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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 35. -5 -38.2 BOX 16 17-- I ■.� NUAW mixi-m 11 A h I T Z+ ti T - ' ,` ' ,, le ` , 46L , 01815 PUTNAM COUNTY DEPARTMENT OF HEALTH 1 DIVISION _OF_ ENVIRONMENTAL HEALTH SERVICES... CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREAT N P SYSTEM PCHD CONSTRUCTION PERMIT # 40 " 00 t )� Located at 2.5 'ri?041A ?-�W WiNY Town or Village P�kTMP /50H / Owner /Applicant Name T)i� I cW cq-P. ' Formerly Tax Map tb 6 . Block ' Lot S $, �-- Subdivision Name PP 9-e 6 Subd. Lot # 0 Mailing Address )U C- J NIAf QtP(,, Poo t'6 ; Zip l r 'A Date Construction Permit Issued by PCHD Separate Sewerage System built by his N' rW {-Q FR ' Address o C-OTP c FiW' WW M W.' 1 W�\ Consisting of Gallon Septic Tank and A100 LF Other Requirements: Water Supply: Public Supply From Address or: Private Supply Drilled by O�UTOIH 1AY POT Address 10 (% K)'3`11r Building Type Has erosion control been completed? Nilmber of Bedrooms" Has garbage grinder been installed? 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 regulat. s of the Putnam CotWty Department of Health. Date: �-� ( Certified by P.E..X R.A. K ( ign Pr fessional) Address q-060 K 1-7-- 6P4,--bJ61— to Ir. 0 License 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 are subject to modification or change when, in the judgment of the Public Health Director, such revocation dificati r change is necessary. By: Title: ( Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES �t 02 WELL COMPLETION REPORT Well Location::..:.,...:, Street Address:. - .:r. S 1 ' &rinljl bja TownNillage: So Tax Grid* M Block Lot(s).;B Z Well Owner: Name: /� Address: It ff Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock _ Other Casing Details Total length At ft. Length below grade --Iq—ft. Diameter _7 in. Weight per foot __171b/ft. Materials: Steel _ Plastic _ Other Joints: _ Welded _ Threaded _ Other Seal: _ Cement grout Bentonite Other Drive shoe: Yes No _ Liner Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped Compressed Air Hours Yield � gpm Depth Data Measure from land surface- static (specify ft) S ee During yield test(ft) 160/110K Depth of completed well in feet 3 Well Log If more detailed information descriptions or sieve analyses are avaliable, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface (lj f, AS. 5 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type S, Capacity L k, Depth 2.7 s- Model `7FN 1v -41 z Voltage :13 6 HP / Tank Type bj)t -3o2 Volume 0-�_- Date Well Completed vU 1 Putnam County Certification No. 007 Date of Report 5A 0a Well Driller (signature) A &- - NOTZ 136cact location of well with distances to at least two permanent landinarks to be provided on a separat eet/plan. -� Well Driller's Name AM /oh Address: Dlf /fie . ,3// I e2 , E rSOA . Signature: Date: �)! White copy: HD 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 GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 1 h-0 $P mow- "�-? , .. Owner or Purchaser of Building -7 M�O\J. coq-� I Building Constructed by 2 gq L'm 1 �)P l o \j P� Location - Street Tax Map Block Lot TownNillage Subdivision Name 1�_ Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed. as shown on the approved plan or approved amendment thereto, and in 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 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. 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 i iz g the system. Dated: Month Day 1� Year Gen a Co ractor (Owner) -Signature _'_V�-, 6SAnIA� Corporation Name (if corporation) Address: CoAA%g, p_ k V M State at As,) Zip \OCoo i Signature: Title: N -N-v 7T�G Gcv;A(0-w Corporation Name (if corporation) Address: kb CdV JL State Z'ip M of Form GS -97 Gi DLEC i 14 Harry W. Nichols Jr., P.E. IrPatterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 279 -4003 Fax (845) 279 December 12, 2001 Mr. Robert Morris, P.E. Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: Individual SSTS Compliance The Barlow Corp. - Lot #2 Sylvia Barlow Way Patterson, N.Y. T.M. #35. -5 -38.2 Dear Robert: Enclosed are the following: _ -4567 J 1. Five (5) prints of Drawing SS -2, "As -Built Plan," dated 12- 15 -01. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 12 -12- 01. 3. Three (3) copies of "Guarantee of Subsurface Sewage Disposal System," dated 12 -12- 01. 4. Well Completion Report, dated 6 -7 -01. 