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HomeMy WebLinkAbout0058DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.15 -1 -11 BOX 1 ILI' i ' . ■ 1 '' ■1 I , -■ ;lm 1661 " .'avallabls' °and the."fDDroval: of s'ub)eet Ao� �m+odificat!on of ch;. )LINTY DEPARTMENT ;OF }HEALTH r t� ', x ' t Fi x kg mental Health Services, Carmel, N Y 10512 r - gtin f x; SI eer Mast Provide.` ANCE FOR_SEWAGE DISPOSAti'SYSTEM, ,;_ , _.:< .a«%yj� /"'7�.SG>%►�_ _� y M. ��.- .'' %�i.9.s Taa `� Formerly Sabdlvision Name�'abdvLot p 92-11I.JV1 p %0 %C7 Date Permit leeaed S� /� O Ga11oa.Septic Tank Address DrIDedby Has E�oeion Control Been ComptetedY M. _Has Ga-bage G indei Been bastalledY .d.� e e l .he p f the completed work copies above prisewere conatucte b m lns standards, rul'ee and requlatione xin,accordancezwith the filed'plan,'and` the permit- isaued,by the x ess . , ddr �` - - j. Lice nia No by theaabove`system(s) shell promptly tike weh action of may be fiseeasary to iourn th* eor ec"i - of any un.�anitary Approval of the separate sevverayesystsm shall becomtnull and becomes void att`aoon as ,a pub( pnitary fwar ; 4. _.. �:" Wif. ea. nnw. challsheromenull-andmvDldT,when .a�:ou611e water .�suDDlv�:beCOmea-aW {IabN. --- Suehwfaooeovhla are 0 i6ition,,modlfleiflon.ot_ ehan0e.'It'meesNry;;_ Title WELL UL)L11YLL' 11VN L%zrVni * * DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET ADDRESS: WNW VICLIGLICI I y TAX GRID NUMBER: 6 6 b tiers on WELL OWNER NAME: ADDRESS: n �c /�2a_ L PO B I o (armed Al 7ao PBIVATE PuBIIC USE OF WELL 1 - primary 2 - secondary 10 RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O .ABANDONED O BUSINESS ❑ FARM O TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT _ gpm. /N0. PEOPLE SERVED S / EST- OF DAILY USAGE 0 gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ®TEST /OBSERVATION []ADDITIONAL SUPPLY VINEW SUPPLY (NEW DWELLING) [] DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH QI ft. STATIC WATER LEVEL 0251. ft. DATE MEASURED 8 Zv DRILLING EQUIPMENT A ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING &OPEN HOLE IN BEDROCK O OTHER CASING TOTAL LENGTH Z _ ft. MATERIALS: 04 STEEL ❑ PLASTIC O OTHER LENGTH BELOW GRADE / ' ft. JOINTS: O WELDED 09THREADED ❑ OTHER DETAILS DIAMETER 7 Jf in. SEAL: CEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT 1b./It. I DRIVE SHOE C9 YES ❑ NO I LINER: G YES 9 NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED. FIRST O YES ONO HOURS SECOND GRAVEL PACK ❑ YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH -ft.1 BOTTOM DEPTH ft. WELL YIELD TEST If detailed pumping METHOD: ❑ PUMPED t tests were done is in- COMPRESSED AIR , `. ormation attached? ❑ BAILED ❑ OTHER ; ❑YES D NO If more detailed formation descriptions or sieve analyses WELL LOG are available. please attach. DEPTH FROM SURFACE Water pear. inQ Well Dla teeter FORMATION DESCRIPTION qoE ft ft WELL DEPTH ft. DURATION hr. min. DRAWOOWN It. YIELD 9Cm- Surface 10 01 r b� ✓ o- -:c blue e5' ei WATER ❑ CLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES ONO STORAGE TANK: TYPE CAPACITY GAT, . PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME Buy') Algrv. S lq IU w&j_ L. Co T7r)r— DATE B aq 93 AooREsS Rrj 5 Ar 572, t1 RE CCKrMe.L Ny 105'!2 3/69 . I // I / I/ ANALYSIS DATA SHEET TYPE: PW LOCATION: Lot #6, Sapling Ct., Patterson, NY REPORT TO: McGlasson Reaalty Inc. ADDRESS: PO Box 610 CITY, STATE, ZIP: Carmel, NY 10512 DATE COLLECTED: 08 -23 -93 TIME COLLECTED: 8:30 AM COLLECTED BY: Ted McGlasson REPORT DATE: 08 -26 -93 LAB # 93 -4077 SAMPLE SOURCE: Well pump DATE ANALYSIS RESULT UNITS METHOD ANALYZED Total Coliform MF Absent SM 17 (9215D)08 -23 -93 THIS SAMPLE AS RECEIVED AT THIS LABORATORY MET THE REQUIREMENTS OF NEW YORK STATE DRINKING WATER STANDARDS. Laboratory Director NEW YORK STATE ELAP CERTIFICATION NUMBER: 11218 618 CLOCK TOWER COMMONS, RTE 22, BREWSTER, NY 10509 / 914-278-7600 / FAX 914- 278 -7754 Insite Engineering & Design, P.C. 1849, Rt. 6 Carmel, NY 10512 Phone: (914) 225 -6200 Fax: (914) 225 -6438 TO &:0 LIFUTEQ (IF MLa SOMDUML DATE 6111 JOB NO. /// 36 �(i ATTEENNTIO RE: Ssl Fd zM 3 > WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 3 %/3 I 3 8 30 13 j019 -a-,t) �eg�, THESE ARE TRANSMITTED as checked below: )I� For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED:( If enclosures are not as noted, kindly