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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -110 BOX 16 01771 �. or L .� :, L , J I L � f �. k .- Ar �. E , 01771 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well - Location. - - -.�. Street Address: � TEAR LAH TowtS�Village:= _ Tax -Grid# Map ��a Block Lot(s) 0 Well Owner: Naa ne: Address: Use of Well: 1- primary 2- secondary X Residential Public Supply. Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion _ )e Compressed air percussion Other (specify) Well Type Screened Open end casing _LC Open hole in bedrock Other Casing Details Total length eft. Length below grade ft. Diameter lD in. Weight per foot lb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded —je Threaded _ Other Seal: �X Cement grout_ Bentonite Other Drive shoe: Lc Yes _ No Liner: Yes _>6 No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours F Yield ,2 gpm Depth Data Measure from land surface - static (specify ft) During yield test(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 / If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information ! Pump Type S� Capacity Depth5 Model l� i= J to 4 iZ Voltage x-30 HP Tank Type wX�302- Volume ( ' 0q d e Date Wey�11Completed Putnam County Certification No. Date of R ort Well Driller (signature) NOTE: Exact location of well with distances to at least two permanent landmarks to be providedj6i0fi separate sheef/plan. Well Driller's Naipe �� Address: Signature: Date: White copy: HD File; Yellow copy- Building Inspector; Pink copy - Owner; Orange copy- Well driller Form WC -97 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Mr. Richard Williams Town Planner Town of Patterson P.O. Box 470 Patterson, NY 12563 Dear Mr. Williams: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed Pool Site Plan for McIntyre at 11 Teal Lane (T) Patterson, TM # 35 -4 -100 This Department has received and reviewed your letter of March 28, 2008 with the enclosed sketches for the proposed in- ground swimming pool and emergency generator for the above referenced property. Upon review of the above, this office provides the following comments. 1. The proposed pool heater and filter equipment are not to be placed in the 100 percent SSTS reserve area. These items have associated piping and /or conduit directly connected to the pool which will compromise the future installation of absorption trenches in the reserve area. 2. Although the generator unit is not located within the 100 - percent reserve area, it should be made a condition of permitting that there shall not be any electrical wiring and /or conduit traversing the future absorption trench locations. Should you have any questions concerning this matter, please feel free to contact this office. Respectfully, Michael J. Director of MJB:kly cc: Patterson Planning Board BI, (T) Patterson Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Far (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 6 PLANNING DEPARTMENT P.O: Box 470 1142 Route 311 Patterson, NY 12563 Michelle Russo. Sarah Wagar Secretary Richard Williams Town Planner Telephone (845) 878 -6500 FAX (845) 878 -2019 March 28, 2008 TOWN OF PATTERSON PLANNING & ZONING OFFICE Michael J. Budzinski, P.E. Putnam County Health Department Division of Environmental Health Services 1 Geneva Road Brewster, NY 10509 Re: Bruce Mc Intyre 11 Teal Lane Tax Map No. 35.-4 -100 Dear Mr. Budzinski: ZONING BOARD OF APPEALS Howard Buzzutto, Chairman Mary Bodor, Vice Chairwoman Marianne Burdick Martin Posner Lars Oleiuus PLANNING BOARD Shawn Rogan, Chairman David Pierro, Vice Chairman Michael Montesano Maria Di Salvo Charles Cook The Patterson Planning Board has received an application to construct a pool at the above - mentioned address. The Applicant has provided a sketch showing the location of the pool. The sketch shows that the Applicant intends to place the pool filter within an area designated as the 100% expansion _ . _ ......- ........_ . _... area for.the subsurface sewage.treatmentsystem: You should also note that-the sketch shows- the-pool - -- --- filter will be located next to a proposed generator. The generator was issued a building permit based on a second sketch plan which showed the generator located outside the 100% expansion area. The generator sketch plan appears to have been based on the as-built SSTS plan. Both of these sketches have been attached. The Planning Board has requested that I contact your office to inquire whether the location of the pool filter would be acceptable to the Putnam County Health Department. Please feel free to contact me if you have any additional questions. Thank you in advance for your response. Sincerely yours, Richard Williams TOWN PLANNER cc: Planning Board w/o attachments Building Department w/o attachments Z P Ysd. J V G b` \o0o G -<P, Q�G 3 5� 42 . 6Ar•oo Q� ,�,tio 2Z 00 yh 2� tia 04 2s 2 Z0 lo"A e 0r Aa 10 T y VL b/ b/ V 32o- �b M h r 0 N ol e JUL -28 -2005 09:00 AM HARRY W NICHOLS 914 279 4567 P.01 PUTNAM COUNTY DEPARTMENT OF HEALTH DM$10N OF ENYRONMENTAL WEALTH SERVICES PCHD Construction Permit # For: Fill Trenches Located: Zrdo.1 (T) Owner /Applicant Name: 4 It Lot T IQ Formerly: __ -- _ —__ -- Subdivision Name: Subdivision Lot # Is system fill completed? Is system complete? Is system constructed as per plans? Is well drilled? Is well located as per plans? Are erosion control measures in place? Date: Date: – g-7 G &.L_ Date: I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in 'accordance with. the issued PCIM Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date: ��,� - Certified by: _....� .. _.....�... .. -. _..._.. __. _ ._.._.._......... - - -- .__. �._ _ _.. D Professional PE Address: �r ` L r- = �v Lie. # Comments: FOR: ❑ ADAM GENE (r] (NAME) Form FIR -99 JUL -28 -2005 THU 09:18 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 I RMITPU TNAM COUNTY DEPARTMENT OF HEALTH #VISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTE r O 6 ' /y Located at "T.e-aj L-42"It e Town or V4 is ge Jam �v 0 � Subdivision name �D-r,--"O Wood d Subd. Lot # —� Tax Map -3-5'- Block -f Lot /id Date Subdivision Approved t —02- Owner /Applicant Name Mailing Address Renewal . Revision Date of Previous Approval Zip -L&' C� Amount of Fee Enclosed oo /j Building Type C a J Lot Area 2,l iti No. of Bedrooms Design Flow GPD foUC Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1000 gallon septic tank and "I / e-J .,._ Other Requirements: To be constructed by -r -D Address Water Su®nly: Public Supply From Address —or: .._ .