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HomeMy WebLinkAbout1061DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.48 -2 -49 & 25.48 -2 -50 BOX 11 I ps i ; INL i r ,. � ! ; tem �'� �- Lo J,', t ,1 0 IN I T � , r I i : � ; o` I . 01061 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: TownNillage: Tax Map # Map Block Lot(s) Well Owner: Name: Address: ` Use of Well: 1- Primary 2- Secondary _Residential _Public Supply Air cond /heat pump _Irrigation Business Farm Test/monitoring —Other(specify) Industrial 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 &t. Diameter _&_in. Weight per foot ZY lb/ft Materials: Steel Plastic Other Joints: Welded -X Threaded Other Seal: Cement grout Bentonite Other Drive shoe: Yes _ No Liner: _Yes No Screen Details Diameter (in) Slot Size Length ft Dept to Screen ft Develo ped? First I No Hours Second. __d—Yes I Wei I­Yield Test---: — _Bailed-- _Pumped- Compressed Air - -: Hours - - -` Yield- A­. gpm------- Depth Date Measure from land su ace- static spec tt 1 / During yield test (ft) 3ept or completed well In ft. D Well Diameter in Formation De cri tion Well Log If more detailed descriptions or sieve analyses are available, please attach. Depth Prom Surface Water Bearing ft. ft. If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth —5' CPU(, Model ? Voltage �, HP Tank Type C / I/G Volume �d �a�e eii omp(eted� Y ��`^° Y : i.:• Y.k a.+ 1NBII Driller K. §}.:{� �'i.. � PC 1�� ;F "��W^ ��,tr..k �?:,:. '�"�^ & '�.'' r�... ..:Y:'r.��� #�' � #..� �» . # � "'i �2 �_ �� �T�`w�.' r. i 1 ,1 '_� "'1 M� Cl W III rillerName 8�'Address +:. # ry #� `*- e'\ � '� �1 . � �S!' a f'.,Y r ,i �Ne p »r2 "L .i 9.? ''" si: ' ".i., ae..•� ;:t . <".. 21 v. i r e�� sre e S 1 ' �� �Y'U� � � p, �i �{, ,� N a #^ dnll� "'A e il'��jPi ih e: z- t� a Pump Installer Name � Address � * � k M . 5.0 a � a . ..,� +� rAW'iyiet. w: �3K. 3'^4:! !}p #� � t � C tWX». iK� '?die` ` R. m st ler si(yn' ur , iw I r-: Cxaci Locauon or well wim aistances to at least two permanent ianamarKS to de proviaea on a s6maram Sheeran. v White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 I i Sherlita Arlen, MD, IBS, FAAP Commissioner of Health _ - Robert Morris, PE Director of Environmental Health Department ®f Health 1 Geneva Road, Brewster, NY 10509 ADDITION APPLICATION RESIDENTIAL ONLY Robert J. Bondi County Executive STREET -6 PA&`I Dr TOWN iB AIOV� pTAX MAP ## NAME . 1 �.�u�� �.. (.,d. PPONE 05..__- ., ..Z� W -107,7, ,PC D# _-d - AVULING ADDRESS 'P.O. Bo 751 BW4r 5k 'J my DESCRIPTION OF ADDITION Lev 66 NUMBER OF EXISTING BEDROOMS Z PROPOSED # OF BEDROOMS _Z __ (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING ;l1VSPEC"1C'OR) "Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary. Co<ie.. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. I.. Certified check or money order for $100.00. :..::.,. 2'. - _.Sketches of_ex sti�tg.flo_or.pian_(clrawn to scale;_ all IN iraclgadi bacer�l n , to be shown and dimensioned and use. of each room specified). (See Section 3.c of Bulletin 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non- professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) . 4. Copy of survey showing all well and septic locations on the subject property to the best: of your knowledge. Include date of installation known. Contact this office with any questions. 5.. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE C 0 M M131\TS A Envlronuaeratal H wkh (845) 278• -6130 Fax (945) M-792-1 VV ate r gapply Section (845) 2,25 -5186 Fax (345.).225-5418 Nursing Sen kes (845) 278••6558 Fax (845)1.78 -6026 T v.rs nr / Home Care Agency (845) 278 -6085 WIC (845) 278 -667£ Early ruierventse =o / Preschool (845) 228 -2847 Fax (845) 2.25-1580 N............. .................... ......... ­ --- -- -- ----Date . ....... .... . ...... ........................................ TOWN OF PATTERSON PUTNAM. COUNTY, N. Y. Application for Installation of Sewage Disposal Fac' ities Fee of *7.50 must accompany Application The undersigned hereby makes a cation for -approval of and a certificate of occupancy for the installation of Septic Tank E] Cesspool ❑ Chemical Toilet ❑ Privy ❑ on the property described beloV. zcu, Location of Property ..... .......................................... ........ / ........... .............. Village Street or Avenue sr X Subdivision.................. L ..................................... .................. ............................................... Block NO. Size of Lot Character of building Dwelling Garage ❑ Store ❑ or other ❑ Z.1. 71 No. of Occupants ...................... Bedrooms ............ .... pa ...... Baths .......... *..'-j .. ...Extra Showers ......... " -7--- Garbage Disposal Sink ............................ Automatic Laundry --Wdshdr-.--...-'--....-.-....'.-.-.'-.-...'.-..'.--...'..'--.-. Source of Water Supply' Public ❑ Drilled Well [3 V"'D u*g. Well ❑ Spring ❑ Ground ❑ Name of Owner..__._. .......... ...... Address ... . ..... ....... -.--. Diagrain-olw.w.mg-loc#ioxL-ot-pro.p.osed. ilasUllation.....on-..:.pto.perty... (Show..... distanqp-. ..from,. adjoining property line and, distance from nearest water, watercourse or source of water supply, within 200 feet. Also show location of dwelling or building to be served.) 94 0 Percolation Test Time In Min., Inches Tank Cap. Linear R. of In Gals. Trench Corrections, if any, to be made by Inspector in red. General Contiaetoz�!tlf_ Subcontractor ............................................................. (sign) (Sign) Address....................................... ........t............--- . - - - -.. Address, .................................. ............................... 4 U SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Town Legal Bedroom Count & Proposed Addition Status . Re: s Name) Tax Map .# Address:, f Town: Year Built: According to records maintained by the Town, the above noted dwelling, is incompliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: 8 This information has been obtained from: Certificate of Occupancy: Other: The plans for the proposed addition are considered: New Construction Addition to existing house only _ Teardown and/or re -build allowed under Town Regulations Bu'lldipf spp6Kr%7, Date J 6. Environmental Health (845) 278 -6130 .'Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 - . Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 /N-S/ T 7Tf7,LANDBAPE ENG1NEER1NGH rECTREPC. LETTER OF TRANSMITTAL 3 Garrett Place _ ....... _ . --.._(845) 225. 969.0_._ -,. ..._....._._--- . - - - -- . _..___ _ ......__ . _._..._... _.,... Carrhel, New York 10512 Fax: (845) 225 -9717 Date: f f. 2- 2-07p I Job No. 0,( iZ,/" Attn: �A�k N5 Re: Q r r WE ARE SENDING YOU ❑ Enclosed ❑ Under separate cover via the following items: ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter, ❑ Change Order ❑ COPIES DATE NO. DESCRIPTION 6111!! -.!C GJ!ll1Y►_r- —_ -- —_ THESE ARE ,TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval or your use ❑ Approved as noted ❑ Submit copies for distribution ❑'As requested ❑Returned for corrections ❑ Retum corrected prints ❑ For review and comment ❑ REMARKS: A1ilC , C44do4X4 .ASe '�il,�l -> %M (mil wwwk4 Gj/Vj f*-ek C^40tc� Me 6& 46 COPY TO: doc IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE s 8 Kendal Dr -Basement r 40' 24' n • lb ...