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Home My WebLink About1766DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -105 BOX 16 I IN I I Ti r. '. is 1 1116- �a ' + '' '' ' V - ,; ,;'m Y6' '� 01766 . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well, Location....... -5trect lWell Address:. L tJr- Town/Village:, JTLN,qrid,# " Map 35 Block Lot(s) 4- o.5 Owner: Name: Address: Itzz ZA z 9 62 0 q Use of Well: 1-primary 2-secondary Residential Business Industrial Public Sdpply Air cona/heat pumpi Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary _ Cable percussion _.X Compressed air percussion Other (specify) Well Type Screened _Open. end casing >( Open hole in bedrock Other Casing Details Total length ft. Length below grade ft. Diameter in. Weight per foot I lb/ft. Materials: X Steel Plastic Other 'Joints: Welded �o Threaded Other Seal: -.>c Cement grout Bentonite Drive shoe: VYes No .Other ILiner : Yes ZNo Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed Pumped )L Compressed Air Hours 1�2 :r Yield gpm --6— Depth Data Measure from land surface-static (specify ft) During yield Etest(ft) Depth of completed well in feet 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 A9 6 Ak 27 O If yield was tested at different depths during drilling, list. Feet Gallons Per Minute Pump/Storage Tank Information Pump Type Capacity Depth Model, �O� ��D Voltage 2z BF Tank Type Volume &•1,1,66101 leoy&144-��7 Date well Completod /1 -L-- Putnam County Certification No. Date of Report --IWell 1111 � 01 A Driller (signature) - NOM Exact location of well with distances to at least two permanenf landmarks to be provided on a separate _sheet/plan. -eoLo) .0 Ira" Well Driller's Name S i gnature: White copy: Address: Date: Yellow copy - Building Inspector; Pink copy - Ownet Form WC-97 PUTNAM COUNTY DEPARTMENT OF HEALT DIVISION -OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTIO , OMPLIANCE SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # -�I Located at 4-4- QUA (1.,.. LAde Town or Village aaep_.50d Owner /Applicant NameW`f 11 Q AM Q H JC:;�'2 Tax Map 35 Block `t— Lot I QS Formerly 1.I Subdivision Name WI � 050R W Dor' S Subd. Lot # Mailing Address g (;D 1 I 1 iJ )&0(, Q WE bREvv S:EV,, Zip Date Construction Permit Issued by PCHD Separate Sewerage System built by N xx C Am EOJ Address 12-4- Kr_,LUT E _Z Z PA 0 W N (-7 LA t4 IDS�PI G Consisting of Gallon Septic Tank andCVQQ L.r:�- Or '24N W i tpE, {Ze Or_- P . II j Other Requirements: '21 �.�. �, F I LL 0 % ) 0 "E F�GU Water Supply: Public Supply From Address I D 54- T?-TIE SZ or: x Private Supply Drilled by BQYD A V_T 551A 0 NJ ELL' - RddressGAg_m rye. , M Y. 105/Z _....Building Type-- hfAH,1 LY RE61 VE Has erosion control been completed? -'(I F_4� Number of Bedrooms 4:: Has garbage grinder been installed? N 0 I certify that the system(s), as listed, serving th!, above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in, a w ssued PCHD Construction Permit and approved plans and the standards, rules and regulations o o, Department of Health. Date: Certified by P.E,-> R.A. ". Address I '5 1✓� �oU v}`'` `" License # Any person occupying premises served by the ab y ert�(s sWI promptly take such action as may be necessary to secure the correction of any unsanitary conditions-idstiMnoom. 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 revocati n, modificat. or change is necessary. By: Title: _.l_ -� Date: White copy - HD ale; Yellewsbpy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 ZUU6-U'1-Z4 '15:51 845Z(YZ6M wM P 4/11 BRUCE R FWY Pu#re._flsalt0r Dkwnw..: - - DEPARTUM OF HMTH i Gft"a Rand Brs Vdw. Now York 10509 LOREWA MOiINAn- Lx, Drt.sic Anmiale Pub& Seahk Dp Ww arm" of Po*d &Y*a ftyb"MeW SUN 014) 373.6130 Fa (914) ?A - 7921 r4wft I"Vkn p14)173. 6SS9 WW p14) 27i - bi18 .1:mx ptq 278 -4085 Z" bkrweatlu (914) 373.6014 trcwMW (914) Z7i6032 Fa(914) 273 . "Q ONMRS NAME: TAX MAP NUMER: E911 ADDRESS:`�.�•\ - �ill %.� aJ 'a Stu TOWN: AUTHORIZED TOWN OMCML: (Sipature) DATE: Z G The Putnam Caw* Department of Health. ioiR not issue a Certificate of Constriction Compliance unless the above form is completed, i.e., a legal E911 address is as d ped by an auftrked tom official. This form is to be submitted with the application for a Certificate of Constriction Complhmce. MI I VERFW PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well. - Location: _ :.... ;Street Address:- -... _. l+ Lgwge Town/Village: ' Tax Grid # - Maps: 5 Block q-- Lot(s) (' Well Owner: Name: Address: Use of Well: I- primary 2- secondary Residential Business Industrial Public S pply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary Cable percussion _ X Compressed air percussion Other (specify) Well Type Screened Open end casing >f, Open hole in bedrock Other Casing Details Total length ft. Length below grade eft. Diameter _in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded _,�c Threaded _ Other Seal: j_..