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Home My WebLink About4615DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.07 -233 BOX 35 04615 .. , is -:,�'� a i , 16 %lolic 34 04615 PUTNAM COUNTY DEPARTMENT OF HEALTH D V Si i�OF- ENV1 -RO THE TAh:- HE-AE" SERVICES' CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR ATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 1pll"U ?, f f Located at IMWoW GfAf T Z) iP/ a f— (1g)or Village AZ6tewf g�� Owner /Applicant Name E /I,* A4 4 y Tax Map Block -2- Lot i Formerly ,(' �iI -c ��lC' sty Subdivision Name A64VI1I-p Mailing Address Subd. Lot # A s --f'4 -r- v, Zip ,. Date Construction Permit Issued by PCHD YY Separate Sewerage System built by Sji dl < A � --7`Address CFA -t-c Consisting of / _Gallon Septic Tank and L,��, 'e / Other Requirements: Water Supply: Public Supply From, Address or: Private Supply Drilled by Address Od%j2 �-••, �� -5- Building Type �i' /,ciG �f� i''ri �� Has erosion control been completed? Number of Bedrooms 'f— Has garbage grinder been installed? A& 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 accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of thSy Countj/pent of Health. Date: / /o 4 Certified by P.E. R.A. .� `al `fin -'—G —� Address �� rt a .� li k �i License # %''J Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocati , mo fflcat r c ge is necessary. By: &jL41 Title: Date: i fori White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pr essional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH H 4-�.L I VIRO V 1 V ENTL.•]i� g;E �L �.�.LL _ ��A® Y "�'O - GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Bu' ing D_e VZ,iddV Building Constructed by ef, 7 2- 3 Tax Map Block Lot �illage ZS2- �Yog� ��, ®�'. Ate e,- 6/0%"r Location - Street Subdivision Name ry � 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 part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of of.the-building utilizing the ,- The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month_ Day w Year Signature: t12�7;�3 Title: - �' General Contractor (Owner) - Signa e ion Name (if corporation Address: State Zip XZJ�,G Corporation Name (if corporatio) �. Address:��C�' ;��JMrr7 L.g,L State ' ,AG Form GS -97 i 0 WMj_ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT ell Location Street Address: wn/Village.- Tax Grid # Map?,'? Block/ Lot(s) Well Owner: N me: Address: C PdQ4 Use of Well: 1- primary 2- secondary Residential Public Supply it cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment iC Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing x Open hole in bedrock _ Other Casing Details Total length 1 i-5' ft. Length below grade / z3 %ft. Diameter d in. Weight per foot /G lb /ft. Materials: _ Steel _ Plastic _ Other Joints: _ Welded x Threaded _ Other Seal: >G Cement grout _ Bentonite Other Drive shoe: --Yes No Liner _ Yes X No Screen Details Diameter (in) Slot Size Length(ft) IDepth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test _ Bailed _ Pumped S�Compressed Air Hours Z Yield L gpm Depth Data Measure from land surface- static (specify ft) obi During yield test(ft) Depth of completed well in feet 3�� 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 3 300' G If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type 3 t rye_ Capacity 5— Depth aR Model Voltage ?