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HomeMy WebLinkAbout0188DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.10 -1 -28 BOX 3 - 0 11 1,1,7. �, '7!11. ' Tl� 1 16.1 = - �, '7!11. ' = = PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: S . Quaker Rd. Town/Village: Patterson Tax Grid # Map Block Lot(s) Well Owner: Name: Address: West East c/o Scott 20 colonial Dr. Danbury,Ct. Use of Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 20 ft. Length below grade 1812 ft. Diameter 6 in. Weight per foot 17 lb /ft. Materials: X Steel _ Plastic _ Other Joints: _ Welded X Threaded _ Other Seal: X Cement grout _ Bentonite Other Drive shoe: X Yes No Liner` YesX No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First NONE Yes No Hours Second Well Yield Test _ Bailed _ Pumped X Compressed Air Hours 6 Yield 15 gpm Depth Data Measure from land surface- static (specify ft) 10 During yield test(ft) 305 Depth of completed well in feet 305 Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 10 6 Soil 10 305 6 Granite,Mica If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type Sub Capacity 8 Depth 300 Model Mey rs Voltage 230 Hp 3/4 Tank Type WX25 0 Volume 4 4 Date Well Completed 8/4/99 Putnam County Certification No. Well 10 Pump 15 Date of Report 8/4/99 Well Driller (sign tyre) r /J{ NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller's Name Maqq Bros. Address: 162 Bak r Rd . Roxbury, Ct Signature: 0_%" Date: F I'l' White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 N F.a N a. B G � A� v B, E. G' F d' y E/ p F� r, ©L DB L 0 4 rgENGH PLAN 6C41,6- / "= zo , 0'6�AKER MANO�e tor 4 A5•o!J /1-r rA ,01E OF P16r M695 NOrE : Powr T /3 ON GOMmoN PROPERTY uA/E mr6 4- # Ar EAST o,eop5gry 4 1NE ar OOMMON lJ,el1/E PO/Nr P 15 400 FEET FR ,fit PDiNr r P0/Nr O /5 53a F�Er FROM PD/Nr r PD /Nr K /5 A eErgegNG6 PD/Nr 99.5 93.0 97.0 90.5 75.0 70.0 45.0 100.0 550 5/-Z /o5.0 S4.5 59.0 61.5 105.40 109.0 73.0 76.5 80.0 Ble•0 BB. 5 /50.0 K A' . /Z/ 5 K q 34.5. k *' //7.0 Pa' /Z /•D K G' 114.0 K P' /10.0 P y1 /33.5 /< E' /09.0 P T' 1¢40.0 K F� 1o5.O l< /02.5 , w r 3 9- K ,q' 1,01-5 w z Z x 4- S K ,r' Yt z 5z Pa ' J15.0 P e' 114.5 PC' 119.0 Pa' /Z /•D PE' 12¢• 6 pfd' /3o•p P y1 /33.5 P r' /370 P T' 1¢40.0 LOCATION MAP `''CAL-V: ('o 1001' SOUM OUAKER Hitt ROAD 51E 0 N �a Or N0. 0 ER MANW VL5VN15/ON LEG MAP ND. Z4 78 z 1250' ,— d•s9a64 ' d: wo.sv L= icBA2' / I 9 / �IrB 407 NO. 3 O QUAKE&C MANORS .51) OV15 /ON /o f /GEP MAP NO. 2G78 / r45EME/VT o / / o / / / PAVEP ZOAD / / d /h / /oP / DRIVE WAY / �jGvELL 2 67DRY / /T ha P�4ME AM' F: WF111 oQ SSAYS / W /7g" 20o• o� 4.Ftt -Y � a I. oI IO w N ti I 2.150 0 � tor NO-6 N \ A I OVAKER? MANO-v 500MV151DA/ Vv1 RUP MAP NQ ZG78 ( L DT N0.3 QVAKERI' MANOR- SUBG/V15/OR P74E17 MAP NO. Z&7.6 Lof 4 Bv3\ AMA, b. Z3 AGKESt \ — ti J eN h 76 I °-� 'M9M iM�MMi !lPiM1MiM5ltN:MaMtllAtM:tMSMi M3M'o.11? 1 y a0 `� � � PUTNAM COUNTY DEPARTMENT OF HEALTH \ DIVISION OF ENVIRONMENTAL HEALTH SERVICES n;�` o CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SE MENT SYSTEM PCHD CONSTRUCTION PERMIT #, ` 9 7 Located a . (2zL "t' ' 1) R.b Town or Village P w Owner /Applicant Name J J p Block — Z9 Lot 1 �iST € � ax Ma 7t (6 Formerly �`� P�'�' � T Subdivision Name (2;) G('I Lr Subd. Lot # Mailing Address Zip a �$Z/ Date Construction Permit Issued by PCHD rq 7 Separate Sewerage System built by &e-At,, ti, a., Address .Consisting of i ��° Gallon Septic Tank and 00 _ r a r sodium (Na) is m W. er containing more t x.. r Other Requirements: pt�cta I y people on, severely restricted sodium diets. Water containing ` more than 270 rng/L of sodium sho',lid not ®e useu vy PcuP=v, u== Wafer Sup&: Public Suppl Ar rt _sodium dks. pUAa &.JssCOUNTY DEPT: OF HEALTH or: Private Supply Drilled by VP A-G-r_ &r Address k�p Xw' . C� _ 1 Building Type Vtw- b tft Has erosion control been completed? Number of Bedrooms ! Has garbage grinder been installed? certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Date: 6 c 1, � Certified b - Address / 9 )WAfj4 ,-� A' 0 County Department of Health. P.Fk" _ R.A. Professional) E /ion 2Y 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 revocations od ficationfiAchange is necessary. By: Title: �/ f���� � Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 -- -- id L1,7.211 vi. :1'i'i !'C8Li11 rh liU, iu, !`i216 *;u)1 P, L BRUCE R FOLEY Public health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LQRM7A MOLTNARI RN., USX. Anocjate Public Health Director Director of pattent Services Eariroaweatal Health (914) 278.6130 Fm (914) 278 - 7921 N urslnR Services (9141278 - 6558 WIC (914) 278 •6678 . Pax (914) 278 -6085 Early laterveatiaa (9 14) 2', 8 - 6014 Prtschool (914) 278 -6082 Fax (914) 278 - 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN- 90F:. ���snr1 AUTHORIZED TOWN OFFICIAL: '?2 (Signature) DATE: The tutnam 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. (E91I ERFW) Julius I. Cesare, P.' E. 19 Washington Cour Pawling, New York 12564 914 -855 -3208 FAX 914- 855 -3216 June 19, 2000 Bruce Foley, Director Putnam County Health Department ATT : Robert Morris 1 Geneva Road Brewster, New York 10509 RE: Quaker Manor Lot 4,As. -built Dear Mr. Foley, Herewith transmitted is a completed As -Built Package for the above noted project. Thank you for your cooperation. Ver truly Julius I. Cesare, P.E. r "EAL I 4r i LABS NORTHEAST LABORATORY OF DANBURY 39 MILL PLAIN ROAD - DANBURY, CT 06811 CT Cert: PH -0404 (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: PROPERTIES EAST L.L,C. 20 COLONIAL DRIVE DANBURY, Cr 06811 SAMPLE SITE: SAMPLING POINT; SOURCE: TREATMENT: DATE SAMPLE COLLECTED: 6/9/2000 TIME COLLECTED: 12:00 P.M. COLLECTED BY: T.S. DATE RECEIVED @ LAB: 6!912000 TESTED BY: LAB# 11471 REPORT DATE: 6/16/2000 LOT #4, QUAKEk MANOR, PATTERSON, N, Y. KITCHEN WELL NONE TEST PERFORMED RESULT: MAXIMUM CONTAMINANT LEVEL BACTERIAL: Total Coliform (Bacteria) 0 per 100 ml 0 per 100 ml PILXSICALS: Color - 0 15 Odor . ND 3 Units pH 5,79 no designated limit Turbidity 0.12 NTTJs 5 NTUs CHEMISTRY: Nitrite N <0.005 mg/L as N 1 mg/L as N Nitrate N 5.50 mg/L as N 10 mg/L as N Alkalinity 34.0 mg/L no designated limits Hardness 116,0 mg/L no designated limits Iron <0,03 mg/L 0,30 mg/L Manganese <0.01 mg/L 0.30 mg/L, [Note: Combined Limit for Iron plus Manganese = 0.50 ing/L] Sodium 52.1** mg/L 20 mg/L ** Lead 0,003 mg/L 0.015 * ** nil = 110iliter mg1L = nullignams per Liter ND = none detected NTU =Units ' *Notiricaoon Level *"Action Level RESULTS BASED ON SAMPLES SUBMITTED: 6/9/2000 SAMPLE, AS TESTED ABOVE: UPOTABLE or NOT POTABLE (PER NEW PORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) a Laboraton, .Director . ?:ORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (''60)81`.) -1WU TOLL FREE WTTHTN CT- 800 -826 -0105 • OL7SIDE CT- 800 -654 -1230 MAY -12 -99 WED 15.:5 -7 "CESARE -ENG... 914 278 3666 P.01 PUTNAM COUNI'Y .D1'Wl')ARI "l lL�'N -1' OF HEALTH DIVISION OF ENVIRONMENTAL SEIRVZCES GUATIANTET OF SUBSURFACE SEWAGE TREATMENT SYSTEM ja-�� Owner or Purchaser of Building -Tax Map -Block I.ot Sit: poq ive -h Building Constructed by TownlVillage SI Glxp cr, C�, el 'p-0 Qua-61- _ 011r--- Location - Street Subdivision Name Building Type 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 constricted as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnatxi County Deparimrrit 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 yean, immediately following the date of approval of the "Certificate o,fConstruction 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 sys0.`ni to operate was caused by the willful or negligent act of the occupant of the building utilizing the systcrn, Dated: Month Dav __ Year _ _ Signature: Title: General ' ntractor (Owner) - Signature Corporation Name (if corporation) Corporation Name (if corporation) Address: State _ -� lip Address: State Forty (;�." " MAY— '12 -99 WED 13:37 "CESARE— ENG... 914 278 3635 P.01 PUTNAM COQ NI TY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL I-111.1A LTII SERVICES GUA TIANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building T ax Map -Block l.ot S � �_U� — —.... Building Constructed by Totivn/Village Location - Street Subdivision Name "0 F Ic Building Type 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 constntcted as shown, on the approved plan or approved amendment thereto, and III accordance with the standards, rules and regulations of the Putnam County Depttrrmcnt 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 year immediately following the date of approval of the "Certificate of Construction Compliance" for thr 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 %vhether or not the failure of the sN swin to operate was caused by the %N,illNl or negligent act of the occupant of the building utilizing the systcrn. Dated: Month j.V' -- Day 12-f Year 2 0 00 Signature: - - -•,- Title: General Contractor (Owner) - Signature Corporation Name (if corporation) Corporation Frame (if corporation) ,address: �..f `_`�l ULAA,0 �� .— _ _ Address: State lt&rrf'ggg F /faS//. lip 12 f %d State Forii, �iS- _ NE NORTHEAST LABORATORY of DAN13URY 39 MILL PLAIN ROAD - DANBURY, CT 06811 CT Cert: PH -0404 I+AiI►S (203) 748 -7903 - FAX (203) 748 -0652 NY Cert:. 11471 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: PROPERTIES EAST L.L.C. 20 COLONIAL DRIVE DANBURY, CT 06811 SAMPLE SITE: SAMPLING POINT: SOURCE: TREATMENT: TEST PERFORMED BACTERIAL: Total Coliform (Bacteria) PHYSICALS: Color Odor pH Turbidity CHEMISTRY: Nitrite N Nitrate N Alkalinity Hardness Iron Manganese Sodium Lead DATE SAMPLE COLLECTED: 6/9/2000 TIME COLLECTED: 12:00 P.M. COLLECTED BY: T. S. DATE RECEIVED @ LAB: 6/9/2000 TESTED BY: LAB# 11471 REPORT DATE: 6/16/2000 LOT #4, QUAKER MANOR, PAT'IERSON, N.Y. KITCHEN WELL NONE RESULT: A ND 5.79 0.12 <0.005 5.50 34.0 116.0 <0.03 <0.01 52.1 ** 0.003 ml = milliliter mg/L = milligrams per Liter "Notification Level * "Action Level MAXIMUM CONTAMINANT LEVEL per 100 ml 0 per 100 ml 15 3 Units no designated limit NTUs 5 NTUs mg/L as N 1 mg/L as N mg/L as N 10 mg/L' as N mg/L no designated limits mg/L no designated limits mg/L 0.30 mg/L mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] mg/L 20 mg/L ** mg/L 0.015*** ND = none detected NTU =Units RESULTS BASED ON SAMPLES SUBMITTED: 