HomeMy WebLinkAbout4839PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES�.,
Gi
Internal Use
PER
U �epair Permit issued in last 5 years U Not in Watershed
❑ �epair within Boyd's Comers, W. Branch or Croton Falls Res. tJ Delegated
❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review
SITE LOCATION Lk iLr'bV `M-Avv I TOWN
OWNER'S NAME
MAILING ADDRESS
APPLICANT
TM #�
PHONE #
s ..0
/ Name & RelatAnship (i.e., own4r, tenant, contractor)
DATE FACILITY TYPE ��S PCHD COMPLAINT #
PROPOSED INS ALLER ltG6 f PHONE
ADDRESS , . &EGISTRATION /LICENSE #`,.9S -9
Proposal (include a se arate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and extent of the repair.
I, as owner,agree to the condition s ted on this form
SIGNATURE DATE G 2.:
(owner)
I, the septic installer, agree to comply wit t conditions of this permit for the septic system repair
SIGNATURE
(installer)
TITLE DATE
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Proposal Approved Proposal Denied ❑
Inspector Signature & Title Date Expirati Date
,Repair proposal is in compliance with applicable codes Yes ❑ No
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
Putnam County Department of Health
Division of Environmental Health Services
Date: 7Jl b •�-- 7/// �l Z SSTS Repair Final Site
Inspected by s nom— installer le
Street Location: Owns: '- ---
Town _� �,�—, Repair Penmit #• iL —[Vn — (2_ TM # ar' r Y6
1. Type of System: Conventional ETAlterosate ❑ Comments:
c Tank
Yes
No
N/A
Comments
eptic tank size —1,000 ...1,250 .
eptic tank installed level ......................
0' minimum from foundation ..................
P
istribution Boa
i. All outlets at same elevation (water tested) ...
ff. Protected below frost .............................
W. Minimum 2 ft. Original soil between box &
trenches
j
e. Junction Box — Operly set ....... ....... ...............
C Trenches
.r
i. __SystenfcqnWletely opened for inspection
E Ed
ii. Length required _q.1 -Length installed Y
iii. P• esl6jx checked ....................... :..........
iv. Installed according to plan .....................
V' 10 ft. from property line — 20 ft — foundations ...
vi. Size of gravel % -1 '/: " diameter clean .........
vii. Depth of gravel in trench 12" minimum .........
viii. Ends qWed .
g. Pug r Dosed stems
3. Sews e &vstem Area
a.. SETS Area located as per approved Plans
b. Fdl section —
c. Distance from water course/wetlands
4. Overall Workmanship
a. Boxes properly grouted and installed correctly ...........
b. All pipes slush with inside of box .........................
c. Backlill material contains stones <4" diameter .........
d. Curtain drain & standpipes installed according to plan
e.. Curtain drain outfall protected & dir to exist watercourse
C Footing drains discharge away from SSTS area ......... .
g. Erosion control provided .............................
AdCuuonai L ommems: -�
E Rev- 011312
I
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIMSION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
owner: <D. &,z Address:
Located at (str-4-7-, _6�, TM #* Secflong:fXocic Lot
municipality: Watershed:
SOIL PERCOLATION TEST DATA
Witnessed by: PC
Date of?re-soaking:.] Date of Percolation Test:'
. Otis
'Hole No.
Ran No.
Time
Start —
Stop
Elapse
Ti . me
(min.)
Depth to
water from
-gund.
ro
surface
(inches.)
Start - Stop
Water
level drop
is Mches
Percolation
Rate
min/inch
4p fa
2 6 - 2 �
2 6 .1
2
3
Igo
4
3
4
2
4
5
3
4
5
Notes:
1. Tests to be repeated at same depth until approximately equal percolation rates are
obtained at each percolation test hole. (i.e., < I min for 1-30 min/inch, < 2 min for 3l -60 min/inch).
All data to be submitted for review. , 7
2. Depth measurements to be made from too of hole.
Form Dn.()7 no i Ne")
V,
:t
TEV4STPIT DATA
DESCRIPTION OF SOILS -ENCqMTEKED IN TEST HOLES
DEPTH HOLE# HOLE #— HOLE # HOLE # HOLE
G.L. Ll A
0.51
1.01
2.0' 0 �4\1
2.5' eig .TTe-f
3.0' - V-o 5
------------
4.0'
45
5.01
6.01
6.5'
7.0'
7.5'
9.01
9.51
-Indicate level .at which groundwater i8 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:
Address:
Signature:
Design Professional = Seal
I
THIS SURVEY IS ACCURATE
AND CORRECT.BY:
Z4��
GERALD L. LYNA
LAND SURVEYOR, ' P.C.
