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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.47 -1 -13 BOX 10 11••• 1 Wr :: NIL. J ■ � �� I I r "'r• blF ' f ♦ � 'I ti `B I ' ■� 11••• A�\�o �\(� PUTNAM COUNTY DEPARTMENT OF HEALTH C..___DLV.ISION QF_ENVIRONMENTAL HEALTH SERVICES_._____. . CERTIFICATE OF CONSTRUCTION COMPLIANCE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # f- I-7 -8l / 1 Located at Town or Village Owner /Applicant Name Tax Map 2e. 4,'J Block �_ Lot 1�7 Formerly Subdivision Name 0TR #1APA`_ PJTiJ*4 LAW0, Subd. Lot # -11 q-4 -7i Jj2, i k1 LLl15lJe_ Mailing Address �ir✓�, %+ p Mt �Arrre?-e� 6%ng11A t4-y. Zip 1015-6Z Date Construction Permit Issued by PCHD O °A"lei Separate Sewerage System built by Nif<ow AA4 g h�ddress64o4 61ff wI Consisting of 1 000 Gallon Septic Tank and.. aJ (r.� G�,����i�,f�p•1 � -� W r &n sis result for soium a i ._ - -- 3U 0n;ainiuS -more than 20 •-ngil ofrodiu m should not be used f6r o drinking by pe0. ple on severeiV Fac.',4 .. `. s;odiwn diets. Wetter containing Other Requirements: r /� . �;sed by panpie an moderately Water Supply: r�rt�`s. . � -- ...,�' "- ,A�dressLPT. OF HEALTH 1ac�, C7'qX 718 r or: X Private Supply Drilled by AL 4W H�&ff � l�p Address FA'f?CC�a� -Building Type -� Has erosion control been completed? Number of Bedrooms Has garbage grinder been installed? t�D 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 regulations of the PutgR County Department of Health. Date: Certified by Address It UJ0` kAA4J 5T, Any person occupying premises served by the P.E. X R.A. License # 4_&*** I I' && system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditionis 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 ar bject to modification or change when, in the judgment of the Public Health Director, such revocation in d' ication ange is necessary. By: Title: ,�(f� `-� Date: AJ13 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 BRUCE R FOLEY x LORETTA MOL1TiARI R.N., IvL3.N. .._._ • -- -__ ._ _ -Pubhc �leerlaA-- D:rec:er•— :....._ ._._.__...... ......___.�._. fi� � - "" �" - ._-_ Aasoc`tata P�oUc Xealth Diracter Director of Patient Services DEPARTNENT OF HEALTH 1 Geneva Road Brcwster, New York 10509 Environmental Health (914)278-6130 Pot (914) 278 - 7921 .ursine Servteee (914) 278 .6559 WIC (914) 27S .6678 Fax (914) 278 - 6083 Early Interveatlari (914) 2-18 - 6014 prachoof (914) 278.6082 Fax (914) 278 - 6648 OWNERS NAME- TAX NIAP.NUMBER: 94 101 taxy z 3; -/, -/- /3 E911 ADDRESS: ®Z / r Va 4 T �PoA TOWN: pVAT %%�S o AUTHORIZED TOWN OFFICIAL: (Signature) DATE: 14/ /o/ o G The Putnam. County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. 'E91 11v FRX 1 YML ENVIRONMENTAL SERVICES 321 Kear Street '--' -^--------�--'------Yor,ktdiWh-H6 i-h��, "'1��98--~------�-��------.----`-------- (914) 245-2800 Albert H. Padovani, Director LAD #: 93.001965 CLIENT #: 12705 ` NON STAT PROC PAGE I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~°~~~~~~~~~~~~~~~~~~~~ NITTOLO, NEIL DATE/TIME TAKEN: 10/03/00 11:30A P.O. BOX 378 DATE/TIME REC'D: 10/03/0() 12:00P BREWSTER, NY 20509 REPORT DATE: 10/12/00 PHONE: (914)~278-4445 SAMPLING SITE: SAMBORN RD. : PUTNAM LAKE, NY COL'D BY: NEIL NITTOLO NOTES ... : KIT TAP ---------- M ---------------------------- DATE FLAG PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C C8LIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE PUTNAM CNTY PROFILE 10/03/00 MF T. COLIFORM ABSENT /100 ML ABSENT 10/03/00 LEAD (IMS) 1.3 ppb 0-15 ppb 10/03/00 NITRATE NITROG 1.87 MG/L O - 10 10/03/00 NITRITE NITROG <0.01 MG/L N/A 10/03/00 IRON (Fe) 0.332 MG/L 0-0.3 mg/l 10/03/00 MANGANESE (Mn) 0.016 MG/L 0-0.3 mg/1 10/03/00 SODIUM (Na) 34.4 MG/L N/A 10/03/00 pH 7.0 UNITS 6.5-8.5 10/03/00 HARDNESS,TOTAL 310 MG/L N/A 10/03/00 ALKAL%NITy (AS 146 MG/L N/A '(TUR-- COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATER( AS NOT) OF A SATISFACT8RY SANITARY QUALITY ACCORD IN NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. mblic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a'sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. METHOD 1008. 9101 9139 9146 2037 YML ENVIRONMENTAL SERVICES _.�___- -'321__Kear_-Street�-__-'_'-_-____--_-__''---------------- Yorktown Heights, N.Y. 10598 (914) 2800 Albert H. Padowami, Director LAB #: 93.001965 CLIENT #: 12705 NON STAT PROC PAGE 2 ~-°~~~~~~~~~~~~~~~~~~~~~~~~W~~~~~~~~~~~ ~~"~~~~~~~~~~~"~~~~~~~~~~~�~~~~=�~~~~~~ NITT8LO, NEIL DATE/TIME TAKEN: 10/03/00 11:30A P.O. BOX 378 DATE/TIME REC'D: 10/03/00 12:00P BREWSTER, NY 10509 REPORT DATE: 10/12/00 ` PHONE: (914)-278-4445 SAMPLING SITE: SAMBORN RD. : PUTNAM LAKE, NY CQL'D BY: NEIL NITTOLO NOTES...: ){IT TAP ----- —m --- --mm— ---- m ---- m—m—w- DATE FLAB PROCEDURE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF �-------------------------------------- RESULT NORMAL - RANGE METHOD 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. SOFTWATER: 0-70 MG/L VERY HARD WATER: ABOVE ��{L�E�L--'__- --'- 'MOO ERATf�L\7'A���-W�--------1-'^ -/--- '----/L- - �--* '� |�r�: ro- �V �� � M8�_ =-, MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: —Z Director ELAP# 10323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM D ZO. 4.1 i I Owner or Purchaser of Building Tax Map Block Lot N rT-(2V0 (A0 qrnj:,N� P+ T KX -M& Building Constructed by Location - Street Building Type f7A-T TownNillage .y 1V A? ' �►� 1 L... Aa Subdivision Hof *�p 71444— -- 715✓4 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 occupant o the buildin t'li 6 g t system. D4 d: M/h 10 ay, Year 00 Signature: Title: - Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: 46* 6-r - Address464- 6HPhROLA State Zip _ I C,1A State Zip 5j do Form GS -97 PUTNAM COUNTY (DEPARTMENT OF HEALTH (DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well-Location- '' — Street-Address:- 17V` "" "'" " "lam,— �jown7Viliage: - Tax Grid # Map ZS,VBlock Lot(s) /3 Well Owner: Name: Address: s Use of Well: 1- primary 2- secondary Residential Business Industrial Public Supply Air. cond /heat pump . Irrigation Farm Test/monitoring Other(specify) Institutional Standby (Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details Total length _ft. Length below grade _9 ft. Diameter. 7 in. Weight per foot _11_lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded _X Threaded _ Other Seal: K Cement grout , Bentonite Other Drive shoe: —XYes No I Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped X Compressed Air Hours Yield gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 6 r If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type &,J4 Capacity 7_OM Depth 1O0 Model. 7igt5 Voltage 30 HP Tank Type &*r0l Volume 86 6V4. Date /11.l Co leted 00 Putnam County Certification No. 007 Date of R port Well Driller (signature) NOTE: yExact location of well with distances to at least two permanpfit landmarks to be provided on a separat,�lfeet/plan. Well Driller's Name ti rl ua � Address: &9 Ac 3/Z AtErSOh Signature: Date: ffhlob White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 � ZARECKI & Engineers Planners ll West Main Street PAWLING, NEW YORK 12564 (845) 855-3771 -------Fax (845) 855_3772 TO WE ARE SENDING YOU El Attached O Under separate cover via � O Shop drawings OPrints OPlans O Copy ofletter O Change order O ____ � /�\�� ��zsu u ��uo `�/u- u uUHNOu u uMu= O Samples the following items: 0 Specifications COPIES DATE NO. DESCRIPTION For approval O Approved ussubmitted O Resubmit —copies for approval • For your use O Approved oonoted O Submit -__-_-__ copies for distribution • As requested O Returned for corrections O Return —corrected prints cz 00 cota For review and comment O O FOR BIDS DUE O PRINTS RETURNED AFTER LOAN TOUS "'' ""C=^"= =o=' ' - - - ----'— -^ - — O For approval O Approved ussubmitted O Resubmit —copies for approval • For your use O Approved oonoted O Submit -__-_-__ copies for distribution • As requested O Returned for corrections O Return —corrected prints � O For review and comment O O FOR BIDS DUE O PRINTS RETURNED AFTER LOAN TOUS REMARKS COPY TO SIGNED: `~-- a enclosures are not eonoted, kindly notify yoat once. JL ANBO S �- _ _ ---- -- =--- -� MIN. = ESE TRIO ►MR � � • 2 415LF I 0 I 45LF '� ` v 46LF N1 kp 46LF CL o m h 49LF� 1�j — --- o M I col I 51 LF nNC\ BEROOM D 52LF l � I 11\15 PROPOSED . SION AREA 1007, EXPAN N51 27 00 180.00v:, 7153 EXI s THREE 7154 FG x HO U I I a x ? IC) 7155 2 P• / P 71_ I to F I I OD I to d I ^I �I I Al -F DIMENSION TABLE_ -_- ......_ _._. No. A B 1 15 28 2 21 29 3 26 26 4 30 25 5 36. 25 6 42 27 7 46 29 8 52 32 9 86 75' 10 84 74 11 81 74 12 78 73 13 76 73 14 75 .75 15 73 75 �x f Putnam County Department of.