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HomeMy WebLinkAbout0727DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.13 -1 -14 MALI I Vill 16 -j 00727 z C898 YORKTOWN MED :ICAL LABORATORY INC y r' ,4 J •� .N' 4 t S Z 3t P.O. B.ox 99 321 Kear�SWW �o CATIONS 'Y.,1059 ❑ 321:KEAR ST YORKTOWN iHEIGHTS N Y 10598 245 3203 Yorkfown Heights, N ❑ 201`BUTTQNW&D`AVE PEEKSKILL N Y:;10566"737 -8777 495.MAIN ST MT. N Y ,410549 666 -3335 245- 3203 ` ,KISCO 'Y V E�RH P L` N 0 STQNELEIGH IT`AL) CARME 1 512 278. 9330 L RESULTS OF >EXAMINATION OF WATER 10/6/80 OWNER TW 4 DATE RECEIVED'` f Har,64 Barrett `10 /6f 80 d" . W P4TNAM COUNTY DEPARTt-UNT OF-J19j1f•1'" Division of Envir9nmental Hoaltil SefVIQQ3 COUNTY OFFICE VUILVINQ - CARMEL, NEVV y9fili 71113 rappri 1j* sq W pornplateO by w411 driller and submitteO to County health Department together with laboratory rerjort'of Qnqjpjeiqf wqtQr.qqFnpIq indicating wator.1.9 of satisfactory bacterial quality before certificate of construction complipri;q Iq jq§LiGj, REPORT NIUST BE SUEINUTTED WITHIN 30 DAYS OF VIVELL COMPLETION -71 M & H- Custom I m Homes ADDREU Deacon, Smith Hill Holmes*, 'NY LOCATIOtj '77 4 Ptfjot� MqN .'.._-Veadon. Smith Hill Patterson. 1158 op OUSINESS powg FFARM AIR OTHER §UFFLY INDUSTRIAL ❑ CONDITIONINQ DIMMING COMPRESSED CABLE OTHER AIR PERCUSSION PERCUS51014 RPTAQV ❑ Opocify) CASI'M) ;-gh'iPiq (top 2 JU 7 jWg12;i6tgj r"It ruvil TIJ89ADED WELPED, PRIVt :W(b LIJ YES 0 YIEW TE&7 0 HOURS G.PA' 1.0 El PU/..4PC-rA CbMPRESSED AJO 1.0 (a.p. f1i 0 1EV4 I491k'Ng.; VW4 4144 §LlRfAC9-5T 6TK($PqQf1y overflow, DURIN4 Y14LD TEST f/091) Depth of Complated Wall total drawdown In foot b qlaw land surfqcat 1,25 wo To' (PVI k 7(4011 ��Wl 414 PlAffiETER (109hfq) IF GRAVEL, PACKEDs pipmetor of well indvdinp 1 gravel pack ftnchaal zl< (in f (09 U rF?'TH FZ()• UMO SUAFACE FORMATION DESCRIPTION Sketch exact Inatlon of )Vq11 WIM tflattinces, 00 at 1704t Iwo p@tm4nqn( landmarks, FEET to Full 0. 5 overburden 0 G� 5' 125 ledge it yield woA jobtad at cliFeront deplho during drilling, list below FICT GALLONS PER MINUTE roc 7' X 61 of P1l4I3Qf!JWf9z Z1PRILLFFj (SlQn4t4ra .9/5/ 60 689/8/80. MEMORY TRANSMISSION REPORT TIME : OCT -02 -2015 02:22PM TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 824 DATE OCT -02 02:20PM TO `88782019 DOCUMENT PAGES J07. START TIME OCT =02 02:20PM END TIME OCT -02 02:22PM SENT PAGES 007 STATUS OK FILE NUMBER 824 * * * SUCCESSFUL TX NOT ICE SHFRLrrA AMI.ER. MD. MS. F.aAI° d Commissfon¢r Qr" —frh 4t L.OR7='rTA MOLiNARI. RN. MSN /- Rsaoaforo Comm /safonnr ofHeo4h DEPARTMENT OF H.A1--rH I Geneva Rpad. Brewster. New York: 10509 .. FAX COVER SfIEET ROBERT J_ SOhi "l Covn�y t= sacutivo ROIEtER'r MORRIS. IPE Olrecxor ofE�svlronmmnro! Hewlth Date- . ^�x� }: Vax #: S? % i� - o I °l (including cover sheet) From- Gene D_ Reed /Yutnalm County I;a.g.arttaent of Xlealtla ✓ For your Fri>rormatEon Ptca>,sC respond For your review Attached as requested As discussed Please call Notes /Messages � c /.s -F- i�a� L'��_�-�c-vc -i-ro� �����L. � �-l.✓-��i� -- 1 ���i'�o s. / C• 6� �I'�- G• -S S ko �J✓I a vL � �-"-�i�l /� © ✓8c� � `�` a.-. . -77� s�li�s� C �` �r � c /rmo�.�u1Gr_S ©t- i cb i vi on_ // �r3e._� i U �_ 7� -4 >ZOLs% Ga>M�G �d Y /`Q� O.