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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.10 -1 -30 BOX 3 C1I1 o t { MAI 16 �� 1 g' '`'' C1I1 o t SHERLITAAMLER, MD, MS, FAAP . Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Dean Barrett 22 Quaker Manor Lane Patterson, NY 12563 Dear Mr. Barrett: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive. ROBERT MORRIS, PE Director of Environmental Health July 20, 2009 Re: Addition- Approval — Barrett No Increase in Number of Bedrooms 22 Quaker Manor Lane (T) Patterson,-T.M. #.4.10 -1 -30 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 20, 2009. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. . 3. All plumbing fixtures ' must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. 4. 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 other.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 your convenience. Respectfully, Joseph S. Paravati,-Jr. , P.E. Assistant Public.Health Engineer . JSP:kly cc: BI, (T) Patterson Environmental Health (845)278-61'30 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418_ Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 r . SHERLITAAMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Dean Barrett 22 Quaker Manor Lane Patterson, NY 12563 Dear Mr. Barrett: DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health July 20, 2009 Re: Addition- Approval — Barrett No Increase in Number of Bedrooms 22 Quaker Manor Lane (T) Patterson, T.M. # 4.10 -1 -30 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 20, 2009. The addition is approved with the following conditions: . . 1. The total number of bedrooms must remain at three without prior approval by this Department. 2. The area of the existing sewage, disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be. updated with water saving devices, i.e., new low flush. toilets, restrictors for shower heads and faucets, etc. 4. 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 other 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 your convenience. Respectfully, Joseph S. Paravati, Jr. , P.E. Assistant Public, Health Engineer JSP:kly cc: BI, (T) Patterson Environmental Health (845) 278 -6130 Fax (845)278-7921, Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 . Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845)228 -2847 . Fax (845) 225 -1580 PUTNA1V1 COUNTY DEPARTMENT OF HEALTH dOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, t4 , BEDROOMS. — ALL SUBSEQUENT REVISION/ ALTERATIONS TO 'THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL TURE & TITLE ` �y —DATE FIRST FLOOR PLAN SCALE 1L4' m V-0. ow. i m,'- -A 5A5EMEN`r FOUN17ATION PLAN GENERAL COMMONS NOTES: 6C,*JX 1/4' a r —o' SPE lW7f M TAM apaoMmfbm am melds In paned tams anh and net apOMM10 .. (1f _WW an b"rtg. TM owner In appying.these spbeftloatlom oaueta Complete ruwd hft for th* use, ahangaa, our ornbalwa SCOPE aF WM The Conhoebor dwell pravka al labor, ffmWAI , applfenow and o**nwd requked to complete al went a whewn an the dmMngs neasawy for a Complete Job. unfew othenrlm spealrled. Al mdrWl and wrMmwrhtp.ehal b• of good qudw. ONISSIONIb Al arNlt figures (Nobs ! anaaaam) an the gear plane or spealfloafbnp ohd tab proosdMe over any drawn 1fWrw (davaW4 Do net -0 Mote. Al dimensions must be v~ by the conbwdar before stet of .andruo0en. Any dleemporrlee on the plane or spedfloallone must In npmted to the Arehitgat prior to oo"*Vuetlan. COOE4: Ad week and WIN Is must aordarm to the bawl end dab buldfng 00" Naflond Board of Fin Underweiten, Nog Energy Canerwaan Code and r.gWrt rams or the Board of Hearth. 9470NAM Strad be hwbaRed aaaording to the manufGCWWe epatflea OML Ad Web shad comply wflh aipilaable wdbnr of the state and local coda and the genmaib aouepted dandor& a lsted o the dab buldlq coda OWNF]t�dP OF PLANS: Them Tana are the properly of NEWILl. Any um or repaduebon. In whale our In part, without hb wANm outhaAoutbn of NEWEAd Is pmhW W. Any prawn or aorporatim using plane wltlout peeper cAmtsatla+ all he responaRk to eempaab the ArehRoaR This plan In for the mnstruetlon of.ane bulidbtg only, EIt0 EER STATUS: En*wr has not been retained by owner to pwas peAWle Job bwepealarr of Job odtnoYlntlan. Purchaser of the plane shdi assume full rwaponemllitlse for any drf — r charges to thew plane. . CARPENTRY NOTES: otr�ir e • a assn' weer ■ w.,pr eery w ti ww r war . er,r u ttr Wk as a W, i�I TIM tr+ery Pr ya�rl IY. i�W Y Iw a. y ,,rrlrr...tr.rtr wnea�.iaa�r�a,►,q+rr Vtr +r iffliAR-H-1w. e r r —..% tr�r'w t""r��.%+"a�a �traa•� ~-a.dra r r "- O.W. At �: i."~i arcw a,r C�ir.oseo t� e-u r a�°1ie��iee.o�m itm�u NOW tta WW teary r ter as ,err arw err t.ew w . wr ale re r ..r . Won F. 0.14 wi.r.e°°wr w,a ,.�:�' nor lire trr`'iwr�i:a i e�w.wir nra�`ta:.�.r wjerr. e...,. amwa AND wstmr a.ar tw a..a reularr. ter true. wee.e SITE WORK: SITE WORN: Prwlda 2' bfaebtdap dlneey. 4' grand boar to street SWmdm to As X-0' wide 4' conarota or 1 -112' flog tons lald in and, from tiara to drhwey. PeovNe top oul and Drib. rood to all area dlsbabrd by the mnsOuctlon or al MISCELLANEOUS METAL• e�`n UAWM Al fraMng lumber to be drew geode Douglas Fir Larch No. 2 or bstbr. smu Shall aordonrw to Axrx wodflaotlan A-w for rhudbnd abd. FRANM ftomhV of the snits bullding elan be meted plum, lad and true, weuroy -lot FlIIC1f BEANS: Al dal plates dad Conform to A.M.N. specifications A-JB fr structural Joist, steels edn etal J dial be doubled e fm ail nderl�Ope. All gush houdel Mal .ter , Ilppigq hp graI�T =brgPu amp WP O' ass. eomtaetad wlfh melon Joint henpsea Dyable reamw under ed parfltlom parallel b frondrtp. Stec i U ;�fieNdi i�}' �itjg .`�01f. � d( '!= of Joist, sheathing and raRar era shown an the Mom. mac., 12' min. from comae and 2 bolt min pr old. Prodde sold doddng under ad pat, SU�� mil be J /4. 0 S B Werlor with afsrlor glue plywood read and "WMtf'['LANS APPROVED FOR BEDROOM COUNT ONLY, SHEATHING: ShO be 112' abrlr grads 0 S B mgW to ouch framing rranber. WOW W= k i aMft Whero .down an plane shat be pro aro treated No. 1 Souftwn lalln wm woad. Afl nods, bons and al metal Tassbninge to be valvarbed. .._ BEDROOMS 7Aiy ALL SUBSEQUENT REVISIONIALTERATIONS TO THESE HOUSE PLANS MUST BE-6UBMITTED l0 THE PCDOH FOR APPROVAL SHERLITAAMLER, MD,.MS, FAAP Commissioner of Health LORETTA MOLINARI, RIY, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT IS, PE, Director of Env n Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET, a / ,z �,�-�_TOWN TAX MAP #�D NAME PHONE [ 1J~ `�' �o� PCHD# MAILING ADDRESS o4 DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS 0 OSED # OF BEDROOMS / (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 accordance with applicable sections of the Putnam County t' Sanitary Code. . Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. ` 1. Certified check or money order for $ 100.00. 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 Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845).278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 2.78 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 SHERLITAAMLER, MD, MS, FAAP. Commissioner of Health LORETTA'MOLINARI; RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS,.PE Director of Environmental Health Town Legal Bedroom Count & Proposed Addition Status Re: (Owner's Name) Tax Map # 3d Address: Town: _LAN Year Built: According to records maintained by the Town, the above noted dwelling, is in compliance with Town Code.�� �d Is not in compliance with Town Code.. The Legal Bedroom Count is: This, information has been obtained from: Certificate of Occupancy: Other: Y&4 t The plans for the .proposed addition are considered: ^z New Construction Addition to existing house only J Teardown and /or re -build allowed under Town Regulations BuildiV Inspector Date 6 Environmental Health (845) 278 -6130 Fax (845) 278 -7931 Water Supply Section (845) 225 -5186 Fax (845) 235 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 . Fax (845) 225 -1580 MA I�I-�K)!T'1<''�"sll1T ?411! : ii(4'H e�l3,dr�t5oa S#reet:Address:. "Town/Yil(age Tax.(grid4 4M UL" Ttesi otial `�Paib3i ? y , ,: rt�a [nd iai insrifufionai Sm mot: Rt�tar3' Cable ?`' Cu�Wessedairpeirs�ssic ► i3th '(gx:afY) ,• � y r ... ..�?:� . {r''r''"'PiiFlr ii��i!ef�'R °'�ti7YlGl , `'Steel ASP doic: idea other 1u+e d} •.' �� K '� i SfA02r f.':z i '.i' +�iCS'.. :,r_'�av t'.r, a dlM1.'U a . ..' a.'• ;.` r T n ManiiAer (in) Slot Size Length(ft) Depth to: Screen' {$ I DevOaip ' °. irst Yos IQe -- „,. • , News �11i "HDiirS ty� •1 � T� �1'G�J L4 �^"""- j�L � � o '��. ;•B :'� ,its �' F rK�eli 'p`• a� '.fFYt�OII - . a - i i .• t %i yS ��it ki .le, .SM L' .. •` .. 2 f -rte, f�jN ipf� y�'61id vwas sted Feet tiatlo & Ptr' _. 'nuKe - .. /Storage Tank -i dbrmatio n 1 YL'YUI `, 11t11e: • '. .. }* �P�/u�mt �%Y`�l,Y.r. - , during Yir i g, ? • ' Mode( L 3 ! ,4www N ' -Exact OCati n of well Whh,distauces Coat iwn. ks.to be .provided an -a selaarate: ,p .. 'L .. .r i wL' / ^!i '� \_'• "` F. .r,.,.�..>' 'A :��D��lle;;.:�e�ow" 3' =�i� � ' Y -•�'_ :c�Rpy.:�:: .. hiteacu�y: Wes= - ;i.e+dat 3'ownorSriiiage l'V`S' ?lJlryfietl �'i�� 't F "ib'Vt- L s�;K S L,. 7Q L '``':clP ` 1 3:div�st�xi`Iame . Sabdi YOi..'rT,�• :• ../' !'I �•a',:.r rte' :..r. .. /'•i �t� I K7 -Lail mw icapa .'mess + •.. a .e .rw '.......«•.... .f- i C, *? 221 b u d? .iv ;x r. �:.,.7�msf�idae a`ah:e:ioria�d�. .. oaf:€ P we 1 iced b r t. 1 /Lis rn -r?ar' f CL r11n�;g;iises. eria'�r+eabouesYs.1Y:e Mamas e::nec�ary *WMt WOn t f. Any, - y'conditions; fz+om t tisane: pXovakafIhcacpnlc.sewage tt�a�a+�ict : sitem sIwi bwome'nth. andwoi"d. as soon as a publie sanitary sewer.beromes,,m s table:andthe,approvaI of:, a ivate w $r: ly : ati: �ec�aan ti Fvr�id when; a< ubiic s y: sue.- Such ' ppt�X�ais ane ,s bje,Gt zo: cation or dmge':; awn,:: an - lh�e;.� of-IbC ubiic ;idea ..:Dire ;such ;reuoc on, echo ang--ismecammy. pp ate `:cnpy- 1.F�1e,Yeilota�!.cApy 'ildigtsptotsaaZc;gopy ='ne; #UrapyrYes�g+n::rtiessioioal h� PUTNAM COUNTY.FBEAGTH DEPT 2 "130'- Brewster NY 10509 { 70 Received of �. ' The Sum Of' Dollars THANK -Y ai �Chec ❑ M O Fl Credif_Card By h� �r �i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P I `� Located at *Z2 .� , f-R Town or Village � c!/ Own ��p1iN� � �`�,^., 6 a s L� Formerly n,Ak-n !1 c& LL& '1A. Tax Map /D Block % Lot 3 D Subdivision Name ua a nv- Subd. Lot # 6 Mailing Address q-'7 e c� /�% -r o �a a 4 Zip Date Construction Permit Issued by PCHD e3 ct q Separate Sewerage System built by adit"1 Address /4-1 ✓ -J Consisting of Gallon Septic Tank and ?06 Other Requirements: Water Supply: Public Supply From. r Address, or: ✓ Private Supply Drilled by a Address Building Type 1409 Has erosion control been completed? Number of Bedrooms Has garbage grinder been installed? ./,6) I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and ulations of a Putnam County Department of Health. Date: ( a, Certified by P.E. ✓ R.A. (De ' n Prof9yssional) Address t,A-S c c,�L License # // 2 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 bject to modification or change when, in the judgment of the Public Health Director, such revocation, , odi icatio change is necessary. By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 jy1 I �� ku �y.r £, I ! � •� ,a 4�rF ! � , � t+ „��` � to-0— .l .. • � N,; � �� trT �;,� ti r i° �a� r M�:• � r �, ��Y ^s u a ���y � ,� � ! � � get -most, I_ ',C��' .iClio nr�l 14r .44 't�?J 1 W'a�; tldl ,l r I N y ,�. �t r `a: � a, + I :p a e .w " � ' 1 ' �•. t,, t ' Y ", � S Y .a ! • � t F d 4 7 y I �N. P $ rn �y re. M ( fl A S'� �l1 d ,•I 'S �Py'�. f C "`1 4 if ; ( d 9 Sh• i > t5 £.W ,e Y £"� 2 T 'S L '1 i 1 4 i H` 4 y Y lift ! d I''. WANG 2 t�4 -,{,. '. fog oil I.u'•' ft 1 �, Kb.0 ..y.( t `��. t r ".a J `� i I !' f,' !"." ✓ f`lS I A A opt low ! k 1 ,C 0 X1 + in "WO lot i1 ! I , i 1 } A k,.y :4 n ! • , 1 r W t j 4 4 77 :777 �n J T A J � Y T 1 I A Ply ,$ m Ask r . , PT Ia t+ I c r I " "`� ! Qon c !'aE�^ wF a { t� ,� ? ` w ! t + 3E { 1i1 t"'k�Ak{ 4� q , 'AJ/ lv. Ko. t t M J £ £ ! 4 a • i o y f ! .� 4 L o c Q -r / o Table of Distance-s, As:--BUilt Lot 6 Quaker Manor Pt M -ks on cornet of—Prop.q.,rty Line Between- Lots 6 & 7 and East 'prooek nine 6• Common Driveway (Quaker Manor; Lane ' Pt N is Stake on PropIy Line Between Lots 6 & 7 475 feet from Pt M Pt P, is Stake on Property Line Between Lots 6 & 7 .60.0 feet from Pt M NA 1.53 PA 77 NB 158 PB 82 NC 1.62 PC 87 ND 167 PD 94 NE 172 PE 1.00 NF 177 PF 106 NG 18-2- PG 111 NH 107 P'H 117 NI 192 PI 123 NA' 224* PA' 101 NB,' 227 PB' 1!05 lid' 23b. PC' 1.08 X32 PD' 112 �E' -235. PE' .11 .7 NF' 238 PF' 121 NG' .240 PG' 12.5, MP -20-- PH . '.-'13 <0:.. -N.I 246 PI' ::1-15. T �e Cerit.r of , -,',V- Center, of PP RT: -2 9.- - 9 T 36', RV 451 S-V 48, Y , 2F 4,0Z I 4ftvwv i Y _< 9g .yrn' lig s +nor t a: . �_ , � • ', - = . � _� , , . .'�O� 'Ott lot, Sri AM, f z ra , ..j Y. `s a ' „.. •.r .. s e. ,. �,. F � __ � • a ; jx�^n oil, v ' ;- '�� 40 s - �4 . vfii � �fx.� `�� `�. 'M1x e1-. 41i±�AtR01'. �'i4M�lllLfIP, °" ' • �a '�r;i < h.s �Ba - s4'.en y ° .'„-. "�r'� t '�', d° �," a.z- ¢*.ry,- .s i• a 4. VIVA van ps, W ✓e - - ^- .i 4-. not. t �. vr♦ �. vim. �'4y� �-. �. us -Vd i.. - ��.c, �•,; 'vp,.. �.„ h�. � � _ x.i .,1 - :.!. - nr,< .:. `�� `,g •`' .Yrr1 i -. :. F. ,.: .. b ..•i ,.,. .,x •. a s"" 3`•+g,y .ter.- -Tt .