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HomeMy WebLinkAbout1812DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -5 -34 BOX 16 oil him ml III � � 1 I� ' 16 I� ' MEN 1 I ` 01812 SITE LOCATION PUTNAM COUNTY HEALTH DEPARTMENT. DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR�� Repair Permit issued in last 5 years ❑ Not in Watershed Repair within Boyd's Corners, W. Branch or Croton Falls Res. ❑ Delegated Repair within 200 ft. of 'a watercourse or DEC - mapped wetland 2f�-doint Review OWNER'S NAME MAILING ADDRESS Z /'Z'Z TOWN G G TM # 35 " 5 —34— b LOAe-S (,l, QA1 PHONE# q /�f & 43a21 APPLICANT Name & Relationship (i.e., owner, tenant, contractor) DATE _ FACILITYTIYPE �h,,,,��.z�r. j PCHD COMPLAINT # 36o "/% PROPOSED I TALLER !' „c�r,1 ��� G�- ��. -�� PHONE # ADDRESS pil 7 ►►+� "� �: %w /�. �•� REGISTRATION /LICENSE # Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and of the rep ir. 6�, P I, as owner,agree to 711is a conditions stated form . SIGNATURE ` E DATE O p (owner) I, the septic installer, agree to comply with the conditions of this permit for the septic system repair SIGNATURE /L ... :.... TITLE ..�­­­ •..,.... DATE /4 (installer) ffi Pro osaI a rove ith the foflowin conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Pro sal Approved Proposal Denied ❑ In ector's Signature & Title Date Expiration Date Repair proposal is in compliance with applicable codes Yes 0 No COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 FRANK O FOWLER III, PE, LS ENGINEERS.SURVEYORS.PLANNERS 72 South Rd HOLMES, NEW YORK 12531 TO P-7 119ITT1212 @IF V ° ° H@59044La. DATE JOB NO. RE: WE ARE SENDING YOU OA ached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ 'THESE ARE TRANSMITTED as checked below: �OF rapproval o r your use • As requested • For review and comment ❑ FORBIDS DUE REMARKS ❑ Approved as submitted ❑ Resubmit ❑ Approved as noted ❑ Submit _ ❑ Returned for corrections ❑ Return — —copies for approval _ copies for distribution corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO FRANK G FOWLER 111, PE, LS ENGINEERS.SURVEYORS.PLANN ERS 72 South Rd HOLMES, NEW YORK 12531 TO WE ARE SENDING YOU ttached ❑ Under separate cover via the following items: ❑ Shop draw gs ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES PATEI NO. DESCRIPTION / THESE ARE TRANSMITTED as checked - below: ❑ For approval ,Por your use �❑ As requested ❑ For review and comment ❑ FOR BIDS DUE REMARKS COPY TO • Approved as submitted • Approved as noted ❑ Returned for corrections ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US SIGNED: /f enclosures are not as noted, kindly notify us at PUTNAM COUNTY DEPARTMENT OF HEALTH FIELD ACTIVITY REPORT ;/ aJ R Street Town State Zip PERSON IN CHARGE 4 (1B_IlITFR VRWF7I: [ l PUMP TEST 0. DOSE TEST REQUIRED GALLONS �f 1)4 51.x' EL. START i EL. STOP I acknowledge receipt of this report: SIGNATURE: 02/96 Title: PUT'I"A1I COUNTY DEPARTMENT OF HEALTH DIVISION OF RONMENT��-HEALTH SER aC ES` -- All information must be fully completed prior to any For: Fill 