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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -2 -48 BOX 33 a ME III III a r! III WN % Zy . is NJ � L �t ,,' , �. r �. -. 04385 u' p� PUTNAM COUNTY DEPARTMENT OF HEA SE SIOI. IF.N I� I! �►!ll l T� --L I CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P V- 3 2- - O ( Located a t 3 I L L 1 /-j rh -f S i RL 4E T- Town or Village 1'y 1-1-h t"i V/ Z Owner /Applicant Name CO iZ t_ o S C o 1z R 14 Tax Map g� Block _ I Lot 4 Q r� Formerly Subdivision Name r' R E y79: I N Subd. Lot # Mailing Address -�W60T lZeR001< ' ?Q CQRT'LF?ND j N,)" Zip 105C Date Construction Permit Issued by PCHD 12 o /01 2 6 3 SPRo u, '01%d K IZ! Separate Sewerage System built by CAP X CO RV CO Ji Address Co R'f"L ��bT. N A/. Consisting of I So o Gallon Septic Tank and G S 3 L I - q- 'A PER Fo R A CC -0 - ;t-s 24 " G2t� t1E L 'Mi ceAS c Other Requirements: t M/ /J 0 j .2s5/-J K R U Water Sup *: Public Supply From Address 15Z 9,4 12GcR s -n?e &r or: Private Supply Drilled byIJORMAP1 AP-n s1R0iJ, /Address fuTAiA m yn tr 1 b t - - - -, -:B Icinig_T�ae. _S i � �., •tom ::= :/d'i�'! - _ � _. os_�uL o een co peed?. . , _ ..� ..._ - _.. R. � . , k cl!' �� -1I• Pr � -con �. 1' Number of Bedrooms I -0,i 2 Has FLT 'r 0/'J C inj-ru ae TZcb120tf I certify that the system(s), as listed, serving the abo built plans (copies of which are attached), in plans and the standards, rules and regulatio o t l Date: --6 - Certified by Address 2 ':To Hn1 W AL CH U, Any person occupying premises served by the above grinder been installed? rsi!ere,conucted essentially as shown on the as- ith the i Construction Permit and approved mMouify Dep nt of Health. P.E. R. A. ssi nal) _ 4LL s WICY `ieLicense # 06 Z ) =sltall'�ptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation modification or change is necessary. By: Title: Apmg- Date: Id c4- �� 7 WhiteF-copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 L .. _ __ . PUTNAM COUNTY DEPARTMENT OF HEALTH bDIVRSICON OF ENVIRONMENTAL HEALTH SERVICES WELL - COMPLETION REPORT Well , ®c Street Address: F j 3 Wit S S„U_6 T Ilage 'Tax Grid Map g Block Lot(s) $= Well Ow ner: N _ e:7 A ress Use of Well: Il- �ria�y - secondary Residential Public Supply Air condtheat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial 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 % Diameter _in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal. _ Cement grout _ Bentonite _ Other Drive shoe: Yes No Liner:_ Yes ><No Screen IlDetails Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First >(S'. S'• 6 _ Yes—No Hours Second Well Yield Test _ Bailed —Pumped xCompressed Air. Hours Yield _1_ gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description fft. ft. Land Surface Q �' If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank,Information Pump T e� Capaci Depth yp Mode . d Voltage 2fjO HP Tank Typ4� W3o- ;,Volume � t5 Date Wel Comp ted Putnam County Certification No. Date of Re ort Well Drill r (signature) IN. 'E: ,t xact location or weii wiri disLances LL) UL 1ei15l, twv pct aiviiraiuipama w vv Yivvluw + was .. o..1,....... ,.... -1 .--.. Well Driller's Name Addres:"Z:r ,�-�, Date: y. Signature: °"'7� / b - - /%, _ White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 UCE Public Health Director Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 - Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 608 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278-6082 . Fax (914) 279 - 6648 OWNERS NAME: TAX NW NUMBER: E911 ADDRESS: TOWN: � AUTHORIZED TOWN OF, (Signature) DATE: �li�l�vazh .y. ,, .�. _ � . -�- :, . :� (ail--`= '�_��d:���.:.F,�:,:k��. �:.N - ..... � :,. It' \A) aflis br�'e_ .V - )13S- Sk(L)L6 0CkV) ivy, 105812 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 Certificate of Construction Compliance. - (E91 I VERFRK PUTNAM COUNTY DEPARTMENT OF HEALTH - :_�- - HEALTH S .E� _-T -- -- - GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM C,ng -f -4 Lnolliaoxi Ci2I?_cxyg Owner or Purchaser of Building L' 04fL C6 S Co FL !A Building Constructed by i13S W I L L I VI Ill s S-F'l2_Cs"T_ Location - Street Building Type g4 I Ll g Tax Map Block Lot u iJ A %h V i9 C C.6 TownNillage R45U -wl <.J S8L_01/J Subdivision Name Subdivision Lot 9 I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system sen-ing 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 oxvner, 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 op erate.�properly�is -cau �dR ��=tl°�e ,Njllful „or negligent act-of the occupant of the build`ing..utilizing the system. 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 failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. .� Dated: Month P4A\1 Day _�L Year 20o Signature: �- •- � ---- -- .�.7� Title: o ►�N �r1�� Cc�Zr� eTt�� General Contractor (Owner) - Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: 2C_? X Pa v '-J'F '77R OK 2i Address: 2 f 0 UG FiiZc e( State Zip % y S 6 7 State CoiZT c,r,) T^ /Zip Form GS -97 LETTE, 111F111i TRANSMITTAL li w -. �nr �, v ..T. -f `Y '�'S-` T1 ""'t'�t�,' � _ :C.� �.. - �a a " , ` .. '.. �- v s � � vy. .... .,. ,. ... ... . � • � r �r� .. f.y=.` 3' •.i -� •C�'C'11'r �.. �`.. i� 1.1: lr i4:C` +v CRONIN ENGINEERING'P.E., P.C. The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914 - 736 -3664 Fax 914 - 736 -3693 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, N.Y. 10509 RE: CARLOS & LAURINDA CORREIA PCDH PERMI #PV -32 -01 1135 WILLIAMS STREET TOWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: May 7, 2004 ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY WE ASE'SENIDINO YOU attached 1.) Three copies of as -built subsurface sewage treatment system plan 2.) Three certificate of the construction compliance. 