&al Division of Environmental Healthe as f Lpprµ� *84 as noted for conformance cc-, apg ica a Rule and Regulations`$ , the am C He lth Departme'Lt '" rat:, t:d} G cd j t.gnature &Title D SEPTIC SYSTEM AS-BUILT i PREPARED PREPARED FOR t }1 EVEN & MARY L. DELANO ' I TOWN OF PATTERSON, PUTNAM COUNTY, NEW YORK I 4' APPROVED BY: J.Z. DRAWN BY.• M.S. 2000 PROJECT NO. 2000.122 CHECK BY. W.A. XKI & ASSOCIATES, L.L.C. DWG. NO. f } ENGINEERS & LAND SURVEYORS } ,:........w..,...rry • . _° - • raouc qu s rsvm. _.., -. - _ _ i- pr: Private SUPPIY e0 by '_ P A n Other Requirements I repre_sent'that I am wholly and. completely resD nsible forthe des above Described will be constructed as shown on the'approved.amen County - Department of Health, antl that•on e: completion thereof a be. submitted to the Department, and a written guaiantee.wilil .. plac im`gootl - operating conDition anylipart of ;said ,sewage: diso ante of the - approval bf the ,Certificate- of,Constructions Compli will be located as shown_ on,the.approved >'plan and that said well -will ` -, County Department of Health. Date ✓�i�f� 1 -;1 11p�� �, n AddressJ_LlCZ1sK� 1 APPROVED FOR'CONSTRUCTION This- approvarexpir4a w ye; .i,,,_!-'revocable for cause or may be.'amended O[. motldied(:When c s' erg ') requires a- new permit.`,. ApplOVetl for 'tl ispOSal'Of "tlOmeAiC *sand ce of th 6�installe Of rr t. Rev..., 1/87 ,i Data = 8v . r.a parate -- sewage dispoial system standards rules an F.— "ZMM—ons.ot Ine TuInam. a tisfactoryto -the Commissioner of Healthwill - - efrs;; 'assiyns_by the builder, that said builder Will f✓, yea 'Immetliately following the -date of the issu it thei o; 2),that the drilled wall'Cesciit »d above Stan ` rQs; rules and .regu a ions' 'of the Putnam , PEA +RA_ License -No t c Iton f the building has been undertaken and is , ny change or alteration of- construction jSP nly, _ Title'— �.. _ . _ ,.... -. -� _ _ - - _ _. ,. y -� �. i t i i i i j t C� - a DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 October 9, 1991 Kr. Michael Doebbler Site Design Consultants PO Box 423 2070 Saw Kill River Road Yorktown Heights, MY 10598 Re: Proposed SSDS: Sieck Tivoli and Sanborn Roads (T) Patterson TH #52 -5 -5 Dear Kr. Doebbler: JOHN KARELL Jr.. P.E.. M.S. Public Health Director 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: 1. Provide current tax map number. 2. Property metes and bounds have not been provided. 3. Fill section detail is to show fill tapering 3:1 to grade. 4. Plan is to shot top and toe of the slope of the fill. 5. All separation distances involving fill material are to be measured from'toe of the fill. 6. Proposed curtain drain is shorn discharging on to the adjacent properties SSDS. This is not acceptable. 7. Review of the records on file in this Department indicates that standing rater was recorded on the above captioned lot by William Hedges, Senior Sanitarian, and the writer at separate times. Therefore, deep test holes and percolation tests are to be witnessed by a representative of this Department during time of seasonal high groundwater. 8. Trench design has not been submitted, i.e., equal distribution system has not been shown in fill section. 9. SSDS profile has not been shown on trench plan. 10. Fill note 3 shall include "fill suitable for absorption should contain no more than 5% and preferably no more than 20% fines by weight. Fines.are silts and clay particles that pass a 200 sieve and no more than 10% by weight, of the fill material should pass a 100% sieve." 11. All curtain drain installations are required to be provided with vertical standpipes of 4" perforated PVC to a depth of 7 feet, installed 5 feet from curtain drain, on each side. 12. neighbor notification is required as per outline in the Putnam County Program Review and Policies for individual.sewage disposal systems. Upon Receipt of a submission, revised to reflect the above comments, this application will be considered further. Verr truly yours,,, Robert Morris Assistant Public Health Engineer RM /Jp Sfre--De..si.gn- Consultants Civil Engineers • Lend Planners September 27, 1991 Mr. Robert Morris Assistant Public Health Engineer Putnam County Health Department 110 Old Route Six Center Carmel, NY 10512 Re: Proposed SSDS for Eileen and Walter Sieck Dear Robert: We are submitting the enclosed items for your review and approval of the referenced project: - Three prints of the proposed fill plan - Sketch showing the system layout - Authorization letter - Design Data Sheet - Construction Permit (for filling only) - Well application - Certified Check for $300 Please contact my office to schedule having the test holes reopened. Thank you. Yours truly, Michael T. Doebbler MTD /cm Enc. P. O. Box 423 • 2070 Saw Mill River Road • Yorktown Heights, New York 10598 19 14) 962 -4466 V//J - V 1 � � 0, =r"T" `'rp` K - > a/ r s Z4,yam` Ci e 1 PUINAM COUNTY DEPARTME Rr OF HEALTH DIVISION OF ENVIRCNMENTAL HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.. Owner = . 6 press r�Y Located at (Street)S,t��gpe Ro 1V Sec. Block Lots ` (indicate nearest cross street) Municipality ,d,"r`j F= SaJ Watershed Date of Pre - Soaking Date of ''Percolation Test ; • '�,1 i HOLE NUMBER CI= TIME PERCOLATION Run Elapse Depth to Water From Water Level- No. Tine Ground Surface In Indies Soil Rate Start =Stop Min. Start Stop Drop In Min/In Drop Inches Inches Inches 110;60-1,01424 ZD z---A:: 210'30- 054-7,4- lo 2 3 310.5 -- 11:'22 24- 2-a : Z3 3 8 5 21 Z0 311: av--I 1!,3-5 7 .� 20 25, 4 5 10*CPCI - �a.3c� 27 Za 23 210'40 -11:01 2 7 2-0 '' 3 31Ii2� it %1 �i 2© 23 fir, ..c�► 4 5 NOTES: 1. Tests to be repeated at same depth until apprm mately.equal soil rates are obtained,at each percolation. test hole. All data to'be submitted for review. 2. Depth measurements to be made fran top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION OF - DFPTH HOLE NO p G.L. CrSo 11e 2' 3' t , 4' e— LA---r QAM 6' 71 8' `l 9' a , 10' i_ J 12' i 13': f INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL To WHICH WATER LEVEL RISES AFTER BEING ENOOUNTFRED. % -p DEEP HOLE OBSERVATIONS MADE BY: �J IT �, _ V �.Tt�S DATE: - DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided 50C)O± No. of'Bedroans Septic Tank Capacity .I is• -Type Absorption Area Provided By L.F. x 24" width trench ; 2 n Other ? . J (� :- D. b...s, QAVG l- F-I t_i.._ 6 F� i 1 d IN TEST HOLE N0. t Aga, Name Addre Signatur SEAL'" . v ' �0. 644 THIS .SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft/gal. Checked by Date ?t :� CCUI\'iV ��� :'y'` -'�'1' CF f-._a -=H - 111 -c1C.V CF �� LCO?� ?t-"J - =� �'-i SZRy: 22 1 71 r, c �T S- =- �� =C D7S �- r -ZS=- I. j;r � Uhl & t �.t =, !1C' tee` cn DrOV1(aa _ eauire3 60 fL t. 00 Eta. � lvDAx, /Ed 11 ? =wit a c1 i c_ ticn fzrDcra te� Rescluticn Plans - Three sc-+ s --uthcriz =ticn Sh •t (DD:.). Deep Hole ,-) COi?S_S* e.''- ?cS.L'' -s Perc tole ceot.7 /S (r) fi_ Cd �;O':5e Plans - do set.-S Wall = =--ut; Variance R? ue5 t =l -RZTI 7e' al S7 bdi v` s - Oil SuJGl -v? S� On AnoroC-al C`:ec {c1 =i-aoo cvGl SSDS Ad!. !o L5 Checkei Ket a_n (T--w-,-/D7--C == :ti R & D) Dat-a On DDS Plans & Perm, it Samne S °hare Sys-Lem Plan - ( ^or i_1 a=rcw) S_!l P=Orile & D_ -. Cns D Or J Bcx; r-ncn /Call-.v; ?=,p p .. Sao -1C Tan-'< - Size, mac`- -i l over Crnst=Ctic -1 =totes (,= rite) & z'.JOI.inc L- L =r,O.1_r a Dr^. n5 (u= r: L �e oC lap . Y and 4-ar: :- v, CK ) Ii PzT-e.•-.1 Pit & D Box Shown & .0tl5e - No. Or Bedrocr-s I':e_lS & SSDS'r ti /1_1 200 0= Pro:.0 - z-, stei.5 r.0.I7e .-et�aC{ Necessary Mi :1L lot) PO'iSe Sewer - 1/4 N O Ber. s; I -lay. . Be n.:S �) � w /Cler i..^.li L S =,a T,ION DIST:* S S� `1_= -. ON F'_ -lGls 10' LC P.L., Driveway, large 1'rCesj_` CL _ill 20' to Fours =ti.cn Val is 100' to cell; 200' i D.L.O.D, 150' its 100' to St- ,ream, T,-}:e 35'L.7. =--C .7 10' to Water Lin` 50' ir'.'�e_mit tent C = ':!a=e CoUrse Sen is Tanks 10' irar, Foundation; 50' to wal -1 i5, Well to Pr o PUTNAM COUNTY DEPARTMENT: OF HEAL. OF ENVIRONMENTAL HEALTH SERVICES Date September., 16, 11991 Re: Property of Walter and Eileen Sieck 'Z Located at Sanbotn Road . and Tivole Road, Patterson, NY 014 Tax Map (T). -Patterson Section 52 Block 5 Lot 5 Subdivision of Converted .# Sec 25 Block 47 Lot 1 - 19 Subdv. Lot # Filed Map # Date. Gentlemen: This letter is to authorize Joseph C. Riina, P.E. # 64431 a duly licensed professional engineer (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 ' ttioh 'tv`1t'h-'-thi:S- ' ia`t'ter-and* ta sixporvise----the-- cons true tion- -o-f- -s-a d- 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. of NEW O CountersignCA t `' ARio.,��� v9 P. E. , R. A.., ## Joseph Site sign. t Address p. �-6443"' Yorktown 4d (914) 962 -4488 Telephone Very truly yours, Signed Owner of Property AeArqgs In xx M &Y To Telephone vt.rn� I lulu v i .