�• avow PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION.OF ENVIRONMENTAL HEALTH SERVICES. APPROVED AS NOTED FOR CONFORMANCE WITH APPLCCABLE RULES AND REGULATIONS OF THE P TNAM COUNTY F LTH DEPARTMENT. // 1{ -40 IG ATURE�& rLE DATE�� a] w PUTNAM COUNTY DEPARTMENT OF HEALTH IVISION_ OF.ENVIRONMENTAL._HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Habitat for Humanity Putnam County Located at 8 Kendall Drive TN Patterson Tax Map # 25'48 Block 1 Lot 49 & 50 Subdivision of NIA Subdivision Lot # NIA Filed Map # NIA Date Filed NIA Gentlemen: This letter is to authorize Insite Engineering, Surveying, & Landscape Architecture. P.C. (John Watson P.E.) a duly licensed Professional Engineer X to apply for the required __.___.__wastewater - treatment- and /or- water - supply- permit(s)- to- servethe- above- noted - property -in- accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law; and - the Putnam County. Sanitary Code. .. _ . �_._.......�_ .._,._ ..... _ _. .... . Countersigned: P.E., R.A., # 77950 John M. Watson P.E. Mailing Address Insite Engineering, Surveying, & Landscape Architecture. P.C. Carmel State New York Zip 10512 Telephone: (845) 225 - 9690 Very truly yours, Signed: lul'� 2LI �*er of Property) Mailing Address: P0 gox 791 B rP'i Jff e r State - Zip_ 'J Telephone: 7 V ,Z, 3 0 8 0 ;uZ 14 Ph W " 61 ° 7 Form LA -97 I.- _ _. _ /NS/ T -E "117 ENGINEERING, SURVEYING & ' LAWDSCAPEARCH/TECTVRE, P.C. 3 Garrett Place (845) 225 -9690 Carmel, New York 10512 " Fax: (845) 225 -9717 LETTER OF TRANSMITTAL Date: / -3-p Job No. Attn:?�t`{a5 Re: Q iht MOM / WE ARE SENDING YOU ❑ Enclosed ❑ Under separate cover via the following items: ❑ Shop Drawings ❑ Prints ❑. Plans ❑ Samples ❑ Specifications, ❑ Copy of Letter ❑ Change Order ❑ COPIES DATE NO. _ DESCRIPTION THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ,For your use ❑ Approved as noted ❑ Submit copies for distribution - -.... _......__.... - ❑ -As requested .. _..... .. _ ❑- Returned-for•corrections - Rerum. __.- ..... -.•- _ -•. ..._... _.._.,_ conected prints. _......_...._..._........__ ❑ For review and comment ❑ REMARKS: I 144 C4VSXd ate_ 141ty A,, `ry WN01 COPY TO: SIGNED: Tcrc. sue. h-�. IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE doc Sherlita Amler, MD, MS, FAAP Commissioner of Health Robert Morris, PE - Director- ofEnvironmental Health November 5, 2010 Department of Health 1 Geneva Road, Brewster, NY 10509 Office (845) 808 -1390 Fax (845) 808 -1937 Habitat for Humanity Putnam County P.O. Box 781 Brewster, NY 10509 Attn: John Parish Re: Addition — Approval — A- 166 -10 No Increase in Number of Bedrooms 8 Kendal Drive (T) Patterson, T.M. # 25.48 -2 -49 & 50 Robert J. Bondi County Executive Dear Mr. Parish: This Department has received and reviewed the plans for the proposed addition application at the above referenced site. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department dated November 5, 2010. The addition is approved with the following conditions - 1:T-he-total- number - of-bedrooms -must remain -at- two -(2-1 -in the proposed- house - without- - - - - - - prior approval by this Department. 2. All plumbing fixtures`must be water saving devices (i.e., n6w low flush toilets, restrictors for shower heads and faucets, etc.). 3. The modifications to the subsurface sewage treatment system (SSTS), under repair permit _ R- 254 -10. are . to -be _completed_prior.to.,issuanee oiacerJificate _.ofocopancyby.the.Town..,..._ _:...�: �... Building Inspector. Any permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. Respectfully, I Michael J. ] Director of MJB:kly cc: BI (T) Patterson J. Watson, PE of SITE LOCATION OWNER'S NAME MAILING ADDRESS APPLICANT PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Internal Use Only PERMIT-# - C) 5 9 V I D Repair Permit issued in last 5 years ❑ Not in Watershed Repair within Boyd's Comers, W. Branch or Croton Falls Res. Delegated Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review J3 �f�tj Dr. TOWN {?4*, %M TM # Z�r,). 9 -2' 49 J 5Z bi goWtGI.I 1%'i}MaV4 l�tM� PHONE # &q%9 -7ZO- WZ'L Name & RelationsAip (i.e., owner, tenant, contrdctor) ' DATE ( PCHD COMPLAINT # --!