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Home My WebLink About4329DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -40 BOX 33 04329 on #;,il. NMI IM :� ' MIN 1 MM 04329 PUTNAM COUNTY DEPARTMENT OF HEALTH 3.186' Division of En-01men'-fid H6'alt'h Services, Carmel, N.Y. 10512 .Engineer Meet Provide PV -27. `-90'.1".1 P.C.H.D.:P6rm1t 'AGE 84- 0�!n, 0s VF.M. 40 at Slew Brook Lane Tax Map— Block Lot - 0- er/ MT.0 er/applicant Nalne,,Nilwil Schwartz —Formerly, Subdivision Name Foothill s,bdv. Let# 6 Address 330 West ,45th.Street _Zlp_� 10036 5; 1996 Date Permit Issued. A . . Lobby Ei . 'NY -NY Separate Sewerage System bflt,by S.J.; Lore. Address 133 S. Broadway ' Red -Hook --NY Gallon Septic Tank and 600 LF of absorption trench C g of 11250 , -Water Suoply.. Public Supply From Address or: X Private Supply. Drilled by NorMah AnderAm Address -Shrub Oak, -NY B,Hdl.' Type Resideantigil Has Erosion Control Been Completed? 9 Number of Bedrooms 4" Has Garbage Grinder Been Installed? Othirifequirerniinti Al' diifdiirl &i i h I certify that the system(s) as listed serving the above premiseg 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 regulat ons, in acc an a vith the filed plan, and the permit issued by,the Putnam County'Departmgnt Of Health. Date Miiy .10i 1956 Carl; I fl.A by P.E. x R.A. Address BADEY & WATSON, P..0 Rte 9 Cold Spring NY Li,,,. No. 62505 Any person .occupyin . 9 promises served by the above, systern(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary cond and. .,I .!tIons. resulting from such_6589e.- Approval of the separate sewerage system shall null and. vo d as soon as a pukl;: sanitary sewer becomes avallable'and . the a'P0r64arqf Iris "-Oriviti',miiter'supply shall dicbme"nuWand void when , a Rqwc_�qpply becomes available. Such approvals are subject to modification or change when, in the judgment of the Commissiloner of��, ch change Is necessary. Title Date y H Fol, IM 0 1A C WLLL UUr1rLZ11VV zzruAi DEPARTMENT OF HEALTH Division Of - Erfv kr-'O" iftli'difta 1 ea lt h, - S e PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only q, WELL LOCATION STREET APJWSS.' 'MWAIVILLAW(JIT TAX GRID mUMBEik 4 .e is /� ,,, 7V�44 WELL OWNEIi 4111AME- vo , �C�_1211"_ -1 O 81VA TE I UBLIC USE'OF WELL 1 - primary 2 - secondary IDENT 6L 6 PUBLIC SUP KY ❑ AIR/COND./HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM 0 TEST /OBSERVATION 0 OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑ AMOUNT OF USE YIELD SOUGHT gpm./NO. PEOPLE SERVED —/EST. OF DAILY USAGE_J�00 gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY []TEST/OBSERVATION EJADDITIONAL SUPPLY RNEW SUPPLY (NEW DWELLING) ODEEPEN EXISTING WELL DEPTH DATA WEL: -DEPTH 3v4 —ft. I 11r STATIC WATER LEVEL -7 J —ft. I DATE MEASURED ILI I0 ell DRILLING EQUIPMENT -W-ROTARY ❑ COMPRESSED AIR PERCUSSION 0 DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE 0 SCREENED ❑ OPEN END CASING -OPEN HOLE IN BEDROCK 0 OTHER LENGTH ft. MATERIALS: ,STEEL ❑ PLASTIC 0 OTHER CASING DETAILS -TOTAL LENGTH BELOW GRADE tt. JOINTS: OWELDED ,&THREADED OOTHER DIAMETER SEAL:,tKEMENT GROUT OBENTONITE OOTHER WEIGHT PER FOOT Z Ib./ft. I DRIVE SHOE.,SYES ❑ NO I LINER: DYES WO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (11) DEPTH TO SCREEN (it) DEVELOPED? FIRST 0 YES E3 NO- -SECOND— GRAVEL PACK 11 YES _0 NO GRAVEL SIZE: DIAMETER OF PACK In. TOP DEPTH —ft. BOTTOM OEM It. WELL YIELD TEST If d�tailed pumping METHOD: ❑ PUMPED tests were done is in- ;Cff�c OMPRESSED AIR formation attached? 