�vi i i�n� i i i Division Of Environmental HqAIth Services TWO COUNTY CENTER — CARMEL, N.Y.. 10512 (914) 225 -3641 - - " "' - APPLICATION TO CONSTRUCT A WATER WELL WELL LOCATION STREEI ADURESS. S _ I WN /VILLA /u Y PA-,—,E,'A X G AiU UMBER. '�� iu� fl WELL OWNER NAME. • ..... ji i��N \ / ADDRESS: WAS- -1"E�S ��K9 �A5PFR L IJ. zPUBLICE 5E OF WELL RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED primary ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (Specify) 2 - secondary ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT t gpm. /No. PEOPLE SERVED / EST. OF DAILY USAGE •Coal. REASON FOR, NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ .TEST /OBSERVATION GRILLING ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL WELL TYPE DRILLED F-] DRIVEN Q DUG Ej GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? — YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: LOTSNO:: i_ i WATER WELL CONTRACTOR: Name ess: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:. _ YES NO NAME OF PU$LIC -WATER SUPPLY: / TOWN /V /C DISTANCE TO PROPERTY FROM-N-EAREST WATER.MAIN )A LOCATION SKETCH & SOURCES OF CONTAMINATION 9. 20' 1 I (date) signa e) i_._.... _..___. 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 2. Disinfect the of the Putnam permit. 3. Submit a Well the Putnam Coy Date of Issue: until the water is clear. well in accordance with the requirements County Health Department attached to this Completion Report on a form provided by anty Health Department. Permit is-Non-Transferrable 19 W Permit Issuing Official I represent that I am whollyand completely, responsible forlho design,and location of the 'proposed systo*m(s). 1) -that the Separate sewage disposal system ndin.4 dance' ith�,the standards. rules and re above described will be constructed'as show-n"on I- the`aipproY66 imeridm-ei ht theire''to 4 I ccor w h, gulat ions of the Putnam County Department of. Health, -and that on completiori thereof -a of Construction' Compliance" latlitactory.t'o'ttie'6i)'Mniisitdner of Hoolthwill be submitted to. ,the, Department, and i.written, quaranteie-W ill be furnished . . the -owner, his successors, heirs or assigns by the builder, that said builder Will place' in ? qood o V f se'Wage,disbosal systern,d6ring e, period of (2) years Immodlatel . 10 fallowli •_—V co.nditi n any -par * said the twedato of the Issu-' once of the approval, of the Certificate of Constriictlon,, I 4t, r`iipoiiethor*66; 2) that thi'dillied-,4011 dosciibod above Compliance of' �oe original system or anij will be located as shown on the approved plan and that said Well will be In I In accordance with the standa 16 Is d rag-usmons of tee Putnam County Department of X V Date' S P 7 R.A. 647)ae!2�)/J I A)� YIAX& 1 Addr__ I �), 2.1�10_D . . . __ I .- - Ic.ense, No APPROVED FOR .CONSTRUCTION.- This approVole , X I PWCShwo'joais frdl�n".the,-dai.*-,'iss6ed,'.unlisi construction of" the building his, been uhdartakin ind.is revocable for cause or may be amended oi► 'modified when considered necesiary . by the COMMISSio'nor 'of.H,eilth. Any change or alteration of construction requires a . now per . . it -Approv"� f r disposal, of domestic sanitary fliwalue..and.4 , or r iv I a I te'Water suoniv only. 01� Title PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FO ATMENT SYSTEM PERMIT # l % ' O/ Located at Sa � 4av-&I Town or VAta--ge Subdivision name Date Subdivision Approved Owner /Applicant Name Subd. Lot # Tax Map:I ,,-f ,7 Block 1_ Lot 13 Renewal _� Revision Date of Previous Approval ' r r Mailing Address 6- /W ca,,, ��� e. .fG,.a �'� �ra�. /�( �/, Zip �3 ,rl/ oQ Amount of Fee Enclosed 3 6 d Building Type oar d e" 4 1 Lot Area j� �j0 )� o. of Bedrooms ?� Design Flow GPD 606 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of l U 06 gallon septic tank and - r, Other Requirements: To be constructed by a, L Address Water Supply: Public Supply From Address or:... Priyate_Supply.Drilled by .. ' .,...� _.. -... _..... .Address - .. _represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion th9reof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. Date 7- :ate,-9y License # `i 6 I �� APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for'cause or may be amended or modified when sidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. roved f ischarge of domestic sanitary sewage only. By: Title: ,- Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Mr, \ ASSOCIATES, LAURE ENGINEERING 20 Milltown Road Brewster; -New York --1 0509 . - .. ---. r.. _ -. -- _....... HARRY W. MCHOLS JR , P.E. (914 )278 -6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS July 26, 1999 Mr. Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS - Renewal Sanborn Road Town of Patterson #25.47 -1 -13 Dear Robert: Enclosed are the following: . P /'7 -67 (61 k c -cpz.) 1. Five (5) prints of SS -1, "Proposed SSDS," dated 7- 26 -99. 2. "Short EAF," dated 7- 26 -99. 3. "Application For Approval of Plans for a Wastewater Disposal System." 4. "Construction Permit for Sewage Disposal System," dated 7- 26 -99. 5. "Application to Construct a Water Well," dated 7- 26 -99. 6. "Design Data Sheet." 7. "Letter of Authorization," dated 7-22-99.' 8. Two (2) copies of Residence Floor Plan(s) for bedroom count only. 9. Review Fee in the amount of $300.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. HWN: JM: his 88068 617.20 Appendix C - State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FOW4 For UNLISTED ACTIONS.-Only _ _ .. _ -- _.___.._�. -_•._. rt 1 - PROJECT INFORMATION (To be completed by Applicant or Project sponsor) APPLICANT /SPONSOR: A-14,1 ,p (J PROJECT LOCATION: 1,Aunicipality„ A PRECISE LOCATION Sa I, to 2. PROJECT NAME: County f CJ Via wt 5-e ,l SS /9 S (Street address and road intersections, prominent landmarks, etc., or provide map) PROP SED ACTION IS: cx4e,w OExpansion OModificationlalteration DESCRIBE PROJECT BRIEFLY: frapoS,e-) SS D AMOUNT OF LAND AFFECTED: Initially CD, -f I acres Ultimately Q, acres WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? PIKes ONo If No, describe briefly WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? Pxltrsidential Olndustrial..__ OCommercial OAgricultural Describe OPark /Forest /Open space 00ther DOES ACTION INVOLVE A PEANUT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNiMErN'TAL AGENCY (FEDERAL, STATE OR LOCAL?? Ve s 0No If yes, list agency(s) name and permit /approvals PC/4 Ca fJwvlcoti , �r�, I ' t I apt `7 / '• �clr ���nc U a�e1 r T DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Dyes &vo If yes, list agency(s) name and permit /approval AS A RESULT OF PROPOSED ACTIOi•I WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ]Yes ,o I CERTIFY THAT THE I .'FORMA r ION PROVIDED ABOVE IS TRUE TO THE 6EST OF f.sY KNOWL�E�D•�GE 7 -0,14 tv I,- the action i5 in s Coastal Ar-za, tend you era a state agency, corn,-:e:: a I' CJiS :..� �•i:e5�:1:_:rt Fo-m lrC`ora proce'ei�ing v:ith this 2:SCSS r PUTNAM COUN'T'Y DEPARTMENT OF.HEALTH DIVISION OF,ENVIR®NMENTAL HEALTH SERVICES - -,- - - -- DESIGN DATA -SHEET - SUBSURFACE "SEWAGE TI ATMENY SYSTEM Owner h h 0 %�.� �`�� Address Located at (Street) E,, L" Tax Map 2,S47Block (indicate nearest cross street) Municipality J/0a -L x a,% Drainage Basin SOIL PERCOLATION TEST DATA Lot J 3 Date of Pre - soaking 8 -2 -95 -3 -99 Date of Percolation Test - 9 Hole No. Run No. Time Start - Stop Ela se Time (pMin.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 2 cl 30 9 ! ss- 2.9- 3 4 5 jr- 2— 1 y! 15 9;28 j 3 -2.2 2S- 3 -4 2.... y';28; -4I I 3 3 3 °J; .4! R; S 13 22 ZT 3 4 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. _ 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 M REQUIRED TO BE SUBMIMED W] APPLICATION DESCR=ION OF SOILS ENCOUNTERED IN '1x;ST-EO1ES DEPTH HOLE NO. HOLE NO. Z HOLE NO. G.L. it 2' 31 4' 5' 61 71 81 91 10, ill 12' 13' 14' INDICATE LEVEL AT WHICH GROUNUAAM IS ENCOUNTERED N /A INDICATE LEVEL TO WHICH WATER LEVEL RISES A G IN ENCOUNTERED NIA DEEP HOLE OBSERVATIONS MADE BY: > 4 DATE: DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided No. of Beclroans Septic Tank Capacity loc-, gals. Type C Absorption Area Provided By L.F. x 24" width trench Other Nam-- 61 Signature Address � F/ LIP 021 SEAL Pr7 T TWSO A) i /,A THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft/gal. Checked by j N I Date I• •� � DI• • ' � IS • • •' • � /' •' ' to Y• 'ly YC � r� DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE ND. owner ' A � N VA7 H ►, e-eN o' K�><�� Address ,iifs,�,1 H f 5, -r D2 F:;^ -f"i r !`l!