%34 HP y Tank Type k3do Volume Date Well Completed Putnam County Certification No. rt Date o Repo �jd f � oa Well Driller (signature) G� INUI�: upct location of well wim Q1stances to at least two permanenL IZUIU111dy b LV UU piUviucu un a bvpalam aimv, F aul. Well Driller's Name Address- 'mil Signature: Date: / Z D White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 YML EN�I ERVICES �� :��/ �u�:x:� ]H*�e��t��'.J��'�^�1059��'��`��' (914) 245-2800 Albert H. Padovani, Director LAB #: 93.000976 CLIENT #: 12331 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MALONEY, EUGENE L. 202 WOOD ST. MAHOPAC, NY 10541 DATE/TIME TAKEN: 07/05/00 12:00P DATE/TIME REC'D: 07/05/00 12:30P REPORT DATE: 11/14/00 PHONE: (914)-621-9791 SAMPLING SITE: 12 MEADOW CREST DRIVE SAMPLE TYPE..: POTABLE : MAHOPAC, NY PRESERVATIVES: NONE COL/D BY: E. MALONEY TEMPERATURE..: < 4C NOTES...: KIT TAP ` COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 0-15 ppb 9101 ' 07/05/00 MF T. COLIFORM PRESNT /100 ML 07/05/00 LEAD (IMS) <1 ppb 07/05/00 NITRATE NITROG <0.2 MG/L 07/05/00 NITRITE NITROG <0.01 MG/L 07/05/00 IRON (Fe) 0.246 MG/L 07/05/00 MANGANESE (Mn) 0.015 MG/L 07/05/00 SODIUM (Na) 23.2 MG/L 07/05/00 pH 7.3 UNITS 07/05/00 HARDNESS,TOTAL 152 MG/L 7 /00 ALKALINITY (AS 170 MG/L - - - .-.-�� —'' 07/05/00 - - �TURBIDITY (TUR�-'' �� <1NTU' 07/05/00 E. COLI (CONFI ABSENT 100/ML ABSENT 1008 0-15 ppb 9101 ' 0 - 10 9139 N/A 9146 . 0-0.3 mg/l 2037 0-0.3 mg/l 2037 N/A 6.5-8.5 9043 N/A N/A �0" '5-]NTV ABSENT | COMMENTS: BACT THESE RESULTS INDICATE THAT THE.WATER (WAS) F A SATISFACTORY SANITARY QUALITY ACCORDING TO THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /CU LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive 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 YML'ENVIRONMENTAL SERVICES 321 Kear Street _ (914) 24572800 | ' Albert H. Padovani, Director | LAB #: 93~000976 CLIENT #: 12331 NON STAT PROC PAGE 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MALONEY, EUGENE L. 202 WOOD ST. MAHOPAC, NY 10541 SAMPLING SITE: 12 MEADOW CREST DRIVE : MAHOPAC, NY COL'D BY: E. MALONEY NOTES...: KIT TAP ---------------�� DATE FLAG PROCEDURE is suggested. DATE/TIME TAKEN: 07/05/00 12:00P DATE/TIME REC'D: 07/05/00 12:30P REPORT DATE: 11/14/00 PHONE: (914)-621-9791 SAMPLE TYPE!.: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORMMETH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 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 CARBONATEv 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. -'.-SOXFr--WArEF;:�-0-70AMG/L' 2'~- - '\/ERY, HARD -WATE]R::`,A8nVE''��0�''�K0/L��-'-` MODERATELY HARD WATERs 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L 11 grain/gallon = 17.2 MG/L> SUBMITTED BY: Albert H. Padovani, M.T.(ASCF) Director ELAP# 10323 ` ' YML ENVIRONMENTAL SERVICES 321 Kear Street _ _ y;�-1�t��-�He / (914) 245-2800 | Albert H. Padovani, Director | | | LAB #: 32.005068 CLIENT #: 12331 NON STAT PROC PAGE 1 MALONEY, EUGENE L. DATE/TIME TAKEN: 08/11/00 10:15A 202 WOOD ST. DATE/TIME REC'D: 08/11/00 10:50A MAHOPAC, NY 10541 ' REPORT DATE: 11/14/00 PHONE: (914)-621-9791 SAMPLING SITE: 12 MEADOW CREST DR. SAMPLE TYPE..: POTABLE : MAHOPAC, NY, 10541 PRESERVATIVES: NONE C[]L'D BY: EUGENE MALONEY TEMPERATURE.": < 4C NOTES...: BATHTAP COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD 08/11/00 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 COMMENTS: ` BACT THESE RESULTS INDICATE THAT THE WATER WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI�� )THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. SUBMITTED BY: ELAP# 10323 I. , - -- DANIEL J. DONAHUE, P.E. A.,,ONSULTI�jG 120 Breckenridge Road Mahopac, N.Y. 10541 914-628-7576 November 6, 2000 Putnam County Department of Health Geneva Road Brewster, N.Y. 10509 Att: A. Steibling RE: As Built SSTS Lot #10 Meadowcrest Drive Putnm Valley TM# 85.07-1-3 Dear Mr. Steibling: Enclosed please find: 1. Certification of Construction Compliance 2. Well Log and Bacti Results 3. Guarantee and two copies 4. Four copies of the asbuilt plan 5. Filing fee of $200.00 .6. E911 Verification. Letter By: Daniel 1: Donahue, P.E. Site - Sanitary - Environmental U-) C) GO U-1 2-, C) CV7 C:) Site - Sanitary - Environmental OCT -26 -00 THU 03:30 PM YML FAX:4142453120 PAGE 1 YML E jjRpNMEN AL S RVICES -i. F:.earree _ -:�'• .,'4• a...... r�.