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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.62 -1 -83, 85 and 86 BOX 12 01202 FU r . �. . 01202 topNow Harry W. Nichols, Jr., P.E. New York city Laurent Engineering Associates Department of Route 22 and Milltown Road Environmental Protection Brewster, New York 10509 Bureau of Water Supply & Wastewater Collection Sources Division (914) 742 -2002 Dear Mr. Nichols: b� RE: Lobraico - Canton Dr. and Barnard Rd. Putnam County, Patterson Project Log 2881 East Branch Reservoir _ Enclosed please find the New York City Department of Environmental Protection's (DEP) SUBSURFACE SEWAGE TREATMENT SYSTEM DETERMINATIONfor the above 465 Columbus Ave. referenced property located on Canton Drive and Barnard Road in Putnam Lake section of the Valhalla, New York 10595- Town of Patterson, New York. 1336 Please contact Margaret Lloyd at 142 -2033 at least 2 days prior to the start of construction of the subsurface sewage treatment system so that we may inspect and monitor the MARILYN cE Commissioner r installation. A copy of this determination must be available at the project site during Commis construction. One set of plans bearing our conditioned stamp of approval is enclosed. ROBERT LEMIEUX First Deputy Commissioner Adn° Difeo1or Very truly yours, Edwin Polese, P.E. Program Engineer Encl:plans xc: Director of Environmental Health w /encl. Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Richard Williams, Chairman w/o encl. Patterson Planning Board Routes 311 & 164 Patterson, New York 12563 Primed on recycled paper I'Tew York City ��'���jj�'r��, ll)e'���Q,�Ietl��e'I�t �i►f' SUBSURIFACIE SEWAGE TREATMENT SYSTEM DETERMffNATffCN Pursuant to the authority granted under: Section 1100 of the Public Health Law; Section 18 -03 of 15 RCNY; and Section 128.1 of 10 NYCRR; and in accordance with the standards of: 10 NYCRR Appendix 75 -A Wastewater Treatment Standards - Individual Household Systems; .NYSDEC Design Standards for Wastewater Treatment Works; and NYCDEP Procedures and Practices for the Approval of Septic Systems and Wastewater Treatment Plants: New York City Department of Environmental Protection makes the following determinations with respect to the sewage disposal system(s) plan described below: Name of II roject: Lobraico - Canton Drive and Barnard Road a.k.a.: Location: Canton Drive and Barnard Road; Putnam Lake; Town of Patterson; County of Putnam Owner: Maureen Lobraico Address: Barnum Corners RFD #3 Brewster, New York Drainage Basin: . East Branch Reservoir Type of Sewage Treatment System and General Description: A separate sewage treatment system consisting of a 1000 gallon septic tank and 222 lineal feet of absorption trenches. Each trench is two feet wide and spaced six feet on center. A reserve area has been provided with adequate area for an additional 222 lineal feet of absorption trench. The system is designed for a two bedroom residence based on a percolation rate of 8 -10 minutes per inch, the witnessed rate was 8 minuted per inch. Dates of Site )Inspections and Soils Test: July 5; 1995 - Witnessed Deep Hole Test July 5, 1995 - Witnessed Percolation Test Approved . ( ) Conditionally Disapproved Conditions of Acceptance: DETERMINATION ( ) Disapproved ( XX ) Accepted design Prior to the commencement of any construction requiring a building permit, the applicant must provide at least 48 hours actual notice to the NYCDEP engineer or his representative making this determination. 2. The facility shall be constructed and completed in accordance with the engineering report, plans submitted, specifications provided, which form the basis of this acceptance, and in accordance with the conditions of this determination. The project construction must be commenced within two (2) years of the date of the determination. 4. The applicant will provide "as built" plans to NYCDEP, certified by the engineer, where required or requested. When installed the system must be operated and maintained in accordance with NYCDEP Regulations and all other applicable regulations and/or standards. 6. In the event that the material submitted is inaccurate or misleading, or the owners of the project do not have the legal right to develop or use the property where and as shown on the material submitted to this office, this acceptance is withdrawn. 7. This determination constitutes approval only, of the physical design of the septic system for proposed installation and operation on a watershed of the New York City Water Supply. An acceptance of the septic system design does not effect any existing property rights, title, or interest, including without limitation, any public or private restrictions upon the use of the land. Therefore this determination shall not be considered to be a grant or waiver of any property right. 8. The sewage disposal system shall be constructed in conformity with the data and plans as accepted or commented upon. Any significant change in the system must be accepted in advance of construction by the Department of Health and this Department. 9. The system shall receive only the domestic sewage from the structures shown on the plans. The nature and quantity of flow from the structures shall not be changed without prior approval of this Department and the Department of Health. 10. All parts of this system are to be operated and maintained properly. In no case is sewage or sludge to be exposed or any other unsanitary or unsafe condition to be created because of the use of this system. Guidance on standards is found in the Waste Treatment Handbook issued by the New York State Department of Health under New York State Code of Rules and Regulations (10 NYCRR 75). CADATA\M1SC\LBRC0C &G. WPD 2 11. Whenever sludge and scum shall so accumulate in any septic tank so as to occupy together at any point more than one - fourth of the distance between the bottom and the flow line, the tank shall be cleaned. 12. Vvllenever sludge and scum are removed from any septic or settling tank or any part oft he system it shall be done in such a manner as to cause no nuisance, and the material shall be disposed of in accordance with applicable regulations. 13. This acceptance shall not be construed to invalidate any rule or regulation enforceable by local authority having jurisdiction. 14. All duly enacted rules and regulations for the protection of the water supply shall be complied with Administrative Rules and Regulations for the Protection from contamination to the Public Water Supply of the City of New York adopted under the authority of Section 70, 71 and 73 of the New York State Public Health Law. 15. This system shall be abandoned and a connection made to a public sewer if and when a public sewer is built that is available to this project. 16. Whenever it is determined by this agency that additional replacement or improved sewage treatment facilities are necessary such facilities shall be professionally designed at the expense of the owner or owners of this project. Plans are to be submitted to this agency and the Health department for review and approval, and facilities shall be constructed and maintained at the expense of the owner or owners of this project. 17. All material removed from the area of the failing subsurface treatment system shall be hauled and disposed of in accordance with all local, state, and federal laws or regulations, including those of this Department, pertinent thereto. Determination made by: :1LL -• Date: November 30, 1995 Edwin Polese, P. E. Program Engineer Environmental Programs New York City Department of Environmental Protection Recommended for Approval: l Senior Environmental Engineer Environmental Programs C:IDATAIMI S CILBRCOC& G. W P D i AM Cr"�G * * 4 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 September 18, 1998 John Calbo Building Inspector Town of Patterson Route 164 & 311 Patterson NY 12563 Re; Labraico Bernard and Canton (T) Patterson PCHOD Permit #P -6 -97 Dear Mr.. Nichols: BRUCE R. FOLEY Public' Heahh' - Director Due to the clearing of the above regarded lot, this Department has received inquires from the public on the status of the property, i.e., has a Health Department Construction Permit been issued. The _,..._ ..._..._ ......... Health Department.Perm.it.P -6-97 was issued on May 2,19-97- However, -2, review. -of cur -files indicates that there are a couple of unresolved matters. This Department respectfully request that the issuance of a building permit not be granted until the matters in question are resolved. A letter has been sent to the design engineer, Laurent Associates, in order to rectify the situation as quickly as possible. If there are any question regarding the above matter, please call me at (914) 278 -6130 ext.166. ►i AW, V ly yours Robert Morris, P.E. Public Health Engineer DEPARTMENT OF BEA]LTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 September 18, 1998 Harry Nichols Laurent Associates Millbrook Office Centre Route 22 & Milltown Road Brewster NY 10509 Re: Labraico Bernard and Canton (T) Patterson PCHOD Permit #P -6 -97 Dear Mr. Nichols: A review of the above regarded construction permit has indicated the following: .._.._BRUCE R. FOLEY Public Health Director 1. It appears the Construction Permit fee of $300.00 has not been received by this. Depar nent. If this is incorrect; -please submit aocumeiifatiodihat"fhe required fee has been paid. 2. The Town of Patterson Highway Department requested that a letter from the Trans - Atlantic Underground Cable stating that the proposed water line installation is acceptable (correspondence enclosed). This letter has not been received. It is this Departments responsibility to insure potable water can be supplied to the proposed home. A letter has been sent to the Town of Patterson Building Department requesting that a building permit not be issued until the above comments are unsolved. If there are any question regarding the above matter, please call me at (914) 278 -6130 ext.166. Ve y yours, Robert Morris, P.E. RM:tn Public Health Engineer enc. TO: FROM: RE: DATE: Town' -of- Patterson Highway Department P.O. Box 445 Pxherson, NewYork 12563 -044S • (914) 878.4341 (914) 878- 6130• F2x: (914) 878 -6130 K8�way Superint-endent: William H. Burdick . HARRY W. NICHOLS Jr., P.E. LAURENT ENGINEERING ASSOC, P.C. WILLIAM BURDICK LOBRAICO PROPERTY REQUEST MARCH 19, 1996 In regards to your letter of February 22, 1996 concerning the property of Ms. Lobraico - Property Y.25.62- 1- 83 -85 -86 and 13 the Patterson Highway Department has no problem with your request of crossing Lakeport Drive 'as long as the pipe is placed in a sleeve at the point it crosses the road, the blacktop .saw cut, backfilled with Item 4 and tampered at 6" inte-ry -al s end- a • mi-ni mum c` 5 0 bla� }stop,- .tcr --be inspected-.by_ .. the Highway. Superintendent when work is to be completed I would also request that your office contact the Trans - atiantic Underground Cable Company to be sure that it-is not a problem with them and that they can be assured that this pipe service won't harm or interfere with the cable. WHB:j cc: Putnam County Health Dept. Gainer Wilbur - Town Eng, 4 , New York 10509 of Health Attn.: Mr. Bruce Foley Director of Public Health Re: Proposed Residential Construction Comer of Barnard & Iroquois (a.k.a. Lakeport Drive) & the Comer of Iroquois and Addison Drive. Dear Mr. Foley: I am forwarding this letter to address my concerns in response to the proposed construction of a residential home on the abovementioned properties; It is my understanding that the owner, Ms. Maureen Labreccio, intends to construct a two bedroom home on the comer of Barnard and Iroquois and intends to install the drinking well on the property across the road at the corner of Iroquois and Addison. As-I = sure the Putnum-County health Depaivnent is aware; this area like all areas within the Putnuin Lake vicinity has faced numerous concerns over ground water quality as a result of poor septic system designs (particularly older systems) and the close proximity of homes. The area in question is a ground; water recharge basin with numerous shallow springs. This water finds its way to Little Pond (along Addison Road) which in return drains into Croton River, East Branch River and ultimately to the East Branch Reservoir, New York City's alternate drinking water system. It is also my 'understanding that the property (located at the corner of Barnard and Iroquois) encompasses three distinct parcel of which two parcels failed percolation tests which by law is mandated prior to approving septic system design. Over the years, Ms. Labreccio has attempted to gain approvals to build on this property. Approval to build on this property has been denied on more than one occasion. Ms. Labreccio is currently planning to submit a plan to build the house on the corner of Barnard and Iroquois, and place the septic on the upper parcel -(the one which passed percolation test). As a hydiogeologist myself, I think we can safely say that regardless of where she pumps the septic to eventually it will have to come downhill. Additionally, Ms. Labreccio plans to put. the well on the diagonal property along Iroquois and Addison Road and pipe it under the road to the house on the other comer. There are four other homes adjacent to the properties in'question to be_looke.d at especially the,property directly across_on.the.o te.�_comer of Barnard. and.Iroqur�is._ __........_�....._ _.: The drinking water well is located in the front of the, property and the proposed septic upgradient of the well poses a potential threat to the drinking water wells. This is not the first time Ms Labreccio has attempted to build a home where it does not belong. Recently another home built by Ms. Labreccio was . built on the corner of Newburgh and Iroquois. I am completely surprised that this building permit was issued, particularly because the corner foundation of the home was built within ' 10 feet of a Class A stream. It is my understanding that there is a minimum of a 50 foot set aside of a Class A stream. I am urging the Putnum County Health Department to make field observations of the existing adjacent homes including the location of drinking water wells and septic systems prior to approving this plan to build. In the nine years I have been a resident of Putnum!Lake, I have witnessed a number of homes being built. I think it is time we look at development from a macro point of view as opposed to a micro point of view. We cannot forget as scientists', that we need to view construction from all aspects including the environmental, social and political issues. The Brewster Central School system is already suffering from the overcrowding due to older residents moving and the numerous new homes that have been built in the last1hree years. I am urging the Putnum County Health Department to help in ensuring that Putnum County does not make the same mistakes other counties have done and ensure that . our drinking water remains pristine for many generations to come. Sincerely, Catherine M. Thomas :........:........ Hydrogeologist &Homeowner. -.. _ �- ...... - ._..'. , . � ._ ........ . _., _..._._..- .._....,....._...._ _ .....: _.... _: cc: Mr. Rober Morris, Putnum County Health Department Mr. John Calbo, Patterson Building Inspector DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 October 5, 1998 Catherine M. Thomas 35 Barnard Road Patterson NY 12563 Re: Labraico Barnard and Canton (T) Patterson PCDOH Permit #P -6 -97 Dear Ms. Thomas: BRUCE R. FOLEY _ Public Health Director I am in receipt of your letter dated September 17, 1998. In response, a review of the file for the above captioned lot has been conducted. Comments and a response to your concerns are as follows: Percolation tests and deep hole tests were witnessed by the Putnam County Department of Health ( PCDOH) and the New York City Department of Environmental Protection ( NYCDEP). Based on the results of the soil testing, along the -SSTS desiD i- prop- osed- -hy- Laurent "Engineering sYdwib current code + " "" " _. separation distances could be met, a construction permit . for a SSTS was approved by the PCDOH on May 2, 1997. The permit P -6 -97 is valid until May 2, 1999. An approval was issued by the NYCDEP on November 30, 1995 and was valid for two years. The current code requires that the minimum distance between a well and a SSTS is 100 feet, 200 feet if the well is in direct line of drainage. The. plans submitted Laurent Engineering indicates that all current code separation distances can be met. I trust the comment above address your concerns. Do not hesitate to contact me at (914) 278 -62130 ext. 151, if you have any other questions. V truly yours, Bruce R. oley BRF(Rvl:tn Public Health Director b11�1:01S1Z 0/d W -1 -V yc yJ /o r / 'r pi ritrr � /•r _ � rrrrr \ M, a.c v \ d,•d' loin ► � = /d._r 1x'19 _ � — ° ao cz'nl Purr rf//•r � � OB ��� l0 rrt�•r ___ 2 Z —_� Jrl /•r Afllr _ — rrt /•/ X211 sl!•r ' o /r /•Y 00.002 \ \ \ .1f / /•Y 1141 1 • \ u• � Q1 _ •-A 61 2l rtirr — — Por /•/ 19 c — A'Y/•r sour Purr — . —� cr-' -- - � r srzr r — — — 0000, — - -� ^MY/r orzr,. y - - -�� HIPP _ — — - — I ew-- M /•r 09991 l V /1 -P 1t / /•r s/rJ•r 1111•r — ow.r _ � --ter oi//•r _ — — � f/t••r B — - =S an-Pr OL— — a //•r frrrr - lUrr - -- £0 — •- -� --- — — — errrr _ :rI// -r /PI /•r rrrrr 1 Jn/•rl9•11•11 1 1 1 1 1 I 1 1 1 I 1• 1 1 I i 1 s I 1 •i 1 1 1 LL 1 1 19L1: 1 I 1 I I I I I 1 1 I II I 1 I I al�r 900911 I 100 901 1 1 I 1 1 i 1 1 1 1 1 1 II I` 1 1 II II 1 I I I 1 1 1 I ram fui 1 rnr U r/ri I sul 1 ani /t/i I i 1 1 °. 8 I 11 1 1 1 LZ 1 L 3 . 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Y%1 • lrr • Jal _ — tour r.r l ,J.,.r1: J•J:r I ,vr,�r ►� 1nJ,.r1J.,,•rl Jir,.lnJ +.r I 1 1 I I 1 1 I 1 1 1 1 < 1 11 , 1 1 11 II SB 1 1 681 1 1 I 1 1 1 1 1 1 1 I I 1 1 1MOM 1 . Fq 0u1 1 I a0 ry11 I 1 1 1 1 1 I 1 1 I I 1 1 1 I 1 1 1 I IZ I 1 1 I I 1!:s/ ivy 1rx/ 1a2v rtvi 1 /:x• I rfl 1 a.'f/ I I 1 1 1 us' NY' _ —__ -- f'N 1 =1!— - !f_' a;w 07 - - r.YY r -.v r ra•r I l Jca.r Irn•r IJr:.r I•c•J•• 1 I 1 1 1 1 1 1 1 �•I I 1 1 I L 1 I g 1 1.9.1 1 1 I 1 1 1 1 I I 1 1 1 1 � �4� 1NOd3Htl'1 I 11 1 1 i ,I�I l .I 1 1 1 tl1 �► 1 I bl 1 1 I I 1 i I 1 _ :rll 10.71 I : t/11 '� I 1 Z4, 0 COli DEPARTIN ENT OF HEALTH Division 0 Environmentdl Health Services 4 Geneva Road Brewster, Yoek 10509 M. (9141) 218 - 6130 f (9141) 218 - 7921 Date: 10- To: 1:9([1 f- Rabic -t- Farr M.— y�3 No. Panes ff (Includin; cover sheet) From: Putnam County Environmental Hearn NoteslMessages d5 RrQ U In the event of transmission/reception difficulties, phase contact this office. BRUCE R. FOLEY Public Health Director I�I'ArWIAIFV IZOAX7 A r FOR as Wo. F07 CLEFV. ab9p.0 I�I'ArWIAIFV IZOAX7 A r FOR as �" I �� I 93,00, PROP wriz ADDISON DRIVE. /00.00, TAM- e-e E�XV 571',o I 1�'AfWlllsl T' I.L 9 PRO pF -20 (11/8&1 • Baron and Sav 0m;, . Cwonant aonot nrantor'a Acts - Individual or Corporation , .Qio Shot) CONSULT YOUR LAWYER PEFORE SJGNING THIS INSTRUMENT —THIS INSTRUMENT SHOULD BE USED BY LAwYEIRS ONLY. This Indenture, made the _, . _ .. -. day Of. March . _._. nineteen hundred and ninety six Between MAUREEN LOBRAICO, individually and as sole heir and child of GEORGE BARKER, deceased, residing at RD #3 Barnum Corners, Brewster, New York 10509 party of the first pan; and MAUREEN LOBRAICO, residing at RD #3 Barnum Corners, Brewster, New York 10509 party of the second part, Witnesseth, that the party of the first part, in consideration of Ten Dollars and othervaluable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, All that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Town of Pat rSon, County of Putnam and State of New York more particularly descr��ed as follows. Lots Number 7744, 7745, 7746, 7747 and 7748 as designated and delineated on a map entitled "Eighth Map of Putnam Lake, Putnam County, New York and Fairfield County, Connecticut ", and filed in the Putnam County Clerk's Office''on the 20th day of March, 1931, File No. 1496 and Lot Nos. A1246, A1247, A1248; A1249, A1250, A1190, A1191, A1192, A1193, A1194, A1195, A1.196, A1197, A1198, and A1199 on the map entitled "Map A, Putnam Lake, Town of Patterson, Putnam County, New York ", and filed in the Putnam County Clerk's Office on March 20, 1931 as Map 149H. This conveyance is made-and accepted subject to the following restrictive covenants which shall run with the land and shall bind the Grantee and their heirs, successors and assigns of the Grantee: .1. That said real property shall forever. remain as one parcel of real property and no part of which shall be sold separately; and 2. That Lot Nos. 7744, 7745, 7746, 7747 and 7748 on Filed Map No. 149G (Tax Map 25.62 -1 -13) shall remain vacant and unimproved with the exception of a well and related pumps and piping Togetherwith all right, title and interest, if any, of the party of the first part in and to any streets and roadi abutting the above descrlbed premises to the center lines thereof; Together with the appurtenances and all the estate and rights of the party of the first part iri and to said premises; To Have And To Hold the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second partforever. And the party of the first part covenants that the party of the first part has not done orsuffered anything wherebythe said premises have been encumbered in any way whatever, except as aforesaid. And the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the Improvement before using any part of the total of the same for any other purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. In Witness Whereof, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF; nAUKtZN _ sole _heir and _childnof - GEORrt:.Ynepv7o - >` PUIVAM' COUNPY DEPAP26EM OF HEALTH . DIVISION .OF• ENVIPMEMI, FMLTS 'SERVICES DESIGN DATA SHEET - SUBSUFACE SFy,'AGE• DISPOSAL SYSTEM FILE NO. Owner {'�AvrP.c: �► l , ,�.� Address A 'IV-is i� �� O: ,� a 1�T� Lxated at (Street) �a✓ �%� - �t,c",�� Sec. � Block Z- hot (indicate nearest cross streetY rA nicipality Watershed SOIL PERcQL 'mG'tI -•SST DATA RDQUIPM TO BE.SU&SI'= WITH APPLICATIONS Date of Pre- Soaking /�ls�!y Date of Percolation Test /S /iy Boa.. NU SHM CLOCK TIME PERCOLAT ON PE.RC)LMON Run No. Sta t Stop Elapse Time Min: Depth to Water From Ground Surface Start Slop Inches Inches Water Level In Inches Drop In - Inches :. .Soil Rate• ; Min/'In. Drop eK �. 4 �,- l �2 4V _ ,_ A5 31' 2 .3 -S3 - 3 v� - y . �o dl 47 0. 2 .._. 3 4 POTES: 1.. ••.Tests: to. be repeated. at. satte depth until apprminately equal soil rates.. are obtained at each percolation test hale.: All.- data to' be: suimni.ttta for review.. 2 :;," Depth measurements*. to,`.be made fran top of hale. �m DEPTH G. L. 2 3' •41. 51 A- 71 .9' .10, jj t 12'. 13' TEST PIT . DATA, REQUIRED M BE . SMITTED WM APPLICATION HOLE NO. . i 1 - HOLE in /Ct-1 t4l �oac ca HOLE NO. 141. INDICATE LEVEL AT WHICH CROONI7 ATEIZ IS ENCOUNTERED N/,k INDICATE LEVEL To. WHICH WATER LEVEL RISES AFTER BEING ENCOUNTEl-M .DEEP BOLE OBSERVATIONS MADE i*.BY.:- �J(t, WIVVA0 77. DESIGN Soil Rate Used 0 Min/1" Drop: S•D. Upable Area ProVided No. of BedBedrooms Septic Tank Capacity gals. Type Absorption Area-Provided By L.F. x 24" width trench Other 17.1.vil 1 rlv_ le- k,27 N a r m Signature Address I SPACE FOR USE BY BEALTH DEPAFMMU- ONLY *. Soil Rate Approved sq•ft/I*j. ''Checked by. . tlr DESIGN DATA SH ET- SUBSUFACE SEWAGE- DISPOSAL SYSTEM FILE Owner �vYP�.►�r 1�6c,� „� P.ddress4�'t��l�lil_ ��0 kL� D�J .�1✓Tc�i,�'`i�. ibcated at (Street) . -T sec. . � -Block Lot b,r ;IS5 — (indicate nearest cross street)' T M- mcipality ���� � %D �� Watershed G U D SOIL PERC7.)=CN..TEST aAM RDQ(TgtE TO HE .SUR' -I'= WITH APPLIC ATIC?NS Date of Pre -Soa- ing Date of Percolation Test ]. fG. •� r -7 +ry iii y 4 - 5 'vl � �% �' /2- - - I� /.3;15 . �y ��, 3 ���,.....: 2 l� °l� - /�: "0�7 3 3 ��- yz -T �7 �� ih 5 �. .1 2 3 .q 5 i °i 1... Tests to be repeated•. at saw depth antil appraximately equal soil rates. are obtained at each percolation test hale. All, data • to' be suhnitU8d for review. 2.:: Depth rreasureTents. to: be made • f -ran top of hole. vya ss CLCCK TIME P P ATION P PERC�iATIC}�I Run Elatse D Depth to E Eater lFrom W Water Level Time G Ground S Surface I In Inches S Soil. Rate •. Start Stop Min: S Start S Slop_ D Drop In B Bin/In Drop ,Inches I Inches I Inches +ry iii y 4 - 5 'vl � �% �' /2- - - I� /.3;15 . �y ��, 3 ���,.....: 2 l� °l� - /�: "0�7 3 3 ��- yz -T �7 �� ih 5 �. .1 2 3 .q 5 i °i 1... Tests to be repeated•. at saw depth antil appraximately equal soil rates. are obtained at each percolation test hale. All, data • to' be suhnitU8d for review. 2.:: Depth rreasureTents. to: be made • f -ran top of hole. vya ss /.3;15 . �y ��, 3 ���,.....: 2 l� °l� - /�: "0�7 3 3 ��- yz -T �7 �� ih 5 �. .1 2 3 .q 5 i °i 1... Tests to be repeated•. at saw depth antil appraximately equal soil rates. are obtained at each percolation test hale. All, data • to' be suhnitU8d for review. 2.:: Depth rreasureTents. to: be made • f -ran top of hole. vya ss 11' 12` 1.3'' - 14' ,INDICATE LEVEL AT WHICfi GROUNU ATER IS ENCOUNTERED. INDICATE LEVEL- TO. WHICH WATER LEVEL RISES AFM BEING ENCOUNTER .DEEP SOLE OBSERVATIONS YjADEi'BY: 1_� � �>:�� � DATE:— DESIGN Soil. Rate Used -/a Minjl" Drop: S.D. Usable Area Provided. No. of Bedroans' Septic Tank Capacity �t000 gals. Type Absorption Area.-Provided By _- - L.F. x 24" width tench Other NaMe UtAW, Signature Address �� 11`?iG' r1IG G� l SEAT; ?.,1..� _ ... 'SPACE FOR USE BY 9FrALT'S DEPARTMEW ONLY:'. Soil Rate Approved sq.ft,%g . 'Checked ..:Date TEST -PIT 'DATA REQUIRED TO BE SUaMffTi'EI) WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. 40LE NO. �---_ o �ps6�•/ _ 2' SAy ��G m T 51 /7' � 3 ` �5 I �� loa,q 5A .5 % t 9r - 11' 12` 1.3'' - 14' ,INDICATE LEVEL AT WHICfi GROUNU ATER IS ENCOUNTERED. INDICATE LEVEL- TO. WHICH WATER LEVEL RISES AFM BEING ENCOUNTER .DEEP SOLE OBSERVATIONS YjADEi'BY: 1_� � �>:�� � DATE:— DESIGN Soil. Rate Used -/a Minjl" Drop: S.D. Usable Area Provided. No. of Bedroans' Septic Tank Capacity �t000 gals. Type Absorption Area.-Provided By _- - L.F. x 24" width tench Other NaMe UtAW, Signature Address �� 11`?iG' r1IG G� l SEAT; ?.,1..� _ ... 'SPACE FOR USE BY 9FrALT'S DEPARTMEW ONLY:'. Soil Rate Approved sq.ft,%g . 'Checked ..:Date RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR., P.E. To: Pu4rarn 1A n q 4-w lk bo 10s -pq. Attention: . Mr- 0".WCArn Gentlemen: We enclose( I ) copies of: ❑ B/W Prints ❑ Reproducibles ❑ Specifications ❑ Memorandum Description: Dur rri Job No.: r1 ic�5 Project: 1 Y�ro � SSL�S- Ln ra i co O Reports O Copy of Letter ❑ Tracings Revision /Date No. ��t?d res ,ci-' se- o� r 5- -03 sent Via: ❑ Our Messenger El You, Messenger Copy to: ❑ Slueprinler_ >�k-fand Delivery I� fO First Class Mail Special Delivery Very truly yours, LAURENT ENGINEERING ASSOCtATES,P.C. Per _� (),�/Jyd:K. `° i f cam} Lu E i Ms. j \ j \ !LAURENT ENGINEERING MILL ROO EIOF dE ff R.E Route 22 S Milltown Road j\ Brewster. New York 10509 (914)278.6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS To: Pu4rarn 1A n q 4-w lk bo 10s -pq. Attention: . Mr- 0".WCArn Gentlemen: We enclose( I ) copies of: ❑ B/W Prints ❑ Reproducibles ❑ Specifications ❑ Memorandum Description: Dur rri Job No.: r1 ic�5 Project: 1 Y�ro � SSL�S- Ln ra i co O Reports O Copy of Letter ❑ Tracings Revision /Date No. ��t?d res ,ci-' se- o� r 5- -03 sent Via: ❑ Our Messenger El You, Messenger Copy to: ❑ Slueprinler_ >�k-fand Delivery I� fO First Class Mail Special Delivery Very truly yours, LAURENT ENGINEERING ASSOCtATES,P.C. Per _� (),�/Jyd:K. `° i f cam} Lu E 14:47 197 E.,NAIN ST. BRC -WSTER P.1• 6 + C 14 DECL MTION OF and O RsnYP_. THIS INS E, made theo?7 day of �� . 1997 MAtTREEN `LOBRAICO, residing at Barnum Corners, Brewster, New York 10509, (hereinafter referred to as the " DECLARANT ") , WHEREAS, the Declarant is the owner of certain real ' property in the Town of Patterson, County of Putnam a %tate of I New York shown and designated as Lot Nos. A1185, A11861 A1187, A1188, A1189, A1195- A1199, 1246 -1250 on a certain map entitled "Map A Putnam Lake, Town of Patterson, Putnam County, New York" and filed in the Putnam County Clerk's Office on March 20, 1931 as Map No., 149 -H hereinafter referred to as the "B'enefited Property ". WEEREAS, the Declarant is the owner of certain real property 'in the Town of Patterson, County of Putnam, and State of New York at Putnam Lake and described as follows to wit: Lot Nos. 7744, 7745, 7746, 7747 and 7748 as designated and delineated on a l map entitled "Eighth Map of Putnam Lake, Putnam County, New York and Fairfield County, Connecticut", and filed in the Putnam County Clerks office on the 20th day of March 1931 as File No. 149G hereinafter referred to as the "Burdened Property ". WHERRAS, the Declarant is desirous of establishing as Easement for the private use in common by the owners of aforementioned described real property and to assure that both the "Benef i ted Property'' and the "Burdened Property', shall remai n -.L X13 _.the_. -Siame- -ownership. NOW THEPSFOR$ : 1, The real property particularly described above .as the Burdened Property is hereby declared to be a well easement for the exclusive use. of the owners of the real property particularly described above as the Benefited Property and said owners of the Benefited Property shall have full and free right and authority to enter.and exit over said easement for the purpose of maintaining and repairing said well and piping leading thereto and the Declarant shall not obstruct the well easement nor.interfere with the use of the well easement by the owners of the real property particularly described above as the Benefited Property and said owners shall maintain the well and pipes leading thereto in good repair.. 2. The Burdened Property shall only be used as a well easement and for no other purpose. 3. Both the Burdened Property and the Benefited Property shall be sold as one parcel and remain in the same ownership. 