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HomeMy WebLinkAbout1606DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -79 BOX 15 111"m I IN r ,. Nil r r� �. N , IN IN I Lo mil 4AN I- C�7MI . PUTNAM COUNTY DEPARTMENT OF HEALTH . D.IVISION..DF.ENVIRONMENTAL HEALTH .SERVICES.. , CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR S MENT SYSTEM PCHD CONSTRUCTION PERMIT # r5 Located at 10b PAW r0 HN" r F-OaD Owner /Applicant Name NCIC. �EVE�o �" CDR' Formerly H A iasj Mailing Address ®'- P'00'15 M- Town or Village Tax Maps Paf nap- o i`4 Block 15 Lot -11 Subdivision Name HL Subd. Lot # &1t-�eEp— ! Zip Date Construction Permit Issued by PCHD G 1941 qi Separate Sewerage System built by NLG PL- NEL4"Eki Address �u%_Ff n Consisting of 6-50 Gallon Septic Tank and 400 Lt k&5 1 &4 m Water analysis. result for sodium (Na) is _ t- _ : _t itraA_fnr Water containing more th,,n zu mg /L or suu'ui ' Other Requirements: a on severely restricted sodium diets. Water containing Water Supply: Public Suppl ".re than•290 mg/L of sodium should not be use by-people atO esI l COUNTY DEPT. OF I3[iEAL.'(f'H or: '� Private Supply Drilled by NUL_ D94u-1 H(A % 0 iyL Address .16 Pu1ifh W ZB06;14L�Je lQ�1 Building Type.... d F61Df_�L-e Number of Bedrooms 4 Has erosion control been completed? Has garbage grinder been installed? HO I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County. De artment of Health. Date: �'� ���� Certified by l'- P.E. X R.A. M \ LT0w � ',ENO (De,gn Professional Address t � � 1 W �a h-E�s ► �Q- i °�'� �i License # 15(0 19-+ Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, o fication hange is necessary. By: Title: Date: /o S White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 93 LAURENT ENGINEERING ;."REN ASSOCIATES, P.C. 20 Milltown Road ,Brewsfer, New York 10509 ;N�:.r �. _.._._.-= (914)278-6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR , P.E. CGNSULTING SITE ENGINEERS Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509. RE: Lot 32, Steinbeck Hill Farm to Market Road Patterson, N.Y. 12563 T.M. #34. -5 -79 Dear Robert: The previously approved SSTS plan for Lot #32 reflected the dwelling being located approximately 100 + /- feet from Farm To Market Road. However, it was constructed 200 + /- feet from the road. Due to the higher elevation, the driveway was installed across the frontage in order to make up the greater grade differential. This placed the driveway within a portion of the SSTS expansion area leaving room for only 275 feet of trench expansion. Also, rock blasting was required for both the foundation and the septic tank. The installer placed the tank in the previously blasted location, which resulted in the tank being 5.5 feet from the foundation.. A d' 1 c or mg y, we respectfully equest a waiver for the following: Pjoyi�l ,275 1. .. trench. expansion area.in lieu of.400 Lf._._..... 2. Provide of separation between foundation and septic tank. Both the house and driveway are in place and there is only enough room to provide the above noted expansion area. The septic tank location was blasted, prior to foundation construction. Blasting cannot now be done which would be necessary in order to move the tank 10 feet away from the foundation. Also note that the tank is on the downhill side of the foundation. Enclosed are five (5) prints of Drawing SS -32, "Proposed SSDS," revised 6 -10 -99 reflecting the actual construction. Kindly schedule this request as soon as possible and should you have any questions, please call. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. H W. Nichols, Jr., P.E. HWN: his 8776 -32 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building S� "n r- Building Constructed by P& e%- %- J�t 1,AA,., L e,+ d 4 Location - Street 1'46,. J Building Type 3�. 1 ' i cl Tax Map Block Lot 19,z 7�erSc Tow �age Subdivision Name 32 Subdivision Lot I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system_ _ _ .... , .... _ . _ . _ _ .......... , ... _.. _. . The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Day /J—Year Z�1' coze J. tK UP, . i UAW / I ��. Corporation corporation) •d e State zip +' Signature: Title: N CC Corporation Name (if corporation) Address: 2-6 2,2- 22 State l�i�_ Zip aS10 J Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well,'Location ` - Street'Addres Farm-to-Market Ttiwn%Village - °Tax Patterson, NY "Grid# " " ' i9�A Map 'N- Block 6 Lot(s) Well Owner: Name: Address: CC DEVELOPMENT CORP., 2022 Route 22, Brewster,'NY 10509 Use of Well: 1- primary 2- secondary xxx Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion XXX Compressed air percussion Other (specify) Well Type Screened Open end casing xxx Open hole in bedrock _ Other Casing Details Total length 31 ft. Length below grade 30 ft. Diameter 6 in. Weight per foot 11_Ib /ft: Materials: xx Steel _Plastic _ Other Joints: _ Welded xx Threaded _ Other Seal: xX Cement grout _ Bentonite Other Drive shoe: X� 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 _.gx Compressed Air Hours 6 Yield L gpm Depth Data Measure from land surface - static (specify ft) 92 During yield test(ft) 800 Depth of completed well in feet 1.000 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 1 3 Loose shot rock 3 1000 Hard .grey &.black granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 500 1 Pump Typesubmersi I> ftacity Depth800 Model 7GS20412 Voltage 230 HP 2 Tank Type DiaphragWolume 120 1000. 5 Date Well Completed .7/28/ 99 Putnam County Certification No. 2 Date of Report 8/:2/99 Welofftfiler signature - NOTE: Exact location of well with distances to at least two permanent landmarks to be provi a on a sepdrate sheet/plan. Well Driller'sN L DR I G C. Address :75 'PUTNAM. AVE.', BREWSTER, NY Signature: Date: '813'/.99 99 White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 REPORT TO: NORTHEAST LABORATORY OF )DANBURY _ -CT Cert: PH -0404 39 -3 MILL PLAIN ROAD - IIDANEURY, (CT 06811 NY Cert: 11471 (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING MILL DRILLING, INC. DATE SAMPLE COLLECTED: 7 /7/99 & 7/16/99 & 7/23/99 75 PUTNAM AVENUE TIME COLLECTED: 2:15 P.M. & 3:30 P.M. BREWSTER, N.Y. 10509 COLLECTED BY: BOB MILL & RUSS MILL DATE RECEIVED @ LAB: 7/7/99 & 7/16/99 & 7/23/99 TESTED BY: LAB# 11471 REPORT )(DATE: 7/28/99 SAMPLE SITE: N.C.C. DEVELOP. CORP., LOT #32 FARM][ TO MARKET RD., BREWSTER, N.Y. SAMPLING NG POIINT: BOTTOM OF WATER TAIL SOURCE: WELL TREATMENT: NONE TEST PERFORMED BACTERL4,L:7 /23/99 Total Coliform (Bacteria) E Coli (Bacteria) PHYSICALS: Color Odor pH 7/16/99 - Turbidity CHEMISTRY: Nitrite N Nitrate N Alkalinity Hardness 7/16/99 - Iron Manganese 7/16/99 - Sodium 7/16/99 - Lead ml = milliliter "Notification Level RESULT: 