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HomeMy WebLinkAbout0557DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23. -1 -21.4 BOX 7 00557 I I OWN No ' r •; i' INN -, No ,9 No ,� fir. l �, , IN 9 Rim 1 r - , 00557 W06W Suppi ' Pddk Supply tole. Address en vr'_Dd"fa supply DOW by ld&. Most, Ic q� lwti 1 represent-that 1 am -wholly and completely responsible far the design and location of the proposed system(s); 1) that the Separate swWage dispo"I system_ above described will lie cpnstruct•d as shown on the approved amendment there to and in accordance ,with the standard; rules ants ns O Colfmty 06Wrtmant Of _►NaKh, and that ort completion thereof a *Certificate, of Construction Compliance" satisfactory to the Commissioner of HaaKhwill be Submitted to the Department. and a written guarantee will be furnished the owner. his successors, heirs of assigns by the builder. that mid bulkier will plec• in good .operating condition any part of said savragfi disposal system during the period of two (2) yew$ immediately following thedats of the Nsu• amm of, the, ap"al of the Certificate , of Construction Compliance, of h original system or any rapir hereto; 2) that the drilled Well desoribed a6ow will be located as shown on the •pproved plan and that aid wall will be Inst in aeco nos h the st rd r s and r•gu ns Of the Putnam County 0afs•rtm•ntt of .tsu th. Date 7 _ -?v Si/ned P.E. R.A. _ Addr•ts MiUb GO e babul License No Sfo� APPROVED FOR CONSTRUCTION: This approval expires two years from the dat issued unless eonstru lon of the building has bean undertaken and is revocable for cause or may be amended or modified when consktered nee ary by th Commissioner of Health. Any change or alteration of construction raouir•s •new permit. Approval for disposal of domeslk sancta► • a tar supply only. / Title 10/88 Data �� �: LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278 -6108 - (FA)Q 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS July 30, 1996 Mr. William Hedges Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Cornwall Ridge Lot #4 of Resubdivision of Lot 46 Patterson, N.Y:. Dear Bill: Enclosed are the following: 1. Four (4) prints of Drawing SS -4 "Proposed SSDS' - Lot 4 ", dated 7- 29 -96. 2. "Application For Approval of Plans Fora Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 7- 30 -96. 4. "Application to Construct a Water Well", dated 7- 30 -96. 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 7- 29 -96. 7.- Two (2) copies of Residence Floor Plan(s), for "Bedroom Count Only ". 8. Money order in the amount of $300.00, review fee. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry, W. Nich , Jr.', P.E. HWN:DJ:bd cc: Mr. H. Lipstein w /enc. APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEH Name and Address of: Appl ic•ant: _�,�'vy,�- WIE�3U /Gr7 r D. 2. Name of Project: �D�aS�� .SS%�S` 3. _ _Location 5 /V /C: A cif - 4. Project Engineer:.6��Q1i 5. Address: riillbrooke Office Cent: Breorster, NY 10509 License NUr�ber; �;� /may Phone: (914). 278 -6108 6.. Toe of Project: _ V Private /Residential Food .-Service .•.•Corrnercial ; Apartm,,ents Institutional H6bile Pone. Park Office Building._ Rea1ty.Subdivision Other (specify) 7. Is this project subject' to State Environmental Duality Review (SEQR)? Tvoe Status (Check One) Type I.. Exempt Type 11. Unlisted. S. 19 a Draft Environmental Impact Statement (DEIS) required? ..........:.. NO 9.: Has DEIS been completed and found acceptable by Lead Agency?, ............ X14 10. Name of Lead Agency Nom. if. is this project in an area under-'the control of -local planning., zoning, or other officials, ordinances? ............�_ `�'9 ....�. 2. if so, have plans be =n.sut, ,Witted to such :autj�or.i ties? ...__... =jC/ 3. Has prel in, inary approval beep granted by such authorities? A4& _ Date Granted: 4 , :. Type of Sewage Disposal: System Discharge ......• Surface Water Ground Waters �. If surface water discharge, what is the stream class designation ?......... Waters index number (surface) WJ Is project located near a public water supply system? .................. o If yes, nave of water supply _IV11 Distance to water supply__ Is project site near .a public sewage col lection or disposal syst:=m ?..... t;G.r,:e of sewage system %.� Distance to sewage system LV�— Date observed: 5. ? . 2.3. Narne of Health Inspector: A�fu�»,(s-n; -- - - - - -- Project design flow (gal Ions per day) ...................... o— zy -------- _ -- G5, is State Pollutant Discharge Elinination System (SPDES) 'Perm It required ?.. A/o 26. Has SPDES Application been sub,7itted to local. DEC Office? 27, Is any portion of this project located within a designated'. esignated Town or State wetland ?..... ..... ....:............... ............................... 28. Wetland ID Number .......:.... ............................... .... 29. 