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25.40 -2 -45 & 25.40 -2 -46
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V_ { 11 PUTNAM COUNTY DEPARTMENT OF'HEALTH
3}486 ; Divislotrof Envlydnmental Health $erykee Whit - N.Y- 10512 _;Engineer,'.to ProA e'Petmlt N, j
�� ' on CERTIFICATE OF COMPLIANCE {
rr _ .,:.
t:.
- ':CONSTRUCTION PERMIT`F013'S AGE,Dh
LAmted Lake Shores DrlvE
Sabdivieton Name Pl? tnam? T aloe
Owner /Applicant Naine " M n n: -i C g .17i t
Ma2hi ,Addrosa 4 C -i r c l e Ro ac
Bauai Type '= One`:: Fame._ Res
Ntimbei o[ Bedrooms 3 3
Separate ewerage System
S to consist of 1
To be constructed
Water Sappy Pabllr Supply Froa
or: 'XXX VIM Dirk
Othei Regalrements 3 f 11 . ".'S E
a? I represent that 1 am wholly and completely..n
above'descnbetl -will be as constructed shown d
County Department., of 'Health, and that.on
be iubmittedr. to; the Department ; <' and a =wri
place.. in good :opera ing condjtion any, part
ante of the, approval of "the ,Certificate ,of�l
t will be located as shown on the approved plan I
County Department of Health,,,:,
7.
Date.. 5i16/86'
• Andress -
AOVROVED FOR CONSTRUCTION This;aF
' revocdDle for cause or may 6. e'p"mended or=;mo
Gallon Septic Tank and 3
r1.1
n- thereof a
signea�
red4ires a now. .perrnit. ':�A, roved for disposal of'dom,klc.1anitaiy. fewaye
Date By
i
-:.l rvaau awuu�suvu�e- roy�ucw�uou rau s Wry _,.,1.
.LF. of .Leaching '.Treriches� ,5 �.6 ' b-Za
rents Pawling;
,t
rose
Brewster 1VY
eas
f the proposed systems) 1) that
"stem
_,t
6 ii accordance wdh the standards, u a ions-0-
am
onstruction Compliance' satisfact Co- ner.
wrier, his w ssors heirs or aui' b i or. t satd u
I '
g th I per f two "(2.)' yea►s'1 fo
-
�ob
ial, site r•� �y, repairs thereto• t t_the. ii
cor nce w' h' he itantlartls'- d,"reg s the
a '.
m
VVe.�
R
`
38 -M o ac , NY , 0 ar 1
issu uMess tonstrucbon of the bui h 4 W
hey OmmisSioner.of"H6alih....Any thing stiuction
it privat0:, water Su
and . �s
: � ?
'f
f
� •
Tdle
.._
DAVID D. BRUEN
County Executive
i
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
July 11, 1986
Coxeter and Coxeter
123 State Street
Albany, New York 12207
Attn: Ms. Susan Coxeter
Re: Proposed SSDS
Virgilio
Lake Shore & Jordan Drive
(P) TM 21- 4- (9,10)
Dear Ms. Coxeter:
JOHN SIMMONS, M.D.
Deputy Commissioner
As per our conversation on July 11, 1986, enclosed is a copy of the
letter sent by this Department on July 7,1986 in reference tp the above captioned
property.
Please contact this office if additional assistance is needed.
Yours,y ery truly,:
Robert Morris
Environments Heath Tec cian
TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
F
DAVID D. BRUEN
County Executive
Mr. Joel Greenburg
RFD # 2,Box 488
Muscoot North
Mahopac, New York 105.41
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
July 7, 1986
Re: Proposed SSDS
Virgilio
Lake Shore Dr. & Jordan Drive
(P) TM 21 -4 -91
JOHN SIMMONS. M.D.
Deputy Commissioner
Dear Mr. Greenberg:
Review of plans and other supporting documents submitted at this time
relative to the.above- captioned project has been completed. Comments are
offered as follows:
The above captioned property does not meet-approval requirements at
this time.
During a field inspection on June 6, 1986 seasonal high groundwater
was recorded at 2 feet below existing grade. If the intention is to lower
the groundwater by means of a trench or curtain drain, this must be performed,
and deemed adequate, by this Department before the approval process can proceed.
Upon receipt of a submission, revised to reflect the above comments, this
application will be considered further.
