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DEPARTMENT PUTNAM COUNTY OF I
_ l f
/f
-;..,:;.:DIVISION-;OF-ENVIRONMENTAL HEALTH SERVICES--- - -
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # - 14 - 06
Located at (00 0L)AI L LA r 15 Town or Village PATTERSON
Owner /Applicant Name `(N G AM H D M ES Tax Map Block Lot _
Formerly }.� �A Subdivision Name ); U)op
Subd. Lot # 2 2.
Mailing Address 166 3o A PEE WSTE P=, t�:% Zipl09
Date Construction Permit Issued by PCHD I I I I (' 1 0,5
Separate Sewerage System built by A m Axx CAMe Address 124 RTE 22 PAWLIt,6 � •
i � ci
Consisting of 12,15 0 _ Gallon Septic Tank and
Other Requirements:
Water Supply: �— Public Supply From � /A Address
Irf4 RoVTE S
or: Private Supply Drilled by bo' OAR: SAO VeLI,(!Addresq!- .}'1 EL ILL[
Building Ty as erosion control been completed?
Number of Bedrooms 4:-:: Has garbage grinder been installed? do
I certify that the system(s), as listed, serving the above
built plans (copies of which are attached), in accord
plans and the standards, rules and regulatior� of , F
Date: j6-Z,0'_6& Certified by
Address
moo. Q5hngi
Any person occupying premises served by the
were constructed essentially as shown on the as-
�Wued PCHD Construction Permit and approved
Devartment of Health.
P.E.X R.A.
License #e264410
take such action as may be necessary
to secure the correction of any unsanitary conditions re-9dftffiffom such usage. Approval of the separate sewage
treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval
of the private water supply shall become null and void when a public water supply becomes available. Such
approvals are subject to modification or change when, in the judgment of the Public Health Director, such
revocat n, modifi atipfor change is necessary.
By: Title: Date:
White copy - HD A; Yello copy - Building Inspector; Pink copy - Own, Orange copy - Design Professional
Form CC -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well Location . . -. -
Street Address:
Town/Village:
Tax Grid #
Map 35 Block 4- Lot(s) X 09
Well Owner:
ame: A dress:
Use of Well:
1- primary
2- secondary
)' Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
Rotary Cable percussion -.)L 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 lb /ft.
Materials: Steel _ Plastic _ Other
Joints: Welded _jeL Threaded _Other
Seal: " Cement grout _ Bentonite Other
Drive shoe: Yes No
Liner :. Yes No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft)
Developed?
First
Yes—No
Hours
Second
Well Yield Test
_ Bailed _ Pumped -Ng Compressed Air
Hours /
Yield" gpm
Depth Data
Measure from land surface- static (specify ft)
Durinp��oo �y*t t(ft )
Depth of completed well in feet
Well Log
If more detailed
information
descriptions or
sieve analyses
are avaifable,
please attach.
Depth From
Surface
Water
Bearing
Waft
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
1/y
Ap
4&C
J44
S
3
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type Capacity 111
Depth r Model
Voltage.= HP
Tank Type y Volume &
v/fv D ,
elf
Date Well Compl /d
Putnam County Certification No.
Date of Report
Xv
Well Driller (sig ture)
NOTE: Exact location of well with distances to at ast two permarfent landmarks to be prov aeci o ;tsneeupian.
Well Drillees Name _ , t, i Address: ff
Signature: Date:
White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
Zuu6-u1 -14 15:51 8452792332 wM P 8/11
� H.'ikh' Db cfe' r
LORb•Tt'A WL6wu RN» Dd".
AWW4afs P4bUd Meaft AWWw
avedur of Puaw Arvka
DEPARTA+M OF HEALTH
1 GMOV4 Road
BrawjW. New York i OS09
ay.lntoaeu Harei p1427t -ita0 tm(9,14) 271.79'21
NW4Wg l 19— (914379.1239 WFC (414x4 -4VI . ftxOI4) Y7f -WM
ft* fMft M WW f 14) 279.6014 hw*Od (914)2716012 Fa (414 174 - 664E
OWftM NAM:
TAX MAP NUMAER:
E911 ADDRESS:
TONM:
7
AUMOREM TOWN OFFICIAL: GU�
(Sigautture)
DATE: 2
'Fhe P'atnam
Con My Department of Health WM not issne a Certificate of
Construction Compliance unless the above form is completed, Le., a legal E911
address is asstiped by on authorized town official 'Phis form is to be submitted
with the application for a Certificate of Construction Compliance.
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. Michael Budzsinki, P.E.
Director of Engineering
Putnam County Dept. of Health
1 Geneva Road
Brewster, NY 10509
Re: SSTS AS -built for Wyndham Homes, Inc.
68 Quail Lane, Patterson, NY
(Map 35 - Block 4 Lot 109- R.S. Lot 22)
Dear Mike:
Please find enclosed the following materials:
June 21, 2006
Via UPS
1. Five (5) signed and sealed copies of the drawing entitled SSTS As -Built Plan R.S. Lot
22 of Deer Wood Subdivision (Map 35, Block 4, Lot 109) Prepared for Wyndham Homes
Inc., Located at Quail Lane, Town of Patterson, NY, dated June 20, 2006
2. Four (4) signed and sealed copies of the Certificate of Construction Compliance dated
June 20, 2006
3. Four (4) signed copies of the Well Completion Report dated June 14, 2006
4. Three (3) signed copy of the Guarantee of Subsurface Sewage Treatment System
dated June.20, 2006
5. One -(1) copy of the Well Water Analysis,dated °May 26, 2006 -
6. One (1) copy of the E911 Address Verification Form
7. Check #490560 in the amount of $300 payable to the Putnam County Dept. of Health
8. One (1) copy of the New York Board of Fire Underwriters Certificate for the septic pump
We are requesting your review and approval of the completed works.
Please call me if you have any questions.
4jr) incerely,
h G. Mastromonaco
RGM /)I
Enclosures
Cc: Joe Darnell
May -18 -06 09:34A Ralph G. Mastromonaco PE 914 271 4762 P.01
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF .ENVIRONMENTAL HEALTH..SERVICES .I."t ". - -:_
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
wYG�D1;AM I�iot�l S! mac. :�5 4- 109
Owner of Purchaser of Building Tax Map Block Lot
f ATTE25o�
Building 'Constructed by TownNillage
60 2) WAIL LAI S WldC>50i? �OD5
Location.- Street Subdivision Name
DIME., FAHIL-f RSSIOENGF_
Building'Type Subdivision Lot #
I represent that I am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is has been constructed as shown on the approved plan or approved amendment thereto, and in
accordanpe with the standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition
any part, of said system constructed by me which fails to operate for a period of two years
immediately following the date of approval of the "Certificate of Construction Compliance" for the
sewage treatment system, or any repairs made by me to such system, except where the failure to
operate pkoperly is caused by the willful or negligent act of the occupant of the building utilizing the
system.
The undersigned further agrees to accept as conclusive the determination of the Public Health
Director of the Putnam County Department of Health as to whether or not the failure of the system
to operate was caused by the willful or negligent act of the occupant of the building utilizing the
system.