— PROPOSED INSTALLER ukd Str{• A 5tSkmS 7C:" PHONE # g1fi5- 2,79 -909 ADDRESS Zp T1 Hilt gA tJY 1009 REGISTRATION /LICENSE # Proposal (include a, separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair,. _ ---') /I i -d r, I, as owner,agree to the conditions stated on this form SIGNATUR �` TITLE ) a ADATE (owner)the septic Witi1 t17p Sonditions-of•this permit'for the "septic system'edpair• SIGNATURE (installer) TITLE i' DATE rwNuaa1 aRUIUVO a vnuI uia wnvwuiy W11URIU110. y 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY posal Approved Proposal Denied El spector's Sign tur (& itle Date Expiration Date Repair ro al is in c liance ithapplicable codes Yes O No COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 0 ri /NS/ TE ENGINEERING, SURVEYING & LANDSCAPEARCHITECTURE, P.C. 3 Garrett Place' (845) 225 -9690 Carmel, New York 10512 Fax: (845) 225 -9717 TO: Michael J. Budzinski P.E. Director of Engineering Putnam County Health Department 1 Geneva Road Brewster, NY 10509 - -- LETTER* OFTRANSMITT]AL - -- ._ _...... Date: 3 -8 -2012 Job No. 10142.100 Attn: Michael Budzinski, P.E. Re: SSTS for Habitat for Humanity 8 Kendall Drive, Town of Patterson TM# 25.48- 2 -49 &50 WE ARE SENDING YOU N Enclosed ❑ Under separate cover via the following items: ❑ Shop Drawings N Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change Order ❑ THESE ARE TRANSMITTED as checked below: NFor approval ❑Approved as submitted ❑ Resubmit copies for approval I. ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested []Returned for corrections ❑ Return corrected prints ❑ For review'and comment ❑ REMARKS: Mike, as requested attached please find an SSTS As -Built Drawing for the Habitat for Humanity Project located at 8 Kendall Drive in Patterson. If you have any questions or concerns please feel free to contact me at the office. COPY TO: John Parish, w / enclosures INSITE file 10142.100 Iot030812mb.dot SIGNED: J hn M. Watson, P.E. V e President, Sr. Project Manager IF ENCLOSURES ARE NOT AS NOTED, KINDLY T ONCE COPIES DATE NO. DESCRIPTION 5 3 -5-12 AB -1 As- Built Drawing r ; i, THESE ARE TRANSMITTED as checked below: NFor approval ❑Approved as submitted ❑ Resubmit copies for approval I. ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested []Returned for corrections ❑ Return corrected prints ❑ For review'and comment ❑ REMARKS: Mike, as requested attached please find an SSTS As -Built Drawing for the Habitat for Humanity Project located at 8 Kendall Drive in Patterson. If you have any questions or concerns please feel free to contact me at the office. COPY TO: John Parish, w / enclosures INSITE file 10142.100 Iot030812mb.dot SIGNED: J hn M. Watson, P.E. V e President, Sr. Project Manager IF ENCLOSURES ARE NOT AS NOTED, KINDLY T ONCE Putnam County Department of Health Division of Environmental Health Services SSTS Repair - Final SitIns ction Date: �2• Inspected by -� installer: - _ ..Street Location: Q- %�Y r - .Ow ler b...t. , - ,.v G � -i� - -- - : _. . Town: Repair Permit #: - _ TM #,r�l' 1. ,Type of System: Conventional ❑ Alternate O Comments: 2. Se tic Tank Yes No N/A Comments a. Septic tank size -1,000 ... 1,250... other... 6 b. Septic tank installed level ...................... c. 10' minimum from foundation .................. d. Distribution Bog i. All outlets at same elevation (water tested) ... ii. Protected below frost........................... 1701 � ,,, /7 �GcIJ L iii. Minimum 2 ft. Original soil between box & trenches e. Junction Bog - properly set ............................ f. Trenches i. System: eompletely opened for inspection 1 - tSZ / Lot-) ii. Length required Length installed x iii. Pie slope checked ........................ :.......... iv. Installed according to plan ................. - . .. . pp v. 10 ft. from property line - 20 ft - foundations ... A. Size of gravel % -1 '/Z " diameter clean ......... vii. Depth of .gravel in trench 12" minimum ........: viii. Ends capped .... ............................... u . Pumv or Dosed Systems 3. Sewa e System Area a. SSTS Area located as per a roved plans b. Fill section - c. Distance from water course/wetlands 4. Overall Workmanship a. Boxes properly grouted and installed correctly ........... b. All pipes flush with inside of box ......................... c. Backfill material contains stones <4" diameter ......... d. Curtain drain & standpipes installed according to plan e. Curtain drain outfall protected & dir to exist watercourse E Footing drains discharge away from SSTS area ......... g. Erosion control provided ............................ Additional Comments 3 f i2k2 A RFSI Rev - 011312 1 Via:. .i . tce? �^'�,dM1 , , .x. s .. ..a. . r ..R -. a .. �.,. r v.Yw i..„y� ^ti.• .� �*Y � r.3.= ww.a 3^Y' .. n. 3 � �a't t` n .. Al _ - x -gyp: �Y� �e3•a: v i A s x _ Y I . y \� �� y � \�� � . . y �� � . �< »«m \ » \�� / °� \��� y � < :2' \�� � � ,. .. ����6�2����.�� �..... . > .� � � : \� � © ®/ - �� �§ �� \ \ «�� » � \� � \ �� `� G . >.� � � ?� � � &� 1� � Q /NS/ TE _« ENGINEERING, SURVEY /IVG..'% __ - LANDSCA'PEARCH%TECTURE, P.C. November 30, 2010 Mr. Michael J. Budzinski P.E. Director of Engineering Putnam County Health Department Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 RE: SSTS Repair for Habitat for Humanity 8 Kendall Drive Town of Patterson Tax Map No. 25.48- 2 -49 &50 Dear Mr. Budzinski: Enclosed please find the following for your initial review and comments: Repair Drawing SR -1 last revised November 30, 2010 (5 Copies) As previously discussed, the enclosed repair drawing for the subject project has been revised per comments received from the Town of Patterson Building Inspector. The proposed house location has been shifted slightly farther away from Kendal Drive to maintain the front yard setback, requested by the Town. This house shift necessitated a revision to the proposed SSTS to maintain all of the setback distances. As shown on the revised plan, the southern most absorption trench has been eliminated and the restrictive distances between the proposed SSTS, the proposed house,'and the property lines have-- - all"been riiaintainad: 14 "shduld'be'noted thafthe Miff in this house location has reduced the proposed length of absorption trenches to less than the required amount, although as previously stated, all of the setbacks to the proposed SSTS have been maintained. If you have any questions or comments regarding this information, please do not hesitate to contact our office. Very truly yours, INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. By: lJohn. e atson, P.E. ent, Sr. Project Manager JMW Enclosures cc: John Parish, w / enclosures Steve Biolsi, w / enclosures Insite File No. 10142.100 3 Garrett Place, Carmel, New York 10512 (845) 225 -9690 Fax (845) 225 -9717 www.insite- eng.com 102210mb.doc I-- . /NS/ T �NG/NEER /NG,- SURVEY /NQ & I=9CAPEARCH/TECTURE, P.C. October 28, 2010 Mr. Michael J. Budzinski P.E. Director of Engineering Putnam County Health Department .Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 RE: SSTS Repair for Habitat for Humanity 8 Kendall Drive Town of Patterson Tax Map No. 25.48- 2 -49 &50 Dear Mr. Budzinski: Enclosed please find the following for your initial review and comments: • Repair Drawing SR -1 last revised October 28, 2010 (5 Copies) • Addition Application • Floor Plans for the proposed dwelling, (2 copies). In response to your comment letter dated October 13, 2010 comment letter we offer the following: _..._..w.1: -. TheSewage- Disposal -Systen7•R pairpermit-has~ been - returned- to -youroffice- and-will-tre-:" - - -- signed by the septic system contractor. 