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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -10.12 BOX 33 lirs rm o + - �' me III ,. - L, i L h' 'P Wit 04307 i! ?!Y E 4� 1 i RJ I'viENT OCT 22 PM 2: 38 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES :. n v ...�, •..a .,. i... fa ♦•.. • r ��\;,• . .. t.,.l. "F'•' <- . : • -,Q w •s'. .. . v -�.,. a- ," .n. ff• ♦•:.WeII1 Permtt'# `' tul!h ` of `fJ�it{T Ar t�J i WELL COMPLETION REPORT Well Location j Street Address: � 5-'4 {p0 R s Town/Village: f P PC, A V Il Tax Map # p�� d_l k Ma lock Lot(s) Well Owner: Name: Address: T Z I /S �Vt, V� Use of Well: 1- Primary 2- Sec6ndary VIiesidential _Public Supply Air cond /heat pump _Irri atio Business Farm Test /monitoring —Other(specify) Industrial Institutional Standby Drilling Equipment 1 otary _Cable percussion Compressed air percussion Other(specify) Well Type Screened !Open end casing _ Open hole in bedrock _Other Casing Details Total Length Zp-ft. Length below grad ;ft. Diameter in. Weight per foot/3' lb/ft . Materials: L,4teei Plastic Other Joints: Welded t-"Threaded Other Seal: ement grout Bentonite Other Drive shoe: Yes _ No Liner: _Yes t.,No Screen Details Diameter in Slot Size Length ft Dept to Screen ft Develo ped? First _Yes No Hours Second Well Yield Test _Bailed • Pumped Compressed Air Hours 2L Yield gpm Depth Date easure from land surface-static spec ► During yield test Depth of completed well In ft. Well Log If more detailed information . sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter in Formation Description ft. ft. Land surface . 1 • _ o v �/ a r d If yield was tested at different depths during drilling list:; Feet Gallons Per Minute Pump /Storage Tank Information Pump Type S c.,. W,,7V�e Capacity Depth Srl. Model 1; Voltage z3a HP_ Tank Type U/X 3 O;( Volume -S' _., ...,;' -, "?`? - ° °r °�'��� Dafe Well Com feted < ". T ... (`/R .. ;Well Driller PCC ��:' O7 �' NY,State #r t7o�ki I' i,'(,��i kS.t7S �: 1 k : JJ:1.Y et I ""Ft�' f'T i �•y° k.[' k mod! 1 z Pumplrisaller PG Certificate: #. t� (� .....:.0 .NY.Sfate _ Date `of'Report'" y1 /sl ki'��lrtl j11! Well rillerName ij -•. f Ai �:.:. pcldress�;s "'_ W 11 Drlller,u(stgn re)�: uF .;,, - t iA,. = V N >' ? ", L(J( C�1 1' ' ..M `l.l( !'F'L :k ' 1'�I k1t 11- I I y 1 4 a .11 1 k ', 1 1. � �.�..:..,:•...:.. :, ,...r x.?�T :5, 1 1t ? yn. .. r'r '� 4l1 It1. P m Installer a 8r ddress k z r '� , = 1 Pu p Installer (si nature). _.. it, tF ° ifd ....7� :1 1 v -InLr" ny "`.rt t' .f tx. 'i,;,'�pr.•1 .; Y "1 i y}'; 1!. ",. i... 11. 11! iR.,�II�V'nW 1,11 "" �.. x r w ;� ... _ , *; "» '- `Y 1 K�' u v �k ,x� Frf ;+ r 1,F� F �y 3 '_ •�. $ - y 4 ') E � � 7 � ,^ I J:' Sf� 1 i ^' NOTE. Exact Location of well with distances to at least two p rmanent landmarks to be proylued 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 JF Q� / CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREA,-" T` YSTEM ]PC)E}lD CONSTRUCTION PERMIT it PV 06 Located at [ 5. BROO V. aLLS CO T- Owner /Applicant Name W I &IW a Arwav/g- Formerly Town or V4k" Tax Map 6'j Block Lot s - /A Mailing Address Date Construction Permit Issued by PCHD Lo� I I lrs M N Separate Sewerage System built by W d LL1 VF VSZ1A Address �� -- t Consisting of Z.5- Gallon Septic Tank and 0 J r e Other Requirements: Water Sulro>aflv: Public Supply From Address or: Private Supply Drilled by ('kq J Address &2r-x " Buildirig Type "- i � . Has erogiori coiitrol been compieteV- Number of Bedrooms Has garbage grinder been installed? A/0 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the utnam Co ty Department of Health. Date: ['r 0 ` Certified by P.E. R.A. (Desi n Professional) Address 2-73 ��1q rd4 2�*t t!�e License # o A -7 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 e' LQ't Title: A, E Date: tO /C -7/0 7 ropy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENV.IRONMENTAL HEALTH SERVICES 1. .� .♦. .. .. ... _. C y ::4•:o. "JG.• T.. C .. .�z+.r . +..c .+. ..y w ra� {y'ry� r,.'..�. . 1 ? �. -__ WELL COMPLETION REPORT Well Location Street Address: Town/Village: Tax Map # k /14 �{I f le faO ! p t� 4, th V f Map Block Lot(s) Well Owner: Name: Address: /rs PC,* r r [ V e Pe M/ 2,� el �� rrVl( T4 U tM Vti f l P Use of Well: esidential _Public Supply Air cond /heat pump _Irri atio 1- Primary Business Farm Test /monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment V14otary _Cable percussion _Compressed air percussion _Other(specify) Well Type _Screened _Open end casing _ Open hole in bedrock _Other Total Length jP_ft. Materials: L4teel Plastic Other Casing Details Length below gradhf P-ft. Joints: Welded L"ihreaded Other Seal: ement grout Bentonite Other Diameter 4 1 in. Weight per foot /T lb/ft Drive shoe: Yes _ No Liner: _Yes LAo Diameter in Slot Size Length ft Dept to Screen ft Develo ped? Screen Details First _Yes _No Second Hours Well Yield Test _Bailed Pumped _j Compressed Air Hours Yield gpm Depth Date Measure from land surface-static specs During yield test ( e p t h o comp re te J we I I I n 3 0 1S Well Log Depth From Surface Well Diameter ft. ft. If more detailed Water Bearing in Formation Description information Land surface descriptions or sieve analyses are available, please attach. If yield was tested Feet Gallons Per Minute Pump /Storage Tank Information Pump Type s c-. n�a�s7Ve Capacity at different depths during drilling Depth S Model s l list: Voltage 130 HP_ Tank Type W X 3 Dc), Volume -S-- Date W II Corn 'leted WeII,Drlller PC Certificate# (,n/ /� . NYState #x` t° l /yn /) DateofReport° t���1 a;: Ph D � Yt�` Y� . �y.+t'. � k S. <S : �: 4 '!, x ta �;� � �.: a i � z Pump Installer;PC�Certificatt: #, t? f.�. NY7State # w ,! t .p. D' Well r(Iler Name!8r Address W, II Driller (sigrn"'. re)¢, ke.2 6x s iy rL � t � 'vv��� i!'4A'�:liF� y w.� d ! t k .•^' <f A a :+t. S. , .+ k a Y R ' M x:'' : P 64 �: ' � �r; Y. E< to r• "J A _ I1 !� 4;:M rr ' Lix" + 4 } a„:�r R. C/.�:.ff..i 3.k ? k ". .. P m` Installer a' a &' `ddress Y W:; re)k �S " ` .r'} # a , ✓ rpe A r §'_ tua ► x e T'i,,wV a+ Na {I4@ H� 4 ~��. ��,'�. i•a4 ka+Ai/� 'Y ''.� �: x �7 i)�"d�.5�'�'A �t� �': } ��''i��drC: A�iY`ik k+ Y ��" 4�N rs'.'A3 YF" .h4a ��t'��'4"�1�•iY "� 3 p„( :2 +.. '. �': Rs NOTE: Exact Location of well with distances to at least two p rmanent landmarks to be prov ded 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 PU TNAM COUNTY DEPARTMENT OplF�p{}�{y 7�HEALTH 7��•� _•t, .� no•,.� -~• (}� -. r- n.. tl'�3'l. W 11..1�� ®�•J3Jl V Y 2LH��1/�1Y1�1 V Ji �4lLJ��� li �L31• �11:IV�� ''- O �� � r a .. �.I: !� -• .-•'!• GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM VP_naZ(,A Owner or Purchaser of Building ^\/t Z,"A Building Constructed by 15 ��a61Z. -�,t, S c. ► , Location - street Wood Frame Building Type &y-. — 1 - 10. 12 Tax Map Block Lot ?J 4N (k n.1 V TownNillage fc� �cl L_S �o�tt crj 2 S .Lac, Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of - the- lautaam- County -department of Health as to whether or not the failure of -the- system to operate was. • - y •- - - caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day —1 Year Z`9d_7 General Co actor (Owner) - SignSfue Signature: __ Title: • &Wiv�.