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HomeMy WebLinkAbout0426DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -3 -95 BOX 5 00235 l,y,. , , ` to 1 110 No a a of IN 6 No Ar A I Am , 00235 i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FO SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # F° 1I - o i . a 3 -1 1,3 « � Located at t Z visrA L AAleC Q©wn or Village r.A rr c2So,,, Owner /Applicant Name Nv - c R A rr RVIL 96, -,C, jwc. Tax Map 13 Block 3 Lot 9s Formerly Subdivision Name A s rR ;, A sru e : SAT C-s Subd. Lot # 2� Mailing Address F. ° . oX s z 16 r ED rog- N y Zip 5 Date Construction Permit Issued by PCHD 1 - 1 3 - 0 1 Separate Sewerage System built by ,vv -CkAFT �Sv��a�2s. r� C- Address Po.. Rvx �Z�3 BCncaa��vY io��� Consisting of T S 0 Gallon Septic Tank and 4l1 q i.' o f t' �� r � B Q d o � t'r� �.v s,#e c vcN C s Other Requirements: 12 - w A Water Supply: Public Supply From. Address or: X Private Supply Drilled by M, i.•rarJ MYAT- Address ftrrt�t2xg,i Building Type A Ci i n c N T/A i. Has erosion control been completed? YEs Number of Bedrooms Has garbage grinder been installed? 1Za 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 the Putnam County Department of Health. I.' Date: 1 z ' 1 NSIrE Gr/6�.�/r�i Address 1. A,v D IC A cO A2C a 0 A A A eTf Certified by P.E. y' It-A4. J(Desin Profess o al) OP A--- C License # CJq31 CA,M 9 i' Vii✓ laS�ti 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 ubject to modification or change when, in the judgment of the Public Health Director, such revocatio mo ificatio o change is necessary. By: Title: U Date: a White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 j. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: lQf1 C. TownNillage: /-GZ E(- G y I Tax Grid # Map 1"3 Block -3 Lot(s) Well Owner: Name: Address:. ' /4- Use of Well: 1- primary 2- secondary Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length QV ft. Length below grade 26 ft. Diameter Tin. Weight per foot 17_Ib /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: Yes No Liner:— Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test Bailed —Pumped X Compressed Air Hours Yield -S gpm Depth Data Measure from land surface- static (specify ft)" iz .. During yield test(ft) Depth of completed well in feet I zc 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 tj�r Sod 97 39 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type - Capacity G rA. Depth Model %6-6(%7 Voltage � HP 0. ,, / l Vol �(3 don Tank Type�Q ume Date W Putnam County Certification No. : 06-7 Date of Repo �' 3 Well Driller (signature) NOTE: Exalt location of well with distances to at least two permanent yandmIrks to be provided on a separa;p4heet/plan. I r Well Driller's Name C� :i ' a Address: Signature: Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 /NS/TE ENGINEERING, SURVEYING A LANDSCA PEA RCH/TECTURE, P.C. 3 Garrett Place (845) 225 -9690 Carmel, New York 10512 Fax: (845) 225 -9717 TO: Putnam County Health Department 1 Geneva Road Brewster, NY 10509 WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter LETTER OF TRANSMITTAL Date: 1 -22 -03 Job No. 98105.325 Attn: Robert Morris, P.E. Re: SSTS for Astro Associates Lot 25 12 Vista Lane, Town of Patterson TM# 13 -3 -95 ® Enclosed ❑ Under separate cover via ® Prints ❑ Plans ❑ Change Order ❑ ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION 5 1 -22 -03 AB -1 ! As -Built Drawing 1 . . . `s 1 -22 -03 . CC -97 _..__.._._._.. . ....... .._ ........... _......... _.._.. ._.__.......__._.._..._......_. _........... _._._._.._........ ____...._._._...._.._. --- _..._._... ----------- _......