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HomeMy WebLinkAbout0133DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.20 -2 -82 BOX 2 � ,� �IIIIIII 00133 PUTNAIVI COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: Dorset Hollow Builders Lot # a 1 15 West Hollow R6ad Brewster, New York 10509 Dorset Hollow Estates 2. Name of project: (formally V anC 1 e e f E s t)3. Location TN: Patterson 4. Design Professional: Peder W. Scott, P.E., R.-5-. Address:3871 Route 6 6. Drainage Basin: East Branch Reservoir 7. Type of Project: X . Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Brewster, NY 10509 Commercial _ Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Type II 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... 10. Has DEIS been completed and found acceptable by Lead Agency? ............... Exempt Unlisted X No N/A 11. Name of Lead Agency Town of Patterson Planning Board 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... Yes:- 13. If so, have plans been submitted to such authorities? ........ ............................... Yes— Subdivision 14. Has preliminary approval been granted by such authorities? Yes Date granted: 1.998 15. Type of Sewage Treatment System Discharge ................. surface water X groundwater 16. If surface water discharge, what is the stream class designation? .................... N/A 17. Waters index number (surface) ....................... 18. Is project located near a public water supply system? ....... ............................... Yes Serviced 19. If yes, name of water supply Town of Patterson Distance to water supplyby system 20. Is project site near a public sewage collection or treatment system? ................ No 21. Name of sewage system Individual Lots Distance to sewage system 22. Date test holes observed i l-� 14 - 96 23. Name of Health Inspector M. B u d z i n s k i P . E . 24. Project design flow (gallons per day) ................................. ............................... 800 cPD 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... No 26. Has SPDES Application been submitted to local DEC office? ......................... N/A Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? No 28. :j Wetlands ID Number ........................................................... ............................... N/A 29. Is Wetlands Permit required? Individual Lo.t ............................................ ............................... No Has application been made to Town or Local DEC office? ............................... N/A 30. Does project require a DEC Stream Disturbance Permit? .. ............................... No 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 No 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 No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? Yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? water'.only 35. Are any sewage treatment areas in excess of 15% slope? . ............................... No 36. Tax Map ID Number .......................... ............................... Map 3.,w Blocky= Lot SA 37. Approved plans are to be returned to ..... Applicant x Design Professional NOTE: All applications for review and approval of a new SSTS to be located within 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 watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False ements made herein are punishable as a Class A misdemeanor pursuant to Sect' 0.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES >" w N MWWAdss :.... ............................... C) O—' Cs 3 O C W. Scott 3871 Route 6 Agent for Applicant Brewster, New York 10509 PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER 115! 4 6t STREET LOCATION: 93 REVIEWED BY: RtL OR, AS, &ATE: IpI°� 2 N / TAX MAP #: (CONFIRMED) �'' 1" N DOCUMENTS (,6(_J. PERMIT APPLICATION ✓' (-/)(�WELL PERMIT O WS LETT UPC -97 UU (ULETTER OF AUTHORIZATION L(UUDESIGN DATA SHEET (DDS) UU ORPORATE RES �UUSHORT EAF (j)UPLANS -THREE SETS V U(_JHOUSE PLAINS - TWO SETS LU(JVARIANCE REQUEST SUBDIVISION (JULEGAL SUBDIVISION USUBDIVISION APPROVAL CHECKED UPERCRATE ?f -wu LU( FILL REQUIRED DEPTH - UUCURTAIN DRAIN REQUIRED GENERAL ( )LOCATED IN NYC WATERSHED (/UUPLANS SUBMITTED TO DEP ( U)UDELEGATED TO PCHD LULf!!�IDEP APPROVAL, IF REQ'D (fJUDEEP TEST HOLES OBSERVED (!