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04397
PUTNAM COUNTY DEPARTMENT OF HEALTH
CERTIFICATE OF CONSTRUCTION COMPLIANCE F .. SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # V (o 0:3
Located at 30 f ye7a,r0NT PZLN_� JZo%1 D Town or Village Po i m /J Y►, A LLE—V
Owner /Applicant Name39 cf2o7ah t>,AA f2oAo c,-Iz Tax Map Block 2 Lot 65_
Formerly
Subdivision Name S7'lZtl W 061t K'W6Lc-
Subd. Lot # 9
Mailing Address 39 cf aTa tiJ aq rh 'Ro4o 6 Sr 1141 N16 tJCK/ Y R K Zip / O IS' C2
Date Construction Permit Issued by PCHD J9F12IL -Loo 3
39 cRt i ore r;vgm ROAD
Separate Sewerage System built by 37 cQoToI4 jpm/h fZ0 AD c yit? Address o sr) K i N G N V' /,a zy-L
Consisting of i2S0 Gallon Septic Tank and Soo L.>' _.CFer FPc7LF0JZA -T(mob 'PVC PIPIs
IN i-� U bF ziq�-1 K12y1'j
Other Requirements:
Water Supply:
Public Supply From.
Address
4 'PuTN'IM flWiQV <s
or: Private Supply Drilled by Pr 13er+L 4 SOW INC, Address CRLs WJ' -reJ2, NV' IoS-109
Building Type S 6L-6 _FJ9M'i L y " ' ' Has erosion control been completed'? % s
7'
Number of Bedrooms 'ra V rz Has
I certify that the system(s), as listed, serving the
built plans (copies of which are attached), m
plans and the standards, rules and regulat' ns W
Date: 7-'' �- '03 Certified by
Address S SdNN VJA L-�'H JTLVP ' (Design Pr
_ �t it kJKI try
'1P-i dtEbb aped? Ir
iise one ct essentially as shown on the as-
ith th "; Issli" C YC nstruction Permit and approved
,;.. r.,,..�- W
m C p of Health.
6290 P.E. R.A.
` License # 6 Z-°)
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
treatment4 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
revocatio ,modification or change is necessary.
�%rSTlh �cJb tic
By: Title: i r_r� i n7I Lg-a,i Date: o
It /Copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
i
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well'IL0 -C' ttion " ""
St eet Addr "ess:' "`' " '
�o pheaScwr�" �Jh 2v
Town/Village:
Putnam Valley
Taz Grid # 84 -2-65
Map Block Lot(s)
Well Owner:
Name: Address:
VS Construction, 37 Croton Dam Road, Ossinipq., NY 10562
gJse of Well:
�-p>r "217
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 5 gpm
DDepth Data
Measure from land surface- static (specify ft)
15'
During yield test(ft)
540'
Depth of completed well in feet
605'
Well Log
If more detailed
information
descriptions or
sieve . aly, es
are. available,
please attach.
Depth Fro nn
Surface
Water
Bearing
Well
Diameter(in)
Formation
Description
fft.
ft.
Land Surface
5
Drillinq
in over
urden clay and boulders
Hit rock
at 5'
5
32
Driltiri '
=iii`:
32
605
Drilling
in rock
ciranite
If yield was tested
at different depths
,during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type sub Capacity 5anm
Depth 560' Model 5GS10412
Voltage 230 HP 1
Tank Type WX302 Volume 86 al o
Date Well Completed
5/6/03
Putnam County Certification No.
001
Date of Report
6/26/03
Well D ' e s'
b
0
(1?IUTE: Exact location of well wtttt atstances to at least two permanent ianamarKs to oe provtgmu on a separate snceuptatt.
Well Driller's Name Pe Fo Address: 4 Rtrg n Ave., Breasber, NY 10509
Signature: Date: 6/26/03
Perry Lo 1
White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
JMS ENVIRONMENTAL SERVICES, INC.
