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HomeMy WebLinkAbout0433DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13. -3 -106 BOX 6 1 ru me 91 all L ;I I T I kll r 1 , In r {� . I -e i r 00242 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Cor-riwa)l t'l! CSt. - WELL COMPLETION REPORT Well Location Street Address: Che �. Town/Village: r Tax Grid # Map / Block Lot(s) jp6 Well Owner: Name: Address: Sorn��,V se Well: I-prima-r 2- secondary Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing V Open hole in bedrock Other Casing Details Total length __ft. Length below grade ft. Diameter 7 in. Weight per foot /7 lb/ft. Materials: Steel _ Plastic _ Other Joints: Welded 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 Compressed Air Hours s Yield gpm Depth Data Measure from land surface- static (specify ft) During yield test(ft) Depth of completed well in feet 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 Ila r- Q S. C 4 i � c �++ A =: Fri rn i T1 C), of f If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Typ< c u zi t Capacity of Depth x 20 Modell fS>S Voltage LSD HP Tank Type ��;ti, Volume io jUq Date Well Completed Putnam County Certification No. 067 Date of Report 9 ��' o� Well Driller (signature) A.fu L6k NOTC: E#act location of well with distances to at least two permanef t landmarks to be provided on a sepolte sheet/plan. Well Driller's Name -f-se T"S Signature: L Address: lm / /'Q ah Date: White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy -Well driller Form WC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P -,::%; -ol Located at CA_�SHRE Q--)y2T or Village Aa?TER -so N Owner /Applicant Name l Amp a PLC- Tax Map J3 Block 3 Lot J °6 Formerly CPRNwAL cL HILL ESTATES Subdivision Name Bap, LLC, Subd. Lot # 9 Mailing Address 166 _:�DMERSET DRIVE, PA7TGR�/tl, NECM ,/oil Zip 1-563 Date Construction Permit Issued by PCHD 3-JS-o4- 2 Separate Sewerage System built by 6ANA0 , L.U_ Address /66 s:;)mERSET .DR PA�TE�n►. N`i ns63 Consisting of Gallon Septic Tank and boo G f cc' 2� WIn6 Ag-goRPTloN TRENc l9 -water analysis result -Fff :� "•: L: 1..... yi . , : -i; ._._.. .__�.'.r �...- ��'� water containing more a"R D ^; iinl�ing by_peogle on seveic3y iet" Water eontainin Other Requirements: 7 CuR-�ini DRA/!3t ' _ " ., ty-. peoole on -moderately move an270111g�rseditt -dam l t3 ; ?:. l � D L 1'i l DEPT. OF AEAL,'I H Water Sup"I Public Supply From stricteci sosliurn diets. Address /o /3 k;1T SII or: X Private Supply Drilled by AI -t3ERT M• 14YAt1 a SONS Address p9 TIFIi,-soN ,NY 12563 Building Type Rr✓ S t-'--ivT/AL Has erosion control been completed? YES Number of Bedrooms S Has garbage grinder been installed? I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam County Department of Health. Date: I L (0`S� Certified by �'�� P.E. )e R.A. Address INS/TE E�vt iNtrERiNG, SuRvEW G uwb&CA E AP•LHIT&cTiA1t p.c.License # 619'3/ 3 GARQEn' "ZF—, CARMEL, NY toSYL Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the. separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatio pso on hange i necessary. 'J! By: ,� �+� Title: Date: l White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 Dec 02 05 02:13p BRUCE R. FOLEY Public Health Director TOWN OF PRTTERSO 845 - 878 -2019 p.2 LORMA MOLINARI. RN„ M.S.N. Associate Public Hedth Director Director of Patient Sarvlces DEPARTMENT OF HEALTH 1 Geneva Road Brewster, Now York 10509 Eavlroowcotal Health (914)278.6130 Fax(%4) 278.7921 Nor3la3 Services (914) 278 -6558 WIC(914)278-6673 Fax (914) 278.6035 Early luterventlon (914)278 -6014 Feeaebool (914)273 -6032 rUtVI4)273-6648 Ma t. ;.__ i 'u. OWNERS NAME: BMW) GLG i TAX M" NUMBER: 131 - 3- /a,(a E911 ADDRESS: I CHESHIRE COURT TOWN. PA MCA $Pg AUTHOIU2ED TOWN FFI • O C UL: (Signature) DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above forte is completed, i.e., a legal E911 address is assigned by an authorized town official: This form is to be submitted with the application for a Certificate of Construction Compliance. 2,2.d 6T02&E&t78 '-01 L116S2Z4be 9N1833NI9N3 311SNI:W021d 12:TT 5002 -1-030 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Corlllwa.l L ,• // J�Sf. -- 9 WELL COMPLETION REPORT Well Location Street Address: C re Town/Village: Tax Grid # Map j Block Lot(s) j6& Well Owner: Name: Address: pffigh G 6 Sorrm-k- e s r2-secondary Well: Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing Open hole in bedrock Other Casing Details Total length" ft. Length below grade �l% ft. Diameter 7 in. Weight per foot Jlb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded Threaded _ Other Seal: Cement grout _L1 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 Compressed Air Hours � Yield gpm Depth Data Measure from land surface - static (specify ft) 6Jr During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are available, please attach. De th From .e Surface Water Bearing Well Diameter(in) Formation Description ft. ft. Land Surface Ila & o ' ael e If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Typ<A c u u i Capacity ji-L Depth 2 2p Model 0[ fS>S Voltage 2-3,9 HP Tank Type �� Volume [p jotf Date Well Comp ted l5- ,)S Putnam County Certification No. 067 Date of Report Well Driller (signature) NOTE: E4act location of well with distances to at least two permanetlt luldmarks to be provided on a sepe9te sheet/plan. Well Driller'sName Alk,rt A. -t-SOPS Signature: Address: l az Date: qh 4-6- White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVII20NM[ENTAL HEALTH SERVICES FINAL SITE INSPECTION �� �/ 7/ o Date: -4 a Inspected by: 6: *Le Street Location t' ga -514 j7r-C C-7-, Owner T2 ,41M p LG G Town /<O"r Permit # t"�— c�G —,o V TM # 1:3 — 3 — I D6 Subdivision Lot # :J 1. Sewaze Svstem 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. 