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Home My WebLink About4396DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -2 -64 BOX 33 1111111 rm „ auto 111 7.17a sp. y JIM 0 sill j -� . LIE 1 All” a �; �` 04396 A `P]�UTNAM COUNTY DEP�ART'AMENT� OF HEALS TH �!1 `. .. _.. �. .:-- ':q7�♦ i�- lY /N�EZ' \- ��Ri'J�Td Y� �1iiZ a��H �L•�►'��i7�••l��T.�� CERTIFICATE OF CONSTRUCTION COMPLIANCE F REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # ?V-4-03 j� /�/ D Located at J"I P H e-a S Y-) N r R y /J RD-. Town or Village 'Py T N A rn VA L L 6 V Owner /Applicant Name 37 CRo roN _pnr4 Rape caAV Tax Map 124— Block 2 Lot Formerly Subdivision Name S-rsA W&ERR `t KAJO LL. Subd. Lot # 03 Mailing Address -q9 C Ro T O 9J DAM Rl? a S S t1-J 1 N 6, N y - Zip 10 S76?, Date Construction Permit Issued by PCHD tIM t L Zo 03 37 c1zo-To*1 Dig^ Ro (34 Separate Sewerage System built by 3'I C1 apt4 DF7A rc)A o caVr. Address o s s i N i N e. NV I oS�2 Consisting of 12154 Gallon Septic Tank and goo L.F-. - 14'>- PyG 'Pt'('C PIJ 24" GROVEL T2t,,,JC 1 Other Requirements: 12 " 01= 09 N K R o N A N D Po rti p S Yx-rcr� Water Supply: Public Supply From Address Pu -riJigr+, AVFN u or: )C Private Supply Drilled by P. F. -gEA L S o iq f Address 9R6 W STE R . N X 106-a(1 'Buildiri I'� e . .S.i +4'6'L'1: '��"� I LY ' lrrs - Has erosion coiltrol'beeii cuinpieted? g � YP Number of Bedrooms 15"a 'J ;-L Has garbage grinder been installed? I certify that the system(s), as listed, serving the built plans (copies of which are attached), in acc plans and the standards, rules and regulation Date: J -� % --0 Certified by ku Address 2 5a KN Wi9t SH ZT4✓L3_ `PCE� ve' �eiises we��.. ns cted essentially as shown on the as- i fill 5ftued� Construction Permit and approved to Cint Dep nt of Health. UJ zJ P.E. Rte' siop� 8C �\ .t (y- License # 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 revocatipp, modification or change is necessary. LDWWORT� OWN Title: Date: tte copy - HD File; Yellow copy = Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF )ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Addr s: f n W 3 `'� Rlnvt 7 Tin 1 c'o Town/Village: Putnam Valle Tax Grid # Map 84 Block 2 Lot(s) 64 Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: I- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby )[Drilling ]Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well 'Type Screened Open end casing X Open hole in bedrock Other Casing IDetaigs Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: Welded X Threaded Other -Seal-: —X Cement grout — Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 8 gpm Depth Data Measure from land surface- static (specify ft) 30, During yield test(ft) 510' Depth of completed well in feet 565' Well Log If more detailed information descriptions or aiet+e analys,.% are available, please attach. Depth Fro tn Surface Water Bearing Well Diameter(in) Formation (Description ft. ft. Land Surface 2 Drilling in over den c1aX and boulders Hit rock at 21 -,-v: .2. . 32 . Drillin -in :rock; set cis iri , - ` orlt?d 32 565 Drillin in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 gpm Depth 530' Model 5GS10412 Voltage 230 HP 1 Tank Type WX302 Volum allon Date Well Completed 2/15/01 Putnam County Certification No. 001 Date of Report 6/30/03 Well iI e 7Be af NUTlE: Exact location of well with distances to at l pr e o permanent landmarKs to De a on a separate sneeuptan. Well Drille. Signature: White copy: HD File; Address: 4 Putzw Ave., limber, NY 10509 Date: 6/30/03 - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 BRUCE 7R FOLE Public Health Director Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (9.14) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OV (Signature) 90 V . DATE: 0 0 M a, M *_ 39 C.RQ I ot--1 I APx fza A v G e iL P- Sec K '. 2 Lo 1-. 69 THEO sigWF RO Q ROAD PO A r-1 !G 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. (E911 VERFRM) ][`VTNAM COUNTY DEPARTMENT OF HEALTH GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 8°7 CRo-fo a1 DAM RoA D CoR P. % 2 Owner or Purchaser of Building Tax Map Block Lot S9 CRo-roN DAW7 1206D CORP. 'FQ-r Jt4 M VA L L6 Building Constructed by TownNillage 341 PNi.ASial-I RotJ Rofq]b STRrjWT? f2fzY ek)Ot_L Location - Street Subdivision Name S�r�Gc.� �i' -1��Y ��slr��'e..►c� Building Type Subdivision Lot I 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'properlyis causea`by the willful-or rietiigdit acf of the occup�nf ofthe buifding'util zincr-he system. The undersio-ned further aorees to accept as conclusive the determination f the Public Health Director of the Putnam County Department of Health as to whether or qo the ai re of the system to op; .7 was caused by the willful or negligent act of the occup t e i ding utilizing the syit �` j A/0 V. Day Year 2-00 (Owner) - Signature 39 C126Tve'j —OPM '20AP cofzl Corporation Name (if corporation) Address: 29 C12oT6N pAtli 26(- D State O S S I N W C 1-I y Zip 10,56 2 Signature: Title: 111 tF—DML`� _92 CRO 7- 6AJ CAN 9011b CaP.P Corporation Name (if corporation) Address: 32 Cka7'aN PAr 1P0- State 09S9J/A) , �Zip j 0 562 Form GS -97 OF PROPERTY BEING -LOT 8 ,z N01r,5. S590324r# 19.49 Located In 7B'E- RR Y KNOLL 'fled in the Putnam County Clerk's Office 15, 2002 as map no. 2900 )"ituate in the OF PUTNAM VALLEY ?"Y OF PUTNAM Iff .50' February /f, 2003. Aug. If, 2003 Foundation Added 10 de cp AA 9T 0 `H AS ANT ran (JR000 Under -co,7,,,. �� 000000000.,.� 0-0 J. tip ai �';•nT,.?��. -e. '^-: s,-V' r�'.�'xi— :...!�. -:.!a .,f•s• v^nM. ?r.r twe�w -. .. :_''L -v..� .. <.�L- .`�T;VV'��<- �• °R.n.�r'::, �-r.. � "TT"'.,:..: �t'n �w`�ev vti.7: �. v w.j��: -., s- 'b =�r��a r. CRON N ENGINEERING G 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 I Geneva Road Brewster, N.Y. 10509 OBEs 37 Cb OTON DAM ROAD CORP. PCIIDH PERDU #PSI- -4-- 03 PB EASANT RUN ROAD "STRAWBERRY KNOLL" LOT #8 TOWN OF PUTNAM VALLEY THESE ARE TRANSMITTED as checked below: November 8, 2003 ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY . _.. _o � -. WF,,: - .�ElY�9�l�. �'�BI`.�rt�ehed ,�, .._� ,.. r .. � .:. _ _ _ :. a - .. � ..::;' . , ._ .. _ _ a. -: -- • -- �.. -.. .� � .:. _ . 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 S.) Well driller's completion report 6.) Water analysis 7.) E911 address verification form 8.) $200 certified check for application fee. 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, KennetfM. urp y Design Engineer JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET .STAM.FDR.D,_CONNECT.LCUT _ o69O5 _ NELAC, CT and- NY..State.Cgrtjfied, Envjron men tat Lob aratary Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: 845 - 279 -2460 Sample's Information: SiteE Lot 8 Peseivative: HNO3 Temperature: <4C Client: VS Construction Zip: 10509 Fax: 845 - 279 -6613 Collector's Information: Name: Kevin Address of site: Strawberry Knolls City: State: Zip: Telephone: Date Collected: 6/26/03 Date Received: - 6/27/03 Time Collected: 14:10 Time Received: 15:00 Lab No.: J034483 Date Analyzed Test Name Result MCL Method 6/27/03 15:00 T Total Coliform A Absent A Absent S SMWW 9222B 6/27/03 C Chlorine Free Residual < <0.1 mg /L N N/A S SMWW 4500CIG 6/30/03 C Color N ND 1 15 Units S SMWW 2120 B 6/30/03 O Odor N ND 3 3 TONs S SMWW 2150 B 6/30/03 I Iron < <0.03 mg /L 0 0.3 mg /L S SMWW 3111 B 6/30/03 M Manganese < <0.01 mg /L 0 0.3 mg /L S SMWW 3111B 6/30/03 S Sodium 1 12.1 mg /L N N/A S SMWW 3111 B 6/30/03 C Chloride 2 22 mg /L 2 250 mg /L S SMWW 4500 Cl C 6/30/03.... -.- : . 94_mg /L N W .... - - -.. - :,__ . "3...m 6-1 ° - - to N Comments: * Below MCL At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg /L- milligrams per Liter ND- None Detected S.U.= Standard Unit NTU- Nephelometric Turbidity Unit MCL- Max. Contaminant Level TON- Threshold Odor Number ug /L- micrograms per Liter Signature. State #: PH -0218 Michael Lapman ELAP #: 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmental.com PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION O NVIRONMENTAL..HEALTH SERVICES CON:STRUCTI�N PERMIT FOR SEWAGE.TREATMENT SYSTEM PERMT # Located at Ph,006c& Mown 0i` ill 1 ' Z t�k Subdivision na , 4 Block 2 Lot Pli Date Subdivision=Approved V IS, 201: Renewal Revision Owner /ApplicanfWame Da Date of Previous Approval h�4�?l, Mailing Address'F�'4 t Zip SG Amount of Fee Enclosedro :Building.Type " ' U m�, L ,11n3 -Lot Area ; h5,4 No, of Bedrooms Design Flow GPD #� Fill Section Only �' Depth 4.Volume 4 PCHD NOTIFICATION IS ItE D MMN FILL IS COMPLETED. Separate Seweraje System to consist of gallon septic tank and Y Other Requirements. To be' constructed by tai � - t6n- ? R066 czj�m Address z a 13 � ,a Water Supt Public Supply From Address t 7 2 - or Pi4i46 Supply l rdled_:by p} t Adc rzss I�represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the narate sewage,treatmenx ys = 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 ConstructtoCorliance" satflsfactory to the Public Health, IIicector will be submitted to the Deparrtment, and`'a written guar ante tiwi be.I'urti theowner his successors; heirs ofassigns by the builder, that said builder will place in good 'said sewage treatment system during the period of two' (2) years t immediately following the date ti issuance 0-f -, I" 'r teal of the Certificate of Construction Compliance of the original `system or any repafrs thereto 41 t �A: ` .: }f Signed.... a:'P.E R:A: :Date E iZ Address F � � i � fi n � 6' 05,6 G License k, W'zt ,fl APPROVED FOR CONSTRUCTION: This a roval-ex Tres two years-from the date issued unless construction of the P P P sewage treatment "' has, been. completed and inspected by the PCHD and is revocable for cause or may be amended or :modified when considered n cessaYy.t the Public Health Director.. 'Any revision or alteration of the approved plan requires anew permit. tpp`roved fair discharge `of dorhestic` sanitary sewage Drily. t r: , ' r r` By; �.''