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HomeMy WebLinkAbout1984DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.31 -2 -10 BOX 18 4• �,i�' b, NAM COUNTY DEPARTMENT OF HEALTH G R a i PROVIDE'' MUST:. \ iVi ion of .Environments/ H6lshh, �' , 4es, CWlMW N Y 1051? P.E RM I T # ERTIFICATt OF .CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL:'SYSTEM 4TIS Town or Village Located at i i Tax Map �YT: -Block. �•rp �� 6HPNA � / Formerly DRNIELS Tax Map Lot a Subd. Lot y (phi -13 Li i�t4 Owner��- ^cam ►'.� -1 , ', Separate Sewerage .System built by AAddress �► +�/ ►�J_!f} �J_ - K-1J IVF3KJ lri Q- N Consisting of 1Qal. `Septic Tank and Other requirements. Water Supply: Public .Supply From Private Supply Drilled By R�Jtoe AddressV Building Type S�C�d No. of Bedrooms Date Permit Issued Has Erosion Control Been Completedi Has garbage grinder been installed? I certify that,the system(s) as listed serving the above premises were constructed essentially as shown.on the plans of the completed.work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the fi d plan, and the.permit issued by the Putnam County De rtment Of Health. Date }( Certified by-", P.E. R.A. Address X License No. 48�Fbb Any person occupying premises served by the above'system(s) shall promptly take such iMionasa may be necessary to secure the correction of any unsanitary conditions resulting from such ;usage Approval'of the ,separate sewerage; system shall becorria null and voii ,as won as a public. senitary ewer: becomes available and the approval of the private water supply shall'Dec6rn nu n -`void when a public water supply becomes availabW ' Such- approvals are sub)ect� to oZRI tLion •or change when, In the judgment: of the, mm one f t ealth a revocation, modification or cMnga is necessarLy: Date Il/ � B � Title . 6 v Rev. 6 /85 . - Y PUTNAM C0UN`N DEPARTMENT OF HEALTH DIVISION OF ENVIRO1NMENrAL HEALTH SERVICES G/ Owner or Puitchaser of Building Block Lot Building Constructed by I.ocaU n - Street Municipality Building Type Subdivision Name Subdivision Lot # GUARANM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 disposal system, or any repairs made- by me to 8iIch 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 Director of the Division of Environinental Health Services 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 the building utilizing the system. n n � n lated this day of Title General Contractor (Owner) - Signature Corporation Name (if Corp.) Corporation Name (if Corp.) ess Address rev. 9/85 mk Wr.LL 1rV11rLL11V1V 1<L,rVitl Office Use Only .e DEPARTMENT OF HEALTH of Environmental Health Services W Y PUTNAM COUNTY DEPARTMENT OF HEALTH STREET ADDRESS: TOWNIVIELAUICIM TAX GRID NUMBER: WELL LOCATION Norfolk 1;oad, Patt., -son, NY WELL OWNER NAME: ADDRESS: Dennis She111,y, 12 Fairfi f1d Drive, Br t-,wste.r, NY Q PRIVATE O PUBLIC USE OF WELL 1- primary 2 — secondary © RESIDENTIAL ❑ PUBLIGSUPPLY O AIR /CONO. /HEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL O STAND-BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST: OF DAILY USAGE gal. REASON FOR DRILLING © NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY.' ❑ TEST / OBSERVATION ❑ REPLACE EXISTING SUPPLY ' ❑ DEEPEN ,EXISTING WELL DEPTH DATA WELL DEPTH 220 TftSTATIC WATER LEVEL 30 ' ft. DATE MEASURED 10/23/85 -- DRILLING EQUIPMENT 0 ROTARY Q COMPRESSED AIR PERCUSSION ❑ DUG ❑'WELL POINT ❑ CABLE PERCUSSION _. ❑ OTHER (specify): WELL TYPE J ❑ SCREENED O OPEN END CASING, O OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH ? 1 ft. MATERIALS:. 0 STEEL O PLASTIC O OTHER LENGTH.BELOW GRADE 20 ft. JOINTS: O WELDED O THREADED Q OTHER DIAMETER 6 in. SEAL: ®CEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT 1 -9 Ib.lit. DRIVE SHOE O YES ❑ NO I UNB-. ❑YES ONO SCREEN DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (it) DEVELOPED? DETAILS FIRST ... ... .- .....,.. :..._.:. _..: O YES ONO HOURS SECOND' _... _ GRAVEL PACK ❑YES O NO GRAVEL DIAMETER SIZE OF PACK In., TOP - DEPTH iL BOTTOM DEPTH It. WELL YIELD TEST pumping If detailed METHOD: ❑ PUMPED a tests were done is in- • COMPRESSED AIR , formation attached? • BAILED ❑ OTHER i O YES 0 NO It more detailed formation descriptions or sieve analyses 1�lELL LOG are available. please attach. DEPTH FROM SURFACE Water Bear. Ing Well Dia- Deter FoRIdATION DESCRIPTION caoE, 1t. it WELL DEPTH 1t. DURATION hr, min. DRAWOOWN ft. YIELD gpm. Land 10 vr1tlln� 11.1 .v , c x vrc.x c:u t 1 uy anrl hrni ^S . . Hit rock at 10 ft:ot 220 6 5 .10 21 Drilling in rods, se; t casi ng, g: °ou 21 220 Drilling in rods granite WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE CAPACITY GAL. PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME P „ F , B3Id ca l & ,Sons, Ir> c DATE 4 r ADDRESS PO B °x B 3109TURE j Bl ewst r., IVY 10509 /( ,.