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83.16 -1 -56
BOX 30
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ILL F - '
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
. «:.�......,_ -.� 4�. __ . _- ._ . .. , _ _ �.:._.. _ . :�, �,•= ., . -. _ . .... -,�. _ _ - �..� Well �Peimit�#�`X ' 1��`r� =�4 � 4 .� ,.,
WELL COMPLETION REPORT
Well Location
Street Address:L /
Town/Village:
VA
Tax Map #
Map3•' G Block Lot(s)
Well Owner:
Name: Address:
V,( Sat % %C.r -i 3) Cv -ofoh 10 a �.d D rtrot1h N
Use of Well:
1- Primary
2- Secondary
Vkesidential _Public Supply Air cond /heat pump _Irrigation
Business Farm Test/monitoring —Other(specify)
Industrial Institutional Standby
Drilling Equipment
IoKotary _Cable percussion Compressed air percussion Other(specify)
Well Type
_Screened `fpen end casing _ Open hole in bedrock _Other
Casing Details
Total Length aj,�Cft.
Length below grade2o ft.
Diameter 6 in.
Weight per foot Ib/ft
Materials: y6teel Plastic Other
Joints: Welded ✓ Threaded Other
Seal: ✓Cement grout Bentonite Other
Drive shoe: Yes ✓ No
Liner: _Yes -,No
Screen Details
Diameter (in)
Slot Size
Length (ft)
Dept to Screen ft
Developed?
First
I
_Yes _No
Hours
Second
Well Yield Test
_Balled _Pumped ✓ompressed Air
Hours 7 H
Yield -7 gpm
Depth Date
Measure from land surface - static (specify ft)
,30dr"
Vuring y1elo test (ft)
13—ep—tF77—completed well in ft.
46-6
Well Log
If more detailed
.infRCCn5$a-5 a ._._. `. _.
descriptions or
sieve analyses
are available,
please attach.
Depth From Surface
Water Bearing
Well Diameter
in
Formation Description
ft.
ft.
t �Dd SW6gf „-�
....
W rt,
�--
If yield was tested
at different depths
during drilling
list:
Feet
Gallons Per Minute
Pump /Storage
Tank Information
Pump Type S m wa -*,, Capacity
Depth 4toa Model sr- r9 - -LZ,-
Voltage 4-46 HP
Tank Typew r c3 V � Volume f?(o
Date Well Co plete
'
1lVel( Driller
Pum
PGrCertiflcate,# r� 04 /a NY S tate # V4, dG�� Y
'*s-2. 2 Yi } L d .. 4 j`- ":-'• �' d1r . 'vx 'F r i g
"b".,66 } :. S\ ., M i` l-0• . S : ... f .+•' , C.
rtificate # > , .04 ]l ,N`frSfate
....._ r.... .
Dade §f Re ort X.
Z\ 4 . 41N? S
i,y �E: �'Y 3 '41 �� r
,
Well Dr(IIer Name�4Address
j' .. \ i { T
Y..
yy 4 Y
-xl r l f ?• l �}
is
p Installer Name &Address ¢a
Pu 7
: r'. i t. 'r4+ N �x,��r� 4 ,} ;• -.. 14x� �. ��r; l` t�i5.: r,,:` t ;�.� a� i �-
p nsfaller(" nature)
.:.z2t.� irSh
R 'k •ir�r' tit '^ ,�
r^ ���':. jfbn�;�ir.. f�,A�, d* � $ � r'� tY ,
NOTE: Exact Location of well with distances to af least two.permanent landmarks to be provided 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
NR
PUTNAM COUNTY' DEPARTMENT OF HEALTH
.
10 -OF i�Y:ROIMEIT� HEAL'�'HER
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHHD CONSTRUCTION PERMIT # N -1Z - 08
Located at 41 AARSH HI L4 - RoAP To or Village 'P1TiJAM VALLEY
Owner /Applicant Name V. S. CNA4S'[YZVCTi,7nl C°RP. Tax Map 83 +16 Block 2 Lot 56
Formerly Subdivision Name FMEMLP R11>6jF_
Subd. Lot # 5
Mailing Address 37 CROTON "PAM RoAD4 OSSiNIN(q I t4Fw )&RK Zip 10562
Date Construction Permit Issued by PCHD 5 -19 -aooia
Separate Sewerage System built by VS- CONSTRUC -TION Co RP. Address OSStN114§ ,w y I °562-
Consisting of i p50o Gallon Septic Tank and 448 4. r. OF q uW 'PeaFo A--rED
?VC TIPS 1N 2q 6"VEL TRENCR
Other Requirements: NNE
Water Supply: Public Supply From Address
U2 1MR4F(t SiQEET
or: X Private Supply Drilled by tVoRMmN AAlDER6cN4 Address FuT1elw V�LG�yT; Ny 1o3'99
Biuidmg"Iype rnlHw+��j lSiI< -` Has erosion�ontrol beenYcomplet.,d. _:,- F,
Number of Bedrooms q
Has garbage grind n15 _ /�o
I certify that the system(s), as listed, serving the above
built plans (copies of which are attached), in accordanQ
plans and the standards, rules and regulations 4i, F i
Date: AwavST 12,201.0 Certified by
(Design Professional)
Address Z JoI4N W40H 81-vD. , PFSK51K1U_,IV\)
*ere cteci sei tially as shown on the as-
issue Co tion Permit and approved
nty EpWiAent of 194 alth.