1500 SUMMER STREET
STANFORD, CON.NE.CT.ICUT-o6905�t
Mailing Information:
Name: PF Beal & Sons Client: VS Construction
Address: 4 Putnam Ave
City: Brewster
State: NY Zip: 10509
Telephone: 845-279-2460 Fax: 845-279-6613
Sample's Information:
'�Site'�L''otF9
Preservative: HNO3
Temperature: <4C
NELAC, CT and N.Y 5tate, .0
Collector's Information:
Name: Kevin
Environmenta.l.L.aborator,,y
Address of site: Strawberry Knolls
City:
State: Zip:
Telephone:
Date Collected: 6/26/03 Date Received: 6/27/03
Time Collected: 13:15 Time Received: 15:00
Lab No.: J034484
Date Analyzed Test Name Result MCL Method
6/27/03 15:00
Total Coliform
Absent
Absent
SMWW 9222B
6/27/03
Chlorine Free Residual
<0.1 mg /L
N/A
SMWW 4500CIG
6/30/03
Color
ND
15 Units
SMWW 2120 B
6/30/03
Odor
ND
3 TONs
SMWW 2150 B
6/30/03
Iron
<0.03 mg /L
0.3 mg /L
SMWW 3111B
6/30/03
Manganese
<0.01 mg/L,
0.3 mg /L
SMWW 3111 B
6/30/03
Sodium
7.89 mg /L
N/A
SMWW 3111 B
6/30/03
Chloride
36 mg /L
250 mg /L
SMWW 4500 Cl C
6/30/03
Hardness _
84 mg /L
_ N/A
SMWW 2340_C,_ .
- 6/30/03 ....... x
� Nitrate,`--
1.64, rng /L:-•
... -10 mg?L .. ,-
.- -WWW-4500 NO3E.:...=
6/30/03 10:00
Nitrite
<0.1 mg /L
1.0 mg /L
SMWW 4500 NO3E
6/27/03
pH
" 5.97 S.U.
6.5 -8.5 S.U.
SMWW 4500 H B
6/30/03
Sulfate
29.8 mg /L
250 mg /L
SMWW 4500 SO4F
6/30/03
Turbidity
0.12 NTU
5 NTUs
SMWW 2130 B
6/30/03
Alkalinity
50 mg /L
N/A
SMWW 2320 B
6/30/03
Lead
<1.0 ug /L
15 ug /L
SMWW 3113 B
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
BRUCE R. FOLEY
Public Health Director
rLORETrA— MOLriVAkl -- Yv, M- ,.S.N. - -
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
E911 ADDRESS VERIFICATION FORM
OWNERS NAME- S9 U o I o --1 DAr"'t f Z o A O
TAX MAP NUMBER: Q14 '��K. 2 L_ � T- : GS SQ %Lt, r --A� 1
E911 ADDRESS: 3 ?NG0 MJ-F Ry',3 R0 A D
TOWN: Py 'i i ► A fY�p4 I-LC- 1/
AUTHORIZED TOWN OFFICIAL,:
(Signature)
PATE:
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 VERFM
PUTNAM COUNTY DEPARTMENT OF HEALTH
�-DIVISION-.GE- ENVIRONMENTAL HEALTH- SERVICES-`.
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
3`] CPO_F60J f>601 -90AD C012 P. N A &S
Owner or Purchaser of Building Tax Map Block Lot
37 CRoTo/J SAM 1 06Q C.612P, �(emuTiJAn1 VII ZL6 y
Building Constructed by TownNillage
3v 'PN��aS�a�T 12v/-J TRo (iD
Location - Street
SlnlG4-CAr��z��
Building Type
S t RtQ W KCRfZ / KNrj L L
Subdivision Name
9
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 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 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 pr*rly.is- c�ib4id�by-�tie vilitul -or negli en ae o-f- the.occtipant ® the -bui dtiag uti izing��tlle',=--' -
`
system.
The undersigned further agrees to accept as conclusive the determi at' n f the u tc Health
Director of th Pu am unty Department of Health as to whether or of he ail o e system
to operat a ca sed t e willful or negligent act of the occupant of e ildi Q utilizing the
system. _
Dated ! vlontl % Day 7 Year 200
) - Signature
37 CV07 --0ff OPP j Rc-)H C(JEp
Corporation Name (if corporation)
Address: 37 e2y'To �J 'OAM '.Von-0
State D SS I n1 J/3 G . Y-� .y, Zip l o S6 2
Signature:
Title: ` rZe! Si J,-V�J -i I
3P C20 i oio r'),wil Vaiq o C072?
Corporation Name (if corporation)
Address:—'32 C 07-6IJ DAII -i RID.
