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HomeMy WebLinkAbout1513DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -4 -7.1 BOX 14 am—, r&2 . Ron all I ' �` ' �;� T ', ■,,, I , 01513 PUTNAM COUNTY DEPARTMENT OF HEALTH" DIVISION OF ENVIRONMENTAL HEALTH SERVICE CERTIFICATE OF CONSTRUCTION COMPLIANCE> FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 03> Located at 92 Z tT Owner /Applicant Name Formerly Town or Village PA W'uz S'Nm t /1\ E Tax Map Block Lot Subdivision Name i r- Subd. Lot # Mailing Address r �� t �'�Jx° �� � ;t��� �� Q 'fie �Q �c ,�.9 �;�-:� �� � lrt `� Zip Date Construction Permit Issued by PCHD Separate Sewerage System built by . 4 r Consisting of 2 �n Gallon Septic Tank and l Other Requirements: Water Supply: Public Supply From Address or—_ L,-' Private Supply Drilled by �- ` F l s Address�{� V�aza k. tilt t Buildin g Ty pe =,; Has erosion control been com leted? �►!� - Number of Bedrooms Has garbage grinder been installed? 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 /1h P County Department of Health. Date: 0 Certified by = IT—&k �° �,.4+C`� P.E. �� R.A. (Design Pr,ss��fessional) Address . i' - ( � � G , (i ( r?�. F'a U �a ;�' ix F;;, nV'� License # �, � 4 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 White copy - HD or change is necessary. Title: copy - Building Inspector; F r-- Date: a 'Z'Ipo - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: 227 Ice Pond Road Town/Village: Patterson Tax Map # Map Block Lot(s) GPS ?u Well Owner: Name: Address: Marchetti Construction, 25 High Ridge Road, Pound Ridge, NY 10576 Use of Well: 1- Primary 2- Secondary X Residential _Public Supply Air cond /heat pump _Irrigation Business Farm Testimonitoring —Other(specify) Industrial Institutional Standby Drilling Equipment _Rotary _Cable percussion Compressed air percussion _Other(specify) Well Type Screened _Open end casing X Open hole in bedrock Other Casing Details Total Length 32 ft. Length below grade 31ft. Diameter 6 in. Weight per foot 19 lb/ft Materials: Steel Plastic Other Joints: Welded Threaded Other Seal: Cement grout Bentonite Other Drive shoe: Yes _ No Liner: _Yes No Screen Details Diameter in Slot Size Length ft Dept to Screen ft Developed? First I I Yes No Hours Second I I Well-Yield Test - _Bailed - -X Pumped --- Compressed Air Hours 6 - Yield - 5 -- - -- - --- gpm - -- Depth Date Measure from land su ace - static specs ft 30' During yield test (ft) 580' Depth of complered well in ft. 1000' 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 WELLr DRh LEDE:BY tOTHERS ; If yield was tested at different depths during drilling list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 gpm Depth 600' Model 5GS15412 Voltage 230 HP 12 Tank Type WX250 Volume 44 gallons .XDate'wepi/i1°Completed' Well Driller�PC Certlflcate # ;.�," k Y �'NY,State Da1=exQf.Repoft ' ?SYf i• 3j u s i .k SR i 3 , S�qi . KR(" "?(' v" %✓h nq, k 6ag,.4y ;' �('+F pta.eC NY State #NYRD1QlQS" _. Well D illelr Narpe &Addri 's, _ a ' , q, k � ' �p Y 1 Y Tr" :1 'G.aC S 'i .. £3 Y`:CX �00 '.`# ,.a%:f.".�T�^r.;Y',':� 'u..,. s.x+k,�...<.v...,"..� , ... .....a.� .:h,<x T"�"�'�'#.� -. ..+�;�'_✓�'�.� k:, «z. 3? We113Dnftir (signature) 4 'Snx Nti m ['§ a> �w.r'3;kY',...5x;�z�. ,G.!9 -:. �. Pump Installer Name &'Address _K ;�•'^ °n. dT€. a 1� S »,,E +1 i n„ a v x '%'S ?"' ` Y Y" � MR fag ,.' 1 ,p K eat & ions , Inc 43utnam Auer ,a ,Brwst nQ Pu lerR(slgnature) ,n• `7H< c..'i 'av'•_� .4- .0 soiBa� A NOTE: Exact Location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. White copy: HD File; .Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 A PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well. Location . �._ :. -.. Street Address: c�o�% �C . p NC �FL17 Town/V.illage:. -. �w . Tax Grid # -. . Map Block A Lot(s)l 14 Well Owner: Name: c.,&JA-r d Address: Pe_in1&crR WID 7&AZ749 rt.J dulh Use of Well: 2- secondary —A1 Residential Business Industrial 'Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary Cable percussion i Compressed air percussion Other (specify) Well Type Screened Open end casing _& Open hole in bedrock _ Other Casing Details Total length eft. Length below grade t p ft. Diameter Chin. Weight per foot alb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded _, Threaded _ Other Seal: _, Cement grout _ Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours _ Yield _L_ gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) ©0 Depth of completed well in feet Well Log. If more detailed information descriptions or sieve analyses are available-- please attach. Depth From Surface I Water--_ Bearing . Well _ Diameter(in) Formation Description I ft. ft. Land Surface t r PA44 cf. & u I dt r-s Ald lGreAq Gnwrrk 6 rtw i Ti If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity Depth Model Voltage HP Tank Type Volume Date Well Completed fF Putnam County Certification No. Oa✓ Date of Report LWeClr�illr (signature) .331 le_? � 7 A;�j j4, NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller's + t' �I d- n1S Address: 64JIL N. , Signature: - Date: 3 J, G White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Apr 16 08 11:13a SPECTRA ENERGY SHERLITA AMLER, MD. MS, FAAP Commissioner q(-Health LORETTA MOLINARI, RN, MSN ,4ssociale Commissioner of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 (845) 278 0036 p.1 E911 ADDRESS VERIFICATION FORM OWNER'S NAME• TAX MAP NUMBER: .j Y -- -eye — %. I E911 ADDRESS: 2 2 P TE.0 Po N p 1J ROBERT J. BOND) County Execwive ROBERT MORRIS, PE Director of Environmental Health TOWN: 4 $ ,c Soo.► AUTHORIZED TOWN OFFICIAL: (S ian atu re) DATE: Z 3 The Putnam County Department of health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. E911 addressverification i Environmental Health (845) 278 -6130 Fax (845) 278.7921 Water Supply Section ;845) 225 -5186 Fax(845)225-5418 Nersing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nurcina Home rare Pax 19451 77R -6085 MARCHETTLCONSULTING ENGINEERS 25 High 40ge Road Pound Ride, NY 10576 (914)764 _9T Fax 764 -9012 May 22, 2008 Department of Health Attn: Michael Budzinski, P.E. 1 Geneva Road Brewster, NY 10509 Re: Construction Compliance for Feinberg @ Ice Pond Road (T) Patterson, TM #34.4-7.1 Mr. Budzinski, In response to your letter dated April 281h'N08, we have made corrections noted and include a revised AS -Built plan as per. your, comments. 1. Enclosed please find the original well completion report form as completed by P.F. Beal & Sons, Inc. _ 2. _: Pleas, note, the,.yield as tested by P.F.. Beal is 5 gpm_done in accordance .with a 6.__ hour test. 3. The label "EOT" (end of trench) is'shown correctly on revised plan. Thank you, r. Peter G. Marchetti P.E. Marchetti Consulting Engineers - SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health April 28, 2008 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health. Peter Marchetti, PE Marchetti Consulting Engineer's 25 High Ridge Road Pound Ridge, NY 10576 Re: Construction Compliance for Feinberg at Ice Pond Road (T) Patterson, TM # 34. -4 -7.1 Dear Mr. Marchetti: This Department has received and reviewed the submitted application and plans for the above referenced project and the following comments are offered for your consideration. �1 An original well completion report form is to be submitted. A faxed copy was included with your application. ✓ 2. The submitted well completion report indicates the well yield is less than 5 gpm. Please refer to Section 6.3.b of Bulletin ST -19 for guidance on this issue. 3. Please identify the labels "EDT -1A, EDT -1B etc." on the as -built plan. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:kly Respectfully, Michael J. Director of 64 Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 -r = Page 1 of 1 41 Kenosia Avenue �� Environmental Services, lrr0. 1'VATEA; SOIL AND AJA ANALYSIS Danbury, Connecticut 06810 I Telephone 203 -798 -2229 Mailing Information: Name: P F Beal and Sons Inc Address: 4 Putnam Avenue City: Brewster State: NY Phone: (845) 279 -2460 Sample's Information: Site: Bathroom Tap Preservative: HNO3 Temperature: <4 Matrix: Water P F Beal and Sons inc' Collector's Information: JMS ID: 064850 Name: Chris Beal Address of site: Marchetti Const. 227 Ice Pond Road Zip: 10509 Fax: (845) 279 -6613 City: Patterson State: NY Zip: Phone: Date Collected: 1/8/2008 Time Collected: 3:45:00 PM Date Received: 1/9/2008 Time Received: 7:45:00 PM Lab No.: J0800234 Date Analyzed Test Name Result MCL Method 01/11108 Lead (flush) 2.96 ppb 15 ppb E 200.7 01/15/08 Alkalinity 162 mg /L N/A SMWW 2320 B 01/10/08 Manganese 0.08 ppm 0.3 ppm SM 3111 B 01/10/08 Sodium 17 ppm N/A SM 3111 B 01/09/08 pH - 6.58 S.U. 6.5 -8.5 S.U. SM 4500 H B 01/09/08 Color ND 15 Units SMWW 2120 B 01/09/08 Turbidity 0.35 ntu .5 ntu SMWW 2130 B 01/14/08 Hardness 154 mg /L N/A SMWW 2340 C 01/09/08 Odor ND N/A SMWW 2340 C 01/10/08 Iron— . _ .- <0.05 ppm 0.3 ppm SMWW 3111.13 OT/14/08 - -- Chl6Hde 37.1"ppm 250 ppm SMWW`41 10 B _... _ . 01/14/08 Nitrate 0.69 ppm 10 ppm SMWW 4110 B 01/14/08 Nitrite <0.05 ppm 1 ppm SMWW 4110 B. 01/14/08 Sulfate 25.4 ppm 250 ppm SMWW 4110 B 01/09/08 Chlorine Free Residual <01 mg /L N/A SMWW 4500CIG 01/09/08 4:30 PM E. Coli Absent Absent SMWW 9223 B 01/09/08 4:30 PM Total Coliform Absent Absent SMWW 9223 B Comments: At the time of the analysis the sample was Acceptable for Total Coliform At the time of the analysis the sample was Acceptable for E. Coli CFU = Coliform Forming Units MCL = Maximum Contaminant Level mg /L = milligrams per Liter N/A Not Applicable ND = None Detected ntu = Nephelopmetric Turbidity Unit ppb = parts per billion ppm = parts per million S.U. = Standard Unit Units = Units Signature: Reviewed By: Michael Lapman Sharon Houlahan, Director President State #: PH -0218 ELAP M 11715 CONNECTICUT. h1E!X YORK AND NF-LAC OrRTIFiED Toll Free 866- JMS -5087 I Corporate Fax 203- 798 -2408 I Lab Fax 203 - 798 -2107 I www.jnnsenAronmental.com u Page 1 of 1 imsEnvironmental Services, lnc. A 41 KenosiaAvenue WATEA, SOIL AND AIR ANALYSIS Danbury. Connecticut 06810 1 Telephone 203- 798 -2229 P F Beal and Sons Inc Mailing Information: Name: P F Beal and Sons Inc Address: 4 Putnam Avenue City: Brewster State: NY Zip: 10509 Phone: (8 45) 279 -2460 Fax: (845) 279 -6613 Sample's Information: Site: Tank Preservative: HNO' Temperature: <4 Matrix: Water Collector's Information: JMS ID: 018523 Name: Mike Forschner Address of site: Marchetti Construction 227 Ice Pond Road City: Brewster State: NY Zip: Phone: Date Collected: 9/11/2006 . Time Collected: 3:00:00 PM Date Received: 9/12/2006 Time Received: 11:00:00 AM Lab No.: J0608657 Date Analyzed Test Name Result MCL Method 09/13/06 Alkalinity 126 mg /L N/A SMWW 2320 B 09/13/06 Lead (first draw) <1 ug /L 15 ug /L SMWW 3113 B 09/13/06 Manganese <0.05 ppm 0.3 ppm SM 3111 B 09/13/06 Sodium 8.38 ppm N/A SM 3111 B 09/12/06 pH - 7.36 S.U. 6.5 -8.5 S:U. SM 4500 H B 09/12/06 Color 9 Units 15 Units SMWW 2120 B 09/12/06 Turbidity 0.98 ntu 5 ntu SMWW 2130 B 09/13/06 Hardness 158 mg /L N/A SMWW 2340 C 09/12/06 Odor 1 mg /L N/A SMWW 2340 C 09/13/06 Iron . 