Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0260
DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 5. -1 -24 BOX 3 r Me „ Lo Me 11 � T ,. IN - eer IN ' - r� ' t� ti NOLL '- L 111.• PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR TMENT SYSTEM PCHD CONSTRUCTION PERMIT # Located at 0 NLIPL45 P'1N1 fLOAD Town or Village Q Owner /Applicant Name J ¢ 14H 6oH Tax Map + Block Lot 2-4 Formerly Subdivision Name��yt� Subd. Lot # Mailing Address V4n-Av,*1-Y Zip Date Construction Permit Issued by PCHD Ow Separate Sewerage System built by Address Consisting of I'M r3 Gallon Septic Tank and Other Requirements: Water Supply: Public Supply From Address or:_ _ Private Supply Drilled by f 1r-` FbGP4 -- Address �' ' 'R �h Pm1 Building Type 1��"'��'� Has erosion control been completed? J Number of Bedrooms _ Has garbage grinder been installed? Ho 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 regulati "of Putnam un Department of Health. Date: �" Q ?' Certified by P.E. %t R.A. esign Profe sional) Address ro K %ll ��W t 9 License # e' Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage. treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, Zo ification or change is necessary. By :/� Title: Date:�i 'L White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 � S MAY -30 -2002 04:35 PM HARRY W NICHOLS 914 279 4567 P.01 Harry. W. N109b Jr., PA Penerwn Park,'Sulte 106 "M Route 33 . Brewster, NY 1.4509 Pboae (84'.) Z79�003 Pe: (545) =794567 . ,Tot �j% l �` Y, �1Ottli Hc1 r r..1 Fax X79- `711 Pa$sv � S -r 3o -0 2 �i nVl��� R \�Af _ f �'�R �1• CVO - 0 Urgent 0 for Wow 0 Pf"" comment D Pke" Reply G Pleas• Reoyale Pu 6 n tl& J � n �r1 l x!r�l sz. r 0 AS - 9�- 9x4,rf9 a 2.10 a�t " 1- 11.1'1 May 21, 2002 Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, New York 10509 Re: Individual SSTS Compliance Bridle Ridge, Lot # 3 20 Bridle Ridge Road Patterson, New York Dear Robert: Enclosed are the following: Marry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 2794003 Fax (845) 2794567 1. Five (5) prints of Drawing SS -3 "As Built SSTS, "As Built SSTS," dated 5/21/02. 2. "Certificate of Construction Compliance for Sewage Treatment System," dated 5/21 /02. 3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment System," dated 5/21/02. 4. Laboratory Reports, dated 4 /30/02. 5. "Well Completion Report," dated 1/25/02. 6. Application Fee in the amount of $200.00 payable to Putnam County Health Department. 7. "E -911 Address Verification Form," dated 1/3/02. If there are any questions concerning the enclosed, please call. Very truly yours, Harry W. Nicho s Jr., P.E. HWN: JM: jmm 00- 149.00 PUTNAM COUNTY DEPARTMENT OF HEALTH`. DIVISION OF ENVIRONMENTAL HEALTH SERVICES GHM GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM JD0 H60H 4 PAI-C'Y L_�o4 5p l Owner or Purchaser of Building wt�wr�5 611M Building Constructed by EO Ba -(R.E Location - Street Mood -�-- `�- i✓�,i�:� -� Building Type 0 Tax Map Block Lot Town/Village BRIDLE PJ Pf4C Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material,. construction an d drainage of the sewage treatment system serving the above- described property, and that is has been constructed• as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate. for „a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment'system, or any repairs made by me to such system,..except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as .conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the' failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. _.. Dated Month 'Day q( Year 7-002 . Signature:* i � ature: 1 -> � % wwa C.C. General Contra5or -(Owner) - Signature Corporation Name (if corporation) Address: J State 1 Zip_ j wsb Title: Corporation Name (if corporation) f z l Address: l y)(27-z Z State II,I y Zip Form GS -97 7 IMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET i M S STAMFORD, CONNECTICUT o6905 NELAC, CT and NY State Certified Environmental Laboratory Mailing Information: Name: PF Beal & Sons Address: 4 Putnam Ave City: Brewster State: NY Telephone: Sample's Information: Site: tank hose bib Preservative: N/A Temperature: <4C Date Analyzed 4130//02 15:00 4/30/02 5/1/02 5/11/02 5/1/02 5/1/02 5/1/02 5/1/02 5/1/02 5/1/02 5/11/02 10:00 5/1/02 5/1/02 5/1/02 5/1/02 Client: Westchester Modulars Zip: 10509 Fax: Collector's Information: Name: C Beal Address of site: Lot #3 Bridle Ridge Rd City: Patterson State: NY Zip: Telephone: Date Collected: 4/29/02 Date Received: 4/30/02 Time Collected: 10:00 Time Received: 11:30 Lab No.: J021623 Test Name Result MCL Method Total Coliform Absent Absent SMWW 9222B Chlorine Free Residual <0.1 mg /L N/A SMWW 4500CIG Color ND 15 Units SMWW 2120 B Odor ND 3 TONs SMWW 2150 B Iron <0.03 mg /L 0.3 mg /L SMWW 3111 B Manganese 0.039 mg /L 0.3 mg /L SMWW 3111 B Sodium 52.7 mg /L N/A SMWW 3111 B Chloride 152 mg /L 250 mg /L SMWW 4500 Cl C Hardness 202 mg /L N/A SMWW 2340 C Nitrate 1.44 mg /L 10 mg /L SMWW 4500 NO3E Nitrite <0.1 mg /L 1.0 mg /L SMWW 4500 NO3E pH 6.70 S.U. 6.5 -8.5 S.U. SMWW 4500 H B Sulfate 25.5 mg /L 250 mg /L SMWW 4500 SO4F Turbidity 0.97 NTU 5 NTUs SMWW 2130 B Lead 2.67 ug /L 15 ug /L SMWW 3113 B At the time of analysis the sample was acceptable for total coliform N/A = Not Applicable mg /L- milligrams per Liter ND- None Detected S.U.= Standard Unit NTU- Nephelometric Turbidity Unit MCL- Max. Contaminant Level TON- Threshold Odor Number ug /L- micrograms per Liter Signature: State #: PH -0218 Michael Lapman ELAP #: 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmental.com V� �R� � J � PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR ATMENT SYSTEM Q PCHD CONSTRUCTION PERMIT # Located at �II- �p �1�� �� Town or Village CH Owner /Applicant Name J A K,N 60H Tax Map G I Block 1 Lot E4 Formerly y Subdivision Name BSI 9 F414F Subd. Lot # b Mailing Address iLrOtJ Ri-� r Zip 10'5—')( Date Construction Permit Issued by PCHD Separate Sewerage System built by 11�Ebl�i�►�h ilz fn��i%,1 Address Consisting of OA 0 Gallon Septic Tank and Other Requirements: my� `)k 4�1-v Water Supply: Public Supply From Address. or: Private Supply Drilled by F'f-` bGQ� -- Address �'�'��"��'" RAE "� pmq Building Type I Has erosion control been completed? Y� Number of Bedrooms Has garbage grinder been installed? Ho J.zertify 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 regulatiofs of the Putnam (:;punV Department of Health. Dater Certified by P.E. % R.A. Address f.0 �'� 1esign Prot s�ona►) �' �a n 0 1 i 43 �� License # Any person occupyingWemises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, /66difcation or change is necessary. i By: Title: Sf Date dli' 'L- White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 f i t :� VStiibi„YI„ Imo, F::d h LE I � �Tc.ea- Lot. r Tai: &p aLck 1 Lot =F- V Dote of Ptevl000 Appri" 116�IIS Adioo� y Tows 12� u) W nary R„hdidision Annroved Fee Enclosed [M AM"Mint �10�•OD Rev. 10/88 ei+ts Tire P' A L, Lot Are. � . � 0" I A(, o, X D-pa � riasim Tjz rfi Kober d Deolgis Flow �fl1) o n ae SeporaM Sowoeoge SYetli11111 to Comm d M2 G aw septic Took bed To be, b! - -� Addmm Wall! S11111*. Plifte SW* Fteo. Ad.d e ►� tH.f..a„ Sop* DAW by odwr .- 1 represent ".that I am' wholly a completely re nsible forth* design and location of the proposed system(s); I) that tM sePara 0 ..s_ew!�di p sal Sy am above defcritied will be constructed as shown on the approved amendment their to and in accordance with the standards, rules an rpu n o1�Puutnam County DePenment o/ Health, and that on cornpletion It a ^Certificate of Construction Compliance" satisfactory to the Commissioner of Health will be snbmktted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said bulkier will pMce in good operating condition any part . of sled sdwage disposal system during the per lod of two (2) years immediately following the date of the lou- ana of the approval of the Certificate of Construction Compliance. of the original system or any repairs then o; 2) that the drilled well dGWIb d a6ow well M loated,as slloarrl on tM'apdrowd glen and that aid well wi ns in aAordancA with 0 ands s, ules and regulations � of the Putnam County Department of Health. Date j ra 1 J Shan P.E. R A. APPROVED FOR CONSTRUCTION: revocable for cause_ or may be, emend requires arQw permit. Approwd'I TT_i ) License No ral. expires two years from the date -issued un n s construction of the building .has been undertaken and is led when considered necessary by the - Commissioner of Health_. Any change or alteration of congtr uctioh .of dornestk sanitary sewage. a�pctira we or supp o ly. c � 0Y Title °'° PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: 20 Bridle Ridge Road, Lot #3 Town/Village: Patterson Tax Grid # Map 6, Block i Lot(s) tit Well Owner: Name: Address: Westchester Modular Homes, 1995 Route 22, Brewster, NY 10509 Use of,Well: 1- primary 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment X Rotary Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic _ Other Joints: Welded X Threaded Other Seal: X Cement grout , Bentonite Other Drive shoe: X Yes No Liner _ Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed X Pumped X Compressed Air Hours 6 Yield 20 gpm Depth Data Measure from land surface- static (specify ft) 60, During yield test(ft) 180, Depth of completed well in feet 245' Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface 3 Drilli n in overburden clay d boulders 3 Hit roc at 3' 3 32 Dril i i , set casing, arouted 32 245 Drillinq in rock ciranite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 7cmm Depth 200, Model 7GS07412 Voltage 230 HP 3/4 Tank Type WX30 al. Date Well Completed 11 /10 /01 Putnam County Certification No. 001 Date of Report 1/25/02 W it r si a al NOTE: Exact location of well with distances toAj least two permanent landmarks to be p on a separate sheet/plan. Well Driller's Name OJS s Inc. Address: 4 Putmm Ave., Brewster, NY 10509 Signature: Date: 1/25/02 Perry e White copy: HD Fil , Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 4 BRUCE R. FOLEY LORETTA MOLINARI• R.N., M.S.N. Public Health Director Auoeiate PWW Health Director . Director Q/ 'Pat(W &rJker , DEPARTMENT OF HEALTH_... _. :. l Geneva, Road Brewster, New Yolk. 10509 8oriroomeaW HWtb (M)179 -t'6130 • F(911) 271.7921 _..: llarelal Sserrica (914)371-( WIC (911) 278.6678 la (911) 278.601$ Etr1y'io9er*k1r6o-(914) 271*• 6614\, Prescb9o1'(k14) 278-6082 Pex (91{) Y7I% 6618 E911 ADDRESS VERIFICATION FORIVI' = • OWNERS "NAME: S 0 � A 6 © :r'+ TAX MAP NUMBER: • ............ E911 ADDRESS: f' ���✓ z:- c/ c TOWN: AUTHORIZED TOWN 0MCLA,: - ; _. :.. __ ...... .:... -(Signature)... _.. .... ..:_._ . _ .- . DATE: The Putnam County Department of Health Will not issue•-a ..Certificate of . Construction Compliance unless the above form is completed,' i.e., a legal E911 ..address is assigned by an authorized town official. This form is .f.Q::.e.:submitted with the application for a. Certificate of Construction Compliance. (E911 VERFRivt) 5 730 01 E 282.67 ` 5 7l' 37'3.2 CJ �� pe \ ^ O 00, �QQ Q�IV� fkIST 3 BR , RESt C/vc Ii PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMI GE TREATMENT SYSTEM PERMIT # Located at XL191 -> P--1 DkE R+DAP / Town or Village T ATTEP'S0H Subdivision name DP O1—E 9-1 D CA E Subd. Lot # Tax Map t Block i lLot 1-4 Date Subdivision Approved 1-112-1181 Renewal ( Rev s on! Owner /Applicant Name J d 4N 60N Date of Previous Approval l l l q hf� Mailing Address ��' GE�I- �° �D �O� N J Zip Amount of Fee Enclosed f;�a® cc, Building Type F-F�r ID ESL Lot Area '' i0l /allo: of Bedrooms Design Flow GPD GOo Fill Section Only X Depth '971 Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 100 gallon septic tank and 9-4 L-F Af,345 P -�r�LN Other Requirements: To be constructed by Water Supply: T- 6 �0, Public Supply From or: .A Private Supply Drilled by 7'4 0, Address Address Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: ' P.E. x R.A. Address W iJ�p�j License # Date 1I`l)�9 6 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 whe onsidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe harge of domestic sanitary sewage only. By: 71/z= Title: b� Date: s Af White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM- STATE OF NEW YORK IN THE MATTER OF THE COMPLAINT AGAINST: Chris Johnson - RESPONDENT(s), Arising out of the Alleged Violations of the Public Health Law of the State of New York, the Sanitary Code of the State of New York, the Sanitary Code of the County of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto NOTICE OF HEARING CASE NO. 78-02-19 TO: Chris Johnson PREMISES: Bridle Ridge Road, Lot #3 111 Cedar Road (T) Patterson, TM# 5. -1 -24 Katonah, NY 1.0536 PLEASE TAKE NOTICE THAT CHARGES have been preferred against you to the effect that you have violated the health laws as more fully set forth on the reverse side of this notice: YOU ARE HEREBY SUMMONED TO APPEAR at a hearing to be held under the provisions of the Putnam County Sanitary Code and Public Health Law of the State of New York before Earle Warren Zaidins, Esq., an Administrative Law Judge of the Department of Health of the County of Putnam on the 10th day of July at 10:00 AM, in the. Hearing Room, located at Route 312, 1 Geneva Road, Terravest Corporate Park, Brewster, New York, at which time the charges will be informally discussed, and such adjourned dates as may be designated. AT ALL TIMES YOU WILL HAVE THE RIGHT to be represented by counsel and the right to deny the charges, in whole or in part, following which the matter will be rescheduled to a date certain and a Formal Hearing will be conducted thereon, and a record of all the proceedings will be made, witnesses will be sworn and examined and cross examined, and documentary evidence maybe offered and received, and you may produce witnesses and evidence in your behalf; IN THE EVENT YOU WISH TO ADMIT TO THE CHARGES, the Hearing may be terminated by written stipulation of discontinuance provided the violations have been corrected; UPON YOUR FAILURE TO APPEAR, a warrant compelling your appearance may be issued or an Inquest Hearing conducted and a determination made; CIVIL PENALTIES up to $1,000 for a single violation, per day, may be assessed against you, and such further orders may be made herein as the circumstances may warrant; THE BOARD OF HEALTH may issue a warrant to any Peace Officer of the County, pursuant to Section 309 of the Public Health Law, to bring to its aid the power of the County whenever it shall be necessary to do so, with the same force and effect as if such warrant had been issued out of a court of record. PUT:7u;ceR. UNITY BOARD OF HEALTH DATED: April 12, 2002 BY: Brewster, NY 10509 Polpy Public Health Director STATEMENT OF CHARGE IT IS HEREBY ALLEGED THAT THE PERSONS HEREIN BEFORE NAMED RESPONDENTS are charged with violations of the Health Laws of the State of New York and the County of Putnam as follows: PUBLIC HEALTH LAW OF THE STATE OF NEW YORK Violations of any and all provisions of the Public Health Law of the State of New York and the State and County Codes and Administrative Rules and Regulations promulgated pursuant thereto - which shall be found to constitute a NUISANCE, particularly, and not limited to the provisions of Article 13 of the Public Health Law. SANITARY CODE OF THE STATE OF NEW YORK PUTNAM COUNTY SANITARY CODE Article III, Section 2, Paragraph C - Erosion control not installed upon inspection on March 25, 2002. ADJOURNMENTS: Public. Health Law violations are serious. They affect or may affect the health, safety and welfare of the community. They cannot be permitted to go on indefinitely. Casual adjournments or hearings will be granted. Applications for adjournments must be made in person or by counsel to the Hearing `Officer at the time set for hearings, except for legal excuses. Persons operating an establishment, business or facility without a permit, for which a permit is required - will not be granted an adjournment. Health matters are involved and the Public SafLq is a paramount consideration. BF:tn cc: B. Foley ❑ R. Carano ❑ G. Reed ❑ SSTS file ❑ File ❑ DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM- STATE OF NEW YORK IN THE MATTER OF THE COMPLAINT AGAINST: Harry Nichols, P.E. RESPONDENT(s), Arising out of the Alleged Violations of the Public Health Law of the State of New York, the Sanitary NOTICE OF HEARING Code of the State of New York, the Sanitary Code CASE NO. 79 -02 -19 of the County of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto: TO: Harry Nichols, P.E. PREMISES: Bridle Ridge Road, Lot #3 Patterson Park (T) Patterson, TM# 5. -1 -24 Suite f06 2050 Route 22 Brewster, NY 10509 PLEASE TAKE NOTICE THAT CHARGES have been preferred against you to the effect that you have violated the health laws as more fully set forth on the reverse side of this notice: YOU ARE HEREBY SUMMONED TO APPEAR at a hearing to be held under the provisions.of the Putnam County Sanitary Code and Public Health Law of the State of New York before Earle Warren Zaidins, Esq., an Administrative Law Judge of the Department of Health of the County of Putnam on the 10' day of July at 10:00 AM, in the Hearing Room, located at Route 312, 1 Geneva Road, Terravest Corporate.Parlc, Brewster, New York, at which time the charges will be informally discussed, and such adjourned dates as may be designated.. AT ALL TIMES YOU WILL HAVE THE RIGHT to be represented by counsel and the right to deny the charges, in whole or in part, following which the matter will be rescheduled to a date certain and a Formal Hearing will be conducted thereon, and a record of all the proceedings will be made, witnesses will be sworn and examined and cross examined, and documentary evidence maybe offered and received, and you may produce witnesses and evidence in your behalf, IN THE EVENT YOU WISH TO ADMIT TO THE CHARGES, the Hearing may be terminated by written stipulation of discontinuance provided the violations have been corrected; UPON YOUR FAILURE TO APPEAR, a warrant compelling your appearance may be issued or an Inquest Hearing conducted and a determination made; CIVIL PENALTIES up to $1,000 for a single violation, per day, may be assessed against you, and such further orders may be made herein as the circumstances may warrant; THE BOARD OF HEALTH may issue a warrant to any Peace Officer of the County, pursuant to Section 309 of the Public Health Law, to bring to its aid the power of the County whenever it shall be necessary to do so, with the same force and