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BOX 35
�IL T J6 ; .�, . Ir
16 em %I Pei 11 Ike
'*j
' 2 . L1 - ■
1�
Located at
Owner/apo"Caut
Mailing Address
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division'oi,Em*6.nftentid.l.teal&!Si' tiimA Y. 10512
En
glazer Must Peovide . 1', `�-�g.
P.C.H.D. Permit
of,
e-
KCONSTRUCTION CONTUANCE.FOR. SEWAGE DISPOSAL SYSICEM
•
el AA lwllce Tax, Map -r _Block Lot
Forme Sub division Name
rly, Su' bdv. Lot
Zlt
//a I //rov, r4o ZIP 00' a 57 �Date Permit issued
Separate Sewerage System built Addrean 1-430'Ir
Consisting of Gallon Septic Tank and
Water Supply: Public Supply From Address
or: Private Supply Drilledby 417AOIVY4CV4P�,30'01 _Address __-1_!56!!:2je4�'_
Boding Type A0 Erosion Control: Been Completed?
Number, of Bedrooms Has' Garba g ' Grinder Been Installed?
e
Other Rkulreikeints
I certify that the system(s) as listed serving the above prdmisei were c6natiucCe.0 essentially as shown on the plans of the completed work, ( copies
of which are attached), and in accordance with' the standards, rules and regulations, in accordVc. witW?the fi4d plan; and the permit issued by -the
Putnam County Department Of Hpaith.
Date -7- Certified by P.E. R.A.
Add ass )h License Net
Any person occupying promises served by the pv..syste.(s) shall promptly c is "y necessary to secure the correction of any unsenitary
P .11 Z., I
conditi, ns resulting from such usage. APO, yal of the separate sawersis system shWI become hull and void as soon as a pubt�sonitiry lower becomes
Z
available and the approval of the private wate.r, supply shall, become null and void whon a public' water supply becomes available. • Such approval's are
subject to modification rlcchange when, in the judgment of the Commissioner.of Health, such revocatla modification or change Is necessary.
V
Date— BYAIZ_7�� Title
V86 I`.
Located at
Owner/apo"Caut
Mailing Address
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division'oi,Em*6.nftentid.l.teal&!Si' tiimA Y. 10512
En
glazer Must Peovide . 1', `�-�g.
P.C.H.D. Permit
of,
e-
KCONSTRUCTION CONTUANCE.FOR. SEWAGE DISPOSAL SYSICEM
•
el AA lwllce Tax, Map -r _Block Lot
Forme Sub division Name
rly, Su' bdv. Lot
Zlt
//a I //rov, r4o ZIP 00' a 57 �Date Permit issued
Separate Sewerage System built Addrean 1-430'Ir
Consisting of Gallon Septic Tank and
Water Supply: Public Supply From Address
or: Private Supply Drilledby 417AOIVY4CV4P�,30'01 _Address __-1_!56!!:2je4�'_
Boding Type A0 Erosion Control: Been Completed?
Number, of Bedrooms Has' Garba g ' Grinder Been Installed?
e
Other Rkulreikeints
I certify that the system(s) as listed serving the above prdmisei were c6natiucCe.0 essentially as shown on the plans of the completed work, ( copies
of which are attached), and in accordance with' the standards, rules and regulations, in accordVc. witW?the fi4d plan; and the permit issued by -the
Putnam County Department Of Hpaith.
Date -7- Certified by P.E. R.A.
Add ass )h License Net
Any person occupying promises served by the pv..syste.(s) shall promptly c is "y necessary to secure the correction of any unsenitary
P .11 Z., I
conditi, ns resulting from such usage. APO, yal of the separate sawersis system shWI become hull and void as soon as a pubt�sonitiry lower becomes
Z
available and the approval of the private wate.r, supply shall, become null and void whon a public' water supply becomes available. • Such approval's are
subject to modification rlcchange when, in the judgment of the Commissioner.of Health, such revocatla modification or change Is necessary.
V
Date— BYAIZ_7�� Title
mIA- _sc �
WbLL UV11r.UM11U11 r"•rVAI Office Use.Only
DEPARTMENT OF HEALTH
P
_Dlvia o
i b. "Of _Eriv..4-tq;;�t4n
PUTNAM COUNTY DEPARTMENT OF HEALTH
STAaEET ADDRESS:'MWNIVI 1 TAX GRtO NUMBER:—
11WELL LOCATION IV
�P
p 1
WELL OWNER
AME.-
�4
ADDRESS:
TE
PUBLIC
USE OF WELL
1 - primary
2 - secondary
IC;7-
RESIDENTIAL ❑ P IC SUPPLY ❑ AIR/COND./HEAT POMP CIIABANDONED
❑ BUSINESS ❑ FARM ❑ TEST/OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑
AMOUNT OF USE
YIELD SOUGHT
gpm./NO. PEOPLE SERVED --/ EST. OF DAILY USAGE J 1 62 -gal.
REASON FOR
DRILLING
ji3-NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION
❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH
-ft.
STATIC WATER
_LEVEL Lft-
DATE MEASURED
DRILLING
EQUIPMENT
NOTARY 0 COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL ftNT ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED ❑ OPEN END CASING. [3 OPEN HOLE IN BEDROCK ❑ OTHER
TOTAL LENGTH
tL
MATERIALS: OSTEEL OPLASTIC 00THER
CASING
DETAILS
LENGTH .BELOW GRADE
wl 1Y ft.
JOINTS: ❑ WELDED RTHREADED ❑ OTHER
DIAMETER
in.
SEAL: ❑ CEMENT GROUT ❑ BENTONITt CROTHER
WEIGHT
PER FOOT
lb./ft
DRIVE SHOE. 0 YES ❑ NO LINER: O YES SNO
SCREEN
T
DIAMETER (in)
'SLOT SIZE
LENGTH
(ft).
DEPTH TO SCREEN (it)
DEVELOPED?
FIRST
.01-YES- ONO
HOURS
SECOND
GRAVEL PACK
I YES
0 NO
GRAVEL
SIZE:.
DIAMETER
OFPACK in.
TOP.
DEPTH _ft..I
BOTTOM
DEM ft.
WELL YIELD TEST I If detailed pumping
m
pumping ]donein-
METHOD: 0 PUMPED 1 tests were done is in-
is
attached?
)% COMPRESSED AIR formation attached?
No
0 BAILED ❑ OTHER 0 YES 0 NO
It more detailed formation descriptions or sieve analyses
WELL LOG are available, please attach.
DEPTH FROM
SURFACE
Water
Pear-
ing
Well
Dia-
mete
In
FORMATION DESCRIPTION
cooe
it.
-ft.
WELL DEPTH
DURATION
hr. min.
DRAWOOWN
ft.
YIELD
YIELD L
gprn-
gpm
Land
Surface
"lot
S�'o (on
7V-
WATER ❑ CLEAR TEMP.
QUALITY ❑ CLOUDY HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? 0 YES 0 NO
STORAGE TANK: TYPE
CAPACITY GAL.
PUMP IXF RMATION
t
TYPE CAPACITY
MAKER DEPTH
MODELS i YVOLTAGEL3_HD
I f_
LER NAME
WELL DRQj Og.YE �4
g
ADD _ SIG1119TURE
e 1�7
6/4
Yorktown Medical Laboratory Inc
LAB #
;87.0116921
321 Kear Street, bate Taken: 7-46-e Time: Q
_ _. ^Ynrktown Hei hts, N. Y.. 10598 Date, -Rc' d : _ -T- �. Time �/ :40 Awl
"(914) 45 -3203 'Dafe Reported. 1, '
Director: Albert H. Padovani M. T. (ASCP) Collected By: zdxg
Referred By: If
1- 1 Sample Location: /7 re
/fix. �./ ase,
7 P0�
e�i�s/u'l/ l/o /l®W. Tiv/d Phone #
loaj In /' ,#f /e / /(/, )/ Phone #
L J Repeat Test?