�- Corporation Name (if corporation) Corporation Name (if corporation) Address: V4tkey Address: t State 1��-J c..l oS' 6; Zip \045 -1 State K)(2c.J S401" IC Zip i 7'T Form GS -97 'BRUCE. R. FOLEY ' : ublic Health Director L.ORETTA MOLMARI- R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTWVIENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental health (914)278-6130 Fax (914) 278-7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (9i4)278-6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 MAI OWNERS NAME: TAX MAP HUMMER:. E911 ADDRESS: %ti� /3�Zdo�4cL5 G TOWN:G�T�4,., c/�l AUTHORIZED TOWN OFFICIAL: (Signature) DATE: z The Putnam County Department. of ]Health will not issue a Certificate of Construction Compliance unless the above form is completed, jx-, 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. (E911VERFRM) "''*�^Q`I~~`oo`"& YML ENVIRONMENTAL SERVICES 321 Kear Street � � ` N.prkjpwq Heights N.Y. 10598 �/�� ^�����~��, Albert H. Padovani, Director | LAB #: 1.703450 CLIENT #: 60228 NON STAT PROC PAGE: 1 of 2 VENEZIA, WILLIAM JAMES DATE/TIME TAKEN: 06/20/07 08:03 15 BROOKFALLS CT DATE/TIME REC'D: 06/20/07 09:12- PUTNAM VALLEY, NY 10579 REPORT DATE: ` 06/27/07 PHONE: (914)-906-3850 SAMPLING SITE: 15 BROOKFALLS CT SAMPLE TYPE..: POTABLE : WELL TANK PRESERVATIVES: NONE COL'D BY: WILLIAM JAMES VENEZIA TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~=~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 0-15 ppb SM 18-19 31139 06/20/07 MF T, COLIFORM ABSENT /100 ML ^ 06/21/07 LEAD (IMS) 3.0 ppb 06/20/07 NITRATE NITROG 0.46 MG/L 06/20/07 NITRITE NITROG <0.01 MG/L 06/25/07 IRON (Fe) <0.060 MG/L 06/20/07 MANGANESE (Mn) <0.010 MG/L 06/25/07 SODIUM (Na) 9.98 MG/L 06/20/07 pH 7.4 UNITS 06/27/07 HARDNESS,TOTAL 52.0 MG/L 06/27/07 ALKALINITY (AS 66.0 MG/L 06/21/07 TURBIDITY_(TUR__' <1 NTU . ` COMMENTS: FAX TO 845-528-6963 ABSENT SM 18-20 9222B 0-15 ppb SM 18-19 31139 0 - 10 SM18-204500NO3 N/A ? 18-204500NO2 0-0.3 mg/l SM 18-20 31112 0-0.3 mg/l SM 18-20 3111B | N/A 6.5-8.5 N/A N/A 0-.�5 N T U SM 18-20 3111B SM18-20 4500HB SM 18-20 2340C SM 18-20 2320B . 9079_---, .. -�'---~^-�-'------�-�-���^-1 COMMENTS: MFTC THESE RESULTS INDICATE THAT THE WATE AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD I NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Hei hts N.Y. 10598 | Albert H. Padovani, Director | LAB #: 1.703450 CLIENT #: 60228 NON STAT PROC PAGE: 2 of 2 VENEZIA, WILLIAM JAMES DATE/TIME TAKEN: 06/20/07 08:03 15 BROOKFALLS CT DATE/TIME REC'D: 06/20/07 09:12 PUTNAM VALLEY, NY 10579 REPORT DATE: 06/27/07 PHONE: (914)-906-3850 SAMPLING SITE: 15 BROOKFALLS CT SAMPLE TYPE..: POTABLE : WELL TANK PRESERVATIVES: NONE COL'D BY: WILLIAM JAMES VENEZIA 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 ----- TRATIOW°-BOTH-E&RESSED SV---''U- -' , 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) SUBMITTED BY: ( UAS & � Direct o/ ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAiL HEALTH SERVICES WELL ABANDONMENT REPORT WELL ABANDONMENT CERTIFICATION I, undersigned, hereby certify that the abandoment of the above - referenced water well has been accomplished and completed in accordance with the methods described in Permit # Ito abandon said water well. Date: !6 2A 0_�__ Signature- Print Name: a l' ,( Q.. Address: S ITV, Form WAR 91 PCHD Well Abandonment Permit # eLf.— rib please print or type Well ]Location Street Address: TownNillage Tax Grid # ��11�� �l'OOIL Q, mil" . �Q.� Map 84 Blocl j Lot Well Owner Name: Address: u� r ? �' 0'_ K0 �} S �; dal I �- Well Type Drilled Driven Dug Gravel Other Depth of Well Well Depth ft Static Water Level 0 ft Date Measured Reason fot . Abando mein$ VJ_Aj� Vtl '1/✓ C_ c� (Description of Completed Work �, /� � .) �'� l.0 i i 'V �' bus -C�Ur �jt-� '� (�]((�1M(j� o r- WELL ABANDONMENT CERTIFICATION I, undersigned, hereby certify that the abandoment of the above - referenced water well has been accomplished and completed in accordance with the methods described in Permit # Ito abandon said water well. Date: !6 2A 0_�__ Signature- Print Name: a l' ,( Q.. Address: S ITV, Form WAR 91 PUTNAM COUNTY. DEPARTMENT OF HE TIC.... .._... _Y .. ... "' '-. • :,:..:.= • >--:»:,.:. -a:= °ate =::� -: LETTER OF AUTHORIZATION RE: _. Property of _ William Venezia Located at Brookfalls Road TN T/ Putnam Valley Tax 1D# 84- 1- 10.12. Subdivision of Resubdivision of Lot 1 Brookfalls Cottase , Inc Subdivision Lot # 1A Filed Map #271-38 Date filed 3-7-2--Oa Gentlemen: This letter is to authorize Beyer & Associates Consulting Engineers. a duly licensed Professional Engineer X 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 construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. . a. ... ... .-... ... r 4� 4 i r. .. ... . . r.s _ - .. ...,.. a.ryr- i. s • ..ei... ..fir. .4�. ..., 1 • ... �... •v ..... •.. -- '• ---•.. ._. r ..4a �E.. ....... • .. .... !+ .......... •.•.w �. • -! . .n.... fr. N n F.n n� Very truly yours, Countersigned;/ Signed: (Owner of Pro ) MICHAEL F. BEYER, P.E. #074597 William Venezia Mailing Address 273 Starr Ridge Road Mailing Address 17 Brookfalls Road Brewster Putnam Valley State: New York Zip: 10541 State: New York Zip: 10579 Telephone: (845) 278 -6212 Telephone: (845) 528 -6963 ON -FILE Form LA -97 273 Starr Ridge Road Tel., (845) 278 -6212 Brewster, NY .10509. Fax. (845).278 -0403 September 18, 2007 Mr.. Joseph S.: Paravati, Jr. Asst. Public Health Engineer .Putnam County Department of Health 4 Geneva Road ... . Brewster, Nero York 10509 Re: Venezia Residence - 15 Brookfalls.Road Town of Putnam Valley,:. Putnam County, New York. Tax flap 84 Block 1 Lot 10.12 Dear Mr.Paravati, The plans have been revised as per your letter dated September 12, 3007 as follows: 1. Afield inspection was completed by the PCDOH. . 2. The as -built plan scale,has been increased to 30 scale. 3. The dimensions for A2 -A8 have been checked and revised accordingly. 4. The Trenches have been checked and revised accordingly. 5. The dimension for the location. of the house have been shown. 6 The existing well has been shown and labeled accordingly. Enclosed please find the following items for the above project: o Four (4) sets of As -built plans dated 8116107 last revised 9118107 prepared.by Beyer &A ssociates. I trust. the above materials are adequate for your approval and complete the submission for the above project, However, if you have any questions concerning this project, please do not hesitate to call me. Very truly yours, ;. ��� Al ic l Beyer, P.E. 3 .a v Project Manager SHERLITA AMLER, MD, MS,.FAAP Commissioner of Health 'LORETTA MOLINARI, RN, MSN Associate Commissioner of Health September 12, 2007 Beyer & Associates Mike Beyer, P.E. 