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00729
I
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 14509
TeL (914) 278 6130 Fax (914) 278.7921
Site Design Consultant
PO Box 423.
2070 Saw Mill River Road
Yorketown Heights, NY 10598
Dear Mr. Riina::
13RUCE R FOLEY
Acting Public Health Dlntaor
July 15, 1997
Re: Proposed SSDS: S,& S Properties
Rt.. 311 & Fair Street
(T) Patterson
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:
"The construction of this sewage disposal system may. be subject to local wetlands regulations.
You should contact local wetlands officials in this regard."
- —" You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of
the State of New York, Title 10, . relative to the need for approval of individual sewage disposal
systems by the City of New York. You should contact city Officials in this regard."
1. Well permit application has not been submitted.
2. Current engineers authoiization letter has notImu.subinitted. .
3. Location map is to be shown on all plans.
4. Erosion control measures for the house and the well is to be shown. and detailed on the
plan. Futtherrriore, a note is to be added stating all erosion control measures are to be
installed prior to the start of any construction.
Upon receipt of a submission, revised to reflect the above, this application will be considered
iurthcr. '
V truly yours,
Robert Monis, P. E.
DQ Pwoo blic Health Engineer
Wip
APPENDIX 3
PUTNAM COUNTY DEPARTMENT OF,HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES"
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
REVIEW SHEET for CONSTRUCTION PERMIT
STREET LOCATION NAME OF OWNER
BY B. HEDGES R.MORRIS OTHER DATE __J__/ TAX MAP# -
DOCUMENTS.
Y ,Y.
C= PERMIT APPLICATION
ERMIT PWS LETTER
ERS.AUTHORIZATION
DESIGN DATA SHEET(DDS)
C= CORPORATE RESOLUTION
C= PLANS THREE SETS
=J HOY SE PLANS - TWO SETS
= VAIANCE REQUEST
g SUBDIVISION
EGAL SUBDIVISION
UBDMSION APPROVAL CHECKED ERC RATE
ILL REQUIRED DEPTH
URTAIN DRAIN REQUIRED =STANDPIPES
T. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE
PUMPED PIT & D BOX SHOWN & DETAILED
USE - NO. OF BEDROOMS
LLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM
)PERTY METES & BOUNDS
USE SETBACK NECESSARY (TIGHT LOT) .
USE SEWER - 1 /4 "/FT.. 4 "0; TYPE PIPE
BENDS; MAX. BENDS 45° W /CLEANOUT
FILL SYSTEMS
CLAYBARRIER
10 FT HORIZONTAL: SLOPE 3:1 TO GRADE
FILL SPECS I17 FILL NOTES
FILL CERTIFICATION NOTE
DEPTH GAUGES
�LL.PROFILE & DIMENSIONS
h.LFMRBI/ZBA GENERAL. IN EXPANSION AREA
APPROVAL SSDS ADJ. LOTS
TLAND ( TOWN/DEC PERMIT REQ ?) TRENCH
A ON DDS PLANS & PERMIT SAME LF TRENCH PROVIDED =60 FT MAX
1969 - NEIGHBOR NOTIFIFICATION PARALLEL TO CONTOURS
100% EXPANSION PROVIDED
100 YR. FLOOD ELEVATION
SEPARATION DISTANCES SPECIFIED ON PLAN
REOUIRED DETAILS ON PLANS
SEWAGE SYSTEM PLAN - (NORTH ARROW)
SSDS HYDRAULIC PROFILE = GRAVITY FLOW
CONSTRUCTION NOTES (GRINDERNOTE)
= DESIGN DATA: PERC AND DEEP RESULTS
= TWO -FOOT CONTOURS EXISTING & PROPOSED
AY & SLOPES CUT
YGUTTERICURTAIN DRAINS
EROSION CONTROL; HOUSE,WELL, SSDS
EROSION CONTROL NOTE
PE HOLES LOCATED
PRESENTAT OF PRIMARY AND EXPANSION
LOCATION MAP
0' TO P.L., DRIVEWAY,, LARGE TREES TOP OF FILL
0' TO FOUNDATION WALLS 15' WELL TO P.L
100 TO WELL, 200' IN D.L..O.D.,.150' PITS
100 TO STREAM WATERCOURSE LAKE (INC.EXPAN)
50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER
10' TO WATER LINE (PITS -20')
50' INTERMITTENT DRAINAGE COURSE
200 FT. RESERVOIR, ETC.= 150 FT. GALLEY SYSTEMS
15' MIN TO C.D. S= >5%,20'- 4 %,251- 3%,30' - 2%,35' -1 %,100' <1 %
t 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS.