LABORATORY REPORT ON THE QUALITY OF WATER
INORGANIC NON- METALS (mg /L) MICROBIOLOGICAL (CFU /lOOmL•)
_ Acidity
— Alkalinity.
Chloride
Detergents, MBAS
— Hardness, Total
— Nitrogen, Ammonia
Nitrogen, Nitrate
— Phosphate, Total
_ Sulfate
Sulfide
Sulfite
GENERAL BACTERIA
Standard Plate Count
(CFU /1.OmL)
MEMBRANE FILTRATION TECHNIQUE.
Total Coliform
— Fecal Coliform
_ Fecal Streptococcus
METALS (mg/L)
MOST PROBABLE NUMBER TECHNIQUE
_ Copper
Iron Total Coliform Index
Lead,
hIangane' — Fecal Colifor�' Index
— Mercury.
— Sodium KEY FOR TERMINOLOGY
Zinc CFU = Colony Forming Units
MISCELLANEOUS
pH (units)
Color (units)
Odor (TON)
Turbidity (NTU)
N/A = Not Applicable
LT = Less Than ( <)
GT = Greater Than (>)
TNTC= Too Numerous To Count
CON = Confluent ( =TNTC)
NR = Non - reactive
REMARKS /COMMENTS (For Lab Use)
Sample Type:
(check one)
� 'Potable
— Non- potable
STP INF
-STP EFF
Other:
Sample Status:
(check each)
Outgoing:
_ HNO3
_ HC1
— H2SO4
_ NaOH
ZnOAc
_. Na2S203
Other:
^Incomings
LE
4 °C
GT
4 °C
—
— pH
LE 2
pH
GE 9
— pH
GE 12
Other:
FLAP #10323
THESE RESULTS INDICATE THAT THE WATER SAMPLE (WA:�) (WASN'T) (N /A) OF A
SATISFACTORY SANITARY QUALITY ACCORDING TO T NE YORK STATE DRINKING WATER
STANDARDS, FOR THE PARAMETERS TESTED, AT THE T E OF COLLECTIOODR .
THESE RESULTS INDICATE THAT THE WATER SAMPLE (DID) (DIDN'T) MEET THE
SATISFACTORY CHEMAL QUALITY STANDARDS OF THE NEW YORK STAT NKING WATER
CODES, FOR THE P$A*TE]�fl TESTED, AT.THE TIME OF COLLECTION.
X/ W
lbert H. Padovani, M.T. ASCPJ, Direct
2 /86(Rvsd7 /87)RWE
PUTNAM C0UM1!Y DEPARTMENT OF HEALTH
_ DIVISION OF ENVIRONMENTAL HEALTH SERVICES
... _. � ' o � b S 'f. , V : �..'*I :G4 4.Yc1 4'• C��.. �Y. rl9...4 °^ I —.. ... � e
Owner or Purc er of Building Section Block Lot
Building Constructed by
Location - Street
11'r-v- IL x'"41
Municipality
Building Type
Subdivision Name
Subdivision Lot #
GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it 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
herpy 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
:.411 gj.- ificate of Construction; Compliance" for the sewage disposal_ system, or any
repairs made by me to `6uc.�i systc�n, except wheretlie9 «lure -•to �- operate- gropgrly -is ,
caused by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive the determination of
theDirector of the Division of Environmental Health Services of the Putnam County
Deprtment of Health as to whether or not the failure of the system to operate was
cawed by the willful or negligent act of the occupant of the building utilizing
the system.
Dat d this day of c k ; e-19 69 Signature
Titlew�q�/
A4
Gerpral Contractor (Owner) S gnat' e
Corporation Name (if Corp.)
Coaration Name (if Corp.)
Address
Actress '
re. 9/85
rnk
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISIOkN OF ENVIRONMENTAL HEALTH SERVICES
L 16
Owner or Purchaser of Building Section Block Lot
To C Lt -r G Ckcw z
Building Constructed by
�- PQeitsauil ��lo�� Twru�iett-
Location - Street
ev rnr+tk V W ey
Municipality
Building Type
AbR, i<L,LA -- (-< MrC-S
Subdivision Name
3
Subdivision Lot #
GUARW= OF SUBSURFACE SEWAGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it 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 disposal system, or any
= teiiairs.'..gade by o: su_ ch system, excegt-.whPSe -the failure:.to- operate properly is
caused by the willful or''neg`ligeA ' "act` of '&6 ' occupant of'' •the 1building utr�izing-
the system.
The undersigned further agrees to accept as conclusive the determination of
the Director of the Division of Environmental Health Services 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 e building utilizing
the system.
Dated this day of ff aV • 19 ya"
Signature
6=_ 0!_9
Title
General Contra or Zownbrl - Signature
Corporation Name (if Corp.)
L� ®+alt + - �oNi�c.zSA i\1Y t 0,jV 3
Address
rev. 9/85
mk
A!/ 5
'fH tT C a Z -' %A)G
Corporation Name (if Corp.)
KEFe—ss
155 Colabaugh Pond Road
Croton -on- Hudson, New York 10520
March 2,1989
Mr. Lawrence C. Werper.
Putnam County Health Department
Division of Environmental Health Services
110 Old Route Six Center
Carmel, New York 10512
RE: Proposed SSDS Drella
Peekskill 'Hollow Tpke
(T) P.V. TM #118 -7 -9.3
Dear Mr. Werper:
In response to your letter dated 02/27/89, I am herewith
submitting the following:
1. One set of house plans, per your request.
2. Revised drawings 1 of 3 and 2 of 3 to reflect your
inquiry concerning the curtain drain which should
be a swale to divert water runoff from the road.
I trust that this submission will meet all of your
requirements for final approval of the subject property.
`.I t would' nave - beeri` more = expet3'i "ioizs "riad y5u- made h s'e.' ,<
comments and requests in your previous letter, since the'
plans reflected the same information and your request for the
house plans was probably inevitable. I have also returned
your phone call twice and left a message to return my call
and a number where I can be reached, but you have not
returned my calls.
Very truly yours,
Fred Ortmann, P.E.
CC: file
J. Drella
S. Ortmann
P.S. I think it would be in all of our best interests to
finalize and complete this application as soon as
possible.
FINAL SITE Ittia: \!ICN Date
y Inspects
by
SZ' UE T ICCATION Abv-16 //6 (,Wv -� %- � CWNFR
. PzRMIT Q A/ ���� 2M p OR SUBDIVISICN LOT p %�� ^.,•
II.
n . iU= al crw-ea =or es. -rs? en, ,eu%
9. Size of gravel 3/4 - li" diaFne_37
10. Depth of gravel in t-rench 12" mir.
L..• Pipe ends carned
h. PRAS OR DOSE SYSTEMS
1.
Size.-Of 'per . chanihY r.
-- - . 2. Over-.Elcw tank M
3. Alain, v? --iaa /audio
4. Purrs easily accessible zoj i
5. First bcx baf=1-ed
C9 •%
to Qrade
6. Cycle wit- nessed by Health Dew anent
esl`imated flow ze-- cvice
IV. fiXSE '
a. Flo, a located Der &yorq ed Dens.
b. Number of bedroars
V. wr;Ir
a. well located as per a =roved plans
b. Distance free SDS area re-- surer 2%s o ft.
c. Casing 18" above grade.
d. Surface dr inaae arour3 well accentable.
VI. OV R LI, WORKMAS -HIP
a. Boxes properly crcuted
b. Ail pines paurtia7!y h- -dKfilled
c. All pipes flush wito h=ide of box
d. Bar-kfill material contains stones < 4" in diameter
e. Ourtain drain installed according to plan
f. 0-= ai.n drain out=all vrote-ted & dir. to a--,st.wat=_
g. Footing drains dlscharae away fran SDS area
h. Surface water prot----ticn adeouate
i. �oslon C'n`o urovide-' cn slopes create -- than 1`
FAUX& of
YES NO COM_'S
CST' T T
-t'a�- "�'�sut�l: -,'a -. ::'1;� . ie,•4•_•,• � •-, � _ ... ... .. - d '.-.:.:,.:. . -,'-s �•'c , ,.+,
a. SOS area located as per a =roved plans
=.7 : uio' - `r:.y.',,.,C:. ..� twr o^-• ...
b.
