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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.06 -1 -9 / 23.06 -1 -10 xi . .kc . r .� h 16 4 .,� ♦ . r. 00642 SO SKEROTA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health ADDITION APPLICATION RESIDENTIAL ONLY STREET ` � r TOWN TAX MAP #o2 ,3. 6P NAME � &A - te,�, PHONE O3 -a 1 Q3 PCHD# f MAILING ADDRESS DESCRIPTION OF ADDITION - ,v 4&- NUMBER OF EXISTING PDRO S PROPOSED # OF E 00 S (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) "Any addition which is considered a bedroom requires formal approval of plans (Construction permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County P Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 - 6130. 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 3. Two sets of proposed floor plan (drawn to scale - with name, street and tax map #) *Non - professional sketches are acceptable 4. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count ROBERT J. BONDI County Executive Rddoe� �- (Owner's Name) Tax .• Address: za44zz Town: //- i!♦ Year Built: / %slj According to records maintained by the Town, the above noted dwelling, is in compliance with Tovcm Code. �/t e'.- `X IA04K is not . in compliance with Town Code. The Legal Bedroom Count is: B This information has been obtained from: Certificate of Occupancy: Other: eawAe,�� Ae., Buildin nspec or , 4 Date Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 A i u SHLRLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Christian Olsen 4 Cann Lane Patterson, NY 12563 Dear Mr. Olsen: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health August 18, 2008 Re: Addition- Approval — Olsen No Increase in Number of Bedrooms 4 Cann Lane (T) Patterson, T.M. # 23.06 -1 -10 I have received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from the Department date August 18, 2008. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained., 3. All plumbing fixtures must be updated with water saving devices, i.e:, new low flush toilets, restrictors for shower heads and faucets, etc. 4. A separate repair permit is required for the new sewer line and the new 100 gallon concrete septic tank. The repair must be performed by septic system contractor licensed in Putnam County. 5. The existing septic system area is to be cordoned off and protected during the demolition and removal of the existing house. 6. The approval is for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals. Any other permits or variances required'are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. jRes ectfully , h S. Paravati, Jr. tant Public Health Engineer JSP:kly cc: BI, (T) Patterson Environmental Health (845) 278 -6130 ' Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 A -0021 ALL CALCS DONE PRESCRIPTIVE HE YRC , TOTAL B.T.U. LOSS: 45,000 I--w i� O U Q o� o- x r. N M a 1 3 2 U) 1 �C 7k g114STRUCTUR MDR' ti �' Hx 4 � O OA (t2t'M SPF,y2 NOR a lr4c5 AS. EA E ® =(14x1�SPFg2 MDR �y A9H UNIT r� x/ 42)A�4 dS. EA UNIT O © -(2 1;J*' LVL IN CL EACH UNIT 4 e ),-116 OR (2) 2 S.C. EACH UNIT ALL CALCS DONE PRESCRIPTIVE HE YRC , TOTAL B.T.U. LOSS: 45,000 I--w i� O U Q o� o- x r. N M a 1 3 2 U) 1 A �' Hx 4 � O C, O let a h 0 pV ^� U Ga r W .S. � E- J h� 4 0 F�# COUNTERTOP DETAIL ALL CALCS DONE PRESCRIPTIVE HE YRC , TOTAL B.T.U. LOSS: 45,000 I--w i� O U Q o� o- x r. N M a 1 3 2 U) 1 FITT:NAM COUNTY DEPARTMENT OF REALTh ROUSI% PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDROOMS. ALL SUBSEQUENT REVISION( ALTERATIONS TO THESE HOUFZ PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL z0'�X�� 4, 5I 'NATURE TITLE DATE 0 p O O p 1 W D � I i r Qj 4 op * std, .0"o" % POI. W-1. I 7 Z See PeAlc',-r-J �s^ vi' 11LL1LSS7 FUSE PLANS APPROVED FOA BEDROOM COUNT ONLY. B 9) - BEDROOMS ALL SUBSEQUENT REVISIONIALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL rfi S GNATURE & TITLE DATA r ! Q-17 r cl v� 3 s C� 00 _I fir/ i tp —L Preview in Browser LIP VAVE a% .9 sip, Wj Page 1, of 1 Olsen Plan Revision August 14th 2008 01F N9 � • � � . alc 'J if Rm ftT r MIS �EiZCtA�o 511DJDCrTS p"DI STitiV lX1~l'x bmat Tom Wm) v 6 Foal ceiling helght kgad Auflust 141h 2008 L A znvilz .0 2314 CS W ff? (C WAL 81, W,YAV VAN DAV, iCtS1' MA om tm f! 15�iitfF i T `6i�t49 L a t2 &7S ?HIR1 12 r M MGC LWYE0 Wm 50f}7I OW-7- WRAP 17.�i1R l�Di�o r /-IJUL 2a $W#2 BARD sW PUTNAM COUN'T'Y DEPARTMENT OF. HEAL "01-1 ROUSE PLANS APPROVED FOR BEDROOM COUNT A i3�3 9 BEDROOMS. K a- ALL SUBSEQUENT REVISIONIALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO -THE PCDOH FOR APPROVAL 2 � 5I ° TATURE & TITLE DATE file://C:\Documents and SettingsWrolsen \Local Settings \Temp \Pho7A3.htm 8/14/2008 C.A) co REV# DRAWN DAMI- occc �r .�. Op v1 V 0 V Drill Hole Set F 2.1' W. ®"I,_SJ2 °J6'21 "W 33746' ' 132.2' x / a former quarry N N;A 10'o Hub Set \ / X on Rock Set 27.5' o Point Mark on Rock D. 45.3 ° 0 3 ti O 15 Hub I� Hub Set o- __ ���' °pproxirn e top of slope icy NJ2'J6'21 "E 261.59' 'O'° Hub Set Approximate Septic Area Size Unknown —, F. 3.5' E. 6' stockade f. ` —x x x :H 4.4' 4 4. ------ `O Mi 0 �d shed 132' �T u I � El. 52 0 lawn deck 11 bin w 1 S(ory Dwelling Vent 0.6' N. i 32.4' ,,,,�„�'� ove hang conc. toop i� oLlawn r Well x x xT x x- x x 6' vinyl f. I ` 4' rail f. NO T.- Contractor is to verify all dimensions prior to construction! Sketch Of Stakes Set Olsen Residence 4 Cann Lane, Patterson, NY 0' 30' 60' +� Staked July 17, 2008, Sketch Revised July 18, 2008 L SCALE IN FEET Kenneth B. Salzmann, LS (845) 855 -3885 I CD NOTE: ALL STAIRS, LANDINGS, & HANDRAILS NEEDED FOR ENTRANCE FROM THE EXTERIOR OF THE HOME ARE TO COMPLY WITH SECTIONS 311 -316 OF THE RCNYS. 9 ®I®� oill . IBM 07HO 'Aim 10-41toll __ �J!imj ■LEO cm in _— RW SHWCL.ES —_� A A i l.-_AISE STAIRS 5/8' 2. CAPE CLOSE -OFF ON -SITE BY OTHERS 3. (1) 3' DRAW & (2) 3/4' SUPPLY FOR FUTURE PLUMBING 4. EMERGENCY SHUT -OFF SNITCH ON -SITE BY OTHERS PER ALL STATE & LOCAL CODES 5. MEAN ROOF HEIGHT DETERMINED USING 24' FROM GRADE TO BOTTOM OF FACTORY BUILT 6. SITE LOCATION: PATTERSON. NY/PUTNAM COUNTY/30# SNOWLOAD/100 M.P.H. WINDZONE /ALL DOORS & WINDOWS MINIMUM DP31.09 IN EXPOSURE -C- 1308 -0021 = 3046 = EGRESS, REFERENCE SECTION 310 OF THE RCNYS. m IS �ai w 2� W 0- c1l O n U � m � o V) a � z G N xa9 m wa 00 I 10 '* NOTE: ALL STAIRS, LANDINGS, & HANDRAILS NEEDED FOR ENTRANCE FROM THE EXTERIOR OF THE HOME 'ARE TO COMPLY WITH SECTIONS 311 -316 OF THE RCNYS. 4 - - ROOF SHINGLES - _ FINISHED GRADE VARIES .RAISE STAIRS 5/8" 2. CAPE CLOSE -OFF ON -SITE BY OTHERS 1 (1) 3" DRAIN & (2) 3/4" SUPPLY FOR FUTURE PLUMBING 4. EMERGENCY SHUT -OFF SWITCH ON -SITE BY OTHERS PER ALL STATE & LOCAL CODES 5. MEAN ROOF HEIGHT DETERMINED USING 24" FROM GRADE TO BOTTOM OF FACTORY BUILT 6. SITE LOCATION: PATTERSON. NY/PUTNAM COUNTY /30# SNOWLOAD /100 M.P.H. WINDZONE /ALL DOORS & WINDOWS MINIMUM DP31.09 IN EXPOSURE "C" = 3046 :k = EGRESS, REFERENCE SECTION 310 OF THE RCNYS. ng!' TIE u 1308 -0021 WAS 0CfRAC= ..AISE S TAIRS 5/8" 2 CAPE CLOSE -OFF ON -SITE BY OTHERS 3. (1) 3- DRAIN & (2) 3/4' SUPPLY FOR FUTURE PLUMBING 4. EMERGENCY SHUT -OFF SWITCH ON -SITE BY OTHERS PER ALL STATE & LOCAL CODES 5. MEAN ROOF HEIGHT DETERMINED USING 24' FROM GRADE TO BOTTOM OF FACTORY BUILT 6. STE LOCATION: PATTERSON, NY/PUTNAM COUNTY /30# SNOWLOAD /100 M.P.H. NANOZONE /ALL DOORS & WINDOWS MINIMUM DP31.09 IN EXPOSURE "C" RIGHT ELEVATION �YS. 9 r del d � w a a� Uz a °a U W xz N BE O THIS STEP IS THE SANE FOR 807H S= OF TRUSS I THIS STEP IS THE SAME FOR 807H 9DES OF TRUSS THIS STEP IS TIE SANE FOR BOTH SUES OF TRUSS FIRED rAVF OPTION - OALV. SIEIl SIRUP Apm N1ii1 lR) AB7r+1 1/R• 0I 613i-J• ltd M N79T- -�-"�� 1uS4 PFA 40tAi FND �g T411S 8AT - _ -� {9) at71- NIJ YiA biCAP • , 5 (e) aurJ ./o APB g �� Dm or, l7) 4nrd7uR8 4wu v.• ` t ' t Q1 N . O a0. , r \� .0.151+ 7 t/f NAYS pt) a,51•u 11i __ ll� ,, 41n•R r ales ' (7) 0.lb•aY Has (~'10� . `1 EA E'NR OF 1911M RE a,]%zFM�°0ws a #R ml= BAY fq aurJ Vr C rte' 4wwAtc 4411•)1/!• MAYS �"` En slasm RINQE] PER �' ,{ loss wAL N/ fU ala•. 1 ,/r ( 'I QW.3 1/4• MAYS lm tR' bR sm FAS�v nna AREA RcsPaNsmllr Om,m c N sm To BUILT OOBN TO AOODYNOOAIE R -VALUE ABO •— �VE]RriATON PER LIXJa. OODE MV4At•J• NABS ETUMM FTSF'r or= L)4 ro f tItSTAl1Fa 06750NG 7d G& Y/ FASOA p,nr . NA(� Pm IM YB�fi 90E aF Y.w. IO a1T'r3I Phi •'ll° tOY1 IMY, • SOENALL ��` 1 SPF R+ SPF 801TW 1Ut PLA "ice -attr m NAYS RAO t6. 4C ly �7 ymu ff `• GE WWJ44L (�1cR'pNS OF ]' "A"s Illf / QD YwPEN aY r ! , 1 natAYRi ewYAYE p{/Nm A!° O. r t 9K5 .L ' NMYALC Y17. • .��a6.iON sagm SLL PAIE 9YY AMY VOW BEFORE YLL ,MALL N/ ML mP RATE ( (I�R7� 4171•J 1 /{• IIAiS iutE m sNM IIORI 900 of LLIL .17 R0 OA 51E0. STRAP N/It 6L71• • S xALS PEII1:fID OF 81WW !lu.,FASTENPIGS SHOWN ARE APPLICATIONS SCENARIOS. , R•I9 BIRBAUX N/ W CLO cFRI SECTTDN 18 (TRIPLE WIDE) AND SECTION 19 OF "THE CALCUTATiON MANUAL STAMPED STAB MAY VARY W TO smAV m NxL snm Rat? g APPROVED BY A REGISTEREb PROFESSIONAL /e4TIM£ a I:ENSFA• ENGINEER ✓k THIRD - - -' IR1x MA41 7Elt E e� or STRAP. �A/s1eAS�� PARTY INSPECTION AGENCY ( )- B• wW THESE STEPS ARE THE SAME FOR BOTH SIDES R -1 e O DETAIL APPLICABLE FOR FOLLOWING: -5/12 TO 1212 PITCHES a -10' TO 15'9 BOX WIDTHS ° - DRAWINGS B THROUGH E TYPICAL SET DETAILS Rm YOR k 9NIOE 3 e cumRID own= .� rem ° soma a 54FF2 RAPnR t3IBi5 ON RID mm o/ fat PAPFR ON //Y 456 ao mm (� 616 O.4 PPOWIUFACi80D IRIS 81 Rs6 SWn =Wm T4 warva PERER MUQTwIUUMR Fl 12 ,:nber even rt q THRU 72 V P RR GTE OYWMM ORP FDA 7d G& Y/ FASOA 9/B'ORTNNL 7A4 OR 7A7 MAMAM NALL sm OBYNALL N/ ML mP RATE (�y{�p k SD$1QD OR FO1W R•I9 BIRBAUX N/ W SAIFO) STAB MAY VARY V. J= NANINN ^ EXIT 0 9ffARMO ! r THE umum sm OR IEORB] sm uA• I B• (r111F�D ea of a:w SPFUZ N 1r = FLOM AoOT hlO sprIz O 1r 4c nm XW v 4to W49Am BY to WD� ° z hOf nM m IMAM 41 PATE e rttrtl/Y SIML PLATE • ° OF110K SFAEM AFL 9m Ctl,NW SEE nAN FOR VOMXE NORM ° A FONUD( l PLAN I ° FOI UWATOW a• DRS rlaott m PER on= SIX cmmrrns `L IALT COlU10/i0a]OiO TYPICAL CAPE CROSS- SECTION DIMENSION CHART (in feet) µ' A 1, B W° j A B I • 10!0.0 ' 79.0 ' 15 154.0 2,G.0, 2 113.0' 77.0 1(n *2.O 58.0' 3 120.0' 14.0' 11 170.0 41.0 4 127 .0' 12.0' 18 175.0 4(o .O 5 135.0' 70.0 19 io (".0 10(..0 , O 142.0' &9.0 20 112.5' 105.0, 7 148.51 68 .0' 21 11'3 •0 105. 0 8 154 •5' 69 - 0' 22 1.2(0.0 105.0 9 160.5 70.0' 23 133.0 10&-0 in IIr, n' all n, n e Inch ii I-- n' Al 52^ a Z � a o � � RoIJT�� NOTES : 3// THIS IS TO CERTIFY THAT THE SEWAGE DISPOSAL SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BY ME BEFORE IT WAS COVERED OVER. THE SYSTEM WAS CONSTRUCTED IN ACCORDANCE WITH-ALL STANDARD RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH AND THE NEW YORK STATE DEPARTMENT OF HEALTH. SURVEY INFORMATION FROM SURVEY PREPARED BY TERRY BER6ENC0RFF COWN5, L.5. M1111110M co SITE SITE LOCATION PLA SCALE: I" = 2000 P � PROPERTY SHOWN ON TOWN OF PATTeK TAX MAP: 23. Oro - I - 9 AND 27 \ \ \ \ \ \ \ EXPgAl \ \ \ \ -�,7 5 16 �h. Putnam County Department of Health Division of Environmental Health SerVJOBB Appr a as noted for conformance With app ica a Rul and Regulations of the C Health Department. v/ =gaature & Title ate v \yy PROJECT PROPOSED SST toYJNERS 6TA &5CaAC+4 Posy d sTA6La✓t ?VJS -II 0 6UTifiR1`!U7 LANE TOWN of PATTE:9--,0t4 NEW . CLIENT: CARMINE 4 NINA LORA ROUTE 22 PATTER -�N , ttEsk .Harry W. Nichols Jr. Suite 106, Patterson 2050 Route 22 Brewster, NY 1050£ (645) 279 -4003, Fax 279 CONSULTING SITE ENGII DRAWING TITLE : AS - BUILT SST LOTio 3 SCALE DATE : iD - Co Of NEW YOq DRAWN BY,: LT C. N CHECKED BY : HVVN JOB No.: 00- C :. ... _. ..: . ...:. ,. .. .. :. .i.l. i .:..�: ...« :.. :... r -.' v. +. :iti +�-- -� +. �w-- V1Aw•. y- �} M. rr�+ L�'.% a' iY4S.%^ w" .'L-0f�+i��G:Y�rvv�"�- rY.