'Is Wetland Pemit, required? ................................................. Has application been made to Town or Local DEC Office ? *..... 30. Does project require a DEC Stream Disturbance Pe �,it ?r, 31. Is or was 'project site used for..agr.icultural activity involving application OT pesticide$ to orchards-or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ........ YES'or.NO o 32. Is project located within 1;000•feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge'-disposal site or any other potential known-source or contamination? .. _...,.YES or NO a DESCRIBE: 33. Is there a local natter plan or file with the Town or Yilla'ge? .. .... �S 3 Are co. unity water, sewer facilities planned to be developed within 15 years? _ MG 3.5. Are any* sewage..disposal areas in excess of 15� slope? 33. Tax:Hap ID Number ....... ............................... ................ 37. Approved Plans are'to'be returned to: ................. • App- licant —, Engine-e-,- the application'is signed by a person other than the applicant shown in Item .1, 'the . Application must be.acc,npanied by Let c� ter of Authorization: Failure to comply with this Drovision may be grounds for the rejection °of.any submission. I hereby affirm, ugder- penalty of perjury­ that information provided on this form, is true to the be'st of cy knou7edye and be 1 ief. Fa.7se sta'te✓,,ents 'made herein are pun ishab7e as a Class .A Xisde��ano u �suAnt to Section 210-45 of the Penal Lew, �l /' 1G-1'ATURES & OFFICIAL TITLES: tillMook:e Office Centtfe LING ADDRESS: Brewster, NY 10509 _.PUTNAM.COUNTY DEPARTMENr OF HEALTH DIVISION OF ENVIRONIENTAL HEALTH SERVICES DESIGN DATA SHEET- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO. - Owner C.oZKIW A LL ka r CVC 3v j Lr:.E2 s, Address /'Z. Sow �H iDGANI� �o_NEwRu/IG.S� /yy/7�550 Located at (Street)- C,0 rzN WALt- N 1 L L o t r> Sec. -Z 3 Block �- Lot z 1. y (indicate nearest cross street) Municipality To v` ►�. n �,6.T� -E Rso�� Watershed SOIL PERCOLATION TEST DATA-REQUIRED TO BE SUBMITTED WITH APPLICATIONS Date of Pre. - Soaking: Z7) 94 Date of Percolation Test i o f 2 8 9 4 HOLE NUMBER CLACK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From Water.Level L-OT N,a. No. Time Ground Surface In Inches Soil Rate O Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches lO is "St -9;10 is Z_>4' . ... Z.7 3 . .- . .6.0 29'.12 g'.sz 20 Z 3 6.7 • i 1 49's7 - !o ;Z3 z to . Z? 5 io',2s - io's 1 2� . Z3 - Z -b 1 9;04 - 9',1s If 17 2 9 :3► 14 4,7 3 los i3 - Io'.33 Zo 19 23 3 6.7 4 11 tot - J1'.Z7 Z(e zz z ZS 2 3 8.7 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 fran top of hole. O TEST PIT DATA, SQUIRED TO BE SUBMITTED WITH M. 'CATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES. DEPTH HOLE N0. 1 HOLE NO. Z HOLE NO. G.`L• $Rowse LLoAm 137zc>wnp Lw�r' T.S. r 13,ZOWN Wi-r4 RGU YQL4,w ycu- 3.BROW}J Wrj!i Rr.P , % Lo AM „ YELLoYv GLiYE n - 13 �i N -. Siai�ia LoJJ,�l1 36 ►t:,E SAt iD 17 Ccor -i �c> yFLLOw 46 5 F1 N G S 1AAj 0 L Cl% Alm /,a r> S4 84 1yo RoZV, 110 izoGK INDICATE LEVEL AT WHICH GROUNDWATER IS INDICATE LEVEL, TO WHICH WATER LEVEL RISES AFTER BEING ENOOUNTERED N� A DEEP HOLE OBSERVATIONS MADE BY: N DATE: g IS-) 9 4 DESIGN Soil Rate Used 8-1c3 Min /1" Drop: "S:D. Usable Area Provided 5000 No.. of Bedrocrns ¢ Septic Tank Capacity ) "ZS© gals. Type c.o u c . Absorption Area Provided By 444 L.F. x 24" Width• trench _ Other Name c: .. - Address Iyi r (l SRoo1G� O F- Y \c�C� �v TRC TZTQ_ r- z- 4 M LU'ro w rj �O.•rD Soil Rate Approved _ sq. ft /gal. Checked by '- DDaate DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL 0 PCHD PERMIT i WELL LOCATION Street Address <=R Village City Tax Grid .Number WELL OWNER Name Mailing Address Wrivate Public USE OF WELL - primary 2- secondary %RESIDENTIAL (]BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify, Q AMOUNT OF USE YIELD SOUGHT `,5 gpm /# PEOPLE SERVED$ /EST. OF DAILY USAGE QO al REASON FOR DRILLING E3 REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION Cl: ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING U DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING /1/kk/ WELL TYPE PDRILLED 13DRIVEN ODUG OGRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES _ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:_�Q Lot No. WATER .WELL CONTRACTOR:. Name_ . __.. li . _ .. 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 PROVIDED C40N SEPARATE SHEET T v (date) signatu PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19 Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date �- 2GjG�_sti Re: Property of Located at (T) fJ� -+� /- Section Block Lot- 2� Subdi.vi.si.on of7.P1Vt� /�la Subdv. Lot , Filed Map # Zjl %t. Date. Gentlemen: This letter is to authorize ��C'I�Y �/ "45,:3 -K. a duly licensed -professional engineer or registered architect... (Indi.ca e to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated.by the Commissioner of. the Putnam County Department of Health,.and.to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said - system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code_ Very- t Signed Counter i ed.: P.E ) , R.A. , /`/ �UA Address 114E�,2Ru 41 //Y Town Telephone .'I 48' BATH BEDROOM 4 C 1 `-J DRESSING BEDROOM 3. } WALK• 13' -0" x 10' -0• j IN CLOSET ._als MASTER BEDROOM BEDROOM 2 _ = OPEN :a 17'-0 x 18'•8-- 11' O., k 15r_$... • l � ,,, L � t t STUDY SECOND FLOOR DINING ROOM 13' 0" w 12%0•r LIVING ROOM 13'•0" w 1 #%0" 4828 = .