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HomeMy WebLinkAbout4357DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -1 -70 BOX 33 I ' ti k ;I rk T V �J I I- 04357 TNAM COUNTY DEPARTMENT OF HEALTH IVISI.ON_OF- ENVIRONMENTAL HEALTH .SERVICE CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEMS, PCHD CONSTRUCTION PERMIT # PV-09 -'08 Located at 107 MARSH W I1..L RQgD Tow or Village PU7 -tAM VAL -LEY Owner /Applicant Name_,S, eoNSM UC- 7gd Q) &P Tax Map 811 Block 1 Lot Formerly Subdivision Name JFMER4/,0 RIDE Subd. Lot # 10 Mailing Address 37 Gww PAM jZpA 0ss!Nq) L, Nam VoRk Zip 105 02 Date Construction Permit Issued by PCHD MARCH ;r 513 VJA6J4JA*T0N ST909'r Separate Sewerage System built by T. Comm 0W MVCTi8d .Address PWX8K1 U. N 1/ 1A566 Consisting of 1500 Gallon Septic Tank and Y05 L X. O c f "Of R6RFoR4'rED PVC PIPE IN 2'y" CARAVEL - PSAMNES Other Requirements: AlO/NE Water Sunaly: Public Supply From Address ✓ 152 BASER 8-nwr or: Private Supply Drilled by Ab&MM "DERSON Address j)TNAt4 1/ka.LEy,N� 105 9 t...yBu ld ngx 'y_pe j!N � L IDF . Has erosion-control-been completed? i/ - r .... _......:_:.�.. Number of Bedrooms Has_gadu- - . c NEW I certify that the system(s), as listed, built plans (copies of which are attar plans and the standards, rules and r Date: �_Z-1_-.)._-VdCertified1 Address 2 JOHN s UN0N been installed? WA constructed essentially as shown on the as- d PCHD Construction Permit and approved Department of Health. / P.E. V R.A. License # 062980 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. B � G%Ctisc��. Title: IQr to copy - FID File; Yellow copy - Building Inspector; Pink copy - Owner; Date: o! ® 1 Orange copy - Design Professional Form CC -97 } PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT p(�o,DO`xY� Svg'►7�d►Sw+.e W_ I _T9 Well Location .Street Address: _ TownNiliage: Tax Ma f Block Lots e, W Well Owner: Name: S C��nS �Y.tti� Address: +ioh -3 -7 Q A. Use of Well: I- primary ,2-secondary Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary Cable,percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing )Details Total length !-,ft. Length below grade ft. Diameter (o in. Weight. per foot lb/ft. Materials: t- Steel _ Plastic _ Other Joints: _ Welded _--threaded _ Other, Seal: Cement grout _ Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes_No Hours Second Well Yield Test _ Bailed _Pumped '"Compressed Air Hoursi Yield Cr CIPM Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet (� cU I Well Log If more detailed information descriptions or sieve analyses ire available,._ please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface r,• v If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth 510 Model i_5-/`j__:-;.?c Voltage . 3 HP Tank Type Volume Date Well Completed ( S Putnam County Certification No. Date of Report / We I Driller (si; nature) ;� :t NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller's NatneA I inn , vt 10i 4. V E 0 ^ Address: Signature: i0Owl Date: i.r ';i�lUSr White copy: HD File; Yellow copy - Building Inspector: Pink copy - Owner: Orange cope - Well driller Form WC -9? -. ,C,: -tip• �� .7 <. •C� .'.,Cr % _ �a,��ir ti ems. •. .. _ "_ -_ BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental. Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278.6085 Early Intervention/Preschool (845)278-6014 Fax (845) 278 - 6648 OWNERS NAME" E911 ADDRESS VERIFICATION FORM � S - CONS rr- U c i oN - OVOIP,. TAX MAP NUMBER: g — i- — E911 ADDRESS: yd T mas H lt-c K°AV TOWN: ?tl i NII�M U AUTHORIZED TOWN OFFICIAL: ,. _ .. t -- - _ w,• (Sig' ature).. DATE: y %O 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 verfrm) B a B D A A V A (a ANS /NSF 81 Pffe- pressulzed diaphragm -type well tanks WN -1 009 200 and 300 SERIES In -Line Models Model No. Tank Vol. Max. Accept. Factor A Height B Diameter Sys. Cann: Factory Pre - charge Working Pressure Ship Wt. 'Lit. Gal mm I ins. mm ins. ins. PSIG PSIG' kg I lbs. WX -101 8 2.0 0.45 321 125/6 203 8 6/4 18 100 23 5 WX -102 17 4.4 0.55 381 15 279 11 6/4 18 100 4.0 9 WX -103 33 7.6 0.42 629 221A 279 11 6/4 28 100 7.0 15 WX -104 39 10.3 1.00 451 176/4 390 156/e 1 38 125 9.0 20 WX -200 1 53 114.0 38 0.81 559 22 390 15'/6 1 38 125 1 10.0 1 22 System Connection: Steel. 6100 PSIG is 689.5 kPa, 125 PSIG is 862 kPa ' System Connection: Steel. Copper Lined Steel Fitting Stand Models Model No. Tank Vol. Max. Accept. Factor A Height B Diameter C Can Sys. Conn ' Factory Pre -char a Working Pressure Ship Wt. Lit. I Gal mm I ins. mm Ins. Ins. Ins. PSIG PSIG- kg lbs. WX -104 -S 39 10.3 1.00 489 191/4 390 15% 116A6 1 38 125 10.5 23 WX -201 53 14.0 0.81 606 23'/6 390 15% 1t6A6 1 38 125 11.4 25 WX -202 76 20.0 0.57 803 316/6 1 390 151/6 1 "A6 1 1 1 38 125 15.0 33 WX-202XL 98.4 26.0 0.44 971.5 38'/4 390.5151/. 