effect as if such warrant had been issued out of a court of record. PUTNAM UNTY BOARD OF HEALTH DATED: April 12, 2002 BY: Brewster, NY 10509 B use R. Foley Public Health Director . STATEMENT OF CHARGE IT IS HEREBY ALLEGED THAT THE PERSONS HEREIN BEFORE NAMED RESPONDENTS are charged with violations of the Health Laws of the State of New York and the County of Putnam as follows: PUBLIC HEALTH LAW OF THE STATE OF NEW YORK Violations of any and all provisions of the Public Health Law of the State of New York and the State and County Codes and Administrative Rules and Regulations promulgated pursuant thereto - which shall be found to constitute a NUISANCE, particularly, and not limited to the provisions of Article 13 of the Public Health Law. SANITARY CODE OF THE STATE OF NEW YORK PUTNAM COUNTY SANITARY CODE Article III, Section 2, Paragraph C - Erosion control not installed upon inspection on March 25, 2002. ADJOURNMENTS: Public Health Law violations are serious. They affect or may affect the health, safety and welfare of the community. They cannot be permitted to go on indefinitely. Casual adjournments or hearings will be granted. Applications for adjournments must be made in person or by counsel to the Hearing `Officer at the time set for hearings, except for legal excuses. Persons operating an establishment, business or facility without a permit, for which a permit is required - will not be gran ted an adjournment. Health matters are involved and the Public Safely is a paramount consideration. BF:tn cc: B. Foley ❑ R. Carano ❑ G. Reed ❑ SSTS file ❑ File ❑ DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM- STATE OF NEW YORK IN THE MATTER OF THE COMPLAINT AGAINST: Chris Johnson - RESPONDENT(s), Arising out of the Alleged Violations of the Public Health Law of the State of New York, the Sanitary Code of the State of New York, the Sanitary Code of the County of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto NOTICE OF HEARING CASE NO. 78-02-19 TO: Chris Johnson PREMISES: Bridle Ridge Road, Lot #3 111 Cedar Road (T) Patterson, TM# 5. -1 -24 Katonah, NY 1.0536 PLEASE TAKE NOTICE THAT CHARGES have been preferred against you to the effect that you have violated the health laws as more fully set forth on the reverse side of this notice: YOU ARE HEREBY SUMMONED TO APPEAR at a hearing to be held under the provisions of the Putnam County Sanitary Code and Public Health Law of the State of New York before Earle Warren Zaidins, Esq., an Administrative Law Judge of the Department of Health of the County of Putnam on the 10' day of July at 10:00 AM, in the Hearing Room, located at Route 312, 1 Geneva Road, Terravest Corporate Park, Brewster, New York, at which time the charges will be informally discussed, and such adjourned dates as may be designated. AT ALL TIMES YOU WILL HAVE THE RIGHT to be represented by counsel and the right to deny the charges, in whole or in part, following which the matter will be rescheduled to a date certain and a Formal Hearing will be conducted thereon, and a record of all the proceedings will be made, witnesses will be sworn and examined and cross examined, and documentary evidence maybe offered and received, and you may produce witnesses and evidence in your behalf; IN THE EVENT YOU WISH TO ADMIT TO THE CHARGES, the Hearing may be terminated by written stipulation of discontinuance provided the violations have been corrected; UPON YOUR FAILURE TO APPEAR, a warrant compelling your appearance may be issued or an Inquest Hearing conducted and a determination made; CIVIL PENALTIES up to $1,000 for a single violation, per day, may be assessed against you, and such further orders may be made herein as .the circumstances may warrant; THE BOARD OF HEALTH may issue a warrant to any Peace Officer of the County, pursuant to Section 309 of the Public Health Law, to bring to its aid the power of the County whenever it shall be necessary to do so, with the same force and effect as if such warrant had been issued out of a court of record. PUT::6uce M UNTY BOARD OF HEALTH DATED: April 12, 2002 BY: Brewster, NY 10509 R. oley Public Health Director STATEMENT OF CHARGE IT IS HEREBY ALLEGED. THAT THE PERSONS HEREIN BEFORE NAMED RESPONDENTS are charged with violations of the Health Laws of the State of New York and the County of Putnam as follows: PUBLIC HEALTH LAW OF THE STATE OF NEW YORK Violations of any and all provisions of the Public Health Law of the State of New York and the State and County Codes and Administrative Rules and Regulations promulgated pursuant thereto - which shall be found to constitute a NUISANCE, particularly, and not limited to the provisions of Article 13 of the Public Health Law. SANITARY CODE OF THE STATE OF NEW YORK PUTNAM COUNTY SANITARY CODE Article III, Section 2, Paragraph C = Erosion control not installed upon inspection on March 25, 2002. ADJOURNMENTS: Public. Health Law, violations are serious. They affect or may affect the health, safety and welfare of the community. They cannot be permitted to go on indefinitely. Casual adjournments or hearings will be granted. Applications for adjournments must be made in person or by counsel to the Hearing `Officer at the time set for hearings, except for legal excuses. Persons operating an establishment, business or facility without a permit, for which a permit is required - will not be granted an adjournment. Health matters are involved and the Public Safety is a paramount consideration. MIN cc: B. Foley ❑ R. Carano ❑ G. Reed ❑ SSTS file ❑ File ❑ DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM- STATE OF NEW YORK IN THE MATTER OF THE COMPLAINT AGAINST: Harry Nichols,. P.E RESPONDENT(s), Arising out of the Alleged Violations of the Public Health Law of the State of New York, the Sanitary Code of the State of New York, the Sanitary Code of the County of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto: NOTICE OF HEARING CASE NO. 79-02-19 TO: Harry Nichols, P.E. PREMISES: Bridle Ridge Road, Lot #3 Patterson Park (T) Patterson, TM# 5. -1 -24 Suite 106 2050 Route 22 Brewster, NY 10509 PLEASE TAKE NOTICE THAT CHARGES have been preferred against you to the effect that you have violated the health laws as more fully set forth on the reverse side of this notice: YOU ARE HEREBY SUMMONED TO APPEAR at a hearing to be held under the provisions.of the Putnam County Sanitary Code and Public Health Law of the State of New York before Earle Warren Zaidins, Esq., an Administrative Law Judge of the Department of Health of the County of Putnam on the 10' day of July at 10:00 AM, in the Hearing Room, located at Route 312, 1 Geneva Road, Terravest Corporate Park, Brewster, New York, at which time .the charges will be informally discussed, and such adjourned dates as may be designated. AT ALL TIMES YOU WILL HAVE THE RIGHT to be represented by counsel and the right to deny the charges, in whole or in part, following which the matter will be rescheduled to a date certain and a Formal Hearing will be conducted thereon, and a record of all the proceedings will be made, witnesses will be sworn and examined and cross examined, and documentary evidence maybe offered and received, and you may produce witnesses and evidence in your behalf; IN THE EVENT YOU WISH TO ADMIT TO THE CHARGES, the Hearing may be terminated by written stipulation of discontinuance provided the violations have been corrected; UPON YOUR FAILURE TO APPEAR, a warrant compelling your appearance may be issued or an Inquest Hearing conducted and a determination made; CIVIL PENALTIES up to $1,000 for a single violation, per day, may be assessed against you, and such further orders may be made herein as the circumstances may warrant; THE BOARD OF HEALTH may issue a warrant to any Peace Officer of the County, pursuant to Section 309 of the Public Health Law, to bring to its aid the power of the County whenever it shall be necessary to do so, with the same force and effect as if such warrant had been issued out of a court of record. PUTNAM COUNTY BOARD OF HEALTH DATED: April 12, 2002 BY: Brewster, NY 10509 Be R. Foley Public Health Director STATEMENT OF CHARGE IT IS HEREBY ALLEGED THAT THE PERSONS HEREIN BEFORE NAMED RESPONDENTS are charged with violations of the Health Laws of the State of New York and the County of Putnam as follows: PUBLIC HEALTH LAW OF THE STATE OF NEW YORK Violations of any and all provisions of the Public Health Law of the State of New York and the State and County Codes and Administrative Rules and Regulations promulgated pursuant thereto - which shall be found to constitute a NUISANCE, particularly, and not limited to the provisions of Article 13 of the Public Health Law. SANITARY CODE OF THE STATE OF NEW YORK PUTNAM COUNTY SANITARY CODE Article III, Section 2, Paragraph C - Erosion control not installed upon inspection on March 25, 2002. ADJOURNMENTS: Public Health Law violations are serious. They affect or may affect the health, safety and welfare of the community. They cannot be permitted to go on indefinitely. Casual adjournments or hearings will be granted. Applications for adjournments must be made in person or by counsel to the Hearing `Officer at the time set for hearings, except for legal excuses. Persons operating an establishment, business or facility without a permit, for which a permit is required - will not be granted an adjournment. Health matters are involved and the Public Safety is a paramount consideration. I.1=1 cc: B. Foley ❑ R. Carano ❑ G. Reed ❑ SSTS file ❑ File ❑ DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM - State of New York IN THE MATTER OF THE COMPLAINT AGAINST d�i4Ri2r/ �►/o�S� ?