notify us at once. PUTNAM COUN'T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES TLM, & s502-11 Owner or Purchaser of Building Building Constructed by Location - Street Municipality I —a:5- Building Type _ � -1-5 a-, i/ Section Block Lot Subdivision Name Subdivision Lot # GUARANIEE 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 whic fails to operate for a period of two years immediately following the date of ap val of the "Certificate of Construction Compliance" for the sewage disposa system, or any repairs made by me to such system, except where the failure to op ate 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 Environirental 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 uilding utilizing Si g natur the system. Corporation Name (if Corp.) Address rev. 9/85 mk Title Corporation Name (if Corp.) Address - PQii1A1[ COD[Rt DSARTMM fl' OF MMALTH +: DlsMws d iobndaaoW HaWlb Saevleaa. Caaalaai. 11.Y. ]SS]1 at R to Pw we Paoali CAIRWATE OF CO1MlrJANCE POIQP FM UWAM DWWU UU M Pawls / alt 5' 'LING. Cipt- t E*-A5-► Were err VMV Nwa. t-'t el-4OOP SWWL Lae r �O Taw NIM 3. i5 >la«t O.dAS..ca.t Memo .. w iLL P�AGkMEKT esr,i1 : iO i /q2 P.O. CSC b 1 O Date of Preview App-4d lyd t Aeneas Town CA*-N-� L ,•IP l 0S L2 -Date Subdivision ARRroved + �tL�C Fee Enclosed ❑ Amnl,nt Said �N _W aost4.1AA1 Amax 10.411 A.U�$ Fm Sedks Y Nmbw of M-L. as DeatSm Flow G P D 6 Q O PCSD Nod§wdoa Is Negmred Wbas Fm Is eaapbtted Seleede Sawaeop S7e1oa to gait d 1000 rase. Selide TO& ..a '300 L AS60P-et Cj-1 1AZENC440>- T. be, by UN•KIN V-44 Addwsa yrhbKNO Wh-� Widw Slap*l Pdlile Sur* Ftba Adilan an flaw -I- sumo Ddvedby Ut�LKNUl11F -S Aa&m �il�lKhlbl.s� samba 1ta�bboaaNw 1 represent that 1 am wholly and completely responsible for the design and location of the proposed systems). 1) that the separate few di cal slam above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a regu ns o nam County Depertment of Halth. and that on completkon.thereof a "Certificate of Construction Compilencxr" satisfactory to the Commissioner of Mealthwill be automated to the Department, and a written guarantee will be furnished the owner. his successors, heirs or assign by the bulkier. that said builder, will Plus in good .operating condition any pant of saki sewage disposal system during the period of two (2) yews Immediately following thedate of the Is u- ana of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 21 that the drilled well described abors will be located as shawl on the approved plan and that said wolf will be Installed in accordance with the standards. rules and reguSi%ns of the Putnam County Department of HoWh. /?� / 3 O.E. M.A. Oats Address i�g �1 l7 Ded Liana No 1 �' APPROVED FOR CONSTRUCTION: This approval expires two ysors from the date issued unless construction of the building has been undertaken and Is "roceble for cause or nay to amended or modified when con~od necessary. by the Commissioner of Health. Any change or alteration of construction "Quires a permit . J0,90POred for all of domestic sanNery andt!L.51vate water supply only. Rev. Oats By 10/88 6 PUn"COUMMANfO .07MIU M< /W7- Dlefaiww dia0oaaastal Sleety Sasdaow Comm& N.Y. low M Fwlnldw lllsaD 1 as GFCONDUAMI- POIer !0! SiWAN DNPOUL Svf Loomed as E'� -(0j:: ec;" t �uG -�A.� �7'i -� tom. air .fees. >ttl WMM New CAI w 8 Co Tae Map- 3. /s Mad Rawsrd ❑ Movida. ❑ OtRaw>•/Apprombt N... _'�f�G P i-1 1G1 I�GA�� Dds of Pllrrlaaa App mvd Taw a grtNANk �(4U- (�i Vp %c -1�= j. Stmt t�p f��� Q.B.L. Lot A"a�.49 P1H nuts. cob 2T Dapab �_ stow -Z so C, t tots Ntitibwe 4110 Dodo Flow G P D � PC® NaN�raUaa► to Sagbhaii Wbw F/ V CaapMed Sapdse Sawogiy $Yosan to Comm d t G2',�C7 Owl= Sq* JIMA ,.a To b.eaowmfuwmad.ip t-- Ir- -+�- �KIt'j Amin as i-11s1 n, hM1 i Waiver Swetn Sop* Faaa Adegww en wpb Ddbi bF _ lievXsl �O A dries Otbwr 1Ra�dllo�we ArP�X . $ $t� eel. c^��HL �i c. a- s� c-�9 3' /�'!'AP i ►epreaanCthat l am wholly end completely responsible for the design and.loation. of the proposed system(s), 1) that the pre. saw dl sal stern abers desvibsd will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a regu ns O Putnam County DOOM nNM- of Health. and that on completion, thereof a "CwUficste of Construction Compliance" satisfactory to the Commissioner of MsaRhwill M sulaaa ted to the Department. and a written gwrantee will be