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25.54 -2 -31
BOX 11
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` PUTNAM COUNTY DEPARTMENT OF HEALTH
t Diyrsron. "of Environmental Health Services, Carme% Y 10512',.
(' ap .
N
. .. Putna>.n .Lake. M 8
CONSTRUCTION' FOR�SEWAGE'DI PO$STFM y n�mn of Pa tergrin-
'�� r }
Yfm-' Of Town or age
4 � a i' Tax Nia -p
Located 'at Fal V.il1C' `Pc 4Ue ,! O Cxy I' le1Cd 56 Block • 2 .
. lots :7005 :'thru: 700.9 :: Pair o:f existing
i, t
ubdivislon Lot, ': Job
o urc ase. y : `iJlr:; . & .Mrs .. Eugene; L. riK ivett ,� 1 9 6- th S reef
r -
r 14ddress !
Building Type 1 fa -mi y- •dwelling Lot Area 10 408 s.f . HiCksv e� New York'
k
be
of Bedrooms " -Three maximum otal bi le Sp ca t'O be .•determ mini ware F
OmeW eac�i ranks° o l )
_Separate Sewerage System• to cbTAsist 'of' 900 Gal. 'Septic ,Ta k iiA L ,Yer7liNiXlNai%]b
'TO tie constructed bY, Nilliam' Boat; e Address Peaceable H' 11 =; Brewster,. ICY
�• -Water SuPPIy Public`'Supply, From
1 x _ Private Supply to be drilled by M111 Drilling TriC.
11 Putnam• Avenue;
;-.*Brew's. T�Tetg Yor � 1Q'509
4 Address
bther Requirements as per plans' VARIAhTCES requested (se:e note ,J)
7 " - -
11 represent that I. am wholly and completely responsible for,the design and'location of the proposed fystem(s),i.l) that the separate sewage disposal. system
above described. will be cpri#ructed,as shown on the approvetl amendment there to and m. accordance; with the.standards,;rules.an regu a, ions of e Putnam , .
„.
County Department :of 'Health,. ,and that'dn completion thereof;a.'"Certificate of;,Construction. Compliance ".satisfactory'..to the Commissioner of Heaithwill
�t• be submitted 't the' Department, and. a written guarantee will ;be furnished the owner h'is successors; heirs or assigns by .the builder,.that said builder will —
be
i
place' in good ;operating condition any:; part1 of• said sewage disposal system during the period of two (2)-.years Immediately'following the date of the issu
a_nce
of the- approval • of '.the Certificate 'of Construction Zornpiiance of, the'original system or any, repairsahereto; 2)'that the drilled well described above
will be. located as.shown,on the approved plan and that said well w1il be installed it .acc'ordanc_e with. the stag; ards :,rules and a iTf`ons +of,. the !'Putnam.
County. Depart ment of 'Health.=
:. eii P E R.A.
Date 814 73 b ign
S
•
RD h2lltown Road; Bre "vies r 509 43.952
Address5
y License No..
i APPROVED FOR CONSTRUCTION This approval expires one year from the date issued •:unless' construction of.the building has been undertaken and is
-;revocable for cause orvmay °be - amended or inodif,ied,when, considered necessary by'.the Commissioner.. of Health'. Any, change• or_ alteration of construction '
requires a new permit. 'App for disposal of domestic samtar s age, rid /or private w c supply only.
Tale
21
'Building Type
Control jeen iciimodfedz tg,
Has.� rqpon..,. be
Tli .
' -,.c(!rt if y that the Sys em(s ) as I�sted serving the above premises w,
attached), and in. accordance 'l, with .6e standards,-,rules dnd4iE4
Date- D b 2 41
Adtlress 11t oU1r
Any perion occupying pir eimises serve , y 't he:above'syst em
coriditi6ni res6ItInO'4r6in:; such- usage. ;AOpriovil of tha.'seqai
av ai I Ab le I and the �approval , of
subject to mod If Icat io n pr change -when. in - he judgment of
Data
-757
No '6.f�_'6ededo ms Date Permit Issued ZF1 r-YI I-%-)
i�llsh6d: with final see
shown '-pn.,tq4krPlaq.s he completed _work -(copies:of which are
s �:pf t
I` s )_ t>,-Put my :Department of ;Health.
t
E_
43952,
cerise- No.—
y to'sec ure, he correction any unsanitaVy '
i!_s ' may be necessary t ,
y -take, SUCKaCtion
e system, shall become null and void as soon as; -a - public sanitary sewer becomes
nd� void when a public wajiq'ir' suppfj, b�iic6mes available. Such approya,is are
i er 'I
ls4 _ikeaJtfi., iu-c-fil"fe" - ii i '.�mod I ti hi
i0c�a on' or. change s necessary.
