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00529
,
3A
NO ,
00529
IN
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
CERTIFICATE OF CONSTRUCTION COMPLIANCE F ATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # —F - Yo %Y�o.�
Located at333 Mpor Village 7T 4--i „�
Owner /Applicant Names- -, kpv, Tax Map lS Block l Lot
Formerly — Subdivision Name
Subd. Lot # S
Mailing Address Sgce \AXbc�[ � ��,� -E- Zip {I
Date Construction Permit Issued by PCHD S -1'S - `\1►
Separate Sewerage System built by 152:kt Address SAC. 1e cD,.,nL 15ttT!s.,-.k-
Consisting of L2 =-,c=- Gallon Septic Tank and
Other Requirements: a` - l.` -7J-7. G.►- _ '-�� [Stl%
Water Supply: Public Supply From
Address
or: X- Private Supply Drilled by 4"z., . Addresser ,JY
Building Type ` -:: .I x Has erosion control been completed?
Number of Bedrooms 4 Has garbage grinder been installed? 1.i*JA
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: /0 -/7-00 Certified by
Address i 4v
P. E. V—
4 License #, Co 1931
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 bject to modification or change when, in the judgment of the Public Health Director, such
revocatio o ficatio change is necessary.
By: Title: Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
0
10/20/2000 15:44 914 - 278 -6392 1NSITE ENGINEERING
OCT -20 -08 04:38 PM TOWN OF PATTERSON 9148 782019
PAGE 02
P.06
J
4
BRUCE A FoLaY " r LORET:A MOLWAN LN„ MS.N,
Fudge &of* Alma Pr6Jro Poo" D &OC cr
Vbww AV PAO" ywVfM
DUARTiNGNT OF ki>rA,t,TH
I (emvs Road
8MW94 NOW York 10509
R++hoaon4l Buto►191y771•ItiO 9s(9J4) :076 -7921
.'trt11AL !H�'ftq fF1a +,T71 -a5li 1lYJ: (stlyi7i•tlTti Botplq 371.6915
orb �Ote�isltob a+14) Z;a • e01� >ifeuliol (!14) 3f�Oq ira {914) iTt • iW
Ow-MRS NAME: YIX' oo oW ,4! Oed G�
TAX 14APr(CrIHER: CA or 0OV,
011 ADDRESS: _.......-11...3 0 x.10.0 t4f L 04^ o
A>3THOA1zEa TOWN 0FFTG?,+►L: �..�..■ -- .....,..� w.r,....
(Signature)
DATE-
The Putnam Co=ty Department of Healm will not issue a Certificate of
Comtrucdoxt Compliance unless the above form b completed, Lan a ltial E911
address is assigned by an authorized town offidai. Tbb foram is to be submitted
with the application for a Certificate of Conatruction Compliance.
(E9: IM.Mu;
BRUCE R. FOLEY
Public Health Director
LOREI`TA`;.MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York. 10509 .
Environmental Health (845)278 -6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
October 18, 2000
Jeffrey J. Contelmo, P.E.
Instie Engineering & Survey
V Routee 22
Brewster NY 10509
Re: Allonge
333 Quaker Lane, Lot #5
(T) Patterson, TM# 15 -1 -50.5
Dear Mr. Contelmo:
The above regarded application is and cannot be processed.
This means the project cannot be forwarded to a Putnam County Department of Health reviewer for
comments or approval until the following has been received:
1) ®Standard E911 Address Form.
2) ❑ Construction Permit Application.
3) El Certificate of Construction Compliance Application.
4) ❑A certified check or money order in the amount of
❑ $300 for a Construction Permit.
❑ $300 for a renewal of a Construction Permit.
❑ $150 for a revision of an approved Construction Permit.
❑ $200 for a Certificate of Compliance.
❑ $100 for a Well Permit.
❑ Other
If you have any question regarding this matter, please call me at (845) 278 -6130 ext. 2152
Very truly yours,
Theresa Nemeth
Senior Typist
.1�')
/NS/TE
ENGINEERING, SURVEYING &
LANDSCA PEA RCHITECTURE, P.C.
1485 Route 22 (914) 278 -4990
Brewster, New York 10509 Fax: (914) 278 -6392
TO: Putnam Countv Health Department
1 Geneva Road .
Brewster, New York 10509
WE ARE SENDING YOU
❑ Shop Drawings
❑ Copy of Letter
LETTER OF TRANSMITTAL
Date: 10 -17 -00
Job No. 96134.305
Attn: Rob Morris, P.E.
Re: SSTS for Alonge - Lot 5
Quaker Lane, Patterson
TM# 15 -1 -50.5
® Enclosed ❑ Under separate cover via
® Prints ❑ Plans
❑ Change Order ❑
the following items:
❑ Samples ❑ Specifications
COPIES
5
1
DATE
10 -2 -00
9 -14 -00
NO.
A13-1
DESCRIPTION
As -built Drawing
$200.00 Fee
1 _
10 -17 -00
CC -97
Construction Compliance
3 _
10 -5 -00
GS -97
Guarantee
...
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:
Rob - The well for this lot was a test well during the subdivision approval process and the well was tested at that time. Copies
of the well completion report and water analysis were submitted with the Construction Permit Application. Please call if you
have any questions.
COPY TO:
Lot2000.dot
SIGNED: J n, P.E.
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
04!25/2390 13:44 91 ,1- 278 -5392 1NSI'TE ENGINEERING PAGE 02
PU'TNAM COUNTY DEPA.RTMT ENT OF HEALTH
DMSYON OF ENVIRONMENTAL HEALTH SERVICES
GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner or Purchaser of Building Tax Map Block Lot
Building Constructed by
Location - Street
Building Type
pillage
Subdivision Name
Ca
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
h-reby guaralitee 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
inu-nediately following the date of approval of the "Certificate of Construction Compliance" for the
sewage treatment system, or a*1y 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 fuzdier agrees to accept .as conclusive the determination of the public health
Director of the Putnam County Department of Health as to whether or riot the failure of the system
to operate was caused by the willful or negligent z.ct of the occupant of the building utilizing the
system.
Dated: Month ° Day S Year �
-301 Contract r (Owner) - Signature
Corporation Name (if corporation)
Address'
State
Zip
r
Signature:
Title:
Corporation Name (if corporation)
Address: 596 l�tAnol�•4�-
State /vim .Zip /,9-5�¢t
Form GS -97
1Z e —•=vt se , o n
PUTNAM COUNTY DEPARTMENT OF HEALTH l3l�da
a DIVISION OF ENVIRONMENTAL HEALTH SERVICES .
a FINAL SITE INSPECTION
Date: #//2/610
Inspecte y: a; h
Street Location OAKETZ7 LAALC Owner A10Ajj6 ,C_
Town ` .4-rr i 50&/_ Permit # 'p — /t — ?'?
TM # / — / - Ste, S Subdivision Lot # 5" -3-rt'PNF_N Atoiu4.c"
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 ...... ...............................
II. Sewa e.S stem
a. Septic c size - 1,000 ...... .........other ................
b. Septic tank installed level ................ ...............................
c. 10' minimum from foundation .......... ...............................
d. Distribution Box
1. All out le at same elevation -water tested .................
2. Protected below frost .................. ...............................
3. Minimum 2 ft.Original soil between box & trenches
e. Junction Bo - properly set., ..........................................
f. Trenches
TZn 1 required CEO Length installed SOb
2. Distance to watercourse measured 'f- 100 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 ..................
.