_._ Construction Compliance 3 10 -3 -02 I GS -97 Guarantee ............................_........................................................ 1 .._...............__..._......_ --- - - - - -- . ....._............._..._......p --- - - - - -- ....._......_......_.._....... _.._.............._._.......... __.._.... .. ...... ..._....__..... ................ ...... ..... ....... . .... . .... ........... ........... ......._..._..........._......_.__........_ ....... ..... ...._.............. I E911 Address Verification I 1 w � ! 12 -6 -02 j --- - - - - -- I Water ra et Test Results .. ............. .... ........... 1 .................._._........;,...................... .-........ .... ...... ....,..._................ i 5 -30 -02 i...__ ........._..__......_.....,.... I WC -97 ..._ .....- ..._................_.... _....._...__....._....._......_....... ............... ........... ......_....__..............__._._._...._.._. .............. ... ... ... .............. ._..... I Well Completion Report 1 ` 1 -21 -03 46703 1 $200.00 Fee j 44271 ....... ... ............. ....... _.............._................................... .........._ --------- ......... -� ........................_ .... .._ .......... .....__..... _.._ -... __.._.._._...._........_._ ..... __...._..._._........._ ..... _...._........ _ ...... _.._... .._._ ..... ..._._ ............... __..............._ .... ...... ... _ .. ------- ....__........_....... i ........ ................................ .... .................... .... ... ....... .................__.. ..............._............. .. _.._.........._....................:..................,_..._...............................,._...__._...- _ ..........._....._..__......... ......... ....... ............................... .... ...... .. ... ..... .... ..................................._..._....._._...._......... ........ _.{._ ........... _ .... _................_ y._......._....._..._........__................_.................... ..._.._._.. ------- .._........""-'...`"_..._...._._..............._.........................._.............. ..._. ... ...... ..__...._.."--...,_....._.............. ........_._................,... THESE ARE TRANSMITTED as checked below: ®For approval ❑Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: COPY TO: 61� ff � r J is J n M. Watson, P.E. lot2002.dot PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser•of Building Tax Map Block Lot Nd•'CRAFT R✓ILDCRS zvC. f4ftCR50N Building Constructed by T wn/Village )-I. V15'/A I.A VS ASI'X .A Sgoc_ /A fCS Location - Street Subdivision Name ��iS /7 ENT /AZ �S 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 the occupant of the building utilizing the system. 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 lo Day 3 Year a z Signature: Title: General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State �ip Corporation Name (if corporation) • Address: Mi I Q KA- F1 R ILbCkj,j�jC, State FO f3°'i Sli k17P,*,g Zip D Form GS -97 �9 JAN -23 -03 10:05 AM TOWN OF PATTERSON 9148792019 P.02 BRCCB R. FOL$Y Public Ntdldl 01rtuce DBFART 1 OF HEALTH 1 Geneva Road Brewatar- New York 10504 LOUTTA MOL ARt RN„ 149,N. Arsoatare Prbha Makh D&wkr Dtr9reror of rdttsret se"Ust 141h aomearal Rewth {914) 278 , 6170 F=(214) 272-7921 *42MaA 36TY1ee6 ;914)173.6351 WIC (AL4) 271.6176 ?= (914) 274.6011 Early i1w-►aatlet p14) 2", t • 6914 PrtHkool (914)17"012 PIN (914) 278 - 6644 OWNERS NAME: JVJ-CaAF-rSUJI'DE-n -s %We,� Vin_ �vE ri TAY MAPINUMBER: 7^ 9-!5 .E911 ADDRESS; 1 ✓ C s rA TONN AUTHORMED TOWN OFFICIAL: �/ ► �.