5. Laboratory Report, dated 10- 25 -0,1. • _ - 6: A- Wieation Fee in the amount $200.00 payable to Putman County Health Department. 7. 911 Address Verification Form. If there are any questions concerning the enclosed, please call. Ve truly yours, Harry W. N* ols Jr., P.E. HWN: his 00- 096.00 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 A ' (914) 245-28O0 Albert H. Padovani, Director LAB #4 32.107270 CLIENT Q 54805 NON STAT PROC PAGE 2 THE BARLOW CORP DATE/TIME TAKEN: 10/16/01 04:00 10 COTTAGE PLACE DATE/TIME REC'D: 10/17/01 10:25 APT BE REPORT DATE: 10/25/01 WHITE PLAINS, NY 10601 PHONE: (914)-6501266 SAMPLING SITE: LOT 2 BALLYHACK RD, PATTERSON, NY SAMPLE TYPE..: POTABLE : KITCHEN TAP COL'D BY: JOSEPH FARESE NOTES...: SYLVIA BARLOW WAY ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE is suggested. PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L HARD, WATER:'7M40'MG/L-_-_MG/�~��'MlLLIGRAM9ERLITER'^�-_� HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: ELAP* 10323 BRUCE K FOLEY LORETTA `MOLINARI•R.N., M.S.N. Public Health Dtrectc+r - Auodate Publk Healih. Dir ctor Director o/ PaWt. Servker DEPARTMENT OF HEALTH I Geneva Road Biowster, New York 10509 . Eoviroomeatal Health (914) 278.6130 Fax (914) 278.7921 Nuniai Semica (914) 278.6558 WIC(914)278-6678 .Fax (914) 278.6081 Early•leterveoff'6o-(914) 278.6014 Preschool (914) 2786082. Fu(914)27f-6648 - E911 ADDRESS VERIFICATION FORM OWNERS NAME: TAX MAP NUMBER:% ° 2 E911 ADDRESS: TOWN: AUTHORIZED TOWN OMCIAL: (Signature) DATE: The_ Putnam County Department of Health' will not is a Certificate . of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. 9 ' a v: 4ia r 9 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - FINAL SITE INSPECTION Date: —wa1c F o Ins ecte Street Location Syl V /,4 23,g721,0 6,,, 4:;vA y Owner ��Z2F_54= Y� � Town 7-T� 1?,epA4 Permit # P — TM # _ 3 S — 57 — 3 S . 2 Subdivision Lot # 1. SeNti ag_e System Area a. STS area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped.. ................. ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank, size - 1,000 .... .... 1, 250.... ... other ................ b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......... ............................... d. Distribution Box .A T -out— outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set ........... .......................... f. - ren' hes — . .... I. Length required 4-o o Length installed ;zz>a 2. Distance to watercourse measured -r- i o o Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1 %2" diameter clean .................... . 9._ Depth of gravel.in trench. 12 "-minimum ..........:........ 10. Pipe ends capped .......:................ .......:..:.................... g. Pump or Dosed Systems 1. Size ot 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........... III. HouseBuild"in a. House of cated per approved plans ................ b. Number of bedrooms ......... ......................?........ IV. Well a. Well located as per approved plans . ............................... b. Distance from STS area measured /v ft........... c. Casing 18" above grade .................. ............................... 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 & dinto exist watercours g. Footing drains discharge away from STS area ............:.. h. Surface water protection adequate... .. .....................:........ i. Erosion control provided .............................. 0 - BRUCE R. FO-LEY -. Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 October 15, 2001 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection - Farese _ Sylvia,Barlow Way, (T) Patterson Lot 2, TM 35 =5 -38.2 " Dear Mr. Nichols: = The above referenced separate sewage treatment system can be backfilled. The following =- comments must be corrected in the field: No further comments. = - --•I €you- have-any- further questions, please contact me at ( 845) -27-8-6130 ext. 2261:- Very truly yours, T 4e - - -- --- - - - - -- Gene D. Reed GI)R:cj Environmental Health Engineering Aide SENDING CONFIRMATION DATE OCT -15 -2001 MON 10:29 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE : 92794567 PAGES : 1�1 START TIME : OCT -15 10:28 ELAPSED TIME : 00'39" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... BRUCE R POM WnT[A MOLINAM RN. M.B.N. .64ra Pllb/k ]kdlh Dbllcfor We PaNk S alth Phmfm Df.dt 4q, Patient 9n�i9v DEPARTMENT OF HEALTH 1 Genova Road Btowstcr, New York 10509 9�lenaushl afa5el (N9)tM -6190 F6(NS)M-7911 71vYe{ s91.w (9;)27$ -6931 WIC(145)21i-6672 Fax(845)27t -6015 " tmarad=(93) 279. W14 ftl(W)97/ -6649 t ,6- 10145)221 -5911 M(t4s) #t -6119 October 15, 2001 Harty Nehols, PE PaBatson Park, Suite 106 ^._.._..._.... _ 2050 Route 22 _. �.,...._.._.._ »_. -.. _._._.