furnished the owner. his swAsOws. heirs or assign by the bulkier. that said builder will ~ IN OWN Opsratbp asdltlOn. any gilt of saki aawage dWosol system during the period of two (2) yews bnmedistely following the date of the isow approval are of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled west chore" above Will N looted M Shawn OR the appared Olen and that saki WON will be Installed In accordance with the standards. rubs and rNTa on�i ti of the Putnam Catmty 04"W" Of ~IL Data S P.E. qRA.. — Addres + � _ _ ( Llterlp No 6:20 t t :S1 APPROVED FOR CONSTRUCTION : This ;p6;Ql6x�fi'atLfWjtY.5 erom`M-al te i&W -6n;U c'o'nntructforl of the building Not, been undertaken and is "ratable for CAU" or may be amanded or modified when considered necessary by the Commissioner of Health. Any change or alteratioin of construction "Quires a now permit. Approved for disposal of domestic sanitary f 08 . an r pirate water supply only. Rev.. Title 1088 ��_ / / 7 Ey�' �I ��r •v�'�- — �"C! E4 5 3 -11: : 24 - 4.11;30 -.►s- 3(0 s �41+Tjlt =h- 11:.20., Z tt =2o 11: '14 3 1t..2S- 11 =co 5 24 TEST PIT CATA . 1�UI:�.ED 'i0 E SL„ � L TZD S =11 r'rf-f r-ATICN DESadWIGN OF SOIIS E:COUN'TERM IN TEST HOLES DEPTH HOLE NO. HOLE NO. HOLE NO. G. L. 3' - 4' 5' 6• 7' g' 10' 11' 12• 13' 14' INDICATE LEVEL AT WHICH GRAUNDWATER IS ENOOUNZE2ID � /A INDICATE LEVEL TO WHICa WATER LEVEL RISES AFTER BEING ENCOUN'T'ERED N f0 tt //S, - DEEP HOLE OBSERVATIONS MADE BY:: DATE:: t4 /A . DESIGN Soil Rate Used Min11" Drop: S.D. Usable Area Provided 330c> S.-F. No.. of Bedroans > Septic Tank Capacity ►Ood gals. Type C)Dt-%C-- Absorption Area Provided BY L. F. x 24" width trench ---�� Other 5`� Name 1r+5-%tE- StG►t-4elpi2AWG t signature Address 1eA''9 Rouft�. Co. SEAL C�.�ZME� , N; 107512 ESSI THIS SPACE FF USE BY HFALTH DEPARUWM 'ONLY: Soil Rate Approved sq.fVgal. Checked by' _______ Date DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # AjOt WELL LOCATION I Street Address iNRW g'- ". ?A Town/Village/City Tax Grid Number . rs WELL OWNER Name Mailing Address �f %2c>. Pu iffPrivate / � O Public USE OF WELL 1 - primary 2- secondary SIDENTIAL O BUSINESS O INDUSTRIAL O PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION 0 OTHER (specify O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED_ /EST. E3 REPLACE EXISTING SUPPLY O TEST /OBSERVATION KNEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL OF DAILY USAGE X90 gal Q ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ODRIVEN ®DUG ®GRAVEL 0OTHER IS WELL SITE SUBJECT TO FLOODING? YES XNO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 1n,4,000LQ7Z,, qa1_) Lot No. WATER WELL CONTRACTOR: Name 41A-kA.OLV / Address: 1/1A-AA"Lcy/1/ IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: A1A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET i 9�-- ( te) V93r re) j PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth 'above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt; (30) days of the completion of water well construction, the applicant 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 attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or 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. Date of Issue: C -�--� 19 C;�O' '2— Date of Expiration 19 / / Permit Issuing 0 ici Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller I. I 13 �1 I P I tea►.' � , qq ry, k1 . .......... ... o +� b ' r+ 'iirpk, pu i J . a ol if t � 1 , f 1 :7 •J 1 TOWN OF PATTERSON HIGHWAY DEPT PHONE NO. 914 878 U30 7m cr WrIFURN 1110fim FElval"ll P. o. OX 44.5 aniurom Now vtlw 12rh 1-0445 944M-4341/C-30 Of u: of wai'll" N. fulmy .q tp . rj,#,-j-jj.sjt j)f jjjqTdly---* TO: __ � -��.j� FROM: 00H PAX # 9L4-878-6130 NUMHl-,R OF PAGES INCLUDING FACE: R U-1 rift) n �j TOWN OF PATTERSON HIGHWAY DEPARTMENT P. O. BOX 445 PATTERSON, NEW YORK 12563 -0445 914 - 878- 4341/6130 office of WILLIAM H. BURDICK Superintendent of Highways October 13, 1992 Curt.i5a, Leibell & Shilling, P.C. Attorneys at Law Mr. William Shilling, Jr. 20 Church Street Carmel, N.Y. 10512 RE: better of 9 -2 -92 /John Calbo /Sapling Court Dear Mr. Shilling: This letter is to inform you that I am in agreement with the letter you recaived from John N. Calbo, Bldg_ Tnapector, on 9/2/92 regarding the 20' drainage easement on lots 6 & 7 on Sapling court. After speaking with former Highway Superint.pndents