��.i... PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CERTIFICATE OF CONSTRUCTION COMPLIANCE F REATMENT SYSTEM PCHD CONSTRUCTION PERMIT # P 19 - Mage Located at By *: hIr ` �k Town or a Owner /Applicant Name Tax Map -,2-3,0 Block �_ Lot Formerly Subdivision Name %dw ti Gri Subd. Lot # 3 Mailing Address Oe. X12 Bre'-Je' Zip Date Construction Permit Issued by PCHD S -U 1 - 0 Separate Sewerage System built by _ L00 A� Address � Ai. ti Consisting of 12-S-0 Gallon Septic Tank and td . Other Requirements: Water Sunnly: Public Supply From. Address or: 1z Private Supply Drilled by ,,�A t 0 �� , %�, ., 'ti Address JS-- Lvbr...' vL �Yew.c jc,- Building Type Z_S (� e i, P I t Has erosion control been completed? t�I Number of Bedrooms Has garbage grinder been installed? /v�7 I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the Putnam Co#nty„Department of Health. Date: 9-1-7-0) Certified by Address P.E. !/ R.A License # I (' (2-9' Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocatiA)n, modification or change is necessary. By: 61 Title: Date: zz White copy - HD F4; Ye opy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CC -97 ram n PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES:.. GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM �51 0 (0 I 921-2- 7 Owner or Purchaser of Building Tax Map Block .Lot Building. Constructed by Location - Street , Building Type P�ir rra� Town)N e Subdivision Name 3 Subdivision Lot I represent that I am wholly and completely responsible for the location, workmanship, material, construction. and drainage of the sewage treatment system serving the above - described property, and that is has been constructed• as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition, any part of said system constructed by me which fails to operate for a period 'of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment. system, or any repairs made by me to such system,,except where the failure. to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the. system.. The undersigned further agrees to accept as. conclusive the determination -of the Public Health - Director of the Putnam County Department of Health as to whether or not the' failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month Da 3 Year a_ X eneral Contractor (Owner) - Signature Corporation Name (if corporation) Address: 97 ,wS1e_4, State " Zip IA9 43 Signat re• x Title: k, t% e4 Corporation Name (if corporation) Address:_�c� State 1U Zip 1462;3 Form GS -97 a Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 2794003 Fax (845) 2794567 July 12, 2001 Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, NY 10509 RE: Individual SSTS Compliance Towners Stage Coach - Lot # 3 Carmine & Nina LoPane Butternut Lane Patterson, New York T.M. #23.06- 1 -9 &27 Dear Robert: Enclosed are the following: 1. Five (5) prints of Drawing SS -3, "As -Built SSTS," dated 9 -6 -01. 2. "Certificate of Construction Compliance for Sewage Treatment System," dated 9- 17 -01. 3. Three (3) copies of "Guarantee of Subsurface Sewage Treatment System," dated 9- 13 -01. 4. Laboratory Report, dated 9- 17 -01. 5. Application Fee in the amount of $200.00 payable to Putnam County Health Department. 6. "E -911 Address Verification form," dated 9- 18 -01. 7. "Well Completion Report," dated 9- 13 -84. If there are any questions concerning the enclosed, please call. Very truly yours, i Harry W. M ols Jr., P.E. HVVN:His 00- 058.03 .�' '- - _... .. YfYglpn .vt enVn Viununwr rruurur •lur art v• COUNTY OFFICC BUILDING + CARMELr NEW YOnX This"reaort is io be eornpleted by well driller and submitted to County •Ficalth Department together with laboratory report of only: of water sample indicating water is of satisfactory baeteriil quSlity before certificate of construction compliance is issued. REPORT MUST BE SUPMITTED WITHIN 30 DAYS OF WELL Coti1PLETION - NAMe ADDRESS c /o' Heenan Realty ®S'i@tER Horizon Construction Coo Brewster NY 10509 LOCA1f0 ?1 (NO. 6 Streor) (TOwnJ (LOI N ✓moor) 61WILL Towners Stagecoach Post & Stables Route 311. Patterson. NY (model house) SCREEN DETAILS SLOT Sii: j DIAMETER (Inches) IF GRAVEL Diameter of;well including IPACKED: gravel pock rircvveld: TEST WELL (—j OTHER 44..�J Iitaeci(rI EOTHER (Soed(Y). (w(:IVE $MOE jjw'�'A'5 �A ING GcJU DT 2 TES � NO LV 1 YES � NO LP M. YIELD(G,P,M,) s•�,,� 50 1 50 Depth of Covivfpiefed Well In feet below Lond surface: L NGTt 365 OPEN TO AQUIFER ;feet) set) ITO (toot) f JPTK Pt Ox LArtD 579FACE1 Sketch 0ract location of won "w /rh oistances. to at least BEET to FEET FORMATION DESCRI?TION two pern:anont )ahamafxS. r 0 10 �yHardpan �?� �,� �, (fe�acl � y ' ---- � 10 365 Medium to hard limestone Utrpi _ 3Z.S ��`�� ` oEja 'vz vCO3a),_-- 14,40. (,2 (slim .l jf e lt)X 30Z vvi, — .® d r r w If Yield was tested of dihorent depths durina drill:nq, list below FEET GAUCINS PER MINUTE 365 50 ALE WILL 4.08%Fttlt0 on c P POnT ]%'VC.LL ptTILL.LIT 9/10/84 I /(3%64 , Pres e- MILL DRILLING, • INC. BUSINESS E3 PROPOSED L a} DOMESTIC ESTACI SHMENT fARM list OF WILL ® CONDITIONING I•..I SUPPLY INDUSTRIAL- G CABLE PERCUSSION 11;QUIPN.EUT lJ ROTARY AIR PERCUSSION BASING LENGTf1 (lost) DIAMEiERpncnes) wtu,MT PER FOOT I WELDED (DETAILS 31 6 17 THREADED VIEW EI ® hot)&$ COMPRESSED UST E'AILED LJ PUMPED AIR 4 WATER MEASURE FROM LAND SURFACE —STATIC (Specltyfact) DURING YIELD TEST fleet) 1 IVEL . -30 365 SCREEN DETAILS SLOT Sii: j DIAMETER (Inches) IF GRAVEL Diameter of;well including IPACKED: gravel pock rircvveld: TEST WELL (—j OTHER 44..�J Iitaeci(rI EOTHER (Soed(Y). (w(:IVE $MOE jjw'�'A'5 �A ING GcJU DT 2 TES � NO LV 1 YES � NO LP M. YIELD(G,P,M,) s•�,,� 50 1 50 Depth of Covivfpiefed Well In feet below Lond surface: L NGTt 365 OPEN TO AQUIFER ;feet) set) ITO (toot) f JPTK Pt Ox LArtD 579FACE1 Sketch 0ract location of won "w /rh oistances. to at least BEET to FEET FORMATION DESCRI?TION two pern:anont )ahamafxS. r 0 10 �yHardpan �?� �,� �, (fe�acl � y ' ---- � 10 365 Medium to hard limestone Utrpi _ 3Z.S ��`�� ` oEja 'vz vCO3a),_-- 14,40. (,2 (slim .l jf e lt)X 30Z vvi, — .® d r r w If Yield was tested of dihorent depths durina drill:nq, list below FEET GAUCINS PER MINUTE 365 50 ALE WILL 4.08%Fttlt0 on c P POnT ]%'VC.LL ptTILL.LIT 9/10/84 I /(3%64 , Pres e- MILL DRILLING, • INC. BREWSTER LABORATORIES Box 224 - BREWSTER, N.Y. WATER ANALYSIS REPORT SAMPLE NO. 55112 SOURCE: Horizon Construction Model House ..Route-311 ^Jell Patterson, NY COLLECTED: September 15, 1984 Sir: dill Drilling, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method 0 per 100 ml. Thit rttult ixdicattt the touret of tht tampb wat of tatitfactery taxitary quality whtx At tamph wat. colltcttd. September 18, 1984. Y Bickwit P. E. Directer PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM cayk L" 1 4 C �1 �l , lltfa. , L 44,ine- . .. 2.3,04 9 -z.7 Owner or Purchaser of Building Tax Map Block Lot Building Constructed by Location - Street Building Type 101V+Vrf o h TownN�+ rage ,,JJ T c> � ors Svc- ,.e, Subdivision Name 3 Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed. as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment'system, or any repairs made by me to such system...except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination -of the Public Health- Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: Month °i Da 3 Year 0. Signat re• Title: 0 �j t, eur eneral Contractor (Owner) - Signature Corporation Name (if corporation) Address: A $c, I- State kL Y, Zip /;LS( '.3 Corporation Name (if corporation) Address: State Zip Z Form GS -97 BRUCE R. FOLEY LORETTA MOLMARI-R.N., M.S.N. Public Health Director y Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278.6130 Fax (914) 278.7921 Nursing Services (914) 278.6558 WIC (914) 278.6678 .Fax (914) 278.6085 Early'Toterven6a-(914)178. 6014 Preschool (914) 2186082 Fax (914) 27F. 6648 OWNERS NAME: TAX MAP NUMBER: E911 ADDRESS: TOWN: AUTHORIZED TOWN OFFICIAL: (Signature) DATE: The Putnam County Department of Health will not issue a Certificate of Construction Compliance unless the above form is completed, i.e., a legal E911 address is assigned by an authorized town official. This form is to be submitted with the application for a Certificate of Construction Compliance. (E911 VERFR1vl) NE NORTHEAST LABORATORY of DANBURY �o %N ACCO' O 39 MILL PLAIN ROAD - DANBURY' CT 06811 CT Cert: PH -0404 �4D 203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 LABS www.NORTHEAST LABORATORIES.com LABORATORY REPORT REPORT TO: MILL DRILLING, INC. DATE SAMPLE COLLECTED: 9/12/2001 75 PUTNAM AVENUE TIME COLLECTED: 9:45 A.M. BREWSTER, N.Y. 10509 COLLECTED BY: ROBERT MILL DATE RECEIVED @ LAB: 9/12/2001 TESTED BY: LAB #11471 LAB I.D. # MD -23 ' >._._..:r:,....;_ -� .`,t.• ,',2EPOR'!'�PATE... -__ ,.., .. _ .__. 9l17/2 1 . SAMPLE SITE: GUERRA. ROUTE 311, PATTERSON. NY. SAMPLE POINT: TANK HOSE BIB SOURCE: WELL TREATMENT: NONE MAJOM[TM CONTAMINANT TEST PERFORMED RESULTS METHOD # LEVEL (MCQ OR STANDARD BACTERIAL: '"'� • Total Colifoiin (Bacteria) 0 per 100 ml SM 9223 ABSENT PHYSICALS: • Color (Apparent) 0 - EPA 110.2 15 • Odor ND - - 3 Units • pH 7.00 - EPA 150.1 No designated limits • Turbidity 0.49 NTUs EPA 180.1 5 NTUs CHEMISTRY: • Nitrite Nitrogen <0.005 mg/L as N EPA 354.1 • Nitrite Nitrogen 1.08 mg/L as N EPA 353.3 • Alkalinity 244.0 mg/L SM 2320B • Hardness 296.0 mg/L EPA 130.2 • Iron <0.03 mg/L EPA 236.1 • Manganese <0.01 mg/L EPA 243.1 • Sodium 18.7 mg/L EPA 273.1 • Lead <0.001 mg/L EPA 239.2 1.0 mg/L 10 mg/L No defined limits No defined limits 0.30 mg/L 0.50 mg/L Combined limit for Iron plus Manganese - 0.50 mg/L 20.0 mg/L ** 0.015 mg/L * ** ml= milliliter mg/L--milligrams per Liter ND =none detected MCL= Maximum Contaminant Level TNTC =Too Numerous To Count — Notification Level ** *Action Level COMMENTS: -All holding times (were) met. SAMPLE, AS TESTED ABOVE: MOTABLE or ONOT POTABLE (PER STATE OF NEW YORK DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) RESULTS BASED ON SAMPLES SUBMITTED: 9/17/2001 0 Swan 1� (I � � � n �-,nnl f�' Fd ld � • Laborai a *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 06037• (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 •OUTSIDE CT: 800 - 654 -1230 PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH SERVICES / d FINAL SITE INSPECTION 8l z pl �� *W'04' ' Date: o Inspecte y: 1, Z.cErn Street Location Owner G'Vpww� Town Permit # F 4 / TM T'_ 5, © Subdivision Lot # 3 1. Sewage Svstetn Area a. STS area located as per approved plans ..- ......................... b. Fill section -date of placement 3:1 barrier Lgth. Width Avg.Dpth c. Natural soil not stripped ................... ............................... d. Stone, brush, etc., greater than 15' from STS area.......... e. 100' from water course / wetlands ...... ............................... II. Sewage System - a. Septic tank size ...... C,250 . ...... other .... Q��.. --�j b. Septic tank installed level ............................................... c. 10' minimum from foundation .......... ............................... d. Distribution Box 1. All out�at same elevation -water tested ................. 2. Protected below frost .................. ............................... .3. Minimum 2 ft.Original soil between box & trenches e. Junction Box - properly set ........... ............................... f. renc es 1. Length required 4� 7 Length installed 4�� 7 2. Distance to watercourse measured +roo Ft........:. 3. Installed according to plan ......... ............................... 4. Slope of trench acceptable 1/16 -1/32" /foot ............. 5. 10 ft. from property line - 20 ft.- foundations.......... 6. Depth of trench <30 inches from surface ........:......... 7. Room allowed for expansion, 100% ......................... 8. Size of gravel 3/4 -1 %2" diameter clean .................... 9. Depth of gravel in trench 12" minimum. .. 10. - P-iae= ends -caoned. " ............. ....... ....... g. rump or-uosea wsrems 1. Size ot pump chamber ................ ............................... 2. Overflow tank ............................. ............................... 3. Alarm, visual / audio .................... ............................... 4. Pump easily accessible, manhole to grade ................. 5. First box baffled ................................................... ..:..... 