-Cl 6 • 8 - _� ....r.._M_ . m ..._.. BREWSTER LABORATORIES.Nm.::. -..i_ Sox 224 - BREWSTER, N.Y. (91 4) 225 -2072 SAMPLE NO. 6445 SOURCE: D & L Shelly Norfolk Rd. Brewster, NY COLLECTED: January 7 0 1987 BY: Joe -L Plumbing & Heating BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method hose bibb - well This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. January 9P 1987 Roy Bickwit P.E. Director 0 per 100 ml. POTNAM COUNTY DEPAMUM OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purc of Building ,� Y Building Constru ted by &M, t_ K l Location - Street Seeti:orr-�- Block Lot To -rtj e,� Lage Subdivision Name TAAd toSA3 -10zc6 Municipality Subdivision Lot # 'Euildin4 Type GUAR*= OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 .disposal systan, or any "repairg tro: *by ine-to, such-system; except-where the failure to- operate -.proper -y -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 Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system.' r Dated this � day of 19 Signature el Title General Contractor (Owner) - Signature Corporation Name (if Corp.) Corporation Name (if Corp.) ess Address rev. 9/85 mk PUTNAM COUNTY DEPARTMENT OF HEALM DIVISION OF ENVIRONMENTAL HEALTH SERVICES a -2d Owner or Purchasek of Building 6�( , Building Construfted by �edefil_ < - .02 Location Street &i�__� Municipality r-, :;OWLM Ac,- Building Type - 6�ctio Tt-�t Block Lot Subdivision Name r 024.3 ° 1OZ4 -& Z (qz iv zf3s Subdivision Lot # GUARAFPM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 disposal system, or any........ repairs made' by' me -to `such systern;" 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 Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this 13 day of 19 Signature Title &� General Contractor (Owner) - Signature Corporation Name (if Corp.) Corporation Name (if Corp.) Address Address rev. 9/85 nk 4 N DIVISION `t*` MIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM - STATE OF NEW YORK-­­­''' IN THE MATTER OF;THE COMPLAINT AGAINST, DENNIS & ELIZABETH SHELLEY, Respondent(s), Arising out of the Alleged Violations of the Public Health Law of the State of New York, the Sanitary Code .of the County of Putnam, and Administrative Rules ,.Regulations and . Standards Promulgated Pursuant Thereto. NOTICE OF HEARING CASE NO: 3 -.87 TO: DENNIS & ELIZABETH SHELLEY PREMISES: NORFOLK ROAD, PUTNAM LAKE (T)-- PATTERSON, TM #34 -3 -8 PLEASE TAKE NOTICE THAT CHARGES have been preferred against you to the effect that you have violated the health laws as more fully set forth on the reverse side of this notice: YOU ARE HEREBY SUMMONED TO APPEAR at a hearing to be had under the provisions-" of the Putnam County Sanitary Code and the Public Health Law of the State of New York before Earle Warren Zaidins, Esq., an Administrative Hearing Officer of the DEPARTMENT OF.HEALTH of the County of Putnam on the lst day of May 1987, at 3:00 P.M., in the Hearing Room, located at 110 Old Route 6.Center, Building 3, Carmel, New York, at which time the charges will be informally discussed, and such adjourned dates as may be designated. - AT. ALL.. TIMES YOU WILL HAVE THE RIGHT. to be represented by counsel and the right - - •to- deny--the- -charges; -•in °whole or in part; following- whI --the matter ° will be rescheduled to a date certain, and a Formal Hearing will be.conducted thereon, and a record of all the proceedings will be made,.witnesses will be sworn and.. examined and cross examined, and documentary evidence may be offered and received, and you may,produce witnesses and evidence -in your behalf; IN THE EVENT YOU WISH TO_„ADMIT.TO..THE. CHARGES, ,the Hearing may be terminated by written..stipulation of discontinuance provided the violations have been corrected: .UPON YOUR FAILURE TO APPEAR, a warrant compelling your appearance may be issued or an Inquest Hearing conducted and a determintion made: CIVIL PENALTIES up to $500 for a single violation, per day, may be assessed against you, and such further orders may be made herein as the circLmstances may warrant; THE BOARD OF HEALTH may issue a warrant to any Peace Officer of the County, pursuant