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PUINAM COUNTY HEALTH DEPARTMENT!
DIVISION OF HEALTH. SFRV_ICES
PROPOSAL FOR SEPOM DISPOSAL SYSTEM REPAIR
OWNER' S NAME; � / F cf J mn17A-- PHONE
SITE L=TION . &Z � Er ��/� dCc� �� 7M#
MAILING ADDRESS
PERSON INTERVIEKED PCHD Camplaint.#
Name & Relationship (i.e, owner,tenant, etc.)
DATE TYPE FACILITY
PROPOSED INSTALLER PHONE �!d, - W% 7
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.
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.�I -r1. 41 �,/�� t L.
/7�." .0 "V!i' /; 141!1 4'1, T
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Proposal approved Proposal Disapproved
Inspector's Signature & Title Bfite
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 corners).
d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep
drywalls surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or reported agent of owner agree to the above conditions.
iG�TURE o TITLE DATE 9 S'-
T% I R- : White (PC D): Yellow Ckmn HE); Pink (Appl icmZ)
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DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
BRUCE R. FOLEY, R.S.
Acting Public Health Director
CERTIFIED—RR" RECEIPT REQUESTED
April 27, 1995
Mable & Ed Smith PLEASE REFER CORRESPONDENCE TO:
__ 29 Kendall Drive . -- - -- _ .. NAME: Mel Kek -- -- - ..... '7- . =.� —. -: _-: - :-
- -- - -- -
Patterson, NY 12563 TITLE'.: Engineering Aide
PHONE: (914).278 -6130 Ext. 165
OFFICIAL NOTICE OF NON `COMPLIANCE -
YOU ARE, HEREBY NOTIFIED that non - compliance with Article III Section 4 of the Putnam County
Sanitary;Code: consisting of a discharged of sewage onto the surface of the ground was found at
_ our _property;�r_operty._.on_37__- Interlaken. Road, _Patterson, NY by a representative of this
y. -
Department on,April 24, 1995.
Please be advjsed that washing machine discharge is considered the same as sewage. It is
belfeved that: you are responsible for correction of this condition. If you are not:responsibl
you are requested to notify 'immediately,,.,. the inspector above indicated.
Y
Please be advised that appropriate steps must
be immediately in order that the sewage
over- fl ow��'cea a by arranging for the septic ..tank to be pumped out andcmaintainetl pumped until t
pror yyrxxe,pai t-s dare made
pe to the system { F ; , j,
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t3t,y Iii' a r tt v f• 4 t a°
w iyF:�Approvalti:ofz proposed repaire .must be obtained, from this Department priaor �toPany alteration 'or
f rebuild //iny��gofl�NexI st i ng ' d i sposal systems . qn appl cat i on is enclosed
i 4 tl Y�y i P, 1K t 4x 'k Y. Mt xL {
.`;r.,
Fa�luretomalnta�n the septic tank pumped,and further,".to correct this condition by
May.,
~ 41995 t!vi l l !make ;you l i abi a for adds tonal :penala i es provided by tl aw,'i ncl ud� ng prosecut
on a charge of comma t i ng a vi of at i on pum shabl a by a 'fine or i mprl 5onment , . or ,both ouch fine
a w �x . try
imprisonment; 'as prescribed by law, in addition to such other action as maybe prescribed. . A
��`r�re�'nspec`t�ontanll ibe made
`t;��*ht�,�s,sn�cerelyhoped that the above mentioned further action will. not be necessary and that }
d't n
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BF /MK /lp, - B;
Enc.` Perm it Application
cc: "'BI (T)
noncompliance
�f this con io
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he'Public Health Director t ti
Y <yours; t
gel `KeW ,
Engineering Aide
gel `KeW ,
Engineering Aide
PUTNAM COUNTY DEPARTMENT OF HEALTH NOS 173 -95 -19
COMPLAINT OR.SERVICE REQUEST RECORD
.. PATTERSON 4/19%95 _ _..
