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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 22.16 -1 -2 BOX 7 00536 ., 1p I ti y 1 1 lose I ML IN F � T 1 1` 1 I 6 ` ■� 00536 FPM COG a� PUTNAM COUNTY HEALTH DEPARTMEVT * * DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME 1 �!' ft"dj(�rnd P� arl n &zrc( j PHM q/V '7 R = q9 L� SITE LOCATION A774 1- ,4,,.;w, A,\ TM# MAILING ADDRESS V \ l / t ij� / i� cl r M. LiJ/ I 0 ll ) Jjylo h rJ kyl/ /,� J `.J [ PERSON INTERVIEWED -3 PaEID Canplalnt Name & Relationship (i.e, owner,tenant, etc.) DATE G ` 7 T q TYPE FACILITY PROPOSED INSTALLER �c11� ;/t- �.1 d 7" G'/ �! � x /- REGISTRATION # Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Proposal approved �_ Proposal Disapproved Inspector's '6/-7 lr� Efate / Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, o reported agent of owner agree to the above conditions. SIGNATURE TITLE6�?v`, DATE %�'� 1HS: V&te (ACID); YeUc w (Tan ffi); Pink (Appllamt) ?91a�7 � °gym' �1 � �?( L Jul 5 1" 5:7 -0 ai qq !j jj ------------ aa, G - - 2 PUTNAM COUNTY DEPARTMENT OF HEALTH ev. J /8ti' Division of Environnientel Healtfi Services, Camel, N.Y. 10512. Q� Engineer Must Provide P.C.H.D. Permit q - ': CERTIFICATE C NSTRIICTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or VWage` Located at D1i17 TTRS J/1( rrA'7D Ta: Map _Black_ _Lot _ Owner /applicant Name [7► 4 '� i ��Formerly y Snbdiv)�on Name Sabdv: Lot M Mailing Address �1� 1� Yt2AD Vp I2'CS J Date Permit Issued (O Separate Sewerage System built by W Address Consisting of © Galion Septic Teak and tI,4 tP Water Supply: Public Supply From Address or: Private Supply Drilled by Address Building Type Hsu. Erosion Control Been Completed? Number of Bedrooms Has Garbage Grinder Been installed? Other Requirements I certify that the'system(a) "as listed serving the above-premises were constructed essentially as shown on lens of the completed work ( copies of which area ached); cad in accordance with the standards, rules and regul a, n rdan with i p n, and the permit issued by the PutnamCOunt D paztm t O Health. Date G/ Certified P.E. R.A. Address License No. Any person occupying premises served by the' above systems) shall promptly take such action as may be necessary to re the correction of any unsanitary conditions resulting from such usage. Approvai- of the separate sewerage system shall become null and void as soon as a pub,': sanitary sower becomes available and the .approval of the private water supply shall become null and -void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Commissioner of NeaRN w revocation, modification or change Is necessary, Date �T�� ?// // B Title T ` COUNTY,OF WESTCHESTER ":` NYS'LL P #10108 DEPARTMENT OF.LABORATORIES:AND RESEARCH; $ E11- Rev 91 :a Y VALHALLA; NEW YORK 10545 t 6ACl`ERIAL' EXAMINATION OF DRINKING AND TREATED VNATERS'4 Lab No. W i r')` �. ' 6110 � Bottle No, LabNo Entgatf6ollz Time Set ,� rr * Time Submitted Tests {circle) SPG; o rc i P /A; or1 ' MP Fecal, Other; 1 Coll'd By ; Agency Coll'd For - - Co11'd From: Name) �. RE. Address (Street) (City, Town, Village) (Zip Code) iCounry) Identification of'Source - Sampling'Point within Premises �-4 a •'�'� Refrigerated? { ,Chlorinated?.'-:'.- Yes :_ No Free mg /1 Total- RESULTS.OF EXAMINATION OF_WATER P/A /100 ml MP. N /100 m1 Total Coliform Total. Coliform x � a <E. Coli y t a Fecal Colrforrn �'"�^�- •_...�- :. _ -:i Standard Plate Count Other ) Bacteria Per mf 48 Hr," „ .... These results indicate sainpl wa as-ri of Reported °6 y: Date satisfactory quality when sample was collected x Anh Marie Bury } .a, PUI'NAM COLWY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMEN`T'AL HEALTH SERVICES Lkog\e 4. Afro -w cL\ - cL- -if)05 Owner or Purchaser of Building r ITI O Building Constructed by Location - Street PP� ! zsnnTg (PuMI RAn L-6), Municipality If-, ' V OCILe 1�--q mk uq Building Type t �) . ,cl, -� Section Block Lot Subdivision Name Subdivision Lot # GUARANIM OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this � day o 19 Signature G ��l�i� ;` �.I!: /:l .i�t�,_ ✓J (� - _Title 0444C-Fe- General ,;• {� _,, ,- l General Contractor ( Owner) - S ' nature 1 v U� 4�, X c c1 yc�- ( v Corporation Name (if Corp.) Corporation Name (if Corp.) E Q (1?),A Address rev. 9/85 mk -T�rwh l I I Cl/-' c t.YyYtE ( r1(.� Addreits z CA_T 01. J/ oto ris '2 WPIL UV1v1.rLL11U14 1USrurU. DEPARTMENT OF HEALTH Division-Of Environmental Health Services PUTNAM COU NTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION E ADDRESS. TOWNIVILUG111CITY. TAX GAtO NUMBER : �tk cr • t/d I ' V e+s 0 Y) WELL OWNER NAME*. ADDRESS: ' P11 -C tj Lt. Ftic I ki 0 A) SPBIVATE PUBLIC USE OF WELL 1 - primary 2 - secondary RESIDENTIAL' ❑ PUBLIC SUPPLY ❑ AIR/CONb./HEAT PUMP ❑ ABANDONED 10 e;03 ❑ BUSINESS ❑ FARM ❑ TEST/ OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND-BY ❑ AMOUNT OF USE YIELD SOUGHT gpm.1N0. PEOPLE SERVED 5' EST. OF DAILY USAGE S0 gal. REASON FOR DRILLING ❑REPLACE EXISTING SUPPLY []TEST/OBSERVATION []ADDITIONAL SUPPLY [RJNEW,S,UPPLY� (NEW. DWELLING) DEEPEN EXISTING, DEPTH DATA WELL DEPTHS ft.1 STATIC WAT ER LEVEL ft DATE MEASURED DRILLING EQUIPMENT ❑ ROTARY I ' COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING a OPEN HOLE IN BEDROCK ❑ OTHER CASING TOTAL LENGTH 15 fL MATERIALS: 9 STEEL ❑ PLASTIC ❑ OTHER C LENGTH BELOW GRADE ft. JOINTS: ❑ WELDED 19 THREADED 0 OTHER :DETAILS DIAMETER in. SEAL: [D CEMENT GROUT,, ❑ 8ENTONITE,..0 OTHER WEIGHT PER FOOT lb./ft. I DRIVE SHOE. M YES ONO LINER: 0YES ONO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft) DEVELOPED? IIIIST 0 YES ONO HOURS SECOND GRAVEL PACK 0 YES 0 NO GRAVEL SIZE: DIAMETER OF PACK — in. I TOP DEPTH —ft. BOTTOM DEPTH 'It. WELL YIELD TEST a' If detailed pumping METHOD: 0 PUMPED i tests were done is in- R,COMPRESSED AIR r formation attached? 0 BAILED, 0 OTHER ❑ YES 01 NO If more detailed formation descriptions or,s jeve analyses WELL LOG are available, please attach. DEPTH FROM SURFACE. water Bear- ing well Oia- i"Oer n. FORMATION DESCRIPTION COOE ft. ft. WELL DEPTH It. DURATION hr. min. DRAWOOWN It. YIELD 9prn. Land Surface tN 0 .5 o ii /�00 4s, 30-17 /Y1 hr ct, �9 C S it 0 00 i- art W El WATER 0 CLEAR TEMP. U r QUALITY T QUALITY 0 CLOUDY HARDNESS 0 COLORED ANALYZED? OYES ONO ANALYSIS, ATTACHED? 0 YES ONO it STORAGE TANK: TYPE CAPACITY GAL., + PUMP p UM UMP INFORMATION P TYPE. TYPE. CAPACITY MAKER DEPTH [MA KER MODEL VOLTAGE — HP WELL DRILLER NAME k1W143_)_1C1- DATE, H—VI DRESS AD SIG4&URE J/ oto ris '2 TYPE ON COMPLAINT FORM Yes No INFOPUMIATION FOR COMPLAINT FORM 'Or�LA INT : `. 22 Lj .G S �.-� �Cc ��'�'' �,�" ._.rte' l �%% .�✓" c-� DIRECTION : // TAREN BY: � REFER�D TO DATE: 74e 1 0 DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION TO CONSTRUCT A WATER WELL 23-06 PCHD PERMIJ # WELL LOCATION Street Address Town/Village/City Tax Grid Number L- uo ►n &-ra L_ - n: Pwa egson - WELL OWNER Name Mailin Address Private F' Ut:, �/ G e O Public C E OF WELL primary 2 = secondary RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP ® ABANDONED BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify, ® INDUSTRIAL O INSTITUTIONAL O STAND -BY p AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGEjt9A L1 1 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION 12-ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING n ie il C � WELL TYPE MDRILLED DRIVEN ®DUG ®GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES A NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDE ON SEPARATE SHEET (d te) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty. (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well dri g operations be contained on this property and in such a manner as not to degrade or o er -se contaminate surface or groundwater. Date of Issue: 12 19 q1 ,Y� Date of Expiration 19- q_3 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller U1 1-, ;7 p `r U 3; Ilr 1'• (r U jrirt t-+ u 1 (1 ,U ID N t_7 I� N (D p n U) ,CI el M ((1 :j in , � r,* � t7 in H. ,' (D I), v , , In rIr' �J U I 1 U) N �Ei � 1-3 ill a (U .3 J� tU (l_ rr , Irl�. 