__...... - -_. ..... _....... __...._t..._ Brewster. Naw Yodc 1 U309 ... .... .... . Re: Field inspection -Farese Sylvia Barlow Way, (T) Patterson lat 02, TM# 35 -5 -38.2 Dear Mr. Nichols: The above referenced separate sewage treatment system can be back9llA The Lollowibg comments moat be corrected in the field: No further comments. If you have any filrtber questions, please contact me at (845) 278-6130 Lott. 2261. Very truly yours, Gene D. Reed GDR ej Etivi9nrinlental Health Engineering Aide PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR + + ATMENT SYSTEM PERMIT # — L4 ©— Located at '5� j (—"`J ( N V �V-LoW UM Subdivision name Subd. Lot # �-- Date Subdivision Approved Owner /Applicant Name 'R+5 -6'�� ►�" Mailing Address id �L-K- M Amount of Fee Enclosed 4 th OQOQ Building Type P-C-WEHAi Town or Village Tax Map / % C) % Renewal rA ItF-to H Block 'b Lot ?? 2.2 Revision Date of Previous Approval W�� VLAiO�i 1' J Zip 0 D Lot Area l.140 No. of Bedrooms A- Design Flow GPD_W Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of ''so gallon septic tank and J Other Requirements: To be constructed by T' B `y ° Address Water Supply: Public Supply From Address 7r- _ Private Supply Drilled by 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 treatmentsystem 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 or any repairs thereto. Signed: Ap"a " " LIJ � P.E. R.A. Date 4114100 Address `) � � G4 Tovo -- G4l� p P {l-1 t l► -CWT I'LL -1� License # 60- 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 whpQpnsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perm i . pproved ischarge of domestic sanitary sewn a nly. By: Title: Cf)011- Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design rofessional Form CP -97 Harry W. Nichols Jr., P.E. 311 Clock Tower Commons Route 22 Brewster, NY-10509 Telephone (914) 2794003 Fax (914) 2794567 April 26, 2000 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSTS Sylvia Barlow Way -Lot #2, Farese Subdivision Town of Patt erson Dear Robert : - Enclosed are the following: 1. Five (5) prints of SS -1, "Proposed SSTS," dated 4- 20 -00. 2. "Short EAF," dated 4- 24 -00. 3. "Application for Approval of Plans for a Wastewater Disposal System." 4. "Construction Permit for Sewage Disposal System" dated 4- 24 -00. 5. "Well Permit Application," dated 4- 24 -00. 6. "Design Data Sheet." . 7. "Letter of Authorization." 8. Corporate Owner Application. ..._._ ......_ ... ...9 .. Two (2) copies of Residence Floor Plan(s) for ">3ed:oom Count- -Only." 10. Review Fee in the amount of $300.00. We would appreciate your review, approval an d issuance of the Construction Permit at your earliest convenience. Thank you. Very y yours, Harry W. 'chols Jr., P.E. HWN:JM. 's 00- 096.02 G 1 •c Iqd 8 1 ilal Do BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH Division of Environmental, Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 DATE T0: An& (T) Reservoir Basin Dear e The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this De artment on is complete. The Department will notify you by c2i 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. ❑ Joint review with the NYCEP will commence pusuant 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 .witK w—hich.yo.u.filed the - application originally, and •a statement thava �decisiorfts' sought iri 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 Dept. 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 Dept.. of Environmental Protection regarding such activities to see if Dept. of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (914) 278 -6130 ext. 166. Very truly yours, Robert Morris, PE RM:tn Public Health Engineer ws2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR _:... _ _._..... _ A WASTEWATER'TR*EATMENT' SYSTEM : 1. Name and address of applicant: T46 R)NL.4*vJ LOP40 WON 10 UMtAF P� A�r r�- ' t t PLPr11'6" N t`1 , � 0601 2. Name of project: LOT- IHONI� XNL6517 3. Location TN: 1'AII't;:i60H 4. Design Professional: Ni(,►44F;5. Address: '� 11 Coq- row- CommQni5 we 6. Drainage Basin: F-Wxr IbPHW STEP— o`f'f !0 � bl 7. Tvne of Proiect: A. Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted X 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... ND 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency Q NA 12. Is this project in an area under the control of local planning, zoning, or other off cials, grdinances� - _..__. ,..,..._ ...._ ...._...... .......,,.:.� „�. ,..,. , s, ............................... _...__ ..,._ ..__._....._._. 13. If so, have plans been submitted to such authorities? ........ ............................... N© 14. Has preliminary approval been granted by such authorities? HO Date granted: MN 15. Type of Sewage Treatment System Discharge ................. surface water X, groundwater 16. If surface water discharge, what is the stream class designation? .................... HA 17. Waters index number (surface) ........................................... ............................... M A 18. Is project located near a public water supply system? ....... ............................... Nn 19. If yes, name of water supply v4A Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ N 21. Name of sewage system 22. Date test holes observed Ar Distance to sewage system tJ Pr (o 23. Name of Health Inspector M, 6 UNJ NS V-1 24. Project design flow (gallons per day) ................................. ............................... $Op 25. Is State Pollutant "Discharge Elimination System ( SPDES) Permit required ?... 26. Has SPDES Application been submitted to local DEC office? Form PC -97 8/99 2 27. Is any portion of this project located within a designated Town or State wetland? N Z, 28. Wetlands ID Number ........................................................... ............................... .. ,... s_ 29. Is Wetlands Permit required? .................... ................... ............................... Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No hrQ 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 (J4 DESCRIBE: 33. Is there a. local master plan on file with the Town or Village? ......................... X10 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... NO 36. Tax Map ID Number .......................... ............................... Map SS Block r:) Lot 37. Approved plans are to be returned to ..... Applicant C� Design Professional NOTE:.AII applications for review and approval of a new SSTS to be located.v I bjn;.tl NY .:1?VAtershed shall: be serif to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans 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 Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on Phis form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal raw SIGNATURES & OFFICIAL TITLES. Mailing Address: ................................... KIM, MY 1,1111 ffl��,Smsmff I 14.164 (9195) —Text 12 PROJECT I.D. NUMBER 617.20 S E( Appendix C State Environmental Quality Review .. �__..... �:�_..... _nr.,...__.._........_ .__ NORT- EN.VIRON.MENTAL ASSESS M ENT -F:O- RM._�_� For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 2. PROJECT NAME 000vriNN�- with 3. PROJECT LOCATION: �('� J�`'iiAtr'" Municipality i r`'`1'* County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) S. IS PROPOSED ACTION: tat New ❑ Expansion ❑ Modificatlon/aiteratlon 6. DESCRIBE PROJECT BRIEFLY; INpiv1(�J� �� 7. AMOUNT OF LAND AFFE TED: u� 1 Initially -`1W acres Ultimately l� acres S. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? &Yes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? KResidential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other Describe: � N�1t.� �1"�� ' ►� 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE OR LOCAL)? ❑ 9No /approvals Yes If yes, list agency(s) and permit 11. DOES ANY ASPECT OF THE. ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? C3 Yes &o If yes, list agency name and permlVapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes 2�No I CERTIFY THAT THE PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE `INFORMATION VV I � � 1G40L51 �� �G ~ A5 AVG4 Appilcant/sponsor, name: Date: Signature: v 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 RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6, f`1KGRR;, PAR T 617.6? It No, a negative declaration may_besupgrsedgQ" by; another.Jnvolved•agency: F ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) Cl. 