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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -2 -32 BOX 9 1 ro I'Ar -If"i T' { r 4 I �i 1 T r =` its. `r% r I f , r 11:1 I represent1hatI -am wholly and compNtelY retponsibiefo►..thedesign . ind location of the proposed system(&) 1 1) that the spared saw di sl s stein above describe will be. constructed as shown on tM approve0 amendment to and in accordance with the standards, rules a ragu ns o County b000tment of H'a line' and that On compNtNn.thereof a "Certificate 'of ,Construction Compliance'• stisfactory to the Commialonw of Hwlthwill be submitted ao the Depntnient. and a writtin' guarantee will be furnished the owner. his sucasors, heirs or assigns by the budder. that Yid bulWer will place in good'.openMW4 ei nenan' any 'pert Of 'Mw sewage Aispowl system during the period of two (2) yews ImnwtlNtely following thedate Of the Isau- Once, ot, the 'app Of the Ci►tifkate, of Construction' Complis . e. of tM originet system any repairs thereto; 2) that the drilled well deso mw above wIM 0a.beated.ireliorvn on the appsow0'plen and that, sid :weli' will instelNO in rdance' th tM ntlertls, rules and rpu ani of the Putnam County Opartmant'ot Health oat 8= 2 9- 9 4. signed P.E. R.A. Add. 1_icense No.(I,1 i2 6 APPROVEO'ROR. CONSTRUCTION =This approval expires tw0 y s Y T the date -issued unless construction of the building has been utlderteken and is revocable for 'use or'mey bii amended pr. modified when consider" esury by the Commissioner of Health. Any change or alteration of construction "Ou =r permit. 'A oved'for disposal of domestic sanitary t supply only. MV. 10/88 Oele .� -� ��— — Title ��. DEPARTMENT OF HEALTH Division of Environmental Health Services��h�,�/, 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 �p APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT .# WELL LOCATION Street Address Town Tax Grid Doansbur d Paterson 15 -3 -4.2 Number WELL OWNER Name Mailing Address Richard L. Rapp Drewville Rd., Brewster NY 10509 OPrivate O Public USE OF WELL 1 - primary 2- secondary % RESIDENTIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 BUSINESS O FARM O TEST /OBSERVATION 0 INDUSTRIAL M INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 500 gal 13 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION GL ADDITIONAL SUPPLY ANEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASoNAjr9ki.c DRILLING nt requires water supp v for a new home to be built on lot. WELL TYPE LX DRILLED ❑ DRIVEN DDUG (3 GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES _ X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: East Branch Woods Lot No. 2. WATER WELL CONTRACTOR: Name To he determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO 'X NAME OF PUBLIC WATER SUPPLY: N1 A_ TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A LOCATION SKETCH & SOURCES OF CONTAMINATION PROVID D 8 -30 -94 ®ON SEPARATE SHEET (date) , (s 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 thirt,• (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 Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise con a e su ce. r groundwater. C' Date of Issue: 19 Date of Expiration 19� Permit Issuing Official i Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3 /g'9 Yellow copy: Bldg. Insp. Orange copy: Well Driller xmu-, PUTNAM :COUis VPHEALTH DEPT. 0264.'02 1 Geneva Road, ,'(845) 278 -8130 n Brewster, NY 10509 Date mil? Ree'eived of The�$um Of — 40::�., O J B For T P. ��So`sz THANK.YOU! 3�, ❑ Cash , ❑.Cheek ❑ M.O. ❑.Credit Gard By� /, N2� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at o0"0',5_ D &_4- F ,9R,4oyc# Ob Town or Village Pi- ITESSojv R(c.4e4 4 RAP1' � z Owner /Applicant Name r rric�h��t ,c�, 2,�PP Tax Map Z Block -7- Lot Formerly v. Mailing Address Date Construction Permit Issued by PCHD d IX/ Subdivision Name OK T QgAwco k4 J'0 r Subd. Lot # Z a � .. Separate Sewerage System built by DG,//XgA Address Consisting of a o o_ Gallon Septic Tank and � o' 7")e&WC*-_r Other Requirements: Water Sup&: Public Supply From Address cLr. I/- Private Supply Drilled by A" Address Zip /a�9 Building- Type o sl .T) - - Has erosion control been completed?-- -- - -- Number of Bedrooms 3 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 regu) tions of tl PutnarR Count epartment of Health. Date: �! o Certified by Address v o o e, 447 7> P.E. R.A. License # Z1i/ 26/ 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 subject to modification or change when, in the judgment of the Public Health Director, such revocati n, m 0ificat* or change is necessary. / G(} By: � Title: Date: l White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 tl X PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: East Branch Road, Lot #2 Town/Village: - Patterson Tax Grid # Map Block Lot(s) Well Owner: Name: Address: R&R Development, Drewville Road Brewster, 10509 Use of Well: 11-primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel _ Plastic Other Joints: Welded X Threaded Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours _fi_ Yield 5 gpm Depth Data Measure from land surface- static (specify ft) 15' During yield test(ft) 540' Depth of completed well in feet 605' Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 10 Drilling in over urden clay and boulders- Hit rock at 10' 10 32 Drilli in rock, Rpt raging, groutpd 32 605 Dr If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 c[pm Depth 560' Model Goulds 5GS10 Voltage 230 HP 1 Tank Type WX250 lume al ns Date Well Complete 4/12/02 Putnam County Certification No. 001 Date of Report 5/20/03 Well D er e NOTE: Exact location of well with distances to at Well Driller's Name P Signature: Perry L. landmarks to be proviclwon a separate sneevplan. Address: 4 Pabmn Ave., Brewsbw, NY 10509 Date: 5/20/03 White copy: HD File; Ye'flow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 L2 BRUCE R FOLEY Pubbc Health Dtrecter n� o LORETTA MOLL ARI R.N., AS,N. Associare Puolie Health Dlrecter Director of Portent servicts DEPARTMENT OF HEALTH 1 Geneva Road Brewstcr. Now York 10509 lavicoameatal Health (91 4)278.6130 F -(914) 278.7921 Nursing Servtcts (9141273.6558 WIC M4) 273 •6678 Fit (914) 278.600: Early Intervention (914) 278 - 6014 Preschool (914) :18.6082 Fmr (914) 278-- 6648 OWNERS NAME: TAY -MAP.NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) DATE: 4-/. -2 - 3 � iY i%liP S o 4-,� 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 