Loading...
HomeMy WebLinkAbout0891DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.38 -1 -21 BOX 10 11:• A Air ir %o. N J 61 -A .- .J T '1 f T F r 11:• PUTNAM COt RTMENT OF HEALTH S � - `��� Division of 'fnvir nrnenta/ Hell: /ih Services, Carmel, N ,Y 112 ;'permst #' ;CERTIFICA OF CONSTRUCTION :COMPLIANCE F.,OR ,:SEWAGE .DISPOSAL._SYSTEIN 79, o AL /mac .r A f�f{�G..�• Y .. Tax Map Brook, _ -Located-at.. � d .A FFoormer�ly, , Tax Map Lot # .�. Subd Lot # 4Ira_ Separate Sewerage System built by y ��itF!l. Address 8 �) �)�L'�S consisting of ' al. Septic Tank and Other requirements�r, •'d� 'E�L� -. _ " Water Supply: Public Supply From f/ Private'SuPPIY Drilled 'By Address Butlding Type IV �7fDF.Il1G No.'of Bedrooms Date permit Issues_ Has Erosion Control Been Completed? I certify that the. system (s) as listed.servinJ4 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 aid regulations,, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. Date `- C' Certified by P E. R. A. Address ! FI1 �Q `'� tapnp No; ��C� Any person occupying..premises. served by the above systems) shall promptly take such action as may be n"ssary 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 snnitary savye► becomes ,available and,the,app[ oval of the. private` water supply shall bee a 11 antl void when s pu ter supply becomes'avatlabN. Such approvals are sub)ect `to modification or change when, in the Judgment Hof t e Co ioner of Health ' such rev, , tion, modifl tion or Chan s cesaary. Date r' 1 C) A ✓/ BY 0 'c PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES -.--.COUNTY- OFFICE BUILDING; CARMEL, - N . Y. - -10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner DO" tb2Z,� Address 134.0 hl, & flf• shoe ILA A7_ 6CPE3093 Located at ( Street OAn)g &A RD Sec. Block 3 �Indica e nearest cross _sT_r_e_eTT Lot `�' t to Municipality. SOW" GT- PC+7j &?'O-f-S Watershed CA 1011) SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole 12r 1 � Z= ► � � Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to a er a er ve 5 IM l (109 No. Time. From Ground Surface in Inches Soil Rate Start -Stop Mina Start Stop Drop in Min. /in drop Inches Inches Inches l c�; 9,Sb iq 21 2� .. � ©.,off is -z- 4W.1_9 lo[ s-b - 7,I 10 5 to sa� I( '. I I -ZI 19 21 5 Y �7i1. �'. �f ��� 12r 1 � Z= ► � � 310'. (t- 4 I�.'L� t614 l I` 21 3 G 5 IM l (109 1 r F4 3 FCCLClVP1I 4 5 UTNAM COUNTY DEPT. OF HEALTV Notes: 1) Tests to be repeated at same depth until approximately equal soil rates are obtained at each percolation.test hole. A11 data to be submitted for review. 2) Depth measurements to be made from top of hole. j- TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE No. HOLE NO.'. HOLE NO. G.L. b, , 7 Err io,. 1211 .1811 24" 1 30" 3611 �� 42' I wz S-Yt N' .• 48" 54 rr 6o" 66" 72,11 78" 84" INDICATE L AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO W CH ATE LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY 4A a G Date DESIGN Soil Rate Used_�7 Min/1 "Drop: S.D. Usable Area Provided a No. of Bedrooms Septic Tank Capacity 1�-n Gals. Type Absorption Area Provided By =� L.F.x24" H trenca . Address Za CA t (Z IL J �•W. 9,,L THIS SPACE FOR USE BY HEALTWD8PARTMENT ONLY: Soil Rate .Approved Sq. F't /Gal'. Checked by Date .. BREWSTER LABORATORIES- Box 224 - BREWSTER, N.Y. (914) 225 -2072 - WATER ANALYSIS REPORT - SAMPLE NO. 5804 SOURCE: Maureen Lobraico Hose Bibb - W611 Overlin Road Patterson, NY COLLECTED: May 24, 1985 BY: P. F. Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the source of the sample was of satisfactory sanitary quality when the sample was collected. May 28, 1985 0 per 100 ml. <ati "••r9 J WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL., NEW YORK This report ..is .to be completed_ by well..dril.ler and submitted to County Health Department together with !sboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION V NAME ADDRESS OWNER ers. Box 221, Brewster, NY LOCATION (No. & Street) (Town) (lot Number) OF WELL Overlin Road Patterson, NY BUSINESS ® ❑ ❑ ❑ PROPOSED DOMESTIC ESTABLISHMENT FARM TEST WELL USE OF WELL 11 SUPPLY El INDUSTRIAL ❑ AIR ❑ OTHER CONDITIONING (Specify) DRILLING COMPRESSED CABLE ® ROTARY ❑ ❑ 1:1 OTHER) EQUIPMENT AIR PERCUSSION PERCUSSION CASING DETAILS LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ❑ THREADED ❑ WELDED VE SHOE jj�� YES NO f'A LNG 301 611 L_) YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ® PUMPED ❑ YIELD (G.P.M.) COMPRESSED AIR 6 5 5 WATER MEASURE FROM LAND SURFACE — STATIC(Specify feet) DURING YIELD TEST (feet) Depth of Completed Well LEVEL 35 t in feet below Land surface: 4451 MAKE LENGTH OPEN TO AQUIFER (feet) SCREEN DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL Diameter of well including GRAVEL SIZE (inches) FROM (feet) TO (feet) PACKED: gravel pack (Inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET Drilling in overburden c ay and boulders Drilling in rock,set casing, 30 circuted 30 445 Drilling in rock aranite. Na ,a "'.. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTES _ •S I DATE WELL COMPLETED DATE OF REPORT WELL DRILLER (Signature) 85 C. i e V pl- Building Constructed by ®Ilex —%V /& 1 Location - Street Municipality A'A,sr,3&NoA Building Type .s-e Section Block f��® Lot — 7 � /, too 0 ubdivision Name :4Zo G 497,3 Subdv. Lot # GUARANTEE OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 success- ors, 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 initial use of the sewage disposal 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 occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determin- ation of the - Director of -the Division of Environmental Health Services- -- of the Putnam County Department of Health as to whether or not'tYi6'­fa l= ure of the system to operate was caused by of the occupant of the bu' ding utilizing Dated this IT day o 19�� i Ti ry N 1 THREE (3) COPIES ARE RE, UZREb'�WITHlTHREE CERTIFICATE OF COMPLETION WIt:U "HE' ISSUED. A ress (3) COPIES OF FINAL PLANS BEFORE GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM.. �M, Division of Environmental Health Services, Putnam County Department of Health •t 4 ; i t 3 11007 dZ top? i s ss 0 e h � 3DLPARiNEIv i OF HEALTH Division of Environnuntal Health Semmes 4 Genava Road Brewster, New York 10509 Trl. (914) 278 - 6130 Far (914) 278 - 7921 .• _. t: 10MUM BRUCE R FOLE.Y Public Health Direcccr STFIEET,!<6 Iv` ME�� i LA,jjD Ca ADDRESS DESCRIPTION OF A \L �It3ER. OF EXIS' (FROM CERT. OF OC;C FA„\CY OR CERTIFICATION' FROM BUILDNG INSPECTOR) *.Any addition which is considered a b edroam requires formal approval of plan (Con-auction Permit) prepared by a -rcfessio..a1 En nee: or Registered Arcluitect in accordance with aaplicab:e sections of tht Pumarn Coznty Sanitazy Code. Please submit this fcrm and the folowing to Putnarn County Health Dept.; 4 Geneva Rd., Brcw•scer, N1Y 10509, Phone 27 S-130. 1. Certified check or mozey order for 5100.00 Skatches of existing floor plan (dmz m to scale, all living area lnclading basement) * Non- professional skete'nes are accept =ble 3. Two sets of proposed r'oor plan (drawn to scale, with name, street, =d tai: rap ) * lion- p :ofessionai skett;hes are acceptable 4. Copy of surveys :owing well and septic location, to the best of vo'z kr�owledge. Include date of installation if kr -o -wn: Label all wets and septic systems within 200 feet of the p:ope-.ty line. Contact this office wit any questions. 5. Copy of Cart. of Occupancy from Town or Certification from Building Dept. 'xith legal bedroom court of dwelling. OF iCB LdF. C:o:nme:ns 0 F:b 93 J. fa �� 4, 3 C � DEPARTMENT OF HEALTH Division . Of Emkonmental Health Services h Geneva' Road, Brewster, New York 10509 (914) 278 -6130 - Putnam County Dept. of Health 4 seneva Road 37ewstcr, NY 105C9 BRUCE R._FJLE`.'