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HomeMy WebLinkAbout4326DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.-l-37 BOX 33 04326 .+-- ec- �... �^'. R,^^' 1". �.. �.- r..+. �a.. . ?.a..-- ;«•�.w:a.ar�xace-r..(.- a -•-acs :..- ,zr.� -- �5�^ -� - .-mower :sil'.c '�'41T.'� T�'�'.� t - .�...•- r.i:...,. -.. .. -. .,. YD 11i1Ap[ CODPilY DMA OF EMALTH d Hellltb'SeeYloes.,Casnad.' N.Y lOSI? "k bo Psovlde park, `�' � cnCB>t;'lII�[CAT80FCOMPIJA . ix COI�FSRQ FO1t SSWAt� D�itJSi►L SYSTt3A[ - - Peaantt �N PV -1 96.. u +�' Town Of Putnam Yalley R� a P ki11'rHollow Road n. P FgotYii 11 Esfates : es- Tae 84. " 81 . 1 .� ' 37 rx Omm/AppRoM Kisiiee Brookfal s Development Corp. Rendwd- o R Date.4 Prevuele Appotowl Jan 18 1996 s A 330' West 45th Steeet Town ` NY . z-1 10036 Date Subdivision Abnroved . June .20f 1990 FM# 2477A Fee Enclosed ® Anln' lint $150:00 Residential 3.586 Ac 1YPe tot Ares FIp.SMOM 0* LJ Dth —vdo=' 4' 800 Nvhar of B olilsis Diikn Flow G P D PCHD Not flosti n V Eequked Wben FAD Is completed Sepeaete Sewed V Sysibas ft comib>< of 1 25%, S@O& To* A". 67%F of 24" w deabsorption trench To be constructed by To be .determined Addmu WM- Sapp: PAO. SsF* Flow Ad�eea X' To be _ determined a, ta.r�... gappb,.Dlfl" by edemas County Department., of Health. and that on compkrtion,theraOf a !!Cafiga be submitted to" tM�Oepartnant, and a writtal' guarantee will be, urnish pyce in good operating conditlon `any tla►t .of: saki sewage dispotit.Yystl aid of the approval of thi` Certifkate of Construction Complk+nce'of'1 wl" be located as'III*. we on tlae pprowd Plan and that Mid, well will pe install County' Department of Health, Doi* '6/7/96. Add nn . WWEY & ,WATSONi. P` APPROVED FOR CONSTRUCTION: This approiral expires two y_ 1 revocable for us or may be'arniinded or modified when consid ed "Quires a dw p ► it. Approved for disposal 'of.domedii san ,, Rev. 10/88 oa By n . us ion- of,•the proposed systom(s), 1 that the separate' tew" "di . sal s stem to and' in Yceordanee.witn the stendards, rules a regu W. o e nom of .Construction Compliance" satisfactory to the Commissioner of Healthwill the owner. .his wicassors,:hiiraor.assigns by the bulkier, -that said builder will during the period:of two (2) years Immhdiatety following'the "to of the Issu- ofiginal system of repairs thereto; 2) that the drilled well described above in rds ' 'w h . M, standard; rules and rag-M Eons oof the. Putnam l P.E. X R.A. ,Z.§ COLD SPRING License No 62505 date Issued- unless Construction of the building has been undertaken and is by the' inissiolier of Health. Any Change or N ation of Construction {nq%or. te' wafter supply only, r, i}1, Title k� . I . q�.. w Pt \ \ Ton`. o f �tnam Val 1 eekski.11 Hollow Road Tooth - '1,Y.. Esta 'es W t 3 84 .� 1 - . 37 i Brookfalls Development Corps — ° °`' Date ca p nv Rio Ag ri DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 AP'PLICATION' TO'•CONSTRUCT -•A• WATER_- WELL` "-..: �� %� -) PCHD PERMIT # `I U 1_- /C% 4 WELL LOCATION Street Address Town Village City Tax Grid Number Hollow Rd Putnam Valle 84. -1 -37 WELL OWNER ..pepkskill Name Mailing Address y r : �• Private Br..00kfa'11s;Develo menu CorpeF 33`O�W 445th St NY NY Public fkRESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ❑ ABANDONED 0 BUSINESS ❑ FARM [:)TEST/OBSERVATION ❑ OTHER (specify, 0 INDUSTRIAL M INSTITUTIONAL ❑ STAND -BY O USE OF WELL 1- primary 2 - secondary AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 500 gal 0 REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION 13 ADDITIONAL SUPPLY )aNEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING To serve proposed four bedroom residence WELL TYPE DRILLED DRIVEN ODUG 13GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Foothill Estates West Lot No. WATER WELL CONTRACTOR: Name to be determined Address: %, I . w '1S PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY -.DISTANCE TO PROPERTY FROM NEAREST WATER'-MAIN: N/A LOCATION SKETCH•& SOURCES OF CONTAMINATION PROVIDED . ®ON SEPARATE SHEET (date) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well'Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drYLg rations be contained on this property and in suc a manner as not to degrade or otnt pate surface or groundwater. �le of Issue: 19�' Date of Expiration �` 19 Per Official Permit is Non - Transfer able White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services APPEPIDIX L AFFIDAVIT - CORPORATE OWNER APPLICATION 11• w FOR PER %IIT APPLICATION SUBMITTED TO PUTNA:I COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In, the matter of application for: Construction Permit for Sewage Disposal - System & Water Well I I,. David M. Schwartz. represent that I am an officer or employee of the corporation 'and am authorized to act for Brookfalls Development Corporation (Name of Corporation) having offices at 330 West 45th Street, New York, New York 10036.: Whose officers are: President: Niles Schwartz, 330 West-45th St., NY, NY 10036.. (Name and Address) Vice - President: (Name and Address) Secretary: (Name and Address) Treasurer: (Name and Address) and that I am and will be. individually. responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this 29 day of._.. Vecembe r, 1995 Notary Public REBECCA W LINDA NOTARY PUBLIC, State of New bob No. 5004353 Qualified in Dutchess County'�®. Commission Expires November 16. � . . 