(�. -_ Private- Supply Dril�led-by. J-193-1) _ . . �:...._. _._..__... _.�..._ 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 s, sy tem described above. will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system o Signed Address R.A. Date 6,so1A °-0 t License # �-6 ( APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires anew perm' . p" provved discharge of domestic sanitary sewage o 1 . By: f�%s�/ Title: Date: 12va _ 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 Pernit Well Location: Street Address: Town/V Tax Grid # pq �,, 0,1 Map 3S' Block Lot(s) 110 Well Owner: Name: J. I)L%ef 4 Address: all ., , i Use of Well: esidential 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 gpm # People Served Est. of Daily Usage 6..00 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling L.-New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes i,-' No Name of subdivision De-c r w oy j Lot No. _ Water Well Contractor: T-8 b Address: Is Public Water Supply available to site? ................................. ............................... Yes No !/ Name of Public Water Supply: ✓4 Town/Village Distance to property from nearest water main: _ Proposed well location & sources of contamination to be provided on separa she plan. Date: 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. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water we driller certified by Putnam County. Date of Issue ®2 Z Permit Issuing Date of Expiration 141 D Title: Permit is Non- Transferrab e White copy- HD file; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WP -97 ml 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, GF, AS,. SRDATE: Y N I DOCUMENTS (__)(__)PERMIT APPLICATION L)(,_)WELLPERMIT ORPWS LETTER UUPC -97 ((_)LETTER OF AUTHORIZATION (__)UDESIGN DATA SHEET (DDS) (__)(__)CORPORATE RESOLUTION (__)(__)SHORT EAF (_)(PLANS -THREE SETS (__)L_)HOUSE PLANS - TWO SETS C--)C--)VARIANCE REQUEST SUBDIVISION LEGAL SUBDIVISION SUBDIVISION PROVAL CHECKED L _)(__)PERC RATE __)FILL REQUIRED DEPTH L _)(_)CURTAIN DRAIN REQUIRED IGENERAL LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP DELEGATED TO PCHD . LJ DEP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED PERCS TO BE WITNESSED EX- APPROVAL SSDS ADJ, LOTS WETLANDS (TOWN/DEC PERMIT REQ'D?) DATA ON DDS PLANS & PERMIT SAME PRE 1969 NEIGHBOR NOTIFICATION LETTER BI/ZBA 1QO,ij2:,�+L00� EI,Ey,ATION.�V/I209'... L (_)SOIL TESTING LOTS >10 YEARS OLD �IREQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SDS HYDRAULIC PROFILE ( �(, )GRAVITY FLOW )CONSTRUCTION NOTES 1 -15 )DESIGN DATA: PERC & DEEP RESULTS )2' CONTOURS EXISTING & PROPOSED )DRIVEWAY & SLOPES, CUT )FOOTING /GUTTER/CURTAIN DRAINS )USDA SOIL TYPE BOUNDARIES )TITLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# )DATE OF DRAWING/REVISION )DATUM REFERENCE )LOCATION OF WATERCOURSES, PONDS LAKES,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 . I . COMMENTS: (REVSHEET)09 /01/00 TAX MAP #: (CONFIRMED) Y ,N (REQUIRED DETAILS ON PLANS CONT'D) (_.�-J(HHOUSE SEWER - %" FT. 4 "0'; TYPE PIPE CAST ]RON NO BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS LSE NOTE (NO CHANGE) FILL SYSTEMS 10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE FILL SPECS/ FILL NOTES 1 -5 (_) FILL PROFILE & DIMENSIONS FILL IN EXPANSION AREA FILL GREA= THAN2 FEEL YCLAY BARRIER FILL CERTIFICATION NOTE DEPTH GAUGES VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (__)USEPARATION DISTANCE FROM TOE OF SLOPE TRENCH LF TRENCH PROVIDED 60FT MAX. PARALLEL TO CONTOURS 100 % EXPANSION PROVIDED DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL (_)(L—)GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN -FROM SSTS 10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS L� 100' TO WELL, 200' IN DLOD,150' TO PITS 100' TO STREAM, WATERCOURSE, LAKE (inc. expan) ( 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER �,,LDIO'TO WATERLINE (pits - 20') 50'- INTERMITTENT'DRAINA-GE COURSE _................ ..... r....._ ........ F 200' /500' RESERVOIR, ETC. ,150' GALLEY SYSTEMS 10' MIN TO LEDGE OUTCROP SEPTIC TANK L�10' FROM FOUNDATION; 50' TO WELL WELL ( DIMENSIONS TO PROPERTY LINES LOCATION OF SERVICE CONNECTION UMIN 15' TO PROPERTY LINE SLOPE �6SLOPE IN SSTS AREA 520 1/6) REGRADED TO 15 %, IF REQUIRED DOS /PUMP SYSTEMS lc--)PUMP NOTES DOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED . l DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) PIT AND D -BOX SHOWN & DETAILED DAY STORAGE ABOVE ALARM CURTAIN DRAIN STANDPIPES, 5' BOTH SIDES, DETAIL C-jM15'MIN to CDS =>5 %, 20'-4 %, 25' -3 %, 35' -1 %, 100 % - <1% 20' MIN to CD DISCHARGE /100' with 182 cons day discharge (_)10' MIN to NON - PERFORATED PIPE 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 matt er of application for: i�d U �rr,/�y represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: (,l) 90 Having offices at 7, , ocJ v Whose Officers Are: President - Name: Address: Vice President - Name: ore cr' I Address: Secretary -Name: Address: 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. Title: Sworn to before me this [' . day of (month) 3 (year) N?.�k Public Corporate Seal Form CA -97 r•. 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. Title: Sworn to before me this [' . day of (month) 3 (year) N?.�k Public Corporate Seal Form CA -97 LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 - WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 October 26, 2004 Harry Nichols, P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Re: Proposed SSTS: Wyndham Homes Teal Lane, Lot # 24 (T) Patterson, TM # 35 -4 -110 Dear Mr. Nichols: ROBERT J. BONDI County Executive of plan -s. and. other - supporting, documents- submitted- at.•this-'Iime -relative to the above - regarded project has been completed. Comments are offered as follows: 1. When the expansion and primary area are separated it is this Departments policy to require at least two percolation and deep test holes in each area. An additional deep test hole and percolation test is requested in the expansion area. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Vevrtrul y your , Robert Morris, P.E. Senior Public Health Engineer RM:km LORETTA MOLINARI Public Health Director DEPARTMENT. OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Harry Nichols, PE Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 RE: Wyndham Homes, Inc. Teal Lane, Lot # 24 (T) Patterson, TM # 35 -4 -110 Reservoir Basin Dear Mr. Nichols: ROBERT J. BONDI County Executive August 10, 2004 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on July 1, 2004 is complete. The Department will notify you by August 29, 2004 of its determination. 