6. Cycle witnessed by H.D.estirnated flow /cycle........... III. House/Buildin a. House located per approved plans . b. yNumbdr of bedrooms: IV. a Well located as per approved plans . ............................... b. Distance from STS area measured a' t e5 D ft ........... c. Casing 18" above grade .................. ............................... d. Surface drainage around well acceptable ....................... V. Overall Workmanship a. Boxes properly grouted ................... ............................... b. All pipes partially backfilled ........... ............................... c. All pipes flush with inside of box ... ............................... d. Backfill material contains stones <4" diameter .............. e. Curtain drain& standpipes- mstal_led accords g4 plan: �.- �i.�. X f. =r rtam drain' outfall "proteeted = &. dirao- exist water co Footing drains discharge away from STS area ........... ... Surface water protection adequate .................: ...... u e✓a Erosion control provide ........... -- F v• COMMENTS 9. h. i. AUG -09 -2001 08:26 AM HARRY W NICHOLS 914 279 4567 P.03 "-W mioa �J :Agv9+o :ma 'R r"H 3o looa ob(I A3anoo m�imnd ot� �o s�onein8 t A� Q� 'jpAPmB e1(i Put swIQ P?badds P" 3!=d 0010=noa CWd Pocs9j 296 qq& oMF=* M a01ojdmoo MIP P gp*A pat paiwadsul mvq I pa ports saoo vooq eq $*"A BA" yqs %% )PR ir'(a Ott 0; n A;.MW 1 Zond ul sam aw tomoo aolswo orir '!S -IL 4mgd,%d fU postwt g*m 9j TV Janulp Ulm ti S1 Z roe pa o�oo tI ... .. ;03� •- c`' � �" �oio1dtQoo m�u�tt st # 1101 colt�+!Dq "S S labs '� -Lsco WIVO)W) q KOJI :atch�y aahtntpgng :� m+od LZ ! . zo•� � g °?�S.Z I1Ii d 'dNl � �� - �:omIH istaos�ddy�sow�p W Q _79 ; �T-'-3 1007 :po3to0 1 •aptm 8mvq toonovdsm togauarz gal 03 sopd po3a14moo J" oq 12= u"t=o;m IN IP.d -am 193123 :io,d sIDuUs ILLTM WUM01 AM 10 KobMt =11M 4110 1x=xvd2a Lwoo K ult w AUG -9 -2001 THU 08:36 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 3° D f r r �! BRUCE R. FOLEY Public Health Director August 10, 2001 DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M. S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Field Inspection - Lopane Butternut Lane, (T) Patterson Lot # 3, TM# 23.06 -1 -9.27 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled except for the end caps. The following comments must be corrected in the field: 1. Expose end caps for inspection. 2. Replace fernco with a more ridged connection. 3. A bedroom count needs to be performed (house was locked). 4. The curtain drain outflow was not found upon inspection. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Very truly yours, Gene D. Reed GDR:cj Environmental Health Engineering Aide 0 r .p : 1/1 SENDING CONFIRMATION DATE AUG-10 -2001 FRI 11:56 NAME PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845- 278 -7921 PHONE : 92794567 PAGES : 1/1 START TIME : AUG-10 11:55 ELAPSED TIME : 00'40" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... s BRUCE R. FOLEY LOREITA MOLINARI R.N., W.N. P.6I7a H. Ah Di— A..o La P-M, Hrhh D&.1. DYrsto, of Poetm Sk- DBPARTWNT OF HEALTH 1 Geneve Road Brow,tar, New Yo* 10509 tI1Walm.m.1 N..hh (943)271.6120 Fu(SO)271 -7921 7lorentl a.fvkM (215)112 -673i WIC (943)271.6671 Fn(t4S)271.6945 sanr rntrrmll.v (W)272.6014 su(145)271.6641 Frrdaad(945)220-9911 en.R43)22t -6117 August 10, 2001 Tfarry Nichols. FE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Ro: Field Tnspoction - Lopane Butternut Lang (T) Patterson Lot 4 3, TMq 23.06 -1 -9.27 Dear Mr. Nichols: The above referenecd separate sewage treatment system can he backf)lled except for the end caps. The following comments must be cortected in the field: 1. Expose end cape for inspection. 2. Replace feroco with a mom ridged connoction. 3. A bedroom count needs to be performed (house was locked). 4. The curtain drain outflow was not found upon inspection. If you have any farther questions, please contact me at (845) 278.6130 mt. 2261. Very truly yours, �Gr<Q 1v Gene D. Recd GDR:cj Environmental Health Engineering Aide tl � O O Y BRUCE R. FOLEY Public Health Director August 29, 2001 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New' York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool. (845) 228 - 5912 Fax(845)228-6113 Harry Nichols, PE Patterson Park, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Filed Inspection - Lopane Butternut Lane, (T) Patterson Lot #3, TM# 23.06 -1 -9.27 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field: 1. The curtain drain outflow needs to be trenched to release water, and gravel added to prevent erosion. If you have any further questions, please contact me at (845) 278 -6130 ext. 2261. Very truly yours, - - Gene D. Reed Environmental Health Engineering Aide GDR:cj e SENDING CONFIRMATION DATE : AUG-30 -2001 THU 13:26 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845 - 278 -7921 PHONE : 92794567 PAGES : 1/1 START TIME : AUG-30 13:25 ELAPSED TIME : 00'39" MODE : G3 RESULTS : OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED... BR17CB K FOIZY LoKMA MOUNAW RN, M.B.N. WNk lkatra DD- Ana hsba M.M Zlbv f Db..Yar of PaeaN Servhv DEPAR'T'MENT OF HEALTH I Gcnevs Read Bmvaror, New Yolk ID509 c.wr.m..m awth p15)271.6150 t>aM0771.Ml &r* (W2711-6351 (µ312n -6351 wrC(945)271.6671 Fa(9M271..fiM F..ly b—W- (14315fl -6616 p6.(143)271.6648 rreuf.a(24J)111.5112 Paf24512201-610 August 29, 2001 Hwy Nichols, PE Patterson Pads, Suite 106 2050 Route 22 Brewster, New York 10509 Re: Filed Inspection - Lopano Butternut Lane, (T) Patterson Lot #3, TM# 23.06.1 -9.27 Dear Mr. Nichols: The above referenced separate sewage treatment system can be backfilled. The following comments must be corrected in the field: 1. The curtain dram outflow nods to be trenched to release water, and gravel added to prevent erosion. If you have any Father questions, please contact me at (845) 278.6130 oat. 2261. Very fly yob v Owe D. Reed Environmental Health Engineering Aide ODR:cj PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SE ENT SYSTEM PERMIT #' Located at P407E 12,)11 ] �JIM15F-H►R L hHe Town or Village Rxm� 0H Subdivision name ,+,k) �it.ES Subd. Lot # �P� Tax Map1.,�� Block i Lot �a Date Subdivision Approved -' D e4 Renewal Revision Owner /Applicant Name W``NA �- OPAIN5 Date of Previous Approval Mailing Address FkrrEPAoiA, N4 Zip Amount of Fee Enclosed ' I X00 ^' Building Type P- �6 i Del•+ Lot Area � jl No. of Bedrooms Design Flow GPD (000 Fill Section Only Depth Volume PCHD NOTIFICATION IS RE UIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1000 gallon septic tank and Other Requirements: N "N? ��`� 1� )i✓lLk r�P` (mayCU�tNl� To be constructed by Water Supply: Public Supply From or: Private Supply Drilled by 4�,D, Address Address Address GO0 �-f kM 11m--A I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatments s� described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. A Signed: Address R.A. Date 11-h M License # 6617,4 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified Aen considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new p i . Appro for discharge of domestic sanitary sewage only. By: Title: a�-- Date: kl- White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desigif Professional Form CP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL / please print or type PCHD Permit # (� Well Location: Street Address: Town/Village Tax Grid # P-0 M /�b1 PA —1 TtEP,190H Map fJAX6131ock ` Lot(s) q+10 Well Owner: Name: Address: krf-ii- k0k %off NE P-T' S!�- pArT'L--9-/noA 1 Use of Well: X Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought C')4- gpm # People Served Or ° Est. of Daily Usage _L _gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type >�_ Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ..................................... ............................... Yes iL No Name of subdivision iOvJ�t�P -� 7TA� �° ���' �Y �f�i.t' Lot No. Water Well Contractor: '�Bit), Address: Is Public Water Supply available to site? .................................. ............................... Yes No . Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate, hee, plan. Date: �°� �''� Applicant Signature: 41, v - PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well 'ller certified by Putnam County. 11 Date of Issue Permit Issuing 0 ial: (/ Date of Expiration Title: Permit is Non- Transferr lc White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 PLITNAiM COUNTY DEPARTMENT OF HEALTH HOUSE PLANTS APPROVED FOR BEDROOM COUNT ONLY; EDR00i4S �. ano,•t`are & Title ute 11' -7 1/2 ". 14' -3 1/4" 3037 ' VINYL 4257 a�av -e- -Ia�I-- 48--- .l5-81/2" GARDEN TU „p x4 48 rx • i O half 6O• 9: 0 all 42” high 8' -2 1/2 DINING FRMSLY 30 EPTH 2 cl 5' r ' �J 3ff'- ---- ------- 30' 3O 30" 24" 48" 48" BEDROOM 1 LTV_ iNG BEDROOM 7 P.'DR�OM q9 6'-4 1/2" 14. -0. 2S7 I uco f ot•r 4257 14' -7 1/2" 10.5 1/4" 8'•6 1/4" 10' -10 1/2" 6`0 1/2' I r- i TO BLOCK - 26XSB RAISED RQLCK 'CERSAR SOJpmBa73I�Q/olLa N. SIDEl.IRL_ - 2.5 �•�, N .0 --- _�.____ A ontsiOry Or •IIbOf/YGY f10aQ r _ CEILL`t hE[Gr'.T E'•0" ru -' IDEAL HOMES / GR.LLRGMER LASE'_ - .... --c w ________«____ ____________________________m_2 i ■ , . § e e ; � | :_ ..l� ■,. �/ � � } | / ! q / § ! @ ■, . ! k � $ ! *` { ■ \ � �� � y ��, ■ . ,. : � �_ � � j � } SIR PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES { DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner C&PAN HF- +- 04 HA L9)�( HF- Address FT Located at (Street) t1 Tax Map 06 Block (indicate nearest cross street) Municipality Drainage Basinr� Lot 9 )p f�p-"61 N SOIL PERCOLATION TEST DATA Date of Pre - soaking I 1 Date of Percolation Test. Hole No. Run No. Time Start - Stop Ela se Time Min.) NtOo Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate KnAnch 2 1 r `��'� 10 17A W /h'% ' M j 1 3 �zy y �rl 10 1 tj to � � � w 7,4114,, 1)141 t4 l � 2 1 u- 1 l0'° . ' 0 Z'►a� %� lil �l`1 ° 40 I 3 [l}►! _ i0H! ij ? Z� ►`1� �I� n ! 4 5 1 . 2 3. 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min /inch, s 2 min for 3.1 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 0 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. A HOLE NO. HOLE NO. G.L. 0.5 0 � TOP45zo.- 0—G TeeiolL 1.0' LT Lx 9p- 2.0' 2.5' 3.0' �iT• �ar�4�0- �F� 4.0' cap, Aft 4.5' 5.0' 5.5' 6.0' 6.5' a 7.0' 1' k,0 mv, IL9,A 'L0fr1,1\. 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed V'0" Indicate level to which water level rises after being encountered 0 Deep hole observations made by: PG1 +01 G R (A0W i- -1Aau)A�4 W-4 t4 Spate Design Professional Name: HL-`� W L M� L►��, J�� Pr Address: -0 M` i -L,--., MA PA Signature: Design Professional's Seal NIChp {,5�;i G. m w x • �rbf 11� 6t: No. 56224 PUTNAI11 COUNTY DEPARTMENT OF HEAL'T'H DIVISION OF ENVIRONMENTAL ''HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of L' �1-- Md►�� �- IytiN� L-� F'/� QME Located at fir. X11 J BJrr R-NJ T L•Pch►G T/V Q,�p.�,oi.� Tax Map Block Lot Subdivision of TO.W �4 P-� ')T -A AA5 U w P°.�T Subdivision Lot # '12 Filed Map Date Filed Gentlemen: This letter is to authorize /kw I '4j' NIL.NO1'6t JI-, M a duly licensed Professional Engineer X or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam Coun 'terry Code. or fitKI ro N IC /Nj Countersigned: 1E_: P.E., R.A., # Mailing Address U N, State j�`�� Zip Telephone: (�1�� � GM Very truly yours, Signed: 7ner of Property) Mailing Address: PXI-6 'V - PA.TrI5 a-t3 oH State NY Zip Telephone: OP-0 V el 114' n�o Form LA -97 HARRY W. NICHOLS JR., P.E. March 9, 1999 \ LAURENT ENGINEERING ASSOCIATES, P.C. MILLBROOKE OFFICE CENTRE Route 22 & Milltown Road Brewster, New York 10509 j (9.14)278.6108 - (FAX) 278 -2658 CONSULTING SITE ENGINEERS Mr: Robert Morris, P.E. Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: Proposed SSTS Lopane Route 311 & Butterfield Lane Town of Patterson Dear Mr. Morris: ti In response to your review letter dated February 23, 1999, we offer the following: 1. Footing & gutter drain discharge is now shown. 2. Driveway location is now shown. 3. 