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HomeMy WebLinkAbout4455DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 84.15 -1 -112 BOX 34 04455 �. ;: .1 ti "fir; ��. , I W6 •Li, .� 1�t- I T Oki �. ' I r -I - 04455 PUTNAM COUNTY DEPARTMENT OF HE DIVISION OF ENVIRONMENTAL HEALTH SEg CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATNI PCHD CONSTRUCTION PERMIT # y - i�� S 7;::��.` -, t. Located at I LL- ST`. Town or Village ► '�1 f`4,4 �' �J . LLE Owner /Applicant Name /�T L.1 hIo I ;I f GC' �. I Tax Map 04-.,,15 Block —� Lot Formerly Subdivision Name XT4U tac P1. I A_Ii I t Ce- L A a -� Subd. Lot # Mailing Address f5_7 b/' *LE_ AQ E�' � SS6 j 1 ��c� 1� r�``, Zip 0-S-6 z Date Construction Permit Issued by PCHD / / �, 51 O 7 Separate Sewerage System built by 0 i J 9\1 C79- Address 522 PALO- AM l: US$, 0 iA Consisting of / Z s 0 Gallon Septic Tank and 4 -4-4-- L 4 i e o1' '2-4'0 i (a 61 [1[ -01l D r C i Other Requirements: Water Supply: Public Supply From Address Private Supply Drilled by P G [Z_t -jA-i4 Address n )wilding Type .,�- -��1 > Has. erosion, control been Completed?., Number of Bedrooms Has garbage grinder been installed? td G I certify that the system(s), as listed, serving the above premises were constructed essentially as .shown on the as- built plans (copies of which are attached), in accor ce with the ' sued PCHD Construction Permit and approved plans and the standards, rules and regulations o t e .,u County Department of Health. / i/ Date: _ Certified by % P.E. R.A. (Desi n Professional) Address '7 P4 LIE 4w4 F. � r ref 1 �i� tti��� . j, � License # Q Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Director /Commissioner, such revocation, modification or change is necessary. i y: & Title: Date: c copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH _ _DIVISION OF ENVIRO,NMENTAL.HEALTH SERVICES - r..- r..��++oa:- .= s°as ,."�'t-.: n'i+il'L. cm�: o :.w'�.c. �-A:1 ,:..- .. a`;++a'. ti.:.id:,al- 'r.'.:' <' -.aCa 1^:. .- i-: n�+.:. r ,= o...'.+os'�t'.i'�.i.�+S"' ®::: a- :�6r`e- •:.•'�:; :rtRo.'.ia..t= '.:'_. "P -re �.�$!'- •.�.:.: =: °.i y WELL COMPLETION REPORT Well Location Street Address: Town/Villa ge: I'Map ax Map # jj GPSw M„ i �" L ( A-1— v5v r' Block I Lot(s) Well Owner: Name: Address: r7 7 04t L" A-\V&-� fa Use of Well: _Residential _Public Supply Air cond /heat pump _Irrigation 1- Primary _ Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Drilling Equipment L40tary Cable percussion Compressed air percussion Other(specify) Well Type _Screened _open end casing _ Open hole in bedrock _Other Casing Details Total Length ttf.S ft. Length below grade* ft. Diameter . 4� in. Weight per foot z-'�- lb/ft Materials: "' Steel Plastic Other Joints: Welded t/ Threaded Other Seal: � ement grout Bentonite Other Drive shoe: Yes _ No Liner: Yes`/ No Screen Details Diameter (in) Slot Size Length ft Dept to Screen ft Developed? First Yes No Hours Second Well Yield Test _Bailed _Pumped ✓Compressed Air Hours 74• Yield -S gpm Depth Date Measure from land surface-static (spec ft) `'30 During yield test (ft) Depth of compete well m . (P e a Well Log Depth From Surface If more detailed ft. ft. Water Bearin -- information-­­, Land.sti fa = - � _moo .. �...+._ . ,.C. _ descriptions or �p sieve analyses are available, please attach. If yield was tested Feet Gallons Per Minute at different depths during drilling list: n) Formation Description Pump /Storage Pump TypeS_4A. .,,eA1., Depth. Voltage a3p Tank Twe t.A.;1c' '3 -v a- nk Information Capacity s Model j�St v Z HP /_ Volume Yf r NOTE: Exact Location of well with distances to at ledst two permanent landmarks to tie provided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM } 5 41-A mkd n(A- c 2'44(S _ 1 -- f(12— Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Town/Village Location - Street Subdivision Name 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 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-pad of said system constructed by me which fails to:! operate for *a period of.two" years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such' system, except where the failure to operate properly is caused by the willful or negligent act of the :occupant of the building utilizing the system. ....... .. -. . _. .. _ h. ^5... fib. The undersigned further agrees to accept as conclusive the determination of the Public health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the _b 'ld' tiliz' the system. Dated; y f Year Zo1© Signature: Title: 0 -7' General Contractor (Owner) - Signature SHERLITA AMLER, MD, MS, FAAP Commissioner of Health P Y:...1��j.:��- ::�'C -T5 : D':.W.��� -•- •..t��•i•b�•:'C't .'..�id'/^t.'x�..c �. �7L-.. �.. � LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Natalino Iamiceli 57 Dale; Ave. Ossining, NY 10562 Dear Mr. Iamiceli: ROBERT J. BONDI County Executive - _ 3` +"- c:rn�D^r:,.a -ate. ��cx:�'�..^h'c ✓i.9:�:',7 =�: P r�- a�'''i+�- �- a.