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I— i lU <; � (D p n U) ,CI el M ((1 :j in , � r,* � t7 in H. ,' (D I), v , , In rIr' �J U I 1 U) N �Ei � 1-3 ill a (U .3 J� tU (l_ rr , Irl�. (-) u l'J U'U 1•'• h I'll (n 1-1 O (n rr 11-1 F 2 �v<11 r- rr U 0Ul z R1 h'i 15. n) G N • :: In rr ice• It rt n U N fif rr Eli Cr!1 a U) J rr (U U7rrU, t V U , G D ili (u t� rr rr , (p It 1llj U7 u) r rU (U) I Jl IU (I,I "I '-J U) ,CI el M ((1 :j in , � r,* � t7 in H. ! I-• n 171 In Q r(1' rIr' �J U I 1 U) N �Ei to (U .3 J� tU (l_ rr Irl�. (-) ID (U 'U (U r 1.1 (1) 0 (n ri r- rr ' O (1) G N • 0 rr ice• It rt n U N fif (u U rr a U) I I•'• n c)1 t V U , \ to n hi IU rn u' i lr ! I•r, r.1 , I II rn I -I z I1 I!) I C-) C) '/1 Q) c �i rr 1� =1 L d7 GAN =. 1U ff -/•444 r 1 �Q C) rJ ;J J J I� cn O K �I In trt.. • I ry J (!1 l +J n .z• W �J tJ r ('I) n ti cn 11 M (f, li (. F, U, cn <<J jFjnq --C XJWY DEPARTMEN'P OF BEALTH s DIVISION OF . ENVIRONgRIML HEALTH SERVICESl�'rrl: DESIGN"DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.." owner11 /�11IiF14�ddress /�D�'�XG�r Located at (Street) �l% /ik 720 kVIZ / P Sec. Block Lot (indicate nearest cross street) Municipaiity /"f47 2.�p�C% Watershed �. SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMI= WITH APPLICATIONS Zza Date of Pre - Soaking -, Date of Percolation Test HOLE - — - . - - -- - NUMHER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No, Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches 1 SID -Of 71 Sz 2 3 i s �- Oil Ih IS d�IGi% ` ©tr I �1Z ��2 ' rs 349 M , lo s 47 Jic U. 3 5 NOTES: li Tests`°,to tie repeated at same depth until approximately equal soil rates are:obtained.at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made fram top of hole. rev. 9/85 D G.L. 1' 21 .. TEST PIT DATA EPTH HOLE NO. "6f' d 31 V,*A 40 5° 6° 7° 8... g° 10' 11° HOLE NO. ' 1 �r r, ,ICATION yp:*� HOLE NO. � 129 13.° _ 14' INDICATE LEVEL AT WHICH GROUNDWATER IS Et OOUNTERED I'd° 2 A a, ct D 91,06 9 INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER ZEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: A, o B DATE: Simi ' DESIGN - Soil Rate Used Min /1" Drop: S.D. Usable Area Provided umee ' ,No. of Bedroans Septic Tank Capacity 1. Ze 0 gals. Type ®d Absorption Area .Provided By 00 L.F. x 24" width trench P c F J-- it A_ • - �� � , „� �.. ;.��!!Il��� ors' i/ _ . � . , � \7 P / W Name e�( Aj t2h F--r, Ko (cu Signature Address 6 SEAL THIS. SPACE FOR USE BY HEALTH DEPART ONLY: Soil Rate Approved sgeft /gal.. Checked by Date ,,,r,,,,U -�- �,�,� -des NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 'PERMIT NO. 3085 -0984 UNDER THE ENVIRONMENTAL CONSERVATION LAW 8 ARTICLE 15, (Protection of Water) ® ARTICLE 25, (Tidal Wetlands) ARTICLE 24, (Freshwater Wetlands) ARTICLE 36, (Construction in Flood Hazard Areas) PERMIT ISSUED TO William Kelly ADDRESS OF PERMITTEE od Road Carmel, NY 10512 e LOCATION OF PROJECT (Section of stream, tidal wetland, dam, building) In wetland LC -14 west of Luddingtonville Road adjacent to the Patterson Town 'line DESCRIPTION OF PROJECT . Install a well for a single family residence by the placement and them, removal of cjeail fill material in accordance with the report and plans prepared by Rudolph Laurent entitled "Wm. Kelly - Proposed SSDS" dated 8 -20 -85 (revised 12- 27 -85), ; COMMUNITY NAME (City, Town, Village) TOWN r ? e Patterson " COUNTY FIA COMMUNITY NO. DAM NO. PERMIT•EXPIRATION'DATE , Putnam December 31, 1987 GENERAL CONDITIONS 1. The permitlee shall file in the office of the appropriate Regional Permit Administrator, a notice of .intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation who may order the work suspended if the public interest so requires. 3. As a condition of the issuance of this permit, the applicant has ac- cepted expressly, by the execution of the application, the full legal respon- sibility for all damages, direct or indirect, of whatever nature, and by whom- ever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from the said project. 4. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of the waterway or flood plain or deep holes that may have a tendency to cause injury to navigable channels or to the banks of the waterway. S. Any material to be deposited or dumped under this permit, either in the waterway or on shore above high -water mark, shall be deposited or dumped at the locality shown on the drawing hereto attached, and, if so prescribed thereon, within or behind a good and substantial bulkhead or bulkheads, such as will prevent escape of the material into the waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. That if future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters. or flood flows or endanger the health, safety or welfare of the people of the State, or loss or destruction of the natural resources of the-State, the owner may be ordered by the Depart- ment to remove or alter -the structural work, obstructions, or hazards caused thereby without expense to the State; and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the Slate of New York on account of any such removal or alteration. 8. That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by of result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 9. That if the display of lights and signals on any work hereby authorize( is not otherwise provided for by law, such lights and signals as may be pre. scribed by the United States Coast Guard shall be installed and maintained by and at the expense of the owner. 10. All work carried out under this permit shall be performed in accor. dance with established engineering practice and in a workmanlike manner. 11. If granted under Articles 24 or 25, the Department reserves the right to reconsider this approval at any time and after due notice and hearing to continue, rescind or modify this permit in such a manner as. may be found to be just and equitable. If upon the expiration or revocation of this permit, the modification of the wetland hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of. Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the 'e to its former condition. No claim shall be made against the State of Nevr York on account of any such removal or alteration. . 12. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 13. The permitlee is responsible for obtaining any other permits, ap- provals, lands, easements and rights-of-way which may be required for this project. 14. If granted under Article 36, this permit is granted solely on the basis of the requirements of Article 36 of the Environmental Conservation Law and Part 500 of 6 NYCRR (Construction in Flood Plain Areas having Special Flood Hazards — Building Permits) and in no way signifies that the project will be free from flooding. 15. By acceptance of this permit the perrnittee agrees that the permit is contingent upon strict compliance with the special conditions on the reverse side. 95 -204 (9/75) (SEE REVERSE SIDE) ,�, � —: _ _ wis - ' _r_ - � .. — •+..1..L'•.eiL — -- — ...o...1a:..wv..u.'_Jvi.)..: ' �..�. _• •r.ar.::+..r�.,t ,- s:�.:,..] —. _. t � ` _ S iPECIAL CONDITIONS 16. To satisfy the requirement of General Condition No. 1, the permittee or a representative shall contact, by telephone, the Division of Law Enforcement in New Paltz (914/255 -5453) 48 hours prior to the commencement of any portion of the project authorized herein. 17. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads and understands this permit and all special conditions. 18. The fill material shall be removed immediately after the well is determined to be operating correctly but before the expiration date of this permit. 19. All necessary precautions shall be taken to prevent contamination of the waters of the wetland and the stream running through it by silt, sediment, fuels, solvents, lubricants, epoxy coatings, concrete leachate, or any other pollutant associated with construction and construction procedures. 20. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. SEQR NOTE: Under the State Environmental Quality Review Act (SEQR), the project associated with this permit is classified as an Unlisted Action and the Department of Environmental Conservation (DEC) has determined that it will not have a significant effect on the environment. Other involved agencies. may reach an independent' determination of environmental significance for this project. T ISSUE DA/ r/ I PE * ADMINIST OR A D ADDRESS 21 S. Putt Corners Rd. wnr., Pni t- _ my 17561 -1696 14 -12 -5 (12/87) -9c NEW YORK STATE DEPARTM T OF ENVIRONMENTA CON ERVATION NOTICE OF INCOMPLETE APPLICATION THIS IS NOT A PERMIT /0GA -771N,' Lc- C.aj1ZlGi-0N k 11 12:� 1?c'4A APPLICATION NUMBER OWNER ID NUMBER PERMIT TYPE(S) WF APPLICANT FACILITY /PROJECT ADDRESS g6o - FAJU CITY •Gr � STATE ZIP CODE LOCATION �5" T- ��rR •off - P�frpa� Your Application for Permit is Incomplete. The Following Items are Required: x�Completed application form (enclosed). El Other DEC permits appear necessary. Submit appli- Y 1Completed Part I of the - IiShort Environmental cations (enclosed) for the following permits: Assessment Form (enclosed). ❑Completed Part I of the Structural - Archaeological If you have reason to believe that all permits should Assessment Form (enclosed). not be processed simultaneously, please notify the ❑Project location map (USGS or equivalent) which clearly contact person below, clearly stating your reasons. ❑The project is being reviewed pursuant to the State shows the project location with respect to identifiable Environmental Quality Review Act (SEQR). A desig- roads and other notable features ( copies). nation of Lead Agency and determination of signifi- ❑ Project plans /Engineering report ( copies). cance will be made before your application can be ❑ Survey map showing the Freshwater/Tidal Wetland considered complete. ❑ oundary at the project location ( copies). ❑ Signed letter from landowner giving you permission to the Lead Agency, has determined that the project may have a significant effect on the environment. A draft apply for a permit on his/her property. environmental impact statement must be prepared or ❑ List of other agencies having jurisdiction over project. accepted by the Lead Agency. Representative color photographs of the project area ❑ The correct fee was not submitted. Please submit a and surroundings. Please label each with a description check or money order payable to the New York State Department of Environmental Conservation for and date taken ( copies). ❑ List of previous DEC permits for owner /facility. ❑ See attached checklist(s). X& You may be contacted for additional information. )(NAdditional requirements: &1e o P.0- vs'7-Ru-a7- �y6A1e1i in 4 1 I da.tt r)t,& Of Sl*� S-' S), 2 r o^e.ascat e Te_ f- �/✓ ��Kok V' x Ao-r l`ock`6Ikq 4KS�S JJea► an Leis S,-,4 �� D4r �0/�a�tG t/ ?tea con-,er" .& -dd / /' �1S L 56-Q k� v� 4 we/ 2 S tad/ CLS � cc �r CL r4a.J tax Fo^ Z.cal eel %¢w� e e6- Please submit requested information by No further action can be taken until all of these materials are received. If you wish to withdraw your application, please notify the contact person below. Thank you. ❑ A conference is recommended to discuss this application. Please contact the person below to arrange a meeting. CONTACT PERSON DATE �a9 90 TELEPHONE NUMBER c9i )as3-- l Return the WHITE COPY of this form to DEC with Requested Information. Retain the YELLOW COPY for yourself. CC: �® GOLG w`,o /'%.' - T_ sr&. Ly .-J 1012F.ex 7 OF Ea?� .-:! - DiVII, SICIY Cr =r i7 S i-� -rER Su: Pr & -Perm, it A:-,ol-;c-- t- Th s Plans ree sa S/S ----------- C p- Data 7 7' -CN -=rz: C P=S S -1-1-olase ':-'-'a-n.s Two s;-=-' S W�ii Vari =-Ice -T-a:7a! S-'O--2 Sub!- Pre-1969 D) D-a-*—= On D S Ea:- '00" tre:lch Z)rovi ded Tj V C., S=---waq-3 C-31TS-, :ieM 17 D S S r-a if cv=r C--n-Str�2c-'icn Notes c- _:^_ -Ca=? V Al Dr-*�;ew= & SI.3r,=s Oa- -V D:-a-ns -T -L L--Catea- - P or S en 0 F 0 ty fl- 1- —17 10 & D Bcx E-lown & ii 1 note-cz House IRC). OJ- f Bp.-f-rocr n-aw szec. SS-LS' S w/-in 200 Zft. Of P:7,DOcS=--: S*.5tem-'s & LOIN lr� c::-=—,-ck Necessaz-v io-) -00 vr. Zflcr- eilev. No May. 3?r,:as 6 30 ,;/cleanOut N T7, ald, S 101 to P.L., Dr -.7 ew T=-g-, T- -7 - -_ ees T= c-f f; 1 201 IS Z'z. r 100' to W�ll; 2001 i.. D-L-O.D, 1501 100' to wa-e-course, -Ta'ke DU �7. 1./—= -I 0 15' - raa—er, 7 L.-O Catch ib' to 'w,7ater Line (pizzz-291 50, irt--m-'ritten- L Se:Dtic Tarks 10' frar, 50' zo well P7 ' 6 .. 10 _ ool toI t` °a , P[ MAM _COUNTY DEPARTMENT OF HEALTH NVIIIIb>; d Fsvbmmi metal Hedlb Servloei: Cirmei.NX ISSI? to Provide Peemlt i' j on CERTIFICATE OF COI hiikNCE, CONST!<UCTION. FPNl r.FOR.,SEWAGE DWOSAL SYSTEM_ Located u - ' G� ad. : ewn S"VWon Name : Lot N TAX Map Bbdi tom* Own - /Argil t Name �'1 E'J . 1 Cif �3.h �! R ~ al_� RevWon � Date of Previous Approval-' " Address' f'GZ t Y''fiGr� Fhh�lil �y' Town zw 3 , tdt Ares q1a 73 ''� '�' Fm setae �:,.• ,:, ... n OWY Depth Number of Bedrooms a Deal& Flow G 0.11 0� -. PCHD Noun b Required wb.. iii Ie completed _... Separate Sewerage System to consw of —Gallen Septic Tack `fins To be constructed by Address : . Watei SpFPh't Public Supply From Addi or: Private ddresr Other Heguieemenb ' I repiasarit'that I am wholly and cornplet6ly responsible IO►tM despn,'and location or 'tn6° proposed; system(:); 1) that1he separate sewage fl sposal "system Above described will tie• :constructed as shown on the�approvetl�ainendZneni their 'to and in accordance with the standards, rules an regu, •_ons o s _.. u Sam County Department -'of_; Health, and that on completion thereof a'.!Certificate of - Construction Compliance -', . satisfactory to the.Commissione► of Weafth.will bo, submitted to, "a Department, and °a written quaiantea will be furnisAad the owner, his suceeuors,'beits or,assgns by the bullltp, ^that,iaid builWr vrlll. place in good operating, condition • shy °part •'of saiitl sewage' disposal systefn during the period of two.(2) years imfeediately foll6witq :lee "to or ahra issu ante of tit approval of the Certificat6 of Construction' Compliance a original system or any repaits thereto: Y) that the drilled well desaibW .above' will be located as shown on the approved plan and'thaf said well wi e' install in ac dance with t .its r s, rubs and requ &7133ns y of :. ,the Putnam Coonty Department of Health Date SIPn P.E._L R A AY Address ' 6' License No ' APPROVED FOR CONSTRUCTION:This approval' expiies tw_o years from the' date issuetl unlesi construction of the building .has. been undertaken and is revocable for• cause or maybe amended:or,m"d fied when considered? necessary, t;y. the Commissioner of.Mealth. Any .change .or, alteratlon' of construction: reauires a new --permit '.,Approved for disposal'•.of domestic = sanitary Vewage, p 'vale 'watei supply only. - G� %s' Title// APPEN,DDC 3 P 22 COUN'T'Y CF F—E= LUH CF -a- -I D0-TV_—''X:-U, i9-T• SUPPLY & SUESS =A C D---SP=-.r S'_ S -W C'CNS__"_RUCT_-CN PE-3m-i -- v - z 1 - - 7:Zly ca:a7e Loc—ation) CC % \-O DCCT_M ----\--PS V- I Permit APPlication A" Co lqm� a U te Resolution V- 12a'1S - 7hrzc sc=-,!_-S S/S gineiers --ut3icr_iZ=_.* D-ata 7 S _7 ON Deep Eole L,-)::; _AP TO COns'Stent Perc Res-1-.1ts (3) r-_ Perc tole ceotlh Cd ca House Plans T ,qo se-- --wel Pe mi t; P _'-Z aria7nc_eR-_:-ueSt NZRAEI Legal Subdivi s. on Pre-1969 b-cAivision Approval -zDrcval S-5 SDS Ad Lots Checked Nei bor notification -- _: R D) and P=.4._ .- rata- On ocs Plaz's & =C1 DrOV-1de-d LF trench orovi I- D -REQUIRE D=_k = ON PLIi-NIS e! 7_ U i r e: d - -1 - Sy s z---m PlEM - (no= =z ar- row ) 60 zct. Max. SiFwage Sv t:-_-,, =Ijara U Pro-cil= & Dime _100% D or i Box ;-_'r___ch/C_aj*. =r,7; p,.2p pi S Septic S-ze, over Cons-L--action Nvotes ' r e) .aer a Cesign Ca - a: ,>z-r- and e-=e:D r qiil, --,z wlz�p MIEN Two,-Foot Cor, ours a,,;:z n & a 110 Privaway & Sloo�-_S Cut F00ti-.1a L_ (dischazze CK) j C: rC r IL'T' SYS`jar L-ative Of rl _�S 1 =�� S IJE'2��C� 10 ty J:: 1 z e f il notes If PL----,--ld Pi -t- & D x & Deta-Led new sD—__. Eouse - No, of Bed-rocrs I lqamllis & SSDS'S wlin 200 of proocz-4 �Z-' O-e:Dtq cauzes PrC)ZDe--',-y & Bo- - - __ _"'s-a-'s House S ( --- I i 'g t lot) _LUU yr. flood ellev. House -Seew r /4 Tyz'e P.Lz:e N o B e �n=d� s '4 '_50 w1cle-F--iout SZRAa ATIONN DISTLN-k SP = ON PLIAN Fi P1 10 ds L Z r D T n 200 C' f Li *- D.T. reservc to we 1, -.O.D 100, to Stl—, 35't0 io L-0 Water Line (p _:z_=-291 50, irt:a--m ittent (arL= C:e Col—IT Se Sebtic Tarils - 10' frcrr, Foundation.; 50' to well 15, Well to Pr DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 February 7, 1991 Alexander Kolenda 210 Marble Avenue Pleasantville, MY 10570 Re: Proposed SSDS: Fricchione Ludingtonville Road (T) Patterson TM #13 -12 -7 Dear Mr. Kolenda: JOHN KARELL Jr., P.E., M.S. Public Health Director Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows 1. A section of the proposed SSDS appears to be in direct line of drainage to the existing well on the property located south, of the above- captioned lot. 2. Expansion area for the proposed SSDS has not been shown on plan. 100% expansion area is required and the minimum one deep test hole in this area is to be witnessed by a representative of this Department. 