HomeMy WebLinkAbout0281DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
13. -1 -13
BOX 4
his
'
T
a 1111
Ilia
I
T
'� �l
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
CONSTRUCTION PERMIT FOR SEWAGE TREATME
PERMIT #
Located at Boulder Brook Lane Town or Village Patterson
Subdivision name Ludemann Subd. Lot # 3
Date Subdivision Approved July 7, 1983
Owner /Applicant Name Milton Ferreira
Mailing Address 66 Argyll Ave., New Rochelle,
Amount of Fee Enclosed
Building Type
Residence
Tax Map 13.1 Block 1 Lot 13
Renewal Revision
Date of Previous Approval
Zip 10804
Lot Area 5.4 No. of Bedrooms 4 Design Flow GPD 8 0 0
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of 1250 gallon septic tank and
of absorption trench 24" wide, 7 Feet O.C.
40OLF
Other Requirements: 2' -0" of R.O.B. gravel fill over entire septic area
To be constructed by Costa & Ferreira Address New Rochelle, NY
Water Suppler Public Supply From
PC. X Private Supply Drilled by P . F . Beal & Sons
Address
Address Brewster, NY
I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the
se2arat� 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 tiff Certificate of Construction Compliance of the original
system or any repairs thereto. KEAN E COPRE!_MAN
ENGINEERS, P.C.
J
PROFESSIONAL CORPORATION*
Signe P.E. 5419 2 R.A. Date D
Address t�. t` , , R 'k h: �; :.i �, a z°, 1010' � License #
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or
modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires
a new pe pproved discharge of domestic sanitary sewage only.
By: Title: Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
J
0
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A WATER WELL '/
please print or type PCHD Permit # - V5 co
Well Location:
Street Address: Town/Village Tax Grid #
Boulder Brook. Lane Patterson Map 13.1Block 1 Lot(s) 13
Well Owner:
Name:
Address: 66 Arayl l Ave.
F &R Development
New Rochelle NY
Use of Well:
X 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 5 gpm # People Served4 -5 Est. of Daily Usage al.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
X New Supply (new dwelling) Deepen Existing Well
Detailed Reason
for Drilling
Residential Water Supply
Well Type
X Drilled Driven Gravel Other
Is well site subject to flooding? .....................:...............:........... ............................... Yes No X
Is well located in a realty subdivision? ...................................... ............................... Yes X No
Name of subdivision Luderriann Lot No. 3
Water Well Contractor: P.F. Real & Sons Address: Brewster, NY
Is Public Water Supply available to site? .................................. ............................... Yes No X
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contami ation be prov' ed on separate sheet/plan.
Date: 0 8 / 17 / 0 0 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 driller certified by Putnam
County.
Date of Issue o Permit Issue fficial :
Date of Expiration rl Title: �11V�
Permit is Non- Transferr b e
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
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
i
September 7, 2000
Keane Coppelman Engineers
113 Smith Avenue
Mount Kisco NY 10549
Re: Proposed SSTS: Ferreira, FR Development Corp.
Boulder Brook Lane, Lot #3
(T) Patterson, TM# 13.1 -14 -13
Dear Mr. Coppelman:
Review of plans and other supporting documents submitted at this time relative to the above -
regarded project has been completed. Comments are offered as follows:
The construction of this sewage disposal system may be subject to local wetlands regulations. You
should contact local wetlands officials in this regard.
If percolation tests were not witnessed by a representative of the New York City Department
Environmental Protection on this lot, percolation tests must be witnessed by a representative of this
Department.
3) "Corporate Resolution has not been submitted.
4) Short EAF has not been dated (enclosed).
5) Water Well Application has not been dated.
6) House plans are considered to have five (5) potential bedrooms.
7) SSTS plan is to be shown at a minimum scale of 1 " =30'.
8) Trench cover is to be designated as geotextile material or equivalent in the typical fill
section detail. Building paper is not acceptable.
