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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 45.-4 -2.1 BOX 18 02120 .. I or } Lin 1, 3r 1 ■ il. . Ir ' ., F ' No 02120 PUTNAM COUNTY DEPARTMENT OF HEALTH - _- DL:.... ZON_OF E VIRONMENTA�L:_HF,_ALTH- - ERVICES.:. ,. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREAT D PCHD CONSTRUCTION PERMIT # Located at 4-7 u-,s��.a- rle� -s %ice Town or Village Owner /Applicant Name /1,0 f�j� e, /�%, Cam. ' Formerly Tax Map 4-r Block 3 Lot r2, / Subdivision Name ,sj ocx, Subd. Lot # /U Mailing Address / � oepe `�3 > Gi fvr�� X l /VJ" Zip Date Construction Permit Issued by PCHD %/- ,Z G--a J Separate Sewerage System built by C�''y� c �pjy fj�- r�sG�;� Addressde,� /L✓J Consisting of %9 :rte Gallon Septic Tank and �y� >,e- ��%G•r�j Other Requirements: 3 � / /Scot, �' // 7 e.4 G,'-402 �7',►�c�,� �r Water Suonly: Public Supply From, Address or: Private Supply Drilled by /dt-z':'Fx o" Joi-Is Address _ _....._. Building Type- ��ts ;o�' -leas erosion control -been.completed? . 49e 15 Number of Bedrooms Has garbage grinder been installed? 170 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 regulations of the Putnam County Department of Health. Date: Certifiedby P.E. -,-' R.A. ' (Design Professional Address 0, Ma '4,5;.70 Cs'. P C3-4!?? �G,)' � � rZ License # ®.5'"5`9,9 9` Pat7v r 4Z7,7 ; C---02i `4--+ Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals ubject to modification or change when, in the judgment of the Public Health Director, such revocatio mo fication change is necessary. By: Title: Date: D 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 WELL COMPLETION REPORT Well Location Street "Address: -' ` - - "" "' rNatz 7Z.r, Town/Village: C,� r �1�L Tax Grid # Map Block Lot(s) Well Owner: Name: Address: / 4� %�1 Gr✓C.0 Use of Well: -prima 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion _X_ Compressed air percussion Other (specify) Well Type Casing Details Screened Open end casing A_ Open hole in bedrock _ Other Total length eft. Materials: Steel _ Plastic _ Other Length below grade _,54e;, ft. Joints: _ Welded Threaded _ Other Diameter (p in. Seal: _)S, Cement grout _ Bentonite _ Other X Weight per footlb /ft. 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 _ Pumpeil----4 Compressed Air Hours Yield L gpm Depth Data Measure from land surface - static (specify ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type C t4 Capacity Depth _U0 Model jQS/,,S' Voltage A30 HP I Tank TypeWeLLILTo LVolume _IJA Date Well Completed Putnam County Certification No. Date of Report Well le (signature) !MOTE; Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller 's M me /4445 -L 'DNS' Address: , Signature: Date: . White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 03/01/04 MON 09:,.44 TEL 914 277 8210 BIBBO ASSOCIATES LLP PCHD 002 Fab 27 04-'01:46p TOWN OF PATTERSO 645-079-2019 p-2 02/27/04 FRI 11:48 TEL 914 277 0210 DIDDO A M CIATES ALP la oin BRVCE R. FOLEY LORETTA MOLINARI M.&N, pubtic Health Director var Axradate Public Head, Din ,Xr4e(j5#- of Polfent services DEPARTMENT OF HEALTH I Geneva Aqajd' B.xcwster, New York 110509 C."Virawwwal 11x4 (914)118-6134 rax (P L4) 279 - 7921 Nursing 5erw1;#A(914)273-fiJ55 WIC 1914] 218 - 4670' Fat (9 W) 279 - 600 1.911 I BUICKICION QHM' Aj)]2RES,5 V OWNERS NAML: TAX ry LAL P rf U IVL)3 - EXL' 8911 ADDRESS: TO NY N: AUTHORIZED TOWN OFACIAL; (Signature) JDATE. -r11t utuam County Departw4at of, Health. will not issue a Certificate of Construction Cojupliance unless the above form is completed,'i.e., a legal E911 address is assigned by an authori=d torn, official. This form is to be submitted with Clio aplAication for a, Certificate of Constr'utfidn Compliance. 02/27/04 FRT 14:34 [TX/RX NO 80111 Z002 03/01/04 MON 14:48 TEL 914 277 8210 BIBBO ASSOCIATES LLP BIBB* 0. ASSOCIATES, L.L.P. Consulting Engineers — Planners:: �N MMA PCHD IM 001 John P McNamara, P.E. Joseph J. Buschyrukli, P.E. • Timothy S. Allen, P E_ Leonard J. Bibbo P.E. Robert X B. Howe, B.S. FROM: # (914)_277 -8210 RE: MESSAGE: r 2`2 z .. i �G��"_���,5 :fir �'�, NUMBER OF PAGES BEING TRANSMITTED (INCLUDING COVER): If you do not receive .0 pages g0s In . legible condlfi6n, please call. (91 4) 277-5805. Planning Site Design - Ehvironmental 589 Route 22 • P.O. Box 403 -,,-Croton -falls, NY 10519 -,.(914) 277-5805 • (914) 277-8210 Fax 6113130 ASSOCIATES LLP 589 Route 22 — Box 403 CROTON FALLS, NEW YORK 10519 (914) 277 -5805 FAX- (914): 277 -821;Q TO WE ARE SENDING YOU ❑ Shop drawings ❑ Copy of letter INUCTIEQ W CT ° IHc@ W QC(TC1fzR& DATE `If -'- DATE ATTENTION � ' -: r. d �s RE, -oa S"- - ;7-, - ❑ Attached ❑ Under separate cover via the following items: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPIES DATE NO. DESCRIPTION - 42(f- e THESE ARE TRANSMITTED as checked below_: Q" For approval ❑ For your use ❑ As requested ❑ For review and comment ❑ FORBIDS DUE REMARKS ❑ Approved as submitted ❑ Resubmit copies for approval • Approved as noted ❑ Submit copies for distribution • Returned for corrections ❑ Return corrected prints 19 ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: ' N enclosures are not as noted, kindly notify US at once. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIR®NMENTAL. ALT - -- SERVICES 1. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 7`�foti /Alli Owner or Pur aser of Building AZ21_ l t, /`ii Gell- Building Co structed by Location - Street Building Type I_vr" 3 62. / Tax Map Block Lot 7�ersP� TownNillage Subdivision Name /3 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 o erate properly is caused b the willful or negli eg_r t aact of the occupant of the,buildrxag_utilizing..the_ a n P P P Y..._.