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 CI-057 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? >- - E] Yes..., -❑ No..... if .Yesi•explain, brie fly- 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 or lead Agency 61 tC Print or Type Name of Responsible Officer to Leaa Agency Title of Respogt IPe Qr,(,cer { It �S c,,� _ I r i 1 S „j f C f Signature of Responsible Officer in Lead Agency Signature ot Preparer (If d rrereni td t IS¢4 ris6ye "Qfii 6 �17iSE Date 2 _PUTNA1-,-00U',rLY DEPA TM ENI OF HEAZTH ' DIVISION OF ENVt)�Oti2fr.►'NTaL HEALTH SERVICES DESIGN DATA :SHEE - SUESUFACE SEWAGE DISPOSAL SXSTE¢Z FIE No. UrrtlSr CSIE AAdress Io CeT'f0L\-r0q PL &6basZE Aamay I06oJ Lo --ated at (Street) : J3AL_CL y,yC,� lZogp Sec. 35. . Block . S Lot 3F3 . .(indices nearest cross street) Municipality Watershed SOIL PERCOLATION TEST DATA-REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date .o£ Pre - Soaking . •9 - IS bate of Percolation Test HOLE 1\riJ�iHEFt CiAC:h TD1E PERCOLATION PERCOLATION Run :.... Elapse o Water Fran Depth t a Water. Level No., Time Ground Surface In Inches Soil. Rate 'Start -Stop Nin. -Start Stop' Drop In Min /In Drop inches 'Inches Inches 1 ►0.34 1(3- 43. 9 Z -O 23 i 3 Z Z, 2' w-44- loss) 7 3 Z.3 3 ►0.54 W o Z 8 1.9._:Z.. -ZZ• Z 3 z, � 5 Q l lo:z3 .los3s JZ I9 V ZZ.Z -az• ' :3 -4. - 2 1)0'36 jn:4s 9. Jg3• Z 1 i 3 3•e� 3 i Z. 1 Z 3 3 0 c 5 t 1. ESLS t0 ? ep°CtO c?i. S?Tr_ dent_ j .wit it •a ppro.xir-,Laiely •et.31:soil - ref. °_S - - - - -, c:;e OOr 1P."� i F1 ?C:: ✓'Z "C1712�? O 1 test hole. �a1 l C' i? �O � _ .sU�(111L'i. E i?� 1 i!'c�.ciSU'_ "Cl'rP:�L�' '� 'i:' T, =^? ,=.'`.,, LQp Ur lIJZ 10' 3?, lc, IhTDICATB LEVEL AT WHICH CROU:`'L'M'iER IS'ENCOULNr E. IIDIC4 T.E. EVEL TO P; T - ,RSAIR 'BVG �INTER - .°i N o N L StlbZ:II'X •1K 1, P.E: tr�ola�. D=1- HOLE OBSE.RVyTIONS M QE 'BY:- 1-1 , LLo v D : r ro y G t> t= P� DATE: 8 ^ -so 9C, DESIGN' Soil. Rate Used 0-5 Min /L" Drop: 'S. D. Usable Area Provided Sor6o No. of E rocrns Q.. Septic 'Tank Capacity 1 Z'-9,o gals., 9 y _ colt' c. Absorption' Area Provided ay 233 L.F. x.241' width trench Othe.r OF G t-. C-: Signature "Tfi -ess • M 1 LL.F32�s+f �t (e'•�r SakL TE 2 2 M ILL.Tow N AD.' Zr o.56124. �. : S S IPA C E FOR USE _ BY HaALTH DETIIAR7I O T M_. . .J,% � Cf "" A p• �� 90FESS14� ^. L`ate - _- - G PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type ..._ _.. P .CHD_Permit # ' 4 %o —N Well Location: Tax Grid # Street Address: TownNillaggee r � E *60H Map Block Lot(s)'W' r"r Well Owner: ,. Nam : Address:. 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 _ gpm #People Served Est. of Daily Usage dal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling 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 No Name of subdivision PNLI 431� Lot No. Water Well Contractor: T By) Address: °C Is Public Water Supply available to site? .................................. ............................... Yes_ No - Name of Public Water Supply: "' Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separ to s eet/plan. I /--Date: 41 Applicant Signature: V 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 wat ell driller certified by Putnam County. Date of Issue 1 Permit Issui icial: Date of Expiration J 0 Z Title: Permit is Non- Transf r abl 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 LETTER OF AUTHORIZATION RE: Property of T'RE: 13ARa-OW L094�OMT1 odd Located at TN PAMF -?-'501'4 Tax Map # a '1G_ Block 'E> Lot /;�a.I- Subdivision of F-MLE6E Subdivision Lot # 'L Filed Map # �-��� Date Filed 1011_10b Gentlemen:. This letter is to authorize ` i"Y W, PF,' a duly licensed Professional Engineer )<' or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam 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, the Public Health .. -Law, andAhe-Putnar��P-,o _ y- -,an-itary. Code. Countersigned:' P.E., R.A., J 11P Mailing Address 6 P-eyi 'sTEp- State N y Zip ` soo Telephone: 9 H ' 2llf 400'�) Uu��'' State e \)j 1 G FAr' Zip , d (=,,C) Telephoner Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES "- "- `-A°FFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: L6T F�'�E�e Subb(yl St OH) TM 4515F'6 _ %4- 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: lC� CCAa �e- ?1a-; l cc-'C>> President - Name: 7Gsp Address: �D Ca-� � ��,. � �r W�� ��'- ��c3,� r�S IUuj 1 Vice President - Name: �0"`3a 4 FO"'SE 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. Sworn to before me this 61"t- day of \_WA (month) ;2,�� (year) Notary Public CAROL K. BAGEN Notary Public, State of New York No. 5003814 Qualified in Putnam County Commission Expires 11/02/00 Form CA -97 Signed: Title: Corporate Seal ........ ! J. . •. �� v� BATH �` 01 (UVJU t r.._..� � z L't iJ l• • .� i �'�,� \® BEDROOM 4 \J .K 0AESStNG BEDROOM 3. WALK' 12' -0' n 10'•0' ��,/ _ IN CLOSET - �r. T• i 1j t x.11./. 1 }T •� 12t MASTER BEOROOM BEDROO OPEN N 17'-0 n 18'•8" SE C O D F L 0.0 R 4828 ='-i 344S F '\ KITCHEN • � itJrt M r \ / DINING ROOM p I - ,.t MORNING ROOM 17' 0' A 12'.0• L. _._.J �• r • am • � rg 1� /N OPEN , ABOVE I LIVING ROOM ' t.d � FAL41LY ROOM ROYER �• l :IFAST FLOOR � 4828 7(F—= r77-7- .7 BATH J1 C 01 BEDROOM A 0 R E SSI. NG. BEDROOM 3. WALK' 13'-0-x 10*-0' I N * CLOSET r BEDROOM 2 13* 0- x 15'•8*• r MASTER SEOROOm OPEN 17'-0 a. 18'.8 SECOND FLO.OR 4828 =.-1344SF ot KITCHEN DINING ROOM p MORNING FIGOAA ' `' Ell OPEN ABOVE LIVING ROOM 13•0- a I a'.O•• FOYER =IRST FLOOR FAUILY ROOM 13' 0- ■ W 0- 4828 EXISTING CONDITIONS BRUCE R. FOLEY Public Health l jl_"" LORETTA MOLINARI. R.N., M.S.N. Associate �-: Public Health • Director - — - Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914). 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 Jeff Moore 311 Clock-tower Commons Brewster NY 10509 Re: Proposed SSTS: The Barlow Corp. Sylvia Barlow Way, Lot #2 (T) Patterson, TM# 35 -5 -38.2 Dear Mr, Moore: June 1, 2000 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: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) The percolation rate in hole #1 is less than 3 min/inch. Therefore, soil modification must be performed as per enclosed guidelines to increase the rate greater than 3 min/inch. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:tn Very ly yours, Robert Morris, P.E. Senior Public Health Engineer BRUCE R. FOLEY Public Health Director °4 LORETTA MOLTNARI .R.N., M.S.N. -.._ ._;, 1, Associate.:.: Public = -- Health.- =Director - Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster,. New York 10509 Environmental Health (914)278-6130 Fax (914) 278-7921. Nursing Services (914)278-6558 WIC (914)278-6678 Fax (914) 278-6085 Early Intervention (914)278-6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 Harry W. Nichol, P.E. 311 Clocktower Commons Brewster NY 10509 RE: The Barlow Corporation Silvia Barlow Way, Lot# (T) Patterson Reservoir Basin Dear Mr. Nichols: May 30, 2000 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on May 22, 2000 is complete. The Department will notify you by June 20, 2000 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. 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 Dept. of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation Letter to: Harry W. Nichols, P.E. - May _ _ _ _ .-2- h M 30, 2000 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 (914) 278 -6130 ext. 2166. V truly yours, e rt Morris, PE RM:tn Senior Public Health Engineer 0 Harry W. Nichols Jr., P.E. r a i L Patterson Park, , Date: To: Job No.: 11�c Project Attention: T 4 S ui�ltie rI' 0 t � z Cry 6 2050 Route 22 . ° `3iewster,NY 1009 elephone (845) 279 400c .3 ax (5)279 -4567 _. — . P� GL , . . r . ... -_. Revision/Date Gentlemen: We enclose ( ) copies of G� j . l � ; � , � -. � �� V� �✓ G , �� :-�S . .v _ RO c T �A S , i —nr• +� � .. _ O B/W Prints O Reproducibles O Reports T r a=c g O Specifications O Memorandum O Copy of letter O Description: Sent Via: RI D Our Messenger O Blueprinter p First Class Ma O Your Messenger O Hand Deli very Copy to L1 chols Jr., P.E. No. O Special Delivery _ Very truly yours, Harry W:-Ni BRUCE R. FOLEY _ y ... -• -Public.- Health;.. Director.:.: , LORETTA MOLINARI R.N., M.S.N. -> _:_,Associate Public' Health 'Director - Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road t 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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 September 6, 2000 Harry Nichols, P.E. Patterson park Suite 106 2050 Route 22 Brewster NY 10509 Re: Proposed SSTS: The Barlow Corporation Sylvia Barlow Way, Lot #2 (T) Patterson, TM# 35 -5 -38.2 Dear Mr. Nichols: 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: The construction of this sewage disposal system maybe subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) Please explain where the "stabilized" percolation data for perc hole #1 came from. Furthermore, did a Department representative witness this test? Upon receipt of *a submission, revised to reflect the above comments, this application will be considered further. RM:tn Ve ly yours, obert Morris, P.E. Senior Public Health Engineer [y CALAC.2.84 21 &50:: 3 5. 