8/84 =- - Cnrnnra'te Sea C 0 tJN'I'Y* D.'!'.PJU1TMf.,q'r oi� APPENDIX. K DIVISION OF ENVIROMMENTAL-11EALTH SERVICES Date December 29, 1995 Re: Property,of Brookfalls DeveXopment Corp----- Located at Peekskill Hollow Road M Putnam Valley Section 84 —Blocl(.__.__ I _—Lo t_3 7 Subdivision Of_ Foothill Estates -. . . . . . Subdv. Lot t'll 3 Filed IMap # 2477A Date 6/20/90 Gentlemen: This letter is to authorize John P. Delano, P.F. a duly licensed professional engineer X or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulag-ated by the Conialissioner of the Putnam Count,,, Departme.nt of Health, and to s-ign all necessary pa-pers on my behalf. in •connection with this matter and to supervise the construction of said system or systems in conformity with the provisions Of K•'Cicle -145 -or 147, Education Law, :1--he Public Health Law, and .the Putnam Couiity Sani- ,tary Code. Very trul.y yours, Signed Owner of Propc -Y uitersigncd: 11rop rrT Ait P.E. , I.xxxx, # ?2505 330 West 45th St-rppt- Address ,BADEY & WATSON, P.C. Address :US Route 9 Cold Sprinq NY 10516 Telephone New York, NY 10036 T a w-n (212) 247-3450 Telephone PUTNAM COUNI.'Y DEPART= OF HEALTH. DIV SION OF HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SSTPGE DISPOSAL SYSTEM FILE. NO. Nay `ri -_ _ • .' "Ow. .e... r -. -e- lo -- p[12I] t' _ b• � °ass .�•i -'ni .a: -' -;-%.. �- . pr ., •,.f -- 'n�;; tie• :rw � ; ^.:; - - . ;;L _:� ;.- �� WPGt _45t-h .S`t- Nv, n1v n0�ti . Located at (Street) p e e k s k i l l Hollow Road See. H 4 1. Lot 37 (indi.cate nearest cross street) Subd ..Lot 3 Municipality T/0 Putnam Valley Watershed peekskill Hollow Brook SOIL PERCDLATiG'N TEST DATA REQUIRED TO BE SUEhLCTTED WITH .APPLICATIONS Date of Pre - Soaking 1/22/88 Date of Percolation Test 1/22/08 BOLE NUfi BER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground,Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In. Min /In Drop Inches _ Inches Inches 1 9:14 -9:44 30 24 �1S_n 30 2 9:48 -10:18 30 23.5 24.0 1 30 3 10 :20- 10:50 30 24 25.0 1. 30 _.. 4 5 1 9:1.6 -9:44 . 30 24 27 10 4.7;- n10.17y 3 .5 1 2 S,q;i7L••ajyf f. 3 4 i r ; y^, .•+. mod' .. 1 .. s N=: 1:'�.:, J ,�,,,ko be. repeated at sari ,depth _.until approximately equal soil rates are obtained at each percolation 'test hole. ,All data .to. be submu.ttbd for review. 2. Depth masurarents to,.be made -.fran top of hole. rev. 9/85 t'1'1• Lu�'LH to u 1 � -J.v L1G Oumn- .L-L -. U rrll.n rarrL. .- n.L -Lun DESCRIPTION OF .SOILS �aNCOUNI= IN :TEST HOLES DEPTH HOLE NO. A HOLE M. B HOLE NO. Topsoil. 0' - 6" .Topsoil 1' Silt Loam Silt Loam 21 w /rocks & cobbles w /rocks & cobles 3' 4,1 5' 61 Clay Loam @ 6' -0" 7' 81 9' Clay Loam 10' 11' 12' 13' 14' Clay Loam @ 61-0" INDICATE _ LEVEL AT WHICH iGROUNU7,VM.R IS ENCOUNTERED. not encountered INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED N/A DEEP HOLE OBSERVATIONS MADE BY: BADEY & WATSON, P.C. DATE: 12/3/87 DESIGN Soil Rate Used 30 Min /1" Drop: S.D. Usable Area Provided 8,000 SF- No. of Bedroans 4 Septic Tank. Capacity 1, 250 gals. Type_ Conc . Absorption Area Provided By 667 L.F. x.24" width trench Other Pump .pit. with audio - visual alarm _ ".evtco�ooPip�o,.. Name BADEY & WATSON Signature Surveying & Engineering, . P., C. . Vj Address Route 9 Ste, ® t7 Cold Spring NY 10516 O ( 914) 265 -9217 ej 0 62 �® �'o ®sOFESSIO��� i THIS S A kqR USE BY 'HEALTH DEPARMT. ONLY.:. D�d86i4i6a Soil Rate Approved sq_£t /gal. Checked by Date pC -1 r -r. PICJTIVAM CC)UWr 'Y 1D1E1PAJ6E''MENr C IF MEALrrM APPL-MATION- FOR--`A'PPRc)VAt -:,—(5 P�;4NS" FOR" a'' 4N? STEW�F�R `�Di5P0�A'L'�YSl'�Ffi°. """`". "' .A;;: °" 1. Name and Address of Applicant: BrookfaTTs:.- Development Corp. 330 West 45th Street New York, NY 10036 1 2. Name of Project: Same as Applicant 14. W Project Engineer: Badey & Watson, P.C. 3. Location .TJKW:Z: Putnam ya 1 1 Py_ 5.. Address;'.. ys Route 9 o• W License Number: 62505 Phone: 265 -9217 Type of Project: X Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) T. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (Check One) Type I.. T Exempt Type II. Unlisted X 3. Is�a Draft Environmental Impact Statement (DEIS) required? NO Has DEIS been completed and found acceptable by Lead Agency? ........... N/A ). Name of Lead Agency Putnam County Department of Health J. Is.-thi.s:_;p.roject•:in. an-area-_under control of local, planni-ng,,: _-zoning, - •< or other officials, ordinances? .... °Y1✓S` If so, have plans been submitted to such authorities? NO Has preliminary approval been granted by such. authorities'? No _ Date.Granted: N/A . Type of Sewage Disposal System Discharge...... Surface Water • X Ground Waters . If surface water discharge, what is the stream class designation ?........ N/A . Waters index number (surface) ........... ............................... Is project located near a public water supply system? .................. N/A NO If yes, name of water supply N/A Distance to water supply N/A . Is project site near a public sewage collection'or disposal 'system ?..... NO . Name of sewage system )ate observed: May 1987 N/A Distance to sewage system N/A 23. Name of Health Inspector.: Michael J. Budzinski, P.E; . Project design flow (gallons per day) ... 800 2. state :Po-lzl.- t- an' t?- D- ischar _g..E.11•mtnat4ora- LSyst--em '�SPDES )•-Permit.- requ­i 6&-... 