 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? n Yes E] No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? n Residential F-1 Industrial Commercial Agriculture Park/Forest/Open Space Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? 21 Yes ❑ No If Yes, list agency(s) name and permit/approvals: Putnam Valley Building Department 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? 0 Yes ❑ No If Yes, list agency(s) name and permit/approvals: Subdivision Approval on May 7, 2007 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes Q No TIFY THAT THE INFORMATION PROVIDED BOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicanVspons name: Michael Marino Date: 6/26/2007 Signature: tl Project Architect If tife ac on is in'the Coastal Area, and y u are a state agency, complete the astal Assessment Form before proceeding with this assessment OVER 1 PART II - IMPACT ASSESSMENT (To be completed by Lead Aciencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAR ,:Yes- e��O:No;- _ � _... -... ., ..- ,- .,.�:...._�a:- . _ -•-� -. w �_.. - �:r.:: x. .-... ..��.,.�.,�v.•:�.- :._... .t- B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. E] Yes ❑ No 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 pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: . 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: 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: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? E] Yes ❑ No If Yes, explain briefly: E. IS-THERE,-OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO PQTENTIAL- .ADVERSE.ENVIRONMFI t4TAI„ij PACT$2 ..`_ Yes ❑ No 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. If question D of Part II was checked yes, the determination of significant; must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. 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 6/26/2007 Name of Agency ate Print or Type Name of Responsible Officer in Lead Agency Title of esponsible Officer Signature of Responsi e O 9cer in Lead Agency Signature of reparer (If different from responsible officer) INLET INLET ELV. 193-2U' E 110 X IVA r- Tr- -Try---- �� - - - - -� III III CLEANOUT COVER I I I I Ill III [ I11 III' f I lil III 1 I I I III III 1 I ! i III 111 ! L_J-L_.- J- iL-- -Jli -- - -j 160x12" NVfM(;RII 1WRECTION COVER RESERI�E STOkAAGE 1853 GAL 32.04 I fSit 392.47 GAL SECTION A 4' -iQp MANHOLE CM AT GRGE / RISER TO GRADE FILL OVER TMK OUTLET ELV, �. 193.89` DISCHARGE BASIN e� ^ (ALARM ENV. 32.50" DRIVER Chi/ Ol 7F , , REDUNDANT ON/ OFF IMPELLER INLET 3" CMU BLOCK SAND OR PEA GRAVEL PUMP CHAMBER SPECIFICATIONS & CAPACITIES, LIQUID CAPACITY A LENGTH , 81 WIDTH C D E INVERT HEIGHT INLET 1250 10' -4" 4' -10" 1 5',8" 1 5' -7" 5" PUMP CHAMBER NOT TO SCALE F ;TRW5= 5My4AR[RO M\Mvjlnv L*T l.Uw9i;j;;fZM Z --5a:N PM, NjM= m)hq wW Lam2ct2550 RIG 7p . '*)tirl nN -A9N -4';?In 1- fnr 1 AR?R79GbR /G:F:T 9,RR7/GT. /9A TWO MUSCOOT ROAD NORTH MAHOPAC, NY 10541 P: 845.628,6613 F: $45.628.2807 e-mail: administrabo6(,c-,Darch-visions.com FAX TRANSMITTAL DATE.- 151 -1,f of No. PAGES TRANSMITTED (including cover sheet): TO: FAX No,: a -7,K- 7�;-) FROM: ORIGINALS TO FOLLOW. 1:1 YES ❑ NO REMARKS: 10 39Vcl ONIISN3369 130f Lo8zeZ9902 iq:2T ROAZ/qT/qn ?ox :)s 49. 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