�.. Y. system:...w:.,�:_ ... , . . The undersigned further agrees to kept as conclus ve the determination of the Public Health Director of the Putnam County Department of Health s to whether or not the failure of the system to operate was caused by the willful or negligent ac of the occupant of the building utilizing the Day Year ontrador (Owner) - Corporation Name (if corporation) Address: f 0 State Toy Y Zip 1 a J b Signatu Title: Corporation Name (if corporation) Address: State J._ Form GS -97 YML ENVIRONMENTAL SERVICES ` 321 Kear Street (914) 245-2800 Albert H. Padovani, Director- LAB #: 33.301393 CLIENT #: 114 NON STAT PROC PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ TORLISH & SONS BOX 271, 45 MAPLE AVE. ATTENTION: DWAYNE TORLISH ARMONK, NY 10504 SAMPLING SITE: FEILDS CORNER RD CARMEL COL'D BY: D. TORLISH NOTES...., DATE FLAG PROCEDURE PUTNAM CNTY PROFILE 12/30/03 MF T. COLIFORM 12/30/03 LEAD (IMS) 12/30/03 NITRATE NITROG 12/30/03 NITRITE NITROG 12/30/03 IRON (Fe) 12/30/03 MANGANESE (Mn) 12/30/03` SODIUM (Na) 12/30/03 p H 12/30/03 HARDNESS,TOTAL 12/30/03 ALKALINITY (AS .12/30/03-7---TURBIDITY (TUR DATE/TIME TAKEN: 12/29/03 03:30P DATE/TIME REC'D: 12/30/03 10:35A REPORT DATE: 01/07/04 PHONE: (914)-273-3448 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ RESULT NORMAL - RANGE MET'OD ABSENT /100 ML 1.4 ppb <0.2 ME /L <0.O1 MG /L <0.060 MG/L <0.010 MG /L 4.71 MG /L 6.9 UNITS 59.0 ME /L 60.0 MG /L <1 NTU ABSENT 1008 0-15 ppb 9i01 0 - 10 9139 N/A 9!46 0-0.3 mg/1 2037 0-0.3 mg/1 2037 N/A ` 6.5-8.5 9043 N/A N/A ��N - ' - COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE AS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems requires that no � more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water- undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is-suggested. w ` 13113130- ASSOCIATES LLP ^ 589 Route 22 - Box 403 CROTON FALLS, NEW YORK lO5l9 (914) 277-5805 TO u- ��' D=��u u ��u� x�~ u n&M1@uuuu u uL%[� REw WE ARE SENDING YOU O Attached O Under separate cover via the following items: � O Shop drawings O Prints O Plans O Samples O Specifications 0 Copy of letter 0 Change order 0 COPIES DATE NO. DESCRIPTION THESE ARE TRANSMITTED ou checked be�w:_����`�_ ' _'— - R~forapprova| O Approved assubmitted O Resubmit--_- O For your use O Approved as noted O Submit_-___ O As requested O Returned for corrections O Retum----_- � O For review and comment O REMARKS —copies for approval -copies for distribution corrected prints O FORBIDS DUE lQ__--' O PRINTS RETURNED AFTER LOAN TOUS � ' � COPY TO _), . t Ionc e. If enclosures are not as noted, kindly notif u PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES - ,.,..,DESIGN DATA SI1,EET - SUBSURFACE SEWAGE'TREATMENT SYSTEM Owner Address �iel�S Cmr,s �o� Located at (Street) ���� �t��ct dL r e✓ds (��, Tax Map 4t Block .3 Lot (indicate nearest cross street) Municipality &ACSO-e Drainage Basin SOIL PERCOLATION: TEST DATA r—; ff 0 Date of Pre - soaking 6&7� Date of Percolation Test. ZO�o� Mole No. Run No. Time Start -Stop Ela se Time (nMia.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop Iu Inches Percolation Rate Min/Inch F 1 1 3-/0/1' Z7 3 3, -10 zs 13 Z ZZ 1-43 3 /625•-/©3 / Z — ZZ .4 4y/- /ass" 2 ?,G. 5 2. 1 0 20 _/ Z- zz 3 103y -i0y ZC2 Zy - Z7 3 .13 4 5 1 2 3 4 In NOTES;,!`; Nests• "to be red �t ,percolation to 1. 21 t :Depth mea�ssid same depth until approximately equal percolation rates are obtaineo at each i.e, s 1 min for 1 -30 min /inch, s 2 min for 31 -60 min /inch) All data to be nests ib be made from top of hole. �x ,� Form DD -97 TEST.PIT. DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. O.L. 0.5' 1.0' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5 A' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.5' 10.0' 2 Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: _ Date Design Professional Name: .\:�5 Address:, Signature: Design Professional's Seal LO , Ty c Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: _ Date Design Professional Name: .\:�5 Address:, Signature: Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES °'K' FINAL SITE INSPECTION Date: 0 03 - Fr/ ae/ Inspected by: -_ . Street Location, Owner Town Permit # P- 3y! -'0 2 TM # g , - 3 - t Subdivision Lot # / 3 1. Sewage 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 ............................ I........ H. Sewage System a. Septic tank size - 1,000 ..... ..... • ...1,250. .other................. b. Septic'tank installed level .......:....... ...................I........... c. 10' minimum from foundation ...................................... Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3... Minimum 2 ft. Original soil between box & trenches e. Junction Box - properly set .......... ............................... 6. Frenches 1. Length required AlflK Length installed 2. Distance to watercourse measured 4- j oo 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 .......:........... ..1.Q: Pipe ends ca ed.......:_ ............... :. pp ........................ . . g. Pump or Dose 1. Size of pump chamber ................. .....................•......... 2. Overflow tank......... ..................... ............................... 3. Alarm, visual/ audio .... ....:........:.. ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. Mouse located per approved plans.... b. Number of bedrooms ...................... ..... ... . . IV. Well �nu5 P'90M &hove gata�e Well located as per approved plans ...w %9 h. e4 ;14 b. Distance from STS area measured ft........... c. Casing. 18" above grade ................ ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanshia . 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 watercourse g. Footing drains discharge away from ' STS area ............... h. Surface water protection adequate: .. ....:.......................... i. Erosion control provided ......... . ............................ . ......... Rev. 12/02 V1 v" a ' t SITE INSPECT>e01�FOR FILI PAD Date: Inspected by: Fill pad located per the approved plan A,g,oe-gars Q �, Fill Pad Length _ % Required Length_ / Fill Pad Width �9 2 Required Width - Fill Pad Depth J� Required Depth Run -of -Bank Fill Quality �� I r /O t 6 ? ef, 6 Slope from Top to Toe Impervious Layer Installed ye-S. Erosion Control Installed yt°!5 Sieve Test Results (if applicable) Additional: Comments: A& , ,,r � ,`'M 3/,f_��� ° EX` r'k, cuJ iyL tfat4 cav #e)4 ne,f- �'ovnd Reserved for Field Sketch if Applicable 10/07/03 TUE 15:23 TEL 914 277 8210 a • v BIBBO ASSOCIATES LLP PCHD [1001 PUTNAM COUNTY DEPARTMENT OF HEALTH DTYISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION C7 ADAM GENE =I Msi-FOR FINAL INSPEalm For: Fill All information must be fully completed prior to any Trenches inspections being made. PCHD Construction Permit # Located:' rrre ds C.o/'rler Owner /Applicant Name: A, Formerly: Is system fill completed? Is system complete? 