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Home My WebLink About0890DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.38 -1 -18 BOX 10 17-- C" Ll i I` � J T ti T .` ■ rj I� .6 f I Bill r �a 1 r t I LA SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J: BONDI County Fxecutive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET �� lL � . � TOWN' TAX MAP# � -/ ;�Q NAME IMjnLAr _ei.ee PHONE PCHD# MAILING D ADDRESS_ DESCRIPTION OF ADDITION . NUMBF�t OF. EXISTING BED O MS PROPOSEDOF BEDROOMSC� (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 Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845).278 -6130. 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. s- SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI - - - County Executive.- - DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal ]Bedroom Count FS SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI; RN; MSN Associate Commissioner of Health ROBERT J. BONDI . County Executive - ROBERT MORRIS PE_ Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Thomas Fickeria & Melissa Carson 40 Overline Road Patterson, NY 12563 To Whom It May Concern: March 4, 2008 Re: Addition- A- 029 -08 No Increase in Number of Bedrooms 40 Overline Road (T) Patterson, T.M. # 25.38 -1 -18 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 this Department dated March 4, 2008. The 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. 4. 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 (845) 278 -6130, ext. 2261. Sincerely, "O� �)' 1 Gene D. Reed Senior Engineering Aide GDR: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 PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY '�27 7- 0 BEDROOMS 0 7A 2- 57. 3 -8 -- ALL SUBSEQUENT REVISION/A'LTERATIONS TO THESE HOUS PLANS MUST BE SUBMITTED TO THE PCIDOH FOR APPROVAL SIGNATURE & TITLE DATE n W� o '- l m m Z :0 F> 0 :..: 1 i 7t 1 D e. X1 m Z r 3) 0� �i ,i fit Uusl�t t w PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS .4 _U � 91 -0g 7.AA dLS, ,3 -9 W- ! —/I? ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOU PLANS MUST BE SUBMITTED TO THE PCOOH FOR APPROV SIGNATURE & +� v i s s Q% •r wr V \ TE <77 ; r • T. 14 7 ... . . .. ..... 7 7-1 + 01 �I } - - -- - - -t - - -- 7 Q CD C)i LAJ CD 7 - - -i. CD LU LL c )I. -j6J - ----- 77-7477 =i : ....... .. .. fy 44 ......... ------ - . . ....... . . JL v rr . ...... . .... ... ... ... . . .......... ....... 4 olo! A)e9 17-HA A, V; I , i , I I - i - I if -�- NIT I I► i_ !A I_ r_ -� __ __ i _ , _ I •..•� i,..�.. ,,,_., '_...Il, :•.��•^�. '. ^= •..� _ �_L - -�. `!,,%r •v. ,- sr�f;.._�:..5'Y': ,,,an�.i - - -I "Y �<'`•.'': '.. � . . I� • . I j I i J .. -.__.. _._......_ ....._.. _ i I I i I 7_0 0 _ ....... ... I - 4 i , ( i : 7 , J_ , 1 ' I I I , I ' 1 F W LI .... . ..... . . . . . . . . . . VA LORETTA MOLINARI Public Health Director. ROBERT J. BONDI County Executive 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 December 16, 2004 Doug Holly Holly Real Estate 102 Route 311 Carmel, NY 10512 Re: 40 Overlin Rd. (T) Patterson, TM #25.38 -1 -18 Dear Mr. Holly: An inspection of the above referenced dwelling was conducted on November 10, 2004 by the Health Department and the Town of Patterson Building Inspector. Based on the joint inspection it was determined that the dwelling is considered a pre- existing three bedroom house. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. Sincerely, ML: lm Michael Luke cc: (T)Patterson BI Public Health Sanitarian 3 'W. ruy. -� M WELL UUr1rLP,1-LUl4 tcr,rvtct *- * DEPARTMENT OF HEALTH - Division Of -Envlronmental-Health-Services- PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only � WELL LOCATION STREET ADURESS: TOWNIViLLAGILICHY TAX GRID mUmBER: 40 0,erlin Road Patterson, NY WELL OWNER NAME: ADDRESS: Katherine Mosher, 40 Overlin Rd. Patterson, NY Iff PBIVATE PUBLIC USE OF WELL 1 - primary 2 - secondary xaRESIDENTIAL O PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED O BUSINESS O FARM O TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT 5 gpm. /N0. PEOPLE SERVED 1 / EST. OF DAILY USAGE gal. REASON FOR DRILLING x2REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL SUPPLY rINEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WELL DEPTH DATA 365 WELL DEPTH ft. I 153 STATIC WATER LEVEL ft. 9116193 DATE MEASURED DRILLING EQUIPMENT ❑ ROTARY xli3cCOMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING 'a OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH — ft. MATERIALS: x® STEEL O PLASTIC O OTHER LENGTH BELOW GRADE ft. JOINTS: ❑ WELDED -Q THREADED O OTHER DIAMETER 6 in. SEALicaCEMENT GROUT ❑ BENTONITE ❑OTHER WEIGHT PER FOOT 19 1b./ft. I DRIVE SHOE:,QYES ❑ NO I LINER: CJ YES ONO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST O YES ONO HOURS SECOND - - GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH ft. WELL YIELD TEST If detailed pumping METHOD: O PUMPED tests were done is in- COMPRESSED AIR , ! ormation attached? O BAILED O OTHER ❑ YES 0 NO 'WELL LOG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE I Water Bear- Inq 1!e11 D'a' meter FORMATION DESCRIPTION coal -- it ft WELL DEPTH ft. DURATION hr. min. DRAWOOWN ft. YIELD gpm. Lan Surface 2O Hardpan 20. 365 Hard grey grant te 300. 1 30 300. 3 365. 6 - 250 14 WATER xSKLEAR TEMP. QUALITY ❑ CLOUDY HARDNESS O COLORED ANALYZEO?xxfia YES ONO ANALYSIS ATTACHED ?xQ YES O NO STORAGE TANK: TYPE CAPACITY GATE. PUMP INFORMATION TYPE submersible CAPACITY % MAKER DEPTH MODEL ?EHO 41 VOLTAGE2M H&I WELL DRILLER NAME MZ11. o Q414' 93 ADDRESS Putnam Avenue SI ANRE tr Brewster, NIJ. Rob rt a 11 it e IN I NORTH AMER9CAN LABORATOM ES, 8 N C. ANALYSIS DATA SHEET TYPE: PW LOCATION: Mosher REPORT TO: Neill Drilling ADDRESS: Putnam Avenue CITY, STATE, ZIP: Brewster, NY 10509 DATE COLLECTED: 09 -17 -93 TIME COLLECTED: 2:48 PM COLLECTED BY: Mill Drilling REPORT DATE: 09 -21 -93 LAB # : 93 -4666 SAMPLE'SOURCE: Tank - DATE ANALYSIS RESULT UNITS METHOD ANALYZED Total Coliform MF Absent SM17 (9215D) 09 -17 -93 THIS SAMPLE AS RECEIVED AT THIS LABORATORY MET THE REQUIREMENTS OF NEW YORK STATE DRINKINGWATER STANDARDS. atory Director NEW YORK STATE ELAP CERTIFICATION NUMBER: 11218 618 CLOCK TOWER COMMONS, RTE 22, BREWSTER, NY 10509 / 914 - 278 -7600 / FAX 914- 278 -7754 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION treet ddre s Town/Villa ge City Tax Grid Number 4 0ver�in Rc ,,. Patterson, IVY WELL...,OWNER Name Mai , Address Kay Mosher, 40 Over ingRd., Patterson, NY rivate O Public USE OF WELL RESIDENTIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 ABANDONED 1 - primary 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 2- secondary 0 INDUSTRIAL 0 INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm, /k PEOPLE. SERVED /EST. OF DAILY USAGE _gal X)M REPLACE EXISTING SUPPLY-,j3Z OBSERVATION d ADDITIONAL SUPPLY. REASON FOR DRILLING O NEW SUPPLY NEW DWELLING DEEPEN MSTINjG WELL DETAILED REASON FOR t DRILLING WELL TYPE DRILLED DRIVEN , J. QDUG []GRAVEL 0 OTHER IS WELL SITE SUBJECT TO.