0 7 r 212.03 YyZ00 �' l J V9.50 7 x `r �'�•� 11.14 A At 26 pn B9 AL `37 . g3sa+, 23.57 AC. CAL. ��' 1• = st �. v A 4.42 \ 13•� �* 8.25 AC. CAL. c 1 Ac 67 • J 907.30 \ 674• ` I CAL.f / y� 14.00 AC • - .:,, ,,.- , 17.17 9r� w 1, ! rn p m 1 7.17 ,y T3 k\ 44 0� ,� 4 6 ` CALL. 1 m - a �� i I 6 - F r • 8 o O 1`/f` // 76 L oar 12 T3 AL li At 72� 609 •1.0e;' w 12 Ile ,1.06 loo 399.76 ± 39 I I 40 I v z aF' aF 72 • 29 A I4.58 I 6.61 AL ,.. I.aeF t 2B 38� u�/a AC. I I Itoo TI e e . 1`a , . ., 333 f s 5.98 AC. CAL. 7� a �• O I s +.One �r 7; el'I 10'� - 10.13 AC. CAL. AC CAL. y/ `IS1.4t 1 I .99 AC. �O A4.,.9 i, �• w I s 1.6fi= `� . 30 ✓ r -�,,,�.- !. I I lam• •� ° 36- '° 0 �..el 1.0 RF /w {'ea ? tt <.% '0 s RF •9 i p .;.,fOi10 AL P/ 236 At, ea r 4::. i /w ay aa.1• T6 36 I ss< nia '� 276 RF 8 t fl • s n` 31 �••`.. �� \ 3.17 ; : 7 ( w a v* s 1�� 55.52 AC. {� 43 \ AC. ' r I, .: 3.17 7 17.02 AC. CAL. met ` AC. N 7' a: y,,,•t ♦ 8 N SOS t, a� t66 \ 't 277 At ; .''. q 4 6 . / / \ 1 2.77. AC. Y ae ' (t 32 .1.93 AC. CAL sb��6 /'' J ) \ \ I,6B AC t. . 5 a 2.. Se ac s 33 22 AC C 45' p1.59 Y M 4 ♦ 292.16 a66 N J ;y St01 • . \ AC 46.2 S*a 3.66 AC. 1.74 1 s M�.. 3 r •ice w 46.1 ^ ;SAC���4 pi 360.59' \ 358.9 1 ' i •: p1.74 °3.13 AC. .68 +° o1.S0 / tx 356.5 `_ :2♦ o a34 0 Lz4 z11.30 + { . 68 +° a 1.50 A • •4 EXEMPT \ • 'y;• zll.oe 1 r 2.96 ` EDUCATIONAL \ 44.74 AC. CAL ays6a 672 bt r P\ . s AC. ALLIANCE INC. 42 \ 179AC '� . z4s•6° S 2.74 AC CAL. 3g'' a3 \b 672 \ <ci 95.58 AC. CAL. 8T 1�8AC `.a • 6 >SM $ Yr > 44 \ 1'ac `'= ' 671 z4 47 25299 f ` �..�90 AC.' CAL. \ 4 � 1.45 Wyy� Aar 7.22 AC. S it AG • T9 � '� � \ .axt" �J. t.�` ♦ 607 • \ ' . 48 ► �, \ 4 r 52 \ 64 0 >49�e £60 \ so c 27.40 AC. 66 i .44.00 AC. CAL. 9' }�...t i �• 1943-OD 15 AC.i'I AL 5.00 AC. ✓ . 1 _ 423.01 7 5 • 197.98 CAL. 7� a 62 g 54 I 31.54 AC. CAL. v ` i + 1 5.54 AC. CAL. t�t4n. g 4.00 AC. \ 22.79 AC. CAL. a 176 41 . 1 x a 501 N g 394.76 61 b, 393. 74 56 _ Iswts Y i ' 5.., '�r ,11 1 . I r8 =: i; ` 4.'s' \ 91515) •1 1 3.67 AC. ` 21.12 AC. ,CAL. 692 AC ;i ` so 'Go e / 126.92 AC. CAL. W =' 14.91 AC. CAL. J 3.68 AC. ta ta r ' 1 us.oe , . .., • 59 x is Harry W. Nichols Jr., P.E Patterson Park, Suite 106 2050 Route 22 ,.....,r. _ ..al. .x ... — Wewster, NY 40509:.:= - _...� v... .... , u......- Telephone (845) 2794003 Fax (845) 2794567 August 17, 200 Robert Morris, P.E. Putnam. County Health Department 1 Geneva Road Brewster, NY 10509 RE: Proposed SSTS: The Barlow Corp. Sylvia Barlow Way, Lot #2 Town of Patt erson, TM #35 -5 -38.2 Dear Robert : Enclosed are the test results for the stabilized percolation test PT #1 of Lot #2. Kindly continue the review process and issue the Construction Permit at your earliest convenience. Thank you. Very trltl yours, . . ..Harry - W: Nichol Jr:, P.e _ HWN:his 00- 096.00 17 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner FQrr'je- Address 16 C., Al Located at (Street) 5�k-i�j Rvrt-leLo _Tax Map -3 �;, Block Lot 3 8 (indicate nearest cross street) Municipality /01W ter;aln Watershed P,,.o-f Si--, SOIL PERCOLATION TEST DATA Date of Pre-soakinLy Date of Percolation Test J1 00 X X- .................... .................... .. ........... th t W r e ( P�e . ...a. .....W.. . r ..................... . .. . ...................... . ...... .............. eve Peic an ... No .Run e Eta se Time - * - Surfit o1 �h -a . .URdW .. " .. .. . .." ...... Rate Hale .... . .... ............. Nv ... .. t Stop eft 22-12- ;Z-S-Yiz ........... . 2 I'57 2-'l 3 3 2- 2-,' 33 /9 Zs 1Z 3 Co,3 4 2-,34 2-'S 2-0 12 2- 3 5 2-:2-12- 3 2 3 4 5 2 3 4 1 5 NOTES: 1. Tests to be reneated at same denth until- anDroximatelv eaual nercolation rates are obtained at each percolation test hole. (i.e. -< I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 Harry W. Nichols Jr., P.E. Patterson ark, Suite 106 2050 Route 22 amvster, MY 10509 Telephone (845) 2794003 Fax (845) 279 -4567 August 21, 2000 Robert Morris, P.E. Putnam County Health Department I. Geneva Boulevard Brewster, NY 10509 RE: Proposed SSTS: The Barlow Corp. Sylvia Barlow Way, Lot #2 Town of Patterson, T.M. #35 -5 -38.2 Dear Robert: Enclosed are two (2) sets of complete architectural plans for the proposed dwelling to replace the generic plans previously sent. If you should have any questions, please call. Thank ,you. Very truly yours, H W. �Nics. P.E. �' HWN:his 00- 096.00 _ PUTNAM COUNTY DEPARTMENT OF HEALTH QJ~1 DIVISION OF ENVIRONMENTAL HEALTH SERVICES G ° DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner ,4�,� Address Located at (Street) X 2 Tax Map 3 S_ Block S Lot % 3 S (indicate nearest cross street) Municipality ,*TT,;-:TZS.Al Watershed SOIL PERCOLATION TEST DATA Date of Pre - soaking 8 0 o Date of Percolation Test 8% g Zoo NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each 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 3 5 a-� s — 3, /.