116A6 1 1 38 125 16.3 36 WX -203 121 32.0 0.35 1143 45 390 15% 116A6 1 38 125 20.0 43 WX 205 129 34.0 1.00 752 295/6 559 22 26A6 1' /• 38 125 28.0 61 WX -250 167 44.0 0.77 914 36 559 22 26A6 1'A 38 125 31.0 69 WX -251 235 62.0 0.55 1187 465A 559 22 26A6 1'A 38 125 41.0 92 WX -255 06.6 81.0 0.41 ..1.432 56'/6 558.8 22 26A6 1'A 38 125 10.0 103 ;;WX =3.02 ` 326`: "8f s0 _i054 `120D'4'A' 66 _2ii,; . ?2'A6 ,;i' %? ' ,: 38.' .,. , ,125.:.56.0 WX -350 450 '19:ff 0.39 157[ 61'/6' 660 26 2'Ae iY < "' ' 38' '75:0 ' 166' ' 125 PSIG is 862 kPa (Stainless Steel Elbow). ' System Connection: Stainless Steel. Max. operating Conditions V Operating Temperature 200° F (93° C) C p A Job Name 9APAVC61 Location ft_ 3 6 �u ( loc 1� Engineer CadA/ my &W& urf�fly; Contractor a °me"1 oN AWDFfZ6W Contractor P.O. No. Specifications Description Standard Construction Shell Steel Diaphragm Heavy Duty Butyl Liner Virgin Polypropylene Coating Blue Enamel' 4 Unless TUF -KOTE is specified. All dimensions are approximate. Sales Representative Model No. Ordered �- Pump Cut -In PSI Pump Cut -Out PSI Pump GPM Rev. 02105 Submittal data sheets can ONLY be ordered as a 'Submittal Data Sheet Pack', using MC# 4400. They are not available to order on an Indi- vidual basis, however each data sheet is available on the Amtrol Web Site and can be downloaded and printed ror use as needed. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,, . .. ., : S']': .. ._:ti Pe" -a •C;:o -:�: ,• � .. _ .. ,v - ..,• _... _.._._ _. .. .. -.. -- t�.• x..10. . •:X'. ".v; e.: g.. 9. a, , GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM V, S. l o VS -rAyC c ol( (kp- Owner or Purchaser of Building V, S. QA/CTk UC -r(Wj 6blzP, Building Constructed by 1,07 MffGf4 14rc.c. Ro /4p Location - Street s+N4(,E htmPUf 1 6r%%VF1VCS Building Type 814 1 70 Tax Map Block Lot Turvoin V ow . illage ,rME0LJ7 RraG,E Subdivision Name t0 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. e . _:. _ .... _..•.r• The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the fa' re o the system to operate was.caused by the willful or negligent act of the occupant o di utilizing the system. _ , Z) w Date o th' Day Year Signature: _ CT�l2 Title: �,/S�NS£D SSTs �} Gene a o tra or (Owner) - Signature V. S, C01,x eVCt►cN C0PP, (V #L6ibVT`1jZ►) j Cr-sAglNl GNsmo-no4 Corporation Name (if corporation) Corporation Name (if corporation) Address ad-rw D" Ro�➢f d s�+N��� Address: 513 t0SH+NGTON 57'F-ar State N y Zip 14566- State N _� Zip Z Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 _A 1-ber -t H �.' Padovan1 Suva -r iktor': .,, .... _ ...... LAB #:- 1.802922 CLIENT #: 58362 NON STAT PROC PAGE: 1 of 1 V.S. CONSTRUCTION DATE /TIME TAKEN: 06/19/08 09:30 37 CROTON DAM ROAD DATE /TIME RECD: 06/19/08 10:15 OSSINING, NY 10502 REPORT DATE: 06/24/08 PHONE: (914)- 447 -4587 SAMPLING SITE: LOT #10 MESDON RIDGE SAMPLE TYPE..: POTABLE : SUBDIVISION PRESERVATIVES: NONE COL'D BY: A. SANTUCCI TEMPERATURE..: .< 4C NOTES.: BOILER MATE COLIFORM METH: MF ------------------------------------ NM' N' NN---- NNNNNNNNNNNNNNNNNNNNNNNNNNNNNN DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 06/19/08 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B COMMENTS: MFTC THESE RESULTS INDICATE THAT THE WATER (WAS),(WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. SUBMITTED BY:_ Albert H. Director dovani, M.T.(ASCP) F ELAP# 10323 R®NIN ENGINEERING PE, PC The Lindy Building, Suite 200, 2- John Walsh Boulevard, Peekskill, New Y Tr 10.5.¢6... _. 4 =`T36= 3664'• °Fax: 914 =736- 3693.. July 17, 2008 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re: V.S. Construction Co►p.- Emerald Ridge SSTS Construction Permit Marsh Hill Roam Lot 10 Town of Atinam Valley, New York Section: 84.00, Block. 1, Lot: 70 Dear Mr. Paravati, 1� u Per your conversation with Keith Staudohar of Cronin Engineering, please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Compliance Certificate at the above referenced lot: 1. Four (4) Revised Subsurface Sewage Treatment System As -Built Plans for the above referenced lot. It appears that the location distances shown for the trench beginnings were never updated with the correct data and were showing data from a different job. Should you have any questions or require .- ..additional information, please do not hesitate in contacting me at: the number above. -: Respectful Submitted, ames W. Teed, Jr. Project Engineer cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati - PCDH- Santua;i-Emerald -Lot 10-Tra r� #- 20080717.doc (CRONIN IEN GIN EIEI ING PE, PC intly.