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Home My WebLink About1676DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -3 -9 BOX 15 I I I I I I �� ; 1 ■ ■ Ir 01676 PUT14AM COUNTY DEPARTMENT OF HEALTH Li Y 1S10�i OF EN%7I1R0 Jv1&FIAL HEALTH SU DICES 72 Pq 1 46- 6A 1210 1/ 7, /4 Owner or Purchaser of Building Section Block Lot Building Constructed by Location - Street Municipality Co Building Type Subdivision Name Subdivision Lot # GUARANPI'FE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM 7Es I represent that I am wholly and completely responsible for the location, workmanship, 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 of Construction Compliance fof 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. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services 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. 1� Dated this J day of 19� Signature N Title General to ntractor (Owner) - Signature Corporation Name (if Corp.) Address rev. 9/85 mk Corporation Name (if Corp.). �0 >r aw(� kd //V AX Address WELL G0F1rLL!1UA AnrU�l- DEPARTMENT OF HEALTH '.:... -.- - ......._: YO _ Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT- ,pF:. HEALTH Office Use Only Q' <..._ -....r ......._. .,.. ......,,...... _. STREET ADDRESS: f 75WNIVICLA1710ir TAX GRIO NUMBER: —�_ WELL LOCATION WELL OWNER NAME: ADDRESS: PBIVATE O PUBLIC USE OF WELL 1 - primary • 2 - secondary RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND.IHEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY. ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH ft. STATIC WATER LEVEL 3 ft. DATE MEASURED �9 DRILLING EQUIPMENT ❑ ROTARY 9COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ' / ® ❑ SCREENED O OPEN END CASING. OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH ft. MATERIALS: 9STEEL O PLASTIC O OTHER LENGTH.BELOW GRADE_ ft. JOINTS: ❑ WELDED eTHREADED O OTHER DIAMETER —in'. SEAL: ❑ CEMENT GROUT 9BENTONITE ❑ OTHER WEIGHT PER FOOT — Ib. /ft. I DRIVE SHOE YES ONO L LINER: O YES eNO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? FIRST O YES ONO HOURS. " GzCOi: ^u GRAVEL PACK ❑ YES O NO GRAVEL SIZE DIAMETER OF PACK in. TOP DEPTH tL BOTTOM DEPTH it. WELL YIELD TEST It detailed pumping METHOD: 0 PUMPED 1 tests were done is in- KCOMPRESSED AIR , formation attached? O BAILED 0 OTHER 0 YES O NO It more detailed formation descriptions or sieve analyses :WELL LOG are available, please attach. DEPTH FROM SURFACE water Bear- Well Dia- peter FORMATION DESCRIPTION ON tt. ft ling. WELL DEPTH It. DURATION hr. min. DRAWOOWN ft, YIELD 9Cm Land Surface /Q 0 " flic-t4-F ac WATER CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? ❑ YES ❑ NO ANALYSIS ATTACHED? 0 YES ❑ NO / STORAGE TANK: TYPE ,LX.tr_y/ �Q ta.l, GAL CAPACITY &V!tir)rf n h o �- PUMP INFORMATION / - TYPE -1 �al r� I A / S- CAPACITY . ` 1 (-r'uitc ,�� MAKER `" DEPTH Q MODEL _75 VOLTAGEQ_ HP �ff �f AMhyATT & SONS, INC. 'DATE ADDRESS Well Drilling SIGrIXTURE 3 �� pATTERSON;RNEW YORK 12563 QGO-, 7 i�auoleeceae Mary t ac>ACO�ttt #� _ - - NANCO LABORATORIES, I'NC. F ROBINSON LANE, R D 6 t WAPPINGERS FALLS, N.Y 12590 SAMPLE NO. 22 1.- > 2485 k€' e iqc `P'?z.+'•'.t�.Rf,�, 'a e_ -:`'.s ':?" ^"x �;= .J`i:: ^ _..`�3' -w .� may,: -c"— ..5:,. ' ;. .a.. NAME` a DATE RECEIVED i . '. _ .tt _- _ _. — '. _. _- - -. Y�' ,rg_ _ .. 1 �` ,t,.- S ✓�' i "� 2 yr. ADDRESS: # it SA�IIPLING ADDRESS =0 .. ^�}�Yi C-: �c, o:..._��C3' c,._ TREATMENT: CHLORINATED' ❑( PPM1;; SOFTENED a OTHER ❑ SOURCE: DRINKING WATER ULWASTEWATER-EFFLUENT ❑ OTHER '. COLLECTED MA., �� TfME o A .1 DATE QAPARTM ENT COMPLEX = °D PRIVATE RESIDENCE _` TflSCHOO:L = _ ❑SEWAGE'TREATME'NTPLANT .. ", _ ;, O'BEACH. x, ( RESTAURANT ;: OSWIM;FOOL " "A ❑OTH'ER - OTAL•COLIFORM COUNTM F.T.. .. `PER 100 11M1.L:,. ❑'TOTAL CObF,ORM'COUNT M.P.N. - - PER 100 M.L. O,FECAL COL +FORM COUNT M F.:T. - __ _ - ` `' PER 100 M'L: " [I'FECALCO'LIFORM COUNT M P.N. PER 100 M.L. FROZEN'DESSERT PLATE Co.UNT y ❑' AGAR'PLATE COUNT ;PER 1 M.L. LABORA T TOR HNICIAN. DAT Rl 11D— a f * LA RATORY DIRECTOR �...y.a. ..�, ..^'a'+n"= Y_- di]�;� —i.�J RmJ W.��"��,"'°t'�;W.'i•1 C�c7>'��-1 J'..i CC]/�.�..�i -'.¢'� vP- �ki`''� -°. c .'��',�C�S` =0 .. ^�}�Yi C-: �c, o:..._��C3' c,._ = 4 b-0EAL<TFI ;EPT..DUPL!`GATE OR AAM r ff _ %/` c tr " poz• ?......,.__,,.w,_.�- ..__..� e=_ lc =-. =,i as Car ar-Orov e= r b_ F- t T s L?ca - Date of pi -1 ta_* i er j,�=�= yv 1 AVC - JF1-� c-. Ea=a SCL' list brash, e -c- • c� =t °— t2ian 1.5 e_ lr0 f • f_�. Svcs_ CCLr T:tia_i ar-L. r,7. E:. -- - I C- 1:E=a'= '._.= �_ i.ic__1 C° .f'-•- CL a'_"== ~Ila =c-r f�_ Oc I -� C_ - WeL _ a _ B—ces rrcte. -.r c= cl=E L- - 1_T pi=es L`.Lj'T tcC`��1Tc_ c_ j-'-, vices f_ u �, wi:_z ins' c- at E—l"c C_ =c_ _c c nta 1s $ tcr-eE a in C3�Ti r— I e_ ecccrci . ^_c to elan all Zrnt�rrc st C_r_t0 E`!- Gt- arc`__'_` "L=Y =e /► �• -c C..C_^c =C° c�v _V t =�'Zl S,S area I -y �7 _ c:= Wct. r - 1 CII s' CCes �"7a?C. �� ••.. �„ /QVO /250 c c_ -,.j. - o c�. .: do b . W �Z?_Tl 10 CT E. - Pj ! C•; is == a� �_ _ e?cici_CIl belc Y f_CE _ _ C :. M_*'_itvt 2 Cric E- a _ c- - 32S z ;- �� =�Te:_ 3�S L Disi =c= Installe- C' G�.c CZ - =r'� r ' -- L 7 - ! 13L "I _cC-- 10 i�-_ �u L= C"cr ='- 1 r� - 20 L =_ - =CL _ -? C =s L'/ C . Verth C.L. - 6- Rcc_TS mac.: I. ex-- ,S, cr_ r 5u.`_ e Size c -f c-,.em-1 3/ "= C= C -jlc� L t EMCh LI` LL'..P'rr' E. Pi re e-^_c C--� =� - .,-... .......... _.. `i J17G OL t- iu -..G� s ever -1c- c • Ala -r-M, v:. Ste__'' /c72- H n = Fi act ra=_ 6. CZTC'? e w- __ _ Ly Zeal t'1 re*:: r,7. E:. -- - I C- 1:E=a'= '._.= �_ i.ic__1 C° .f'-•- CL a'_"== ~Ila =c-r f�_ Oc I -� C_ - WeL _ a _ B—ces rrcte. -.r c= cl=E L- - 1_T pi=es L`.Lj'T tcC`��1Tc_ c_ j-'-, vices f_ u �, wi:_z ins' c- at E—l"c C_ =c_ _c c nta 1s $ tcr-eE a in C3�Ti r— I e_ ecccrci . ^_c to elan all Zrnt�rrc st C_r_t0 E`!