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HomeMy WebLinkAbout4354DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -67 BOX 33 No oil ,- IN me 16 r rl 'A!4- 04354 PUTNAM COUNTY DEPARTMENT OF HEALTH Z^ DIVISION OF ENVIRONMENTAL HEAL_ TH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT PCHD CONSTRUCTION PERMIT # PV — Z 1 6r4 Located at CIO H 4RSH HI(L� RAAp To or Village Rf MAM VA"V Owner /Applicant Name VS. CoN6TRuGT10Y CORP. Tax Map Block i Lot 0 Formerly Subdivision Name F-1 EZ40 R i 04 E Subd. Lot # 3 Mailing Address J? CPO7bN AAM 'ROAD , 6SS 1NIN4 IV6w Yov.K Zip 105 (p2 Date Construction Permit Issued by PCHD 31- CUTW JX4M Ra, Separate Sewerage System built by V S • Con►STXuLTroni CORP. Address ©SS#AI 1NN ! 4y 105&7- Consisting of 1 5Od Gallon Septic Tank and �� 4 k 6r- !y"40 f f 9 F AAT0 TVC PIPE W Zy" GRAVEL TaEA " Other Requirements:. No c" Water Supply: Public Supply From Address 5 2 $ERG 6R S'rR.E*-t' or: X Private Supply Drilled by N/O MM AMRS 0IS/ Address &'rWAM VA °G4.E 1NT 79 .Building..Typp '5044l.E- F%lui-- 966IDMA* Has erosion control been completed?.._. 5 Number of Bedrooms 'y Has garbage grin �ied? IV D I certify that the system(s), as listed, serving the above pr " is we c J e sentially as shown on the as- built plans (copies of which are attached), in accord th a is C ns ction Permit and approved plans and the standards, rules and regulations o ounXeptment�af ealth. Date: 10 Certified by �I � V, ;' u� P.E. X R.A. (Design Professio K FESy�� � Address 2 bmv ty BLVD, KI cense # 06Z9 $0 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 or change is necessary. r Title: �f Date: _�) oZl t y: ��� ,h e copy - HD File; Yellow copy - Buildin Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 9kAy..x...xn9,.0 WELL COMPLETION REPORT Well Location Street ddress: 4/v `�: ! owlln/Villag e: V r Tax Map # Map t� Block Lots � Well Owner: Name: Address: As Use of Well: Residential ^Public Supply Air cond /heat pump _Irrigation 1- Primary Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment e,-Aotary _Cable percussion Compressed air percussion Other(specify) Well Type _Screened pen end casing __-- Open hole in bedrock _Other Total Length JN I ft. Materials: (/Steel Plastic Other Joints: Welded ✓Threaded Other Casing Details Length below gradeaO ft. Diameter Ain. Seal: Geyftnt grout Bentonite Other Drive shoe: Yes .moo Liner: _Yes _Nov Weight per foot lb /ft Diameter in Slot Size Length ft Dept to Screen ft Developed? Screen Details First _Yes No Second Hours Well Yield Test _Bailed _Pumped _CBompressed Air Hours Yield <S gpm Depth Date Measure from land surface-static specify ft) During yield test (ft) Dept o compete we n K. O-O Well Log Depth From Surface Well Diameter ft. ft. If more detailed Water Bearin 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 -e Capacity_6_ at different depths during drilling Depth -IT) Model list: Voltage 2,36 HP 1 `!4 Tank Type Lit cS a Volume Da�ea1Ne1 16 f� /t'� , 1NellrDrlller Pump 4nstaller PC Certlflcate # o y NY State # C3 ", ®f DateafRepgrt;� k PCFCertlficate # . Up . „a.. -U . .,_IVY State # Well Dri ler Name &Address riller , n s s t nature ) ,. VS 9n c $.yam Pu Jnstaller Nam &Address >> _ ' Pumpinstal er(signature) , _; �' xr' t£�Ka�CC �d pX ? / . .: V.