1IJ DATE REFERRED TO
TAKEN BY PM TELEPHONE CALL X IN PERSON LETTER
CONFIDENTIAL
REQUEST FROM James Allard 278'7851
TELEPHONE
ADDRESS 31 Interlaken Road, Patterson (Put. Lk)
ENVIRONMENTAL HEALTH: Home'Sewage Rodents Refuse Public Water Food Service
Migrant Camp Other
COMPLAINT OR REQUEST Rental, 37 Interlaken Road, septic fields flooded, smells
and is running into road.
ACTION TAKEN BY Ma
L C,
FINDINGS
r
DATE
M
FOLLOW.UP -TASPECTION 4S.,
DATE FINDINGS �� ��' 119�
DATE FINDINGS
PROBLEM A TED
DATE PERSON NOTIFIED
ESTIMATED TOTAL MAN HOURS SPENT
77
10
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LORETTA MOLINARI
Public Health Director
ROBERT J. BONDI
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
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
February 13, 2004
Mr. John Winward
37 Interlaken Road
Patterson, N.Y. 12563
Re: Addition — Winward, Interlaken Road
No Increases in Number of Bedrooms
(T) Patterson, TM# 25.56 -1 -22
Dear Mr. Winward:
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 February 13, 2004. The addition is approved with the following conditions.
- - - 1 The,.total number- of bedrooms must- remain at-2-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 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.
ML: cf
cc: BI (T) - Patterson
Very truly yours,
/ 1M1 GX� ✓Cc
Michael Luke
Public Health Sanitarian
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DEPAR i MAN i OF I -MALTH
Dlvlrion of Environmental Health Services
4 Genava Road
Brewster, Naw York; JOS09
Tel. (9 :4) 278.6130 . Fax (914) 278-7921
�.. .� 1. to-3,211 •__
BRUCE R. FOLeY
Publi Hzcith_ Direvcr
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STREET TOWIX «7%,25,-,TX IMAP #
N: �IE�Iv�,�` c�1�.v 444 Q FHO�'EL 1 - %rs` � PCHD r A,3
M4.fl.M ADDRESS
DESC'.RDTiON OF ADDITION Oio-a D-CL9-
NI UMBER OF EMSTITNVG BEDROO-�yLS Z PROPOSED # OF BEDROWAS
(FROM CERT. OF OCCJ°ANCY OR
CERTIFICATION, FROM BUILOLNC INSPECTOR)
Any addition -,,,'hich is considered a bedrodm iequires formal approval of pIars (Con,-crLtction
Permit) prepared by a rrcf_ssional Engineer or Registered Architect in accordance with
aanlicab ',e sections of tht Puraam Cou,-1ty Sanitary Code.
Please subnit this fct=: z, d the fo'lowing to P, &am County Health Dcpt., 4 Geneva Rd.,
Brcwster, NY 10509, Phone 27S-144130. :
1. Certified check or money- order for 5100.00
2. S�S�ches of existing floor p;ari (drawn to scale,. all living area Including basement)
'" Von= professional sketch -s arc accep&ble
3. Two sets of proposed moor plan (drawn to scale, ,y6th name, street, and tw. rnap T)
. *No a—pro cssionai sketches are acceptable ,
4. Copy of sarvey showin; well and septic location, to the best of your Lrowledge. Include date
of installation if kno-Nn: Label all wets and septic systems wit'!i n 200 feet of the p:operty lane.
Contact this office wi-h any questions.
5. Copy of Cent. of Occupancy frcm Town or Certification from Building Dept. ,pith legal
bedroom court of dwelling.
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DEPARTMENT OF HEALTH
Division . Of Environmental Health Services
Gene,4 Road, Brewster, New York 10509
(914) 278 -6130 -
Pu*nim, County Dept. of H;.ait"
4 Geneva Read
Brewster, NY 105C9
C;entit.men:
BRUCE R._FOCEY. F c
AetIA9 PUhlle Mealth 0j.-t:tar
Re: q-P ke Q ej C)
Residences
Tax Map 2s :sip -I-_s `(ZZ)
Town f�Aerscn
According to re:,ords mai;itaired by the To�wi, the above noted d� elling
is -
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in corn-pi ian:,—� \, lth To%%, code and the total number cF bedrooms on record
is 2.
This information .has been obtained from:
CERTIFICATE" Or OCCUPANCY:
ASSESSORS RECORD.
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