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BOND11 County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Construction Compliance - Venezia 15 Brookfalls Court (T)Putnam Valley, TM #84 -1 -10.12 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. P lG f oT 1. The well, the existing well abandonment, and the house for bedroom count have 91 not been inspected by a representative of this Department. - .. ZI The as. built plan needs to be at a minimum -of 1 " -30'. r /It appears as built dimensions A2 -A8 are incorrect. c The trenches are scaling to 67' on the plan, not 62' (2'.solid + 60'trenches). The dimensions with respect to the property lines are to be provided for the house. The existing well location should be shown noting that the well is now abandoned. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, JSP:lm oseph S. Paravati, Jr. Asst. 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 273 Starr Ridge Road Tel.. .(845) 27.8-62,12. Brewster, NY 10509 Fax. (845) 278=0403 August 16, 2007 Mr. Michael Budzinski, P.E. Senior Public Health Engineer Putnam County Department of Health, 4.Geneva Road Brewster, New York 10509 Re: Venezia Residence -15 Brookfalls COurt . . Tax Map 84 -1 -10.12 Town of Putnam Valley, Putnam County, N.Y. Dear Mr.Budzinski, Enclosed please find the following items for the above project: o Certificate of Construction Compliance application form o E -911 verification Form o Three (3) Copies of Guarantee of Subsurface Sewage Treatment System. o Well Completion Report. o Water Analysis Report o Well Abandonment Report o Letter of Authorization - :.:.....::�.:.:..:a ..o Four (4)'sets•ofAs -built plans dated= 8116 /07 prepared by. Beyer &•Assoeiate,c..: i.....v o Application fee —in amount of $300 I trust the above materials are adequate for your approval and complete the. submission for the above project, However, if you have any questions concerning. this project, please do not hesitate to call me. Very truly yours, Mic el Beyer, P.E. Project Manager, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION low 0 GENE REQUEST FOR FINAL_ INSPECTIO For: Fill All information must be fully completed prior to any Trenches inspections being made. PCHD Construction PerEgit Located: Ayes —t j&n 114"-e �f Owner /Applicant Name: tau u Am &xA a -4 TM' St Block l Lot 0 � Formerly: ___ —_ Subdivision Name: 46 &-t. Subdivision Lot # - ._J $_T - Is system fill completed? - P t Is system complete? ye Is system constructed as per plans? Y CA Is well drilled? _ __Y45 _ Is well located as per plans? — YOS Are erosion control measures in place? M5 Date: — Date: Date: _!T—1 /C) I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of ... Date: _ �' r _ __ Certified by: PE !G RA Defign Professional Address :' -_.27 � —P &c -4Lr ef Lic. # �7 � 7 FX�aT Comments: i tt-L � WEE' ABP W Dxm-en'T` Form FIR -99 ql:?Ol 0 f ? 11))VII, SHERLITA AMLER, MD, MS, IFAAP, � = Commissioner of Health ' r ..°- ..�_-- '-p ^.a rte: <t•'. Yz; -..-•: �. _„�. x.� -,.a. LORETH'A MOLINARI, RN, MSN Associate Commissioner of Health November 30, 2006 Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: R®HERT .D. H ®NDI _ _ County Executive, - . T., -: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Venezia Brookfalls Road, (T) Putnam Valley TM # 84- 1- 10.12, Lot # 1A The above referenced separate sewage treatment system can be backfilled. If you have any further questions, please contact me at (845) 278 -6130 ext. 2155. JD:kly Sincerely, yigit mil Josep 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 ATTENTION A AWK 0 GENE REQ jFST FOR, EDLk : INSPEUION For. Fill _ All information must be fully completed.prior to any Trenches_ inspections being made. PCHD Construction Permit Located: (T) (�j: :'t `f �AM VA Owner /Applicant Name: tou-u +awe .hc4 a -u ry TM Block i Lot a ,11 Formerly:. - - -- _ Subdivisioin Name: r�tnu. [yri AG-►j. Subdivision. Lot # f� Is system fill completed? /�-� r�3` . _ Date: t Is system complete? yes Date: ;zy lot, Is system constructed as per plans? _ Is well drilled? . IJO - bate: Is well located as per plans? Are erosion control measures in place? I certify that the system(s), as listed, at the above premises °has been constructed and I have inspected and verified their,. Completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, _Rules and Regulations of the, Putnam Couiaty Department of Date: y O G . Certified,by: of PE RA D04n PAofessional Address.- 7��'i� c ... Lic. # �s� 7 Comments: srZ7 �►•• ..r,.,......l�Fc�x BNt Form FIR -99 • ni uITV r.rnnnTMraSl'f ng A ___1 _. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES >� FINAL, SITE INSPECTION Date: 14§p.ected by: tre- Iasara inn ; .. �, !�. l%iL V :_ Owner-°.: Town n -) a)Qf"1 .VA a 41 Permit # 12y- 06 — 06 TM # /0 Subdivision Lot # / R 1. Sewage System Area a. STS area located as per approved plans .......... : ................ b.. Fill section - date of placement 3 :1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................. d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands .... ............................... H. Sewage System a. Septic tank size - 1,000 ...:.....1,250..' .....other ................ b. 'S eptic'tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set .......... ............................... 6. Trenefies 1. Length required 4� D d - Length installed 0 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ......:........................ 4. Slope of trench acceptable 1/16 - 1/32 /foot ............. 5. 10 ft. from property he - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ...................: .9., Depth of gravel in trench 12" minimum ....... :........... 10.. Pipe ends -ca ed::::.:............ :::. ......... ......... g. Pntaan or'D ®se vstenis ._ 1. Size of pump chamber ...................................... *......... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................................................... 6. Cycle witnessed by H.D. estimated flow /cycle........... IM House/Buildiaig T douse located per approved plans............. b. Number of bedrooms .. ........................................... IV. Well Well located as per approved plans .............. .. . b. Distance from STS area measured l�� ft........... c. Casing- 18" above grade ................ .............:................. d. Surface drainage around well acceptable ....................... V. OveraU Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate.... .... : .......................... i. Erosion control provided ................. ............................... Rev. ?2102 9 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICE PERMIT # Located at GPrri +_rALL s 1-2x Subdivision name ] r'trtAs (a,"y-! Subd. Lot # _!