0 BAILED ❑ OTHER ❑ YES C3 NO Ft A Y r- —ji it more detailed formation descriptions or sieve analyses WELL 'LOG are available, please attach. FROM DEPTH FROM ACE SURFACE water Bear- ing Well Dia- Meter FORMATION DESCRIPTION calle It. I ft WELL OEM It. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Land .rj, Surlae r 00, A WATER A(CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS .-- 0 COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? OYES ONO STORAGE TANK-: TYPE A/z� }l —% CAPACITY a GAT,. PUMP INFORM&TION TYPE 3 CAPACITY I( MAKER - DEPTH [E MODEJ M 0 0 EF L _Tf 0 VOLTAGez� L HP WELILDRILLERNAME . ADORES IIJ SiGNATURE 1/t5v ~ ° YM|. F-NV7RONMFNTA|' SFRVTCES 321 Kear Street Yorktown Heishts, N.Y. 10598 <914> 245_2800 . Alhert H. Padovani, Director AB #: 32.414951 CLIENT #: 5698 NON STAT PROC PAGF 1 FOOTHILLS HOME B|)TLDER ` DATE/TIMF TAKEN: 06/13/96 12:00 330 WEST 45TH ST ^ DATF/TIMF REC'D: 06/13/96 120o NEW YORK, NY 10036 REPORT DATE: 06/14/96 PHONF: (212)-265-8189 SAMP| ING SITE: LOT 6 SLFEPY BROOK KANF SAMP|'E TYPF..: POTAB|'E : P1/TNAM VA1FY OUTSIDE RIR. PRESFRVATTVES: NONE COL'D BY: DAVID SCHWART7 TFMPFRATURF".: { 40 NOTES...: -COLIFORM MFTH: MF L BACT DATE FLAG PROCEDURE RESULT NORMAL — RANGE 06/13/96 MF T. C0'IFORM ARSFNT /100 M|. ABSENT COMMENTS THFGE-.RESULTS-I.NDICATF T NOT) ^SATTSFACTO . | �SA@TTARv Q AiTTY AC HE CORDT 'NE | YO STAN- AND - FPA FFDERA{' DRINKING WATFR STANDARDS, FOR THE PARAMFTERS ' TESTFD, AT THE TTMF OF COLLFCTTON. � ` SURMTTTFD BY:' ---- --------------- Albert H. PRdcvani, M.T.(ASCP) & Director - \ ` EiAP# 10323 05/03/1996 17:27 2125814334 DIVIS100 OF ENVIRUI MIs'�lz`:i3.L'HF.�L'.[11 SJMVIC,_'S Niles Schwartz Owner or Purchaser ai Bui.ldirtg Same_ Building Constructed by Y Sleepy Brook [,ane Location - Street Putnam Valley Residential Building 'l'yPe - - - - - - - - .~-- -- - PAGE 02 $4 1 . 40 Section Block Lot Foothill Estates_ west SuWivision Name- Subdivision Lot # I _ ......�_....._.__ �_.. - - GUAI�NI'�e" Ur_ 5U335t3ztt'ACF:- SL•��MU2 DISPOSAL, SXSTFM�� I represent that I am wholly and completely responsible for the Location, wor)minship, material., construcL-ion and drainage of the sewage disposal system serving the above ciFscribeed property, and U)nt it has } >sen constn- Icted as sham on the approved plan or ,approved. amendment_ thereto, and in accordazice with the standards, rules and zegutati.ons of the Putnam County Department of Flealt)a, and hereby guarantee to the ownc?z, his suc cessors, heirs or assigns, to place in goad operating condition any part ai said syste,'n constructed by me :•)hi.ch fails to oQexate for a period o.f two yeas irrmediately fol.lodi•ng the date of.