YES 1 NO I COMMENTS
`8. Size of gravel 3/4 - 1' /z" diameter clean .................
9. Depth of gravel in trench 12" minimum ...................
10. Pipe ends capped ................... ...............:..........'•• )2t
g. Pump or Dosed Systems c
1. Size ot pump chamber ........:......................................
2. Overflow tank ............................. ...............................
3. Alarm, visual/ audio .................... ...............................
4. Pump easily accessible, manhole to grade. .. ...............
5. First box baffled .......................... ...............................
6. Cycle witnessed by H.D.estimated flow /cycle...........
III. HouseBuildin
aHoouselocated per approved plans.......... ....
b. Number of bedrooms ....................1f.:......� .�`- -�
IV. Well
a.7-Well located as per approved plans . ...............................
b. Distance from STS area measured 13 o ft...........
c. Casing 18" above grade .................. ...............................
d. Surface drainage around well acceptable .......................
V. Overall Workmanship
a. Boxes properly grouted ................... ...............................
b. All pipes partially backfilled ........... ...............................
c. All pipes flush with inside of box ... ...............................
d. Backfill material contains stones <4" diameter..
e. Curtain drain & standpipes installed according to plan..
f. Curtain drain outfall protected & dinto exist watercourse
g. Footing drains discharge away from STS area ..... 4.�a
h. Surface water protection adequate ... ...............................
i. Erosion control provided ................. ...............................
Rev. 6/97
FAF
INS
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BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914)'278 - 6085
Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
Date: `>t /l
To: 1r,10' IFk4
UA le C-!- IAAI6 5- - l -�0,5
From: Gene D. Reed
Putnam County Department of Health
_ X For your information
For your review
X_ As discussed
Notes/Messages 6 0 M M FN— T5 ;
Fax #: 0�78 - 6 312
No. Pages z
(Including cover sheet)
Please respond
Attached as requested
Please call
PLLJ
3�(Ei;75 j3EDT2ooM cOei4r;
/c A10-r /,A/ -T'!fe /o0% j6�>KPA1q 51014 AteC—A,
In the event of transmission /reception difficulties, please contact this office at
(914) 278 -6130 ext. 2261.
04/11/2000 14:09 914 - 278 -6392 1NSITE ENGINEERING
PUTNAM COUNTY DEPARTMENT OF REALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
ATTENTION ® ADAM GENE
'FOR FINAL INSPECTION For: Fill
All information must be fully completed prior to any Trenches
inspections being made.
PAGE 02
PCHD Construction Permit # "
Located; CxUA-KCK LAN's fT) ,V) 1°A1���Sor1
Owner /Applieaut Name: 51'e9►4 gW6 I N4 5, Block _ j� Lot • 0.5
Formerly: Subdivision Name: boox
Subdivision Lot TM
Is system fi!I completed? _ a IA Date: A- '
Is system complete? YES Date: 4 ° I O • 00
Is system constructed as per plans? YF�
Is well drilled? `(AS Date: R Z`t -9 --
Is well located as per plans ?_
Are erosion control measures in place ?„
I certify that the system(s), as listed, at the above premises has been constructed and I have inspected
and verified their completion in accordance with the. issued'PCHD Construction Permit and
approved plans and the Standards, Rules and Regulations of the Putnam County Department of
Health.
Date: Certified by: PE RA
De ap Pro a Tonal
Address: Lic.
iAv-* sr-wfv ' A4zc, a ric'r-'f'E, Pte-
Comments: 14'0:!5' Pr-. zz , 8 «+sTr T- , / Y r o 5 °
Form FIR-99
04/11/2000 14:09 914 - 278 -6392 1NSITE ENGINEERING PAGE 01
Y /V /-.7 E
_=NGINEER/NG SURVEY /NO 8
L4NDSCAP.-A gaHFzi: ;i AE, P.C.
Facsimile Cover Sheet
To:
Company:
Phone:
Fax:
Gene Reed
PCHD
27"130
278 -7921
From.,
Company:
Phone:
Fax:
Date:
Pages
(lnOluding ft Cover page):
RE:
Comments:
John M. Watson
Insite Engineering. Surveying & Landscape Architecture, P.C.
(914) 2784990
(914) 278.6392
4 -11.00
2
SSTS asbuift for Alonge - Lot 5
1485 Route 22, Brewster. New York 10809 (914) 278.4990 Fax: (914) 278 -6392
www. in site -en g. com
fax Cover.Clpt
BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
John Watson
Insite Engineering & Survey
Route 22
Brewster NY 10509
Re: Proposed Compliance: Allonge
333 Quaker Lane, Lot #5
(T) Patterson
Dear Mr. Watson:
October 25, 2000
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. A current water analysis must be submitted for the existing well.
Upon receipt of a submission, revised to reflect the above comments, this application will be
considered further.
RM:tn
Very ly yours,
Robert Morris, P.E.
Senior Public Health Engineer
/NS/*TE
7M17ENGINEERING, SURVEYING &
LANDSCAPEARCHITECTURE, P.C.
1485 Route 22 (914) 278-4990
Brewster, New York 10509 Fax: (914) 278 76392
T0: Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
WE ARE SENDING YOU
❑ Shop Drawings
❑ Copy of Letter
LETTER OF TRANSMITTAL
Date: 11 -10 -00
Job No. 96134.305
Attn: Rob Morris, P.E.
Re: SSTS for Alonge - Lot 5
Patterson
11 -9 -00
I
® Enclosed ❑ Under separate cover via
❑ Prints ❑ Plans
❑ Change Order ❑
the following items:
❑ Samples ❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
11 -9 -00
I
Water test results
THESE ARE TRANSMITTED as checked below:
® For approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
® As requested ❑ Returned for corrections
❑ For review and comment ❑
REMARKS:
COPY TO:
Lot2000.dot
❑ Resubmit
❑ Submit
❑ Return.
copies for approval
copies for distribution
corrected prints
SIGNED:
C/ n M. Watson, P.E.
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
'ML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
(914) 245-2800
Albert H. Padovani, Director
LAB 0 93.002297 CLIENT #: 12824 STAT PROC PAGE I
BRIMSTONE DEVELOPMENT DATE/TIME TAKEN: 11/06/00 11:00A
586 WOOD RD. DATE/TIME REC'D: 11/06/00 11:35A
MAHOPAC, NY 10541 REPORT DATE: 11/09/00
PHONE: (914)-628-4675
SAMPLING SITE: QUAKER LANE
: PATTERSON, NY lOT #5
COL'D BY: STEPHEN
NOTES...: KIT TAP
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DATE FLAG PROCEDURE
SAMPLE TYPE..: POTABLE
PRESERVATIVES: NONE
TEMPERATURE..: < 4C
COLIFORM METH: MF
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-
RESULT NORMAL - RANGE METHOD
PUTNAM CNTY
PROFILE
11/06/00
MF T. COLIFORM
ABSENT
/100 ML
ABSENT
1008
11/06/00
LEAD (IMS)
<1
ppb
0-15 ppb
9101
11/06/00
NITRATE NITROG
0.22
MG/L
0 - 10
9139
11/06/00
NITRITE NITROG
<0.01
MG/L
N/A
9146
11/06/00
IRON (Fe)
<0.060
MG/L
0-0.3 mg/l
2037
11/06/00
MANGANESE (Mn)
<0.010
MG/L
0-0.3 mg/l
2037
11/06/00
SODIUM (Na)
2.15
MG/L
N/A
11/06/00
pH
7.1
UNITS
6;5-8.5
9043
11/06/00
HARDNESS,TOTAL
94.0
MG/L
N/A
11/06/00
ALKALINITY (AG
68.0
MG/L
N/A
11/66/00
TURBIDITY (TUR
<1
NTU
0_5 NTU
COMMENTS:
BACT THESE RESULTS INDICATE THAT THE WATER
WAS NOT)
OF A
SATISFACTORY SANITARY QUALITY
ACCORDING TO THE 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.