4. The Town of Patterson shall have no responsibility for maintenance and repair of the well and pipes leading thereto. i=4 4c 1'f,' L- NHii'v M H 31OPGOO86 5. this Decliatation shall run with the land and be binding upon the undersigned and her respective heirs, successors and assigns. IN NITM9 WUREFOAM, the party of the first part has duly executed this instrument the day and year first above 4 written.. MAUREEN LOBRAICO STATE OF NEW YORK ) ).8s.: COUNTY OF PUTNAM ) , On the Q7 day of February, 1997, before me personally came MAUREEN LO$RAICO, known to me to be the individual described in and who executed the foregoing instrument and SHE duly acknowledged to me that SHE expc:v.ted the game. otary Public RIC! {i!.RD I. 0WL .qqD Ne4%- York Q4i�l!fied in f'�ll;,,,,t t.y�,;,i� PJo. 11 Cotnu;rssiou F ip;res UCtuber 3, d '.. t -L ('4f p� n7 6c'), a, D7- 4=3 --24 14:4-1 197 Eo HAIll ST. E,REIASTER N.Y. LAW OFFICE ATTORNEY & COUNSBLOR -AT LAW 197 EAST MAIN STREET BREWSTER, NEW YORK 10509 914- 278 -2000 FAX: 914 -278- -9650 FACSIMILE COVER SHEET DATE: March 24, 1997 TO: Harry Nichols FROM: Joyce RE: Maureen Lobraico NUMBER OF PAGES (INCLUDING THIS SHEET): (5) COMMENTS: , * * * * ** IF YOU DO NOT RECEIVE ALL PAGES INDICATED, PLEASE CALL (914) 278 -2000 AS SOON AS POSSIBLE. NOTE: P. 1 THIS MESSAGE IS INTENDED ONLY FOR THE USER AND MAY CONTAIN INFORMATION THAT IS PRIVILEDGED'AND CONFIDENTIAL. IF YOU ARE NOT THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE. THANK YOU. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CORTSTRUCT A WATER WELT. PCHD PERMIT 0 IS WELL SITE SUBJECT TO FLOODING? YES k"' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. HATER WELL CONTRACTOR: Name Address: IS PUBLIC STATER SUPPLY AVAILABLE TO SITE: YES G--' NO NAME OF PUBLIC WATER SUPPLY: {U/ TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: U LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE / M ON SEPARATE SHEET (date) (signature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise cont_ e— str -f� a or groundwater. Date of Issue: __� Date of Expiration 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 Street Address awn Village City Tax Grid Number %,%, LOCATION o G fl Name t IMailihg ddre s �5 *Private . ,WELL OWNER ` Ce - Q. %' C3 Public USE OF WELL SIDENTIAL ® PU LIC SUPP Y ® AIR /CON / EAT PUMP 0�o ABANDONED 1 - primary /20 0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify, 2- secondary 0 INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED 'Gr % /EST. OF DAILY USAGE_&,-,V.0a1 0 REPLACE "EXISTING SUPPLY 0 TEST/ OBSERVATION 13. ADDITIONAL SUPPLY REASON FOR DRILLING ANEW SUPPLY NEW DWELLING D DEEPEN EXISTING WELL DETAILED f5i IQ REASON FOR DRILLING FELL TYPE `DRILLED DRIVEN ®DUG ® GRAVEL. © OTHER IS WELL SITE SUBJECT TO FLOODING? YES k"' NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. HATER WELL CONTRACTOR: Name Address: IS PUBLIC STATER SUPPLY AVAILABLE TO SITE: YES G--' NO NAME OF PUBLIC WATER SUPPLY: {U/ TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: U LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE / M ON SEPARATE SHEET (date) (signature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise cont_ e— str -f� a or groundwater. Date of Issue: __� Date of Expiration 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 97- 03 -24 14:45 197 E, hIRIN 9T. BREWSTER N, Y, .. P.2." r t kl /76 ... BIPG�083 ' a PUTNAM COUNTY RECORDING AND ENDORSEMENT PAGE J1115 PACE FORMS PART' OFTHE INSTRUb :cNTl' r RECORD & RETURN TO: (Name, Address, & Zip). TYPE OR PRINT IN BLACK INK ONLY I GRANTOR/MORTGAGOR Q LD l � lS i t ° v I DO NOT WRITE BELOW THIS LINE INSTRUMENT TYPE: DEED_ MORTGAGE- SAT_ ASMT_OTH$R G �✓ PAGES I7 RECORDING FEES RCD FEE STAT CHO r REC MGMT CROSS REF CERT /COPY TOTAL 'DEED TRANSFER TAX CONSIDERATION $ 11) I= d I REAL ESTATE I ITTN I I TRANSFER TAX I I PUTNAN COUNTY I I I MORTGAGE TAX MTX AMOUNT TOTAL TAX SERIAL NUMBER AFFIDAVIT FILED TP -584 ( X ) $5.00 E &A ( ) $25.00 3730 RESERVE FOR TIME STAMP W j c �t- o . zN Y Alr. � 35 pr a 4r- �C -co F-o rr, PUTNAM COUNTY CLERK'S OFFICB RECORDED 014 LIBER I/ �UPAGE AND EXAMINED. 4PUTRAM L. PELOMd JR.JR. COUNTY CLERK MORTbAGRIAXED TAX DISTRICTS: TOWN OF CARMEL TOWN OF KENT TOWN OF TTE ✓ TOWN OF PH IPSTOWN TOWN OF PUTNAM VALLEY TOWN OF SOUTHEAST UNAPPORTIONED MORTGAGE TYPES: A COMMERCIAL /VACANT LAND B 1 -. 2 FAMILY C UNDER $10,000 D CREDIT UNION /PERSONAL MTO E 3 - 6 UNITS N EXEMPT )G> YJ T' ]�'T ,A. _AQPLICATIQK ,FOR._APPROVAL. OF PLANS_,.FO.R A .WASTEWATER..DISPOSAG.SYSTEM i . Name and Addrpss. of Applicant: Zo«d 2.' Name of Project: 4. Project Engineer: License Number: o�Lsb1l Phone: •2ZI-14 6 . Type of Project: � .:. . 1 �'... -, . ..; • , °� _V• Private /Residential Food.Service ....Commercial , Apartments Institutional Mobile Home Park Office Building ,4.1 Realty -Sub�- jvision Other (specify) 3 7. Is.this project'subject•to.State Environmental- Quality Review.(SEQR)? Type Status (Check One) Type I.. Exempt Type II. Unlisted. 8. 1,9 a Draft Environmental Impact Statement (DEIS) required? ..... 1`� 9.'Has*DEIS been completed and found acceptable :by Lead Agency? ....:...:.. 1o. Name of Lead Agency A114 l...'18"-this project in an area under the control of -local planning, zoning, .or• other officials; ordinances? ..:..- ... °:.. . . ....:..:....::.. :.::...... i2. If so, have plans been .submitted to such,author.1 tie s ?...................... t. t" 13. Has preliminary approval been 'granted by such authorities? W4tc Date Granted: i4. Type of Sewage Disposal: System Discharge...... Surface Water Ground Waters 15. If surface water discharge, what is 'the stream class designation ?........ :6. Waters index number (surface) 90 /A :j. Is project located near a public water supply system? 9)D 8. If yes, Hare or water supply Distance to water supply s. Is project site near a public sewage collection or disposal system ?..... 0. Name of sewage system Distance, to sewage system 1. Date observed: Ir7, 23. Name of Health Inspector: Project design flow (gallons per day)..................... %�/�! 25: Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. 26. Has SPDES Application been submitted to'local DEC - Office? �1 /hr 27. Is any portion of this project located within a designated Town or State wetland ?.............. .... ............................... t1� 28. wetland ID Number.. .................................................... 4/4 29. -Is wetland Permit required? ............................................. Has, application been made to Toun 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 pesticide$ to orchards or other crops, solid or hazardous waste disposal',``' lzndfilling, .sludge application or industrial. activity? :....... YES'or�NO x,50 32. Is project located-within i -,000•feet of existence of abaddoned landfill, hazardous waste site, salt stockpile, landfill, sludge.disposal site or . any other potential known-source of contamination? .....'.........YES or NO DESCRIBE: J • 33. .Is there, a _local master plan or fiid: with the .Town or Yil.lage? 34. Are community water, sewer facilities planned to be developed within 15 years? 35_ Are any sewage disposal - -areas -in excess of 15p slope? .......................... 36. Tax Hap ID N umber ..... ......., ....................... ...... ............ �3� 37. Approved Plans are to "be: returned to: ................ . App-licant c/ Engineer If the application is signed by a person other than the .applicant shown in Item .1, the. pplication must be -accompanied by y-a Letter of Authorization: Failure to comply with this .provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury;• that information provided on this form is true to the best of my knoxled,e and belief. False statem -ents made herein are punishable as a Class A Hisderreanor pursuant to Section 210.45 of thE: renal Law. 3IG�,NATURES & OFFICIAL TITLES: 'AILING ADDRESS: APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAG•SYSTEH 1. Name and Address of Applicant: ."o kkr « 2. 4. 7. E:M 91 Name of Project: 5e -1 ) 3.•_•_Locationd5N/C: Project Engineer: &2m )y1 Z tt/ 5. Address: License Number: n�LsT5I Phone: ]2Zy 6T ins Type of Project: :: .��. —` •• t/ Private /Residential Food.Service ....Commercial , Apartments Institutional Mobile Home Park Office Building Realty-Subdivision Other (specify) Is this project subject:to.State Environmental - Quality Review.(SEQR)? Tyoe Status (Check One) -Type I.. Exempt Type II. s Unlisted. Is .a. Draft Environmental Impact Statement (DEIS) required? .............. I/ Has.DEIS been completed. and found acceptable,by Lead -Agency? 10. Name of Lead Agency 11. Is this project in an area under the control .of-local planning, zoning, o.r other. officials, ordinances Z.,;,.-. - :...::..- :•........... :.... 12. if so, have plans been.*submitted to such, author .sties ? ...................... dll� 13. Has preliminary approval' been granted by such authorities? 1� %b�- Date Granted: 14. Type of Sewage Disposal: System' Discharge. ..... ^ •Surface Water Ground Waters 15. If surface water discharge, what is 'the stream class designation ?........ :o. Waters index number (surface) ...... ..... ........................... oll /T_ �. Is project located near a public water supply system? .................. a)D °. If yes, name or water supply �3 Distance to water supply 9. Is project site near a public sewage collection or disposal system ?..... X10 0 - Name of sewage system Distance to sewage system 1 • Date observed: III �yJ. 23. Name of Health Inspector• IA)I t. AV '�iG2 ProJeCt design flow (gallons per day) ..................................... Anl) _ 2;e 'o 25, Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. �) A 26. Has SPDES Application been subimitted to'local' DEC- Office ?, ............. 27. Is any portion of this project located within a designated Town or State wetland? .................................. ............................... tJ 2 28. Wetland ID Number ........................ ............................... it %4 .29. •1s Wetland Permit• requi red? .............................................. Has application been made to Town o'r Local DEC Office? 1 30. Does project require a DEC Stream Disturbance Pemit? D 31. Is or was project site used for agricultural activity involving application o•f pesticide$ to orchards.. or other crops, solid or hazardous waste disposal;```' lend{ illing, .sludge application or industrial. activity? ....... YES 'or NO 32. Is project located-within 1;000-feet of existence of..abaddoned landfill, hazardous waste site, salt stodk.pile, landfill, sludge.disposal site or . any other potential known•sourcd of contamination? ..............YES or N0 �1i1 DESCRIBE: 33. .Is there a local master plan or. filo•with the Town or Village ?.... ......... 3d. Are community water, sewer facilities planned to be developed within 15 years? 35. Are any sewage disposal-areas in excess of 15, slope? ......................... 4V 36. Tax Hap ID Number .............. . .................. ...... ........:. 37. Approved Plans are*to"be returned to: ................ Applicant c/ Engineer Ir' the application is signed by a person other than the .applicant shown in Item.1, the. pplicatiori must be accompanied by a Letter of Authorization: Failure to comply with this crovision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury;• that information provided on this form, is true to the best of my knorrle-dse and belief. False states -'ents made herein are punishable as a Class A Hisde,-,sanor pursuant to Section 210.45 of the Pena 1 Lair. /l 17 � >IGNATURES & OFFICIAL TITLES: '.AILING ADDRESS: M :: — ,— rte.,- •�— ,— .,:- -, •`. - .......... _ _. 'own of Patterson Highway Department P,O. Box 445 0 Person, New York 12563 -0445 a (914) 878.4341 (914)878-61200 Fax: (914) 878 -6130 Highway Superiarendent: William H. Burdick TO: HARRY W. NICHOLS Jr., P.E. LAURENT ENGINEERING ASSOC. P.C. FROM: WILLIAM BURDICK RE: LOBRAICO PROPERTY REQUEST DATE: MARCH 19, 1996 in regards to your letter of February 22, 1996 concerning the property of Ms. Lobraico - Property #.25.62- 1- 83 -85 -86 and 13 the Patterson Highway Department has no problem with your request of crossing Lakeport Drive as long as the pipe is placed in a sleeve at the point it crosses the road, the blacktop saw cut, backfilled with Item 4 and tampered at 6" intervals,, and a minimum of 5" of blacktop, to -be inspected by the Highway. Superintendent when work is to be completed I would also request that your office contact the Trans- atlantic underground Cable Company to be sure that it is not a problem with them and that they can be assured that this pipe service won't harm or interfere with the cable. WHB:j cc: Putnam County Health Dept. Gainer Wilbur - Town Eng.. tl DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Harry Nichols Laurent Associates Millbrook Office Ct. Rt 22 & Milltown Rd. Brewster, NY 10509 Dear Mr. Nichols: BRUCE R. FOLEY, R.S. Acting Public Health Director February 9, 1996 Re: Proposed SSDS: Maureen Lobraico Canton Drive & Bernard Rd. (T) Patterson TM #25.62- 1 -83, 85 & 86 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. The proposed well is located 120' from the existing sewage disposal system to the north, TM #25.62 -1 -21. Our files indicate that this sewage disposal system consists of four by four galleys. Therefore, the minimum separation distance must be 150 feet. 2. Metes and bounds description is lacking. 3. Erosion control.must,be shown around_residence _ and.driveway as well.as the. well and SDS. 4. Footing and gutter drains should be shown and connected to existing road drainage. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yo.,�G,,_ William Hedges Sr. Public Health Sanitarian WH /jp Lcc: DEP, Ed Polese, 465 Columbus Ave., Valhalla, NY 10595 6.1 1 1 BRUCE Fi. FoLEY R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster; New York 10509 (914) 278 -6130 February 9, 1996 Harry Nichols Laurent Associates Millbrook Office Ct. Rt 22 & Milltown Rd., Brewster, NY 10509 Re: Proposed SSDS: Maureen Lobraico Canton Drive & Bernard Rd. (T) Patterson TM #25.62 -1 -83, 85 & 86 Dear Mr. Nichols: 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. The proposed well is locate 120 rom the existing sewage disposal system to the north, TM #25.62 -1 -21. Our files indicate that this sewage disposal system 'consists of four by four galleys. Therefore, the minimum separation distance must be 150 feet. 2. Metes and bounds description is lacking. 3. Erosion control must be shown around residence and driveway as well as the well ,and SDS. .. .. 4. Footing and gutter drains should be shown and connected to existing road drainage. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours William Hedges Sr. Public Health Sanitarian WH /jp ' Lcc: DEP, Ed Polese, 465 Columbus Ave., Valhalla, NY 10595 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of_ Located at �[% , Zt_ P -- ' (T) p Section Block Lot' %�C �. Subdivision of�� Sub dv. Lot # Filed Asap # Date Gentlemen: 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 Departriernt 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. ` Counters i n d4` V Rr 1 ; �� o . J P.E. , �lA. , ,` �. G. wim �` Z Telephone Very truly ours, Signed/0 ner of Property XAftil kA �9 ITT Ad Tess Tow-n elephone :Available for ati #omatic.`anci - - ,SPECIFICATIONS.: _ manual'operat ±on:`'Automatic - - - - - -- - =rriode.ls include fNercu -ry Float:j:`:; :. Swltch as'semblbd. and preset Pump:.. fat the'facto��'`'' • Sollds. handling;ca'pablllty. t � t S t k 3/4 °;.Maximum �T - rte rr <� _ • Capacitle T s'•lJp to 55 GPM, ,.' s i rti ota Heads: Up to 24 feet.; APPLICATIONS „_,�,�;,� _'_•,_,;>;,.µ. � Discha�ge,Size }11./2' NPT � �'','' - t� ` • MecFianical Seal Carbon`Rotary'+ Sp:eclficallytdesl'gned for they Head /Ceramic Stationary Seat, following uses - F Buna N Elastomers.;,�'.J • Effluent;syster�s [ r t Temperature 140 °F (60°C) , r a, s• + e , I r Maximum Farms, f7 Fasteners 300 Series Stainless Fteavy'duty sump �`I> Sieel ��� Water. tran�fel" 1` > < Cap bie�o� runr'ing d- y-Without 3 Dewate�ing {, > t �t `damage fo components: `' r { ti :• Phase:0 4HP;•11.5 or. 230.4;;: VoIt,,60Hz f550 RP.M; built in over 'load ' wi h m• -i t auto a t c'i•eset:. Power ord: 10 foot standard•'`'-,= G I n t h1° . 1 6/3 J T :wi th N m a 5 - • 15 9 3 rori r ,n i ou d n I ` u . i onal 0 -t .' .......... .. 20'.. length;: 9 th;: 1 3 SJTW w' h N e m a= 5 -15P' 3, ron roundin lu ::.. 4 g ,.., P..... 99 9P.9 z {1. s i .a - ••S i`ti t t •Ja ,�:. "rig: — - �• •,�. t - {may _ +2. t•. ; Via.. _:S`a r-�r t ,.+F re�Nw� - .r�f�,5 � Sri 5i � Tr rti ."K. tf•4 Y. h � ��I fit, ',t 1% y�•,'1ri�ET,,'4 i 7,✓t r �j • #. '�. r 1 '� i :.1.i:< m 1988 Goulds Pumps Inc � °' ' r � Y , �" ?}�`sT� �'� 'T"�`` "' ?`�1•� "'� +'�' '' �"' r'�; '.� -. ,y , ..1 : � -i - -T... rf,,. •fit.. .:���. Goulds Submersible Effluent Pumps :3871 +FEATURES�, �> Impeller:: :ThermoplasticSem= 'Jti~:' �Vorfez'desl ri`,witii� urri ••'out Vanes <�•�A. -.for mechanlcalaeal arotectlon.�t��: •�., � �,Stainless`.steei fasteners �� CSA Listed' models available "`' a • pct '�. re istered General beciric Matenal.� :• t r` r.: �.J G r ' J 1. T f t4 , •'' •' �'tu���;�uuu��u�uuru� r� 01988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE Effective October, 1988 PRINTED IN U.S.A. . 8 7 _ Q UJ 6 U. z =� 4 o N 3 O H - 2 j 0 r� 01988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE Effective October, 1988 PRINTED IN U.S.A. . IM-M PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Property of. Located at 4, (T) _Sectionps,SY ---Block Lot Subdivision of rif I NVINd, 40 1,k ( Subdv. Lot , 64t-7-1 .7-7 Filed Map # 4A���Date A_ Gentlemen: This Ie*tter is to authorize a duly licensed professional enginee r or ..registered architect (Indicate) to- apply for a Construction Perimit for a separate -sewage system, to serve the above noted' property in accordance with the standards•, ruleq or regulations as promulqgated by the Commissioner of the Putnam Co'unty ...Department of ke'alth',. and to' sign al-1- .necessary papers on 'my :behalf.-in. connection with this matter and to supervise the construction of said system or systems in conformity' on ormi 147, Education Law, the -Public Health Law, and the Putnam County Sani- tary Code. very truly yours, NNI" Sign 'Oumer of Propert Countersign P E kA e.t�t Addr ss I I Addre s Telepho* ne . LI TeD( _-pho'ne �M - — - - -- - �- •�•••- ••••�- �••�••••. ...�w...v..+..e m.rw.� ramsronemmssyww� .r+rrv�ew.ncvwo..w. 3 t ! 1 'x/61 -.✓ • : �. V. ''�� 1 - �+ +:�"' -". WWI zq LAURENT ENGINEERING ASSOCIATES, P.C. 'MILLBROOKE r OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278-6108 - (FA)O 278-2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS LIST OF PROPERTY OWNERS ABUTTING & ADJACENT TO MAUREEN LOBRAICO CANTON & BARNARD ROAD PATTERSON, NEW YORK 25.62-1-6 Grazioli, Joseph'j. & Caroline 72 Barnard Rd. RR 1 Box 496' Patterson, NY 12563 25.62-1=21 Graziola, Nicholas 35 Barnard Rd. Patterson, NY 12563 .25.62-1-22 Hart, Margaret M. 31-49 86th St. Jackson Heights, NY 11369 25.62-1-78 Oppromolla, Daniel & B. Canton Rd. i Patterson, NY 12563 25.62-1-82 Schmatl, Frank & Mary Ann 20 Canton Rd. Patterson, NY 12563 25.62-1-84 Petrino, Arthur '1:134'"J6ffer_s6`n'' AV6._ West Islip, NY 11795 25.62-1-87 Demayr Charles R. 29 Barnard Rd. Patterson, NY 12563 SO :Z YJ C�j �0' 61 S fo" A 0 Al Grazioli, Joseph J. &-Caroline RE: Department of Health Review of 72 Barnard Rd. RR 1 Box 496 Proposed Sewage Disposal System: : . . Patterson, NY 12563 for property: Name: Maureen Lobraico Address: Canton & Barnard Rd. Town: Patterson, N.Y. Tax Map: 25.62-1-83, 85 & 86 Dear Mr. & Mrs. Grazioli: Please be advised that an application for a Construction Permit rel.ative to the construction of-a sewage system and/or well .proposed for the captioned.p-roperty has been made-to the Putnam County Department of Health. Attached please find a copy of the latest site -plan. If you have any questions, concerns or information which may bear on the Health D'epartment's review: of this application,. you may call Mr. Hedges or Mr. Morris of the Health Department at 27376130. RECEIVED BY Address: Tax Map: JK;cj i r . FORMAT NEIGHBOR NOTIFI'CATION' CONSTRUCTION PERMIT I Date 1 -19 -95 RECEIVED• BY : Address: Tax Map: JK;cj e RE: Department of Health Review of Grazioli, Nicholas Proposed Sewage Disposal System . 35 Barnard 'Rd. for property: Patterson, NY 12563 Name: Maureen Lobraico Address: Canton & Barnard Rd. .Town: Patterson, N.Y. Tax Map: 25.62 -1 -83 , 85 & 86 Dear Mr. Grazioli: '. Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the.captioned.property has been made-to the Putnam County Department of Health. Attached please find a copy of the latest site -p-lan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 278 76130. Very truly yours, By Title jt RECEIVED• BY : Address: Tax Map: JK;cj e F ORMAT NEIGHBOR NOTIFICATION CONSTRUCTIO14 PERMIT Hart, Margaret M. 31 -49 86th St. Jackson Heights, NY 11369 Date . 1 -19 -95 RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: Maureen Lobraico Address: Canton & Barnard Rd. Town: PattpTson, N.Y. Tax Map: 25.62-1=83, 85 & 86 Dear. Ms. Hart: Please be advised that an application for a Construction Permit relative to the construction of a sewage system-and /or well proposed for the captioned property has been made- to the Putnam County Department of Health. Attached please find a copy of the -latest site plan. Ifyou have any question's, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 278 76130. Very truly yours, By V"'7 Title Ag t. RECEIVED BY: Address: Tax Map: JK;cj FORMAT = Date 1 -19 -95 NEIGHB'O`R'-. NOTIFICATION CONSTRUCTION PERMIT Oppromolla, Daniel &.B.` RE: Department of Health Review of Canton Rd. : proposed .Sewage Disposal System Patterson, NY 12563 for property Name: Maureen Lobraico Address: Canton & Barnard Rd. Town: Patterson, N.Y. Tax' Map: 25.62 -1 -83, 85 & 86 Dear Daniel & B. Oppromolla: °lease be advised that an application' for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made-to the Putnam County Department of Health. Attached please find a copy of the latest site -p.lan, Ifyou have any questions, concerns or:information which may. bear on the Health D'epartment's review of this application, you. may call Mr. Hedges or Mr. Morris of the Health Department at 278 -6130. Very, truky yo.urs,.. ' By zo Title Ag t RECEIVED BY: oe Address: Tax Map: JK;cj FORMAT Date .__ 1- 19- 95_.__._.._ T NEIGHBOR NOTIFICATION CONSTRUCTION PERMIT Schmazl, Frank & Many Ann RE: Department of Health Review of 20 Canton Rd. Proposed Sewage Disposal System Patterson, NY 12563 for property: Name: Maureen Lobraico Address: Canton & Barnard Rd. Town: Patterson, N.Y. Tax Map: 25.62-1-83, 85 & 86 Dear Mr. & Mrs. Schmazl: Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made- to the Putnam .County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 278 76130. -Very truly yo ors; By 1 4, Title Ag t RECEIVED BY: Address: .Tax Map: JK;cj FORMAT NEIGHBOR: "NOTIFI CATION CONSTRUCTION PERMIT Petrino,.Arthur 1134 Jefferson Ave. West Islip, NY 11795 Date 1 -19 -95 RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: Maureen Lobraico Address: Canton & Barnard Rd. Town: Patterson, N.Y. Tax Map : 25.62 -1 -83; 85 & 86 Dear Mr, Petrino: Please `be advised that an application f *or a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has-been made-to the Putnam County Department of Health. Attached please find a copy of the latest site -plan. 0 If you. have any questions, concerns or information which may bear ;:; on the Health Department's review of this application,'you may call Mr. Hedges or Mr. Morris of the Health Department at 278r6130. - Very... truly y.o..urs., .. _ ... ................ By Title jt RECEIVED B-Y : Address: Tax Map: - JK; c j . 0 _ . FORMAT* -.__. NEIGHBOR NOTIFICATION CONSTRUCTIO14 PERMIT Demay, Charles R. Date 29 Barnard Rd. RE: Department of Health Review of Patterson, NY 12563 Proposed Sewage Disposal System for property: Name: Maureen Lobraico Address: Canton .& Barnard Rd.. Town: Patterson, N.Y. - _ Tax Map': 25.62 -1 -83, 85 & 86 Dear Mr. Demay: Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made- to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If; you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at 278 76130. Very 'truly you "rs ", By Title A9 9t RECEIVED BY-: Address: Tax Map: JK;cj H also wish to receive the . l,. - .. 940R17 also so CD "Cl 2 for additional services. w Complete items i and/or following services (for an extra .2 ,1 cD SENDER: V I also wish to receive th, • Complete items 3, and 4a & b. > "I • Complete items I and/or 2 for additional services. averse of this form so that we can fee): CA U) • Print your name, and address on the r • Complete items 3, and 4a & b. following services (for an extr 7 return this card to•You. i 1. ❑ Addressee's Address Cn r"I CUD) Print your name and address on the reverse of this form so that we can fee): > • Attach this form to the front of the mailpiece, or on the back if space return this card to you. "icle number. 2 . . t at. C it 'T > pace 1. ❑ Addressee's Address does not permit. Attach 4D Write "Return Receipt Requested" on the mailpiece below the article number. 2. ❑C1 Restricted- Delivery q). cD ch this form to the front of the mailpiece, or on the back if s liv d te - -permit. m the article was delivered and the date 0 V does not Consult V = aster for fee. 4) i1 4' write 'Return Receipt Requested" on the mailpiece below the article number. 2. El Restricted Delivery The Return Receipt will show to who Consult Postm M ", = - C delivered. 4a. Article Number The Return Receipt will show to whom the article was delivered and the date 3. Article Addressed .1 q,5 :3 0 0 to: delivered: Consult postmaster for fee.- -o , (D (D I , -0 3. Ariicle Addressed to: 4a. Article Number (D 4) har 4b. Service-Type CC 7- 7& El Registered ❑'Insured CM (hrol('ne- E aq edr fo-f El COD 4b. Service Type 0 tR Certified BOY -1101 ❑ Registered ❑ Insured E] Return Receipt for 0:3 0 ;Pnr rl�fj ❑ Expreh Mail Merchandise 0 W Certified El COD 7 Deli of D Ii y r POL+ Z-On ❑ Express Mail ❑ [] Return Receipt fol 7. Da Merchandise 0 Cc 0 p 7 >_ a ! . 7. Date of Delivery 4 ! Aaare5zi %%J111Y requested 'Y' a / 2 /- ��� Z 8. Addressees id) C I < i - Ile/ - re :(Addressee) Ae and _f_e_e _is_pa ca =,I- Z 5. Si ture (Addy Ssee) and fee is paid) e r 8. -Addresseo's Address- (Only if request- ge 0 S* naT awt - UA 6. SiAR6 Lure -(An_en_b- 0 *U.S. GPO: I gga--352-714 D OMESTIC RETURN RECEIPT Form 3811, December 1 Z791 I I 0 PS ---------- >- PS Form 3811, December 1991 *U.S. GPO: 1993--a52-714 DOMESTIC RETURN RECEII 3 SENDER: -74 IIl n. ; • Complete items 1 and/or 2 for additional services. V * Complete items 3, and 4a & b. • Print your name and I also wish to receive the following services (for an extra . j 0) -,w SENDER: u) Complete items 1 and/or 2 for additional services. items I also wish to receive the address on the reverse of this form so that we can D return this card to you. ). • Attach fee): 11 > • Complete 3, and 4a & b. • Print your name and address on the reverse of this formso••that we can following services (for an extra fee): D this form to the front of the mailpiece, or on the back does not permit. if space Addressee's Address 1 V 4) return this card to you. > D • Write "Return Receipt Requested" on the mailpiece below the article numb (n • Attach thi6 form to the front of the mailpiece, or on the back if space 2 does not permit. 1. ❑ Addressee's Address • The Return Receipt will show to whom the article was deliver delivered. daer. ad d the date 2. ❑Re stricted Delivery Consult 4) 0 0 • Write "Return Receipt Requested" on the mailpiece below the article number] '�Receipt will show to whom the article was delivered • The Return 2. ❑ Restricted Delivery i 3 3. Article Addressed to: Postmaster for fee. 4a. Article Number W and the date C delivered. ' 0 - Consult postmaster for fee. 7- 9-TS -a 3. Article Addressed to: 4a. Article Number je P,0,_ rscr� 4b. Service Type ral 7- 9-75 1 is, tip:;, -ICK- E3 Registered El Insured JZ Certified El COD tM �j G E I 0 0 i3o r na nj C,) 26 4b. Service Type ❑ Registered ❑ Insured EZ Certified ❑ ❑ Exprq'j�-M,il ❑ Return Receipt for M LO .1 P,+-�? rson as COD ❑ Express ❑ Return Receipt for chandise 7. Date of Deliv r - 0 Mail Merchandise 0 5. Sig ature a 8. Addressee' Address (Only if requested Y j and fee is-paid) tp � 6. ': naturee (Age Uj '-PS F6rm 3811 /December 1991 *U.S. GPO: 1993-352 1 714 0 0 DOMESTIC RETURN RECEIPT 5. Signature (Ac ti. S nature _(Aj RS Form 38�t i 7. Date of Delivery 8. Addressee's ATdre', and fee is paid) (Only if requested - DOMESTIC RETURN RECEIPT SENDER: Complete items 1 and /or 2 for additional services. • Complete items 3, and 4a & b. i also Wish to receive the following services (for an extra ' NCS.S;� fee): r.• V SENDER: rn Complete items 1 and /or 2 for additional services. return this card to you. e Attach this form to the front of the mailpiece, or on the back if also wish to receive the 1. ❑ Addressee's Address m o Complete items 3, and 4a & b. foes not permit. Write "Return Receipt Requested" on the mailpiece below the article number. following services (for an extra V t2 o Print your name and address on the reverse of this form so that we can fee): > > return this card to you. u Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address rj does not permit. t Write "Return Receipt Requested" on the mailpiece below the article number. 2 ❑ RQStrlCted D811Very r 26 o The Return Receipt will show to whom the article was delivered and the date c delivered.. Consult postmaster for fee. U 3. Article Addressed to: (D 4b. Service Type El Registered El Insured 4a. Article Number ; f4) a (QniQ a vs,• !