0,;VN Trenches Inspections being made. PCHD Construction or Repair Permit # Located: 2/ Z Z Z'Z (T) (V) �a Owner /Applicant Name: D0101165° k cl In P%" TM Block 5; Lot 54- Formerly: IVW Subdivision Name M1 Subdivision Lot # IVW Is system fill completed? IV)kq Date: 12 zM &0- Is system complete? Date: Is system constructed as per plans? Is well drilled? Ex/5-11170 Is well located as per plans? Are erosion control measures in place? Date: IVA 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 PCHD Construction Permit and approved plans and the Standards, Rules yRe ations of t nam County Department of Health. Date: / f Certified by: � W��� PEA / RA Design Professional Address: /V 1Z ;3% Lic. # 59 t Comments: F,JI� I� (((� "' i �. S' �s:iC �Z -(..C. G3 ✓L-C :�i' �i(!.. --1 Z_ Form FIR-99 nviroW neritaI } Protection Caswell F. Holloway Commissioner — - _. _ .. _......_.._.. November 4, 2010 Mr. Joseph Paravati, Jr., P.E. Putnam County Health Department 1 Geneva Road Brewster, New York 10509 Paul V. Rush, P.E. Re: Dolores Wunner SSTS Remediation Deputy Commissioner (T) Patterson, Putnam County Bureau of Water Supply prush @dep.nyc.gov Bo Brook Reservoir Drainage Basin g g DEP Log #2010 -BB- 0976 -CR.1 (Joint Review) 465 Columbus Avenue Valhalla, NY 10595 -1336 T:(845)340 -7800 F: (845) 334 -7175 r co- 1 a 0 C N Dear Mr. Paravati: This letter is to inform you that the New York City Department of Environmental Protection (DEP) has no objection to the above - referenced activity, subject to the following conditions: 1. The owner must maintain an effective septic tank pump -out schedule until the subject repair is completed. 2. The subject repair cannot be used as a system to provide sewage treatment for new construction or expansions on this site. This determination is based on the review of submitted documents including the drawings titled "Repair Site Plan for Sewage Disposal System for Dolores Wunner," 2122 Route 22, Patterson, New York", dated October 20, 2010 If you have any questions, I maybe reached at (914)742 -2055. c: Roger Sokol, NYSDOH Sincerely, Danny Shedlo, P.E. Civil Engineer III Wastewater Design Review EOH NYC Environmental , .. - - Protection Caswell F. Holloway Commissioner Mr. Joseph Paravati, Jr., P.E. Putnam County Health Department 1 Geneva Road Brewster, New York 10509 November 4, 2010 Paul V. Rush, P.E. Re: Dolores Wunner SSTS Remediation Deputy Commissioner (T) Patterson, Putnam County Bureau of Water Supply Bo Brook Reservoir Drainage Basin g g prush @dep.nyc.gov DEP Log #2010 -BB- 0976 -CR.1 (Joint Review) 465 Columbus Avenue Valhalla, NY 10595 -1336 Dear Mr. Paravati: T: (845) 340 -7800 F: (845) 334 -7175 0 CV This letter is to inform you that the New York City Department of Environmental Protection (DEP) has no objection to the above - referenced activity, subject to the following conditions: 1. The owner must maintain an effective septic tank pump -out schedule until the subject repair is completed. 