- Cement grout _ Bentonite Other Drive shoe: Yes No Liner Yes „No Screen Details Diameter (in) Slot Size Length( ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Depth Data _ Bailed _ Pumped ;L Compressed Air Measure from land surface - static specify ft) During yield test(ft) Ho=zPr— Yiel d 6 gpm Depth of completed well in feet a Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameteron) Formation Description ft. ft. Land Surface - If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information ' Pump Type & Capacity &4ZW Depth Model &r Vy °�� Voltage HP Tank Type % 1 Volume 4L ,, c, '1,i Date Well Completqd Putnam County Certification No. Date of Report Well Driller (signature) NOTE: Exact location of well with instances to at least two permanent IanMlarKs to be proviaen on a separate neevptan. Well Driller's Name A,66,A01 Al- Signature: Address: Date: White copy: HD �ile; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well d5rilil er Form WC -97 A 7 rJL / 7GJJL Will r c/ c wT$'F-- �'�J' -06 05Y *zV Ralph G. MasCV&10naC0 PE 914 271 4762 P -02 PUTNAM. COUNTY DEPARTMENT OF HEALTH D SIGN OF ENVIRONMENTAL :U.EA,LTH; SERVICES -_ = � . .. _.. :: y= GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Own= or'Purchaser of Building Building Constructed by 6?t�Atl_ �atJh Location - Street Building Type _35 4- Ian Tax Map Block Lot TownlWillage W l �cwpaP oo� Subdivision Name 17 Subdivision Lot # I repres t that I am wholly and completely responsible for the location, workmanship, material, co on and drainage of the sewage treatmcctt system serving the above- described property, and that is had been constructed as shown on the approved plan or approved amendment thereto, and in accordan _ with the standards, rules and regulations of the.Putnsm County Department ofHealth, and hereby arantee 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 tnade by me to such system, except where the failure to operate • opedy is caused by the willful or negligent act of the occupant of the building utilizing the system. - The undj Director to opera system. � signed farther agrees to accept asRconch>sive�tbe determination of the Public Health 'the Putnam County Department of Health as to whether or not the failure of the system was caused by the willful or negligent act of the occupant of the building utilizing the Day Year Z.rCXXo S Signature Corporation Name (if corporation) h4;; Corporation Name (if corporation) Address: 17A 2WM Z2_ PAWLIt k State A924YoR.i� Zip I Z (1) e45 878 -act>1 Form GSA7 YML ENVIRONMENTAL SERVICES 321 Kear Street �'.yn�ktown,Heights,.N�Y�. 1� , (914) 24��-28�30 - ' Albert H. Padovani, Director LAB #: 1.602027 CLIENT Q 57197 NON STAT PROC PAGE: l ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~` WYNDHAM HOMES 8 COLLINWOOD DRIVE RALPH TEDESCO BREWSTER, NY 1O509 DATE/TIME TAKEN: DATE/TIME REC'D: REPORT DATE: PHONE: (845)-279 04/05/06 08:30 04/05/06 09:35 O4/11/O6 SAMPLING SITE: 44 QUAIL LANE SAMPLE TYPE..: POTABLE : BREWSTER PRESERVATIVES: NONE COL'D BY: JOSE TEMPERATURE.', < 4C NOTES...: WELL TANK �� Lc:i-r T CO| lFORM METH: MF DATE FLAG PROCEDURE RESULT PUTNAM CNTY PROFILE 0 - 10 9052 04/05/06 MF T. COLIFORH ABSENT /100 ML 04/07/06 LEAD (IMS) 7.3 ppb 04/11/06 NITRATE NlTROG 1.18 MG/L 04/07/06 NITRITE NITROG <0.0L MG/L 04/05/06 IRON (Fe) 0.184 MG/L 0400/06 MANGANESE (Mn) 0.021 MG/L 04/10/06 SODIUM (Na) 5.70 MG/L 04/05/06 pH 6.4 UNITS 04/07/06 HARDNESS,TOTAL 80.0 MG/L 04/07/06 ALKALINITY (AS 48.0 MG/L 04/10/06 TURBIDITY (TUR 1.2 NTU COMMENTS: FAX TO 845-279-2332 NORMAL - RANGE METHOD ABSENT 1008 0-15 ppb 9003 0 - 10 9052 N/A 9162 0-0.3 mg/l 9002 0-0.3 mg/1 9002 N/A 9002 6.5-8.5 9043 N/A N/A 900� COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD lNG-~�3~~HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION., Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no more distribution points have a LEAD value of more COPPER'value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 _ ^ _`_ __ , (914)`l�45-2800 1 . � Albert H. Padovanir Director LAB #: 1.602027 CLIENT #: 57197 NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ WYNDHAM HOMES 8 COLLlNWOOD DRIVE RALPH TEDESCO BREWSTER, NY 10509 SAMPLING SITE: 44 QUAIL LANE : BREWSTER COL'D BY: JOSE � NDTES...: WELL TANK ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 04/05/06 08:30 DATE/TIME REC`D: 04/05/06 09:35 REPORT DATE: 04/i1/06 PHONE: (845)-279-2022 SAMPLE TYPE..: P0TA8LE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH lS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMlSTRY., WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE GUM PF THE CALCIUM ,& MAGNESIUM ---- ' -CQNCENTRATI8Ny-BOTH EXPRESSED AS'-CALOfUM CARBONATE, lN MG/L. THE- HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: qo S e Director METHOD ELAPO 1032a SIIERLITA AMLER; MD,' -MS; FAAP �. -- , Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joseph Darnell Wyndham Homes, Inc. -8 Collinwood Drive Brewster, NY 10509 Dear Mr. Darnell: DEPARTMENT OF - HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT:J.- BONDI:� : -:, :;" County Executive October 26, 2005 Re: Potential Bedroom Count On October 24, 2005, Dr. Sherlita Amler, Commissioner of Health and I met with Mr. Richard Shunk to conduct a walk- through of "The Franklin" model home to determine the total potential bedroom count. The specific issue was the area above the garage labeled as a "Family Room" on the house plans. Please be advised of the f51lowing:- 1. This Department has determined that the potential bedroom count of a home with "The Franklin" type floor plan has 5 potential bedrooms. 