� Merchandise Z 15 ) q`�� Q cra E I '0 4b. Service Type r�6� Jli�re C 5. Signature (Addressee) ❑ Registered ❑ Insured ❑` COD c w `�ti_]�j_,�, C� (off J �C T t�t��n ,Certified ❑Express Mail ❑Return Receipt for : Merchandise m oc I JJ ~ l U' 6. Signature (Agent) o ;I Q 7.L Date of Delivery���� 3 c cc 5. ure (Addy ee B. Addressee's Address (Only if requested ,Y ;. D and fee is paid) LU 6. Signature (&n3 ~ > PS Form 3811, December 1991 *U.S. GPO: 1993 -352 -714 DOMESTIC RETURN RECEIPT SENDER: Complete items 1 and /or 2 for additional services. • Complete items 3, and 4a & b. i also Wish to receive the following services (for an extra ai U • Print your name and address on the reverse of this form so that we can fee): •�>, return this card to you. e Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address N N foes not permit. Write "Return Receipt Requested" on the mailpiece below the article number. 2. ❑ Restricted Delivery d The Return Receipt will show to whom the article was delivered and the date. Consult postmaster for fee. v felivered. 3. Article Addressed to: 4a. Article Number Cr 4a. Article Number -ts 2 75 I X13 ��13 .. , h l ro�njK1 1�c�ry inn �r lr+ Qr�`° ` /- S� ' 4b. Service Type ❑ Registered ❑ Insured Cr �I 49 g19 4b. Service Type El Registered El Insured Certified, - _ ', ❑ COD ❑ Expr Meit' "" n Return Receipt for S 1- �l] Certified ❑ COD vs,• !� Merchandise e ❑ Express Mail ❑ Return Receipt for Merchandise 7. Da D '0 7. Date of Delivery r�6� Jli�re 5. Signature (Addressee) 8. � _�,Ad if requested c 8. Addressee's Address (Only if requested and +ty�i 6. Signature (Agent) PC Pn RR 11 r)ar•nmhar 1441 *U.S.'GPO:1993 -352 -714 PNIHAI =CTI( RFYI IRM RFf_FIPI SENDER: y c Complete items 1 and /or 2 for additional services. I also wish to receive the following Services (for an extra V Complete items 3, and 4a & b. y e Print your name and address on the reverse of this form so that we can fee): . > N .return this card to you. N o Attach this form to the front of the mailpiece, or on the back if space 1. ❑Addressee's Address N N does not permit; d > Write "Return' Receipt Requested" on the mailpiece below the article C number. 2, ❑ Restricted Delivery *' C m ' +' > The Return Receipt will show to whom the article was delivered and the date Consult postmaster for fee. cdelivered. M 3. Article addressed to: 4a. Article Number -ts fY e .. , h l ro�njK1 1�c�ry inn Z I q3 a M E ' 2� 4b. Service Type El Registered El Insured � �.0 uo oa 01 �l] Certified ❑ COD f w Pp.-� e sDn, y '�g ❑ Express Mail ❑ Return Receipt for Merchandise z o p_--- 7. Date of Delivery "- 5. i nature (Addressee) g 8. Addressee's Address (Only if requested x and fee is paid) m ~ l U' 6. Signature (Agent) 4 7 PS Fnrm ;R'11. December 1991 *U.S. GPO: 1993- 352 -714 noMESTIC RETURN RECEIPT LAURENT ENGINEERING ... ..., .... _ . _ ... . _ .. .. _.... .ASSOCIATES,. P:C•. , ..... ... .. _ MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278 -6108 - (FA)O 278 -2658 HARRY W. NICHOLS JR., P.E. H CONSULTING SITE ENGINEERS January 19, 1995 Mr. William Hedges Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Barnard Rd. & Canton Dr. Patterson, N.Y. Dear Bill: Enclosed are the following: 1. Four (4) prints of Drawing SS -1 "Proposed SSDS ", dated 1- 17 -95. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 1- 19 -95. 4. "Application to Construct a Water Well ", dated 1- 19 -95. ... ..5.� -- ".Des�r- gr:•- Duta• - -- Sheet ".,... .... _ . _ . ..._..... ... .. _..�. .... �... ... .._..._...... _ .... -- ._��.: 6. "Letter of Authorization ", dated 1- 19 -95. 7. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 8.. Check in the amount of $300.00,' review fee. 9. One (1) copy of Goulds Submersible Effluent Pump Model 3871. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Cn 7 ( l Harry W. Nichols, Jr., P.E. HWN:bd 94085 cc: Ms. M. Lobraico c LAURENT ENGINEER ASSOCIATES, A ES P CING € \ MILLBROO E OFFICE CENTRE Route 22 8 Milltown Road Brewster, New York 10509 j \ (914)278. 6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS March 8, 1999 Mr: Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Compliance Canton Dr. & Barnard Rd. Maureen Lobraico Town of Patterson Dear Mr. Morris, Enclosed are the following: 1. Three (5) prints of Drawing S -1, "As -built Plan," dated 3 -3 -99. 2. "Guarantee of Subsurface Sewage Disposal System," dated 1- 29 -99. 3. "Well Completion Report," dated 2- 12 -99. 4. "Laboratory Report," dated 2- 18 -99. 5. "Certificate of Construction Compliance for Sewage Treatment System, dated 3 -3 -99. We would appreciate your review, approval and issuance of the Certificate of Compliance at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Jc�-- Harry W. ichols, Jr., P.E. N: :his 94085 MlONAM 11 ..IMI!INIftlllMZAAMPIMpI/.MI"- P-AlAPIMU e r C � (G� r C _ C( ry (LVVI' - TNVt1IVAV1rIJVTV VIHI'IIV'I1V 11I1lVTV �11l�rlVVtYIiIVti March 11, 1999 Mr. Adam Stiebeling Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: Proposed SSTS Lobraico Town of Patterson TM #25.62 -1- 83,85, 86 &. 13 Dear Mr. Stiebeling: In response to your review letter dated March 11, 1999, we offer the following: 1. Nitrate has been retested and now conforms to state standards. Refer to attatched analysis. 2. Pump /Storage tank information is now provided on the attached well completion report. 3. Distances have been canceled and revised accordingly. We trust that the above addresses all of your concerns and we request the issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Larry W. Nichols, Jr., P.E. HWN: JM: his 94085 LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road HARRY W. NICHOLS JR., P.E. / \ Brewster, New York 10509 (914)278 -6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS' March 11, 1999 Mr. Adam Stiebeling Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: Proposed SSTS Lobraico Town of Patterson TM #25.62 -1- 83,85, 86 &. 13 Dear Mr. Stiebeling: In response to your review letter dated March 11, 1999, we offer the following: 1. Nitrate has been retested and now conforms to state standards. Refer to attatched analysis. 2. Pump /Storage tank information is now provided on the attached well completion report. 3. Distances have been canceled and revised accordingly. We trust that the above addresses all of your concerns and we request the issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Larry W. Nichols, Jr., P.E. HWN: JM: his 94085 - BRUCE.-R; -- FOLEY_ - Public Health Director _LQRETTA M- 01ANARI R.N.,. M.S.M...... r.._.. . Associate Public Health Director Director of Patient Services DEPARTMENT --OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 March 11, 1999 Harry Nichols Laurent Engineering Millbrooke Office Centre Route 22 & Milltown Road Brewster, New York 10509 Re: Maureen Lobraico TM# 25.62 -1- 83,85,86 & 13 Town of Patterson . Dear Mr. Nichols: This office has received and reviewed the most recent set of as -built plans for the above .mentioned project. We would like to offer the following comments for your consideration.. 1. Water analysis for nitrate exceeds state standards. It is advised that the system be flushed and the water retested for nitrate. _..... -.... L.. _...._...Coriplete the. "yump /storage-tank 1nf6,=atlon7! section on..tl::;_v�r ell- :,ompletlon report. 3. The as -built tie distances do not coincide with the plan view. Please revise accordingly. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact us if any questions arise. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj P'u S A M COMM ^fT T UI F "iP A iYil D = OF M=M I TY•{ UM.•�. a( FPa.h.wnsermal I:Ir..a.6n}n `..vb CaEa2% ox. 11' I.' Ffa,yriawrr n.., f"...id. Pe.,�k 1 as IMYAit TlIFl1 A T} lu F (pro A11P'I J A ti lYg 1 i CTk9M F' av : jM OID''T8'T2 t�Q�T1U)''{ Y"��1 MITiT 1°'inQ Si} w A (ri1P UIL�S1truS A 1 r� R Saeiad. lslw a+oc tiaiGd let i 1 .M Al an Fi'Lx.1 I a L' w r. � . I ■ W r . Lalmm ■ IL Dab r.l "r <,fta. {pyM .J 1 aakser m! flnd�rmora Ilk..r���r:�� I ',. I' IP u>,�Gfi1.. u} „� D. It ...y mihrtid µ � f'ltlll �� �ipira,o..1 - i yry�pll. � Frt.ao-r. `+arpy�l� Ilr,yllk..1 G.. f �� {,�Ldrruw I roproaont hot 1 am wholly and complotely responsible for. the dotign and location of the prOposed system(s); 1) that the toporat0 s rogo diaposol system 'obdtl0 deeiri00d will be' constructed -as Shown on the approved amendment there to and in aeeordonee with the standards, rules a rcgu Ipns _07- ham County .:®oportrncnt of H=Nh, and that on complot” thereof a "Cortificato of Construction Compliance" otisfactory, to the Commission= of Hoolthwill Lao aeammtcd to too Oep ARMt, and o wfitton Vubrontoo will bo .furnished the ownw. his sueeomwe, hoirs or amtons by tho buiegC7. thou mW buildC7 will Once 'ra paid opc7ottap eowelition ony sort of cold COMM dispowl syatom during the par lad Of two (8) yonra Immcigiotoly folCowiltj the Cato of the JMU. 0=0 of tho .oRWOual- of Me Cortiticoto of Construction Compliance of the Iginal system or any ropoba oto• 2) that the drillcd ewoll do=M d obovo twill bo loeatoal as she �a:on, t0oo oiwovca pion and that -.mid well will be into in aeeordo VA ho do rd b and rc8u aeons of the Putnam County 0o�rtntowt 00 M MIth. ' / Doto 4- �— 9 5 n P.E. Ca R�: Addro v Litenso No APPROVED FOR CONSTRUCTION* This approval empires two ycers from the date issued unless construction of the building has boon undortotton and is rOvocoDle. for -Cause or may, be omorided or modified when considered nocesa�l"�"��,.y��''o Coo minis &`i3ho of Health. Any change or alte7ation.of con. rust Ion romuiroa a note permit. Approvod for dispomi of domestic sanitary ^- v. J0�88 Data ® Title —1 " m wi PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION i _ ._..... .... -Date:.. . - Inspected by: – Street Location f ,A7z N,4 �( Owner aRA IG o Town 1�ATTcenAl Permit # TM # a 5 1?- - 1.— g _3 S 5 0 C t z 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 coursehvetlands ...... ............................... II. Sewage System a. Septic t t size Wellevel .......1,_50 ......... other ................ b. Septic tank insta ........� .... ............................... c. 10' minimum from foundation .......... ............................... d. Distribtuion Bo 1. All outlets at same elevation -water tested ..........:...... 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction BoY - properly set ..................... ........................a I - ...... Length required �+ Length installed 2. Distance to watercourse measured -t1 oiDFt.......... 3: IM ordi an ........ .........................:..... 4. Sch acc 5. 1 property e 20, - foundations.......... 6. Depth o trench m surface .................. 7. W r-1tn)! si on ,100 % ......................... 8. z ravel 3/4 -1 %" diameter clean .................... 9. Depth -of gravel in trench 12" minimum ................... . 10 Pi' a ends cad e g. -Pum .orD' 'ed S�'�steins . _.._.., ize o pump c am ef ............... ............................... 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/Buildin a. House located per approved plans .................................. b Number of bedrooms ............... .. s:f �tcl.. IV. Well / down g--Aq; 15 jJst-3 6e ,-n ren��✓ a. Well located as per approved plans ............................. b. Distance from STS area measured +;.© o 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 watercourse g. Footing drains discharge away from STS area .............e) , h. Surface water protection adequate .. ............................... i. Erosion control provided ................. ..........................:.... YES NO COMMENTS X u X u . 8 � ..tea .� � •�. oC X iq •'_ _ ? 'rF '- at Y -ZZ , ` 4 2 J! ,+"- -W = -y3. _' �'f " y s g;' T Shcet' of 1... 7E r , PgTTl�t� COUNTY D�i'Al�'T1igEIVT3fDF EI]Et�i.'�'IEi 4 '�T� S��l�t QlC � '�'F 'oI:V� :�IT�iv� A�1[�. = E��%aC -S r 11 �, �0� x IE+'YEl(,D ACT'l'VIT�'3.R�lPOR7[' „` %; - E :,. AA ��y9 q -:4 - T�iA AAF rat J'� / '� s -�, V'PI s > - " - Street _ = Town State s Zip 1. - 1. .. '� A e - - - •L 5 - - `PERS�O��I�t�I�Ny ��iGE Y b i. 11 r - 'Name end Tale - iX �1 .T'i'�'E tF FACILITY#, _ F y 11 ., , v� . - - 3 }; r - ,. �kf ~ .i as z _ .�, _ ,b 3 "A f F r . , r �' - F,FPJDIP�6GS ' R,, A r �f _ �� $ �/ � .1 ,_ s - o - F: . - - � -: ,. $ - . 15 1 - r -t r ' � Y'mp: e - a '. z - ...f.. �: -`2.` : S.. . r : -�. .P. `E. -11 e, w S_:,,L,."T�"X.:s. �.- c�.,. -- ,' f r r .ms 5 - ,-"-a- P .� ''u..�--- — 5°°-=- ° h�,Q"= s'c" --a - _ y ', hF "F i¢ �t 9 I , � , � =- I - � �� - . ,�". . :1 —,,,, —', � 1, . I ; '. � -, � - � - � " - - w v � . . 1. s.tf - . - _ -. _? F, , J�-- �� I � '' , , I .' ,' ,,,,,j, — � . ._�@ v s - r. . -` ti: .,.. - - -, i - t A - �, .�.up3" f _ p ryP - t �. Srgnatp and Tide - , .�- R FpQ�PVCF ALE � � " 11 I 'acknowledge ,receipt o - this report S , rNATtTREs 5 lll� p S t -tea- $ _ + - a x .� 0Z� 96 . ; Title, ` °Rev V PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location lIroquois Street'Address: & Addison Road Town/Village: Patterson, NY Tax Grid # Map Block Lot(s) Well Owner: Name: Address: Maureen Lobraico, 465 Doansburg Road, Brewster, NY 10509 Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) T Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 33 ft. Length below grade 32 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: __X_ Steel _ Plastic _ Other Joints: Welded X Threaded, Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No _ Liner Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First _ Yes No Hours Second Well Yield Test Bailed X Pumped x Compressed Air Hours _ Yield L gpm Depth Data Measure from land surface-static specify ft) 30' During yield test(ft) 145' Depth of completed well in feet 185' Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 15 Drilling in over urden clay and boulders 15 Hit rock at 15' .15___- .33_ __ .Drillin ig.roc -X set -.casino: _. uted..__Y.__ 33 185 Drill in in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Cio CapacityjlwGhv. / m1r Depth 1(2701 ModelfA565?k ILL Voltagel4o.. HP Tank Type 104--'kl4i� Volume 5 Rti W11U% It Date Well Completed 12/17/98 Putnam County Certi ication No. 002 7:2/99 ort Wei r Beal nvi r,: txact tocatron or wert wan atstances to at teas" o permanent tanamartcs to ue pr aea on a separate sneevptan. 4 Putnam Avenue Well Driller's Name P. F. a Address: Brewster, NY 10509 Signature: Date: 2/12/99 Perry L. Beal �-11aSsitt�.EO 13� H f•�-o �D White copy: HD File; Ye 7w copy - Building nspector, Pink copy - Owner; Orange copy - Well driller MA�1�.AN9 Form WC -97 -)ARrimr c, Pblwv4 Cowry f,,i;,t m, mmaii DMSIQN.'GF : ENVjROLNIMFt4IIj,.!'1 SERVICES Z. 7 7 ?ee) / W/ _j ej;,"or'. Purchasek. of'94 Jocati6n,- Street i*ici Building Irype-.' ac: igri lock' Lot OLY-livision &-ute Subdivision ot # vision GUARM U f:J? X, SYSIVIN I... . W bolly ti I d Y ropongi'bl® for the location, n! w Vorkminshl p, mateiia co6sttuction and d,rai,nhqe of the spwag6 clisposal'systpm d that it :'-as been constructed as shown on serving the abci � d "' . . g th V . esqri� •.lproperty, an the approved p1lin"' or' approved . IIIIUIILIMU'iiL I-I'le're-Lo, and In accordance with the standards*,' rulet.:,ana,:iegu!.ations of the Putnam. Cou.nty.Departnent of Health, and hereby' guarantee to the 'owneri`his succcssors, or assigns, to place in good operating 'condition- -any part of said system constructed by me which fails to � or>-.zate'f or .a . period. of . two. years immediately f ollow iqg the date of approval of the ".. ,"Certificate bf'Con:3trpction Compliance" _Lbr:-#e sewage disposal systen, or any -ode by me to iti6 ny!