to Section 309 of the Public Health Law, to bring to its aid the power of the County whenever it shall be necessary to do so, with the same force and effect as if such warrant had been issued out of a court of record. PUTNAM UNTY 0 BY: DATED: April 17, 1987 Carmel, New York V� STATEMENT OF CHARGE.._ IT IS HEREBY ALLEDGED THAT THE PERSONS HEREIN BEFORE NAMED RESPONDENTS are charged with violations of the Health Laws of the State of New York and the County of Putnam as follows: PUBLIC HEALTH LAW OF THE STATE OF NEW YORK: Violations of any and all provisions of the Public Health Law of the State of New York and the State and County Codes and Administrative Rules and Regulations promulgated pursuant thereto - which shall be found to constitute a NUISANCE, particularly, and not limited to the provisions of Article 13 of the Public Health Law. SANITARY CODE OF THE STATE OF NEW YORK: PUTNAM COUN'T'Y SANITARY CODE: Article III, Section 1 - Operation of a subsurface sewage disposal system and well without a Certificate of Construction Compliance, issued by the Putnam County Health Department. Article III, Section 1 - Construction of water supply well in location other than that shown on approved plans. ADJOURNMENTS - Public Health Law violations are serious. They affect or may affect the health, safety and welfare of the community. They cannot be permitted to go on indefinitely. Casual adjournments or hearings will not be granted. Applications for adjournments must be made in person or by counsel to the Hearing Officer at the time set for hearings, except for legal excuses. Persons operating an establishment, business or facility, for which a permit is required - without such permit - will not be granted an adjournment. Health matters are involved and the Public Safety is a paramount consideration. t I; represent that I ani wholly and completely responsible for the design and location of the proposed 'system(:! i above described will berconstructed.,es shown on the approved amendment there to and in aecordance.with the- County, .bepartrrient A - Health, and that on completion thereof a "Certificate of ,Construction Compliance' t •'; 'be submitted to'the Department, and. a written guarantee will be furnishes the owner, his successors heir i' place. In .good operating condition any part of said sewage disposal system during the peio6a of two (2)* ance,;.of the approval;oVthe Certificate of Construction Compliance of. the original system:or any�iepa!rs t will be located, itishawn.on;the approved plan and that said`w611 will be installed in accordance, with V-6- 'st County Department of Health. p 1 �4L72 Date Signde' k .. Address •D: -6 .$... 35 New York 512 t APPROVED FOR CONSTRUCTION: This approval expires one year from he date- issued. unl y c nstructi i revocable..for rouse or may be amended or modified when� 44FM e ry by -th Corn !on of H' requves a new permit. pro or disposal of dorr�stic san tary s _age, / r privy w ply. B y that th satisfactory toythe Comrriissioner,of Health will s:or assign's by the;bu!I`der,;that said•builder,Will years 1mined!ately following the date ­ of the issu thereto 2) that the ,deiIled•well ;described,;above l s rules and regula —fions of V: the Putnam :> P,E. ^ R.A. License No , 29206 on of ttie building has been undertaken and is ealth. Any change or alteration ction." only. Title' ' TUTNAM COUNTY DEPARTMENT OF HEALTH Division of krj rbnmenral Health Seivrces `Ca mel /V Y S1D512 X §tJ :Patterson. ':DISPOSAL:SYSTEM ON: CONSTRUCTI PERMIT,FOR SEWAGE => & ap ofP�utn, n loge, Tenth xM or-- "' Lakeshore Ar Norfolk Rd Block ill _ ,. _ _ Subdivision Putnam - >Lake ' „Section .11 UUW /� 4- o Job SQ640 L °t 43`417 ' 3 ` o erome, & ;Jean "Daniels . Q282 47 East 19th' Street owner gddressN� ` New York, N'Y 10010 Bu!Idm9;TYPe Lot Area I Three me Nuber. of,", B diooms' Total Habitable Spacer rx a Squar Feet 1000 150 _ X36 inch f Separate Sewerage System Ao consist of Gal. SepUC 'Tank. (meal meet X width trench i ' TO be constructed by Address a N/ater, Supply Public. Supply From r . ' v x ? a Private Supply to be drilled by ( r� Address Other Requtremehts {— t I; represent that I ani wholly and completely responsible for the design and location of the proposed 'system(:! i above described will berconstructed.,es shown on the approved amendment there to and in aecordance.with the- County, .bepartrrient A - Health, and that on completion thereof a "Certificate of ,Construction Compliance' t •'; 'be submitted to'the Department, and. a written guarantee will be furnishes the owner, his successors heir i' place. In .good operating condition any part of said sewage disposal system during the peio6a of two (2)* ance,;.of the approval;oVthe Certificate of Construction Compliance of. the original system:or any�iepa!rs t will be located, itishawn.on;the approved plan and that said`w611 will be installed in accordance, with V-6- 'st County Department of Health. p 1 �4L72 Date Signde' k .. Address •D: -6 .