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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -20 & 24. -2 -21 BOX 9 I '� . , X Welool i - •+Y.m>4?r -an-v� —'•ter «,ra- .- ,.��.,. „."r'�5 !*Zy q'''ui +, t a r 1 Na'T`5is st.'X'x „y` 4 a;r d.�. ... r.;• ; IQIiQA/[ CODIHY DlAllil�il' OF �ALTH 4( I, { �Dblaii ei He�MA Saealoee: Casel: & Y I/dU r c.�+lcs o Pwrlt)i i"OD S�WA6E. D&►L S1f$!8M U ._ :CO[�1SilIIL7lOB1 .. .. . . .. . .......... ... _. Cyr , Si.ww xe N /.mot ' c.ea 'L« r Tau Asap Jodi2 _ ° y� 20 #21 o.dA�.t i�... fro �e�-�' Co r,� � �i.►� Iw,.� =❑ , � � o , 116tAAt)i+dl i ,'` G S� ©ft°�� ✓L° R�'3Tewn �YGWS-- TG1r�` QSpq Harp Subdiv "s ion = Approved Fee Enclosed Amn,inr ,f ��� i p • " ., Velaase oc� NoI1R ar Hei�a�a Dalgi lbw G P • D C® Noll�tloa`4 T<egb�ed Whale V Wit. p i O P P19 _SeMetla siW.1a ewit di2$Q ci.Y.. sptic T.nt L �' � � J 3 �' , T� w�0�h� cad bJ` '77 8r Wailer $al�k/ Pine Ss��/ Fa'eae Atl�eea 1 repreaMt that 1 am whO11Y and compNtiN nsponsibN for tM detign� and location Of the propOSW aYatam(sf 1) that th 'se rat0 fstw di YI" system a0ow dauiOW wiq IN constructed as shown on "Chi approw0 amendment thYere to and,In acco►&" with'tM standards, !4 as apal rpu ns o • PuthIN County, ,l1•partnlant .;t11 IlMlth, and Chit On e'ompNtion thireof a Cert {f'"to of Construttlon Comptl+nd satisfaetory,t0 the Commissbnar, 01 MNlehwill be' ,tubmlttad•;te tM,DeparinNnt and to wr {ttpi quarantea wlfcia;, furnisMA tM owrur his sucapo►s, tNMSOr aligns bY'tM builA�r that;fal0 bgBdM will .loco M °pod oparatttq colldltloh any cart Of, said saswtia AtspoiiiiV —st m curl Me perbA of two (2 s UnnMdNtHy followin0 tMAate of the lnu- anil of ;tM app/Oral ":of tM Cwtiskatn of ConR►udiOn ;t:oniplNnce of t rorgiraal�sy em o ny rstpa ChM o 2) that', the drilled will described 06ove will be NntsO as she ves On tM pprov�d;PNn ane tnat Yfd „will will M Inst 1 in aced q' lM a .pu s of; lM Putnam s r 1 P E i A. 4. . .. 1 Addna e lfterue No APPROVED ROR CONSTRUCTION TMa approvil expiref two y • r m date issu alas Construct n of tM buiWinq less. been undertakNn and Is nvocaON:fw nua;w ma be•imende0'o►nw0iti�0when;tonsi „y Yt;OY'trie .(Wone► Of ^'Mealtn , Any.'CENnOe ot.•altMatbn.,ot conttruttbn nouMes a'nOw mit; for- ^aitpoYl.of domestIc W it 6, and /a -` water supply only. Rev. Oaa BY Title 10/88 2 1) 1'2. - it .3•ll'21-I��' 4 5 1 2 3 a - _J . � Lo !Dc., rC` c- - , a •l s -fie dCe..1 -I c, t. i 1 1 1 C�.t�. 3.. al.�ma? � r L.IlL..J. t.'L.X - W.-1. �.. r;jt._,..P. :' Cckjm DERA R'L iE. Z.-L OF REAL L C -C '. D*r SSICZ4 .OF EWvT CZl-M ML REA.LT -d •Sr--R�UC Sr . DESIGN aWA 'SILECD- SUBSUFACE SB'TA-G:E• DISEOSAL SXST H F= ICJ. Cxr7Tle -i' _� <,1�1���4 ��� 1�•. Imo) I�1 P.L�.�eSS `5� �I� J�i2� 1J3G . ��� �1� C�.��� I ��. . Ibca ted at (Street) ,�S�C' p -N G 1� i2�,�41� Se-C. _�2 , Bloc: (indicate nearest cross street)' 1•�.u�.i-cirxeiity i A=- --12� �'latershed � Tai tai COIL pZRO &MCN. - .`T'ES`1' Dz, 1. RDQULE2r`7J TO EE .S(RxI9 -Lc D WI`l'fi PPPLi=CN�S Date of Pre- Soaking Date of Percolation Test • 24MR -M C= TDI-Ml PDRc6LATICN Px.,'CIJ1 r" IG`Z Run Elabse F Depth to Water Zron Peter Spvel' No. Ti � Ground Surface In Inches ; Soi1 RRte- Stai`t -S_top Min: Sta_rt. S1!.op Drop Yn 1-{in/In Dr _ inches Inches inches E2 2 1) 1'2. - it .3•ll'21-I��' 4 5 1 2 3 a - _J . � Lo !Dc., rC` c- - , a •l s -fie dCe..1 -I c, t. i 1 1 1 C�.t�. 3.. al.�ma? � r L.IlL..J. t.'L.X - W.-1. �.. r;jt._,..P. :' i -? Coil tion i es,t Al I Gala J I >: L C -C '. lr;.. _.... - i `lrl PI' 1, i2D(2U `110 HE S�ix•fC^ -�r`�. 3 APPLICATION DF-- .t1amw OF SOILS ENvOGRME-RM xN TES's' EOLES DE I'd IlO.LE NO EOLE NO. HOLE TX�. G.L. �L Jrt'S� S alrj i�o:5�'2 1' . 21 3` .. j1: yS SPACE, FOR USE BY EEALTd _ :>> ?1 51 eaf-el .74' 6' 71 f g `. 