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HomeMy WebLinkAbout0854DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25. -1 -18 BOX 9 11 ro ..Ill IIIIII �r y 1 in IN „ IN me �` �` I' I IN �' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of M&RC'A'arT G�'�Srw r-_� Located at I {zMS "DME i1I UI ' fZ,0A0 T/V fA7F- DSOO Tax Map # 2-5 Block Lot S _ Subdivision of Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize °-7 J L PfMr__Wt_j a duly licensed Professional Engineer 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 - an Putna itary Code. P.E., R.A., # Mailing Address Very truly yours, Signed:qykv QW84 — (Owner Property) State l-� \� Zip IzG 03 Telephone: 1645 -49S 1 Co�LS nn Mailing Address: jib 1,,1�.��(,z pc' -' . 4�4e A.%-, A") f State -` /V ) Zip `I Z Telephone: yc- k7 P - -7ld!l Form LA -97 PUTNAM COUNTY HEALTH DEPARTMENT ' DIVISION OF ENVIRONMENTAL HEALTH SERVICES YES NO/ Internal Use Onlyl - ❑ 14 Repair Permit issued in last 5 years VDelegated f in Watershed ❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION 170 W4Ms-i4JE 'Eiji,(_. F—P TM # OWNER'S NAME �I G- �A(��'T// t� PHONE #, f'7,- 7.1dY MAILING ADDRESS LJL IMP_ 'I�n,..� %�C,� - ,:r.,. /A A.,�Y / 1,-rT APPLICANT MM,&A? j G CkZUF�U. Oyvjr� Name & Relationship (i.e., owner, tenant, contractor) DATE FACILITY TYPE PCHD COMPLAINT # PROPOSED INSTALLER PHONE # ADDRESS REGISTRATION /LICENSE # Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed trenches) NOTE: Repair must be in same location and,of,same-type as original sewage disposal system. Different location and proposed pump systems will require submittal of proposal from licensed professional engineer or registered architect. I, as owner, or reported agent of owner agree to the conditions stated on this form SIGNATURE TITLE DATE Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name b. Site Street Name, Town and Tax Map number c. Location of installed components tied to two fixed points d. System description (e.g., 1250 gal. Concrete septic tank, etc.) e. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions. Proposal Approved . Proposal Denied `j 4 Inspector's Sign5tur"et Title D to COPIES: White (PCHD); Yellow (Town BI); Pink (Installer), Orange (Applicant) PC -RP 99ML Rev. 8/05 Sheet ( of PUTNAM COUNTY DEPARTMENT OF HEALTH _ DI_V_ISI.ON OF ENVIRONMENTAL HE_ATLI_I SERVICES FIELD ACTIVITY REPORT NAMF: Teh AT)nuss: /70 - 6fiuns4y it e. hl Z Street Town State Zip PERSON IN CHARGE Name and Title v TYPE OF FACILITY: ::5t S: r. S f WIWI c Signature and Title RFPoRT RF('FTVFT) RY: I acknowledge receipt of this report: SIGNATURE: 02/96 !Rev. Title: ;4 PUTNAM COUNTY DEPARTMENT OF HEALTH -DIVISION_.O.F_ENVIRONMENTAL IfEATL-ILSERVICES - - -- — =— - - -___ FIELD ACTIVITY REPORT AT)T)RFC4; /7 /CIM'iZBN `i�YTI�B�I Street Town State Zip PERSON IN CHARGE : X PUMP TEST ❑ DOSE TEST 3" EL. START V Signature and Title RFPCIRT RFC F.TVFT) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: STOP REQU RED GALLONS Ct g 3.s x 71 1-75 r` I` B3\9 01 (D m (cn I 3" EL. START V Signature and Title RFPCIRT RFC F.TVFT) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: STOP REQU RED GALLONS Ct g 3.s x 71 1-75 � � O A 3" EL. START V Signature and Title RFPCIRT RFC F.TVFT) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: STOP REQU RED GALLONS Ct g 3.s x 71 1-75 170 Stv�kml ©he 2W r,94 o jo- % A, 02.E -1° 98 E �R 69, i AT— R 6 114 � � O . 4P��l,� 1_18,0 CIO F - 12, O S _ 18,0 �,�-j� l K °- o2b , 0 'D,711"16pon BOX w%Qlh 99 170 �n 4� CGS o H.W *i -Igo w 0 zo ,y�l Punam COUNTY HEALTH DEPARTKM C L DIVISION OF ENVIRON MHAL HEALTH SERVICES 225 -0310 PROPOSAL FOR SEWAGE DISPOSAL -SYSTEM -REPAIR OWNER'. S NAME Ric (ne.0 11i v�:S „Y PHC%]E 9.°l°t - -149 6 SITE LOCATION # MAILING ADDRESS 150.µ•C PERSON INTERVIEWED Av I li AS a� wee•, Pa]D Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE `% •-► O -Ql ( TYPE FACILITY PROPOSED INSTALLER PHA Proposal (include sketch locating all adjacent wells): NOTE:. Repair mustbe in same.location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. ts �`wr V�e•�J OOC� 0, k V% 'C►K�n. Av.