1 00' from water course / wetlands ...... ............................... II. Sewage System. a. Septic tank size - 1,000 ...:.. 4115 ........other ................ b. ' Septic'tank installed level ................ ...................... .......... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All outlets at same elevation -water tested ................. 2. Protected below frost .................. ............................... 3. .. Minimum 2 ft. Original soil between box & trenches e. Junction Box properly set .......... ............................... 6. renc es 1. Length required Length installed 2. Distance to watercourse measured --r 1 O ° Ft.......... 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 - 1/32" /foot ............. 5. 10 ft. from property he - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface .................. 7. Room allowed for expansion, 100 %.......... ............... 8. Size of gravel 3/4 - I lk" diameter clean ...................: 9. Depth of gravel in trench 12" minimum ....... :........... 10. Pipe ends capped ........................ ............................... g. Pump or Dosed Systems 1. Size of pump chamber ................. ............................... 2. Overflow tank ......................... .............. ... ............'-- 3. Alarm, visualJaudio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........... ]OIL House/Buildiii a i louse located.per approved plans IV Well `��..:-,�:�:�: .,.:..����� �L, t 3 � "�« .� �I .� '� •� Well located as per approved plans . ............................... b. Distance from STS area measured ,L loo . J ft........... c. Casing. 18" above grade ............................. : ........... ...... d. Surface drainage around well acceptable ....................... V. Overall Worlananshin . a.. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backf.11 material contains stones <4" diameter .............. e. Curtain drain & standpipes installed according to plan.. f. Curtain drain outfall protected & dinto exist watercourse g. Footing drains discharge away from STS area ......:........ h. Surface water protection adequate .... ....:.......................... i. Erosion control provided ................. ............................... Rev. 12/02 COA DENTS s f- SEP -29 -2005 09:28 FROM:INSITE ENGINEERING 8452259717 TO:2787921 66-7IId resod X7'7 vv ) :ssa ppv �a •mix jo lwwMdaa 4moo umgnd op 3o suoms k+Il P m =M S PBe sagd paAOxd&, pm Pwd WWWWO allN ponsm aq =wpm= ui uoFMdmoa XrJT POUPaA pus pa;aadsu� enrtq I P P� sas�urald a�ogg 1e'pv tl se `(s} sus atI} f0m I '- Lid m sommm lo moo uoxsm ary y L=Wd ,god sg pallooj llom ST P2 k -*MCI _ LPa1fuP [Iam sI &mMd gad m pWr n=oa v wfA sI c)Vq tapTdmoo malsAs sI LpapIdmoo ng mals cs sI # 101 "ns ��'/ •--- -•—�•— # Ind coAo4mo'J CZxDd •apaw Sum suou. m&m Am o; aaw P"Rdm'a Af.m aq VAU, uongwojuc IN 9 Hd�BpP 11 �IOLtt�i�' S23IAUSS H.LrWXR WAAW&JONSAW AO IMOISM(I SEP -29 -2005 THU 09:47 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 P: 1/1 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health September 30, 2005 DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Insite Engineering & Survey Jeffrey Contelmo 3 Garrett Place Carmel, NY 10512 Dear Mr. Contelmo: ROBERT J. BONDI County Executive Re: Field Inspection — BMMD LLC Cheshire Court, (T) Kent Lot #9, T.M. 13. -3 -106 The above referenced separate sewage treatment system can be backfilled. The following comments must be addressed: 1. A bedroom count needs to be performed by this Department upon completion of construction. 2. It appears the house was not installed in the approved location. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR: cw Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 13Mnr%L) LGG 13 3 J 06 Owner or Purchaser of Building Tax Map Block Lot 9Cvn -P_K Building Constructed by 9 GHESHjRF_ co,) T Location - Street RESIDEAPA. Building Type Q-4e ySc Town/Vi lag& CORNWALL O LL ESTq -rES Subdivision Name 9 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 determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month / 2— Day 6 Year o s- General Contractor (Owner) - Signature Corporation Name (if corporation) Address: State Zip Signature: Title: /6A,.4 s u- �,y,�,a L L c-- Corporation Name (if corporation) Address: State /tJ,rw ,yo• -�s Zip 1ST Form GS -97 YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Paduvani, Director LAB #: 1.507786 CLIENT #: 56173 NON STAT PROC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ BMMD LLC 166 SOMERSET DRIVE PATTERSON, NY 12563 SAMPLING SITE: LOT 9 : 9 CHESHIRE CT, PATTERSDN COL'D BY: NOTES : BASS FAUCET DATE/TIME TAKEN: 11/15/05 10:45 DATE/TIME REC'D: 11/15/05 12:00 REPORT DATE: 11/23/05 PHONE: (845)-590-9734 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE..: < 4C COLlFORM METH: Ml'-'' ~~~~~~~~~~~~~~~~~~~~~~°~"~~°~~~~~~~~~~~ DATE FLAG .