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Home My WebLink About2073DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.48 -2 -30 BOX 18 :' a IN l; r IN I� �1 1, 1 L -NJ ` o , „I , .J � -,, i I i . ` i' f - - i - #- `, 02073 lr f f BRUCE R Foi-By Public Hecirh Direvc, YAK "I MEiV A" OF HEAL"11 DlvWon of Etnir,vnmanta1 Health Serywes D 4 Genava Road BTewS.4r, Naw York; 10509 Tcl..(914) 278.6130 Fax (914) 275 - 7921 PROP US ADS MON A PPLICATIONN Q. ESIDMI _ L QIL lSl 1 STREET .2 &o 4 NAm E�� PHONE PCHD YAMP40 ADDRESS c DESC M1 710 I OF ADDIMON NL IIER OF E�ZST?�rG BEUAOOlLS PROPOSED 4 OF 13EDROOIIS (FROM CUM OF OCCUMN -CY OR CERTITICATIO'i FROM BUILOLNC IVSPECTOR) "Any addition titi-hich is co=der.d a bedivam requires formal approval of pla,r.9 (Construction Permit) prepzed by a P rcfeskorual Engineer or Registered Arcn tect in accordance with applicable sections of the Puamm Cmzity Sanitary Code. Please submit this form and the folowing to Putnam Counry He th Dcpt., 4 Ger n—a Rd., Brewsler, NY 10509, Phone 27rs- 130. 1 Certified-check or mor.:ey order for 5100.00 2. skmhes of existing floor plan (drzwato scale,. all Dying area including basement') No.- professional skeTCh:s arc accept =ble 3. Two sets of proposed moor plan (drawn to scale, with name, street, a.:d tall r. ap T) * lion -pro p_ssionai sketches are acceptable 4. Copy of survey slowing well and septic location, to the best of your k a ledge. Inci'.tde date of ins?allatioa if Label all NveLs and septic systems within 200 feet of the p :open L'r+e. Contact this office wi-h any questions. 5. Copy of Cen. of Occupancy frcm Town or Certification from Building Dept. "pith legal bedroom court of dwellinng. F v' OF I � �i F, 3 Fob 93 DEPARTMENT OF HEALTH 0,10sion . Of Environmental Health Services 4 Geneva' Road, Brewster, New York 10509 (914) 278 -6130 Putt.. County Dept. of Health 4 Geneva Rvad B:ewstrr, NY 105C9 BRUCE R._FOIE,!. R c_ ACZtIM9 Puhile health Dsre:t. .jt Re: esidence Tax Map 3�- �%' Town Gen�i� men: ?ccordin 'o records maintained by the Town, the above noted dwell," ing is IS NOT in cornplian -e v,;th ToNti . code and tre total number of bedrooms on recd; d i5 This information has been obtailed from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: (-) HER 16%�6 Z7 Building 'inspector LORETTA MOLINARIr .._.. _.,_. . 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 Michael Rudkin 15 Rhincliff Rd. Brewster, NY 10509 Dear Mr. Rudkin: August 25, 2004 Re: Addition- Rudkin, 15 Rhincliff Rd. No Increases in Number of Bedrooms (T) Patterson, TM #36.48 -2 -30 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 August 25, 2004. 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. 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, 7 William Hedges WH: hn Senior Public Health Sanitarian cc:BI (T) Patterson =meal- Property Consultants Inspection and Testing Services +� R 498 $orsepound Road Carmel, New York 10512 Sanitary System Evaluation Client Information: Michael and Christine Rudkin 54 Cameron Road Brewster, New York 10509 TEL: 279 -0073 Inspection Information: 15 Rinecliff Road Patterson, New York Testing Date: 07 -0802 Testing Time: 10 AM Point of dye placement: Toilet Date of visual confirmation: 07 -09 -02 Time of confirmation: 7: AM Test performed by: JOSEPH CMAR - Witnessed by: F.C. ( ) Positive results ( dye observed leaching) Negative results ( no traces of dye observed ) operating satisfactory (approximate location of system) Note: The septic dye test is an indication that The disposal area was not leading or Sat zated during the visual inspection. This test is not a guarantee for the Entire system... ,i (71D ev MOUSE PLANS BEDROOM COU Signature & T If P,e 0 clar�acsy 91 X 6 54&d /G FOR .:r L� w f W F.2 12x Y s us /6 No. , Y /o FAR -Tw5is /6 "o.0 77G ��R� 2 e Ax Jo Su diems �ao� �1 0� 0 h3� ��clo 0 f„ Z3 •r /ZGcv 3d, 6� ,1,cto Sozs�- —� x �y ` , _ J�� , �s EIO a c 0 W0 7-0 � N tia) co N rn _E z w N003' rr 1 t+ r v I /a — 7 c� r /r WWI Mg Fpc��4 `fir s 6 4le h 3d Too-F inso lA 'ovt 7-ce. �cv4r 61,,e �rd9� 30 y� v .� 1 y � 1;' 1 I �l . 1. - -'.- -. . I 7717 ddb cc L I -sei t-I to � ail WO 7717 ddb cc L I -sei t-I to � i i i ,1. F-T- E . ............. a��AM C PU NAM COUNTY HEALTH DEPARTMENT � �� DIVISION OF HEALTH SERVICES / PROPOSAL FOR SEWAGE DISPOM SYSTEM REPAIR . OWNER'S NAME �i�-P _E i .. PH(IE SITE. LOCATION " , TM# . MAILING ADDRESS ,i • . PERSON Il3RVI ol ,q Nave & Relationship"U.er awner,tenant, etc.') DATE 'L TYPE FACILITY PROPOSED INSTALLER PHONE Z4_r 3 F Zt_ 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 reg=,arpitect. Proposal approved.C-- Proposal Disapproved Inspector's Signature &Title - K _. 'Proposal approved with hee� following conditions: 1.- _ Pr ::,_.;.ement of': any' ' t,.: if..a ., cable......:._ 2. Sul i ion of as built r r sketch in d � pa plicate showing.: a. Owner's name.' b. Site Street Name, Town and Tax Map number. 'c. Location of installed canponents tied to two fixed points (e.q.,house corners). d. System description (e.g., 1250 gal. concrete septic tank,.three precast 61 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, SI TITLE Z Pus: V&te mm); . Yalcw (An HI); Pink ( WUaint) _4 .6.1 ' . .. .. C �'~f l! f+, .sX 'f.'+ !l�l t��[,�e. .: r ?� r . � k Y •ti w -r%k.. .y'i1.�"� 4;L.:� AU G ^ 4 1992 RcnMM 00(wr Fps MOW 225,6114 PROPOSAL FOR SEWPIGE DMSPOSAL WE �'.. •' 1 l;r' 1y1 r 'r• ' �. LM1 =-MWZ �o�sal ( include sketch locating all adjacent wells) : ME: Repair must be in same location and of same ,type as original smkge disposal Mateo* )ifferent location may require submittal of proposal from licensed professional engineer or -eg' teredard!itect. SS 57 . /J Proposal approved '7 � Proposal. Disapproved L •-� / ._.ter• Inspector's Signature & Title...--- Vaite roposal approved with the following conditions: .�.r.M- 1. Procurement of any Tb;5 n penn4.t, if applicable.- 2. Sutmisgion of as built repair sketch in duplidate showing: a. owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to W6 fixed points 16.96, A sae comers). d. System description (e.g., 1250 gal. concrets..septic tank, three pest 69. disci. x 6' deg 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 conditioas.' I, as owner, or reported agent of owneri agree to the above conditions. •� SI T1= DATN ' i 4 PIES: Pink Lkglia wt) _� e OWNER'S NAME SITE LOCATION MAILING ADDRESS PERSON !IItVIEWED DATE PROPOSED INSTALLER PUTNAM OOUNTY HEALTH DEPART DIVISION OF ENVIR0NQWAErfUWM SERVICES 225 - 031.0 PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR PM Complaint cant, etc.) TYPE FACILITY zdC . PHONE 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 reg tered.arcfiitect. A . _ _ ./ — ___ ♦ ^ w n - A i 11,/ v F X C Proposal approved per— Proposal Disapproved Inspector.'s Signature & Title ate Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Subni.sgion 