- Gt- arc`__'_` "L=Y =e /► �• -c C..C_^c =C° c�v _V t =�'Zl S,S area I -y �7 _ c:= Wct. r - 1 CII s' CCes q s' Fuvv` _I srfhcl6Ar Yys .. .... .... flu rerrmn a.�,�,�,x i 5 k t D Svc -tom boy — P/n uj �ft „� d��e�z0& A --Pj a41W, IV, Ilk John M. Simmons, M.D. 'PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES w Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of INSPECTION NAME %� ,�, % _ Orig. Routine f� _ Orig. Complain ADDRESS � s � _ Orig. Request Street =Town 71 No. _ Compliance MAILING ADDRESS P.O. Box Post Office Zip Code Name and Title DATE s2 TYPE FACILITY TIME ARRIVED. ?or TIME LEFT Complaint Ccmp Final Group Illness Construction Reinspection Field, Sampling Only Field Conference Other FINDINGS: / eo- Explain tA 4e INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: . :. TITLE: -4 _ i PUTNAM COUNTY. HEALTH DEPAR24EW DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Commissioner of Health - FIELD ACTIVITY. REPORT - Sheet Z- of INSPECTION NAME rlyw D, v v ® �° f� _ Orig. Routine c,. _ Orig. Complain ADDRESS G� e _ Orig. Request No. Street Town 21 Noe _ Compliance Complaint Comp 1MfAILING ADDRESS _ Final P.O. Box Post Office Zip Code Group.Illness Construction TELEPHONE Reinspection PERSON IN CHARGE Field, Sampling Only OR INTERVIEWED _ Field Conference Name and Title Other DATE TIME ARRIVED TYPE FACILITY TIME LEFT Explain ^ — „-- ® � T . . iA/ Si a.m._ i;eiP ozzrv, ---, M2.^ ,�,.e INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy'Comissioner of Health - FIELD ACTIVITY REPORT !�e MAILING ADDRESS P.O. Box Post Office zip code ONDWAa61 d- � /7"?J? 16 G PERSON IN CHARGE OR INTERVIEWED f e 11v+-5 ':5 -A ":7� Name and Title DATE TYPE FACILITY TIME MW/ 0 TIME LEFT FINDINGS: Sheet Of )CTION Orig. Routine Orig: Complain Orig. Request Compliance Complaint Comp Final ' Group Illness Construction Reinspection Field, Sampling Only Field Conference Other Explain INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE:.- 6/86 TITLE: PUTNAM COUNTY HEALTH DEPARTMENT M.D. �iouer of Health - FIELD �C7ZVII� �O�O�I - Sheet / of � ---^_ _-- JF Street Municipality (T)(V)(C) Box Post Office Zip Code Name and Title TYPE FACILITY TIME LEFT INSPECTION Orig. Routine Orig. Complain Orig. Request Compliance --- Complaint Comp ' Final Group Illness Construction ^~ Reinspect ion ' Field, Sampling Only _ Field Conference ---- Other Explain ' ' u� U� ALSO CAN C Signature and Title OR INTERVIEWED: :`�,',Yeceipt of a copy of this SIGNATURE: f PUTNAM UNTY-DEPARTMENT KNT OF HEALI ail- , _ - , � 'k Permit M me-eks" 1`14 Y` , - , 4 DiAdloia 0 &WImentw IffiW& Came, .10512, _7 on CERTIFICATE;/)F COMPLIANCE PeInIt... Ct N-PI OlkSj*Albibi'SkSAL'� CO 1) SYSTEM OWN ;,T -)T\ Q J),A�PtRR-p( I FARM �20� MAR D MARKET - ROAD I T6wii oi.'VMa go —4— 7 1, Slzbd lb., Sub& Lot # --77 iaxld Lot I R ewal w'n , pp. cant ame— THOMAS :SMITH Date of'Olrevldits'Approva BREWSTERt NY., 57 I - %4ftg Address MINOR :ROAD Town- -'ONE J?Am o RE So 202705 ACRES Banding Type.. 2 L�V Aim 3+ Frf"; -110,0 completed ' y N=ibjr.,pt.Bjdv;b�j 3 libbb" Sepainte 37 OF System to consist of LEACHING TRENCHES %Gallon -Septic Tank and -ROGER. MAY ES QARMEL.i :'NY-: 105512 D -4 Water Sappy — Pikqc-Supply Fio- ddiesi ;— .7 - -P 6r. �Pd�Eite Snp0ly trilled -by- F BEAL&SO 'BREWSTER, Other Reatthemente — 3 IB P,. DRAIN' - ni' '; i' r:� he proposed system( s 4 1. d late v� 4'sn"" As le'.f 6 i0n`,,0.`,i );'I at'ih4114rat I ft.cl o � I r'the diisia'nlpnd'lo'cati�; - "' " 7' i " , ) th systi ' ' will 6 - -;jjjj�je6 �aSLihl5l"'bi th' " - "' - ' id i -Odl�orlt I above !, sc!ib! po�pv ed IF a jti C 6 be sub, m it ted ". to the . 60'rt ent a�iiiij al�144ritiin juiiirif6i"w�I'll' be , iurn " i viace in goo! bpi-i ipn any t f S�l a s y ance,, of the approval oftIhe:Ceitificate 'of 6instiuction' Compliance ., ., f will be located is ih6 n onjhj approved plan a 'n%dihe i i said' well_ will be inst -dourilly ijepirtm`enlf of Hialih*' Date 8,:-119B9 Signed AddresMUSC-00 NO R V APPROVED :FOR FOR iC6NiST13UCTION:Ttiis:agiprovilreipiibs ' li4. year, !,on revoclibli,f6r cause oi-. may 'be:a'men4ed' or,mo5i!iej' wrt -A considered -40 R d f6 p rover ;disposal �f domestic san,tary' v Rev. 4 a the'.Sti;nd!rqs, ruljqrq regq!aqjnW.,,4rpF!jjv4%,n? 0 N F—'0 v 7 OPAC, vv cen 0 No uniai, co tstrAMW IAhe buildin has been undertaken and is 1rniisio6lir of Heal". Any change or alteration of construction w a I t - or su pply only • • �• r ry iy Z-• «y. DESIGN DATA S&EE SUBSUFACE SEWAGE DISPOSAL SYSTEK FILE NO. Owner Thomas Smith Address 1568 150th Place Whitestone, NY 11357 Located at (Street) Farm 'Market Rd. Sec. 71 Block 2 Lot 14 (indicate nearest cross street) Municipality Town Of Patterson Watershed New York City SOIL PERCOLATION TEST DATA RDOMM TO BE SUBMITTED WITH APPLICATIONS . • Date of pre - Soaking 10/15/87 Date of . Percolation Test ..10/16/87&10/19/87 -HOLE •. - -- - � -.- _ _ NUK3F R CLOCK TIME PF.E2CQLAIZCJN PERCOLUION Run Elapse Depth to Water Frcm Water Level _ No. Time Ground Surface In Inches Soil Rate Start -Stop Mina Start Stop Drop In Min/In Drop Inches Inches Inches 112.00 12.30 30 16 18.25 2.25 30/2.25=1 3, 3 212:31 1:01 30 16 18.25 2.25 30/2.25 =13.3 31:02 1:32 30 16 .18.25 2.25 30/2.25 =13.3 4 , FrT4-2 112:05 12:35 30 16 18.2 2.2 30/2.2 =13.6 ^` 212•: 3.6 .1:06 30 16 V 18. _ 2.2 30/2. 2 =13.6 31:07 1:37 30 16 18.2 2.2 30/2.2 =13.6 PTN'3 .1...9:45' '. `• 10:15 2-10:19..... 10 :49' . 30 •15 30 15. 17.15 17.75 .2.75 2.7511_ 3012,75=11- 30/2.75 =11 3 10.53 = 1-1,23 30 115 L7*- 75 '2_75 - 30/2.75 =11 .• f?TA 4 1 94, 50 ' , .10 :20 30 16 19. 