2. The subject repair cannot be used as a system to provide sewage treatment for new construction or expansions on this site. This determination is based on the review of submitted documents including the drawings titled "Repair Site Plan for Sewage Disposal System for Dolores Wunner," 2122 Route 22, Patterson, New York ", dated October 20, 2010 - If youhave any questions, I may be reached•at• (914)742 -2055: - - - c: Roger Sokol, NYSDOH Sincerely, Danny Shedlo, P.E. Civil Engineer III Wastewater Design Review EOH FRANK G FOWLER 9019 PE, LS ENGI NEERS.SU RVEYORS. PLAN N ERS 72 South Rd HOLMES, NEW YORK 12531 TO D DATE JOB NO. ATTENTl�� - -�•— ...' . RE: NO. DESCRIPTION WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop dra Ings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED as checked below: or approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FORBIDS DUE REMARKS ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US N COPY TO SIGNED: -✓��'� H enclosures are not as noted, kindly nodly us a nce. J I kCj� GAU -o,Js Sp,�Jf05 �uS4'in� f ii f ,c 1130 4370 11c) o6 ,51 0 . to S,4,) 1... .10 -165o1- 6c -7 66 to to &�a /Y 16 1 A3 O FRANK G FOWLER III, PE, LS EN GI N EERS.SU RVEYO RS. PLAN N ERS 72 South Rd HOLMES, NEVI/ YORK 12531 W-- WE ARE SENDING YOU ached ❑ Under separate cover via _ ❑ Shop drawing ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ [AUU G3 OCF 4 ° e MMOVULad ' ''A ' • min ❑ Samples the following items: ❑ Specifications THESE ARE TRANSMiTTED'as checked below: or approval ❑ For your use ❑ As requested ❑ For review and comment ❑ FORBIDS DUE REMARKS • Approved as submitted • Approved as noted ❑ Returned for corrections ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: If enclosures are not as noted, kindly notify us at SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 1 0509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health TO: DEPAI"ENT OF ENGINEERING AND DESIGN REVIEW 7 DELEGATION S'T'ATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM JOINT ICE VIE W A J C9/1_v PROJECT: (/�' U %'1 v)�! ` J TOWN: f��a %�` s� SUB'D APP DATE—. ify` NOTICE OF COMPLETE APPLICATION: DATE: l A� ❑ Within the drainage basins of West Branch, Boyds Corner Reservoirs or Croton Falls. ❑ Within 500 feet of a reservoir, reservoir stem or control lake. ❑ Within 200 feet of a watercourse or a DEC wetland and appearing on a subdivision map approved after December 31, 1992. ❑. Design-1to_w greater than 1000 gallons /day. Commerci Sal STS\ v jtreviewrepair Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (843) 225 -5186 Fax (845) 235 -5418 Nursing Services (845) 278 -6558 Fax (8=45) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (8=45) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SY$TEM Owner Qci 6/1e5 Address /V 5/ 1054� Located at (Street) 2120 Tax Map Block Lot34— Municipality (indicate nearest cross street) Waters . hed 6 CC/ 49101^0C)e" SOIL PERCOLATION TEST DATA Date of Pre-soaking .9' /70 //0 Date of Percolation Test -9/.--t, / /10 Form DD-97 .... .. .............. ......... ..... W D pffito'l-at' Gr'o'0** er ;::�`U.v Y e erc 4r Hole No ..... . .. . .. .... 