- +Buililirig;. Suite 2Q0;" 2;; Jahn,Walsh;Boµlevard,Peekskitl, Netii -Yorl Tel.: 914 - 736 -3664 o Fax: 914- 736 -3693 June 25, 2008 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re. VS. Cmstmcllon Corp.- Emerald Ridge SSTS Construction Permit Marsh Hill Road- Lot 90 Town of PuWarn Valley, ifew York Section: 8100, Block. 9, Lot. • 70 Dear Mr. Paravab, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Permit Renewal at the above referenced lot: 1: One (1) E911 Address Verification Form Signed by Authorized Putnam Valley Official. 2. Three (3) Guarantees of the Subsurface Sewage Treatment System signed by a licensed Putnam County Septic Installer and the Owner. 3. One (1) Certified check for $300 made payable to the Putnam County Health Department on behalf of the above referenced application 4. Four (4) Subsurface Sewage Treatment System As -Built Plans for the above referenced "I ehewal) dQR 5. Four (4) Subsurface Sewage Treatment System Construction Compliance Applications for the above referenced lot (Renewal) 6. Four (4) Copies of the Well Completion Report originally submitted to the Putnam County Health Department at the time of Subdivision Approval. 7. One (1) Specification Sheet for the Well Tank installed at the above referenced property. (WeIl�X Trol Model WX -302) 8. One (1) Copy of an As -Built Foundation Survey for the above referenced property. Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Respectf Submitted, �' .�- . s Teed, Jr. Project Engineer oc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati -PCDH- Santucci- Emerald-Lot 10 -Trans jt- 20080625.doc '08 -06 -18 13 :44 FROM- T -991 P001/001 F -729 (345) Z.?s- 39V . `ci t: 'l: ., -. .. � . .. :':.i -r. +•_.._...:.. f. •. .�.. ci. �:.. • ;. ._ .. to1K -.. ai.er- J PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION ADAM Q GENE 01a l- P RF,(tFF.S"C FOIL. FTIVAT, INSPECTION For: Fill All information must be fully completed prior to any Trenches inspections being made. PCHD Construction Permit Located: H ILA-, Roar Owner /Applicant Name: o 'i' C onl TM 60V Block � L t .. Formerly: Subdivision Name: FM6 r Subdivision Lot # /0 Is s�stem fill completed? _ N 1A _ Datd: Is s�.stem complete? Date---..0 zu�ti? Is system constructed as per plans? VF8 Is well drilled? V ,S Date: 01,12-005, Is well located as per plans? YES Ate erosion control measures in place? I certify that the system(s), as listed, at the abov and verified their completion in accord _.apptoved plans and the Standards, Mules n+ Ire ih, Date " l Certified b4 NEW Y e Y$s�i� ed d I have\iaspected i o ruction Permit and ins nty. Department of w c� PE ItA I pROFES5�0 Address- Comments: daKIV /A Lic. # Comments: Form FIR -99 I SHERLITA AMLER, MD, MS,1:AAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health June 20, 2008 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, NY 10566 To Whom It May Concern: ROBERT J. 13 ®NDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Emerald Ridge Marsh Hill Road; Lot # 10 (T) Putnam Valley, T.M. # 84 -1 -70 The above referenced separate sewage treatment system can be backfilled. A bedroom count, well -inspection and.trench:inspection was preformed today and there are- no further comments or concerns If you have any further questions, please contact me at (845) 278 -6130, ext 2155. JD:kly Si erely, Jose Digit Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 Street Location [ TNI9_% PUNAL SE INSPECTION ��- Date: Inspected by: Owner t'rIVA✓ul .4!'Fl.� - Permit # _ — —0e ' Yubdivision Lot 1. Sewage Svstem Area a. STS area located as per approved plans .......... :................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ..............:.... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage Svstem Moo a. Septic tank size - 1, 000 ... ......1,2�0.........other.... b. ' Septic'tank installed level ........... ............................... .. c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested.......... .:...: . 2. Protected below frost .................. ............................... 3 Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set ........ .............................� 6. Trenches – . // ��V,,�5 1 ' 1. Length required `7 Length installed 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ........................ 4. Slope of trench acceptable 1 /16 - 1/32" /foot ............. S. 10 ft, from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ........................ ............................... g. Pump or Dosed Systems e of um chamber ..:.:....:..:...:.... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio ........:........... ......:........................ 4. Pump easily accessible, manhole to grade ................. 5. First box baffied ........................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. house located per approved plans . ...................:........... b. Number of bedrooms .... ............................... ........ M Well Well located as per approved plans ................ I ............ V b. Distance from STS area measured ........... c. Casing 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............. ................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ............. ............................... Rev, 12/02 IMAM MM VAMM V�M ��® WIAM MAM ��M MA- WAMM =MM v.. CONSTRUCTION PERMIT FOR SEWAGE TREATMENT YST&' PERI�UT # PQ/ -Vq- Ofr Located at MARSH HILL ROAD To or VillagePUTNAM YALLlc Subdivision name lE Lp �8®gj� Subd. Lot # �® Tax Map (Sq. Block t Lot �;O Date Subdivision Approved NoysAr mg :19, 2.00T-: Renewal Revision Owner /Applicant Name V0 S. C01qSTR �Xnapj COMA Date of Previous Approval Mailing Address V4 `} t1,•' ,.W DAM RoA T ►) 0 `} M l ^16] NEW 1, l J) Fl :� 10512 zip Amount of Fee Enclosed A .500. do Building Type SQL" FAMILY Lot Area.5AW No. of Bedrooms q Design Flow GPD 800 FBI Section Only Depth Volume PCH D NOTIFICATION IS RE N>1RE1<D WHEN FILL IS COMPLETED Segau•ate Sewerage Sts>tem to consist of 10500 gallon septic tank and 1165L-!F- ®r- V14 PC-PF0AATSV PVC PIPS /N Z'y" 6WVE&- T3RAM Other Requirements: MWE To be constructed by i Do De Address Water Su nniy: Public Supply From Address _ or: V PrivaWSupply-Drilled"by 15 9 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 system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and re ulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construct " satisfactory to the Public Health Director will be submitted to the Department, and a written guarante ,*J e 51pled a owner, his successors, heirs or assigns by the builder, that said builder will place in good operafiriv leA on any' 4 f"\aid sewage treatment system during the period of two (2) years immediately followinhP date of tie issu;are;f thepVrol of the Certificate of Construction Compliance of the original system or any re irslfereto. 1, PP -. I '- 40. Address 2- %JOHW 07, r }� r y ^: /PL.E. , �9 R.A. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. B � Title: Date: khij/copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF DEAL ISION OF ENVIRONMENTAL HEALTH SER CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at MARSH HILL ROAD 1 To or Village PUTNAP4 VALLEY Subdivision name .EMERALD RINlIE Subd. Lot # 10 Tax Map q._ Block 1. Lot q0 Date Subdivision Approved NOVEMrm 19, Zool- Renewal Revision Owner /Applicant Name V.S. CONSTRUCTION CORP. Date of Previous Approval Mailing Address Y4 CROTW t7AP1 ROAD . OSSINIA167 NEW VokK Zip 10562 Amount of Fee Enclosed 1500. 00 Building Type SI460- FR 4 Lot Area 5N35 No. of Bedrooms Design Flow GPD 800 RESIDEA/CE (ACRES) Fill Section Only Depth Volume PCND NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1,500 gallon septic tank and y05 t_•f. CF �iof d P0= RF mTr=b PVc PIPE /At zy Jg*VEL T1zEd6I Other Requirements: NONE To be constructed by T'6• D• Address Water Supply: Public Supply From Address or: Private Supply Drilled .by r$• -D. 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 treatments stem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of, Co etfo — Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a writt a EWwrfkla aJi mished the owner, his successors, heirs or assigns by the builder, that said builder will place i ting(O ion\ y part of said sewage treatment system during the period of two (2) years immediately foll i thte of ( u he approval of the Certificate of Construction Compliance of the original system or any r ai Signed: Address 2 P.E. R.A. Date 016 $ i L,1VV 10566 License # 062980 APPROVED FOR CONSTR: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 (e'S 1 •` i 's 74T u) v./ Y HEALTH. OF EN`kt7M01W WAL AFFIDAVIT - CORPORATE OWNER APPLUCATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Subsurface Sewage Treatment System Construction Permit (TM#:Bq - ( -.-fo ) Val Santucci represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: V. S. Construction Corp. Having offices at: 37 Croton Dam Road, Ossining, New York 10562 Whose Officers Age• President - Name: Val Santucci Address: 37 Croton Dam Road, Ossining, New York 10562 Vice President - Name: Address: Secretary -Name: . h.: r r..r ..tea.. r ..,n.