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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.14 -1 -16 BOX 3 .ti `I +♦ J l , r '64 , i-' 11 ., 00007 Q POTNAM COUNTY DEPA>:Tlr Rr OF HEALTH n 1 DhMm a[ wheoma dd Red& Saevbea. Caneel. N.Y. 10612 der to Pavvlae Pewit / ` ovi CERTIFICATE OF - MPUANCE �' PaeoDM ° p � - co N PERK FOIL SEWAGE DWOSAL STSTIM op, Lsrai+sd d Q own or valuge_ � Sr,b1111 1 1 low. W Y Tax Map Hlodl rot Lail!, Reslewad_ ❑ Revision p Owner /App@=W Naas 1� .J� E � ail! 71— us'*rn �+ Date of Previous Approval � A,�,a2U LtL•h &l g 1�P • t '�A�ra'tIR.Y Cf. Ci6371 Town Z ate Subdivision Approved Fee . Enclosed f-a Amn,inr 3cls Swuhs Type W W O Lot A. ' Z 3 Pm Seatl- Ootr Depth Ya.. z Nss.bar of Bed�nOasss Desip Flow G P D PCHD Notll!146.Is ResmhM Wbea FM 1s completed Separate Sewe reo Sya m to om ixt of �GeOas Sep& Tank .a To be cumb ded by Address Wafer SuF* PdAle Supply Ftrous Address on - Pelvate Supply Delved by _ Addreas Other Raadeameata 1 represent that 1 am wholly and completely responsible for the design and location of the proposed system(s): 11 that the separate sewage disposals stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a regu ens o e nem County Department Of, Health, and that on completion thereof a "Certificate of Construction Compliance' satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, hi} successors, heirs or assigns by the builder, that aid builder will place in good operating condition any part of aid sewage disposal system'during the period of two (2) yeas Immediately following the "tie of the iau- ance of the approval of the Certificate of Construction Compl ce of the original system or any repairs thereto. 2) that the drilled well described above will be located as shown on the approved plan and'that aid well will Installed i actor ernes wit he standards, rubs and r gu a�T'i%ns of the Putnam County Department Of. eH�i /alth. Data !D Sign P.E.fRA. Addn License No Wl'o APPROVED FOR CONSTRUCTION -This approval exp K two fro th. date _issued unless, construct n of the building has been undertaken and is revocable for cause or may be amended or modified when consid- ry' Oy Commissioner of H lth. Any change or alteration of construction requires a new permit Wooed for disposal of domestic snit y - e, a privet. water supply only. n ReV. 10/88 D1te_ - 8Y Title G� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # 5 IJ " I7-U ( y° J _�3 l� - 3- Located at 50,)714 G tlMeg /f %l L /2!y _Town or Village PArrt2S0N Owner /Applicant Name IhU /� (Z � Tax Map , 14- Block I Lot Formerly J 1 °tkoz Ai N00 ,-1 Subdivision Name a 0 Ak-, it 0-4 1 A OiZ l Subd. Lot # l Mailing Address 4- 5, sl& 6 J8 „R iu) Zip 17- 5 k3 Date Construction Permit Issued by PCHD 3 b Separate Sewerage System built by 114091) (WWI Address 10,4- ie)0N4V4- k4LtJ1Q A D Consisting of /yo o Gallon Septic Tank and to L; ” Other Requirements: ( 5 C 1OIAi e� Water Supply:,_ Public Supply From Address or:_�rivate Supply Drilled by %jpV D AlZir5l ddress LP L 1�1."j, Building Type 60D ERA&4P Has erosion control been completed? Il 5 Number of Bedrooms �. Has garbage grinder been installed? iJ 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 regulations of the Putnam County Department of Health. Date: 3 Z b.2 Certified by P �} Address %9 5e (biz f b M h P.E. R.A. License #— 1122'i572 Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals subject to modification or change when, in the judgment of the Public Health Director, such revocation, odific nor chan ge is necessary. By: Title: Date) .1� White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM.COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES .a. FINAL SITE INSPECTION Date: - o� d Inspected by: cam,: ZcEa Street Location 5�f•- /�U�KrQi? jIL /_t Owner T�- Town A7Tc N Permit #. S,�V 17-OZ TM # Subdivision Lot # C/ 1. Sewage System Area YE 'NO COMMENTS a. STS area located as per approved plans ...:...................... �b. Fill sectionrdate_of placement- --- L3: 1 barrier Lgth Width.__ _.Av D 1 - i .��,.H' g P �o _�.� a �t C. Natural soil. not stripped ............... ..........................',..f .: - -- —� d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... / II. Sewage g System a. Septic tank size - (1,000 ) ....... :1, 250 ......... other .... ............. b. Septic tank iristall'ed level ................ ............................... c. 10' minimum from ; foundation .......... ............................... d. istribtuion Box 1:;) - g"k outlets at same elevation -water tested ................. ice,:,,+ , ,r. r � e, 2. Protected below frost .................. ............................... .3. Minimum 2 ft.Original soil between box & .trenches Junction Bo properly set........................ ...... .... .. 1. Lend required enth installed -r i' - ,', 7-.; . (L 7e� C 2. Distance to watercourse measuredj� e7 Ft.......... :! ' 3. Installed accordin g to plan..,.. ...... ............................... �, a " � ref' 4. ,Slope of trench acceptable .l /16 - 1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface................. f' Room allowed for expansion, 100% „- _� 8. Size of- gravel 3/4'= 1- %z diameter clean......... -� 9. Depth of gravel in trench 12" minimum............ ........ 10. Pipe ends-capped ........................ ............................... ✓' g. P.um�a Dosed Svs ems r �7 r N tze o _pump�'fiam eer.... S .e....:�........ {: .......... - 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........... M. ouse/Buildin a. House located per approved plans ... ............................... y b. Number of bedrooms ................:. .. ..............rte............... IV. Well a. Well located as per approved plans . ............................... -� x ) k b. Distance from STS area measured its . ft........... c. Casing 18" above grade .................. ............................... d. Surface drainage eround well acceptable ....................... V. Overall Workmanship �r 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-draui S-,*. uistall& according f. Curtain drain outfall protected & dinto exist w r g. Footing.drains discharge away from STS area ` to e " I Surface water_ protection adequate...:: ~ _ - i. Erosion control provided ....... ............................... % tZ Q Rev. 1/97 fonn 6 1 - PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL I1EATLII SERVICES FIELD ACTIVITY REPORT AT)nTzF. S q: 5i QaG&,5i7 P Street Town State Zip PERSON IN CHARGE OR TNTERy,rpvjpn. T)nte, A4-.Z PUNT TEST TEST REQUIRED GALLONS > T ;;7 EL. START EL. STOP Signature and Title RFPnRT IRRCRIVED BY-0 I acknowledge receipt of this report: SIGNATURE: 02/96 Rev. k 16 0,67 ZA cl "'t ©� O O O TEST REQUIRED GALLONS > T ;;7 EL. START EL. STOP Signature and Title RFPnRT IRRCRIVED BY-0 I acknowledge receipt of this report: SIGNATURE: 02/96 Rev. k 16 0,67 ZA -F3CM ATTENTION (TFUiDEC 12 2002 21 :45/ST.21 :44/0.633E628549 P 1 PUTNA.M COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ADAM ❑ GENE For: pill All information must be fully completed prior to any Trenches inspections being made. PCHD Construction Pern it # _ 540–/7-0 Located: ' W7k QVA>cAZ, P X4 /Z0. (T) M Owner /Applicant Name: 7csy! 6hMjT TM 4.14- Block i Lot Formerly: 42uh-011 M d—A-WL Subdivision Name: AyArt& MAAA*, SvhZhyi --u Subdivision Lot # Is system fill completed? Date: Is system complete? qe S Date: )900 Is system constructed as per plans? Is well drilled? –q e5 Date: 12 j Igt Is well located as per plans? cfPS Are erosion control measures in place? U— I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health. Z 6 Date: T _ Certified by: PE RA Design Professional Address. 