$... 35 New York 512 t APPROVED FOR CONSTRUCTION: This approval expires one year from he date- issued. unl y c nstructi i revocable..for rouse or may be amended or modified when� 44FM e ry by -th Corn !on of H' requves a new permit. pro or disposal of dorr�stic san tary s _age, / r privy w ply. B y that th satisfactory toythe Comrriissioner,of Health will s:or assign's by the;bu!I`der,;that said•builder,Will years 1mined!ately following the date ­ of the issu thereto 2) that the ,deiIled•well ;described,;above l s rules and regula —fions of V: the Putnam :> P,E. ^ R.A. License No , 29206 on of ttie building has been undertaken and is ealth. Any change or alteration ction." only. Title' ' ,._,:...:.. >.. ,.,:.......,.. -..,. ..� .:� ..., .�., t.. -.. �,PUTNAM- "*,COUNTY 'DEPARTMETVU" DF:-- HEA`LTH— ::, F DIVISION OF ENVIRONMENTAL HEALTH SERVICES Dat / - V g� Re t Property of Q���, � _.. J Z7 A /U Located Section Gentlemen: This letter is to authorize John H. Pmitfts 9 PS, a duly licensed professional engineer XX or registered architect (IndicaTe—j- to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of. the Putnam County LG 611 U Vl nZ:a_.U11, and U l.) .51 1 c1.1.1 necessary papers On my behalf In connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or Eduea --ion Law;, the -- Public--= Health - Lana;- County Sa.n : = -- tary Code. Carmel , Mle�.'r York, 10512 914- 878 -6170 Pe ep one Very truly yours, • -• / / ner of • p- dwr Address-c' ' �4 -1* O a No. 4926 P oriHE S4Aj_0 D I S I V T r�) I-V O`i , '! DE S I G N DA Tz:% SH "EE T_ - S EZPA SiE S, 7,- G E DTS7`S L SvS-- FILE L E LN 0 A d,-:, & OEWO d -a t S t r -e Loca� (IP.d ic:n -e E� n N 1 .[,L,n.-ic pal -i, 9a," %aLershec! -N pp.r I C -1 T T,3 SOII, PEERC-Or�ATTOV TEEST D: �,"'_A RE -,,'o QU--'T7�7ED �VTI TH Z�� - - - -L OLII? - 7 1 - ::� - - __ !'_ _.-� I � tip'? 2 14 4�4 IA s 2 -3 I Vin. a IN ot e S: tz .- -' --s �e d8pt' unt" ap-)ro:.�17=tely- so,*l -ra-e:z =re c�--- Test�. t o be r e p e. Z-11 Le d, L a _—L L rum -t- for taine_' 2t e_=c`1 test 11 o I e . All d=ta to he 2) Dpnt" to be r:,-mcle -F-1'07" to:) of t10'1-. T�o L'�u e C C.- p" A T 7 r,\, PERCOT_- 7 f- E1 Dse Deo to `0"=� a �_E� r .-el o Tinie 0- -Oun' ' S Soil RIN te S t a r L L­_ L S: pop %1471 S- SJo !)�-O:) i.-.. Mia/in 'fr27) I ric s 1.7. C gip% Izg: tip'? 2 14 4�4 IA s 2 -3 I Vin. a IN ot e S: tz .- -' --s �e d8pt' unt" ap-)ro:.�17=tely- so,*l -ra-e:z =re c�--- Test�. t o be r e p e. Z-11 Le d, L a _—L L rum -t- for taine_' 2t e_=c`1 test 11 o I e . All d=ta to he 2) Dpnt" to be r:,-mcle -F-1'07" to:) of t10'1-. TEST 4 PIT 7 D 7, ^ %jTTTE-- 1:) r TIC,\ DESC S LE" NO HO F Y, 6 12.1' 24** 30" 3 6". of 427: 49 S 4 66" 70, 841, 00 -I' N"D I CA":' C:.r N �T oat 7) I I C.A T T,=-, -I, TO L, I L- - Tj R7S A F T E IR 71 S E N C OU NN ERCE D T%: i S X-A DE 4 it ' n gj&dw Date S o 11. R.:: te U s AT Absorpti.OA r`%--rea flrovi6e +4 n Se t -;c d R �7 Tank Ca: a c I t U Z L tj. Address G, B. 353 .4L ra nnn,!JL� P TL NAM CCUN D-EL-D—R, T--\--i CI L-m -,LT4 Ft. /Gal. Checked. Date S.D. r2l) Gals 3.5 w ; ri -L-1 ire n c h 0 t, -7 4' ` � � ... ��1® �� �! �� � � ��� � . _ .��. CI ��_4� �} � � �� �— ���.�� T,�Y� n __�__+� � � — r � �-- �� , „ U� �` � � ` �� i �t All 17 DAVID 0. SRUEN T County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services Dennis & Elizabeth Shelley Norfolk Rd. Brewster, New York 10509 December 30, 1986 44y JOHN SIMMONS. M.D. Deputy Commissioner Re: SDS Compliance Lakeshore Dr. & Norfolk Rd. Patterson TM 34 -3 -8 Putnam Co. Health Dept. Permit # P -18 -85 FINAL NOTICE OF NON - COMPLIANCE YOU ARE HEREBY NOTIFIED that.an informal hearing was held December 29, 1986 at 10:30 a.m. for the purpose of resolving the continuing violation of the Putnam County Sanitary Code Article III Section l consisting of operation of a Sewage Disposal System (SDS and well without a Certificate of Construction Compliance. Mssrs. John Calbo, Patterson Building Inspector and your engineer, Tom Daly were present: Mr. Daly acted as your representative in.your absence. As a result of the hearing it was required, that a complete application'for.