SEPTIC TANK
=1'0' FROM FOUNDATION; 50' TO WELL
COMMENTS:
M
Site Design Consultants
Civil Engineers • Land Planners
June 24, 1997
Mr. Robert Morris
Putnam County Health Department
4 Geneva Road
Route 312
Brewster, NY 10509
Re: Permit No. P 8- 9.1
S &S Properties
Route 311 and Fair Street
Town of Patterson
Dear Robert:
Enclosed please find the following items to renew the Construction Permit for Sewage Disposal
System for the referenced project:
- ,Construction Permit Application
- One set of plans
Site conditions on this project have not changed since its previous approval. A copy of the expired
Permit is enclosed. Please call our office if you need additional information. Thank you.
ON
Yours ruly,
a
Joseph Ri' a, P.E.
JCR/cm
Enc.
251 -F Underhill Avenue Yorktown Heights. New York 10596
41 Waters Edge Way Ridgefield, Connecticut 06677
(9141 962 -4488 (203)431-9504 Fax (9 1 41 962 -7386
f�
W�
A Qi A WCpG DEPARTMENT OF HEALTH
�� Division of Environmental.Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512(914) 225 =3641
APPLICATION TO CONSTRUCT A WATER.WELL.
PCHD PERMIT #
WELL LpCATION
Street Address
illage City Tax Grid Number.
g...
WELL,`OWNER
Name
Mailing Address
1
QPrivate
0 Public
USE 'OF-WELL
1 - primary
2- secondary
Q RESIDENTIAL
O BUSINESS
0 INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
O INSTITUTIONAL O STAND -BY
[3 ABANDONED.
O OTHER (specify,
O
AMOUNT OF USE
' YIELD SOUGHT_ _gpm /# PEOPLE SERVED 1 /EST. OF DAILY USAGE�� gal
REASON FOR
DRILLING.
NEW SUPPLY OPROVIDE ADDITIONAL SUPPLY
0REPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL
OTEST OBSERVATION
.DETAILED
REASON. FOR
''DRILLING
adz
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:
Lot No.
WATER WELL CONTRACTOR: Name $19 _ Address: p0
IS.P.UBLIC WATER SUPPLY AVAILABLE TO SITE: YES bC NO
NAME. OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
O ON REAR OF THIS APPLICATION. ON SEP �TESIHEET
(date) - (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 apphicant shall: .
` 1,.,. ;,Pump" the wel l 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 m County
Health Departure t.
Date of Issye: 1174 � 19��
Date of Expiration: 19�
Permit Issuing Official
Wh
Permit is Non - Transferrable
Mite copy: H. D. File
Yellow copy: Building Inspector
2/87 Pik Copy: Owner
Orange copy: Well Driller
YUmNAM COUNT
��t , Division otivlionmeTatal ]
} a �s•o- x
k TRUCTIO FOH SEWAGE DISPOSAL 'SYSTEM
Ssdtdlvlalon Mime — w- s- Snbd' L'ot�N�
Owner %Appilcan� Name '� 4 j i "4
4
r,e v-','_� Address' nLiG►�+' °.�'� J iY, �4ase
w
�-
Ka"i
.�r� f7
_ Balidhtg' Typo '� �b1 22YLL_f::,'Q Ares`_
i Namtiei +of Bedrooms ps l l � � '` - Illesigm �Fltiw �G �P rD��
Septliiite Sewerage Sy.teml b�conelit of Gllon 1Sapfk Tanli�tu
To tie constrictedlby
Water, Sa�p1J ; ' Pablk' Snppiy Flom
- ortT Prlvate:Sap Iy;Drllletby1+
J reDr4oi that!.Q am (wholly and (completely arespons'ibleYfor the des�gnla4
t above+tlsscribed' wUllbetonstructeiJias sf)own on�ltherapprovedamer(dmei
County lR- Pmrtments rof' IHeaRh4 ahtllltf�`_at�on completion thereof a Cey
c Abe' 'subefiitte0, (td the Depa►�tnte - sand ;a: r3 itfenj.i y pnteeu}'01111 lbs, "N
'pNce; -iirl good; operajggpeonel --' Many pa %t ofr�said1**Aye,adi!POklo
once, ,of ,the rapprgjOa�ll (cd'y w(C—erUpole o ' Const ►uct�on�.(Gomglia�ce;
will'Ue 11Wc#Od r ss�hawn6ns elapprov lfplsn sndtthat,(saidw % e111wilUbebi
rCoUntY Department rdfr�ealth ¢, ' "� �: ,- "
:1