Yo ery truly,
Robert Morris
Environmental Health Technician
RK%jP
cc:'Monica Virgilio
4 Circle Road
Tuckahoe, New York 10707
T \Afn r ni WTV r 9:K1TGD - ('AQAAP N V 9051) (Q9.1) 77tZ-9r-A9
7
DAVID D. BRUEN
County Executive
Mr. Joel Greenberg
RFD # 2,Box 488
Muscoot North
Mahopac, New York 10541
rA
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
July 7, 1986
Re: Proposed SSDS
Virgilio
JOHN SIMMONS. M.D.
Deputy Commissioner
Lake Shore Dr..& Jordan Drive
(P) TM 21 -4 -9:1
Dear Mr. Greenberg:
Review of plans and other'supporting documents submitted at this time
relative to the above- captioned project has been completed. Comwnts are
offered as follows:
The:above..captioned property does not meet approval requirements at
this time.
During a field inspection on June 6, 1986 seasonal high groundwater
was recorded at 2 feet below existing grade. If the intention is to lower
the groundwater by means of a trench or curtain drain, this must be performed,
and deemed adequate, by this Departwmt before the approval process can proceed.
Upon receipt of a submission, revised to reflect the above comments, this
application will be considered further.
Yo ery truly,
Robert Morris
Environmental Health Technician
RM/jP
cc: Monica Virgilio
4 Circle Road
Tuckahoe, New York 10707
r�
:K:�• :�:o✓•:yC =< rc1 :: �+Y�-
—r'
ia"}
�-.,v v^^'[f'+�vi^•
lTP-:s
.F
ft.
INITIAL SITE INSPECTION YES Z" NO
COMMENTS
Wetlands on /or proximate to property ..............
-
pay"VnAm peewlto e-1 F
5
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY /SUBSURFACE SEWAGE DISPOSAL SYSTEMS rc
FIELD INSPECTION REPORT
ft.
1O / C ' i
IN P. BY:� ,
i2
(Name of Owner) (Street Location) -
ft.
INITIAL SITE INSPECTION YES Z" NO
COMMENTS
Wetlands on /or proximate to property ..............
ft.
pay"VnAm peewlto e-1 F
Property lines or corners found ...................
Can estimate house location ........................
Will driveway need cut ............................
Must trees be removed - note these.................
Deep holes representative of entire SDS area.......
Additional deep holes needed.......... ..........
Sufficient SDS area available considering driveway
cut, house location, separation distances,etc...
7
Adjacentwells /septics ............................
Access to prgposed well location for drillin ..
D.H. - Deep Hole
G.W.- Groundwater
D.H. 1 Lot D.H. 2 Lot
D.H. 3 Lot
Depth to G. W. Depth to G. W.
Depth to G.W.
Depth to rock Depth to rock
Depth to rock
Soil Descri.pt,
0 ft
3 ft.
6 ft.
9 ft.
12 ft.
FINAL SITE INSPECTION
Mi
Soil Descri tion
0
ft.
/ 3
ft.
6
ft.
9
ft.
12
ft.
DATE: _
INSP.BY:
House SSDS located per approved plan .............
Length of trench measured
Width of trench average
Slope of tile line and trench acceptable.........
Room allowed for expansion trenches ..............
;:Over 100 ft. from watercourse ....................
Natural soil not stripped or SDS area
unnecessarly graded.............................
10 ft. maintained from property line and
20 ft. from house..... .......................
Distance well to SSDS (ft.) ......................
Number of bedrooms checks ........................
Stones, brush, stumps, rubble, etc., greater
than 15 ft. from nearest trench ................
15 ft. of peripheral soil horizontally
fran trench ..... ...............................
Boxes properly set.. . .... . .. .........
Could surface runoff fran roads,
ground surface, etc., channel near SDS area....
Does lot drainage appear OK in area of SDS.......
5oll Descrl
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
P
C5
PUTNAM COUNTY'DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date May 16, 1986 ,
Re: Property. of Monica Virgilio
Located at Lake Shore Drive & Jordan Drive
(T) Patterson — Section 21 Block 4 Lot 9
Subdivision of Putnam Lake
Subdv..Lot ## 3737 3741 Filed Map ## 149 -E _ _Date March 30, 1931
3747- 3751
Gentlemen:
This letter is to authorize Joel L. Greenberg
a duly licensed professional engineer_ or registered architect xxx
(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.
�aED qR
NCE GR Chi
Y
c
0.
A
44!
Very truly - yours,
®.
v.
Ca
Of NF-%N
Signed
to
Co to sig d:
Owner- of- P
. erty
P.E.,ft .,#
11056 . ..._._ ................