�••l . tll.,U:� ,. ���� l yTSy;. , rF:rCa `.k..::. w... .'^�x�.�'a b2'�: "� c?� s W� 3iro...:f�.�`&i �,T:,:� :� � u ... °Yxw3c.�'vx..�i. Yx.S�?,.�F���ex:� NOTE: Exact Location of well with distances to at9east two permanent landmarks to 0e provided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM V, S ay5rr COR-P Owner or Purchaser of Building Tax Map Block Lot S +I, F, ?Uz1"qn1 Building Constructed by Town/Village :'o NI 514 N «. Rof 124E Location - Street Subdivision Name J wcli raa- �� ��iS • F2 Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the .... - system: The undersigned further agrees to accept as conclusive the determination of the P blic Health Director of the Putnam County Department of Health as to whether or note f lure the system to operatexvas used by the willful or negligent act of the occupant b ldi . lizing the Day O� Year U ( o (Owner) - Signature V. S. Cam, Corporation Name (if corporation) Address:-37- Ck4 o4 *bA rn R-o. , Wtsy(A State N Zip 1.0117- Signature: Title: Corporation o on) Address: State Zip Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 AIbe t- H. Padovani, Director _ LAB #: 1.003913 CLIENT #: 2500 NON STAT PROC PAGE: 1 of 2 ANDERSON WELL DRILLING DATE /TIME TAKEN: 09/14/10 09:45 152 BARGER ST DATE /TIME RECD: 09/14/10 10:35 ATTN: NORMAN, SARAH REPORT DATE: 09/21/10 PUTNAM VALLEY, NY 10579 PHONE: (845)- 528 -1491 SAMPLING SITE: LOT 3 #40 SAMPLE TYPE..: POTABLE MARSH HILL, PUTNAM VALLEY, NY PRESERVATIVES: NONE COLD BY: NORMAN ANDERSON. TEMPERATURE..: < 4C NOTES...: SANTUCCI COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 09/14/10 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B 09/17/10 LEAD (IMS) 1.0 ppb 0 -15 ppb SM 18 -19 3113B 09/17/10 NITRATE NITROG 1.12 MG /L 0 - 10 SM18- 20450ONO3 09/15/10 NITRITE NITROG <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 09/16/10 IRON (Fe) <0.060 MG /L 0 -0.3 mg /1 SM 18 -20 3111B 09/16/10 MANGANESE (Mn) 0.024 MG /L 0 -0.3 mg /1 SM 18 -20 3111B 09/21/10 SODIUM (Na) 12.5 MG /L N/A SM 18 -20 3111B 09/14/10 pH 6.4 UNITS 6.5 -8.5 SM18 -20 4500HB 09/16/10 HARDNESS,TOTAL 182 MG /L N/A SM 18- 20.2340C 09/16/10 ALKALINITY (AS 88.0 MG /L N/A SM 18 -20 2320B 09/15/10 TURBIDITY (TUR <0.3 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: MFTC oliform = This result indicates that the water Ma (was not) of a satisfactory sanitary quality according to w York State and EPA federal drinking water standard for this parameter. This comment applies to the Total Coliform test only. Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 •{/y .p y1rL (914) 2T455y- •\2800 _�♦ a:Ijj .. L!�...p. v.. �.Jfl \*.r� \� t 4':::: p.„ P, lbl. ofiL' Mr• H .:�,;ad ©�Fa313.f:.�r}Da..G'�lrQ i.LvY 1Tr\ Y ri•••h•{f�..Y N_.