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HomeMy WebLinkAbout0568DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23. -1 -32 BOX 7 IRS INN% IN #; �Nlr , a V I ' I � r dl IN I kP 11 .: —J. PUTNAM COUNTY DEPARTMENT VF HEALTH .-'�'�� � Rd 3186. Division of Envlromnental Health Services, Caimel, N.Y 10512 ;: 0. P.C.H.D Peiiuti CERTIFICATE .OF.CONSTRUCTION COMPLIANCE FOR SEW_ AGle DISPOSAL SYSTEM —777 Tat at 0 wner/ap-Plicazit'Name 774J E "k &�"Fo Subdivia. nn Date Pet�qdt-&"Md Mailing Address Separate Se- verage YO m biitliy_ Consisting of /Z-O Gallon Septic Tank and Water Supply: - #0116 Suopi, fism 01 Address, Address Private' Suipply Drilled b7 ors Type - n r1a.--Has Erosion Control -Bee Completed? Number. of Bedrooms Has Garb no Grinder lufft.alled? L Other Requirements certify that the systems) as listed .serving . . t . . . . ;,is . sei . Fy . ing the above piomAs#a were essentially I , asshown the plans of the completed work copies of whi6k'are attach), �cco?rdanco:with. thei.standiids,:,ru tionsi in ace. i� e' .dance with e.fi d plan,,.and the Permit issued by the Putnam county 99partment 01 Health. Car -fie P.A. t .1 by Date License No. Ad r. ��l 1,12 r- . f ess Any person ciccupyini promises served "b,j theatioxe wstem(ti'siiill promptlY take such act" as maybe necessary to secure the correction of any unsanitary ns rikulting from skopro4al 'o!, the - sepa . !a , te�,!!�Worwi;*_SYOOM "11, tl-- sanitary Wkw becomes conditions j�uch Ujjjj; become null.'pn.d.. void as.soon as &pub is water void when a p4blic-water sijpply.bocomea available. Such approvals are available and'Wi a0pr!oval of t he pr Iyate. subject t qbange wh in _1 the juO Moo o rnodl Ication 0 .9men of thS'COfnM S of such revocs n, modification Of change Is necessiiv. en, '79 Oats Title By D 13 f j PU'TNAAR C ®UN'TY IEAL,T& ®EPT. Y 110 Ofd Rt 6 Ctr'; Pnorie s14 225 -oalo PUTNl COUNTY 0�6N7 a Carmel, New York< 10512 a th Ser _ �,Qro'nment � 19. 0 12 105 12:12 P.F.BEAL INC. r r WELL COMPLETION REPORT DEPARnIENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATIONI Hampshire Ct. Pa WELL OWNER NAME: Cornwall Home Bldrs., 155 USE OF WELL C9 RESIDENTIAL O PUBLIC SUPPLY 1 , primary O BUSINESS O FARM 2 • secondary O INDUSTRIAL O INSTITUTIONAL P. 2i2 Iffice Use Only CJ TAx GAIO NUmilik terson NY Lot #24 A00AISS: 18P80 PIV E. Main St.? Brewster, NY BLIC 0 AIR /COND./HEAT PUMP ❑ ABANDONED El TEST /OBSERVATION O OTHER (specify) O STAND -BY Cl AMOUNT OF USE YIELD SOUGHT gpm. /N0. P50PLE SERVED �/ EST. OF DAILY USAGE-gal. REASON FOR E3REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY + DRILLING ®NEW SUPPLY (NEW DWELLING) C] DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH Ao❑ -' ft. STATIC WATER LEVEL . �48_it. DATE MEASURED ORILLING ® ROTARY aCOMPRESSED AIR PERCUSSION ❑ DUG EQUIPMENT ❑ WELL POINT ❑ CABLE PERCUSSION 0 OTHER (specify): WELL TYPE 10 SCREENED ❑ OPEN END CASING CR OPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH CASING LENGTH BELOW GRADE DETAILS DIAMETER WEIGHT PER FOOT SCREEN DIAMETER (in) DETAILS FIRST GRAVEL, PACK j ❑ YES IGRAVEL 11 ❑ NO SIZE: WELL YIELD TEST I It detailed pumping METHOD: O PUMPED teats were done ►a in• COMPRESSED AIR ;formation attached? . 