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Home My WebLink About0149DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.20 -2 -98 BOX 2 t6 ,, F V �' �r 00149 PUTNAM COUNTY DEPARTMENT OF HEALTH h �a DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYS /TEI 4 . i U' e.. LC.,a 1C a -' PCHD CONSTRUCTION PERMIT # ls.' -alp t �,°� 12411 r Located at 43 Town or Village .a Owner /Applicant Name 1_1 A-wt A Tax Map 3, �7-0 Block 2- Lot `i 8 Formerly Subdivision Name VA O CL.ia-r— iaTn -:7 : Subd. Lot # ( O Mailing Address /4 3 (,,i t3"25 i s --1YZ.G2T- PATM—K-S & J Zip Date Construction Permit Issued by PCHD Imo' Separate Sewerage System built by PA-i tit iJ U ALL- - Address 9-0 VQ 41 t L oy., 6 YZ. Li' srtrr� Consisting of-oz--j 5; vd Gallon Septic Tank and I- r+ IJ 58 1_ l °5 com, v`1 /ttio � tog au-s eawt-5 Other Requirements: i+t41, LAN&N, o. J g�PL"6 w O� C5 Water Supply: X Public Supply From ?A-� C�12 S 6iJ 0 A- IM Address V l 5 tyZ.l Cam' or: Private Supply Drilled by Address Building Type Has erosion control been completed? l Number of Bedrooms CA Has garbage grinder been installed? 1 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 acc ance 'th the issued PCHD Construction Permit and approved plans and the standards, rules and regulations f utn County Department of Health. Date: .o S 13 Certified by P.E. R.A. (Design Professional) Address '3 3"7 1 �0 fvQ f3 J r P. s7 , A 12� SrW , P V 10,5'-6 9 License # U 5`% 3 q 6 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 are subject to modification or change when, in the judgment of the, Public Health Director, such revocation, modification or change is necessary. 4ite Title: Date: A5 Ll py - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SU9SURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot GX�S�iI o4 1 k-o Building Constructed by Location - Street Building Type TownNillage Subdivision Name 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 occupant of the building utilizing the system. Dated: Month /0 Day & Year 20/ 3 General Contractor (Owner) - Signature Corporation Name (if corporation) Signature: Title: Co oration Na e (if co oration) Address: Address: 2-0 State Zip State Zip �J� Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION 'OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 3p� .2- q Owner or Purchaser of Building Tax Map Block Lot Building Constructed by -13. Location - Street �DOv�CC:, Building Type TownNillage VA-nl Gl.t� �—S ►�4�Z%� Subdivision Name lU, 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 occupant of the building utilizing the system. ° Dated: Month Day Year Z01-5 Signati Title: General Contractor (Owner) - Signature Corporation Name (if corporation) C rporation Na a (if co oration) Address: State Address: 2—,o f va gj'(t Da Zip State Atj Veii, Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION 'OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM L l 4vtt A H-fVL- Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Location - Street P0.;cD0-t,)cA' Building Type TownNillage VA-,J Subdivision Name (b 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 occupant of the building utilizing the system. Dated: Month ZQ Day Year Signature: ��_ Title: re-5 General Contractor (Owner) - Signature ff Corporation Name (if corporation) C rporation Na a (if co oration) Address: Address: 2,62 va 9812a State Zip State j Zip SAD Form GS -97 NORTH SEPTIC SITE PLAN SCALE: 1 "=::3U LOCATION CHART PT. # DESCRIPTION LOCATION FROM POINT A B 1 EXIST. 1250 GAL.SEPTIC TANK 19.5' 45' 2 NEW 500 GAL. SEPTIC TANK 21' 37.5' 3 EXIST. DBOX #1 31' 37.5' 4 EXIST. DBOX #7 63' 67' 5 NEW DBOX #8 69' 73' 6 NEW TRENCH START 69.5' 72.5' END : 102.5' 75.5' DE DT #1 DT #'g DE To: Joe Paravoti PCDOH 1 Geneva Rd Brewster, NY 10509 Scot t Engineering & Architecture, PC 3871 _Route. 6, Brewster, NY 10509 845. 278.2110 Fax: 845. 278.2166 Letter of Transmittal Date: May 22, 2014 Re: Ahern We are sending you: ■ Attached ❑ Under Separate Cover via ❑ Drawing(s) ❑ Letter(s) ❑ Plans ❑ Misc Documents the following items: Copies Date Pages Description 2 5/19/14 1 AB1 (24 x36) (stamped and signed) These are submitted (as checked below): ❑ For Approval ❑ Approved as Submitted ❑ Re- submit Copies for Approval ❑ For Your Use /Records ❑ Approved as Noted ❑ As Requested ❑ Returned for Corrections ❑ Return Corrected Prints ❑ For Review & Comment Remarks: Copy To _ /'`•\1 . FT «.,....„,:++,.1 Ate.. Signed PW Scott Engineering & Arc itecture PC 3871 Route 6, Brewster, NY 10509 . 845. 278.2110 Fax: 845. 278.2166 www.pwscott.com pwscott2 @comcast.net Letter of Transmittal To: Gene D. Reed, Principle Engineering Aide Date: October 28, 2013 Putnam County Dept of Health 1 Geneva Road Brewster, NY 10509 Re: Ko Residence We are sending you: ■ Attached ❑ Under Separate Cover via the following items: 0 Drawing(s) 0 Letter(s) ❑ Plans ■ Misc Documents - Copies Date Pages Description 4 10/16/13 1 PCDOH Guarantee of Subsurface Sewage Treatment System (all signed originals) 1 10/8/13 NCR PCDOH Certifictae of Construction Compleiance for Sewage Traetment System, Form CC -97 (NCR form) 4 10/9/13 1 AB 1 As -Built (24 x 36) (stamped and signed) These are submitted (as checked below): ■ For Approval ❑ Approved as Submitted 0 ae- submit Copies for Approval 0 For Your Use /Records 0 Approved as Noted ❑ As Requested 0 Returned for Corrections ❑ Return Corrected Prints 0 For Review & Comment Remarks: Copy To _ OAT f..o \Co.. «et.,. I \n-,I.t.... \T et+o. ,.F T...........: tt.,i .r. Signed May 19, 2014 Joe Paravati Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster NY 10509 Re: Ahern - 43 West Street (T) Patterson, TM 3.20 -2 -98 Dear Joe, Enclosed please find two updated copies of the As -built septic plan for the Ahern septic. The dimensions have been corrected for the given locations. Wraith/ Regards, Adel- ecaa Peder Scott, P.E., R.A, President Attach A R C H I T E C T U R E ` E N G I N E E R I N G " S I T E P L A N N I N G S \Open�Projects\Ahern Uan C1eef Septic\Paravatrltr asbuilt 5.19;14 dqe P.W. Scott pwscott2@comcast.net Engineering& Architecture, P.C. www.pwscott.com 3871 Route 6 (845) 278 -2110 Brewster, NY 10509 FAX (845) 278 -2166 May 19, 2014 Joe Paravati Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster NY 10509 Re: Ahern - 43 West Street (T) Patterson, TM 3.20 -2 -98 Dear Joe, Enclosed please find two updated copies of the As -built septic plan for the Ahern septic. The dimensions have been corrected for the given