0 per 100 ml NEGATIVE 10 ND 8.64 _ - 4.2 NTUs 0.015 <0.50 78.0 56.0 0.218 0.040 30.4 ** 0.004 mg/L = milligrams per Liter ** *Action Level MAXIMUM CONTAMINANT LEVEL 0 per 100 ml NEGATIVE no designated limit 5 NTUs mg/L as N 1 mg/L as N mg/L as N 10 mg/L as N mg/L no designated limits mg/L no designated limits mg/L 0.30 mg/L mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] mg/L 20 mg/L** mg/L 0.015 * ** ND = none detected NTU =Units RESULTS BASED ON SAMPLES SUBMITTED: 7/7/99 & 7/16/99 & 7/23/99 SAMPLE, AS TESTED ABOVE: MOTABLE or CINOT ]POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director °NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037° (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 o OUTSIDE CT: 800 - 654 -1230 Harry W. Nichols Jr., P.E. CONSULTING SITE ENGINEERS September 27, 1999 Robert Morris, P.E. Putnam County Health Department 4 Geneva Boulevard Brewster, NY 10509 RE: Individual SSDS Compliance Steinbeck Hill - Lot #32 188 Farm to Market Road Town of Kent Dear Robert: Enclosed are the following: 1. Five (5) prints of SS -32, "As -Built Plan," dated 9- 27 -99. 2. Certificate of Construction Compliance for Sewage Disposal System, dated 9- 27 -99. 3. "Guarantee of Subsurface Sewage Disposal System," dated 9- 15 -99. 4. Well Completion Report, dated 8- 13 -99. 5. Laboratory Report, dated 7- 23 -99. 6. Application Fee in the. amount.of $200.04. payable to Putnam County.Heatth _ .. Department. If there are any questions concerning the enclosed, please call. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nirols ., P.E. HWN:his 8776 -32 / \ LAURENT ENGINEERING - ASSOCIATES,,P.C,- -..... �: -... ..z j/\ \ .., . =_:. _.:.�..._. ...... _ - --kh lltownRoad ' Brewster, New York 78-26 (91478 -6108 - (Fax�78 -2658 Harry W. Nichols Jr., P.E. CONSULTING SITE ENGINEERS September 27, 1999 Robert Morris, P.E. Putnam County Health Department 4 Geneva Boulevard Brewster, NY 10509 RE: Individual SSDS Compliance Steinbeck Hill - Lot #32 188 Farm to Market Road Town of Kent Dear Robert: Enclosed are the following: 1. Five (5) prints of SS -32, "As -Built Plan," dated 9- 27 -99. 2. Certificate of Construction Compliance for Sewage Disposal System, dated 9- 27 -99. 3. "Guarantee of Subsurface Sewage Disposal System," dated 9- 15 -99. 4. Well Completion Report, dated 8- 13 -99. 5. Laboratory Report, dated 7- 23 -99. 6. Application Fee in the. amount.of $200.04. payable to Putnam County.Heatth _ .. Department. If there are any questions concerning the enclosed, please call. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nirols ., P.E. HWN:his 8776 -32 -I, O 8I)3 99, `ll /o /Qq PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION -,Street Location FB 'To Town �ATTE7PS�N TM# 30, -2- -L Date: 7 2 Inspecte y• Owner ,Ne c� eV. Fe nm ed hoc, u-3=6 Permit # -- 0 8 – L9 7 Subdivision Lot # 1. Sewage System Area YES NO COMMENTS a. STS area located as per approved plans ............... ............. 1C b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ............ ............................... �C 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 ............................... `.. .`.'..Gr `w d. Distribution Box ` ' A4,w //as 1. All 13 out ets at same elevation -water tested ...........:..... 2. Protected below'frost .............. ....... ......................... ... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set ........... ............................... f. Trenches T. TFng_1h required rt o o -: Length installed 1/67/--) ° @ z-,-;: 2. Distance to watercourse measured f -k O a Ft.......... . 3. Installed according to pl .. ................ ... .... �� 4. Slo f nch acc le 6 1/32" /foot ............. 5. 1 fr property 1 e - .- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Ro low rred ion °100�/o............ 8. Si a i ete {c ►. ............. 9. Dep ra e rench 12 minimum . .................. 10...:.Pipe ends - capped :... ..:.....:....:.:::.::. .:. _ g. Pump or Dosed Systems 3" ' _r Size o pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... ` ;e- 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... ry 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building -j e- e- 6) 1r� a. Rouse ocated per approved plans ... ........................ ........ b. Number of bedrooms ....................................... I.............. IV. Well a. Well located as per approved plans . ............................... b. Distance from STS area measured DO ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ..................... :............................ b. All pipes partially backfilled ........... ............................... X c. All pipes flush with inside of box ... ............................... �C d. Backfill material contains stones <4" diameter .............. X/ 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......... s o � ry h. Surface water protection adequate ... ............................... i. Erosion control provided ................. ............................... Rev. 6/97 Fot I d Exe, > reoc li --J /0ARKE t ' eaCy 1/4"-1 ,-t 4-p�ag 5 4 �Q A q :n 1 I d Exe, > reoc li --J /0ARKE t ' eaCy 1/4"-1 ,-t 4-p�ag ,K, PUTNAM COUNTV1HEALTH ®EPT i� � r , ,4 Geneva Road (914) 27&6130 L x st j �: �`` �•r � �_-� -; Srevester, NY,10508 �" ; .l F 'Dat 19 7^ r+ x� � t ' � _ 't. ,i t.� ; .4 � �a ,�.'i ?' S ^.-, •�S � La: L'r t' y3 � a• r } 3. cl ,'� � �v t, .� �'� �'�..J� F Rec V6. ax ..The iD Do{lars j � s �` !' /�/ tl� � '1 OVr Cash CheckM O ❑ Credit Card t r` { � h annnF�co A `T© �'!IAYZ`WE'l" �?� `?�T7"�1ZSo�%: %��� /�-�6� Street Town ; e State Zip PERSON IN CHARGE ._ OR TNTF.RVrF. ` 63 3 Name and Title r TYPE OF FACILITY: FINDINGS. ex Nee ef f >: 6�Q'� �l}'�2l'�N / � t I Vill 1512, L_ `- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAG T SYSTEM PERNIIT # p 88-9 7 - - c� Located at �--ar,,,,, fd Aab- c- T kCoaj Town or Village Subdivision name , �, I • % Subd. Lot # 3.-)— Tax Map 90 Blocky Lot, Date Subdivision Approved c - 3 I7 Renewal Revision Owner /Applicant Name IL v, Mailing Address I 0 . 1 Amount of Fee Enclosed /3-6 Date of Previous Approval &--.3 -°17 Zip Building Type Kes, id,� It c;. % Lot Area 0,'1131 No. of Bedrooms 't Design Flow GPD 6,00 Fill Section Only Depth Volume Separate Sewerage System to consist of I Z1.91-0 gallon septic tank and 406 ) Other Requirements: To be constructed by Address Water Sup&: Public Supply From Address Private Supply Drilled by Addiess _.., 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 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. Signed: Address R.A. Date License # S-G 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 considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 W1 a; WUMAM CODFFSY DEPAMOM OF EWAF.TD 1 DMdm 4d Bed& Sarver. Ca>d. N.Y. ICS12 to Pravlso a k' cmCZMMCATZOFCqWVuW CIS } �J ®w ]FOR WWA= Dffi 1s8. �� 4 P 0 Pimp in to G F /'a" r-f .1431117 -]?P T. Map —A=— cz- 1,.e _ OaCry� I / FiettecraL_�I Eevle4oa � u.