'DYES ONO SELL DEPTH DURATION QRAµ/OOWN YIELD it, Nr, min. 11. Qpm. ,ATER O CLEAR TEMP. UALITY 0 CLOUDY HARDNESS O COLORED ANALY2E07 0Y95 ❑ N0 ANALYSIS ATTACHEDI 0 YES ONO UMP INFORMATION 0E _— CAPACITY .r.._ — AM DEPTH OOEL VOLTAGE HP _ b 2 tL MATERIALS: 29 STEEL a PLASTIC O OTHER 61 h, JOINTS; O WELDED EO THREADED 0 OTHER In, SEAL. 91 CEMENT. GROUT ❑ BENTONITE [3 OTHER _19 lb./It. DRIVE SHOE M YES ONO I LINER: DYES ENO 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (11) 0EYELOPED7 ❑ YES 17 No HOURS [DIAMETER ITOP BOTTOM OF PACK ln. DEPTH _ M. OEI" tH � M. WELL ��� II more deta led formation descriptions or aleVA analyse are aysilable, pieast Attach. O UNFACFM Wirer 1 :11 At�r• mela FgAIMATION OESCAIPTION taa! it, it. Ina to rojck at S' set cas 8J93 jydjof acturing Proc-eudre 8193 Ale 6ased welll. :4x6 seal ;ii STORAGE TANK; TYPE CAPACITY CAYr. ■Y WELL DRILLER NAME T.F. Bea 1 & Sons , Inc . . AoORESS 4 Putnam Avg, SIGNA1y Brewster, NY 10509 NORTH AMERICAN LABORATORIES, INC. ANALYSIS DATA SHEET TYPE: PW LOCATION: Lot 24, Hampshire Ct.,_Patterson, NY REPORT TO: Cornwall Homebuilders, Inc. ADDRESS: 155 E. Main St. CITY, STATE, ZIP : Brewster, NY 10509 DAIS COLLECTED; 09 -13 -93 TIME COLLECTED: 1:55 COLLECTED BY: S:J. Pecora Jr. REPORT DATE: 09 -15 -93 LAS # 93-4524 SAMPLE SOURCE: Kitchen tap DATE ANALYSIS RESULT UNITS METHOD ANALYZED Total Coiiform MF Absent SM 17 (9215D)09 -13 -93 THIS SAMPLE AS RECEIVED AT THIS LABORATORY MET THE REUU1REMbN'I'5 QV NEW YVKK STATE ORMKIN(iWATER STANDARDS. . " 1111 Ar r roator NEW YORK STATE FLAP CERTIFICATION NUMBER: 11218 F, 1 R ri nrk' T()1A /FR f ('IAAkAC'1hIC RTF ) '). RRFWSTFR NY 10 500 / (41 4-97A.7(,,00 / FAX 414 -278 -7754 PUTNAM OOUNlY DEPARZMFNT OF BFALM DIVISION OF ENVIROiAL fiFA.LTH SERVICES Owner or Purchaser of Building Building Constructed by �oM�f�G� C '17t2�U� Location — Street Municipality Building Type Section Block Lot Subdivision Name Subdivision Lot ff GUARANTEE OF SUBSURFACE SENAGE DISPOSAL SYSTEA 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 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 Director of the Division of Environiental 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 the building utilizing the system. Coaviall Corporation Name (if Corp.) V. 15' ` Address rev. 9/85 mk Signature �< �� wy�,t� -a &MJt-C1<,,Q,� Title LT Corporation Name UX Corp -) N � ds0 Address ' PUTNAM COOMR DEPANTMENI' OF M&AEM y DNOrbte e[ ®nlraamealil BeaJ�'9eevloae. Ceasel. R1 Y 11613 to FtievWe Pea�lt i C8�1II+IGlZB OF COLIANCB \�� a PSIIQI' � �� LeerW q ✓Y esrB aV't Sttb 1st g = Tax Map abat Ressm, _ r c ' �lEe bba `, r� OwMdApMaartt Neime /"Lrl J ►`. r!v ._ / �►-! �1 Daft of Pwvbo Ap�aoval -3D Noma AAAWN Date:Subdivision- ARRroved Fee Enclosed Amn,;nt J. l Am 3 � r9 4 � � Deg �e Na6bie aI Beder>slm � DeW1: Flow. G. P D � a PCHD to What Fm Is . S"w@ft,S@reagp Sy"m to ago "'d irL CTO&O Sep& To& an 4 6U T® bB eiiwotia.b� z b n lldtlrean way sib: s.F><,o Aaaaa y l--oa &0* ut®aa llr a O&W 1 rtprassntaMt,l am whollyndycompNtaly cespons�ble the design and location 'oR'`the _proposed, systam(s)i 1) that time se rota sew' disposal. stem above dmW" will.be cofnstructed As shown on the appro ved amendment the/s to and in accordance with the standards, rules a regu ns:O The rumem County OipNtmint ' oP tMOlth, anA that on completion tharsof a "Certificate o/ _ Construction: CompHanp",'Ytisfactory to the COmmiglorW of, NMtth Will be �"inlitba to tfta'.Oepart iiant and s written gwnntee will tlq /urnisliad tM Dada► .hie wcgsfo►i;.Mirs or.essipns by the builder, loaf feed buiwar will pqq in hoed operating condition 'any part of 'pip shays dlspossl ayetom die ing the: period