_Vcik ion?.
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.
To be purchased by: 139 6th Street
30UVMMr, & Mrs. E.L. K ivett Address Hicksville New York
between Fairvi e ar ie on nor h side g
Located at (Street) uogue Road. .Sec. 56, Block 2 Lot � 8
(Indic e nearest cros;s�� s, ree
Town of PaVers-on Overland - eventually finding
Municipality Putnam Lake-. Map. # 8;1 . Watershed its wad to east branch of .the
Subdivyision Lots 7005 thru 7009 Croton der.._
SOIL PERCOLATION TEST DATA RE UIRED TO BE SUBMITTED WITH'A- MICATIONS
Holes saturated befor testing: July 27, 1973
Hole''
Number CLOCK TIME PERCOLATION PERCOLATION
RM Elapse Depth to Water Water Level
No. Time From Ground Surface in Inches Soil Rate
Start -Stop Min. Start Stop Drop in Min. /in drop
Inches Inches Inches
3011 deep 1 0- 10 f (7 25
Pere hole 2 _ Z ►Z
25 Z Q 3 4=. d
3 0- 46 16 Z- Z 8 4-, 0
Pere bale 1 O 46
in. .bottom .... _ ... ........... _ ....
deep hole 3 d-
for review.
2) Depth measurements to be made from top of hole.
per hole 1 O'. ¢..
¢
(30
1) 2
in bottom
of .7 2
i
deep hole 3 0 _
5
so
Z.; �s5
.Note: in view'of the fact
that
all three holes
percolated at a rate
of 5 min /in
use this as design rate.
(Holes still open and available for
inspection
and Pere rate verification
- 8- 14 -73)''
Notes: 1) Te'�ts to be
repeated'At:same depth.until
approximatelyy equal soil
rates are obtained at
each
percolation test
hole. All data to be
submitted
for review.
2) Depth measurements to be made from top of hole.
F
Address
pRC1FEsS10.NAL ENL6[Nr -cM
THIS SPACE FOR USE BY HEALTH DEPARN
Soil Rate Approved Sq. Ft/
by Date
_
'7
C�. 0 G S o
��t s o N 3...Y
TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH
HOLE NO.
HOLE NO.' 2 HOLE NO.
G.L.
611
O
C&Aw lG
09,GAo y lC
12 "aRa+�0.1
1$"
Lao "
OR A,
2411
3011
�P.
�
MRQY
361��Y��
42"
L, ®AM
UoP, m
48"
_
5411
60"
GQ EF y .
66"
��?�
G
GREY
721
A t,�.:
SA V-a
78"
43®
100s, PE C
tvi9a-N 'rE�C9E" t 1Ao L
INDICATE
LEVEL AT WHICH GROUND
WATER IS.-ENCOUNTERED . cir �OVC.ovNT 2
INDICATE
LEVEL TO WHICH WATER LEVEL RISES AFTER �BEING ENCOUNTERED ®. N iA
TESTS MADE
BY �lg Fp �j 5�-
s -� it0N► • r Date `T - 2.7 -75
t P- G&JA 92ow al E
DESIGN
Soil - Rate,
Used O°- 5' Min/l "Drop:
®S S. D. Usable Area Provided :597C cAX. cur' VDJG
XM-aveD
No. of Bedrooms�K
Septic
Tank Capacity X00 Gals. Type
Absorption Area Provide
.
Address
pRC1FEsS10.NAL ENL6[Nr -cM
THIS SPACE FOR USE BY HEALTH DEPARN
Soil Rate Approved Sq. Ft/
by Date
Putnam Lake - Town of -katteirs'&n.
