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Home My WebLink About1772DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -4 -111 BOX 16 01772 III' ' IL ILI I. is I :0 g 11 Is Ism 9F T MAN I rLl I I MIT III 01772 . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: _ _ - TownNillage = Tax: Block 4- Lot(s) Well Owner: N e: Address: UAQJW 1 fX, .&M41Ao 41Z.Za6A Use of Well: 1- primary 2- secondary X_ Residential Public Supply Air c(%'d7fieat pump I igation 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: Steel _ Plastic _ Other Joints: — Welded S6 Threaded _ Other Seal: A 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 Y Compressed Air Hours Yield _ gpm Depth Data Measure from land surface- static (specify ft) /61 During yield test(ft) it-,e ly , � 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 Nf I-// If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity .r;,.1iI Depth Model JJ'' Voltage �_ HP 7y�_ Tank Type �� Volume G Date Well ompleted 1; llz�h Putnam County Certification No. Date of Re /orrtt / Well Dr. Iler (signature)/ NOTE: Exact location of well with distances to at least two permane'ht landmarks to be provi ed arate shedtplan. Well Driller's Name /'. Address: Signature: W j Date: , White copy: File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 PUTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Loeati ®n ,_ h _._ _Street Address: r T ) Tax: Grid # Map35 Block 4 Lot(s) Well Owner: N e: -Address: A)M Use of Well: 1- primary 2- secondary _X-aesidential Public Supply Air cdn'd7fieat.puftip Ifrigation 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 _�L Open hole in bedrock Other Casing Details Total length ft. Length below grade ft. Diameter in. Weight per foot ' lb /ft. Materials: >L Steel _ Plastic _ Other Joints: _ Welded _,V 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 ,y Compressed Air Hours Yield _j_ gpm Depth Data Measure from land surface- static (specify ft) Ji / During yield test(ft) i6iliz P101j'V9k& Depth of completed well in feet g�� 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 B( J b If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Capacity _j&�J Depth Model Voltage zz�_ HP Tank Type �' Volume RA !Z 64 Ad Date Well gompleted Putnam County Cert ification No. Date of Re ort Well Dr'ller (s'gn tune NOTE: Exact location of well with distances to at least two permanent landmarks to be provi ed arate sheet/ Ian. Well Driller's Name /ve. Address: A1Y Signature: Date: White copy: File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 w �p PUTNAM COUNTY* DEPARTMENT OF HEALTF DIVISION OF ENVIRONMENTAL HEALTH SERVII CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P I Located at � I 'L Town or Village PA T T 69501 Owner /Applicant Name \,6& OQ �HO H 6j j Tax Map - 5 Block 4 Lot Formerly NLA Subdivision Name Wli DSDPA" AKA D��Awav Subd. Lot # 2_6O Mailing Address �J W cc) t7 L J2_J\/l; r Date Construction Permit Issued by PCHD Z I (v O S Zip D Separate Sewerage System built by ;t MAX).( C AM9oiJ 1-A" ddress I Z4- R-oUT t= 5 2 CA em EL_ Consisting of I S O Gallon Septic Tank and 5-71 LF 24'1 I W I A 10-J T-V_E✓ GH I Other Requirements: Z B. F IL.L' ., -7 1 DE EP GU TA1 t7�AI �. Water Supply: Public Supply From Address 19 � f i t75�- IZotjT'� SZ or: Private Supply Drilled by {p A R'•ESIAd h/ I:LL Addres p4 r__ 1, , Q:-( I oS12 _Building Type (!E W I d V_et7, Has erosion control been completed? Number of Bedrooms Has garbage grinder been installed? _ d 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 accor wiflI klkslued PCHD Construction Permit and approved plans and the standards, rules and regulat' n of Date: I8 ICXP Certified by Address 1 � %1G r2"�J of Health. 110112TP- 0f,10P R.A. -, License # QGj� Any person occupying premises served by the. abov promptly take such action as may be necessary to secure the correction of any unsanitary conditions re om such usage. Approval of the separate sewage treatment system shall become null and void as soori lg 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 White copy - HD change is necessary. G" Title: Date: + co y - Building Inspector; Pink copy - O er; Orange copy - Design Professional CIO Form CC -97 LUUO'UI'LM 17 =2L 047LIyL33L YOM r 71 1 1 - -BRUCE. L. Fps a . . Awaelaee Publlo MwM Dir aw mar of Padw Sit OwMM MANZ: TAX N" NUMMEL E911 ADDRESS: TOWN: AUMORIM TOWN ®MCIAL: (Signature) PATF.: The Putnam C®munty Department of Bed& wM not issue a Certificate of Coustrastton Compliance Mess The above forma is completed, i.e., a legal E911 address is assigned by an authorized town of'iciaL 7%s form is to be submitted with the appiica#ion for a Certficate of Construction Compliance. \�A- 2\,D ppsC") PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM \A/Y . odAM H oM 35 4 ! 