26. Has SPDES Application been submitted to local DEC Office? ............... NO 27. Is any portion of this project located within a designated Town or State wetland? ... ............................... ............................. 28. Wetland ID Number ........................ ............................... 29. Is Wetland Permit required? ........................ NO N/A Q Has application been made to Town or Local DEC Office? .................. N/A 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, landfilling, sludge application or industrial activity? ........ YES or NO NO 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO NO DESCRIBE: 33. Is there a local master plan or file with the gown or Village? YES 34. Are community water, sewer facilities planned to be developed within 15 years? NO -35-!-Are any sewage disposal areas jr excess o'f 15/10 slope? ........................ . N 36. Tax Map ID Number ........................................................ 84.-l-37 37. Approved Plans are to be returned to: Applicant X Engineer 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. 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. _ r-, SIGNATURES & OFFICIAL TITLES: ie,C!/1��tty-zac) ria Engineer for Applicant BaVey & Watson, Surveying & Engineering, P.C. MAILING ADDRESS: Route 9 Cold Spring NY 10516 BADEY & WATSON Surveying and Engineering, P.C. Aotitp 9— ff'§Pring, Nfiif5Y6-' (914) 265-9217 739-3577 628-1800 FAX (914) 265-4428 - TO: Putnam County Department of Health 4 Geneva Rd. Brewster, NY 10509 We are sending you: Via: Hand Deliver Attached These are transmitted: Remarks: Copy to: For approval. LETTER OF TRANSMITTAL Date: December 29, 1995 Attention: Mr Robert Morris, P.E. Re: Brookfalls Development Corp. SSDS Permit Peekskill Hollow Road Town of Putnam Valley TM# 84.- 1 - 37, Sub Lot # 3 Description SSDS Permit Application Well Permit Application Application Form PC -1 Check for $300 as application fee. -:L6tter_of.-Aiithotiiatibii-' :*;�'----.—'-'-:'�--�-'—'.-.--.,,. Corporate Resolution Design Data Sheet SSDS Plan - A Signed: Kurt Schollmeyer, P.E. Gies Date No. 1 12/29/95 1 12/29/95 - 12/29%9` 1 12/29/95 1 3 12/29/95 These are transmitted: Remarks: Copy to: For approval. LETTER OF TRANSMITTAL Date: December 29, 1995 Attention: Mr Robert Morris, P.E. Re: Brookfalls Development Corp. SSDS Permit Peekskill Hollow Road Town of Putnam Valley TM# 84.- 1 - 37, Sub Lot # 3 Description SSDS Permit Application Well Permit Application Application Form PC -1 Check for $300 as application fee. -:L6tter_of.-Aiithotiiatibii-' :*;�'----.—'-'-:'�--�-'—'.-.--.,,. Corporate Resolution Design Data Sheet SSDS Plan - A Signed: Kurt Schollmeyer, P.E. APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES aAI. =. SUPPL' i':;.&.. .SEUBS-UUAC-E�SEWAGF-,Y)ISRO�4. YSTE�.S REVIEW SHEET for CONSTRUCTION PERMIT STREET LOCATION NAME OF OWNER BY B. HEDGES R.MORRIS OTHER DATE TAX MAP # - DOCUMENTS. Y Y ERMIT APPLICATION XP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE 1 IF PUMPED PIT & D BOX SHOWN & DETAILED_ LL PERMIT PWS LETTER ,HOUSE - NO. OF BEDROOMS AUTHORIZATION DESIGN DATA SHEET(DDS) CORPORATE RESOLUTION �LANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST SUBDIVISION LEGAL SUBDIVISION SUBDIVISION APPROVAL- CHECKED 3 PER C RATE /,F"/,ILL REQUIRED DEPTH CURTAIN DRAIN REQUIRED mSTANDPIPES WELLS & SSDS'S WIN 200 FT. OF PROPOSED SYSTEM ROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) lHOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE -NO BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS LAYBARRIER 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE FILL SPECS m FILL NOTES FILL CERTIFICATION NOTE DEPTH GAUGES FILL PROFILE & DIMENSIONS VOLUME GENERAL FILL IN EXPANSION AREA EIj'EX- APPROVAL SSDS ADJ. LOTS WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH l o ATA ON DDS PLANS & PERMIT SAME LF TRENCH PROVIDED m 60 FT MAX P ! - . - 1969 :NEIGHBOR NOT, IFICATION ..., _ 0PARAL' U*L TQCONTOURS ETTER FUZBA 100% EXPANSION PROVIDED 00 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS ' 'EWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE m GRAVITY FLOW CONSTRUCTION NOTES (GRINDER NOTE) DESIGN DATA: PERC AND DEEP RESULTS TWO -FOOT CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES CUT AIN DRAINS tROSION CONTROL; HOUSE,WELL, SSDS EROSION CONTROL NOTE kRC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY AND EXPANSION t a' x.10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL ® 20' TO FOUNDATION WALLS Ei 15' WELL TO P.I 100 TO WELL, 200' IN D.L.O.D., 150' PITS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (PITS -20') 50' INTERMITTENT DRAINAGE COURSE © 200 FT. RESERVOIR, ETCH 150 FT. GALLEY SYSTEMS M" 15'MINTO C.D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' <1% M 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. SEPTIC TANK m 10' FROM FOUNDATION; 50' TO WELL COMMENTS: f. P.UTNAM COUNTY DEPARTMENT OF HEALTH L � RE 3/ 6 Division of Env,`mental Health Servicee;'Carmel, N.Y. 10512 / F ... V/ Enghieer ee Mt Provide 2 P.0 H D. Permit (iT- GODTSTRIJGTIOXV.COMPUANCE F.OR >SEWAGEvDESP:Q5&..k T y is ^�'� Town�or'V e" if Located at Tea Map Black _Lot _ -7 ''w p� i` l.l� v5T -tES� ... �b�,�1 �� �+f�ormerl Sabdivlsion -Name Sabdv..Lot N- Owner /appllcart Name Y Melling Address' P Date Permit issued Separate Sewerage System built by >� Q't Address Consisting of Z Gallon Septic Tank and