9) Design data, i.e., deep test hole and percolation results are to be noted on plan.
10) All 100 year flood plans within 200 feet of the property are to be shown and a note
added that none exist except as shown.
Letter to: Keane Coppelman Engineers - September 7, 2000 -2-
11) Ail watercourses, water bodies, and wetlands within 200 feet of the property lines are
to be shown and a note added none exist except as shown.
12) SSTS profile does not show fill extending 10 feet horizontally past the edge of the
last expansion trench before tapering to grade at a 3:1 slope.
13) Construction notes 1 -15 have not been provided on the plan.
14) Footing/gutter drain discharge has not been shown.
15) USDA soil type boundaries or if no soil boundaries exist on the property, soil type
has not been shown.
16) Proposed basement elevation is to be noted.
17) The location of the well is to be dimensioned from two property lines.
18) The location of the service connection from the well to the house is to be shown.
19) Mailing address has not been provided on PC -97 (enclosed).
Upon receipt of a submission, revised to reflect the above comments, this application will be
considered further.
Very y yours,
Robert Morris, P.E.
RM:tn Senior Public Health Engineer
enc.
PUTNAM COUNTY DEPARTMENT OF HEALTH
.DIVISION OF ENVIRONMENTAL HEALTH SERVICES
AFFIDAVIT - CORPORATE OWNER APPLICATION
FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT
To: Public Health Director
In the matter of application for: A w AST E: W ATE IZ T (,6 AT ME WT 5\(6T E M
MILTON VER�EIRA
'Pi r_ N is t*;p
represent that I am an officer or employee of the-e nd am authorized to act for:
Name of Corporation: E0, DE\/EL- OPMENT C-0.
Having.offices at: 6(b AR(aY L-L A\15- NEW R,oCHE L L >✓, rN�{. 10804
Whose Officers Are:
President - Name: R f I n N Sgja r"1 j
Address: bb hi.6lt L Ak K&W t i L ti-
Vice President - Name: kepQr-50 �r_ Q-11h -eflo
Address: 1 DIV I
Secretary -Name:
Address:
Treasurer - Name:
Address:
and that I am and will be individually responsible for any and
to the approval requested and all subsequent acts relating. thf
Sworn to before me this day of
2�
(month) ear
Form CA -97
of the corporation with respect
Signed:
Title: N
Corporate Seal
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
September 7, 2000
Keane Coppelman Engineers
113 Smith Avenue
Mount Kisco NY 10549
RE: Ferreira, FR Development Corporation
Boulder Brook Lane, Lot #3
(T) Patterson, TM# 13.1 -1 -13
Reservoir Basin East Branch
Dear Mr. Coppelman:
The Putnam County Department of Health (Department) has determined that the above referenced
application, including fee, and received by this Department on September 7, 2000 is complete. The
Department will notify you by September 27, 2000 of its determination.
® The Project has been delegated to the Putnam County Health Department for
review pursuant to the guidelines set forth in the Watershed Agreement.
❑ Joint review with the NYCDEP will commence pursuant to the guidelines set forth
in the Watershed Agreement.
If the Department fails to notify you within the above referenced time frame, you may notify the
Department of its failure by certified mail, return receipt requested. The notice should be sent to my
attention at the above address. This notice must include your name, the.location of the. project, the
office with which you filed the application originally, and a statement that a decision is sought in
accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed
Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the
notice, your application will be deemed complete, subject to standard terms and conditions as set
forth in the regulations.
Please be advised that projects within the NYC Watershed may also require Dept. of Environmental
Protection review and approval of other aspects of a project, such as stormwater plans or the creation
Letter to: Keane Coppelman Engineers - September 7, 2000 -2-
of imperdious surfaces, and the project applicant should contact the Department of. Environmental
Protection regarding such activities to see if Department of Environmental Protection review and
approval is required.
