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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84. -2 -66 BOX 33 .. , 1 0 r 1! y su. Ir rZ' �� ( % E, ,. 0 I ' I L V cis L I `. T •� I, .. '.. la I __J PUTNAM COUNTY DEPARTMENT OF HEALTH -H CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SE ENT SYSTEM PCHD CONSTRUCTION PERMIT # PV- 3 3 Locatedat 28 PHQ96610- RuN Rot9D Town'or Village., u 7- W tiq Vf) L-L C Owner/Applicant Name:31) CRo-rd W pnr'4 go,9z) ;zpTax Map S+ Block 2,—Lot G6 Formerly SubdivisionName 9TRiqWgERRV 1GAoLL f Subd. Lot# 10 MailingAddress S9 CRO*T'ON D0901 'RoAf) OSSIWIF46, N,Y Zip 10,S-62- Date Construction Permit Issued by PCHD. 4 0 CI?07-o t.J 0#90-7 201qO Separate Sewerage System built by 29 cj2a-r6rq DAr*,? *RmD coRP Address -o Gr, i Ig I tq 6 �J /0 -76 2 Consisting of Gallon Septic Tank and 146' ter f2ig FV C- . 6 ?I PC 11,4 Other Requirements: Water Supply: Public Supply From, Address 4 Pup-JAM t4vcwc or: Private Supply Drilled by &-M 4 '�otq X 9 /IQ IC . Address ;FRcWS7-C)2, N Number of Bedrooms Fa o (?, Has I certify that the system(s), as listed, serving the bi4lt plans (copies of which are attached), in acc plans and the standards, rules and regulatiops.4 Date: 4--Z61--63 Certifiedby 45;" (DesigNn. Address EZV-D P!��A, installed? )age NEtNV rtnio cl isp Y,,,re C cted essentially as shown on the as- �_p With Aped Construction Permit and approved '.w. Ant of Health. a mm eD P.E. K R.A. License # 41 6'Z�6),C-0 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are sub ect to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. By: ( 4'd 4, L4_144_V71_b d . _..' ... Title: AsiJ--0,bkA14 Date: '7/i(/o3 copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC-97 PUTNAIMl COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Lbc tiii S eet ddres5: 018' �NEASi'� 2 ✓l� iLi7R'D Towii/Village: PutnamVallev Tax Gn # Map 84 Block 2 Lot(s) 66 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 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 Depth Data Measure from land surface - static (specify ft) 30' During yield test(ft) Depth of completed well in feet 5401 605' Well Log If more detailed information descriptions or sieve analyses:: - • -; ._..__..- _ are available, please attach. Depth From Surface Water Bearing Well Diameter(in) ]Formation Description ft. ft. Land Surface 8 Drillin in over den clay and boulders Hit rock at 8' .,,; :_ > -8..d 32 Drillin in- rock set -casi .°_ routed :_-, 32 605 Drillin 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 5gpm Depth 560' Model 5GS15412 Voltage 230 HP 1'k Tank Type KgO2 1 10 Date Well Completed 5/9/03 Putnam County Certification No. 001 Date of Report 7/1/03 W ell Dr" (Sig p Beal NOTE: Exact location of well with d ces le o permanent lanamarxs to De provtuc n a separate sneeupiau. Well Driller's Name P. F Address: 4/Pu /lit Axe., Bt3ster, NY 1 Signature: Date: 7/1/03 Ferry La White copy: HD File; Yel ow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 ,BRUCE•° -`R •- FOLE%`"., .« , 7 Public Health Director DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 LO.RETL& ,MQL• 1NARI R N.,� M.S.N.. - Associate Publiic Heolth Diieclor` "" " °° `�' "' Director of Patient Services Environmental Health (914)278-6130 Fax (914) 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: 39 CRo 10N DA(--\ fZo A n c e 2'j? TAX NIAP NUMBER: S6 G - `OAK '. 2 L a T . 66 SVI?LOT 1 C1 E911 ADDRESS: AT FNG1 /O SANT Ry'J ROAD TOWN: �'� i (� �`' `�V l� LL6 AUTHORIZED TOWN OY (Signature) DATE: 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) IPUTNAM COUNTY DEPARTMENT OF HEALTH GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 3 1 CRa?o 0J Qd M -90 AD CO R R 8 � 01, (0(0 Owner or Purchaser of Building Tax Map Block Lot 37 CRoTvA1 DAM %O 9D C. 121, Pu-r,,JAl rh (% ccC Buildina Constructed by TownNillage ,�23 ,PHCA sRij'-r 11u,�j Vo riD S KNOLL Location - Street Subdivision Name SI/JCLC Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above- described propem,, 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 _loQerate:: o rly is:_cau zd-byxhe �i lful:�ii negltgent a;�_afxlte occupant cf -:the- IIildi�i� system. The undersigned further agrees to accept as conclusive the determinati the f lic Health Director of the utna County Department of Health as to whether o t_oftt e ailur he system to op ate a ` aus b the willful or negligent act of the occupan e ildiilizing the syste t 1 11 Z6 Year ZOOS Da Mo th � Day Signature: 