62990 P.E. X R.A.
J,
,0&X—__ icense # 0(02980
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: , / 4" Date: g?/?D/to
ropy - HD File; Yellow copy - Building Inspector; Pink copy Owner; Orange copy - Design Professional
Form CC -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL_H_ E_ALTH SERVICES
.. .��a. -'yPw [ ..._ Si. ., r .`r- W. .. � � v. .r•aa c1... .. n. ._ • _ -r .. ..- - ems►. -Orr -� ..r �.. ..+. \r ♦� .. r nw♦ ... .. .` +
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
V-5, C01ySTKU( -T1 and Cow, $ 3, 1(0 T SG
Owner or Purchaser of Building Tax Map Block Lot
V.G. CON6'n&yc;Tio4 Coap. Pu-NAM V/ LkE
Building Constructed by To illage
(01 MARSH H 11,L ROAP
Location - Street
S(AAtz- F-lqmlum 1Z"1Dr4VCF
Building Type
F,MEmw R1946
Subdivision Name
6
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
. .qC .v-... x+• .rr 1.y.item....r ro.w p -ry . }s.rs:eW .....- s- .v...... .+y.aF.,..., .« .�. m-.0 r..'.�... .. i+l r ..r. .- .�--. .....W t s .r.n •....-r.a.. .. ..,....... ... -...» -.-..�
The undersigned further agrees to accept as conclusive the determinatio o the lic Health
Director of the PutnAR County Department of Health as to whether or of a lu the system
to operatp wfi cauy the willful or negligent act of the occupan f b ld utilizing the
Day Year Signature:
Title:
General C(%itractor (Owner) - Signature
V.S. Cori yXu (.0 CpR.Q. V. CONSTIZUGiIOtJ Core.
Corporation Name (if corporation) Corporation Name (if corporation)
Address:
�J CQDTonl -DAM RD., 1)
SjAhnlGa
Address: A,,A .
State
N Zip
10562-
State Zip
Form GS -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
:.DIVISION OF_EMVIRONMENTAL.HEALTH SERVICES
WELL COMPLETION REPORT
Well Location
Street Address:
Town/Village:
pt,���.`�
�. Mla
Tax Map #
Ma�O� 7
p "' Block Lot(s)
GPS �.'
Well Owner:
Name: Address:
VJ saK¢.,« 3) Crdfu&i OC41* kel ® cerst1,
Use of Well:
"esidential _Public Supply Air cond /heat pump `Irrigation
1- Primary
Business Farm Test/monitoring —Other(specify)
2- Secondary
Industrial Institutional Standby
Drilling Equipment
4rotary _Cable percussion Compressed air percussion Other(specify)
Well Type
_Screened --!--:Open end casing _ Open hole in bedrock _Other
Total Length aLi ft.
Materials: ✓S`teel Plastic Other
Joints: Welded w" Threaded Other
Casing Details
Length below gradelo ft.
Seal: dement grout Bentonite Other
Diameter L in.
Weight per foot lb /ft
Drive shoe: Yes ✓ No
Liner: _Yes _✓No
Diameter in
Slot Size
Length ft
Dept to Screen ft
Developed?
Screen Details
First
_Yes _No
Hours
Second
Well Yield Test
_Bailed _Pumped ✓Compressed Air
Hours
lYield 7 gpm
Depth Date
Measure from Ian surface-static specs ft
Joe
Dunng yle test ft)
ept o complete well in ft.
4 r
Well Log
Depth From Surface
Well Diameter
ft.
ft.
If more detailed
Water Bearing
in
Formation Description
descriptions or
sieve analyses
are available,
please attach.
If yield was tested
Feet
Gallons Per Minute
Pump /Storage
Tank Information
at different depths
Pump Type 6 m.aa: *, Capacity
during drilling
Depth 4tod Models —L�6
list:
Voltages X'hd HP
Tank Type- W)r c� ya Volume '%
Date Well Co plete
T
Well Drlller PC Certficate# 604 /a NYState #$`1 ���/
Y
Pumpinstaller3PC Certificate "# t'10, ,IVY State# li!6+'fyY/
QateKQf Re ort "
Well DrlIWNaWO ", Address g £n f � Well Drlller (st ature)= k
} ,ovw... '` �cr;svr. �.~u .���'.�� °at,r err%' � _.:� ..c..�a!f►,...��.t� � ... ,� � .���`
Pu p Installer Name � 8� >Adtlressyy ' s pinstaller( ature�$x ,
j:'9 W$i 3 S' S ✓k°' I : Y.: ryipYS .:i. k §: S'i
k'iS u#'I.:" dF t y t✓T4 .tt ' 'X 'xt't`i^ 3 zaMi .�erx ;S
NOTE: Exact Location of well with distances to af least two permanent landmarks to be provided 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
BRUCE R. FOLEY
Public Health Director
c ' LORETtA MOLWAM M4. M:9.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278.6085
Early Intervention /Preschool (845) 278.6014 Fax (845) 278 - 6648
E911 ADDRESS VERIFICATION FORM
OWNERS NAME: , Y e 6 e Colve'Te,
TAX MAP NUMBER: °
12
E911 ADDRESS: 61 HAK06H H I t L i20A'D —
TOWN:
Ju i t\) Am VA
AUTHORIZED TOWN OFFICIAL:
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 Certificatc of Construction
Compliance.
(E911 vertrm)
Sherlita Amler, MIS, MS, FAAP
Commissioner of Health
Director of Environmental Health
August 20, 2010
Robert J. Bondi
County Executive
Department ®f Health
1 Geneva Road, Brewster, NY 10509
Office (845) 808 -1390
Fax (845) 808 -1937
Timothy Cronin, PE
The Lindy Building, Ste 200
2 John Walsh Blvd.
Peekskill, NY 10566
Re: Field Inspection
ars -Hill Road--- ..
(T) Putnam Valley, TM # 83.16 -1 -56
Dear Mr. Cronin:
the above rvtrehad scpapation sewage trea i er f -ystiE
comments to be addressed at this time in reference to this Department's open work inspection.
If you have any further questions, please contact me at (845) 808 -1390, ext. 43261.
Sincerely,
..,� g. ��/
Gene D. Reed
Sr. Environmental Health Engineering Aide
GDR:kly
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Date: Vlv 410
Inspected by:,,j,']E
Stmt
cat 14 1411-,- Zan
Town T -U TA 1, 0 M Permit # 7>v - I-) -,ol
TM 4- < 3, 16 5-6 Subdivision Lot
1. Sewage System Area
a. STS area located as er approved plans ..........
p .................
b.. Fill section - date of placement
3:1 barrier Lgth. Width—. Avg.Dpth
c. Natural soil not stripped...... ............. ...............................
d. Stone, brush, etc., greater than 15' from STS area..........
e. 100' from water course/wetlands ..........................
II. Sewage Svstem
a' Septic tank size 1, 000 1, 25 0 ......... othe
b. 'S eptic*tank installed level ........ .......................
c. 10' minimum from foundation ...........................................
d. Distribution Box
1. All outlets at same elevation-watertested ...............
2-. Protected below frost .................................................
