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HomeMy WebLinkAbout0403DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -3 -49 BOX 5 61 r.. 1, a Ir ly I 00212 Y. +�« ,� ; .. .-- "'.-- .,,r...n� ,.cam- ^a-- ..," -..v a �a c•. -.1r- .-ter- a.r, -r; - �^.'"°-rF- x '� y. o sr 7 a ,, �.y -r- -- 'e- ---T— P fifi PUTNAIYI COUNTY DEPART11HrNT OF HEALTH {, `u # Dlvlebn otPmvhronmen4l H Servl000 ,C�emel N.Y 10512.` Eng6see to Provide Peemlt M f OF On S—U CEE1iP1 LL+►N i ermit ..,kM C CONSTH . PE>ZMIT FO$ SEWAfiE DLSPOSAL SYSTEM . P C tv t Locates st Vie .. , ,. � own o: t SnbdilsbdName, Suhd. Lot k ` T iockLot Owner/ t APP>� _ Date o;[ P'7revious, Approv6l Ma111ng r Town for S�n i 7d :. b- P Bouding,e AiaA L, Lot Area Fill'Secdon Only Depth Volume Nnm6or of Bedrooms Dealg,t Flow, l3 P D PCHD NotlBcatlon I' Regai�es Wh "'I la cgmpieted . '' TT��77^^�� , Separate Sewerage System to consist of 16cb n Septic Tank an Ky To 6e constiiacted by Address water Supply: Pttbpc Supply From Address on_Pelvitte SaPPIy, Drilled by lL1IC1LNrdraes Other Re! }airemente , I represent.that I am vrholly and completely responsible fo►'the deli nand location of the proposed system s), lj"tliat the sap8rate sewage disposal >'ystem above described, w^il.be " con str•ucted.as shown on the'approyed amendment Chore.; to and, ;in accordance wdli the standards, rules an .• repu a �onso e u nam, County gepartment of Haaltli, and th6t,op completion thereof a "'Certificafe' of Construction`Cornpliance setiifsctory to, the Commissioner of�Healtli,wtll be-iubmitted to`:the Department and 'a, wrlttan`quaranteezwtll be^ urnislied' the owner fits successors, hetrs'or;asspns , by he_builder that• :saki builder will place in. good opersting' condition any, part -ot said sewage disposai.'system-durinq the perpod.of two (2) years immediately following thedate of the, issu. ince of the'approvaL of the Certificate'- of Consfruction ";Compliance of theorig�nalsystem o;any repair •thereto; 2) thabthe drilled 'well- despibed iboge.' will be located at shown on the.approved plan and that said well will be Irista1 accordance ,with "the - ards, `rubs and 4p—u aeons of the, ' :,Putnam Count yliO part enf Of Health ,.. Date, b S � Z- SKIII P.E. R A. —. C �' Adtlress �J7.. Llcense. No •APPROVED FOR CONSTRUCTION This approval expves. two years, from the -date issued unles construction of the building has been undertaken and is revocable for cause or :may De- amanded'or.motlified when considered nQsessary by the• Commissionor o£,Health.:.`, Any. change or alteration of construction equi►es a new permit.: AApproved for disposal of domestic sander sew ra er private water poly only: \�`�'�✓rOate __5��/ � D ts;' gy ����'.�le Bafta Tip, -Residential Lot At 60.373 : SF + FM Nt�barot Beioa�a 3 DeNp Flow G P D .600 PCHD Nod&mdm Is Begalmd When FM Is caawleted Sepeepia SitweW Sydow a oaaiilat daMQ -GWI= Septle Tank ad Finn, up sr 9411 .14i r7 +h Trench TO he' cewkla aed.by Addle= Watetr Sam: PodiIIc: Ski P>ro® . Addrm v. Dted by I*aoa sp� Not yet.det ot' ermi 0 i r e�pre»ot ttheat�l am wholly an4 completely re ponsiblo for the design and location octho proposed fystem(M 1) that the- separate sawapa.diyi system above described will be constructed as shown on the approved amendment there to and. in accordance with the standards, rules aia regu (i'wns O nafn County Department of ,H aRl%,.and that on coe►plet ion. thereof a? -,Certificate Of,_Coristruction Complisrica".eatisfactory loth* Comnlissloha Of. Mwlthwill be submitted, to the Departeent. and a written guarantee wilt be furnished the owner. -his successors;' heirs or assgrrs by the buikter, that said builder will place iA pod operating ct►iWition any an of oa aawpe disposal 'system during the period of two (t) Years immediately' following thedate Of the Issu- ppro al of tho'C,ortificate of Construction, Compliance 01 „the orgineF system or nV repairs theretoi 2) that the drilled well described a6ow WHO be located as slrou+n on ihe'appioved Plan and that said well will be in st 'in' rdence the. standards. rubs and reguSIOns of the Putnam County pepartnnnt Of FlMlth. Date 9/7/951 P.E. X PA. ' .Addn P..O.. Box 374 reirster . 10509 LiCe1,fe No 051011 ; APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the building has been undertaken and is revocable for cause or may be,arnailded Or modified when eonsidered'neeeMry b oner of MYlth.. Any Change Or NteratWn of construction repuires aa, new permit. !A�}P'p►ove/0�f�ar disp/o�sal of alomes{k sanitary sewsg ate Rev. BY Title T J. R. FOLCHETTI & ASSOCIATES ENVIRONMENTAL ENGINEERS 247 Route 100 47 Route 17K 1849 Rte. 6 Pinewood Bus. Ctr. , Newburgh, NY 12550 Carmel, NY 10512 Somers, NY 10589 914 /562-0153 914/225-1510 914 / 232 -2500 914 / 562 -0279 FAX 914 / 225 -1704 FAX 914 / 232 -6827 FAX TO: WE ARE SENDING YOU • Shop Drawings • Copy of letter 77 a iL 117 ll ►1� 1T1I j (0)IF U �c—i T T : ffHTT .L DATE: JOB NO: ATTENTION: RE: �pnrz�so�i s Tic s ysT,��s eVy a Z 2 ❑ Attached ❑ Under separate cover via • Prints ❑ Plans • Change order ❑ ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION. Z a Z 2 Ate- 7� THESE ARE TRANSMITTED as checked below: • For approval ❑ Approved as submitted • For your use ❑ Approved as noted • As requested ❑ Returned for corrections • For review and comment ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US z. • Resubmit _ copies for approval • Submit copies for distribution • Return corrected prints REMARKS: / COPY TO: SIGNED: 1/14r DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL RENEWAL PCHD PERMIT # WELL LOCATION Street Address Town/Village/City Tax Grid Number Cornivall Hill Road Patterson 1 -6 -7 &8 WELL OWNER Name Maili g Address ox revs er 14Private C.E. & J.L. Garrison c�o J.R. Folchetti & Assoc. O Public USE OF WELL 1 - primary 2- secondary O RESIDENTIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O ABANDONED D BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify, D INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm/ # PEOPLE SERVED 6 /EST. OF DAILY USAGE 450 gal 0 REPLACE EXISTING SUPPLY O TEST /OBSERVATION 13. ADDITIONAL SUPPLY M NEW SUPPLY NEW DWELLING C1 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Domestic Water Supply WELL TYPE ®DRILLED DRIVEN DDUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Garrison Lot No. 2 .WATER WELL CONTRACTOR: Name Not yet selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: >500- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 9/7/95 (DON SEPARATE SHEET (date) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt, (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 Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health 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 otherwise contaminat05:;Surface or groundwater. Date of Issue: � /r} 19 7 —� Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller F_�) DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL _ l - rCH1 rERMIT # 6 WELL LOCATION Street Address. Cornwall Hill Road Town Tax Grid Number Patterson 1 -6 -7 &8 WELL OWNER Name Mailing Address P.O. Box 374, Brews te rO Private C.E. &J.L.Garrison c/o J.R.Folchetti & Associates OPublic USE OF WELL 1 - primary 2- secondary ® RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP OABANDONED 0 BUSINESS O FARM ❑ TEST /OBSERVATION O OTHER (specify, O INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 450 gal REASON FOR DRILLING 13 REPLACE EXISTING SUPPLY ® NEW SUPPLY NEW DWELLING ❑ TEST /OBSERVATION 12-ADDITIONAL SUPPLY ® DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Domestic Water. Supply WELL TYPE DRILLED ®DRIVEN ®DUG ®GRAVEL. ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Garrison Lot No. 2 WATER WELL CONTRACTOR: Name Not Yet Selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: -- -- TOWN /VIL /CITY tP -1 9 DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: ;' 500' LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED . [Z]ON SEPARATE SHEET 9/19/90 (date) signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirtir (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 erations be contained on this property and in such manner as not to degrade or other Ise ontaminate surface or groundwater. Date of Issue: 4 19 '?" �� A�Rftl(-' Date of Expiration 19 q Z Perm 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 RENEWAL: September 19, 1990 Date July 1, 1986 Re: Property of C.E. & J.L. Garrison Located�at Cornwall Hill Road, Patterson NY 12563 (T) Patterson` Section 1 Block 6 Lot 7 ;8 Subdivision of Garrison Subdv. -.Lot # 2 Filed Map # Date Gentlemen: This letter is to authorize J. Robert Folchetti & Associates a duly licensed professional engineer X 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. Countersigned: P.E., R.A., # P.O. Box 379 Address 051011 Brewster, NY 10509 914 - 279 -3346 Telephone Very trul ou , Signed Owner of Pro i erty 1 Blue Hill Plaza Address Pearl River, NY 10965 Town Telephone J.R. F®LCHEM ASSOCIATES Environmental Engineers 98 Mill Plain W. P.O. Box 374 Danbury, CT, 06811 Brewster, NY 10509 (203) 790 -6445 (914) 279 -3346 FAX (203) 792 -2092 TO Putnam County Health Department Geneva Road, Route 312 Brewster, NY 10509 [LEE EN OF TURS, MODUUM DATE AuIjust 13 .1992 JOB NO. ATTENTION RE: Garrison R.S. -- Permit Renewals 1 LOT #2 -- Construction Permit for Sewage Disposal WE ARE SENDING YOU ® Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change. order ❑ COPIES DATE NO. DESCRIPTION 1 LOT #2 -- Construction Permit for Sewage Disposal System; Application to Construct a Water Well Renewal 2 LOT #4 -- Construction Permit for Sewage Disposal System; Application to Construct a Water Well Renewal THESE ARE TRANSMITTED as checked below: IR For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted > ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ .❑ FOR BIDS DUE 19 REMARKS COPY TO File J. Garrison PRODUCT 2402 AWMWIK. OMm. M- 01471, • Resubmit copies for approval • Submit copies for distribution • Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US SIGNED: If enclosures are not as noted, kindly notify us at regory L.Folchetti /• •• Ul"I DEPA�T OF �.DIVISION.. • r o iU v •EALTH -',.'SERVI u� DESIGN DATA SHEET- SUBSUFACE SEWAGE.DISPOSAL SYSTEM FILE NO Owner C,�, .5,�,, GAIM50 �1. Address CoIN Wt�i.c._ !�� �.- izt�,: Located at (Street) dOW WALL I -��LL. 1��.%7-T.311 Sec.. . � Block Lot' (�o(,ES2E�z�� (indicate nearest cross street) Municipality ?ATiEZS01 J Watershed : CIZO-ror -A SOIL PERC0 T20N TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre - Soaking 411 b t3t, Date of Percolation Test HOLE m[mm C= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No'. Time Ground Surface In Inches. Soil, Rate Start-Stop Min. Start Stop Drop In Min/In.Drop L.oT ' Z- Inches Inches Inches. iK6 SoAX/l 16- 40 -11 .t �W VZ ��II,Z9- 11.58 29 Z I2,7 Z4 ZS 4.1 3 3 37 7b Z4 Z T ( 3ca 11 o � - . � ► ; a 5I Zq- Z6/4 V/4- Z z:. NOTES: 1. 2. rev: 9/85 Tests to be repeated'at same depth until ..approximately :.l.soil rates are. obtained at each percolation test hole. ,. All data _ to''be : submitted..:' for review. Depth measurements to be made from top of hole. aw4 a TEST , PIT DATA RDQUI] DESCRIPTION OF DEPTH HOLE No. 2 I- AI.E �iz01�1r• "► QTY COY LC,,A m 21 12.3b 3' 4' 5' 6' s' 9' 10' 12' 13' 14' Lsk I.TY CL A-{ LoAo4 s►L-cy Eby TO BE! :.SUBMITTED WITH. HOLE . NO.:, F NTK 7� --UW SI L—/ L©AM Sti ury LoAm yEL�,o►,�r .G �Ay �Ic.T L OAI-A CLAY L.oA1,*1 114. `► INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: F-47L: e u Ls- r r i DATE: 19 8!fl NOTE- MATTL�ti1G O�Stic �.1� AT 441t DESIGN Soil Rate Used 31- q•S Min /1" Drop: S.D. Usable Area Provided Scoop C� No. of Bedrooms 3 Septic Tank Capacity 100 &;P gals. Type Absorption Area Provided By L.F. x 24" width trench Other Z' IZ, F, Name �'4 L C 41 I =:771 A%OC . Signature c Address 5'24 SEAL, e' yF� x.0509 r rc° THIS SPACE FOR USE BY HEALTH DEPAR24RU ONLY: 0 1 a, Soil Rate Approved sq.ft /gal. Checked by iL I PUTNAM COUNTY DEPAR2 -UM OF HEALTH - .DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT DATE REVIEWED: BY: (Name of Owner) (Street Location) COMMENTS YES NO DOCUMENTS J Permit Application f ;, J [26 Corporate Resolution Plans - Three sets / Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results (3) 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan Sewage System Hydraulic Profile - Gravity Flow Fill Profile & Dimensions.- Volume D or J Box;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Ag Driveway & Slopes Cut i `� Footing /Gutter Curtain Drains -' Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed 3 House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessa House Sewer - 1 /4" /ft. " No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town/DEC Permit R & D) Data On DDS Plans & Permit Same from the desk of — JOHN KARELL JR., P.E. Director Of Environmental Health Services IC Vi f p m I/ - SS � S s to 1 n C�►�t ' sue- 0 ! l X t� ,, vii PUTNAM"COUNTY DEPARTMENT OF HEALTH DIVISIOW OF ENVIRONMENTAL HEALTH SERVICES Date July 1, 1986 Re: Property of C.E. & J.L. Garrison Located at Cornwall Hill Road, Patterson NY 12563 (T) Patterson Section 1 Block 6 Lot 7;8 Subdivision of Garrison Subdv. Lot # .2 Filed Map # Date Gentlemen: This letter is to authorize J. Robert Folchetti & Associates a duly licensed professional engineer X or registered architect (Indicate to apply fora 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 thi.s.matier and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani tary Code. Very trul ou , Signed Countersigned: Owner of Property P.E., R. A. # 051011 1 Blue Hill Plaza Address P.O. Box 379 Address Brewster, NY 10509 914 - 279 -3346 Telephone Pearl River, NY 10965 Town Telephone — 16 '_"� ♦ 11 +r } ,-iv � -' a "'�r.� .�•`..F l �s.:,,•r .`, t. :. v r ,.li PUTNAM COUNTY DEPARTMENT OF HEALTH Re V 3/86 Division of Eavlromneatal$ealth Services Carmel N Y 1051? Engineer to Provide Permit r 3 _ oa CEIiTIFICATE,OF COIYIPLIANCE6L7 CONSTRUCTIQN PERMIT FOR AGE 1)iSPOSAL SYSTEM Permit lY t ' Located at'S�t>`tu�Pd C'2-I �•Lf, i4. -Town or': Village z Sabdlvision Name �'� -I,4 l c !h �l C Z , �` �o 47 ' _177 t Snbd 'Iot k Taz Map /:. " Btock Lot J. _ Renewal'_ O Revision ❑ Owner /Applicant Name -` Date of Previous Approval Matllig Addreea fh> .C� LC IF %R T 6i5C r?� . Town Zip' Baildtng Type' k r G �° � R" l A Lot Area 3 t FIB Section Qnl � ---r .,, -, y `. Dept Ndmber of Bedrooms f` Design Flow PCHD Notification s Required When FIB, Is completed $e orate Seive e S te'm to consist of• p P rs6 Ys . j Gallon Se" tic Tank eadf. -_ c f' To'be constricted b Y Address_ WatecSuPPb: x Pablic:$apply From Addttrees:' `• orPrlvste.Sapply DrWed by` )+ t't / l y, Otter. Regalremonte ' I represent thal!1 am wholly and completely responsible for ttie design: and location of tie proposed systems) lj that the sewage" disposal system above described, will be: constructed as'shown on the.appr`oved amendment thereto and in• accordance with the standards; rules an regu a ions o e u nam County Department 'of.' Health ' 5nd th5t on eortiplet�on thereof a . Ceibf�eate ;of Cb;itruetion Compliance sat�'faetory to the Conimissionerof Healthwill. be suDm�tted';ao the "Department; aAd 'a wrdteri'gua�antae wJl be furnished the owner.; his successors, heirs or auiyns by the.DUilder, that said builder will place, in good'..operating condition any ;part of 'said sewage, d�sposab, system dur�ng,,the period of two (2) years imiiiediately following the date of the.issu- ance, of the'`approval'of, the Certificate,'of Constiuctio`n Compliance, of the onginal'.system or'any repairsAhereto l2) that I the ' drilled well described above, will be located A shown on'thiapproved pladanit,that,sajd well w�lI, install :i- •.accordance with the�'.itan} rds,, rules and regu ads of the Putnam County Department of Health Oats P R.A. — --� Add►ess" •'0 a License No APPROVED FOR CONSTqU9T,lO N. This aDProval expues "one year from a to issi revocable se or 'ma ended of modified when.consideied neces ry ' y the'i requires w pe t;' p ved'for disposal of, domestic.samtary se and /or Oats ✓ °'' t3v 0 -4. r do o the building has been undertaken and is of h n 8_w –al ation of constrr ctlon .C7 v /•. Title 'D" — vi . `,Cf a• an NORTIERNI IL- HOMES N The James Madison .I1 1j �a ,CQUr11Y `DAP =-11I Na 'G� G t` 7- PLANS 1! rPR017E, D 7� MUD ROOM WINING BREAKFAST 12x11 & KITCHEN FAMILY 19x11 14xi8 DN LAM BEAM LAV LIVING N CATHEDRAL CEILING O 4e X23 THIS ROOM y Ic of. FIRST FLOOR PLAN pO�C R. BEDROOM E=. BEDROOM 11x12 11x11 CA L DH L BEDROOM 0 0 18x1'3 BATH 1 fw CANTILEVER SECOND FLOOR PLAN O= T �J 0 / 518 . 0 Wat<_ SIG 518 / ! W 51 I Lof 6 �-9 -- -- — 514 • {✓i7N D.PJC/A� 514 512 410 — —512 MIN, , '0 508 - 1SEPTIG ` -- 508 SAS 1 70E FILL , oP FILL ^ 506 TYP 5o4 5c.)4 Qf 10• TvacTlo Box 0 502 � � •. PH w • �\ NZ �10� 9'0 � - - 4� Xr- 50i 500 I `� Ta►. o� Fig -o° co _J V) ` 0 500 c� N. 10 32'00"W, 11.9 95' r=co r.� w4r_L Nit-" SEPTIC TANK SIZE - 10001�,,e,L N C —� - L� FILL VOLUME NO. BEDROOMS. 3 DESIGN DATA':•.. I PERC RATE - 3I : qS h iNlir�1 SSDS I /i72EA CO.000 5 F = DEEP HOLE SOIL - Stt.Ty s1w CN�I FIELD LENGTH SCJ>4E I "-'So t • WELL oos ,001 09 doiaor. .ol bOS .....� Sl f�� X05 �sC d� 905 -1'1W d L OD09I 19XS5; pin ;wr •., b 0 Id i i 909— anv �I1d�S o I. 1 SOS N O OD / o 0 0 'NIW ?IS— — 0l5 015 — �— — �'13�� Atl j Z19 M b15 ' l 815 s'srSI1G�j/ O I9 — i r ,e LO, N � i � � V I u SZ bZa� �y ,- ozs H 006 0 0 r— T In OD \ 0 O 9z H0 \ . I. O oos ,001 09 doiaor. .ol bOS .....