` PROCEDURE RESULT NORMAL - RANGE METHOD 1--TJTNAM CNITY PROFILE 1105/05 MF T. COLIFORM ABSENT /100 ML ABSENT 10O8 1015/05 LEAD (IMS) ' 2.6 ppb 0-10 PPP 9003 11/18/05 NITRATE NITROG 0.91 MG/L 0 - 10 9052 11/17/05 NITRITE NITROG <0.01 MG/L N/A 9162 11/16/05 IRON (Fe) <0.060 MG/L 0-0.3 mg/] 9002 11/16/05 MANGANESE (Mn) <0.01O MG/L 0-0.3 mg/l 9002 11/18/05 SODIUM (Na) 83.6 MG/L N/A 9002 11/15/05 pH 7.4 UNITS 6.5-8.5 9043 11/18/05 HARDNESS,TOTAL <2 MG/L N/A 11/18/05 ALKALINITY (AG 176 MG/L N/A 900). 11/22/05 TURBIDITY (TUR <1 NTU 0-5 NTU COMMENTS: BACT THESE RESULTS INDICATE THAT THE WATE <WAS NOT) OF A SATISFACTORY SANITARY QUALITY ACCORD *HE NEW YORK STATE AND EPA FEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Pb /Cu LEAD limits for p EPA Lead & Copper than 10% of their than 15 ppb and a treatment must be potential. ublic schools are set at 15 ppb. Rule for Public Systems i that ys ems requ res a no more distribution points have a LEAD value of more COPPER value of 1.3 mg/L, else water undertaken to reduce the waters corrosive Fe/Mn If both iron and manganese are present, their total value combined shall not exceed 0.5 mg/L. Na No limits for Sodium are proscribed. Suggested guidelines state that for people on a sodium restricted diet,the water should contain no more than 20 mg/L of Sodium. For those on a moderately restricted diet, a maximum of 270 mg/L of Sodium YML ENVIRONMENTAL SERVICES 321 Kear Street Yorktown Heights, N.Y. 10598 (914) 245-2800 Albert H. Padovani, Director LAB #: 1.507786 CLIENT #: 56173 NON STAT PROC PAGE: 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8MMD LLC 166 SOMERSET DRIVE PATTERSON, NY 12563 SAMPLING SITE: LOT 9 : 9 CHESHIRE CT, PATTERSON COL'D BY: NOTES...: BASEFAUCET -----------~-- 71, ---------�������������� DATE FLAG PROCEDURE DATE/TIME TAKEN: 1I/15/05 10:45 DATE/TIME RE00 11/15/05 12:00 REPORT DATE: 11/23/05 PHONE: (845)-590-9734 SAMPLE TYPE..: POTABLE PRESERVATIVES, NONE TEMPERATURE..: < 4C COLlFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~,~~~ RESULT NORMAL - RANGE METHOD is suggested. pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pH IS ONE OF THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMlSTRY., WATER WITH A LOW pH MIGHT BE CORROSIVE TO METAL PIPES AND FIXTURES. THE NORMAL RANGE OF pH IS 6.5 TO 8.5. Hd TOTAL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESIUM CONCENTRATION, BOTH EXPRESSED AS CALCIUM CARBONATE, IN MG/L. THE HARDNESS MAY RANGE FROM 0 TO HUNDREDS OF MG/L, DEPENDS ON THE SOURCE AND TREATMENT TO WHICH THE WATER HAS BEEN SUBJECTED. SOFT WATER: 0-70 MG/L VERY HARD WATER: ABOVE 300 MG/L MODERATELY HARD WATER: 70-140 MG/L MG/L = MILLIGRAM PER LITER HARD WATER: 140-300 MG/L 0 grain/gallon = 17.2 MG/L) SUBMITTED BY: 0 ��puo 'C'j- Directur, ELAP* 10323 / -N5/ T 7)_T�7GINEERING, SURVEYING & LANDSCAPEARCH/TECTURE, P.C. 3 Garrett Place (845) 225 -9690 Carmel, New York 10512 Fax: (845) 225 -9717 TO: Putnam County Health Department 1 Geneva Road Brewster, NY 10509 WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter LETTER OF TRANSMITTAL Date: 12 -06 -05 Job No. 99147.309 Attn: Robert Morris, P.E. Re: SSTS for Cornwall Hill Estates Lot 9 9 Cheshire Court, Town of Patterson TM# 13 -3 -106 ® Enclosed ❑ Under separate cover via ® Prints ❑ Plans ❑ Change Order ❑ the following items: ❑ Samples ❑ Specifications THESE ARE TRANSMITTED as checked below: COPIES j DATE DESCRIPTION 5 12-01-05 _mVCC AB-1 _ As-Built Drawing _._..._................._........_..._..___..........................._..-.._.._............_...-_......_. ............ ... ........ ....... 1 ........................ 12 -06 -05 -97_ Construction Compliance....__ --......_.. . ......... .._ ..... . . ...... ....... _...._. _- ___.___.__ (-12 t- __.._�_ - ..___ - ___.___...______._...__..._._ _ -... w_..._. ... . V........._._......_.......___._.. ...... _..._.-__.___. ...... 3 -06 -05 GS -97 Guarantee _ __.. _..__._.___._.._._._.._._.._.__ ......... ..._ ...... _.._.__I- _.._....- .- - - - -._ _._ 1 ? 12 -02 -05 __ _ _._.___ --- - - - - -- _. __.__ __ _ E911 Address Verification ..... ..............._._......................_.................--...;.........._.._._.................................__.............._._.......... 1 1 11 -15 -05 .........._..._._.............. --- - - - - -- _. ......... .._ .......... _._.__ .......................... _ ........................... . .................................... _.. ...... ....._...__._ ....................... _.. .......... ............................ ..... __ ........ _ ............. ..................... .. ... ........... .. ... _ .... ... .... Water Test Results 1 19 -16 -05 i.. WC -97 Well Completion Repgrf ......................... .... ............................................ ....... . ............ ........ .....:. ... .......................... .................. ............ ................................................ 1 11 -28 -05 .... .......................................................... 1418853755 _............... $300.00 Fee ... .w........ _..._........._......._...._.. ......_....._._ . ....._....__._.._....._.._.._._ ......._, _...._........ ...-....._._.. .... ..... _ _ _.._ _ _... _ ... _......_.. ....._..._..__....._.._.__..... ........ ._.._ .........................._.._........._.........__...._........