locations. Wraith/ Regards, Adel- ecaa Peder Scott, P.E., R.A, President Attach A R C H I T E C T U R E ` E N G I N E E R I N G " S I T E P L A N N I N G S \Open�Projects\Ahern Uan C1eef Septic\Paravatrltr asbuilt 5.19;14 dqe ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E., MPH Director ofEnvironmental Health May 15, 2014 PW Scott Engineering Peder Scott P.E. 3871 Route 6 Brewster, NY 10509 Dear Mr. Scott: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Re: Construction Compliance — Ahern 43 West Street (T) Patterson, T.M. 3.20 -2 -98 MARYELLEN ODELL County Executive This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration. It appears the relocation dimensions for points 3 -6 are incorrect. This office will continue its review upon consideration of the above mentioned comments. Please feel free to contact me at ext. 43157 of any questions arise. Very truly yours, (,Joseph S. Paravati, Jr., P.E. Assistant Public Health Engineer JSP:cml OCT -09 -2013 12:08 PW SCOTT P.01/01 �''� , lCb ' ' *PARTMENT OF HEALTH .... OF NTAL HEALTH SERVICES ATTENTION, Q GENE REQMIPDX For: Fill Pail infor=664- t ';f1 ► °�giia� -to any Trenches inspections beigrt: PCHD Located: _ _ �'".,>,`i� , h.►%r (T) (v) P� Ovmer /Applicant i4mo, �+�i Ni i i it TM _Zo Block Lot -9 9 Formerly, 'Subdivision Name: v #-�± c` Vr iF Subdivision Lot # 10 Is system fll?. +. ,;�'Ml: ', _,,�., Date. — – Is system comow, Date: 11Z �- - Is systc Iswell drUl''Al. n we - ' ':, . �:"'.�, ..�,.n: ate: Is well located,i s .;s,�;'��. Are erosion oari< '� . I certify � • . ' y s $t d'; ai;'i tV, Apremises has been constructed and I have inspected and verified tl pc i'''ii "ac iric frith the issued PCHD Construction Permit and t , approved plats pan%'fie' of the Putnam County Department of tat T -WIN Date::' fi'. • a ,� "�' PE RA Design Professional 'v"AL Address: Lic. # I' orm FIR -9 , •' ii i, s, ' `'fit'' ?1 At ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E.,MPH Director of Environmental Health October. 23, 2013 PW Scott Engineering Peder Scott P.E. 3871 Route 6 Brewster, NY 10509 Dear Mr. Scott: DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Re: Field Inspection — Ahern 93 West Street (T) Patterson, TM 3.20 -2 -98 The above referenced separate sewage treatment system can be backfilled. MARYELLEN ODELL County Executive There are no open comments to be addressed at this time in reference to this Department's open work inspection. If you have any further questions, please contact me at (845) 808 -1390, ext. 43261. Sincerely, Gene D. Reed Principal Engineering Aide GDR:cl Sheet of� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEATLII SERVICES FIELD ACTIVITY REPORT NAME-• AV1 6$ n - Tel. AT)T)RF44; q3 Wee,T S +, i w-'eJ',;0 ✓I Street Town State Zip PERSON IN CHARGE Name. a6d Title ` TYPE OF FACILITY: FINDINGS: 45 U-61 EAOJ s-� e-vLj l � AL Signature and Title REPORT RFC F-TVFT) FtY. I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. M ALLEN BEALS, M D., J.D. Commissioner ofHealth ROBERT MORRIS, P.E., MPH Drredor ofEm+iromnerttal Health . Liam Ahern 43 West Street Patterson, NY 12563 Dear W. Ahem, DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (8457 90 8-1390 Fax # (845) 278 -7921 July 25, 2013 Re: Addition — Approval - Ahern Increase in Number of Bedrooms with new SSTS 43 West-Street, (T) Patterson, T.M.# 3.20-2-98 MAR : ' + ODELL 6WO &ecuave I have received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department dated July 25, 2013. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at 6 without prior approval by this Department. 2. All plumbing fixtures must be updated with water saving devices (i.e. new low flush toilets, restrictors for shower heads and faucets, etc.). 3. Approved SSTS must be constructed according to the approved plans certified by Peder W. Scott, P.E.. Any deviation from. the plan requires a revision be submitted to this Department. 4. SSTS must be inspected by this Department before any back filling. 5. The house must be inspected for bedroom count before the compliance is issued. 6. Once SSTS has been inspected and backfilled, a construction compliance package must be submitted for review and approval before operation of the new SSTS. 7. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals. Any permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at (845) 808 -1390 ext. 43157. Re ectfully, l J eph S. Paravati, Jr., P.E. JP /jmg ssistant Public Health Engineer cc: BI (T) Patterson PUTNAM COUNTY DEPARTMENT OF HEALTH , DIVISION O ENVIRONMENTAL HEALTH SERVICES a F' v � CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # .. -::/� b � q ' 13 Located at 43 west Street Town or Village Patterson Subdivision name van Cleef Estates Subd. Lot # _ 0 Tax Map 3, Block Lot 2, 9S Date Subdivision Approved 1999 Renewal Owner /Applicant Name Liam Ahern Mailing Address 43 West Street, Patrterson I�'Y Amount of Fee Enclosed Revision . x Date of Previous Approval 2002 Zip 12563 Building Type Residence Lot Area 1.0 No. of Bedrooms 6 Design Flow GPD goo Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1250 + new 500 gallon septic tank and EMisting 406 LF + new 58 LF primary and 464 reserve Other Requirements: High level averflaw bores To be constructed by Pat Tynemii Address 20 Lvy Hill 1 Rd, Brewster, rev 10909 Water Supply: Public Supply From Patterson Water District or: Private Supply Drilled by Address Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Director /Commissioner will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the-builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. v k vt l I v j-A hl Signed: P.E. R.A. Date J Address 3871 Daiioury Rd, 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 considered necessary by the Director /Commissioner. Any revision or alteration of the approved plan requires a new pel-mit. Approved for discharge of domestic sanitary sewage only. III 1� Date: y opy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 ALLEVRk4LS,1 D.,J.D. Commissioner ommdth ROBERT MOR1U% P.E. DhVd0rofBavi ww2mWHed4fi k! ` DEPARTMENT OF •HEALTH 1 Geneva Road, Brewster, New York 10509 Telephone: (845) 508 4390; Fax. (845) 278 -7921 MARY.EUXN ODftL . COMWExecutive . ADDITION APPLICATION RESIDENTIAL ONLY STREET 43 Vest Street TOWN Patterson TAX MAP # 3.20 -2 -98 NAME Liam Ahern PHONE 914- 742 -4890 PCHD# A MAILING ADDRESS 43 West ..