1 I Owner or urchaser of Building Tax Map Block Lot PATTERS-D� Building donstructed by TownNillage 49 c UA l L LA � fi 1 N060 R W00252 Location - Street Subdivision Name OBE M ILA RESto Z Co Building type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, constructipn 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 accordande with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part ;of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. i 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 utiliz system. / Dat d: Mo., .IuLi Day__* Year ZOC70 Signature: c r ✓�' %, Title: Ge eral ontractor (Owner) Signature \ J-f4DNAM Home-, T_Jc,- is xx(AMEor LAJosc_-APlJds Corporation Name (if corporation) Corporation Name (if corporation) Address: ) J3 5? QouTE 311 -M 301 A Address: 124 P.ourE AZ,' eA d lg(r. State NaKag� I He W `f oper, Zip 105O9 State deyi you Zip Ice Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 _. ..:..__.. _ . _.. (7-14) 245---2000 -.. Albert H. F-`adovani, Director LAD #3 9.600953 C1.. I ENT #i e 57197 NON rTAT F'1=tt: C PAGE,- I WYNDFIAIvI HOMES DATE:: /TIME TAKEN-. 06/PP/06 09-.30 0 COLL. I NWOOD DRIVE DATE: /TIME REC ' D ;; 06 /2 2 /0e) 10:10 RALPH TEDEsaCO REPORT DATE s 06 /29 /06 BREWSTE R, NY 10509 PHONE':.- (045)---@79--P 022 SAMPLING SITE:, 69 QUAIL LANIE FAT'[EgSDi3 SAMPLE TYPE....,: POTADLE:: BREWSTER (TIA. 435 -4 -111) PRESERVATIVES". NONE_ COL ' D BY ; JOSE: Z.S.I.o-r Z(o TENPE:RATURE . 4C NC)TE:S... -. WELL- TANK COL. I FORM METH.- VIF DATE FLAG PROCEDURE' RESULT NORMAL -- RANGE METHOD PUTNAM CNTY PROFILE 06/22/06 MF T. COL. I FOI=tM ABSENT /100 ML_ ABSENT 1008 06/26/06 LEAD � (If Ira) 1.. / ppb � --I ") pph C��y003 06/2.3/06 NITRATE: NITROU 1.15 MG /L 0 -_ 10 70.-2 06/23/06 NITRITE htITROG -:0.01 MG /L N/A 91.62 06/23/06 I RON (Fe ) 0.2'71 MG /L 0 -0.3 mg/1 9002 06/23/06 IvIANGONE: SE (Mn) 0.092 MG /L 0- --0.3 mg/l. 9002 06/23/06 SOD I U11 (Na) 19.61 MG /L. NIA 9002 06/22/06 pH 6.5 I -1N I TS 6.5•-8.5 9043 06/28/06 HARDNE: :SS , T-OTAL 5B.0 MG /L 1\1 /A 06/23/06 ALKALINITY (AS ::313.0 MG /1_ N /A 9001. 06/23/06 TURBIDITY (TUR 1.5 NTU 0- °.5 NTU COMME:.NT S e BACT THESE RESULTS INDICATE THAT' THE' WAT'Et i ( DAS NOT) Oh A SAT I. SFACTORY SANITARY QUALI TY ACCORD I NEW YORK STATE E AND EPA FEDERAL_ DRINKING WATER STANDARDS, FOR TTIE: PARAMETE:RS TESTED, AT 'T'HE: 'TIME OF COLLECTION.. Pb /Cu LEAD limits for p EPA Lead & Copper - than 10% of their than 15 ppb and a treatment: Must be potential. ,. _tb I i c schools are set at 15 ppb. Rule for- Public Systems require,-; that no ator-e distribution points have a LEAD ViAlUe of more COF'F'EE; 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 .Mall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines; state that for people can a sodium restricted diet,the water- should contain no more than 20 mg/L. cif,. Sodium. For those on a moderately r•esstr•i.c;te I 'ctiets a maximum of 270 mr1 /L of Sodium YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 9.600953 CLIENT #: 57197 NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ WYNDHAM HOMES 8 COLLINWOO/ DRIVE RALPH TEDESCO BREWSTER, NY 10509 SAMPLING SITE: 69 QUAIL LANERATTEeSotO : BREWSTER ~ COL'D BY: L JOSE �.�.OT~~ �L , NOTES...: WELL TANK ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FI AG PROCEDURE is suggested. DATE/TIME TAKEN: 06/22/06 09:30 DATE/TIME REC'D: 06/22/06 10:10 REPORT DATE: 06/29/06 PHONE� (845)-279-2022 SAMPLE TYPE..: POTABLE PRESERVAT]VES: NONE TEMPERATURE..: < 4C rOLlFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~^'~~~ RESULT NORMAL - RANGE METHOD PH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH JS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT DE 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 & MAGNESlUM CONCENTBAT%ON° 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 ='MlLLlGRAy{PER LlTER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) BY: Albert H. F/adovani , M.T. (ASCP) Director B-AP4i, 10323 RALPH G. MASTROMONACO, P, E., P.C. Consulting Engineers 13 Dove Court, Croton on- Hudson, New York 10520 (914)27 1 -4762 (914) 271 -2820 Fax Mr. Michael Budzinski, P.E. July 27, 2006 Director of Engineering Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Via UPS Re: SSTS AS -built for Wyndham Homes, Inc. Quail Lane, Patterson, NY (Map 35 - Block 4 - Lot 111- R. S. Lot 26) Dear Mike: Please find enclosed the following materials: 1. Five (5) signed and