2. Enclosed please find an addition application for the subject project. 3. The floor plans have been revised to label and identify the rooms in the proposed house. 4. A basement floor plan has been enclosed with this submission. 5. The Repair Drawing has been revised to show the location of the existing SSTS. 6. The deep test hole and percolation test hole locations are shown on the revised Repair Drawing. 7. The deep test hole description has been provided on the revised plan. 8. As shown on the revised plan, the locations of the existing septic components are closer to the existing well than the proposed SSTS. 9. As noted on the revised plan, during the field investigation the existing metal septic tank was found be empty and mostly eroded. At that time the septic tank was crushed and backfilled with existing onsite soil. If you have any questions or comments regarding this information, please do not hesitate to contact our office. Very truly yours, INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. 102210mb.doc 3 Garrett Place, Carmel, New York 10512 (845) 225 -9690 Fax(845)225-9717 www.insite- eng.com RE: SSTS Repair for Habitat for Humanity Page 2 of 2 8 Kendall Drive, Town of Patterson October 28, 2010 \ a A( By: Joh M. Watson, P.E. Vice President, Sr: Project Manager JMW/ Enclosures cc: John Parish, w / enclosures Steve Biolsi, w / enclosures Insite File No. 10142.100 102210mb.doc i /NS/ T ENGINEERING, SURVEYING & -- - " "- - - --- 2AIVDISCAPEARCIIITECTURE -NC. -. - -- 3 Garrett Place (845) 225 -9690 Carmel, New York 10512 Fax: (845) 225 -9717 Age .,�. LETTER OF TRANSMITTAL Date: 104 -50 Job No. tol(lZ-10 Attn: M LL 'I Re: V 1 f •Y wt1� WE ARE SENDING YOU Enclosed ❑ Under separate cover via ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ ❑ Samples the following items: ❑ Specifications COPIES f DATE /0- /3- 7470 { NO. I DESCRIPTION M - ?aY- ,o`_c. i _ ---- -... p ... .... ....... -. __ _....._ ............ __.. __._;. _ - _ _ -_. THESE ARE TRANSMITTED as checked below: []For approval ❑ Approved as submitted ❑ Resubmit copies for approval - --❑-F-orTouruse-.. _.. -......_._ _. = '❑'APProved asnotad.._....__...❑.g�;bmit ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: w5l u4c,Wal �OCeasQ �i k�l f-te 605 1 V'Ac I u,c v pl- w 1' w ..JM P . .7Q0 7yll� 11 w;11 ,. 6 Lf W '� w' Ill c use dl�� I! COPY TO: lot2002 lines.dot SIGNED- e IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE She?lita Amler, MD, MS, FAAP Commissioner of Health Robert Morris, PE Director of Environmental Health October 18, 2010 John Watson, PE Insite Engineering 3 Garrett Place Carmel, NY 10512 Dear Mr. Watson: department of Health 1 Geneva Road, Brewster, NY 10509 Office (845) 808 -1390 Fax (845) 808 -1937 Robert I Bondi County Executive Re: Proposed SSTS Repair for Habitat for Humanity at 8 Kendall Drive (T) Patterson, TM # 25.48 -2 -49 & 50 This Department has received and reviewed the submitted application and plans for the above - mentioned project and the following comments are offered for your consideration. �t-1. The sewage treatment system repair permit is to be signed by the septic system - contractor. ,2 Since the existing house is being rebuilt, an addition application is required to complete your submittal. rooms -on the - submitted house floor.•plans,are to-be identified and labeled:- _. • A basement floor plan is to be provided. ,f3 The location of the existing SSTS is to be shown on the plan. The locations of the deep test hole and percolation tests are to be shown on the plan and labeled. ,If The deep test hole description is to be provided on the plan. L/9' The proposed absorption trenches shall not be any closer to the existing well than the existing SSTS. A note is to be provided on the plan stating the existing septic tank is to be pumped of its contents by a NYSDEC permitted septage hauler and the tank either removed or filled with inert material. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. Respectful] Michael J. Director. of MJB :kly PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR YES Internal Use Only PERMIT # - 0 - f D ❑ Repair Permit issued in last 5 years ❑ Not in Watershed ❑ Repair within Boyd's Corners, W. Branch or Croton Falls Res. A Delegated ❑ ,r"l Repair within 2`00 ft. of a watercourse or DEC - mapped wetland El Joint Review ` SITE LOCATION � � -E>r. TOWN ?a ssn TM # -2- Sa_ OWNER'S NAME b, qdWdyuJ21 4,wt (AA46 PHONE # MAILING ADDRESS $ APPLICANT A61ol i 4C auhW iA {?+i-b► ri vol M c/o Jok�, Name & Relationship (i.e., owner, tenant, contrdctor) r DATE /Q_ /3 -'mod FACILITY TYPE srciQN► 1GI,I PCHD COMPLAINT # PROPOSED INSTALLER "i "l 4-goh;o Sm,s PHONE # A4�- Q2-='J ADDRESS 2,6 Rib �Ib r y tgSP_J REGISTRATION /LICENSE # Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. I, as owner,agree to 41, :-Cr the conditions stated on this form SIGNATURE ��` TITLE - !tom DATE _... _. I, the septic inst ler, agree to comply with the conditions of this permit for the septic system repair SIGNATURE TITLE DATE (installer) Proposal approved with the following conditions: 3 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of Installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved ❑ Proposal Denied ❑ Inspector's Signature & Title Date Expiration Date Repair proposal is in compliance with applicable codes Yes O No COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 .4 mp� PUTN,-.k,VI COUNTY DEPARTMENT OF HEALTH DDISION OF ENVIRONNIENTA.L HEALTH SERVICES DESIG3N DATA SHEET — SUBSURFACE SEWAGE TREATMENT SYSTEM Owner: 11,4AITAI- AVE Address: 1) Kav4e I Located at (street): TM r"r' Section: — Block — Lot Municipality: =,t:- --SCAI Watershed:. 4 4ST -5TZAtJe—I+ SOIL PERCOLATION TEST DATA Witnessed by- - Date of Pre-soaldnr: 0 Date of Percolation Test: V130 72a Hole No. Run No. Time Start— Stop Elapse pse Time (min.) Depth to ater from ground surface (inches) Start Water level drop in inches Percolation Rate min/inch A 1 Xz I 2 X90 I o S —/2 13 .3 30 4 5 2 I. 3 4 5 2 3 4 5 2 4 mores: 1. Tess to be repeated at same depch until approximacaiy equal percolation races are TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES Indicate level at which groundwater is encountered Indicate level at which mottling is observed — Indicate level to which water level pises4after being encountered Deep hole observations made by: In JIV('(14 Date Design Professional Naive: Address: Signature: Design Professional = Seal /NS/ TE ENGINEERING, SURVEYING & _ "- "NDSCAPEARCHITECTURE, PC. October 13, 2010 Mr. Michael J. Budzinski P.E. Director of Engineering Putnam County Health Department Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 RE: SSTS Repair for Habitat for Humanity 8 Kendall Drive Town of Patterson Tax Map No. 25.48- 2 -49 &50 Dear Mr. Budzinski: Enclosed please find the following for your initial review and comments: • Repair Drawing SR -1 dated October 8, 2010 (5 Copies) • Proposal for Sewage Disposal System Repair (PC -RP 99ML Form). • Floor Plan for the proposed dwelling, (2 copies). If you have any questions or comments regarding this information, please do not hesitate to contact our office.. Very truly yours, INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. By: John . Watson, P.E. Vice _.resident, Sr. Project. Manager. _........ T_.� ..�.._...r_. ._ .� Enclosures cc: John Parish, w / enclosures Steve Biolsi, w / enclosures Insite File No. 10142.100 3 Garrett Place, Carmel, New York 10512 (845) 225 -9690 Fax (845) 225 -9717 www.insite- eng.com 100810mb.doc c SDR is 0 WIPT OPE (TYP.) C.L SouthwestF:;y 4.9'' V, n Co I -i,