3 30/3=10 _2 1p•21 Y�n•�i An !3 n -•� i n 57 ` 11:22 30 ' 16 18.75 2.75' ` ' t 30/2.•75 =11 �`•'i °•. .. r'r,L�r .. ... .. .... .. .. '• Est . NOTES: 1. Tests to be repeated at same depth until apprc+ximately equal soil rates are obtained ,at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 DEP —Ld G. L. 21 31 41 5 69 71 80 go 10, 12' 13' 14" TEST PIT DATA RE TO BE 1 WITH APPLICATION IN TEST HOLES HOLE- N0- Timp Mh INDICATE UMM AT WKaj GROUNDWATER IS ENMUNTERED See Above INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENMUNTERED Remains as Above DEEP ROLE OBSERVATIONS MADE BY: Joel Greenberg DATE: 9/29/87 DESIGN Soil Rate Used 11-15 Min/1" Drop: S.D. Usable Area Provided q, nnnqT? No. of Bedrooms 3 Septic Tank Capacity - 1000 _gals. Type e Absorption Area Provided By 375 L.P. x 24" width trench by 6 I Other 7ft. Curtain Drain & 3 ft. Bank Run Fill D4,, 3 Name Joel Greenberg Signature Address Muscoot North. RFD #2 a box 488 SEAL Mahopac,, NY 10541 THIS SPACE FOR USE BY HEALTH DEPARTKEW ONLY: Soil Rate Approved sq.ft/gal. Chec Date V Lox IN I DESIGN DATA SHEMr - SUBSUFACE SSIAGE DISPOSAL SYSTEM FILE NO. Owner Thomas Smith . Address 1568 150th Place .Whitestone•, NY 1135 Located at (Street) Farm Market Rd. Sec. 71 Block 2 Lot 14 (indicate nearest cross street) 3 1:0 7 1:37. 30 16 Municipality Town Of Patterson Watershed New York City SOIL PERCOLATION TEST DATA RB(WIRM TO BE SURMI= WITH APPLICATIONS Date of Pre- Soaking 10/15/87 Date of Percolation Test 10/16/87 &10/19/87 HOLE 17.75 2.75 .' , 30/2.75 =11 I•, NCM M C= TIME PEPC 4%=CJN 30/2.75 -11 PERO LUZON Run Elapse Depth to Water From Water Level No. Time Ground .Surface In Inches Soil Rate Start -Stop Mina Start Stop Drop In Min/In Drop Q�.. Inches Inches Inches PTA -J' 112:00 12:30 30 16 1.8.25 2.25 30/2.25 =13.3 212:31 1:01 30 16 18.25 2.25 30/2.25 =13.3 31:02 1:32 30 16 18.25 2.25 30/2.25 =13.3 4 for review. PT14-1 112:05 12:35 30 16 .18.2 2.2 30/2.2 =13.6 212 -: -36 1:06-30.- - 16 18.2 ...-2-.--2- •30/-2: 2 =13: 6 3 1:0 7 1:37. 30 16 18.2 2.2 30/2.2 =13.6 P79-8 .1.. 9:45 r ' • • • .•'• 10 15 30 •15 ice+ ��\\\�•\ 17.75 2.75 .' , 30/2.75 =11 I•, 10:49 . 30 15 17.75 •2.75 30/2.75 -11 3 10:53 11:23 30 15 17'- 7 5. -2 7 30/2.75 -11 _ ~4 I .9 •• 5, 0_:_;;; 10.20 30 16 19. 3 30/3 =10 2 10.21 �� n �� n Q�.. •�n�i,�� n- . _',: i n •.s� .11:22 30 1.6 1B 75 `2 -'25' ` t .._.......�.�...._�., 30/2•.75 =11 -- .- ••--- NOM: 1. Tests to be repeated'at same depth until approocimately equal soil rates . are obtained.at each percolation test hale. All data to'be submitted for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION _ DEPTH_ HOLE NO,. HOLE N0. ....r� HOLE NO... , 3 4 5 6 7 G.L. To so' 1 10 Loam Sandy Loam & some clay 2° 3° R 40 waHr e 5.5° 50 water Ref 6059 y 5.5° 5.5° 69 ef. Ref Ref Ref Ref Ref 7° 80 Ref 9' 10° 11° 12° 13° INDICATE LEVEL AT WHICH GROUNM aM IS F.NOOUNTERF,D See Above INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED Remains as Above DEEP HOLE OBSERVATIONS MADE BY: Joel Greenberg DATE. 9/29/87 DESIGN Soil Rate Used 11 -15 Min/1" Drop: S.D. Usable Area Provided g..,.nnnSF No. of Bedrooms 4 Septic Tank Capacity 1250 gals . Type p ra a �,- Concrete Absorption Area Provided By 500 L.F. x 24°° width trench Other 7ft. Curtain Drain & 3 ft.' Bank Run Fill Name Joel Greenberg Signatur Address . Muscoot North.RFD #2,Bbx 488 SEAL M Mahopac, NY 10541 ° ot�o`��0 DF NEB ' THIS SPACE FOR USE BY•HEALTH DEPAR`IMENT ONLY: Soil Rate Approved. sq.ft /gal. Checked by Date COUNTYrDEPARTMENT OF HEALTH J� v Divlelo'n of EIIVlronmoIItal Health Ser &ii Carmel N Y 1051? - ngin". to Provlde_Permit q N'. CERTIFICATE OF CO i �: g�4C .t.; CON Ut Tll)N PERMIT FOR SEWAGE DISPOSAL SYSTEM s :. h �'PATTERSON FARM ` 'TO MARKET ROAD TO.vp or •; dlll' go Sabdivlaion Name r' Sabd Lot tY Ta: Msp` Z� Block ZL 'Lot w � t ' �, lt• { , -' } �, ` t ReII0We1 ❑ { s S� r RevlBloII Owner /Appllcatit Name THOMAS SMITH}" ❑ .f r fil Date oae Approval ' 101auin Address" 1568 1i5Oth .PLACE ' TowII WHITE'5TONE, NY Zip 1135.7 B 3 BW�g'rONE RESo Lot , :2027:05 ACRES4" Number of Bedrooms 3' Dei n Flow G P D Separsice Seweeage System to copetet of -1 b 0 0 Ga11oII Septic�TaIIk sad 5 0'O LF O f LEACHING TRENCHES To be ctinehnctedsby ROGER MAYSS Addeeea �CARMELv'{. NY 105'2 .ry t �''' 4ff :•� b , ��'y' 3T ` �. S� �Sh } 11 r�, w h ?e",e V ark 4„� T iV �. �'` T d Water Sappy Public Supply Feom s Address ors XX Private Sapply,DrWed by P F "SEAL so BREWSTER ��NY 10509 7 _ 1, 4• _r a "� _'. r ms's Other Renairemente ' ' '� �' F '• - c (,represent athat�l am wtiolly antl Completely responsible for tfie tles�gn end 1ocaLonfi of -the pro"zpo _ J "� stem(s) 1) that toe; separate sewage dispose) system above:descnbed,w,ll be +constructed ss show,n on therapDroved? amendment thdre?to antl �nx5ccord6; a ithzthe standards rules an regu p ions o F e u nam: County Department tof. Health and that completion thereof s CerUfiaateyyiof,.Construction "o Dance satisfactory to Cris Commss�onor,,ot Healthw�lt be submitted .to the Departnierit" and _a`}wntten ;guarantee ;will De ed ;tt e' owner; his, cce rs %heirs or; assigns _ "the builder, that "said builder will place 4n gooG,.