Dahed: Mon u Day 2D Year 20000 Signature:}
(Owner) - Signature
WiwD! -�At� H oMEs , Dc
Corporation Name (if corporation)
Address: 153 5 P- aom312SuiTE 3 01 A
State EVJSTEe. , ��± Zip 1050�
Title:
AMAXXcAME LA DSCAPWI,
Corporation Name (if corporation)
124 ROUTE 5z
Address CA P.M 6L
State � w Zip 10511-
Form GS -97
YML ENVIRONMENTAL SERVICES 2v
321 Kear Street
Yorktown Heights, N.Y. 10598
- _
- .. .... (91,4). 24.5. 2.80.0
_ - Albert H Padovani, Director= =.. .
LAB #: 1.602973 CLIENT #: 57197 . NON STAT PROC PAGE: 1
WYNDHAM HOMES DATE /TIME TAKEN: 05/18/06 04:00
8 COLLINWOOD DRIVE DATE /TIME RECD: 05/18/06 05:15
RALPH TEDESCO REPORT DATE: 05/26/06
BREWSTER, NY 10509 PHONE: (845) - 279 -2022
SAMPLING SITE: 68 QUAIL LANE SAMPLE TYPE..: POTABLE
: BREWSTER PRESERVATIVES: NONE
COL'D BY: JOSE W. QUICENO TEMPERATURE... < 4C
NOTES.... WELL TANK Tme SS -4 - /09 9.S.LoT ZZ COLIFORM METH: MF
DATE FLAG PROCEDURE
RESULT NORMAL - RANGE METHOD
PUTNAM CNTY
PROFILE
05/18/06
MF T. COLIFORM
ABSENT
/100 ML
ABSENT
1008
05/24/06
LEAD (IMS)
2.0
ppb
0 -15 ppb
9003
05/25/06
NITRATE NITROG
8.36
MG /L
0 - 10
9052
05/19/06
NITRITE NITROG
<0.01
MG /L
N/A
9162
05/25/06
IRON (Fe)
<0.060
MG /L
0 -0.3 mg /1
9002
05/19/06
MANGANESE (Mn)
<0.010
MG /L
0 -0.3 mg /l
9002
05/19/06
SODIUM (Na)
3.65
MG /L
N/A
9002
05/19/06
pH
6.6
UNITS
6.5 -8.5
9043
05/19/06
HARDNESS,TOTAL
70.0
MG /L
N/A
05/19/06
ALKALINITY (AS
38.0
MG /L
N/A
9001
05/25/06
TURBIDITY (TUR
<1
NTU
0 -5 NTU
COMMENTS:
BACT THESE RESULTS INDICATE THAT THE WATE (WAS) WAS NOT) OF A
SATISFACTORY SANITARY QUALITY ACCORDI THE NEW YORK STATE
AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS
TESTED, AT THE TIME OF COLLECTION.
Pb /Cu LEAD limits for public schools are set at 15 ppb.
EPA Lead & Copper Rule for Public Systems requires that no more
than 10% of their distribution points have a LEAD value of more
than 15 ppb and a COPPER value of 1.3 mg /L, else water
treatment must be undertaken to reduce the waters corrosive
potential.
Fe /Mn If both iron and manganese are present, their total value
combined shall not exceed 0.5 mg /L.
Na No limits for Sodium are proscribed. Suggested guidelines state
that for people on a sodium restricted diet,the water should
contain no more than 20 mg /L of Sodium. For those on a
moderately restricted diet, a maximum of 270 mg /L of Sodium
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
(914) 245 -2800
'Padovarii;'- Director
LAB #: 1.602973 CLIENT #: 57197 NON STAT PROC PAGE: 2
WYNDHAM HOMES DATE /TIME TAKEN: 05/18/0.6 04:00
8 COLLINWOOD DRIVE DATE /TIME RECD: 05/18/06 05:15
RALPH TEDESCO REPORT DATE: 05/26/06
BREWSTER, NY 10509 PHONE: (845)- 279 -2022
SAMPLING SITE: 68 QUAIL LANE SAMPLE TYPE..: POTABLE
: BREWSTER PRESERVATIVES: NONE
COLD BY: JOSE W. QUICENO TEMPERATURE... < 4C
NOTES... WELL TANK (rm—# 35- �%_�D%,j R. Lor2ZCOLIFORMNMETH: MF % N -------- NMMNNN
DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD
is suggested.
pH pH SCALE IN WATER RANGES FROM 1 -14. MEASUREMENT OF pH IS ONE OF
THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY.
WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND
FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5.
Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM
CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG /L. THE
HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG /L, DEPENDS ON THE
SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED.
SOFT WATER: 0 -70 MG /L VERY HARD WATER: ABOVE 300 MG /L
MODERATELY HARD WATER: 70 -140 MG /L-- .._._.MG /L = MILLIGRAM PER LITER
HARD WATER:- 140 =300 MG /L - - _ .. - - - --(1 grain /gal -lob = '17'.'2 "MGft)"-
SUBMITTED BY: \ �'-
Albert H. P dovani, M.T.(ASCP)
Director / ELAP# 10323
Ck4P1YPAbB 07: 8Y = 4u2037300318 845279237AM ELECTRIC
6dM PA& 2�4IO2
CERTIFICATE 1713 1, BY THIS COMPLIANCE
YORK-BOARD - Mkt- D r R r i T - r J
BUREAU OF ELECTRICITY
44 FULTON STREET — NEW YORK, NY 14DO38
CERTIFFIES THAT.
Upon the application of upon premises owned by
KEELER ELECTRIC
151 GRASSY PLAJN STREET C -1
BETHEL, CT. 06801,
Located at 68 QUAIL LN.BREWSTER, IVY 10609
Applicetion Number: 2094686
WYNDHAM HOMES
68 QUAIL LN
BREMTER, NY 10509
Certificate Number: 2094686
Section: 35 Block: 4 Lot: 109 Building Permit, 38406 6DC: W104
R.S.Lox Z
Described as a Residential 0 -599 square fL occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, lesated inlon the premises at:
Hasemont, Outaido,
A visual Inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conducted in accordance
with the requirements of the applicable code and /or
standard
promulgated by the State of New York,
Department of State Code Enforcement and Administration,
or other
authorW Having jurisdiction, and found to
be in compliance therewith on the 7(p Day of June, 2006.
Name
QTY $ot4 Agm Qircu it zz
Amount
SEP7I1 :,Puw : '..
$0.00
Alarm and lEmerpney 2quiptnent
Sensor
2 0 Moats Alarm
$0.00
lPancl Board
1 0 Septic Alarm_
50.00
Appliances And Accessories
PUMP Motor
2 0 Septic F.Rp.
$0.00
Wiring and Devices
Motor Control Center
1 0 Septic Special
$0.00
Imroicc ToW
$85.00
Dett:ea rpvaviously mportcd, as items of non- compliaace, have been coned. A visual inspcdion made of.the exposed electrical equipment in
tht premiscs indicated found no obvious unsatisfactory condition_
seal
I of I
This certificate may not be altered In any way and is validated only by the presence of a raised seal at the location indicated.