�M �C�ANG —� j Date o[ F � 2 - - NaWxkg Approval 2 ; f5 A t%. �UX a� 1 Town 22p Date Subdivision A rov�d `3/- % Fee Enclosed ❑ AVount c�C %P�n �-i'd D -�3 l F B Typo J-' (� Faso AIteB Flll Beetle® On{y Deptb yolpmw RI> s oS Deolgn Floc G P D PCHD MotMaAlod la Rettaised Wbea Fill In completed S%-Sft Seams Sy5k_ go ds c d1= E0 r Sep& T..& aDd_u...tl L Af3 _ To be ansftmdod by p Addm w i Wa . Supply: —P1& Saspply A. A :i Pdvab Supply WOW by �D _Add,... to A�usr' M AAV446L4-_ eoQg�_s /F 5,16MIrl" fy2 r_ "ff_tJAL : - 1 represent that 1 am wholly and completely responsible for the design and location of the proposed systerri(s). 1) that the separate sewage disposal systam�y� above described will be constructed as shown on the approved amendment there to and In accordance with the Standards, rules a regu ions o u nampl _ County Department of -~Ith, and that On completion thereof a "Certificate of Construction Compliance" satisfactory to tho CORlmiGoonor of Nealthwil0i Da submitted to the OapaRmont, and a d,ritten guarantee drill be tarnished the owner. his wccossors; heirs or assigns by the Duildct, that said Duildefr wiil: " ?, place in good operating condition any pait,of said sawago disposal system during the par led of two (2) years Immediately following tho dato of tho;wu -,,! anco of the approval of the Certificato of; Construction Compliance of -the original system or any pa'as her to: 2) that tho drilled violl doteribod nbovo'a; .. - will ba located as shaven on trio approved plaAAnd that said well will bo In led in accordanco r•+ith std r rubs and rcgu ia�ona of the Putnam County Department O of Health. – �. //+ Sign. O1r r r/fliJf P.E. R.A. — F! ! /P Address •✓ r j —�' `' , / S License No 5: APPROVED FOR CONSTRUCTION; This approval enpiros two y fr the a issued unless construction of t D ilding has boon undortakon and is rovoeaDlo for cause or may be amended or modified when eansid s ry Dy the missioner of Health. An nge or alteration of construction rcauiros a npwm� ,q,provod for disposal of domestic so it y a a w i at for wpply only. Rev • Data i BY T Mb 10/88 F , :i - a 06 -03 -1999 11 :29AM FROM TO 92787921 P.02 PUTNAM COUN'T'Y DEPARTMENT OF HEALTH t DIVISION OF ENVIRONNIZYTAL HEALTH SERVICES :�. a 1. •.: _ .1. - -- A, _ M. �. For: Fill Torches )( . PCHD Construction Permit # F- qa - $I Located FAQ -T9 - P)NM -C ROAD (V) p�'1°t P-hor Owner /Applicant N=e � c.L g- t(t\SKK TM 9 0 Block Z' Lot 1-6.1 Formerly i�AaxSEt+ _Subdivision Name T Is system All completed? Date Is system Complete? Date j� • Win n Is system constnucted as per plsns9 " Is well 16 t-lq drilled Y� Date Is well lorAted as per plans? Are erosion control measures in place! `l S. 1 certify that the sy.tem(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 owd the Standards, Rulcs and Regulations of the Putuarn County Department of Health. --Date:, Gfla.yq.- _Certifisd..by.: 'C�'�%a _ Ii ,,. pE X RA De gn Professional a Address 1_ 111w17 Wt' P-D .. `"�°''�'�►' Lic. # io {'01 %IZH Comments: form FIR -99 TOTAL P.02 05 -02 -199'7 02 :04PM FROM LAURENT ENGINEERING ASSOC TO 98797514 P.02 PUTNAM COUNTY DEPARTMENT OF'HEALrH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date -12-2.. Re: Property Located ati7') 77 rl7l�}72�T. S_QA) Section Flock � Lot Subdivision of CZ Subdvo Lot # a ]Filed Map Gentlemen: This letter is to authorize A)1(2 AZ L.S F , a duly licensed -professional engineer or registered architect (Indic-ate) to apply for a Construction. Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulativ as as promulagated by the Commissioner of. the Pvttuam County Department of Health,, and to sign all necessary papers on my behalf its - -coizzr�ct on�wx h tkiis matter and to supervise the construction oaf' said system ar systems i.-Ii conformity with the provisions of Article 143 or 147, Education tary Code. Cour-tersigne R.A. , Addreo,s n 7, _ r� r"'i✓ y� "a"� - • �RAfi�SS1��1' is Health Law, and the Putnam County Sani••- Very truly y , 217 Si,brned / Owner of lyroperty TeIcpiton.,. Address To t,w Telephone TOTAL P.02 7C7111T. APPLICATI0;1 FOR "APPROVAL. :.OF -PLANS FOR.A.NASTEWATER OISPOSAL'. SYSTEM Name and Address .of: Appl ic,ant: /-b��%5� 2. Name of Project: 1° ;G?S r� �`5� 3.,_•_Location T/V /C: i�TT�,G'Sd �. Project Engineer: �x Y— til -)iC_t��/L5 S. Address: Aiillbroolce Office Cent. NY ..10509 License Nur�ber: �Ln /U Phone: (914) 278= 6108:.. 6.. TYDe of Project.- � Private /Residential Food.Ser.vice Cor,nercial , Apartments_ xnsti'tutional hiobi.le ',Home. :Par.k Office Building. -Re alty.:Subdivisi on' . -.Other.-(specify) Y. Is this project subject * to State Environmental-Quality Review (SEQR)? Tvoe Status (Check One) Type I.. Exemot Type II. Unlisted, S. Is .a Draft Environmental Impact .Statement (DEIS) required? . A)0 9. Has DEIS been completed 'and found acceptable by :Lead Agency ?• ........... 0_ N�ne:of- _Lead „Ag:e.ncy 1 . Is this project in an area under• the control of -local planning., zoning, or other of-Ficials, ordinances? ......... ............................... .._�. ?. 'I'._ so, have plans been .sub;mitted to such 'author.ities ?.... :......... • ___ Has prel in, inary approval beep 'granted by such -authorities ?. 1019-- Date Granted: -/f _ Type or Scqage Disposal; System Discharge ......• Surface water Ground Eaters If surface water discharge, what is the stream class designation ?....... neters index, number (surface) ” '.s project located nee.(: a public water supply system? 0___._..._ -- nacre o water supply Az' Distance to hater suppl;,' TS o.ect sits near a public sewage collec ion or disposal syst..� ?..... A) am -2 0 s e w a Q e sysl.ei;l .— - ��1t - .Distance' to sewage syste�r.. •----- .._.._..._ -- "-- - - - " - -- " - -• 23'. ar, e a t He a I In .1"nspecto, _s design c, ( :i1ons ,,er da;) ...................... _ .25. Is State Pollutant Discharge Elimination System '(SPDES') 'Permit required ?..' 26. Has SPDES Application been submitted 'to local DEC- Office? : '.:...:...... /l, 27, Is any portion of this project located within a designated`Town or'State wetland? ........ ......::............................................... ......... 28. Wetland ID-Number ................ ...............� ........ 29. -is Wetland Perm it required? /i Has application been made to Town or Local DEC Office ?' ................ ...:. � 30. Does project require a DEC Strearn`Disturbance Permit? ................ 