Fill section - Date of place-rent
2:1 barrier . I=- W= AVG.DPTE
c.
Natural soil not stri=ped
( .
d.'
Stone, brush, etc., create_- t2han 15' fran SDS Pre--
e.
100 ft_ fran wa.te_r course /wetlands.
ISt- I I
Ste. E DISPOSAL SYS M
a. Septic tank size 1,00 1,250
b.
Septic tank insj-= i i leve_i
c.
10' minlman fron fc&da ion
I I
d.
No 90" be-nds, cle=..nout w? thin 10 ft- of 45" bend
I I I
e.
DIST=L -TION BOX I�
1. All out' e-ts at sa-r_ e'evati an -wit er tested
p
2. Protected be-cw frest I
I I
.3. b4inimun 2 f t. crigiradl soil be_weern box and tr_nc-:es (
I
f.
JUNCTION BOX - vrot%erly set
-
9-
MEN=
.16
2 . Dist nC9 to waterC:�L �s me= -' =C ft
3. Ins== i ed ac -_,ro i ncT to ulan I
4. Distance Chi °3' to c_7Le_r
S. Slone of tench acc_st ble 1/16 - 1/32 " /foot.
�
6. 10 10 feet from vrcaer`y line - 20 feet - four:aticrs
7. Death of t_e.*icz < 30 i-nches frame sarace .�
-I —j-
n . iU= al crw-ea =or es. -rs? en, ,eu%
9. Size of gravel 3/4 - li" diaFne_37
10. Depth of gravel in t-rench 12" mir.
L..• Pipe ends carned
h. PRAS OR DOSE SYSTEMS
1.
Size.-Of 'per . chanihY r.
-- - . 2. Over-.Elcw tank M
3. Alain, v? --iaa /audio
4. Purrs easily accessible zoj i
5. First bcx baf=1-ed
C9 •%
to Qrade
6. Cycle wit- nessed by Health Dew anent
esl`imated flow ze-- cvice
IV. fiXSE '
a. Flo, a located Der &yorq ed Dens.
b. Number of bedroars
V. wr;Ir
a. well located as per a =roved plans
b. Distance free SDS area re-- surer 2%s o ft.
c. Casing 18" above grade.
d. Surface dr inaae arour3 well accentable.
VI. OV R LI, WORKMAS -HIP
a. Boxes properly crcuted
b. Ail pines paurtia7!y h- -dKfilled
c. All pipes flush wito h=ide of box
d. Bar-kfill material contains stones < 4" in diameter
e. Ourtain drain installed according to plan
f. 0-= ai.n drain out=all vrote-ted & dir. to a--,st.wat=_
g. Footing drains dlscharae away fran SDS area
h. Surface water prot----ticn adeouate
i. �oslon C'n`o urovide-' cn slopes create -- than 1`
FAUX& of
T:1�7
3"
r. T t LL
7
COUNT-Y.DEPAM.
zz
._. 'RijOr to Novi
"keawtoao i iq Y 105.1.2 ncib
diPeiiidiff
on _CEIM
CATS ®P tOm
FOR*
4
41. ri
A,,4,��
/v :4
69v �A
p
7-i
7
71,
'J
_FM
46e
fl� fA4r
Bill"' , T J� I OC-11-
g JY&I Section Only 'Depth Volume
-no
Wotf ow 0. M mm us
ti
Separate fidw 1 116"
;Wve-
Ic D
T,
or: abi Supply DAM'
'RI Z
k
tP ` that t , he s I sparlite..-Sewawdisposai Jystem-
_L,represent',3ha_t,_I a I t Sm
_y a cqmpje.eiy,! P�P�,op-S -
'a"bov"e"described will 'be r6nitruit66,Alhowh "approved ahven6v�vi'hVi�`t d �r" u M, f !pe., Putna7g.
w
f IIA' Compliance!,y, sat
't
it 'AOISMMIOY,�Tloq 'theit�uild�r,
e-s" mi ed�) lw owner' his ;�that Isi hfbuildiii Willi
ry gfurnishe
p ce in p
o;i4 -,6peirit ihj�T�i&o;4 rt,�6f,"ima:. sewage-,dl 9" 1 SY two y�ri'linMediiteiy,'foll"irvo'thi�diite'iif A_h4,JSIU .
ante of jtion�.&qy..ps
app► dra W wsllIi4
"I "6f �i cerufkiii,�of"td 'C�e,i i�:r itiad .�above
MMaTI3ns-o" am
hand that taut wall will,bcIns 4110d;,iin aCCOrdanCe. with the will �,�",Ioca-bod a��sh-p�yn,oT,t!1e,ppW"R plan _4]:
Diati'd
HM gg
"A
County Dep rtm t f Health
P.
IT
APPROVED thii:iPpro4al: X 0 ^con
Ryth
c ange or al!!iAlon"bf '66Wuitjon •
I,_,req4ires a new, :perm. ed or" ;private at --only.
• ter. nir' ly
/)17 Data -77 Titid
n.
FRED ORTMANN & ASSOCIATES, INC.
155 Colabaugh Pond Road
CXItOtholll•Hudson, New York 10520
(914) 271 -9505
A t•.:;� c. � r. . c -. •n• 1'x �. -e` � + �J+ � - +'�'t ".. _ *i•o r; {�. fr •.y lr f�
DATE
TO: -I
,ta-
PURCHASE ORDER NO. JOB NO. ITEM NO.
L
SUBJECT: S_ S> P-
GENTLEMEN: 77A. /$- Me -
We are forwarding herewith / under separate cover the following drawings with status as indicated.
STATUS
I - PRELIMINARY
2- REFERENCE FOR
YOUR USE
3- APPROVED
4 -OTHER
NO. OF.
COPIES
DRAWING NO.
SUBJECT
/
02 Id c' .
jj`-r' r . ]K�
1
COPY TO FORM
,-,)NG. SVC. (ROUTE TO) ❑
PURCHASING
ENG. FILE ❑
2000 U (Rev. 10 /e6)
DRAWING Very truly yours,
1:1
r
.t: ��, :,--a, : t..c •:. .:....: �'irr :,:r ';q of .. :a -x:.i ..i:�•r .. v'.'i7 `:L �.�,D .S dl`o Vb'�bd'lE9LV bV p�•�o Sl o�-'�•::.o ..,: -�r .Z'�ti �'q'�..: a�- .Y.`:i si: 4e' •.:�:'. �''x�c ,. �'��'. i•�'. ... ..
155 Colabaugh Pond Road
Croton -on- Hudson, New York 10520
February 10,1989
Mr. Lawrence C. Werper
Putnam County Health Department
Division of Environmental Health Services
110 Old Route Six Center
Carmel, New York 10512
RE: Proposed_SSDS Drella
Peekskill Hollow Tpke
(T) P.V. TM #118 -7 -9.3
Dear Mr. Werper:
In response to your letter dated 12/12/88, I am herewith
submitting the.following:
1. One completed Construction Permit for Sewage Disposal
System
2'. Revised deep test hole inspection data
3. Three sets of drawings revised as requested to show
dose calculations and revised deep test data.
I trust that this submission will meet all of your
_,.. F.
.:...._ .i6 ::::�eq.u�.�rem�:rits �:.��r= .f�nal:�a- pprova�l:�- o-fT thy -• scab- �e�t- �;pr-- o�e�- ty:��:- -- .,�. -;.�. _._ �:. .� ._ . _
In the event that additional forms are required to be
submitted, please include such forms with your request in.the
future.
Very truly yours,
Fred Ortmann, P.E.
CC: file
J. Drella
S. Ortmann
a
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
September 6, 1988
Fred H. Ortmann
155 Coladaugh Pond Road
Croton —On— Hudson, New York 10520
Re: Proposed SSDS'— Drella
Peekskill Hollow Turnpike
(T) Putnam Valley
TM#118 -7 -9.3
Dear Mr. Ortmann:
CARRUTHr M.P.N: ; •- •^ :'
Public Health Director
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL Jr., P.E.
