Loading...
HomeMy WebLinkAbout4817DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.34 -1 -1 BOX 36 ME I I - 1 1 16 11, 1 7 '' •I1 1 L 16 1 r Not 1 - ollm T ■ :N 1 Ll �1 ■ � 1 1 . No �r All tit Jk% - [ar - ollm PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES SITE LOCATION Internal Use LJ'/ . Repair Permit issued in last 5 years Repair within Boyd's Comers, W. Branch or Croton Falls Res. Repair within 200 it. of a watercourse or DEC - mapped wetland AW A T & TOWN44ft4- OWNER'S NAME MAILING ADDRESS APPLICANT ln� A J5DA-hV yiKrr Name & Relationship (.e., owner, tenant, contractor) PERMIT # / K -LZ Mr,Not in Wal 11 Delegated ❑ Joint Revil ri TM # a/1 AA DATE ,r�Z[ let FACILITY TYPE, 1C,GS PCHD COMPLAINT # PROPOSED INSTALLER AWIAV14 A11atira, ;i✓G PHONE# 9/¢ Tyr ADDRESS !Op Gn.on►.v& REGISTRATION /LICENSE # &"44 a'A14- A4 Y< /0$rt1l Proposal (include a separlate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. 1, as owner' agree to 1. SIGNATURE ITLE DATE (owner) I, the septic installer, agree to comply with the conditions of this permit for the septic system repair $IGNA7URE /eZ�:+�.. TITLE_ -DAT E' eP (installer) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicateli showing: a. Owners name, Site Street Name, Town and Tax Map number b. Location'of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be back-filled until authorization to do so has been 06tained from the Department. INTERNAL USE ONLY Propo Approved Proposal Denied El i � A I 11DAY l ectdr's Signature & Title Da a Ex ration Date Re it proposial is in corn Hance with applicable codes Yes Nol 0 COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 J , ,r [� .;YWCA s j: T , rt .Ytr •7r t uJ...... ....:. .... ..... <. :: ..: .... �' :,.., fit\ 5 Y. 1 .. i H, ...... ...:.......... ,. . , .,. -. ..... i - ,t. .. r t _ mar :. t ., MAS . �'. .,, ,:I . . ........ ....... .f..J.,... 1.. ..,I .. ,.... k. .., ... ,•t,. h, .. .f ., .. ...,....L ...... :. .. ..F' ........ .r... .. .,.. .. 1 2' •i : ,r < t 3) .'y r � AiAll 1•i} It .. L' ,..,. ........ .i. r.: rr. ,. ,. J•.c. i. .Y F k 1 -. i ^ =vF V I••rl �P'tl��.'- �.I.ft•�'''... JI N p r r COOK A v • i I ,i.i. 11. I t r ,I y;. 0". :r. i •. ,' .'•:. .� 1 . W�K� r4 • y'�': '. 1 1: 1 r .F r r ,r .. • .1. :1 ,.I r •v 'J. 2 %• r �t r -, a y♦� r, - 3Y" }. t Y i) r� r. r kT i.J ':i:. •4 :I r. ` • At1 `` p " V''..'. rJ �•: ,.. i'.4 F. 1. r r i -�' �j 7 i" a r �_� 1a r �J,, . 1 ........:... .. ... {, : •. .; :e.; r „'!• f. •ter- -� Y2' , t J'M' itl1 I i t 9 Lt 7 t ;1• t,, � . t' ct�' N •� Y •' _ Pi ' , , - �1 I q vi At !ft: 'S•: v '!t J • r e: P. r. S 7F o 4. J _ < +J . . ,.,.. ... .r .. . , K .,, % > � Y .. .- „. . :, ..... .,, . . �k . li_ 1 t � . .. , ,•'[S � ... .r I j 1..(.. I .. r ..,.r . .. ., Dam _ r t : < <,•. .. .Y <. 'c , 1 4:1 1 in. } : I ", C a � 1 A � .. m . .. .. .. . r. Y, r . ..�.. ..t 1 1 5 ,:,,r ..:,z,L.t •• . ,e q - t ions ! r: :r me 1 .Yi /'� 4 MI. 'r • � r. r�'LI t'rr J^ a .. r,i' , I tt�Y 1 4' ( l• d / S - 7 C:' 1 A 7 7L. r4r >`✓ W 1 M'.' : } t S ...t. r nu;v� f• W.I. I -.::.. • ' . , .:. : , .... : ..., ., .. ..: ... .. y.. .r. t. Is 1 r , t 4 r ( t� •L / >r• '3 I� 1:r r 1 r�l , i ..... .. ..:. , , t .rL. 1 i f 3 ' •1 R f c. � 1 1 r: c. - rY M' tik •t. - • f r` 1' ri •: a �:� YP s' 3 a 1 k. u. r I: r. t n f 7 ,:t 1 1 a r ':1 : I v , 5 y Y f - C.. f 1 J. .1 3 •le 5 t. F tJ s• 3Jr 1 4 ilr : N i, , fCjy xn', ..,•t.r is •z.. ' ..wr u AWN. M 1 1 l.,. 1 u.i I r / <y v L j J I '211/2014 FW: Send data from MFP - 0711661512101/201416:23 From: Gene Reed <Gene. Reed @putnamcountyny.gov> . To: baf500 <baf500 @aol.com> _$qibject: FW: Send data from MFP- 07116615 12/01 /201416:2: .