_ ............. ..... ......... ...... ..._............ _ ................ . ._ .... ..... -.._....__.___.._...._.................... ............ . ..... .......... ..... THESE ARE TRANSMITTED as checked below: ®For approval ❑Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ REMARKS: COPY TO: SIGNED: r� Joh M. Watson, P.E. ject Engineer, Associate IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE Iot2002.dot BMMD LLC 166 Somerset Drive Patterson, NY 12563 Date: Sept'l , 2005 From: Bruce Major To: Robert Morris, PCBOH Subject: Review of House Plans for Cornwall Hill Estates Lot 9 previously approved Re: Per Tax Map: 13 Block 3 Lot 106 Address: 9 Cheshire Ct Rob, As per our conversation I am submitting a revised Plan for Lot 9 to include a -finished basement with one bedroom. This would bring the total bedroom count to 5. The house is currently under construction but no on site inspection by PCBOH to date. Thanksi vance, Attached: Three copies of plans & return envelop BMMD LLC 166 Somerset Drive Patterson, NY 12563 Date: Sept'1, 2005 From: Bruce Major To: Robert Morris, PCBOH Subject: Re: Rob, Review of House Plans for Cornwall Hill Estates Lot 9 previously approved 0 Tax Map: 13 Block 3 Lot 106 Address: 9 Cheshire Ct As per our conversation I am submitting a revised Plan for Lot 9 to include a finished basement with one bedroom. This would bring the total bedroom count to 5. The house is currently under construction but no on site, inspection by PCBOH to date. Thanksi r a nce, Attached: Three copies of plans & return envelop PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDROOMS -11.ONS TO THESE HOUSE pCDO-TLi FOR APPROVAL FRONT ELEVATOIN Lof q Co f VW,4 I/ / I;// "-B H"D iLc J�ff 'Dios U01c; uoljopurlo� ni 1. -ow v�w ip n L J 'Al P"O dw 4w, ,i L - J %Asnio L T Td T L- L Ch -Bed Pvo t4 Mil, LT -u lal 1 T I %_w I vKr 2m =mn PIT 2m ir 'mm 2=2 )bw vscb Son cock phon &Gang or :Z�E4 5V.d Pr Men P*. =2827�2 AM off a 7P-2 0' = -2 w to "I le 2M2 -2 Tdoill";l M. i n co i awn 4 or vwt m& ev law. 4 W LVL OW CO I 3W. q LW LA Ndb,. Great Rm. Can" cio y D � � �' 1 : ( : Kitctlen - o t 2 PKIN 4V own M 010 A A Poster 41 colt Sts M. Bath J_Q 0 IOL60t Y 4' IrL !r 2r 26 0' 410 L Tr.� Wd 74LV Lwmd 2dOiW. f-0" C.4 No- L2' 0 -_ - I room, LOVA 24P Pits" Dr. wl, -­l L X t lei " — — - nmmd Cabom MIND W4 a 6 P.T. WTAmsc4p VWAvdft Lai 5w TO. Ir amen ad M"d 111ta" At So& SWWm dt a 1g ftme I At CA" phww q. W" bw Alt 16 V40' = 61"No TO 1 V.4- V'r Floor Plan Sctalel AmL I I rvv -I 2M2 1/4- 1 I'-V- Residme For Al. R. BAPM-e 6,OEAEY A I A j, -",c f­ the riaht z Egan Midas slur: no I 1 WO 54110 814W 2497 i I 1. Raor I I I I 2 All Mltltl 10' Of Flow To Now T film* Oat* * I 3. AD 6lmtg In Doors t 11111 Enbslg i Not Tuba MM X7001 Tab% Sane* Sion* Rama, Bahpbe and SHata "ft 60' T0,31401 (1) 2 x -6 Mdr, 10 Hdr \ O Teepaed Elm*. 4. AD Eg+s* M6vlots To Mars A /Mwt* 17-0- Top Plot• Gear � Aroo Of 5.7 5I Total rJ I Roo► 1 I 12'-0' Top Rot• S ocftdbee Far All 011ler Yidelofbrt 5. N- 2'-0' xAeswall To Maros Fuq tuba Teepered Uew� 011ltr� liot•0 QI P1•• I Catch Ba mN Bmk I i 2 x 6 Gollar TM • W a/,- I I 1 I I 1 -- - - --- - - - - - - - - - - ---- - -- - -- I ROer I Roof 1 i b I 1 4 - _ 3 I Coon To exsat Me. Balm , c o O IT47 27`47 • 4' x n % Q 1-9h6- _� - Dropped N&.114' LVL .1 O O 0) 18/4• x V4' LM- � Nd -- °---- - - - -�- tgWg _ �O 7 -66';j 1 � .0 Pd N Roo► ' I ' ir9dm w: 1. All Va "To ee Lott I- ftkbd Elms w R-3) Q6032). 2 All Mltltl 10' Of Flow To Now T film* Oat* * 5�1 Ohtj /dl Olfen FNI 3. AD 6lmtg In Doors t 11111 Enbslg Not Tuba MM X7001 Tab% Sane* Sion* Rama, Bahpbe and SHata "ft 60' T0,31401 (1) 2 x -6 Mdr, 10 Hdr Of Pbxbn or Door Ilgt Sldl Now O Teepaed Elm*. 4. AD Eg+s* M6vlots To Mars A /Mwt* l To 61-0' () 2 x b Hdr Gear � Aroo Of 5.7 5I Total rJ /0 O 24' Ml Geor Ib� Mile Gea PWK Mhf Nat *. S ocftdbee Far All 011ler Yidelofbrt 5. AN M hd" or Dori Muted W REM' To Maros Fuq tuba Teepered 1 1 0 rs 12xb OW 2° o _ Notes: Legend: Wood Header 5aheWe =F, MsAlere To Be 2 (4) 2 x Mxd Poet R ..d � � lirOder °she � - Lorch Or .tt" All Partlbro or A* Now Ll T0,31401 (1) 2 x -6 Mdr, 10 Hdr Pa+dbl o rraru g O Y Bank Fbdwo l To 61-0' () 2 x b Hdr Il Tile Roar Is To Be MD Job /0 O loot Defe<t r Fttdr• w/ pjq glo Nat *. rf>amg me" ror.Addlaw" n/ Battery 8ack4)p p OIRbt Uew� 011ltr� liot•0 QI P1•• O Catch Ba mN Bmk 6rourd Faux ktwnptar (6W M All Met Mean (Ab R-qured Bg Lod*) "— Pion-- ff—dyd R5- 9- -.w-A. a__:J_._ __ Builder reserves the rlaht Roof i I I , 2 x 6 Coate nm / l 12'-0' Tap Plot 161.0' AEvve Rrst Flo, i I D Roo r- d- T4Y KnOOMMI tts�!ti It abutft � O 26 4 ^ all 20 I !� I I y 1 1 I I. I - i I 1 I I I I 1 /Ma' e1 I I I ! I I I I I I Rao/ I i - l I I f I e I I ec0nd i+loor Plan Scale. 1/4' = 1' -0' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # L � O Located at CAC%a C00" To or Village QATTrtLSo►� %MMq, lac. Subdivision name6cptko; Pub k H,« Cyptns) Subd. Lot # q Tax Map 13 Block 3 Lot 1o6 Date Subdivision Approved 4-4-01 Renewal — Revision _ Owner /Applicant Name $MAD , uc- Date of Previous Approval Mailing Address a -fkrJ g G ( A ROAD b?