�.::c� -. DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 Re ROBERT MORRIS, PE Director of Environmental Health March 15, 2010 Construction Compliance — Iamiceli 39 Mill Street (T) Putnam Valley, TM # 84.1 -1 -11.2 This- office has received and reviewed the most recent set of plans for the above - mentioned project. We would like to offer the following comment for your review and consideration. The final - survey informationis to be provided on the plans (date of final'survey, house location with respect to the property lines) and the surveyor is to be noted. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. JSP:kly ry truly yours, oseph S. Paravati, Jr., PE Environmental Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845)278-W8 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention /Preschool (845) 228 -2847 Fax (845) 225 -1580 Aug 21 08 12:18a natalino iamiceli 914 762 3365 p.l Natalino M. Iamiceli 57 Dale Avenue Ossining, NY 10652 Fax / Phone (914) 762 -3 3 65 U- - � 1 (4-) 7 &o -- 4-ki y FACSMLE TRANSMISSION FORM TO: i2C,'i —AL 4c -- c_ ci��- - 4 ,14 l Z�Li d 2)L-:(? FROM: IT- 1Ay t Gam- r .-i ATTN: _ (n L= N C 2 C:: e- tZ DATE: TIME: A.M. P.M. FAX NO.: q- s "Z-`Z 9^ 1—) RE: WE ARE SENDING PAGES INCLUDING THIS PAGE T rc�� v X41 Z. Aug 21 08 12:18a natalina iamiceli 914 762 3365 p•2 AUG-11-2001 01:58PAI FROM-ENVIRONWNTAL HEALTH 8452787921 T-322 P-001/001 F-686 PUTNAM COI NTY DEP.ARIMNIT OF HE�UTH DrMION OF ENVIRONMENTAL EMALTH SERVICES -k ATTENTION D JOSEPH GENE PQ0TMqT FOR FINAL INSPECTION Tor: Fill All information must be fully completed prior to any Trenches X- inspections being, made. PCHD Construction Permit ;Y yn i Located: P bi-A-V-1- Owner /Applicant Name: k: Formerly: — Is system fill compl6ted? Is system complete? — (T) M TM24tL5-Block I Lot JLL-- _2 Subdivision Name: --- I &hj L C-L- Subdivision Lot # '2 g Da-,e: - LIAR Daie: V 1i(_ c Is system constructed as per plans? Ye> Is well drilled? rLC2 Date: Is wet located as per plans? Are erosion control measures in place? I certifythatthe system(s), as listed, at the above premises has been constructed and I haveinspected and verified their completion in accordance with the issued PCFM Construction Permit and q, approved plans and the Standards, Rules and Regulations of utnam County De/para=nea.i 'of Health. # VC R—A Date: C rdfiedby; g -,P n r ssi6fi* Address-. 2 Lic, # U / Comments. C7 Form FIR-99 lei tAL STl, INSPECTION g D� g o� Date: �? /�L �� Inspected by: " Street Location Owner G L Ava A.aetl Town 49111W40 ,�► L/: �� Permit # 0 _ 4 ..7..I ale! ic; �uadivisiu Lof #'- ;3 '.. w- 1. Sewaze Svstem Area YE NO COlYIlVMNTS a. STS area located as per approved plans ........................... - b.. Fill section - date of placement 3:1 barrier Lgth. )ATidth . Avg.Dpth c. Natural soil not stripped.... ......... ..................... d. Stone, brush, "etc., greater than 15 from STS area .......... �✓ C-i: T NAi� jw S-f " o e. 100' from water course/ wetlands ...... ............................... II. Sewaye Svstem .....1250 .........other ................ a. Septic tank size - 1,000 ...� 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 Bog - properly set ....... ............................... 6. Irenches 1. Length required Length installed 2. Distance to watercourse measured Ft .......... ,� 3. Installed according to plan.....` /ter.: c:- ..� -s.fi.z—/:-`�4 ry r .oC412�' L F_VT1 x-A6(Z '01thl 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 - 1112" diameter clean .................0 e t , Y-./- 9. Depth of gravel in trench 12" minimum ................... ` 10. Pipe ends capped ........................ ..............................CA11 -r 4vOC F, CAU g. Pump or Dosed 5vstems 2. '(verfl "ow tank ........:.. .............. :.::.................... :..:. jq..� ... 3. Alarm, visual /audio ........:........... C � . 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .............. ' .............................."I !Q1(­" . , ;. 6. Cycle witnessed by H.D.estimated flow /cycle........... 4"A �•'- �t + , III. House/Builditia , a. house located per approved plans .............., b. Number of bedrooms .......................... �..1a....(� 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 .................. ....................... . C �- *Ox ( b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ............................... i. Erosion control provided ................. ............................... 5° N <. ,c, Rev. 12/02 Form 73 SHERLITA AMLER, MD, MS, FAAP x - (711:m. iss!oner, of-Wealth .i LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Agostino Paese Consulting Engineer & Assoc. 57 Dale Avenue Ossining, NY 10562 Dear Mr. Paese: ROBERT J. BONDI :,County FxeCt %tivv ROBERT MORRIS, PE Director of Environmental Health May 27, 2008 Re: Field Inspection - Iamiceli Mill Street (T) Putnam Valley, TM # 84.15 -1 -11.2, Lot 2 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. w _1:. - The'latest•trench of,the sy.5tern.needs tp,gbe,removed-and replaced _du_ e,to siltation..:;: v =: 2. Some pipe connections to and from.junction boxes are not properly sealed. 3. The 6" C.M.P. sleeve.under the drive needs to be exposed for inspection. 4. The pipe feeding the last junction box has a reverse pitch. 5. The dwelling pantry needs to be completed. 6.. The well needs to be inspected upon completion. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:kly Very truly yours, 20 Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 40 / i / / / / . // � / / ooll \/ AID IRQC LEADERS"5HAi L: BE ! lol* WECTEf7 /TO XCH BASIN IN / / NF \t WV AKD. THAI! TO RIP,RAPPED fl Fo} T+i�G NAIR VGA E f O G C�RI�fECNAy ARSE POKT // / y. (V\7 ltli¢jv/ j , owl Jv W EL 393' F i- - ±if/ ��� Vii• / / /� • .....- w"'.."'" ....w..:- R - D -P Dec'- � 1/ J.L IFVY: EL. -81.75 / / ` Mar 10 10 C18:00p . Natalina Iamiceli 914 - 762 -3365 p,1 Natalino M. Iamiceli 57 Dale Avenue Ossining, NY 10652 Fax / Phone (914) 762 -3365 FACSIMILE TRANSMISSION FORM FROM 114 " i 1 f� i t k C It', ATTN: Cn N FAX NO.:�= RE: _ p r' iz r1 t E DATE: TM E : A.M. P.M. WE ARE SENDING PAGES INCLUDING THIS PAGE le- G C, fv� E 1 A"-i c C l fit. Public Health Director --LORETTA M, 01JM AI XNI i- M.S.N.,_.. Associate Publte Health Director Director. of PatieW Simms DEPARTNfNT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (843) 278 - 6085 Early Interven6ow7reschool (845) 278 - 6014 Fax (845) 278 - 6648 `4 E911 ADDRESS VERIFICATION FORM OWNERS NAME: A-TAL1r'o 1,AKxe F-u TAX MAP NUMBER: g q- 1 ( " I 2- E911 ADDRESS: Kl u— TOWN: l.. t► AUTHORIZED TOWN OFFICIAL: lam' 1 (Signatur ) r . -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. (Egi lverf&m) YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ( 914 ) 245-28-00.. ,. _ f. .... `r _... Albert H : Padovani`,, ,b'ir' erector LAB #: 1.00049'7 CLIENT #: 4820 NON STAT PROC PAGE: 1 of 2 IAMICELI, NATALINO DATE /TIME TAKEN: 02/08/10 11:48 57 DALE AVE DATE /TIME REC'D: 02/08/10'12:10 OSSINING, NY 10562 REPORT DATE: 02/1.5/10 PHONE: (914)- 262 -3365 SAMPLING SITE: 39 MILL ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN.TAP PRESERVATIVES: NONE COLD BY: NATALINO IAMICELI TEMPERATURE..: < 4C NOTES :_: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 02/08/10 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B 02/12/10 LEAD (IMS) 1.6 ppb 0 -15 ppb SM 18 -19 3113B 02/15/10 NITRATE NITROG <0.2 MG /L 0 - 10 SM18= 204500NO3 02/09/10 NITRITE NITROG <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 02/11/10 IRON (Fe) <0.060 MG /L 0 -0.3 mg /l SM 18 -20 3111B 02/11/10 MANGANESE (Mn) <0.010 MG /L 0 -0.3 mg /l SM 18 -20 3111B 02/15/10 SODIUM (Na) 9.24 MG /L N/A SM 18 -20 3111B 02/08/10 pH 7.7 UNITS 6.5 -8.5 SM18 -20 4500HB 02/15/10 HARDNESS,TOTAL 122 MG /L N/A SM 18 -20 2340C 02/09/10 ALKALINITY (AS 104 MG /L N/A SM 18 -20 2320B 02/09/10 TURBIDITY (TUR 0.6 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: PICK UP COMMENTS: MFTC a oli.form = This result indicates that the water (was), (was not) of a satisfactory sanitary quality according to Gew York State and EPA federal drinking water standard for this parameter. This.comment applies to the Total Coliform test only. Fe /Mn.If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium. is suggested. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914:) 245 -2800 rlbert_:H Padovani, Director LAB #: 1.000497 CLIENT #; 4820 NON STAT PROC PAGE: 2 of 2 IAMICELI, NATALINO 57 DALE AVE OSSINING, NY 10562 DATE /TIME TAKEN: 02/08/10 11:48 DATE /TIME RECD: 02/08/10 12:10 REPORT DATE: 02/15/10 PHONE: (914)- 262 -3365 SAMPLING SITE: 39 MILL ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE COLD BY: NATALINO IAMICELI TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD pH pH SCALE'IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L' VERY HARD WATER: ABOVE 300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER HARD WATER: 140 -300 MG /L 1 (1 grain /gallon = 17.2 MG /L) THE ABOVE TEST PROCEDURES MEET ALL REQUIREMENTS OF NELAC, AND RELATE ONLY T )THESE SAMPLES RECEIVED BY THE LAB SUBMITTED BY:. fy Albert Padovani, M.T.(ASCP) Di recto ELAP# 10323 Mar 10 10 08:OOp Natalino Iamiceli 914 - 762 -3365 p.2 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown. Ne.ight.s (914) 245 -2800 Albert H. Padovani, Director LAB #: 1.000497 CLIENT #: 4820 IAMICELI, NATA'LINO 57 DALE AVE OSSINING, NY :10562 NON STAT PROC PAGE: I. of 2 DATE /TIME TAKEN: 02/08/10 11:48 DATE /TIME RECD: 02/08/10 12:10 REPORT DATE: 02/15/10 PHONE: (914)- 262 -3365 SAMPLING SITE: 39 MILL ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE COLD BY: NATAL'INO IAMICELI TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 02/08/10 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B 02/12/10 LEAD (IMS) 1.6 ppb 0- 15.ppb SM 18 -19 3113E 02/15/10 NITRATE NITROG <0.2 MG /L 0 - 10 SM18- 204500NO3 02/09/10 NITRITE NITROG <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 02/11/10 IRON (Fe) <0.060 MG /L 0 -0.3 mg /l SM 18 -20 3111B 02/11/10 MANGANESE (Mn) <0.010 MG /L 0 -0.3 mg /1 SM 18 -20 3111B 02/15/10 SODIUM (Na) 9.24 MG /L N/A SM 18 -20 3111B 02/08/10 pH 7.7 UNITS 6.5 -8.5 SM18 -20 4500HB 02/15/10 H:ARDNESS,TOTAL 122 MG /L N/A SM 18 -20 2340C 02/09/10 ALKALINITY (AS 104 MG /L N/A SM 18 -20 2320B 02/09/10 TURBIDITY (TUR 0.6 NTU 0 -5 NTU SM 18 (21302) COMMENT'S: PICK UP COMMENTS: - MFTC oliform = This result indicates that the water (was), (was not) of a satisfactory sanitary quality according to ew York State and EPA federal drinking water standard for this parameter. This comment applies to the Total Coliform test only. Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium is suggested. Mar 10 10 08:0Op Natalina Iamiceli 914 - 762 -3365 p.3 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights,,-N.Y. j0598..:,. ._i....:...� - 5x..2 (914) 24 - 800 Albert H. Padovani, Director LAB #: 1. 000497 CLIENT #: 4820 NON STAT PROC PAGE: 2 of 2 IAMICELI, NATALINO DATE /TIME TAKEN: 02/08/10 11:48 57 DALE AVE DATE /TIME RECD: 02/08/10 12:10 OSSINING, NY 10562 REPORT DATE: 02/15/10 PHONE: (914)- 262 -3365 SAMPLING SITE: 39 MILL ST, PUTNAM VALLEY, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COLD BY: NATALINO IAMICELI TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS- DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER HARD WATER: 140 -300 MG /L (1 grain /gallon = 17.2 MG /L) THE ABOVE TEST PROCEDURES MEET ALL REQUIREMENTS OF NELAC, AND RELATE ONLY T•,THHEESE SAMPLES RECEIVED BY THE LAB SUBMITTED BY: Wes/ uf Albert ul Padovani, M.T.(ASCP) Directo ELAP# 10323 PUTNAM COUNTY- DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONS'T'RUCTION PERMIT FOR SEWAGE TREAThIENT SYSTEM PERMIT# Located at STfi-- E'e-T— Town or Village P'D-�,j,¢tft �,_I A-wz`t hlPrT•4ta nc. o C=1, Subdivision name 1 A=t-� t G tZ t Subd. Lot # 2- Tax Map 0 ®lSBlock � _ Lot 1 Date Subdivision Approved 4-1 [ 1 le� 4, Renewal Revision- Owner/ Applicant Name LAMU' kic l A-w L c tE c- Date of Previous Approval Mailing Address _ 5--2 j,>41ja- 4-i e7-- Zip 1d6 Z Amount of Fee Enclosed . Opp C1 , n 0 Building Type � c v S Lot,-4rea � ► 3 q No? Bedrooms _4 Design Flow GrPD S O r7 Fill Section Only Depth Volume PCHD NOTIFICATION I&BIQUIRED WHEN FILL IS COMEPUTEV 50arate Seweragg System to consist of gallon-septic tank and 4-4 -4- L, lit . Olt Other Requirements: To be constructed by (2 w rJ Mf L Address c M e-- 4:S 4-30L/L—:77- Water Supply: Public Supply From �i �� Address .:.Ili ;� ='°^ Private:$op�1 Drilled by. yLZ4dlyBi 511 Address. I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the desgn' bed above will be constructed as shown on the approved amendment thereto and m 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 furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any Mmirs theretp• Si d- llp�lt � -c P.E. T UU �� R.A. Date Address r .S' 7 r /DAL -E- 4 --J G igLs cuff License # 4-67(9 1 APPROVED FOR CONSTRUCTION: This approval expires two ye/ms s f iff date issued unless construction of the sewage gent system has been compered 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 Ell ' Approved for discharge of domestic sanitsieyy sewage only. �p o B (U. Title: Date: • D File, -Yeiiow copy � �5� SPY ' 'ner; orange copy Design Professional Form CP -97 PUTNAM COUNTY-DEPARTMENT OF HEALTH.. DIVISION OF .ENVIRONMENTAL HEALTH SERVICES COONMUCTION PERMff FOR SEWAGE TREATMENT SYSTEM PERMff # Located at M. I >✓ L STTz -E, 077 - -- - Town or Village PLLD.AA -Ml \WWZ-7`i 1.1AT•4 u,u.0 �-(. _ Map O +.( �_ -_I 2- - Subdivision name � l A-1� t � � i Subd. Lot # Tax mlSBlock Lot 1 e Date Subdivision Approved 4-/[ ( le '6 Renewal Revision Owner /Applicant Name LALO 4 A-VI L c_ L- Date of Previous Approval Mailing Address ,5- 7 i7A �� q• E �S S (��l 1 �.��k` f, Zip 1. d I- Z Amount of Fee Enclosed OC ­0 Q 4. U 0 Building Type a v S e Lot Area T- 3 No.. of _— Design Flow GPD f a 0 Fill Section. Only_ Depth Volume 50arate Sewerage System to consist of gallon- septic tank and 4-4 -~4- L, Other Requirements: To be constructed by 69wi -tU 2 Address Seq:ks,1 6 AS A-60t./07 Water Sunoly: Public Supply From Address •!'- ..hate Supply Dolled P V. % 41�L�9�yz �lr�l l '7 I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the 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 furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately fgi4wing the dame of the issuance of the approval of the Certificate of Construction Compliance of the original system or Signed: A* ti Pa R.A. Date Address License # ¢ er e9 I I V APPROVED FOR CONSTRUCTION: This approval expires two from dabs issued unless construction of the sewage treatment system has been completbd 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 't. Approved for discharge of downestic sanitary sewage only. Title: 47O&C Date: 3��7 py --HD File; Yellow-copy = Boil ' tivvner; 4rnge copy Design Professional Form CP -97 c CONSTRUC nON PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT O `�' 9 �' 00 Located at d'p'i. Li_L STfz- E-�-r -- - -- Town or Village PL MAA-t L T�IPrT•4 -�.1 u. c� C`t Subdivision name; 1 A- t,i t c- t-�- i Subd. Lot # Tax Map 0 4,.( Block �_ Lot Date Subdivision Approved Renewal Revision Owner /Applicant Name LLATALAif2 Date of Previous Approval Mailing Address. 5'- 7 D AL-10- E r�5 S (i�l 1 �, �1 �• Zip I- Amount of Fee Enclosed 0!