.3. .. Nfinimurn 2 ft. Original soil between box & trenches
e. Junction Box properly set .........................................
6. 1'renches
1. LTnjE required fl zli Length installed V-,1,6
2. Distance to watercourse measured o Ft..........
3. Installed according to plan ........................................
4. Slope of trench acceptable 1/16 - 1/32"/foot ..............
5. 10 ft. from property line - 20 ft.t. foundations..........
6,, Depth of trench <30 inches from suffice .................
7. -Room allowed for expansion, 100% ....................
8. Size of gravel 3/4 - Ilk" diameter clean ........
9 Depth of gravel in�trench 12" minima,,,,,,;;,,,,,
--'-Pipe en .cappeA
.-..0.....-*
g. Pump or Dose& Systems
1. Size of pump chamber .................................................
.2. Overflow tank .........................
* i -audio .................... ...............................
3 Alarm, visual/
4. PUMP easily accessible, manhole to grade........ :...... ...
5. First box, baffled .......................... ...............................
6. Cycle witnessed by H.P.estimated flow /cycle...........
ILL House/Buildiiiia
a. House locatedper approved plan& ......
b. Number of bedrooms ............................ V 8-:�/Z--
IV. Well -
Well located as per approved plans .................................
b, Distance from STS area measured le c:, ' - ft...........
c. Casing. 18" above grade ................................... I ............
d. Surface drainage around well acceptable ........................
V. Overall Workmanship
a. Boxes properly grouted ..................................................
b. All pipes partially backfilled ...............
c. All pipes flush with inside of box ..................................
d. 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 away from STS area ................
h. Surface water protection adequate ................ I ....................
i. Erosion control ovided ................................................
Rev. E/02
'10 -08 -11 09:38 FROM-
T-836 P0001/0001 F -772
I COUNTY DEPAR'T1YI
PIUTNAkV ENT OF HEAT i
DIVISION OF ENVIRONTYIENTA.L E ALTH SERVICES
ATTENTION d ADAM
RF.QT TEST FOR FINAL TNSPECTION
All information must be fully completed prior to any
inspections being made.
A GENE
For- Fill
Trenches i{
PCTD Construction Permit #�� �9 0 _ On-LL-64 Located: 6-1 H ft:ILsm H 1 LL. 90AQ (b (V) PU N 4r"
Owner /Applicant Name: I /p5. Q,yS- 'uGrtrdl�C���< T1VI 6 L Block Lot S
Formerly: Subdivision Name: Ai(cx WD 91a#
Subdivision Lot
Is system fill completed? NA Date: N 4
Is system complete? .S Date: I o /2o 1,0
Is system constructed as per plans? 140
Is well drilled? _ R-5 S Date: 10
Is well located as per plans? S
Are erosion control ineasures in place?
I certify that the system(s), as listed, at the above
and verified their completion in accordance
approved plans and the Standards, Rules and
Date: O 1d 0 Certified by:
and I have inspected
truction Permit and
aunty Department of
RA
Address: 2 `� ° �_ `", Lic, # JcI
Comments: �3 ��ry �1 L M oV5 D
ti
Form FIR-99
_ _ __ ,.,y %., mil. x jL ,..rL� r&.Exii mr n 1 Ur - ILA-L I 1i
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
{
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Qwzjer 0 Address'37 &0!�s D fioPD r 5
Located at (Street) MAtt,54 tHU- ?GOAD. Tax Map 04 . Block 1 Lot S
(indicate nearest cross street) Pt�R- ,'►dNf of . �� - 1 — 10.1 , (0.2� 10.3
Municipality a) PunuAm y Drainage Basin &-Sy_6 LL It U. -jo w 13t2�I�
��Date SOIL PERCOLATION TEST DATA
of Pre - soaking - o 7 - cs -o4 Date of Percolation Test o7 •Qq --o ¢
Hole No.
Rein No.
Time
Start-Stop
Elapse Time
(Min.)
Depth to Water
From Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Indies
Percolation
Rate
NIirAnch
C1
+%
ur'
2
3
?-At
7,
g
4
5
2
2
._2i.
4
Izs if s1
5
2
.
..
° F
4
5...
nuih1): 1. ".1 ests.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
V/ DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE .NO- _
.177 HOLE NO. A� HOLE N0.
G.L.. , ... is `�ryPT- tjL '� TDF 1501 `L-
0.5'
1.0' L'=
' Ub,tK 13POWN -QWA L. B�a5 L 4u r Saowu taA
1.5 .. � ... uGbK RoG.w . qND
2.0'
2.5'
3.0'
3.5' Z"
4.0 (pew ii
45
5.0'
5.5' tr
6.0' 90aA114 JANb4 Le, Ate►_
6.5' w . Zo rye
7.0'
7.5'
8.0' b N
9.0'
9.5 - - - -
10.0'
GO
Indicate level at which groundwater is encountered U
Indicate level at which mottling is observed are NC 011,k zvt-p
Indicate level'to which water level rises after being encountered N JA 6.2 • �S
Deep hole observations made by: C�NW a -,WGWf UM4 C-, J�C, % R[w Date � . .6 . o
t31 15TAV 6f4,yL Z -10C PAA4yari
Design Professional Name: M 1, 61z0014
, itEW
Address: N W Lvj D �.` `' L c �YO��r•
Signature:
EAJ
S 62980
Design Professional's Seal �� "�'OFESS��N��
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
-o:, o .: r'•a s -. .. 0+ � ... -..._ n r. '.,.? , � .. .. .. 'C w. - p; . ... . - a:ai r. R.; : my - . r• a. � _.. a e. . ... ... ae��.f �, 1 _- q .. .. o v P� ..... � -.
AFFIDAVIT - CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT
To: Public Health Director
In the matter of application for: Subsurface Sewage Treatment System Construction Permit (TM #:83./6 -1-5� )
I Val Santucci
represent that I am an officer or employee of the corporation and am authorized to act for:
Name of Corporation: y- S. Construction Corp.