`operatin9 cond,tion any 'part o1 said sewage disp sal °syste "tlunng the per.i_ d' o two (2) yearsiin tely following thetlate of the isw- 1. ance,of tlieapproval bf the Cert,i,cate;of Construction Gompl�an'` o/ the,or1 q�nal system ,o, irs theroto; hbt'the drilled well descrilietl above ' will be located bs shown_on the approved Dlan and that sa�0 well will ben rd`_ance w h h p s,. r. I n requ ssTi'ons of the Putnam,. County Department o} ;Health , T f NOU, 18 1987�,L YC SI ned n�fi P E R A Date f 3 /,+ y a n 9 r i x Address Y'MUSCOOT NO RsFD 488 MAHOPAC Ce�p41 1105'6 APPROVED,iFOR CONSTRUCTION Tnis approvalGezpirestwo yea fro he a issued unless-constr.uction of the.bu (ding has-been undertaken and is revocable for *cause or'may,be amended or -modI ietl when considered ssar y the .EOmmdsionerFOf'Health• ; Any c rigs dr,alte►ation.of construction reduces a w ". permd Approved tOr tl�spOSal�o/f <dOmestic` sanitary. few antl /Or pr.wate water Supply OMy D at ' w K. PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES `r....' iCOUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner THOMAS SMITH' Address 8 WA$HINGTON ST.',HICKSV.IL;LE!, NY 11801 Located at Street 'ARM TO MARKET RD -See. 71 Block 2 ' Lot ` 14' IMIcate . HERR cross s ree - Municipality'.'.:., TOW- -* OF'' PATTERSON ' Watershed NEW' YDRK:'CITX:' :.:SOIL PERCOLATION TEST DATA REQUIRED•TO BE SUBMITTED WITH• APPLICATIONS O O Number :.CLOCK.TIME PERCOLATION PERCOLATION Jiuu r CL.Puo =pun Lo weLL.nr W"Lotir Lavni . .No. ,�.::...., . Time Froni��Ground Surface in Inches •• • Soil Rate Start-Stop Min. Start Stop Drop in 'Min. /in drop Inches Inches Inches PTH #1 -1.. 9:45' ' : • ": 10:15 30 • •15 1 11.75 2 2.75-: 3 30/2.75 = =11 _ :. • 10:14'"''. 1 10:49 . 30 1 15. 1 17.75 1 10 75 ' ' '.10/2.75=11- 16-:53 11:23 30 .1 17'_ 75 _ 30/2..75-11 PTH #2 ' .1. • 9:50: 10 z 20 _30 16 -- - - 9 3 3013 =10 .. .. f. _..__ ..__ ..._.._.... �� _..� _ _ • � .- :�..., _� _ .•1. .. � _ .. .-. �.. ..... Y..,.. v .. .... _. , ... _. ... .. ._tit n , r, 3n _ =r,.._. ?39 =..., '3 ._ 10,4 3_ 1 n ._ 11:22 30 ' 16 18.75 2?75'— t 30/2:75 =11 Notes: 1) Tuts to be repeated:at same rates are obtained-At each percolation for reviev.' - °.'2) Depth measurements to be'made depth until approximatel equal soil test hole. All data tole submitted from top of hole. TEST PIT DATA REQUIRM TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH BOLE NOo DTH #1 HOLE NO. HOLE NOo G. L. TOP '.SOIL to SANDY LOAM 20 30 a 4° 6° 7° " 8° 9° " 10° 110 1a° 13° 14° INDICATE LEVEL AT 'WHICH GROUNDWATER IS FMWNTERED _ 30 _.._ INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING EN00UNTERED 3' DEEP HOLE OBSERVATIONS MADE BY. JOEL L. GREENBERG DATE. JULY 1, 1986 DESIGN Soil Rate Used 11 -15 Min/1u 'Drop. S.D. Usable Area Provided 5000 NO. of Bedrooms 3 Septic Tank Capacity 1000 goo ZypGPRECAST CON, Absorption Area Provided By 500 L.F. x 24°° width trench Other rZ A Na JOEL L. GREENBERG Signature C -� Address MUSCOOT NO,RFD #2, BX 488 Ste, - MAHOPAC, NEW YORK 10541 r,.r THIS SPACE FOR USE BY HEFUTH DEPARTMENP ONLY. Soil Rate approved sgaft /gal. Check ki# Dsite ;... DEPARTMENT OF HEALTH - Division Of Environmental H,%a;th Services -TWO COUNTY CENTER CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL WELL TYPE 0 DRILLED F_� DRIVEN F� DUG GRAVEL F-1 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME.OF SUBDIVISION: LOT NO 14 WATER WELL CONTRACTOR: Name P.F. BEAL Address: BREWSTER, NY.10509 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES XXXNO NAME OF PUBLIC -WATER SUPPLY: N/A TOW11 /V /C - -f�I �T,A�TT.CE = -TO- PRO�?ERTY FF:OM- N•EtiF�cST �._R/ ,- _ ... _ • . LOCATION SKETCH & SOURCES OF CONTAMINATION. 8/4/1986 _ ARCHITECT (date) I� (s g ature) _ -- 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 2. Disinfect the of the Putnam permit. 3. Submit a Well the Putnam Col until the water is clear. well in accordance with the requirements County Health Department attached to this Completion Report on a form provided by anty Health Department. Date of Issue:., Permit Issuing Official!T Permit A 05. IUWNjVILLA / I T IAX (iRiU NUMBER. WELL LOCATION FARM TO MARKET ROAD TOWN OF PATTERS'ON 71 -2 -14 WELL OWNER ' NAmE.. .. ADDRESS: ®PgIVATC THOMA$ SMLTH 8 WASHINGTON STREET, HICKSVILLE ,NY 11801 ❑ PUBLIC USE OF WELL ® RESIDENTIAL ❑ PUBLIC SUPPLY ' ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED 1 - primary ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify) 2 - secondary ❑ jNOUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ hIOUNT OF USE YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 4_ / EST. OF DAILY USAGE 300 gal. REASON FOR 1l NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION DRILLING ❑ gEPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL WELL TYPE 0 DRILLED F_� DRIVEN F� DUG GRAVEL F-1 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME.OF SUBDIVISION: LOT NO 14 WATER WELL CONTRACTOR: Name P.F. BEAL Address: BREWSTER, NY.10509 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES XXXNO NAME OF PUBLIC -WATER SUPPLY: N/A TOW11 /V /C - -f�I �T,A�TT.CE = -TO- PRO�?ERTY FF:OM- N•EtiF�cST �._R/ ,- _ ... _ • . LOCATION SKETCH & SOURCES OF CONTAMINATION. 8/4/1986 _ ARCHITECT (date) I� (s g ature) _ -- 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 2. Disinfect the of the Putnam permit. 3. Submit a Well the Putnam Col until the water is clear. well in accordance with the requirements County Health Department attached to this Completion Report on a form provided by anty Health Department. Date of Issue:., Permit Issuing Official!T Permit tion) Permit Application Corporate Resolution Plans - Three - sets Engineers Authorization' Design -Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Fla, Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit devils Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut 'Footing /Gutter Curtain Drains ,Perc & Deep Holes Located Representative of Sewage_& Expansion Area Expa ion Area:;shoem• ravit� flow'suff-. size s ,g .._.�,_ ..., ~ If Pub Pit & D Box Shcwn & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located 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 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, lake (inc. ex-can). 