12a 31. Is or was, project. site used for.. agricultural activity involving application OT pesticide$ to orchards-or other -crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? YES''or:h0. 32. Is project located -within - 1;000•feet,of"existence-of abandoned landfill,_.: hazardous waste* site,' salt: st.ockpile,'Ichdfill" sludge.disposal'site or any other potential known-source of conta-m ination? .:...'........:.YES or NO' ✓(%. DESCRIBE: 33. Is there a local master plan or file with the Town or Village? _ lU 31. Are col: -n unity water, sewer facilities 'planned to be developed within 15 years? 35_ Are any:.se.w.a.y�e...diesposa °1 -areas""ihi excess of slope? V() :5. Tax Nap ID t;urnber ....... ............................... . ................ -� �7. Approved Plans are to­be returned to: ................. ' Applicant � Engin =er r" the appli cation !is signed by a person other than the .applicant shown in Item .1, the. Pplication must be•accompanied by-a Letter of Authorization: Failure to comply with this rovision may be grounds for the rejection :of any submission. X hereby affirm•, under penalty of perjury;• that information provided on this for- is true to the best -oF my knowledge and belief. False statezents mode herein are punishable es a Class A Hisde;;eenor pur uen to Section 210.45 of the Penal Lau. A ::`« T URcS 2: 0; - TCT,.L T T i�L ES: G h .. I I i I Arm -A. ii11�rM6.,e Oiiice CeI, Lre Brewster, NY 0509 :.���,,G ,'- ,OQnESs: crews T 1 , ... .., .. �, BRUCE R.' F0i' Y' - ""':" ;.:_.., Acting Public Health Director DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 Ham Nichols Laurent Engineering Millbrook Office Center Route 22 & Milltown Road Brewster, Y 10509 Dear Mr. Nichols: May 19, 1997 Re: Proposed SSDS: Hanson Farm to Market Road (T) Patterson Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: "The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard." "You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for. approval of individual sewage disposal systems by the City of New York. You should contact city Officials in this regard. ".... 1. New owners name must be noted in the title block. 2. Trench cover must be noted as geotextile material. Upon receipt of a submission, revised to reflect the above, this application will be considered further. Ve yours, Robert Morris, P. E. Public Health Engineer RM/jP LAURENT ENGINEERING RE: Proposed SSDS - Hanson Renewal & name change Farm to Market Road (T) Patterson, New York Enclosed are four (4) prints of SS -32 "Proposed SSW ", revised 5- 20 -97. ASSOCIATES, P.C. '. MICLBROOKE- OFFICE - CENTRE Route 22 R Milltown Road Brewster, New York 10509 (914)278 -6108; (FAX) 278 -2658 CONSULTING SITE ENGINEERS. May 20, 1997 Robert Morris, P.E. Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 Dear Robert: We have revised the driveway, per your comments of May 19, 1997, as follows: 1) New owner's name appears in the title block. 2) Trench cover is revised to filter fabric. Kindl .. .:._- ......:....,.___, _...._. -.�.. sue, the renewal Construction Permit at your - earliest- opportunity: °° Very truly yours, LAURENT ENGINEERING ASSOCIATES; P.C. Harry W. Zol's, Jr., P.E. HWN:TR:bd 8776 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 -APPLICATION- TO'CONSTRUi:T -A- WATER" WELL' PCHD PERMIT WELL LOCATION Street Address t, Town Vi a City Tax Grid Number / �d ll'o, DeOGc J "Gl S a / WELL OWNER Name 1)&21S Mailing Address ,, // P i O � �� �}4% P � OPrivate O Public SE OF WELL - primary 2- secondary GRESIDENTIAL D BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEA PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY O ABANDONED 0 OTHER (specify, O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED,�3 _5 /EST. OF DAILY USAGE *IET 0Bal O REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION 12. ADDITIONAL SUPPLY 12 NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN CIDUG []GRAVEL. ❑OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: ; S Lot No. WATER WELL CONTRACTOR: Name n D Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: A)1+ TOWN /VIL /CITY ,DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED } (3ON SEPARATE SHEET XL, &. (date) e/ 2 i g nature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well dril operations be contained on this property and in such a /fanner as not to degrade or oth r cont pate surface or groundwater. Date of Issue: �D 19 Date of Expiration 19 Pe it Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller pbkkm COUM, DEPAHTMM ®7 IMUM FAI 0.17. Man F�1 _SP i l� �JPGI� /9 I Ha 3 0 4nu Sip �{or�OHi�srh �2(l O . 4, Date Subdivision Ap�riivedL3���7'2a57 Fee Enclosed ® v 7o by ti 1 ioprmosnt;tPat'1'am Wholly _ohd eompWtely _s"nsiblofor thedm>pgn o,sd location of tho p►opoa�d systoni(s); 1): that tho'- separate, soewa a °4 is owl system above delixibed will be constructed os shown on tho appror©d amendnscnit them to and in accordance with tho standards, rules at regu a. wns O e n6 enty Dd"rnot of 6lareiQli, said tha4 on Compbtioei 4hareof e','CmtifiC09 04 CohssQructio i Complitsncai� ssotisfactory to th©. Coohmisdloner of kw0thwill 9101) INCA HO Hhet,OOpaiflooaoitt, 'an0 a errltt®ri guarant®o will oo'fuinisheal the owas�, his•sucooaeov> 'lwlisoo' e�As,bY; the.,®uilly that SMd guilder will •Disco' iJi .good _opmotheo eoilt®Itbh mig ps ,pf .fold &�iWM disp062I *i 6in durinil' the': pas bid o4.Hao A.2 years' bnlhodis4oly'folt®ailop fli6 dttte'of tlw isssli- esoeo of HPO .a00170vo Of tho Cortif"O o9 Constrtidi" , CoinOii ice of .4NO ovipiriaf systoiw or any vopribs thereto; 3) that the drillod .well 414SON ed 060WO dtiNl N D6te4ed off eltaaiirw Ort.tN3 :epprOC70d' plan oi,d Qha4 mld`iyoll uirill Instal in ,aeeordaAOO. eiit :the sea vd8, ru s wood rc�u�s oQi�ns o4 the Putnam county D"artw* Of "Moth. ®e4o Si i61i p It _ j2 zt .. fiddress ' . , karm lao _ �Gt2 -f AppolO,VED FOR COl STRUCTIPWihts appvObal ottpirBS:4wO yoars, Orom,tho dato IUJ`od unims construction of tho building has bean undertaken and is rev Otebko for cause of may;pe an"ad'o ► modified whon "considerod.nixossoey by ,tho,'Cominiasiw r of HmIlh. Any charego or alteration of construction rc uiroa a sr "Win It ApprovaL1 for ss"l of k sanitary f.Owag® rid /or Ivato esiator .fupply only. Rev. ° °f DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION --- TO--'CONSTRUCT -=A- WATER WELL PCHD PERMIT #k WELL LOCATION Street Address � Village City Tax Grid Number WELL OWNER Name Ma' ling Address �%r�N¢a vt, v�Oy private oZ G, , /O Public USE OF WELL ® - primary 2- secondary O RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify 0 INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED_t /EST. OF DAILY USAGE lklyo Sal O REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION M ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED 13DRIVEN EIDUG DGRAVEI. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES _,g_NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. 3� WATER WELL CONTRACTOR: Name T (' �-,t, z eal Address': IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES N0 NAME OF PUBLIC WATER SUPPLY: /(/�i TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: _.. - -- - -'V W - LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (date) ( ignature PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump.the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manaer as not to degrade or otherwise surface or water. Date of Issue • Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller LAURENT ENGINEERING •. ASSOCIATES,. P.C. MILE_99' E OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278- 6108 - (FAX) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS February 3, 1995 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Renewal Steinbeck Hills - Lot 32 Farm to Market Road Patterson, N.Y. Dear Bill: Enclosed are the following: to Four (4) prints of Drawing SS -1 "Proposed SSDS - Lot 32 ", revised 1 -26 -950 2. "Application For Approval of Plans For a Wastewater Disposal _ -System".- _ 3. "Construction Permit for Sewage Disposal System ", dated 1 -27 -950 4 0 "Application to Construct a .Water Well ",,_dated 1 -27 -95.0 ....._. , . 5. "Corporate Affidavit ", dated 1 -27 -950 60 "Letter of Authorization ", dated 1 -27 -950 We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry �. Nichols, Jr)., P.E. HWN :bd 8776 -32 enc. cc: Mr. J. Cioccolanti w /enco xD E r_> .A. R'r M E N 'x' APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEH w • ..i.....,.:2me and Address o.'�Applicant: ui c�cij'k,����vc %oe ��r, °C�-1 J �.. r 2. Name of Project: I i-� 0.5� �S/�S .3..-.-Location 61PIW •.: ,. P. le: -soy. 4. Project Engineer: 14C ry. 1n/ 5. Address: Millbrooke Office Cer License Number: Phone: (914) 278 -6103 6. Tyre of Project: Private /Residential Fcod:Ser.`rice Apartments Institutional Office-Building Realty Subdivision Brewster,. .NY 10509 Corme rc i a 1 , 1?6b 11 e - Nome Pa :rk Other (specify) 7:. Is this project subject to State Environmental Quality Review (SEAR)? Tvoe Status (Check One) Type I.. Exempt V/_ Type U. Unlisted. 8. Is a Oraft Environmental _':,pact .Stater +gent (DEiS) required? .. ...... 9. H,as DEIS been .completed and. found acceptable by Lead Agency ?•,.:..::. ;::... - S0. N;are of Lead Agency ti. is this project in an area under the control of -local planning, zoning, or other of,:ic.ials,- or.di.na.n.c.es ?__............ l�n so, have plans been.:5u mitted to such ; author .sties ?....................... 13. ;-;as preliminary approval been 'granted by such authorities? A4 Date Granted: t 14- Type of Sewage Disposal :;System Discharge...... Surface Water V/ Ground Waters 15. If surface water discharge, what is the stream class designation ?......... :5-- Waters index number (surface)..,................. IV I-4 .. �. Is project located near a public water supply system? .................. N e If yes, name or water supply Distance.to water supply 9. Is project site near a public sewage collection or disposal system ?..... . he `3 'lame of sewage system Distance, to sewage system i • Date observed: 23. Name of Health Inspector: V 47s ` Project design flow (gallons per day) ...................................... �yp' 2: 25. Is State Pollutant Discharge Elimination'System (SPOES) Permit required ?.. f\/o 2fi has Sp�ES":Appl'ic'ation °been suitLed to:.local' 27. I's any portion ,of.this project located within a designated Town or State wetIand? .................... . .. ....... .............................. _ Yo -- 23. Wetland ID Humber ........................ ............................... %y 29. -Is Wetland Permit• required?* .............. ............................... Has application been made to Town o- r'Local DEC Office?. .................. V 30. Does project require a -DEC Stream Disturbance Pe mit? :.................. Yv 31-. Is or was project site used for agricultural activity involving application of pestioide5 to orchards- or other crops_, solid or hazardous waste disposal, l.andfiII. ing, sludge application or industrial activity? ........ YES'or NO NO 32. Is project located -within 1;000•feet of existence of. abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge .disposal site or any other potential known source of contamination? .....'.........YES or h0 No DESCRIBE: 33. ',Is there a.local master plan or file.uith the.Toun or Village? %S 34. Are cow:munity water, sewer facilities planned to be developed within 15 years? UrkHd✓: 35. Are any' sewage disposal areas in excess of 15- slope? No 35.. Tax: Pap ID Number ......................... ............................... 37. Approved Plans are'to''bia returned to: ................ • ;Applicant V Engineer Ir the application is signed by a person other than the applicant shown in Item.1; the. 'pplication must be accc:-npanied by a Letter of Authorization: Failure to comply with tFiis; -provision may be grounds for the rejection of any submission. I hereby affi ,,- , under Pena 1 ty of F-- rjury;• that info m ation provided on this ,or-,77 is true to the best of cy knoule�'ge and belief. False state,;�nts herein are punishable as a Class A Xisder�anor pursuant to Section 210.45 of the Pena 1 Law. 31G,NATURES & OFFICIAL TITLES: 'QJ LIhG ADDRESS: MillbroW,e Office Centre / Brewster, NY 10509 Putnam County Department of Health Division of Environmental Sanitation AFFIDAVIT - CORPORATE agNER APPLICATION FOR. PERMIT. APPLICAT•ION• SUBMTTT£D -'T0 PUTNAM COUNTY HEALTH DEPARTMENT ; TO: Co issioner of Health - In the matter of application for Z'P/ so� represent. that .I am an officer or -employee of the corporation acid am-. authorized ' to act for, _ _ L`' Aj1-x/ AV( _ (name of corporation)— t- — having offices atM-2 .._� _ _ — _ : _ _ _ •_ _ _. �,_ _ _ _ _ _ Whose officers -are President _ _ �'O %i— /_ _ _ _ TName anAddress) ... _ — — Vice - President _�j�li %iJ,�FLL • ' � . '(Name and Address) _ r _ 7 ` _ ..._ '� `� L. _' • Secretary — — '- `� �"CG —��• _ ; _ _ _ _ (Name and Address) Treas .urer' _ _ ' — — . _ _ „._ r...__.CName,.and. Address) and t?tat I= am- and will be individually responsible font any*or all .aptp of. the-corporation with respect to the approval requested and-all .sub seque 't acts relating -thereto. ' ' Gam; -; Sworn to before me this _day ASigned — — _ �- - of 19 Ti tle Notary 'FU ic- kARGAPET T. AMBpOSE ' Nota;y Public, State of New York No. 0058875 Qualified in-Putnam County , Perm Exf';res• Y�4 oI /� / - •• Corporate Seal L. E PUTNA -M COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .Daze Re: Property 6f. NoY� do✓h �e ✓t,�P�w�� t� ci��ar, . Located at �%asYL,,, system or systems in con�orri�.