Having offices at: 37 Croton Dam Road, Ossining, New York 10562
Whose Officer §A> e:
President - Name: Val Santucci
Address: 37 Croton Dam Road, Ossining, New York 10562
Vice President - Name:
Address:
Secretary -Name:
Treasurer - Name:
Address:
and that I am and will be individually responsible for any an If the corporation with respect
to the approval requested and all subsequent acts relating t �rjo
Signed:
Title:
Sworn to before me this ' � day of
No 1' No: 4938872
Qualified in Out0less County
Commission Expires December 16, 1 OP
Corporate Seal
Form CA -97
RE:
PUTNAM COUNTY DEPARTMENT OF HEALTH
F- ENTN'1RONMEN-'TAL`:HEALTHI=MR CE � . - ...:,.:.:
LETTER OF AUTHORIZATION
Property of V.s: Construction Corp.
Located at Marsh Hill Road
Putnam Valley - - Lot 56 FT�V Tax Map $ f o Block
Subdivision of Emerald Ridge
Subdivision Lot # 5 Filed Map # 3Z3.4 _1 Date Filed d608ER 19jZCo7
Gentlemen:
This letter is to authorize Timothy L. Cronin III, P.E.
a duly licensed Professional Engineer I ✓ I or Registered Architect 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, of said wastewater tretment and /or water supply systems in
conformity with the 1cl 45 and /or 147 of the Education Law, the Public Health
TLaw; aiid "tlie Puo Sani�
Counter Ked:
P.E., R.A., # _
062980
Mailing Address Cronin
2 John Walsh Boulevard, Peekskill
State New York
Telephone: (914) 736 -3664
Zip
6.29.80
ering P.E., P.C.
10566
�;.. Very
Signe
Mailing Address: V.S. Construction Corp.
37 Croton Dam Road, Ossining
State New York
Telephone: (914) 447 -4647
Zip,
10562
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWATER TREATMENT SYSTEM
1. Name and address of applicant: V.S. Construction Corporation
2.
4.
6.
7.
37 Croton Dam Road
Ossining, New York 10562
Name of Project: Emerald Ridge- Lot 8 3. Location: TN: Putnam Valley
Design Professional: Timothy L. Cronin III 5. Address: 2 John Walsh Boulevard
Drainage Basin: Peekskill Hollow Brook
Tvve of Project:
✓ Private/Residential Food Service _
Apartments Institutional _
Office Building Realty Subdivision
Peekskill, New York 10566
Commercial
Mobile Home Park
Other (specify) _
8. Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/No No
Type Status (check one) ...................................... ............................... Type I Exempt
Type II Unlisted ✓
9. Is a Draft Environmental Impact Statement (DEIS) required ? .................... Yes/No No
10. Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes/No N/A
11. Name of Lead Agency Not Applicable
12. Is this project in an area under the control of local planning, zoning, or other officials,
ordinances? ............................................................. ............................... Yes/No Yes
..�. �_ �..._......__r..w._ -.......- .. ..._..... _Y..._..
13. If so, have plans been submitted to such authorities? ............................... Yes/No
14. Has preliminary approval been granted by such authorities? N/A Date granted: N/A
15. Type of sewage treatment system discharge ........................ surface water ✓ groundwater
16. If surface water discharge, what is the stream class designation? .......................... N/A
17. Waters index number (surface) ............................................. ............................... N/A
18.
19.
20.
21.
Is project located near a public water supply system? Yes/No None
If yes, name of water supply Not Applicable Distance to water supply N/A
Is project site near a public sewage collection or treatment system? .......... Yes/No None
Name of sewage system Not Applicable Distance to sewage system N/A
22. Date test holes observed
24.
25.
26.
23. Name of Health Inspector
Project design flow (gallons per day) 800 GPD
Is State Pollutant Discharge Elimination system ( SPDES) Permit required? ... Yes/No No
Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A
Rev. 11/02 Form PC -97
Pg. 1 of 2
27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No No
28. Wetlands ID number .................................................................. ...............................
N/A
29.
30.
31.
32.
Is Wetlands Permit required? ...................................... ............................... Yes/No No
Has application been made to Town or Local DEC ........................... Yes/No N/A
Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No No
Is or was project site used for agricultural activity involving application of pesticides
to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge .
application or industrial activity? .......................................... .........................Yes/No No
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? ................................... ............................... Yes/No No
DESCRIBE:
33. Is there a local master plan on file with the Town or Village? ........................:Yes/No Yes
34. Are community water and/or sewer facilities planned to be developed within
15 years in or adjacent to project site? ......................... ...............................
35. Are any sewage treatment areas in excess of 15% slope? ...........................
36. Tax Map ID Number .............. ............................... Map 83.16 Block 1
Yes/No No
Yes/No No
_ Lot 56
37. Approved plans are to be returned to ................ Applicant W 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
approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require
DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious
surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit
those forms to DEP for review and approval.
If the application is signed by a person other than the applicanth_. 1, the application must be
accompanied by. a Letter of Authorization (Form LA -97). F ir�ze`'t� Zvi his provision may be grounds
for the rejection of any submission.``�,r�
I hereby affirm, under penalty of perjury, that irr t'6n rdi?ire�l on is rm is true to the best of
my knowledge and belief. False statements mad' e in ar #h"able faj lass A misdemeanor
pursuant to Section 210.45 of the Penal Law% ,
SIGNATURES & OFFICIAL TITLES:
Timothy L. Cron i '-P�Ek'':
Mailing Address Cronin Engineering
2 John Walsh Boulevard, Peekskill, NY
Form PC -97
617.20
Appendix C
State Environmental Quality Review
.,;.SHORT ENVIRONMENTAL-ASSESSMENT- FORK
For UNLISTED ACTIONS Only
PART I - PROJECT INFORMATION (To be completed by Anolicant or Prniert gnongnrl
1. APPLICANT /SPONSOR
2. PROJECT NAME
V.S. Construction Corporation
Construction of Single Family Residence
3. PROJECT LOCATION:
Municipality Town of Putnam Valley County Putnam County
4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map)
West side of Marsh Hill Road, 2650 ft. north of intersection of Marsh Hill Road and Peekskill Hollow Road
5. PROPOSED ACTION IS:
R] New [:] Expansion Modification /alteration
6. DESCRIBE PROJECT BRIEFLY:
Construction of a new single family residence, SSTS and Private Well Supply.
