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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -21 BOX 9 00799 !7- ,% , ,: IL i' 16 . 00799 ri 61717- k1l". I . COUNTY DEPARTMENT OF HEAL VISION OF ENVIRONMENTAL HEALTH SERA. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P 0-1 -0(p Located at gyp% / s� ha v, 12oadl Town or3L 4W �� -;rSQL Owner /Applicant Name L p, f 21114 a Co iq k I i tTax Map Block Lot Formerly Subdivision Name Subd. Lot # Mailing Address 1-3-7 d i tcl %, r i Lac,.( Lh -1 -F4i caL, 9,1 _ Zip j 3 Date Construction Permit Issued by PCHD 1 % - Separate Sewerage System built by C"O"L-1 Address 13~7 ► r�� � /[� Consistin of 'Z-�-O Gallon Septic Tank and '`x 00 1,�t t e Other Requirements: Water Supply: Public Supply From, Address or: 1/ Private Supply Drilled by 45_ Address Building - 'ype`- /L,rsi a� , J �w Has-erosion control been-completed? 7 �S Number of Bedrooms - Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulatigni of the Putnam County Dgpartment of Health. Date: -4 2-6 - 0 S Certified by Address P 6 ,off- P.E. (X R.A. License # -6e -12-1 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification oy change is necessary. By: Title: Date: _ White copy - HD Fi ; Yel w c py - Building Inspector; Pink copy - Owne Orange copy - Design Professional Form CC -97 - PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SU$SURFACE SEWAGE TREATMENT SYSTEM T a Z 21 Owner or Purc aser o uilding Tax Map Block Lot Building Constructed by Town/�� - Location - Street Subdivision Name Building Type.' SUbdiv-ision Lot # I represent that I., am wholly and completely responsible for the location, workmanship, material, constractiort and�drainage of the sewageireatment system serving tlie'above- described property; and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition.._ -- any parr-of said"-s-ysterh constructed by`me which fails'to operate..for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for'the sewage treatment system, or any repairs made by me to such system, .except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. :.._... -- ._.__.._.__.....__._... The undersigned further agrees to accept as conclusive .the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the•failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing: the system. Dated: Month Day Year 2-od 9 Signature: Title: '- General Co • act O(C*er ignature . Corporation Name (if corporation) Corporation Name (if corporation) Address: ('3 7 G(v-�L gill 042 �$ �rsGL. Address: ( 7 "Lei State Zip � State i er c.-, "- Zip Form GS -97 BRA: CE R FOLEY Public Pfealih Dtrecxr LORETTA MOLDiARI• R.N.. NUN. F Aviodaw- public 'Health Direacr - Director of Patient Strvicn DEPARTMENT OF HEALTH I Geneva Road Browzter, Now York 10509 l"aritoameatal Health (9L4)278-6130 Foc (914) 278 - 7921 Nurflaq Urvtep (9141272 -6553 5P1C (9141 271.5678_ Fix (914) 27a - 608: Urly Laterfcatloa 014)2;8.6014 ?rnchool (914)278.6082 Fax(914)318• -6648 OWNIERS NkME: TAY MAPNUNIBER: E911 ADDRESS: TOW1: -2-1 AUTHORIZED TOWN OFFICIAL: (Sianature) DATE: The Putnam. County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official, This form is to be submitted *ith the application for a Certificate of ConStruttion Conipliatce. (191 1 b'Ir- -�.�1) Harry W. Nichols Jr., P.E. P.O. Box 252 - Brewster, NY 10509 — Tel (845) 855 -9275 March 31, 2008 Michael J. Budzinski, P.E. Director of Engineering Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Re: Individual SSTS Compliance — Conklin 671 East Branch Road Patterson, NY T.M. #24. -2 -21 Dear Mr. Budzinski: Enclosed are the following: 1. Five (5) prints of Drawing S -1, "As -Built SSTS ", dated 03- 24 -08. 2. "Certificate of Construction Compliance for Sewage Treatment System ", dated 04- 28 -08. - 3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment System ", dated 03- 21 -08. 4. Laboratory Report, dated 03- 14 -08. 5. "Well Completion Report", dated 08- 10 -07. 6. Application Fee in the amount of $300.00 payable to Putnam County Health Department. 7. "E -911 Address Verification Form ", dated 03- 31 -08. If there are any questions concerning the enclosed, please call. Very truly yours, Harry W. Nic Is Jr., P.E. HWN:his 06- 005.00 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 Albert H. Padovani, Director LAB #: 9.800308 CLIENT #: 55074 NON STAT PROC PAGE: 1 of 2 CONKLIN, ROBERT DATE /TIME TAKEN: 03/06/08 10:50 PO BOX 627 DATE /TIME RECD: 03/06/08 11:15 PATTERSON, NY 12563 REPORT DATE: 03/14/08 PHONE: (845)- 878 -4100 SAMPLING SITE: 671 EAST BRANCH RD, PATTERSON, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COLD BY: ROBERT CONKLIN TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 03/06/08 MF T. COLIFORM ABSENT /100 ML ABSENT SM 18 -20 9222B 03/13/08 LEAD (IMS) <1 ppb 0 -15 ppb SM 18 -19 3113B 03/13/08 NITRATE NITROG 0.68 MG /L 0 - 10 SM18- 20450ONO3 03/07/08 NITRITE NITROG <0.01 MG /L 1.0 MG /L SM18- 20450ONO2 03/11/08 IRON (Fe) 0.090 MG /L 0 -0.3 mg /l SM 18 -20 3111B 03/11/08 MANGANESE (Mn) <0.010 MG /L 0 -0.3 mg /l SM 18 -20 3111B 03/13/08 SODIUM (Na) 4.28 MG /L N/A SM 18 -20 3111B 03/07/08 pH 7.2 UNITS 6.5 -8.5 SM18 -20 4500HB 03/11/08 HARDNESS,TOTAL 68.0 MG /L N/A SM 18 -20 2340C 03/11/08 ALKALINITY (AS 54.0 MG /L N/A SM 18 -20 2320B 03/11/08 TURBIDITY (TUR 1.2 NTU 0 -5 NTU SM 18 (2130B) COMMENTS: MFTC THESE RESULTS INDICATE THAT THE WATE .