3. T e minimum of two percolation tests are to be witnessed by a representative o� this Department. 4. Enclosed are the Putnam County requirements for fill sections greater than two feet, revise plans accordingly. 5. Fill is to be shown extending 10 feet from the end of the absorption trench and then extending 2:1 to grade: 6. House sever is to be noted as having a minimum slope of 1/40/ft. 7. Engineers authorization form has not been completed, i.e., address and telephone number of owner has not been provided. S. North arrow appears to be incorrect. 9. Erosion control measures are to be shoirn and detailed on plan. Upon Receipt of a submission, revised to reflect the above comments, this application will be considered further. Ver truly yours, Robert Morris Assistant Public Health Engineer RM /jp Ceem NTH flOSl ?R t° provlde'MP� S PpTNAM COUNTYMPAR MOM OF Dlvbiloti of Envhgnmental Had& Sea kiss on A OF CO CE ` CON _ .. ON PERIYdi FOR SEWAGE DISPOSAL SYSTEM, p `'M' Lomted .d�It�B "4iTl�tdld1��'�fj� -CD - .;' own or ,i�rge , SnbdlvWon Name ttlbd: Lot d Tag ASP Block i 2 Lot Renewal Revle"lon otvnor /Ap Welle Name 0, a e`s O! ! l✓� Ir s� ,11 ate t•Pievloaa Approval � G �• � .�> Addreee W i-ea To Tdp Melling v'° 8 TyPe . Lot Ares Fill Section Oily Depth: Volome Namber of B e d t g o m e Deeign Flow G P D ,(a Q PCHANoUffin don Is Required Wben Fill is completed , Seporaoe Setretse System to tGpb Taol any 000s To, be eonateacted by Addre e Wfiter Suppb: Pdblic.Sapply °From Address or: PAvate S4jo ElMod by Otliee Reoaleetuonta 1 represent that 1 11M wholly and completely responsible for the design end location of the proposed systeni(t); 1) that .the separate sewage disposal system a0ove tlsscribe0 wlltbe constructe0 as shown on t�e;sDDrovedsmentlment there to and in accordance with, the standards, rules an regulations o 0 u nam County` Department of Hwlth antl that,on Completion thereof a " Certificate. of Construction; Compliance" wtisfactory:to the,Commissioner o4 Heelthwill be submitted to the, Department, and a written'gusrantee. will be furnished the owner, his successors'. heirs or assigns by the builder; that'said builder will place in good. - .operating condition any part 6f. said sewage. dispoul'system, during the ,period. of two, l2) years' Immediately following the date of the issu- arice Of the, apopval of the Certificate' of ConstruetJt. ?, ompliance of the -oiigin6Csystern or, any repairs thereto;.2) that the drilled well desc►ibed� above will be located es shown on the'appL .e plan and that said well will D in ,actor ants with the stbntla rules and regu�Tiions f the Putnam county ciepartment of .Ftealtfl .r., . Oete 4-� �� ��� Sgned .s 0 E A- A'dtlress ` License No APPROVED FOR CONSTRUCTION T,hii .ppproval,ekpi►es.two years .Iron the date issued unless construction Of' the building has been undartaken.and is revocable for cause or may be amended or modified when considered necessary .tiy Ithe 'Commissioner of Health. Any Change o.r aneratiop of construction repuires a now.permit.' vad for A401#1 of domestic_sanitary.,sewage, snd /O� water supply only. . /187 Date 8 �� - PU1.. M COUNTY DEPARTMENT OF HE. )H ENGINEER TO PROVIDE PERMIT # ON CERTIFICATE OF COMPLIANCE, Division of Environmental Health Services, Carmel, N. Y. 10512 PERMIT # STRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM i�r� , ; �: •, 1 i'Ct� i '' Town or Village I ? ocated at _ U' 1 VI Q t% i ( ► i r t2 / Tax Map .l.. _` csc: ,_ wt Subdivision Subd. Lot M Renewal _ ❑ Revision _'E] I1 f1 11 owner /Address (, I/ ,' ! tt4 -•1, \ � � 11 � I, r• 1 1 7 r+ Date Of Previous Approval Builtling Type t G Lot Area ;� � > •� Fill Section Only fl Number of Bedrooms — Design Flow G /P /D 1a( P.C. N. D. Notification / Separate Sewerage System to consist of 00 Gal. Septic Tank and To be constructed by Address Water Supply: Public Supply From Private Supply to be drilled by Address Other Requirements _ 1 represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations or the u nam County Department of. _Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill 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 disposal system during the period of two (2) years immediately following the date of the issu- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be inifalied in accordance with the stand rds, rules and regulat— o� ns of the Putnam County Department of Health. Date J A,-) Cl Cl Lp Si91ne !�< <X� -!7" i. ,'i..7.��: /.'..�f �i. f .,r�. P.E. R.A. r , Address d1r r /Y' �� r•��• 3 License No. APPROVED FOR CONSTRUCTION- This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alteration of construction requires apew�� permit. Approved for disposal of domestic sanitary sewage, and /or, brivate';water .supply only. �� _ y Date_` =-i By ,.Qtir1' 44 fP` %I7i Title A', `& Rev. 6/65 .. ..._..._.. _... .. _ . _. _ . Health •�'Dat'e of Prevlonoe�ibprovdtt` r y Api 4r 1(r+1 r$( s o �r'S�ti e��' Q U rYOH� Y go(ir�pgY�f �KC Q n Let :Asea '7.Si� I ✓ :V 9 TiO.�eCiIOD 0"V t i�eQtb f T I�OIYmO i, r DeatQn Flow G P D ®�` PCHD Not(8aflon b Hequhed Whoa FtII Is ooanpleted '.; ,•..,.••. t• ; w. d r � i- yH... -t r .. ... ,,.. o-i ,.. r s w x�'s- t �f .u'hR S '�. i �. C �eparste SeweeaQe 5yatam "fo oonatat a[ aOeo SeQtk Tack ;i'wTOfb00000�OC(aa� � - � � t � ¢ �a[Me �'S 5`t, .�'7�s ,< I- yFrctt'rs ,�F' 'S•i^i - i? i. -� r � t 3iigf��Ra,A' �'l�'� t, wt � e '� ..lh.��V .SN'A4 [ 3u bs�t j6�^� '``�,�y�y'�" '�r1,�`cs�$b{�• .�� / rr ? rr r � afe[ Sapply' x, '>a�u.' PknO! '/% 3 r ♦AA.d.. ! 4 ! 15 r�L d c s X 3 ? p� r rrmyt x�6r l� a�'?�: f 3Y ;� wv"1f A t, . aft. <L 9, ►it¢ .�1 �v� `' ii A h "CS' i'drta•t' t yy ,: R,�,r� '. �5, .- Qt6etj:eQylr'E�enbMi,°tI",:°� +��'�..i'�7N, �i,'�ix; n +r,:i ��MYir.`�:T.{�i4'�'��l 's":? ...�fi'�•.,`' s.'�.- .:u�?,Yt�r,St.• -.. dw;.� t. trt?r %�f.♦ �'� 1 represent that 1 •m wholly and completely responsible for the design and location" of tth• .pi oposed..system('M'4 )' "that the separate towage disposal eystem'. atwve described will be Constructed as shown on the approved amendment th•ro Qo and M accordance with the standarids, l`ules and regulations o • u nam .County Department of Health, and that on completion thereof a "Certificate..of Construction Compliance ".;satisfactory to the Commisslon•r of'N•althwill .b• submNted to the O•p"tment,.aeW I .wNtt•n guarantee will 0• furnished tho owns. his aueoossorf; helrsor attigns by tho bulid•r,tMt pId builder will g bc• if1 good Op•nting COndflian: any qn of _ pW swage difpofal system durkp the p•rbd of two (Zl years Immwatoy tollOwirg tMdat• of the kstr-. ,i'f -once Of tho approval Of ;M CertNicat• of Constructbn Complbnce Ot the Original system or any repo Ns thar•to, 2} that tfM'drNled well scribed abOvq will be located as shown on the approved plan and that Yid well will * in actor ands wild.. the stand tuba and ;fepu !'TT'on %f the; nam "Count M Of NMlth. „ ti b1\ /Q� .`' r' e `SFSrx�i'1+J,4`.- �1,MJ►edress`7 tf P-!�, ��l �.'1 t.�' rlV �1'�Yir •..) .APPROVEO FOR- tdl4STRUCTION: This approval exolres two.years `tram the vale issued' unless construction ii vevocable for Cause or maybe amended or modified when considered necessary iby the. Commissioner, of Health,. taguir•f a nsw �fermit.74ppprovd (or 4lsposal..of domestk ianitar tewaga' red /a ` prate water 9upply;,onli .Y , (Permittee) h and 0 't PERMIT. "NUMBER .: .. . is is to advise `the Putnam "County Health Department - 'that fill has been placed on the below captioned property on Da `` /0 (Street to t' ) ( Town) ,. (Permittee) h and 0 �s 713 q cov_t-� New York State Department of Environmental Conservation , 21 South Putt Corners Road New Paltz,.NY 12561 -1696 914 - 255 -5453 Thomas C. Jorling Commissioner February (b , 1988 Mr. & Mrs. Fricchione 180 Fairfax Avenue Hawthorne, NY 10532 Dear Mr. & Mrs. Fricchione: Re: Permit No: 3- 3724 -4�7 -1 Town of Patterson, Putnam Co. PERMIT MODIFICATION In accordance with the written request of Mr. Randolph Laurent dated January 12, 1988, the above referenced permit is hereby transferred from the previous permittee, Mr. Louis Olivier to you. The expiration date remains December 31, 1989. Under the State Environmental Quality Review Act (SEQR), this project is classified as an Exempt Action and therefore is not subject to the provisions of that law. Enclosed is a copy of the original permit for your.use. All other terms and condi.tions remain as written in the original permit. Very truly yours, Alexander F. Ciesluk, Jr. Deputy Reqional Permit Administrator Division of Regulatory Affairs Region 3 MDM:zI Enc I .6c;1 1 4A;,1,L feko+f f d cc: P. Keller - Law Enforcement G. Cole /J. Steeley R. Laurent, P.E. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512; DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE N0. Owner - i L Address / fni Located at ( Street -Sec. / Block Lot, 7 (7n d neares cross street) Municipality Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 1 :� 2in .sue 1 J— �,Z_ , OL_7 3 9cO Cif .00 -- 3'0'.2- L 27. ag_v -a-i 3 W 5 2 / /.io :0.3 3 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. Hole Number CLOCK TIME PERCOLATION :PERCOLATION Run Elapse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches /W a7 1 :� 2in .sue 1 J— �,Z_ , OL_7 3 9cO Cif .00 -- 3'0'.2- L 27. ag_v -a-i 3 W 5 2 / /.io :0.3 3 Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. f HOLE NO'. HOLE NO. G. L. 6 Zc 1811 2+11 30" 3611 42" 48" 5411 6011 66" 7211 78•• 84 " .NDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO.W CH WATER LEVEL RISES AFTER BEING ENCOUNTE TESTS MADE BY G �-U Date �- L L _ `� DESIGN GN - Soil Rate Used -TS Min/1 "Drop: S. D. Usable Area Provided No. of Bedrooms Septic Tank Capacity /00 L? 04 $c` Of _ Absorption Area Provided By L.F. x24" — 36'r— Addres, A43 THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /� hum p Lu "jai . V) 5n cra r- SEAL , (P Checked by U Y l)16 f� �a :B t_. 1 r1 Date PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services Mr. Randolph Laurent, P.E. 73 Fairfield Road Patterson, New York 12563 Dear Mr. Laurent: /1 n JOHN SIMMONS, M.D. Deputy Commissioner January 13, 1988 RE: Anthony & Laurie Fricchione Ludingtonville Road (T) Patterson TM 13 -12 -7 P23 -86 I have received and reviewed the application.for renewal to construct a sewage disposal system and individual water supply on the above captioned property. The Article 24, fresh water wetlands permit #3085 -0984 expired as of December 31, 1987. Renewal of this permit must be obtained before review and approval can be granted. Very truly yours, William Hedges, Jr. Sr. Public Health Sanitarian WH:mk 110 OLD ROUTE SIX CENTER - CARMEL, N.Y. 10512 (914) 225-0310 DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 September 5, 1991 Alex Kolenda 210 Marble AVenue Pleasantville, NY 10570 RE: Proposed SSDS Fricchione Ludingtonville Road (T) Patterson TM #13 -2 -7 Dear Mr. Kolenda: JOHN KARELL Jr., P.E., M.S. Public Health Director Review of plans and other supporting documents submitted at this time relative to the above- captioned project has been completed. Comments are offered as follows: 1. Well permit has not been submitted (enclosed). 2. Plans show 498 L.F. of absorption trench, for a 21 -30 min /inch percolation rate 500 L.F. of absorption trench is required. 3. Dimensions and volume of fill has not been noted on plan. My calculations indicate the minimum of 495 cubic yards of R.O.B. fill is required. 4. Junction box, erosion control, septic tank, absorption trench, well and curtain drain detail has not been shown on plan (Examples have been enclosed). 5. Finish floor elevation has not been noted on plan. 6. Standard required SSDS Notes 1 to 5 have not been noted on plan (enclosed). 7. Standard required fill notes 1 to 3 have not been noted on plan (enclosed). 8. Design data, i.e., percolation rate has not been noted on plan. 9. Footing and (utter drain discharge has not been shown on plan. It is suggested that the footing /gutter drains are connected to the proposed curtain drain. Alex Kolenda - 2 - September 5, 1991 10. Proposed house is to be labeled as three (3) bedroom on plan. 11. Absorption trenches are to be designed 6 feet on center. 12. Fill must be shown extending to full depth 10 feet beyond the edge of the absorption trench and sloping 2:1 to grade. A clay berm is to be placed on the perimeter of the fill section. This is to be noted on plan. 13. 100 foot buffer boundary is to be shown on plan. 14. Proposed curtain drain is to be located 15 feet upgrade from proposed SSDS. Minimum curtain drain depth is to be 7 feet. 15. The minimum distance from the foundation to the SSDS is 20 feet. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. V5Fntruly yours, Robert Morris Assistant Public Health Engineer RM:mk enc. ,'99.30.6 (9!86) -25c DEC PERMIT NUMBER 3- 3724 - 00047/1 -0 FACILITY!PROGRA,M NUMBER(s) Freshwater Wetland LC- 14(Class II) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Am 0ftwd lmw PERMIT Under the Environmental Conservation Law F7Article 15, Title 3; 6NYCRR 327, Anthony & Laurie Fricchione 328, 329: Aquatic Pesticides ADDRESS OF PERMITTEE Article 15, Title 5: 180 Fairfax Avenue, Hawthorne, NY 10532 Protection of Water ACENT FOR PERMITTEE /CONTACT PERSON Article 15, Title 15: TELEPHONE NUMBER Water Supply Article 15, Title 15: aArticle Wafir Transport One .acre Frcchione.property,_on Luddin Article 15, Title 15: aArticle Long Island Wells Article 15, Title 27: oArticles 'Wild, Scenic and Recreational I Putnam Rivers 6NYCRR 608: Water Quality Certification Article 17, Titles 7, 8: SPDES aArticle 19: Air Pollution Control* aArticle 23, Title 27: Mined Land Reclamation Article 24: Freshwater Wetlands N —New, R— Renewal, M— Modification, C- Construct ( *only), 0— Operate ( *only) EFFECTIVE DATE EXPIRATION DATE(s) December 31, 1992 PERMIT ISSUED TO Article 25: Anthony & Laurie Fricchione Tidal Wetlands ADDRESS OF PERMITTEE Article 27, Title 7; 6NYCRR 360: 180 Fairfax Avenue, Hawthorne, NY 10532 Solid Waste Management* ACENT FOR PERMITTEE /CONTACT PERSON Article 27, Title 9; 6NYCRR 373: TELEPHONE NUMBER Hazardous Waste Management 34: aArticle Coastal Erosion Management One .acre Frcchione.property,_on Luddin 36: aArticle Floodplain Management 1, 3, 17, 19, 27, 37; oArticles 6NYCRR 380: Radiation Control PERMIT ISSUED TO . Anthony & Laurie Fricchione ADDRESS 21 South Putt ADDRESS OF PERMITTEE JjE"r _awJ3,Fta 1/ 180 Fairfax Avenue, Hawthorne, NY 10532 Michael D ACENT FOR PERMITTEE /CONTACT PERSON 1 TELEPHONE NUMBER N/A NAME AND ADDRESS OF PROJECT /FACILITY (If different from Pennittee) One .acre Frcchione.property,_on Luddin tonville Road LOCATION OF PROJECT /FACILITY COUNTY TOWN /C9 =tkbt%Jt UTM COORDINATES Same I Putnam Patterson DESCRIPTION OF AUTHORIZED ACTIVITY To construct a curtain drain and a 9,600 square foot leachfield in the adjacent area of freshwater wetland LC -14 for a.sanitary sewer disposal system SSDS o-^ construction of a single.family house in accordance with plans prepared by A.E. Kolenda, P.E. surveyed May 15, 1989 and as conditioned herein. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli- ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto. 1. The permittee shall file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify him /her promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public interest so requires pursuant to ECL §71 -0301 and SAPA §401(3). 3. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descrip- tion resulting from the said project. 4. The Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when: a) the scope of the project is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found: or b) the permit was obtained by misrepresentation or failure to disclose relevent facts: or c) newly discovered information or significant physical changes are discovered since the permit was issued. 5. The permittee is responsible for keeping the permit active by submitting a renewal application, including any forms, fees or supplemental information which may be required by the Department, no later than 30 days (180 days for SPDES or Solid or Hazarduous Waste Management permits) prior to the expiration date. 6. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit 7. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights- of-way which may be required for this project 8. Issuance of this permit by the Department does not, unless expressly provided for, modify, supersede or rescind an order on consent or determination by the Commissioner rm issued heretofore by the Department or any of the terms, conditions, or requirements contained in such order or determination. (12/89) 9. Any modification of this permit granted by the Department must be in writing and attached hereto. Continued on Attachment "A" PERMIT ISSUANCE DATE . PERMIT ADMINISTRATOR, Deputy ADDRESS 21 South Putt Corners Rd. JjE"r _awJ3,Fta 1/ 61 Michael D New Paltz NY 1 AUTHORIZED SIGNATURE /' /' Page 1 of 2 — t 95 -20-6f (7/87) -25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS For Article 24 Freshwater Wetlands 1. Prior to commencing construction, the permittee shall obtain the approval of the Putnam County Health Department for the design of the sanitary sewer disposal system. 2. Work shall be done in accordance with the approved plans. Any modification to these plans that will affect Freshwater Wetland LC -14 or the adjacent 100 foot buffer area must be approved by the Department prior to being undertaken. 3. All necessary precautions shall be taken to prevent contamination of the waters of wetland LC -14 by silt, sediment, fuels, solvents, lubricants, epoxy coatings, concrete leachate, or any other pollutant associated with construction and construction procedures. 4. Bales of hay or other means to control erosion are to be used on the downslope edge of any disturbed areas. This barrier to sediments is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until all disturbed land is heavily vegetated. 5. All areas of soil disturbance - resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. STATE ENVIRONMENTAL QUALITY REVIEW Under the .State Environmental Quality Review Act (SEQR), the project associated with this permit is classified as an Unlisted Action and the Department 'of Environmental Conservation (DEC) has determined that it will not have a significant effect on the environment. Other involved agencies may reach an independent determination of environmental significance for this project. DISTRIBUTION R. Manna Law Enforcement G Cole /J. Steeley } J. -Karell P•CHD ;'. ' A.E. Kolenda, P.E. DEC PERMIT NUMBER J—J//4—UVUi FACILITY ID NUMBER PROGRAM NUMBER A Pate 2 of 2 95.20.6 (9i8611-25c DEC PERMIT NUMBER 3- 3724 - 00047/1 -0 FACILITY:PROGRA.10 NU OSER(s) Freshwater Wetland LC- 14(Class II) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ' PERMIT Under the Environmental Conservation Law EFFECTIVE DATE EXPIRATION DATEW December 31, 1992 Article 25: Tidal Well Article 15, Title 3; 6NYCRR 327, 328, 329: Aquatic Pesticides a 6NYCRR 608: Water quality Certification �J Article 15, Title 5: Protection of Water a Article 17, Titles 7, 8: SPOES AGENT FOR PERMITTEElCONTACT PERSON Article 15, Title 15: Water Supply TELEPHONE NUMBER Article 19: Air Pollution Control* Article 15, Title 15: Wafer Transport NAME AND ADDRESS OF PROJECT /FACILITY (If different from Permittee) Article 23, Title 27: Land Reclamation -1 Article 15, Title 15: Long Island Wells LOCATION OF PROJECT/FACILITY Article 24: Freshwater Wetlands 71 Article 15, Title 27: Wild, Scenic and Recreational Rivers N —New, R— Renewal, M— Modificatlon, C— Construct (*only), 0— Operate ( "only) EFFECTIVE DATE EXPIRATION DATEW December 31, 1992 Article 25: Tidal Well PERMIT ISSUED TO ands Anthony & Laurie Fricchione Article 27, Title 7; 6NYCRR 360: �J Solid Waste Management* aArticle 27, Title 9; 6NYCRR 373: AGENT FOR PERMITTEElCONTACT PERSON Hazardous Waste Management TELEPHONE NUMBER Article 34: Coastal Erosion Management NAME AND ADDRESS OF PROJECT /FACILITY (If different from Permittee) Article 36: One acre Fricchione property, on Luddin Floodplain Management LOCATION OF PROJECT/FACILITY Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO Anthony & Laurie Fricchione ADDRESS OF PERMITTEE 180 Fairfax Avenue, Hawthorne, NY 10532 AGENT FOR PERMITTEElCONTACT PERSON TELEPHONE NUMBER N/A NAME AND ADDRESS OF PROJECT /FACILITY (If different from Permittee) One acre Fricchione property, on Luddin tonville Road LOCATION OF PROJECT/FACILITY COUNTY TOWNIC3TJUJtbKfC UTM COORDINATES Same Putnam Patterson DESCRIPTION OF AUTHORIZED ACTIVITY To construct a curtain drain and a 9,600 square foot leachfield in the adjacent area of freshwater wetland LC -14 for a sanitary sewer disposal system SSDS 'r construction of a single family house in accordance with plans prepared by A.E. Kolenda, P.E. surveyed May 15, 1989 and as conditioned herein. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli- ance with the ECL, all applicable regulations and the conditions specified herein or attached hereto. 1 . The permittee shall file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a notice of intention to commence work at least 48 hours in advance of the time of commencement and shall also notify himlher promptly in writing of the completion of the work. 2. The permitted work shall be subject to inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public interest so requires pursuant to ECL §71 -0301 and SAPA 1401(3). 3. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions. damages and costs of every name and descrip- tion resulting from the said project. 4. The Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when: a) the scope of the project is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found: or b) the permit was obtained by misrepresentation or failure to disclose relevent facts: or c) newly discovered information or significant physical changes are discovered since the permit was issued. S. The permittee is responsible for keeping the permit active by submitting a renewal application, including any forms, fees or supplemental information which may be required by the Department, no later than 30 days (180 days for SPOES or Solid or Hazarduous Waste Management permits) prior to the expiration date. 6. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work or as authorizing the impairment of any rights, title or interest in real or personal property held or vested in a person not a party to the permit. 7. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rightsof -way which may be required for this project 8. Issuance of this permit by the Department does not unless expressly provided for, modify, supersede or rescind an order on consent or determination by the Commissioner issued heretofore by the Department or any of the terms. conditions, or requirements contained in such order or determination. 9 Any modification of this permit granted by the Department must be in writing and attached hereto. Continued on Attachment "A" (12/89) PERMIT ISSUANCE DATE PERMIT ADMINISTRATOR, Deputy ADDRESS 21 South Putt Corners Rd. �ECrn'rL{13rtsZ )/ r 6; IMichael D. Merriman New Paltz NY AUTHORIZED SIGNATURE Page 1 of 2 .6-6f (7187) -25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS For Article 24 Freshwater Wetlands 1. Prior to commencing construction, the permittee shall obtain the approval of the Putnam County Health Department for the design of the sanitary sewer disposal system. 2. Work shall be done in accordance with the approved plans. Any modification to these plans that will affect Freshwater Wetland LC-14 or the adjacent 100 foot buffer area must be approved by the Department prior to being undertaken. 3. All necessary precautions shall be taken to prevent contamination of the waters of wetland LC -14 by silt, sediment, fuels, solvents, lubricants., epoxy coatings, concrete leachate, or any other pollutant associated with construction and construction procedures. 4. Bales of hay or other means to control erosion are to be used on the downslope edge of any disturbed areas. This barrier to sediments is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until all disturbed land is heavilv vegetated. 5. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass seed and mulched with hay or straw within one week of final grading. Mulch shall be maintained until a suitable vegetative cover is established. STATE ENVIRONMENTAL QUALITY REVIEW Under the State Environmental Quality Review Act (SEQR), the project associated with this permit is classified as an Unlisted Action and the Department of Environmental Conservation (DEC) has determined that it will not have a significant effect on the environment. Other involved agencies may reach an independent determination of environmental significance for this project. DISTRIBUTION R. Manna Law Enforcement G. Cole /J. Steeley J. Karell, PCHD A.E. Kolenda, P.E. DEC PERMIT NUMBER FACILITY ID NUMBER PROGRAM NUMBER Page 2 of 2 a K e' Mr. John Karell, Jr., P.E. Director Environmental Health Services Two County Center Carmel, NY 10412 Dear Mr. Karell: RANDOLPH W. LAURENT, P.E.,P.C. 73 FAIRFIELD DRIVE PATTERSON. NEW YORK 12563 914_278_6108 CONSULTING SITE ENGINEER November 11, 1985 RE: William Kelly Ludingtonville Road Patterson, NY R1 Misr XEQjVEr. Vi 1 4...1985 f�'J�'IIAA4 Reference is made to your letter dated November 7, 1985 regarding the above referenced project. I wish to clarify the items contained in your letter as follows; Item 1 A construction permit application was submitted at the time of submittal and is dated August 16, 1985. We are enclosing a photocopy of same for your information. If the original copies are not in your office we would be pleaseito resubmit the application again. Item 2 -12 Following my telephone conversation with Mr. Hodgens, the plans were revised to reflect these items. Item 13 After the September 24th telephone conversation regarding the wetland area, I contacted Mr: John Feltman, N.Y.S.D.E.C., New Paltz, NY immediately thereafter. My conversation with your office was that approval was necessary for drilling the well in the wetland area. I contacted Mr. Feltman immediately thereafter and he requested a plan of the lot with a letter requesting what we wanted. Enclosed is a copy of my letter dated October 1, 1985. Mr. Feltman replied to me by letter dated October 10, 1985. On October 16th I forwarded a Freshwater Application for Permit and my check in the amount of $10.00(ten dollars), copies of which are enclosed. A reply dated October 22nd was received from N.Y.S.D.E.C. requesting additional information. We are in the process of replying to this request. Enclosed is a copy of this request. L V Mr. Karell November 11, 1985 page 2 This project continues to be active. Since I felt that the wetland permit is required together with the changes requested by Mr. Hodgens, I did not resubmit the plans to Putnam County Health Department. As you can see this application has taken longer than anticipated by the fact that a permit is being required by N.Y.S.D.E.C., not a letter indicating approval by D.E.C. allowing a well to be drilled at a future time. When we receive a permit we will resubmit the entire package in conformity to your requirements. truly yours, ndolph W. Jaurent, P.E. enclosures. cc: Mr. W. Healy Mr. W. Kelly RWL /abc a'`'' �T ►M_ C ITV r).rr'A,RTMrNT o 'eeCALT11 r.a,, daa lip 1 N k :NVI N.M ' 'PaL 11CA.I.T11 SCRVIC 'S 1ae11 t lel� o b-� o sv.AY - ThisM�$glib to to authorize / �La d� � �•�•�^�.a4i ioidttl °o� 6o ip T wi sa A dmly liconeed VrotwwAonsl engineer_ regiaterod amhlVqct (Indlicat to apply.. for a . ,trwti.on Permit for ® aeparate sewage eystem; to serve the above noted property in accordance with the standards, gales or regul &tione aa vromlag4tw by the Commissioner of the Ratnom Cotenty Aa'•,paeertment ®fod t® sign,1 necary papers on my behalf In ..•...&Vt s •%06a eme all #*6"ft all" siU(1t rvibe:' 1.110 CU11b L1 -UC d1U /1 Of Jimid oya.tem or systeso In cmmforl lty with the provisions of Article 14� or 147. Ldu®etion towo the Public hemIth lave, and the Putnam County Sani- tary Code. very � �igre�e Cc] 11te*rS .Ail; Te irphww Telephone rw CwD N0V141985 PUTNAM COU.N.TY DEPT, OF HEALTIJ 0 I V�- ^ ^. � October 1, 1985 .. ( ` RANDOL9HVuLAWmENT,�E.,PC. rx pmnpIELo oowe nmremoom. NEW YORK ,2**v w1*-ora-owe CONSULTING SITE ENGINEER ` ` New York State Dept. of Environmental Cons. . 21 S. Putt Corners Road New Paltz, New York 12561 Attn: Mr. John Feltman RE: William Kelly Well Installation Ludingtonville Road K t N York. ` en , New Dear John, As discussed, we are herewith enclosing one (1) print of Drawing SD-1, "Proposed S8DS", Rev' 9-30-85. The present owner of the lot is in the process of obtaining Health Department approval of his lot. The Health Department has requested that we obtain a letter from your office indfcating that the proposed well on the lot be allowed to be drilled within the wetland area. The wetland area extends to the stone wall as shown on the plan. Because of the lot depth of 390 feet, it was not possible to draw the well location relationship to the stone wall', the well would be located about 50 feet inside of the wetland area. At the time of drilling the'well, the owner- of the lot at that time would be required to obtain a permit from ^ N^Y.S.D.E.C., however at this time we request that we receive approval from your office that the well would be allowed to be located within the wetland area. Thank you for your cooperation. K�� ��� .���U~� �.0V 141985 0 ph W. Laurent � PUTNAM RWL/pw. DEPT. Y� ty t t t app NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION APPLICATION NUMBER' APPLICATION FOR PERMIT Read Instructions on back before completing this application. Please type or print clearly in ink. Use separate addenda and exhibits to provide all data and explanations for which space on this form Is inadequate. ❑ ARTICLE 15, TITLE 3 (CONTROL OF AQUATIC INSECTS, WEEDS„ OR UNDESIRABLE FISH). ❑ ARTICLE 1S, TITLE S (PROTECTION OF WATERS) ❑ For the construction, reconstruction, or repair of a DAM or other impoundment structure. ❑ For the disturbance of a STREAM BED or excavation in or fill of navigable waters. ARTICLE IS,,TITLE IS ❑ WATER SUPPLY O LONG ISLAND WELL ' ARTICLE 24 (FRESHWATER WETLANDS) Permit. ❑ Letter of Permission ARTICLE 2S (Tidal Wetlands) 1. NAME Of APPLICANT: �J 1 EL 4- 2. APPLICANT IS MAN Individual ❑Partnership C1 Association El Corporation ' El Municipality ❑Governmental Agency 3. NAME AND TITLE OF OFFICIAL. SIGNING APPLICATION RAM no�.� AV 4"W7" P NE. M-4-2-72-0c)a t STREET ADORESSIPOST OFFICE POST OFFICE STATE ZIP CODE 4. NAME AND ADDRESS OF OWNER of not applicant) PHONE STREET AODRESSIPOST OFFICE L IZ POSI Off ICE C G� ST TE o ZIP CODE S. PROJECT LOC:AIION: NAME OF STREAM OR OTHER WATER BODY: 6. WILL PROJECT A) City of Village If appropriate; if unnamed, show on map —See UTILIZE STATE- L> .T �1 [� &I yiLL � �� Item Sbl OWNED LANG{ -- __L,_U Town ❑ Yes ,K No 9 _ _P,'C-AT E Sf�� lawnly .F_QT T. bl Specific protect site or area is marked on U.S.G.S. or equivalent map. attached as Exhibit Number 7. PROPOSED USE: Private 8. PROPOSED STARTING DATE: S1. APPROXIMATE COMPLETION DATE: 10. FEE OF ❑ Public Commercial GT. CD 0(,7- r / S 1 I S 10'. ' Enclosed It. PROJECT DESCRIPTION: feel of tip -rap new channel; cubic yards of malerial to be removed; draining, dredging, rifling, and location of disposal sites; type of structure to be installed: height of dam; size of impoundenl; capacities M propsed water sources; extent of distribution system; etc. J N I: THIS PROJECT WILL REQUIRE ADDITIONAL PERMITS. APPLICATIONS FOR WHICH ARE THE RESPONSIBILITY OF OTHERS: ❑ I s..IV.Itiun ❑ Will I'III Slreem Disturbance ❑ SPDES/NPOES ❑ Wrier supply ❑ L.1. Wells " ❑Freshwater Welland 13 Tidal Wetlands I i NAME AND ADDRESS OF OFFICIAL NEWSPAPER OF LOCALITY WHERE PROPOSED WORKS ARE LOCATED: COU eJ &_(>--s T->-O- � zzo, CAV,,J-i L, N. X- X05 �z 14. IS ANY PORTION 0� THE ACTIVITY FOR-WHICH A PERMIT IS SOUGHT NOW BEGUN OR COMPLETEW ❑ bilfNo Vei If YES, explain in addenda, giving reasons and dates, end show existing work on drawings or map. ' IS. CERTIFICATION: 1 hvrrby alfinn that under penalily of perjury that information provided on this form and all attachments submitted herewith is true to Lhe best of my knowledge anti Irelrc•1 False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. As a condition to the issuance of a trnnit. the .glpht ant accepts lull responsibility loi all damage, direct or indirect, of whatever nature, and by whoa •r suffered, arising out of the project described I,creln and agrees to Indemnity and save harmless 1 . e om cuons, damages and costs of every Pam nd d scdp lion resulln, from said project. � C RANDOLPH W. LAURENT. P.E., P.C. 73-FAIRFIELD DRIVE PATTERSON,, NY 12683 2253 50.7091 PAY TO THE [U. ' � , /,i , .� $ "I ORDEfl OF OLLARS p B PAWLING SAVINGS DANK rwuNG. YFi `00% 18644 toC -w ell ._>t y%a I10022S311' of: 2 2 L9 709 L91: 0.391 03.221611' jr ME j i l', PU -fNAM COU *jy DEPT. OF HEALTH m New York State Department of Environmental Conservation 21 South Putt Corners Road, New Paltz, NY 12561 -1696 (914) 255 -5453 Henry G. Williams NOTICE OF INCOMPLETE APPLICATION Commissioner APPLICANT: William. 