— ���,/] � �-c %✓' � ®�s✓1 i10c7S �'',. In the event 4D1F transmission /reception diMmcultlos please contact this orrice at (848) 275-6130, ext. 2261 • ti.avi.roomoatsl Health C945)1278-6130 Fax (8453 278 -7421 Water Supply Section (845) 225 -5 186 Fax (845) 225 -5418 Nursing :.orvi¢¢s (845) 278 -6558 Pax (845) 278 -6026 W1C (845) 278 -6678 Nursing Horoe Care Pax (845) 278 -6083 "..!y Ineorvention/Presohoot (845) 278 -6014 Fax(845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Date: / ° /z— //' 1> DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 FAX COVER SHEET ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health To: _ l o ae�rs�., h Fax #: 171 — o (`l ui 1 d iin a l /ager4—&,� '!:5V1kZ1-0A1 No. Pages: 7 (including cover sheet) From: Gene D. Reed Putnam County Department of Health /For your information For your review As discussed Please respond Attached as requested . Please call Notes/Messages %'�, /�, F �.c��zs C' Qjd +f UC-76 aQ aJ-4, , Cs- 4-h y-e-f- 7� id ©!y7 � P TAI G 0.S S �OLc'✓j O ✓L � �t�/p j^ ©V.-. � � a 4--'j 7&V�- 6 ocS C-0NSTY'=he- f�lY-� f"Ct,�% 7�°�- �/✓Q °iyl5, .��.T /S !iOLc% GOl�l�i /G�L°i�e� QL ��'? t7�lJ�omr✓! •i? ©c�SC-'.. In the event of transmission /reception difficulties please contact this office at (845) 278 -6130, ext. 2261 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 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 105122 CONSTRUCTION' PERMIT FOR SEWAGE DISPOSAL SYSTEM Tip ?77_e;FF0A / Town or Village Located at. - Cam" / y� r Tax Map Block Subdivision ,{i�6L b �°�� ®�s! (J•� Lot Owner IV Isg `z z-7 1`c �j� Address Building Type 0� /� Lot Area A e Number of Bedrooms IF Design Flow 6.6>0 Separate Sewerage System to consist of ` ©p `G`al. Septic Tank To be constructed by `o Be � ,o7�A4iA .1,6D Water Supply: Public Supply From Job Total Habitable Space Square Feet and Address — Private Supply to be drilled by `® 13g- Addres�sl Other Requirements I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that. the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regula ions 07 the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage disposal system during tt riod of two (2) years immediately following- the date of the issu- ance of the approval of the Certificate of Construction Compliance of the origigaf s em or any Ijpairs thereto; 2) that the drilled well described above will be located as sholn on the approved plan and that said well will be installed i rdance it a Stan rds, rules and regulations of the Putnam County Department of H Ith. Date Signeds� P.E. R.A. Address y'���✓� �"' License No. APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unle construction of the building has been undertaken and is revocable for cause or may be amended or modified When considers scar by t omm' ner of Health. Any change or alts ion of construction requires a new permit. Approved -for disposal of domestic sani ary /oyl priv ( . r. Ire PUTNAM COUNTY DEPARTMENT OF HEALTH 'Division of Environmental Health Services. Carmel, N. Y. 10512 ;AL SYSTEM T'"� TTEKu o1 Town or Village Located at f - --err i-y�y Ni /117' / L7 /AL f-, i�.