If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2166:
RM:tn
Veryy y�ou/rsj '}�
4v/� t/ / �G��
Robert Morris, PE
Senior Public Health Engineer
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRON'`IENTAL HEALTH
INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS
REVIEW SHEET FOR CONSTRUCTION P -vIIT
NAME OF OWNER: "� r STREET LOCATION:
REVIEWED BY: #U6R, AS, SRDATE:
Y DOCUiiNMNTS
4PERMI T APPLICATION
" WELL PERMIT OR PWS LETTER
(,N PC -97
LETTER OF AUTHORIZATION
U(UDESIGN DATA SHEET (DDS)
(__) CORPORATE RESOLUTION
SHORT EAF
UUPLANS -THREE SETS
C-J _,HOUSE PLANS -TWO SETS
U(__)VARIANCE REQUEST
SUBDIVISION
uViLLEGAL SUBDIVISION
(_JC_)SUBDMSION APPROVAL CHECKED
UUPERC RATE
4L REQUIRED DEPTH
UUCURTAIN DRAIN REQUIRED
0�" GENERAL
( 4(�)LOCATED E i NYC WATERSHED
SUBINITTTED TO DEP
A E TO PCHD
'PROVAL, REQ'D
EST -HO.L OBSERVED
nROVAL SSDS ADJ, LOTS
.LANDS (TOWN/DEC PERMIT REQ'D ?)
A ON DDS PLANS & PERMIT SAME
PRE 1969 NEIGHBOR NOTIFICATION
LETTER BI/ZBA
0 FLOOD ELEVATION W/I200'
G LOTS>10 YEARS OLD
AGE SYSTEM PLAN - (NORTH ARROW)
; HYDRAULIC PROFILE
VTTY FLOW
ION NOTES 1 -15
A: PERC & DEEP RESULTS
S EXISTING & PROPOSED
TVEWAY & SLOPES, CUT
OTING /GUTTER/CURTAIN DRAINS
DA SOIL TYPE BOUNDARIES
ME BLOCK, OWNERS NAME ADDRESS
19, PE/RA; NAME, ADDRESS, PHONE#
%0F DRAWINGAREVI.SION
REFERENCE
I TION OF WATERCOURSES, PONDS
KES,WETLANDS WITHIN 200' OF P -L.
:OPOSED FIMSH FLOOR AND
6EMENT ELEVATIONS
ELLS & SSDS'S WAIN 200' OF SSTS
LOPERTY METES & BOUNDS
FSI CP71 -f1-' y a
COMMENTS:
TAX hLAP=: (CONFIRMED) T3d
USE SEWER - %1' FT. 4 "0'; TYPE PIPE CAST IRON
BENDS; DL-LX BENDS 45° W /CLEANOUT
RENEWALS
SITE NOTE (N0 CHANGE)
FILL SYSTEMS
10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE
L-JVJ FILL SPECS/ FILL NOTES 1 -5
((' FILL PROFILE & DIMENSIONS
UFILL IEXPAltiSION AREA
s FILL GREATER THA N 2 FEET
Y BARRIER
CERTIFICATION NOTE
CH GAUGES
ON PLAN FOR R O.B., UNCLASSIFIED & IMPERVIOUS -
'ARATION DISTANCE FROl1 TOE OF SLOPE
. TRI;N H
TRENCH PROVIDED 60FT MAX.
RALLEL TO CONTOURS
EXPANSION PROVIDED.