�.:.y. - 4�:ire = a...- ,4. -'se+ 3k "�c.� "" - wA: ". �..,�,•o.t� r: - 4isb�e� =es. ,.. sv '�r''i" �.:�. e.. �' _ ....'-0:..a .. -Yor•Ictown�Heag�ity, N.Y. i +�� (914) 245 -2800 Albert H. Padovani, Director LAB 0: 930000976 CLIENT ##: 12331 NON STAT PROC PAGE 1 . rN. v. v- -- -MNN- --- V------ -IVNNNNNNNNIVN NNNNN NNIVNNNNNNNNNNN NNNNNNNNNNNNNNNNNNNNNNNNN MALONEY. EUGENE L. DATE /TIME TAKEN: 07/05/00 12 :00P 202 WOOD ST'. DATE /TIME RECD: 07/05/00 12:30P MAHOPAC, NY 10541 REPORT DATE: 10/26/00 PHONE: (91i►)- 621 -9791 SAMPLING SITE: 12 MEADOW CREST DRIVE SAMPLE TYPE..: POTABLE : MAHOPAC. NY PRESERVATIVES: NONE COLD BY: E. MALONEY TEMPERATURE..: < 4C NOTES..,: KIT TAP COLIFORM METH: MF NNNNNNMNN N,,, ------------------------ --- NNN NNNNNNNNNMNNN,..NNNNNNNNNNNNNNN NNNNNNN DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 07/05/00 MF T. COLIFORM ABSENT /100 MI_ ABSENT 1008 07/05/00 LEAD (IMS) <1 ppb 0 -15 ppb 9101 07/05/00 NITRATE NITROG <0.2 MG /L 0 - 10 9139 07/05/00 NITRITE NITROG <0.01 MG /L N/A 9146 07/05/00 IRON (Fe) 0.246 MG /L 0 -0.3 mg /l 2037 07/05/00 MANGANESE (Mn) 0.015 MG /L 0-•0.3 mg /1 2037 07/05/00 SODIUM (Na) 23.2 MG /L NIA 07/05/00 pH 7.3 UNITS 6.5 -8.5 9043 07/05/00 HARDNESS,TOTAL 152 MG /L NIA 07/05/00 ALKALINITY (AS 170 MG /L N/A 07/05/00 TURBIDITY (TUR <1 NTU 0 -5 NTU COMMENTS-; BACT THESE RESULTS INDICATE THAT THE WATE n-(WASWAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD.limits for p EPA Lead & Copper than 10% of . their than 15 ppb and a treatment must be potential. jblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg /L, else water undertaken'to reduce the waters corrosive 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. OCT -26 -00 THU 03:30 PM YML FAX:9142453170 PAGE 2 YML ENVIRONMENTAL SERVICES _321 Kear. Street `oi°'k t'dii FieY c�h is ( 914 ) 245- 2800 Albert H. Padovani, Director LAB #: 93.000976 CLIENT #: 12331 NON STAT PROC PAGE 2 N N- N N N--------------------------------- - N- -- --- N N N N-- NN --- w- N- N-- -- N N- N w N- MALONEY, EUGENE L. DATE /TIME TAKEN: 07/05/00'12:OOP 202 WOOD ST.. DATE /T'IME REC D: 07/05/00 12:30P MAHOPAC, NY 10541 REPORT DATE: 10/26/00 PHONE: (914) -621 -9791 SAMPLING SITE: 12 MEADOW CREST DRIVE : MAHOPAC. NY COL D BY: E. MALONEY NOTES...: KIT TAP - Nww -N-N N-N N- NNN- N- N ----- NNNNN- N- N- ---- DATE FLAG PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METHS MF - N -- N N- N N N- N N N-------- N --------- N ------ 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 'mE CALCIUM & MAGNESIUM CONCENTRATION. BOTH EXPRESSED AS, CALCIUM CARBONATE, IN MG /L. THE .HARDNESS MAY RANGE FROM 0.T01 HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT T'0 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: 144 -3C >0 MG /L (! grain /gal lon = 17.2 MG /L ) SUBMITTED BY- :__�_____,J___ - �-- lbert H. Padovani, M.T.(ASCP) Director ELAP#F 10323 Public Heali/t Director Associate Public HeaUh Director Dineetor of Pattern &rvkxs DF2ART&ffiWT OF HFALTH 1 G1e ®a Road Brewster, New York 10509 Environmental Hcdtb (914)278-6130 Fax (914) 278-Ml 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 TAX EMAP RS NAME: a AX 1V rYJEBEF.-. ]E911 ADDRESS: TOWN: Z 0rst- C 13 ) �- Y F..4rrrn0 C`'je C,,S7 --)/ f �F� AUTHORIZED TOWN OMCIIAL: (Signature) IlDAT` E: C'o rj .. _ .,.. � .._ � ..�: ,. �: %` .,fir_,:... _ .. � r ._. _.._ .. _._ ...._ , � ., �.. _ - _��:,.•........� �.