3.) Three guaranties of SSTS 4.) Copy of survey showing foundation location E9 1 address verification form $30 ertified check for application fee. 7.) wo sets of house plans The information enclosed is submitted for review only the water analysis and well completion report will be submitted when it is obtained from the well driller (P.F. Beal). Should you have any questions or require additional information regarding this matter, please contact me at the above phone number. Thank you for your time and assistance in this matte. Respectfully submitted, Kenneth M. Murphy Design Engineer Town TM # PUTNAM COUNTY (DEPARTMENT OF HEALTH (DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: 3/ ,r -g+ spec e Permit # PLI = 3:;k-v Subdivision Lot # a 1,�5&Q;p SJ$poal' 1. Sewage System Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................. ............................... d. Stone, brush, etc., greater than 15' from STS area......:... e. 100' from water course / wetlands ...... ............................... I.I. Sewne System a. Septic tank size - 1,000 ...:.....1,250 ......... other.16.49o'•.. b. ' Septic'tank installed level ................ ...... .......................... c. 10' minimum from foundation ................................. I........ 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 Bog - properly set .......... ............................... 6. Trenches 1. Length required Length installed 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property 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 .......:........... g. Ppe_endscapged_:� =::•: �- ....:. , )�umn or Dose vstems 1. Size of pump chambe ................ e.. .. 2. Overflow tank . ........................ ' .�:............. 3. Alarm, vis audio ........:........... ............................... 4. Pum ealily accessible, manhole to grade ................. 5. st box baffied .......................... ............................... C�yycle witnessed by H.D.estimated flow /cycle...... Di House/Budditig a. douse located per approved plans......... `�.:.1 .... .:...... . b. Number of bedrooms .................. ............................... IV. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured ,100 ft........... c. Casing. 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... Y. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ............ ........................... c. All pipes flush with inside of box ............................. 11. d. Backfll material contains stones <4" diameter.......... e. Curtain drain & standpipes installed accordin f. Curtain drain outfall protected & dir.to exist ate ourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ....:.......................... L Erosion control provided ................. ............................... Rev. 12/02 «1 013/08/2004 10:20 9147363693 CRONIN ENGINEERING 1 PAGE 01 PUTNAM COUNTY DEPARTMENT OI DIVISION OF ENVIRONMENTAL HEAL] 0� ATTENTION Oaf Q GENE REQUEST FQR EINAL INSPECTION For: All information must be fully completed prior to any inspections being made. PCHD Construction Permit # TV 32.0 Located;-1175' ocated: 117 5' FIpe it! y na Owner /Applicant Name: CA 12LO r.. c-o t 14. - -- T Formerly: _ Subdivision Nan Subdivision Lot # Is system fill completed? Y8-.f Is system complete? �e a I. Is system constructed as per plans? Is well drilled? Is well located as per plans? Are erosion control measures is place? HEALTH El SERVICES Fill Trenches M PUT,JAr%. VA$ -L v-- `a `f Block _ A. Lot _4 R��t�rN xc�c.t�r �.► t Date o 4 • Date I certify that the system(s), as listed, at the above premises has been and verified their completion in accordance with the issued .` a roved_ lass and the = Standards Rules and: Regulations of th - - -Pp-� -- p.__._ ,,. .. _� _ _. Healtb, . Kam.► 1'h � Date: MA! OOY Certified by: Qka1J t,4 ej Design. Prof Address: 'L'-aNA) W A't 4H Comments: Form FUL 99 rk+ onstructed and I have inspected CHD Construction Permit and Putnam County,Department.of,. _ n....�. . PH 6, .C^ PE A- RA. ional Mno_o --MMMA MnK1 4 M! a7 TPi ! A40;-?7R -7921. NAME: PUTNAM COUNTY DEPARTMENT OF P. 1 71 DATE : MAR-5-2004 FRI 17:28 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 1 845-278-7921 PHONE : 919147363693 PAGES : 1/1 START TIME : MAR-05 17:27 ELAPSED TIME : 00'39" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. o Jmwiliucivu �.LmLu,wirVid3-uk" ww--tw-d-sm: M ww im.4 bm-r-mm 66-XU UUDA H 00 PIY�4 � S. ROD" pm 4-0 vu ad Vv =Mw r-AA. P- RuW& -par W*3 UH3k I P—. 9ql qR& O—P-- 0! -40ift- MOP PF- P- pmd- oaq I p- Pam-,— uwq aq -spag -op " jilpWl a lt)nuy& aqj M fg- I --z3d iWvjd q "Xwom foxwo wpm$ Div hmqd jad so pw3mol ""A 51 as PP A � - =Tlaasl qx— 4mKd na a plannsum unith el ME ea �aA U*394 51 1 plomNpq[LS w I ftAsvvrw-Ll* J W U 1^1') l 1 p=wo-j c'ZZ A,& :� aagawtl bv ca 100 pavidmou ATM aq W- -p=rp. RV MA 30A ROUMBNI 7V=TM7lZM ZW'513 M15*0 NOU92LLLY 79y BAtI3S 9 LIM IVIRMOZAAM J10 N01"(1 f0 JXZKUIV&la AINMW ft'Vh= 19 3'w-a--2� i OH lIsNa Himmo E69e9u016 90791 OR9Z/90/e9 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR VtrAGE TREATMENT SYSTEM o PERMIT # V�3a 'O Located at P &Sr Y R o A O Town or Village Pj -1 -w4 h V4 L z e Y Subdivision name `�1Qc u 3i� s� L i�~ Subd. Lot # i Tax Map 13 q Block - 1 Lot 4 c Date Subdivision Approved-:S'vrJ.1C 16.0 19' 8 g Renewal Revision Owner /Applicant Name C F1 IZLL-)S Co R 1Z C r A Date of Previous Approval Mailing Address 2 63 Sell a j I312o© K C o r2 rL A nt l)-r n 4tJ o R , /Q. Zip G "1 Amount of Fee Enclosed �d Building Type SjN���" rtlfti `f Lot Area ±1b5'4�No. of Bedrooms Design Flow GPD _,,00(3 Fill Section Only Depth Volume '± Y-5-0 Cu. >iD. PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of /S5-60 gallon septic tank and Gz,> Other Requirements: Eq o r 9;S .jKn y d To be constructed by u y i rco Sgr ri � S' .S--'rr rh J' Address 31 d RA I LRdA 0 is VC, Ali-C Water Suoaly: Public Supply From Address `ors Private i p : - r_,iillec{ =b}i`' o :� _l c;t_ - - _ Address-; q- iP-vrtja I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the s_parate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of C4?ja y liance" satisfactory to the Public Health Director will be submitted to the Department, and a writte "," iaf ished the owner, his successors, heirs or assigns by the builder, that said builder will place i. d o wing co, part of said sewage treatment system during the period of two (2) years immediately fo ' wthe e o an f e approval of the Certificate of Construction Compliance of the original system or 4 rep irs a to. Signed: ��' _ �' P.E. _ 6,29.80 Address 2 5" &W WA - , R k'.