$ treet, Patterson, NY 12563 DESCRIPTION OF ADDITION Expand Sept is from 4 to 6 bedrooms *NUMBER OF EXISTING BEDROOMS 4 NUMBER OYPROPOSED NEW BEDROOMS 2 * (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) * *Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordancb with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health, Dept., 1 Geneva Rd, Brewster', NY 10509, Phone: (845) 808 -1390. 1. Certified check or money order for $1.00.00. 2. Sketches of existing.floor plan (drawn to scale, all living area including basement, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA '1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best, of your knowledge. Include date of installation known. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the own or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE COMMENTS 5. .'. r. ✓•(t-= =-P-MAL S, i....I Clyne_'" SRG P.c=Ss -, : •7 M,� r+?�?RG N om! �d, Vz �. �o . • � loSaS zo at (S tr aet) f2f3 /i g' Sec- /3. s- Blc._ -c > mzt ( .Z1Cy.Cvw nea.=esz Ccss s=eet) �`•...:.�_ - � ' �� T!^- _son/ Wa'•.�rs � ri20Ti�N R*- mom; �a �^^D- „� ?S"�Cri�.._C,I : qtr Of Pre- scaking Date or Pe-- =Iat =cn Test /0 151'1,7/j Holz 3 Z= yn -2 =-4: -4 10K ..LIIl F.I Z� Se Deotn t7 .4`later W, at Lave1 Ho. Time Grcuza SL= ace. in Lzches ' Sci? Wit_ S i'} -S t`.oD .iii. S ��•?..T SL- COP B- OO Li 1 3 7,= 2 b1CZ'SS: 1. Testy to be re: eater?: at � dew h =:tii a�rccnate?y eq =1 soi'_ =L,.ess _ are ' obtained .at eacz oe= =iaticn tast hole. - 'dI1 ca;a :.o' be so.� -ai. tip for review. 2. Dept's masureneat-s t= be mace of hale_ re<r. 9/85 3 Z= yn -2 =-4: -4 10K i 2 b1CZ'SS: 1. Testy to be re: eater?: at � dew h =:tii a�rccnate?y eq =1 soi'_ =L,.ess _ are ' obtained .at eacz oe= =iaticn tast hole. - 'dI1 ca;a :.o' be so.� -ai. tip for review. 2. Dept's masureneat-s t= be mace of hale_ re<r. 9/85 TEST PIT DATA T i✓RL•U TO BE SUMMIT � • , = APPI -- ,TT_CN L ro DZSC =2 :CN JF SOILS LN=R r—= IN `EST HC.- S - Da-71M HCT,^ N.O. r I EOI m. rCir i30_ G.L. 21 ! �. -ss+•/ i� w /al �riF_v �y <�/ / %. / /w3li�.i 7 91 . 3' 4! ' 5' I I . / 1% 8' 7 9' INDICT L.7= AT WHICH GRCUNI7C"Tr. "% IS E- N=U= -JM 4 L`IDICA= Lr.V.T,:-.r TO WHIG °. NATM 1EVEL RISES AF'?'F_.R B=. - G =UNI TERED D= HOLE OBSERVATIONS MADE BY: DATE: DESI�I Soil Rate Used .Min /1" Drop: S.D. Usable Pzea Provided No". of Bed:oans 1 Septic Tale: Ca:.-t,T gals.. Type rye ',• /� . Absorption Area Provided By SIX) L. F. x 24" width trends t • Otter Name W. grat c s . -. uj Address :?87'1 . ur gr,Js r„z 10,50-9 �p 693 THIS SPACE FOR USE BY MUTH DE2 -kr"' \TX CNLY: Soil Rate Approved scT:ft /gal. cheaked by Date PUTNAM 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: UN, A A--k6W / C� , l 2. Name of Project: M 3. Location: (2)V: : A �r�C�v 4. Design Professional: �(,J 7 l 5. Address: 6. Drainage Basin:�1��il�jl 7. Tvvr, of Project: Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR) ? .............. Yes/ o` Type Status (check one) ...................................... ............................... Type I Exempt V Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required ? .................... Ye(/-5�0 �] 10. Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes o f 11. Name of Lead Agency I M T 0A) &UILDWC� 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ............................................................ ............................... Yes o 13. If so, have plans been submitted to such authorities? . ............................... e No 14. Has preliminary approval been granted by such authorities? 1JIN Date granted: %gPWISJA) lot 15. Type of sewage treatment system discharge ........................ surface water groundwater 16. If surface water discharge, what is the stream class designation? ...... WiN.......... 17. Waters index number (surface) t�!": . ......... ............................... 18. Is project located near a public water supply system? . ............................... (@ No 19. If yes, name of water supply712WAJ PkMUQ& Distance to water supply (f4W 4ECrO 20. Is project site near a public sewage collection or treatment system? .......... Yesso 21. Name of sewage system Kf Distance to sewage system 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ............................. ............................... 100 25. Is State Pollutant Discharge Elimination system ( SPDES) Permit required? ... Yes o 26. Has SPDES Application been submitted to local DEC office? ......................... Ye /No Rev. 11/02 Form PC -97 Pg. 1 of 2 27. Is any portion of this project located within a designated Town or State wetland ?... Ye(/No 28. Wetlands ID number .................................................................. ............................... 29. Is Wetlands Permit required? ...................................... ............................... Yes/No Has application been made to Town or Local DEC ........................... Yes/No 30. Does project require a DEC Stream Disturbance Permit? ............................. YeG . 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landflling, sludge application or industrial activity? ...................................... .............................Ye 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? ................................... ............................... Yesc DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ........................ GNO 34. Are community water and /or sewer facilities planned to be developed within 15 years in or adjacent to project site? ............................................................ Yes o 35. Are any sewage treatment areas in excess of 15% slope? .............................. Yes o 36. Tax Map ID Number .............. ............................... Map '3 Block _&-) Lot 37. Approved plans are to be returned to ................ Applicant 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 1, 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 statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES. Mailing Address: ........................... Form PC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES !LETTER .OF AUTHORIZATION !RE: !Property -of Liam Ahern _ i.ocated at 43 West Street, Patterson, NY 12563 TN Patterson Tax Map # 3 Block 20 Lot 2 -9F, Subdivision of V a n C l e-e i. E � -t a t e s Subdivision Lot # 10 Filed Map # Date Filed Gentlemen: This letter is to authorize Peder W. Scott, P -H: -, 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 the Putnam County Sanitary Code. Very truly yours, L Countersigned: �` Signed: R.A., # I (owner of Property) PW Scott Engineering & Architecture Mailing Address 3871 Danbury Rd _ Mailing Address: 43 West Street �13rewster. Patter- -son State NY Zip 10509 State NY — Telephone: 845 -278 -2110 Telephone: 914- 742 -4890 Form LA -97 I-1,- IIc000 fZ Tlr I it I A/ O D V R- E vv E s -s- -r. L o d. I)♦ H FA ljfl'll UzuSF PLANS APPROVED FOR BEDROOM COUNT ONLY. 13FDROOINIS /*4 - o 3 (7) I IST NS TO THESR- HOUSF. 