__....._ - -- The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, Le., a legal E9111 address is assigned by an authorized Iowan official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERMO BRUCE R. FOLEY.. X brz2 ` *ealih Dire' 4Ar -LORE'TA. YI40LINARI -RN. Associate Public Health Director Director' of Patient Services DEPARTMENT 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 (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 November 13, 2000 Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 Re: Application of Certificate of Construction Compliance, 12 Meadow Crest Drive TM# 85.7 -2 -33, Town of Putnam Valley Dear Mr. Donahue: This office has determined that the above referenced Certificate of Construction Compliance application, received by the Department on November 8, 2000 is incomplete. Please be advised that the following information is required before the Department may commence its review. Original copy of Water Quality Analysis, a copy is not acceptable. � C t %-(r This office will continue its review upon consideration of the above mentioned comments. Please feel Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj BRUCE R LEY, Public Health Director _ _ a .i;t� rTr Mb mrAiZY It:IV., MIX** Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH H 1 Geneva Road Brewster, New York 10509 Environmental health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (9 14) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 June 15, 2000 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 Mr. Dan Donahue, PE 120 Breckenridge Road Mahopac, New York 10541 Re: Jastine, Meadows Realty Subdivision TM# 85.07 -2 -31, Lot #10, (T) PV Dear Mr. Donahue: As discussed at the joint site inspection on Wednesday, June 14, 2000 the following is required by this office. A. Elevation shots to be taken at all distribution box tops and top of pipe(s) at all ends of laterals. B. Adjustment of "set" distribution boxes if feasible based on field elevation survey. C. A minimum. of at least 8" of cover over the top of lateral piping to finished grade. :... _- .T..would asL to beprese_rlt:during field elevation survey and request, grade stakes be=ava l&1e for installation for required finished grade elevation notation. Please contact this office to schedule field appointment. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj cc: Jastine Construction Corp. 12 Z _311 0--0 t .� � r ,. �: *6' � r_q .'_�6.•. '., ,. r C`t : — .�*. r,. ., ��'; as�� - [ti� ..DK }:.. A�: ..�F.: r ut• .t� 0 n ...BRUCE ,.:E -F.G E54 s=.a v•�: , ... Public Health Director r.'=;.LQRETTA•i-,UOLWAF.I =R.i1 ;M.SN. Associate Public Health Director Director of Patient Services DEPARTMENT OF B EEA,TH 1 Geneva Road Brewster, New York 10509 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 April 11, 2000 CERTIFIED RETURN RECEIPT REQUESTED Jastine Construction Corp. 8 Apple Summit Lane Lagrangeville, New York 12540 Re: Meadows Realty Subdivision Lot #10 Meadow Crest Lane TM# 85.07 -2 -31 Dear Christine L. Garay: It has been brought to my attention that construction on the above referenced lot has begun. - Tliis notice isrty advise you that the required erosion`canir 'measures-have'not-t een installed-of are installed incorrectly, as shown on an approved plan dated November 22, 1999. Effective immediately, a notice of non - compliance will be issued for a violation of the Putnam County Sanitary Code, Article III, Section 2, Paragraph C, and a stop -work order shall be requested from the Town Building Department as required by Article III, Section 2, Paragraph D. This matter is to be corrected by Monday, April 17, 2000. Please feel free to contact me at ext. 2157 if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj cc: (T) PV Building Inspector Dan Donahue, PE :•„-• - . E��C?�B° ;� : FOB:' - -• ..- '�� - . n . - Public Health Director Date: 13 00 To: _' �L0RETfA MOLiNtiRl' RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH I Geneva Road Brewster, New York .10509 Environmental Health (914) 278 - 6130' Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 F ?ax (914) 278 - 6648 wlc F1AX7C 9 OVER SHEET - 6085 From: Adam B. Stiebeling Asst, Public Health Engineer Fax #: No. Pages —2 (Including cover sheet) y : :tiol? - - -- - Please respond: _ F your review As discussed Notes/Messages V V4 V/W-? A L Attached as requested Please call joo,� �T 'S 7.z10 i '�o OAJ O -rte) In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 157. PU'IITNAM COUNTY DEPARTMENT OF HEALTH IIvap (DF_ :]FNwR(QNMJE1��'AEI.