assi med by an authorized town official. This form is to be submitted v�ith the application for a Certificate of Construction Compliance. (E91 ) PUTNAM COUNTY DEPARTNI-ENT OF HEAL "I'l -I DIVISION OF ENVIRONMENTAL I- WALhI-I SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block .ot .4-R q � Corp ah- rsc3r�, l Building Constructed y Towri.Nillage Location - Street Subdivision Name ranch LA-g Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the < ' system. Dated: Month ; Day Year a003 Gentr'al Contractor (Owner) - Siy a re. Sign Title: Pff,5iden � _ f�W-R lDeNd" 4 ►P.,2 avdopo -en, Corp Corporation Name (if corporation) Corporation Name (if corporation) Address: 1040 reu9v i oe 2 5re_LjS!er_Addre"ss: Inc) I III I�W5lei -- t State. ZIP i State �1 lip IO�o °i F,, Gs -9 Julius I. Cesare, P.E. PO Box 478 Dover Plains, New York 12522 845 - 877 -9398 FAX 845 - 877 -9398 December 4, 2003 Director Putnam County Health Department 4 Geneva Road Brewster, New York 12522 RE: East Branch Woods Lot # 2 East Branch Road, Patterson, New York, 12563 Dear Sir, Herewith transmitted is the following As -Built Package on the above noted project 1. Certificate of Construction Compliance 2. Three copies of a two year contractors guarantee 3. Water Analysis results 4. Well completion report 5. Three sets of As -Built Plans 6. Certified check in the amount of $200.00 to cover fee 7. E -911 Address Verification Form Very tr y yours, Julius I. Cesare, P.E. TA I CES 21 '','ear Street. 1'crki :0wrl Heights. IN.i'_ 1(a �;n t914 ) 245-P800 Albert. H. Padovar.i , Director b - LAP 4., 93.303t_i81 CLIENT <tt:: B401 I •^/N tiNY•• -•ry •vN rVNry NK rV Nn••vNM1 NNN�Y. +•n /N�I.r •v •fir rn Y-- --- NON STAT PROC -NNNAr rr /NArw /.r,yNwINNNNwr nr nrrwr F :'AGE•: !. nl w /wrNn•w•w•w n K 8: R DEVELOPMENT CORE" C)ATE/TIML'•: TAl -`EN: 1. 1./,��� /1:aa uk•:i:�c. x 1C)4(') 0R1= WV I LL.L' RD. ^ � /'� c' DATE /TIIh� hE�r D;r lr.. /.si 1:�," ') •' / 3 �.9.:1..L.: ATTN: MICHAEL. RAPP 'REPORT DATE:: 12/0 5 /03 BREWSTER , NY 105o9 9 F HGNE : (91 zi ) -2 79 --4496 SAMPL I NO S I TE s 60;5 EAST ORANCH RD. P'ATTE KITCHEN R150N . NY WAr-1f "LE' TYPE. _ a POTi= 1ML_5: TAP Fl,- I ESERVAT I VES :. NONE` COL' D BYE 1'IICHAEL RAPP i'E•MF,,,FpnrrURF_ C' NOTES. .. CC)L'l r= ORII MI "1'1•i : MI ..•n..v ..r w..r .�NNruNry N,�N NNNwrNN n NNn /NNry YNrVN ry ----- Nw/----- -- .y.v---- w,-- -- v../w. •rwrr.•w wrNti•.. r•./M. r./,r; -.DATE FLAG PROCEOUR5 hESUL.T IVOF;MAL - RANCiL. METHOD. PUTNAM CNTY PR'0 F ILE 12/01/03 MF T, 'COL I FORM ABSENT /100 ML ABS CENT 1 008 'la /01 mg LEAD (IMS) "I ppta 0i 15 opt', 91()1. 12/61 /t.3 NITRATE NITROG 1 .1j 1'• MG /1- Q - 10 91317 18/01 /03 NITF tTE N:CTROG <0.01 MG /L N/A 9146 1 /OS 1 RON (Fe.) 0..378. Me /I_ - o- 0. 3 mg ." I 20:37 12/01 /02 MANt ANES1_:: (Mn) 0'. 022, MG /L 0--0.-7-3 n / 1 �-'.� i0"" 12 /1a 1 103 SoD I UM (N a ) 95:9:: MG /I- N /A 12/01 /03: pf✓I 12/Q 1 /03 HARDNESS•, T&AL •192 MG /L N /A /1�1/Ca3 ,..,,_ ..A01(ALINITY_.(AS _. .'_122.:MG /L_ _N/A _1 12/01 /o2 TURBIDITY (TUR '7.;9`iNTU 075 NTU COMME'NTG BACT TFIE SE ' RESULTS I ND I C ATE . THAT . THE WATER (WAS) ( WAS IVC1T`) C]I�`' A SATISFACTORY- SANITARY QUALITY ACCORDIhf HE NEW YORK - STATE: AND EPA FEDERAL ]DRINKING WATER" ;�TAN[�Akbs''," FOR THE TESTED,, . AT' THr� T I.ME . OF COLLECTION ` I�b /Cu LEAD limits for public schools.'are, set, at 15 ppb. EPA Lead u Copper- ' Rule for Public : Systems requires that r10 .More. than 10% of their dirstribution `pgint5 have a 1-1-AD value of more than 15 ppb and a COPPER value bf. 1.3:, mg /L, Else water treatment. must be Lindertaken .ta r,educe, the `waters corr•osivp- potential. 1°e /1.1n If �bpth iron and manganese are present, ,their total value Combined shall not exceed 0.5 rt►y Na No limits for Sodium are proscribed: Suggested guidel-ines State that for people an a sodium r-estricted diet,the water- should contain no more than 20 mg /L of Sodium. For those on a moderately restricted diet, a maximum of 270 'niy /L of Sodium. up 1z,,�i,,2003 09:30 FAX 8452793608 YML ENVIRONMENTAL SERVICES 321 'N"'ear Streelt. Yorktown Heights, N.Y. 1059e (914) 24!5-2600 Albert H. Padovani, Director Iris LAS it: 93.3030BI CLIENT 0: 848 L NON si,(-),r PFmc PAGE E R 9: R DEVELOPMENT CORP DATE/TINE TAf,-`EN_ 111'30.iO3 04:C.W! 1c►40 DREWVILLE RD. OATS /TIME REC'T)-- 'i21011(_V3'J)9:,()(:) ATTN't MICHAEL RAPP REPORT DATE,, E(REWSTER. NY 105 19 PHONE: (914;-279-4496 SAMPLING BITE: 905 EAST BRANCH RD, PATTERSON, NY SOW"LE.' TYPE. 1::'OTAOLE K`ITCHEN TAP PREsitrivA-rIVES. - NONE COL.'D Ply! HICHAEL. RAPP TEMPERATURE ..:t -:', 4C DATE r1_A(3 PROCEDURE RESULT NORMAL - RANGE I I E-- TH 0 D i5 suagest�tl.. pH pH SCALE. IN WATER 'KANGE . 5 FROM 1-14, NEASURE'llENT. OF- pH IS' CJ.NE OF THE: I IMPORTANT AND FREQUENTLY USED TC--15TS.1N WAJ'F_F� CHEMISTRY. WATER WITH 0) LOW pH MIG14T BE.CORROSIVE TO METAI_ I-- 11= FS AND FIXTURES--THE NORIAL-'RANGE OF :PH IS 6.5 TO B.'S. Hd TOTAL' 1-4AriDNESS IS DIffrINED AS THE SUM OF THE CALCIUM MAGNESIUM CONCENTRATION, BOTH EkPk�f-SEI);AS CALCIUM CARBONATE, I N M(3',,L * THE: jAARDNESS.:MAY *RANGE r- nm' 0".- -TO HUNDREDS OF vis /I- DEPENDS ON -. T14� SOURCt.,AND �:TREAT'MENT',T',Q W41 CH THE WATER HAS, BF -.T:N -,s.uujE:cTED AT J30FIT.-W ERi..0.7_70',MG/L.' VERY HARD WATER.-'AB NODEr'%-AtEL,V� HARD. WATER-.-. 70-140 M(3 /L MG /L rl I LL I (3F%1AM. PER (_ I TER, HARD WA t Ek • '140 -SD MQ/L tl grain/gallon 17.2 MG A-) J7 SUBMITTED BY; Albert H. Padovanit M.T. Direc,tm- Ei-AP4 1. o323 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 December 30, 2003 Julius I. Cesare, P.E. P.O. Box 478 Dover Plains, NY 12522 Re: Proposed Compliance: Rapp 805 East Branch Road, Lot #2 (T) Patterson, TM# 24. -2 -32 Dear Mr. Cesare: ROBERT J. BONDI County Executive Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. Address on the E- 911_form and compliance application differ. Revise as warranted-. - 2. Water analysis results for iron exceeds State standards. 3. The water sample results documentation is a photocopy. All documents submitted must be original. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, SIN Robert Morris, P.E. Senior Public Health Engineer I' YML ENVJ NTAL SERVICES 321Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director / .' LAB #: 93.400018 CLIENT #: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ R & R DEVELOPMENT CORP 1040 DREWVILLE RD. ATTN: MICHAEL RAPP BREWSTER, NY 10509 STAT PROC PAGE 1 DATE/TIME TAKEN: 01/06/04 11:30A DATE/TIME REC'D: 01/06/04 12:30P REPORT DATE: 01 /08 /04 PHONE: (914)-279-4496 SAMPLING SITE: 805 E.BRANCH RD LOT # 2 SAMPLE TYPE..: POTABLE : PATTERSON NY FAX RESULTS 845-279-3608 PRESERVATIVES: NONE COL'D BY: MICHEAL H. RAPP TEMPERATURE..: < 4C NOTES...: KITCHEN TAP COLIFORM METH: N/A DATE FLAG PROCEDURE 01/06/04 IRON (Fe) 01/06/04 TURBIDITY 01/06/04 pH COMMENTS: FAX TO 845-279_3608 RESULT <0.060 MG/L (TUR <1 NTU 6.5 UNITS NORMAL - RANGE O-0.3 mg/1 O-5 NTU 6.5-8.5 COMMENTS: Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. 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. SUBMITTED BY: Director METHOD 2037 ELAP# 10323 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800'' Albert H. Padovani, Director LAB 4: 93.303081 CLIENT #z 840J R & R DEVELOPMENT CORP 1040 DREWVILLE RD. ATTN: MICHAEL RAPP bREWSTER, NY 10509 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~°~~~~~°~~~~~~ DATE/TIME TAKEN: 11/30/03 04100 DATE/TIME REC'D: 12/01/03 09:00 REPORT DATE: 12/05/03 PHONE: (914)-279-4496 ` SAMPLING SITEg 805 EAST BRANCH RD, PATTERSON, MY SAMPLE TYPE..: POTABLE � : KITCHEN TAP dOL'D BY: MICHAEL RAPP ' NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PRESERVATIVES: NONE TEMPERATURE..':./ 4C COLlFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 12/01/03 MF T. 'COLIFORM ABSENT /100 ML ABSENT 1008 12/01/03 LEAD 8MS> <1 ppb 0-15 ppb 910J. 12/01/03 NITRATE NITROG 1.01 MG/L 0 - 10 9139 12/01/03 NITRITE NITROG <0.01 MG/L N/A 9146 12/01/03 IRON (Fe) 0.378 MG/L� 0-0.3 mg/l 2037 12/01/03 MANGANESE (Mn) 0.022 MG/L 0-00 mg/l 2037 12/01/03 SODIUM (Na) 95.9 MG/L N/A 12/01/03 pH 6.2 UNITS 6,5-8"5 9043 ' 12/01/03 HARDNESS,TOTAL 192 MG/L N/A 12/01/O3 ALKALINITY (AS 122 MG/L N/A 12/01/03 -TURBIDITY (TUR 7.8 NTUA ' ' 0VATii-'.L- '------ COMMENTS: BACT THESE RESULTS INDICATE THAT THE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDINE�=�9�THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. n . Pb/Cu LEAD limits for p EPA Lead & Cbpper ' than 10% of their than 15 ppb and a - treatment must be potenti4l. ablic 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 Sodiul'I . I YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #g 93.303081 CLIENT #4 8481 NION S)TAT PROC PAGE 2 R & R DEVELOPMENT CORP DATE/TIME TAKEN: 11/30/03 04:00 1040 DREWVILLE RD" DATE/TIME REC'D: 12/01/03 09:00 ATTN: MICHAEL RAPP REPORT DATE: 12/05/03 BREWSTER, NY 10509 PHONE: (914)-279-4496 - SAMPLING SITE: 805 EAST BRANCH RD, PATTERSON, NY SAMPLE TYPE..: POTABLE KITCHEN TAP PRESERVATIVES: NONE COL'D BY: MICHAEL RAPP TEMPERATURE..: < 4C NOTES...: ' COLlFORM METH: MF ~~~~~~~~~~=~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: AD-140 Mg/L MG/L =hIL[fdRAM PER [IM HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Albert H. Padovani, M.T.(ASCP) Director ELAPO 10323 455 COL IIA(RUS A VENUE Oovrr PALHALLA, NEW YORK YOSPS (��� fir. FAX jr773. 0343 ,�-7 L Transmit to FAX #! g 45 -7cl Z I - Number of pages: - Date: 05-16-01 .. alnciuding _C.over_Sheet) 'Deliver To: izo 6eA 140 f rt" Fram: Phone'. %4416 Subject: 1 0 l3 c rth G� W ov �'c�c10 cQ • L o 2 JF.THERE ARE ANY PROBLEMS REGARDING THIS FAX PLEASE CALL 914• F 7 3~ Vy/ 6 TO'd 00: OT T0, 91 fipW MO -Lz - VT6:Xpd 9NId33NI9N3 d3Q JAN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH I\i -DWIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT - REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: kAT pp r ...—STREET LOCATION: �V) /ul REVIEWED BY: R%L GR, AS,SATE: /f-1 S TAX MAP #: (CONFIRMED) Y N DOCUMEINTS U(_JPERtiITT APPLICATION Le)( )WELL PER�NUT OR PWS LETTER VJL_)PC -97 (Q( JLETTER OF AUTHORIZATION C,-J-(__JDESIGN DATA SHEET (DDS) U(_-.!000RPORATE RESOLUTION UUSHORT EAF UUPLANS -THREE SETS (_J(_C HOUSE PLANS = TW Q SETS (_)(_X)VARLANCE REQUEST SUBDIVISION (JULEGALSUBDIVISION 5'/Js�frs- ( /jUSUBDMSION APPROVAL CHECKED UUPERC RATE U(,gFILL REQUIRED DEPTH ( _)(_�CURTAU 1 DRAIN REQUIRED GENERAL ( _�'J( _JLOCATED Di NYC WATERSHED ( _J(___) PLANS SUBMITTED TO DEP C_JCYJDELEGATED TO PCHD U(_JDEP APPROVAL, IF REQ'D UUDEEP TEST HOLES OBSERVED JC__)PERCS TO BE WITNESSED ( /JC___)E� - OVAL SSDS ADJ, LOTS (( WETLAND /DEC PERMIT REQ'D ?) ( /� A ON DDS PLANS & PERMIT SAME j�PRE 1969 NEIGHBOR NOTIFICATION (__)(LETTER BUZBA (—J(:—JlUO YR-�FLOOD ELEVATION W /1200'- (—)(4SOIL TESTING LOTS >10 YEARS OLD REOUIRED DETAILS ON PLANS (f (SEWAGE SYSTEM PLAN - (NORTH ARROW) (-ZJ(___)SSDS HYDRAULIC PROFILE UUGRAVTTY FLOW (-fj"( JCONSTRUCTION NOTES 1 -15 ( IjUDESIGN DATA: PERC & DEEP RESULTS (__)U2' CONTOURS EXISTING &PROP_ O�SED ( DRIVEWAY & T FOOTING /GUTTE CURTAIN DRAINS ` ( (USDA SOIL TYPE BOUNDARIES (7Q(_JTTTLE BLOCK- OWNERS NAME ADDRESS TM #, PE(RA; NAME, ADDRESS, PHONE# ( g JDATE OF DRAWING/REVISION (2( _JDATUM REFERENCE (__)LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. /J(—JPROPOSED FINISH FLOOR AND Y . N (REQUIRED DETAILS ON PLANS CONT'DI ' (_/J'(_)HOUSE SEWER - %" FT. 4 "0'; TYPE PIPE CAST VJUNO BENDS; bIAX BENDS 45° W /CLEANOUT RENEWALS (� %E NOTE (NO CHANGE) '�/ FILL SYSTEMS (__)(__)10' HORIZOiNT-AL, PAST TRENCH SLOPES 3:1 T (�(�FILL SRECS/ FILL NOTES 1-'5 UUFILL R WFLY& DIMEN SIONS ON AREA FILL GREATER THAN2 FEET IRON O GRADE UU CLA BARRIER UFILL C TIFI ON NOTE _)DEPTH GES UUVO _ N PL FOR RO.B., UNCLASSIFIED & IMPERVIOUS PARATION D TANCE FROM TOE OF SLOPE TRENC (� (ELF TRENCH PROVIDED � 60FT MAX. /U(_JPARALLEL TO CONTOURS ( U100% EXPANSION PROVIDED. (f __)DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL UUGEOTEXTILE COVER -.. SEPARATION DISTANCES ON PLAN -FROM SSTS UU10TTO:P L. DRIVEWAY, LARGE TREES, TOP OF FILL (�U20' TO FOUNDATION WALLS U(__)100' TO WELL, 200' IN DLOD,150' TO PITS UU100' TO STREAM, WATERCOURSE, LAKE (inc. espan) (Z)(__)50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER C,!