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
May 30, 2006
DEPARTMENT OF - HEALTH
I Geneva Road, Brew er, New York 10509
Ralph Mastromonaco
13 Dove Court
Croton -on- Hudson, NY 10520
Dear Mr. Mastromonaco:.
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Field Inspection — Wyndham Homes
68 Quail Lane, (T) Patterson
The above referenced separate sewage treattnerit.�system can be backfilled. The following
comments must be corrected in the field.
1. No 7 pipe to be connected at D box # 1.
2. Pump chamber to remain open pending pump test.
If you have any further questions, please contact me at (845) 278 -6130.
JD:kly
Sinc ,
v .
eph Digit
Environmental Engineering Aide
Environmental Health .(845}; 278 -6130 Fax (845) 278 -7921
Water Supply Section (845,)225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
FINAL SITE INSPECTION
Street Location�A
Town 7r
1. Sewaze Svstem Area
Owner �YI-/
Permit #
Date:
Subdivision Lot # 2 L
a. STS area located as per approved plans ..........:..............•.. '
b. Fill section - date of placement
3:1 barrier Lgth. Width . Avg.Dpth
c. Natural soil not stripped ................:.
..... ...............................
d. Stone, brush, etc., greater than 15' from STS area..........
e. 100' from water course / wetlands ...... ...............................
H. Sewage System //
a. Septic tank size - 1,000 ...:.. ...1,250..�! .... other .................
b. 'S eptic'tank installed level ..... ....................... I ............... ....
c. 10' minimum from foundation ......... .............................:.
d. Distribution Box
1. All outlets at same elevation -water tested ................... -
2. Protected below frost ................. ............................ :..
3. .. Minimum 2 ft. Original soil between box & trenches
e. Junction Box - properly set...... ...............................
6. TrencHes
1. Length required — Length installed��
2. Distance to watercourse measured Ft.....t.no
3. Installed according to plan ............... :.....: .
4. Slope of trench acceptable 1/16 - 1/32 /foot .............
5. 10 ft. from property line - 20 ft.- foundations..........
6. Depth of trench <30 inches from surface..... ..............
7. Room allowed for expansion, 100 % .........................
8. Size of gravel 3/4 - 1'h" diameter clean ...................:.
9..Depth of gravel in trench 12" minimum .......:...........
- 10:�-Fip-e�ends-capped ::.- ..-.:::..:.. ... ...:........................
g. Pump or Dosed Systems , . i
1. Size of pump chamber.. it 10.?�.. Ia �(�� .
.. ........................... .
2. Overflow tank .................
... .......... ..... ............................... .
3. Alarm, visual/ audio ....... .:........:.... ............................::.
4. Pump easily accessible, manhole to grade .................. .
5. First box baffled ........
................... ..............................:
6. Cycle witnessed by H.D.estimated flow /cycle...........
M. House/BuildinS
a. house located�per approved plans .... ...................:...........
b. Number of bedrooms ....................... ...............................
IV. Well
Well located as per approved plans......: :.........
b. Distance from STS area measured ft...........
C. Casing 18" above grade ................ ............. ...................
d. Surface drainage around well acceptable .......................
V. Overall Worlamanshiu .
a. Boxes properly grouted ................... ...............................
b. All pipes partially backfilled ........... ...............................
c. All pipes flush with inside of box ... ...............................
d. Backfdl material contains stones <4" diameter ..............
e. Curtain drain & standpipes installed according to plan..
f. Curtain drain outfall protected & dir.to exist watercourse.
g. Footing drains discharge away from STS area ................
h. Surface water protection adequate .... ....:..........................
i. Erosion control provided... .............................................
Rev. 12/02
Jun -15 -06 10:22A Ralph G. Mastromonaco PE 914 271 4762 P.01
_. S45.778 -792! r-Ax
PUTNAM COUNTY DEPARTMEWT OF EMALTH
DIVISION OF ENVIRONMENTAL $EALTH SERVICES
RFO[=T FQR FINA1. INSPg; jON For: Fu M P E51
Date:
PCHD donstruction Permit # 1+"05
Located: _6p, 0 21264. L Ade R:�!o0
Owaer /Applicant Name: Dl�tAM H oMG-s TM _ y Block 4- Lot 109
Formerly: Subdivision Nun:.�n�l
Subdivision Lot # �Z
Is system fill completed? Date:
Is system complete? "(E Date: 16 O%
Is sys 4 constructed as per plans?
Is well drilled? ` MS Date:
Is well located as per plans?
Are eroioa control measures in place?
I certify that the systew(s), as listed, at the above premises has been constructed and I have inspected
and vedtfied their completion in accordance with the ' PCHD Construction ' Permit and
approvdd plans. and the Standards, Rules and of the Putnam County Department of
Health.
_ ... _.. _ ... Date: '5. 0(v Certified by: P-A RA '
Design Profesaioaal
Addresst 13 Drr/tEGouerG � i-� uybot�� I�IY. Uc. # C&4 05
FOR ❑ ADAM ❑ GENE O
(KAW)
Form FIR-99
Jun -15 -06 10:23A Ralph G. Mastromonaco PE 914 271 4762 P.02
r-'JVJYPA)92 07: W -*4D283739 9318 i%5ZfVZ3A&LER ELECTRIC W PA& 29 ?/82
BY THIS ' CERTutrATE ' OF OOMPLLAME THE
NIEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF EL..BCTNICITY
40 FULTON STREET - NSW VORK, MY LOWS
CERTIFIES THAT
Upon the apolicatlan of
KEELfiR ELECTRIC
151 GRASSY PLAIN STREET C-1
BETHEL, CT. 08841,
Located at 88 QLWL L N.6REW8TER, NY 11
AppliaaWn Number: 20941M
upon premises owned by
WYNDHAM HOMES
88 QUAIL Ltd
SIREW3i1ER, NY 10508
Certificate Number: 2094688
Section: 36 Block: 4 Lot: 108 Buiiding Permit; 38406 SOC: W104
RSA Z2
Described as a Regden iol 04S99squereIL occupancy, wtwe!n the ormises electrical system consisting of
electrical devices and wiring, described below, Iocatk in /on the premises at:
Baser vent, oul8ide,
A visual ihspection of the premises electrical system. limited to electrical devices and wiring to the extent detailed
heroin, v48s conducted in accordance with ,he requjrerWIM_ of the applicable code and/or
standard
promulgatl ed by the State of New York,' Department of State Code Enforcement and Administration,
or other
authority Laving jurisdiction, and found to be In compliance therewith on the 70 Day of Jum, 2006.
AIM I3" rg= I=
Ai-
SEPVC 6,w
SO.QD
Alarm and Emergency 24cipmd
Sensor 2 0 11l0at8. AIM
50.00
pmel Board t 0 9egtio AtZ=.
$O QQ
Appliance# and Accemoriies
Pump Mock 2 0 Sapdc F.XP.