0 Title: 'PROS I o = T- Genera ntr r (0� er) - Signature 37 C'170-r-o j opt-I iZoH_0 coVP Corporation Name (if corporation) Address: 39 e/2yTotJ OAM 120A_Q State 0 SS 1r1 //,3 6- iJ Zip 10 S6 'Z F 3P CfZo i o,0 DAB 2aiq o Cof2i'. Corporation Name (if corporation) Address: _S2 0267 -,a1J DA"17 VD- State 0 SSIN //J 6, NN/ Zip 10 56 Z Form GS -97 F7JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET i m s STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory Mailing Information: Collector's Information: Name: PF Beal & Sons Client: VS Construction Name: Kevin Address: 4 Putnam Ave Address of site: Strawberry Knolls City: Brewster City: State: NY Zip: 10509 State: Zip: Telephone: 845-279-2460 Fax: 845-279-6613 Telephone: Sample's Information: 66:- 1ot'.10 Preservative: HNO3 Temperature: <4C Date Collected: 6/26/03 Date Received: 6/27/03 Time Collected: 13:45 Time Received: 15:00 Lab No.: J034486 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 29 mg /L 250 mg /L SMWW 4500 Cl C 6/30/03 Hardness 88 mg /L N/A SMWW 2340 C = ._..6/; /03 . -_.. _.._ . ,: mitrate..:__�.. __ _ :.._ _.: _ .. ". � .:.:._.1..63. me /L . 10 mg /.1.._. SG�1�Q- 450 N0.3E 6/30/03 10:00 Nitrite <0.1 mg /L 1.0 mg /L SMWW 4500 NO3E 6/27/03 pH " 5.94 S.U. 6.5 -8.5 S.U. SMWW 4500 H B 6/30/03 Sulfate 23.1 mg /L 250 mg /L SMWW 4500 SO4F 6/30/03 Turbidity 0.08 NTU 5 NTUs SMWW 2130 B 6/30/03 Alkalinity 62 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 imsenvironmental.com RONIN ENGINEERING, P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 T Joseph S. Paravati, Jr. Assistant Public Health Engineer Putnam County Department of Health Division of Environmental Services I Geneva Road. Brewster, N.Y. 10509 Re: SSTS Construction Compliance 37 Croton Dam Road Corp. P.C.D.HPermit #PV-3-03 28 Pheasant Run Road Town of Putnam Valley Dear Mr. Paravati July 7, 2003 - Please- - &enclasei plan has been revised to show the installed cast iron sewer pipe. Also included is water analysis report and well drillers completion report. Please review at your earliest convenience. If there are any questions or if additional information is required please do not hesitate contacting me at the above number. Thank you for your assistance in this matter. Respectfully submitted, 411 Kenneth M. Murphy/' Design Engineer 07/07/2003 15:58 9147363693 CRONIN ENGINEERING 1 PAGE 04 IMS ENVIRONMENTAL SERVICES, INC. 15oo SUMMER STREET `5TAMHWO CONNECTICUT o6go5. Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: W Telephone: 845- 279 -2460 Site, Lot 10 Preservative: HNO3 Temperature: 0C 6/27/03 15:00 6/27/03 6/30/03 6/30/03 6/30/03 6/30/03 6/30/03 6130/03 6!30403 . 6130103 6/30103 10:00 6127/03 6/30/03 6/30103 6/30/03 5/30/03 NELAC,'CT ar7d' State Certified tnvironmentol Loboratory �a fir• Calleaft Is Information: Client: VS Construction Name: K vine Address of site: Strawberry Knolls City: Zip: 10509 State :. Zip: Fax: 845-279-6613 Telepho e: Date Collected: 6126/03 Time Collected: 13:45 Test Name Date Re ived: 6/27/03 Time Re elved: 15:00 Lab No.: J034486 Total Coliform Absent Ab Chlorine Free Residual <0.1 mg/L SMWW 2120 8 Color ND 15 Odor ND 31 Iron <0.03 mg/L 0.3 Manganese <0.01 mg/L 0.3 Sodium 7.89 mg/L. t Chloride 29 mg/L 250 .:Hardn®ss: _ .: -<. , 88 mg/L.:.:. .... : 0 ._...•...- Nitrate ...�.. _..,___..._ •_. _- -•1.63 mg%�- "`�'� 1� Nitrite <0.1 mg/L 1.0 pH f 5.94 S.U. 6.5.8 Sulfate 23.1 mg/L 250 Turbidity 0.08 NTU 5 P Alkalinity 62 mg/L 1' Lead X1.0 ug/L 15 Comments: ' Below MCL At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg/L. milligrams per Li S.U.= Standard Unit NTU• Nephelometric Tu MCL- Max. Contaminant Level TON- Threshold Odor N ug/L- micrograms per Liter Signature: Michael Lap-man President L ant SMWW 9222B A SMWW 4500CIG nits SMWW 2120 8 INs SMWW 2150 S Ig /L SMWW 31118 Ig/L SMWW 3111 B A SMWW 3111 B SMWW 4500 CI C ig/L SMWW 4500 NO3E S.U. SMWW 4500 H B ng/L SMWW 4500 $04F Us SMWW 2130 B A SMWW 2320 B q/L SMWW 3113 B ND- None Detected Unit State #: PH-0218 ELAP #: 11718 'rel 20", 90 9(HI Il Frey? : tihn 5n% 5i)1;; Fax 2-)., o,>l Uyty imsenvironmentQl,roni SUNNI;;; OR ANSMITTAL ` .q .:�. a �t t�r0•''M1 -`-.• .<� `I'�.. rr �.� i P �.r tom. 1°', _. _ <._ v.r �A �. � '�+4j'�; �.�i•irG�L.i�'tu' .�- �+�i�n °r.• ,'^fr:.•. r f`�'. �.' � t .c.•. �r«��. r .;� 4. ., o. ."i a.�.q♦ �I CRO Hl\ ENGINEERING d.LIliING S.