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 canponents 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 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. SIGMMM TITLE 1 5: White MD); YeUcw (fin HI); Pink (Ap UcBnt) AUG. 4 1992 PUTNM OWNER'S NAM ~ 4YM k&p Ll I. t M' OWN '.I iq SITE IMTICN 2 z "ft MMLIM ADDRESS 11 Tp, zlA PERSON MIEWED Be, at J onship, (i DATE 7 FACUM PROPOSED INSTAUM - P90W..': &Lf - 3 9 Zte Proposal (include sketch locating all adjacent wells): Nam Repair must be in same location and of same type as original set tge, disposal system. Different location may require, submittal of proposal from. licensed profesaional engtn r.OF reg tered,architect. 777T Proposal approved with the following conditions: 1. Procurement of any Toup pexmit, if appl,'icablei"., t" repair sketch in i&IEe showing: 2. Submisqion of as built d a. owner I s name. ie b. Site Street Namer Town and Tax Map number.:. c. location of installed oanponents tied to tm6 fixdd points (s. ers) d. system description (e.g"f 1250 gal. concrete .,septic tank, three. t.61 di*L x. 61 dot drywlls 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 owned agree to the abo06 conditions. • pirkI, 4 5.k Ri ff li P V W Proposal approved Proposal. Disapproved 71 Inspector s- Signature & Title ...... Proposal approved with the following conditions: 1. Procurement of any Toup pexmit, if appl,'icablei"., t" repair sketch in i&IEe showing: 2. Submisqion of as built d a. owner I s name. ie b. Site Street Namer Town and Tax Map number.:. c. location of installed oanponents tied to tm6 fixdd points (s. ers) d. system description (e.g"f 1250 gal. concrete .,septic tank, three. t.61 di*L x. 61 dot drywlls 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 owned agree to the abo06 conditions. • pirkI, 4 5.k OWNERI S . NAME SITE IACATION W, PUI'NAM C)OfJIM HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES ----225"010 PROPOSAL FOR SFPGE DISPOSAL SYSTEM REPAIR PCHD Complaint f ant, etc.) . TYPE FACILITY PHONE L,)-�- _3 Proposal (include sketch locating all adjacent wells): NOTE:. .Repair must be in same location and of same type as original sewage disposal sys". Different.location.may require.sulmittal of proposal from licensed professional engineer or tered, architect. ,. l/1'�1D�o.c.r ®.✓� kart �U2 �. a...4. .�,��s SS n S Proposal approved Proposal Disapproved with the following conditions: afite 1. Procurement of any Town permit, if applicable. 2. Submisgion of as built repair sketch in duplicate showing: a. Goner'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' 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. as owner, or reported agent of.owner agree to the above conditions. SIGNATU ZA TITLE DATE • • M .- M. - . Mkin W .• .. �. } . 4 09/19/1999 11:18 9142255164 LEVINE PAGE 02 . QU F-F- NS1 1 utter � d�.aani..a u's wa a ..�� -. � - .._•a- _irat'F: _ -. -.: a — ..s. :._ aan.�r a ws.ur -. �*'s. ._w. a�•�?�r+lm.►aaa :- c�OC- .ean�I.+. a.t n_T -.Fv�� -r .rs1¢...gK.ry..'f »gip y�elw i . M 010G 4�I5 9°ite 19'�'r 9N9 '9Yi . I� 8 .mew: 6.P-TS ACX f 8 121oao eF't j 0 O Q I 91b 91T 9iCo I 915 ,ICJ, ■ FR4N!!. L'IN� 1 9W i I.P. a E •' FtHINELLIFF / ' 5URVEY. OF PROPUTTY RSIP; 10 FIRY'< AMf�PtIGMJ 'PRFYARED 4em l Y 'BIA P49W YORK. L-T05EPH LaM 13113 Pr7 9- y�iCo -9'1g Pal TIIC_ N �P_la ,=pI_•IquA,�NM ,yE� C�A l•,� _ AV . 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