� Sl f�� X05 �sC d� 905 -1'1W d L OD09I 19XS5; pin ;wr •., b 0 Id i i 909— anv �I1d�S o I. 1 SOS N O OD / o 0 0 'NIW ?IS— — 0l5 015 — �— — �'13�� Atl j Z19 M b15 ' l 815 s'srSI1G�j/ O I9 — i r ,e LO, N � i � � V I u SZ bZa� �y ,- ozs DEPARTMENT OF HEALTH - Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #•I WELL LOCATION p Street Adofess Town/Village/City Tax Grid Number WELL OWNER Name a ' Address 41), 'c �C rivate 0 Public USE OF WELL <V- primary 2- secondary RESIDENTIAL BUSINESS 0 INDUSTRIAL OPUBLIC SUPPLY OAIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY OABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT jr)gpm /# PEOPLE SERVED_ /EST . OF DAILY USAGE LU gal REASON FOR DRILLING NEW SUPPLY O PROVIDE ADDITIONAL SUPPLY REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE ODRILLED O DRIVEN ODUG O GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: GA'eA1SdA1 S. Lot No.�. WATER WELL CONTRACTOR: Name //ti %=�h > D Ki Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES i _NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL/CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: A/ LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED _ Q ON REAR OF THIS APPLICATION 0 SEP RATE SHE ( at ) (signature PERMIT TO CONSTRUCT A WATER WELL This permit'to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Date of Date of Health Department. Issue: 9/��""_ ----' Expiration: lg Permit ssuin f icia Permit is Non - Transferrable 2/87 White copy: Yellow copy: H. D. File Building Inspector Pink Copy: Owner Orange copy: Well Driller ' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date July 1, 1986 Re: Property of C.E. & J.L. Garrison Located at Cornwall Hill Road, Patterspn NY 12563 (T) Patterson Section 1 Block 6 Lot 7;8 Subdivision of Garrison Subdv. ,Lot # 2 Filed Map # ka 73sr1_F,, Gentlemen: PLITNAP-A This letter is to authorize J Robert Folchetti a. duly licensed professional engineer X 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 inconformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very trul o.0 , _ Signed Countersigne P.E., R.A., # 051011 P.O. Box 379 ..Address Brewster, NY 10509 914- 279 -3346 Telephone Owner of Property 1 Blue Hill Plaza Address Pearl River, NY 10965 Town Telephone DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL j�C�c� /a "� ---•_ PCHD PERMIT # WELL LOCATION Street Address Cornwall Hill Road Town/Village/City Tax Grid Number Patterson 1 -6=7 0 WELL OWNER Name Mailing Address P.O. Box 374 , Brewster Private C.E. & J.L. Garrison c/o J.R. Folchetti & Associates 0 Public USE OF WELL 1 - primary 2 - secondary 13 RESIDENTIAL ❑ PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS 0 FARM 0 TEST /OBSERVATION 0 OTHER (specify 0 INDUSTRIAL []INSTITUTIONAL 0 STAND -BY O AMOUNT.OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 450 gal REASON FOR DRILLING ❑ REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION 13- ADDITIONAL SUPPLY El NEW SUPPLY NEW DWELLING 93 DEEPEN EXISTING WELL DETAILED REASON FOR •DRILLING Domestic Water Supply WELL TYPE ®DRILLED DRIVEN ®DUG ® GRAVEL ® OTHER IS WELL SITE SUBJECT TO FLOODING? YES x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Garrison Lot No. 2 WATER WELL CONTRACTOR: Name Not yet selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES x NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 500' LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED (DON SEPARATE SHEET 8/5/92 (date) (signature) . PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and.provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant any and all water or waste products from such well property and in such a-manner as not to degrade o Date of Issue: 0 L � 19 CZ Date of Expiration 191 Permit is Non - Transferrable 3/89 shall take appropriate action to assure that drilling operations be contained on this r other a contaminate surface or groundwater. ,%4- w Perm t Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIAN E TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P-6G' Orf J 1- a -v n Located aAl� C4LHWhLtL- 1+11,1' I--0 Pry Town or Village P P� -rTEP -6 oN Owner /Applicant Name 44-A i P1 HH Formerly 6 N W 6OH Tax Map A 1, Block 1� Lot Subdivision Name C 14A 94-E 6 t 3 P WH &"5br) Subd. Lot # Mailing Address 6 VJ V'� i v�0 l,LOy-J kkD Zip `J) '!�'D I Date Construction Permit Issued by PCHD 5 4W Separate Sewerage System built by ALLAH P�IHH Address 1 S +-K iJ"ucW Nn• ikvbwp; is 0i Consisting of Gallon Septic Tank and '%%I LF- 1 %4 - TP-45MLa+ Other Requirements: 00 5� kA G k 6 P*EQ-- i V f(14, Water Supply: Public Supply From, Address or: X Private Supply Drilled by m1U. P P4WOtA Address %' ?0W per' ,—� W 0<01i Building Type P-e 6 10 5H L15 Has erosion control been completed? I�E� Number of Bedrooms Has garbage grinder been installed? rio 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 regulationslOf the Putnam County Pepartpent of Health. Date: / / - 16 '0)-- Certified by Address 1-0 SO K U 6 P.E. X R.A. �A License # 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 ubject to modification or change when, in the judgment of the Public Health Director, such revocati m ificatio change is necessary. i By: Title: Date: o 2— White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street Address: A Jjjjj Cornwall. Hill Road Town/Village: Patterson Tax Grid # Map 11)). Block ^0 Lot(s)41 Well Owner: Name: Address: Dorsett Hollow Builders - 15 Solorons Hollow Rd, Brewster, "iY 10509 Use of Well: 1- primaryXXXX 2- secondary X Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion __I_ Compressed air percussion Other (specify) Well Type Screened Open end casing X Open hole in bedrock Other Casing Details Total length 61 ft. Length below grade 60 ft. Diameter 6 in. Weight per foot 7 lb/ft. Materials: _X_ Steel Plastic Other Joints: Welded X Threaded Other Seal: Cement grout Bentonite Other Drive shoe: Yes No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _ Pumped X Compressed Air Hours 6 Yield 12 gpm Depth Data Measure from land surface - static (specify ft) 50 During yield test(ft) 300 Depth of completed well in feet 365 ft. 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 .45 Sanely Clay 45 50 Sand Stone 50 365 'Jite Lime Stone If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 365 12 Pump Type 51,_6_ Capacity 7 Depth -JCWBY OTHERModel 76 NO'71Z( Voltage I ! �— HP ` 5 Tank Type -Tr ,, I Volume OTHERS Date Well Completed 1.0/18/02 Putnam County Certification No. 2 Date of Report 10/29/02 Well Driller ' - NOTE: Exact location of well with distances to at least two permanent landmarks to b r wided on a separate sheet/plan. Well Driller'sNa DRILLING, IF -C. Address: 75 Putnam Ave,, Brewster, I4Y Signature: Date: 1/1 '7 [07, White copy: HD File; Yellow copy -Building Inspector; Pink copy- Owner; Orange copy -Well driller Form WC -97 BRUCE R FOLEY - LORMA-I MOLD AIt! RN., M.S.N. Public Health Dirrcla y Aiaociau Public Health Director Din*tor of Patient Scutt" DEPARTMENT OF HEALTH 1 0onova Road' - - Browster, New York 1.0509 Barlr000acaW Hcsltb (914)271.6170 Pa(914) 271.7921 Nurslal &erica (914)271.6331 WIC (914)271.6671 .Fu(M) 271.6095 Early'Totcrrio�oo'(914)17i 6011 Frod9ol (914)37W$2 Fax(914)27r-6641 E911 ADDRESS VERIFICATION FORM - - ......._ OWNERS NAME; ...... ...... TAX MAP NUMBER: E911 ADDRESS: n��� C%0H WA L, HILL, TOWN: P� i TARS o tJ _... -.. AUTHORIZED TOWN 6MCIAI,; (Stgnature) 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 offlcial..This form is to be submitted' �Yith the application for a Certificate of Construction Compliance. CE91 1 VERFRM) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION .OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building ADAM F11 --11- -I Building Constructed by 1015 GD�Loy sw A (Lt, �p PAD Location - Street PE /5 ID6M�� Building Type 10), ro 41 Tax Map Block Lot PAI'i F�SoH TownNillage Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described 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 Director of the Putnam County Department of Health as to wl to operate was'caused by the willful or negligent act of the c Novi � ,spay .14 Year 200 (Owner) - Corporation Name (if corporation) Address: 15 ' W e'�§V i-44 VAd k Si, determination of the Public Health ether or not the failure of the system building utilizing the Title: 0w►tQ%- Corporation Name (if corporation) Address: 1` � 4U \rj k- 46 j`� State Zip State NJ Zip 1pSA Form GS -97 JMS ENVIRONMENTAL SERVICES, INC. 1500 SUMMER STREET STAMFORD, CONNECTICUT o69o5 Mailing Information: Name: Mill Drilling Co. Address: 75 Putnam Ave City: Brewster State: NY Telephone:. Sample's Information: Site: water tank Preservative: HNO3 Temperature: <4C. Client: Dorsett Hollow Bldrs Zip: 10509 Fax: 845 - 279 -5075 NELAC, CT and NV State Certified Environmental Laboratory Collector's Information: Name: Bob Address of site: Cornwall Hill Rd 11� 3115 City: Patterson State: NY Zip: Telephone: Date Collected: 11/4/02 Date Received: 11/5/02 Time Collected: 16:30 Time Received: 12:00 Lab No.: J024203 Date Analyzed Test Name Result MCL Method 11/5/02 15:00 Total Coliform Absent Absent SMWW 9222B 11/5/02 Chlorine Free Residual <0.1 mg /L N/A SMWW 4500CIG 11/6/02 Color ND 15 Units SMWW 2120 B 11/6/02 Odor ND 3 TONs SMWW 2150 B 11/6/02 Iron 0.086 mg /L 0.3 mg /L SMWW 3111B .11/6/02 Manganese 0.047 mg /L 0.3 mg /L SMWW 3111B 11/6/02 Sodium 16.1 mg /L N/A SMWW 3111 B 11/6/02 Chloride 16.0 mg /L 250 mg /L SMWW 4500 Cl C 11/6/02 Hardness 170 mg /L N/A SMWW 2340 C 11/6/02 Nitrate 1.62 mg /L 10 mg /L SMWW 4500 NO3E 11/6/02 12:00 Nitrite <0.1 mg /L 1.0 mg /L SMWW 4500 NO3E 11/6/02 pH 7.06 S.U. 6.5 -8.5 S.U. SMWW 4500 H B 11/6/02 Sulfate 18.8 mg /L 250 mg /L SMWW 4500 SO4F 11/6/02 Turbidity 1.16 NTU 5 NTUs SMWW 2130 B 11/6/02 Lead <1.0 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 M 11715 President Tel 203 961 9911 Toll Free 1 866 567 5097 Fax 203 961 9919 jmsenvironmental.com PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES. ! FINAL SITE INSPECTION Street Location C'C7,k 14eC Town TM# 1. Sewage System Area a. STS area located as per approved plans... ............ ............. b. Fill section - date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil. not stripped ....... :.......................................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course /wetlands . ...... ............................... II. Sewage System --i a. 8eptic tank size - 1,000 .... t` I;250..)....other..........� b. Septic tank installed level �- : ................................... c. 10' minimum from foundation .......... ............................... d. Distribfuion Box 1. Alr outfits at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. Minimum 2 ft.Original soil between box & trenches Junction Box -' roperly set. .. ..................... ............................... 1. engt required 8 8 Length installed 8 8 9 2: Distance to watercourse measured--f--/,!570 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 .................. 7. Room allowed for expansion, 100 % ......................... 8. Size of gravel 3/4 -1' /z" diameter clean .................... 9. Depth of gravel in trench 12" minimum ................... 10. Pipe e ped ........................ ............................... g. Pump or osed S stems . S ize o p c am er ................ ............................... 2. Overflow tank ............:................ ............................... 3. Alarm, visual / audio ............ ............................... . . 4. Pump easily accessible, manhole to grade..... ...... 5. First box baffled ............ ..................... ........... .._._._ Date: io x l 02 Inspected by: C, j2 ��,� Owner forin�w►., a r`Ni 5nz7 .Permit # t�' — �,6 sG Subdivision Lot # ;t M. H TF__ U11" am ouse ocated per approved plans ............. a.......... b. Number of bedrooms .................. G'/� IV. Well a. Well located as per approved plans . ............................... b. Distance from g STS area measured f i �� �� ft........... c. Casio 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 ... ............................... YES, '"NO COMMENTS v 0000" Ile, '00'A" - arovo y� 2.. _ CA .r . .- 0 =� I� ell V November 14, 2002 Robert Morris, P.E. Putnam County Health Department 'One Geneva Road Brewster, New York 10509 Re: Individual SSTS Compliance - Alan Finn Garrison Subdivision, Lot # 2 375 Cornwall Hill Road Patterson, NY Dear Robert: Enclosed are the following: 1. Five (5) prints of Drawing SS -2, "As -Built SSTS," dated 11/18/02. 2. ."Certificate of Construction Compliance for Sewage Treatment System," dated 11/18/02. 3. Three (3) copies of "Guarantee of Subsurface Sewage. Treatment System," dated 11/18/02. 4. Laboratory Reports, dated 11/5/02. ;. 5. "Well Completion Report," dated 10/29/02. r' 6. Application Fee in the amount of $200.00 ayable to Putnam County Health Department. 7. "E -911 Address Verification Form," dated 11/18/02. If there.are any questions concerning the enclosed, please call. Very truly yours, Harry W. Nich s Jr., P.E. HWN:JM:jmm o2- 098.00 OCT -19 -2002 10:28 AM HARRY W NICHOLS 914 279 4567 a 4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES I&EQURST FOR F.2W.. INSPEOTIQN For: Fill Date: — 1d::&--02- Trenches v P. 02 epa -o 41 ej PCHD Construction Permit # P - ��/ ` 94 Located: C:er (T) Owner/Applicant Neme: �,.,� � a l�a.., Mil's. TM 1 r Block Lot Formerly: G +6 a r r sati Subdivision Name: K'a x„r.A;dh �� ✓r j e ti_ Subdivision Lot # Is system fill completed? Date: Is system complete? Date: lIQ -1 ti -4,2- Is system constructed as per plans? Is well drilled? I W% -:am* Date: W-t 7.0 2- Is well located as per plans? Are erosion control measures in place? I certify that the system(s), as listed, at the above premises has been constructed and I have inspected and verified their completion in accordance with the issued PCHD Construction Permit and .approved plans and the Standards, Rules and Regulations of the Putnam County Department of Health, Date: l0 - 1 E02— Certified by: L PE RA D gn Professional Address: a.dTL �� ode" A Lie. # � 1 2_4 Comments: FOR: ❑ ADAM GENE 0 (NAME) Form FIR -99- J -a BRUCE '.;R. ' . FOLEY `� - LORETTA MOLINARI - R.N -,. M. S.N. Public Health Director . O� . Associate Public Health Director Director of Patient Services DEPARTMENT : OF HEALTH 1.Geneva Road, Brewster, New ,York 1.0509 Environmental Health• (845) 278 - _6130 Fax (845) 278 - 7921 'Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 :Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278- 6648 October 22, 2002 - Harry Nichols, PE Patterson Park, Suite 106 . 2050 Route'22 Brewster, New York 10509 Re: Field Inspection - Dorset Hollow Builders Formerly Garrison; Cornwall Hill Road (T) Patterson, Lot # 2, TM# 11-3 -49 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. ' The following comments must be corrected.in the field. 1. - The cast iron pipe connection needs to be completed. 2. A dose test needs•:to.be performed and.witnessed by this Department. 3. Silt fence•needs to be installed below the well construction area. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Sincerely, Gene D. Reed GDR: cj Environmental Health Engineering Aide 0 a ° SENDING CONFIRMATION DATE : OCT -23 -2002 WED 12:19 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92794567 PAGES : 1�1 START TIME : OCT -23 12:18 ELAPSED TIME : 00'41" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. 0. BRUCE R FOLEY LORMA MOUNARI RN., hi9.N. DMaler 4f F.&M Arrinr DEPARTNWNT OF HEALTH •. I Geneva Road, Brewster, New York 10509 Tmlrmalealal'flalt8 (545)271 -6130 F.(945)278.7921 NuUq 9aMOa (615) 278.65!9 WIC(845)278-6671 Fat(W)VA-015 FArl7 lLrwarlm Pmeboul (145) 278 - 6014 In (845) 278 - MAI October 22, 2002 Hatry Nichols, Pi Patterson Park, Suite 106 2050 Route 22 Brewster, New Yolk 10509 Re: ° Field Inspection - Dorset hollow Builders "Formerly Garrison, Cornwall Hit Road (T) Patterson, Lot q 2, TM# 13.-3-49 Dear Mr. Nichols' i The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field, I. The cast iron pipe connection nods to be completed. 2. A dose test needs to be performed and witnessed by this Department. 3. Silt nose needs to be installed below the well construction area. ifyou have any further questions, please contact roe at (845) 278 -6130 est. 2261. Sincerely, Gene A Reed 1 i GDRcj Environmental Health Engineering Aide BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 6, 2002 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22. Brewster, New York 10509 Re: Field Inspection - Dorset Hollow Builders Formerly Garrison, Cornwall Hill Road (T) Patterson, Lot # 2, TM# 13. -3 -49 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. No further comments. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Sincerely, Gene D. Reed GDR:cj Environmental Health Engineering Aide 0 NOV -01 -2002 10:58 AM HARRY W NICHOLS s 3�UCE R FOLEY P -br:c Neolih..Direetor -- 914 279 4567 P.01 DEPARTMENT OF HEALTH 1 0eneva Road Brewster, New York 10509 LORETTA MOLTNAM R.N., M.S.N. Associate Public !Health Director D(reotor of, Patient Sorvices RE'QU ST DOR FIEX,J? TF P ATTEir"• IO,N: o AW1 MEBELING )49En REED AJI information below must be Ju4 completed prior to any scheduling. DATE: 2— EiNGl`lEEP, OR FIM • 6tv, ki PE !PHONE #: 7 --4'00 REASON: _ - DEff - C FJE RCS: o PUMP TEST; o 51040v% ROAD /STREET: �- - T 0 _)VN; - 'SAX irW #; SV8DtYlSlON; LOT #:._.2. 