3 7Z_ 492 44 %m„ /'!_�eJ•' 'TM V5'- Block a Lot -el Subdivision Name: S 6' ~CS, t s. Subdivision Lot # 13 T des Date:./617�p� Date: Is system constructed as per plans? _�_ Is well drilled? �y�i Date: Is well located as per plans? Are erosion control measures in place? -� I certify that the systern(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with .the issued PCED Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date: %— Certified by: E ZRA Design Professionaf Bibbo Assoaates LLP Address: ConsuWngineers and Lic. 589 Route 22-P.O. Box 403 Comments: Croton Falls. NY 10519 Form FIR 99 A• . • "'LO=A "MOI,INARI ' R.N., Public Health Director DEPARTMENT OF HEALTH, 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 October 9, 2003 Joe Buschynski Bibbo Associates 589 Route 22 Croton Falls, New York 10519 Dear Mr. Buschynski: ROBERT J. BONDI County Executive Re: Field Inspection — Miceli Fields Corners Road, (T) Patterson Lot # 13, TM# 45. -3 -2.1 The following comments trust be corrected in the field: 1. Fill pad slope (top to toe) must be a 3:1 slope. - - 2: _ It appears portions of the f 11 pad_are in the °100- £oot�we tlanls�bffer,.. 3. This Department's files show no record that an inspection was made for the existing curtain drain shown on the approved plan. Please submit any information you may have to this department in regards to inspections of, or witnessing installation of the curtain drain. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. Very truly yours, 4�- 0, . Gene D. Reed Environmental Health Engineering Aide GDR: ej BIBBO ASSOCIATES, LoL.i? Consulting Engineers — Planners October 10, 2003 Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 ATTN: Gene D. Reed RE: Miceli SSTS Fields Corners Road (T) Patterson Dear Mr. Reed: John P. McNamara, P.E. Joseph J. Buschynski, P.E. Timothy S. Allen, P.E. Leonard J. Bibbo P.E. Robert A. B. Howe, B.S. We have received your letter of October 9, 2003 regarding your inspection of the above and offer the following: 1. We are in agreement that the slope of the fill surrounding the R.O.B. exceeds the requirement for a 1 on 3. However, the slope has not been brought to finished grade. Following the addition of topsoil the required slope will be provided. 2. The issue of wetland limits was crucial to the approval of this lot during the subdivision process. The current owner had the wetland buffer staked in = = - accordance with the wetland boundary defined by the New York State Department of Environmental Conservation and the Town of Patterson. No portion of the fill pad is within the 100 foot buffer. 3. The curtain drain was installed in early 2000 to address the request by your Department to demonstrate the effectiveness of a curtain drain on this lot (see enclosed letters dated December 15, 1999, March 2, 2000, March 6, 2000 and April 17, 2000). The drain was subsequently installed and monitored (see letter dated September 25, 2000). Per the monitoring results, the requirement for three feet of R.O.B. was indicated on the SSTS Schedule on the Subdivision Plat as approved by your Department. Please call if you have any questions. Very truly yours, Joseph J. Buschynski, P.E. JJB /bs Enclosures Planning • Site Design • Environmental 589 Route 22 • P.O. Box 403 • Croton Falls, NY 10519 • (914) 277 -5805 m (914) 277 -8210 Fax o - LORETTA MOLINARI Public• Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845)-278 - 6648 November 5, 2003 Joe Buschynski Bibbo Associates 589 Route 22 PO Box 403 Croton Falls, New York 10519 Dear Mr.. Buschynski: ROBERT J. BONDI County Executive Re: Miceli Fields Corners Road, (T) Patterson Lot # 13, TM# 45. -3 -2.1 An inspection of the fill pad at the above referenced project has been completed. Trench plans must be submitted to this Department for final approval of construction prior to the installation of the separate sewage treatment system. Please note that field measurements by this Department in no way suggests the exact size, depth and location of the fill pad. If you have any further questions, please contact me at 845 - 278 =6130, ext. 2261. Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide GDR: cj e s 4 ' SENDING CONFIRMATION DATE NOV -5 -2003 WED 17:44 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 919142778210 PAGES : 1/1 START TIME : NOV -05 17:43 ELAPSED TIME : 00'21° MODE : ECM RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED. 4 LORE1TA MOLINARI ROBERT I. BONDI paa0a Hmeh plmlw dab 8.W1+ DEPARTMENT OF HEALTH t Geneva Rand. Brewater, New York 10509 ' RYvoeaemlal no" (845)276.6170 Pa7(m)179 -9921 A9nin Sarvka (845) 779.6558 WIC (945)171.6678 Fox (845) 278.6085 Earls t.urm9gadFrmbad ()45) 271.6014 Pax (9457' 78-6648 November 5, 2003 Joe Buschynski Bibbo Associates. 589 Route 22 PO Box 403 Croton Falls, New York 10519 Re: Miceli Fields Comers Road, M Patterson fAd # 13, TMP 45.•3 -2.1 Dear Mr. Buschynski: An inspection of the fill pad at the above referenced project has been completed. Trench piano must be submitted to this Department for Baal approval of construction prior to the installation of the separate sewage treatment system. Please note that field measurements by (his Department in no way suggests the exact size, depth and location of the fill pad. If you have any 8uther questions, please contact me at 845 - 278+•6130, ext, 2261. Sincerely, n ,r 70. vl Gene A. Reed Sr. Environmental Health Engineering Aide GVR:cj 11/17/03 MON,17:30 TEL 914 277 8210 BIBBO ASSOCIATES LLP 444 PCHD "TNAM COUNTY DEPARTMENT OF MALTA D ION OF ENVIRONMENTAL .HEALTH SERVICES ATTENTION E] ADAM � GENE QUEST FORFINA,j,, INSPECTION For Fill All information must be fully completed prior to any Trenches % inspections being made. [a 001 PCHD Construction hermit # Located: (T) (V) Ownerh pant Name: 4,o2 o,,& it A5,Ev . " , TM _!9,r Block Lot �- Formerly: Subdivision Name: tS/tf��%'�sF�^s'o� G/'�� •��' = Subdivision Lot # ! 3 Is system fill completed? � �ee S bate: 101710,7 Is system complete? G S hate: / dg Is system constructed as per plans? - c xf Is well drilled? 9_.s' ___ Date: Is well located as per plans? !�>e— Lf Are erosion control measures in place? E % I certify that the system(s), as listed, at the above premises has been, constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Date: Certified by: PE ✓ RA t signs Professional Address: i ��i¢s. [s.