�70 61 , n 0 Build' mg T ype � � v S � Lot :A res 5 3 � N. of Bedrooms Design Flow GPD R C 0 Pill Section Only Depth . Volume PCHD NOTIFICATION IS,U&IRLD WHEN FELL IS COMP Separate Sewerage Sydgm to consist of gallon- septic tank and 4-9~4- L, ncG Other Requirements: To be constructed by O w p L & R --- - - Address Sd:p -1 E,� 4S A 3D l/ 67 Water SAUOIy: _ Public Supply From _/ a Address Private S_pXJ y_�rilled_ by T- v, I�✓TiAd2:1� e-7 I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the 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 Direction will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will p rri;good operating condition`any part of said sewage treatment system during the period of two (2) years anmediately lowing the date of the' 777 of the Certificate of Construction Compliance of the original system or sn the Signed .E: R.A. Date Address S ZDi4-L-671 License # 4- i!f 62 I APPROVED FOR CONSTRUCTION: This approval Wires two yeasfrom � date issued unless construction of the sewage treatment system has been completed and inspect by 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 't. Approved for discharge of domestic sanitary sewage only. : Title: Date: % /07 B y —� - HD File; -Yellow copy - B dinginspectoe;ilink-ropy -= wner, Orange-copy;-Resign-Professional _.__.... Fo m CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A. WATER WELL - please print or type _.PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # TI,, a,jA W Op PUT n \#A 'Map 16,4,, IS'Block Lot(s)1 Well Owner: Nvn -rA 0 Address: S-7 L�4 L, e A-w e, Use of Well: -*Se 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`" gpm # People Served;, Est. of Daily Usage &VCS gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling . New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ...............:. ........................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes X No Name of subdivision 1�j.A-T4Usy,t3 �.t , 1Xt a 1 '.-0 Lot No. Water Well Contractor: lilt -9f�aA -�J xjg�ms©i%j ag.tt Address: t c-) t--- : e-? �l - (P��, � t o Is Public Water Supply available to site? .................................. ............................... Yes No V T Name of Public Water Supply: A Town/Village A,uZ4 an Distce to property from nearest water main: k a A Proposed well location & sources of contamination to be provided on se, arate sheet/plan. Date: - =A: lieant S' n tyre :. 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 ! �, S` /'0 7 Permit Issuing Official;'', Date of Expiration Title: �,, �, Wer- f ,64 �_ '„g, : • d� -� Permit is Non - Transferrable 'r ` ` . White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Agostino G. Paese, P.E. Natalino M. Iamiceli Consulting Engineer &Assoc. CdRsWmg- Engineer - k 4 s- 57 Dale Ave., Ossining, N.Y. 10562 (914) 762 -3365 January 18, 2007 Gene D. Reed Sr. Environmental Engineering. Aid Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Response.to Comments Dated 1/16/07 Proposed SSTS — Iamiceli Tax ID: 84.15 -1 -11.2 Dear Mr. Reed 1. A distance of fifty feet (50') has been indicated on the plan for the well to septic tank distance separation. 2. The proposed number of bedrooms at the house location has been shown on the plan. 3. Two 45 degree angle bends have been shown and indicated by a note at the pipe from the septic tank to the first junction box. 4. 6" C.M.P. pipe sleeve's has been shown and indicated with a note at all driveway crossings for the SDR 35 pipe from the septic tank to the septic fields. 5. A Meets and Bounds'plan has been provided on drawing S -2 at a reduced scale. _6:: Erosion: control- measures:have been shown -ord th -TlPT� below the-SSTS-system and below, -:- - '�..�y ..�.- .-.... .....-- !..s.....a7n... -.Q .p.ro-m...lYm- -•- ..- YYi -._. �.... .'w o_... �- yC..- .�yw --. ..n ..- -.. -�.. -. «... -.. -. �... -fD -� a-• b� + -._ �._. .- ..a4.-- 4+��_. - . the well location. t e e 7. The grading at the proposed SSTS has been adjusted indicating R.O.B. fill where required for grading purposes only. A note has also been placed on the plan indicating same. 8. Dimensions from 2 property lines to the proposed well have been shown. 9. A well service line has been shown and indicated with a note. 10. A note stating that a licensed land surveyor shall stake out the house, well and SSTS has been placed on the plan below the title of the plan. 1 �, j?x sE�� ric�I� P��sS �e�►� ^ "gp Sincerely, Natalino Iamiceli SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health January 16, 2007 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Agostino Paese, PE 57 Dale Avenue Ossining, NY 10562 Re: Proposed SSTS - Iamiceli Mill Street, (T) Putnam Valley TM # 84.15 -1 -11.2 Dear Mr. Paese: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health 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: �1. A distance of fifty'feet (50') minimum needs to be indicated on the plan view from the ` well to the septic tank. 2. The proposed number of bedrooms needs to be indicated on the plan, at the house location. 3. It appears that two: 45° angles will be needed on the pipe from the septic tank to the first junction box (90° is not approvable). This needs to be shown and indicated on the plan / view. ✓4.. A six inch C.M.P. needs to be used as a sleeve for the SDR pipe as it crosses under the driveway.. .,..... �.._. Flt cn�ire pr e needs td be sl�o �r vvitli a I r-an aril convenient scale). 