ablic 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 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`
is suggested.
yML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 1059E
(914) 245-2800
Albert H. Padovani, Director
LAB #: 93.002297 CLIENT #: 12824 STAT PROC PAGE 2
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
BRIMSTONE DEVELOPMENT
586 WOOD RD.
MAHOPAC, NY 10541
SAMPLING SITE: QUAKER LANE
: PATTERSON, NY lOT #5
COL'DBY: STEPHEN
NOTES...: KIT TAP
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DATE FLAG PROCEDURE
DATE/TIME TAKEN: 11/06/00 11:00A
DATE/TIME REC'[y: 11/06/00 11:35A
REPORT DATE: 11/09/00
PHONE: (914)-628-4675.
SAMPLE TYPE..: POTABLE
PRESERVATIVES: NONE
TEMPERATURE..: < 4C
COLIFORM METH: MF
RESULT NORMAL - RANGE METHOD
pH pH SCALE IN WATER RANGES FROM 1-14. MEASUREMENT OF pHIS ONE OF
THE IMPORTANT AND FREQUENTLY USED TESTS IN WATER CHEMISTRY.
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 EXPRESSEDAS 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 (1 grain/gallon = 17.0 MG/L)
SUBMITTED BY:
Ajjdrt H. Padovani, M.T.(ASCP)
Director
ELAP# 10323
-0
K
ER
Q�
AREA
1.986 ACRES
(86,494 a f *)
S 18 5010" W, 28.
s
.,1
i
LOT 5
NO.
coxHOe of
HOUSE
B
cMER of
HOUSE
REMARKS `
1
51'
28'
1,250 GALLON SEPTIC TANK
Z
63'
30.'
DROP - BOX
3
64'
37'
DROP. BOX
4
65"..
42'
DROP BOX
5
67'
48'
DROP BOX .
6
70'
54'
PROP BOX
7
72'
59'
J.. DROP BOX
8.
75',
64'
DROP BOX
9
48'
83'
END OF TRENCH
10
46.'
76'
END OF TRENCH ti
11:
41'
72'-
END OF TRENCH
12
33'
71'.'.'
END OF TRENCH i
13
31 `
64'
END OF TRENCH
14
2T
59'
END OF TRENCH. '
15
51'
35'
END OF TRENCH a
16
Ili'
END OF TRENCH.
17
106'
64'
. END OF TRENCH
1.8
105'
59',
END OF TRENCH i
191.
103'
54'
END. OF TRENCH .
20
. 103
50'
END OF TRENCH.
21
162'
46'
END OF TPENCH' {
22
102'.
41'
END ,OF.TRENCH j
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM
PERMIT #
T /?9
Located at 6?L", -k,wr <Oto or Village
Subdivision name A-k n Subd. Lot # _4:�— Tax Map jc7 Block j_ Lot
Date Subdivision Approved t= - 99 Renewal Revision
Owner /Applicant Name SSG Date of Previous Approval
Mailing Address woo--, l- -E-r Zip
Amount of Fee Enclosed
Building TypeV-er,;,j ,,,+j L Lot Area .%-t No. of Bedrooms L- Design Flow GPD 43rav
� trdex��..w ter. i ,ti
Fill Section Only Depth Volume
PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED
Separate Sewerage System to consist of j?-� gallon septic tank and Scz-� cr-r-
-T
Other Requirements: ok ti `Pat -41 4..=
To be constructed by Address
Water Supply: Public Supply From Address
or: b-� Private Supply Drilled by `p`�.- 't�a�.A.(.•� k 1�� . Address
tom,
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 s,, stem 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. DL Date
Address �o ea Licenseir (Oil-lbp1
APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the
sewage treatment system has been completed and'iiispected by the PCHD and is revocable for cause or may be amended or
modified wh nsidered necessary by the Public. Health'.Directoi. +Any revision or alteration of the approved plan requires
a new pe 1 proved f ischarge of domestic sanitary sewagee only.
By: 4 Title: Date: JP f3
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CP -97
7MIMIlVVf1A1MIMIlI�in nIMIMV1. MMiMIM7MIMIMIMIMIM1lU7�11 /MIMfl111IMi!UIMV1.�1!11}ln 111MI n�11MIMi�I�IMIM IMIMIAA7A/.�iw�IM/M10%05 �in/,AI�I.�
7mm
a�
172
,., r..... , yj .r
Ea
_ r _
MM
_ t•'
_ , :i% - I,t _ � - PI � GI Clli r -•- 11 - � _ �� 1' �'���L`�� �' F� :�'.
� —' � !!111;: ' •'�n �•�l „ .
r_ ,._._E it W�Lll
two-or ..
1 . 1111 ■ 1►T
'r149SCARSDALE 11
2T8" X 48, • 2656 Sq. Ft.
0D
0 000 BEDROOM4 BEDROOM3
/ II' -0' x 9'- 7" 10' -0" x 13' - -0"
O I
27'8°
MASTFR BEDROOM BEQROOM2
17'-2rz x 16'- 8" , 16' -4 2 x 13' -0"
I
I
I
I
48' 1
First Floor
PUTNAM i-- u_u IN I x jj
PLANS kROVED . BEDROO 4; UNT ONLY,
O;O KITCHEN i i BREAKFAST FAMILY ROOM
I 12, -0 "x is-o" I V -5'x 13' -o" 20' -o "x 13' -0'
BEDP I �1
I I 1
- I I
BSEQUL ALT RATIO S ' 0 THESE HOUSE
not 'l' PF. S112j/iAL;TTZD TO THE PCDOH FOR APPROVAL
TURE &
DINING ROOM LIVING ROOM
13'- 9" x 13 "- 0" 18'- 9" x 13'- 0"
up
� 1
48'
STANDARD SCARSDALE 11 FEATURES
• 4- Spacious Bedrooms
• 2%z Baths
• Open Two -Story Entry Foyer
• Formal Dining Room
• Formal Living Room
• Spacious Country Kitchen with Breakfast
Room and Pantry
• "Cottage- Style" 3056 Lower Level Windows
with Architraves on Front
27'8"
• Framingham Pediment on Front Door
• Fireplace Options Available
• "Boxed -out" and 'Angle Bay' Options
Available
• Consult an Authorized Westchester Builder
for a Complete List of Options
• Artist's renderings and Floor Plan Dimensions are
approximate. All specifications must be Written in the
Contract No oral conditions.
ESTCHESTER MODULAR HOMES, INC.
P.O. Box 900 e Dover Plains, NY 12522
(914) 832 -9400. (800) 832 -3888
a
BRUCE R. FOLEY
Public Health Director
Jeffrey J. Cantelmo
Insite Engineering
Route 22
Brewster, NY 10509
Dear Mr Cantelmo:
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648
WIC (914) 278 - 6678 Fax (914) 278 - 6085
RE: Alonge, Quaker Lane
(T) Patterson
TM# 15 -1 -5
East Branch Reservoir Basin
July 29, 1999
The Putnam County Department of Health (Department) has determined that the above referenced
application, including fee, and received by this Department on July 19, 1999 is complete. The
Department will notify you by August, 19, 1999 of its determination.
