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34. -5 -68
BOX 15
01598
t
BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI. R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
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
March 13, 2000
Harry Nichols
311 Clock Tower Commons
Brewster NY 10509
Re: Addition- Gideon Noach - Farm to Market Rd.
No Increases in Number of Bedrooms
(T) Southeast Tax # 71 -1 -11
Dear Mr. Nichols:
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 form this Department dated March 132000 The addition is approved with the
following conditions:
1. The total number of bedrooms must remain at Five 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 SSTS must be expanded as shown on plans approved by this Department on
3/13/00.
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Southeast.
If you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
WH:kg Senior Public Health Sanitarian
cc:BI
IFUTNAM COUNTY DEPARTMENT OF HEALTH
Dff VffSffON OF IENVff E O NM ENTAIL HEALTH SIERWCIES
APPLICATION TO CONSTRUCT A WATER WELL
please print or type "' PCHD Permit # a of —OCY
Well Location:
Street Address: Town/Village Tax Grid # 34.-5-68
345 Farm to Market Rd Patterson Map Block Lot(s)
Wen Owner:
Name:
Address:
1345
Gideon Noach
Farm to Market Rd Brewster NY 10509
Use of Well:
X Residential Public Supply Air /Cond/Heat Pump Irrigation
I- primary
Business Farm Test/Monitoring Other (specify)
2- secondairy
Industrial Institutional Standby
Amount of Use
Yield Sought 5 -10 gpm # People Served Est. of Daily Usage gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) X Deepen Existing Well
Detailed Reason
ExistiMwelll-not-adequate
for Drilling
Well Type
_Drilled Driven - Gravel Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ...................................... ............................... Yes No
Name of subdivision Lot No.
Water Well Contractor: Pe Fa Beal & sons, Inc. Address: 4 R,f„e, Aup_� Rmwdpx., NY 1OM9
Is Public Water Supply available to site? .................................. ............................... Yes No
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provide separ a heet/plan.
-Date: 10/3/00 Applicant Signature: C .
b21c15hn To Beal, Jr.
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVIEIlD.IFOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. AAY revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water ell Mller ce 'fied by Putnam
County.
Date of Issue Permit Issum . ial:
Date of Expiration &s Title: —c
Permit is Non- Tranaffe ra Ile
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
L1 V lolkjir kir L11N V 1KUIN iv l.ir 1 AL 11LA.L 1 n O n V It' -J Z)
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
O«•ner i tiUti ✓V (% 0- C' Address - y luai eMd Poi e,-Se x
Located at (Street) l�cwL., %'c, /��, -�Lr %C��I� Tax Map 3-4, Block Lot C,- 4,
(indicate nearest cross street)
Municipality P12 fa Drainage Basin Cry
SOIL PERCOLATION TEST DATA
Date of Pre- soakinor l Z- 21= 77 Date of Percolation Test l � -. 2.�- Q
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates arc obt-1111.0 -•
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 mir/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
Form DD -91
De th to Water
Water
krom Ground
Level
Percolation
Time
Ela se Time
Surface (Inches)
Start Stop
Drop n
Inches
Rate
Nlia/Inch
Hole No.
Run No.
Start - Stop
(1kin.)
1
q: 3o
2-0 " z3
2
1S-
2' 2-3 �
'5
3
R';S1 - /o: 14
1S-
2v° 2-3
5'
4
5
:
1
9 � T
2-4 -
.3
2
9:5�- 10:1s
74
�4 .z3�
'3
�7
3
1o.:1.C�_-.LO.:3�
. 2-O
mod -2-3„
3,.
- ...7_.
4
5
1
2
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates arc obt-1111.0 -•
percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 mir/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
Form DD -91
DEPTH
G.L.
,0.5'
1.0'
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
9.5'
10.0'
DESCRIPTION OF SOILS ENCOUNTERED.IN TEST HOLES
HOLE NO. I HOLE NO.
rS
HOLE NO.
C)
CD
rn
y;>c
MM
tz-<
Indicate level at which grbundwater is encountered /-a ML
Indicate level at which mottling is observed �lot4F
Indicate level to which water level rises after being encountered Ajo4I=-
Deep hole observations made by: /U1 t k�. L 0 Date 4:1-0 -5
Design Professional Name:
Address:
Slgnatur2
Design Professional's Seal
;;Y!'
rocs`V, 4�
` � M\
- li�p
L;..
MENNEN
DEPARTMENT OF HEALTH
Division ,Of Environmental Health Services
4 Geneva'1 Road, Brewster, New York 10509
(914) 276-6130
Putrarr. County Dept. of Healt1h,
4 Getiev-a RQad
Brewster, NY 10509
Re:
Residences
Tax Map,
Town
Gentlemen-
BRUCE R.-FOLEY, R.s
Aeting Puhlle,Mealth DI.ect.1t
?according to records maii.itainod by the Town, the above noted dwelling
IS
IS NOT-
in compliant vJth Tom —n codv% and the total number of bedrooms on record
i5
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:.
ASSESSORS RECORD:
9f HER
a-4 ' ( --1-4nca-
Idin,g, Inspector ce,
�,�.r-�,�-:9., _II i•� ,. ?'1 . ^4 h11 ..! E1��1L;;i l!. �Ly
4
DEPAR SENT OF HEALTH
Division of Envimpw atal health Services
4 Genavi Road
BraWst ®r, New York 10509
W. (914) 278 - 6130 Fax (914) 278 - 7921
- -!--BRUCE R FOLEY
Public Health Director
STRERT zt '4,4,6� TOWN iW,,,JX MAP #
NIPHOIE ' ' _ � � PCHD #
NADDRESS
DESCRIPTION OF ADDiT10.14
NUNI MER OF EXISTING BEDROOMS PROPOSEID # OF BEDR00.1 S
(FROM CERT. OF OCCUPANCY OR S
CERTIFICATION FROM BUILD NG INSPECTOR)
*Any addition which is considered a bedroom requires formal approval of plans (Construction
Permit) prepared by a Prof.ssiorial Engineer or Registered Architect in accordance with
applicable sections of the Pumarn Co,=ty Sanitary Code.
Please sub_ mit this fern and tha fonowing to Putnam County Health. Dept., 4 Geneva Rd.,
Brewster, L.Y30509,Fhone 279 -6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan ( drawn to scale, all living area Including basement)
* Eton- professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tai: map #)
* Non - professional sketolles are acceptable
4. Copy of sun�ey s wing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property live.
Contact this office with any questions.
5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OEL : E II E
Comments
Feb 9$
2z
. . . ....
CERTIFICATE OF OCCUPANCY AkD COMPUANCE
4"
(alafim of llhfferoon lJork
! f
ir N2 2045 i.:
1995
Mir,
�•• .i �" ~.tom.
DATE ISSUEV--juue
THIS IS TO CERTIFY TH
ON THE PROPE13TY 0E------JLame
LOCATED ON Farm t' Ha' k't Ro�3d
0 r e
-A-
HAS 13EEN SUBSTANTIALLY CONSTRUCTED:T0 THE REQUIREMENTS OF
THE BUILDING CODE, ZONING ORDINANCE AN6 LOCAL LAWS • THE TOWN
OF PATTERSON, NEW YORK AND MAY BE 6CCUPIED AND USED AS—
Single Family Wel
lins!
ki
Building Permit Dated rmit No. ....7J.0... Application No . ......... &&Wfti
5 pe
SECTION ....... L ............... BLOCK ......... I .............. LOT ......... 11 ... Ony.TK - 34--5-68)
-00
FEE $ 15
IV BUILDING INSPECTOR
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