'O'F�'T IEV ONIALTERATIO �Vlu-�T BE SUBMITTED TO THE PCDOH FOR APPRDVAL -6A -n4 Koo r�,q POTENTIAL IE C K IS A T- 14 T) I jv / N v o o ro, 0 L r- L r iR 1IO 3,�r !�5i � ►PLC BEDROOM 'noNif5 Roo m \ P ®TENT9AL tol(ANC L POTENTIAL POTENTIA � POTENTIAL. E R ®� BEDROOM " a BEDROOM C L . Y i i !'1.:.1 N AM COUNTY DEPARTMENT OF 1 EALi t+�. / /a L PLANS !APPROVED FOR BEDROOM COUNT ON�EI. L� l_ �_..._ SE i10oms 1�4jf 3,20 8 M--,.N. T REVISIONjALTERATItNS TO THESE HOUSE PFL,A:fttip VKUS'I' BE SUBMITTED TO THE PCDOH FOR APPROVAL /Y'3 Ito 4''d:'1� " & TITLE � �? -p(f� ATE PW Scott Engineering &Architecture, PC ........ ...... 3871 Route 6, Brewster, NY 10509 845 - 278.2110 Fax: 845. 278 -2166 www.pwscott.com pwscott2 @comcast.net Letter of Transmittal To: Joe Paravoti Date: July 8, 2013 Putnam County Department of Health 1 Geneva Road Brewster, NY 10509 Re: Ahern Septic — 43 West Street We are sending you: ■ Attached ❑ Under Separate Cover via ■ Drawing(s) ■ Letter(s) ❑ Sample(s) ❑ Plans ❑ Change Order(s) the following items: Copies Date Pages Description 1 7/8/13 1. PWS Itr to Paravoti re 2 n tank in series added 3 7/8/13 3 SP 1 (24 x 36) (stamped and signed) These are submitted (as checked below): ■ For Approval ❑ Approved as Submitted ❑ Re- submit Copies for Approval ❑ For Your Use /Records ❑ Approved as Noted ❑ As Requested ❑ Returned for Corrections ❑ Return Corrected Prints ❑ For Review & Comment Remarks: Copy To Signed P.W. Scott pwscott2@comcast.net Engineering & Architecture, P.C. www.pwscoft.com 3871 Route 6 (845) 278 -2110 Brewster, NY 10509 FAX (845) 278 -2166 July 8, 2013 Joe Paravati Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster NY 10509 Re: 2nd Tank in Series Ahern - 43 West Street (T) Patterson, TM 3.20 -2 -98 Dear Joe, In response to your request a second tank has been added in the series. Please find drawings attached. Wraith/ Regards, P e - JeOtt Peder Scott, P.E., R.A, President Attach A R C H IT E C T U RE* E N G IN E E R I N G " S IT E P L A N N I N G S �pei3 Pr .)- cts`A1�zr�� V i,Cieef Se aiavati „lti re nd'TAnlc dried doc ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E., MPH Director of Environmental Health June 26, 2013 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 PW Scott Engineering Peder Scott, P.E. 3871 Route 6 Brewster, NY 10509 Dear Mr. Scott: MARYELLEN ODELL County Executive Re: Proposed Addition — Ahern 43 West Street (T) Patterson, TM 3.20 -2 -98 This office has received and reviewed the most recent set of plans for the above mentioned project. We would like to offer the following comments for your review and consideration: 1. The septic tanks are shown in parallel, not in series. The sewer line is to enter the first tank and the effluent line is to exit the second tank with the two tanks connected. 2. The 500 gallon tank does not appear to be to scale in the plan view. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. Respectfully, J seph S. Paravati, Jr.; P.E. Assistant Public Health Engineer JSP:cw Christina Walsh From: P.W. Scott Eng. & Arch. PC [pwscott2 @comcast.net] Sent: Tuesday, June 25, 2013 1:01 PM To: Christina Walsh Subject: Ahern Septic - Joe Paravoti Importance: High Joe, Please let us know the status of your review of the septic for the Ahern Residence at 43 West Street, Patterson. Thanks Paula Please consider the environment before printing this e-mail. This e-mail and any attachments are confidential and are intended solely for the use of the individual to whom it is addressed. The communication may be legally privileged. If you are not the intended recipient or the person responsible for delivering the e-mail to the intended recipient, please note that any unauthorized use or dissemination of this e-mail and any attachments is expressly prohibited. If you have received this e-mail in error, please notify us by telephone at 845- 278 -2110 or by reply e-mail. If you are not the intended recipient, please delete the original transmission and destroy all copies. ALLEN BEALS, RD, J.D. Commissioner of Health ROBERT MORRIS, P.E. Director of Environmental Haft June 4, 2013 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Telephone: (845) 808 -1390; Fax: (845) 278 -7921 PW Scott Engineering Peder Scott, P.E. 3871 Danbury Road Brewster, NY 10509 Dear Mr. Scott: MARYF'.L EN OD19LL County Executive Re: Complete Application Determination for Ahern (T) Patterson, TM 3.20 -2 -98 East Branch Reservoir Basin The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and revisions received by this Department on May 22, 2013 is complete. The Department will notify you by June 24, 2013 of its determination. 0 The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ❑ Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed approved; subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 808 -1390 ext. 43148. R pectfully, oseph S. Paravati Jr., P.E. Assistant Public Health Engineer JSP:cw PW Scott & Architecture, PC _ 3871 Route 6, Brewster, NY 10509 845. 278.2110 Fax: 845.278.2166 www.pwscott.com pwscott2 @comcast.net Letter of Transmittal To: Michael Budzinski, PE Date: May 13, 2013 Director of Engineering Putnam County Department of Health 1 Geneva Rd Brewster, NY. 10509 Re: Ahern Septic 43 West Street, Patterson We are sending you: ■ Attached ❑ Under Separate Cover via the following items: ■ Drawing(s) 0 Letter(s) ❑ Sample(s) ❑ Plans ❑ Change Order(s) ■ Application Form Copies Date Pages Description 1 5/13/13 4 PCDOH NCR Form CP -97 (Construction Permit for Sewage Treatment System) — Revision (Signed) 1 10/31/96 1 PCDOH Design Data Sheet Subsurface Sewage Disposal System Form 1 N/A 1 PCDOH LA -97 Form Letter of Authorization (signed original) 1 N/A 2 PCDOH PC -97 Form Applicstion for Apprival fo Plans for Wastewater Treatment System (signed original) 1 5/2/13 1 PWS Septic Expansion Review 1 N/A 1 House photo (8'/z x 11, color) 1 N/A 3 House Sketches (as purchased 2000) (first and second floor, from owner) 4 5/3/13 1 SP (24 x 36) (stamped and signed) These are submitted (as checked below): ■ For Approval 0 Approved as Submitted ❑ Re- submit Copies for Approval ❑ For