-61. Respondent(s) Arising out of the Alleged Violations of the Public Health Law of the State of New York, The Sanitary Code of the State of New York, the Sanitary Code of the county of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto. STIPULATION OF DISCONTINUANCE CASE NO: kW lglef, " 8 /©T ;�3 IT IS HEREBY STIPULATED AND AGREED by and between the respective hereto that the within matter is hereby terminated upon the following terms and conditions. 1. The Respondent(s) admit the truth of the allegations set forth in the Statement of Charges. 2. ThatXespondent(s) represent: it is in compliance with the Code(s). it will be in compliance with the Code(s) by 3. That Respondent(s) understand an appropriate civil penalty may be imposed by the Public Health Director by Order which amount will be determined at the discretion of the Public Health Director. 4. That in mitigation Respondent(s) assert that TUL_ �0_nw 'pa-s- p- t�.es�,r✓1�, �,c �.--- � y �� u,t. Pte, DATE: ! - Al' 02— Brewster, New York 10509 Administrative Law Judge FH #3 -97 ZV 1J.© , iV4 6W-A " F DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM - State of New York IN THE MATTER OF. THE COMPLAINT AGAINST ,¢�P2yc�yo�S� i Respondent(s) Arising out of the Alleged Violations of the Public Health Law of the State of New York, The Sanitary Code of the State of New York, the Sanitary Code of the county of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto. STIPULATION OF DISCONTINUANCE CASE N0: W - ©071 kW Aer©xe IT IS HEREBY STIPULATED AND AGREED by and between the respective hereto that the within matter is hereby terminated upon the following terms and conditions. 1. The Respondent(s) admit the truth of the allegations set forth in the Statement of Charges. 2. ThatXespondent(s) represent: ✓✓ it is in compliance with the Code(s). it will be in compliance with the Code(s) by 3. That Respondent(s) understand an appropriate civil penalty may be imposed by the Public Health Director by Order which amount will be determined at the discretion of the Public Health Director. 4. That in s mitigation Respondent(s) assert that- v`""`� g P () Q"Ii�w 0..m - A�- K4Q�vk 1AW Lt. AQAA� DATE: [ - Al- - 02-- Brewster, New York 10509 ix�z ' 46�r-- Administrative Law Judge FH #3 -97 PUTNAM COUNTY DEPART`IENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES b FILIAL SITE Iti'SPECTION Date: Inspecte y: Street Location l7�L -� 121��F_�G Owner ,sonl Town Permit # P — ;2-:2 - 9-3 TM r S — Subdivision. Lot # 3 1. Sewage System Area YE �.. ' 10 COMMENTS - , a. STS area located as per approved plans ........................... = b. Fill section = date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ............... d. Stone, brush, etc., greater than 15' from STS area.......... 11 A* e. 100' from water course/ tlands ...... ............................... I.I. Sewage System a. Septic tangy.,• siz - 1,000 ........1,250 ......... other ................ J b. Septic tank insta evel ................ ............................... 1A V c. 10' minimum from foundation .......................................... d. DistributionBox ` 1. All at same elevation -water tested ................. '— — 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches ' f. J renco sBox - properly set ........... ............................... Length required 2 Length installed 2. Distance to watercourse measured -+ oo Ft.......... 3. Installed according to plan ......... ............................... 4. Slope-of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface ........ :......... ZX 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 314 -1 V:" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe`ends capped ........................ ............................... ' g. Pump or Dosed Systems _ 1. Size ot pump chamber .. ............... . ............................... 2. Overflow tank ........................................ :................... 3. Alarm; visual / audio .................... ...........................:... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... �6�Cycle v�ntn se sed;by H D estunatedTflow /cycle�� � �� � 3�` Rio ��° ice" ��` -�`�" �- III. Hous—i uildi a ouse I ocated per approved plans IV. Well _ a. V(ell Iocated as per approved plans ................ ................ b. Distance from STS area measured c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. 'Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate............................ .:....... ' i. Erosion control provided ........... :..................................... Z" BRUCE R. FOLEY Public Health Director May 6, 2002 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Patterson, New York 12563 Re: Field Inspection - Johnson Bridle Ridge Road, (T) Patterson Lot # 3, TM# 5 -1 -24 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field. 1. A bedroom count needs to be performed by this Department (house was locked). 2. A pump test needs to be witnessed by this Department once the electrical inspection has been completed and notification of such has been submitted to this Department. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:cj Sincerely, Gene D. Reed Environmental Health Engineering Aide APR-26-2002 09:44 AM HARRY W N I CHOLS 914 279 4567 P.02 60 Pfq.0 0 PUTNAN COUNTY DlPART=N T 0? BXAL= : -- DIMON 41 ZDnUONNMAL EMAL7l UIMCSS A??ENTYOK O ADAM I�CENE • 1�a�t, ,r r F... b WA INSPI=TON. Fan, Fill,.. Adl iaf'ormad= out be lli y 4=pletcd prior to any Treacbm lopecdoos being made. PCHD Constt edon Permit Located: A t7wnulApplicaat Netae: Tbl T' Block 1.ot .;: , Pos�euly. _ 5ubdivisian Name: S6d`visloa Lot Is ryst= lu completed? ""-- Date: U 3y:tim cetaplate? 13 "am comwoted as pez pkw? Is win drilled? ' .1 Is wcU located u w plans? Are erosiva control AULUes In place? i cwify that the sy va(s), as listed, at the above promises bas baen conanwed and I bave lupeated Bad vorified their completion in Accordance with the issued PCHD Conactu*n Permit and approved plans and the Scandrd3, Rules cad RtSuMoas or the'pum= County Deputmat of Herltl� %? out: CenWed 1 Form FIR. -99 , PE ,(.BRA APR -25 -2002 THU 19:56 TEL:845 -278 -7921 NAME•PHTNAM cn1INTY'nr:PaPTMGAiT nr 0 MAY -16 -2002 02:54 PM HARRY W NICHOLS 914 279 4567 _P. 01 BRUCE X FOLLY Public Health., Director LORI:TTA MOLINARI P.M, M.S.N. AmftWs Pubtle 0salth Dlreetor D(rteta oj.Patwt Senlcts . DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 $EQ„ U .EST E:QQ FIELD TESTING ATTEN710N: o ADAM STIEBELIItiG 'GENE REED All information below must be Lally completed prior to any scheduling. DATE; E►NGIiVEER OR FIRM: r �' tV l.r 1 �, J_n, 0 � - PHONE 0; -L7�'�`�4 3 REASON: DEEPS: to PERCS: a PUMP TEST: ROAD /STREET: till �� X—JgJre, Ka'ad TOWN, Ift 6L TAX MAP #: S SUBDIVISION: 17 4 L01#; ITS NO P V, Proposed SSTS-within the drainage basin of West Branch or B.oyds Corner Reservoirs. C3 $K Proposed SSTS within $00 feet of a reservoir, reservoir stem or control lake. Q P Proposed SSTS within 200 feet of a watercourse or it DEC wetland, o a Proposed SSTS design flow greater than 1000 gallons /daror SPDES Permit required. o V.. Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status. (Joint or Delegated) based on the response. if you answered= to any of the questions, NYCDEP must witness the soil testing. This Department will coordinate it mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. It a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP, FOR COV& t!$$ ONLY TIME; i (MLDTEST) __. n-7n_'7004 NAME • PI ITNAM r nt INTY n1:P0PTMPMT nr P PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OI ENVIRONMENTAL I1EATLH SERVICES FIELD ACTIVITY REPORT AC'f)DIZESS: Street Town State Zip PERSON IN CHARGE nv _t PUMP TEST [] DOSE TEST r r� i` REQUIRED GALLONS � 3„ 7, , � = .. Z 7, 7.5 7 EL. START EL. STOP TN4PFC'TQR* TFT • -- Signature and Title REPORT RFC'FTyF-n RV• I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rav_ �o 0 om i` REQUIRED GALLONS � 3„ 7, , � = .. Z 7, 7.5 7 EL. START EL. STOP TN4PFC'TQR* TFT • -- Signature and Title REPORT RFC'FTyF-n RV• I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rav_ The New York Board of Fire Underwriters is in the process of issuing a certificate of compliance for the electrical installation as covered in an application noted below. The certificate will provide n ilof he items inspected on and certified to be in compliance with the National Electrical Code as of that date. (Application Number) 6-,J'EG r 32 Avg lie, (Location) (Inspector) 1130 (Rev. 01/96) DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OF PUTNAM - State of New York IN THE MATTER OF THE COMPLAINT AGAINST C�A L� �" W Respondent(s) Arising out of the Alleged Violations of the Public Health Law of the State of New York, The Sanitary Code of the State of New York, the Sanitary Code of the county of Putnam, and Administrative Rules, Regulations and Standards Promulgated Pursuant Thereto. STIPULATION OF DISCONTINUANCE CASE-NO: IT IS HEREBY STIPULATED AND AGREED by and between the respective hereto that the within matter is hereby terminated upon the following terms and conditions. 