�)()10' TO WATER LINE (pits - 20') (,/:� )(_)50' INTERMITTENT DRAINAGE COURSE %� 200'/500' RESERVOM ETC. 150' GALLEY SYSTEMS MIN TO LEDGE OUTCROP /11 SEPTIC TANK (UU10' FROM FOUNDATION; 50' TO WELL WELL UDIMENSIONS TO PROPERTY LINES ULO CATION -OF SERVICE CONNECTION UMIN 15' TO PROPERTY LINE SLOPE U( __)SLOPE IN SSTS AREA- � (S20' /o) (__)(ZJREGRADED TO 15 %, IF REQUIRED UUPUMP NOTES UUDOSE 75% 0�P U( JDETAIL FOR Fig UUPIT AND D -BOX UUl DAY STORA9 VOLUME NOTED $, (PIPE TYPE, ETC.) � DETAILED ALARM BASEMENT ELEVATIONS U)WELLS & SSDS'S W/IN 200' OF SSTS UUSTANDPIPE , 5' B TH ES)DETAIL METES & BOUNDS UU15' MIN to CDS= >5 , 0'4 %, 5'-3%,35'-l%,100%-<l% U(__)20' MIN to CD DISC RGE/ 00' with 182 cons day discharge (_)(_)10' MIN to NON -P F TED PIPE COMMENTS: (REVSHEET) NOW April 27, 2001 Robert Morris, P.E Putnam Co. Health Dept- 4 Geneva Road Brewster, NY 10509 Re: East Branch Woods Subd. Lot 2 Doansburg Rd.. Patterson, Putnam East Branch Reservoir DEP Log # 10857 (Joint Review) Dear Mr. Moms: This letter is to inform you that the New York City Department of Environmental Protection (Department) has determined that the above - referenced application is 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 submitted documents including the plan titled "East Branch Woods Lot 2 ", dated 06/08/00. The applicant must contact Sissy Dc 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. Sincerely, Margaret Lloyd, P.E. Supervisor Engineering Design & Review xc: James Covey, PS, NYSDOH k718) ocv -MtLP ZO'd OO:OT t0, 9t 6pW iKO- i�Z- b16 :Xpd 9NId33NI9N3 d3a DAN �. .'�a a .� . i. i�. a Julius I. Cesare, P.E. 64 Blackberry Drive Brewster, New York 10509 914 - 279 -7115 November 2, 1999 Bruce Foley, Director Putnam County Health Department 1 Geneva Road Brewster, New York 10509 ATT: Gene Reed RE: Proposed SSTS : East Branch Woods Proposed Lot 2 (T) Patterson Dear Mr. Reed, As we had discussed by phone, the most recently approved individual SSTS on this project expired in 1996. The owner has engaged me to pursue a new approval. As we discussed the test data is more than ten years old. Accordingly, I made a date with you to undertake testing on Dec. 1 -2, 1999. Enclosed herewith is a copy of the old layout and a location map for you use during this testing phase. This plan is not being submitted for comment at this time. Subsequent to the testing I will submit a complete package to Mr. Morris for his review. Thank you for your cooperation in this matter. very t my yours, Julius I. Cesare, P.E. - RECORD OF PHONE CONVERSATION DATE: TIME: PERSON CALLING: Zra4 /0-,S 5,4 rr-- PHONE #: :. 7 9 — 7f/ 5 REASON ( ) Inspection: Deeps and /or eres: SCHEDULED FIELD MEETING DATE: TIME: ROAD /STREET: �f �CD TOWN: TAX MAP #: - SUBDIVISION: OWNER: eA?P. COMMENTS: LOT #: �z PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA.SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM /� 14 l,,,a Addrej Located at (Street) ` 69" 1f /' Tax Map 2 Block2 Lot 2 (indicate neare t cross street) Municipality. 64, Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking /9 9 Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se 1VIi Time �n.) De th to Water )r�rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 1 10!1r /01.2-7 Z 2 C/O 27 2 /a; .rZ /6! 5--r CP -2-7 3 4. / !-ry 12'o1 .30.. 2 27 �' D 1 m C) Zz�.� 23 �,. / .7 3 4 y 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO.' HOLE NO. HOLE NO. G.L. 0.5' 1.0' � -tbP so , / 4`t-6P vat/ 1.5' 2.0' w-' 2.5' 04) k-e-, f,-"AP-7 3.0' 3.5' 4.0' .. 4.5' 5.0'. � M S4E;ErA-er 5.5' 6.0' �V 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered 6 ° Indicate level at which mottling is observed ff6 ^� Indicate level to which water level prises after being encountered _ Deep hole observations made by- %c G-��� Date Design Professional Nam k, LAW r Address: % �9-sf� /r���'D Of- (A' '2 ` Design Professional's Seal SOV NEW y� ' t t p g IN, 2 Q 3 AP r -" h Julius I. Cesare, P.E. 19.'Washington- -Court Pawling, New York 12564 .914 -855 -3208 FAX 914 - 855 -3216 "Bruce Foley, Director Putnam County Health Department ATT : Robert Morris 1 Geneva Road Brewster, New York 10509 Dear Mr. Foley, Se 2s 2000 RE: East Branch SD Lot 2 SSTS An individual sanitary design had been approved and renewed in the past and all approvals have all expired. As a result we are herewith submitting a complete new application which includes new testing witnessed by Mr. Reed. A complete application package is herewith included as follows: 1 . Four (4) sets .of plans 2. Construction Permit Application 3. Letter of Authorization for.Design Professional 4. Application for-Approval of a Wastewater Treatment System 5. Short Environmental Assessment Form 6. Design Data Sheet 7. Fee Check in the amount of $300.00 8. Design Report 9. Well Application Thank you for your cooperation. Very truly yours Julius I. Cesare, P.E. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of tt c ka )- , RA-n" .T-' e /YID cA4� . //' P"10 Located at Fs 1~ �, .e.tA Q D Ah- o-! r9 Cee-C T/V O�a.v Tax Map # Block Lot Subdivision of Subdivision Lot # Z Filed Map # 20 7 Date Filed /?<P` Sr' Gentlemen: This letter is to authorize '4 cle- a duly licensed Professional Engineer 2� or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to- serve -the above -noted property -in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign 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 Education Law, the Public Health Law, and the Putnam County Sanitary Code. Very truly yours, Counte i Signed P.E., R. # (Owner of Property) Mailing Address Mailing Address: /o KU /J ✓� . Cf State Zip -2-S-6 ltO State A' ��� Zip �o C9 Telephone: a�� - 3 2 d J Telephoner z F(Y'_ " 2 71? " 51Yf 6 Form LA -97 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 4&Ln 2. Name of project �S s J-:X 2 3. Location TN: 4. Design Professional'l'f u' 5. Address: 6. Type of Proiect: �Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office.Building Realty Subidvision 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? .......................... — 9. Has DEIS been completed and found acceptable by Lead Agency? ............... 10. Name of Lead Agency ^ 11. If this project is an area under the control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... 12. If so, have plans been submitted to such authorities? 13. Has preliminary approval. been granted by such authorities? Date granted: 14. Type of Sewage Treatment System Discharge ................. surface water k— groundwater 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? ....... ............................... d 18. If yes, name of water supply Distance to water supply 19. Is project site near a public sewage collection or treatment system? ................ Ala 20. Name of sewage system Distance to sewage system 21. Date test holes observed /2 q 22. Name of Health Inspector C C-WE /�670 Form PC -97 2 23. Project design flow (gallons per day) ................................. ............................... 6 0 6 24. Is State Pollutant Discharge. Elimination System ( SPDES) Permit required ?...