-1344S F 48' 17 of- KITCHEN M•VV r MORNING FlOOM 1 OPEN ABOVE FAMILY ROOM 13' 0•' ■ 17' 0" FOYER FIRST FLOOR r 4828 BROP05E4 55•DS 1 II 1 \ \\ \ I \ 0) / �= a .ice �T � •, I I \ I I (40.5) C O \ IZSo c.AC. ---• -- � \ \ \ \ \ I x 00 ppOSEQ SEPTiG TANK _ \ I 15 RM I C4G7.2) RES�oENCE � \ \ 4 y8.6 M .5f D ' \ �J \ 50' I \ \SPRE/1DER ' e e�iai_e i °Oaaa��00�< ♦� e�eeaaae �aaeeeeea�e0eeele � ����i i i . �aieseieioiaeQ' !o ►. ,aaeeeeea• �eeeeoeeaa�. e�e�e�eee�es�s �ppe�e�e�e�eee�� �OOoe000�eiei .�eoeooeo� y qq LOCATION • Y SCALE PROPERTY •.• ON •' OFPqrrEqPm DESIGN DATA :.. DESCRIPTION 444 I-F TEST PIT • • • • • i i ♦ 0'0'-0-'8" / 0'8"-3'-0" / i LEGEND ® ® ®® DAl1DFATY t iNF Revc `,.. ,CER7 U"._ at Cato `An9 " °oiifoe �a ies -here covet cted >easen ally ass dn.t plane of the completed work (.copies ales and r 'u tione in cco ce:vi the 1 .plan and -the permit issued by the X. 0 b�eoma� ova llable.: ; Such iOWavall nodlflgafion or dunq� Is nacaanry.` Title l C�� /` Tr.T T /1AlAT1T r+TT AAT DL�T)/1T]T .t W Wr,LL l,VPlrLrrL.LV0 �r.rvnt DEPARTMENT OF HEALTH Division'Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH of Use Only J/ _ Q3, — / WELL LOCATION STREET ADDRESS: wNivl 1 i TAX GRID NUMBER: Lot 4, Cornwall Rd., Patterson WELL OWNER NAME: ADDRESS: 122' Harry Lipstein, Cornwall Bldrs. , 12 So. Plank Rd., Newburgh, NY ❑ pgIVATE Cl PUBLIC USE OF WELL 1 - primary .2 - secondary (3 RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED O BUSINESS ❑ FARM. ❑ TEST /OBSERVATION ❑ OTHER (specify) '❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING ❑ NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION ❑ REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA ` WELL DEPTH 124 ft. STATIC WATER LEVEL 18 TftDATE MEASURED 1/23/97 DRILLING EQUIPMENT ❑ ROTARY © COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): Mu.-TYPE ❑ SCREENED O OPEN END CASING. ® OPEN HOLE IN BEDROCK ❑ OTHER CASING DETAILS TOTAL LENGTH 64 ft. MATERIALS: ® STEEL ❑ PLASTIC ❑ OTHER LENGTH.BELOW GRADE 63 ft. JOINTS: O WELDED [M THREADED ❑ OTHER DIAMETER . 6 in. SEAL: ❑ CEMENT GROUT ❑ BENTONITE ®OTHER WEIGHT PER FOOT 17 Ib. /ft. DRIVE SHOE. K] YES ❑ NO LINER: ❑ YES ® NO SCREENS DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED?` FIRST O YES ONO SECOND HOURS GRAVEL PACK': °YES ❑ NO GRAVEL SIZE DIAMETER OF PACK in. TOP DEPTH ft- BOTTOM DEPTH It. pumping WELL YIELD TEST ng t It detailed METHOD: O PUMPED tests were done is in- 13 COMPRESSED AJR ,formation attached? O BAILED ❑ OTHER ; ❑ YES O NO i�LL LOG 11 more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM suafacE Water Bear - ing Welt D'a- In FORMATION DESCRIPTION CODE. it. ft. WELL DEPTH It. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Surface 10 Sand 10 124 x 6 Granite 124 8 0 80 8 WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? O YES ❑ NO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE—. CAPACITY GAL. WELLDRILLERNAME J. T. Eckerson, Inc. I DAIE. 218 /97 ADDRESS 1613 Route ' 9W Stet Milton, NY 12547 �"�G�'� „C��� Vice President PUMP INFORMATION TYPE CAPACITY MAKER DEPTH MODEL VOLTAGE HP APPENDIX C FINAL SITE INSPECTION DATE: Inspected by: STREET LOCATION _ �� 2d IAl �!� k. d OWNER (� t PERMIT # I" TM # OR SUBDIVISION LOT # t I. SEWAGE DISPOSAL AREA a. SDS area located as per approved b. Fill section — date of placement C. Natural soil not sti d. Stone,brush,etc..gr e. 100 ft. from water II SEWAGE DISPOSAL SYSTEM a. Septic tank size - b. Septic tank install, c. 10' minimum from fog d. DISTRIBUTION BOX Boxes properly g 1. All outlets at & All pipes partia 2. Protected below All pipes flush 3. Minimum 2 ft. or e. JUNCT I Old BOX - properly set f. TRENCHES- 1. Length reauired G Lei 2. Distance to watercourse measured_`'L 3. Installed according to plan 4. -Slope of trench acceptable 1/16 = 1/. 5. 