State DS-S W ItJC, Ni/ Zip 10 S6 2
Form GS -97
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PUTNAM COU ITY 'DEPARTMENT OF HEATH
DIVISION OF E ON"NIENTAL BY-ALTO SERVICES
ATTENTION
All information must be fully
inspections being made.
PCHD Construction Permit #
Located: 3,0 PWO SA N
Owner /Applicant Name: 3'
Formerly:
. ~7 i ❑ GENE
Is system fill completed?
Is system complete ?_
Is system constructed as per plans?
Is well drilled? A
Is well located as per plans?
Are erosion control measures in pig
For: Fill
prior to any Trenches 'ter
- ro- 03
J N IZ404to (T) (V) - irt4An IlAu y
W J:Wh ROAD ce Tel If Block '. Lot CS
Subdivision Name: STIZA WM7Z 11 KNo L
Subdivision Lot #
Date:
Date: 7
I certify that the system(s), as listed, at
and verified their completion in ac
approved plans and the Standards,
Date. "7'Z-,!3/ 20 2003 C
Address:
Comments:
Form FIR-99
f
Date:
O
above premises has been constructed and I have inspected
dance with the issued PCHD Construction Permit and
.s and Regulations of the Putnam County Department of
rtified by: E"N(r/Vt L-- ttrNC PE •k P k
Design Professional
Lic. #
10 39dd t 9NI833NI9N3 NIN060 669696LO16 LT :LT 6@0Z/Z0/L0
07/02/2003 17:17 9147363693
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JUL-2-2003 WED 15:29 TEL:845-278-7921
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NAME:PUT'NAM COUNTY DEPARTMENT OF P. 2
CRONIN ENGINEERING
1
PAGE 02
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JUL-2-2003 WED 15:29 TEL:845-278-7921
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NAME:PUT'NAM COUNTY DEPARTMENT OF P. 2
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
- � � .... � .. - .. .... .. _. ..� •4 .. � � _ _ 1. .. h ._ ,
CONSTRUCTION PERMIT FOR SE MALTREATMENT SYSTEM
PERMIT # �'(0'�3 L i °aa 2'
_.
Located at Pheasant Run Road Town orV#riage Putnam Valley
Subdivision name strawberry Knoll Subd. Lot # J Tax Map 84 Block 2 Lot
Date Subdivision Approved May 15, 2002 Renewal Revision
Owner /Applicant Name 37 Croton Dam Road Corp. Date of Previous Approval N/A
Mailing Address 37 Croton Dam Road, Ossining, NY Zip 1 n-s 2.
Amount of Fee Enclosed $300.00
Building Type Residential Lot Area 2. d D No. of Bedrooms 4 Design Flow GPD 800
A,-
- Fill Section Only Depth Volume •-I' e4O A Y.
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of 1250
of 4" PVC Perf. Pipe in 24" Gravel Trench
gallon septic tank and 6d,9 L. F.
Other Requirements:
&
J �,o/ of
PZua .
To be constructed by
37
Croton Dam Road Corp.
Address 37 Croton Dam Road, Ossining, NY 10562
Water Sunaly: Public Supply From Address
or: X Private Supply Drilled by �n
AIy 1450-9.
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in
accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion
kthereof a "Certificate of Construction Compliance7,,4atisfactory to the Public Health Director will be submitted to the
Department, and a written guarantee will`e `fi m- 0_heil. wner, his successors, heirs or assigns by the builder, that said
•i builder will place in good operating coz diti,6m any`par#-, %f sa sewage treatment system during the period of two (2) years
immediately following the date of tie is%'mce of the appfq &I the Certificate of Construction Compliance of the original
system or any r irs hereto. FA��
1
Signed:
Address 2 John Walsh Blvd;
skill,NY 1056E
Date
License # 062980
APPROVED FOR CONSTRUCTION: This approval. expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new permit. Approved for discharge of domestic sanitary sewage only.
Ll;c
By: Title: `5 Date:
Wh a copy - HD File; Yellow copy !Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
P UTNAM COUNTY DEPARTMENT OF HEALTH
DffWMIGN OF IENVE R®IMIEN TAIL HEALTH S EllRWIC1ES
A- PPLAC ST GNCQ CDN TIlB �WATL8 WELL
Y ..
please print or type PCHD' ermit .# -
WeH Location.
Street Address: To Putnam Tax Grid #
Pheasant Run Road, Sublot# ,9 Valley Map t9z/ Block .9 Lot(s) !i5,
WeR Owner:
Name: 37 Croton Dam
Address:
Road Corp.