30.00
Wiring an� neAces
Moron cotrtrol Cotter I 0 1111191111: 3peeiai
SO-OD
tavoicc ToW
533.00
Dereag Vavliou* mPo ftd, as items of nw-.a yliaacs, have beers con **4 A vimal inspcceoa made ofthe ciposad a wuical equVam m
Ou orerriscs indicated found no ckvims unaatis*ory eendifion.
sear
I of i
This certificate may not be altered In any way and is valid only by the prowve of a raised awl at the location indicated.
PUTNAM COUNTY DEPARTMENT OF HEALTI
HVISION OF ENVIRONMENTAL HEALTH SERVI
PERMIT #
CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
Located at % B Q yA I L LA N a Town or Village PATT
D E2 WOOC> Ak.A
Subdivision name 1�/�r• pSOr��n/ooDS Subd. Lot #7-2- Tax Map 35 Block _4::__ Lot
Date Subdivision Approved -J O —"7 HO '(' Renewal Revision
Owner /Applicant Name W-`� P� A M M ES Date of Previous Approval
Mailing Address g6c) 1 1 1 dwoo D PP—I\/a ,SIZE W,5MP= Iy, y t . Zip Q
Amount of Fee Enclosed f 4-Oo
Building Type s I FAH ILY RC-5, Lot Area 13 07 No. of Bedrooms-4--Design Flow GPD�
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of 12-5C) _gallon septic tank and ( (7 L.F OF
Z 41 'VV I OF-- A Pf�P- PT- 1oJTRF_t L
Other Requirements: 1 25 p
L. PU M P G�A M I
To be constructed by To 6E D ET E R M t � E D Address
LOW
Water Suonly: Public Supply From II Address
.Pri
-vate .Supply Drilled by To E LM i NEB 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 guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said
builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years
immediately following the d uance of the approval of the Certificate of Construction Compliance of the original
p !ftmi O/ ,_
system or any repairs th o.� ,- o��, ,
Signed:
Address
P.E. R.A. Date 9 1 29 65
�, dzf IpsZoLicense # 544G1
APPROVED FOR C =h. 0Pe
is approval expires two years from the date issued unless construction of the
sewage trea nt s ste d and inspected by the PCHD and is revocable for cause or may be amended or
modified whe co sidered essary by the Public Health Director. Any revision or alteration of the approved plan requires
a new permi p roved ischarge of domestic sanitary sewage only.
By: Title: U Date G u
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
May -23 -06 04 :16P Ralph G. Mastromonaco PE 914 271 4762 P.01
�- Zee -?4zi tiu�
PUTNAIM COUNTY DEPARTMENT OF HEAL'T'H
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
REMMtT FOI, FiNAi . INSpErm )N For: Fill
Date: _ �% Z 3t o� Trenches X
PCHD Construction Permit # f214- — o5
Located: j LJ_ Alde (T) ('V) RAT�rEi25c4J
Owner /Applicant Nauae: i�lDI�AM ®M�h Tm Block Lot 109
Formerly: Subdivision Name: 1A 1 P_ w�.,
Subdivision Lot # 2
Is system fill completed? Date.
Is system complete? `{E Date: S Ildoco
Is system constructed as per plans?
Is well thrilled? Date: '5110106
Is well 1dcated as per plans?
Are erosiori control measures in place?
I certify the system(s), as listed, at the above premises bas been constructed and I have inspected
and verified their completion in accordance w4.ula ' ed PCIM Construction Permit and
approveid plans and the Standards, Rules and R o of the Putnam County Department of
Health.
Dater 2 0% z Certified by:L e��E _ RA
Design Professional
FOR -❑ ADAM ❑ GENE ❑
(NAME)
Form FIR -99
"+ IF �. _ ;, TF! : FS4S- 278 -7921 NAMF' PI ITNAM i- it It.IT`.' r1 =DCjMTMFAIT nr n
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 #
jQU LA�E P T` E Map-3'> Block-- Lot(s) I
Well Owner:
XMO�Am Hom E S
Address: w I
I�WOOD DP. B>z>=WSTEa NY, 105
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 _5t gpm # People Served Est. of Daily Usageal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
iC New Supply (new dwelling) Deepen Existing Well
Detailed Reason
O SE P_V IG> A P 2.o OS S I G L E FA M I L ES I D E 1=
for Drilling
Well Type
>!5;: Drilled Driven Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No >_
Is well located in a realt subdivisi,o�} ? ..................................... ..`.....�........................ Yes_ No
pes-p__
Name of subdivision I fJDSp2 WcLCX7-A Lot No. Z�
Water Well Contractor: 1-6 pr- D F=J1 Ij� Address:
Is Public Water Supply available t ite? .................................. ............................... Yes No
Name of Public Water Supply: A Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination o e provided on separate sheet/plan.
Date: Z9, 05 Applicant Signature:
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director y revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water ell filler rtified by Putnam
County. `�
Date of Issue 1[1164r" Permit Iss ' Off ial:
Date of Expiration v Title:
Permit is Non- Transfe rable
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
U JV 111JW1UVUJV 1111 YI IVJ WVIY111U •JWVIY kVVL VLI.. .�1lV • IJl _'L'l.!: 111 it tJCJ✓JG- CIG -IYVl
j
s
November 10, 2005
`Enviirohir►iental
'';Rrtetio Robert Moms, P -E
' Putnam Co. Health Dept.
~� 4 Geneva Road
!: Brewster, NY 10509
' -' ' '__: '•.;.: Re: Deerwood Subd, Lot 22.
68 Quail Lane ( v
j�l�.' s... , :•.r ix .. Patterson, Putnam
,CogRmiis'+t►, ' ;,`J :z<, East Branch Reservoir
DEP Log # 2005 -BB- 1111 (Joint Review)
'Td. (T'(8) 59 461 .
Dear Mr. Morris:
mWeR6'!.t.WM6rs4ih, , t..;., !. This letter is to inform you that the New York City Department of Environmental
ads ►,d Protection (Department has determined that the above - referenced application is
complete. In addition, the Department has no objection to the approval of the
.., sr.ig., above - referenced regulated activity. This determination is based on the review of
a# f<P� , ; : submitted documents including the plan titled "Proposed SSTS Deerwood
I` Subdivision Lot #f 22" prepared for Wyndham Homes, dated 09/30/05.
r= a�:49a7a�o3aa:.; s The applicant must contact Sissy De La Ossa of my staff at (914) 173 -4416 at
least 2 days prior to the start of consduction of the SSTS so that a Department
..,. .
p Y P and monitor the
'C' _re resentatrye ma II1S eCt installation.
j ..A. .
�•
�r~otd . Sincerely,
? Y 773-44,70
:
Danny Shedlo, P.E.
Civil Engineer II
Engineering Review Group
' I >
Y
x Roger Sokol P.E NYSDOH
G= ,. ,,
t a• • i
4
ZO 'd L l :9 L 5002 01 AON E:b0i1 -1 LL -� l6 :xe�
SHERLITA AMLER, MD, MS, FAAP
., .. Commissioner of
LORETTA MOLINARI, RN, MSN
Associate Commissioner ojHealth
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Ralph Mastromonaco
13 Dove Court
Croton -on- Hudson, NY 10520
RE: Wyndham Homes, Inc.