Director
Review of plans and other supporting documents submitted at this
time relatiave to the above — captioned project has been completed.
Comments are offered as follows:
1) A construction permit for sewage disposal system must be
submittted. CrJ-40i„,C C &A!/ / =f(. .l;ja,
2) A letter of authorization must be submitted.
3) Deep test hole data must be shown.on plans.
4) Pump pit details must be shown on plans including amount
of dose calculations.
5) Hydraulic profile for septic system must be shown on
plans.
6) Well detail must be shown on plans. ✓ ��1J
7) Construction notes must be shown on plans.
8) Locations of deep test holes and perc hole must be shown —�
on plans.
9) Wells and SSDS's within 200 ft. must be shown on plans.
10) Pits must have a minimum distance of 150 ft. from ✓`l
surrounding wells. /
11) Show proposed contours on plans.
12) A.concrete footing must be shown under distribution box.��
w4� -per-. ?f t• �I'A.Tl Y'r'* <e �.w�f -i.'i �'a(. :•Y�t:'f�•zi, C•5.�. r ..- S.- a'7:�..
13) The 3 foot to 7 foot cut proposed in the septic area will
change.the characteristics of the soil. it is the policy of this
Department to.keep as much of the original soil in the proposed
septic area as possible. Please revise - plans to reflect this.
14) Three sets of plans must be submitted.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Very truly yours,
C_ �L -
Lawrence C. Werper
Assistant Public Hlth Engr.
LCW:jz
.- .a - ar. --. • y • .,. ..,.. �....L...... r .... . •,.�., .F, . v-.. *,.. . ya _ ^ b.y ..� J .. . _ ♦.t+ —•. , �-- ° w �-:.c. � ... , ..� _ .. o ..o .... � .... . .
/ FRED ORTMANN & ASSOCIATES, INC.
155 Colabaugh Pond Road
9rQt4th0nRhY91Qh; New York 10520
,00U7)Ellf"
L J
SUBJECT: I *off
PURCHASE ORDER NO. JOB NO.
JITEM NO.
GENTLEMEN:
We are forwarding herewith / under separate cover the following drawings with status as indicated
NO. OF.
COPIES
DRAWING NO.
SUBJECT
DATE
441,
T
,
3fo2�8 y
r
1.//Afi eA C kc
/�
&16� �!L
,00U7)Ellf"
L J
SUBJECT: I *off
PURCHASE ORDER NO. JOB NO.
JITEM NO.
GENTLEMEN:
We are forwarding herewith / under separate cover the following drawings with status as indicated
NO. OF.
COPIES
DRAWING NO.
SUBJECT
441,
R
LG �fvYC.v r` V I G/°' �• i'/f' /�/V/Y � ♦ 14/ p
�1-11D. &M,19 .ate a a7 ,PF 70 071 A(Al
COPY TO
Very truly yours,
a
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
December 12, 1988
Mr. Fred H. Ortmann
155 Colddaugit Pond Road
Croton -on- Hudson, NY 10520
Re: Proposed SSDS DRELLA
Peekskill Hollow Turnpike
(T) PV
TM, #118 -7 -9.3
Dear Mr. Ortmann:
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Review of revised plans and other supporting documents
submitted at this time relative to the above captioned
project has been completed. Comments are offered as follows:
1. A Construction Permit for Sewage Disposal System must be
submitted not a Certificate.of Construction Compliance for
Sewage System.
2. Deep test ho-1•e.s . requir:ing _holes- �e.gua l to the pit
. _.. •c}rmarts i orr°-da.pttr p l �;s ._e i.x.:'C�6) f eems: -: _Dat = �.brrii t eu sr uw`s•..orn l =y -.
nine (9 Feet).
3• Dose calculations must be shown on plans.
Upon receipt of a submission, revised to reflect the above
comments, this application will be considered further.
Very truly yours, /
Lawrence C. Werper' v
Assistant Public Health Engineer
LCW /jp
V-
APP= B
Pr.PI' -M CrL 7rf DEPnF = OF EF -ALTS - DIVIS104 OF 2WMCMa?ML E�:c.�L�r' S�VIC S
EMIVID L W=R SUPPLY & SUE -q FA, =- SEv-A = DISPCEU SiSTIMS
..- .- ---- - - - -- '�-_,. _. •REJL.TN S:�I' - CONSI "nl.:C�"- TCN- P�- �'n,N�T_'" , ... • : -" °.
BY:
(Name of Ovr_ar) (Street Lccstica)
DCC'.:`ITS
Permit Amo1 i cs ticn
Cogcrate Resclut' cn
Plans - Three sets s/s
Encinee-rs Author- ZatiCn
Desicn Data Sheet (DCS) SS
ICN
Deep sole Lcc p`
Ccr.SiSt nt Pero Resu _ (') Fi i 1
Pero sole Dept- C"
HCLe P'_ans - T,, o set=
We i
variance Ror_ues t
L 1 Sa? d i vi sicn
Succi °r_'sica A -ccraVr-7 C::&_k-Z.:
SSDS Ad-:.
We t_and (TC•,vTi /DEC Pe ' _ It R & D)
Da - Cn DDS Plans & permit 5-5:=
P
EQ=R0, DF�, =, c CV - 1S
ar:zw/
c= -wage S-v S a--q HN-r ra -u '_C P. `,t___ ('-rte i _ _'i Fi "
Fill Profile & DLm:= nsicns - Vc-DZIM -
D or J Ecx;irencn /C - p, pi
Septic TLnx - Si2 °, Detr it
We?! Cet=i1, Service Lire if cve
Ccnst_-icticn Notes (c nor rate)
T c -Fact Contours Existing & prccosed-
Driveqav & Slopes Cat
FcotinC/Gatte_r,ear'=i_i Drains (discharce CX)
Perc & Deeo Holes Lc-ca-t-=,;
Represzrit .tive or pr_r=- ara = r-ansicn
- MC ,- -;sicc A?-a... -; shav -n; q ravitJ f aw, �� fi. size
I Zope Pit & D Bcx S(�cw� & I}eT�.il�:
House -3 No. of Ee^r=is
Wells & SSDS's Win 200 ft. cr Proecsed S75tz
Prcce_rLy Metes & Ecunds - -
Heuse Setback Necessarj (Ticbt lot)
House Sewer - 1 /4 " /=Lt. 4 "0; -Z_,za pine
No Bends; Max. Eenes 45° w /c_eancut
SEPaRAME -N, DIS'LMti�: SPECL7= CN P1. 7
Field--
10' to p.L., Drivevav, Lee` Tre.�,Tcc of i
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' Pit=
100' to (StreE[n, Wet= _-courSe, TGK? (1r:C. E`t:
15' to Drains ==�lr ? i n, Leader, Fcotinc
35'tc =tc_'1 basin, s -Mm. 1n,-3 — Wct-ar --C
10' to Feater Line
50' .int=—n i t tent G�rr.' Lace c--=s
Szmtic Tanks
10' f ::= Foundation; 50' tc ,, i
15' Wa 1 tZ) PL
APPENDIX B
PUTINAM COUNTY DEP.AR`2�= OF HEALTH DIVISION OF ENVIRO AL HEALTH SERVICES
( Name of Nne_'- )
& SUBSURFACE S]E P& - DISPOSAL
REVIF /1 SHEvT - CONSTF=ION PERMIT
DATE �REVT �,vrl):
(Street Iecaticn)
DOGS
Pemdt Application
Corporate Resolution
Plans - Three sits
Engineers Authorization
Design Data Sheet '(DCS)
Deep Hole Log : -.