sealed copies of the drawing entitled SSTS As -Built Plan R.S. Lot 26 of Deer Wood Subdivision (Map 35, Block 4, Lot 111) Prepared for Wyndham Homes Inc., Located at Quail Lane, Town of Patterson, NY, dated July 26, 2006 2. Four (4) signed and sealed copies of the Certificate of Construction Compliance dated July 18, 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 July 14, 2006 5. One (1) copy of the Well Water. Analysis dated June 29, 2006 6. One (1) copy of the E911 Address Verification Form 7. Check #490559 payable to PCDH in the amount of $300. We are requesting your review and approval of the completed works. Please call me if you have any questions. Sincerely, Ralph G. Mastromonaco RGM /jl Enclosures Cc: Joe Darnell w /plan 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 j1 Tax Grid # l0 ee I UA I L L A dE PAT _ RsON Map :35 Block 4 Lot(s) Well Owner: N e: '' JJ M DI-�AM H 0MC� Address: i t Wcb D2 1 Vr✓ �_( ws_rE:P_ I 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 F gpm # People Served Est. of Daily Usagegal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason RQVIPe �Jq 2.0 X51 t,E IL') 1= 1✓ for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No ?C Is well located in a realty subdivision? ....`..../....( ..........�96T'� ........ ............................... Name of subdivision � 2W OW A KA W 1 ri0�� Yes No Lot No. Water Well Contractor: -- rT�,oi5 � pylt ED Address: Is Public Water Supply available to site9 .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to pp provided on separate sheet/plan. Date: D I -ZQJ OS Applicant Signature: P9 6t - F4k5TP_0M6L'1� 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 Directo y revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller cglified by Putnam County. Date of Issue t O r, I Permit Issuin Date of Expiration 2 L Title: Permit is Non- Transferra le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'DESIGN DATA-SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner \A&tAPdAM H0Me2-,Ljc Address 8 C'01, I I t w' oco Dp-ivE Reev6q-ar f�y-- Located at (Street) 69 1��LjA I L L Tax Map 31S Block 4— Lot indicate nearest cross street) Municipality 17'ATTERSod Watershed ane,- B>Riclor- SOIL PERCOLATION TEST DATA Date of Pre-soaking ------- Date of Percolation Test -7- 7-9 ..... iuie No Ruff No- ..... . ... ..►... Mart . StopNLn J- ifargl. nc b P s "S to rD :n . . : .... ............. ....... . .. I 10.15 -10:4 30 221 ...... . ........ ......... . I0,44.-1114 3 ig 1.49 :3,0,. Z Z_ Z4- 4 5 Z,4- z 1/z 2 10:46v 11:14a 30 0 zz 1Z 4 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates ate 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 BOLES HOLE NO. 4— HOLE N0. 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 51 L.TY LOAM W E 10.0' I t Fo�lATlor S . pWAAe-' 2Eod dAs BEE P26vioec')'8Yo Eps. I Indicate level at which groundwater is encountered `E. 1 -"& Indicate level at which mottling is observed s ' —d t Indicate level, to which water level rises after being en o rltered Sl —dt P Y :Z', M o At� i�^lG� Date Dee hole observations made b : M. ,��.j ®L5,''� ., .E. Design Professional Name: q 61. MA,5reomn PE, Address: 13 CA F (f 0021' of Ew Signature �Q moo„ r n @; o Np 05449 pROFESSIONP�' 2 ru iLINAM COUNTY DEPARTMENT OF HEALTH 2(� r DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT_ SYSTEM T X01:_ M.a►'(1:12, _.::... X55 �x � . Owrier'MIG�I,A�t� M>;l�Ai�I�p Address LAg. a oyAl_ Located at (Street) _Gt7a' A205 94A I2 Tax -Map 35 Block' Lot (indicate nearest cross street) Municipality Drainage Basin 15;� SOIL PERCOLATION TEST DATA Date of Pre - soaking 7 (o _�Z> Date of Percolation Test 7 -7 -Yg Hole No. Run No. Time Start - Stop Ela se Time Min.). Depth to. g` %aier a Water rpm Groand .evel Surface (Inches) Dro In Start Stop Inctes : ?�rcolatio . . lRate Min/Inch �0 2 _10,44, 1 �. ?0 22 2 15 3 30 . �2 �} .. 2 15 4 1 o' 3d 22 ?A � 2'1-z 1'2. 4 5 1.. NOTES: -1. < Test&to be reneated at same depth until anoroxitnately equal eercolation rates are obtained at'each percolatioiitest.hole. (i.e..s I min for 1 -30 min/inch-,,:c 2 min for 31 -60 min/inch) AlUdata to be ,submitted for review. 2. °Depth measurements to be made from top of hole. Form DD-97 .. S AA Indicate level .at which groundwater is encounteredi D " Indicate level at-which mottling is observed Indicate level to Which water level rises after being encountered Deep hole observations riiade`by: ,T. L.GA �p�Pi Date D'es'ign Professional Name:,V1�ttCt c, .. _ P•1< . Address: Ka l3 `, Y�ts o it • .j Signature: Design Professional's Seal oF NEW ro ntcHO r o: W U No..56124 O�AQFESS0)1 P' SHERLITA AMLER, MD, MS, FAAP . Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Ralph Mastromonaco 13 Dove Court Croton -on- Hudson, NY 10520 Dear Mr. Mastromonaco: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive December 14, 2005 Re: Proposed SSTS: Wyndham Homes 69 Quail Lane, Lot 26 (T) Patterson, TM # 35 -4 -111 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. Please provide standard fill notes 2, 3, and 4 on the plan. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. °` " °° Ifpercolatibn tests -were not witnessed,by'a representative -of the New'YorkCity Department 'of-- Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:kly V ly your A,_/ Robert Morris, P.E. Senior Public Health Engineer 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, INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR ,CONSTRUCTION PERMIT. NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, OR, AS, SRDATE: TAX MAP #: (CONFIRMED) Y DOCUMENTS Y (REQUIRED DETAILS ON PLANS CONT'D) . PERMIT APPLICATION OUSE SEWER -' /<" FT. 4 "0'; TYPE PIPE CAST IRON _) WELL PERMIT OR PWS LETTER �NO BENDS; MAX BENDS 45° W /CLEANOUT PC -97 �_ RENEWAL 5 " LETTER OF AUTHORIZATION SI E NOTE (NO CHANGE) DESIGN DATA SHEET (DDS) LL SYSTEMS CORPORATE RESOLUTION l 0'" ORIZONTAL; PA�T�RENCH SLOPES 3 :1 TO GRADE SHORT EAF LL SPECS/ FILL NOTES 1,� C_)PLANS -THREE SETS N5IONS ((_)HOUSE PLANS - TWO SETS vUFILL IN EXPANSION AREA UL-- )VARIANCE REQUEST FILL GREATER TKAN2 FEET SUBDIVISION AY BARRIER LEGAL SUBDIVISION CERTIFICATION NOTE (� SUBDIVISION APPROVAL CHECKED VFiLl, PTH GAUGES PERC RATE L. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (� L REQUIRED DEPTH ARATION DISTANCE FROM TOE OF SLOPE . L, CURTAIN DRAIN REQUIRED TREN GENERAL F TRENCH PROVIDED 60FT MAX. (� LOCATED IN NYC WATERSHED PARALLEL TO CONTOURS PLANS SUBMITTED TO DEP 100% EXPANSION PROVIDED DELEGATED TO PCHD DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL DEP APPROVAL, IF REQ'D (GEOTEXTILE COVER DEEP TEST HOLES OBSERVED _, SEPARATION DISTANCES ON PLAN - FROM SSTS (� PERCS TO BE WITNESSED �10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL ' EX- APPROVAL SSDS ADJ, LOTS 20' TO FOUNDATION WALLS ' WETLANDS (TOWN/DEC PERMIT REQ'D ?) (� 100' TO WELL, 200' IN DLOD,150' TO PITS ' DATA ON DDS PLANS & PERMIT SAME 00' TO STREAM, WATERCOURSE, LAKE (inc. eepan) PRE 1969 NEIGHBORNOTIFICATION 0' TO CATCH $ASIN, 35' STORMDRAIN, PIPED WATER � BUZBA 0' TO WATER LINE (pits - 20') 140_YR,.FI�OQD X50' INTERMITTENT DRAINAGE COURSE -. U SOIL TESTING LOTS >10 YEARS OLD 200' /500' RESERVOIR, ETC. 150' GALLEY SYSTEMS REQUIRED DETAILS ON PLANS _ 10' MIN TO LEDGE OUTCROP SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE SEPTIC TANKTANK (_)�(_)10' FROM FOUNDATION; 50' TO WELL FLOW WELL (_)GRAVITY NOTES 1 -15 L MENSIONS TO PROPERTY LINES (—!,�CONSTRUCTION � ESIGN DATA: PERC & DEEP RESULTS (___) LOCATION OF SERVICE CONNECTION ' T CONTOURS EXISTING & PROPOSED �) ' 15' TO PROPERTY LINE L , WAY & SLOPES, CUT SLOPE DOTING /GUTTER/CURTAIN DRAINS SLOPED SSTS AREA 520 ° USDA SOIL TYPE BOUNDARIES D REGRADED TO 15 %, IF REQUIRED Cef (TITLE BLOCK; OWNERS NAME ADDRESS DOSE/Pump iVI# S , PE/RA, NAME, ADDRES , PHONE# ATE OF DRAWING/REVISION, DATUM REFERENCE �ULOCATION OF WATERCOURSES, PONDS / LAKES,WETLANDS WITHIN 200' OF P.L. U ROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS VLLS & S'S WOF SSTS OPERTY METES BODS OSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE 'OMMENTS: MVSHEET)09/01/00 NOTES OSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED (� ETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) �) PIT AND D -BOX SHOWN & DETAILED (_) 1 DAY STORAGE ABOVE ALARM CURTAIN L� ANDPIPES, 5' BOTH SIDES, DETAIL (_) 1 'MIN to CDS = >5 %, 20'-4 %, 25' -3 %, 35' -1 %� 100 % - <l% (_) 20' MIN to CD DISCHARGE /100' with 182 cons day discharge (_) 0' MIN to NON - PERFORATED PIPE IrM �.; December 6, 2005 Robert Morris, P.E Putnam Co. Health Dept. 4 Geneva Read Brewster, NY 10509 . I Re: Deerwood Subd. Lot 26 69 Quail Lane Patterson, Putn&m East Branch Reservoir DEP Log # 2005 -BB- 1175 (lo nt Review) Dear Mr. Morris: This letter is to inform you that the N w York City Department of Environmental Protection (Department) has determin d that the above - referenced application is complete. In addition, the Departmen has so objecdion to the approval of the above - referenced regulated activity. s determination is based on the review of submitted documents including the pl titled "SSTS Plan R.S. Lot 26 of Deerwood Subdivision" prepared for Wyndham, Domes, dated 10/19/05 and last revised 12/01/05. The applicant must contact Sissy De 'a Dssa of my staff at (914) 773 -4416 at least 2 days prier to the start of constr action of the SSTS so that a Department -'representative may inspect- and -merit r the instillation.