of two'(2) yews lmnioaiately following i te,0 the iW ahq of the approval Of the CeitNieate or "Construction. "Compliance of the originai'systsnt or any repair$ thereto; 2) that the drilled well dawitied Ydove WA be located os Ylorrn on tM,approved.plan and that seep wall will 0a instal in eccordance with kM 'eta ro rules, ?ptd. reyu ono PYiMm COUntY �epaftflNlll oPaMealfh. . Gate 'i P/ �e 3 nsQ P.E. R A. Address �f�GicenN No APPROVED FOR CONSTRUCTION: This approval expMat.tWo Yeah fro.in the data -issued .unless con'st►uaton of the building has been undertaken and it revocable for cause or may be amended or modified when considered natassary py,. the Commissioner .of M®Yith.' Any Change -or alteration of � construction requires a now perm —it. /Apparid for dilssl`Of domestic sanitsty sewage p►Wata.. supply only. 10/88 oat" ' �_� B Title a DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT WELL LOCATION S reet Address C L L - �,, Village Cit Tax Grid Number 3 - I - 32- WELL OWNER Name i Mailings L JO.-, ddre//sIs (�'y��h�� GT 04'&sd rivate 'a (4'a r..-. DV & ✓e_ '� l O Public OF WELL - primary J1 E - secondary SIDENTIAL ❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL b INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# E3 REPLACE EXISTING SUPPLY SUPPLY NEW DWELLING PEOPLE SERVED_j�4L/EST. OF DAILY USAGE OG al ❑ TEST /OBSERVATION 12. ADDITIONAL SUPPLY 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING w -e-t t&lwtLc WELL TYPE OMLLED ODRIVEN ODUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES _Zl NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: e Lot No. WATER WELL CONTRACTOR: Name r Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES J,,XNO NAME OF PUBLIC WATER SUPPLY: /� _ TOWN /VIL /CITY �-- DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED WN SEPARATE SHEET date) ( gnature) 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 thirt3, (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manne as not to degrade or otherwise ontaminate surface or groundwater. Date of Issue: Date of Expiration 19_ Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PtU'TNAL� COUNTX DEp,P,,R'z'L�ENT OF )`3EALTH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL'SYSTEM I. Name and Address of Applicant: ., / G J o c� 3G 2. Name of Project: _ ;_C10a5_�/ SS%�S 3.._. Location T1 /C: a• �r 4. .Project Engineer: y7�, �1ffIGG, ,!'. C, 5. Address: 73 �'� License Number: S C�(�1 Phone:7J�"�L�c� 6. Type of Project: Private /Residential Food .Service . ....Commercial , Apartments Institutional Mobile Home Park Office Building. Realty Subdivision Other (specify) 7. Is this project subject t' o State Environmental Quality Review (SEAR)? Type Status (Check One). Type I.. Exempt 1/ Type II. Unlisted 8. Is a Draft Environmental Impact Statement (DEIS)"required. .. . . 9. Has DEIS been completed and found acceptable by Lead Agency? ........... 10: Flame of Lead Agency N//_ 11. Is this project in an area under the control of -local planning, Zoning, ,1 or other officials, ordinances? ........................................ 12. If so, have plans been .. submitted to such. author .s ties? ...................... 13. Has preliminary approval been 'granted by such authorities? Date Granted:_A�a 14. Type of Sewage Disposal: System* Discharge.....,. Surface Water Ground Waters 15. If surface water discharge, what is the stream class designation ?........ :6. Waters index number (surface) ........... ............................... 17. Is project located near a public water supply system? ................. E. If yes, name of water supply /� Distance to water supply 9. Is project site near a public sewage collection or disposal system ?..... _/—(/G . -0. Name of sewage system N�j'� Distance to sewage system 1. Date observed: �e��i� 23. Name of Health Inspector: /uL 130 CJ- 2111r Y. Project design flow (gallons per day)...8................................. 2. 25. is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. *0 26. Has SPDES Application been submitted to local DEC Office? ............... ✓ 27. Is any portion of this project located within a designated Town or State wetland ?...... ......... v 28. Wetland ID Number ........................ ............................... 29. 'Is Wetl and .Permit- required? .............. ............................... . Has application been made to Town or Local DEC Office? 30. Does project require a DEC Stream Disturbance Permit? ................... 31. 'Is or was *project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal;`'` landfilling, sludge application or industrial activity? ........ YES or NO �v 32. Is project located-within 1;OOO - feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or A) any other potential known source of contamination? ..............YES or No DESCRIBE: 33. Is there a local master plan or file with the-Town or Village? 34: Are community water, sewer facilities planned to be developed within 15 years? /vd. 35. Are any sewage disposal areas in excess of 15m slope? ......................... , d 36. Tax Flap ID Number ....................................................... z3, -r -3Z 37. Approved Plans are to'be; returned to: ................ • Applicant engineer If the application is signed by a person other than the applicant shown in Item.1, the. application must be-accompanied by y-a Letter of Authorization.' Failure to comply with this )rovision.may be grounds for the rejection of any submission. I hereby affirm, under- penalty of perjury;- that information provided on this form is true to the best of my know7edge and belief. False statements made herein are punishable as a Class A Hisdemeanor pursuant to Section 210.45 of the Penal Law. >IGNATURES & OFFICIAL TITLES: ':AILING ADDRESS: J,z / I , /u % 1 represent .that'I am wholly and ,completely responsible for too tles�gn an location of ttis proposed systeniis) 1) ,that the.- separete sewago'.disposal;;system a' bove describe i_vV II.be.i:onstructed as shown on "the approved•amendm5nt them to and' ineccoidsnce wdtli the standards rules an regu a. ions o e •: u nam County Department -of. Health,:.and that on compleGOn thereof a "Cerbficate� of Construction'ComDliance" satisfactory to the Commissioner of Health will be ,submitted.to tne'Oepartment, and a wntton guarantee wJl De,fumishedahe owner, his successorswheirs or assigns Dy'the Duilder; that said builder Will place in _d condition- condition any'�,part ;of` said `sewage, disp�ossl'system dung' the period -of two; 2j year slmmediately f011owi6lg.the-date of the issu- ance •of the approval of _the Certificate:_of Construction Compliance .o1 the original system or any repairs th d ;' 2) ihat.the drilledrweld described above will be IoGteC 6s shownon the approved plan snd that said well will e, install n acc dance with the sfjn�!,g !ides and ;regu a ions of th Putnam County Department of