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 RE: 37 CROTON DAM ROAD CORP. PCIDH PERMI #PV -3-03 28 PHEASANT RUN ROAD TOWN OF PITNAM VALLEY THESE ARE TRANSMITTED as checked below: June 309 2003 ❑ FOR APPROVAL ❑ FOR YOUR USE ❑ AS REQUESTED OR _W AND COMMFNT� X PLEASE REPLY w.. -.WE. E.SFNDING Y.0,U.attached:. 1.) Three copies of as -built subsurface sewage treatment system plan 2.) Three certificate of the construction compliance. 3.) Three guaranties of SSTS 4.) Copy of survey showing foundation location 5.) E911 address verification form 6.) $200 certified check for application fee. The information enclosed is for your review only. The well completion report and water analysis will be submitted when it is obtained from the well driller (P.P. Beal & Sons). Thank you for your time and assistance in this matte. Respectfully submitted, Kenneth M. Murphy Design Engineer 9E5/25/2003 15:31 9147363693 CRONIN ENGINEERING 1 PAGE 01 PUTNAM COUNTY DEPARTMENT OF PMALTH DIVISION OF ENVIRONMENTAL HEAL T* SERVICES -T&7 ATTENTION 13 Aamwm 13 GENE REQUEST FOR FINAL INSPEMON For: All information must be fully completed prior to any inspections being made. PCHD Construction Permit# PV—:3 — 03 Located; 2 nC,4119-*Jr RUN R019P (T: Owner/Applicant Name: 39 CROT60 OP1111 1ZO AD TM Formerly: - Subdivision Name: Subdivision Lot # — Is system fill completed? 141 IS Dat6, Is system complete? )LL–r Date, Is system constructed as per plans? Is well drilled? )(&–r Date: Is well located as per plans! ) Lie -S Are erosion control measures in place? Fin Trenches M VALLE 64 Block Z Lot CC KNOLL At Id -,jpe sc 2 =4 that the system(s), as listed, at the above premises has been tonstru-cted and I have inspected and verified their completion in accordance with the issued I CHD Construction Permit and approved plaw.and-,the.-Stszdards, Rules and Regulations of tht Putnam County Department of Kr';--,j M0, Date: 'sulo,jer 2Co 21016 2 Certified by- CfttkK 6- r4 EC IX PE &A. Design gen Pro sional Address: ?-- Comments- %j1b 4SA-1 A rl W, Lic. 9 A��Ok Z> C Z,, ",/ 1�. IFIL TNAM COUNTY DEPARTMENT OIF HEALTH DIVISION OIF ENVIRONMENTAL H]EAIL'II'1HI SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM .. PERMIT # 6 V - 3 - o3 Located at Pheasant Run Road Subdivision name Strawberry Knoll Town Putnam Valley Subd. Lot # —0 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 10-; 9 Amount of Fee Enclosed _,$ jnn - nn Building Type Residential Lot Area --s No. of Bedrooms 4 Design Flow GPD 800 Fill Section OaRy Depth de� "Me. VoRume 8tt /9, 0: Y SejQzrate Sewerage System to consist of 1250 gallon septic tank and # /f -�Z L.F. of 4" PVC Perf. . Pipe in 24" Gravel Trench Other Requirements: To be constructed by 37 Croton Dam Road Corp, Address 37 Croton Dam Road, Ossining, NY 10562 Water Sunnly: Public Supply From Address - - .... • ®u�: "' _ Jr', •�, - Private- `Siipp�Iy Drilled �y ' '""� �"`.13'ea /__�'. ��;� S- -- -.1 nom.- '�- 1di�reRS - E} l��r�oh�' ��...._ _ _ t� 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 thereof a "Certificate of Construction, Go lime" satisfactory to the Public Health Director will be submitted to the Department, and a written guarante'w�ll be rnlie owner, his successors, heirs or assigns by the builder, that said builder will place in good operatin4`cgc('�iit art o aid sewage treatment system during the period of two (2) years immediately follo a date f he, suan e o the' ' 0 1 of the Certificate of Construction Compliance of the original system or an epairs ereto. , Signed: r �; P.E.' . Date Z 2 Address John Walsh Blv0 Bdg` eeks1ri11,NY 10566 License # 062980 APPROVED FOR CONSTRUCTION: �iiis 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 rmit. Approved for discharge of domestic sanitary sewage only �s� s-�i' Public By: Title: 14eA1.1� Eta i Date: 7 3 to copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ APPLICATION TO CONSTRUCT A WATER WELL please print or type Well Location: Street Address: Town/ Putnam Tax Grid # Pheasant Run Road, Sublot # /Q valley Map 8 Block ,2 Lot(s) eK Well Owner: Name: 37 Croton Dam Address: Road Corp* 37 Croton Dam Road, Ossining, NY 10562 Use of Well: X Residential Public Supply Air /Cond/Heat Pump Irrigation 1- 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 Uf gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling X New Supply (new dwelling) Deepen Existing Well Detailed Reason Water supply for new residence for Drilling 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. /D Water Well Contractor: P. F. Beal $ Sons, Inc. Address: 4 Putnam Ave . , Brews ter, NY 10509 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: * 6001 (out of town & county) Proposed well location & sources of contamination e rovided on separate sheet/plan. -!