(WAS),(WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD limits for p, EPA Lead & Copper than 100 of their than 15 ppb and a treatment must be potential. iblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg /L, else water undertaken to reduce the waters corrosive Fe /Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg /L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg /L of Sodium YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245 -2800 - Albert H -. - Padovan- -i-; -- Director - LAB #: 9.800308 CLIENT #: 55074 NON STAT PROC PAGE: 2 of 2 CONKLIN, ROBERT DATE /TIME TAKEN: 03/06/08 10:50 PO BOX 627 DATE /TIME RECD: 03/06/08 11:15 PATTERSON, NY .12563 REPORT DATE: 03/14/08 PHONE: (845)- 878 -4100 SAMPLING SITE: 671 EAST BRANCH RD, PATTERSON, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE COLD BY: ROBERT CONKLIN TEMPERATURE..: < 4C NOTES...: COLIFORM METH: MF -------------------------------- - - - - -- - I----------- - - - - -- ----------- - - - - -- DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD is suggested. pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE'300 MG /L MODERATELY HARD WATER: 70 -140 MG /L MG /L = MILLIGRAM PER LITER __ -- -HARD WATER: 0.3 0__ � . I /L ,(1 grain /gallon _ = . 1.7 ...2- ..MG %�)• -..- - SUBMITTED BY: Albert H. adovani, M.T.(ASCP) Director ELAP# 10323 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health " LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 3, 2007 Harry Nichols, P.E. P.O. Box 252 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Conklin East Branch Road (T) Patterson, T.M. # 24 -2 -21 The above referenced separate sewage treatment system -can be backfilled. The following co ents need to be addressed: 1. A bedroom count needs to be performed upon further completion of the house. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. Sincerely, GDR:ens 1 Nursi..::. , Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6646 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health September 28, 2007 Harry Nichols, P.E. Patterson Park, Ste 106 P.O. Box 252 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Conklin East Branch Road (T) Patterson, T.M. # 24 -2 -21 The above referenced separate sewage treatment system can be backfilled: The following comments must be corrected in the field. /1. There is no cleanout on the main line from the septic tank to the first 'unction box as per P. J p the approved plan. 2. Instead of cast iron pipe from the house to the septic tank there appears to be a black plastic pipe; please clarify. If you have any further questions, please contact me at (845) 278 -6130. JD:ens Sincerely J yep Digit Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225. -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 =6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES `oli /0.7 -60 FINAL SITE INSPECTION Date: b Street Location 4A-Sl- �� �� R�) Owner ;oR k spected by: Town pA'T7`eaoy Permit # 04-0(, TM Z ? O 2/ Subdivision Lot # 1. Sewaee Svstem Area a. STS area located as per approved plans .......... :................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped .................................................. d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course /wetlands............ .................... II. Sewage System a. Septic tank size - 1,000 ...:.....1, 250 .........other ................ b. ' Septic tank installed level .......................... c. 10' minimum from foundation .......... ............................... d. Distribution Bog 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3... Nfinimum 2 ft.Original soil between box & trenches e. Junction Bog - properly set .......... ............................... 6. Trenches 1. Length required 0 Length installed, 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ........................................ 