Your Use /Records ❑ Approved as Noted 0 As Requested ❑ Returned for Corrections ❑ Return Corrected Prints ❑ For Review & Comment Remarks: Copy To _ Signed P.W. Scott wscottl cvcomcast.net Jim Engineering & Architecture, P.C. www.pwscott.com 3871 Route 6 845) 278 -2110 INVAIN , _ Brewster, NY 10509 FAX (845) 278 -2166 May 2, 2013 Ahern Septic 43 West Street Patterson, NY Lot #10 Van Cleef Estate Tax Map #: 3.20 -2 -98 (T) Patterson The following is a review of the system to expand from 4 to 6 bedrooms. Existing 406 Primary 406 Reserve Percolation Data: 1" drop in <7 minutes Required Field Size: 450 LF primary &reserve Extra Fields Required: 44 feet Proposal: Primary Add one trench above original designated primary area with a length of 58 LF which will fit beyond 20 feet setback from the residence. Reserve The 44 feet of reserve is proposed at'the corner of property beyond the 25' house setback in 2 runs of 22 feet above and below original "reserve now primary" septic area. Refer to attached sketch layout. Final drawings shall be submitted once PCDOH reviews concept. With Regards, P dew Scott Peder Scott, P.E., R.A. President ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E. Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 MARYELLEN ODELL - County Executive TO: NYCDEP DEPARTMENT OF ENGINEERING AND DESIGN REVIEW ATTN: FROM: DELEGATION STATUS •ql SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM DELEGATED New Application Renewal ❑ PROJECT: LOCATION: TOWN: DATE SUB'D APPROVAL -?f -i - l NOTICE OF COMPLETE APPLICATION DATE: DELEGATED I L LUC;A TI ON MAP SCALE:1 " =500' '13 NO2 ".;6 W I- .4' 0 \ \ A (4W) 1 #; `s i ` DECK / t .F 6 BEDROOM 1 I "d: 1 ,>:•� HOUSE 1, it "I 452.50r 4 G'.. BSMT: 443.90 ' 'a SE �r: 451.50 PTI 500 �XI TyVG 140 GAIL 1 i � Kc l5FPT1C TANK. 1% $ILT SCE l n -v1 11 01.1 m �r. z1� - -- 150.�fr- — 7819 p. fN mod r� ri o .�•sti�— „ �x STREET WE T SURVEY NOTES: HOUSE AS —BUILT LOCATION DEPICTED FROM BERGENDORFF COLLINS SURVEY. SEPTIC SITE PLAN C- /� A I F- -1 )) -7 r, 'H A -At -Au1I \Ai 150,06' V\/Fl I 5�' NOI ° 10 00 W 78.19' n r n -7- 1 /\ A 7") r- A. m A N I I` °° Air, 1 -A AII w 150,06' - -- w y, ,, NOI ° I O' 00 "W -5-r 78,19' 5- rlt f ccDTlr` APFA DI ANI x mrx t a LOCATION DESCRIPTION FROM POINT A B 1 ST 43' -10" 37' -8" 2 ST 47' -3" 34' -6" 3 DB 37' -10" 50' -0" 4 DB 42' -3" 53' -9" 5 DB 46' -10 '57'-0" 6 DB 51' -6" 61' -3" 7 DB 56' -8" 65' -6" 8 DB 62' -3" 70' -4" 9 DB 67' -4" 75' -0" 10 TRENCH -P7 71' -9" 122' -6" 11 TRENCH -P6 67' -8" 121' -7" 12 TRENCH -P5 61' -10" 116' -5" Y 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FO ATMENT SYSTEM PCHD CONSTRUCTION PERMIT # ��- 0 VP Located at T� ��Cs �'E Y�C-� Town or Village Owner/Applicant Name P�,ec H44 f;2t1 (tA_ ->Tax map Block --Lot Formerly VQ/1k M_'-4 Subdivision Name � ,-�- f��1�m'l 3�'2e- nr, Subd. Lot # Mailing Address �� qk't_ fb 1 ��Yt/i'i{ S'� ; / Zip K° _(b % Date Construction Permit Issued by PCHD��/ RW Separate Sewerage System built by 6161'�J ifG( Address (!�p f /�' � li � \ r ` � r "� Consisting of fZ� 7 Gallon Septic Tank and +p6 l-T r� ��`Fit� "&t-tdJL --,9 (7 Royv Other Requirements: Water Summly: X' Public Supply From btlhr&�- i%�;- trt`C-c-: Address or: Private Supply Drilled by Address —t Building Type Re- So'df4- AtikCA Has erosion control been completed? Number of Bedrooms `f" Has garbage grinder been installed? 4G 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 acc ce with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations o e utnam Compartment of Health. Date: ( l S i `- *Z Certified by Address n, I Raive C , Rr�-'w P.E. iC R.A. License # 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 are ubject to modification or change when, in the judgment of the Public Health Director, such revocation, tlio( fication& change is necessary. By: /�✓� Title: Date: 1 /4-,l White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PE GE TREATMENT SYSTEM- MR PERMIT # n Located at 43 West_ Street Subdivision names o r s e t H o 110 w E s Subd. Lot # 10 Date Subdivision Approved 1998 Town or Village Patterson Tax Map 3 .2 0 Block 2 Lot 100 Renewal Revision Owner /Applicant Name Dorset Hollow Builders 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 - 9 2 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 1250 gallon septic tank and 406 L- F of aA4" 4j;je - -re.lc 7 row P SA L o % reseruC- Other Requirements: To be constructed by Dorset Hollow Builders Address 15 Town of Patterson Water Supply: X Public Supply From Water District West Hollow Rd., Brewster, NY Address or: Private Supply Drilled by Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment sy3Lem described above will be constructed as shown on the approved amendment thereto,and in accordance with the standards, rules and "regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. X R.A. Address 3 7 1 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 considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved for discharge of domestic sanitary sewage only. I: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM i� l(�,,, Q 1,L 1 I de4:S Owner or Purchaser of Building brsrs-e t- (40 11_>►n, b L1 i Building Constructed by Location - Street Building Type . ,ZU Z (4- Tax Map Block Lot �C1 —F'f `C'ri—S TownNillage L"brse-c- yaNQ E!�t _6c5 Subdivision Name 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 t e occupa of the building utilizing the Day (-� Year "O Owner) - Signature Corporation Name (if corporation) Address: UeC,L 1461(( RA, gretiv"5 -(C3-- State 1`VY Zip /qf �) Si Title: 8 W 4 f'r, Corporation Name (if corporation) Address: S� State 4l (' w AG1, Zip Form GS -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION " Date: Inspecte y: 1, 61) Street Location 5 rZi5�E.T Owner Z>,OV54-T .%LGDu/ BoI4aigg-s Town l�,¢TTEx S o,� Permit # P— 2 6- o o TM # 3 Subdivision Lot # / D 1. Sewage System Area a. S I'S area located as per approved plans ........................... b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ........................................... . d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from grater course / wetlands ...... ........................ ........ II. SeN age System a. Septic tank size - 1,000 ....... 1;25 .........other ................ b. Septic tank installed level ................ ............................... c. 10' minimum from foundation .......................................