0.07 ppm 0.3 ppm SMWW 3111 B 06/13/06 r, Chloride 29.7 mg /L 250 mg /L SMWW 4110 B 09/13/06 Nitrate 0.5 mg /L 10 mg /L SMWW 4110 B 09/13/06 Nitrite <0.05 mg /L 1 mg /L SMWW 4110 B 09/13/06 Sulfate 22.5 mg /L 250 mg /L SMWW 4110 B 09/12/06 Chlorine Free Residual <0.1 mg /L N/A SMWW 4500CIG 09/12/06 2:00 PM E. Coli Absent Absent SMWW 9223 B 09/12/06 2:00 PM Total Coliform Absent Absent SMWW 9223 B Comments: At the time of the analysis the sample was Acceptable for Total Coliform At the time of the analysis the sample was Acceptable for E. Coli CFU = Coliform Forming Units MCL = Maximum Contaminant Level mg /L = milligrams per Liter N/A = Not Applicable ntu = Nephelopmetric Turbidity Unit ppm = parts per million S.U. = Standard Unit ug /L = micrograms per liter Units = Units Signature: j��REL _ Reviewed By: Michael Lapman Sharon Houlahan, Director President State #: PH -0218 ELAP M 11715 CONNECTICUT. NEW YORK AND NELAC CERTIFIED Toll Free 866- JMS -5097 I Corporate Fax 203- 798 -2408 1 Lab Fax 203 -798 -2107 I www.jmsenvironrnental.com PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Z-d 1-e; b 'ev g Owner or Purchaser of Building �Y ,�• �ll� Co +. Building Constructed by 2 2 7 Z7 e.c Pa r-4 Location - Street Building Type 3+ 4 7;1 Tax Map Block Lot Town/Village I lawkls AERfc Subdivision Name 4-1- 3 Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, . construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, -to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly. is caused by the willful or negligent act of the occupant of the. building utilizing the M The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health_as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month d Day 2 0 Year O 7 /_,Z� -'* l 10 Gener ontractor (Owner) - Signature Corporation Name (if corporation) Address: Signature: Title: d- �-� Corporation Name (if corporation) Address: State Zip State Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION O7ENVIRONME`NTAl; JtIEATLII SERVICES FIELD ACTIVITY REPORT Street Town State Zip PERSON IN CHARGE "ze- k ,:)-(/D v� j� PUMP TEST DOSE TEST REQUIRED GALLONS j — g/0 a � 91 y #`7Yq 'co—? /.,29 LOP, '36 _......_....... EL. START EL. STOP Signature and Title RFPQRT RF(- F.TVFn RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. i �7 l ,off OC ( , .. I Vol m O © : N 1 I O O I!n rn REQUIRED GALLONS j — g/0 a � 91 y #`7Yq 'co—? /.,29 LOP, '36 _......_....... EL. START EL. STOP Signature and Title RFPQRT RF(- F.TVFn RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. i �7 l ,off OC ( , .. z BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK: BOARD ...OF FIRES. UNDERVNR-ITERS BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT Upon the application of PRECISION ELEC. BOX 1112 CARMEL, NY 10512, Located at 227 ICE POND RD PATTERSON, NY 12563 Application Number: 2095618 Section: Block: Lot: upon premises owned by EDWARD FINEBERG 227 ICE POND RD PATTERSON, NY 12563 Certificate Number: 2095618 Building Permit: 446 -06 BDC: W104 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in /on the premises at: Basement, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 22nd Day of May, 2007. , Name . • TY Rate - • Ratin Circuit Type Service Disconnect: 1 200 CB Meters: 1 seal 2 of 2 Thiscertificate may not be altered in anyway and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW - Y KK:.-. AR.D OF FIR: .:.UN-D RWROT R =...-. BUREAU OF ELECTRICITY 40 FULTON STREET — NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by PRECISION ELEC. BOX 1112 CARMEL, NY 10512, Located at 227 ICE POND RD PATTERSON, NY 12563 Application Number: 2105348 Section: Block: Lot: EYEIRE HAWKS 227 ICE POND RD PATTERSON, NY 12563 Certificate Number: Building Permit: 857 -06 2105348 . BDC: W104 Described as a Residential 600 -1199 square ft. occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in /on the premises at: Basement, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and /or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 22nd Day of May, 2007.., Name _ . TY . ,Rate_.._ RRgling Circuit- -_Type.­­. - Alarm and Emergency Equipment & Sensor 1 0 SEPTIC Alarm Panel Board 1 0 SEPTIC Alarm Appliances and Accessories Pump Motor 1 0 SEPTIC F.H.P. Wiring and Devices Motor Control Center 1 0 SEPTIC Special An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. seal 1 of 1 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. r ' BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK., BOARD O- F� FIRE --UNDJ.RWRI_T,ERS:- BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of PRECISION ELEC. BOX 1112 CARMEL, NY 10512, Located at 227 ICE POND RD PATTERSON, NY 12563 Application Number: 2095618 Section: Block: Lot: upon premises owned by EDWARD FINEBERG 227 ICE POND RD PATTERSON, NY 12563 Certificate Number: 2095618 Building Permit: 446 -06 BDC: -W104 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in /on the premises at: Basement, Outside, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and /or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 22nd Day of May, 2007. Name - - QTY Rate Rating Circuit Type - Miscellaneous._.- ..... ..�.. MODULAR Alarm and Emergency Equipment Sensor 1 0 Smoke Appliances and Accessories Air Conditioner 2 0 30 Amps Air Handler 2 0 F.H.P. Panels This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 1 200 38 Wiring and Devices Fixture 8 0 Incandescent Receptacle 18 0 General Purpose _. Switch 7 0 General Purpose Receptacle 3 0. GFCI Arc Fault Circuit Interrupter 0 0 Switch 1 0 WELL Motor Control Service sea/ 1 Phase 3W Service Rating 200 Amperes Continued on Next Page n, 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Marchetti Consulting Engineers 25 High Ridge Road Pound Ridge, NY 10576 Re: Field Inspection — Feinberg Ice Pond Rd, (T) Patterson Lot # 1, T.M. # 34. -4 -7.1 Dear Mr. Marchetti: ROBERT J. BONDi County Executive ROBERT MORRIS, PE Director of Environmental Health June 14, 2006 The above referenced separate sewage treatment system can be backfilled. The following comments need to be addressed. • A pump test needs to be witnessed by this Department once the electrical inspection has been completed and notification of such has been submitted to this Department along with a request - form... If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:Idy Sincerely, Gene D. Reed Senior Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION e' Date: (,' / 3 a 6 / Inspected by: -- StreetLoca_tion Owner Townars ©►n Permit # P— /2'© 3 TM # 3 7, Subdivision Lot 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3:1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ................................................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... IL Sewage System a. Septic tank size - 1,000 ' , ...... 1 25 .........other ................ b. ' Septic'tank installed level ............................................... c. 10' minimum from foundation .......... ............................... d. Distr- ib`ution"Boxf's 7 _ 1. All outlet's at same 2. Protected below frost .................. ............................... 3. 1Nlinimum 2 ft. Original soil between box & trenches e. Junction Bog properly set .......... ............................... 6. Trenches 1. Length required 41 g o Length installed y So 2. Distance to watercourse measured -- to o Ft.......... 3. Installed according to plan ......................... 4. Slope of trench acceptable 1/16 - 1/32 Vfoot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface ................:. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1112" diameter clean ...................: 9. Depth of gravel in trench 12" minimum .......:........... 1 . e ends ca ed .... ize of'pump`cl amber -- .......................:.... 2. Overflow tank ............... .............. ............................... 3. Alarm, visual / audio .... ....:........:.. ....................... ........ 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. C�yycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. house located per approved plans ... ....................:.......... b. Number of bedrooms ......................�..� IV. Well Well located as per approved plans . ......:........................ b. Distance from STS area measured 120° 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 & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ................. ............................... Rev. 12/02 r�M N ,W i I EWA= E� SITE INSPEMON FOR FILL PAD 3 G Date: Inspected by: Fill pad located per the approved plan Fill Pad Length f ej PeL V. Required Length % f Fill Pad Width Pe-,t �� �c. ti Required Width / 41a Fill Pad Depth Required Depth -(-,:V Run -of -Bank Fill Quality Slope from Top to Toe Impervious Layer Installed Y Erosion Control Installed Sieve Test Results (if applicable ) �%/�� - Additional Comments: - Reserved for Field Sketch if Applicable N6 \S i Av o.CJ v® 76'j SHERLITA AMLER,MD; MS; FAAP - Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health November 15, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J.: BONDI County Executive Marchetti Consulting Peter Marchetti 25 High Ridge Road . Pound Ridge, NY 10576 Re: Fill Pad — Feinberg Ice Pond Road, (T) Carmel Lot #1, T.M. 34. -4 -1 Dear Mr. Marchetti: An inspection of the fill pad at the above referenced project has been completed. Comments are offered as follows: 1. Per the fill plan submitted and approved by this Department, the width of the fill pad is proposed at 140 feet. Field measurements indicate the existing width to be 115 feet° This-would put-the width of the pad 25 feet short. -� - 2. Field measurements indicate the length of the fill pad at 70 feet on one side and 42 feet on the other. This is inconsistent with the approved plans. 3. The top of the fill pad appears short in depth. An appointment must be made with this Department to dig deep test holes in order to prove out proper depth. A machine must be on site at the time of this testing. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR: cw Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 FROM MARCHETTI CONSULTING ENGINEERS FAX NO. : 19147649012 Jun. 12 2006 12:51PM P2 tu- e:jej TO, 14 7649012 PI-VI PL-MAM COUNTY DIPARIMOT OF MALTH DIVISION OF ENVIRONNMIML MMALT8 51IRVICES 0*. ATTENTION 0 SErH a EEO= For: Fin All infmation must be My ampleto d prior to my Trenches PCHD Co tionpwnit# Z„ Qom: .1wr; 7>61&A rn IV, M 1% 1 Owm—JApzop t i4nw.- locX Lot S"Visim Lot # Is system fill comp? Is system compleft? Date: .Ad tv"A mg is sr"m mmhuded as per Vkw? '(404, Is well drinw? Doe. 40_ Is wa 1WAftd as per 01=7 Are erosion comml mcwxm in Ph &? I certify tba tie ,systcm(4 as 115NA atthe above pmmm has bcmcmwucted and I havemsTected wd verified their comomdon in mmdume wdh tea. nowd POM. COUM'efioxt P= it and appovM playas and the Stw4ards, Rules and Regulation of the Pignam County Depardamt of Daw: 4.611Z. jo� 5- PE RA Addrcss-. Rks?6e cm A—aft-W? Lic.0 cwmcm, Aftl"K w L.-,c =6adic- -NLfr,- 'if-IsAn&Iia OQag 0 SgP5 UP form FIR-99 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health _ LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County. dye, ROBERT MORRIS, PE Director of Environmental Health March 16, 2006 Peter Marchetti Marchetti Consulting Engineers 25 High Ridge Pound Ridge, NY 10576 Re: Fill Pad Inspection - Feinberg Ice Pond Road, Lot # 1 (T) Patterson, TM# 34.4-1 Dear Mr. Marchetti: An.inspection of the fill pad at the above referenced project has been completed and found to be in compliance with the approved plans. Trench plans must be submitted to this Department for final approval of construction prior to the installation of the-separate sewage treatment system: Please note that field measurements by this Department in no way suggest the exact size, depth and location of the fill pad. If you have any further questions, please contact me at 845- 278 -6130, ext. 2261. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax(845)278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool(845)278 -6014 Fax(845)278 -6648 2 'd d0 1N3WINUd30 AiN100 WUNind:3WUN T26L- 8)-2 -St78: -131 t-=2:HT 31 Il 0002- 8T -Ntif SEP -20 -2005 11:44 FROM:PUTNAM COUNTY DEPART 845 -278 -7921 TO:919147649012 P:1/1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF HEALTH SERVICES ATT.ENTMON JOSEPH GENE UMMT FOR IItiAL INSPECT For: Fill All inform fion must be frilly completed prior to any Trenchcs inspections boitg mado. PCHD Cowstrnetion Permit # Located: 'L�'`! xatr Po,, b RA (T) (v) Owncr/ApplicantIdamc:. is TM 3 -4- )Block Lot Ai Formerly: ' 2� -6ww.► A Subdnv%si on Name: -�A Atw 10Es fi&gLig Subdivision Lot # 41.01 ( _. Is system fill completed ?_ Date:. -- Is system complete? - Date: _ Is 6". t m cojsttuctcd as per Sans? _ % R Is well drilled? Date: Is well located as per plans? Al A Are crosion control measures in place ?