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 11/2" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends ca ed ...................................................... g. Pumn or-Dosed ystems 1. Size of pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio .....:..:........:.. ..............................: 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... I II House/Buildine a.. house located er approved plans .......................... b. Number of bedpooms ........................ ............................... , IV. Well Well located as per approved plans.. .....:........................ b. Distance from STS area measured . ft ........... c. Casing 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ............................... i.. Erosion control provided ................. ............................... Rev. 12/02 JK �� I MAN= PAVARM FRE A.AMW41'' M= • AM K M W►M WaN A EKE = I M 'WAS A MRS JK 14 =16-4 (9/95) —Text 12 PROJECT I.D. NUMBER 617.20 SEAR Appendix C State Environmental Quality :ReJlew SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR Qoblal' cosskLw 2. PROJECT NAME 3. PROJECT LOCATION: Municipality QAS' "zSo►1 County A, 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) �AS� BtZAJGN Qp�.3� 5. IS PROPOSED ACTION: R New ❑ Expanslon ❑ Modlflcatlon /alteration 6. DESCRIBE PROJECT BRIEFLY: �oassl¢JGto►� of Qts,a>wG=, DQ1Jtk'),Ay r trJtll, SST'S 7. AMOUNT OF LAND AFFECTED: t "Ji�`' Initially acres Ultimately !� 1 acres S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR-OTHER EXISTING LAND USE RESTRICTIONS? ® Yes ❑ No If No, describe briefly 9.L WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other Describe: 5104 Lt Fnt" I 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ® Yes ❑ No If yes, list agency(s) and permlUapprovals T0,4>0 OV QA%-Le50&3 ^ 603% utlar, .b�.Ql�ti�►htv►�:. 6J11.�1h�% 49 -t-ti' Too a of e^IT"LQsoa — 1A zw wk y 3�"ASVH L V ,06.L%%j4.w►.y *2-b T- 11. DOES ANY ASPECT OF THE ACTION HAVE.A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes RNo If yes, list agency name and permlUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes "ONO. I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: SQ. pe. Date: © 1n�lMw Signature: ; v If the action Is in the Coastal Area, and you are a. state agency, complete the . Coastal Assessment Form before proceeding with. this assessment OVER 1 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate'the review process and use the FULL EAF. ❑ Yes No B. WILL ACTION R CEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. ❑ Yes No C. COULD ACTION 6ESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion,, drainage or flooding problems? Explain briefly: v� v C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community. or neighborhood character? Explain briefly: /j © C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened'or endangered species? Explain briefly: �1 C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. 4 C5. Growth, subsequent development, or related activities likely to be induced by the proposed. action? Explain briefly. C6. Long term, short term, cumulative, or other effects not Identified in C1-05? Explain briefly. C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? ❑ Yes No E._IS.THERE, OR 11 THERE LIKELY TO BE,.CONTROVERSY RELATED TO POTENTIAL ADVERSE-ENVIRONMENTAL IMPACTS? ❑ Yes No If Yes, explain briefly PART III — DETERMINATION- OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring;.(c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question D of Part II was checked yes, the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a positive declaration. ` Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary., the reasons supporting this determination: Name of Lead '.Agency 10=jvI �0 Print Type Nagmof Responsible Officer in Lead Agency I Title of Re sible O i r Signatur of Resp ns le Officer in Lead Agency; F Signature of Preparer (If .if erent rom responsib e o icer) ,4. Date 2 SEP -26 -2007 12:08 PM HARRY W NICHOLS 914 279 4567 P.01 .d -0 Ll PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RF,QLTEST FOR Ella INSPECTION For: Fill Date: -d 7 Trenches L� PCHD Construction Permit # t431 -0('e Located: (T) ( f _ ,0a -ff- -e sod Owner/Applicant Name: TM Block —.. Lot 2—�-,- Formerly: Subdivision Name:` Subdivision Lot # Is system fill completed? I5 system complete? Is system constructed as per plans? Is well drilled? Is well located as per plans? WX Are erosion control measures in place? Date. Date: O Date: -0 I certify that the system(s), as listed, at the above premises has been constructed, and I have inspected and .verified their completion in accordance with the issued PC14D Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. _- Date: - - �- ... --G 7 Certified by: uLPE—RA ._... Professio Address: P, 0, 6d x 7�'2_ - .