� ;S` � is ,ZoZ� f � ��,y' Lic. # ,vy 40 Comments: l%l_" ,� Form FIR -99 -1 �}.o. FOLEY .,- __..,_a�t�u}57ic 'Nea'!th` Director:. �.•.,:r,:,- ,�::,,....... F_- .,...w.,...,ti ,. -- LORETTA MOLINARI R.N., M.S.N. `° ., ..-• A. ��v�iate'Piu61i�"'fi'edith"i7twi� tor'" _'.�. °x'.... 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 December 15, 1999 Mr. Joseph Buschynski, P. E. Bibbo Associates 589 Route 22 Croton Falls, NY 10519 Re: Ginsburg Development Corp. Realty Subdivision (T) Patterson Dear Mr. Buschynski: This Department, in conjunction with the NYC Dept. of Environmental Protection, has received and reviewed the subdivision plans and supporting information relative to the above captioned project and the following comments are offered for your consideration. r 1. A minimum of two (2) test wells are required to be drilled and tested for yield and quality per Section 3.K of Bulletin RS -21. - 2. The proposed SSTS areas for lots #1, 3, 4, 5, 7 (lower area), 12, 13,15 and 16 do not appear to be large enough to accommodate the primary and reserve systems for four bedroom dwellings. In this regard, the design of the primary and reserve systems are to be provided on a separate sheet for each of the above lots. 3. The depths of the deep test holes are to be provided in the soil description column of the SSTS schedule. 4. The, proposed SSTS areas on lots #2, 15 and 16 are to provide a minimum separation distance of 35 feet to the stormwater piping. 5. Please be advised that the percolation rates 11 -15 min/inch and 16 -20 min/inch require 375 LF and 429 LF of absorption trenches, respectively, for three bedroom dwellings. The SSTS schedule is to be revised accordingly. 6. A copy of the issued NYS Dept.. of Environmental Conservation wetland permit, for all proposed activity within the 100 foot wetland buffer, is to be provided to this Department prior to approval. 7. A portion of the lot #3 SSTS area exceeds the maximum allowable grade of 15 percent. The SSTS area is to be shown regraded, to a maximum of 15 percent, and the appropriate fill requirements specified in the SSTS schedule. 8. 9. 10. 11. 12. 13. ✓ 14. ✓ 15. ,/16. 17. 19 20 Note #4, under the SSTS schedule, is to be revised as follows "Dosing required for a 4 bedroom design ". Note #4 is to be added to the remarks column of the SSTS schedule for lot #7. The construction plans are to differentiate between the existing and proposed stone walls. All proposed SSTS areas are to maintain a minimum horizontal separation distance of 10 feet to all existing and proposed walls. The plan is to designate the primary and reserve system areas for lot 97. The footing and leader drains for all proposed dwellings are to be shown on the plans. This office recommends relocating the lot #9 well 40 feet off the southwest corner of the lot. The lot 911 SSTS reserve area can not include the existing SSTS area. The specified finished floor elevation for lot #12 will not provide gravity flow to the entire SSTS area. Based on the.existing ground slope of 3.8 percent, the minimum required separation distance from the proposed curtain drain to the SSTS area is 21 feet for Lot #13. Due to the documented groundwater level at 30 inches below grade within the proposed SSTS areas of lots #13 and 14, this Department will require that you demonstrate the groundwater can effectively be lowered during the seasonal high groundwater period (March 15th - June 30th). Plans for the proposed method of lowering the groundwater are to be submitted to this office for review. One deep test hole and one percolation test hole within the lot #15 SSTS are not labeled. Mottling was observed and recorded as follows: Lot # Mottling depth 7_ - - _ 15 36 inches The design data sheets and SSTS schedule are to be revised and the appropriate revisions made to the SSTS designs. Kindly advise us if there are any questions. Respectfully, Michael J. udzi ski, . E. Director of nginee MJB/Jp cc: Janine McColgan, DEP BIBBO ASSOCIATES, L.L.R Consulting Engineers - Planners March 2, 2000 Patterson Planning Board 2 Route 164 Patterson, NY 12564 ATTN: Herbert Schech, Chairman John P. McNamara, P.E. Joseph J. Buschynski, P.E. Timothy S.Allen, P.E. Leonard J. Bibbo P.E. Robert A. B. Howe, B.S. RE: Ginsburg Development Corp. Subdivision Dear Members of the Board: Enclosed in the above matter are two prints of Dwg. #3 from the project construction plans. As a result of the Putnam County Health Department review of the subdivision, the applicant is required to demonstrate that seasonal high ground water within the sewage disposal area of lots #13 and #14 can be lowered. This is normally accomplished with the installation of an open trench or curtain drain. The effect of the drain on ground water levels will be monitored from standpipes on each side of the drain during the spring season of March 15 to June 30. The proposed curtain drains have been highlighted on the enclosed prints. A 20 foot wide ,path will be cleared over each drain to provide,adequate. access.andwork area. Rather than leaving.an.open french; fhe applicant will- install a complete curtain drain with perforated, pipe• arid- _ :_- - - -- crushed stone. The trench will then be returned to original grade. As shown on the plan, the pipes which outlet the drains and part of the Lot 13 curtain drain extend into the 100 foot controlled area of Town regulated wetland. We are therefore requesting approval of the Planning Board to conduct the required work. The wetland at the trench outlets will be protected from siltation with silt fence. Larger trees in the path of the curtain drain trenches will be spared where possible. All cut brush, branches, small trees will be chipped. The work area will be finish graded, seeded and mulched upon completion. Given the temporary nature of this work, no long term impacts on the wetland are anticipated. Due to a very protracted approval process with the New York City Department of Environmental Protection and the requirements of the Health Department, at this time we also request the approval of the Planning Board for a six month extension of the Preliminary Plat approval which will expire on April 3, 2000. Based on the ground Planning - Site Design - Environmental 589 Route 22 - P.O. Box 403 - Croton Falls, NY 10519 - (914) 277 -5805 - (914) 277 -8210 Fax _N A ...