6WNrER: N -Y D •P CRJ L4J OZ AND WITUESSINQ OF S01Xe. .STI Proposed SSTS,within the drainage basin of West Branch or B,oyds Corner Reservoirs. e JR Proposed SSTS withln 500 feet of a reservoir, reservbir stem or control lake. e �ti Proposed SSTS within 200 feet of a watercourse or a DEC wetland. o Proposed S575 design flow greater than 1000 gpllons/day -or SPDES Permit required. G Proposed SSTSToir A"Commerieal project. Ii is the responsibility of the design prof4sional to provide the above information prior to soil testing, This Department will determine the KYCDEP project status (Joint or.. Delegated) based -on the. response, ifyou- anawe'red= to any of the questions, NYCD1P'must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCA1rP, If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEf_.k.rcqulred to witness the soil testing, it will be jhe sole responsibility of the design professional to schedule re•witnessing of the soil testing with NYCDEP. FOR COUNTY Us8 ONLY TD19i F,1n11_ 1 _0rAMD COT 1 1 ! 1 a TF► : A4S - ?7R -7921 NAME: PUTNAM COUNTY DEPARTMENT OF P. 1 POMP CMAMBHG Z I A a R.R PET. WAS V N•. C I.P SET i .°DOS • $� .a 3.4 '30'LF TRHMG4' J. Box T 8 as 4 19 as E 37 4 21 381. : r _ 22 I ' 391 . 40 : - 24 A mD°LID PJ< 7 04 2s I 4! p so 42 a F ... .. TRFiGH�TYP)' I _ I•p SET_,:. 43 )ad I I 44 11 27 45 Iq !28 I 46 Is Z9 47, IS 30 o cp 4B 17 31 49 19 .- - 32 I 100 % 33 I S 59* 20'0 I.P SET �, E= PA -MS IptJ I _ .:.G — C i I I.P SET W �- -- .- I I N 89' 00' 00" E 85.40' I I \ \ I I I.P SET S 01° M, 00'E / 119.9 Putnam C . Divisio °'"" I.P SET n oY CORNWALL Hlll ROAD Appro a. appl ab e j C e i Io tY Department of Health ironmental Health Servioes ted for oonformanoe with fA and Regulations of the. Health Depaitmen . 0 t NOTES THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH. ANp_THENEW YORK STATE DEPARTMENT OF HEALTH. I SURVEY INFORMATION FROM SURVEYOR PREPARED BY TERRY BERGENDORFF COLLINS 33 .. 16S 154 34 .. -.. 168 96 35 74 101 36... $0 " 105 37 ., 86 109 38... 92 1 14 39 98 119 40 104 124 41 110 129 4L 116 134 85.47' 4 3 123 13 0, 44 129. 144 45 134 149 46 " 140 154 47 14,6; 159 4'8 152 164 :.49. IS8 .170 SO 124 106 tY Department of Health ironmental Health Servioes ted for oonformanoe with fA and Regulations of the. Health Depaitmen . 0 t NOTES THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH ALL STANDARD RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH. ANp_THENEW YORK STATE DEPARTMENT OF HEALTH. I SURVEY INFORMATION FROM SURVEYOR PREPARED BY TERRY BERGENDORFF COLLINS NO WELLS OR SEPTICS 200' THIS SIDE S ?' PROPOSED WELL 0 z � N4 25'55 "E o 0� 1 165,55' / I 26.80' / v / SILT FENCE / 04 i EXISTING WELL d LOT 2 ° ;y ��- -516 ' i PROPOSED 4 BE M RGQ v� RESIDENCE 6 F.F.ELEV. - 1519, i 518- BASEMENT ELEV 9.310. FOOTING DRAIN 516� r /�4" CIP 0Yi 514 CURTAIN DRAIN ELEV. 507.5 i .' PER FOOT % II STANDPIPE FOR CURTAIN DRAIN \, SEPTIC TANR �e / MONITORING (TYP. OF 2) 514 - 1 - 0 CHAMER" -" -t�- I -T - -__ - 512_ -- 512 i. - �•� :— 5 MIN i' z LOT 1 _510 I 51A� •�� LATERAL I Z OF 14 _ - - -; 1. — - - - - - SILT FENCE _ (TYP.) . EXIST, SSOS J 508- • 1 I _�. .�� I _— ` _ / 5 08 / EXI' -- _ - - ,f - - -- - -- -506 _ } 506-- i ; ' p r� LATERAL I ^e• \' 18) OF ' TYP. 28 - 504= 1i.- xp - -504 it 1• ! 502, i -- — REP, LOCATION 500— �i \ RESERVE — I II 20' LATERAL I 31' (TYP. OF 28) \ III � d I;; EDGE FlL 15'M c 3 , 21 00 "E 'n SO'53'35*E 97.50' 2 •45' • CORNWALL HILL ROAD .:. ::'• :: ' ::.::::::' . ., :.'• .: :' •': :'' 1 , b PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES M CONSTRUCTION PERMIT F REATMENT SYSTEM PERMIT it Located at CORN6 AL.L HILL ROAD Town or Village PATTERSON Subdivision name GARRISON Subd. Lot # 2 Tax Map 13 Block 3 Lot 49 Date Subdivision Approved 8/86 Renewal X Revision X Owner /Applicant Name CHARLES & JOHN GARRISON Date of Previous Approval 6/10/96 Mailing Address 603 GATEWAY VALLEY COTTAGE, NY Amount of Fee Enclosed $300.00 Zip 10989 Building Type SINILENFEMILYLot Areal . 38 9do. of Bedrooms 4 Design Flow GPD 800 Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage S sy tem to consist of 1125,0 gallon septic tank and . DOSING CHAMBER WITH 889 LF (MIN) OF ' ABSORPTION TRENCH 2-E) Fet 7— Other Requirements: N/A To be constructed by Water Sup -p—I N/A Public Supply From Address Address or: X Private Supply Drilled by N/A 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. P.E. BUSINESS Cl R.A. : Date ? h-10 License # <7/ ra/ 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 considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new p it. Approv for discharge of domestic sanitary sewage only. j dpA— Date: By: �� Trtle: `i : White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or; 'type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # Cornwall. Hill Road Patterson Map 13 Block 3 Lot(s) 49 Well Owner: Name: Charles & Jo ddress: Garrison 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 Served Est. of Daily-Usage 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 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, r a r r i -g n Subd; v i s i on Lot No. 2 Water Well Contractor: Address: 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 contamination to be provi ed on parate sheet/plan. Date: Applicant Signature: X 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 wat w 11 driller certified by Putnam County. Date of Issue ,� lb b Permit Issuing Date of Expiration 1 33 Title: J Permit is Non- Transfer able White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 ,SECO u f -I • MM • i • • • ` EN" PCI)bH. JPO APPROVAL (, - - 7CHEN oIN & T1 � MOANING ROOM f 13' 0" . 12' 0" �-- Eli eVE LIVING MOON FAUILY nOOU 1 J' 0•' ■ 1 7' 0" FOYEM �. FIRST FLOOR r 4828 .� FUMAM CODN4 DEFAKERIMT OF HEALTH \� �(\ DhYw 1 w6d Hsallb Ssrvlooa. Caaral. N.Y.1FSl2 zMabow to Fir O& ptir G ou CERMICATE OF MWIJANCE t70N18'17<IIC1iON P=4r FOR SEWAGE DL4FOSAL SYsTEM Lsdt�� C- wall Hill Road Patterson .w. vtn.�e swaiuvww Nara cold. Lst R T" Mop 1 Block 6 td 7,9 Ow r/ApprrautNiaa C.E. & J.L. Garrison R°O0"y itert.t.o O c/9 J. R. Folchetti & Associates Date of Previous Approval Adihmes ' P.O. Box 374 Tee Brewster, tit zhp 10509 Date Subdivision Annroved A /86 Fee Enclosed Amnnnt Busdiss Type Residential Lot Area 60,373 SF +_ 17PCHD Seetlou Ody Deptb vobtms Nobsr of Heltilusrs .3 DeslV Flow G P D 600 _ Nodlit" e b Bea!ed Wbea FM ki oerpiaosd Sepeeals Se romp Suer to esualal 4 1000 G.B. S.ptic Tack W 600 T E rr - _ - ul To be oauatruebd by Addraas I _ Water Sw*. -PdWic Supply From ' Addren stns x Sopply DOW by Not yet determi _ J Otbar Regulrureub ----- -•-�._ 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the a d l `s �!4m, rI l f above described will be constructed as shown on the approved amendment there to and in accordance with the standards, ruin na 1: County Department 11 =Kh, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwlll� be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or anions by the bulkier, that said builder will plate in good operating condition any part of sold sewage disposal system during the period of two (2) years immediately following the date of the I su- arsca of the approval of the Certificate of Construction Compliance of the original system or {{ny repairs thereto; 2) that the drilled well desorlbed above will M located of shown on the approved pion and that sakd well will be Inst 1 In a cordance yfith the standards, rules and regu Tro-n of the Putnam County Department of Health. Date' 9/7/95 Sion P.E. i R.A. P.O. Box 374, ewste.r ].0 509 051011 Address License No APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the building has been undertaken and is revocable for cause of maybe amended or modified when considered necessary b _ the. Co pissloner of Health. Any charge or alteration of construction requires permit. Approved for disposal of domestic sanitary sewage /o"o, ate �erite�suooly Ply-only. �r >/ Rev $ Dot. _:Zr 6 "7 /G B . -_l IG� rft� `��j�y_ ✓(/ 7 !1 L_8 �r Y TttN y Y / �+ .k DEPARTMENT OF HEALTH Division of Environmental Health Ser 4 Geneva Road, Brewster, New York 1 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER1 ju�'l I D , i "TE CHD'- PERMIT-°#- _ WELL LOCATION Street Address Town/Village/City Tax Grid Number Cormrall Hill Road Patterson 1 -6 -7 &8 WELL OWNER Name Nail i g Address x Brewster rews er J1Private C.E. & J.L. Garrison J.R. Folchetti & Assoc. OPublic USE OF.. WELL 1 - primary 2 - secondary ® RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL. CIINSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE X50 gal ❑ REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 12-ADDITIONAL SUPPLY 0 NEW SUPPLY NEW DWELLING) 0 DEEPEN EXISTING WELL REASON_ FOR DRILLING DETAILED REASON FOR DRILLING Domestic Water Supply WELL TYPE ®DRILLED DRIVEN DUG GRAVEL 0 OTHER :IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Garrison Lot No., 2 WATER WELL CONTRACTOR: Name Not yet selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 500' LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 