a7P_1d'ilrass- -
APPROVED FOR CONSTRUCTION aThisr_iipd?oval'vexpues twol rs
revocable for u4se or °ma�sDemb)tdedior rnotlAled',whernco da dfi
requir.s a n 72be/Ir��d %jrApproved for disposal of domest0 sa y
FIFNE- , WF HEA M
eivloes r(a`rmel N:Y� 1051? rEfig- m r tbjhho*W6 fermgt Y
on(CERTTG�A+fE,OF,C NW CE-
{-
Penmiti. ;M
' 1a Town oY `'Village -
�r ;Renewal'_ ❑1 1 Revision 1p -
'`�' `�� �'`Dste of'Provloae>;Approval , t -� . F -
*'��?H�
' FW' Section +On1Yb ' Dep �
ths' !Volame,
PCHDtiNoH6catlon Is Ralgaired "WhenFUids completed i
1
-
Addresa
F
za - -- ,
ion ot,rlthe� E ^ s), �1 +) t" hat{ the. separate _sewage,,di'sposalssys4em� �+_� ��r �
�o'and;,i n w, _M ndafls rules an regu a ions o, ew , u nam tr �a+, rL +,
of C _ di " ceR saetory�ko t_hsnComrt�ssioraer of'IHeglthxw�ll °� J
s s or iyns +!by tW lbullder4,, thOtl sold builder
tq� rtq;it` iod;o,two�_ rid.,- mediaiely follow�ng�thelCafe of ths'issu r.0.. ^`��
,, r i _. � e repii�t e►et " �l2) �thatilt�ff�e�d► 311etltwelUlile °ser,,ibed�'atiovei+ati ;�'�� �s',�7
nsce� rd 'starlda les rand�regu a ons6, of w'lthe ,P,ufnam�x� '' ?i
r
Cat YAU: u ss41 -0 u o thti�bu�ltlmg has`lie�en undertaken and isl
by �- o A`ny change<or itte,ition of;rconstruction
afar
i/
ti
n.
PC-1
RECEIVED
♦ Y DEPARTMENT OF HEALTH
APPL D&TAIN R- VA
P PRO AL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
1. Name and'Addeess of Applicant: S 8� S Properties
Box 361
Lincolndale, NY..10540
2. Name of'.Ptoject:
4.. Project Engineer: Joseph.C. Riina,P.E.
.7,
3. Location-T/V/C: Patterson
5. Address: Route 311 & Fair Street.
2 63
1�atterson, NY., 1 _ _ 5
License'-Numbe'r- 64431 Phone: '962-4488.'
6.' Type of Project:,
Ix Private Residential- Food Service Commercial
Apartments Mob i 16 -Home, Park
par ments Institutional
Office Building Realty SubdiVision Other (specify)
7.. Is this project' subject to State Environmental.,QuAlity Review (SEQR)?
TYDe, Statui `(Chec'k One,*) Type' I.. Exeq)t
Type Ii. x
Un! isted
8. Is'a DraftEnVironmental.Imoact:St'atement '(DEIS).rdquir6d? ........ ....... No
.9. Has DEIS' been completed and found acceptable .by Lead Agency? N/A
10. Name of, Lead Agency N/k'
1.'A- Is this -06"ject In an area under the. control. of local p.lanning,..zoning, ., •
or other `:61 ff i 6i it 1 s 'ordinances? ......... .......................... No
12. If so.- have :Olains 6666 submitted i*6' su7cfi'ju'jfio' r-ftie's? . ............
13. Has preliminary'gp 'p roval. bddh�'. g ran idd by tuch: . tuthorit imes? D . ate. Granted: N/A
S:
14. Type of wage Disposal System bi scharge. . __Surface .Water, �A�Ground Waters
74
-;z7-- . 71 F: 7 'tF
ru 77`!� -, '--- ! Y7�m T
15. If surface water. d.ischarge,.what -is'. the:-.strear6 class designation ?.
16. Waters index--hUmber._(sU'rface)
�T'
near a blic r .`,wate supply 17. Is project
systems
Z k,
18. If yes, name.of water supply* N/A Dis'tance-to water supply, N/A
"
19. Is prdject'-site -am -sewage iosI `system..:.:
bistaficeito sewage syste im N/A
20. Name of sewage system
?1.' Date obse rv*ed' .--Name 7 0
q
?4.m" Project design flow (ga'I Ions per day)... .. . . . . MI. 600
iz
_ 2. r .
25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. No
26. -Has SPDES Application been submitted to local DEC Office? ....••••- ••••.. N/A
27. Is any portion of this project located within a designated Town or State
wetland? .................................. ............................... No
28.