. �.'= r . Title t r „r Date c. ,f White copy - HD File; Yellow copy, building Inspector; Pink copy Owner; .Orange copy - Design, Professional Form CP -97 ■ y jo, PU TNAM COUNTY DEPARTMENT OF HEALTH --SERVICES-.", mW .:'._ .: M FIELD ACTIVITY REPORT Street PERSON IN CHARGE Town State TEST DOSE TEST Zip V-! 703 V REQUIRED GALLONS �c'� C> w w wc•.nb'�.n - ..+. .e - ...... .. �o-. .-.. - �. �... ,y ... .-.o - n .._.....- ..r... ..,+i . .o.�.b.r"�..... -.. .s . e ...- . �� ..-. n....._ � .. •�► ��... w. _.�► n .. �.- ....... �. Si �e O A c EL. START EL. STOP TNSPFrT()R ! TFT Signature and Title I acknowledge receipt of this report: SIGNATURE; \•02/96 Title: o 0 0m i w w wc•.nb'�.n - ..+. .e - ...... .. �o-. .-.. - �. �... ,y ... .-.o - n .._.....- ..r... ..,+i . .o.�.b.r"�..... -.. .s . e ...- . �� ..-. n....._ � .. •�► ��... w. _.�► n .. �.- ....... �. Si �e O A c EL. START EL. STOP TNSPFrT()R ! TFT Signature and Title I acknowledge receipt of this report: SIGNATURE; \•02/96 Title: 11/06/2003 17:52 9147363693 CRONIN ENGINEERING 1 PAGE 01 ROM 2 JOHN tl's ALS H B O WSJ E V ARD THE LINDY BLDG; SUITE 200 PEEKSKI LL, NY 10566 TO: FROM: .doe Pamviti JY. Keta Muq ohy COMPANY: »ATF: RCHD, NO F,R G, 2003 FAX NU1MJaF+R: TOTAL NO. OP PA xrS INCLUDING COVER I. PHONE, NUMBER: SENDER'S REFERE NCF NUMBER: Pheasant Rim Road RE, YOUR REFERENG NUMSEX 37 C�'DtOR�1 P Oad Cofp. Puttima Valley 0 URGENT 0 FOR REVIEW 0 PLEASE Co MMHN -1- ®PI.P SE ) ® PLEASS RECYCLE SSIS Pump Strawberry Knol, lot #8 Please find y 'g RILo (994)736 =3664 N FAX ( 4)736 -3691 11/06/2003 17:52 9147363693 CRONIN ENGINEERING 1 PAGE 02 Nov 06 03 04:30p Premier Rthle•ticCiub '9147397156 P•2 . , .,.., 4 u.W.� & *. v0 it t�0 »i ytl r4Y BMRD PAGE . 01 OF' r,04 t/1ii 6i NEW YORK BOARD OF FIRE NDERWRITERS BUREAU OF ELECY'RI ITY 40 FULTON STREET - NEW YOR . NY 10038 CERlIF1E5 THAT Upon me application of I pan premises owned by VEL ARDO ELECTRIC V S CONSTRVOTION 203 BARNES ST. 37 CROTON DAM ROAD 099"NG, N.Y. 111562 -1404, OSSINING, MY 110502 Located at art PHEASANT RVN PUTNAM VALLEY, TN *, NY 10579 Apploovea II Ameg. 1172145 CaNcelleNumber.. 1172148 Some.; Block; Lo:: a Bind ng Permit: 1,�4x -Q8 EIDQ w108 Described as a ReAusev .l xet4)ency, rvWOin premses elactriCal system aonsIS" at electrical dowses aria wlrV$ d$W bod aelow, located Won the premises 8M MM Fiml Flow, Second F1 W, A,ltaehed ftaV, Atrk, was Inspected In aceordsm* with the Natlorml Electrical Codt and the detai of the installation, as set forth beklw, was found to be In compliance dtarewith on the 106 Day of octo0•r, 700". N�tanaNew OUTLET FOR SEtYX PUMP AND ALARM. WlrlaS ad Devices Roceplacle 1 0 110 00 _. • sore7Qe - "1 Phaig I*' Seevk* Raties 206 8trvix Di,eomeect: t _ ZOQ . iKetots: i Cr; 40 No TMs Ortlf;cate It1ey tot de attorP.d in any way and is validated only by trw aresance I raised seal at tree location Wicoted ►1rni_c_Orar217 Tull 4C.nC TCI •O/ -070_7004 tiIOMC•'PimKiOM r^f'1111.ITV nC7POPTMr:MT r1P P P PUTNAM COUNTY DEPARTMENT GIF HEALTH IIDIIVffSIIGN (DIF IENWIRZGNMIENTAL HEALTH S ERWCCES P>ERMffT # Located at cC ®1�YST1[S�J T><GIY? ERMI<T-IFOWSIE`WAGIE TR]EA� ' SYSTI�MI 7-01 Pheasant Run Road Town or- Putnam Va1leY Subdivision name Strawberry Knoll Subd. Lot # Date Subdivision Approved May 15, 2002 Owner /Applicant Name 37 Croton Dam Road Corp. Mailing Address 37 Croton Dam Road, Ossining, NY Amount of Fee Enclosed $300.00 Tax Map 84 Block 2 Lot Renewal Revision Date of Previous Approval N/A Zip 10562 Building Type Residential Lot Area t&� y No. of Bedrooms _ 4 Design Flow GPD Rn,i A c2E1 MIR Section Only ✓ Depth /z ",4iuyollume �t)d P. . IFC#-I[I<D NOTIFICATION ffS RE UI R EIlD WHEN ]FILL IS COMPLETED Separate Sewerage'system to consist of 1250 gallon septic tank and :5•00 L. F. of 4" PVC Perf. Pipe in 24" Gravel Trench 1 Other Requirements: 1,2 d#01WWJ EV 14. o t 50M ✓\ d V l ?,r e*r' X G x �u��i�o ✓ �i-�as c° 12� O Uvltoi :4cre L v,n� tsn �� Wl, Y Y c, �tG s�¢0 +�%� Or 45'vc� To be constructed by 37 Croton Dam Road Corp. / Address 37 Croton nam Rnnd,_Ocsinina, NY 1U562 Wzk S_U49Ra: Public Supply From _'rtc�ate S�:rpply 'Drilled-by.,yxP'. -..�: 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 treatmentsystem 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 Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee "will'be "i rIished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating.condifio4 aqy p�,q of said sewage treatment system during the period of two (2) years immediately following the date -of the issuance of fhe,approval of the Certificate of Construction Compliance of the original system or any re -s therdt Signed: j P.E. ) Date � YA-Z Address 2 John Aalsh t ? skill 062980 )Re 6 t�OFESS "�. `' APPROVED IFOR CONSTRUCT - .yids 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 pe it. Approved for discharge of domestic sanitary sewage only. By: Title: �u��rG Date: /r-, Wh' copy - HD File; Yellow copy - ffuilding Inspector; Pink copy - Owner; range copy - Design Professional Form CP -97 RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New.York 10566. . ., :. .. _ _..... .. ,,, ........y4�. 1.i�... ♦�'M .. :,... r ., . ....�� .... ., ._... . ., April 1, 2003 Joseph Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services 4 Geneva Road, Brewster, N.Y. 10509 Re: SSTS Construction Permit Strawberry Knoll Subdivision — Lot 7, 8, 9, 10, 12 Pheasant Run Road, Town of Putnam Valley Dear Mr. Paravati: i Find enclosed three sets of copies of the revised SSTS Plan, dated March 27, 2003 for each of the above referenced lots. The plans have been revised in accordance with our .previous: phone..wrlversation and tlae.letters received from. your. office., ated February 27, IViarch' 7; anMai6 17; 2003. "The SSTS plan and'protlle Forlot #-12 fias'tieen modified to provide a 1.5% slope instead the previously .proposed 1.0% slope from the septic tank to the first junction box. Additional information for lot #7 and lot #9 is enclosed as follows: Lot #7: 1. Copy of the design data sheet for the deep hole #14a submitted during the Subdivision approval.. The rock depth is 5' or 60" as shown on the SSTS plan. The total depth is 5'- 4" instead 54" which is a typo on the Subdivision Plan. 2. Copy of the percolation test #14b is enclosed and incorporated on the SSTS plan. 3. Two copies of the proposed residence plan are enclosed showing no doors and 6' ft. opening at the conservatory and study room. Lot #9: 1. Copy of the design data sheet for the deep hole #18b submitted during the Subdivision approval. The rock and total depth is 5.5' or 66" as shown on the SSTS plan. Kindly review at.your earliest convenience. 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 matter. Respectfully submitted, Luis Hernandez Project Engineer Stmwbeay Knoll - lot 7,8,9,10,12R1,PCDH,03- 31 -03.doc i.:,psi v• i:. �> t�+ a�l? �T�. cY1FYJVl' lY1' �i• �. r' �t, ��l' :r�7. "��- js•i%'w`::'= ti::.: =.�:. Acting Public Health Director Director of Patient Services March 7, 2003 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 GAT 4q RORT r. BONDI County Executive 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 Luis Hernandez Cronin Engineering The Lindy Building, Suite 200 2 John Walsh Blvd. Peekskill, New York 10566 Dear Mr. Hernandez: Re: Proposed SSTS - 37 Croton Dam Road Corp. Pheasant Run Road, (T) Putnam Valley TM# 84 -2 -64 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. 1. The expansion area appears to be under 100% when measuring by scale and no room has uti Fo b'pipe-s -. - -.4, � -. - :b :pro ' r 2. A note for removal of existing stone wall in and within 10 feet of proposed SSTS or a note referencing SSTS note # 9 should be provided. 3. The label in the profile for the proposed bleeder hole should read 1/4" hole, instead of 1 1/4 ". 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. JSP:cj Very truly yours, �,�/Joseph S. Paravati, Jr. Assistant Public Health Engineer PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH - INDr ITJWSUPPLY SL TTRf .�M7S AGE IAFAT VlN'httEN>R - iuE- I W SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: S / Gs1& lbw /w[ STREET LOCATION: REVIEWED.BY: RM, GR, W, SRDATE: % Jj TAX MAP#: (CONFIkNM) Y N DOCUMENTS Y (REQUIRED DETAILS ON PLANS CONT'D1 $ o ! w ERMTT APPLICATION � � t � g ELL PERMIT OR PWS LETTE ,C =97 0 `t/� TTER OF AUTHORIZATION (� V U ESIGN DATA SHEET (DDS) CORPORATE RESOLUTION ( �/1.(i )SHORT EAF (�� PLANS -THREE SETS (�LJHOUSE PLANS - 3WO.SETS R 6isl�" . tNe't I C__.) VARIANCE REQUEST SUBDIVISION ( LEGAL SUBDIVISION ' L USUBDIVISION APPROVAL CHECKED UPERC RATE --414, /S_ "l CCU REQUIRED, /. O , DEPTH C,U CURTAIN DRAIN REQUIRED GENERAL (_}�OCATED IN NYC WATERSHED C��PLANS SUBMITTED TO DEP ✓✓ ELEGATED TO PCDD C�(_•'DEP APPROVAL, IF REQ'D ( ✓JEEP TEST HOLES OBSERVED C _)( ERCS TO BE WITNESSED (_J(.� APPROVAL SSDS ADJ, LOTS WETLANDS (TOWN/DEC PERMIT REQ'D7) (�(�ATA ON DDS PLANS & PERMIT SAME CU RE 1969 NEIGHBOR NOTIFICATION . (�I ) ✓.le0 YR. E'LOOD ELEVATION'% 200' - C UC L�SQM TESTING LOTS>10 YEARS OLD f REQUIRED DETAILS ON PLANS U"USBWAG" SYSTEM PLAN (I+tORTH ARROW) (� SDS F(� GRAICONCTION NOTES 1 -15 - DESIGN DATA: PERC �c DEEP RESULTS �C.�(;_)2' CONTOU1tS EXISTING & PROPOSED (�DRIVEWAY & SLOPES, CUT ►FOOTING /GUTTER/CURTAIN DRAINS (� USDA SOIL TYPE BOUNDARIES (UCUTITLE BLOCK; OWNERS NAME ADDRESS - TM#, PE/RA; NAME, ADDRESS, PHONE# -JDATE OF DRAWING/REVISION DATUM REFERENCE . LOCATION OF WATERCOURSES, PONDS LAR ES,WETLANDS WITHIN 200' OF P.L. (PROPOSED FINISH FLOOR AND . BASEMENT ELEVATIONS ( � WELLS & SSDS'S W/IN 200' OF SSTS (U ROPERTY METES & BOUNDS .