� 25.' Has SPDES Application been submitted to local DEC office? 26. Is any portion of this project located within a designated Town or State wetland? 27. Wetlands ID Number ........................................................... ............................... 28. Is Wetlands Permit required? Has application been made to Town of Local DEC office? ............................... 29. Does project require a DEC Stream Disturbance Permit? 30. Is of 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/No � 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? Yes/No� DESCRIBE: 32. Is there a local master plan on file with the Town or Village? ......................... y T 33. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................. ............................... 34. Are any sewage treatment areas in excess of 15% slope? ............................... 35. Tax Map ID Number p z- .......................... ............................... Ma Block Lot 36. Approved plans are to be returned to ..... Applicant Design Professional If the application is signed by a person other than the applicant shown in Item I .,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 TITLE Mailing Address: .................................. 14.1&4 (2187) —Text 12 PROJECT I.D. NUMBER 617.21 SEOR Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be. completed by Applicant or Project sponsor) APPLICANT /SPONSOR ✓ 2. PROJECT NAME x2 SS 1)S b e 4/01111-1 n s o 3. PROJECT LOCATION: Municipaiity y�" County o� 4. PRECISE LOCATION (Street address and road Intersections, prominent prominent landmarks, etc., or provide map) / df 5. IS PRO? ACTION: ex ❑ Expansion ❑ Mcdificationlalteration 6. DESCRIBE PROJ_CT BRIEFLY: k516_2L, P41 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres S. WILL PRO° SED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? es r No If No, describe briefly 9. WHAT I ESENT LAND USE IN VICINITY OF PROJECT? esidentia! C Industria! ❑ Commercial ❑ Agriculture ❑ ParWFore3VOpen space ❑ Other Describe: 1C. 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 permitlapprovals J t 1.. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes j2tNo ,. If yes, list agency name and permlt/approval ' 12. AS A RESULT OF POSED ACTION WILL EXISTING PERMIT /APPROVAL REOUIRE MODIFICATION? ❑ Yes No I RTIFY THLTE NFO ATION PR . DIED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE, ' Applican1.1sponscr n e: Date: Le ce_f signature: 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 7 PART 11— ENVIRONMENTAL ASSESSMENT (To be completed by agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate.the review process and use the FULL EAF. ❑ Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? It No, a negative declaration maybe superseded by another Inv dlved agency. ❑ Yes ' ❑ No C. COULD ACTION. RESULT IWANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible) Ct. 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: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: 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 O O . C5. Growth, subsequent development, or related activities likely to be Induced.by the proposed action? Explain briefly. J G1 4C _. 06. Long term, short term, cumulative, or other effects not identified in Cl-05? Explain briefly. 33s C+J C7 C7. Other impacts (including changes in use of either quantity or type of energy)? Explain briefly. a D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes ❑ No It Yes, explain briefly 1 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. r ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY I occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. j❑ 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: Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Name of Lead Agency Date ID Title of Responsible Officer Signature of Preparer Ili different from responsible o (icer) C r —f –r; BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate P_ ublic Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 December 5, 2000 Julius Cesare, PE 19 Washington Court Pawling, New York 12564 Re: Application to Construct a Subsurface Sewage Treatment System on Rapp, Doansburg Road East Branch Woods Realty Subdivision,. Lot #2 (T) Patterson Dear Mr. Cesare: The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on November 21, 2000 is incomplete. Please be advised that the following information is required before the Department may commence its review. - Two (2) sets of house plans for the proposed 3 bedroom residence. The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed and Putnam County Department of Health regulations. Should you have any questions or care to discuss this.matter further, please contact me at (914)- 278 -6130 extension 2159. Sincerely, awn Rogan Public Health Technician SR:cj SSTS DESIGN.REPORT EAST BRANCH SUBDIVISION LOT 2 3 Bedroom Design 600 Gal /day Pere Rate = 30 minutes Application Rate = 0.60 Required Area (SF) = 600/0.60 = 1000 Required Absorption Field Length = 1000/2 = 500 LF Use 10 x 50' Laterals for each System and Expansion Julius I. Cesare, P.E. 19 Washington Court Pawling, New York 12564 May 23, 2001 Bruce Foley, Director Putnam County Health Dept. Att. Robert Moms 1 Geneva Road Brewster, NY 10509. RE: Proposed SSTS: Rapp Doansburg Road, Lot #2 (T) Patterson, TM# 24. -2 -32 Dear Mr. Foley, Herewith transmitted are four copies of the updated plan for the above noted project. These plans have been updated consistent with your comment letter of May 17, 2001. Be further advised that percolation tests on this project were witnessed by Mr. Reed of your department. Very truly yours, Julius I. Cesare, P.E. `��d 6Zd�, 0 siA 8'3 P' y, �I X1 BRUCE R. - FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 May 17, 2001 Julius Casare, P.E. 19 Washington Court Pawling NY 12564 Re: Proposed SSTS: Rapp Doansburg Road, Lot #2 - (T) Patterson, TM# 24.-2732--- ... __._.. _.. _..