Wetland ID
Number ........................ ...............................
N/A
29.
Is Wetland.Permit
required? ..............................
... .... N/A
Has
application been
made to Town
or Local DEC Office?
30. Does
project require
a DEC Stream
Disturbance Permit? .....'.
N /A.
31. Is or was project site used for agricultural activity involving application
.of pest.cides`to orchards or other crops, solid or hazardous waste disposal,.
landfilling, °sludge application or industrial activity? ........ YES or NO 1`To
32. Is project located within 1,000 feet of existence of abandoned landfill,.`
hazardous waste site; salt stockpile, landfill, sludge disposal. site or
any.other potential known source of contamination? ..............YES or NO .No
DESCRIBE: _
32. 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 ?...
35. Are any sew .ge disposal areas i.n :excess• of 15 slope ?O>
• - - Mp •71,816& 1. Lot
. Tax Map I0 Number .. ... ... .. . 5
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`_
°pplication :must be':'accompanied by'a Letter -of- Authoriatfon.` Failure to comply with `this
)rovisi-an may be grounds .for the rejection of any submission.,- - _
Si[e'Design Consultants
Mr. Bill Hedges
Senior Public Health Sanitarian
Putnam County Health Department
4 Geneva Road
Route 312
Brewster; NY 10509,,.
Re: S & S Properties
Route 311& Fair Street
Section 73 Block 1 Lot 5
Dear Bill:
Civil Engineers • Land Planners
March 1, 1995
Enclosed please find the following items for the referenced project which we are submitting for septic
and well construction permit:
- Construction Permit for Sewage Disposal System
- Application to Construct a Water Well
- Application for Approval of Plans for a Wastewater Disposal System
- Design Data Sheet - Subsurface Se%A!age Disposal System
- Engineers Authorization Form
- Four (4) sets of plans
Please review for approval. Call me if you have any concerns. Thank you.
Enc.
Yours Truly,
J eph C. Ri' a, P.E.
1603 Commerce Street • Yorktown Heights, New York 10598
41 Waters Edge Way • Ridgefield, Connecticut 06877
(91 4) 962 -4468 (203).431-9504 Fax (91 4) 962 -7386
r:: � A=D]
PC -1
PUTNAM COUNTY DEPARTMENT Off' HEALTH
APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM
1. Name`and Address of Applicant: 4 finer
2. Name o. f Project: s 5 �h�,�.r,�h 3. Location DV/C:
4. Project Engineer: �=��� � � _ 5. Address: 1Pb03 e.,p t�
i�olyuAawrJ {- Q1�t75 • I M"� . � a Sa B.
License Number: OMAN Phone:
6. Type of Project:
_>e� PPrivate /Residential Food Service Commercial
F Apartments' Institutional Mobile Home Park
Office Building Realty Subdivision Other (specify)
7. Is this project subject to State Environmental Quality'.Review (SEQR)?
Type Status (Check One) Type I.. Exempt
Type II. Unlisted
8. Is a Draft Environmental Impact Statement (DEIS) required? ............. ►�o
Has DEIS.been completed and found acceptable by Lead Agency? ...........
10. Name of Lead Agency _Te.
11. Is this project in an area under the control of local planning,•zoning,
or other- officials,•ordinances? ......... ................:..............
12:_If�so,'.have, -plans been submitted to such authorities? .................. Llo
13. Has preliminary approval-been granted by such authorities? Date Granted
14.. Type of Sewage 'Disposal 'System Discharge...... Surface .Water ,l Ground Waters
15. If surface water discharge, what is the stream class designation ?........
16. Waters index number (surface) .. ................... ..
17. Is project located near a public water supply system? IJ o
18. If yes, name of water supply Distance to water supply
19. Is project site* near a public sewage collection or disposal system ?..... t�r�
20. Name of sewage system *AAA Distance to sewage system _
2.` Date observed: 23. Name of Health Inspector: FAWK
24. Project design flow (gallons per day) ...... ............................... 1,0C _>
f
I
FA
�25. Is State Pollutant Discharge Elimination System (SPDES).Permit required ?.. On
26. Has SPOES Application been submitted to local DEC Office? _ /,6_
27. Is any portion of this project .located. .within a designated Town or State
wetland ? .............................. :: ...............................
