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DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
Frank Plunkett
Rt. 164
Patterson, NY 12563
BRUCE R. FOLEY
Acting Public Health Director
April 24, 1997
Re: Addition - Sacramone
Route 164
'To increase in number of bedrooms
Patterson TM #24 -1 -42
Dear Mr Plunkett:
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 latest revision date of
April 23, 1997 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
1. The total number of bedrooms must remain at three 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.
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.
Aquip
c :c : BI (T) Patterson
Very truly yours,
William Hedges
Sr. Public Health Sanitarian
%
BRUCE R. FOLEY, R.S
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
PROPOSED ADDITION APPLICATION _ (RESIDENTIAL ONLY
STREET: R 7 I6
TOWN (P 7`79RSo� TX MAP #
NAME: /--R 4IVA 6) /V(t I':- T'T PHONE 77-F '974, Jf PCHD PERMIT # '+G 7
MAILING ADDRESS RI-t: 164 13QX ?.3Z , ekTT ,6 RSC>1V 12_ G63
Description of Addition /1lGLOv,� Sum L%Ech
Number of existing bedrooms .3 Proposed number of bedrooms (�
from Certificate 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 HEALTH DEPARTMENT,
4 GENEVA ROAD, BREW.STER, NY 10509, Phone 278 -6130 with the following information.
..r1. Certified Check for $100.00.
2. Sketch of existing floor plan (all living area including basement, if any)
Non - professional drawing is acce table.
3. Sketch of proposed floor plan . •2 r5 '715)
Non professional drawing is acceptable.
4. Copy of survey showing well and septic location, to the best of your
knowledge. Include date of installation if known.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. Copy of Certificate of Occupancy from Town or Certification from Building
Department of legal bedroom count of dwelling. ta
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
■
1
CERTIFICATE OF OCCUPANCY AND COMPLIANCE
Eaftm jaf 'pat#exson, o
N_ 806
1988
DATE ISSUED October 4,
THIS IS TO CERTIFY THAT Frank &Katherine Plunkett
ON THE PROPERTY OF Same
LOCATED ON Rt . 164
HAS BEEN SUBSTANTIALLY CONSTRUCTED TO THE REQUIREMENTS OF
THE BUILDING CODE, ZONING ORDINANCE AND LOCAL LAWS OF THE TOWN
OF PATTERSON, NEW YORK AND MAY BE OCCUPIED AND USED AS
One Family Accessary Structure
Building Permit Dated ..? : ? -88.. Permit No. ..1145... Application No. ....0001 ...........
SECTION .......15 ............. BLOCK ........1............. LOT ........ 13 ... .....
FEE . $ 15.00
BUILDING INSPECTOR
CERTIFICATE OF OCCUPANCY AND COMPLIANCE
Tafim of 'afterson, Ndu-IJorh No
19 88
DATE ISSUED October 4,
IS TO CERTIFY THAT Frank &Katherine Plunkett
ON THE PROPERTY OF Same
ON Rt . 164
HAS BEEN SUBSTANTIALLY CONSTRUCTED TO THE REQUIREMENTS OF
THE BUILDING CODE, ZONING ORDINANCE AND LOCAL LAWS OF THE TOWN
OF PATTERSON, NEW YORK AND MAY BE OCCUPIED AND USED AS
One Family Accessary Structure
Building Permit Dated
Permit No. ..1145... ,application No. ....000i...........
SECTION .......15 ............. BLOCK ........1............. LOT ........
1. ... .....
FEE . $ 15. oo c
BUILDING INSPECTOR
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
BRUCE R. FOLEY. R.S.
Acting Public Health Director
Re:
Residence
Tax Map c2 y" --/_ z�
To��n
Gentlemen:
According to records maintained by the ToNvn, the above noted dwelling
IS /v
IS NOT
in compliance with Town code and the total number of bedrooms on record
is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
�4
n.. st
u:-(s
PLC MAN ' COUNTY'DEPA_RTM ENT OF HEALTH
DIVISION OF E RONNIENTAL HEALTH SERVICES
DESIGN DATA SHEET- SUBSURFACE"SEWAGE TREATMENT SYSTEM .�
Owner - GAL yAI k' ,�5 TT Address / 6
Located at (Street) Tax Map Block �_ Lot W, a
(indicate nearest cross street)
Municipality ,. �.�r?'�iTZ�oc] Drainage Basin
SOIL PERCOLATION TEST DATA
Date:of Pre-soaking F3 �. ®s . Date. of Percolation. Test 8 13 o 0
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are odtainea at each
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, <_ 2 min for 31 -60 min/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
Dep the to Water ..