% /. Tax Map Block Owner 1461-1 1 oyi -no✓I I- lkloer-s _1iw• Tax Map Lot li �.3 subd. # Separate Sewerage System built by �% Address n Cohsisting of 0Q Gal. Septic Tank and " LC l6Z DJ- Other requirements .'J`Ol? Lr/QLLOA , �a��r✓1 water Supply: Public Supply From J X Private Supply Drilled By Address Building TypeAa/L /-� `/ No. of Bedrooms Date Permit Issued V Has Erosion Control Been Completed? FeS I certify that the systems) as listed. serving the above premises were constructed essentially as shown on. the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, cordance with the filed plan, and the permit issued by the Putnam County Department of Health. Date Certified by P.E. - R.A. Address �' ` � '4'J' (/ License No.O V30co 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 sewerage 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 Commissioner of Health, such Ion, modification or change is necessary. Date© �� �© By d w�'��' Title f) 11S ---- ------- ............ .... ..... .. . 17- SA;. 'c" -cl !31 A sb iI li A pe-w 7 i`�' Of NE;p Q 3 SS10%, - REVISIONS GEORGE A.:HAUGHNEY,:P. CONSULTING ENGINEER, Route 52 Carmel, New York 1051.2 ........... TITLE SCALE D ---El Ya --.QRAWiNG NO: ON — r) sb iI li A pe-w 7 i`�' Of NE;p Q 3 SS10%, - REVISIONS GEORGE A.:HAUGHNEY,:P. CONSULTING ENGINEER, Route 52 Carmel, New York 1051.2 TITLE SCALE D ---El Ya --.QRAWiNG NO: -.D L fi t -- _1..1_..l i Y- S t f Fh _!s :t a r . � ti r A ...g p -f x 1 -. % jL- .'7.� f 3 .i i. , �# .4 r . . a 1 - 's t °- t ,i? F f ? 1 r.. L -,. T -'rt tt 4 ti ji t r _ .�l r y -. -. e F1 �. i d r F 1. / i r - _r r l 't �� a + r ` •r 1 y j a- I L i,, ; 3 qq L fi t -- _1..1_..l i Y- S t f Fh _!s :t a r . � ti r d . ay ! r 1 "I { f _ 7 t { f 1 #'z r -t f s - f ` ji t r _ d r F F, ' i z < $ • F i i 3t 1 4 '- s t t ' - , r f { _. 'r ,,< ..._ .. .. ti ' � , . ; B 4 - . :. t. —'r. - �. iv. S F. l : ! - .Q � y. 1 Pa. '. +... ,. .f. ' �'. s - . �. - ,i J tS vy.. ., l t� ��'. } :.' yy li-i ✓ � i` A + ti �' : i 7 � n / a t { ^� t' r' i ^ y a :. 1; d . � - - G - s �.. /(�;. S s s �c 7 e -:T; t t j , . / } / — t f J Yt 'r k { F .l -! a _t i ] > "k! ly y { j, !tt l .? y F y 1 �< ! 1• F t / i i -} . j 1, <" �., r t., `. c ; % �h F rt t 41 t 1 ->r `F r , " r, C� f! K ✓ 4 T t1 4:..—I .1/ 11 _ 1 ," i. + r? x V t Iv = 1 �4 f Jj l ,se r s ! g 1 t i:�.K tf A. -.I h. / " 3 ,z i�py,� "', J Srh 1 A =T � � , 1 - L w,T'•; 1I 'W' -�AY.r s - � ;j t cF e � f x n ff ,1 _ ; 1 �E' z Ze r '>:` �.I 5. - `S h. , f e i . a .'z R. tp W. r X S '? A. j t f' fi ! t _ ATP!' d - c'' . r ^. a s ,+' 1, L s" & a`� 1 -•s''t `;'y�`` -S,c - +:C4, s+trr'- '.',.;ice •...a___;., . - J. r Name of Agency RE /MAX Realty Center Address 25 Deacon Smith Hill Road Patterson, New York 12563 United States Map It I HERE BY APPLY TO INSPECT/THE FOLLOWING RECORD . I would like to know if this septic is for a two bedroom house. It appears the owner bought it as a 3 bedroom house and it is on the market presently listed as a 2 bedroom. There are 2 bedrooms upstairs and a one bedroom downstairs. Thank you I request that the aforementioned records be provided, if possible, in electronic format • Yes Applicant's Name Jennifer Goodnow Applicant's Address 1820 New Hackensack Road Poughkeepsie, New York 12601 United States Map It Applicant's Phone Number (914) 406 -0966 Applicant's E -mail Address igoodnowrealtorta'.optonlinem t FOR AGENCY USE LY ' FOR OFFICIAL USE ONLY APPROVED: DENIED: Record of w Qh his Agency is a Legal Custodian cannot be found Date: September 30, 2015 Record is n X nta ined by i Agency By; % Wfv Aikhad e. J3a4a&W 1 f/ Michael C. Bartolotti Title Date: Public Information Officer NOTICE: YOU HAVE A RIGHT TO APPEAL A DENIAL OF THIS APPLICATION TO THE PUTNAM COUNTY EXECUTIVE flame Business Address WHO MUST FULLY EXPLAIN HIS REASONS FOR SUCH DENIAL IN WRITING SEVEN DAYS OF RECEIPT OF AN APPEAL. I HEREBY APPEAL: Signature Date Donna Cammarota From: Lorrie Pelliccio < lorrie .pelliccio @putnamclerkny.com> Sent: Wednesday, September 30, 2015 11:20 AM To: Linda Martin; Donna Cammarota Cc: jgoodnowreaitor @optonline.net Subject: 9.30.15 FOIL REQUESTER JENNIFER GOODNOW RE 25 DEACON SMITH HILL ROAD, PATTERSON, NY Attachments: 9.30.15 FOIL REQUESTER JENNIFER GOODNOW RE 25 DEACON SMITH HILL ROAD, PATTERSON; NY.docx Dear Linda & Donna: Attached please find a FOIL request (signed by MCB) from Jennifer Goodnow of RE /MAX Realty Center, 1820 New.Hackensack Road, Poughkeepsie, New York 12601, 91- 406 -0966, jgoodnowrealtor («@ optonline.net, requesting information pertaining to 25 Deacon Smith Hill Road, Patterson, New York 12563. This FOIL request was received at the Putnam County Clerk's Office today and is being forwarded to Putnam County Health Department for review and further processing. Once processed, please advise whether this FOIL request has been approved or denied. Thank you for your attention to this matter. Lorrie A. Pelliccio Confidential Secretary to Putnam County Clerk & FOIL Officer Michael C. Bartolotti 40 Gleneida Avenue Carmel, New York 10512 845- 808 -1142 Ext. 49301 lorrie .pelliccio @putnamclerknv.com PU`i'NAM COUNTY DEPARTMENT OF BrIALTH DIVISION. OF ENVIRONMENTAL HMLTTT SERVICES COUNTY OFFICE, PUTLDI.NG, CARMI?L,. N. Y. 10512 DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner Address Located at (Street Sec. Block Lot *11ate n arcs cross s ree Municipality,) l wx) Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS 5 Notes: 1) "Tests to be 'repeated at -same depth•-*.until ar. prox watelyy equal soil rates are obtained at each percolation test hole. All da�a eo be submitted for review. A 2) Depth moasurements to be made from top of hole. Hole Number. CLOCK TIME PERCOLATION PERCOLATION' Run No.' Start -Stop apse Time Min. Depth. to is From Ground Start ,Stop Inches ter Surface Inches Water ve in Inches Drop in Inches Soil Rate Min. /in drop 2 6�� e:174P 9'a1- 9 •off � ��' �� /" � 2 ZAf 4 -. 5 1 2 5 Notes: 1) "Tests to be 'repeated at -same depth•-*.until ar. prox watelyy equal soil rates are obtained at each percolation test hole. All da�a eo be submitted for review. A 2) Depth moasurements to be made from top of hole. TEST PIT DATA REQUIRED TO ICE SURPr17:T`l'.lM WIT1I APPLICATION DESCRIPTION OF SO]'L:I IN TEST HOTS DEPTH HOLE. N0. HOLE NO. HOLE NO. G.L. SPACE FOR USE BY IIEALTH DEPARDIENT ONLY; Soil RatIe:'Approved Sq. Ft /Cal. Checked 18 2411 4 3011 ,•„ ' . 36" 4 4211 48 11 C'' 11 . T;. ;f 72" 7 8411 . - INDICATE LEVEL AT MMCH GROUND WATER IS ENCOUNTERED INDICATE "LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED ? TESTS MADE BY '. DESIGN Soil Fate UsediO-t�r Min/1"Drop; _. S.D. Usable Area ProvidedcS���'' No.. of Bedrooms Septic Tank Capacity 1O6Y Gals. Type ice% Absorption Area I'rov ded By O L. F. x24 width trenc Other q- Name Signature Address' THUR,y� SEAL d r Q r THIS SPACE FOR USE BY IIEALTH DEPARDIENT ONLY; Soil RatIe:'Approved Sq. Ft /Cal. Checked