_ I certify that the system(s), as listed, at the above premises has bees constructed and 1 have inspected and verified .their completion in acoo dedce with the issued PCHD Construction Permit and approved plans and the Standards, Rules and RegaMons of the Putnam 'County DeparMent of Health. _ Dater J�' a Certified by: Aite.At pF _t� R P► y e a Design Prof salon 1 Address: 7 5 1(��4 'P E - Lie, comments: L L t „� P L Am4 -- -- -- - --- ,_ Form FIR -99 2 'd 2T06- b9L -i►T6 aiuuo0 diS:SO SO 80 ^oW J 4 PUTNAM COUNTY DEPARTMENT OF HEALTH j:.. DIVjSION,.UF ENVIRONMENTAL `HEALTH SERVICES -G CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # ` ft `° iZ -c Located at Z_ZZ Z / C //Ib ROAD Tommor Village Bf R / Subdivision namedqL, ,) A�6 Subd. Lot # _/ Tax Map3_ Block Lot Date Subdivision Approved Renewal Revision — Owner /Applicant Name Date of Previous Approval Mailing Address In /y • /3t5)F02tb ;P4). /�t��� f/ %�Cr�,� Zip Amount of Fee Enclosed Building Type* Lot AreaZLffff No. of Bedrooms of- Design Flow GPD Fill Section Only Depth Volume A ,q &D Separate Sewerage System to consist of %_6_0 gallon septic tank and l 000 67,f z- - A14,/) Other Requirements: To be constructed by Water Supply: Public-Supply From-'-- ... :.......: .__ , .1_.. _ .�.._., .._Address. or: i Private Supply Drilled by Bcl ` -SNs Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment s sY tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or qpy- repairs thereto. Signed: Address R.A. Date 3 "a -06 MACense # 4 15z8 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modifi d when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new ermit. Appr ed for discharge of domestic sanitary s age only. 3y: �-- - Title: Date: White copy - HD le; ell copy - Lilding Inspector; Pink copy - Ow4, 04Qe copy - Design Professin at [LEVU 3 O[F 4 ° CIS @W0VVLad 2 "Hig"h Ridge, _ TO WE ARE SENDING YOU. El Shop drawings ❑. Copy of letter DA 4'E JOB�NO. NO. ATTENTIO s / _ r RE: 7Z!le q V t/LJYco ❑ Attached ❑ Under separate cover via the following items: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPII�ES` DATE NO. DESCRIPTION V t/LJYco THESE ARL TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted • For your use ❑ Approved as noted • As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS ,- -1�� COPY TO SIGNED: r- /f enclosures are not as noted, kindly notify us at once. �; :::.. _,t :w.._d .::.. _.. -_ ...,..... ,...... NURCHETU CONSUL TINGENG �TEERS- 25 High Ridge Road Pound Ridge, NY 10576 (914) 7649011 Fax 764 -9012 April 19, 2006 Putnam County Dept. of Health Attn: Mike Budzinski �-- 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS Trench Plan Feinberg @227 Ice Pond Road Patterson, NY TM #34 -4 -7.1 Mr. Budzinski, I have received your comments in letter dated 4/6/06 for the above referenced site concerning the plans for the proposed septic system. Our responses are included here-in. The force main has been changed to a 2" PVC from the pump to the distribution - box. We have increased the absorbtion trenches to 60 L.F. for each lateral. This equals a total of 480 L.F. of trench. The pump float elevations have been shown on the detail. The invert for the inlet to the pump pit has also been shown. We have revised the trench length to 480 L.F.. The force main trench detail has been clarified to show a 3' -6" minimum cover. - We have located the percolation holes performed on the fill pad. They are identified as P -1, P -2 & P -3. P -1 & P -2 are located in the primary area and P -3 in the expansion area - A distribution box detail has been added to S -2. The force main is shown terminated in the D -box with a downward facing 90 degree elbow. - The absorbtion trench detail has been revised to indicate a vertical separation minimum of 5' -0" to ledge rock. - The absorbtion trench detail & plan specifies that the ends of the laterals are to be capped. If you have any questions, please contact my office. PwO you, Peter G. Marchetti P.E. SHERLITA tAMLER, MU, MS, FiAAP • - :. t z-. - CCommissioner_of Health- LORETTtA MOLINtARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Mr. Peter Marchetti, Jr., PE 25 High Ridge Road Pound Ridge, New York 10576 Dear Mr. Marchetti: April 6, 2006 R®BERT d. BOND1 ,County E ve$ 1 tIVC. ROBERT M®RRM PE Director of Environmental Health Re: Proposed SSTS Trench Plan For Feinberg @ 227 Ice Pond Road (T) Patterson, TM# 34 -4 -7.1 This Department has- received and reviewed the submitted -application and plans for the above referenced project and the following comments are offered for your consideration. 1. The septic site plan shows a four inch sewer line from the pump pit to the distribution box although the pump pit detail indicates a two inch PVC force main. to be- utilized, the•lengthsof all of-the absorption trenches-are-to be.. equal. 3. The elevations for the pump floats are to be specified on the pump pit detail (i.e. pump off, pump on, high level alarm). The invert elevation of the pump pit inlet pipe is also to be specified. 4. Please be advised the minimum required length of absorption trenches for a four bedroom dwelling and a 10 minute per inch percolation rate is 444 LF. 5. The force main trench detail is to specify a minimum cover depth of 3.5 feet. 6. The locations of the percolation test holes which were conducted in the fill pad, are to be shown on the plan. 7. A distribution box detail is to be provided on the plans. The force main should terminate inside the distribution box with a downward facing 90 degree elbow. 8. The absorption trench detail is to be revised to indicate a vertical separation minimum of five (5) feet to ledge rock. 9. The absorption trench detail is to specify that the ends of the laterals be capped. t t� Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing home Care Fax (845) 278 -6085 & ariv 6ntnrvontinn/Prncrhnni /Rdi17'7R -6[114 Fax (R44177R -664R Y . SHERLITA AMLER, MD, MS, FAAP (jogTNissioner.of.Health..: ^ LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI _r. _ _....... _ .....County Executive - .....- .sue- .... -.e_ ..- — <A'..- .. .ter _n.. - .... - .... . ... �...z ....- a..... .icy. DEPARTMENT OF HEALTH Geneva Road, Brewster, New York 10509 April 6, 2006 Mr. Peter Marchetti, Jr., PE 25 High Ridge Road Pound Ridge, New York 10576 Re: Dear Mr. Marchetti: ROBERT MORRIS, PE Director of Environmental Health Proposed SSTS Trench Plan For Feinberg @ 227 Ice Pond Road (T) Patterson, TM# 34 -4 -7.1 This Department has received and reviewed the submitted application and plans for the above referenced project and the following comments are offered for your consideration. l " l . The septic site plan shows a four inch sewer line from the pump pit to the distribution box although the pump pit detail indicates a two inch PVC force main. - -,/' 2 ---�If a'distribution'b-ox'iyto be utilized; the•iengths-of all of the absorption trenches are to be.-..--. - equal. 3. The elevations for the pump floats are to be specified on the pump pit detail (i.e. pump off, pump on, high level alarm). The invert elevation of the pump pit inlet pipe is also to be specified. V4. Please be advised the minimum required length of absorption trenches for a four bedroom dwelling and a 10 minute per inch percolation rate is 444 LF. I,/5. The force main trench detail is to specify a minimum cover depth of 3.5 feet. . V16. The locations of the percolation test holes which were conducted in the fill pad, are to be � shown on the plan. V . A distribution box detail is to be provided on the plans. The force main should terminate inside the distribution box with a downward facing 90 degree elbow. LA. The absorption trench detail is to be revised to indicate a vertical separation minimum of five (5) feet to ledge rock. The absorption trench detail is to specify that the ends of the laterals be capped. Environmental Health (845) 278 -6130 Fax(845)278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 �:: •.:::. : = pon,omp etion -•of the above,' this Deartmont Evill- continue ifs review: -'Kiniy- advise us-if ` there are any questions. MJB:cj Respectfully, Michael J. B.t&dz' ski, of Director krlai eerie Public Health Director - ~ - . -LORETTA MOLINARI R.N.; ,M:S -'Xt 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 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 5 �� LA ass A, TO: DEPARTMENT OF ENGINEERING AND DESIGN REVIEW DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM DELEGA TED �S�S r2 ctj CA- T-LIvi PROJECT: I fie) agC� � V/vii= —dam S _.. TOWN: C SEj• K- PV DATE SUB'D4APPROVAL:- .. -..;- l •� - -� -� NOTICE OF COMPLETE APPLICATION DATE: 4-& L MARCHETTI CONSULTING ENGINEERS 25 High Ridge Rd. POUND RIDGE, NY 10576 (914) 7649011 Fax (914).764-9012 TO _ 47-'/ nL d�44C�Q OCR 4 ° a a��7��4Lad DATE f� JOB�N ATTENTION � - ! ,•A ', � Rib. WE ARE SENDING YOU iS4aached ❑ Under separate cover via the following items: • Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications • Copy of letter ❑ Change order ❑ THESE A�2E TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval For your use ❑ Approved as noted ❑ Submit copies for distribution /❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: M__' _ if enclosures are not as noted, kindly notify us at once. PUTNAM COUNTY DEPARTMENT OF REALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner- 2 Address 22q Located at (Street) -V-Ce f oAA, Q Tax Mal) A+1 Block Lot (indicate nearest cross street) r , — -4 C, Municipality .10. rA Watersheds fix: 13 SOUK PERCOLATION TEST DATA Date of Pre-soaking 3131 Date of Percolation Test 41116L :.;Mole Nolun .... . loo. . ..... ... ... .. Stgrt . Shop 'ro Mart ;S op v. e- Percolation qqz 15 2 q;2 13 41 1611 301 3 .l35 is 1411 1.-7 11 3 4 q; - — io 3,5 if o 5 q.�5o 03 j -3 2 25 2- 0 3 5 4 /a; 50 1 P0 0) l 1 `7 5 J 1(0 �ti S.. 2 L 11:51 2G 33 3 3 4 IZ 17 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. ,5 1 min for 1-30 min/inch, :5 2 min tor 31 -6U min/inch) All clata, to be submitted for review. 2. Depth measurements to be made from top of hole, Form DD-97 .1 Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Marne: Address: c, RID 516 Signature: Design l r ofeesslO mOs SCSI qh 'ICIEST PrT DATA 2 ON OF SOILS IENOMWIERED IN TIEST HOLIES DIES HOLE-NO.- - _ - - - -- HOL _.- ...... a G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 4.0' --� 4.5' 5.0° - 5.5' 6.0' 6.5' 7.0' 7.5' 8.01 8.5 ' 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Marne: Address: c, RID 516 Signature: Design l r ofeesslO mOs SCSI qh PUTNAM COUNTY DEPARTMENT OF HEALTH DWISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TRiATA&9T SYSTEM Owner r�;v T-C -,,A3P-r2- ct Address 2 1 lcepr-:eA-o Sal Located at (Street) - -EC-c- f c4,4- JZJQ Tax Map A+1 Block Lot (indicate nearest cross street) Municipality 112,1 -Az Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking 3131 Date of Percolation Test 4111a6 0 R . N ................. ... .. A M i mm" .......... .. . . .. . m ...... es: -IPFCO lation t f d 1 q cjz 1 2— /5 4., D 2 c1l 15 q-2e, 301 r S., 3 ,35 40 5 4 q;4S 16 -5. 3 L) 5 22 /0 .-I it 2 25 20 6,10, 3 .41 5 P: 50 to b- C5 5 � 3 2 Wr 35 i 1:51 2- C, rb, 33 3 3 4 7-.3'2- 17 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. -< I min for 1-30 min/inch, :K 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 .1 T-ZsT Pir ]DATA 2 IDES ON 07 SOMS cC(D M D H' TEST HOLES _ DEPTH .... _ - H&E Yet ®. ... _ ®LE,I40:- . _ - ... _.._ .. HOLE NO. Ca.L. 0.5' 2.0'� 2.5;y` 3.0 3.5' -« 4.0' , 4.5' r r 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.51 9.0' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design Professional Namme: J j' Address: 5 i�la -1� ��oG C — Signnature. HDesagu proffealomal9$ Sul s, I C PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREAT YSTEM D��f1 PERMIT # T' /a" 03 r� � /� Located at �.CrE [ y ryy(� 1`dl r Town or Village f�'T -GZ►" Subdivision name IA FEW Y C, Subd. Lot # Tax Map Block A— Lot I o Date Subdivision Approved �'l.