-S---I N N Located at (Street) 5A N PLO FZN Sec. Block Lot 2 (indicate nearest cross street) Municipality '?A-(T C--9-f�zv-! Watershed 41-'l 2011 19 N ,Date of Pre- Soaking : Iq - 05 -0,12 Date of Percolation Test 'If -0 "e5-o HOLE NOMBER Cl= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Frcm Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 1 �.50_6 CGi :►� Imo" li� �„ 4 5 1 5.5o -6, (Z� 4 5 1 2 3 4 til'iTC -,' 01� 5 o t > NOTES: 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 measurements to be made from top of hole. rev. 9/85 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL l __ ... _.._.. -- please print or type PCHD Permit # l'� ` � 5� Well Location: Street Town /Ville Tax Grid # Address: 5-C-41 yO r v, -� rs en, Mapes q Block I Lot(s) /_3 Well Owner: Name: h�((''�� Address. ` y� A04) Ro lq. f�'��ti2�T� Cy ky as ter 11 vSel, Use of Well: r/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 9— gpm # People Served 1 Est. of Daily Usage _& 00 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. Water Well Contractor: T_ B D Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: fi-- Town/Village -- Distance to property from nearest water main: N A Proposed well location & sources of contamination to be provided on separate sheet/plan. '7-2 Date: — 91 Applicant Signature: .., y PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or. groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water driller certified by Putnam County. j Date of Issue %t Permit Issuing Official: Date of Expiration It/ t// Z" f Title: Permit is Non- Transferra White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 EUTItiAIK COUNTY DEPARTMENT OF HEALTH DIVISION1 OF EN Y ^IROL\IMENTAL HEALTH SERVICES RE : Prop e rty of ,•'i v1 LETTER OF AUTHOR.IZATION Located at S-4an, - -._ ..._...... b� T(�aTax Map r-�`, 7 Block Lot Yrsn�► /.3 Subdivision of Subdivision Lot r Filed Map r Date Filed Gentlemen: This letter is to authorize hLa V, V-91 IV I _1 to ;'L 1r ��_. a duly licensed Professional Engineer _1�,4 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 treatment and/or water supply systems in conformity Nvith the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam CcZitary Code. _6Y/ gQ 41� NICNO p¢ _..._ ..... _.. . _....._.... -. __. Vdry teuly`youis, Countersigned: 3 � Ui Seed- P.E., R. A., r� _ (ownvofP,roper.1) Mailing Address P: w State , Zip 1 6(-419 Telephone: = (e, 16 9 Mailing Address: /'V. 2-11� State Zip_ Telephone: 27 Gj (a 3S 3 — F0r7 Lk'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: 2. Name of project: i-a dsc SSA 3. Location T/ff: Ad�011 4. Design Professional: /1% Address:.,U,i1�� 6. Drainage Basin: L22Jr�c� <�r_ 7. Type of Project: L_ Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? V-ef Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted 2,--- 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... a- 10. Has DEIS been completed and found acceptable by Lead Agency? ............... _1y'J'4 11. Name of Lead Agency ,�vl),4-_ 12: Is this project in an area under the control of local planning, zoning, or other officials ordinances. ...._ ......._.... - _. .,...__.._.__ s 13. If so, have plans been submitted to such authorities? ........ ............................... Ad 14. Has preliminary approval been granted by such authorities ?,4� -Date granted: 15. Type of Sewage Treatment System Discharge................. surface water //groundwater 16. If surface water discharge, what is the stream class designation ?.... ................. 4+ 17. Waters index number (surface) ........................................... .................... ............ /U �- 18. Is project located near a public water supply system? ._�U;� 19. If yes, name of water supply /W4 Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ d 21. Name of sewage system 14- Distance to sewage system —J 22. Date test holes observed 9 23. Name of Health Inspector � li �vl ef 24. Project design flow (gallons per day) ............................................................... C��d 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... �v u 26. Has SPDES Application been submitted to local DEC office? ......................... lv ,4-' Form PC-9 -' 2 • 27. Is any portion of this project located within a designated Town or State wetland? Ivy' 28. Wetlands ID Number ............................. ........ „ :.............................. �7 .._ 2.9:. --Is- Wetlands Permit required? ............................. ............. ... ............................. t Has application been made to Town or Local DEC office?..: ............................ 30. Does project require a DEC Stream Disturbance Permit? .................................. 31. Is or 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 d 32. Is project located within 1,000 feet-of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any �r other potentially known source of contamination? .......................... ..... Yes/No lV d DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... 34. Are community water and/or sewer facilities planned to be.developed within 15 years in or adjacent to project site? ................................ ............................... OL, k4 d w 35. Are any sewage treatment areas in excess of 15% slope? . ............................... Yle�_ 36. Tax Map ID Number .......................... ............................... Map x.-47 Block ( Lot 1.3 37. Approved plans are to be returned to ..... Applicant L,-- Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the_Depa_rtment, and need not be senfin duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is trite to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to SIGNATURES & OFFICIAL TITLES: /0 IV/ Mailing Ali ess...d�' ODD , �;.• ; 6 y of e4� dills Typo Lot Ares D �� FE Settle, Oeb mimplib volaeae Nobiu d sedtoasa DWW Flow G P D PCHD N*dbcadm b Reguhod Wheel PSI b cumPkbd oA Sopo/aab S&WMW System to eeoeb[ d O 0 rr2� GWIM Soptb Took and -*3 To be.e...4.eaa by ,L7, :. Addome WSW SMpb': Pore Sop* Fitens Adbove Sop'* Dead b7 T� , Q, .dd.u.. Odw )l.�.r..o.ta 1 representAftat 1 am wholly a" completely responsible for the design and location of the proposed system(s); 1) that the more faYr di sal s stem above described will be constructed as shownon the approved amendment there to and in accordance with the standards, rules and 7egu na 0 na County Department of MealNh. and that on completion. thereof a "C"fkbte Of Construction Compliance' satisfactory to the Commissioner of Healthwill be submRteA to the Oepa imant, and a written guarantee will be furnished the Owner, his suceossors. heirs or assigns by the builder, that said builder will ptaq in good. Operotiffilg condition ;any part of Bahl aewage disposal system during the period of two (2) years immediately following tliedete of the itau- anoa of the approval at the Certificate of Construction Compl original system or any rooks thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will tie In ailed in actor nee ith std a. rules a regu dire of the Putnam County Rmannwm of "With. Date , 1 993. , Signed TLicense No -7�/ APPROVED FOR CONSTRUCTION. This approval expires two years from the date .issued unless construction of the building has been undertaken and is revocable for cause or may be amenaod or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a w perm -it. pproved or disposal of .domestic sanitary sevdgejand /or prat to water supply on 0/88 Date��r GG %�C�i 1 By — Mile � MitAm CDU*T DZOARfNM r OF HFAL1g - � Mikkke Rod& SWV666 Ca INN N.Y 1SS12 zMabsewtorwMe reseals � �If 1 �r, „ w CFaTnPWATE OF COMPUAM i CIiON FIT FOR UWAIM DMOSAL SY_SlSM P" Q.VL r RV ad Lusted at D D /L 4 `Sa`dti.bloi -Nar .. - -- -- - cued: Legg - - - - 3.. _ Bioe# Tau'Map ° �4 _ - t - _ OwodApplls.t Naeao r-l'I Ma Kjr Ags Dare Approval Town !a. N zip MMMIG Addfeaa Date Subdivision ADD rove Fee Enclosed:. Amntmt , dills Typo Lot Ares D �� FE Settle, Oeb mimplib volaeae Nobiu d sedtoasa DWW Flow G P D PCHD N*dbcadm b Reguhod Wheel PSI b cumPkbd oA Sopo/aab S&WMW System to eeoeb[ d O 0 rr2� GWIM Soptb Took and -*3 To be.e...4.eaa by ,L7, :. Addome WSW SMpb': Pore Sop* Fitens Adbove Sop'* Dead b7 T� , Q, .dd.u.. Odw )l.