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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
OFFICIAL USE ONLY
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SITE LOCATION 7 DU:zro L5i kQ. TM#
OWNER'S NAME ►, h_ M c- C act- A PHONE fq, -
MAILING ADDRESS �� PaTI �So ►� �3. - -
PERSON INTERVIEWED UJW J .04 C jW kA PCHD Complaint #
Nwn7e & Relationship i.e., owner, tenant, eta
DATE TYPE FACILITY
PROPOSED INSTALLER C, LJ -C AID FjELy Nc . L.1 , C, PHONE ,-�,a 3 - 7 9 3 S
ADDRESS 6 hrzaP 00a D .1) R . REGISTRATION#
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system .Different location
may require submittal of proposal from licensed professional engineer or registered architect.
-- l,_aS owner ,. o repOrterl J,e er 2orPP to tlZe �nnr�itiOnc.stata�_nrZ thig fn,,,2 . -- - -, -_ -.- _ -- - -_ -_•- _ - - -- -__.. .
SIGNATURE TITLE / "6M E.M'(Act DATE �l
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be pe ormed in accordance with the above proposal and conditions.
Proposal approved
A�,94U . 71z"CL61
Inspector's Signature & Title DATE
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
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PETER C. ALEXANDERSON
County Executive
:Doreen & David Fox
�5 Quincy Road
:Patterson, NY 12563
Dear Mr. Fox:
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
July 26, 1989
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Re: A110 -89
Proposed addition
5 Quincy Road - Putnam Lake, Patterson, NY
I have received and reviewed the plans for the proposed addition to the above.
mentioned residence.
The plans indicate that a 24' x 24' two car garage will be added to the south
(side of the existing structure. A great room and bathroom will be added above
-the garage.
The survey indicates that sufficient area exists to expand or repair the sewage
disposal system, should it become necessary in the future. Therefore, based on
the information submitted, the above mentioned addition is approved with the
:following conditions:
1. The total number of bedrooms must.remain at two without prior approval by
:Z. The area of the existing sewage disposal system, and its expansion area, must
be maintained.
:3. All plumbing fixtures must be replaced or updated with water saving devices,
i.e., low flush toilets, restrictors for shower heads and faucets, etc.
Approval is granted for sewage disposal only. Any other permits or variances
required are the responsibility of the applicant and the jurisdiction of the Town
of Patterson.
Jf you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
Sr. Public Health Sanitarian
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cc: BI (T) Patterson
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