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Home My WebLink About1363DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.79 -1 -21 BOX 13 %. . I Y vol Jr L or 16 , ' Ir W. I J2 01363 _ BRUCE. -R. .FOLEy -- - Public Health Director - :LOREJ'TA ?..OTINAMI R.N., a `.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 November 16, 1999 Hilda Tineo 2 Taylor Road Patterson, NY 12563 Re: Addition - Tineo, Taylor Road No Increase in Number of Bedrooms (T) Patterson TM 925.79 -1 -21 Dear Ms. Tinco: 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 latest revision date of November 12, 1999 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: L. .. ,Th,e total .n»mber_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. 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. If you have any questions, please contact me at your convenience. Very truly yours, Michael Luke ML-jp Public Health Technician cc: BI (T) Patterson x` t OWNER'S NAME f % ,4w�- PHONE " SITE LOCATION ';�-R To �• .. •ice• �,:�,• • • � �:, �; MAILING ADDRESS PaZy- PERSON INTERVIEWED P(HD Canpl.aint # Name & Relationship (i.e, owner,tenant, etc.) DATE -' 7 - % % TYPE FACILITY PROPOSED INSTAILM PHONE 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. C)AVEI1 • - _ .. _. e aLt-? / 9 f If u roposal 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 oorners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells 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. SIGNATURE TITLE QO nE: *dtie (PQBD); M 1 CW 030 ffi) a Pink (P, OICI nt) Pr-RP Q7 ig 80 'D ol le E MWO =F101 -25.7f. 1.3-47 1 1101.61 LOAD 91 VA- v N" ;'T .4 ZV. &I.TT ro IM 14 4138 190, jr, P c" 2 A CA /03 -4'-�y .1 F-9 PUTNA.M COUNTY DEPARTI'IENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WTIAL INDIVIDUAL ADDITION / REPAIR FO' RM SECTION A. GENERAL INFORMATION Name of Project_ 7 ZAJC O u Year of Construction_ 4 o 'x ' � Size of Parcel � � SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1• Offilly Mollinc, 0steep slope Gentle slope 111at 2. ClEvidence of wetlands []Low areas subject to flooding OBodies of water Drainage ditches . ❑Rock outcrops P 3. Property_lines evident? 4. Water courses exist on, or adjacent to parcel? YES NO 5. Existing individual wells within 200ft of the existing SSTS? ❑ SECTION C, . EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM (SSTS) 1. Physical character of existing SSTS area. A. OLevel ®Gentle slope Osteep e slo P B. ❑Well drained Moderately well drained Some' omewhat oorl drained OPoorly P Y drained C. Area available for SSTS. (Primary. & Reserve) CIE- xtremely limited omewhat limited dequate ft x ft D. INSPECTION Date 9, Inspector p6y-- XNo evidence of failure ClEvidence of failure DEvidence of seasonal failure .IY I r� — A- (dicateNorth) - --------------------------------------------------- (1) Indicate location of SSTS A. Size and type of septic tank gallons BMetal Oconcrete Plastic .B. Type of absorption area' 1. Fields ft. 2. Pits 3. Gables ft. Y. X-VF- -c, T 970ft� (2)•Indicate setbacks, front street, backyard, and side yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EXISTING WATER SUPPLY CIPWS [1hared well ® well Drilled 0Dug 06asing above ground COMMENTS: JEwgL.E �qC� v�3 �� n�3E T07--c 7^ ,� pa PEA V GeIC ,v z/ PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project �' vim- t` (T)M -r�4 TMrr Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. O/Hilly ❑Rolling Clt-e-ep Slope UGentle SloP e ❑Fat 2. ❑Evidence of wetland []Low area subject to flooding ❑Bodies of water ❑Drainage ditches ❑Rock outcrop l _ YES NS2 3. Property lines evident? ❑ ❑ 4. Water courses exist on, or adjacent to parcel: ❑ ❑ 5. Existing individual wells within 200ft of the existing SSTS? ❑ ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level UGentle Slope ❑Steep slope B. ❑Well drained LJModerately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS. (Primary & Reserve) ❑Extremely limited ❑Somewhat limited ❑Adequate _ft x ft D. INSPECTION Date I I 7 Inspector EN-to evidence of failure []Evidence of failure 13EN-idehoe of seasonal failure ------------------------ ------------- --- - - - - -- - - - -- - - - - =- - = - - -- (Indicate North) .s-, h"k HOUSE �\ (1) Indicate location of SSTS A. Size and type of septic tank gallons Metal 13 Concrete nPlastic B. Type of absorption area 1. Fields ft. 2. Pits 3. Gallies ft. (2) Indicate setbacks, front street, backyard, and side yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EXISTING WATER SUPPLY 13PWS M Shared well L'KIndividual well Ovrilled ODucy casing above ground CONI BENTS REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 PROPOSED ADDITION APPLICATION SIDENTIAL ONLY) BRUCE . R.. FOLEY -. - Public Health Director STREETk -tP I L 0 TOWN PA 1 H TX MAP #. ---fi "1 _Z1 NAME �—�'i N� •Co 'P oN>✓9 -C �71-"O 1D # 1_._i DESCRIPTION OF ADDITION 2 C,t3r►�' �'�`` Z �x^GtrnS ooh -��. NUMBER OF EXISTING BEDROOMS .3 PROPOSED # OF BEDROOMS (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., 4 Geneva Rd., Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00 — 2. Sketches of existing floor plan (drawn to scale, all living area including basement) * Non - professional sketches are acceptable 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 location, 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 Cert. of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb 98 DEPARTMENT OF HEALTH Division ' Of Environmental Health Services 4 Geneva' Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: i1H9F0 Residence Tax Map BRUCE R. FOLEY, R.S. Acting Public .Health Director Gentlemen: According to records maintained by the Town, the above noted dwelling IS. IS NOT in compliance with Town code and the total number of bedrooms on record is Ij This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER wilding Ins ctor .� ;i �;' r - 1r �o a] ill OAK 0 > > r 7,4 4w a s N �. 1r �o a] ill OAK i E 4w a i E