� Lic. # q61 Comments: FOR: a nnnM A GENE ❑ Fortin FIR -94 AM COUNTY DEPARTMENT OF HEALTH IVISION OF ENVIRONMENTAL HEALTH SERVIC CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # ?— U Located at EAs-r SaA.Ie-N aoAD Town or Village &%ri-R.SoO Subdivision name -� Subd. Lot # - Date Subdivision Approved Tax Map '24. Block 2 Lot XN# a 6 Renewal Revision Owner /Applicant Name 0-061Qf coy 140 0 Date of Previous Approval Mailing Address 151 1111zCkA R aL 2eA,3� P,otTt¢soJ N Zip 1264 3 - Amount of Fee Enclosed 50D C Building Type Rssg >iL! e-z Lot Area 0l► No. of Bedrooms ¢ Design Flow GPD f(100 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage -System to consist of 1250 gallon septic tank and 400 I-S ASS . TRfuc" Other Requirements: To be constructed by TIB;C Address Water Supply: Public Supply From Address or: X_ Private Supply Drilled by TBm Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the senarat� sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address I R.A. Date 0001D i &, License # 5612-4-, APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new enmit. Approve for discharge of domestic sanitary se age only. By: Title: Date: .4-17 White copy - HD f le; Yel v copy - Building Inspector; Pink copy - Oofer;(O�inge copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # Well Location: Street Address: Town/Villa a Tax Grid # °#6r R► PM7- 1�_ �N Map `%Aa Block - Lot(s Well Owner: Name: Pow cot�\w- '-A . Address: 1-�i DIVA *u., Wo P �(* r�y `qj�v� Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought *4- gpm # People Served ' Est. of Daily Usage %10 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No ?� Name of subdivision Lot No. -- Water Well Contractor: LQ Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: -' Proposed well location & sources of contamination t be provided on separates t/ Ian. Date: 0%101 10 Applicant Signature: LL PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and 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 or their designated representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED, FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County.. J X Date of Issue Permi Date of Expiration ' -[T-0 Z Titled Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - OvAer; Orange copy - Well driller Form WP -97 I April 11, 2006 Michael Budzinski, RE Putnam Co. Health Dept. 4 Geneva Road Brewster, NY 10509 . Re: Conklin Subdivision Lot # 1 East Branch Road Patterson, Putnam East Branch Reservoir DEP Log # 2006 -EB -0432 (Joint Review) Dear Mr. Morris: i.obrbau6fw*i supply This letter is to inform you that the New York City Department of Environmental ass comma" '.Aver "e 7 Protection (Department) has determined that the above - referenced application is veine�� New Yak.. - . ( p ) PP 10595-1336' complete. In addition, the Department has no objection to the approval of the above- referenced regulated activity. This determination is based on the review of Michael A. Principe, Ph submitted documents including the plan titled "Proposed SSTS Lot # 1 ", of Deputy comnussioner Conklin Subdivision, prepared for Robert Conklin., dated 02/01/06. Tel ;.(914) 742 2001 ' TAX .(s1a) 7a,1 -0348 The applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 at - least 2 days prior to the start of construction of the SSTS so that a Department representative may inspect and monitor the installation. Joseph Maggio, P E:; Deputy Director `EngineenngDivIslon EOH Sincerely, r Tel ;(914)773- 4470 Fax (914) 773-0343 Danny Shedlo, P.E. t � Civil Engineer II Engineering Review Group xc: Roger Sokol, P.E., NYSDOH r J ' CITY DEPggT ` �NMENTAI 09- DEP HELP; SHERLITA AMLER, MD, MS, FAAP Commissioner of Health . _ - _ - LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Hang Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster; New York 10509 March 28, 2006 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Conklin SSTS East Branch Road (T) Patterson, TM# 24 -2 -21 East Branch Reservoir Basin . The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on March 21, 2006 is complete. The Department will notify you by April 16, 2006 of its determination. O The project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ❑x Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice. must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the New York City Department of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed approved, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the New York City Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2148. MJB:cj Ws2 Respectfully, Michael J. Budzins PE Director of En rneeri Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921. . Nursing Services (845) 278 - 6558- WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 