�JUPERCS TO BE WITNESSED (UUEX- APPROVAL SSDS ADJ, LOTS (WETLANDS (TOWN/DEC PERMIT REQ'D ?) (/ )( )DATA ON DDS PLANS & PERMIT SAME ;1969 NEIGHBOR NOTIFICATION "TER BI/ZBA YR. FLOOD ELEVATION W/I200' L TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS USEWAGE SYSTEM PLAN - (NORTH ARROW) ( -! f)( HYD ULIC PROFILE VDUCONSTRUCTION NOTES 1 -15 (fUUDESIGN DATA: PERC & DEEP RESULTS ( /�jU2' CONTOURS EXISTING & PROPOSED (EUDRTVEWAY & SLOPES, CUT (/)( _JFOOTING /GUTTER/CURTAIN DRAINS 2(_)USDA SOIL TYPE BOUNDARIES (_JTrrLE BLOCK; OWNERS NAME ADDRESS Tb1#, PE/RA; NAME, ADDRESS, PHONE# (�j( _JDATE OF DRAWING/REVISION � / / (�( JDATUM REFERENCE ( J(_JLOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. U(_JPROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS (!!�j(_JWELLS & SSDS'S WAIN 200' OF SSTS (Zj( _JPROPERTY METES & BOUNDS COII,IENTS: m r rcyrr r. q-� Y • N (REQUIRED DETAILS ON PLANS CONT'Dl &(__JNO (_)HOUSE SEWER -' /," FT. 4 "0'; TYPE PIPE CAST IRON BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS UUSTTE.N (NO CHANGE) F L ST S (_)(_)10' HORIZONTA ; PA TRENCH SLOPES 3:1 TO GRADE UUFILL SPECS/ FILL OLTES 1 -5 ()(___)FILL PROFILE D IONS (_ )(_)FILL IN EXP SION A f7LL OREA E KHAN 2 FEET LUU_), CLAY BARRIER U LL_)FILL CERTIFICATIO OTE LULUDEPTH GAUGES LULUVOL. ON PLAN F RO.B., UNCLASSIFIED & IMPERVIOUS U)LUSEPARATION D STANCE FROM TOE OF SLOPE TRENCH (__)LF TRENCH PROVIDED 60FT MAX. . (_)PARALLEL TO CONTOURS 0100% EXPANSION PROVIDED. L _)DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL (Z )LUGEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS (L_)10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL L—)20' TO FOUNDATION WALLS �-1100 TO H-,459:_TA PTI-S (Z)(U100' TO STREAM, WATERCOURSE, LAKE (inc. espan) (/)L_)50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER ( /)(_J10' TO WATER LINE (pits - 201) V)(___)50' INTERMITTENT DRAINAGE COURSE X200' /500' RESERVOI , ETC. _ 150' GALLEY SYSTEMS L__ 0' MIN TO LEDGE OUTCROP SEPTIC TANK (- 6(_)10' FROM FOUNDATION; 50' TO WELL W L LUL JDIMENSIONS T:FRTY OP LINES UULOCATION OF CONNECTION (_)(_)MIN 15' TO P LII S C/--)C--)SLOPE IN SSTS AREA ( 0 %) l L_)V) REGRADED TO 15 %, IF REQUIRED DOSEIPUMP SYSTEMS U)PUMP NOTES (_)DOSE 75% OF PIPE VOLUMEMOSE VOLUME NOTED LUDETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) (_)PTr AND D -BOX SHOWN & DETAILED (,UU)i DAY STORAGE ABOVE ALARM CU '!�'YN UC__)STANDPIP 5' BOTH S , DETAIL _)15' MIN to CDS=> -4 %, 25' -3 %, 35' -1 %, 100 % - <1% _)(__j20' MIN to CD D R D;with 182 cons day discharge (_)(_,10' MIN to - PERFORATED PIPE 1 z 3b ILL COMPUTED BY: C.Y Q Project Name: Dore'et HWIM TsTccrm Lot, 2 DATE: /o - 13 - 00 PUMP ANALYSIS WORKSHEET Effluent production for 4 bedroom = 9o0 gallons Dosing Volume = 75% of trench volume = .75(.6gal /If.)(4#;5 If.) =2016 gallons Propose dosing of icogal /cycle. Therefore 2 dose is /are proposed on a daily basis. The pump chamber is sized for dosing plus 24 hour emergency detention period of the daily production ( 9"®Q gallons). A precast tank of 12SD gallon(s) is proposed. Capacity of pump chamber = 1b gallons Interior dimension of chamber ft �:S ft _ 4277 sf/ ft of depth Use depth = 1 • Chamber inside top to pipe inv. = 5" minimum Pump chamber cap 6 °Sump 7, S " 66se Vol. 3 " Alarm Vol. .30 " 24 Hours acity check: 60 gallons Z 00 gallons = 1?0 gallons = o0 gallons Total Required 1 i 0 gallons Pump Calculations: F'r, via ry . Description Box Inv. In Elevation = ��2, q (f-.r Pump Pit Elevation = -*47, 1 *4p7,1 SV ttic Head , = S. Ir ?_ _ C = 150 D = 1.5" L = CB►r` ) lIff' �Zese,►vet Equivalent L = 'If ' (PhN;N / ) /�, $'xse.rve) Total L = /v If . t- ( C Pr,`W CVYY) 163' C dese Ve Pump Rate Estimation: Dose in 20 minute intervals = lV gpm fnIY1, Dynamic Head Loss = 10.44 (total L) (gpm)1.85 (C)1.85 (D)4.865 = 10.44 (17j4,5) ( 4o )1.85 ( 1ta )1.85 ( !C,�- )4.865 13, 16 (Pri wetry) _ lo, �4F C 16 P-) "' (et-0 ) 1, C / S-) , Mr 13 , & ( Res evwe Dynamic Head Loss @ gpm �''Y�� �%3, 6 9 31 JPm C R'eS&ym) Total Head (tdh) _ /3,16 + Pump Model = WE o311 1- (Pr' k'1"4'10 8, 6 t. 7, =.