6/9/2000 SAMPLE, AS TESTED ABOVE: DOTABLE or CINOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) .t Laboratory Director •NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 /1 MAY -12 -99 WED 15.:57 "CESARE— ENG... 914 278 3656 PUTNAM COUNTY DEA'ARTINIENTOF HEALTH DIVISION OF ENVIRONMENTAL 1111"AL'I'll SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or }'urchaser of Building V —CP t i C Building Constructed by kw R-o Location - Street V VOd0 Budding Type Tax Map .Block I.ot ! Cr Z7 To-wnfVillage Subdivision Name Subdivision Lot # P.01 1 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, aisd hereby guarantee to the owner, his successors; heirs or assigns, to place in good operating condition any part of said system constructed by nie which fails to operate for a period of two year." 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 Healtlt Director of the Putriazn County Department of Health as to whether or not the failure of the 5N-stem to operate was caused by the willM or negligent act of the occupant of the building utilizing t13c systerl Dated: Month Day _ Year General Coitractor (Owner) - Signature Corporation Name (if corporation) Address: State _ - Zip Signature: Title: Corporation Name (if corporation) Address: State Furir tip -��- PUTNAM COUNTY DEPARTMENT OF HEALTH a DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Date: 6 0 Inspected y: Street Location :50a?7u WAAECOR M&I Tea Owner W-0 -r EST '7t gAA-r Tn us Er Town Permit # - 2_c TM #_ 4, /0 -- ! -A0 Subdivision Lot # if "qua kcr N)aa¢r 1. SewaLye Svstem Area a. STS area located as per approved plans .............. .............. b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System a. Septic tank size - 1,000 .... ....1,250 .......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 T.-Te-n-g—th required Length installed y1O0 2. Distance to watercourse measured -V i Oo Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 - 1' /s" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... PoIiN ends capped .............° Pum r Dosed Systems '--+--Size ot pump c am er ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... III. House/Building a. House located per approved plans ..................... b Number of bedrooms .......................... .. . .......... IV. Well a. Well located as per approved plans. b. Distance from STS area measured f o'Z.o o 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 & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ... ............................... i. Erosion control provided ............................. :.................. Rev. 6/97 -I.icknowW 6 receipt " ,6f this i _s re GNATIM: 02196 Title: �Aev. -P-,tJT�NAM-�COUN-T-�Y-DE-PARTMENT'OF'H:EALTII 'DIVISION OF ENVIRONMENTAL HEAT SERV­ic J i IELWACT ViTy PORT I -RE "v ME: -NA - �Tfi i IF AT�T'RFC4: Street T_ i ..— PERSON: N-CHA G E- ­ VTF_XW TYPE OF ,.FA - FINDINGS, P Of kA: AA 77( 4 r Q _!rVT -Signature and Title -I.icknowW 6 receipt " ,6f this i _s re GNATIM: 02196 Title: �Aev. 4� �14 Sheet of -PUTNAM COUNTY DEPARTMENT OF HEALTH t DIVISION 'OF ENVIRONMENTAL HEATLH SERVICES ACTIVITY REPORT- . . N A�rF:['�( <' - l''lA1�f D TPt• AT�T�RFC4� J:Se lyl fF; Street = Town z€ State Zip PERSON IN CHARGE INTER WIFT). - Name and Title, TYPE OF FACILITYJ��yt� UP FINDINGS�� c a ". F o k r _ - -' :-• _ INSPECTOR Signature and. Title -. RFPOR RRC FTVFT RV:' ; I - acknowledge Teceipt ofthis report: SIGNATURE: 02 / 9 6 Title. = 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 (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 Date: © v To: 17a-1-111-5 Gi--�-5 A>Z E lRe, S,, Qy.4 Kg.2 i4l 2c, W, From: Gene D. Reed Putnam County Department of Health X_ For your information For your review As discussed Fax #: 6 3x-16 No. Pages o2 (Including cover sheet) Please respond Attached as requested Please call Notes/Messages �J �/S� CTloff/ GcJ 1PG E Tt c 6W We5-C& 4c, :, no Al ©/V 4-6 ac-111,1- c 111, In the event of transmission /reception difficulties, please contact this office at (914) 278 -6130 ext. 2261. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SE MENT SYSTEM PERMIT # Located at So 047!( Qt. vy-a' #7th ,�.� Town or Village P� Subdivision name Q L,, /� -to, Subd. Lot # � Tax Map l(I Block ' Lot Date Subdivision Approved 1 267 A? t Renewal Revision Owner/Applicant Name ° ` -" `' 7 pp i/1��') �1�-s J� �c '�a Date of Previous Approval �U►.��.- Mailing Address '� Ce �o nc� �R . �,�•�t�ua,, CT- _ Zip �d�� Amount of Fee Enclosed Building Type Lot Area�,7-1 No. of Bedrooms T Design Flow GPD Fill Section Only Depth 2. Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 2Sa gallon septic tank and 6 od I TX — Other Requirements: -- ---� To be constructed by Water Supply• Public Supply From Private Supply Drilled by Address 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. 