4 .0 -ircle Road .....
Address
_ musrnnt mnrth
Address
RFD #2. Bx 488
_ Tuckahoe New York 10707
�
Town
_'Mahol?acNY
10541 —
.914- 779 -7683
Telephone
914- 628 -6613
-_. __.
Telephone -
--------- - - -
- --
DESIGN 11ATA SHEET- SEPARATE
SEWAGE' "DISPOSAL SYSTEM` PILE NO.
Owner Monica Virgilio
Address 4 Circle Dr.,Tu6kahoe.,Ny 10707
LQCBted at. (Stfreet') Lake Shore
&JordaSec. ' .21 Block 4 Lot 9
ca e
neareat cross street) ... .. ._ , ,
Municipality.. 'at'te so I.
Wate s Croton
.:•.SOIL PERCOLATION TEST
DATA
MUIRED.TO BE SUBMITTED WITH - APPLICATIONS
Number CLOCK. TIME
PERCOLATION PERCOLATION
tun apse
Tepth to Water 'Water ve .
No. ...::.......... ._._.......'. Time
From. Ground Surface in Inches Soil Rate
Start -Stop Min.
Start Stop Drop in 'Mi.n. /in drop
Inches Inches Inches
PTH #1 .1-9:45 "• 10: 15
30
15 17.75 2.75: 30/2.75 =11
2....10 :19. - • . 10:49
30
15. 17.75 .2.75 30/2.75=11
3 10:53 = 11:23 .30.
15 17•_ 75 -2. 7-5 30Z2.75=11
5
PTH #2 1..9':50: 10:20
30
16 19' 3 30/3 =10
^-
3043
11:.22
30
16 18.75 2. 7 30/2..75 =11
2 �-
Notes: 1) WAts to.be repeated at same depth until approximatelyy equal soil
rates are obtained -at each percolation test hole. All data to be submitted
for review."_.
'2) .Depth measurements to be made from top of hole. �.
Name Joel L. Greenberg Signature c`
Address Muscoot No,RFD#2,Bx 488 S
Mahopac,NY 10541
THIS SPACE FOR USE BY HEALTH DEPARTP4ENT ONLY: ATE OP NEB 4o
Soil Rate Approved Sq. Ft /Cal. Checked by e
4
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOTLS E NCOUN`'ERFD IN TEST HOLES
DEPTH
HOLE NO. DTH #1 HOLE NO. DTH #2 •HOLE NO.
G.L.
Top Soil Top Soil
611
....................
If
1211
18"
Sandy —with Sandy - with
24"
Silt & clay Silt & clay
3011
& Small stones & small Stones
3 11
ii if
442211
„
.48"
-.5411
If
60"
6611
72„
n „
781+
If
84"
. .
INDICATE
LEVEL AT WHICH _GROUND WATER IS ENCOUNTERED
- �T+LI�tiTE
r�.. _ __ _
I;"VLL TO- '���C- H-- :AmEF�- LES -.�L- RISES .- AFTE;R._BEIIYG,�ENCOUNTERED 3' from _ground_
TESTS MADE BY Raymond Carter Date April 25,1986
DESIGN
Soil Rate
Used 11- 15MirVi "Drop: S.D. Usable Area Provided 80 x 80'
No. of Bedrooms
3 Septic Tank Capacity 1000 Gals. Type_
_
Absorption Area Provided By 375 L.F.x24" xxx b" wid
Name Joel L. Greenberg Signature c`
Address Muscoot No,RFD#2,Bx 488 S
Mahopac,NY 10541
THIS SPACE FOR USE BY HEALTH DEPARTP4ENT ONLY: ATE OP NEB 4o
Soil Rate Approved Sq. Ft /Cal. Checked by e
4
CLEANOUT
COYER
F:
-1 it
W11 RE19tFORCING Asas 27' x r
itswimo. 'xspfCrwN 17
COVER COWER
F77!
SEPTIC TANK SPEICIFIbATIOM & CAPACITIES
SECTION A-A
U-
I .
r vEwT
. - W 4
f
t
UOUW LEVEL 48"
INLET/
W, to
wrlic
CAPAWT
\BAFFLE
/
I"AT
6-xs- OUTLET
SEPTIC TANK SPEICIFIbATIOM & CAPACITIES
SECTION A-A
U-
A
INLET/
W, to
wrlic
CAPAWT
LENGTH
WSDTI4
I"AT
WZD
WWM
SC40
OwTLIT
Atil
p.