�d�resS,< r c.- .. r. � ..• �� s .t.. -�. •i.•'hv ....y. .... —. 4 .s .TPS— q�K..... +. <.r..... .. ... �. _ _ �Mt Treasurer - Name: Address: and that I am and will be individually responsible for any 1 cts Fthe corporation with respect to the approval requested and all subsequent acts relating Signed: Title: Form CA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH D�P I-SIO-N �OF -ENVIRONMEI - TA- L-HE.A -T, H- °SE 1 YW S-..., LETTER OF AUTHORIZATION RE: Property of V.S. Construction Corp. Located at Marsh Hill Road 1-IN Putnam Valley Tax Map # 84 Block I Lot 70 Subdivision of Emerald Ridge ;;063 4 Subdivision Lot # 10 Filed Map #.38644 - Date Filed X P8 4U!% z ^ Gentlemen: This letter is to authorize Timothy L. Cronin III, P.E. a duly licensed Professional Engineer LiL or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve. the above -noted property in accordance, with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary.papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with th oy f Arti a 145 and/or 147 of the ducation Law, the Public Health - :LaW,' - ..5' '� a ode: &W theP a :..:��. �_.....�_�.� ..4.. ... . �.N __. P.E., R.A., # 62980 Mailing Address 2 John Walsh Boulevard, Peekskill State New York Telephone: (914) 736 -3664 ,Zip 10566 ` Very tru wi Signed: z �` J' .C. Mailing Address: V.S. Construction Corp. 37 Croton Dam Road, Ossining State New York Telephone: (914) 447 -4647 Zip 10562 Form LA -97 PUTNAM COUNTY DEPARTMENT • n i •wJ�4 -.. .._.v f.� -. r.P:••�P':♦ Y..,�S..i L� DEPARTMEYT ®F HEALTH O VFENVIRON NTAL -:H A- L- TII- S- E- RVIC.E-�T ...: i..r - } �- yam. F. r� -• APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM][ 1. Name and address of applicant: V.S. Construction Corporation 37 Croton Dam Road Ossining, New York 10562 2. Name of Project: Emerald Ridge- Lot 8 3. Location: T/V: Putnam Valley 4. Design Professional: Timothy L. Cronin III 5. Address: 2 John Walsh Boulevard 6. Drainage Basin: Peekskill Hollow Brook Peekskill, New York 10566 7. Type of Project: Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/No No Type Status (check one) ...................................... ............................... Type I Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required ? .................... Yes/No No 10. Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes/No N/A 11. Name of Lead Agency Not Applicable 12. Is this project in an area under the control of local planning, zoning, or other officials, ,.; _ Yes ordinances? ..... ...... : ...... :: ...........Yes/No - 13. If so have plans been submitted to such authorities Yes/No Yes 14. Has preliminary approval been granted by such authorities? N/A Date granted: N/A 15. Type of sewage treatment system discharge ........................ surface water ✓ groundwater 16. If surface water discharge, what is the stream class designation? .......................... N/A 17. Waters index number (surface) ............................................. ............................... N/A 18. Is project located near a public water supply system? ................ Yes/No Hone 19. If yes, name of water supply Not Applicable Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? .......... Yes/No None 21. Name of sewage system Not Applicable Distance to sewage system N/A 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) 800 GPD ............................. ............................... 25. Is State Pollutant Discharge Elimination system ( SPDES) Permit required? ... Yes/No No 26. Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A Rev. 11/02 Form PC -97 Pg. i of 2 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No No >�.. i�4�. >is ° =sia :�na V.oF'., a w. :q6..~i'.% =-a. r... 1. �'0 . :YI e. ,C•q'.� .: {,� v :e- �'.a•••w.'r ::� =Ri o:;ea v,�i •.: . :w�..i -.,�. r.J.: 11 .... -•r� :7•v, ,�q.ir�r:+f++ 28. Wetlands ID number N/A 29. Is Wetlands Permit required? ...................................... ............................... Yes/No No Has application been made to Town or Local DEC ........................... Yes/No N/A 30. Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No 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/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ......:............................ ........ .................... ..... Yes/No No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .........................Yes/No Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? .................................. .........................Yes/No No 35. Are any sewage treatment areas in excess of 15% slope? .............................. Yes/No No 36. Tax Map ID Number .............. ............................... Map 84.00 Block 1 Lot 70 37. Approved plans are to be returned to ................ . Applicant * Design Professional .. ♦10 .. o... .r .r M.e •.. .• n. ... ... r rryt .+.M. ... ...• a...e.... .. ...w w.. ..,,' ..tea ..,y r-.. .i .... �... .r .. •.Y.. �,. n. +. ..... w� A.w.. ... ... .. , ..�... .. .. ...��. y .�,.M. NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown ivItem 1, the application must be accompanied by a Letter of Authorization (Form L , ��41 comply with this provision may be grounds for the rejection of any submission. "s '��RVr I hereby affirm, under penalty of, my knowledge and belief. False si pursuant to Section 210.45 of the on this form is true to the best of ble as a Class A misdemeanor SIGNATURES & OFFICIAL TITLES: VII' - — : 'v . Timo e1P E. Mailing Address: ........................... Cronin 2 John Walsh oulevard. Peekskill. NY Form PC -97 617.20 Appendix C - - State.Environmen�al C alit. Review.. _ - .�} -fie: .,Y._...:F u.�:•r+l,`° SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I. PRCLIFCT INFORMATION (To be completed by Applicant or Proiect Sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME V.S. Construction Corporation Construction of Single Family Residence 3. PROJECT LOCATION: Municipality Town of Putnam Valley County Putnam County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) West side of Marsh Hill Road, 3580 ft. north of intersection of Marsh Hill Road and Peekskill Hollow Road 5. PROPOSED ACTION IS: New Expansion Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: Construction of a new single family residence, SSTS and Private Well Supply. 7. AMOUNT OF LAND AFFECTED: Initially 5.435 acres Ultimately 5.435 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ZYes 0 No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential E� Industrial Commercial 0 Agriculture Park/Forest/Open Space Other Describe: Surrounding lands are zoned R -2. (Sin9 le Family.gesidential) -.:- .... . ..,w- w.T... .. +ter .._. r.. .-w. �� ;-y.; ,.rq..F.. �.+.✓ .0 rF -�.as a�aa -.� .__. �..- �+:i -.. r f! ?�l't °...._..� �-.. w_- .�..- .,T„� --�q mot•. ._..�, r iX�i. •aa 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? Yes F-1 No If Yes, list agency(s) name and permit/approvals: Town of Putnam Valley- Building Permit 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes EJ No If Yes, list agency(s) name and permit/approvals: Town of Putnam Valley- Site Development Approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? E] Yes 0 No I CERTIFY THAT FORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: C in Enginee ng, P.E., P.C./ James W. Teed, Jr. Signature: If the k6on is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II - IMPACT ASSESSMENT (To be completed by Lead Aaencvl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. []Yes. EJ. No.. B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. E] Yes 11 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Longterm,, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? El Yes E] No If Yes, explain briefly: T::.t$-THEF3E;DR'IS:T.NFf.?E (sK�L,Y.T0.OE, G.ONTROVCRSYRELATED,TO P,pTEigTIAL. SDI F- RSF_•, EN_ V .IRON"N'4EN,TAL-LKt,AC7S ?.'.,.. Yes ❑ No If Yes, explain briefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. F] Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FU EAF and /or prepare a positive declaration. Check this box ifyou have determined, based on the information and analysis above and any supporting documentation, that the proposed action Wl NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determinatic Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) SHERLI<TA AMLER, MD, MS, FAAP Commissioner of Health rff ­;r,1;0 -T-TA A G NAYYLL, 1k V, MJR`.�:yp •a •tr... q• ' FTi. Associate Commissioner of Health January 25, 2007 James W. Teed, Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, NY 10566 Dear Mr. Teed: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: R®RERT J. 1s ®NDI County Executive ROBERT MORRIS, PE Director of Environmental Health Proposed SSTS — VS Construction Corp. Marsh Hill Road, (T) Putnam Valley TM # 84.4-70 Review of plans and other supporthig documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1". Please complete and resubmit construction permit in carbon form (see enclosed). .�G�Notations for leaders and drains are misplaced. 