and the Department of Health, I find no reason why you cannot proceed with the project as planned. It will nest be a problem if you expect to go over the easement.. If I can be of any further assistance please feel free to contact me. Sincerely, A l- William H. Burdick Supt. of Highways WHB:j TOWN OF PATTERSON HIGHWAY DEPARTMENT P. 0. BOX 445 PATTERSON, NEW YORK 12563 0445 914 -878- 4341/6130 Office of WILLIAM H. HQRDICK Superintendent of Highways October 13, 1992 Curtiss, Letibell S Shilling, P.C_ Attorneys at Law 14r. William Shilling, Jr. 20 Church Street Cannel, N.Y. 10512 RE: Lett - er Q1 9 -2 -92 /John Calbo /Sapling Court Dear Mr. Shilling: . I This letter is to inform you that I am in agreement with the letter you received from John N. Calbo, Bldg. Inspector, on 912/92 regarding the 20' drainage easement on Iota 6 & 7- on Sapling Court. lifter speaking with former Highway Superint,endento and the Department of Health, I find no reason why you Cannot proceed with the project az planned. It will nQt be a problem if you expect to go over the Easement. If I can be of any further assistance please feel free to contact me. Sincerely, William H. Burdick Supt. of Highways WHBIj DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva Road, Brewster, New York 10509 (914) 278 -6130 June 15, 1992 Attn: Bill Bricklemeyer Insight Engineering and Design, P. C. 1849 Route 6 Carmel. NY 10512 Re: Construction Permit Application Joseph Kincart, Lot #6 - Sapling Court Maplewood - (T) Patterson Th #3.15 -1 -11 Dear hr. Bricklemeyer: JOHN KARELL Jr., P.E. M.S. Public Health Director I have received and reviewed the application for the construction of a sewage disposal system and individual well on the above noted parcel. The following revisions and additional information is required. 1. The sewage disposal system requires the placement of Run of Bank fill to a depth greater than two feet. Therefore the construction plans should show the fill section only. 2. The drawing should clearly show the length, width and depth of the fill section. 3. The standard fill notes are lacking. 4. The location of grade st9cks must be noted. 5. Note 10 is insufficient. Crossi" grading from lot #6 to lot #7 must be required, or the plan must show 10' separation from the ends of the trench to top of slope and a 3:1 minimum to toe of slope. 6. The expansion area is shown within the drainage easement to the west. 7. All restrictive distances, i.e., 100' to existing well to the south, 50 feet to catch basin must be from the toe of slope of the fill section. 8. The well to the west (Nulrizio) is noted as an estimated location. A more precise location is required. 9. This well and the well on lot 1 may be considered in direct line of drainage. Therefore 200 feet separation may be required. - 10. Show the proposed well and SDS on lot #7. 11. Although the lot was created after 1469, the size and location of these parcels will require a letter from the Building Inspector, Town of Patterson, and standard neighbor notification, redesign, including the above mentioned comments, may generate additional concerns. If you have any questions, please contact me at your convenience. Very truly yours, William Hedges WH /jp Sr. Public Health Sanitarian r• •• �• • -.4 i 12, z 0 We) . •' • ■• •' �� V' •1 �• M�. DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Address Located at ( Street) �8' u.SH �� �,,� Sec. s'. J5 Block / Lot (indicate nearest cross street) Municipaiity Watershed n�c�n✓ Date of Pre- Soaking /� c� `7 Date of Percolation Test glql HOLE -- NUMBER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level 4 �i2Z /l:/� f No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches r, n 0 5 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fray top of hole. rev. 9/85 4 �i2Z /l:/� f !� �� 3 5 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fray top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. IJ G.L. 1' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' 13' 14' R'(DCK C..,.