`.• a Certificate .of` Construction' Compliance for the SDS and well be'� submitted in approvable form by'January 30, 1987. Failure to do so will ­ r sult in­ the scheduling of a formal hearing. Content of the submission is detailed in.�"Program Review and Policies for Subsurface Sewage Disposal and Water Supply Facilities for Single Family Residence: and includes: 1. Complete copy of form ''Certificate of Construction Compliance" (PCHD Form) 2. Three copies of a two (2) year Guarantee form signed by the installer and the general contractor. (PCHD Form) 3. If the water supply is fran a drilled well, a satisfactory bacterial sample will be required. 4. Well Log including the results of at least a six hour pump test will be required. This is to be signed by the well driller. 5. Three (3) sets of as -built plans, showing the actual layout of the sewage system as it is constructed, including location of adjacent SDS. 6. A Certified Check or Bank Money Order in the amount of $25.00 payable to the Putnam County Health Department. -1- TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 I Dennis & Elizabeth Shelley -2- December 30, 1986 If there are any questions on this matter, refer communication to Mr. Jay Hodgens at 225- 3838/3833 or 225 -3641. ery tru y YO, urs, hn Karell, Jr: P.E. Director Environmental Health Services JK /JSH /JP cc: Tom Daly, P.E. (Hand Delivered_ John Calbo, Patterson Building Inspector file y� DAVID D. 'BRUEN County Executive N DEPARTMENT OF HEALTH Division Of Environmental Health Services Dennis & Elizabeth Shelley Norfolk Rd. Brewster,New York 10509 December 22,,1986 JOHN SIMMONS, M.D. Deputy Commissioner Re: SDS Compliance Lakeshore Dr. & Norfolk Road Patterson TM 34 -3 -8 Put: Co. Health Dept. Permit # P -18 -85 OFFICIAL NOTICE OF HEARING YOU ARE HEREBY NOTIFIED that an informal hearing has-been scheduled for 10:00 A.M. Monday December 29, 1986 in the Office of the Putnam County Health Department, Division of Environmental Health Services located in the Putnam County Office Building on Route 52 in Carmel, for the purpose of discussing continuing violation of the Putnam County Sanitary Code consisting of the operation of a sewage disposal system and well .without a Certificate of Construction Compliance. It is expected that.you or your.representative,will attend, w th -the :designing _g_.._.._ for the•_faites:;_. :._�'om_.I) al_b: resolve.: this_ matter. Faa- l�ar�--= _._._:- - -. -•- _.._._�. to attend will result in initiation of formal hearing proceedings. It is-sincerely hoped that further action will not be necessary: If there are any questions on this matter, refer communication to Mr.Jay Hodgens at 225 - 3838/3833 or 225 -3641. Very ly ours , girecihn Kare ll, Jr., P.E. tor Environmental Health Services JK /JSH /JP cc: Tom Daly,P.E. (Hand.Delivered) John Calbo, Patterson Building Inspector file Jsh Ter-E Re el ltz TWO. COUNTY CENTER - 4RMEL, N.Y.' 10512 (914) 225 -3641 JOHN SIMMONS, M.D. Deputy Commissioner DEPARTMENT OF HEALTH Division Of Environmental Health Services November 26, 1986 CERTIFIED RETURN RECEIPT REQUESTED Dennis & Elizabeth" Shelley Norfolk Road, RD #3 Brewster, New York 10509 SECOND NOTICE OU 2 1Z' Please refer correspondence to: NAME: Jay Hodgens TITLE: Assistant Public Health Engineer PHONE: (914) 225 -3838 ext. 243 OFFICIAL'NOTICE OF NON - COMPLIANCE YOU ARE HEREBY NOTIFIED that non- compliance with Article III Section 1 of the Putnam County Sanitary Code consisting of operation of a subsurface sewage disposal system and well without a Certificate of Construction Compliance from the Putnam County Department of Health was found at the property of Dennis and Elizabeth Shelley, Lakeshore Drive and Norfolk Road, Patterson, New York (TM 34- 3 -8)'by a representative of this Department on October 23,1986. ,. As the ;permittee;:you are ,responsible "for correction of this condition.., "You , should contact your consulting engineer to discuss the action necessary for correction. Failure to correct this condition by December 12, 1986 will make you liable to the penalties provided by law,'including prosecution on a charge of committinq a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as prescribed by law, in addition to such other action as may be prescribed. It is sincerely