)From Ground
Water
Level
Percolation
Hole No.
Run No.
Time.::
Start - Stop ,
Ela se.Time .
(Min.)
Surface (Inches) '.
Start Stop
Drop In,
,.'Inches
Rate
Min/Inch
j
1
w;�o- Il'7,0
3i,
13 %y -as112-
WK
17.1
2
HVM. -/4-k
5
.k
s1- l(. 0
1q
,Zg 'z
4
�Lr' 37
30
�Ls-
10
5
J/1 11111
3-
�,$
3
! 0
l .
10
Z7
2
it; 03 1 l ►1
2-7
3
•
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are odtainea at each
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, <_ 2 min for 31 -60 min/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
DEPTH
G.L.
0.5''
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.5'
5.0'
5.5'
6.0'
6.5'
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
TEST PIT IDATA► .
DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES
HOLE NO. HOLE ISO. HOLE N0.
`.% Fc
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed A] 'hi g
Indicate level to which water level rises after, being encountered
Deep hole observations made by: 6, � r , _ ' `?_ c.;-c> , (4 Date 7
Design Professional Name:
Address:
Signature:
I xg'"
3o4l
PUTNAM. COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
7
DESIGN DATA SHEET- SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner P
Address
Located at (Street) Tax Map Block Lot
(indicate nearest cross street)
Municipality Watershed
SOIL PERCOLATION TEST DATA
Date of Pre-soaking Za tr Date of Percolation Test a /W Lo !—i
................. ... ..
.....
'N
.. . ......
..........
t
. ... ......... ...
.. ........ .
j. Dsg� Am
.....
......
t
... .. ...... Qp
........
n
64":
8;57 -q;
30
/0
2
9,,3 1 - laro �
30
X3. Y1
17A
3
10;01., /0; M
30
1 3
1 Yoe
1-7,
4
5
/0
-tV 9-7
3
-33
2
24 ;L'7
3
f,7
3
%X7— 9,IV4
/7
;Lf — 27.
3
4
9"415-- 16F".01
/7
7
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. :5 1 min for 1-30 min/inch, :5 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'
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'
10.0'
TEST PIT DATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO. 'I- HOLE N0. I A
-- /
HOLE NO.
Indicate level at which groundwater is encountered lJo AJ
Indicate level at which mottling is observed A1o,,jF—�
Indicate level to which water level rises after being encountered
Deep hole observations made by: �, 1 C� EIA ? G,�, E-(. Date
Design Professional Name: --
Address:
Signature:
Design Professional's Seal
0
PUTNAM COUNT'S DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
K
REALTY SUBDIVISION SITE INSPECTION FORM
SECTION A. GENERAL INFORMATION
Name of Subdivision /_UNkE ( ((Tj�V) �,C/County (J- ✓i7
Site Location �7 �, VW 2 It r / — S/,2 , 2
Distance to: Public water supply ? Public sewer system A .) o
Building construction begun Ye 5 Extent ap►1 10i r
Is property within NYC Watershed?.. '{::. N, Yes ❑ No
SECTION;B. TOPOGRAPHY (Please check all appropriate boxes)
1. Hilly I❑ Rolling 0 Steep slope ❑ Gentle slope ❑ Flat
2. ❑❑ Evidence of swampland Low area subject to flooding ❑ Bodies of water
❑ Drainage ditches Rock outcrops
3. Do water courses-exist on or ro
e adjoin the .............. ❑❑ Yes No N0 "� koir
J P P rty ...............
4. Will these affect the design of the sewage treatment facilities ?.......... ❑ Yes dNo
5. Do watershed regulations apply in this development ? ....................... FZYes ❑ No
6. Will extensive grading be necess Yes No_,
7. Will extensive fill be necessary? ........................ ............................... ❑ Yes ❑ No
8.- Do filled areas exist in the tract?............ ......... ............................... ❑❑ Yes ❑ No -
If yes, what is the condition of the fill?