- f. S - HOLE NO HOLE NO. pi S INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED /l DEEP HOLE OBSERVATIONS MADE BY: DATE: C.z gn -- DESIGN - Soil Rate Used ©-7 Min /1" Drop: S.D. Usable Area Provided No. of Bedroams Septic Tank Capacity / ,0©0 gals. Type Absorption Area Provided By `3C96 L.F. x 24" width trench Other. Name ZivsiTLs �wr; -i / �Dsr�. f G. Signature Address rF3 /Ciz' SEAT, THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PC -1 PUTNAM C OUNTY D E PARTMENT O F H EAL TH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: Pub 2. Name of Project: Ki►.kA PA 3. Location T /V /C: 4. Project Engineer: 5. Address: License Number: LP 19 3l Phone: ZZS -�cz� 6. Type of Project: Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR) ?. Type Status (Check One) Type I.. Exempt Type II. Unlisted —_ 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... 10. Name of Lead Agency r'A . 11. Is this project in an area under.the control of local planning, 'zoning, or other officials, ordinances? ......... ............................... F�2B�C. 12. If so, have plans been submitted to such authorities? .................. N� 13. Has preliminary approval been granted by such authorities ?N /1 Date Granted: r� A 14. Type of Sewage Disposal System Discharge...... Surface Water Ground Waters 15. If surface water discharge, what is the stream class designation ?........ 16. Waters index number (surface) ........... ............................... tJ1 17. Is project located near a public water supply system? .................. A-0 . 18. If yes, name of water supply l+✓ / Distance to water supplyi 19. Is project site near a public sewage collection or disposal system ?..... �® 20. Name of sewage system' �� Distance to sewage system —e�l 21. Date observed: ' 'Z 23.'' ' Name' of Health Inspector: 24. Project design flow (gallons per day)..;; ................................... C� 2. 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. (`�U 26. Has SPDES Application been submitted to local DEC Office? .....:......... r --) 27. Is any portion of this project located within a designated Town or State wetland ? ..................... ........... ............................... N� 28. Wetland ID Number ........................ ............................... t-}�h. 29. Is Wetland Permit required? .............. ............................... No Has application been made to Town or Local DEC Office? .................. t� /A 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 or NOU 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination. YES or NO 1� DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... 34. Are community water, sewer facilities planned to be developed within 15 years? 35. Are any sewage disposal areas in excess of 15% slope? ........ ... kg5 .X� Tb r' S 36. Tax Map ID Number ......................... ............................... 111 37. Approved Plans are to be returned to: ................ Applicant —�< Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by,a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on 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 Pena 1 Law. SIGNATURES & OFFICIAL.TITLES:_ MAILING ADDRESS: 18 6q)"arz - f /c5 9 /2— cf- z"o 5'—� C7 17-- D C-- C-n.t= cn TI Z Cat C-3 2C' t-7 waLl; 2cc, tz stra-F-M, fz- nctas SZE=C- t: a I 5'—� C7 17-- D C-- C-n.t= cn TI Z Cat C-3 2C' t-7 waLl; 2cc, tz stra-F-M, INSII ENGINEERING &DESIGN, P. C. September 3, 1992 Mr. William Hedges Senior Public Health Sanitarian Putnam County Department of Health Geneva Road Brewster, New York 10509 Re: Fill Permit Application for Single Family Residence Joseph Kincart, Sapling Court, Maple Wood Subdivision, Lot 6 Tax Map 3.15 -1 -11, Town of Patterson Dear Mr. Hedges, In response to your letter dated June 15, 1992, we offer the following comments: 1. The fill drawing shows the fill section only. 2. The fill section on the fill drawing is dimensioned. 3. . The standard fill notes are shown on the fill drawing. 4. Grade stakes have been shown on the fill drawing. 5. Note 10 on the construction drawing and note 8 on the fill drawing state that if the required fill for lots 6 and 7 is not installed simultaneously, the fill shall be brought to the lot 6/7 lot line and then graded off at a 3 on 1 slope onto the adjacent lot. The easement for this cross grading onto the adjacent lot will be forward to you when available. 6. Please see the attached letter from the Town of Patterson Building Inspector. Due to the nature of the lot and surrounding constraints, it is only possible to maintain the separation distances from the trenches. 