7Erosion control measures need to be shown below the well and the SSTS. 7 appears ROB fill will be needed for grading in portions of the proposed SSTS area. �Dimensions need to be shown from the proposed well to two separate property lines. . The well service line needs to be shown and noted. A note needs to be added to the plan stating that the house, well and SSTS is to be staked out be a licensed land surveyor prior to construction. 1. The house plans submitted have a bedroom count.of 6 potential bedrooms. The rooms titled laundry room. upstairs and pantry downstairs are considered potential bedrooms by this Department's guidelines. Respectfully, Gene D. Reed Sr. Environmental„ Engineering Aide GDR:kly Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 3 N're- ....,, = x �: -e: -.: '. � .i,. � .. ... x a±. '. � _ ., �.•___ tsa �`..+- -.. -.rte � ..a„ ... � xr�— �� � - n ,,. -tee . � �,- w '_ _ _. r...C... ...1 •. .� ___ _-x.F _.. <a._.. LETTER OF AUTHORIZATION RE: Property of w t--a•,sj2 Located at r-j C t- L_ ST. i " pv t-iAM , 4"(_ Ei T/V — -S_;�f Tax Map # 9' : i S_ Block Lot Z Subdivision of (�4 R-1-t r� D M K U4NiLC- i.,i Subdivision Lot .# Filed Map # 3 n 2 6 Date Filed '7Z/2—/06 Gentlemen: This letter is to authorize ,46,7& ! —I tnic �� a 222t E:s (;F- a duly licensed Professional Engineer I/' or 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 Co th Department, and to sign all necessary papers on my behalf in connection with this at`te °o �t1�v ervise the construction of said wastewater tretment and/or water supply systems in 0 it th e provisions of Article 145 and/or 147 of the Education Law, the Public Health tie Very truly yours, 400 �v� Ll / / Signed: (Owner of Property) Mailing Address 5-' 7 ;tAL_e- A -ec S Al Gi State Zip ze SG Z-- Telephone: T,(¢ - 7G z - Mailing Address: r-7 2],r4L_C r¢�L 1� S S phi[ I-& G State Zip 10,T4 2 Telephone: 2/� - 7 k - 4-6 e/ Form LA -97 617.20 Appendix C State Environmental Quality Review .. : -•r.x �• c i.L,`:+.: r-JC. �.:' . r. "4; - _SHORT ENVIRONMENTAL ASSESSMENT FORM _ �- y •Vr;VNLISTAV qI0IS�l r�. ... .PART 1 _ PRA.IFCT INFORMATION 1Tn hp mmnleted by Annlicant nr Prniect Snnnsnrl 1. APPLICANT/SPONSOR 2. PROJECT NAME 3. PROJECT LOCATION: Municipality Pon [_ — County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 5. PROPOSED ACTION IS: New Expansion Modification/afteration 6. DESCRIBE PROJECT BRIEFLY. X69 Pep S E�r D S E P 71 C_ 1.fFF U_ dR- A (E w d v S E 7. AMOUNT QF LAND AFFECTED: Initially acres Ultimately ° acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? KYes No If No, describe briefly 9.. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Residential Industrial F] Commercial. Agriculture Park/Forest/Open Space Other Des 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? :. _Q Yes No If Yes, list agency(s) name and pemril/approvals: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes No If Yes, listagency(s) name. and permillapprovals: 12. AS A RESULT OF PRQPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? Yes No 1 CE FY T E INFORMATIO OVIDED ABOVE IS TRUE TO THE BEST OF MY IWOWLED�E/o Applicant/sponsorna t ��� Date:r Signature: i _ If the action is in the Coastal Area, and you area state agency, complete the Coastal Assessment Form before proceeding with this assessment .�, OVER 1 OVER 1 PART 11 - IMPACT A-qqF-q4;MFNT (Tn he ctnrinnieted by Lead Anpnrvi A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, , PART 6i7'.4?' K yes, coordinate the review process and use the FULL EAF. Yes No � 5, WILL ACTION RECEIVE�C66RDINAT!b REVIEW AS PROVIDED FD14 UNUSTED•ACTIONS It4-6 NYqRR, PART, 1 7;6? If No, 9 negative 6 ay be superseded by -m DYes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. )dsti6g air quality, -surface orgnDund%4aterq6'ardyorquantity; noise levels, existing trafl56 Oaftem, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood charader9 Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4: A community's existing plans or goals as offloially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development or related activities likely to be Induced by the proposed action? Explain briefly: iQ6.. Long term, short term, cumulatiyd,ci other effects not identified in CI-CS? Explain briefly: C7. Other impacts (including) changes In use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THF-F-W.IRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? E] Yes []'No'. -4fYes,ex ptaip brief�y; E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL , IMPACTS? ;Yea Na -. -.Af-Yes, explain briefly: I.... 4.7 PART III - DETERMINATION OF SIGNIFICANCE (To be,pom by,Agqnc . I :. T e, ._p y .:,&. . .. . : ' — 1 1. . INSTRUCTIONS: Foreach adverse effect identified above, determine iiAiether it is substantial, large, imp6"rtan6i- otheniviiiisignificant. Each effect should be assessed in connection with its (a) setting (Le. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; {e) geographic scope;* and (f) magnitude. If necessary, add attachmefits or reference supporting materials. Ensure that explanations contain Uficient-detail to-showthatall relevant adverse Impacts have beenidentified Ani�qoequateiv.ad.dressed....I.f..quesbon D. of Part 11 was checked yes, the determination of significance mui�&aluatethe pote have R-16 #WCEA- prqppsed,�c!" 99 the environ��ilil chara,. fiaiWtif El Check this box if you have identified one or more potentially large or sillniffidant adveys6iffipids which MAY occur: % Then proceed.