20' is now provided between the house and SSTS. 4. Frost protection is now provided for the D -_box. 5. All lines now originate from one D -box. We trust that the above addresses all of your concerns and we request the issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. HWN: JM: his 98027 103 9502-71. SHEET CF Z - CO.MPUTEO BY ,�1H DATE CHECKED BY �wN OATE 11V lq9 �•12.9t SCALE TiG.::.... _ _ .............. _.... . _IVA 10 _ ......... ...... -- ...... :..._... i-1 2 ' ............._.. . oo ..:.. • _'__ G ; ._TO.._T1..zC._._�%1.���u�! ���.�1 °�._Lc_t�..C?.:T.l�.� .......:. ;I�Sa?A_�.�. _...:. _._•.._.. . � .:.._... .d.,. _ �, �Sv�. �i">.__ P.. t1. 1` CP.. �_ K ;QT�...._.y..55- •.C�.�.- �.NL.�. :....._:�...... � ...... _ -- .. :.._....._ .. .....:. ___ �...' � l= �zt�- c���__l. ���_.( 2."_ P, �: c>>.__ _..E�, ?_L•�_�....5s5._..r =.�t,. f laa.h.c.,...; .:__.. LAURENT ENG,. •CERI,NG ASSOCIATES, P.C. hilLLBRGOKE OFFICE C_NiR= 22 E M;;! :own Road .\Route Brewster. New York 10;09 CONSULTING SITE ENGINEERS 103 9502-71. SHEET CF Z - CO.MPUTEO BY ,�1H DATE CHECKED BY �wN OATE 11V lq9 �•12.9t SCALE TiG.::.... _ _ .............. _.... . _IVA 10 _ ......... ...... -- ...... :..._... i-1 2 ' ............._.. . oo ..:.. • _'__ G ; ._TO.._T1..zC._._�%1.���u�! ���.�1 °�._Lc_t�..C?.:T.l�.� .......:. ;I�Sa?A_�.�. _...:. _._•.._.. . � .:.._... .d.,. _ �, �Sv�. �i">.__ P.. t1. 1` CP.. �_ K ;QT�...._.y..55- •.C�.�.- �.NL.�. :....._:�...... � ...... _ -- .. :.._....._ .. .....:. ___ �...' � l= �zt�- c���__l. ���_.( 2."_ P, �: c>>.__ _..E�, ?_L•�_�....5s5._..r =.�t,. f laa.h.c.,...; .:__.. SP40 Performance and Dimensional Data 2 2 w W LL a a W S J Q H O F 1 2" STO. PIPE 0 0 20 ao U. G 0 cr) TgS PER MINUTE so too t2o • NOTE: CASTING OIM. MAY VARY SP50 Performance and Dimensional Data SP50 — MAX. SOLIDS 1'/:" SPHERE — 1750 RPM 29 24 20 •. w U. z 16 0 a w J a 12 F O F 8 4 0L 0 FULL LOAD AMPS AT 16 115V. 12.0, AT 270V. 6.0. FULL LOAD AMPS AT 90 23OV. 9.8, AT 460V. 1.9 •I I I 20 40 60 80 100 120 140 160 U.S. GALLONS PER MINUTE hJf2. CASTING CMI 161AY VARY :'!, ;To. PIPE MEN 1111111 NOMINEES No win vv�l1�►�����0. ME MENOMINEE ME 1 2" STO. PIPE 0 0 20 ao U. G 0 cr) TgS PER MINUTE so too t2o • NOTE: CASTING OIM. MAY VARY SP50 Performance and Dimensional Data SP50 — MAX. SOLIDS 1'/:" SPHERE — 1750 RPM 29 24 20 •. w U. z 16 0 a w J a 12 F O F 8 4 0L 0 FULL LOAD AMPS AT 16 115V. 12.0, AT 270V. 6.0. FULL LOAD AMPS AT 90 23OV. 9.8, AT 460V. 1.9 •I I I 20 40 60 80 100 120 140 160 U.S. GALLONS PER MINUTE hJf2. CASTING CMI 161AY VARY :'!, ;To. PIPE KEW. 3 -12 -99 rrruru�cr� ,pur�urivv � 01 --- EX /Sr /NG GRADE 624 PROPOSED GRADE +650.00 PROPOSED SPOT GRADE RD & Fo PROPOSED R00F44 FOOT/N6 DRAINS Pr. PERCO[AT /ON TEST LOCAT ION T.P. TESr PIT Z.04C4RON ,. EX /STING WEL L PROPOSED WELL Ex /57,11vG SSDS PROPOSED SSDS EXIST /NG TREE LINE EX /STING STONE W,41L PROPOSED SILT FENCE PROPOSED STRAW BALED /KE PROJECT: Ply 0 PO 5F.0n STS ToWNFEph STAGEC0AeH P61iT RNP 0.,?Ae?LW7- J drlj PATTE A----)o N R° Vr l 3N 1 4 avrr --HUT LAHa NEW Y� cL/ENr: CARMINE � NINA LOPA NE RouTr- 22 PA- rraJL5ol.j NF-W Yol LAURENT ENGINEERING A$50CIATE45 F. G. M /LLDROOKE OFFICE CENTRE Route 22 & N1111own Rood Brewsfe� New York /0509 (914)278-6108 - (FAX)Z73 -2658 CONSULTING SITE ENGINEERS DRAWING TITL•% PROS 06 E.0 650T5 L 0 T '. SCALE: / "s c50 ` -% DATE 12 -2 I 8 I'v, , \Y �n DRAWN BY: pc �CHECKEOBY: HWN Joe No: 3802 DRAWING N0.• t%&"- J05 No. 960E I SHEET No. F OF_ Z COMPUTED BY JM DATE �.1211g9 CHECKED BY (-{WN DATE r SCALE LAURENT ENGINEERING ASSOCIATES, P.C. j ' MILLBROOKE OFFICE CENTRE Route 22 d Milltown Road Brewster, New York 10509 CONSULTING SITE ENGINEERS J05 No. 960E I SHEET No. F OF_ Z COMPUTED BY JM DATE �.1211g9 CHECKED BY (-{WN DATE r SCALE cr I ._..:.._ � ' :._... ?•b._:1- �r '�.._.._; :.. �•i .� fit: �2 �1:�2y��....� .. :2:`tt...._ ^- .:...---- ...._..._...:_._� -cQ' ..:...._.... • ___. :2'! -141 Z 7. 4 ....._..__.._ _"Ct HA 7- __ .-..........._.._._._.._. :._..: o -7- _ BRUCE R FOLEY Public Health Director DEPARTMENT OF 1 Geneva Road Brewster, New York HEALTH 10509 LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 February 23, 1999 Jeff Moore Laurent Associates Millbrook Office Centre Route 22 & Milltown Road Brewster NY 10509 Re: Proposed SSTS: Lopaine Route 311 and Butterfield Lane (T) Patterson, TM# 23.06 -1 -9 & 10 Dear Mr. Moore: Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regard. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) Footing/gutter drain discharge is not shown. 2) Driveway has not been shown. 3) Minimum distance from the foundation to the SSTS is 20 feet. 4) Frost protection is not shown for the d -box. 5) Split systems are not permissible. All lines must originate from one d -box. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. RM:tn Ve . 1 yours r Robert Morris, P.E. Senior Public Health Engineer PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT STREET LOCATION _Olr. 3 /l /� 444Y o�,r,►, NAME OF OWNER 9' 41 ,V E REYIENYED BY RBI, GR, AS, NIB, B $ K DATE a as S 4 TAX MAP # Y N DOCUMENTS Y N, Sv�aQ w¢ awe 3 PERMIT APPLICATION PC -1 WELL PERMIT_ PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) ORATE RESOLUTION SHORT EAF LANS - THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST FEE SUBDIVISION LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE FILL REQUIRED DEPTH URTAIN DRAIN REQUIRED STANDPIPES GENERAL LOCATED IN NYC WATERSHED PLANS SUBMITTED TO DEP DELE TED TO PCHD APPROVAL, IF REQ'D DEEP TEST HOLES OBSERVED PERCS TO BE WITNESSED EX -AP OVAL SSDS ADJ. LOTS TLANDS (TOWN/DEC PERMIT REQ'D ?) 5TAON DDS PLANS & PERMIT SAME RE 1969 NEIGHBOR NOTIFICATION ETTER BUZBA Y FLOOD ELEVATION R REQ'D PERMITS) REQUIRED DETAILS ON PLANS SEWAGE SYSTEM PLAN - (NORTH ARROW) SSDS HYDRAULIC PROFILE eF9VITY FLOW EROSION CONTROL:HOUSE,WELL, SSDS. PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION IOCATION MAP EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED, PIT & D BOX SHOWN & DETAILED HOUSE - NO.OF BEDROOMS WELLS & SSDS'S WAN 200' OF PROPOSED SYS. PROPERTY METES & BOUNDS HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER -1/4" F.T. 4 "0; TYPE PIPE NO BENDS; MAX.BENDS 45° W /CLEANOUT FILL SYSTEMS CLAY BARRIER AFT. HORIZONTAL;SLOP�FILLNOTES FILL; gRECS FILL CER A 10N NOTE DEPTH GA FILL FILE & DI SIOT � ]FILL IN EXPANSION AREA TRENCH g100% TRENCH PROVIDED �P� 60 FT MAX. RALLEL TO CONTOURS EXPANSION PROVIDED SEPARATION DISTANCES SPECIFIED ON PLAN - FROM SSTS QIU R11/:EWAl4 LARGE TREES, TOP OF FILL 20'TUFO T g A _lO:N[WA. Lp _15'WELL TO PL 100' TO WELL, 200' IN DLOD, 150' PITS 00 TO STREAM WATERCOURSE LAKE (inc. expan) TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATER LINE (pits -20') 0'- INTERMITTENT DRAINAGE COURSE 01500' RESERVOIR, ETC. _150' GALLEY SYSTEMS CONSTRUCTION NOTES to CDS= >5 0/o,10'- 4 %,25'- 3 0/o,30'- 2 0/o,35' -I %,100' - <1% ESIGN DATA: PERC & DEEP RESULTS 'MtN to CD discharge /100'with 182 cons day discharge 2' CONTOURS EXISTING & PROPOSED SEPTIC TANK DRIVEWAY & SLOPES, CUT 10' FROM FOUNDATION; 50' TO WELL F 0 'G /GUTTE CURTAIN DINS- WELL S IL TYPE BOUNDARIES IM i S SMEPROW.RMETNE TLE BLOCK; OWNERS NAME ,ADDRESS FVF—1 LOCATION OF SERVICE CONNECTION TM #,PE/RA; NAME,ADDRESS,PHONE# DATE OFDRAWING /REVISION DATUM REFERENCE OCATION OF WATERCOURSES, PONDS S AND WETLANDS WITHIN 200 FEET PROPOSED FINISH FLOOR AND BASEMENT EL. COM]NIENTS: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT STREET LOCATION REVIEWED BY RNI, GR, AS, MB, BH Y N . . ]DOCUMENTS . =PERMIT APPLICATION PC -qq- L PERMIT _ PWS LETTER LITER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION SHORT EAF PLANS - THREE SETS HOUSE PLANS - TWO SETS VARIANCE REOUEST LEGAL SUBDIVISION SUBDIVISION APPROVAL CHECKED PERC RATE NAME OF OWNER Y N EROSION CONTROL:HOUSE,WELL, SSDS '+Pe-wL- PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY & EXPANSION LOCATION MAP AANN l ilft laeA44, 1 u" ZMCO rt�" EXP. AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE IF PUMPED, PIT & D BOX SHOWN & DETAILED 0 4o�6 fl2o5f PO-a4a0ij HOUSE - NO.OF BEDROOMS AIOLIP4 01J 91PN WELLS & SSDS'S WAN 200' OF PROPOSED SOP400 M 11 uL, PROPERTY METES & BOUNDS;ciaJ HOUSE SETBACK (TIGHT LOT) HOUSE SEWER - 1/4" FT. 4 "0; TYPE PIPE NO BENDS! MAX BENDS 45° W/CLEANOUT Wi1lt14 0 M'9-r O'F- t"0 FILL SYSTEMS CLAY BARRIER MW -7- 10- FT. HORIZONTAL;SLOPE 3:1 TO GRADE FILL REQUIRED DEPTH FILL SPECS FILL NOTES CURTAIN DRAIN REQUIRED FILL CERTIFICATION NOTE STANDPIPES 'lT9 o% DEPTH GAUGES ' ?JiN�— fi FILL PROFILE & DIMENSIONS LOCATED IN NYC WATERSHED VOLUME PLANS SUBMITTED TO DEP , j(�, FILL IN EXPANSION AREAn DELEGATED TO PCHD ( TRENCH DEP APPROVAL I r LF TRENCH 6O FT MAX. (�,fQAt;i1� 6�'° M EP TEST HOLED% kup t PARALLEL TO CONTOURS PERCS TO BE WITNESSED 100% EXPANSION V"u.,a." .5�W dJ ! --- EX- APPROVAL SSDS ADJ. LOTS SEPARATION DISTANCES SPECIFIED WETLANDS (TOWN/DEC PERMIT REQ'D ?) ON PLAN - FROM SSTS DATA 0 DDS PLANS & PERMIT SAME 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL RE •19691EIGHBORNOTIFICATION'M:ii 20' TO FOUNDATION WALLS _15'WELL TO PL LETTER BI/ZBA 5t"3P11 4G 4-f6it- i3jiLwA ix -r I00' TO WELL, 200' IN DLOD, 150' MR `v P1 PS 100 YR. FLOOD ELEVATION 6bkW41wxj 100' TO STREAM, WATERCOURSEOLAKE (inc. expan) .. 4, fgl'"- OTHER REQ'D PERMITS) 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER e,4crq REQUIRED DETAILS ON PLANS 10' TO WATER LINE (pits -20') SEWAGE SYSTEM PLAN - (NORTH ARROW) 50' INTERMITTENT DRAINAGE COURSE SSDS HYDRAULIC PROFILE 200' /500' RESERVOIR, ETC. _150' GALLEY SYSTEMS GRAVITY FLOW CONSTRUCTION NOTES &— 1 15'MIN to CDS= >50/.10'- 4 %,25'- 3 %,30'- 2 %,35' 71 0/0,100' - <10/0 DESIGN DATA: PERC & DEEP RESULTS 20 'MIN to CD discharge /100'with 182 cons day discharge T CONTOURS EXISTING & PROPOSED SEPTIC TANK DRIVEWAY & SLOPES, CUT 10' FROM FOUNDATION; 50' TO WELL FOOTING /GUTTER/CURTAIN DRAMS WELL SOIL TYPE BOUNDARIES r DIMENSIONS TO PROPERTY LINE TITLE BLOCK; OWNERS NAME,AD LOCATION OF SERVICE CONNECTION TM #,PE/RA; NAME,ADDRESS,PHONE# DATE OF DRAWING/REVISION A Ataix 4j01 -AnAlc Ali af- pkpC"7jw( t s ON , ' 41(- Tip&- DATUM REFERENCE LOCATION OF WATERCOURSES, PONDS LAKES AND WETLANDS WITHIN 200 FEET PROPOSED FINISH FLOOR AND BASEMENT EL. CONINL LENTS: LAURENT ENGINEERING ASSOCIATES, P.C. N1ILLBROOKE OFFICE CENTRE jRoute 22 & Milltown Road Brewster, New York 10509 CONSULTING SITE ENGINEERS JOB No. 60/Vi -- SHEET No. OF COMPUTED BY J DATE I i CHECKED BY ION DATE I�2��°� 1 SCALE :..._....... _... _......._............_... -- __......._.......... -- . ...... �-7 x 0.09 - - -------- I hyi M, w �Olf-Cl .y W4 YA These pumps are ideal for residential pumping of sewage or other high capacity sump duty. Designed to comply with health and sanitary codes. Will handle all waste from water closets and lavatories as well as drainage from laundry trays, floor drains and seepage tiles. SP40 and SP50 pump systems rate high in of ficiency for high capacity handling of sewage from large residences and buildings, drainage water from basements, dairies, stores, and in- dustrial pumping of wastewater. BULLETIN 210.8 SP40 4110 H.P. SP50 � =- 1/2 ' H.P. ;j y J r , �� ,_ , 1 li rr � �• y I 1 y y •. 1 X �� i Residential yr {y sewage ejector; sUbmersible 1 SI i. t yClq high capacity f° n sump ;service k y � tii rt,'. ,1 r :1 1 irs i lZ r ,i HYDROMATIC ILno PUMPS A Marley Pump Company 9 a s SP40 Performance and Dimensional Data SP40A — MAX SOLIDS 1' /e" SPHERE — 1750 RPM 24 20 F - t W ON Au U. 0 Q 12 O H 8 0 FULL LOAD - It AMPS AT 16 115V. 4 9.4, AT 230V. 4.7 a FULL LOAD AMPS AT 36 230V. 2.72, AT 460V. 1.36 5'r• 2" STD. PIPE 0 0 20 40 6 Cp 80 100 120 O PER MINUTE NOTE: CASTING DIM. MAY VARY -_ h" U.S. GALL SP50 Performance and Dimensional Data 28 24 20 W W LL z 16 D Q W S J H 12 O F 8 4 0 0 SP50 — MAX. SOLIDS 11/2" SPHERE — 1750 RPM FULL LOAD AMPS AT 16 115V. 12.0, AT 230V. 6.0. FULL LOAD AMPS AT 36 230V. 3.8, AT 460V. 1.9 1 1 1 20 40 60 80 100 120 140 160 U.S. GALLONS PER MINUTE NOTE: CASTING DIM. MAY VARY _ 'r* 'or 3" TD. PIPE SP40 and SP50 Features PUMP MOTOR — 4110 horsepower (SP40) and 1/2- horsepower (SP50) motors are ball bearing design, oil filled and protected with auto- matic reset thermal type overload. Three phase motors do not have overload protec- tion and should always be used with a starter having overload protection. Motor housing filled with dielectric pure, clean insulating oil, which rapidly dissipates heat and lubricates ball. bearings. POWER CORD — 10 -foot power cord with 3 -prong grounding plug furnished as standard. 