8. Our office has researched the location of the well to the west on the Mulrizio property and has not been able to locate a more precise location. It appears that at the time this lot was created the well was not able to be precisely located either (see enclosed copy of original integrated plot plan). The location of the well as shown on the map is the best estimate that we can provide. 9. The proposed SSDS is in the general area as approved by the Putnam County Health Department with approximately the same separation distances (see filed map 1166) 10. The proposed well and SSDS on lot 7 are shown. 11. A letter from the Town of Patterson's Building Inspector is attached. Copies of the letters sent to the neighbors are enclosed as well as the return receipt cards. d x849, Route 6, Carmel, New York 10512 (914) 225 -6200 0 7 DeLavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -x742 Fax: (914) 225 -6438 41 `t The surveyed location of the rock outcroppings on the property have been added to the plan. A copy of the original intergrated plot plan showing the approximate location of the Mulrizio well is enclosed, as requested by Jack Karrell on July 21, 1992. Should you have any comments or questions concerning this project, please feel free to contact our office. Very truly yours, INSITE ENGINEERING AND DESIGN, P.C. By: Je Co telmol PEE. neer JJC /WJB /mth cc: Joe Kincart Insite File No. 91137.306 JOHN N. CALBO Building Inspector TOWN OF PATTERSON PUTNAM COUNTY PATTERSON. NEW YORK 12563 September 2, 1992 Curtiss, Leibell & Shilling, P.C. Attorneys at Law Mr. William Shilling, Jr. 20 Church Street Carmel, New York 10512 RE: Sapling Court Dear Mr. Shilling, Lr-��rr This letter is in response to your letter dated August 8, 1992 relating to the 20' drainage easement for the benefit of the Town of Patterson on lots 6 & 7 on Sapling Court. In going over the survey relating to the above property with the Highway Supervisor, Bill Burdick, we both ascertained that there would be no problem with the placement of the expansion area of the septic system located in the drainage easement. Therefore, we can see no reason for you not to proceed with the construction you desire. If I may be of further assistance, please do not hesitate to contact my office. Sincerely, — L /j"�'7 ' =idding N. Calbo Inspector JNC /cs Telephone 878 -6319 JOHN N. CALBO Building Inspector TOWN OF PATTERSON PUTNAM COUNTY PATTERSON. NEW YORK 12563 September 2, 1992 Curtiss, Leibell & Shilling, P.C. Attorneys at Law Mr. William Shilling, Jr. 20 Church Street Carmel, New York 10512 RE: Sapling Court Dear Mr. Shilling, This letter is in response to your letter dated August 8, 1992 relating to the 20' drainage easement for the benefit of the Town of Patterson on lots 6 & 7 on Sapling Court. In going over the survey relating to the above property with the Highway Supervisor, Bill Burdick, we both ascertained that there would be no problem with the placement of the expansion area of the septic system located in the drainage easement. Therefore, we can see no reason for you not to proceed with the construction you desire. If I may be of further assistance, please do not hesitate to contact my office. Sincerely, _L/," J N. Calbo lding Inspector ,Vi JNC /cs Telephone 878 -6319 AVENUE CL Lu CD O . :::c cn L= F- >: LL - C) CS CL 2! f4i 9 ; H ti VIII SENDER: 1 also wish - to receive the , • Complete Items tend /o_r.2 for,edditional services.' , Complete ttems;3, and following services (for an extra - .Print dour nam e and address or)'the reverse of this form so that wa can .:fee) return this card to YOU. - • Attach this form to the'fiont`of the mailpiece, or "the beck d space 1. ,❑ Addressee °s Address _ doea:not permit. Write "Return Receipt Requested" on the mailpiece below the article number. 2 _Restricted Delivery The Return Receipt Fee -will provide.you the signature of the person delivere ^to and the data of deliverv. Consult:: ostmaster' for. fee. 3 Article Addressed'tc 4a. Article Number ervice . tared F1 Insured Certified ❑ COD ❑Express ail ❑•R Meturn Receipt for - Merchandise y -14.,( ti 7. Difte of elivery 8 4 ddr see'.s Address (Only if, requested and fee is paid)` - 6. Signature" (Agent P$ Form-, 3811, November-1990 •aU.s GPO; ts911 2s7•oes .. 'DOMESTIC. RETURN `RECEIPT,_ SENDER - t • Complete Hems.