____Dear.Mr. Casare:..._ Review of plans and other supporting documents submitted at this time relative to the above- regarded project has. been completed. Comments are offered as follows: l.. The 100 year flood plain boundary is to be shown or a note stating above exists within 200 feet of the property.. _ 2. The footing/gutter drain must discharge below the SSTS. Turthermore, the minimum distance from the discharge pipe to the SSTS is 10 feet. 3. Standard fill notes 2, 3 and 4 are to be provided on the plan. The construction of this sewage disposal system may be subj ect to local wetlands regulations. You should contact local wetlands officials in this regards - "- - percolation - tests were not witnessed by a representative --of - -the New =York - City - Department - Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve truly yours, Robert Morris, P.E. Senior Public Health Engineer . - ... _.... RM:tn -- . AIV BRUCE R. _ FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 April 17, 2001 Julius Casare, P.E. 19 Washington Court Pawling NY 12564 RE: Rapp Doansburg Road, Lot #2 (T) Patterson, TM# 24. -2 -32 Reservoir Basin Dear Mr. Casare: The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received.by this Department on November 21, 2000 is complete. The Department will notify you by May 8, 2001 of its determination. E.I. The Project has been.delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ® 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 naive, 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 NYC Dept. 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 complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC 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 o.. .q Letter to: Julius Cesare, P.E. - April 17, 2001 -2- 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. 2166. Veqlwy yours, Robert Morris, PE RM:tn Senior Public Health Engineer a , COUNTY DEPARTMENT OF HEALTH -fit a PUTNAM COUN "Z DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner %�,��'�� Address �oAN58v�G '�� & e, Located at (Street) ,4V��;4 ; ,;;� aQ' Tax Map Block. = Lot 3;2 (indicate nearest cross street) Municipality �,� Watershed OA5.7- BTZ.4.UGN SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test z 2- Z;Z z < < ?1" IvI N ry 3L° !l xF� - t5:x?' .3 1 it f UL zo_ 4 5 2 3 al., G. . 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 5 2 c'Y 7 7 D ;%z— `:4 3-0 3 3 on oZ -7 - !7 7 % 3s f UL zo_ 4 5 2 3 al., G. . 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES DEPTH HOLE NO. -HOLE NO. 2 HOLE NO. 3 G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' _6.5' 7.0' 8.0' 8.5' 9.0' 9.5' 10.0': J CA', Indicate level at which groundwater is encountered Indicate level at .which mottling is observed ,fin w �= Indicate level to which water level rises after being encountered Deep hole observations made by: ZEED Pi GE 2 Date Design Professional Name: Address: Signature: Design Professional's Seal \� PUTNAM COUNTY DEPARTMENT OF HEALTH �\ DIVISION OF ENVIRONMENTAL HEALTH SERVICES CCONSTRUCTION PERMIT FOon REATMENT SYSTEM PERMIT # Located at e `' -1 �4i� /� or Villagb' A_T�R X a mot/ Subdivision name 4FA;rX iA,xW "J?ubd. Lot # ? Tax Map ?.-S4 Blo k Lo Z Date Subdivision Approved (IS -5- Renewal Revision Owner /A licant Nam t /&-r / t pp eQ ck L, RiR,o�' 9 . ,Q,APP Date of Previous Approval Mailing Address /y sc., Zip d g Amount of Fee Enclosed Building Type W06 b Lot Area b 76 if'No. of Bedrooms 3 Design Flow GPD 6o V Fill Section Only Depth Volume PCHD NOTIFICATION IS RE UIRED'WHEN FILL IS COMPLETED Separate Sewerage System to consist of l 0 0 gallon septic tank and !!57b C Qther Requirements: / I fg // To be constructed by &/7AC51�r Address Water Sup. upply: Public Supply From Address or: Private - Supply Drilled by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s, sy tem 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. Sign ( P.E. R.A. Date 6 0.0 Ad 4 f v C, �/ ct �✓L(� t;- /i%7 2� )OLicense # 011-24 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage trea t system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified w en onsider necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perm' . pprov d r discharge of domestic sanitary sewage only. By: Title: Date: 44 /z/41 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange 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- # — 01 '3 0 Well Location: Street Address: Town/Village Tax Grid ## 3 2 cr.,s b� P a ds4 Map*` -- _ Block Lot(s) Well Owner: ) e L_ RAPS, -' Add ss: M 104WL $+. /2,V/* 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 5- gpm # People Served Est. of Daily Usage �gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type x'Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes e No Name of subdiyisionEWT_X 4 VChL ta(ca or Lot No. Z Water Well Contractor: If., Q,ot,, c,-- Address: Is Public Water Supply available to site? .................................. ............................... Yes Nock" Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: (, ZV Applicant Signature: 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. y revision or alteration of the approved plan requires a new permit. Well to be constructed by a water, el driller c ified by Putnam County. Date of Issue /� Permit Issuing Date of Expiratio Title: Permit is Non- Transferr ble White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 s _ mi. M L o 011 IN � �S c �.. ► °l _: w r' •of��g c 4 .2 'a te � rassy u; a? " r Z b a fri w w a� bFu Ck '• t, s O • in Qtni��i r V �.g� C14 ri ii. + _ CA i of 0. ,4, s DEPARTMENT. OF HEALTH.... „A Division .of :Env.iiorimental.. Health ,Services TWO COUNTY CENTER ir'CARMEL, N.Y.. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD. PERMIT,,i' # 'WELL LOCATION Strddress Town iif%e Citp' Tax. Grid Number Patterson . 15- -3-4.2 Name Mailing_ Address d[Private WELL. OWNER.. RidlaW L. lZapp ; DeFIWVilie Road, Brewster, .NY 10509: D Public:: USE1:OF3 WE] .RESIDENTIAL OPUBLIC' SUPPLY' QAIR /COND /HEAT'.PUMP O'ABANDONED 1' '- primary 0` BUSINESS O FARM Q TEST /OBSERVATION 0 OTHER (specify 2 - secondary O INDUSTRIAL b,INSTITUTIONAL Q STAND -BY, O AMOUNT: OF USE " • ,, . YIELD SOUGHT =. - 5 gpm /4� PEOPLE SERVED . 5 /EST. OF DAILY USAGE 500 ':gal REASON, FOR NEW.SUFPLY ❑PROVIDE ADDITIONAL. SUPPLY OTEST OBSERVATION . }.:DRILLING ;' O REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL ter' 1 fcr a:nev hone to be built on lot*.: DETAILED cant wa REASON FOR :% p. DRILLING,., WELL .TYPE X�DRILLED aDRIVEN []DUG GRAVEL [O tHER IS WELL SITE: SUBJECT TO FLOODING? YES X NO IF WELL IS,LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: East BTaIbC�l' WOOCYB L.qt No. .2 1 WATER WELL .CONTRACTOR• ;Name + TD "b0. cteritLiliiBd Address:_ .. I$ PUBLIC WATER SUPPLYAVAILABLE TO SITE:'' YES X NO NAME OF PUBLIC WATER 'SUPPLY: N/A TOWN /VIL /CITY �-- DISTANCE „ TO PROPERTY FROM NEAREST WATER MAIN: N/A C& D LOCATION SRET QON .,REAR OF THIS APPLICATION x ©0 ' SEP HEET ` (date) (signature). so tr.N. 115 PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of'Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant 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 De artment. Date of Issue: u 0 19� Date of Expiration: 19 �C� emit Issuing Of i al .