(j�PEROSION CONTROL FOR HOUSE, WELL & SETS, EROSION CONTROL NOTE tEEvSEm")09i0v00 HOUSE SEWER - ' /T FT. 4 "0'; TYPE PIPE CAST IRON L-JC—JN0 BENDS; MAX BENDS 45' W /CLEANOUT (DI0 CHANGE) FILL SYSTEMS ( 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE ( FELL SPECS / FILL MOTES 1 -5 ('FILL PROFILE & DIMENSIONS (�(--)FILL IN EXPANSION AREA FILL GREATER T ET J� CUU CLAY BARRIER � UUFILI CERTIFIC� N NOTE I ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS 'ARATION DISTANCE FROM TOE OF SLOPE TRENCH ' TRENCH PROVIDE 'Co 0 60FT MAXG"}' C (___) DETAUL DUST FREE CRUSHED'STONE OR WASHED GRAVEL (�(_)GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM'SSTS 10' TO P.L. DRIVEWAY; LARGE TREES, TOP OF FILL 0�0' TO FOUNDATION WALLS )100'TO � WELL, 200' IN DLOD,150' TQ PITS (��100' TO STREAM, WATERCOURSE, L�ICEnc.;egpan), 50':7C0 CATCH BASLN, 35' STORMDRAIN, PIPED WATER ( �10' TO WATER LINE (pits .20') 050'- INTERMITTENT DRAINAGE COURSE �200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS 10' MIN TO LEDGE OUTCROP SEPTIC TANK C(�10' FROM FOUNDATION; 50' TO WELL WELL DIIVVYEENSYONS TO PROPERTY LINES 4BLOCATION OF SERVICE CONNECTION ( j 15' TO PROPERTY LINE SLOPE (Z(__.)S Oft IN SSTS AREA( 0,00 %) (UwEGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS PUMP NOTES )DOSE 75% OF PIPE VOLUMMOSE VOLUME NOTED ✓( u ) IDETALL FOR FORCKMAIN, (PIPE TYPE, ETC.) ✓( 1(/7 )PIT AND D -BOX SHOWN & DETAILED ✓( CUI DAY STORAGE ABOVE ALARM CURTAIN DID f C_,,,)(�STANDPIPES, 5' BO , DETAIL /( (x(__)15' MIN to %, 20'-4 %, 15'-3%,35'-1b/6, 10 °o- 1° ( —)C- -3 ' o CD DISCHARGE/100' with 182 cons day discharge (,--N 110' MIN to NON PERFORATED PIPE ®MMENTS: ! /Li Li ' "" 'Lt GqY� J /' �n o n-,, / of P.C. Walsh Blvd., PeekAill, New York 10566 14)•7-c- January 22, 2003 Assistant Public Health Eng me e Putnani 't6i ep, en of H Ub Division F, Ideiva, o 10509. Re: SSTS Coitstru6tib.fi, Permit St?iawb6i?.Y'Y,,:.nbllf-Subdiv7sion - Lots 8, 9, 10 .......Pheas'ani.Riiiz'.,-R6ad, -Toivn OfPutnam Valley it 1 M P;Mt`aa: 1.1,1.1111�,�, T: 11, i .1 nef6flowing, information has been enclosed for your review, for each of the aboyc l ltks! subdi*ik6 'Three cooi es of the S.STS Plan prepared by.this office and datdd'.J6h6a 2002 . - 2. L etter. of :A�thorzati6n. i't P;A Treatment 4: oi. -for Approval of -.-Plans *-..for-.,,d.-z.WagteWiter! .pp n DesJ 5.,... oi ;Subsurface . Dat6 Sheet at'i nez �ftt' Sy �4i i ft A"&"ir;,,h6n-Pe ft-hit-fof Sewage -Tre 7. Well Completion Report for 100$ 'a Water Well :.f 1669�_4� 8. App�fi6gii6 to Constriict 9 Wr� T, 10. Application fee of $6.00.0.01$300/1, N 0 e� PuW $,y% oWpo� pum foilot #8�" Rr, 0 A-2 T" copies ...6 e ous6, it -M. M.- `l� The PT Opos 6d k bU efs n 7anyq e ong ge W _q M receipt from theowneryk or Should "0, ave number amed ease, �y OF 14j.- Wg this r cobtlaAft4t4he'La, ove,p Of "Ou, ElL �r"OCP�, 4 PUTNAM COUNTY DEPARTMENT OF HEALTH H DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT ....:.. _ .... Well Location Street Address: Mills Street Lot 8, Strawberry Knolls Town/Village: Putnam Valley Tax Grid # Map 84 Block 2 Lot(s) 5 Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock _ Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic Other Joints: _ Welded X Threaded — Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes—No Hours Second Well Field] Vest _ Bailed X Pumped X Compressed Air Hours 6 Yield 8 gpm Depth Data Measure from land surface- static (specify ft) 30' During yield test(ft) 525' Depth of completed well in feet 565' Well Log If more detailed information descriptions or s EVe analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) ]Formation Description ft. ft. Land Surface 2 Drillin in o)m )urden clay and boulders 2 Hit rock at 2' _.z _ - 32-- ~Dti3-ling in ��cicic set" casing, rr�eg—d' - - __. 32 565 Drilling in o If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Vol m Date Well Completed 2/15/01 Putnam County Certification No. 002 T��3/1 of Report 2/01 Wei r s' re p l NUT E: Exact location of well wttn atstance� to at teTtwo permanent tanamarKS w oe pruv;uyn U« a buFaIa« OUVIuNlal- Well Driller's Name Po F o Inc. Address: 4 Putr m Ave., Brewster, NY 10509 Signature: Date: 3/12/01 Perry Lo White copy: HD File; Y low copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 PUTNM COUNTY DEPARTMENT OF HEALTH A .- -` DIVISION. OF ENVIRONMENTAL HEALTH S_ERVIC_ ES _ .. f' w V tiL ✓ •y - }_: _ ..-. - +-m. .t .f . ^.i?s . �_.- rt-� - �.' -�...- i. 'n1Y�- �.. F ..+ V.w •.� ... �, _ .. -_� - �..�. Y 1- :� =..." �'r' •1if Z 4CYC LETTER OF AUTHORIZATION RE' Property of 37 Croton Dam Road Corporation Located at rMill Street (CR #23) / Lover's Lane) .PUN 12"0.4_ T/T Putnam valley Tax Map # g 94 Block 2 Lot Z, ' Subdivision of Strawberry Knoll Subdivision Lot # 9. Filed Map # -2BODA -F— Date Filed IaA y /5; gd d 2. Gentlemen: This letter is to authorize Timothy L. Cronin III a duly licensed Professional Engineer X or- R-egistered Architw to apply for the required wastewater treatment and/or water supply permits) 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 b alf in nnection with this matter and to supery ction of said wastewater a ent d/o a er supply systems m.conformity.wit< ° Rif icle' 14S and/or - .147 -o �tl.e .du :ion. ,�a, the Public Health•- - T Law, and the Puunty..Saif�t _,.._ ... _....... . r t Very tru 1 � ,a•..,. Z i 4� Countersigned: -.c.. ��0 �` Signed: #r. � •��, p�. P.E., R.A., �.G a• �; (0 er of Mailing Address 2 John Walsh Blvd., #200 Peekskill State N.Y. Zip Telephone: (914) 736 -3664 10566 Mailing Address: State NY UW41 37 Croton Dam Road Ossining Telephone: (914) 739 -7362 Zip 10562 Form LA -97 A�P�UTNAM C�OU�I��T'I�',Y DEPARTMENT OF HEALTH ,:�... :`sg.��; � v v.,:�r w.. - .a ,�-a -: n- ..s�� -r• „�. ,.�.. Boa —•. �. �... � a _s ..• —... , ' - i��'re- .•a�- •6ffi:�• AF'F'IDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBNIITTED TO PUTNANI COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Construction of SSTS and Water Supply I Val Santucci represent that I am an officer or employee of the corporation and am authorized to act for: - Name of Corporation: 37 Croton Dam Road Corp. Having offices at: 37 Croton Dam Road, Ossining, NY 10562 Whose Officers Are: President - Name: Address: Val Santucci (Same as Above) Vice President - Name: Same as President - Address: (Same as Above) Secretary -Name: Michelle Santucci Address: (Same as Above) Treasurer - Name: Address: Same as Secretary (Same as Above) and that I am and will be individually responsible for any to the approval requested and all subsequent acts relatin; Siant Title: Swim to before me this day of month) 04 (year) Notary PublicU KELLY M. LENT Notary Public, State of New York Corporate Seal No. 01 LE6026834 P Qualified In Westchester Count Commission Expires June 21, 2 Form CA -97 all ion with respect I/Y -C-!.�F P-1 - 12, (914).736-3664 Fax (914) 736-3693 DATE -; r-.v I . . ...... . .. 4 -J. . ... .......... .......... ry� , yP ... ....... . ..... .......... .......... AY=' Fit 11 ......... . • . ......... ... ................. - - --------- ------------- ...... . ........... 6 ... . . . .... . ...... .... . . ..... ....... ... ---------- ------ --- - Wk .......... ......... . ....................... A tl 7 ............. .............. . .......... ..... ..... --------- iA ..... ..... .......... . ........... . - .............. . .... ...... . . . ..... • F ........... .. . .......... ........ . . .......... ..... ........ .... ......... . . .... . .......... ....................... ........... .......... . .......... ......... .............. - Ll ............ .... ........... ...... ..... .. . . ......... ....... .. ................. —r.�> t4 NffM Pump Characteristics Pump/Motor Unit Submersible Manual Models SP40M1 SP40M2 Automatic Models SP40A1 SP40A2 Horsepower 4/10 Full Load Amps 9.4 4.7 Motor Type Split -Phase R.P.M. 1750 Phase 0 1 Voltage 115 230 Hertz 60 Operation Intermittent Temperature 140 °F Ambient NEMA Design A Insulation Class A Discharge Size 2" HPT Solids Handling 1 -1/4" Unit Weight 60 lbs. Power Cord , _ . 18/3: S1TW,.115V =.10.' std.. 230V = 20' std. M®teirosaQs ®f ConstQ°flElct90n Handle Steel Lubricating Oil Dielectric Oil Motor Housing Cast Iron Pump Casing Cast Iron Shaft Stainless Steel Mechanical Shaft Seal Seal Faces: Carbon /Ceramic Seal Body: Brass Spring: Stainless Steel Bellows: Buna -H Impeller Thermoplastic Upper Bearing Single Row Ball Bearing Lower Bearing Single Row Ball Bearing Fasteners Stainless Steel Performance Dwo ■■Sail ■ ■■ ►�� ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ H: 12 16 20 24 28 120 108 9 0 68 42 20 a. FIF =101 3-15/16 6-1 3/16 1. All dimensions in imhes f SCHARGE 3: Not for construction purpose 4-5/16 unless 11 ry' _ Q'• 4. Dimensions and weights are i approximate .v 5. We reserve the right to .� 3- A make revisions to our products and their I 13 -1/16 14 -1/16 12 -1/4 ISCHARGE PUMP HEIEi74-5/16 I�GHT ON 3 -3/4 IV 1MP OFF AM MU /I) YBDIMMl' TOC Pumps, an¢o 1840 Baney Road, Ashland, Ohio 44805 (419) 289 -3042 '?j'V w�u= s VELOCITY HEAD AND FRICTION LOSS IN FEET PER 100 FEET OF PIPE IRON /STEEL Schedule 40 PLASTIC Schedule 40 COPPER Type M US GPM _ Vol. Ft./ Sec. Vel. Md. Ft. Head Loss Ft./ 100' Vol. Ft./ Sec. Vol. I Hd. Ft. Head Loss Ft./ 100' _ Vol. Ft./ Sec. Vol. Md. Ft. Head Lois Ft./ 100' 10 1.6 - 0.8 1.6 - 0.7 1.8 0.1 1.2 12 1.9 0.1 1.2 1.9 0.1 0.9 2.1 0.1 1.6 14 2.2 0.1 1.5 2.2 0.1 1.3 2.5 0.1 2.2 16 2.5 0.1 2.0 2.5 0.1 1.6 2.8 0.1 2.8 18 2.8 0.1 2.4 2.8 0.1 2.0 3.1 0.2 3.5 20 3.2 0.2 2.9 3.2 0.2 4 3.5 0.2 4.2 22 3.5 0.2 3.5 3.5 0.2 2.8 3.9 0.2 5.0 24 3.8 0.2 4.1 3.8 0.2 3.2 4.2 0.3 5.8 26 4.1 0.3 4.8 4.1 0.3 3.8 4.6 0.3 6.7 28 4.4 1 0.3 5.5 4.4 0.3 4.5 4.9 0.4 7.8 30 4.7 0.3 6.3 4.7 0.4 5. 