15' to Drains-Curtain, Stom, Leader, Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GaU AL Legal Subdivision Subdivision Approval Checked .Ex- approval SSDS Adj. Lots Checked Wetland (Tam/DEC Permit R & D) Data On DDS Plans & Permit Same r�® _ ` o 1111 1 IMF! tion) Permit Application Corporate Resolution Plans - Three - sets Engineers Authorization' Design -Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Fla, Fill Profile & Dimensions - Volume D or J Box;Trench /Gallery; Pump pit devils Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut 'Footing /Gutter Curtain Drains ,Perc & Deep Holes Located Representative of Sewage_& Expansion Area Expa ion Area:;shoem• ravit� flow'suff-. size s ,g .._.�,_ ..., ~ If Pub Pit & D Box Shcwn & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located 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 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, lake (inc. ex-can). 15' to Drains-Curtain, Stom, Leader, Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GaU AL Legal Subdivision Subdivision Approval Checked .Ex- approval SSDS Adj. Lots Checked Wetland (Tam/DEC Permit R & D) Data On DDS Plans & Permit Same 7. btrijae - cpaing - miaimm 20" in shorter 8. Pff-I e ecter-E 2 braid. cf I id. cInth above ligaid level (4' , b=1011, (3=5; b42") - 9. if lath G.T. 9 feet - Q 2 amprtimnts- 10. Mininm tark apdty 1000. MO baamw- 1.200 gal/4 hsl=mI34 d,13 b5 n ;161 cf/4 bdm 11. psd-,-atic coking fcr reirfaned ax=r=te. 12. ML-t tE,-4atae 16' hele-4 f Lcw line. 13. c)-&lp± teWhT:Eb-- 1811 bE!cw flew line. 14 Inlet pire s1cpe IV pEc fxt, min. (2%) . 15. Inlet Pipe cast irm, 4,tnm 16. atlet pipe slG� 1/8" pE-- foot irdn. (A). 17. calikEd joints fcr sanitary tees. I MWAValladd 1. Inlet insert idm. T abom oitlLat MmErt- 2. All a±Iets at ele-vaticn. I Otht 1" to 5" above tank botbmL 4. Mirimm 12" be33irxg clean sExd cr pEa gmwl. 5. InI& }Pfnt-_ 6. Msdr=12" m r- 7. Femve-ble am--r f= 10. Frost gctectuzL 1. Sqm 1/16 in./ft. to 1/32 im (0.5% to O-2A). 2. a,/V to 1P mnlid st Cm cr 3 grEvd t- 3. 4" miri lateral diaTetEz- 4. T minfi= agqre to O;er htEra-. 5. 6' minimm ag7e:,ate U-a--r late-Mal. 6. uibnatO b2iklirg pepa-z cr 2" -of stow cuer 7. 6" minfimjr, 12,, mmcfi= earth bx3&jU_ 8. aafM to allay fcr set± ; rm, V --G 9. 21rr& un b= tru)d botton to 10. 5'EirLfron trimch bottom to iqxmviom 7 ft- gm3e. 11• M3a-rh Epacing=dn. 6'O.C. (24"t:rench) 12. U=m:.-ts3 lateral eras mjs4,- be pluggEd. 13. FM - 2:1 slopes ni• 101 bwa)d trexi. dq:th:3J,mv_over xa:k+;2'm-:Dc.a;er Tooter •vEnfill .•- :. mil lmdd.Ul 2. 6' Utreated bjildir• PB-r=- • JJ" cleen gawl • sb=n. 5. min. 4,, padcmte pipe- §. Pipe in� 6'-' cEE bott 241, wide b�z�_ 8. rEpth a5agmte. 9. Sqmmtim fran SS:S arEa 151 ndn. 2. Oar=tcr cutlet LI" abme latEB1 a_t!,Et_- 3. Iatezis ffi� with bottcrrL. 4. �t joints pine-s bab,;6m.b=es. Liz. -. _RM DEPAF,11-IENI: Ur --r=d w.Ln ,AJA.W "J i -S REVIEW SHEET -7 1: SEP= TM rE= Wn DOZ. 1•. Qatlet 2- belay klet, T:p cEmsing 18's-abome 2. kn v m 3- bEd CC- pea 271. .2m cf msing 2'. above 15AL cr tat - 3. dEpffi cf ligii 41 .3. n- 20 azxig cE sted cc wm#& iraL 4• leigth - mini= Mce width to mR)mm far 4. 3bI nirii= gttt into rack. times width. 5. Outlet 41 bdcw O.G. min. 5. llt n 12" cover. 6. Smitary S l 6. I=tim sue_ 7• Gmmd gmad a-ay b=1 wM. 7. btrijae - cpaing - miaimm 20" in shorter 8. Pff-I e ecter-E 2 braid. cf I id. cInth above ligaid level (4' , b=1011, (3=5; b42") - 9. if lath G.T. 9 feet - Q 2 amprtimnts- 10. Mininm tark apdty 1000. MO baamw- 1.200 gal/4 hsl=mI34 d,13 b5 n ;161 cf/4 bdm 11. psd-,-atic coking fcr reirfaned ax=r=te. 12. ML-t tE,-4atae 16' hele-4 f Lcw line. 13. c)-&lp± teWhT:Eb-- 1811 bE!cw flew line. 14 Inlet pire s1cpe IV pEc fxt, min. (2%) . 15. Inlet Pipe cast irm, 4,tnm 16. atlet pipe slG� 1/8" pE-- foot irdn. (A). 17. calikEd joints fcr sanitary tees. I MWAValladd 1. Inlet insert idm. T abom oitlLat MmErt- 2. All a±Iets at ele-vaticn. I Otht 1" to 5" above tank botbmL 4. Mirimm 12" be33irxg clean sExd cr pEa gmwl. 5. InI& }Pfnt-_ 6. Msdr=12" m r- 7. Femve-ble am--r f= 10. Frost gctectuzL 1. Sqm 1/16 in./ft. to 1/32 im (0.5% to O-2A). 2. a,/V to 1P mnlid st Cm cr 3 grEvd t- 3. 4" miri lateral diaTetEz- 4. T minfi= agqre to O;er htEra-. 5. 6' minimm ag7e:,ate U-a--r late-Mal. 6. uibnatO b2iklirg pepa-z cr 2" -of stow cuer 7. 6" minfimjr, 12,, mmcfi= earth bx3&jU_ 8. aafM to allay fcr set± ; rm, V --G 9. 21rr& un b= tru)d botton to 10. 5'EirLfron trimch bottom to iqxmviom 7 ft- gm3e. 11• M3a-rh Epacing=dn. 6'O.C. (24"t:rench) 12. U=m:.-ts3 lateral eras mjs4,- be pluggEd. 13. FM - 2:1 slopes ni• 101 bwa)d trexi. dq:th:3J,mv_over xa:k+;2'm-:Dc.a;er Tooter •vEnfill .•- :. mil lmdd.Ul 2. 6' Utreated bjildir• PB-r=- • JJ" cleen gawl • sb=n. 5. min. 4,, padcmte pipe- §. Pipe in� 6'-' cEE bott 241, wide b�z�_ 8. rEpth a5agmte. 9. Sqmmtim fran SS:S arEa 151 ndn. 2. Oar=tcr cutlet LI" abme latEB1 a_t!,Et_- 3. Iatezis ffi� with bottcrrL. 4. �t joints pine-s bab,;6m.b=es. PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY SUBSURFACE SENAGE DISPOSAL SYSTEMS FIELD INSPECTION REPORT _ DKIEe 67f 1141k6 Son ITFd FniR_n►- -'fb- m PD INSP. BY: (Name of Owner) (Street Location) INITIAL SITE INSPECTION YES NO CHI'S Wetlands on /or proximate to property .............. Property lines or corners found ................... Can estimate house location ....................... ✓ Will driveway need cut ............................ Must trees be removed - note these ................ VN & h!o Deep holes representative of entire SDS area...... Additional deep holes needed..... . ............ ? Sufficient SDS area available considering driveway cut, house location, separation distances,etc... r►ows- wi-rriv ao8 Peer Adjacent wells/ septics ............................ Access to prgMsed well location for drill in .. ... -mrrscs Amt- c LZAME-b D.H. - Deep Hole G.W.- Groundwater D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot Depth to G. W. 3o" Depth to G.W. Depth to G. W. Depth to rock — Depth to rock Depth to rock Cp HAL ;�-,DEPARFBMW--�� ELTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simimns-, M.D. Deputy Camnissioner of Health FIELD ACTIVITY REPORT . Sheet of INSPECTION NAME le22 -le �Ze2 Orig. Routine I Orig. Ccmplain ADDRESS r4 0wo" 40? V 1-.2 Orig. Request No. Street Town IR4 NO. Compliance Canplaint Comp MAILING ADDRESS Final P.O. Box" Post Office Zip Code Group Illness Construction TELEPHONE Reinspection PERSON IN CHARGE C Field, Sampling only OR INTERVIEWED 0 Field Conference Name and itR! Other DATE TYPE"FACIL-I IN '0- 1 TIME ARRIVED TIME LEFT Explain FINDINGS,,, /"0// .mss.. 72 -z sr -� INSPECTOR: TELEPHONE: Signature and Title PZZSOIN T N CMARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: 6/66 T i o__ _. _._ . _ _ _..�_.�.. ._._�:.... _y _ . _... . 0° �-- ,` New York State Department of Environmental Conservation 21 South Putt Corners Road, New Paltz, NY 12561 September.18, 1987 Thomas C. Smith, Jr. 28 Salem Way Glen Head, NY 11545 Re: Freshwater Wetlands Permit Town.'of Patterson DEC 43724 -28 -1 Thomas C. Jorling Commissioner Dear Mr. Smith: It was a. pleasure meeting with you .on.. September. 11.as well as Mr. Greenberg and Mr.:Hedges to discuss concerns relative to-your permit application referenced above. To summarize our .discussions, .the .Department is prepared to issue a permit for the.various disturbances to. Freshwater Wetlands.Bk -7 as -shown on the submitted plans with the exception of the filling of a portion of the wetland proper to gain a 100 foot separation distance to the sewage disposal system. We under - stand you will be supplying additional. soils data to the Putnam County Department:,, of Health for a final determination of a. request for a variance from the separa- tion requirement. If approved, we ask,that you.provide three copies of plans deleting.this filling, adjusting.erosion control measure (staked hay bales) accordingly, and containing revised. notes as -to. the volumes of fill for the other activities. Should this waiver request be denied,.we ask that you.provide a copy of the letter from the Putnam County Department of Health clearly indicating such denial. If there are any questions, please do not hesitate to call. Thank you. Sincerely, Lawrence G.. Biegel Senior Environmental Analyst Region 3 LGB:sw cc:. J. Steeley J. Karell /W. Hedges, Putnam Courity.DO J. Greenberg g New York State .Department of Environmental Conservation 21 South Putt Corners Road, New Paltz, NY 12561 (:- 25 -545 June 10, 1987 Thomas C. Smith Jr. 28 Salem Way Glen Head, NY 11545 Re: Freshwater Wetlands Permit .Town of Patterson DEC #3724 -28 -1 Dear Mr. Smith: Henry G. Williams Commissioner We have received copies of again revised plans (dated 5/22/87) from your consultant for your permit application referenced above. Our review of this application is continuing. As indicated in our letter of January 14, 1987, the Department has reservations on permitting the filling - of protected wetlands merely to create a separation distance of 100 feet to a sewage disposal system. According to a letter dated April 27, 1987 by your consultant, attempts to .obtain a waiver from this separation requirement by the..Put�nam_ County :Health Department werg__unsuccessful, :..Prior.,ao. reach. ng„a .0 decision on your application, we ask 'that you provide a letter from.the Health V Department clearly indicating their unwillingness to grant such waiver. If there are any questions, please do not hesitate to call. Thank you. LGB /jb cc: J. Karell, PCHD J. Greenberg e Sincerely, Lawrence G.. Biegel Sr. Environmental Analyst Region 3 PETER C. ALEXANDERSON County Executive JOHN SIMMONS. M.D. Deputy Commissioner DEPARTMENT OF HEALTH JOHN KARELL. Jr., P.E. Director Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 July 24, 1987 Mr. Lawrence Biegel Sr. Environmental Analyst Region 3 NYS Department of Environmental Conservation 21 S. Putt Corners Road New Paltz, New York 12561 RE: Proposed SSDS Thomas & Roseann Smith Farm to Market Road (T) Patterson Dear Mr. Biegel: Please be advised that the Department has reviewed the plan for the above system, prepared by Joel Greenberg, revised May 1, 1987. The plan indicates that a stream, a discharge from a dug well and storm drainage from Farm to Market Road all affect the proposed sewage disposal area. The plans provide for the diversion of the storm drainage and dug well discharge around the proposed sewage disposal area. proposed . sewage disposal area. The Department will not approve this project with the stream,or the watercourse associated with the stream, within 100 feet of the proposed sewage system. It is noted that the design professional has proposed to relocate the stream, and fill part of the wetland which requires your approval. The Department will complete its review of the project within the next few days and advise Mr. Greenberg of our comments on the proposal. If you have anv questions, feel free to contact me at ext. 304. JK:mk cc: J. Greenberg Thomas Smith WH J.K urs, ;tit Jr.. P. E. Envirom- rental Health Services p, 95 -20-6 (9186) -25c NEW,YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DE- JERMIT NUMBER 3724 -28 -1 Under the Environmental Conservation Law Article 15, Title 3; 6NYCRR 327, Thomas C. Smith, Jr. 328, 329: Aquatic Pesticides ADDRESS OF PERMITTEE Article 15, Title 5: 1568 150th Place, Whitestone, NY_ 11357 Protection of Water