37 Croton Dam Road, Ossining, NY 10562
Use off WeH:.
X Residential Public Supply Air /Cond/Heat Pump Irrigation
I -primary
Business Farm Test/Monitoring Other (specify)
2-secondary
Industrial Institutional Standby
Amount of Use
Yield Sought 5 gpm # People Served 4 Est. of Daily Usage 500 gal,
Reason for
Replace Existing Supply Test/Observation Additional Supply
DrilUnng
X New Supply (new dwelling) Deepen Existing Well
Detailed Reason
Water supply for new residence
for IIDnrillinng
Well Type
X Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No X
Is well located in a realty subdivision? ...................................... ............................... Yes X No
Name of subdivision Strawberry Knoll Lot No. .s
Water Well Contractor: P.F. Beal 4 Sons, Inc. Address: 4 Putnam Ave . , Brews ter, NY 10S09
Is Public Water Supply available to site? .................................. ............................... Yes No X
Name of Public Water Supply: N/A Town/Village N/A
Distance to property from nearest water main: ± 600' (out of town � county)
Proposed well location & sources of contamination provided on ep to sheet/plan.
Bate:�'�j�� ���� �`AP�•icari�.S,ignatitre:�- - �,, �� � v ..: . � _: _ ._..
PERMIT TO CONSTRUCT A WATER WELL
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.
APPROVED ' FOR CONSTRUCTION: 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 by Putnam
County.
Date of Issue L/ / Permit Issuing Official:
Permit is Nona- Trannsffefira'
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
a_ Q
RONIN ENGINEERING P.E. P.C.
The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566
"( 914)- 736- X664a.Faac::(91.-4)736- 36 -33.. -.
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
�D
Re: SSTS Construction Permit
Strawberry Knoll Subdivision – Lot 7, 8, 9, 10, 12
Pheasant Run Road, Town of Putnam Valley
Dear Mr. Paravati:
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.convetsation and the.letters received from.your office dated Feb_tllary.27,
Ma" 6-7 anTMaYch T7, -2003: 'The - SSTS" plan and pfofi1� fof lot #'12 °has
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 platter, please contact me at the above phone
number. Thank you for your time and assistance in this matter.
Respectfully submitted, `--�
it
Luis Hernandez
Project Engineer
Strawberry Knoll - lot 7,8,9,10,12R1,PCDK03- 31- 03.doc
N ;; LORETTA'MMINARIR.N. ','M:S.N.
Acting Public Health Director
Director of Patient Services
February 27, 2003
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509.
ROBERT J. 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 -65
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.
r "Existing coniours are hard to see. Please clarify.
2. The proposed fill appears more than 3 feet in some areas of the proposed SSTS. This will
require a two sheet submission (fill and trench plan).
3. If possible, please provide existing spot grades inthe proposed SSTS area. Spot grades would
help in better determining how much fill is actually being proposed.
This office will continue its review upon consideration ofthe above mentioned comments. Please feel
free to contact me at ext. 2157 if any questions arise.
JSP: cj
3
Ire-
Very truly yours,
Joseph S. Paravati, Jr.
Assistant Public Health Engineer
PUTNAM COUNTY DEPARTMENT OF HEALTH
D"ION OF ENVIRONMENTAL HEALTH
INDIVIDUAL WATER SUPPLY & SUBSURFACE, SEWAGE TREATMENT SYSTEMS'
REVS SHEET FOR CONSTRUCTION PERMIT
NAME OF OWNER: 3 7 644 D( �'I i( �l STREET LOCATION: 'I eiS61+7 e d
REVIEWED BY: RM, GR, A0,PSRDATE: 02 3 TAX MAP#: (CONFIRIIIBD)
Y f N DOCUMENTS
t PERMIT APPLICATION
L,ZJL-)WELL PERMIT OR PWS LETTER
(.LETTER OF AUTHORIZATION
DESIGN DATA SHEET (DDS)
CORPORATE RESOLUTION
C_ )I )SHORT EAF
,(/'PLANS -THREE SETS
(�(___) USE PLANS - TWO SETS
(__)�ARlAANCE REQUEST
SUBDIVISION
U�LiEGAL SUBDIVISION
�SUBD'IVISION APPROVAL�CEED
���--� PERC RATE
L ( L REQUIRED /. DEPTH
U TAIN DRAIN REQUIRED
GENERAL
UU'� ATED IN NYC WATERSHED
PLANS SUBMITTED TO DEP
(_)(� EGATED TO PCHD
U EP APPROVAL, IF REQ'D
_)DEEP TEST HOLES OBSERVED
C_) RCS TO BE WITNESSED
L j - APPROVAL SSDS ADJ, LOTS
WETLANDS (TOWN/DEC PERMIT REQ'D ?)