- Sincerely, Danny Shedlo, P.E. Civil Engineer 11 Engineering Review Group 01+00 -UI -V L6:xeA RALPH G, MASTROMONACO, P,E„ P,C, Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (914) 271 -4762 (914) 271 -2820 Fax ,• Mr. Robert Morris, P.E. Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS for Wyndham Homes, Inc. Quail Lane, Patterson, NY (Map 35 - Block 4 - Lot 112 - R.S. Lot 26) Dear Robert: December 1, 2005 Please find enclosed four (4) signed and sealed copies of the drawing entitled SSTS Plan R.S. Lot 26 of Deer Wood Subdivision (Map 35, Block 4, Lot 111) Prepared for Wyndham Homes Inc., Located at 69 Quail Lane, Town of Patterson, NY, dated October 19, 2005, revised December 1, 2005. As per the review by the New York City Dept. of Environmental Protection, we have made the following revision to the drawing: o The seven -foot deep curtain drain is measured from the existing grade. The total depth shown is 10 feet. Please replace the earlier drawings with these plans. Copies of the latest, drawings have been „ forwarded fo the NYCDEP as requested. Please call me if you have any questions. ly, ph G. Mastromonaco RGM /jl Enclosures SHERLITA AMLER, MD, MS, FAAP Commissioner of Health_. LORETTA MOLINARI, RN, MSN Associate Commissioner of Health November 16, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Ralph Mastromonaco 13 Dove Court Croton -on- Hudson, NY 10520 RE: Wyndham Homes, Inc. 69 Quail Lane, Lot # 26 (T) Patterson, TM # 35-4 -111 Reservoir Basin Dear Mr. Mastromonaco: ROBERT J. BONDI County Executive The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on October 24, 2005 is complete. The Department will notify you by December 6, 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 attention •dithe alj6ve address. -This notice mustincrudi 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 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. Very truly y s, t _ C,t.« Robert 64's, PE Senior Public Health Engineer RM:kly Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 RALPH G. MASTROMONACO, P.E., P.C. Consulting Engineers 13 Dove Court, Croton -on- Hudson, New York 10520 (914) 271 -4762 (914) 271 -2820 Fax Mr. Robert Morris, P.E. Public Health Engineer Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 Re: Proposed SSTS for Wyndham Homes, Inc. Quail Lane, Patterson, NY (Map 35 - Block 4 - Lot 111 - R.S. Lot 26) Dear Robert: Please find enclosed the following materials: October 21, 2005 Via UPS 1. Four (4) signed and sealed copies of the drawing entitled SSTS Plan R.S. Lot 26 of Deer Wood Subdivision (Map 35, Block 4, Lot 111) Prepared for Wyndham Homes Inc. Located at Quail Lane, Town of Patterson, NY dated October 19, 2005 2. Four (4) signed and sealed copies of the Construction Permit Application dated October 20, 2005 3. Four (4) signed copies of the Application to Construct a Water Well dated October 20, 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.- • Ore- (+)- signed- -copy of -the-Short Environmental Assessment= Form--dated October, 20,,--- 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. Bank check #449155 payable to the PCDH in the amount of $400. This application requires a joint review with the NYCDEP. We are requesting your review and approval of the submitted materials. Please call me if you have any questions. Sincerely, Ralph G. Mastromonaco RGM /)I Enclosures Cc: Wyndham Homes w /copy of plan 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: C.0i -X:� represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: Having offices at: IPS Q �� '-� Whose Officers Are: President - Nam��C-�z7r;zs i Address:��,�u�d,��`ye7s,.. \Uc� Vice President - Name: Address: Secretan, -N Treasurer - Name: Address: and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating the to. Signed: , Title: Sworn to before me this day of _(month) (year) N lic `i:T. 