J
Consistent Perc Res,f!ts
Perc Hole Dept's '
House Plans - Two sets
s/s
SUi✓DIVIS ION
Perc
(3) Fill
cd
Well Fermi t; P'Ys 1 et"r
Variance- Reauest
Gr.'QERAL - -
L&--a1 Subdivision
Subdivision Approval C�ecced
-a_ _ rcvai SSDS Ad- Lots Checkad
Wetland (Tcw-n /DEC Per mai. = R & D)
Data Cn DDS Plans & . Permi. t
REQfj -= DET -A=S ON PL2-TS
StFNage S tan Plan - (North arr„-w )
SeAage System Hydraulic P_or_l� - Gravity Flc-,
,N11 Profile & Disnensicnsgt�-n
D,or J Box;Trencn /Gallery• F�-r pit dEvails
Septic Tank - Size, Derail
Well Detail, Service Line i= over
Construction Notes (grinder rte)
Design Data: Perc and. deep resu1`
Two-FobL Cbht�urs+'ising
Drive*aay & Slopes 0,1t
Footin /Gat' ter Drains (discharge OK)
Perc & Deep Holes Located
Representative or primary and ex..ansion
Expansion Area; shown; gravity flcw,s-aff. size
If Pmgxd Pit & D Box Shcw-n & Detailed
House gNo. of Bedrooms
Wells & SSDS's w /in 200 ft. of Proposed Syste
Property Metes & Bounds
House Setback Necessary (Ticht lot)
House Sewer - 1 /4 " /ft. 4"0; T_, e pine
No Bends; Max. Bends 45° w /cleanout
SE PA.RATIM DISTANCES SPECIFIED ON PLAN
Fields
10' to P.L. , Driveway, I; rge Trees,Too of f
20' to Foundation Wails a
100' to Well; 200' in D.L.O.D, 150' its .
100' to Stream, Watercourse, Lr.xe (inc. ero✓
15' to Drains C rtain, Leader, Footing .
35'to catch basin, Stor_mdrain,A122�j wate-rcOu;
10' to Water Line (pits -201)
50' intermittent drainace course
Septic Tanks
10' fran Foundation; 50' to well
L5' Well to PL 9
'ENVIPUZENTAL'HEALTH SERVICES
DESIGN DATA SHEET- SUBSUFACE SEtti= DISPOSAL SYSTEM FILE NJ.
owner s�,�s,� �i7.�11� : Address. V0&9A 10144 ffotl ow T ,4R//d1Ae#r,
..Located at, (Street) APAW -u /*GGowAa,,YV• Sec. //j Block 7 Lot
(indicate nearest cross street)
Municipality 7� 6�GlTJ _x" 4� uf Watershed /'EEI�S/L�GG
SOIL PERCOLATION TEST DATA RMU= TO BE SUBMITTED WITH APPLICATIONS
Date 'of Pre - Soaking /y� /q f�� Date of Percolation Test /O /91,/
HOLE
NUMM CLOCK TIME
PERCOLATION ATION
/09 1/2
PERCOLATION
Rune Elapse
Depth to Water Fran
. Water Level
• -/' V �� .�. �%w �.r .. �• C n ..L� • _tee ♦ .�....
No. Time
Ground Surface
In Inches
Soil Rate
Start-Stop Min.
Start Stop
Drop In
Min/In Drop
Inches' Inches
Inches
cvtlriN�/ �B:' DAM
IO � 00
.VC?- 2J'V IA.
.~
3`'
I ,w,w.
- _ 2 /orS% ?¢ M tge 59" 02 `� 3 er I I ► 3 3,
3 //:32 - /2: //
:.. -4 _ is - 112 :'' c'•/ 39M;N• S 9 `' .... G 2 4 3
_- 5
/ =- /• 9'�•„N• .
/09 1/2
3�
3.00
- ..
.. �.. /.�
• -/' V �� .�. �%w �.r .. �• C n ..L� • _tee ♦ .�....
..� -s.. ... 1� • .. �...K... �1�� )•.y'W •- .1.....gry
. y. C �.. ♦
73 7�•._ . .y
v
3
/09
//2' 3 f
L0
3
.VC?- 2J'V IA.
/op l/2
3`'
_- 5
/ =- /• 9'�•„N• .
/09 1/2
3�
3.00
3
.VC?- 2J'V IA.
/op l/2
3`'
G •33
-5 ..e�: S�� 3 416 ..:.. 2 �r,��,V•
%g _ ... //2 .• ..
3 a
�, G 7. p�
NOTES:
l., ,Tests to be repeated' at same depth until approximately equal
soil rates
are cbtained.at each peroolation..test-hole.
All data to-be sukmittbd
for - review.
2.. Depth measurements
to be made fran top of hole.
rev.
9/85
TEST PIT DATA REQUIRED TO BE SUM
DESCRIPTION OF SOILS ENCOUN.
WITH APPLICATION
IN TEST HOLES
DEPTH HOLE No. 7R HOLE NO. XRig HOLE NO. /VIA
_- G.L. � �' ®le- 7�L�� ~5'�Ie.
1
2°
3°
4°
5°
6°
7°
91 ®AR9
.101
11°
12°
13°
14°
„ - .-,Z,'�'JIdMmt 3LEV i, FzT- i iS0i • G' Pm1'N95m' TP1___IS ENCC3uNTERED . A/D>%
INDICATE LEVEL TO WHICH WATER LEVEL ' RISES AFTER BEING EM0UNTERE'D ft/�i9
DEEP HOLE OBSERVATIONS MADE BY: )5ZaWr 0,p_77,&A1A1, DATE:
DESIGN
Soil Rate Used Min/1" Drop: S.D. Usable Area Provided 75.3
No. of Bedrooms Septic. Tank. Capacity, :1008 gals.. Type e4AIC,
.Absorption Area Provided By
Other. 7v�0 5�.�?% /lEq'� —° 8,0 # /o 1,0W c 3 COS-1) = 7S3
P J �,e — -)/ t -pow ram %_
Name S
Address /SS- 40e_ � ixe� all Amo Ao
Arab
THIS SPACE FOR USE BY HEALTH DEPAR24EM ONLY:
�7.
SEAL
Soil Rate Approved q;f
t/gal o ::Checked by
,P/ V 59.
q�.�F: to
PUrNAM COUN'T'Y DEPARTMaZr OF. HEALTH ..
DIVISION '.OF. ; HEALTH SERVICES
DESIGN DATA SHERT- SUBSUFACE.S5gWE DISPOSAL SYSTEM
Owner , .$45AW 4Z64,44 Address �
7Iocated at (Street) R"Arrt44
(indicate nearest cross street)
FILE, ND. .
Sec. /= Block 7 Jot 1•.�
Municipality Watershed 4104rlela
SOIL, PFRCnr.ATION.- TEST. L»,TA P C? 2Ea TO P.E ,a= WITH APPLICATIONS
Date of Pre-soaking /D / iAe Date of Percolation Test Ad 0?
HOLE
NUMBM CLOCK PERCOLATION PERCOLATION
Run Elapse Depth to Water Froa Water Level
No. Time Ground Surface In•Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min/In Drop
Inches Inches Inches ,.
58 p
2 10133 - /o
3 /0 j41F /v S'S 7
5 it %t Z //% 7 ... zs . 5�' r 3''
i2
2I /�a:. � .off .. -.��.��'�:,_e_ :- .��"�`' = �. -�i'b _�o ...J,� �:�.._:� ;e .,�: ._Z.�,.. � .
.o Nhv
4 /- 41/--/• i/y .3 //0 // �.O
2 /;fd - x:06
//o
5 2;
Ma
i /3 ...
3
S. 37
3 =0.3
NOTE'S: 1.. ,Tests
to, be. repeated' at same depth, until approximately equal
soil rates
are obtained at each percolation..test-hole.
All data to' be sukmitttd
for.review.
2. Depth
measurements to be made
from to of hole.
rev. 9/85
TEST PIT . DATA RMUIRED TO BE SUBMITTED WITH APPLICATION
DESCRwTION OF SOILS ' ENCOUNTERED IN T ra HOLF.S
DEPIH HOLE NO. % MOLE NO. HOLE: W.