-approval of the "Certificate of Construction c_ompl.ia0ce" for the sewage disposal systm, ot.any repairs made by me to such :5Ystw, except where the failare to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The. undersigned .Gunther. agrees to accept as conc]_L1si.ve the determination of the Ditector of the Division of Snvironfrental Health Services of the Putnam County Department of Health as to whether or not the failure o e sy tem to pa ate was caused by U)e willful or negligent act of the occ,u e .buildi_ zing ti the system. Datecl Ulis ___q_ day of 19 y� General Contractor (Ow ter) - Signature Brookfalls Development Corp. Corporation Name (,if Corp.) _ cbby-.,M . - NY�, . NY .1.Q03Fz - rev. 9/85 mk Sigtkiture V S.J'b sore Corporation Name (if Cord.) 133 S. Broadway Red Aook NY ,Address IPUTIl AM t;OUNTX DIEIIAlt'IMIl - tv'1' UL iL1i1_.l it . DIVISION or CNVZROMMENTAl, HEAL. k1 sz;nvZCLppptNDZX i. 'Re : Property of Njjjegj , Located at Sleepy Brook vane (x) utnam Ya7 i fy Seetio.n 84 —Block 02 Lo 40 Subdivision or Subdv. Lot Filed MOP �'�_ 2477A Dote 6 -29 -90 Gentlemen: This letter is to au N. apbn o -- n i and p E s.. a duly licensed professiQnol eneinec,.r or re 4 stexed architect. (indicate) .�.�. to apply for a Construction Paronit for a separate sewage system, to _....... ..... ......_........w...�... a..- .�..... v.. �... ......!p . -.'v rS.. . :.., n e.. .... .. . ._...... ... .. .. •.. ... -.... ..v. � v. �. . .I•h -. t. eY. J.n ih. - serve }Se above ziot�a Fz'op8rty i;i tac�cordance with'�th� sraridw�� cl. ; rul�:s or regulations ag promillagatcd by tht Gonuni9si.on ^r of �ha P%ttziani CC-ant), Department of Hoolth, nim?, -to sign all .tiacvssary I'oZ ere on, my behAlf in .connection with this matte. grid to supervine i;hr constrjction of Ae7_Cl system or systems i;% conformity with the provisions of 147 duca'Liori 1 ;cs., the Public 1ja,11•til .L�lw, and the putzs%m Caujity S.�%i., Mary Code. very truly you,-$ Signed -- Uwnar. of Rxap Ly Cousxtersi�rabd: P.E. R.A ohn P. Delano, P. E. —..._ NY$ Lic. No. 62505 $etQev j .Wat gjon' 5wryajt1 R17��% Sag ,neec -ing Address 0.5. Route .9 CQId Sorx9, • (914i 2659217 " ��Yephon� •�� 330 WOSt 4�th -Lobby A d d. r. e h •s N, %v York; NY .10036 Town . 22 xclespl� one BAHDEY & WATSON Surveying and Engineering,1P.C. Route 9 Cold Spring, NAY 10516 (914) 265 -9217 739 -3577 628 -1800 FAX (914) 265 -4428 TO: Putnam County Department of Health 4 Geneva Road Brewster NY 10509 (—Copies Date No. 1 10/05/95 1 10/05/95 3 10/05/95 1 10/04/95 These ark transmitted: Remarks: Copy to: LETTER OF TRANSMITTAL r Date: October 5, 1995 Job No. 86 -192 Attention: Mr. Robert Morris, P.E. Re: David Schwartz SSDS Permit - Renewal Sleepy Brook Lane Town of Putnam Valley TM #84 -01 -40 Sub lot 6 We are sending you: Via: Hand Description SSDS Permit Well Permit SSDS Plan Letter of Authorization Attached Signed: Kurt Schollmeyer, P.E. :� ... •a .. - .._ _.. 4: '�.. -tr. _ Irq. _. �•��i� J�.. 3. u. ._ ... ..� ��fs .b_ .. �. 4 •�a T. � ...- ��_.cl ^+C... ^.Jti_i_. _. ,I�x,� .y. .� DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION `TO -CONSTRUCT,• -A WATER WELL ' PCHD PERMIT 0 PV -27 -93 WELL LOCATION Street Address Town/Village/City Tax Grid Number Sleepy 84 -01 -40 Subd. # WELL OWNER Name Mailing Address OPrivate USE OF WELL 1 - primary 2- secondary ® RESIDENTIAL O PUBLIC'SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION 0 OTHER (specify, 0 INDUSTRIAL U INSTITUTIONAL O STAND -BY O ,AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE60_ 0 gal O REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION 13 ADDITIONAL SUPPLY C1 NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Urnvi dp P wat•Pr aLpl y for new residence. nefiahl WELL TYPE ®DRILLED DRIVEN 13DUG GRAVEL. -0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes, Foothill Estates West Filed Map No. 2477A, Date 6/20/90 Lot No. 6 WATER WELL CONTRACTOR: Name to be determined Address: 19'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' "•.r :. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET October 41 1995 A4 I (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 thirt}• (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 drilling operations be contained on this property and in such a manner as not to degrade or othed•w se contaminate surface or groundwater. r i 3 '• 1;.-ce of Issue: lC) %L. 19 Date of Expiration / , 19411 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller LF Of 2-411 mi de 6haarption trench Iro D* =3ft,,Wj, to be determined AM— .,de ctrtain drain t706 bo Cocatod at chawoon-tr , 06 '. 6 , pixio-tro'd p6n�in4i twcoid wokt�ui bo Initbi in- 91 0 W h fthlout r4ords. rucos and rGa–UN13hoof tho Putnarn County O=rtwtoc�2 09 MAN. -'APPROVED FOR COMSTRUCT�!OP4,: This approval oupiros-two,V66rs'irom the dato issued unless construction of tho building.has boon undortokon and is it, and r*/�4rfvato wator supply only. Ies/. � �mo IO/88 � � � ' ~ BADEY & WATSON Surveying and Engineering, P.C. Route 9 COLD SPRING, N.Y. 10516 -. 739- 357..7 _- 628 - 1000.- _• .. , . •�. .,. y ..-� n TO Putnam County Department of Health 4 Geneva,Road, Route 312 Brewster, NY 10509 LIEUTEQ OF TRUSS URL August. 26, 1993. �6 -19.2 NO. RE: Schwartz SSDS Permits Sleepy Brook Lane Town of.Putnam Valley Subdivision--Lots 5,' 6__ &" 7 Construction Permits SSDS 1 WE ARE SENDING YOU X1 Attached ❑ Under separate cover via LTG Ma; 1 the following items: • Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications • . Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION' 1 7 -30 -93 .3 Construction Permits SSDS 1 -- 3 Application Forms PC -1 1 -- 3 Design Data Sheets 1 8 -6 -93 3 Letters of Authorization 1 7 -30 -93 3 Construction Permits Well 1 8 -18 -93 3 Check for $300.00 2 -- 3 lHouse Plans 4 7 -30 -93 3 Pro osed SSDS Plans m - y +TTHESE ARE TRANSMITTED as checked below: j REMARKS COPY TO 40% Pre- Consumer Content -10% Post-Consumer Content SIGNED: Kurt S c h o l l m e y e r If enclosures are not as noted, kindly notify us at once. For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted O Submit , copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO 40% Pre- Consumer Content -10% Post-Consumer Content SIGNED: Kurt S c h o l l m e y e r If enclosures are not as noted, kindly notify us at once. APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION. OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS �. . REVIEW VIEW SHEET for CONSTRUCTION PER,'IgIT NAME OF OWRE STREET LOGATI N_� "� BY DATE TAX DOCUMENTS. � c' Y,1 , PER'KIT APPLICATION PC -1 WELL PERNffTLiJ PERMIT PWS LETTER ENGINEERS AUTHORIZATION 3N DATA SHEET(DDS) HOLE LOG I CONSISTENT PERC RESULTS (3) PERC HOLE DEPTH CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIAJWCE REQUEST '=1�GERTERAL LEGAL SUBDMSION SUBDIVISION APPROVAL CHECKED