&661ly to the FULI EAF and/or prepare a positive declaration, Check this box ifyou have determined, based on the information and analysis above and any supporting documentation, thatthe proposed action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting this determination Name of Lead Agency Date Print or Type game of Responsible Officer in Lead Agency signature of.,Respons0te UMDer in Lead Agency rifle of Responsible Officer 7 'Signature to Preparer (if different responsible cqr) 03 PUTNAM COUNTY DEPARTMENT OF HEALTH Lo � 21 DIVISION OF ENVIRONMENTAL HEALTH SERVICES Z-firm GNt)ATA:-SHEET SUBSUiWA&S kwX:G-� AIN— 9­1W SYSTEM Owner KIATAL] a 0 - I A-M % 6-e--k- I Address. I a 2— -Tax Map J�q &Mock Lot tj .2 Located at (Street) Ni I L (indicate nearest cross street) Municipality -E0-rs.Ajn kjA=!=L_!M Watershed. SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test G /Z�D S� NOTES: 1. Tests to be repeated at same -depth until apvro)dmatelv eaual percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 minlinch, s 2 min for 31-60 mintinch) All data to be submitted for review. 2. Depth measurements to be made from top.of hole. Form DD-97 T I AMR "ne D ;p a to mater , r om G rOun :,;tIICipsIiilcl u . , T-00--q.130 '50 1.3 g 3 74 2 q'3 0 —10�vO 14 3 ?C7 30 -712 4 5 ­2 3 30 . 2-1 it 3 if to 4 14 96 it 1 it 5 3,0 2-1 1.0 -7. 4- 2 T V-101,tqo '50 21',x^ Ito s 3 lGivo -1011,30 3 0 Z_ I .:I I CPO -30 Z,1 1-7 5 NOTES: 1. Tests to be repeated at same -depth until apvro)dmatelv eaual percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 minlinch, s 2 min for 31-60 mintinch) All data to be submitted for review. 2. Depth measurements to be made from top.of hole. Form DD-97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES p DEPTH HOLE,NO. HO LE NO. HOLE NO.0 G.L. TOW S c�p (L, Q 5 00L - 0.5''— It Za T` S, ��� y Z� o "T S. 1.0' 1.5' 0- 2- it fiD a-` 6 2.0' L1G�i i 13P-ev�n! 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' 10.0' i' T- o-)Loll Go a.cvs E �� 4-Lb" -r o _7 �,V f i 1,..t(•,t}� t3R-n wtiL G b A1..SE 5,47.L�j . Indicate level at which groundwater is encountered go C deEvy Indicate level at which mottling is observed. Indicate level to which water level rises after being encountered Deep hole observations made by:,p�Ta ,� �., i,,� �� Date Design Professional Name: A&es1 1^0 Address: .Signature Design Professional's Seal �Q(Eof NEW Y�Ry �\`AO . G. CO A,9 o NO 400" s`� pROF�SS;ONP�. TEST PIT DATA � � Z 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES D�P II- - . - -HOLE 14.01 G.L. :Ve 12 5, o t t ._ 0.5' ( — M11 -rep sac 1, 1.0' 1.5' +_o'� -t' o ::2 o +c 2.0'1k� 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' 10.0' Indicate level at which groundwater is encountered "0 � _�,�,,,tc� u,a� � �,•t c av,.iT�c� =� Indicate level at which mottling is observed ----- Indicate: level to which water level rises after being encountered Deep hole.observations made by: QA-h4t.,,�-o (A-Kj C eL4 Date DesighYrofessional Name: ) G,o5, i,,Lo G, P/ Address: ✓ '"?;`.'DA7 --C A-40_ - of WRj yo g /'106 r.4 �' VF Signature: ---,c �,� Design Professional's Seal eo,e,' ­Jr SS ROBERT J. BONDI County Executive July 13, 2006 Natalino M. Iamiceli' 57 Dale Avenue Ossining, NY 10652 Dear Iamiceli: "THE GUARDIANS OF FAIRNESS" GEORGE R. MICHAUD, Certified County Director SUBJECT: TOWN OF PUTNAM VALLEY TAX MAP # 84.15-1-11 As per our conversation and fax on the above mentioned parcel of land, please take note of the following: File map number 3026 splits tax map number 84.15-1-11 into two lots. Therefore subdivision lot # 1 will be known as tax map number 84.15-1-11.1 with 5.22 acres and subdivision lot # 2 will be known as tax map number 84.15-1-11.2 with 5.39 acres. See enclosed copy of the revised tax map. 't you ave any rurdie r questions, please do riot-hesitate to tali: Sincerely, George R. Michaud, CCD - Director cc: Ed Vreeland, Town of Putnam Valley Assessor �,UTNAM COUNTY REAL PROPERTY TAX SERVICES AGENCY . 40 GLENEIDA AVENUE- CARMEL, NEW YORK 10512 i��I: (845) 225-:3641 ext. 310 --; Fifx.- (845) 228-4030 E-mail george.michaud@putnamcountyny.com Qv, on • ,yr I IIIK Qv, on PUTNAM COUNTY CLERKS OFFICE OFFICIAL RECEIPT 40 GLENEIDA AVE., CARMEL NY 10512 RECEIPT NUMBER-0012050 ENTERED BY: NYPUJIMI DATE-07/12/2006 DRAWER: 01 TIME- 10:11:53 USER: NYPUJIMI Issued to:. NATALINO M IAMICELI 57 DALE AVENUE OSSINING NY 10562 ------------------------------------------------------------------------------------------------ DOCUMENT NUM NUM MORTGAGE AMT NUMBER DESCRIPTION ITEMS ADD CONSIDERATION AMOUNT ------------------------------------------- I ----------------------------------------------------- 0000313 MAP - FILING 10.00 RJOU%RKS: 3026 SHEET 1 OF 2 SUBDIV FOR NATALINO M IAMICELI --------------- - -- TOTAL FOR DOCUMENT 10.00 0000314 MAP - FILING 10.00 REMARKS: 3026A SHEET 2 OF 2 NATALINO M IAMICELI ------------------ TOTAL FOR DOCUMENT 10.00 7714842 MAP - COPY 8 80.00 REMARKS: FOUR COPIES EACH 3026/3026A --------------- - -- TOTAL FOR DOCUMENT 80.00 --------------- - -- TOTAL FOR ALL DOCUMENTS 100.00 CASH 100.00 TOTAL COLLECTED ----------------- ;10.0:. -'3-n' THANK YOU DENNIS J. SANT COUNTY CLERK ti PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES "a�...c�� •-- ir,..,.y, .i;�.r:._. .. w�.y.,,.. '. APPLICATION ,. .. .. a.,. � oo-: ,.