10` 121. - 13'' D\'DICA= LEM-i AT i,rdICB GRCURUx A = IS EN"CCOWMM ' -- INDICATE L=- TO. PT-dICE K-ATE;4 LVM RLS ES A F`I� &DZ�;G EKm EJ . DZEP SOLE OBSF- RVAl'ZOVS t.sa.DE I'BX: DESIGN Soil Rate Used - .tiro %l" Drop: , %� S. D. Usable Area Provided c0�; No. of BeirociLs G'r Septic Tank Cagaci I %.�57 gals' 2yP° Absorption Area- Provided By J' %; 1 L.F. x 2411 width trench .. Other +� ✓Q NICi���^' %� ,i �L Jrt'S� S alrj i�o:5�'2 �OF�SS�Qy���% j1: yS SPACE, FOR USE BY EEALTd _ :>> ?1 eaf-el e I LAURENT ENGINEERING \� �\ ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 &Milltown Road HARRY W. NICHOLS A, P.E. June 12, 997 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Proposed SSDS - Conklin. East Branch Road (T) Patterson, New York Dear Robert: In response to your review letter dated 5- 14 -97, we offer the following: Brewster, New York 10509 (914)278 -6108 - (FAQ 278 -2658 CONSULTING SATE ENGINEERS 1. A copy of the wetland permit is enclosed. 2. Neighbor Notification mailings were made. After 10 days, a copy of the mailing list and the green cards will be submitted to your office. 3. A letter from the Building Inspector is enclosed stating the subject lot is a legal building lot. 4. The percolation tests were witnessed by NYCDEP. 5. The clay berm is. shown on the SSDS profile. 6. Fill spcifications are noted on the plan. Enclosed are four (4) prints of Drawing SS -1, "Proposed SSDS ", revised 6 -5 -97. Kindly review the enclosures and issue a Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichol r., P.E. HWN:TR:bd 95037 yS- ZU- tilrwyUl•[oc na DEC PERMIT NUMBER 3- 3724 - 00125/00001 FACILITY /PROGRAM NUMBER(s) N/A NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Am PERMIT Under the Environmental Conservation Law (ECL) EFFECTIVE DATE March 3, 1997 EXPIRATION DATE December 31, 1998 TYPE OF PERMIT (Check All Applicable Boxes) ® New ❑Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate F-1 Article 15, Title 5: Article 17, Titles 7, 8: Protection of Water SPDES Article 19: F-1 Article 15, Title 15: Water Supply n Air Pollution Control F-1 Article 15, Title 15: Water Transport Robert Conklin Article 23, Title 27: Mined Land Reclamation F-1 Article 15, Title 15: Long Island Wells X FX Article 24: Freshwater Wetlands NAME AND ADDRESS OF PROJECT /FACILITY Article 15, Title 27: Wild, Scenic & Recreational Rivers LOCATION OF PROJECT /FACILITY Article 25: Tidal Wetlands F-1 6NYCRR 608: Water Quality Certification El Article 27, Title 7; 6NYCRR 360: Solid Waste Management F-1 Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management Robert Conklin (914) 279 -9682 F-1 Article 34: Coastal Erosion Management CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT /FACILITY Article 36: Floodplain Management LOCATION OF PROJECT /FACILITY West side of East Branch Road (CR 65) F1Articles 1, 3, 17, 19, 27, 37; 6NYCRR Radiation WATERCOURSE/WETLANO N0. 380: Control F� Other PERMIT ISSUED TO TELEPHONE NUMBER Robert Conklin (914) 279 -9682 ADDRESS OF PERMITTEE 256 Lake Shore Drive, RD #3, Brewster, NY 10509 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT /FACILITY Conklin Subdivision, East Branch Road LOCATION OF PROJECT /FACILITY West side of East Branch Road (CR 65) COUNTY TOWN WATERCOURSE/WETLANO N0. NYTM COORDINATES Putnam Patterson DP22 (Class 1) E: N: 4 DESCRIPTION OF AUTHORIZED ACTIVITY Construct a well access and drill a well within Freshwater Wetland DP22 in conjunction with a three lot subdivision in accordance With plans entitled, "Final Subdivision Plan, Drawings SP -1 and SP -2" dated May 25, 1995, last updated January 20, 1997, prepared by Laurent. Engineering Associates and as conditioned herein. By acceptance of this permit, the .permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified and any Special Conditions included as part of this permit. DEPUTY PERMIT ADMINISTRATOR ADDRESS Alexander F. Ciesluk, Jr. 21 South Putt Corners Rd., New Paltz NY 12561 mrRDB AUTHORIZED SL@NATUR E � Data 3 n Page 1 of 4 rU i r Conklin.pmt (RD4)eh NEW YORK STATE ENVIRONMENTAL CONSERVATION GENERAL CONDITIONS Inspections 1: The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of 'Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71 -0301 and SAPA 401(3). A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site. Failure to produce a copy of the permit upon request by a Department representative is in violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify,,suspend or revoke this permit when: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. 3. The permittee must submit a separate written application to the Department for renewal, modification or transfer to this permit. Such application must include any forms, fees or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. 4. 'The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. - - - Other Legal Obligations of Permittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of'whatever nature and by whomever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. 8. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights -of -way that may be required for this project. DEC PERMIT #3- 3724 - 00125/1 Page 2 of 4 ADDITIONAL GENERAL CONDITIONS FOR Ah i ICLES 15 (TITLE 5), 24,25,34,36 AND 6NYCRR PA... 608 Freshwater Wetlands Me 11 That if future operations by the State of New York require, an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation if shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 12. All necessary precautions shall be taken to .preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants,_epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. .13. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 14. There shall be no unreasonable interference with navigation by the work herein authorized. 15. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and 'manner as the Department of Environmental' Conservation may require, remove- all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 16. If granted under Article 36, this permit does not signify in any way that the project will be free from flooding. 17. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and .307 of the Clean Water Act of 1977 (PL 95 -217) provided that all of the conditions listed herein are met. 18. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by on SPECIAL CONDITIONS ♦ The permittee or a representative shall contact by telephone, the Division of Law Enforcement in New Paltz (914) 256 -3013, 48 hours prior to the commencement of any portion of the project authorized herein. ♦ -The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands and complies with this permit, including all special conditions to prevent environmental degradation. ♦ For Article 15, Protection of Waters permits, the permittee or an authorized representative shall notify the Department by mailing the attached form at least 48 hours prior to the commencement of any portion of the project authorized herein'. Continued on next page... DEC PERMIT NUMBER 3- 3724 - 00125/1 PROGRAM /FACILITY NUMBER apage.frm (3/93) PAGE 3OF4 Adk 95.20- 6F(7/87) -25CR3 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS For Article 24 (Freshwater Wetlands) 1. For any of the lots in the subdivision containing portions of Freshwater Wetland DP -22 or the 100 foot adjacent area, the deed for each such property shall contain a notice as written below: "For as long as any portion of the property described in this deed is subject to regulation under Article 24 (the Freshwater Wetlands Act) of the