20 -foot length available at extra cost. IMPELLER — SP40 is high capacity, non -clog, two -vane sewage type. SP50 is semi -open two - vane sewage type with impelling vanes on back shrouds to prevent stringy materials from bind- ing blades or wrapping around shaft. Vanes also keep abrasives from shaft seal and reduce seal operating pressure, thus increasing seal life. SHAFT SEAL — Precision mechanical seal prevents leakage into motor. Seal faces are Specifications carbon and ceramic, super lapped for long leak -proof life. SWITCH — Choice of automatic or manual. CONSTRUCTION — All pump parts and motor housing are cast iron. Pump and rotor shaft are corrosion - resistant steel. All bolts and screws are stainless steel. Bronze construction available on special request. LEVEL CONTROL — Diaphragm type pressure switch enclosed in water -tight housing, mounted to pump. Switch diaphragm is isola- ted by oil which is sealed in with a second dia- phragm; prevents solids from affecting switch operation. Magnetic starter is available for three phase pumps. Level switches set for 8" level (Special settings to 40 inches can be supplied). COMPLETELY FIELD SERVICEABLE FACTORY TESTED — Each unit is given a com- plete pumping check before leaving factory. Model Capacities to Heads to Solids Handling Capacity NPT Discharge Motor HP Phase 'Voltage SP40 120 prn 28 feet 1 -114 inch 2 -inch 4110 1 115VI230V SP40 120 gpm I 28 feet 1 -114 inch 2 -inch 4110 3 230V SP50 150 gpm 29 feet 1 -112 inch 2 or 3 -inch 112 1 115VI230V SP50 150 gpm 29 feet 1 -112 inch 2 or 3 -inch 112 3 230V 'Other voltages available on special request. Model Number Explanation Series (SP) — Submersible Pump Control (A) — Automatic (Switch attached to pump) (M) — Manual (No switch) Construction — (0 Nothing) — Cast iron . (B) — Bronze Electrical (1) —. 16115V (2) — 1 (b 230V (3) — 36 230V EXAMPLE: SP50M3 — SP Series Submersible Pump, 112 H.P. Manual Operation, Cast Iron, 36 230V. Specifications subject to change without notice. MMO PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES j APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: C- ^�-HINE 't' 2. Name of project: L01' tLt'Q WN iVAt— ;6T� . 3. Location T/V: 4. Design Professional: 144- V! I H�( *I-T i � E 5. Address: U (MLLrowi F4" q 6. Drainage Basin: r—:Pei 7. Tyne of Project: Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ................ ............ .......................... Type I Type II 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... Exempt Unlisted X 1-410 10. Has DEIS been completed and found acceptable by Lead Agency? ............... No 11. Name of Lead Agency NA 12. Is. this project in an area under the control of local planning, zoning, or other officials, ordinances? .......................................................:. ............................... 1`t5 13. If so, have plans been submitted to such authorities? ........ ............................... 9 14. Has preliminary approval been granted by such authorities? Nd Date granted: kA 15. Type of Sewage Treatment System Discharge ................. surface water groundwater 16. If surface water discharge, what is the stream class designation? .................... NA 17. Waters index number (surface) ..............:............................ ............................... N4 18. Is project located near a public water supply system ?. ....... ............................... No 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ No 21. Name of sewage system — Distance to sewage system �- 22. Date test holes observed 1 `� 23. Name of Health Inspector . yT1E�, 24. Project design flow (gallons per day) ................................. ............................... 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... lVn 26. Has SPDES Application been submitted to local DEC office? N A Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? Nc 28. Wetlands ID Number .............. ......................................... ............................... �A 29. Is Wetlands Permit required? ......................................:....... ............................... Has application been made to Town or Local DEC office? ............................... N 30. Does project require a DEC Stream Disturbance Permit? .. ............................... lie 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, Nc landfilling, sludge application or industrial activity? ............................ Yes/No 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? . ............................... Yes/No DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site? ................................ ............................... _ N J 35. Are any sewage treatment areas in excess of 15% slope? . ............................... 36. Tax Map ID Number .......................... ............................... Map Block Lot 37. Approved plans are to be returned to ..... Applicant Design Professional NOTE: All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is' signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law, SIGNATURES & OFFICIAL TITLES: Mailing Address: ................................... �F-Eto i Ey- 1,4Y 1 �) `—M 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only 'art 1 - PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT /SPONSOR: �� ��� NINA UFAwa 12. PROJECT NAME: 1l,4 Rv 3. PROJECT LOCATION: Municipality pfa P -601 —I County FAH.Ah 4. PRECISE LOCATION: (Street address and road intersections, prominent landmarks, etc., or provide map) o) 11 + JiTEP-Nrfi LN)-a 5. PROPOSED ACTION IS: ❑New ❑Expansion %Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: LoHSYIL�C.iIoN ta[- II�DI.ttOJPA, S' Tp 5)r(iyI C�t15T1Ht" �%'' DwewmtA i1�MwN ►y U�lt�� N� W4r@,gP�s..� A3�9 SIRS cn� �ctwu(t� 1n1 iq�U riK'ad !� tkt� Slbo,X, kpcaasr0 v4,A\iw Lb',JaT tl'- jii0i Jn1p C� Nt1-a rA,p��c ►3 ' i 7. AMOUNT OF LAND AFFECTED: Initially lu acres Ultimately acres I 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? IKYes ONo If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? kesidential ❑Industrial,. - ❑Commercial ❑Agricultural ❑Park /Forest /Open space OOther Describe: 61H(A : rp�rr \vt 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL, AGENCY (FEDERAL, STATE OR LOCAL)? % OYes CJNNo If yes, list agency(s) name and permit /approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? OYes- WNo If yes, list agency(s) name and permit /approval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? OYes (1.No ::icr<aur I CERTIFY THAT THE IN- FORMATION PROVIDED ABOVE IS TRUE` TOO THE BEST OF NY KNOWLEDGE A .:n;or narle• �R � �' HkuLml Y r •A' -?c . If the action is in a Coastal Area, trnd you a.a a state agency, complete a I! Coastal Assessm.e :rt Form before proceeding with this assessmer.; �! HARRY VI. NICHOLS JR.. P.E January 21, 1999 Mr. Robert Morris, P.E. Putnam County Health Department 4 Geneva Road Brewster, NY 10509 LAURENT ENGIN =ERIN G VILLBROOK ASSOCIATES, CE CEN i RE: Routo 22 6 Milltown RsaC at*. Star. Now Yortit 10509 V (914)27d -610a • (FAx) 2741•2iU CONSULTING SITE ENGINEER; RE: Individual SSDS Carmine & Nina Lopaine Towners Stagecoach Post & Stables -Lots 2 & 3 (T) FdrrEPL60 N Dear Robert: Enclosed are the following: 1. Five (5) prints of SS -3 "Proposed SSDS," dated 1- 21 -99. 2. "Short EAF," dated 12- 21 -98. 3. "Application For Approval of Plans For a Wastewater Disposal System." 4. "Construction Permit for Sewage Disposal System, dated 12- 21 -98. 5. "Application to Construct a Water Well," dated 12- 21 -98. 6. "Design Data Sheet." 7. "Letter of Authorization," dated 12- 21 -98. 8. Two (2) copies of Residence Floor Plan(s) for Bedroom Count Only." 9. Review Fee in the amount of $300.00. ♦5 We would appreciat-your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. N' ols, Jr., P.E. HWN:JM:his 98027 `� � d �t1 E1�j° BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278,- 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 February 23, 1999 Harry Nichols Laurent Associates Millbrook Office Centre Route 22 & Milltown Road Brewster NY 10509 RE: Lopaine Route 311Butternut Lane, Lot# 2 & 3 (T) Patterson Reservoir Basin East Branch Dear Mr. Nichols: The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on February 18, 1999 is complete. The Department will notify you by March 10, 1999 of its determination. ® The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. ❑ Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Dept. of Environmental Protection review and approval of other aspects of a project, such as stormwater plans or the creation Letter to: Harry Nichols - February 23, 1999 -2- of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Dept. of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (914) 278 -6130 ext. 166. Very,; ly yours, 1 Robert Morris, PE RM:tn Senior Public Health Engineer (a 30 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner L cfP,4 Address + Located at (Street) =A;6 rte H1,j/{N p , Jax Map 23;oG Block ! Lot (indicate nearest cross street) Municipality `,4T-r0*gSo,t1 Watershed LA.sT 8RANey SOIL PERCOLATION TEST DATA Date of Pre - soaking Log — 0 1 -- Date of Percolation Test /0 4F NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole: (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 » ::.:......::.... ;:;::::::::: >;::: . _..: - e th to !titer.... From Ground :. Vi?a ear Level Percolat►on Hole No Ruh No �e Start Stogy Ala se T►me : Ln } Surface (ICnches) Start Staff A'op �n Ine es .:. ate 1 11104 9:/7 ?0 �3 - 3 3 2 .� /8 9�� 10 3,3 3 q, , el (p jQ 3 A6 4 f`c( 0:v d 3 114 6-1 S 5 top( /d, -(7 167 30 �e. 2 9,140 10'(0 Bo a3 3i 3/ il0 3 ro.(( 10: 30 93 023!/e� 3 #® 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole: (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 A 4 RECORD OF PHONE CONVERSATION Time: 1/ ,.,® O Dater Person calling:. /�u'�Gt �� Phone #: Reason () Inspection: Deeps and /or eres: & y'_ j Scheduled FIE Time: Date: Tentative /to be confirmed () ( ) Town: �Q ` Road /Street: 3 Tax Map Comments: =50A /0 EL C--©,�>L c11 - tiles u 2 9 ti 090 �s# /OQQ ..+t.ytT�Y•'+ ''iii` " "r � ��� �T- •i'.,P 3 8yf, 1.66 AC. CAL 1 2% t>" �w t.• 38 o 1.309 4 C 200 37 _ u 2 9 ti 090 �s# /OQQ O 4 1.58 AC. CAL. ROUTE 12 3.09 AC. IB IIlN 5 8.51 AC. CAL. 3 8yf, 1.66 AC. CAL 2% �w t.• 38 o 1.309 4 C 200 37 _ O 4 1.58 AC. CAL. ROUTE 12 3.09 AC. IB IIlN JUN -27 -2000 09:32 AM HARRY W NICHOLS 914 279 4567 P.01 BRUCE R. FOLEY Public Health Director DEPARTMENT 1 Geneva Brewster, New OE HEALTH Road York 10509' LORETTA MOLINARI R.N., M.S.N. Ansoclate Pabllc Health Director Director of Patient Services ATTENTION: o ADAM STIEBELING GENE REED All information below must be JW-11 completed prior to any scheduling. DATE: 610 ENGINEER OR FIRM: 1+AW w ' HIWOLS J ("5 PHONE M- %45.111-140D1 REASON: DEEPS: o PERCS: X PUMP TEST: o ROAD/STREET: TOWN: I TAX MAP#: SUBDIVISION: 5t'WE(.P, TO odo r Qotir, t rftk'V5 LOT #: 211M- OWNER: I.O QikME \i " oxem I 1313 rxvl za tell" cl *Wit vilf3c) 1 i I iL 1 / a YES NO o )4, Proposed SSTS within the drainage basin of West Branch or B.oyds Corner Reservoirs. ❑ QL Proposed .SSTS within 500 feet of a reservoir, reservoir stem or control lake. a A Proposed SSTS within 200 feet of a watercourse or a DEC wetland. 13 Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. 11 Proposed SSTS for a Commerical Project. It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered)= to any of the questions, NYCDEP must witness the soil testing. This Department Hill coordinate a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil testing, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP: FOR COUNTY USE ONLY Pe Ye S naTC: ` Z7 %11 0 3"30 Ttase: 7 % o C 9 © o COJt����7S: (IMU)TEST) Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 2794003 Fax (845) 2794567 April 25, 2001 J Department of Health - One Geneva Road Brewster, New York 10509 Att: Robert Morris, P.E. Re: Proposed SSTS: LoPane ti , CC Butternut Lane, Lot #3 Patterson, New York Dear Robert: v In response to your letter dated January 25, 2001, we offer the following: 1. Soil testing was performed on March 30, 2000 and July 20, 2000 with Gene Reed of . Putnam County Health Department. 