hoped that the above - mentioned further action will not be necessary and that you will.cooperate by securing the correction of this condition. V r truly ours Karel Jr., P. E. rector Environmental Health Services JK:cj cc: Tom Daly, P.E. John Calbo, B.I. (T) Patterson JSH File . hl County Executive October 31, 1986 CERTIFIED RETURN RECEIPT.REQUESTED DEPARTMENT OF HEALTH Division Of Environmental Health Services Dennis & Elizabeth Shelle Norfolk Road, RD #3 Brewster, New York 10509 Deputy Commissioner ' Please refer correspondence to: NAME: Jay Hodgens TITLE: Assistant Public Health Engineer PHONE: (914) 225 -3838 ext. 243. OFFICIAL NOTICE OF NON- COMPLIANCE YOU ARE HEREBY NOTIFIED that non - compliance with Article III Section 1 of the Putnam County Sanitary Code consisting of operation of a subsurface sewage disposal system and well without a Certificate of Construction Compliance from the Putnam County Department of Health was found at the.property of Dennis and Elizabeth Shelley, Lakeshore Drive and Norfolk Road, Patterson, New York (TM 34 -3 -8) by a representative of this Department on October 23, 1986. As the permittee, you are responsible for correction of this condition. You should contact your consulting engineer to discuss the action necessary for Failure to correct this condition by November 12, 1986 will make you liable to the penalties provided by law, including prosecution on a charge of committing a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as prescribed by law, in addition to such other action as may be prescribed. It is sincerely hoped that the above- mentioned further action will not be necessary and that you will cooperate by securing the correction of this condition. U r ruly ours Karel Jr., P. . 'rector Environmental Health Services JK:cj cc: Tom Daly, P.E. John Calbo, B.I. (T) Patterson JSH File TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641 p" 'F PUTNAM £OUNTY HEALTH - DEPARTMENT, :. DIVISION OF ENVIRONMENTAL `HEALTH SERVICES John M. Simmons.,, M.D.. „Deputy Commissioner o£ Health _ ;FIELD E ACTIVITY ' <REPORT Sheet. of 'r _ . - - . INSPECTION;: NAME Orig Routine s _ 0 -Compi.rig.ain" ADDRESS r _ 0 rigi. equest No. _ Street, Municipality (T).(V)(C); - Compliance: a. ! r Gompla_int Comp ." Box Post O'ffiee' Zip ;.Code ;Group- 4`Illness Con s t r- "uc t ion TELEPHONE =- f' R- inspection PERSON. IN CHARGE Fie am ld,: Splring Only _ CrR> INTERVIEWED ' Field Conference •• e ;Name d-Ti °le 4 ,ant _ 0 the DATE r ©,`�j' �r� TYPE FACILITY TIME ARRIVED f TIMES LEFT' x Explain FINDINGS t6, jk • s. - . m jc- RL tee c , IA c, _ P p v= Ar t — INSPECTOR r r „ . . < TELSPHONE . Si azure aril Title,_ PE1tSON IN-"C GE 4R INTERVIEWFDf I acknowledge. rece =1pE of a c "opy of this SIGNAT�JRE Field Activi=ty Report.._. - :'.. _ y - TITLE ' - 01 Y. I PERMITS I ;1' , I C.:COMPL_IANCES� 5 Date ie 'd. I Owner — O I Date Recd. I Owner �[rrfii� Location w I Permit ' Location Ole w TM.# B1. l Lot Town TM.# B1. Lot Town Date App. L SubdvST�S}J `P �Subdv.�� I Date App. I Subdv. Subdv. # op 1 �•�S Engineer I ; ( Engineer BY: .I I BY: I Dat S/ t�gc d. I Owner - � '!�F I Dart R c' -d. Owner Pe mit Location ! I y,Permrt �� ^•y.1 Location (7. A141.0 �TM.. o ' �S # B1 Lot Town' I I . TM.# B1. Lot Town Dat A p. I Subdv.�(�7-4 Subdv.# M gZ -,� I Date App: � Subdv. Subdv. �+I.Oi/f w I Engineer I I Engineer BY: A .I I BY: Date R� d /Lt Owner /j e vL Date Recd. I Owner -. :rR Location I Location u TM.�� t Town Per{{nn I Location Of Permit Location ".. I flv rg TM.# B1. Lot Town I I TM.# B1. t ��Town �f _ Date App. I Subdv E -�� Subdv.# Date App. I Subdv. r ' 'SU%` dv. / J 1� I Engineer I I Engineer '`' x 71 BY: I�.�( I G I BY: °y Date ' Owned_ Pe�i'mi 5 I Loca t io TM .# Date App. I Subdv. _ ;rgineer I Subdv. I Date Rec'd. I Owner -' Permit ion Location I Location u TM.�� t Town IV. Z BI,1�0 99Lot Town 'Date App.. I Subdv. Subdv. # I Engineer iiE igiz -dAtl i4- 1AP;3 BY: I 03Al3jjd llate a 'd. •oRiie*r 1W e p I Date Rec,';d. I Owner e ni.t� 4.� I ion I Permit f I Location I TM.�� t Town I I. TM.# B1. Lot Town Date App. I Subdv. ubd S I..Date.App. I Subdv. Subdv. # I Engineer I I Engineer BY: I I BY' �f _ A,: ..... . . . . . . -qb -:R e,775. tHOR* T -7- .4V 150 Widi .......... We f d4 f 4, i�io and dee molld LO �F :� - PAW ors 40mop,:: l of 14 IVE PR 5 "'407? -,DA - tz -', W.A. ET DAVID D. 