2. All future and current submissions with the "The Franklin" type house plans will be considered as having 5 potential bedrooms unless the room over the garage is less than 80 square feet or has a horizontal measurement of 7 feet or less. 3. This Department acknowledges that the revised bedroom count guidelines were forwarded to Design Engineers and Architects only. This is a standard procedure, as the Design Professions are expected to advise their clients as to the Putnam County Department of Health current guidelines. This Department also acknowledges that Wyndham Homes, Inc. may have closed a sale on a house with "The Franklin" floor plan layout prior to receiving knowledge of the new guidelines. Therefore, the houseplans for lot # 17, Quail Lane, T.M. # 35 -4 -104, will be considered under the previous guideline,. Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 .:__4:.- jn_the Tuture dus.Department will attempt to forward,potential bedroom count code revisions to the builders and the Builder's Association. If there are any questions please feel free to call me at 845- 278 -6130 ext. 2166. Sin ly, 9�w X;/ Robert Morris, P.E. Senior Public Health Engineer RM:kly cc: Sherlita Amler, M.D. Michael Budzinski, P.E. Joseph Paravati Larry Werper Gene Reed 11 PUTNAM COUNTY DEPARTMENT OF HEALTH: - , DIVISION OF ENVIRONMENTAL _ . - HEALT'I3 •S- RACES : _ LETTER OF AUTHORIZATION RE: Property of \-%�!s\j xc)d �� Located at f e1 T/V ,d, Tax Map # 5 a Block _Lot Subdivision of t N ( yosg -2.L -ps AK Fes. =2 Subdivision Lot # Filed Map # 2 59 1 Date File.d.. 3 -14- Gentlemen: This letter is to authorize _Z4CM AAST -AA yr4 4'L1Z a duly licensed Professional Engineer .Z!5' or Registered Architect toapply for the. required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordaaiae with the standards, rules or regulations as promulgated by the Public Health Director of the .Putharn County Health Department, and to sign all necessary papers on my behalf in connection. with -this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the p�pyisions. of Article 1�5 and/or 147�of the Educ�tioa•Law; ic,P. blic_I ealth_` , S- - .. - - Law, and the Putnar",`�ou Code. Countersigned: P.E., R.A., # e Mailing Address State Zip p1 52O Telephone: 2 11 - 4 161, Very truly y urs, - w— Signed: (, wne of Property) r Mailing Address: 1k 3-e- State Zip IN Telephone. 2 Fo=LA -91 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER. TREATMENT SYSTEM 1. Name and address, of applicant: e. . 0. . 2 4. 6. Type of Project: Private/Residential Apartments Office Building Location TN: Address: e 3 DcyE (fou-p_-r Gaoro�l -a�l- uvsa.11�1%loszo Food Service Institutional Realty Subidvision Commercial Mobile Home Park Other (specify) — 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt X Type II Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? ............: Wp 9. Has DEIS been completed and found acceptable by Lead Agency? ............... Ni A 10. 1 l.. Name of Lead Agency NIA If this project is an area under the control of local planning, zoning, or other .y . officials, ordinances? ......................................................... ............................... Y -5 I� A h A 12. If so, have plans been submitted to such authorities? ........ . .............................. 13. Has preliminary approval been granted by such authorities? Date granted: 14. Type of Sewage Treatment System Discharge ................. surface water h groundwater 15. If surface water discharge, what is the stream class designation? ..................... _N IA 16. Waters index number (surface) ............. ............................... 1J ,a 17. Is project located near a public water supply system? 18. If yes, name of water supply 1 IA Distance to water.supply A 19. , Is project site near a public sewage collection or treatment system? ................ �O 20. Name of sewage system A Distance to sewage system 21. Date test holes observed 12 Gl 22. Name of Health Inspector M, 0QZlt�l Form PC -97 2 23. Project design flow (gallons per day) ............... ............................... 24. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... �® 25. Has SPDES Application been submitted to local DEC office? ......................... W 26. Is any portion of this project located within a designated Town or State wetland? 14 27. Wetlands ID Number .. ...............................:.....:................. ............................... LA 28. Is Wetlands Permit required? .............. _ Has application been made to Town of Local DEC office? ................. WA 29. Does project require a DEC Stream Disturbance Permit? ... .............................. 30. Is or was project site used for agricultural activity involving application of pesticides to orchards or-other crops, solid or hazardous waste disposal, B landf lling, sludge application or industrial activity? ............................ Yes/No 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ... ............................... Yes/No �-6 DESCRIBE: 32. Is there. a local master plan on file with the Town or Village? ......................... YOS 33. Are community water an sewer facilities planned to be developed within 15 years in or adjacent to project site ?......... ..... -. 