62 Quail Lane, Lot # 22
(T) Patterson, TM # 35 -4 -109
Reservoir Basin
Dear Mr. Mastromonaco: .
ROBERT J. BONDI
County' - Executive
October 20, 2005
The Putnam County Department of Health (Department) has determined that the above
referenced application, including fee, and received by this Department on October 5, 2005 is
complete. The Department will notify you by November 12, 2005 of its determination.
❑ The Project has been delegated to the Putnam County Health Department for
review pursuant to the guidelines set forth in the Watershed Agreement.
❑x Joint review with the NYCDEP will commence pursuant to the guidelines set
forth in the Watershed Agreement.
If the Department fails to notify you within the above referenced time frame, you may notify the
_. Department of. its_failure by certified mail, return receipt requested. The notice. should be sent to
' "my attentiori At Ilid'above address: This notice must includC your name, the locatiori' of thE`" -'
project, the office with which you filed the application originally, and a statement that a decision
is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection
Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the
receipt of the notice, your application will be deemed approved, subject to standard terms and
conditions as set forth in the regulations.
Please be advised that projects within the NYC Watershed may also require Department of
Environmental Protection review and approval of other aspects of a project, such as stormwater
plans or the creation of impervious surfaces, and the project applicant should contact the
Department of Environmental Protection regarding such activities to see if Department of
Environmental Protection review and approval is required.
If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2166.
RM:kly
Ve trul yours,
Robert Morris, PE
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
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: 67--t;L— SS2., — W \ t�QSOR= WpoC)C57
represent that I am an officer or employee of the corporation and am authorized to act for.:
Name of Corporation:
Having offices at:
Whose Officers Are:
President
d d r e s `
Vice President - Name:
Address:
Secretan, -N
Ad'd'ress:
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 thereto.
Signed:
Title:
Sworn to before me this . day of
k (month (year)
ublic
'G - Corporate Seal
Form CA-97
,.,RALPH G. MASTROMONACO, P.E., P.C.
e
Consulting Engineers
13 Dove Court, Croton -on- Hudson, New York 10520
(914) 271 -4762 (914) 271 -2820 Fax
Mr. Robert Morris, P.E. October 4, 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 109 - R.S. Lot 22)
Dear Robert:
Please find enclosed the following materials:
1. Five (5) signed and sealed copies of the drawing entitled SSTS Plan R.S. Lot 22 of Deer
Wood Subdivision (Map 35, Block 4, Lot 109) Prepared for Wyndham Homes Inc.
Located at Quail Lane, Town of Patterson, NY dated September 30, 2005
2. Four (4) signed and sealed copies of the Construction Permit Application dated
September 29, 2005
3. Four (4) signed copies of the Application to Construct a Water Well dated September
29, 2005
4. One (1) signed copy of the Corporate Affidavit dated January 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 Environmental Assessment Form dated September 29,
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.
12. One (1) signed and sealed copy of the pump calculations
13. One (1) copy of the pump curve
We are requesting your review and approval of the submitted materials.
Please call me if you have any questions.
S n erely,
Ral h G. Mastromonaco
RGM /jl
Enclosures
Cc: Jay Metcalf, Wyndham Homes, w /four (4) copies of plan
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Z "'I DESIGN- DATA: SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
661 woci
Owner ��d0dAm,,�I�o'mE.5-�jrIC,.;'Addressl-'O Ffi o DR.B2EYVIS1
t4-r 105&j
Located at (Street) I A I L LA E Tax Map 35 Block 4- _Lot I C9 R.s.6T2, �
(indicate nearest cr ss street)
Municipality PAI-T E -2 Watershed goe-, E >Pxpny-
SOIL PERCOLATION TEST DATA
Date of Pre-soaking Date of Percolation Test 8, 19 100
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
......
....
De th o:: er::
From Ground
Level
......
Percolatt4tt
...... .............
Hole 'N"
.........
Rutt W..
Mart . .'.S1t0'*
.........................
... . . . . . . . . . . . . . . . . . .
"Time
$e
. . .... .
surface �ft h6o
. J'Ji.
. ... . .... .. .
. . . .
. .
9:0z
. . . . . . . . .
9:3z
. . . . ...
3o
233/4.- 2 5'/z
13/,4.
. . . . .
17.1
2
9:3310
;03
a 3o
23-3/4-,251
1.
2 D
3
IUC4 1D:3
30
2331425'14-
177,
20
4
1 1:C0
3C>
233/4 2 5
'14 -
Z4
5
11,31
-1130
12,01
30
2-7J 4 -25
1114
64-
1 z
TO&
9.'23
17
221/2 2 5 V?-
3
57
-2-'--T24
9-444
20
221/2 Z5' /2
3
61
3
9:46
10:o5.
20
2Z/2 Z5' /z
3
6.7
4
I 1 :0Z
11*32
30
2221/2 * 25 %2
3
ID
5
11341
Z:04.
30
2Z'lz 25/4
23/4
ID-9
1
12:37-
1:07.
3C)
Ulk Z5
Z 3/4-
10.1
2
3
4
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 2
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE E NO. 1 HOLE NO:.:: � 2 -� HOLE NO.
G.L. To P501 L -
- I opsol L.
RED99DW95A LOAM
RED BRoW>J SA�V( LOAM
2.0. .
2.5' .
3.0'
3.5'
4.0' FI E GREY SA 51T
4.5' F1n1G6xREYSAtJDw�sILT
5.0'
5.5'
6.0'
7.5'
8.0'
8.5'
-
9.5' _._.....r.._.._. _.... _ _ ._ _. _
10.0'
IIJF: R�IATIC: � sit- ova/ICI HE�ZEo I�A� B�E1� PP- o�!1DEr7 6'f D Eps.
Indicate level at which groundwater is'encountered N6� E'
Indicate level at which mottling is observed fJ 6t
Indicate level to which water level r ;se. a_ f�er bging encountered: t J/A _
tG OLS VR.PE.
Deep hole observations made by: Date -77/12-/00
Design Professional Name: t<A L p �
Address: (,:,- oL) eq-
Signature
01
!O A -
ki
1igh 'oessional's Seal
OF N
D�E
pR0 ESSIONA�
R GOULDS PUMPS
APPLICATIONS
Specifically designed for the
following uses:
Homes
• Sewage systems
• Dewatering/Effluent
• Watertransfer
• Light industrial
• Commercial applications
Anywhere waste or drainage
must be disposed of quickly,
quietly and efficiently.
SPECIFICATIONS
Pump
• Solids handling capabilities:
2" ma)dmum.
• Capacities: up to 183 GPM.
• Total heads: up to 38 feet TDH.
Discharge sue: 2" NPT.
threaded companion flange as-
standard, 3" option
availablebut must be ordered
separately, (Order no. Al -3)
• Temperature:
104OF (40"0 continuous
1400F (6n intermittent
• See order numbers on reverse
side for specific HP, voltage,
phase and RPMs available.