�.r..o.ta 1 representAftat 1 am wholly a" completely responsible for the design and location of the proposed system(s); 1) that the more faYr di sal s stem above described will be constructed as shownon the approved amendment there to and in accordance with the standards, rules and 7egu na 0 na County Department of MealNh. and that on completion. thereof a "C"fkbte Of Construction Compliance' satisfactory to the Commissioner of Healthwill be submRteA to the Oepa imant, and a written guarantee will be furnished the Owner, his suceossors. heirs or assigns by the builder, that said builder will ptaq in good. Operotiffilg condition ;any part of Bahl aewage disposal system during the period of two (2) years immediately following tliedete of the itau- anoa of the approval at the Certificate of Construction Compl original system or any rooks thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will tie In ailed in actor nee ith std a. rules a regu dire of the Putnam County Rmannwm of "With. Date , 1 993. , Signed TLicense No -7�/ APPROVED FOR CONSTRUCTION. This approval expires two years from the date .issued unless construction of the building has been undertaken and is revocable for cause or may be amenaod or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires a w perm -it. pproved or disposal of .domestic sanitary sevdgejand /or prat to water supply on 0/88 Date��r GG %�C�i 1 By — Mile � m LAURENT ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE _ ..._.____.._...._._.._. _ - PATTERSON; NEW YORK 12563 ' RANDOLPH W. LAURENT, PE. (914) 278.6108 -(FAX) 278 -2658 HARRY W.NICHOLS, JR., PE. CONSULTING SITE ENGINEERS March 5, 1993 Putnam County Health Department Route 312, Geneva Road Brewster, NY 10509 Att: Mr. William Hedges Re: Renewal Permit no. P -17 -89 Sanborn Road - 53 -4 -2 Ann & Kathleen O'Keefe Patterson, N.Y. Dear Bill: Enclosed are copies of the following items: 1. "Construction Permit for Sewage Disposal System ", dated March 4, 1993. 2. "Application to Construct a Water Well ", dated March 4, 1993. 3. "Authorization Form ", dated March 4, 1993. Permits were issued by Putnam County Health _..:....... �.._.._.. 198 -9- ..and- renewe-d---April- -26-l'-1'9-9'1" for ` the construction of th'e' SSDS,, and to drill a well. We are requesting a renewal of the enclosed:_..., for an additional two (2) years. If you have any questions, please feel free to call. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Randolph W. L urent, P.E. 17 RWL:bd 88068 enc. cc: Mrs. A. O'Keefe LAURENT ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE PATTERSON,_NEW YORK 12563 RANDOLPH W. LAURENT, PE. (914) 278 6108 - (FAX) 278 2658 HARRY W NICHOLS, JR., PE. CONSULTING SITE ENGINEERS April 19, 1991 Putnam County Health Department 110 Old Route Six Center Carmel, New York 10512 Atts Mr. Robert Morris RE: Renewal Permit No. P -17 -89 Sanborn Road - 53 -4 -2 Ann & Kathleen O'Keefe Patterson, New York Dear Bob: Enclosed are copies of the following Items: 1. . "Construction Permit for Sewage Disposal System ", dated April 19, 1991. 2, "Applicatio.n_.to Construct a Water Well " -,. dated April 19, 1991. 3. "Authorization Form ", dated April 19, 1991. Permits were issued by Putnam County Health Department on May 10, _.:..._.- .._.._ .1.939...fo.r.. ,the.. - construction of the SSDS and to drill -a well. - We are requesting a renewal of the enclosed for an additional two (2 ) years.. If you have any questions please feel free to call. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Randolph W. L urent, P.E. 88058 /map cc: Mrs. Ann O'Keefe 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Located at q- (T) Pa' Section Block Lot '7--' Subdivision of Subdv. Lot # Filed Map # Gentlemen:. / ,+ i ,) This letter is to authorize �\4-4-,L 1,V � Date a duly licensed professional engineer or registered architect (Indica e) 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 - sys-t-em----or--- systems ---irr•-con- fortuity-- •with--the-- pro- vrsions ,--of- --Artic-l--e•--14-y- - °ar�- 147, Education Law, the Public Health Law, and the Putnam County Sani- .'��o tary Code. �•� 0 W°y� Q ILLIq o,Q� Very truly yours, Cou'ntersignkaC No. 0451 81 P.E , R. A. , #'�. 7-3 fz'f Id-Dj-c J -e Address I (2MI 7,7r> -610P Telephone Signed ` " °/ L./ Ve Owner of Propert Py dress ' Town Telephone 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 # WELL LOCATION Street Add s Town Vit#g+e Tax Grid Number WELL OWNER Name .. ' -. Mailing Addres :1el�s �; S b V%,. Private O Public USE OF WELL 0- primary 2 - secondary CKRESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY O FARM M INSTITUTIONAL Q AIR /COND /HEAT PUMP ❑ TEST /OBSERVATION ❑ STAND -BY O ABANDONED 0 OTHER (specify, .AMOUNT OF USE YIELD SOUGHT .5 gpm /# PEOPLE SERVED 3;S /EST. OF DAILY USAGE-600 gal ❑ REPLACE EXISTING SUPPLY O TEST /OBSERVATION M ADDITIONAL SUPPLY - NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ®DRIVEN ®DUG ®GRAVEL. ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name % B D Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: i1J� TOWN /VIL /CITY DISTANCE TO PROPERTY • -- FROM- FEAP.EST.WATER-- K&I.N..- - -_- .N/�' ...._.._ _..._...... _..._..- _......_ _.__..__ ...................._._.._:._.:_..- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET u 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 thirt;r (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 any and all water or waste products from such well property and in such a manner as not to degrade or Date of Issue: 19 Date of Expiration 19 Permit is Non - Transferrable White shall take appropriate action to assure that dr operations be contained on this i o r 'se contami ate surface or groundwater. ermit Issuing Of icial 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 Re: Property of Located at V-1-. P G (T) Pq f'�g -yam Section Block Lot -7/ Subdivision of WA4 Subdv. Lot # Gentlemen: Filed Map # This letter is to authorize I Date a duly licensed professional engineer or registered architect (Indica 2 to apply for a Construction Permit for a separate sewage system, to serve the above rioted 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 §ystem or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, 0 W ILLIAq'0�1 tary Code. and the Putnam County Sani -. Ifs "CEP• 9 Very truly yours, za fZT'rr eId -Dr-( l/ -er Address j),y /z 63 Z1 , ? -, 6 /'odO Telephone Signed .... Owner'of Propertif- dress Town Telephone PUTNAM.COUNTY DEPARTMENT OF HEALTH NO 609.-89 =19 COMPLAINT OR SERVICE REQUEST RECOR DATE 'Sept. 19-, . 1959- ._.-- REFERRED...TO- --Bill Hedges TAKEN BY Bill Hedges TELEPHONE CALL X IN PERSON LETTER CONFIDENTIAL REQUEST FROM Judy Gross TELEPHONE 275 -gOgl ADDRESS Putnam Lake ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public water Food Service Migrant Camp Other COMPLAINT OR REQUEST O'Keefe - Shanborn Road, Putnam Lake - permit - new house - proposed well is in direct line of drainage of her septic system. DIRECTIONS: Shanborn road Putnam Lake NY ACTION TAKEN BY DATE--:--> FINDINGS FOLLOW UP INSPECTION (s) _ _.DATE -.. __......_.�...._.. __.....__. .F?1�TDINGS..../ .::.GEC. /�f.._..... _ ... _r` -...`f.� -� f'~a� _..��.5...�i DATE FINDINGS NOTIFIED 6� r ey � D ESTIMATED TOTAL MAN HOURS SPENT !� 77 John M. Simmons, M.D. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME Orig. Routine a _ Orig. Complain ADDRESS y, Orig. Request No. Street TOO TM No. _ Compliance Complaint Ccmp MAILING ADDRESS Final P.O. Box Post Office Zip Code — Group Illness _ Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED Field Conference Name and Title 4 Other DATE TYPE FACILITY TIME ARRIVED TIME LEFT Explain M INSPECTOR: 0 TELEPHONE: Signature and Title PERSON, IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: PUTNAM COUNTY DEPARTMENT OF HEALTH . . COMPLAINT OR SERVICE REQUEST RECORD TOWN ' PATTERSON NO 609 -89 -19 DATE Sept. 19, 1989 'REFERRED TO Bill' Hedges~- TAKEN BY Bill Hedges TELEPHONE CALL X IN PERSON LETTER CONFIDENTIAL REQUEST FROM Judy Gross TELEPHONE 278 -9091 ADDRESS Putnam Lake ENVIRONMENTAL HEALTH: Home Sewage Rodents Refuse Public Water Food Service Migrant Camp COMPLAINT OR REQUEST O'Keefe-Shanborn Road, Putnam Lake - permit - new house - proposed well is in direct line of drainage of her septic system. DIRECTIONS: Shanborn road Putnam Lake, NY, ACTION TAKEN BY DATE. FINDINGS FOLLOW UP INSPECTION (s) —FINDINGS 4- Z?z 7 -e- e- C> DATE FINDINGS DATE NOTIFIED 4 D ESTIMATED TOTAL MAN HOURS SPENT 77 DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 - -APPLICATION TO CONSTRUCT A - WATER WELL - PCHD PERMIT WELL LOCATION Street Address Town/Village/City Tax Grid umber ,0 pi V 5_?