28. Wetland ID Number ........' ................ ............................. ��
29. Is Wetland:Permit required? ...... .......... ...........................
Has applj'cation 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
32. Is.project located within 1,000 feet of existence of abandoned landfill,
hazardous waste site, salt stockpile, landfill, sludge disposal site or
any other potential known source of contamination? ...............YES or NO
DESCRIBE:
33. Is there" ,a-'focal master plan or file with the Town or Village?
34. Are community water, sewer facilities planned to be developed within 15 years?
35. Are any sewage disposal areas -in- excess of 15% slope? ......................... I b
36. Tax Map ID Number ..... ............................... vlpv l --LOTTO
37. Approved;Plans are to be returned to: Applicant K- Engineer
If the application is signed by a person other than the applicant shown in Item 1, the
application must be' accompanied by a Letter of Authorization. Failure to comply with this
provision may be grounds for-the rejection of any submission.
fP,
I hereby, affirm, under.penalty of perjury, that information provided on this
form is ;true to the best of my knowledge and belief. False statements made
herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of
the -Pena 1 Law. 1
SIGNATURES & OFFICIAL TITL
Y
i
SAILING ADDRESS,-
r
•' 04 ►• •• 1'01' • 01411 Pi A • • •
10 MAM WORM PUPA IVW U12IN VA M WARN oil
DESIGN DATA SHEET- SUBSUF'ACE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner Address]
Located at (Street) - ;G Sec. _]3 Block 1_ Lot E)
(indicate nearest cro s str e� t)
Municipality . Watershed
SOIL PERCQIATI TEST DATA RDQU7RED TO BE SUBMI= WITH APPLICATIONS
Date of Pre- Soaking 4- •q Date of Percolation Test S' i's ' 1 A
HOLE
NUMBER C7AC:R TIME
PERCOLATION
PE ROOLATION
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
12:OrJ- -x:35 30
ZD 27�'Iv
���z
i Z
2 2:x•0- 3 : � 0 30
2Z'I z
2 ��Z
� 2'
3 3:15 - 3'. 45 3o
ZD Z,2. 11y
7i �rTi
�i
I
4
5
2,0 -2205
2 7 �- 3:15 150 Z Z'!� Z. 7,3 14-
4
5
x
NOTES: 1. Tests to be repeated at same depth until appradmately equal soil rates
are obtained at each percolation test hole. All data to* be submitb2d
for review.
2. Depth measurements to be made from top of hole.
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. HOLE NO. Z. HOLE NO. 3
G.L.
2'
31
4' �,01'�1�•
5'
6'
7'
8'
9'
10'
12'
13'
14'
i T _
i • a• M I= AT WHICH C• • • h YDI• is ENmuNTERED s
INDICATE L01 • WHICH, WATER LEVEL RISES AFTER BFJVG E O E• E1 �� !
DEEP HOLE OBSRWMONS MADE
1• �
DESIGN
Soil Rate Used .�+ . Min/1- Drop: S.D. Usable Area Provided L -••
No. of Bedrooms 4= Septic Tank Capacity I ZSO of
RLO
Absorption Area Provided,By 5tip -L.F. x 24" width trench o
Other I �� °/ Mx�,d J5 i n � - e.9
U)gnjr� (Z04WL.-rAATS I MAW T"
Address P-0. . I /
I
. I �•1 �� • • P, ••I
THIS SPACE FOR USE BY BEALTH DEPARTMENT ONLY:
Soil Rate Approved sq.ft /gal. Checked by
Date
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
�em
Re: Property of `jp�yej
Lo c a t e d a t ,'f �p�112, 1!0 i X
(T) Section *11 ( Lot
Subdivision of
Subdv. Lot #
Gentlemen:
Filed Map #
Date
This letter is to authorize
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-
-connect-ion.-with this matter and to supervise 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-
tary Code.
Countersign
P.E., R.A.
. •
Very truly y %%airs ,
S i gne cIT�
Owner of Property
ii
Telephone
i=ce u �J M TI
�' "I ✓ '� /
iw,- >b
Telephone
h
DEPAR I ML-N I Ur htAL- I h
,-,vision Of Environmental H%$lth Serv,.
r TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641
APPLICATION TO CONSTRUCT A WATER WELL
---3TA�Ej
AUORESS.
IMNiVILLAG 1( I Y 11" 6Riu NuMbER.
WELL LOCATION
-73J''5
WELL OWNER
NAME. � �
,XRESIDENTIAL
— ADDRESS:
6 PUAI16 SUPPLY ❑ AIR /COND. /HEAT PUMP
❑ PUBLIC UBLIC .
❑ ABANDONED
USE OF WELL
(p primary
❑ BUSINESS
❑ _FARM ❑ TEST /OBSERVATION
❑ OTHER (specify)
2 -secondary
❑ INDUSTRIAL
❑ INSTITUTIONAL ❑ STAND -BY
C7
MOUNT OF USE
YIELD SOUGHT
S # gpm. /N0. PEOPLE SERVED 3 / EST. OF DAILY USAGE gal.