�r (� Renewal Revision Owner /Applicant Name Date of Previous Approval �y Mailing Address ` 2�-y \ � s Zip Amount of Fee Enclosed Building Type V) eeb t OtNice Lot Area _J' 1kCfi§No. of Bedrooms 4 Design Flow GPD d) Fill Section Only )_ Depth 3 e� Volume DOd C� PCHD NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of j Z �J © gallon septic tank and FOUR- Jjue k02ED A r_,. ;o L - - e.. — I -.c _ t -rvy O _I r u . A -.T. , X% ► -R -h 4 v5+ Other Requirements: ! ° b' ` o F °-�r a «� " �� o 4e 2 S ST S 1:11CCZN r To be constructed by - 10 VW Ca s Address �2�� C.-t- Water Supply: _ Public_ Supply- From _ . _ Address or: Private Supply Drilled by ` oR-% S e. ti k�j Address 'l GG Fl f\ i r= kA Qatiwo R_, p4 c) AlY I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatments stem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or airs thereto. Sign P.E. R.A. Date G 6 a3 `, 6 y License # ,i 2 Address 7_ lti {� 0 t4, N( �. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when sidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permi veAlfor discharge of domestic sanitary sewage only. By: ///o& Title: &I � Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 i kti� ��11 �•'t�ST �� � �•1- ,T"10 N. VAUTV sJN� 12 ()L,`F OF Ft eL05 f5 �rtl� EXT - -Em '3ttAG to I=EsT OF- �U ~! � FRI ONLY r, 4: Tltlo •i t 111? Tll Tiff= 'iltnan County ?`epa,stment Of Health cif tole r T;c, HAWKS AERIE SUB! 227 ti. POTQN, - -�;- 'Rol Drawing i i lzl e .r......__ . .1.. -... 3 FROM : MARCHETTI ENGINEERS FAX NO. : 19147649012, Mar. 30 2006 04:16PM P1 ' - ............................... ........ _ .......... — '---_--_'__'—_-_— MARCHETTI CONSULTING ENGINEERS 25 High Ridge Road Pound Ridge, NY 10576 (914) 764-9011 Phone 764-9012 Fox marcengeoptonline. net FAX..... ............. ............. ....................... . ..... . ................. Sep 2 0 05' 12; 'It '.:i P SEP-20-2Xr', 11:-1,4 Cnnn i e FPOM:PUTNAM COUNTY DEPART 845-27e-7921 914-764-9012 p.2 TO:919147649012 P:1.1 PUTNAM COQ DEPARTMWw OF HEALTH ' DIVISION OF ENVIROMWITAL HL4,LTE SERVICES ATTEN"ON 0 JOSFPg XGENE W,LLTajjQ_R j2LA,j__DLS�Q �O For Fill All information mug be Uly completed prior to am Trenches i.tspections bmttg made. Pe" Construction Permit# Located: 1— 19-6 Foh 4. m (V) P*-MP__R S6,4 OVffia,/AvpbcW'.NaMc: fc-qt , A A TM _N-± J Block Lot. A I Subdivision Name: kjS-4 1«S - SulAivision Lot # - *Lgr 41 h; system !fill completed? Date-, 9Y Z.// 0.6 Is system complete? fl Date.- Is system coistructed ar, Per plans? is well drilled? --- rAP -_ - Data:___ Is well locawd as per plans? - W A Are erosion control measures in place? I certify that the system(s), as listedatthe above premises has been constructed and 1haveinspected and verified their complelion in a=ndanac with the issued PCHD Construction Permit and approved p1wLs and the Standards, Rules and Regulafions of the Putam'County Deparment of HeWth. —Date.:-.. j-_—a)5 Cerdficd by: M6%(-.WPE- (// RSA. Design Professional Address: .--- _. _k"e Lie, it 6 1 19 2 Commems: 1.5 1-4 PL-MC_-__ Form FIR-99 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVMONMENTAL HEALTH SERVICES FINAL SITE INSPECTION _ Street Location Town TM # 1. Sewage Svstem Area a. STS area located as per approved plans .......... .. ................ b.. Fill section - date of placement 3 :1 barrier Lgth. Width . Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank size - 1,000 .... ..... 1, 250 ......... other ................ b. ' Septic*tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Bog 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft. Original soil between box & trenches e. Junction Box properly set .......... ............................... 6. Trenches 1. Length required Length installed 2. Distance to watercourse measured Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 %........ : ................ S. Size of gravel 3/4 - 1112" diameter clean..................... 9. Depth of gravel in trench 12" minimum .................. 10. Pipe ends cap pped ........................ ............................... g. Puma or-Dosed Systems 1. Size of pump chamber ................. ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. douse located er approved plans ... ....................:.......... b. Number of bedPooms ....................... ............................... IV. Well Well located as per approved plans .......:.............. b. Distance from STS area measured ft........... c. Casing. 18" above grade ................ ............. ................... d. Surface drainage around well acceptable ....................... V. Overall 'Worlimanshin . a.. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfih 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 ............... h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ................. ............................... Rev. 12/02 Date: Inspected by: Owner Permit # Subdivision Lot # r SITE INSPECTION FOR FILL PAD Date: o Inspected by:� Fill pad located per the approved plan Fill Pad Length Required Length Fill Pad Width L fl Required Width Fill Pad Depth Required Depth Run -of -Bank Fill Quality Slope from Top to Toe O', k Impervious Layer Installed �� -5 Erosion Control Installed 2 S Sieve Test Results (if applicable) Additional Comments_Li Reserved for Field Sketch if Applicable l q a �© / U 1, 141 01) SHERLITA AMLER, MD,_MS,,I±AAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Peter Marchetti Marchetti Consulting Engineers 25 High Ridge Pound Ridge, NY 10576 Dear Mr. Marchetti: ROBERT J. B.ONDI County Executive September 23, 2005 Re: Fill Pad Inspection - Feinberg Ice Pond Road, Lot # 1 (T) Patterson, TM# 34.4-1 Per your request an inspection of the fill pad at the above referenced project has been completed. Comments are offered as follows: Upon inspection it was noted that there are gross inadequacies within the construction of the fill pad. InyshQrt;.coia,,,tructio.T of the fil.tpad is only half.. completed.. P_lease..noti�, that..it.,i -,.nQt tbis............�.. _. _.._. . Departments policy to monitor the construction phases of any one project, but rather the responsibility of the acting Engineer or Architect as noted on the construction permit. It is hoped that correspondence with your firm and this Department can have a more productive working relationship in the future. Kindly fax your request for final inspection to this office upon completion of construction. Please note that field measurements by this Department in no way suggest the exact size, depth and location of the fill pad. If you have any further questions, please contact me at 845- 278 -6130, ext. 2261. GDR:kly Sincerely, -4�e- V. r(�� Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ .._..._.. _ APPLICATION TO CONSTRUCT. A. WATER WELL lease print or type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # .1 -C_IE ?Z, J q Map '3 Block Lot(s) d Well Owner: Name: Address: 'Fe- � r.t � p 'c:� Use of Well: L,Residential Public Supply Air /Cond/Heat Pump Irrigation - r><mary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought .f gpm # People Served 5 Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision W Itg- V I Lot No. I Water Well Contractor: 5k2 ,' C\n.wz Address: 'Fom AD f, ti4 E Is Public Water Supply available to she? ........:........................ ............................... Yes No d/ Name of Public Water Supply: L/ Town/Village �-- Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. �_ _ _.; - Applicant Signature: . Rate: . PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a wate e 1 driller rtified by Putnam 1A i County. Date of Issue Permit Issuing Offic Date of Expiration d J //j / 6A Title: L Permit is Non- Transfe White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 f l�; 11/18/02 11:39 FAX 5708373764 fBS SALES OFFICES MONTGOMERY I !po - UTILM -0?x 11EN 1" FAMILY ROOM 1.�'•�" x 11'•11' LIN CLO PAN Vf- 4CLO DEN FOYER 13' -10" x 1x -11' OPEN 1'0 ABOYE 2848/66 TW y',; , FIRST STORY PL1 Fi�1T THESE HOUSE 1480 8Q.. S .31 BE SU13 l-71 AI.i> i CD r« OR APPROVAL 2860 SQ. FT. TOTA Z, - - S NA URE -� E .. DATE, WALK SEDR6014 *2 CL IN. 1r-0, x9'-6' CLO BATH BATE! #2 � it _ - _ _ _ :.:_.... _ _ tea: le -HALL- IM 006 DINING ROOM 12' 10" x ir-11, LIVING ROOM PUTP6WTC TY .DEP1 TRTPJE�vT OF HEALTH PLANS APPROVED FOP. EDROOM COUNT ONLY, BEDROOM #1 161-3' x ir-ir OPEN TO BELOW T BEDROOM #3 1r-s" x 12' 611" r BEDROOM #4 15' -2" x &W-11" MONTGOMERY I 2848156 TWO STORY SECOND STORY FLOOR PLAN 1450 SQ. FT. 2860 TOTAL SQ. FT. NOTE: ELEVATION ON FRONT LS ARTISTS RENDERING ONLY PLEASE INQUIRE WITH r' AUTHORIZED BUILDER AS TO AVAILABLE OPTIONS SHOWN. i 00/I0160(I331ISAM1) 3aia Q3I.Y2i033 la-):OR 04 IZW .OTmn 310H'IOiI OJ NO1SOli lso, agaugasm sup S 03 Z8T galet.00I/3JZLYHJSIQ ao ()I)Ul I ,OEMM '�'I'I3M 3SllOH�iO3'IO2iZNOJ'I.Q1SO�i3nn scNnoa v S3.Lm xiii3aove —r-) SISS aO.00t ALUM SMISS v STI3Mnn 'II�i3Q S3QISHiOg.S S3dIdQ.\IYLSC�C� S96II:YA313193MSY4 n QATYdobz3Hsima a3soaoaaC --)M . 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FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road —Brewster. New York 10509 r' 1 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services REQUEST FOR EELD- TESTING ATTENTION: a JOSEPH PARAVATI , )(GENE REED All information below must be fully completed prior to any scheduling. DATE: 3 O 0 3 ENGINEER OR FIRM: —K ARC— ARC— CztitSltu'r1At PHONE #: � t� ^ �',(� 4_-- lot i -pje�rorz rzx Ak x — 7el, REASON: DEEPS: PERCS7,�' PUMP TEST: ❑ ROAD /STREET: I C — tfQ9A K V- TOWN- "' �� �o � TAX MAN: 1 3A � 7 �.a SUBDIVISION• . s A E R 1 a X 'LOT # - OWNER: . ' �;.*�3a r�!'�- ',:S ALVAQe� &S NYCDEP CRITERIA. FOR JOENT REVIEW ASCII 54LNG OF SOIL TESTING Proposed SSTS within the drainage basin of West Branch. or Boyds Corner Reservoirs. a Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. a Proposed SSTS within 200 feet of a watercourse or a DEC wetland. o Proposed SSTS design flow greater than 1000 gallous /day or SPDES Permit required. 0 Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This .Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ,q to any of the questions, NYCDEP must witness the soil tests- This Department will coordinate a mutually suitable time for field testing with the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. P(',C °- ?5 acs, K FOR C_Oi1An USE ONLY Pe Wc5 f V e-,e of DATE: CO. 57-/ 1-y- n'4' . VL N MAY -1 -2003 THU 08:43 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 1 �� 18�,�� . 102.89 AC. CAL. X. `.. 1 j -I/ AC. ,yo' 20 19 ,a,s 2.49 a �'° n'16 1 9pp a5 27 s . n X36,4, AC. E34At,A �4. AC. CA \..i -••_• _..r.., 1296.1 p 42 AC,� 14 IC .48 ,0 6 173 177 94.03 7 t o W I AL 74 J 1 9.55 AC. {! �. JL - - 1 i 6.29 AC. - .... .. ..- • m 387.03 165.0 , ;u °� 8 _L.. 7. 4.00 ,. _ r 10 A: O . • ' a Y1911AL CBMID . I 45 � POND PUTNAM COUNTY, • NEY1 YORK PART OF PARCEL 60UMDARY - - PARCEL MUA99ER T2 AL 15 ` / 64.98 AC, M . N!i' 35�AC. CAL. :/ i'/ 26 4 �9� 44� _ Y 1 67 K 75 u ` 3 4 14 Q CAL 70.06 AC. CAL. 4.49 AC. yf.W-3.09 9 j�e �� �379'AC. S - �p`�..y __......_ ._.... _��.. t I 62 .47 3fi0.6b 1 - AC. y�uo 4r, f 4.45 AC. 7.76 + 5t 19 43.4 m AC. \`b 16 J 344.02 i0- 26.60 AC. qS4 eb / ACS 67T . \ 49 .61 `� 0 A - i12 60 40.73 AC. CAL. A.. ` 39 a ExEAL 10.09 AC. CAL 38 � TOhw OF \sot� 5 AC. 9.39 AC. ti s 37.3 CAL. I 21.05 A C. \e •�' 35 N 34 EXEMPT f TOWN CF ° PATTERSON 48.36 .51 AC. 32 49.02 AC. + \ JL 806.66 \ �ry ' 1ri 31 zss1� 30 29 ' N ''a 12.63 AC. CAL. 1 20.87 AC. ay 41 LEGS \ , , zsA10 z4 25 P R E L I M I N A R 1� DI9T�ED AWS ......I........ + 71.91 AC. 96.59 . OEYELwmS LOT M"s. s . 14 ROAD R.O.W. STREAM/WATERLIME' - .•- •- -•.-•• 74.41 AC. 33 • � 35 � TOWN OF PATTERSON SPECIAL DISTRICT LINE . -F CALCIAATED AREA L34 AC. CAL 75.97 AC. c ' ' • ' SCHOOL DISTRICT LINE -S Y1911AL CBMID . I 45 � POND PUTNAM COUNTY, • NEY1 YORK PART OF PARCEL 60UMDARY - - PARCEL MUA99ER T2 39L34 4 �9� 44� AL �'�• h u ` 3 4 14 Q AL e Q 4.49 AC. yf.W-3.09 9 j�e �� �379'AC. S - �p`�..y __......