>.-- Applicant: Sinattire: 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. /1 Date of Issue - a Permit Iss ing Official: Date of Expiration o Title: r Permit is Non White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 A RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 Tel.'( 914)736 -36640 F.az,.•(914)736 -3693. 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: 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.pbgne conversation and, the letters received from yqur,p ice dated Y ruary 27, t `Maren 7� andMaich' 17, 2003.7 T1 e-S�STS pl"ari arid- profile for ro-t #IZ'has been'mddified 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. __ , b. 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, ,-1 .Luis Hernandez Project Engineer strawberry Knoll - lot 7,8,9,10,12R1,PCDH,03- 31- 03.doc �� °O _Z4 � �PERC RATE ' L-_-) . ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (U( >FILL REQUIItEI? `-/ it DEPTH EPARATION DISTANCE FROMTOE OF SLOPE UU7CURTAIN DRAIN REQUIRED TRENCH' GENERAL ( LF TRENCH PROVIDED 60FT MAYL OCATED IN NYC WATERSHED fi PARALLEL 'TO CONTOURS C_)L—?PLANS SUBMITTED TO DEP 100% EXPANSION PROVIDED t y 6U ELEGATED TO PCHD DETALL/DUST FREE CRUSHED'STONE OR WASHED GRAVEL C_Jjj,tjDEP APPROVAL, IF REQ'D (�(__)GEOTEX'TILE COVER UD EP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN - FROM'SSTS C__)Ci6PERCS TO BE WITNESSED J LOTS CL 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL (_)(� APPROVAL SSDS AD J, O (,/ 20 TO FOUNDATION WALLS C_U✓ WETLANDS (TOWNIDEC PERMIT REQ'D ?) 100' TO WELL, 200' IN DLOD,1501 TO PITS (� ATA ON DDS PLANS & PERMIT SAME (__ )100 TO STREAM, WATERCOURSE LAKE (inc, egp�a) (___)(U 1969 NEIGHBOR NOTIFICATIUI�1., .. , ...... . - (- - 0' TO CATCH BAaLN; 35'. STORM(DEA�i,PIPED WATER - C. x-C, . _�... k 10' TO WATER TINE (pits - ao') 0 YR. FLOOD ELEVATION W1I 200' �50'. INTERMITTENT DRAINAGE COURSE UUSOM TESTING LOTS>10 YEARS OLD r ,,0200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS `�' (W�SWAGE SYSTEM PLAN- (NORTH ARROW) U �C-)10" 10' MIN TO LEDGE SEPTIC TANIC SDS HYDRAULIC PROFILE FROM FOUNDATION; 50' TO WELL (GRAVITY FLOW WELL CZ-X--)CONSTRUCTION NOTES fl -fly (/ )DIMENSIONS TO PROPERTY LINES J DESIGN DATA: PERC & DEEP RESULTS 7( )( )— LOCAT %ON OF SERVICE CONNECTION a' CONTOURS EXISTING &PROPOSED (6(�)MIN 15' TO PROPERTY LP ( u }DRIVEWAY & SLOPES, CUT SLOPE C!nC_ )FOOTING /GUTTER/CURTAlN DRAINS U�( JSLOPE IN SS'TS AREA (� JUS3DA SOIL TYPE BOUNDARIES c/ �) TILE BLOCI{; OWNERS NAME ADDRESS �— (:I. REGRADED TO 15 %, Ili' REQUIRED TM#, PE/RA; NAME, ADDRESS, PHONE# DOSE/PUMP SYSTEMS IJIA-, DATE OF DRAWING/REVISIOPI UUPUMP NOTES . YUDATUM REFERENCE (•_)UDOSE 75% OF PIPE�01;v DOSE VOLUME NOTED (�ULOCATION OF WATERCOURSES, PONDS U )DETAIL FORF ®RCE.MAIN, (PIPE TYPE, ETC.) LAICES,WETLANDS WITHIN 200' OF P.L. L—)(—)P D -BOX SHOWN & DETAILED (,U( _)PROPOSED FINISSH FLOOR AND DAY STORAGE ABOVE �j BASEI�NT ELEVATIONS - CURT �1 (�USTANDPIPES 5' B IDES DETAIL U WELLS 4% SSDS'S WAN. 200' OF SETS ' Lcj- PROPERTY METES & BOUNDS (_,,(�15' MAN to %, 20'-4 %, 25' -3 %, 35' -lb /o, 100 % -<1% (EROS %ON CONTROL FOR.HOUSE, WELL & (-- )( --)20' to CD DISCHARGE/100' with 102 cons day discharge SETS, EROSION O� OL NOTE U(2 0' MIDI to NON PERFORATED PIPE r% 5 r PUTNAM COUNTY DEPARTMENT OF HEALTH b DIVISION OF ENVIRONMENTAL HEALTH INDIMUAL WATER•SU7P Y & SUBSITR. A E:SEWA.GE =TREATM[ENT SYSTEMS 'REVIEW SHEET FOR CONSTRUCTION PERMIT n J -7 CEo fy; t I n NAME OF OWNER: J STREET LOCATION: _ 1. 1 Ts REVIEWED BY: RM, GR, AS; SRDATE: TAX MAP #: (COD) Y N DOCUMENTS Y Y�N awOUIRED DETAILS ON PLANS CONT'Dl C ()PERMIT APPLICATION r rr(�(' MOUSE SEWER - %" FT. 4 "0'; TYPE PIPE CAST IRON L,- . WELL PERMIT OR PWS LETTER (�UNO BENDS; MAX BENDS 45' W ANOUT PC =97 o N NEWALS C=--) ETTER OF AUTHORIZATION.TFE'NOTE ( (NO CHANGE) � CORPORATE RESOLUTION ( (�(�10' HORIZONTAL; PAST TREN PES 3:1 TO 1 (CL/ C : UUFILL SPECS /FILL 1 -5 (�( JPLANS -THREE SETTS ( (�UFILL PR & DEMENSIONS ( ( OITSE PLANS -TWO SETS ( (J� EXPANSION AREA UU` VAR.ACE REQUEST F FILL GRF,ATE THAN � SUBDIVISION ( �y / LEGAL SUBDIVISION C C—)L LI, CERTIFIC NOTE jSUBDiVISION APPROVAL CHECKED (DUDE ES �PERC RATE ' L-_-) . ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (U( >FILL REQUIItEI? `-/ it DEPTH EPARATION DISTANCE FROMTOE OF SLOPE UU7CURTAIN DRAIN REQUIRED TRENCH' GENERAL ( LF TRENCH PROVIDED 60FT MAYL OCATED IN NYC WATERSHED fi PARALLEL 'TO CONTOURS C_)L—?PLANS SUBMITTED TO DEP 100% EXPANSION PROVIDED t y 6U ELEGATED TO PCHD DETALL/DUST FREE CRUSHED'STONE OR WASHED GRAVEL C_Jjj,tjDEP APPROVAL, IF REQ'D (�(__)GEOTEX'TILE COVER UD EP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN - FROM'SSTS C__)Ci6PERCS TO BE WITNESSED J LOTS CL 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL (_)(� APPROVAL SSDS AD J, O (,/ 20 TO FOUNDATION WALLS C_U✓ WETLANDS (TOWNIDEC PERMIT REQ'D ?) 100' TO WELL, 200' IN DLOD,1501 TO PITS (� ATA ON DDS PLANS & PERMIT SAME (__ )100 TO STREAM, WATERCOURSE LAKE (inc, egp�a) (___)(U 1969 NEIGHBOR NOTIFICATIUI�1., .. , ...... . - (- - 0' TO CATCH BAaLN; 35'. STORM(DEA�i,PIPED WATER - C. x-C, . _�... k 10' TO WATER TINE (pits - ao') 0 YR. FLOOD ELEVATION W1I 200' �50'. INTERMITTENT DRAINAGE COURSE UUSOM TESTING LOTS>10 YEARS OLD r ,,0200'/500' RESERVOIR, ETC. 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS `�' (W�SWAGE SYSTEM PLAN- (NORTH ARROW) U �C-)10" 10' MIN TO LEDGE SEPTIC TANIC SDS HYDRAULIC PROFILE FROM FOUNDATION; 50' TO WELL (GRAVITY FLOW WELL CZ-X--)CONSTRUCTION NOTES fl -fly (/ )DIMENSIONS TO PROPERTY LINES J DESIGN DATA: PERC & DEEP RESULTS 7( )( )— LOCAT %ON OF SERVICE CONNECTION a' CONTOURS EXISTING &PROPOSED (6(�)MIN 15' TO PROPERTY LP ( u }DRIVEWAY & SLOPES, CUT SLOPE C!nC_ )FOOTING /GUTTER/CURTAlN DRAINS U�( JSLOPE IN SS'TS AREA (� JUS3DA SOIL TYPE BOUNDARIES c/ �) TILE BLOCI{; OWNERS NAME ADDRESS �— (:I. REGRADED TO 15 %, Ili' REQUIRED TM#, PE/RA; NAME, ADDRESS, PHONE# DOSE/PUMP SYSTEMS IJIA-, DATE OF DRAWING/REVISIOPI UUPUMP NOTES . YUDATUM REFERENCE (•_)UDOSE 75% OF PIPE�01;v DOSE VOLUME NOTED (�ULOCATION OF WATERCOURSES, PONDS U )DETAIL FORF ®RCE.MAIN, (PIPE TYPE, ETC.) LAICES,WETLANDS WITHIN 200' OF P.L. L—)(—)P D -BOX SHOWN & DETAILED (,U( _)PROPOSED FINISSH FLOOR AND DAY STORAGE ABOVE �j BASEI�NT ELEVATIONS - CURT �1 (�USTANDPIPES 5' B IDES DETAIL U WELLS 4% SSDS'S WAN. 200' OF SETS ' Lcj- PROPERTY METES & BOUNDS (_,,(�15' MAN to %, 20'-4 %, 25' -3 %, 35' -lb /o, 100 % -<1% (EROS %ON CONTROL FOR.HOUSE, WELL & (-- )( --)20' to CD DISCHARGE/100' with 102 cons day discharge SETS, EROSION O� OL NOTE U(2 0' MIDI to NON PERFORATED PIPE r% 5 r I.- —, - ..c RONIN ENGINEERING P.E. P.C. The Lindy Building, Suite 200, 2 John Walsh Blvd., Peekskill, New York 10566 Tel.' (914) 736. 3664• Fax. (914) 736 -3693• —_ • - - -- •- - January 22, 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 —Lots 8, 9, 10 Pheasant Run Road, Town of Putnam Valley Dear Mr. Paravati: The following information has been enclosed for your review, for each of the above referenced subdivision lots: 1. Three copies of the SSTS Plan prepared by this office and dated January 21, 2003. 2002. 2. Letter of authorization. 3. Affidavit Corporate Owner application. 4. Application for Approval of Plans for a Wastewater Treatment System. 5. Design Data Sheet — Subsurface Sewage Treatment. 6: Construction'erlrtit for sewage Treatment System. - 7. Well Completion Report for lot #8. 8. Application to Construct a Water Well for lots #9 and #10. 9. Short Environmental Assessment Form. 10. Application fee of $600.00 ($300/lot). 11. Pump / System Curve for the proposed pump for lot #8. 12. Two copies of the house plans. The house plans for the proposed 4 bedroom dwellings will be sent under separate cover upon receipt from the owner. 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. cc: Val Santucci StmwbenyKnoll,Lots8,9, l0,PCDH,01- 22- 03.doc Respectfully submitted, Luis Hernandez Project Engineer PUT NAM COUNTY Y DEPARTMENT OF HEALTH DMSIGN OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION , RE: Property of 37 Croton Dam Road Corporation Located at Mill Street (CR #23) / Lover's Lane) — 7,,Ve11_5X,417 iUVIV P01q.0. T/ Putnam Valley Tax Map # Block z Lot 4Q;' Subdivision of Strawberry Knoll Subdivision Lot # /0 Filed Map #,9-900 A -6: Date Filed 0&y )l . zooZ Gentlemen: This letter is to authorize Timothy L. Cronin III a duly licensed Professional Engineer x er- Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health De V,� , ign all necessary papers on m bId/or alf i ection with this matter and to su r i c ct of said wastewater eat ent ate supply systems in conformityw pro ' ' s le 145 and/or 147 o the . duc on L e Public Health ..Law; &d the P' . rift ae . ,\ c Countersigned- P.E., R.A., # f 11 Very tru o s i, 6,2980 