'c:, - Corporate Seal Form CA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH:. DIVISION OF ENVIRONMENTAL HEALTH SERVICES',.. LETTER OF AUT'H®RIZAT'I ®N , RE: Property of �nq JAI L. Located at - �1 [ N ti.s _`tc,�s c�l� 10 T/V EA-Cfe (25� Tax Map # 5 m Block. Subdivision of W1ffDi snit QQO i -+mss Subdivision Lot # 2. Filed Map # 2891 Date Filed. _ 3 Gentlemen: This letter is to authorize l AASZZAatq ,c.n - a duly licensed Professional Engineer 7C or Registered Architect to apply for the. required wastewater treatment and/or water supply permit(s) to serve the above- noted-property in accordiiaice with the standards, rules or regulations as promulgated by the Public Health Director of:the•PtitnAm* County Health Department, and to sign all necessary papers on my behalf in connection v�rith 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; the Public Health Law; and thePutnaYnEoun OF NEW P.E., R.A., # N. Mailing Address Very truly Yours _ Signed: L,4y0j,6AV-11,1( �y �,� r ��✓ m ( )vner of Property) GPZoTO�- oil -Huuso� State NE\W OfZv- Zip 105ZO Telephone : (214) 2-71-4-7( Z Mailing Address: (A State _ ��2 Zip �= Telephone: R ",ro - Form' LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES "APPLICATIOi� FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address. of applicant: r •• 2. Name of project: WI 2z:,0 2. Woo p5 3. 4. Design Professional:R�Tpa U. (�'rQrpMon�AaaS. 6. Type of Project: ?C Private/Residential Food Service Y l o5 Location TN: PA7-rEpsog Address: 1?:? poJ� Commercial Apartments Institutional Mobile Home Park -Office Building Realty Subidvision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted 8. Is a Draft Environmental Impact Statement (DEIS) required? ......................... o 9. Has DEIS been completed and found acceptable by Lead Agency? ............... 10. Name of Lead Agency 1 L. If this project is an area under the control of local planning, zoning, or other . officials, ordinances? ......................................................... ............................... I� fy 12. If so, have plans been submitted to such authorities? ....................................... 13. Has preliminary approval been granted by such authorities? 4 Date granted: N 14. Type of Sewage Treatment System Discharge ................. surface water groundwater 15. If surface water discharge, what is the stream class designation? .................... VA 16. Waters index number (surface) .......................................... ............................... 17. Is project located near a public 'water supply system? ....... .................... ............ O 18. If yes, name of water supply tJ�A Distance to water.supply 19. Is project site near a public sewage collection or treatment system? .......... ....... O 20. Name of sewage system Distance to sewage system 4A 21. Date test holes observed Z% q g 22. Name of Health Inspector m.13 0D21 1G`� Form PC -97 0 23. Project design flow (gallons per day) ................................. ..................... ........... X00 24: =is .Srtate Pollutant Discharge Elimination System (SPDES) "Permit required ?... IJ 0 25. Has SPDES Application been submitted to local DEC office? ......................... 1J 26. Is any portion of this project located within a designated Town or State wetland? `(E5 27. Wetlands ID Number' :..' .............:.:........................................ ............................... �> P. — 3 �3 28. Is Wetlands Permit required? ..... ............ Has application been made to Town of Local DEC office ?, ............................... 29. Does project require a DEC Stream Disturbance Permit? .. ............................... 14o 30. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, II landfilling, sludge application'or industrial activity? ............................ Yes/No NO 31. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ... ...........................:... Yes/No �O DESCRIBE: 32. Is there a local master plan on file with the Town or Village? ......................... 33. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site?........... ....................... ............................... 1�0 34: Are any sewage treatment areas-iii excess of 15% s]ope? . ............................... " 3 5. Tax Map ID Number ...................................... :.................. Map Block Lot 36. Approved plans are to be returned to ..... Applicant X Design Professional If the application is signed by a person other than the applicant shown in Item 1 Jhe 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 state, o herein are punishable as a Class A misdemeanor pursuant to Section AJ= kaw. P Pt 1 w�- Paso 14 -16.4 (9195) —Text 12 PROJECT I.D. NUMBER 617.20 SEOR Appendix C State aFnvironrnentai = Quaiity- Review - " SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) MIPUPWiSPONSPI2 P NAME D G. I DS0 2 3. PROJECT LOCATION: 1� a Municipality ATT E P_'=,0 J County P A 1� �p I 4. PRECISE LOCATION (Street dress d road Intersections, prominent landmarks, etc., or provide map) �uA L L.AtE.17?_ M ILE Wf=SI' of P-c>VTI; Z Z. 