�y.. aitlT she- proves s_i.orLs_. Ql..arzicle 145 or 147, Education La-w, the •Publ'ic Health Lai, *, i and the Putnam County Sani- tary Code., ' , ' 'C? NE i 0% Very 4���', Very tru. Y your 7 ,W gn 101, ;,ner of Property Countersigns P.E., R.A., Millbrooke Office Centre Address $rewster, NY 10509 914 - 278 -6108 Telephone ; Ad ress �� > Town Al a `1 �13 Tel-4-Phone T ection $GJ Block Lot' • Subdivision of Subdy. Lot :30� -Filed Aian 1 Date Gentlemen: This letter is to authorize �ayv,_ ev 7• ..a duly licensed prof essior_a1 engineer or registered architect (Indicate) ! to' apply for a Construction Permit for a separate -sewage system, to serve the above noted property in accordance with the standards•, rules. or.. re dlations: -as 'promulagated by the .Commissioner. of: Putnam County- Fn Departmen' of 'riealzh', and to sigiZ l-1 necessary papers on my :behalf . in connection ;Pith this matter and to supervise the construction of said system or systems in con�orri�.�y.. aitlT she- proves s_i.orLs_. Ql..arzicle 145 or 147, Education La-w, the •Publ'ic Health Lai, *, i and the Putnam County Sani- tary Code., ' , ' 'C? NE i 0% Very 4���', Very tru. Y your 7 ,W gn 101, ;,ner of Property Countersigns P.E., R.A., Millbrooke Office Centre Address $rewster, NY 10509 914 - 278 -6108 Telephone ; Ad ress �� > Town Al a `1 �13 Tel-4-Phone PDTNAM COON TT DEPARTMENT OF HEALTH ^ � DLMon aii Bov6someml Red& Seevi es. awINol. N.Y. 10512 to Provide Pack 0 \ 0 ^ an CERTMCATB OF COMPUANCE S/ N P FOR SEWAGE DISPOSAL SYSTEM Peemk 0 (, 6�o a / � TTown Beoewa' —)0 Yevidon 29 1�/1 �Ck-14106-0 O..odApNe.lu ��II Date Approval•�:'� Melling Ad&ew Il , l%. �O�l a i Town A-4-, �a 3J AA A anion, Type �CS,`/ Pin �-7 ll V dot Ana Fm Section O* Li Depth Vahme, Nbabea at eedsoo>•a Design Flow G P D �!% n PCHD Notifiennt�ion is Begaked Wbea F91 In completed Sep xvm Sewomp Symm io eaalalat d. GA= Sspdc Tmk amL L �5 To be oanat;aded b7� Address Wow Slfp*: PdAt Supply Finas Address . t on k Prl.ate Sgply DMW by � Ads. omw �ODLtc,gB l'0DFk IF S ✓8)I41A D AD/L 4"eklAL• 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s). 1) that the separate sew di sal system above described will be constructed as shown on the approved amendment there. to and in accordance with the standards, rules a regu ns o nom County Department of Health, and that on completion thereof 4 ^Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be submitted to the Department, and a wiitten guarantee will be furnished the owner, his successors. heirs of assigns by the buider, that said builder will place in good operating condition any pert of sad sewage disposal system during the period of two (2) years Immediately following thedate of the tau- once of the approval of the Certificate of Construction Compliance of the original system or any irs her o: 2) that the drilled well described above will M located as shown on lM approved plan and that laicd well will be In had in ac rdance with sta r rules and regulations 31 the Putnam County Depart no of Health. _0 '�� Signed (' 1/' r P.E. R.A. Onto r7 AOdra /I�s�✓00 �.... License No �z�V APPROVED FOR CONSTRUCTION: This approval expires two y,, ff the a issued unless construction of t b ilding has been undertaken and is .revoc bie for cause or may be amended or.modifled when consid ry' by the mission? of Health. An nge or alt- gyration of construction ;-.quips e w m�j ppioved for disposal of do T0 Ic it 0 a a a it supply only. E �p/ Title L• water JY . -� YOID AQQSesa • . e uPP Y, Ize • or. Private "SupPP1y Drilled by-, 0th ®r Regn � iremeats 7 ALL''.* `, represent that 1 am wholly and completely responsible for the design and location *of the proposed system(s); 1) that the separate. sewage. disposal system , above described' will be.constructed as shown on the approved amendment there to and in accordance with the standards, rules an regu a ;Ons o e u nam County Department of. Health, 'antl thaton.completionthereof a'l'l ertificate of Construction Compliance" satisfactory to the Commissioner of Heilthwill be submitted to the Department,, and a written guarantee will :De furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition „any petof'.said sewage; disposal system during'ahe,period of two (2) yea. "rs mmetliately following.thedate'of the,issu- once of the approval of the Certificate of Construction. Compliance of he'•original system or any repairs ther o; 2) hat the drilled well described above will tie located as shgwri ort.the ipproved; plan and,that said well will;be snit in accordance ith� t e slander ,'iu -and. u a wns of the Putnam County Department of: Health..: Date �leC \..:� _ Signed. - P E:. Addresr[' License No' - APPROVED FOR CONSTRUCTION This approval expire yebr from the'date i suetl unless construction of the building has been undertaken and is \revocable for cause or may be amended or moddied;when.cons�dered:neces ry by tCOmmissioner of Health. Any Change or alteration of 'construction' requires a new permit. Approved foi disposal of domestic sam ry age'an rivate a ly only. M__ Date =3i °d!.� :.BY Title � .J DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL 1ZrzV 15 Fc,D W 9t LL LO C A-t i r)m PCHD PERMIT # WELL LOCATION.. Street Address Town ` w7reasotJ Tax Grid Number 2 lv 3 z - 26, WELL OWNER fnop"e 1} &CqK7r � o Mailing Address oo f,o.3o 70 . !�1 %flSl'Z pPrivate O Public USE OF WELL a1 - primary 2- secondary �/ 6 RESIDENTIAL 0 BUSINESS O INDUSTRIAL O PUBLIC SUPPLY O FARM d INSTITUTIONAL O AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY O ABANDONED O OTHER (specify Q AMOUNT OF USE YIELD SOUGHT ! gpm /# PEOPLE SERVED Q- -(v /EST. OF DAILY USAGE p0 v gal REASON FOR DRILLING ONEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY 0DEEPEN EXISTING WELL O TEST OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE ©DRILLED DRIVEN ODUG 13GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 57&14 P rrve4L I Li- Lot No. ' 32. WATER WELL CONTRACTOR: Name To 136. 