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HomeMy WebLinkAbout0505DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 15. -1 -14 BOX 6 00505 e-1-1 NAM COUNTY DEPARTMENT OF HEALTH 0 _. CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # D 3 Located at 221 CoAgA F -e^c,7 Town or Village 'Psi -sari Owner /Applicant Name (, f V&ZL.ES Tax Map 15 Block I_ Lot / 4 Formerly l,►IA- Subdivision Name ST-A�( C- Co/4c�k P. l•-��. Subd. Lot # Mailing Address 1'� rjpr,.1'p`{ ST?-E f , r-1A VvPi� . ��. Zip JC>Sfl Date Construction.Permit Issued by PCHD JD 1I O5- pur.J -'-%�e Lo vSc�, J(- Separate Sewerage System built by Addressq Consisting of of (eoo Gallon Septic Tank and A'8;0 L , F )F 2 W l pf� k3So R P'['i o Tc2 -�c� Other Requirements: 31 k ? -.0.3. Fl 6),4c- Water Supply: Public Supply From. Address I52 eoAttset- ST or: Private Supply Drilled by t,�r1A,,3 AojmEgSo,, ,, ic— Address Vi u_Ey _ - Building , Has• erosion - control -been completed?. .. - Y��j- _ _........:.. _........._ ._. Number of Bedrooms 3 Has garbage grinder been installed? r 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 regulation unty D ent of Health. Date: t I u I Certified by P.E. v- R.A. (Design Pro essional) Address Fu- rr4otm P,,-Lz- ,4 oL-p Foore- <v License # 0& -7441(o 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 e s bJect to modification or change when, in the judgment of the Public Health Director, such r6vocatiqn ific n or change is necessary. By: Title: (fl\-� Date: bl f White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 11/16/2005 WED 12:30 FAX 0003/004 I � PUTNAM COUNTY DEPARTMENT OF HEALTH ...X SZDN - ►F.- ENA'BRONMENTAL HEALTH SERVICES - -_ GUARANTEE OF SUBSURp'ACE SEWAGE, TREATMENT SYSTEM Owner or Purchaser of Building Clncer�S rrk-,F, w Building Constructed by r ;);� I GaL k A)- Location - Street �s I �y Tax Map block Lot 2ciA—UNSOIN-� Nq Town/Village Subdivision Name, Building ype 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. D Day Year acoS ner) - Signature Sign ature: Title:�QA Corporation Name (if corporation) Corporation Name (if corpo n) Address; Address: State Zip - (1 ?1 State d Zip to S Z Form Gs -97 11/16/2005 SPED 12:31 FAX BRUCE R FOLEY Public Hearth Director Q004/004 L0M17A : M01:MPJ: RN„ K0 4. - Aaaciate Pu6tie Health Director Director of Paden! &rues DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 rs•itonteeatd F1vdth (914)278 -6130 F&%(9L4)27&-79Z1 Nurslag Se. v a (914) 273 - 6558 WIC (9 14) 278 - 6678 Foot (914) 278 - 6085 geriy. Inimmtion (914)278 -6014 Ytreaehad (914)278 -6Q82 Fa(914)278.6648 OWNERS NAME:Y TAX MAP NUMBER-: E911 ADDRESS: ' � cA _ TOWN:�,CI1 AUTHORIZED TOWN OFFIML: (Signature) DATE: The Putnam County DVartment of Health will not issue a Certificate of Construction Compliane •Mess the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application fer a Certificate of Construction Compliance. r. (E91 l VERERIvi) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well >L,oeation Slr t Address 1` wn/Y Ia :;: ,�. Tax grid Map Block Lot(s) Well Owner: Nama, Address: Use of Well: 1- primary 2- secondary _Residential Public S ply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment 5< Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing � Open hole in bedrock Other Casing Details Total length _eft. Length below grade ST-/y ft. Diameter << in. Weight per foot alb /ft. Materials: Steel _ Plastic _ Other Joints: _ Welded �Grhreaded _ Other Seal: _,,c, Cement grout _ Bentonite Other Drive shoe: )-C 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 Yield ,o gpm Depth Data Measure from land surface- static specify ft). so During yield test(ft) - Depth of completed well in feet �3 � o Well Log If more detailed information descriptions or or sieve analyses are available, please attach. Depth From Surface Water Bearing . Well Diameter(in) Formation Description ft. ft. Land Surface _�.a" If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type3Ark-t- Capacity _ ' Depth o Model A s Voltage 13 0 � � HP Fee Tank Type 3c Y• Volu , r.. Date Well Completed f/ lel� /0 / I Putnam County Certification No. Date of Report I � Lize) �' I W ell Driller (signature) � - /'"'; - _� NOTE:/Exact location of well with distances to at least two permanetit landrharks to be provided on a separate sheet/plan. Well Driller's Namei�9 i�n�.,..• /Gi+ti� -e Signature: 4iai �v, --�-�_ Address: 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 WELL COMPLETION REPORT Well Location=:.. �...:Str...t °Address:~ .{- :......_.._ .....:.: �:.. T 'w" n/V' 1> Map Block Lot(s) Well Owner: Nam • Address: Use of Well: 1- primary 2- sec6ndary Residential Public S ply 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 #co ft. Length below grade s'T`rft. Diameter << in. Weight per foot alb /ft. Materials: Steel . Plastic _ Other Joints: _Welded _ZLThreaded _ Other Seal: -,?L Cement grout _ Bentonite Other Drive shoe: X 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 :2t Yield 0o 'gpm Depth Data Measure from land surface- static (specify ft) D During yield test(ft) Depth of completed well in feet XJ—© 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 :2.. - -- If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information . ��; Pump Type--?m--t- Capacity s— Depth o o Model 7 S o - 3 Voltage 2-3 O HP Tank Type 4�4�y Volume --j , Date Well Completed tl , Putnam County Certification No. - Date of Report bf'10 Well Driller (signature) �j . X NOTE:/Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. Well Driller's Name'-7,z, ,... � -e Signature: A��,�.�� Address: Date: White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 ,w YML ENVIRONMENTAL SERVICES 32J. Kear Street Y k N Y 1059B Albert H. Padovani, Director LAB #: 9.502411 CLIENT #: 58898 NON STAT PROC PAGE: 2 MARINO, CHARLES J. 221 STAGE COACH ROAD SAMPLING SITE: 221 STAGECOACH ROAD : PATTERSON COL'D BY: CHARLES J. MARlNO NOTES...: KlTCHEN TAP DATE FLAG PROCEDURE DATE/T[�� TAKEN: 1,0/14/05 07:30 DATE /TlME REC'D: 10/14/05 12:30 REPORT DATE: l0/24/05 PHONE: (845)-661-8165 SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE TEMPERATURE,.: < 4C ��LlF�RM METH: MF RESULT NORMAL - RANGE METHOD 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 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 MlGHTBE CORROSlVE TO METAL PlPES AND Hd TOTPL HARDNESS IS DEFINED AS THE SUM OF THE CALCIUM & MAGNESlUM ~---'—'-C, UKTC,ENfink ATTOIT, -BOTH~ E­XPRE1SSE-rY-144T iq-MG -Tvw-�'~--_-~'-~-'' 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 M0/L (1 grain/gal}nn = 17.2 MG/L) | Director ELAP# I0323 YML ENVlRONMENTAL SERV[CES 321 Kear Street Yorktown Heights, N,Y. 10598 3004_,`�'-'' Albert H. Padovani, Director LAB At 9.502411 CLIENT #: 58898 NON STAT PRDC PAGE: 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~^~~~ MARINO, CHARLES J. 221 STAGE COACH ROAD PATTERSON, NY 12563 SAMPLING SITE: 22). STAGECOACH ROAD : PATTERSON COL'D BY: CHARLES J. MARINO NOTES...: KITCHEN TAP ~~~~~~~~~~~~~~~~~~~~~"~~~~~~~~~~~~~~~~~ DATE FLAG PROCEDURE PUTNAM CNTY PROF[LE 10/14/05 MF T. COLlFORM 10/19/05 LEAD HMS) 10120105 NlTRATE NITROG 1O/!4/05 NITRITE NlTROG 10/19/05 IRON (Fe) 1O/20/05 MANGANESE (Nn> 10/28/05 SODIUM (Na) J.0/i4/O5 pH 10/20/O5 HARDNESS,TOTAL 10/20/O5 ALKALINITY (AS 10/20/05 TURB}DITY (TUR ' .. COMMENTS: PlCK UP DATE/TIME TAKEN, 10/14/05 07:30 DA-FEE/TIME REC'D: 10/14`/05 U2:30 REPORT DATE: 10/24/05 PHONE: (845)-66j.-8165 SAMPLE TYPE..: POTABLE PRESERVATlVES: NONE TEMPERATURE..: < 4C CDLIFORM METH: MF ~~~~~~~~~~~~~~~~~~~~~~~~~~~^~~~~~~~~~~~ RESULT NORMAL - RANGE METHOD ABSENT /100 ML 1.3 pph 0.36 11(3 /1 <0.0l MG /L <0.060 MG/L <0.010 MG/1 17.2 11(3) /L 7.3 UNITS 61.0 MG/L 74.O MG /L <1 ' NTU ABSENT 1008 0_J.5 ppb 9O03 0 - 10 9052 N/A 9162 0-0.3 mg/*.( 9002 0-0.3 mg /J. 9002 N/A 9(*KX� 6.5-8.5 9043 N/A N/A J. 0-5 NTU COMMENTS: BACT THESE lNDlCATE THAT THE WAT > OF A SATlSFACTORY SANITARY QUAL[TY ACCOR O413�FFI1*-*-*. 