'R "n:No`;"' ....... 7. .. ... Start S to osp. Ti­ me II, Surface Ofi nc'* h. e s Start to JDropp . ... .. M ne ION Z- 19 Z, 2 19 ZZ 3%!5,b -7 3 z 4 'ea v7 9, /9 S-4 5 5 %l� 19 22-, '3 Z& 2 5 ?2 3 56P147 � -Z -3 ZLO 3 4 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. 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 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO, ® � 5 91d, t7�e HOLE NO. HOLE ^NO. o; 2 Indicate level at which groundwater is encountered %!e,4 C_ Indicate level at which mottling is observed e4 it Indicate level to which water level rises after being `ene untered Allf Deep hole observations made by- �'nN�lowl� d6e 14MV0 75'� kf® Date Design Professional Name: Address: 72 57cei7, Signature: Design Professional's Seal FO 9 a � a Poor SW FEATURES 1. Impeller 2. Casing 3. Mechanica Seal 4. Shaft 5. Motor 6. Bearings - Upper & Lc 7. Power cabl 8.O -Ring 1 a MODELS Series HP Volts Phase Max.Amp. RPM Solids Wt. WE0311L 115 7.0 9.4 460 WE0312L '/3 _ 230 _ WE1512H 4.7 1750 56 WE0311M 115 1 9.4 , 9.2 WE0312M 23t WE1534H 4.7 WE1512HH WE0511H 115 15.0 80 13.0 208/230 WE0512H 230, WE1534HH 6.5 3 WE0532H 208/230_ 3 3.4 .3500 WE0534H 460 .3500 1.7 60 WE0511 HH 115 1 13.0 90 WE0512HH _ 230 60 6.5 WE0532HH w 208/230 65, 3.3 87 WE0534 HH 460 56 1.65 WE0712H 230 1 10.0 84 VVE-0-732FF 3/, 208/230 3 5.4 3500 WE0734H 460 ,,45. 2.7 70 WE1012H 230 1 12.5 WE1032H 1 208/230_ 3 7.0 WE1034H 460 WE0532H 3.5 _ WE1512H 230 1 15.0 WE1532H 208/230_ 3 9.2 WE1534H 460 WE1534H 4.6 WE1512HH , 1 /2 230 1 15.0 80 WE1532HH 208/230 1 9.2 WE1534HH 460 3 4.6 EFFLUENT EJECTOR SYSTEM Effluent ejector system offers ease of ordering and installation. A single _ ordering number specifies a complete system _ designed for most resi- dential and commercial sump and effluent pump applications. ISENECA FALLS. NEW YORK 13148 Package Includes: Submersible Effluent Pump, WE63,1L 12L or WE031 1 M, 12M, WE0511HH, 12HH Mercury Level Control Switch A2 -5 (115V), A2 -6 (230V) Basin A7 -1801 S Basin Cover A8 -1822 Check Valve A9 =20 `, Order No.: SW E0311 C, SWE0312L, Goulds _ q,u. S 4 , S .d f f ��.Y R •:� � R ss li '.. - s x k q.�.J ± ` ,i i Y i m gf� . r • *f IS PERFORMANCE RATINGS (Gallons Per Minute) Series WE0511H WE0512H E0712 WE1012H WE0511HH WE151211 WE0512HH WE1512HH N0. WE0311L WE0311M WE0532H WE0732H WE1032H WE1532H WE053211H WE1532HH WE0312L WE0312M WE0534H WE0734H WE1034H WE1534H WE0534HH WE1534HH HP ''/3 % '/2 % 1 1'/ '/2 1'/2 RPM 1750 1.750 3500 .3500 3500 3500. .3500 3500 . 5 .100 .70 -.80 ' 90 106 - 60 - 10 80 65, 76 87 102 112 56 84 15 60.:. 57 72 84 100 108 53 82 20. .30 '. ,,45. 65. 79. 95 105.. ._ 48 77 . . 25 25`1.; 59 '74 91 100 45 75 A 30 50 67 85 96 , -.40 .72: 3 35 . 40,:,? .•:61 79 92..: 35 70 40 26 52 72 86 30 67 LL 45 10 64 80 25 64 d 50 30 J 54 73 18 60 = 55 17 42 65 12 58 0 60 6 30 54 3 54 �- .65 70 5 26 47 75 14 43 80 4 40 90 33 100 24 110 15 120 5 DIMENSIONS. (All dimensions in inches) (Do not use for construction purposes.) 