0 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 attention at the above address. This notice must include your name, the location 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 complete, 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 O Letter to: Harry Nichols, PE 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:km Cc: Danny Shedlo, NYCDEP Vpmtruly yours, A*0 obert Morris, PE Public Health Engineer AM. COQ: �a Sheet lof PUTNAM COUNTYDEPARTIVIENT OF HEALTH a DIVISION OF ENVIRONMENTAL "HEA7t'LH S.RVICES fiW YO� FIELD ACTIVITY REPORT - NAMF: h : -TPIr° A )MR.CS: Street ; Town State Zip n PERSON IN CHARGE _ Name and Title c TYPE OF FACILITY FIND Ve' _ i i d '7� ;. TNSPFCTOR• -~ <. TFT-i , Signature and Title K RMFPnR T RFh!_0_j VFFn R Y " I- acknowledge receipt oftlus ° report: SIGNATURE: Q2/96 Title:j Rev . - 2'�J 'L--f. 1�4 "Min. - .- - _— , % ry / ��� — , `•i' � 12" R.O B OEEP�.: FOOT /NO u f.., r, ...---— •---�/ ' /iFO SECTION A= A — �a ;lc, �9- ' OX DETAIL . P NOT 70 SCALE (h��O° F /LL FOR SETTLEMENT 1 FINISHED ORALIf + , t - F �✓ ,,, tl CLEAN PL[ - _ 'j '' ✓;;: 4 "� PERlOR ATED P (PUCJSLOPE 1 CRUSHED STONE (DUST FREE) OR W/ //Z ASHED GRAVEL JO /NT CAP ENO 0f EACH ' LATERAL SS , 3 9 „OPERFORA 7E0 610) & moo• • •`. t .'' PIPE(. V.C.) SLOPE L_SECTION - - -- _ y _ PROP. w!✓u. - _� -y 1 P k y o _ .� IL 1: _ -A _ - -�- - --v- ------ELK'' z” "NLNES •/N WET O/L --------- -- — ;IV ` -- _ N )TTOM OF TRENCH PR/OR ,`.� °,y� &1 "'.'t -L. ENOS OF ALL "'.'t SORPTION TRENCH a I _ 11.0 (q.0 * / N DISTANT C. 14' , ` 3 , tsoP°3ED r DIUANCE ik 10, ,LO f �• [' h • t !7 — — _ — I 50 tF, xefr .yam ax•vi81i3 - t „',i., i fo25._ Is 100 : a } S r; K yx t is I Og1. p3 10 t f tt 1 d. 35' 227`30' d 20 k 2 x q5 m 1 _ r�'t'\..' e �. t4 r•_. L►•c Z98 °31 39'. `. `� J 1 << +"1.► I'+ ``?.:,..' air t� n} L y r t s P. , _ 30.00 p NOTES a L z ZS.>Y7 L - ZL6.i8' ' S( Wl"'� t 1 gg ai r,l i n' 1 f � e A J_ \ 1 1111 ti'V \J l \ A A A. SJA. L A L t A1Jl V A D- MSIOIIVD .. ENVIRONMENTA:E =HEA LTH•SERV -IiaE •••APPLICATI'ON FOR APPROVAL OF PLANS FOR - A W-- - TEWATER TREATM -tl4-T SYSTEM' -= -; = °- 1. ±Name a id address of appticanf: � [�w i� Gam-. ' ....._,i�; ,► <� JA w. . . � � �� l r � ���,�,� �Y; vim;;:. ..•J;:,.:• -;.:::;, :Oz ... .. 'J .S .• :�: 1. : ... 2. Name of project: Are 10#-1 e : SS TS 3. Location T/��.: e,,, 4. -Design Professional: v{r., 5.. address: ,� - r e,,, . Er. . Drainage Basin: ' 7. Type of.Project? :; . _Pnvate%Residential Food Service Commercial w - Apartments--: Institutional Mobile- Heme_I?ark . _ Office Building Realty Subdivision _Other e s ci ` (P . fY) 8. is this project subject.to State Environmental Quality Review (SEQR) ?' T e--Status check ane . - ` _... Exempt ' Type II' -.. : Urilis ed 9. Is a Draft Environmental1inpact Statement (DEIS) required? ......................... d ` 10. Has DEIS been completed and found acceptable. by Lead Agency? .... 11.. Name of Lead Agency - -- _ _11. Is this project.in an -area under the control of local planning, .zoning,.or other officials, ordinances? ..............:.. ............ ..::,:-:.... 13.. f so, haue �lan. een.submitted'to.such authorities? ................................. r • 14. Has preliminary. approvaI been - granted by such authorities? Date granted:` -� . -'•15 Type of Sewage•'I'reatment System Discharge:::::....:..:.:. surfacem ater �gro`un�v� ter - 16.: Ifsurfacevwafer discharge;: what is the stream clan' s* *&signation? 17. Waters index number (surface) ................................................ . ................ '..` 1.8. Is project located near•a public water supply system? .............:....... :4 . 19. If yes name nfwater -su. l� � j� - :....�.:�.. .� {:,� ... • ..�.� . supply Distance water: supply : 0: Is' .project site near a public sewage collection or tteatment.systern? - J2t. Name of sewage7system :. `� :.• Diatance;fo sevraO sys ear ` — 22. Date. test-h-olts- observed i g4 oc,,,; 3: 'Name of Bealth.Irispectdr ,;., 24. Froj�Jct'design flog (gali`ons er ay.) ................... ' .......... ............... ...... -...:- .,.: - . 25. Is -State Pbllutant Discharge Elimination Systeni,(SPDDS) Perin 'it:required? .: ✓v�l 26. Has SPDES A licatiori been submitted to local DEC office? ............. PP ;.......... �U Form PC-. 2.7: • Is: any portion= afth -is proj_eP L located within, a designated Town. or State wetland ? = oW<,. — 28. Wetlands JD-NU mb. er ........................ ........... ...... ......: :..............::.... . 29. -is Wetlands Permit requirtd?� .......:. ...:..:....... .......................It...... Has application been made'to Town or Local DEC office? ....►� yvrx 30. 'Does project req)aire a DEC Stream. Disturbance:Permit? ........:.. :. :' ........... .. t G 3 l: Is or was project site usedfor agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfillir%g,•Sludge application-or in activity. ......... Ye's/N9 32.' Is project located within 1,000 feet -of existing or abandoned landfill ... hazardous -waste Oe, salt stockpile, landfill, slu4oe disposal site or any other potentially known source -of contamination? ............................... Yes/No AJ DESCRIBE: ' • . _.. _. 33. Is there a local master plan on.file with the Town or Village? ........................._ - - 34. , Are community water and/or sewer facilities:planned to be developed- ithin ' - - 15 years in or adjacent to project site ? ................: (j ,�.� 35. Are any sewage treatment areas in excess of 1.5% slope?.. .::.... : ..::...::.........:...: 36. Tax Map ID. Number ...........:......... ............................... .. .. Block -4 Lot 37. Approved plans are to be returned to ..... Applicant _.Design Professional . :OTE: All applications for:review and approval of a new SSTS-tb be located within the NYC Watershed shall he.serit to the Department,. and need not be sent in duplicate to: the DEP, although the. project may require DE- _ 'approval of the`SS•TS' �riar'to final =approval by the Department. Projects within the watershed. -ma also require DEP review :and:approval. of other aspects of a project,'such' as stormwater.ptazis_or the creation of impervious•surfaces`, and the project applicant should obtain the appropriate forms: for .