� OZmdt Pon � -N r � 's Ike/ & Title Proposal Disapproved Date 'roposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of.as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points*(e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic .tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be perfornted in accordance with the above proposal and.conditions. I, as owner, or reported agent of owner agree to the above conditions. SIGNATURE ,. ��_ 477 TITLE 6 ra-+� _ DATE 5: ftte (MD); YeUjcw MJ n BE); Pink Qai iamt) j .4 yo , ado 510,. N8437'30'W /V/F- STROP _. 209.78• 0 30.W S� '2g.16• A174-20, F _ 133 '8• PARCEL I 1.31 ACRES OR 56.879 SQ.FT. ?�O �R� �4t •� O Pq O xq, , N74'07'30'W _ S�p363p* eUl p NC 2 -E 74-o", N1552'3 N1� 5T 0 30.00 95.98• 3 O 12.07. S 7g -00• 1 1. nouff zed alteration or addibb. to o sunray m op t/ �* bearing o /¢eresed land sunryar's seal is o nohtion or i�1) r � E 74.33• N16'12'00'E — 5.87• . section 7209• subdiisbn 2 of the New York Slate %lO education to . `• 0'E — 9.00' 2 ONy copies tram the original of this survey marked r ' with on ong;nol of the /and surveyors sea/ shalt be considered velid copies. J. Urdergraund ;mpm wnents or encroachments if any am not shorn. 4. subject to the Tndngs or on accurate abstract or tide. 5. Guarantees or certirwations indcoted hereon shall run any to the persons for whom the survey is pmpamd and on his behaH to the aw company, governmental agency and the /end7q autitub "on. Guarantees or cerb'rmations am rat transrerobh to additkxa/ institutions of ,.• �°'+ HUDSON' VALLEY ENGINEERING subsequent owners. & LAND SURVEYING, P.C. 6. Subpct to any eosementa, right —O /- -rays and or ogreamenls that ubTty companies may have. 20 West Mein Skset WnzhkVb nvme New York 101W2 777ERI01�:(M5)4Q1J/70 IIVEetlBme FAX:(ere)en•1sm Certircations indicated hereon signify that this survey was prepared in accordance with the existing code of practice for land surveys adopted by the New York State Association of Professional Land Surveyors. Said certirrcotions shall:<. re uee� "��"Op1° a ,K K..ae ���,�,,° " "'• w"°e " "m® 1d1O 9""Ph v" ° " epu°ar sr "e o,�,m, ,,,. � �"� a .,... a>� d ....n .n...,. 6,,,E m „mm,.�,w�oae °a 1°"°'anas,,,,m".„ 9e A a„e,.�. ,. azanr`e� a:. Fn LL SURVEY �� ws run only to the person for whom the survey was prepared, and on their be off to the title company and /ending institution listed, hereon, and to the assignees of the /ending institution. Certirrcations are not transferable to . ,.,E,�, a.eK ro ;,e,cw.rom1°.E,.,�O .ae ee �..� MARGARET 10& �°9LE SCALE 8 9m e additim.1 institutions or subsequent owners. —� C ANTWELL : &oe R CERTIFIED ONL Y TO. MARGARET G. CANTWELL ` �� PATTERS 9 _ GENEVA MORTGAGE CORP. its successors or assigns STATE COUNTY ~ STA1E NEW I YOtiK PU7N K £ T/MEL Y TITLE SERV/CES, LTD. EDWARD T. CANNON• P.LS., N.Y_S. License No. 049907 9 Oeff 9 7 ROBERT J CAMERON JR. ARCHITECT 14 RABBIT TRAIL ROAD POUGHKEEPSIE, -NY -1 -2603 - -- -- - -- -- 845- 485 =1625 Mr. Gene Reed Putnam County Health Department 1 Geneva Dr.:r, Brewster, NYC 10500 February 12, 2007 Re: SSTS Repair #R- 116 -06 Margaret G. Cantwell 170 Brimestone Rd., Town of Patterson TM# 25 -1 -18 Dear Mr. Reed, Enclosed please find drawings and information for the above. referenced repair. In response to your letter of January 29, 2007 the following has been addressed; 1) Note #14 and #15 have been voided 2) Fill pad dimensions have been added to the plan and profile. 3) A note has been added indicating the fill pad is to be inspected by the design professional and PCHD before the trenches are installed. 4) A note has been added 'indicating the' existing SSDS tank' is to be pumped prior to' abandonment. 5) The SSDS tank and pump chamber have been moved as far as practical from the well. 6) A 90- degree downward elbow has been placed on the force main as it enters the distribution box on detail 4/HD -2. 7) The pump chamber tank dimensions have been changed to reflect a 750- gallon tank. 8) The detail 5/HD -2 has been revised to indicate that the absorption trench and pipe be set level. 