12Y2 ".'' x� 53/"-1 s ROTATION > 2' NPT 3,/4" -- KICK -BACK SWE0311M, SWE0312M, D "'/3,'/2, %and 1 HP. 15 except for model.WE0712H &.WE1012H 113 "; . SWE0511HH, SWE0512HH. 1Y2HP = 18 Available Certilicatlons:CO Canadian Standards Association ' Testing Laboratories SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. PRINTED IN U.S.A. Performance Curves METERS FEET h j�+ MODEL 3885 SIZE 3/4" Solids GPM L L I 0 10 20 30 ml /h CAPACITY MGOULDS PUMPS, INC. SeZCA FALLS NEW YDW 13148 METERS FEET 90 120 _.___11.0... 100 90 80 70 60 50 40 30 20 10 0 25 80 Q 70 w v 2 20 J H 660 0 H 50 15 40 10 30 20 5 10 0 0 h j�+ MODEL 3885 SIZE 3/4" Solids GPM L L I 0 10 20 30 ml /h CAPACITY MGOULDS PUMPS, INC. SeZCA FALLS NEW YDW 13148 METERS FEET MODEL 3885 SIZE 3/4" Solids 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L I I 0 10 20 30 m' /h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 35 _. 30 25 2 20 J 0 H 15 10 5 0 120 _.___11.0... 100 90 80 70 60 50 40 30 20 10 0 v MODEL 3885 SIZE 3/4" Solids 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L I I 0 10 20 30 m' /h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 :TABLE n k 4 Friction Losses Through Plastic Fittings in terms of Equivalent Lengths of Plastic Pipe Type Nominal Size Fitting & Pipe of 1-1/411 1-1/211 211 2 -1/21' 311 411 Fitting Equivalent Length of Pipe - Feet 900 STD. Elbow 7.0 8.0 9.0 10.0 12.0 14.0 45° Elbow 3.0 3.0 4.0 4.0 6.0 8.0 STD. Tee (Diversion) 7.0 9.0 11.0 14.0 17.0 22.0 Check Valve 11.0 13.0 17.0 21.0 26.0 33.0 Coupling or Quick Disconnect 1.0 1.0 2.0 3.0 4.0 5.0 Gate Valve 0.9 1.1 1.4 1.7 2.0 2.3 TABLE 5 FRICTION LOSS PER 100 FEET OF PLASTIC PIPE FLOW PIPE SIZE (IN.) RATE GPM 1 " 1 -1 /4" 1 -1 /2" 2" 2-1/211 3" 4" 2 0.3 3 0.6 4 1.0 0.3 5 1.5 0.4 0.2 6 2.1 0.6 0.3 7 2.9 0.8 0.4 8 3.6 1.0 0.5 9 4.6 1.2 0.6 10 5.5 1.5 0.7 0.2 12 2.1 1.1 0.3 14 2.7 1.3 0.4 16 3.5 1.7 0.5 0.2 18 4.4 2.1 0.6 0.3 20 5.2 2.5 0.9 0.3 2 3 0 3.8 5.2 1. 1.8 0.5 0.6 -; 35 24...._. 0:3 40 3.1 1.0 0.4 :45 3.8 1.3 0.6 50 4.7 1.6 0:7 60 2.2 0.9 0.2 70 2.9 1.2 0.3 80 3.7 1.5 0.4 90 4.6 1.9 0.5 100 2.3 0.6 9L�<< 'I'M A PUTNAM COUNTY. DEPARTI'VLENT OF HEALTH DIVISIO-N, 017 ENVIRONIMENT-4&L HEALTH SERVICES DESIGN DATA SHE —ET— SUBSURFACE _—)E__)k7AGE TREATMENITT SYSTEM Address r, Owner: v =0 YLe�_�� Located at (street, 3!( Block Lot Municipality: 191, Watershed: SOIL PERCOLATION TEST DATA Witnessed by: Pair Date of Pre-soaking: 1,3 0 //0 Date of Percolation Test: I Note -s: 1. Tests to be repeated at, same depth until armrox-i'mately acual ot-,colatiOr- Mies are obtained a, each percolation esT hole. < 1 mir, fo-, 1-30 minimch, < mir for S.!'-,6(: rr. . in/incri i. .6,11 data zo be submitted for revie•. Depth m- asur- menis cc, be made from t n of hole. .1� I i i . Depth to Time Elapse water from Water i Percolation Hole -No. Run -No. Start - - -around surfac- 'Me- _J " - -,-- --r - -- I Stop (nnin.) (inches) in inches mintline Start - Stob ZQ -1b.