�_ I IC,'�'1�[��]EIl�V CES :� .. e. c.. r. "'". "-. *w7 .. .. , st •. c". .'..:+� ..c CONSTRUCTION ]PERMIT FOR SEWAGE TREATMENT SYSTEM PE # -� r Located at Village' Subdivision name Subd. Lot # le) Tax Map f- &2Block J Lot ,? / i Date Subdivision Approved I �jf Renewal Revision Owner /Applicant Name j &Ujt rI Date of Previous Approval Mailing Address k & rte. Amount of Fee Enclosed '" � lrD Zip Building Type' 1171 7 Lot Area No. of Bedrooms `�t_ Design Flow GPD &)Q Fill Section Only Depth Volume PCl$IID NOTIFICATION IS RE UIR EIID WHEN FILL IS COMPLETED ;; System to consist of Z1, 01) gallon septic tank and Other Requirements: To be constructed by Address Water Su yiDW:, Public- Supply From...:: Address or. jC�-- Private Supply Drilled by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage 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 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 repairs t reto. Signed: P.E. R.A. Date Address i-% L /-� li-fo License # APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the P blic Health Director. Any revision or alteration of the approved plan requires a new roved fo arg f do stic sanitary se age only. By: Title: Date: Z White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Pro ssional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT -A WATER WELL - -•' ��}`y /�{' .f,. f..i•D, � rl .... Y4. �= .•i�.,r��¢_. }jM. � ... r - siL�s.v. i�t'. �'V'U [. .•. i^ 4 i 9 ♦ 6.' •'. rr � `r V / �C '� \.mss ��4'1f 1` please print or type PCHD Permlt V Well Location: Street Address: To illage Tax Grid # MaP yi',4.17 Blocka Lot(s)?/ Well Owner: ame: Address. Use of Well: residential Public Supply Air /Cond/Heat Pump Irrigation rimary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought _ gpm a le Served . Est. of Daily Usage L ?, gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason S' Pr i �7 lelert Ae414.1 -- for Drilling Well Type 01-Drilled Driven Gravel Other Is well site subject to flooding? ................................................ ................................ Yes No Is well located in a realty subdivision? ...................................... ............................... Yes 4 No Name of subdivision y/)d sy�.f' Lot No. le Water Well Contractor: r–l'sr V Address: Is Public Water Supply available to site? Yes No Name of Public Water Supply: '— Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be pro rided on soxate sheet/plan. 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. 2' Date of Issue � � Permit Iss g Official: Date of Expiration G% Title: Permit is Non -Trans erra le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH D1W_5ff0.N_OF. DENVER NMEN 7AL H EA_g TH. SSE 'RVXE5._ ._ ..r RE: Property of Located at LETTER OF AUTHORIZATION (T,k &� IN/ '�11- 41f7Tax Map # ?'S , 07.6? - G'69lock Subdivision of 0 Lot Cam. t`l?7 Subdivision Lot # ` Filed Map # OaQ ( Date Filed Gentlemen: This letter is to authorize )) AU 1' F L bVk) a duly licensed Professional Engineer � or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with. the'-provisions, of-Article 1-45 and/or 11,47. Of the Education Law,. the Public health Law, and the Putnam County Sanitary Code. Countersigned: P.E., R.A., 4 (�7' Mailing Address /4-0 ��~ �'� i = State Zip / Telephone: Very true yours, Signed: Lazl�_ aLl�e (Owner of Property) Mailing Address:, f � State L4 zip —2 a C D Telephone: '� S Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT= 'CC)YLPORATE °OWN�ER=API'L'IC. T110N: ;.... ::. FOR PERMIT'APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Board of Health Approval 1, Daniel E. Garay, Jr. represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Jastine Contracing Corp. Having offices at: 8 Apple Summit Lane, Lagrangeville, New York 12540 Whose Officers Are: President - Name: Christine L. Garay Address: 8 Apple Summit Lane, Lagrangeville, New York 12540 Vice President - Name: Daniel E. Garay, Jr. Address: 8 Apple Summit Lane, Lagrangeville, New York 12540 Secretary -Name: Address: �-- `Treasurer Name:. _.. � .. �•: �. , . � y w: _.. �. __�..:- . __.._.. � .: � ...: - .. � _ • �.