°-FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUB BIVISION,-NAME-,OF-S DIVISION: No. r Lot No. WATER WELL CONTRACTOR* : -._Name. - MILL DRILLING, .INC,, Address: PUtncm Ave„ Brewster, IVY IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: t YES 40(__NO NAME OF PUBLIC WATER SUPPLY: no � TOWN /VIL /CITY DISTANCE -TO r ^RvPEb'TY --- FROM-- NEAREST:_[dATER MAIN_:_- Wa :: LOCATION SKETCH & SOURCES OF CONTAMINATION PROV,;,DED, ; qN SEPARATE SHEET f� r 9/14/93 D ON } (date) RArt As 'MY re)P s i & n t PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt -y (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the Department attached to this permit. 3. Submit a Well Completion Report on a form requirements of the Putnam County Health provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a mann r as not to degrade or otherwise contaminate surface or grou Date of Issue: �f 19 Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller J e � z , Y I I i 1. ( r N 0.7 r - O 7 ,. 0-7 yy , I Tfl7-, LDT N0. 18 j ARLR = 0. Xs N R Ely— L4 ?-3 L i i I I I I I caHC. aLOU� I L I t Ux. awl `_...l 1 . GO\1C0.ETC P11TiO]'RND WA<.NS L`i'I P�IC_Al.� I LLEPII � Q 0 T ( G ° L __g_' r ti231 a N230 r 0 6.55 0 VE0. LI wC L METAt FPAIt.E SHED .. .. .... -40.3' +. .. . W OOa puL1 I 0 I C2 r � -_ i =0.01 R.OD FnUNO i J i •0.2'S�N S OD° Z0, o0 ".E MALADRM DR1V� 12.5' L CO STDLE REt ',r4 R�t Ct1 Gr OP aAAC11DAM TRAVELED WET ,.T OVERLIN ROOM i i UT��q yy 'TR T� i C I�> i I� ZD O � r r ( ! l rf r r J ` ( r I J I / r � r I / 1 ;SZ IIj I i 4 ' 2g3 ti2sS - _. _- _•__... __. _.._.._ —. _ / I. �ZS` TI L 0 T % O r / TAX LOT 110. 15 .9 r P'Tt 0.I s q Rcv li- I tJ n r � � r z / / r o r - � N p7. 4L_ , S p7� 07•• E 07.. VN 79t7. LOT N0. 18 itLON R00 N i I I I i ►iZ33 gz3Z HZ31 9 4230 i ; r o I .T- _ .._ - - #�'_- .1.�`.� •0.ct. wary f — .. 10. »rI Minimum Side Yard 15 FT 17.3 FT Minimum Rear Yard 20 FT > 56 FT Maximum Building Height 3OFT 13.67 FT Maximum Impervious Coverage (Percentage of Lot Area) 38 % bldg. area lot area 12.12 X _ 2,424 SF 20, 000 SF ,SURVEY ACKNOWLEDGEMENT THE INFORMATION INDICATED ON T1419 PLOT PLAN WAS TAKEN FROM. A SURVEY-. ,,,n PREPARED BY TERRY,9ERGENDORFF COLLINS FOR . APRIL Tr, 2007, AND.. R£LtSFX MAY 5, 2007. THI5 INFORMATION 15 SHOWN FOR - REFERENCE ONLY. THE ARCHITECT ASSUMES NO RESPONSIBILTY FOR ITS ACCURACY. 1. PIN 5eT PE:P?Y POAI2 ( UNIM'pOVr:b) N 85-13' 00 W I. PIN FNn 120.00' � f _ g � 8 � � 8 t017AL AMA— 20,000 51't � p - 0.459 AGt 8 ._ � 8 3882 388 I2EM. P05T & 358_4 5886 I Q U WIM FeNCe 3887 888 Q 3889 AL N 585 13 0 ..E _ n 1. PIPE FNP l X 30 39 �28 3927 3926 I, PIN S 25 ON ANGI -e I. PIN 5e (SI 15 I p I. PIPE FN o.oB' YA D NVAX IM4tC ', (SIDE 8 0,31' w tai, s BAC s4s1c�, P Tlo YARD 5 04- 47'00" W BACK loo,00�� COQ. F12AMe I PROPOSED PROP K SHED 1 B2' a CONC NC. 7 17.75' ( Tw) cm FK'AMe 26. 1' SHED 4,75' e 3924 1 5ry FRPAMe ,. ._ '.... _ ' -u 'ROPOSED ONE STORY ADDITION r g o p �K: WO j4 AAo, U, .V ROPOSED ONE STORY COVERED �S 17.46' �- Q V Vy pj l 'ORCH 0 �IMNey 0 1 � 17 f — 0 8 _ 09' `s �i Zp�� IniiQNQ i�o