_19_ MAP 2`7`13 A Date Subdivision Approved _Pcyo N' 2 - 3 -° o Owner /A licant Name ' i PP UV ILL1 �asw% G-VJ E7—a (V Town or Tax Map _ Block 0 Lot 10,1,2- Renewal Revision Date of Previous Approval Mailing Address % % % ;?.eicsx�%�2L i %2�. � i��,..sr+,,,► d��?z�� =� i�•'�� Zip 00 -7` Amount of Fee Enclosed Building Type ^spi7r,j Lot Area 2.9'Z. No. of Bedrooms Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of `1 � gallon septic tank and 420 V s;,P a Z 1rJ lt�t� dah5�� "� �vu�2d�� �► �s Other Requirements: To be constructed by '%/31) -Zj o- -. W1, Water Supply: Public Supply From Address or _ Private:Supply;DrilIed:by. `TRD I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. Date 3-31-06 License # 4MVr? 7 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 for discharge of domestic sanitary sewage only. VcopyTitle: �� Date: l� D 6 - HD File; Yellow copy - Buil ing Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 P TIi NAM COUNTY DEPARTMENT OF HEALTH DMSffON OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL _. please print or type. .. ti. . _ PI:ID Pertlllt # PV . Well Location: Street Address: Town/V4lage Tax Grid # R �1=ALL�s 12O V-,)� 0�` ��,. MapSJ Block I Lots) Jz.,, 12- Well Owner: Name: Address: WILL' G FrJ 7-- 2- lil I JC7/cF-<9Zi /Z.A.0 , Pvi7- -4V11t. 1/441-C Use of Well: X_ Residential Public Supply Air/Cond./Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2- secoadair v Industrial Institutional Standby Amount of Use Yield Sought _5_ gpm # People Served �_ Est. of Daily Usage e,00 gal. }reason for Replace Existing Supply Test/Observation Additional Supply Dr llanng A New Supply (new dwelling) Deepen Existing Well Detailed Reason for IlDrill1i ng r-- vv, Via.: 12gss -7 6,;-! te, Well Type Drilled Driven Gravel Other Is well site subject to flooding? Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision )�d= s�;��i�z,s ��,-? r4 1-i 2'L'o A'"J Cc`imc'rj L.'Cy 8 Lot No. Water Well Contractor: ' AP -- fir � � ;� J.�yy Address: Is Public Water Supply available to site? Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: >SZxrtl Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: °-3 i — (c� _ , .Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue . �/I 5 0 Permit Is ping Offici d Date of Expiration 5' o Title: e�.Olt ':0 Permit is Non-Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 1�i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - •.r.�va P: .-� •YR •.^� ^cF'� �.. �- .:Y`T . .i r�- �.��,�y... `f� �..,'— ..... ,y- :�•�•rA�e. .�. _....� ;x^: ��.�:..::.._.. �_a�.. �.C.. �p4�.�s..v ��o c�.q. • :'�'... .✓._w APPLICATION TO ABANDON A WATER WELL please print or type PCHD PERMIT # + V -06 06 Well Location: Street Address: 5 lZDQ ►COAL," (DlA� Towne Tax Grid # �vi ►�° ,inn A LL Map 9 4 j Block / Lot(s)/P.17— Well Owner: Name: 6 �- L I A w� 1� iN _7 Address: -// / % .3 IZc�% C��t�s R� ?v7VVxl` -i 1*t r Well Type: Drilled Driven is Dug Gravel Other Depth Data: Well Depth s ft Static Water Level 0 ft Date Measured S-4-106 Use of Wells Residential Public Supply Air /Cond/Heat Pump Abandoned 1- primary Business Farm Test/Observation Other (specify) 2- secondary Industrial Institutional Standby Water Well Name: Address: Contractor: 713 D Reason For / /"� �"' rChSiz Abandonment: Description of Work To Be Performed: C' /3 %— yGG�s�YN✓ /rfN if�'Ij�fi�i,iiuus /ilr4 %� <R(_ /i► ',� iZ (= d.p Date: to Applicant Signature: �ra�/ PERMIT This permit, to abandon one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and/or Part 75 of 10 NYCRR and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. Date of Issue it Issuing Official PA/ Title White copy: HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WA -97 . is .+sk`ARMi=Ya°: "n'J". "�. -.. •:1.#M_sA3`^Cw�'»..�.n 27� Starr Ridge Road -6212 Brewster, JYY 10509. Fax. i' 278-0403 May 8, 2006 Mr. 'Joe Paravati Putnam County Department of Health .4 Geneva Road Brewster, New York 10509 Re: Venezia Residence Brookfalls Road Town of Putnam Valley, Putnam County, New York Tax Man 84 Block 1 Lot 10.12 Dear Mr. Paravati, Enclosed please find the plans as revised as per your comment letter dated May 3, 2006: 1. The fill notes have been added to the plans. 2. An Well abandonment form is enclosed. Enclosed please find a copy of the following items for your review and approval: o Application to abandon well form. o Plan and Profile- Separate Sewage Treatment System (4 copies) "trust the aboveIiidiirials are'adequate for. your`approval and com-I'- te -the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call me. Very truly yours, Michael J& E. Project Manager SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN T Associate Commissioner of Health Mike Beyer, PE Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509 Dear Mr. Beyer: ROBERT J. BONDI County Executive V� ROBERT MORRIS, PE ~ Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 May 3, 2006 Re: Proposed SSTS — Venezia 17 Brookfalls Road, (T) Putnam Valley TM# 84 -1 -10.12 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. Even though fill is for grading only, the fill notes still need to be provided. 2. Please provide a well abandonment form. This office will continue its review upon consideration of the above - mentioned comments. r 4 _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 ZZ-fStarr KidgeKoad Tel. (845) 278-6212 Brewster, NY 10509 Tax. (845) 27870403 April 24, 2006 Mr. Joe Paravati Putnam County Department of Health' 4 Geneva Road Brewster, New York 10509 Re: Venezia Residence Br6okfalls Road Town of Putnam Valley, Putnam County, New York. Tax'Man 84 Block I Lot 10.12 Dear Mr. Paravati, Enclosedpleasefind the plans as revised as per your comment letter dated April 14, 2006.- Fill is required for grading purposes only. The fill notes have been removed from the plans. The deep hole descriptions have been corrected. tt Veit co V,O The datum reference for this project is arbitrary as per the surveyor. There is minor grading shown for the proposed driveway. The common driveway is existing and will not be regarded. I nverts have been added to the seepage pit detail to illustrate a gravity system. A seepage pit detail has been added to the plans. 'Enclosedpleasefind a copy of the following items for your review and approval: Design Data,ShMi ® Plan and Profile- Separate Sewage Treatment System (4 copies) )fi I trust the above materials are adequate for your approval and complete the submission for the above project, However if you have any questions concerning this project, please do not hesitate to call. me. Very truly yours, Michdel Beyef-, P.E. Project Manager PROJECT ID NUMBER 617.20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTi& C136NS Oniy:. PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPONSOR 2. PROJECT NAME William Venzia Beyer & Associates Venezia Residence 3.PROJECT LOCATION: - Brookfalls Road, Putnam Valley Putnam County Municipality County 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or Drovide map 1/2 Mile north of Peekskill Hollow Road Intersection 5: IS PROPOSED ACTION: © New ❑ Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: New single family residential dwelling with onsite subsurface sewage disposal system and drilled water well. A total disturbance area of 7. AMOUNT OF LAND AFFECTED: Initially 2.92 acres Ultimately 2.92 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? © Yes ❑ No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ❑ Residential ❑ 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) ❑Yes ❑ No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE . A CURRENTLY VALID PERMIT OR APPROVAL? ©Yes E-1 No If yes, list agency name and permit / approval: Putnam Valley Development Approval Plan 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? es ✓ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name er'& Associates Consulting Engineers Date: March 31, 2006 Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment � ®l�7 BI .