Water Supply: Public Supply From Address _ or: Private Supply Drilled by • 1k) Address ` k, J . Ar L-Lt Building Type iG j( j!j JNTI ib.'L Has Erosion Control Been. Completed? Number of Bedrooms �' Has';Garbage Grinder Been'installed? Other Requirements ir'�/u L1� Cr+r uAc I certify that the system(s) ae listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in 'accordance with the standards, rules and regal Iona in ace an ith the filed plan, and the permit issued by the Putnam County Department Of Health. Date �.1�, c I ru, + t Certified by P.E. � R.A. h'Qr —,, 1^J �l.icensa No. Address _ J 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 were sy ' m shall become null and void as -soon as a publi: unitary sewer becomes available and the approval of the private water supply shall become null n. vo wtian. a public ter supply becomes available. Such approvals are subject to m dificati or change when, in the judgment of the Corn I er f' HH,aea�llthh. suc ocation, modlfication or change Is necessary. Date Z y :— Title co� WELL COMPLETION REPORT VLL LCC UOC %J&L.Ly DEPARTMENT OF HEALTH �� .Y��a division Of" k PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATION STREET VAIVILLAGILICHY TAX GRID NUMBER: 0 F 'A WELL OWNER ADDRESS: Co TAY 149-0S411 0 PQIVATE 0 PUBLIC USE"OF WELL 1 - primary 2- secondary —aAglOENTIAL "0 PUBLIC fUPPLY ❑ AIR /COND./ EAT PUMP 0 ABANDONED 0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (spe'cify) C3 INDUSTRIAL 0 INSTITUTIONAL 0 STAND-BY 0 AMOUNT OF USE YIELD SOUGHT _L_ gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE 2� _0 gal. REASON FOR DRILLING .[]REPLACE EXISTING SUPPLY OTEST/OBSERVATION []ADDITIONAL SUPPLY ONEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH —ft. I STATIC WATER LEVEL ft. I DATE MEASURED DRILLING EQUIPMENT FIROTARY 0 COMPRESSED AIR PERCUSSION 0 DUG 0 WELL POINT 0 CABLE PERCUSSION 0 OTHER (specify): WELL TYPE 0 SCREENED 0 OPEN END CASING 0 OPEN HOLE IN BEDROCK 0 OTHER TOTAL LENGTH ft MATERIALS: 0 STEEL 0 PLASTIC 0 OTHER CASING DETAILS LENGTH BELOW GRADE ft JOINTS: OWELDED JaTHREADED OOTHER DIAMETER in. SEAL: 9LCEMENT GROUT 0 BENTONITE 0 OTHER WEIGHT PER FOOT j 1b./It. I DRIVE SHOE. 2-YES ONO I LINER: DYES KNO SCREEN DETAILS. DIAMETER (in) 'SLOT SIZE LENGTH (11) DEPTH TO SCREEN (ft) DEVELOPED? FIRST 0 YES ONO GRAVEL PACK I YES 0 NO GRAVEL SIZE: DIAMETER OF PACK in. I TOP DEPTH —ft. BOTTOM DEPTH — ft. WELL YIELD TEST If detailed pumping METHOD: 0 PUMPED tests Weir 0011G 15 in- ,,COMPRESSED AIR !ormation attached? 0 BAILED 0 OTHER 0 YES ❑ NO more detailed formation descriptions or sieve analyses WELL LOG Ire available, please attach. DEPTH FROM SURFACE Water Pear- Inq Well Dia- meter In FORMATION DESCRIPTION CDOE tt. tt. WELL DEPTH DURATION hr. min. DRAWOOWN It. YIELD 9prn. Land Surface -A� 3 6" WATER j2'tLEAR TEMP. QUALITY .0 CLOUDY HARDNESS 0 COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? 0 YES 0 NO STORAGE TANK: TYPE CAPACITY GAI,. PUMP IXFQRMXTION TYPE 342441— CAPACITY s 0 MAKER &dtT±V,2 DEPTH to MOOFt 4TO, 5 9 /3 VOLTAGE x 20Z HP WELL DRILLER NAME '7to,20� g9o4&,A�-.,&e nATF S�r ADDRESS SIGNATURE ,�y YML ENV1RONMENTAL SERVICES 321 Fear Street Yorktown Heilhts, N.Y. 10598 (914) 245 -2800 Albert H. Padovani, Director .• _ :•.•_ �.._.., _ ...... :.. i ' ... • r ra 4 cr : r t . a . -. .> ,: . � _ . q . - .' r.� '"y'° .. ..- : "m: .... r erw c. -, a.. is . ... , r ... :.a• LAB #: 32.41933! CLIENT #: 5698 NON STAT PROC PACE 1 NN / + /Jppj Nl'J /J /J /iN/J IJN----- N/JNNN - --- ---- NN/JNN ----------- ---- NN/JNNIJrJP+ /JNN /. ---- IJNNN / +/ +PJryN FOOTHILLS HOME BUILDER DATE /TIME TAKEN: 12/20/96 11:00 330 WE:-T 45TH ST DA'rE /'TIME RECD: 12/20/96. 12-'20 NEW YORE'., NY 10036 REPORT DATE: 12/23/90 PHONE: (212) - 265 -5189 SAMPLING SITE: 117 PEEKSKILL HOLLOW RD SAMPLE TYPE..: POTABLE PUTNAM VALLEY NY 'PRESERVA'r I VEE;: NONE C:OL'D BY: DAVID SCHWARTZ TEMPERATURE..: C 4C NOTES....: OUTSIDE HOSE COLIFORM METH: MF Nr +N /+/ +� +NNNNNN /+N /JNN /JNNI+N / +NI•JNNN /+ry /JN /JN /INN /JN NNN /JN /JNNN /J /JNN NNIJN /J /J /JN /+N /J /J- --/+/J I4I--- -/J - -- DATE ..FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 12/20/96 Mt- T. COLIFORM ABSENT /100 ML. ABSENT COMMENTS: BACT THESE RESULTS INDICATE THAT THE WA'T'ER (WAS NOT) OF A SATISFACTORY tANITARY.OUALITY ACCORDING "i'O THE NEW YORK STATE AND EPA FEDERAL DRINKING+ WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. 3UBM I TIED BY: __ - - - -__ ----------------- Albert H. Padovani, M.T. (ASC•P) Director FLAP# 10323 12 -20 -1996 10:43AM FROM S J LORE 914 876 1276 XV.LaJ.v'-. vc ��V.L[SVL�t'WL�l7ttilJ 3Sxi�iL I.- .a.;�•%�a`,;; e".f.':s�x' �_. -.r.. �•_•s, .r ....v.- .. >v2: .:.:J�s-,�;.;; -is; :;:�;sb,= ,ws'anc Miles Sohwartz 0 xe or dldSP.i Brookfalls Development Corn.. Town of Putnam Vill Ii 84 1 35 �Ft on Block Lot Foothill Zst:ates West subdivision Nan* Subdiviti=f i bat I I represent that I am wholly and completely responsible for the location, workmanship, rateria3 constrzaction and draxnag�; of the sewage :disposal. system serving the above ' described property, and that it has been const ' cted as shmn on f the approved plane approved amendment thereto, and in accordance. with the standards, rules an4 regulations of the Putnam County Department of Health, and hereby guarantee to e owner, his suwesso>;s, heirs or assigns, .to place an good operating condition any part of said system constructed by me which fails t® .operate for a period Of two years i =ediately following the date of approval, of the "Certificate vg. Construction Compliance" for the sewage disposal system, or any repairs made by re to such system, except where the failure to operate properly is ca>ise y the willft or neg3.zgent act of the ccaq=t.,.of.. the .buildin.g. utiliza4 • = . the S�t�.. - -:: ._... _ . . ,.. _.. _ ._ _ ... _ , .