Health., ` t._,, Date �_q._ ��_. Signetl .. :.P.E. R.A. — ' Atltlress License No APPROVED FOR CONSTRUCTION This approval. expires.tw years from th ' -pate issued- unle s` onstruction of the -building has been undertaken and_ is reQUi[esl of �r w p m may per mantled 0iiMid when con��dere :necessary., he .0 m is 6 r of'Health; Any change or aRer,ationr:of ^construction 8L f; domestic ni y�sewage, n or xt "' 6 Dpiv only /187 Date gy Title m DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL �f PCHD PERMIT. # WELL LOCATION Street Address Gt�N LL 1AiLL_ ep. za .1 (.4 Village City Tax Grid Numb r IzTn- nz,,j WELL OWNER Name Mailing Address efrivate zr IN O Public USE OF WELL 1 - primary 2 - secondary CTIRESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY O AIR /COND /HEAT PUMP ❑ ABANDONED 0 FARM O TEST /OBSERVATION ❑ OTHER (specify, b INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED!, � /EST. OF DAILY USAGE 6CXDgal REASON FOR DRILLING ff9k SUPPLY - OREPLACE EXISTING SUPPLY OPROVIDE ADDITIONAL SUPPLY OTEST /OBSERVATION DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING S i' — -0 WELL TYPE DRILLED DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: j2c12Qin%pi -L j ac Lot No. WATER WELL CONTRACTOR: Name °'Co Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES f NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: � LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION ►�SEP RAT SHEW/") Q- c-- 6-7 (date) (si nature) 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 well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well ompletion Report on a form pr vid d by t Put a Co ty Health Depart ent. `� Date of Issue: 6 19 � / Date of Expiration: lg ermit ssuing ficia Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Droner Orancte coov: Well Driller APPENDIX B PUTNAM COUN'T'Y DEPAX<TMENr OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES .INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT Ir� DA B Y I �/? `f (Name of Owner) CAS (Street YES Location) DOCMWS Permit Application Corporate Resolution Plans - Three sets s/s Engineers Authorization Design Data Sheet (DDS) SUBDIVISION Deep Hole Log Perc Consistent Perc Results (3) Fill —� Perc Hole Depth cd ----- House Ply s - Two sets ell./ permit; PWS letter Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder notes) Design Data: perc and deep results Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shoran & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPDCIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains - Curtain, Leader, Footing 351to catch basin,stormdrain,piped watercourse_ voe LF trench provided required 60 ft. Pa ell contours S ---- �- VV ` FILL SYS cla rier 10 ftJ fill tqtes new sbec. de gauges 100 yr. lood elev. 10' to Water Line (pits -201) 50' intermittent drainage course Septic Tanks 10' tran Foundation; 50' to well 15' Well to PL 0 April-30, 1987 Putnam County Department of Health 110 Old Route 6 Center Carmel, NY 10512 Att: John Karell, Jr., P.E. Director, EHS Re: Cornwall Ridge, Lots 10, 23 & 24 Cornwall Hill Road (T) Patterson, New York Dear Mr. Karell, Enclosed are three (3) prints each of the following revised drawings for the proposed SSDS designs for the above mentioned lots: SS -10 "Proposed SSDS -Lot 10 ", revised 4- 28 -87; SS -23 "Proposed SSDS -Lot 23 ", revised 4- 29 -87; SS -24 "Proposed SSDS -Lot 24 ", revised 4- 29 -87. Below is a summary of the revisions