Lots 7005 thru 7009 t6; pure hased by
Pe
J�l
Mt. :K nett AKMR 10 -
MC LAUGHUN
Eugene pROFM6tOj4AL ENGINEER
##AMWN ROAD, R. D. r1- 4. T TO 3' bed-
N, Yll, 10509 1 1
MeWSM. '4 room Maximumi
to be furnished bE
P1, x for any construct
J O�K,,
'�.%e-a-t-t-&chmen t
Des-ign data- sli'�'.
Percs x
Min. 30 perc test de-,"
7
C1 x
Con re'S'uits f!.
D. H.ole 1. og I
---77
Cor-oorat..6 Affid.,,wit for other 'tnn I n/a
Autboxi,iZation for erg ,, -I-. x
line = ' e- r
IiAte- f,romz, Vtatlr SuPP-1
Y
variance I-emue.-sted--such not ,,-,,d on pD.11XIS K 1 1 see note S on plar
charg.- is propcsed.,
R,�J Stjng Con*,C":)'W*,S Sho-vin /cQao-Ti new conl`,01).rs)
Slopes for drivall-way cuts, etc. shown
Water servi-11e lin.- location x
x
Footing-drain., etc. lccati6n
TOT siope,, botkt-,om. s3. of f:17T---
Pe,rcolatii:)n tests, Pnd rRe,-.p test piiu 1.0cation '— i ---
S+;--,t tic lhark si.ze, a,l')rl st(j- x i
ho-use
no drastic change
in sods o area
h s e
Ln6t e -
Lila-
,i by st
T—x Per zonin te E
Hlom,m- se-11-1back 9—�Ro
x h
per Code
't 'ere is -i
n"i'
J.Plan -shown.
prnf-'L le I riTiri-Pi In rip-0 "nri a
1008
reference made or
shc -n
»per
i x
3
Aap 8
SEPn "101"', D- Tj ------
x
X I
i
1001
t
e e S'C' J
X
75 t ._on.
ex ns,ion
to
.r.°
,,0.-.re7*ai L cL jv-
ii7
-1;C,
'none shown
J�j
f� C, e T 'Y' olt;-- r) t
p
co de
DO
to
IT , P
s t c r rr, d rinl
a
; per
code
t
ac e trees
i per
code
-;L0
tr
ou.n.rdat`, c�ri t 0 Dt 1 0 •
r, OFF;
x
jper
C
c
1
Putnam Lake - Town of Patterson
Lots 7005 thru 7009 to be purchased, by
M "C' 1j"
Fj_ LD
MR. 8, LUIS -EUGENE L. EDIVETT ......
Date:
insp by:._se f
5 17 ;dll,
1 JTE
ARTHUR P - MC LAUGHUN
PROFESSIONAL ENGINEER
MILLTOWN ROAD, R. D. 5
BREWSTER,, N. Y. 10509
B-14-73
—.1KEHIT-122
> , 'ou�
.t. j.YI-azt nd
1'rqpc--; ty 1-L
Can estima'L,I-e
Wi-'1.1 dr_iveway cut
t -trees be r-enjoved--note these
_r -1 f nt E.-DIS a-i-ea
Ard, deep
Addit-imal deep holes needed...
SDS a_nea, availla:ble cc)nz-j1, J.crii-_,g
drivemay cuft,house 1-1-aca t ion,
� C
dis"canc.-s., 4.
C.
Z
DJEEP 1111012", DhTA
DePIC./h% ,
Water elevat-ion:
Rock elevation',
Soils description:
FINU. SITE, INSPECTION
iris
. UV:
x
x
Comrtl,en,s
front (street) cor.
per no e
node askn
for a variance in
Ithis regard
per design data
c3
sheet- -
Hnou,n. locatod -0,1ere shm,,Tn oni appro-,,,ed plan
STNS lo,�Ated 7.17.ere
'Width. of [.Tench average
- j I T�, Le
-ile tren
.
Slope ol 1,nd 'F, - p
.....
on tllenc!-,
CVer 50 ft - from ,2*iamp9 watercourse-
Natuml s*()Jl -not strip�)ed or Sr0 a' mza
uhnecessari Y graded . . . . . . o
------
)T --e and
10 Ft. maintained frcm pr,_p-1_Jn
20 ft . fl'lom house . t . I. . . .
_-
Selaration. turench, house, well
etc. follows .7plan . . . . • . .