- . __...:. ...�.. �_.........� , . The undersigned farther agrees to accept as conclusive the deteaninat -jen of the Director of the, Division of Snvi.ron�e tal Hezl to S ces o the Putnam County. Department of Heal as to whether or not ttse fai e s 'en o to was caused by the wailful or negligent act of ..ocm nt of tine bu' d'ngj liziag the system. Dw.ted this % d New York, rev. 9/95. mic Of 19 17-k Lure w Yok 10036 Title S.J.. Gone 233 57 Broadway R90-0-0k, Haw Address TOTAL P.CA2 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION I'0 `CONSTRUCT' A' WATER' - WELL -- -� «1 �= . A 9•mY PCHD PERMIT I I WELL LOCATION Street Address Town Village City Tax Grid .Number it AVr i �rA 1 t1/J64 k . WELL OWNER Name Mailing A dress kffi % ��1 p7 j -G Ly 9tr74"5 tm „1 6,�1 Gr��l a �� y ,'Private b Public SE OF WELL - primary 2- secondary 9BUSINESS RESIDENTIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INDUSTRIAL 0 INSTITUTIONAL O STAND -BY ❑ ABANDONED O OTHER (specify p AMOUNT OF USE R SA aC YIELD SOUGHT _gpm /# 11,01 H -SERVED /EST. OF DAILY USAGE �e Q tal O REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13 ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING pev,- A ,p"/t_4 1.J L WELL TYPE DRILLED DRIVEN [3DUG OGRAVEL 0OTHER IS WELL SITE SUBJECT TO FLOODING? YES k-'NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: S'U% ,�� 1 1j �w+ WATER WELL CONTRACTOR: Name 210 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: /# /If TOWN /VIL /CITY DiSTANCE;TO PROPERTY FROM NEAREST WATER MAIN: --- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED IZ]ON SEPARATE SHEET (date) J (signat re) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall t appropriate action to assure that any and'all water or waste products from such well drill g o erations be contained on this property and in such a manner as not to degrade or other w ontam to surface or groundwater. Date of Issue: �-- 19 q - �/ Date of Expiration 19� Permit Issuing Official Permit is Non - Transferr ble White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller . •� 9t M� � au' u�d ..N_I,�Yi'l�AYI1/�I.v,.u1g3 ��6BL:W ®LL' 1CLOibaL}LyLL(fyal ^/v��'e� 402 . fi^ �1�1VI lWYa..&t1YW N II� Y °�A LL6/. gW}/�Ctl�Wp6i�Y _ �y�y N 7PV!!l�YifDW Era= 8J 13w1044f' -' �Vq l P--dw am 0 V ''(l. + L . �6l[` t � v •' � :.. rt '.:. - Dad. ad A.'eve. kliiwov� Subdivision.-ARgroved 10 Fee. Enclosed 0406 � .rA "1/L % /� �GRr '.. ., . IIrrDQ Aii<aa , IP@� DwA Flo' PCEM m wwml aw e mi&== G I? HD m Od mwxhQ4 mm Oe emdwa � 3r ����, of aI, - D . 1.re prosont.that I..am, whollylana -eoi above d6scribed. Will be constructod county d*rtrpC l4 09 , DOegl¢h, a1 bo WrAfnit4od 'QO' 4iju Do�?rtmont, Pbco in {arid ogcaaitiWp crDwQliQlon 0740 09-:tlio ap ?6ye1 09 tlq::Gortii pNl ®O.CSaCL14E1d 0s L906�W dfl tIto now C®Ynty Dcarivi664 o9 HCgtQ bate 3 y 69. APPROVtO FOR COWSYWUCTIORI this approval. expires rovoldbio for cause 'o''r ay.Do' ameruia 6r'modificd when e D^ vemui►os a 110 pormi Apprasod Rev. 10/88 Doto — lesignand. locution,; of.. tho .- .proposaB.systom(s)1.1). -that the.saparota',sew+ di sel atom andmont there t0 and in accordance with the standards. rules a regY ns 0_ nem I a "f:ortifjwto.,or Construction Compliance" wtisfaetory to the Corrlmisslorm of HoalQhenill i 6 furnished the oirnw. hls suceos!=% holrs or awlene by.tho build¢r, that sold builder will isgo>�1 sys!orn durk* the porlo® of teeo.(2) ycarss imn"Iatoly 4o110a1ir1a tho®bto of Oho Imu 711gnce of,,. t66 original system pF any reROara thdoQO; 2) that tholarillod rrolf i®oasal®c4 abovo till, bo lnstalle tcordaneo "eo he'.sQarl�gr® ukla and rOgY a( $bona 04tbo Putnam bnod A.A. r A14 10 e /�. /' i L License P10 ..,ZI P4eA1 rears fro 'the date issued,,PM-oss construction of the building .has boon undertaken and is &6if iv ' by the Cof Missionor of Wolth. Anv change Or_altcration Of construction PUT NAM C OUNTY DEPARTMENT O F HEALTH APPLICATION FOR APPROVAL OF PLANS. FOR A- WASTEWATER DISPOSAL SYSTEM, .�.. .... e.iu t- :� "y"; :..'wt' r.r ._ ., :vr.',�m•- 'oG�....a. ;. r .. r� .. r.. ,'R=.c w Name 'and Address of Appl icant: y1d f'NF_ P & ,A-1 D opt Zt Lt E fIPTaL. -61-Et/ o1A`r . Al - y 4-4 V-1/1111 Name of Project: PA 010 k('RA775 041 r6i 3. Location&& /C: jr%►a, ^ LALG4c.7' . Project Engineer: J)AAllfl- J-Z)a1V49&E 5. Address: /.10 PP -eE'A<rNAi4G.¢Vo License Number: Phone:.'' %( %G Type of Project: X Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other,(specify) Is this project subject to State Environmental Quality, Review (SEAR)? Type Status (Check'One) Type I.. Exempt Type II. Unlisted Is a Draft Environmental Impact Statement (DEIS) required? ............. Ala Has DEIS been completed and found acceptable by Lead Agency? ........... At /A Name of Lead Agency Is this project in an area under the control of local planning, zoning, ....or .othe.r. ,officials or �, -- .._;,..., :. _ ............ ...... - 1 Qa es . _ ..... . If so, have plans been submitted to such authorities? .................. NO Has preliminary approval been granted by such authorities? Date Granted: Type of Sewage Disposal System Discharge...... Surface Water Ground Waters If surface water discharge, what is the stream class designation?........ /y /e Waters index number (surface) ............ ............................... J� 1 Is project located near a public water supply system? .................. N O If- yes, -name of water supply % Distance to water supply Is project site near a public sewage collection or disposal system ?..... )[D Name of sewage system At 14 Distance to sewage system Date observed: 23. Name of 'Health Inspector: h64 elf . Project design flow (gallons per day) ...... ............................... 4,0 D G pv . �i 2. 5. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. Ala `PES''A`ppl i'cation' been submitted to „local DEC Office? ............... 7. Is any portion of this project located within a designated Town or State - wetland? ............................. .... ............................... I-Cjaarn.► 3. Wetland ID Number ....................................................... 1. Is Wetland Permit required? .............. ............................... N Has application been made t Town r Local DEC Office? ). Does project require a DEC Stream Disturbance Permit? ................... lye) !. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste dispos , landfilling, sludge application or industrial activity? ........ YES or '. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES oro DESCRIBE: . Is there a local master plan or file with the Town or Village? ........... _�e-* Are community water, sewer facilities planned to be developed within 15 years?- No Are any sewage disposal areas in excess of 15% slope? ... ........_.........,a........._. Tax'MAp ID Number ......................... ..... ........................... Approved Plans are to be returned to: ................. Applicant � Engineer the application is signed by a person other than the applicant shown in Item 1, the :lication must be accompanied by a Letter of Authorization. Failure to comply with this ;vision 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 Laid. � A "-1-2 z., NATURES & OFFICIAL TITLES: .ING ADDRESS: la'-Z> ;Foe" /ery 4 et ".,q R 8RUCIV R. •FOLEY,'R.S.r' Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 January 6, 1997 Dan Donahue 120 Breckenridge Road Mahopac, NY 10541 Re: Proposed SSDS: Palmo Peach Lake (T) Putnam Valley Dear Mr. Donahue: Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." Tax Map number is to be provided. Tax map number noted on plan submitted does not correspond to the above captioned lot. tf q -s AI y "'P.A 4"" °� w H� F,� Location map: is to be provided on plan. p v 6 �. . Entire parcel is to be shown on plan afany convenient scale. Property metes and bound are to be noted. 4. Standard form PC -10 has not been signed. '0 °""r' _ �;,- Rercolation_ rate- sh©uld be noted'as-8- 10= inin%irieh on plan 6. Design Data sheet notes four bedroom design and a 1250 gallon septic tank. Plans and construction permit notes a three bedroom des! . Revise accor� as ,rta� v�T# qr*l parz R. Togowi6j� Aoi,4#. n1-t *..,y4&2rfx p6 le , .g od+r ~,e Upon receipt of a submission, revised to reflect the above, this application will be considered further. Very truly yours, Robert Morris, P. E. Public Health Engineer RNVjP _ PUIMM COLWY MARDM OF HEALTH re DIVISTON OF SERVICES Off' 3.9 - DESIGN : ,5(JBS'JF�iCE SEWAGE ,DIS . O A- L . , .. .. / n. -- P - -- -- - ' Owner Address pd di ess 2/ "1r..G(, Located (` � " [) % t �jL i .._ ,fF•� �w r at (street) �F61 �/� / �� Sec. 7 Block _/ Iota, 3 (indicate nearest cross street) Rmicipality e0 % ,* r-t Watershed bSG -f 4,.-f SOIL PFitoOUTIM TEST MM RE10E = M RE SUS W= APPLICATIONS Date of Pre - Smoking L5A- Date of Percolation Test RODE Na9M C= TL14E PaCrLATIM Run El msce Depth to Was= From Hater Level NO. Time Ground Surface In Inches So Rate Start -StaD Aline Start stop Drop In Mir./in Drop Inches Inches Inches 30 SD 3/or/ d / / a2 12 4///'v 3 D'7" 5 / /s��� S a � D /D -Z -- 3 / /e / /�b 36 �b /0 4 // /mL 06 5 1 3 5 kXM: go Tests to be repeated are cbtained at each for review. 2. Depth measurements to Inc. at same depth until approximately equal soil rates percolation test hole. All data to* be suhmatted be made from tcp of hole P?I —TEST Prr mm DEPTH ECIP NO. — -04 G.L. 21 31 41 51 61 71 81 91 10, 12' 14' 00,00',yoorTIN M�Me ROLE NO. J�4 - D 6 tq,4 �7 Address /.I o? INDICATE LEVEL TO MUCH WATER LEVEL R:SES AFTER MING ECOUNTERED DEEP HOLE OBSERVAMONS MADE BY: V 04 DATE: DESIO Soil Rate Used Min/1" Drop: S.D. Usable Area Provided 6,6 4 0 x re, No. of Bedroans Septic Tank Capacity 0 0 gals. Type Absorption Area Provided By L.F. x 24" width trench ...... Other Name Dokxj 4. D 6 tq,4 Address /.I o? fe t- 4; C' Signature \: SEAL NO *7 4, THIS SPACE FOR USE BY HEALTH DEPARTMW ONLY: I PLJTNAM. COUNTY, IDEPARTMENT. OF 14 EA11, TFI . APOLICATION FOR APPROVAL OF- "PLANS ; FOR - A. *WASTEWATER QISPOSAL_ SYSTEM Name^ and Address of Applicant:-' ppl i cant: V/A iAt F—'- L �-1 O 64F A1 D-Mr Al - y i /J, 6 Name of Project: hAGMO SF,07 Sf� f�.7 3. Location&V /C:' �c.TitlAirr IiALL�c�- Project Engineer: AN/Fi- J Ddy4*#i,6, 5.i•Addr�ess: 11w,p�Fc, r.v•o/46,4it,J License Number: Phone. % Type of Project X Private /Residential Food Service Commercial Apartments Institutional <'r Mobile Home Park Office Building ; Realty Subdivision `Other (specify) Is this project subject ,'to . State. Environmental 'Quality`Review (SEAR)? Type Status (Check.One) Type I:.. .Exempt Type II.., Un 1 i sted Is a Draft Environmental Impact Statement: required? ...