\t0 S q4k � N y 1060.9 Zip Amount of Fee Enclosed % 00 • no Building Type lks tK JTk At, Lot Area :)•dSt /- No. of Bedrooms 5 Design Flow GPD 1)00D Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of ,,Soo gallon septic tank and Other Requirements: TOO C O RT AI N S Rg1.a To be constructed by -(d 'b a r E(L At 140 Address rJI A' Water Supply: Public Supply From Address or: X Private Supply Drilled by -ro 90f VC-TO-0\00 Address Soo L , OF dj A I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate to sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: Address R.A. License # Date 128 � (01431 3 (AMETT rLgc,t ) cgVMEl Ny IQ>Ia 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 en onside d necessary by the Public Health Director. Any revision or alteration of the approved plan requires anew pe Appro for discharge of domestic sanitary sewage only. i By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional om 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: o illage Tax Grid # C( Cm wf CouR 9A-rt EllS"3 Map ►3 Block 3 Lot(s) lob Well Owner: Name: gMMD , k L L Address: a -rNAGC L Qo t o 1,b(Lt,45r((L 01 , ►oS C9 Use of Well: _K Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2 -seeee Industrial Institutional Standby Amount of Use Yield Sought s gpm # People Served 5 Est. of Daily Usage 3 o o gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling 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 (_,,gL AAU, OkLL r✓ssnrO Lot No. 9 Water Well Contractor: -To gE 0ETE9,1v\,00 Address: rjlp� Is Public Water Supply available to site? .................................. ............................... Yes No X Name of Public Water Supply: n►If� Town/Village NIA Distance to property from nearest water main: NIA Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: ( I 28 104 Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Directo y revision or alteration of the approved plan requires a new permit. Well to be constructed by a wat r we 1 drille certified by Putnam County. r J Date of Issue � J' � Permit Is u Offic'al: Date of Expiration Title: Permit is Non- Transfe ab e White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 fiV CTJ //L to) LJ r r7 aJ PUTNAM COUNT' DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner _ _,?N M L L L Address o2 MA Lj�- 12 )2 6AV) 15,e>< H Yt!-e: Located at (Street) 60E WALL kL Tax Map .3 Block 3 Lot (indicate a st cross treet) ne re Municipality Nr 1 fry 5C, N Drainage Basin O r Q (y�wwkcc. tf I J SOIL PERCOLATION TEST DATA Date of Pre - soaking 4.11 G o Date of Percolation Test co Hole No. Run No. Time Start- Stop Ela Time 61.). " Depth to Water From Ground Surface (Inches) Start Stop Water Level Dropp In Inches Percolation Rate Min/Inch " 3 d% a3ly 4 7, o 5 , 14 9'0j o?3% 3 3.3 Lss� 2 1/:3G ao% a 3/y 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be 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. 1 9.0' 9.5' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES GJ <.i V 55,Z pl A,5 le?�s . HOLE NO. 9_ HOLE NO.9 f-,3 HOLE NO. . Indicate level at which groundwater is encountered 11j0�ir Indicate level at which mottling is observed NO N1r Indicate level to which water level rises after being encountered N Deep hole observations made by: -1OKA rt. G4-6vd . Date a- i� -Oo Desi&I IQ essionalNa111 free J. Contelmo, P. E. Address:lnsite Engi ing, P.C. f ' Signature: c„ 0 LY �' - '� la's ,N S � ! �i6A .j �» "o, r�SS '7.h6stS t Professional's, al /f ` 6 , may' � •1..ti � �� • ..•,. {)'>' PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, OR, AS, SRDATE: TAX MAP #: (CONFIRMED) Y DOCUMENTS Y N (REQUIRED DETAILS ON PLANS CONT'D) PERMIT APPLICATION UUHOUSE SEWER - Y," FT. 4 "0'; TYPE PIPE CAST IRON WELL PERMIT OR PWS LETTER UC�NO BENDS; MAX BENDS 450 W /CLEANOUT PC -97 RENEWALS LETTER OF AUTHORIZATION (�C_)SITE NOTE (NO CHANGE) DESIGN DATA SHEET (DDS) FILL SYSTEMS CORPORATE RESOLUTION (__)0101 HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE EAF THREE SETS PLANS - TWO SETS [CE REQUEST SUBDIVISION (� SEGAL VISION APPROVAL CHE CKED DEP H REQUIRED GENERAL (_J(__)LOCATED IN NYC WATERS C__)(__)PLANS SUBMITTED TO DEP (_,(_)DELEGATED TO PCHD (U(UDEP APPROVAL, IF REQ'D (__)C__)DEEP TEST HOLES OBSERVED UUPERCS TO BE WITNESSED (_)(__)EX- APPROVAL SSDS ADJ, LOTS (_)(__)WETLANDS (TOWN/DEC PERMIT REQ'D ?) (_)(DATA ON DDS PLANS & PERMIT SAME (_)(PRE 1969 NEIGHBOR NOTIFICATION (_)(_)LETTER BI/ZBA (_,0100 YR. FLOOD ELEVATION W/I200' C_) __)SOIL TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS (__)(__)SEWAGE SYSTEM PLAN - (NORTH ARROW) C__)C_)SSDS HYDRAULIC PROFILE (_))GRAVITY FLOW UUCONSTRUCTIONNOTES 1 -15 (_J(__)DESIGN DATA: PERC & DEEP RESULTS (__)(__)2' CONTOURS EXISTING & PROPOSED (_)(DRIVEWAY & SLOPES, CUT L_) __)FOOTING /GUTTER/CURTAIN DRAINS (___)C__)USDA SOIL TYPE BOUNDARIES ((__)TITLE BLOCK; OWNERS NAME ADDRESS TM #, PE/RA.; NAME, ADDRESS, PHONE# C__)(__)DATE OF DRAWING/REVISION UC _)DATUM REFERENCE (_)(_)LOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. U(__)PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS (__)(WELLS & SSDS'S W/IN 200' OF SSTS (_)(__)PROPERTY METES & BOUNDS (__)C__)EROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (REVSHEET)09 /01/00 C_)(__)FILL SPECS/ FILL NOTES 1 -5 (__)(__)FILL PROFILE & DIMENSIONS (__)C__)FILL IN EXPANSION AREA FLT GREATER THAN2 FEET CLAY BARRIER ((__)FILL CERTIFICATION NOTE (__)(__)DEPTH GAUGES (_) __)VOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (_)(_)SEPARATION DISTANCE FROM TOE OF SLOPE E C C_DC_)LF TRENCH PROVIDED 60FT MAX. (_))PARALLEL TO CONTOURS (_)0100% EXPANSION PROVIDED (_)(__)DETAIL/DUST FREE CRUSHED STONE OR WASHED GRAVEL (_)C__)GEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS C_)C_)10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL (__)C__)20' TO FOUNDATION WALLS 0(__)100' TO WELL, 200' IN DLOD,150' TO PITS TO STREAM, WATERCOURSE, LAKE (inc. expan) C__)C__)50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER x)(_)10' TO WATER LINE (pits - 201) C�C�50' INTERMITTENT DRAINAGE COURSE (__)(__)200'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (__)0101 MIN TO LEDGE OUTCROP SEPTIC TANK (__)(__)10' FROM FOUNDATION; 50' TO WELL WELL (__)(__)DIMENSIONS TO PROPERTY LINES (__)ULOCATION OF SERVICE CONNECTION C )C__)MIN 15' TO PROPERTY LINE SLOPE (__)C__)SLOPE IN SSTS AREA (920 %) C__)C_)REGRADED TO 15 %, IF REQUIRED UUPUMP NOTES L_)C__)DOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED (___)UDETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) C_)C__)PIT AND D -BOX SHOWN & DETAILED DAY STORAGE ABOVE ALARM CURTAIN DRAIN ((__)STANDPIPES, 5' BOTH SIDES, DETAIL 0(_)151 MIN to CDS = >5 %, 20' -4 %, 25' -3 %, 35' -1 %,100 % - <1% (__)(_)20' MIN to CD DISCHARGE /100' with 182 cons day discharge (_)(_)10' MIN to NON - PERFORATED PIPE /NS/ TE ENGINEERING, SURVEYING & LANDSCAPEARCHITECTURE, P.C. 3 Garrett Place (845) 225 -9690 Carmel, New York 10512 Fax: (845) 225 -9717 TO: Putnam County Health Department 1 Geneva Road Brewster, NY 10509 WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of Letter LETTER OF TRANSMITTAL Date: 1 -28 -04 Job No. 99147.309 Attn: Robert Morris, P.E. Re: SSTS for Cornwall Hill Estates Lot 9 9 Cheshire Court, Town of Patterson TM# 13 -3 -106 ® Enclosed ❑ Under separate cover via ® Prints ❑ Plans ❑ Change Order ❑ The following items: ❑ Samples ❑ Specifications COPIES DATE 1 NO. DESCRIPTION 5__ 11 -226 -04 CD -1 Construction Drawing - 3 1 -26 -04 ' CP -97 Construction Permit 3 i 1 -26 -04 WP -977 Well Permit 1 1 -26 -04 PC -97 Application for Approval of Plans 1 1 ; 1 -26 -04 5 -1 -01 j --- - - - - -- ACA -97 Short EAF Corporate Owner Affidavit 1 -- - - - - -- LA -97 Letter of Authorization _ — �- 1 _ 6 -20 -01 DD -97 Design Data Sheet 1 -- - - - -- - - - - -- 5 Bedroom Modular Floor Plans y o .00 F E THESE ARE TRANSMITTED as checked below: ®For approval ❑Approved as submitted ❑ Resubmit ❑ For your use ❑ Approved as noted ❑ Submit ❑ As requested ❑Returned for corrections ❑ Return ❑ For review and comment ❑ REMARKS: COPY TO: L02002.dot Copies for approval Copies for distribution Corrected prints SIGNED:r �jhn M. Watson, P.E. IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE THESCARSDALE Second Floor - 48, 27'S" First Floor 00 , -- TNA143 COU ('i: is <'.'' i' 13r7T Oi HEALT I i , 0;0 KiTC 13 s� ED F0:,-_1 'RT.7 : �WOWUNT 0 ,Y - t I2 -0 °: Ir0° I 6 -5"z IS -0 20' -0 z Is -0" BEDROOMS &M.. A.6, E AIL SUB TO THES OUSE VAL �, E e ) F DINING ROOM S�G TIi u LIVING ROOM W -9 1Iz IV -0" r A i up i _ Erse J STANDARD SCARSDALE If FEATURES • 5- Spacious Bedrooms a Framingham Pediment on Front Door • 2%2 Baths . 9 Fireplace Options Available • Open Two -Story Entry Foyer ® "Boxed -out" and "Angle Bay' Options • Formal Dining Room Available • Fornal I wing Room e Consult an Authorized Westchester Builder • Spacious Country Kitchen With Brea st nor a Complete List of Options Room and Pantry 9 Artist's renderings and Floor Plan Dimensions are • "Cottge- Style". 3056. Lower Level Windows contract n oral and atio mist be Written in the Moth Architraves on Front t :• ; B a P. O. Box 900 o Dover Plains, NY 12522 (914) 832 -9400 - (800) 832 -3888 2 'd A0 1N3Wi8Ud30 AlNnoo wbNind:3WUN t26L- 8L2 -Sb8 X31 P. F . •A t .f Mar b 10, 2004 l7f/ /I. i pepart-menf:of Erivi�artrifierrtaC `* �' : `,' . Robert Morris, P.E PutWIn Co. Health Dept. 4 Geneva Road A a • . Bre�ester, NY 10509 'YydheNa'1"Nodk: i )R e: Comwall Hill Estates. Lot 9/BMMD, LLC. `Chisto'pher': Ward °y I 9 Cheshire Court :. Coimmissii�oer : ' Patterson, Putnam East Branch Reservoir _ DEP Log # 14290 (Joint Review) , A P1 in Fr �c (gi 4) 77349 J. d •, •Ylir'^ �•s,- :�'�:/�r �i }rp•v.�', i.�.73 ] 11 w•F• •. •- �.WwW.+.u�� ,w:_'• W_Y4'. +ray Mr. Morris: Sb :2t 03M 0002- 01-NUW letter is to inform you that the New 'Stork City Department of Environmental rction (Department) has determined that the above - referenced application is Mete. In addition, the Department has no objection to the approval of the e- referenced regulated activity. This determination is based on the review of dated documents including the plan titled "Proposed SSTS for BMMD, LLC./ wall Subd. Lot 9 ", dated 1/26/04. applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 at 2 days prior to the start of eonstrdrtion of the SSTS so that a Department ,sentative may inspect and monitor the installation. Margaret O'Conn4P. S ervisoI Ez I gineerix�g Review Group ",., w...: ,m:� f •,,,:.1: , J xd': ram=s Covey, 'D'R INMQT%OH • •[ , I' � � $affil nTp� I #s ' I: S D'E-P•:•jH L ZO'd W LI OOOZ Ol JeW EbEO- £LL- p16.xe� Fax:914 -773 -0343 Mar 10 2004 11:48 P.01 o� AUT Q5L�1d ' Jo15- ,Url, 511 7 >;)11\ sat IIq ii nano w nloul) :s2A to aagwnN (aa2yS � 1 ] :2UOy� Q :01 ? L -IC[ 'T 80 Iddlis f'� LIQIS1.1i(I f uT.X3alli T.T3 PU13 U.OI�1�.I2GTo rtV "A A v xVJ . . . ..). s. �a/a a MAR -10 -2004 WED 12:45 TEL:845- 278 -7921 i NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 