�.....;j.:,: water. monitoring .prog ram _r;equired by the Health Department, the collection of data will extend through Juno, 2000. If the results are satisfactory, issuance of an approval Irorrr the Health Department ig anticipated shortly thereafter. We would appreciate your scheduling these matters for the next rrreeting of the Planning Board on March 16, 2000. Very truly yours, Joseph J. Buschynski, P.E. JJB /bs Enclosures cc: S. G. Richards 0 � � ap moo, � �o �, ��y: o °.� � � J6. oe 0 Of 147 as wF � ;. (pol. x, PIP 0 cog 490 ; 0- V I STV BIBBO ASSOCIATES, L.L.P. John P. McNamara, P.E. Joseph J. Buschynski, P.E. Consultin g En g ineers — Planners Timothy.S.Allen, RE. Leonard J. Bibbo P.E. Robert A. B. Howe, B.S: March 6, 2000 Putnam County Health Department 4 Geneva Road, Route 312 Brewster, NY 10509 ATTN: Michael J. Budzinski, P.E., Director of Engineering RE: Ginsburg Development Corp. Subdivision Town of Patterson Dear Mr. Budzinski: Enclosed in the above matter is one print each of Dwgs. 2 and 3 and two Water Well Application forms. In accordance with your letter of December 15, 1999 we are making arrangements to.begin the installation of curtain drains on lot nos. 13 and 14. The drains will be constructed as shown on the detail on Dwg. 3. A monitoring pipe will be installed on the upgradient side of each drain. Monitoring pipes are currently located . within, the.proposed disposal" areas on the downgradient. sides. Approvals`,to.. iinstall the"- " drains will also be required from the Patterson Planning Board since the solid outlet piping for each drain is located within the 100' controlled area of Town regulated wetland. We are scheduled to appear before the Planning Board for approval of the work on March 16. With regard to the required test wells, we are proposing that wells be drilled and tested for yield and quality on lot .nos. 10 and 15. Please call "if you have any questions or comments. Very truly yours, Joseph J. Buschynski, P.E. JJB /bs Enclosures Planning • Site Design ® Environmental 589 Route 22 . P.O. Box 403 • Croton Falls, NY 10519 • (914) 277 -5805 • (914) 277 -8210 Fax BIBBO ASSOCIATES, L.L.R Consulting Engineers — Planners John P. McNamara, P.E. Joseph J. Buschynski, P.E. Timothy S. Allen, P.E. • y...� .�. r_Ca - -w a. i^. �.. r. t. .s. •^h.� a� .� :... ... - ♦ F .6- x -...au ar.. :^pxr...0 ..<�rs rr;..a�. r��, - -•.a. .. :�.i .. � ..•. .. .,a .. _.. n.. . • e -f a.... April 17, 2000 Putnam County Health Department 4 Geneva Road, Route 312 Brewster, NY 10509 ATTN: Michael J. Budzinski, P.E., Director of Engineering RE: Ginsburg Development Corp. Subdivision Town of Patterson Dear Mr. Budzinski: Leonard J. Bibbo P.E. Robert A. B. Howe, B.S. We are writing in response to your letter of December 15, 1999 regarding the above. Enclosed are two sets of the Preliminary Plat and Construction Plans, one set of 11" x 17" worksheets, and one copy of a revised design data sheet (lot #15). In accordance with your letter we offer the following: 1: As you know, we intend to drill test wells on lot numbers 10 and 15. The drilling is scheduled for the..month of May. - . -.. 2. The enclosed work sheets demonstrate the feasibility of SSTS layouts on the lots which you requested. 3. The SSTS Schedule has been revised to include test pit depths in the soil description column. 4. The minimum separation between the SSTS and storm drain pipe is now noted for lots #2, #15, #16. 5. The required length of absorption trench for three bedroom homes has been corrected in the SSTS Schedule. 6. The N.Y.S.D.E.C. requires that the N.Y.C.D.E.P. issue approval of the Stormwater Pollution Prevention Plan before issuing a Wetland Permit. All issues raised by the D.E.P. have been satisfactorily addressed and we anticipate receipt of their approval soon. We will forward copies of each approval upon receipt. Planning • Site Design • Environmental 589 Route 22 • P.O. Box 403 • Croton Falls, NY 10519 • (914) 177 -5805 • (914) 277 -8210 Fax 6% -s -.7 .,it .. • The::•filling•;required4o reduce -the slope in the lot #3 SSTS is now addressed in- the SSTS Schedule and on the grading plan. 8. . Note #4 of the SSTS schedule has been revised as requested. 9. The SSTS Schedule now references the requirement for dosing on lot #7. 10. Proposed stone retaining walls are now differentiated from existing stone walls. 11. The SSTS's are now separated from proposed stone walls by 10 feet. Stone walls are noted for removal on lot numbers #4, #5, #6. 12. The lot #7 primary and expansion areas are now noted. 13. Roof and footing drain locations are now shown. 14. The lot #9 well has been relocated as recommended. 15. The lot #11 reserve area has been adjusted. 16. The house and SSTS layout for lot #12 has been adjusted to provide for gravity flow. 17. The lot #13 layout has been adjusted to provide for 21 feet of separation from the curtain drain and SSTS. .We received. a_ Wetland: Permit to nstallthe_�curtain:drain ,on..lot - #13 from PE L_ ;: Patterson Planning Board on April 6. Work on the drain began on Monday, April 10 and was completed on April 12. We have begun monitoring of the up and down gradient standpipes. The seasonal high groundwater elevation on lot #14 was of concern to both the Planning Board and owner, and resulted in a decision to delete lot #14 and merge it with lot #13. Subsequent editions of the plans will reflect deletion of the lot. 19. The unlabeled deep and perc tests on lot #15 have been removed. These were unwitnessed tests conducted for exploratory purposes early in the subdivision design. 20. Since our field notes did not indicate the presence of mottling in lot #7 deep tests, new tests were excavated on February 9, 2000 and observed by Adam Stiebeling and Jannine McColgan. The absence of groundwater and mottling was confirmed. On lot #15, two to three feet of R.O.B. fill and a curtain drain are proposed. �l. �r - - ___,:Fendin.g. successful. results on lot #13, a_final plat will -be prepared. for l5 Jots and, submitted to your Department for approval. Please call me if you have any questions. Very truly yours, Joseph J. Buschynski, P.E. JJB /nn Enclosures A. BIBISO ASSOCIATES L.L.P. J John . McNamara, P.E. f Joseph . Buschynski, P.E. Consulting Engineers — Planners Timothy S.AIIen, P.E. t<:... r.