7. AMOUNT OF LAND AFFECTED:
Initially 2.397 acres Ultimately 2.397 acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
Yes No If No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
0 Residential 1:1 Industrial Commercial Agriculture Park/ForesUOpen Space ❑ Other
Describe:
Surrounding lands are zoned R -2 (Single Family Residential)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY
(FEDERAL, STATE OR LOCAL)?
Yes EJ No If Yes, list agency(s) name and permit/approvals:
Town of Putnam Valley- Building Permit
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
Yes No If Yes, list agency(s) name and permittapprovals:
Town of Putnam Valley- Site Development Approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes Z No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
ApplicanUsponsor name: ngtn ng, P.E. P.C./ James W. Teed, Jr. Date: ZQi g
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
I
PART II - IMPACT ASSESSMENT (To be completed by Lead Adenrvl
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF.
Yes No
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 1:1 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 11 No If Yes, explain briefly:
E. IS THERE, R IN�t?.E LIKEhY T.p BE jo VERSY RELATED TO POTENTIAL ADVERSE ENVIROIN'MEtiTAL iMP:;0TS
❑ Yes M 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 11 was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
ElCheck this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the
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
NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determir
Name of Lead Agency
Print or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency
Date
Title of Responsible Officer
Signature of Preparer (If different from responsible officer)
RONIN ENGINEERING, PE, PC
The Lindy Building, Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566
March 4, 2008
Mr. Joseph Paravati
Assistant Public Health Engineer
Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
Re. V.S. Construction Corp.. Emerald Ridge
SSTS Construction Permit
Marsh Hill Road- Lot 5
Town of Putnam Valley, New York
Section: 8316, Block. 1, Lot- 56
Dear Mr. Paravati,
Please find enclosed the following regarding an application for a Subsurface Sewage Treatment
Construction Permit Renewal at the above referenced lot:
1. One (1) Affidavit of Corporate Ownership authorizing Val Santucci to represent V.S.
Construction Corporation.
2. One (1) Letter of Authorization authorizing Cronin Engineering P.E., P.C. to apply for a
construction permit at the above referenced lot.
3. One (1) Certified check for $500 ade payable to the Putnam County Health Department
on behalf of the above referen application
A.. . Four. (4) Subsurface Sewage Treatment System Construction Permit Plans forthe above-
-referencedlot----
5. Four (4) Subsurface Sewage Treatment System Construction Permit Applications for the
above referenced lot.
6. Four (4) Applications to Construct a Water Well at the above referenced lot.
7. One (1) Application for Approval of Plans for a Wastewater Treatment System
8. One (1) NYSDEC SEAR Short Environmental Assessment Form.
9. One (1) Design Data Sheet
10. Three (3) Sets of proposed House Plans at the above referenced lot.
Should you have any questions or require additional information, please do not hesitate in contacting
me at the number above.
Respectfully Submitted,
es W. Teed, Jr.
Project Engineer
cc: Owner- Val Santucci (V.S. Construction Corp.)
File- Paravati-PCDH-Santucci-Emerald-Lbt 5-Transit-20080304.doc
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERV-Iw�,,l
CONSTRUCTION PERMIT OR SEWAGE TREATMENT SYSTEM
0—o i
Located at MARSH H # LL RoAp To or Village AM VAUZ YY <
Subdivision name NOKALO 'Rama Subd. Lot # �_ Tax:Map @Ob Block 1 Lot %
Date Subdivision Approved AVEMSER 19, 2 0r�.,,
Owner /Applicant Name V.5. coigmuc iom (::r
Renewal' Revision
Date of Previous Approval
Mailing Address 37 CRGrWJ *DMM F40% ®S61#0 NSW VoRN Zip
Amount of Fee Enclosed
Building Type 5jNdjLEFM jW Lot Areal.
Fill Section Only
No. of Bedrooms 14 Design Flow GPD 800
Depth Volume
Separate Sewerage —System to consist of 1j 500 gallon septic tank and 1/80 L•F. OF
WO PER A RP PVC WE IN Z
Other Requirements: F-
To be constructed by To 8. V, Address
Water Supply: Public Supply From Address
or:. ... - w Private Supply- Drilled.by.. , 6•.��....... ddres
:A . �,
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 c<itons of the Putnam County Department of Health, and that on completion
thereof a "Certificate of Co t�uctiogarx}�llxric satisfactory to the Public Health Director will be submitted to the
Department, and a written Inteb�will be fiii'nisad the owner, his successors, heirs or assigns by the builder, that said
builder will place in ptthg condition anyparf�pf said sewage treatment system during the period of two (2) years
immediately foil o 'ng th ate of the; issuaneea of the ap�roval of the Certificate of Construction Compliance of the original
system or any
Signed: �=
Address 2.
qJ
P.E. . R.A. Date 03— 0 — 2.DtaS
License # 4X29 g®
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new permit. Approved fAdischarge of domestic sanitary sewage only.
hit copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION-TO CONSTRUCT A WATER SELL _
. ._
please print or type PCHD Permit #
Well Location:
Street Address: To illage ' Tax Grid #
RH -L goAt17 AMK VALLEV MapS3.0 Block J– Lots) �(d
Well Owner:
Name:
Address:
V,5tCbN5TRLCMot4W-
137%bTtw 6551618 N 105(n2.
Use of Well:
V Residential Public Supply Air /Co d/Heat Pump Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought S gpm # People Served Est. of Daily Usage 800 gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
for Drilling
Well Type
Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes
—
Is well located in a realty subdivision? ...................................... ............................... . Yes No
Name of subdivision _ FMf. AQ) R1D4E Lot No. _
Water Well Contractor: 7; $,D. Address: —
Is Public Water Supply available to site? .................................. ............................... Yes No
Name of Public Water Supply: 14 T illage AJ/A
Distance to property from nearest water main: NIA
Proposed well location & sources of contamination to i separate sheet/plan.
D_ at_ e, .�..��._.° 4 .. , A R plicant Si ra t ares
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam
County.
Date of Issue o ? Permit Issuing Offici
Date of Expiration S 1,q t o Title:
Permit is Non -Tr insf rra le
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
James W. Teed, Jr.