� Date: Mon, aD&T, 20 4° �3'pm =„ ;� :_,.hr... _ . . ::'9,. Attachments: DOC120114- 12012014162244.pdf(897K) Bruce, Per our conversation you will only be installing four rows of infiltrators. We are trying to keep the system as close to fifty feet from the we-1-1 as possible. The infiltrators need to be installed in gravel. The sewer lire +' from the tank to the system needs to be encased in six inches of concrete (all sides). A separate letter will be sent to the homeowner pertaining to the j protection of the well water. The revised olan and permit are attached. Thanks for your patience in this matter. - - - -- Original Message---- - From: scantomail ( mailto :scantomailOputnamcounty.gov] Sent: Monday, December 01, 2014 4:23 PM To: Gene Reed Subject: Send data from MFP- 07116615 12/01/2014 16:23 Scanned from MFP- 07116615. Date: 12/01/2014 16:23, Pages:2 Resolution:206x200 DPI ---------------------------------------- i httpsJtwebmail1.mail.aol.com/ 38848-117 /aol- 6terrus /mail /PrintMessage.aspx 1/1 O PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES REQUEST FOR FIELD TESTING ATTENTION: ❑ ,Michael J. Budzinski, PE ❑ Joseph S. Paravati, Jr. All information n :ust be Lull y comrletedrrior to any scheduling. Date: 140 < Engineer or Firm: A /, {�o�_ i� Phone #: f?-I 5 .Reason: Deeps ❑ •Peres �� °� �?y/ — 3300 0 Road/Street: log__ #044,0 sTl va. vs/a�.�u~✓ �� luny - Town: Tax Map #: Subdivision: c Owner: �V) 57 —o 4g l:/ 9� Project not. within NYC Watershed Lot #: NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING - -. YES, NO ❑ Proposed SSTS within the drainage basin of West Branch, Croton Falls, or Boyds Corner reservoirs. ❑ ,�/ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ ld Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ 3"' Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ 2�' Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ,yes to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professions and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY DATE: TIME: COMMENTS: (FlUXEST)m 7/13 Description 1000 GALL HD WAITING TIME OVER ONE HALF HOUR CHARGES ARRIVED START DROP END DROP_ OVERTIME OVER ONE HALF HOUR DRIVER SIGN Not responsive for damages off curb -side >' p Sales Tax (7.375 %) $73.01 Total $1,063.01 Payments /Credits $0.00 Balance Due $1,063.01 Mid Hudson Concrete Products, Inc. I• Mid -Hudson Conoete Products .. . - Redi Rock of The Hudson Valley 3504 Route 9 Date # _ .Cold Spripq NY.10516._ - o n'� ,. - :' . - > -•z. . - - .. _Invoice ., a'•�'„"`-"s'*.' fir. � Phone# (845) 265 -3265 11/12/2014 26682 Fax # (845) 265 -3741 Bill To Ship To Anthony L. Fiorito Inc. 104 100 CROTON RIVER RD Hollbrook rd OSS.INING, NY 10562 Lake Peekskill 914- 490 -9398 914- 490 -9398 Description 1000 GALL HD WAITING TIME OVER ONE HALF HOUR CHARGES ARRIVED START DROP END DROP_ OVERTIME OVER ONE HALF HOUR DRIVER SIGN Not responsive for damages off curb -side >' p Sales Tax (7.375 %) $73.01 Total $1,063.01 Payments /Credits $0.00 Balance Due $1,063.01 Putnam County Department of Health Division of Environmental Health Services SSTS Repair — Fin I Site In Date: 4l �y — Inspected by: %�; Installer: Street Lo ott: o Owner: TNIfr�.- 1. Type of Dysrem: Lonvengronai u Alternate u comments: 2. Se tic T nk Yes No N/A C®xnments a. Septic tank size (2,Y.. 1,250... other..... / !, rCa v b. Septic tank installed level ...............:...... c. 10' minimum from foundation .................. d. Distrl u 'on Box i. All outlets at same elevation (water tested) ... ii. Protected below frost ........... . ................. iii. Minimum 2 ft. Original soil.between box & trenches e. J n Bo — properly set ........................... f. 1`' gn c _. i- Stem completely opened for inspection ii. Length required Length installed 7� iii. Pipe slope checked ... ............................... iv. Installed according to plan ..................... 1'e?;17 C'4 PC, n V. 10 ft. from property line — 20 ft — foundations ... vi. Size of gravel % -1 '/s " diameter clean ......... vii. Depth of gravel in trench 12" minimum ......... T ... - -v1Y. -Ends ..... :mob& .. ....._'.