• Permit is Non - Transferrable Whits copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller S ; 0 tarlr N kleati� N rhoM CwntY pyartrnant �e1 oa 7=29 92.;; ANNOVEWFOA COW "Ouk "iiaar Nri lOt. Rev 0 LF of PPVG : -Pipes kao , bPOo . vs NnniwlitNyIollawlry _tfogsta of t" Imo- into: 2) that t4M A►NNO wall Aaso*M" —AO n sa. rules and iss ors, of tM mutn m y \ 04E x . R.A. Y. 11:52" Ns 41126. GUAM buibhp Joi pMn undi ► taken ;antl is ,. '.'Any: tAnpi oraltwition ot..eeratrudbir Title DEPARTMENT OF HEALTH Division of Environmental Health Services 4- 1932 TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #J _� WELL LOCATION Street Address Doansburg Town ft r Tax Grid Number Patterson 15 -3 -4.2 WELL 0 ER Name Richard L. Rapp Mai lingg Address diPrivate Drewville Road, Brewster, NY 10509 D Public USE OF WELL 1 - primary 2 - secondary ® RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED O FARM 0 TEST /OBSERVATION 0 OTHER (specify O INSTITUTIONAL 0 STAND -BY i7 AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 5 /EST. OF DAILY USAGE 500 gal REASON FOR DRILLING 0 NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY [3 TEST OBSERVATION OREPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Applicant requires water supply for a new hcme to be built on lot. WELL. TYPE E]DRILLED 13 DRIVEN E]DUG 1-1 GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: East.Branch Woods Lot No. 2 WATER WELL CONTRACTOR: Name To be determined Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY - -- DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDVQ ON REAR OF THIS APPLICATION ��O SEP SHEET 7 -28 -92 (date) (signature) So. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant 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. Date of Issue: 0 19� �� Date of Expiration: 19 �G ermit ssuing f la White Permit is Non - Transferrable copy: H.D. File ' too Yellow Dopy. ldin Btu g Inspea r Pink Copy: Owner 2/87 rl► -anrrc mrnrr Moll flri l l ar S`TEE Shah Trans/Environ Engineering, P.C. Civil Engineers & Surveyors July 29, 1992 Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: East Branch Woods Subdivision Town of Patterson Subject: Permits Renewed for Lot Nos. 2, 3, 4 and 7 Gentlemen: Enclosed herewith please find the following: 1. Four SSDS construction permits. 2. Four Applications to construct water wells. 3. Four drawings showing SSDS and well locations.. 4. Four Authorization Forms. This submission is for the SSDS and well permits renewal for Lot ..___._Nos: 2; 3, 4 and 7 of the East Branch Woods Subdivision. If you have any questions regarding this submission, please feel free to call me. Very truly yours, TRANS /ENVIRON ENGINEERING, P.C. T . Taiesir Fanek Project Engineer TF /ap Encl. successor to Baldwin & Cornelius, P.C. established 1890 Int R. Beraen Place. Freeport, New York 11520 TEL (516) 868 -0900 • FAX (516) 868 -1714 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AUG 4 '1992 Date July 22, 1992 Re: Property of Richard L. Rapp Located at East Branch Road (T) Patterson Section 15 Block 3 Lot 4.2 Subdivision of East Branch Woods Subdv. Lot ## 2 Filed Map # Date Gentlemen: This letter is to authorize Julius I. Cesare a duly licensed professional engineer X 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 ' provisi.ons -of Article 145 or 147, Education Law, the Public Health Law,''and the Putnam County Sani- tary Code. ' Very truly yours, r Signed Countersigned: Owner of Propertyl Richard. Rapp P ..E . , . , ## 4112 1040 Drewville Road Address Shah Trans /Enviro Eng veering, P.C. Brewster, New York 10509 Address Town 101 S. Bergen Place, Freeport, NY 11520 516 - 868 -0900 Telephone 914 - 279 -4496 Telephone MW AVPROVED FOR c00 R IoyoCitON fob cou" of '� o"was Rev. . cl�te i. I 1018.86 -7---�- LU---Ckgm S"Iftlok sod- i e etermined'. AA W will ispi- 6., r V.E. R.A. 666714 construction of thi bilildift has been. uriiertakein and is w I of I H of , in. Any c herq* or: an or at jow of construction +uoob only.. Title DEPARTMENT OF,HEALTH Division.of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT dk� WELL LOCATION Street Address Town East Branch Road, Patterson ..Tax Grid . Number 15 - 3 = 4.2 WELL OWNER Name Richard L. Rapp, Mailing Address ®Private Dremille Road Brewster New York 10509 O Public USE OF WELL X primary 2- secondary D RESIDENTIAL O BUSINESS 0 INDUSTRIAL D PUBLIC SUPPLY O FARM O INSTITUTIONAL: O AIR /COND /HEAT PUMP O ABANDONED O TEST /OBSERVATION O OTHER (specify, O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED. 5 /EST. ❑ REPLACE EXISTING SUPPLY O TEST/ OBSERVATION >(3 NEW SUPPLY NEW DWELLING)- . O DEEPEN EXISTING WELL OF DAILY USAGE 500gal d ADDITIONAL.SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING Applicant requires water supply for a new home to be built on lot. WELL TYPE DRILLED 3DRIVEN []DUG GRAVEL OTHER . IS WELL SITE SUBJECT TO FLOODING? YES XX NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME.OF SUBDIVISION: East Branch Woods Lot No. 2 WATER'WELL CONTRACTOR: Name To be.determined Address: IS PUBLIC WATER SUPPLY.AVAILABLE TO SITE: YES XX NO NAME OF PUBLIC WATER SUPPLY: N/A TOWN /VIL /CITY -- DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/A LOCATION SKETCH & SOURCES OF CONTAMINATION .PROVIDED ®ON SEPARATE.SHEET k � 4/1/90 (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 applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance.with the requirements of the Putnam County Health. Department attached to this permit: 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in sZ17— a manner as not to degrade or of w e contaminate surface or groundwater.' Date of Issue: 19 je a Date of Expiration 19 42-- Permit Issuing Official Permit is Non - Transfe rable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT'OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date April 1, 1990 Re:, Property of Richard L. Rapp, Sr. Located at . East Branch Road (T). Patterson Section 15 Block 3 Lot 4..2 Subdivision of East Branch Woods Subdv. Lot # 2 Filed Map # 2074 Date Gentlemen: This letter is to authorize John F. Eberle, P.E. a duly licensed professional engineer x 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. Countersign32 6 P..E. , R.A. , 74( / Baldwin & Cornelius. P.C. Address RD 5, Route 22, Brewster, New York (914) 279 -7115 Telephone Very truly yours, Signed Owner of-PropAfty Drewville Road Address Brewster, New York Town (914) 279 -4496 Telephone -r-m- -s=ue - -�'-•- ., �- - ,•..o-- ,.,c....