2. Revised House Plans are now enclosed. 3. Water at 4' - 0' is the correct level. The Plan has been revised. - 4. Curtain drain has been lengthened to- provide adequate protection for the system: 5. Filed Map Number and Date of Approval has been added to the Letter of Authorization (FM 1980 June 19, 1984). 6. Refer to 3/21/01 letter from Richard Williams, Town Planner. 7. Refer to 3/12/01 letter from Richard Williams, Town Planner. 8. Refer to 3/21/01 letter from Richard Williams, Town Planner and 2/8/00 letter from Assessors Office. 9. Type of effluent pipe has been added to the Plan. Kindly continue with your review and issuance of the Construction Permit. Very truly yours, f Harry W. Nic is Jr., P.E. HWN:jm 5 9.51 AC. CAL. 0 � `0c I rr 1 I llm I I I o �I NI O I�I I N I r'-goo. I -Pr 11 IV, . rJ PUTNAM COUNTY DEPARTMENT OF HEALTH 3";z 1 DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Q�! Owner 1-6-pAlIgg, —Address 'F-t, 31/ Located at (Street) 'Z-¢- z 6 � Tax Map ;Z'3, 4 Block _I Lot Z . (indicate nearest cross street) Municipality p - ATr,C_-fe5,0W Watershed J_:�A5-r BIZA.4Lj.j SOIL PERCOLATION TEST DATA Date of Pre-soaking 3 Za 9 /0® Date of Percolation Test 3/.3&400 ....... ........ . ...... ..................... ............................. ........... . ............ . .. . .......... .. ..... .. ......... ......... ..... ...... .. ............. ........................ epth e r ... Wafer .............. . ........ ... X. .. ..... ...:.From::. Gro und t .................... ..... . ... ................... " .... ... Start dole i�o Run .... t K Stogy Indies ; 1 i0:,,2 7 ag�?- 3 ®2j -9_3 2 10l-33 //1103 '3 1,;2- c:> 3 /1 AD 4 5 1 7115-5 _/00126 30 lo- 2 10;31- /11,01 '30 yk 3 4 36 -/;20106 so Xy 2 ,q 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD-97 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' TEST PIT DATA 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES 9 HOLE NO. HOLE NO. D E'c'� rcQ 7Z oG(C HOLE NO. Indicate level at which groundwater is encountered Indicate level at which mottling is observed 6A14 Indicate level to which water level rises after being encountered Deep hole observations made by: G ow Date 0 ).G. D,H. OoA;Aeer Design Professional Name: Address: Signature: Design Professional's Seal ds�oa � l 1 r ` s A n ;y. 1.84 Ac. $� NAT z i r n 'r o tiy,•A B9.0D °_I O Rt 7 SAN£ 'aJ� 0 2.32 AC. CAL. • Cl sin �0p' 12 121.00 �0 2.64 AC. CAL. s a 3.09 AC. 4x2�m 232 B) ,�4r� $ 1bg,1fl // • J .3 $ t4o.�aD� 19 - , — < <;:Y � 6 15 $ eaoo a�`p9 18 4 « 'P 2.29 AC. CAI. 16 17 h JI fop use 20 FARM W n 25 IO 21 2I /J #4 p _ 24 23 22 - , 6 Sti 1150 I IL00 /9 114.00 /B /7 `� c 117.17 434.44 I S I I N 8I.42 •.� 5L39 I U.63 v ti• J —I 29 I 28 1.41 AC. I I AC. ���' 14A I0 199.1s 164 STATE ROUTE I 138.01 DI 211.861 D1 I I NAT z i r n 'r Y o 30 °_I O Rt 1.38 A01 8A 0 2.32 AC. CAL. c Cl 0 2.64 AC. CAL. s a 4x2�m 232 I _ 31 $ t4o.�aD� I < <;:Y 33 34 4 « 'P 2.29 AC. CAI. Y 03 -08 -2000 01 :13PM FROM BRUCE R FOLEY Public Health Director TO 92787921 P.08 YV6 27 DEPARTMENT ENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services ATTENTION: 0 ADAM STIEBELING .GENE REED All information below must be uile completed prior to any scheduling. DATE:-3-2-00 ENGINEER OR FIRM: &V r�..� �. Aflf c_ PC. - PHONE #: a.7,09 ,6ja a REASON: DEEPS: X PERCS: X PUMP TEST: o RO.JLDISTREET: dZ1-t— i l TOWN: w a TAX MAP#: 234 (a —1 Q: 2"2- . SUBDI"SIO': 4 rA / LOjT #: :2- OWNER: CG rK,. e 4 t c.t -e l +•b�keo� I'� M �l �er Id� NYQEk CRITERIA FORJQI \T REViEWA; \'D NVITNESSING FO SMIL IESTING YES NO 0 Proposed SSTS within the drainage basin of Nest Branch or Boyds Corner Reservoirs. 0 Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Proposed SSTS within.200 feet of a watercourse or a DEC tvetland. 0 Proposed SSTS design flow greater than 1.000 gallons/day or SPDES. Permit required. 0 Proposed SSTS for a Commerical Project. - It is the responsibility of the design professional to provide the above information prior to soil testing. This Department will determine the NYC:DFP project status (Joint or Delegated) based on the response. If you answeredycs to Any of the questions, NYCDEP must witness the soil testing. This Department will cuordinate.a mutually suitable time for field testing with the PCDOH, the Design Professional and NYCDEP. If a. project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDF.P is required to witness the soil testing, it Will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. FOR COUNTY USE ONLY�1 DATE! TINIr: (M-LDTEST) I i i t i `MiMIMTMfMIMIF,AIO.R IAAIMtMIMf"lAA /.ATMiMinniRnlwrRl�TMIyIf�Al� ALA AIM1 �P D .1AIMiMIMI!1�IMtiMIMIMIMIMiMV1Ai AA 04 Al1IMI�r!RAIM1/.1AI�; y I' 1 y y C( ® ® 1e ® ® Wall Ilia [V YVIi1117V1iiNVIVVi1lVl- " iVV11/ VfYHii lJl�lli:l/IITGf�f�filli/YlV ili�/i17171i2Y117Y/111 WIHtilT�lFlilViilNiH Vii/ 11IWTHNi1/ 1T/ NL'll/Y"1H11[1lHfifLiVVCV1/IHl" 11111111111f H1 /1Vlitl/YIH11f�(y1.70ii111IVVly 0 PUTNAM COUNTY DEPARTMENT OF HEALTH x DIVISION OF ENVIRONMENTAL HEALTH SERVICES /CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # - C% Located at bUrF L►Urf i-kuF� Town or Village Subdivision name N6T- -t' 6tf X-4 Subd. Lot # Tax Map V) ob Block ( Lot R �� Date Subdivision Approved l B y Renewal Revision Owner /Applicant Name GAa-6\1NE Date of Previous Approval Mailing Address F-OViE 7,� Afw 5-1-69— r t4 `� ' Zip Amount of Fee Enclosed Building Type �5196NLe Lot Area No. No. of Bedrooms �" Design Flow GPD g Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of T-R-Ek bA Other Requirements: To be constructed by Water Supply: GAP-' mo Dp-NN EM Public Supply From or: X Private Supply Drilled by 1?,6o F, X16-'IH(A gallon septic tank and 66-7 142' Nei Address Address Address represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the ?separate sewage treatment s, sum described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion t(iereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. X Address R.A. Date I 1 10 01 License # 5 G 1 i-4 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified en onsidered n cessary by the Public Health Director. Any revision or alteration of the approved plan requires anew perm' . ppro ed f ischarge of domestic sanitary sewage only. V�By: Title: Date: d 1 White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional Form CP -97 BRUCE R FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. - Associate Public, Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 • i TO: DEPARTMENT OF ENGINEERING AND DESIGN REVIEW DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM DELEGATED PROJECT: TOWN: C sF&k PV DATE SUB'D APPROVAL: NOTICE OF COMPLETE APPLICATION DATE: 5 0 :•i:.: .v i• J v\ SECOND FLO.0R ��§ � ,;__.: r'.e � �r �= b 4SF :,"u, 'HE PCDOH it OR APPROVAL � AN KITCHEN i f�� OINING HOOAA J MORNING ROOM 12. 0• „ 12•.0• L. IF (' - OrEN p� + ABOVE ► -' LIVING MOOM — —�— u —= �.— FAUILY MOOM 12'0 —a 1)'0" 0 l9L FOYEM 1 FIRST FLOOR _ 4828 = 1 .1nacF Now v BATH BEOROOM Q J DRESSING' y.,8.. x 12.0•• BEDROOM 0. i WALK 13' -0— x 10' -0.. l — I N CLOSET - MASTER BEOROOM BE0R00M 2 j OPEN N 17'-0 it 16'•8" 11' 0— x 1 5'•8'• - COUNTY EPARTMENT OF HEALTH NOME PLANS APPROVE R BEDROOM COUNT ONLY, SECOND FLO.0R ��§ � ,;__.: r'.e � �r �= b 4SF :,"u, 'HE PCDOH it OR APPROVAL � AN KITCHEN i f�� OINING HOOAA J MORNING ROOM 12. 0• „ 12•.0• L. IF (' - OrEN p� + ABOVE ► -' LIVING MOOM — —�— u —= �.— FAUILY MOOM 12'0 —a 1)'0" 0 l9L FOYEM 1 FIRST FLOOR _ 4828 = 1 .1nacF PUTNAM COUNTY DEPARTMENT OF HEALTH .. DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of 4-- W I WA L- 0 P A-H� . Located at �1 _.... Pg` i J � i i" � 4�7— L,A � TN' i 7`G� i�1 Tax Map # Block Lot Subdivision of -t``'WH b t--7 Subdivision Lot # Filed Map # M)C� Date Filed G, Gentlemen: This letter is to authorize�t` a duly licensed Professional Engineer , or Registered Architect _ to apply for the required wastewater treatinent and/or water supply permit(s) to serve the above-noted property in accordance with the standards, rules or regulations as promulgated by the Public lfealth Director of the Putnam. County Health Department, and to sign all necessary papers'on my behalf in connection with this maner and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, .the Public Health Law, and the Putnam CouWY-Sanitary Code. N Countersigned: P.E., R.A., # — as1z4'/ Mailing Address State Zip Telephone: � ova 1 � Very truly yours, Signed". (ovocr of Property) r Mailing Address: state 'J Zip Telephone: if CHAIRMAN Herbert Schech Secretary Melissa Brichta Town Planner Richard Williams March 21, 2001 Mr. Jeff More Harry Nichols Engineering 2050 Patterson Professional Park Suite 106 Brewster, NY 10509 PLANNING BOARD 2 Route 164 Patterson, New York 12563 Re: Towners Stagecoach Post & Stables subdivision. TM #23.6 -1 -12 & 23.6 -1 -27 MEMBERS: Michael V. Montesano Andrew Andretta Russell Shay David Pierro Telephone (845) 878 - 6319 • Fax (845) 878 - 2019 This is to confirm our discussion concerning the proposed utility easement on the above - mentioned subdivision. As shown on the subdivision plat approved by the Patterson Planning Board, there is a 20 foot -wide utility easement which begins at Lot #3, crosses Butternut Lane - and Lot #4 and then follows Towners Farm Lane to a proposed common septic area located on "recreation lands" which has never been constructed. The property owner is proposing to use the utility easement install a sewer line from the house located on Lot #3 to a new septic ,system located on what was formerly Lots #21 & 22, which have now been combined into one lot. It would appear that the proposed use of the utility easement is consistent with the intended use as approved on the final subdivision plat, and therefore no additional review or approvals would be required by the Town for the property owners intended use of this easement. Prior to proceeding the property owner should confirm that the utility easement has been recorded with the Putnam County Clerk. However, in reviewing the plan it appears that, assuming that the existing entrance for Towners Farm Lane is located as it is shown on the final subdivision plat, that the new driveway entrance for the rear. lot has been constructed across Lots #21 & 22. In addition, this driveway has been construction parallel to and then crosses a stream. It is my recommendation that the new driveway be survey located to better understand what impact, if any, its location may have on the use of these lots for the septic system for Lot #3. Further, the construction of a new road, Towners Farm Lane, was originally proposed within the context of the above - mentioned subdivision in order to provide access to Lots #6 through #20. These lots have now been merged into one single lot which also contains the barn located on Lot #7. The approved access to the barn located on Lot #,7 as shown on the subdivision plans, is from Butternut Lane. Towners Farm Lane is therefore no longer needed to provide access to Lots #5 through #20 and as such, the Town may wish to consider abandoning the road. If, however, the new driveway is found to be located with the roadbed of Towners Farm Lane, as shown on the final subdivision plat, the property owner should then abandon the driveway entrance currently marked as " Towners Farm Lane" and relocate the street sign to the new driveway entrance. Please feel free to contact me if you have any further questions. cc: Code Enforcement Officer Town Board Town Attorney Town Engineer Nina Lopane Sincerely yours, Richard Williams TOWN PLANNER i I _ . BRUCE R. FOLEY Public Health Director DEPARTMENT. OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 ' Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 -.6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 January 25, 2001 Harry Nichols, P.E. Paterson Park Suite 106 2050 Route 22 Brewster NY 10509 Re: Proposed SSTS: LoPane Butternut Lane, Lot #3 (T) Patterson, TM# 23.06 -1 -9 & 27 Dear Mr. Nichols: Review of plans and other supporting documents submitted at. this time relative to the above - regarded project has been completed. Comments are offered as follows: The construction of this sewage disposal system may be subject to local wetlands regulations. You should contact local wetlands officials in this regards. If percolation tests were not witnessed by a representative of the New York City Department Environmental Protection on this lot, percolation tests must be witnessed by a representative of this Department. 