❑ The Project has been delegated to the Putnam County Health Department for
review pursuant to the guidelines set forth in the Watershed Agreement.
® Joint review with the NYCDEP will commence pursuant to the guidelines set forth
in the Watershed Agreement.
If the Department fails to notify you within the above referenced time frame, you may notify the
Department of its failure by certified mail, return receipt requested. The notice should be sent to my
attention at the above address. This notice must include your name, the location of the project, the
office with which you filed the application originally, and a statement that a decision is sought in
accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed
Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the
notice, your application will be deemed complete, subject to standard terms and conditions as set
forth in the regulations.
Please be advised that projects within the NYC Watershed may also require Dept. of Environmental
Protection review and approval of other aspects of a project, such as stormwater plans or the creation
A
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 (914) 278 -6130 ext. 2159.
Very truly yours,
r elShawn Rogan
SR:mb Public Health Technician
ws2
j3RUCE R FOLEY
Public Health Director
PROJECT: QC:
TOWN:
LORETTA MOLINARI- R.N., M.S.N.
Associate Public Health Director
Director of. Patient Services
DEPARTMENT Ur HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648
WIC (914) 278 - 6678 Fax (914) 278 - 6085
DELEGATION STATUS
FOR
SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM
JOINT REVIEW
— /-- s-D ,
NOTICE OF COMPLETE APPLICATION:
DATE: Z02 1
Within the drainage basin of West Branch or Boyds Corner Reservoirs.
Wit ' 7ecem feet- of- a�e.�.ervoir reservoir stem control lake.
thin feet of wa e a DES etland a 'cl appearing on a subdivision map approved
after er 31, 1992.
Design flow greater than 1000 gallons /day.
(JTREV)
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH .
INDIVIDUAL NVATER SUPPLY & SUBSLRFACE SENVAGE TREATME \T SYSTEMS
REVIEW SHEET FOR CONSTRUCTION PERMIT
STREET LOCATION �e' (X`�`2� NAME OF OW \'ER �� Q
RENTEWED BY RYI, GR, AS, MB, B $ K a E z", � TAX iVi.4P /S /-
Y N DOCU •IENTS Y N
PERMIT APPLICATION
PC -1- PC 49�
WELL PERMIT_ PWS LETTER
Cj LETTER OF AUTHORIZATION
DESIGN DATA SHEET (DDS)
CORPORATE RESOLUTION
SHORT EAF
PLANS - THREE SETS
HOUSE PLANS - TWO SETS
VARIANCE REQUEST
FEE
SUBDIVISION
LEGAL SUBDMSION
SUBDMSIO 1 APPROVAL CHECKED
PERC RATE It r s'
FILL REQUIRED """ .DEPTH
CURTAIN DRAIN REQUIRED
STANDPIPES
EROSION CONTROL:HOUSE,WELL, SSDS
PERC & DEEP HOLES LOCATED
REPRESS \ -fATIVE OF PRIMARY & EXPANSION
LOCATION iNtAP
EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE
41 PUMPED, PIT & D BOX SHOWN & DETAILED
HOUSE: 0 O FB60� V
WELLS & SSDS'S WIN 200' OF PROPOSED SYS.
PROPERTY METES & BOUNDS
HOUSE SETBACK NECESSARY (TIGHT LOT)
HOUSE SEINER -1 /4" FT. 4 "0; TYPE PIPE
NO BE\, MS; MAX.BENDS 45' W /CLEANOUT
FILL SYSTEMS y:t_/ t
CLAY BARRIER (/ r� _
10- FT. HORIZONT=A - :SLOPE 3:1 TO GRADE
FILL SPECS --- FILL NOTES
FILL CERTIFICATION NOTE
EN'S 4 L FILL PROFILE &- DRNIENSIONS
/ LOCATED IN NYC WATERSHED VOLUME
PLANS SUBMITTED TO DEP FILL N EXPANSION AREA
DELEGATED TO PCHD TRENCH
DEP APPROVAL, IF REQ'D LF TREN'CH PROVIDED ,SD0 60 FT MAX.
: DEEP TEST HOLES OBSERVED PARALLEL TO CONTOURS
or PERCS TO BE WITNESSED 100% EXPANSION PROVIDED
/ EX- APPROVAL SSDS ADJ. LOTS SEPARATION DISTANCES SPECIFIED
A / 6'7
WETLANDS (TOWNIDEC PERMIT REQ'D ?)
0-N PLAN - FROM SSTS
of DATA ON DDS PLANS & PERMIT SAME
TO P.L.,ZM F_. Y LARGE TRESS, TOP OF FILL
PRE 1969 NEIGHBOR NOTIFICATION
_ . � -t )-AM— ON W"AL�S ,/IYWELLTOPL
LETTER BYZBA
100' TO WELL, 200' N DLOD,150' PITS
100 YR. FLOOD ELEVATION
100' TO STREAM WATERCOURSE LAKE (inc. expan)
/ OTHER REQ'D PERMIT(S)
50' TO CATCH BASH, 35' STORMDRAN, PIPED WATER
REQUIRED DETAILS ON PLANS
10' TO WATER LNE (pits -20)
SEWAGE SYSTEM PLAN - (NORTH ARROW)
50' NTERIMITTENT DRANAGE COURSE
®
SSDS HYDRAULIC PROFILE
00' /500' RESERVOIR, ETC. _150' GALLEY SYSTEMS
/
GRAVITY FLOW
.2p'
CONSTRUCTION NOTES
15',%fN to CDS= >5%�'- 4 %,25'- 3 %,30'- 2 %,35' -1 %,100' - <1%
DESIGN DATA: PERC & DEEP RESULTS
2 'MIN to CD discharge /100'with 182 cons day discharge
T CONTOURS EXISTING & PROPOSED
SEPTIC TANK
DRIVEWAY & SLOPES, CUT
10' FROM FOUNDATION; 50' TO WELL
FOOTING /GUTTER/CURTAIN DRAMS
WELL :r yam'
SOIL TYPE BOUNDARIES
/
DI „SENSIONS TO PR61rERTY L E
TITLE BLOCK; OWNERS NAME,ADDRESS
u u
�
LOCATION OF SERVICE CON CTION
IM, ,PEJY A; NAME,ADDRESS,PHONER
FTIDATE OF DRAWINGIREVISION
DATUM REFERENCE
LOCATION OF WATERCOURSES, PONDS
LAKES AND WETLANDS WITHIN 200 FEET
F—M PROPOSED FINISH FLOOR AND BASEMENT EL.
COMMENTS:
Rot► 4r
D P
PHONE (914) 742 -2001
FAX (914) 742.2027
August 11, 1999
.... ......_... �. �... r.�..���•n..t'yF.`l4�xe'MtYt =^. • L^. Y1�JI... �. ii' v' N: �_` 4" ��. �tl '�1'.�.' {.:�.:5�'t�:�Sll'v�+ -xi ��1':�i'��1:IE
THE CRY OF NEW YORK DEPARTMENT OF ENVIRONMENTAL PROTECTION
JOEL A. MIELE, SR., P.E. Commissioner
WILLIAM N. STASIUK, P.E.,Ph.D.
Deputy Commissioner
.:Robert Morris, RE
Putnam Co. Health Dept.