FREE CRUSHED STONE OR WASHED GRAVEL
COVER
SEPARATION DISTANCES ON PLAN - FROM SSTS
(,�10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL
20' TO FOUNDATION WALLS
100' TO WELL, 200' L I DLOD,150' TO PITS
U 100' TO STREAM, WATERCOURSE, LAKE (inc. espan)
( )50' TO CATCH BASIN, 35' STORMDRAI 1, PIPED WATER
10' TO WATER LINE (pits - 20')
0' INTERMITTENT DRAINAGE COURSE
(__)0200'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS
(310' MIN TO LEDGE OUTCROP
SEPTIC TANK
CZ610JR01M FOUNDATION; 50' TO WELL
WELL
( -41) 1•EN IONS TO PROPERTY LINES
DCATION OF SERVICE CONNECTION
0 15' TO PROPERTY LINE
SLOPE
LOPE IN SSTS AREA (520 0/6)
EGRADED TO 15 %, IF REQUIRED
JMP NOTES
OSE 750/6 OF PIPE VOLUMEMOSE VOLUME NOTED
ETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.)
fT AND D -BOX SHOWN & DETAILED
DAY STORAGE ABOVE ALARM .
CURTAIN DRAIN
TANDPIPES, 5' BOTH SIDES, DETAIL
S' MhN to CDS= >5 %,20'4 %,25'- 3 %,35' -1 %,100 % -<1%
0' MIN to CD DISCHARGE /100' with 182 cons day discharge
0' MIN to NON- PERFORATED PIPE
Qapa 3.01 AC 61T.a a� A� ? 25 W 26..23 2 iE AL w
239.SIN
297.91 1019.2! 1.7"
zz.2 , 23 s Ni�� ccal 2.27 I.BB r~ �2ao t�R
2
,... 41 $
ems} 21 x 1.84 AC `6�' ,a+ :zo 1w.24 �� /v
4 42
t `45y. 43 q � n ae6o9 ae� aD•� •
6.17 AC. z2_ I �'1' 44 "
o`
?•e
�4 2.16 CAL
4.02 AC
I.so'1.7 ac 38 200 nr
X47 46 ' 1.761.65 41 40 e39 1 Y 46 -S- 1.46
' 48 • i4 AL i =' . a 1 .1 . AC. a _
.0 .A it ,.
'5.12
i9CAL
JIstss
Q
n ! . �� y$
�a� ' AGO IA�C.CAI. .. 3.99' AC.
. 4 S
CiiO
e 37 jute 48 f
• .+`°� AC % 1110 120 120 1.9 AGC C 162 a .,,3
.r % X60 " 36 b `8.64 AC. CAL. ..
CAL x 51 g1.9 AGCAL� 6,St1 49
' fy" 35 iG ` 3.3 AC. CAL
i ¢ ><, 13.63 AC. CAL 0 2 IB AC.. ,an g "
p F
i 16lY rrt 211 aGtal� 34 0
5.12 AC r� sr 6oso4 s 33 ¢ \rV, ISC� CA
s .05 A 6y
14 a 52 2� :..222 AGCAL�,n.n '& 51..
'$`
2 4 ABC. CA 6�'»
3.8 AC A�'��'v , • It S 216 AGGL0 32
3.50
j ISI AC.
• . a62AC:Itoi4 i .s�.9 199.91 }*! '? 53 q 3a4� U61s7 9 9 52
• •b
191. i u i � 1.67 Ac Y t�js sAGtA 4ti\ab
12 30 + 4.67 AC. CC
$•1.o
2 06
3�a A
AC. 5.OJ9' AC. �`p/ /`54 1. 53
2-ceac. 5.41 AC. tl
„ate e 8 9 'd, 6.21 AC. CA
2.45
AC. CAL . 294.65
• 5.24 AC s\ �e� SI AG 166 se 10 y
1S4 163
L93AC zos 5.59 69AC. e4ti1 _ _ 57
4.95 AC. 1 5s
s 6C
7.34 gt. i / 1,5.35 A5
CAL. /
.2.0 AC
5 (D
1
103.86 AC. CAL.
I /
j
�'•� �1
�
II i 6 �
102.98 AC. CAL. I I
�
" •1 l
I �►
%
83.92 AC. CAL /
jI
i S 1 690.96
i i
I 1 l I 3.2
65685 AC.
L \ 19.96
I
I t ,
IAL'I
171.19
1 .r
2
I /.•1 I 391•
\
I / / 121.7AC.