PERC RATE FILL REQUHU D CURTAIN DRAIN REQUIRED STANDPIPES `-'U_EX- APPROVAL SSDS ADJ. LOTS WETLAND (TOWN/DEC PERMIT R & D) DATA ON DDS PLANS & PERMIT SAME RE- 1969 - NEIGHBOR NOTIFIFICATION R BDZBA l00 YR FL C+OD`ELEVATION: REQUIRED DETAILS ON PLANS SWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE m GRAVITYFLOW D/ J BOX M TRENCH/GALLEY ED P- PIT DETAILS SEPTIC TANK - SIZE, DETAIL WELL DETAIL, SERVICE LINE IF OVER CONSTRUCTION NOTES (GRINDER RATE) DESIGN DATA: PERC AND DEEP RESULTS 9'TWO -FOOT CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES CUT FOOTING/GUTTER/CURTAIN DRAINS COMMENTS: _ ,DISCHARGE {OI{) ® PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY AND EXPANSION EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED PIT & D BOX SHOSVN & DETAILED HOUSE - NO. OF BEDROOMS WELLS & SSDS'S W/I��1200 FT. OF PROPOSED SYSTBf PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - U4 "/FT. 4"0; TYPE PIPE ENO BEADS; MAX. BENDS 45 W /CLEAIITOUT FILL SYSTEMS E�JCLAYBARRIER 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE FT-1 FILL SPECS 09 DEPTH GAUGES FILL PROFILE &: DL%fENS10NS C� VOLUME TRENCH 01F TRENCH PROVIDED ®60 FT MAX b PARALLEL TO CONTOURS m I00% EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN FEELDS DRn"EWAY,. LARGE .TREES, TOP OF FILL 20' TO FOUNDATION WALLS EP 100 TO WELL, 20V IN D.L.O.D.; 150' PIT'S 100 TO STREAM WATERCOURSE LAKE (Pi 1C.EXPANT) 50' TO CATCH BASIN, 35' STOR_MDR.MN, PIPED WATER $10' TO WATER LINE (PITS -20') 50' INTERIVITTEtiT DRAINAGE COURSE 200 FT. RESERVOIR, ETC.M "150 FT. GALLEY SYSTEMS SEPTIC TANKS m10' FROM FOUNDATION; 50' TO -WELL 1VFLLS m15' WELL TO P. PUTNAM COUNTY .DEPARTMENT OF HEALTH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM ,,.. ,•, 6i ,�. .r-z .+ts,,. ., L _ .. ,.. .r.'..7.i�_.. -., ..•. . ,,. .� �,' � .. .... '�•` "irri.. ,.'i.. r.l. ..b �;��: Name and Address of Applicant: Niles 5chwa'fz' 330 Vilest 45th St., Apt. Lobby E New York, NY 10036 2. Name of Project: Niles .Schwartz 3. Location Tit` Putnam Valley 4. Project Engineer: John P. Delano 5. surveying sin BADEY & FVATSON, S •C• Y g U.S. Route 9, Cold Spring, NY License Number: 62505 Phone: (914), 265 -9 6. Tyoe of Project: . Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEAR)? Type Status (Check One) Type I.. Exempt Type II. X Unlisted 8: Is a Draft Environmental Impact Statement (DEIS) required? ............. No Has DEIS been completed and found acceptable by Lead Agency? N/A 10. Name of Lead Agency N/A 11. Is this project in an area under the control of local planning, zoning,. or other officials, ordinances? ........ ...........,................... Yes 12. If so,' have plans been'submi,tted to such authorities? No 13. Has preliminary approval been granted by such authorities? N/A Date Granted: N/A '14.'Type of Sewage Disposal System Discharge...... Surface Water....X Ground.WAters- 15. If surface water discharge, what is the stream class designation ?........ N/A 16. Waters index number (surface) ........... ............................... N/A 17. 'Is project located near a public water supply system? .............. ..... No 18. If yes, name of water supply N/A Distance to.water supply N/A 19, Is project site near a public sewage collection or disposal system ?..... 