Number c bedrootivs,
Stones m8h., si umps, rubble., etc. Brea ter
'b
thsm,. 15 ft. from nearest tre.,�nch
1. 5 lit, , c, f periphera-11. soil ��ori.zontally frCm
-1 Set,
jwi,ct- ion bcjxe,,3 properLy
of P-orrj roads
Col-dd surf'ace L J. 4
-md surface el -ne r 3,
grot ;, rltn
area. . . . . . . . . . . .
JX)es !t drain.:.ge a_ppecar O.K.
IFTWAL GRPLID-ING OF SI-11"YE A,CCEPTABLIE
Owner or Furchasel, 01' `Building
Building Constructed by
'` l r
4ocatlon - Street /'
Building Type
unicipa ity
Section
Bloc
Lot
GUARANTY 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
:orstructed as shown on the approved plan or approved amendment thereto,
.a:d in accordance with the standards, rules and regulations of the Putnam
County Department of Health, and hereby guaranty to the owner, his succes-
:o-s, h -°irs or assigns, to place in good operating condition any part of
system constructed by me which fails to operate for a period of two
;:cars immediately following the date of initial use of the sewage disposal
z stem, or any repairs :Wade by me to such system, except where the failure
operate properly is caused by the willful or negligent act of the occu-
pant of the building utilizing the system.
The undersigned, furthe..r... agrees. to. accept as conclusive the. de, .
- aerinin ion of the Director of the, Division of Environmental Health 'Ser-
vices of the Putnam County Department of Health as to whether or not the
failure of the system to operate was caused by the willful or negligent
act of the occupant of the building utilizing the system.
Dated this _.1_ day of 19.�7j Signature_,��.
Title AJ,Af
corporation, give name
and address)
- - - - - - - - - - - - - - - --- - -
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM.
Division of Environmental Health Services, - Putnam County Department of Health
BREWSTER LABORATORIES
Box 224 - BREWSTER, N. Y.
WATER ANALYSIS REPORT
SAMPLE NO. 3098
SOURCE: C & lei Realty — new we l l
,V e l l No. 1
Putnam Lake
COLLECTED: NO V O 30, 1973
BY: Nil l Drill i ng, Inc,
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
This result indicates the source of the $ample was
of satisfactory sanitary quality when the sample was collected.
LJeco 11 1973
0 per 100 ml.
'ioy Bickwit P. E.
Director
r
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH
3/71 ' Division of Environmental Health Services
COUNTY OFFICE BUILDING • CARMEL, NEW YORK
This-report-is to be completed by-well-dritler and.- submitted to County- Health- Department together. with • laboratory- .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
NAME ADDRESS
OWNER r F� 1 RGAL�1'Y, INC. Route ;x`22, Brewster, blew YorR
LOCATION (No. 11 Street) (Town). (Lot Number)
OF WELL Java, Road, Pii.tna.m Lai-,e Patterson, DIY.
BUSINESS
PROPOSED } DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL
USE OF
WELL ❑ SUPPLY El INDUSTRIAL ❑ CONDITIONING ❑ OTHER if )
DRILLING COMPRESSED
EQUIPMENT F] ROTARY ❑ AIR PERCUSSION
PERCUSSION ❑ CABLE ❑ (Specify)
ify)
CASINO LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT DRIYE SHOE
DETAILS 18 F 17 x❑ THREADED ❑ WELDED f- TES ❑ NO 'A YES NO
YIELD HOURS G.P.M. YIELD (O.P.M.)
TEST ❑ BAILED ❑ PUMPED ❑ COMPRESSED AIR Il 6 6
WATER MEASURE FROM LAND SURFACE— STATIC(Speclfy j feet) DURING YIELD TEST reef)
Depth of Completed Well
LEVEL %n 24K in feet below land surface: 245
.1— ILENGTH OPEN TO AQUIFER (feel
SCREEN
DETAILS
DEPTH FROM LAND
FEET to FI
0
I')
IF GRAVEL Diameter of well including
PACKED: gravel pack (Inches):
FORMATION DESCRIPTION. ttwotpermanentolanp'marka well with distances, to at least
12
Clay
and.
boulders.
21y[
Hard.
-ray
g-romite .