• Ah,f .r �.. �iS:.r �.v �w L'{�'Y ~ -.. LAB #: 1.003913 CLIENT #: 2500 NON STAT PROC PAGE: 2 of 2 ANDERSON WELL DRILLING DATE /TIME TAKEN: 09/14/10 09:45 152 BARGER ST DATE /TIME RECD: 09/14/10 10:35 ATTN: NORMAN, SARAH REPORT DATE: 09/21/10 PUTNAM VALLEY, NY 10579 PHONE: (845)- 528 -1491 SAMPLING SITE: LOT 3 #40 SAMPLE TYPE..: POTABLE : MARSH HILL, PUTNAM VALLEY, NY PRESERVATIVES: NONE COLD BY: NORMAN ANDERSON. TEMPERATURE..: < 4C NOTES...: SANTUCCI COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER HARD WATER:,-140-300 MG /L (1 grain /gallon = 17.2 MG /L) THE ABOVE TEST PROCEDURES MEET ALL REQUIREMENTS OF NELAC, AND RELAT ONLY TO THESE-SAMPLES RECEIVED BY THE LAB SUBMITTED BY: 4Ws Albert 14. Padovani, .T.(ASCP) Director ELAP# 10323 19RUCE R_ -FOLEY. DEPARTWMNT OF BEALTH I Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., X&N, yeaiti Director Director of Patient Services Envirennentmi KealtN (845) 279 - 6130 Pax (845) 278 - 7921 Nursing Services (845) 279 - 6558 WIC (845) 278.6678 Fax (945) 279 - 6085 1 Refly IntenvadouffiVeschoW (945) 278 - 6014 Fax (945) 279 - 6648 E911 ADDRESS VERIMCATION FORM OWNERS NAME: VS CONSTRUCTION-CORE, TAX MAP NUMBER: 84.-l-67 E911 ADDRESS: 40 Marsh Hill Road TOWN: Putnam Valley AUTHONZED TOWN OFFICIAL UATE., The Putnam County Department of Health will not issue a Certificate of construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form-is to be submitted with the application for a Certificatc of Construction Compliance. (E911 Verftm) R®NIN ENGINEERING_-., PE, PC The Lindy Building, Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566 Tel.: 914- 736 -3664 a Fax: 914 - 736 -3693 October 7, 2010 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re: V.S. Construction Corp.- Emerald Ridge SSTS Construction Permit (Change of Engineer) Certificate of Construction Compliance 40 Marsh Hill Road Emerald Ridge Subdivision - Lot 3 Town of Putnam Valley, New York Section: 84, Block: 1, Lot: 67 Dear Mr. Paravati, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Permit (Change of Engineer) and also the following regarding an application for a Construction Compliance Certificate at the above referenced lot: 1. One (1) Certified check for $300 for the As -Built fee. No fee for change of engineer on construction permit. 2. Four (4) Subsurface Sewage Treatment System Construction Permit Plans for the above referenced lot. (Change of Engineer) .3:.:. our.0).Subs0rfdce Sewage Treatment System Gon'sirucfion Permit Applications for-the above referenced lot. (Change of Engineer) 4. Four (4) Copies of a two (2) year guarantee signed by the Owner &'the Installer 5. Four (4) Well Completion Reports signed by Norman Anderson (The Well Driller) 6. One (1) Copy of Satisfactory Results of a Water Analysis by a Yorktown Medical Laboratories, a NYSDOH Approved Laboratory. 7. One (1) E911 Address Verification Form verified by the Town of Putnam Valley. 8. Four (4) Certificates of Construction Compliance 9. Four (4) Sets of "As- Built" Plans signed and sealed by Timothy L. Cronin III, the Design Professional. 