1m 1.0. Name of 'sewage system NlA Distance to sewage system N/A s )ate observed: 23. Name of Health Inspector: Michael J. Budzinski 8 00 ,roject design flow (gallons per day) ...... ............................... 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... No s� 2. 26� :Ras��SRDE-S -.A Ii�cat�ion' be6n` submi= tted-'fo `local-- C,-- O � ..:.- .....:...... th A 27. Is any portion of this project located within a designated Town or State No wetland ?..... ..............' ............. ............................... 28..Wetland ID Number ............... ........ ............................... N/A 29. Is Wetland Permit required? .... .. .................. .................. Has.application. been made.to Town or Local DEC Office? ..... .............. 30. Does project require a DEC St "ream. Disturbance Permit? .................. No N/A 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 Town or Village? ........... Yes 34. Are community water, sewer facilities planned to be developed within 15 years? No 35. Are any sewage disposal areas in excess of 15% slope?. ........................ No •36. Tax `Map ID Number ..:.': .., :.......- ...... ........................ - - 40-77 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 b`e accompanied by a Letter of Authorization. Failure to coop ly 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 Pena 1 Law. SIGNATURES & OFFICIAL TITLES: "P.F. Engineer for Applicant WATSON, Surveying & Engineering, P.C. •1AILI.NG ADDRESS: . U.S. Route 9, Cold Spring, NY 10516 y -: .,�_,,...y::..'"` -- _ .n. -� i....r::.,�;. c- i..r,?-r.' '.::. -n r_ '"es;�}:"sa. ^+-c. �';.. .— ..:• :�,s,^e•""" :�'!s- G• *-`r '?� v' ! _ --- --�... �. �� Dlo t�nr•n�all9etlb aff�•1.N,Y 1i61?1 ( 18m S•e�1�. � O Tai!W S3eep�z Brook Lane TOWN `a11y To` of Putnam 4 Foothill Estates West- �.t H° Ta>< 84 ; Ol ,,,. 40, Owar/ Plta� Ni 1 pa Seh Wnew�t_O PaddM ❑ wartz _ ,,P Y :. Tow. �N�Y �� .: 10036 330 West 45th Street A t. Lobb E r _. . .. , 3. narp.Subd�ivis ion- ADDroved& 6/,20/.90 ,.. #- :247 -1k, :• Pe'62riclosed-® Am6,,.,r -$ 00. 00...- Residential X1;.182 Ac f a g Dliil� Tip» Iot Ana 4 D Pffi:S•a�..:0a.y •pth 1�►.loe 15 f�111' Nt�•r atr saw.. 4 DW :Fbw G r Tn °S00 PCB NomralM�ti •d.W6ak t� laa yM� a1 only s.�titw &memos . t. a al.t ttt 1250 rte.. ..a' 400 LF of �� iida ati orgt cuz tr ►nch T, w to be determined Aail6rra . We* Srks Pi a Stf�4; Fear X AaWte�a ael X ••ti e, Sl Ddftd h to rbe determ� neal��. L Orlin foot ROB fill and- six foot deed curtain drain. 1 represent that 1 am who11Y aid compNtaly ratponsibN fa tM dafgn and location of the propolW that the separate •waM. al +�po�al syaxam oeow dacriljod will be construi,ted of flown on the s 'p.— arraandm•rat tMra to irrd °i a accor4gnGa with'thestandardf, ruNs ano,regummiR ,o commir OaQartnwat of t4Mltth. and that on compNtion tMnof a 'C.rtifkats of Construpbn Compliarioa' YtlAactory to the Commbaloner of Maailthwlll M'.tut►mktW to tM OapNtnlMt, anal a wrlttMr'wwM.d w +11�lN.furnipl tM ownw, hif fucpoo►f, MMiar aWjnf'tly tMtwlWw. that Yid btiNSF will HMq M loon opa►ati4 condltkln enyypmt of`pW fa!Ma•a 'dltpotal fyst ni`durinp` >tM oarlo0 of two'.