T- f4,.
t .o - o
N,
10 #CXA.
4-1
C-
1-1
Zl
� a L.AKC tl
SSDS asp*, V,
200.
Z-746'
.4m1 rq , 7 ib "Pul
1� i .,
N _V1. Z:� . \ 1,
x ;4 -0/ row
200
-00
.00,
rorcA
dORDA N DRI
Jos,n
IC�Gf'Cl 01'
c jDs cs per 0.fEr
O.fly 0
L.. T- r
MOM-- I
at I V A
0
t^ 4f -J:4 TJ
05/17/01 19:45. PW SCOTT 4 2787921 NO.003 002
BRUCE . L ' FOLEY '
Public Health Director
DEPARTMENT
1 Geneva
Brewster, New
- C012ETCA lvfilLlPtARI R.iv.I- M.S., N.
Associate Public Health Director
Director of Patient Services
OF HEALTH
Road
York 10509
JLk*1111 0; a ate-oxmitl
ATTENTION: 0 ADAM STIEBELING 0 GENE REED
All information below must be fuU completed prior to any scheduling. DATE: 6-
ENGINEER OR FIRM: —: LA SCOT' 00A. I PRONE #: Wr A7 [r--1 11O
REASON:
DEEPS: R PERCS: x PUMP TEST: 0
ROAD/STREET: 40 Dt,,-b 09-4 Lh-r
TOWN: SPI��2 -` > 0 o TAX MAP #: ;57 Y 0 - Z - S V4
SIlBDIYISION: LOTH: I$10 .
OWNER: FhOS R A
u e Nom- _ e : 1 ►� J.42U 7V_ 41 v. s
YES N9
o d Proposed $ STS within the drainage basin of West Branch or Boyds Corner Reservoirs.
0 W Proposed !;STS within 500 feet of a reservoir, reservoir stem or control lake.
0 - Proposed ! /STS within 200 feet of a watercourse -or a DEC wetland
O l°� Prugosed ; /STS design flow greater than 1000 gallons /day or SFDES Permit required.
o t� . Proposed ;STS for a Commerical Project.
It is the responsibility of tie design professional to provide the above information prior to soil testing.
This Department will determine the NYCDEP project status (Joint or Delegated) based on the
response. If you answer : d -,_e£ to any of the questions, NYCDEP must witness the soil testing. This
Department will coordin::te a mutually suitable time for field testing with the PCDOH, the Design
Professional and NYCDE ?.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates NY CDEP is required to witness the soil testing, 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: �� 1 �i �Pi TIME: � -/02 22 tQ %&c t '� 0
CO!►tM&NTS:
(MLOTEST)
Cranberry Mountain
CC
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r Z %
z O
Peed
$�a {��
i
I d 1
Mns�
RD
aviiand
r Olio''c
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y
164 65 ° g
NJlE9
iames
fo
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tcN
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s.
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— -
- - -- - 6
-- -
wirl
Porid
4 make - - -
mum
iti Lost
.6.6
A1
o � Lake
harles School
oe
Ique Area Mount Ebo t�\\ r r$ Alli
Corporate +! ��` e
Corner
Pond
i lIJJ JIJ! / '
lb
i JIID / JIJJ
21 ' NO
Na JISf l JI6I I J_I6J l~ - -
_ .. "� •� Jlnl 191 / 1 r !aC ! _ _ _ ..
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LEGEND
25.32
�
- o
PRELIMINARY MAP 25.4D
SCALE 111
TOWN OF PATTERSON
- - _ - _.. _........ _ _ . -- _. _ 50...
PUTNAM COUNTY, NEW YORK DATE a Amm wocRArtt+. „. „a -10.67 GATE W MIP._.2
N+ STIIE RAZE COOf�iM1E9 IRE MADBi IK
.A,I was L.E Iw :,+ex �s.
OEYELOPflIS l01 MIA9tl1 J
=0 COMM (01
�0 CIIE1AIp1 . _ . -.... � ,00c :� _
cuauTEOMG L7a AC cu
}ARCH lII.OU 1?
25.39
25.4
—i
25.47
25.48
25.49.
Ww” mm
o,.