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. �blic schools are set at 15 ppb. Rule for Public Systems requires that 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 lf both iron and manganese are present, their total va1ue [ / combined shall not exceed 0.5 mg/L. PUTNAM COUNTY DEPARTMENT OF HEALTH OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # T- 0 Located at 5 ' i2OLib oTownr Village Subdivision name 5'T, -E aA6k &', Subd. Lot # Tax Map 1:5 Block j Lot Date Subdivision Approved '% jsr� 1997 Renewal Revision Owner /Applicant Name 11/�ne/_ES /V%wm/o Date of Previous Approval Mailing Address 94l*466 A/Z Zip /Oi° Amount of Fee Enclosed / Building Type 51AI &LE' 24AA4 Lot Area A# AcNo. of Bedrooms Design Flow GPD 4cy Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPUTED Separate Sewerage System to consist of / 00(% gallon septic tank and Other Requirements: To be constructed by Water Sup "I Public Supply From.. or: Private Supply Drilled by Address Address ... _ ..._ .. � _. - -Address .. _ ... ,. �..... _ ..... - _ . I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatmentsystem 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 Signed: Address P.E. Ll R.A. License # Date 0 -o?6• Ar,0 3 APPRO D FOR CO ST UCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new pe t. Approved f r 'scharge of domestic sanitary silwage only. By: Cl�C `� '� Title: :C% - f Date: ' e ?t 3 White copy - HD File; ellow(co�y - Building Inspector; Pink copy - Owner;prange -e6py - Design Professional � Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please 1intor type Well Location: Street Address: o ill Lye Tax Grid # Sr" CccN RVID TYrVffC)1-1 /�/• , Map 15 Block / Lot(s) / Well Owner: Name: Address: el-141246S1*P -1A10 -Uk fMer AM N ,94 Al 1'05# Use of Well: ✓ Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served Est. of Daily Usage &P0 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling _New Supply (new dwelling) Deepen Existing Well Detailed Reason Th t Ier ,a • for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes ✓ No Name of subdivision Lot No. Water Well Contractor: -/V 13E Z),e7zVZ 1A1t0 Address: Is Public Water Supply available to site? .................................. ............................... Yes No /' Name of Public Water Supply,: M Town/Village ,u%/ Distance to property from nearest water main: A&M -0 f Proposed well location & sources of contamination n to be rov' rrs plan. Date: •'Z% flp 3 Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a Ov7 ate well driller certified by Putnam County. Date of Issue �� �1 ' ' Date of Expiration If ' Permit is Non-TrankTerrable Permi Title: White copy - HD file; Yellow copy - Building Inspector; Form WP -97 I I LITVAM _.,......_.. �._.__ NEINEERINE , PLLC. Engineers and Architects _ SEPTIC SUBMISSION FORM TO: �c>5Ef-T I`3of- 4S DATE: PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: 4'1148 -%'Jo SSA (gcr-IEVd�'L�) ENCLOSED,, PLEASE FIND: UK" COPIES OF THE SSDS PLAN ❑ COPIES OF THE HOUSE PLANS ■ ■ ■ ■ REMARKS: COPIES TO: (SepSubForm -2001) CONSTRUCTION PERMIT APPLICATION (Ftrie4kJAL-) WELL PERMIT APPLICATION (0-erJiewk-l) HEALTH DEPARTMENT FEE ($400.00) SHORT EAF DESIGN DATA FORM LETTER OF AUTHORIZATION APPLICATION FOR WASTEWATER TREATMENT (PC -97) LETTER OF EXPLANATION SIGNED: _ i�j�- -Z-tNpio 4 Ow RouTE 6, BREWSTER, NEW YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 - EMAIL: putnamengineeting @nn.com PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL. HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of GN /ac'�I.ES � Q- I r V> Located at '_-n-kGE` 4&AL14 TN P'pr-��b.1 Tax Map # Is Block I_ Lot _A Subdivision of c.�IA Subdivision Lot # Filed Map # 'Z+V5 Date Filed _l 20 98 Gentlemen: This letter is to authorize Ry 7r lPt F-e-IG,,JeEC_ tt � & F LL c- a duly licensed Professional Engineer >-- 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 tretment and/or water supply systems in conformity with th ' ' f:Article 145 and/or 147 of the Education Law; the Public. Health Law, and the Pu ry Code. A., # Mailing Address fnjj DtA> fie_ 5ftW5Ta?- State Zip ID So`i Telephone: s> Very truly yours, Signe . caner of Prope Mailing Address: �/ �; &Jud-C, z4y-i_ State ,� Zip 10 S I Z Telephone: E `{ S - 6c, 1 -2-j 6 Form LA -97 SF.-I.ERLITA— A -MLER, MID, MS,, FAAP. Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Putnam Engineering 4 Old Route 6 Brewster, NY 10509 To Whom It May Concern: ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 October 6, 2005 RE: Marino Stage Coach Road, Lot # 4 (T) Patterson, TM # 15 -1 -14 Reservoir Basin The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on October 4, 2005 is complete. The Department will notify you by October 28, 2005 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. 0 Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. -.._If the.pepartment 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 Ve sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed approved, 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 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 yo Robert Morris, PE Senior Public Health Engineer RM:kly 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 SHERLITA AMLER, MD, MS, FAAP LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Putnam Engineering 4 Old Route 6 Brewster, NY 10509 To Whom It May Concern: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI September 21, 2005 Re: Proposed SSTS: Marino Stage Coach Road, Lot # 4 (T) Patterson, TM # 15 -1 -14 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: 1. The construction permit P -16 -03 expired on August 12, 2005. A renewal for the permit must be submitted.,:... . Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:kly V truly your 6 Robert Morris, P.E. Senior Public Health Engineer 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 7. SHERLITA AMLER, MD, MS, .FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health August 10, 2005 Putnam Engineering Paul Lynch 4 Old Route 6 Brewster, NY 10509 Dear Mr. Lynch: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Re: Field Inspection — Marino Stage Coach Road (T) Patterson, Lot 4, T.M. 15. =1 -14 An inspection at the above referenced lot has been completed. Comments are offered as -follows: - - - -- - -- • This Department is requesting a sieve test of the R.O.B. fill for the above referenced lot. The sieve test must be from an independent lab and the results submitted to this Department. Please note that field measurements by this Department in no way suggest the exact size, depth and location of the fill pad. If you have any further questions, please contact me at (845) 278 -6130, ext. 2261. GDR: 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 Rariv TnfPrvPnfinn/PYO h..1IRdfl1'74_,<!NA V— fOACN' "0 CCA0 . UTNAM NEINEERINE, PLLE - « ~ Eng/neers and Architects "" -'`' " September 14, 2005 Gene Reed Putnam County Health Department 1 Geneva Road 'Brewster. NY 10509 RE: Charles Marino — SSTS PCHD Permit # P -16 -03 Stagecoach Road (T) Patterson, TM # 15 -1 -14 Dear Mr. Reed: In accordance with your letter dated August 10, 2005 regarding the above referenced project I am enclosing a sieve analysis for the existing R.O.B. fill. Please contact me at this office if you have any questions. Sincerely, PUTNAM ENGINEERING, PLLC Richard J. Z4wr. RJZ /ea Enclosure (LO5339) 4 Ow ROUTE 6, BREwsTER, NEw YoRK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 • EmAc putnamengineedng @suscom.net 09/14/2005 10:12 203 - 798 -8966 ESM ASSOCIATES PAGE 02 :,ESMASSOCIA- S-,- INC.' a. ENVIRONMENTAL IENCE MANAGEMENT' - CONSULTANTS L. - - - - - -- - - - - - - - - - - 7 Denver Terrace Danbury, CT 06811 203 M9500 FAX 203 - 798 -8966 Mr. Charles J. Marino 91 Gleneida Ave. Carmel, NY 10512 Sample delivered 9 -12 -05 Site: 221 Stagecoach Rd. Patterson, NY 12563 SIEVE ANALYSIS September 14, 2005 Fax: 845- 228 -5485 Gn- . z ° SIEVE SIZE PERCENT PASSING PUTNAM COUNTY HEALTH DEPT SPECIFICATIONS 3.5 100 100 `.0 97.8 1.0 94.8 0.5 82.9 114 72.5 .10 20 40.4 40 26.5 100 6.9 0-10, 200 3.0 0 -5 ESM ASSOCIATES, INC. Environmental Scientists 7 Denver Terrace Danbury, Connecticut iG Dr. Gene McNamara, CEI President 11/031X2005 THU 09 33 FAX -)-+4 PCHD PUTNAM COUNTY DEiAkTMZNT OF HEALTH DINqSIO-N OF ENVIRONMENTAL HEALTH SERVICES ArfENTION JOSEPH eNGENE RF-OLT,.ST-EQR FINAL WPECTION For: Fill All kdomiation. must be fully completed prior to any, Trenches inspections being made. [it 002/002 PCHD Construction Permit 9 Located: C-en (V) Owner/Applicant Name: CND :PS lnmu,.ka —TM. 19 Block I Lot Formerly: --. Subdivision N ame: 1-51r Subdivision Lot A !;�— Is system Ed completed? 