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box -properly set ........... ............................... f. Trenches c es en required _ Length installed2 2. Distance to watercourse measured * iv d Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 -1 %Z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped ........................ ............................... g. _ umR or Dosed Systems 1. Sizes pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ........................................ : .......... :..... .. 6. Cycle witnessed by H.D.estimated flow /cycle........... III..HouseBuildin a. House located per approved plans.... ............................... b. Number of bedrooms ...............` v IV. Well / da,v•.•, 5 f v�ve�...... a. Well located as per approved pfans ........ .................... b. Distance from STS area measured ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... 11/13/00 13:29 PW SCOTT 4 19142787921 NO.023 002 b PU7 NAM COUNTY DEPARTMENT OF HEALTH DIVISI 3N OF ENVIRONMENTAL HEALTH SERVICES ATTENTION Ci ADAM A GENIE REOUES? FOR FINAL INSPECZON For: Fill All information must be i illy completed prior to any Trenches inspections being made.' PCHD Construction P nait # a Located: iF3- � - (T} (V)� Owner /Applicant Name :: wip5mv Qk ' e )%2-V Block '}- Lot (° 0 Formerly: (him 1,94 _ r�4f0t6&A! Subdivision Name: Q mot- v✓►/ TS t'rtre3 Subdivision Lot # j Is system fill completed? �YIA Date: Is system complete? _ _ Date: 0 Is system constructed as per plans? # o S•ee PAV-S Is well drilled? Date: Is well located as per plans? N Are erosion control mea; ures in place? I certify that the system(s) , as fisted, at the above premises has been constructed and I have inspected and verified their completion in accordance with the is PCI ID Construe ' Permit and approved plans and the Standards, Rules and Regula ' s of a Putn unty Department of Health. Date: j ° Certified by: V74-17 PE X RA b)esrgii'Professiona1 Address: Comments: r, CxsHt rccc, ter- sw;-t c4 psi rr M 7 0 res451rw -eySt tt+i s-t,'t( weets aff - <e_t4A cz `�Qli,Ir cs Form FIR-99 I NORTH 1I1M�Srt' - _w01'10'00 11W 551't2E�1' 78,19' SUI2N�Y O� :I'1201'�12fY FWFAMP F012 ANI: NUAI,A MFI2N ,. L01' NO. I O A9 5HOWN ON 'FINAL 516171VI510N FLAT OF VAN QE�F ESTATES" 'rCWN Oro FAMI?50N rUrNAM Co., N.Y. 5GALF, s III — 50' AUGU5'' 22,2 011% c01'ma -tf 0 2000 TE Y MMONVO1FF COLLIN5, ALL laaW51- 5eRvrlp NOVEM M 26. 2000 (CURT-5) cm1 lmw.'f0; LIAM & NLIAI.A A-ERN, & VECEMMR 2. 2000 ( LFVATB) NA TI SFMIt7ARV A GAG�.CORP .IT5 c- e5'501� AJJ17 /.00rc /SIGNS . Pt20:11 fLE .:Aciew F012-OL12 RrmA LIcNAnONAL 1111:�:INSl6ZANCE'60Mi'ANY °, .. ,' JOD N0.1205DLIf7C G; \�AVNINGS\51 U?�IV\ 1205�131b \fzOStil O.t7WG) j< "t—WIADOOS I.i-r o bf 5 #33 ,V OT re :)CAZ-,c "C- Li I �s DO w el T-' a -PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PE GE TREATMENT SYSTEM PERMIT # "00 Located at 43 West Street Subdivision names o r s e t H o 11 o w E s Subd. Lot # 10 Date Subdivision Approved 1998 Town or Village Patterson p� Tax Map 3 .2 0 Block 2 Lot 1zW V Renewal Revision Owner /Applicant Name Dorset Hollow Builders 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 • 9 2 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 1250 gallon septic tank and y0( t-F of 24" wiAe 7-re.vc�P� lc 7 row -, P Jib LF) aj l00 reserlic Other Requirements: To be constructed by Dorset Hollow Builders Address 15 West Hollow Rd.; Brewster, NY Water Supply: X Public Supply From or: Private Supply Drilled by Town of Patterson Water District Address Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. X R.A. Date !V 1 -,?Doo Address 3 7l 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 w n onsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe pproved ischarge of domestic sanitary sewage only. By: Title: C / `LG �� Date: 0111�1 6_u White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 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, New York 10509 1_2 sMRI o03 �T H WOIU rZaL DATE it r� 0 � � Boa NO. A rTEN rION RE: Septic As —Built (z�,+, �,Z> WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: • Shop drawings Cl Prints ❑ Plans = Samples ❑ Specifications • Copy of letter ❑ Change order .❑. COPIES DATE NO. DESCRIPTION 1 1 Certificate of Construction Compliance 3 1 Guarantee of Subsurface Sewage Treatment System 3 1 As —Built Septic Plan Fee: $200 THESE ARE TRANSMITTED as checked below: �X For approval i ( For your use ❑ As requested ❑ For review and comment ❑ FORBIDS DUE REMARKS ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ Resubmit copies for approval C Submit copies for distribution C Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COP'( TO J�.p,, '(JI "l SIGNED: 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 # 10 (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 PCDO)-yfor use to meet the demand requirements for the subdivision. Very Edward Bloes G &E Development PO BOX 352 BEDFORD, NY 10506 14 -16 -4 (2/87) —Text 12 PROJECT I.D. NUMBER 617.21 SEOR Appendix C State Environmental Duality 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: (formally Van C l e e f Estates) Municipality Patterson. County Putnam 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) Lot 110 - Dorset Hollow Estates (formally Van Cleef Estates) 43 Wept street, 1�c�,i�erso�, Ni 5. IS PROPOSED ACTION: El 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 AFFECTED: _ Initially J acres Ultimately 0..9 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? 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. OR 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 THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /sponsor na P.W. Scott , P . E . , R.A. Date: 7 I-00 1 � 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 11— 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 8. 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-05? 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 EAF and/or prepare a positive declaration. ❑ Check. this box' if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Name of Lead Agency � . 11 Print or Type Name of Responsible O ficer in Lea Agency Title o Responsi A f'f r er W 41 • n ' $ �i J Signature of Responsible Officer in Lead Agency Signature of Preparer (If differenVt?6fh' fi, si l fifer/ Ad V 1. 