9/7/95 []DON SEPARATE SHEET (date) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. .During all well drilling operations, the applicant shall take appropriate action to assure that any 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 otherwise contaminat urface or groundwater. Date of Issue: J - 19 Date of Expiration 19� 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 DMSION OF ENVIRONMEN TAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: VfM/`^''f STREET LOCATION: REVIEWED BY: GO R, AS, SRDATE: Y /(V DOCUMENTS / PERNIIT APPLICATION WELL PERMIT OR PWS LETTER PC -97 LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION 1SHORT EAF ,r )PLANS -THREE SETS TAX MAPr: (CONFIRMED) 13 ' — t 1 Y REQUIRED DETAILS ON PLANS CONT'Dl OUSE SEWER -/1' FT. 4 ".0'; TYPE PIPE CAST IRON UUNO BENDS; MAX BENDS 450 W /CLEANOUT RENEWALS U ITE NOTE (NO CHANGE) / FILL SYSTEMS (� HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE ILL SPECS/ FILL NOTES 1 -5 LHOUSE PLANS ,TWO SETS PROFILE & DIMENSIONS REQUEST U' UFILL L�1 EXPANSION AREA MSION FILL GREATER TH.A�'2 FEE SUBD T ((___)LEGAL SUBDIVISION CLAY BARRIER ® FILL CERTIFICATION NOTE (�(__)SUBDMSION APPROVA,j.CC�jE,$ DEPTH GAUGES UUPERC RATE � 11 `� VOL. ON PLAN FOR RO.B., UNCLASSIFIED & IMPERVIOUS ((__)FILL REQUIRED 7_ DEPTH U(__)CURTAIN DRAIN REQUIRED (_) SEPARATION DISTANCE FRO-M TOE OF SLOPE TRENCH / GENERAL N CH PROVIDED LOFT MAX. LOCATED IN NYC WATERSHED eFTRE ARAI,LEL TO CONTOURS )PLANS SUBMITTED TO DEP PROVIDED / DELEGATED TO PCHD ( DEP APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED _)(l ) PERCS TO BE WITNESSED X- APPROVAL SSDS ADJ, LOTS ✓ETLANDS (TOWN/DEC PERMIT REQ'D ?) lATA ON DDS PLANS & PERMIT SAME RE 1969 NEIGHBOR NOTIFICATION ,ETTER BI/ZBA 00 YR. FLOOD ELEVATION W/I 200' (�JSOIL TESTING LOTS >10 YEARS OLD IZEOUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE (_�J GRA FLOW CO TES 1 -15 )DESIGN DATA: PERC & DEEP RESULTS T 2' CONTOURS EXISTING & PROPOSED DRIVEWAY & SLOPES, CUT OOTING /GUTTER/CURTAPi I DRAINS U USDA SOIL TYPE BOUNDARIES �ITLE BLOCK; OWNERS NAME ADDRESS M#, PE/RA; NAME, ADDRESS, PHONE# TE OF DRAWING/REVISION TUM REFERENCE L/JLOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. (J([JPROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS WELLS & SSDS'S WAN 200' OF SSTS PROPERTY METES & BOUNDS (_D ___)EROSIOY CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (REVSHEET)09 /01 /00 :TAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS D' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL D' TO FOUNDATION WALLS 00' TO WELL, 200' IN DLOD,150' TO PITS 00' TO.STREAM, WATERCOURSE, LAKE (inc. espan) 0' TO CATCH BASIN, 35' STORtiIDRAIN, PIPED WATER 0' TO WATER LINE (pits - 20') 0' INTERMITTENT DRAINAGE COURSE 00' /500' RESERVOIR, ETC. _•150' GALLEY SYSTEMS 0' NIIN TO LEDGE OUTCROP / SEPTIC TAN L K }U10' FROM FOUNDATION; 50' TO WELL WELL (�� DIMENSIONS TO PROPERTY LINES �LOCATION OF SERVICE CONNECTION INIIN 15' TO PROPERTY LINE SLOPE UUUSLOPE IN SSTS AREA (S20 %) (_J(_JREGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS PUMP NOTES PDOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED DETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) AND D -BOX SHOWN & DETAILED 1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN (__)USTANDPIPES, 5' BOTH SIDES, DETAIL U(__)15' MIN to CDS = >5 %, 20' -4 %, 25' -3 %, 35' -1 %,100 % -<1% U(__).20' MIN to CD DISCHARGE /100' with 182 cons day discharge UU10' MIN to NON - PERFORATED PIPE sr: .--�. BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH -I 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 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 J. Robert Folchetti & Associates 274 Route 100 Somers NY 10589 Re: Proposed SSTS: Garrison Cornwall Hill Road, Lot #2 (T) Patterson, TM# 13 -3 -49 Dear Mr. Folchetti: April 17, 2001 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 disposaf system may be subject to local wetlands regulations. You should contact local wetlands officials in this regards. Construction notes 1 -15 have not been provided on the plan. . v2�1' Depth of the curtain drain is to be labeled in the plan view. Pleas' be advised all required separation distance are to be dimensioned from the absorption trench for fill sections requiring 2 feet of fill or less. to The minimum of 2 feet of fill is to be provided for the entire SSTS. L5/" All trenches have been labeled "Reserve Lateral ". Revise accordingly. Roof/gutter, footing and curtain drain discharge is to be located below the SSTS. Minimum distance from the solid pipe to the SSTS is 10 feet. . 1Y -� V Curtain drain should be located 15 feet upgrade from the first trench. USDA soil boundaries are to be shown. Title block is to note owner's name and the street address of property. Fill note 2, 3, and 4 are applicable for fill sections 2 feet or less in depth, remove or cross out notes 1 and 5. Construction Permit does not note that 2 feet of fill is required and.fill volume. k12i Well location is to be dimensioned from two property lines. Letter to: Mr.' Folechetti - April 17, 2001 -2- Curtain drain standpipes are to be shown in the plan view and detailed provided. Location map is to show actual property location. Upon receipt of a submission, revised to reflect the above comments, this application will be . considered further. Ve truly yours, Robert Morris, P.E. RM :tn Senior Public Health Engineer. N^ V 1 PUTNAM COUNTY DEPARTMENT, OF HEALTH DMSION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION /P+ERMIT NAME OF OWNER:` STREET LOCATION: r REVIEWED BY: Rtii, GR, AS, GATE: � �G � TAX 1,LAP -: (CONFIRMED) 11-3- Y N. DOCUMENTS L_)L_--)PERDIIT APPLICATION "C--)WELL PERMIT OR PWS LETTER UUPC -9 LU(ULETTER OF AUTHORIZATION (__)(__)DESIG\ DATA SHEET (DDS) UUCORPORATE RESOLUTION (_J( JSHORT EAF UUPLANS -THREE SETS (__)(HOUSE PLANS - TWO SETS UL_)VARLA\CE REQUEST SUBDIVISION (__)(__)LEGAL SUBDIVISION (__)(__)SUBDMSION APPROVAL CHECKED UUUPERC RATE LJL__)FILL REQUIRED DEPTH UUCURTAL\' DRAIN REQUIRED GENERAL (—JL_)LOCATED IN NYC WATERSHED UUPLANS SUBMITTED TO DEP (__)UDELEGATED. TO.PCHD (�� LDEP APPROVALIF REQ'D UUDEEP TEST HOLES OBSERVED UUPERCS TO BE WITNESSED UUEX- APPROVAL SSDS ADJ, LOTS L_J(UWETLANDS (TOWN/DEC PERMIT REQ'D ?) LJLJDATA ON DDS PLANS & PERMIT SAME UUPRE 1969 NEIGHBOR NOTIFICATION L_JULETTER BI/ZBA LJU100 YR FLOOD ELEVATION W/I200' LJL_JSOIL TESTING LOTS >10 YEARS. OLD REQUIRED DETAILS ON PLANS (��SEWAGE SYSTEM PLAN - (NORTH ARROW) (—"f---,SSDS HYDRAULIC PROFILE ('� ( GRAVITY FLOW (CONSTRUCTION NOTES 1 -15 ( k-_' )L_JDESIGN DATA: PERC & DEEP RESULTS (t�OU2' CONTOURS EXISTING & PROPOSED CA!nLJDRIVEWAY & SLOPES, CUT onTrxr: /G JER/CURTAIN DRAINS (�( kAUSDA SOIL TYPE BOUNDARIES> (t!fjL__)TITLE O -� ; O �NERS NAME ADDRESS ThI9, PE/RA; NAME, ADDRESS, PHONE# DATE OF DRAWING/REVLSION DATUM REFERENCE LO CATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. ( ��PROPOSED FINISH FLOOR AND ( �BASEMENT ELEVATIONS WELLS & SSDS'S WAIN 200' OF SSTS PROPERTY METES & BOUNDS L JEROSION CONTROL FOR HOUSE, WELL & SSTS,. ERbSION CONTROL NOTE COMMENTS: (REVSHEET)09 101/00 Y N (REQUIRED DETAILS ON PLANS CONT'Dl �(�� HOUSE SEWER -' /1' FT. 4 "0'; TYPE PIPE CAST IRON. NO BENDS; M.AX BENDS 450 W /CLEANOUT RENEWALS UUSFT*TE (NO CHANGE) FILL SYSTEMS 2,C--J)FILL 10' HORIZO\"TAL; PAST TRENCH SLOPES 3:1 TO GRADE SPECS! FILL NOTES i-T ' Y �UFILL PROFILE & DIMENSIONS ,)FILL IN I EXPANSION AREA FILL GREATER THAN 2 FEET UU C Y B R UUFILL TIFI ATION NOTE U(UDEPT AUG S L�LJVO .ON' FOR RO.B., UNCLASSIFIED & IMPERVIOUS L -JLJSE ARATION DISTANCE FROM TOE OF SLOPE ;T ENCH CUULF TRENCH PROVIDED 6OFT MAX. UUPARALLEL TO CONTOURS (,100% EXPANSION PROVIDED (( DETAIL/DUST FREE CRUSHED, STONE OR WASHED.... GRAVEL (.�LJGEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS X10' TO P.L: DRIVEWAY, LARGE TREES, TOP, OF FILL 20' TO FOUNDATION WALLS �ji 0100' TO WELL, 200' IN DLOD,150' TO PITS (.J_ L_J100' TO STREAM, WATERCOURSE, LAKE (inc. expan) (C!:O(_j5O' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER (e!::jLJ10' TO WATER LINE (pits - 20') L--JL _)50' INTERMITTENT DRAINAGE COURSE (QLJ200' 1500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (.ZL_)10' MIN TO LEDGE OUTCROP SEPTIC TANK (,!!I'( )10' FROM FOUNDATION; 50' TO WELL WELL-.. 8 C—)(2DIMENSIONS TO PROPERTY LINES LOCATION OF SERVICE CONNECTION 15' TO PROPERTY LINE SLOPE (fJL_)SLOPE IN SSTS AREA (520 %) L —)(REGRADED TO 15 %, IF REQUIRED -_ UUPUMP NO ES L_J(_JDOSE 75% IPE V LUME/DOSE VOLUME NOTED UUDETAIL F OR IN, (PIPE TYPE, ETC.) UUPTT AND -BO N & DETAILED' . (_JUl DAY ORAGE ABOVE ALARM CURTAIN DRAIN (t6LSTANDPIPES, 5' BOTH SIDES, DETAIL L_JLJ15' MIN to CDS = >5 %, 20' -4 %, 25' -3 %, 35' -1 %,100 % -<1% L _JL_j20' MIN to CD DISCHARGE /100' with 182 cons day discharge (_)(_)10' Mh 1 to NON- PERFORATED PIPE PUTNAM COUNTY DEPARTMENT OF HEALTH VISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM Located at CORNWALL HILL ROAD Town or Village PATTERSON 13 Subdivision name GARRISON Subd. Lot # 4 Tax Map X,X Block 3 Lot 51 Date Subdivision Approved 8/86- Renewal X Revision X Owner /Applicant Name CHARLES & . JOHN.