REASON FOR
;P*EW SUPPLY .
❑ PROVIDE ADDITIONAL SUPPLY
❑ TEST /OBSERVATION
DRILLING
❑ fiEPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL
WELL TYPE ,DRILLED DRIVEN 0 DUG GRAVEL OTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF.SUBDIVISION:
LOT NO.:
WATER WELL CONTRACTOR: Name
Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: _ YES. NO
NAME OF PUBLIC -WATER SUPPLY: TOWN /V /C
DISTANCE TO PROPERTY FROM- NEAREST WATER -MAIN •IJ /A
LOCATION SKftCH & SOURCES OF CONTAMINATION.
`(date) I ( ign &ture)
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 complet'ion'of water well construction, the applicant
shall:
1.
2.
3.
Date of
Pump the well until the water is. clear.
Disinfect the well in accordance with the requirements
of the Putnam County Health Department attached to this
permit.
Submit a Well Completion Report o%atz—fOrm provided by
the Putnam County Health Departm
Is sue : q1 19�/��
Permit Issuing Official
s Non— Non— Transfprrahle
S & S PROPERTIES
Box 361
Lincolndale, N.Y. 10540
914 248 5444
June 18, 1991
Putnam County Health Dept.
Carmel, New York 10512
Dear Sirs:
Please.be advised that S & S Properties is not
a.corporation. It is a limited partnership.
Yours truly,
S &.S .• ZOP P 'SIES
Fred R. Shaw
Owner ,
Eugene Schiavone
Owner
. ...... NNOMMEM, MEW
Kir
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNrERED IN TEST HOLES
DEPTH HOLE NO. HOLE NO. Z. HOLE NO.
.-r-130 -
G. L. TOPl:;'DII-
21
3'
41
51 :
71
81
91
10,
lit
121
13'
14'
INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED
INDICATE LEVEL TO WHICH, WATER LEVEL RISES AFTER BEING ENCOUNTERED:
DEEP HOLE OBSERVATIONS NAM BY-.SM DATE:
DESIGN
Soil Rate Used, Min/1- Drop: S.D. USable Area Provided
No. of Bedrooms Septic Tank Capacity I ?..SO galS. Type cAX.6.
Absorption Area Provided By 5pp L.F. x 24" width trench
OF IEW)_"
Other: lr-'x�clp. r--..:PA'J4..i..A CA
Name'5rr& '0Mjgfj (Z04WLIWITS Signature *gagE��
Address F 0- &4c SEAL
q 64431
• 1059p, FESS10%
Soil Rate Approved
sq.ft/gal. Checked by Date
ri
PUTNAM COUMY DEPARTMENT OF
DIVISION OF ENVIRONMENTAL BEALTH STMCES
rT
a
DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. = �, `2:
r h.� _ - '-
Owner =P- Af�rP_SS Located at (street) o * sec. `73 dock
Indicate nearest cro s str t)
tyunicipality
Date of Pre - Soaking. 4• •q I
n
u:
Watershed
Date of Percolation Test S-IS 11
HOLE
NUMBER CI,OCR 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
12�o� -Z:35 30 2D 2Ti'Iv ti'bo I Z
3 3*. IS - 3:46 3o 7-,Q
4
6i
l2 ►o- 2:4.0 �0
2 10,
3?2 :ZO -350 30 Z,�o 1.7./8 2Alt 14- -
4
5
2 2:4- 30 2.2 2218 Z % 14
33: �- 3�5F► zo Z2� ���. Iq-
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates
are cbtained.at each percolation test hole. All data to'be suimitt�i
for review.
2. Depth measurements to be made from top of hole.
PUINAM CXXJNIY DEPARTMENT OF HEALTH
DIVISION • RATIRUMNIAL HEALTH SERVICES
DESIGN DATA SHEET-SUBSUFACE SEWAGE DISPOSAL SYSTEM
FILE NO.
Owner 3 ro) C::- Address _F>0j<Cp MADLY 1%�
Located at (Street) r-O :23H**&IR,,!!!�� Sec: 73 Block Lot rJ
idat-1:7-nearest 7 crods str&t)
AdFr
Municipality
y
0jW*► -jW - - 00 RS0 NE LE '
Watershed
Date of Pre-Soaking 4 -91 Date of Percolation Test
HOLE
NC�93ER �C= TIME
PERCOLATION
PEROOLATION
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
30
210 2207,
2 0
Z-
3 *3. IS 3:45 So
ZQ &2- 7z,
4
P�
11: ;90 2,0 170.5
4-
22A45 810 Z, Ve 14-
3 3:W-550 So
4
2,0 2-A 14-
10 Z:06 LVE). 14
3$:Ar3*99 30
4
5
NOTES: l.' Tests to be repeated at same depth until appradmately. equal soil rates
are obtained at, each percolation. test hole. .All data to* be submitb?d
for review.