-*.tr-M,-oxrPpf. r U n repairs n 19 wh(;,-.e. �i* fafl.urn to operate properly is " caused" U-1 or negligent act"'bFU-7- . ., . :.. .. ... )e oc-upant of e building utilizing the system. The undersigned further Conclusive the determination of t .-Dire&tor of the Divi'sion� f Environrrez al U he 0 ht Services of the Putnam County. Department of Hearth as to whether or not ul,_, ot the systen t0:' opexate''was used by,t�o willful n 9. r I u L Jin buildincj utilizing or o C I it i o, -.mL of L the system. d n v.^1 Dated this ay of 19 5 al Con c tor (Owner) = Signature T_ Corporation Name (if Corp. .r. , /05 Ti.,Ue Corporation Name (if Corp.)' Z 6;xie_ F95, i Address Al ""I % AE NORTHEAST LABORATORY OF DANBURY 39 -3 "MILL Piani Ro eln DA1�isuRx, CT 06811 " LABS (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: MS. MAUREEN LOBRAICO 31 BARNARD ROAD PATTERSON, N.Y. 12563 SAMPLE SITE: AS ABOVE SAMPLING POINT: NOT STATED SOURCE: WELL TREATMENT: NONE TEST PERFORMED RESULT: CHEMISTRY: 11301- Nitrate N - 2.6 ml = milliliter mg/L = milligrams per Liter * *Notification Level ** *Action Level CT, Cert: PH _Q4Q4_. , NY Cert: 11471 DATE SAMPLE COLLECTED: 3/11/99 TIME COLLECTED: 4:30 P.M. COLLECTED BY: NOT STATED DATE RECEIVED @ LAB: 4/12/99 TESTED BY: LAB# 11301 REPORT DATE: 3/17/99 MAIOMUM CONTAMINANT LEVEL mg/L as N . 10 mg/L as N ND = none detected NTU =Units RESULTS BASED ON SAMPLES SUBMITTED:3 /12/99 (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 all Ii. NOO1': "I�IiI:��� "I� Lt�l•�t�)FZt� "I'(�)R�' �•,f I�)��,F:;i E,�ti .CT Cert.PH -0404 39 -3 MILL 1PLAxx 118 ®AID - IIDANIE$>< Ry, CT 068 111 NY Cert: 11471 (203) 748 -7903 - FAX (203) 748 -0652 REPORT TO: HAVILAND PLUMBING KENWOOD ROAD PATTERSON, N.Y. 12563 SAMPLE SITE: SAMPLING POINT: SOURCE: TREATMENT: TEST PERFORMED BACT1ERL&L: Total Coliform (Bacteria) PHYSICALS: Color Odor pH Turbidity CHEMISTRY: Nitrite N 113 01- Nitrate N Alkalinity ................. _ .._.._. -a _.._.__.v- Hardness Iron Manganese Sodium Lead DATE SAMPLE COLLECTED: 2/18/99 TIME COLLECTED: 3:30 P.M. COLLECTED BY: H. HAVILAND DATE RECEIVED @ LAB: 2/18/99 TESTED BY: LAB #11471 & 11301 REPORT DATE: 2/24/99 LOB RICO, 31 BANARIlD lE1;IID., PUTNAM LIB., PATTIERSON, N.Y. STORAGE TANK - HOSE BIB WELL-NEW NONE RESULT: MA3UMUM CONTAMINANT LEVEL 0 per 100 ml 0 per 100 ml 0 ND 5.64 no designated limit 0.77 NTUs 5 NTUs <0.005 mg/L as N 1 mg/L as N 11.0 mg/L as N 10 mg/L as N 37.0 - mg/L no designated - limits 168:0 mg/L no designated limits 0.050 mg/L 0.30 mg/L 0.254 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] 56.4* mg/L 20 mg/L ** 0.005 mg/L 0.015 * ** ml = milliliter mg/L = milligrams per Liter ND = none detected NTU =Units * *Notification Level ** *Action Level RESULTS BASED ON SAMPLES SUBMITT E><D:2 /18/99 SAMPLE, AS TESTED ABOVE: MIPOTABLE or OINOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) ca Laboratory Director oNORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037° (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800 - 654 -1230 _ - - - RECOPY -OYPHONE-- CONVERSATIOr; _ ......_ _ Time: Date: 2ZO Person calling: ,lje� 4k er Ld pet Z�- Phone #: ;,L % (� �p Reason 04-Inspection: �ym�D ��'4- ( ) Deeps and /or Peres: Scheduled Field Meeting Time: 2 f 3 Date: he? Y N Tentative /to be confirmed O ( ) Town: pa, -7f It Road /Street:ct/— Tax Map #: �5,�� - 3 . gs� 86 J� 1 3 Comments: !.t vision o-f ith conformance -Vi :,.pproved as noted fZ5- --Dlicable V-ales and Regala-•iOns of )utna-m Co l jty--U_q2, D jth ,-3x ant. ul I-- '11001 �l REV. /* -PROJECT eov Vkg rV 7 -7—ir LAURENT:. ASS.0:CIATES-,?.C. MILLBROOKE OFFICE CENTRE Route 22 ' P. Milltotivn Road, Brewster, New York 10509 (914)278-6108 -'.(FAX)'278-;-2658 CONSULTING SITE EVIGIVE;P.;;q :L $ -7- 1 D -IN G TITLE,: RAA SCALE DATE 17 -9-f C:" DPAI�Nl BY,:, I V4� KED'BY Ch-Ec' Dw N: o. 56 U 4 JOB ,N 0. Ne. Ae, "G No.:'. FEmp DRAWN ICA, LAURENT:. ASS.0:CIATES-,?.C. MILLBROOKE OFFICE CENTRE Route 22 ' P. Milltotivn Road, Brewster, New York 10509 (914)278-6108 -'.(FAX)'278-;-2658 CONSULTING SITE EVIGIVE;P.;;q :L $ -7- 1 D -IN G TITLE,: RAA SCALE DATE 17 -9-f C:" DPAI�Nl BY,:, I V4� KED'BY Ch-Ec' Dw N: o. 56 U 4 JOB ,N 0. Ne. Ae, "G No.:'. FEmp DRAWN .q PUTNAMCOUrfff O f id- ah H & -tress l H S . erv% C—W, N Y D 10512 Fabeer to Fmvsde Pack 0 a I1 �� CERTIFICATE OF COMPLIANCE )IM N PZRMrr FOR SEWAGE DISPOSAL SYSTEM LeKSead r n a r, �t I owl or VMNO Lot M T. Map-a . L Z Block —/ —Lot SS 4y-) 01srow /Affbasat No/) � ) J Renewal_ O Nauss- % V l4 ✓ y< -e-!a L�r, h Y I f Q $evldon 0 ff, J� Date of Previous Approval Maf>b>s Addteaa - f._ r 1� v++� v n s,� S7 /L �Q _� Town �f ►,� S� ^v It %,r tip l LI Sopwabo Sewmw Systea te oeadd ot AMOGallou Septic Teak aaa 3-2Z 11-11 To be aeohaNed by —7 6)p Address water Supply: Pombe Supply Frm Addiees on �' Pawl,. S.p* D,, a by r B b L vf' _T dd. Otber R..&.!! I represent that 1 am wholly and completely responsible for the design and location of the proposed system(s): 1) that the separate sewsga.'disposal system' above described Will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o • Putnam m County O•part•nt of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a written guarantee will be furnished the owner, his succemors. heirs at assigns by the buikW, that said builder will Place In good operating condition any part of sad sewage disposal system during the period of two (2) years Immediately following the dati of the Isw• ante of the approvaf 'of the Certificate of Construction Compliance of the original system or any repairs U-•to; 2) that the drilled well destrib•d abov wilt be located as shown on the approved plan and that sad well will be Instal in accords wit the :71rdules and requ • iionf 0f the Putnam County Department of Health, 1 Date .Q� 3_ 7 Signed P.E. R.A. Address ` l.leensa No APPROVED FOR CONSTRUCTION: This approval expires two years from the date •Issued unless construction of the building has bean undertaken and Is revocable for cause or may be amended or modified when considered n•cess&W -by- ho Commissioner of Health• Any Change or'alteration of rPnttructbn repuires aa�nnow permit. Approved for disposal of domestic sanitary 11ewage, 71t wPP Y on Z��88 oats,^ c.• 9vf" ��,�'�'r .►sr:..._.- --�-� Title i DEPARTMENT OF HEALTH Divi - -on of Environmental Health Se..lces NGeneva Road, Brewster, New York 10509 (914) 278 -6130 _,APPLICATION TO CONSTRUCT. A WATER WELL. PCHD PERMIT 0 ALL LOCATION Street Address r1 n ez G� ., v own Village City �) Tax Grid Number 1 WELL OWNER � Name' i��L LN ;A dreis I ( L f f74!% .'' 0 rivate 9j . O Public USE OF WELL 1 primary 2 - secondary )2 SIDENTIAL ® BUSINESS 0 -INS SU TRIAL ® PU LIC SUPPLY I Q AIR /COND /HEAT PUMP FJO ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify y 0 INSTITUTIONAL O STAND -BY' AMOUNT OF USE YIELD SOUGHT of gpm /# O REPLACE EXISTING SUPPLY GrNEW SUPPLY NEW DWELLING PEOPLE SERVED lk,'12 /EST. OF DAILY USAGE &V gffi1 ® TEST/ OBSERVATION ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING �111%111nV t: WELL TYPE ` ®DRILLED 13 DUG DUG ®GRAVEL ®OTHER IS WELL SITE SUBJECT TO FLOODING? �` YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME 'OF SUBDIVISION: Lot No. MATER WELL CONTRACTOR: Name ,¢j.►-'- Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES 4--" NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE v DON SEPARATE SHEET (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,� (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 il,." 19 Date of Expiration 19f Permit Issuing Official ermit is Non - Transferrable White copy: HD File Pink copy: Owner !8�� Yellow copy: Bldg. Insp. Orange copy: Well Drille • J. ` � f / • 1 1 / • r j 1 1 1 1 1 . 1 • 1 1 1 L • 1 1 • 1 1 . L 1 1 1 1 1 ! l . 1 1 L 1 I t 1 ' 1 1 1 . 1 . 1 ' t 1 • t CHALET #2 = 2BR., ] 3 /4BATH 27 X 36 9 I. i r ► ► ► ► ► ► ► ► ► ► ► ► ► ► i • CHALET #2 2BR., 1; 3 /4BATH 27 X 36 0 I ! ! s ! 4 . r J I (; J J 1 r � r ► ► ► t ► ► ► I. i r ► ► ► ► ► ► ► ► ► ► ► ► ► ► i • CHALET #2 2BR., 1; 3 /4BATH 27 X 36 0 _ .- ,. . . ��� ._ . � ... .. �. ,. _t . ��b. _ y� ... .. .. .. , �.... , , ..... ... �. 1 - r .. � f .. PROJECT , i • Q CA;v T ON PRI VE C AM Mf p ; � 50.5° 55" 10T /oo• oo' =E �F 4 i. f PUTNAM LAKE �� � /4dsouvvvc ! SITE LOCATION PLAN ::J_ - O 38 ro (ryI) O PROPERTY SHOWN ON 'TOWN OF Ps}TTE,e5olV t a0 42' TAX MAP: z5. &Z - l- 89,06, '?to % /3 0 O N o i/) 7 � •: i a I REV. 3- 12- 99 h uj EryANSiON ' e1- � AREA o s 05° 55,lDE c 100.00, P?J c O S ' 'p9 00 . v 1 ravK \O t '` W . 0 .Z� �SJIEV.S't �1.1Up %� P (7f-0- of I /NS/OE W t / p raPj M h . t � o Nos° 55 ; /o "w • -1 } - ZOO. oo" I BARNA RD - DRIVE i PROJECT , i SITE C AM Mf p ; � =E �F 4 i. f PUTNAM LAKE SITE LOCATION PLAN ::J_ SCAN; 1"= /000 PROPERTY SHOWN ON 'TOWN OF Ps}TTE,e5olV TAX MAP: z5. &Z - l- 89,06, '?to % /3 l � •: i REV. 3- 12- 99 PROJECT , i ! 2 2 105. 8' I oZ I - 2 t- D'7 - s { .So . - I s y: . PUTNAM COUNTY DEPARTMENT OF HEALTH ...... - ._ - ..... _ ...DIVISION-.OF. gNVIRON- MENTAL..HIEAI,TH- SERVICES-_ _ CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR TMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at &414-1W DPJvE 4 C.AHioN DWyF Town or Village PATrEP-601-4 Owner /Applicant Name b Lo Al" Tax Map U• Gl Block Lot V1 A6- Formerly Subdivision Name pUTHAM I-A'Y -r-- Subd. Lot # 1144 -1145, jkUgo..A11gj,AlTAC-a114o Mailing Address BAP-NV rA\ UO -HO-6 p-D W Pf 0 h 6 W06-To- Hy Zip 10 S 01 Date Construction Permit Issued by PCHD Separate Sewerage System built by J KES U ACAL4 A" i Address V) GIRNE fAW 4. PA OLAAj� VL5 Consisting of 1000 Gallon Septic Tank and M Lf A�6 TP-gµLH Other Requirements: Po" 5; TEK Water Sup IV: Public Supply From Address. or: X Private Supply Drilled by Pf Wk, + 60 MGJ Address 4 �rl WiR ME- 6WA00AYMai _..... _ _ -Builu din, :3.pe.- ..__...13 -� � i.. i N F _ Has- erosicn control bee. cc:npleted? — ...YES- - - Number of Bedrooms 2 Has garbage grinder been installed? NO 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 Putnam County Dept' rtment of Health. Date: Certified by `K ( esign Professional) Address 2O M 1 L4,70 WH Roa V 096VA -f& hr 1 P.E. � R.A. License # 5(o124 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification or change is necessary. By: OL ALL Title: l Date: 14 White copy - HD File; Yellow copy - uilding Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUPTIl'Yt DEPAYifA"l OT OF l$EAE — Cvi®lon of E®viron®e ®tai Elealdh Servlc®d. Cannel, N.Y gQ3 ? , ngln . e to Provide Permit# st DI on CEI8MCATE OF COMPU ANCI j a CO W-S - UMOK `PEMW FOiS,SEWAGE DISPOSAL Si(STEAq Permif p . - T P,atte>"sosa � s LpcdSmd st Qg jf—n*t F_ Tt -a °d °ram , Town or Vlllage I Sabdlvfoion dine Putnam Lake Sabel dot iY Tnu F 61 7Bloalc 3 sAt 3/9 f ° )Reneerol_ 18ev1 ®ioa Ow� eQiA�PUt Rla�e Maur'.een l;obraco i Datm of'Peevioa® Approval'` AS(alu®gAdaHaooa 8as�1u1:1 Corz1P;=G Town 'Brewster, NY Zip, -' 10509 _ >3aua➢l�g Modular' 4 at t 40000 Sq Ft l!ms�abno�iy` NO DePrly 18" "Veiam�257'Cu. Yds. Fia®bee of l®edroo ®o Three Deslgd Flow G P.D.: 600 PgM.N0tMCii ton la ]aegaleed 96'c9 ®a.FUl la compl ®t®a r �p Sm� ®BOge Syat�® tm rnaoi�t o¢ 2" 1, 000GpO0 Spd� TanEi � 400: Toilet sWastl s &267': Kitchen / <Laundr.y wastesx24" w1 �d,�e.co ®oteted by` -� Ate'. ' x 1$:t' Deep woww S i . , �P 7 Pabuc: Sapply -�ro®t oe: ` - Prly ®t® Stapply Driued by :Adtir�oo- Ot�eefiSenair® ®enta R - -O -B Fill Section. 18" deepx6000f .Sq Ft: (257,Cu. Yds.) &190'x5'Deepic24' w., curta i. 1 represent that 1 yam, wholly and,.completely - responsible foY�the design: and location of _the proposed system(s);'ll) that.Ihe- separate,se wage, disposal SystemDra n t ,. above +described, will be con"stiucted as shown on the- approveC amendment 64Wio and in accordance with the standards, rules an - regu a ions O -,the U namb - County Oopaitinent ot. Hoblth, ;and that -on completion ttierept a 6ert�ficate of Construetion ,Complwnce iatisfactoryao the Commissioner:of Health'willDayll e be submitted ao •the = Department and a wntton guarantee will de,furmshed- the•owner,.h. succeuors, heirs,or" assigns by'the•builde'r, that said builder -wil, . -place in good'opeiating condifionrany part of said Sewage ;1466silsystem during -a,e peripA, f two(2;) yoars;immoCiafely following thedate of the, issu- once of the approval bf the Ce�t�ticate of Construction COmDl�ance'of the ong�nal system or ony ropaics thereto; 2) that1he drilled well d'ascribod:above wJl be,located`as shown on the approved pl n and that said well will be'Installed' °'n accordance -with standards; rules -and' regu a�Toni ot:''.tbe - Putnam ` County Oepaitment of Health S. Date, 2, Jul y..1987 a�gned /- ? 6 E X R A. — Aaare::'RD9 Fair .'St. Car - NY 10512. License wo 29206; . APPROVED _FOR CONSTRUCTIOW This approval: expires two years from the.`data issued unless construction' of the building has, been undertaken and is: reyouible -for ca`us'e or maybe amended 'o �mod•ified- when, considered. nac ®ssflry- .'by.the:Commissioner of,, Health ' Any change.or alteration - ot - .construction - - rooui►os a 'new, permit.' Approved for disposal of;' domestic samtary.aewage,:and %or ;private :water supply Only;, S- V87 Data '8Y Title L_.,. .T.:. .. .:.• .. "- -_.,. -�.__. ...._.� s.- _._.�.:.. -. Sl r�-v.. . =fir_. _... .. .�, .r .. ._.. - - .. •a. .-- .. - - W1 _o PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Maureen Lobraico Barnum Corners R.F.D. #3 Brewster, New York 10509 December 1, 1987 ResVariance Request proposed SSDS/Well (T) Patterson JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Dear Mrs. Lobraico: You are hereby advised that your request for a variance from provision of the required 200 foot separation distance bewteen your proposed sewage disposal system and the well on an adjacent parcel has been considered by the Board of Health on November 30, 1987 and denied. V X trul yours, / Ra ones J y President Board of Health RJ /jp cc: Building Inspector (T) Patterson John Prentiss JK file N PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 October 14, 1987 Maureen Lobraico. Canton & Bernard Road Putnam Lake, New York 12563 Re: Lobraico Canton & Bernard Road Putnam Lake (T) Patterson TM - 61 -3 -3 -9 Dear Miss Lobraico: Please be advised that the matter of your variance request has been placed on the Board of Health agenda for November 16, 1987. The meeting begins at 7:30 offices in the Boces compl. Prior to that meeting your submit three copies of the uncluttered by the details the bottom of the page. JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director P.M. in the Conference Room in our max. .... _. engineer, Mr. Prentiss, must plan, with the plan view and labeling the existing well at In addition, the extent of the property owned by you must be clearly shown, i.e., the upper left parcel is believed not to be a part of the parcel you own. If the revised materials are not received prior to the November meeting, this matter will be removed from the agenda. If you have any questions, please contact me at Ext. 304. Ve y t ly y urs, ,0 0 J h Kare 1, r. , Director, Environmental Health JK:pt Services cc:Mr. Prentiss I.: i REQ IVES? I�I 1 nJ'iI.IC'i1 -- I..