_ ._.... _��.. Ce �� AC. y�uo 4r, f 4.45 AC. 7.76 + 5t 19 43.4 m AC. \`b 16 $ ACS 67T 22.26 AC. CALF A 9bs,oD \02.87 I7 A 1 2 BTAC - , 2. 11544 AC At WAEL 7.3 1.84 Ac �I SCN s slasl 4.15 AG - r »a+a a A• s 3T.sr► �� 2U^ r $ 24 I 4`~ 22.27 a 10.71 AC CAL. 21 J 3 C+ 93.50 AC. , 9.3840 $� �' pop ba :� /'22.26 ,4.02 � p y 1 2.28 22.25 °o E 3.09AC. ^Nn 4 i 44 .28AC. '1q a.'- a o° 22.241 AC. ° 3` 22.29 2.42AC. h h� 381.038.24 , No �3.29AC.' G !; .ea7�+ 22.23 23 *� �! 7.65 AC. N asT.os21 + S 2.4AC. Y ?� L08 AC 22.224a''�' ct tv' 973.fi6I`• sll �2.54AC. ' a . 7- _. 1.85A�. °g N 1 60 40.73 AC. CAL. A.. ` 39 a ExEAL 10.09 AC. CAL 38 � TOhw OF \sot� 5 AC. 9.39 AC. ti s 37.3 CAL. I 21.05 A C. \e •�' 35 N 34 EXEMPT f TOWN CF ° PATTERSON 48.36 .51 AC. 32 49.02 AC. + \ JL 806.66 \ �ry ' 1ri 31 zss1� 30 29 ' N ''a 12.63 AC. CAL. 1 20.87 AC. ay 41 LEGS 22 23 z4 P R E L I M I N A R 1� DI9T�ED AWS ......I........ nAros LIME AND SnIBOL �._� CONTINUOUS OWMERSMIP •�••► OEYELwmS LOT M"s. s . ROAD R.O.W. STREAM/WATERLIME' - .•- •- -•.-•• CUD OIA4e1BIOM Iwo) SCAiD) DIAIETL91oN 1001 SI 33 • � 35 � TOWN OF PATTERSON SPECIAL DISTRICT LINE . -F CALCIAATED AREA L34 AC. CAL ' ' • ' SCHOOL DISTRICT LINE -S Y1911AL CBMID . 44. 45 PUTNAM COUNTY, • NEY1 YORK PART OF PARCEL 60UMDARY - - PARCEL MUA99ER T2 PUTNAM COUNTY DEPARTMENT OF HEALTH . DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A . WASTEWATER. TREAMENT-SYSTEM.: -.... w ...: _... _...._........ - 1. Name and address of applicant: 714,/ p 2. Name of project: k ✓) W Kam 4. Design Professional: 'Pe re-f— tA8�s clne 6. Drainage Basin: 7. Type of Project: j� Private/Residential Apartments Office Building 2 J 3. Location T/V:A rs� 5. Address Food Service Institutional. Realty Subdivision NY, G- Commercial Mobile Home Park Other (specify) N 8. Is this project subject to State Environmental Quality Review -(SE,QR)? Type Status (check one) ............... ............................... Type I Type II 9. Is a Draft Environmental Impact Statement (DEIS) required? ........ D .......... 10. Has DEIS been completed and found acceptable byLead'Agency? ....:�.::.. Exempt Unlisted 11. Name of Lead Agency 12. Is this project in an area under the control of local planning, zoning,- or other, officials ordinances? ......................... `..r.tL . 5................. .......... _.. :.. ,S 13. If so, have plans been submitted-to such authorities? ... : ............. ..:................ is 14. Has preliminary approval been granted by such authorities? ( Date granted: j U 15. Type of Sewage Treatment System Discharge ..... r,...��.:'R surface water ilo groundwater 16. If surface water discharge, what is the stream class designation? .............. 17. Waters index number (surface) .... ......................................... . ........................ " 18. Is project located near a public water supply system? .:..... ...................:........... 46 19. If yes, name .of water. supply Distance to water supply . 20. Is project site near a public sewage collection or treatment system? ...:............ 21. Name of sewage system Distance. to sewage system -- 22. Date test holes observed 23.. Name of Health Inspector Cje, ie , j�&,q=p 24. Project design flow (gallons per day) ......:.......................... ............................... PC ' 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required? ... t4_0 26. Has SPDES Application been submitted to local DEC office? ......................... �°- Form PC =97 2 -27. Is any portion of this project located within a designated Town or State wetland? 28. Wetlands ID Number ...:................. �—` 29: J Is Wetlands Permit required? . ............................... ..... ............................... Has application been made to Town.or Local DEC office? 30. Does project require a DEC Stream Disturbance Permit? 31. Is or vas project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landf lling; sludge application or industrial activity? ............................ Yes/No 32. Is project located within 1,000 feet -of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No 'DESCRIBE: 33. Is there a local master plan on file with the Town or Village.? 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ............................... ............................... .<� 35. Are any sewage treatment areas in excess of 15 %slope? . .............................. l 36. Tax Map ID Number .......... 0 ........... ............................... Map 3 Block Lot 37. Approved plans are to be returned to ..... Applicant _ Design'Professional NOTE:;Al1 applications,forreview and.approval of a.new.SSTS to be locatedzvvithin the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other.aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA-9' A -97,. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief.. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & QPTICIAL TITLES: Mailing Address': .... .........:................. ..... PROJECT ID NUMBER 617'20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED• ACTIONS Only-'- _...:..x:_ ..• _ PART�1'- PRFSJECi'fNFORMATION "`('To be completed by Appl cantor Project Sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME :•. ` : n �-C-5 9'Z{2� s�CG�� yi5 tc',•/ 3.PROJECT LOCATION: Municipality County 't—kV_(_1111 4: PRECISE LOCATION: -Street Addess and Road. Intersections, Prominent landmarks etc or provide map 2� fCI,'„ PGN9 5. IS PROPOSED ACTION : a New Expansion ;; Modification alteration L 6. DESCRIBE PROJECT BRIEFLY: 1pp_ A \ ?a-, (-CA. at,4 A el,,'_'l� Ste. y Cis a,-\k 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres & WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRIC-tIOIV6 ?: Yes a No It no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as mairy.:as apply.) Residential Industrial Commercial DAgriculture []Park/ Foiest / Open�Space Other (describe) . • . 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY: OTHER .GOVERNMENTAL. AGENCY (Feedde[[al, State or Local) QYesNo If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY. VALID :PERMIT OR.. APPROVAL?....,. Yes No -If yes, list agency name and permit / approvaL 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT / APPROVAL REQUIRE MODIFICATION? Elyes ❑ No I CERTIFY THAT THEE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ` ' , Date: Signature____________ ____ If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before'proceeding with this assessment PART II - .IMPACT ASSESSMENT'(To be completed -by Lead Agency) A.' DOES ACTION EXCEED ANY TYPE*[ THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN'6 NYCRR, PART 617.6 ?. If No, a negative declaration may be superseded by another involved agency. EYes No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing'traffic pattern, solid waste: production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or comrrid6ty or neighborhood character? Explain briefly: - " C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endarigered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of.use of land or other natural resources? Explain briefly: �0 C5. Growth, subsequent development, or related activities likely to be induced by the proposed'pi tfcrY? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy? .Explain briefly; D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT.OF A CRITICAL _ " ENVIR.0.NMENTAL AREA (CEA)?.. Il' es,- explain brief) : ... _ • "._ . _ _ _. -.._,_ .._ _..;.:._.....:." .. _ .... _ Yes No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes ex lain: Yes No PART III -DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring: (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked vac the rlptPrminntinn of sin nificance must evaluate the ootential imoactof the Dr000sed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impact's which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actin WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of Lead Agency Date Mi Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (f different from responsible officer) 0 MARCHETTI 7 Ryes CONSULTING ENGINEERS o �y lvkt . TO ,D co t "i, `-1 WE ARE SENDING YOU ? Attached ❑ Under separate cov via fo g I ems: ❑ Shop drawin' s Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. �� %•r � n ❑ Submit copies for distribution • Returned for corrections � A corrected prints Z 1S WE ARE SENDING YOU ? Attached ❑ Under separate cov via fo g I ems: ❑ Shop drawin' s Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION • Approved as noted ❑ Submit copies for distribution • Returned for corrections ❑ 3 corrected prints Z 1S THESE ARE TRA MITTED as checked below: approval ❑ For your use ❑ As requested REMARKS • Approved as submitted ❑ Resubmit copies for approval • Approved as noted ❑ Submit copies for distribution • Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE �I S 19 ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: " If enclosures are not as noted, kindly not/fy at once. LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 —6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 To: 6ti—, • I `-o-J L Fax: %I y> k3t, From: Date: a3 1n CC: Pages: W ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ROBERT J. BONDI County Executive CONFIDENTIALITY STATEMENT: The information contained in this facsimile may contain CONFIDENTIAL and legally protected information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissension, distribution, or copying of this telecopy is strictly prohibited. If you have received this telecopy in error, please immediately notify us by telephone (845 -278 -6130) and destroy all documents associated with this facsimile. SENDING CONFIRMATION DATE SEP -19 -2003 FRI1014 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 919147649012 PAGES : 3/3 START TIME : SEP -19 10:11 ELAPSED TIME : 0213611 MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... a LORM7A MOLINARI R.N, M.S.N. « pyt.0a H-" D;da ROBBRT J. BONDI Cwy' a .avtw DEPARTMENT OF HEALTH 1 Gonovs Road. &mvaar. New York 10509 IG.. moo0d Nnha (646) 278.6:70 In (845) 278.7921 Nordst Berri— (t4S)272 -Mir WIC (845)278.6671 Fea(8a5)218.6015 WY tnterrntWffrt.2*d (145)278 -6014 1.(W)278.6648 FACSINME TRANSMITTAL To: Data- Re: Pages. —3 CC: i ......................................................................... ............................... ❑ Urgent O For Review O Please Commom ❑ Please Reply I j I COWIDFNTLUM STATmt@NT: The intbtmaden aontamod in this btafmile taly attain CONMWMAL ud lq" pmtecled intonoaem tao..nded only fordo u6C of ft indlvidoal or awry named above. If dtc.roula of this tnesu e is not We hmmdM redpioo , you am botchy mulled that any dlaeeaiiar% distriha oq or oapft of this talavpy to sWcSy pfahibited If you have received this telocopy In ever. pkaso bnmedist* notify m by telephone (849.2794120) and drabay all doe memo mood" atih tldsfaasiotifc. I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner FLAL,?Ci Address f 'T CEP f6t9 � 1(5, AtY Located at (Street) e Ljo QCQ Tax Map' Block Lot. (indicate nearest cross street) Municipality. Jt-6,,,,,Aw ?,,kk:q sole Watershed !E_, - lasonA, SOIL PERCOLATION TEST DATA Date of Pre-soaking 2,>) Date of Percolation Test ....... ......................... . ........... ........ pi s t A W . ......... . 0m:::GJF.4j:UU ............. et ii . P .. ........... . P:,b 2 1 1,6 21 14 2 if V 1-11'A 21 3 [C) 3 V, 1 11 —5 — 2-1 S L23 4 2. 