WAPPINGERS FALLS, N.Y.
N.Y. REG. LAND SURVEYOR
No. 049292
�e
LOT 3392 I LOT 3391 ' LOT 3390
164'04' 47
//
CA
STONE i• , C!1
DWG. — a%
ENCI_ flI
CONC. PORCH
DRNEWAY (B(n —
i
<v �~ AREA= 0.1!kAc.
m
CoNC. RET. VI" C
S 64'04' W 117:03
��/ t.oT Selo
-- I HEREBY CERTIFY TO --
ESQUIRE FUNDING GROUP, INC.
It's successors and /or assigns
TIMELY TITLE SERVICES, LTD.
As agent for
CHICAGO TITLE INSURANCE COMPANY
0-
/1
1
SURVEY
GERARD
TOWN OF
(PUTNA]
PUTNAM
NEW
TiT�TTT7 • r.�
PLANNING DEPARTMENT
P.O. Box 470
1142 Route 311
Patterson, NY 12563
Michelle Lailer
Sarah Mayes
Secretary
Richard Williams
Town Planner
Telephone (845) 878 -6500
FAX (845) 878 -2019
June 13, 2012
To: Town Board
From: Town Planner
Re: 12 Irby Road
Tax Map No.25.40 -1 -1 g
TOWN OF PATTERSON
PLANNING & ZONING OFFICE
ZONING BOARD OF APPEALS
Lars Olenius, Chairman
Howard Buzzutto, Vice Chairman
Marianne Burdick
Mary Bodor
Gerald Herbst
PLANNING BOARD
Shawn Rogan, Chairman
Thomas E. McNulty, Vice Chairman
Michael Montesano
Ron Taylor
Edward J. Brady Jr.
I was contacted by a Mr. Gerald Duffy, owner of the property identified above, for a "strip of
frontage requested from Town to complete county- required work ". It appears that Mr. Duffy's septic
system has failed and the Putnam County Health Department is requiring that the system be repaired.
It was suggested by Cris Dellaripa, PCDH that Mr. Duffy contact the Town to use a portion of the
road right -of -way for septic fields. On June 13, 2012 I accompanied Russ Goff, Patterson Highway
Superintendent to the site to further evaluate the proposal.
The area in question is a 10' to 12' wide grass strip between a stone retaining wall and the edge of
the road pavement. The grass strip creates a slight swale which conveys stormwater runoff from the
road to the southwest. It was not certain how stormwater would be managed should this swale be
eliminated and the area be used for septic fields, except through the installation of a catch basin and
pipe to convey stop nWater. to the .opposite side of the road, and to a lo�vcr elevation. Iti.addition; this
area is used as a snow shelf for snow removal during winter road maintenance operations, a use
which would not be compatible with a use of the area for a septic field. It appeared that the loss of
the road right -of -way by placing the septic fields in this area would not in the best interests of the
Town, would negatively impact road maintenance operations, and/or would create potential
liabilities for the Town.
In addition, there appeared to be area on the site that would be usable for septic fields, and although
this area is probably not the cheaper solution, would be a viable option. For the aforementioned
reasons, it was our recommendation that this area not be used for the septic system repair.
cc: Cris Dellaripa, PCDH
PLANNING DEPARTMENT
P.O. Box 470
1142 Route 311
Patterson, NY 12563
Michelle-Lailer
Sarah Mayes
Secretary
Richard Williams
Town Planner
Telephone (845) 878 -6500
FAX (845) 878 -2019
June 28, 2012
Mr. Gerald Duffy
12 Irby Road
Patterson, ,NY 12563
TOWN OF PATTERSON
PLANNING & ZONING OFFICE
Re: Tax Map No.25.40 -1 -18
Dear Mr. Duffy:
ZONING BOARD OF APPEALS
Lars Olenius, Chairman
Howard Buzzutto, Vice Chairman
Marianne Burdick
Mary Bodor
Gerald Herbst
PLANNING BOARD
Shawn Rogan, Chairman
Thomas E. McNulty, Vice Chairman
Michael Montesano
Ron Taylor
Edward J. Brady Jr.
The Town has considered your request to use a portion of the Town's right -of -way for a subsurface
sewage treatment system servicing the above - mentioned residence. On June 13, 2012 both myself,
and the Highway Superintendent visited the site. In our opinions, the area in question is being used
for drainage and winter maintenance, and it would not be in the Town's best interest to give up the
use of this area. In addition, it appears that there are other areas on your property that you could
consider for repair or replacement of your subsurface sewage treatment system. As such it was our
recommendation to the Town Board that this area -not be used for the septic system repair. On June
28, 2012 the Town Board review our recommendation and concurred.