} and /or,2 for additional services I a1S0 Wlah "f0 receive the "- "3 •. Complete items and 4a & b. r following Services (for an extra ? - • Print`your name and address onthe< reverse of-this forrn.so that_ we can fee) retum this card to you. = • Attach this form to the fronYOf the mail or on the back '. [ rf❑ - Atdressee s Address does.not permit. l Write''Re ;urn Receipt Requs ted "on themailpiecebelowthearticle 'number. 2 4 -,❑ Restricted Delivery = • The Return Receipt Fee will provideyou the signature of person delivere ' to and the date of delive .. = ConSUlt postr6aster.for fee 3 Article 'Addressed to 4a,.Qrc a Number I �- cjC7 46 Service —, a- Registered! ❑ Insured � :�.Certlfied ❑ OD Receipt for A r � Express Mail ❑Return . r ! ✓� Merchandise 7.. Dar of elivery 1. 5 Slgnature (Addressee) y r$. ddr sae's Address (Only if requested nd fee is paid) •6. Sigogy ie (Agent) ; PS Form 71, November 1990 *US:;GPo:1891 2s�oes_ w . DOMESTIC RETUO - RECEIPT, SENDER: 1 also wish - to receive the , • Complete Items tend /o_r.2 for,edditional services.' , Complete ttems;3, and following services (for an extra - .Print dour nam e and address or)'the reverse of this form so that wa can .:fee) return this card to YOU. - • Attach this form to the'fiont`of the mailpiece, or "the beck d space 1. ,❑ Addressee °s Address _ doea:not permit. Write "Return Receipt Requested" on the mailpiece below the article number. 2 _Restricted Delivery The Return Receipt Fee -will provide.you the signature of the person delivere ^to and the data of deliverv. Consult:: ostmaster' for. fee. 3 Article Addressed'tc 4a. Article Number ervice . tared F1 Insured Certified ❑ COD ❑Express ail ❑•R Meturn Receipt for - Merchandise y -14.,( ti 7. Difte of elivery 8 4 ddr see'.s Address (Only if, requested and fee is paid)` - 6. Signature" (Agent P$ Form-, 3811, November-1990 •aU.s GPO; ts911 2s7•oes .. 'DOMESTIC. RETURN `RECEIPT,_ JJ]t SENDER _ .. • .Complete items 1! and /or 2.for additional services . = I aISO ,WISh t0 reC81Ve the . • Complete rtems 1 andlor 2 for additional services i 8150' WISh "t0 re¢eiVe the `.. • iromp{gte items 3 and.4a & b: following services (for an extra ' N •. Complete items 3, and 4a & b. following. services (for an extra !_ Print -your name and address.on the reverse of this form so that we can • Attach this fom to,the front of the mailpiece, or.onthe back if space 1. ❑ Addressee's Address - does not permit _ . " return this card to you - •. Attach this formao tfie front of the mailpiece, ar on the:back rf..space 1 QAddressee s Address does not permit 3 Article Addressed to 4e Article Nrru��mber • Write %'Return Receipt Requested on'the mailpiece below.the article number. 2 Q Restricted Delivery he Return Receipt Fee will provide you the signature of =thepers_ on delivered to and the date of delivery: 'Consult postmaster for fee 3:' Article Addressed. to: 4a. Article Number ❑Express Mall Return Receipt for 111 j Merchandise f reb ervice Type 7. D of silvery gistered E): INSIT&-O� &NDES�GN,NP.C. Date -`(- b-111, RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: Jc>—c EF j KiNCART Address: CouRr Town: PATTERSUI4 Tax Map: 3,►6' 1 - I 1 Dear 11R. PAut_ A�+D RNTA S�HAF%RAN Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed f or the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or s of the Health Department at (914) 278 -6130. Very truly yours, INSITE ENGINEERING AND DESIGN, P.C. By: �SY Je r J. o elmo, P.E. Principal Engineer RECEIVED BY: Address: Tax Map: (Please sign and return in the enclosed envelope) i� 1849, Route 6, Carmel, New York 10512 (914) 225.6200 n_r e, ..,� �Ylnnn nvar� F„R, Nonr W4 issoo (914) 297 1742 INSIT&-q��N�GNE�ERI�NGDESlGNP. C. Date 115.91- RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: ,IosenA KiOCARN Address: SA?Wt -1 1 GouRT Town: PATTF -F--0 l Tax Map: 3, ►S - % - % % Dear MR. v►GTOR A*Ac> MRS. 5-v1E7TE 1-EAL Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please,find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges orb of the Health Department at (914) 278 -6130. Very truly yours, INSITE ENGINEERING AND DESIGN, P.C. By: �---' Je re on imo, P.E. Principal Engineer RECEIVED BY: Address: Tax Map: (Please sign and return in the enclosed envelope) V1849, Route 6, Carmel, New York 10512 F1 - n_r A....,0 1Y1nnn;nn?ts Falb Alva, Yr4 12100 (914) 225-6200 (9r4 ) 297-1742 