(' 6 LL; A . --� Date lv ( J �0 l 0 5 6 ` License # , ®6 Z 6)S 0 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 th Public Health Director. Any revision or alteration of the approved plan requires a new pe 't. Appr ed r 'sch e o omestic sanitary sewa a only. By: Title: Date: I v W o White copy - HD File; Yellow copy - Building Inspector; Pink cop - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL - _ - please print or type g aPCHD Permit #'/ Well Location: Street Address: Town/Village Tax Grid # PL—J6_4 kok4_0 fv ,'PAM V11L LC Y Map P 4 Block I Lot(cs) 4 Well Owner: Name: CA R t.e I Address: 2 E:? S,fV_ e v'7- EV(w K RwIV cot2fze-'A cotzrzAl,)ar �''�rAwcrL �. ., IOS6'7 Use of Well: —� Residential Public Supply Air /Cond/Heat Pump Irrigation 1- p>riman-y Business Farm Test/Moniton'ng Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought < gpm . # People Served ,5— Est. of Daily Usage _F,! _o o gal. Reason for Replace Existing Supply Test/Observation. Additional Supply Drilling I New Supply (new dwelling) Deepen Existing Well Detailed Reason VJ13 T t5 It So P P L F6 R N i to 4 � `4= for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding. Yes No--) Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision 'Mr.uail s ui o o P DS a P- 9 6 u tr /'.J Si�7 L 01'r ► " Lot No. I Water Well Contractor: f? .�, 'Qe- A c -e Soti -II yJ c . Addr 11 12P 1 C R o A-D (+Ve . E:: b ogv NK r �v .................... :. *.,:�.:'.. .':4k�.: ....... Yes No Is Public Water Supply available to site? ......................... t_ Name of Public Water Supply: To ill' e Distance to property from nearest water main: iu . / �..: Proposed well location &sources of contamination rov ` .,, vepar to eet/plan. I '- `L_` .Date: ./ a App�licant� Signature: PERMIT TO CONSTRUC LL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. :j APPROVED FOR CONS'II RUCT]l ON: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified LPuttnam County. Date of Issue ��' 1/0 10/ f I Permit Issuin Official: Date of Expiration ( Z' 1 .7 10-3. Title: Permit is Non-Transferrable' White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of CAELOS CaiL(LCIA- Located at 'dose .y Ro eq 19 T/V FurN4o, VA iLe It Tax Map # 914 Block 1 Lot Subdivision of "Mj.-foR SU'3DI Vis Iom Lr4ND1' ar .R65_U(?lty SC COW" Subdivision Lot # I Filed Map # I Date Filed 6 / t 8 i Gentlemen: This letter is to authorize C12o Aiw � a duly licensed Professional Engineer A- or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems ...in conformity.w.ith.th�:pr_9vis7, n icle.145.-and/or.147-of the. Education the., Public Health..: . ' Law, and the Putnam.0 i y ode. Very truly yours . W Countersigned: - `` ,_ Signed: P.E., R.A., # (Owner of Property) �( QQ� �kOFESSI G. /¢ OIL 0.5 C. D�Q -��j Mailing Address. 2 r'a 11 1?4.VO Mailing Address: /J L 1,00 y MO C Su o is 20 0 State 9 -W 1/02 K Zip '10 S4'6' S6,-? SPRou7' 9PoaK 12ori State Co12?"1_t11jb7- 1y9d0R.,d y' Zip /OSf 7 Telephone: M 14) -7 3 - 3 4C41 Telephone: Form LA -97 CRONIN ENGINEERING P.E., P.C. The Lindy Building; Suite 200 2 John Walsh Boulevard Peekskill, NY 10566 914- 736 -3664 Fax 914 -7�6 -3693 Adam B. Stiebeling, Assistant Public Health Engineer Putnam County Department of Health 4 Geneva ]load, Brewster, N.Y. 10509 RE: CARLOSCORREIA PIANO MOUNTAIN IPOSEY RD. / W,LLAMS RD. TOWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: October 16, 2001 ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMNENT X PLEASE REPLY WE AIIBL SIEN DIING YOU affached ..:.: °> tev o`p$es "'Off subs races wage .treat*sidsa$ �s s- "fl, - - - -- -~ 2.) Three SSTS construction permit application 3.) Letter of authorization 4.) Application for approval of plans 5.) Application to construct a water well 6.) Soil data sheet 7.) Short environmental assessment form 9.) $300 certified check for applications fee The Information is provided based on our April 10s' joint site inspection and ensuing discussions. Please review at your earliest convenience. Thank you for your assistance in this matter. Respectfulfly submitted, Kenneth M. Murphy Project }designer a BRUCE R. FOLEY Public Health Director - LORETTA M61 ARI R.N., .M.&g. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH J. Geneva .. Road , ' Brewster,' . 'New York' 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 November 27, 2001 t Timothy Cronin, PE Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Re: Correia, Posey Road (T) Putnam Valley, TM# 84 -1 -48 Dear Mr. Cronin: This office has received and reviewed the mosf recent set of plans for the above mentioned project. We .would like to offer the following comments for your review, and consideration. -Dc u� Construction Permit CP -97 a_ a. Complete the date the subdivision was approved. Letter of Authorization - LA -97 a. Complete filed map number and date filed. General: 1. The plan is to include the SSTS profile. 2. The plan depicts 623 lineal feet of proposed trench, the system requires 625.0 lineal feet of.trench based on 11 -.15 design for a 5.0 bedroom dwelling. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if, any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj Enc. CP -97, LA -97 y. )) 0. BRUCE R FOLEY y LORMA MOLINARf RN., M.S.N. P.M, Haim 0~-, Aarxiab P.6az Nralta Dlwcror Ofroew q( P6aW $cn4rs' DEPARTMENT OF HEALTH 1 GCoM Road Brewster, New York 10509 r rrammm tram (e6s)rn•6tlo F.(134s)M -7911 a'araal aeneaN (W)77a'655a WIC (H6)Z)/ -6671 r- (U$)77a -6015 — Earb l.ue..aa.. (165)271.6016 F..(/65)771.6661 Mal" (165)176.5912 Pas(165)2x/ -6113 November 27, 2001 Timothy Cronin. PE Cronin Engineering The Undy Building, Suite 200 2 John Walsh Blvd. Peekskill, Now York 10566 Re: Correia, Posey Road (1) Putnam Valley, TM# 84 -148 Dear Mr. Cronin: This office has rweived and reviewed the most recent set of plans for the above mentioned project. We would like to offer the fallowing comments for your review and consideration. Documents: 1. Construction Permit CF -97 a- Complete the data the subdivision was approved. 2. Letter of Authorization -1A -97 a. Complete filed trap number and date filed. General' 1. The plan is to inclutk the SSTS profile. 2. The plan depicts 623 lineal feat of proposed trench, the system requires 625.0 lineal feel of trench based on 11 -15 design for a 5.0 bedroom dwelling. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 2157 if any questions arise. Ve truly Yom Adam B. Stiebeling Y Assistant Public health Engineer - • •aajmKSNM IMM"oa JMM ao SOVd ssza a x0 : SLUM HOZ : SaOW 1,££,00 : Sus GHSdVM TV:60 £O-OW : SKIy yHVyS T/T : SH!)Vd £69£9£LK6T6 : MOM TZ6L- 8LZ -SV8 ral HZTM aO ZNB jHVdBa x1,Nf100 NVN Xnd : aWNI Z'V:60 NIOK TOOZ -£ -O8a : Siva NOIRMHOD 9NIMS A u Lil-r n —yo t . -r rAK1 LVlGt\ 1 uk nr:ALTH DIVISION OF ENN'IRONXENTAL HEALTH LNDTVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTIOi 1 PERM T N.AbiE OF 0W1i IER: �"� )� �� �h S T LOCATION: I')Si y' �✓ - 1 . ,. :. REVIEWED BY: G�SRDATE: 7 -.'..TAX hLaP =: (COi`IFTftIviED) SSLL��JJ Y N __ Yrs X .fRVOTITRFTI nrTltt C nV. VT ATTC f A�iTT\ Zd1IEAPPLICATION3 (Z HOUSE SEVER -' /I' FT. 4 "0'; TYPE PIPE CAST IRON LL PERMIT OR S LETTER U.' BENDS; -,,LAX BENDS 450 W /CLEANOUT 97 RENEWALS E.TER OF HORIZ.ATION E NOTE (NO CHANGE) S A SHEET (DD FILL SYSTEMS RPORATE RES O , 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE ORT EAF ML SPECS; FILL NOTES 1 -5 TS N O SETS I SUBDIVISION4Ca� ULEGAL SUBDIVISION U SUBDIVISION APPROV CHECKED " PERC RATE S M UFILLREQL`DtED DEPTH UUCuTAIN DRAIN REQUIRED GENERAL U �L ATED LN \YC WATERSHED Lj �L' SUBNITTTED TO DEP GATED TO PCHD U EP APPROVAL, IF REQ'D U� P TEST HOLES OBSERVED U(,Q RC 'O BE WITNESSED LJ PROVAL SSDS ADJ, LOTS �19)0�kIGRBORNOTIFICATION S (IOWNIDEC PERMIT REQ'D ?) (__)(JDDS PLANS & PERMIT SAME " XRTER BVZBA 00 YR FLOOD ELEVATION W/1200' ,OIL TESTING LOTS >10 YEARS OLD ARROVV)' ,iSTRUCTION NOTES 1 -15 SIGN DATA: PERC & DEEP RESULTS ONTOURS EXISTING & PROPOSED NEWAY & SLOPES, CUT DTTIG /GUTTER/CURTAIN DRAINS )A SOIL TYPE BOUNDARIES 'LSE BLOCK; OWNERS NAME ADDRESS `'", PE/RA; NAME, ADDRESS, PHONE' " it -OF DRA)'MG/REVISION TUNI REFERENCE CATION OF WATERCOURSES, PONDS IKES,W ETLANDS WITHIN 200' OF P.L. AP OSE D FINISH FLOOR AND 4SEMENT ELEVATIONS ELLS & SSDS'S W/IN 200' OF SSTS LOPERTY METES & BOUNDS COMMENTS: 4 (REVSHEET) e6 L PROFILE & DIMENSIONS FILL L\ EXPA`iSION AREA FILL GREATERTA4N2 FEET J r CLAY BARRIER . �( FILL CERTIFICATION NOTE DEPTH GAUGES VOL. ON PLAN FORRO.B., UNCLASSIFIED & IMPERVIOUS S kTION. DISTANCE FROM TOE OF SLOPE TRENCH qtj .TRENCH PROVIDED 60FT MAX. ALLEL TO CONTOURS z r,,4ETAIIJDUST ° EXPAiNSION PROVIDED FREE CRUSHED STONE OR WASHED GRAVEL r�_)G TEXTILE COVER S P A TION DISTANCES ON PLAN - FROM SSTS TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL TO FOUNDATION WALLS TO WELL, 200' LY DLOD,150' TO PITS � 0' TO STREAi`I, WATERCOURSE, LAKE (inc. eipan) _ TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LIZ B (pits - 20') ( 0' INTERMITTENT DRAINAGE COURSE 00'!500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS . O,;,TfN T 0 LEDGF• OUTCROP ' ^r SEPTIC TANK 10' ROl1 FOUNDATION; 50' TO WALL WELL IMENSIONS TO PROPERTY LINES OCATION OF SERVICE CONNECTION ( lDi 15' TO PROPERTY LINE SLOPE. LOPE IN SSTS AREA 520 %) (REGRADED TO 15 %, IF REQUIRED DOSE/PUivIP SYSTEMS PUMP NOTES ( DOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED U DETAIL FOR FORCE NIALN, (PIPE TYPE, ETC.) ( PIT AND D -BOX SHOWN & DETAILED 1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN )AjSTA-N, 5'_ BOTH SIDES, DETAIL IIN 15' NILY to CDS = >S %, 20'4%,25'-3%,35'-1%, 100 %•<1% 20' NI IN to CD DISCHARGE /100' with 182 cons day discharge 10' NILN to NON- PERFORATED PIPE '1!.Tel. (914)73&3664 -Fax. (914) 736-3693 RONIN ENGINEERING, P.E. , P.C. The Lindy-Building, Suite 200,.2 John Walsh Blvd., Peekskill, New York 10566 December 3, 2001 Adam B. Stiebeling, Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services I Geneva Road. Brewster, N.Y. .10509 M ,Re: SSTS Construction Permit A pplication Carlos Correia "Reubin Seldin Subdivision" Posey Road, Lot 1 .Town of Putnam Valley Dear Mr. Stiebeling: ...Please. find enclosedthe_reques�ted ipf�ionlm�0,94_.Yow letter dated November 27, —.2001. Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. Thank you for your assistance in this matter. Respectfully sub i ed, 1W Kenneth A Murphy Project Designer 11 - I U11) hb,3 /L / /'Lbbl lb: 410 y14 /JbJbJJ BRUCE R. FOLEY Public Health Director GRONIN ENGINEERING 1 PAGE LORETTA MOLINARI RN., M.S.N. Associate Public Health Ditrotor Director of Patient Semen DEPARTMENT OF HEALTH l Geneva Road . C'Jo P Brewster, New York 10509 UYt R-EF2UAST-FOR FIELD TESTING ATTENTION: St ADAM STIEBELING o GENE REED All information below must be fuU completed prior to any scheduling. DATE: 3 A 1 d 1 ENGINEER OR FIRM: CrzoN t N 6-W i d C eR 1 rte PHONE #: q i Y- 7 ?4' — .TCCe1 REASON: / 73 DEEPS: W' PERCS: 0 PUMP TEST: ❑ ROADISTREET: A>S Y 1Ze0 '9p fvlWevl. JALLWY L1L'-%Ar%.r OR. KTOWki) TOWN: F� T1Jw rti V1A LL a Y TAX : 94 - 1 f if 8 SUBDIVISION: LOT #: OWNER: YES NO 0 Proposal SSf S within the drainage basin of West Branch or Boyds Corner Reservoirs. .Proposed SSTS vvitltin. 