Cronin Engineering
The Lindy Building, Suite 200
2 John Walsh Blvd.
Peekskill, NY 10566
Dear Mr. Teed:
ROBERT.I. BONDI
...County.Ezecutive
ROBERT MORRIS, PE
Director of Environmental Health
March 19, 2008
Re: Proposed SSTS — VS Construction Corp.
Marsh Hill Road
(T) Putnam Valley, TM# 84 -1 -69
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. The pipe from septic tank to SSTS needs to be SDR -35, please correct this on the
plan and profile.
iei �ioris' f<om; the proposed well •need_tocbe.shown at ,tAni6 -irid i'vid a- ] ,property
lines.
3. The absorption trench detail needs to note "Clean dust free crushed stone or washed
gravel ".
4. Please show a separation of 20 ft. minimum from house to SSTS.
5. In the subsurface sewage treatment system box please.change certified septic system
contractor to Licensed Septic System Contractor.
6. The tax map number on the plans and documents appears incorrect.
7. The subdivision lot # was not provided on the plans.
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,
( s eph 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
RONIN ENGINEERING, PE, PC
The Lindy, Building, Suite.200, 2 John Walsh Boulevard, Peekskill, New York 10506-•
-7136-'3664'e- &L�: 914-736-3693
May 5, 2008
Mr. Joseph Paravati
Assistant Public Health Engineer
Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
Re.- V.S. Construction Corp. - Emerald Ridge
SSTS Construction Permit
Marsh Hill Road- Lot 5
Town of Putnam Valley, New York
Section: 8316, Block. 1, Lot 56
Dear Mr. Paravati,
In reference to your comment letter dated March 19, 2008, please find enclosed the following regarding
an application for a Subsurface Sewage Treatment Construction Permit Renewal at the above
referenced lot:
1. Four (4) Revised Subsurface Sewage Treatment System Construction Permit Plans for
the above referenced lot.
Should you have any questions or require additional information, please do not hesitate in contacting
me at the number above.
RespectfuUmaubmitted,
i Teed, Jr.
44oject Engineer
0c: Owner- Val Santucci (V.S. Construction Corp.)
File- Paravati-PCDH-Santucci -Emerald -Lot 5-Trans-ft-20080505.doc
PUTNA.K COUNTY DEPARTMENT OF HEALTH
f- L
V 4 •
..DIVISION OF ENi'g2O NTAL fiEA�
SEW A
_ =r:_. • '� ll�tY ?TVTDYTtiL'�0"Af23VPLI'`:di SUSCIRF TMENT SYSTEMS
REVIEW SHEET FOR CONSTRUCTION PERMIT
N4IVM OF OWNER: j, 4c. Gv^j-,T, r -0-9 -' STREET LOCATION: MA-p,,514 i.Ei -Z2AD
R.EVIEWED.BY: RM, (g Jam', SRDATE: 3 t78 f TAX MAP#: (CONFIRMED) 63" !f l `�
Y / N DOCUMENTS Yom; "N (REOUMFD DETAILS ON PLANS CONT'D)•
✓ UPERMIT APPLICATION C �/ UHOUSE SEWER -1/7 RT. 4 "0'; TYPE PIPE.CAST IRON
" WELL PERMiT ORPWS LETTER U(�NO BENDS; MAXBENDS 45' W /CLEANOUT
P G -97 # RENEWALS
LETTER OF AUTHORIZATION SITE NOTE (NO CHANGE)
DESIGN DATA SHEET (DDS) FILL SYSTEMS
ZUCORPORATE RESOLUTION 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE
/J( )SHORT EAF : (_ } FILL SPECS/ FILL NOTES 1 -5
PLANS -THREE SETS FILL PROFILE & DID ENSIONS
-7—PLAN
PLANS -TWO SETS ' �1C' ZL_)FILLINtkPANSIONilt &A,
)(VARIANCE REQUEST FILL GREATER THAN2.FEET
4/73) SUBDIVISION CLAY BARRIER
LEGAL SUBDIVISIONF7LL'CERTIFICATION NOTE
SUBDIVISION APPROVAL CHECKED 21, DEPTH GAUGES
C RATE.. • D �V . DEPTH VOL. ON PLAN FOR R.O.B., TJNCLASSOD & IND?ERVIOUS
� L REQUME . SEPARATION DISTANCE FROM•TOE OF SLOPE
)(CURTAIN DRAIN REQUIRED TRENCH*
; GENERAL ( LF TRENCH PROVIDED Y ;l g 60FT MAX.
�GATED.IN NYC FYATERSHED �-JPA.RALLEL 'TO CONTOURS
a PLANS SUBlYII.TTED TO DEP C /)0100% EXPANSION PROVIDED
- ELEGATED TO PCHD (� I7ETArH7DUST�FREE"CRU'�D'STONE OR WASHED GRAVEL
_X ) EP APPROVAL; IF REQ'D GEOTEXTILP, COVER
,) SEEP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN = FR(YM'SSTS
_ ) /PERCS TO BE WITNESSED (U10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL . "
�U :4PPROVAL SSDS ADJ, LOTS U ZO? T,0 FO.�TNDATION WA L?S - - 5k.t./ it P �a. ✓t
WETLANDS {TOWN/DEC PERMTT REQ'D ?) .' 100' TO WELL, ZOO' IN'DLOD,150' TQ InTS '