. R S Acting Puhile Health Di-e•t .,r Re: �Rcsidence � -� Tax Map 2 Town C:enuamen: According to records maintaiced by the Tow-al the above noted dwelling is JL in cornpiian.. <<,ith Tov, code and ere tctal number cf'oedreoms on record is This infomnation ha5 been obtained from: CERTIFICATE OF OCCUPAiICY: � SESSOR S RECORD: THE Building inspector J P1yTN#M COUNTY Pal `Division W Environmental RTIFICAYE OF CONSTRUCTION COMPLIANCE FOR S DEPARTMO'TI)OF HEALTH Fes /th Sw ca, Cowl, N. Y. 10512 Permit t :WAGE DISPOSAL SYSTEM �T ujL aF . rPl�7T��So/U_ Town or village Located at 0r `^R—z-/" v �1Qy Tax Hap v/ Block 13 Owner M. 1-o,R' J GO / Formerly Di A/l r T 1 Tax Hap Lot r ,�� � subd. l of a Separate Sewerage System built by ���TI Address . 1<X�:) FQ ► /a VE< �"- �f�al. Septic Tank and Consisting of Other requirements Water Supply: / Public Supply From Private Supply Drilled BY r'-�r� Address -P /i1�E I"�c. T�� �x Building Type ! 1" �I V 'D G� No, of Bedrooms_ Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) 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, in accordance with the filed plan, and the permit issued by 'the Putnam County Department Of Health. A Date _ 14) p 1 e-! P.E. k/ RA, Address' ^A I `Z.. aA R) L Wi/. _ /D 3/ License No. � Ady person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsaniq►y 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 shalt bec a 11 and void whetl a P ter supply becomes avatlabw Such approvals. are Subject to modification or Change when. in the judgment Of t e CO scone ► of Health such rev =Ply or than f gfpry. Date By Rev. 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 7, 2002 Mark Shisler 50 Overlin Rd. Patterson, NY 12563 Re: Addition - Shisler, Overlin Rd. (T)Patterson, TM #25.38 -1 -20 Dear Mr. Shisler: I have received and reviewed the plans for the proposed addition to the above mentioned residence. _ The plans indicate that the proposed_ addition_ will consist of the following: adding a garage with a master bedroom above and remodeling the basement. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The media room is considered a potential bedroom. 2. The legal bedroom count for the dwelling is three . The potential bedroom count of the dwelling with your proposed addition is four 3. The addition of a potential bedroom requires this Department's approval of a revised septic system plan from a professional engineer. Please revise the proposed floor plan to reflect no more than three potential bedrooms, or have a professional engineer or registered architect design a sub- surface sewage treatment system meeting present code requirements. If you have any questions, please contact me at your convenience. ML:lm Very truly urs_,,,�7 Michael Luke Public Health Technician [:PJV cit::+ _ H SRUS 02 NOV — I PM 12. 24 Nn�J31�o os ,mod X115 20 SL , LS' Oo t Slzh )07Zh i 1 S I is Z -ah uOD N 5`�2h r1ouid4b Q2z r^p• q,W" 1poz ,,3— N d35Q,i0?� o��JZH 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 November 19, 2002 Mark Shisler 50 Overlin Road Patterson, NY 12563 Re: Addition- Shisler, 50 Overlin Rd. No Increases in Number of Bedrooms (T)Patterson, TM #25.38 -1 -20 Dear Mr. Shisler: 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 November 19, 2002 . The addition is approved with the following conditions: 1. The total number of bedrooms must remain at tbtee 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. WH:lm cc:BI William Hedges Senior Public Health Sanitarian NOV -19 -2002 09:11 ETHAN ALLEN INC 203 743 8298 P.02 Town of Patterson Building Department Putnam County Department of Health November 18, 2002 Re: Shisler Proposed Addition 50 Ovedin Road Patterson, N.Y. 12563 Dear Sir, The Blowing informa bon is being submitted to resolve the issue regarding the proposed Media Room for the above referenced residence. 1. The door opening into the Media Room will be increased to a 5 foot trimmed opening, having no door. 2. The wall that the new opening will be constructed in is not a load bearing wall. If you require arty addiitional-informaiion, piease contact me. Ca Mark Shisler John IPler Regards, William J. Moreau, P.E. NOV-19-2002 09:11 Lu ETHAN ALLEN INC 203 743 8298 P.01 C%k\"\ M At ovl..A. O'5.- (3Y&-y U� t-A pit -.4 4 --------- ----