3. The trench detail needs to note (clean, dust free crushed stone or washed gravel)._ .. . ....... -. , o d x e_fr m.: se tic fink to distnliut iori-ox needs =to be SDR-:35:­­­­- ' �.. �:. fl It appears two house outlines are shown, if one is in error, please remove or provide additional information. Please show a 20 ft. separation distance from the house foundation to the SSTS. ,,! The main profile needs to note its own section as not to confuse it with section "A -A ". This section also needs to show on the plan view. ,Notes provided in a separate box titled "subsurface sewage treatment system" needs to note the contractor as licensed as apposed to certify. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. JSP:kly Resp ctfully, c Jo eph S. Paravati, Jr. Assistant Public Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAIVZ COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL E[zALTS __ : _.. -.. _ ._ F1�t33FYTDC3L'°VYAISTfPPI7Y' & SU'BSURFti SEA GE TREATMENT NT SYSTEMS — ...: ..... REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: 1, 5• CoA ,i- •n,4.k-,l .g*d& -STREET LOCATION: Aw ,sip l4 J!/ McXAeE' REVIEWED.BY: RM, OD SRDATE: 3b •O TAX MAP#: (CONFIRNM) g 1 ' 70 Y N DOCUMENTS Y % ' IREOUIItED DETAILS OlY PLANS CONT'Dl �(�E R1VlIT- ARPEICA'FION - �Vtz.t ��t l�e. ��, .;ts / HOUSE SEWER -1 /." F'T, 4 "0'; TYPE PIPE.CAST IRON gC )WELL PERMIT OR PWS LETTER �- CxtSM4a UNO BENDS; MAX BENDS 45' W /CLEANOUT PC =97 { LETTER OF AUTHORIZATION RENEWALS (SITE NOTE (NO CHANGE) DESIGN DATA SHEET (DDS) FILL SYSTEMS CORPORATE RESOLUTION 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE 1� , }SHORT EAF FILL SPECS / FILL NOTES 1 -5 / .PLANS -THREE SETS FILL PROFILE & DIMENSIONS �j OUSE PLANS - TWO SETS (^) L IN EXPANSION AREA V ARIANCE REQUEST FILL GREATER THANI FEET / SUBDIVISION CLAY BARRIER, LEGAL SUBDIVISION FILL'CERTIFiCATIONNOIE S DIVUION A.PPROOVAL CHECKED (� DEPTH GAUGES CRATE �._�: , a`) YOL. ON PLAN FOR RO.B., UNCLASSIFIED & i1VVIPERVIOUS L REQUIRED DEPTH •(wry *' U EPARATION DISTANCE FROM'TOE OF SLOPE CURTAIN DRAIN REQUIRED TRENCH' GENERAL �OCATED IN NYC WATERSHED F TRENCH PROVIDEDr�� 60FT MAX. PARALLEL TO CONTOURS PELEGATEDSUBMITTED D �-- L )100% EXPANSION PROVIDED CHD UL--)DET'����E��USHED'STONE'OR WASHEb-G- RA;YE DEP APPROVAL; IF REQ'D �E COVER (-- )GEOTEXTIL EEP TEST HOLES O$SERVED-- SEPAiiATION DISTANCES ON PLAN : FROM' 'SSTS P RCS TO BE WITNESSED L_-)L_)10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL. - APPROVAL SSDS ADJ, LOTS (-j( )ZO' TO FOUNDATION WALLS WETLANDS ( TOWNIDEC PERMIT REQ'D ?) TA ON DDS- PLANS & PERMIT SAME_ .... _, L)L)100' TO WELL, 200' IN DLOD,150' TQ PITS .L; ( 10U�T0 SS t fi.°4�'A'15ERCOTIRSE;`LAXE a _ RE39Cr0IIG�ORP�OY`iCATi4Pr. (aac. 'PQ :. , (x(___)50 CATCH BASIN, 35 .STORMDRAIN, PIPED WAXER �10' TO WATER LINE (pits - 20') • 0 YR; FLOOD ELEVATION W1I 200' U(U50'' IN'T'ERMI,TTEN'T DRAINAGE COUP. .' SOIL•TESTING LOTS>10 YEARS OLD L__)(, _j200'i500' RESERVOIR, ETC. 150' GALLEY SYSTEMS RLU ON PLNS D ARROWpv� TO LEDGE ..OUTCROP SEWAG& S• Y'ST-EM= P3rAN= (lYOitTS- SEPTIC TANK PROFILE L_)U10' FROM FOUNDATION, 50' TO WELL FSSDS'HYDRAULIC GRAVITY FLOW WELL CONSTRUCTION NOTES 1 -18'' 17 L JLJDIMENSIONS TO PROPERTY LINES (_,DESIGN DATA: PERC &DEEP RESULTS L—)(JLOCATION OF SERVICE CONNECTION - OL�'IOURS EXISTING & TROPOSED) 38' . LJL_ MIN 15' TO'PROPERTY LINE ���: V r DRIVEWAY & SLOPES, CUT A"' SLOPE e _ ,)L- -jF00T iGf RlG It 'AIN DRAINS.- "I., ,/USDA SOIL TYPE BOUNDARIES U(__-)SLOPE IN SSTS AREA (fTXTLE BLOCK; OWNERS NAME ADDRESS L )LJREGRADED TO 15 %, IF REQUIRED TM# •NAME ADDRESS PHONE# DOSE/PUMP SYSTEMS . , PE/RA, , , DATE OF DRAWINGIREVISION DATUM REFERENCE �( jLOCATION OF WATERCOURSES, PONDS Z, LAKES,WETLANDs WITEEw 200' OF P.L. PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS W 'SBc= SSIfS'S /II�I200'=QP�SSTS:)-N °, e. PROPERTY METES & BOUNDS �LJEROSION CONTROL FOXHOUSE, WELL & SSTS, EROSION CONTROL NOTE L_)LJPUmP NOTES . UL_JDOSE• 75% OF PIPE VOLUME/DOSE VOLUME-NOTED L)L_)DETAIL FORFORCKkAIN, (PIPE TYPE, ETC.) UUPIT AND D-BOX SHOWN & DETAILED L_JL_j1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN UUSTANPPuw, T BOTH SIDES, DETAIL L-)LJ15' MIN to CDS =•>5 %, 20'-4%,l5'-3 %, 35'-1 %,100 % - <1% L___20' MIN to CD DISCS ARGE/100' with 182 cons day discharge (_JL-)10' MIN to NON - PERFORATED PIPE E1'IlYIENTS: S'D 2. 