SECTION C. SOIL OBSERVATIONS
9. Appearance of soil: Sand ❑Gravel Loam ❑Silt Clay ❑Hardpan ❑Mixture
10. Observed from: ❑ Borings ❑ Bank cut �ackhoe excavations
11. Soil borings /excavations observed by on ZZ=
12. Depth to groundwater Aioiag
13. Depth to mottling_ --
14. Soil percolation tests made by R'V.
15. Soil percolation tests witnessed by 6, .
SECTION D. DRAINAGE
16. Will proposed grading materially alter the natural drainage in this or adjacent areas? ❑ Yes �No
17. Will groundwater or surface drainage require special consideration ? ....................... ❑ Yes ❑, No
on
on J
on o �
on �7
18. Will gullies, ditches, etc., be filled and watercourses be relocated ? ......................... ❑ Yes ❑ fNo
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 ZN o
Inspection data
20. Have previous sections of this proposed realty subdivision been approved? ............ 0 Yes ffNo
If yes, describe
21. Will there be additional sections of this subdivision? .............................. ...........2.❑ Yes F7 No
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 #.
Hole # Lot #
Depth to water
Depth to water
Depth to mottling
Depth to mottling
Depth to rock/imp.
Depth to rock/imp.
G.L.
G.L.
0.5
0.5
1.0
1.0
2.0
2.0
3.0
3.0
4.0
4.0
5.0
5.0
6.0
6.0
7.0
7.0
8.0
8.0
9.0
9.0
10.0
10.0
Hole # Lot #
Depth to water
Depth to mottling
Depth to rock/imp.
G.L.
0.5
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
PiUTNAM COUNTY DEPARTMDNT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
W
DESIGN 3 DATA SHEET - SUBSURFACE SEWAGE 'TREATMENT SYSTEM
`
1 � '
Owner �U�� j �' Address
Located at (Streit) :Tax-Map � Block Lot
(indicate nearest cross street)
Municipality Drainage Basin
SOIL PERCOLATION TEST DATA r
Date of Pre - soaking Date of Percolation Test
Hole No.
%
Run No.
Time
Tim
Start - Stop
Ela se Time
min.)
De th to Water
rom Ground .
Surface (Inches).
Start Stop �
Water
Level
Drop
Inches
Percolation
Rate
Min/Inch
1
R-
2
3
4
5
2
. -
3
4
5
.2
i
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at eacu
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, _< 2 min for 31 -60 min/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
DEPTH
G.L.
0.5'
1.0'
1.5'
2.0'
2.5'
3.5'
4.0'
4.5'
5.0'
5.5' .
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.5'
10.0'
AMx.71 ias artaaa.,
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO. HOLE NO. HOLE NO.
It, a-/
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed 4.29,U,c
Indicate level to which water level rises after being encountered
Deep hole observations made by: Zg , g5 A, �?G �7, Date ! o
Design Professional Name:
Address:
Signature:
Design Professional's Seal
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
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
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE NO. HOLE NO.
�1- HOLE NO. .3
-L 58 S, 7,5
W . In
Indicate level at which groundwater is encountered
Indicate level at which mottling is observed 110A 1,
�
Indicate level to which water level rises after being encountered
Deep hole observations made by: j<'j S.c , �:1i4. c Date -7// 9 os
Design Professional Name:
Address:
Signature:
Design Professional's Seal
z
081107/2005 TUE 10:90 FAX 4 -+4 PCHD
BRUCE R. FOLEY
Public Health Director
-
DEPARTMEN- T OF HEALTH
1 Geneve. Road
Brewster, New York 10509
Q 001 /001
LORETTA MOLINARI R.N., M.S.N,
Associate Public Xeallh Director
Director of Patient Services
REQUEST FOR r WLD TESTING
ATTENTION: u JOSEPH PARAVATi . ; XCEN-F, REED
Allinformation below must be fully completed p; or xp au-V scheduling, DATE; � �' �` �--
ENGTNFER OR FIRM- - __t'Qnj -Ak �"' {%� i�;��r� !��C4� PHONE
REASON:
DEEPS; PERCS ;x ft VIP TEST; 0
ROAD/STREET- `r S' . i _' L y /
TOWN: I/�� yl�ii�J TAX MAPIf. 7 IV Z Z
ST J1RDTVTSI0N: - -_ -.— /� LOT #:
OWNER! �.._... hZ13' .i _r...� �1�.'U �Gr_ T _
NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTLNG
IrES NO
❑ 'x*` -- .-- P- roposed "SSTS with in the drainage basin of West Branch orYoyds - Corner -Res ervoirs.
o Proposed SSTS within 500 feet of a reservoir. reservoir stem or control lake.