0 6 LORETTA MOLINARI Public Health Director 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 March 1, 2004 Insite Engineering 3 Garrett Place Carmel, New York 10512 Re: BMMD, LLC 9 Cheshire Court, Lot 9 (T) Patterson, TM# 13 -3 -106 Dear Sir or Madam: ROBERT J. BONDI County Executive The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on February 3, 2004 is complete. The Department will notify you by March 20, 2004 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. X 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 would be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with Section 18 -23 (d) (6) of the New York City Department 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 project, such as stormwater plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if DEP review and approval is required. v v If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2166. V ly yo s Robert Morris, PE Public Health Engineer RM:cj PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AFFIDAVIT - CORPORATE OWNER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY HEALTH DEPARTMENT To: Public Health Director In the matter of application for: Cornwall Hill Estates Lot # q I, Bruce Major represent that I am an officer or employee of the corporation and am authorized to act for: Name of Corporation: BMMD LLC Having offices at: 2 Tanager Road, Brewster, NY 10509 Whose Members Are: John Boyle Bruce Major Bruce Major John Dale and that I am and will be individually responsible for any and all acts of the corporation with respect to the approval requested and all subsequent acts relating thereto Signed• Title: -Manager Sworn to before me this 1 s-r day of (month) 4 el (year) 206 / Notary Public .9� r=r Corporate Seal NotapyPubk-- stateotd P+X�. 01 PA6p2q� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of BMMD LLC Located at Cornwall Hill Road TN Town of Patterson Tax Map # 13 Block 3 Lot 106 Subdivision of Cornwall Hill Estates Subdivision Lot# Filed Map # 2856 Date Filed 04-04-2001 Gentlemen: This letter is to authorize Insite Engineering_ & Landscape Architecture, P.C. Jeffrey J. Contehno, 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. Very truly yours, A 0 p4Ftp C Countersigned: Signe P.E., # 61931 (Owner of Property) Mailing Addre p_.-. �&vevinjz Mailing Address: 2 Tanager Road i. 's�' W4, s ecture, P.C. Brewster Brewster State New York Zip 10509 State New York Zip 10509 Telephone: (845) 278-4990 Telephone: (845) 279-3613 Form LA-97 PROJECT ID NUMBER 617.20 SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)k 1. APPLICANT / SPONSOR 2. PROJECT NAME BMMD, LLC. SSTS FOR CORNWALL HILL ESTATES LOT #9 3.PROJECT LOCATION: Municipality PATTERSON County PUTNAM 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map q Garet" R-z Gov— o FE ,L,./watL H c of, ✓fir D 5. IS PROPOSED ACTION: z New ❑ Expansion r_1 Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: CONSTRUCTION OF ONE SINGLE FAMILY RESIDENCE, DRIVEWAY, SSTS, WELL AND APPURTENANCES 7. AMOUNT OF LAND AFFECTED: Initially 2.25 + /- acres Ultimately 2.25* acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ❑✓ Yes 1:1 No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) P-1 Residential El Industrial El Commercial ❑Agriculture El Paris / Forest/ Open Space Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) PiYes El No If yes, list agency name and permit / approval: DRIVEWAY PERMIT -TOWN OF PATTERSON, SSTS & WELL PCHD, BUILDING PERMIT -TOWN OF PATTERSON 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? RYes Rl No If yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT / APPROVAL REQUIRE MODIFICATION? es ✓ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name INSITE ENGINEERING, SURVEYING & LANDSCAPE Date: I r281or' Signature "(-t ARCHITECTURE, P.C. 1 If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be comaleted by Lead Mencv) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. Yes [:] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. Yes 1:1 No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Longterm, short term, cumulative, or other effects not identified in C1 -05? Explain briefly: C7. Other. im acts (including than es.in use of either quanti or t e of ene ? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? If es, ex lain briefl : Yes F-1 No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If es a lain: El Yes El No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the F EAF and /or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed ai WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting determination. Name of Lead Agency Date Print or Type Name of eeponsi a Officer in I ea d Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer f different from responsible officer) 1. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM Name and address of applicant: BMMD, LLC 2 TANAGER ROAD BREWSTER, NY 10509 SSTS FOR 9ORNWALL HILL ESTATES �, 2. Name of Project: SUBDIVISI LOT #9 3. Location: : PATTERSON JEFFREY J. CONTELMO P.E. INSITE ENGINEERING, SURVEYING & 4. Design Professional: 5. Address: LANDSCAPE ARCHITECTURE, P_C. 6. Drainage Basin: EAST BRANCH 3 , N PLACE g CARMELMEL NY 10512 7. Tvne of Proiect: 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) ? .............. Yes/No YES Type Status (check one) ...................................... ............................... Type I Exempt Type H Unlisted x 9. Is a Draft Environmental Impact Statement (DEIS) required ? .................... Yes/No NO 10. 