NkoFESS�O�i � Signed: 62980 (Ow. ro O e Mailing Address 2 John Walsh Blvd. , #200 .Mailing Address: Peekskill State N Y. Zip Telephone: (914) 736 -3664 10566 State NY 37 Croton Dam Road Ossining Zip 10562 Telephone: (914) 739 -7362 Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH ...: D...IVISIOlV.:O. F E.NYIRONIVIENTAL HEALTH SERVICES,.:. AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBNIITTED TO PUTNAM 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 N 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 Sworn to b fore me this day of month) year Notary Public KELLY M. LENT Notary Public, State of New York No. O1 LE6026834 Qualified in Westchester Couni;� Commission Expires Jun Form CA -97 Sio-ned: Title: Corporate Seal co oration with respect 07/09/2003 10:38 9147363693 CRONIN ENGINEERING 1 PAGE 01 .CC R:O N IN EV. GIN E —, RffN +2 JOHN WALSH B.01U THE E LI D Ii B IL D G; S PEEKSKILL9 MY 110566 TO: PROM: Theresa Ncuaeth Ken Miml . I�eEo9P.C. EeVAR,D E A E 200 iby COMPANY: DAT5: RCRD. .JULY 9, 03 FAR NUMBER; 'TOTAL NO. OF PAGES INCLUDING COVER: PHONE NUdffiER S>rNNDERS RP 28 Ph CE NUMBER; Ruu RE: YOURREF"BAL� 37 Croton Dam road Corp. P.C.DH, NUhW&% cmuit #P1 -3-03 O URGIENT 13 Fox, ikEvxuw ® PLEASE COMMENT Cl PLE kSE RL•:PLY ® PLEASE RECYCLE Tovm of Putnam Vaky SM Construction Compyance Strawberry Knoll, lot 10 ci vdl crso liaance fox a alive referenced a�ofert. infomudon o .-. „ _.. _ _ ._ do not hcd=lo-c0l h - -tom TEL. (914)736 -3664 a PAX (914)736-3693 11.16.4 OA7) —Tart 12 PROJECT I.D. NUMBER 61721 Appendix C SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEAR 1. APPLr_WT JSPONSOR 37 Croton Dam Road Corp. 2. PROJECT NAME Strawberry „Knoll, Sublot # /11, 3. PROJECT LOCATION: m„lwl"h Town of Putnam Valley County Putnam County t. PRECSE LOCATION (Straet addnaa and road Intersections, prominent landmutu. etc., or Provide n1801 Pheasant Run Road S. is PROPOSED ACTION: ® NIM ❑ Expansion ❑ ModltkatlordalUratIon 6. DESCRIBE PROJECT BRIEFLY: 'Construction of Subsurface Treatment System and Well Water Supply to Serve a Single Family house. 7. AMOUNT OF LAND AFFECTED: �J Initially .�• aerp Ultimately sera S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LANO USE RESTRICTIONS? U yea ❑ No It No, daalbe brielly 6. WHAT le PRESENT LANO USE IN VICINITY OF PROJEC77 J3 Resio tial ❑ Indusurtal ❑ Commercial ❑ Agrlcultun ❑ P%WFonst/OPen apace' ❑ Omer Surrounding Lands are zoned Single Family Residential rr 10. DOES ACTION INVOLVE A PERMIT APPROVAL OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE OA LOCAL)? ® Yes ❑ No It yea. flat agency(s) and pormitlapprovals , Town of Putnam Valley Building Permit ' 11. DOES ANY ASPECT OF THE ACTIC 1 HAVE A CURRENTLY VAUD PERMIT OR APPROVAL7 nysa ❑ No Ii yea, Wt agency mmr and pemNUapproval Subdivision Plat Approval - "Strawberry Knoll Subdivision” 12. AS A RESULT OF PROPOso ACTION mu. caSTINO PERMrr /APPROVAL RewRE MOOIFICJ1T10N? ❑ Yw ® No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE 13 TRUE TO THE BEST OF MY KNOWLEDGE n.mr Cronin Engin e ,, ng, PE PC / Keith Staudohar Oa1s: 0 Signature If the action is In the Coastal Area, and you art a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART It— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. OOHS ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYt:RR, PART 40.1a7 It yoa. eoardlnato MO rout= protopo prod uao the FULL EAF. l J Yea o t 8. WALL ACTION RECEIVE C.00RGIHATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN B HvCRR, PART 617.67 It No, a nmgetivo doclarntlon may @a oupwsoded by anolner Innotvcd ogonCy. C. COULD ACTION RESULT IN ANY AOVWWE EFFECTS ASSOCIATED WITH THE FOLLOWINL'l: (Anavoro may b tiranbt mien, It wgibwl CT. Esioltag air quality, audwo at greundwator quality or quantity, nolao levolo, axlating traffic pettsrno, oalld T,asto production Or dleposal, pWontlal for oroslon. drainage at flooding problems? Explain WIofyr. C X Aaaa wtte, agricultural, arehadologlcal. hlatafe. a other natural at cultural rosources; or edmmunity of nolgnb*Moad eharactw? Explain bdofhr: ;V0 rel C9. Vegatailon or fauna, fish. shollffsh or vildflfo speeloa, algnifleant habliate. or throatonod of endangatod aperloo? Explain brtalllr. 