1) There is no record of soil testing being witnessed by this Department. 2) The house plans submitted are not acceptable. Passageway dimensions are to be provided. 3) Design Data Sheet notes groundwater at 4 feet, plan notes groundwater at 4' 6 ". 4) The curtain drain, as proposed, does not adequately protect the SSTS from high groundwater, two feet of fill is required. 5) Engineer Authorization Form is not complete. Filed map number and date of approval has not been provided. 6) A letter from the Town of Patterson is required stating that the effluent line can pass under Butternut and Towners Farm Lane. 7) Submit documentation that notes the allowance of the effluent line in the 20ft wide utility easement. Letter to: Harry Nichols, P.E. - January 25, 2001 -2- 8) Submit documentation that the applicant owns both parcels. 9) Type of effluent pipe is to be noted. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. ! 7► iM Very truly yours, Gnu ✓� ���?i� Robert Morris, P.E. Senior Public Health Engineer BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N: Associate Public Health Director Director of Patient Services Environmental Health, (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278.- 6558 • WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Harry Nichols, P.E. Paterson Park Suite 106 2050 Route 22 Brewster NY 10509 RE: LoPane Butternut Lane, Lot #3 (T) Patterson, TM# 23.06 -1 -9.27 Reservoir Basin Dear Mr. Nichols: January 25, 2001 The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on January 16, 2001 is complete. The Department will notify you by February 6, 2001 of its determination. ® The Project has been delegated to the Putnam County Health Department for review pursuant to the guidelines set forth in the Watershed Agreement. F-1 Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the office with which you filed the application originally, and a statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Dept. of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of the notice, your application will be deemed complete, subject to standard terms and conditions as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Department of Environmental Protection review and approval of other aspects of a project, such as stormwater plans Letter to: Harry Nichols, P.E. - January 25, 2001 -2- or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2166. Ve ruly yours, Robert Morris, PE RM:tn Senior Public Health Engineer PUTNAM COUNTY DEPARTMENT OF HEALTH DMSION OF ENVIRONMENTAL HEALTH INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE TREATMENT SYSTEMS REVIEW SHEET FOR CONSTRUCTION PERMIT NAME OF OWNER: STREET LOCATION: REVIEWED BY: RM, GR, AS, SRDATE: TAX MAP .': (CONFIRMED) DOCUMENTS -.RMIT APPLICATION ELL PERMIT OR PWS LETTER LETTER OF AUTHORIZATION DESIGN DATA SHEET (DDS) CORPORATE RESOLUTION THREE SETS PLANS - TWO SETS m (___))VARIANCE REQUEST SUBDMSION (_)C__)LEGAL SUBDMSION (_)USUBDIVISION APPROVAL CHECKED (__)(__)PERC RATE U(_)FILL REQUIRED DEPTH UUCURTAIN DRAIN REQUIRED GENERAL Zr--)LOCATED IN NYC WATERSHED 4r � LQ ( OaC__)PLANS SUBMITTED TO DEP _ (�JDELEGATED_TO.PCHD ( LJDEP APPROVAL,.IF REQ'D UDEEP TEST HOLES OBSERVED (__) PPRCS TO BE WITNESSED (__)EX- APPROVAL SSDS ADJ, LOTS UWETLANDS (TOWN/DEC PERMIT REQ'D ?) i (DATA ON DDS PLANS & PERMIT SAME U( __)PRE 1969 NEIGHBOR NOTIFICATION U(__)LETTER BI/ZBA (__)U100 YR. FLOOD ELEVATION W/I 200' C.�_)(_JSOIL TESTING LOTS >10 YEARS OLD REQUIRED DETAILS ON PLANS vUSEWAGE SYSTEM PLAN - (NORTH ARROW) UUSSDS HYDRAULIC PROFILE (__)(__)GRAVTTY FLOW (__)(_JCONSTRUCTION NOTES 1 -15 (_J(__)DESIGN DATA: PERC & DEEP RESULTS JU2' CONTOURS EXISTING _ & PROPOSED U(__)DRNEWAY & SLOPES,CUT (JU FOOTING /GUTTER/CURTAIN DRAINS (—) _)USDA SOIL TYPE BOUNDARIES . U(__)TITLE BLOCK; OWNERS NAME ADDRESS TM#, PE/RA; NAME, ADDRESS, PHONE# vUDATE OF DRAWING/REVISION UUDATUM REFERENCE (_JULOCATION OF WATERCOURSES, PONDS LAKES,WETLANDS WITHIN 200' OF P.L. ( _J(__)PROPOSED FINISH FLOOR AND BASEMENT ELEVATIONS (__)DWELLS & SSDS'S WMI 200' OF SSTS (_J(__)PROPERTY METES & BOUNDS UUEROSION CONTROL FOR HOUSE, WELL & SSTS, EROSION CONTROL NOTE COMMENTS: (12EVSHEET)09 /01 /00 Y N (REQUIRED DETAILS ON PLANS CONT'D) (__)L__)HOUSE SEWER -'' /�" FT. 4 "0'; TYPE PIPE CAST IRON (__)(___)NO BENDS; MAX BENDS 45° W /CLEANOUT RENEWALS U(__)SITE NOTE (NO CHANGE) FILL SYSTEMS (_)(_)10' HORIZONTAL; PAST TRENCH SLOPES 3:1 TO GRADE ((-__)FILL SPECS/ FILL NOTES 1 -5 (__ )UFILL PROFILE & DIMENSIONS (_)(__)FILL IN EXPANSION AREA FILL GREATER THAN2 FEET (__)(__) CLAY BARRIER UUFILL CERTIFICATION NOTE U(_)DEPTH GAUGES (___)UVOL. ON PLAN FOR R.O.B., UNCLASSIFIED & IMPERVIOUS (__)USEPARATION DISTANCE FROM TOE OF SLOPE TRENCH (UULF TRENCH PROVIDED LOFT MAX. UUPARALLEL TO CONTOURS U(-_-)100% EXPANSION PROVIDED -( )(�_JDETAIL/DUST -FREE CRUSHED STONE OR WASHED GRAVEL (UUGEOTEXTILE COVER SEPARATION DISTANCES ON PLAN - FROM SSTS U(_J10' TO P.L. DRIVEWAY, LARGE TREES, TOP OF FILL (___)U20' TO FOUNDATION WALLS (_Lj(_j100' TO WELL; 200' IN DLOD,150' TO PITS (_) (_,100' TO STREAM, WATERCOURSE, LAKE (inc. espan) U(_)50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER (__J(_)10' TO WATER LINE (pits - 20') (- __)U50' INTERMITTENT DRAINAGE COURSE (_)(_)200'/500' RESERVOIR, ETC. _ 150' GALLEY SYSTEMS (x(__)10' MIN TO LEDGE OUTCROP SEPTIC TANK . UU10' FROM FOUNDATION; 50' TO WELL WELL - (__)(__)DIMENSIONS TO PROPERTY LINES _.._((LOCATION OF SERVICE CONNECTION =JMIN 15' TO.PROPERTY LINE—— SLOPE (_)(_,SLOPE IN SSTS AREA (520 %) (._JUREGRADED TO 15 %, IF REQUIRED DOSE/PUMP SYSTEMS (_J(__)PUMP NOTES (_-)UDOSE 75% OF PIPE VOLUME/DOSE VOLUME NOTED (_J(_JDETAIL FOR FORCE MAIN, (PIPE TYPE, ETC.) ((__)PIT AND D -BOX SHOWN & DETAILED U(�1 DAY STORAGE ABOVE ALARM CURTAIN DRAIN U(__)STANDPIPES, 5' BOTH SIDES, DETAIL (__)U15' MIN to CDS = >5 %, 20' -4 %, 25' -3 %, 35' -1 %,100 % -<1% (_)(___)20' MIN to CD DISCHARGE /100' with 182 cons day discharge (__)(__)10' MIN to NON - PERFORATED PIPE Harry W. Nichols Jr., P.E. Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 ZZ Telephone (845) 2794003 Fax (845) 2794567 April 25, 2001 Department of Health One Geneva Road Brewster, New York 10509 Att: Robert Morris, P.E. Re: Proposed SSTS: LoPane L� Butternut Lane, Lot #3 Patterson, New York Dear Robert: In response to your letter dated January 25, 2001, we offer the following: 1. Soil testing was performed on March 30, 2000 and July 20, 2000 with Gene Reed of Putnam County Health Department. 2. Revised House Plans are now enclosed. 3. Water at 4' - 0' is the correct level. The Plan has been revised. 4. Curtain drain has been lengthened to provide adequate protection for the system. 5. Filed Map Number and Date of Approval has been added to the Letter of Authorization (FM 1980 June 19, 1984). 6. Refer to 3/21/01 letter from Richard Williams, Town Planner. 7. Refer to 3/12/01 letter from Richard Williams, Town Planner. 8. Refer to 3/21/01 letter from Richard Williams, Town Planner and 2/8/00 letter from Assessors Office. 9. Type of effluent pipe has been added to the Plan. Kindly continue with your review and issuance of the Construction Permit. Very truly yours, Harry W. Nicl}ols Jr., P.E. HWN.jm a/ FEB -08 -00 12:17 FM PATTER,��,,- TI]WN HALL CHRISTOPHER BORM IAO Assessor Telephone (914) 878.9300 Far (914) 8786343 914 .786343 TOWN OF PAMRSON, NEW YORK P. 81 quo 27 PATTERSON TOWN HALT, 2 Route 164 Patterson, N.Y. 12563 TO: Harry Nichols FAX 278 -2658 FROM: Donna DiPippo Patterson Assessor's Office RE: Nina Lopane DATE: _ February 8, 2000 Please be advised that per owner's request, Tax map numbers 23,6 -1 -26 & 27 have been combined into TM #23,6 -1 -27, If you have any additional questions, feel free to contact us, Thank you. LAURENT ENGINEERING ASSOCIATES, P.C. MIL E OFFICE CENTRE Route 2 Route 22 6 Milltown Road Brewster, New York 10509 (914)278 -6108 - (FAj 27.8-2658. HARRY W. NICHOLS JR., P.E. \ CONSULTING SITE ENGINEERS August 24, 1998 r Bruce R. Foley, Director 1 `� Putnam County Health Department 4 Geneva Road Brewster, New York 10509 RE: Carmine LoPaine Towners Stagecoach Post and Stables Route 311, Patterson New York Dear Bruce, We are requesting permission to perform percolation tests on lot #3 of the above referenced subdivision. The owner of the property, Mr. LoPaine, is in a serious situation where the bank who holds the mortgage on the property is proposing to foreclose. Lot #3 consists of a house that was built fourteen years ago but never occupied since the central sewage system was not built and cannot be built under todays regulations. We have already performed deep test holes which were witnessed by your department and we are respectfully requesting your permission to proceed with the required percolation tests. Since time is of the essence, kindly respond as soon as possible. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. Nichols, Jr., P.E. HWN:his 98027 cc: Mr. & Mrs. C. LoPaine s Harry W. Nichols Jr., P.E. January 11, 2001 Mr. Robert Morris, P.E. Putnam County Health Department One Geneva Road Brewster, New York 10509 Re: Individual SSDS Carmine & Nina Lopaine Towners Stagecoach Post & Stables -Lot # 3 (T) Patterson Dear Robert: Patterson Park, Suite 106 2050 Route 22 Brewster, NY 10509 Telephone (845) 279 -4003 Fax (845)279 -4567 Enclosed are the following: 1. Five (5) prints of SS -3 "Proposed SSDS," dated 1 /11 /01. 2. "Short EAF," dated 1/11/01. 3. "Application for Approval of Plans for a Wastewater Disposal System" 4. "Construction Permit for Sewage Disposal System, dated 1 /11 /0l. 5. "Design Data Sheet." 6. "Letter of Authorization," dated 1 /11 /01. 7. Two (2) Copies of Residence Floor Plan(s) for Bedroom Count only." 8. Review Fee in the amount of $300.00. We would appreciate your review, approval and issuance of the Construction Permit at your earliest convenience. Very truly yours, Harry W. Nic is Jr., P.E. HWN:JM:jm 00- 058.00 14.164 (9/95) —Text 12 PROJECT I.D. NUMBER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEAR 1. APPLICANT /SPONSOR GAP —M4 NI: •i- PI NA L-0 2. PROJECT NAME 3. PROJECT LOCATION: )" t Municipality County 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) TTrP-HV T L_ftH� 5. IS PPOSEI) ACTION: ALVOW ❑ ❑ Expansion Modlflcatlon/alteratlon 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: (� Initially , Jam-' acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR -OTHER EXISTING LAND USE RESTRICTIONS? 