315 Sc l,'d' 012.e_ 2.e. M6e, e a`Z.ru ;rrT, vt. 6e_ 14�, 55 ;--.5 b s' ROIL IN ENGINEERING., PE, PC The Lindy Building, Suite 200, 2 John Walsh Boulevard, Peekskill, New York 10566, tie- — Tel:. -914=736 -3664 o Fax: � 914= 736 -3693 February 14, 2008 Mr. Joseph Paravati Assistant Public Health Engineer Putnam County Health Department 1 Geneva Road Brewster, New York.10509 Re: VS. Consnacdon Corp.. Emerald Rime SETS Cons&ucdon Permit fWarsh Hill Road- Lot 90 Town of PuMaaem Valley, New York Section: 84.00, Block: 9, Lot: TO Dear Mr. Paravati, Please find enclosed the following regarding an application for a Subsurface Sewage Treatment Construction Permit Renewal at the above referenced lot: 1. One (1) Affidavit of Corporate Ownership authorizing Val Santucci to represent V.S. Construction Corporation. 2. One (1) Letter of Authorization authorizing Cronin Engineering P.E., P.C. to apply for a construction permit at the above referenced lot. 3. One (1) Certified check for $500 made payable to the Putnam County Health Department on behalf of the above referenced application — Four.N W)surface Sewage T:eatment:System Consl_tu Qn permii.Plans,for.tha. above referenced lot. 5. Four (4) Subsurface Sewage Treatment System Construction Permit Applications for the above referenced lot. 6. One (1) Application for Approval of Plans for a Wastewater Treatment System 7. One (1) NYSDEC SEQR Short Environmental Assessment Form. 8. One (1) Design Data Sheet 9. Three (3) Sets of proposed House Plans at the above referenced lot. Should you have any questions or require additional information, please do not hesitate in contacting me at the number above. Res ubmitted, Teed, Jr. roject Engineer cc: Owner- Val Santucci (V.S. Construction Corp.) File- Paravati-PCDH- Santucci-Emerald -Lot 10- Trans4t- 20080214.doe DB,qSION OF ENNIRONMENTAL HEA.LTH SERNUES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTENI 07 � A-_ .. .11 . 60M U6;ncv,Q 60Az I �Nj Located at (Street) Mil iMi- PC;A -P Tax Nf� ,:) 3 4, Bloc: Lot 5- (indi=z nnres' C-1033 37-111-7) Fb.V-�I?Pyi, of ..&4- 10.3 t t /A U�--5 r 1v -c Lj- HrL vi gaz c i p a Drain SOIL PERCOLATION TEST DATA Data of Pre -s da kin cr 0-7.17--c,4- Date 61'Percolation Test 0-7-1.3. of iN u I L3: 1,-, 1 11sts to be raoeat.,(l at same depth untl[ Ittairied at -ach p'11rcolati0ft*t. test hoie:� I min for 1-30 mia/incill, 5 2 rn�n Sr 31-60 mir�inch) All data to be -submitt-d,--F&r--review,. 2 —, D -i ,,l measure . ment5 to be made from top of hole. Fon-n DD-97 th �. Water. DV.oroun Water �om G* ' d Level Percolation Run Time Elapse Time Surface (Inches) Start Stop Drop Rate Hole No. No. Start - Stop Inches NliuAnch ?.GI'A { 1 3�_ 3� G to -zl � 3 2 I-Of I, 2 ILLB— I'Lo 9 { ll�-LI I 3 5 14 +3 4 L 56 t.Lol 61 5- 2.1 3 5 { { -3 .4 iN u I L3: 1,-, 1 11sts to be raoeat.,(l at same depth untl[ Ittairied at -ach p'11rcolati0ft*t. test hoie:� I min for 1-30 mia/incill, 5 2 rn�n Sr 31-60 mir�inch) All data to be -submitt-d,--F&r--review,. 2 —, D -i ,,l measure . ment5 to be made from top of hole. Fon-n DD-97 1 '\ TEST PIT DATA V� DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE N0. HOLE NO. p3Ar HOLE NO. 0.5` � I.0' 1.5' 2,0• Llla�+r &Wu,1 fINj 51446 Iti L14lT O- QWJJ �FJN� S4,Vb � CiR�ve w./ c:opgfGs 1 wG�iiT gaa,,,u cq:01 4A; GILOCU�2 w�,�s.. .. 2.5' 3.0' 3.5' 4.0' 4,5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' r Cite V ri NL'� C A ... _ Indicate level at which groundwater is encountered N O P L 6, CWo NCI D Indicate level at which mottling is observed ty® NG 05-51: rQC> Indicate level to which water level rises after being encountered NIA 6 • Z. • �5 Deep hole observations made by: GgvN1�j 1;1AINmwj -4 P e ,PG• % Pcyf Da1e •g • o -In 4FAVD60,tIL JnE A-ft4VArrrl Design Professi l Na e: M . Lptjw --ITI Design Professional's Seal 517.53' 17 53 r OPEAr ,SP14CE 1 U) t 1 ALL TRENCH ENDS ''' - '�';:�� '•I ARE CAPPED +�,;. � +;' %'', ,; +•'•' .; ' . %�s.:J;+ ; 5 \ ABSORPTION '�- (TYPICAL INSTALLATION - %, d > •� • , '•' �, ° t `1 ��n TANK + / °' '� � � ✓+ E 5 PRO 1 /''� 25 BSI EXPANSION AREA ti �'� ; � /; /.i• �, ;fig. LOT >0 �Iroar O F I TO 7 MINUTES PER INCH Y LAND SURVEYIN ' BRUARY 5, 2004 WITH : SUBDIVISION AND SITE NAM COUNTY CLERKS (oz) . ......... ................ . . ... ......... 1. AS-BUILT S.S.T.S. LOCATION DISTANCES i. DESCRIPTION A 8 SEPTIC TANK CENTER 49.7* 14.4' DISTRIBUTION BOX CENTER 62.1' 25.0* TRENCH I BEGIN 52.2' 35.10' TRENCH 2 BEGIN 54.9' 32.2' TRENCH 3 BEGIN 58.7' 31.0. _4 BEGIN Z-61.7- 30..0' TRENCH 5 BEGIN 65.8' 30.0' TRENCH 6 BEGIN 70.2' 31.7' TRENCH 7 BEGIN 73.8' 33.6' TRENCH 8 BEGIN 78.2' 36.8' TRENCH 9 BEGIN 82.0' 40.0' TRENCH I END 96.0' 76.1' TRENCH 2 END 97.7' 75.1' TRENCH 3 END 100.4' 753 TRENCH 4 END 102.2' 74.9' TRENCH 5 END 104.6' 74.8! TRENCH 6 END 107.4' 75.4' 458.75' AS -BOIL T SUE CON44 AS-BUILT S.S.T.S. LOCATION DISTAN( DESCRIOfib"K TRENCH 7 END 109.5, TRENCH 8 END 112.4' TRENCH 9 END 114.8'