500 .feet,o_f.a.rgservQirYrestmoir stem or control lake. Proposed SS I S within 200 feet of'a wi ercouise'o a BEC wetland: ,Proposed SSTS design flow greater than 1000 galloWday or SPDES Permit required. Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ym to any. of the questions, NYCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY 11C&c -r lam' . I /Lil «, 0 03/27/2001 16:40 9147363693 CRONIN ENGINEERING 1 ppAM 0� PAGE 02 A�AOO $9vr�e 6 omit9S�� Q +3 .oa 0 d ab� JSFFERSOVA Mgt Ld YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, V. 1C)598 - ---_- - -----~-v-� ' ' ' ' ' (911t. Albert H. Padovani, Director | LAB On 1.507445 CLIENT #: 58642 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CORREIEx LAURIE 1135 WILLIAMS DRIVE SHRUB OAK, NY 10588 SAMPLING SITE: 1135 WILLIAMS DRIVE : SHRUB OAK COL'D BY: LAURIE CORRElA NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 10131/05 12:00 DATE/TIME REC'D: 10/31/05 01:05 REPORT DATE: 11/08/05 PHONE: (914)-760-5628 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..k < 4C COLlFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 11/01/05 LEAD (IMS) 1.8 ppb 0-15 ppb 9003 11/04/05 NITRATE NITROG 0.36 MG/L O - 10 9052 11/02/05 NITRITE NlTROG <001 MG/L N/A 9162 11/02/05 IRON (Fe) <0.060 MG/L 0-0.3 mg/l 9002 11/02/05 MANGANESE (Mn) 0.024 MG/L 0-0.3 mg/] 9002 11/01/05 SODIUM (Na) 21.7 MG/L N/A 9002 10/31/05 pH 5.4 UNITS 6.5-8.5 9043 11/03/05 HARDNESS, TOTAL 40.0 MG/L N/A 11/01/05 ALKALINITY (AS 12.0 MG/L N/A 9001 11/02/05 TURBIDITY (TUR <1 NTU 0-5 NTU COMMENTS: Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than ION of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive | potential. 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 moder. tely 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 `�//orktP ghts, N.Y. 1 '' -~YOU> 24098U0 | Albert H. Padovani, Director LAB #: 1.507445 CLIENT #: 58642 NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CORREIE, LAURIE 1135 WILLIAMS DRIVE SHRUB OAK, NY 10588 SAMPLING SITE: 1135 WILLIAMS DRIVE : SHRUB OAK COL'D BY: LAURIE CORREIA NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 10/31/05 12:00 DATE/TIME REC`D: 10/31/05 01:05 REPORT DATE: 1i/08/05 PHONE: (914)-760-562B SAMPLE TYPE..: POTABLE PRESERVATIVES: NDNE TEMPERATURE..: < 4C COLIFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD Hd TOTAL HARDNESS I5 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) AW SUBMITTED BY: Director RONIN ENGINEERING, P.E. P.C. The Lindy.Building, Suite 2001,2 John Walsh -Blvd -J'jrek-*ilh.Nqw York 0566 Tel. (91,� 736-'3"6_ 64 o'—F*'x'. _(914)736 -3693 '9 * November 9, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services I Geneva Road. Brewster, N.Y. 10509 Re: SSTS Construction Compliance Carlos & Laurinda Correia P.C.D.HPermit #PV-32-01 1135 Williams Street Town of Putnam Valley Dear Mr. Paravati rfeise'�id`enclfbrsed the-origihal-watc�. -analysis -f6r-the-tibbve referenced project,.- - ie -report - has been completed to show the required PCDH profiles. This letter is also to inform you that Laurie Correia will personally be picking up the construction compliance when your department has issued it. Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. Thank you for your assistance in this matter. Respectfully submitted, Kenneth M. Murphy Project Engineer RONIN ENGINEERING P.E. P.C. - hp-Lindy, Building, Suite 200, 2. John Walsh Blvd.; Peekskill, New York 10566...._.. .. Tel. (914) 736 -3664 o Fax. (914) 736 -3693 October 20, 2005 Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services 1 Geneva Road. Brewster, N.Y. 10509 Re: SSTS Construction Compliance Carlos & Laurinda Correia P.C.D.HPermit #PV -32 -01 1135 Williams Street Town of Putnam Valley Dear Mr. Paravati easefind =en Ic sed Elie �r nal- Nell;conxple>iici - r�port::anil �o fir / er.anabgsi:�for_il�ti above referenced project. The report will soon be completed to show the required PCDH profiles. . Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. . Thank you for your assistance in this matter. Respectfully submitted, ei V Kenneth M. Murphy Design Engineer YML ENVIRONMENTAL SERVICES ' 321 Kear Street Yorktown Heights, N.Y. 10598 Albert H. Pado van i, Director � LAB #: 1.506955 CLIENT #: 58598 NON STAT pROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ CORREIE, LAURIE 1135 WILLIAMS DRIVE SHRUB OAK, NY 10588 DATE/TIME TAKEN: 10/�1/05 09:45 DATE/TlME REC'D'. 10/1l/05 12:00 REPORT DATE: 10/13/05 PHONE: (914>-760-5628 SAMPLING SITE: 1135 WILLIAM-13 DRIVE SAMPLE TYPE..: POTABLE : SHRUB OAK PRESERVATIVES: NONE COL'D BY: LAURIE CORREIE TEMPB ATURE. .: < 4C' NOTES...: KITCHEN TAP COLIFORM M7H: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 10/11/05 MF T. CO! IFORM ABSENT /10O ML ABSENT 1008 COMMENTS: BACT THESE RESULTS INDICATE THAT THE WA PL'7 WAS NOT) OF A SATISFACTORY SANITARY QUALlTY ACCORD HE NEW yORK STATE AND EPA FEDERAL DRINKING WATER STANDA , R THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. -` ' '— SUBMITTED BY: Director ELAP# 10323 7 1 N C'�L�v1Si0 y 49 °s 37 399.8, N M N O� ar . 5. , - 624.32 f e1 off• ( 77 ? 59 o, 0: 224.66 12' 99 540.93 m 0 9.16 AC. co ' N ti c ° b Q 6.2 I AC. r 555 50 tv 1 ., AC . _ ' /+ sc ti h v s� �,/jj / I -f V 1_ I 48 h P CAADWtCy 18.15 05 co 47 2s 1 89.00 AC. ° CO 31.04 AC. t " Sq 60 e7. / I 369 g2 / 6. 752.93 \ 509. 