� w F;. ''�t' y ,s ,6 ` �g, f^ '; ; �•- s .s: _.s bit 7 OTAL A .RHA ILOT ...,r, -.• ,.> S "' ,nom .:¢., f`e`nce ��' '.s':' „af?.� to tG� J. nr yL," ^ sn - • '.v , �� i � \ � �"' �,� � � `: r $ .� w' z..':, r� . 4.• p (� a - Y s'is x :,, 'a .h : :'. .. ,., ,. z :.h :.. f.. n:..,,�i ° �: =i ,n e �.: :: =. �� a Yi.`S',e, v•'3 ..: ^� y N r All!2 f4 ' tiic E X. '•. �s. ' >. gr -� , -, ,:;. ,.�.. .,�. n, s ,s�, z. *,, � Pte. icy ejf S �f wr i qt ��€€ N .. ., . �>:a :.. ,.... .. ,'.�'a' i �.#_.• -, ' °:,.,i€..•,. .: °3 . - Qqy ya s 1 a� .J ��g ."'va"�� ��+°' c s r`��,5,• ¢, ^. � iW At �eE a In A - - g rd. _ L 3F ar. , 5 - < - , AW YX TOP till al OCT -10 -01 WED 15:21 "CESAR - __ 914 278 3656 P.01 i'AX FORM t'rom the OFFICE Of DATE: �i o .i ULT_tiS 1. CESARE, P.. E. �9 Washington Court Pawling, Law York 12564 PHONE 914 855 --;208 FAX 914 855 -3216 ' J TO: of i _tiff] ■ r Ll I ti- OCT -10 -2001 WED 16:12 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 f'UTN<- M COUNTY DIVISION OF ENVIRONNIFATAL HI ALT11 SERVI(. ES GUARANTEE OF SUBSURFACE, SEW'AGL' TRF:ATi LENT SYSTEM Owner or Purchaser of Building Building Constructed by �-2 � to a � t ��4 � o✓ oL-q ^Q Location - Street -e-CAabAw+r�. uilding Type C) Tax Map Block Lot ToxvnNillage 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 propertti,, 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 Vvo years immediately following the date of approval of the "Certificate of Construction Compliance" for the selvage treatment system, or any repairs made by me to such system; except � here 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 "l-Iealth Director of the Putnam County Department of Health as to whether " of the failure of the system to operate was caused by the willful or negligent act of the occupa t f the wilding utilizing the System. Dated: Month I Day 3 Year 6 r ek Signature: j General Contractor (Owner) - Si -anature Corporation N..me (if corporation) .1d- _lress:.— . - - - - -- - si.;tc -- -- __ Tip ... __ Title: . orporation Name (if corporation) 47 4 Address: State A,'<-7 Lily f 2 F S-9- BRUCE R FOLEY Pubkc Health Duet .,cr DEPART,*vffiNT OF, HEALTH 1 Geneva Road Brewster, New York 10509 LOR=A MOLD;ARI RN., &LS.N. rlsJociara Paolic Health D&ecrer Dweror of Pat;snt serviers $aviroameatal Health (9 L4) 278 - 6130 Fex (914) 278 - 7923 Narslnq Services (9141277.6351 WIC (914) 273 -6678 Fax (914) 278 - 608: Early Iaterveatloa (914) 278 - 6014 huchool (914) 278 -4082 Fax (914) 278-- 6648 `W2 I W- 1111 C 4 OLVITMI-84 1 VWX Ito \ M 1 a OWNERS NAME TAX 34APINUMBER: 30 E911 ADDRESS: AUTHORMXD TOWN OFFICIAL: (Signature) DATE: g , o� 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. (D 1. t VERrn41) PUTNAI4I COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES l013 tl FINAL SITE INSPECTION Date: 7 / � o Inspecte y: S,TeEgz Street Location-isa-rd ©aAkQZ %Ji _L 7A Owner Town P, *r2-E2z1, oti Permit # P — / -a - 9,7 TM #, /o - / — 3 a Subdivision Lot # 6 1. Sewage System Area YES NO COMMENTS 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. SeNyage System a. Septic tank size 1,000 ..... ,250. ...other ................ b. Septic tank installed level ................ ............................... c. 10' minimum from foundation ......................................... xaw, d. Dist Q :� a.e %►A= � efs`' 2 ,L!- cted below frost .................. .:............................. 3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set .......................................... 'nc f. Trenches i. Length required 900 Length installed `ADO 2. Distance to watercourse measured +idp Ft.......... fit- F- 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 %2" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe ends capped .................................. :.................... g. Pump or Dosed Systems 1. ize ot pump chamber ................ ........ ........................ 2. Overflow tank ........:.................... ............................... 7 9 K 16 ;a 5 lale- 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade.. .. .............. 5. First box baffled .......................... ............................... • cre ass . :Destrnrated III. ouse ldi a. House ocated per approved plans ... ............................... b. Number of bedrooms ........................ ............................... �f IV. Well a. Well located as per approved plans . ............................... b. Distance from STS area measured °t-' a0a 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 drainh-standtkiesinstalled accordine to Dlan_ g.'�-Foo in drains discharge away from STS area ..... ..-: h. Surface water protection adequate .............. :.................... i. Erosion control provided ........... :..................................... PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IiEATLH SERVICES FIELD ACTIVITY REPORT G1tit � � � i i ✓. Street Town State Zip PERSON IN CHARGE nR TNTFRVIFV FT): ITUL /US G S/¢%2 ?� TlatP_ % % 13 PUMP TEST n DOSE TEST O p ` \9 REQUIRED GALLONS ro P NCB /1/,eed4�S �4 "dNo�O EL. START EL. STOP Signature and Title RFPQRT RRrFTVFD RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. II I IJ Q m O p ` \9 REQUIRED GALLONS ro P NCB /1/,eed4�S �4 "dNo�O EL. START EL. STOP Signature and Title RFPQRT RRrFTVFD RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF. HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 July 16, 2001Julius Julius Cesare, P. E. 19 Washington Court Pawling, NY. 12564 Re: Field Inspection: Opromolla, Jr. South Quaker Hill Rd (T) Patterson Lot #6, TM #4.10 -1.30 Dear Mr. Cesare: The Septic Sewage Treatment System can be backfilled at this time. The following comments must be corrected in the field: 1. A pump volume of approximately 450 gallons needs to be obtained. 2. Speed levelers need to be installed in the distribution box. 3. The curtain drain outlet appears to be directed at an existing SSTS. If this is the case, it must be relocated. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Very truly yours, Gene D. Reed Environmental Health Engineering Aide GDR/jp I Julius 'I. Cesare, P.£. 19 Washi "gto" Court Pawling, New York 12564 845- 855 -3208 fAX S45-85f-3216 Oct. 2, 2001 Bruce Foley, Director Putnam County Health.Department Att. Robert Morris I Geneva Road Brewster, New York 10509 RE: Quaker Manor Lot 6 As -Built SSDS Dear Mr. Foley, Herewith transmitted is a complete as -built package for the above noted -project. The transmitted materials are as follows: 1. Three (3) copies of as -built Plans 2. Certificate of Construction Compliance 3. 