✓'�� �"�" (Signature) DATE: Y10 3 The Putnam Count. Department of Health will not issue a Certificate of Coastruction Compliance unless the abase form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. 01 OVTRMMI� 91 4 .� t.'il.i III NN!, V f e0 �... '•i`. _ it ; t. _c N3 NORTHEAST LABORATORY OF DANBURY . p 1N ACcORpgy 39 MILL PLAIN ROAD - DANOMY, CT 06811 CT Cert: PH -0404 (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 v LABS www.NORTHEAST LABORATORIES.com < LABORATORY REPORT REPORT TO: HYATT PUMP SERVICE DATE SAMPLE COLLECTED: 11/22/2002 229 SOUTH ROAD TIME COLLECTED: 9:30 AM HOLMES, NY 12531 COLLECTED BY: C. HYATT DATE RECEIVED @ LAB: 11/22/2002 TESTED BY: LAB #11471 & 11301 DATE TESTED: 11/22- 11/29/2002 LAB I.D. # HYATT PUMP- NY1365 REPORT DATE: 12/06/2002 SAMPLE SITE: NUCRAFT BUILDERS, LOT 25 VISTA LANE, PATTERSON, NY SAMPLE POINT: KITCHEN FAUCET SOURCE: WELL TREATMENT: NONE MAXIMUM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (MCL) OR STANDARD BACTERIAL: • Total Coliform (Bacteria) 0 per 100 ml SM 9222B 0 per 100 ml PHYSICALS: • Color (Apparent) 5 - EPA 110.2 15 units • Odor ND - - 3 Units • pH 7.23 - ASTM- D1293 -99 No designated limits • Turbidity 0.87 NTUs EPA 180.1 5 NTUs CHEMISTRY: • Nitrite Nitrogen <0.005 mg1L as N EPA 354.1 1.0 mgfL • Nitrate Nitrogen 3.0 mg/L as N EPA 353.3 10 mg/L Alkalinity 276 m91L SM 2320B No designated limits • Hardness 364 mg/L EPA 130.2 No designated limits • Iron 0.05 ( <Q) mg/L EPA 236.1 1 0.30 2 mg/L • Manganese <0.01 mg/L EPA 243.1 0.30 2 mg/L 2 Combined limit for Iron plus Manganese = 0.50 mg/L • Sodium 1.2 mg/L EPA 273.1 No designated limits 3 • Lead <0.001 mg/L EPA 239.2 0.015 mgE * ** • Chlorine Residual <0.05 mg/L - - - - -- ml=milliliter mg/L= milligrams per Liter ND=none detected MCL= Maximum Contaminant Level TNTC =Tao Numerous To Count <Q= Analyte detected below quantitation limits. Data deemed estimated * *Notification Level ** *Action Level 3 -Water containing more than 20 mg/L of sodium should not be used for drinking by people on severely restricted sodium diets. Water containing more than 270 mg/L of sodium should not be used for drinking by people on moderately restricted sodium diets. COMMENTS: - Sample, as received, complies with all State of New York regulatory guidelines. . -All holding times (were) . met. SAMPLE, AS TESTED ABOVE: O OTABLE or OT POTABLE CF (PER STATE OF NEW YORK DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) e Quality Control Officer Laboratory Director -NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TILT T FUBE? AA TT TMT !'7`• QnA "4 Al AC - nT T -rQTnp f- r. 0 11A 4GA 1 11A ^ 0 • 4 �' T C 11250 GALLON SEPTIC TANK 12 -;WAY DISTRIBURON`BOX PRIMARY A9SORf(11ON 2 TRENCH (TYP)sr 2 . 5 ON_ fZLED PROPOSED 1 0. � ssrs iocanDro �: PFR• ` D t -- EXPANSION. ABSORP. 77ON x L t TRENCH (TYP.) (10& EXPANSION PRONDED) 4' SSYS LOCA`7T PER PERM /T - 1 - r-, r `SY 43 - - 1 T � ! z C f" t T � T , S ` Putnam County Division oPEnvir h AP Pro as not r 'app 'cab e_:Rul 1 s ' i,gf. Ti 7 - � Y, a Ccas1� ' V or AS Gl_ IZCAf �r r ze S ` Putnam County Division oPEnvir h AP Pro as not r 'app 'cab e_:Rul 1 s ' i,gf. Ti 7 - � Y, a Ccas1� ' V or AS Gl_ IZCAf �r r PUTNAM COUNTY DEPARTMENT OF HEALTH w DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: 30 02 Inspected by: E Street Location 12 VI!57 t 2 4 Owner �-�„ ate, Town Permit # TM # 13 — 3 — 5- �. a. Subdivision Lot # :2 g` 1. Sewage Svstem Area a. STS area located as per approved plans ... .. ....................:.. b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil. not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. SSewe e System size,- - 1 000 ........1 250 .. other ................ b. Septic tank installed level ................. ............................... c. 10' minimum from foundation .......... ............................... 'd. Distribtuion Box - outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box roperly set. .................. .. 1. .. ............................... eng required % Length installed�� 2. Distance to watercourse measured 4- Ov Ft.......... 3. Installed according to plan .. ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 - 1 %" diameter clean .................... 9. Depth of gravel in trench 12" minimum :.................. 10. Pipe ends capped ........................ .......... .I.................... g. Pump or Dosed Systems 1. Size o pump, chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. HouseBuildin a. house located per approved plans...... ! .... ............. b. Number of bedrooms ................:.. .........................:..:.. IV. Well a. Well located as per approved plans . ............................... b. Distance from STS area measured_ ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ........................ V. Overall Workmanship a. Boxes properly grouted .................: . ............................... b. All pipes partially backfilled ........... ........................... ..... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercours g. Footing drains discharge away from STS area ............... h. Surface water protection adequate......'. ... i. Erosion control provided ................. .............................. Rev. 1/97 Form 01 SEP -26 -2002 14:06 FROM:INSITE ENGINEERING 8452259717 TO:2787921 fi PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION ❑ ADAM RE�LtESTFORFIl�AT- INPFTICj All information must be fully completed prior to any inspections being made. ErGENE For: Fib Trenches PCJH7 Construction permit # f- f 1- �r Located: 12, vi g4 [ANA Owner /,A,ppbean.t Maine: Afla La.-U e c 7'on.19 -- TM 3. Block „_I— Lot s9!.-xs Formerly: rvIA _ Subdivision Name: As-rieo A". mru Subdivision Lot # Is system fill completed? N 44 Date: Is system complete? yct Date. Is system constructed as per plans? . xgc Is well drilled? YGS Date: ' - LoZ Z. Is well located as per plans? _ r(s _ Are erosion control measures in place? I certify that the system (s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the. issued PCHD Construction Permit and. approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date: (OZ— Certified by: inslte Engineering, Surveying esi Profess o Landscape Architecture, P.C. Address: 3 Garrett Place Lic. # ^� C//t21 Cannel, Now YM 10512 Comments: Form FIR -99 -- - -I.OA�_070_7aa1 NAMF:PUTNAM COUNTY DEPARTMENT OF P P:1 /1 y,..Q BRUCE R. FOLEY Public Health Director LORETTA . MOLINARI R.N.; M.S.N. 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 October 3, 2002 Jeffrey Contelmo, 'PE Insite Engineering 3 Garrett Place Carmel, New York 10512 Re: Field Inspection, - Astro Associates 12 Vista Lane, (T) Patterson Lot # 25, TM# 13. -3 -55.25 Dear Mr. Contelmo: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. Replace 90° elbows from the septic tank to the system using 45° elbows. 2. Re- install silt fence in ground. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR: cj Sincerely, Gene D. Reed Environmental Health Engineering Aide y .s 4 ", PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # 1- Located at Z. V ( s rA L A 4 1�- Gown or Village PA-trCA S e> AJ Subdivision name bsfino AssoclATEiSubd. Lot # Zr Date Subdivision Approved /O-S' -oa AstAo A ssoc IATEs Owner /Applicant Name 4& t ov i s PCsc A ToA 6 Tax Map (:5_ Block s Lot CAA. 2 r Renewal Revision X Date of Previous Approval '5 ° VS — O' 1 Mailing Address Qz -So Q vegAiv e,)vL EVARCD _ k 6ao pq g k , �'! Zip 11314 — Amount of Fee Enclosed 150.00 Building Type P >st-) Enl'1A L Lot Area ®, 9 7 No. of Bedrooms 4 Design Flow GPD Oo Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage -System to consist of (, z !;-d gallon septic tank and ql q L- i : of �tIn A 9SdR P-r io1V -rA6MCW t-S Other Requirements: II-WAY `ra Sr2l ✓ r ro^r BOX To be constructed by Nu G1Af°r 6 vi'O exS Address f o, 8 o)c st-o, Water Supply: Public Supply From Address or: _ < Private Supply Drilled by R 4AIT " Address P A fftn.SaN I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the sgparate sewage treatment sstem 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 thereto. Signed: Address P.E. CANnScAPE A4011TErfvRG, . w y arl z_ License # Date 9 -.15-' 0 cif .1 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 w c sidered necessary by the Public Health Director. Any revision or alterat n of the approved plan requires a new pe i A proved discharge of domestic sanitary sewage only. CL� U By: 1 Title: Dater 13 01 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Forin CP -97 /NS/ TE -JV�7 ENGINEERING, SURVEYING & LANDSCAPEARCHITECTURE, P.C. 1485 Route 22 1 (845) 278 -4990 Brewster, New York 10509 Fax: (845) 278 -6392 TO: Putnam County Health Department 1 Geneva Road Brewster, New York 10509 LETTER OF TRANSMITTAL Date: 9 -3 -02 Job No. 98105.325 Attn: Robert Morris, P.E. Re: SSTS for Astro Associates - Lot 25 Vista Lane, Town of Patterson TM# 13 -3 -55.25 WE ARE SENDING YOU N Enclosed ❑ Under separate cover via ❑ Shop Drawings N Prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION -.--_....____..__ ..... _. _ ........ ....... ..__- _,__�...__ .___- ....__..._ { i I THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval N For your use ❑ Approved as noted ❑ Submit copies for distribution N As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: Rob - Enclosed is a copy'of the 5 bedroom SSTS plan and the 5 bedroom construction permit as requested. Please call if you need any additional information. - John COPY TO: SIGNED: --- 4n JM. Watson, P.E. IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE lot2000.dot P V TNAM F HEALTH \.aF✓y'r's- -�-� -" ":zf��!?',K^F- '.'zf�;i.%m"f?i., �� � � �, � .� , s. r ,?a,. Y ..� ... .} CPS' ...A DIVISION OF E ONIVIENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM =� PERMIT # i� 11 - - -cj! �' �.. �� Located at _ _ QU 3 11 S-A - LQ A,( Town r Village ,� Subdivision name Oka A9S0clArY ; Subd. Lot # Tax Map ) 3 Block '2�,_ Lot ' f' S-Y—. S Date Subdivision Approved Renewal Revision ASPO ASS 106.5 Owner /Applicant Name /Q Loy! S Date of Previous Approval ---" Mailing Address /�– j QVI'�1tl5 P�DUZi Q ��D AR. 1�• Zip, . Amount of.Fee Enclosed Building Type i 10W T L._. Lot Area ' o. of Bedroom .Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED UIRED WHEN FILL IS COMPLETED Separate Sewerage.SyAemto. consist of /,S�i gallon septic tank and I i -off 2' �nllpl AgSo�P�ro� 7"���y���S OtherRequirements:... / VA P151'R1 UrJ11h To be constructed by flnl ii/fi.tJ Address NN Water Supply: Public Supply From Address ` , or: Private Supply Drilled by O11j��OW Address ).Y A I represent that I am wholly and completely responsible for the design and location of the proposed systems) 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" satisfagtory.to.th6 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 thereto. Signed: Address P.E. R.A- -- - Date — N 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 maybe amended or