�- : WELL OWNER Name A� f Mailing Address O'L C A)C /mss -PP- j v0 rivate O Public UE OF WELL primary 2- secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY O FARM O INSTITUTIONAL O AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY 0 ABANDONED 0 OTHER (specify, O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED3 • !;'7- /EST. OF DAILY USAGE _&�gal REASON FOR DRILLING 0 NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING OeS172WEE5 WELL TYPE DRILLED O DRIVEN DDUG O GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: aAq TOWN /VIL /CITY _._...DIST.ANCE_ TO. PROPERTY -FROM NEAREST. WATER. MAIN :_.. - LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED � []ON REAR OF THIS APPLICATION U v SEPARATE SHEE 91/) (date) (sign e) 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 proviod by the Putnam County Health Department. Date of Issue:Z1'7c!y /d 19 1 Date of Expiration: 19 Permit Issuing Dffic Permit is Non - Transferrable Wh te copy: H. D. File Yellow copy: Building Inspector Pink Copy: Owner 287 Orange copy: Well Driller nV 13GOtl V 80d _ " "'u 31V1S �1210d M3N lVA08ddy j0 d�ly13 lY 13113U A1IHOHYI00 011Y uisnOH d0 6OISIAIO 31y1 ?,4 ,42 4 } cl ! S YUOA M3H z1, r) .9-. L I -- n ,2 -,££ r. i r r r J G C4 C L -i -o -, z3 ---I PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED, FOR BEDROOM COUNT ONLY; _BEDROOMS Signature &Tit PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date -7JC� yg J Re: Property of aAW Q X12 E� T Located at �)29/y A) (T) M, TMSON Section 62 Block `T Lot o� Subdivision of N /� Subdv. Lot ## Filed Map ## Date Gentlemen: nn This letter is to authorize a duly licensed professional engineer V 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. Countersigne (�_ E:-), R -A-., a ;,•. pfiE�c�is. ,.. - ?_) V4 i 1/� Address Telephone Very truly yours, Signed Owner of Propert X lit' 44dress J Town Telephone �• •� r ERR r 1a • - 1 21A 6 r. DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL;`SYSTEM FILE NO. Owner Ati7 N L �>;N O IK���F Address Located at (Street) 5AN 2OrzN 12�Z',O Sec. � Block Lot 2 (indicate nearest cross = -street) Municipality Watershed e5 -12-p O N SOIL PERCOLATION TEST DATA. P3XD2ED TO BE SUBMITTED WITH APPLICATIONS Date of Pre- Soaking - -dpi Date of Percolation Test BOLE NLMHER CLOCK TIME PERCMACION PERCD=CN Ran Elapse Depth to Water From Water Level No. Time Ground Surface in Inches Soil Rate Start-Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 4 5 �l #2 -i 2 C- '.!� -�- 4 5 1 2 3 MIN 4 ed I& ., - . )4 ( r! @ 2 - 5 NOTES: 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 measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO.' 2 HOLE NO. G. L. 1' DEG 29 31 41 .51 61 71 91 10, .12! 139 141 o =61 .-IMICATE-LEVIM-AT-WHICH G1Z(DMTV2A=-- _IS -ENC0U—NTEPM . .......... 7 INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED N ZLI DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used Min/1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity /00 gals. Type Absorption Area Provided By L.F. x.24" width trench Other Name tiW1212)1' 14-D 1,S -,,V, P, F . - Signature Address _j � elP 102 j ye'- SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Ig NELjf < NlCi-47 Soil Rate Approved sq.ft/gal. Checked by Date W ES S 15 Soil Rate Approved sq.ft/gal. Checked by Date LAURENT ENGINEERING \ ASSOCUATES,PC. . --` -- - --' ��--------'----- - - 73 FA IFL YORK �26Y3"----------------' ' ----- 814'2786108 RE. HARRY wiwICxoLSu�RE. CONSULTING SITE ENGINEERS March 30, 1989 Putnam County Department of Health 110 old Route 6 Center Carmel.= NY 10512 Att: John KareIl, Jr., P.E. RE: Proposed SSDG Sanborn Road Patterson, NY Dear John: Enclosed are the following: 1' Four (4) prints of Draiwing SS-1, "proposed SS0S", dated --'---------------------------'------------'----'------- ---- - 2. "Construction Permit for Sewage Disposal System", dated 3/29/B9; 3. "Design Data Sheet"; ^ ' n 4. Letter of Authorization"' dated 3/30/B9; ' � - 5' Two copies (2} of Bi�sidemce Floor Plan(s) , for "Bedroom Count Only"` � ~ 6' "Application to r'�' ruct a Water- Wel1 ` 7. One-hundred dollar review fee.. . We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Ni��o�s, Jr.r. P. E. HWN:mt Encl. cc: Ann & Kathleen Q'l,"'eefe w/1 copy each m C=- "'•,E;T' CF F= :'_': - OrVISiC1 CL: CUY ' _ .y N f"`_ r `1U ? 1N Cf Cwt-a -i (Ei_ LCGr`Cw) ca I = I NO ( CCC•`f -- pest A--_.! T c_ t_cc �- I E::�inccrC C1•_ °L L�- 1CriLa_ c-n (ACS) - ��T` Ecle Ce_ `z I . c- and T- CG- C,-, SCE 1 r _ Well I G�� J �C Li 1_ C`IC_ 'E�c_Cl LcL= :__•LSE -r,C_c �!C ° =_ i���= ... .. _............. Dr: ;eiav & S? c-ce= C.?t RE7r°cn_L✓ -V7c CL =_ - ='T cr_ c2--2-::'_s_C. Yr-u= I= pza:e' p4".& D ECx silcvi: & De. = ??-� -- Ecusz - N.C. c= EeExcc s� A= v siE I E.:S & E'C'C t W /:� 200 L =. C: ~-�.L CS= C °Ci_^ C =T_Cac __s C& ZCL'rr I 47 -- rte- __ - I . L„ I I � I I I I I 'I -•T• C'TC -�'.tC I L��y-� I 10 f- rT I 1 AGL�� I and T- CG- C,-, SCE 1 r _ Well I G�� J �C Li 1_ C`IC_ 'E�c_Cl LcL= :__•LSE -r,C_c �!C ° =_ i���= ... .. _............. Dr: ;eiav & S? c-ce= C.?t RE7r°cn_L✓ -V7c CL =_ - ='T cr_ c2--2-::'_s_C. Yr-u= I= pza:e' p4".& D ECx silcvi: & De. = ??-� -- Ecusz - N.C. c= EeExcc s� A= v siE I E.:S & E'C'C t W /:� 200 L =. C: ~-�.L CS= C °Ci_^ C =T_Cac __s C& ZCL'rr ECi1 °e Ecc =cC:{ Nc' =sF `i (Tic it- :1C,. / LE11 /ckf .= . 4110�; T-_ C ` __ S Ecc--e se- %c F_�i 10 t'c ? L Dr_f:��z_� L;- I`_'= �,c= cf 20' tr�c° 100' to T'E._1; 200' i:. D- -_C -D, 1 =�7' P'--= EX- 100, t:: s` =-_m, c- 1_71 t.-' 10, tz) 'Wztar Line jr I `) .0 ti?- f , Cc- aie�r. I . L„ I � I I ECi1 °e Ecc =cC:{ Nc' =sF `i (Tic it- :1C,. / LE11 /ckf .= . 4110�; T-_ C ` __ S Ecc--e se- %c F_�i 10 t'c ? L Dr_f:��z_� L;- I`_'= �,c= cf 20' tr�c° 100' to T'E._1; 200' i:. D- -_C -D, 1 =�7' P'--= EX- 100, t:: s` =-_m, c- 1_71 t.-' 10, tz) 'Wztar Line jr 4� RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR., P.E. April 13, 1 LAURENT ENGINEERING ASSOCIATES, P.IC 73 FAIRFIELD DRIVE .- .._. . PATTERSON, NEW YORK 12563 914.278.6108 CONSULTING SITE ENGINEERS Putnam County Department of Health 110 Old Rte. 6 Center Carmel, NY 10512 Att: Mr. William Hedges RE: Proposed SSDS Sanborn Road Patterson, New York Dear-;.'Bill: Our response to your comments of 4 -10 -89 is as follows: 1. SSDS west of proposed well was measured in the field to be 100'. 2. D.L.O.D. key hole has been indicated on plan for proposed well. 3. All wells & SSDS's. within 200' of the proposed; system are shown on the plan. 1 4. House setbacks are labeled on the plan. / 'T 5. Roof & Footing - drains are indicated. 6. Septic tank size taken from Rotondo & Sons, Inc. Precast Septic Tank ST100 (1000 gal.--tank). 7. Percolation & Deep Hole locations are indicated on plan. 8. SSDS setbacks from property line are labeled. . 9. Note to have well staked by surveyor is on the plan. Enclosed find four (4) prints of SS -1 "Proposed SSDS ", revised 4- 13 -89. Very ?truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. HWN:mt Efic . DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION•- - -TO CONSTRUCT--A--WATER-WELL PCHD PERMIT WELL LOCATION Street Addr a Tax Grid Number ` 0 .5' 3 - z WELL OWNER Name Mailing Address e rivate c P AI Y13 D Public (0SE OF - WELL - primary 2- secondary RESIDENTIAL 9BUSINESS O INDUSTRIAL ❑ PUBLIC SUPPLY O FARM b INSTITUTIONAL O AIR /COND /HEAT PUMP O ABANDONED O TEST /OBSERVATION O OTHER (specify O STAND -BY O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED 3j /EST.: OF DAILY USAGE__,gal E3 REPLACE EXISTING SUPPLY O TEST /OBSERVATION Q ADDITIONAL" SUPPLY El NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED. REASON •FOR DRILLING c L e WELL TYPE DRILLED 0 DRIVEN QDUG ❑ GRAVED ❑ OTHER IS WELL SITE SUBJECT TO FLOODING? YES >C NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name =�3,r_)., Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES /` NO NAME OF PUBLIC WATER SUPPLY: N1/4 TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION P ON SEPARATE SHEET (date) s gnature) 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 such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue, Date of Expiration 1 Permit Issuin icial Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller s 1% BATH D RiM I K/ I TCILJI CIE N BE G B ATH -1 t T-- 0 o, 18 1'�B m � O �j[.ro. 9 J. c4j S4 V- 2S• HALL ro BED. RM 2 BED RM -3 (D 0 Q : PUTNAM COUNTY -DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, 3 B E D R 0101M 3 'I" �' �-SE HOUSE ALI, I'lLAD' 1`0 ThE -1 .:ii APPROVAL & TITLE Ti.: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION l l " Date: o Inspecte .y. :. �- P ..o - Street I;ocation SAxlBo7zA/Zo.4b Owner Town 1TEro,� Permit # 7>-17 - 59 TM #- 9--T, 4f-7- 1-t 5 Subdivision Lot # -�— 1. Sewage System Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank size 1,00 ...1, 250 ......... other ................ b. Septic tank instal a level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Pistributio n Box . All outlets at same elevation -water tested ................. 2.. Protected below frost .................. ............................... 