�- .. _ .::__':�::'e: Address: and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts Sworn to before me this day of 0C h , r (month) 1 (year) Nogary Public SM 7. WINN Notary Public, State of New York No. 4901244 Quallfled in Westchester Count COMMlssion Expires Aug. 3, Form CA -97 Corpor, e DANIELS. DONAHUE, P.E. CONSULTING ENGWEERS ... , ... t`.. :.�..:% .. c..: derma. .. _ .. .. .��- :�. s '.Y"wo �- ... �... ".. . q ... -r t- r .. �.. +v ,.. _ . ....&. :�. ��r . •Fa•o i: -. �., :♦ '� R 9 120 Breckenridge Road Mahopac, N.Y. 10541 914 - 628.7576 October 26, 1999 Putnam County Department of Health Geneva Road Brewster N.Y. 10509 Att: Mr. Adam Steibling. RE: SSTS Permit & Well Permit Property of Jastine Contracting Corp. Meadows R.S. Lot #10 Putnam Valley Dear Mr. Steibling: Enclosed herewith please find the following: 1. Form PC -1 2. SSTS application 3. Well permit application 4. Design data sheet 5•'. Letter of authorization 6. Fee in the amount of $300.00 8. Corporate Affidavit 9. Two sets of house plans 10. Three sets of construction plans By: Daniel J. Do e, P.E. Q Site o Sanitary o Environmental I I/ • �Q IBC PT a, _ '..y ,. . Z.•i..." - -,ate n � � �� . 64t4_ 1 COOAA ±t Q' ht'CS l'iwl4 n o awl o u �L -?� o� Tie �$� ell- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF E"RONMENTA]L HEALTH SERVICES , APPLICATION' FOR`APPROVAL OF'-Pi ANS FOR, A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: %N l�i�' G °'r`l �` 7 2. Name of pr0ject:zaV',S'g.7s 3. LocationQV: 4. Design ProfesAonal:Z),g/y po��ANuF,r?r'. 5. Address: /.,i{1 &g,c~fNRl,ue !Pp 6. Drainage Basin: l,�;r�, M �X a ,��.� /v, ' 7. TYRe of Proiec : Privatesidential .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 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... NC 10. Has DEIS been completed and found acceptable by Lead Agency? ............... /Y I L Name of Lead Agency d a i .1.2.. Is_this.project.in.an area under the control of local planning, zoning, .or..other. ..y — .-........................................ ............................... .r �. ..ai ^... w- ...�ety.. u � •. .... ca,+V a- ..,.G C.�.• Sr. .��r . .. .. jr— ..� .,`Y• ..�+'I ". �. .., .. officials, ordinances? ................. 13. If so, have plans been submitted to such authorities? ........ .....:......................... NO 14. Has preliminary approval been granted by such authorities ?A& Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water K-. groundwater 16. If surface water discharge, what is the stream class designation? .................... All# 17. Waters index number (surface) ............................................ ............................... /1' /#y 18. Is project located near a public water supply system? ....... ............................... it/Q 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................* /00 21. Name of sewage system d tfi Distance to sewage systern' &moo 22. Date.test holes observed Y3&P 23. Name of Health Inspector.!". 9� alsA J��t 24. Project design flow (gallons per day) 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... A1n 26. Has'SPDES Application been submitted to local DEC office? ......................... Nfo 2 27. Is any portion of this project located within a designated Town or State wetland ?