'f/( 2C ✓ R.A. Date 4 G Add s 6 V AZ�,w,� � Qa r,,-y* /M /o 9 License 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. By: Title: Date: Vi►'hite 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 J DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner )/\/e)1- . ,vY> Ld,C Address -?4 Located at (Street) Tax Map �`LGd Block Lot (indicate nearest cross street) Municipality �/ U Drainage Basin SOIL PERCOLATION TEST DATA r Date of Pre - soaking �% S Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Mi Time n.) Depth to Water From Ground Surface (Inches) Start Stop ' Water Level "Dropp In Indies Percolation Rate Min/Inch 4 5 3 17 4 5 1 , 2 of NEW 109 3 4 5 NOTES: 1. Tests to be repeated at same depth until app oxi tely Cju '!6itiAtXh rates are obtamea at each Percolation test hole. (i.e. s 1 min for 1 -30 mm/inch, s 2 min fo 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 Locariokj A44P I' =/000' �y joy N = NN QUAKER MANOR SUBDIVISION LOT N° 5 U565 SUS' E 61L� Jr�oG��r1 dry �r 1T �,Uuc*, / L .E h Off' ti �l 680 % yq0 ALL INS' o sp % "o' - QUAKER MANOR SUBDIVISION LOT N2 3 780 7_90 SPECIAL NOT _800 i WHEN FILING BUILDING IN FILED WITH D4fum - ej0 PROPOSED \ X20 �' ssos .� _ WPROP ELL 0 / N/F OHARA / / m �5 °44'03 " E 76.28 0 S A I represent that 1 am. wholly and completely responsible for the design and location of the proposed systemts). If that the .separate sewage disposal system, above A•ser'itied will be'constructed.as`sho,rn on the approved amendment there to and in accordance with the standard; rules a ,rogu ions o e .0 n m County Department of ,H4Ntti; 'and thaYoncomplotion thereof a I-C• tificato of Construction ComplNnce ". satisfactory.to ihe`Commissioner of Health will - be submttt•0 to the t)epartiheht, and a -written `guarantee will be furnishal the owner, his wcpssors, nsirs w assigna by aM•buiWar, that sold buiWr will place in good operating condition any,,,part of said swinge disposal system during the period of two M7. lmmadNt•ly followteq "tMdata:ef,tM'iau amp of the apparel of the Certificate of 'Construction Complia a oI tM original system or any repairs thereto; 2) that M• drilled well d•aptt1W above wttl b• located as shown on the approved Plan and that said well will nstaligd in ti or ci ,wit e' standards, rues and ra4u „a�i oiT n; . of the Putnam County Department of Heatth`. Date q Sgn P E:', R.A. Address r + 21I Ucenso No. APPROVED -FOR - CONSTRUCTION :- Thit- approval.exp!as.two,y rs r he date .i ad: unless. eonstructi n of the building'has bosh undartalten and Is revo4blo for ca use p r may be amended or modified when consider a ry byPt onlrniss'iorier of'Heatth. Any change or alteration of construction E nqulr•s a new it pprove0' "f Or disposal of- domestic sanita ago and rvatawater supply only. Z Rev. 10/88 era %� sy Title 0 _, ti DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL . PCHD PERMIT Xzt --77 WELL LOCATION Street Ad4ress .S', LlAw, ttt Town/Village/City Tax Grid Number P Su.v /o WELL OWNER Name 6 'j'L Mailing Address Zc> Colom,AA1c PA- `r_Uj .s'�r KP 6F-ft Private 0Public USE OF WELL primary `r_ secondary )P- nSIDENTIAL _0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT S gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGEOF_z�a gal REASON FOR DRILLING E3 REPLACE EXISTING SUPPLY O TEST /OBSERVATION LE ADDITIONAL SUPPLY AU-NEW SUPPLY NEW DWELLING GI DEEPEN EXISTING WELL _ DETAILED REASON FOR DRILLING WELL TYPE DRILLED 13DRIVEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES ?�-_ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: a NZrJ- 4 o'hid-S Lot No. WATER WELL CONTRACTOR: Name Address:. IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED /1 lqqj ON SEPARATE SHEET r (da e) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within third* (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of. the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drill' ,;kq operations be contained on this property and in such /a manner as not to degrade or othe i cont minate surface or groundwater. Date of Issue• U 2-F 19 A" Date of Expiration 19,074 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller BRUCE R. FOLEY Acting Public Health Director DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278-7921 July 22, 1997 Julius Cesare RD #7 Blackberry Hill Brewster, NY 10509 Re: Proposed SSDS: Quaker Manor Lot #4 (T) Patterson Dear Mr. Cesare: Review of plans and other supporting documents submitted at this time relative to the above - captioned 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 regard." "You are referred to Article 128.1 of the official compilation of Codes, Rules and Regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You should contact city Officials in this regard." 1. Minimum distance from a septic tank to a well is 50 feet. 2. Two fill plans were submitted, three is required. Upon receipt of a submission, revised to reflect the above, this application will be considered further. V truly yours, fJ� Robert Morris, P. E. Public Health Engineer RNVjp ---FT PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 94pe(G 2. /9 9eS Re: Property of Wr--%T r-Wr(' A--�aL7z,, �2c,s7�� d� fir, 9 c-.TT' Located at c o l PJu,4e,:�t A/ /I 2D. (T)_ YAcro,o Section /o Block, /. Lot a".r 2,,' Subdivision of (911A41 R,4,yoR Subdv. Lot # Filed Map # Date 2G 78' Gentlemen: This letter is to authorize - GlApr a duly licensed professional engineer '1-11 or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards,. rules or regulations as promulagated by 'the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter.and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed Countersign Owner of Property . P-E., R.A. , 24 Address _ &ear S A// Address Telephone Town '2-,e-3 -7 y2 - �7 6 Telephone 24. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. X 25. Has SPDES Application been submitted to local DEC Office? ............... 26. Is any portion of this project located within a designated Town or State . wetland? .................................. ............................... ° 27. Wetland ID Number ........................ ............................... 28. Is Wetland Permit required? .............. ............................... Has application been made to Town or Local DEC Office? .................. 29. Does project require a DEC Stream Disturbance Permit? ................... 30. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ........ YES or NO .31. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO DESCRIBE: /(v 2. 2: 4 Is there a local master plan or file with the Town or Village? :.......... ° 3. Are community water, sewer facilities planned to be developed within 15 years? :. Are any sewage disposal areas in excess of 15� slope? . rl.�Yt5* -''.. � ....... 5. Tax Map ID Number ............................ .......:....................��0 28' 5. Approved Plans are to be returned to: Applicant Engineer r the application is signed by a person other than the applicant shown in Item 1, the Dplication must be accompanied by a Letter of Authorization. ,Failure to comply with this rovision 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 Hisdemeanor pursuant to Section 210.45 of the Penal Law. _ GNATURES & OFFICIAL TITLES: ILING ADDRESS: v pe"� ew G A, spa w- �t~ PC -1 P U T N AM COUNTY DEPARTMENT O F H E A L T H APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: 2 4. M 20 C�lofft.4./ YRIW Name of Project �v , /y% *,- SQ )-I- S'S OS 3. Location T /V /C: -t- IPA4�410V Project Engineer: �.1 X111' �_ 6;*,? brt - 5. Address: 4.4-c .'4" A// License Number: �� Phone:'Z?'F �7 //I' Type of Project: k Private /Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status'(Check One) Type I.. Exempt Type II. Unlisted X 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. / 9. Has DEIS been completed and found acceptable by Lead Agency? ............ •, 10. Name of Lead Agency 11. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? .......... 12. If so, have plans been submitted to such authorities? 13. Has preliminary approval been granted by such authorities? '"Date Granted: —' 14. Type of Sewage Disposal System.Discharge...... Surface Water "/ Ground Waters 15. If surface water discharge, what is the stream class designation ?........ 16. Waters index number (surface) ............................................. 1.7. Is project located near a public water supply system? a 18. If yes, name of water supply ^' Distance to water supply -' ;9. Is project site near a public sewage collection or disposal system ?..... o ,0. Name of sewage system jj Distance to sewage system 1. Date test holes observed A_ 22. Name of Health Inspector: ke-K 3. Project design flow (gallons per day) ...... ............................... ° 11/93 PUI'NAM. COUNTY TY DEPARTME NT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT- CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PU NAM COUNTY HEALTH DEPARTMENT TO: Commissioner of Health In the matter of application for: represent that I am an officer or employee of the corporation and am authorized to act for 4Vej- f. (Name of Corporation) having offices at _ ZO 6® e o� M Whose officers are: Name and address) Vice - President: (Name and address) Secretary: r' (Name and address) Treasurer: (Name and address) and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this Z ?'day Signed: of rr� NotRy Title: is � Corporate Seal o6rell, 20 -SUBSUFACE SESIAGE DISPOSAL SYSTEM FILE M. --MoAlor Address. -Po ma baosg- at a t (Street) QjNjee'r Sec. Block Lot Undicaee nearest cross street) (S r:twiicipality Slatersbed Orc )4o), S0Z PEROOLUMN MT DATA REQUMM TO BE summm wait Appmayrims on )aLe of Pre - Soaking J* 01 Date of Percolati* Test 110M JUMM" CLOCK TIME MCOLATIM PM100=0N No., 'Time Start-stop klim � 1 I- 5 Y 2. 3 Water Fran Surface stop*. In Inches'- Soil Rate Drop, Ifi, MO Inches k - R� Q, 4 b t t% 5 Cat. .1980 A t A. )TES I Tests.Eo be repea�W-at same depth until apprcocimately eqtarV&1-1-- are obtained .at, each :percolAtion test hole. All data t0*.Ly3 subftitttd for review. 2. Depth neasuramfibi be node from top of hole w.. 9/65 T PIT DATA. J ^ . IQOi OL �^JOUVI "i rR1ErD � I�, i TEST .rF� HO HOME h0. HOLE I10. 3 OLE N 611 pw 1.211 2411 3011 y 3611 421t. � , 481.1 `� 11• Y r u � I N1 ' FFF 6011 : L. _Y w ry b, t N� 1 �T i�`�1�f3'��•+$h:�;�Cr,yy�f� ' u�9 � t } } f v }� , #c s •, �S,c ( 1 - 1 . 8 1 i . 0 r INDICATE L.�'VEI� AT kJHLCH. GROUND: STATER IS ENCOUNTERED INpICA�TLA �LEVEL TO WHICH '.WATT' LEVEL` RISES' AFTER BEING Soi'l`Rateli1 §edsz���Min/1 "Drop` S D Usable Area `Provided �ucc yr No of Bedrooms, fFw ' Septic :Ta_nk Capacity CZ,�ti Gals.' Type Cs n!C Absorption; ren Area rov a t c Other ., 2 S Ft,LC. ., C�.