05/17/01
l
� , -
• .: ' � .•� iii/ �` \ \ r -•�
J-4- 1 • I --
<-;,�
oe
an
Z.
o
�. / �•••+•� . ` ` ice•. '• wIa ' 1 1 »`�} =no• rr I . �:t
• M„ ter.._.. 1 � '/ aw 11•• d1i ;,�-
'; ♦I ♦'a --� I i +- �, \ � \ • O ~ . ^� ''� ' � � +•��••��y y I•w ' 101 •w 1 � � -
..t-. •:',•,t' k � �:���1�`� pe »^•ti- _ 11w� y •'N ( :. r.►�-- M •� :wn: ��t �'{'i'r
-j. • \•`,. ♦ ., / �/ ms's `,K
, ' bC�.••; �.1 ••!�,•^...•w•' ••wf •.♦ ~ f i' ~1
_O I/ f =�
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IL
d9>
CD
. •fin _ / � n.f�?
19:45 PW SCOTT � 2787921 NO.003
003
L -`*�
N�
7
TEST PIT DATA Q 2
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE NO. =HOLE NO.: HOLE NO.
f � k
t , 1 Sc[t y
3 5'
1 6vo. -{cy k�b�,9e
8 -y',
f
Aic&ma 02
t:
Design Professional Name:
Address:
Signature:
Design Professional's Seal
- .._..__ . - - - - - - -- .............
PU'I'1�TAM C ®1[T1�ITY Y)EPAI�'ME1�IT ®1F HEALTH
DIVjISION- OF - -]E1 R-ONM -ENTAL REALTH- SE]kVlCgS-
INITIAL, INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM
SECTION A. GENERAL INFORMATION
Name of Project PkM 771 ( _,07 -r- 250A/ County INvMAZIAM
Site Location J'"o127�.q.v 2a0
Building construction begun p Extent
Is property within NYC Watershed ? ................. Yes F__J No
SECTION B. TOPOGRAPHY (Please check all a7pi ropri a boxes)
1. Hilly Rolling a S ep slope_ G entle slope - E Flat
2. o Evidence of wetlands Low area subject to flooding Bodies of water
vary u,cf-
Drainage ditches - Rock outcrops
3. Property lines or corners evident.......:......... - Yes No
4. Do water courses exist on or adjoin the property
-Sec la -- - --
5. Will these affect the design of the sewage system facilities ?............ Y No
6. Do watershed regulations apply in this development ? .....................:. Yes No
7 Will extensive grading be necessary? ................ ............................... Yes
�..
' -- a. Wil'i extensive fill be necessary for SSTS9 ........... Yes
9. Do filled areas exist within the SSTS area?..:... ................................... Yes No
If yes, what is the condition of the fill?
SECTION C SOIL OBSERVATIONS - -- -- -- - - -- - _ - ::- - - - - -
10. Appearance of soil: Sand Gravel � Loam FBackMhoe lay F Hazdpan F Mixture
11. Observed from: 0 Borings 0 Bank cut excavations
12. Soil borings/excavations observed by 67. eeo �� G , l7, H ; on i
13. Depth to groundwater ' - o" on
14. Depth to mottling 3 ��D'� on
15. Are test holes representative of primary & reserve areas ... :.................................
16. Soil percolation tests made by �f L�/. SG o T7' on
17. Soil percolation . tests witnessed by 4" Teegn 'P, G. U. H. • or
SECTION D (on back)
n
Form ST -i -- -
re
SECTION D. DRAINAGE
18. Will proposed grading materially alter the natural drainage in this or adjacent areas? Q Y s No
19. Will groundwater or surface drainage require. special consideration? ..................... Yes eN 20. Will gullies, ditches, etc., be filled and watercourses be relocated ?........... .............. � Yes
SECTION E. REMARKS
21. - If a common water supply is proposed, has an inspection been made of the
existing or proposed source and facilities? ....................... ......... ........................... Yes No
Inspection data
22. Do adjacent wells and/or sewage systems exist ?........:.. VtT /.N...6.......... .......... E6 Yes No
23. Additional comments
- lL
sip -mss
24. . Site observer /inspector and title - --
--
25. Date(s) of observation(s)inspection(s) 6/.
%:/
TEST PIT PROFILES
Hole # Lot #
Hole. #_ " . " Lot #
. - : - Hole# - Lot #
Depth to water
Depth to water
Depth to water_ -
_Depth to_mottli_T!g -- - -
Depth to mottlirg
Depth to mottling
Depth to rock/imp.
Depth to rock/imp.
Depth to rock/imp.
G.L.
0.5
0.5 0.5 -:
0.5 - - - -= -- -
2.0
2.0
2.0 -
3.0
3.0
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
I acknowledge receipt of this report: SIGNATURE.-
02/196 Title;