modified when co sidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. fA roved for s�Charge of domestic sanitary sewage only. 1 By: � Title: '' Date: � ! J .), t White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design )'professional Form CP -97 WADED A WAY FROM WELL ADAPTER liROUGH T IRON WLL CASING. OF 20' TOTAL AND MINIMUM TO ROCK. EN77RE PORTION OF ;ING INTO ROCK TO BE GROUTED. E BLE PUMP D HOLE IN SOLID ROCK 'L .. °r�eavntrncrrt'. ^emrr ° �rtm. rvrv��a -�r- �•���•.:;..:�r:���:- . as part of the Certificate of Occupancy Application. 13. This Plan is approved for sewer treatment ands -'or water supply only, and off required permits and /or approvals are the responsibility of the permittee. 14. The Putnam County Health Deportment approval expires two (2) years from t date on the approval stamp and is required to be renewed on or before the expiration date. The approval .is revocable for cause or may be amended or modified when considered necessary by the Department. 15: A copy of the house plans submitted to the building inspector of the local municipality, when riling for a building permit, must be submitted to the Put, County Health Deportment to verify the bedroom count. 16.' No existing wells within 200' of the proposed SSTS and no .existing SSTS's w. 200' of the proposed. well unless noted otherwise. 17. Contractor must notify the design engineer 72 hours prior to the installation any portion of the SSTS 18. Distribution and drop boxes to have speed levelers as required. 19. The limits of the 100 year flood plain boundary ore greater than 200 from a, property lines according to the FEMA Flood Insurance Rate Maps. 20. All facilities proposed, unless noted otherwise. 21. The soils in the' area of the SSTS are CrC, charlton— chatfield complex, 2 %1. slopes according to the USDA —SCS soils mapping. 22. Boundary and topography taken from filed map #2846. Datum is U.S G S . 23. AI/ erosion control measures for building(s), wells) and SSTS(s) are to be installed prior to any construction. The soil erosion and sediment control pra, as shown is a minimum. Additional erosion control shall be required as neede shall be installed in accordance with "New York- Guidelines for Urban Erosion Sediment Control' latest edition. Areas of exposed earth should be minimize( exposure should be kept to the shortest time practicable. Erosion control me shall remain in place until all disturbed areas are suitably. stabilized. N0. I DATF REVISION INS I TA5 ENGINEERING, SURVEYING & ! ~ LANDSCAPE ARCHI TEC TURF, P.C. PROJECT- SSTS FOR ASTRO ASSOCIATES LOT 25 NSTA LAN- PATTERSW PUINW COUNTY, NEW YORK DRA WING. C TRUCON DRA KING 1485 Route Brewster, N) (914)278-4 (914) 278—f www, insit a —e r IE OF Ncr� W. J. R. f DRAWING NO. A.J. G. CD--7 PROJECT 98105.325 PROJECT NO. MANAGER DA TE 2-26-01. DRAWN BY SCALE AS SHOWN CHECKED BY 1485 Route Brewster, N) (914)278-4 (914) 278—f www, insit a —e r IE OF Ncr� W. J. R. f DRAWING NO. A.J. G. CD--7 .o— P e . I, MRIM 470 PROPOSE!) .:;.. 5 BEDROOM DWELLING F.F. EL. = 492.0 MIN. IN V. OUT = 489.0 4.0 CIP ® 114 %FT. MIN. SL OPE ?. 1 GRAL 7?WA RIMARY A6 RENCH TRIBU TION 1500 GALLON SEPTIC TANK 4 "0 SDR 35 1 18 " /FT. MIN. SLOPE SS TS PROF SCALE.- HORZ: 1" VERT. 1 " Putnam 6'imnt7 P rtg*M Of l@Kth Division g$ Envir& mentetij Hee`ltl� Servideff Approved as noted :er @&d6Tb -gnm'6F with app ie tle RUu1 ' ad e- g,,Adtf oha off` t Cyr Health- DepaT&e fir 13 .�1_ S gnat== Ee AL7ERA77ON OF THIS DOCUMENT, UNLESS UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER., IS A VIOLATION OF SECTION 7209 OF ARTICLE 145 OF THE EDUCA77ON LAW. / y i CP F TO cz 490 ; . UN