�.1 A � �r /� • f I�0:1 G R.I;.crt� I c-U r(1R ;b j 4'x{1 - ✓, -�`� 6� lE• J1'� ry( r I. , l C .SE P, A '�FA r'_T PEWOLATION TEST DATA r i t!Amn VC VG4 Kr-_4 M A"JGl? C) 7i� .+�`,��r�i l�.i •�. DATE :1Y ?f'1q 1-')At2u -J6- Inspector A,y (,,:; LA L T t. »L Lot 110. Teut Isola No. Teat Bole Depth Soil Type Soaked TEST RUNS 1 2 3 JG tl r F 10--07- #0 .0(.k iZ: 1 S t:: �t t C'. U i it: LH It . sy W 0:1 T *I m.4 h m(Ov // (�C tl YF S F z:00 12'. Cs" IV.Oq S, ID.I t0'. t— tt:SW 12 -'. -" 12: 0:5 T1 3 U 14 P 14 mW mwf -)_ ro. ;t .Ct4t S � —P UAKOL, F T , 5� ` .t �G S j S- F I z. C 12'. i & 2�i: tZ:3j: It: ' :► S : t iZ: •t i2 y: iP T :,+� ►� v►r N q m,:,. 3 'h M t:,r '3 3/0 m m, n (- 3t7 j `� F 10`: Lit# 16n. 6 10. l�• g. S 114 10 ..12.. 10'. q -7 T min) i rt �,,. :-, i� M N •. `> 3 Luw ?O F IV S-3 :3.: jZ: s(s : 30 S j? - :SF. 1Z:54:•ii T ;:I z . ;ej 1 s/40 1-rt.N F' S T ` 11 30 ly S F F .Z il' o IZ: tO I� ai S c5" u : i tl �a rZ 11 T 17 ; mOP p mid% F S T F S T F S T Z049A the undersigned, certify that these percolation tests ,are done by myself or under iky direction according to the standard procedure. The 'uCa and results resentad are W correct. �� OF YO?t 8 )aced: Si nature OOF iccnse No. 4'11 PROFESSION ) BRUCE R. FOLEY, R.S. Acting Public Health Director f DEPARTMENT OF HEALTH bivision Of Environmental Health Services ✓L(�S �7 4 Geneva Road, Brewster, New York 10509 V (914) 278 -6130 U4. 5q, vie- Re: Pro osed SSDS: Dear Review of plans and other supporting documents submitted at this time relative to the above - captioned 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 regard." "You are referred to Article 128.1 of the official compilation of Codes, Rules and regulations of the State of New York, Title 10, relative to the need for approval of individual sewage disposal systems by the City of New York. You should contact city Officials in this regard." Upon receipt of a submission, revised to reflect the above, this application will be considered further. Very truly yours, Robert Morris, P. E. Public Health Engineer RNVjp watershed APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET for CONSTRUCTION PERMIT STREET LOCATION NAME OF OWNER BY B. HEDGES R.MORRIS OTHER DATE TAX MAP # DOCUMENTS. Y m PERMI-TAPPLICATION L-- MELLPERMIT W PWS LETTER m IN_EER AUTHORIZATION m A SHEET(DDS) m - RESOLUTION CD PL SETS m OUS - TWO SETS m VARIANCE REQUEST SUBDIVISION m LEGAL SUBDIVISION m SUBDMSION APPROVAL C m PERC RATE *- CE M FILL REQUIRED__3_�_DE M CURTAIN DRAIN REQUIRED GENERAL m Y m EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE m IF PUMPED PIT & D BOX SHOWN & DETAILED m HOUSE - NO. OF BEDROOMS m WELLS & SSDS'S W/IN 200 FT. OF PROPOSED SYSTEM m PROPERTY METES & BOUNDS m HOUSE SETBACK NECESSARY (TIGHT LOT) m HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE m NO BENDS; MAX. BENDS 45° W /CLEANOUT FILL SYSTEMS m CLAYBARRIER m 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE m FILL SPECS m FILL NOTES m FILL CERTIFICATION NOTE m DEPTH GAUGES m FILL PROFILE & DIMENSIONS . m VOLUME m FILL IN EXPANSION AREA EX- APPROVAL SODS ADJ. LOTS m WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH m DATA ON DDS PLANS & PERMIT SAME m LF TRENCH PROVIDED X60 FT MAX m PRE- 1969 - NEIGHBOR NOTIFIFICATION m PARALLEL TO CONTOURS m LETTER BI/ZBA m 100% EXPANSION PROVIDED m 100 YR. FLOOD ELEVATION REQUIRED DETAILS ON PLANS m SEWAGE SYSTEM PLAN - (NORTH ARROW) m SSDS HYDRAULIC PROFILE m GRAVITY FLOW m CONSTRUCTION NOTES (GRINDER NOTE) m DESIGN DATA: PERC AND DEEP RESULTS m TWO -FOOT CONTOURS EXISTING & PROPOSED m DRIVEWAY & SLOPES CUT m FOOTING /GUTTER/CURTAIN DRAINS m EROSION CONTROL; HOUSE,WELL, SSDS m EROSION CONTROL NOTE m PERC & DEEP HOLES LOCATED m REPRESENTATIVE OF PRIMARY AND EXPANSION m LOCATION MAP SEPARATION DISTANCES SPECIFIED ON PLAN FIELDS m 10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL m 20' TO FOUNDATION WALLS ffi 15' WELL TO P.I m 100 TO WELL, 200' IN D.L.O.D., 150' PITS m 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) m 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER m 10' TO WATERLINE (PITS -20') m 50' INTERMITTENT DRAINAGE COURSE m 200 FT. RESERVOIR, ETCH 150 FT. GALLEY SYSTEMS m 15' MINTOC. D. S= >5 %,201- 4 %,251- 3 %,301- 2 %,35' -1 %,100' <1% m 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. SEPTIC TANK m 10' FROM FOUNDATION; 50' TO WELL COMMENTS: APPENDIX 3'/ PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS RE /IE S FAT for CONSTRUCTION PERMIT STREET LOCATION 111 NAME OF OWNER BY B. HEDGES R.MORRIS OTHER DATE TAX MAP # DOCUMENTS. r Y NL L� RMIT APPLICATION / d�L 02A -1 ELL PERMIT �WS`L R G ORIZATION SI S ORATE RE UTION GrJYK _ [ PLANS E SETS [ HOUS S A RIANCE REQUEST SUBDIVISION LEGAL SUBDIVISION r [ SUBDIVISION APPROVAL C ECKED [ PERC RATE [ FIL � [ RTAIN DRAIN I D GENERAL [ EX- APPROVAL SSDS ADJ. LOTS Y [ EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE [ IF PUMPED PIT & D BOX SHOWN '& DETAILED [ HOUSE - NO. OF BEDROOMS [ WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM [ PROPERTY METES & BOUNDS [ HOUSE SETBACK NECESSARY (TIGHT LOT) [ HOUSE SEWER - I /4 "/FT. 4 "0; TYPE PIPE [ NO BENDS; MAX. BENDS 45° W /CLEANOUT FILL SYSTEMS [ CLAYBARRIER [ 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE [ FILL SPECS [ FILL NOTES [ FILL CERTIFICATION NOTE_ [ DEPTH GAUGES [ FILL PROFILE & DIMENSIONS [ VOLUME [ FILL IN EXPANSION AREA [ WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH [ DATA ON DDS PLANS & PERMIT SAME [ LF TRENCH PROVIDED [60 FT MAX [ PRE- 1969 - NEIGHBOR NOTIFIFICATION [ PARALLEL TO CONTOURS LETTER BI/ZBA [ 100% EXPANSION PROVIDED [ 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS FIELDS [ SEWAGE SYSTEM PLAN - (NORTH ARROW) [ 10' TO P.L., DRIVEWAY, LARGE TREES 7 TOP OF FILL m SSDS HYDRAULIC PROFILE [ GRAVITY FLOW [ 20' TO FOUNDATION WALLS T 15' WELL TO P.L [ CONSTRUCTION NOTES (GRINDER NOTE) [ 100 TO WELL, 200' IN D.L.O.D., 150' PITS [ DESIGN DATA: PERC AND DEEP RESULTS [ 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) [ TWO -FOOT CONTOURS EXISTING & PROPOSED [ 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER [ DRIVEWAY & SLOPES CUT [ 10' TO WATERLINE (PITS -20') [ FOOTING /GUTTER/CURTAIN DRAINS [ 50' INTERMITTENT DRAINAGE COURSE [ EROSION CONTROL; HOUSE,WELL, SSDS [ 200 FT. RESERVOIR, ETC.[ 150 FT. GALLEY SYSTEMS [ EROSION CONTROL NOTE [ 15' MIN TO C.D. S= 15 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -I %,100' <l% [ PERC & DEEP HOLES LOCATED [ 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. [ REPRESENTATIVE OF PRIMARY AND EXPANSION SEPTIC TANK [ LOCATION MAP =I O' FROM FOUNDATION; 50' TO WELL COMMENTS: SSDS DESIGN REPORT QUAKER MANOR SUBDIVISION LOT # 4 QUAKER MANOR LOT 4 PUMP DESIGN 4 Bedroom Design Design Flow: (4)(200 gal /bed.) = 800 gallons Field Length: (See Design) = 600' Dosing Volume: (pi)(2/12)2(600)(.75)(7.5) = 275 gal. Maximum Dose Permitted 100 gal. Use 90 Gal. PUMP PIT SIZE Use 4 x 6 (180 gal /vert Foot) 90/180 = .5 (6 ") Storage in PUMP PIT Required storage 1 Day Flow = 800 Gal. 800/180 = 4.44 Vert Feet = 415" PUMP Losses Static Head Pump 1 Outlet - DB 61.9 Use 2" Force Main Length of Force Main 344' EQ Pipe 2 45° elbow 2 x 2.5 = 5.0 1 Check Valve 13.0 1 Gate Valve 1.2 Total EQ Pipe 19.2 Total Length of Pipe 344' + 19.2' = 363.2' Total Length (363.2)@ 6.3 Loss /100' = 22.9 Total Losses 61.9 + 22.9 = 84.8' Use Gould WE 1512 HH 11 2 HP 100 THD @ 25 gpm 230V Single Phase 3500 RPM QUAKER MANOR SD LOT # 4 4 Bedroom Design Design Flow: 4(200 gal /bed) = 800 Gallons Perc Rate: 16 -20 Application Rate: 0.7 Req. Area: 800/0.7 = 1142 Req. Field Length: 1142/2 = 572 LF Actual 600 Septic Tank: 1250 Gallons RLI: 775.0 Use 10 lines, 60' for System 8 lines, 75' for Expansion 2.5 feet Fill Required Use Pump System Pump Static Head DB Inlet 837.40 Pump Outlet 774.50 PC1 - DB = 344' 61.90 — HAY-10-1,34 17:41 1 D: WATER = 1UPPL':' SD[i New York City Department of Environmental Protection Bureau of Water Supply rk Wastewater Collection Sources Division (914) 742.2012/3 Division of drinking Water Quality Control (914) 742.2080 465 Columbus Ave. Suite 350 valhJll&, New York 10595. 1336 Commissioner RICHARD D. CAINER, P.E. Deputy Commissioner D�P Julius Cesare, P.E. Blackberry Hill Brewster, New York 10509 Dear Mr. Cesare: TEL =;t-'I F'01 May 10, 1994 .,e: Quaker Manor SSTSs (T) Patterson, Putnam County The Department has inspected the deep holes, witnessed the percolation tests and inspected the sites for ten proposed individual subsurface sewage disposal systems (SSDS) for the proposed project. The lots are shown on the site plan labeled Final Plat Quaker Manor and dated 4/4/94. The ten SSDSs for lots 1 -10 meet the requirements of 10 NYCRR Appendix 75 -A. The ten sites as located on the Final Plat are approved for SSDSs. Requirements for final individual SSDS drawings for construction approval will follow shortly. Should you have any questions, please call: 914- 742 -2065. Sincerely, "�:W. Ja s Roberts, P.E. Program Engineer xd: Town of Patterson Planning Board Putnam County Department of Health APPENDIX 3` PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS . REVIEW SHEET for CONSTRUCTION PERM// IT . STREET LOCATION So v a Hi /� o/ . _NAME OF OWNER 464S BY B. HEDGES R.MORRIS OTHER T S. DATE 2 /ZPj 97 TAX MAP # gya -Z DOCUMENTS. Y J?ERMIT APPLICATION PC -1 m " e- WELL PERMIT M PWS LETTER nod- S � ,e j ENGINEERS AUTHORIZATION DESIGN DATA SHEET(DDS) v CORPORATE RESOLU LANS THREE SETS_ HOUSE PLANS - TWO VARIANCE REQUEST. Y =1 EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE P�T1GIFh">TRI.£ & D BOX SHOWN & DETAILED V BEDROOMS ? ED SSDS'S WAN 200 FT. OO 0OSED SS�TEMP � � ROPERTY METES & BOUNDS YY HOUSE SETBA CESS.