� ".i. •i� - FOkt AiPPKC)VAL OF PI;A g i'OI� ` A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: &, ArTA-Ueu D I. A -M 1- ,1FL- l � D A-L,� A �.r t✓ 2. Name of Project: jq?0%?o6•r' y SS S . 3. Location: 4. Design Professional: 0,1 Et5 of 5. Address: S 7 D'4 t--c-- ., -,r c . 6. Drainage Basin: 4Jy��Sy�( SS (At C7 , hL.y cvi"G Z 7. Type of Project: >< Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/No X Type Status (check one) ... ............................. ............................... Type I Exempt Type H Unlisted X 9. Is a Draft Environmental•Impact Statement (DEIS) required ? .................... Yes/No '4J D 10. Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes/No /1 (� 11. Name of Lead Agency V,4- I.LE`i Pt,4,d,, l (,,CCx l3o4voA , 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? . ... ..,..... 13. If so, have plans been submitted to such authorities? .. ............................... Yes/No y� s 14. Has preliminary approval been granted by such authorities? 'i0 Date granted: e,� 15. Type of sewage treatment system discharge ........................ surface water // groundwater 16. If surface water discharge, what is the stream class designation? .......................... —z�Al 17. Waters Index number surface .................. 18. Is project located near a public water supply system? . ............................... Yes/No 19. If yes, name of water supply Distance to water supply 20. Is project site near•a public sewage collection or treatment system? .......... Yes/No -( 21. Name of sewage system I�(� Distance to sewage system 22. Date test holes observed 7 21r Le 4 23. Name of Health Inspector 24. Project design flow (gallons per day) ............................................................... r► c9 0 25. Is State Pollutant Discharge Elimination system (SPDES) Permit required? ... Yes/No 26. Has SPDES Application been submitted to local DEC office? ......................... Yes/No e� 5 Rev. 11/02 Form PC -97 Po 1 of 7 V -b- 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No /d 0 X_ 21I: r.::r� tlamds =.Ili riiunl `per ..::..................... era::..:.................... .......................:::..... 29. Is _Wetlands Permit required? ...................................... ............................... Yes/No c-e5l Has application been made to Town. or Local DEC ........................... Yes/No 30. Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No itk 67 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 �J 62 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 C7 DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ........................ .. Yes/No 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? .................................. .........................Yes/No A.L 0, 35. Are any sewage treatment areas in excess of 15% slope? .............................. Yes/N9 `,A G C�2 36. Tax Map ID Number .............. ....................... ......... Map d S Block _�_ Lot 11 ® '2_ 37. Approved plans are to be returned to ................ !/ Applicant Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit. those forms to DEF' for review and approval. If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a 'Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true. to the best of my knowledge and belief. Fafte,statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the l'enad L o 1Z. SIGNAIT URES do OFFICM TTITTLES. Mailing Address: ........................... Z >AL-6 — A-te- NO. SYMBOL SYMBOL A B �entG /� '- 0„ 1.471 3,E FIELDS rn D. 1 129'_ 9" 82'. 2" 2 127$--21$ 761-61' _ ^1w'� yp r - ..;Gi. �'��}�6.� _- �. w.r ._y;::�..�T.:•}�Yf�c;" k-�n' :.•l�%Y� - ^ii` Tiy�• 1�..( -...�d �T�.. �14 _`'Qt T�� ��.�'d .i.. > �A .f�- �J��av�n�,� ^, NO. SYMBOL SYMBOL A B TMKC 150 '- 0„ 1.471 3,E FIELDS C D. 1 129'_ 9" 82'. 2" 2 127$--21$ 761-61' 3 122' -11" 70,_7, 4 8I_ 11 » 64,-8 it 5 1.) 5' -2» 58' -10" 7 1'4'- 8 46' -.3 8, 95'_ 5" -. 39f_ l 9 85,_x» 34' -1" _11 901,31) 83' -9" 12 9.0.'-6" 74' -0" 13 8G' -10" 74'= 3" 14 85 ' -9" 65.0" 15- 71 67' -3" 16 68' -2" 63' -7" 17 65-- ' -2» 58' -8" 1;8 6,w5,� 47,_11„ 19. 150'-8" 8714„ 20 1411 4" 78'- 4" • 21 1 �2' -1" 69 =10» 22 1 2',g" :61'_6 . i LXIS I IINb WLLL "fin" I stow -,or formerly :F'ERTUCCI �o\\ e i olo / 447.61.0 y. / --- CB \ / FRAkfE � SHEIJS! <�` U ?rly LOCATION MAP ;+ SCALE.' 1- 2.000 -f 7 9c�y, c°6 /�Z ole 1 P \\ guy cable•`' l 1 E ` f� -� le 1 329.59' 'n C? guy cab /e . tree 11.5' E. o lipe b /�' + 2 �_ 5Lt2 I — - TYP. L - —60 + FlELDS AREA LOANSIDN 4' SOLID PVC BETWEEN _ _ BB +2— T _ Guide Rail JUNCTION BOXES (TYPl/ 60 + 7+ 7 LXIS I IINb WLLL "fin" I stow -,or formerly :F'ERTUCCI �o\\ e i olo / 447.61.0 y. / --- CB \ / FRAkfE � SHEIJS! <�`