�IflAP ®%T ®SSESSAAEIUY /Te be cem�nleted I,v dead A ® ®ncal A. DOES ACTION CEED.ANY TYPE I THRESHOLD IN 6. NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAR ... E Yes No B. WILL ACTION R EIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No,.a negative declaration may he superseded by another involved agency: Yes C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers me y 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. �G Le— Aesthetic,_ agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: i C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: j .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, orrelated activities likely to be induced by the proposed action? Explain briefly:. i C6. Long term, short term, cumulative, or other effects not identified in C1 C5? Explain briefly: C7. Other im acts Qncludino chap es in use of either quantU or a of ener . Explain briefly: . D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTALAREA CEAt ?. if yes, explain, briefly: E: IS THERE, OR THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es ex lain: EYesNo , 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 significance 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 FL 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 act WILL NOT result in any significant adverse'environmental impacts AND provide, on attachments. as necessary, the reasons supporting I determination. ' Name of Lead Agency Date �O.SLpG, S. Lac l�l�t/L- (� f' rS` S r� �^� �/�LLC � G.�r�+ ����j /vt�%✓ Print "'o'rTyypeeName of legible Utticer in Leaa Agency Title of Responsible Officer o Responsible Officer in Ler Agency Signature of reparer different from responsible officer) _j SHERLITA AMLER, MD, MS, FAAP. Commissioner of Health - LORETTA MOLINARI, RN, MSN . Associate Commissioner of Health Mike Beyer, PE Beyer & Associates 273 Starr Ridge Road Brewster, NY 10509. Dear Mr. Beyer.: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive . ROBERT MORRIS, PE Director of Environmental Health April 14, 2006 Re: Proposed SSTS - Venezia 17 Brookfalls Road, (T) Putnam Valley TM# 84- 1- .10.12 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. Based on test data from the subdivision fill is not required. Please clarify the.reason and-why thz�f`i — 110tes-is'noting*3.5=fi'll 2. Deep hole descriptions for holes 3 arid. 4 don't match the subdivision file. .3. A datum reference needs to be provided. 4. _ Please show any regrading necessary for the common driveway and driveway. 5. It doesn't appear that the footing drain discharge can reach the seepage pit by gravity. 6. Please provide a seepage pit detail. 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, Q Jo, eph 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 InterventioniPreschool (845) 278 -6014 Fax (845).278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH.. .' TNDTVIDiJAL WATER SUPPL,$X &.SZ�A�g;SE�r•.�.�L'I�AT1i1ENT SYSTEIVLS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: kEVMWED.BY: RM, QR, J7P, SRDATE: ©(o TAX IvIAP#: (CONbIItbi1ED) aY -' l - l©. L Y N DOCNTS Y UMEN (R.EOUIRED DETAILS ONPLANS CONT'D� • 4�WELL PERMIT APPLICATION � HOUSE SEWER - �/d' FT, 4 "0'; TYPE PIPE. CAST IRON PERMIT OR PWS LETTER (�NO BENDS; MAX BENDS 45- W /CLEANOUT RENEWALS (��LETTER OFAUTHORiZATION (�} I4)4NOTE (NO CHANGE)_. - -. -- 7 l.eJI�ESIGN DATA SHEET (DDS) ��� SYSTEMS.i . (� CORPORA TE RESOLUTION I� -� (�(�10' HORIZONTAL; PAST TREPICH SLOPES 3:1 TO GRADE =(SHORT EAF L,JUFILL SPECS / FILL NOTES 1 -5 PLATtS -THREE SETS . `sue �w5 ». •.UUFILLPROFILE & DDZNSIONS (�(_ j9OUSE PLANS TWO SET 3 5 (�UFILL IN EXPA ION-AREA - (_LftAR7ANCE REQUEST or GREATER T}TANZ FEETµ SUBDIVISION (_,(___) CLAY BARRIER - - '+ LEGAL SUBDIVISION (_}(FILL CERTIFICATION NOTE SUBD'IV'ISION APPROVAL CHECKED �� �' � � UUDEPTH GAUGES ERC RATE 1 `7 /� 3 ryr� - - ---- - - - -- h9 UUVOL. ON PLAN FOR RO.B., fi3NCLASSTFIED & IMPERVIOUS RE HIRED DEPTF(u U(_,�SEPARATION DISTANCE FROM•TOE OF SLOPE CURTAIN DRAIN REQUI ED , �t` // TRENCH* � OERA'L (�L JLF TRENCH. ROVIDED 7�� 60FT MAID l(oo rectri'. �c UU`JLOCATED .IN NYC WATERSHED (,/ PARALLEL 'TO CONTOURS U - � A F-'D p PCHD DEP 100% EXPANSION PROVIDED E I PROVAL, IF HD U DETAEMUST FREE CRUSHED•STONE OR WASHED GRAVEL, GEOTEXTILE COVER- ' L�lEEP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN • FROM'SSTS / /(_j9ERC5 TO BE WITNESSED U��- 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL . / EX- APPROVAL SSDS ADJ, LOTS �20' TO FOUNDATION WALLS TLANDS (TOWN/DE ERNIIT REQ'D? ,c�.,.. 100' TO WELL, 200' IN DLOD,150' TQ PITS ATA ON DDS• PLANS & P!ERMIT SAME ( RE 1969 NEIGHBOR NOTIFICATION ., ck?3 C.-f) 100' TO.S'TREAM WATERCOUIRSE,,LAICE.(iac. ezpaA)^ !' ( jr,/ ( A0,' TQ -`a'_t 3ASIPE;3T.§TORNfDR2WMPLD rI.fiER'' '- � 10' TO WATER LINE (pits 20') . 0 YR. FLOOD ELEVATION W/I 200" ( -�50'• INTERNIITTENT DRAINAGE COURSE SOIL TESTING LOTS >IO YEARS OLD 200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS : (!jU10' MIl'� TO LEDGE .OU' TCROP SEWAGE SYSTEM PLAN - (NORTH ARROW) SEPTIC TANK �ESSDS � HYDRAULIC PROFILE ( U10, FROM I�'OUI�IDAT %ON; SO' TO WELL GRAVITY FLOW -- CONSTRUCTION NOTES 1 -15 DIM _ Y LMS DESIGN DATA: PERC &DEEP RESULTS L�ENSIONS TO PROPERTY T�IE5 OCATION OF SERVICE CONNECTION K=UR<S• FIST -Wa PROPOSED (� 15' TO PROPERTY LINE tD SWAY &SLOPES, CUT `'"°` ��` SLO E FOOTING/GU_TTER/CURTAiN re-) L LOPE w SSTS AREA _,LL__oam SDA SO UND S REGRADED TO 15 %, IF REQUIRED (�TTI'LE Bi,OCIC; OoVNERS NAME ADD'a'. U TM#, PE/ U, NAME, ADDRESS, PRO `' j°° r^ DOSE/P S U PUMP NOTES STE G f c°lenl,�n. .11)(' MTE nRDRsViSION (_)UDOSE 75% OF PI,PF.�tOLTJ1Vl�/DOSE VOLUME NOTED DATUM REFERENCE 1 (�LOCA TION OF WATERCOURSES, PONDS UL _)DETAM FOltFORCK.MAIN, (PIPE TYPE, ETC.) LAKES,WETLANDS WITHIN 200' OF P.L. • (-�; -PIDAY ' -BOX SHOWN & D7ETAMED �UPROPOSED FINISB[ FLOOR AND STORAGE ABOVE ALARM .- BASEMENT ELEVATIONS CYJRTAIN DRAIN (_)USTANDPIPES s' B?TH Sm �_-3PROPERTY WELLS A SSDS'S W/JN 200' OF SSTS METES �c ROUNDS (_ (_JIV MIN to CD ° , -4 %, $5'�3 %, 35' -1 %,100 % -<1% ERASION CONTROL FOR - HOUSE, WELL & UU20' A T ISCHA•RGE/100' with 102 cons day discharge SSTS,'EROSION CONTROL NOTE L_ � to NON - PERFORATED PIPE 5 h fix- (�Zv� �- P' �••� . PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH SERVICES .: APPLICATION FOR AI' -ROVAL OF PLANS FOIL A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: WILLIAM VENEZIA 17 BROOKFALLS ROAD PUTNAM VALLEY, NEW YORK 10579 2. Name of project: VENEZIA RESIDENCE 3. .Location. TN- TOWN OF PUTNAM VALLEY, NEW.YORK 4. Design Professional: BEYER & ASSOCIATES 5. , Address: ,273 STARR RIDGE RD, BREWSTER, NY 10509 .6. Drainage Basin:. HUDSON RIVER WATERSHED BASIN 7., I Me.of Project: xxxx Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (Specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....... ............................... Type I Exempt � m Type H Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required ? ............................ NO 10. Has DEIS been completed and found acceptable by lead Agency ? ...................... 11. Name of Lead Agency N/A 12. Is this project in an area under the control of local planning, zoning or other officials, ordinances? ............................................. ............................... YES 13. If so, have plans been submitted to such authorities? ....... ............................... YES N/A 14..Has.piTliminary approval been_granted by such authorities? YES _ Date�anted� 1a17ro5 15. Type of Sewage Treatment System Discharge:...... surface water xxxx 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 wA Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system ? ..................... NO 21. Name.of sewage system N/A Distance to sewage system N/A 22. Date test holes observed MAY 12, 2003 23. Name of Health Inspector JOE PARAVATI 24. Project design flow (gallons per day)....... ...................: ............................... 800 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 27. Is any portion of this project located within a designated Town or State wetland? YES 28 Wetlands ID N_ umjier. - , s ..... . •. • ...... ..... N/A _...._ .._ � .. f .v. .. r.. .iE .. ' .. � �•� ?;w. ..o--'�vi'c� Rl•. - >' ....._ •. _. ..v •..._ .. .:F i� �. ..,. -.y: ��.�` ...� -...v 29. Is Wetlands Permit required? .........................::.. ............................... YES Has application been made to Town or Local DEC office ? ....................:.... YES 30. Does project require a DEC Stream Disturbance Permit? ................ . NO 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, land filling, sludge application or industrial activity? ............................... Yes/No NO 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? T ............... Yes? No? NO DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ........:...................... YES 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ............................ ............................... NO 35. Are any sewage treatment areas in excess of 15% slope? ..... ............................... NO 36. Tax Map ID Number ...................... ............................Map sa Block 1 Lot 10.12 37. Approved plans are to be returned to: ............ Applicant XXXX Design Professional .....o.....-- ......- _. _.. _ - - _ .... .v _ o .. .. ...,.....•. ;a..,p a �• _. s..�. —. . _. . _ �...e .... ... --.. < _._.. �,.•. E•, - -.... ... ., m..,,.: :,a .. .- �c:..;,w.. 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 applicant shown in Item 1, the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFTFTICM TITLES. M�ijing Address: ........................... 273 STARR RIDGE ROAD BREWSTER, NEW YORK 10509 (845) 278 -6212 r PUTNAM COUNTY DEPARTMENT OF HEALTH ' DIVISION OF ENVIROMENTAL HEALTH SERVICES -DESIGN DATA'SHEET'- SUBSURFACE °SEWAGE TREATMENT SYSTEM Owner Bill Venezia Address 17 Brookfalls Road, Putnam Valley Located at (Street) Peekskill Hollow Road Tax Map 84 Block 1 Lot 10.12 . (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre = soaking 3/23/03 Date of Percolation Test 3/24/03 Hole No. Run No. Time Start -Stop Elapse Time (Min.) Depth to Water From Ground Surface (inches) Start Stop Water Level Dropp in Riches Percolation Rate Min/Inch P -1 1 4:44 - 5:03 19 18" - 21" 3" 6.3 2 5:05 - 5:25 20 1811- 21" Y 6.6 3 5:26 - 5:45 19 18" - 21" 3" 6.3 4 5 P -2 1 4:45 - 5:00 15 21" - 24" 3" 5 .2. 5 01 -5:16 __�5 � 4 : » 5'--" _- 3 5:18 -5:35 17 21 " -24" 3" 5.6 4 5 P -3 1 2 3 4 .. ivu i mss: t: tests, to,.oe repeatea at same aeptn until approximately equal percolation rates are obtained at each percolation test hole. (x : 5� 1 min for. -,1;30 min/inch, 5 2 min for 31 -60 min/inch) All data to be submitted for review. 2,,�1 ,p %easuremerits to be made from top of hole. Form DD -97 l DEPTH G.L. TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES, HOLE NO. 3 8" TOP SOEL 0.5' 1.0' REDISH BROWN SANDY LOAM . 1.5' 2.5' - 3.0' BROWN SANDY LOAM + 3.5 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5 9.0' 10.0' HOLE NO. 4 8" TOPSOIL 4 REDISH BROWN SANDY LOAM Indicate level at which groundwater is encountered GROUND WATER @ 6' -6" 6Y.6p9 Indicate level at which mottling is observed N/A HOLE NO. Indicate level to which water level rises after being encountered 6' 619 Deep hole observations made by: Joe Paravatti PCDOH, CC Beyer & Associates Date 05112103 Design Professional Name: Beyer and Associates Address: 273 Starr Ridge Road Signatu Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES -1WS1G--r-VDA-TA- SHEET-- UBSURFIACE-SEWA-GE'TREAI-IMENT`SYSTENI;---- Owner Venezia Address 17 Brookfalls Road, Putnam Valley Located at (Street) Peekskill Hollow ow Road Tax. Map 84 Block 1 Lot 10.12 (Indicate nearest cross street) Municipality Putnam Valley Pr4inage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test Hole No. Run No. Time Start —Stop Elapse Time (min•) Depth to Water From Ground Surface (inches) Start Stop Water Level D )riches ro n Percolation Rate Min/Inch 2 .4 5 NOTES: 1. Tests,tb'be retwit6d at same ame denth until annroximatelv eaual nercolation rate's are ohtained at each newenlatinn tp.-,t sole. i.e. 5 1'min for 1-36 n*inch,:5 2 min for 31-60 min/inch All data to be submitted for.review.- 2. be�th measurements i' ';'to! be"made from top of hole. til A, 14 Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Ir., � ,- �.. .. r> .:A:. r ti:??� �. �.. . -b w P �"cSCi; ^',i Y ..:.i;`. __�• -. _ . "'i: 1,. .r ... - .��'... --� ,- ns s. .e•. .:a:.. .� G.L. 0.5' . HOLE NO. 1 HOLE NO. 2 HOLE NO. 2" TRACE TOP SOIL 2" TRACE TOP SOIL BROWN SANDY 1.01 LIGHT BROWN SANDY LOAM LOAM 1.5� WITH GRAVEL 2.0' 2. S' DARK BROWN SANDY LOAM 3.0' . . 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' QQ8.5' 10.0' BOTTOM OF HOLE, NO ROCK BOTTOM OF HOLE, NO ROCK Indicate level at which groundwater is encountered 594" CIS' Indicate level at which mottling is observed NONE Indicate level to which water level rases after being encountered 5' -6" Deep bole observations made bye Joe Parovati - PCDOH, CC - Bever & Associates Date 5112103 Design Professional Name: Beyer and Associates � Address: 273 Starr Ridge Road Rre ter, N.Y 10509 Signature: 1" t q Design Professional's Seal _R PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES A, SHEET r IMSURFACE..SENVAGE TREATMENT SYSTEM-. - Owner Bill Venezia Address 17 Brookfalls Road, Putnam Valley Located at (Street) Peekskill Hollow Road Tax Map 84 Block 1 Lot 10.12 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking 3/23/03 Date of Percolation Test 3/24/03 Hole No. Run No. Time Start — Stop Elapse Time (Min.