9) An existing note on the drawings indicates there are no wetlands within 200 feet. Please do not hesitate to contact me if you have any questions. ROBERT J CAMERON JR. ARCHITECT 14 RABBIT TRAIL ROAD POUGHKEEPSIE, NY 12603 845- 485 -1625 Mr. Gene Reed t Putnam County Health Department 1 Geneva Dr. Brewster, NY 10509 January 19, 2007 Re: SSTS Repair Margaret G. Cantwell 170 Brimestone Rd., Town of Patterson TM# 25 -1 -18 -- -Dear Mr. Reed,--_.._.. Enclosed please find drawings and information for the above referenced repair. Due to the nature of this repair (new pump system) you had required engineering drawings be submitted. for review. Please do not •hesitate to contact me if you have any questions. - -- - ROBERT J CAMERON JR. ARCHITECT 14 RABBIT TRAIL ROAD POUGHKEEPSIE, NY 12603 845- 485 -1625 May, 19 2006 Re: SSTS Repair Margaret G. Cantwell 110 Brimestone Rd., Town of Patterson TM# 25 -1 -18 Mr. Gene Reed Putnam County Health Department 1 Geneva Dr. Brewster, NY 10509 Dear Mr. Reed, Enclosed please find an application for a repair permit, survey, house plan, authorization letter, $150.00 fee and a plan of the proposed repair. The subject property does not have - an SSTS located on the premises. -The SSTS- area.is:ptesently on a parcel located across Brimstone Road. It is necessary for the owner to have an SSTS on their parcel. Initial peres and deeps have been performed in the proposed repair area. Due to the difference in elevation a pump system will be required. Please review the application and advise of a field inspection date. Please do not hesitate to contact me with any questions. Rlrd� N84'37'30"W :209.x`8' nt�,•30,0�� N/F STROL -_N74 a F PARCEL. 1 1,31 ACRES OR _ 56,879 SO.FT- EPA1R ARP• i9� ,� . olTqW` � ' f- ..!..., O cv 0 s n MP�tK "( g, �, ►�5t-e1N�'�cNV tt,t,� �►`J . .. �XlS�JlVG � � 1o`ta'1- D'y BUa� G IZ5d lANjc S70.036 "3U" t`1A UJ ` '' fk)" 12.07' PAvEp RvaD�v� S79' 0'50 "E 74.33' BR,� v 7, SSTS Ph1(� sK 'tC1 -I QAD jA-A-RC ->N F- E i G. C aN-c \v VIL-U ay 0_ 'C J CAr'��R�N JR � K,P • . l� Ra1 tT 'CKF►l� FOOGHKec-Psi1z NY mcgo3 �xt5'" C� -r�Nk inn �t�t pS F- � E'*�A►.cVoNEJ�. TA -1�1K 485 - 1(o 25 1 ,t_ SO' To t5 E �I 1 ai e`er 0 1 N84 *3730 -W _ �. . _.. <• „ _. ,- 209.78' " a IV 30;30 "K, S� 129,16' ..., ... �s! N74 0 �0" 13,3 78• PARCEL I 1.31 ACRES OR 56.879 SQ.FT. �R• tk'gt e� - °n O "W T' N74'07'30 SD (J/77 570. BUL /N G 2 . 3630. G "E _ N15'52'30 74.073o 30 - 65.98, 12 07 1. thauthorired alteration or addition to a survey mop TpNE S79 00'g0 E 74.33' 6 '00"E — 5.87' t beoriny o %9, sut land s s gaol is o not - "E 2 of t State — 9.00 section 7'X19, ram - vision 1 of the New Ywlr State �ip � education law. +• A f� - 2. Only copies from the angina/ of this survey marked ' with on teV wt of the land surveyor's sea/ shop he considered mAd copies. ' J underground improvaments of encroachments if any are not shorn. - f. Subject to the rnd'ngs of an accurate obstroct of title. ' 5. onlyG wto m tnt or indiated hereon shall hes P rm the survey is Mepared and on his behalf to the LYIe comPonY. goren+menta/ agency and the /ending msrtution. Cuorontees or cerurco%ons ' E ' . am tronsferobm to odd'twrw/ uutYurons ar I HUDSON' VALLEY ENGINEERING not subsequent owners. & LAND SURVEYING, P.C. -of 6 Subject to any easements, right -of -ways orM or zp vest Matr. Strut waeanpmnvma Ne�v vo.x U.7= 7gpR101E (BLS)�W3170 ..wJlvErb9mm FAX (W) 4U.7= agreements that ufikYy cowponies hero. ' ' vrmc�a ame.oa� ro . ,,.r e ru . um.zn rvrmou. uo sincmrs v. e • mwm. a asiv > ��• Certifications indicated hereon signify that this survey was prepared in accordance with the existing code of practice �,� z w n<,� ,� ,,a, ,.. SURVEY - adopted by the New York State Association of Professional Land Surveyors. Said ceraxotions shat/ i�a� miorrm . z °° "D�„n"a"c ro ,mm�.�.soo°1�Dime r o ens for /and ",', ''m PREPARIM FOR DATE` surveys �;, ®c®: wc'.�o o.a.'