1°
2°
3°
4°
5°
6°
7°
8°'
9°
10°
11°
.12
13°
14°
INDICATE LEVEL AT'fiff N— GROCJfi D A'1M -IS' `ENOOUNTEIRM
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: DATE:.,..
DESIGN
Soil Rate Used Min/ll.' Drop: S.D. Usable Area Provided
Noo of Bedrooms Septic Tank Capacity. gals. Type
Absorption Area Provided By _ L.Fo-x-2411 width- i�rench -
Other.
Name Sig t ►y '�'
Address SEAL
.THIS SPACE FOR USE BY HEALTH DEPARMAEM ONLY: 9lF of NEll
Soil Rate Approved PP � sq e f t,/gal. Checked by Date
PJVA
PUTNAM COUMT DEPARTMENT OF
RIVISION. • •' •• ' 1= V' HEALTH SEWICES
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner �,., �' / ,Q,�L4.9 • ~ iIIA ress 4129
Located at (Street) ,45,0es'au Iobe&)w ,rJ'�,�,�, Sec: Block 7 Lot
(indicate nearest cross street)
Municipality 9uzxld"
IIW LW . Watershed ES N lLL!:�11
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUffiMI= WITH APPLICATIONS
Date of Pre- Soaking
'Date of Percolation Test
HOLE
NUMBER CLOCK TIME
PERCOLATION PERCOLATION
Run Elapse
Depth ;to Water From Water Level
No. Time
Ground Surface In Inches Soil Rate
Start -Stop Min.
Start Stop Drop Iii Min /In Drop
Inches Inches Inches
2
1
. 4- .. '^ a -•4 .,.a .. .. -. 5 n • - .<-. _ .. ._. � mac.. •� +�•• �'+� ..°�'.T -•TJ.. .y�a+ ... b.•6 ..��i. • -.T�• •..�. .. a- .• ar.. �.M1i�... �u �•r
L
3
4
t�� J
2 F
NOTES: L. Tests to be repeated at same depth until approximately equal. soil rates
are obtained at each percolation..test•hole. All data to•be submitted
for.review.
2. Depth measurements to be made from top of hole.
rev. 9/85
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
b
DEPTH
G.L.
2°
4°
5°
6°
7°
8°
9°
10°
11°
.12
HOLE NO. / HOLE NO.
HOLE NO.
13°
. 1ND_ ICATF..::T,LV L.;AT M3 C _ff.. ROU, DWA-TER. ZS FMOUNMERMI.
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: A DATE: ✓rJ'J+/, aTQ
•DESIGN
Soil Rate Used Min /1" Drop: S.D. Usable Area Provided 3
Noe of_ Bedrooms • ,i Septic Tank Capacity, /000 gals. Type OyAIC,
Absorption Area Provided By _ L.F. x 24" width trench
Other ..3- iC � � � . J� �'�T�, �- �� 3 41�dxj-'
V P" 059554
\Z flf NEW
Soil Rate Approved sgeft /gala Checked by ` Date
PUTNAM
COUNTY
DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
SERVICES
Date
Re: Property of S prn
C_k)
i
i oJtAy AU� i�Ci.t
-•
Located at '} Pe�res�t
+ll. I
ll ( ''Nn)jee —
R4rA.41Lt V4tc_y
(TX- AUP-4" 1565 Section H Block q-- Lot_
Subdivision of
Subdv. Lot # Filed Map # 15 a Date.
Gentlemen:
This letter is. to authorize �,2g� �.� %OA•�/�� .1�-
a duly licensed professional.engineer 1.1�or registered architect
(Indicate
to apply for a Construction Permit for a .separate sewage system, to'
serve the above noted property in accordance with the siandards,.rules,
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf. 'in
connection with this matter and to supervise the construction of said
~" system orsys`tem's 'in 'conformity with the provisions of Article 145 or
147, Education Law,' the Public Health Law, and the Putnam County Sani-
tary Code.
Countersigned:
P. E. , R. A. , #
Address
TT/� d d/- Lr,�SdNi /U l0 ZU
Telephone
046) 27 1-9se'r
Very truly yours,
Signed
0 r o P perty
42-q 0 b LL4V C, .
Address
�OrvK.0 ft,$ N Y l 0 }D3 .
Town
Telephone
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center,, Carmel, New York 10512
(914) 225-0310
Mr. Fred•H. Ortmann PE
155 Colabaugh,Pond Road
Croton -on Hudson, NY 10520
Dear Mr. Ortmann:
February 27, 1989
Re: Proposed SSDS - Drella
Peekskill Hollow Turnpike
(T) PV TM #118 -7 -9.3
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Review of revised plans and other supporting documents submitted at this
time relative to the above - captioned project has been completed. Comments
are offered as follows:
1) Revised house plans to reflect new footprint must be submitted.
2) What is the purpose and depth of curtain drain?
Upon Freceipt of_a.,submissionf; .-revised .tor =ref] -ect fheabovewcommerrttis;- this' - r
application will be considered further.
LCW: jr
Very truly yours,
'2"
Lawrence C. Werper�...,.
Assistant Public Health Engineer
1l
i
i
w FRED H. ' ORTMANN;`' P': E . `r
155 Colabaugh Pond Road
Croton -on- Hudson, New York 10520
April 17,1989
Mr. Lawrence C. Werper r
Putnam County Health Department -°
Division of Environmental Health Services
110 Old Route six Center
Carmel, New York 10512
RE: Proposed SSDS Drella
Peekskill Hollow Tpke
(T) P.V. TM # 118 -7 -9.3
Dear Mr. Werper:
Please be advised that the above referenced project has been
suspended as of this date and that no further action or
inspection should take place until my specificic letter of
continuance has been received from me in the near future.
Should no letter.be received from me within 30 days, please
consider this subject application null and void and consider
that my registration for this project is hereby withdrawn,
and that I will no longer be liable or responsible for the
design of this project , ,nor do I approve of any further
action on this project or any similar design by others which
may be a dopy of my design.
Thank you very much for your concerns and cooperation in this
matter. This Notification is sent Registered, Return.Receipt
Requested.
CC: file
S. Ortmann
J. Drella
Very truly yours,
Fred Ortmann, P.E.
0
C`0!f
PUTNAM COUNTY HEALTH DEPARDIEW
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John 'Me Simmons, M,De
Deputy ;.Camni-ssioner of Health -FIELD ACTIVITY REPORT -
FINDINGS e
(L
v %f7 C
AiOL4 ko ✓ (sue
QiG_:rS
Sheet of
INSPECTION
Orig. Routine
Orig. Complain
Orig. Request
Compliance
Complaint Comp
Final
_ Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
INSPECTOR° �_-,___Z_ �� TELEPHONE:
Signature and Ti
:PERSON IN CHARGE OR INTERVIEWED:
I.acknowledge this Field Acti vity Report. SIGNATURE°
6/86' TITLE:
wADDRESS.. 0/15e)CS/,C/(C
of -(,0
Street
Town
/ TES Noe
°MAILING ADDRESS
P.O. Box
Post Office
Zip Code
;TELEPHONE
tPERSON.. IN CHARGE
-,OR :ANTERVIEWED
Name and Title
TYPE FACILITY
TIME ARRIVED // : v v
TIME LEFT
4
FINDINGS e
(L
v %f7 C
AiOL4 ko ✓ (sue
QiG_:rS
Sheet of
INSPECTION
Orig. Routine
Orig. Complain
Orig. Request
Compliance
Complaint Comp
Final
_ Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
INSPECTOR° �_-,___Z_ �� TELEPHONE:
Signature and Ti
:PERSON IN CHARGE OR INTERVIEWED:
I.acknowledge this Field Acti vity Report. SIGNATURE°
6/86' TITLE:
PETER C. ALEXANDERSON
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Mr. Fred H. Ortmann PE
155 Colabaugh Pond Road
Croton -on Hudson, NY 10520
Dear Mr. Ortmann:
February 27, 1989.