5.3 0.4 8.8 32 5.0 0.4 1 7.1 5.0 0.4 5.8 5.6 0.5 10.0 34 5.4 0.4 7.9 5.4 0.5 6.6 6.0 0.6 11.2 36 5.7 0.5 8.8 5.7 0.5 7.3 6.3 0.6 12.5 38 6.0 0.6 9.8 6.0 0.6 8.1 6.7 0.7 13.7 40 6.3 0.6 10.8 6.3 0.6 8.8 7.0 0.8 15.0 42 6.6 0.7 11.8 6.6 0.7 9.7 7.4 0.8 16.5 44 6.9 1 0.7 14.2 7.0 0.8 10.6 7.7--0.9 1 1.3 18.0 46 7.3 0.8 _12.9 14.0 7.3 0.8 11.4 8.1 1.0 19.5 48 7.6 .0.9 15.2 7.5- 0.9 12.4 8.4 1.1 21.1 50 7.9 1.0 16.4 7.9 1.0 13.3 _8.8 1.2 22.7 55 8.7 1.2 J9.7 8.7 1.2 16.0 9.6 1.4 27.2 60 9.5 1.4 23.2 9.4 1.4 18.6 10.5 1.7 31.8 _ 65 10.2 1.6 27.1 10.2 1.6 21.6 11.4 2.0 36.8 70 11.0 1.9 31.3 11.0 1.9 24.9 12.3 2.4 42.4 7.5 : l l .8' 2:2° -3 i 1r8 -2:2> : 28.2 13:1 " 2.7 •48.1 80 12.6 1 2.5 40.5 12.7 2.5 32.0 14.0 3.0 54.2 180 '13.4 2.8 45.6 13.4_ 2.8 35.3 39.5_ 14.9 15.8 3.5 60.5 _85 90 14.2 3.1 51.0 14.2 3.1 3.9 67.3_ 95 15.0 3.5 56.5 15.0 3.5 43.7 16.6 4.3 74.3 1_00 15.8 3.9 62.2 15.7 3.9_ 47.9 17.5 4.8 82.0 97.5 110 17.3 4.7 74.5 17.3 4.7 57.3 19.3 5.8 120 18.9 260 88.3 18.9 5.5 67.2 21.0 6.9 115.0 133.0 130 20.5 _5.6 6.5 103.0 20.5 6.5 78.0 22.8 8.1 140 22.1 7.6 119.0_ 22.0 7.5 89.3 150 23.6 8.7 137.0 30.6 14.5 166.0 160 25.2 9.9 156.0 32.5 16.4 187.0 -- 170 26.8 11.2 175.0 34.4 18.4 209.0 180 28.4 12.5 196.0 36.3 20.5 233.0 190 29.9 13.9 218.0 38.2 22.7 258.0 _ IRON /STEEL Schedule 40 PLASTIC Schedule 40 COPPER Type M US GPM Vel• Ft./ Sec. Vol. Md. Ft. Head loss Ft./ 100' Vol. Ft./ Sec. Vol. Md. Ft. Head Loss Ft./ 100' Vol. Ft./ Sec. Vol. Md. Ft. Head Loss Ft./ 100' 20 1.9 0.1 0.9 1.9 0.1 0.9 2.0 0.1 1.1 22 2.1 0.1 1.0 2.1 0.1 1.1 2.2 0.1 1.3 24 2.3 0.1 1.2 2.3 0.1 1.2 2.4 0.1 1.5 26 2.5 0.1 1.4 2.5 0.1 1.4 2.6 0.1 1.8 28 2.7 0.1 1.6 2.7 0.1 1.6 2.8 0.1 2.0 30 2.9 0.1 1.8 2.9 0.1 1.8 3.0 0.1 2.3 35 3.4 0.2 2.4 3.4 0.2 2.4 3.5 0.2 3.1 40 3.8 0.2 3.1 18 0.2 3.1 4.1 0.3 4.0 45 4.3 0.3 3.9 4.3 0.3 3.9 4.6 0.3 5.0 50 4.8 0.4 4.7 4.8 0.4 4.7 5.1 0.4 6.0 _55 5.3 0.4 5.6 S:3 0.4 5.6 5.6 0.5 7.1 60 5.7 0.5 6.6 5.7 0.5 6.5 6.1 0.6 8.4 65 6.2 0.6 7.7 6.2 0.6 7.6 6.6 0.7 9.7 70 6.7 0.7 1 8.9 6.7 0.7 8.6 7.1 0.8 11.2 75 7.2 0.8 10.1 7.2 0.8 9.8 7.6 0.9 12.6 80 7.7 0.9 11.4 7.7 0.9 11.1 8.1 1.0 14.3 85 8.1 1.0 12.8 8.1 1.0 12.5 8.6 1.2 16.0 90 8.6 1.2 14.2 8.6 1.2 13.8 1 9.1 1 1.3 9.1 1.3 15.8 9.1 1.3 15.3 1 9.6 1.4 _17.8 19.6 _95 100 9.6 1.4 17.4 9.6 1.4 16.8 10.1 1.6 21.6 110 10.5 1.7 20.9 10.5 1.7 20.2 11.1 1.9 _ 120 11.5 2.1 24.7 11.5 2.1 23.5 12.1 _25.8 30.4 130 12.4 2.4 28.8 12.4 2.4 27.3 13.1 _2.3 2.7 _ 35.1 140 13.4 2.8 33.2 13.4 2.8 31.5 14.2 3.2 40.3 150 14.3 3.2 38.0 14.3 3.2 35.7 15.2 3.6 45.8 160 -170 153 3.6 43:0 15 ,,3 _I:3:S :_ riu:4 ;1k.2'. 4:1:..5>.5`T 16.3 4.1 48.4 16.3 4.1 45.1 17.2 4.6 1 57.7 180 17.2 4.6 54.1 17.2 _ 4.6 50.3 18.2 5.1 64.1 190 18.2 5.1 60.1 18.2 5.1 55.5 19.2 5.7 70.7 _200 19.1 5.7 66.3 19.1 5.7 60.6 20.2 6.3 7.7 77.9 220 21.0 6.9 80.0 21.0 6.9 72.4 22.2 93.1 240 22.9 8.2 9_5.0 22.9 8.2 85.5 24.3 110.0_ 260 24.9 9.6 111.0 24.9 9.6 99.2 26.3 _9.2 10.7 127.0 280 26.8 11.1 128.0 28.3 12.4 145.0 300 28.7 12.8 146.0 30.4 14.4 165.0 320 30.6 14.5 166.0 340 32.5 16.4 187.0 360 34.4 18.4 209.0 380 36.3 20.5 233.0 400 38.2 22.7 258.0 EQUIVALENT LENGTH (FEET) OF STRAIGHT PIPE FOR PIPE FITTINGS (BASED ON HYDRAULIC INSTITUTE PIPE FRICTION MANUAL) ''".i �'� %_._, .1.• ,a;� y,:. °_`?o�%i. .ti i•r.��. "�,-- °r°h"!� ';,:x= iGi1�P'!a;'il�,�i it�'ETL,C�`t .�=. °. _ `�w.n. .... -�.AF'+3 PIPE FITTING 3/a 1 11/4 11/2 2 21/2 1 3 4 5 6 SCREWED RETURN BEND OR (� REGULAR SCREWED ELBOW 4 6 6 7 9 9 11. 14 - - LONG RADIUS SCREWED ELBOW 2 3 3 3 4 4 4 5 - - REGULAR SCREWED 45° ELBOW 1 1 2 2 3 3 4 5 - - SCREWED T -LINE FLOW 2 3 5 6 8 10 13 18 - - SCREWED T- BRANCH FLOW 5 7 8 10 12 14 17- 22 - - SCREWED INCREASER (1 PIPE SIZE) 1 3 1 3 2 4 10 - - - SCREWED GATE VALVE 1 1 1 1 1 2 2 3 - - SCREWED GLOBE VALVE 27 32 41 45 60 66 84 112 - - cC33c4a SCREWED COUPLINGS & UNIONS 1 1 1 1 1 1 1 - - - SCREWED SWING CHECK VALVE 9 11 13 15 19 23 28 40 - - SCREWED ANGLE VALVE 16 16 18 18 18 18 20 20 - - �� INWARD PROJECTING PIPE OR SUDDEN INCREASE 3 4 5 V 9 11 14 20 26 33 REDUCERS 1 1 1 1 2 2 3 4 4 7 FOOT VALVE - 3 4 5 7 9 11 16 21 26 .44D BELL MOUTHED INLET 0 0 0 0 0 1 1 1 1 2 -�- SQUARE EDGED INLET 1 2 3 4 5 7 10 13 16 :REGU.LA9 F NGb D R T�� N:BEND•: OR REGULAR FLANGED ELBOW - 2 2 3 3 4 5 6 8 9 LONG RADIUS FLANGED RETD. BEND OR LONG RADIUS FLANGED ELBOW - 2 2 2 3 3 4 4 5 6 LONG RADIUS-FLANGED 45° ELBOW - - 1 1 1 2 2 3 4 5 5 — FLANGED T- LIN�-FLOW - 1 1 1 2 2 2 3 3 4 FLANGED T- BRANCH FLOW - 4 5 6 7 8 10 14 16 19 FLANGED INCREASER - - - 1 1 1 1 1 1 1 Q FLANGED GATE VALVE - - - - 3 3 3 3 3 3 FLANGED GLOBE VALVE - 45 57 63 74 83 98 120 156 192 4CE FLANGED SWING CHECK VALVE - 7 10 . 13 18 22 28 40 53 65 FLANGED ANGLE VALVE - 1 16 18 18 21 23 30 1 39 53 65 BASKET STRAINER - -_t,10 11 13 14 17 22 25 28 It!, SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health John Scialdone 34 Pheasant Run Rd. Putnam Valley, NY 10579. Dear Mr. Scialdone: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: ROBERT J. BONDI County Executive April 7, 2005 Addition — Scialdone, Pheasant Run Rd. (T)Putnam Valley, TM #84 -2 -64 I have received and reviewed the plans for the proposed addition at the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The legal bedroom count for the dwelling is four. The potential bedroom count of your proposed addition is six. 2. The addition of a potential bedroom requires this Department's approval of a revised septic .-system.plan from a professional engineer. Please revise the proposed floor plan to reflect no more than four potential bedrooms, or have a professional engineer or registered architect design a sub - surface sewage treatment system meeting . present code requirements. If you have any questions, please contact me at your convenience. Ve ly yo 17 Robert Morris RM:lm Senior Public Health Engineer 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 SHERLITA AMLER, MID, MS, FAAP BER J RO BON T IDI Commissioner of Health - County Executcye ...' : LORETTA MOLINARI, RN, MSN - L _ _ _ •.. .. _ _ _ - - �� . r - -. - - - - r - Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 March 25, 2005 John Scialdone Pheasant Run Road Putnam Valley, NY 10579 Re: Proposed Addition Scialdone, Pheasant Run Rd. (T)Putnam Valley, TM #84 -2 -64 Dear Mr. Scialdone: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. ,Comments are offered as follows: The proposed renovation of the basement area has been returned. All proposed rooms are to be labeled. Furthermore, please be advised that typically basement renovations are approved if there are no walls separating the area into more than one large room. -Upon -f ceipt`of a submission, revised to re iect the aboe`60riinents; this'appiicat on win be considered further. Sin re y, RM lm Enc. Robert Morris, P.E. Senior Public Health Engineer 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 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ', - �' {'• 'A.i..�o,K.�.. +,V'.K r.RA `V :t. r .r ♦ ti4 �'Y..`.• -`, . ♦ ` {w.� v w iM •. , LORETTA MOLINARI, RN, MSN Associate Commissioner of Health 0 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 John Scialdone Pheasant Run Road Putnam Valley, NY 10579 Dear Mr. Scialdone: ROBERT J. BONDI County Executive March 25, 2005 Re: Proposed Addition Scialdone, Pheasant Run Rd. (T)Putnam Valley, TM #84 -2 -64 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: The proposed renovation of the basement area has been returned. All proposed rooms are to be labeled. Furthermore, please be advised that typically basement renovations are approved if there are no walls separating the area into more than one large room. iptYo!s>bniission; revisad to reflect the ab ®ve.coiiirrients: this- applic:itoii_wil' be considered further. Sin re y, RM:hn Enc. Robert Morris, P.E. Senior Public Health Engineer 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 Public Health Director DEPARTMENT OF -HEALTH 0 Associate Public Health Director Director of Patient Services I I Geneva Road Brewster, New York 10509 Environmental Health (84S)278-6130- Fax (845) 278-7921 Nursing Services (845)278.6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845)278-6014 Preschool (845) 278-6082 Fax (845) 278 - 6648 ADDITION APPLICATION BESIDENTIAL ONLY STREET S a,-JN f2valfl-TOWN PAKA TXMAP-9 3q_7_6V vwul NAME_ al d U-P'; -t PHONdy e-2112— PCHD#. Am& MAILING ADDRESS 3-1 Pk,&v1,,,-r &,,j IZ,,.d Ai /n, V1,4±11 � 4 DESCRIPTION OF ADDITION. Rz,,ne c,�d Cbwv Its NUMER OF EXISTING BEDROOMS 4 PROPOSED # OF BEDROOMS SA"� ('FRbm CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit.) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278-6130. I . Certified check or money order for $100.00. 2. Sketches ofexisting floor plan (drawn to scale, all living area including basement) .*Non-professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map *Non - professional sketches are acceptable. 4. Copy of survey- showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic system within 200 feet of the property line. Co * ntact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept: with legal bedroom count of dwelling. . OFFICE USE Comments Feb98 BFhouseguidelines i CERTIFICATE OF OCCUPANCY _DAM -._1112_5/20,03: _ -. .1: • - +'�!., a -de. >' -.< .. �.:" :.n c-. �. i. ::..o -.. -. ,� ... - . .. _ O.�i: �. �.v =•.... •:r-• ii1.::<a ii=: ».-: w...: �. ;. PERMIT NO: 2003 -301 TAX MAP #: 00/84. -2 -64 LOCATION 34 PHEASANT RUN RD ISSUED TO : SANTUCCI VALERIO 37 CROTON DAM RD CROTON, NY 10562 This certificate covers the construction of: ONE FAMILY RESIDENCE WITH 2 CAR GARAGE- 4 BEDROOMS; ); FIREPLACE; UNFINISHED BASEMENT. The applicant having heretofore filed an application fora building permit pursuant to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by _.personal inspection ascertained that improvement of thcproposed structure . is incompliance with the requirements of the laws as aforementioned; that the said work and materials meet every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions of law. Now, therefore, the Certificate of Occupancy is hereby issued under the seal of the Town of Putnam Valley. TOWN .OF PUTNAM VALLEY, NY Bpi:✓" i Code Enforcement Officer' i P Commissioner of Health LORETTA MOLINARI, RN, -MSN Associate Commissioner of Health December 7, 2005 John Scialdone 34 Pheasant Run Road Putnam Valley, NY 10579 Dear Mr. Scialdone: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J.