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25.48 -1 -56
BOX 11
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SHERLITA AMLER, MD, MS, FAAP . a, .a ROBERT J. BONDI
Commissioner of Health * * ` County Executive
.__ 0 _ - _
- - LORETTA MOLINARI, RN, MSN FI{r Y 4� T ROBERT MORRIS, PE .
Associate Commissioner of Health Director of Environmental Health
DEPARTMENT.'OF HEALTH
I Geneva Road. Brewster, New York 10509
July 24, 2009. i
a Richard Joyce
12 Hazel Drive
Patterson, NY 12563
Re: -Addition- Approval Joyce .
No Increase in Number of.Bedrooms
32 Lawrence Drive '
.(T) Patterson, T.M. # 25.48 -1 -56
Dear. Mr. Joyce:
' 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 the Department . .
dated July 23, 2009: The addition is. approved; with the following conditions:
1: The total number of/bedrooms must remain at two without prior approval by this Department.
I 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,
..
re'strictors for.shower..heads and faucets, etc.....- _ �....;:......�.:.._.. _. _ .. �._ ..,.......... _ ,. .., ...._..
~ ~ 4. The ,approval islor 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 your convenience.
Respectfiilly,
oseph S. Paravati, Jr. , P.E.
Assistant Public Health Engineer
JSP:kly _
cc: BI,,(T) Patterson
' ' Envirodmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845.) 225 -518.6 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care Fax (845)'278-6085 WIC (845) 278 -6678 .
Early Intervention / Preschool (845)228 -2847: Fax (845.) 225 -1580
0
PXfA
1'7'-6"
WING I K1 C11EN /DINING
/O'-//"
RF-DROORIq---
STiiIR DOWN
8' -a D�DROOM 2 /� -la'
33' -lO 1 /Z"
pl?0P05�P FL001? PLAN FII?5f F1.001?
kale; 3 /!Ca "sl' -O"
Properly tlddre55' 32 Lawrence 1 (A;i &a*P— ,`'1'�)eI'I) °r' I�r A�.'i��I[[�
ONLY,
Tax Mop
P l E !'CANS AFPKOVED FOR BEDROOM COUNT
n A f.,(9 C?
/Vane,' PIchard Joyce
Dale 1 /9/ nUENT ItEV1SION'ALTERATIpC OH FOR THESE
Ar,I.
(JTi-.N7ATURE i5 MUST BE SUB I'rTED lU 1xE LO 3'v5
GATE
& TITLE llfyfilfl
A
32' -6"
B/15EMENT
/6' -6"
ly -a'
DASEMENT
DOILEP
STillP UP
29 -T'
GP�iWL 5Pi1GE
l5' -10"
pp0p05En F�00F PLAN PASfM'
1'iopedy Addre55; 32 Lawrence Or,, f o//eAibWN WM-1 DEPARTMENT OF HEALTH
Tax Mop # l aSuf -I -SG, 40USE PLANS APPROVED FOR 13EDIIOOM COUNT ONLY,
Nome,' Pichard Joyce BEDROOM~ A -0
Dole,, 71,1'7109 ALL SUBSEQUENT REVISIONIALTERATIONS TO THESE HOUSE
PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL
� DATE
: (, N.- kTTJTtE tit TITLE �(�
29' -2"
20 2
K!r CHFN
FX15MCA FOR, PLAN FII?5f FL00F
Propedy Addre55' 32 Lawrence Dr,, Paffer5on, NY 12503
7-ox I''l op # 149P
Nome.' P/chard Joyce
Dofe:
Z9'-Z"
Y -4"
20'-Z"
�'-4" 6ii5�MENT
GRliWL 9P�iGE
�45TIN6 F1.00p PLAN MSNM
Properly Addie55, 2�2 Lowience Or,, Polfer5on, NY I25G3
Tax t l op # /49r,
Name; Plchard Joyce
Da/c: 712109
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J. BONDI
County Executive
® OBERT MORRIS, PE
of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
STREET ,��� n.'C �s' TOWNOM TAX MAP # -
NAME g tQ,Sj � PHONE Y K-; -7a_ 5f' " PCHD#
MAILING
ADDRESS
DESCRIPTION OF
ADDITION' 1' ��'�.S11� 3 ��-���R� . 1� /ulr
NUMBER OF EXISTINGBEDROOMS._� PROPOSED # OF BEDROOMS
(FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING IN CTO )
* *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.