If yield was tested at different depths during drilling, list below
FEET I GALLONS PER MINUTE 1
EIL 49
®�
0
1016AP
DATE WELL COMPLETED DATE OF REPORT IWELLORILLE . R (Signature) Pre i.det'!t
11/30/73 17/7/73
IJ T.T. T)T?TT.T Tn1r - T'',Tr .
` SHERLITA AMLER, MIJ; MSS FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J: BONDI
County Executive
DEPARTMENT OF HEALTH
September 19, 2005 1 Geneva Road, Brewster, New York 10509
James. and Karen Thompson
7 Quogue Road
Patterson, NY 12563
Re: Addition — Approval - Thompson
No Increase in Number of Bedrooms
7 Quogue Road
(T) Patterson, T.M. 25.54 -2 -31
Dear Mr. and Mrs. Thompson:
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 September 15, 2005. 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 your convenience.
Very truly yours,
41, 9J. fzee'-e
Gene D. Reed
Senior Environmental Engineering Aide
GDR:cw
cc: Building Inspector, (T) Patterson
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
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
SHERLITA AMLEW-*ID,-MS,- FAAP-- -
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
September 1, 2005
James & Karen Thompson
7 Quogue Road
Patterson, NY 12563
�_ ..._..._ -. - -- ..... _..ROBERT. J..BONDL...._ ._ _ ..... _..... _..
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re: Proposed Addition — Thompson
7 Quogue Road
(T) Patterson, T.M. 25.54 -2 -31
Dear Mr. and Mrs. Thompson:
Review of plans and other supporting documents submitted at this time relative to the above
mentioned project has been completed. The following comments are offered:
1. A sketch or copy of the survey showing the house, well and SSTS locations has not been
submitted.
-' 2 Is the noted room divider a�wall extending across the- room ? - --
3. The foundation is shown to be 45' 11" long. The proposed plan only shows 24'. A plan
is to be submitted showing the entire basement area 23' 10" X 45' 11" (outside
dimensions). Each room is to be dimensioned and labeled.
4. All plans are to be labeled as existing or proposed.
Upon receipt of a submission, revised to reflect the above comment, this application will be
considered further.
RM:cw
Sineerely,
Robert Morris P.E.
Senior Public Health Engineer
Environmental Health (845)278-61.30 Fax(845)278-7921
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
r
SIIERLITA AMLER, MD; MSS FAAP ------
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
September 1, 2005
James & Karen Thompson
7 Quogue Road,
Patterson, NY 12563
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re: Proposed Addition — Thompson
7 Quogue Road
(T) Patterson, T.M. 25.54 -2 -31
Dear Mr. and Mrs. Thompson:
ROBERT J: BONDI
County Executive
Review of plans and other supporting documents submitted at this time relative to the above
mentioned project has been completed. The following comments are offered:
�1. A sketch or copy of the survey showing the house, well and SSTS locations has not been
/ submitted.
` Is the noted room divider awall -extending across the room? tic.6 Q" 2_....._.....
J3. The foundation is shown to be 45' 11" long. The proposed plan only shows 24'. A plan
is to be submitted showing the entire basement area 23' 10" X 45' 11" (outside
�dimensions). Each room is to be dimensioned and labeled.
. All plans are to be labeled as existing or proposed.
Upon receipt of a submission, revised to reflect the above comment, this application will be
considered further.
17uRO
Si ly,
Robert Morris P.E.
Senior Public Health Engineer
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
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
i
H 'o. U 3 E c 0 R . H Fs- R (di stance - in 1. f. ) W�
3 - -
DEC2 71973
97,67
x 42 A 32 q7 -
GOUNI �H
B H --0 B 45.4 1 N
• OLVIkoNM EA
ENTAL ONL
a . _ .
8 a2 44.2'
66 -
8 8 - -
F 71 E 29 6 . 4.7,8- - j ARTHUR ' P. MC tAUGH LIN
8x5 17.2 PR�e ESE;. ;vim. rNi4 ec4z
t i MILL1GWN RGAC, R. U 5
BREM'STFt?, N,. T. 10504
"A3= BUIIT" Sanitary Disposal System
or: -Mrs. `Eugene L. K ivett Cal.