-such activities -from: DEP and submit those forms to DEP for�review and approval-. If the application is signed by a person other than'the applicant shown in Iicr l :,the'application must m� be accompanied by -'a Letter of Auf�olrization (Form LA-97).,-Failure-to comply with ihis:provisiotg,�> may, be grounds for the rejection -of any submission. IN I hereby:afj�rmj .crnder penalty of perj�rry, that •informatioir pro•viderf'ori tfi s form. is rcite "' _ ,to the hest of m' knowle4ge and betlef. False slafetnenis-made herein: are punisha e a a Class A misrferrreanor. p "ursuant to Sectio 210.45 of the Penal' w == SIC•!YA-T kEM. - OFFICIAL Tl"��FS< ...... Mailing Address :.... .....:.. :....,:... :..... September 7, 2004 Putnam County Health Department One Geneva Road Brewster, New York 10509 Aft: Robert Morris, P.E. Re: Proposed SSTS - Lot # 24 Deerwood Subdivision Teal Lane Patterson, NY Dear Mr. Morris: Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: -(S45) 279 4003...._ Fax: (845) 279 -4567 Email: hnengineer@aol.com In response to your July 28, 2004 review letter, we note the following: 1. Archway opening provided for second story loft. 2. Proposed trenches reflect 2" solid PVC on both the detail and the plan view. 3. Trench length all scale 2.5 feet more than required functioning perforated pipe accounting for the 2' solid and half of the "J" - Box width. 4. Junction box detail revised. 5. PC -97 has been fully completed by answering # 22 and correcting # 29. Copy of. wetland permit issued by Town of Patterson previously forwarded to Putnam County Health Departmen- 6. New corporate affidavit enclosed. 7. All proposed and existing wells and SSTS's within 200' of property shown on plan. 8. Adjacent water courses within 200' added to plan. Reflecting the above, enclosed are five (5) copies of the following: SS -24 "Proposed SSTS - Lot # 24," revised 8/23/04. Kindly review the enclosed and issue the necessary construction permit. Very tru y yours, L< Harry W. Nich s Jr., P.E. HWN:gav 03- 056.24 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: 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 - Name �cl gnn;ze�L Vice President - Name: Address: Secretary -Na 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 ther to. Signed: Title: Sworn to before me this \, day of L c (month. (year)' -- Notary 114bIic J ANfdi:MROSADO Corporate Seal Notary Public, State of Nevi °dork p N% 01808103335 Qualified In Putnam County C4.mrntlsalor, SxRira Form CA •97 k0303210006( ARTICLES OF ORGANIZATION OF WYNDHAM DEVELOPMENT AT WINDSOR WOODS, L.L.C. Under Section 203 of the. Limited Liability Company Law Filer: Hankin, Hanig, Stall, Caplicki, Redl & Curtin LLP 319 Main Mall Poughkeepsie, NY 12602 REF. 07CI 5620 E0, Wd LO Z I Z HVH 0- �Al30?� STATE GE NEW YORK DEPARTYMENT E F`E MAR 2 1 2003 FILED APR 10 2003 DR.AWD OWN NIS -27 030321Uo4��,J/ November 10, 2003 Putnam County Health Department One Geneva Road Brewster, New York 10509 Aft: Robert Morris, P.E. Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 279 -4003 Fax: (845) 279 -4567 Email: hnengineer @aol.com Re: Individual SSTS Deerwood Subdivision - Lot # 24 Teal Lane Town of Patterson T. M. # 35.4-110 Dear Mr. Morris: We have revised the architectural plans as directed for the proposed residence and the SSTS expansion area per the new additional deep test holes. Reflecting those changes, we are enclosing the following: 1. Five 5) prints of SS -40, "Proposed SSTS," revised 11/9/04. 2. Three (3) copies of Residence Floor Plan(s). 3. Design Data Sheet for test holes "C" & "D ". We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry W. Nic Is Jr., P.E. HWN:jmm 03- 056.24n AON I,@ :: x June 28, 2004 Putnam County Health Department 1 Geneva Road Brewster, New York 10509 ATT: Robert Morris, P.E. Re: Individual SSTS Deerwood Subdivision - Lot # 24 Collinwood Lane Town of Patterson T.M. # 35.-4 -110 Dear Mr. Morris: Enclosed are the following: Harry W. Nichols Jr., P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 279 -4003 Fax: (845) 279 -4567 Email: hnengineer@aol.com 1. Five (5) prints of SS -24, "Proposed SSTS ", dated 06/25/04. 2. "Short EAF ", dated 06/28/04. 3. "Application for Approval of Plans for a Wastewater Disposal System ". 4. "Construction Permit for' Sewage Disposal System, ", dated 06/28/04. 5. "Application to Construct a Water Well ", dated 06/28/04. 6. "Design Data Sheet ". 7. "Letter of Authorization & Corporate Resolution" .dated 06/28/04. 8. Two (2) copies of Residence Floor Plan(s), " Bedroom Count Only". 9. Review Fee in the amount of $400.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry W. Ni is Jr., P.E. HWN:gav 03- 056.24 14 -16 -4 (9/95) —Text 12 PROJECT I.D. NUMBER 617.20 S EQ R Appendix C State. Environmental Quality. Review - SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. A/PP'LICAN SPONSOR ]� ' ;40 2. P JECT NAME W G, L 1 1^D C ' 3. PROJECT LOCATION: Q pal PO Municipality +P IrFo County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Te,. l La h e— 5. IS PROPOSED ACTION: M New ❑ Expansion ❑ Modificatlon /alteration 6. DESCRIBE PROJECT BRIEFLY: C T TS- 7. AMOUNT OF LAND AFFECTED: Initially �� j� acres Ultimately �► t9�[_ acres 8. WILL PPOSED ACTION COMPLY WITH EXISTING ZONING OR-OTHER EXISTING LAND USE RESTRICTIONS? 1(ryes ❑ No If No, describe briefly 9. WHATLS PRESENT LAND USE IN VICINITY OF PROJECT? Idential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? IT GYes ❑ No If yes, list agency(s) and permlt /approvals j�(i +Vpp �aw't O�Oa/lrn•So`7 �• �U41�v ��rr..�J 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? D'es ❑ No If yes, list agency name and permit/approval t % P �.� 1 �7 % VIj / 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes 140. I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicanUspon o name: V Vl Lv" 6t Date : �TJ 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 II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) 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- .RECEWE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If*No, a negativeYdeclaration 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) C1. 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: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources;.or 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. 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. O -- • .y rte`: � :...,. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OFG-?CEA2k ❑ Yes ❑ No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes ❑ No If Yes, explain briefly 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. Each effect should be assessed in connection with its (a) setting (i.e. 