U 4TA ON-DDS- PLANS & PERMTT SAME.-
__.. •.,. '.._ _. .., ._.. ... _. _..... _... ,._...(�_j1.d0.')'.O: SIRE. �.1Y1;WATERC(ZIIF.SE,:.]..,A�'. iaa•e= sei.
;1969
RE GHBOR NOTIFICATION -'� (�✓ ��" 50' TO CATCH BASIN, 351. STORMDRAIN, PIP}JD WATER
S ETTER.$I1ZBA 200 c �(4' )10' TO WATERLINE (pits - 20'1)
ccccc�����/////( X00 yg; FLOOD ELEVATION WTI (�1 U50 • DRAINAGE COURSE,
SOIL TESTING LOTS>10 YEARS OLD (�U_ _200 '/S00 ' RESERVOII2, ETC. 150' GALLEY SYSTEMS
UDETL N N 10' KM TO
LEDGE OUTCROP
EWAGE SYSTEM PLAN- (NORTH ARROW)
DSHYDRAULIC PROFILE (4(J10' FROM FOUNDAT ON -,50 TO WELL
4_/'lRAVTrY FLOW �f UmT.T_
CONSTRUCTION NOTES 1 -]?S 17
(-D(_)H- IIVIENSIONSITO PROPERTI ZIIlES
DESIGN DATA: PERC & •DEEP RESULTS
(__D ,(LOCATION OF SERVICE CONNECTION
)�)2' CONTOURS EXISTING & PROPOSED
(�i (��J 15' TO'PROPERTY LINE
/DRIVEWAY &SLOPES, CUT
P' •' 'SLOPE
FOOTING /GUTTER/CURTAINDRAINS
� /U$LOPE IN SSTS AREA 57 �(SZO %)
4vUSDA SOIL TYPE BOUNDARIES
(�(- ✓REGRADED TO 15 %, IF REQUII0%)
�(�TTTLE BLOCK; OWNERS NAME ADDRESS
DOSE/PUMP SYSTEMS
TM#, PEMA; NAME, ADDRESS, PHONE#
OF DRAWING/REVISION
(__,�PUMp NOTES .
� )DATE
DATUM REFERENCE
U DOSE 75% OF PIPE VOLUME /DOSE VOLUME NOTED
,
(__)LOCATION OF WATERCOURSES, PONDS
U ETAIL FOR FORCE-MAIN, (PIPE TYPE, ETC.)
pTT AND D_BOX
//' LAKES,WETLANDS WITHIN 200' OF P.L.
//L_)PROPOSED
SHOWN &DETAILED
(%( ,)I DAY STORAGE ABOVE ALARM
FINISH FLOOR AND
BASEMENT ELEVATIONS
CURTAIN DRAIN
STANDPIPES BOTH
T SIDES, DETAIL
WELLS & SSDS'S W/IN 200' OF SSTS
15' MIN to CDS =>5 %, ZO' -4 %, 25' -3 %, 35' -1 " / °, 100 % -<1%
PROPERTY METES & BOUNDS -
(X_2EROSION CONTROL FOR - .HOUSE, WELL &
20' MIN to CD DISCHA'RGRA00' with 182 cons day discharge
.:
SSTS, EROSION CONTROL NOTE
10' MIN to NON - PERFORATED PIPE
MMENTc S Vie"i5 � Ok
- \ /. -
24c liz' % 1 elr '�sC'�"'�PC.�'GGjif'iCViS�'Nb �7- 'Ed9C+ll Or�2•i r(�US� (2e%/
-
V.S. CONSTRUCT[ON
:n 1
Sl L- -a 4{ 6,_6,
VOTES
I. 2x6 EXT WALLS B L6' 0.C./2x4 KARR WALLS
'
2. 9 0' CLG HT.
3. 2x,0 SPF82 FLOOR JOISTS B 16' O.C. / JOIST WINGERS
4. KV BRICK KO,L➢ DBL HUNG VINDOVS <TVBDH ML242LOM. R2.2842M, 03M•
5. CLG 6 CLO GIRDER OVER DRTI R TUBE 2-1 I /2' X11 1 /4(xI4'�I01 ML L<6.1.91 H.L. <6
7. FLR GIRDER UNDER UNITS A' /'B' TO DE- 4-1 1/2'x9 1 /4'x58' -0' Nl.
9. t LAYER 3/8' TYPE 'X' GYP. BOTX SIDES <ONE SIDE -MARK. VALU OVER 2'
561EATH0'O GYP.f1(T, WALL B 16' O.C., ATTACH /6d CENENT COATED NAII
9. t LAYER 5 /8' TYPE 'X' GYP. APPLIED VERTEC?LLY ON ONE SIDE OVER 2x1
R 16' O.C.. ATTACH /6d CENENT COATED NAILS (! -7/8' LONG /1/4' DIA.
10.2x10 SPF82 CEILING JOISTS OVER GARAGE. BASE LAYER S /8• TYPE 'X' GY
ANGLES TO CLG AISTS. ATTACH /1 1/4' TYPE S' DV SCREWS AT 24. 0.
TYPE X' GYP APPLIED AT RIGHT ANGLES TO CLG JOISTS. ATTACH / 1 71
DW SCREWS AT 12' QC. SE7 BACK SCREWS 2' AT END JOINTS AND STAGGE
2' -0' EACH LAYER. 7/l6' OSB OVER AISTS PERPEN. x /Btl NAILS <RC260U
IL CEILING DRYVALL VIOL BE OMITTED FOR ALL ON -SITE PLUMBING CONNECT]
1&A- DENOTES CENTRAL VAC OUTLET
l3. BI INSTALLED HEATING SYSTEM TO COVER A 99,000 BTU LOSS
L4.MIN R -L9 FLOOR INSULATION REQUIRED PER NY,S.E,C.C.
LS. BASED ON LOU MPH WIND LOAD 6 EXPOSURE B'
,6.SITE LACATD3N PUTNAM VALLEY, NYI PUTNAM COUNTYI 45 PSF SNOW LOAD
— 91 1®
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II.ONIN ENGINEERING, PE, PC
The Lindy Building, Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566
Tel.: 914 - 736 -3664 Y Fax: 914 - 736 -3693
Mr. Joseph Paravati
Assistant Public Health Engineer
Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
Re: V.S. Construction Corp.
Certificate of Construction Compliance
4 Bedroom Residence
61 Marsh Hill Road
Town of Putnam Valley, New York 10579
Section: 83.16, Block. 1, Lot: 56
Subdivision Lot 5 of "Emerald Ridge"
0
Dear Mr. Paravati,
August 24,2010
Enclosed for your review and approval please find the following items regarding the application for a
Certificate of Construction Compliance at the above referenced project:
1. One (1) Certified Check in the amount of $300 made payable to the Putnam County
Health Department.
2. Four (4) Copies of a two (2) year guarantee signed by the Owner & the Installer
3.. Four ,(4) Well Completion Reports_signed by Norman Andersen (The.Well Driller)
4. One (1) Copy of Satisfactory Results of a Water Analysis by a Yorktown Medical
Laboratories, a NYSDOH Approved Laboratory.