(2) yai[s.k111rwd+otmy f•Itowlay tIN'Oit. 01 tM boo- itgto M 1fN' °apf+►eu�l >,of th Car6fkati of 614iuetion°;=t ia'na of tlia oryinagftan, any in thwotol 2) that the drilled Weil'daorlMO above ft�N be klCilfif0'at Iladrn Ow tM'approo.diplan anO tMt YIO wtN IeflalNd h "t do f,' rul•s'.and F"ubf oneOOf the Putnam Comely DilpairtlMat 'M ►IMRh. " D July 30. ; 1993 S, +a <' P.E. X III.A. Addrasf $ADEY' &. .WATSON P. Route 9 Co1d,-S ran NY 62505 LktM• Ne APPROVED FOR ,CONSTRUCTION: Thh apprOaial aaapi►•f:tw0 y a►t tM ,GN ifflaa0 unNSS eonstroetbn of the Widi g',Ms been undwUkon and Is IwOia•M lor. causroIr may Mlataraal %W'or naoditled wlwn'con ry Oy tM C Issioraar of':MIYRh ; Aey thongs Or alteration of constructbn, . palukn a' now par It. ppron•d. for difpoMI `of domaslk fan a► and /a • water sup0ly only. 10/88 on• a Title A( DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 a i 1 . _ _ _ _ Y.Y'J. ^IK 'C. Zi LY O •'L :t _ APPLICATION TO CONSTRUCTyA WATER WELL - PCHD PERMIT FALL LOCATION Street Address. Town Sleevv Brook Lane Putnam Valle Tax Grid Number 84- 01-40, Subde # 6 WELL OWNER Name Niles Schwartz, Mailing Address 330 West 45th St., Ate Lobby E NY CIPrivate NY 100360 Public USE OF WELL 1 - primary 2 - secondary OI RESIDENTIAL ® BUSINESS 0 INDUSTRIAL ® PUBLIC SUPPLY' 0 AIR /COND /HEAT PUMP ® ABANDONED 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify U INSTITUTIONAL 0 STAND -BY OUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. ® REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION NEW SUPPLY NEW DWELLING) 03 DEEPEN EXISTING WELL 2=ide able water supply for new residence, OF DAILY USAGE 600 del 13-ADDITIONAL SUPPLY REASON FOR DRILLING., DETAILED REASON FOR 'DRILLING WELL TYPE ®DRILLED ® DRIVEN ®DUG ® GRAVEL. O OTHER IS TELL SITE SUBJECT'TO FLOODING? YES X NO IF TELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Yes Foothill Estates West Filed Map NQ 2477A. Dare 6/20/0 Lot No. 6 VATER WELL CONTRACTOR: Name q�, hp r7Pi- prm;ned Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: N /P, TOWN /VIL /CITY .. DISTANCE TO - PROPERTY- =FROM ,NEAREST WATER MAIN: 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. 3.1 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 drilling operations be contained on this -roperty and in such a manner as not to degrade or otherx-fiR contaminate surface or groundwater. -_:ate of Isaue: 19 Date of Expiration 20 19 Permit Issuing Official Permit is Non- Transferra le White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller t DIVISION' 'OF HEALTH SEF�VICES DESIGN DATA SHEET- SUBSUFACE SOgALE DISPOSAL SY81IIT1 FILE' NO. Owner.. Ni,les., Schwartz .Address 330 .West 4.5.th_.St ..,.. Apt.. Lobby E, NY, NY _ Located at (Street) Sleepy Brook Lane Sec. 84 Block •01 Lot 40 (indicate nearest cross street) Subd. Lot 6 Municipality Town of Putnam Valley Watershed Peekskill Hollow Brook S01C, PERCOLATION TEST DATA REQUIRED TO BE SUBMITTEO..WI'TH APPLICATIONS Date of Pre - Soaking .1/22/86 Date of Percolation Test 1/22/86 HOLE 1 NUMBER CLOCK TIME PERCOLATION PERCOLATION. Run Elapse Depth try .Water From Water Level A No. Tim Ground.Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches ._ Inches Inches A 1 11:51 - 11:57 :6 24 27 3 2 2 11:59 - 12:05 6 24 27 3 2. 3 12:06 12:12 .6 24 27 3 2 B 1 11:51 - 12:00 9 24 27 3 3 2 12:12 - 12:26 14 24 27 3 5 _... 