�_ Pump> no4I WZ 0 1 1'. L CReserve) BRUCE - R. FOLEY Public Health Director DEPARTMENT 1 Geneva Brewster, New OF HEALTH Road York 10509 LORETTA MOLrNARI RN., M.S.N. Associate Public Health Director Director of Patient Services 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 E911 ADDRESS VERIFICATION FORM OWNERS NAME: Dorset Hollow Builders Lot 2 TAX MAP NUMBER: 3.20 -2 -82 E911 ADDRESS: 93 West Street Patterson TOWN: AUTHORIZED TOWN OFFICIAL: (Signature). DATE: .z3/ au The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E91 i VERFW 14.16 -4 (2/67) —Text 12 PROJECT I.D. NUMBER 617.21 •SEQR Appendix C State Environmental Quality Review. SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT !SPONSOR 2. PROJECT NAME Dorset Hollow Builders Dorset Hollow Estates 3. PROJECT LOCATION: (f o r m a l l Van C.1 e e f Estates) Municipality Patterson County Putnam 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) Lot I 2 - Dorset Hollow Estates (formally Van Cleef Estates) �3 West/ styte t, ,, PCLt et_C" /V- 5. IS PROPOSED ACTION: F1 New ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: Construction of subsurface sewage treatment system - for single- family .resid'e.nce and connection to public water supply. 7. AMOUNT OF LAND AFF CTED: O� ` Initially acres Ultimately acres 8. WII--L�IL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? L` I Yes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ® Residential ❑ Industrial ❑ Commercial ❑Agriculture ❑ Park /Forest/Open space ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE. 08 LOCAL)? ❑ Yes ® No If yes, list agency(s) and• permit /approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ® Yes ❑ No If yes, list agency name and permit/approval Subdivision approval from Town of Patterson Planning Board /PCDOH 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? ❑ Yes ® No I CERTIFY THAT ORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE M Applicant/sponsor name: P • S t t , P . E . . A . Date: Signature: -- 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 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I 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 may be superseded by another Involved agency. ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, of 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-Cl-CS? Explain briefly. C7. Other Impacts (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ 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 (aj 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 EA'F 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 C� 01 }t:7...Print5Type Name or Responsible Officer in Lead Agency Title of Responsi le Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) G.) => d O Date PA G &E DEVELOPMENT, LLC Gregg Macaluso 914 - 878 -4355 March 17, 2000 Robert Morris P.E. Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Dorset Hollow Estates Lot # 2 (formally Van Cleef Estates) Edward Bloes 914- 234 -2281 This letter is to serve as a notice that I as the contractor for the Dorset Hollow Water District, currently under construction, can provide adequate pressure to serve the proposed lots. This water plant shall be inspected and approved by PCDQH for use to meet the demand requirements for the subdivision. Very Edward Bloe`s G &E Development PO BOX 352 BEDFORD, NY 10506 I ATICN '4 'PLY =T 'P T MTA 1= Z) TO Er SM 1= = Al - N tv DZSC=M SOILS a\=-AUR=---ZM IN TEST FiC l w TZ NO 1.1= NO. Hozz M. lit 3' 41 61 71 81 91 10 12 14 INDICM= LO• AT WELCH GR='D=— IS a\=-U'\=M ... ..... . .. L'qD!CA=- IT_= To =v= RISES AFTER BEING =U1,717—ERED DEEP F,01,7-- OBSERVATIONS I%LME BY: DATE: DESIGN Soil Rate Used Min/l" Drop- S.D. Usable Are,-- Provide-a SC gals. Type Septic N6. of Bedroais c Tank Car, a-c ty .Abscrpt; on Area P.-ovidcd -�_,,r L.F . x 24 -width tzench Other A Narn--- W. Sr nTr 0 A,G1,VeStelIV6i Address 38 ISE. ONLY dIS SPA= FOR USE B�C a—rUrrE DE22�.MENT Soil Rate approved sq.,.,L. t/ga-1. Checked by Date _........_ ... _ .... A2a y,..= GNlle: SR /> AFx'l/ /.S_ /T_ /oN Gr+2,•°. ,.0 D?SS �_ i %�.�N�i�•i2:�N��! .?��_ `.f/Nir� a��.ycM/ S ZO 2 %0605 ZO at (S t= ae- -) Sec. neE eS z CCSS S asc:) / n Wa I er y/���/�/�• BE r,-r-- car 2ra- scaking rate of. Pe_ iatiea Test / / //y /9,f �CLc. . LLlil1 .:.:.avSB Deotl LO .•fYdt .r G"1 Water Lave�� No. T -, GZcu ld su=- -ac_. 