2. Depth measurements to be made fran top of hole.
4'
RE
7'
IUTRED TO BE SUBMITTED WITH APPLICATION
_ OF SOILS ENCOUNTERED IN TEST HOLES
`' fC7ixs7D1(` c_
- � � l.st�_ l.A.l�► i/i
ol/
ILSr AR V//
o-
8'
9'
10'
11'
12'
13'
14'
INDICATE LEVEL AT WHICH GROUNDRATER IS ENCOUNTERED j CJI-0
INDICATE LEVEL TO WHICH, WATER LEVEL RISES AFTER BEING ENOOUN'I�RED: iJDa
I S
DEEP HOLE OBSERVATIONS MADE BY: ��.�Gs.�. �OIJ�L2��� DATE:
DESIGN
Soil Rate Used _j( Min/1" Drop: S.D. Usable Area Provided LCXXF &f
4
No. df Bedrooms _ Septic Tank Capacity 17.--50 ' gals., Type. c ".
Absorption Area Provided-, By E5 _ -L.F. x 24" width trench
OF Et1 'S
° A Other ''
.J o5eAzu G TZ. I ItI
Name'Srr& VM�MJ C04WLTAJT'S Signature
Fri
Address P o. bcA SEAL No. 6 1
YC' • 1 • �J ROfESS10NA�F��
THIS SPACE FOR USE BY HEIMH DEPARMARU ONLY:
Soil Rate Approved sq.ft /gal.
Checked by Date
A
DEPARTMENT OF HEALTH.
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, . New York 10512
(914) 225-0310
Michael Doebbler
Site Design Consultants
PO Box 423
2070 Saw Mill River Road
Yorktown Heights, NY 10598
June 12, 1991
Re: S & S Properties
Route 311 & Fair.Street
(T) Patterson TM 73 -1 -5
Dear Mr. Doebbler:
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. PC -1 form has not been submitted (enclosed).
2. A corporate resolution has not been submitted.
3. Well permit has not been signed by owner (en-
closed).
4. House plans have not been submitted.
5. Length of trenches are to be noted on SSDS plan.
6. Drop boxes are to be shown at 50' intervals between
the proposed septic tank and the proposed SSDS.
Upon receipt of a submission revised to reflect the above
comments, this application will be considered further.
V y truly yours,
Robert Morris
Assistant Public Health Engineer
RM:mk
JOHN KARELL Jr., P.E., M.S.
Public Health Director
Site Design Consultants
Mr. Robert Morris
Assistant Public Health Engineer
Putnam County Health Department
110 Old Route Six Center
Carmel, NY 10512
Civil Engineers ^ Land Planners
June 26, 1991
Re: 'S & S Properties, Route 311 & Fair Street
Town of Patterson TM 73 -1 -5
Dear Robert:
Enclosed please find the following items regarding S & S
Properties:
- Completed PC -1 form
— Letter stating S & S is a partnership and not a
corporation
Well permit signed by owner
- Three sets of house plans
- Four sets of the latest plan showing changes to SSDS
Items 4 & 5 stated in your letter of June 12 have been
addressed and added to the plan.
Please continue your review on this project based on the
enclosed information. Call me if you have any questions.
Thank you.
Yours truly,
Gre Dooney
/cm
Enc.
P.O. Box 423 ^ 2070 Saw Mill River Road • Yorktown Heights, New York 10596
(914] 962 -4466
�'I'J
�_ -- In ,
Sire Design Consultants
Mr. John Karell Jr., P.E.
Public Health Director
Putnam County Department of Health
110 Old Route Six Center
Carmel, NY 10512
Re: S &S Properties Application
Dear John:
Civil Engineers " Land Planners
May 21, 1991
Enclosed please find the following items we are submitting
for a construction permit:
- Three prints of the plan
- Construction Permit for Sewage Disposal System
- Authorization form
- Design Data Sheet
- Application to construct a Water Well
- Certified check # 4779 - Application fee of $150
Please review this application for your approval. Thank you.
Michael T. Doebbler
/cm
Enc.