911 Address Verification Form 4. Three (3) originals of contractor Guarantee 5. Well completion report 6. Well test results 7. Board of Fire Underwriters certification 8. Fee Check C APPb(CrB-4V Thank you for your cooperation in this matter. Very truly, yours Julius I. Cesare, P.E. 7 C,#-e) FROM FAX NO. 3523601026 Oct. 31 2001 10:55AM P2 Rlxw, 4s, zrl e.rss`o� .4 op rr' 44 00%t6 /,e4Pr -49 Abe avla'.oa� a�/ /•.• r a4- ar YML EyX.fRQNMENjAL SERVICES cear.tree Yorktown Heights., N.Y. 1059B (914) 245-2B00 Albert H. Pa.dovani, Director, LAB #-.-93.101819 CLIENT #: 13551 NON,STAT PROC PAGE I MNNNMNMNNNNMNNNNNMNNMNNNNNNNNNNNNNNM ----------------- BARRETT, DEAN DATE/TIME TAKEN: 07/03/01 ii.-oeA ee QUAKER MANOR LANE DATE/1JME.REC'D.- 07/03/01 ie:oop NY 1e563 REPORT DATE: 11/01/01.. PHONE. (845)-878-7484 SAMPLING SITE: e2 QUAKER MANOR LANE SAMPLE TYPE..-..POTABLE PATTERSON, NY, 12563 PRESERVATIVE NONE* cbL',D BY: DEAN BARRETT TEMPERATURE.,: < 4C NOTES... ..':-KIT TAP COLIFORM-METH: MF. FLAG PROCEDURE DATE RESULT NORMAL RANGE --METHOD .PUTNAM CNTY PROFILE .07/03i01 MF T. COLIFORM ABSENT /-100 ML ABSENT 1008 07/03/01 LEAD (IMS) <I.ppb 0-15 Ppb 9101 .07/03/01 NITRATE NITROG 0.32.MG/L 0 - 16 9139 07/63/01 NITRITE NITROG <0.01 MG/L N/A 9146 07/03/01- IRON (Fe) <0.060 MG/L 0-0.3 (fig/l 2037 07/03/01 MANGANESE (Mn) 0.0691MG/L 0-0.3 mQjl 2037 07/03/0.1 SODIUM (Na) 4.58 MG/L N/A 07/03/01 PH' 5.5 UNITS 6'.5-8.5 .9043. .07/03/01 HARDNESSJOTAL 60.0 MG/L N/A 07/03/01 ALKALINITY (AS 36.0 MG/L N/A 07/03/01, TURBIDITY (TUR <1 NTU 0-5 NTU COMMENTS.: BACT THESE RESULTS INDICATE THAT THE WAT ER (WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDI THE NEW YORK STATE AND EPA FEDERAL.DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD l.kqiA is for pi EPA Lead li_ Cooper than 10% of their than 15 ppb and a treatment must be potential. jbl.ic schools are set at. 15 ppb Rule fdr'Public --Systems requires- that. no distribution points have a LEAD value of COPPER value of 163 mg/L, else water undertaken to reduce the waters corrosive more Fe/MnIf both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted dietthe water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium is suggested. o YML.ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani,, Director LAB #c 93.101.819- CLIENT #:-13551 BARRETT.. DEAN 22 QUAKER MANOR LANE PATTERSON'.. NY 12563 SAMPLING SITE:. 22 QUAKER MANOR LANE :.PATTERsbN,, NY,.12563 COLD BY: DEAN BARRETT NOTES... :.KIT TAP DATE 'FLAG PROCEDURE NON STAT PROC PAGE 2 DATE/TIME TAKEN-. 07/03/01 I1-.02A DATE/TIME REC D: 07/03/01 1200P REPORT DATE;.. 11/01/01. PHONE: (845)-878-7484 SAMPLE TYPE-- POTABLE PRESERVATIVES: NONE TEMPERATURE—: < 4C COLIFORM METH: MF ------------ -------- INNHI RESULT - NORMAL - RANGE METHOD pH pH SCALE IN WATER RANGES FROM 1-,14.. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER.-WITH A LOW.pH'MrGHT BE CORROSIVE TO-METAL PIPES,AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5.. Hd- TOT ' AL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENYRATION9, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF.MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS-BEEN SUBJECTED. SOFT WATER: 0-70 MG/L . VERY HARD WATER: ABOVE 306 MG/L MODERATELY HARD WATER: 70-140 MG /L. MG/L..=MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (I grain/gallon = 17.2 MOIL) SUBMITTED BY: Alb. •t H. Padovani, M.T. 11'1'CP) Director ELAP# 10323 The New York Board of Fire Underwriters Bureau of Electricity is in the process of issuing a certificate of compliance for the electrical installation as provided for in the application for inspection # I-e,4,j i New York Board of Fire Underwriters Bureau of Electricity Inspection activity pursuant to Application has been completed and a certificate of i compliance setting forth the detail of the electric system is bein prepared. A dl Inspector Date Form 00 (Rev. 06/00) x_28 Fine Sandy Loam .' Z'8_57 Sil'.t"y:' S andy Loam w. /cob fr- ✓ _3 "� rrR1' r4 �� > :;mss- '- 'v,,2. 4 9, 5,� r ill 4. 'S5''; ()-6 Top Soi: ' ( -33 Pi-w- Sanely Loam 33 - -55 Silty Loam w /cobbles 2 Feet F i 11 )9. . O 11e 1 V. 776.\\ \ INV. 766..20 'tRV. 776. AQ / P( E � � \v / r O g E O x� F. F. O"0", Ptl1NP C B\ \\ �SEP TAi� \ - I\ 76.50\ \ � 780.0 \ \ � � f \ 2 0 # y0 R Ear o c 3E C12UCTION _ 3 } PO\ \ \ \\ \ \ \ \\ \ t \ \ 8 A 4 C F S fMF T i al \ \ 2.. d FOR k r c� x,i 9, .» ,,.•- .�, .. ��`, •. 4: x:.. rte".. ,. .. •:.xrt��, 3: ,, ~< "..w.- ,^,�.,,, i �` % > -. - .�.._r ... .,.,. .�:.� ..�' *�_ . �-''�• -: �-- .,4 --?� ...x- .: � _ a -. ; \ ....Sr , _'_ _^,,,'°�=� ;TRI8UT31�'N , �r �•.. ,' - �-r�,,.;. _. ..�.:'�� , „, ..>,: -... .. .:.- r�',.,�...�w�� ��.s .Ram. /O �:. •^��,<�'� �� r,.- _ Gi ,Qn e.� 825.25 �= \ \ \ \ \ \ \ \ \\ Sys \ I. 2 NRH \ sr NPT11 \ \ \\ De a °nmenta1 Health services -- \ \ \ ations `of- \ a o ble Rules and -Ree4 Health De t jl : f., i8pature tle < ` Date I �': -PERC. HOLE - - ■ DEEP HOLE NO WELLS WITHIN 2-' 0' OF SYSTEM ■ NPT DEP 'WITNESSED \ \ \ \ —e- SILT FENCE AND HAY13ALES OF Nf — CURTAIN DRAIN O Locoq-rlo" Mao LOT # 6 TEST DATA HOLE DEEP SOIL ROCK WATER HOLE PERC,` ■ HOLE* # RATE DEPTH 7.51 0-8 Top Soil 3A 60 8-36 Med Br Silty Loam 36-90 Stony Loam NPHI 9 4 7.5' 0-8 Top Soil NPH2 4 8-80 Silty Loam NDH3 5711 0-7 Top Soil 7-28 Fine Sandy Loam 28-57 Silty Sandy Loam w/cobbles ND114 5 J5 6-6 Top Soil 6-33 Fine Sandy Loam Itk\, 33-55 Silty Loam w/cobbles .2 Feet F ll i . . \7\ ��J',r �h�'+"' LMOAIR M.L{r�wr `nf ..v`.'`- t' yy Alt < ' °.a".� � � � � .a ?� o-} �.sm +cj° .�S.a... -.✓`, fi5. � raw,. •,I 0 .. .,-, -..: ... .. ... .�..- ..'s "�+9:5�� "• c =�-'R T ;^i�.. yea q� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES \ ' CONSTRUCTION P WAGE TREATMENT SYSTEM PERMIT # Located at Sn &, (24a L / , I /,/ . h - Subdivision name - ��� ALaZubd. Lot # Date Subdivision Approved -1116- Owner /Applicant Name q)OP -0 m o a k Mailing Amount of Fee Enclosed -.3, zoo Town or Village bn1ii—do—Ij Tax Map ' 10 Block—/ Lot ''W 3 O Renewal_ Revision Date of Previous Approval Lx4gri � � � Wes•- O i✓`4�+- .Zip, WeVT I Building Typelz6y Lot Area-S"4" No. of Bedrooms Design Flow GPD 4!�_" Fill Section Only Depth 7 Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage ftstem to consist of 7: :7 /' Other Requirements: To be constructed by Water Sup &: Public Supply From `2-5-D gallon septic tank and 911-' Address Address or: �� Private Supply Drilled by Akt,,a4&- Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the aeparate sewage treatmentsystem described above. will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the.Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said 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. R.A. Date O� 22�617_ License 9 �c 2-d APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed andinspect ,,. FAby the PCHD and is revocable for cause or may be amended or modified whe sidered necessary,,by�ft ?ubliciH�alth pirector. Any revision or alteration of the approved plan requires a new permi . p roved f scharge of domestic sanitary sewage only. p� e ,11 ` c 4 By: �` � � h s {3 '., t �,�'Ttle: 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 v DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner , d,�/�,yf OPR wgat G y Address es A9 Located at (Street) 2z Tax Map Block Lot — S� (indicate nearest cross street) Municipality _ Drainage Basin SOIL PERCOLATION TEST. DATA Date of Pre - soaking Date of Percolation Test be made from top of hole. i at each I to be DEPTH G.L. 0.5' 1.0' 2.0' 2.5' 3:0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 0 TEST. PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO::, HOLE NO. :HOLE NO. P 7.5 8.0' 8.51 �l 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by (fir I3sn'lfessional Name. Lesign rrofessional's Seal 400, of rgle yo �. a 41126 ��FessioN�`' :v' •:. •.L .:.. v v ti:' :'ti.. : : :r L \L•::•.�: 1.�::: ::.......L .: :::• ::''. ..L•.:: I. ..L.r. I.�Yr:' :. :. M•- •'• :•: :v::'.:L ••. • l i ti : . r::•:•::r..... : ti :• •:ri'r:• }:•... wii::•:: i 4. r.« Y.L .:i: i::. � .•::: rv:� :v'• •.•: :.v.:•X•; ; ' BATH r 1 < �•� • , O BEDROOM 4 DRESSING. 12'•0•• BEDROOM 3. WALK' 12' -0- at 10.,0.. 1 N CLOSET �r MASTER 8EOROOM eEOROOM 2 j _ OPEN N 1�•0 ta••8•• 13• o•• � 1 s.•8... • i .. ^'TY D ARTMENT Off' HEALTH �� �H USE LANS APPROVED FO ' BE COUNT ONLY, BEDROOMS . it ` r'.•`. SECOND FL`0.0R 177 °' • ALL S . (�UMT I 7:% ISTONIAI,TERATIONS TO'r O �Ey PLA1��T I L S AliTTED -TO THE PCDOH a , } 4 S F DINING ROOM 13' 0" 12••0•• .87 - KITCHEN i p L. r OPEN ABOVE LIVING A0041 V. 1 3'•0" • 1 t'•0'• j i M4J� r MORNING ROOM FOYEM `• FIRST FLOOR FAMILY ROOM 1 �' 0" � 11' 0" • 4829 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # � ` 1 Quo, aJ MapQ6 Block Lot(s) Well Owner: Name: > Address: ,mil Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served Est. of Daily Usage _gal. Reason for Replace Existing Supply Test/Observation - Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for. Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes Nom Is well located in a realty subdivision? ... ............................... .............. Yes A-- No Name of subdivision ��4�� /Ili^- Lot No. �- Water Well Contractor: DlSl-- yam'- le"-, Address: Is Public Water Supply available to site? .................................. ............................... Yes No Y Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: 2 Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well 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. Well to be constructed by a water 1 driller certified by Putnam County. Date of Issue g .. ' ,k. Permit Iss Official: goo Date of Expiration Title: Permit is Non- Transfe, ',a e. White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH r DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: Town/V'llage: _ Si) �j Tax Grid # 1Map1/,J19 Block Lot(s) 30 Well Owner: Name: Address: Use of Well: 1- primary 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment . Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened . Open end casing Open hole in bedrock _`Other Casing Details Total length 1 ft. ' Length below grade 416ft.. Diameter 7 in. Weight per foot lb /ft. Materials: Steel Plastic _ .Other Joints: _ Welded _ Threaded,_ Other Seal:' _ Cement grout Bentonite Other Drive shoe: Yes No Liner :* Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) . Developed? First _ Yes No Hours Second Well Yield Test _ Bailed _Pumped Compressed Air Hours A Yield _agpm Depth Data Measure from land surface- static (specify ft) 97 During yield test(ft) Depth of completed well in feet TO 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 14L c7 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type q(;Q&S Capacity i I rG/'�'` Depth _',��' Modely�' Voltage ,� HP i/"L. Tank Type C (AUA Volume rk `/ Date Well Completed Putnam County Certification No. a Date of Rep rt W ell Driller.(signature) g9lo, Nu i*hy/ ✓xacte'ocation of well with distances to at least two permanentAancpharks to be provided on a separate �vplan. Well Drillees Name l h Addess: d S ► �1 > n N.i Signature: Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Gx� anti i d�e� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address :5, Located at (Street) Tax Map D Block �_ Lot 3 a (indicate nearest cross street) Municipality RAZZgjF_5g2M Watershed T: R4ly_1Y SOIL PERCOLATION TEST DATA Date of Pre - soaking a L% 7. %9 9.. Date of Percolation Test S %g 19 9 _ _ _ 1 `3S— 10,co.T Q-3 — k 73 N4 3 fD 2 41 �a 3 B- 'OS ga 3 33/ G �. 4 5 1 2 3. 4. 5 1 2 3 4. 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to bE submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 DEPTH G.L. 0.5' 1.0' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0'' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT. DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. HOLE NO. 2 4 ....-k Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design. Professional Name: Address: Signature: Design Professional's Seal l 7ZeP--,th an Gam jF � 6 Ile r 52 r .. - �M k Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date Design. Professional Name: Address: Signature: Design Professional's Seal Julius I. Cesare,, P.E. 64 Blackberry Drive Brewster, New York 10509 914 - 279 -7115 August 20, 1999 Bruce Foley, Director Putnam County Health Department 1 Geneva Road Brewster, New York .10509 ATT: Robert Morris RE: Quaker Manor Lot.6 Opromolla, -T. Patterson TM# 4.101 -30 Dear Mr. Foley, Herewith transmitted are 4 sets of the updated plans for the above noted project which reflect all comments contained in the.Department letter of July.12, 1999. Very ru yo s, f Julius I. Cesare, P.E. BRUCE R FOLEY Public Health Director Julius I. Cesare . 64 Blackberry Drive Brewster NY 10509 Dear Mr. Cesare: DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LQ--i MOLI NARI RN., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 JWy 12, 1999 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Re: Proposed SSTS: Opromolla, South Quaker Hill Road Quaker Manor, Lot #6 (T) Patterson, TM# 4.10 -1 -30 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1. Soil data submitted is + 10 years old and is no longer valid. Please contact Gene Reed at (914) 278 -6130 ext 2261 to set up an appointment to perform new soil data. 2. Please show the limits of the 100 years flood plain or add a note to the. plan stating none exist within 200' of the property line. 3. Show all watercourse, ponds, lakes, and wetlands within 200' of property line or add a note to the plan stating non exist with 200'. 