3. Minimum' 2 ft.Original soil between box & •trenche e. Junction Bo properly set ... ............................... .. f. Trenches Length required 3 3 q Length installed --t- 3So 2. Distance to watercourse measured4 /' o oFt......... 3. Installed according to plan ... ...............................I 4. Slope of trench acceptable 1/16. - _1/32" /foot........... 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ...................... 8. Size of gravel 3/4 - 1' /Z" diameter clean ................. . ( 9. Depth of gravel in trench 12" minimum ................... pe ends capped ........................ ....................... g. um r D� osed Systems Size of pump chamber ................ ............................... 2. Overflow tank ...........................:. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle.......... III. House/Building a. House I ocated per. approved plans ... ............................... b. Number of bedrooms ....................... ...P9. .......... �"'J. IV. Well a Well located as per approved plans . ...........................:... b. Distance from STS area measured - / D 0- ft........... c. Casing 18" above grade ................................................. d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted .......:........... ............................... b. All pipes partially backfilled ........... ............................... c. - All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan. f. Curtain drain outfall protected & dir.to exist watercour g. Footing drains discharge away from STS area............. h. Surface water protection adequate .. ............................... i. Erosion control provided ................ ..............................I Rev. 6/97 ruin .-ii -i 2!` ,7_ A-x c rest ►+sJoy IC"J WWI IBM ICSWAS I!� ICS WA ruin .-ii -i 2!` ,7_ A-x c rest ►+sJoy s� BRUCE R. FOLEY - Public Health - Director- -_- _.___..._- ._._..._ _. DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M:S.N. -"Director - Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 Date: 8/ / 6 �o a To: 111kGTEi2 s - -- From: Gene D. Reed Putnam County Department of Health - For your information For your review As discussed Notes/Messages C4�lM.EiYTS ,= Fax #: 85— 3 7 72 No. Pages Z (Including cover sheet) -;. Please respond Attached as requested Please call o.z%&=�ANWO'A T�i�lilliv In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 2261. I n,� L_ t c i I EXPANSION AREA ADD R. 0. B. FILL. TO TAPER TOP OF SLOPE IN THE EXPANSION AREA AND UE•IN BEFORE THE START O� THE FIRST TRENCH DEPTH OF FILL SHOULD SE 1:,5 FEET AT THE DEEPEST POINT AS e,ep jTTe.-,f SHOM. i PRI MARY AREA j DELANOY . SSDS GROSS !$ECf /ON SKETCH Not to scale_ ; - 49KL(;Kl r:r a A LRECKI Assocum, L.L.C. Consulting Engineers, Land Surveyors, Land Planners 11 West Main Street Pawling, NY 12564 (914► 855-3772 fox I (9141405-Wl 11m TO Gene Reid Fmm Dave Johnson Fma 278-7921 Psom: 2 p1moc Owtv. .1111312000 Res Delany- Compliance JoW: 2000.122 PAGE 01 0 UnISM 0 For Review E3 In"n Cos~ 0 None " 0 pkmwo rt*C"* • Comm ft.. Gene, Here is a sketch of what we agreed on in the field. I will have the Oonlrector do this right away. Ix Iz A GO /11I LVGG V7: 3b 0753 /I'L ZARECKI PAGE 02 ----PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION 0 ADAM All information must be fully completed prior to any inspections being made. X GENE For: Fill 'Trenches X PCHD Construction Permit # Located: PID. (-n 1,ow Owner/Applicant Nam 12M I Ai610%!f 'TM ft.&Z Block I Lot _L�_ Formerly: a 41rodgaft Subdivision Name: Subdivision Lot Is system fill completed? 4/A. Date: K)& Is system complete? yrn Date: Is system constructed Ian$? Is well drilled? Date: Is well located as per plans? !Its Arc erosion control measures in pla6e? I certify that the systesn(s), as listed, at the above premises has been constructed and I have inspected and, verified* their completion in accordance with'the :issued PCHD Construction Pentut .and approved plans and the Standards, Rules and Regulations of the Put County Department of Health. Date: 1,,v OW Certified by: ✓ RA A76 sional Address: 11 LAAik ST- f)AJ&IWA Lic. # _ geo' 94< Cominents: Form FIR•99 - -1 r c 4AKLI-Al PAGE 01 OcZ AR-ECKI ASSOCIA'TES, L.L.C. COVER Consulting Engineers Land Surveyors Land Planners Joseph Zor", PE JOHM Becker, LS To: Date: 7/ Z- -eAn — Curt Johnson, MP Job No. 1 1 Wea Main Sr. Phone: No. of pages: 9?-"' Pawling. NY 1256A )914) 855.3771 8553772 Fax Fax: Fax: From: J enroii: mnxk3TT10ool:com �'�! •+ 31 Bailey Ave. Ridgeri0Wr CT 06877 (203) 438.7094 (203) 4W 157 Fox 2 �~O F z �KI 94, a i11ES uc Q SURVEYING DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster; New.York 10509 (914) 278 -6130 APPLICATION-TO CONSTRUCT°- A- WATER WELL PCHD PERMIT # WELL LOCATION Street Address Town. y Tax Grid Number _C2 *I - -/3 WELL OWNER Name Mailing Address Y QPrivate O Public USE OF WELL primary - secondary W RESIDENTIAL O BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY. O FARM b INSTITUTIONAL O AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY O ABANDONED p OTHER. (specify, O AMOUNT OF USE YIELD SOUGHT__5'_gpm /# PEOPLE SERVED' -5 /EST. OF DAILY USAGE��al E3 REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 13 ADDITIONAL SUPPLY JXNLIW SUPPLY NEW DWELLING) DEEPEN E ISTI G WELL REASON FOR. DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN DDUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: da. Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ C NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED f3ON SEPARATE SHEET �_'�� �C'���i(•GT/( 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 any and all water or waste products from such well drilling operations be property and in suc a manner as not to degrade or otherwise contaminate Date of Issue: Z� 19 Date of Exp ion 19 4 s Permit Issuing Official action to assure that contained on this surface or groundwater. Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller i 02 22FM FROM I . RENT ENG I f�'EEI� i Nu ASSOC T�7 rssr i 27$5798 P. X31 ILTY DEpARTAlE?vT OF HEAL'T'H -- - DIVISXON E� SVANVIROXMI� NTAL HEALTH SERVICES Date -S- Re : Property o£ -�►��, LOCdtetl at ��` — - ' (T)( t Section. Block l Lot �; • •Subdivisi f on O 'lvnn11 ZA Subdy. Lo,: -7: -` :- i` I�.ed Da At it Gen�lsr�etx: •;; This l e i, a 7C` a, s t o x`u th o a duly li.ce:ised proees! i;ona.1 9.19iiieer or regi.s lered architreot to, apply. ,£ox' a Constry t;,iozz Pexmi.L =:or a separate SA:.�a,cc3 Svstem, to sexv,3 the 'aUovp izoted tloperty. �zi� accord'arce-�zi+tli tt�e st.ar►da.L,ds, -rul: as, ^ - or regul 'tions..as prom' ?� gated by tIi Co,;,,-�isszorier of thu> . PO :nam County �3epar�raeriz o£ iieal.`th', r'id to' siSzi al'? a�3tessar �ap2i's 0ri 'mv 'b9r�al.f, X connection this system or systems in 147, �duca ti on Law, Lary Code . n ,'; ,,er and to supecvi se bhp. Cor:s'�YuCti,ori o'C said r lAforclity with the provi.s:.oxzs of ArtiCl.e 145 or tr, ub?:zc Kpai.th Lai,-,; e:xd the .�ut:tam County Sanx� Millbrooke Office Contrp Addd e Birewster, NY 10509 916,278 -6105 Telephone Very truly yours, S:gzxed Address Aa To im Telephone •i , -; Very truly yours, S:gzxed Address Aa To im Telephone LAURENT ENGINEERING ASSOCIATES, P.C. _ - ...- -•• - '- `.. ".MICE "BROOI(E- 6FFICE- CENTRE Route 22 8 Milltown Road Brewster, New York 10508 RANDOLPH W. LAURENT. P.E. (914)278 6108 - (FAX) X78-2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS January 26, 1995 Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 ATT: Mr. William Hedges RE: Renewal Permit No. P -17 -89 Sanborn Road T.M. 25.47 -1 -13 Ann & Kathleen O'Keefe Patterson, N.Y. Dear Bill: Enclosed are copies of the following items:. 1.. "Construction Permit for Sewage Disposal System ", dated January 26, 1995. 2. "Application to Construct a Water Well ", dated January 26, 1995. 3. "Authorization Form ", dated January 26, 1995. 4. Four (4) prints'of Drawing SS -1 "Proposed SSDS ", revised 1= 26 -95. The Tax Map was revised to show new map number. Permits were issued by Putnam County.Health Department on May 10, 1989 and renewed April 26, 1991 and March 17, 1993 for the construction of the SSDS and to drill a well. We are requesting a renewal of the enlcosed for an additional two (2) years.. - If you have any questions, please feel free to call. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Randolph W. L urent, P.E.. RWL:bd 88069 enc. cc: Mrs. A. O'Keefe fANt� � t APVROVEO'FOR CONSTRUCTION:aTAit.apj .«Duna /a' -uuw oc,m�y e.:i�wnaw -or =n nouns a n.' j4 ' c. Aoo.o_r:a ro. ; Rev. a +:nd 6 .. '. 10/88 CIO Y � t { Y.E. R.A. I�j �j � il 11Q11�1A�[ CODM'tgD�AZ'1�!'.OF +HEALTHY e, ` .��5��'�; —f ?!� �'� DI�d���s raltlBM115Sinlow.