- BONIDI _ County Ezecutive Re: Addition — Approval - Scialdone No Increase in Number of Bedrooms 34 Pheasant Run Road (T) Putnam Valley, T.M. 84. -2 -64 I have received and reviewed the plans for the proposed addition to the above mentioned residence: The proposal for the addition has been approved as per plans bearing the approval stamp from the Department dated December 7, 2005_ . The addition is approved with the following conditions: 1 3. 4 The total number of bedrooms must remain at four without prior approval by this Department. .The. area of the existing sewage disposal system and its expansion area must be All plumbing fixtures must be updated with water saving devices (i.e. new low flush toilets, restrictors for shower heads and faucets etc.). The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper. approvals. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at. your convenience. Very truly yours, Michael Luke Public Health Sanitarian ML:cw cc: Building Inspector, (T) Putnam Valley Stewart Mudd Environmental Health (845) 278 -6130 Fax (845) 278 -7921 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 OCT -21 -2005 09:31 FROM:PUTNAM COL14TY DEPPiRT B-15-278-7921 TO:9526BB06 P.'3/ SHERLITA AMLER, MA MS, FAAP Cbmmkviincr of Health LORETTA MOLINARI, AN, MSN Asrodwe Commialoner offfiabli ROBERT J. BONDI DEPARTMENT OF HEALTH 1. Geneva Road, Brewster, New York 10509 .00 AP.RULO.N A_tWICAMON RMENIML ONLY STRER16k AW �Ulli TOWN ).Vlw Vft-7—TAX MMWC0/X.--2-94 NAMEC-�L[f V S PHONE 8??:j"S-67UJ PCHM MAHING ADDRESS 2Z6A-&l MUW761010E 103 0702. DESCRIPTION OFU�u�cx�Nl ADDITION NUMBER OF EXISTING BEDROOMS PROPOSED #OF-BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) **AW addftm which is camidard a bedroom requim fonnal approval of plow (Con wxdoro pmmit) prepared by a FwfessimW Engineer or ftistcud Archftact in accordance with opplic0le sections of the Putum County Sanitary Code. Please submit this fortis and the following to Pumom Codoty Health Dept., 'l Geneva Rd, Brewster, NY 10509, Phone: (845)-279-6130. --d 2. Sketches of existing floor plan (drawn to scale, all living area Including basement) 3. Two sets of proposed floor plan (drawn to scale - with name, street and tax map *Non-professional sketches are acceptable .4. Copy of survey showing well and septic locations to the best of your knowledgc. Include date of installation if Imown, label all wells and sTfic systems within 200 feet of the property line, Contact this office with any questions. 5. Copy of Certificate of Occupancy ftm Town or Certification bom Building Dept. with legal bedroom count of dwelling. OFFICE USLE COMMENTS Rovironme"tni Health (94S) 279-6130. Fax (845) 279-7921 Muning Servieeo (945) 278-6552 WIC (843) 2784679 Fax (845) 279-6085 Early InterventlowlPrairbool (845) 278-014 Fax (845) 278-6648 F RUMI: PUTN89 ,COUNTY DEPART 845 -278 -7921 ..- _ .•,�" a. '�'.'�'ip'Ais;��::+°ty�':i��9 ts"�'/�lsua L ..— ;c,;;t comet bTimmer of Health LOR911 B'A MO9. KARL RN, H.SPJ 4ssoclote Commissioner of lfealth I - .. y DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10S09 12n ggel fed.r ®mm (Count TO:9526BM6 P: 4/4 I� County &ecutive Re: SC:7AT,DnNF. (Owner's Name) Tax Map #: 84.-2-64 ASS: 34 Pheasant Run Road Town: Putnam Valley Year 13>galt:. According to records maintained by the Town, the above noted dwelling, Is �X in compliance with Town Code. is not in compliance with Town Code, The Leg* Bedroom Count is: 4 TKi iufozmation bass been obtained from: Certificate of Occupancy: attached Other: Assist. Building Inspector , John Allen 10/27/05 Date 1 11*0atnentat Health (84S) 278 -6120 Fan (845) 278 -7929 Nordaair Srvicn (843) 278 -6558 Fax (845) 278 -026 WIC (845) 278 -6678 Wunin8 Roane Care Fax (945)279-MS l DAY (845) 278-5014 Fax (845) 278-6648 I Z SMVVnt�)l (QF1V,6V,q eAD SP-0A)SzLY2 NC11U '/oar/ lozcc . ( 1 Abv 65 -. &kCc&ED A&d��.�r �WldX� To To old AkV�,E IMCL400 7b- T �YJS /l/141 91110Y&. ItO/Z St -7, Z0Cl AAA 4S 34- s0 �11/CCOJL�J I'S Ch&,(41 loo CYO � r TU A0 ys 17 2Z it-M7 , 1N,(1VA/7?4AVs�,c AUJ ©70 ?Z Z. 7Z-z # Fe7-163.6700 x 207 'T/ow �v SzVPf,17 10vdr-) Classic Conservatories, Corp. 1111 Route 22 East o Mountainside, New Jersey 07092 • Office: (908) 389 -0755 • Fax: (908) 389 -0955 (888) 863 -6700 CERTIFICATE OF OCCUPANCY CERTIFICATE NO: 2003 -336 DATE: 11/25/2003 PERIVHT NO: 2003 -301 � TAX M[AP # : 00/84. -2 -64 LOCATION: 34 PHEASANT RUN RD ISSUEID TO : SANTUCCI VALERIO 37 CROTON DAM RD CROTON, NY 10562 This certificate covers the construction. offe ONE FAMILY RESIDENCE WITH 2 CAR GARAGE; 4 BEDROOMS; ); FIREPLACE; UNFINISHED BASEMENT. The applicant having heretofore filed an application for a building permit pursuant to the Town Code, Sanitary Code,. the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, _....:... ....NY, : hayin a -the re uired.;fee i. therefor and the. undersi. od..having by __ _ _g :... .._ . . _ . .... , personal inspection ascertained that improvement of the proposed structure is in compliance with the requirements of the laws as aforementioned; that the said .work and materials meet every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready.for occupancy pursuant to the provisions of law. Now, therefore, the Certificate of Occupancy is hereby issued under the seal of the Town of Putnam Valley. 'OWN OF PUTNAM VALILE Y9 NV By, Code Enforcement Officer PUTNAM COUNTY DEPARTMENT OF HEALTH / DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: Inspected by: t�'tiT3F Street Location � S� `?ar -= - 0 .r _ 7 Permit #� -^ TM #— _ Z _ 4, �/ Subdivision Lot 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 ................. .::................. II. Sewage System a. Septic tank size - 1,000 .... ..... 1, 250.. .....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. rent ies S6 v 1. Length required S `=' Length installed 2. Distance to watercourse measured Ft ......... Al 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 - 1' /i' diameter clean ...................: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends capped ........ .......................... ...... I .......... •........ . _ .. . -Putno or,Dosed Sysiems - !, _ .. 1. Size of pump chamber..... .............:... . 2. Overflow tank .... ............................... �...........,' .. .... 3. Alarm, visual / audio ........:........... ............:.................. 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated.flow /cycle - -- .. - - -- III. House/Building a. House located per approved plans .............. ... b Number of bedrooms ................... . ................... IV. Well Well located as per approved plans....... ".......... b. Distance from STS area measured ft........... 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 w 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 YES I NO �� COMMENTS /`e(0. >' icy/ v J ✓�. �r v� ,r n 4qk- Z9 4 4=092 mo/ ,�- shA,= c Form x es � SITEINSAtTid FOR FILL PAD Fill pad located per the approved plan Fill Pad Length Required Length' Fill Pad Width Required Width Fill Pad Depth Run-of-Bank Fill Quality Slope from Top to Toe Impervious Layer Installed Erosion Control Installed Sieve Test Results (if applicable) Additional Comme Reserved for Field Sketch if Applicable Required Depth Date: Inspected by: 14-16-4 MrI —Test 12 PROJECT I.D. NUMBER t.i1 SEAR Appendix C �� _ � ,...:.I;;: --- _ - - _ �:t. - - _ =:�� .. _ = S�Y�Liii"virot9it►ea#al�r`Ili�f q"1'iiiliti�i � �;' �.;;�;, �:, : -��: --.; ; ; , . .,.- :� 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 37 Croton Dam Road Corp. Strawberry Knoll, Sublot # 8, 2. PROJECT LOCATION: Munklpaft Town of Putnam Valley county Putnam County .4. PRECISE LOCATION (Street address and road interaction&. Pmmltwnt landmarks, eta. a pradde map) Pheasant Run Road S. IS PROPOSED ACTION: ® Neer . ❑ E�cpanslon ❑ ModltkatloNalteratlon 6. DESCRIBE PROJECT BRIEFLY: Construction of-Subsurface Treatment System to serve a Single Family House 7. AMOUNT OF ,LAND �AFFECTED. �� C,5 Initially cues Ultimately saes S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? tTYes ❑ No It No, describe brNlhr B. WHAT 18 PRESENT LAND USE IN VCNITY Of PROJECT? fR ReeWential ❑ l d strtw ❑ Commercial ❑ Agriculture ; . ❑ P&jWForest1OW space ❑ Otr w Describe 1 . , - - • . .. Y.._ ,_ .._., .. .. -.. .. -�.. ....�.. era .,..5 -. ......r � -_.. _�.�.- .- ..- ..... - -. _. v_.r .:Q -' •'> .Surrounding Lands are zoned Single Family Residential r' 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE OR LOCAQ? ® Yes ❑ No 11 yes, list agency(s) and pwmltlapprovals ' Town of Putnam Valley Building Permit ' 11. NY DOES A ASPECT OF THE ACTIC. HAVE A CURRENTLY VALID PERMIT OR APPROVAL? c�ys I� y. ❑ No H yes, list agency name and pemNUawwal Subdivision Plat Approval - "Strawberry Knoll Subdivision" 12. AS A RESULT OF PROPOSED ACTION WILL E)MNG PERM(TIAPPROVAL REQUIRE MODIFICATION? ❑ Yea ®No , i CERTIFY THAT THE INFORMATION PROVIDED ABOVE is TRUE TO THE BEST OF MY KNOWLEDGE AQVk,,, ti Cronin Engirt er' ith St audohar Da1e: //Z/ OF Signature: M It the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART It— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYP`E 1 T14RESHOLD IN 0 PIYCAR, PART 017.179 It yoo. coordinato tho rovk*a procmoo or1® we the FULL EAF. l J Y. 60;40 1 ®. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCAR. PART 017.0? If No, a negativo dsclaration may fix ouparsedeg. by andth€x Invofvd.OAenCp. G YC3 cl:�Ja o _ C. COULD ACTION RESULT IN ANY.ADVIESSE EFFECT8 ASSOCIATED WITH THE FOLLOWING: (Anowors may ba hondwItlen, It ioelbsa) ' C1. ExI0114 air quality, surtko at Groundwater quality or quantity, nolw Iav010, exloting traffic ptrtlorno, Colld MGM production or dlepoaal, potentlal for erosion, drainage or flooding problenla9 Explain W101yt C1 Aoathetle, agricultural, Wchaoologiral, historic, at other natural at cultural roocureoa; or eornmunlly of nolghborhoad eharactwl Explain briefly: /A/vJ,7 C9. V000tatlon or fauna, flap, &41111oh or tvIldilto opecloo. Significant habitats, or threatened of cndan(lorod apodan? Explain briolyr.. Flr � Cd. A mmmunity's existing plans at pals as officially adopted, or a change In use or Intensity of use of land ar athcr.natutal reoourm? Explain briefly / V J ✓I CZ CS. Growth, eubasquont dovolopmont, or rolatsd aetlrltlea likely to bo Induced by tho proposed action? Explain brlofty. - /Uo�qc C8 Ling form, Short corm, cumuiattvo, or othor offccts not Identlllod In C1-C31 Explain Maly.. C7. Other impacts (Including ehangos In use of olthor quantity or typo of onorgy)? Explain Molly. AIV M t D. 10 THEAE. OR IS THERE LIKELY TO BE CONTROVERSY AELATUD TO POTENTIAL ADVERSE ENVIRONtMeWAL IiMPACT27 _ C3 Y'5- No IVY aa. akploln brieftq.... rr PART W —D ETiE RMINATION OF SIGNIFICANCE (To be completed by Agency) IA0MUCTt N&- For own adram affect Identlffed above, determine arh®tWx It Is oUOetavttlal, law, Important or othervit" signit(cent. Ew-A affect should be assasmW In eonnalsctlon with Its (a) netting p.e. urban of rurafk (b) probability of tsscurrirlg; (e) duration: (d) If voersibiltt . (o) g"mphic sego; and (f) magnitude. It , add ettrachmonta or rolcrvrscrl supporting materials. Ensure that ®xpdafiona contain sufficient detail to show that all relevant adverse Impacts havo bwn Wentifl a8 reed adequately addressed. ❑ Check this box If you have idaltnt191ted one or more potentially large or significant &&mw Impacts which MAY occur. Then proceed directly to the FULL. EAF and/or prepare a posittm dsclamtlorL CO-CheCk this box It you have - determined, bitsecl on the informilon and a)n*sels abova and any supporting' docurnsntation, that the proposed action WILL NOT result In any slgnifi m e a6erm onvironnwrifid Impacts AND provide on attachments aLa nacessaq, the recsond supporting this d®Wmination: W .. ht es;72"f K8r K@r rn le A$irnty ionatura W Preparm (11 diffamat imm u+tko oa K@fl 7 D3. Data 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 37 Croton Dam Koad,Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Located at (Street) 1oFW, , Aiy7- azlly- .. Tax Map clef Block X Lot (indicate nearest cross street) Municipality (T) Putnam yaleex Drainage Basin Peekskill Hollow Creek �� SOIL PERCOLATION TEST DATA ate of Pre - soaking o!�F -A5 — da Date of Percolation Test o5 /G — '0'0' Hole No. Run No. Time Start - Stop Elapse Time (pvlin.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch RIO- 1 2 °� _� 12 2� ._ 2 6 . 20 V` 2 �zr_2sr 2% I 23- 26 3 — 3 19 27 23 - 26' 3 9, 4 5 2 z�_ 3 oy 3 3 2;2 -,25 3 /1 3 -3 °—'- 3*-2 33 22 -,2.5 3 // 4 5 1 2 3 4 5 1V V 1 r.J: I. 1 ests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I 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 2 TEST PIT DATA E S IBS ��.a.,��-g�..�� To'z.►�x� s- L DEPTH HOLE NO. HOLE NO. /gr HOLE NO. G.L. / o % �fl i 0.5' 1.0ii9id��c 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' (�ycu• e/L. �� 4.5' 5.0' 5.5' 6.0' f 7.5'� 8.0' 9.0' 9.5' 10.0' - - Indicate level at which groundwater is encountered 4 Indicate level at which mottling is observed Indicate level to which water level rises after being encountered% Deep hole observations made by: Adam Stiebeling/ Keith Staudohaur Date ,27'-00 .. PCDH Cronin Engineering " ,,,,, Design Professional Name: Timothy L. Cronin III Address: 2 John Walsh Blvd. #200 Peek NY 10566 is Signature: Design Professional's Seal Ui '��J�U E5Sti0,� I� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR `r A.ASTE °r�VATLI'� TIA'Ii1T= S'STL;�ti 1. Name and address of applicant: 37 Croton Dam Road Corp. 37 Croton Dam Road Ossining, New York 10562 2. Name of project: Strawberry Knoll 3. Location Tom': Putnam Valley LO g . 4. Design Professional: Timothy L. Cronin ITT 5. Address: 2 John Walsh Blvd; 200 Lindy Bldg 6. Drainage Basin: Peekskill Hollow Creek 7. Tvpe of Protect: X Private/Residential Apartments Office Building Food Service Institutional Realty Subdivision Peekskill, New York 10566 Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review %(SEQR)? T check one ..................... Type Status ( ) .............................. ... Type I Type'II 9. Is a Draft Environmental Impact Statement (DEIS) required? .... ........... 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency Town of Putnam Valley Planning Board Exempt Unlisted x NO 12. Is this project in an area under the control of local planning, zoning, or other _...officials, ordinances? _ _..1.... .................. _�... .._ :;•:.::::. ... ;::.:..... ,. �; .Xes _.:.... �; .,. _^ _ .. 13. If so, have plans been submitted to such authorities? ........ ............. ................... Yes 14. Has preliminary approval been granted by such authorities? Yes Date granted: Jan 2001 15. Type of Sewage Treatment System Discharge ................. surface water x 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? ....... ............................... No .._.... 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? ................ No 21. Name of sewage system N/A Distance to sewage system N/A 22. Date test holes observed April &May 2o0o 23. Name of Health InspectorAdam Stiebelina 24. Project design flow (gallons per day) ...................... ........... ............................... 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... 800 Gal /Day NO 26. Has SPDES Application been submitted to local DEC office? ......................... No Form PC -97 N 27. Is any portion of this project located within a designated Town,or State wetland? A1' 0 28. Wetlands ID Number ........ N/A 29. ~ Is Wetlands Permit required ............�........ ........... ............................... NO Has application been made to Town or Local DEC office? .... NO 30. Does project require a DEC Stream Disturbance Permit? .. ............................... NO 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ...........:.... 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? ......................... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? ...........:. YES. 35. Are any - sewage treatment areas in excess of 15% slope? . ............................... No Map .................. Map Pf Block Z Lot 6 36. Tax Ma ID Number ........ ............................... 37. Approved plans are to be returned to ..... Applicant x Design Professional :. I'JO.TT_... All applicatiora,for revs -v ., 'arid upprovai of r,ev STS 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 in Item l .,the applic4@Dn must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this4rovision may be grounds for the rejection of any submission. I hereby of lrm, under penalty of perjury, that informatiorpro-v+ided on Ihl?forttrs trace to the best of my knowledge and belief' False sta e4is Made hereiaa ai`o' ,,ft�`, hable hS lo a Glass A misdemeanor pursuant to Sectio 10. Soft e Perini; L SIGNATURES & OFFICIAL TIT'LE'S: Timothy L. Cron i�� 652-9,2) Mailing Address: .................................... Cronin Engineering,"R IC-z�— " 2 John Walsh Blvd; 200 Lindy Bldg; Peekskill,NY 10566 CONSTRUC Ir s. ■ t � r (8S 0ino CNAW RAIL DINING ROOM 1725 LIEM RECD DA3 VENT RECD 0.N LIGHT MN V'0 D$ VCNi PRDVT --- ----- XDR a 94 �• Clrt vnrt IEE IYJTE �9 - __ - - -r LIVING ROOM 21(.92 SD I 1719 L/O1T RECD L60 V RECD 2144 u— PR 06TH PLATE. STATE < 6 Ws LAim Lw � Q ?Q. 3042 AL 72g z44z w cR4s y,Lq D x^..c�, - 9 3T 13.0 SM , STUD R VEW x£K I m I KITCHEN SP 45-9' V 2x1 S T CAn1 1MT ➢CL LY 27' SLTTIT �T Y -10' S[I -9 1/2' R36 , LANDWG AC/EC�T� 'L' sNNED - 2 ❑E SO L .SST ST�YIRS tSNf r0R SD , rCLG LOF 1 TERXJNJ.81L _ J !CR {TRWDE CL (ILLY _ (SL RECD TREAD I RA _ h BIRDER CLO PER APPLICABLE CODES - 1 1/4' 3Y -34• wwLaAR Icr ! 2' -3' 1 llaz VENT PRDVT FOYER P 0j (PCII TO HOVE P .1 I I I ®� A. I I � rRExcX �. ry all 14-5 1/2' J! CLG PER }l VYaO WI ML.(VERI)l') �4 Q N CC49O 2 =6 N 1 q 2p6DA O Q N rl� 61 3' -4' ' -0' 11.10' 121_01 40TES; 41'- 6'(TVO STORY) 1.2x6 E%' WALLS E 16' O.C. /2x4 HARR WALLS 2.9'-0' CLFFii HT. 3.2x10 SPRD2 FLOOR JOISTS 2 12' O.C. ./ JOIST HANGERS 4. ROOF SYSTEM TO BE 16. O.C. 5.MV VIN OVS (81=24210, R2 =2842, •3 =3046, R4 =2852, e11=2856) (SEE PAGE p9) 6. CEILING'DRYVALL WILL BE OMITTED FUR ALL ON -SITE PLUMBING CONNECTIONS 7.RAISE,ALL INTERIOR /EXTERIOR DOORS 3/4' / EXCEPT UTILITY (UNIT 'A' 6 'B' ONLY) B.STRAP A L TRUSSES /RAFTERS TO WALL STUDS 6 WALL STUDS TO FLOCIR wl 1 1/2'x26 GAUGE STEEL STRAPS - 9.CLG G:RDER OVER LIV /DIN TO BE; 4 -1 1 /2'x11 1/4'x16' - 10'/19' -6' M.L. 7.1.37 0. BUILDEP. •RESPONSIBLE TO PROVIDE MIN. R -19 FLOOR INSULATION PER N.Y.S.E.C.C. 1.1 LAYERIS /8' TYPE X' GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS B 16' O.C. ATTACH'44 /6d CEMENT COATED NAILS (1 -7/e' LONG /I/4' DIA. HEAD) 2 7. O.C. (8U356) 2.SITE %CAT10N PUTNAM VALLEY, NY, PUTNAM COUNTYI 45 PSF SNOW LOAD 3.FUR HEADERS SEE EXCEL HUMES CALC.'S MANUAL PAGES 8.1.12 CALL REG PTICLES SERVING KITCHEN COUNTER TOP AREAS WILL BE GFI PROTECTED IN ACCORDANCE VITH NEC 210.52.(C) S.EACH BATHROOM LAVATORY BOWL VILL HAVF A GrT PRnTrrirn OrrrPTTrIr / I < U 31V TIC 'x' GYP.- - U,ILITV , IN V 4 S -2 S�CCT;m�I m r� 5 /D' TYPE 'Y' GYP. — 5'�8 1/2 18'-11 3/4' �I VASHjI c GARAGE 1 I TWO LAYERS OF 5/8' TYPE 'X' GYP, ON CLG. DASE LAYER APPLE AT RIGHT ANGLES TO JOISTS WITH t 1/4' TYPE 'S' DRYWALL SCR S E .F 24' O.C. FACE LAYER APPLIED AT RIGHT ANGLES TO JOISTS T H G ASE LAYER WITH 1 7/8' TYPE 'S' DRYWALL SCREWS 12' O.C. AT NTS AND INTERMEDIATE :JOISTS FACE LAYER JOINTS OFFSET 24' FR ASE 1.111 -� f�y1 l� s�erf(o'tZ I ).e rQS q75 �( ()L� 1 . LAYER JOINTS, 1 1/2' TYPE 'G' DRYWALL SCREWS PLACED 2' BlIC ON EITHER SIDE OF FACE `AAYER END JOINTS B 104 O.C. '7 { m •i I - ITT cna n ID40 LlfiHf RECD 1 �s . c< P `• _ •. .. -. ., - . 