1. Certified check or money order for $100.00.
2. Sketches of existing floor plan (drawn to scale. all.liv._ing.pren. including..:basement,..tb..be. _......_ .. _.;. ._
`shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin
HA -1)
3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #)
* Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1)
4.. Copy of survey showing all well and septic locations on the subject property to. the best
of your knowledge. Include date of installation known. Contact this office with any
questions..
5. Copy of Certificate of Occupancy from the Town or Certification from the Building
Department with legal bedroom count of dwelling.
OFFICE USE
COMMENTS
5
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
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580
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'l0509
Town Legal Bedroom Count & Proposed Addition Status.
Re: `Co' Gam' (Owner's Name)
Tax Map # o1S
Address: S;a-IA400p i 7ce
Town:
Year Built: z � >
According to records maintained by the Town, the above noted dwelling,
is in compliance with Town Code.
Is not in compliance. with Town Code.
The Legal Bedroom Count is: 3
This information has been obtained from:
Certificate of Occupancy:
Other:4�1 -G
The plans for the proposed addition are considered: .
New Construction
Addition to existing house only
Teardown and/or re =build allowed. under Town Regulations
Building nspec.o� . Date.,
6
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
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 - 6678 .
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580
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,. PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION.OF ENVIRONMENTAL HEALTH SERVICE 6 ��l' -_'
PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR -��
YES No/ Internal Use Only PERMIT #
❑ Eif Repair Permit issued in last 5 years ❑ Not in Watershed
❑ ❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. ❑ Delegated
❑ ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review
SITE LOCATION ' ,5,2 %yLreaCe, n TOWN TM #. QA . Y r - J -
OWNER'S NAME rcl-W- ,irct PHONE
MAILING ADDRESS I ':;L, I T-4-, Af L
APPLICANT
f Name & Relatidhship (i.e., owner, tenant, contractor)
DATE FACILITY TYPE PCHD COMPLAINT #
PROPOSED IN TALLER PHONE
ADDRESS Zv /LICENSE # 1�
Proposal (include a separate sketch locating the house, property. lines, all adjacent wells within 200 r
feet of repair and the location of existing and proposed system) ���
NOTE: The Department may require submittal of proposal from licensed professional depending on the X1 ,r
nature and extent of the repair. C�
I, as owner,agree
SIGNATURE
on this form
.-.e------TITLE
DATE
(owner) r -
I; the septic installer, agree to c mpith the conditions of this permit for the septic system repair
SIGNATURE e TITLE DATE /
(installer)
Proposal ap2roved with the llowi bondit-
1. Procurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
IWTPOMA! "QC nNl V
Proposal Approved Proposal Denied ❑
9/-Z
Inspector's Si nature & Title 0 Date Expiration Date
,Repair proposal is in compliance with applicable codes Yes No O
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2107
' Z-
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner: -�J Ce Address:
Located at (street): TM A Sectiono5 Bloc1¢ %(� Lot / —S
Municipality: l G� Watershed:
SOIL PERCOLATION TEST DATA
Date of Pre - soaking: 101 -71
Witnessed 6y:
Date of Percolation Test: '/S
Hale No..
Run No.
Time
Start —
Stop
Elapse
Time
(min.)
Depth to .
water from
ground
n
surface
(inches)
Start - Stop
Water
level drop
in inches
Percolation
Rate
min /inch
1
- iDOS
z-- �'
x
2
z
5
I
2
3
I
2
3
5
I
2
3
4
Notes:
1. Tests to be repeated at same depth until approximately equal percolation rates are
obtained at each percolation test hole. (i.e., < I min for I -30 min/inch, < 2 min for 3 1-60 min /inch).