4. Please show all required separation distances (i.e., 20' from curtain drain discharge to fields, 10' from foundation to septic tank). 5. Give the dimensions from two property lines to proposed well. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, Shawn Roga� SR:tn Public Health Technician BRUCE R FOLEY Public Health Director Julius I. Cesare 64 Blackberry Drive Brewster NY 10509 Dear Mr. Cesare: 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 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 RE: South Quaker Hill Road Quaker Manor, Lot #6 (T) Patterson, TM# 4.10 -1 -30 Reservoir Basin East Branch :J July 12, 1999 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on June 30, 1999 is complete. The Department will notify you by July 20, 1999 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 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 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 Dept. of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation v�y Letter to: Julius I. Cesare - July 12, 1999 -2- 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 (914) 278 -6130 ext. 2159. SR:tn Very truly yours, C7Shawn Rogan Public Health Technician +• /p rS vf� 4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF EN VIRON.NMN 'AL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREAT\fE,\T SYSTEMS REVIEW SHEET FOR CO \STRUCTION PERMIT STREET LOCATION 113a, NAME OFOWiNER t)zr )mE)LL,� REN'IEWED Bl R-NI, GR, AS, MB, B $ K DATE g S TAX Ni f aLZ, b —/ -3� Y N DOCUMENTS Y N PERMIT APPLICATION PC -1- Pe- 9iz WELL PERMIT _ PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION SHORT EAF PLANS -THREE SETS HOUSE4PLANS - TWO SETS VARIANCE REQUEST . -_ " 0&-) <' `bps ru,p 4E -i-- -� SUBDIVISION ftI,,e SySf4 LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE W-40 I FILL REQUIRED 0 DEPTH CURTAIN DRAIN REQUIRED STANDPIPES QENNERAL LOCATED IN NYC WATERSHED / PLANS SUBMITTED TO DEP DELEGATED TO PCHD DEP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED PERCS TO BE WITNESSED EX- APPROVAL SSDS ADJ. LOTS WETLANDS (TOWN/DEC PERMIT REQ'D ?) DATA ON DDS PLANS & PERMIT SAME / PRE 1969 NEIGHBOR NOTIFICATION / LETTER BVZBA OTHERREQ'D PERMITS) REQUIRED DETAILS ON PLANS FTF—ISEWAGE SYSTEM PLAN - (NORTH ARROW) \ SSDS HYDRAULIC PROFILE GRAVITY FLOW EROSION CONTROL:HOUSE,WELL, SSDS PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION LOCATION MAP EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PLII-IPED, PIT & D BOX SHOWN & DETAILED HOUSE -NO.OF BEDROOMS WELLS & SSDS'S W/IN 200' OF PROPOSED SYS. PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER -1/4" FT. 4 "0; TYPE PIPE NO BENDS; MAX.BENDS 45° W /CLEANOUT1 FILL SYSTEMS CLAY BARRIER HORIZONTAL; E 3:1 TO GRADE FILL � 5 FILLNOTES FILL CERTIF Z<011 NOTE DEPT". GES FIL OFILE & DIMENSIONS FILL 11 EXPANSION AREA TRENCHt LF TRENCH PROVIDED 60 FT MAX. \ PARALLEL TO CONTOURS 100% EXPANSION PROVIDED SEPAR4TION D151ANCES SPECIFIED ON PLAN -IRONI SSTS 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL 20' TO FOUNDATION WALLS _15'WELL TO PL 100' TO WELL, 200' IN DLOD,15V PITS I00' TO STREAM WATERCOURSE LAKE (inc. expan) JA 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER \ IO' TO WATER LINE (pits -20) A 50' INTERMITTENT•, DRAINAGE COURSE 2007500' RESERVOIR,.ETC, _150' GALLEY SYSTEMS CONSTRUCTION NOTES ', 15'bIPJ to CDS=> 50/ oX- 4°/q 25'- 3 %,30'- 2 ° /q35'- I ° /g100' - <I% DESIGN DATA: PERC & DEEP RESULTS 100'witli 182 cons day discharge 2' CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES,,CUT ' m 0 WELL r FOOTING /GUTTER/CURTAIN DRAINS WELL SOIL TYPE BOUNDARIES TITLE BLOCK; OWNERS NAME,ADDRESS LOCATION OF SERVICE CONNECTION TMR,PE/RA; NAME,ADDRESS,PHONEf, DATE OF DRAWING/REVISION DATUM REFERENCE LA�iFB-"" T MPROPOSED FINISH FLOOR AND BASEMENT EL. J� '00�J m p dtk,� � 1, BRUCE . R. FOLEY Public Health Director TO: T✓ /"C"S 1, &Ad4'2 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, .New.- York .10509 - Enviroumental Health (914) 218 =6130 Fax (914) 278 = 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Date: Re: Proposed SSTS: I/ro MO1la, .SI✓V e (T) Dear: Review of plans and other supporting documents submitted at this time relative to the above- regarded project.has been completed. - Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. fOQ�` t o - Sub tk i �-o I S +/ Q yu r s as c t S A-10 /�sG cev�.%s� l�-e� �ee� chi` (`P�y� a. � 8'-G �3d 8.K �. aal� � � ae�` t,4�o _ _�,• P4 4 "r-a,. A)�&o sal, cf a �I s1e ;6'm� Upon receipt of a submission, revised to reflect the "above comments, this application will be considered further. L 3 . S �4 t:�Saa , Pte° �J4 4) R.ti P Very truly yours 0C " G PJV t-e.. dry /�►. S/ i%r� �. -P✓riS r� � t� aJ8 fr s �� �`� � �� haven Rogan SR:tn d l s ItIA) I D r6' Public Health Technician sstsproposed J. S• G..,;.,p. `ltn{ or/�`�S �� �� �O ��'6" -/ ;'�1�C,Jtp f�0 �Ib�O�t/ G PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of a `owl a L4 Located at So, Ap T/V PA-11t1f%fJ67 Tax Map # 1 !> Block i Lot Subdivision of "C�m/fa -W� Subdivision Lot # _ Filed Map # Date Filed ho . Gentlemen: This letter is to authorize - -er -f I a duly licensed Professional Engineer 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. Countersi e P.E., R.A., l� Mailing Address igetlo i . State Zip lyszq Very truly yours, Signed: C (Owner of Property) Mailing Address: 2_9 _y12 1/1 -e.,.. R_ V' State % Zip (. ? Telephone: %f f ®r V71 - -7/l< Telephone: r: Form LA -97 SEWAGE DISPOSAL SYSTEM FILE N0. ` Lo;+ Corp., Jowk Forbes MLi nlnr ACMreSS• -a,rP.{yge5g2C Q40 SIP— MY. %CSO°► j •r— ,at �Stxeetl_ n. PI k9 eykrim, '''' i � See. Block Lot WALcate [learestCross street) �nicipal ity �aGl.r Watershed Ca SOIL p 1�1::: dATA', gDQU7REp : TO BE SUBMIi�ID WMI 11PPLIC11TI0NS a gate oE'1E're- 8oakiug S�ZyI Date of Pervolatbn Test_` ( AC2< . PEE�OOI, IaN PEROOLMION Run ELapSe Dap 'tv Water P7roin Water Level - Titn' Grwnd Surface In Inches No. Soil Rate' Stazt StAp f rMin. Skart `� t' Stop DL'op Is din /In �oP 7 7 _ 11]Che3 It1CheS I�,�,h , � n a r 2:3y 4l EiMaj ft�� • AAA 2.1 _ 5 3'0 Z 3 o 3 tife,K rrfr�4:t u 3 K- .4' L t .{ {1 ! e .t'�i �hFaH' I, .f, 1 d f i ,j L.y r\ 1; .f fA f X 54': ✓: !