'BRUEN County Executive _ ... v ,JOHN SIMMONS. M.D. Deputy Commissioner DEPARTMENT OF HEALTH Division Of Environmental Health Services January 12,1987 Mr. John Harmke Dept. of Enviromental Conservation 202 Mamaroneck Avenue White Plains, New York 10601 Re: Shelly contaminated soil Lake Shore Drive, Patterson, TM 34 -3 -8 Putnam County , Dear Mr.Harmke: As a result of the conversation with Femi Falade of DEC, New Paltz Office on October 22, 1986 and our conversation on October 24, 1986 and the copy of complaint transmittal, it was my understanding that the DEC Division of Environmental Enforcement had undertaken an investigation of the subject incident. Enclosed for your.use is a copy of soil test results taken October 23, 1986. I understand scme''enforcement action has been taken: Please grovide me wii1i"- the details. Also of great importance, was it determined.where the contaminated soil originated? This may have bearing in an investigation being conducted by this Department of a groundwater contamination episode. Very truly yours, owrn.+t cQ ames S. Hodg s Assistant Public Health Engineer JSH /jp Enc. cc: Femi Falade file Terry Revella, DEC, WP TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641 COUNTY OF WESTCRESTZ1,- ~ DEPARTMENT OF LABORATORIES AND RESEMH VALRALLA, NEW YORK. 10595 , RESULTS OF ANALYSES GASOLINE COASPONENTS� (DOIi` 310 -19) Lab No. r51090 Bottle No._,'fQnj "T Date Recd I 23 Date . Coll °d l a f� Time: Agency Co21 ° d for C Q. Coll °d B� -- Collected From: NameT (LaSL] v 0eirsL] , 0 h9E. Address Q.�C�?.� ,rr✓ 'f G `11C t . i SC (St. Rd.)- (Town Village ge City - (Zip Coe ) (County Sampling Point (q r k 'Yct-rd Identification of Source fnidwq�, y betuJeen trte.s a.:nd hc4se, Gasoline Criteria according to New York State Department of Transportation. Test Procedure for Gasoline Components in Water .(Purgeable Aromatics) (DOA Procedures 310 -19) : .. 1. The following compounds must be present: Compounds u / .Benzene Toluene Ethylbenzene m- xylene p= xylene , o- xylene -2. Tile` xylene isomers -must be approximately the same concentration (within a factor of 2). 3.` Presence of additional peaks in the chromatogram with the following retention times (Benzene = 1.0'minutes) *Major peaks - must be present. Method R. T.'s (min.) Actual R. T.'s (min.) 3.9 3 4-d 4.25* .4- 2;7 4.5* 5.1 *� J: 5.6 5.9 - Q Gasoline Criteria Met [� Gasoline Criteria Not Met � Reported By Date Reported PUTNAIN COUNTY D K ARTMENT .OF HEALTH y- N Permit «= �J� bi �r Division of Environmental :Health Services Carmel N 1' 105. CONSTRUCTION PERMIt FOR SEWAGE DISPOSAL SYSTEM{ v i Town or iiiage r (� LGCpted at Tax Map alock Lot _ Cis` y ' _ pl A A , SubtlivifiOn RP Suhd:. Lot q Renewal Revision - ,Owner /Address - _ `'� z Date 'Of Previous Approval / .7 1 Builtling TypeEStA�nlTirk Lot Ares �� Pill Section Only ❑� ' z s E Number 'of Bedrooms Design Flow G /P /D �• P c R... D Notification Requires Separate Sewerage. System to consist of 107 Gal zSeptic Tank and O� r' "�1 j .To tie constructed by'c' ci NIt1E�' Address Water Supply. Public Supply From + Private SuPPIY} to De tlrilled by `G `77 "ii- ' Address Otiier Requirements 1. represent' that i, ni wholly and completely iespons�t>le for the tles�gn.:and location of 'the proposed system(!), 1) that the separate sewage disposal ;system `above: described wJl be,construeted "5s show,n.on the app►ovetl,amendm'ent there;ao antl in, accordance with'the stanrfsrtli, rules and re u, nam. Count De ailment of Health, and that on eom letion thereof a Certificate of Construction Compliance satistaetory;to the ^Eommi iioner of :Health:will; Y;. P p .- r t be submitted to <the .Department, rand `a written guarantee :will De fiirnished'the owner his successors'- heir' or-- assigits:by the builder; that said builder,wlll place In'gootl operating contl lon:'any ,part of said sewage tlisDOSaI' system :'AUr�ng the period of'' tw ' (2) yeari immediate) Ilowing thedate of:'the 1pu i •., once of the approval ;of. the Certificate -.of`Const ruction Gomphanee_ of the: original ,system or.'ahy-repairi; thereto; 2► -'tho h�'• drilled well Cescribed''above will be IoeateA ar'shown on the.approved.plen and that l will be;;installed ..in aeeardanee with the, !tan ds ru d` ula ons of the' Putnam County. Department of Health Date Z Signed P ER. "A. .,` -r y Lice se;NO. n APPROVED li,6R NSTRUCTION This approval expues one yearfiom the ,tlate ,issu u ess construction of the budding has been; undertaken and is ;revocable /or cauie:or may amended or modified when:co, Mlir*fte. rya.by' the ` omm