Re: Proposed SSDS - Drella
Peekskill Hollow Turnpike
(T) PV TM #118 -7 -9.3
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Review of revised plans and other supporting documents submitted at this
time relative to the above-.captioned project has been completed. Comments
are offered as follows:
1) Revised house plans to reflect new footprint must be submitted.
2) What is the purpose and depth of curtain drain?
~° "Upon" receipt • of d submission, evised � to reflect f they above comments, this
application will be considered further.
LCW: j r
Very truly yours,
-L ( c,n
Lawrence C. Werper,
Assistant Public Health Engineer
.i °
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Res Property of
Located at
(T)
' . Date
6W
Section block 7'
�►:r
Lot f J
Subdivision of '
Subdv. Lot # Filed Map # S Date
Gentlemen:
This letter is to authorize t7 d3%% yy �� �� /✓
a duly licensed professional engineer or registered architect
(Indicate)
to apply for a'Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the-Putnam County
Department of Health, and to sign all necessary papers on my behalf in
- corua -eiti- oii°-w t-h --tiais'`rAdtteir -an-d' to-'siapery a the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani.-
tart' Code.
Counters3.jxne4
P.E. 9
Very truly yours,'
Addrefss
Telephone
Totm
"bi 2L) -
Telephone
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services. Carmel, N.Y. 10512 Engineer to Provide Permit p
on CERTMCATE OF C LIANCE
CONSTRU ON PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit #
Located at. ... ,f�PPk -�� i 7 l Ho1 � ow T i n '' i k ° .r';;,: �•�, ;� -- - o � f ^� �;�;.�.... . .
-- p P wn e
Subdivision Name Subd. Lot q -� `� Tax Map 118 Block-7 :Lot 9-3
Owner /Applicant Name Joseph Drella r Renewal_O Revision ❑
Date of Previous Approval
Mailing Address Peekskill Hollow Turnpike Town— Putnam Valley, Y
�4
Building Type Modular Lot Area 1 o 14 Ac Flu Section only Depth Volume
Number of Bedrooms _3 Design Flow G P D 6o O PCHD Notification Is Required When Fill Is completed
Separate sewerage System to consist at --iQ"auon Septic 430 LF of 241 Trench c Tank m
To be constructed by Howard Grauer t Address n s .awana Lake Road P-31-
Water Supply; Public Supply From Address
or: X Private Supply Drilled by A n d o r s o n Address
Other Requirements Pump system with 750 Gallon Pump Ui
I represent that I am wholly and COmplete,jyar®pomst�le la th.R.&D aQj"''%T.0jpf the proposed systentt��
above described will be constructed as shown on the approved amendment there to and in accordance withot %s`
County Department of Health, and that on completion thereof a "Certificate of Construction Como�����
be submitted to the Department, and a written guarantee will be furnished the owner, his successor I
place in good operating condition any part of said sewage disposal system during the period of1t
ante of the approval of the Certificate of Construction Compliance of the original system or a6 rrs
will be located as shown on the approved plan and that said well will be installed in accordance witth te� am
County Department of Health,
Date ,April 21, 1988 signed , o
Address 1 Northrid. e R6U, Peekski 1,
APPROVED FOR CONSTRUCTION: This approval expires twbredne the $ate is ad unless coa3t
revocable for cau or may be amended or modified when can Wsaryby Commissioner di requires a new rrp¢, &Qoved for disposal of domestl rivate ater su 96
lev.
/87 Date By
v
Y
larm
V,1116COmmissioner-of Healthwill
rho .builder, that said builder Will
lei1�(`fohlowing thedate of the issu-
iftlte:d►illed well described above
nd 1pq—LT OOs of the Putnam
°'a::.i•' : ^., P.E. X R.A. -
r
��ujyldil'lg nse No 2784'6
.tias been undertaken and Is
,;g,
ges�r anIteera�tiioo�n of construction
1810 1 0 o Y
ooeooe
- Title
DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
.. .. � .._ = :mot.= `o+�-`, a .,. .. <<..fi .. . .. .. _ - _ ,� .. �...;m•:.':�'C'.•v
APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #fi/yy
WELL LOCATION
Street Address Town/Village/City Tax Grid Number
Peekskill Hollow Turnpike Putnam Valle sNY 118 -7-90
WELL OWNER
Name
Joseph Drella
Mailing Address
Peekskill Hollow Turnpike P.V.
MPrivate
O Public
USE OF WELL
1 - primary
2 - secondary
J) RESIDENTIAL
® BUSINESS
® INDUSTRIAL
® PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP
O FARM ❑ TEST /OBSERVATION
t3 .INSTITUTIONAL O STAND -BY
❑ ABANDONED
0 OTHER (specify,
AMOUNT OF USE
YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 600 gal
REASON FOR
DRILLING
10 NEW SUPPLY []PROVIDE ADDITIONAL SUPPLY
❑REPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL .
® TEST /OBSERVATION
DETAILED
REASON FOR
DRILLING
New Resed'enee
WELL TYPE
®DRILLED
DRIVEN ®DUG []GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES _X _NO
IF WELL IS LOCATED INSA REALTY SUBDIVISION, NAME.OF SUBDIVISION: Drelln Fstat_s I
Lot No. 3
WATER WELL CONTRACTOR: Name Andprnnn WA II T)r' 1 prs Address':g.:,rgpr St Putngm Vella, I
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __X _NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: e
LOCATION SKETCH & SOURCES OF CONTAMINATION
®ON REAR OF THIS APPLICATION
4Z21188 None
(date)
PROVIDED
ON ARAT E SHEET
SF,�PA
nZZ (signature)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of 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 s.hall:
1. Pump the 2. Disinfect wthe well linhaccordance with
with the requirements of the Putnam
County Health Department attached to this permit.
3. Submit a Well Completion Report on a form pqqvided by the Putnam - County
Health Departme t. WU 4,
Date of Issue: % �' 19
. P, K1, Permit ss 1 g fficia
Date of Expiration: 19 �—
Permit is Non - Transferrable White COPY H.D. File
Yellow copy: Building Inspector
2/87 Pink Copy: Owner
PUTM COLUN DEPARTMENT • Y.
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN -DATA SHEET- SUB_SUFACE SEWAGE "DISPOSAL SYSTEM FILE NO
_. .. ..4 -r 'i ... .... ��. a. �.. ... ,,1 ^?•:. • .... ^.'tic `.rq.= .. _' ... a y-... ..- a ..t. .:r: -.y:. �,: y;. ,•.. .- :cT?: iy', . ,•. � •.. .bri�m.
Owner Drella Address Peekskill Hollow Turnpike9 put Valle
- - y
Located at (Stree Peekskill Hollow Turrke ° =118 -7 Lot 903
j l (indicate nearest'aross-street) 0 7T
1� �hun3cipality Putnam Valley Watershed Peekskill
Date of Pre - Soaking A rn_ i 1 7, 1988 Date of Percolation Test April 89 1988
HOLE
NL24BM C1= TIME
PERCOLATION
PERCOLATION
,Run ,`.Elapse
Depth to Water From
Water Level
No. Time
Ground Surface
In. Inches
Soil Rate.
Start -Stop Min.
Start Stop
Drop In
Min /In Drop
Inches Inches
Inches
(1)1 200 3100 30
16.50 18.50
2000
15000
2 3: o4. 3 :34 30 16.50 18025 1075.. 17014
3 3:39 4109 30 16.50 18025 1.75 17.14
4.
+ '5•
2
3
5
n
NOTES: 1. Tests to- be.repeated•at.same depth.until approximately equal soil rates
are obtained at each percolation test 'hole. All data to-be submitted
for review.
2. Depth measurements to be made.fran top of hole.
rev. 9/85
50 � .