� run only to the person for .whom the survey was prepared, and on their behalf to the lit /e company and lending �� �°°„�„e ;� a institution listed hereon, and to the assignees of the lending institution. certircations are not transferable to ,.. o..a a.d. - MARGARET 9LE SCALE additional institutions or subsequent owners. F —1 CANTWEL'L '01 CERT /F /ED ONLY TO.' '� : MARGARET G. CANTWELL Tom OF PATTERSON, 9 GENEVA MORTGAGE CORP. its successors or- assigns i —� OpUNTY OF PUTNAY. SPATE OF NEW YORK sir T/MELY 77TLE SERVICES, LTD. EDWARD T. CANNON, P.LS.. N.Y.S. License No. 049907 9 9 i i I 25 05 02 :51p 1 David Bodisher 845 878 2523 2s. -1-i3 - PUTNAM CQUNW . HEALTH DEPT£ DIVISION OF HEALTH SERVICES 225- -0310 PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR p.2 l0 jZMIs NAME i� �� /�j�1� +�5 PxaNE ��►°t -`i�96 �TTE WCATION ; •^� 5 {a �C - c� �v. rSo� GU t1_ 7 &=W ,ADDRESS 5CA,— C '�I I E wiam fA,\" i�'1 11 caw ter, PC B Car�plai nt Name & Relationship (i.e, bwner,tenant, etc.) GATE `7 -11 -9I TYPE FACILITY i 'ROP OSED INSTAIM ( PHONE (include- sketch locating all.adjacent wells): pm: Repair must be in same location and of same type as, original sewage disposal system. )if ferent location may require submittaa of proposal fran licensed professional engineer or egistererd architect. Inspector's cxnature & Title �G....1�.1 c�McS ��1c�tS vNe'i 1006 !a CLIL- v o ok\,ev we'k\c e-ko c,-.r h*%.c.r. /S�r { Proposal Disapproved. ?r000sal aoproved with the following conditions: i t 7 to 'l. Procurement of any Town permit, if applicable. ' i2. Subnission of as built repair sketch in duplicate showing: a. Owner's name. b. Site.Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points (e.g.,hcuse corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deel drywells surrounded by one'foot .+.gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. C, as owner, or reported agent of owner agree to the above conditions. _11IGNAMM �i' %U1 '.(� '/9��9: TITLE X44 ri-• 1 DATE ?g5: W-l.i.te (F01)): YeUcw tk n BI); Pirk (AMUCent) PAUL P. PIAZZA Building Iwed". TOWN OF PAT PERSON CODE ENFORCEMENT OMCF - PUfNAM COUNTY P.O. Boa 470 Patterson, New York 12563 September 13, 2005 RE: TM-- 25.-1.18 (Dwelling) 25,1-13 (Vacant Land) 11VULL>INS, RICRARD & BARBARA 170 Brimstone B,oad (Dweftg) 171 Brimstone Road ('Vacant Land) Patterson, New York TO wHOM 1T MAY comm; Tde*na (845) 878.6319 Fa+t (845) 978 = 2019 Aceoiding to our records, the 3 bedroom, single -banlly dwelling with deck awd acrecn room on the above numbered lot was evidently c=L -*ucwd prior to our Zoning Ord u nce reQui ft a Certificate of Occopmtticl+. The Town of Patterson. did not requite building permits or CertiSeifts of Oeeupaacy liar above groaad swimming pools or their respective decks prior to Match 2000. The Building Department does not have a file or record of consvuethm or violation for this dwelWg. All dwellings far resale MUST have but and smoke detectors is each bedroom and hallways prior to closing and also a CO2 detector on the lowest floor level OA lm bedrooms. the bVorma on mgmdng dru dweling wvs o8Wywd froPL , Building _ Department , Assessor's records XXX . Health Department Compliance If you have any questions, plisse do not hesitate to contact this office. Very truly yours, / 7y, iMdy'f I. , Building Department TOWN ROAD _M�, STATE ROAD_,, COUNTY ROAD PRIVATE ROAD TOTAL P.02 . h b,&IM Comments: 12.0' ' 32.0' Kitchen Bath Den o 6 c r) . N Dining Living Room Family Room 44.0' 18.0' 0 c 10.0' Bath o 12.0' o ° 2. ' 0' ° Bedroom Bedroom Bedroom o ao °0 40.0' El -- - - - - -- - ROBERT JCANIEROIVJR.ARCHITECT 14 RABBIT TRAIL ROAD POUGHKEEPSIE, NY 12603 845- 485 -1625 May, 19 2006 Re: SS'I'S Repair Margaret G. Cantwell 170 Brimestone Rd., Town of Patterson TM# 25 -1 -18 Mr. Gene Reed Putnam County Health Department 1 Geneva Dr. Brewster, NY 10509 Dear Mr. Reed, Enclosed please find an application for a repair permit, survey, house plan, authorization letter, $150.00 fee and a plan of the proposed repair. The subject property does not have ~ an SSTS. -located -on- -the premises.- The -SSTS- area -is presentl_y.on.a.parcel located across Brimstone Road. It is necessary for the owner to have an SSTS on their parcel. Initial peres and deeps have been performed in the proposed repair area. Due to the difference in elevation a pump system will be required. Please review the application and advise of a field inspection date. Please do not hesitate to contact me with any questions. if r. - PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner e ",'AArrG✓.