�, .r. •...• �.,.. .. Sx -- I.J. +s_ .. . _ ♦ .. ♦ r , f � ♦. .n.a. a-.,. no.w s._Alr.. �.. s +Ti•�!. s-�.: t.. . ✓. rw. -r,. r... .- �.rt. .. K mot.. •_.� n.... . s ♦ • �t s...ra rc�..a ,�_Y�r.. r � .-.. Leonard J. Bibbo P.E. Robert A. B. Howe, B.S. September 25, 2000 Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 ATTN.: Michael Budzinski, P.E., Director of Engineering RE: Ginsburg Development Corp. Subdivision Town of Patterson Dear Mr. Budzinski: Enclosed for.your review in the above matter are the following items: Three (3) sets of the Final Subdivision Plat drawings 2. Three (3) sets of the Preliminary Plat and Construction Plans 3. One (1) copy of the Stormwater Pollution Prevention Plan Approval from the New York City Department of Environmental Protection 4. - One'(1)'66py of Lot #13 Ground Water Level Measurements 5. One (1) copy of a 1 " =30' worksheet of the Lot #13 SSDS Layout 6. One (1) copy of the Test Well Reports for wells drilled on Lot Nos. 10 and 14 As previously discussed in our letter of April 17, 2000, the plans are now revised to combine Lot #13 with the former Lot #14, resulting in one less lot. Water level measurements were monitored over the spring season on Lot #13 and indicate that the curtain drain lowered the level in the SSDA sufficiently such that 30 inches of R.O.B. fill .will provide the required separation to ground water. The wetland application to the New York State Department of Environmental Conservation has been determined complete. We will forward a copy of the permit upon receipt. An application for final subdivision plat approval has been submitted to the Patterson Planning Board. We are scheduled to appear before the Planning .Board at their October 5 meeting. Planning - Site Design - Environmental 589 Route 22 - P.O. Box 403 - Croton Falls, NY 10519 - (914) 277 -5805 - (914) 277 -8210 Fax :P,lease call. if you have any questions. Very truly yours, Joseph J. Buschynski, P.E. JJB /bs Enclosures i Bibbo Assc tes Job Z'ltl ir�ti •� �.v - CONSULTING L „sINEERS - PLANNERS SHEET No, OF Rt. 22 & Hardscrabble Rd., P.O. Box 403 Croton Falls, New York 10519 CALCULATED BY �Z DATE _ CHECKED BY DATE F�or�► Gi',4,0S- (1,Ac144-s) 34 J-- /9 - o ® �o G 3 9 ZI - / 7 - a0 - 7 yt- - o (/,nA /N 4/1, 0) 4ir 4 IL J-- /9 - o ® Ecrr 1 41 PUTNAM COUNTY DEPARTMENT OF HEALTH a DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR nivATMENT SYSTEM �) n PERMIT # Located at 47/�/G4 Town or Village zz&�n �1*7� Slira 1 f rz*PC r, os Subdivision name AXj ubd. Lot # 13 Tax Map % Block J Lot / Date Subdivision Approved�� Owner /Applicant Name ,�����.;, �, -cell Renewal Revision Date of Previous Approval Mailing Address /Op &2 ,21- i , hg ©,rgGA -, &Y Zip. Amount of Fee Enclosed \,t,369z5P Building Type Lot Area No. of Bedrooms Design Flow GPD Fill Section Only e/ Depth _ Volume �4G Separate Sewerage System to consist of /02,.$—a gallon septic tank and Other Requirements: f " q � To be constructed by �r,0• Address Water Supply: Public Supply From Address or: 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 treatments sy tem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. n �&- ® &A t& sl � S &, 6/K IM-0 � I2 APPOCYAL Signed: _ �_� � P.E. e," R.A. Date — '? -a7 Address License #��9� �- Cf'eTd," /-a? 4& j NVY APPROVER 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 w onsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. Approve discharge of domestic sanitary sewage only. By: Title: � Date: 12-1V1.0 Z. White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Z 'd 30 1N3W18tid30 J,1NnOO WUNind:3WdN T26L- 8L2- Sb8:-131 62:2T 3ni 2002 -2 -030 .',• "�'' December 3, 2002 Robert Morns P.E '. Putnam Co. Health Dept. 4 Geneva Road ; A BTawster, NY 10509 : Vs�tiiaB�'�k'aradc ' 4't339 ;':;`:::'''t'. ••:. ' `:''.'::•:: `;' Re: Camatari Subd. Lot 13 /Anthony Miceli n P. =': ' .: Fields Corners Road _:u`'`f Patterson, Putnam. Middle Branch Reservoir DEP Log # 12588 (Joint Review) Dear Mr. Morris: This letter is to inform you that the New York City Department of Environmental protection (Department) has determined that the above- referenced application is :::.. •. ,.:: °. ° ..; °'. -:;::, : ; complete. In addition, the Department has no objection to the approval of the , A Practae above - referenced regulated activity. This determination is based on the review of submitted documents including the plan titled "SDS property of Anthony Miceli ", dated 6/21/02, and last revised 11 /I8 /02. The applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 at :_. . least 2 days prior to the start of construction of the SSTS so that a Department :._.re esentative m a ct and monitor the mstai ation Sincerely, Danny Shedlo, P.E. Project Manager Engineering Design & Review xc: James Covey, P.E., KYSDOH ' •' ,•r g tly�11ol,1' ZO'd ZS :TT ZOOZ i OaQ HdNOibA d3Q 3AN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL, HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL _..., .. _ ._ Please print or type PCHD Permit # -y Well Location: Street Address: Tax Grid # ®Town/Village Map -r, Block 5 Lot(s) ,W> Well Owner: Name: Address: /0'a 45 ' e2`l3 �����c //�%✓� %G�S"3�' Use of Well: d/ 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 .st gpm # People Served Est. of Daily Usage3e:�tP gal. 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? ;f�! -pG� s: ��/lr�r�l�?�.1f%- eJ-' Yes ✓ No Name of subdivision Lot No. Water Well Contractor:,,, Address: 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 separate sheet/plan. Date: 7- %-O.Z Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water driller certified by Putnam County. Date of Issue—/ 2, l o L Permit Is Official: Date of Expiration/ o Title: Permit is Non -Tra sierra le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 BRUCE Public Health Director LOIMTT A -.45L,MW'.R.N. M.S.N. _.._. -- Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH i Geneva Road Brewster, New York 10.509 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 July 24, 2002 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Bibbo Associates 589 Route 22, PO Box 403 Croton Falls, New York 10519 Dear Mr. Bibbo: Re: Miceli, 47 Fields Comer Road, Lot # 13 (T) Patterson, TM# 45 -3 -2.1 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on July 11, 2002 is complete. The Department will notify you by August 15, 2002 of its determination. 