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 D 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 and/or 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: Name. of Lead Agency Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer, in Lead Agency Signature of Preparer (If different from responsible officer) Date C • •- . -1 V, 11 \1`�.lil L.•v4Jl\ 1 1_JJL _C I1Y1:G1,1.I Vl' 17.:L'�tXiJ'1'.17: - -• •• � _, DTVTSION -OF- ENVZRONM- ENTAE•- HEALTH .SERVIaES` APPY;fCA'TION FOR APPROVAL OF PLANS .FOR - = A,'VYA;STEWATER TREATMENT SYSTEM d address 1. Name an of - COAL, L4,J692d, al %-i6L Al plicant: - 2. Name of project: �o on •�T_ 3. Location 11:: ,. 4. -Design Professional: h 1. _A) ,&U5 5.. Address: r - _ &__ Drainage Basin: v 7. Type of Project: Fnvai ti. sidential Food Service Commercial .....Apartrrients••: Institutional Mobile Horne -P -ark,. Office Building Realty Subdivision _ . Other (specify) ` 8. is this project subject-to State Environmental uali Review SE R Type-Status ( check - one) :..:...:.............. . ............................... Type I Exempt' . Type II Unlis ed' 9. Is a Draft Environmental" Impact Statement EIS required? �J 10. Has DEIS been completed and found acceptable. by-Lead Agency? ........,;::.,..t LAL 11. --Name of Lead Agency - - ✓4- .' :.12:.Is this. project in an area under the control of local planning, zonirig, .or other officials, ordinances? ..................... .... ....................:.. ............ - ..:: >' : 13. If so, have plans'-been submitted to.such authorities? ........ ............................:.. J 14. Has'preliminary approval been•grarited by such authorities? .Date•granted:~ 15 "I ype of Sewage Treatment System Discharge:..:.:......:. surface water• wi groundwater - .: 16..Ifsurface wafer discharge;:what is the stream class'.designation(. .............. .. 17. Waters index number (surface) ....... ..............:...... .. .............................. ~; 1.8. As project located near-a public water supply system? ...... ....... ........:....:..:.......; . 19.• If yes, name -of water•supply Distance'to wa- t&supply..i- . pfoject site near a public sewage collection or tteatment- system? - -2•i-. Name of sewage s Dista c'64o _setivage'system - 22. Date test-holes- observed 21 Name of I- Tealth.Inspectdr 24. roj pct design flow (gallons -der day) ...... .............................................. :......- :..: 25. Is State Pollutant Discharge Elimination System. (SP-DES) Permit required? .: ✓�� 26. Has SPDES Application been submitted to local DEC office? :..........' Form PC -97 -2 Is any poilion:of zh'is proj :etaocated vyatfiin "a desi`gated Towri or State wetland? - 28. Wetlands 1 D. Norhb. er ........................ ............... ................... .:.......................... ' 29. ---Is Wetlands Permit required? ...:::.:....... " Has application been -made -to Town or Local D"EC office? ............................... /4� �- 30. Does project require a DEC Stream'Disturbance�.Permit? .. ............................... O 3 L Is or was project site used for agricultural activity involving application of pesticides to -orchards or other crops, solid or hazardous waste disposal, landfiili- a", application•or industrial activity? ............................ Yes/No CJ 32.' Is project located within 1,000 feet -.of existing or abandoned landfill, ... hazardous .waste site, salt stockpile, landfill, "sludge disposal- site or any other potentially known source-of contamination? ............................... Yes/No DESCRIBE: 33. Is there a local master plan on.file with the Town or Village? ......................... - 34. " Are commuriity water and/or sewer facilities :planned to be develop6-d.within -- 1� years in or adjacent to project site? ....................... ........................._..... ".. 6�Ll w 35. Are any sewage treatment areas in excess of 1 S% slope? 36. Tax 'Map TD Number. _. -.:. ............. : : :..........:: Map Block _Lot 37. Approved plans are to be.returned to ..... Applicant (D esign?rofesskWal` .\`OTE: Alt applications far.review and approval of�a new SSTS to be located within the NYC WVatershed .4all — he "sent to the Department,.and need not be sent in duplicate to the DEP, although the' project may requireVEP', "_approval *of the�SSTS prio io final :approval by the Department. Projects withia..the watershed.'maycaso require DEP review: and approval. of other aspects of a project, such as stormwater.plas._or the• creafoof� impervious.sdrl rice`s, and the project applicant should obtain the appropriate forms . for such. activities from, - DEP and submit those forms to DEP for,review and -approval-. If the application is signed by a person other than the applicant shown-in Itern 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,affrm; .under penally of perjury, flrat- informatioir pro•videcf-on-iftis form. is true _ to the best of my knowledge and-belief. False statements made herein: are punishable -as, -= a Class A misdemeanor. p`ursuanl to Section 210.95 of the Penal w.. `N'A'TURES'& - OFFICIAL TITLES: `Adress , ................. 1 r ,+ 05 0,56- z 4 44TI _4V '711' -HEAXjH PUTNA_M..0 YDEPAR MENT OF t. my.. DIVISION ,0FENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET SUBSURFACE SEWAGE. TREATMENT SYSTEM Owner'; Located at (Street) Tax Map:-357_.Blo.ck f Lot "--tha- .(indicate nearest'cross street) Municipality Watershed :BOCA _j SOIL, PERCOLATION TEST DATA Date of Pre-so, g. Date of-Percolation. Test 04 NOTES: 1. 'lests to-tie reptaA 'atsaine�depth until approximately equal percolation rates are obtained at each:.. prcolatipin -Iist hole. '(Leml- :5 f m", i'q*. for -' ;;-3,0.�m"'W'.i"n"cb- :5-- 2 -rnih,fbr;3j,-;0Q.1_ in/inch A'J1-ddtYtd,b submitted fbr review.. 21'. Dgpth.m6asurpments. to be: made.' from top Form DD -97. '..D 'i't 41"14 P 'g, iN .. .. rom- M. - E J". ... R, :n..... IN` 10:" to 24- 2 7 3.0 ------------ 10:36 (9):3R .9 24-21 4 24-271 10.03- 10:16 (0:.3 r-, 1.Z. 3, Y' 24- Z 4 5 2 Z- :3 NOTES: 1. 'lests to-tie reptaA 'atsaine�depth until approximately equal percolation rates are obtained at each:.. prcolatipin -Iist hole. '(Leml- :5 f m", i'q*. for -' ;;-3,0.�m"'W'.i"n"cb- :5-- 2 -rnih,fbr;3j,-;0Q.1_ in/inch A'J1-ddtYtd,b submitted fbr review.. 21'. Dgpth.m6asurpments. to be: made.' from top Form DD -97. TEST. PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED.IN TEST HOLES. --DEPTH- HOLE NO.- . ... HOLE NO; B HOLE N0. G.L. yo P so t -.. P $ - 0.5' 1.5' 2.0, 2.5' 3.0' 3.5' L d"J'IL 4.0' _. 4.5' 5.0' 5.5' 8.0' -V 8.5'.... 