ate. TO: DEPARTMENT OF ENGINEERING AND DESIGN REVIEW ROBERT J. BONDI County Executive DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM JOINT REVIEW PROJECT: TOWN: 5 SUB'D APP DATE NOTICE OF COMPLETE APPLICATION: DATE: Z? ❑ Within the drainage basin of West Branch or Boyds Corner Reservoirs. ❑ Within 500 feet of a reservoir, reservoir stem or control lake. Within 200 feet of a watercourse or a DEC wetland and appearing on a subdivision map approved after December 31, 1992. ❑ Design flow greater than 1000 gallons /day. ❑ Commercial SSTS. jtreview PUTNAM COUNTY DEPARTME HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET SUBSURFACE SEWAGE TREATMENT SYSTEM L.A XG er co z T NJ K L 111 Address B. rt C-- w S. -r F- R y I O.S<)g Located at (Street) [-:AST SRA -.4 C. 1-A (.5) Tax Map Block 2 Lot• zo z I "(indicate nearest cross street)"' 7 E P rz-i-'T 0 Municipality '(T) P'A T Z S 0 N Watershed F/A LL5 LOT O S0.1.L,PERCOLATION TEST DATA Date of Pre - soaking' V- a Date of Percolation Test 11 - .E6je'-N .:Ijz e ... .. .. . .. o r m`GrQv XI ...... . ..... S t -w- v 6 rpQ 13 t 1 tic 9: 59 - .'1.0 :08 9 Z! Z- z S7 2 -1 0. 9 0'. Z Z' z Z:. zS 4.3 3 io:zZ- 10,36. 1 4 Z Z. 4 10..36 woo 5 z 0 Z3 Z, 0 2 7 :16 8 z3' 3 z.7 3. a3 " .3,o 4 0:34. C) 0 .-3 2 - 3 4-, NOTES: L. Tegs,'to be repeated at, same depth until approkimately equal percolation rates. are obtained at each -'percolation'.`Ie.st hole., (i.e. s -1 min for 1-30 min/inch, 2 min for 31-60 min inch) All data to be submitted forreview*' j 2. 'Depth measurements'to be made from :fop of hole. Form nn-07 UTNAM COIL NTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE; Property of LETTER OF AlPrH 7RIZATYON Located at �s A// ---I TIV' -r.:.: Tax.Map..# ... Block -_ Lnt' °4�- Subdivision of &XtAUI� Subdivision Lot # Filed Map # Date piled Gentlemen.. This letter is to authorize a duly licensed Professional Engineer 0;'' or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above-Doted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sip all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in, . conformity with the provisions of Article 145 and/or 147 of the Educafion Law, the Public Health ):,avv, and the Putnam County Sanitary Code. �o�f yo Very truly yours, Countersigned; ; � � Signed: � .7 , t� P.1r., R,A., # (owner o (2Perry) Mailing Address Mailing Address: /3 % 4c/L, L P=La- �ftss�o �i State Zip IAS`6,? State Al �� Telephone; ��� _ � Telephone: � qo�1-100 z__ w4i' TO rra Mid S1d3S 1VIl03Qf1 W Funn LA -97 0Z98598968 0T'-5T 900Z,'9Z/10 Y PUTNAM COUNTY DEPARTMENT'O,F HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET SEWAGE TREATMENT SYSTEM _LAX G Owner er -,R,<D F, E_z_ T C, c) N i< L i i-,j Address. s w- r__ w"s T F_ _R -f"J y 1 0 6 0 9 Located at (Street) [-:A-.T E�MAWC-1-4 MO. Cr.z. s�) Tax Map Block Lotza4z, . :. , . .. ntarest'tross'stroe Municipality '(T > P.A T F -;z s o N: Watershed CM-To� FALLS L 0 T (D soILPERCOL ATION TEST DATA Date of Pre-soaking.. i - a Date of Percolation Test 11 4-9.9 percolation.'test hole. (i.e. s I min for 1-30 min/inch, g 2 min for 3 f-60 n1iAnch) All data to be submitted for review' 7 Depth measurem'ents'to be made from top of hole. Fnrm r)r)-0'7 . e D"16o, a Fx 2 .09 W r o m rou O.A.; 3. Z Z..-. 10 :36 14 2Z ..grco. . Ho e N I o 4 S (..Mi t z 7_S" 9:59 -.10,08 9 Z: Z ZT percolation.'test hole. (i.e. s I min for 1-30 min/inch, g 2 min for 3 f-60 n1iAnch) All data to be submitted for review' 7 Depth measurem'ents'to be made from top of hole. Fnrm r)r)-0'7 2 .09 W 4.3 3. Z Z..-. 10 :36 14 2Z 4. T .... 4 10-,36 t z 7_S" Co Z o, Z3 3 Z.o ...... .. 2 o:07 o:15 8 23'' 3 Z,7 3. 1 o: zc 9 3— 3,o 4 0:34 5' Z-0" Z3" 3 1. C) 0.* 20 23 3� 2 3 4 5 NOTES: I Tests to be repeated at same depth until approii'mately equal percolation rates are obtained at each percolation.'test hole. (i.e. s I min for 1-30 min/inch, g 2 min for 3 f-60 n1iAnch) All data to be submitted for review' 7 Depth measurem'ents'to be made from top of hole. Fnrm r)r)-0'7 � TEST PIT DATA 2 L o Y ','J DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH - HOLE NO. HOLE NO. 2 G.L. T`o'Qs0)4- To'pSo 1 L 0.5' 1.0' r"EDIU1 -1 aR0WIQ oV- Al -a E YINT 1.5' 2.0' 2.5' 3.0' ).51 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5�* 10.0' SAr.Ir�Y SILT{ I -OH ►`� S A Ij rz> YII L O 1r1 W M Ei)IkJM 13 ROWN 5.UNDY 51c.T Y LOA 114 FINE 5!a NVY LOAM I Indicate *level at which groundwater is encountered N o 1v E Indicate level at which mottling is observed Nt d n1 c Indicate level to which water level rises after being encountered. N/A: Deep hole. observations made by: A. S T C1 86 L1,v 6 ( 0 0 H> M C. o G QN ( o E 'Date i ► - 4.9 9 Design Professional Name: H.AZZY W. NJ Ic► -,oLS, Ale., P E. Address: _PA T T E 2 SQ N P A R-K LJ I-T E 1 0 ZoSo IZoUTE Lz`_SREWSTF_1= NY 10509 Signature: Design Professional's Seal 1�aF NEtyYo... �P Act, q� r i Cr 1 w Li F� No. 56124 AgOF[ss1CN / PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Q06zQ1 cows i_l.t 64 111 St"2A JAILL_24AD 2. Name of project: fe gos 5 3. - Location T/V: P_ � 4. Design Professional: A9&1 w. 0,r..6c14 Ta. Pc. 5. Address:. 