0 Cd. A aammunity's existing plans or goals as officially adopted, or a ehango In ulw Of Intensity of uoo of land or other natural resoureas? Explain briefly CS. Grocrth, tsubs®quont development, or related activitlao likely to be Induced by the proposed action? Expioin Melly. W C& Long farm, anon corm, cumulativo, or othor olfects not identlflod in Cl-;S7 Explain briefly. rV C7. Other impacts pneluding ehangos In use of olthor quantity or type of energy)? Exatain brtoity, r D. 18 T'HERF- OR 18 THERE LIKELY TO M COWTFROVURGY RELATIZD TO POTENTIAL AOVEPSE EHVIROP1MEWAL IMPACT27 ❑ Yoe It Yea: expialn b igity r� PART 189— DETEFMIMATION OF SIGNIFICANCE (To be completsd by Agency) ld>99MUCTM& For ewh advmrso affect Identli'lod ebovcl, detwmino wNt?w It Is sulbrstantlal, Wrgra. Imparts nt or otherrmise afgnif(ca nt. E=h effect should bo aaaataed In connection with its (sa) setting 0.9. urban or rum t; (b) pnobabtlity of occurring: (c) duration; (d) irro:a©oTllblllty, (0) geographic W-09 s; and (f) magnituda. If nracsaoaaty, add attachmcrnts or rolisTeincio supporting matertais. Enoum that ®xpdartatlans Contain cuff clalt d©tsall to shoe Mat tell relamt aldvem Impacts ham D= Identified &W adoWstailyr eddr+rased. 0 Chock this box if you haw Identiflod one or more potentially IarQ<a or slgnlflcant adverue Impacts which UAY occur. Than proceed directly to the FULL EAF andfor prepare a poQlthb decfmtlort. -�cit this box If you h:lm® determined, based on the Information and ar-Wyi is above and any aupporting documentation, that thss proposed action WILL NOT result In any significant advww onevironmserital Impacts AND provide on attachments as naarossary. that masons supporting thlo d® wminratlon: CD14 Mama w Load ApQnCV P"nq lrfir Name ofOattWdQ OttKQf in Loa4f Aaency rigid a' ItC300111044 016K01 iJ i 5'e -tum oa ItQsOonuoia OIfK&r rn Ly6d Aconcy lomaturo c4 Preparof (it diffamm tram r uwns+oga or►KQri 03 • ate 2 27. Is any portion of this project located within a designated Town or State wetland? AID, 28. Wetlands ID Number ...................... ................... N/A =29; -.Is'Wetl� rids "Permit - required? ..................... " ..:�:- " .::.::: .:::.::........................ 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? .............................. Yes/No No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No No DESCRIBE: YES 33. Is there a local master plan on file with the Torn or Village? ......................... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project. site? ................................ ............................... No 33. Are any sewage treatment areas in excess of 15% slope? . ............................... No 36. Tax Map ID Number .......................... ............................... Map g Block -, Lot 6'0, 37. Approved plans are to be returned to ..... Applicant x Design Professional NOTE: All applications for review and approval of a new SST_S to be located within the,NYC Watershed shall.: be-sent-to -the-Departrrient; 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 creat ion of impervious surfaces, and the project applicant should obtain the appropriate forms for such activ'gs from, DEP and submit those forms to DEP for review and approval. ZZ If the application is signed by a person other than the applicant shown in Item l .,the applica4on must be accompanied by a.Letter of Authorization (Form LA -97). Failure to comply with this provikdi- may be grounds for the rejection of any submission.'` o I hereby affirm, under penalty of perjury, that infor atronfoial�e�ro his form is true To to the best of my knowledge and belief. Fals t e s "made heiOn' a unishable as a Class A misdemeanor pursuant to Se on naPLai ) SIGNATURES &OFFICIAL TITLES:r,y` i 1 Timothy L. r 'n so Mailing Address: ................. Cronin Engine Nfg';EF}aP° 2 John Walsh Blvd; 200 Lindy Bldg; Peekskill,NY 10566 PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR ..... 'A' WAS>FEW 'I' R:TREATMEI�:T. SYST— I— -.. 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 TN: Putnam Valley 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 b Lead Agency? P P Y - Y ................ 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? .......................................... Ye -s: 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) ................ ............................... 