-i',� II i Ile OA %3-,�J� I. . of —. 4A, III S �.� • .i �. I,' I e 4 / i ✓ PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 October 14, 1987 Maureen Lobraico Canton & Bernard Road Putnam Lake, New York 12563 Re: Lobraico Canton & Bernard Road Putnam Lake (T) Patterson TM - 61 -3 -3 -9 Dear Miss Lobraico: Please be advised that the matter of your variance request has been placed on the Board of Health agenda for November 16, 1987. The meeting begins at 7:30 offices in the Boces compl Prior to that meeting your submit three copies of the uncluttered by the details the bottom of the page. JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director P.M. in the Conference Room in our =x. engineer, Mr. Prentiss, must plan, with the plan view and labeling the existing well at In addition, the extent of the property owned by you must be clearly shown, i.e., the upper left parcel is believed not to be a part of the parcel you own. If the revised materials are not received prior to the November meeting, this matter will be removed from the agenda. If you have any questions, please `contact me at Ext. 304. Ve y t l41,rZ., s, 0 J h Kare Director, Environmental Health JK:pt Services cc:Mr. Prentiss PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 September 22, 1987 John Prentiss RFD #9, Fair Street Carmel, New York 10512 RE: Maureen Labraico Canton & Bernard Rd. Putnam Lake, New York TM #61 -3 -3 -9 Dear Mr. Prentiss: JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director Enclosed please find one copy of the plans for the sewage disposal system and individual well to serve the above mentioned lot. The plans'are not approved for the following reason: The-well-to-the west across Bernard Road is considered-in- direct line of drainage. Therefore, a 200 foot separation ^ is required. If you wish to redesign the sewage disposal system in the area not covered by the "key hole ", bear in mind that all wells and sewage disposal systems within 200 feet of the proposed well and sewage disposal system must be located. If you have any questions concerning this matter, please contact me at your convenience. Very truly yours, William Hedges, Jr. Sr. Environmental Health Technician WH :mk enc. cc: N. Molle, BI PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION CF- ENVIRONMENTAL'HEALTH SERVICES Date 2 July 1987 Re: Property of Maureen Lobraico Located at Canton & Barnard Roads (T) Patterson Section 61 Block 3 Lot 3/9 Subdivision of Putnam Lake Subdvo Lot # Filed Map # Gentlemen: This letter is to authorize John H. Prentiss Date a duly licensed professional engineer X or registered architect_ (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in - �oruiect-ori -whir this °matter and to supervise ttre caps t x °uc t i on 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. Ft "'u%At y�o N. PRe Very truly yours, Signed �d Owner of Property Co ntersigned: �� �® � Barnum COrners RcA. , # Address Brewster, NY 10509 Address JOHN H. ppLPJTISS, P.E. Town Ring FAIR CT 914 -873 -6170 CARiMEL, NEN ffialc 10512 914-279- Telephone Telephone 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 4 WELL LOCATION Street Address Canton Barnard Town Village City Tax Roads T. Patterson Grid Number - - WELL OWNER Name Maureen Lobraico Mailing Address Barnum Corners Brewster NY 10509 jkPrivate O Public USE OF WELL 1 - primary 2- secondary R RESIDENTIAL O BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify, O AMOUNT OF USE YIELD SOUGHT Five gpm /# PFOPLE SERVED Six /EST. OF DAILY USAGE 400 gal REASON FOR DRILLING SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING Residential Supply WELL TYPE DRILLED DRIVEN ODUG O GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: piitnam Lake Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ___X _NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE `1'O PROPERTY FROM NEAREST WATER MAIN: Over one mile LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED(See dwg. #l,Job #S.0.2426 By John H. Prentiss []ON REAR OF THIS APPLICATION [!]ON SEPARATE S P.E.) 2 July 1987 (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 s.hall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: 19 Date of Expiration: 19 Permit is Non - Transferrable 2/87 Permit Issuing Official White copy: H. D. File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller DESIGN DATA SKEET- SUBSUFACE SEV'AGGE DISPOSAL' 'SYS 1= Owner Address C4,-6,, mg Bairn gird Located at (Street) 4.a�e _ �v�+ Sec.7H 61 Block T Lot --5 (indicates. nearest cross street) Municipality Pd�rsevl Watershed C6:6. SOIL PERCOLATION TEST DATA RDQMED TO BE SUBMr= WITH APPLICATIONS Date of Pre - Soaking Date of Percolation Test HOLE NUMBER CLOCK TIME PE RCMATION PERCOLATION Run 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 1 2 Sege psi 4 i ha i 5,A6 M i s-T t B J 3 5 3 f1f M Bar R. Moms 4 ZrI4r rn. �n 5 �rn 2 3 NO w. � 4 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 frm top of hole. rev. 9/85 2 3 f1f M Bar R. Moms 4 ZrI4r rn. �n 5 �rn 2 3 NO w. � 4 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 frm top of hole. rev. 9/85 � JY. G.L. 1' 2' 3' 4' 5' 6' 7' 8' 9' 10° 11° 12' 13' 0 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE " N0. 11, .. HOLE M. 0 �9 INDM:aTE I-AIM AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used Min /1" Drop: S.D. Usable Area Provided No. of Bedroans m Septic Tank Capacity 2.r 9 ®® ® gals. Type A Absorption Area Provided By em L.F. x 24" width trench 'q®o ��9�ai m /�eeead� Other UZ tA-a rx.- a 0 c4A.,.M e gfern"' r., b g ad '� 16 (54TS YA'A Name J®HO H. PRENTISS, P.E. Address R09 FAIR ST 914- 870 -6170 NCI N OAK Mia SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date Beechwood Series P. 0. BOX 323 BERWICK, PENNSYLVANIA 18603 (717) 7525914 _ 2444SF_. _ .... . Action Associates Inc. i Barnum Corners Browsteri NY 10509 r SVOGESTEO LOWER/i EVEI all -\I Optional 3/4 BEith With 2 closets 018 7%ove Aaeo ow Ave /// /far M4graP�..rgt .0 '..__ . Ig -.•a��og4�f' le 7 50^4 Elevations are artist renderings and may vary to actual construction. Floor plans and room sizes are approximate. Appliances shown *e optional. Plans; Spdt illoations and Pklc6t Jre subject to change without notice if lEsachwood asn' S's P. 0. BOX 323 BERWICK, PENNSYLVANIA 18603 F---7 -- Action Associates Inc. N Barnum Corners .Brewster, NY 10509 1 Optional 3/4 Bath With 2 Closets 018 SUGGESTED LOWER/LEVEL e 001. OOOr 001, f.O.E. UTILITY . AM atrare (9o1 e® SINGLE CAR GARAGE FAMILY ROOM DEN/ STUD, f 1 �a� �� C°� 6 0 ����%� J� t► �1A�i"�LWl�1�' o� I 1----------------- - - - - -1 ._____— _- - - -. —J Elevations are artist renderings and may vary to actual construction. Prim nlanc and rnnm cd7ac ara annroximata- Annliances shown are ontional. Plans. Soecifications and Prices are subiect to change without notice i v Located at PUTN AM Division of Enm SEWAGE DISPI COUNTY DE -7 _OF�-HEALTH - - :ENGINEE - R TO PROVIDE PERMIT # ARTMEN,T - e QN-CERTLF4CATE OF COMPLIANCE. SeServices, Carmol, -N. ' Y� 10612, PERMIT' If Section Aie, n ypj, �?ildi g: T; .- .' Notification Requ Number of Bedrooms _,De.igi� Flo G/P/P H, R pot.if.i _ Separate " Sewerage System to consist o Q Gal• .'..So tic a iz Z A N '!To by Address Water Supply : Public Sup ly F.ydm 41, Private ly rille W6 "4 r.' Ad Other Requirements ystern(". .1 .1 represent t - hat - 'I - am wholly and cor��Pletal\y`rVr'p",Iin,ibli f6r the dis!gn"a'nd'-Io-c'ati'on-�"'6f .the •proposed 5 s) ,that the separate. sewage disposal system as shown to and In Accordance with the standards; rules and regulations of the Putnam above described will'be con on,the approved artment I of -Health,. n' 'and that ocompletion thdreof a "Certificate icate *of �construqitioW Compli - ance" . satisfactory to the Commissioner of Health'will. county _Dep be submitted to the Department,.: and a written guarantee Will'.6e furnished the',owner, hli;.miccess6rs,• heirs or. assigns by the builder,, that said builder will c n any I �'duilnj,_ihe 4.0 t place in;goocl�operating p ditioA �irt of said' s period f (2): years Immediately following �the date ' of the issu- -repairs thereto; 2 ante of-the' approval of =the Certificate of. Construction Compliance of 'the originaCsystem,or any. ),that the drilled well described above will be located : as sh - a . wn.on the appr . 6v . edip I Ian and thai'sald well be"inifahid in -accordaitice' with the standards, *rules and:reguraUqns- of the Putnam' County Department of Heal P.E. R.A. Address A, _W', 7-- Date ri . I a 17 777777, License NO.' V4, ,- APPRCIVED-FOR CONSTRUCTION'-. This approval iexpires-4ne year frqiii thii:date Issued 'unless construction "of the building has-been undertaken and Is T _ - ' Health. ;Any chang-e7or alteration of rev6caife, fo'r cause- or,ma yl*be amended or.,ihod'ified when- considered .niaiiirr by thC Commission6i, 'of, construction f4 ..requires a new permit: Approved for 'disposal of domestic .-sanitary :sewage.-and/or pr Iva water. ,supply oniy,. Date 'B Title )N PERMIT FOF PUTN AM Division of Enm SEWAGE DISPI COUNTY DE -7 _OF�-HEALTH - - :ENGINEE - R TO PROVIDE PERMIT # ARTMEN,T - e QN-CERTLF4CATE OF COMPLIANCE. SeServices, Carmol, -N. ' Y� 10612, PERMIT' If Section Aie, n ypj, �?ildi g: T; .- .' Notification Requ Number of Bedrooms _,De.igi� Flo G/P/P H, R pot.if.i _ Separate " Sewerage System to consist o Q Gal• .'..So tic a iz Z A N '!To by Address Water Supply : Public Sup ly F.ydm 41, Private ly rille W6 "4 r.' Ad Other Requirements ystern(". .1 .1 represent t - hat - 'I - am wholly and cor��Pletal\y`rVr'p",Iin,ibli f6r the dis!gn"a'nd'-Io-c'ati'on-�"'6f .the •proposed 5 s) ,that the separate. sewage disposal system as shown to and In Accordance with the standards; rules and regulations of the Putnam above described will'be con on,the approved artment I of -Health,. n' 'and that ocompletion thdreof a "Certificate icate *of �construqitioW Compli - ance" . satisfactory to the Commissioner of Health'will. county _Dep be submitted to the Department,.: and a written guarantee Will'.6e furnished the',owner, hli;.miccess6rs,• heirs or. assigns by the builder,, that said builder will c n any I �'duilnj,_ihe 4.0 t place in;goocl�operating p ditioA �irt of said' s period f (2): years Immediately following �the date ' of the issu- -repairs thereto; 2 ante of-the' approval of =the Certificate of. Construction Compliance of 'the originaCsystem,or any. ),that the drilled well described above will be located : as sh - a . wn.on the appr . 6v . edip I Ian and thai'sald well be"inifahid in -accordaitice' with the standards, *rules and:reguraUqns- of the Putnam' County Department of Heal P.E. R.A. Address A, _W', 7-- Date ri . I a 17 777777, License NO.' V4, ,- APPRCIVED-FOR CONSTRUCTION'-. This approval iexpires-4ne year frqiii thii:date Issued 'unless construction "of the building has-been undertaken and Is T _ - ' Health. ;Any chang-e7or alteration of rev6caife, fo'r cause- or,ma yl*be amended or.,ihod'ified when- considered .niaiiirr by thC Commission6i, 'of, construction f4 ..requires a new permit: Approved for 'disposal of domestic .-sanitary :sewage.-and/or pr Iva water. ,supply oniy,. Date 'B Title M".' Y: G' SL "da'!Y'J:Md��"�:'GNEI%a�= '••;e. aeitilL.wTtl tldl_. �..� •'- �.• ••.Sf IY�S�IMU1�'Yleid+r�.ye'f1E: 51fB T�aaL'-'.. n. �ua6A�:" a` �6EJeifM '9n.4Y•i'1CiiA5�5'ulihuY �BWX RY' M�. L. dk^-+= ��+ f�. ii:: SitiEf. itw, rN` etSY. Y. diY1 {fllluhl4ivb..i.:.4.:.La.w.=e a•:• 1 Cpl DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services May 8, 1986 Howard Kelly, Jr., P.E. Fair Street Carmel, New York 10512 JOHN SIMMONS, M.D. Deputy Commissioner t 1 RE: Proposed SSDS Action Associates- Lobracio Canton & Barnard (T) Patterson Tax Map 61,3 -3 &9 Dear Mr. Kelly: I On May 5, 1986, Mr. Morris of this office witnessed a soil percolation test on the above captioned property in the presence of Mr. Richard bameron of your office. 1 The results of the test indicated a rate exceeding 60 minutes per inch (3/4 inch in 55.minutes). Th.i s r. a.t.e . d_i f. f e_r.s _r.o.n sA,d.e.r..a.b -1.y. _f ro m..t h e .d e s i. g n -r'a t e:, Based upon a review of the latest plans, the above and pursuant to Article III of the Putnam County Sanitary Code and Part 75 of the State of New York Official Compilation of Codes, Rules and Regulations, you are advised that the proposed method of providing sewage disposal for this property is considered inadequate. As such,approval of the proposal canot be granted. If you have any questions, contact me at Ext. 241. er tr 1 y u , oh Karell, Jr., P.E. irector, JK:pt Environmental Health Services cc:JK File TWO COUNTY ' CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 I r ' � ct,,>i l'. O� c DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services March 25, 1986 Cashin Associates Howard Kelley Fair Street Carmel, New York 10512 Re: Proposed SSDS Action Associates Canton & Barnard T.M. 61 -3 -3 & 9' (T) Patterson Dear Mr. Kelley: Review of materials submitted at this time relative to the.above- captioned project has been completed. Comments are offered as follows: JOHN SIMMONS, M.D. Deputy Commissioner 12 It is noted that this Department presently, has an active application for a construction permit which includes adjacent Lot 1 a'nd your Lot 9. 2. If Action Associates is a corporation, a corporation o resolution must be.executed. If a partnership, a partner must sign the application and indicate that they are a partner. Two sets of house plans are not provided. A hydraulic profile, to scale is not provided. A typical profile is not acceptable. The extent of the'2 feet 'of fill is not evident,' dimensions and volume are not provided. Details of the distribution box, well and septic tank are not provided. TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 Cashin Associates March 25, 1986 Foot /gutter drain discharges are not provided. Soil percolation and deep holes are not located on the plan. 10 Property metes and bounds are not shown. The house set backs should be indicated due to the tightness of the lot. The house sewer must be specified as 4 inch diameter with a slope of 1/4" per foot. In light of the size of the lot, a representative of the �M Department must witness a soil. percolation test. You should call Mr. Morris at Ext. 228 to arrange, a.suitable time and date. Upon receipt of a submission revised to reflect the above, this project will be considered further. V ry ruly r�s, J/ Kar 1, Jr., P.E. irecto.r, JK:pt Environmental Health Services cc.R.M. M. B. Fi1e�' v A� CO *.. PUTNAM COUNTY'HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH•SE-RVICES John.M Simmons,.M.D. :. Deputy. Commissioner of Health. - FIELD ACTIVITY REPORT Sheet of / �• Lx � NAME 1 '/ U� o �/Z�IG6 el L�f', 4 Sgy (4` /. / • ADDRESS, &Aeljwe -AW7,74, mil✓ No. Street.. Municipal -ity, (T)(.V)(C) MAILING ADDRESS % �''. 