� / 1 2 3 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 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 4 " PUTNAM COUNTY DEPARTMENT OF HEALTH w DIVISION OF ENVIRONMEN'fAL HEALTH SERVICES INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM SECTION A. GENERAL INFORMATION Name of Project (T)(V) f �7T�T1sd�! County Site Location R d y� y ,� A:, : k . Zf,,4, Building construction begun 442 Extent —. Is property within NYC Watershed ?............ ...... Yes F__J No SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. dHilly a Rolling F__� Steep slope F-1 Gentle slope Flat 2. � Evidence of wetlands a Low area subject to flooding F__J Bodies of water Drainage ditches F__J Rock outcrops 3. Property lines or corners evident ................ 4. Do water courses exist on or adjoin the property? ........ ..... 5. Will these affect the design of the sewage system facilities ?............ 6. Do watershed regulations apply in this development ? ....................... 7 Will extensive grading be necessary? .................. ............................... :. _:....._ 8.- Will extensive.fill- be- nesess'ary far-- SSTS ? : .:..:.::..:.:.::: 9. Do filled areas exist within the SSTS area? ........ ............................... If yes, what is the condition of the fill? Yes © No 0 YesNo Yes dYes F__] No F__] Yes E�-`No F7 ]Y-Yes-- 0— No7 ? ^._... - -- - _ . Q Yes [D'-'No SECTION C. SOIL OBSERVATIONS 10. Appearance of soil: &Sand a Gravel EZrLoam D Clay . F] Hardpan E] Mixture. 11. Observed from: F Borings F_-� Bank cut a Backhoe excavations 12. Soil borings /excavations observed by 'PO 72 c S ©y► /1Z on 8 /8 / ©�, 13. Depth to groundwater ---- on 14. Depth to mottling on 15. Are test holes representative of primary & reserve areas ...... ............................... Yes 0 No 16. Soil percolation tests made by I c f/i1 L s on 8 Is /na 17. Soil percolation tests witnessed by � ,ci,6 � ` ZEa U r= on 97 a SECTION D (on back) Form ST -1 G TR-55 CURVE NUMBER COMPUTATION VERSION 1.11 - s t- --RS C-,''- ---Da�t-e-:- Pr� '. '-Off Projecf��-:' o-' -- County Putnam State: NY Checked: HwN Date: 4-F-o-oo Subtitle: Detention Basin (25-Year Storm) - EXISTING Conditions Subarea : Area A ------------------------------------------------------------------------------- Hydrologic Soil Group COVE . R DESCRIPTION A B C D Acres (CN) ------------------------------------------------------------------------------- OTHER AGRICULTURAL LANDS Woods fair 2.49(73) Total Area (by Hydrologic Soil Group) 2.49 ------------------------------------------------------------------------------- SUBAREA: Area A TOTAL DRAINAGE AREA: 2.49 Acres WEIGHTED CURVE NUMBER:73 ---------------------------------------------------------- ----------------------- TR -55 Tc and Tt THRU SUBAREA COMPUTATION Project : Prop . Of f ice Bld' g`. ( Hanna ) User's- RSC ` County : Putnam State: NY Checked: Hw►.i Subtitle: Detention Basin (25 -Year Storm) - EXISTING Conditions Subarea #1 - Area A 7 VERSION 1.11 Date:' 4-'zo -oo Date: 4- zo -oo Flow Type 2 year Length Slope Surface n Area Wp Velocity Time rain (ft) (ft /ft) code (sq /ft) (ft) (ft /sec) (hr) --------------------------------•----------------------------------------------- Sheet 3.5 120 0.133 H 0.186 Shallow Concent'd 235 0.136 U 0.011 Shallow Concent'd 35. 0.314 U 0.001 Time of Concentration = 0.20* - -- Sheet Flow Surface Codes - -- A Smooth Surface F Grass, Dense - -- Shallow Concentrated - -- B Fallow (No Res.) G Grass, Burmuda - -- Surface Codes - -- C Cultivated < 20 % Res. H Woods, Light P Paved D Cultivated > 20 % Res. I Woods, Dense U Unpaved E Grass - Range, Short * - Generated for use by TABULAR method 0) C� Putnam County Department of Health ivision of Environmental Health Services noted for conformance with ---:Lnd of the DIMENSION CHART (in feet) N umber A 29 57 2- 115 13 9fi 3 11 A 136 4 114 133 I I A 130 100 65 7 9 64 2 9 65 e a 10 164 193 iI 164 IaI 179 12 164 144 177 13 11 I F.,Alol I SCALE I"= too' -42/