322 VENT ECD N I�i4te vuET�iT p pp" (` ON -SITE STEEL HEADER N L., , ; -�� J�`�a "✓� •.i ¢ DESIGNED, PROVIDED L INSTALLED 1 I ON -SITE BY BUILDER_ SN- �zaF. - / 1?'dl..�" f'. 16,_1• I I TM� VVD1eB01 VV➢1¢001 PRE-441LED ,1 I I �4 9YBYRJY.:Y /LL9y( -.. I I __ rGa T -zxlo v .z S(L ST NDR a 100' K! 3Y -8' 7•_4. P ■ 3" �- ` b• , NOOK; in om 127 kart REC➢ FAMILY OOH 2' -2 K Y - 31X LICCRT REp" z9Dm sD FT " 2320 LI(M RECD ENT 13" V PRCID N 6,y T 1160 VENT RE" 3216 Ll( PTAVT _;,. 3 ■ IRDV'0 17.73 VENI - n - ®1 -SITE fAW - O ' XEATILATVt lDILPLK{ •3' 1 5' -11 1/2' NODEL eNIG36 ). Rn 39 3/8•.40' m e2 tbl' rlPPT . /19'�SD'xb' IffARTX 1 n 1 n � i 1V' SM TO AiTit � t � En LRUM 37 N =� a Cl �Sie• riPE 'i• Gn. LANDWG AC/EC�T� 'L' sNNED - 2 ❑E SO L .SST ST�YIRS tSNf r0R SD , rCLG LOF 1 TERXJNJ.81L _ J !CR {TRWDE CL (ILLY _ (SL RECD TREAD I RA _ h BIRDER CLO PER APPLICABLE CODES - 1 1/4' 3Y -34• wwLaAR Icr ! 2' -3' 1 llaz VENT PRDVT FOYER P 0j (PCII TO HOVE P .1 I I I ®� A. I I � rRExcX �. ry all 14-5 1/2' J! CLG PER }l VYaO WI ML.(VERI)l') �4 Q N CC49O 2 =6 N 1 q 2p6DA O Q N rl� 61 3' -4' ' -0' 11.10' 121_01 40TES; 41'- 6'(TVO STORY) 1.2x6 E%' WALLS E 16' O.C. /2x4 HARR WALLS 2.9'-0' CLFFii HT. 3.2x10 SPRD2 FLOOR JOISTS 2 12' O.C. ./ JOIST HANGERS 4. ROOF SYSTEM TO BE 16. O.C. 5.MV VIN OVS (81=24210, R2 =2842, •3 =3046, R4 =2852, e11=2856) (SEE PAGE p9) 6. CEILING'DRYVALL WILL BE OMITTED FUR ALL ON -SITE PLUMBING CONNECTIONS 7.RAISE,ALL INTERIOR /EXTERIOR DOORS 3/4' / EXCEPT UTILITY (UNIT 'A' 6 'B' ONLY) B.STRAP A L TRUSSES /RAFTERS TO WALL STUDS 6 WALL STUDS TO FLOCIR wl 1 1/2'x26 GAUGE STEEL STRAPS - 9.CLG G:RDER OVER LIV /DIN TO BE; 4 -1 1 /2'x11 1/4'x16' - 10'/19' -6' M.L. 7.1.37 0. BUILDEP. •RESPONSIBLE TO PROVIDE MIN. R -19 FLOOR INSULATION PER N.Y.S.E.C.C. 1.1 LAYERIS /8' TYPE X' GYP. APPLIED VERTICALLY ON ONE SIDE OVER 2.4 STUDS B 16' O.C. ATTACH'44 /6d CEMENT COATED NAILS (1 -7/e' LONG /I/4' DIA. HEAD) 2 7. O.C. (8U356) 2.SITE %CAT10N PUTNAM VALLEY, NY, PUTNAM COUNTYI 45 PSF SNOW LOAD 3.FUR HEADERS SEE EXCEL HUMES CALC.'S MANUAL PAGES 8.1.12 CALL REG PTICLES SERVING KITCHEN COUNTER TOP AREAS WILL BE GFI PROTECTED IN ACCORDANCE VITH NEC 210.52.(C) S.EACH BATHROOM LAVATORY BOWL VILL HAVF A GrT PRnTrrirn OrrrPTTrIr / I < U 31V TIC 'x' GYP.- - U,ILITV , IN V 4 S -2 S�CCT;m�I m r� 5 /D' TYPE 'Y' GYP. — 5'�8 1/2 18'-11 3/4' �I VASHjI c GARAGE 1 I TWO LAYERS OF 5/8' TYPE 'X' GYP, ON CLG. DASE LAYER APPLE AT RIGHT ANGLES TO JOISTS WITH t 1/4' TYPE 'S' DRYWALL SCR S E .F 24' O.C. FACE LAYER APPLIED AT RIGHT ANGLES TO JOISTS T H G ASE LAYER WITH 1 7/8' TYPE 'S' DRYWALL SCREWS 12' O.C. AT NTS AND INTERMEDIATE :JOISTS FACE LAYER JOINTS OFFSET 24' FR ASE 1.111 -� f�y1 l� s�erf(o'tZ I ).e rQS q75 �( ()L� 20' -0' R.R. 12 BOX 693 LIVERPOOL. PA 17045 . (717) 444 -3395 FAX (717) 444 -7577 JUN 316 42/616 JEFFE ON n w/2424 GARAGE A 1ST STORY Z< LAYER JOINTS, 1 1/2' TYPE 'G' DRYWALL SCREWS PLACED 2' BlIC ON EITHER SIDE OF FACE `AAYER END JOINTS B 104 O.C. { m `ON -SITE BY BUILDER' ITT cna n ID40 LlfiHf RECD 1 �s p G I I P `• _ •. .. -. ., - . 322 VENT ECD N I�i4te vuET�iT p pp" (` ON -SITE STEEL HEADER N L., , ; -�� J�`�a "✓� } ¢ DESIGNED, PROVIDED L INSTALLED 1 I ON -SITE BY BUILDER_ 3, ---------- --- -------------- - - - --J I_ STEEL BEAM ON BY BUILDER / Q I I ,1 I I �4 9YBYRJY.:Y /LL9y( -.. I I i• Of NE" 44 7•_4. 3'-BV 3/D' TTPE GYP. SEE Imc w I I .41 PANELIZED WALLS c 007 Vr WALL MJ VERIFY ` b• , 20' -0' R.R. 12 BOX 693 LIVERPOOL. PA 17045 . (717) 444 -3395 FAX (717) 444 -7577 JUN 316 42/616 JEFFE ON n w/2424 GARAGE A 1ST STORY SN-, I r. Y. ! Mile ON CORP./SCIALDONE (8SK) MR TW 41'-6'TWO STORY�7, 82' M�ZED 5, 14• 5 1/2' 2'-0' ry 6' -6. vp BEDROOM #3 16�6 = FT CLO BEDROOM #4 1386 UCHT RECD 644 VENT 141M W uumT RE� R' 2L Ll 1182 w = =D �3 U4� 1 U� RECD T LLB2 VENT 9i SM 13 BATH 02 mN -SITE BOS/DUXXZM ! sm r— -CFF T. S.-M CLO -=mn, 7' > SN-, I d I WALK-IN CLOSET CMTT —6- SECT -LG!=.3 1/2' T V.w M. L — GIP r 610 1/2' 3/ 11-1. (THIS AREA FINISHED ON SITE BY BLDR.) THIS EA ATH #1 77 P. L- 0. 3 1/2 wTER mm � RCCr is CZETCD BY BLDR ) RE _ "'TE ME BY TME J�DER. SD Z. y i1 39 Vr.92 112. RE, 4- WALK-IN 7' 37' E vrlvcs SCE M 17 CLOSET By L. BEDROOM ❑ #1 BLDR.5 IN MT, LIN E son (THIS AREA FINISHED ON SITE BY CLO —SC 4' 2� LICkI RECD M� VE4T RECD M�D \ LRADI. IT 1.44 L101T MW,q PER APPLICABLE CURES VENT 6 MT 3C -]1' H4ILORAR 93 1/2' z• _.- 3 It B ILMM BEDROOM 02 lyn F- IZ48 U— IEao c- &21 VENT RC= u V_ PROVT El - Ini- STTE F" To 41` -. • D'ING D _P"T. 141 !/2' 14'-3 1/2' 11 V2.4• NDIp 3-06 WF02 'm 32x6 swie - ---- ------------ . ------------- O MR KR -1 19 VV RIA�ERTTY) 0 I 0 01 L. 4" pt . 3' 8 k -:D. I O�, 34' 2' :)'-4' 60' 3' 7' 4 — ,4;: 14'-8' _101 41'-6' 12'-2- MR TRUES IN MR L NO 1. 2x! EXT WALLS @ 16' O.C. /2x4 HARR WALLS 2.8' 0' CLG H 2 3 ---------------------- ------ x10 SPF#2 FLOOR JOISTS @ 12' O.C. 4 ROE] SYSTEM TO BE 16' O.C. JEFFERSON 5: Mw 'WINDOWS (#1-24210, #2-2842, #3=3046, #4-2852, #11m2856) (SEE PAGE 119) 316 616 JEFFERSO BR#2/#3 TO BE- 4-1 1/2'xI6'I0'/I9'-6' M.L. 7,1.32 R.R. /2 BOX 683 6: F R GIRDER UNDER PA 17045 L 2ND STORY 7 CLG BEAM OVER BATHOI/HALL TO RE- 2-1 1/2'xil 1/4*x41'-6' M.L. 6.22 LfwppooL, S. FOR READERS SEE EXCEL HOMES CALC.'S MANUAL PAGES 8.1.12 (717 ) 444-3395 "05/22/2003 9. CLG BEAM OVER MARRIAGE WALL TO BE: 2-2xI0 SYP*2 UNLESS NOTED OTHERWISE. DOC to. EACH BATHROOM LAVATORY BOWL WILL HAVE A GFI PROTECTED RECEPTICLE -7577 REVIS1uls Dux No1i IN ACCORDANCE WITH NEC 210.52.0) TAX (717) 44� ;4 Y. d I WALK-IN CLOSET CMTT —6- SECT -LG!=.3 1/2' T V.w M. L — GIP r 610 1/2' 3/ 11-1. (THIS AREA FINISHED ON SITE BY BLDR.) THIS EA ATH #1 77 P. L- 0. 3 1/2 wTER mm � RCCr is CZETCD BY BLDR ) RE _ "'TE ME BY TME J�DER. SD Z. y i1 39 Vr.92 112. RE, 4- WALK-IN 7' 37' E vrlvcs SCE M 17 CLOSET By L. BEDROOM ❑ #1 BLDR.5 IN MT, LIN E son (THIS AREA FINISHED ON SITE BY CLO —SC 4' 2� LICkI RECD M� VE4T RECD M�D \ LRADI. IT 1.44 L101T MW,q PER APPLICABLE CURES VENT 6 MT 3C -]1' H4ILORAR 93 1/2' z• _.- 3 It B ILMM BEDROOM 02 lyn F- IZ48 U— IEao c- &21 VENT RC= u V_ PROVT El - Ini- STTE F" To 41` -. • D'ING D _P"T. 141 !/2' 14'-3 1/2' 11 V2.4• NDIp 3-06 WF02 'm 32x6 swie - ---- ------------ . ------------- O MR KR -1 19 VV RIA�ERTTY) 0 I 0 01 L. 4" pt . 3' 8 k -:D. I O�, 34' 2' :)'-4' 60' 3' 7' 4 — ,4;: 14'-8' _101 41'-6' 12'-2- MR TRUES IN MR L NO 1. 2x! EXT WALLS @ 16' O.C. /2x4 HARR WALLS 2.8' 0' CLG H 2 3 ---------------------- ------ x10 SPF#2 FLOOR JOISTS @ 12' O.C. 4 ROE] SYSTEM TO BE 16' O.C. JEFFERSON 5: Mw 'WINDOWS (#1-24210, #2-2842, #3=3046, #4-2852, #11m2856) (SEE PAGE 119) 316 616 JEFFERSO BR#2/#3 TO BE- 4-1 1/2'xI6'I0'/I9'-6' M.L. 7,1.32 R.R. /2 BOX 683 6: F R GIRDER UNDER PA 17045 L 2ND STORY 7 CLG BEAM OVER BATHOI/HALL TO RE- 2-1 1/2'xil 1/4*x41'-6' M.L. 6.22 LfwppooL, S. FOR READERS SEE EXCEL HOMES CALC.'S MANUAL PAGES 8.1.12 (717 ) 444-3395 "05/22/2003 9. CLG BEAM OVER MARRIAGE WALL TO BE: 2-2xI0 SYP*2 UNLESS NOTED OTHERWISE. DOC to. EACH BATHROOM LAVATORY BOWL WILL HAVE A GFI PROTECTED RECEPTICLE -7577 REVIS1uls Dux No1i IN ACCORDANCE WITH NEC 210.52.0) TAX (717) 44� ;4 I 1112."i o I�¢ I U 0 o � I U; Ip0 I" mm fV I �• UNE CA DI — � —_ � iF ,o r BARRIER N ' CRUS D :L? _ �I •:'.''y.. 1AZ4YE1YL,. r "r I I R MANUFACTURER 7�OPENING 4" STEEL PIPE COLUMN L) I 4" POURED CONCRETE SLAB WITH 66- W1.4xWI.4'•WWF OVER 4 ML. VAPOR I — I 1 I ON 3' -0" x 1' -0" DEEP; 'Lx0 Utl;t INV _ — 8' CONTINUOUS POURED CONCRETE FOOTING k""° 1 fit_ k! I ao _4 - =.n_• 2 -2x8 LEDGER (TREATED) BOLTED TO , '? :' ° -' EXISTING STRUCTURE W/5/8-D. BOLTS - 'Is 19'- TYPICAL 4 DN I��— aO A N O 2'-0" O.C. (STAGGERED) FLASH TOP`'f (TYPICAL). N GC TO CO - -- — INATE LOCATION OF - -- — _ -- — !— 220 —_ _ - - -_ - -- — STAIR W/ MO R MANUFACTURER PROVIDE FIRE' RATING AS REQUIR Y :. ... r w NYS CODE AT - FURNACE HEA / UP , ,.;•:: PRODUCING EQUIPMENT- D I TEPS TO GRAD 10" K POUREDI, E 20" x 10" DEEP CONDITION...' ' _�• —••�- I CONCR FOUNDATION AS REQUIRED I CONTINUOUS POURED siY I N WALL - rs Y CONCRETE FOOTING I ;% TYPICAL i 60' -4' ri F 77 77 � ,,••�• �� :'� — — — - -• — — — e _ �:. — --J �? 12' 15' -9" � � 26' -3" I 2' -2" ' ADD LLY COLUMN ADD LALLY COL MN _ GC TO COORDI TION OF Tl HO DIMENSION HOLD DIMENS 0 W/ MODULAR MANUFACTURER I BEAM POCKET '(TYP.) I 1112."i o I�¢ I U 0 o � I U; Ip0 I" mm fV I �• UNE CA DI — � —_ � I— __ ,o WWF OVER M- OR BARRIER N ' CRUS D �.- ._ _ �I •:'.''y.. 1AZ4YE1YL,. r I I I R MANUFACTURER 7�OPENING 4" STEEL PIPE COLUMN L) I 4" POURED CONCRETE SLAB WITH 66- W1.4xWI.4'•WWF OVER 4 ML. VAPOR I — I 1 $�� ON 3' -0" x 1' -0" DEEP; BARRIER ON ,4 ". CRUSHED _ — 8' CONTINUOUS POURED CONCRETE FOOTING STONE /GRAVEKI BED I _4 TYPICAL 4 I GC TO CO INATE LOCATION OF - STAIR W/ MO R MANUFACTURER PROVIDE FIRE' RATING AS REQUIR Y FOR ADDITIONAL UCTURAL INFO . r w NYS CODE AT - FURNACE HEA / UP , ,.;•:: PRODUCING EQUIPMENT- D ©©p t CONDITION...' ' _�• I siY ;% F 77 77 � ,,••�• �� :'� — — — - -• — — — �; _ �:. — --J �? TYPICAL � � oi _ SECTION o ' ``— — _ I 1112."i o I�¢ I U 0 o � I U; Ip0 I" mm fV I �• UNE CA DI 4" POURED CO RITE ° SLAB WITH 6 -W . xW1.4 e°,I ,o WWF OVER M- OR BARRIER N ' CRUS D STONE RAVEL BED_ W12x40 w /2X6 NAILER E DROP FOUNDATION T GARAGE DOOR COORDINATE W/ R MANUFACTURER 7�OPENING L) I I 1112."i o I�¢ I U 0 o � I U; Ip0 I" mm fV o� y�.. •13 Ay � /, 01 1y p'i ° 40 g1 A� �6 1SA6 y`� A r 0 AAA g 51 s�� 1 A 6 c°'ai � AA1 I Wood Deck ty0 ma `� f �ellin9 � 1 J Slate 4� y�ry Porch \� \ °•o 1 1 Well °6 orb I ~ I lamp oJ`Z 16 00'H'' % 6p pasts sg9 9 S59.32'47" 8,135 92 19.49' AS p\rr n ' pad Under Cons,r,c ,, \ � J \ 1 I' l SURVEY OF PROPERTY BEING LOT 8 Located In "STRAWBERRY KNOLL" As Shown on a Map Filed in the Putnam County Clerk's Office on May 15, 2002 as map no. 2900 Situate in the TOWN OF PUTNAM VALLEY COUNTY OF PUTNAM, NY Scale: P'50' February /1, 2003. Aug. ff, 2003 - ,Foundation Added Nov. , 2003 - Final locations & certifications added wfNr SYs7ru (sSTS) Is DESIGNED 1 U. tU wi IN ucr1 rim(- -/H r1ol I 7 OF 11 r0 15 MINUTES PER SH££r). 