CIA ON DDS PLANS & PERMIT SAME
(� ✓ RE 1969 NEIGHBOR NOTIFICATION
UIL
ETTZR sUZ1BA
I0 3fR: FI,�OI�iF;��TION W1I 200'
( SOIL TESTING LOTS>10 YEARS OLD
REQUIRED DETAILS ON PLANS
(�. SEWAGE SYSTEM PLAN-(NORTH ARROW)
SSDS HYDRAULIC PROFILE
(W7)GRAVITYFLOW
)NSTRUCTION NOTES 1 -15
MIGN DATA: PERC & DEEP RESULTS
CONTOURS EXISTING & PROPOSED
UVEWAY & SLOPES, CUT
�(__)FOQTING /GUTTER/CURTAIN DRAINS
;i3SI)A SOIL TYPE BOUNDARIES
TITLE BLOC&- OWNERS NAME ADDRESS
TM#, PEIRA; NAME, ADDRESS, PHONE#
J
��DATE OF DRAWING/REVISION
,/ DATUM REFERENCE .
LOCATION OF WATERCOURSES, PONDS
LAKES,WETLANDS WITHIN 200' OF P.L.
(_JPROPOSED FINISH FLOOR AND
BASEMENT ELEVATIONS
WELLS & SSDS'S WAN 200' OF SSTS
LJPROPERTY METES & DOUNDS
JC_JEROSION CONTROL FOR,HOUSE, WELL &
SSTS, EROSION CONTROL NOTE
)li b ENTS: 6X (S .V�q (nrn _ 0 ✓ r S ntA,r( '�v
VSHEET109161100
Y /IQ (RlE0UII2ED DETAILS ON PLANS COP1T'D�
L�-n HOUSE SEWER - W' FT. 4 "01; TYPE PIPE CAST IRON
(_JNO BENDS; MAX BENDS 45' W /CLEANOUT
TSE �FA�E�NO'CHANGE)
FILL SYSTEMS
(_J10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE
C �(,JFILL SPECS / FILL 140TES 1 -5
)FILL PROFILE & DIMENSIONS
(.(__)FILL IN MANSION AREA
'UL_) CLAY BARRIER
(_J(�FELL CERTEnc �NOTE
UUDEPTH G S
UUVO PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS
EPARATION DISTANCE FROM'TOE OF SLOPE
TRENCH ✓i t.(,' S��
(LF TRENCH PROVIDED :S'jnb 60FT MAX
0PARALLEL TO CONTOURS X04
�100% EXPANSION PROVIDED
DETAIL/DUST FREE CRUSHED'STONE OR WASHED GRAVEL
�)(�GEOTEXTILE COVER
SEPARATION DISTANCES ON PLAN - FROM'SSTS
(::�)(_J10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL
(UU20' TO FOUNDATION WALLS
(!f _�(_)100' TO WELL, 200' IN DLOD,150' TO PITS
100' TO STREAM, WATERCOURSE, LAIKE (iac.
CATCBASIN,35' STOP.IVIDRAIN; PIPET) WATER
o� TO WATER LINE (pits - 20')
(_�J50'- INTERMITTENT DRAINAGE COURSE
`� 200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS
(_J10' MIN TO LEDGE OUTCROP
SEPTIC TANK
(Z(_J10' FROM FOUNDATION; 50' TO WELL
WELL
gC_JDIMXNSIONS TO PROPERTY LINES
��BM OCATION OF SERVICE CONNECTION
15' TO PROPERTY LINE
SLOPE
( %J"C )SLOPE IN SSTS AREA
C_)( %-IREGRADED TO 15 %, IF REQUIRED
DOSE/PUMP SYSTEMS���
UUPUMP NOTES
UUDOSE 75% OF PIPE V OSE VOLUME NOT
..DETAIL FOI,FOR MAIN, (PIPE TYPE, ETC.)