-GARRISON Date of Previous Approval 6/10/96 Mailing Address '416 VILLAGE VIEW LONGWOOD, FL Zip32779 Amount of Fee Enclosed $ 300.00 SINGLE FAMILY Building Type RESIDENCE Lot Areal . 28ACNo. of Bedrooms 4 Design Flow GPD 800 Fill Section Only Depth Volume Separate Sewerage System to consist of 1,250 gallon septic tank and DOSING CHAMBER WITH 889 LF (MIN) ABSORPTION TRENCH L L Other Requirements: N / A To be constructed by N/A Address Water Suooly: Public Supply From or: X Private Supply Drilled by N/A Address Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the Senan±te 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. r v Signed:... P.E. R.A. Date 7247 ROUTE PINEWOOD BUSINESS CENTER Ad s SOMERS, NEW YORK 10589 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 permit. Approved for 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. R. FOLCHETTI & ASSOCIATES, L.L.C. CIVIL /ENVIRONMENTAL ENGINEERS 247 Route 100 40 Railroad Avenue Pinewood Bus. Ctr. Montgomery, NY 12549 Somers, NY 10589 914 / 457 -5318 914 /232-2500 914 / 457 -9392 FAX 914 / 232 -6827 FAX TO: PUTNAM COUNTY HEALTH DEPARTMENT GENEVA ROAD. ROUTE 312 BREWSTER. NY 10512 WE ARE SENDING YOU ❑ Shop Drawings 0 Copy of letter � 113MR ®IF TAH5h =AL DATE: 05/08/01 ATTENTION: ROBERT MORRIS, P.E. RE: APPLICATION TO CONSTRUCT A SUBSURFACE SEWAGE DISPOSAL SYSTEM AND WELL FOR A NEW SINGLE FAMILY RESIDENCE IN THE TOWN OF PATTERSON TAX MAP 413 -3 -49 (Lot -2) ■ Attached ❑ Under separate cover' via HAND DELIVERY the following items: ❑ Prints ❑ Change order ■ Plans ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION 1 COPY OF PCDOH CONSTRUCTION PERMIT FOR SEWAGE TREATEMENT SYSTEM (REVISED). 4 REVISED SSDS DESIGN PLANS AND DETAILS (2 SHEETS EACH SET). THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ■ For review and approval ❑ • Resubmit _ copies for approval • Submit copies for distribution ❑ Return corrected prints ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: REVISIONS PURSUANT TO COMMENTS RECEIVED FROM PUTNAM COUNTY DEPARTMENT OF HEALTH ON APRIL 19.2001. COPY TO: C. GARRISON SIGNED: ' FILE PAUL J. PELUSIO BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 April 17, 2001 J. Robert Folchetti & Associates 274 Route 100 Somers NY 10589 RE: Garrison Cornwall Hill Road, Lot #2 (T) Patterson, TM #13 -3 -49 Reservoir Basin Dear Mr. Folchetti: c The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on March 27, 2001 is complete. The Department will notify you by May 7, 2001 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 nalm,.the location of the proj ea, .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 Department of Environmental Protection review and approval of other aspects of a proj ect, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of ;eta 1 Letter to: Mr. Folchetti - April 17, 2001 -2- 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. Ve ly your , Robert Morris, PE RM:tn Senior Public Health Engineer Pr;r40-_( ( pq PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES z. DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Address Owner M 13 //V' 1114 Located at (Street) g -f Tax Map 13 Block Lot lyz 9 (indicate nearest cross street) Municipality Watershed oA:57-, SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test 9 /9,7 ....... ....... ............. ..... ... .. ... ....... ltlepth i;a o ........ . r ................ ... ...... 4 ......... ........... .... .. . .... ....................... G oun A- om:;. r From Level ............... ........... ......... .. .. ............. .. No .... . ....... . .......... . .... Runt . N". . ......... :T . Ul .... . ., .. .St ,,...Percolation, .. . M ifflW": Hale C 33 2- 3 30 _'zg 4 5 1 /.0;,5 J, 941- 30 0 2 a 3.1� 3 ;2-3 A Iq 4 5 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. :5 1 min for 1-30 min/inch, 5 2 min for 31-60 min/inch) All data to bi submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' .6.5' 7.0', 7.5' 8.0' 8.5' 9.0'. 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. Z r � &:ff 7 -tl HOLE NO. 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: a,' La- Ya-n/4 Date P. G. D_ I-1 _ V, -7 -, IA M SS N6. Design Professional Name: Address: Signature: Design Professional's Seal Sheet of PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEATLII SERVICES FIELD ACTIVITY REPORT ADDRF4�o,: G07Zwj al-L lei G ?ZL� �/g%T�ZSG��I III, Street Town State Zip PERSON IN CHARGE Name and Title TYPE OF FACILITY 11 /g/ F�p FINDINGS: re '" Sma %C4 Ito le- S o `t Go eq /v <j 1-- 4.. /V G. 6-4 Signature and Title I acknowledge receipt of this report: SIGNATURE: 02/96 3a X;L2 J. R FOLCIIETTI & ASSOCIATES, L.L.C. CIVIL /ENVIRONMENTAL ENGINEERS 247 Route 100 40 Railroad Avenue Pinewood Bus. Ctr. Montgomery, NY 12549 Somers, NY 10589 914 / 457 -5318 914 / 232 -2500 914 / 457 -9392 FAX 914 / 232 -6827 FAX TO: PUTNAM COUNTY HEALTH DEPARTMENT GENEVA ROAD. ROUTE 312 BREWSTE . NY 10512 WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of letter ILIE`Il°°IrIEIR OF MAHMIIII°II AL DATE: 03/30/01 ATTENTION: ROBERT MORRIS, P.E. RE: EXECUTED PERMITS FOR AND PCHD PLANS FOR GARRISON SUBDIVSION LOT No.'s 2 & 4, LOCATED ON CORNWALL HILL ROAD TOWN OF PATTERSON TAX MAP #'s 13 -3 -49 (Lot -2) and 13 -3 -51 (lot4) ■ Attached ❑ Under separate cover via HAND DELIVERY . the following items: ❑ Prints ■ Plans ❑ Samples ❑ Specifications ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 1 06/10/96 EXECUTED CONSTRUCTION PERMIT FOR SSDS (Permit #P- 56 -86, Lot #2) 1 06/10/96 EXECUTED CONSTRUCTION PERMIT FOR SSDS (Permit #P- 58 -86, Lot #4) 1 06/10/96 PCHD APPROVED PLANS '(Lot #2), 1 -SHEET 1 06/10/96 PCHD APPROVED PLANS (Lot #4), 1 -SHEET THESE ARE TRANSMITTED as checked below: • For approval ❑ Approved as submitted. • For your use ❑ Approved as noted i ■ As requested ❑ Returned for corrections ❑ For review and approval ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US ❑ Resubmit_ copies for approval • Submit copies for distribution • Return corrected prints REMARKS: COPY TO: C. GARRISON SIGNED: e'F rL' �C- I• / -�-" FILE PAUL J. PELUSIO /I J. R, FOLCHETTI A ASSOCIATES, L.L.C. CIVIL /ENVIRONMENTAL ENGINEERS 247 Route 100 40 Railroad Avenue Pinewood Bus. Ctr. Montgomery, NY 12549 Somers, NY 10589 914 / 457 -5318 914 / 232 -2500 914 / 457 -9392 FAX 914 / 232 -6827 FAX TO: PUTNAM COUNTY HEALTH DEPARTMENT GENEVA ROAD ROUTE 312 BREWSTER NY 10512 ILIEUMEIR 07 7RANO DATE: 03/05/01 ATTENTION: ROBERT MORRIS, P.E. RE: APPLICATION TO CONSTRUCT A SUBSURFACE SEWAGE DISPOSAL SYSTEM AND WELL FOR A NEW SINGLE FAMILY RESIDENCE IN THE TOWN OF PATTERSON TAX MAP #13 -3 -51 (Lot -4) WE ARE SENDING YOU ■ Attached ❑ Under separate cover via U.S. MAIL the following items: ❑ Shop Drawings ❑ Prints ■ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 1 CERTIFIED CHECK IN THE AMOUNT OF $300.00 1 PCDOH LETTER OF AUTHORIZATION FOR DESIGN PROFESSIONAL 1 SHORT ENVIRONMENTAL ASSESSMENT FORM 1 PCDOH APPLICATION TO CONSTRUCT A WATER WELL 1 PCDOH APPLICATION TO CONSTRUCT A SEWAGE TREATMENT SYSTEM 1 SOIL PERCOLATION AND DEEP HOLE TEST DATA 2 HOUSE PLANS (FOR BEDROOM COUNT ONLY) 3 SETS OF SSDS DESIGN PLANS AND DETAILS (2 SHEETS EACH SET) THESE ARE TRANSMITTED as checked below: • For approval ❑ Approved as submitted • For your use ❑ Approved as noted • As requested ❑ Returned for corrections ■ For review and approval ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US • Resubmit _ copies for approval • Submit copies for distribution • Return corrected prints REMARKS: COPY TO: C. GARRISON SIGNED: FILE PAUL J. PELUSIO PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of CHARLES AND JOHN GARRISON Located at CORNWALL HILL ROAD T/V PATTERSON Tax Map # Block Lot Subdivision of GARRISON Subdivision Lot 2 Filed Map # Gentlemen: Date Filed This letter is to authorize J. ROBERT FOLCHETTI & ASSOCIATES., L.L.C. a duly licensed Professional Engineer X 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. Mailing Address 247 ROUTE 100 PINEWOOD BUSINESS CENTER SOMERS State NY Zip 10589 Telephone: 914- 232 -2500 Very truly yours, Signed: (Owner of Property) Mailing Address: 6 �.3A >-A1 State t Zip D Telephone: f1/4- ?�6' r `- Form LA -97 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: CHARLES AND JOHN GARRISON 2. Name of Project: LOT 2 SSDS 3. Location TN: PATTERSON 4. Design Professional: J. R. Folchetti & Assoc., LLC 5. Address: 247 Route 100 6. Drainage Basin: East Branch Croton Reservoir Somers, NY 10589 7. Tyne of Project: X Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ............ .............Type I Exempt X Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ............. 10. Has DEIS been completed and found acceptable by Lead Agency ?.......... N/A 11. Name of Lead Agency ............ ............................... N/A 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ........... ............................... YES 13. If so, have plans been submitted to such authorities? .... RS APPROVED SSDS - N/A 14. Has preliminary approval been granted by such authorities? Date Granted: N/A 15. Type of Sewage Treatment System Discharge .... surface water X ground waters 16. If surface water discharge, what is the stream class designation? ............. 17. Waters index number (surface) ......................................... 18. Is project located near a public water supply system? ...................... NO 19. If yes, name, of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ........... NO 21. Name of sewage system Distance to sewage system 22. Date test holes observed: // 30 00 23. Name of Health Inspector: 66Nc P—Ge-2 24. Project design flow (gallons per day) ................................... 600 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required? .... NO 26. Has SPDES Application been submitted to local DEC Office? . ........ . Form PC -97 PA 27. Is any portion of this project located within a designated Town or State wetland? NO 28. Wetland ID Number .......................... ..................... 29. Is Wetland Permit required? .............. .......................... . Has application been made to Town or Local DEC Office ? .................. 30. Does project require a DEC Stream Disturbance Permit ?.......... ....... NO 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, Not to best of landfilling, sludge application or industrial activity? ........ Yes/No knowledge and belief 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or Not to best of any other potential known source of contamination? ......... Yes/No knowledge and belief DESCRIBE: Listed sites not currently visible. Kessman Landfill and Patterson SWMF located = 3000 feet south. 33. Is there a local master plan or file with the Town or Village? ............... N/A 34. Are community water, sewer facilities planned to be developed within 15 years NO in or adjacent to project site? 35. Are any sewage treatment areas in excess of 15% slope? ................... NO 36. Tax Map ID Number ........................ Map 13 Block 3 Lot 4-17 37. Approved Plans are to be returned to: ...... Applicant X 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 creations 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 1, 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 Penal Law. SIGNATURES &OFFICIAL TITLES: Mailing Address........... ...:. . 11411 / Z J,0595 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Address e_,o;zywo,1 &zzz ;eV, ' Lot Located at (Street)- 4( T ax Map Block (indicate nearest cross street) Municipality Watershed, SOIL PERCOLATION TEST DATA Date of Pre-soaking 2,off Date of Percolation Test 3A1_0e1;' .......... . ... ........ ......... ......................................... .. . .... .... .......... .. . r. '" Ground .. i.:-. .. el: dh. . ...I . . . . ........ ...... .. . ' dole ..... T ;;Surface (Inches) z h es .........;, . .TN m un-N . . . ..... n still M A a: 2_6 — � 5-6 2 174*-18% 71j1 .'4 5 2 ;V .5ft - 3.1 2- , %. 4/0 3 3.30 AL Z/ 0 4 3. 4. NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. :5 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 a TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED 1N TEST HOLES DEPTH HOLE NO. HOLE NO. n_ r HOLE N0. 9 _Indicate level itwhich groundwater is encountered - - - ^- Indicate - level to _which water level rises after being encountered Deep hole observations..made by: 7), ; FA F0 T;, P, G _p t f, Date jLZ3o ao. Design Professional Name: Address: Signature:- Design Professional's Seal eoRNW.atC_ 1411-` 'Pd NP 0 ' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM SECTION A. ,GENERAL INFORMATION Name of Project 7,¢�/ �Q_A, M(V)71W -TE o,f/ County 'tom- y� Site Location GoTZNU/l1LL // /L- �1. Building construction begun A1,1 Extent Is pryrty. within NYC Watershed ? ................. Yes No, SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. Hilly _ Steep slope _Gentle slope -- - -- -Flat - .. _ 0 2. Q Evidence of wetlands Low area subject to flooding F� Bodies of water Drainage-ditches F_'� Rock outcrops 3. Property lines or c omers evident ....................... ...............:........:...... 0 Yes No .. . courses exist on or ad'o�o e ..: Yes J P P rty? ........................... 5. Will these affect the design tithe sewage system facilities ?............ No 6. Do watershed regulations apply in this development.......................... Yes N -- �- 1 7 Will extensive grading be necessary?::: .:.:::.:::: .::::__�__._._.._._._..- _ -.__ -� F s No..._ 8. Will extensive fill be necessary for SSTS .. &Qif.l+�y Yes o . . ..l. .�� ................. 9. Do filled areas exist within the SSTS azea? ........ ............................... Yes No If yes, what. is the condition of the fill? SECTION C. SOIL OBSERVATIONS 10. Appearance of soil. Sand L ' Gravel Loam __ ...... Clay.._ . - -- Hardpan. Mixture 11. Observed from: a Bo. orings Bank cut a Backhoe excavations G- 12. Soil borings /excavations observed by �'�c1 E i7- -�i2Et 6 P� . -D; ?], on 3e vo 13. Depth to groundwater w&&,Fc on 14. Depth to mottling i '- i " / 3 d " on 15. Are test holes representative of primary & reserve areas ...... ............................... 16. Soil percolation tests made by on 17. Soil percolation tests witnessed by jlcg%) on SECTION D (on back) on Form ST -1 2 { SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural, drainage in this or adjacent areas? ❑ Y s No 19. Will groundwater or surface drainage require special consideration? ......:.............. Yes a Zo 20. Will gullies, ditches- etc., be filled and watercourses be relocated ? ......................... � Yes SECTION E. REMARKS 21. • If a common water supply is proposed, has an inspection been made of the existing or proposed source and facilities? ................................ ............................... Yes No I*ection data 22. Do adjacent wells and/or-sewage systems exist ?..::....:.. :::::::: :.::. .::.::........:........... Yes No� 23. Additional comments 24. Site observer /inspector and title -D, 7zar-n E. - - 25: "- Date(s) of observation(s)inspection(s) TEST PIT PROFILES Hole # Lot # - __.....- -- - .Hole # Lot # Hole # -Lot # --- -. - - -. - Depth to water Depth to water Depth to water Depth to mottling Depth to mottling Depth'to mottling Depth to rock/imp: - ' Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 :- - - -- 0.5 0.5 2.0. :. -:.: _...- _::. - - - -- 2.0 .3.0 --- -___.. 3.0 3.0 4.0- ._ =..._. . 4.0 4.0 5.0 5.0 5.0 6.0 6.0 6.0 7.0 _ . 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 ,.d(7- o. PUTNAM COUNTY, DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL•HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TRE ATMENT SYSTEM Owner Address KILA_ Xb. Located at (Street) 2- Tax Map j 3 -__B 194. 3 Lot (indicate nearest cross street) Municipality I? -rmuwu Drainage Bisln SOIL PERCOLATION TEST DATA Date of Pre-soaking L 4',&-:� Po-, Date of Percolation Test 11,'30-00 t^ Hole No. Run No. Time Start - Stop Elppike Time kiv.11n.) Depth to Wafer Grgund- Surface (Inches) Start Stop Level Dro In Inc%es Percolation Rate Min/Inch # C_ V 53 2 1- 4 S 3 4 5 Patwal y) 2. 3o Illv, 3 4 z1 (00 1-7 1 1q 11 2. 4 2 3 5 NOTES,: I..- Tests to be repeated at same depth until approximately equal percolation rates are obtained at each CL I n test hole. (i.e. ,5 1 min for 1-30 min /inch, -60!min/inch) All data to be p�r o atio ch, 2 min for 31, Jinia4for review. --- 2. D ep t h,mdasic ments to be made tWofio"le'. . Form DD-97 .4 F 1- L 0 1..' _S 2 TEST PIT DATA ' . a ° DESCRIPTION OF`SOII$ ENCOUNTERED IN TEST HOLES DEPTH :HOLE NO `" HOLE O. HOLE NO G.L. 0.5' 1.0'x) . 2.0' 2.5 2. 06 L 3.0' F. 4.0' 4.5' 5.0' ' - 5.5' 6.0' ; wm iT y�uu. 6.5' 7.0' 7 f 7:5' 8.0' 8.5' rid _'i4 ... ,. 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered Ps *AYE' E Indicate level at which mottling is observed. Indicate level to which water level rises after;being encountered (46piF Deep hole observations made by: Gevie iteto + ?c:yoq 6 DWLJ1T7LWftm ,• aFADate it -3o •oo Ir (w Y,o r,P 4 aN 502 Fil PN 2w' 0 52 24'2 5 { .. 520 { , • 1 X5.55' + gip; -n 515 rSUP 51(0 _— --- Y 1 514 514 512 510 3`l0 512 MIQ. a o 50$ _ L •"" (000 G AL• S L FT! r— T4U r �' _ DISTRiP,L)n _ TOE• FILL '3 1 50(0 — — — ^ ` ' . ' fat 9o'C -nA�) � ,,.• av �F1u , �, 504 — — — (w Y,o r,P 4 aN 502 Fil PN 2w' 0