All data to be submitted for review,
2. Depth measurements to be made from top of hole.
Fomi DD -97, po I of''_
Indicate level.at which groundwater is encountered
Indicate level at which mottling is observed
Indicate Level to which water level rises after being encountered
Deep hole observations made by: Date
Design Professional Name:
Address:
Signature:
Design Professional = Seal
r
MEMORY TRANSMISSION REPORT
SEP -26 -2011 - 03a03PM
TEL NUMBER : 8452787921
NAME ENVIRONMENTAL HEALTH
FILE NUMBER : 445
DATE SEP -26 03:02PM
TO 82795989
DOCUMENT PAGES . 001
START TIME SEP -26 03:02PM
END TIME : SEP -26 03:03PM
SENT PAGES : 001
STATUS OK
FILE NUMBER : 445 * ** SUCCESSFUL TX NOT ICE * **
PIJTNAM COUNTY HEALTH nEPAFtTMENT
OIWISION OF ENVIRONMENTAL HEALTH SERVICE
PRQFOSAL. FOR SEWAQE TREATmP -m-r SYSTEM REPAIR
XGA Internal Use anly PERMIT aM R -"
Repair Parnit lasudba In east a yoa.a Not in
M RQQeir within 9oydb Corners, w. Branch or Croton Fm no Rea Cl Ded�
[] Q Repair wlthln 2o0 ft of a watercourse or of weoand ED Joint F
SITE LOCATIdN a TQWN TM # -a.3'- '. Y it / - -,A !°
OWNER'S.NAME PHQNE a
MAILING ACCRUES -S� I --1x- "/V L�
APPLICANT n (--9,
--f Noma Relatl fUp (l.e., owner .,contractor)
�--
DATE FACILITY TYPE rQ.� c _ PCHC CO�MyP�LAINT M
PRCWCOSEC IN TAL R PHQNE
A�CRES9 Pi GIp7rMATION %LICENSE fY, / 8� S'�� • ' _
Y Proposal (Include a nape 1 akatoh locating the noun. property lines, all adUacent wolfs within 200 ^\
feakof repair and the location of exlating and proposed aystern3
NOTE: The Department may require submittal at'-proposal from licensed professional depending on the- r�{I�`
nataire and extent of the repair. '
_} ift _ L! .. .
1, as owner,agrea tdth�cBl ltlons /�tatigj on this form
t31aNATURE CATS
(Owner
1, the saptio Installer, agree, to mp ter the conditions of this permit for the, septio system repair - J
8113NATURE TITLE DATE___ //
(Installer)
Protxsaral !11 •ed with tine fiefilowin�cnndHiona-
1 . Proourtrment of any Town Pern'th. It applloable.
2. Submission of as built repair takstch by the septic system Installer withln 30 days of the repair. In dupllcste !showing:
a. Owrter'm name. Site Street Nama, Town and Tax Map number
b. Location of Installed components tied to two fixed points
o. System description esription (e.A.. 1250 gal- Conarate aeptic tank. eta)
d. Installers' name and phone number
3. Oyatem repair to ba parformed In a000rdsnce wtth the above proposal and conditions
4. The propomad SOTS repair Is considered a hart fit dasign and there Is no guarantee to the rlurntlon at which the
completed SSTS repair wlli function -
6- No oompletad work Is to be backfilled until authorization to do so ham been obtained from the Owpartmant
INTERNAL_ 11!39 C1NLY
- roposal Approved Proposal Danled
nspeator ature B& Tttl a Uate Expiration Dat®
aranalr "me. 1 to In c rnplianoo with aPplipatblo --Clem ` Yma � NO t7
COPIES: F-4--HM; Owner: Installer
PC-RP 99ML Aev. W07
YNDALL
EXCAVATING CONTRI
SEPT/C SYS 20 Ivy Hill Rd., Brewster, NY 1050
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YNDALLEXCAVATING CONTRACTORS
SEPT /C SYSTEMSimc. 20 Ivy Hill Rd., Brewster, NY 10509' (845) 279 -8809
Oct 04 11 03:18p Tyndall (845) 279-5989 p.2
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Name: R Joyce
address: _12 Lawrence Dr. ,Pat
Street
Person in Charge or Interviewed:
Sheet-1 of _1_
Putnam County Department of Health
Division of Environmental Health Services
Field Activity Report
Telephone: 279 -3897
Town State Zip
Date: 1015111
Name and Title
Findings: R- 203 -11, went to site for final inspection. The work was done as per permit and
drawings.. Nice Job
Inspector: Telephone:
Signa a and Title
Report Received by:
I acknowledge receipt of this report: Signature:
Field Activity Report: cw
Title:
Date:
f
--9/27/11
Memo to file
Repair # R- 203 -11
Septic
32 Lawrence Dr. Patterson
TM #25.48 -1 -56
Went to site, Tyndall was contractor. He replaced the 750 gallon
septic tank. As I was there we discussed with the H/O options for a
possible repair. While I was there I witnessed a deep hole .
Cris Dellanpa, CCM, PMP
Projects Coordinator, Putnam County Health Dept