INSITE-4&DESIGN, NP. C. Date -7-b-17 RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: do-SF—PA Ki06ART Address: SA?Ot-A� fOk-'RT Town: PAiTegeO J Tax Map: 3, %6 - 1 - I% Dear MR. Jos t. PN ,w,:;, M KS. *Tt- F -R,ESA Pr LU ct A Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call Mr. Hedges or of the Health Department at (914) 278 -6130. Very truly yours, INSITE ENGINEERING AND DESIGN, P.C. By: AW-f 1, Jeff r y J. telmo, P.E. Principal Engineer RECEIVED BY: Address: Tax Map: (Please sign and return in the enclosed envelope) V1849, Route 6, Carmel, New York 10512 (914) 225-6200 n - n,l Wabbinpers Falls. Neu YmP 12 5go (914) 297.1742 INS1 TE4 &NDESIGN,NP. C. Date _7 • 8 - i Z RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: ;JoSEN KlOcART Address: SAPI_INCa �s� -►RT- Town: PATTERsoti1 Tax Map: S, %S, - % - I 1 Dear MS. S WF-F- I A`( PIAJRI ZkO APA> .AVRO TNK FA IJN IKILA y Please be advised that an application for a Construction Permit relative to the construction of a sewage system and /or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or inf ormation which may bear on the Health Department's review of this application, you may call Mr. Hedges or his of the Health Department at (914) 278 -6130. Very truly yours, INSITE ENGINEERING AND DESIGN, P.C. By: je &n /• G�- J ff y J telmo, P.E. Principal Engineer RECEIVED BY: Address: Tax Map: (Please sign and return in the enclosed envelope) 1849, Route 6, Carmel, New York 10512 (914) 225 -6200 �YlphhinFerc Falls. New Yo4 12,�oo (914) 207 -1742 • Complete items 1 and /or 2 for additional services. I also wish to receive the • Complete items 3, and 4a & b. following services (for an extra • Print your name and address on the reverse of this form so that we can fee): return this card to you. • Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address does not permit. • Write "Return Receipt Requested" on the mailpiece below the article number. 2. ❑ Restricted Delivery • The Return Receipt Fee will provide you the signature of the person delivers to and the date of delivery. Consult postmaster for fee. > 3. Article Addressed to: 4a. ALticle Number 1 4b Service Ty q egistered �❑ Insured 's nyr &ef) ( Q XCertified ❑ COD �eUOn f 1 i • Y ❑ Express Mail ❑Return Receipt for Merchandise 7. 7. Date of Delivery 5. 'ign a (Add ssee) _'' ^+ _ N �' 8. Addressee's Address (Only if requested and fee is paid) 6. Signature (Agent) PS Form 3811, November 1990 >ru. o:1991- 287-086 DOMESTIC RETURN RECEIPT ENGINEERING INSITE-4&DESIGN, P. C. Date -1 - S • 9Z. RE: Department of Health Review of Proposed Sewage Disposal System for property: Name: -�OSEPN KlOcART,t t- ESQ- %e K %OCAKT Address: SAPI -WN 6 5u9'V Town: PATT�RSOtJ Tax Map: 3,t6 - 1 - 11 3•t5' 1 -Q- Dear MR. �1- tlt_IP k4l> MRS. ELL>k5E foKC -6LL% r' Please be advised that an application for a Construction Permit relative to the construction of a sewage system and/or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or inf ormation which may bear on the Health Department's review of this application, you may call Mr. Hedges orris of the Health Department at (914) 278 -6130. Very truly yours, 1NSITE ENGINEERING AND DESIGN, P.C. By: , . 1 Jef. rey f. Contelmo, P.E. Principal Engineer RECEIVED BY: Address: Tax Map: (Please sign and return in the enclosed envelope) t� 1849, Route 6, Carmel, New York 10512 (914) 225 -6200 z UL Q U N/F MALI f-�I ZI O IJI I N G COU 121" ALTERATION OF THIS DOCUMENT, UNLESS UNDER THE DIRECTION OF A LICENSED PROFFESSIONAL ENGINEER, IS A VIOLATION OF SECTION 7209 OF ARTICLE 145 OF THE EDUCATION LAW. AS -BOIL T MEASUREMENTS NO. A B REMARKS 1 34 20' 1000 GAL ST 2 80' 90' DIST. BOX 3 104' 112' CL END TRENCH 4 123' 108 CL END TRENCH 5 103' 84' CL END TRENCH RECORD OWNER: TED MCGLASSON P.O. BOX 610 CARMEL, N. Y. 10512 TOWN OF. PATTERSON PUTNAM COUNTY, NEW YORK TAX MAP NO. 3.15 -1 -11 NOTES• 1. THIS IS TO CER7IFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY INSI7E ENGINEERING AND DESIGN, P.C. BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULA77ONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. 2 ALL FACILITIES EXISTING, UNLESS N07ED OTHERWISE. 3. TOTAL LENGN OF FIELDS REQUIRED: 300 LF TOTAL LENGTH OF FlELDS PROVIDED: 300 LF 4, HOUSE AND PROPERTY BOUNDARY TAKEN FROM SURVEY PREPARED BY RICHARD H. GORR, L.S. DATED 2121192, AND BROUGHT TO DATE 7127193.