aArticle Article 15, Title 15: TELEPHONE NUMBER Water Supply aArticle 15, Title 15: aArticle Water Transport Farmers Market Road 15, Title 15: aArticle Long Island Wells �j Article 15, Title 27: I I Wild, Scenic and Recreational Putnam Rivers Under the Environmental Conservation Law N —New, R— Renewal, M— Modification, C— Construct (*only), 0— Operate ( "only) EFFECTIVE DATE December 31, 1989 6NYCRR 608: Thomas C. Smith, Jr. Water Quality Certification ADDRESS OF PERMITTEE Article 17, Titles 7, 8: 1568 150th Place, Whitestone, NY_ 11357 SPDES aArticle Article 19: TELEPHONE NUMBER Air Pollution Control" 23, Title 27: aArticle Mined Land Reclamation Farmers Market Road Article 24: aArticle Freshwater Wetlands N —New, R— Renewal, M— Modification, C— Construct (*only), 0— Operate ( "only) EFFECTIVE DATE December 31, 1989 PERMIT ISSUED TO Article 25: Thomas C. Smith, Jr. Tidal Wetlands ADDRESS OF PERMITTEE Article 27, Title 7; 6NYCRR 360: 1568 150th Place, Whitestone, NY_ 11357 Solid Waste Management` aArticle 27, Title 9; 6NYCRR 373: TELEPHONE NUMBER Hazardous Waste Management Article 34: NAME AND ADDRESS OF PROJECTIFACILITY (If different from Permittee) Coastal Erosion Management Farmers Market Road aArticle Floodplaiain Management n 1, 3, 17, 19, 27, 37; aArticles 6NYCRR 380: Radiation Control PERMIT ISSUED TO Thomas C. Smith, Jr. ADDRESS OF PERMITTEE 1568 150th Place, Whitestone, NY_ 11357 AGENT FOR PERMITTEE /CONTACT PERSON TELEPHONE NUMBER Joel Greenberg' 628 -6613 NAME AND ADDRESS OF PROJECTIFACILITY (If different from Permittee) Farmers Market Road LOCATION OF PROJECT /FACILITY COUNTY TOWN?CXrXPZXKgX UTM COORDINATES Freshwater Wetland BR -7 Putnam Patterson DESCRIPTION OF AUTHORIZED ACTIVITY Construct a pond with the above wetland and adjacent area and a single family residence_ with.,_associated well driveway and drainage,- stru.c.t.ur..es._in_ .the wetl.a.nd. . - ... adjacent area in accordance with plans dated August 6 1986 last revised December 21 1987) as prepared by Joel L. Greenberg, and as conditioned herein. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli- ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto. 1. The permittee shall file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him /her promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public interest so requires pursuant to ECL §71 -0301 and SAPA §401(3). 3. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descrip- tion resulting from the said project. 4. The Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when: a) the scope of the project is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found; or b) the permit was obtained by misrepresentation or failure to disclose relevent facts; or c) newly discovered information or significant physical changes are discovered since the permit was issued. 5. The permittee is responsible for keeping the permit active by submitting a fenewal application, including any forms, fees or supplemental information which may be required by the Department, no later than 30 days (180 days for SPDES or Solid or Hazarduous Waste Management permits) prior to the expiration date. 6. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 7. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights -of -way which may be required for this project. 8. Issuance of this permit by the Department does not, unless expressly provided for, mo ' ersede or rescind an order on consent or determination by the Commissioner issued heretofore by the Department or any of the terms, conditions, or r�uirE•ments con fined in such order or determination. 9. Any modification of this permit granted by the Department must be i�riting and atta ed hereto. FPMRMIT ISSUANCE DATE PERMIT ADMINISTRATOR ( /I ADDRESS 21 South Putt Corners Road .3. j%0,-,5 Lfl Wi 1 am F. . StPi dl e ___ New Paltz, NY 12561 AUTHORIZED SIGNATURE ' A I-& I Paae 1 of 4 95 -20.6a (1!861 -25c ADDITIONAL GENERAL CONDITIONS F,OR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 ( Freshwater Wetlands ) 10. That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the 11 12 13 teration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waie`r{ or floiid'fTows or`eniianger' the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon, the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be com- pleted, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. Granting of this permit does not relieve the applicant of the responsi- bility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any 14 15 16 17 18 19 project. Any material dredged in the prosecution of the work herein permitted shall be remey!edievyer ly yvithgv,O ay.ing aargg;ref4se piles, ridges acrosV the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. There shall be no unreasonable interference with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under Article 36, this permit does not signify in any way that the project will be free from flooding. If granted under 6 NYCRR Part 608, the NYS Department of Environ- mental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95 -217) provided that all of the conditions listed herein are met. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. . Such approved plans were prepared by SPECIAL CONDITIONS CONTINUED ON NEXT PAGE on DEC PERMIT NUMBER 3724 -28 -1 PROGRAM /FACILITY NUMBER 2 of 4 _ e�m A95-20-6f (7/87) -25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS For Article 24 Freshwater Wetlands to To satisfy the requirement of General Condition No. 1, the permittee or a representative shall contact, by telephone, the Division of Law Enforcement in New Paltz (914/255 -5453) 48 hours prior to the commencement of any por- tion of the project authorized herein. 