10 feet from property line - 20 feet 6. Depth of trench < 30 inches from sur, 7. Room allowed for expansion, 100 8. Size of gravel 3/4 - 13" diameter cl 9. Depth of gravel in trench 12" minimu 10. Pipe ends capped g. PUMP OR DOSE SYSTEMS 1. Size of pump chamber 2. Overflow tank 3. Alarm, visual /audio 4. Pump easily accessible manhole to gr 5. First box baffled 6. Cycle witnessed by Health Department 1 1 1 . HOUSE a. House located pei b. Number of bedroa IV. WELL a. Well located as b. Distance from SD c. Casing 18" above d. Surface drainage V. OVERALL WORIQKQM I P a. Boxes properly g b. All pipes partia c. All pipes flush d. Backfill materia e. Curtain drain in f. Curtain drain ou g. Footing drains d h. Surface water pr i. Erosion control m 0 nd trenches instal l ed &Go ft. -11 /C_ NO I. COMMENTS WrNPI•i COUNIY DEPA -rM/"T OF HE&kLIH DIVISION .OF ENVIRO\M E L fffikLTH SERVICES Orner or z�urchaser of Euilding Section Block Lot 1-,-"r- ao/ G I7 25 .Building Constructed by Location - Street 1•51iici p_l ity kid /v7i A Building `ypa (WNkVAtL llel pag;_ Subdivision Name Sub3ivision Lot GUARk'-LE OF SUBSU?.DACr Sr ,tL.CE_ DXSFOQ.kL SXSTFci I represent that 1 an. wholly and co:-iipletely responsible for the lccat';on, For;a-relishio, material, construction and drainage o€ the sewage disposal System serving the above descri b�. property, and. that it has .n •beL constriucted as shown ca the approved •plan or approved amendment thereto,..and-.. n. accordance .with -- the staneards, rules -and- regulations of tide :Putna„t County Depar-trent or Health, and hereby Cl`f'_r- cniE�� -to the cYn7ne? ", his sm)ccessors, heirs or assigns,. .to place in go&,d operating condition any. part of said syste-, constructed by me which fails to orate for a period, of two years iv.�ately following the date of approval of the "Certificate of Ccnstru.ct,ion. Compliance" for the sewage disposal system? or any repa- rs riade by ,n-- to such system, except where the failure to operate, properly is caused: by. the -willLul or negligent act of the cccuirxnt .of the building utilizing the system. The undersigned further agrees to accept as conclusive the dete.-rainati on of the Dixector of the Division of I~'nviron 7,eP.'ce]_ Eealth Services of the Putna:a County Depart_, e n t of Eealth as to wmether or not_- the failure or_ the system to oaarate w._s czused by the wi11fu1. or nealicent act of the occur-ant of the building utilizing the system. CA�/l�G�Lj- fdd7�lI�ILD� AN F -ddres s Zev- 9 /05 Sicnature n Title Cor�raticn 1�:,,e (iL ro. i l- �re. ss LAURENT ENGINEERING ASSOCIATES, P.C. . MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509. (914)278 -6108 - (FA)) 278 -2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS June 13, 1997 Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 RE: Individual SSDS Compliance - Lot 4 Cornwall Ridge - Lot 46 Patterson, N.Y. Dear Robert: Enclosed are the following: 1. Four (4) prints of Drawing S -4 "As -Built Plan", dated 6- 12 -97. 2. "Certificate of Construction Compliance for Sewage Disposal System ", dated 6- 13 -97. - 3. "Guarantee of Subsurface Sewage Disposal System ", dated 6- 12 -97. 4. Well Completion and Well Log Report, dated 2- 18 -97. 5. Water Analysis Report, dated 4 -7 -97. 6. Money order in the amount of $200.00 payable to Putnam County Health Department. If there are any questions concerning the enclosed, please call Very truly yours, LA URE ENGINEERING ASSOCIATES, P.C. Harry W. Nich s, Jr., P.E. HWN:TR:bd 93071 -4 �_ - Client Name: ETL Sample Number: Client 1.0.: Date C011ected., Date Received: Comments: Federal Id: Collected by: Inorganics Analysis Data Sheet Form I - IN CORNWALL BUILDERS CORP. 171587.01 PATTERSON LOT #4 KITCHEN TAP 07•APR-97 07•APR•97 PAID Project Name: LOT #14 Matrix: 1 DrinkH2O Analysis Result Units Method Analyzed EN ........... R' Total ASENT". /100 MLS 9223 0-0R.97' Remarks: Sample passes NYSDOH drinking water standards. F-nvirdTeat 1 PIT1NAM OOUNIf DBF� OF �ALTH ]DIVIIIIiIIII ion Hof815 Qasol. N Y le w _' 18b Pwvl� l+fa�lt \ a OF `0� !S FOS - DEWOSAL SY TEM r Patterson Cornwall Hi 11 Road.. "S Stibltjj ii Garrison R "S. _ �, 4'.." > 1 6 , 7 & 8. C.E. & J.L. Garrison Renewal Qo�elen ❑ OwMe /At Ns SOCla _es Dialled.— Prealeo.,ilppeov.(, Afliue P.0 Box 374... Brewster r. NY 1 d Town 05Q9 Date 'Subdivision -Approved 8/86 Fee Enclosed 1.. Am6ifnt saiws T Residential rot n,e,. 55,500 SF + ma«no, Nober d BeioNe Design Flow G P D 6QQ Pty NodScs" le Ras dk d When FSk ONE pkted - SeptieNe,S.rw.:p S�1e. a 6RdiW d, 1000 r..B � ..a 667 LF of 24" :Width Trench T6 . be aattate�egd b� Adltien Wo/er St>pAr PltAlic Strpp4 Ffoas Adbee X Not et -determ; oet oa..�. Dd led �, Y. 1 represent that 1 am wholly and eompNt ly retponsibl� foa tM design and location of" „the proposed system(si —p that the saperato, saw ' di dal ; stem abOYa datcribed will be constructed of shown on the approved amindmant there to arW 'ipaccordance with the standard!, rules end regulations O . Mm County .Oepertrrwnt 'of .HSitRN and that on completion thereof -a "Carttf1"" of. Conitruetiori Compliane�' satisfactory Ad tha.CommiWon r`of MwKhwill be fubmltted to'the.Departhiant .and a' written .qua►int” will be 'furnished the owner, his fuccgfsors, heirs or'assisnf by the builder. that said builder will pteto, b good op.ratllg cOflditbn any' pert '01' said , aawage disposal system "during the„ period of two (2) years Immediately following tMaato of tha Itau NKe of the spprarat of o4`Certikiie;of Construction Compliance of- the origin l fyst Nt the►ato:2) that the drilled wall. described above ,win a bcatW;as shoarn on tt pprovadplan and;that said well will be in in' accorWnp: wit cards,: rules and rqu_aTi%nf . of tM "t�utmanl county Department of HNlth. Date 9/7/95 , site P.E. _ RA. P -.0.: 'Box, 374 r.ewster, 10509.. 