205o P ►a22 ee :ys��e tJ1� 105oq 6. Drainage Basin: k(A 7. Tvne of Project: X_ Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building. Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review '(SEQR)? . Type Status (check one) ....................... ............................... Type I Exempt Type.II Unlisted X 9. Is a Draft Environmental Impact Statement (DEIS) required? .......................... eta 10. Has DEIS been completed and found acceptable by'Lead'Agency? ............... .11.. Name -of Lead Agency . 12. Is this project in. an area under the control of local planning, zoning; or other. officials, ordinances? 13. If so, have plans been submitted-to such authorities? .......... .......... 4....... .I............ 14. Has preliminary approval been granted by such authorities? 00 Date granted: 15. Type of Sewage Treatment System Discharge ................. surface water ) groundwater 16. If surface water discharge, what is the stream class designation? .................... 17. Waters index number (surface) :............................. ............................................. 18. Is project located near a public water supply system? ....... . .I ................. :........... No 19. If yes, name .of water. supply N/A Distance to water supply 20. -Is project'site-near a public sewage collection or treatment system? ...............:. No 21. Name of sewage. system 0 /A Distance to sewage system — 22. Date test holes observed it - 04.99 23. Name of Health Inspector CgLr., g c 'e lre .� 24. Project design flow (gallons per day) ................................. ............................... moo 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... N o 26. Has SPDES Application been submitted to local DEC office? ......................... pp, Form PC -97 FA -27. Is any portion of this project located within a designated Town or State wetland? 28. Wetlands ID Number ............:............ ... 29. Is Wetlands Permit required? ..................... .................. ............................... Has application been made to Town or Local DEC office? ............................... �+ 30. Does project require a DEC Stream Disturbance Permit? ... ..........................:.... 00 31. Is ormas 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/No Nti. 32. Is project located within 1,000 feet .of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No DESCRIBE: . 33. Is there a local master plan.on file with the Town or Village? � 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to.project site? ............................... ..............................: _ oa�No�t11. 35. Are airy sewage treatment areas in.excess.of 15% slope? . ............. ................::. No 36. Tax.Map ID Number .......................... ............................... Map 24.. Block _Z_ Lot Zo � z1 37. Approved plans are to be. returned to ..... Applicant . ✓ Design'Professional NOTE:.All applications for review and approval of anew SSTS to be located within the'14WWatershed shall be sent to the Department, .and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval. by the Department. Projects within -the watershed may also require DEP review and approval of other.aspects of'a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 'L the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply:with this provision 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 knowledge and belief. False statements made herein are punishable . as a Class A misdemeanor pursuant to Section 210:45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: NAQa~y N. 0tr -"Ls S¢. P. c. ..i t Mailing Address: �, , 10. — Harry VJ. Nichols Jr.., P.' Pettcmn Pui; suiCc l06 2050 Routc 22, BrewsLcr, NY 10509 Tcicphonc (845) 27911003 Fax (845) 279 -4567 Dater To: - Job No.: OL �Q Project Attention:\ �Jy�c�S�t✓I 1�P, }� i'�J�!� Gentlemen: We enclose copies of t3/v/ Prints Reproducibles Reports .Tracings Specifications Memorandum Copy ofImcf. Descmption: Revision/Date No. Sent Via: -Our Messenger uepririter First -Class -Mail* . Special. Delivery . Your Messenger Hand Delivery . Copy to Very truly yours March 7, 2006 Putnam County Health Department 1 Geneva Road Brewster, NY 10509 ATT: Michael J. Budzinski, P.E. Director of Engineering RE: Individual SSTS - Conklin East Branch Road Town of Patterson T. M. # 24. -2 -20 & 21 Dear Mr. Budzinski: Harry W. Nichols Jr., I.E. ` Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 2794003 Fax: (845) 279 -4567 Email: hnengineer@aol.com Enclosed are the following: 1. Five (5) prints of Drawing SS -1, "Proposed SSTS ", dated 02/01/06. 