- ............ Ala Has DEISrbeen completed and.found acceptable by Lead:Agency? ..:. .. _ Name of Lead Agency Is this project tn an area under_:the control. of focal planning;' zoning, or- other off ficials,.. ordinances) .. ... .... ' If so,-have plans been submitted to such authorities? : : :............... /1/D Has 'prel imi nary approval been granted by. such authorities? Date , Granted.: Type of Sewage Disposal System Discharge..::.`: "'Surface Water Ground. Waters If surface water discharge, what is the stream class designation ?. .,....... /X Waters index number (surface) ... :..:..... .................. A(I* Is project located..near.a. public water'supply system? ...... N y If yes, name of water supply /( //A_ Distance to water supply, Is project site near a public sewage collect 'ion:or disposal system ?..... i1/D Name of sewage system "_ At /!-i Distance :,to .sewage system,. Date observed: 23:. Name .'of.- Health Inspector: F Project design flow (gallons per day)'., DveP,O 2. 5. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?. ". No___ ���.c'"r 'xv- :.::;;. S....: r .�'_ - ' ��. -a - ... _4. ..' =Z .;'s.`.� ,..'..,'c" n."^,o`,.:+- t;.`•`� b. -�. - ' ;f- ' Y°.� T _ - :' ..� 6. Has SPDES Application been submitted to local DEC Office? .. N Mt 7. Is any portion of this project located within a designated Town or State wetland ? ........................................ ��,r / r 3. Wetland ID Number ......... /y / 1. Is Wetland, Permit required ?.. .. ... ............................... NO Has application been made t Town r Local DEC Officel,.................... �= ). Does project require a'DEC Stream Disturbance Permit ?. ................... V() ?. Is or was project site used for agricultural activity involving application . of pesticides to orchards or other crops, solid or hazardous waste dispos ., landfilling, sludge application or industrial activity? ........ YES or Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known. source of contamination? .......:......YES or (NO DESCRIBE: . Is there a local. master plan or.file with the Town or- Village? ........... .... -Are community water, sewer facilities planned to be developed within.15 years? No Are any sewage disposal areas in excess, of 15X.slope7 - -.- Tax Map ID Number ..... ............................... .................. . Approved Plans are to be returned to: Applicant _ Engineer the application-is signed.by a person other than the applicant shown in Item 1, the �"cat-on must be accompanied by a Letter of Authorization. Failure to comply with this )vision 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 know7edge and belief. False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the Pena 7 Law. :NATURES & OFFICIAL TITLES: LING ADDRESS: 1• •• � 71• • '�1 I? • mI M7 �; • •1 7 2 •' 11 /V :171 • •19.' DFSIG,v DATA SriEEr- suBSCFACE EWA c, DryPOM SYSM F3M- No. _..Cwmer Located at (Str eet) Pr,-4' ew'.4 G *IV. 4 Sec. 7:? Block _ Lot (indicate. nearest =oss street) Mi iicipality PU % WA wr l/41—t or IS- I Watershed Roe$ a c SOIL PERCO ACTT ES MM M aE WITS APPLT C ATIMc , Rate of Pre - Soaking. �� L %�JC� Date of Percolation Test HOLE NEMM CL TIDE P LATION ° Pm=A=CN -y Run. E1anse Depth to feu Frcm Water Lei No. rime Ground Surface In Inches Sc_­ Rate Start -Stoo Min. Start Stop Drop In Mir./T� Droo Inches i9che5 Inches i 30 SO. 2/0 30 c;LY 7 3 w 1/0 `s /bJ`� 3// / /�6 36 it2 5 - `i —2 Aln 3 .. 4 5 NO'IT:S: 1. Tests. to be repeated at salve .depth until approximately 'equal soil rates are obtained at each percolation test hole... All data to* be submitted for review. 2. Depth measurements to be made froia top of hole. n Inc G.L. 1' o So iL 2' q 4' VA 8' g' f. llp 12° 13' BCLE NO. f 42 J% 14' INDICATE LEVEL AT WHICH H GMUWM IS R COUNTEPM A) bAI ��- A INDICATE LEVEL TO MICR WMER LEVEL R MS AFTER MING. EVOOUNMMM DEEP HOLE OBSERVATIONS MADE BY: 14 L J . ?.1 a �+.¢ /� v r' DATE: - — - - -- DESIST .. . Soil Rate Used Z 0 Min/In Drop: S. D. Usable Area Provided (p, ,O d D sQ FT NO. of Eedroans _ Septic Tank Capacity gals. Type �► Absorption Area Provided By L.F. x 24" width trench Other _-- sFt�FESS Name D#AJ Signature Address 1.10 o e°w� �8 / ?r£�° asas� .40 c`�� THIS SPACE FOR USE BY BEAM DEPARTHM ONLY: 14' INDICATE LEVEL AT WHICH H GMUWM IS R COUNTEPM A) bAI ��- A INDICATE LEVEL TO MICR WMER LEVEL R MS AFTER MING. EVOOUNMMM DEEP HOLE OBSERVATIONS MADE BY: 14 L J . ?.1 a �+.¢ /� v r' DATE: - — - - -- DESIST .. . Soil Rate Used Z 0 Min/In Drop: S. D. Usable Area Provided (p, ,O d D sQ FT NO. of Eedroans _ Septic Tank Capacity gals. Type �► Absorption Area Provided By L.F. x 24" width trench Other _-- sFt�FESS Name D#AJ Signature Address 1.10 o e°w� �8 / ?r£�° asas� .40 c`�� THIS SPACE FOR USE BY BEAM DEPARTHM ONLY: APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH -. DIVISION OF ENVIRONMENTAL INDIVIDUAL WATER SUPPLY ,.