Environmental Conservation Law of the State of New York (ECL), there shall be no construction, grading, filling, excavating, clearing or other regulated activity as defined by Article 24 of the Environmental Conservation Law on this property within the wetland area or 100 foot control areas as shown on the Final Subdivision Plat. at any time without having first secured the necessary permission and permit required pursuant to the above noted Article 24. This restriction shall bind the Grantees, their successors and assigns and shall be expressly set forth in all subsequent deeds to this property." If requested by the Department, the permittee shall submit a copy of the deed of the first sale for an affected lot to the Regional Permit Administrator in the New Paltz office within 30 days of receipt of the request. 2. EROSION CONTROL: Prior to commencement of the activities authorized herein, the permittee shall install securely anchored silt fencing and /or continuous staked hay bales as shown on the plans or drawings referenced in this permit. These erosion control devices shall be maintained until all disturbed land is fully vegetated to prevent any silt or sediment from entering the freshwater wetland or its adjacent area. Silt fencing, hay bales and any accumulated silt or sediment shall be completely removed for disposal at an appropriate upland site. 3. The permittee shall employ measures sufficient to. prevent contamination of the freshwater wetland by sediment, fuels, concrete leachate or any other pollutants associated with construction or construction procedures. STATE ENVIRONMENTAL QUALITY REVIEW Under the State Environmental Quality Review Act (SEQR), the project associated with this permit is classified as a Type 1 Action with the Town of Patterson Planning Board designated as the lead agency. It has been determined that the project will not have a significant effect on the environment. Distribution: Law Enforcement (2) R. Wood L. Kolts mmum 00'10, a i:en E %g iiee g <! Town of Patterson Planning Board DEC PERMIT NUMBER 3- 3724 - 00125/1 FACILITY ID NUMBER PROGRAM NUMBER Page 4 of 4 JOHN N. CALSO Buildinu InBpector TOWN OF 'PATTERSON PUTNAM COUNTY Telephone • $78 —b319 PATTERSON. -NEW .YORK 12563 June 12, 1997 Leamen.t Engineming Mi -et own, Road 9 Route 22 F,�teml,5ten, New YoAk '10509 RE: TM 69 -2 -918 (Neti TM - 24-. -2- 2011211 CONK.LIN SUBDIVISION Ea6t Bunch Road Pa.ttvt:son, N�uo Yohlz 7'0 WHOM 11° MAY CONCERN: Acc-o.2d'blq to r'c:etltk n sore iecvl? Code .th.. above aie. . -o be feau.l!, bu.i.:f'dccbye tots YI) you. ti:'_4u,�,te jju,,thv, ,t.l•G�yc', mC4�dt`Y1., p4en,�e do I ?(1t t' :t.'SCt.f..4 ?_, to u0act tihZ6 on Gjct' . Jo i N. C. z•s En v.,celnent L ?3�j.Lcen DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PrUn PRRMTM A na?' 9 WELL LOCATION r Street Address �� G �. ru r�C Tow�Village City 2 Tax Grid umber _2642J WELL OWNER Name Mailing r Lakwe Address S ae �w ' r. XfPrlirate Al. Y, IMY O Public USE OF WELL 1 - primary 2- secondary O RESIDENTIAL 0PUBLIC SUPPLY QAIR /COND /HEAT PUMP 0ABANDONED 0 BUSINESS O FARM 0 TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL b INSTITUTIONAL. O STAND -BY Q AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED 3-5' /EST. OF DAILY USAGE 50 stal REASON FOR DRILLING ❑ REPLACE EXISTING SUPPLY NEW SUPPLY NEW DWELLING ❑ TEST /OBSERVATION 13 DEEPEN EXISTING WELL D. ADDITIONAL SUPPLY DETAILED REASON FOR DRILLING WELL TYPE EDDRILLED 13DRIVEN ODUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES CK NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: NO Lot No. WATER WELL CONTRACTOR: Name 77—,R D. Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _,>< NO NAME OF PUBLIC WATER SUPPLY: /�% /� TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 97 NON SEPARATE SHEET (date) Rnature 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 drill operations be contained on this property and in such a manner as not to degrade or oth TW'S/ontamin a surface or groundwater. Date of Issue: Q 123 19 e T- Date of Expiration 073 19a& Pe it Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller APPLICATION FOR APPROVAL-;,OF -PLANS, FOR. A'`, WASTEWATER DISPOSAL SYSTEH 'Name and Address; .bf. Appi i cant:;: 01� 1�'1 'C�a,'1 K /��• n 25.6 --5)7,qr-'2 Q51r, Ve 10502. ---------- 2— Name of Project: 'NIX l:ocatio n T/V/C: ev LK so r .41 Millbrooke Office Cent:. 4. lProject. Engineer: 'h' E, 5. Addres's. Br6w S "t e f Y 1-1 10509 • License Number: �56 Phone: 9 i4 7 8 - 610,9:.. 6' . TY, rivate/Res'idential De of Project: Food Se r.vi ce r, en rciAl X P Apartments ins*ti'tut iona, I H6 bI I e .,P.ome'.:'.Pa rk Off i ce Building.. Qthe'r.-�.(spec'i f y): on.,,, Is -this project su,bject' t 6 State Environmental Quality Review (SEQR)? Type Status (Check One) Type .1. Exemou Type 11. Uni.isted. X wo 1s a Draft EnArb'n..-'ii=_n_ta.1 Impa.cjt-. Sta.temienU. (DEIS); required? 9.,.. Has."DEIS been completed-and Ifo u n d a*cceptable, by.-.Lead Agency?• A/A 1A 0. Ram e' of Lead Agency Is this project in an area under-•:the control of -local planning.,. zoning, or other olFf'icials, ordinances'? ......................... . ................. Ato so, have. plans been suL-;-,i tted to such .'author.l ties?... ......... L A Granted: Has preliminary approval beep* 'grahted by authorities? Date GranL Type of Sewage Disposal: System Discharge ......• .•Surface Water' (_Ground Watcrs, 1`7 surface water discharge, what is the stream class designation ? ......... e rs index number (surface) ............... s project- I oc a 'Led public water supply system? .................. yes, nane of Y C L C su P p'l , A11A Distance to water suppl 7, P ct s i t r. e a. r ia.'.publ is sewage col lect ion or disposa I s ys, 0 s e w a 9 6 s y s t em _A .DisL Distance' to sewage syster . _4 b S e I'V El 23, N�ame o*f Health inspector: Mgtjdz 9,5 e s k CZ al ion:; p,:, r day ................................. . I -r-2.Ll 25._ Is. State%Pollutant Discharge. E1'inination' System' required ?.. N 26. Has SPDES Application been 'sub,�i.tted to . aocal DEC Office? ..:........... 27., `Is any portion of this project.locat.ed within a_designate8,`,Town or State wetland ?..... .... ........ ...... ................... eS 28. Wetland _,ID.Nun,ber ......: 29.',•Is Wetland Permit! required? .... .........:. ........... �$ Has .appl,icat.ion. been made to Town or Local DEC Orrtce. ....,..............:. �_S 30. Does projec require a n ' DEC Stre�" "Disturbance' � � Pe ft? ............ . 3i . Is or was 'project site -used for..agr,acultural.. `activity tnvolving''applicati' on OT pesticide* to Orchards' Or othe('.- crops_, Sol i8'.or - hazardous waste disposal, landri 11 ing, sludge application or industrial activity? YES 32. is project located within- 1;000•feet, or'existence'of abandoned . landfill, hazardous waste ite,:'aalt_ stockpile,' lzridrill; sludge .disposal site or any other pot "ential known source of conta"riination? .YES or NO NO DESCRIBE: _. 33. Is there a local Waster plan or- - file:`Nith the Town or Vi 11a'ge? ..... D 34. Are co :unity rater, serer fzcilities planned to be developed within 15 years? __A1 1A ?5.. Are any sewage. disposal areas in excess of 15; slope? NO ;5'. Tax: Nap ID Humber. �4 °2. -20 .7. r,pp'r-oved Plans are' to 'be returned to: ................. Applicant )C Engineer the„ application'.is signed by a person ocher than the .applicant shown in. Item .1' the. Ppl ication must be•acccmpaQ jed by "a Letter of Authorization: Failure to comply with this rovision may be grounds for `the rejection ;of any sutmlission. I hereby affirm, under penalty of perjury;- that information provided on this fo is. true to the best -or my knoxle8ge and be l ief. False state,,e.nts' -me de herein are punishab7e as a Class A Kisde; -eenor pursue to Section 2107 of the in Lau. �q TU °cS & DFFTCIAL TITLES Millbrooke Office Centre __._ .. . i.ING ;,ODnESS: Brewster, N1 10509 No. 56124 oAR�FESSI��P�� ;;;;. .;:`:�.