�GL Address 13RiMSro N6 lZo&n Located at (Street) Tax Map X:5, Block �_ Lot (indicate nearest cross street)' Municipality ?.4ZMEg_S0A! - Watershed SOIL PERCOLATION TEST DATA Date 1910ES: 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. r Form DD -97 /g' -3 3 4z, 7 2 3 15- d - .23 a So 4 5 1 1:10 -J.fl26 -3 % 1. 2 4 5 1 2 � 3 4 5 1910ES: 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. r Form DD -97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES - DEPTH - - -HOL- E NO:.T_ HOLE NO: -- - - HOLE NO.- - -- G.L. 0.5' '' 715 , 1.0' s 1.5' 2.0' fit e- . . 2.5' `✓� / `►mac s 3.0' 3.5' f�' sa � 4.0' 4.5' Af 7.5' - 8.0' 8.5' 9.0' 9.5' 10.0' . x Indicate level at which groundwater is encountered Alo tv C, Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: , zaa!rm 6;.¢ ? G V ,H- Date Design Professional Name: — Address: Signature: Design Professional's Seal `PUTNAM COUNTY DEPARTMENT OF HEALTH - ' DIVISION OF, ENVM0TgMENTAL HEALTH SERVIrES INITIAL INDIVIDUAL /COMMERCIAL SITE I".CTI " ©1P�1 FOB,IVI i r SECTION A tiGENERAL INFORMATION .. .: Name of Prod ect (iV) P,,�jZstJCo"unty Site'Locationn //� Building construction begun . YreS Extent`y.l r T Stye %• f.� Is .propdrty it 'un l C :Watershed? Yes No SECVON.B ..:TOP4GRAP.IY (lease check all appropriate Doges) 1. T -hilly Rollug Steep slope Gentle;slope; a a o o' a 2. a Evidence of wetlands Low area subject to flooding Bodies of water Drainage' ditches Rock outcrolis. ,5e_e_ �(aK 3. Property lines .or corners evident ............... des. No . 4. Do: water courses exist on onad�oin the property ........... N ;� Yes No 5. Will- these:affe.cttle design oftle.sewage system facilities? ............ es No 6. Do watershed regulations apply in thus development ?...:::...... ...:........ Yes No 7 Will.extensive adin `be.necess ? ..:............ ::..........:.. Q Yes No 8. Will extensive.fill be;necessary for S STS ? :.:...........:............ Yes No' .9. Do" filled areas exist within theS STS: area? ....... ............................... Yes E���No If yes;.what::is the condition of the fill? SECTION:C. SOIL OBSE AT-IONS 10. Appearance of soil Sand Gravel /Loan Clay =Hardpan Mixture' 11. Observed from: 0 Borings � Bank cut Backhoe excavations 12: Soil borings /excavation`s observed.by��r, on U. D.epth'to groundwater 610 hl p on 14. Depth t6,mottling Xjd^1 on 15 16. 17. Aretest °holes representative of primary & reserve areas ................ ...... ::............... Q Yej No `Soil percolation tests made by 20 Ca_h2T-o tn. . ', > on .: Soil percolation tests witnessed by /a., , fed on SECTION D (on back) Form ST -1 SECTION D. DRAINAGE 18. Will proposed'!, ading inatenall3 alter the natural drainage in this or adjacent azeas� Yes a No . 19. Will ound enter :or'surface drainage. require. special cbii d atioiv : .. .............. a Yes ' N o [ ' 20. Will gullies, ditches; etc., lie filled and watercourses',be relocated ? ...............::.:.... 0 Yes =No SECTION E RENit RKS �_ �.. . ° : _ A. 21. If a common water supply is proposed, .has an i spection been made of the source existing or proposed .. .................. and facilities . ................. _ ..... Yes .^ No , Inspection -data ��r��,�d�a ai.�ll ,. ,t , _ 22, Do adjacentwells arid/or sewage systems exist ?�tV4et e.... i." !hl ....1.QQ ....., a Yes 'No. 23. Additional comments 24. Site observer /inspector- -and title e<. , }- 25. Dates) of obse'rwi ion(s)inspection(s) TEST PIT PROF -MES Hole # Lot: # : ; Hole # Lot # !Hold # : `' lot Depth to water Depth to water .Depth =to water' __Depth to mottling Depth to mottling Depth to.rnottling . Depth to rock/irnp..: Depth to rock/imp.. Depth to rock/imp . G.L. G.L.. G.L. 1.0 1.0 1.0 2.0; 2 0 2.0 3.0' 3.Q 3.0' 4.0 - 4.0 4.0 5.0 5..0 .` :. _ 5.0 6.0 6.0 6:0 7:0 . 7:0 7.0 8.0 8.0 •8:0 9.0 9.0 9.0 10.0 10.0 10.0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Located at 0 15r-1 N\STONE fl I Q, F-DAP T/V f-A—T � SOFJ Tax Map # 25 Block Lot Subdivision of Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize 6fl j C�N� a duly licensed Professional Engineer 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 PutnapQ6W itary Code.. - , Very truly yours; oun igned. o: � Signed: 9%1,6e P.E., A., # o'j. N ' 1 O �{- ► (owner f Property) Mailing Address Mailing Address: �b i,✓Z., �v..