UC_)P ..AND "D -BOX SHOWN & DETAILED
1 DAY STORAGE ABOVE ALARM
CURTAIN D f
L_J __JSTANDPIPES, 5' BOTH S TAIL
(r,J(_)15' M-I to CDS, 5>>S- ., 20'-4%, 15' -3 %, 35'- 1%,100 % - <1%
(�(�20' 'C] DISCHARGE/100' with 152 cons day discharge
C_X__—Jt0"MlN to NON- PERFORATED PIPE
-q 3,mThe Lindy "-Biiil4iiig,,'Siiii-i 200,:2- 6hn'Walsh Blvd., PeekAill, New York 10566
Tel. (914)736-3664 • .Fak (914
)796-3693
C.— knuary 22, 2003
TosenhvaravAfl.ji.-..".
Aiksb''hi"Publie Health "E, 'er
:;
P.,
uthkm County Department of Hea1th
Services DArikoh of Efi bhffidfitAl s6
Re: SSTS Coiisifu'edoh--Pormit
Strdwberr y 11
-Kno Subdivision —Lots 8, 9, 10
�7d
ea'san R R To
..Th* t, zih.� o wn of Putnam Pralley
11W ;....
D&arAft.* Panay va ti
The following : information* has been enclosed for your review, for each of thp. above,
P.;
1. Three copies of the SSTS Plan prepared by this office and date:dJanuar
12'002.:
... . ......
yy
.h I 5,�
2
3.,. . _Affidavit Cotnordte 0 wner:application—_..
4 Applitafioihr Approval -ofPlans for Wastewater Ty"
eatme
5. Design Data Sheet—Submifidd Sewage' Treatment
,
..-:,.6.. Construction Nunit.. for Sewage
Completion Report for lot
letiQA gep o
8. Apphcdtion to C onstritcta Water.Welt Jfor 6
9> Short ,,Environmental -Assessment -Form .11
10. Application . fee of $600.00.
W
1. -pump: p f of6'.4f
,house 12, Two 6
."T 1k'
d 6&"1jLU W$ h-s""'qu.1
g
Sh
y be4sent under)
receipt from the. owner ,:lkl� questions
an
r .this ttter,,piease.coniacr,me aEiTne aDOVe;pno. F.
0
M
4 Ron
;03, d
0
PUT NAM COUNTY DEPARTMENT OF HEALTH
DMSHO N OF ENVIRONMENTAL HEALTH SERVICES
• ..r.. ...« r , ..""�.: t' . ;ssi ten- • ,i ^. ':�� •m` .. - .. _ T�n .wi� ... � � w�:;'r'� .... � n .. °i, «l .C�f: i. �.:,.
LETTER OF AUTHORIZATION
RE: Property of 37 Croton Dam Road Corporation
Located at Mill Street (CRf23) / Lover's Lane, — /�HE:�s,9.v� ,�u� 2_014r.3
T/ Putnam Valley Tax Map # 49,5�4 Block Lot E*:67
Subdivision of Strawberry Knoll
Subdivision Lot # �
Gentlemen:
Filed Map # 2900A -h Date Filed 144 Y 15, .
This letter is to authorize Timothy L. Cronin III
a duly licensed Professional Engineer X or Registered Ar-cNte-ct 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 b alf i connection with this
matter and to superv' �BFiyp ction of said wastewater ea n d/o ter supply systems
R
m conformity wi raz� l VNA 6f.' . icle 145 and/or 147. the du tion the.,Ppblic Health >::. aw, and, the P ;ount�y_S . __... _. --
E
w Very o rs VV1
W
Countersigned:`,'�.sao - -- �� Signed:
P.E. R.A �`' v
., m _ ^Kp ( ner of P P , )
Mailing Address 2 John Walsh Blvd. , #200 Mailing Address: 37 Croton Dam Road
Peekskill Ossining
State N.Y. 10566
Zip State NY Zip 10562
Telephone: (914) 736 -3664 Telephone: (914) 739 -7362
Form LA -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION -Q-IF ENVIRONMENTAL a. HEALTH
�
AFFIDAVIT - CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PUTNAIM COUNTY HEALTH DEPARTMENT
To: Public Health Director
In the matter of application for: Construction of SSTS and Water Supply
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: Val Santucci
Address: (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 relatil
Sw rn to efore me this /off- day of
(month) (year)
Notary Publi
KELLY M. LENT
Notary Public, State of New York
No. 01 LE6026834
Qualified in Westchester Count-Y—,,
Commission Expires June 21, 2_--_
Form CA -97
Co
SiQne
Title:
alj cts ff the corporation with respect
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
TM #
1. Sewage System Area
a. STS area located as per approved plans ...........