1�f�- tF.M.1� Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V'1 NO NAME OF PUBLIC WATER SUPPLY: A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: N/n LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED OON REAR OF THIS APPLICATION ON SEPA TE S T k' (date) signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Hea th D partment atta ed to t ' pe mit 3. Submit a W 1 C mpletion R r o form pr vid d by u m unty Health D ar a t. Date of Issue: 19 Date of Expiration: V 19 rmit Issuing Official Permit is Non - Transferrable 2/87 White copy: Yellow copy: Pink Copy: Orange copy: H. D. File Building Inspector Owner Well Driller DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT WELL LOCATION Street Address --t6 V_n. 1 To Village City Tax 0 K i lz5; -i3 Grid Number - Z--Z, 0. WELL OWNER Name Mailing Address • zz�)( L- . CL vate O Public USE OF WELL primary 2 - secondary SIDENTIAL ® BUSINESS O INDUSTRIAL ® PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 FARM 0 TEST /OBSERVATION 0 INSTITUTIONAL 0 STAND -BY 0 ABANDONED O OTHER (specify AMOUNT OF USE YIELD SOUGHT `J gpm /# PEOPLE SERVED 4-(p /EST. OF DAILY USAGE_jQjMgal REASON FOR DRILLING NEW SUPPLY O REPLACE EXISTING SUPPLY 0 PROVIDE ADDITIONAL SUPPLY O DEEPEN EXISTING WELL ® TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE RILLED DRIVEN ®DUG ®GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES v-'NO , IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:'j-TG:; 1� Lot No._ WATER WELL CONTRACTOR: Name -'ca &7='����� Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES v--'NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON REAR OF THIS APPLICATION N SEP TE S• 8111/8-7 (date) nit if re PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provide by the Putnam Cou ty Health Departm9nt. Date of Issue:- L36 19 Date of Expiration: 19 i Issuing Official Permit is Non - Transferrable White copy: H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orancre copv: Well Dri11P -r O'•Do10 we PUiNAM COUNTY DEPARTMERr OF HEALTH - DIVISION OF ENVnZCNMENTAL HEALTH SM ICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS SHEET - CONSTRUCTION PERMIT i-7zw=.�J k7 I(Aiz BY: (Name of Owner) (Street Location) C0MMENTS YES DoC[Il+ MUS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS)' Deep Hole Log Consistent Perc Results Perc Hole Depth LF _required U 60 ft. max. Parellel to 10 new K. W 6�11 s/s SUBDIVISION Perc (3) Fill y ca House Plans - Two sets Well -' permit; PWS letter Variance Request GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS S stem Plan - (north arrow) cage System H 1 ,� , r prof�r - ravity Flow Fill Profile Dimensions — Volume D or J Box;Trench ery; pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder notes) Design Data: perc_.and .deep r . Two-Foot Contours - Existing & "Propos " Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area;shown;gravity flow,suff. size If Parped Pit & D Box Shown & Detailed House - No. of Bedroans Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds . House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains--Curtain, Leader, Footing 351to catch basin, stormdrain, piped watercourse 10' to Water Line (pits -201) 50' intennittent drainage course Septic Tanks 10' from Foundation; 50' to well 15' Well to PL 9 RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR., P.E. August 31, 1987 LAURENT (ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE' PATTERSON, NEW YORK12563 !% 914.278.6108 CONSULTING SITE ENGINEERS Putnam County Department of Health 110 Old Route 6 Center Carmel, N.Y. 10512 Att: John Karell, Jr., P.E. Re: Steinbeck Hill Lot No. 32 Farm To Market Road Patterson, NY Dear Mr. Karell: Enclosed are the following: le Three (3) prints of Drawing SS -32 "Proposed SSDS - Lot 32 ", dated 7- 30 -87; 2e "Construction Permit for Sewage Disposal System ", dated 8 -11 -870 3. "Application to Construct a Water Well ", dated 8- 11 -87; 4o "Design Data Sheet" 5, "Letter of Authorization ", dated 8- 11 -87; 6. Two (2) copies of Residence Floor Plan (s), for "Bedroom Count Only". 7. $100°00 Filing Fee submitted under separate cover by client. 80 "Affidavit - Corporated Owner Application ", dated 8 -11 -870 we would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. tTr; Harry W. Nichols Jr., P.E. /map CC: Mr. Dave Ciocciolanti w /1 copy each enclosures: 77 Punv�mY " OOUB7I'Y DEPARMENT OF HEALTHY . DIVISION OF ENVIRUMNIAL HEALTH SERVICES . DESIGN_ DATA SHEE -S_ UBSUFACE SEWWE. DISPOSAL SYSTEM _ FILE NO. t;z-t Zoe owner _ , . L_ O. Address V0 ZjX R-TO C1�Q(Ec _� K( 1051Z;� Located at (Street)C1il�! -Sec: � Block ;Z . Lot o,• (indicate nearest cross street) Municipality "'i✓dvJ1,j Cif= Q-C-—,k_*j • Watershed Crxxtt7 j SOIL PERCOLATION TEST DATA RDOU. M TO BE SUBMiTM WITH APPLICATIONS Date of Pre- Soaking .._ -7 1(0 " E,7 Date of Peroolation Test 1-7 —B7 HOLE 1KW1%I6ER CL�OCR TIME Tmco =r" PERCOLATION Run Elapse Depth to Water Fraa Water.Level' 3 O:O - o•.+ No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min/ln Drop Lo-r-37— Inches Inches Inches Z 2 Z-4 - /1 1:55-- ►o :oo 5 Z4 .Z-7 -3 2 10 i0 -ice: 0-7 Co T7 Z,O 3 O:O - o•.+ Zd Z7 7S Z•3 4 5 .7z4 Z7 Z 2 Z-4 - 3 10:Z.7 - i 0 : 3Z !D Z3 5 .. 1 2 y . 3 . 4 NMS: .:...1 ... Tests to be repeated at same depth until apprcacimately . egml soil rates are obtained at each percolation test hole. All data to' be. suimittW for review.:.. ;• ,. .r.,, - " 2. " Depth measurements ' to be made fram top of hole. "•'�''' ' OF 17 *Y'�= IN TE 29 3° 4° T DESIGN Soil Rate Used _�'7 Min/1" Drop :' S.D. Usable Area Provided 5(D00 Noe of Bedrooms Septic Tank Capacity 12-5D gals. Type Absorption Area Provided By AQ ) L.F. x 24" width trench . Other VZkL-L- Name lTQli.iE?Il�i(� �aSS C. Signature Address '7`Z �\ZEIEl VAV� SEAL ;r THIS SPACE FOR USE BY HEALTH DEPARMEM ONLY: Soil Rate Approved sgoft /gal, Checked by Date A PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date v_LU(SU Si 1 ► �Q87.,..... I Re: Property of Mo!,I cga- 4GG iFC peje;1.,-)R-ielm CC) , , C-7rO, Located at —Ct) Section jn Block Z :Lot . Zfp, i Subdivision of Subdv. Lot # ��Z Filed Map # '0= 7 Date �3[3 ( 3 7 Gentlemen: This letter is to authorize 4x_;v�Y a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a. separate, sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by. the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the 'construction of said _ system.. or_..sys.tems, .in.._c.on.formity` with• the- provisions- of Article 145- or 147, Education Law, the Public Health Law, and the Putnam�County Sani- tary Code. .NlCN�< J' � # QQ p r • F � Countersi ed No. 56124 o�FESSJQI � P.E., R.A., # Address (g 14� -z1,8 I Telephone Very truly yours, NlOA R 06 #6 161 TS jo*ePMeW r Coy LJ D V Signed d � ' Owner of Property o 'Address dress � 19 k In eL 0 Town Telephone �i 4� I� Putnam County Department of Health Division of Environmental Sanitation AFFIDAVIT - CORPORATE.-OWNER- APPLICATION_. FOR PERMIT. APPLICATION SUBMITTED TO - - :� PUTNAM COUNTY 11EALTH DEPARTMENT. Tb: Commissioner of Health - In the matter of application for ` o�1�Qo E nt; ( 6-k L .. 