5. One (1) E911 Address Verification Form verified by the Town of Putnam Valley.
6. Four (4) Certificates of Construction Compliance
7. Four (4) Sets of "As- Built' Plans signed and sealed by Timothy L. Cronin III, the Design
Professional.
8. One (1) Copy of As -Built Foundation Survey by Donnelley Land Surveying.
Please review the above items at your earliest convenience and should you have any questions or
require additional information, please do not hesitate in contacting me at the number above.
Respe bmitted,
James W. Teed
Project Engineer
cc: Val Santucci - owner
File- Paravati-PCDH- Santucci -Marsh Hill Road -Lot 5-SSTS As- Built- Trans- JT- 20100824.doc
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
_..... (9.14.), 245 72.800 - _..
Albert` ".H: -; Pa( OVanf ,.::Director
LAB #: 1.003211 CLIENT #: 2500 NON STAT PROC PAGE: 1 of 2
ANDERSON WELL DRILLING DATE /TIME TAKEN: 07/29/10 04:00
152 BARGER ST DATE /TIME RECD: 07/29/10 04:35
ATTN: NORMAN, SARAH REPORT DATE: 08/05/10
PUTNAM VALLEY, NY 10579 PHONE: (845)- 528 -1491
SAMPLING SITE: 61 MARSH HILL, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE
: VAL SANTUCCI PRESERVATIVES: NONE
COL'D BY: VAL SANTUCCI TEMPERATURE..: < 4C
NOTES...: KITCHEN TAP COLIFORM METH: MF
DATE
FLAG PROCEDURE
RESULT
NORMAL - RANGE
METHOD
PUTNAM
CNTY PROFILE
07/29/10
MF T. COLIFORM
ABSENT
/100 ML
ABSENT
SM
18 -20 9222B
08/03/10
LEAD (IMS)
1.1
ppb
0 -15 ppb
SM
18 -19 .3113B
07/30/10
NITRATE NITROG
1.10
MG /L
0 - 10
SM18- 204500NO3
07/30/10
NITRITE NITROG
<0.01
MG /L
1.0 MG /L
SM18- 204500NO2
08/04/10
IRON (Fe)
<0.060
MG /L
0 -0.3 mg /l
SM
18 -20 3111B
07/30/10
MANGANESE (Mn)
0.124
MG /L
0 -0.3 mg /1
SM
18 -20 3111B
07/30/10
SODIUM (Na)
16.5
MG /L
N/A
SM
18 -20 3111B
07/29/10
pH
6.5
UNITS
6.5 -8.5
SM18 -20 4500HB
08/02/10
HARDNESS,TOTAL
162
MG /L
N/A
SM
18-20 2340C
08/02/10
ALKALINITY (AS
94.0
MG /L
N/A
SM
18 -20 2320B
07/30/10
TURBIDITY (TUR
0.4
NTU
0 -5 NTU
SM
18 (2130B)
CTNew*(York MFTC liform = This result indicates that the water
was not) of a satisfactory sanitary quality according to
State and EPA federal drinking water standard for
this parameter. This comment applies to the Total Coliform test
only.
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. 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.
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
(914) 245 -2800
Albert. H. Padovaizi .- Dir�.ctor-
LAB #: 1.003211 CLIENT #: 2500 NON STAT PROC PAGE: 2 of 2
ANDERSON WELL DRILLING
152 BARGER ST
ATTN: NORMAN, SARAH
PUTNAM VALLEY, NY 10579
DATE /TIME TAKEN: 07/29/10 04:00
DATE /TIME REC'.D: 07/29/10 04:35
REPORT DATE: 08/05/10
PHONE: (845)- 528 -1491
SAMPLING SITE: 61 MARSH HILL, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE
: VAL SANTUCCI PRESERVATIVES: NONE
COLD BY: VAL SANTUCCI TEMPERATURE..: < 4C
NOTES...: KITCHEN TAP COLIFORM METH: MF
DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD
Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM
CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE
HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE
SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED.
SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L
MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER
HARD WATER: 140 -300 MG /L (1 grain /gallon = 17.2 MG /L)
THE ABOVE ?PRO EDURES MEET ALL REQUIREMENTS OF NELAC,
AND REL THESA SAMPLES RECEIVED BY THE LAB
SUBMITTED BY:
Al Padovani, M.T.(ASCP)
Director
ELAP# 10323
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D �Z
112.5 L.F. OF 4 °0 CAST IRON PIPE
LOT 6
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I I
LOT 5
Area =>09, 392 Sq. I
= 2.3965 Acres
4 °0 PVC ROOF LEADER &
4'0 HOPE FOOTING DRAIN
DISCHARGE AWAY FROM SSTS
C
- -___
. _ r �. � ._...- .f e.. .a .. r.. t'd^. c -.Y ^. n � _ _ r.. ". .. � -r � .. �.. :. �.r. -1 .1 .� i .t .: �6•:: �- _.. a. .
)F 8 TO 10 MINUTES pER
.LY LAND SURVEYING
JGUST 8, 2008 WITH
SUBDIVISION AND SITE
TNAM COUNTY CLERKS
AS -BUILT S.S.T.S. LOCATION DISTANCES
DESCRIPTION
A
B
D
SEPTIC TANK CENTER
17.8'
60.3'
JUNCTION BOX 1 (1)
36.5'
77.0'
JUNCTION BOX 2 (2).
41.7'
82.7'
JUNCTION BOX 3 (3)
47.0'
88.5'
JUNCTION BOX 4 (4)
52.3'
94.0'
TRENCH 1 END NORTH (5)
84.2'
82.2'
TRENCH 2 END NORTH (6)
86.6'
87.6'
TRENCH 3 END NORTH (7)
89.2'
93.0'
TRENCH 4 END NORTH (8)
92.2'
98.4•
TRENCH 1 END SOUTH (9)
50.7'
56.7'
TRENCH 2 END SOUTH (10)
ro54.6'�
62.4' s.
TRENCH 3 END SOUTH (11)
59.1'
68.2'
TRENCH 4 END SOUTH (12)
63.4'
73.8'
AS -BUILT WELL LOCATION DISTANCE
DESCRIPTION B C
WELL 80.0' 103.0'
AS -i