1{ejly. . , , , , , , o DATE:O,ctop r,22, ,1985 �7 ljiliwgo� Rgad . . . . . . . . . . Carfiel,, IVY, 10512 , , , . . . , , , Application Number: 3085 -0984 Location: Wetland LC -14 (Please refer to this number in all your correspondence.) Luddingtonville Road Penni t Applied For: Freshwater Wetlands Permit T /Patterson Construct a well for a proposed residence. YOUR APPLICATIO14 FOR THIS PERMIT IS INCOMPLETE: _ You failed to include with your application the full amount of the required fee. Please submit a check or money order in the amount of $ payable to the Department of Environmental Conservation. XX Please submit the following data: 1. Construction: Please explain how the wetland will be altered in.order to construct the well. Will there by any temporary or permanent filling of the wetland? If so, please also show the length, width and depth of this fill area on revised site plan. 2. Other Work: Please describe any grading, filling or other construction activities within the 100 foot wide adjacent area that lies between the edge of.•the wetland and somewhere to the rear,of your house if there is any, please show the dimension:; of it on a revised site plan. 4 1985 PI-IT NAM rouA'TY OF HEALTH For further information please contact: Michael D. Merr_ima enior Envir. Ajialyst 21 South Putt Corners dJ New Paltz, New York 12561 cc: Cole (914) 255 -5453 .J. Steel.ey (w /encl . ) R. Laurent 29 Washington Place N. White Plains,, NY 10601 (914) 428 -3693 October 16, 1989 To Whom It May Concern: Let this serve as a letter of authorization allowing Alex Kolenda to design a septic system on our property located on Ludingtonville Road, Patterson, New York. Anthony & Laurie Fricchione 'b DAVID D. BRUEN County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services November 7, 1985 Mr. Randolph Laurent, P.E. 73 Fairfield Drive Patterson, New York 12563 RE: William Kelly Ludingtonville Road (T) Patterson Dear Sir: JOHN SIMMONS, M.D. Deputy Commissioner Review of Department files relative to an application for a construction permit for a subsurface sewage disposal system and well to serve the above- captioned property indicates that on September 24, 1985 Mr. Hodgens of this office communicated his comments to you in a telephone conversation. To date, a revised submission has not been received in this office. For your information, the following items are required or outstanding: A construction permit application has not been provided. House plans have not been provided. YtTLE- &LCx_r- r,v FtST>Jpt ✓ 3. 1800 square feet of absorption area is required, including expansion area; 1200 square feet is provided. No expansion area is provided. � .,,The fill volume is not indicated. A detail across the fill is necessary showing- necessary ten feet of fill beyond trench plus 2:1 slope to grade. ° 5. Footing and gutter drainage is not shown. --6. Proposed final contours is of shown. 7. The existing well to the south is within 100 feet of the SSDS. ✓ 8. The gallies are within 20 feet of the house. - continued - TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641 w~ Mr. Randolph Laurent, P.E. - 2 - November 7, 1985 --" 9. The curtain drain is within 15 feet of the SSDS. 10. All deep holes are not shown. X11. A note indicating that all trees within 10 feet of the sewage area will be removed is not provided. `— 12. Fill must settle for 2 - 3 months. A note is necessary. " 13. The property to the rear of the property is a State wetland. The extent of the wetland and the 100 foot protective zone must be shown on this plan. A permit is required from DEC for the installation of the well in the wetland or 100 foot area. 14. Lot area is not indicated on the plan. If this project is no longer active, this Department should be so notified. If you have any questions, please call the writer at ext. 241 or Mr. Hodgens at ext. 242. JK:mk cc: William Kelly JK JH File .// � � r V Ve truly yours,; 1 'John Karelf, Jr., P.E. Director Environemtanl Health Services n • . -- I . 0 VqI . fiOCUi�:iITS X, _ V11i . MAP LOCA710N 't �S2JlX Souse plans 0. K. Design data sheet Peres presoaked? 30" perc test depth Const. results for 3 runs 1- q D. Hole log O.K. Corporate Affidavit f'or other than individual Authorization for engineer letter from Plater Supply if applicabl e If variance requested -such noted on plans &apps. E ' EfPp S�Oi,I E 'F ^•IQ AIHTtlRE �. SEJ4L .OrJ PEA DETAILS . F14- DEPH AREA SROWN( t f) E' P LAN TO 6E FROJ +CED Existing ontours 1 , shown (show new contours) Slopes for driveway cuts, etc. shown rater service line location Footing drain, etc. location Top slope, bottom slope of fill Percolation. tests and deep test pit location Septic tank size and conformance to std. j B.R. house minimum House setback shown Distribution box ft below frost All water within 36L�. of:.PL shown 4)Etl•CASING IV gpOVE- GZADC Plan and profile SDS All other wells and 309 closer 200, 'shown or reference made Property boundaries (metes and bounds- clearly teGR< 3�SDIU1SIOn'� _ S,�irXlSTlt ApP200AL 1 REgLTy JOS '10' to P.L. Xesd ✓ '� X20' */ to Foundation walls i0o to Nearest well iLb' to stream, march, lake, etc. incl. expansion 5' to Curtain drain 0' to water line (pits-201) 5' to storm drain 0''to large trees 0' from foundation 2 septic Lan: 5' to pipe from leader drain &.I'oot;llrz L11,5111 . 12b To crtTCµ 6RsiNa 15' WEi.L TD c�� gat `✓ e% - �. I ✓� Property lines or corners found Gan estimate house location . . . . . . . . S .� Will' .driveway need cut . . . . . Must trees be removed -hote these Is deep hole representative of entire SDS Brea Additional deep holes needed. ,�- r .� r r • FIELD CHf:CK LIST. Date: `` _ I Z Insp.by: INITIAL SITE INSPECTIdP1 f I F41) -- Xesd No Comments Property lines or corners found Gan estimate house location . . . . . . . . S Will' .driveway need cut . . . . . Must trees be removed -hote these Is deep hole representative of entire SDS Brea Additional deep holes needed. .� r Sufficient SDS area available considering driveway cut, house location,separation ✓ distances, etc. .. RU. W6W /SEPTIte . - . _ _ DE13P HOLE DATA Depth: Water el.evation:. • -` Rock elevation: Soils descr_intion: Date : - FIVAL SITE 711SPECTION IL . by* House located where'shoirn on-approved plan SAS located where approved . . . . . . . - Length of trench measured 1•Iidtli of trench average Slope of tile line and trencn.aacceptable . . . Room allowed for expansion trenches . . . . . Over W5'ft. from swamp,lratercourse Natural soil not-.stripped or SDS area • w•mecessar:ily graded 10 1,t. maintained from prop.line and . 20 ft. from house . . . Separation of trench from house, well - -- etc. follows plan - -- - - - . . . . . - -- - - -- - --- ... - - - -- - •._ ._ 'Number of bedrooms checks . . . . . Stones, bruzll, . stumps, i�Libble, etc'. greater than 15 ft. from nearest trench 15 FL. . of periplieral soil horizontally from trench . . . . . Jwncfion boxes properly set Could surface run off from driveway, roads, • ground surface, etc. channel near SDS .. . . area . . Doe:; lot dra in.� to an par 0. K. J.n area of SDS FINAL GRADING OF SITE ACCEPTAlIT..E N o� - � 7 o• Cu er- o -------------------- ------------ - - - - -- ----------- PeoQOS�� e�5��►scE t------ - - - - -- _ ToE oi✓ SLOP q C.l. 1r l 000 GALV lV� A" ` Dl e)o B(U1 -.iv`I � - �l..i`�• 1�1Zq� {o ,P'1 -Z ' Ad l9 r06 OF-\ "----- ---------- -- - - -- - -- --- - - - - -- — ----------------------------- - - - - \� - .. _ ii1Ti11Y1111 liOliA�L�i��L�tly,.Y,}+.wroa�.. ..� ���-r _ .l V.� �,,�. .1N�v '1'r,- �-•��v ' VV{.(�.I.1 V FJ�- `�^.fr - . , J1vleion of Envi V +++ erAgl He81th S8r910Y� _ • F ✓ 2 P . �) W • G,t1 F�v - `� tiuroved as noted for oonformanoe with pplioable Rules and Regulations aS "the •utnam County Realth . Deyartment.- BT1 THIS AS 1.0 C '17Y THAT TH, SEWAGE' DISPOSiL•$1'STEM ��i�AS ' CONTRUCTrD AS INDICATED ON'THIS PLAN ANl�: % THE y,.,A��a Ttt7w lf�t�� —T SYSTEM.WAS IN BY ME BEFORE IT WAS COVERED pVEi�, ' THE SYS1'E vi VC AS CONSTRUCl'ED , IN ACCORDANCE WITH ALL - . THE RULES AND. REGUI:ATIONS Ul' THE ' kUTNAB4 COUNTS DBPARTI,LLN'I of _ ' 0 . -- 1F �` `� � . 61_ !0 b5 =9 5_ ' dtxrlwzifEi ;,,/ LUAK► 'Towl ml i-i `. �� f :, T . I app 4:I, MA!VN{Zf cL J I V!. nz4.���II�I> =i ii° r f If�ll� r'�•�V ��; . � ��• . � 1l % �� it J , � "'�' �,/ � how ��' P�'tT `X�I.,.� A42F If ' CoU. _ � 101' 'b' ✓�''� 1 `t./ y t, FC p 1 � • •' f 1. op "W (, K pa . >. 41 ..