1. The Respondent(s) admit the truth of the allegations set forth in the Statement of Charges. 2. That Respondent(s) represent: ✓ it is in compliance with the Code(s). it will be in compliance with the Code(s) by 3. That Respondent(s) understand an appropriate civil penalty may be imposed by the Public Health Director by Order which amount will be determined at the discretion of the Public Health Director. G i t 4. That in mitigation Respondent(s) assert that, AA" 664k Lu r h n 0j V *�. DATE: '( 0 ( G� Brewster, New ork 10509 For Repo de s For Putnam County Health Department Administrative Law Judge FH #3 -97 JAN -02 -2002 06:09 PM HARRY W NICHOLS o� m ATRHTWII y 914 279 4567 or IMAM at JIM +�• Li •' FOtS . Z'l� Nu tatbnau�oamut bn ►oomll�od pdw to IV Yr�atbofi Wspadoas b ft sue. OwaalApptiabt NNmic rJo 1M j' . •�Fotmetly►: sub�rW�oo Ne�oc • ��divZdoo Le I is in via~ is no Dste: �s grsam o oi�d,fw p»t pb„ & b as!! dtlilfad� s Date: is waloww-upwow �. Are a�dofa000srol �t --�- I tbsf the ty Of , a stl6fi sbov has bems mtt c eW &a 1 haw idspeated sad vaffiod tbdr oof --- -- !p «000td itt6 tLw tuned P tD Qoatotttetioo Pamh ad wroved plf�s'�ad tint 8tsadu+dt, Rubs u d moot of ti l tf o CoUM DepM=t of HukL • Ae toiossioful P.02 • Oo -1"l�j.od : r ONOO �on� i�1�9 .. • JAN -2 -2002 WED 18:21 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 BRUCE R. FOLEY Public Health Director January 11, 2002 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE - Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Johnson Bridle Ridge Road, Lot # 3 TM# 5 -1 -24, (T) Patterson Dear Mr. Nichols: In regards to the above noted property, the following comments must be corrected in the field: 1. Measurements taken in the field show the fill pad to be 118 feet X 48 feet. This would indicate the fill pad is short in size and length. 2. Measures must be taken to ensure the slope of the pad does not exceed 15 %. 3. Measures must be taken to ensure the toe of slope does not encroach upon the property line. Measurements taken by this Department in no way suggests the exact size, depth or location of the fill pad. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Very truly yours, Gene D. Reed GDR:cj Environmental Health Engineering Aide � 6 e BRUCE R. FOLEY Public Health Director April 3, 2002 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Johnson, Bridle Ridge Road, Lot #3 (T) Patterson, TM# 5.4-24 Dear Mr. Nichols: An inspection of the fill pad at the above referenced project has been completed. Trench plans must be submitted to this Department for final approval. Please note that field measurements by this Department in no way suggests the exact size, depth and location of the fill pad. If you have any further questions, please contact me at (845)- 278 -6130 ext. 2261. Very truly yours, zo�/ 0, A4// Gene D. Reed Environmental Health Engineering Aide GDR:cj BRUCE R. FOLEY Public Health Director April 3, 2002 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI RN., 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York. 10509 I= Dear Mr. Nichols: Johnson, Bridle Ridge Road, Lot #3 (T) Patterson, TM# 5.4-24 An inspection of the fill pad at the above referenced project has been completed. Trench plans must be submitted to this Department for final approval. Please note that field measurements by this Department in no way suggests the exact size, depth and location of the fill pad. If you have any further questions, please contact me at (845)- 278 -6130 ext. 2261. GDR:cj Very truly yours, I Gene D. Reed Environmental Health Engineering Aide 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) 278 -6082 Fax (845) 278 - 6648 Date: f�/-y l ®2 To: Z7 �A/7R V A Ile # 5 BVID20 i212446� Z�7`0-3 Pik i7�Je50-/ From: Gene D. Reed Putnam County Department of Health ZFor your Information For your review As discussed Fax #: 2 7 9 — of6 % No. Pages 2 (Including cover sheet) Please respond Attached as requested Please call Notes/Messages //V-5 P4F e--7 /OA/ 0 F a i L T AAA Z lc, � ©y WC->4Z1-7-10X1 /S /Et 2 621 - ��y_ In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2261. BRUCE R. FOLEY Public Health Director April 11, 2002 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection - Johnson Bridle Ridge Road, Lot # 3 (T) Patterson, TM# 5.4-24 Dear Mr. Nichols: The following items are in violation of Article III, Section 2C of the Putnam County Sanitary Code: • A reinspection on March 25, 2002 was performed at the above referenced project. It was noted that erosion control measures were not installed below the fill pad or well. A formal notice of hearing may be issued if the violation is not corrected within 5 days. It is truly hoped that the above violations are corrected without having to take legal action. Very truly yours, Gene D. Reed Environmental Health Engineering Aide GDR:cj PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM �r- v" ", PERMIT # .2a.—°l / r�,� Located at 13 r r d t.- �?y,J Town or Village 10 -.Mors cab J Subdivision name ;- s Al Subd. Lot # _3 Tax Map's Block _1 Lot Date Subdivision Approved Renewal Revision Owner /Applicant Name G6 ;� J� �, ,� Date of Previous Approval /0 l q 6,o Mailing Address 1l 1 Ce ll,,. k4�'.4 ,/1/ � • Zip /�5- 3C� Amount of Fee Enclosed Building Type Rc.5 iJ" Lot Area ),,`joj No. of Bedrooms 3 Design Flow GPD Co-06 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS. COMPLETED Separate Sewerage System to consist of G D d gallon septic tank and -4 ;?-q / Other Requirements: / -v To be constructed by •719 j) Address Water Sunaly: Public Supply From Address or: _� Private Supply Drilled by 1:13 Q Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will. place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. Date--4-4-0? License # � 12� APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe it. pprove r discharge of domestic sanitary sewage only. T' 016L Date: aZ By. rtle. �t� White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 2794003 Fax (845) 2794567 April 4; 2002 Putnam - County Health Department One Geneva Road - Brewster; NY 1 -0509 ATT: Robert Morris; RE: RE: Individual SSTS Trench Permit Bridle Ridge, Lot #3 Bridle Ridge Road Patterson; NY T.M. #5.=1 =24 Dear Robert: Enclosed are the following: ` HTE�}RF�jI 1; Five (5) prints of Drawing SS -3; ".Proposed SSDS -Lot 0; revised 10- 10 -00. 2, Construction Permit for "Trench Installation;" dated 4 -4 -02. Kindly review and issue the Trench Permit at your earliest convenience. Thank you. Very truly yours, Larry W. Nichols r.; RE: HWN :his 00- 149.00 I I PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES PERMIT # Located at CONSTRUCTION PERMIT F IWAGE TREATMENT SYSTEM _ Town or Village PA 0 Subdivision name 6PQ-j---- Date Subdivision Approved Subd. Lot # Tax Map 6, Block ( Lot Renewal Revision X Owner /Applicant Name 614 P—`'5 JD i4 N 1'-I Date of Previous Approval I-Vqlll Mailing Address d 11 t� O AFL. P-o AD V—ATO N ,A, µ) �J �/ Zip l Amount of Fee Enclosed jGj O 00 Building Type F-664 D5 G5' Lot Area 2-901 No. of Bedrooms '; Design Flow GPD Fill Section Only X Depth Volume 150 CM PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1 4 41D gallon septic tank and° Other Requirements: JrEM To be constructed by 1-9 Address Water Supply: Public Supply From Address or: _� Private Supply Drilled by -Ft3p Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment 5y stern described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to' the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) -years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. X R.A. Date 10 1161 Uo Address �-o,� e N+ (0`909 License # 6/ Z-4 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new perm' . pproved f ischarge of domestic sanitary sewage �o,�nly.. B y. Titl� v" Date: t o �q o e. < c7 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 3 R ' • PUTNAM C_OUDEPARTMENT TY DEPARTMENT Or HEA LTI q ROUSE PLANS 'APPROVED ER �3EDROOM COUNT LY, St+dr Dlnlnp Rmq� �M(t Aem� Mi W BEDROP.MS - i .. op"Id About ALL SUBSEQUENT R.EVISIONIALTERATIONS TO 3E HOUSE PLAN E� DOII lITT I F0 VAL NATURE & TITLE - e wn dorm �r ' t0itahAe � P 4ry ❑ Fawn _ jo P-_ tDt�141� � tDFtM91 ►D11Sid/ Harry W. Nichols Jr., P.E. Suite 106, Patterson Park 2050 Route 22 Brewster, NY '10509 (845) 2794003, Fax 2794567 GONSULTIN . sjjE I NSINRI_RS ; : .... ............... . ... ....._.. d03 N.)..,.. SHEET !:o• �-- C COMPUTED BY JM DATE _ CHECKED BY 1414N DATE SCALE.......__....... ..... � ..:.._ i2�s :tl�t.>3U��a.��...��.�..a.�y�i� ��.:f.. �1_. �...�o2�od • ��` .... ....... . :...: -- ..::Pll�rLP.:.s✓t- �.r.��R. _>:G'o.�. �4 «1.11_.. i _ j. + `f.� •nu Cii��'.%�iLw••71?�► -: L .r.. � .I. «f.°...ir..» a « * ....._.. ».:............. '��, `� .� 1. . ' ..... - -.t..� ...:._..�: I t�:� r; �2:�1��2YS ;�?.' ..rte.`....: �...�.- ° -• -- :�.....�.�_ .. ».. 21 � -�L' .. _ :...:.... . • � ...' _-- =-- r.�.��•�2 "_��/�'...�! x/1445' G�.....�t.?-- y.- •--- .:.::_..._ .tt5�.�'. �•r,......- - -• ... • ° . . 1 _.:..