76 �f bR. Ab, MMOPaC ki4_- 106*1 Lic. # 07jj27 Comments: 5q:5rcM A6 S1-tb tJ &1 J j>esl&N PLpy -S SW 06 TA.,�-e) RoE RAM qo(✓ -es-1 bNM6eTog ONE`f lti6rl+ Q2Cp C>10�4 575 rM 10R*s Form FIR -99 DFC -13 -2002 FRI 10:38 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6614 Fax (845) 278 - 6648 December 18, 2002 Mike Beyer Beyer Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Field Inspection - Barrett South Quaker Hill Road, (T) Patterson Lot # 9, TM# 4.14 -1 -16 Dear Mr. Beyer: The following items are in violation of Article III, Section 2C of the Putnam County Sanitary Code: • Erosion control measures have not been installed. This violation may lead to an enforcement hearing and subsequent fines. The violation is to be immediately corrected to minimize the number of days you are out of compliance. Please note that fines may be issued for every day the violation is not corrected. Sincerely, Gene D. Reed Environmental Health Engineering Aide GDR: cj 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 December 18, 2002 Mike Beyer Beyer Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Field Inspection - Barrett South Quaker Hill Road, (T) Patterson Lot # 9, TM# 4.14 -1 -16 Dear Mr. Beyer: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. It appears additional run -of- -bank fill is required in the expansion area to maintain 100% expansion. 2. Expose several sections of the curtain drain for inspection. 3. A re- inspection of the dose test needs to be performed. The first test was approximately one hundred gallons over. 4. All erosion control measures must be installed. Please note that all erosion control measures must be installed prior to the start of any construction. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Sincerely,. Gene D. Reed GDR: cj Environmental Health Engineering Aide LORETTA MOLINARI R.N., M.S.N. Acting Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC(845)278-6678 Fax(845)278-6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 December 18, 2002 Mike Beyer Beyer Associates 73 Secor Road Bryant Pond Plaza Mahopac, New York 10541 Re: Field Inspection - Barrett South Quaker Hill Road, (T) Patterson Lot # 9, TM# 4.14 -1 -16 Dear Mr. Beyer: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. All erosion control measures must be re- installed in the ground. Please note that all erosion control measures must be properly installed prior to the start of any construction. 2. Curtain drain stand pipes must be installed five feet above and five feet below the curtain drain. 3. Roof leader /footing drains must extend beyond the SSTS area. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Sincerely, Gene D. Reed GDR: cj Environmental Health Engineering Aide T acknowledge-"receipt of this report SIGNATURE; 02 / 9:6 .: Title; , A:. coG Sheet of * " PUTNAM COUNTY DEPARTMENT OF' HEALTH = ' DIVISION OF ENVIRONMENTAL HEATLH SERVICES f YOB FIELD ACTIVITY REPORT NAMP! TPA Street Town _..`_: "mat .Zip PERSON IN CHARGE R, TNT S Q - p Name° and Title _ ..... TYPE OF FACILTTY:p�iST /mil FINDINGS: = e 5 ` _ t - Ave LZ ;. - i emu.. r - wu 5_ "'-,4 R! TPTz Signature and: Title - RFPORT_RFCF.TVFT) RY. : °: ' �I I acknowledge receipt of this report SIGNATURE- [92./96 Title LORETTA MOLINARI R.N., M.S.N. Acting 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Beyers & Associates 78 Secor Road Bryant Pond Plaza Mahopac, NY 10451 Re: Proposed Compliance: Barrett .South Quaker Hill Road, Lot #9 (T) Patterson, TM# 4.14 -1 -16 Dear Sir: ROBERT J. BONDI County Executive April 1, 2003 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: 1. Curtain drain standpipes have not been found. 2. Salt fence along driveway is in disrepair. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve truly yours, /W Robert Morris, P.E. Senior Public Health Engineer RM:tn 78 Secor Road, Bryant Pond Plaza, Suite 5 Mahopac, New York 10541 Mr. Robert Morris Putnam County Department of Health 4 Geneva Road Brewster, New York 10509 Re: Barrett Residence Quaker Hill Road, Patterson Tax Map 4.14 Block I Lot 16 Dear Mr. Morris, Tel.(845) 621 -4756 Fax. (845) 628 -1905 March 24, 2003 Please find the enclosed materials for the As Built submittal for the above referenced property. This submission includes the following items: 1. Certificate of Construction Compliance Application 2. Three (3) copies of Guarantee of Subsurface Sewage Treatment System 3. Well Completion Report 4. Water Analysis Report 5. Three (3) sets of As -Built Plans 6 Application fee of $200 7. E -911 Address Verification Form I trust the above materials are adequate for your approval and completely satisfy your previous comments for the above project. However if you have any questions concerning this project, please do not hesitate to call me @ 621- 4756. Very t I Y ours Chris Caralyus Project Manager PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building Tax Map Block Lot Building Constricted by ToN n/ illage 6�tJAk-22 I—M�L 1ZBAr� Location - Street Subdivision Name Z,�)OQD r-l�ftgAe Building Type Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material,. construction and drainage of the sewag.- treatment system serving the above- described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two, years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dat &d: Month ay Year General C ntractor wner) - Signature re7 ( -1 - � a I-P Corporation Name (if corporation) Address: 3 State 134111_11 rl 0 J1/ y Zip Signature: Title: / 5, Corporation Name (if corporation) Address: State Zip Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 93.300167 CLIENT #: 55152 NON STAT PROC PAS!'' PHILBURN CONST. CORP. DATE/TIME TAKEN: 01/22/02 09:00 P.O. BOX 13 DATE/TIME REC'D: 01/22/03 10;30 BALDWIN PLACE,, NY 10505 REPORT DATE: 01/29/03 PHONE: (914)-447-5998 SAMPLING SITE: 84 SOUTH QUAKER HILL RD, PATTERSON, MY SAMPLE TYPE..: POTABLE NITRATE NITROG : BATHROOM PRESERVATIVES: NONE COL'D BY: DEAN BARRETT - TEMPERATURE..: < 4C NOTES...: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 01/22/03 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLlFORM METH: MF 01/22/03 DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD PUTNAM CNTY PROFILE 01/22/03 MF T. COLIFORM 01/22/03 LEAD (IMS) 01/22/03 NITRATE NITROG 01/22/03 NITRITE NITROG 01/22/03 IRON (Fe) 01/22/03 MANGANESE (Mn) 01/12/03 SODIUM (Na) 01/22/03 pH 01/22/03 HARDNESS,TOTAL 01/22/03 ALKALINITY (AS 01/22/03 TURBIDITY (TUR ABSENT /100 ML <1 ppb 0.84 MG/L. <O.O1 MG /L <0.060 MG/L 0.017 MG /L 3.06 MG /L 6.0 UNITS 58.0 MG /L 18.0 MG /L <1 NTU AB5EN� 1O08 O-15 ppb 910l 0 - 10 9139 N/A 9146 0-0.3 mg/} 2037 0-0.3 mg/l 2037 N/A � 6.5-8.5 9O4., N/A N/A 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORDIKK������HE NEW YORK STATE AND EPA ADERAL DRINKING WATER STANDADS,,FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb/Cu LEAD limits for p EPA Lead & Copper than 10% of their than A5 ppb and a treatment must be potential. tblic schools Rule for Pub distribution COPPER value undertaken t are set at 15 ppb. ic Systems requires that no more points have a LEAD value of more A 1.3 mg/L, else water reduce the waters corrosive Fe/Mn If 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 diet,the water shouid contain no more than 20 mg/L of Sodium. For those on a moderately restricted di t , a max i mum o f 270 mg /L of S di um YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 1059G (914) 245-280O Albert H. Padovani, Director LAB #: 93.300167 CLIENT #: 55152 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NON STAT PROC PA8E ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 PHILBURN CONST. CORP. DATE/TIME TAKEN: 01/22/02 09:00 P.O. BOX 13 HARDNESS MAY RANGE FROM 0 DATE/TIME REC'D: 01/22/03 10:30 BALDWIN PLACE,, NY 10505 REPORT DATE: 01/29/03 BEEN SUBJECTED. PHONE: (914)-447-5998 VERY HARD SAMPLING SITE: 84 SOUTH QUAKER HILL RD, PATTERSON, NY SAMPLE TYPE../ POTABLE ; BATHROOM HARD WATER: 140-300 MG/L PRESERVATIVESm NONE COL'D BY: DEAN BARRETT - TEMPERATURE..: < 4C NOTES.—, ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ COLlFORM METH: MF DATE FLAG PROCEDURE RESULT NORMAL - RANGE METHOD is suggested,4 pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF �HE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY. WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF PH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, 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 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L (1 grain/gallon = 17.2 MG/L) SUBMITTED BY: Alb Dir o M.T.(ASCP) ELAP# 10323 u FEB -05 -03 WED 14:39 "CESARE— ENG... 8458771515 P.01 /��`" vy� pa,, # FW y0� WELL CUMrLETIVN KbrVK-i pEPARTHENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH off ice use only WELL LOCATION VAUT AODRESS: Tow0viculclocily TAX GRID NUMBEd So vAK�-R i �ArrE�PSOn/ C3ia, WELL OWNER NAME ADDRESS. 4�jz—zz �BE 1.o ULC. U USE OF WELL 1- primary 2- secondary O RESIOENTIAL O PUBLIC SUPPLY O AIR /COND. /HEAT PUMP 0 ABANDONED O BUSINESS O FARM CirTEST /OBSERVATION O OTHER (specify) O INDUSTRIAL O INSTITUTIONAL O STAND -BY O MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED 4 J5- / EST. OF DAILY USAGE gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY OTEST /OBSERVATION []ADDITIONAL SUPPLY WELL JMNEW SUPPLY (NEW DWELLING) []DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH � 65 it. STATIC WATER LEVEL _ � v !t, DATE MEASURED DRILLING EQUIPMENT Q ROTARY WOMPRESSED AIR PERCUSSION O DUG ❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE O SCREENED 0 OPEN END CASING' WOPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH ___ p?0_ fL MATERIALS: XSTEEL O PLASTIC 0 OTHER LENGTH BELOW GRADE ft. JOINTS: O WELDED R THREADED 0"I ER DIAMETER _-4—In, SEAL: 32fZEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT Ib. /ft. ORIVE SHOEMES ONO I LINER: a YES 0 SCREEN DETAILS DIAMETER (In) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (It) DEVELOPED? FIRST � DYES ONO HOURS .— SECOND GRAVEL PACK 3 YES GRAVEL SIZE: DIVAETER OF PACK. in, TOP DEPTH Tl BOTTOM I DEM)I II. WELL -YIELD ?EST It deta(ted pumping METH00: O PUMPED tEsts were done is in- 'COMPRESSED AIR ; formation attached? D BAILED p OTHER i OYES ONO WELL LOG if more detailed formation descriptions or sieve analysts are available, please attach. �fPprTNH osUAFACEM sFaacc w.".! Inp as t �etu FORMATION DESCRIPTION Doll IL ft. WELL DEPTH It. DURATION M. miA. DRAW001#14 IL YIELD (iRM- 3uniee 0 -' /00 Leo w�v R oC.0 ro r1a ` (o WATER O CL W Tt mp. QUALITY O CLOUDY HARDNESS Q COLORED ANALYZE07 OYES ONO ANALYSIS ATTACHED? OYES ONO STORAGE TANK: TYPE CAPACITY — ____ _ __ GA;i . PUMP INFORMATION TYPE 1tAXFR MODEL CAPACITY OEPYH �.- VOLTAGE HP WELL DRILLER NAME,QOYA 447455✓.9A/GJEZ4 C'10• �/G- oAtE ,30 ADDRESS S '�V1 .5-�.. StW��t1U t�Qm EL/ NS%IDJ�I.� de l L Z[ r !� • f_� -`-! ,-�- i MAR -28 -03 09:32 AM PATTERSON TOWN HALL FROM (WED)MAR 26 2003 514AT, 5-34/0,6338628917 P. .2 v 9RUCB. R. FOLEY LOPXffA MOUNAM LN.. M.S.N. 11bik+ Rtohh Romp Amo ift PrWk Mo@hh AmfOr Dirselar of Ppmem sr vkt! DEPARTMENT OF HEALTH i 00neva Road Brewster. Now York 10509 is &viroameoul Ifedtb (914) 270.6130 Ira (914) 27 6r t N vnles &mists (011)371 -6511 WIC (911)211 -6671 , Ps11 (01) 171.4485 LuA► lstenlesAo� (916} 211.6011 �rneloel (911)111.6413 !h� (911} 111.668/ E911 ADDRESS YERIFICATION OWNERS NAM' DeAJ BARReTr f: - TAX MAP NUMBER: E911 ADDRESS: .., TOWN: AUTHORIZED TOWN OFFICIAL: • (Signat�ro) , DATE: T/-2 rv/o 3 The Putnam County Department, of Health will not issue a Certifcate of Constfaction'Compbance Wess the above form is completed, Le., a legal E911 addras is assigned by an authorized town official. This; form is to be submitted 'With ie application for a Certificate of Contraction Compliance. 1. 4 l N �I v .i i S+ MIM3MIMIM ;MIMFMVMIM[MiMZM1Mel1/�sM MfMCMZl 11. frAAeMIMiM[ MIMtMer. 4liMl�r€ MtMfMiMZM' � /!AiMeeMerfM;nMMn.Iw =MZeIiIMZ.. eMeM!!l? C 1 I PUTNAM COUNTY DEPARTMENT OF HEALTH q ji DIVISION OF ENVIRONMENTAL HEALTH SERVICES QNS I I VION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # W � YY / D zz�� Located at— aa Subdivision nam - Subd. Lot # Date Subdivision Approved S- Owner/Applicant Namea,�� Mailing Address Town or Village o- V Tax Map *(f f Block j Lot Renewal _ Revision Date of Previous Approval Amount of Fee Enclosed ` 13® 0 i Building Type M v b 19�_ Lot Area '2-3 No. of Bedrooms3 Design Flow GPD Zip Fill Section Only Depth 0-9,,,5- Volume 2-3 — PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 10049 gallon septic tank and LV Lc= -- Other Requirements: To be constructed by 4 Water Supply Public Supply From Address Address or: _ Private Supply Drilled by Address 64 2 rte( 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. P.E. R.A. Date VC 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 n considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new p rmi A roved for discharge of domestic sanitary ,fs/e'wage only. By: Title: 1CJ� r ep6 Date d 0 l White opy - HD F e; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 BRUCE R. FOLEY Public Health Director NAME: ADDRESS SITE LOCATION DATE: STAFF PRESENT: 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 PUTNAM COUNTY DEPARTMENT OF HEALTH SPECIFIC WAVIER ` "�';, - ,I_'�4 +: i►:��.�����' ,• N; °4 1, �� ;%' j �;;.� - � SPECIFIC WAVIER DOES THE PROPOSED VARIANCE REQUEST POSE A ENVIRONMENTAL CONTAMINATION PROBLEM? YES WILL DISAPPROVAL RESULT IN A SIGNIFICANT HARDSHIP YES DISCUSSION APPROVAL OR DENIED x0 t—_AP_.. • REAS )&F—Q9 DENIAL DIRk,tOR OF LIC HEALTH X NO NO DENIED NEW YORK STATE DEPARTMENT OF HEALTH Specific Waiver Bureau of Community Sanitation and Food Protection from Requirements of Part 75 and Appendix 75- A,10NYCRR for Individual Household Sewage Treatment Systems Name of Applicant No. Street Cityfrown State Zip Address No. Street Cityrrown State ZAP Site Location 0,4A VWU� 146 A ID p a� 1. Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)): Separation distance cannot be achieved. xcessive slope. High groundwater. Inadequate depth to bedrock or impermeable layer. Soil unsuitable. Other (explain) ...................... ............................................................ ............................... 2. Proposed design or conditions of waiver: ................................................................................................................................................................................. ............................... . . . .. . ... .. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . .. .. . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . ... . .... . . . . .. . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. The proposed design may have the following limitations (check appropriate box(es)): increased risk of well or spring contamination. increased risk of surface water contamination. Expected design life of the system will be diminished. Operation of sewage system is subject to mechanical problems. Other (explain) ...........:................................................................ ............................... ............................... ............................... ........... . .......................................................................................................... : ....................................................................... . ............................. ...... Additional information attached Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. In accordance with New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver may be revoked by t uing official for a change in conditions for which this waiver was granted. A0 ESENUfii 'tbO hlhtiSSiONER OF FiEAL7H .......... . '*" ..... ORIGINAL - Local Health Agency COPY - Applicant/Design Professional OAT.. . ... ..............:. , DOH -1326 (7/92) (GEN -152) PART II—ENVIRONMENTAL ASSESSAENT (To be completed by 4gency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes 5D No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another Involved agency. ❑ Yes ® No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WiTH THE FOLLOWING: (Answers may be handwritten, If legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly. NO C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: NO C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: NO C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly NO C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly. NO C6. Long term, short term, cumulative, or other effects not identified In C1-05? Explain briefly. 11"TC C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly. NO D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes .0 No It Yes, explain briefly PART iII— DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. if necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a* positive declaration. J Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental impacts AND provide on'attachments as necessary, the reasons supporting this determination: PUTNAM COUNTY DEPARTMENT OF HEALTH BRUCE FOLEY Print or ype Fame o Responsi le Officer in lead Agency ///) 1A -, 94 5-igigure W1 f6d$onsible O i Name of Lead Agency D E OR > r Title "R nsi le Officer whmo . Brent from responsible officer) cerin Lead Agency Signature of (If D to 2 p -zoo w,tH1N. � No S5p5 OR .wE��s 54\ °�pSOp ,w 69• is / ,/ BANOR 0 QO AKER e °° Lp� \V \StON .N 1. SUg N' \0 // + -01 / 7 01). Okop %r�� A// 300000 li - e 3 /j� lh /l� o s8 / /pp ^ tr � dc's ,`Op• % , •4ounty Department c th N 1 F " ml ®n 04 Unviro mental Health Services ipp TO PLACE FILL ONLY 'DES'IGNED FOR FILL SECTION 0N' Y' :n mccordanee with applicable RU188 and tegulatione Of the Putnam County U )epart3ent. WEST EAST LAND LLC., $1SO. QUAKER HILL ROAD -j))) TM -�¢_ ,CO Tfit1m SSDS TRENCH DESIGN of NC r Y� QUAKER MANOR SD DEPART IEN7 OF HEALTH Division Of Environmental Health Services Geneva Road, Brewster, New York 10509 1914 278-6130 'Mao TO: ALL PROFESSIONAL ENGINEERS, REGISTERED ARCHITECTS AND LAND SURVEYORS FROM: JOHN KARELL, P. E. DIRECTOR OF PUBLIC HEALTH RE: FILL SECTION & STEEP SLOPE DESIGNS DATE: SEPTEMBER 17, 1992 FILL SECTION- GENERAL JOHN KARELL Jr., P.E., M.S. Public Health Director Please be advised that this Department has revised the notes pertaining to fill sections (see attached Appendix E - Rev. 9/92). This Department will only allow fill sections which have been allowed to settle naturally for a period of at least 6 months, including one freeze -thaw cycle or fill stabilization may be achieved by mechanical compaction as stated in note 41. This Department is also requiring that the fill placement certification note be placed on the "trench layout' plan with the appropriate information added to the note and the signature of the design professional provided. This Department will also accept fill sections designed in accordance with the detail on the attached sheet which reduces the amount of peripheral ROB material from 10 to 3 feet. STEEP SLOPES Slopes in the 15% - 20% range are generally only suitable for subsurface sewage disposal if slope is reduced to 15X by placement cf ROB fill and all of the following criteria are met: 1. Soil percolation rate is less than 30 minutes per inch 2. Fill is not necessary due to the presence of shallow rock or groundwater. n � , APPENDIX E CONSTRUCTION NOTES �ZUBSURFACZ SEWAGE DISPOSAL SYSTEMS g WELL WATER SUPPLIES SERVING SINGLE FAMILY RESIDENCES Basic Required Notes 1. All trees within 10 feet of the proposed SSDS shall be removed. 2. SSDS to be inspected by the design engineer/ architect and the Putnam County Health Department after construction and prior to backfill. 3. No trucks, machinery, building materials, nor excavated earth shall be allowed in the sewage disposal area. Construction of SSDS to be in accordance with these plans, any revisions thereto, and the rules and regulat ions of the permit issuing governmental agency. 4. Mini-mum well yield of _5 gpm is reeu; red. Yields less than 5 gpm will be immediately -reported to the Putnam County_Department of Health. 5. The sevaoe system desion shown hereon does not 'provide-f or-installation of.a_. oarbaoe orinder. Such i nstallation reauires the aoproval of the Putnam County Department of Health. Notes Required When ROB Fill Pr000sed 1. ROB _ill must be stabil_ zed by ailoving the ROB fill to settle naturally for a period o_` at least e months and include at least one freeze -thaw cycle or fi11 stabilaticn may be achieved by mechanical compaction in approximately six inch lifts to the approximate density of the undisturbed underlying granular soil. The results of density tests performed in the undisturbed underlying soil and in the fill pad are to be submitted tc the Putnam County Health, Department if mechanical compaction is to be utilized. 2. S1tc modification activities involving placement of fill are to be conducted during relatively dry periods to minimize soil smearing and excessive soil compaction. 3. Run of bank fill shall be suitable for sewage absorption, be free of fines or other unsuitable material and shall have an in -place percolation rate at least equal to that in the natural soil after the required stabilization period. The engineer /architect shall perform final percolation tests in the fill after stabilization. 4. The impervious fill, clay barrier, shall be a dense clayey soil with little or no sewage absorption capacity. 5. Fill suitable for sevaoe absorption should contain no more than 5% and preferably no more than 2% fines by weight. Fines are clay and silt particles that pass a 200 sieve and no more than 10% by weight, of the fill material should pass a 100 sieve. The following certification statement is to be added to the construction (trench layout) plan: This design engineer has inspected the ROB rill material on ---- - - - - -- -and does hereby certify that requirements approved fill suitable for settled f11 Rev. 9/92 (date) such materia; has been placed and stabilized in accordance with the of the HYS Dept. of Health, the Putnam County Department of Health and the plan. The material itself has been tested and at this time is considered use in a subsurface sewage disposal system. The soil percolation rate in the based on percolation tests after stabilisation is ------------ --------------------------- Signature P. E. or R. A. FILL SECTION DETAIL (N. T. S) 2 a 3' 5' W ac t . 1 ON 3 SLOPE EXISTING \ GRADE Fill pad material (ROB gravel) must extend three (3') feet beyond center of trench. After fill pad material, there must be seven (7') feet of additional soil, with the final two (2') feet being impervious soil with a one (1) to three (3) horizontal slope. The toe of the slope shall extend into the virgin soil 6 to 12 inches deep and 24 inches wide. Topsoil shall be applied in accordance with Appendix 75 -A, Section 75 -A.9 (a- 4 -iv). V92 • O►i- r► N PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES SSDS/WS REVIEW SHEET - DETAILS a. SEPILC T*R EEMI S 1. Qitlet 2" belay inlet 2. Minimm 3" bed of pea gravel 3. Minimm depth of 1 i p,id. 4' 4. le-gth - minfmm t wim mr &h to maxi = fas times width. 5. MDd=12" cover. 6. Iccat-ian stab. 7. Nrhnle - ding - mininun 20" in shorter dfiTe sicn. 8. Baffle extsri 20% of li aid &pth above Liquid level (dam' , b=10 ", &51,b-3-29. 9. If 3err3th G.T. 9 feet - use 2 cm1partrents. 10. Minim= tank mr -acity 1000 qaO foam, 1200 gal,/4 badrean:134 cf/3 b3n;161 cf/4 blmL 11. Psfhati,c c atmg for rau faxed mss. 12. Inlet tee/baffle 16" belay f Lc w line. 13. Qztl et teq I affle 18" belay flaw line. 14 Inlet pipe slope P per foot rn n. (2%) . 15. Inlet pipe cast iron, 41lnin. 16. Qztlst pipe slope 1/8" per foot min. (A) . 17. Gu Lked joints for sanitary tem. I -eM DIl. ') I'M : )YI_•► .*C N2 i 1. Inlet inert min. 2" a cxe aitlet invert. 2. All aitlets at sage ele`aticn. 3. Qitlets 1" to 5" anove tank bot tcm. 4. Minimm 12" bs`lding clan Saab cr pea gravel. 5. Inlet baffle. 6. Mmdmn 12" c er. 7. provable aver for a=Ess. 8. Sealed pipe joints (asd-ltic cr egad). 9. SLcpe aitlets at 1/8 in/ft:. (1%) 10. Frost pcotq�-tim. ,:.•;ICY •. i:2►i , f -1-0 z_ tali• 1�: 1. SLcpe 1,/16 in. /ft.. to 1/32 in. (0.5% to 0.25%) . 2. V4" to li" crushed store cr vad-ra3 gravel 3. 4" mini=m lateral dimater. 4. 2" miniunm ate yes' lateral. 5. 6" minira n aggregate urbr lateral. 6. Untreated Wilding paper cr 2" of stew over ague. 7. 6" minim=, 12" rrexhn earth mill. 8. Overfill to allow for settling, 4" -P. 9. 2'wu' imm fran tai bottan to ;sager- 5ft.gma b 10. 5'n- n.fran trench bottan to fiq�r%a2s 7 ft. gra3e. 11. Trench speci.rr3:rrun.6'0.C. (24 "traici) . 12. Umrncied lateral. a-&. mst be plums. 13. Fill - 2:1 slopes min. 10' beyond trench. dqpth:3Puax.aar rock +;2'max.aer ;hater bpermaUe bare'. . � sac• 1 1. T.. of .: _.o - .r. 3. Minimm 201 aising cf sted .c 5. •itl- belcw O.G. . Sianitaiy e. CLIUNN M1 V 1. Overfill to allcw for settling: 4"--6' nataral soil baiMilL 3. Utreated hAhling gper. 4. V to 1111 clean gravel cr stan. 6. • .- invert 6" ciEf bottcm. .- traxh. • Semraticn fran 1•. area 151 rnin. 10. S&iVpes. each side. 1. gable bai cotes. 2. OxrBcbcr aitl et 14" above lat2ml cutlet 3. Iatetals flush with bottan. 4. Tight joints pipes bet-jam bps. s v- NSli'• I v 1. Amite goer pup line fre�zing cr slTe enitze line to pmp Pit. 2. Overflccw a Vacaty,cra chy,other ale anzngarra7t. 3. Patp proof bcK outer diarrier. 4. D�se 75% pipe volure. 5. Mann -audible - visible. 6. 93m ft. min. p.mp pit to fwxhticn. 7. Fifty ft min. pmp pit to well. 8. IIect. v,-rk arrply with Mr- 9. Check valve,gate valve, adm. 10. Riffled D-bcx cr ,l-LK -1st box. 11. Hlanl.ic infonratium - operating levels Pit -rpm vs. had pimp with o ves. 11 SSDS DESIGN REPORT QUAKER MANOR SUBDIVISION LOT # 9 KYYt.LV1111i 1.1 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT- CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT . TO: Camnissioner of Health- ........... _. ... ...7 ....:...... .. .. .._ . In the matter of application for: u _S.t� A-CQ-ti I l A.,y01 z� represent that I am an officer or employee of the y-orpomrion and am authorized to act for r (Name of Corporati n) having offices at 20 .Whose officers are: President: (Name and 4d3ress) Vice - President: (Name and address) Secretary: (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. S worn to before me this .. • 15Li1; Signed'`"_ Title: Corporate Seal 20 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 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, P Julius I. Cesare, P.E. page 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date P2 u- 2, /9 5.< Re : Property of I�IC -S't �4ST C- yv17'�, �2us7�� d v �-i SC 77 Located at Rp, -9 QUA-Kcac A111 2D• (T) ®Ax ro,y Section /o Block /. Lot 2 S' Subdivision of��aAZI /yA"YOA Subdv. Lot �#� Filed Map # Date Gentlemen: This letter is to authorizes,) �,, �� u c l• LeSArtez- 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. , 26 Address �2eNsk X069 9/ So 2 ?9 Telephone Very truly yours, Signed Owner of Property Address Town T 7 ,3 2 X77-6 Telephone F1A`('- 10—' 94 17:41 D WE gP I F1: I,•.IHTEF' UF'F'L =,fit I May 10, 1994 P01 Julius Cesare, P.E. Blackberry Hill Brewster, New York 10509 New York city Rut Department or : Quaker Manor SSTSs Environmontal Protection (T) Patterson, Putnam County Dear Mr. Cesare: Bureau of Water The Department has inspected the deep boles, witnessed the percolation testis supply & Wastewater and inspected the sites for ten proposed individual subsurface sewage disposal systems Collection (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 Sources Division for SSDSs. Requirements for final individual SSDS drawings for construction approval (914) 742. 2012/3 will follow shortly. Division or prinking Should you have any questions, please call: 914- 742 -2065. Wator Quality Control (914) 742.2060 Sincerely, 465 Columbus Ave. Suite 350 _ Valhalla, New York 10595. \ 1336 Ja s W. Roberts, P.E. Program Engineer Commissioner xd: Town of Patterson Planning Board Putnam County Department of Health RICHARD D. GAINER, P.E- Deputy Commissioner 0 P CMG a -< FW q0� WELL (;UMYLl;l1V1V KC,YUtCl DEPARTMENT OF HEALTH Division Of Environmental'-Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET ADDRESS: TOWNIVILLAGLIC11Y TAX GRID NLI&WER: So. 41A&,M /-/ AArrERSav A3 /Z .[�f WELL OWNER NAME: ADDRESS: &/ F% // 6 00a6TRtt_-T16M P0MP 140 JS6 9b. n/ BIVATE t] PUBLIC USE OF WELL 1 - primary 2 - secondary ❑ RESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED O BUSINESS O FARM IRTEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL O STAND -BY O MOUNT OF USE YIELD SOUGHT :J— gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING ❑REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY MNEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH. t2 (05 ft. STATIC WATER LEVEL _L0 —ft. I DATE MEASURED S— 9 -90 DRILLING EQUIPMENT ❑ ROTARY WOMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING PEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH _ tL MATERIALS: RSTEEL O PLASTIC O OTHER LENGTH BELOW GRADE ft. JOINTS: O WELDED JRTHREADED ❑OTHER DIAMETER_ in. SEAL: 3KZEMENT GROUT O BENTONITE OOTHER WEIGHT PER FOOT 1b./ft. I DRIVE SHOE:J3:2YES O NO I LIN ER: 0YES NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (it) DEPTH TO SCREEN (it) DEVELOPED? FIRST O YES ONO SECOND HOURS GRAVEL PACK O YES O NO GRAVEL .SIZE: DIAMETER OF PACK in. TOP DEPTH fL BOTTOM DEPTH ft. WELL YIELD TEST' 1t detailed pumping METHOD: O PUMPED i tests were done is in- XCOMPRESSED AIR t formation attached? O BAILED O OTHER OYES ONO WELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water BC7f. ing Well Dia- meter FORMATION DESCRIPTION aoE tt. It. WELL DEPTH It. DURATION hr. min. DRAWOOWN it. YIELD 9Cm• Land SO / Z- 0- /00 ROGJti! /eO C,< 60 IaA SC Y AS T' WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ONO ANALYSIS ATTACHED? OYES ONO STORAGE TANK: TYPE CAPACITY GAL. PUMP WFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME ,�jOyA Aer�sl/9n/ li%F'G CO, =itl� , DATE Q '7 3o,.7/ ADDRESS /2'6 S �DUTES�Z slGhAW �'e� �Ly Ny /D., / C ZC "� • f 7 �Lj c /L� 3/89 ,� ;;I, S — --� I c/ G, r OLle «J�:17c1. ' 1)1111 :i�(: {•! Ul•' 1'1•:v "IJ�•: ". + 1!!:f \I:li :ii•:�Z�.1- t:t.:: �L4 W trNesseD By ME L P. C.H.D. pf-;G.{ a-% TA = yUliS:il�tC: SE.WhGc. OL,- )C6,1L StSl ".M Fall NJ. -- --..__ �1�,n rte+ p owner LOf� ! COMP. &OhN FoF�r�s rorlrress mated at (St;ert)_ S, QUAke -A HILL A&aD SL=-- Block roc (indicrte nearest cross street) r".uii�oa"ty. QUA K R M AIJOR S Q RDi%j'j wat`rshed C ho i ON 4]� j?t °2CYJIt�T1(yi '�' .^. 4DC�tJL°.k'J Zi0 B✓ WTTA AP °rSC� -act4S Dzte cf P- re- ScaJcina 7/2 g Date of Pe~colaticn Test 110E . P —am mai Alll.: F�.2l:SZ 'KCL--- IeVe—I Time Grct= Sur-: a� 7n Incies Soi? Wit° �`. asp -Stm ; 2�.ui St�st Stop .. Drco In Min/I Deco Ir - 3 ILeL% II:S� 0::. as /y 13:3 3 ' O -•v' r- 4 = CQ 1980 i -. , e.. ---1, Oz, Fc'SSION 1- ses;s to be reo,�t-d' at szjre deoth until aoorarimate_'y iaqq� soi2 rates are obt.aina6 at aach petcola Lion hest hole- All data to be sib . tted for revied. z_ Depth measuremnt, to be nice. free LOP of• hole. TEST PIT DATA RNQUMM TO BE SUBMITTED WITH APPLICATION l DERRUY ION OF SOILS ENOOUNI'IIM IN TEST HOLES 1 / / DEPTIi HOLE NO. HOLE NO. • Q�j HOLE N,0. G.L. Name �c� ..�-.► 4 C-c k ;a Address 1' or Wulw �w TUIS SPACE IUR USE BY HEALTH DEPARTMrNP ONLY4 3' Soil Rate Approved rq_ft,/gal. 'Checked by 41 Orr" r 5': ! 1 r .. , 81 9• h t � f ur 5:F r _ S i .ii ice (. 6 r 7 13 e '- Olose:,�,•ed .vi �,�lr1 by T,�c.h � It�k 4 woe 14' MVICATE ;WEG AT WHICB C b0 2IS OMERE , ]NDICATE LEVEE 210 WHICH •WATIIt. IEVa RZSSES AFTEEt BEING N /yam 1 a �' ZS DEW l BY G • o' 'a SEA �= CO -190 yf Sy vOF�� ' ................... Date Name �c� ..�-.► 4 C-c k i9 �` Address TUIS SPACE IUR USE BY HEALTH DEPARTMrNP ONLY4 "---` Soil Rate Approved rq_ft,/gal. 'Checked by o' 'a SEA �= CO -190 yf Sy vOF�� ' ................... Date TEST DATA �rT6C) Inspector` %oC Tout Tact' Soil No: IIolu iiolo R rt 2jipa �Soakad TEST RUNS .Dc th• _... *.; i__,. Z.. 3, 5 Id s r rr I s .1 , iN ..... s o got 1 }�(S ' g 777 ; IF : ..5,. _ _..7T. _.. _. � •. � t• t�C 1, • � -,�� R ^r �'Tt = °E�, t_e• "itJ f`': fi';'1� '�} rRC 'SCiX'CG`Lbi'��:t.�'; - `,:C`,•�;': , - - ,the pndors}gn�cd,. 'done' certify `. tha�to percolation t ware by inyacll� or' and according to ' tha atandar n. Ths resuTt`s-'pt''aaonce �.� . �'c rect. �E4Y.J• to F •� Da ccd.: $ttaCu C�" r iecnsc'l�0. (P.E l i 1 '' No. 4�5�6 � f7?OFESSIO1'7 TOPS FORM 4151 k. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DateP2 /G 2. /9 %c/. Re: Property of �/cS'� �-Sr R-ALr , 7i2us7�� d� rn S C,f'TT Located at R,,Y -9 Qu.44f, 6411 �. (T) P,4.�ra,y Section ock /. Lot IW- AL Subdivision of aArl 194f0A / Subdv. Lot # 9 Filed Map # 2678'' Date '7lldl Qd Gentlemen: This letter.is to authorize Z. ESQ 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. , 26 Address X�2 f Lf& 0 9i 2 ?9 '?�i s Telephone Very truly yours,. Signed �- Owner of 'Property 2�. CoLdIC(A (24 Address Town Zv 7 ?92- Y77-6 Telephone PC -1 P U T N A M COUNTY D E PA R T M E N T OF H E A L T H APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: 20 C� low /.� ^D,¢(W 4WdQ z. CO--W .. D b-S-19 2. Name of Project� .SO )or 9 SSOS 3. Location T /V /C: I-- /mow 4. Project Engineer: k.�ar cc AMir 5. Address: L 4kt-44 ,, A// License Number: ---r Phone:27�I^7 //� 6. 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 (SEAR)? Type Status (Check One) Type I.. Exempt Type II. Unlisted _ C- 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. / 9. Has DEIS been completed and found acceptable by Lead Agency? ........... .. ,0. Name of Lead Agency 1. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ....................... 2. If so, have plans been submitted to.such authorities? .................. 3. Has preliminary approval been granted by such authorities? "—Date Granted: 4. Type of Sewage Disposal System Discharge...... Surface Water Ground Waters 5. If surface water discharge, what is the stream class designation ?........ "^ 6. Waters index number (surface) ........... ............................... 7. Is project located near a public water supply system? K' 3. If yes, name of water supply Distance to water supply 9. Is project site near a public sewage collection or disposal system ?..... a J. Name of sewage system Distance to sewage system 1. Date test holes observed -4 110 22. Name of Health Inspector: KE?� 3. Project design flow (gallons per day) ...... ............................... 11/93 A�// 2. 24. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?.. X 25. Has SPOES 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. I's 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 _ �v 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: 32. Is there a local master plan or file with the Town or Village? 4/4 33. Are community water, sewer facilities planned to be developed within 15 years? 34. Are any sewage disposal areas in excess of 15X slope? . F�Y!5;�:+..•�'....... 35. Tax Map ID Number ........... ............................................. �1Lf� 36. Approved Plans are to be returned to: Applicant Engineer f the application is signed by a person other than the applicant shown in Item 1, the °pplication must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and be 1 ief. False statements made herein are punishable as a Class A Hisdemeanor pursuant to Section 210.45 of the Penal Law. _ IGNATUP,ES & OFFICIAL TITLES: U n� AILING ADDRESS: Pe PUi'NAM CO(JtM DEPARTMEVT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT- CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PLM4AM COUNTY HEALTH DEPARTMENT TO: Carmi.ssioner 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 (Name having offices at ,mod L .6 l yt c 4-2- 06 / Whose officers are: 62, President: 1 a /1� g 607 (Name and address) / Vice - President: (Name and address) Secretary: t. (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. Sig Title: 1017-1 Sworn to before me this 2 Pday j -ek Corporate Seal 20 41,e �vr 61 1. DEEP TEST RESULTS Date'. lame Of property: ;.-g uav-s >.1717A U09- y.(C) 'Aal v an V". Cww) )wncIr of property: Engincer.: 'crs04 Airccti �tpst:: —So--�C-24 Rep AvWA M-rAja�j4---- M I-10I.C, )took 'Wat.cr;` To tal Number `Number Depth Depth -D.Cptb S'oil'.des.crip.tion *3 ---77, -77,-' . . ...... 77 NO tjo SO I ILI 4- 1-3 1. V-'4 i A ac 'S, I L7 .401ven NO NO 01 - 10 Ff, I A f3 L. C- wl+kV\- r3to tic( -7 Q S,4 "b;j L vA to-, 10 V L. ry L'bAh'� U) tw 7"Cr-- rr? 0 Tr I :3 0 8 z General remarks* n r) springs, streams, etc.) v 41,e �vr 61 1. QUAKER MANOR SD LOT # 9 3 Bedroom Design Design Flow: 3(200 gal /bed) = 600 Gallons Perc Rate: SYSTEM 31 -45 EXPANSION 11 -15 Application Rate: SYSTEM 0.50 EXPANSION 0.80 Req. Area: SYSTEM 600/0.5 = 1200 sq. ft. EXPANSION 600/0.8 = 750 sq. ft. Req. Field Length: SYSTEM 1200/2 = 600 Actual 600' EXPANSION 750/2 375 Actual 390' Septic Tank: 1000 gallons Dosing Due to Lateral Configuration Dosing Volume:; System: (pi)(2/12)2(600)(.75)(7.5) = 294 Expansion: (pi)(2/12)2(390)(.75)(7.5) = 191 Dosing Chamber: SC 4 x 4 170 E = 28" RLI: 618.0 o: . _...— Julius Cesare, P. E. Blackberry Hill Brewster, NY 10509 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 BRUCE R. FOLEY Acting Public Health Director -March'-)4,1997 Re: Proposed SSDS: West East Realty Trustee South Quaker Hill Road Lot #f9 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. Primary and expansion area are to be designed on the same percolation rate, i.e., a 31 -45 min /rate. Therefore, the expansion area is to provide for. 600 L. F. of absorption trench. 2. File map number and date of filing is to be noted on engineers authorization (enclosed). 3. Standard form PC -1 has not been submitted. 4. Original well log is to be submitted. 5. A completed corporate resolution is to be submitted enclosed. 6: Design data sheets, i.e., deep hole log and percolation test results have not been submitted. 7. Deep hole log test data on plan notes trace of mottling. The depth of the mottling is not noted. 8. Please be advised that current Putnam County Codes do not require alternate system for trench lengths less than 667. 9. General note 12 should be revised to where effluent lines exceed 50 feet. Drop boxes are required. 10. SSDS profile is to note finish floor elevation and maximum slope in fill area. 11. Current code requires that the SSDS area with slopes between 16 -20% be reduced to 15% by the addition of fill. All slopes greater than 15% are unacceptable. 12. Footing and gutter drain discharge is to be shown and labeled. 13. Erosion control measures for the house is to be shown and detailed on the plan along with a note stating all erosion control measures are to be installed prior to the start of any construction. 14. A location map is to be provided on all SSDS plans. I— 15. Title block is to note; current property owner, road, tax map number and is to be titled "SSDS Design ". 16. House is to be labeled `Proposed 3 bedroom residence" on SSDS plan. 17. Sewer line is to be noted as cast iron, 4 inch diameter and having a minimum slope of 1 /4 "/ft on SSDS profile. 18. Trench detail is to note cover as geotextile material or equivalent. 19. SSDS profile is to show clay berm at the edge of the fill section. 20. Revise or replace the following details to reflect current codes a) trench detail Section B -B b) Typical section drilled well c) typical fill section for sloping ground, (guidelines enclosed). 22. Revise fill note 1 to current codes, enclosed. 23. Filed subdivision map "Quaker Manor" notes a curtain drain is required on this lot. Curtain drain depth is noted as 7 feet and lens h of 280 feet. Upon receipt of a submission, revised to reflect the above, this application will be considered further. RM/JP Very truly yours, li&ov- 4OU0 Robert Morris, P. E. Public Health Engineer Julius I. Cesare, P.E. 19 Washington Court Pawling, New York 12564, 914 -855 -3208 FAX 914- 855 -3216 Jan. 16, 2001 Bruce Foley, Director Putnam County Health Department ATT : Shawn Rogan 1 Geneva Road Brewster, New York 10509 RE: Quaker Manor Lot 9 Renewal t. of Patterson TM # 4.10 -1 -f[o Dear Mr. Foley, Herewith transmitted is a completed package for a renewal application on the above noted individual lot SSDS. Thank you for your cooperation. Very truly yours, Julius I. Cesare, P.E. 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 Y N ''— PERMIT APPLICATION m m EXP. AREA; SHOW RAVITY FLOW, SUFF S PC -1 CD IF PUMPED PIT & D BOX SHOWN & DETAILED WELL PERMIT PWS LETTER EN P AUTHORIZATIO�1 1G6 /� i �a�Z = HOUSE - NO. OF BEDROOMS [� NERS m SHE WELLS & SSDS'S W/IN 200 FT. OF PROPOSED SYSTEM DESIGN (MYS) = PROPERTY METES & BOUNDS m CORPORATE RESOLUTION m HOUSE SETBACK NECESSARY (TIGHT LOT) m PLANS THREE SETS m TWO m HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE HOUSE PLANS - SETS m NO BENDS; MAX. BENDS 45° W /CLEANOUT m VARIANCE REQUEST SUBDIVISION FILL SYSTEMS m CLAYBARRIER Fn SUBDIVISION m 10 FT HORIZONTAL: SLOPE 3:1 TO GRADE UBDIVISION APPROVAL- CHECKED m FILL SPECS m FILL NOTES J PEER___R_ATE it —11 . �_ m FILL CERTIFICATION NOTE � m FILL REQUIRED— - -- - DEPTH m DEPTH GAUGES m CAIN DRAIN REQUII - D =STANDPIPES m FILL PROFILE & DIMENSIONS VOLUME GENERAL m FILL IN EXPANSION AREA m EX- APPROVAL SSDS ADJ. LOTS m WETLAND ( TOWN/DEC PERMIT REQ ?) TRENCH m DATA ON DDS PLANS & PERMIT SAME LF TRENCH PROVIDED m60 FT MAX m PRE- 1969 = NEIGHBOR NOTIFIFICATION m PARALLEL TO CONTOURS m LETTER BI/ZBA m 100% EXPANSION PROVIDED m 100 YR. FLOOD ELEVATION SEPARATION DISTANCES SPECIFIED ON PLAN REQUIRED DETAILS ON PLANS FIELDS Lt-J SEWAGE SYSTEM PLAN - (NORTH ARROW) m 10' TO P.L., DRIVEWAY, LARGE TREES TOP OF FILL ,v SSDS HYDRAULIC PROFILE m GRAVITY FLOW m 20' TO FOUNDATION WALLS Ed 15' WELL TO P.I x6NSTRUCTION NOTES (GRINDER NOTE) m 100 TO WELL, 200' IN D.L.O.D., 150' PITS DESIGN DATA: PERC AND DEEP RESULTS m 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN) TWO -FO TAEONTOURS EXISTING & PROPOSED m 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER DRIVEWAY & SLOJPES CUT m 10' TO WATERLINE (PITS -20') m F T G/GU R/CURTAIN DRAINS m 50' INTERMITTENT DRAINAGE COURSE m EROSI CONTROL; HOUSE,WELL, SSDS m 200 FT. RESERVOIR, ETCH 150 FT. GALLEY SYSTEMS m EROSION CONTROL NOTE m 15'MINTO C.D. S= >5 %,20'- 4 %,25'- 3 %,30'- 2 %135' -1 %,100' <1% m P,E C & DEEP HOLES LOCATED m 20' MIN TO C.D. DISHARGE /100' WITH 182 CONS DAY DIS. m iUJRZENTA IVE OF PRIMARY AND EXPANSION SEPTIC TANK IS] LOCATION MAP =I 0, FROM FOUNDATION; 50' TO WELL COMMENTS: 6W P9,W19 4A &A PA IJ 51,o,) h, 23 Julius I. Cesare, P.E. 19 Washington Court Pawling, New York 12564 Bruce Foley, Director Putnam County Health Department ATT: Robert Morris 1 Geneva Road Brewster, New York 10509 March 20, 2001 RE: Proposed SSDS: West -East Land LLC South Quaker Road, Lot 9 (T) Patterson, TM# 4.14 -1 -16 o' Dear Mr. Foley, Your letter of Feb. 14, 2001 contained comments relative to the above noted project. With reference to those comments please be advised as follows: 1. We acknowledge that the 911 Form should be submitted with the as -built drawing. 2. We have removed the Profile from the Fill Plan Detail Sheet so as to only show details and noted pertaining to the Fill Plan. 3. It is recognized that the area in which the SSDS is proposed does contain some borderline 20% slopes. For your information the representatives of the NYCDEP did in fact perform a grade check during their field review and concluded that the grade was acceptable and considered not greater than 20 %. This would be consistent with the acceptance that topography is not necessarily infallible and that some margin of error could exist. The fact that the subdivision and the SSDS design have both been approved by the PCHD and the NYCDEP should be reason enough to assume that the grades are acceptable and no greater than 20 %. Nevertheless that does leave the issue of the new regulations of flattening the slopes on grades of 15 -20% to 15 %. It is our understanding if all other features of this application are acceptable it would still necessarily be rejected because of this new regulation. Accordingly, if the application is acceptable in all other page 1 respects we herewith request that the application be submitted to the Waiver Board for their April Meeting so that they may consider granting a waiver on this project. The Board should be made aware that this Lot was created by an approved Subdivision and has already received an approved SSDS Design prior to this renewal request. 4. The curtain drain discharge has been extended to achieve the proper separation. Thank you for your cooperation in this matter. Very truly yours, Julius I. Cesare, P.E. page 2 0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 0Q_2 /G Re: Property of Located at Rn 4# 9 n U,4��t Ai /l 29. (T)� s0 Section /IF Block /. Lot 2W_ Subdivision of �u, �„ RA-goR / Subdv. Lot # 9\ Filed Map # Z�iB' Date %lfdlQd Gentlemen: This letter is to authorize �i �,,�i u r f• ( ,E'j`� 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. , 12.6 &2d , A// Address Telephone Very truly yours, Signed �- Owner of Property '2-, (SOZ "" A (2 4 Address CZ Town ZvT 7 9 z Y77i Telephone BRE:CE R FOLEY Public R#ahh D.,reeror 1DEPARTNEENT OF HEALTH 1 Oeneva Road Brcwater, Now York 10509 LORETTA MOUNiARt RN., NLS.N. Anociau Public HsaPA DWULI► Di/ICtal of PGffin1 jorVIC&I Eovlroamsatel Health (914)211.6130 Pa(914) 278.7921 YumlMt Services (914) 271.6138 WIC (914) 211 -66701 Ita (914) 270.6001 Early iatervegtlaa (914) 278 .0016 Preschool (914) 211.6062 Atx (914) 271- 6643 OWNERS NI AML G-g— , � e TAN mApIlq-UMBER; E911 ADDRESS; - _ -- TOWLN- AC3THORIZED TOWN O)FFIOLaLs (Signature) / DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, ix., a legal E911 address is assigned by an autborind town official. This .form is to be submitted with the application for a Certificate of Construction) Compliance. (:911%'7ERMM' FE43- 05 -01. 