'Date: Is system Gorr�,Plete`l Date: A Is s�siem constructed as per plans? Is well drilled? Date, Is well located as per plans? `Le< Are erosion control measures in place? I certify that the system(s), as'like d-, at the above promises has been constructed and I hayeinspeoted and verified thzir'completion" in accordance with the issued PCHD Construction Permit and approved plazas aml the Staadards,*. Rules and Regulations of the Putnam County Department of Health. Date: Certified b)�. RA Desiga Prof i s onal Address: fV(-,3 xP Lic.4 n(o 446 4- oio Comments: Form FIR.-99 JAN-13-2000 THI-; TEL:845-27e-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 2 P L ITNAM NGINEERING, PLLC. Engineers and , feffleects SEPTIC SUBMISSION FORM TO: F=obE9 C mQ p—e— 1 S DATE: Ei PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: e f4 z—Ll5S I'°`I6zt irlO ., J'�{j . Pr= y1°1 or P-1&-°o3 rt- ENCLOSED, PLEASE FIND: COPIES OF THE SSDS PLAN ❑ COPIES OF THE HOUSE PLANS CONSTRUCTION PERMIT APPLICATION ❑ WELL PERMIT APPLICATION ❑ HEALTH DEPARTMENT FEE ($400.00) ❑ SHORT EAF lJ DESIGN DATA FORM ❑ LETTER OF AUTHORIZATION ❑ APPLICATION FOR WASTEWATER TREATMENT (PC -97) ❑ LETTER OF EXPLANATION REMARKS: COPIES TO: (SepSubForm - 2001) SIGNED: f=p1 c-1e-- Zxpl° 4 OLD RouTE 6, BREMTER, NEw YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 • EMAIL: putnamengineering@rcn.com 30" • P V 11. AM C O U1. T'Y DEPARTMENT MENT OF HEALTH DIVISION OF ENVIRONAIENT'AL HEALTH SERVICES a DESIGN-DATA BEET I - S€T'3l SbJRFACE- SEWAGE TREATMENT SYSTEM Owner Address Ti 5,s,>sfl-j sr, , mAex <_ nl -_(. Located at (Street) 5rk� c ooc_kA —Tax Map I Is Block 1 Lot (+____ (indicate nearest cross street) Municipality. 3 Drainage Basin T--wer- Date of Pre - soaking SOIL PERCOLATION TEST DATA Hole No. Run No. Time Start = Stop Ela se (pMin Time .) D to Water Prom Ground Surface (Inches) Start Stop Water Level Drop Iii Inches Percolation Rate A in/Inch S4 - 2co `JZ 2 2,,o2, - V, alb 30 Z(p 2 14 4 '; 1 o -3 %4C> 24 - 2534 (34 1-1.1 5 �- .... 1 . f , - 2 -aF� 25 ..1-1 . 3 . _. 3 _ 2 3o 2A -- 2-1 2> 10.0 3 26 4 3 11 - 3 tk 3o 2A ZCo 2 15-,o 5 1 2 3 4 5 NOTES: l Tests to be repeated at same depth until approximately equal percolation rates are obtained at eac►l percolation test hole. (i.e. _< 1 min for 1 -30 min/inch, <_.2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. DEPTH . � G z,,. 0.5' 1.0' 1.5' 2.0' 2.5' 4.0' 4.5' 5.0' 5.5' " 6.0' 6.5' 7.0' ALva aad DESCRIPTION OF SOILS ENCOU111TERED IN TEST HOLES HOLE NO HOLE NO. 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: Date Design Professional Name: — F NEW Address: ,4 ' oc- i. l -- ,�� �r� � yc f� � 1`Q �'�- (GL.J5 i �'►2 n��i:, to�D`� C') cc i e Signature:�� Q674 AR�FESSIU`iy', Design Professional's Seal AM COUNTY DEPARTMENT OF HEALTH 1, K OF ENVIRONMENTAL HEALTH SERVICES ,RUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM„ ... ; PERMIT # ° I Located at �5T e-oAc_tk Rcvk Subdivision name £' i,.K_, Subd. Lot # Date Subdivision Approved ']IZI3�ej Owner /Applicant Name C1}-AX4.5 MAXi,l© Mailing Address Town or Village Tax Map 1 Block �_ Lot Renewal Revision Date of Previous Approval a Amount of Fee Enclosed R �co ®Eo &Lt rp 1e' � w r Building Type Lot Area i# --No. of Bedrooms Design Flow GPD Zip o5 I Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of gallon septic tank and 4-w t. r Other Requirements: /i �- .C���, BLA, ( a3_ `I l To be constructed byj;; 'qtr -��iJD Address Water Supply: Public Supply From °Private-Supply`Drilled'by' `c" —6 ►�:9%- > Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. K R.A. Date -O29 oS Address''y.T,JArn a_v� po.r T Cry 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 whe co sidered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permi . proved f scharge of domestic sanitary sewag only. By: Title: Date: 7� a White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Fonn CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES please print or type PCHD Permit # F— I (V —0 3 Well Location: Street Address: Town/Village Tax Grid # 6066 60AC " 62,0AV pp-r re*sc.•' Map J 6 Block ) Lot(s) j Well Owner: Name: Address: 6-11kRLeS MAV- 0 —11 6&4D'y i -( , MA00 AC o�Y. ia5$8 Use of Well: —,>4 Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served Est. of Daily Usage Cv00 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason 65.0 'G, LL- °' ,, iar- -t Pee>lce Z for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding. ....................... Is well located in a realty subdivision? ...................................... ............................... Yes No Yes '>4 No Name of subdivision 5;�� coNUA �Q 0C • Lot No. _ Water Well Contractor: i o 66 ps-- ;wJGD Address: Is Public Water Supply available to site? .................................: ............................... Name of Public Water Supply: tJ A Town/Village Yes No es! A Distance to property from nearest water main: C4!� Cep- - 0 r- rl ►'.c Proposed well location & sources of contamination to be r Dafe... �. .... _ .. _ '�� � " "� � Applicant Signature: •� .. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. ,Ad revision or alteration of the approved plan requires a new permit. Well to be constructed by a water ell ller ified by Putnam County. / , Date of Issue 101alo r Permit Issuin Date of Expiration v "" Title: Permit is Non- Transferr ble White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 '9 UTNAM NGINEERING, PLLC. Englneers and Architects SEPTIC SUBMISSION FORM TO: P-M�-" r6(z(Li5 DATE: dl/-, o5- PUTNAM COUNTY `HEALTH DEPARTMENT PROJECT: GkP� -Le� 1'`]�2►�0 2Z1 5-�c�E ���kt (Lr��p Chmil: f,-16-05 ENCLOSED, PLEASE FIND: . L:1 COPIES OF THE SSDS "AS- BUILT" PLAN CONSTRUCTION COMPLIANCE CERTIFICATE OJ WELL LOG 0 REMARKS: COPIES TO: (SepSuAFo m -2oM) HEALTH DEPARTMENT FEE ($300.00 ) WATER ANALYSIS ... UAR.ANTEE FORMS - 3 ORIGINALS E 911 ADDRESS FORM. LETTER OF EXPLANATION SIGNED: 4 Ow RourE 6, BREWsrER, NEw YoRK 10509 • (845) 279 -6789 • FN( (845) 279 -6769 • EmAtu puthamengineering ®rcn.com I . 1b 08/104/2005 THU 14:47 FAX PCHD. 0002/002 . PUTNAM COUNTY DILPART=ff OF HEALTH DIVISION OF ENVIRONMZNTAL MWALTH SERVICES ATTENTION JOSEPH �IB REQUEST )FolLIWAL zispE cnQN For: Fill X All information must be fully completed prior to any Trenches inspections being made. PcHD construction permit # F— 14o —o3 (V) Located: :2y (1) Owner /Applicant Name: 4ghy--L_q� r)►&Ljy TM 1S Block I Lot j_1f_. Formerly: Subdivision Namt: 6 Subdivision Lot Is system fill completed? YAS Date:_ Is system complete? jLJA Daft: is syd= constructed as per plans'? tAIA Is well drilled? Date: Is well located as per plans? 0- 1A Are erosion control measures in place? Iic I ceftifythat the . system(s), as listed, at the above premiats has bees constructed and I have Inspected and verified their completion in accordance with the , issued PC.HD Construction Pe=t and approved plans and the Standards, Rules and Regulad6mm, of the Putnam 'County Department of Health: - RA Datc certified Desip Wofessional Address: F ' AQW0 04Wnt Lic. # o Co-7 4 Comments,: 011r--d-PV1Rc-% THII 14-P7 TFI:845-278-7921 N41E:PUTNAM COUNTY DEPARTMENT OF P. 2 PUTNAM COUNTY DEPARTMENT OF HEALTH ,. DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION g /os Date: Inspected by: Street Location ST, 44 G - Owner Town Permit # e� - 1 - v TM # / t—,,— Subdivision Lot # 1. Sewage 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. 100' from water course / wetlands ...... ............................... IL Sewage System a. Septic tank size 1,000 ........1, 250 ......... other ................ b. ' Septic'tank installe evel ........... ............................... .. c. 10' minimum from foundation .................................. I...... 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 // Bo Length installed _f 2. - Distance to watercourse measured ..¢- i o o 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 - 11/2" 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, visual / audio ........:........... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baMed .......................... ............................... 6. Cycle witnessed by H.D.estimated flow /cycle........:.. 