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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -4 -86 BOX 14 01565 Re'v. 3L,86 PUTNAM COUNTY DEPARTMENT OZ; HEALTH !Division of Environmental Health Semces, Carmel, N.Y. 10512 Engineer Mast Provide �r� P C.H D. Permit }i— -- — CERNSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM P� �, 59-saly � Town• or-.Located Rv D Tax Map_ 11� Blocii atf��L - 7 Owner /applicant Name §.�OAI,- C O S A CA-, _Formerly : Subdivision Name j!/fpr/ Sabdv. Lot # jVlalWtg Addreee r��� DR Sit/, ilk .'/ -A%i, Zlp Date Permit Issued 41 Separate Sewerage System built by Address r // �OV V Gallon Septic Tank and 9& &E t J . Z L �. l� Ze- r • Consisting of Water Supply: Public Supply From Address or: X Private Supply Drilled by RIZ4 ` 0R14L/✓✓< nn Z /41C. Address _l 1/l x•14/1 AVO ,Q/ZLFV✓ -rrfe - /✓/ Building Type nr-SpI D10651MC IE Has Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been Installed? A Other Requirements I certify that the system(s) as listed serving the above premises were constructed essentially as shown on t lans of-the completed work ( copies of which are attached), and in accordance with the standards, rul r...and_re ulations, in accordance with th fi d plan, and the permit issued by the Putnam County Department Of Health. - / f Z— D 9 _ ��p Certified by °° P.E. F R.A. Date ��' / t Address 1 �s �� ✓�' '�� Lam' ` �� 1 �� /c S��Y /Y 7r• License No. �j ��0 Any person occupying premises served by the above system(:) 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 sewerage system shall become null and void as soon as a pub;': 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 Commissioner of Health, suchhmodification or change Is necessary, Date fD 4aC/ — —� Title If GRAVEL PACKED: to poll FORMATION D.SCXIMON 12 lFilled-ground & silt 2 30 Medium to 'hard fractured .0 300 Hard `grey &- blac'k' granite. I I Yigld war ts,rnd of oiffl,anr deorhl dwr✓,q drill:nq, hrl belo.+ F[IT •GAIlONS rER MINUTE 300 40 D,ometer or well Inclvdrng pro.el pock (invferl: SReteh tract loeatron of wall wrrh Orslances. to al Iasi/ rwo porrranent lan71"arrr41. i r . COUNT%' EN`FICC.. 4L)ILL)INC CA11MGL, NL W Y011[ lis report is to bc'eompleted by well driller and submitted to County+iealth Department together with laboratory report of alpi; of water ;ample Indicating water I; of satisfactory bacterial ou5llty before eertllic yce of conztruetion compliance is isiue:!. C'PORT"PJlt7ST"111 SUBMITTED MTH7W30 OF �•b'L•LL CO.M9 LET10'�` ►4.•+t AaaaEss rq DALE.& SANDRAE CUSACK ( Pine Driven RD #1010, Carmel, NY :O N (MO. L Slyd.lJ t Clown) (LOI h ✓mo.q lu Stone Hedge Estates Kent, NY 7 ❑ ED ❑ SED ESTA SNMENT DOMESi1C CL FAP A TEST WELL )F ?,UBLIC ❑ ❑ INDUSTCIAL AIR. ❑ CONDITIONING"• OTHER Iipac' t) SUPPLY RG COMPRESSED CABLE I'MUSSION ❑ PERCUSSION OTHER ❑ .EIIT 10 ROTARY AIR (So.dlr). ILlnG1n peNJ CIAMEILArrneAe31 IWOLP"I Ptl 1001 ❑ WELDED SMO:i' II WAS �A LNG 1�—C 0vuD OX YES L_JNOI LJ LS 47 6 19 THREADED YES u NO ❑ ❑ MOULS DX 4 G.P.*A. 40 YIELD 40 BAILED PUMPED COM!RESSED AIR ;q htE!SU1! I&OM LAND SURFACE— SIAIIC(SOcclirNet/ aURING YIELD TESL 1 /eOtJ Qeptb of Completed Well L 30 .300 In reel below Lund wrio:e: 300 , A"L I:NGTtt O►E:i TCJ AGUIFE: :N ;S SIGs Sa. alArtETER lincnas) G1AVEl SIZE Uncnes/ t1OM 110111 TO 110#t/ If GRAVEL PACKED: to poll FORMATION D.SCXIMON 12 lFilled-ground & silt 2 30 Medium to 'hard fractured .0 300 Hard `grey &- blac'k' granite. I I Yigld war ts,rnd of oiffl,anr deorhl dwr✓,q drill:nq, hrl belo.+ F[IT •GAIlONS rER MINUTE 300 40 D,ometer or well Inclvdrng pro.el pock (invferl: SReteh tract loeatron of wall wrrh Orslances. to al Iasi/ rwo porrranent lan71"arrr41. i r . too EXPANSION ARE A �e i � w "° V '.' Lyra a �1 / I000 SA L• ExIS-T. WELL Ij14"LF ASS TgENaN 2 y.'EPTICTANK 52• 14 15 4' 1 4 c.I.P. 6XIB-TiW6 3 BR. 16 41 5� 5 RESIDENCE 17 0 3 6 IB 7 B 19 4 8 20 40' 9 21 41' Io +. q SOLD PVC (rYP) 22 Lc0 y Z3 Lac " 1a �J. Box (TYP) 4 v L o� _ 150. -III N07 °57'37 "F 60.00' NO2° 21'54" W TAMMAl \4Y HALL RD Putnam Counter DegartmtMt of Dealt" Division of Environmental health Services 1Ppr ed as notedf.or conformance with a lice ale Pe. :s and r'egal.ati.ons of the �Pu',nam C I ty Pealth Depart lit PROJECT: PROPO: '14,4 TAMMANY PA'tTERSON G'L�E1.T JOHN I RICNh pl AWING, TITLE AS- BU i t S: r t; �.M DIMENSION CHART (in feet) Number A V 13 28 2 .22 39 3 23 35 4 .24 31 5 27 27 6 32 25 7 36 24' g 41 25 9 46 27 10 52 30 II 57 34 12 62 39 13 70 79 14 70 77 I S do 73 16 .. 69 72 17 66 66 IS 68 66 19 71 66 20 73 66 2 1 79 69 22 96 g8 23 99 90. R O O I? 0 P n L9 o oo 0 -._.- 0 ®xPANS(0N 1 PUTNAM COUNTY DEPARTMENT OF HEAME DIVISIOiV OF ENVIRO I'AL .HEALTH. SERVICE'S. . Owner or Purchaser of Building Section Block Lot BuiLding Constructed by L3uL_ �Ao "r--r _R�AJZ�, Location - Street o Y] Municipality Building Type _STo�.JEHE�E s= ST.�T'ES Subdivision Name Subdivision Lot # GUARAN= OF SUBSURFACE SEWAGE DISPOSAL SYSTEM A/ , � I represent that I am �h�?i1• era v responsible for the location, worknanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 Construction _Compliance"._far_ -the. sewage disposal_' system.- _or_.any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. S,0 wi ELLIS A. TARLTON LABORATORY DIVISION OF• ELLIS` A. TARLTON, ENGINEERS, INC. CHEMICAL r' 34 PLEASANT STREET DANBURY, CONN. 06810 WATER -WASTEWATER PHYSICAL.c . � METHODOLOGY BIOLO�ICPL....-- _- P.O. Box• 246. . 203_.748 - .7903.........__.._._ �...._._. APHA WQO - ASTM REPORT OF BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF WATER NAME AND ADDRESS OF-1l Drilling, Inc. SOURCE OF SAMPLE PERSON TO Water Supply Cusack RECEIVE Putnam Ave Bullet Hole Aoad REPORT Carmel, N.Y. Brewster, N,Y, 10509 _ DATE OF COLLECTION Sept o 201 1985 DATA COLLECTED BY Mill Drilling Hydrogenion COLOR TURBIDITY ODOR CORROSION INDEX DISSOLVED SOLIDS Concentration LANGELIER (P„) RYZNAR NTU Mg /L Alkalinity as CaCO3 Fluoride (F) Bicarbonate Nitrite Mg /L Mg /L Mg /L NITROGEN Alkalinity as CaC0 3 Chlorine Residual Carbonate CONSTITUENTS. Nitrate Mg /L Mg /L Mg /L AS Total Hardness as CaCO 3 NITROGEN (N) Ammonia M9 /l Mg /L Mg /L Albuminoid Mg /L Iron as Fe Mg /L Mg /L Chlorides as CL Mg /L Manganese as Mn Mg /L Mg /L Detergent as MBAS Mg /L Sulfate as SO4 Mg /L Mg /L Tfi6—Arifhhiefic'me'bn of• °AII''st'andard samples ""examined "paT month using the' membrane, filter technique shall not exceed MEMBRANE FILTER TEST one colony per 100ml. Coliform colonies per standard sample shall not exceed 3/50m1, 4 /100m1, 7/200m1, or 13/500ml Coliform Colonies /100ML in: (a) Two consecutive samples; (b) More than one standard sample when less than 20 are examined per month; or (c) 0 More than five per cent of the samples when 20 or more are examined per month. © 1. The results of the analysis of this sample are satisfactory and meet requirements lore potable water. F] 2. The results of the analysis of this sample satisfactory for a potable water but certain of the chemical or physical constituents are high. These are as follows: F] 3. This sampla is not satisfactory since it does not meet the bacterial requirements for potable water. The presence of organisms of the colitorm group in a sample of potable water is undersirable and, while not necessarily Indicating the presence of any disease - producing organisms, does indicate that such contamination might survive to the same extent. The presence of organisms of the coliform group may also Indicate that the treatment was not adequate at the time the sample was collected. El4. This sample is unsatisfactory as a potable water because certain chemical or physical constituents are above acceptable limits. These are as follows: COMMENTS Certified 4 ;; 0 ° 3 l -gam ma' 2 j `' • � �., .. �. .