4 Geneva Road
Brewster, NY 10509
Re: Alonge Subdivision. Lot #5
Quaker Lane
Patterson, Putnam
DEP Log # 9558 (Joint Review)
Dear Mr. Morris.
Bureau of Water Supply,
Quality and Protection
This letter is to inform you that the New York City Department of Environmental Protection
( Department) has determined that the above- referenced application is complete. In addition, the
Department has no objection to the approval of the above - referenced regulated activity. This
deterfnination is based on the review of submitted documents including the plan titled "SSTS for
Alonge", dated 06/21/99.
The applicant must contact Sissy De La Ossa of my staff at (914) 773 -4416 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,
ql""'l
Margaret Lloyi
Supervisor
Engineering Design & Review
xc: James Covey, P.E., NYSDOH
465 Columbus Avenue, Valhalla, New York 10595 -1336
T.n e4 (Z7.: QT RA. TT BnH CbCfl— C'JJ— t»TF.:XPa QNTN1- A1TPN1 Ala 111)
PUTNAM C*JNTY: DEPARTMENT ft .'HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
PWC4114_
Owner STLS PHA% Az -oi✓6- Address 1-/0d0 ST MA10,04G NJ /054 /
Sri "ADD A v
Located at (Street) �klrj i j' kvAD - - Tax Map /S, Block % Lot So
'(indicate nearest cross street)
Municipality Pg776-oz_SW Drainage Basin ZiOST eyeAP16 --H
SOIL PERCOLATION TEST DATA
Date of Pre - soaking S (1 Date of Percolation Test 5 (f' g7
Hole No.
Run No.
Time
Start - Stop
Ela se Time
Min.)
Depth to Water
From Ground
Surface (Inches)
Start Stop
Water
Level
Drop In
Inches
Percolation
Rate
Min/Inch
PSA
1
1:2- 1
.30
?,�% 2.6
-2,( /z
12
2
i"I - r; S4.
0
�3 �s� /Z
2_'17
l�
4
5
2
/,/7 -~ f;q-c
20
3
f; - :12-
6
4
5
I
2
3
4
1� V 1 r.J: I i esTs io oe repeated at same depth until approxtm
percolation. test hole. (i.e. s 1 min for 1 -30 min/i
submitted for review.
2. Depth, measurements to be: made from top of hole
2
a
TEST PIT DATA l
! DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH
G.L.
0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
HOLE NO. &S,6 HOLE NO. '658, HOLE NO.
Indicate level at which groundwater is encountered IVjY9
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered /`✓{�
Deep hole observations made by: ,-)2>W fvK onl Date S 1(4 0 7
Design Professional Name: Jeffrey J. Contelmo, P.E.
Address:Insite Engineering &•Surveying, P.C.
' Rrn�tP �2
Brewster, New York 10509
Signature:
Design Professional's Seal
of NE q y
�ptssio�yF`'
11/23/98 MON 16:59 FAX
PUT% A COUNTY DEPARTMENT OF HEAD °fH
P DIVISION OF ENVIRONMENTAL HEALTH SERVICES
WELL COMPLETION. REPORT
U005
Brimstone Contractinct
Well Location
Street Address:
Quaker Lane
Town/Village:
I Patters=
Tax Grid #
Map Block Lot(s)
Well Owner:
Name: Address:
Brimstone Contracting, 586 Wood Road, Mahogac, NY 10541
Use of Well:
1 -primary
2- secondary
x Residential Public Supply Air cond/heat pump Irrigation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
Drilling Equipment
X Rotary Cable percussion _j_ Compressed air percussion Other (specify)
Well Type
Screened Open end casing X Open hole in bedrock _ Other
Casing Details
Total length 32 ft.
Length below grade 31 ft.
Diameter 6 in.
Weight per foot 19 lb/ft.
Materials: X Steel Plastic Other
Joints: _ Welded K Threaded _Other
Seal: K Cement grout T Bentonite Other
Drive shoe: X Yes No
Liner:_ Yes x No
Screen Details
Diameter (in)
Slot Size
Length(ft).
Depth to Screen (ft)
Devcloped?
First
_ Yes—No
Hours
Second
Well Yield Test
_ Bailed __L Pumped g Compressed Air
Hours 6
Yield 5 gpm
Depth Data
easwe Aom.land swfwc -static spaify R)
50'
During yicld tcst(ft)
195•
Depth of completed well in fcct
345'
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
12
Drillimi
in ova
der. boulders
12
Hit r
at 121
12
32
Dri.11i
in rocks
set casing, grouted
32
345
DrilliW
in roa
c ranite
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type Capacity
Depth Model
Voltage HP
Tank Type Volume
Dam Wcll CompLeftd
8/i8/98
putoam County Gatihcation No.
002
Date of Report
9/29/99
Well Drill ' a
i x(----,/
per a ;r/'
Nu'i-E: Exact locations or well wim antances to a gas! perm m
anent tanaams m oe provtueu opa separate meevptan.
WeII grillers Name P - � rxe at s'ic • Address:
4 Pubm Ave.. Bmwtff, WY IM
Signature: Date. 9/23/98
al
White copy: HD Fil , Yellow copy - Building Inspector, Pink copy - Owner; Orange copy - Well driller
Form WC -97
11123/98 MON 16:57 FAX
LAW
10002
NORtHEAST LABORATORY OF DAxaURY
39-3 MILL PLAW ROAD - . DAM M, CT 06811
(203) 745 -7903 - FAX (20317'43-0652,
LABORATORY REPORT -- WATER SUPPLY TESTING
REPORT TO-
P.F. BEAL & SONS
4 PUTNAM AVENUE
BREWSTER, N.Y. 10509
SAMPLE SITE:
SAMPLING POINT;
SOURCE:
TREATMENT:
TEST PERFORMED
BACTERIAL:
CT Cert: PH -0404
NY Cert: 11471
DATE SAMPLE COLLECTED: 9/1/98
TM E COLLECTED: 12:00 P.M.
COLLECTED BY: MTB
DATE RECEIVED @ LAB: 9/1/98
TESTED BY: LAB #11471 & 11301
REPORT DATE: 914/98
BRIMSTONE, QUAKER LA., PATTERSON, N.X.
TOP OF WELL
WELL
NONE
RESULT- MAXJMUM CONTAMINANT LEVEL
Total Coliform (Bacteria)
0
per 100 M1
0 per 100 ml
PHYSICALS:
pH
7.02
no designated limit
Turbidity
4.5
NTUs
5 NTUs
CHEMISTRY:
Nitrite N
<0.01
mg/L as N
1 mg/L as N
11301 -Nitrate N
0.55
mg/L as N
10 mg/L as N
Alkalinity
57.0
mg1L
no designated limits
Hardness
80.0
mg/L
no designated limits
Iron
<0.03
mg/L
0.30 mg/L
Manganese
0.030
mg/L
0.30 mg/L
(Note: Combined Limit for Iron plus
Manganese = 0.50 mg/L]
Sodium
2.1
mg/L
20 mg/L*
Lead
<0.005 .