1 oi-)1—jo,35 16 1-6 2 111Z 3f 4.1 3 P,36-, —21/6 4 It. K/ 5 2 .3 4 NOTES: L'. jestg to be repeated at same depth until approxiqi4te`ly, equal,pbroolation rates,; are obtained at each ,percolation test hole. (i.e. s I min for 1-30 rnin%iiich, :5 2 min for 31-60 min/inch) All data to be submitted for review. .2. Depth measurements to be made from top of hole. Form DD-97 DEPTH' G.L. 0.51 1.01 1.51 2.0' 2.51 3.01 3.51 4.0' 4.5' .5 5.01 5.5 6.01 6.51 7.0' 1 -7.5 8.01 8.5' 9.01 9.51 10.0, TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES -- - -- - HOLE NO. j HOLE No., 2_ -fb(> sot L 9 5'� WA*% 0) I __V 5 I !:S-A Le 4.21 L- - t--`P G t--- Indicate level at which groundwater is encountered Indicate level at which mottling is observed r-A k Indicate level to which water level rises. after being encountered = � A Deep hole observations made by: ?erep- m ,QVqA A, e-.,t ke_� Date MA, L6, Design Professional Name: C-s M^a6AQ_V-i Address: 2_�- Wy, Signature: Design Professional's Seal A N 06157'6 ..,:.,0,C,,-s to N. .13 p PV, a C\Vf It^ le)*, MARCHETTI CONSULTING ENGINEERS 7 Ryan Street STAMFORD, CONNECTICUT 06907 ::.:. gr3 329- 3584 Fax- -(203) 329- 3561. =_- . _ . _.:: TO Q► A 10'�)09 . WE ARE SENDING YOU ❑ Shop drawings ❑ Copy of letter ❑ Attached ❑ Under separate cover via ? Prints ❑ Plans ❑ Change order ❑ �-� • ILIEUVIRN W. <, 4 ❑ Samples the following items: ❑ Specifications ❑ ATTENTION .�:. is "i.! tiff � _ �► ' Approved as noted ❑ Submit copies for distribution • As requested ❑ Samples the following items: ❑ Specifications THESE ARE TRANSMITTED 'as :Necked below`. 1� For approval ❑ Approved as submitted DESCRIPTION • For your use ❑ Approved as noted ❑ Submit copies for distribution • As requested ❑ Returned for corrections ❑ Return corrected prints IL • For review and comment ❑ \• �� 1 ❑ FOR BIDS DUE l0 19 ❑ PRINTS RETURNED AFTER LOAN TO US THESE ARE TRANSMITTED 'as :Necked below`. 1� For approval ❑ Approved as submitted ❑ Resubmit copies for approval • For your use ❑ Approved as noted ❑ Submit copies for distribution • As requested ❑ Returned for corrections ❑ Return corrected prints • For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: if enclosures are not as noted, kindly notify us at once. "o : >t LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 April 12, 2004 Marchetti Consulting 25 High Ridge Road Pound Ridge, NY 10576 Re: Proposed SSTS: Feinberg and Saunders 227 Ice Pound Road, Lot 1 (T) Patterson, TM #34 -4 -7.1 ; Dear Sir or Madam: ROBERT J. BONDI . County Executive Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: _...... _.........:..1........,..D.eep test-hole and percolation test locations are-to be shown on the-floor -plan. 2. I have enclosed a sketch of a fill section closer to what is required. Please be advised of the following. a) Side slopes must be 3:1. b) Fill cannot be placed at a slope greater than 15 %, i.e., maximum slope of the fill must be 15 %. c) Minimum depth of fill is 3.5 feet in all sections. d) Minimum width of the section is 141 feet when 120 L.F. of fields is proposed, i.e., (2) 60 ft. runs, drop box 1 ft., fill extending 10 feet horizontally past the edge of trench. e) Minimum distance of a retaining wall or the house foundation, if used as a retaining wall, to a trench is 20.5 feet. This distance is applicable if you cannot get back to grade on the lower part of the fill pad. . The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 01 �° T Letter to: Marchetti Consulting - April 12, 2004 A -2- Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. V ly yo s, a Robert Morris, P.E. Senior Public Health Engineer RM: hn a a .1, v LORETTA MOLINARI R.N., M.S.N. Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Peter Marchetti, P.E. 25 High Ridge Road Pound Ridge, NY 61528 Re: Proposed SSTS: Feinberg Ice Pond Road, Lot #1 (T) Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: t ROBERT J. BONDI County Executive September 19, 2003 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. Subdivision lat notes 3 feet of •fill..is .ze uired, - therefore fill -plans., must b&----. - - submitted. 2. Boundaries for the entire property is to be shown with metes and bounds provided. 3. Expansion trenches are to be shown, hatched lines are acceptable. 4. North arrow is to be shown on the plan. 5. SSTS hydraulic profile is to show: a) The sewer line from the house b) House finished floor and basement elevations. C) Expansion trenches. 6. Existing contour 834 is not legible. 7. The trenches should be proposed as parallel to the existing contours as possible. Trenches are shown crossing 4 to 5 feet of elevation change. 8. Design data, i.e., deep hole and percolation test results are to be noted on the plan. 9. Footing /gutter drain discharge pipe is to be shown on the plan. 10. USDA soil type and boundaries, if present, are to be noted on the plan. 11. Title block is to note: a) Owners name. b) Subdivision lot number. C) Town the project is located. Letter to: Peter Marchetti, P.E. - September 19, 2003 -2- 12. Datum reference is to be noted on plan. 13. Proposed well for project is to be noted as "Proposed Well ". 14. No hand changes to the plans are acceptable, i.e., all plans must be prints only. e 15. Erosion control measures for the house, well and SSTS are to be shown in the plan view and the detail provided. 16. House sewer line to the septic tank is to be noted as cast iron with a minimum slope on 1 /4 " /ft. Furthermore, no bends in the sewer line is allowed. The sewer line cannot t be constructed as shown on the plan without elbows. 17. Length of primary and expansion trench is to be noted on the plan. 18. Trench detail is to note geotextile material as trench cover. 19. Trench detail is to note dust free crushed stone or washed gravel. 20. Septic tank detail is to show: a) Sewer line invert. b) Effluent line invert. C) Wall thickness of tank. d) Minimum 3" bed or pea gravel or sand. e) Minimum 6" maximum 12" backfill. A waste tight expansion collar is to be provided if the tank is greater than 12" below grade. 21. Minimum distance from foundation to septic tank is 10 feet. This should be noted on the plan. 22. The proposed well location is to be dimensioned from two property lines. 23. Service connection from the well to the house is to be shown on the plan. If the line _.,......... _......_...- _ passes =under the.driveway.a Toad-bearing sleeve pipe. is.to -be provided. This-'pip'e is. to be shown on the plan with the plan with the diameter, type and length noted. 24. Minimum distance from the well to the property line is 15" The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. V y your , I 1 Robert Morris, P.E. Senior Public Health Engineer RM:tn May 11, 2004 Marchetti Consulting 25 High Ridge Road Pound Ridge, NY 10576 Re: Proposed SSTS: Feinberg and Saunders 227 Ice Pond Road, Lot 1 (T) Patterson, TM #34 -4 -7.1 Dear Sir or Madam: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. Trenches must be shown parallel to proposed contours. 2. Fill is to extend 10 feet horizontally past the edge of the trench. 3. Side slope must be 3:1 makimurri. ' �_.. _.. _.....__..,_. . 4. Minimum distance from a trench to the retaining wall is 20.5 feet. This distance is to be scaleable on the plan. 5. A waiver will have to be sought for fill depth exceeding 3.5 feet. 6. There are two proposed contour lines (834) this is not possible. 7. Stone wall detail is to be provided on fill and SSTS plan. 8. SSTS profile is to be shown on trench plan and fill plan. Fill plan profile is not to show trenches. The actual profile must be shown. Typical profile is not acceptable. 9. SSTS profile is to show clay barrier or per current code requirement. 10. SSTS profile is to show expansion area. 11. Please review. the current Putnam County guidelines for the plan requirements for an individual SSTS and water well and for fill sections greater than 2 feet. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. July 7, 2003 Marchetti Consulting Engineers 25 High Ridge Road Pound Ridge, NY 10576 RE: Application to Construct a Subsurface Sewage Treatment System at Feinberg Ice Pond Road, Lot 41 (T) Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on June 12, 2003 is incomplete. Please be advised that the following information is required before the Department may commence its review. • Standard f6rm PC -97 has not been "submitfed: • Short EAF has not been submitted. • Dates have not been provided on the Design Data Sheet. Futhermore, all data is to be noted on the Design Data Sheet, "see data by Gene Reed" is not submissable. (Enclosed). • House plans are considered to have (5) five potential bedrooms. • Zip code for owner applicant has not been provided on construction and well permits (enclosed.) The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam. County Department of Health regulations. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2166. Very truly yours, Robert Morris, P. E. Rlk/f•tn QA"; �r L7-4k �.. Y1HGOr Marchetti Consulting Engineers 25 High Ridge Road Pound Ridge, NY 10576 Re: Proposed SSTS: Feinberg Ice Pond Road, Lot #1 (T) Patterson, TM# 34 -4 -4.1 Dear Mr. Marchetti: July 7, 2003 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1; --Dates have notbeen provided on the Design Data Sheet. Furthermore all data is to be noted on the Design Data Sheet, "see data by Gene Reed" is not surmisable. (Enclosed). 2. House plans are considered to have five (5) potential bedrooms. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris, P.E. Senior Public Health Engineer RM:tn enc. Q d November 17, 2003 Peter Marchetti, P.E. 25 High Ridge Road Pound Ridge, NY 61528 Re: Proposed SSTS: Feinberg Ice Pound Road, Lot #1 (T)Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1. Fill plans.-are _to be. -submitted, as per .current. Putnam County Department. of Health guidelines. Plans previously submitted do not cod&ffi to current guidelines. 2. All sheets, e.g., 1 of 2, 2 of 2, of the SSTS engineering plans are to be attached by the design professional. Plans not submitted with separate sheets will be returned to the design professional. 3. Sewer line is to note a minimum slope of 1/4" per foot slope. The construction of this sewage disposal system maybe subject to local wetlands regulations. You should contact local wetlands officials in this regard. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. U-MU Very truly yours, Robert Morris, P.E. Senior Public Health Engineer November 17, 2003 Peter Marchetti, P.E. 25 High Ridge Road Pound Ridge, NY 61528 Re: Proposed SSTS: Feinberg Ice Pound Road, Lot #1 (T)Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: - - 1. Fill plans are to be submitted' as current Putnam Coun De artment of Health - _.... _._.. u... p.__..__.._.... _'. I?. ...v__ guidelines. Plans previously submitted do not conform to current guidelines. 2. All sheets, e.g., 1 of 2,2 of 2, of the SSTS engineering plans are to be attached by the design professional. Plans not submitted with separate sheets will be returned to the design professional. 3. Sewer line is to note a minimum slope of 1 /a" per foot slope. The construction of this sewage disposal system maybe subject to local wetlands regulations. You should contact local wetlands officials in this regard. The construction of this sewage disposal system maybe subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris, P.E. Senior Public Health Engineer 17u�'i1 e...0 Q Peter Marchetti, P.E. 25 High Ridge Road Pound Ridge, NY 61528 Re: Proposed SSTS: Feinberg Ice Pond Road, Lot #1 (T) Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: September 19, 2003 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: L Subdivision plat notes 3 .feet - -of. fill . is required, -. therefore, fill plans must be submitted. 2. Boundaries for the entire property is to be shown with metes and bounds provided. 3. Expansion trenches are to be shown, hatched lines are acceptable. 4. North arrow is to be shown on the plan. 5. SSTS hydraulic profile is to show: a) The sewer line from the house b) House finished floor and basement elevations. C) Expansion trenches. 6. Existing contour 834 is not legible. 7. The trenches should be proposed as parallel to the existing contours as possible. Trenches are shown crossing 4 to 5 feet of elevation change. 