'Ama H L L 2oAo 5. IS PROJXXED ACTION: ❑ Expansion ❑ Modlficatkxnfalteration 6. DESCRIBE PROJECT BRIEFLY: G• eAsTJZUcTi ot-` o f A 51IJ6AL E F=A M I LY R eS I PISIJ VV 1714 W�l.l.�P2N6WA --r ANk;>,AS5 1ATEr-> G1P-AC>I�G 7. AMOUNT OF LAND AFFEPTED. Initially acres Ultimately r—). cA— was 8. WI PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? �fes ❑ No If No, describe briefly 9. 'WHIN IS PRESENT LAND USE IN ViCiNilY OF PROJECT? Idential ❑ Industrial ❑ commwrlal O Agricuiture ❑ Pa WForest/Open space ❑ Other Describer 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? r❑ No if yes, list a ency(s) and permit/ provais u;,'� M Gou14rr DEPT. oF- }- eZiL �4 Town! of PArrS2S0tJ - g01 LPIl 6,R-= LM I T- 11. OES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? 7es ❑ No It yes, flat agency name and permittapproval TowiJ o f PArrE 2.sct4 - A PPzc>vA L 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? ❑ Yes o I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE RA L� ,6 . MA,5M_U)HodAcc> Date: 0 AppllcanNsponsor -�.� Signature: f1 . 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 a.' WILL ACTION-RECEIVE COORDINATW-REVIEW:AS PROViDED,F.OR_UNUSTED ACTIONS. IN; 6.NYCRR;.PART 617.6 ?, ;: ;H;No, _t neg�tive;decl�ratisin._._ 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. C&: Long term, short term, cumulative, or other effects not identified in C1-05? Explain briefly. C7. Other Impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? ❑ Yes ❑ No E IS THERE. OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? C3 Yes ❑ No If Yes, explain briefly _ - PART III — DETERMINATION OF SIGNIFICANCE (To be compieted,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 If 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 . ( 1.4 . cy Print o Type poni e O rdei.h Lead Tide o Responsible Officer ((771111 .r Signature of Responsible-Officer in Lea Agency Signature of Preparer (if different from responsible officer) Date l'J ry ... ; : yr:..•. ••• •. r�,r..:�. ��r.. wr_r • ul �7 Y •Ll'J CI 11 SI�JI/JC -7—J�U r; December 6, 2005 1. `, Robert Morns P.E •S. �;::,. .��.��. '.i i:h ': �F.'r• .. Putnam Co. -HealthDept.- 4 Geneva Road Brewster, NY 10509 rs.;` ;.: revised 12/01/0, p r p'a•.. The applicant must contact Sissy Ile a Ossa of my staff at (914) 773 -4416 at .ir'; �,:,..,.�.;' #�• .,;•::x is ` `r; - aF least 2 days prior to the start of cons Mon of the SSTS so that a Department representarive y`ingpect end inn' the'installdtion: x Re: Deerw'ood Subd: Lot: 26 Dear Mr. Moms: 69 Quail Lane + Patterson, Putnam :F t�::.a:: •;�::.,- East Branch Reservoir . ,• <.• :.. ,, , DEP Log # 2005 =BB- 1175 (ro t Review) ;' 4.• _ > '- -,�; ` complete. In addition, the Dopartimcn rs.;` ;.: revised 12/01/0, p r p'a•.. The applicant must contact Sissy Ile a Ossa of my staff at (914) 773 -4416 at .ir'; �,:,..,.�.;' #�• .,;•::x is ` `r; - aF least 2 days prior to the start of cons Mon of the SSTS so that a Department representarive y`ingpect end inn' the'installdtion: x �-; Sincerely, Dear Mr. Moms: + This letter is to inform you that the N York City Department of Environmental Protection a artment has dCtermin (D p } that the above - referenced a lication is application ;' 4.• _ > '- -,�; ` complete. In addition, the Dopartimcn has no objection to the approval of the above - referenced regulated activity - his determination is based on the review of '' °a = #' - =$= s -'- • ' ` submitted documents including the pl titled "SSTS' Plan R.S. Lot 26 of Deerwood Subdivision" prepared for yndham Homes, dated 10r 19/05 and last rs.;` ;.: revised 12/01/0, p r p'a•.. The applicant must contact Sissy Ile a Ossa of my staff at (914) 773 -4416 at .ir'; �,:,..,.�.;' #�• .,;•::x is ` `r; - aF least 2 days prior to the start of cons Mon of the SSTS so that a Department representarive y`ingpect end inn' the'installdtion: x �-; Sincerely, + :' .'AA., 9 F4��.• �1r' ^��`�7F'ilJ�iJF�.. V-i:-r :, {� : =r . L: ., a.:`�r•t�a:ii. 3,� ..:a• ire':: ��;^ rrr.F; 4 :.a:7k°..`- ' %!dity,':,':E.= 'dt,`s• _•- :.: >�._� _:.:�, :r':� `' Danny Shedlo, P.E. . Civil Engineer II Engineering Review Group F r,. xe: Roger Sokol, P.E., NYSDOR ZO •d H:91 5002 9 �a0 ObEO— ALL- 916:xe� December 6, 2005 �a C . Robert Morris, RE Putnam Co. Health Dept. 4 Geneva Road Brewster, NY 10509 Re: Deerwood Subd. Lot 26 69 Quail Lane Patterson, Putnam East Branch Reservoir DEP Log # 2005 -BB- 1175 (Joint Review) Dear Mr. Morris: 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 "SSTS Plan R.S. Lot 26 of Deerwood Subdivision" prepared for Wyndham Homes, dated 10/19/05 and last revised 12/01/05. 