�:•ii:i� .•.. .�i � ��'� mow:.::: � • \w. .y_,�� . r::: •: T:•:v:•:� Sri �:�' . r.. .: •.'.:: �^'�. .. . n•T::•.:... . r... •: n•: ::v. ....... .1 . .... ...... '�'::. .1 . •: /. ..1 . ': is ,�.... . .r• ?1•• SX4i.•.. 1 v 'Y- . 1 y: '.1 48, ` BATH` BEDROOM 4 y.•8.. x 12'•O.. ORESSING' BEDROOM 3. WALK' 13' -0" x 10••O" �� 1 IN. I.t CLOSET j MASTER BEDROOM BEDROOM 2 OPEN 17'-0 x 16'•8" 13'0 "H 1S.B...• i --� f SECOND FLO:QR _ 4828 = .13445 48' of PUTNAM COUNTY L�;`'N�pITIiATH' DINING ROOM p � MORNING AGOM KKJr PC R 6ECP�` loM, COUNT ONLY .- ', DROGMS S�gnatuxp. & Title �a . -T- :- N LIVING DOOM 13..p...x 1 m'.p•.• hl FOY 0 i \I ��R28 Re: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION.OF ENVIRONMENTAL HEALTH SERVICES Date Property ofo Locdted at as ?' 1E/_QV l 7 �t oa•� (T) eo- arsok Section . 2 Block '20 Lot Subdivision of NO Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorized rr•/ lA/ %V %C�JO /S it r. 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 connection 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. eery truly yours, � Qr • V9 � � W S CountersigneJ�O No.66t24 �•�� P . E . R . A . ,}` AR0FESSI�� J�61Z /Of 11A roo ke A? i'ee Cevr �re Address V4) 27S- 6108 Telephone igned Owror of Property JeS .Lakes .5X6rc- 9ri'yc Address ter,' /t/. /i .5L 9 • Town (9/4) 279.- Telephone BRUCE R. FOLEY Acting Public Health Director DEPARTMENT OF HEALTH Division of Environmental Health Services '4 Geneva Road Brewster, New York 10509 TeL (914) 278-6130 Fax (914) 278-7.921 May 14, 1997 Harry Nichols Laurent Engineering Millbrook Office Ctr. Route 22 & Mlbrook Road Brewster, NY 10509 Re: Proposed SSDS: Conklin East Branch Road (T) Patterson Dear Mr. Nichols: 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. If a wetland permit is required, the wetland permit must be submitted prior to the issuance of a SSDS construction permit. 2. Neighbor Notification is required. 3. A letter from the Building Inspector /Zoning Board of Appeals is required stating the above regarded lot is a legal building lot. 4. Percolation test must be witnessed by a representative of this Department. 5. A clay berm has not been shown in the SSDS profile. 6. Fill specifications have not been noted on the plan. Upon receipt of a submission, revised to reflect the above, this application will be considered further. V truly yours b� Robert Morris, P. E. Public Health Engineer RNVjP 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 2 BY B. HEDGES &MORRIS OTHER DATE 1� TAX MAP # - DOCUMENTS. M/PE�MITAPPLICATION m PC -1 = WELL PERMIT m PWS LETTER = ENGINEERS AUTHORIZATION_ M DESIGN DATA SHEET(DDS) = CORPORATE RESOLUTION = PLANS THREE SETS = HOUSE PLANS - TWO SETS LTA VARIANCE REQUEST SUBDIVISION LEGAL SUBDMSION SUBDIVISION APPROVAL CHECKED PERC RATE FILL REQUIRED DEPTH CURTAIN DRAIN REQUIRED =STANDPIPES GENERAL = EX APPROVAL SS J LOTS Y EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE PUMPED PIT & D BOX SHOWN & DETAILED luunt - NO OF BEDROOMS IN0ELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM OPERTY METES & BOUNDS 00 USE SETBACK NECESSARY (TIGHT LOT) USE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE B ENDS; MAX. BENDS 45° W /CLEANOUT FILL SYSTEMS EO CLAYBARRIER En 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE FILL SPECS = FILL NOTES FILL CERTIFICATION NOTE DEPTH