��` . °_.. ��'� 111 1 :'� i�i ` ''; •,, ': 'e'' i , I ` .. a:e, �f1ti: .[il.:i' �; }lh- rt2.i{ie „• "T'(1!t ; 0!, 1 T oFpT 94F, p� ..0� Notes, 1). Tests to be . repented.. at sawe depth unt..1. ; a e. �I soil Mites are 0bta d • et each. per�cal.atJ on test hole. �• data. to be axi�uitteed. L :Depth mu6summents to. be tradij fjro , i:ap of hale.. `. 4. PUTNAM COUNTY DEPARTMENT OF HEALTH i DIV13ION-OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEI, N. -Y. 10512 _............ DES IGN DATA 3j1f= -•` ABATE SEWAGE DISPOSAL SYSTEM FILE NO.�_.„�,� , .....Owner D21 Addres f-D", °C� c� c "� � X14 -Wd �q Located at (Street g. Sec . Block I�ot % 1 .l ca a nearest s, c oss s -ree , . ter "�i� �� Wa shed C. SOIL PP:RCOI,ATION .TEST DATA REQUIRED �'0 BE SUBMITTED WITH APPLICATIONS DATA — RS s- --- �--- -- 7 Ole Numbur CLOCK TIME PERCOLATION PERCH' TION "Run apse pt o Water WaterIevel No. Time From Ground Surface in Inches '" Soll Rate .•. Start- Stop. Mid. Start Stop Drop in Min. /ip drop Inches Inchea Inches t"'1 �307f- ; 19 V � 2 4 ;; 0 ° 3 l -gam ma' 2 j `' • � �., .. �. .��` . °_.. ��'� 111 1 :'� i�i ` ''; •,, ': 'e'' i , I ` .. a:e, �f1ti: .[il.:i' �; }lh- rt2.i{ie „• "T'(1!t ; 0!, 1 T oFpT 94F, p� ..0� Notes, 1). Tests to be . repented.. at sawe depth unt..1. ; a e. �I soil Mites are 0bta d • et each. per�cal.atJ on test hole. �• data. to be axi�uitteed. L :Depth mu6summents to. be tradij fjro , i:ap of hale.. `. 4. T T PIT DATA REQUIRED TO BE SU143MIl`TJM WITH APPLICATION INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE WATER `LEVEL RISES AFTER, BE�[,NG..ENC_0_iJJN'T _ rt- �'E.S'1`S "MA13�Y L1t i�1 Irate e r`IY 15 5 L�'.alV1V soil Tkate U3ed__;2.XjrVj "Drop: S.D. Usabl No of Bedrooms Septic Tank Capacity /0, Absorption Area rov 6 By L. F. x24" cat £rir�,i�i. Address i:'c'YU. y:,Fy sib • THI3 SPACE,. FOR :USE .BY HEALTH DEPARTMENT ONLY.' �! Soil Rat: ApF►;roved Checked by Data It it �MIAA!AAIAAMAV.1AVAA, P: MMA /MYMdM7MtlMCAAlAAF"AAMAIRAMAIM / .. <. ,.... 14 Lf` •. _ *i_ �.:aGT = .T.�.'.'__ ti�r�4 tZ R^_C':F •.f 2 ro F, ) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'CONSTRUCTION'PERMIT FOWSEWAGE TREATMENT `SYSTEW ._.M' PERMIT # 13 Y' O Located at I b 4 TA-rtiovAA_1P; h VtAic, a&A -o or v i age ���Y"C11j Subdivision name Subd. Lot # b Tax Map 3/ Block _j Lot Date Subdivision Approved 1 It 0c) Renewal Revision r Owner /Applicant Name j o t,{ N rA t (LA P, i L.l o Date of Previous Approval Mailing Address I O aer&c� pv 04 K Zip Amount of Fee Enclosed ' 30c) Building Type Oj�� l Lot Area 0-14 A No. of Bedrooms 3 Design Flow GPD 60o Fill Section Only Depth 5 Volume PCHD NOTIFICATIO IS RE UIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 12SV gallon septic tank and To, z�i L.F Other Requirements: i OF F ► Lk_ To be constructed by Ti3 0 Address Water Supply: Public Supply From Address or:-.-. )(- Private Supply.Drilled_by - 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 system described above will be constructed as shown on the approved amendment thereto and in :r ccordance 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 any repairs thereto. Signed: _Adt- P.E. R.A. Date D Address 3 fi l i r2ojrn�5- L0 . t314� S_rk'( N 1c y l License APPROVED FOR CONSTRUCTION: This approval expires-two years from the date issued unless construction of the sewage treatment system has been completed an'd inspected by the PCHD and is revocable for cause or may be amended or modified w c nsidered necessary by the Public Health Director.-, Any revision or alteration of the approved plan requires a new perni Pproved fhAdischarge of domestic; sanitary, sewage -only. By: / �� Title:.. �i"� Date: Z Z �/ White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNA1M COUNT TY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ^ APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWX ERTREATMENT S'Y'STEM 1. Name and address of applicant: John Mirabilio 1 Richmond Road Poughkeepsie, NY 2. Nameofproject: Rosewood Subdivision 3. LocationT/V: Patterson P.W. Scott, Engineering 4. Design Professional, & Architecture , P . c . 5. Address: 3 8 7 1 Route 6 6. Drainage Basin: East Branch Reservior Brewster, NY 10509 7. Type of Project: X Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted x 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... N o 10. Has DEIS been completed and found acceptable by Lead Agency? ............... N/A 11. Name of Lead Agency Town of Patterson Planning Board 12. Is this project in an area under the - control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... Yes 13. If so, have plans been submitted to such authorities? ........ ............................... Yes - S ub.d i v i s i o n 14. Has preliminary approval been granted by such authorities ?Y e s Date granted: 8 /19 7 15. Type of Sewage Treatment System Discharge................. surface water X groundwater 16. If surface water discharge, what is the stream class designation? .................... 17. Waters index number (surface) .......................................... ............................... 18 N/A N/A Is project located near a public water supply system? ....... ............................... N o 19. If yes, name of water supply N/A Distance to water supply N / A 20. Is project site near a public sewage collection or treatment system? ................ No 21. Name of sewage system Individual Lot Distance to sewage system 22. Date test holes observed 3/?6/.96 23. Name of Health Inspector M i k e ,B u d z i n s k i 24. Project design flow (gallons per day) ................................. ............................... 600 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... N o 26. Has SPDES Application been submitted to local DEC office? ......................... N/A Form PC -97 27. Is any portion of this project located within a designated Town or State wetland? No 23. Wetlands ID Number ......................................................... ............................... N/A ..� 29. Is Wetlands Permit required? ........................... No Has application been made to Town or Local DEC office? ............................... N/A 30. Does project require a DEC Stream Disturbance Permit? .. ............................... N o 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No o 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 N o DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... Y e s 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... Yes 35. Are any sewage treatment areas in excess of 15% slope? . ............................... No 36. Tax Map ID Number .......................... ............................... Map M. Block Lot 0(a 37. Approved plans are to be returned to ..... Applicant X Design Professional NOTE: All applications for review and approval of a new SSTS to,be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval..of t4. "SS.TS prior to..final.approval by the Department. - Projects- within-the'watef-shed-inay 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 I.,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. _Fats ments made herein are punishable as a Class A misdemeanor pursuant to Secti�0�45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: Peer W. Scott; P.E., R.A. - Agent for Applicai Mailing Address: 3 8 7 1 Route 6 Brewster, NY 10509 BRUCE -R: 'FOL'EY -- Public Health Director DEPARTMENT OF 1 Geneva 'Road Brewster, New York 4LORETTA MOLINARI R.N., M.S.N. ~+ Associate Public Health Director Director of Patient Services HEALTH 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Peder Scott, P.E. PW Scott Engineering 3871 Route 6 Brewster NY 10509 Re: Proposed SSTS: Mirabilo 164 Tammany Hall Road, Lot #8 (T) Patterson, TM# 34 -4 -86. Dear Mr. Scott: August 22, 2001 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. The minimum of three feet of fill is to be provided for the entire expansion area. Reserve trenches 1, 2 and 3 do not show adequate fill. 2. Trench detail and drop box detail are not to be shown on the fill plan. 3. Minimum distance from the toe of the fill to the property line is 10 feet. 4. Areas of the SSTS are proposed on slopes greater than 15 %. 