•) Depth to Water From Ground Surface (inches) Start stop Water Level D 0 s =e' Percolation Rate Minch P_ 1 1 4:44 — 5:03 .19. 18 -721" 3 6.3 2 5:05 — 5:25 20 18" - 21" 3 6.6 3 5:26 — 5:45 19 18" - 21" 3 6.3 4 5 P-2 1 4:45 — 5:00 15 21" — 24" 3 5 .--5:01.— 5:16 24 :,..... 3 5 3 5:18 — 5:35 17 21"—. 2491 3" 5.6 4 5 P-3 2 3 5 NOTES: 1. Jests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. ( i.e.:5 1 min for 1-30 min/inch,:5 2 min for 31-60 min/inch) All data to be submitted for review. 2. ;Depth measurements to be made from lop of hole. Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES I . ..a • +n, ...�..o.v c: ",_w c . d �� .. -, ..G7 ��i � ..5,; , .. .,r.. :.'� F., �..: � .�7,_ ..,*.:..�• - >r•-, +n. + .'• e, DEPTH HOLE NO 3 HOLE N 0. 4 HOLE NO. G.L. 0.5' Lo, 1.5 2.0' 2.5' 3.01 3.5' 4.0' 4.51, 5.0' 5.59 6.0' 6.5' 7.09 7.5' 8.0' 8.5' 9.01 10.01, 8" TOP SOIL REDISH BROWN SANDY LOAM BROWN SANDY LOAM + .GROUND WATER @ 6'-6" Indicate Revel at which groundwater is encountered 69-69$ Indicate Revel at which mottling is observed N/A Indicate Revel to which water level rises after being, encountered 6, 611 Deep hole observations made by: Joe Paravald - PCDOH, CC - Beyer & Associates Date 05112103 Design Professional Name: Beyer and Associates Address: 273 Starr Ridge Road Brewster, N.Y. 10509 Signature Design Professional's Seal NEW F q7 IV PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROMENTAL HEALTH SERVICES E SEW.A.GE 'TREATAIENT- YS: .. Owner Bill Venezia Address 17 Brookfalls Road, Putnam Valley Located at (Street) Peekskill Hollow Road Tax Map 84 Block 1 Lot 10.12 (Indicate nearest cross street) Municipality Putnam Valley Drainage Basin Hudson River Watershed SOIL PERCOLATION TEST DATA Date of Pre- soaking 3/23/03 Date of Percolation Test 3/24/03 Hole No. Run No. Time Start - Stop Elapps�e Time (M) Depth to Water From Ground Surface (inches) Start Stop Water Level Dropp in Inches Percolation Rate Min/ch In P -1 l 4:44 - 5:03 19 18" - 21" 3" 6.3 2 5:05 - 5:25 20 19 91 - 21" 3" 6.6 3 5:26 - 5:45 19 1893- 21" 3" 6.3 4 5 P -2 1 4:45 - 5:00 15 21" - 249' 3" 5 '217' -24;, 3" 5 3 5:18 -5:35 17 21 " -24" 3" 5.6 4 5 P -3 1 2 3 "? i- NOTES: 1. lests-to be, repeated at,same depth until approximately equal percolation.rates are obtained at each percolation test hole. }(�i.e. 5 1 min for 1 =30 5 . min/inch, 2 min for 31 -60 min/inch) All data to be submitted for review. 1 ` epth measurements to be made from top of hole. ;u: �. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES x 'I1`•J�; � :„p. :. sy' Gs r r,r. Y>:z o � i ..> +" :.�:�,c. ...w..`y ... �. :q.i: �,{':..xy o t_ _.. �,i .'.. psi.- -`M'•" ''� F' OK: Ski '<i �!�. ...., a... ..-.w. 4 ra. - r.q.- •,y• -� si e' :r '•. DEPTH HOLE NO. 3 HOLE NO. 4 HOLE NO. G.L. 8" TOP SOIL 8" TOP SOIL. 0.5'. 1.0 REDISH BROWN SANDY LOAM REDISH BROWN SANDY LOAM 1.5' 2.0' 17 1 2. S' BROWN SANDY LOAM + BROWN SANDY LOAM + GRAVEL W COBBLES GRAVEL W/ COBBLES 3.0' 3.5' 4.0' 4.5' 5.5' 6.0' 6.5' 7.0' GROUND WATER @ 6' -6" 7.5' 8.0' 8.5' 9.0' 10.0' Indicate fleveR at which groundwater is encountered 61°699 Indicate level at which mottling is observed N/A Indicate level to which water level rises after being encountered 6.6" Deep bole observations made by: Joe Paravatti e PCDOH, CC a Bever & Associates Date 05112 103 Design Professional Nance: Beyer and Associates Address: 273 Starr Ridge Road signatu Design Professionall's rr PUTNAM COUNTY DEPARTMENT OF HEALTH DIXISIOMOE ENVJRONMRNTA�: HEALTH LETTER OF AUTHORIZATION RE: Property of . William Venezia Located at Brookfalls Road TN T/ Putnam Valley Tax IN 84 -1 -10.12 Subdivision of Resubdivision of Lot 1 Brookfalls Cottage . Inc Subdivision Lot # 1A Filed Map 2 ` Date filed .3-2-Z-06, Gentlemen: This letter is to authorize Beyer & Associates Consulting Engineers. a duly licensed Professional Engineer X 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 construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. _..._..__...: Very truly-yours, Countersigned;/ Signed: (Owner of Prop ) MICHAEL F. BEYER, P.E. #074597 William Venezia Mailing Address 273 Starr Ridge Road Mailing Address 17 Brookfalls Road Brewster Putnam Valley State: New York Zip: 10541 State: New York Zip: 10579 Telephone: (845) '278 -6212 Telephone: (845) 528 -6963 Form LA -97 F� act 21 05 01:30P Planning Board (914) 526 -3307 p.5 -.a OF R .t4/T _ .. .DOH1S M. Z�EtC ®N THOMAS PATTERSON Chairman PLANNING BOA Secretary MCHAEL J. RAIMONDI 263 Oscawana Lake Road RICHARD FULLY Vice Chairman Putnam Valley, NY 20379-2004 EUGENE T. YETTM J PL THE CHAZEN COMPANIES JOSEPH C. AF.t".ERRA Town Planner (843 )526 -3740; Fax., (845)526 -3307 . (Adhoc) IINSITE ENGINEERING LAURA L. LUSSIER 'own Engineer Clerk October 17, 2005 BROOKFALLS COTTAGES INC. FINAL SUBDIVISION APPROVAL SITE DEVELOPMENT PLAN APPROVAL ri of 1) WETLANDS PE&MIT BROOKFALLS COURT TM.* 84.=1-10.1 FILE: 84.1705/986 & 987 WHEREAS, the Putnam Malley Planning Board is currently reviewing an application to permit a 2-Lot subdivision on 20.09 (fl-) acres of land located on Brooldalls Court in the Moderate - Density Residence (R-2) Zoning District; and WHEREAS, the Putnam `!alley Planning Board issued a Negative Declaration and granted Preliminary Subdivision Approval on October 17, 2006; and VMREAS, the Planning Board has determined that a final public hearing for the subdivision is not required; and WHEREAS, in accordance with §165.16 of the Zoning Code, a Site Development Plan is required;..and WHEREAS, the Planning Board has determined that a security is not required under §66- 7C(8)(b) of the Subdivision Regulations or §166-16C(3) of the Zoning Code; and WHEREAS, in accordance with Chapter 144 of the Town Code, a wetlands permit is required; and WHEREAS, the Code Enforcement Officer has determined that a Major Grading Permit is not required. NOW, THEREFORE, BE IT RESOLVED THAT, on motion by dtachard Tully, seconded by Michael Raimondi and carried, the public hearing for Final Subdivision Approval is hereby waived; and Page t of 3 Oct 21 05 01:31p Planning Board (914) 526 -3307 p.6 BE IT FURTHER RESOLVED THAT, on motion by Richard Tully, seconded by Eugene T. Yetter, Jr. and carried, the Planning Board hereby approves the Final Subdivision Plan prepared <W330 Herz° A I iY f?F;18s 1 i ;Sep er�1, t 8 bJe�cko- a beloiff -hite BE IT FURTHER RESOLVED THAT, on motion by Richard Tully, seconded by Eugene T. Yetter, Jr. and carried, the Putnam Valley Planning Board hereby approves the Site Development Plan prepared by Beyer & Associates, dated September 8, 2005 subject to the below-listed conditions; and BE IT FURTHER RESOLVED THAT, the Site Development Plan is valid far a period of 18 months after said Plan.has been signed by the Chairman and may be extended once, at the request of the applicant, by