and /or comments: LOT No. 10 1. Two (2) copies of second floor plan are also enclosed; 2. The proposed well has been moved; 3. Lot 35 Proposed SSDS area has been added to the plan indicating approximately 143 feet separation from the proposed well of Lot 10 and not in direct line of drainage. (Please note that we have not been authorized by the owner to design Lot 35 yet and it is not known at this time what type of dwelling or number of bedrooms is proposed since these plans are only prepared when a purchaser has selected a- specific house to which the plan is specifically designed). 4. The distribution box has been relocated and the profile has been revised accordingly. LOT No.23 1. The absorption trenches have been reorientated to parallel the contours and the profile has been revised accordingly. LAURENT ENGINEERING j ASSOCIATES, PC. 73 FAIRFIELD DRIVE PATTERSON. NEW YORK 12563 914.278.6108 RANDOLPH W. LAURENT. RE.. HARRY W. NICHOLS JR.. PE. CONSULTING SITE ENGINEERS April-30, 1987 Putnam County Department of Health 110 Old Route 6 Center Carmel, NY 10512 Att: John Karell, Jr., P.E. Director, EHS Re: Cornwall Ridge, Lots 10, 23 & 24 Cornwall Hill Road (T) Patterson, New York Dear Mr. Karell, Enclosed are three (3) prints each of the following revised drawings for the proposed SSDS designs for the above mentioned lots: SS -10 "Proposed SSDS -Lot 10 ", revised 4- 28 -87; SS -23 "Proposed SSDS -Lot 23 ", revised 4- 29 -87; SS -24 "Proposed SSDS -Lot 24 ", revised 4- 29 -87. Below is a summary of the revisions and /or comments: LOT No. 10 1. Two (2) copies of second floor plan are also enclosed; 2. The proposed well has been moved; 3. Lot 35 Proposed SSDS area has been added to the plan indicating approximately 143 feet separation from the proposed well of Lot 10 and not in direct line of drainage. (Please note that we have not been authorized by the owner to design Lot 35 yet and it is not known at this time what type of dwelling or number of bedrooms is proposed since these plans are only prepared when a purchaser has selected a- specific house to which the plan is specifically designed). 4. The distribution box has been relocated and the profile has been revised accordingly. LOT No.23 1. The absorption trenches have been reorientated to parallel the contours and the profile has been revised accordingly. page 2 John Karell, Jr.; PF.E. Lot No.24 1. Lot 26. proposed SSDS area has been added to the plan indicating approximately 173 feet separation from the proposed well of Lot 24 and not in direct line of drainage. 2. The baffle boxes have been replaced with junction boxes. 3. An additional junction box has been added mid -run between the septic .tank and the first junction box for clean -out purposes. 4. The profile has been revised accordingly. 5. The junction box detail has been added. We trust everything is now in order for the issuance of the permits. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Richard S. Clark /map CC: J. Mastropietro w/ one copy each. PUTNAM.COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services AFFIDAVIT — CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: RECEIVED Cornwall Hill Estates, Inc. t: EF t� �' I f� W1r. "� E � "� t. I, Kenneth Emerson APR L represent that I am an officer or employee of the corporation and am authorized to act for Cornwall Hill Estates. Inc. (Name of Corporation) having. offices at 223 _ Katonah Avenue Katonah, N.Y. 10536 