- 441 11� -7 2 I to: Y i- s0 '07 3 I iav_ I -7 L. 37 5 lr 1 1-7 - 2 -1 r- 'I L. 3 5' 03 -. a(, 4 1 3 li1:36- 1`:q� i 1 -3 32 4 2 3 4 I Note -s: 1. Tests to be repeated at, same depth until armrox-i'mately acual ot-,colatiOr- Mies are obtained a, each percolation esT hole. < 1 mir, fo-, 1-30 minimch, < mir for S.!'-,6(: rr. . in/incri i. .6,11 data zo be submitted for revie•. Depth m- asur- menis cc, be made from t n of hole. .1� 03 Sln vie 5ok-W A4. -? I 03 Sln vie 12/17/2009 10:38 18452261108 INTERCOUNTY RL!'1 NAM CCUN TY HEAL 1 H DERAFTkE DIVISION OF ENVIRONMENTAL HEALrw SERVICES THIS IS NOT A REPAIR PERM-IT PROPOSAL FOR EXPLORATION OF SE-PTrC SYSTEM FAILURE All information below must be UN compfeted priar to, any'schedufing r1mur- 01.1 U1 SITE LOCATION 941 19a TOWN OVAINER'S NAME a�•o ail rc'ari r��Nnl FHOI�IE 7/ - Q�t 1 � MAUNG ADDRIESS _1&�R V1)C1';:JA -T&aAl 12 a1U JA4Q f'RQPOScD CON i P.AC TO Fiji P?-60N•G -0 A_� � qaop E � S E Q rtE;1s- RA7laNIICi =vWir Reason for_ exgforatiort: ❑ failure to surface 0 back -up in house V find limits of system for repair k other (explain baJow) kly:excei:sectic. ') �, Ian jt� lie— 2�1 L,-j N. (A r vt 0— VI-I 41 LAC, f-yo 041" 6u ve cj, Lt- g `-, l - (", 5,vh--- IL _ _ _ _ �_. �___ _ �._u .__..... w _v -k i _ ` y UFO_- I MEMORY TRANSMISSION REPORT JIME MAR709-2010., 04:00PM TEL NUMBER 8�52787921*� NAME ENVIRONMENTAL HEALTH FILE NUMBER 493 DATE MAR-09 03:59PM TO 819147730343 DOCUMENT PAGES 003 START TIME MAR-09 03:59PM END TIME MAR-09 04:OOPM SENT PAGES 003 STATUS OK FILE NUMBER 493 SUCCESSFUL TX NOT ICE SF- ,E:r-,Lr-t 2 3 --3 ofrzc!e ax :"3-+s 1:90. -r- _! .•r: = /Y' 1liT� Y•G. -wS =_ :/ 'r P.— a;-- 3-s z:::!-s i- tr,:y -.A 3"9 - %_;! SHERLITA AMLER, MD, MS, FAAP Commissioner ojHealth LORETTA MOLINARI, RN, MSN ^ `~ Associate Commissioner of Health ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING All information below must be fully completed prior to any scheduling. DATE: ak(o ENGINEERING FIRMI�5:- /b jam/ �L.1� PHONE PERSON TO CONTACT: �,,�ruyilar ❑ NEW CONSTRUCTION XJtEPAIR PROGRAM ❑ ADDITION PROGRAM REASON: DEEPSX PERCS X PUMP TEST: ❑ ROAD /STREET: 12!7- TOWN: 'Zol // JJ ® r) TAX MAP #: 35o —5 —,q4- SUBDIVISION: No e, . / LOT #: J�.l OWNER: A0Q1ort! ' t1C/1I,Q e NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES NO ❑ Proposed SSTS within the drainage basin of West Branch or Bo ds Corner &_. -.. Cro R ton Balls eservoirs. ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ox ❑ Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. The Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered Les to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professional and NYDCEP. 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 tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR.COUNTY USE ONLY DATE: lr p a COMMENTS: TIME: 57 : 3,,>,11t14 REQ. FOR FIELD TFSTING:KLY 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 (843) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 JAN -1 -2002 12:00P FROM: _ _ _ TO:8458784031 P:1 /1 COUNTY OF PUTNAM & TOWN OF PATTERSON I Bill No. ON660 2009 COUNTY & TOWN TAXES Sequence No. 2992 For Fiscal Year 01/01/2009 to 12/31/2009 • Warrant Date 12292008 Page No. l of 1 [AXE CHECKS- >PAAB'LE•'I100: u.