sloner.of Healthl.;Any Change pr =al at ion of construction ,. _ r revu�res a new permit Approved '.for disposal of tlomesti -sa :antl /or res at i4i only. Date i I dlw gy Title z ¢f CERTIFIED RETURN RECEIPT REQUESTED DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 August 22, 1991 Mr. & Mrs. Dennis Shelley Arden Road Patterson, New York 12563 RE: Case No: 3 -87 -38 Dear Mr. & Mrs. Shelley: JOHN KAHELL Jr., P.E., M.S. Public Health Director Review of Departmental files indicates that as of August 15, 1991, this Department has no record of a fine payment in the amount of $250 which was assessed as the result of a Formal Hearing Action. This fine is long overdue, however, we are allowing a grace period un- til September 30, 1991. - Failure -to pay -this -$250 fine by September;30, 1991, will result in the the institution of legal action on behalf of Putnam County to collect. this fine. In addition, should you operate a permitted facility, your permit to operate will not be renewed upon expiration; until the fine is paid. Operation of a facility requiring a permit, without such permit, will result in a separate legal action by the Department. It is hoped that such action is not necessary and that you will cooper- ate by forwarding your payment to this office. Very truly_ y s, t _ John Kareil, Jr., .E. Public Health Director JK:mk enc. cc: B. Foley, Associate Public Health Sanitarian o. PUTNAM COUNTY DEPARTMENT OF HEALTH ° DIVISION OF ENVIRONMENTAL HEALTH SERVICES 'Dat.e� ti A?P-IL Re: Property of I i Located at (T) Ac- JZ Section Block Lot Subdivision of t•,J*f mop &F Subdv. Lot # jpy,¢3 -!v Filed Map # /0 902- -6- Date Gentlemen: This letter is to authorize ICC_ a duly licensed professional engineer or registered architect (Indicate to apply for a Construction Permit for a. separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said •----syst -em --or- -systems -in-- conformity with - t.e--provi•sions- of ..Article - 145 -or -- 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very Signe, Counter. igne R.A. , # 4E)4 Address Telephone Address Town /V/ S/ Telephone D4 /t/lS , g 3,:4-;; , P' Q � Y PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISIONi.OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING,`CARMEL, N. Y. 10512" DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL- SYSTEM FILE N0: Owner —d iPC Y Z �sSAA) (CAS- Addre s s Located at (Street L�E-Sk2E f /lleFU4 Sec. Block Lot - n ica e nearest cross street) Municipality k-rreg Watershed ��t.�v;j SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTID WITH APPLICATIONS ... Hole- Number CLOCK TIME PERCOLATION PERCOLATION- Run No. Elapse Time Start -Stop Min. Depth to Water From Ground Surface Start Stop Inches Inches Water Tievel in Inches Drop in- Inches - Soil Rate:::: Min: /in_drop 27 Cv 2 00 '+ Zk `i 1 f49' 14(o - 3 Z (2— 2 : 3(jo 2L9 4 5 1 2 3 5 Notes: 1) Tegts to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA :REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF .SOILS ENCOUNTERED IN TEST HOLES D9.PTH :HOLE NO.. l 'HOLE NO. HOLE NO.. v G.L. --J&PSot L 6 n 12" 2 :,t Lo 3611 6" 42.11 48" .�t 60" 66" 72" 1. 78tt 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED,, INDI GATE- 1E- VEL- 20- WHIOH- WATER _.T. ETF'LT RISES. AF- TER-m-BEING - .ENC=T'ERED� TESTS MADE BY Date DESIGN Soil Rate UsedFj'(© Min/1 "Drop: S.D. Usable Area Provided,. -�-- No. of Bedrooms Septic Tank Capacity CO Gals. T �� Absorption Area Provided By L.F.x24 Vi ene herd - ,. Al— i-I Address 3 SEAL THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate-Approved Sq. Ft /Gal. Checked by Date .. ' LOGdT1O.S 101 c 7.2 TANK f, 4m \ \ \ \ --- . �IVE TO i�oRFD�A•' ow 1 a2 (m0'- p `. cut, cut, VJALic � IIK �gGAT laJ Pt R } \ \ fIA 5 �L I l -D " �t 0� la i v� p A,2 65wTlG fro r?Eab U 1000 CAL vv 01f T 6 IMYV 3,3 t�. (a -0L9" TREtJGt1 wTS 10M3- 102AIo t02�L' �YOZ$ra btu OoTr' "T6ATh MAP OF F NAM LAKE.. GAG" PMT 1 L r N0U6E yJ�i'L tAGAf{ONs AS FAR SU vE( NSTA"6V ${ rttUOUAS GNAf)S PATf'D MAY I, �9a7 torn &A1 f�Y �Prle TAtJK NaIZfUIK KC1AD a Yu u1Sw 6y TOWN OF MITG50� 4 _ jIvislon of Environmental Health Servicen roved as noted for conformance with pplioable Rules and Regulations of the '( t t - .) i I : t. 1 i •i } ' Cc H Department... r T, MiCR V1 M 15.ti CC.�' 16':i)UVUL. } �y0 Ety } VAS j sk6kture R Ttt7.a }A g S1 -\ t� ti1't' tt! �PfPyICHF� }ova �t S' it ;1 }b i.,At; t } �L.L.A:' _�5 OZ ii�l i o a IL o 0 4g6e tad , m 7: I l cl Yi a ii i,