Sincerely yours,
Richard Williams Sr.
TOWN PLANNER
cc: Patterson Highway
Building Department
Cris Dellaripa, PCDH
MEMORY TRANSMISSION REPORT
TIME JUN -22 -2012 i1:10AM
TEL NUMBER 8452787921
NAME ENVIRONMENTAL HEALTH
FILE NUMBER 402
DATE JUN -22 11:08AM
TO 82795989
DOCUMENT PAGES 001
START TIME : JUN -22 11:08AM
END TIME JUN -22 11:09AM
SENT PAGES 001
STATUS OK
FILE NUMBER 402 * ** SUCCESSFUL TX NOT ICE
RU-r"^ N COU➢VTY HEALTH �EPARTNidEY�IT
f31VISf ®N OF EN\.,ii tONmP -NTAL HmAu -r" SERVICES
�� ®P ®SEAL IFCV� SEliilQa2�E -1T6�{EATfAAERlIir °slPS4E6i6f [r'$E � fl-A ft � i� � �..�u
1D [�Z�hKl
spair Pem+a Issuod in last 5 years
LI No in watershed
[�
p01r within 9oyd's Comers. w. eranah or Croton Falls Ras
8
elegated
epair within 200 R_ of a watercaourma or OEC- mapped wetland
ED
Joint Reylaw
SfTE LOCATION
/� C��IdC�_ TOWN Lk- 4- P—`cizy,
TM #
- yy -11 f
QWNER'S NAME
tr sr- t��I _
PHONE
MAILING AflCRESSS
�-
APPLICANT '�7 i+ �s
�. �� o�•r^- 1.�.��� -,.r
DATE FACILITY TYP ��.r�.c PCHD CQMPLAfNT #
PROPOSEM INS ALLEFk PHONE #, =ja
AMMRESS. i Ef31STRAT[ON /LICENSE #la..S"
Pro oral (incltada a se grata mket,- t locallmia tRte Ptouse, properW lines, alt adDaoe"ll wales wlil tin Zoe
feet of repalr and tlsa Bocatlort o4 existing and proposed system)
NOTE: The Mepartment may require submittal of proposal from licensed professional depending on the oL
nature and extent cf the repair.
i
a .yo ra�sJ
1, as owner,agrv!la it" thew condition ted on this form
SIGNATURE / O T1TLE MATE G % 7
1, the septic Installer, ag a to comply wit ,conditions of this permit for the septic system repair '
SIGNATURE _sew r TITLE DATE -
(lnsteller) .
1. Procatr ®mane of any Town Permit, if sppllcable.
2. Submission of as built repair sketch by tha septic system installer wthin 30 days of the repair, in duplicate showing:
a. Owner's name, Site Strut Name, Town and Tax Map number
b_ °•loo of installed components tied to two fixed points
c. System desdnption (e.g., t250 pal. (=oncrata septic bank, etc_)
Cl. Installers' name and phone number
3. System repair r
to be parfomad In accordance with the above proposal and conditions
a: The proposed SSTS repair is cons(dered a bast tit design. and there is no guarantee to the duration at which the
completed SSTS repair will function_
S_ No completed work is to he bacldllled until authorization to do no has been obtained from the Department
trdTENMAt.. LDSE CbNat -`r
Proposal Approved Proposal Menfed
Inspeato gnature fi< Title veto Explral 0�'t Mate
Ra air oral im in porn fiance wIth monligaickloa cod Yes d No
COPIES: PCHM: Ownar; Installer
PC -RP 99ML Rey. 2/07
REBECCA W=T BERG, RN, BSN
Public Health Director
ROBERT MORRIS, PE
Director ofEmnromnewd Health
DEPARTMENT. OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
MARYM&N ODELL
Cormiy Executive
TO: NYCDEP DEPARTMENT OF ENGINEERING AND DESIGN REVIEW
ATTN: 'Pe4i n
FROM: C,
DELEGATION STATUS
FOR
SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM
DELEGATED
New Application Q Renewal El
PROJECT:
LOCATION:
TOWN: P6 DATE SUB'D APPROVAL
NOTICE OF COMPLETE APPLICATION DATE:
DELEGATED
EXCAVATING CONTRACTORS
20 Ivy Hill Rd., Brewster, NY 10509 (845) 279-8809
e.
0, rA b a -PFX
LL
pa++-�,_Y-s o rj / vAIV
bL41/
"I