5. Minimum distance from the fill to the curtain drain is 15 feet. 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, 4�� /V"�, " (-r,) Robert Morris, P.E. Senior Public Health Engineer E7Tm PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner VVkLtZA lbj"c� Address I 9-ictimoNo (zcL*A Foul ou� slu-j Ni'l Located at (Street) [(,L( AA-tL "Ao Tax Map bq Block Lot I (indicate nearest cross street) Municipality Watershed v-A,6r- f �aA+j<-i( SOIL PERCOLATION TEST DATA Date of Pre-soaking -4 1 � Date of Percolation Test ...... .... . . . D e p th , 6, t r Water X ............ ..+.. . +..'......... - . From Ground rc 41 o n :+ Hole N ' R 6 Time * rt Stop EIa se Time Surface C e Start Stop :D I . t iVlrnflnch ..... . ... ............ . ...... n . .. . .... J�3i -I' .14 2 Z: 3Z' 3u ya 3 y- 1.33 -3 60 g-611 4* 5 J" 2 p,-00 2-:30 L) 3 4 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 min/inch, :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 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: I11, LW 4 D Dk--p Date 3 a—u Design Professional Name: P. w. S cow Address: 3 W I ( ( , A 13338 Design Professional's Seal TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES - DEPTH ...... _._._ _... _HOLE NO. KA HOLE NO... HOLE NOw G.L. 0.5' J 1.0 LoAv- n ibaerw. j LC mow. 1.5' 2.0' ,. " i 4' 2.5' 3.0' 3.5' 4.0' 4.5' S, t 5M►0 Lofto,- s+ L IS&NO t.uAIIN St L SA-#,JQ ipAaw 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' i1`3�' Y�it -KIT P.T -nor p,r 8.0' 8.5' _ ... 9.01 9.5' 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: I11, LW 4 D Dk--p Date 3 a—u Design Professional Name: P. w. S cow Address: 3 W I ( ( , A 13338 Design Professional's Seal J 3 .. „STATE OF'NEWYORK-: DEPARTMENT OF STATE 41 STATE STREET ALBANY, NY 1 223 I -000 I F. TREADWELL tY OF STATE February 22, 2001 ` 1 ; �Mr. Robert Hoffman Muncy Homes,lnc. PO Box 246 - Route 442 East Muncy, PA 17756 -0246 Re: Approval No. M 1387 -97 -024 Manufacturer No. 1387 Dear Mr. Hoffman: Your request for an extension of the expiration date of Factory Manufactured Home Approval No. M 1387 -97 -024, applicable to a system for one and two family dwellings, is hereby granted subject to the conditions of the initial approval. In addition, the manufacturer shall be responsible for assuring that homes or components bearing insignias issued during the extension period also comply with the current requirements of the NYS Uniform Fire Prevention and Building Code. expire 'on April 12; 2001. A copy-of this ietter shall- •accompany plans or specifications submitted for a building permit and be deemed .a duplicate original. I am hopeful.that you will find this extension of assistance. �ery truly yours, George E. Clark, Jr. Director, Codes Division HTTP : / /WWW.DOS.STATF-.NY.US ° E-MAIL: INFO @DOS.STATE.NY.US RECT LM PAPCR PUTNAM COUNTY DEPARTNIENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERbIIT NANIE OF OWNER: STREET LOCATION: REVIEWED BY: RM, GR, AS, SRDATE: DOCUMENTS PERDIIT APPLICATION. —66—)WELL PERi1IIT OR PWS LETTER (_j(__)LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION SHORT EAF PLANS -THREE SETS HOUSE PLANS - TWO SETS C-ffC_-)VARlANCE REQUEST SUBDIVISION ( _JULEGAL SUBDMSION L__)L_)SUBDIVISION APPROVAL CHECKED UUPERC RATE U(.,)FILL REQUIRED DEPTH U CURTAIN DRAIN REQUIRED GENERAL LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP DELEGATED TO PCHD (� DEP APPROVAL, IF REQ'D (DEEP TEST HOLES OBSERVED �PERCS TO BE WITNESSED EX- APPROVAL SSDS ADJ, LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) DATA ON DDS PLANS & PERMIT SAME PRE 1969 NEIGHBOR NOTIFICATION LETTER BI/ZBA C_)IOD YR. FLOOD ELEVATION W/I200' (�USOIL TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE LiGRAVITY FLOW (CONSTRUCTION NOTES 1 -15 - -- Li __)DESIGN DATA: PERC & DEEP RESULTS (__)(__)2' CONTOURS EXISTING & PROPOSED (j( JDRIVEWAY & SLOPES, CUT ' ( J( JFOOTING /GUTTER/CURTALN DRAINS (__)(USDA SOIL TYPE BOUNDARIES (__J(__)TITLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# (__)(__)DATE OF DRAWINGIREVISION (_J(__)DATUM REFERENCE (_)(JLOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. ( _JUPROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS . C_)UWELLS & SSDS'S WAN 200' OF SSTS ((__)PROPERTY METES & BOUNDS. UUEROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (ItEVSHEET)09 101/00 TAX btaP-: (CONFIRNIED) Y N (REQUIRED DETAILS ON PLANS CON'T'D) LUUHOUSE SEWER -' /�" FT. 4"0'; TYPE PIPE CAST IRON UUNO BENDS; \IAX BENDS 450 W /CLEANOUT RENEWALS UUSITE NOTE (NO CHANGE) FILL SYSTENTS x)(__)10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE UL_)FILL SPECS! FILL NOTES 1 -5 (_J(UFILL PROFILE & DIMENSIONS LUUFILL IN EXPANSION AREA FILL GREATER THA.V 2 FEET UU CLAY BARRIER UUFILL CERTIFICATION NOTE LPL _)DEPTH GAUGES UUVOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS UUSEPARATION DISTANCE FROM TOE OF SLOPE TRENCH UULF TRENCH PROVIDED LOFT MAX. U( JPAP-kLLELTO CONTOURS. UU100% EXPANSION PROVIDED UUDETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL UUGEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS (-- )( _J10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL U(__)20' TO FOUNDATION WALLS C_)(_J100' TO WELL, 200' IN DLOD,150' TO PITS (.__)L_)100' TO STREAM, WATERCOURSE, LAKE (Inc. espau) . U(_j5O' TO CATCH BASIN, 35' STORlYIDRAIN, PIPED WATER (_)(-)10',Tq NVATER LM.(pits -.20') , - UU50' LXTERAITIT'ENT DRAINAGE COURSE (__)U200' /500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (__)U10' bIIN TO LEDGE OUTCROP SEPTIC TANK L_J(__)10' FROII FOUNDATION; 50' TO WELL WELL UUDIMENSIONS TO PROPERTY LINES _ .... _ _ _ _.._ -... _ _......_.__ _..... ( J(__)LOCATIOii OF SERVICE CONNECTION (__)U.IIlN I5' TO PROPERTY LINE SLOPE UUSLOPE IN SSTS AREA (920 %) ((__)REGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS C_)(__)PU,IIP NOTES (__)(__)DOSE 75% OF PIPE VOLUNIE/DOSE VOLUME NOTED (__)(JDETAIL FOR FORCE MAIN, (PIPE TYPX, ETC.) UUPIT AND D -BOX SHOWN & DETAILED U(__)l DAY STORAGE ABOVE ALARM CURTAIN DRAIN (__ (_JSTANDPIPES, 5' BOTH SIDES, DETAIL (_JL_J15' DIIN to CDS = >5 %, 20'-4%,25'-3%,35'-1%, 100%-<I% (_)L_)20' NIIN to CD DISCHARGE /100' with 182 cons day discharge ( J( JIO' MIN to NON - PERFORATED PIPE P. W. SCOTT Engineering & Architecture, P.C. 3871 Route 6 BREWSTER, NY 10509 E -Mail: pws @bestweb.net _(914) 278 -2110 FAX (914) 278-21-66_ T 14 'LMQ'-S� S1 -tosoe WE ARE SENDING YOU ❑ Attached • Shop drawings • Copy of letter ILIEC�TlgQ @IF DATE % < ,� JOB NO. RE: a O ❑ Under separate cover via ICI the following items: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: if enclosures are not as noted, kindly notify us at once. P. W. Scott Engineerinc 3_871 Route Brewster, N September 17, 2001 & Architecture 6 _ Y 10509 Robert Morris P. E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Rosewood Subdivision Mirabilio Lot #8 164 Tammany Hill Road (T) Patterson (34 -4 -86) Dear Robert: The following is a response to your memo of September 13, 2001. email: pwscottLrcn.com (845) 278- 1. The well has been relocated to allow 100' distance separation from the toe of slope. 