AL
----- ---- -
'---
-_____'__- ---_--__'_-
-
_
- _!�\�-V\�� U8"
- ------
A
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
LETTER OF AUTHORIZATION
RE: Property of F &R Development Co.
Boulder Brook Lane
Located at
TN Patterson Tax Map # 13.1 Block 1 Lot 13
Subdivision of Ludemann
Subdivision Lot # 3 Filed Map # 1916 Date Filed 07/07/83
Gentlemen:
This letter is to authorize _}'�'��+��� �Gp�C�f�j
a duly licensed Professional Engineer t/ or Registered Architect to apply for the required
wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance
with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam
County Health Department, and to sign all necessary papers on my behalf in connection with this
matter and to supervise the construction of said wastewater treatment and/or water supply systems
in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health
Law, and the Putnam County Sanitary Code.
Countersign
PE, ,
Keane Coppleman Engineers
Mailing Address 113 Smith Avenue
Mount Kisco,
State NY Zip 10549
Telephone: 914-241-2235
Very
Signed:
(Owner of Property)
Mailing Address: 6& ,4)-67yUj _ 41e-
Aye) Pckflol /e
State Zip %off y/
Telephone: 74
Form LA -97
KEANE COPPELMAN ENGINEERS, P.C.
113 Smith Avenue
MOUNT KISCO, NEW YORK 10549
(914) 241 -2235
TO PUIMMA COUNTY DEQT.
OF 4 EA t_-r N
WE ARE SENDING YOU ,eAttached ❑ Under separate cover via
❑ Shop drawings Prints ❑ Plans
❑ Copy of letter ❑ Change order ❑
LLLTTITLM OU V o U H@LJ OUCT11
❑ Samples
the following items:
❑ Specifications
THESE ARE TRANSMITTED as checked below:
;20'For approval
❑ For your use
❑ As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
COPY TO
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
• Resubmit copies for approval
• Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED: to-�,�
if enclosures are not as noted, kindly notify us at once.
DESCRIPTION
". _ • "I
L 4w
A
.
THESE ARE TRANSMITTED as checked below:
;20'For approval
❑ For your use
❑ As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
COPY TO
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
• Resubmit copies for approval
• Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED: to-�,�
if enclosures are not as noted, kindly notify us at once.
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner F &R Development Co. Address 66 Argyll Ave. , New Rochelle, NY
Located at (Street) Cushman Rd. &Boulder Brook Tax Map 13.1 Block 1 Lot 13
(indicate nearest cross street) Lane
Municipality Patterson Drainage Basin N. Y. C.
SOIL PERCOLATION TEST DATA
Date of Pre- soaking 07/19/00 Date of Percolation Test 07/20/00
Hole No.
Run No.
Time
Start - Stop
Ela se Time
(pMin.)
Depth to Water
I rom Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
1
1 .10:47
-54
7
18 -21
3
2.3
2
10:55 -03.
8
18 -21
3
2.6
3
04 -15
11
18 -21
3
3.6
4
16 -27
11
18 -21
3
3.6
5
1
16 -32
16
18 -21
3
5.3
2
40 -57
17
18 -21
3
5.6
3
58 -16
18
18 -21
3
6
4
18 -37
19
18 -21
3
6.3
5
1
2
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data td 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.
1 HOLE NO. ' 2
HOLE NO. 3
G.L.
-Organic
Organic
Organic
0.5'
1.0'
It-
19
1.5'
Loose Sandy
Loose Sandy
Loose Sandy
2.0'
Loam W /Small
Cobbles Loam W /Small
cobbles Loam W Sma obble
2.5'
a
��
3.0'
3.5'
It
It
4.0'if
4.5'
5.0'
Ledge
Ledge
Ledge
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: Keane. Coppelman Engineers Date 7/18/00
Design Professional Name: Daniel P. Coppelma
aaaress:�?.ea.ne Coppelman Engineers
- "..
c-113 Smith Ave.,Mount Kisco,NY 1
j
FOR
KEAN
Sign4m- re: ' ENGINEERS, P.C.