10. One (1) Copy of As -Built Foundation Survey by Donnelley Land Surveying. Please review the above items at your earliest convenience and should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Respectfull Submitted, Ja . Teed, Jr. lect Engineer cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati -PCDH- Santucci -Marsh Hill Road -Lot 3- SSTS - Trans- JT- 20101007.doc "I I AM COUNTY `. IIiI I" AR I M I \ I OIF HEALTH I I I II >IVIMON GIF ENWRONMEN7AL HEALTH III SI RW(I PERMffT # (91—co Located at qQ MARSH HILP, Rc>AP Tao or Village ?UM.40A W P-y Subdivision name RAW R ip4F- Subd. Lot # Tax Map 8q Block :1 Lot Date Subdivision Approved P4oVr -M BED 19, Z Owner /Applicant Name V-6. Comm yc-nay CORP. Renewal X Revision Date of Previous Approval Mailing Address 311 CBOT p4 D+,4 jto4p s 0S3aq1&j4 A Af6w , eiw Zip 10562- Amount of Fee Enclosed Building Type -SjW_ L E Lot Area o� No. of Bedrooms � Design Flow GPD 900 Fill Section Only Depth Volume Sclparatc Sewerage p'stcnn to consist of :. is ®® gallon septic tank and 'Y®® da r OF TY PERma'M TVC Pme Ill 21" Ads- 1 c,4 Other Requirements: To be constructed by T 13,Po Address Watt supply. Public Supply From 1: 'i I - - *' og: V...: :Private Supply;Drilled-by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s, sy tem descr' _ +e will be constructed as shown on the approved amendment thereto and in accordance with the standards, ru , 'arid �i11t1.9 f the Putnam County Department of Health, and that on completion thereof a "Certificate of Cons , i lCetrlpl' e" `s isfactory to the Public Health Director will be submitted to the Department, and a written gu an e) ill b furnish dxt owner, his successors, heirs or assigns by the builder, that said builder will place in good op �at i co ony pa of aid sewage treatment system during the period of two (2) years � ,k_.....;, immediately following t�ie�d o the is Yae'�af�the appro: al of the Certificate of Construction Compliance of the original system, or any repair thereto Signed: o�G r 6z9so� �` Address 4114 Sd;VO • i,4 ate. P.E. / R.A. Date 0r-`I'®jjgA ` , ��d0 License # 062990 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 a it. Appr ischarge of domestic sanitary sewage only. By: Title: '1� Date: hc)* Whi copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 � aT ,� � •1 J �1 Y in '!•111 .p t. . O 1 1 M LOT 3 1 'a � Area =259, 8>,5 Sq. Ft. 5.9696 Acres ►� 1 � aT ,� � •1 J �1 Y in O M LOT 3 'a Area =259, 8>,5 Sq. Ft. 5.9696 Acres ►� = m 4'0 CAST IRON PIPE t AS BUl1:T SEPTIC TANK (1500 rALLON CONCRETE) - 345.5 L.F. OF 4'0 SDR35 PVC PIPE / /�i ``` i ALL TRENCH ENDS •.• 0 � " _ ARE CAPPED y \� - --- - -- - - - - - \ 13 2' SOLID PVC PIPE to / 1 (., AS�BUILT 0.0' \ \\ \ \i OD 1 SETBACK - 1 \ \ `�\ (TYPICAL C AL I ST (TYPICAL INSTALLATION) � 1 Q well 2' Un \ PRIMARY,,REA 00 \ \\ ; (400 F .' TOTAL) ABSORPTION TRENCH L. (TYPICAL INSTALLATION) i . . \ 4.0 PVC ROOF LEADER 8 149.89 HDPE FOOTING DRAIN , YO / Arp ry \\ \\`CHARGE AWAY FROM SSTS ��'�QQ 1 °34 '31 ")v -Con serve xs- 5611. v S•S• 8 11 Olt, DE T cpsCENTER 36 820 SEPTIC TANK .73-- JUNCTION BOX 1 (1) 780� SO 2 (2) 1 -Y ..—NCT JUIOSSO 94 ION -50X 3 (3 99. JUNCTION 80% 4 (4) 57.6'i 107.6 TRENCH A F-t4o t4oRTti (5): 63.6 112.4! NORTH (ro) I -T ct4 2 FEN , jJ7 R04 C)9.5 11 -ffko4CVj 3 END t4oRr" (7) 75.6k\ 121.5' TRE CvA 4 F-No t4 RTVA (S) Bro.N A Ft4o souf" (91 92.2- TRE NcVA 10) 2 EM) Sou"Ill 91.9 TRENCH 3 END t) sc)u-rti 103.N TF04c" . U'TVA o2). TRENCH 4 END -kkp-TjON Q. 37.7 i, 50-Y WELL