- 1,x','y P�k'3 ,Y - F 4 ,✓ y 5 y4Fy tY J k (y 1 i f� •Hatt L: y3 r "3x t `' � �j i t tf x 5 akSi a Ana rl v n_ r - t r "•� �rx ci�i� +"tn s>a ;'. � " -' 3✓ ` � ? � fk y(g* i� k r " 3 2`07 LAQ. a 2 715 3 3 3.19 ��51 3Z 2(4 yZ , �Q 4 mc `SEAL C')_ G►� -rye { v �eol t n 0 Ila le m KnEst 1• Tests to be repeated at same depth "until or Boil.YdL2s are obtained ,at each percolation best mole. All data to, for preview. •�, ;.:' •._ ' ,, 2• Depth measurements to be made fray bop of hole. {''''•..,,::••••''• :ev. 9/85 . 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 # WELL LOCATION Street A dress T wn Village City Tax Grid Number �� N to s— WELL OWNER Name 7'eagr Mailing lr_ Address `20 C -0 olviA M ArPr—ivate d .SWT_ AVA C'Q= 065'_11 OPublic USE OF WELL ;�- primary 2` secondary IVIRESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGEydu Sal REASON FOR DRILLING O REPLACE EXISTING SUPPLY AM SUPPLY NEW DWELLING ❑ TEST /OBSERVATION L1 ADDITIONAL SUPPLY 0 DEEPEN EXISTING WELL .DETAILED REASON FOR DRILLING WELL TYPE f 3TRILLED ODRIVEN 0DUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: aAbc-- i'► A,00^ 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 ON SEPARATE SHEET date) (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 thirty (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 aad all water or waste products from such well dril g operations be contained on this property and in such a manner as not to degrade or of erw se co taminate surface or groundwater. Date of Issue: �.� 19 q A--- Date of Expiration u/ 19 Pe it Issuing Official 11 Permit is Non - Transferrable White copy: HD File Pink copy: Owner ` 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller APPLICATIONS Specifi. :; designed for the lollowir.y uses: • Homes • Farms • Trailer courts • motels Schools Hospitals Industry Effluent c�vstems 11PECIFICATIONS Pump: • Solids handling capabilities: '/: maximum. Discharge size: 2' NPT. . Capacities: up to 128 GPM. Total heads: up to 123 feet TDH. Mechanic al: silicon carbide rotary seattsilicon carbide- stationary seat, 300 {= tbrles stainless steel metal parts, BUNA -N elastomers. amperature: 1041(40 °C) continuous 1401(6o -C) intermittent. faaleners: 300 series Winless stfiel. 4Pable of I ji:,ning dry Imhout damage to kole phase: % HP, 115 «230 V 60 Hz 1750 RPM; Iwo 115 V. 60 Hz, � RPM, '/2 HP —1'/ HP, V, 60 Hz, 3500 RPM. 140verio;to with nlitic reset. ;atgt B Insulation. Three phase:'/ HP — .1 % HP 200/230/460 V, 60 Hz, 3500 RPM. Class B insulation, overload protection must be provided in starter unit. Shaft: threaded, 400 series stainless steel. • Bearings :ball bearings upper and lower. • Power cord: 20 foot standard length (optional lengths available). Single phase:'/ and 1/2 HP =16%3 SJTO with three prong plug: l.A% HP -14/3 STO with bare leads. Three phase:' /z -1'/2 HP —14/4 STO with bare leads. On CSA listed models 20 foot length SJTW and SM are standard. METERS FEET . 0 a 1s 0 J a i7 10 12 5 0 CANADIAN STANDARD ASSOCIATION S P FEATURES Motor: Fully submerged in Impeller. Cast iron, semi- high-grade turbine oil for lubrication and efficient heat open, non -clog with pump- transfer. out vanes for mechanical seal protection. Balanced for Designed for Continuous smooth operation. Silicon Operation:: Pump ratings are bronze impeller available as within the motor manufacturer's an option. recommended working limits, Casing: Cast iron volute can be operated continuously without damage. type for maximum efficiency. 2' NP.T discharge adaptable Bearings: Upper and for slide rail systems. , lower heavy duty ball bearing Mechanical Seal: Silicon construction. _ . carbide vs. silicon carbide Power Cable: Severe duty sealing faces. Stainless steel rated, oil and water resistant. metal parts, BUNA -N Epoxy seal on motor end elastomers. provides secondary moisture Shaft:.Corrosion- resistant barrier incase of outer jacket damage and, to prevent oil stainless steel. Threaded wicking. design. Wcknufon three phase models to guard . _ 0 -ring: Assures positive against component damage sealing against contaminants on accidental reverse rotation. and oil leakage. 5-111■■■■■■■■■■■■■■■■■■■■ - :: ■1•S■■■■■■■■® ■■■ CZ2tea■■■■■■■ ■ ■■ dOW■■�0\■■■■ ■■■■■■■■ L"ZINOM■■M, "■■ ■■■■■■■■ 1►i■■\`N■■■ft'W\■■■■■■■■■■■■■■ ' P :M■■■1i1®■■!W■■■■■■■■■■■ ■■ ill WWVMM■W0WM■fi0\■■■■■■■■■■ ' ■■■■■OV1■■■ft_0!■■ \v■■■■■■■■ !'M\■■■■\'MW■■!'V1■■■\\■■■■■■■ Lgmavl•■■■■my■■il►�■■■ON ■■i■■■ VM"M■W Z%MMMftMWMWv■■ \':�■■ ■: ■■■■■■■■■■■1h_C1% ..a1N■M■■ ■■ ■� ■■■■■■■■■■■■ ■11■■�rn.■■■■■■ ■ 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM I I I 0 10 20 30 m3/h CAPACITY • •• ��1•'' 1 191 • I r 20 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. Date P2IL 2, /9 9K Res Property of Yl_ E4 S Countersign T'ti 2us7�� d d 7or-i s'C�7T P.E., R.A., 2,6 Address —61 9i Sv 2 -7 9 s Telephone Signed Owner of Property 2c� C:01e "c.,�( Cie Address Town -- Telephone SSDS DESIGN REPORT QUAKER MANOR SUBDIVISION LOT # 6 QUAKER MANOR SD LOT # 6 4 Bedroom • Design Design Flow: 4(200 gal /bed) = 800 'Gallons Perc Rate: 46 -60 Application Rate: 0.45 Req..Area: 800/0.45 1777.8 Req. Field Length: 1778/2 = 889 LF Actual Septic Tank: 1250. Gallons. PUMP.SYSTEM RLI: 777.0 Use 12 lines,.76' for System and Expansion No Fill Required 912. Use Pump System Pump Static Head DB 825.70. Pump Outlet 776.20 PC1 - DB 450' 49.50 PUTNAM COUNTY DEPARTMENT OF. HEAL-TH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: 21. Date test holes observed 22. Name of Health Inspector: KE1� 23. Project design flow (gallons per day).... ... ............................... ° 11/93 2. 24. Is State Pollutant Discharge Elimination System (SPOES) Permit required ?.. /ilo 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? ................... ............................... /yo 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 appliCatloq of pesticides; to orchards or other crops_,.solid_or hazardous waste disposal, landfilling, sludge application or industrial activity? YES, or NO, /``o >>. Is project located within 1,000 feet'.of existence of, abandoned IandfJ,l.l, hazardous waste site, salt stockpile;. landfill,.sludge disposal site or any other potential.A.nown source of contamination? YES or NO DESCRIBE::, 2: Is there a local.master plan or file with the Town or Villager .r 3. Are community water, sewer facilities planned to be developed w1,th7n--'I 5. years? �. Are any. sewage disposal areas in excess of 15X slope? . M(916;-V :. ..... o 5. Taz Map IO Number ........... .... 6. Approved P.lans.are to be returned to: ............. .:..'. AppliCant L Engineer f the application.is signed by a person other than .the appltcant shown in Item 1,.-the pp I i Cat i on,: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 Misdemeanor pursuant to Section 210.45 of the Penal Law. IGNATURES & OFFICIAL TITL cvc- ILING ADDRESS: OF, LOC r r Tc+�t T Teat Soil Soaked G t t _ f ::PEST =RUNS,. the standard procedure. The 1 . 