tng1L
0.015• **
ml = milliliter mg/L = milligrams per Liter
ND - none detected NTU =Units
**Notification Levcl
** *Action Levu
RESULTS BASED ON SAMPLES SUBNIITTED:9 /1/98
SAMPLE, AS TESTED ABOVE: MOTABLE or DOT POTABLE
(PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER)
e t i
Laboratory Director
•NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037. (860)828 -9787 - FAX (860)829 -1050
TOL-LfREE WITHIN CT: 800 - 826 -0105 .OUTSIDE CT: 800 - 654 -1230
11/23/98 MON 16:58 FAX
t � i
NORTHEAST LABORATORY of DANBURY
39 -3 M>Qx PLM ROAD - DANBURY, CT 06811
(203) 743-7903 - FAX (Z03) 748 -0653
INORGANIC CHEMICALS (A" THEIR LEWTS)
REPORT TO:
P.F. BEAL do SONS
4 PUTNAM AVENUE
BREWSTER. N.Y. 10509
SAMPLE DESCRIPTION:
SAMPLE LOCATION:
SAMPLE POINT:
PARAMETER:
• ANTIMONY
• ARSENIC
• BARIUM
• BERYLLIUM
• CADMIUM
• CHROMIUM
• CYANIDE
• FLUORIDE
• MERCURY
• NICKEL
• NITRATE NITROGEN
plus NITRITE NITROGEN
e SELENIUM
• SILVER
• SULFATE
• CHLORIDE
• THALLIUM
• COPPER
• COLOR
• ODOR
• TURBIDITY
WELL WATER
10 003
CT Cert: PH -0404
NY Cerc: 11471
DATE SAMPLE COLLECTED:
9111198
TIME COLLECTED:
1:30 P.M.
COLLECTED BY:
P. BEAL
DATE RECEIVED @ LAB:
9111/98
DAMS) TESTED:
9/11/98 - 9/22/98
TESTED BY:
LAB #11471 & 11301
REPORT DATE:
9/24198
BRIMSTONE CONSTRUCTION, QUAKER LANE, PATTERSON, N.Y.
WELL
MAXIMUM CONTAMINANT
LEVEL (MCI.) OR STANDARD RESULT (me/L) TESTED BY (Lab IDO)
.006
<0.003
11301 .
.05
<0.005
"
2.0
0.058
•`
.004
<0.001
'•
.005
40.01
"
0.1
0.012
"
0.2
<0.01
4.0
0.12
11471
.002
<0.0002
11301 '
.1
<0.002
11471
10.0 (as N)
2.6
"
.05
<0.002
11301
.05
<0.01
11471
** .
23.0
"
250.0
120.0
41
0.002
<0.00l
11301
• *•
0.24
1147I
..
0
yi
ND
..
5 NTUs
0.15
"
** MCL HAS NOT BEEN ESTABLISHED FOR THIS CHEMICAL.
* ** MCL (RE: LEAD & COPPER): SEE LEAD & COPPER RULING, SECTION 19- 13 -BI02 (i) (6)
mg/l,--milligrams per Liter
Laboratory Director
*NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITEN CT. 800 - 826 -0105 . OUTSIDE CT: 800 -654 -1230
.11/23/98 LION 16:58 FAX 4 004
Brimstone Const
NORTHEAST LABORATORY OF DANBURY'
Results based ou sample(s) submitted: 9/17/98
ND - None Detected
Laboratory Director
•NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITHIN CT: 800 - 926-0105 . OUTSIDE CT: 800 -654 -1230
CT
Cert: PH -0404
39 -3 Mti t. PLAIN ROAD
- DANDURYp CT 06811
NY Cert: 11471
(203) 748 -7903 - FAX (203) 748 -0652
EPA METHOD 524.2
Measurement of Purgeable Organic Compounds in Drinking Water
by:
Gas Chromotography -Mass Spectrometry
REPORT TO,
P.F. BEAL & SONS
DATE SAMPLE COLLECTED: 9117/98
4 PUTNAM AVENUE
TIME COLLECTED: A.M.
BRESTER, N.Y. 10509
COLLECTED BY: P. BEAL
DATE RECEIVED @ LAB: 9/17/98
TESTED BY: LABOI0916
REPORT DATE: 10/2198
SAMPLE SITE:
BRIMSTONE CONST., QUAKER LA., PATTERSON
SAMPLING POINT:
TEST WELL
SOURCE:
WELL -NEW
(all results expressed in micrograms per liter)
C_ O�UND
AMOUNT
LIMIT OF COMPOUNA AMOUNT
LIMIT OF
DETECTED
DETECTION DETECTED
DETECTION
1,I,1,1 Tetrachloroedtane
ND
0.5
Iiromoform
ND
'05
1,1,1,- Trichloroethane
ND
015
is4,2- Dicb1oroethme
ND
0.5
1,1.2,2- Tetrachloroethanc
ND
0.5
- 1,3- Dichloropropene
NO
0.5
1,1,2- Trichloroethanc
ND
0.5
bon temchloride
ND
0.5
1,1- Dichloroethanc
NO
0.5
hloroform
ND
0.5
1,1- Dichlorocthene
ND
0.5
lorobeozene
ND
0.5
I,1- Dichloropropene
ND
0.5
hloroethanc
ND
0.5
1,2,3- Trichloroba=e
ND
0.5
orowhalle
ND
0.5
1,2,3- Trichloropropane
ND
0.5
thy1 Bc=nc
ND
0.5
1,2,4- Trichlorobenzcnc
ND
0.5
rich lorotrifluorethane
NO
015
1,2,4- Trimethyl Benzene
NO
0.5
exactdorobutadiene
ND
0.5
1,2- Dichlorobenzenc
ND
0.5
sopropyl uenzmc
NO
0.5
1,2- Dichloroethanc
ND
0.5
ethylene Chloride
ND
0.5
1,2- Dichloropropane
ND
0.5
ethyl tart -Butyl Ether
ND
0.5
1,3,5- Trimethyl Beaune
ND
0.5
- Bumnone (MEK)
NO
0.5
1.3- Dichlorobcnzene
ND
0.5
aphthalme
ND
0.5
0- Dichloropropane
ND
0.5
Butyl Benzcue
NO
0.5
1,4- Dichlorobenaene
ND
0.5
-Propyl Benzene
ND
0.5
2,2- Dichloropropane
ND
0.5
- Xylene
NO
0.5
Dibromochloromcthmtc
NO
0.5
Isopropyltolucne
NO
0.5
Dibromomcthane
ND
0.5
cc-Butyl Bcnaene
ND
0.5
Dichloroditluoromethum
ND
0.5
tyret<e
ND
0.5
2- Chlorotoluene
ND
0.5
cans- 1,2- Dichloroethenc
NO
0.5
Trichlorofiuoromethane
NO
0.5
cans- 1,3- Dichloropropme
NO
0.5
4- Chlorotoluene
NO
0.5
ett -Butyl Benzene
NO
0.5
Benzene
ND
0.5
etrachlomethylene
ND
0.5
Brorno Dichloromethanc
ND
0.5
oluene
ND
0.5
Bromo Benzene
ND
0.5
richloroethylcne
ND
0.5
Bromochloromethane
NO
0.5
inyl Chloride
NO
0.5
Bromometimc
ND
0.5
,D- Xylcne
ND
0.5
Results based ou sample(s) submitted: 9/17/98
ND - None Detected
Laboratory Director
•NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050
TOLL FREE WITHIN CT: 800 - 926-0105 . OUTSIDE CT: 800 -654 -1230
14.164 (2187) —Text 12
'PROJECT I.D. NUMBER 617.21 SEOR
q' Appendix C .