_ 28. Wetlands ID Number .......................................................... ............................... 29. Is Wetlands Permit required? ............................................. ............................... Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... AM 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or " other _ crops, solid or hazardous waste disposal, landfl"ing,.sludge application or industrial activity? ............................ Yes l6 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 6 DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... i;rx 34. Are community water and/or sewer-facilitie's planned to be deve1'6 d .rith; 15 years in 'or ad to project site? ......... .....:....... :.......... _ Nei 35. Are any sewage treatment areas in excess of 15% slope? . ............................... juO 36. Tax Map ID Number .......................... ............................... 1VIa C,Q/ Blocky_ Leki jL j 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 DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, sander penalty, offer, jury, that information Provided on this form as trace to the best of may knoWedge and belief. False statentbas made herein are pullshable as a Class A misdemeanor pursuant to'S' ction 210. of th P 1 Law. SIGNATURES & ®FFICL4L TITLES. Mailing Address: ................................... PUTNAM COUNTY DEPARTMENT OF HEALTH ENVIRONMENTAL HEALTH SERVICES. DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner - (4SrIlvIff e Address. Located at (Street) e- Vrl A—. Tax Map Block Lot (indicate nearest cross street) Municipality Watershed J644-kzl"Ioll SOIL PERCOLATION TEST DATA Date of Percolation Test . J Date of Pre-soaking 7 ... ...... .................. ......... ................ ........... ... .. ..... . ...... ........ . ....... . 2 0 PL 3 CIL 14 5 Y 2 13 3 d 6 4 5 2 3 4 NOTES: I.- Tests to be repeated at same depth until approximately equal percolation rates are obtained of each percolation test hole. (i.e. s I min for 1-30 min/inch, :5 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 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH H- OLE N0. HOLE NO HOLE NO G.L. 0.5' 1.0' 1.5' 2.0' 25 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered 2 Dee hole observalions made by: - /'�'��i'r` f' 1-r Date l Design Professional Name:.' Address:.�,��°��re. Signature: Design Professional's Beall c' Uj ,,? 2 14.184 (2187) —Teat 12 PROJECT I.D. NUMBER 61%.21 7Aopandik-, ..... ` . ; SEAR' State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APP L CANT /SPONSOR 2. PROJECT NAME 9. PROJECT LOCATION: Municipality U��/%xl G L o; County t. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) S. IS PROPOSED ACTION: New ❑ Ex ;ansion ❑ Modificatlonlalleratlon S. DESCRIBE PROJECT BRIEFLY: Pi��u d 'jii! rJ 7 /d N p Ni t 4 7. AMOWri OF LAND AFFECTED: initially - acres Ultimately 96 acres 8. WILL PROPOSED ACT] 014 COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes Q No It No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? r-1 r Restdentia! "u lndustriil' ';y` O'COmmeroliI ' � ArAcu)!'�rn _�, .. F"Fordstl0;an e;^sce y t..J Other• -• 1••- —v 10• DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE OR LOCAL)? Yes ❑ No If yes, list agency(s) and permlVapprovats 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes No It yes, list agency name and pertilUapproval 12. AS A RESVLT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑ Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appllcant/Sponsor -to` Q� ' —` Date: name: Signature: ' rr.. It the action Is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER to PART 11-- ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN S NYCRR, PART 111117.112? If yes, coordinate the review process end use the FULL EAF. DYOa ONO - +�,�•"S- �.j.........W.— �.