2. The septic design will remain the same as originally designed. 3. The dimensions to the well have been added to the fill plan. Please accept the revised plans for consideration Wi ar s, P der W. Scott, P.E., R.A. President W -- 4 ;,1'1,✓ .j k'. ". " 5)U A R C H I T E C T U R E * E N G I N E E R I t� I �} y� Ey L A N N I N G ... ..� • : � -. �. ,,,. ,r ,;,' <c ;-,`, ;;�k�l �,.� ..; ._ C'(�, �1r;9 � �;5 �l hl �i r r�.:i ',? sic J i..� J0 1 nvu1[ o ty14) _�/6-:I t BREWSTER, NY 10509 FAX (914) 278-2166 LETTER OF AUTHORIZATION Re: . Property of - ,C)t+1O M t P_'4' 1 L► 0 Located at 1(A Tp, MA, tj A. X_ 9-OAM TNFA,Tr- YLsot3Tax Map # Block Lot 8(�o Subdivision of F-65-e W 00 n Subdivision Lot # 8 Filed Map # -So Date Filed Gentlemen: This letter is to authorize Peder W. Scott, P.E., R.A., a duly licensed Professional Engineer X or Registered Architect X to apply for the required wastewater treatment and /or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and /or water supply systems in conformity with the provisions of the Public Health Law and all applicable Sanitary Co es. Very truly yob' C ntersigned: Pe der W. Scott, P.E., R.A. P.E., R.A. #: � cj 3- (Q Mailing Address: 3871 Route 6 Brewster, NY 10509 (914)268 -2110 Signed: (Owner.of property) Mailing Address: I 1p_I c.�l-w 0&310 P-10 Pvv4 m6e- p.5 1 N 11Co O3 Telephone: gam} 5- - 417 1- Sl 9 9 A R C H I T E C T U R - E N G I N E E R I N G - S I T E E P L A N N I N G BRUCE R FOLEY Public Health Director r _- ^LORETTA ~MOLINARI RN., M.S.N. v Associate 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 (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 June 19, 2001 P.W. Scott Engineering 3 871 Route 6 Brewster NY 10509 RE: Application to Construct a Subsurface Sewage Treatment System at Mirablio Tammany Hall Road, Lot #8 (T) Patterson, TM# 34 -4 -86 Dear Mr. Scott: The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on June 1, 2001 is incomplete. Please be advised that the following information is, required before the Department may commence its review. ® Fill .plans are to be submitted as per Putnam County Guidelines ST -19. Please be advised that a 7 foot curtain drain is required as per the subdivision plant titled "Rosewood Subdivision ". Thee 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. RM:tn Senior Public Health Engineer %f P. W. SCOTT Engineering & Architecture, P.C. 3871 Route 6 BREWSTER, NY 10509 E -Mail: pws @bestweb.net FAX '(914) 278 -2166 TO Putnam County Dept. of Health 4 Geneva Road Brewster, New York 10509 WE ARE SENDING YOU ❑ Shop drawings ❑ Copy cf letter 2I T"TEE � O7 IT ° H @lti i ccr LJ 6 L ❑ Attached ❑ Under separate cover via the following items: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPIES DATE NO. DESCRIPTION Application for Approval Construction Permit for Sewage Treatment System (form CP j Letter of Authorization (form LA -97or CA -97) Design Data Sheet (form DO -97) Short Form EAF House Plans'(2sets) Application to Construct a Well (form WP -97) Check # ' for the amount of THESE ARE TRANSMITTED as checked Eelow: n g s ❑ For approval ❑ Approved as subm!tted ❑ For your use ❑ Approved as noted As requested ❑ Returned for corrections For review and comment ❑ ❑ Resubmit copies for approval ❑ Submit copies for distribution 7.; Return corrected prints ❑ FORBIDS DUE C1 PRINTS RETURNED AFTER LORAN TO US REMARKS l � I I Ui-'YZ- Es C��110,&l �— t� HM) ill &—&JJ LZ� !r_-.IFD 9 Engineering Brewster: -NY ' 1 May 24, 2001 Robert Morris P. E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Rosewood Subdivision (T) Patterson Lot #8 - Waiver Request Dear Robert: P. C. email: A Please find enclosed a Septic Site Plan for a 3- bedroom residence to be located on Lot #8. Due to the elimination of the Putnam County Department of Health waiver for construction of septics on slopes over 15 %, the septic cannot be constructed in compliance with the Putnam County Department of Health regulations. The plan submitted includes 500 LF of primary and 500 LF of reserve - 24" wide trenches, which are in compliance with the regulations. The waiver deals with the reduction of the setbacks for the reserve septic fill area. In order .to_ locate the septic fields, within the terrain on the site, the fill setback must be reduced-to 6 feet, where a fill slope extends to the property line. The waiver is therefore the reduction of the setback from 10' to the toe of the slope to (0') zero feet. Beyond the property line is the expanded right -of -way for Tammany Hall Road. Please accept this package and schedule a waiver review meeting at your earliest convenience. .r'W. Scott, P.E., R.A. ident A R C H I T E C T U R E * E N G I N E E R I N G ` S I T E P L A N N I N G Cocci. m nts'kOpen Projects\Kosewood\LTR Morris (WAIVER LOT 8) 02- 24- 01.doc. net 278 -21.10 __.. _..... 278 -2166 - P. W. Scott Engineering & Architectui 3871 Route 6 - �- "B�ewster: �IVY`�1 Q609� August 27, 2001 Robert Morris P. E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Rosewood Subdivision Mirabilio Lot #8 164 Tammany Hill Road (T) Patterson (34 -4 -86) Dear Robert: P.C. The following is a response to your memo of August 22, 2001. email: 'FAX 1. The plan has been modified to reflect 3.0 feet of fill minimum across the site. Reserve Trenches 1,2 & 3 have the 740 contour defined to reflect proper fill. 2. The details are deleted from the Fill Plan. 3. The toe of the fill is 10 feet from the property line. The fill extends to original grade 10' from the property line. From this point, to maintain a graded slope, common fill is added up to the existing stone wall to a depth of 2.0 feet. Therefore the SSTS -•••• - complies- with.- general statues. The subdivision- was--approved with SSTS areas - defined on slopes greater than 15 %. This design criterion was the basis for the design of the project and therefore requires waiver from the State Department of Health. If an application to the State DOH is required by this office, please notify this office so we may complete this SSTS design. 4. The curtain drain has been relocated to ensure the setback is accurately defined on the SSTS Plan. Please accept the revised plans for consideration With regards, Peder VScott P. R. A. President A R C H I T E C T U R E * E N G I N E E R I N G * S I T E P L A N N I N G ,-, aT ) i}$-: %l..01 C1C:; MITI 278 -2110 278 - 2'166 P. W. Scott Engineering & Architecture, 3871 Route 6 Brewster. NY-'10509, "-_..— August 27, 2001 Robert Morris P. E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 RE: Rosewood Subdivision (T) Patterson Lot #8 - Waiver Request Dear Robert: email: FAX .net 5).278:211. 