2�fts ❑ No If No, describe brleHy 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? _ &esldentlal ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open apace O Other Describe: 5 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? ❑ Yes ® No If yes, list agency(s) and permlt/approvals 11. GOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes ®No If yes, list agency name and permitiapproval 12. AS A RESULT PROPOSED ACTION WILL EXISTING'PERMIT /APPROVAL REQUIRE MODIFICATION?, ❑ Yes NO ENO I[`J. I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE 1 F}� LA, )4tC,140ti• djz-- t i Il %�6 AppllcanVsponsor nam � Date: ' 1144L ZI SI to e. na r • "� � M If the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617,47 If yes, coordinate the review process and use the FULL EAF. Cl Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a. negative declaration may be superseded by another Involved agency. ❑ Yes ❑ No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing trafllc� patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly; C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or• threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change In use or intensity of use of land or other natural resources? Explain, briefly. C5. Growth, subsequent development, or related activities likely to be Induced by the proposed action? Explain briefly. C6. Long term, short term, cumulative, or other effects not Identified in C1•C5? Explain briefly. C7. Other Impacts (including changes In use of either quantity or type of energy)? Explain briefly. D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? ❑ Yes ❑ No E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATEb TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS ?' ❑ Yes ❑ No If Yes, explain briefly PART III — DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether It Is substantial, large, Important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or,.rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed. If question D of Part II was checked yes, the determination and significance must evaluate the potential Impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have. Identified one or more potentially large or significant adverse Impacts which MAY occur. Then proceed directly•to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: ; Name of Lead Agency Print or Type Name of Responsible Officer in ea Agency Title of esponsi a Officer Signature of Responsible Officer in Lead Agency Signature of reparer different from responsible officer) Date 2 PUTNAM COUNTY DEPARTMENT OF HEALTH 'DTVISION,.,OF.E.NYIRO IMENTAL HEALTH.SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM 4N; N I N� . P 1. Name and address of apprcant .6W,5f5JL 141 2. Name of project: i '' •4140 a' Dom , '3. Location TN: 4. Design Professional: W` �' ��' 5. Address: U6 6. Drainage Basin: 7. TYPe.of Proiect;.. PrivateAesidential Food Service Commercial Apartments Mobile Home Park Office Building Realty Subdivision Other (specify) 8. Is this project subject to State�Environmental Quality Review (SEQR)? ' Type Status check one .................... . )... .............:.....:.:....... Type. I xempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... No 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 11: Name of Lead Agency N 12. Is this project in an area under rthe control of local planning, zoning, or other ....... ... : officials; ordinances? ........ :. ................::............. .. 5 .............................. 13.. If so, have plans been submitted to such authorities? ......................................... N� 14. Has preliminary "alp oval been granted by such,.authorities? N d Date granted: 14 P, 15. Type of Sewage Treatment System Discharge .....:........... surface water X groundwater 16. If surface ,water discharge, what is.the'stream class designation? .............. ::.... NA 17. Waters index number (surface) : ..................... • :....::::...:..... . ............................... 18. Is project located near a public water supply system? ....... ............................... N o 19. If yes, name of water supply N Distance to water supply 20. Is project site near a public sewage. collection or treatment system?-............... ` No 21. Name of sewage system A Distance to sewage system NN 22. Date•test holes'observed 23. Name of Health Inspector G.1 =N'E QED 24. Protect design flow'&llons per'day) ......:................ .......... ............................... 25. Is State Pollutant Discharge Elimination,. System (SPDES) Permit required.... �D 26. Has SPDES'Applicationbeen submitted to local DEC office? .......................... N Form PC -97 27. Is any portion of this project located within a designated Town or State wetland? HO 28. Wetlands ID Number ........................................................... ....:..........::.............. N 29. Is Wetlands Permit required? .............................................. ..........:.................... N D Has application been made to Town or Local DEC office? ............................... N 30. Does project require a DEC Stream Disturbance Permit? .. ............................. ... j4D 31. Is or was. project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? .:.................. :........ Yes/No 32. Is project located; within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes/No N� DESCRIBE: 33. Is there a local master plan on file with the Town or Village? .......................... 34. ..Are community water and/or sewer facilities planned to be developed within Ye�) 2" 15 years in or adjacent to pr?)ect site? ................................ ............................... 35. Are any sewage treatment areas in excess of 15% slope? . ............................... N 36. Tax* Map ID Number .......................... ............................... Map 27 ,Ob Block I Lot 9 27 37. Approved plans are to be returned to ..... Applicant 5C Design Professional NOTE:.All applications for review and approval of a new SSTS to be located within the NYC Watershed shall be sent to thebepartment, and need not be sent in duplicate to the DEP, although-the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater plans or the creation of impervious surfaces, and"the project applicant should obtain the appropriate *forms for such activities -from DEP and submit those forms to DEP for review and ,approval. If the application is signed by a person other than the applicant shown in Item l .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to. comply with this provision may be grounds for the rejection of any submission. t I hereby affirm, under penalty of perjury, that information provided on this form is tr e to' the best of my knowledge and belief. False statements made herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Pena! SIGNATURES & OFFICIAL TITLES. - Mailing Address: ................................... 20 sQ V- 2� PUTNAM- COUNTY DEPARTMENT Of HEALTH .DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM owner c_Ap JHE I- HIMA L10?'f<HF_ Address-P 'I-L, ?ft__rC-P-6ot4 � 12'50 Located at (Street,) _MT-044 V! Tax Map 9 D6 Block Lot 1 (7-1 (indicate nearest cross street)' Municipality. Watershed SOIL PERCOLATION TEST'DATA Date of Pre-soaking Date of Percolation -Test + 0 ...... . .. " tb.t.....: U. D e e T OMI. rob 1^7 W.". .. 1_0 E4W It 4 !.1 ti I'fq 2-1 f I 5 2 3 101 4 ...... 5 2 3 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31 -60 m Winch) All data to be submitted for review. 2. Depth measurements to be made from top of hole.. Form DD-97 DEPTH G.L. 0.s' 1.0'- 1.5' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5• 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' 9.5' 10.0' . TEST PIT .DATA -2 DESCRIPTION OF"I SOILS- ENCOUNTERED WTEST HOLES HOLE NO. HOLE NO. Z HOLE NO. 01 HE Indicate' level -at which groundwater is encountered` Indicate level at which mottling is observed 41_ °� Indicate level to which water level rises after being encountered 4'- 0 Deep hole observations made by: Date Design Professional Name: MLk NJ HkGkL� , J�, f r, Address: 'r Signature:' f Design Professional's Seal �Y \ t No. 56124 R70 ESS\� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES _UALTY SUBDIVISION SITE INSPECTION FORM SECTION A. GEN rF��MA TION.Name of Subdivision i�(V) County �nn� Site Location 2o,-;� rc lit z 164 Xco:.-c-sAo tt- � Distance to: Public water supply Public sewer system ocs Building construction begun Extent�,�� Is property within NYC Watershed ? ................. EZIes 0 No SECTION B. TOPOGRAPHY (Please check all appropriate boxes) . 1. F7 Hilly © R olling Steep slope Gentle slope Flat 2. F-� Evidence of swampland F--] Low area subject to flooding Bodies of water Drainage ditches Rock outcrops 3. Do water courses exist on or adjoin the property? ............................ Ye a No 4. Will these affect the design of the sewage treatment facilities ?.......... Yes No 5. Do watershed regulations apply in this devefopment ? .............:......... 'es a No 6. Will extensive grading be necessary? ................. ............................... Yes No 7. Will extensive fill be necessary? .............•.......... ............................... Yes No. 8. Do filled areas exist in the tract? ....................... ............................... a Yes No If yes, what is the condition of the fill? SECTION C. SOIL OBSER TIONS 9. Appearance of soil: Sand Gravel Loam Silt Clay Hardpan Mixture 10. Observed from: Borings Bank cut Backhoe excavations 11. Soil borings /excavations observed by AJ�A szw , ti� on i Q 12. Depth to groundwater woo ►.c on 1 13. Depth to mottling o�A on 14. Soil percolation tests made by on 15. Soil percolation tests witnessed by on SECTION D. DRAINAGE 16. Will proposed grading materially alter the natural drainage in this or adjacent areas? D Yes E0 o 17. Will groundwater or surface drainage require special consideration ? ....................... 0 Yes to 18. Will gullies, ditches, etc., be filled. and watercourses be relocated ? ......................... ED Yes FE< Form RS -1 SECTION E. REMARKS 19. If a common water supply is proposed, has an inspection been made of the existing or proposed source and facilities? ::.......... ............................... Yes [::] No Inspection data ..: 20. Have previous sections of this proposed realty subdivision been approved. ? ......... es [�D No If yes, describe ?114 oeu 21. Will there be additional sections of this subdivision? ............................................. F7 Yes E�140 22. Is it probable that the total number of lots will exceed 49? ... ............................... Yes No 23. Additional comments 24. Site observer /inspector and title 25. Date(s) of observation(s) /inspection(s) TEST PIT PROFILES Hole # _� Lot # NIV Depth to waterft� Depth to mottling Ionef, r Depth to rocklimp. 7 G.L. OAF Hole # Lot 9 Hole 9 Lot Depth to water Depth to water Depth to mottling Depth to mottling Depth to rock/imp. G.L. 0.5 pet, (I r/ T S 0.5 1.0 2.0 3.0 4.0 1.0 2.0 �- Z �- O tl 3.0 �T i�ir►a S� 4.0 �. 5.0 6.0 5.0 6.0 Depth to rock/imp. G.L. 0.5 1.0 2.0 3.0 4.0 5.0 6.0 7.0Q SS L.ot 7.0 7.0 8.0 (�� Z�-7 8.0 8.0 9.0 itf C7L, 9.0 10.0 10.( 9.0 10.0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of C- �'WNI� 4 NINA L0 PA< l� - Located at P-oJT� T/V PP TTr iP- lH Tax Map # 4 (o Block i Lot 1 �1 Subdivision of T° W N S ;r^65 O P-� PQ 6-r + 151 —A&E� Subdivision Cot # - ' 1� Filed Map # Date Filed Gentlemen: This letter is to authorize R#`HL� \rj' l G E �' A— Q l> a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Directbr of the Putnam County Health Department, and to sign all necessary papers'on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County a itary Code. Countersigned: P.E., R. A., # Mailing Address 4_5w5 State N Zip t 0 i "_01 Telephone: (� *� �1 � - -4 00'7 . Very truly yours, Signed (0 ner of Property) Mailing Address: F�=F �L Pprrr o H State H Zip 1310!163 Telephone: (945) 81 b ^ q� �� Form LA -97 y -./ \y�°vyrF 1 rl Lar 63 7i \ 1 Kx1 cz) .1L9• -5o -� E � KI /F APTIST . C:Wo-f -H li -Zy-E f t, 1f / 0 14 Q 3Z'- .9.. Z1" E' f ?0 N) I t ! 0r Q: Qa 3S ep(J , N--CrrF-s. �, -91 -0 -F I a4 � 9 39;�oV zc-'A S. S� ►I �t -iWAVS F+:¢iGS \ N.1:,LJ'T� .L.L1['> 2ESECVaiT'1Cw,14 6rJOltJ� -1 G�.1 A2� HEPlc$I - 'trF'F��n F'C¢ ATOV -Ip THE -IOkJ►J CJr FMCTi'EV_4>Ot.,l. �*P: tsh1011lLJ IIExf.•• = AeE .t�6JEL.T ,AVce:^.l,I r--kj s Com Z1LE 55 N33 - I,,�$= 4• E. LI�.O. ' :5E cF `r .•r,.:s-r2LXT1or -t .awn � � . V2.�au.JCa LJ1.Jr L- 6L.-" -nME Al, 7-IE > t4llE � ALGE.P'+icL� P.Sf -tl�E ZOkJIl oC' pF'"{1.iE_ l_AI -lC7 tb �,,./3JECl' �0 12EST'Q.iGT1dJS ...E. I.T -rylE C.CLaJTY GI.LiLIG'S �-�1LE t -:►.lam iGTid -1 OF' L.P. 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