�...., g. Pump or to 3. SewaitAXAMAM a SSTS Area located as per approved plans b. Fill section— - c. Distance from water course /wetlands 4. Overall workmanahi a Boxes properly grouted and installed correctly ........... . b. All pipes flush with inside of box .......................... c. Backfill material contains stones <4" diameter ......... d, Curtain drain & standpipes installed according to plan e, Curtain drain outfall protected & dir to exist watercourse f. Footing drains discharge away from SSTS area ......... g. Erosion control provided ............................ Additional Comments: 11 Rev- 011312 ALLEN BEALS, M.D., J.D. Commissioner ofHealth ROBERT MORRIS, P.E., "MPH Director of Environmental Heafth DEPARTMENT. OF HEALTH 1 Geneva Road,_ Brewster, New York 10509 Phone .# (845)1808 -1390 Fax # (845) 278 - 7921._ December 1. 2014 4 William Strand 104 Hollowbrook Road Putnam Valley, NY 10579 Re: SSTS Repair at 104 Hollowbrook Road (T) Putnam Valley, TM 91.34 -1 -1 Dear Mr. Strand: Per this Department's sewage treatment system repair approval, the following comments are offered for the protection of the well water. 1. This Department strongly recommends that the well be double cased to a.depth of 100 feet. 7.,2.. T'bis :,Deparlanent_also strongly- recommends, t_rzat an-ultraviolet -unit be installed in:the incoming main water line. If you have any further questions, please contact me at (845) 808 -1390 ext. 43261. Sincerely, Gene D. Reed Principal Environmental Health Engineering Aide GDR:cml PUTNAM COUNTY HEALTH DEPARTMENT i_ - - -- DIVISION OF ENVIRONMENTAL HEALTH SERVICES p ° F) ern ��am�rue�� -e o-n &pg U nM &aa u Q V %P u. &una.."&.J_' " . � Internal Use Only PERMIT O ©/ Repair Permit issued in last 5 years IJ' Not in Watershed ❑ VRepair within Boyd's Comers, W. Branch or Croton Falls Res. ❑ Delegated Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION , TOWN 44g,, TM # gi. 3 Y - / OWNER'S NAME MAILING ADDRESS APPLICANT Miry Le 6oAIrty Name & Relationship (i.e., owner, tenant, contractor) DATE 6�/&Z.I FACILITY TYPE X05 PCHD COMPLAINT # JAI PROPOSED INSTALLER Z(aa.��r �i+/� PHONE # 9,f 0 ®99Jr ADDRESS B00 iVXHyi , ` ,0 REGISTRATION /LICENSE # o�ss�✓ra�, etJ Y� /os'�� Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the I, as owner,agree 4thh ond itions stated on this form SIGNATURE ITLE DATE (owner) the septic installer. agree -to comply with the:conditians of this permit for the septic syptem4 repair. M 4 f� SIGNATURE da TITLE ,,0x4,:5 DATE (installer) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. me ITMMI Am 11c-1T ^flog v 1191 GI'919ML V7G VI9LT Propo Approved Proposal Denied ❑ L5,7 +. 1114Y 11 l>-l4/ Aector's Signature & Title Da a Ex ration Date ,Repair proposal is in compliance with applicable codes Yes lk No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML I Rev. 2/07 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SUBSURFACE SEWAGE TREATM ENT- SYSTEM Owner. Address: Located at (streeQ:_jC)q --TM# Municipality: Watershedi Son, PERCOLATION TEST DATA witnessed by: Date of Presoaking: Deft of Percolation Test: "1 11,4-11 �z 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percq4tiop Whole. (i.e., :5 1 min for 1-30 min/inch, —< 2 min .3 fo -r1-60 min/i — nch). All data to be submitted fbr review. 2. Depth measurements to be made from top of hole. Form DD-97, pg I of 2 II Depth to webr from ground snrim (bides). I Sad - Stop watio ievel drop inches M. I 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percq4tiop Whole. (i.e., :5 1 min for 1-30 min/inch, —< 2 min .3 fo -r1-60 min/i — nch). All data to be submitted fbr review. 2. Depth measurements to be made from top of hole. Form DD-97, pg I of 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Address: Signature: iITNA� COUNT4F IDesign Professi®naIl9s Smell Revised July 2013 IU0V 2 2014 ,I) PAFTMC,tVq 0 NEAuH