� r AK i i i r SiUA, Y FAiui i i 971W R -6.3# :CE1V£R OF TAXES ! ATTU SON TOWN HAI..t, Address: 2122 Rt 22 BOX 421 1142 ROLFM 311 Town of: Patterson TAN, NY 12563 PATTERSOK NY 12-%1 School: Brewster Central 5478A300 X 18 MUN - FR1 9 AM TO 3 PM NYS Tax & ,Finance School District Code: Wunner Ernest 4312 - cras alwiiwl T oh $eect. i Wtmner Dolores Parcel Dimensions, 750.00 X 0.00 248,Foggingtown Rd Account No. 018860 Brewster, NY 10509 Vank Code T X-F r-,nr Estimated State Aid: TOWN 30,000 tOPER; Y 1 Ant•nYER � ore.1. Gr l�lvrl'i'S he assessor estimates the , Full Market Value of this property as of July 1, 2007 was: 518,200 im Tou-1 Asse=d :rafi= ofvhdspr •"•i is: 51800 heUniform Percentage of Valite used to establish assessments in your municipality was: 100,00 f you feel your assessment is too high, you have the right to seek a reduction in the future. For further information, please ask your ssesso 'O t'- '{1 -kW, "I low tea File 1 COII! lainC 6II Yatrr ASSe95SiEIIt��. 1'1C3a'C DOi► t::at t:lE period for filing complaints '_�_ !1SC bove assessment has passed. ' "' ' _ . _ . _._�__._._. _._.. _ . ? _ , g p F:emption Wig Tax Putnosc Eall_Va1ue E8L-W Exemption Value Tsz Punwac Full Value Fstimats� :O:: T ;' ;,`"S .- ._.�...._..._........�_.... „h Change l roo► CasaWeAaesed valrrc 6tsus 51000 *zinc Pure Toul Tut Lew prior Year or Units u r py tlait DR AM0001 riOWHOMESTEAD PARCE1-01 Iwn Tax 4,862,636 0.8 i4vy q io,oUV V.7 reel! 'IY t'A•1, 1 11A '111 j•� rubagc Uist UNITS JLL PAYMENT DUE BY JANUARY 31 Nh urU. FA YNILN 1 M)L JANurU: P i l DLLGCTING SATURDAY JANUARY 24 AT PATTBRSON TOWN HAU. 10_-1 .%1.11.1.111 \lJ Jf \l VJW /11 JIU \L' %V:l J1 A•! 1'lJ I l..11./ I_.1..L 1 UL!10USL 10 -1 iB PAYMENTS DUE WITH I %.MAR<`H PAYMENTS DUE WTM 2% PLUS 52.00 ? i 3�v "v.UV 1.Lz i yi 4 :,1 )9.5 518,200.00 3.209608 1.663.22 iii,200.00 1"3i ,43.4i S 1 R 21X) 4N) .77717$ 402.73 1.00 375,385800 375.39 -opaty description(s): 06900000020320000000 007500000OOOOO0000296 69 -2 -32 Yee..tltwenterrst A1rMOtertr - -- ..1AW UUt $3,745.26 1't Ry. n nnnn 1 roc ter. 3 �yc 2F Apply For Third Party Notification By: 11/1 52009 Taxes paid by CA C t-i ,ETURN THE ENTIRE BILL WITH PAYMENT AND PLACE A CHECK MARK IN Tf S, BOX YOU WANT A RECEIPT r t'A li A41sly 1. 1 iiL ALC LIV'ER'S STU R MUS't* till Kx rusuvr;U era 1 ii 1 °AY IALN7. 2009 COUNTY & '1'OWN TAX- S H;ll N.._ 04460 Iwn of: Palw xoll RECEIVER'S STEUB 372400 35. -S -34 ch /wl: Drewstc: Ccntrll •open' fWdreas: 111E IU " 'Bank Code Pay By: Gif VA-00i 3,745.26 3,745.26 Wunncr Pmest Wunder Dolores •''iJ Cu�iu lUwt7 kV 13rewsrer,' 10509 TOTAL TAXES DI IF, $3,74516 Aug 0510 09:10a Frank Fowler 8458784031 p.1 SHERLITA AMLER, MD,. MS, FAAP Commissioner of Heaali LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING ROBERT J. BOND[ "CbuxTy Lrzecritve _.._.._:. All information below roust be fully completed prior to any scheduling. DATE: .512 6 ENGINEERING FIRVI:,LlC ggnt J rE PHONE S ej% �. PERSON TO CONTACT:l7,,� ❑ NEW CONSTRUCTION AIEPAIR PROGRAM ❑ ADDITION PROGRAM REASON: DEEPS: PERCS: PUMP TEST: El ROADISTREET: Z/z z- Z-- TOWN: 'A07 of) TAX MAP #: 35. -.5 SUBDIVISION: Mn e- LOT #: /�l9 OWNER: VQ %[�/'tC' NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES - - -NO- ❑ Proposed SSTS within the drainage basin of West Branch or Boyds Corner & Croton Falls Reservoirs. ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ Proposed SSTS design flow greater than 1000 gallonslday or SPDES Permit required. ❑ Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. The Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered des to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professional and YYDCEP. 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 tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY DATE: TIME: COMMENTS: ACQ. FOR RE�.0:'U` WQXLY 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 (843) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 r.__i.. r ...- �....��:....ID.,.e..l.....1 M1r)')7R.Fflid Pav (QA5) �73Z-AFAR j 1 g I'} a • i : 115. -- ----t- -- -- + - -- --- -'---- — - - -- - -- - - --!'-, � �-- f— - -t- -'- - -- --- ii L 2�� ' 2'5Ch'40 P1C. Folce Main I , i I F_ Z �" cc _ cor I Castj /ron i 4' SOR 95 I j i p w Ro i Cine 1X Mii -S /ope m C o II 105 I i — - -I ' -- — _, a CL IN THE 'DESCRIPTION" VALL SHOWN ALONG '' --- — -- - -- -- - -- '-- j - - - ,. 100.7. -- � i ! 1 I I � i •I { I { I j Red Line represents I Existing ; i , i I ! i of Eoster/y wo // referencing of As Built dimension i I i 90 40 80 120 160 200 240 280 320 210.43' S02 °20'15 11 W Stone l40 // 216.80' . SO1 °54'20 "W - B Tofo ® 6B ' Eo. J M Top 1, 000 Go% _ -- — _ C . Sep. Tnk. 1000 Go% _ -' - _ OT ` -oM S1'd. Leo h Trench S i�he in `- `5� - - •• /ev (9409 pump Ch - -- _ A7 e — ..Foxe, 40 - - -- - _. — Cost /ron _ -- -__ � � - ` �"� -�� •� \ �- _._-- - - ---- 1 _. � = � __. - y-- -- - -- — __ ---��- - - -_ . \�� , �� �� , \ - -- - - -- Note.• There are no wells within 200' Septic System except os shown 1 Sty. S /ock • 1 2 `�., _ __\\ _ _ `_ _ \� Goroge •'' I'll' Sty. Block & Frome 1(lv p osmg 3 Clev. 102.44 �FFFI IIFIJT TRFA F S. S. AS -BUIL T INFO. NO. A Cor. Bldg. B Cor. Bldg. C SEE NO TE BELOW D FA CE & END SOUTH WALL DESCRIPTION 1 24.5 21.0 TANK MANHOLE 2 17.5 52.2 PUMP CH. MANHOLE 3 10.6 95.9 DI S T. BOX 4 10.6 95.9 BEGIN TRENCH 1 5 21.5 91.9 BEGIN TRENCH 2 6 28.6 92.4 BEGIN TRENCH 3 7 17.8 28.8 END TRENCH 1 8 33.1 24.6 END TRENCH 2 9 44.2 25.5 END TRENCH 3 THE DISTANCES NOTED IN COLUMN C" ABOVE REPRESENT THE PERPENDICULAR DISTANCE TO THE POINT REFERENCED IN THE 'DESCRIPTION" COLUMN FROM THE RED LINE SHOWN ON THE SITE PLAN AS BUILT THAT IS A LINE DRAWN PARALLEL TO THE STONE WALL SHOWN ALONG ITS WESTERLY FACE. PUMP CALCULATIONS: PRIMARY SEPTIC DISTRIBUTION BOX INVERT .................. 132.0 BOTTOM PUMP CHAMBER .................. 94.0 STATIC HEAD .................. 38.0 (SH) EQUIVALENT PIPE LENGTH (FOR 2" DIA. PIPE) AMT. FITTINGS EACH TOTAL 2 45 ELBOW 4.0 8.0 1 CHFrK VA VF 17n 1 -7 n 2». e4 SOS