FEATURES
a impeller. Cast iron, semi open,
non -dog, dynamically balanced
with pump out vanes for
mechanical seal protection.
optional silicon bronze impeller
available.
a Casing: Cast iron flanged
volute type for maximum
efficiency. Designed for easy
installation on Al 0-20 slide rail.
■ Mechanical Se* SILICON
CARBIDE VS. SILICON CARBIDE
sealing faces for superior abrasive
2002 Goulds Pumps
W"Ilva nrtnher. 2002
Submersible
Sewage Pump.
Prosurance available for residential applications.
resistance, stainless steel metal
a Class R insulation.
parts, BUNA -N elastomers.
• All single phase models
x Shaft Corrosion resistant, 400
feature capacitor start motors
series stainless steel. Threaded
for maximum starting torque.
design. Lodcnut on three phase
Single phase (60 H*
models to guard against
• Built-in overload with
component damage on
automatic reset
accidental reverse rotation.
• 'h and 1h HP -16/3 S1TOW
a Fasteners` 300 series stainless
with 115 V or 230 V three
steel.
prong plug.
■ Capable of running dry without
• 1!a and 1 HP -14/3 STOW
with bare leads.
damage to components.
w Designed for continuous
Three phase (60 H*
• Overload protection must be
operation, when fully
provided in starterunit
submerged.
• 'h'1 HP -14/4 STOW with
bare leads.
MOTORS
IiMi1 Designed for Continuous
a Fully submerged in high grade
Operation: Pump ratings
turbine oil for lubrication and
are within the motor
effident heat transfecAll.ratings .. _ --
—manufacturers recommended
are within the working limits of
working limits, can be
the motor.
operated continuously without
damage when fully sub-
merged.
■ Bearings: Upper and lower
heavy duty ball bearing
construction.
0 Power Cables: Severe duty
rated, oil and water resistant.
Epoxy seal on motor end
provides secondary moisture
barrier in case of outer jacket
damage and to prevent oil
wicking. Standard cord is 29.
Optional lengths are available.
■ Motor Cover O-ring: Assures
positive sealing against
contaminant and oil leakage.
AGENCY LISTINGS
Tested to 10 878 arxl
csa 22.2 108 standards
By Canadian Standards
c us Assodatim
ire hjVg 49
Goulds Pumps is ISO 9001 Reostered.
0 IQ 20 3Q dQ m'ih
FWw RAiE
PUMP Mop�LS I O'B� GOuds Pumps
I
��A'rlt�lsl. PD I_ ITT IIldUStiIES
3o:a5
COMPUTATION OF SYSTEM DYNAMIC HEAD LOSSES
WYNDHAM HOMES- LOT 22 QUAIL LANE
_._-- FLOW; =GP.M. 42 NUM: PUMPS ON 1
DESIGN FLOW: CFS 0.094 FLOW: GPD 60480
ITEM
VALUE
INTERNAL PIPING
719.00
DIAMETER: INCHES
2.00
LENGTH OF PIPE: FT
5
HAZEN C FACTOR
145
AREA PIPE: SF
0.02
HYDRAULIC RADIUS: FT
0.04
DESIGN FLOW: GPM
42.00
VELOCITY: FPS
4.289
HEAD LOSS: FT
0.18
BEND 90 DEGREES
K VALUE
0.75
VELOCITY: FPS
4.29
HEAD LOSS: FT
0.21
CHECK VALVE
K VALUE
3
VELOCITY: FPS
4.29
HEAD LOSS: FT
0.86
BEND 90 DEGREES
K VALUE
0.75
VELOCITY: FPS
4.29
HEAD LOSS: FT
0.21
BEND 90 DEGREES
K VALUE_
0:75
VELOCITY: FPS _
4.29
HEAD LOSS: FT
0.21
INCREASER
INITIAL DIAMETER: IN.
1.25
INCREASE TO DIA.: IN.
1.500
K VALUE
0.46
VELOCITY 1: FPS
4.29
VELOCITY 2: FPS
2.98
HEAD LOSS: FT
0.01
FORCEMAIN PIPE
DIAMETER: INCHES
2.000
LENGTH OF PIPE: FT
168
HAZEN C FACTOR
145
DESIGN FLOW: GPM
42.00
DESIGN FLOW: CFS
0.09
AREA PIPE: SF
0.02 .
HYDRAULIC RADIUS: FT
0.04
VELOCITY: FPS
4.289
HEAD LOSS: FT
6.07
TOTAL HEAD LOSS: FT
HEAD LOSS COMPUTATIONS
HIGH POINT
719.00
PUMP ELEV.
699.75
STATIC HEAD: FT
19.25
DYNAMIC HEAD: FT
7.77
0.18
0.21
m:.
0.21
0.21
0.01
6.07
7.77
TOTAL HEAD: FT 27.02
P 2/5
2005 -09 -29 15:48
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERWrES
DESIGN DATA SIMET = SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner G o cog»
M A-f
r ,� q ��A E� �a�aM o Address L a ►� c_ UQ r aY,. tl� ��v Ya
Located at (Street) OLD
JZ QA O Tax Map 3 s Block 4 Lot (.9
(indicate nearest cross street)
Municipality
(T') P A?' L _ � Q ►,, _ Watershed 13 o S ao o w, 3Z s s .
L o r Z Z
SOIL PERCOLATION TEST DATA
Date of Pre - soaking
a] e 100 Date of Percolation Test
. • �q+�
fix`• ,
1'viS..f`•.'^ N:.A,•(j�A`yy .. ., �y� .�.N,'y �. ��'.
t$M.:er �ti<te7r :s.
:.. 4 •�• r• s^` �•• � k; . �.T �'.
t
+
'sr
ti :
e it om.C.rn w YeVi�l a
•: <$pi-4"AcleK . ; w ` "
g��jr]8c/a a�lr�t}g tt
.s; .a•n >>
yj
ttP o '
N
t l
l
9:0z 9:32 30 Z34 z 'a J! )7.1
2
9:33 10:03 30 Z•3 4 Z54 12 z0.0
3
1o:o4 10:34 30 20 0
4
z s
5
11:31 It:01
30
Z34 ZS
14
Z4.0
12
1
9 :06 9 -,Z3
17
ZL,i ZS it
3
5.7.
-' -_
2
9:24 9;44
20
ZL `L ZS:t
.3
(0.7
3
y:gs Io:os 2 0 zz zs i 3 (6.7
4
1I;oZ r1:3z 30 z z zs i 3 10.0
5
1, :34 12:04 3'O zz z 2s 4 z ¢ 30.9
1:07 3o ' 2L a zS• Z a 10.9
®
I
s
NOTES: 1.
Tests to be,repeated at same depth until approximately equal percolation sates are obtained at each
percolation test hole. (i.e. s 1 min for 1.30 mintinch, s 2 min.for 31 -64 min(inch) All data to be
submitted for review. ;_ '
2,
Depth measurements to be made from top of ho1e.
t:nnn nn_o'l
2005 -09 -29 15:49 P 3/5
TEST PIT DATA
z DES , :
...... ®N OF SOILS ERtC® '.E D IN TEST HOLES
HOLE Vii®.