2. Short EAF, dated 03/07/06. 3. "Application for Approval of Plans for a Wastewater Disposal System ", dated 03/07/06. 4. "Construction Permit for Sewage Disposal System ", dated 03/07/06. 5. "Application to Construct a Water Well ", dated 03/07/06. 6. "Design Data Sheet ". 7. Two (2) copies of residence floor plan(s), for bedroom count only. 8. Neighbor Notification Paperwork. 9. Review Fee in the amount of $500.00. If there are any questions Very truly yours, Harry . Nicf�' Is Jr., P.E. HWN:gav 06- 005.00 °14 Q• LIST OF ABUTTING PROPERTY OWNERS Robert Conklin (06- 005.00) Patterson, NY T.M. # 24. -2 -20 & 21 24. -2 -18 - Patterson Executive Park, Inc. 677 Commerce Street Thornwood, NY 10594 24. -2 -19 - Gezirjian, Edward & Gezirjian, Christine P.O. Box 14 Patterson, NY 12563 24. -2 -22 - Knapp, Drina P.O. Box 121 691 East Branch Road Patterson, NY 12563 24. -2 -62.1 - Emmert, Ralf & Quigley, Judy 694 East Branch Road Patterson, NY 12563 24. -2 -62.2 - Catapano, John & Catapano, Alice 680 East Branch Road Patterson, NY 12563 24. -2 -62.3 - Torres, Fernando & Torres, Maria 664 East Branch Road Patterson, NY 12563 24.-2-62.4. - Leahy, James & Leahy, Heather 650 East Branch Road Patterson, NY 12563 24. -2 -62.5 - Brooks, Albert & Parker, Kathryn 636 East Branch Road Patterson, NY 12563 Date Obtained: March 8, 2006 I 27 CAL. I- <116 12.47 AC. • o \A \\ 0 2 , 6 26.4 . 7 AC. 1145.7S JUT 14 1 �.67 AC.- 32.65 AC 2 IC. CAL 5wo 15 9.81 AC. LOT 17 rp 35.07 j / 28 10.13•4 CAL. .5 I. - � 11.72\Ar. CAL. J 056 • Ac. 13 A Milo 312 24 . 23 • • - — S MEN - 8 5.66 AC. 38.56 AC. 22 12.14 A 1 .0 A 17 393.43 60.5; AC. 2 . V : 55 .%6.584 AC. 59 ih I A C �O 6 3.31 AC.; 1 4,2 AC. 9.16 AC. CAL i AL. 0 35- .25 P/O 24-2-1-7 1 P/O-F - 2-- -18- P/024-2- .25, 24 632AC. 8.25 AC. CAL\ in 2 . 3 165.29 AC. CAL. \u '\ 01-- - �-22 CA C. 2 * 84 7 19 11.14 AC. AL tele 26 23.57 ;C. CAL. JAL 4.42 AC 16 9.50 'AC.. 352.76 y 39 1 1 .0915 14'.581 1 40 1 6 , 6.60 AC. AC. I 1 5.98 AC. CAL. b" uoo 22.88 AC. CAL. I 5d" . ........... Date H*C- , r ';—M(.... RE: Department of Health Review of Proposed SewageTreatment System for Property Name: Qob%ai coa V_U o Address: =AST BRAN IWj.D Town: PAvvt tso v N i 2S6 3 Tax Map #: 24.- - 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 information which may bear on the -- Health -. Department's review of this application, you may call the Health Department at 278 -6130. Very truly yours, .. - .. _ Title: Received By:. Address: _... Tax Map #: yo _ ��'$.,. i�o^�►J 9 August 1997 -. Ui 1 , LU No 66124 A G {___✓t;� -.n` �k.� �p�i"a° 4a l i�i1��r���i7 y� h s s{ a� _'� .i1 '�'��4�'��, 11 4�1�° -�'�s� i,��j�,�t7.�,93`�?r {� "t �'�d�+�y "`lr E��{� }i� '� a �i� X > .;. � ffim Sr � , 1t o ��,; r� �I. ti �l ��•+iLt]fj,E"'i4t(,- .7, -,s� i iii S �'J1 .+ I" 7C,+ a 1 Z.:ve r`;i � h... '" ' Y y: 9,.{ y, �y�� 3�. +1�� la m ��i(1 } #'C4�A°4°�y(��. rc°rt ° :,.a m °'Ctl� .ntlry ..,�. �' °. . °o .'y�• Postage $ 6.87 UNIT ID: 0012 Postage $ 0.87 UNIT ID: 6012 M ' m O Certified Fee a Certified Fee C3 2-40 O Return Receipt Fee Postmark C3 C3 Return Receipt Fee Postmark (Endorsement Required) 1.85 Here (Endorsement Required) 1.85 Here O Restricted Delivery Fee QM.. ResMctad Delivery Fee Clerk: ° [17F5R0 M (Endorsement Rsquired) Clerk:: Q7FSR0 m (Endorsement Required) ° " E3 Total F ��a.114 43/10/06 Total Poe, �.12 03/10/06 u1 Brooks; 111be " rt & 3 Catapano, John & O sent o Sent o C3 Parker Kathryn Catapano, Alice C3 st�ef Ar °---- r- street a 636 East Branch Road or PO Box 680 East Branch Road orPos Patterson NY 12563 ......... Gtr state; Patterson, NY 12563 ciy sip , :rr rr old .e 'o IN111,11313" 0 Ln Ln 0. 0 • 1. 0 . . . .•. MN .•. m M I C3 MORE I •IAL ,hI I•AL USE Postage $ 0.87 UNIT ID: 0012 Postage $ 0.87 UNIT ID: 0012 M m OCertified Fee O Certified Fee Postmark O Return Recei Postmark � Return Receipt Fee pt Fee Here (Endorsement Required) 1.85 Here (Endorsement Required) 1.85 Qom•+ Restricted Delivery Fee Clerk:• lI7FSR0 p^ Restdcted Delivery Fee Clerk: 07F5RO M (Endorsement Required) m (Endorsement Required) C3 Total Leah James & 03/10/06 C Torres, Fernand 03/10/06 °o ant Leahy, , Heather C Torres, Maria . .......... r 664 East Branch Road ..................... orpo 650 East Branch Road orPO Patterson, NY 12563 city, s Patterson, NY 12563 :rr rr :rr June,2002 .