�Q�w1.N Y1�61? �,� ✓7 ham. aI " MAW M� A�iwr ,tLf3 alit nclosed s++ft . :. P • N�a'o[ Oi� =' G ^P D ®Niotldcllai � • _ fANt� � t APVROVEO'FOR CONSTRUCTION:aTAit.apj .«Duna /a' -uuw oc,m�y e.:i�wnaw -or =n nouns a n.' j4 ' c. Aoo.o_r:a ro. ; Rev. a +:nd 6 .. '. 10/88 CIO Y � t { Y.E. R.A. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # i WELL LOCATION Street Address Town/Village/City Tax Grid Number 2 . WELL OWNER Name. Mailing Address a cPiivate Public SE OF WELL 1 - primary - secondary RESIDENTIAL O PUBLIC SUPPLY O BUSINESS O FARM O.INDUSTRIAL O INSTITUTIONAL Q AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY O ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT _gpm /# PEOPLE SERVED: - /EST. OF DAILY USAGE4 sal O REPLACE EXISTING SUPPLY . ❑ TEST/ OBSERVATION 11 ADDITIONAL SUPPLY [$NEW SUPPLY NEW DWELLING) 0 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING 12��Ir7riG� _ WELL TYPE ®DRILLED DRIVEN DUG ®GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES _ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. r WATER WELL CONTRACTOR: Name 'T8t2 Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: N 1A TOWN /VIL /CITY DISTANCE-TO-PROPERTY FROM NEAREST. WATER.MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED [21ON SEPARATE SHEET 3- (date) gnature 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 thirt3r (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 dril ng operations be contained on this property and in such manner as not to degrade or oth r Cnta ate surface or groundwater. Date of Issue: � 19� Date of Expiration J 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller - - _ - LAURENT ENGINEERING ASSOCIATES, P.C. MIL _ _ _ -•• -- -._.. LBROOk�.OF.F.IG.E- CENTRE - ' `- Route 22 6 Milltown Road. Brewster, New York 10509 (914)278 -6108 -(FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS, May 5, 1997 Robert Morris, P.E. Putnam County Health Department 4 .Geneva Road Brewster, NY 10509 RE: Proposed SSDS - Renewal Ann & Kathleen O'Keefe Manchester Drive (T) Patterson, New York Dear Robert: Erosion control measures for the house, well and SSDS are shown and detailed on the following `enclosures: i Four (4) prints of SS -1 "Proposed SSDS"; revised- 5 -5 -97. - - - Kindly issue a renewal permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. HWN:TR:bd 88068 � .V �:G f � ,'�'s•l is a � v. ,`' .:': `s ! i'eEx�� � c 1 �p�n• �;ts_.. LAURENT ENGINEERING ASSOCIATES, P.C. — MILL'BROOKE- OFFICE "CENTRE ..... Route 22 & Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278- 6108- (FA)O278.2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS March 18, 1997 Robert Morris, P.E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Renewal :Permit No. P -17 -89 Sanborn Road T.M. 25.47 -1 -13 Ann & Kathleen O'Keefe Patterson, N.Y: Dear Robert: Enclosed are.copies of the following items: ' 1. "Construction Permit for'Sewage Disposal System ", dated 3- 18 -97./ 2.. "Application to Construct. a.Water Well", dated 3- 18 -97. 3. "Authorization Form ", .dated 348 -97 4. Four (4) prints of Drawing 'SS -1 "Proposed SSDS ", revised 3- 18 -97. We are requesting a renewal of the enclosed for an additional two (2) years. If you have any questions, please feel free to call. Very .truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. ichols, Jr., P.E. HWN:TR:bd 88068 enc. cc: . Mrs. A. O'Keefe ,� L E j.A I' l J., �g •i`I A J Gentlemen: This letter. is to authorize a duly licensed-professional engineer .or registered architect (Indicate ) to -apply fora 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;.'arid ' to sign: all• necessary papers on my behalf iu 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 Lam "„ -' e e,, r 1 tary Code. VV Countersigned: 0 P.E. , R.A. :ublic Health Law, and the Putnam County San!- 4 V- %.' C Very truly yours, Signed Owner of Property/. Address Town Telephone W BRUCE R FOLEY Acting Public Health :Director DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 TeL (914) 278-6130 Fax (914) 278-7921 April 4, 1997 Ham Nichols Laurent Engineering -iillbrook Office Ctr. Route 22 & Millbrook Road Brewster, NY 10509 Re: Proposed SSDS: Ann & Kathleen O'Keefe 'Manchester Drive (T) Patterson Dear Mr. INIchols: Review of plans and other supporting documents submitted at this time relative. to the above- captioned - - - - - -- - - -- .... - -- -- - -- -- captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." "You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You should contact city Officials in this regard." 1. Erosion control measures for the house. well and SSDS are to be shown and detailed on the plan. 2. Current codes require all slopes within the SSDS area greater than 15% less than or equal to 20% be reduced to 15 90 bi, the addition of fill. Upon receipt of a submission, revised to reflect the above, this application «ill be considered further. Ve truly yours; Robert Morris, P. E. Public Health Engineer R-\,Ujp W — ''BRUCE R. FOLEY Acting Public Health Director DEPARTMENT OF HEALTH Division of m Environmental Health Services 4 Geneva Road Brewster, New York 10509 TeL (914) 278 - 6130 Fax (914) 278-7921 .Apiil4, 1997 Ham -Nichols Laurent Engineering Millbrook Office Ctr. Route 22 & Millbrook Road Brewster, NY 10509 Re: Proposed SSDS: Ann & Kathleen O'Keefe Manchester Drive (T) Patterson Dear. .N!r. \gichols: Review of plans and other supporting documents_ submitted at this_time.relative_to .the. above- captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." -`.You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You should contact cih, Officials in this regard." 1. Erosion control measures for the house, well and SSDS are to be shown and detailed on the plan. 2. Current codes require all slopes within the SSDS area greater than 15% less than or equal to 20% be reduced to 151-o by the addition of fill. Upon receipt of a submission, reused to reflect the above, this application will be considered further. Ve truly vours. dv_ Robert Morris, P. E. Public Health Engineer II-M/iP BRUCE i . FOLEY Acting Public Health Director. DEPARTMENT OF HEALTH Division of; Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278 - 7921 April 4, 1997 Harry Nichols Laurent Engineering Millbrook Office Ctr. Route 22 & Millbrook Road Brewster, NY 10509 Re: Proposed SSDS: Ann & Kathleen O'Keefe ?Manchester Drive (T) Patterson Dear Mr. Nlichols: Review of plans and other supporting documents submitted at this time relative to the above- . _ _ ...__ .. _._ captioned project has heeri completed: Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." "You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You should contact city Officials in this regard." 1. Erosion control measures for the house, well and SSDS are to be shown and detailed on the plan. 2. Current codes require all slopes within the SSDS area greater than 15% less than or equal to 20% be reduced to 151,0 by the addition of fill. Upon receipt of a submission, revised to reflect the above, this application will be considered further. VeyKtruly yours, //�_ Robert -,\Iorris, P. E. Public Health Engineer PUM/b —•._ - _ BRUCE R. FOLEY Acting, Public Health Director DEPARTMENT OF HEALTH Division of.. Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 F= (914) 278 - 7921 April 4, 1997 Harry Nichols Laurent Engineering NIillbrook Office Ctr. Route 22 & INtillbrook Road Brewster, NY 10509 Re: Proposed SSDS: Ann & Kathleen O'Keefe 'Manchester Drive (T) Patterson Dear fir. Nichols: Review of plans and other supporting documents submitted at this. tune relative to the- above- captioned project has been completed. Comments are offered as follows: `=The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard.'.' - ° "You are referred to article 128:1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. 'You should contact cih? Officials in this regard." 1.. Erosion control measures for the house, well and SSDS are to be shown and detailed on the plan. 2. Current codes require all slopes within the SSDS area greater than 15% less than or equal to 20% be reduced to 15 °o by the addition of fill. Upon receipt of a submission, revised to reflect the above, this application will be considered further. VeRNtruivIvours. Robert Morris, P. E. Public Health Engineer P-\, /jP z� IV �a 68 Y an j F � � t • � 1 r [.�L ✓& LV.r-v`�p- �� • }� t .. eF r s 4ount Ebo rs' :orporate �c L @e►rt�r -- 5 _ i . XI�K \ exlyr.5ypg/ �Oy hE1 WWO OtGK � i i I; z 1 N 98'33' E . / GXI`T. Po w I. Ai�1 �u veto 1 ed ��K q' r i I IOOO GAL ef "14 I 1 1 I I I 1 • '� I I. I i I ' i 10' i� Y i. f'A 11 IOOLriA._'eAt!1yFBN �. 9g. A6 Ott I IOhI �Z�MCiFi! h i e S` -5 53 co vv I I I `1- 1; a= fi i AI 3Y