'Ln Inches ' Soil- Rate Sta:. -S :CD b4L start stcp iDrCD IZ ndheS Inc±1es 1nLnes _ Zy'' S7 4 3 2 y'' 2 3 NOTiS : 1. '-rests to be- rer atea at Same depth un'---I a=rcd mate? y equa ssoi? rats _ are' obtained .at eac-h oe`wiat_on test hole. • Al IT data. to' be suL-n:ti. for review. Depth rrm si=eD zts `o be m^rp =n t;o of hole. rev. 9/85 3 IZ %ZZ -%2=45 i 2 3 NOTiS : 1. '-rests to be- rer atea at Same depth un'---I a=rcd mate? y equa ssoi? rats _ are' obtained .at eac-h oe`wiat_on test hole. • Al IT data. to' be suL-n:ti. for review. Depth rrm si=eD zts `o be m^rp =n t;o of hole. rev. 9/85 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE F REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 12--01 _ �P�I Located at q-J Town or Village P Al T ERZSON Owner /Applicant NamebbRSE T NOj-w GU OK-Tax Map -� 110 Block "I Lot 'K 2- Formerly Subdivision Name VAN GLEE F Subd. Lot # 2- Mailing Address 15 WV--S T \A o f -0w Ro M g Zt 1 fy zip—[ 03 ()1 Date Construction Permit Issued by PCHD 'Separate Sewerage System built by'bg ZS WLL0\4 9661 LMk6kddress d5 WEST S T. BREiA E-1 NY 1093 Consisting of �'Z� Q Gallon Septic Tank and 45(Q LF Mt S 12 rGivCV\ Other Requirements: Water Supply: '�'K_ Public Supply From /V1 U C 1 P P\ L Address P A -V T V1 RS QAJT%y Y or: Private Supply Drilled by Address Building Type U- N G Has erosion control been completed? E Number of Bedrooms 4- Has garbage grinder been installed? N 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 regulationslof the Putnam County Department of Health. Date: t9 — b O 1 Certified by Address P.E. "Y, R.A. # 5&1214- 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,= subject to modification or change when, in the. judgment of the Public Health Director, such revocation", 4dificatiA pr change is necessary. By: �/ Title: lJ G" Date: /w/o White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 DIMENSI ®N CHART (in feet) Number 1 2 3 90' I t5' I0' 1 $5' -7&1 $9' S4' 93.5' 90,5. l0 9'1.5' q15' 1\ (04' 115•y' 1•Z � p' l 19.S' 13 'l lo' 123, 5' iR IS �4,' I33' Ito 43,5' 131' t-7 9 A.51 1411 Is 51' 15 l9 l02' %0' 20 toy' SS-51 21 14.5' 9Q.S' 23 S LO' 105 ' 24 9 \,S' 112' 15 59' �t�•S` 2S0 (00.5' 17 61' 9to.5' 28 ,6o' 30 3 I 8l0' q2t 11 S' 12 1' f. r; r E I h A6, i i a o� s; 7_ F a: ;} l } K EX�S�� NG 4 ¢ES��En1CF _ ►50--'x— 1 g ESP AN S \D N--1 r---- --'-- q� S C 4 3q, A tie 3q \� o 7 ZO 21 \3 22 1� 1q WAY D -f3OX "^" \.EST STREET Putt um County Department of Health DIVISIOn of ja ironmental Health Services F P P + BOEHM Harry' W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Ox Telephone (845) 2794003 Fax (845) 279 -4567 June 6, 2001 Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, NY 10509 ^t Re: Individual SSTS Compliance Van Cleef Subdivision Lot #2 93 West Street Patterson, NY 12563 T.M. #3.20 -2 -82 Dear Robert: Enclosed are the following: 1. Five (5) prints of Drawing S -2, "As -Built Plan," dated 4/26/01. 2. "Certificate of Construction Compliance for Sewage Disposal System," dated 6/06/01. 3. Three (3) copies of "Guarantee of Subsurface Sewage Disposal System," dated 6/06/01. 4. Laboratory Report, dated 4/05/01. 5. Application Fee in the amount of $200.00 payable to Putnam County Health Department. 6. 'T-91 1 Address Verification Form," dated 4/20/01. If there are any questions concerning the enclosed, please call. Very truly yours, Harry W. 'chols Jr., P.E. HWN: JM: jm 01- 026.02 I -< 2 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva • Road Brewster, New York 10509 LORETTA MOLINARI - RN., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278.7921 Nursing Services (914) 278.6558 WIC (914) 278.6678 Fax (914) 278 - 6085 EarlyIiterveodon-(914) 218.6014 Preschool (914) 278 -6082 Fax (914) 278-- 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: A T S Y F_ ET TOWN: AUTHORIZED TOWN OFEICIA -L: (Signature) DATE: ;e Q The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town.official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFRK A NE NORTHEAST LABORATORY OF DANBURY 39 MILL PLAIN ROAD - DANBURY, CT 06811 CT Cert: PH -0404 LAB►S� (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 LABORATORY REPORT REPORT TO: MR. ALLAN FINN 15 WEST HOLLOW ROAD BREWSTER, N.Y. 10509 SAMPLE SITE: SAMPLING POINT: SOURCE: TREATMENT: TEST PERFORMED BACTERIAL: DATE SAMPLE COLLECTED: THE COLLECTED: COLLECTED BY: DATE RECEIVED @ LAB: TESTED BY: LAB I.D. #: REPORT DATE: 4/3/2001 NOT STATED A. FINN 4/3/2001 LAB #11471 APR -10 4/5/2001 DORSET HOLLOW ESTATES, LOT #2, PATTERSON, N.Y. KITCHEN TAP MUNICIPAL NONE RESULT: METHOD 4 MAXIMIUM CONTAMINANT LEVEL (MCL) Total Coliform (Bacteria) 0 per 100 ml SM 9222B 0 per 100 ml CHEMISTRY: Chlorine Residual ND mg/L - - - - -- ml = milliliter mg/L = milligrams per Liter ND = none detected TNTC= Too Numerous To Count COMMENTS: - Holding Times (were) met. RESULTS BASED ON SAMPLES SUBMITTED: 4/3/2001 SAMPLE, AS TESTED ABOVE: MOTABLE or NOT POTABLE L�_ (PER STATE OF NEW YORK DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060370 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 . OUTSIDE CT: 800 - 654 -1230 PUTNAM CvUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Dai?­�GT H0L[.ew f3v1LDG_R- Owner or Purchaser of Building T7o R -SCT HoLLovJ SU1LDr- -Z5 Building Constructed by 93 WG-ST 5i RCCT Location - Street 729- S)DG►,ICE 3 . 'Z o Z 8 Z Tax Map Block Lot PAT T iZ-,CD N Town/V4'$kkW Subdivision Name Z Building Type I Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by. me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system,..except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the o of the building utilizing the system. 771 \ _ Month �_ Day DORSET "oLLow f3VIl DEi2� Corporation Name (if corporation) Address: i s w EST Ho LLO\Aa Rn , 'B RC ws-rWo R State V, Y Zip osQ 9 Signature: Title: ,T>oRSE -' M01 -Low BUiLDE S Corporation Name (if corporation) Address: 15 i e-A-r ►yoL1_Q W sio, %9 ws,mt State ,,,v Zip 106o9 Form GS -97 I r ,i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES / _ t< FINAL SITE INSPECTION f Date: `f g � o! Inspecte y:6, 7?c E?, Street Location Owner 7�mz��r Noai_cacei . nz� Town f,f Permit # 'P-- TMI 2 - 0 2 Subdivision Lot #.a 1. Sewage Systen Area YES O O COMMENTS a. STS area located as per approved plans ........................... b. Fill section -date of placement n �c L_1__-- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IIEATLII SERVICES ►Iul � FIELD ACTIVITY REPORT Anmnzss: GyESZ" S % � RZYT>c725 0,0V Street Town PERSON IN CHARGE nR TNT /7 7OR X AJ le-- ©G S 1 i State PUMP TEST [-] DOSE TEST Zip REQUIRED GALLONS �2- oZ 3 Signature and Title ..: ..: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: 5 x_a, 3 1, 10 I I 119 O O Zip REQUIRED GALLONS �2- oZ 3 Signature and Title ..: ..: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: 5 x_a, 3 1, APR -24 -2001 10:13 AM HARRY W NICHOLS 914 279 4567 P.01 O I - 0? (a. OZ PUTOX COUNTY DEPARTIb= 01F MALT'S DIVOON Of ENV WNb=AL ZZ"73 $ZMCZ$ AT?MN17ON C3 ADAM ■ GENE • �R,�t iPSt �oA PYN n�cPi:c'rlox For:. Fill All iafanoaatloa must bg My completed prior to Lay Trenches - inspeWons bimS made. PM Coostuetion Permit I _ P 01 , Located' 93 WEST SiRC6r M•Y" OwaerlAppUcant Name: nj 3• z 0 Block –&— L.ot ,�Lz— Formally SubdivWoo Nana: Y ekm c_ L R E. .�� ' Sobdhrlsioo Lot # 2 Is system uli completed? N/ A Date: 1s system coximet, .,.�.e_ _,.._,�s Date: 11 system cmtstieted as Der pbu? ._ ^SEA 1s wet driiled? ., T",, A w u .�: =ti.. Date. N % A Is Well locoed as per plans? Are erosion control ouasutes is place? —ZAX. I cat* that tba sy cm(sj Ls Bated, U the above pram' es has bew commeted ad I have inspected aad verified their a mpledon in eecordwe V41h the issued PCHD Construction Permit &ad T approved plus and the Standards, Rules ad Regulations of the Putum County Department of Catdlid by: kAx.g�j w . I.i.lrrttt ;,?t • PE –2L_ RA — Desivn Professional Address: ZeSt?..STE t�1 g 1141 IM13MLfq "X- 1 o 902 Commcata; .. Form P'>RA4 BRUCE R. FOLEY Public Health Director April 27, 2001 ,�;.� LORETTA MOLINARI R.N., M.S.N. �' w �� Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Dear Mr. Nichols: Re: Field Inspection - Dorset Hollow Builders West Street, (T) Patterson TM# 3.20 -2 -82, Lot 2. The following comments must be corrected in the field: 1. The clay barrier needs to be installed below the separate sewage treatment system as shown on the approved plan. 2. A pump test needs to be witnessed along with the distribution box. 3. The separate sewage treatment system trenches appear to be within 10 feet of the property. 4. The footing drain was not found. 5. Silt fence has not been installed. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. - Very truly yours, Gene D. Reed GDR:cj Environmental Health Engineering Aide t BRUCE R. FOLEY Public Health Director April 27, 2001 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection - Dorset Hollow Builders West Street, (T) Patterson TM# 3.20 -2 -82, Lot 2 Dear Mr. Nichols: The following items are in violation of Article III, Section 2C of the Putnam County Sanitary Code: • Silt fence has not been installed. All erosion control measures must be installed prior to any construction. Civil penalties up to $1,000 for a single violation, per day, can be assessed if found liable for the violation, and a formal notice of hearing may be issued if the violation is not corrected within 5 days. It is truly hoped that the above violations are corrected without having to take legal action. GDR:cj Very truly yours, Gene D. Reed Environmental Health Engineering Aide BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI 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 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Date: #45,9 %/ To: &A zrC Y ,1✓>4Nvt,--;, eKe- : 17orzSF_ T /,locLaw Zo7- From: Gene D. Reed Putnam County Department of Health -✓ For your information For your review As discussed Notes/Messages Fax #: 9-72— 41'5-67 No. Pages (Including cover sheet) Please respond Attached as requested Please call In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2261. M FtY -30 -2001 09:02 AM HARRY W N I CHOLS 914 279 4567 P.01 BRUCE R FOLEY Public N with- .- Dlrator O! — O;i.00 LORMA MOLINAW R.N., M.S.N. datoel" Pwblk H641A D(rector Dlroctor oj. Patten Strvkes _Q t DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 ATTENTION: 0 ADAM STIEBELING GENE REED All information below must be fub completed prior to any scheduling. 'DATE: -24 - ENGMI ER OR FIRM: 4atk!a IV, �(% �rr �. PHOiYE #: REASON: DEEPS: 0 PERCS: o _ PUMP TEST: ROAD/STREET: -- TOWN: /°Q a 16 TA, X MAP #: '124 .2 SUBDIVISION: C LOT #: OWNER: _�. � cam•; � � ti �.,. _.� .; �._�..�., YES NO 0 Proposed SSTS within the drainage basin of West Branch or B.oyds Corner Reservoirs. 0 51' Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. o 0 Proposed SSTS within 200 feet of a Watercourse or a DEC wetland. o id Proposed SSTS design flow greater than 1000 gallonslday or SPDES Permit required. 0 Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered y= to any of the questions, NYCDEP must witness the soil testing. This Department svill coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR couh'TY USE ONLY DATE: TIME: � /L Stt�1liF�i: MLDTEST) 1�1� --- -- ------ a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # C a -0 Located at 93 West Street Subdivision names o r set Hollow E s Subd. Lot # 2 Date Subdivision Approved 1 9 9 8 Owner /Applicant Name]) D o r s e t Hollow Builders Town or Village Patterson Tax Map 3.2 0 Block 2 Lot 8 2 Renewal Revision Date of Previous Approval Mailing Address 15 West Hollow Road, Brewster, NY Amount of Fee Enclosed $300.00 Building Type Residence Zip 10509 Lot Area .92 No. of Bedrooms 4 Design Flow GPD 8 0 0 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of a7:L 10' <nj',,d e- ovf mt v�, 1250 gallon septic tank and 4 41 Z F- !a o Y Rres&,rve. Other Requirements: / Z �-9 % CtA p C11(40m bit- To be constructed by Dorset Hollow Builders Address 15 West Hollow Rd., Brewster. NY Town of Patterson Water Supply: X Public Supply From Water District Address or: Private Supply Drilled by Address r I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the senarar to sewage treatmentsystem described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said btilder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately followiq&lke date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any �6. Simed: P.E. X R.A. Date /0 > V00 Address 3871'Route 6, Brewster, NY 10509 License# 059346 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 when T=dlered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. ved for di rge of domestic sanitary sewage only. &: Title: Date: C Wite copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI 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 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 February 28, 2001 Peder Scott PW Scott Engineering 3871 Route 6 Brewster NY 10509 Re: Proposed SSTS: Dorset Hollow Builders 93 West Street, Lot #2 (T) Patterson, TM# 3.20 -2 -82 .:- ..:.:._.. Dear Mr. Scott: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regards. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) The SSTS should be proposed as far away from the house footing drains as possible, i.e., move the primary system to the area currently shown for the expansion trenches. Furthermore, a two foot wide clay barrier is to be shown between the SSTS and the house footing drains. The minimum dept of the clay barrier is to be the depth of the footing drains. The location of the clay barrier is to.be shown in the plan and profile view. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very ly yours, �v Robert Morris, P.E. RM:tn Senior Public Health Engineer P. W. SCOTT Engineering & Architecture, P.C. 3871 Route 6 BREWSTER, NY 10509 E -Mail: pws @bestweb.net (914) 278 -2110 FAX (914) 278 -2166 TO p IlrAlAy KRUT912 @1P DATE z 13 JOB NO. 0 ATTENTIO RE: L Z WE ARE SENDING YOU Attached ; l \ er via the following items: > tIR, • Shop drawings Prints ❑ Plans ❑ Samples ❑ Specifications • Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION /h ho THESE ARE TRANSMITTED as checked below: ❑ 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 ❑ PRINTS RETURNED AFTER. LOAN TO US REMARKS //-2L3/c)/ COPY TO SIGNED: ` If enclosures are not as noted, kindly notify us at once. BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI 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 Preschool (845) 278 -6082 Fax (845) 278 - 6648 January 23, 2001 Peder Scott PW Scott Engineering '3871 Route 6 Brewster NY 10509 Re: Proposed SSTS: Dorset Hollow Builders 93 West Street, Lot #2 (T) Patterson, TM# 3.20 -2 -82 Dear Mr. Scott: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regards. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) The SSTS should be proposed as far away from the house footing drains as possible, i.e., move the primary system to the area currently shown for the expansion trenches. Furthermore, a two foot wide clay barrier is to be shown between the SSTS and the house footing drains. The minimum dept of the clay barrier is to be the depth of the footing drains. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. R%,l:tn k ruly yours, /#OJW Robert Morris, P.E. Senior Public Health En(-,ineer . P. W. SCOTT Engineering & Architecture, P.C. 3871 Route 6 BREWSTER, NY 10509 E -Mail: pws @bestweb.net (914) 278 -2110 FAX (914) 278.2166 TO M WE ARE SENDING YOU Att separate cover via ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ DATE 1 I _ RE: ❑ Samples COPIES DATE NO. DESCRIPTION it THESE ARE TRANSMITTED as checked below: ❑ For approval XFor your use (❑ As requested ❑ For review and comment ❑ FOR BIDS DUE REMARKS ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections the following items: ❑ Specifications • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: RESOLUTION WE, the undersigned, being all of the Members of G & E Development, LLC do hereby consent to the application by the Limited Liability Company to construct a Subsurface Sewage Treatment System on premises known as 93 West Street (Lot No. 2, Dorset Hollow Estates), in the Town of Patterson, Putnam s County, Ne;,v York. MED STATE OF NEW YORK, COUNTY OF On the I(( day of November , 2000, before me, the undersigned, personally appeared EDWARD BLOES & GREGG MACALUSO , personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same intheircapacity, and that bytheirsignatu.re on the instrument, the individual or the person upon b alf of ch the individual acted, executed the instrument. Notary Public DEBORAH L. FRULLA Notary Public. State of New York No.01FR4609795 Qualified in Dutchess County Commission Expires I )S � O.Z i -IERKMAN & HUDAK, RC. •�� /i � � i i JORDAN W. BERKMAN ELIZABETH D. HUDAK Peter W. Scott, P.C. 3871 Route 6 Brewster New York 10509 RE: G & E DEVELOPMENT LLC Dear Sir: 38 GLENEIDA AVENUE CARMEL, NEW YORK 10512 19141 225 -5827 19141 225 -5912 FAX NO. NOT FOR SERVICE OF LITIGATION PAPERS November 29, 2000 As requested, enclosed please find a fully signed Resolution relative to the Subsurface Sewage Treatment System at Dorset Hollow