__ arc n .. .. wn ti, bYIL.ACt10fY RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN f) NYCRR, PART 617,0? it No, a negative declaration My be superseded by another Involved agency. • . ❑ Yes C. COULD ACTION RESULT iN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) Cl. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, 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 Character? Explain briefly: C3. Vegetatlon or fauna, fish, shellfish or wildlife species, significant habitats,.or threatened or ondengered species? Explain briefly: Al,�,we Ca. A community's existing plans or goals as officially adopted, or a change In use or Intensity of use of land or other natural resources? Explain briefly CS. Growth, subsequent development, or related activities likely to be Induced'Qy the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other offects not identified !n C1•Cti? Explain briefly. C7. Other Impacts (including changes in use of either quantity or typo of energy)? Explain briefly. 0. IS THERE, OR IS THERE LIKELY TO BE. CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? D Yes Mft If Yes, explain briefly PART ill — DETERMINATION OF SIGNIFICANCE (Po be completed by Agency) INSTRUCTIONS- For each adverse effect Identified above, determine whether it is substantial, large, Important or otherwise significant. Each effect should be assessed In connection with its (a) setting (i.e. urban of- rumQ-,.(b) probability of occurring; (c) duration; (d), Irreversibility; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials, Ensure that explanations contain sufficient detall to show that all relevant adverse impacts have been Identified and adequately addressed. D Check this box If you have identified one or more potentially large or elgnificant adverse Impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any ralgnlflcant adverse envlronmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: I Name of ea Agency Print or Type Name of Responsiblo 61ficar in Lead Agency Title of esponsi a dlrcer rr . .,gnotvre of esponsl a Officer in tead Agency Sianotife at eepater (it dif terent from responsi e o icert ate FA/NT ARK .-586'45'10"E /00.00 STONEMWALL ON i TO STONE WALL GENERALLY ON PROPERTY L/N jEXISTING WEL; J LocanoN SSTS TIE - INS (MEASURED BY TAPE) � Q � 30 -ft. -ft. REA R :SFTFLgG Y) SENPITTI'C .< . TANK -A..� •B 27 •_y, �rC1.7 � m = _ .• s^. F , ` ;. J. B.1 86 42 WELL LOCATED 10 /3/00. \ 2 84 45 I I 3 83 48 , 4 82 53 \obff \ \ STAKE SET 5 82 57 6 81 61 p�. AREA: I 7 81 66 8 81' 70 z 4 53 sq. ft. END OF TRENCH 1.02 acres 9 123 103 10 119 95 11 128 103 1 ? 12 129 97 13 121 87 q W I SLATE E 14 122 85 ro p 0 STY. BR1CK 'CM EY r 15 118 78 I Y TO 33 1 tioo 16 118 74 I foepdo 64 17 55 18 illy, 1 \ STAKE SET 18 50 26 45.8' %�� ME \ `� // 20 399 40 fou o on \r°n I 21 30' 46 4 22 30 53 Q! 23 25 61 GAR4 U3 11 11 . 4A r m Q � 3 W V 'Z •O ,a C r �`� a� FR R Bf+GK io W _ - 5— F" I ' to e 531 L,Ir !_ R= 381.161 .40161'5 I n If 1kt � N PL N TO 7 CABLE T.V. ELEC. 0e Iva — E _ RIV CABLE T.V. CATCH SASW D M E A D O W SURVEYBY. LINK, THIS IS TO CERTIFY TNAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE . WITH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH ASBUILT PLAN SEWAGE TREATMENT SYSTEM I JASTINE CONTRACTING CORP. LOT #10MEADOWCREST. DRIVE rUU*34''wU nLY LtljrBi'U"r vI Atlr AVA TM #8507 -2-31 4y161on of Environmental Realth'34mioii• PUTNAM VALLEY (T) tyyroved as noted fo 'Con%oralli: n1 ai„h. syyl cable ea and gulatiorw t:.l the DANIEL, J. DONAHUE, P.B. Put C th artment., CONSULTING ENGINEERS 628-7576 l 4mw MAHOPAC, N.Y. 10541 '1:agnature A. T+ +.7 DATE: OCTOBER 6, 2000 lt%r -,. SCALE 1 " -30' ROLAAID LS Q�pfES�\lr,� SURVEYBY. LINK, THIS IS TO CERTIFY TNAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE . WITH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH