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PUTNAM COUNTY DEPARTMENT OF HEALTH.
V . 3186 Division of Enviroameutal Health Services, Carmel, N.Y. 10511 Engineer to PioA 'd
ermit q
ib on CERTIFICATE OF COMPL_ IANCE
NSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Permit q �y.
G Patterson
ted.at North Birch Hill .Road Tern or "ylllage
White Tail Acres 1 ;, 1 7
Subdivision Name Sid. -Lot N
Tax Map Block Lot
Owner /AppllcantName William J. GUldo~
Renewal ❑ ` Revision O
Date of Prevlous Approval, . 7/31/86
P.0'. Box 51 Pawling 12564:`
l
'Malling-Address Town y
Single Family 10.836 Ac
Fill com leted
Building Type g X Let. Area Fill section only Depth' _ Vohrme
Number. of Bedrooms 3 Deslo Flow. G/P /D 600 PCHD Notification is Required When Fill is completed
z : -t
1 000 35T LF Trenches
Separate Sewerage System to consist of r ; . Gallon Septic Tank and
To be constrfiiked:by Brill -: EXCflVatOrS Address . PAinll flf7 Nelnl ". Ynrk
Watei,SupPIJ : Public Supply From Address
or. x Private Supply Drilled h.!'�� file0 Address
�rewsQ.r a1_.
Other Requlrements
I represent that I- am wholly and completely - responsible for the design and location `of the proposed system(s); :I). �thaf the separate sewage. disposal •system
'above described will be constructed�as shown on the approved amendment�tiiere to and in accordance with'the standards, rules an regu a eons o e ,u name•.
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, fu' i6 tfie"owner, his successors ,,heiis'or,` assigns 'by the builder, -ihat_ said :bwider� will I'm place in..good operating condition any: part of said sewage,d�sposal 3yste during the period, of two,.(2)� ears immediately following the datebf the'issu-
lance of the approval of the Certificate of Construction ComPhance rof ; original system or' any re th o;'2) that.the drilled_well dekribed above'
.. .
will be locatedas shawn,on the "approved "plan and .t hat said well will De inst I in accordance with he' d ,`rules and ragu a— Iations of .'the Putnam
,iCountYDepartmentof Health.',: Me
Date . .10/28/86 " Sig ed '.., P.E.- R.A.
Address BaldWin. & CAIT] '1 : RD 6 q. 22 stet NY.. License Ne.: 61750, '.
APPROVED FOR CONSTRUCTION:— This ♦- ,
approval expire one year from the °date'issued' unless construction'of .the building has been undertaken and is
revocable for cause or maybe amended or- rhodified••when''c - itlered ecessar 'b he Commissioner of .Health. •Any change or alteration of construction
,requires a newj permit. Approved for disposal of aonle i sanitar sewa a �privawalar o nly. :
Date — Title
Fi
BALDWIN & CORNELIUS, P.C.
Engineers- Architects -Site Developers
RD #6, Rte. 22
BREWSTER, NEW YORK 10509
(914) 279 -7115
TO
Cyr WV j . N 'y
LIETTEEQ OF MUSOMD"Ir"IQL
DATE to/z7/96
Boa NO. C,510
ATTENTION -
M � ue t3J� zr�,3it:
RE:
3
WE ARE SENDING YOU X Attached ❑ Under separate cover via the following items:
• Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
• Copy of letter ❑ Change order ❑
COPIES
DATE
NO3195
DESCRIPTION
3
Ia /Z7
Le `t -e,Y-
THESE ARE TRANSMITTED as checked below:
• For approval
• For your use
• As requested
❑ For review and comment
❑ FOR BIDS DUE
REMARKS
• Approved as submitted
• Approved as noted
❑ Returned for corrections
• Resubmit N copies for approval
• Submit copies for distribution
❑ Return corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
COPY TO j
SIGNED: tt�
If enclosures are not as noted, kindly notify us at once.
BALDWIN & CORNELIUS, P.C.
CONSULTING ENGINEERS - LAND SURVEYORS
RD 6 - ROUTE 22, BREWSTER, N.Y. 10509 (914) 279 -7115
October 27, 1986
Mr. Michael Budzinski
Putnam County Health Dept.
2 County Center
Carmel, New York 10512
Re: White Tail Acres Lot #1 (P- 51 -86)
Town of Patterson
Baldwin & Cornelius Job #65037
Dear Mr. Budzinski:
On behalf of'. our client William Guido, we request
the approval of this resubmission.
White Tail Acres Lot #1 already has been approved
for fill section only. Enclosed is a copy of the
construction permit and 3 sets of plans. If you
have any questions please call us at the above
number.
Very truly yours,
BALDWIN & CORNELIUS, P. C.
William Hurley
Design Engineer
Enc.
Jc
\ � r
PUTNAM COUNTY DEPARTM= OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WXTER SUPPLY SUBSURFACE SEWAGE DISPOSAL SYSTEMS
FIELD INSPECTION REPORT
(Name of Owner) (Street Location)
INITIAL SITE INSPECTION YES NO
Wetlands on /or proximate to property ..............
Property lines or corners found ...................
Can estimate house location .......................
Will driveway need cut .............................
Must trees be removed - note these ................
Deep holes representative of entire SDS area......
Additional deep holes needed:........ ... .....
Sufficient SDS area available considering driveway
cut, house location, separation distances,etc...
Adjacent wells/ septics ............................
D.H. 1 Lot
Depth to G.W.
Depth to rock
Soil Descri tic
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
D.H. 2 Lot
Depth to G. W.
Depth to rock
Soil De,
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
DATE:
INSP. BY:
D.H. - Deep Hole
G.W.- Groundwater
D.H. 3 Lot
Depth to G. W.
Depth to rock
0 ft.
3 ft.
6 ft.
9 ft.
12 ft.
5011
- - DATE: 1 C) ' 'Ly - `boo
FINAL SITE INSPECTION INSP.BY: A i �.
YES
NO
House SSDS located per approved plan.. .......
Length of trench measured ?> '
Width of trench average
Slope of the line and tr ench acceptable.........
Z ,
Roan allowed for expansion trenches ..............
Over 100 ft. from watercourse ....................
Natural soil not stripped or SDS area
_ ,f AV I ,
f
f ,Y
unnecessarly graded........... ... ......
10 ft. maintained from property line and
20 ft. fran house... .........................
Distance well to SSDS (ft.) ......................
Number of bedrooms checks ........................
'y
y
Stones, brush, stumps, rubble, etc., greater
,✓
than 15 ft. from nearest trench ................
L5 ft. of peripheral soil horizontally
'
,-
fran trench ..... ...............................
3oxes properly set... ... ........... ........
could surface runoff fran driveway, roads,
if
ground surface, etc., channel near SDS area....
bes lot drainage appear OK in area of SDS.......
UNAL GRADNG OF SITE ACCEPTABLE..
"
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BALDWIN & CORNELIUS, P:C.
Engineers- Architects -Site Developers
RD #6, Rte. 22
BREWSTER, NEW YORK 10509
(914) 279 -7115
TO / °l l Cq�f rjyC�Zt�SI
�f.4 r��t1Q I z N
WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via
❑ Shop drawings
❑ Copy of letter
❑ Prints ❑ Plans
❑ Change order ❑
LIETTEa of "MUS D"TURL
DATE 7! 7c) /N6 JOB N06 5-0 3 7
ATTENTION
RE:
❑ Samples
the following items:
❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
3
'7/3el A_G
cc f 3 Pa SS17S D,5
LA-47, Art 14r l- C r e s 1 ►'-
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
❑ For review and comment ❑
❑ FOR BIDS DUE
• Resubmit copies for approval
• Submit copies for distribution
❑ Return corrected prints
19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
� 1�'� -z_. 3 Pa.ee 55 DS
d.2 S r 9 W If_g� t; /c&,Y 6 -1 e r- Corr -e c-4—1 o„ On
.� s slows 4�' r t sP +/ Th it ya
COPY TO
SIGNED:
PRoom 240.1 IA—,e—us-7 im. GmtxL am 01471. If enclosures are not as noted, kindly notify us at once.
DAVID D. BRUEN
County Executive
Mr. William Hurley
Baldwin & Cornelius
RD #6, Route 22
Brewster, New York 10509
Dear Mr. Hurley:
r
DEPARTMENT. OF HEALTH
Division Of Environmental Health Services
July 8, 1986
RE: PROPOSED SSDS
Lot #1 White Tail Acres
(T) Patterson
JOHN SIMMONS, M.D.
Deputy Commissioner
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:
1. The Construction Permit Application should be signed by the design enginer
, and the fill section parameters completed.
2 A letter of authorization is required along with two (2) sets of house
plans to complete your submittal.
3. The soil data sheet must be signed and sealed by the design engineer.
4. The extent of the fill section must be delineated on the plan along with
the clay barrier.
5. The septic tank must be a minimum of 50 feet from the proposed well.
6. The stream location should be shown on the plan.
Upon receipt of a submission, revised to reflect the above comments, this
application will be considered further.
MJB:mk
VerA truly yours,
� Ua
Michael J. Budzin�ki
Public Health EncFl eer
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914)..225-3641
PUTNAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS
(Name of Owner)
REVIEW SHHEET�_- CONSTRUCTION PERMIT 1
./ I ' �-�" l DATE MEWED:
IA ( Z `C
BY:
(Street Location)
DOCUMENTS
Permit Application
Corporate Resolution
Plans - Three sets
Engineers Authorization
Design Data Sheet (DDS)
Deep Hole Log
Consistent Perc Results (3)
30" Perc Hole
Other
House Plans - Two sets
If PWS - Letter
Variance Request
REQUIRED DETAILS ON PLANS
Sewage System Plan
Sewage System Hydraulic Profile - Gravity Flow
Fill Profile & Dimensions - Volume
D or J Box;Trench /Gallery; Pump pit details
Septic Tank - Size, Detail
Well Detail, Service Line if over
Construction Notes
Design Data
Two -Foot Contours Existing & Proposed
Driveway & Slopes Cut
Footing /Gutter Curtain Drains
Perc & Deep Holes Located
Representative of Sewage & Expansion Area
Expansion Area;shown;gravity flow,suff. size
If Pumped Pit & D Box Shawn & Detailed
House - No. of Bedrooms
Wells & SSDS's w /in 200 ft. of Property Located
Property Metes & Bounds
House Setback Necessary (Tight lot)
House Sewer - 1 /4 " /ft. 4 "0; Type pipe
No Bends; Max. Bends 450 w /cleanout
SEPARATION DISTANCES SPECIFIED ON PLAN
Fields
10' to P:L., Driveway, Large Trees
20' to Foundation Walls
100' to Well; 200' in D.L.O.D, 150' pits
100' to Stream, Watercourse, Lake (inc. expan)
15' to Drains- Curtain,Storm,Leader,Footing
25' to Catch Basin
10' to Water Line (pits -201)
Septic Tanks
10' from Foundation
50' to Well
15' Well to PL
GENERAL
Legal Subdivision
Subdivision Approval Checked
Ex- approval SSDS Adj. Lots Checked
Wetland (Town /DEC Permit R & D)
Data On DDS Plans & Permit Same
9- BALDWIN & CORNELIUS, P.C.
CONSULTING ENGINEERS - LAND SURVEYORS
RD 6 - ROUTE 22, BREWSTER, N.Y. 10509 (914) 279 -7115
July 23, 1986
Mr. Michael Budzinski
Putnam County Department of Health
Division of Environmental Health Services
Carmel, New York 10512
RE: White Tail Acres - Lot No. 1 - Re- Submission
Dear Mr. Budzinski:
On behalf of our clients, Anthony Mastracchio and William Guido,
we request approval of this re- submission.
Our responses to the Putnam County Health Department comments of
July 8, 1986 are as follows:
1. The Construction Permit Application was signed by the
Design Engineer and the fill section parameters completed.
2. The Letter of Authorization and two sets of house plans
are enclosed.
3. The soil data sheet has been signed and sealed by the
Design Engineer
4. The extent of the fill section has been delineated on
the plan along with the clay barrier.
5. The septic tank is now eighty feet away from the pro-
posed well location.
6. The stream is located on the plan.
Please call me if you have any questions or.c.omments regarding
this three -page design.
Very truly yours,
BALDWIN & CORNELIUS, P.C.
William Hurley
WH /b
Encl /House Plans (2 sets)
Engineer's Authorization
Three -Page Design (3 sets)
Signed Soil -Data Sheet (2)
Construction Permit Application
i utjutui utiulll'Y 11151 III 11114151' T Ulr 111MM
1
L1V151UI1 Clr L''(1V11iU11f1L11'1'/iL 1 � L'1'll SL''liV1C ��
CUUII'ry U1r1r1CL 13Uiw111U. C/Iingb'. y. Y. 1U512
' 8 LL II)ESIU11 UATA SI 1- SLlAlATL SLWA3L ll1SI'USAL SYS1L1I4 /1/ U.
Uullev . White Tail Acres Addreau No. Birch Hill Road (AKA Stagecoach)
Loc:ULed UL (Stivet) B s��ii�� Road,Sea. look - 1,vL I
`�lidic:aL•e liearouC -uFouu 5U eeG
IiWt1ClJ11l;y Patterson Wai;etulled
GU1L 1'LIICULITIOU UST Ltl1TA REQUIRED '1'U 13B SU131.111"1' r W1'1'11 A1'1'L1C111'1U113-
l lvl u
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.'ful• revIeW.
2) WpWimeauuvemeute to be made from Lop of hole.
TEST PIT DATA MQUIRED TO BE
DESCRIPTTO11 OP SOIL Z B1,1
ITED 111TH APPLICATION
RED IN TEST 110LE-3
EPT11 11012 , 140i. D 2 A HOLE 110.
n 9 R
TOPSOIL TOPSOIL*
Loam with Sand Loam with Snnd
HOLE NO.
211
(311 --------------
J1 It
011
,611
211
1311 3. 51 to Rnrk
Jill
3611
T211
31111
1111DIME LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
I1,1D1CATE LEVEL TO W1j1C11 WATER LEVEL RISES AFrEB BEING ENCOUNTERED
TESTS MADE BY Dalwin & Cornelius Date
Soil Rate Used 10 MitVl"Drop: S.D. - Usable Area Provided 5,000 S.F.
P
11o. of Bedrooms 3 Septic Tank Ca Type
Capacity 1000 Gals. Ty
Absorption Area ProvIded By 3�� L. F. X24!1 xx '36" width rei
Other
<
flatue Baldwin -& QorneliLj-q, P-r_ UIgmture
y
Address RD 6, Route 22
SEAL:;
6
—Brewster., New Ynrk
THIS SPACE FOR USE BY 11MV11 DEPARTMENT ONLY:
d'. Date
Soil Rate Approved Sq. Ft/Gal, t0hedlko
Re:
PUTNAM COUNTY DEPARTMENT OF HEALTH
APPENDIX K
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date '7- jg $to
Property of Will,
ta_,_ as {r
Located at Ijy�r c, 1-0
v., Section Block Lot
(T) ct . �-
Subdivision of vw�a, ("r�.�.Q Acre o }
Subdv. Lot # Filed Map # 21416 16 Date
Gentlemen:
This letter is to authorize =�,7Gt�'` �cN t�1 Uws �C
a duly licensed professional engineer V or registered architect
(Indicate
to apply for a Construction Permit for a separate sewage system, to
serve the above noted property,in accordance with the standards, rules
or regulations as promulagated by the Commissioner of the Putnam County
Department of Health, and to sign all necessary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
147, Education Law, the Public Health Law, and the Putnam County Sani-
tary Code.
Very truly/yours,
Signed
Countersigned:
Owner of P erty
,(/t-¢-
P.E. , R.A. # t�n17S0 Address
/%tix GI,G[rL,� i eCA n e6:4,.4
4,.e C
Address Town
_fZy 22 b�re�sr�- �I.' 16Saq
2,03 - 74 59 51
Telephone
272- 7115
Te 1 e phone
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9-7' 3' -7 I/2' r-8 74•
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PUTNAM COUNTY DEPARTMENT OFALT yN .
S i P.
MOUSE PLANS APPROVED FOR i
EDROOM COUNT ONLY; id
_ice. HD%MTiRRE tTEH
1 LIVING RDDM v� cUfElf/TE VEH- " i _ in 1{EDR EUTIRE USE
____—UED -.00MS Y
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EDROOM COUNT ONLY; id
_ice. HD%MTiRRE tTEH
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VESIUII MIA I1111-M- ULI'AIMIS DLHAUR L)IBI JAL 1311 C114/12M Y1Lli IiU.
uvllull White Tall Acres Addt•aee No. Birch Hill Road (AKA Stagecoach)
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1
2
Ilutenl 1) Tonto tube relwlated at a jpulo `le Itll uutll o 11l -6 1131011 81 1 11 •p l l
t11 Lee urn ubLaluud at eault peraulptluo to t Ila 1o. A11 do a to Do Ii n�lmI tloJ ,
.-Iur t'ov ov.
2 Ixlptll eaaew•ellsut■ to be made Aron top or Iwle.
TEST PIT 11aTA REQUIRED TO DE SUW;IrfFD WITH APPLICETIOII
DEBCRIMOil OP Soils rtIMIUK11TI.PD I11 TMIT I101.3
DEITII 11018 110. 02A '.11011 NO, nvn ROLE NO.
0. L. TOPSOIL TOPSOIL
6 "• Loam with San oam .Irr. ao n
]21 •
Lu"
za1 '
4181 _ 3.5• to R—k ip teal
Saw
60"
661
741"
641
INDICATE IEVEL AT UIIICII GROUND WATER IS ERCOUNTERED
IIIUIME LEVEL 1&0 HIJICII HATER LEVEL RISES AFTER BEING EIICOUNTERED .
TES-19 I14DE DY at' n 6 Cufneli -s Late
DESLANI
3o11 Rate Uelad to Rlll/Mrop1 B. D. Unable Arne Provided 5.000 S.F.
Ila. of Bodroome 3 Se do Tank Ca evlt Cale. 1» �
Absorption Aree rov e y . 333 L.P.x2a .. yb'r vidth Erench.
. ... .. OLDer
ilaw Baldwin 6 rorneli— 0 r Signature
Addl•eee RD 6, Route 22 BEAL
Bfewster. New Ynrk
THIS SPACE FOR USE BY MUM DEPAIMIE lT (TILLY,
Sall [late Approved Sq. Ft /Onl. Cbeckod by Late
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CORNELIL1 S-.
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