+�.,.- -�.-�° - KT+e --", r - ,:� _ ^ fx- .r. s. .. .i .. . g� /. PUTNAM COUNTY DEPARTMENT OF HEALTH E;N�iNEER TO PROVIDE :P.ERMIT # ON CERTkF-1C OF CO PL IAANCE. / Division of Environmemal Health 'Services; Carmel N ' 10512 PERMIT �CONSTR CTION.PERNIIT)FO,R S�WAGE;DISPOSAL SYSTEM ' Patters`on own ' ::or Villa . ,Located' at' Doan'. sburq Roatl _ Tax Map 15 elock '> Lot iL East, Branch Wootl s• 2 ,Subdivision Subd.,tot H Renewal _� Revision, 0. . ,owner /AddressBzchard Rapp *, •- ',OreWVi Ie �Rd. 0 Brewster. ,—NY Date of Previous. Approval House 1:77 A pudding Type Lot,A[ea Fill section only 0 'Numbenof Bedrooms Des'ign Flow G /P /D P.C. H. D.' Notiiication kequired Separate ,Sewerage System. to consist of %CJ00 Ga,l., Septic Tank antl To be constructed,,by Address Water Supply: Public Supply From _✓ Private Supply to be 'drilled by P F ;,;Beal & Sons, .Inc.• 4 Putnam Ave., Brewster:, NY 10509 Address Other Requirements. i. represent that l am wholly and,coTpletgiy reiponsib,leforthe des ignand location of the proposed,system(s); 1) that the: separate, sewage.: disposal. system above.described wilbbe constructed as shown on the.aporoved amendment there to and in accordance with the standards, rules an regu a ions:o e u nam County ` Department of Health, and that oncompletion thereof a Certificate of `Construction Compliance satisfactory to the commissioner Health will tie submitted to the ,Department, and`•a written guarantee will beiurnished'the'owner; his successors, heirsor-assigns by the builder, that said builder will place iii good dperating" condition *any part of said" sewage disposal. system during the Period.of two (2 years immediately. following thedate of the Issu- ance of the approval of the Certificate of, Construct,on' Cemplmnce of 'the ginal.system or any repairs thereto; 2) that the drilled well described above will be located as shown on.the approved plan and that said,will' will 6.1 'S a 1 i accordanc w the standar rules and regu aT o� ns of the Putnam County Depart gent f Flealth. Date CJ S ign Address '/C -''U 0 , %G--V 4; C✓G - fN,Cr!4 a APPROVED FOR 'CONSTRUCTION:' This approval expire ne year from the'•date revocable for cause or may be amended or modified when ns ered necessary by.A requires anew permit, Approved, for disposal, of dome 4a ita 17'sewage; d Date �� 9y, IL Rov . A /nS .. - . _ .. ...- �.._._.. _ _.... -- -f, License No. e uules construction of the building has been undertaken and is Pmmissigber of Health. An y_sfLp - Iteratlon of construction Title PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - Date- -August 8, 1985 Re: Property of Richard L. Rapp, Sr. & Richard L. Rapp, Jr. Located at Do.ansburg Road (T) Patterson Section 15 Block 3 Lot 4 Subdivision of East Branch Woods Subdv. Lot 2 Filed Map # Date Gentlemen: This letter is to authorize 04-jdwin & Cornelius, F:.�', a duly licensed professional engineer -X Or registered architect (Indicate . to apply for a Construction Permit for alseparate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by Ahe 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 c conformity with t the provisions o of Article 145 or 147, Education Law, t the Public Health L Law, and the P Putnam County•Sani- Code. Very.truly yours, Signed Countersigned: Owner of Property • �'% G e.3 Drewville Road P.E., # - Address RD # 6 Rou _P 2? Address Brewster New York 10509 279 - 7115 Telephone Brewster, New York 10509 Town 279.- 449E Telephone r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 - DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Richard L. Rapp Sr Address Drewville Rd Brewster NY 10509 Located at (Street poansburg Rd Sec. 15 Block 3 Lot 4 �Indlcate nearest cross street) Municipality Patterson Watershed Croton SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS I I MV Number CLOCK TIME PERCOLATION PERCOLATION —fiun Elapse Depth to Water Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 20 - 51 31 14 14.875. .675" 35.4 2 52 - 98 42 14 15.25 1.25.. 33.6 3 38 - 73 35 14 15.25 1.25 28 414 6 - 47 33 14 15.06 1.06 31.1 5 48 - 78 30 14 15.06 1.06 28.3 4 15 - 48 33 6 7.25 1.25 26.4 5 49 _ 79 99 6 7 1.00 29 Tlotes: 1) Tests to be repeated at same depth until approximately equal soil .rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measur6ments to be.made from top of hole. 3.4 __ . 64' _ 30 6 -- - 7 . _... .1:00 1'.00--, 30.00 2:05 - 39 34 6 7 1.00 34.00, 3139 - 74 35 6 7.10 1.13 30.9 4 15 - 48 33 6 7.25 1.25 26.4 5 49 _ 79 99 6 7 1.00 29 Tlotes: 1) Tests to be repeated at same depth until approximately equal soil .rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measur6ments to be.made from top of hole. DEPTH G. L. 611. 12" 18'1 2411 ,On J 3611 4211 4811 5411 6o" 6611 7211 TEST PIT DATA REQUIRE -D TO ME STrL,'KJTTED WITH APPLICATION DESCRIPTIOIJ OF SOILS •ICOUT ?T -!-"ED IId TEST HOLES HOLE NO, 2 HOLE NO. HOLE N0. Sandy Loam 7811 8411 iVU �UGk �N[OJNtt�cO INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED - no water encountered INDICATE LEVEL TO -WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADY BY Richard - -J. Zapp Jr. Date 1/19/84 DESIGN Soil. Rate Used_�_M.in/1 "Drop: S. D. Usable Area Provided 5000 No. of Bedrooms 3 Septic Tank Capacity 1000 Gals. Type- masoory Absorption Area Prov e By 500 L. F. x24 "������� wig o. Name Baldwin & Cornelius Address Rt. 22 =-1 Brewster, CD- THIS SPACE FOR USE BY HEALTH DEPARTMENT 0NLY3 ' Soil Rate Approved Sq. Ft /Gal. � COR . o-o' tCNP� Late ✓i 1 Table of Distances A -C 23' B -C 32'6" A -'D 31' B -D 38' A -E 33' B -E 35' A -F T616" B -F 36' A -G 3`7' 8 -G 4.0' A -H 7-8' a -H 41' A=I 42'6" B: -I 4.6' A -3 81' B -J 45' A -K 47' H -K 51' A -L AV B -L 50;' A -M 52' B'�^M 55' A:: -N 85'6" B ^N 58'6" A -0 57'6" ae�._O 61' A=P. 89:`6" B -� 601.6" A-Q 62' BrQ 67' A -R 9-TO $ R 65' A -8 69' 98 ' 73' A -T 9.716" B -T 71' A -U 74.' B -U 78' A -V 101' B -V 76'6" A -W 80'6" B -W 85' A -X' 105' B -X 82' N J9Ao n ALL SUAWY AND ION by Xg T2, Collsne 5 S4 I 2 404.1,