& _SUBSURFACE SEWAGE. DISPOSAL • :: �= .: ;;: -.: y" ° , :- ;: - REVIEW -SHEET 'foi' CON'STkISC 'I© -1i' -PERMIT• . STREET LOCATION NAME OF OWNER BY B. HEDGES R.MORRIS OTHER DATE _J� TAX MAP # DOCUMENTS. T APPLICATION yor Sfokeo - PERMIT PWS LETTER tOtNGINEERS AUTHORIZATION ���"DnEES N D ATA SHEET(DDS) { ORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST HEALTH SERVICES SYSTEMS " Y XP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE ED PIT & D BOX SHOWN & DETAILED 7jOUSE NO.OF�BEDROOMS &TN OF PROPOSED SYSTEM = MRTFC Ar Rrli I f-1 HOUSE SETBACK NECESSARY (TIGHT LOT) OUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE m NO BENDS; MAX. BENDS 450 W /CLEANOUT _ FILL SYSTEMS SUBDIVISION f/ e VF BARRIER M LEGAL SUBDIVISION � HORIZONTAL: SLOPE 3:1 TO GRADE = SUBDIVISION APP L �CKE5_"­_ PECS =FILL NOTES PERC RATE ERTIFICATION NOTE. FILL REQUIRED EPTH H GAUGES CURTAIN DRAIN REQUIRED =STANDPIPES ROFILE &DIMENSIONS GENERAL . Cp F�L IN EXPANSION AREA m EX- APPROVAL SSDS ADJ. LOTS m WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH DATA ON DDS PLANS &.PERMIT SAME Z LF TRENCH PROVIDED X60 FT MAX = PRE- 1969 - NEIGHBOR NOTIFIFICATION ARALLEL TO CONTOURS LM. , ER.B /Z,BA:.: _ _ Fel00 %.EXPANSION FROVIDED ® 100 -YR. FLOOD ELEVATION' ... -.:::.�,. - SEPARATION DISTANCES SPECIFIED ON PLAN REOUIRED DETAILS ON PLANS FTELDS WAGE SYSTEM PLAN - (NORTH ARROW) 'TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL SSDS HYDRAULIC PROFILE = GRAVITY FLOW 0' TO FOUNDATION WALLS Ei 15' WELL TO P.1 = CONSTRUCTION NOTES (GRINDER NOTE), 0 TO WELL, 200' IN D.L.O.D., 150' PITS eESIGN DATA: PERC AND DEEP RESULTS Nom' 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) WO -FOOT CONTOURS EXISTING & PROPOSED �,--�- 0' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER KRIVEWAY & SLOPES CUT �-s�--� 10' TO WATER LINE (PITS -20') FOOTING/GUTTER/CURTAIN DRAINS �50' INTERMITTENT DRAINAGE COURSE EROSION CO S = 200 FT. RESERVOIR, ETC.= 150 FT. GALLEY SYSTEMS ROSION ONTR ENO = 15'MINTOC.D.S= >5 %,20'- 4%,251- 3 %,301- 2%,35' -1 %,100' <1% PERC & DEEP HOLES LOCATED = 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS, REERESENTATFvw, OF PRIMARY AND EXPANSION SEPTIC TANK OCATION MAP =10' FROM FOUNDATION; 50' TO WELL oij COMMENTS: JAv PUTNAM COUNTY DEPARTMENT OF HEALTH _D. su �_ ... .... .. ... i.: J', �.T�K'V ..r .Y.. �A.'.w, C. '..P .5.. ..M.�'.�- 'KS.r^.:«:: • G. _ .. _.. � �I x. «..r.. �_ 'FCl' eT e. i.K.r;cnTi.��..�;�.�L•':�Y`�+Sr r—. y.p�R:•..J�...:Y .s. . .. - DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date v Re: Property of a AV 11116 Located at (T) )Ot.l 'T/Y/tM4"e,�4,, 'Section _Block JL Lot %? Subdivision of Z /I / /G44el.1' 41 Subdvo Lot # Filed Map # -.2 Date Gentlemen: This letter is to authorize ,INA1/ a duly licensed professional engineer Y or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards,"rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers -on my behalf in connection with this matter and to supervise.the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed Countersigned: `? er of Property P.Eo 9..R.Ae, # Address Address` Telephone Oa Rs Town (21,S) yid- 9 -716 Telephone DANIEL J. DONAHUE, P.E. CONSULTING ENGINEERS e: a. :n. •��,.- f...! ^'.w,`..:.�Z,' ".ii,��;r •.^f••'++- ' K' ca' v,. i _ _. _ : f':... Yin:: "Rit< -`:;;, 7.; - ".: -y:- .� f •: p- '.+i.'.S,p::..;r.:.i'v •...i. -.. :.r n. . ,. .. .. . 120 Breckenridge Road6 Mahopac, NX 10541 914 -628 -7576 December 16, 199.6 Putnam County Department of Health 9 Geneva'Road Brewster, N.Y. Att :.Robert Morris, P.E. RE: Proposed Sewage Disposal System Property of Palmo Lot #3B Michael's Way R.S. Putnam Valley Dear Mr. Morris: Enclosed herewith for your review and approval are the following: 1. Form PC -1. 2. Construction Permit 3. Check for "5300 00 4, Design Data Sheet 5. Letter of Authorization 6. Two Sets of House Plans 7, Four Sets of Construction Plans .,._a.. .:. 8::' :We.11:::P.��r�f`�` "ApPhicaton " - ,..__.�...: ,' . , .; -. � •�: _,..��:'. .. .. -.._; __._.m., Sin el , Daniel Donahue, P.E. Site • Sanitary • Environmental ` BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 1 January 6, 1997. Dan Donahue 120 Breckenridge Road Mahopac, NY 10541 Re: Proposed SSDS.: Palmo Peach Lake (T) Putnam Valley Dear Mr. Donahue: Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." 1. Tax Map number is to be provided. Tax map number noted on plan submitted does not correspond to the above captioned lot. 2. Location map is to be provided on plan. 3. Entire parcel is to be shown on plan at any convenient scale. Property metes and bound are to be noted. 4. Standard form PC -10 has not been signed. 5. Percolation rate should be noted as =10 min/incii on plan. 6. Design Data sheet notes four bedroom design and a 1250 gallon septic tank. Plans and construction permit notes a three bedroom design. Revise accordingly. Upon receipt of a submission, revised to reflect the above, this application will be considered further. Very truly yours, . &At Robert Morris, P. E. Public Health Engineer RNVjP it o 0 .Alpli Ole" ONG�,S�Q�G ��,� %q AS-BUILT RELOCATION - DIMENSIONS 1 A 12.1' SEPTIC TANK - IN 1B 44.4' SEPTIC TANK - IN 2A 20.0' SEPTIC TANK - OUT 2B 46.0' SEPTIC TANK - OUT 3A 23.3' PUMP PIT - IN 313 47.2' PUMP PIT - IN 4A 33.0' PUMP PIT OUT 4B 51.9' PUMP PIT OUT 5A 50.5' START LATERAL 5B 72,3' START LATERAL 6A 34.3' END LATERAL 6C 43.8' END LATERAL 7A LATERKIL"' 7C 81.0' END LATERAL 8A 82.9' START LATERAL 8B 113.5' START LATERAL 9A 80.2' DIST BOX 9B 109.0' DIST BOX