34. Are any sewage treatment areas in excess of 15% slope? . ............................... . NO 35. Tax Map ID Number .......................... ............................... Map S Block 4- Lot 36. Approved plans are to be returned to ..... Applicant X Design Professional If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. i; I hereby affirm, under. penalty of perjury, that info r avf 6t►t p on this form is true to the best of my knowledge and belief. False stat a re punishable as a Class A misdemeanor pursuant to Section 21 • 1 1 I i�j�7 � � „i l I� T PROJECT ID NUMBER PART 1 -'PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTEd ACTION $ Only '. (To be completed by Applicant or Project Sponsor) SEQR 1W��GdA APPLICANT /SPON S O 2. PROJECT NAME r oM� "AKA Wlr�o` W�Ds 3.PROJECT LOCATION: PArrE PLJ Am Municipality Co unty 4. PRECISE LOCATION: Stfeet- A ess an Road Intersections. Prominent landmarks etc - or provide ap, ..! ` LAW,- '�ZMILE WEST'oF [2q-E- L2.OFF,L� ��tLL �o� Q UAIL. • �i:� 5. IS PROPOSED ACTION: New Expansion ❑ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 99 :.:.. olsw � G 10 N Of A tD� E FAH I L f a51 DE CE W1 pprniW9L Lj D�IJEWA 7. AMOUNT OFAND AFFECTED: Initially acres Ultimately acres r ; - • & WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICZ16NVS ?. Yes No If no, describe briefly: IS PRESENT LAND USE IN VICINITY OF PROJECT? •(Chpo .se as many. as apply.) �r9.--W++HAT I`)(J,Residential F Industrial Commercial []Agriculture Park / Fo ?est / Open 'Space aOther (describe) 10. DOES ACTION. INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY.OTHER .GOVERNMENTAL AGENCY. (Federal, State or Local) Yes a No If yes, .list a ency n me and permit / approval: �,.0 Ft.0i'i� •� • Q 1 . 6Wr4 t�a►T'�'ERSvt,I -. 601 LD1,NG PE R t"t �:i.: 11. D�O S ANY ASPECT OF THE ACTION HAVE' A CURRENTLY. VALID :PEkMIT, OR., APPROVAL?....,. 1�/lYes . ❑No -if yes, list agen ` -: name and ,permit "l approval �ovJ i� of IATTC-".. I3PNISio;P�ovdL. 12. AS A_agjSJJLT OF PROPOSED ACTION WILL EXISTING PERMIT / APPROVAL REQUIRE MODIFICATION? QYes X440 I CERTIFY THAT THE; INFORMATION PROVIIDpD,�E.D��AtBOV IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /Sponsor ��►LI '' • MA�1"�`' ` �/ �'� Date: �! �C9'�� ..; Signature_________ If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before•proceeding with this assessment PART II - IMPACT ASSESSMENT (To he comnletarl-hv I Parl Gnanr�vl A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. Yes No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN'6 NYCRR, PART 617.6 ?;' If No,:a nega.Uvz declaration maybe superseded by another involved agency. Yes [:] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten :'if ., legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing* traffic pattern, solid wa ste. production or disposal, potential for erosion; drainage or flooding problems? Explain briefly: C2. e ...' E.. 7 Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or commuriity or neighborhood character? Explain briefly: - C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endarigered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of.use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities. likely to be induced by the proposed set'iory? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy? ,Explain briefly D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT GtA CRITICAL ENVIRONMENTAL AREA (CEA)? If yes, explain. briefl El Yes No _ C " E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ltves ex lain:''' Yes No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant.' EiQ , effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (a) irreyersibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or refereniye supporting materials: Ensure that exp'Ianations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impactof the proposed action on the environmental characteristics of the CEA. Check this box if you have identiried,one,or more potentially larga or significant adverse irripacis which•MAY occur: Then proceed directly to the F EAF and /or prepare a positive dedlarakh' . Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed a WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting determination. Name of Lead Agency Pate Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Preparer (if different from responsible officer) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBS_ URFACE SEWAGE TREATMENT'SYSTEM Owne H0.E-5. Address 8 Cdlv vvoop Da. Baewsme. �i. LA E-. Tax --5 'Block Lot Located at (Street) QUA 1 !05C9 p (indicate nF,req cross street) Municipality K ,*�SOIL;P,IERCOLA�TIONT.E�'ST';6 tkp Date of Pre-soaking Date of Percolation Test 16 —9 H 61 N ............... ... ............ TimeIa ......... ... . . ...... se f Time hio .,ep From Ground Surface :(Indies) 02 .......... .. . . .... .... .... `Water .. Level : n. Percolation Rate ...... ....... .1.0 ....... . . . ... S t aft I . . ..... . h 1 I ®:lo- Ip:Z ... . ... . ... °I3f!� Z3 h 31 ........ 2 l0 :3®- 10:43: 3 117, ZZ 14- 3'A. 4 3 I0144-10:56g Z �� 3 223/4 4 J 5 1: 57- 10.-z,6 20 2a> 3 q 2 10-27-IQ57 30 20 2Z 7/S 10:58-11: Z8 30 20 2Z7/,e 8 I 0.3 4 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min-for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES - - =DEPTH - - =HOLE NO. G.L. Iopso s L 2.5'�F� 3.0' ozyribm YJ. EAT Ep-C-0 W M OTTLIN4 4.5' 5.0' 5.5' 6.0' . . 7.0' 7.5' 8.0' 8.5' 9.0' 10.0' HOLE NO_ 2�_ HOLENO..