- ..TO-TA. W? ::. r1t1.1 �L�.. ��'. l° c.�.,t�!.C�:TIt.��......:..;;:• -•L.....:._ :..- -; �...._t. »a..,d...i::A��lJUi.�iY _��1`lP._�T.4.�f.. «�...r .." » }l:. aT:..►-:i.•��. ... ..L :CS•:s°:: «_. ....... .. .. .3i_ :.TO.TA.L .1:�1J�1•��S1Gi.:.�:::l��.Q.. � ...».. : «.. ««.. �__. «:.._:. �..._ «..... . �._ :.... _�.... � .. :._. ......_: _ .-. "C�?1- 1�_ =�5��?`J�...k��.t?_._t . r�.l�T1Q.i�1 s�-1�t�C�_•__ ' « _ w ...._ .. . _: .. . i�: 1' .w✓.1•.1•r:�il,..�(����I..IS•F� � ^:r ....,.16� ..�•�r. »`�?slir.,T� �. 1�• �l�l.T� \'�.�i.•.�i�!�.�•!.��... .. _..... .:y._a.....i.._...:....r_ ....»__..i. _ 71 f «... LJ. .1 .._. i.•••t_•••_r••rw •- •ra_«.�_••r•__._r•y_•. »••r.i'•• «. «�.• _ ..• • _..rl ..... ».L ..... 1 `w _ ._..... _... -__ « .. _..... . ;._ .. rte.. . _ .......x .... _. -....... ,. __. ...... . ..,..SUM -P- ,A,R,;�...._:.::...._ __, .._ ».....__.___ .. .. _ ..:....- -- •._._..........._• . . . ... .. .. .d �.� � ;.r .. ••.••.t .•a •�. •� _'•••r -T_••� _ iii •._ +.�« :T_ � %• . • • • '�� -• »• -._••. _...__.._ .• ._.• -�... •_-- �._ t.. - -• . -. - 00 Harry W. Nichols Jr., P.E. JOB No.., Suite 106, Patterson Park 22 SHET Ho. I P 113! 0 0' 2050 Route COMPUTEO BY d A4 OAT E Brewster, NY 10509 . ���� - (84S)'2794003, Fax 2794567 CHECKEO BY OAT E- .. �-CQNSULTIMG S ITEElirINFES _ SCALE .. . i�: 1' .w✓.1•.1•r:�il,..�(����I..IS•F� � ^:r ....,.16� ..�•�r. »`�?slir.,T� �. 1�• �l�l.T� \'�.�i.•.�i�!�.�•!.��... .. _..... .:y._a.....i.._...:....r_ ....»__..i. _ 71 f «... LJ. .1 .._. i.•••t_•••_r••rw •- •ra_«.�_••r•__._r•y_•. »••r.i'•• «. «�.• _ ..• • _..rl ..... ».L ..... 1 `w _ ._..... _... -__ « .. _..... . ;._ .. rte.. . _ .......x .... _. -....... ,. __. ...... . ..,..SUM -P- ,A,R,;�...._:.::...._ __, .._ ».....__.___ .. .. _ ..:....- -- •._._..........._• . . . ... .. .. .d �.� � ;.r .. ••.••.t .•a •�. •� _'•••r -T_••� _ iii •._ +.�« :T_ � %• . • • • '�� -• »• -._••. _...__.._ .• ._.• -�... •_-- �._ t.. - -• . -. - Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Li Telephone (845) 2794003 Fax (845) 2794567 October 10, 2000 Putnam County Health Department 1 Geneva Boulevard Brewster, NY 10509 ATT: Robert Morris, P.E. RE: Individual SSTS - Revision Bridle Ridge, Lot #3 Bridle Ridge Road Town of Patterson T.M. #5. -1 -24 Dear Robert: Enclosed are the following: 1. Three (3) prints of "Preliminary Design for Fill Placement Only," dated 10- 10 -00. 2. One (1) print of Drawing SS -3, "Proposed SSTS," revised 10- 10 -00. 3. "Construction Permit for Sewage Disposal System," dated 10- 10 -00. 4. "Pump Calculations," dated 10- 10 -00. 5. Revision Fee of $150.00. 6. Two (2) copies of Proposed House Plans. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry W. Nichol Jr., P.E. HWN:JM:his 00- 150.00 mouUmerbilu sewage Nimm MODEL 7 C 0 0 0707rl IT- TT �- W -T� �-5f �rn'r rT, tl rC :1!i' 77�( 11 r Try H� I ki: p, - 74 4 it 4. A", 7 z� oo it yr S 0i Ll I "WI, _yt gn a R7 i�'�'i-,GOULDSRUMPS, INC. W p v wwaE Nimn! GOULDS MODEL • • UZI 9w Y, t; � 'elk. it 170. ;10 U4. rt It'LI7iy IR-4 "v q rl 4 -�4rm— "Fri{ l4?v� N1 i�Pt-: -4. I tip, Ert j.n 44 ...... . . . . . K9 Al, L. 1 4--, - I V 9 - . . . . . . . . . . . ki q 6. 0 Performance Curve METERS FEET 16- 50 14- N' 12- 40 LU 10 - 30 0 8- 6- 20 4- 10 2- n- 0 0 L 0 20 40 60 80 100 120 140 ibu 1W urm . I I I I 10 20 30 40 M3/hr CAPACITY [qGOULDS PUMPS, INC. SBECA FALLS WW YORK [3148 01985 Goulds Pumps, Inc. Effective July, 1985 N' H 0 L 0 20 40 60 80 100 120 140 ibu 1W urm . I I I I 10 20 30 40 M3/hr CAPACITY [qGOULDS PUMPS, INC. SBECA FALLS WW YORK [3148 01985 Goulds Pumps, Inc. Effective July, 1985 BRUCE R. FOLEY Public Health Director Date: To: Dear 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 Re: Field Inspection - The following items are in violation of Article III, Section 2C of the Putnam County Sanitary Code: A formal notice of hearing may be issued if the violation is not corrected within 5 days. It is truly hoped that the above violations are corrected without having to take legal action. Very truly yours, Gene D. Reed Environmental Health Engineering Aide GDR: cj PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL P-2 please print or type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # a?ZJl)E F)NAF= PJhD FAIT -r='R- ON Map r Block Lot(s) Well Owner: Name: Address: Glt�46 J. 0kH604 ill C ONZ FLOAP "TONAtAi Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served '}1 ' Est. of Daily Usage 60 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling X New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type X Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No }C Is well located in a realty subdivision? ............. ...................... ............................... Yes 'A No Name of subdivision S P-IPLF- 14 D EN5 kT P ATTEP6oN Lot No. n0 Water Well Contractor: Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contaminWtioto be provided on sepaye eet/ lan. Date: Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or.alteration of the approved plan requires a new permit. Well to be constructed by a water 71 driller ceTtified by Putnam County. Date of Issue lq.fl Permit Issuin > cial: Date of Expiration 1 Title: Permit is Non -Trans a rab e White copy - HD file; Yellow copy - Building Inspector; . Pink copy - Owner; Orange copy - Well driller Form WP -97 1 , r � I- t 4r ry9%� -�-r 1 / / 2'82.67 �' 7% 61A..INLET - L 0 / // \ —/ p. / 7 // i / .. �� '' -/J I/ .•_/ /� / of / _ /�.1� �,�� fF i i. USE ra '4* <7 STAKES / 'i ILI .ANGLE STAKES TOWARD SPACES. B• TO t .APART WATER _SOVRCE - I / =RE, FABRIC TO' / I / � / / / / 1 �" `_ A EACH STAKE', l e �Ljp GEOPAB t. iaATER z5_ ? OR APPROVED EOUAL. /l / l<O?1 I uT DDS ya1V ,d� p OEZACE I; ��� --�. /'' / -- �``�•X ,,r I �'P%c \I II 1 0/ \ vl a� I I / URrfABRIC N UP -MLI IE' Ir EF FABRIC MLL o (I +arxfl SILT, FE.NCE — g / I `� I;"00 Cr E NOT` TO SALE ? Qo Prq Xy / // / � / � � ,• \\�� 596 � ��I\`� I % I \ .�+ e� h A° F N ( ' ...; . , , , , ■ ° � / mmaX ■, , &��` « | ■ . ■ � n � ■ w ,. ; � � �.��� m 13 11 -13 -1998 01 :35PM FROM TO 912125953261 P.02 PUTNAM COUNTY DEPARTMENT OF HEAL'T'H DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of C04; Located at T/V (�Rn'9`4aO0 Tax Map 9 Block l Lot 1M Subdivision of 5(1 -101-15 P-AV (A F- F- 5TM� Subdivision Lot # Filed Map # �-�J B� Date Filed Gentlemen: This letter is to authorize �+Awi 0' 1 )�•. a duly licensed Professional Engineer }G or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Departmew, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the p.eov.i� o�of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam "urn .- ._aR�fary Code. .ri`C Very truly yours, j Countersigned:`", .ot5 Signed: P,E., R.A., # ,. _ (owner of grope ) Mailing Addressp Sit ` w Mailing Address: ;State NEr' O�4- Zip 1 Q Q `� State N� YDIa► -I� zip Telephone: Telephone: Form LA -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ti DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner C-l+ " D ' j d i+M 60I4 Address I I I t,EPAR- ROAD ILni 4 0 A I067p(o Located at (Street) �WL—"' F40 (45 P-3A0 Tax Map �L Block ` Lot 1A indicate nearest cross street) Municipality FNTTE4 -60H Drainage Basin IFP�� I��� I+ SOIL PERCOLATION TEST DATA j2/10l 0 11 Ij1I9>3 Date of Pre - soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Time. (pMin.) De�ppth to Water >r`rom Ground Surface (Inches) Start Stop Water Level Drop n Inches Percolation Rate Min/Inch I 1 10�1.-. -1028 % 1A - 21, '�" g. "i 1 2 l o ^'A - 10b 12-1 / A - 21" 3 1® ,- III-" 21 �A - 27° �' qt 4 5 /� 1 1p °� - 10 ►! I1h �4 1.1 A Vii' +tj 1 2 14Le _ Ibl� 16 3 IOU- 4 5 1 2 3 4 5 NOTES: _ 1. "Tests to be repeated at same depth until approximately equal percolation rates are obtained at eacn percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. 2 HOLE NO. G.L. 1.0' 1.5' 2.5' 3.0' 3.5' 4.0' 11MP•'Et— �'-o'' 1No4.L((— c,4` -4 4.51' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed (� Indicate level to which water level rises after being encountered !� Deep hole observations made by: F(-W Date 9,10 Design Professional Name: i4A*j W, H JC,1014 J�- Address: NE N I Ci Signature: �� Mi, . t Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: G14 P—IS J o J+N�oN LZA170 �0�ki 14 1 o 6�C 2. Name of project: 3 4. Design Professional: �%94q 5 6. Drainage Basin:��� 7. Type of Project: Private/Residential Apartments Office Building RXA+A4-4A Location TN: PATT-EP -6 0N Address: mil- t- TO'a`�t� Food Service Institutional Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ......................: ............................... Type I Type II 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11. Name of Lead Agency Exempt Unlisted x No NA HA 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ......................................................... ............................... 'tees 13. If so, have plans been submitted to such authorities? ........ ............................... No 14. Has preliminary approval been granted by such authorities? ko Date granted: NA 15. Type of Sewage Treatment System Discharge ................. surface water X groundwater 16. If surface water discharge, what is the stream class designation? .................... NA 17. Waters index number (surface) ........................................... ............................... NA 18. Is project located near a public water supply system? NO 19. If yes, name of water supply Nfl Distance to water supply Nfl 20. Is project site near a public sewage collection or treatment system? ................ No 21. Name of sewage system kAk . Distance to sewage system NA 22: Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ................................. ............................... (loco 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?... i 0 26. Has SPDES Application been submitted to local DEC office? ......................... NIA Form PC. -97 Fa 27. Is any portion of this project located within a designated Town or State wetland? ""E5 LTNIO) 28. Wetlands ID Number ........................................................... ............................... N 29. Is Wetlands Permit required? .......................................:....... ............................... R Has application been made to Town or Local DEC office? ............................... 0 l4 30. Does project require a DEC Stream Disturbance Permit? .. ............................... +� 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ Yes/No Na 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No o DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ............ .............. yes 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... N 6 35. Are any sewage treatment areas in excess of 15% slope? . ............................... 36. Tax Map ID Number .......................... .................... ............ Map �, Block I Lot 2A 37. Approved plans are to be returned to ..... Applicant ' Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Pe al Law. SIGNATURES & OFFICIAL TITLES. c? k Mailing Address: ........ ; .......................... ('fli i.-L O\rso n ,r► �T�p�- Mai 1 o So °1 i :I '-i i i l �I `j ( to C_ -r' o.. OZ. Ex BED RiM -I - . 4/ T /!_ 617.20 - Appendix C • . State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only art 1 - PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR: CML6 J 14HISOv 12. PROJECT NAME: Lo°r INPIV►DVAL 5 ,5725 PROJECT LOCATION: — Municipality �R�TTEh• -�oN County FJTHArA PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) 9P-0L —f: �L1oV\a P-10 NP PR�O,1POSED ACTION IS: &Ne"v OExpansion 0Modification /alteration .. DESCRIBE PROJECT BRIEFLY: I WDOJ ID\0� AMOUNT OF LAND AFFECTED: Initially—t-501—acres Ultimately 2.9o`I acres WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? *es ONo If No, describe briefly WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? KResidential Olndustrial. ._. OCornmercial OAgricultural OPark /Forest /Open space OOther Describe: 5iiy�NHi.� 0. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNtiMENTAL AGENCY (FEDERAL, STATE OR LOCALR OYes AWO If yes, list agency(s) name and permit /approvals _i 1. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? OYes ANo If yes, list agency(s) name and permit /approval ?. AS A RESULT OF PROPOSED ACTIOi•I WILL EXISTING PERMIT /APPROVAL REQUIRE tAODIFICATION? OYes &4o I CERTIFY TH,-\T THE IN'F-O, =1MACTION PROVIDED AoBBOVE/IIS�TRUE TO THE BEST 0= f.tY1KN ^OjWL/E�DGE Its Af? &62'11 D:.;C 11'rilh 1 l - -- vV 1 ii if the action is in a Coastal area, Lind you a.a a state agency, comae a I'• Form before proceeding v.ith this a.sCSS lc::; January 27, 1999 Mr. Robert Morris, P.E. . Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Bridle Ridge -LOT b Bridle Ridge Road Town of Patterson Dear Mr. Morris, Enclosed are the following: 1. Three (3) prints of Drawing SS -317, "Preliminary Design For Fill Placement Only," dated 1- 27 -99. 2. One (1) print ofDra\ving SS -3, "Proposed SSDS," dated 1- 27 -99. 3. Short EAF, dated 1- 27 -99. 4. "Application For Approval -of Plans For a Wastewater Disposal System." 5. "Construction Permit for Sewage Disposal System," dated 1- 27 -99. 6. "Design Data Sheet." 7. "Letter of Authorization," dated 1- 27 -99. 8. Two (2) copies of Residence Floor Plan(s) for "Bedroom Count Only." 9. Review fee-in the amount of $300.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience:. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Jr., P.E. H,/N:JM:his 98051 LAURENT ENGIN =cPIN G ASSOCIATES, P.C. MILLBROOK_ OFFICE CENTRE Rout* 2i—& Kgalt.w, Rs+C // � \\ Bra.. -stir, New Yar>t iC`.4'9 (31,)273 -fit Ca - (FA)C) 213.2 i!3 HARRY W. NICHOLS JR.. P.E. CONSULTING SITE ENGINEERS January 27, 1999 Mr. Robert Morris, P.E. . Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Bridle Ridge -LOT b Bridle Ridge Road Town of Patterson Dear Mr. Morris, Enclosed are the following: 1. Three (3) prints of Drawing SS -317, "Preliminary Design For Fill Placement Only," dated 1- 27 -99. 2. One (1) print ofDra\ving SS -3, "Proposed SSDS," dated 1- 27 -99. 3. Short EAF, dated 1- 27 -99. 4. "Application For Approval -of Plans For a Wastewater Disposal System." 5. "Construction Permit for Sewage Disposal System," dated 1- 27 -99. 6. "Design Data Sheet." 7. "Letter of Authorization," dated 1- 27 -99. 8. Two (2) copies of Residence Floor Plan(s) for "Bedroom Count Only." 9. Review fee-in the amount of $300.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience:. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Jr., P.E. H,/N:JM:his 98051 -30 C gip: _q al PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 7ggbj6,o)4C Address F2RjD/_E 7t7p6g, :j2, Located at (Street) �flR-<g kjtz_ � Tax Map 5' Block Lot P, (indicate nearest cross street) Municipality P,41--ragt5o/y Watershed �zAA<_ff SOIL PERCOLATION TEST DATA Date of Pre-soaking Z Date of Percolation Test i .2- /—/1 ... .... .. .. ............. ........ ....... ...... ... Time Surface 0 dropp I In i�;. ...... .... on: M. i0110 a -16 �11_ nl 1 -7 8,7 2 4 5 0,'Oit 2 v2 7 3 5j3 3 WL' .315 - 10 6'3 Z 7 4 I;z 11Z z :3 5 1 2 3 4 5 NOTFq! I - Test-, to he repeated at same denth until annroximatelv eaual percolation rates are obtained at each percolation test hole. (i.e. !g I min for 1-30 min/inch, !g 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 0G2 a Sheet_of P-UTNAM COUNTY DEPARTMENT -:OF HEALTH _ - - " .� DIVISIONOr ENVIRONMENTAL IiEATLII SERVICES FIELD ACTIVITY.REPORT :. -N 1 4F VOPAP'zo t! TPIr /V� 9 T)T�RF4C'• IDLE "Ti'I�G % Street - - Town: = State Zip PERSON IN CHARGE OR TNTFRVTFWFIZ natP: O`9R _ Name and Title T7 TYPE OF FACILITY G 5'1-- FINDINGS C%C i o�., j' Signature and Title I acknowledge receipt of this report SIGNATURE:. 02/96 =, Title; Rev. RECORD OF PHONE CONVERSATION Time: !a r � 7,> Date: _ /%2 Person calling: DOFF jca& Y eyffi Phone #: 2 7 8 Reason ( ) Inspection: gDeeps and /or e Scheduled Fie Time: Date: I 1V Tentative /to be confirmed ( ) ( ) Town: P_ �, Y Road /Street: Tax Map #: fir-- f a2 41 Comments: -43,12( - J�_:: 2 I )c F_:� L if)fi --4L- 3 TRW -REQ9 . . 1 -800 -345 -7334 -' x 3 a � s` x sum R� yl iPUTNAM Cl I� I i I I I I� I� IQ to Ia I I i 1 I I I 0 ti 'o- I° .a kZ--PAWLING 1.09 107.2 214.7 BREVISTER I 1- DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #/ WELL LOCATION Street Address To Village City Tax Grid Number WELL OWNER Name 11�b 22 2AO��P� Mailing 1P 1t! Address JLI ®Private 256 O Public USE OF WELL 0- primary 2- secondary ® RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABAVDONED O FARM O TEST /OBSERVATION p OTHER (specify M INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT ? gpm /# 17 REPLACE EXISTING SUPPLY RINEW SUPPLY NEW DWELLING PEOPLE SERVED 57 /EST. ❑ TEST /OBSERVATION 13 DEEPEN EXISTING WELL OF DAILY USAGE 4 0 gal D ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN DDUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓ NO NAME OF PUBLIC WATER SUPPLY: 1\i //A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:% LOCATION SKETCH & SOURCES OF CONTAMINATION P 1 DON SEPARATE SHEET (date) r (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirti (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwize ^contaminate surface or groundwater. Date of Issue: 19 Date of Expiratio 192 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF ' HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property ofd o� / A !