1 3 Z S 3 1 1 4 S. aced: 3 P • T , JJ 'pct icense Igo. F p aii • t .. / Z t Il` tis T . .� <Si►1N�1 .,;i r r'11'N z z�,P1�iJ a a1`.Iq.wi � �.AI /Ai lX a t £ £r; `� �l � � �...�J , i ..,,. L L ,._ r4 t tG��)� -` P i F 1 1 l� t ti ( 1 1Z OC i i.f CS• � �2 ��.q z, y y.. i�'� ! ! • .. � �1 S 1! Z Zf. C 1 .. '` I IZ ."S .1 s �s t t- " ' ir.. ( (O J.. -- V��11�iQ - — T7�{iVl�♦ � �. i ..the.:.nndo Ilk �r '1 . t Y' : +zr.• , signed. certify --that" thcde porcolation .. tear are done b y,myself, or under"' direction according to the standard procedure. The 1 . eta and results resentn c. am corre r _ Rai• aced: 3 P Signature , JJ 'pct icense Igo. • � t .. / Z t tis Na T ev TEST`} {''RESULTS Date+ i 22Q1 f� 14). (C) Name of . property r -.CX yl��� E1� .., } w<- - :�aFzaa `� Ln�inccr. Ohincr . of 'property. (' - _-.-- /`� -Y+. Pcx�onkcl7.rccC3 ties .t < .. _ K r t M1 { Lo:: +t •total hock Dc th= . �� Ch=: t, Uesit }S4i� dcxcx`x ton _ Num�icr- Nlim Ac J) G i •t 1 r! T - ', �wGa 4f rV�.A Av +nti.7F •l r �• � � 1 � LO Y t s o kr s, i l �2. .I x.• s; r t � _ _ —• - a�- � � �,fs' Ir_ ` � SAr%n� T72�►v Sc'tT aSTan1 1 ill 5.t� j S r] �`L wt�O• *� A'�' i t F _} ' �Aw �•� ` :. � �i 4b����.�, � Y .Kr l{�� � t ��ryr Y .V • . VX f 1 31 �Y * 1 v' ,. ,iV r �a:�,t's4i {'19th_ . a ! { 7 � � �- 11 ,;.�I�;i SR W• 4�a sit x 1t - pk r OF I EW'y\ w ci., ° >a inG,= scre ..etc..). `T , ,r k� I WN �� ' • �i4 TA L_RED TO BE SUBMITTED VUTH APPLICATIG �J! L' HOILE NO. F,s is Ip7=Z0�0F S07.LZ � NIC v" T "' " '� ' ^OUii i'�RED II; TEST HOI �' � U y pi's- . '•; S J ; � NO AIN NAIj C1� t 1 ' titer' y; rri:'ttem�lZ`; TC, :FN('.[i1111Fi'F:RED �: ` ✓Qn ..�r1 u_. A'� ti sk!� { TH MEPARTNiEVT OTJLY ' Ft /Cal Checked ..•��''�.Sq. / / 1 trench- V: to 1 �r Gentlemen.: This letter is to 'authorize .n�w�c� r ( ESA4li 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 promul'agated by the Commissioner of. th,e.: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. , 26 Address da Telephone Very truly yours, Signed Owner ,of Property cozo "c-#i. Oe- Address Town 203 ? I z '( 7K Telephone nC PARTS Item No. Description 1 Impeller 2 Casing 3 . Mechanical seal ' 4 Shaft 5 Motor 6 Bearings - upper and lower 7 Power cable 8 0 -ring 7 5 8 1 2 6 4 3 MODELS P ' . 208 -230 . 3 9.2 WE1534H 11A PERFORMANCE RATINGS (gallons per minute) Order No. H HP V Volts :Phase M 15.0 . Max. Amp. R RPM Solids Wt. (lbs.) W 200. `. 10.6 WE0511H WE WE0311L 1 .. 208 =230.. 3 115 9 D" /1,'r4,'/ and 1 HP =.15' 9.4 W 460 Order W WE0512H WE0712H WE1012H WE1512H WE WE0312L 2 230. 4 4.7 t tJo. W WE0311L WE0311M WE0532H WE0732H. WE1032H WE1532H WE WE0311M ' '/8 1 115. ; . 9.4 1 1750 56 W WE0312L WE0312M .WE0534H WE0734H WE1034H WE1534H WE WE0312M 2 230. ,' ' . 9 4.7 H HP ' '/a '/z 3/4 1 1'/z WE0511 H 1 115. 1 13.0 r riPM 1 1750. 1750. 3500 ' 3500 3500 3500 WE0512H 2 230 - 6 6.5 5 5 - - WE0538H 2 200 3 3.9 1 10 8 80 65 WE0532H . 230 3 3 3 3.4 1 15 6 60 57 69 • 90 104 128 . 2 460 1 1:7 6 20 3 36 45 60 83 98 122 WE0511 HH ; 1 2 4 115 : ' ' 1 13.0 60 .. 2 25. 2 25 50 76 92 1.16 WE0512HH ; ;;230 1 1 ' '6.5 3 30 3 38 67 85 109.. WE0538HH, : :;200 3 3.8 3 3 3 35 2 26.. 58 78 102 WE0532HH 2 230.' . 3 : 3 3.3 . .40 1 15 47 70 94 WE0534HH 4 460 > . .".. ; 1 . : LL: 4 45 8 86 50 2 WE0712H ' ". 2 230 :. 1 1 1 10.0 , ,°, 5 WE0738H 2 200 6 6.2 ' '�' _ _ 5 55 1 17 42 67 WE0732H : ; ;208 - -230 3 3 5 5.4 ; ;g 6 60 8 8 32 56 WE0734H 4 460. - 2 27 3 3500 1 12 6 65 2 21 46 WE1012H 2 230 _ 1 1. 1 12.5 70 7 70 1 11 35 WE1038H' 2 200 ,:.. 8 8.1 7 75 2 25 j 1 - WE1532H ' . 208 -230 . 3 9.2 WE1534H 11A 4.6 Bo : DIMENSIONS WE1512HH . 230.<`-- :.:1 15.0 . . WE1538HH. 200. `. 10.6 (All dimensions. are in inches..Do not use for const WE1532HH .. 208 =230.. 3 9.2 D" /1,'r4,'/ and 1 HP =.15' WE1534HH 460 .4.6 except for model WE0712H and WE1012H = 18`;1.'x! 35 30 o20 5 1- NOON \ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ' NNONN\ ■■ MEMOI C■■NNN ■\1■. , MEMOI :•.■■■■■■..■ NONE ■NO■EE■■■ ■N■Ei ' = iinNii� ■siiil��il�iiiiiru�el■ni�� ' C��iiiiiii►iaEiii�eii�, moon NNNNON■E►�■■ ■ ■ E►■■■NEENN■ ■ N' M:MM:CM:=M:MMMC::::: NNCENNC'M.CNUMMBER ' �:C:M::Om�i� ®CCCCCM I 12W 6y'. ROTATION D' KICK -BACK _r EFFLUENT EJECTOR SYSTEM < . Effluent ejector system PaekaQ offers ease of ordering Subr i r and installation. A single 121.6�N ordering number specifies AeS°°ry -0 10 20 30 40 50 so 70 e0 e0 100 GPM a complete system designed U gasi 0 10 man+ for most residential and Cho C� CAPACITY commercial sump and Oro' PffhPAnl nllmn nnnHratinns SK I 12W 6y'. ROTATION D' KICK -BACK _r EFFLUENT EJECTOR SYSTEM < . Effluent ejector system PaekaQ offers ease of ordering Subr i r and installation. A single 121.6�N ordering number specifies AeS°°ry -0 10 20 30 40 50 so 70 e0 e0 100 GPM a complete system designed U gasi 0 10 man+ for most residential and Cho C� CAPACITY commercial sump and Oro' PffhPAnl nllmn nnnHratinns SK -0 10 20 30 40 50 so 70 e0 e0 100 GPM a complete system designed U gasi 0 10 man+ for most residential and Cho C� CAPACITY commercial sump and Oro' PffhPAnl nllmn nnnHratinns SK New Yak City oepanment of Envlrontnonlal Protection Uumau of water Supply &;Wastewater Collection Sources Division (914) 742.2012/3 Division of drinking water C)% arty ConMO1 (914) 742.2050 46S.Columbus Ave. Sum 350 VaWlla, New York 10595. 1336 Commissioner RICHARD D. GAINER, P.E. Deputy Commisslorw May i0, 1994 Julius Cesare, P.E. Blackberry Hill Brewster, New York 10509 Rz: Quaker Manor SSTSs (T) Patterson, Putnam County Dear Mr. Cesare: The Department has inspected the deep lioles; 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 414194. The ten SSDSc for lots.1 10 meet the rec}uiremerits of 10 NYCRR Appendix 75 -A. The ten sites as ioeated on the Final Plat are :approved for SSDSs. Requirements for final individual SSDS drdwings'for construction approval will :follow shortly:: Should you have any questions, please call :,V 414 -742 -2065 Sincerely; J s W. Roberts, E.. Program :Engineer xc: Town of Patterson Planning Board Putnam County Department of Health Bruce.Foley, Director Putnam County-Dept., of Health . 4 Geneva Road . Brewster; New York 10509 Atts 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 10.1ots'. 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 Des.ign.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 8.' A certified check in the amount.of ,$3,000.00 to cover the combined fees on all 10 lots i,s 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 constructea 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, A 6_z. Julius I. Cesare, P.E. page 2