- . D � �9LLoW_.R6Q LOAM LOAM to rvom Poor, W/ MOTIOUNA x'13 L,311 i Indicate level at which groundwater is encountered 9 —O 1 Indicate level at which mottling is observed --31 —3e° 1 Indicate level to which water level rises after being encountered Deep hole observations made by: H. L Larr;pfDW MAji Design Professional Name: Address: Signature 11 0 r. �►ff Y� � 1 RALPH G. MASTROMONACO, P.E., P.C. Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (9 14) 271 -4762 . , (9] 4) 271-2820 Fox__, . Mr. Robert Morris, P.E. July 27, 2005 Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Via UPS Re: Proposed SSTS for Wyndham Homes, Inc. Quail Lane, Patterson, NY (Map 35 - Block 4 - Lot 104 - R.S. Lot 17) Dear Robert: Please find enclosed the following materials: 1. Five (5) signed and sealed copies of the drawing entitled SSTS Plan R.S. Lot 17 of Deer Wood Subdivision (Map 35, Block 4, Lot 104) Prepared for Wyndham Homes Inc. Located at Quail Lane, Town of Patterson, NY dated July 27, 2005 2. Four (4) signed and sealed copies of the Construction Permit Application dated July 26, 2005 3. Four (4) signed copies of the Application to Construct a Water Well dated July 26, 2005 4. One (1) signed copy of the Corporate Affidavit dated July 5, 2005 5. One (1) signed and sealed copy of the Letter of Authorization 6. One (1) signed and sealed copy of the Application for Approval of Plans for A Wastewater Treatment System - 7: One (1)-signed copy of the Short Ehvironmental Assessment Form dated July 26, 2005- �~- 8. One (1) signed and sealed copy of the Design Data Sheet 9. One (1) copy of the original Design Data Sheet for the subdivision approval 10. Three (3) sets of architectural plans for a four - bedroom house 11. Check payable to the PCDH in the amount of $400. We are requesting your review and approval of the submitted materials. Please call me if you have any questions. G. Mastromonaco RGM /jl Enclosures Cc: Jay Metcalfe, Wyndham Homes, w /two copies of plan PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, OR, AS, SRDATE: Y N DOCUMENTS (___)(PERMIT APPLICATION L)C-JWELLPERMIT ORPWS LETTER UUPc -97 L_)C—)LETTER OF AUTHORIZATION )(_)DESIGN DATA SHEET (DDS) (_)C_)CORPORATE RESOLUTION )(_)SHORT RAF L_)C__)PLANS -THREE SETS (_))HOUSE PLANS - TWO SETS (_)(___)VARIANCE REQUEST SUBDIVISION L_)C_)LEGAL SUBDIVISION (_)(_)SUBDIVISION APPROVAL CHECKED U(__)PERC RATE (__)( _)FILL REQUIRED DEPTH ,(_)CURTAIN DRAIN REQUIRED GENERAL LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP f DELEGATED TO PCHD DEP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED PERCS TO BE WITNESSED EX- APPROVAL SSDS ADJ, LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) DATA ONDDS.PLANS & PERMIT SAME PRE 1969 NEIGHBOR NOTIFICATION LETTER BUZBA `' '10II I'R•. "'FLOOD ELEVATION W/I200'` -` - -- ( ( )SOIL TESTING LOTS >10 YEARS OLD EWAGE SYSTEM PLAN - (NORTH ARROW) SDS HYDRAULIC PROFILE GRAVITY FLOW ' ONSTRUCTION NOTES 1 -15 iESIGN DATA: PERC & DEEP RESULTS 'CONTOURS EXISTING & PROPOSED iRIVEWAY & SLOPES, CUT ( -DV;FOOTING /GUTTER/CURTAIN DRAINS USDA SOIL TYPE BOUNDARIES (__)TITLE BLOCK; OWNERS NAME ADDRESS T1V1 #, PE/RA; NAME, ADDRESS, PHONE# (��DATE OF DRAWING/REVISION . DATUM REFERENCE (_�)(_)LOCATION OF WATERCOURSES, PONDS I AKES,WETLANDS WITHIN 200' OF P.L. PROPOSED FINISH FLOOR AND ()BASEMENT ELEVATIONS (WELLS & SSDS'S W/IN 200' OF SSTS PROPERTY METES & BOUNDS ((_)EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (REVMEET)09 /01 /00 MAP #: (CONFIRMED) Y (REQUIRED DETAILS ON PLANS CONT'Dl HOUSE SEWER -1/4" FT. 4 "0'; TYPE PIPE CAST IRON (_)NO BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS (STTE NOTE (NO CHANGE) FILL SYSTEMS , 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE (_ F) LL SPECS/ FILL NOTES 1 -5 ( f) ILL PROFILE & DIMENSIONS ILL IN EXPANSION AREA FILL GREATER THAIV 2 FEET CLAY BARRIER FILL CERTIFICATION NOTE DEPTH GAUGES VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS SEPARATION DISTANCE FROM TOE OF SLOPE TRENCH C /S(�LF TRENCH PROVIDED 60FT MAX. PARALLEL TO CONTOURS 100 % EXPANSION PROVIDED DETAIUDUST FREE CRUSHED STONE OR WASHED GRAVEL LK)LGEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS ( �)10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL C20' TO FOUNDATION WALLS (__)100' TO WELL, 200' IN DLOD,150' TO PITS 100' TO STREAM, WATERCOURSE, LAKE (inc. espan) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER _ . 10',T O WATER LINE.(pits. - 201) 50' INTERMITTENT DRAINAGE COURSE 200' 1500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS 'C)10' MIN TO LEDGE OUTCROP SEPTIC TANK L�10' FROM FOUNDATION; 50' TO WELL WELL dgDlMENSIONS TO PROPERTY LINES LOCATION OF SERVICE CONNECTION MIN 15' TO PROPERTY LINE SLOPE L� OPE IN SSTS AREA (S20 %) ( ^_ GRADED TO 15 %, IF REQUIRED C. DOSE/PUMP SYSTEMS yc- UMP NOTES OSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED ETAIL FOR FORCE M AIN, (PIPE TYPE, ETC.) IT AND D -BOX SHOWN & DETAILED DAY STORAGE ABOVE ALARM STAIN TANDPIPES, 5' BOTH SIDES, DETAIL 5' MIN to CDS =>5 %, 20'-4%, 25' -3 %, 35' -1 %- 100 % - <i% 0' MIN to CD DISCHARGE /100' with 182 cons day discharge 0' MIN to NON - PERFORATED PIPE SHERLITA AMLER, MD'; MS,'FAAP -' ' Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Ralph Mastromonaco 13 Dove Court Croton -on- Hudson, NY 10520 Dear Mr. Mastromonaco: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI' County Executive September 7, 2005 Re: Proposed SSTS: Wyndham Homes, Inc. Quail Lane, Lot # 17 (T) Patterson, TM # 354-104 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. House plans are considered to have 5 potential bedrooms. The construction of this sewage disposal system may be subject to .local .wetlands regulations. You should contact local wetlands officials"in this regard: ` Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:kly Ve y your Robert Morris, P.E. Senior Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 RALPH G. MASTROMONACO, P.E., P,C, Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 „ (914) 271 -4762 (914) 271- 2820.,Fax„ . _.. Mr. Robert Morris, P.E. Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS for Wyndham Homes, Inc. Quail Lane, Patterson, NY Lot 17 (TM #35 - 4 -104) Dear Robert: August 26, 2005 Please find enclosed drawing entitled SSTS Plan R. S. Lot 17 of Deer Wood Subdivision (Map 35, Block 4, Lot 105) Prepared For Wyndham Homes Inc., Located At Quail Lane, Town of Patterson, NY, dated July 27, 2005, last revised August 23, 2005. As per your review memo dated August 18, 2005, we offer the following responses: 1. Profile has been corrected as noted 2. Curtain drain is labeled on the profile 3. Note has been added to the drawing 4. House plans are being reviewed by architect and to be addressed under separate cover 5. Standpipe detail added onto drawing - 6. Standpipes are --labeledon drawing 7. Wells and septics within 200 feet of property line 8. Sewer line slope labeled on plan 9. Fill section detail and notes added to plan We are requesting your continued review and approval of the submitted materials. Please call me if you have any questions. Sincerely, m Ralph G. Mastromonaco RGM /jl Enclosures - SHERLITA AMLER; MD; =MS; FAAP ' - .. - Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Ralph Mastromonaco 13 Dove Court Croton-on- Hudson, NY 10520 Dear Mr. Mastromonaco: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive, September 7, 2005 Re: Proposed SSTS: Wyndham Homes, Inc. Quail Lane, Lot # 17 (T) Patterson, TM # 35-4 -104 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. House plans are considered to have 5 potential bedrooms. The construction of this sewage disposal system may be _subject to local wetlands regulations. You should contact local wetlands officials in this regard. " Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:kly Ve ly your Robert Morris, P.E. Senior Public Health Engineer Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 RALPH G. MASTROMONACO, P.E., P.C. Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (914) 271- 4762... -(914) 271 -2820 Fax Mr. Robert Morris, P.E. Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS for Wyndham Homes, Inc. Quail Lane, Patterson, NY Lot 17 (TM #35 - 4 -104) Dear Robert: August 26, 2005 Please find enclosed drawing entitled SSTS Plan R. S. Lot 17 of Deer Wood Subdivision (Map 35, Block 4, Lot 105) Prepared For Wyndham Homes Inc., Located At Quail Lane, Town of Patterson, NY, dated July 27, 2005, last revised August 23, 2005. As per your review memo dated August 18, 2005, we offer the following responses: 1. Profile has been corrected as noted 2. Curtain drain is labeled on the profile 3. Note has been added to the drawing 4. House plans are being reviewed by architect and to be addressed under separate cover 5. Standpipe detail added onto drawing 6. Standpipes are labeled on'drawing 7. Wells and septics within 200 feet of property line 8. Sewer line slope labeled on plan 9. Fill section detail and notes added to plan We are requesting your continued review and approval of the submitted materials. Please call me if you have any questions. Sincerely, Ralph G. Mastromonaco RGM /jl Enclosures DEPTH HOLE NO. l HOLE N0. * 2 HOLE NO. G.L. 0.51. aP 'o.l V ; Topsal I, I A'.. I.5' I& I 2.0 t OAA ( W j467De�i. 2.5' 3.0' GIG W , 4._: 7.0' :.. 7.5' -1 �'r- - -- S�r<P L 2" 60,--P) 9.5' .......10.0'. Indik:.: leveA :un tir .Le ....:r� tered C7CP Indic;.te level at which mottling is observed indicate level to which water level rises after being encountered 3 0 " {•�t7 Deep hole observations made by: Iii . -( I r4 Sk1 Date Design Professional Name: LI.W . N jtj.4g Address:..2o mIL=16g 1�AI2 _r.s,?Ut"'fr;:;� 152 oF 14EW V Signature Design Professional's Seal nicko� �- * Tt • 9 a: r ` Lu LU n No. 56124 ,o v \ ROFESSIO r . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Ate V19W050A UjC)0 ®5 represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Having offices at: IiPS Those Officers Are: President - Nam �ckNC , S :L Vice President - Name: Address: Secretan, - Names: • Treasurer - Name: Address: and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating the o. Signed: Title: F SAS' rn to before me this .day of (month) ear) t lic �0, Vxk Corporate Seal r Form CA-97 t i .. t Ulf ow tb95 01. 47 040L I7G3d "L WYNVHAM NUMtb 1NU. r Ak3t UZ p�UTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVYROIMENTAL BEAL'T:R_SER'VICES DESIGN. DATA.SHEET - SUBSURFACE. SEWAGE.TREATM ENT SYSTEM Owner Address LA le 0 Nf —/N-r Wl Located at Street ��pw�,L2iD5 1 r. Tax Map 35 Block_ Lot _ (Street) :� indicate ne.arest'oross street • ' Municipality. faa=A•`a?fA ' Drainage.Basin . g12 rii� es=y- SOYL• PERCOLATION TEST DATA . Date of Pre - soaking I1 -18 •q & Lg m :. `.: • Date of Percolation Test perooiatiga test hale. (i.e.. s 1 miii for 1•30.,inrmch,. s Z min for 3. -69 miNmcnl Air oats oa _' ' "suli�itted'forteview. ' , . _ _ . ^_.. y::� .... x:- ::._::- .