Putnam- e, own or a eraon TM 56 -
---'- BL 2 - p/o existing lot. # 8
SEEPA?3E P* TS 2 c� 2 -- .._.._. _. - -:.•:
STACKED --
EACH GROVP DRAWN A.P.Y. A•P•M• 12 -23 -73 sca►rcl "/12 .
S,.* 4'x. 3, aEEP E/1 cHE �c ted w� R.K " " 408 tip.
A
91sTRr4ur�oq ®cs� REVISED aw.ATS 1 1
�y. ( -1.7 ,c S.W.) it6VUS OATS SOP
SEPTIC TAM9 (Putnam Lake Lots 7005 thru 7008)
TIGN <4.v x O.8" xS bap) ;
"This is to certify that the - sewage
disposal system was construoted as
ff. indicated on this plan and that the
41 :. C..
(SAWITARY :DISPOSAL system Was inspected by me before it
SYST -EM eY BOTTGE) __ NE was: covered over. The system was
BACK` constructed in accordances with the
rul'se and regulations of the Putnam
County De artment of Health* -
c
eE Ar ur
P. Molalaghrl
T Now York State Li e�
4 including vari M e *\
WELD
} (6Y HILL) U'
_ •---- _' _ Q
0 O G V - - - - -
TIC
i v
��sls
----------
itri'VAM COUNTY DEPARTUNT OF HLALT4
HOUSE PLANS APPROVED F01%
BEDROOM COUNT ONLY;
BEDROOMS
Z-1 ", .4 4cve t — �Non0tdM
PA
r,),7• .2
A We OF
>n
%A
itri'VAM COUNTY DEPARTUNT OF HLALT4
HOUSE PLANS APPROVED F01%
BEDROOM COUNT ONLY;
BEDROOMS
Z-1 ", .4 4cve t — �Non0tdM
PA
r,),7• .2
46' Co4oN RA901 y4' = �� �64NAI►T/QAI
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SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
- ._...- _ -.._. LOR.ETTA.MOLINARI,.RN, MSN— - . - - -. -.. -
Associate Commissioner of Health .
ROBERT J. BONDI
County Executive
DEPARTMENT ' OF HEALTH L
1 Geneva Road, Brewster, New York 10509
( d
ADDITION APPLICATION RESIDENTIAL ONLY
STREET A A91 JOWN - TAX MAP#,-�s-:5'/ ,.Z 3
NAME t.� / _ PHONE PCHD#
MAIL G �
ADDRESS % ��,C� a. � Az?eMt:i, . A,)I /�S�.3
DESCsuir I .,.r AT
ADDITION
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS d
(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 - 6.130..., _.. :..
1. 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
Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085
Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648
� - a
rJ -
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 1050.9 ,.
PUTNAM COUNTY DEPT. OF HEALTH
1 GENEVA ROAD
BREWSTER, N.Y. 10509
To Whom It May Concern:
RE: L
It
Residence
TAX MAP#
TOWN,���
According to records maintained by the Town, the above noted dwelling:
IS_ . c .
IS NOT
-- - - - -
IN-COMPLIANCE WITH town code -arid`'the' total number of bedrooms j
is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY
ASSESSOR'S RECORD
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
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T_ -SESPAGCZ PITS 2 00 2
STACKED EACH GROUP
A 4•'-3' SEEP EA)
PsM.BuTtoo eoK
SEPTIC TANK
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P� C 2 71973
COUNTY
ENVIRONM"IML nLMLI
ARTHUR V MC LAU GRIM
M IM C)
1,ev. F.OAC�, V. D .5
"AS-BUIIN" Sarlitary Disposal System..
for Kir_. W-Mrs, Eugene L. Yiv"ett
Putnam Lake 19 Town of PatteF-son TM 56
BL---2.. ---..p/o - existing lot # 8'.
OR.& A, P e,�,_
.w
-12-23-73
iiCALIW II n I' ns ec ted w/ -R ,K
NO,
0 A 17.
r
R E V W FM. OATIR 4P
(Putnam Lake--Lots 7005 thru 7009)
"This is to certify that thp uewag+e
disposal system was constructed as
indicated on this plan and that the
system was inspected by me before it
was covered over. The syst;m was
constructed in accordances with the
rules. and regulations of the Putnam
County Department of Health*
Arthur, P, McLalughYi
New York State Li Rb
Including vari,,ne e,
-Z rM
NIF O' MAL.LFY. .