5) 278 -216 Please find enclosed a Septic Site Plan for a 3- bedroom residence to be located on Lot #8. Due to the elimination of the Putnam County Department of Health waiver for construction of septics on slopes over 15 %, the septic cannot be constructed in compliance with the Putnam County Department of Health regulations. The plan submitted includes 500 LF of primary and 500 LF of reserve - 24" wide trenches, which are in compliance with the regulations. Please accept this package and schedule a waiver review meeting at your earliest convenience. With regards, 1 , Peder W. Scott, P.E., R.A. President ARCH ITECTURE *ENGINEERING *SITE PLANNING ASV()- )j1V_TR i'viof r l 0 IA!,1 ER 1_C1! S) 05- 24- 010RE -V 1 . �i C Q: - _-6 .... _ .. BRUCE .:R.:-TOLE-Y-- Public Health Director. 0 _r :. _,..... - :-- LORETTA MOLINA FRX-, Associate 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 July 17, 2001 Peder Scott, P. E. PW Scott Engineering 3871 Route 6 Brewster, NY 10509 Re: Proposed SSTS: Mirabilio 164 Tammany Hall Road p'' (T) Patterson TM #34 -4 -86 Dear Mr. Scott: 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: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. 1. The - minimum of three feet of fill is required on all of the SSTS areas. 2:' 'Trendies i`n the fill - profile and the tren -ff,- tail are not to be shown on the fill plan. �3 Minimum scale of the location map is to be 1" = 2000'. The volume of ROB, common and impervious fill is to be noted on the fill plans. Well location is to be dimensioned from 2 property lines. Standpipe detail is to note minimum depth as seven feet. �7. Erosion control measures for the well is to be shown. Curtain drain detail is to note cover as geotextile material or equivalent. Depth gauges are to be shown and detailed. Curtain drain standpipe location are to be clearly shown and labeled. E Minimum distance for the toe of slope of the fill to the property line is ten feet. X1'2. Minimum distance from the fill to the house foundation is 20 feet. X13. Areas of the SSTS are proposed on slopes greater than 15% (22 %). %- -.i -2- 14. Minimum distance from the fill to the curtain drain is 15 feet. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM/jp Very ly yours!, ILI- Robert Morris, P. E. Senior Public Health Engineer -BRUCE, R;,_. FQLEY. _ ..... _... - Public Health Director DEPARTMENT OF HEALTH .1 Geneva Road Brewster, New York .10509 LORETTA- Iv10LINARI R.IV.;' N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Peder Scott PW Scott Engineering 3871 Route 6 Brewster NY 1009 Re: Proposed SSTS: Mirabillo 164 Tammany Hall Road, Lot #8 (T) Patterson, TM# 34 -4 -86 Dear Mr. Scott: September 13, 2001 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.. -. -. -The proposed well is to be minimum- of 100 feet from the toe of the fill. - - 2. Michael Budzinski, Director of Engineering, has revised the codes for fill sections greater than 2 feet in depth. The measurement is now 20 feet to the trenches. This may help in the proposed design. 3. The trench plan and fill plan is to note the dimensions of the proposed well location from two property lines. 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 ly yours, Robert Morris, P.E. Senior Public Health Engineer RM:tn PUT NAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL PCHD Pertnil` i'" ` o _ ........:...;..: . Well Location: Street Address: Town/Village Tax Grid # 11041 VVP -MA-4 RAc ROA,O , P,'�-7G'- gu0Map B�{ Block i Lot(s) 6(E, Well Owner: Name: Address: 11- Use of Well: Residential Public Supply Air/ ond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served Est. of Daily Usage feo 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 9-0 Lot No. F3 Water Well Contractor: J'15 D Address: Is Public Water Supply available to site? .................................. ............................... Yes No X Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: Applicant Signature: LAt 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 y revision or alteration of the approved plan requires a new permit. Well to be constructed by a wat wel driller certified by Putnam County. Date of Issue b Z , D Permit Issuing O Date of Expiratio d Title: Permit is (von- Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM a ) Lli Owner or Purchaser of Building Tax Map Block Lot Building Constructed by TownN4age Tnt� WA CA Location - Street Subdivision Name �Zj! d-e-,J -a Building Type Subdivision Lot # I.represent.that I am wholly and comp letely -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 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 The undersigned further agrees to accept as conclusive the determinati Director of the Putnam County Department of Health as to= whether or not to operate was caused by the willful or negligent act of the occupant of 1 system. ..._._. Dat M th -I Day Ge eral Contract (Owner) - Signature ,r f J�q Corporation Name (if corporation) Address: �— c, �- r.4\ o rs� I" P ` OL State Zip 2 b S of the Public Health failure of the system byiing utilizing the Title Corporation Name (if Address: State 4 Zip ��= 3 Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street &:z,6'orktown -��:������ (914) 245-2800 Albert H. Padovani, Director ,AB #: 32.208989 CLIENT Q 11705 NON STAT PROC PAGI--i MIRABILIO DATE/TIME TAKEN: 11/29/02 01:O0 ' JOHN 1 RICHMOND RD. DATE/TIME REC'D: 11/29/02 02:20 REPORT DATE: 12/O6/02 JAV BUILDERS, INC POUGHKEEPSIE, NY 12603 PHONE: (914)-471-5199 SAMPLING SITE: 1.4 TAMIDY HALL RD SAMPLE TYPE..: POTABLE - PRESERVAT[VE�� NONE : KITCHEN TAP COL'D BY: JOHN MIRABILIO TEMPERATURE..: < 4C NOTES...: = ~ COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~, RESULT NORMAL - RANGE METHOD DATE FLAG PROCEDURE ' PUTNAM CNTY PROFILE 11/29/02 MF T. COLIFDRM ABSENT /100 ML ABSENT 1O08 11/29/02 LEAD (IMS) 1.5 ppb 0-15 ppb 9101 11/29102 NITRATE NITROG 0.71 MG/L 0 - 10 9139 11129/02 NITRITE NITROG <0.01 MG/L N/A 9146 11/29/02 IRON (Fe) <0.060 MG/L 0-0.3 mg/l 2037 11/29/02 MANGANESE (Mn) 0.011 MG/L 0-0.3 mg/1 2037 11/29/02 SODIUM (Na) 4.44 MG/L N/A 11/29/02 pH 6.9 UNITS 6.5-S.5 9043 11/29/02 HARDNESS,TOTAL 14.0 MG/L N/A 11/29/02 ALKALINITY (AS 12.0 MG/L N/A _11/29/02 -TURBIDITYATUR. COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI THE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for public schools are set at 15 ppb. EPA Lead & Copper Rule for Public Systems requires that no more than 10% of their distribution points have a LEAD value of more than 15 ppb and a COPPER value of 1.3 mg/L, else water treatment must be undertaken to reduce the waters corrosive potential. Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown ic�ts N.Y. 1 9 �..~, � '� �� r'^-+'` - '� � ' ' MAY ICA-28<)N�' Albert H. Padovani, Director LAB #: 32.208989 CLIENT #: 11705 NOW STAT PROC PAGE MIRABILIO, JOHN DATE/TIME TAKEN: 11/29/02 1 RICHMOND RD. DATE/TIME REC'D: 11/29/02 02:20 JAV BUILDERS, INC REPORT DATE: 12/06/02 POUGHKEEPSIE. NY 12603 PHONE: (914)-471-5199 SAMPLING SITE: 164 TAMIDY HALL RD SAMPLE TYPE..: POTABLE : KITCHEN TAP PRESERVATIVES: NONE COL'D BY: JOHN MIRABILIO TEMPERATURE..: < 4C NOTES...: COLlFORM METH: Ml:-- ------- m-m-mmm --- -------------- m" ------------------- DATE FLAG PROCEDURE RESULT NORMAL - RANGE MET}�)D is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L WATER! '70-14O^M87L' -'MG7L-0'MD-[IGRAM`PER LITER ' ' HARD WATER: 140-300 MG/L (1 grain/gallon = 170 MG/L) SUBMITTED BY: Albert A. PhAvani; M.T.(ASCA' Direchor ELAP# 10323 .40L ZY AmooWs. Pv&k Health D;Ictor public Health Director Dkvctoe of Patten Servica .... D_ EPARTWENT OF HEALTH I Geneva Road' Birmter, New York 10509 . ...... 