PIRUFLty t:AU N
Design Profession
14.164 (2187) —Text 12
PROJECT I.D. NUMBER 817.21 SEAR
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNUSTEO ACTIONS Only
PART I— PROJECT INFORMATION (To be completed by Applldant or Project sponsor)
1. APPLICA T rSPONSO
F
2. PROJECT NAME,
&t Dev?jopment
3. PROJECT LOCATION:
Municipality Patterson County Putnam County
4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map)
On Boulder Brook Lane W /Driveway easement to Cushman Road.
5. IS PROPOSED ACTION:
)QNew ❑ Expansion ❑ Modificationlalteration
6. DESCRIBE PROJECT BRIEFLY:
Sewage disposal system /Residential
7. AMOUNT OF LAND AFFECTED:
Initially • 3 5 acres Ultimately acres
8. WILL PROPOSED ACTION-COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
0Yes ❑ No If No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
❑ Residential ❑ Industrial Commercial ❑ Agriculture ® Park/Forest/Open space ❑ Other
Describe:
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE OR LOCAL)?
M Yes ❑ No If yes, list agency($) and permit/approvals
County & Town Permits
it. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
❑ Yes JDWo If yes, list agency name and permlt/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes ® No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
M'lton Ferreira 08/17/00
Applicant/spo or e: Date:
r
Signature: 11 1
If the action is in the Coastal Area, and you are a state agency, complete the
Coastal Assessment Form before proceeding with this assessment
OVER
� ' ,,
PART II— ENVIRONMENTAL ASSESSMENT (To be completed by 4gency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAR
❑ Yes _ ❑ No
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration
may be superseded by another Involved agency.
❑ Yes ❑ No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly
C5. Growth, subsequent development, or related activities likely to be induced.by the proposed action? Explain briefly.
C6. Long term, short term, cumulative, or other effects not identified In C1-05? Explain briefly.
C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly.
D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
❑ Yes ❑ No If Yes, explain briefly
PART III— DETERMINATION OF SIGNIFICANCE (ro be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether It Is substantial, large, important or otherwise significant.
Each effect should be assessed in connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d)
Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that
explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed.
❑ Check this box If you have identified one or more potentially large or significant adverse impacts which MAY
occur. Then proceed directly to the FULL E4F and/or prepare a positive declaration.
❑ Check this box If you have determined, based on the Information and analysis above and any supporting
documentation, that the proposed action WILL NOT result In any significant adverse environmental impacts
AND provide on attachments as necessary, the reasons supporting this determination:
Print or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency
Name of Lead Agency
Date
Title of Responsible Officer
Signature of Preparer (if different from responsible officer)
KEANE COPPELMAN ENGINEERS, P.C.
113 Smith Avenue
MOUNT KISCO, NEW YORK 10549
(914) 241 -2235
TO P�TN ANl �o�UTV 1DEpAtL,A E AJ
WE ARE SENDING YOU 0-'Attached ❑ Under separate cover via _
❑ Shop drawings - Prints ❑ Plans
❑ Copy of letter ❑ Change order ❑
THESE ARE TRANSMITTED as checked below:
❑ For approval
• For your use
• As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
COPY TO
P-11E L1 L1 IEQ 01P V ° ° M v�0VV&l
DATE l o U
JOB NO.
ATTENTION
oT3E,Q -T a2. 5
RE: I
PF-uslineme
Air ('nize.
5culA;C.
3
RAV sNT
- -t
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
❑ Samples
the following items:
❑ Specifications
DESCRIPTION
RC
Resubmit copies for approval
❑ Submit copies for distribution
❑ . Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
SIGNED: L /l/
ff enclosures are not as noted, kindly notify us at once.
f