T.O PSO1 L v
Pztrs �r��A� , aTn
FINE Gee:/ LnwrS� vy :tiLT
Design Professional's Seal
2
PUTNAM COUNTY DEPARTMENT OF HEALTH...
DIVISION OF ENVIRONMENTAL HEALTH -SERVICES-.�...,:-.'..-.:'
LETTER OF AUTHORIZATION
RE: Property of
Located at ( 25 Q UAIL LANE, PAT-1-Er�soJ
TNPAI'M2Sot�. Tax Map # 2L5- Block
--Lot 109
Subdivision Of *i r,)602_ \Vbc>c)5 -A KA
Subdivision Lot # '' 2 Z—
G entlemen:
Filed Map #ZB91
Date Filed_ . 3— 14-6Z
This letter is to authorize YALR iA 0 tNS—M-ft LAo w Ac m
a duly licensed Professional Engineer or Registered Architect tO-APRIY for the. required
wastewater treatment and/or water supply permit(s) to serve the above-noted property in accordance.
with the standards, rules or regulations as promulgated by the Public Health Directo'ri'65-ft c -Putn ' ani
County Health Department, and to sign all necessary papers on my behalf in connection.-w*ith* -t'his
matter and to supervise the construction of said wastewater tretment and/or water supply systems mi
conformity with the provisions. of Article 145 and/or 14.7 of the- Education. Law, -.the Public Health
Law, and the Putna& C U,- Code.
EW
Very truly yours
Countersigned
P.E., R.A.,
&4
Mailing Address
State �evq -fou, Zip 10520
Telephone: 914 211-41&
IL11 , ; Sighed: 0 7
Mailing Address:52)
State Z ip, �
•
Form LA-97
a
November 10, 2005
Re:. Deerwood Subd. Lot 22
68 Quail Lane
Patterson; Putnam
East Branch Reservoir
DEP Log # 2005 -BB- 1111 (Joint Review)
Dear Mr. Morris:
,qP
3s -U -�aJ
This letter is to inform you that the New York City Department of Environmental
Protection (Department) has determined that the above - referenced application is
complete. In addition, the Department has no objection to the approval of the
above - referenced regulated activity. This determination is based on the review of
submitted documents including the plan titled "Proposed SSTS Deerwood
Subdivision Lot # 22" prepared for Wyndham Homes, dated 09/30/05.
The applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 at
least 2 days prior to the start of construction of the SSTS so that a- Department
representative nidy T mspecf and monifor -the - mst`allation.
Sincerely,
Danny Shedlo, P.E.
Civil Engineer II
Engineering Review Group
xc: Roger Sokol, P.E., NYSDOH
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION REPORT
Well Location _
Street Address:
Town/Village: = -
% IMap35B
Tax Grid#
lock + Lot(s) � 09
Well Owner:
game: 'Address:
Use of Well:
1- primary
2- secondary
) Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
Rotary Cable percussion _)�L Compressed air percussion Other (specify)
Well Type
Screened Open end casing Open hole in bedrock Other
Casing Details
Total length 5 ft.
Length below grade 4:E2 ft.
Diameter _�in.
Weight per foot lb /ft.
Materials: Steel _ Plastic _ Other
Joints: _ Welded Threaded _ Other
Seal: Cement grout _ Bentonite Other
Drive shoe: Yes No
Liner: Yes No
Screen Details
Diameter (in)
Slot Size
Length(ft)
Depth to Screen (ft).
Developed?
First
Yes No
Hours
Second
Well Yield Test
_ Bailed _ Pumped 2e� Compressed Air
Hours
Yield gpm
Depth Data
Measure from land surface- static (specify ft)
During_y���tg�t(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
W
Diameter(in)
Formation
Description
ft.
ft.
Land Surface
!i
`
-
L.. ..._ _
...
rot:*.
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type �_ Capacity] r�l
` Model
Depth A
Voltage HP
Tank Type Volume b
eANv �4
Date Well Compl ed
Putnam County Certification No.
Date of Report
Well Driller (sig tune)
NOTE: Exact location of well with distances to at ast two permanent landmarks to be pro v ded orl arat sheetlpIan.
Well Driller's Name /1! Address: ��%�
Signature: Date:
White copy: t py - Building Inspector; Pink copy - Owner; Orange copy - Well driller
- Form WC -97
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
_ . AI'PDICATiON FOR APPROVAL OlrPLANS1 R
A WASTEWATER TREATMENT SYSTEM
1. Name and address. of applicant: Wye
2. Name of project:
4. Design Professional:
6. Type 9f Proiect:
Private/Residential
Apartments
Office Building
060LLII WOVD DRIVe
3. Location TN:
• d d DZR
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 �c
Type II Unlisted
8. Is a Draft Environmental Impact Statement (DEIS) required? ............ ..........
9. Has DE IS been completed and found acceptable by Lead Agency? ............... --� A
10. Name of Lead Agency
-1-1.: ff this -proj-ect is ari aria Bader the oontrol of local planning, zoning, or older
officials, ordinances? ....................................................... ...............................
12. If so, have plans been submitted to such authorities? ........ ............................... /A
13. Has preliminary approval been granted by such authorities? 4/A Date granted: WA
14. Type of Sewage Treatment System Discharge... .. ............. surface water
15. If surface water discharge, what is the stream class designation? .................
16. Waters index number (surface) ......................................: ..............................,
17.
18.
19.
20.
21.
Is project located near a public i#ater supply system? ....... ............................... NO
If yes; name of water supply Distance to water.supply
Is project site near a public sewage collection or treatment system? ................ O
Name of sewage system = N IA Distance to sewage systembVA
Date test holes observed 22. Name of Health Inspector A hoozi Y--(
Form PC -97
F)
23. Project design flow (gallons per day) .................................. .................... ..........
"Z4: Is State Pollutant Discharge Elimination`Systen '(SPDES)�Permit required
25. Has SPDES Application been submitted to local DEC office? .........................
26. Is any portion of this project located within a designated, Town or State wetland? ice_
27. Wetlands ID Number. ... ...................... .. ............ .................... }�
28. Is Wetlands Permit required? ..........:............................:....:. ...............................
Has application been,made to Town of Local DEC office? ............................... vv�
29. Does project require,a DEC Stream Disturbance Permit? D
30. Is or was project site used for agricultural activity involving application of
pesticides to orchards or other crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ............................ Yes/No n
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 D
DESCRIBE:
32. Is there a local master plan on file with the Town or Village? ......................... E5
33. Are community water an d/or 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? . ............................... 1�I
35. Tai Map ID Number .............: 35 ............ ............................... Map Block Lot
36. Approved plans are to be returned to ..... Applicant_ 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 hereby affirm, under. penalty of perjury, that information provided on this form is true
to the best of my knowledge and belief. False statemen
5.ts made herein are punishable as
a Class A misdemeanor pursuant to Section 210.4:$" the
SIGNATURES & OFFICIAL TITLES.,
Mailing Address: ...................................