0 The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ® 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 would be sent to my attention at the _ above address.. This notice must include your name the location of the ro t the, ce th_which.you: =v. _� s ._ ... - -: _.._.._ _. -s R.- ,lee offsi _... _....- _ - a.. . _ ... ,. . `fifed t1ie application ongmally, and a statement that a decision is ought in accordance with Section 18 -23 (d) (6) of the New York City Department of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if DEP review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext: 2166. Ve K.F�y I&A�o A�� Robert Morris, PE RM:cj Public Health Engineer BIBBO ASSOCIATES LLP 589 Route 22 CROTON FALLS, NEW YORK 10519• (914).277-5805, .,,....,,..y FAX . (914) 277 = 88210._ . TO WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ \ DATE 9p � �- JOB N0. \ \ ATTENTION - �yd: s / RE: ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION THESE ARE'TRANSMITTED as checked below:- For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FORBIDS DUE REMARKS COPY TO • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US SIGNED:- If enclosures are not as noted, kindly notify sat once. l i �4 i PUTNAM COUNTY DEPARTMENT OIL HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION .;. RE: Property ol'j�J�iiri�r Located at TN soA Tax Map # lf� Block _, _ Lot / Subdivision of Subdivision Lot # Filed Map # Date Filed 1-19 62v1 Gentlemen: This letter is to authorize Z1- a duly licensed Professional Engineer L,-*" or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the abovc -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 treatment and /or water sup systen in conformity with the provisions of Article 145- and/or _14:7 of c Education.I 1ofProperftty)' --Law, °and the �Putndhi' 6bniy Sanitary Code. Very truCountersigned:'"Signed: P.E., R.A., # D"5` 'e (owner Mailing Address ,�'`� ��o��� 2 z Zkw 463 State ' /t'% r Zip �F Telephone: Mailing Address: /'�,r,l' a2 ?J State Telephone: �7�/� •Z--31 Form LA -97 • PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES :_._.,.,.,.,.:...�:... -DI;�[GN.'DATk-SHEET- -'SVBS JRI ACE -SkWAGE TI A�°MY';1��" SYS'TEM".. . ". Owner - L`ifLiae�y C� /� - Address /?�GX %✓7%�c,O%� �� /�S�v Located at (Street) 4-71:1-e-1,4 Cazhy-zs 1W Tax Map s: Block Lot a?- (indicate nearest cross street) Municipality Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking h7 -.�— �l'� Date of Percolation Test. Hole No. Run No. Time Start - Stop Ela se Time (PMin.) Nth to Water on, Ground Surface (Inches). Start Stop Water _ Level Drop In Inclies Percolation. Rate Min/Inch Gl �' 2 as i `F 3 D 3 ��/ - / /V r O 4 5 -- /.S- 3 oZ,oZ-1 ; a 7 4 5 1 2 3 4 . 5 NOTES:.'.. 1. Tests to be repeated at same depth until approximately equal percolation rates are obtainea at eacn e dlation test hole. (i.e. s 1 min for 1 -30 min /inch, s 2 min for 31 -60 min /inch) All data to be F, tlm'ttted for review. 2. :Depth ',;rneasurements to be made from top of hole. r k`° Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES DEPTH HOLE N0. G.L. _ /rail Sla. 0.5' 1.0' 1.5' 2.0' S�rt�s /f Cod 2.5' 3.0' 3.5' 4.0' 4.5' Ge tie © Ca 7a 1, 5.0' 5.5' 6.0' 6.5' 7.0' HOLE NO. HOLE N0. .fd/lSbi�� Indicate level at which groundwater is encountered Indicate level at which mottling is observed ���V Indicate level to which water level rises after being encountered p 414; Deep hole observations made by: �' �; ��h;;T�, /'7,��o%ii.� Date Design Professional Name: w Address: ;� r;� i¢.ss'as l G� Of 1\1E Signature: zc�z - r '. ► L F '•. b� �o. b' { Design Professional's Seal ?h9 .1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES w._APPLI�ATI�N_: 'OR APERO�dAL-OF PLAN,SzF0 t ._ r ......a.. .... , K, _ A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant:�%Go� 2. Name of project:`3 3. Location T/V; ,Er/cSOyl 4. Design Professional A120 %S �s:,LLi° 5. Address: ,,5'e_f7✓Fae,,7`c •� 2 6. Drainage Basin: 7. Type of Project: _1 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 7 Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? .................... /(Jib 10. Has DEIS been completed and found acceptable by Lead Agency? ............... /C � 11. Name of Lead Agency 12. Is this project in an area under the control of local.lannin_g,..zonirg,,or other. offrci 1 ortfiirra ;te ?�.:: : ° .:.:::.:::.:.:: :.:::::.:::....... :.:.- ........... : :. : :... :. �'.. �c_ - .__.:._�........ 13. If so, have plans been submitted to such authorities? ........ ............................... e S 14. Has preliminary approval been granted by such authorities? Date granted:,%ice / _ 15. Type of Sewage Treatment System Discharge ................. surface water r/ groundwater 16. If surface water discharge, what is the stream class designation? .................... 17. Waters index number (surface) ........................................... ............................... 18. Is project located near a public water supply system? ....... ............................... Vya 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ l/o 21. Name of sewage system Distance to sewage system 22. Date test holes observed 1(W2u, 1JJ 9 23. Name of Health Inspector /l/4" 24. Project design.flow (gallons per day) ................................. ............................... eeoo 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... Wa 26. Has SPDES Application been submitted to local DEC office? ......................... Form PC -97 2 i 27. Is any portion of this project located within a designated Town or State wetland? eS 28.... Wetlands III Number ..............:? ;'OG . jOVC?. .................. 29. Is Wetlands Permit required? ............................................... ......:........................ e' S Has application been made to Town or Local DEC office? ... ............................ /,4 P� 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 d 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 e DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... _� s 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? . ............................... 