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 Aprilway 2000 23. Name of Health InspectorAdam Stiebeline 24. Project design flow (gallons per day) soo Sal /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 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES { ;:•: - - ,I IJSIGI\l 17ATA'S EE`X`. --.S B9V1 tFACE:SMAGtrtkhATM�'I'tSYSTENIj . _..._._: Owner 37 Croton Dam !toad .Corp. Address 37 Croton Dam Road, Ossining, NY 10562 Located at (Street) Blk"Z%4Mr M? Tax Map B4 Block 2 Lot �G (indicate nearest cross street) Municipality (T) P utnam Valley- Drainage Basin Peekskill Hollow Creek SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test 05-17-60 Hole No. Run No. Time Start - Stop Ela se Time M in.) DeSpth to Water From Ground Surface (Inches) Start . Stop Water Level Dro In Inc es Percolation Rate Min/Inch D. A 1 g_y�� 2 z3 _ZG g 5 3 6 iJ z. 3 -. a G 3 /D 4 6 3 c7 5 1 22..x.24. 3 3Y 4 5 1 2 3 4. 5 1`1 V l t): ►. nests 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 1.01 15 2.0' 2.5' 3.01. 3.51 4.01 4.51 5.01 5.5' 6.0' 6.5' 7.0' 7.5' 8.01 8.51 9.51 10.01 TEST PIT DATA DESOUPTION OF SOILS ENC Tg .9VN_ D.1N.T_EST_HOLES,.,.:,-. HOLE NO. ZD 7o? it HOLE NO. 005 HOLE NO. 17 's A)fc- W 2 Indicate level at which groundwater is encountered MIA' Indicate level at which mottling is observed pjlA Indicate level to which water level rises after being encountered NIA Deep hole observations made by: Adam Stiebeling/ Keith Staudohaur Date 034 - 27- PCQH Cronin Engineerir-d-7 yam Design Professional Name: Timothy L. Cronin III N Address: 2 John W sh Blvd. #200 Pee 105�&7 Ui LU Signature: 6.2980 OFESS Design Professional's Seal i..., r. � -. "' n+FS 4�� .- ... � .. tea. .,, 7� �.�.. •�`.�"'e ""�. Y'i /`+�rrr4 ^'�'.cti- �',.� -. =.r b°�j�'+" °.~i'3 r??;i. r .f*C''""',�� � - D t,. ^ AWES' ! 1 t'SUBSURFACE SEWAGE ON A SOIL PERCOLA17 / /NCH DROP (SEE 'SO/L 7 40) , .ER 'WAS N071F7£i PRIOR TO BACKFILUNG ,UNAUTHORIZED A LTERA. A KOLA 77ON OF SEC77C �€OUCA770N LAW. F + ` 4• HOUSE- AND WELL LOCH ". SURVEYED AND PREPAR� 5. PROPERTY HEREON 7S LG 4 wN� e 5{�OWIV ON A MAP RLED; MA Y 15, 2002 AS M f I 4 r 11 rBC 1 3! JCr b `EAS! /NC WA LER MAIN^:•�A' (APPROX/MA l£ CLCA i7av) IGT5 i A. >F $/ / lOOx E.fPANS7CN AI!£A , >� /2 G. Cm'.L.'i.�+?t -w �J.. a ROO'VG ORA/N; +" —� h 0 ', f1 ii /6 Nr ROU CEAOERSI / \ ` 7 rl H. _ '.•q'` "5�cix.. rz NQODLSfW 7 i / `/� �� - ` \, �' \. y '0 1 ! , r . / .. ; t rr �2 it •,,, .' 18 . /.(h•�"� I \� /( /.e j Iry, Ft�! 7(� J J "f.�F 1` 44BLF. –i "e PERF PLf;' 1fI !'rf!l'71 JrS,7 J! 14' CPA KC IR£NCY/ r Q (kAVS ARE CAPPED)) - I J 7/ 1J - rzLx_ 4b YL` P SORJS P IPE / r! ,: ! MIN (4) 22' BENDS AS Wow B - r/ _ I- 1250 GALLON CUVCR£7E SEPIrC LANK `i 1`` r •T l�� -i t i 47aY 9� ii _ qllrs� z' sY ion / °o� Vvk 4 o EX/SRNC {PATER SERVICE 4" SZWJB PLC P.�E' r7rO.v i . lNSr. BOX X IC PCRF. P ..+ orslmBUnav BOX / ZOP /NO. 10 r— , .i, 1 1' r1 n' 33 .p . sj Y's e� t 1. 1 r ' 1 � H/7H (ZJ IS' H£NOS AS 9YONP+' \ �•r � STRA WBERR Y KNOLL --LOT 010 AS-19U/LT SEWAGE: TREATMENT SYSTEM 4 ;: SCALE.- 9 0, _ .30','F-T.. TANK DISTANCES a}P7mm,zm aE L10 1SY1f11cam C L GCE i X B g£anc rahvK 41.5 75" DIS7RISunoN BOX 63' '100'.' DISTANCES TO START OF SSTS a}P7mm,zm aE L10 1SY1f11cam C L GCE i X B START.OF 1ST , 7BENCH 70: -104' START OF 2ND. TRENCH THIS IS TO 4'ERAFY • TVA T n"/£' SEWAGE DISPOSAL SYSTEM WAS 709.5` START OF. 3R0. TRENCH 82' 102' START OF 4774. TRENCH 87' JO8' CONSTRUCTPD,AS INDICA TED .ON THIS PLAN AND THAT 7-HE SYSTEM 93' 126.5', START OF 6774. ' TRENCH 100' 131 ' ' START OF 7TH. TRENCH. 106' WAS /NSPEC?FD BY ME BEFORE 1T. WAS COVERED OVFR. THE SYSIPM START OF 871-1 )BENCH i' 14_T, WAS CONS CTED /N ACCORDANCE WTH ALL STANDARD RULES DISTANCES TO START OF SSTS X B START.OF 1ST , 7BENCH 70: -104' START OF 2ND. TRENCH 76' 709.5` START OF. 3R0. TRENCH 82' 102' START OF 4774. TRENCH 87' JO8' START OF 5TH TRENCH 93' 126.5', START OF 6774. ' TRENCH 100' 131 ' ' START OF 7TH. TRENCH. 106' 13T START OF 871-1 )BENCH 111 ' 14_T, wFLC LoCAnav X HELL -1 " '97' 't211.5` DISTANCES TO ENDS OF SSTS ENO OF >�T TRENCH . " '97' r90'. END OF ,�ND. 4RENCH 103' 96' END 'OF .3RD. 7RENCH 107' 102' EIVD'OF 4TN, TRENCH 111. JO8' ENO` OF 5; .' TRENCH,. 116,' END OF` 6J .. 7RENCH. 120' 120.' END OF 77H. 7RENCH 125`. END OF 8TH'777ENCH 730'. 134' AND;REGULA770N9. OF. THE PUTNAy COUNTY DEPARTusvr OF H£AL7H AND 7HE.N�W.'YORK STATE DEPARTMENT OF HEALT7 -„ SU�SU�FiACE -SEWAGE TREA 7UfNT SYSTEA1 CONS( T1 OF 'A 1250 GALLON CONCRETF SEPTIC TANK, AND 448L.F.- 4 "� PERFORA,7E'D PVC PIPE IN 24 " GRA VEL TRENCH. e 37 CROTON'DAIt/ ROAD CORP. 37_ CROTON OAM ROAD CORP. 37 CROTON DAM ROAD 37 CROTON DAM ROAD OSSNING N Y- ,1 "0562 OSSINING N. Y. ; 10562 �A1g14 Y,` MAW � PRIVA7F ►tL•L•.�B.Y-.• -. PEEKSKILL HOLLOW BROOK INC. F P EKSKILL WA S ED 4 PUTT/AM A VENUE i '7 a 'J t r g / n1 y