051011 Address' t itenfe No APPROVED FOR CONSTRUCTION This;;apprevat,expiras,two y.ars, f►om'the date issued urns is ,consiruction,`of the building has bean,.undwtaken and if revocable, for cause or,riuy bi''arnended or modified when,considered:eeceu ry b wua0 Onei of Health, Any change or alteration of construction required a new perirNt. Approved for,, disposal of'-domed ic sanibry sewage, nd /o ,p► t�trORr pply ony. y� Rev. 10/88 Date�y��j ��C1 my sy�'�% Title 0 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 r (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL RENEWAL PCHD PERMIT 0 WELL LOCATION Street Address Town Village City Tax Grid Number Cornwall Hill Road Patterson 1 -6 -7 &8 WELL OWNER Name Mailing ddress x brews ter, ]Private C.E. & J.L. Garrison c/o J.R. Foichetti & Assoc. D Public USE OF WELL 1 - primary 2- secondary 19 RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED D BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify, D INDUSTRIAL U INSTITUTIONAL O STAND -BY p AMOUNT OF USE YIELD SOUGHT 5 gpm/ # PEOPLE SERVED 6 /EST. OF DAILY USAGE 450 gal ❑ REPLACE EXISTING SUPPLY O TEST/ OBSERVATION 13. ADDITIONAL SUPPLY ® NEW SUPPLY NEW DWELLING) 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR _DRILLING Domestic Water Supply WELL TYPE ®DRILLED ODRIVEN DUG aGRAVEL OOTHER IS WELL SITE SUBJECT TO FLOODING? YES X NO IF WELL.IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Garrison Lot No. 4 WATER WELL CONTRACTOR: Name Not yet selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: >500' LOCATION SKETCH 6 SOURCES OF CONTAMINATION PROVIDED 9/7/95 ®DN SEPARATE SHEET (date) (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 drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19 Date of Expiration 19 t5 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller J. R. FOLCHETTI & ASSOCIATES ENVIRONMENTAL ENGINEERS 98 Mill Plain West P.O. Box 374 1849 Rte. 6 Danbury, CT 06811 Brewster, NY 10509 Carmel, NY 10512 203 / 790 -6445 914 / 279 -3346 914 / 225 -1510 203 / 792 -2092 FAX 914 / 225 -1704 FAX TO: PUTNAM COUNTY DEPARTMENT OF HEALTH 4 GENEVA ROAD BREWSTER, NY 10509 WE ARE SENDING YOU ❑ Shop Drawings ❑ Copy of letter ]LIETTIER ®IF URAMOM Al DATE: 9/11/95 JOB NO: ATTENTION: MICHAEL BUDZINSKI RE: GARRISON PROPERTY 9/7/95 LOT 2 GARRISON R.S. SSDS LAYOUT 3 tZ Attached ❑ Under separate cover via HAND CARRIED the following items: • Prints • Change order ❑ Plans ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION 3 9/7/95 LOT 2 GARRISON R.S. SSDS LAYOUT 3 9/7195 LOT 4 GARRISON R.S. SSDS LAYOUT 1 9/7195 LOT 2 C.P. & WELL FORM 1 9/7/95 LOT 4 C.P. & WELL FORM THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑ For your use ❑ As requested ❑ For review and comment ❑ FORBIDS DUE • Approved as noted • Returned for corrections 0 • Resubmit _ copies for approval • Submit copies for distribution • Return corrected prints 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: MIKE - PER OUR RECENT DISCUSSION ENCLOSED IS THE NECESSARY DATA FOR THE 2 GARRISON LOTS. A NOTE CONFIRMING SITE CONDITIONS HAS BEEN ADDED TO THE DRAWINGS. OLD PERMIT NUMBERS ARE P56 -86. PLEASE LET ME KNOW IS THERE ARE ANY PROBLEMS. FA COPY TO: FILE w Date�Su� T ke, -- X A Norma , tMt W1", SbOvs 418900W Will ` O�wlhrr O�piAwwit M '- to�wNtfM to 1r itilw i tio•r Maii eeilutY eu•twwlts AMQOVEO'i011, ;0 ''� IMOCt�N /q, eWw e . NwI�M • _ WO illy'_M1d eoliloNtNy iipontleNfi* tlloid4Ngn pnd�_klutlon Of tM- I*OPD.9 *d. N�fhuttid if t7�own'onfM •ppPO�iD k�ndmant tMrY to'inC in accoidr±np,wttK tM �st�nOMgR! 5 t iN1�1.w k ®d R er NY 50 51 °011 6�tq {owod, "uNU eonftruetbn ;ot tM tiufkltnt{ lMS,�ttMn undwgk�n, aea If xb: OY tM Comm 01 ►tMItN. ", Any ifti t m of comArtietlain i11A/O( prku or PPti only. *•.. TItM {{ _ �/� y VHF, � yi�VJii��Y1�WVa��a� _ rG. -' '.1 �tir�_f�1 ••i+� 10�� Vim.'^ T 11�L -`'� x j 1 HillRoad 3 - P terso:n r - m R 4 _ 7 8 Q Garson ri _ r. o o ssociates DWatBnlwA�rw�i 0 rBox 3.74 , . _ = Brewster_,NY 105'09 on Avuroved `y{� /8E6 � Fee Enclosed � ��Amnnnt '' lential , 55:,500ft N 9x .. - y � w w n -.. ,. .. _ £ r �i i � � � � n • .� � J � • y � gyp- r� t z .� .. _._ . .I illy'_M1d eoliloNtNy iipontleNfi* tlloid4Ngn pnd�_klutlon Of tM- I*OPD.9 *d. N�fhuttid if t7�own'onfM •ppPO�iD k�ndmant tMrY to'inC in accoidr±np,wttK tM �st�nOMgR! 