�� State ty � , Zip 12 6 0 Telephone: 16�5 .49C -) 16 's State /V1 Zip / 2` 2 Telephone: 0 - k7 P - % J,0 %( Form LA -97 PUTNAk COUNTY DEPARTMENT. p OF HEALTH / � t ' DIVISION OF ENVIRONMENTAL HEALTH IND`rMtTAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS - - REVIEW SHEET FOR 'CONSTRUCTION PERMIT NAME OF OWNER �.4rU1"L�1�LL STREET LOCATION: 170 �iZI NL rOA1� 14-a l 7Lo r`? _ REYIEWED.BY: RM, �TSr', SEDATE: 2 o TAX MAP#• (CONFIRMED) 4Y -,*N'' DOCUMENTS ( REQUIRED DETAILS ON PLANS CONT'Dl PERMIT APPLICATION HOUSE SEWER - Wl PT. 4 110'; TYPE PIPE.CAST IRON WELL PERMIT OR PWS LETTER L'x;i�M (ENO BENDS; MAX BENDS 45' W /CLEANOUT. :w `•' PC-97. RENEWALS ETTER OF AUTHORIZATION SITE NOTE (NO CHANGE) DESIGN DATA SHEET (DDS) FILL SYSTEMS CORPORATE RESOLUTION 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE SHORT EAF L/ RILL SPECS/ FILL NOTES 1 -5 PLANS-TIME SETS Q UHOUSE PLANS - TWO SETS PRt1FILFr8c�?I1V1SIF3iQS� " � jVARIANCE REQUEST �FIiL IN EXPANSION AREA -- AI o �XP°4"�g r'a n SUBDIVISION FILL GREAZEITHr1N2 FEET LEGAL SUBDIVISION CLAY BARRIER, SUBDIVISION APPROVAL CHECKED •' UFIL'L CERTIFICATION NOTE . PERC RATE'; • : �DEPTFI GAUGES LZ VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS i FILL REQUIRED. DEPTH SEPARATION DISTANCE FROM"TOE OF SLOPE (� URTAIN DRAM REQUIRED TRENCH GENERAL �LF• TRENCH PROVIDED XO O 60FT MAX. CATER .IN NYC WATERSHED -s Fira"cti ARALLEL TO CONTOURS PLANS SUBMITTED. TO DEP 0% EXPANSION PROVIDED - LEGATED TO PCHD DETAdIIaDUST FREE CRUSHED'STONE OR WASHED GRAVEL EP APPROVAL, IF,REQ'D GEOTEXTILE COVER. DEEP TEST HOLES OBSERVED SEPARATION DISTANCES ON PLAN, F10M'SSTS rERCS.TO BE WITNESSED 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL . _) APPROVAL SSDS ADJ, LOTS LfY, 20' TO FOUNDATION WALLS WETLANDS (TOWNIDEC PERMIT REQ'D ?) 100' TO WELL; 200' IN'DLOD,150' TQ FITS DATA ON DDS PLANS & PERMIT SAME 100' TO STREAM, WATERCOURSE, LAKE (ina ezpan.) • - PRE 1969 NEIGHBOR NOTIFICATION - :• -- - .. - 50' TO CATCS BASIN, 35.STOR_MDRAIN, PIPED WATER 10'TO WATLETRBZA YR:LOOD XLEVATION W1I 200' -... _ . .. ._ - 50'• I]V"TERNIITTENT DRAINAGE COURSE . . SOIL-TESTING LOTS>10 YEARS OLD 200500' RESERYOM ETC. 150' GALLEY SYSTEMS REOUIRED DETAILS ON PLANS : (� 10' KN TO LEDGE QU'TCROP BSWAGE SYSTEM PLAN-(NORTH ARROW) SEPTIC TANK j DS HYDRAULIC PROFILE (•_•,10' FROM FOUND*TION; 50' TO WELL GRAVITY FLOW �'v wt• (L MMUL O�tST G3'IONNOT& �I=I'3 "IZe wtcw�i a DIMEXfSIONS TO PROPERTY LINES �i „�� =DESIGN DATA: PERC &DEEP RESULTS U OCATION OF SERVICE CONNECTION 6x t 2' _CONTOURS EXIS WG & PROPOSED IS' TO PROPERTY LINE r }DRNEWAY & SLOPES, CUT rx;sf °K9 SLOPE FOOTING/GUTTER/CURTAINDRAINS (_j ORE IN SSTS AREA cm) USDA SOIL TYPE BOUNDARIES C__._) REGRADED TO 15 %, IF REQUIRED � T1TLE BLACK; OWNERS NAME ADDRESS DOSEMUMP SYSTEMS IT PE/RA; NAME, ADDRESS, PHONE# ATE'OF DRAWINGIREVISION PUMP NOTES . —3 L ATUM REFERENCE . =~ I sE" 5- Yo-OPPIPE VOLUM HOSE VOLUME NOTED _JULOCATION OF WATERCOURSES, PONDS ETAIL FOR FORCE'.M&W, (PIPE TYPE, ETC.) LAKES,WETLANDS WITHIN 200' OF P.L. IT AND D -BOX SHOWN &DETAILED ROPOSED FINISH FLOOR AND CUI. DAY STORAGE ABOVE ALARM BASEMENT ELEVATIONS CURTAIN DRS ANDPIPES T BOTH SIDES DETAIL WELLS 44 SSDS'S WAIN 200' OF SSTS' (� ' ' ERTY METES & BOUNDS •. 15' 1ViTN to CDS�S %, 20'-4%,15'-3%,35'-1'/-., 100 % -cl% 0' MIN to CD DISCHARGE/100' with 182 cons day discharge ( CONTROL FOIL: 10' MIN to NON - PERFORATED PIPE SSTS, EROSION CONTROL NOTE - '`.:��irretr�r -�, _...:.n:.,Mr2s'r — sit: ��iA�� •� °�w+..,�:...r,...�•��•...��. P SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health January 29, 2007 Robert Cameron 14 Rabbit Trail Road Poughkeepsie, NY 12603 Dear Mr. Cameron: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed SSTS — R- 116 -06 Cantwell 170 Brimstone Road, (T) Patterson TM # 25.4-18 Review of plans and other supporting documents submitted at this time relative to the above regar ed project has been completed. Comments are offered as follows: �Construction notes 14 and 15 need to be removed from the plan. . Fill pad dimensions need to be added to the plan view and profile. 