9.0' 9 10.0'`. Ind eate.-level at which gr4un'dwater i ncountered..., .. %��,.tn �....._:. ....... _ . .._w.r.- :�:>:..s�.w, • :. � . Indicate level at whieh.mottling is.observed _ z- Indicate4 level to which water. level :rises:after:b.eing.:encountered Deep hole. obs.ervationirriade by: -af►at eg -,j ?zQ!j Date. 03.24. oti K��• 011.o .oy PUTNAM COUNTY DEPARTMENT OF HEALTH U DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner W Address 7 Co L /1 ra w,0d & k_ _e_1j Located at (Street)_- �� e _ Tax Map 35 Block _� Lot�. (indicate nearest cross street) Municipality )g_co Drainage Basin 00611 py-Q �V=. SOIL PERCOLATION TEST DATA Date of Pre - soaking 10 - 23 -°I Date of Percolation Test 10 • ?7 l -mil Hole No. Run No. Time Start - Stop Ela se Time Min.) Didto Water rom Ground Surface (Inches) Start Stop Water Level Drop In Indies Percolation Rate Min/Inch 1 2 2 1-7 - 2' � o * I 4 ,12 0 i. 3 AV (00 4 5. 2.....,..... 2 3 2'.50- 3' 20 3o I 21 2 15 4 5 2 3 4 5 NOTES: 1 Tests to be repeated at same depth until approximately equal percolation rates are obtained areacn percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made-from top of hole:.... Form DD -97 2 2 'PEST PIT DATA,: DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. \ HOLE NO. G.L. 0.5' -TO sa I L- 1.0, io'' 1.5' LL . 8 . L,2AM 2.0' 22' S1 C71 FOAM 2.5' D I I—, A LL . 1512 3.0' SA tAO-( LDAM 3.5' _ IV's SIN OLI`i u�' 4.0' 4.5' p. . 5.0, 5.5' _ 6.0 y, 6.`' .. - 7'0 _.. _ ©... 8.0 Z- 8.5 . _ - -9.51 10.0' Indicate level at. which groundwater is encountered — a 11 e, ` _ ............ . . Indicate level at which mottling is observed Indicate level to which water level rises after being encountered fl)6 h,C -- Deep hole observations made -by': M. L-Le-{rte- 3 12 -q-4 D -F) (t��p�} kA I NSW-1 (N 2) Date 12 i2.Li4 C�-Io) D esign Professional Name: -jj . . N ttJ4 -�Dl _� . 512.. Y. . Address_: 20 1&t)"L ' Signature: U t..e r Design Professional's Seal aF NEW yo9 Uj No. 56124 OAA�FESSI��P� A. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM wzzl Owner 41,v tlf2 Address — ,¢� X Located at (Street) Tax Map _ Block Lot (indicate nearest cross street) Municipality Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking /6 o Date of Percolation Test z / Z NOTES: 1. Tests to be reheated at same depth until at)oroximatelv eaual percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 01,40 - 40" /IV l ;2-1/ 52L-7 .......... 3,3 2 10;'Zo - 7 3 4 10"3710:41 /0 2- 7 5 10,'03 /3 -7 3 111-3 2 7 3 3 10,'3 4 / ©f 5-.Z 22 3 4 2-4� — V-7 3 :5 � 5 2 3 4 . . . 5 NOTES: 1. Tests to be reheated at same depth until at)oroximatelv eaual percolation rates are obtained at each percolation test hole. (i.e. :5 1 min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST MOLES DEPTH ,,,.._ --HOLE NO. G.L. 0.5' 1.0' L. 1.5' 2.0' 2.5' 3.0' 3.5' 4.01- S 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' Co� h f izocic� 8.0' �rnu41a.x/ 8.5' 9.0' 10.0' HOLE NO. HOLE NO: K Indicate level at which groundwater is encountered itl o y Indicate level at which mottling is observed Alg Vo Indicate level to which water level rises after being encountered -- 1 Deep hole observations made by: Date Design Professional Name: Address: Signature: Design Professional's Seal PUTNAM -COUNTY DEPARTMENT OF HEALT"'T'.:., DIVISION OF ENVIRONMENTAL HEALTH -SER-VICES.."`,,,,-,.,-. LETTER OF AUTHORIZATION - - --------- RE: Property of 112C-. Located at '+P�i L L--� h t T/ W;tev 70 Tax Map 4 3 Block Lot Subdivision of SubdivisionLot # Filed Map # Date Filed_ -. S- 30 �,o Gentlemen: This letter is to authoriz e I)r, - a duly licensed Professional Engineer" or Registered-Atehftet*— tu-Appl .y 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 14e'alth Dire'd6r''ofthe-N& 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 provisions. of Article 145 and/or 147 of the Education. Law.,4hePublicHealth'-*-- Law-, and the Putnq$ ary Code. -Countersign, P.8., R.A., # Mailing Address State ip. t RA ' z 10 Telephone: - -?q ,1- -- 100 3 Very truly YO Signed: (ow r of Property) Mailing Address: -7. -C-,a A!q "j'00' J-h State zip L L-4 Tel6plfbne: Q-7j'- t ; Form-LA-97 Slice of�_ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL.HEATLH.SERVICES . --.. - FIELD ACTIVITY REPORT NAMF: �1 ��� _ /�I l�/yl��J TPI: AZ %& Street Town State Zip PERSON IN CHARGE OR TNTERVTEWFT): Gf i i D ( f2 Name and Title TYPE OF FACILITY FINDINGS: ;- -4 Signature and Title RFPnRT RF.0 F-TVFT) BY. I acknowledge receipt of this report: SIGNATURE: . 02/96 Title: Rev. a Y .50 PM HARRY W NICHOLS BRUCE - P_TOLEY Public Nealth...Director - 914 279 4567 P.01 a 3-0 sty lbpiii TA MOLINARI ILN., M.S.N. ,frroclate Public Xeahh Director Director oJ.Pottenl Services DEPARTMENT OF IMALTH 1 Geneva Road Brewster, Now York 10509 ]REQUEST FOR FIELD 1011 NG aTTENTIO,N: a ADAM STIEDELINC GENE REED All information below must be J completed.prior-to any scheduling, DATE: EYGIYEER OR FIRhI; c PHONE #: REAS OLi ; _ ROAD /STREET DEEPS: a PERCS;` . PUMP TEST: a 1 TOWN; ! l 1- TALC MAP #: SUBDIVISION: l ll �4n4 LOTO: YES NO ❑ ., Proposed SSTS -within the drainage basin of Nest Branch or Boyds Corner Reservoirs. _ ❑ Proposed SSTS within 504.feet of a.resenioirpreservoir stem-or controlUkke. " - µ d '- '- Proposed §STS within 200 feet of `watercourse or a DEC wetland. 0 Proposed SSTS design flow greater. than 1000 gallons /day-or MES Permit required. ❑ `s(_ Proposed SSTS for a. Commerical Project. It Is tKe' responsibility of the design professional to, provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. lr you answered= to any of the questions, NYCDE.P.must:witness the soil testing. This Department will coordinate a mutually suitable tulle for field testing with. the PCDOH, the Design Professional and NYCDEP. If a project has been determined .to be Delegated based on the above response and then subsequent information indicates NYCDEP Is.required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing. with NYCDEP. FOR COON*TY tlSE ONLY. DATE: A9 0 i TWE; C1 i (FZEI.DTEST) APR -5 -2004 MON 13:08 TEL:845 -278 -7921 -.NAME:PUTNAM.COUNTY DEPARTMENT OF P. 1 T AM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICE CERTIFICATE.OF CONSTRUCTION COMPLIANCE p PCHD CONSTRUCTION PERMIT # I i " 04 FOR SEWAGE TREATMENT SYSTEM Located at I I Town or Village Pi&,TT- -60H Owner /Applicant Name W Hp1ikM H ©H+ 6 Tax Map *�6 1 Block 4 Lot NO Formerly Subdivision Name ca-`rinov Subd. Lot # IM Mailing Address % (,0i L W KP $R-ENs lam- i Zip ®5 Date Construction Permit Issued by PCHD Separate Sewerage System built by \NYHORAH WMP1 Address COL-WNW000 W- WO-e Consisting of DUD Gallon Septic Tank and 661 bi i T)Zetu& -a Other Requirements: ` 1 1 Water Sup& Public Supply From Address or: x Private Supply Drilled by RtYD f QK6101N W1 LL Address 10q":4- PT S2, (A Pfl�- q Xl l Building, Type �`�� L�R%!L� Has erosion control been completed? Number of Bedrooms '/ Has garbage grinder been installed? _ A.S N0 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulatipip of the Putnam Co un De p nt of Health. Date: 61 105' Certified by P.E. X R.A. Address !