5 t iN1�1.w k ®d R er NY 50 51 °011 6�tq {owod, "uNU eonftruetbn ;ot tM tiufkltnt{ lMS,�ttMn undwgk�n, aea If xb: OY tM Comm 01 ►tMItN. ", Any ifti t m of comArtietlain i11A/O( prku or PPti only. *•.. TItM {{ _ 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 PCHD PERMIT f -5846 WELL LOCATION Street Address - Town/Village/City Taai� MGd. Number Coun.wall Hill Rd Pattersca�a 1 -6 -7& WELL OWNER Name' Mailing Address. J)Private C.E. & J.L. Garrison c/o J.R. Folchetti Associates 0 Public USE OF WELL 1 - primary 2- secondary ® RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED O BUSINESS O FARM O TEST /OBSERVATION p OTHER (specify O INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 6 /EST. OF DAILY USAGE 450 gal EI REPLACE EXISTING SUPPLY O TEST /OBSERVATION Gt ADDITIONAL SUPPLY ® NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Domestic Water Supply WELL TYPE ;;; ®DRILLED 13DRIVEN DDUG aGRAVEL 0OTHER IS WELL SITE,SUBJECT TO FLOODING? YES x NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: !'_nrri _q An Lot No. WATER- WELL CONTRACTOR: Name n of ;,Pt- CP1 Pr t'pd Address IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES' x NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: > 500' LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 0 ON SEPARATE SHEET 8/5/92 jig (date) (sig ature) 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 thirt3! (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or other contaminate surface or groundwater. Date of Issue• 0" 19 � L Date of Expiration t f 19 C! Pe t Issuing Official Permit is Non-Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller 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 PCHD PERMIT UPS—q; WELL LOCATION Street Address Cornwall Hill. Road. Town Tax 'Grid Number Patterson 1- 6 -.7 &8 WELL OWNER Name Mailing Address P.O.Box374, Brewster IDPrivate C.E. &J.L. Garrison c oJ.R.Folchetti & Assoc O Public USE OF WELL 1 - primary 2- secondary 6 RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED 11. BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify O INDUSTRIAL O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT 5 gpm/ # -PF.OPLE SERVED 6 /EST. OF DAILY USAGE 4 5 0 Sal ,REASON FOR DRILLING ❑ REPLACE EXISTING SUPPLY M NEW SUPPLY NEW DWELLING O TEST /OBSERVATION Ll<ADDITIONAL SUPPLY Ci DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING Domestic Water SugplY WELL TYPE 13 DRILLED ®DRIVEN ®DUG ®GRAVEL ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES _ENO .IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: - Garrison Lot No. 4 WATER WELL -CONTRACTOR:'" Name -Not Yet Selected Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO NAME OF PUBLIC WATER SUPPLY: - - -- TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: x'50 0! LOCATION SKETCH & SOURCES OF.CONTAMINATION PROVIDED,... -" 06N SEPARATE SHEET W/ .. 9/19/90 (date) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, thirty (30) days of the completion of water well construction, 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the Department attached to this permit. C, T ^ �wJ granted under t'heYproVisions and provided_-.,ithat within i the applicant' shall : _ , requirements of the Putnam County Health 3. Submit a Well Completion Report on a form 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 drillin operations be contained on this property and in such a manner as not to degrade or oth wi contaminate surface or groundwater. Date of Issue: 19 —� Date of Expiration 19q Pe it Issuing Official Permit is Non- Transferr ble White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RENEWAL: September 19, 1990 Date July 1. 1986 Re: Property of Located at C.E. &, J.L. Garrison Cornwall.Hill Road, Patterson, NY 12563 (T) Patterson Section 1 Block 6 Lot 7;8 Subdivision of Subdv.-.Lot # 4 Filed Map # Date Gentlemen: This letter is to authorize J. Robert Folchetti.& Associates a duly licensed professional engineer X or registered architect__ (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulati.ons.as promulagated by the Commissioner.of the. Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this.matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very trul o s Signed Countersigned: Owner of Property P.E., R. A. # 051011 P.O. Box 379 - Address Brewster, NY 10509 914- 279 -3346 Telephone 1 Blue Hill Plaza Address Pearl River, NY 10965 Town Telephone J.R. - FOLCHETTI ASSOCIATES Environmental Engineers P.O. Box 374 BREWSTER, NEW YORK 10509 (914) 279 -3346 TO Putnam County Health Department 110 Old Route 6 Center, Bldg. #3 Carmel, NY 10512 L [EcTUEEa o[F TURSEDUMU DATE September 19, 199 JOB NO. ATTENTION RE: Garrison R.S. -- Lots 2 & 4 Permit Renewals For your use 1 Construction Permit for Sewage Disposal System -Lot #2 1 WE ARE SENDING YOU 0 Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 1 For your use 1 Construction Permit for Sewage Disposal System -Lot #2 1 As requested 2 Letter of Authorization - Lot #2 1 For review and comment 3 Construction Permit for Sewage Disposal System-Lot 1 ❑ 4 Letter of Authorization - Lot #4 1 5 Well Permit Application.