2 / ° ?0 CDw�cr� AC. ATION AREA / N =w A 22.69 AC. CAL. 1035.57 / PUTNAM CO. 1280(s) � 971.31 CO. _ a 44 JTr_.HESTER , PiJTNAM COUNTY DEPARTMI ENT. OF ,ALTII , _ - = ' --OF ENVIROM TAL-HEALTH SERVICES. INITIAL M1VMUAL /COMMERCML SITE INSPECTION FORM SECTION A. GENERAL INFORMATION Name of Project (I)(V) County Site Location- Building construction begun Extent Is proierty within NYC Watershed ? ................. Yes F-1 No SECTION B. TOPOGRAPHY, (Please check all appropriate boxes) 1. —1 Hill a Rolling __' f __ .Steep.slope._.._� - Gentle slope — _- - Flat =- -- 2. [--1 Evidence of wetlands Low area subject to flooding Bodies of water ❑ Drainage-ditches F'_J Rock outcrops 3. Property lines or comers evident ....................... ............................... I ........ . ° =4::.. Do water courses exist 66 or ad�om a property . . .............. ............... 5. Will these affect the design of the sewage system facilities ?............ 6. Do watershed regulations apply in this development....................... -7 .Will extensive grading be 8. Will extensive fill be necessary for SSTS ? ....................................... Yes No D Yes 0 -N6 Yes No �❑ Yes No ±~ .e -- �� -No _ _ Yes . F-1 No . - -- 9. Do'filled areas exist within the SSTSarea? ........ ............................... F-1 Yes E] No If yes, what is the condition of the fill? - -- - -- " - - -- SECTION C. SOIL OBSERVATIONS _ _ 10. Appearance of soil: Sand_ a Gravel . J I Loam [D Clay - E] Hardpan Mixture 11. Observed from: Borings F-1 Bank cut Backhoe excavations 12. Soil borings /excavations observed by on 13. Depth to groundwater on ' _ - ... 14. Depth to mottling 15. Are test holes representative of primary & reserve areas.: ........................ I.. ......... on E] Yes [:] No 16. Soil percolation tests made by on 17. Soil percolation tests witnessed by on SECTION D (on back) 6 .,SEC'T'ION D, DR:k?A GE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? ® Yes ON 0 19. Will groundwater or surface drainage require'' equire special consideration ...................... ® Yes �� No 20. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... ❑ Yes ❑ No SECTION E. REMARKS 21. • If a common water supply is proposed, has an inspection been made of the existing or proposed source and facilities? ................................ ............................... ® Yes - ®No Inspection data - -- - 22. Do a Iacent:wells and/or sewage systems exist? ...............:::... .. ............ _ Yes No, 23. Additional comments 24. Site observer /inspector and title - 25. -- Date(s) of observation(s)inspection(s) - TEST PIT PROFILES Hole # � Lot # _mole # _ -..._ _ _ . _Lot # -Hole # 3_��__ t Depth towater Depth towater Depthtowater - ---- Depth to mottling Depth to mottling _ Dep! to mottlin - _ t�ep i o rcc Uunp: ` Depth to rock/unp. Depth to rock/ imp. G.L. G.L.. G.L. IL 1.0 1.0 1:.0_.__ -. -- .....___..... ..2.0 (a `t 2.0: 2:0 - 4.0 7- 4.0 4.0 5.0 5.0 5.0 6.0 tj �- 6.0 6.0 7.0 w h 7.0 7.0 8.0 - 8.0 ^ 8:0 9.0 9:0 _1 9.0 10.0 10.01 10.0 Hole # Lot # Hole # Lot # Hole # Depth to grater Depth to water J Depth. to water _ Lot # �_ Depth to mottling Depth to mottling gt�.x� an�ttling:. -." • R IIzpIh,fo- ocldimp: :- ' : Depth to rock/imp. p � De th to rock/imp. G.L. 0.5 0�_gr� 1.0 2.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 G.L. 0.5 7 1.0 5vic, 2.0 . i 3.0 (0-5 -0 Off 4.0 5.0 G.L. 0.5 C' _ 1.0 LS 2.0 • r� 3.0 G _v 4.0 5.0 6.0 . 6.0 7.0 7.0 8.0 8.0 9,0 9.0 10,0 10.0 Hole # k Lot # Hole # Lot # Hole # Lot # Depth to water lit Depth to water . Depth to water Depth to mottling Depth to mottling M De�ti' troliiig: _ _ JJ = Ir "h to iockimr ' � Depth to rocklim r• e Depth to rock/imr y Y rr G.L. 0.5 0 $ � 1.0 F 3.0 r Z 4.0 5.0 i( 6.0 7.0 '�,.,� r'71✓ 9.0 10.0 G.L. G.L. 0.5 0.5 1.0 1.0 . 2.0 2.0 3.0 3.0 4.0 4.0 5.0 5.0 6.0 6.0 F 7.0 7.0 8.0 8.0 9.0 9.0 10.0 10.0 Hole # Lot # Hole # Lot # Hole # Lot Depth to water Depth to water Depth to water Depth to mottling Depth to mottling Depth to mottling Depti� to roc imp. - Depth to fo,Adimp. Depth to rock/imp. G.L. G.L. G.L. 0.5 0.5 0.5 1.0 1.0 1.0 2.0 2.0 2.0 3.0 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 Hole # Lot # Hole # Lot # Hole # Lot # Depth to water Depth to water Depth to water Depth to mottling Depth to mottling Depth to mottling - - ` Deptli t"o rocicluisp:� "`�° 7 Depth'to rock/imp. Depth to rock) imp. G.L. G.L. S G.L. 0.5 0.5 0.5 1.0 1.0 1.0 2.0 2.0 2.0 3.0 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES C F AL OF PLANS FOR APPLI ATION OR.APPRO.V A ""A TEWikAR`'I`REATMENT SYSTEM 1. Name and address of applicant: C/4 iZ L 0 S Cc) MZ 61 r'{' 2. Name of project: EST S 2C 3 0 U 0 C0RTC1q.'J0 i /'"/J6J? 3. - Location TN: 4. Design Professional:'-rir, &-rHY L-, LRWO%-:VV'-5. Address: 2 -J-o k/,J 'W (+ L-CH 'rf1 .1//2 6. Drainage Basin: - re,�'K- KILL f/OcLoW C)5 7. Tvpe of Project: 1 Private/Residential Food Service Commercial Apartments Institutional Mobile. Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ........................ ............................... Type I Exempt Type II Unlisted X' 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... A) b 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency owp o R)nor,+r -, V(4 LL (��Y PLt4PP'i�JC ;5(itwp 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? .. _ ........................... ............. . :..... y _ 13. If so, have plans been submitted to such authorities? ........ ............................... r c 14. Has preliminary approval been granted by such authorities ?V4:5J Date gr "anted: 15. Type of Sewage Treatment System Discharge ................. surface water X groundwater 16. If surface water discharge, what is the stream class designation? ....................l 17. Waters index number (surface) .............:............................. ............................... /i 1t . 18. Is project located near -a public water supply 1 system? ....... ............................... /J 0 19. If yes, name of water supply • Distance to water supply N i� 20. Is project site near a public sewage collection or treatment system? ................ /J 21. Name of sewage system Distance to sewage system 22. Date test holes observed !o. 0 1 23. Name of Health Inspector s -rige6-ci;id' 24. Project design flow (gAo' n' s'per day) ................................. ............................... /060 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... /16 26. Has SPDES Application been submitted to. local DEC office? N O Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? , J 0 28. Wetlands.ID..Number.. - - F- 29. " 1 : �•,: P.;i:�a �. •:••.. y..,. ,..aan' .'•rrw••X ^q 4Cke :*-rJX i• "tf'f,��r�M•�'A`•'�fP4•i�a r•�..:... _ ...........»..... - _ *: a a'a• I Is Wetlands Permit required? .............. .................. .............................................. Has application been. made to Town or Local DEC office? ............................... /06 30. Does project require a DEC Stream Disturbance Permit? ................ 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 N 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 M6 . DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... yc s 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? .................:.............. ............................... 35. Are any sewage treatment areas in, excess of 15% slope? . ................ ..........:..... 36. Tax Map ID Number ...:...................... ............................... Map Block I Lot. 49 37. Approved plans are. to be returned to ..... Applicant x Design Professional »� E:.AlI aPlicatioa%s fax revievw,au�l• aipro-�ai_ of a- ne�wSSTtcz b,ted within the NYC Watershed shall °- == -- - be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. ; If the application is signed by a person other than the applicant shown in Item I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Fail mply with this provision may be �oF "Ew y grounds for the rejection of any submission. ��� r I hereby affirm, under penalty of perjury) that irr r a 'prqpik4 on Is orrn is true to the best of my knowledge and belief' Ea a sta e s ma of u fishable as a Class A misdemeanor pursuant to Sec ion 2 A, o e W. r 1 SIGNNATURES & ®F'F'ICL4L TITLES. /.:"i • s,. . canon Mailing - Address :.:.:. .::.:.......................... 2 3 (3 qP W r0 e-J'll fs'L Jl? 14.164 047} _Tazt 12 PROJECT 1.0. NUMBER s121 SEAR Appendix C State Envi'm4mental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME S If the action Is In the Coastal Met, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER .1 'S 1-4' U-4. L PEItr�,1 •r- I'- cstti.- C Lv1' co R�' Pcs� ©fie ..r7'ow1J Ql� U Nn• 3. PWJECT LOCATION: ` twnkfpeuttr .-Fo W iJ Of pooT/✓r�� V 4 L_ L' Count FU i 'W t4 r �i C 0 u,J T Y .4. PRECISE LOCATION (Street addfeea and rood Infersectlorw prorfflnent WWmarkc sic., or provide nap) ?L 0 (+ I TO W JN .0I (-ZI 7 -FJ11 M. VA L-L�Z- Ll V%/lLL IAn_t` 0 jV kI (T ©i.. J d'r GAKTow v S. IS PROPOSED ACTION: 464vme ❑ Eapansbn ❑ Modlfkatlordalteratlon S. DESCRIBE PROJECT BRIEFLY: GaN -► '?�2v c 7'1 of-r cT F �f':� t`�.I' i� f Z FIB e r'` �S'� W � 6-(S- T ©v0 L W�C.L 7. AMOUNT OF LAND AFFECTED: ..p- /0.5 ± `� Irowly acres Ultimately act" S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LANO USE RESTRICTIONS? 'Eryee ❑ No If No, de emm briery I. WHAT 16 PRESENt LAND USE IN VICINITY OF ►ROJECT? Resid*ntbal ❑ INhOtrW ❑ Commercial ❑ Agriculture ❑ ParfdForemlOpan space ❑ OUw Dowrow �;.Si= 72 vi , s^r_.�.,1� t/�/J r� .;{ ..: j'�7Zi "- c�ti► �.:..'::S'i, CL3' -: ii /L L( 1Z�'"s'�rrN t7—/r) L 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING,, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR LOCAQ? J�'Ya ❑ No If Yes. Ilaf apeney(sl and perrnittapprovels ' t'�' b %7 N c� ,� '. �c� "N�i r�, - . l� C.0 (✓ �(— �c� i C, � l.�f 6' �"`ZI'� � T' 11 • DOE$ ANY ASPECT OF THE Acnc.0 HAVE A CURRENTLY VALID PERMIT OR APPROVAL? If no louapwww )*s; o9wicy nwm am ON 12. As A RESULT OF PROPOSED ACTION WILL OUSTINO FMKIAPPROVAL REQUIRE MOOtFICATION? ❑Yes ta-Io 1 CERTIFY THAT THE INFORMATION PROVIDED AWE IS TOW TO THE MY KNOWLEDGE {BEEST,OF Ap011CafliripOrlepf nnr C R 0 N 1 � ems%', b 1 �4FL !Z 1'A) Y' C f �rN / '� /�l� // `� Osfe: /� /`j If the action Is In the Coastal Met, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER .1 PART 19—ENVIFIONMENTAL ASSESSMENT (To be completed by Agency) A. DOU ACTION EXCEED ANY TVP% I T14RESHOLD IN 6 MYCRk PART $17.127 If r0a. coordiftoto tho towtoo proceall mw me Ira- FULL EAF. 0 voo ONG 911. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN G MYCAR, PART 017.07 If No. a "&live doclaiallon - May ft suporeaded by another Involved 000ne yi- 63 7, CI No C. COULD ACTION RESULT IN ANY ADVERSE 1111"FECTO ASSOCIATED WITH THE FOLLOWINCI: (Aflacroto may bs harotarilten. it I"Ibigil C1. Ealsong air quality, surfus or gfoundwalor quality or quantity, noise lavolo. oulallne Italft Pallotno, 9011111 MOW production or dispoaal, polonlial for wosk"% drainap or flooding probtarrul? Explain MatIr. C2. Moubliflu. aeftulturd, archocological, histaft, or other natural Of cultural 1`03011rcGO, or COMInunitY Of 11101011110mood characW? Explain briefly: C1 VWtallon or fauna, flak, oWiflaft or *Ildlifo o"so, oigniflewt hablfalO. Of thraillenod of cAdonewc4 op=loa? Explain briol1r. C4. A community's oxislIng plans of goals as off Wally adoptod, or a change in wo or Intonally of uco of land or otter natural fasoutew? Explain briefly CS. Growth, subsequont dovolopmont. or ralatod activities likoly to be Induced by the PrOPOU4 action? Explain Wally.: C& Long corm, short torm, cumulalivo, or Other offocts not ldontiflod in C1-C8? Explain Molly.' C7. Othcr impacts (Including.changas In use of althm quantity of IYPO Of onOrgY)l Explain Molly. D. IS THM OM IS THgpp. U;(gLy TO Qg. CQNTX0VgNY RELATED TO POTENTIAL ADVERSE ENVIRMD4101TAL IMPACTM. Oyco -.ON* --If-YC:L-(Mo1aI" biwli PART I&I—DEMAIIINATION OF MINIFICANCE (To be completed