-©� c � 40 n 14- Profgs�onal) i 5 Q 1 License # �' 1 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals ubject to modification or change when, in the judgment of the Public Health Director, such revocatio , 1 i�ficat' or change is necessary. J"A'— By: /�'' Title: Date: d/,v °r White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNIAMI COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETIONI REPORT Welll- Location ..-:_ =. Street Address: :._- �, _ 1Aj- LAH� To ''- ,9 Tax- Grid-# Map iii", Block Lot(s) f l0 Well Owner: Name: Address: GV a y +i Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing _ Open hole in bedrock Other Casing Details Total length ft. Length below grade () ft: Diameter in. Weight per foot lb /ft. Materials: Y Steel _ Plastic _ Other Joints: _ Welded -e Threaded ` Other Seal: X Cement.grout _ Bentonite Other Drive shoe: _ Yes _No Liner: Yes —>e,' No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Ise Compressed Air Hours A Yield gpm Depth Data Measure from land surface - static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are�available;� - please attach. If yield was tested at different depths during drilling, list: Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface /to ailx- Feet Gallons Per Minute Pump /Storage Tank Information 00 / Pump Type Si Capacity 13 Depths Model d u != J ao 4 1Z- Voltage 2-30 HP Tank Type 4vX`302- Volume a( Rv os in f Q- . ! Xyvw ►�_ s-,g- /dA Date We Completed Putnam County Certification No. Date of R ort Well Driller (signature) NOTE: Exact location of well with distances to at least two permanent landmarks to be providedayfi separate sheef/plan. Al1e�;1iW-� /*Z/ /��u Well Driller's Name /fit Address: /o? Signature: Date: IV White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rug 01 05 09:28a TOWN OF PRTTERSO 845 -878 -2019 p•2 J VL,- G7-.GGi1J 18 :42 AM HARRY W HICHOLS 914 279 4367 P.82 eAL'CE A TOLSY 1 LORBTTA MOLTNAX -JLN., MS.X ' l�liic Xrofdi dlhrrror• •• -• .. - .tuectore tuAtk,.X�alui :%�i'rthr:.::. : - - - .., . ._.._• . 1 Qreneve •Reed. .. ..... . Brewster, New YoJjc ., ,.• .. -' fCarSnemee4lftultt (f1f)311•fl'li l+xitl�)371.19t1 . . Mrnt,f, &rrkd {0101:8 4M— NZC (PIIr2?i +1f7! .F1ltQ! <) !7i • iDif � r ..w ., r Lulyriena��c•pJ{ji7t•lell frrsU«I A1o771 -feq ranm -imi - F911 ..A RRSS'•VF,R1.E'iCA,TION FORM . OWRERSNAME: 1JY��tii�bt LtekF TM�ttmrs$Ex�" ! 313- 4 <<a _ . TOi'9'Tt a AIJTHQRTI.EA TOV- it .i1=C7N+e ' (91grl�ture) _.. T%C' IPUUm= COVUty► DtPArI==t of Health will not issne a Ve4MCete of Construction COmpltanee•unless the above form is. Completed; i.e., a legal9i1 • _ - addrM 3s gsslgned by_ gn sL thorized lawn oiCdal. This foraris to be subatitttd -' - _......._ ." . with the applicadm for Cerollca<o of ConstMction Compltanca 0 August 1, 2005 Robert Morris, P.E. Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Harry W. Nichols Jr.; P.E. Patterson Park - Suite 106 2050 Route 22 Brewster, NY 10509 Tel: (845) 2794003 Fax: .(845) Z79-4567 .. - _....._ ,.._ _.... - Email: hnengineer@aoLcom RE: Individual SSTS Compliance - Wyndham Homes, Inc. 11 Teal Lane - Lot # 24 Deerwood (Windsor Woods) Subdivision Town of Patterson, NY T. M. # 35. -4 -110 Dear Mr. Morris: Enclosed are the following: 1. Five (5) prints of Drawing S -24, "As -Built SSTS ", dated 07/29/05. 2. "Certificate of Construction Compliance for Sewage Treatment System ", dated 08/01/05. .3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment 'System , dated 07/29/05. 4. Laboratory Report, dated 05/24/05. 5. "Well Completion Report", dated 06/30/05. 6. Application Fee in the amount of $300.00 payable to Putnam County Health Dept. 7. "E -911 Address Verification Form ", dated 08/01/05. If there are any questions concerning the enclosed, please call. Very truly yours, Harry W. Nic Is Jr., P.E. HWN:gav 03- 056.24 -PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF. ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot Building Constructed by TownNillage Location - Street Subdivision Name Building Type.' Subdivision Lot # I represent that I. am wholly" and completely responsible for the location, workmanship, material, construction anddrainage of the sewage1�reatment system serving ttie `above - described property; and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition_._ -- any parr -of said ls�sterh constructed ti v, me which fails- to operate fora period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system,..except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the`failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. .. .. _ . _ Dated: Month JUL-1 Day Year - Ge ecal Co "t c `(Own r) = signature v . God Pclt�ro. 4rpdation Name (if corporation) Address: C-D" 'WOOD W, 6 V01151- State WY Zip Signature: Title:- V\JyN0 ,&NA\ Ronx S wu. Corporation Name (if corporation) Address: % UL W�00(J0 k, d qjg'AL State W Zip OA Form GS -97 l � A YML ENVIRONMENTAL SERVICES ' ' 321 Kear Street Yorktown Heights, N.Y. 10598 (914 ) 245-2800 Albert H. Padovani , Director LAB #: 9.500962 CLIENT #: 57197 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~=~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ WYNDHAM HOMES 8 COLLINWOOD DRIVE RALPH TEDESCO BREWSTER, NY 10509 SAMPLING SITE: 11 TEAL LANE, PATTERSON : WELL TANK COL'D BY: JOSE NOTES...: .~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE DATE/TIME TAKEN: 05/13/05 O8:3O DATE/TIME REC'D: 05/13/05 09:20 REPORT DATE: 05/24/05 PHONE: (845)-279-2022 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: COLIFORM METH: N/A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 05/13/05 MF T. COLlFORM ABSENT /100 ML ABSENT 1008 05/19/05 LEAD (INS) 6.1 ppb 0-15 ppb 9003 05/20/05 NITRATE NITROG 0.84 MG/L 0 - 10 9052 05/18/05 NITRITE NITRO8 <0,01 MG/L N/A 9162 05/17/05 IRON (Fe) <0.060 MG/L 0-0.3 mg/} 9002 05/18/05 MANGANESE (Mn) 0.013 MG/L 0-0.3 Mg/1 9002 05/17/05 SODIUM (Na) 7.65 MG/L N/A 9002 05/16/05 pH 6.5 UNITS 6.5-8.5 9043 05/18/05 HARDNESS,TOTAL 108 MG/L N/A 05/18/05 ALKALINITY (AS 114 MG/L N/A 9001 05/20/05 TURBIDITY (TUR Q NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATER (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD 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 pntential. ublic schools are set at 15 ppb. Rule for Public Sisbems 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. 