20 The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads and understands this permit and all special conditions; 3. As depicted on the approved plan, prior to commencement of all non pond - related construction, a continuous row of staked hay bales shall be installed and fully maintained until a suitable vegetative cover is established on all bare soils. 4. The pond is to be constructed in accordance with the plans and recommendations of the Putnam County Soil and Water Conservation District, Except for the berm area along the southerly side, the banks of the pond should generally blend with the existing elevations. 5. The sewage disposal system shall be constructed in strict accordance with the requirements and final approval of the Putnam County Health Department. 6, Other than the minimum required for pond construction, heavy equipment shall not-operate within the wetland proper, 7. , No filling of the wetland proper is permitted. Vegetation removed shall not be disposed of within the wetland or adjacent area, with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. 9. For any of the lots containing portions of Freshwater Wetland BR -7 or the adjacent 100 foot control area, the deed for each such property shall contain a restriction as written below: "For as long as any portion of the property described in this deed is subject to regulation under Article 24 (the Freshwater Wetlands Act) of the Environmental Conservation Law of the State of New York (ECL), there shall be no construction, grading, filling, excavating, clearing or other regulated activity as defined by Article 24 of the Environmental Conservation Law on this property within the freshwater wetland area or 100 foot control.area as shown on the site development plan for Thomas and Roseann Smith at any time without having first secured the necessary permission and permit required pursuant to the above noted Article 24, This restriction shall bind the Grantee's, their successors and assigns and shall be expressly set forth in all subsequent deeds to this property DEC PERMIT NUMBER 3 /L4 —Go -1 FACILITY ID NUMBER PROGRAM NUMBER Page 3 of 4 1 . 95.20 -61 @9195) SPECIAL CONDITIONS For Article 24 ( Freshwater Wetlands SEQR NOTE: Under the State Environmental Quality Review Act (SEQR), the project associated with this permit is classified as an Unlisted Action and the Department of Environmental Conservation (DEC) has determined that it will not have a signifi- cant effect on the environment. Other involved agencies may reach an indepen- dent determination of environmental significance for this project. DISTRIBUTION: P. Keller Law Enforcement R. Wood J. Steeley J. Greenberg/ .W: Hedges .DEC PERMIT NUMBER 3724 -28 -1 PROGRAKFACILITY NUMBER Page of � .1 PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Joel Greenberg Muscoot North RD #2, Box 488 Mahopac, New York 10541 Dear Mr. Greenberg: July 24, 1987 JOHN SIMMONS, M.D. Deputy Commissioner JOHN KARELL, Jr., P.E. Director RE: Thanas Smith Farm to. Market Road (T) Patterson ZM 71 -2 -14 A field inspection and review of the reviewed plans for the above mentioned project was conducted by myself on July 22, 1987. The following counts are offered: 1. As per John Karell's letter of July 22, 1987, we cannot approve a sewage disposal - -system within 100 feet of a body of water such as the stream'located on the plans. - 2> The sewage disposal system must be a minimum of 35 feet fran the proposed catch basin and culvert pipe. 3. The deep test hole did not appear representative of the entire SSDS area. An additional three (3) deep test holes and perc test holes must be dug in the SSDS area. 4. Because of the questionable soils in the area, perc tests must be witnessed by this Department. Please make the necessary revisions and arrange for perc tests to be done at your convenience. Very truly yours, a William Hedges, Jr. Sr. Environmental Health Technician WH:mk cc: N. Molle, BI (T) Carmel. 1 r 5� i TX .-'"� �' -....- � "" -,� -. -_. � � ;tit »g�•, -�.ya �r�T Eli Saw sa, 0 1 O I i c AM o I ims t I 4�tp 4 Eli t•i s t ` v` 6i�r d t � y ��., ��Yr ��G,i -"*'g«xa�+p"s' m,� '°� 0.,T 3" 'm+y t' '^ ��.r s Lc • sy� O •PU M'P TAN lL 56 P 9z' -74' �ry 1�11� C FI Lr2 �UNC--7 0 K ►3 !� 9 � I O (oq �r 5 12 { 5i 1 `?) : 79' r 25 7 ' i� �j lL 56 P 9z' -74' �ry e_ < NIF -10 PITRA -It 2, FM. 1724 AREA-= 2.2705' acres W �Urooh C11 0 0 O. 0, O1,1 001 29-85' Land5CO, Ire ret w711 21.. cimp Certified To Thomas C. Smith, Jr. Roseann L.Smith Pooi7g Savings Bonk Chicago Title Ins. Cc for policy TTP-5381 o/S 109.5 S -T OFN Cc,-.cstab *6 FR HOUSE SIrl. Underground Utility Service 0 open P0,01 0/6 to House wiM 2nd, 4.. 3 Z In. h.. de Ck guy catl� el I w y !One 1. 'es OO, 7 �e i NO3-37-45w— FARMI TO MARK 0 IET ROA 86 29 2 x 2 L-Nit-25-OOW NOO-56 , 00w N04- 40.0.0E rop Oct 78-60' 60-00'.. I //0, 06, ASSUMED LINE -.—A106_ 09 OOE 6200, SURVEY PREPAREO... FOR ROSEA NN L. 8r THOMAS C. SMI TH JR. SITUATE.... IN TOWN'0-Ac 1 1011-11TTERSON -COUNTY OF PUTNAM, STATE OF NEW YORK 'SCALE. NOVEMBER 16, 1988 JAMES K.. DE VINE JUNE. /6, -198.9 LAND SURVEYOR F "verevow or evenesteve bMciew %*Rw Oro, OW fib womp ;;::=I, = w- eft" Cab d w to TM SMU VAP 18 A VOIATM OP 493 ROUTE 22 wcm" "a M OF TNE.NRW YOKOM ON, " Y&k 9— AnOdIft et�*QNWw Lem FC&MT=L" 9--ft— Sew lueiiieeft Or m lih-00 own . OnN ft." woon for ed" go Mwev is W.P"'K COMES 0F9WWWM--TM"= PAWLING, NEW YORK and'onft' Ne 81 THE LAND BURVEYORS D$8008= WL Q' eyenep end kf!S!0kA "W" N9W 1weee end t, SHALL Nar a conewow W ft WAD of . TUEOCIP, 1-2564 "n"W04 Se WwabW i6 s&M hvtl" UN EPORM AND 089MM MVRM A W16M or iesbeewNww AND/OR ENCROA04MOft V AW. NOT 88112 SHO" HEREON.