(TIGHT LOT) = HOUSES E 4 "0• , E PIPE _ = ND BENDS 45°' LEANOUT no c eaxvt �s ------------- -.. ✓ S cwr� SUBDIVISION \ ) Cam, = LEGAL SUBDIVISION iii--- , ^ TM 1V • 1 SUBDIVISION APPROVAL CHECKED R. ILL = PERC RATE �' = FILL REQUIRED DEPTH DE = CURTAIN DRAIN REQUIRED =STANDPIPES GA 40 AL: SLOPE 3:1 TO GRADE = FILL NOTES GENERAL FILL IN EXPANSION AREA = EX- APPROVAL SSDS ADJ. LOTS = WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH � '1 DATA ON DDS PLANS & PERMIT SAME LF TRENCH PROVIDED =60 FT MAX = PRE- 1969 - NEIGHBOR NOTIFIFICATION ARALLEL TO CONTOURS = LETTER BI/ZBA 100% EXPANSION PROVIDED = 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS FIEL OH/SEWAGE SYSTEM PLAN ORTH ARROW) 0' TO P.Lz,, DRIVEWAY, LARGE TREES TOP OF FILL SSDS HYDRAULIC PROFILE TY FLOW 20' TO FOUNDATION WALLS 15' WELL TO P.L ONSTRUCTION NOTES (GRINDER NOTE) ��s = 100 TO WELL, 200' IN D.L.O.D., 150' PITS DESIGN DATA: PERC AND DEEP RESULTS = 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) TWO -FOOT CONTOURS EXISTING &PROPOSED = 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER iDRIVEWAY & SLOPES CUT = IV TO WATER LINE (PITS -20') / OTING /GUTTER/CUR ND S m 50' INTERMITTENT DRAINAGE COURSE OSI OU L SDS eS = 200 FT. RESERVOIR, ETC.= 150 FT. GALLEY SYSTEMS OSION CONTROL NOT = 15' MINTOC. D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' <1% EP OCATED = 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. SENTAT F PRIMARY AND EXPANSION S IC TANK = OCATION MARJ OfffO'FROM FOUNDATION 50' TO WELL `P p. ar oS k.Cr/ COMMENTS: (:"-I. 6 11 et-1 7 3 V- 4 �� qq? �30 LCI j4t, IN... A Julius I. Cesare, P.E. Blackberry Hill Brewster, New York 10509 914- 279 -7115 May 15, 1996 Bruce Foley, Director Putnam County Dept. of Health 4 Geneva Road Brewster, New York 10509 Att: William Hedges RE: SSDS Quaker Manor Lots 1 -10 Dear Mr. Hedges, We are herewith transmitting completed construction permit submission packages for the above noted 10 lots of the Quaker Manor Subdivision. This letter will serve as a transmittal letter for all 10 submissions. A copy of the letter will is included in each of the submission packages. In accordance with department requirements we are submitting the following: 1. A completed Construction Permit Application. 2. A letter of authorization for the Engineer for each lot. 3. A corporate resolution for each lot. 4. An Engineers Design Data report for each lot. 5. Three sets of plans sealed by the Engineer containing all the required data as outlined in the Departments policies. 6. As these lots are being sold unimproved but with SSDS Approval, we are not submitting specific house plans for each lot. Be advised the Lots 1 -8, and 10 are designed for four bedrooms and lot 9 for three bedrooms. We will advise buyers by providing copies of this letter that they are to provide you with house plans before start of. construction. 7. We are providing Well Permit Applications on lots 1, 3, 4, 6, 8, and 10. Wells already driven page 1 v m. will be used on lots 2, 5, 7 and 9.' Logs of these wells are herewith included. 8. A certified check in the amount of ,$3,000..00 to cover the combined fees on all 10 lots is herewith included. The field data for lot 5 would indicate that no fill is required for the system design and a two and one half foot fill required for the expansion design. The plans are presented as such, however the toe of slope for the expansion fill will encroach upon the now.to be constructed system. 'The two options are to build the system in fill or to request a waiver for construction of the expansion fill at this time. As the deep holes in the system area show more that sufficient depth it would not be good engineering judgment to construct a fill. We are therefore requesting a waiver of the requirement that the expansion fill be constructed at this time. Please be advised that during the course of the subdivision design representatives of the NYCDEP did visit the site, review all available test data and determine what additional testing would be required. All that testing was completed and witnessed by them and again by your department. A copy of the NYCDEP letter is herewith included in each of the submittal packages. Thank you for your cooperation in this matter. Very truly yours, Julius I. Cesare, P.E. page 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date P2 /L 2, /9 7./ Re: Property of ! QA-LT-;j rc-24,1 S C,,TT- Located at _Rol-:#- t QUA-1r-c 1A111 (T) "410-1y Section /o Block /. Lot 2 S- Subdivision of 0uteri RA.,YOA Subdv. Lot # Filed Map # Date Gentlemen: This letter is to authorize �J w��� c f / ,rS7 AfE a duly licensed professional engineer '� or registered architect (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Countersign P.E. , R.A. , 24 Address 9i 2 ?9 Telephone Very truly yours, Signed ` Owner of Property Address 'P 'c4'-o- -) c -_-C - Town '2-e-3 -7, - x'77 6 Telephone r�rrr�vli:u 1•� PCTrNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIROnIWAL HEALTH SERVICES AFFIDAVIT- CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT TO: Camnissioner of Health In the matter of application for: c cev- represent that I am an officer or employee of the gorpomtion ar�d am authorized to act for r (Name of Corporati n) having offices at 20 C-4 1"WIo-< `b2i1,c Whose officers are: President: (Name and 4d3ress) Vice - President: (Name and address) Secretary: (Name and`\address) Treasurer: (Name and addre-Ss4- and that I am and will be individually* responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto. Sworn to before me this Signed: '_ Title:j` corporate Seal 20 t i t� f Ji 1 r