3 �" �,, '. _ R.O. Box Post, Of #ice Zip Code TELEPHONE Q;7- PERSON IN CHARGE `OR- INTERVIEWED P,41 Y7 ,Z . _ Name and Title - .DATE � � �'G� TYPE FACILITY TIME ARRIVED o2;0 TIME LEFT : INSPECTION Orig. Routine Orig. Complain Orig. Request Compliance Complaint Comp Final Group Illness _ Construction Reinspection Field, Sampling Only Field Conference ..Other �-CeoLiai 7i"' Explain FINDINGS:: • X4ep Pi ' lwewis .z. =.o. ... -p• ,.��ty., .:,max GO • CCc ,:c.w3c�:t�'= f=,?C�,.ioc�.;.o ,n �.' - 1���� -:. 4Y -STS: aac :. ^n coc �^, -, �5.•OO. �ccCT- �o�T+*" ^c�cmC�o o c 7 Z INSPECTOR: Signature and Title PERSON IN-CHARGE OR INTERVIEWED:, I acknowledge receipt of a copy of. this SIGNATURE: Field 'Activity Report .... ...... - TITLE• TELEPHONE: Re: Property of Located at- <f.4111 f7"n!`,�� -ii (T) • f`�'ATt7Y- iZ5-5 tA Section w Block_ Subdivision of i'ZLALA. •�1 id�� „ Ij'17 Subdv. Lot # Filed Map # :::Dente a duly licensed professional engineer" or xpgist.er,ed.,;arcpa tect (Indicate to apply for a Construction Permit for a separaid. seWrag.e''.$y'st.eM to serve the above noted property in accordance win th.'th8 �xda- rdsi,'9 rules :. or regulations as pr,omulagated by the Commiss.ione,r of ":th&..Put aam County Department of Health, and to sign all necessary •papers,.' o:pa:my:'.,behalf in connection with this matter and to supervise.the.consigctction?-of said system or systems in conformity with the provisions .off; :'.ticl ®: 145 or 147, Education Law, the tary Co .oFF-ssio/. ��.ne < UZ[2 J Y �. (.) Count ' nS \ \. 1 P.E., R. � N Le' Address C, Telephone 1 Ow er • of ]Ptpp ty re D Telephone; VLO DESISHEET -S[JBS.� SEWAGE DISPOSAL SYSTEM FILE NO.' O ess Located at (Street) G,gli7707 3 � SAG2NA;27,.�. Sec. Block 3 Lot 3 q (indicate nearest cross street) 6 Municipality "TQmlAf <:�c a -zscmf Watershed. G00T-Zt�t\/ SOIL, PERCOLATION TEST DATA REQUIRED TO BE SUBMITIED WITH APPLICATIONS Date of Pre- Soaking 7 osc, �PS Date of Percolation Test 7 T�• HOLE NUMBER CLOCK TIME PERCOLATION PERCOLATION Run 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 2 3 fl : 14 4 l� ; -a� . Z- X9 ZO 5 Z 1 2 3 n 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at, each percolation test hole.° All Zata to' be submitted. -for review. 2. Depth measurements to be made from top of hole. rev. 9/85 3 4 j-Z; LXo l ?" j �g .... � Zq 3 5 Z;Z•4 j y; zo Z t 2-4 1 2 3 n 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at, each percolation test hole.° All Zata to' be submitted. -for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED -TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENOQUNTERED IN TEST HOLES DEPTH HOLE NO f HOLE NO. Z- HOLE NO. r- T. 1 °. 2' 3' 4° 5' 6° 7' 8' 9' 10' 11' 12' 13' 30 IL 14' 11N117�C�1Th aVf.L Ar 'WHYCH GROUNDY+l TM 1S ENMURTMU s INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED ] DEEP HOLE OBSERVATIONS MADE BY: DATE: `7-C-C—C S - - DESIGN -- -- Soil Rate Used 8 -.dam . Min /1" Drop: S.D. Usable Area Provided D X40 No. of Bedrooms ) Septic Tank Capacity 1000 gals. Type MA'5C*dZ `Absorption Area Provided By -33& L.F. x 24'° width trench Other C,' C(.S —RZ- A t kj -r->iZA1 NJ .PoF Ess,o Name Signature,, o A. K q Address Ha4*VZF-> A A45LL SEAL CA JZAteL fah.•. .. 'V .THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: �T 38998 Soil Rate Approved . f t/ al . Checked � aF of N �w o�� sq g by Date OF HEALTH - • ' N' • * V :1:/• `1�i• M R VP= SUPPLY & SUBSURFACE S3i= DISPOSAL REVIEW SHEET - CONSTRUCTION PERMIT DATE : 3 _ BY: (Name of Owner) (Str Location) COMMENTS YES f, NO I DOCUKWM Corporate Resolution -- — `Plans =Three sets -`• Engineers Authorization' Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results.(3) 30" Perc Hole -�oea6 House Plans Two Sets _ If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Pr � S oBY ofxst;em H Ydaulic Profile Gt r avit y F low `+ FSewage Volume D o `details ile Dimc _ Trenci%Gallery P�p Pi ptic. Tank - Size, lDeil;7Service Line if over ,C'�W61ta Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area; shown; gravity flow,suff. size If Pimped Pit & D Box Shown & Detailed -. House . -_ No..:of .,Bedrocros Wells & SSDS's Win 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot). House Sewer - ft pipe. No Bends; Max. Bends 45" w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 101 to P.L., Driveway, Large Trees 201 to Foundation Walls 1001 to Well; 2001 in D.L.O.D, 1501 pits 1001 to Stream, Watercourse, Lake (inc. expan) 151 to Drains - Curtain, Storm, Leader, Footing 251 to Catch Basin 101 to Water Line (pits -201) Septic Tanks 101 fran Foundation 501 to Well 151 Well to PL GENERAL Legal Subdivision - Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked "-Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same \oo� g LC �®L & S D(�/ • ✓r W", " SSDS iFFN 7ni ^sHm - DETAns SEIP= WK UMMS 1. dtJ 2 °1 be1w inlet 2. Ku- mm 3" bad cf pea gaud 3. i iniaiuin dEptih cf liolid -4'._... 4. le %jth - minimm bua m wulth to umamn fax time width. 5. lmdman 12" air. 6. locates star. 7. Pile - qm*g - nuniutaatt 20" in shorter _ dfinamim 8. R;fflie ederd 20% cf ].ig dd d igai above l level (d -', b=1D ", (5-511b -12 "). 9. If ]sxlth G.T. 9 feet. - use, 2 ate. 10. Minimm tank capacity 1000 galf3 bedroaM IZ00 .gal/4 belzmml34 co bdnn ;l61 cf,/4 bchm. 11. Agim1.tie cmdr 3 fig' reinfcxned ar=ete. 12. Inlet tegAmfEle 1b" belay flow lire. 13. Qxtl:et tee/taffie 18" belay flea lire. 14 inlet pipe &1cpe "'per foot min. (2%). 15. Net pipe cast i.rrn, 4'Ytdm 16. C1utlet pipe slrcpe 1/8" per foot min. (1 %). 17. QLAked joints for sorb t ny trees. 1. Inlet inert min. 2" alb cutlet invert. 2. All cutlets at s elevatim 3. cutlets 1" to 5" above tank bhtt m. 4. Miniram 12" bas ing clean sard cr pea growl. 5. Inlet baffle. 6. Amdn& 12" cover. 7. Faravable cover for acce-ss. 8. S<ale3 pipe joints (aspb tic cr equal) . 9. Slgm cutlets at 1/8 Wft. (1 %) c MEW= MEKH & IAIIF M DMUS 1. Stage 1/16 in. /ft. to 1/32 in. (0.5% to 0.25$). 2. 3/4" to 11" c rudned stern cr wad-ed gmel te- 3. 4" m nimin lateral dimeter. 4. 2" mi &rm aggapte over lateral. 5. 6" minim n ate urxbr lateral. 6. Utxeabel building paper cr 2 .cf stmw ever agprj3Lte- 7. 6" mfriftun, 12" nwdtr m earth backfill. 8. Overfill to allw for settling, 4" --61. 9. 21tmnirm fran trench bottom to later- aft.gr& 10. 51min.frQn tram h bottom to kpmvicus y ry7�f,.t,,.�,,gt�e. /� 11. aimcch q= spelt n.6'D.C- (24 "t�) . y12. �aa.�nma:te.+ lateral e-ds mzt be pl . 1.3. Fill -2 :1 sippm min. 101 b3 trench. dq:th:3jInmc.cvec mdc +,2 °mx.v, -r vaater hpem able bolder. •:. rid: , LE1' 1 1. tbP o v.,. above gmzxL t.:. of as :. 21 above HL cc wM3ertight. 3-- Midam 201 asing cf steel cr wrought irm. 1' i r � .• :. Otlit 41 below O.G. i 6* SmAtary seals 7. C • i:. ur3a. aery . • e. WOO UPM DEMUCS 1. Overfill. to allow fcc• awl i -. 4 "--6" 2. 6" -12" rabtnal soil bkkEi]l. 3. Utreated building pgxr. 4. P to 11" Clmn gravel: cc stem. 5. Min. 4" perfaabEd pipe. 6. Pipe invert 6" off bottcn. 7. 18" - 24" wide trench. 8. Depth a3agmte. 9. Separation frm SSM area 15' min. F .- .. • - •.; •o i. a •. • r APPENDIX D _.. - CONSTRUCTIQN NOTES SUBSURFACE SEWAGE DISPOSAL SYSTEMS & WELL VQ= SUPPLIES SERVING SINGLE FAMILY RESIDENCES Basic Required Notes 1. All trees within 10 feet of the proposed SSDS shall be removed. 2. SSDS to be inspected by the design engineer /architect and the Putnam County Health Department after construction and prior to backfill. 3. No trucks, machinery, building materials, nor excavated earth shall be allowed in the sewage disposal area. Construction of SSDS to be in accordance with these plans, any revisions thereto, and the rules and regulations of the permit issuing governmental agency. 4. Minimum well yield of 5 gpm is required. Yields less than 5 gpn will be immediately reported to the Putnam County Department of Health. Notes Required When Fill Proposed 1. Fill must be allowed to stabilize for-60 to 90 days following placement and be inspected by the Putnam County Department of Health for acceptance, prior to installation of the sewage system. Date of placement must be reported to Putnam County Department of Health. 2. Run of bank fill shall be suitable for sewage absorption, be free of fines or other unsuitable material and shall have an in -place percolation rate at least equal to that. in the natural soil after the required stabilization period. The engineer/architect shall perform a final percolation- test in' the fill-after stablilizatic:r:.. ...... ... 3. Impervious fill, clay barrier, shall be a dense clayey soil with little or no seArage absorption capacity. DAVID D. 'ORUEN County Executive Cashin Associates Howard Kelley Fair Street Carmel, New York Dear Mr. Kelley: DEPARTMENT OF HEALTH Division Of Environmental Health Services 10512 March 25, 1986 Re: Proposed SSDS Action Associates Canton & Barnard T.M. 61 -3 -3 & 9 (T) Patterson Review of materials submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. I -t is noted that this Department presently has an " ti " *Vb' - -a'pp l "i"cati on : for a" constru6'ti on perm i t "1Wh ch includes adjacent Lot 1 and your Lot 9. JOHN SIMMONS. M.D. Deputy Commissioner 2. If Action Associates is a corporation, a corporation resolution must be executed: If a partnership, a partner must sign the application and indicate that they are a partner. 3. Two sets of house plans are not provided. 4. A hydraulic profile, to scale-is not provided. A typical profile is not acceptable. 5. The extent of the 2 feet of fill is not evident, dimensions and volume are not provided. 6. Details of the distribution box, well and septic tank are not provided. TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 _.... - 2 - ......._...... _ ._ _.... Cashin Associates March 25, 1986 8. Foot /gutter drain .discharges are not provided. 9. Soil percolation and deep holes are not located on the plan. 10. Property metes and bounds are not shown. 11. The house set backs should be indicated due to the tightness of the lot. 12. The house sewer must be specified as 4 inch diameter with a slope of 1/4" per foot. In light of the size of the lot, a representative of the Department must witness a soil percolation test. You should call Mr. Morris at Ext. 228 to arrange. a.suitable time and date. Upon receipt of a submission revised to reflect the above, this project will be considered further. V /ry ruly . s, J Kar 1, Jr., P.E. irector, JK:pt Environmental Health Services cc.R.M. M.B. File Putnam County Department of Health Division of Environmental Sanitation AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT - TO: Commissioner of Health - In the matter of application for 19 - - - - - - - - - - - - - - - - - - — — — — — — — — — s represent that I am an officer or employee of the corporation and am authorized to act for (name of corporation) having offices at Whose officers are President_________ (Name and Address) ___ _ — — — — — — Vice-President .______ __ ____ ^(Name and Address) — — Secretary _ (Name and Address) Treasurer (Name and Address) and that I am and will be individually responsible for any or all acts of the corporation with respect to the approval requested and all sub- sequent acts relating thereto. Sworn to before me this day of 19 Notary Public Signed — — — — — — — _ — — — — — Title Corporate Seal - / r -: JA,1 r COUNTY:" DEPARTMENT OF HEALTH ENGINEER TO PROVIDE PERMI1 a _PUTN.AM ON cERTFicArE OF COMPLIANCE Division of fn Health Services Carmel, N. Y� 10512 PERMIT • y C_ ON RUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM '; i • rS� �/�( Town or Village, (�� Block, i Lot ¢¢ Locatetl at /Y� Tax ,MaP r � J Subdivision �t- V I %V /�✓t� - � �C S -Ud - Loot ii �, q � Renewal Revision :13 , owner /Address"' v WW1 • l `- Dale Of Previous 'Approval _ Buiid�ng`;Type �/QwI�� •LOt Area' �� 4-�t Fill" Section Only El Number•of Bedrooms Design Flow G /P %D%�'r P C' H D Notification Required i 77 � 'Separate Sewerage- System to consist of Gal Septic Tank. antl Y' ' -�`r To be constructed by ` �p� Address �1G/�}lil� V Water - SuPPIy Public SuPPIy -From . .. ,Private - SuPPIy,• to be d ►illetl .bY I ill ~AJ�I ASC - -. Address .r ; Other Requ irem ents // L� e'!71]l i ('represent that t am wholly and completely ,responsible foi the design and location ,Oi the proposetl' system(s); 1) that the separate sewage disposal system ' above described: will be constructed, as`shown on the approved ameridrnent there to grid -in accordance with the standards, rules an :regu a ons o e Putnam ,County .Department of Health, "and that on completion thereof a'.'Certificate -of Con. . ction'Compiiance 'satisfactory to the Commissioner of Health will be submitted to the Department,''and a written guararitee will bedurniihed the ;owner, his °successors, heirs or assigns, by. the builder; that said builder will, place in good operating condition" any part of said sewage disposal system during the period, of two (2) years immetllately following, the date of the issu- ake of, the - approval of the Certilicate.'of Construction Compliance of:the original. system. or any repairs thereto; 2) that the drilled well described above will beocated as•shown on.the approved plan and that said well will be installed in ac ordance with the stand rds rule and regu aZl ons of he Putnam County Department of Heal Signed, P R.A. r Address S Z� License No. APPROVEDaF.OR CONSTRUCTION , •This approval expires one yeanirom the date issued unte ;s' construction, of ,the building has been undertaken and is revocable for cause. or may be. or modified when considered necessary by Commissioner of Health: Any change or alteration of construction },requires a new' permit. ' 'Approved for disposal.oi ,domestic, sanitary sewage,.and /or.;private water. supply :only Date 8Y Title m C. MILTON WILSON Licensend Professional Engineer ?'S /i WE - 0 4"'7z, 47 42 Lakeshore Drive -112 Brewster, New York 10509 Tel: (914) 669 -5290 N.Y. License 012646 Conn. License 10461 Design of Septic Sewage and Water Syst. ems. for Residential and Commercial. Buildings and Real Estate Sub - Divisions. ol f - 3 J-) -F �( r7 br w -W q "S Io ru'""' C� ROAD B�RNAkV �s . •J \__" ..._ ._..__.. +..... _..,_... �.•- _�..._ y- �. Off_, 4.`T - - --. ...._.- ..__�- ._._��' -- try_ ........- ROAD g,gRNRRU MO. 0 UP JA7 Cog i . T.' ` - - -- - -. - -' - -- j i • � JUNCTION ®03t f 5"1 Z O . off., �~_S`� // • to � y 1 N- , ?,1 LF. DI. 'izi URJ 3Un 7 OLTrc.ETS 5Cr 57 71 Mi 24' r0'ON C.Eknm rim I�DIY 2. I o � ion _ • tr. G. _� � t%� RF_gw RC S' o i Ti B N }p !0 ` c S. E iJ +,, 0( AI EA iZ ; N ri .q Q Fl S.S.. S VtlCb.i�t' IF ! RR 3g 9g opt 3 OF N�� 4 I I