11 Has DEIS been completed and found acceptable by Lead Agency ? ............. Yes/No Name of Lead Agency N/A N/A 12. Is this project in an area under the control of local planning, zoning, or other officials, ordinances? ............................................................. ............................... Yes/No YES 13. 14. 15. 16. 17. If so, have plans been submitted to such authorities? ................. Has preliminary approval been granted by such authorities? NO Type of sewage treatment system discharge ........................ If surface water discharge, what is the stream class designation? Waters index number (surface) .......... Yes/No NO Date granted: N/A surface water X groundwater N/A .......................................... ............................... 18. Is project located near a public water supply system? .................... N/A Yes/No N/A 19. If yes, name of water supply N/A Distance to water supply N/A 20. Is project site near a public sewage collection or treatment system? .......... Yes/No NO 21. Name of sewage system N/A Distance to sewage system N/A 16-00,6-20&21-00, B -3-00 22. Date test holes observe 23. Name of Health Inspector ADAM STIEBELING 24. Project design flow (gallons per day) ............................. ............................... 1,000 25. Is State Pollutant Discharge Elimination system ( SPDES) Permit required?.... Yes/No NO 26. Has SPDES Application been submitted to local DEC office? ......................... Yes/No N/A Rev. 11/02 Form PC -97 Pg. 1 of 2 27. Is any portion of this project located within a designated Town or State wetland ?... Yes/No NO 28. Wetlands ID number .................................................................. ............................... N/A 29. Is Wetlands Permit required? ...................................... ............................... Yes/No NO Has application been made to Town or Local DEC ........................... Yes/No N/A 30. Does project require a DEC Stream Disturbance Permit? .... .........................Yes/No 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, landfilling, sludge application or industrial activity? Yes/No NO 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ................................... ............................... Yes/No NO DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .........................Yes/No UNKNOWN 34. Are community water and/or sewer facilities planned to be developed within 1. 15 years in or adjacent to project site? .................................. .........................Yes/No UNKNOWN 35. Are any sewage treatment areas in excess of 15% slope? .......:...................... Yes/No NO 36. Tax Map ID Number .............. ............................... Map 13 Block 3 Lot 106 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 creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item 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, ii�or, rovided on this form is true to the best of my knowledge and belief. False stateme Pfn�ad er're nishable as a Class A misdemeanor pursuant to Section 210.45 of the ` r SIGNATURES & OFFICIAL TITLES: `'' ;?, �. y uJ � 1�i• re -- a I E� `; U W-Y G & LANDSCAPING Mailing Address AR R f ,�. 3 GAR . ARM ' EW YORK 10512 Form PC -97 / i / i EXPANSION ABSORPTION / ®j TRENCH (TYP.) / 1/ (100% EXPANSION .. / PROVIDED) / / / / / / / / / / / Ile // / // /. / / g �0 /10, // /� 8 / /'o, / /� 7 / /.0e / 6 pf)p Typ.) BOX /Gp(P)-- - -CLEANOUT (TYP.) C] 8 017 0016 ® PRIMARY ABSORPTION °�— TRENCH (TYP.) CURTAIN DRAIN 20 GD(P) 1500 GALLON SEP77C TANK 3 A GA D Aw WEL Q lv v 23 TOWN OF PA✓TTERSON PUTNAM :COUNTY- NEW ' YORK ; � ., S 4' 9. -;THIS IS TO CERI IFY- 7HAT`7NESEWAGE.`1REA71l4ENT SYSTEM:: WAS CONSIRUCIED AS "INDICATED .ON. THIS PLAN, AND. THE.SYS.TEMI WAS 6BSERVfD:.BY %NS/TE:' ENGINEERING 'SURVEY/NG,. &.. LANDSCAPE ARCHITECTURE, •P.C.. BEFORE /T • WAS...- COVEREU. OVER. - •THE SY57EM:'WAS 'CONSTRUCTED'7N GENERAL A {CCORDANGE WITH ALL STANDARD. RULES AND REGULATIONS - or -THE PUTNAM ,COUNTY DEPARTMENT 0 THE` NEWYOF HEALTH N01 STAIF DEPARTMENT OF,HEALTH. 2 `ALL FAClU71ES EX/S71NG, UNLESS NOTED OTHERWISE , =; 3 PROPERTY <L /NE HOUSE AND WELL IS BASED ON F/EL0 °SURVEY BY .INSLTE ENGINEERING ' SURVEYING, ;AND LANDSCAPE ARCH /LECTURE, P.C. COMPLEIFCI NOVEMBER 23,. 20Q5 _• AS =BU .. /L T .MEASUREMEN,TS N0: aaER 6F C ER cis REMARKS DWELUNG_:« . ,,:DNEWNG. �; CLEAnodr :. :2 62- 22 - - 1500 GAdON'Sfl°7/C r,+Hir .3 65' G'L EANaV/ :4 - 114 ' 91 ' - a.FiwoUr� .. ;. 5 121 ' 107 - .oRa?eox 6 123• 111 ' S :; - - 'DIRW Box` 7 126 115' - DROP, Box. 8 . 128 121 ' s - . `.vrrciP sox: 132" 127' - = oRaw aox 144' . _ .©W OF MINCH ::149' - END OF *ENaH ti. :. 12 173:' 152, _ OF T)MWCH 13 175' END,0F TRENCH ,. r 14 179 162' 4 - Evv : aF i�iva+ 15 74' _80' _ Er oF•>RnicN 16 78' : . 86' ; _ - avb OF TREw 17 82' °92, - ENn of 1RFrra+ .. 18 86'- :98' - ENU.AF iROVaN , 19 92' END Cr rnENaf 0' 54 „' r BEOW R� Tov TA/N -DRAIN 160:' .' END PERFOMPA TED, BEl7N «• 51ptlD WRTA/N; ORA/N ' 22 216' 193' — CURTAIN: DRAIN U/SCt/ARb Health = - - :: 'Serviaeg ; ice with s of the NO. DAIF,, REVS /ON BY