• .. , 2. `:Depth measurements to he made from top of hole - . Form DD-97 Daoth tc 7la.ter From Ground Water Level Percolation ' �kTTole No— Run No.- Th.-le Start -- Stop. EIa se Time oM•m.) Surface (Inches) Start Stop Drop In Inches Rate Mid` -cb 2 ;; 3. 4- ... _ " 2 - 20 22�� 2 lD.3 2 3 .. ...... 02 ' 4 • 2 NOTES: '1.. • Teststo• be:ceneated at same depth untit approxim el y equal percolation• rates ate obtaiaed at each perooiatiga test hale. (i.e.. s 1 miii for 1•30.,inrmch,. s Z min for 3. -69 miNmcnl Air oats oa _' ' "suli�itted'forteview. ' , . _ _ . ^_.. y::� .... x:- ::._::- .• .. , 2. `:Depth measurements to he made from top of hole - . Form DD-97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive M .0 To: ALL ENGINEERS AND ARCHITECTS From: Sherlita Amler, MD, Commissioner of.Health Cc: Loretta Molinari, Associate Commissioner of Health. Date: March 9, 2005 Re: Bedroom Count Policy Please be advised that the Putnam County Health Department policy for bedroom count related to new septic system installations is as follows: 1. The Department will allow on the first floor of a single family, stand alone dwelling, the following rooms: _ a. Living room ✓ b. Dining room c. Kitchen ✓' a.._. d. ' mily roo.. � f' -5wi ,J>J�&� Y 2P-+0 e�/1 PLA J a oe. f UF-j Any other rooms beyond the 5 above mentioned rooms, regardless of openings, will be considered potential bedrooms, except for rooms which meet the following criteria: • If the room has a floor area less than 80 square feet. If the room has a horizontal dimension less than 7 feet. If the room in question can only be accessed through another room with no . other means of potential egress, one of the rooms will be considered a. potential bedroom, if the dimension criteria for a potential bedroom is met or exceeded by one or both rooms. 2. Any room proposed on the second floor will be considered a potential bedroom, .regardless of openings, whether the room is finished, bonus room, or loft areas. Noted below. are the exceptions: ® If the room has a floor area less than 80 square feet. ® If the room has a horizontal dimension less than 7 feet. 1 , Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 • If the room in question can only be accessed through another room with no other means of potential egress, one of the rooms will be considered a .potential. bedroom, ifthe_dimension. criteria. for a potential bedroom -is met or - exceeded by one or both rooms. The bonus room will not be considered a potential bedroom if it can only be accessed Fr'ough the garage and if it has no potential access through the living area of the house. 3. The basement area can be converted into one large room. Any other rooms proposed in the basement, laundry rooms, storage rooms, etc... will be considered potential bedrooms regardless of opening, whether it is finished or unfinished or whether or not it has windows. Noted below are the exceptions: • If the room has a floor area less than 80 square feet. • If the room has a horizontal dimension less than 7 feet. 4. The following is concerning special circumstances: a. Utility /mechanical rooms will be allowed in the basement where the purpose is to enclose the furnace, water heater, etc... b. Architectural house plans will be required for a two bedroom house. The two bedroom house plans if approved by the waiver committee must be the house constructed on the lot. c. Raised ranches will be considered to have a basement and 1" floor, i.e. the lower area will be considered the basement. 5. All submitted house plans must have a title block noting the owner's name, street address of the property and tax map number. All house plans approved by this Department must be original prints, i.e. hand revisions will not be acceptable, The above policy will go into effect on April 1, 2005. Please advise all new septic system _.... -.. -- installers of-this change +n- policy..., -- .- . _.. . .. .. ._.._._.. . _ ._..__.._...- ._ .._. • Page 2 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN,.MSN Associate Commissioner of Health Ralph Mastromonaco 13 Dove Court Croton -on- Hudson, NY 10520 Dear Mr. Mastromonaco: ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 April 6, 2006 Re: Field Inspection Wyndham Homes, Inc. Quail Lane, (T) Patterson TM # 35 -4 -104, Lot # 35 The above referenced separate sewage treatment system can be backfilled. There are no open comments to be addressed at this time. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:kly _ . . . . Very truly yours, - -- _ Gene D. Reed Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Mar -29 -06 04 -S4P Ralph G. Mastromonaco PE 914 271 4762 P.01 _. .. .. PUTNAMCOUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENIIION ❑ JOSEPH GENE REQUFST FOR FINAL INSPECTION For: Fill =Z1__oanon m ust be fully completed prior to any Trenches io s being made. i p PCHD C nstruction Pernu'j # Located. U L (T) (V) TT'ERso� Owner /A plie t Name: TM 35 Block Lot fie?