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 may inspect and monitor the installation. Sincerely, Danny Shedlo, P.E. Civil Engineer II Engineering Review Group xe: Roger Sokol, P.E., NYSDOH SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health......... ; ....._ ....: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Ralph Mastromonaco 13 Dove Court Croton -on- Hudson, NY 10520 Re: Field Inspection — Wyndham Homes 69 Quail Lane, Lot # 26 (T) Patterson, T.M. # 35. -4 -111 Dear Mr. Mastromonaco: ROBERT J. BONDI County Executive ROBERT MORRIS, PE _ Director: of Environmental- Health . August 7, 2006 The above referenced separate sewage treatment system can be backfilled. There are no open comments to be addressed at this time. If you have any fiuther questions, please contact me at (845) 278 -6130 ext. 2261. GDR:Idy Sincerely, 4LvJ Gene D. Reed Senior 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 Aug -03 -06 02:12P Ralph G. Mastromonaco PE 914 271 4762 {P.01 PUTNAM COUN'T'Y TDEPARMKXNT OF HEALTH DWISION OF ENVIRONMENTAL HEALTH SERVICES REOMT E09 ON f,{{ ,�P .TION For: Fill Date:" 81I Trenches l� PCHD Construction Permit # P- (P - 05 Located: (9 Q VA iL LAi-le (T) M FA TM 4ui2J Owner /Applicant)I N W ��ame: Y�0 4m HC>M j S JI TM Block �� Lot Formerly: _ 6V lA Subdivision Nam: tXon.. ( a Subdivision Lot # Z Is system fill completed ?. 1 Date: Co i5 �Olv Is system complete? _ `'(Gh Date: ,.(r -15 I(* Is system constructed as per plans? Is well drilled? 'f Date: I Is well located as per plans? _'y Are erosion control measures in place? .^ I certify that the system(s), as listed, at the above premises has beta constructed and I have inspected and verified their completion in "accordance viith the issued PCHD Construction Permit and approved plans and the Standards, Rules and ons of the. Putnam County Department of Health. Date: �U� E ? ZOQ(o _.Certified by: - PE-2—K- RA - Design Professional Address: 13 047,, Gr. C o,.j -Nu!25g4 tJY Lic. # OWAtl8 Comments: _ 6;qFkJ.P,_ �A)F F1 Lp NI_ FOR ❑ ADAM XGENE. CJ (NA E) Form FM-99 AUG -3 -2805 THU 1.:.7:30 rEL:845 =278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVIC: .. CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # Located at G9 QUAIL L Al E Town or Village PATT E fro D EE R W aoA A KA Subdivision name � � ?5oR Woop:-> Subd. Lot # 26 Tax Map 35 Block 4- Lot Date Subdivision Approved 3 I D Z Renewal Revision Owner /Applicant Name"DdAM �D �/LES� .�c Date of Previous Approval Mailing Address e) Col l I i 0 waoy Dpz I Ve P---) IZ r= w, ep= Zip J OLSC�q Amount of Fee Enclosed +00. Building Type 1 PAM ILY REe, Lot Area i �.D4No. of Bedrooms 4— Design Flow GPDBC)t�D Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 12 50 gallon septic tank and 511 L.FoF 24 "wim- nzr= c+-) q Other Requirements: 2' R.o.� FILL ; -71 DEEPcvl? -' K1 [)PAIN To be constructed by -ro ,55 DETF-2 MI Oho Address Water Supply: Public Supply From Address 0 _� Private Supply Drilled by.-rp M 06Tr--IZMI t e C - Addte" s 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 goo tdng;condition any part of said sewage treatment system during the period of two (2) years immediately followin �dat Q�tlie.sn�nce of the approval of the Certificate of Construction Compliance of the original � ` system or any r it rd"to. Pl E Signed: <, P.E. O R.A. Date O 20 v5 Address RASP .. R� - 09�)Z0 License # 05 APPROVED F CON : This approval expires two years from the date issued unless construction of the sewage trea nt sy tem has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified wh n on dered essary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. p oved ischarge of domestic sanitary sewage i By: Title: Date: l� l0 6 J' White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 II I� . II II (l1yll �a 0 UZ WV OW W� O Z ... I / / I � F a z z o" w w <UU aW Q 0 O Oa� D� z m Z J a Z /I aLL0 yC0 I Z F d .OZ Wow C i� yF O m O Z0W Z €Z / Om p .06 ��f I K yrc < / w CN2 <- �Oii ioZ O m VJ 11 O a 11 1� NFU / I W 2 I; w J Z ow �� ;/, l a i 3 / / z < I I 11 l .,� / /� /. gi' /' /�' 0 1 �tn�/ Z / I aT O W 11\ � W o N it a ry t mn m I orcz — — 15' ADS h ' I s ye 00 Np :s. .syy_ er a O'N uj0 \ I O w f5 n o z m Wz n Wmr N0O 7 1m -Zo Qm 9» U¢zz J A TIE DISTANCES TRENCHES A B T1 27.9' 16.3' T2 34.3' 24.4' JB1 45.3' 42.5' JB 2 48.0' 46.5' 54.6' 5 3.5' JB4 61.3 60.6' J135 68.5' 68.1' JB6 76.2' 75.8' J137 83.2' 82.7' L1 79.0' 72.3' L2 85.0' 79.1 ' L3 9 2.5' 87.0' L4 98.7' 93.5' L5 104.6' 100.0' L6 111.6' 107.4' L7 .107.5' 104.3' L8 6 7.3' 71.7' L9 57.8' 65.3' L10 51.3' 59.8' L11 44.8' 54.0' L12 39.0' 49.0' L13 33.3' 44.4' L14 26.4' 36.2' TRENCHES REQUIRED = 571 L.F. PROVIDED = 571 L.F.