10a 36. Tax Map ID Number .......................... ............................... Map Block_,2 Lot o?- 37. Approved plans are to be returned to ..... Applicant Design Professional . _ .... NQTE:. Ati1l.appldcations.for review and- approval of a new SSTS to be located ,withiri the NYC Watershed shall be sent 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 watershedc: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 actigies.&Sm 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 appliaioni' st . be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with thi`6provis on may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury; that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICiAL TITLES: Mailing Address: ................................... 14.16-4 (2187)—Text 12 PROJECT I.D. NUMBER 617.21 SEAR Appendix C SHORT. ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only -PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR 7/-07' 2. PROJECT NAME 2 JX16; Cih C� �Gr�� -,� a s�csJ� 3. PROJECT LOCATI ,cr✓7 Municipality �%f ✓�G' County 4. PRECISE LOCATION (Street address and Intersections, prominent landmarks, etc.,, or provide map) /road jo 5.. IS PNPOSED ACTION: New ❑ Expansion ❑ Modificationlalteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially % acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ❑ ,�1 Yes No If No, describe. briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ,Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ ParklForestlOpen space ❑ Other dDescribe- � , z ..w ..._. _ . _._ ..._ , .,........ ...:.. �:___......_. �. _... ...._ 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL. STATE OR LOCAL)? Yes ❑ If yes, list agency(s) and �_I/� /perrmitlapprovals /No/�c� �G yi eliSGtr .� /GT✓ � t�Q� f� � `� lG✓� � U`�`d -ai f � . 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? *Yes ❑ No If list yes, agency name and permll1approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes ZNo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ' / J%!�rr�/�i G Applicant/sponsor name: Date: Signature: l✓'✓' - ' '', HI 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 1 THRESHOLD IN 6 NYCRR, PART 617.12? 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. NYCRR, PART 617.6? If No, a negative declaration - ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible) Ct. 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 brlefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly; C4. A community's existing plans or goals as officially adopted, or a change In use or Intensity of use of land or other natural resources? Explain briefly C5. Growth, subsequent development, or related activities likely to be Induced.by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not Identified In C1•C5? Explain briefly.. C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly.. D.— S-'?HEM 011801 THERE -LJIKELY TO-BE.-CONTROVERSY-RELATED TO -POTENTIAL ADYfRSE-ENVIRONMENT,AL4MPACTSI. El Yes Yes ❑ No If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether It Is substantial, large, important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed'. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and /or prepare a* positive declaration. ❑ Check this box If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency Print or Type Name of Responsi e Officer in Lead Agency Title of Responsible officer Signature of Responsible Officer in Lead Agency ' Date 9 Signature of Preparer (if different from responsible officer) Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 .LORE'ITTA 4MOLINARI R.N..,. M.S.N. Associate Public Health Director Director of Patient Services 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 September 17, 2002 Joseph Buschynski, P.E. Bibbo Associates 589 Route 22 Croton Falls, NY 10519 Re: NYCDEP Response: Proposed SSTS: Miceli 47 Fields Corners Road, Lot. #13 (T) Patterson, TM# 45. -3 -2.1 Dear Mr. Buschynski: This letter is to inform you that the New York City Department of Environmental Protection (DEP) has responded to the above referenced project (letter enclosed). Upon receipt of a submission, revised to reflect the' above - comments, this application will be considered further. Yours y, Robert Morris, P.E. Senior Public Health Engineer RM:tn (718) DEP -HELP . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # )P-3 I- - 0.2 Located at s-�� S ` (� --wh Sr Villages %s��i Subdivision name 'r r7/As�' Subd. Lot # / Tax Map Block Lot s Date Subdivision Approved d ±fi �Cy�'� Renewal Revision Owner /Applicant. Name A,l &l Date of Previous Approval Mailing Address ZO& 42�-K ,311�,5 ZZl�e;--44 j , /U% Zip Amount of Fee Enclosed Building Type r' Lot Area '7-5—f No. of Bedrooms _!f_ Design Flow GPD. Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of gallon septic tank and J-19-!f Other Requirements: ,41e fte To be constructed Z b ���.,�� Y c��G� %r c.� Address 5 ,�r;�%��JE�r, Water Supply: Public Supply From Address , r or: ,✓ Private Supply Drilled by f��- ;'s� %�,.s Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in 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: Address Date // -,,2 f- -6>.3 # Cori � 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 w n nsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. rov or disc of domestic sanitary sews a only. By: Title: Date: Allf-6 Ze White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Do e I Do ? W O W a ri \ I \ I \ I 0 � N o \ 1250 GAL \ .8 PIC CONC I Z SEPTIC TANK \ \ \ \ 1 \' M MIN \ }/v �b4'i i m IN o \ MOST 'r DEEP DRAIN o» DRAIN ..._ Iff 2 �O 7.6 ROB RLL IQ YW \LEVEL ,$ SPREADER PLAN ,,/ GRAPHIC SCALE Go 170 � N IN Peer) to > inch a 90 tL ,::�l 'UNAU niORIZED ALTERATIONS OR ADDITIONS TO THIS DRAWING ARF A vw ATV W rw +,,� THIS IS TO CERTIFY THAT THE SEWAGE TREATMENT SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARDS RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. -tment of Hea- t ` : HOUSE LOCATION AND PROPERTY BOUNDARIES L he:alt� Serve ! <- FROM SURVEY PREPARED BY: DONNELLY LAND SURVEYING, P.C. confor�na��ce with d ea zlations Of the 4 t �e tmrn SHEET: 45 BLOCK: 3 LOT: 2.1 RS #13 FIELD REQUIRED: 444 FT. 24 IN. WIDE TRENCH FIELD INSTALLED: 450 FT 24 IN. WIDE TRENCH