'OR TO SrAR77NG KVRK AND VCH£S. -.OR ADDITIONS TO THIS DRAWING IS 709 (2) OF 7H£ NEW YORK S 7 1F t15a,F -11/1 PCK 7rMLENE FpGCE L ME--- PLACED JN 77r_£A 17A£N,T. " .e 9%V OF SSTS� BANKRUN %S CLEAN AND FREE IND LARGE ROCKS BANKRUN DOZES HAVE )F LESS THAN 5 MINUTES PER INCH DROP? OISMBURAN BOX M77N BAFFLE wrH RESPECT TO PROPERTY LINES WAS �\ Y.- DONNELL Y LAND SURVEYING. P. C. ,-, y 0 SDNJQ PW PiPE FRAM - -- LOCArED IN STRAWBERRY KNOLL " AS 0151 8M N PERF TRENCH PIPE 9HE PUTNAM COUNTY CLERKS OFFICE — . �idj Vo. 1900. / 5000. F. -.1 PER" p IN '." LRAKL 7RENCH (ENDS ARE CAPPED) AREA & !)" MIN. Of BANKRUN (SHADED AREA) 11 . 100X CYPAN90N AREA 7 0 / IMPLNN(k /S RUI/NDARY AI _ LOWER ENO (HA rCHEO AREA) F ' 7e V }p o ING M5_ _ _ y A— AND —1 ALARN h (L OCA RCN IN BASEMENT) \ • re m e oo 0, c r CQ \\ Oq \ \\ �\r S TRA WE�E-RR Y' K&OL L - LOT #8 A S- SU /L T SEWAGE TREA TMEN T S YS TEM SCALE: 9 '° = .30 FT. i� Q1 PUMP DA TA 1250 GAL PUMP CHAMBER INSIDE DIMENSION: 4 " -6" x 9' -6" DUMP ON: 41 1 2 DUMP OFF.• 51" 9RAW- 101, 90SE: 260 GALLONS PUMP- GOULDS PUMPS WE1012H END OF SS TS A B. 149' 202' 145.5• 199' 141.5' 196• 138' 193.5' DISTANCES TO NORTH END OF SSTS PUMP CHAMBER WI7H GOULDS WE1012H PUMP AI A B NORTH CND ,OF 1ST. TRENCH .79 92 NORTH END OF 2ND. TRENCH 73• 87' NORTH END OF 3RD. TRENCH 67" 81.5' NORTH END OF 4TH. TRENCH 61.5 76.5" THIS /S TO CERTIFY THA r 7HE SEWAGE D/SPO� CONSTRUCTED AS INDICATED ON THIS PLAN At WAS INSPECTED BY ME BEFORE lT WAS COVEN WAS CONSTRUCTED IN ACCORDANCE WITH ALL AND REGULA77ONS OF THE PUTNAM COUNTY-L' AND 7HE NEW YORK STATE DEPARTMENT OF f SUBSURFACE SEWAGE MEA CONS /SrS OF A 1250 GALLON CONCRETE SEP77C PUMP CHAMBER WI7H GOULDS WE1012H PUMP AI PVC PIPE IN 24' CRA VE IN 12" MINIMUM OF RUA SiEPARAYE SEWAGE SYSW 0Y: 0 37 CROTON DAM ROAD CORP. 37 FOR 37 CROWN DAM ROAD 37 CROR OSSINING, N. Y. 10562 OSSINING, mm? SQL Y: WA 7? S) PRIVATE HELL BY.• PEEKSKILL� P.F. BEAL & SONS INC. (C /rY OF 4 PU7NAM AVENUE RREWSrER, MY 10.500 iG �l30 t:A;f0h CLWCRffr PUMP CHAMBER —1, t',OLADS OW1012H PUMP - 19L ;* ". At wp.L' Ppr .5t.l. .4"o cASI IRCW PiPt 'E DISPOSAL SYSTEM WAS PLAN AND THAT '7HE SYSTEM 4S COVERED .OVER. THE S Y5 7FV WITH ALL STANDARD RULES COUNTY DEPARTMENT OF HEAL rH - IfN T OF HEAL TH. 7REA 7uEN r SYSTEM TEm rC SEP 77C TANK, 1250 GALLON CONCRETE � PUMP AND 506t. F. - 4'o PLcRFoRA rED 'M OF RUN OF BANK o*w & autcm ROAD CORP 37 CROTON DAY ROAD OSSINING, N Y. 10562 iA 7M SWM PEEKSKILL HOLLOW BROOK (CITY OF PEEKSKILL WATERSHED) *nL L OCA RON I x I y swu 1 8.3.5- 1 37' TANK DISTANCES A 8 SEPnC TANK 55' 19' PUMP OMM&R 67* 19, DISM18unoN Box 97' 140'. I ..�`�.+g�4_' . �..._,,....:,-.._.. �f' s' r!- :3:...:'o`.y�`�?�:�`°- 3.- :..-FH �:��..__.._:��"�. .a:,.,: {'Ti:x.< "- `s -.-;c. !�; ^.:'� --?C :•:.,. ,.:= ,�i'`�` �1YyYy( j j en Of a3sy r SS CA q 4 � LJ a j r —:JF •V- _w... .... .'�% � ��:. —,.sO is .. • i "".��. �� s . —tie• .y.• � •1 4''u �. I ..� /? .,... —, p tr 1 \ V.S. CONSTRUCT SN- /ON- 2021868/NY W_. ole 0 0 de 14- IIZ' A, 11. A .;o 0 112• to 6 "1 4.1 --- - ------ ----- von -- T C( .1, ED IT .3 5 1 If 5n' TM M ON CLG, RASE LATER 1. LIV 1p0. �ES TO JOT IS vi., 1/4' TYK 'S' WVVAL L� FATE LAYER A—MD AT R �ES TO JOISTS I LAYER VZTH 1 718' TYPE ICKV-S 111. � AT I I s z s, AmD TfTEEDIATE JOISTS. FAF SET �.� G� LAYER INTS SET 24� L.M. TTS, I — TYPE DRYVALL SC—S PLACED 2• T, 'Tuiy ET:7 SIDE OF I EXkRYEq? JOINTS AA ZLOER, FEmR -SITE ir LOER .:L.R, ON -SITE STE CN-SITE IT xIIILOER—__+ 14-9 7/B' 4' STEEL K� ON-SITE WT WILOTTI t 71 T -4. _4� PANELIZED VALES NOTE. STORY) . 6 EXT VALLS e O2.1 MARR VALES z. -o• u6 NT L es 7 ..2.10 SPFk2 LORI GISTS t R' JOIST K. AGCRs T. L 'SEE PACE !9> l 2w-0' YVALL WILL RE RATTED rm ALL ON -SITE ft 'I /4' 1 E�T UTILITY "A 'E ' CaS"E'U"TEUrT=.VST— �Y) STRAP ALL WT I ��L TO 'LIM .1 1 11V-2. �E SIM STRAPS JOIN 9."o GIRDER � LIV/DIN TO M 4-1 1/ TO I�TDE — 1-11 W�.R KS�SOXE RT , C n 1 LAYER 5n' T� 'X' — AMIED W AW%.A`fV CEMENT � TEL. _. L I—) 12.SIT KA�� EY, �, T. &R.0, so, 316 4?/AI6 IFFFE ON ./2424 GARAGE OA L IX FM HEADERS SEE EXCEL �S CA MAN PAGES 0.1.12 __& " I T excel IST STORY (E AIL_ SE-- KIT— (ETEj, TOP �". V� BE CTI MIECTE. 1. KE 21— . ("') "'-' __ " 1—t- .,. 114-0-1 DOE L AVATESVY 2� "'L A �STTCCTED RECEPTICLE IN AC[p2plytC IT. ZTO. f 0 GOINSIDE OUT FROM THE W�5 AT TURN=E/ EQUIPMENT ,i PUTNAM COUNTY DEPARTMENT OF NEALT" HOUSE PLAAj.5.Appr,,,qVED,,(jR BEDROOM L '1UNT ONLY, Date a a. IFtDONE (8SK) 'i KO(0011 I) u1z K O rmY1 ATV.031.G CLO Oy )Edtml 11 a1 VM I6WAIR'1 /l ➢ tt0 12' -6• M TIm • B'-0' 61•-6• ITL m' AVTOti t01H RATH K " W ACCORDNNE VTH NE[ 2103L(W . _ .. FROM PROVIDE FIRE RATING AS REOUIR NYS CODE AT FURNACE /HEA i. (THIS AREA FINISHED W SITE 11 LLMl " —K-IN CLOSET ITHLS MEA FINISHED W SITE BT BLDR.l 02t86f 1.1 ja �n i ilk tl ---------------- � 0 FR /2 F➢I 660 316 616 JEFFERSON LP6FP➢OL PA Tsws 2ND STORY D ryn11u -esys o - . PAr ryM �� - >6n .Hn. 1� °� �ros`/zz /zom vvr-r m.eresrxDNes.ror _ _ �z {¢gq ai�zNa�a c�1�N'r� Lc��a��aEN� o� "EAI-TM }at1U5E PiAt�g APP': �vti:0 r00 IiEo )tA CCUh OilLY; Si4patu vKV[i LIN.. �Ll - - T 5 l l._T. m n .q0 • 3❑I/2' 2' -)•O3' s sa1 x.rult1OY" b b_ . w 1! 1 wa yr ❑ ❑•-P 1 1411 112' . ' Q 17 t ti ITS 3 -t K.s O O __ O O N3._B. ' 3 3._1. B._2. 3_1. • 6 6._0 ® 6.p N ' 1 11'-10' 1 12'-0' 1 11' - ➢' 1 . i tiers• L216 E %T VALLS t 36. —.4 NARR VALLS 2xlo �1Y RWt —STS ! 12. U. ROpF "ST" TD BE 16. OG 1 - ) 1111 YNV WDOVS (1141210, L"20-4 3016, 114 2036) ISCE PAGE 19> 6. CLR GIRDER WDER BR12/O -1 1 /Ya16'10' /IY -6' ML. ).1.32 2 -1 IR'xll' 1/1.111' -6' IIL 62E B. FOR HEADERS SEE E %CEL S C61G'S NNAIAL PAGES 81.12 exc 9. CLG BENZ OVER MARRIAGE VALL. TO q. 2 -B.tO SYP12 UNLESS NOTED O OTNERVISG F'� e (THIS AREA FINISHED W SITE 11 LLMl " —K-IN CLOSET ITHLS MEA FINISHED W SITE BT BLDR.l 02t86f 1.1 ja �n i ilk tl ---------------- � 0 FR /2 F➢I 660 316 616 JEFFERSON LP6FP➢OL PA Tsws 2ND STORY D ryn11u -esys o - . PAr ryM �� - >6n .Hn. 1� °� �ros`/zz /zom vvr-r m.eresrxDNes.ror _ _ �z {¢gq ai�zNa�a c�1�N'r� Lc��a��aEN� o� "EAI-TM }at1U5E PiAt�g APP': �vti:0 r00 IiEo )tA CCUh OilLY; Si4patu 3 -2x10 3- 2x -1Tk70 3 -2x10 ��,y�l ��6'x6' WOOD POSTS (TREATED) CONCRETE GP & 1 80.5E CONNECTORS ON 16' SON -O-TUBE \'��,-k I ' I PIER /FOOTINGS (TYPICAL). t. LINE OF DECK ABOVE I OECKIN'b • ^ �--I- -I: 2 -2x8 LEDGER (TREATED) BOLTED TO 12' I _ - o EXISTING STRUCTURE W /5 /8'DIA. BOLTS 19 LpN ' Ys m O 2' =0' O.C. (STAGGERED) FLASH TOP I— • — i `� — — (TYPICAL) . —2 2 0 — — — — — — — — 10' K POURED STEPS TO GRADE •. — — — — — I CONCR FOUNDATION As REQUIRED 20' x 10' DEEP WALL - CONTINUOUS POURED r - - - -' n CONCRETE FOOTING 71 L •i. ' TYPICAL / 60'= 15' -9' 2 -3' / , / 112' ' I ' ADD Y COLUMN ADD LALLY CO MN GC TO COORDINATE LOCATION OF - I T NO IMENSION, HOLD DIMENS N� W/ MODULAR MANUFACTURER J . BEAM POCKET (TYP.) r .. I ..I _ -�_ erg.. ' :< (s,-- _ :Y.z.r;.l:',�1•: °.w: - I T —7, TIN ri—r � R •�`• -- - - - - -- —'t;= BASEMEN — — — — — — — . `• I x CONCRETE — I � r 4' STEEL PIPE COWMN WWFOVER 4 MMLVAPOR ON X-0' x 1-0' DEEP � ✓��' I � I BARRIER ON 4' CRUSHED - _ CONCRETE FOOTWGED STONE/GRAVEL STONE /CRAV BED ._ TYPICAL - I :�:: '-4' 184V 112- 4 GC TO INATE LOCATION OF "' ?>„ Jt . .. . rt ` STAIR W/ M MANUFACTURER D • FOR AD ITIONAL UCNRAL INFO PROVIDE FIRE RATING AS REQUIR -UP NYS CODE ATFURNACE/HEA PRODUCING EQUIPMENT- i� ®` 1. I'� I '�I CONDITION. _4y. I 4' POURED RETE i ( I •` - I SLAB OVER 6 -W 01.4 R I gg BARRIER 4'C . y STONE RAVEL BED •:PI �_ W12,40 r ; I tl- — — _ — — — — ..r... ..,....:— — I GVI DROP FOUNDATION WALL AT GARAGE 5 .I • — :,. _..., .a 1 r(PICAL — OPENING COORDINATE W/ I 2$ MODULAR MANUFACTURER �I R L — — — — — — J SECTION 4 I ';: (TYPICAL) sj PUTNAM COUNTY BEf? f TMEN7 OF NEALtN f l6USE PLANS APPT)VED F'R f3E0RU0Nj CUiJNT ON ": t .' y -=-�-- `— — Date ! • ignatU(d title. f .c • 1 , s PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT NOTE: Exact location of well with distances to at l prg o permanent landmarks to be d on a separate sheet/plan. 12,19 1 Well Drille Signature: White copy Address: 4 Put= Ave., Brekstw, NY 10609 Date: 6/30/03 ; copy - Owner; Orange copy - Well driller Form WC -97 -�L -- - - ' ,q I n �0i� TownNillage: Putnam Valle Tax Grid # -. Ma Block Lot (s) P 84 2 () 64 Well Owner: Name: Address: VS Construction, 37 Croton Dam Road, Ossining, NY 10562 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing. X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: _ Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours 6 Yield 8 gpm Depth Data Measure from land surface- static (specify ft) 30 r, During yield test(ft) 510, Depth of completed well in feet 565' Well Log If more detailed information descriptions or Steve analyses„ ...::- ..,....... are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 2 Drillina in over den clay and boulders Hit rock at 2' _:2, :; _. - 32 iIrill n IrIJ, 32 565 Drillin in rock gKoite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 c[pm Depth 530' Model 5GS10412 Voltage 230 BP. 1 Tank Type WX302 Volum allon J Date Well Completed 2/15/01 Putnam County Certification No. 001 Date of Report. 6/30/03 Well d NOTE: Exact location of well with distances to at l prg o permanent landmarks to be d on a separate sheet/plan. 12,19 1 Well Drille Signature: White copy Address: 4 Put= Ave., Brekstw, NY 10609 Date: 6/30/03 ; copy - Owner; Orange copy - Well driller Form WC -97