8. Design data, i.e., deep hole and percolation test results are to be noted on the plan. 9. Footing /gutter drain discharge pipe is to be shown on the plan. 10. USDA soil type and boundaries, if present, are to be noted on the plan. 11. Title block is to note: a) Owners name. b) Subdivision lot number. C) Town the project is located. 12. Datum reference is to be noted on plan.. ; 13. Proposed well for project is to be noted as "Proposed Well ". 14. No hand changes to the plans are acceptable, i.e., all plans must.be prints only. 15. Erosion control measures for the house, well and SSTS are to be shown in the plan view and the detail provided. 16. House sewer line to the septic tank is to be noted as cast iron with a minimum slope on' /4" A Furthermore, no bends in the sewer line is allowed. The sewer line cannot be constructed as shown on the plan without elbows. 17. Length of primary and expansion trench is to be noted on the plan. 18. Trench detail is to note geotextile material as trench cover. 19. Trench detail is to note dust free crushed stone or washed gravel. 20. Septic tank detail is to show: a) Sewer line invert. b) Effluent line invert. c) Wall thickness of tank. d) Minimum 3" bed or pea gravel or sand. e) Minimum 6" maximum 12" backfill. A waste tight expansion collar is to be provided if the tank is greater than 12" below grade. 21. Minimum distance from foundation to septic tank is 10 feet. This should be noted on the plan. 22. The proposed well location is to be dimensioned from two property lines. 23. Service connection from the well to the house is to be shown on the plan. If the line passes under the driveway a load bearing sleeve pipe is to be provided. This pipe is to be shown on the plan with the plan with the diameter, type and length noted. 24. Minimum distance from the well to the property line is 15" The construction of this sewage disposal system may be subject to local .wetlands regulations. Nou F _ should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris, P.E. Senior Public Health Engineer RM:tn PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH . INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS �.: REVIEW SHEET FOR CONSTRUCTION.PERMIT NAME OF OWNER: T LOCATION: REVIEWED BY: RM, OR, AS, SRDATE: TAX MAP #: (CONFIRMED) Y N DOCUMENTS C__)C_)PERMIT APPLICATION L— J"WELL PERMIT OR PWS LETTER UUPC -97 (__)(__)LETTER OF AUTHORIZATION (_)(_)DESIGN DATA SHEET (DDS) (_)C_)CORPORATE RESOLUTION C__)(__)SHORT EAF (__)C__)PLANS -THREE SETS (_))HOUSE PLANS - TWO SETS UUVARIANCE REQUEST SUBDIVISION (__)(__)LEGAL SUBDIVISION C_)USUBDIVISION APPROVAL CHECKED C__)C__)PERC RATE U(_)FILL REQUIRED DEPTH UC__)CURTAIN DRAIN REQUIRED GENERAL (_)(_)LOCATED IN NYC WATERSHED UUPLANS SUBMITTED TO DEP (_)(_)DELEGATED TO PCHD C_)(__)DEP APPROVAL, IF REQ'D (_)(_)DEEP TEST HOLES OBSERVED UCUPERCS TO BE WITNESSED C__)C__)EX- APPROVAL SSDS ADJ, LOTS C_)C__)WETLANDS (TOWN/DEC PERMIT REQ'D ?) (_)(_)DATA ON DDS PLANS & PERMIT SAME (_)(PRE 1969 NEIGHBOR NOTIFICATION ((___)LETTER BFZBA - (0100 YR.- FLO ©D ELEVATION W/I200' C_)C_)SOIL TESTING LOTS >10 YEARS OLD U E FSo N S C� SEWAGE SYSTEPLAN- (NORTH ARROW) SSDS HYDRAULIPROFILE ( A,4GRAvITY FLOW DNSTRUCTION NOTES 1 -15 ESIGN DATA: PERC & DEEP RESULTS CONTOURS EXISTING & PROPOSED AY & SLOPES, CUT ING /GUTTER/CURTAIN DRAINS SOIL TYPE BOUNDARIES ITITLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# (DATE OF DRAWING/REVISION TUM REFERENCE )(_)LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. L/j- )PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS WELLS & SSDS'S W/IN 200' OF SSTS PROPERTY METES & BOUNDS )EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE BUT D 0 (REVSHEET)09 /01/00 Y -N, (REQUIRED DETAILS ON PLANS CONT'I (Z�HOUSE SEWER - %" FT. 4 "0'; TYPE PIPE CAST IRON C ol(__) +O BENDS; MAX BENDS 45° W /CLEANOUT RENEWALS T HANGE) FILL SYSTEMS ; PAST TRENCH SLOPES 3:1 TO GRADE C_��FIL SPECS; NOTES 1 -5 ( )I�FIL OFILE & DIMENSIONS CU(__)FILL IN EXPANSION AREA FILL GREATER THAN2 FEET UU CLAY BARRIER F C VTIIFI TION NOTE T OR RO.B., UNCLASSIFIED & IMPERVIOUS �)(�S STANCE FROM TOE OF SLOPE TRENCH LF TRENCH PROVIDED 60FT MAX. f��PARALLEL TO CONTOURS /)(_,:)100% EXPANSION PROVIDED DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL C_)(_)GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS L��10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS 100' TO WELL, 200' IN DLOD,150' TO PITS 100' TO STREAM, WATERCOURSE, LAKE (inc. eapan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO.WATER LINE (pits - 20') _ .._.. > . . 50' INTERMITTENT DRAINAGE' COURSE 200'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (--)10' MIN TO LEDGE OUTCROP SEPTIC TANK C_4<_)10' FROM FOUNDATION; 50' TO WELL WELL (_� IMENSIONS TO PROPERTY LINES OCATION OF SERVICE CONNECTION MIN 15' TO PROPERTY LINE SLOPE SLOPE IN SSTS AREA (S20 %) (_)REGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS PUMP NOTES DOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) PIT AND D -BOX SHOWN & DETAILED C__)1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN STANDPIPES, 5' BOTH SIDES, DETAIL 15' MIN to CD.S =>5 %, 20' -4 %, 25' -3 %, 35' -1 %, 100 % - <1% 20' MIN to CD DISCHARGE 1100' with 182 cons day discharge 10' MIN to NON - PERFORATED PIPE MARCHETTI CONSULTING ENGINEERS 7 Ryan Street STAMFORD, CONNECTICUT 06907 0 WE ARE SENDING YOU � O Shop drawings • Copy ofletter O Attached O Under separate cover via � /F��� � �=��u u���u �xu- uu�sau\��vuu�uu MuL the following hams: ,,El "Prints O Plano O Samples O Specifications 0 Change order 0 COPIES DATE NO. DESCRIPTION ~ -'"THESE • For approval • -For your use • As requested .0 rFor review and comment O FORB|DSDUE -------_ REMARKS COPY TO • Approved assubmitted • Approved aunoted O Returned for corrections lA • Resubmit -_-____ copies for approval • Submit __-____- copies for distribution • Return -corrected prints O PRINTS RETURNED AFTER LOAN TOUS AONCO SIGNED: if enclosures are not ao noted, kindly notify uoatonce. LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 December 30, 2003 Marchetti Consulting 25 High Ridge Road Pound Ridge, NY 10576 Re: Proposed SSTS: Feinburg and Saunders 227 Ice Po nd Road, Lot #1 (T) Patterson, TM# 34.4-1 Dear Sir: ROBERT J. BONDI County. Executive Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: I: ^All.plans requiring multiple sheets must be attached in the appropriate order prior to submission. All future plan submitted that are not attached will not be reviewed and returned back to the design professional. 2. All existing and proposed wells within 200 feet of the wells and SSTS's are to be labeled as existing or proposed. 3. The SSTS profile is to show the actual existing surface grade on the fill and SSTS profiles. 4. The minimum of 3.5 feet of R.O.B. fill is to be provided for the entire SSTS. 5. USDA soil type and, if applicable soil type boundaries, are to be shown. 6. Fill is to extend 10 feet horizontally past the edge of all trenches. 7. Datum source is to be noted on the plan. 8. The erosion control must be shown protecting erosion from the entire length of the fill pad. Furthermore, the silt fence cannot be shown perpendicular to the contours. Silt fence must be installed parallel to the existing contours. 9. Volume of R.O.B., unclassified and impervious fill is to be noted on the plan. 10. The fill plan is to show depth gauges and the detail is to be shown. 11. Please be advised that the water line is to be installed 4 feet below grade. The water line is shown close to a ledge outcrop. 12. All trench lengths are to be noted on the plan. Letter to: Marchetti Consulting - .Decembe00, 2003 13. All trench lengths are to be "dust free crushed stone or washed gravel." 14. The road is to be shown and road name provided on the plan view. 15. The septic tank should be shown parallel to the house. The sewer line should be shown perpendicular to the house. 16. It appears from the tax records that 34. -4 -1 is not the correct tax map number for this Lot. Please verify. If incorrect, revised all documentation to the correct tax map number. 17. A location map, minimum scale 1 "= 2000', is to be provided on the plan. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Robert Morris, P.E. Senior Public Health Engineer RM:tn enc. LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 17, 2003 Peter Marchetti, P.E. 25 High Ridge Road Pound Ridge, NY 61528 Re: Proposed SSTS: Feinberg Ice Pound Road, Lot 41 (T)Patterson, TM# 34 -4 -1 Dear Mr. Marchetti: ROBERT J. BONDI County Executive Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1- -Fill- plans- are to - be--submitted, as per- current -Putnam County Department of Health- guidelines. Plans previously submitted do not conform to current guidelines. 2. All sheets, e.g., 1 of 2, 2 of 2, of the SSTS engineering plans are to be attached by the design professional. Plans not submitted with separate sheets will be returned to the design professional. 3. Sewer line is to note a minimum slope of 1/4" per foot slope. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve ly yours, Robert Morris, P.E. Senior Public Health Engineer RM:tn LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 May 11, 2004 Marchetti Consulting 25 High Ridge Road Pound Ridge, NY 10576 Re: Proposed SSTS: Feinberg and Saunders 227 Ice Pond Road, Lot 1 (T). Patterson, TM #34 -4 -7.1 Dear Sir or Madam: ROBERT J. BONDI County Executive Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: 1: Trenches must be shown parallel to proposed contours. 2: -- Fill is to extend 10 feet horizontally past the edge of the trench. . 3. Side slope must be 3:1 maximum. 4. Minimum distance from a trench to the retaining wall is 20.5 feet. This distance is to be scaleable on the plan. 5. A waiver will have to be sought for fill depth exceeding 3.5 feet. 6. There are two proposed contour lines (834) this is not possible. 7. Stone wall detail is to be provided on fill and SSTS plan. 8. SSTS profile is to be shown on trench plan and fill plan. Fill plan profile is not to show trenches. The actual profile must be shown. Typical profile is not acceptable. 9. SSTS profile is to show clay barrier or per current code requirement. 10. SSTS profile is to show expansion area. 11. Please review the current Putnam County guidelines for the plan requirements for an individual SSTS and water well and for fill sections greater than 2 feet. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. r' Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve ly yours, U!L' Robert Morris, P.E. Senior Public Health Engineer RM: Im PUTNAM COUNTY DEPARTMENT OF..HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES7 DESIGN DATA SHEET - SUBSURFACE. SEW AGE.TREATMENT SYSTEM Owner J Address I, e-' Located at (Street) .7Zajl-� Tax Map. 3 el Block y Lot 7 (indicate nearest cross street) Municipality Watershed. SOIL. PERCOLATION TEST DATA Date. of Pre-soakine Date' of Percolation Te*st- 5--116 /,V:? )- y i, �-4,1 er ep . . . . . . . . . . . . . . . . . Ue7 -7 F V A .. . ..... "JD' .1 IMP R -win. NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min f6r 1-30 min/inch, -,5 2 min for 31-60 min/inch) All data to be submitted for review. A 2. Depth measurements to be made from top of hole. Form DD-97 AJQ Y— 2 0 /J -3 2 I- .2 4 .4 5 101i08 -/Q,,1 ./V 7 3 2 5 ----------- NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min f6r 1-30 min/inch, -,5 2 min for 31-60 min/inch) All data to be submitted for review. A 2. Depth measurements to be made from top of hole. Form DD-97 AJQ Y— 2 0 /J -3 2 3 4 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min f6r 1-30 min/inch, -,5 2 min for 31-60 min/inch) All data to be submitted for review. A 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN.TEST HOLES DEPTH:.. -HOLE NO HOLE N' Q. ' L' HOLE NO. 5 . G.L. ` .3 ly " tv le" 417-i .... 4S' . 4 -d � 5 to :. _ , . 7 10��p 5.0' Lc��c G. iyrt,'• 5.5'.... 