3. A note needs to be added to the plan. stating.(The fill pad must be inspected by the- acting design professional and the Putnam County Department of Health before the SSTS j trenches are installed). 4. A note needs to be added to the plan stating (The existing septic tank must be pumped out prior to abandonment). 5. The proposed septic tank and pump pit locations are in close proximity to the existing well. The Department is requiring that the proposed locations be fifty feet minimum from the well or as close to fifty feet as possible. ✓ 6. In reference to the distribution box detail, the force main needs to be shown entering the /box with a 90° downward facing elbow and be noted to do so. 7. In reference to the pump pit detail, please check the dimensions shown for the tank to /8. reflect a 750 gallon tank. In reference to the typical absorption trench detail, please specify that the trench bottom and perforated pipe be set level. 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 /The construction of this sewage disposal system may be subject to local wetlands regulations. - You should contact local wetlands officials-in this-regard :--- -- -- Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Respectfully, g 6 Gene D: Reed Senior Environmental Health Engineering Aide GDR:kly 25 05.!::0.2:- _15;1-p David Bod i sher 845 878 2523 25. -1 -13 PUTNAM COUNTY HEALTH DEPAR-TMENr DIVISION OF e• • E :E►• -COMCES 225-0310 PROPOSAL FOR SINAGE DISPOSAL SYSTEM REPAIR p -2 Q � LINER'S NAME _ �i���.���{ / 1y I� +�nS PHaQE ��°1- -I�96 ;ITE WC'ATION' YQd AILING ADDRESS 5 C ,EYZSCN RmMVIEPM {fit �� �.<�i M v 1 5 , • .ef, PC HD Canpla i.nt # Name & Relationship (i.e,.owner,tenant, etc.) `7-- -� TYPE FACILITY ROPOSED INSTALLER PHONE (include sketch locating all adjacent wells): )=:. Repair must be in same location and of same type.as original sewage disposal systgn. )if ferent location may require submittal of proposal from licensed professional engineer or registered architect. . r GtiCi tr%v `S rlr r 1, 1 r Ooo ` vice o rvetl P dr ?roposal/approvled Proposal Disapproved r Inspector's Signature & Title 'r000sal amroved- with the following conditions: 11-1-17-1 to 1_ Procurement of any Town permit, if applicable. ' 2. Submission of as built repair sketch in duplicate shaving: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' dee) dxywells .-surrounded by one foot + gravel) . e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. [, as owner, or reported agent of owner agree to the above conditions. TITLE :Z c ite (PCff)): Yellnw rl^vx, BI) i Pink. LA= iar&) PAUL. P. PIAZZA Building Inspector TOWN OF PATTERSON CODE ENFORCEMENT OFFICE PV_ IMAM COUN'1"Y — - P.O. Box 470 Patterson, New York 11563 Telephone (845) 878.6319 Pau (843) 878 = 2019 September 13, 2005 RE: TM -- Z5: 1.18 (bweiling) 25.4-13 (Vacant Land) MULLI NS, BICHAIRD dt BARBARA 170 Brimstone Road (Dwelling,) 171 Brimstone Road (Vacant Land) Pattar=6 New York TO WHOM IT MAY CONCERN: According to our records, the 3 bedroom, single- tasnUy dwelling with deck and aereen room on 'the above numbered lot was evidently zone ructed prior to our Zoning Ordinance requiring a Certificate of Occupancy. The Town of Patterson did not require building permits or Certifieafts of Occupancy for above ground swimming pools or their respective decks prior to March 2000. Tbo "ding Department does not have a file or record of construction or violation for this dwelling- AD dwellings far resale MUST have Lest and smoke detectors in each bedroom and hallways prior to closing and also a CO2 detector on the lowest floor level that has bedrooms. n a igbrmation regmdmng this dwdUng was obtained from: Building Department ,'Assessor's rtcetds XC . Health Department Compliance if yon have any questions, please do not hesitate to coarsen this office. very truly yours, Building Department TOWN ROAD �M STATE ROAD COUNTY ROAD PRIVATE ROAD TOTAL P.02 Bortower CRem Cantwell Pr6erty Address 170 Brimstone Road City Patterson County Putnam State NY Ap Code 12563 Lender Geneva Mortgage ' 00mb AMN- 12.0' v 32.0' Kitchen Bath Den 0 6 c co � N Dining Living Room Family Room 44.0' 18.0' 0 0 c 10.0' Bath 12.V c v v 2. 