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 � moderately restricted diet, a maximum of 270 mg/L of Sodium " ^ YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 ` (914) 245-28O0' ~ Albert H. Padovani, Director LAB #: 9.500962 CLIENT #: 57197 NON STAT PROC PAGE: 2 WYNDHAM HOMES DATE/TIME TAKEN: 05/13/05 08:30 8 COLLINW8OD DRIVE. DATE/TIME REC'D: 05/13/05 09:20 RALPH TEDESCO REPORT DATE: 05/24/05 BREWSTER, NY 10509 PHONE: (845)-279-2022 SAMPLING SITE: 11 TEAL LANE, PATTERSON SAMPLE TYPE..: POTABLE : WELL TANK PRESERVATIVES: NONE COL'D BY: JOSE TEMPERATURE..: NOTES...: ----------------------- m ------- m ------ m CDLlFORM METH: ------------ m ---------------------�..��. N/A 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 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 SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, [N MG/L. THE HARDNESS MAY RANGE FROM O 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-��TIR�-140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: ~- I-- /--- _ -, '__ Director ELAP# L0323 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 816 / ®s =_ a �G FINAL SITE INSPECTION / Date: S Inspected by: 6,_=z Z Street Location 7e—_ a_ f Z a" :4 Owner - Town'- H Permit # P — // - o of . TM # 3 5-1 — ! / d Subdivision Lot # 2_y 1. Sewage System Area YE5 COMMENTS 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. 1 00' from water course/ ands ...... ............................... IL Sewage System a. Septic tank siz - ,000 . ......1, 250 ......... other ................ b. ' Septictank ifi el ................ ............................... 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. renc es ;< 1. Length, required / 7 Length installed 2. Distance to watercourse measured 4- 1 Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1116 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6 Depth of trench <30 inches from surface :7 Ro.om allowed7for expansion; 100% : _ ''"_ s =: °=" q� J 8. Size of gravel 3/4 - V/2" diameter clean .................. 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ........................ ............................... g Pumb.or -Dosed ysteins_._..... 1. Size of pump chamber ................. ............................... 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........... D1 House/Buildiag a house located er ap roved plans _ :.� _ P b 4Number of�bedPooms K T r Well located as per approved plans ................................. o b. Distance from STS area measured ft........... c. Casing. 18" above grade ................ ............................... V d. Surface drainage around well acceptable ....................... V. Overall Workmanship . a.. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... _ c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall - protected & dir.to exist watercourse g pp ., g drains discha ge away =from :STS areas 77. ., _ - ,.1- �Suiface water protection adequate........:... i. Erosion control provi oim -ded ................. ............................... 3 Rev. 12/02 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health y LORETTA MOLINARI, RN, MSN Associate Commissioner of Health August 3, 2005 Harry Nichols P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Re: Field Inspection — Wyndham Homes Teal Lane, (T) Patterson Lot 24, T.M. 35. -4 -110 The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. All common fill in the 100% expansion area must be removed. .2. A bedroom count need to be performed by this Department. 3. The footing drain was not found upon inspection. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR:cw Sincerely, f4' �. Gene D. Reed Sr. Environmental Health Engineering Aide Water Supply Section (845) 225 =5186 Fax (845) 225 -5418 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 { ee SENDING CONFUNTION DATE AUG -3 -2005 WED 09:43 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE PAGES START TIME ELAPSED TIME MODE RESULTS 92794567 1/1 AUG -03 09:42 00'41" G3 OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. SHERLITA AMLER. MD, MS, FAAP i :nmml�tfnnrr of Xmtrh LORETTA MOLINARI, RN, ISSN �f.rcnrturc Cammliri6ncr ofFlroflh August 3, 2005 Harry Nichols P. E. Patterson Park. Ste 106 2050 Route 22 Brewster, NY 10509 ROBERT J, BONUI ('n,anN f curivc DEPARTMENT OF HEALTH 1 Onnevu Raved. Rr —ster, Ne. York IOvW Re- F1cid Inspection — WyndhAm Harries 'renI Lane, ffl Patterson Lan 24,r.M. 35. -4.110 Dearivlr. Nichols: The. above referenced separate sewage Treatment system ;:an tw harkfillcd. The fullowing conuncnts must be corrected in the field. I. All common flit In the 100% expansion wea must be removal. 2. A bedroom count need to be perfonmed by this Departmom. 3. The footing drab) was not found upon inspection. If you have any fnnhcr questions, please contact me at 1845) 2' %R- I+130. est. 2261. Sincerely. (icnc n. Reed Sr. Environmental Health Gngincering Aide tiDR:cw . NroK 9�pyd wMOn 114512254116 M.114�) 2!6 411 ,n",unwamtd Hmhh (145)771+t1M Fiat (M513no '�42r NaM.88— A.a(M5)2786552 Wir:(345)276 -6671 P4a(a45)2754615 B4r (rinterveo1hmMMrkr1(a45)276 -W1a &x(6e5)27666n1 F SHERLITA AMLER, MD, MS, FAAP Commissioner of Health . - LORETT.A:MOLINARI, RN; MSN. -- ..,-Associate Commissioner of Health August 8, 2005 Harry Nichols P.E. Patterson Park, Ste 106 2050 Route 22 Brewster, NY 10509 Dear Mr. Nichols: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Re: Field Inspection — Wyndham Homes Teal Lane, (T) Patterson Lot 24, T.M. 35.-4 -110 A re- inspection at the above referenced lot has been completed. There are no further comments to be addressed at this time. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR: cw Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 4) Al ° / / 2E n` aFy o z � �a►�Si 6 �a � d v` e` 5 p OA E a � U d CIA z �a �- "*a13�'� tit 05 �" . 7ISda�' -V Nay 9 oop\ to v0� W � nQ0 ts o2�Z00 *05 ,. 9g DIMENSION CHART (in feet) Number A V G 1 18 4I Z 34 35 3 36 31 4 43 as 5 41 26 6 52 2G 7 57 27 8 6 3 t9 9 69 35 10 76 41 1 1 92 48 1 32 29 13 35 35 14 39 41 15 44 48 16 tot 91 17 95 14, is 99 l2 19 83 6$ 20 21 92 87 22 9 88 23 90 90 24 88 92 25 88 95 t c t