Fill section - date of placement
3:1 barrier Lgth. 'Width . Avg.Dpt
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. ' S eptic 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 & tr
e. Junction Box - 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.....
- ..10. Pipe.endscapped,........ ............
g. - -puiRp ose d Systems
:.
1. Size of pump chamb .....................A .. 2. Overflow to ........................ ....,
3. Alarm, audio ....
4. Pu easily accessible, manhole to grade......
first box baffled .............................................
6. Cycle witnessed bar H.D.estimated flow /cycle
III. House/Buildiri?-
a. house located er 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 tb
f. Curtain drain outfall protected & dinto exist wa
g. Footing drains discharge away from STS area...
h. Surface water protection adequate ........:............
i. Erosion control provided .... ............. ...................
Rev. 12/02
Date: _
Inspected by:
Permit # eV 6 —43
Subdivision Lot # Sa � A''T
ITE 1NSP Ct1O* F ®R l Fit FAD
Fill pad located per the approved plan
Date:
Inspected by:
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)
_- _._A,dditional. Comments: .
Reserved for Field Sketch if Applicable
Required Depth
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner 37 Croton Dam Road .Corp .
Address 37 Croton Dam Road, Ossining, NY 10562
Located at (Street) .4 ri4y 90//P.'-Tax Map R� Block 2 Lot ee, - .
(indicate nearest cross street)
Municipality (T) Putnam Vall X Drainage Basin Peekskill Hollow Creek
SOIL PERCOLATION TEST DATA
Date of Pre - soaking 05-11-00 Date of Percolation Test 6. --l7-- d U
Hole No.
Run No.
Time
Start - Stop
'Ela se Time
Iin.)
De th to Water
Iprom Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
2
Zit -
3
c X /,,D
24- 2 E . J
2 , 3-
�.
4
5
:30
2
91( -9
13
2y_27
3,
4
5
1
2
3
4
ri V 1 r.J: i .. i ests 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, < 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
DEPTH
G.L. .
0.5'
1.0'
1.5'
2.0'
2.5'
3.0"
3.5'
4.0' .
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8:5'..
9.0'
9.5'
10.0'
2
TEST PIT DATA
: -LS, TEST HOLES
DESCRIPTION ®1SOI L� _
HOLE NO. 1914 HOLE NO. ARO HOLE NO.
fog L
yz 3Y�,
Y' � ��v! // - 1�' {rLJG %4 � Cl � � '7 lu"eu' {�l ✓ C� %/.�..Gl?,� ..
Indicate level at which groundwater is encountered //%
Indicate level at which mottling is observed V /,A
Indicate level to which water level rises after being encountered -A11A
Deep hole observations made by: -Adam Stiebeling/ Keith Staudohaur Date' 0' 27 4/)
PCDH Cronin Engineer erfQ-�77
Design Professional Name: Timothy L. Cronin III
Address: 2 John Walsh Blvd. #200 j � 0tip �.
Peekski 1OS66,
'
Signature: �\`�
1� 62980
v
Design Professional's Seal
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH 'SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
p, WASTEWATER TREATMENT- SYS.T-EM:'..
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 T Putnam .Val ley
SU15 Lot,
4. Design Professional: Timothy L. Cronin III 5. 'Address: 2 John Walsh Blvd; 200 Lindy Bldg
6.
Drainage Basin: Peekskill Hollow Creek Peekskill, New York- 10566
7.
Type of Project:
X 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? ..
No
10.
Has DEIS been completed and found acceptable by Lead Agency?
N/A
11.
Name of Lead Agency Town of Putnam Valley Planning Board
12.
Is this project in an area under the control of local planning, zoning, or other
officials,.ordinances?:`- —_T •• ....... _ ..: _
. Yes.
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 Aprilvay 2000 23. Name of Health InspectorAdam
Stiebeling
24.
Project design flow (gallons per day)
soo Gal /Day
25.
Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?...
NO
26.
Has SPDES Application been submitted to local DEC office? .........................