6.5' sys'4 -,n L.''rn i Sysf'e� 5 7.0' 8.0 r,p 8.5' 8eloc•/ (5 _ 10.0' 2 �' Indicate .level at which groundwater is. encountered iv o;y Indicate level at which. mottling is observed 4,1 Indicate level to which water level rises after being encountered -�- Deep hole observations. made by: M5612 Date 5 6 03 Design Professional. Name: Address: Signature: Aar Design Professional's: Seal p�,D�k�to2 .�•%+ ov.��do� 1.5' j-, 2.0' 2.5' 3.5' x-e //,v r, G,ra,, so��c��• Lam,,:, 4.01 ••'fo �eA e _. . ` .3 ly " tv le" 417-i .... 4S' . 4 -d � 5 to :. _ , . 7 10��p 5.0' Lc��c G. iyrt,'• 5.5'.... 6.5' sys'4 -,n L.''rn i Sysf'e� 5 7.0' 8.0 r,p 8.5' 8eloc•/ (5 _ 10.0' 2 �' Indicate .level at which groundwater is. encountered iv o;y Indicate level at which. mottling is observed 4,1 Indicate level to which water level rises after being encountered -�- Deep hole observations. made by: M5612 Date 5 6 03 Design Professional. Name: Address: Signature: Aar Design Professional's: Seal p�,D�k�to2 .�•%+ ov.��do� IL PUTNIAM COUNTY DEPARTMENT- OF .HEALTH. -- v N DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVIDUAL /COMMERCIAL' SITE INSPECTION FORM SECTION A. GENERAL INFORMATION Name of Project 54U/1D0Z!; ( ) P.4M.50 *4) County Pll nZ '- Site Location 146 Po vD 2 - 7 20 _0� Building construction begun Extent Is property within NYC Watershed ? ................. F__] Yes F] No .SECTION B. TOPOGRAPHY (Please check all appropriate' boxes) 1. Hilly Rolling E:�" slope Gentle slope Flat �ipNJt? � j�j'c%cy� i5 %S APB 2. F1 Evidence of wetlands a Low area subject to flooding F7 Bodies of water Drainage ditches Rock outcrops-&, 3. Property lines or corners evident ....................... ............................... F7 Yes dNo 4. Do water courses exist on or adjoin the property? N.orz...`.< r:. z -0,2' 0 Yes No �; 5. Will these affect the design of the sewage system facilities ?............ F7 Yes d No 6. Do watershed regulations apply in this development ? ....................... Yes No 7 Will extensive grading be necessary? F7 Yes ffNb 8. Will extensive fill be necessary for SSTS? ......... ............................... Yes No 9. Do filled areas exist within the SSTS area? ........ ............................... 0 Yes ffNo If yes, what is the condition of the fill? SECTION C. SOIL OBSERVATIONS 10. Appearance of soil: F.I Sandl F Gravel Loam Clay Hardpan F7 Mixture 11. Observed from: T_� Borings 0 Bank cut E:Z"Backhoe excavations 12. Soil borings /excavations observed by , ZE E -0 c , '-D, r / on `5 13. Depth to groundwater rt10A1 � on 14. Depth to. mottling p^,/ on 15. Are test holes representative of primary & reserve areas ...... ............................... 16. Soil percolation tests made by ' TrTr g g_-4_,4r& p, F on 17. Soil percolation tests witnessed by 4 �1= -P >G., 'D. N , on SECTION D (on back) 0 Form ST -1 a 2 k k SECTION D-. "DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? F--] Yes ffTN o 19.. Will groundwater or surface drainage require special consideration? ..................... F7 Yes EZ'No 20. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... Yes ffN o SECTION E. REMARKS 21. If a common water supply is proposed; has an inspection been made of the existing or proposed source and facilities? ................................ ............................... 0 Yes No Inspection data 22. Do adjacent wells and/or sewage systems exist? ..................... ............................... Yes No 23. Additional comments `,� i-5 4--'.154. 1-01:55 A,41) 24. Site observer /inspector and title 25. Date(s) of observation(s)inspection(s) 6-11.6 l o TEST PIT PROFILES Hole # Lot # Hole # 'Lot # Hole # Lot # Depth to water Depth to water Depth to water Depth to mottling Depth to mottling Depth to mottling Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 .0.5 0.5 1.0 1.0 .1.0 2.0 2.0 2.0 3.0' 3.0 3.0 4.0 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 7.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 5 PUTiIADI COUNTY DEPART \IE \T OF HEALTH - DMSION OF ENVIRONMENTAL HEALtH INDIVIDUAL WATER SUPPLY & SUBSURFACE SENVAGE TREATMENT SYSTEMS REVIEW SHEET FOR QONSTRu,CTION PERMij NAh1E OF OWNER- STREET LOCATION: • REVIEWED BY: RIM, OR, AS, SRD ATE: k% I,. LAPa: (CO��%TED) Y 1 DOCUtiIENTS 1' ,' (REQUIRED DETAILS O\ PLANS CON-''D) (-J()PER`11T APPLICATION USE SEWER - VA" FT. 4"0'; TYPE PIPE CAST IRON. "(_)WELL PERMIT OR PWS LETTER (� NO BENDS; DIA\ BE \DS �5° \i7CLEANOUT UL--)PC -97 RENEWALS (_)(__)LETTER OF AUTHORIZATION SITE NOTE (O CK•kNGE) U(_)DESIGN DATA SHEET (DDS) FILL SYSTEMS (- JL-)CORPORATE RESOLUTION (__)10 HORIZONTAL; PAST TRENCH SLOPES 3:I TO GRADE UUSHORT EAF (_ jFI L SPECS.' FILL NOTES 1 -5 UUPLANS THREE SETS F L PROFILE d: DINSENSIONS ULUHOUSE PLANS -TWO SETS ILLL`i E.X"PANSIONAREA UUVARLkNCE REQUEST FILL GREATER MA\'2 FEET SUBD SION CLAY BARRIER `?FLEGAL SUBDIVISION FILL CERTIFICATION NOTE . SUBDIVISION APPROVAL CHECKED (JDEPT4- GAUGES UUPERC RATE s (JVOL ON PLAN FORRO.B., UNCLASSIFIED & I -NIPERVIOUS L_UUFILLREQUIR _,DEPTH U SEPaRXTION DISTANCE FROM TOP. OFSLOPE TAL i DRAIN REQUIRED TRENCH GENERAL NCH PROVIDED GOFT IYIAR. LOCATED IN NYC. WATERSHED ' p EL TO CO \TOURS . PLAN AION PROVIDED DELEGATED T'0 PCHD UST FREE CRUSHED STONE OR WASHED. GRAVEL. f EP APPROVAL, IF REQ'D. (�L()GEOTEXTILE COYER ' DEEP TEST HOLES 'OBSERVED PERCS'TOBEWITNE3SED _ SEPARkTIO`( DISSAtiCESONPLAN- FROlIS51'S'. ° -; 1010 P.L. DRIVEWAY, LARGE T_REESJOP, OF FILL . C—A R /,�. W D W \ - . V$ TLANDS 'ITOWI`i/DEC.PERbIU.REQ'D ?) 00` TO WELL, 200' Lti.DLOD; I50' TO PITS DATA-0l DDS:PLANS.&'PfiRi121T SAIiIE U 00"'!: O STREkM, WATERCOURSE, LANE Cih c. espid) PRE 19G9 NEIGHBOR-NOTIFICATION '0' TO CATCHBASIi1,35' STOiLrIDILkV, PIPED WATER LERBI/ZBA C--) ETT 10' TO VATERi:TI`IE its -20' -- -•- 100 YK FLOOD ELEVATION W/I200' - 50' LNTEpl'LNI - ENT DRAIN4G &COURSE . t SOIL TESTING LOTS>10 YEARS OLD 0200'/500' RESERVOIR, ETC._ 150' GALLEY SYSTEMS. DETAILS O S 0'b nTO LEDGE OUTCROP - SEWAGE SYSTEM .PLAN- (NORTHARROW), U SEPTICTAN (�SSDS HYDRAULIC PROFILE (J10' FROM FOUNDATION; 50' TO WELL ' GRAVTTY FLOW W- FLT OYSTRUQ'x'jQNKQTES_1.15_ — •- • - -(_)� DLSI•NSIOYSTO•PROPERTY -LriES ESIGN DATA: PERC & DEEP RESULTS LOCATION OF SERVICE CONi IECTION, CQN ZOURS EXISTING & PROPOSED UNIN 15' TO PROPERTY LIVE ' ' (6 IVEWAY & SLOPES. CUT' SLOPE OOTTNG /GUTTER/CURTAIN DRAINS SLOPE I`ii SSTS AREA 20% USDA SOIL TYPE- BOUNDARIES UU o � ) TITLE BLO CK; OWNERS NAME ADDRESS (_ LJREGRADED TO 15%, IF REQUIRED PHONE# DOSE/PUMP SYSTEMS bIA, PE/RA; NAME, ADDRESS, UUPUhIP NOTES ATE OF DRAWING/REVISIQN U( —) DOSE 75'/° OF PIPE V0LUME/DOS•E VOLUME NOTED DATUM REFERENCE (,J(JDETAIL FOR FORCE A•IAIN, (PIPE TYPA, ETC.) - U�C,LOCATION OF WATERCOURSES, PONDS L . AND D -BOX SHOWN & DETAILED - L'AKES,WETLANDS WITHIN 200 OF R.L. U PROPOSED FII`IISH FLQoRAND UL-.�1 DAY STORAGE ABOVE ALAIX MENT ELEVAT. 19 S cuRrArLnn arN _ WELL SSDS'S WAN 200' OF SSTS UUSTANDPIPES, 5' BOTH SIDES, DETAIL' UU15' bMf to CDS -->S %, 2014 %y•25' -3 %, 3S'•1 %, 160 % -<l% ER'TY METES &BOUNDS (_:_)U20' h12N to CD DISCHARGE /100' with 182 cons day discharge (_ jEROS10it�CONTROL FOR HOUSE, WELL & UU10' b0 to NON- PERFORATED PIPE SSTS, EROSION CONTROL NOTE . COMMENTS: (KEVSIiELT)09 /o1 /0a — LORETTA MOLINARI R.N., M.S.N. Acting Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Marchetti Consulting Engineers 25 High Ridge Road Pound Ridge, NY 10576 Dear Mr. Marchetti: ROBERT J. BONDI County Executive July 7, 2003 RE: Application to Construct a Subsurface Sewage Treatment System at Feinberg Ice Pond Road, Lot #I (T) Patterson, TM# 34 -4 -1 The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on June 12, 2003 is incomplete. Please be advised that the following information is required before the Department may commence its review. • Standard form PC -97 has not been submitted. • Short EAF has not been submitted. • Dates have not been provided on the Design Data Sheet. Futhermore, all data is to be noted on the Design Data Sheet, "see data by Gene Reed" is not submissable. (Enclosed). • House plans are considered to have (5) five potential bedrooms. • Zip code for owner applicant has not been provided on construction and well permits (enclosed.) The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2166. Ve / ly yo Robert Morris, P. E. MARCHETTI CONSULTING ENGIN ERS t Z�h�/ ���1� 7[2�w�G` /Vd ///y.C�� /M44CG OCR 4 ° ° GJ�104`t�Lad �' �{A� /�� // •I •VJ /� 4t4 .DATE... JOBN 4 F, 17 '� - - j RE: WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested For review and comment ❑ FOR BIDS DUE • Approved as submitted • Approved as noted ❑ Returned for corrections ❑ Resubmit ❑ Submit _ ❑ Return —copies for approval _ copies for distribution corrected prints 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS SIGNED: is _..��_�..��� �..� ...s .... �.. �...�I 47ww77.i ..i.IfA. i�c. s• .�wwe I DESCRIPTION mg c NOMMEN THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested For review and comment ❑ FOR BIDS DUE • Approved as submitted • Approved as noted ❑ Returned for corrections ❑ Resubmit ❑ Submit _ ❑ Return —copies for approval _ copies for distribution corrected prints 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS SIGNED: is _..��_�..��� �..� ...s .... �.. �...�I 47ww77.i ..i.IfA. i�c. s• .�wwe I PUTNAM COUNTY DEPARTMENT OF HEALTH _DIVISION OF-.ENVIRONMENTAL.HEALTKSE _ S _ WELL COMPLETION REPORT Well Location Street Address: 227 Ice Pond Road Town /Village: Patterson Tax Map # Map Block Lot(s) `GP.S ,ter Well Owner: Name: Address: Marchetti Construction, 25 High Ridge Road, Pound Ridge, NY 1057.6 Use of Well: 1- Primary 2- Secondary X Residential _Public Supply Air cond /heat pump _Irrigation Business Farm Test/monitoring —Other(specify) Industrial Institutional Standby Drilling Equipment Rotary _Cable percussion Compressed air percussion _Other(specify) Well Type - Screened _Open end casing _X Open hole in bedrock . Other Casing Details Total Length 32 ft. Length below grade 31ft. Diameter 6 in. Weight per foot 19 lb/ft Materials: Steel Plastic Other Joints: Welded Threaded Other Seal: _Cement grout Bentonite Other Drive shoe: Yes _ No Liner: _Yes No Depth Date Measure from land surface - static (specify ft) 30' Diameter (in) Slot Size Length (ft) Dept to Screen (ft) Developed? Screen Details First I _Yes _No Hours Second Well Yield Test _Bailed X Pumped _ Compressed Air Hours 6 lYield 5 gpm Depth Date Measure from land surface - static (specify ft) 30' During yield test (ft) 580' Depth of completed well in ft. 1000' Well Log If more detailed information-. descriptions or \ sieve Ana es zr are v jra ie, 6r _- pleaseattach. Depth From Surface Water Bearing Well Diameter (in) Formation Description ft. ft. Land surface * *WELL DRI LED BY OTHERS# _- If yield was. testgd' at different depths li during - drilling list: t,•.; Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5 gpm Depth 600 Model 5GS15412 Voltage 230 HP 12 Tank Type WX250 Volume 44 gal ons Date Well Completed N >_W :, Well `Driller PC Cert(ficate # State # n` Rump lrstaller, PC.Certif(cate' #..0245 NY State #NYRD1(J105 ...:. Date of Report ,12%5/06.;:.:... NOTE: Exact Location of well with distances to at least two permanent IandmarKS to be provided on a separate sneetipian. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06 N/F HYH A550CIAT�5, L.L-C rOIIIACKN� OMn ROAt2\\ VIV1510N OAP N LIAP NO, 1250 EOf —Efr (D 2A r -EOf -IA AMA- 2,869,AC-i- EDGE MAC 5.48- EW: �,�,R -,' 3 .-__. %Alt WALK & I-OVINCA Stow 5IMP5 PCLECTW) Jw Sf e L ,-L 5a'29'00"r N/ p 'OTHA' CKEp WELL A 5EP-nC 1"ANK 208' -O l PUMP CHAMPS P 46 ' _p l l PI3 -1 36' -pl J[3 -I 1150-011 J5_2 122'-611 JI3 -3 120' -p J3­4 1171-611 F-01" -IAA 115' -611 160' -pl � FO1" -2A0.1'_26._ �I ' -Oil 78.' 6-71 -Oil � 01=36 17-7' -p E p,r_ -1A� 621-611 175' -6 59' -011 *k F-Or - ENP Or- TENCH I TH15 151'0 CE1;1nFy THAI' THiE 56 5Y5TEM WA5 CON5-I�UC TEE A5 WA PLAN ANb THE 5Y5TFM WA5 IN INI�IC PEFOM If WA5 COVFpEn p� SP :Cj CON5TI;UCTE12 IN ACCOI;IbAN THE SfiANbApnS PULES C� WITH PUTNAM COUNTY HEATH ANf� �GULATION� I�EPAp1"MENfi OF HE ,n�Pfi, ANI� i11 -1'N,