GAUGES FILL PROFILE & DIMENSIONS VOLUME FILL IN EXPANSION AREA = WETLAND ( TO EC PERMIT ?) TRENCH m DS PLANS SAME F TRENCH PROVIDED =60 FT MAX PRE- LwAEIGHBORNOTIFIFICATION VARALLEL TO CONTOURS = BUZBA 100% EXPANSION PROVIDED = 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN AGE SYSTEM PLAN - (NORTH ARROW) i HYDRAULIC PROFILE m GRAVITY FLOW STRUCTION NOTES (GRINDER NOTE) [GN DATA: PERC AND DEEP RESULTS ) -FOOT CONTOURS EXISTING & PROPOSED AY & SLOPES CUT, AIN DRAINS EROSION CONTROL; HOUSE,WELL, SSDS EROSION CONTROL NOTE PERc & DEEP HOLES LOCATED PRESENTATIVE OF PRIMARY AND EXPANSION LOCATION MAP 10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL 20' TO FOUNDATION WALLS bJ 15' WELL TO P.L j00 TO WELL, 200' IN D.L.O.D., 150' PITS J00 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 %,201- 4 %,25'- 3 %,301- 2 %,35'- 1%,100' <1% 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. 10' FROM FOUNDATION; 50' TO WELL COMMENTS: FORMAT NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT greens P°` n dui Ide rS no Dear G�ens`nn lcc �t�der�'. Date (,:,' � o�►a RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: X O-8L ,- T 00Nk1 -19 Address: 9AsT Bf2APC14 RG�P Town: P677-ERSON , N7 Tax Map: 24-,'- 2 - 20 - 21 Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site .plan.. If you have any questions, concerns or informat.ion which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 273 -6130. Very truly yours, By_ ( W,., Title RECEIVED BY: Address: Tax Map: J K ; c j FORMAT NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT Bwanc �O Dear Mr. P�fS . Ki Date 5 -q I RE: Department of Health Review of Proposed Sewage Disposal System for property; Name : 2G8�R-� CoN,�LIN Address: 2A67 ApC14 Ra)}p Town: Pf9�TjE1e.50N , Ny Tax Map: 2q - 2 - 20 -L Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site .:plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at .273 76130. Very truly yours, B y Title RECEIVED BY: Address: Tax Map: JK;cj FORMAT NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT Date RE: Department of Health Review of Proposed Sewage Disposal. System . for property: Name: RGbE2T C'oNki -14 Address: F,Ast- Z5PApC14 9G,)q,0 Town: - 94TTF-le50/J , Ny l . Tax.' Map : 14% -2 - 20 2) Dear Y. �.�jfS • C��aP0.�o •. Please be advised that an application for a Construction Permit relative to the construction. of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site :'plan'. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of. the Health Department at 273 =6130. Very truly yours, B Y Title �-Gw RECEIVED BY: Address: Tax Map: JK;cj FORMAT Date NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT Pp► ash Farrel �OO� RE: Department of Health Review of �.�. 1`3oX )a� Proposed Sewage Disposal System for property: Name: -T OOWkl -14 Address: 2MST 8(1APC14 9M)9 Town: Tax Map : Dear Please be advised that an application for a Construction Permit relative to the construction of a.sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site• plan: If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 273 76130. Very truly yours, By Title -Gw� RECEIVED BY: Address: Tax Map: JK;cj FORMAT NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT Date G �i�•ian� o . ©_ Box FoL0�1 I�� la��� RE: 1 Department of Health Review of I Proposed Sewage Disposal System for. property: Name: �2C8�2T CoNkLIII Address: i�AS7 5RAPC14 90gP Town: PR77-)ERs01Q , N7 Tax Map: 24-, - 2 - 20 J- 21 Dear Mf. 1 (S• Ceti J ian Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site .plan: If you have any questions, concerns or informat.ion� which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 273 76130. Very truly yours, B Y Title o-�w RECEIVED BY: Address: Tax Map:. JK;cj FORMAT Date (0-5-9-1 NEIGHBOR .NOTIFICATION CONSTRUCTION PERMIT bec sch� &r�hLLr -lo Ac I l i Hvc kan iCOJ i t NeLj qor� Dear RE: Department of Health Review of Proposed Sewage Disposal System for. property: Name : Q08, --P-T CoNk)-il Address: BAST ANC14 RGF}T> Towns Tax Map: 24-, - 2 - 20 d- 21 Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /on well proposed for the captioned property. has been made to the Putnam County Department of Health. Attached please find a copy of the latest site 'plan'. ; If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 273 76130. Very truly yours, B Title 01 -e,LV ' RECEIVED BY: Address: Tax Map: JK;cj 24. -2 -18 24. -2 -19 24. -2 -22 24. -2 -23 24. -2 -62.2 24. -2 -62.3 24. -2 -62.4 24. -2 -62.5 95037 06/04/97 LAURENT ENGINEERING ASSOCIATES, P.C. j \ MILLBROOKE OFFICE CENTRE / \ Route 22 & Milltown Road Brewster, New York 10609 (914)278 -6108 - (FA)) 278-2658. HARRY W. NICHOLS JR.. P. E. CONSULTING SITE ENGINEERS LIST OF ADJACENT PROPERTY OWNERS Robert Conklin -Deutsch, Arthur c/o Allied Mechanical Trades I 343 E. 66 St.- New York, NY 10021 Gezirjian, Edward & Christiane P.O. Box 14 Patterson, NY 12563 Knapp, Drina East Branch Road P.O. Box 121 Patterson, NY 12563 Catapano, John & Alice RR 1 East Branch Road Patterson, NY 12563 Mill, Donald & Ann East Branch Road Patterson, NY .12563 Greenspan Builders P.O. Box 330 Briarcliff Manor, NY 10510 �x LAUREt4T ENGINEERING ASSOCIATES. P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road. Brewster; New York 10509 (914)278-8108 - (FAX) 278 -2858 CONSULTING SITE ENGINEERS A .� Gentlemen: We enclose copies of: ❑ B/W Prints ❑ Reproducibles ❑ Specifications ❑ Memorandum .. Date: IIY,tlt:::_: i/o ..Ig� 01 Job No.: Project: Pr20f�SF D SSID - C22 L) ❑ Reports ❑ Tracings ❑ Copy of Letter ❑ Description: Revision/Date CA GV poll M,29.11a I low CZt\/ �w (N L5_ Sent Via: ')§Our Messenger ❑ Blueprinter ❑ First Class Mail ❑ Special Delivery ❑.Your Messenger ❑ Hand Delivery ❑ Copy to: Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. . Per:, LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE - - Route 22 8 Milltown Road Brewster. New York 10509 (914)278 -6108 - (FA)O 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS April 25, 1997 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Robert Conklin East Branch Road Patterson, New York Dear Robert: Enclosed are the following: 1. Four (4) prints of SS -1 "Proposed SSDS ", dated 4- 21 -97. 2. "Application For Approval of Plans For a Wastewater. Disposal System ". 3. "Construction Permit of Sewage Disposal System ", dated 4- 25 -97. 4. "Application to Construct a Water Well ", dated 4- 25 -97. 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 4725 -97. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 8. Money order in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Niols, Jr., P.E. HWN:RL:bd 95037 Im-, SENDER"' "'Y_' i Wish to receive the 0I mConi , plete items &_46 ind'4b--' — 'aP'rint your name and address on t14�r6vdhFe'of,thi6 f6iiTi so that we, can returnA itua eXtra joe): -' card to you * f >0 ■Attach this tone t6 the front of'6i:"10 -�, or on thd,b-adc i space oe¬ .'l'..O 'Addr6sse e's Address� sWrite'Ratum ' 'Receipi Requested' bh ttii'mii[Oiicilbeldi4' the -article inumber. 10 Resiricted. Delivery - U), ■T�6"Retum Rd'celptwill show to4hi5rri the iihicisi was deilvired,and the date Consult delivered. Ddstmatterforf0e. S 3. Article. ddr"s6d to % - .4k, Article, Number, vo c 4 n. CL :E. i .4b..'Se rvide Type .0 Q b,'Re'gistered g0ertified ' ❑ Express Mail. 11 insured S ❑ Retum Receipt f6r:Merchandise 0 COD 7. Bite of I NY 0 5. ReceiVefl3y: (Print Name) 9.,Addre gnA re: bdt Ac@fts (0r)'quested c and f9Fj aid) Si a (Addr6ss bAgdfi - — '. 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