N�F w1LLIAMS ?041 - 7047 5
.'
(LOTS 7037 90 40) .. .(Lois 7oo.2 — 7004)
[ w9'tL PROPORTeZ oA LoT
CMIELL IN 'FRONT_ '
s'EPTIC IN REAP �„ rJ A/
G 5q -
- g 84 0- 04' 1 - 56 " W -
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9L '8. 40' OFKEi �\ \\
U . ..70 (p \ \ \
to
111 \ { ' ",0\ER FI_•: i� �
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b! i 21 i 4 >W t p t
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10 \' MIN .
PRORiSED�, .rWREE r5�
vt` �pc' 1AVQQ'' {�E�
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cn % M IN `•\ t L Are w.
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N 8+0- '04'' - 50 " r --p-
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•' O,� Tp a 1039 •'
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G�UOG UE ROAD �k OF 15
7
G B. ►4; PK` i9 PAVSM£NT
STREffT -
CALL
3 N ELSY. -
. OO
l �a �` ��s isE �$ � '?r (r �. '�- •t, ,� �v1 .r P,� ,,, �A ,,��'�.�.rr -Y J. ti' rr w' � r. a '1 sq j Z w:
t
1 + +.„ l� �s � ��) S�t� t ^" nt ��. "41ge Wh. o .< 1, 1 �.W c
��.`_ )� . ) x T, � 1 u a n�,1l 1 a 2+ y �.. , ) ,e• Pds � 3 z ti E , r'', °'� + ) + '.� . .
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A: System.l0 be COnsiructetl im accv dance.with t'he re es and regulim ans of,'
the Putnam County Departmenl of Hea.1th,.and letter of. dune 15,•1875
to Consulting,Efigjneers.
B. System shall not be Dzcktiifed. until.rn;nected by Design Eng!neer •and
•Health Department '
Three .('3} 61 oid, • .
C. System to copsist of a; 900 gal fom,septic' tank and -�. ra;.
OiS� lFX3{X E leachirt;, tax$$ :8a doe:
(Omega Concrete Prodncta, Ino: 'dcrg no
D': for typical: details, reference the , "Standards for Waste ,TrteaiRent Works`'
(Institutional and Commercial. Se.erage Facifities)" el the`Nitw Ybrft Stafe'' '
Departmenl.of Environmental Conservation (1970);
Figure 1.1 Typical Concrete Septic Tarry. k'
Figure Y 7SX)VCj 07o F0 i's fri,butian 80: Deteif;•
Figuee VI - Typical Seepage Pit
t E, For, geit eraI specifications-on sewage disposal eyeless., refer,Ence'itle••�.'\''
"Aufes and Regulations for the.Design and- Construetton o! "Sara Sewage,`•
Disposal Systems and Recommendations for their Proper fsaintenance" .. "
of the Putnam Cot•r(y Department of'Hea!th Dlvision,of EnOronmea ;fa I
Health Services.
F. Catalog,cuts, shop drawings, and .'ot. other man uf,act+rrer's.desctiptire
literature to be submitted foi approval befnre - in'staftatlon ot'system'.•
for: Precaet: dr
Septic :Tank, Distribotlair Box, pipet etc.
G. Pits to be located accurately to preclude occupying area reserved for >expansion,'.an
or encroaching on proposed well. Pit excavation must be'et-least'9f,above: 'ground '
water table. Use fill,, if required,, to attain this condition as ;�
H. Stadia elevations and•locations using an ess-msd datum/benchmirk. Ref ere ac e., filed o
Map # 8 of Putnam Lake for boundary layout of lots. 7: s
I. Proposed dwelling to be;_e;three.bedroom maximum occupancy." - .modular 'per i Realt
Estate. House plans to'be furnished befor any_construotion ' is permuted. t N,
J. In the submission of this plan, it is .requested' -that consideration '!be'-:
permitting the foli6wing' variances :from the County Health'Rules', a6 ame ded{t ar
1. Permit the use of the bottom area of the pits ,for. oomput'ing the usat is ages ,
available, as Permitted -in the state regulat, ions;:. t
r,. 2.. Permit the downsizing of the spacing between pits from`3 dlamsttir$•to 2 diamete,
(from outside of pits) between pits; L. %.E ",3..at�MET'ttts - -c tr rq cirN , - Hi4jrlDfa�;
3. Permit the expansion, area to encroach to within feet of gropo$ed:;aallne{
`he 100• -feet -apse3 •iedvfr ,'the cefle. b „E
-D W- - tilte; exPANia
Sn�
J4. FJaive the criteria:of a "minimum `of S,oOQ aquaxb feet ; . ,asilL,bq ;regui)Ced on;
each building lot exclusiveiy.;f r secrage;_diposal. purposes ". This;dimerisional area ie
#' available if all . available wand. within 75' ft of`Laell, and l0 ft off property lines ''
k is considered.
