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HomeMy WebLinkAbout0529DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 15. -1 -50.5 BOX 6 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 ex))05¢ G: /,M Ce) TuN k t, 'Pl;)e , /e c-l- .5 ;/e L� 4 q6 fo Ft, c(rc ,'u 3-A, �?o 36 �. 37 - L .m D O 0 b Q 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