NO
Form PC -97
2
27. Is any portion of this project located within a designated Town or State wetland? NO.
28. Wetlands ID Number ...................... .... N /A.
Wetlands Permit required ?�.�....... y...:...................:.. ... ............................... No
Has application been made to Town or Local DEC office? ...............................
30. Does project require a DEC Stream Disturbance Permit? .. ....................:..........
NO
NO
31. Is or was project site used for agricultural activity involving application of
pesticides to orchards or other crops, solid or hazardous,waste disposal,
landfilling, sludge application or industrial activity? ...:..................::.... Yes/No No
32. Is project located within 1,000 feet of existing or abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or any
NO
other potentially known source of contamination? ............................... Yes/No
DESCRIBE:
YES
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? . ...............................
35. Are any sewage treatment areas in excess of 15% slope? . ............................... No
36. Tax Map ID Number .......................... ............................... Map 8 4 Block Z Lot er'5.
37. Approved plans are to be returned to ..... Applicant x Design Professional
All applications _fonreview_ and approvals of a new S�-TS-to belotated .within. the NWC W4t�hed 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 appliytiorimust
be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with t]9f prov s on
may grounds for the rejection of any submission.
I hereby affirm, under penalty of perjury, that in orm ation'p pav8dO4'-an khis ova is_tr re :
.f ; per. .. ,. .�,
to the best of my knowledge and belief. False atemenls -de hereinvare` u liable. rs'
a Class A arrisdeaneanor pursuant to Sect' n 210.4 �8ja�eal as
SIGNATURES & OFFICIAL TITLES:
Timothy L. Cro ' 11 S 629i30
Mailing Address: Cronin Engineerin ,soN�
Ff
. '' ^.
f.�
LU``.
2 John Walsh Blvd; 200 Lindy Bldg; Peekskill,NY 10566
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES .
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner 37 G[LoTD.0 a+-m llG�tu 401ZP Address 37 GRorr 1)4M '� ossj_-T; e ,vy
Located at (Street) I LoyazY Nc Tax iV1ap ,*. 4 Block t Lot 2-3
(indicate nearest cross street) 14
8•¢.t 9 1 t
Municipality (T) Pa w4M t/� Lt!EtiI Drainage Basin
o
SOIL PERCOLATION TEST DATADSO�'
/VAaDateof Pre - soaking Date of Percolation Test oS -t 7-zpo
Hole No.
Run No.
Time
Start - Stop
Elapse Time
i Iin.)
De th to Water
from Ground
Surface (Inches)
Start Stop
Water
Level
Dro In
Inches
Percolation
Rate
11in/Inch
9#00-1141,
v`
I -
3
!o
"
2
X43
3o
12- S
Z•�
I 1Z
.�
if? -lo13
30
I '26.5
2
I l V
4
5
30
2
'7 g dt-4
3
C3 #A_ 101-7
13
2 -27
3
�/
4
5
2
3
4
5
INOTE5: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at eacn
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
DEPTH
G.L.
0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
TEST PIS' DATA
DESCRIPTION OF SOILS ENCOUNTERED gT'EST- -H0LES .
HOLE NO.
7VP [ L
13RCWa 4 LOAM
HOLE NO. 1913 HOLE NO.
sot
20C14
2
Indicate level at which groundwater is encountered 4A
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered
Deep hole observations made by:
Design Professional Name: -rr/ro-7&v L. cgoiv,w
Address:
Signature
Design Prof'essional's Seal
Date L54-z7 -moo
.
i, .',•, it
INTO E RIM] MTJ VA 0 1 M, I I
TTAL
':k' - - ra. .w 1f> .F .r .ti. `A v. . • r¢.{G:. n .�. . ._ �.r �. a.. ..• •' . - fy •J -:.� \ :..i • .
CRONIN ENGINEERING P.E., P.C. 'July 8, 2003
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: 37 CROTON DAM ROAD CORP.
PCDH PERM #PV 6 -03
30 PHEASANT RUN ROAD
TOWN OF PUTNAM VALLEY
THESE ARE TRANSMITTED as checked below:
❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED ❑ FOR REVIEW AND COMMENT X PLEASE REPLY
I „ WE ARE SENDING YOU a ttae e -h
d
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
5.) 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 sub fitted,
Kenneth M. Murphy
Design Engineer