Estates, Patterson, New York (Lot #2)• Very truly yours, r 4(e, ELIZ TH D. HUDAK EDH:dd enc. BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI 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 Preschool (845) 278 -6082 Fax (845) 278 - 6648 October 25, 2000 Peder Scott PW Scott Engineering 3871 Route 6 Brewster NY 10509 RE: Application to Construct a Subsurface Sewage Treatment System at Dorset Hollow Builders 93 West Street, Lot #2 (T) Patterson, TM# 3.20 -2 -82 Dear Mr. Scott: The Putnam County Department of Health (Department) has determined that the above referenced application, received by the Department on October 18, 2000 is incomplete. Please be advised that the following information is required before the Department may commence its review. v Corporate Resolution form. The review of your application will commence once the Department receives the requested information and determines that the application is complete. The Department will notify you within 10 days of its receipt of the requested information as to the completeness of your application. Please be advised that failure to submit information to the Department or to follow procedures is sufficient grounds to deny approval, pursuant to the New York City Department of Environmental Protection Watershed Regulations and Putnam County Department of Health regulations. Should you have any questions or care to discuss this matter, please contact me at (845) 278 -6130 ext. 2159. Very truly yours, C; Shawn Rogan SR:tn Public Health Technician P. W. SCOTT Engineering & Architecture, P.C. 3871 Route 6 BREWSTER, NY 10509 E -Mail: pws @bestweb.net (914) 278 -2110 FAX (914) 278 -2166 TO Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 WE ARE SENDING YOU CXAttached ❑ Under separate cover via • Shop drawings ❑ Prints ❑ Plans • Copy of letter ❑ Change order ❑ dIFE`tTC[TCF.G3 OIP CTn&H1QMVV&1 DATE I ( 10 1� JOB No. - 99— 1 5 9 ATTENTION At, 6,e+,_(_ RE: Dorset Hollow Estates -t. L (formally Van Cleef Estates) Subsurface Sewage Treatment System (SSTS) Application for Approval of Plans (PC -97) the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION Application for Approval of Plans (PC -97) 1 Construction Permit for Sewage Treatment System (CF-97) 1 1 Letter of Authorization (LA -97) 1 2 Design Data Sheet (DD -97) 1 House Plans (2 sets) 2�(7/��� 1 Letter from G & E Development,LLC, Re: Public Water I Check # 3t- ((2- 7 . for the amount of $ v'0,00 1 Short Form EAF THESE ARE TRANSMITTED as checked below: XFor approval ❑ For your use ❑ As requested X] For review and comment ❑ FORBIDS DUE • Approved as submitted • Approved as noted ❑ Returned for corrections • Resubmit copies for approval • Submit copies for distribution ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS List Continued: 4 �ijro 1 Septic Site Plan Drawings 1 j y� �� 1 E911 Address Verification Form (E911 Verfrm) Pump Atictty�� r COPY TO SIGNED: nrily not Gregg Macaluso 914 - 878 -4355 March 17, 2000 Edward Bloes 914 - 234 -2281 Robert Morris P.E. Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Dorset Hollow Estates Lot # 2 (formally Van Cleef Estates) This letter is to serve as a notice that I as the contractor for the Dorset Hollow Water District, currently under construction, can provide adequate pressure to serve the proposed lots. This water plant shall be inspected and approved by PCDQH for use to meet the demand requirements for the subdivision. Very tr lq ours, Edward Bloe G &E Development PO BOX 352 BEDFORD, NY 10506 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Dorset Hollow Builders Located at 93 West Street TN Patterson Tax Map# 3.20 Block 2 Lot 82 Subdivisionof Dorset Hollow Estates (formally Van Cleef Estates) Subdivision Lot # Gentlemen: 2 Filed Map # 2 7 7 1 Date Filed 12/24/88 This letter is to authorize P e d e r W. 3. c o t t, P. E . , R. A. a duly licensed Professional Engineer X or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and t q Putnam County Sanitary Code. Countelsigned: P.E., R.A., # 059346 Mailing Address 3 8 7 1 Route 6 Brewster State New York Zip 10509 Telephone: ( 9 1 4 ) 2 7 8 - 2 1 1 0 Mailing Address: Dorset Hollow Builders 15 West Hollow Road, Brewster State New York Zip 10509 Telephone: ( 9 1 4 ) 2 7 9 - 1 3 3 9 Form LA -97