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HomeMy WebLinkAbout1097DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.54 -2 -31 BOX 11 k r�I�� � JK , F 1 R A I , ■ VAX r�I�� ` 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 ►� I I rt I_�1 ( 1 i 7 t � I I } L 0 �. F ;7OPA at '--7w J o �GI'tk Y v� f OPEN INCAS 16'A32! T _1] Z — — ..._ -as- 45'L tI# a 7 } I 1 1 OjuV r STEEL poST I S W SAME -FIEIGWrAS WALL �! °° t� 8 8 to I o ?AFTER ROLL oN I��fE4 r�-- aarrrwe� � Ass 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 r e N Qv - Item- N, H- Q- U - S E c -6-R .1f E R -(di6t'ance in-l.f.)l str' MUR9 0 ( 1 0 40 0 1 .4- 32-.7 60 41.3 68 45.4 .4 40.2 62.4 .2 44.2 66.5 - 26 4 45.6 .9 29.6 47.8 58.5 17.2._ T_ -SESPAGCZ PITS 2 00 2 STACKED EACH GROUP A 4•'-3' SEEP EA) PsM.BuTtoo eoK SEPTIC TANK 1p 'E <SAk tTARY I S POSA L S. r 'D SYST-E W(. 1B0_rTG*0. SE RDA ►E LL __166 CeY HILL) 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 - o 9L '8. 40' OFKEi �\ \\ U . ..70 (p \ \ \ to 111 \ { ' ",0\ER FI_•: i� � v � \ W' b! i 21 i 4 >W t p t r C. O 10 \' MIN . PRORiSED�, .rWREE r5� vt` �pc' 1AVQQ'' {�E� rA 1 ate', � Lb cn % M IN `•\ t L Are w. t. \ i N 8+0- '04'' - 50 " r --p- IoO. 0 •' O,� Tp a 1039 •' r. 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'', °'� + ) + '.� . . 1 i 1 f; 2 < w J J Q 0 z 3 0 t r -- 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♦