� h1Tvt�2 Located at % j Z�j���� 1pC IF— FV (T) Sectionrj Block Lot_ -T� Subdivision of Subdv. Lot % Filed clap #,# 2�%fi%� Date Gentlemen: This letter is to authorize aor. ;O1-� W , rze -131 _ 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. e O o. Counte--'signed' P. E. , "• , h Address Telephone Very truly yours, f{-- Signed Owner of 'Property �i 6� 4almew Address 2'::� L P191-, I I d ' /Y Town Telephone To: Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 Attention: Mr. William Hedges Gentlemen: We enclose ( 4 j copies of: Q0 B/W Prints D Reproducibles 0 Specificotions O Memorondum Job No.: 93051 Project: Proposed SSDS Bridle Ridge Road - Lot #3 Patterson, N.Y. • Reports O Tracings • Copy of Letter O Description: SS -3F "Preliminary Design for Fill Placement Only" We-have added silt fence per your comments. ;ent Via: Our Messenger O Blueprinler I Your Messenger (g Hand Delivery opy to O First Closs Mail O Revisloh /Dole No: ..Rev. 8 -4 -93 O Special Delivery Very truly yours. LAURENT ENGINEERING ASSOCIATES, P.C. Per: J_. (f3A} Harry W. Nichols. Jr.. P_F .,, �� LAURENT ENGINEERING ASSOCIATES, P.C. ' 73 FAIRFIELD DRIVE PATTERSON. NEW YORK 12563 914.278.6108 CONSULTING SITE ENGINEERS Date: 8 -4 -93 To: Putnam County Health Dept. 4 Geneva Road Brewster, NY 10509 Attention: Mr. William Hedges Gentlemen: We enclose ( 4 j copies of: Q0 B/W Prints D Reproducibles 0 Specificotions O Memorondum Job No.: 93051 Project: Proposed SSDS Bridle Ridge Road - Lot #3 Patterson, N.Y. • Reports O Tracings • Copy of Letter O Description: SS -3F "Preliminary Design for Fill Placement Only" We-have added silt fence per your comments. ;ent Via: Our Messenger O Blueprinler I Your Messenger (g Hand Delivery opy to O First Closs Mail O Revisloh /Dole No: ..Rev. 8 -4 -93 O Special Delivery Very truly yours. LAURENT ENGINEERING ASSOCIATES, P.C. Per: J_. (f3A} Harry W. Nichols. Jr.. P_F PUT NAM COUNTY D E PART MEN T O F H EA L TH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM i . Name and Address of Applicant: I 2. Name of Project: ���� 3.._• Location/ /C•� d 4. Project Engineer:Tl'LNi7y�t'tfi t!N 5. Address: License Number: 4Q-7 Phone: 6 D2) 6. e of Pro ect: T t Private /Residential" Food.Service ...Commercial Apartments Institutional Mobile Home.Park Office Building, Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (Check One) Type I.. Exempt _V�' Type II. Unlisted 8. Is. a Draft Environmental Impact Statement (DEIS),required? ............. 9.. Has DEIS been completed and found acceptable by Lead Agency? 10. Name of Lead Agency 11. Is this project in an area under the control of-local planning, zoning, or other officials, ordinances? ......... ............................... 1J D !2. If so, have plans been .submitted to. such: authori tie s ?..................... 13. Has preliminary approval been 'granted by such authorities? PA Date Granted: I 14. Type of Sewage Disposal_ System" Discharge...... ^ Surface Water /_Ground Waters 15. 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? .................. 8. If yes, name of water supply n1"k Distance to water supply 9. Is project site near a public sewage collection or disposal system ?..... 1�U 0. Name of sewage system k) /k Distance to sewage system r. I- Date observed: 23. Name'of Health Inspector: 4. Project design flow (gallons per day) ...... ............................... %rdd 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. 00 26. Has SPDES Application been submitted to local DEC Office? ............... 0 /A 27. Is any portion of this project located within a designated Town or State wetland ? ............... .... ........... ............................... tJ o 28. Wetland ID Number .. .................... ............................... N &- 29. -Is Wetland Permit - required? .............. ............................... fJ D Has application been made to Town or Local DEC Office? 30. Does project require a DEC Stream Disturbance Permit? ................... I�iO 31. Is or was project site used for agricultural activity involving application of pesticide$ to orchards or other crops, solid or hazardous waste disposal''`'` landfilling,•sludge application or industrial activity? YES or NO 00 32. 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 X10 DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... 34: Are community water, sewer facilities planned to be developed within 15 years? otn!I� 35. Are any sewage disposal areas in excess of 15% slope? ........................ 1 36. Tax Map ID Number .......................................................... 37. Approved Plans are to *be returned to: ................ Applicant V/ 'Engineer If the application is signed by a person other than the applicant shown in Item.1, the. application must be-accompanied by-4 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 belief. False statements made herein are punishable as a Class A Hisdemeanor pursuant to "Section 210.45 of the Pena 1 Law. /-) 1AILING ADDRESS: SOMI i }.., • •• • a •• •• �a r• -� a- tea, DESIGN DATA SiiEE.'T- SUBSUFaCE SE TAGS DISPOSAL SYSTEM FILE NO. Owner WA - IAVT � -A `��1J`(G {�t� PAdress ��� ���t�,��i2'r H 114, r-P" �tiJ U Located at (Street) ±,12�-iyw, ryr, �✓ Sec. �5 Block ( Lot Z� (indicate n ' 1 est cr ss street) t�nicipaiity P �"� � N Watershed SO1Z PE?ZCOLA.TIGN TEST D. REQUIl�ED TO BE SUT>'�IITI�D w7'Tfi PPDLICATiCtJS Date of Pre - Soaking 7 - 7 - I- ? Date of Percolation Test 7 - rj - �� HOLE %�D 2�� 'r ECG° �%i a 1�• /� Nul B C1= TII2 PERCQLATIGN PERCO=CV Run Elapse Depth to Water Fram hater Levu No. T1r� Grour_d Surface In Inches Soil Rate Start -Stop Min_ Start Stop Drop In Min /In Drop 2 Inches Inches Inches 3 12 =27 12 h7 ' Rio 2�,� - r 'L�2u 12'n 2 I I . tiU _ 12 :2v %�D 2�� 'r ECG° �%i a 1�• /� 3 4 '�7t� t{ u 2 21 31 a 3 12 =27 12 h7 ' Rio 2�,� - 'Z-6l2`�. 'L�2u 12'n It 5 i� 2 3 4 5 NOIES: 1. Tests to be repeated' at, saw depth until approximately equal soil rates are' obtained at each percolation test hole. All data to' be submitted for review. 2. Depth neasurernents to be made fran top of hole. rev. 9/85. DEFrd G.L. 21 31 41 ,,A- 51 61 71 81 91 10 12' 13 -. 14►.'-, DESCRIPTION OF SOILS RKMbMERM IN TEST HOLES HOLE NO. I HOLE NO. . t/ Gil l� rDl� 14, r` 0 IMF I-A rz a imiakm LEVEL rio waicakATER LEVEL RISES AFTER BEING ENXUNMM.— DEEP HOLE OBSERVATIONS MADE BY: DATE:. DESIC-4 Soil Rate Used 2 0 Ydn11" Drop: S.D. usable* Area Provided No. of Bedroams. Septic Tank C.-a-cpacity joD/7 gal-s.' Type e-nIJ6, Absorotion Area Provided By L.F. x 24" width trench Other Name 1A1, Signature Address — SEAL T No. 04579t THIS SPACE FOR USE BY HEALTH DEPARIMENT ONLY: 490 r�esslol Soil- Rate Approvecl sq ft/gaI Uieck-Oa' Date LAURENT ENGINEERING ASSOCIATES, PC. 73 FAIRFIELD DRIVE PATTERSON, NEW YORK 12563 RANDOLPH W. LAURENT. PE. (914) 278.6108 -(FAX) 278.2658 HARRY W.NICHOLS, JR., PE. affl CONSULTING SITE ENGINEERS July 15, 1993 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 Re: Individual SSDS Bridle Ridge Road - Lot #3 Patterson, N.Y. Dear Bill: Enclosed are the following: 1. One (1) print of Drawing SS -3 "Proposed SSDS - Lot #3 ", dated 7- 15 -93. 2. Four (4) prints of Drawing SS -3F "Preliminary Design For Fill Placement Only ", dated 7- 15 -93. 3. "Application For Approval of Plans For A Wastewater Disposal System ". 4. "Construction Permit for Sewage Disposal System ", dated 7- 15 -93. 5. "Application to Construct a Water Well ", dated 7- 15 -93. 6. "Design Data Sheet ", dated 7- 15 -93. 7. "Letter of Authorization ", dated 7- 15 -93. 8. Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 9. Check in the amount of $300.00,.review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Sincerely, NT ENGINEEPIAG ASSOCIATES, P.C. Randolph &aurent,"'. RWL:bd 93051 cc: Mr. F. Santoro w /enc. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT STREETLOCATION 6f ibAL ICI b6-E- Ab, NAME OF OWNER `1o�iNScr�- REVIEWED BI: RINI, GR, AS, NIB, BH SSE I E a TAX NIAP Y DOCUMENTS PER`fIT APPLICATION PC -I WELL PERMIT _ PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) RPORATE RESOLUTION SHORT EAF PLANS - THREE SETS HOUSE PLANS - TWO SETS RIANCE REQUEST FEE SUMDIVISION GAL SUBDIVISION BDIVISION APPROVAL CHECKED PERC RATE FILL REQUIRED_ DEPTH TAIN_DRAIN REQUIRED y OSION CONTROLNOUSE,WELL, SSDS PE RC & DEEP HOLES LOCATED PRESENTATIVE OF PRIMARY & EXPANSION LOCATION MAP E AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE TF PUMPED, PIT & D BOX SHOWN & DETAILED HOUSE -NO.OF BEDROOMS WELLS & SSDS'S W/IN 200' OF PROPOSED SYS. 'PROPERTY METES & BOUNDS' liOUSE SETBACK NECESSARY (TIGHT LOT) USE SEWER - 1/4" FT. 4 "0; TYPE PIPE NO BENDS; MAX.BENDS 45° W /CLEANOUT FILL SYSTEMS CLAY BARRIER 10- FT. HORIZONTAL;SL :1 TO GRADE L SPECS FILL NOTES FIL CERTIFICATION NOTE PTH GAUGES GENEM V F4LL PROFILE &, S LOCATED IN NYC WATERSHED VOLUME PLANS SUBMITTED TO DEP MFILL IN EXPANSION AREA DE;.EGATED TO PCHD JE. tEN!C EP APPROVAL, IF REQ'D ,�c2 LF TRENCH PROVIDED y3 60 FT MAX. DEEP TEST HOLES OBSERVED PARALLEL TO CONTOURS PERCS TO BE WITNESSED 100% EXPANSION PROVIDED EX- APPROVAL SSDS ADJ. LOTS SEPARATION DISTANCES SPECIFIED WETLANDS (TOWN/DEC PERMIT REQ'D ?) ON PLAN - FROM SSTS DA�'A ON DDS PLANS & PERMIT SAME IMT.O� ., DRIVEWAY, LARGE TREES q'0I'•VE:FIL-L ARE 969 NEIGHBOR NOTIFICATION O FOCINDA F10N 1(A LS _115ZELL TO PL SETTER BI/ZBA 100' TO WELL, 200' IN DLOD, 150' PITS 'f00 R FLOOD ELEVATION 100' TO STREAM WATERCOURSE LAKE (inc. expan) OTHER REQ'D PERMIT(S) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER REQUIRED DETAILS ON PLANS 0' TO WATER LINE (pits -20) SEWAGE SYSTEM PLAN - (NORTH ARROW) 0' INTERMITTENT DRAINAGE COURSE SSDS HYDRAULIC PROFILE 200'/500' RESERVOIR, ETC. ,150' GALLEY SYSTEMS GRAVITY FLOW CONSTRUCTION NOTES 15'MIN to CDS= >5 %,10'- 4 %,25'- 3 %,30'- 20/.,35' -1 %,100' - <1% DESIGN DATA: PERC & DEEP RESULTS 30 'MIN to CD discharge /100'with 182 cons day discharge T CONTOURS EXISTING & PROPOSED' DRIVEWAY & SLOPES, CUT SEPTIC TANK Effl0' FROM FOUNDATION; 50' TO WELL FOOTING /GUTTER/CURTAIN DRAINS WELL SOIL TYPE BOUNDARIES ENSIONS TO PROPERTY LINE TITLE BLOCK; OWNERS NAME,ADDRESS LOCATION OF SERVICE CONNECTION TM #,PE/RA; NAME ,ADDRESS,PHONE# DATE OF DRAWING/REVISION DATUM REFERENCE LOCATION OF WATERCOURSES, PONDS LAKES AND WETLANDS WITHIN 200 FEET jPROPOSED FINISH FLOOR AND BASEMENT EL. COMMENTS a