94yWoutsaW HWIh (914)271.6130 F"(914) 278.7921 NvrsWI34rvIcu(914)271-635I WIC(914)278.6671 .Pa (914)I7;-60IS X&rIy'T-akMi66a'(914)212'-014 Prodool (914) 378-6012 F"(914)279'.6641 E211 ADDRESS VERIFICATION FORM OWk,RS NAME: TAX MAP NUMBER: E911 ADDR988: AUTHORIZED TOWN OFMCLQ: (Signature) DATE: 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 a4d. res . s is assigned' by an authorized town official. This form is to, be submitted with the application for i Certificate of Construction Compliance. (E91 I YERMA) tl�� t �• New fiAil 41F PW !` i W -3 k S y� "i CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 10 34 Located at i b" T4 t""VUC, 01 / n `' &) Town oryiUage Owner /Applicant Name J-) k' Ai, a ot a Formerly Mailing Address Tax Map 31 Block I Lot 0(a Subdivision Name Ro SC--k/00 ) oa c! Subd. Lot # �o /ice L7 � cnnc Date Construction Permit Issued by PCHD N I `l - o 2_ Zip 12-4.-0 -3 Separate Sewerage System built by t/ J3 v J )e y1 Lg_ Address 9 In J v Consisting of 1.000 Gallon Septic Tank and 5~oy !, F ; ./Q�✓sGY�, � r, /�o �� -ca7i e_ / Other Requirements: Water Supply: Public Supply From. Address or: Private Supply Drilled by /� + �i4�.� �, a Address 01A Ale, 3 i 1 jp a7�sa Building Type rr, �:�-, ice, Has erosion control been completed? Number of Bedrooms 3 Has garbage grinder been installed? A0 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 9f the Putnam County D�paArtment of Health. Date: j - i I - G2 Certified by Address P.E.4," R.A. License # 2-4" 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 revocat' n, odificat' or change is necessary. Y• B Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATM r9,s PERMIT # ` ' �`� " ' N� � �l /.? 0i Located at Town or Village�� Subdivision name P-W Subd. Lot # Tax Map Date Subdivision Approved 0 M Do Renewal Block 4 Lot 4 Revision Owner /Applicant Name j0 4 Date of Previous Approval q `2titol Mailing Address d t"« MQ O o " ► �pU�l Zip Amount of Fee Enclosed X700 f A,10 Building Type �E751 DES Lot Area No. of Bedrooms Design Flow GPD Ov Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage Sxstem to consist of 1 D o ® gallon septic tank and 00 1-k Ncfw Other Requirements: F( V To be constructed by TU Address Water Supply: Public Supply From Address Private Su 1 Drilled -b y----,-- 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 treatmentsystem 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 any repairs thereto. A n Signed: Address P.E. R.A. Date License # 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 wh c sidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perm t A proved discharge of domestic sanitary sew me only. By: Title: Date: 1' v Z White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well-Location,-: ,` Street: Address:'. Town/Village: - re A 1, Tax Grid -- Map ;4 Block-q Lot(s) e(e Well Owner: Name: Address: Cox, rLAU-71LVN Use of Well: I- primary 2- secondary I Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details , Total length ft. Length below grade ft. Diameter -7in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: X 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 ,k Compressed Air Hours Yield gpm Depth Data Measure from land surface- static (specify ft) g Ar. elt During yield test(ft) t &AL Depth of completed well in feet 62K ' 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 ` T If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type 15, h, Capacity ) 3 Depth 1T1;- Model 6FJ076tI2_ Voltage x.36 HP Tank Type W -Ae2_ Volume f3 4 Date Well Co plete Putnam County Certification No. 01'7 Date of Re ort Well Driller signature) NOTY: Exit location of well with distances to at least two permanetlf land#tarks to be provided on a separatdeuptan. Well Driller's Name e rt #L19t4� � S Address: . 3 Signature: Date: Gr White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 PUTNAM.COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES . FINAL SITE INSPECTION Town 7 TM # - 1. Sewage System Area a. STS area located as per approved plans............. b: 'Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil.not stripped .:.....:........... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage g System a. Septic tank size -1,000 ...... 50 ... ,2.... other ................. . b. Septic tank in: stalled level ................ :.............................. c. 10' minimum from ; foundation .......... ............................... d. Distribtuion Box 1AlI outlets at same elevation -water tested ................. 2. Protected below frost................................................. .3. Minimum 2 ft.Original soil.between box &.trenches Junction Box - properly set ....................... :........ ...................... 1. Len gth required Length installed 2. Distance to watercourse measured + id0 Ft.......... 3. Installed according to plan .......... ................ .I.............. 4. -Slope of trench acceptable.1/16 - 1/32" /foot ............. 5. 10 ft. from property line _'20 ft.- foundations.......... 6. Depth of trench <30 inches from surface.................. 7. Room allowed for expansion,, 100% ......................... 8. Size of gravel 3/4 - 1' /Z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ......................... ............ .................... Pumn•.or.Dosed• Systems• T -Size otpump comber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual/ audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baf fled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. o se/Buildin a. House located per approved plans ... ............................... b. Number of bedrooms ................:...... ......................... ....... IV. Well a. Well located as per approved plans . ............................... b. Distance from STS area measured J-_ / 30 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. 1/97 Date. Zw. Inspected by: Owner. 1&& 4B7J_>0 -- Permit # 1T - -3 4 -o/ Subdivision Lot # 6 Form NOV -27 -2002 02:58 PM HARRY W NICHOLS 914 279 4567 P.01 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF ENVIRONMENTAL HEALTH SERVICES REQUEST ED]& FINA INSPEC110N For: Fill Date: — Trenches PCHD Construction Permit # Located: l (T)i'arso Owner /Applicant Name, - �� /� 1.�9 �1 n TM � Block Lot h -' Formerly: Subdivision Name: u�oa Subdivision Lot Is system fill completed? Is system complete? y Is system constructed as per plans? Is well drilled? Is well located as per plans? Are erosion control measures in place? Date: _... Date: Date: 11 a2 --0-2- I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued P'dHD Construction Permit and approved plans and the Staudards, Rules and regulations of the Putnam County Department of Health. '- -- -�l z= -=0 Z Certified oy: -PE 1ZA D Professional Address: t7� � 6U�s fe.,.. %�, X Lic. # Sts 1 ;W Comments: FOR: 0 ADAM GENE 17 (N) NOV -27 -2002 WED 15:12 TEL:845- 278 -7921 Form FIR. -99 - NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 e Public Health Director _ -.. _ . ,._r - �:.: LORETTA .�:MOIINARI: ;R:N.,- •M;S:1A1 •,..:..<.�. -._ Associate 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 December 4, 2002 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection - Mirabilio Tammany Hall Road, (T) Patterson Lot # 8, TM# 34.4-86 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. The following comment must be corrected in the field. 1. A bedroom count needs to be performed by this Department. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Sincerely, Gene D. Reed GDR:cj Environmental Health Engineering Aide PUTNAM COUNTY. DEPARTMENT . OF HEALTH DIVISION OF ENVIRONMENTAL, HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner )OM, PAAWIvo -_ Address'l P��('1 @R" ..flk, N IUP ?' ........ ... . -� ' Block Located at (Street) Tax Map (indicate nearest cros s street) - Municipality FQ� ... Watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2.' Depth measurements to be made from top of hole. Form DD -97 0 N.4 ww�" wim NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2.' Depth measurements to be made from top of hole. Form DD -97 Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 Dote. rewster, Nf 109 ^ Telephone (845) 279 -4003 Fax(845)279-4567 November-8,2002 Putnam County Health Department. One Geneva Road Brewster, New York Att: Robert Morris, P.E. Re: Rosewood Lot # 8 164 Tammany Hall Road Patterson, New'York T.M. # 34.4-86 P -34 -01 Dear Robert: Enclosed please find the following: 1. Five (5) prints Drawing SS -1, "Proposed SSTS - Lot # 8," revised 11/8/02. 2. "Construction Permit," dated 11/8/02. 3. "Soil Percolation Test Data," dated 11/8/02. Kindly issue the necessary Trench Permit at your earliest convenience: Very truly yours, 4eAA Harry W. Ni ols Jr., P.E. HWN:JM jmm 01 -091.00j ek - BRUCE 'k. °FOL'EY _ -,.- .�...._ . , y_ _- ....._.... Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster,.New York 10509 LORETTA - MOLINARI`R:N:;'M:S:N." Associate Public Health Director- Director Director of Patient Services 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 October 28, 2002 Harry Nichols, PE Patterson Park, Spite 106 - 2050 Route 22 Brewster, New York 10509 Re: Mirabilio 164 Tammany Hall Road, Lot # 8 (T) Patterson, TM# 34 -4 -86 Dear Mr. Nichols: An inspection of the fill. pad at the above referenced project has been completed. Trench plans must be submitted to this Department for review. Please note that field measurements by this Department in no way suggests 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. Sincerely, Gene D. Reed Environmental Health Engineering Aide GDR: cj :2� SENDING CONFIRMATION DATE : OCT -29 -2002 TUE 10:32 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92794567 PAGES : 1/1 START TIME : OCT -29 10:31 ELAPSED TIME : 00'40" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. a � w BRUCE R FOLEY LOREM MOL MILL AN., M.S.N. Pub /fC Nrahi De.alx A&-- AuM PW. lfr.ee D&m DEPARTMENT OF HEALTH"Q P-1— srnMr I Geneve Rued, Brewster, New York 10509 LaNnerradl It"Ith ( /45)278.6150 Fu(845)278.7921 Neni.0 ernk.r (145)271.6358 WIC (845)278.6678 Fox(S4S)171 -6055 Rarly 1ok4 t1o.nlmd,00l (845)271.6014 Fu(245)278 -6641 . October 28, 2002 Harty Nichols, PE i PattersoD Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re. Mrabifio 164 Tammany Hall Road, Lot S 8 M Patterson, TW 34486 Dear Mr. Nichols: An inspection of the fill pad at the above referenced project has been completed, Trench plans mu6t be submitted to this Department for review. Please note that field measurements by this Department in no way suggests the enact size, depth ' and location of the fill pad. If you have any fiuther questions, please contact meat (845).278 -6130 ext. 2261. i Sincerely, i Gone D. Reed Environmental Health Engineering Aide GDR.cj ON yr 09/04/02 09:31 PW SCOTT 4 845-278-7921 kp tt NO. 137 IP02 LAS 46, !A4 Roc OUT( fi kp tt NO. 137 IP02 09/04/02 09:31 PW SCOTT 4 845 - 278 -7921 NO.137 1?01 asalmn ao ajq!Hajp 91 uopsnasaeaa sp 31 Oi IZ-BLt-s" nl* astai(l � 1 � ch� I ty7o S p7ajG)A5 T120J �-V :ssaawmo� � 20 b '31dc7 ;Ivj.LIWSNVH.L -70NI s3Jdd .4a ON :Xdj :Xtl-q :a1. :o1 g p'� p a('� S o► :103POad 7V"l#VS'N".L "d 99 i L-BL L 19") xvd 6090t AN IGISM3WE 0 tVVLi label 9 31now il8£ 'O'd '9unip311HOEIV V 9M03NION3 woo-uai ftoosMd pews L.Loos 'M,d SEP -4 -2002 WED 09:26 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 :xd:j :o-L :of g p'� p a('� S o► :103POad 7V"l#VS'N".L "d 99 i L-BL L 19") xvd 6090t AN IGISM3WE 0 tVVLi label 9 31now il8£ 'O'd '9unip311HOEIV V 9M03NION3 woo-uai ftoosMd pews L.Loos 'M,d SEP -4 -2002 WED 09:26 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 OCT -18 -2002 10:28 AM HARRY W NICHOLS 914 279 4567 P.01 PU'1!'NAM COUNTY DEPARTMENT OF HEALTH T> MSION OF ENVIRONMENTAL HEALTH SERVICES R EQl JERT FOR FINAL INSP_EC= For; Fill Date: lO -J U- 0 Z Trenches PCHD Construction Permit # P 3-Of -0/ Located: -, ` i . (T) Pu r_•,rs a�, Owner /Applicant Name: rid [.c %d — TM_ Block _ Lot Formerly: Subdivision Name: IGCr o,r Subdivision Lot # Is system fill completed? yes Is system complete? ~* Is system constructed as per plans? �- Is well drilled? — Is well located as per plans ? Are erosion control measures in place? Date: 10-17-C2- . Date: Date: 14 -^l -7 - G Z. I certify that the system(s), as Listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. - Date: �0 �G8-d2 Certified by pE RA Dt*Professional Address: Lic. Comments: FOR: ❑ ADAM ❑ GENE. ❑ (NAME) Form FIR -99 a BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPART I ENT OF HEALTH I Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WWWIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 August 26, 2002 PW Scott Engineering 3871 Route 6 Brewster, New York 10509 Re: Dear Mr. Scott: MiraWio 164 Tammany Hall Road, Lot # 8 (T) Patterson, TM# 34 -4 -86 An inspection of the fill pad at the above referenced project has been completed. The following comment needs to be addressed: It appears the fill pad is not sufficient in size (see attached). Please note That fiela' measurements by this Department in no way suggests the exact size, depth and location of the fill pad. Please contact me at (845)- 278 -6130 ext. 2261 to discuss this matter further. Sincerely, V` -1a447/ Gene D. Reed Environmental Health Engineering Aide GDR: cj a - ...... Public Health Director Associate 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 August 26, 2002 PW Scott Engineering 3871 Route 6 Brewster, New York 10509 Re Dear Mr. Scott: Mirabilio 164- Tammany Hall Road, Lot # 8 (T) Patterson, TM# 34 -4 -86 An inspection of the fill pad at the above referenced project has been completed. The following comment needs to be addressed: • It appears the fill pad is not sufficient in size (see attached). Please..note: that field .measuremepts.by -this. Department in_no wav-suggests..the.-exact .size, depth_:....._._ and location of the fill pad. Please contact me at (845)- 278 -6130 ext. 2261 to discuss this matter further. GDR: cj Sincerely, 92, lznjel/ Gene D. Reed Environmental Health Engineering Aide 08/21/02 17:11 PW SCOTT 845 - 278 -7921 TI l I /� r ,r fie' - , , �0 3> �' • 1 NO. 052 901 f , i / .01- /A_`4 / 1// UT R C� 1 IA A 66 OUG -21 -2002 .WED 17:05 TEL:845 -278 -7921 f NOME:PUTNOM COUNTY DEPARTMENT OF P. 1 08/21/02 17:11 PW SCOTT 4 845 - 278 -7921 I Pr Top %rl•� 1 %•� r � � r J ,• J / I Y / / � 1 (�� ��, j �, � r • • �,� t � 0 z 11![[["'�r���ILUU 111 , I I 1 /fr f nnano 3> cN r NO. 052 D01 I 1 t if co co of ... 1 ' oiir -ai `aAAa WFn 17:05 TEL:845 -278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 Ile 0 .Of 7 . . . . . . . . . . . . . . UVEWLL FOR. SETIFUZ4M 1---C TOPSOIL X L 12 tit X wam STAKFE OF Flu- M-W—k a _/r To I 1 /r u TEST HOLE RUSHED TOE OR GAAYEt PT PERCOLATION HOLE 6 PIE2EOMETER (#1 TO #9) lar GFUNDE STAKE o A;URTXIN DRAIN rn PROPOSED FILL SECTION ul It DETAM, P LAN so _LS L E G E NO 1.5•T 5.0' 20 CrC CHARLTON— CHARFIELD COMPLEX ti ROLLING VERY ROCKY TOPSOIL CUD CHATFILM—HOWS R= OUTCROP COMPLEX HILLY SURVEY NO E5: 1. INFORMAMON TAKEN FROM ROSEWOOD FINAL SUBDIVISION PLAT. FILED MAP No. F11 ED DECEMSM 24. 1988 IN THE TOWN OF m dSKADC PROPOSED FILL SECTION ul It DETAM, LL 1.5•T 5.0' 20 TOPSOIL 6' MIN. 0, md x CL pq 2, 60 1— ORIGINAL GRADE 1 T . ,} Yom, `-� eJ � � � ••- '� � ~.', � ` --''° • /,� rn Ln a LL 023 30 Af Y7. ►� al t A B e PIEZEOMET'ER # (FT -) (FT.) Ff.) 1 122 126 2 123 128 3 51 59 4 52 63 5 38 13 6 4D 19 7 68 88 LO 8 142 180 9 138 150 - Cop d 11Wa PMC pip. 6 < aI Pappas® ®aug a# ' 5ben ® $ fy.aan W. 7 s,ea ••: :Id raWta ... 1 7'/`In Aaanfppla of . 9s 9 r.... Q 4 r y r a u G,'Zoum0 WhTeft MOMMOR9I4G Wr' " LEGEND -- PROPERTY LINE LO T 8 SEPTIC , EXISTING CONTOUR SCALE: . CALE t�= Zf'1" c -� x 46.3 EXISTING SPOT ELEVATION ti.1 V L (421 PROPOSED CONTOUR + - c } (4ea3) PROPOSED SPOT ELEVATION ® EXISTING CATCH BASIN � ' • a ' �, '"�' �`'' PROPOSED SWAL_ { STR AM, f r T LAND. EXISTING STORM DRAIN = FLOOD PLAIN DISTANCES: a w!» PROPOSED CATCH BASW 1 r . w.y ,t QN�11 ' '�•� , co 8 142 180 9 138 150 - Cop d 11Wa PMC pip. 6 < aI Pappas® ®aug a# ' 5ben ® $ fy.aan W. 7 s,ea ••: :Id raWta ... 1 7'/`In Aaanfppla of . 9s 9 r.... Q 4 r y r a u G,'Zoum0 WhTeft MOMMOR9I4G Wr' " LEGEND -- PROPERTY LINE LO T 8 SEPTIC , EXISTING CONTOUR SCALE: . CALE t�= Zf'1" c -� x 46.3 EXISTING SPOT ELEVATION ti.1 V L (421 PROPOSED CONTOUR + - c } (4ea3) PROPOSED SPOT ELEVATION ® EXISTING CATCH BASIN � ' • a ' �, '"�' �`'' PROPOSED SWAL_ { STR AM, f r T LAND. EXISTING STORM DRAIN = FLOOD PLAIN DISTANCES: a w!» PROPOSED CATCH BASW 1 r - Cop d 11Wa PMC pip. 6 < aI Pappas® ®aug a# ' 5ben ® $ fy.aan W. 7 s,ea ••: :Id raWta ... 1 7'/`In Aaanfppla of . 9s 9 r.... Q 4 r y r a u G,'Zoum0 WhTeft MOMMOR9I4G Wr' " LEGEND -- PROPERTY LINE LO T 8 SEPTIC , EXISTING CONTOUR SCALE: . CALE t�= Zf'1" c -� x 46.3 EXISTING SPOT ELEVATION ti.1 V L (421 PROPOSED CONTOUR + - c } (4ea3) PROPOSED SPOT ELEVATION ® EXISTING CATCH BASIN � ' • a ' �, '"�' �`'' PROPOSED SWAL_ { STR AM, f r T LAND. EXISTING STORM DRAIN = FLOOD PLAIN DISTANCES: a w!» PROPOSED CATCH BASW 1 r G,'Zoum0 WhTeft MOMMOR9I4G Wr' " LEGEND -- PROPERTY LINE LO T 8 SEPTIC , EXISTING CONTOUR SCALE: . CALE t�= Zf'1" c -� x 46.3 EXISTING SPOT ELEVATION ti.1 V L (421 PROPOSED CONTOUR + - c } (4ea3) PROPOSED SPOT ELEVATION ® EXISTING CATCH BASIN � ' • a ' �, '"�' �`'' PROPOSED SWAL_ { STR AM, f r T LAND. EXISTING STORM DRAIN = FLOOD PLAIN DISTANCES: a w!» PROPOSED CATCH BASW 1 r 08/21/02 s 17:11 PW SCOTT 4 845 - 278 -7921 NO.052 904 P.W. SCOTT - email pwscott@rcn.com ENGINEERING & ARCHITECTURE. P-C. 3871 ROUTE 8 (845) 278 -2110 . 11REYVSTER, NY i.9�a�19. FAX 1134 1 276.2188. FAX TRANSMITTAL PROJECT: M / 0 Lp—r a TO: KO- Q TO: FAX' FAX: TO: TO: FAX: FAX: NO OF PAGES INCL. TRANSMITTAL: 4 FROM: • Comments: DATE.• �5�� -�l t 71 C..41� Ur° �� r� � , �,42r ��c..� G✓t1 t Please call 845278 -2110 if this transmission is illegible or unclear AUG -21 -2002 WED 17:07 TEL:845 -278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 4 d d dU 11YdW_L0V0MU A111II IU-J wVI'I11 Ia •:1WVI`I 1� ri =FU I NAI"Yl C—UNTY DEFARTI ENT OF HEALTH- D MISION OF ENVMONMENTAL HEALTH SERVICES ATTEN110N ❑ ADAM ENE UQUEST FOR FINAL INSPECTION For: Fill V �� All information must be fully completed prior to any Trenches inspections being made. PCHD Construction Permit Located: MAAJ (T) ( 1 /t ` Owner /Applicant Name: WJJ FM TM Block Lot Formerly: il IN 01 k—r-1 Subdivision Name: Subdivision Lot # Is system fill completed? Yes. Date: Is system complete? tj 0 Date: Is system constructed as per plans? LIAS Is well drilled? Date. Is well located as per plans? Are erosion control measures in, place? RI/rJ � !o • s ♦ I certify that the system(s), as listed, at the above premises has been coastructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations the Putnam County Department of Health. -- - Date: _. Certified by:: PE . RA Design Professional Address: 1971 iZ 6 ROU _ JU Lic. # 57-9-'To comments: -rwr '55n'S ui(k 3 ,0' fi Co00 C� cocif Form FIR -99 &J4 G Z06 LtiWON TEE)?,- 8LZ -Sb8 E- lions Md L17:9Z 20/80/80 r'6 SENDING CONFUNTION DATE : AUG-26-2002 MON 13:53 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845-278-1921 PHONE : 92782166 PAGES : 2/2 START TIME : AUG-26 13:52 ELAPSED TIME : 00'39" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... BRUCE R. FOLEY LORHTTA MOUNARI ILK. MJX PWk Ar.silk Db.'W A-1 Nbrk Jkhh Dk.w DEPARTMENT OF HEALTH I Geneva Road. Brewster. New York 10509 It -h—nw I 11"Uh (945)179.6130 Fu(843)2II-7911 ,4'duc &MM(345)ZIN-052 WIC(US)27R-6679 F.0"271-025 E.r!yh*--do.ft.d.d($45)278-6014 Ru(945)278-6642 August 26, 2002 PW Scott Engineering Brewster, Kew York 10509 Re: P&abdio 164 Tammany Hall Road, Lot # 8 M Patterson, TM# 34-4-86 Dow Mi. Scott: An inspection of the fill pad at the above referenced project has been completed. The Wowing comment needs to be addressed: • It appears the fifl pad is not sufficient in size (we attached). Please note that field measurements by this Department in no way suggests the intact size, depth and location ofthe 6U pad. Plena contact me at (845)-278-6130 axt. 2261 to discuss this matter further. Sincerely. V� la'-J/ Gme D. Read Environmental Health Engineering Aide GDR.qJ a Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 iWIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 September 12, 2002 PW Scott Engineering 3871 Route 6 Brewster, New York 10509 Re: Mirabilio 164 Tammany Hill Road, Lot # 8 (T) Patterson, TM# 34 -4 -86 Dear Mr. Scott: Review of submitted sketch for the above referenced project has been completed. Comments are as follows: 1. House foundation setback needs to be twenty feet to toe of fill for fill pads that exceed two feet in depth. 2.. The first trench shown-in the primary area a ears to be in original soils or at the oiz-1t where fill ties to grade. Please note that all trenches must be installed in the required three feet of fill. Please submit a revised sketch showing any and all'changes required to conform to current code. Please contact me at (845)- 278 -6130 ext. 2261 if you wish to discuss this matter further. Sincerely, Gene D. Reed Environmental Health Engineering Aide GDR: cj rt. SENDING CONFIRMATION DATE : SEP -13 -2002 FRI 10:05 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92782166 PAGES : 1/1 START TIME : SEP 713 10:04 ELAPSED TIME : 00'22" MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... BRUCE R PO1.EY LOREWA a9n MMU R.N„ M.3.N. PW1v H-M De war d..00lw ►oaoe JW." Dh etx Drew of PWW.Brnka DEPARTMENT OF HEALTH 1 Geneve Rued, &owster, New York 10509 Fns4MareI —K (U5)271-6130 FU(245)279-Ml nersiq &rskq (845)278.6558 WtC (845)278.6676 Fm(845)272-6M5 uu.y 1aNmotle &..beet (845)27t -60U F-(845)M -6848 September 12, 2002 .. - PVv Scott Rogineering .• - - -_ - -- - - . _ .__. 3871 Rmttc 6 _ - 6rewster, New York 10509 Re: Muabillo 164 Tammany Hill Rood, Lot 4 8 M Patterson, TNW 344-86 Dear Mr. Scott: Review of submittcd sketch 6or the above referenced project has been completed. Comments are 88 tbllows: 1. House foundation setback needs to be twenty fbet to toe of fill for 6E pads that exceed two feet in depth. 2. The fins trench ahown in the primary area appears to be in oria" soils or at the point where an ties to grade. Please note that all trenches must be installed in the required three feet of frA. Please submit a revised sketch showing any and all changes required to eontbrm to current code. Please contact me at (845 )-278 -6130 act. 2261 if you wish to discuss this matter further. Sincerely, Gee D. Reed Environmental Health Engineering Aide. GDR:cj