❑ �' Proposed SSTS within 200 feet of a'svatercourse or a DEC wetland,
❑ : ' � Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required.
❑ Proposed SSTS fora Commercial Project.
It is the responsibility of the design professional to provide the above information prior to soil testing.
This Department wilt determine the N'VCDEP project status (Joint or Delegated) basal on the
response. If you answered yLf to any of the questions. NYCDEP must witness the soil tests. This
Departineut-will coordinate a inulually suitable time for field testiugvt•ith the Design Professional and
NYCDEP.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates 1N -YCDEP is required to.vaitness the soil tests, it will be tine sole responsibility of
the de.9ign professional,to schedule .re- witnessing of the soil testing with NYCDEF.
FOR COUNTY USE ONLY
DATE: 7..
COMMENTS:
PUTNAM ENGINEERING, PLLC
4 Old Route 6
Brewster, New York 10509
Phone: 845-279-6789
Fax: 845-279-6769
e-mail: -putnamengineering@rcn.com
TO: 66i4f,
_P
FU.-'TrIAt%
. ... ............ ....
..... ..... . .... .
.... . .........
LETTER OF TRANSMITTAL
Date: _- Q /¢- -- —
RE:
P/E Job:
We are sending you attached under separate cover, the following items via
...... U. S. Mail, Overnight, Hand Delivery, Pick Up:
Originals Reports Plans
.... ..... . ...... Prints Photographic Exhibit Specifications
. . ... .. .......... Colored Prints Other:
Dwq. No.
-- ---------
Description
These are transmitted: For approval Approved as submitted
For your use Approved as noted
As requested Returned for corrections
For review/comm.ent Resubmit copies for approval
Submit — copies for distribution
REMARKS:
L
. .... ..... .......... . . .. ........
Copies to.:
SIGNED*__
It enclosures are not.as noted. kindly notify this office.
07/20/2005 WED 10:53 FAX 4- +-* PCHD
BRUCE R. FOLEY
,Public Health Director
DEPART NT OF HEALTH
I Geneva Road
Brewster, New York 10509
13 3M —**I-@ 0 : � ( -t -
Q 002/002
LORETTA MOLINARI RN., M.S.N-
Assoeiate Public Health Director
Drector of Patient Services
ATTENTION; ❑ JOSEPH PARAVATI GENE REED
All information below must bd kLft completed prior to.any scheduling. DATE: -1
ENGINEER OR FIEMM: �-roA-n W-4 !!@ R;ft&_ ; PONE #: Z-7 i —1`0-1 bq
REASON:
DEEPS:. ❑ PERCS; V PUMP TEST: o
ROAD /STREET: P-16- Fcxa i c • . l.(�i
TOWN; _ ,_�5�, -� TAX MAP #; 74 — j —4-L
SUBDIVISION: 41A, LOT #;
OWAR;
ICDEP CRITERIA FOR low REVI>luW AND WTY'lVF,55ING OF SAIL 'I'FTING
YES NO
o.- .. - - -...
Proposed 8STS within tbedralaWbadn of We stBranchorBoydsCorner Reservoirs.
Q pX Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake.
o Proposed SSTS within 200 feet of a watercoarw or a DEC wetland.
0 Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required..•
v PL Proposed SSTS for a Commercial Project.
It is the responsibility of the desto professional to provide the above information prior to soil testing.
This Department will determine the NYCURP project status (Joint or Delegated) based on the
response, If you answered yes to any of the questions, NYCDV must witness the soil tests. This
Department will coordinate a mutually suitable time for field testing with theDesign Professional and
NYCDEP.
If a project Ms been determined to be Delegated based on t1% above response and then subsequent
information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of
the design professional to schedule re wittessing of the ail testing with NYCDEP.
FOR COUNTY USE ONLY
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