P.O. Box 423 ° 2070 Saw Mill River Road ^ Yorktown Heights, New York 10598
(914) 962 -4488
f�
APP-='VDIX 3
CrUNJ Uy CZ A:r.r�-\T CF F-EALT? - Dr%,cICN CF
L?�Iy SDI_ -L itt_` SUPPLY & 5i tSL ACv SFt ?C D_S T, S'S=S
( _�c._me cl (Street LO.:_atic.^. )
r sired _
60 ft. ra x.
100 ex-p. _
sD;" U" E— `. I'S
Pa' -mit r,-01? C3t'_cn
Corporate Resolution
Plans - 1 :ree sets
EnaLn ors Zs_hcri zat_cn
rasign Data Shzzt (D:S)
`Deep Hole Log
s/s
Cons? stelt _ e rC cicS':'_ tS (3 )
Parc col_ Ceo`'1
Plans - 1wo
L ` d t;
Sets
Pz
S =ON
7cr`
Fit_
Cd
-LI.Ct
Variance Remues 1.
Leal Sabdi vision
Siladlv'_Sion Pooroval C %CC'e
Ex- acorc,al SSDS Pali. Lots Che --ked
i'Tetland (T . /1FC e-zmi t R & D)
Data On DDS Plans & _ a =i t Safi e
R-QULR:-:D- D=- , A S ON PLI�-\S
Sewage Systzn Plan (north arrow)
S—e age S., Sze^.? P-oril e - l:ra -_Y FlcY
Fill P=oi11° & t7='_._ LC?S - 1,701, =me
D or J Box; Trench /Caller, ?.yt-p pit
SeptiC 1^a n'{ - S_ze, -: =;1
well Detail, Service Line if over
Constriction =Notes (grin-der rate)
Design rrc and aeeo r -su _s
�, V Fool.. Contou-rs E�ri-sting & Proposes
Driv�aay & Sloo-s Cut
Foo-' inc/GsL-l.er,C �r �_n �rl3- --
?erc & D_eo , =c =es r-r-c c-ed
�: i
Repres °:i� wve of pr_!i.azy and c.4_.cr-S:0. ^.
Evansion �yea;s ^oh- �;g_szl?ty flcw,stf=. Size
Ii PL-- Pit & D Box Shcw -n & Data i l d
House - No. of Baroc
Wells & SSDS' S w /in 200 i of
P_cc�ee=ty :_motes & Bounas
Propcs-,� S-yste -s
House Se-]�a-c{ Necessary (T?g::o lot)
House Sewer - 1/4"/iL.j4"0; iy -e p_r
No Ba7 s; May. 3-amis 43 w /Cler..^out
SLP R,rTION DISTL\.- S SP K=, ON PL '-'\
Fields
10' t0 P.L., Dr? ;7ewav, Tr =es,`''..p Of fill
20' to r o'�n�� t1Cn ;•;alts
100' to W=-11; 200' in D.L.O. D, 1301 pi is
100' to Stream, Lake (.:,c. ex--an)
13' to Dr=_ -�iT"�_', r►Cer, t�l_
J7' L-o C= LC_ 1 L'cS?:l, S_O__: a_n, LlOw -wazarcoarSe
10 to Water Line (o is -20')
50' irate -iPi ttent Cia_ ?.^ co,—,-se
Se_7tic Tanks
101 ir.Zii Fou- ndaticn; 50' to Well
15' Well to Pr 9
O
TO:
.f
'_Putriam . County Department of Health
Bureau of Environmental Quality Control
110 Old Route 6 Center
Cbtrmel, NY 10512'
Date: 4- -17 -91
Re: Property of s' & s Properties
Located at NYS Rte 311 /Fair St.
.9806i= Block 1 Lot 5
Tax Map 73
G entl emen:
This letter is to authorize Joseph C. Riin&, P.E. a duly licensed
professional engineer -c � s - eked - eh-iteet to apply for ' a
Construction Permit. for a: sewerage system; private water
supply; to serve the above -noted property in accordance with the'stan-
dards, rules, or regulations as promulgated by the Commissioner of the
-Putnam. — County Department of Health, and to sign all'ne'cessary
papers on my behalf in connection with this matter and to supervise
the construction of said system or systems'in conformity with the
provisions of Article 145 or 147 of the State Education Law, :the Public
Health Law, and the Putnam- .County Sanitary Code.
OF
�� Very truly y s ,
c ~r t o
6'�
0
Saw .Raver Road
TO_r=Dvm Heig ts,= NY
el ephone) 914 =962 -4488
Si
Owner of Property-) / .
OE Fred Shaw:
. .
431,;x:``''
Seal ). ess Box .0 Maple Avenue
Lincolndale, NY 10540
' :_" a ep one 248 -5444