�• F.
All lines from the :distribution box to be 4"' tight•.lines' • Equalizer pipe ,(overflotr3
set• between pits 13,41-.0-td baja4e dosage Pits AtIYnd C. to =be dosed directly�frbtn y
distribution box."'tA?B, can to dosed -from either ;A or ,C ,WA".4t; overflows 'Seen
note D above for refereriae to installatio :d'ettiils.:y- •� - t '
., .
L. Provide swale(s} to•int' @rcept:surfac*e waters from sidelill drainage`jPram flcw6' ot�
to area reserved'. for leacHirig (•seepage); pits. Roof .and footing 8rains'�to• tie`dise�saI
ged away from sanitary disposal area.,' to, grade:
M. House is to be positioned, high enough such that -waste can flow;by!9tavity from th @••
lowest house receptacle's -to *the_ septic., tar-& and thence o -the distributioa.box.'
N. Location of the septic tink,caa tie''aitered to take advantage of •best plutabing.,; r
connection to d';vellingp :honvever 'the proper - offset distances are 'ao be.: respected
0, Well to be' drilled. In accordance with the-applicable regulations. of .the'Putnam
County Department of Health.: 'Test; pumping data,., log; etc.to'`be Turn shed.” r
P. Driveway access to.dwelling.isnot to encroach upon areIa,reseraed for,sewage.dIsp'oeaa
and expansion.. A
Q. Final finished grade in the sews a disposal area is "to be`•seven'f.so above -ledge
1. rock. Sewage area is to,. be thoroughly cleared.' and grubbed ,t,o' rem ), A." .hl tree: roots
and large boulders which interfere with the inBtallation of tYie' system'i- Ho:rever N
topsoil is to be unnecessarily stripped, nor.is the area to be.:unnecessarily-.regrade
R. Guarantee required by health department on' gstpp
k contractor and the :septic system installer..'.
-' Qt`R1'Hl1R i�$i.AUGHL:I.N
It is the responsibility;of th'e.general
contractor to secure the. necessary' paper- 'ENG1NE:ER .. fir ` SURVEYOR
work from the septic installer'- 'well drillf r,.-
etc. RR' #•5 MftLTOWN::RD
S. House location. to 'be in 'conformance •with' BREWSTER,, N Y 10501
torn zoning regulations' ",and not occupy' • SANITARY 'SYSTE09 DE`SiGN,.for '
b space intended for system or expansion. ' vt
T.. Final grading is t.o be completed before t
Lands to be'purchased by e
issuance of a construction compliance Eugene. L.;.& Cathieen'A, Kivett (H/�4)
t certificate. (refer to tote' howeder). Putnam Lake- Town of Patterson
U. Any alteration of.-looation,. size, depth, Putnam Comity NeYr Fork ". `
c etc of pits, would,
'.re
etc departmen
- approval prior to nstai'?ation. Subd ill aion L$ts 7005 ihru 7009 r.
r _ �r •�g �(y lax map 56 ook —Par •o ex:1,4 g�
5-V X9.S CAt,.E :t
�w r �\ ORnWN • n n •u _ DATE P-14
SEP25 1973. O
2'
MM
euTNeu Mlv ' r1f7r. OF HF1RW 1A t
INVIRONMENTAL HEALTH SMIM
Deed:,•Re ore
nee -'
vt p' DATES ,% 75 SHEET
EVISED.
a or,: f ormerly Caslino -{ L398 /CP 231) ; u y ,;
Para & deep hole$
CHECKED " DA7E 49A NC
1, •+ELL T'' 5 -' -ORC �' ? DITS-
R�LOCq♦