Whose officers are: President: Edward H..Emerson, 223 Katonah Ave., Katonah, N.Y. 10.536 (Name and Address) Vice - President: Kenneth Emerson & Martin Diano, 223 Katonah Ave., Katonah, N. Y . (Name and Address) Secretary: Janet G. Mastropietro, 223 Katonah Ave., Katonah, N.Y. 10536 (Name and Address) Treasurer: Lynne Diano, 223 Katonah Ave., Katonah, N.Y. 10536 (Name and Address) and that I am and will be individually responsible for any and all acts of the corporation with respect to the 4pproval requested and all.subsequent acts relating thereto. J1rhL Sworn to before me. this % day Signed: of 19 tary Public .LIONlEL WEINSTEIN Notary Public, .Stato of. Now Yaff No. 60.4199160 QuafieJ in Westchwler Coen►q 13Wnnmtssiotr Expires hatch 30, �g Title: Vice President Corporate Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DE510 5VrA - SHf2,T- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. (hrr�arCr,►zr.1WQ� -�- l���L E5i1>Li =s I Qc. Addreaa •ZZ3 VZ - o►.ix q Ja c .. �t�-��tiiAi� ,�1q IC :3 Located et (Street 2TC R04 Sec. I S Block IAt Zvi Undicate nearest cross street) t 4 Mwilcipality. �J�"T��Q.sstii Watershed SOIL P1~RCO1,6TION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 1To1 1 �m Nwul Io r CLOCK TIME PERCOLATION PERCOLATION —Rwl kuapse Depth to a er wate r ve No. Time From Gro,uid Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches sli Mm 357 3`1 2 a:3g .2 . 4 a a 3 1 -- `±--- - - - - -- --------- -- - - - -- -- -- Notwti: 1) Tests to be repeated at same depth until approximately equal soil vat.es are obtained at each percolation test hole. All data to be submitted for rev1f-w. pth measurement, to he made from . top' of hole. h 1 �m 4 357 3`1 2 a:3g .2 . 4 a a 3 1 -- `±--- - - - - -- --------- -- - - - -- -- -- Notwti: 1) Tests to be repeated at same depth until approximately equal soil vat.es are obtained at each percolation test hole. All data to be submitted for rev1f-w. pth measurement, to he made from . top' of hole. h DEPM G.L. 610 12" 1890 24 01 . 30 n 3b" 42" 48" I-A n wit 66" . yll 84 TEST PIT DATA HEQUIRM TO BE SUBMI'ITIM WITH APPLICA'T'IQN Dl=RIP`I'ION OF' SOIL I,IJCOUNT IN TEST MOLLS HOLE NO. HOLE NO. HOLE NO. �1 • V INDICATE LlsVP.l. AT WHICH GROUND WATER IS . ENCOUN'1'ERLD 1 NI) I CATS LEVEL TO WHICH WATER LEVEL RISES AFTER BEING. ENCOUNTERED '1'1i. T3 MADIi I3Y . `.. Date 4l ®s . DES IGN Suit Rate Used 6 -7 Mlrvl "Drop: S. D. Usable Area Provided $coo f.F No. of Bedrooms 4 Septic Tank Capacity IZ50- Gals. AUuurpLion Area rov cla By X100. L.F.x24" Trnr rench. �Al FA & Im NJ 11113 SPACE FOR USE BY HEALTH DEPARTMENT ONLY: 3o11 Rate Approved Sq. F c;al. Checked by Date ty � ���t SEP 2 C 1985-. PUTNAM COUNTY DEPT, OF HEALTH A5 - 1�U1 L-C t71MEN510N CHAK-f N° A I 56.0 51 .O 2 .7"T.0 , 11.0 131 .0 '16.5 4 135.0 101.0 5 138.0 110.5 Co I4 3.0 116.0 I q-8.0 12.0 158.0 13gt.0 1 I6�1.0 lq'SD I 0 113.0 150.0 11 113.0 O 12 190.0 145.0 13 188.0 151'.0 14 1616.0 1614.0 15 206.0 1 ?-7.0 16 218.0 fbb D 1-1 218 D 1X1.0 15 21C.o 181.0 THIS IS TO GEteTiFY THAT THE 5tIWAGE OI st°05A l., 5'f5TM M WAS GON5T tlWr-Tr--tO AS INO1GATE0 ON THIS PLAN ANU THAT THE S`f 5T I✓ M WAS Me �1✓FDt�E IT IWAS COVEtCEO OVEN. THE 5-(STEM WAS CONS- rMUGTr-tO IN ACC0Mt2AWCF- WITH ALL 5TANVAt2b KULI✓5 AWO MEGULATlON5 OF THE PUTNAM GOUNT'i HEALTH Ot5rAIKTMENT THE NEW YOLK 5TATE HEALTH tOE5:PAV�,TMENT. k0U5r-, � WeLL LOCA`fVN "CAKE✓N 1;12OM svtev�r or rKol°eKT,r " McPAt<,Er2 t3-f e�ONNEY A550GlA1�5 S.