111L House/Building a. house located er.approved plans ............. ................ b. Number of bed looms ................ ...3.... �............. IV. Well wl vh 'H -`S',c e Ait,,' Well located as per approved plans . ......:........................ s b. Distance from STS area measured 38 c. Casing. 18" above grade ................ ............. ................... , I9 d. Surface drainage around well acceptable .......:............... V.. Overall Workmanship A.. Boxes properly grouted ................... ............................... b. All pipes partially baclfilled ........... ............................... 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 & dinto exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate .................................... i. Erosion control provided ................. ............................... Rev. ?2/02 ,,, s1 .- .,.,... . ... v .-- r 1 r - SrrE RjSPgCYTON FOR FILL PAD' Date: 8 O Inspected by: Fill pad located per the approved plan �� ,c,, e? Pei �aK Fill Pad Length U� .'Q,�, s Required Length Va `� s . � Fill Pad Width &5�P - /l g5 Required Width Fill Pad Depth , S Required Depth Run -of- -Bank Fill Quality Slope from Top to Toe Impervious Layer Installed Y el- S Erosion Control Installed �lP 5 Sieve Test Results (if applicable) �)3 , Additional Comments: A, X C) Q 5,f�� Reserved for Field Sketch if Applicable UTNAM NCINEERINC, PLLC. Eriglnee�s anrJ-ArchlCects °" ` ' �" SEPTIC SUBMISSION FORM TO: i J'b�% IY�%/2/�J,�, P.. PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: G "f�i�•�'LES /;///).p 67a) ENCLOSED, PLEASE FIND: J COPIES OF THE SSDS PLAN ,I q -7 rad COPIES OF THE HOUSE PLANS LJ CONSTRUCTION PERMIT APPLICATION Ll WELL PERMIT APPLICATION HEALTH DEPARTMENT FEE ($300.00) Ll SHORT EAF DESIGN DATA FORM LETTER OF AUTHORIZATION DATE:_'' APPLICATION FOR WASTEWATER TREATMENT (PC -97) El LETTER OF EXPLANATION REMARKS: COPIES TO: oxi 8'a0z • SIGNED: 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 - (845) 279 -6789 - (845) 279 -6769 - NrAiL: puteng @bestweb.net w UTNAM r r= NGINEERING, puc. Engineers and Architects SEPTIC SUBMISSION FORM TO: ' PUTNAM O EALTH DEPARTMENT PROJECT: ENCLOSED, PLEASE FIND: ❑ COPIES OF THE SSDS PLAN 0 COPIES OF THE HOUSE PLANS ❑ CONSTRUCTION PERMIT APPLICATION ❑ WELL PERMIT APPLICATION ❑ HEALTH DEPARTMENT FEE ($300.00) ❑ SHORT EAF u DESIGN DATA FORM Ll REMARKS: COPIES TO: LETTER OF AUTHORIZATION DATE: gw' .�?O ®3 APPLICATION FOR WASTEWATER TREATMENT (PC -97) LETTER OF EXPLANATION SIGNED: 5u' 4 OLD ROUTE 6, BREWSTER, NEw YORK 10509 • (845) 279 -6789 • FAX (845) 279 -6769 AIL: puteng@bestweb.net CTNAM COUNTY DEPARTMENT OF HEALTH �'VISION OF ENVIRONMENTAL HEALTH SERVICES gMENTSYS E SEWAGE IGN DATA T rAT Owner Ad�ress 7, 7 Located at (Street) 6M z746! Tax Map Block Lot (indicate nearest cross street) Municipality IOA7-7-4p_,Sn6l - Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre-soaking dl.lb• Date of Percolation 'Test �17,RIV3 Hole No. Run No. Time Start - Stop Elaq Time in.) Depth to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 3 -let 56 VA1,11d. 2 do 'd 4 3 J ao;l 4 4 5 -5 19 2 3 mw d 4 o.` 19 -tea' 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are Mained a! Moil percolation test hole. (i.e. ; I min for 1-30 min/inch,- <_ 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. .__ ..._...DEP -TH 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' iMj0i rlt :Lt�lt% DESCRIPTION OF SOILS ENCOUNTERED IN' TEST HOLES HOLE.NO. HOLE NO._L HOLE NO. Wj SL. A4077!1AA'Po?r6.a M1vT7iVA11►j'a' 1,a " Indicate level at which groundwater is encountered Indicate level at which mottling is observed o?' - -lam " Indicate level to which water level rises after being encountered Deep hole observations made by: 6exle �EE'7� PcNn -P jc�*,,o 7rA4,, 1° €, Date �•1'7• ;ro3 Design Professional Name: rrIz I/� i ilOC1Rn Urninccinnal�c .Cani of NE�y el� 4,D, rtiAE4 f 3^ tM -� August 25,,,2003 ZI P EY- Ei LITNAM I INEERINEPLLE. In response to a letter from Robert Morris, P.E. dated August 20, 2003 regarding the above, we have revised the attached plans. Specifically, the following is offered: 1. A minimum of 10' has been provided from the toe of fill to the property line. 2. The reserve area has been extended as required. 3. The proposed fill extends 10' horizontally from the edge of all absorption trenches. 4. Due to the constraints of this previously approved subdivision lot, the toe of fill cannot be 100' from the existing stream along the properties frontage. A waiver of this requirement is therefore requested. Please note, that the absorption trench is in excess of 100' from the stream. 5. Revised plans were previously submitted to the New i'ork City ' epartmentoftn Protection (NYCDEP) as requested, and NYCDEP has issued a no objection letter regarding ., the approval of the project. 6. A minimum of 2.5' of fill is provided for the entire SSTS. Portion of the right side of the system have been eliminated to accomplish this. Upon your review of this information, should you have any comments or questions, please contact me at this office. Very truly yours, PUTNAM ENGINEERING, PLLC Gary A. Tretsch G A T/rk Enclosure cc: Charles Marino tL03436) 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 (845) 279-6789 FAx (845) 279-6769 EMAIL: puteng@bestweb.net Michael Budzinski, P.E. Putnam County Health Department Geneva Road Brewster, New York 10509 RE: Marino Stage Coach Road Town of Patterson Tax Map #15-1-14 Dear Mr. Budzinski: In response to a letter from Robert Morris, P.E. dated August 20, 2003 regarding the above, we have revised the attached plans. Specifically, the following is offered: 1. A minimum of 10' has been provided from the toe of fill to the property line. 2. The reserve area has been extended as required. 3. The proposed fill extends 10' horizontally from the edge of all absorption trenches. 4. Due to the constraints of this previously approved subdivision lot, the toe of fill cannot be 100' from the existing stream along the properties frontage. A waiver of this requirement is therefore requested. Please note, that the absorption trench is in excess of 100' from the stream. 5. Revised plans were previously submitted to the New i'ork City ' epartmentoftn Protection (NYCDEP) as requested, and NYCDEP has issued a no objection letter regarding ., the approval of the project. 6. A minimum of 2.5' of fill is provided for the entire SSTS. Portion of the right side of the system have been eliminated to accomplish this. Upon your review of this information, should you have any comments or questions, please contact me at this office. Very truly yours, PUTNAM ENGINEERING, PLLC Gary A. Tretsch G A T/rk Enclosure cc: Charles Marino tL03436) 4 OLD ROUTE 6, BREWSTER, NEW YORK 10509 (845) 279-6789 FAx (845) 279-6769 EMAIL: puteng@bestweb.net d AO iN3WIdUd30 AiNnoo WUNind:3WUN bdb4-dz-r--5WU; I=U oz 5 1• 1 In-L e—Welt. 1� 1491, 0 11 - 011 Robert Morris, P.E Putnam Co. Health Dept 4 Geneva Road Brewster, NY 10509 Re: Stage Coach Rd./Lot 28/Marino. SSTS Stage Coach Road Patterson-Pum= East Branch Reservoir DEP Log# 12955 (joint Review) Dear Mr. Morris: This letter is to info= you that the New York City Department of Envirorunental Protection (Department) has determined that the above- referenced application is complete. Ja addition, the Department has no objection to the approval of the above-referenced regulated activity. This determination is based on the review of submitted documents including the•lan titled "SSTS Plan and Details prepared for Charles Marino", dated 04/16/03 and last revised 8/20/03. The applicant must contact Sissy De La Ossa of my staff at.(914)-,77344l6.at least 2 days prior to the start of construction of the SSTS so that a Department '_ representative may inspect and monitor the installation. Sincerely, V, Danny Shedlo, P.E. Project Manager Engineering Design & Review xc: John M. Dunn, P.E., NYSDOH b0 : 9T jo, TZ End JVO-5IZ-VT6: x2J 9NId33NI9N3 d3a DAN : »-.LOR£TTA- MOLiNARI °R:N ; `k. '.N:. • :. - ;. 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 Gary Tretsch, P.E. Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Re: Proposed SSTS: Marino Stage Coach Road (T) Patterson, TM# 15 -1 -14 Dear Mr. Tretsch: ROBERT J. BONDI County Executive August 20, 2003 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: 1. Minimum distance from the toe of the fill to the roP e rt3' line is 10 feet. P Reserve area appears to be short in length by 45 feet. - . - Fill"is to'ext' 10-feet-horizontally from the`edge 6f the absorption trench. . Minimum distance from the toe of the fill to the existing stream is 100 feet. 5. Please submit two sets of trench plans with the revisions. One will be reviewed in this department, the second will be forward to New York City. Department of Environmental Protection. ✓6 The minimum of 2.5 feet of fill is to be provided for the entire SSTS. Portions of the right side of system does not appear to provide the adequate depth of fill. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. V y yo Robert Morris, P.E. Senior Public Health Engineer u I 40 Department ,of Environmental Protection. August. A3,.20.03,4. -_,-.:_, . _...-.. _... . Robert Morris, P.E Putnam Co. Health Dept. 4 Geneva Road Brewster, NY 10509 Re: Stage Coach Rd. /Lot 28 /Marino. SSTS Stage Coach Road Patterson - Putnam East Branch Reservoir DEP Log # 12955 (Joint Review) Dear Mr. Morris: Please note, the following comments regarding the system design: Bureau of Water Supply Michael A. Principe, Pn.M 1. Trenches at the reserve area are short by 45 feet. Deputy Commissioner Tel (914) 742 -2001 2. Appendix 75 -A.4 -b states that the separation distance from raised i= axtsta >rr3-03a3 systems should be measured from the toe of slope of the fill. At the above referenced project the distance between the toe of .._�... �._ ...__ ..:._...:.:...._:. _:..:._....:slQpe:of.the' fill . and. . the - property_ line .does..not'meet.the..requiced. �._. _ ....._ 10 feet. If you have any questions regarding this matter, you may contact me at (914) 773 -4416. Sincerely, Sissy De La Ossa Assistant Civil Engineer Engineering Design & Review xc: John M. Dunn, P.E., NYSDOH Public Health Director „ LORETTA . M_OLINARI .R.N,,. M.S.N. Associate Public Health Director - Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brtwster, 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 -5912 • Fax (845) 228 - 6113 FAX COVER SHEET Date: To: From: Robert Morris, P.E. Senior Public Health Engineer Emergency Response Coordinator kz-E - it No. Pages S (Including cover'sheet) "`o1r.your information Please respond _ - For your review As discussed Attached as requested Please call Notes/Messages wool D o d D A'L PA u &. 4'0M&ZaJ,9— � . '1 R 0 - SJ &Mt` 1vkJ$' T- M R16 ` 4 ' ®�1 ail ® & 6 S o— pr v o V UAW In the event of transmission /reception difficulties, please contact this office at (845) 278 -6130 ext. 2166. Acting Public Health Director Director of Patient Services ti..�..r. __. .- .-ROBERT-'J..BONDI''... County Executive 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 Gary Tretsch, P.E. Putnam Engineering 4 Old Route 6 Brewster, NY 10509 Re: Proposed SSTS: Marino Stage Coach Road (T) Patterson, TM# 15 -1 -14 Dear Mr. Tretsch: June 4, 2003 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: 1. It is-.strongly advised that Putnam County Department of.Health:.forms that are in quadruplicate not -be submitted using computer generated forms. These forms are available in this office. This will expedite the approval process and simplify future inquires into these applications. 2. Construction permit for S STS has been photocopies. Original signatures must be on all documents. The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:tn Ve ly your , Robert Morris, P.E. Senior Public Health Engineer i Acting 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 Gary Tretsch, P.E. Putnam Engineering 4 Old Route 6 Brewster, NY 10509 RE: Marino Stage Coach Road (T) Patterson, TM# 15 -1 -14 Reservoir Basin Dear Mr. Tretsch: June 4, 2003 J. BOND1 County Executive The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on May 28, 2003 is complete. The Department will notify you by June 25, 2003 of its determination. ❑ The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ® Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require 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 °"` Enyl�ieers `aricl'Archftects�_..;�:.�� � ..: �: ,... n._ ,�...- �-- -.� - -_ -�. •.,,.:..�. _ SEPTIC SUBMISSION FORM TO: '/A0,wor /go/u/53 yc��- PUTNAM COUNTY HEALTH DEPARTMENT PROJECT: Ll, �1449495 A1,0121A40 (7-)6ZJ, (7-M /J;-- I - /4 DATE: 5'-V, 2C08 ENCLOSED, PLEASE FIND: lJ t COPIES OF THE SSDS PLAN 3 , SDP /ES 0 �iLL PLAV COPIES OF THE HOUSE PLANS CONSTRUCTION PERMIT APPLICATION ®' WELL PERMIT APPLICATION HEALTH DEPARTMENT FEE ($300.00) SHORT EAF ELK DESIGN DATA FORM ❑ LETTER OF AUTHORIZATION 2 APPLICATION FOR WASTEWATER TREATMENT (PC -97) ❑ LETTER OF EXPLANATION REMARKS: COPIES TO: _ SIGNED: 4 OLD RouTE 6, BREWSTER, NEW YORK 10509 (845) 279 -6789 • FAX (845) 279 -6769 EM r.: puteng @bestweb.net PIJTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of �?114?tFS Art /1,e/,V 0 Located at 57,,4&E 6da Zb. & 49W " 'T0,5 Tax Map # Subdivision of /.5 Block 1 Lot /yZ Subdivision Lot # Filed Map # c� c? Date Filed 7 , !qk Gentlemen: This letter is to. authorize a duly licensed Professional Engineer ✓ 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 Pumam 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 confoirhity'with the provisibns ofArticle 145 and/or 147 ofthe Education'Law; the'Public Health Law, and the Putnam County Sanitary Code. Mailing Address 1'u/�I ,�i�l�riz /itlLy // OLD RN75 �, i6,,e,7-,&_ State Zip !o Telephone: A5JN*b7WV Very truly (Owner of Mailing Address: 77 .Sq� g( State— �4` Zip /0 J Telephone: rrL(� - Z:7-r- %C)OC) — PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR T „_...:... , A WASTEWATER TREATMENT SYSTEM--, 1. Name and address of applicant: C/11444ES "41ellya 2. Name of project: 61114aZAS /r PlAlb 3. Locatio &: 7"z-Z,SOnI 4. Design Professional: 4ry.4,rh,6,---6/yaie/� 5. Address: -'/ 01_0;2P0� 6 6. Drainage Basin: Am, 41G®Qk 0 //< /J 7. iype.ofProject 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 (SEAR)? Type Status (check one) ......................: ............................... Type I Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... ti!o 10. Has DEIS been completed and found acceptable by Lead"Agency? ................ rev 11. Name of Lead Agency 1014 12. Is this project in. an area under the control of local planning, zoning, or other. officials, ordinances? .... ............ .. ES . :.ne.,. .. ut ra. ..... _.... «._.. ..«. .._... «....... «. .ra .�. Y_�.. .. ..: . .. ... ... �. •. - -n w.r_ �. .._._ _.r_. Y.....« �. r „I. 13. If so, have plans been submitted-to such authorities? 14. Has preliminary approval been granted by such authorities? Date granted: NO 15. Type of Sewage Treatment System Discharge ................. surface water ✓groundwater 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? ................. ..... iU0 19. If yes, name .of water. supply _ Distance to water supply . / Aar' 20. Is project site near a public sewage collection or treatment system? ................ 21. Name of sewage-system Distance.to sewage system Z-0—mvf 22. Date test holes observed -17/d-v7d0 •23. . Name of Health Inspector��E�EE� 24. Project design flow (gallons per day) ................................. ............................... � 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... /\10 26. Has SPDES Application been submitted'to local DEC office? ......................... /•10 Form PC =97 7, 27. Is any portion of this project located within a designated Town or State wetland? d 28. Wetlands ID Number.............................................. _ 29. Is Wetlands Permit required? .............................................. ............................... AJO -. 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, landfilling; sludge application or industrial activity? ............... .............. Yes/No . iJO 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, /•1� DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .............. ............ Vie 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... X10 35. Are any sewage treatment areas in excess of 15 % slope? . ......:.:.................:..:. /elm 36. Tax Map ID Number .......................... ............................... Map /5 Block /Lot Lot 37. Approved plans are to be returned to ..... Applicant v1 Design'Professional NOTE:.All applications for review -and approval of anew 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 L,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 ClassA misdemeanor pursuant SIGNATURES & OFFICIAL TITLES Mailing Address: .................................... m 14.181 (9195)_Text 12 PROJECT I.D. NUMBER 617.20 SEAR Appendlx.C. State Environmental Ouallty Review' �- SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS. Only PART I— PROJECT INFORMATION (To .be completed by Applicant or Projedt.sponsoi) 1. APPLICANT ISPONSOR C/,�•q�2L�s V,4121Al0 r QM , i�lCrJh/ 2. PROJECT NAME ,4 LAS d/ 11,10 J. PROJECT LOCATION: Municipality P/' ��(� . County 41 /�%Q/t%% 4. PRECISE LOCATION (Street address and road Int rsectlons, prominent landmarks, etc., or provide map) S. IS PROPOSED ACTION: E New 0 Expansion 0 Modlficatlonlalteratlon 8. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately �� �� acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? LK Yea ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? LW'Resldentlal O industrial O Commercial O Agriculture . .O ParldFofesUOpen space ❑ Ottler Describer 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ,,--.��.J' �� 0 `L Yes No If yes, list ageney(s) and permll1approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A WAHENTLY VALID PERMIT OR APPROVAL? 0 Yes O If yes, list agency name and permlUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMITIAPPROVAL REQUIRE MODIFICATION? 0 Yes [a <o 1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE . a11Al2L ,5`5 9,4121AIV 1/21jlrwwg N Date. ✓ °�1l a�OdJ� AppllcanUsponsor name "'" ` Signature: If the a ion s In the Coastal Area, and you are a state agency, complete the C" I Assessment Form. before proceeding with this assessment OVER 1 I� PART 11-- ENVIRONMENTAL ASSESSMENT ([o be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes ,.coordinale.the.review.process and use the FULL .,: ❑'Yes .o . - . . _ . _. , .�... _ . B. WILL ACTION RED EIVE C60ROINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another Involved agency. I_ Yes No C. COULD ACTION ESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Ar =veers may be handwrilten 'll legible) Cl. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosiion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural. archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: Iq o 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. l' w C6. Long term, short term, Cumulative, or other effects not Identified in Ci -057 Explain briefly. `vl./ C7. Other impacts (Including changes in use of either quantity or type of energy)? Explain briefly, D. WILL THE PROJEC T HAVE AN IMPACT ON THE.ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? -' _'— ❑'Yes•_..._. .�o. :� -.: � :. _ ....... ......._.,__ .._....... _.-- - -- - =.__ ._._..._..._.__.. �..,. -._. _. >.. ... ..___..... . E. IS THERE, OR IS tHERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes !1[No If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (ro be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether It Is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (f.e. urban or rural); (b) probabfllty 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 and 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 ccur, Then proceed directly to the FULL .EAF and /or prepare a positive declaration. Check this box If you have determined, based on the information and analysis above and any supporting ocumentation, that the proposed action WILL NOT result In any, significant adverse environmental Impacts AND provide on attachments as ne essary, the- reasons supporting this determination: a 114wei, #e,te , . I/P. P e1. - /dole ilk PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner. ZI 4121AJE) Address. Located at (Street) 73112�--y yZ41 Tax Map 15 Block Lot (indicate nearest cross street) Municipality Watershed 2W57– -Bj?"e-d SOIL PERCOLATION TEST DATA Date of Pre-soaking — I/ /A6 Zev 3 Date of Percolation Test yl / 7. 613 ............ . . . ......... IX ............. . ........... . ..... . ... ...... .... .... . . ......... . ..... t »:: >:: >::::<: X::': :nc: esl:-. >::;> :7:: X: C/ 2 A17 3y, 3 0 NY 4 5 --73 2 IM32 — la,'3.9 7 3 /o1j,0 - /0., 4e? 91 3 -/af 2-Z 5 2 3 4 E : 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I 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 , TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE No. S HOLE NO. G.L. 0.51 1.01 2.0' 2.5' 3.01 3.51 4.0' 4.51 5.0' X 5.5' 6.01 6.5' 7.0' HOLE NO. 07 141 j MAP, ,a 7-5 - -4 0 . -.4 of Indicate level at which groundwater is encountered 411,0 Indicate level at which mottling is observed 3 o Indicate level to which water level rises after being encountered Deep hole observations made by: 17, H Date !Y11 7 03 Design Professional Name: Address: Signature: Design Professional's Seal 7.5' 8.01 8.51 9.5' 10.01 HOLE NO. 07 141 j MAP, ,a 7-5 - -4 0 . -.4 of Indicate level at which groundwater is encountered 411,0 Indicate level at which mottling is observed 3 o Indicate level to which water level rises after being encountered Deep hole observations made by: 17, H Date !Y11 7 03 Design Professional Name: Address: Signature: Design Professional's Seal Ilk PUTNAM COUNTY.-DEPARTMENT OF HEALTH • DIVISION OF ENVIRONMENTAL HEALTH SERVICES ®� DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner �s Mlljp Address S?'i9A g Located-at (Street) 3 =j/ N /L,z PI/ Tax Map 15 Block _L Lot �! (indicate nearest cross street)' Municipality � T� s ©iV Watershed 4� 6 —/ luen', SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test 1 2 3 4 I ._ .. 1_ is 1 5 1 f 1. Tests to be repeated at same depth until approximately rates are 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. TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES _. _HOLE NO.,� . - -_ IOL;E NO::_ . . HOLE NO.' XT- 4:U',G t \J tr C � 6.0' 6.5'. 7.0' 8..0':. 9.0' 10.0' 2 M Indicate level at which groundwater is encountered a Z .11 — A/o% i t Indicate level at which mottling is observed /;z ' r wale # / Indicate level to which water level rises after being encountered Deep hole observations made by: 43c Ze -:7 ? G ,17 n Date Design Professional Name: Address: Signature: Design Professional's Seal e 'PUTNAM COUNTY DEPARTMENT OF HEALTH .. .D.IVIS.I_O-N- OF.ENVIRONMENT`AL HEALTH SERVICES. INITIAL INDIVIDUAL /COMMERCIAL SITE INSPECTION FORM SECTION A: GENERAL INFORMATION Name of Project &Milio. �(' V) PA-TlgfZS,0A) County P�Win/ �f Site Location -,.07' nL IF Building construction begun Extent Is property within NYC Watershed ? ................. 0 Yes No SECTION '.B.. TOPOGRAPHY (Please;check all appropriate boxes) 1. -dilly I Rolling dSteep slope a Gentle slope F7 Flat 2. F7 Evidence of wetlands 0 Low area subject to flooding Bodies of water El/ Drainage ditches © Rock outcrops 3. Property lines or corners evident....... .......... 4. 'Do water courses exist on or adjoin the-property? ............................ 5. Will these affect the design of the sewage system facilities ?............ 6. Do watershed regulations apply in this development ? ................. ....... 7 Will extensive grading be necessary? ................. ............................ .... Xes ElNo Kly-es No 0 Yes M 'No I jes No 0 Yes Q No 8. - Wiill extensive fill beiiecessary "for SS' TS?........................................... /Yes No 9. Do filled areas exist within the SSTS area? ........ ........................ ...:.... a/ Yes F-1 No If yes, what is the condition of the fill? SECTION C. SOIL OBSE VATIONS 10. Appearance of soil: ffiand,' 0 Gravel Et Loam a Clay F—I Hardpan E:] Mixture 11. Observed from: F-__� Borings F7 Bank cut F71 Backhoe excavations . 12. Soil borings /excavations observed by on �11 7 .e3 i 13. Depth to groundwater r a g e A z 14 F,ve; a v e, on 14. Depth to mottling �, �,r / ? ,` / 141-er 3,9 on 15. Are test holes representative of primary & reserve areas ...... ............ .................... 16. Soil percolation tests made by M i�FO on 17. Soil percolation tests witnessed by on SECTION D (on back) X Form ST -1 2 SECTION D. DRAINAGE 18. Will proposed grading materially alter the natural drainage in this or adjacent areas? es No 19. Will groundwater or surface drainage require special consideiation? ..................... Yes No 20. Will gullies, ditches, etc.