State Environmental Quality Review
SHO_ RT .ENVIRONMENTAL ASSESSMENT FORM,
For UNLISTED ACTIONS Only
PART 1— PROJECT INFORMATION (To be completed by Applicant.or Project sponsor)
1. APPLICANT /SPONSOR Ina. �,..��,�ec� -r.
2. PROJECT NAME,
3. PROJECT LOCATION:
Municipality County
4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map)
5. IS PROPOSED ACTION:
5heW ❑ Expansion ❑ Modification /alteration
6. DESCRIBE PROJECT BRIEFLY:
�1
rRi'v \C1CV%4r_e_ OAT- W�
1
L
��' ? C7r.� 'iii r� � {�°T.trl/•t��C�C.S ,
7. AMOUNT OF LAND AFFECTED:
Initially (• 0t acres Ultimately I .R2� acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
& Yes ❑ No 11 No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
84Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/ForesUOpen space ❑ Other
Describe:
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE OR LOCAL)?.
Q•Yes ❑ No If yes, list agency(s) and permlVapprovalllss
.cam
�P � V t- w �.�hw� : {— '° � l ovJu�. �•�` [ a�e�"{s'A�4c� v�
11. DOES ANY ASPECT OF TH ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
❑ Yes §�No If yes, list agency name and permit/approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes ®•No
[CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
���..:- �•t..��E- ►��r�t`P.� --
\
Applicant/sponsor name: ._ I I�w r� - �-� Date: -t • "_��
Signature: - w
. vrS7
If the action is in the Coastal Area, and you are a state s dR bi�e
Coastal Assessment Form before proceeding with thig; 9. tad
OVER
1
PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency)
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.12? 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 , E-114,0
=
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE' FOLLOWING: (Answers may be handwritten, If legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels,. existing traffic patterns, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly:
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
C4. A community's existing plans or goals as officially adopted, or a change In use or Intensity of use of land or other natural resources? Explain
C5. Growth, subsequent development, or *related activities likely to be Induced:,by the proposed action? Explain briefly.
C6. Long term, short term, cumulative, or other effects not identified In C1-05? Explain briefly.
C7. Other impacts (including changes In use of either quantity or type of energy)? Explain briefly.
D. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
❑ Yes ❑ No If Yes, explain briefly
PART III — DETERMINATION OF SIGNIFICANCE (ro be completed by Agency)
INSTRUCTIONS: For each adverse effect identified above, determine whether It. Is substantial, large, important or otherwise significant.
Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural);.(b) probability of occurring; (c) duration; (d)
Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that
explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed.
❑ Check this box If you have identified one or more potentially large or significant adverse Impacts which MAY
occur. Then proceed directly to the FULL 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 action WILL NOT result in any significant adverse environmental Impacts
AND provide on attachments as necessary, the reasons supporting this determination:
Print or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency
Name of Lead Agency
Date
E
Title of Responsible Off icer
Signature of Preparer (if different from responsible officer)
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION FOR APPROVAL OF PLANS FOR
A WASTEWATER TREATMENT SYSTEM
1. Name and address of applicant:
2. Name of project: P��4� S...t�;`;, � 3. Location:
Insite Engineering, Surveying & Landscape
4. Design Professional: Jeffrey J. Cmtehro, P.E. 5. Address: Arcutecu , P.C.
6. Drainage Basin:
7. Tvpe of Proiect:
Route 22
apaw.tar, Nuox Year 19591
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? ......................... ,11420
10. Has DEIS been completed and found acceptable b Lead Agency? �`�"`
P P Y ............... ,.
11. Name of Lead Agency
12. Is this project in an area under the control of local planning, zoning, or other
officials, ordinances? ......................................................... ............................... tick
13. If so, have plans been submitted to such authorities? ........ ............................... ;n a
14. Has preliminary approval been granted by such authorities ?,A Date granted: &D
15. Type of Sewage Treatment System Discharge ................. surface water _— groundwater
16. If surface water discharge, what is the stream class designation? ....................a..
17. Waters index number (surface) ........................................... ...............................
18. Is project located near a public water supply system?
19. If yes, name of water supply Distance to water supply �..
20. Is project site near a public sewage collection or treatment system? ................ �o
21. Name of sewage system Distance to sewage system
22. Date test holes observed 23. Name of Health Inspector M ey, -F->sA -7
24. Project design flow (gallons per day) ................................. ........ ........................ g�
25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?...
26. Has SPDES Application been submitted to local DEC office? ..........................
Form PC -97
2
27. Is any portion of this project located within a designated Town or State wetland? ;,c,
28. Wetlands ID Number ........................................................... ............................... �.
29. Is Wetlands Permit required? .......... ................... .....:....... ............................... t^--.N
Has application been made to Town or Local DEC office? ............................... %A- tc
30. Does project require a DEC Stream Disturbance Permit? .. ...............................
31. Is or was project site used for agricultural activity involving application of
pesticides to orchards or other .crops, solid or hazardous waste disposal,
landfilling, sludge application or industrial activity? ............................ Yes/No ono
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
DESCRIBE:
33. Is there a local master plan on file with the Town or Village? .........................
34. Are community water and/or sewer facilities planned to be developed within
15 years in or adjacent to project site? ....................................... ........................,,,�,,.
35. Are any sewage treatment areas in excess of 15% slope? . ...........:...................
36. Tax Map ID Number .......................... ............................... Map ic�, Block t Lot v.s
37. Approved plans are to be returned to ..... Applicant -A- 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 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.
1 hereby affirm, under penalty of perjury, that information provided on this form is true
to the best of my knowledge and belief. False statements made herein are punishable as
a Class A misdemeanor pursuant to Section 210.45 of the Penal Law.
SIGNATURES & OFFICIAL TITLES:
Mailing Address P.0-$.�...�..�f...
S3AdS HJ, -IV3H AN3
�t1N(iQ WvNind
d3A1303a
(I}Sc:6 Z2.
T?�_
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
LETTER OF AUTHORIZATION
RE: Property of A- Pr�a�Er�
Located at
Div Tax Map # l
Subdivision of k6vT0e;(--;__
Subdivision Lot #
Gentlemen:
Filed Map #
Block Lot
Zr7gZ Date Filed 60 "30" °(`l
This letter is to authorize incite Fhgineeri , surveyim & Larescape Architecture, P.C. (Jeffrey J. oonteLm, P.E
a duly licensed Professional Engineer' x_ or Rcg=*=d)0rKbd=xxxxxto 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,
Countersigned: Signed:
P.E., 11XXK., # (own of Property)
Mailing Address incite ayojneering, surveying
& Landscape Architecture, P.C.
Route 22
Braister, New YerAe 10509
State u w York
Telephone:
Zip
(914) 278 -4990
10509
Mailing Address: 5' °D '5f� -
`rr�to�i�
State Ny _Zip I
Telephone:
&Zr -oSo8
Form LA -97
/NS/ TE
ENGINEERING, SURVEYING &
caNOSCaPE aRCHirECruRE P.c. LETTER OF TRANSMITTAL
Route 22 (914) 278 -4990
Brewster, New York 10509 (914278 -6392
7 DeLavergne Avenue (914) 297 -1742
Wappingers Falls, New York 12590
TO: Putnam County Health Department
1 Geneva Road
Brewster, New York 10509
Date: -7-14 -99
Job No. 96134.305
Attn: Robert Morris, P.E.