6 env p represent that I am an officer or employee of the corporation and am authorized to act ifor (Jv�Woi5 :/J %�_ (name of corporation) having offices at '1 61? —.._ —..� O-S- Z� — _ _ _ Whose- officers are 1. PresidentQ - Name and Address) Vice - President o CG.c9 c.-fi47/ G�to� -' (Name and Address) _ Secretary (Name and Address) = _ Treasurer . -- - _ (Name- and Address). — — _ _ _ `- — and that I am and will he individually responsible for any or all;acts of the corporation with - respect to the 4pproval requested and a1l'sub- sequent acts relating.theretoo' Sworn to before me this /� day Signed _ __....._.e. of 197 Title .otary Public I ANNE B. CGhR1DRN ' ,:0oWc9,yet c arte n. Mch 23 19 47' Ref U,�aaya CV t � 4i1 I Corporate Seal 4 � H- x 1 w 0 E-H z - 4 f TWO STORY .. 4828 H c° 48' -' C7 E; Tn H o 6 c^ U 0 �f C CD CQ d 28' M. ° O O• w:l.c. MASTER BATH W /GARDEN TUB SECOND FLOOR 4828= 1344SF ' 48'. j KITCHEN t.J 1 DINING HO OM MOANING ROOM 10'.0" 17.0 281 -. �..7r : i -:.� - •.._ .... MN . ABOVE . LIVING ROOM •.� iii- 1 FAMILY ROOM 17.,0.. • 10.•0.. 10..0.. 17••0,• FOYER FIRST FLOOR _ 4828= .1344SF. ALL FLOOR PLANS AND -ROOM SIZES ARE APPROXIMATE NORTH AMERICAN HOUSING CORP./ � oii gas= ssoo�• (301) 694 - 9.100• � (300 a 2 -14 o.: Plans, Prices And Specifications Subject To Change Without Notice Copyright 1985 (See•Reverse Side) Z10 gembod will bo'co.nstructe- d-60 oi"n on -t he appr6kd- affi, c ov_ ,"Mch. OnvokVis tox0mitted- to 240 -00310"RIVIR -8016 a writton bhorantoe will W1 -6m Oft a es wwam dk oRw of M a ®1,®¢ M C6rQ9kit6,-ji 060iiilktl",CQIIAP t Ego ao DOW *-,C&t if ica . t I 0° 1 .- of d6risirucklon cornoll i 6kel tho Coinmia-aloft.67 of HOORMvill a-'., 'hi's 'm='ogima. h6bs* 603iPli 6Y.2610 WIDIX7. that saw buim= ails goo , 1�.'ftitifn,dui" -ihb j=,hw.og two VORV Jiaig 0446to ol.tbd lam- 1li�'-iO4 44.jiiriiinai mistom 2) 2.002 tho, drillcw well doewmCm.06=0 PA7 ltonc= conswtictlal 11"mi!0onT. o A tm 'o c gopp= 11 1 a Of - t�iho : Puinorn U com No. i of tho building hasbcon undortakon ond Is W. An :,choMa or aftc7aMn of Conotruet Ion fly. TIM ml PUTNAM COUNTY DEPARTMENT_OF- HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Aa4i Re: Property of 0 ,!5 /-I,51 r A,5y,E4 o �� ^�F�r CIO- LTA_ Located To M412r, Er 2v (T) / -747'7_)C/2- SoA/ Section 80 Block Z Lot ZG. / Subdivision of .5%ri /L/94'c& / -I/LL Subdv. Lot # 3 Z Filed Map # Gentlemen: ZZ.S7 Date 813148-7 This letter is to authorize A4fZ/2Y W. fit/ /Cyoz - -s .��. a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the s,tandards, rules or regulations as promulagated by the Commissioner of the Putnam County - _- - -_. --- Depa- rtment -of Health, and to -sign a- 11-- nec- essary -papers -on my behalf in - . -. - - -_ connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersigrik is P.E. , R.A. , #}` 7_12 '-'1 -CG D Address dF NEpy CO s 1 ,4P0 .56124 OESSIONi 9/¢ 273- �lvf3 Telephone Very truly yours, Signed A', 4m4p Owner of Property ,Pa 9DX 970 Address C42M '5L '-7_Y 1,9S 1z Town /9 /y) 2?_9 .,l! elephone DEPARTMENT OF HEALTH aN 4.41 q -. Division of.Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #_p 39-97 WELL LOCATION Street Address Town Tax Grid Number WELL OWNER Name ,'VTZ�Okl f Mailing Address CIO. fZV 6 Iz v-rr: 7- Mrivate 6f' 'S7r z- D 0 ®Public USE OF WELL �- primary, 2 — secondary eRESIDENTIAL D BUSINESS D INDUSTRIAL ® PUBLIC SUPPLY 0 FARM t3.INSTITUTIONAL ® AIR /COND /HEAT PUMP 0 TEST /OBSERVATION ® STAND -BY ® ABANDONED 0 OTHER (specify D AMOUNT OF USE YIELD SOUGHT > gpm /# PEOPLE SERVED /EST. OF DAILY USAGE LIA5Z__Sa1 ® REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION 13 ADDITIONAL SUPPLY XNEW SUPPLY NEW DWELLING) D DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR 'DRILLING WELL TYPE DRILLED ®DRIVEN - - ®DUG ®GRAVEL. ® OTHER i IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: h ILL Lot No. ;52 . HATER WELL CONTRACTOR: Name . PTZ I'zXLtvtit Address : IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ �NO NAM OF PUBLIC WATER SUPPLY: N off— TOWN /VIL /CITY DISt"d TO PROPERTY FROM DTEAREST_ WATER MAIN: Ah .k LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED DON SEPARATE SHEET / (date) signa ure) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty. (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the.Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this ,~property and in such a manner as not to degrade or oth wise poTItaminate surface or groundwater. gate of Issue: 19 i ite of Expiration V?4/ - 19 �Z. Permit Issuing Official rmit is Non - Transferrable White copy: HD File Pink copy: Owner `9 Yellow copy: Bldg. Insp. Orange copy: Well Driller LAURENT ENGINEERING `ASSOCIATES, P.C. 73 FAIRFIELD -DRIVE .._ _ ... :... .. PATTERSON, NEW YORK 12563 j;- 914.278.6108 RANDOLPH W. LAURENT, P.E. HARRY W. NICHOLS JR.. P.E. ' CONSULTING SITE ENGINEERS January 19, 1988 Putnam County Department of Health 110 Old Route 6 Center Carmel, NY 10512 Att: John Karell, Jr., P.E. RE: Steinbeck Hill Lots # 27 & 32 Farm to Market Road Patterson, NY 12563 Dear Mr. Karell: Enclosed are the following: 1. Three (3) prints each of Drawing SS -27 "Proposed SSDS - Lot #27 ", revised 1 -19 -88 and Drawing SS -32, "Proposed SSDS - Lot #32 ", revised 1- 19 -88. 2. "Application to Construct a Water Well - Revised Well _.. __... Location ",' _l­ 19=8.8 (for..Lot# ,32) Please note that lot #32, which was approved on September 30, 1987, is being resubmitted with a revised well location (construction has not begun on this.Lot). This change is,being requested due to comments received from the Board of Health on Lot #27 relative to the separation between the proposed SSDS (lot #27) and Well (lot #32). We would appreciate your continued review, approval and issuance of the Construction Permits at your earliest convenience. Sincerely, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. /map CC: Mr. Dave Ciocciolanti w/ 1 copy each enclosures: V• aW ' 0 L�ioOY 6xPANSion! — 1 j afzEA 5 FOL K A84 �J�M O cryp 4 �8 lu , 4•fSauD PJG- a ire O.I 41NCTinq BoX CTYRJ� N c I i � N 10° 0�' 22'p 2 ' 1�•89� l N!O °18 / i FARM TO MARKET KOAD 1. • L�XIS�I N� 't �D�G�M R�y�pEN� A' i 1250 2 GL a4N DUT ri � I i � I � I • iq a V 4 r m � 7 .I � 30 N 0 EXtStING WE LL N I w cV Nm I. N � i aW ' 0 L�ioOY 6xPANSion! — 1 j afzEA 5 FOL K A84 �J�M O cryp 4 �8 lu , 4•fSauD PJG- a ire O.I 41NCTinq BoX CTYRJ� N c I i � N 10° 0�' 22'p 2 ' 1�•89� l N!O °18 / i FARM TO MARKET KOAD 1. • L�XIS�I N� 't �D�G�M R�y�pEN� A' i 1250 2 GL a4N DUT ri man DIMENSION CHART°" in No. A B I 48' Iq' 2 -74 g 102 98� 4 135' 13�� 5 1 1 148 (21 1 4& -7 152 1 54� g 15 8 1620 g 12°, 142 , 10 I �y5' 14-7 I I 140 153 . 12 14Co � 15°J 13 153 I<o5� 14 15 Co 1 s 158 I52� 18. i 50. 141