- be filled and watercourses be relocated ?..... Yes No SECTION E. REMARKS 21. If a common water supply is proposed; has an inspection been made of the existing or proposed source and facilities? ...................................................... ......... Y6 No Inspection data 22. Do adjacent wells and/or sewage systems exist? .............................................. ....... ffYes 0 -No 23. Additional comments 24. Site observer/inspector and title 6 T '-- C 25. Date(s)-of observation(s)inspection(s) ZI 7 ZO 3 TEST PIT PROFILES Hole # Lot # Hole # 'Lot # -Hole# Lot # Depth to water Depth to water Depth to water D�epth.tp_motfling Depth to mottling --Deph to-mottling-­ .t Depth to rock/imp. Depth to rock/imp. Depth to rock/imp. G.L. G.L. G.L. 0.5 .0.5 0.5 1.0 1.0. 1.0 2.0 2.0 2*.0 3.0- 3.0 3.0 4.0 4.0 4.0 5.0 5.0 - 5.0 .6.9 6.0 6.0 7.0 7.0 8.0 8.0 8.0 9.0 9.0 9.0 10.0 10.0 10.0 02/10/2003 17:11 FAX 845 2796769 IL BRUCE R. FOLEY Public Health Director PUTNAM ENGINEERING -+ PUT CO HEALTH DEPARTMENT OF HEALTH I Goneva road Brewster. New York 1.0504 li jool /001 LORETTA MOLINARI. R.N., M.S.K Associate Public Health Director Director of Patient Services ATTENTION: ❑ ADAM STIEBELING NIdGENE REED All information below must be fuU completed prior to Any scheduling. DATE: ��� I l ? --o'�� ENGINEER OR FIRM: �J—PJ ell I ' :w ,(C lr�( s- 'C C PHONE REASON: DEEPS:.., IPERCS: PUMP TEST: o ROAD /STREET: 9- OV'Kj TOWN: _ 19t_)_7 41 °`J � TAX MkP #, 1.5' SU13DIVISION: LOT#i: OWNER: ,,l u V%71 VLSI YES N _ ....._.... _.,. �__..._.._.. ❑__._,, Proposed S &TS within the drainage basixr• of4V -est-ih- sach-Ior-BoydsCorner Reservoirs. - ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ T_i�~ Proposed SSTS within 200 feet of a watercourse or a DEC wetland. o Proposed. SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ya to any of the questions, WCDEP must witness the soil testing. This Department will coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil. testing with NYCDEP. L AyG�L�� COUNTY USE ONLY p t (FIR LDT6ST) �` //� 3; - /� r� Ir ®6.. FEB -12 -2003 WED 16:06 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 q' SCALS IN 1110 OF AN INCH 1- 800 = 345-7334. r . ,....,.� _ .......n 916000:..- ...a_..: � : _ _, _ �:.- ., <.:. - ,:- �..._._ _ � _- - -- - ....�....- - - �•�- - ,- ...�.�Tw -: :_.- - - - - =r'_ - �-== w • ��- - - - - -- P/0 4.1-71 � -/ / 19. 399.43 : I I I tl r . WI t 6.89 AC 139 20 I a' Ij 18.28 AC. LC< 1 ill , tocsl 16o1.ee I I �1 '.540.07 •I _ I IQ 9�1 R i I I I I I I� (° Ia I I I I m Y3 Y4 15 .\ 11I.A' 4 16 ^4.84 AC 144.19 AC. CAL. ` 22 95.11 AC. Pj - 6y.044 12 1.aeac A 25. i•r 0 22.79 ACI -- q 2.73 AC a� 1.84 240.99 291.4 i 20.4010 . LT;� AC . g 90 ,�• 6io 30414 26 / ap � ,r•i ,�o'� g g 53.73 AC. CAL. �• ,y 30 AG (OECD) a \� 31 � 25.90 AC 18.26 AC. �n� ,�, 1�•la 1peto \ 29 20.0 AC. 30 1 ' 8+ 204 21 &21 210 1, ''� 26.09 AL. LAL. I ul. HAVILAND � 28 * .'' " K 7 8.03 AC. CAL. AL AL AL J # 0 4 !6 270 16.14 AC. CAL a Gael' � i 4 116 Aj C�6L. 4 O 4.55 AC.•.& ' 6 e 5.99 AC..,`� I Fes. CAL sae ` 3 AC. .`,e -. P 39.2 0.34 At 37 116.88 1 . , _1 I t,�A.,­.,__. ­ Located�at' ; Tax, Map Subdivision: Wt # LD�.X f Date,q, Previous !Appi6iiilq H E.' �.R,E;N 1 fame '2 5 6`q­ 4s' Type Lot Fill Sqctipp only ❑ .4 Number of .Design 10_w - G/P/b r R. �oii fi6 _ati on Reqw L r -77 C ;with o Gal."-'S6p "and Q 0, Jteb.: h' Separate 'Sewerage System' '1' 1 f 24 g:, p,.:p &.'1.000 -5 D a —pl,pp pit To be constructed Adilre, by over fl, ow ..t la n X ,p,",. Whiter Supply:� Public F lvateSupplv','a d �,Oux. aj,n.::, 'r` a -66,6- t_ "'d �.,cqih*plptdlV,,r-gkp'g��ible::f or,,thiii� location ',-�iRfth �151_ _r sent 1hitTerh wh6rily. i6sed*1:AyA6rn(i;'. U­,thAt,,!Pe separate .sewage-I'lillspo'sal iiisiern a 9F with the standar s-,-rules and r ulatiOnS of Ane�­Puznam atiovii disc�iliiilid•will be coristructbd,as.ill�bw. in accordance t., eg 06 d t" pva� Tent o D -o -HeaItP,"a_'q,_d't6_ I"' mpl6tidri therebf . b"!-Cliertil to the Comm lisloniir'of �Healthwlll Ic;tq __Al -.o4r!ty qpa!tment� be i6brhittiiid - to' -'the 66-pa-Atn'-ent and 'a 'Wriftili guarantee,'wili be u�r'q­ j shed '6i;owne'r is successors, he is,6rfasslqns by the•ouiioe►, that said builder' will , pla' ceA n,goo dfooiratlrg�c onckiqj%any part of 'd 'd --t' iod of two (2) years Immediately following the date of 6"a, I itu a6cje.,.,df,t a approval of .'l ih i Certificate i -'t e,of ;ConstrUcto'n,CC 0 a original the, liNd W ii a�066d_ � 'b ova will be as-shoWnqnjh e;approve d that co r d ar rules and r 7`u a ions, of the" P4i nam o%rty-j Depar tinent of Health Z Date Aug 2 8 ­199 3' I E: X, Address License No. L6 1 APPROVED FOR CONSTRUCTION This ,approval -,expires,, less 'construct on of .'ih'* undertaken and is of �'kiiilth ti S -1 1 erati n 0 revocable for cause or maV�Wel�;qAdid'oji�rnod If iiid-Whin Any 'chanje 0 of, construction ruc on requires -a new permit Approve /d ., or disposal - of doiiesiic , sari water supply only Title itl Rev `9 81 0 DEPARTMENT OF HEALTH Division of Environmental Health Services A TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 E� ._ <....._ _.._..., _ -._. t . -.APPL.Ie,.TI,ON- TO..- ..CONST.RUC- Ta-.A.:WATER WELL PCHD PERMIT # T/9 WELL LOCATION Street Address Town/Village/City Tax Grid Number Stage Coach Road Patterson 8 -1 -28 WELL OWNER Name Address XdPrivate MUELLER, RENHOLD 1551 Merry Ave., Bronx, NY 10461 OPublic USE OF WELL 1 - primary 2 - secondary XM'RESIDENTIAL ❑ BUSINESS ❑ INDUSTRIAL ®PUBLIC SUPPLY OAIR /COND /HEAT PUMP 0ABANDONED O FARM ❑ TEST /OBSERVATION 0 OTHER (specify d INSTITUTIONAL ❑ STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 300 gal REASON FOR DRILLING PTEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY OTEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING To supply water t0 proposed new dwelling WELL TYPE nRILLED DRIVEN ODUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES XX NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Stage Coach Properties , In( Filed Map 2425 Lot No. 28 WATER WELL CONTRACTOR: Name t . b . d . Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: NAME OF PUBLIC WATER SUPPLY: YES X X X No TOWN /VIL /CITY - DISTANCE- ­.DISTANCE --P•ROPERTY- FROM <NEAREST :[+LATER MAIN - 0 -u6.1 -*.1= 000- .f.e.et - - -:. -- -- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION QX)N SEPA WE E 0 H S . ROMEO,. P . C Aug. 28, 1993 (date) (signature)by MATTH A. NOVIELLO 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. Date of Issue: �� / 195__ -== Date of Expiration: 19 �`� ermit Permit is Non - Transferrable M. JOHN S. ROMEO, P.C. . :CONSUL TING :ENGINEERS- .AND = LAND - 'SURVEYORS -- 1 NORTHRIDGE ROAD PEEKSKILL, NY -10566 (914) 737 -1056 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 110 Old Route 6 Carmel, NY 10512 Re: PROPERTY OF LOCATED AT TM Gentlemen: This letter is to authorize MATTHEW A. NOVIELLO, P.E., a duly licensed professional engineer to apply for a Construction Permit for a Separate Sewerage Disposal System and or Private Water Supply, to serve the above noted property in accordance with the standards, rules, or regulations as,promulgated by the Commission- er 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.,. sy_ stems formity with the provisions of Articles 145 or 147 of'the New York State Education Law, the Public Health Law, and the Putnam County Sanitary Code. Dated: a��►�r Z6, Ig9l Countersigned: bR. MATTHEW A. NOVIELLO, P.E. Lic. # 061145 Route 9D & Elvins Lane Garrison, NY 10524 (914) 424 -3560 Very truly rours , Owner Address AV City, `State Zip PUTNAM COUNTY DEPARTMENr OF HEALTH. -DIVISICN OF ENVnkal,�L.HFALTR SE[MCES DESIGN DATA SHEET-SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. er .15'5­Merry Ave. Bronx N.Y. 10461 Located at (Street) Stage Coach Road Sec. 8 Block 1 Lot 2 8 (indicate nearest cross street) Municipality Town, of Patterson Date of Pre-Soaking Watershed Me PARINRIVU - 7/30/93 Date of Percolation Test 7/ 3 0/ 9 3 HOLE NUCER C= TIME PERCOLATION PERCOLATION .Run Elapse Depth to Water Fran Water Level No.. Time Ground Surface In Inches Soil Rate Start-Stop Min. Start stop Drop In Min/In Drop Inches 'Inches Inches . H . P 1 4:20-4:45 30 2411 .101, 2 4:45 -5:10 30 24'. 