the Planning Board for a period not to exceed six months; grid BE IT FURTHER RESOLVED THAT, on motion by Richard Tully, seconded by Eugene T. Yetter, Jr. and carried, the Putnam Valley Planning Board hereby issues a Wetlands Permit subject to the signing of the Site Development Plan. The Wetlands Permit shall be valid for a maximum period of three years from the signing of the Site Development Plan. All work associated with the Wetlands Permit shall be conducted in strict compliance with the Site Development Plan and shall be completed within six months following the initiation of construction; and BE IT FURTHER RESOLVED THAT, in accordance with Chapter 144, the Planning Board, Wetlands Inspector and/or Code Enforcement Officer shall have the right to inspect the project from time to time; and BE IT FURTHER RESOLVED THAT, the Wetlands Permit shall automatically expire upon completion of work; and BE IT FURTHER RESOLVED THAT, the below-listed conditions must be completed within 6 months of the date of this resolution. Should the below - listed conditions not be completed within the allotted time frame, this resolution shall become null and void unless an extension is requestoo-Jil.writin_.g from the'ppplicant- within said _q month4period and granted by the Planning Board. 1. Submisgion of all applicable fees and escrow. 2. Submission of $5,000 recreation fee. 3. The conditions specified in the Preliminary Subdivision Approval resolution shall lie completed. 4. The driveways on Lots 2 and 3 (as shown on filed map 2793) shall be constructed in accordance with their respective Development Approval Plan, approved October 17, 2006. 5. This wetlands permit shall be prominently displayed at the project site during construction. 6. Prior to the issuance of a Building Permit, a pre - construction meeting shall be held with the applicant, contractor, Building Department, Highway Department, Wetlands Inspector, and Town Engineer. 7. Prior to the issuance of a Certificate of Occupancy, the Building Department small confirm with the Planning Board Clerk that all applicable fees and escrow have been paid in full. Page 2 of 3 4' Oct 21 05 01:32p Planning Board (91¢) 526 -3307 p.7 S. In an effort to ensure compliance with the approved Plana, monthly site visits shall be conducted with the applicant, contractor, Building Department, I3-ighway Department, Im09etor Win&- '-ToWn'Engineer aria -,a, final site,inspection sh:ill=be =r6na uctU :`: :. . prior to the issuance of a Certificate of Occupancy. 9. An as -built siuvey demonstrating compliance with the approved Plan shall be submitted to the Planning Board, Town Engineer, Town Planner, and Code Enforcement Officer prior to the issuance of a Certificate of Occupancy. 10. Prior to the signing of the Final Subdivision Plan or the Site Development Plan by the Chairman, a final report from the Town Engineer and Town Planner addressing resolution conformance shall be submitted to the Planning Board. 11. The Final Subdivision Plat shall be produced on mylar and contain the signatures of the owner of the property, the Putnam County Department of Health, a Licensed Land Surveyor, and a Licensed Professional Engineer. Eight original copies of the "Final Subdivision Plan shall be submitted for the Chairman's signature. 12. Fight original copies of the Site Development Plan, signed by a Licensed Professional Engineer and the owner of the property, sliall be submitted for the Chairman s signature. John M. Zarcone, Jr., Chairman N ichael.J. Raimondi, Jr., dice Chairman Thoma d Patterson, Secretary Euge T. Jose Bye tF�ojm . Z y' ! r' Yea Nay Abstention Absent X X X X Y • '. 273 Starr Ridge Road Tel.. (845) 278 -6212 Brewster, NY' 10509 'Fax. (845).278 -0403 Dear Mr.. Paravati, Our client, William Venezia, proposes to construct a single-family residence at the above address to be. serviced by an individual subsurface sewage. treatment system and a private;drilled well. The SSTS has been designed for a four bedroom residence, the client would like to finished the basement in the future and would prefer to upgrade and install the.system at this time. Enclosed please find a' of the following:items for your review and approval: • Construction Permit for Sewage Treatment System Application for Approval of Plans ford Wastewater Treatment System Application to Construct a Water Well -_ ... - ..._... • .... Design Data Sheets_ ., • Short Environmental Assessment Form. - • Plan and Profile- Separate Sewage Treatment System (4.copies) Fee'- Certified Check in the amount of $500 House Plans Layout (3 bedroom)( 2 Copies) • Letter of Authorization • Copy of Development Approval Plan, Wetland Permit Approval dated 10/17105. • Copy of Filed Map 2793A — Resubdivision of Brookfalls CottageLot L. I trust the above materials are adequate for your approval and complete the submission for the above project, . However if you have any questions concerning this project, please do not hesitate to call me. Very truly yours, . ll *4el Beyer, P.E. Project Manager Lu ® 7 °C 0 a QQ ((� J W W Z I i3 a _ zm O co ® O O � O0 1 0 Cpl j ... ..,. _.._. ._.._ .. ... .�. -.� _<� .PRA tF- __ � •.� . <_ _r ._�,:_ _ .a - ., ._... � _,: _a. --..`, .�. __ ...� ..... C-, ro 1 OY Z _ o , n ' cn D09,00 W 187 00 9 SSTS AS -BUILT l Cf%AI C• 1'— in' SWING TIES TABLE (FT.) MICRON- mmu� INN B�mw- Migo own w-,-, ON -M. owe OPEN No 0 �0- - No ON ► ME a" op-31-4- MR. IWM-04-91-0 E 0 r "T -M oll EMM-190- ON -M. o"00-151"o-M W-F. 9=1041-4- ON R. Mo. -01-0 ON 9.092601". M Mala WRENN- 0 NO -M. '"Zo 001-0 ON Immom-MR-4 ON ME M-M. m"WE"ll-la ON Ma Mo-WIR-4 -M. al I ME ow-wIlp"M OWE ► MOM 1,400- ON 0 �-- No NOW ► 0201"M ON -9. 09=21114-04 ON ► ME we 0-110"p-M ON opwom-p 1-04-4 w-wil"MIR -4 ON ► -M. mwr-ppd. @0 ON Emown -molp-M-4 ON ME lomp- M-M-0 NO 02-1, MR-0 00-mm"M-0104-4 w-M.'"MM"Imp-am ON ME w9l a-, 1p"M al ► Sm"m -10-1041-1 -Ma 0-0. ON ► -0. 290-10-141-4- ON 193"m up-14--a-M 0 ► 0 �M- - Ma a NEW 41-4 NO ► I p-M-PIR-01- ON -M, Mw-, No- -0 M-M., no a"Mod-4--a ON EMO-0 Mlop' -0 ON ON Room -0010"M NIN M."EmMoll., P.M. =Mplapo- ON SOM -woo IM ON ME wom-21 M-4 0 �w- - �lq a 0-mil ► mm-" la"O'Na soffil-Borm"wo ► opp-l-M-14 -_-a - ME ON ► 8=12M.-Ma ON ► p-owmapall-lo al I W-080020--a- IN=- - 'do ►=1 INN ON ► -M. own -plolop"M ON ► -M. Mo., plai'M ON ► imm"MOMEM-4-4 0�00- Moo NOR ► =0-0100-0- 1-0-02.041-04 0- -M. M-plapa"M NO ►-M. NO ►-M. Mwom"Goll, la ON ► im. 0 wimap 001"M OR. Own -2001-40 ON B."m pl-004" ON ON am ► EPSON Wl Opm Wl ► M go, 1-0-10Q -0 �-- 0 90 m 0 1 aM .. � lb.- -,oggM pppp- I NAME ppphp - INCOMES 'Ash 4111 �h�b-P-P-PA�p- PAb4hh- SEPTIC TANK Sra (GAL) OVERFLOW TANK (GAL) '/ ON ON wil"awow.0—No VIIII-0 ON ADDRESS: 17 BROOKFALLS coukT, PUTNAM VALLEY, NY TAX MO NO.: SECT 84 BLOCK 1 LOT 10.1. 2 SUDIVISION: BROOKFALLS COTTAGES RE-SUBDIVISION DESIGN PROFESSIONAL BEYER AND ASSOCIATES ADDRESS: 273 STARR RIDGE ROAD JtF,15FWiz, Fin VENEZIA RESIDENCE 15 BROOKFALLS COURT. PUTNAM VALLEY TOWN OF PUTNAM VALLEY PUTNAM COUNTY '/