Re: SSTS for Alonge - Lot 5
Quaker Lane, (T) Patterson
TM# 15 -1 -50.5
WE ARE SENDING YOU ® Attached ❑ Under separate cover via
❑ Shop Drawings
❑ Copy of Letter
® Prints ❑ Plans
❑ Change Order ❑
the following items:
❑. Samples ❑ Specifications
COPIES
DATE
NO.
t DESCRIPTION
4
'Zl-1.1
C -1
Construction Drawing
1 �7
-7 -99
CP -97
Construction Permit
1
LA -97
Letter of Authorization
1
7 -7 -99
PC -97
Application for Approval of Plans for a Wastewater Treatment System
1
9 -29 -98
WC -97
Previously Submitted Well Completion Report
1
-W
5 -14 -97
—
DD -97
Previously Submitted Water Analysis Reports (3 pages)
Previously Submitted Design Data Sheet
7 -7 -99 �
'7 -If
�--
Short EAF
SSE
THESE ARE TRANSMITTED as checked below:
® For approval ❑ Approved as submitted
❑ For your use ❑ Approved as noted
❑ As requested ❑ Returned for corrections
❑ For review and comment ❑
REMARKS:
COPY TO:
LoM.dot
❑ Resubmit
❑ Submit
❑ Return
I ` -,
copies for approval
copies for distribution .
corrected prints
SIGNED:
Co mo, P.E.
omw)
IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE
Solis Legend
✓c,vu
vu�unie
rtcmur.
>p.os, a5' - ?5' rddlrb brows loo+r
CIC
CHARLTON LOAM, 87 - 157 SLOPI
CSD
CHA TFIELD -. .CHARL TON COMPLEX .
nonOy loan'
7'
>7'
16 -20
129
429
571
Pro#. as' -?.1' -dam b— lo-
ran% loan
.owe, o.s' - ?' r.ddan be.� lion
`"y ra'dy I—
ipso/, a5' -l.5'r ddbrA brown lows
>7'
>7'
16 -20
1 J%
429
571.
SEE PCHO N
^•y .aody room
pros, as' -?' ndd/rn be- 1 w
'dylOO"'
>7'
>7'
16 -20
8%
429
571
Pro% a5' -2' ..ddin boss loom
e3. roa.n .
nro4 a3 = 2' mddV n b— sown
dy/a
>7'
>7'
1 -7
119
J00
400
pr t a5'-15' rd" brown loan
sm dy /own
pwe, a$' -?' r ddlab bom loam
dy law"
pwe. a5' -?' r dda9 bm- loam
>7'
>7'
11 -15
1 J%
J75
500
ndy loom
Rood Dedlcatlon Area 12
A t dd' td t
rea o be a lca e o
Town aI Patterson for
purposes
Solis Legend
\ (25' from q of road)
Area - 9,276 s.f±
CIB
CHARL TON LOAM, 2% - 8% SLOPE•
M9 2
CIC
CHARLTON LOAM, 87 - 157 SLOPI
CSD
CHA TFIELD -. .CHARL TON COMPLEX .
\ \
`vvv� ', 'I lµ ►- 100'
1c
y )'LAND N.1 �DEC�YrET1 AND.✓ - rBR�'f
BUFFER QV.-
\ 5`,
p
(GENERAL NOTE 41)
v� �\ \ _ I \ \ \ \ (} ,` ., Bood Area _!1_ Dedicouon
591.1x \
H drso'a' a n..
LOT 1� I �I 1 pl.: l ,rl I\ \ 11 11 \\ y1 \I\ \ r\ • \ es \\ \\ \-5 Q L A P
+aw�sVwww
1 1 \ \ \ \ \ P58 \ / \ 1.f
:0-� /x583.0 rS
yz
x580.9 V s]7.3x sad.: l• -ro•
A4 x
t.GS'
OF CONNEC ` \ I l i /Id 1 �.�.,.,.. 578.8
avn /775 x
�\ \\ \�
LOT 5 �P sts
N/F PALLADINO BUILDING, INC.
Final Subdivision Plat
NYSDEC WETLAND BR -4
(GENERAL NOTE 11)
Q'
0wner/A,oplican t
Stephen & Linda Alonge
586 Wood Street
Mahopoc, NY 10541
SSTS Schedule
J
LOCH TION MAP
Scole: 1"=1000'
---r\
500.6
Rood Dedication Area 12
\ y`1 —_ — — — Area to be dedicated to
x Q 6.4. — — — _ -' — _ _ _ Town of Patterson for
road widening purposes
"9 (25' from (F of road)
\ ! q — — — — — _ — — — Area = 9,276 s.f.t
\ X t7`z �� — — — — / \ 5091
59,.3 y ��D
591.5 / / � ... r._.. - -=e= � .. \\ \ \ \
\ \
/ L /R 1 a7d
595.0 \ \
\ — _ / / / / /j'�j -� /T� — 610 — \VO�t�\ \ ;�'y ~ \ '• \ _' _
Soils Leg end
CIB
CHARL TON LOAM, 29" — 89' SLOPt
Mottling and /or
CHARL TON LOAM, 89 —. 15Z SL OF
CsD
X Slope
Req'd Amount of
Lot
Lot Area
Deep Test Hole
Ground Water
Imperv.
Perc. Rate
S.S.T:S.
Absorption Trenches (ft)
ROB Fill
Curtain Drain
3 Bedrm
4 Bedrm
Depth
Volume
Depth
Volume
Remark:
Number
(in s. f.)
Description
Elevation
Layer £l.
(min.11n.)
Area
DIA: 0' -a5' tapaoe, 0.5' -25' rsdd1.h brvm I-
1
80,000
2.5'-7 .andy 1°
7'
>7"
16 -20
129
429
571
of& 0' -D.5' tapm4 a5' -25' -dw h brown loom
2.3' -7.5' sandy loom
D2A D' -a5' tap-k a5' -2' r.ddlah brown lomn
2
80,000
2' -z5' g y -dr 1—
>7'
>7'
16 -20
13%
429
571
SEE PCHD NO
D2& o' -a5' tapaW, as' -t.5' r.ddi h b,.- romp
L5 " -7 qny .andy roam
DJA: 0' -a5' tapsa4. 0.5' -2' reddish brown loam
3
100,424
2' -7 .andy loom
>7'
>7'
16 -20
89
429
571
D.ltk 0' -0.5' topso4 a5' -2' ,."M brom I-
2' -Y sally loom
D4A: 0'-0.5' tcplwo. a5 =2' r.W1M brown i-
4
129,429
2' -7 soedy loam
>7'
>7'
1 -7
119
300
400
D48., 0'-0.5' topso9, a5' -25' rdddlsh b— loam
25' -7.5' Bondy loam
.
as&. 0'-a5' tapsol, as' -2' reddish brown loam
5
86,494
2- Y .andy loam
>7"
>7"
11 -15
139
375
500
'
DSB: 0'-a5 ' (.F-I. a5' -2' r ddith brom loom
2-7.5' sourly loom
---r\
500.6
Rood Dedication Area 12
\ y`1 —_ — — — Area to be dedicated to
x Q 6.4. — — — _ -' — _ _ _ Town of Patterson for
road widening purposes
"9 (25' from (F of road)
\ ! q — — — — — _ — — — Area = 9,276 s.f.t
\ X t7`z �� — — — — / \ 5091
59,.3 y ��D
591.5 / / � ... r._.. - -=e= � .. \\ \ \ \
\ \
/ L /R 1 a7d
595.0 \ \
\ — _ / / / / /j'�j -� /T� — 610 — \VO�t�\ \ ;�'y ~ \ '• \ _' _
Soils Leg end
CIB
CHARL TON LOAM, 29" — 89' SLOPt
CIC
CHARL TON LOAM, 89 —. 15Z SL OF
CsD
CHA TFIELO— CHARL TON COMPLEX.
i v