04:17 PM c FES-- 03 - -e.L MON 14.57 ° GESARE-ENG.. - 914 278 566 BRUCE X FOLEY 'hiblie ifaalrh piPecreP f -. ,mow DEPARTWNT L Clem! Brewster, New P. 03 P.02 LORSMk MOf<.IKAW R.N.. M.S.N. Assoetore Public F=kh Ptrrctar nowfor of Patttrl 5ervlcsv EvIronm aW Hadth (445)276-6130 FiA (841)278.7421 Nurtiq $ar'►eet (645)276.6515 WIC (843)278.6678 rut (845) 278.608S Early Inctrvtriion (845)278-6014 rmcloal (845) 27a -6082 Fax (34S) 278 - 6643 Janucuy 30, 2001 Julius Cesare, P.E. 19 Washington Court Pawlk* NY 12564 RE: Applicatiol, to Construct a `Subsurlteo Sewage Ticatrtient System at West But Realty Trustee South Quaker Hill Road, Lot 09 (1") Patterson, TMO 4.14 -1.16 Dear Mr. Ces"rc, The Put= County Depattmerd of health 09partment) has determitled that the above referenced application, received by the Depf0menton January 22, 2001 is incomplete. Please be advised that the NIOWing information is zequircd befotc the Deparrt7nent may Comniamoe its review. • Cgrzexnt Engineer Authorizatiaol Form has not Non submitted, Please be advised photocopied documents ate not acceptable for submission. The review of your application will comment once the Depailment ieceivca the requested i»f'omation and determines that the application is complete. The Department VVUI notify you withic 10 days of its receipt of the requested information as to the completeness of your application- please be advised tbat failure to Submit information to the Depamnrmt or to follow procedures is sufficient grounds to deny approval, puxsuw.t to the New York City Depa lment of Erivirori rental Protection Watershed Regulations And Putnam Comty Depart rent of Health regulations. Should you have any questions or care to discuss tlals rnatter, ptease contaot me at (845) 278-6130 ext, 2166, Vco %l,Y Yo�ttt bert Morris, P. E. 1; \4;tn Senior Public Health Engineer FEB -06 -01 04:16 PP7 FED -04 -01 NON 14:'56 "G €SPIRE- ENG... 514 27e 566 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE-. Property of V(efr LET'T'ER 0F.4,UTHO)PUATION `-C)e0 mr C/a T60— rc J7'— Located at so, J[4 T/V P Tax Map # Block Lot Subdivision of Subdivision Lot 4 Filed Ivxap # Date Filed Genticrnon. '1'lris letter is to authorize 4^4 Fl. E9 2 a duly licensed professional Engineer o! or Registered Architect � to apply for the required wastewater treatment and/or water supply permit(s) to sorve the above -noted property in accoxdanco 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 bzhalf ira connection with this matter and W superMse the construction of said wastewater tretrnent and/or water supply system in conformity with the provisions of Article 145 and/or 07 of the 1?ducation Law, tho Public Health Law, and the Putnam County Sanitary Codc. Very truly yours,,,,, Counter Signed ; (owner of proput)0 Malting Address / ` W0047WAAA C;r' State alp •i"� Telephone; - r NlailingA,ddress: 2-0 CO I's • —PA- -P.. _ M / State. dip D 6J_ Pom LA -071 BRUCE R. FOLEY Public Health Director DEPARTMENT . OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 -'6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 February 14, 2001 Julius I. Cesare, P.E. 64 Blackberry Drive Brewster NY 10509 Re: Proposed SSTS: West -East Land LLC South Quaker Hill Road, Lot #9 (T) Patterson, TM# 4.14 -1 -16 Dear Mr. Cesare: 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: 1) Current codes requires that the E -911 Form be submitted with the Certificate of Construction Compliance (enclosed). 2) Fill plan detail sheet is to only show details and notes pertain to this fill plan: 3) SSTS is proposed on a slope of approximately 21% current codes do not allow the construction of a SSTS on a slope greater than 15 %. 4) Curtain drain discharge is to be shown the minimum of 2' below the SSTS. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regards. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Very truly yours, � 4� � Robert Morris, P.E. RM:tn Senior Public Health Engineer enc. West East Realty Trustee % Tom Scott February 6, 2001 This is a hard copy for the renewal application on this septic permit. Located at South Quaker Hill Rd. lot 9 TN Patterson Tax Map # 4.14 -1 -16 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509, LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 April 5, 2001 Julius Cesare, P.E. 19 Washington Court Pawling NY 12564 Re: Proposed SSTS: West -East Land LLC South Quaker Road, Lot #9 (T) Patterson, TM# 4.14 -1 -16 Dear Mr. Cesare: 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: 1. The plans, as submitted, are not acceptable for the current requirements for a "fill section only plan". Current codes require that a fill section only plan be submitted for fill sections greater than 2 feet in depth. This includes fill used for grading purposes. Please refer to bulletin ST -19 for current requirements. 2. Please be advised that a request for a slope wavier cannot be requested until a formal denial has been issued. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Ve truly yours, Robert Morris, P.E. RM:tn Senior Public Health Engineer BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 April 20, 2001 Julius Cesare, P.E. 19 Washington Court Pawling NY 12564 Re: Proposed Construction Permit: West -East Land LLC South Quaker Hill Road, Lot #9 (T) Patterson, TM# 4.14 -1 -16 Dear Mr. Cesare: Review of plans dated May 8, 1996 last revision dated April 6, 2001 and other materials relative to a construction permit for the above captioned property has been completed by this Department. Based upon such review, and pursuant to the provision of Article III of the Putnam County Sanitary Code, you are hereby advised that the proposed method providing water supply and sewage disposal are considered inadequate as set forth below. Therefore, approval of these plans cannot be granted. 1) The SSTS is proposed on a slope of approximately 21% current codes do not allow the approval of a SSTS on a slope greater than 15 %. It is your legal right to request a waiver of the denial based on item(s) noted above. The denial request must be submitted in writing after the receipt of this letter. The request must specifically state the waiver being sought. If you have any questions, please call me at (845) 218 -6130 ext. 2166. RM:tn Ve ly yours Robert Morris, P.E. Senior Public Health Engineer Julius I. Cesare, P.E. 1, Uashington Court PaATlino, ,led !or- . 1. 5 April 2Y, 2oul ;truce r'olef, director .'utnam Countr 'health department A'2T: rZobert Morris 1 Lieneva Road Brewster, rfew York 165 -,y Qual:e-r i4anor Lot r�l dear sir. . 2 ole f, it is our understanding from four letter that all aspects of this application are acce;jtable except that it requires a waiver because tiie fields are on a slope of greater than 1 >%. 4ccordin.,l f, we herewith re�luest to be placed on the agenda of tiie clavier Committee to entertain our request for such a waiver. Would you please; advise tie ;laiver :doard that this lot has previouslj been a ,)proved at both the subdivision stage and as an individual O'Si)S. Thanx you for your cooperation in this matter. Very truly yours, Julius I. Cesare, P.E. 'OUT H / 570) ' -� �ls woo rip OAKS / bg1l / /A4l. oo I kLo // 5901 UT ON 6b / V. I N 9.2 INV.OU D T I / VIN INV. T 600.0 O P S E - OP MH 4.8 INV. I TT / i . OUT 611.0 DOSI HAMB 1 IN 61614.88 \0 0 1 °�SEP IC TA NV. IN .8 INV• T 6157.42 / •peyartme oY Se. -Go Cgealth ervioe / Dim on °; ED To enACE ON SL loable es e with tnso tY ae� eocordas of the C { / / ® ®o 0 > > 0 4 PVC PIPE ° o Q h °o o- �' �° o DOSING CHAMBER I � 1 �QO 4 BAFFLED JUNCTION BOX`` B \ 1 000 3 00 \000 GAL. SEPTIC TANK A C \ F � t \ i \ 1; OCP��pN o vw liN u l lr.a l alill , r "1'. ► ITEM A B C D 1 -- 16.0 51.2 _. ..._ ._.. __- --�•__ _ _ _ -"___ 2 20 43.5 310 GAL. DOSE 310 GAL. DOSE 3 23 39:8 4 29.5 32.5 �C ' 5 95 29 6 101 85.5 7 105.5 92 8 106 98 -- -- - - -- 9 115 103.5 10 119.5 109.5 11 124.5 115.5 12 130 121.5 _ 13 135.5 128 14 78.5 93 15 81.9 91.9 16 87.2 97.92 17 _ 92.48 103.84 18 97.87 109.87 19 103.33 115.85 20 108.84 .121.84 21 150.95 119.34 x 22 153.27 153.27 123.36 - ��..... ..I, 23 155.79 127.54 24 25 158.50 131.86 161.39 136.31 -� 26 164.44 140.87 - 27 150 134 28_� 33. 34 35 36 - - -37 WELL 82 112 CURTAIN DRAIN OUTLET. �/� ..- \.'�j �:: - � •...,�/ ITEM REQUIRED PROVIDED SEPTIC TANK 1000 GAL. 1000 GAL. ABSORPTION TRENCH 600 LF 670 LF PUMP CHAMBER N/A N/A DOSING TANK 310 GAL. DOSE 310 GAL. DOSE BAFFLE BOX YES YES