� •o m ' ' For delivery information visit our website at www.usps.com For.'deliver I IAL o �� - AL U Postage $ 0.87 UNIT ID: 0012 Postage $ 0.87 UNIT ID: 0012 M m O Certified Fee O Certified Fee ? 0 Return Receipt Fee Postmark O Retum Receipt Fee Postmark Here (Endorsement Required) 1.8`5 (Endorsement Required) 1 „85 C3 C3 m (Endorse e, Required Clerk,: 07F8R© Restricted nt Aruy Fee Clerk: 97FSR4 M (Endorsement Required) C3 To + -° - 5.12 03/10/06 C3 Total Por ” — 5.12 03/10/06 `^ APP' Drina "' C3 C3 Sent o Emmert, Ralf & Seri C3 P.O. Box 121 C3 Quigley, Judy •- - - - - -- orF 691 East Branch Road. or w 694 East Branch Road or PO Boa c76 Patterson, NY 12563- ------- - - - - -- c "n; semis Patterson, NY 12563 1 B 4 r t'�• �'J �C zE�+�� -i �i.F1� lci'�lV r i x y s. iiks :� E i fL r.9 a Ilj J011,1E, E.11 11,9781. 1 A L U S `E, rti Postage $ 0.07 UNIT ID: 0012 M O Certified Fee QReturn Receipt Fee c Postmark Here (Endorsement Required) 1.85 O Restricted Del" Fee E' (Endorsement Required) Cler6; :.t?7F5R0 M C3 Total Postage & Fees 5.12 03/10/06 Ln C3 Sent To- Patterson o Executive Park, Inc. r` orPO 677 Commerce Street or PO Ba c si6e Thornwood, NY 10594 ------- ru a t��aNaU ��Jtt1��rr�If ANA It i�- UI.j?��}� i Ln 'a'.,'',- M a 0 Postage $ 0.57 UNIT ID: 0012 M M Certified Fee C3 Postmark O Return Receipt Fee Here (Endorsement Required) 1.85 O RsstrictedDeliveryFee Clerk: C!7FSRO Q' (Endorsement Requlred) M C3 Gezirjian, Ed, d & 03/10/0° C3 sa Gezir ian, Christine rC3 A P.O. Box 14 .------- -- ---- °' Patterson, NY 12563 -------- - - - - -- :rr �� Harry V/. Nichols Jr., P.E. Petteison Parr, suiCc'106 2050 Roulc 22' Brewsvr, NY 10509 Tcicphonc (945) 279 =4003 Fax (94 3) 279 -4567 Date: To: Job No.: C3 0 Project (, " Attention: U' nSl� iPir o / Gentlemen: We enclose (copies of: 1/ r3/V1 Prints Reproducibles Reports .Tracings Specifications Memorandum Copy of letter. Description: RevisiorJDace No. Ic: ZvL Sent Vla: `VurMessenger Bluepririter First0 ass -Miil' . Special Delivery. Your Messenger Han.d.Delivery Copy to - V ery t y yours - _ Ha t W* Nichols r., ;?:E. - MAR-23-2004. I 1 i 4-11•1 HARRY W NICHOL.'.-:-. Harry W Nichols Jr., P.R. Patterson Park - Suite 106 -2050koutc22 - - Brewster, NY 10509 Td: (845) 2V-4003 Fax: ($45)'279 -4561 Email; hnen&crz@ac)j.ro;n FaX 914 279 4567 P.01 Td- From; Pages., Phonet 04m: 3 .•2.3 -6 Ret .... ... .... Urgent ❑ F*r Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle '; 1-ij ; i 1 �"-1 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 914 279 4567 P.02 MAR- 23- 2k +v > >�.. � 6. ��t� Ii PI HARRY W NLCHOLS .__ - _- '- -- -• --. —^ - t • AL CAL. /Z 1 4 \ 1! �l' 18.38 C CAL. _ _ If� } A 39 k \ y w I y 22.17 AC. • A I r,q 61 y / •' i + 96 At CAI,' • 40,81 AC, CAL. J w 2 � 41��•AC. �'r 1 a "�' I J6 I a r AL i I 4.66 AC. a 1 34 1 I 94.00 AC, 4 x10 At y 127.82 AC. y I _ - I• CAI,. 4,46 AC: CAL" \ m I / (Z 411 Ac oTM 1 i - • x ` f ` . 1'� x•31 . ?� 11`33 A rAL. JL so r•! • 29 �� ,! 12,13 AC, I J�6 AC. 9 , y L03 At, ` ,,Ii01 Ac.. ' y y 21 e f • 3E.50 Ar. 181.: `� �. ,' ,rn S1 e" x•,12.47 AC. / _ 1.147 AG. \� + II&T! •j4 J., 1 A /fir ,9i All CAI. 1 Y P 55 1 • w \ 1 zs Tn.6o4 ac. �y.67 AC, • 11.12180', CAl- 56 i 1 ?..FS AC e� !n j w ilr b r \ A6 I r��a •13 \ �` �' X23 71: 24 IJ! xl. rEOr,.N r nm-{I �` � • Y li CC 192�AG y — 18 5.66 AC: k i • �/ • � i•A U A �' r• N I 1151, AC. GAi� +� 0,9 56 .1c. p, 1 iA 12,14 A ' ,61.3 , a p.e9A0, / 21 6L4 0,94A 9-91 4l: a ; 17 \ ` 12.01 AC, CAL �� LOW.� 1 L . i J +1''�3 W.n 60.50 AC. j 'vr, i� 59 r� 1287 , !f ,� r,n f •� 11.72 AC. CAL .�� ra�Atc, r.L AGO I ` P/0 LIP 1., -...)C ... i 16 7� r # . + 19 \ r ] Al AC. a 1#6 / �• /11.42 AC, :� _ L _ I _ _ _ _ 916 AC. _ 3.53 0,r' IM1 rr P/0 35.5-27• Eoow Knoll? 4whos" — — - LEGEW ,IK NO 9*W �,_,: , 3 4 r 5 'RE L I M !NARY sMAE Lot mot. DIABII,M Idol 23 25 TOWN OF PATTERSON Im u AC c, LIK - _.1. -- wClA..rro AREA i!1 At [q T Ll,t - - 0,h - .IEw, Ca mlo • 34 35 36 PUTNAM COUNTY, NEW YORK BATE a FMAL hMbUR MC._4-10- .ormDM1 .� lRRr t� wOFe it _ _ MAR -23 -2� I:1_, 1. 1;; TEL: 845 - 278 -7921 - -- NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 �XPAN51 -0N \pp 12 V.C. _rrp t6 -4 s0t_10 P t5 / tt 14 10 4o'LF A �ENCN 3 13 / TY�• °$ 8 WELL 87 — — — — v 5Dg'3 2 EXA BEDROOM 9\1.C.5 RESIDENCE /� t2:�O- GAL..:CoN 5�, rtC TA(iK `. poRCx A L �Evi " / Iv Q' C� � -r ra �.� L:2G1.-3 $' 0. f, to c c A DIMENSION CHART (in feet). Number 3 89' 81' 4 ' 91' 8 l S 93.5 6 "1 loo' 89• 8 50 9 s9' 36,5 to 58 381 -10.5' 12 67' '¢3' 13 130' 19 131, 123' 15 132.5 f23.5 16 135` 129` 17 13$' . 12 5 a ~ O / 0 Q IA `o . a •N o° :i; �I • 2�MN. �OOT /NO "GTION 'A—A" DETAIL Mir NALY ?/C IIto P/Pt QUSHEb S70NE (DUST. Fltl:l3) �PAYEL v EACH •ORA7E0 ;J'SIOPf i Q 9WORS ?ENCH i FFf Of i�Fi• s ----------- (er36 Z 100 YEAR FL x IOD PLAIN 80 UA/ DARY� _ _