`GoL.
jq
2°
4°
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SO
IN TEST HOLES
eep
Deep
Perc
Per
x 1
HOLE NO. 2
HOLE NO. 3
l'.opsoil .. _
.�..-,ops'oil
Topsoil
Topsoil=
Topsoil
Topsoil
-- Topsoil
Topsoil
s ilty9 sandyy oam 1
trace clay
- S.il y9 s .y
trace clay
omm
loam
9
sandy
trace
-
-.I -
trace clay
6°
71,
10 °
11 •��
12°
13°
14°
INDICATE LEVEL- AT WHIM GROUNDI ATERc _I - _ENC)OUNTFRED_
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
DEEP HOLE OBSERVATIONS MADE BY: D9 Trud.eau (JSRomeo ) DATE: April 79 1988
-- DESIGN
Soil Rate Use3 16-20 Min /1" Drop: S.D. Usable Area Provided 5000 SF
No. of Bedrooms 3
Septic Tank Capacity 1000
Absorption Area Provided By &30 L.F. x 24" width trench
gals. Type Masonry
s0o0ce
Name John S. Romeo Signature
Address 1 Northridge Road. SEAL_'
2706
Peekskilla NY 10566 �oIt Af6'�0�.•
THIS SPACE FOR USE BY HEALTH DEPART ONLY:
Soil Rate Approved sgoft /gala Checked by Date
PUTNAM COUNTY DEPARTMENT OF HEALTH
D.IV.ISION OF ENVIRONMENTj4L, HE 1I H
Date April 219 1988
Re: Property of Joseph Drella
Located at Peekskill Hollow Turnpike
Putnam Valley 118 7
(T) Section Block Lot 9.3
Subdivision of Drella Estates
Subdv. Lot # 3 Filed Map # 1505 Date 1974
Gentlemen:
This letter is to authorize John S. Romeo
a duly licensed professional engineer (X) or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department.of Health, and to sign all necessary papers on my behalf in
connection w th this- matter and.-to su eryi se th ;ems _ _.... .
._..,.._....5� i?: :e�orjs.txuc:t .on.. of :sa..d.
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly yours,
R
Signed LT'L 1
Countersigned: .- er of Property
eekskill Hollow Turnpike
P.E.; RXIX, # 27846
0oon• o and Address
1 Northridge Road. a Qty f1�6 /yf�� `. Putnam Valley, ny 10579
Address ° �� , a �iF l9�y Town
Peekskill,
C o
NY 105660 T
`.
737 -1056
Telephone
o
0
! ®AO ®o ®®
2-33
Telephone
=1
PETER C. ALEXANDERSON
County Executive
ENID L. CARRUTH, M.P.H.
.:;Pukhc- -HeaNh '%Director'. •r •.
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL Jr., P.E.
DEPARTMENT OF HEALTH Director
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(9* 225 -0310
May 19, 1988
John Romeo, P.E.
1 Northridge Road
Peekskill, New York 10566
Re: Proposed.SSDS - Drella
Peekskill Hollow Turnpike
(T) Putnam Valley
TM #118 -7 -9.3
Dear Mr. Romeo:
Review of plans and other supporting documents submitted at this
time relative to the above- captioned project' has been completed.
Comments are offered as follows:
1) Fill sections greater than two feet require that plans be
submitted showing fill section only, this plan shall not
show thrench design, distribution Box, etc. (see page 3 of
"Program Review and Policies Subsurfaee Sewage Disposal and
Wa'tr Faci-- iE-i -e=s ` -for - S.inglze 'Fam•ilq - R- es1d76-nce=s
2) Hydraulic profile does not appear to represent septic plan.
Upon receipt of a submission, revised to reflect the above comments,
this application will be considered further.
Ver truly yours,
c
Lawrence C. Werper
Assistant Public Health Engineer
LCW:jz
MARVIN O'DELL
Inspector .
TOWN OF PUTNAM VALLEY
BUILDING, ZONING, AND SANITARY DEPARTMENT
May 13, 1988
Joseph & 'Maria Drella
17 Peekskill Hollow Tpke.
Putnam Valley, N.Y. 10579
- TSOW.. -N;1 7 ALL.
y.• -
PUTNAM VALLEY, NY
(914) 526 2377�GQi—
V�
VIL
Re: Dangerous Condition
-TM #118 -7- 9.1,9.2,9.3 & 9.4
Peekskill Hollow Turnpike
An inspection of your property pursuant' to having; received
complaints of dangerous conditions, verified they following,:
Tejo (2) unprotected deep (6 -7 feet) holes filled to surface
with eater adjacent to occupied homes..
Understanding the intended purpose of said excavation was for
soil testing, I must advise that a serious hazard does exisL
::. :• .....,._ which must: ,be -corrected. _ -- --
Your prompt action towards correcting the above, either by
filling, or properly protecting is important, thereby
preventing further necessary action by this office.
Please advise this office when you have complied or have
any questions regarding same.
Ihankinc, you in anticipation of your cooperation in this
matter, I remain.
Very truly yours,
-T ARVIN O'DqZ
Building Inspector
MO'D:es
cc: .,john Karell, Putnam County Board of Health
APPENDIX B
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
(Name of Owner)
REVIEW SriEE'r. -. CONS IQN._PE RMIT ,
P�11's DAT
iCl�l ! / qa(,i uW 7'uRwilw BY:
(Street Location)
DCCUMPrS
Permit Application
Corporate Resolution
Plans - Three sets
Engineers Authorization
Design Data Sheet (DDS)
Deep Hole Log
Consistent Perc Res•,its
Perc Hole Depth
a.
�td
s/s
S'JBDIVISICN
Perc
(3) Fill
cd
House Plans — Two sets
Well perm.i t; P'NS letter
Variance Request
Gr'�tL +
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Tcw-n /DEC Per:ni t R & D)
Data Cn DDS. Plans & Permit Sane
REQLTRED DETAILS ON PL?-NS
Swage Systrn Plan - (north err )
Sewage Systrn Hydraulic Profile - Gravity Flcw
Fill Profile & Dimensions - Volu°ne
D or J Eox;Tr;-:nda /Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Service Line if over
Construction Notes (grinder rate)
si L a: :her .4pd ,deep r.2s'�ilts
Two -Foot Contours Existing & Proposed
Driveay & Slopes Cut
Footing/Gatter,Curtain Drains (discharge OK)
Perc & Deep Holes Located
Representative of primary and expansion
Expansion Area; shown; gravity flcw,suff. size
If Pmved Pit & D Box Shawn & Detailed
House - No. of Bedrooms
Wells & SSDS's w /in 200 ft. of Proposed Syster
Property Metes & Bounds
House Setback Necessary (Tight lot)
House Sever - 1 /4 " /ft. 4 "0; Type pipe
No Bends; Max. Bends 450 w /cleanout
SEPARATION DISTANCES SPECIFIED ON PLAN
Fields
10' to P.L., Driveway, Large Trees,Top of fi
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Iake (inc. erg
15' to Drains - Curtain, Leader, Footing
35'to catch basin, stormdrain,piped Hrate- 'pour
10' to Water Line (pits-201)
50' intermittent drainage course
Septic Tanks
10' fran Foundation; 50' to well
15' Well to PL 9
'r
m 1
,
n
x1b ` u m�, � C;r'%t A nn ,�r
d s�G7JOiI
3
�a �`� ..� .z•'' t � .Yt 3,.: � '_, %/�" I✓ / /d6/a�" D /t4�7e ..«�f I'��i�'�wi F
`?-s_ �- s �. a �`` � i t f.,�- � � 7 � ^ � 7't , x ... �` _...d;'e � - � �/ ^-'3 / ♦J �. J � ♦ '+s`I�� ,
i
p �
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4
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r
'' �`` $ ? Yntnea County DeyartIDaAt'OS Hea1tL •
- _ r � t OivisioII of Ea "vironmental Health Service
�yyroved ae'noted:ffor•cunformance with
� t
l�
�•i
! �r
oe
_ we
4.
a 3 --
AS- BUILT
1
=the a
ee - ge flf8 posal';aye am: vJr1�
i2 .k.w,.t�.::on �thl's Ulari:flnfl thsx`'the -: Y�9tf,_�IIJ' -.'
e St". was ,c
. 1- '..,,a �° i'he Putnam Canty Daz�t
rit o�Y
�at:i ate Iiopartmert of dealt
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i?
E DI SPOSAI
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1
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