L
1 a, n" I c
0.
\
i
i
14.164 (9195)=Text 12
PROJECT LO. NUMBER 617.20 SEAR
Appendix C
Sta2Q_E yir_Qnme�t .I- Quality .Review,
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only .
PART I-- PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APfLICANT IS NSOR
M
HOM
E S
DG
•
2. PRO4ECT, NAME
W oO
3. PROJECT LQCA'nON: PL)
PUT L E- AW
Municipality ILIA H VA L County TI
4. PRECISE LOCATION (Street dr and road Intersections, prominent landmarks, atc, or pnmlde map)
6ZQAIL.LAI ,Jess E. 112 MILE WE5T of 12ouTE 22
DFFA FPLE HILL R oA0.
S. IS eROJIOM ACTION:
3&ew ❑ Expansion ❑ ModifloadonfWteratlon
.6. DESCRIBE PROJECT BRIEFLY:
G.OIJ sT R X-T IOIJ o f A S i�Gt LE FA M I LY R E5i D� W i)•'
SEPTIc,,WELL pwvr=- WAY A�� ,�s5c�1.a►�l� �R,dal�G..
7. AMOUNT OF LAND AFF CTEM
3• ' 3•� /
InitlaRy acres ulurnatety acres
a. ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
UPROPOSED
es ? ❑ No it No, deswft briefly
9. IS PRESENT LAND USE IN VICiNrIY O PROJCCT7
) identtat ❑ Industdai . oma rciai ❑ Agriculture ❑ ParWForestlOpen space ❑ 0am
Describe:
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL.
STATE QR LOCAy?
❑
Yes No K yes, llst agencM and permitlappmals
Boo. �.Q -
Towt•1oF PA rTEj2�or1- P:;'0ILplt.6 Fb_RMI T`
11._ : ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
' It
❑
1��'i`„� es No . yes, Nst aa"gency�� name and permitlapproval
Town) cF PwrTe;z e _'SLalz,Dl�/ISIoN
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE Is To THE BEST OF MY KNOWLEDGE
`T TRUE
Applicantisponsor �LP ' `�: ` _ ASTR�I� odACc:> pat Z9 05
9:
Signature:
If the action is in the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
1
PART 11-- ENVIRONMENTAL ASSESSMENT (To be completed by Agency)
A. DOES ACTION EXOEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF.
❑ Yes ❑ No
'6: 11 ILL'ACTIbN- RECEIVE COOADINATED-REVtEW AS PROVIDED-FOR UNUST£D ACTIONS IN 6 NYCRR, PART 617.6f- 44446, i negative declaration•
may be 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)
Ct. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal,
potential for erosion, drainage. or flooding problems? Explain briefly:
M Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources. community or neighborhood character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered 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 action? Explain briefly.
CIL Long term, short tern, cumuiative,.or other effects not identified in C1-05? Explain briefly.
C7. Other Impacts (including changes in use of either quantity or type of energy)? Explain briefly.
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CFA?
❑ Yes ❑ No
...L.IS 3:HERF,.OR.ISTHERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
❑ Yes ❑ No If Yes, explain briefly
PART 111 — DETERMINATION OF SIGNIFICANCE (TO be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether, It is substantial, large, Important or otherwise significant.
Each effect should be assessed In connection with its (a) setting (i.& urban or rural); (b) probability of occurring; (c) duration; (d)
irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure-that
explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If
question 0 of Part ii was checked yes, the determination and significance must evaluate the potential impact of the proposed action
on the environmental characteristics of the CEA.
❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY
occur. Then proceed directly to the FULL EAF andfor prepare a positive.declaration.
❑ Check this. box if you have determined, based on the information and analysis above and any supporting
documentation, that the. proposed action WILL NOT result in any significant adverse environmental impacts'
AND provide on attachments as necessary, the reasons supporting, this determination:
Sq"me of Lead Agency
Print or Type Name of Responsible Officer in Lea Agen Title of Responsible Officer
ignature of itesp!o!s!ble i RFWU d'Agehcy Signature of Preparer (If different from responsible officer)
1 Ain J1
Date
K
y
4
JANO
" N 01'10'30' W 437.16'
p SSTA
8,000 s.f.
15' MIN.
Dal Li
L2
HIN 100' UPSLOPE.;; 4- SOLID PVC (TYPICAL) ID
— —74 L3_
OF DRAINAGE 2' PVC FORCEMAIN — _ 74� — —" ` ` L4 I PROPOSED
SHOWN. TIE _ 74; _ 6 _ LINED SWALE
,POINT 'A' — "— L6
D WELLS 0' OWNSLOPE << ' -- L7 al
J"l i1NG SSDA F ` ` L8 =�L9
X75', — — -- —� ` ` I ALL LATERALS HAVE
R — — n ( CAPPED ENDS (TYP.) \
'3 t
t �'rT�R1VEWAY���'�
EXISTING 3 cA� �A. 100%
WELL y 18.T� EXPANSION
TIE -_. r
/TIE POINT 'C' f'O1NT8 AREA
/ 4' PVC SCH40 T2 T3 c
4' PVC - -----/ T
FOO ING // 1250 GAL. CONC. T4 �ti Z
/ SEPTIC TANK I q.,� . � — — . — _ � m
1250 GAL. CONC.
PUMP CHAMBER FORCEMAIN SLEEVED O
4' PVC i \� UNDER DRIVEWAY tO+ D.I.•
m
ROOF DRAIN a RIM
N INV.
\a �
1
4/vi)
1
�� ✓;zap y�,,
yg"k' p6
K�Q 4 dh
ski i�
'�'ry"S�Y2je?
1
I
LOT 21
TIE DISTANCES
Lg 147.3' 150.9'
TRENCHES REQUIRED = 667 L.F.
TRENCHES PROVIDED = 667 L.F.
PUMP TEST PERFORMED 6/19/06
PUMPED VOLUME = 330 GAL /CYCLE
A
B
C
T1
23.5'
11.1'
T2
17.1'
16.9'
T3
16.8'
17.2'
T4
R7755'
15.0'
27.3'
DB1
103.3'
JB1
1=05:8•- _ -.__
-. -- ... :.
JB 2
101.8'
JB3
76.2'
98.0'
JB4
75.0'
94.1'
JB5
74.4'
90.7'
J96
74.3'
87.2'
J137
74.9'
84.4'
J138
75.4'
81.5'
J89
76.9'
79.2'
L1
149.5'
166.4'
L2
148.8'
164.3'
L3
148.7'
162.7'
L4
147.2'
159.7'
L5
146.6'
157.4'
L6
147.4'
156.4'
L7
145.9'
153.2'
L8
146.3'
151.7'
Lg 147.3' 150.9'
TRENCHES REQUIRED = 667 L.F.
TRENCHES PROVIDED = 667 L.F.
PUMP TEST PERFORMED 6/19/06
PUMPED VOLUME = 330 GAL /CYCLE