by Agency) lW=UCMN* For each &dVWW iliffelat Idillintifled AbaM, dellilififflinG 0141111PIM It 10 80318110% W", IMPOTtaft8 or othW*186 signit"t. Each offwt aftuld be assessed In connection vivith Its (a) setting 0-9. urban of rumik (b) jimbWlity of occurring; (c) durstlott; (d) Iff1wWbilitr. (a) gill miphic scaps; and (4 nutgriltuds. It rAce"wy. add stlactinwto of lzilwave oupponIng matsMA. Ensure that OngiNtallam contain sufficlent'detall to show that all mlowt adv4ru Imowls Mve bm Mollified and ukq"t4* addmus& Manw, ai Lead AgW4V Fr—m ca T-vp* N&W 0# 105POlIZZ9 Of 111-COF in Load AfMV YWE af Kespomme Officof Taftatwo of ilasPonsitillo Off'= M Load AG=V sioNturo W PRFam (l G= rosw. icarl PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ESIGINVA'1CA SHEE -T SUSIIRFACE-S)E;'vVAGE`TREATMNT SYSTEM 261 S M a u ORuo K Owner Cpl Lo-S' Co R 2 t ir-1- Address co 2'TLANl0T M41VoR, IvY. tOS6 Located at (Street) PoSE Y &OP Tax Map . 134 Block �_ Lot q� (indicate nearest cross street) Municipality ?UT JA rti yt L L C K Drainage Basin Ct c K-s' K1 L L. �j o t a W SOIL PERCOLATION TEST DATA Date of Pre - soaking /� zoo t Date of Percolation Test r'17/9 Y W g zoo Hole No. Run No. Time Start - Stop Else Time iI in.) Depth to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 1 i l40 i 2 2zf 6 2 1 205- p v�, 30 6� 3 4 5 �U I�" 2a " 3 I .o ....:. 3 4 Is. 14, lot' `s �S 5 P3 l 1250 11 2 } "' i b 3 i 2 I� y.� �o �', 3 116 3 `f 2� `� 30 20 j�. 2 J& j2 4 ��s 2�� 3d 20'��; .5 NOTES: 1." Tests to be repeated at same depth until approximately equal percolation rates are obtained at each Percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 0) TEST PIT DATA DESCRIPT)ION.OE SOILS EEI COUNTEI�,ID,.IN TaEUII QUE-5 DEPTH HOLE NO. ®1 � Ot HOLE NO. D.3 HOLE NO. DS 6 G.L. A. oSo1L 0PSo 1r1QdW St T`t 1990W 7 siLTY 0.5 S�DY ZoFlM SRiJ. Y teA0, .S1LT� S( -�N�Y Lei- �o'►,. 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' S'paay Y L 6 A r, f o c:. K Sr�P -DY Lo jq on �o c- K ov%,P 7.0' 7.5' 8.0' 9.5' .-10.0' e, r� Indicate level at which groundwater is encountered Indicate level at which mottling is observed AO Mo i- TL i N 6 - Indicate level to which water level rises after being encountered S Deep hole observations made by: I (Na H k' L. C-Rori dN =3C Date Design Professional Name: ii i/�oTH q &- cRat1 i n1 Address: °So H0,=!qA L-C H 'FC. VO . Signature Design Professional's Seal VtVV c "j, a \1 41 N�YOFE -Sk " - ("1 f PVC IN 24' CRAWL' 7RVXH (DUOS ARE CAPPED) R 0 p '4A LEDGE ourck6p•' 02 Z. 0 ? R 0 p '4A LEDGE ourck6p•' W (5) 22- "S AS -';-fOIW It Its-, ". (3 Z. z m LAJ 0 • CL 0 z 0 z Z W x m zao z FL: uj V) YTS "4 - hi ikv 1,0! W (5) 22- "S AS -';-fOIW It Its-, ". (3 Z. z m LAJ 0 • CL 0 z 0 z Z W x m zao z FL: uj V) YTS 0 z J . :. Z" Xco. 0, W 'k e!2 vfA V, ROL rn: DRAWN W: �Wi� !N 4, O (602, CHECKED. KC DA M: 516104 DWG fXr: wc >11 -Axtollooil C.AR405-'C-0RR-E!i 'I , A I - % 100X L'XPANVOJV AREA �� ° `, 14 V LE,DGE ,,- �c"a E D G f POOPNO DRAWS AAV i r C R 0 P ROOF LEADERS (PP) E,"SMG "ELL 0 ti 629E0 Z 'Zi W D, co DEP W' EWA GE WA MEN T S YS MM PUMAN CO. r OF HEAL W v �0'w -CONCR6.7r 7657�.'-'e� (L V 24' GRAVEL DRENCH IN 24 OF BANKRUN. PUT Mm COUNTY DEPARTMENT OF HEALTH am SERVICES. DIVISION OF ENVIRONMENTAL HEALTH CARLOS CORRE 1A A-, L"- 6 6 g;� OVjD ' . 40 263 9PROW'BROOK ROAD APPR AS NOTED APPUGW RULES NO REMUT= OF THE 10567 COR&ANDTMANOR, MY 10567 PUTNAM COUNTy HM INDEPAMENT MOT am (9YAOtD AREA 105 ACRES STS -TANK L0CAfl0M A one TANK 1EAN04YT 64.5` i5oo cAuovv cavo7 vr zpnc 6 ±7Lr-470 PW SDR35 RVE mu r 404 7MV �x z 5L.P. - 4,0 CASr AWN PVFE- W 1 63' 79.5 A A JUNC77ON BOX 11 OF 1ST. 7RENCH 146 1295' 107' 1*4 XN . CnON BOX JJ OF. JRD. TRENCH 154" 139. 5' ',OF 4Th. TRENCH 158.5' 145' OF 5TH. TRENCH 163, 151 OF 6TH- 7RENCH 169, 157' i'OF 7TH. MDVCY 174' 142.5' OF MIX TRENCH .179' 168.5' ',OF 9TH.. n?DVCH 186' 176' '.OF 107N. 7RENCH 190' 180.5' 1• OF. II TH. TRENCH 196' 187' OF 12TH. TRENCH 200' 192' (9YAOtD AREA 105 ACRES STS -TANK L0CAfl0M A one TANK 1EAN04YT 64.5` i5oo cAuovv cavo7 vr zpnc 6 ±7Lr-470 PW SDR35 RVE mu r 404 7MV �x z 5L.P. - 4,0 CASr AWN PVFE- W 1 63' 79.5 A B JUNC77ON BOX 11 101.5 97' .VNCnON BOX 12 107' 1*4 XN . CnON BOX JJ 111' 107' AN C77ON _BOX 14' 115 112' -.,.-XNCn0M'B0X'A .120-11 Aa �C n6% VNCnOVV BOX P IJ9.5' 135' P11 /V AINC77ON BOX f0 144:5' 147*� .153' AINC77ON BOX P1 150 159' (9YAOtD AREA 105 ACRES STS -TANK L0CAfl0M A one TANK 1EAN04YT 64.5` i5oo cAuovv cavo7 vr zpnc 6 ±7Lr-470 PW SDR35 RVE mu r 404 7MV �x z 5L.P. - 4,0 CASr AWN PVFE- W 1 63' 79.5 7 DISTANCES TO SSTS BOXES A B JUNC77ON BOX 11 101.5 97' .VNCnON BOX 12 107' 1*4 XN . CnON BOX JJ 111' 107' AN C77ON _BOX 14' 115 7 DISTANCES TO SSTS BOXES A B JUNC77ON BOX 11 101.5 97' .VNCnON BOX 12 107' 101' XN . CnON BOX JJ 111' 107' AN C77ON _BOX 14' 115 112' -.,.-XNCn0M'B0X'A .120-11 Aa �C n6% VNCnOVV BOX P IJ9.5' 135' P11 141' AINC77ON BOX f0 144:5' 147*� .153' AINC77ON BOX P1 150 159' W,11 L C D 0 C OUTCROP rHIs is ro crR 77F-Y THAT ME Sim Gr 77?EA TMEN r SYSTEM wA s CCVVS7??UC7FD AS INDICATED ON THIS PLAN AND THAT INE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSMUCMD IM ACCORDANCE WITH' ALL STANDARD RULES AND REGULATIONS OF THE Pu77vAm COUNTY DEPARTMENT OF HEALTH AND ME NEW YORK S 7A 7F DEPARTMENT OF HEAL TH. 85'32' .w SM-3YO5'V v,, , Kk. A VNC77ON BO�4,0 XNC770N 80A�P'. IJ4' VNCnOVV BOX P IJ9.5' P11 AINC77ON BOX f0 144:5' AINC77ON BOX P1 150 WVC naV 80i 02 155.5' it , W,11 L C D 0 C OUTCROP rHIs is ro crR 77F-Y THAT ME Sim Gr 77?EA TMEN r SYSTEM wA s CCVVS7??UC7FD AS INDICATED ON THIS PLAN AND THAT INE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSMUCMD IM ACCORDANCE WITH' ALL STANDARD RULES AND REGULATIONS OF THE Pu77vAm COUNTY DEPARTMENT OF HEALTH AND ME NEW YORK S 7A 7F DEPARTMENT OF HEAL TH. 85'32' .w SM-3YO5'V v,, , Kk. A CONSYS; PEW 10R, CARLOS 263 -In