- Lot #2._ _ 1 6 well - Permit. Application - Lot #4 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 ❑ ❑ FOR BIDS DUE 19 REMAR ❑ Resubmit copies for approval ) —' _Z7 . - ❑ Submit coples�forl=d sfribdti?n.,� ❑ Return corrected prints ❑ PRINTS RETURNED;—AFTER' LOAN .TO _US COPY TO File SIGNED: PRODUCT240 -T e Im. Wn um 01471. If enclosures are not as noted, kindly notify us at once. I k. PUTNAM KENTOFJMAITH`-- 4;1 UNT,—Y%DEPARTI Provide` p 6wtI# n&ef fkivi"iantid El n 0 'dim CERTIFICATE OF ZqN§IjtqC37 PERMIT FOR SEWAGE DISPOSAL SYSTEM #'r t S�NTown or ..... . . . . . ---Vi E 'g La Tai-` n�,�' Su u In I A. q enewal '- Dste�ef-, i4i Approval V. q MEL 4M Section Bu Odhig TyOe r --p Nii6i Of 73 "liA Fl CHD:f4oiifii=d4i 6 R640is# When FM le Separate Sewerage Syitem to consist of -G�llon Septk T To be r bti�6d,by Address ' wwil. Water` scippis"; Address pdvaw UDD V D Oi4 166 system(s) : a 1-4'ep-res�ant t"t 1, am wholly and spoul sysem !Sign enj ippation, of the ab 1diieribad will I�i structed and in acc�rdirfci4iith the standards, rulesj?7reg 1pns�Rf- the., pt�tjsrn OYP. r*n pt4! r,niii,, - _�f -6 h 'stru" Commissions[ Ithwill bs 4�ibiniiileti6h-'theiriof, a coun�ly, ,Health;, hi i i ,-6n ct Wlmsllt.�"And 'a j��ritton i6r, -saidbuildari Will at " 11 '. --- , ji that iukrnitt§d;�i:6, the,6 --- - ' ' - ` - : " ` h: i �s6icessors. - a rs or, asst -Ouarah, assigns �bV this bo condition ,-any- part ihm'adiiiily.fo,16;�In�q thedats o 'the issu. �!h good: operating .s6vwagc'.dIsposal 'o -,two,(2), year s r p r -: the led.well I tlie:,approval. of system o Ali* thereto; dril delic►ibid above ancero that PMI? ors or said e With ..utnam will ,6i io�iti-d' 'i'Wjcv#Oihp 111-1— 1. � — approved - 'Hoak" County D par men of A Prev I a - P.E. R.A. �.S Address APPROVED FO,R CONSTRUCTION This approval expuas two yeari'lfro has -been :'nded&ksn and is revocable tor. cause Or :may 68 amended or modified' when cons�daretl necessary by the COm�ilss)oner of Flsalth: Any change or. alteration -of nst!udion. 'requ;res a new,: perm�t.'.`Approv`ed for disposal of''do eat is "sanitary - sewage and /or private way wppl ' Rev. 1/87 n M DEPARTMENT OF HEALTH Division of Environmental Health Services TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # i WELL LOCATION Street Address To Village City Tax Grid Number -T S - WELL OWNER Name L Mai ing Address rivate O Public Z- E OF WELL primary 2 - secondary d RESIDENTIAL O BUSINESS O INDUSTRIAL AIR /COND /HE PUMP O PUBLIC SUPPLY O AT O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY ANDONE AB D. O OTHER (specify, AMOUNT OF USE YIELD SOUGHT # PEOPLE SERVED_ /EST. OF DAILY () USAGE al REASON FOR DRILLING ONEW SUPPLY O PROVIDE ADDITIONAL SUPPLY OREPLACE EXISTING SUPPLY ®DEEPEN EXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED ODRIVEN ®DUG 13 GRAVEL ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN Q REALTY SUBDIVISION, NAME OF SUBDIVISION: (AfL2r]SC71V S. Lot No. WATER WELL CONTRACTOR: Name Ul\) o4wiQ Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: n% A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: IV A LOCATIO SKETCH & SOURCES OF CONTAMINATION PROVIDED ` VET S �(AtOitQ0Y ON REAR OF THIS'APPLICATION �ON SEPARAT ET ( at ) (signa ure) 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 s.hall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. Date of Issue: 19 g� Date of Expiration: 19 erm it Issuing c a Permit is Non - Transferrable Whi te copy; H.D. File Yellow copy: Building Inspector 2/87 Pink Copy: Owner Orange copy: Well Driller J.R. FOLCHETTI ASSOCIATES Environmental Engineers P.O. Box 374 BREWSTER, NEW YORK 10509 .(914) 279.3346 TO Chris Johnson c/o Putnam County Health Dept. Carmel, NY 10512 [L[EVUEEa orF VabOSEDUVIL DATE JOB NO, 8/9/88 ATTENTION RE: WE ARE SENDING YOU 6d Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter .❑ Change order .0. COPIES DATE NO. DESCRIPTION" 1 eacl Well permit 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 ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS This is to confirm our recent conversation regarding the renewal of the construction permits for Garrison Lots 2 & 4. I believe the original Permit numbers are'-P-5686 (lot 2) and P -5886 (1nt 4) _ rpul d yolz please double check these and fill them in on the applications2 Also, T am linc9ar the impression that the original permits expire on the 13th of thiG month and woul& appreciate it if the application process was coApleted Prior to this date. Thank you very much_ COPY TO J. L. Garrison f ile SIGN omminum r.� u... mui It enclosures are not as noted, kindly ne at once. PUTNAM-COUNTYDEPARTNWNT ,Z WIL Is -oi MR Tiz *a on N aT W. Area Kai T T6 be construbted, by Adi� Date _Sign P.E R.A 31 '86 : equin tied pa m .6 buil 0 he ding has be u m stied when co ry by Date u ~ Gentlemen: This letter is to authorize J. Robert Folchetti -& Associates a duly licensed professional engineer or registered architect_ (Indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the. Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this.matter and to supervise the construction of said system or systems in.coriformity with the provisions of Article 145 or .147, Education Law, the Public Health Law, and the Putnam County Sani- tary .Code. Very trul o s Signed Countersigned: Owner of Property P.E., R.A., # 051011 1 Blue Hill Plaza Address P.O. Box 379 Pearl River, NY 10965 Address Town Brewster, NY 10509 914 7279 -3346 Telephone Telephone. PU�MM COUN'T'Y DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMEMAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET - CONSTRUCTION PERMIT 1 '� C-7 DATE REVIEWED. BY: 0 (Name of Owner) (Street Location) COMIEVTS YES INO, DOCUMEI S v Permit Application Corporate Resolution Plans - Three sets \1'ak Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results 30" Perc Hole Other House Plans - Two sets If PWS - Letter Variance Request REQUIRED DETAILS ON PLANS Sewage System Plan (3) `6-- 6 0 hUA1 1AA, VA %A Sewage System Hydraulic Prof' vity Flow Fill Profile & Dimensions. Vsl D or J Box;Trench /Gallery; it details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes Design Data Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Jl a ooting /Gutter Curtain Drains Perc & Deep Holes Located Representative of Sewage & Expansion Area Expansion Area;shown;gravity flow,suff. size If Pumped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Property Located Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4" /ft. 4 "0; Type pipe No Bends; Max. Bends 450 w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (i.nc. expan) 15' to Drains- Curtain,Storm,Leader,Footing 25' to Catch Basin 10' to Water Line (pits -201) Septic Tanks 10' from Foundation 50' to Well 15' Well to PL GENERAL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland (Town /DEC Permit R & D) ,� Data On DDS Plans & Permit Same PUnMM COUNTY DEPARTMENT OF HEALTH DIVISION: OF:, ., -- HEALTH SERVICES DESIGN, DATA. SHEET.SUBSUFACE.S3N GE DISPOSAL SYSTEM FILE NO. Owner C, E, 4, L , !SATZ.1e150t-4 Address C'O'F- N- \,4 /AL L. �-(1 l.4 Located :at . ( Street) Cor.Q L�L =. J 1 Sec . Block , C Lot (indicate nearest cross treet) Municipality GATT'_'$ Watershed G�oTy�4 SOIL PERCOLATION TEST DATA RDQUIRED TO BE SUBM = WITH APPLICATIONS Date of Pre- Soaking. 41191 at-,o Date of Percolation Test 44 19 1 s e HOLE NUMBER CLOCK TIME PERCOLATION 44 PERcOLATION Run Elapse Depth to Water Fran Water Level No...,. Time Ground Surface, In Inches Soil Rate 48 Start -Stop Min. Start Stop Drop In Min /In Drop c,T 5 Inches Inches Inches .1 ZIZZ- j ;ZZ 400 13 IS ' /z Zi /Z.: 7,4-- .2 1-55- z :44 44 13 .14 °/L I V? 3 2..49- 5,2. 1 5Z i5 14- I 3Z .5 4 44 44 2 49 3 3t.11- 3. 1 Z¢ Vt- 48 5 1 - 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 sutvdtted for review. 2. Depth measurements to be made'frcm top of hole. rev. 9/85 DEPTH G.L. 21 31 1 r4-z 41 51 61 71 4-7-16� 81 91 TEST PIT DATA RE TO B&'.'SUBMITTED WITH. L04*6-110-41090 6144�40 HOLE N0. 4s 10, 102-1, HoLE No., .4 tJ vj )_12. 1&1L-r'-K LOAN -7o 5-ILTy 0,Lky Loktj Av 5h"AVA 17p 12' --TD. 1Zo HOLE NO. 13' 141 INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE LEVEL To WHICH WATER LEVEL RISES AFTER BEING ENMUNTERED, DEEP ROLE OBSERVATIONS MADE BY: DATE: 19 I Boo wo-M - -Ste, ►, DESIGN Soil Rate Used 4-,5-(aO Min/1-1 Drop: S.D. Usable Area Provided 7260 No. of Bedroans Septic Tank Capacity o o a gals. Type Absorption Area Provided By X0107 L.F. x 24" width trench Other 099=ft . 4 ir Ivew- Name J. A.S50C. Signatur Address 101:;09 0 THIS.SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved sq.ft/gal. Checked by N The James Madison S i g,w,iturc, & Title Date 0 DINING BREAKFAST :12x11 & KITCHEN 19x11 LIVIT 18X3 / MUD ROOM FAMILY 14x18 LAM BEAM i .: o a., :. c+`` 23 CATHEDRAL CEILING x23 THIS ROOM ti0 h - -�\ CIO Fo 11,04 cl� % BEDROOM E_.. } BEDROOM 11x12 11x11 L / DN y�O L / BEDROOM 0 18x13 BATH �J 1 It. CANTILEVER %J SECOND FLOOR PLAN e�Rha ooh • 9 . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date July 1 1986 Re: Property of C.E. & J.L. Garrison Located at Cornwall Hill Road, Patterson, NY 12563 (T) Patterson Section 1 Block 6 Lot 7;8 Subdivision of Of Subdv. Lot # 4 Filed Map # Dates Gentlemen: This letter is to authorize J. Robert Folchetti ; & Associ�W'Ts O a. duly licensed professional engineer X or registered architect (Indicate to.apply for Construction Permit for a .separate sewage system, to serve the; above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the.Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this.matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. �.� Countersigned: P.E., R.A., 051011 P.O. Box 379 Address Brewster, NY 10509 914 -279 -3346 Telephone 1 Blue Hill Plaza Address Pearl River, NY 10965 Town Telephone