0' Bedroom Bedroom Bedroom 'o6 2. 2.0' 0 40.0' v AREA CALCULATIONS SUMMARY Cade Deacdp6on Net She NetTakdo GLA1 Hirst Floor 1192.0 1192.0 GLA2 Second Floor 852.0 852.0 Net LIVABLE Area ( Rounded) 2044 LIVING AREA BREAKDOWN Breakdown Subtamts First Floor 26.0 x 44.0 1144.0 4.0 x 12.0 48.0 Second Floor 10A x 18.0. 180.0 4.0 x 40.0 160.0 8.0 x 44.0 952.0 4.0 x 40.0 160.0 6 Items ( Rounded) 2044 Form SKT.BldSId - "TOTAL for Windows' appraisal software by a la mode, inc. - 1.800- ALAMODE ROBERT J CAMERON JR. ARCHITECT 14 RABBIT TRAIL ROAD POUGHKEEPSIE, NY 12603 845- 485 -1625 May 31, 2006 Re: SSTS Repair , Margaret G. Cantwell 170 Brimstone Rd., Town of Patterson TM# 25 -1 -18 Mr. Gene Reed Putnam County Health Department 1 Geneva Dr. Brewster, NY 10509 Dear Mr. Reed, Enclosed please find a Letter of Authorization and Request for -Field Testing. Please do not hesitate to'contact nie with'any questions. x SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health r� DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING All information below must be fully completed prior to any scheduling. ROBERT I BONDI County Executive DATE: S 15 D CD ENGINEERING FIRM: tr J rw 9— RA PHONE #:_ 5, 485, i (P15 PERSON TO CONTACT :_'(` CAIIhC,,K.�C?J� ❑ NEW CONSTRUCTION REPAIR PROGRAM ❑ ADDITION PROGRAM REASON: DEEPS: PERCS: PUMP TEST: ❑ ROAD /STREET: 110 691 M .45TCN & TOWN: �'ri,�h1 TAX MAP SUBDIVISION: LOT #: OWNER:%��gR,�,�'r NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES NO ❑ )t Proposed SSTS within the drainage basin of West Branch or Boyds Corner & Croton Falls Reservoirs. ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ '4 Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ )9 Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ K Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. The Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ves to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professional and NYDCEP. If a project has been determined to be Delegated based on the above response and then subsequent . information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY DATE: 00 COMMENTS: REQ. FOR FIELD TESTINCKLY 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 (843) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 i� `d" PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property ofj,q�.E7 CAFtjy�1 Located at 1?0 011 M 5 To N S RD T/V WfOftOt4 Tax Map # 25 Block —J— Lot 18 Subdivision of Subdivision Lot # Gentlemen: Filed Map # Date Filed This letter is to authorize Aog:f T J C#rM%6%3 � . a duly licensed Professional Engineer 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 supe a construction of said wastewater tretment and/or water supply systems in conformity !� �' of Article 145 and/or 147 of the Education Law, the Public Health Law, and o _ itary Code .. . ......... . ... b Countersi P.E., R.A., Mailing Ads State I`t y , Zip 12-aw0 Telephone: $*6 -485 1&2.9 Very truly yours, Signed: (Owner of Property) Mailing Address: State --S� �., -� Zip Z,7- frL Telephone: 5?'Yf" Form LA -97 . . . . . . . . . . . . . . . . . . Pi1TNR C ©LINTY r: ' � V, �.• � ..d t'yJ {�..i F-_ f+cis c, r�F ly �"` .r •r�'' y- a °= �`W1erG groo. ' a t ��• -ate. -'S''^`.d; Memt� s3 c Akins a . Corners 4 jY Y ¢� c un Mful - �lrat �� @. Cranberry Mountain a` �'f �, U Wildlife Mr��nagement '*`� � '' �o. � E3 �3 a � ( The l\ w Great 1 \ 64 w o P � Q Bran < c n° A; M r ou . 311 � Swamp ,4 12563 Am y Cem n �` Q� 22 D abllBnt,I 164 4y� . Hollow � £ ' Mendel Pond Ew b4 S 164 65 wq 3 Little . o Pond ssmari Corners Pond E 62 rIEw. y �Ary9 67 �a9 d I ,Smiths r F" {t Pond. Ball utna ¢$ $ , f�..; .: ` a.n ' •Pond �Zodill. -f s '7a• ��y ao -E �: val c' Pill 200 Ft. to 4-,t. WELL p All { f n sill sisill so cl �:• w 4'Y A i�6�° i _ ti 211 pv� FO�GEMAIN,1�� 2 s 'NTp• �` w�►� l �4%� . — — j 1 M�s�fiM MM MAO , '.o.t..- wosr� tl.`_ y .,___ 1— N79!.0030• R `� - liss h{pllltAlN 5 0° MIIJ C b NAVIIALLY FOR A PERIOD FitEEjE-111A,r CYCLE OR FILL All IN APP'ROXMATELY 6 INCH D IS fill Ill UNDERLYING SOIL. . OF FILL ARE METE CONIAXTED ARIN6 AND EXGE551VE 901E S .10 A I R. P I l r