1 2 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 (914)278-6130 Fax (Q14) 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 OWNERS NAME: E911 ADDRESS VERIFICATION FORM Dorset Hollow Builders Lot 10 TAX MAP NUMBER: 3.20 -2 -98 43 West Street E911 ADDRESS: Hatterson TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) DATE: z3 /Go 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 VERFRM) W BRUCE R FOLEY Public Health Director LORETTA MOLINAAI . RN., M.S.N. Associate Public -Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New ; York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 = 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914).278 - 6648 TO: DEPARTMENT OF ENGINEERING'AND DESIGN REVIEW DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM JOINT REVIEW PROTECT: TOWN: �A) NOTICE OF COMPLETE APPLICATION:. SUB'D APP DATE: Z DATE: • Within the drainage basin of West Branch or Boyds Comer Reservoirs. • Within 500 feet of a reservoir, reservoir stem or control lake. • Within 200 feet of a watercourse or a DEC wetland and appearing on a subdivision map approved after December 31, 1992. • Design flow greater than 1000 gallons /day. (QV) 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 C(Attached ❑ Under separate cover via ❑ Shop drawings ❑ Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ DATE Li -12 o� I' d l - O � � 8 A 50e NO. 99— 1 5 9 ATTENTION Hobert Myrri6 RE: �j J Dorset Hollow Estates —L�-t, /0 (formally Van Cleef Estates) Subsurface Sewage Treatment System (SSTS)' Application for Approval of Plans (PC -97) I ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION I Application for Approval of Plans (PC -97) I 1 Construction Permit for Sewage Treatment System (CP -97) I 1 Letter of Authorization (LA -97) 1 2 Design Data Sheet (DD -97) I House Plans (2 sets) 2 1 Letter from G & E Development,LLC, Re: Public Water 1 1 Check for the amount of $ JW,p6 1 1 Short Form EAF THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested X7 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 1 Septic Site Plan Drawings I 1 E911 Address Verification Form (E911 Verfrm) COPY TO SIGNED: ( Z&94 If enclosures are not as noted. kindly notify us at once. PUTNAM 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 # 10 15 West Hollow Road Brewster, New York 10509 Dorset Hollow Estates 2. Nameofproject: ( formally VanCleef Est)3. LocationT/V: Patterson 4. Design Professional: Peder W. Scott, P.E., R.'�.. Address:3871 Route 6 6. Drainage Basin: East Branch Reservoir Brewster, NY 10509 7. Type of Project: X . Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted X 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... No 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 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: 1898 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 19. If es name of water Supply Town of Patterson byrsystem yes, pp y Distance to water supply 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 j- l y- 9 6 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 GPD 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 27 2s 2 Is any portion of this project located within a designated Town or State wetland? No WetlandsID Number ............................................................ ............................... N/A 29. Is Wetlands Permit required? ............... Individual . . ..Lo.t ........................... ............................... Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No 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 DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... No N/A No No No Yes Water' Only No 36. Tax Map ID Number .......................... ............................... Map 3,.io Block A Lot cig 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 1.,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 statements made herein are punishable as a Class misdemeanor pursuant to Section 2.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: Mailing Address: ................................... v er W. Scott Agent for Applicant 3871 Route 6 01 :6 WV 'I 88V 00 „ Brewster, New York 10509 Is ?r�'T,I' D= ��`7Z' CF a : u=� Di'T?S =C:V CF .4Vz %OSDS ZO 'zt,:.:'t...^. Ste_ /3.V BI.CC- J Zct J . ne =ez z CCSS Seel-) tµ..:.�_ � � r P�f- r�- -%,LSOn/ Wat =-"- er GR�Ti1 N • ��;C✓%,�^';CiV 'I'�.' 1' L,a. �.'? � :�.,�'I.'� � �. �?.,c.I'_"� . ;v"_"� �� = ��_'I' =CyS G4' ., 10 rat- or P-n-` along Date or Pa—_= at=c n Test. /0 151 LOLL irl'�ST L„�' �► _T'. � � n••` P!T M— 1 CL\ T C Run �.I.d 58 i `r^ rY I:eDt:"1 to . fYat CZ er T cv; 1 WdT.._ .,+.,. � e. No. •• T .-�e Gra nd Surface. 2n ?-icc�es ' Scil S`t ax-t St`_cm Broo 1n Min/:n —L".. cp -i nd"1es Tn=* es Inc -'7es _ NG'LS : 1. nests to be re-c atea' at scup: deb, ih until a_ :.rccmate? y equal sca rats are' obtained .at eeca tae= =iat`cn tst hole.. 'Al'_ da .a be for review. 2. Depth ;rte _m=e:man:l.-z to be made trp of hale_ C7 7 i Z NG'LS : 1. nests to be re-c atea' at scup: deb, ih until a_ :.rccmate? y equal sca rats are' obtained .at eeca tae= =iat`cn tst hole.. 'Al'_ da .a be for review. 2. Depth ;rte _m=e:man:l.-z to be made trp of hale_ TEST PIT DATA R' LRID TO BE SUaHl= W=-L APP17 -7 ION DZSC=- P TON JF SOILS EL\1CCvi r�..• IN TEST HC_. J " DE:''TH ri0: E \lC. J EO=. M. r_OL IL C_ 0 G.L. 2' ! �.'lrr i y may' '. r�? i ✓�'w'�/Fy \� < c1A /i_ / //� Sl i /i 3� - I ' 5' i, v y, 8, 7 9' io INDICT L.nIF•.I, AT INMICi CRCUNUiz= IS r- N- COU=M - a INDi= Lrwrm To wMC_v WA=.% T•-"VEL RISES AFT'F.R B-TMN- G =NTL'RED D=- HOLE OBSERVATIONS MADE BY: DATE: %..- DESI&N Soil Rate Used _ .Min /l" Drop: S-D. Usable Pse Provided N6. of Bea,: owns L Septic Tank Caza- city %? gals. Tyre Absorption Area Provided By i7W L -E. x 24" width trencz Other Narre R W S607T .VGin�C�,I2iN6 Aec.yir� rit /. ¢ C ,r Ind Address rn u 1050 9 THIS SPACE FOR USE BY h`-UTH DEPA�"a ONLY: Soil Rate Approved : ft /gal . ' Czectied i�v Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Dorset Hollow Builders Located at 43 West Street TN Patterson Tax Map # 3.20 Block 2 Lot 9s Subdivision of Dorset Hollow Estates (formally Van C lee f Estates) Subdivision Lot # 10 Gentlemen: Filed Map # 2 7 7 1 Date Filed 12/24/88 This letter is to authorize P e d e r W. s. c o t s, 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 the Putnam County Sanitary Code. V Countersi ed•i - � Si 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 14 ) 2 7 9 - 13 3 9 Form LA -97 CI 0 f' May 31, 2000 2. %ew �, Department of Robert Morris, RE Environmental Putnam Co. Health Dept. Rrotection 4 Geneva Road Brewster, NY 10509 Re: Dorset Hollow. Lot 10 West Street Joel A. Miele Sr., P.E. Patterson, Putnam Commissioner East Branch Reservoir DEP Log # 10227 (Joint Review) Dear Mr. Morris: This letter is to inform you that the New York City Department of Environmental Protection (Department) has determined that the above - referenced application is complete. In addition, the Department has no objection to the approval of the above- referenced regulated activity. This determination is based on the review of submitted documents including the plan titled "Septic Site Plan Lot 10 prepared for Dorset Hollow Estates ", dated 04/17/00. The applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 at least 2 days prior to the start of construction of the SSTS so that a Department representative may inspect and monitor the installation. Sincerely, Margaret Lloyd, P.E. Supervisor Engineering Design & Review xc: James Covey, P.E., NYSDOH •��yO0.K CITY DEPA,? l F a2 a�N'HEMAL. PROTE�`. www. ci . nyc. ny. us /d @ P (718) DEP-HELP 465 Columbus Avenue, Valhalla, New York 10595 -1336 t . r BRUCE R FOLEY Public Health Director May 15, 2000 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 . N. Diu LORETTA MOLINARI -R.N., 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 PW Scott Engineering 3871 Route.6 Brewster, New York 10509 Re: Dorset Hollow Builders, 43 West Street, Lot # 10 (T) Patterson, TM# 3.20 -2 -109 Reservoir Basin .Dear Mr. Scott: The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on April 25, 2000 is complete. The Department will notify you by June 5, 2000 of its determination. ❑ The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ® Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by CertifiedMail, Return Receipt Requested. The notice would be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with Section 18 -23 (d) (6) of the New York City Department of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if DEP review and approval is required. If you have any questions regarding this matter, please call me at (914) 278 -6130 ext. 2166. Ve ly yours, Robert Morris, PE Public Health Engineer RM:cj TIV LL PrIc SYSTEAFSmc. EXCAVATING CONTIP 20 Ivy Hill Rd., Brewster, NY 105 Ai Liz 1 /I p- l '�o 2- LI i A rOrC-rJ7 (C+,O) liepuA 1 roRs (845) 279-8809 1-1 C;W . - -4-o ejZ:LL LL 60 AO K 02'k3' 561, W 150,06' t Q AMA - 0.918 NG. t w •�i su �o al 41,72' O gO.32' Q Gam, L. --A .9F' rL1:C. DOK `� r- C7e! ta-O6 35'51 V V L�J"T NOI' l0'00 "W 78.19' 7'd (;Prq —R /7 (Pt7R) I nP.CN I/( I 0 17. 1 1 1 1 on AnK l Nov UU 11 11:2(a Tyndall (845) 279 -5989 p.3 Property Details - Image Mate Online Putnam County A6G Image Mate Online IINavigation GIS Map Tax Maps Residential Property Info _ Owner /sales L t 7 nventory .Improvements_ Tax Info .Report. Comparables ORPS Links Assessment Info Municipality of Patterson, Town of SWIS: 1 372400 ITax ID: 1 3.20 -2 -98 Tax Map ID / Property Data Status: Active Roll Section: Taxable Address: 43 West St Property 210- 1 Site 210 - 1 Class: Family Res Property Class: Family Res Site: Res 1 In Ag. No District: Zoning Code: Residential Bldg. Style: Colonial Neighborhood: 00906- School Carmel District: Legal Property 00100000050030000000 005600000000000006568 1 -5- Description: 3/3.20-2-20 2011 - Total Equalization Tentative Acreage /Size: 0.92 Rate: 100.00% 2010- 100.00% 2011- 2011 - Land Tentative Total Tentative $68,800 $454,900 Assessment: 2010- Assessment: 2010- $68,800 $478,800 2011- Full Market Tentative Value: $454,900 2010- $478,800 IDeed Book: 1539 Deed Page: 496 Page 1 of 2 Help I Log In Photographs No Photo Available Maps View Tax Map Pin Property on GIS Map View in Google Maps View in Yahoo! Maps View in Bing Maps Map Disclaimer httn: / /Dutnam. sdp-nvs.com /DrODdetail.asr)x ?swis= 372400 &i)rintke... 11/9/2011 Property Details - Image Mate Online Grid East: 736008 Grid North: 976084 Special Districts for 2011 (Tentative) Description Units Percent Type Value Dorset hollow water 1 0 0 Garbage dist 1 0 0 Park district 0 0 0 Patterson light 0 0 0 Fire #1 0 0 0 Dorset hollow dist 1 0 0 Special Districts for 2010 Description Units Percent Type Value Dorset hollow water 1 0 0 Garbage dist 1 0 0 Park district 0 0 10 Fire #1 0 0 0 Dorset hollow dist 1 0 0 Patterson light 0 0 0 Land Types Type Size Primary 0.92 acres Page 2 of 2 http://Putnam.sdgnys.com/propdetail.aspx?swis=372400&printke... 11/9/2011 Property Details - Image Mate Online Putnam County _ Image Mate Onfine Page 1 of 1 Navigation GIS Map I Tax Maps III ORPS Links I Assessment Info Help Log In Residential Property Info Owner /Sales Inventory_ .. Improvements Tax Info Report __ _ Comparables Municipality of Patterson, Town of SWIS: 1 372400 Tax ID: 3.20 -2 -98 Ownership Information Name Address Liam Ahern P.O. Box 651 Patterson NY 12563 Nuala Ahern P.O. Box 651 Patterson NY 12563 Sale Information Sale Date Price Property Class Sale Type Prior Owner 12/19/2000 $331,612 311 _ Res vac land Land & Building G & E Development Llc Value Usable Arms Length Deed Book Deed Page Yes Yes 1539 496 Photographs No Photo Available Maps View Tax Map Pin Property on GIS Map View in Google Maps View in Yahoo! Maps View in Bing Maps Map Disclaimer httn- / /nrntnnm erlanve i-.nm /nrnndi -tail aernr7evvie= '17')AOORrnrintlrP 11 /9/7()1 1 Property Details - Image Mate Online Putnam County "G, Image Mate Online Page 1 of 2 Navigation GIS Map Tax Maps ORPS Links Assessment Info Help Log In Residential Property Info Owner /Sales Inventory Improvements Tax Info Report_ _ _ _ Comparables _ Municipality of Patterson, Town of SWIS: 372400 Tax ID: 1 3.20 -2 -98 Structure Building Style: Colonial Number of Baths: 2 (Full) - 1(Half) Number of Bedrooms: 4 Number of Kitchens: 1 Number of Fireplaces: 1 Overall Condition: Good Overall Grade: Average Porch Type: Porch Area: Year Built: 2002 Basement Type: Full Basement Garage Cap.: 0 Attached Garage Cap.: 0 sq. ft. Area Living Area: 3,400 sq. ft. First Story Area: 1,856 sq. ft. Second Story Area: 1,232 sq. ft. Half Story Area: 312 sq. ft. Additional Story Area: 0 sq. ft. Three - Quarter Story Area: 0 sq. ft. Finished Basement: 0 sq. ft. Number of Stories: 2 Photographs No Photo Available Ma View Tax Map Pin Property on GIS Map View in Google Maps View in Yahoo! Maps View in Bing Maps Map Disclaimer http://putnam.sdgnys.com/propdetail.aspx?swis=372400&printke... 11/9/2011 Property Details - Image Mate Online Utilities Sewer Type: Private Water Supply: Comm /public Utilities: Gas & elec Heat Type: Hot wtr /stm Fuel Type: Gas Central Air: No Page 2 of 2 htti):Ht)utnam. sdv,nys. com /-Proi)detail. aspx ?swis =3 72400 &printke... 11/9/2011