3:. -12- 29 - - 12- :43 14 24 - __ ..2.7 ----- _ __3 ,5. 4.... 1 4 2 • 5 A B 1 11:51 - 12:00 9 24 27 3 3 2 12:12 - 12:26 14 24 27 3 5 _... 3:. -12- 29 - - 12- :43 14 24 - __ ..2.7 ----- _ __3 ,5. 4.... 5 NOS: l.. Tests to be repeated at san-P depth until approximately equal soil rates are obtained at each percolation. test. hole. All data to' be subnittO3 for review. 2_ Depth wpasurenents to be made from top of hole_ rev. 9/85 1 2 3 A 5 NOS: l.. Tests to be repeated at san-P depth until approximately equal soil rates are obtained at each percolation. test. hole. All data to' be subnittO3 for review. 2_ Depth wpasurenents to be made from top of hole_ rev. 9/85 DESCRIPTION_.OF ;SOTES' ENCOUI D IN .:TEST• ;HOLES HOLE NO.. A HOLE NO. B HOLE NO. - G. L. Topsoil Topsoil. - - - - - 1' _ . 21 Silt 'Loam Sijt- Loam 3� 4'. 5' Sandy Loam Sandy Loam .6' 71 a 10' 1J.' 12' 13' o - 14' INDICATE LEVEL AT WHICH GROUNUATER IS ENCOUNTEf2ED not encountered :. INDICi TE'�LEVEE . �.: WHICH TER LEVEL . RiSES :AFTER BEING N� DEEP HOLE OBSERVATIONS MADE BY: BADE.Y. & WATSON, P.C. DATE: 5/27/87 DESIGN Soil Rate Used 5 Min/1"-Drop- S.D. Usable Area Provided . 5 , 0 0 0 SF " 4 Septic Tank Capacity 1250 gals. Type Conc. Absorption. Area Provided By 400 L.F. x 24" width trench Other Provide 1 -0" ROB ,fill. and 6 foot deep curtain. drain. Nam BADEY & WATS.ON Sigi -k Tture Surveying & Engineering, P Ce Address Route 9• Ste' Cold Spring, maw York 10516 SPACE -FQR USE BY HEALTH DEPARDEW ONLY: Soil Rate Approved sq.£t /gal. Checked by F NEW ko, le, gyp. bye!_ it pq�F DAP ,J PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date: August 6, 1993 RE: Property of: Niles Schwartz Located at: Sleepy Brook Lane T /0: Putnam Valley Section 84 Block 01 Lot 40 Subdivision Of: Foothill Estates West Subd. Lot No. 6 Filed Map No. 2477A Date 6 -20 -90 Gentlemen: This letter is to authorize John P . Delano, P . E . , a duly licensed Professional Engineer, to apply for a Construction Permit for a Sewage Disposal System and /or a Private Water Supply, 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 An conformity, with.: the provisions...,of .:.: Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sanitary Code. BADEY & WATSON, Surveying & Engineeing, P.C. Awl', &&(J, P� John P. Delano, P.E.. NYS Lic. No. 62505 U.S. Route 9 Cold Spring, N.Y. 10516 ;(914) 265 -9217 Very truly yours�J, Signed /1�t - &-.:: -� �- i.0t -, Owner of Property '' 330 West 45th Street Apt. Lobby E New York, New York 10036 Address (212) 265 -8189 Telephone tAMM 630000 \a 0 j V 3 Existing .�S.D.S i 1 i I 1 `V ,i f' AS -BUILT RELOCATION- DIMENSIONS i 52.2' DROP BO% `V ,i f' AS -BUILT RELOCATION- DIMENSIONS A -1 52.2' DROP BO% B -1 58.3' " A -2 79.0' " B -2 83.8' ' A -3 108.0' END LATERAL B -3 82.3' ' A -4 115.0' " B -4 80A' - A -5 104.2' ' B -5 55.2' " A -6 103.0' ND CURTAIN DRAIN 0-6 40.8' A -7 37.3" 1 END LATERAL B -7 76.5' 1 " A -8 47.0' " B -8 74.3' i • " A -9 56.6' 1 ' B -9 74.8' `t " A-10 39.0' SEPTIC; TANK B-10 47.7' " Putnam County Department of Health Division of Environmental Health Services Approved as noted for conformano'e with applicable Rules an Regulatlon9" of the Put -Y q.al - .Departmen S1�natuTe & Title -- , s 1..