} Formerly _ Subdivision Name: Subdivision Lot # _ Is system! fill completed? %5 Date: - 3- i (P. O% Is systea ti:� replete? Date: 3.1(o .Oro Is systen constructed as per plans? Is well d illed? _ Y>1S _ Date: 110.0( Is well located as per plans? Are, Bros on coatrol measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and. veed their completion in accordance with the issued PCHD Construction Pennit and approv plans and the Standards, Rules and Regulations of the Putnam -County Department of Health. ,. ..... Date: 3 2,1 Oco Certified by: PE. RA Design Professional Addicsl: _� _ _Pp ✓ E e%A V g �i•�TD -� 1✓1U Lie. # O 5 44`JI S T Comments: Form T4R. {),o eUTNAM COUNTY DEPARTMENT OF HEALTH ISION OF ENVIRONMENTAL HEALTH SERVICE CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM RMIT �,, L II . I p �- Located at (!:2 UA I L. A N u- Town or Village PA-rTr Pc,0iJ Subdivision name R VOO® Subd. Lot # Tax Map 5 S Block 4- Lot Date Subdivision Approved 31 O n. Renewal Revision Owner/ApplicantName\A/W04Am. HO A et tC, Date of Previous Approval Mailing Address C-ol I i �YIOO® [,)12IVF, 5P-Elfi��TI� Eliy V ogy- Zip '509 Amount of Fee Enclosed �l�t�. Building Type bbl '� �5. Lot Area �. No. of Bedrooms Design Flow GPD000 Fill Section Only Depth Volume PCHID NOTIFICATION IS iE UIREID WHEN FILL IS COMPLETED Separate Sewerage System to consist of 25® gallon septic tank and o � L; . 'o 7,#1 W l 1e� A DD o J 7-g e G�4 Other Requirements: 21 P-. ®a Fy. F I LA - ; -7 l DEW G To be constructed by -ro- M QeTg?Hltj e0 Address Water Supply- Public Supply From Address _ Private -Supply Drilled byQ �' .17 �'r� P� l Address-'--- - I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in 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 ill be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in go P p E o on any part of said sewage treatment system during the period of two (2) years immediately followin o GE of the approval of the Certificate of Construction Compliance of the original system or any ir/ttit I \ I', jz % Air �l Signed: Address P.E. _A�' R.A. Date -726 05 k), Mf It63D License # 0�44 8 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 w co sidered ecessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pemi . prov r discharge of domestic sanitary sewa only. By: i Title: Date: %o A P White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ APPLICATION TO CONSTRUCT A.WATER WELL please print or type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # u 11 � L LA PATTE RSON Map-315 Block + Lot(s) � (� Well Owner: Name: V_f, dAM Home Address: 0Go) I 1 �,Wo o Dlz. B2e&JSTE DIY lmm Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought, 5 gpm # People Served Est. of Daily Usagei5 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason 0 -2W-V ICr-, A PRO OI W �51 " G EAH i LY E>V LL B kki for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No >< Is well located in a realty subdivision? ............ ............................... ...................... Yes x No Name of subdivision IN D A" ' ID Lot No. 1-7 Water Well Contracton-ro $15: r71;Ta 12 �-1 i Jeo Address: Is Public Water Supply available to site? .................................. ............................... Yes No >< Name of Public Water Supply: _ Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination-to be pr 'd don separate sheet/plan. Date:.- .26.05.. -:. Applicant Signature.: -. C r PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water W/" ller cq4tified by Putnam County. Date of Issue o be. /0 Permit Issyft Official: Date of Expiration I IW6 Title: Permit is Non - Transfer abl , White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 3 O OOry O O Z N/F KATZ VACANT LANDS t x 7'08' E 54.11' S 89'10'24' E 97.88' . 4AS BEEN URVEY AND L. S. CEI E- S 67'21'35' E 100,01' N ROOF '1 FO O 88'07'38' E 50.19' S 84'330' TING de 34.76 EX. 0.1. E DRAIN DISCHARGE + /� x•04' S 88'31'20' E 130.01' / l0 - _ _ _ _ ' A 1. 0 1111__ 18__DS DMH _ EX. 18' ADS C.B. PROPO §ED 23' V1 DE 15, CURTAIN DRA N DISCHARGE DRAINAGE EASEMENT i �L _ _ _?//�1 �1I EXTENSION 1 �O C.D. MONITORING r / STAND PIPES I I I I I I SSDS AREA LOT 1 7 T, ' I.1, (I 16,fiDD J. z gl YI $i gl gl gl of 113,628 s.f. - I I I I I 1 1 -1 2.609 acres j" ml m1 �1 ml �I ml N1 EXISTING STONE RETAINING WALL � / EXISTING ' / ✓ / / / EXPANSION / THERE ARE NO SEPTICS LOCATED WITHIN 100' UPSLOPE WELL OR 200' DOWNSLOPE IN DIRECT LINE OF DRAINAGE 35.8' O gp OF THE EXISTING WELL LOCATION AS SHOWN. THERE ARE NO EXISTING OR PROPOSED WELLS / ` sus• }° ' 1 // / Iry LOCATED WITHIN 100' UPSLOPE OR 200' DOWNSLOPE IN DIRECT LINE OF DRAINAGE OF EXISTING SSTS S 8911'47' W 383.00' z t' i Y 1 LOT 18 N 58'05'06' W 15.0 S 33'54'54' W 11.1 CEI E -2 -' g� / x � 1 t , 1 } C9 E -2 -2 • ix<1x { p T DEEP CURTAIN DRAIN \ ALL LATERALS HAVE / / x § WITH MONITORING PIPES . EXISTING CAPPED ENDS (TIP.) ' tl sORIVEWAYkt S 8911'47' W 383.00' z t' i Y 1 LOT 18 N 58'05'06' W 15.0 S 33'54'54' W 11.1 CEI E -2 -' g� / x � 1 t , 1 } C9 E -2 -2 TIE DISTANCES TRENCHES REQUIRED = 500 L.F. TRENCHES PROVIDED. = 500 L.F. A B T1 21.3' 70.7' T2 23.5' 61.4' JB1 36.1' 57.1' J132 41.0' 60.9' JB3 46.0' 64.9' JB4 51.1' 69.4' JB5 56.4' 74.2' J86 62.0' 78.8' JB7 _ 67.6' - 83.5' L1 67.0' 29.8' L2 70.1' 35.4' L3 72.6' 41.6' L4 75.8' 47.5' L5 79.5' 53.3' L6 83.2' 59.1' L7 65.3' 96.9' L8 63.5' 109.0' L9 58.1' 105.7' L10 52.3' 1 102.3' L11 46.9' 99.4' L12 41.5' 96.7' L13 37.2' 94.6' TRENCHES REQUIRED = 500 L.F. TRENCHES PROVIDED. = 500 L.F.