3011 611 3 5:10 -5:40 30 24" 3011 611 4. 5: 40-6: 10 30 ..2411 3011 611 5 .H.#2 1 4:40 -5:10 30. 2411 26 1/211 2 1/211 3 5:40.-6:10 _3V 24 15 4 6:10 -6:40 30 2411 2611 211 15 5 2 3 N0I2:S.-' I -:"Tests- to be repeated at same depth until approximately equal soil rates '6 obtained.at each percolation test hole. All data to'be submitt�d for review. 2. Depth measurements to be made from top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE. SUBMITTED. WITH APPLICATION DESCRIPTION OF SOUS ENVCOUN'12RED IN TEST HOLES DEPTH HOLE NO 1 HOLE NO. 2 HOLE N0. d' G.L. 6" Top So 1 6 Top Soil 1� Silty Loam Silty Loam 2' 3' A 9' 10' 11' 12' 13' 1 _. __�._... INDIC. ATE `LEVEE, ' AT "WHIG i INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: Matthew A. Novi el 1 o, P. E. Dom: 7/30/93 DESIGN Soil Rate Used 15 Min /1" Drop: S.D. Usable Area Provided 750 No. of Bedrooms 3 Septic Tank Capacity 10 0 0 gals*. Type Conc. Absorntion Area Provided By 375 L.F. x 24" width trench Other Matthew A. Noviello,P.E. Name John S. Romeo P . C . Signature Address l Northri dqe Road SEAL Peekskill!.N.Y. 10566 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PUTNAM COUN'T'Y DEPARTMERr OF HEALTH DIVISION OF. HEALTH'SERVICES DESIGN DATA SHEET-SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. Owner` h o 1-d Mueller Address 1551 Merr' Ave. Bronx N.Y. 10461 Located at (Street) Stage Coach Road sec. 8 Block 1 Lot 2 8 (indicate nearest cross street) Municipality Town of Patterson Watershed Date of Pre- Soaking 7/30/93 Date of Percolation Test 7 3 0/ 9 3 HOLE NUMBER C= TIME -PERCOLATION PERCOLATION .Ran 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 Inches. Inches Inches .H.#1 1 4:20-4:45 30 2411 2 4:45 -5:10 30 2411 :30" 611 3-5:10-5:40 30 2411 3011 611 4 5:40-6:10- 30 .2411 .3011 6 5 .H.#21 4:40-5:10 30 2411 26 11211 2 11211 "T 3 5:40 -6:10 30t. 24 26 21 15 4 6:10 -6:40 30 2411 26" . 211 . . 15 5 3 . I ,,, 'i! L, NOTES: Tests to be repeated are obtained.at each for review. 2. Depth measurements to rev. 9/85 at same depth until approximately equal soil rates percolation test hole. All data to' be submitted be made fran top of hole. TEST PIT DATA REQUIRED TO BE. .SUBMITTED.WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 1 HOLE NO. 2 HOLE NO.. G.L. �6" Top Soil �6" Top Soil 1� Silty Loam. Silty Loan _ INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED. DEEP HOLE OBSERVATIONS MADE BY: Matthew A. Novi el 1 o, P. E. DATE: 7/30/93 DESIGN Soil Rate Used 15 Min /1" Drop: S.D. Usable Area Provided 750 No of Bedrooms 3 Septic Tank Capacity 10 0 0 gals. Type Conc. r�,j'sation Area Provided By 375 L.F. x 24" width trench L=3 1 1 - .Matthew ' A. Noviello,P.E. Name :John S . Romeo P.C. Signature Addr. �s lNorthridgge Road SEAL ` Peekskill -N.Y. 10566 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PUrN• M •• 0TY DEPARTME OF,HEALTH -OF -HEALTH DIVISION.' • -ENVI11aVE24TAL DESIGN DATA S=-SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.' Owner. Renhold Mueller Addr6ss 1551 Merry Ave. Bnonx.N.Y. 10461 Located at (Street) Stage Coach Road. Sec. 8 Block 'I Lot 28 (indicate nearest cross street_) municipaiity Town of Patterson Watershed SOIL PERCOLATION T= DATA PSW= TO BE SUBMITTED WITH APPLICATIONS Date of Pre-Soaking 7/30/93 Date of Percolation Test 7/30/93 .H.#1 1 4: 20 -4 : 4 5 30 2411 .1011. 611 2 4:45 -5: 3 5 -:10 -5:.40 30 _2411, 3011 6 if 4 5:40-:6:10 _30 .24 11 30 6 5 H. 1 4:40-5:10 30. 2411 26 1/2 11 2 1/2 11 72 -5-: 10 -:5.40 - 30.._....._..._ -24 Z& .11 3 5 : 40-.6 :10 30-- 24 11 26 2.. 15 4 6.:.10-6:40' 30 24"-1- 26" 211 .15 5 2 3' NOTES: Tests to be repeated at same depth until approximately equal soil rates are obtainedat each percolation test hole. All data to'.be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 HOLE NUMBER CLOCK .= PERCOLATION PERCOLATION .Run Elapse Depth to Water Fran Water Level No. Tim. Ground.Surface . In Inches Soil Rate Start-Stop Min. Start stop Drop In Min/In Drop Inches .,Inches -Inches .H.#1 1 4: 20 -4 : 4 5 30 2411 .1011. 611 2 4:45 -5: 3 5 -:10 -5:.40 30 _2411, 3011 6 if 4 5:40-:6:10 _30 .24 11 30 6 5 H. 1 4:40-5:10 30. 2411 26 1/2 11 2 1/2 11 72 -5-: 10 -:5.40 - 30.._....._..._ -24 Z& .11 3 5 : 40-.6 :10 30-- 24 11 26 2.. 15 4 6.:.10-6:40' 30 24"-1- 26" 211 .15 5 2 3' NOTES: Tests to be repeated at same depth until approximately equal soil rates are obtainedat each percolation test hole. All data to'.be submitted for review. 2. Depth measurements to be made fran top of hole. rev. 9/85 DEPTH G.L. 1 2' 3' 4' 5' 6' 7' 8' 91 . 10' 11' 12' 13' 14' TEST PIT DATA REQUIRM,TO, BE SUBMITTED. WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. 1 HOLE NO., 2 HOLE NO. 6" Top Soil 6 Top Soil' Silty Loam Silty Loam 5 01 ti INDICATE 'LEVEL -AT `WHICH' GROUND;QATER -IS ENCOUNT= _....> ,... ....._.._ .... �.:-.<a�. _. INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED D E E P H O L E OBSERVATIONS M A D E BY: Matthew A . N o v i e l l o, P. E. DATE: 7/30/93 DESIGN Soil Rate Used 15 Min /1" Drop: S.D. Usable Area Provided 750 No. • of Bedroans 3 Septic Tank Capacity 10 0 0 gals : Type C o n c . Absorption Area Provided By 375 L.F. x 24" width trench Other Matthew A. Noviello,P.E. Name John S. Romeo P. C. Signature Address l Northri dae Road SEAL Peekskill N: -Y: 10566 THIS SPACE FOR USE BY HEALTH DEPARDIENT ONLY: Soil Rate Approved sq.ft /gal. Checked by Date ' 4 4••— 46' S' 52. 0' 5' 7' ' 6' e' I 6' 9 1/4• 23.6 3/4• 7 3• 18 O 2642 O 2432 3046 NOFt 2- 2X6 SPKO f23 2430 230 2' !1' 6. 10 1/4' 33"10" • 36 SF O 246 m m 2' FILL m >< ° f 1/2' FILL a 9 9 _ 10' 6' -�. 6. 1 1/4' �. 9' S 1/2' 1 1 § BATH NOOK m #2 DINING O N BR #1 ZD O " ° o V30 158D i/ II KITCHEN m L. II , 1O i 1 n 7' 9 1/4• 2' 0' ' t iI r I 1 1/2' FILL ATH # 9N' - -- - cc a Sfi6C 5 P1Q_ 1 O ELEC 6C6 2 -1.5' X 10_ 10. 2430 2430 '� DROP O 6'- - - - - - 9 9.3/4' 3. 0' 3• 6' 3' 1' 10' 4 1/2' . HALL 5 3' 0' 7 ` O _- � a S BR #2 LIVING RM BR #3 9 6' 4 1/2' tD m FIN TO FIN } ?MAX i 1'iry 20 T0' �','�ENT ;)k'' N7Q, f r T a 10' S 1/2• ° 2• 0' 11' 0' /J y ^C7 1z 5' 1'1,�• v 3046 ` �. 6•,' 10* ) -O 3046 9' f 3/4' 10' 6 3/4' O 3046 10' 2 1/2' O 3046 7, 4, .. 37' 3. _ 26• 1 1/4 i 17• 6 1/2' 20 g 6' S 2/2' 24' 10 1/2' L. 5T S7- 10 5TW TUU' sQ - - -�_ ® LYNWO D �•� _ DRWN BY: DATE: �? CHKD BY: DATE: PLAN NO. PENN LYON HOMES, INC. t 335 MUELLER 4. r 1 JSHN S. ROMEO,PE, LS (1924 -1991) " %fA' TA W A. NOVIELLO, PE JOHN C. HOFFMANN, LS JOHN S. ROMEO, P.C. CONSULTING ENGINEERS & LAND SURVEYORS 1 NORTHRIDGE ROAD ._- PEEKSKILL, NEW YORK 10566 (914) 737 -1056 FAX (914) 737 -9333 Nv August 28, 1993 PUTNAM COUNTY BOARD OF HEALTH Old Route 6 Carmel, NY 10512 Re: MUELLER WELL & S.S.D.S. TM 8 - 1 - 28 TOWN OF PATTERSON Dear Sirs: Enclosed please find the original application for well and septic systems approvals for the above captioned property. Included are the following: 1. A signed Engineering Authorization. 2. Two sets of House Plans. 3. Three signed, sealed prints of the S.S.D.S. design. 4. A Well Construction Permit Application. 5. A S.S.D.S. Construction Permit Application. 6. Three signed and sealed Design Data Sheets. 7. A bank teller's check in the amount of $300. Kindly approve the plans and return them to me. If you would like to inspect the site with me please give me a call. Very truly yours, JOHN S. ROMEO, P.C. by A0 A XA IF, Matthew A. Novie lo, P.E. -rg "9 -�— - - -- ---- - - - - =— - - - -- --- � --- --- '°fit, S. WIN, Nil ID------------ Ip J � Q - - ._ -. - _ .` •_ a T`E`S u 2. 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I I I I I I I' I W1;LL I I I I CONC, CLAIM. 69,4'' D G 105.12' 68,0' OA VOXIMATE LOG. .� B t'O�CH 1000 GALLON ` - - - -- _ SEPTIC TANK CLEAN OUt ACCESS t0 ` CJISTP,I(3Ut10� 6PAM MANHOLE Dox (.TYP) _ - q 34 � I N Z CELLAR 2 AP CR VON I TENCH (Tyr.) \ I , I � , I ; ' I 24" CMP - GUY w m, C TYP) �4 W POLE w \O � G I I ENt. I 105.04' j I ELEC, METE I I I� I Io 49.8 515 °54'I' - 30 0 15 30 -. ''' 60 i 1 inch 30 ft A5 -BUILT MEA5UREMENT5 ( IN FEET ) 1 2 3 4 5 6 7 b ' q 10 11 12 13 14 15 16 17 Ib Iq 2C A 10 51 5b 61. bpi 73 7b b4 71 85 Sri 013 q7 102 5q 65 70 75 bl b B 15.5 47 52 56 bl 65 70 75 7q q4 q7 i00 103 IOb 55 44 50 560 62 6b 0 23 D 32 ;'